Bladder fever: rare complication of the "safe period" method of contraception

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Splenic lymphangioma: luminal surface ultrastructure; a scanning electron microscopic study

A splenic lymphangioma removed from the abdominal cavity during an exploratory laparotomy in a 16 year old girl was studied by light microscopy and scanning electron microscopy (SEM). The tumor was composed of numerous vascular channels some of which were filled with clotted lymph. SEM revealed these channels to be lined with an uniform endothelial lining composed of two morphologic cell types: one with a smooth surface; the other with numerous microvilli. The literature on the SEM of lymphatic vessels and lymphangiomas is reviewed and compared to the splenic lymphangioma.

Distinction between normal and leukemic bone marrow by water protons nuclear magnetic resonance relaxation times

Pulsed nuclear magnetic resonance studies have been carried out on bone marrow of normal human subjects and patients with leukemia: chronic myeloid leukemia (CML) and acute myeloid leukemia (AML). It was observed that the proton spin-lattice relaxation time (T1) value was discriminatory in the normal and leukemic cases with a statistical significance of (p less than 0.01). Ouabain treatment of cells did not show any perceptible change of T1 value when compared with the nontreated cells, indicating that the concomitant cation effluxes do not affect spin-lattice relaxation time. The water contents of normal, leukemic, and ouabain treated cells were in the range 60%-80%. Higher Fe levels were encountered in the normal than the leukemic samples, while levels of Zn, Cu, Mn, Co, and Ni were elevated in the leukemic samples compared with the normals. Despite the T1 differences observed, the multiparameter studies do not uniquely pinpoint factors responsible for the elevation of T1 in the malignant state.

Effects of dihydrocodeine, alcohol, and caffeine on breathlessness and exercise tolerance in patients with chronic obstructive lung disease and normal blood gases

We measured breathlessness and exercise tolerance in 12 patients with chronic airways obstruction, moderate or severe breathlessness, and low or normal arterial carbon dioxide tension, after the patients received dihydrocodeine, alcohol, caffeine, or placebo (through double-blind administration). Forty-five minutes after ingestion, dihydrocodeine had reduced breathlessness by 20 per cent and increased exercise tolerance by 18 per cent, with a reduction in ventilation and oxygen consumption at submaximal work loads but with no change in spirometric volumes. Oxygen also reduced breathlessness and provided additional benefit to that achieved with dihydrocodeine (at three hours after ingestion) when the two were given together: the reduction of breathlessness was 18 per cent with dihydrocodeine; 22 per cent with oxygen; and 32 per cent with dihydrocodeine plus oxygen. Alcohol increased forced vital capacity by 9 per cent, and exercise tolerance by 7 per cent. Caffeine had no deleterious effect on breathlessness or exercise tolerance, despite increasing ventilation during rest and exercise. We conclude that opiates may be valuable for the treatment of breathlessness in selected patients; further evaluation is needed, particularly of the long-term benefits and safety.

Role of serotonin in the nicotine-induced depression of the brainstem auditory evoked response

We have examined the role of serotonergic and/or dopaminergic mechanism in the mediation of the nicotine-induced depression of brainstem auditory evoked responses (BAER) to auditory stimuli. Nicotine produced dose- and time-dependent decreases in BAER amplitude. Administration of serotonin-depleting drugs (reserpine or p-chlorophenylalanine (PCPA), prevented this decrease. Administration of catecholamine-depleting drugs (alpha-methyl-p-tyrosine, disulfiram or Dopa), on the other hand, had no effect. These data thus suggest a role for serotonergic mechanisms in the mediation of nicotine-induced depression of the brainstem auditory pathway.

Inhibition of cell division by interferons: Changes in the transport and intracellular metabolism of thymidine in human lymphoblastoid (Daudi) cells

The Daudi line of human lymphoblastoid cells shows a high sensitivity towards growth inhibition by human interferons. In cells pretreated with 70 reference units/ml of an interferon preparation for 48 h, the incorporation of exogenous [3H]thymidine into DNA is inhibited by as much as 85%. We are investigating the extent to which this effect reflects a true inhibition of the rate of DNA synthesis or whether it may be caused by changes in the metabolic utilization of exogenous thymidine by the cells. Interferon treatment results in a 30% inhibition of the rate of membrane transport and a 60% decrease in the rate of phosphorylation of [3H]thymidine in vivo. The latter effect is due to a decrease in V of thymidine kinase without any change in the value of Km for this enzyme. In addition to these changes, incorporation of [3H]uridine into DNA, which occurs as a result of the intracellular conversion of this precursor into thymidine nucleotides, is also inhibited by 75%, whereas RNA labelling by [3H]uridine is decreased by only 15% in interferon-treated cells. Thus several different metabolic events associated with thymidine nucleotide metabolism and DNA synthesis in Daudi cells are disrupted by interferon treatment.

Cross-sectional echocardiographic visualization of abnormal systolic motion of the left ventricle in mitral valve prolapse

In 11 of 34 patients with typical mitral valve prolapse on the M-mode echocardiogram, cross-sectional echocardiography in the apical four-chamber view revealed a characteristic abnormality not previously described. In mid- to late-systole the ventricular septum contracted vigorously, forming a bend or sharp convexity toward the left ventricle, while motion of the posterolateral basal left ventricle was diminished and delayed. This finding was not encountered in 35 other patients with innocent systolic murmurs, or in 15 patients with mitral regurgitation of etiologies other than mitral valve prolapse. This abnormal pattern of left ventricular contraction on cross-sectional echocardiography occurred with equal frequency in patients with holosystolic and late-systolic prolapse; it was seen more frequently in patients with severe prolapse than in those with mild to moderate prolapse.

Spontaneous splenic rupture in plasma cell leukemia

A case of plasma cell leukemia complicated by spontaneous rupture of the spleen is presented. Plasma cell leukemia occurs in less than 2% of patients with myeloma and is associated with an increased incidence of splenomegaly due to infiltration by malignant plasmacytes. Sontaneous splenic rupture is known to occur in patients with acute and chronic leukemia, but has been reported only once previously in a patient with plasma cell leukemia. Etiologic factors and the need for prompt diagnosis and management are discussed.

Ampullary carcinoma associated with multiple duodenal villous adenomas

A 39-year old Asian with multiple duodenal villous adenomas and an adenocarcinoma arising from one of these tumors is described. The rarity of villous adenomas at this site is stressed and their tendency to undergo malignant change reviewed. Immunoperoxidase studies using carcinoembryonic antigen (CEA) antiserum were positive in high dilutions (1 in 8,000) in the carcinoma and the largest adenoma. This stain would appear to show functional malignancy before histological evidence of malignancy is found.

Angiomatous lymphoid hamartoma or pseudolymphoma of pelvic retroperitoneum: clinical significance and evaluation of pelvic ureter

Angiomatous lymphoid hamartomas or pseudolymphomas have been reported most commonly within the chest and usually are mistaken for thymic tumors of lymphomatous tissue. Pelvic retroperitoneal location, to our knowledge, has been described only on three occasions. Only a high index of suspicion can make one recognize this rare lesion and save unnecessary radical surgery and/or radiation therapy. Removal of the mass led to dissappearance of associated systemic manifestations in many of the patients.

Transition metals in an experimental tumour system

In this report we present an analysis by atomic absorption spectrometry of some of the transition metals Fe, Zn, Cu, Mn, Co, and Ni in tissues and nuclear fractions in an experimental tumour system.

Pulmonary toxicity from carmustine (BCNU): a case report

A patient who had a pneumonectomy for lung carcinoma was treated with carmustine when brain metastases developed. His pulmonary function was mildly compromised prior to the pneumonectomy by many years of smoking. After six months of carmustine therapy [total dose: 2,250 mg (1,200 mg/m2)] he developed interstitial pulmonary fibrosis with histologic changes consistent with drug toxicity. With seven previously reported cases of this drug-effect and the addition of our case, carmustine must be added to the list of cancer chemotherapeutic agents that can cause pulmonary toxicity.

Lymphoma of the prostate presenting as benign prostatic hypertrophy

A case of lymphocytic lymphoma involving the prostate is reported. Lymphomatous infiltration of the prostate had been mentioned infrequently in the literature, so that the incidence, prognosis, and treatment are not well known. Lymphomatous or leukemic infiltrate should be considered as a causative agent of prostatism, particularly in patients with hematologic abnormalities where chemotherapy may relieve the symptoms.

When "lymphoma" is not lymphoma: diagnosing immunoblastic lymphadenopathy

Immunoblastic lymphadenopathy, a newly described disease, is clinically similar to lymphoma but has a specific histologic picture. It usually does not have malignant potential and is best treated initially by corticosteroid in high doses. Chemotherapy is used when corticosteroid fails or when malignant conversion occurs.

Diagnostic value of liver function tests and Entamoeba histolytica antibody studies in East Africans

Liver function tests and Entamoeba histolytica (E.H.) antibody titres have been studied in a variety of tropical and liver diseases. Patients with hepatic amoebiasis had a raised E.H. antibody titre and tended to have a low pseudocholinesterase activity. In two cases of amoebic liver abscess, which were treated by aspiration and emetine, there was a remarkable drop in the E.H. antibody titre. In a number of other hepatic and tropical conditions the E.H. antibody titre was not significantly raised and the liver function tests were typical of the various conditions studied.