[A recurrent case of TSH-PRL secreting microadenoma following hypothyroidism]

A thirty-seven-year-old housewife whose chief complaints were recurrence of galactorrhea and amenorrhea three years after having a selective adenomectomy. Hormonal examination done as a result of the continuation of the endocrinism revealed a hyperprolactinemia and high level of TRH due to hypothyroidism. Serum prolactin responded to neither TSH stimulation nor L-Dopa suppression tests. In addition, serum TSH did not react to TRH test. Contrast enhancement CT showed an intrasellar enhancing mass the size of which was less than 1 cm in diameter. A unilateral septal transsphenoidal operation was performed; and a soft white-yellowish mass 7 X 5 X 5 mm in size was found in the left inferolateral aspect of the pituitary gland. Histological studies of frozen sections of this revealed it to be a pituitary adenoma, with the border between tumor and normal tissue being quite distinct. Immunocytochemical diagnosis further confirmed it to be both PRL and TSH producing adenoma. Electron microscopy showed more than three different hormone-producing cells. The PRL cells contained large, and the TSH cells had small hormone granules; but some tumor cells contained secretory granules of both sizes suggesting production of both PRL and TSH in the cytoplasm. It is necessary in the management of patients like this, during the post-operative period, to adequately institute a thyroid hormone replacement therapy so as to prevent recurrence.

Cytotoxicity of interleukin 2-activated lymphocytes for leukemia and lymphoma cells

Studies were undertaken to determine whether leukemia and lymphoma cells would be lysed by autologous and allogeneic lymphokine-activated killer (LAK) cells. Peripheral blood mononuclear cells (PBMC) from patients and normal donors were cultured for five days, 2 weeks, and 4 weeks with medium containing 2,500 units of recombinant interleukin 2 (IL-2) per mL, and their cytotoxicity was assayed by a five-hour 51Cr-release test. Of primary tumors isolated from patients with acute nonlymphoblastic leukemia, acute lymphoblastic leukemia, and non-Hodgkin's lymphoma, tumors of 37 out of 40 patients tested were shown to be susceptible to normal donors' LAK, and tumors of 18 of 20 patients tested were shown to be susceptible to autologous LAK. LAK cultured for longer periods showed a tendency to have lower cytotoxicity. LAK had also low, but significant, levels of cytotoxicity for nonmalignant target cells. Because PBMC expanded in IL-2-containing medium consisted mainly of OKT3-positive pan T cells, OKT8-positive suppressor/cytotoxic cells, and Leu-11-positive natural killer (NK) cells, and treatment with OKT3 and Leu-11 monoclonal antibodies (mAb) reduced LAK activity for autologous and allogeneic tumor cells, both T and NK cells appeared to be effector cells for LAK activity. Mechanisms of target-cell recognition in the LAK system seem to be different from those in alloreactive cytotoxic T lymphocytes (CTL) based on the results that, while cytotoxicity of alloreactive CTL was inhibited by the treatment of effector cells with mAb, OKT3, and OKT8, and by the treatment of target cells with a mAb that reacts with HLA class I antigen, LAK activity was not inhibited by the above treatment. When chromosomes of IL-2-expanded PBMC in nine patients and two normal individuals were analyzed, PBMC from one patient showed chromosomes of clonal abnormalities, and PBMC from five donors showed those of nonclonal abnormalities.

[An ultrastructural study on squamous cell nests of the human pituitary]

The squamous cell nests which appear to have developed in the base of pars tuberalis are studied electron microscopically. A fresh pituitary was obtained from a 59-year-old white woman, who underwent hypophysectomy to reduce the pain due to the breast cancer. Each squamous cell nest was completely enclosed by the basal lamina, consisted of squamous cells, and sometimes contained adenohypophyseal parenchymal cells. The squamous cells were classified into cells in the basal layer and those in the spinous layer with intercellular bridges. Most of the former cells (B cells) possessed a nuclear membrane of strong interdigitation, well-developed desmosomes and tonofibrils. Adjacent to the squamous cell nests, there were acini which consisted of adenohypophyseal parenchymal cells, a few agranulated stellate cells, follicular cells in rare cases. As no transitional types between the B cells and the adenohypophyseal parenchymal cells were observed, B cells may not be said that they have been formed through the direct metaplasia of existing adenohypophyseal parenchymal cells. In view of the morphological similarities of the earliest B cells to the stellate cells, of the close positional relationship between the squamous cell nests and the acini and between the adenohypophyseal parenchymal cells and the squamous cells, and of the past reports that squamous cell nests increase in number with aging, B cells appear to originate from the stellate cells.

Pale-cell acanthosis. A distinctive histologic pattern of epidermal epithelium

Pale-cell acanthosis is a distinctive reaction of epidermal epithelium and is analogous to other epithelial reaction patterns such as epidermolytic hyperkeratosis, focal acantholytic dyskeratosis, cornoid lamellation, and follicular mucinosis.

The distribution of 2,4-dinitrophenyl groups in guinea pigs following feeding of 2,4-dinitrochlorobenzene

An immunofluorescent technique using anti-DNP antibody was employed to investigate the distribution of 2,4-dinitrophenyl (DNP) groups in various tissues following the feeding of 125 mg/kg 2,4-dinitrochlorobenzene (DNCB)-ethanol to guinea pigs that had been starved for 1 day. DNP groups were detected in the areas corresponding to the cytoplasm and the cell membrane of the epithelium in the upper gastrointestinal tract as well as on the cells of mesenteric lymph nodes, Payer's patches, the spleen, and peripheral blood. These results are discussed in relation to the mechanism of tolerance induction produced by the feeding of haptens.

Gangliocytoma of the pineal body. A case report and review of the literature

Ganglion cell tumours are mostly seen in children and young people, but they are extremely rare, accounting for 0.1-0.5% of all brain tumours. It usually occurs in the floor of the third ventricle and the temporal lobe. Recently we have experienced a pineal gangliocytoma, probably the first ever seen in Japan and the fourth case in the world, and have succeeded in a total removal of it. The case concerns a 51-year-old man who suffered from intermittent blurred vision and headache of 3 years' duration. CT showed, together with severe hydrocephalus, positive contrast medium enhancement and a somewhat irregular but sharply circumscribed high density lesion suggestive of a meningioma. But the brain scintiscan revealed a badly and irregularly demarcated region of warm activity and having little change with time mainly in the pineal region, which was strongly suspicious of gliomas. Hence this scan was thought to be important in diagnosing this tumour. As an operative procedure, biparieto-occipital craniotomy was successfully performed in the "sea lion" position to remove the tumour totally. Pathological findings indicated a mixture of dispersion and concentration of giant cells possessing prominent nucleoli, abundant chromatin and a prominent nucleus or several nuclei of varying sizes and process-like cell bodies polygonal or irregular in shape. GFAP stain showing no glial fibres and the tumour was thought to be a gangliocytoma.

Symptomatic Rathke's cleft cysts located entirely in the suprasellar region: review of diagnosis, management, and pathogenesis

Three cases of an entirely suprasellar symptomatic Rathke's cleft cyst, two of which were associated with normal sella turcicas, are reported. In all cases, the cysts caused compression of the optic chiasm, and two produced hypothalamic dysfunction. The diagnosis of these entirely suprasellar masses was enhanced by metrizamide cisternography. Two cases were treated by frontal craniotomy and one was treated transsphenoidally, with good results in all cases. The radiology, pathology, and surgical treatment of these unusual cases is presented. An embryological pathogenesis for the occurrence of an entirely suprasellar Rathke's cleft cyst is discussed.

Intraventricular primary cerebral neuroblastoma in adults: report of three cases

Primary cerebral neuroblastoma most often occurs in the cerebral parenchyma in children. When it occurs in adults, it is also described as an intraparenchymal neoplasm. We report three cases of primary cerebral neuroblastoma in adults presenting as an intraventricular mass.

Criteria for histologic differentiation of desmoplastic trichoepithelioma (sclerosing epithelial hamartoma) from morphea-like basal-cell carcinoma

Histological differentiation between desmoplastic trichoepithelioma and morphea-like basal-cell carcinoma may be exceedingly difficult. Because the criteria for this differentiation published to date have not proved satisfactory to us, we undertook a study with the aim of formulating repeatable and reliable criteria for distinguishing between these two conditions of wholly different biological potential. We believe that the 26 sets of criteria listed here will permit reliable differentiation of desmoplastic trichoepitheliomas from morphea-like basal-cell carcinomas, even in biopsy specimens taken by shave and punch techniques.

Malignant melanoma and extramammary Paget's disease in the same patient

Axillary Paget's disease was found in a 34-year-old man who died of metastatic malignant melanoma. The primary cutaneous malignant melanoma was diagnosed 6 years before the patient's demise and was confirmed by the presence of melanin, a positive dopa reaction, and immunohistochemical demonstration of S-100 protein in neoplastic cells. Postmortem examination revealed Paget's disease of the axillary skin in addition to widespread metastases of malignant melanoma. Paget cells were positive for periodic acid-Schiff reaction and alcian blue. They were also immunohistochemically positive for carcinoembryonic antigen, but were negative for S-100 protein. This association of malignant melanoma and Paget's disease in the same person has not, to the best of our knowledge, been described before.

Photobinding of 3H 8-methoxypsoralen to monkey intraocular tissues

Young (less than 1 year) and old (greater than 15 years) Rhesus monkeys were utilized in this study in order to determine whether ultraviolet (UV) radiation at ambient levels induces psoralen photobinding in primate eyes (in particular the lens and retina). Unilateral aphakia or pseudophakia was induced surgically and the eyes were allowed to heal. The animals then were given a single intraperitoneal injection of 3H 8-methoxypsoralen (8-MOP) and immediately exposed to BLB lights (of measured radiation intensity at the corneal surface). The animals were killed at varying time periods (2-6 weeks), and the eyes were removed immediately. One-half of each cornea and lens was frozen for subsequent optical spectroscopy and the remaining ocular tissues were fixed for histopathologic studies and autoradiography. These data demonstrate that low level UV radiation (less than 0.4 mW/cm2) can cause 8-MOP photobinding to lens proteins and DNA and to aphakic, pseudophakic, and young phakic primate retinas. The older phakic primate lens serves as a protective UV filter and prevents psoralen photobinding within the retina. These data suggest that older aphakes and pseudophakes may require UV radiation protection to prevent direct as well as photosensitized retinal photodamage.

Mechanisms of adverse effect of air-oxidized soy bean oil-feeding in rats

In order to clarify the mechanism of the adverse effects of air-oxidized oil feeding, the effects of dietary soy bean oil on body weight gain, food consumption, fecal consistency and gastrointestinal functions were investigated in rats. Feeding of oxidized soy bean oil with a peroxide value above 350 produced significant reductions in body weight gain, food consumption and intestinal sucrase activity, and severe diarrhea. These adverse effects were prevented with the concurrent feeding of Gobo dietary fiber and were rapidly eliminated within a day after switching to the diet containing the unoxidized soy bean oil. Furthermore, the remarkable release of sucrase from the small intestine was observed on perfusion of the jejunum with Ringer's bicarbonate solution containing the oxidized soy bean oil at the 1% level. These findings suggest that the adverse effects occurring after air-oxidized oil feeding are due to a disturbance of gastrointestinal functions, and raise the possibility that the primary cause might be solubilization or exfoliation of the brush border membrane.

Immunocytochemical identification of CRF in the human hypothalamus

Immunoreactive ovine corticotropin-releasing factor (CRF) was revealed in the cell bodies of parvocellular neurons in the paraventricular nucleus of the human hypothalamus by an immunocytochemical technique. The immunoreactivity was negative in magnocellular neurons. Immunoreactive nerve fibers were found in the subependymal layers of the third ventricle and in the perivascular space of the primary plexus in the lower hypothalamus. No CRF immunoreactive cell bodies were found in the supraoptic nucleus.

Drinking induced by angiotensin II in fishes

Among 20 species of freshwater fishes examined, Pseudorasbora parva, Rhodeus ocellatus, Cobitis anguillicaudatus, Carassius auratus, Oryzias latipes, Gambusia affinis, and Gyrinocheilus anymonieri were found to drink water like seawater fishes, while 13 remaining species did not drink. For fish species found exclusively in fresh water, angiotensin II (AII) treatment did not induce drinking. In contrast, those freshwater fishes which survive in estuarine brackish water (Leuciscus hakonensis, C. carassius, Parasilurus asotus, G. affinis, Chaenogobius annularis, Tridentiger obscurus, and G. anymonieri responded to AII by drinking. Furthermore, some freshwater fishes which survive either in hypertonic water (C. auratus) or in sea water (Anguilla japonica and O. latipes) also responded to AII by drinking. Of 17 seawater fishes examined, Eptatretus burgeri, Triakis scyllia, and Heterodontus japonicus failed to drink water, and for Trachurus japonicus, Platichthys bicoloratus, and Glossogobius giuris fasciatopunctatus, water intake was minor (similar to freshwater fishes). The 11 remaining seawater fishes drank water. AII did not induce drinking in fishes living exclusively in sea water. However, seawater fishes which survive either in tide pools (Chasmichthys dolichognathus gulosus) or in brackish water (Sillago japonica, Mugil cephalus, G. giuris fasciatopunctatus) responded to AII by drinking. P. bicoloratus, Acanthopagrus schlegeli, and Fugu niphobles were exceptional, in that they survive in brackish water, but did not respond to AII. Although some exceptions exist, it is generally concluded that a drinking response to AII is characteristic of fishes which encounter water more hypertonic than that in which they typically reside. Accordingly, a drinking mechanism induced by AII may be a compensatory emergency reaction to dehydration stress.

[Pharmacological actions of oxatomide (KW-4354). 3. Actions on experimental asthma and Schultz-Dale reaction]

The present experiment was carried out to elucidate the effectiveness of oxatomide for prophylaxis in the bronchial anaphylaxis and Schultz-Dale response. 1) Oxatomide administered i.v. was found to be as active as disodium cromoglycate (DSCG) in inhibiting IgE-mediated active anaphylactic bronchoconstrictions in rats. In contrast to DSCG, oxatomide was effective when administered p.o. 2) Passive anaphylactic broncho-constrictions in guinea pigs mediated IgG-like rabbit antibody against egg albumin was also prevented dose-dependently by treatment with oxatomide given p.o. and i.v., but not by DSCG. 3) Oxatomide and DSCG inhibited passive anaphylactic bronchoconstrictions in guinea pigs mediated by IgE-like antibody against BPO X BGG. 4) The anaphylactic reaction of the isolated guinea pig ileum, the so-called Schultz-Dale reaction, showed a bi-phasic response: a short, rapid contraction followed by a partial relaxation and a slow contractile response. Oxatomide significantly depressed both the rapid first contraction and the slow sustained one. 5) Oxatomide administered after the development of antigen-induced contraction of isolated guinea pig trachea resulted in relaxation. These results suggest that oxatomide may be effective for the treatment of allergic bronchial asthma.

Hemangioendothelioma of the neuraxis: an ultrastructural study

Hemangioendotheliomas are vascular tumors that rarely involve the neuraxis. However, when they do, they must be differentiated from the other neoplastic vascular lesions that more commonly involve the central nervous system (CNS). We describe the ultrastructural features of three hemangioendotheliomas of the neuraxis. These lesions are characterized by the proliferation of endothelial cells around vascular lumina and of pericytes outside of the endothelial basal lamina. These features differ from those of other vascular tumors of the CNS. Based on these observations, we consider hemangioendothelioma to be a distinct entity among the neoplasms of vascular origin in the CNS.

Supratentorial subarachnoid epithelial cyst: case report and ultrastructural study

Supratentorial epithelial cysts are rare entities that have evoked controversy regarding their pathogenesis. Recent ultrastructural studies have failed to resolve this controversy. We present a case report and an ultrastructural study of such a cyst. The cyst wall was lined by columnar epithelial cells with prominent cilia and microvilli at their apical surface. They were joined by well-developed junctional complexes and contained abundant intracytoplasmic, electron-dense, granular material, some of which was membrane-bound. These ultrastructural findings suggest that epithelial cysts are derived from elements of the embryological tela choroidea.