Vulvitis plasmacellularis: two new cases

Vulvitis chronica plasmacellularis or Zoon's vulvitis is a rare benign circumscribed inflammation of the vulvar mucosa. It is found in women ranging in age from 26 to 70 years. Shiny, macular erythematous lesions, which are irregular in shape and sharply marginated are usually observed. The histologic findings show chronic subepithelial dense inflammation composed largely of plasma cells. We here report two cases of vulvitis plasmacellularis with typical clinical manifestations, courses and histopathologic findings.

Helicobacter pylori-induced gastritis in the domestic cat

Helicobacter pylori has been cultured from the inflamed gastric mucosae of naturally infected cats; the lesions in H. pylori-infected cat stomachs mimic many of the features seen in H. pylori-infected human stomachs. To determine whether H. pylori-negative specific-pathogen-free cats with normal gastric mucosae were susceptible to colonization by this bacterium and whether gastritis developed after infections, four H. pylori-negative cats treated with cimetidine were orally dosed three times with 3 ml (1.5 x 10(8) CFU/ml) of H. pylori every 4 days. All four cats became persistently colonized as determined by gastric cultures and PCRs from serial gastric biopsy samples and necropsy samples at 7 months postinfection. H. pylori was not isolated from the two control cats, nor were their gastric tissues positive by PCR; one of the two cats had a few focal lymphocytic aggregates in the body submucosa, whereas the second cat had a normal gastric mucosa. All four H. pylori-infected cats had multifocal gastritis consisting of lymphoid aggregates plus multiple large lymphoid nodules, which were most noticeable in the antral mucosa. In addition, one H. pylori-infected cat had a moderate diffuse infiltration of polymorphonuclear leukocytes in the subglandular region of the antrum. H. pylori-like organisms were focally distributed in glandular crypts of the antrum. Two of the H. pylori-infected cats had significant (eightfold) increases over baseline in levels of immunoglobulin G H. pylori serum antibody. The H. pylori isolates from the four experimentally infected cats had restriction fragment length polymorphism patterns specific for the flaA gene that were identical to those of the inoculating strain. H. pylori readily colonizes the cat stomach and produces persistent gastritis.

Prostaglandins and sex steroids from corpora lutea of pregnant mares. In vitro studies

To delineate endocrine mechanisms regulating equine luteal function and the possible functional differences between one month and three month corpora lutea of pregnancy (CL), the in vitro basal releases of prostaglandin F (PGF), prostaglandin E2 (PGE2), progesterone, and 17 beta-estradiol by one and three month CL of pregnant mares were evaluated. In addition, the in vitro effects of PGF2 alpha PGE2, progesterone and 17 beta-estradiol on synthesis of prostaglandins (PGs) and sex steroids were studied. PGF, PGE2, and 17 beta-estradiol secretion was higher in one month than in three month CL, while progesterone was secreted similarly by both types of CL. PGE2 treatment decreased 17 beta-estradiol in one month CL; progesterone increased PGE2 in one and three month CL; 17 beta-estradiol increased PGE2 in one month CL. This study suggests that, in one month CL, PGE2 production could be regulated by progesterone and 17 beta-estradiol, while, in three month CL, this prostaglandin seems to be under the control of progesterone alone.

Six additional cases of the KBG syndrome: clinical reports and outline of the diagnostic criteria

A diagnosis of KBG syndrome was made in six unrelated patients. They presented with slight mental retardation, macrodontia, and skeletal abnormalities. Microcephaly, short stature, facial anomalies, and syndactylies were also noted. The diagnostic criteria of the KBG syndrome are discussed.

Final height after growth hormone therapy in non-growth-hormone-deficient children with short stature

We report the effect of growth hormone (GH) treatment for 4 to 10 years in 15 prepubertal non-GH-deficient short children (10 boys, 5 girls, aged 7.4 to 13.2 years). In 7 patients, GH was administered at a dosage of 0.5 U/kg per week (group 1: 4 boys, 3 girls) and in 8 patients (group 2: 6 boys, 2 girls) at a dosage of 1.0 U/kg per week. After the first year, mean linear growth velocity had significantly increased in both groups. The increase in growth velocity was sustained during the first 4 years and then declined to pretreatment values in the majority of subjects. Treatment with GH did not induce an earlier onset of puberty, but there was a tendency toward faster skeletal maturation. The mean final height standard deviation score (SDS) was similar in the two groups and was significantly higher than the height SDS for chronologic age before treatment, but it did not differ from mean pretreatment predicted adult height SDS nor from mean target height SDS in both groups. Final height was significantly correlated with target height in both groups. These preliminary observations indicate that GH treatment does not generally increase final height over target height in short non-GH-deficient children.

Modulation of non-adrenergic non-cholinergic inhibitory transmission in rat duodenum: role of opiates and 5-hydroxytryptamine

In rat duodenal segments in vitro, electrical field stimulation induced a TTX-sensitive relaxation in the presence of atropine and guanethidine. A correlation between the amplitude of the evoked response and stimulus frequency was observed. Opioid peptides DAGO, DPDPE and DYN caused a dose-dependent increase in the amplitude of the response to EFS. Naloxone shifted to the right the dose-response curves for each opioid peptide significantly enhancing the ED50 values. The amplitude of the response to EFS was enhanced, dose-dependently, also in the presence of 5-HT. Such an effect induced by 5-HT was prevented by 5-HT receptor desensitization, but persisted unchanged after naloxone pretreatment. Opioids failed to affect the response to EFS after 5-HT receptor desensitization. Results suggest that in rat duodenum opioids modulate NANC inhibitory neurotransmission, indirectly the release of 5-HT.

[Focal infection in dentistry: the in vitro specific lymphocyte blast test]

The authors used an "in vitro" test of specific blastogenic response to streptococcal antigens, to evidence a sensitivity status in chronic odontogenic infections. The authors didn't find always a direct correlation between specific lymphoproliferative response and haematologic tests but found a good correlation with clinics. They conclude an increased value of specific lymphoproliferative response as predictive meaning of metafocal diseases.

Pitfalls in counselling: the craniosynostoses

We describe three families to highlight the variability of expression and penetrance that can occur in the craniosynostoses. In two of the families, gene carriers were only identified in retrospect by looking at photographs of other family members. In the third family, identical twins were initially thought to be discordant for sagittal craniosynostosis until early skull x rays were examined and both were found to be affected. The dilemmas faced when counselling these families are discussed.

Spontaneous electromechanical activity in the rat duodenum in vitro

Isolated rat duodenum shows spontaneous mechanical and electrical activities. Mechanical activity consists in changes both in endoluminal pressure and in isometric tension. Electrical activity is characterized by slow waves with superimposed bursts. This spontaneous activity is tetrodotoxin (TTX) resistant and therefore it is myogenic in origin. Indeed, TTX pretreatment, even in the presence of atropine and guanethidine, caused an increase in amplitude and in frequency of the electrical and mechanical activities. This finding indicates the presence of tonically active inhibitory intramural non adrenergic, non cholinergic (NANC) nerves. Duodenal longitudinal strips showed a spontaneous mechanical activity resembling that one recorded from isolated segment. Instead, circular strips are quiescent under resting condition and a contractile activity can be detected only after TTX pretreatment suggesting that: i) the circular smooth muscle layer is tonically inhibited by intramural NANC nerves and, ii) the contractions observed in the rat duodenum are due to the activity of the longitudinal one.

[Peptidergic innervation of the human dental pulp: neuropeptide Y]

The localization and distribution of the Neuropeptide Y (NPY) has been studied with immunofluorescent methods in the human dental pulp. Immunofluorescence for the NPY has been observed in nervous fibers running in medium and big nerves associated in vascular structures, and in single fibers scattered in the pulpar connective or organized in the subdontoblastic plexus.

Simpson-Golabi-Behmel syndrome: an X-linked encephalo-tropho-schisis syndrome

We report on another family with the so-called "gigantism-dysplasia syndrome", an X-linked condition characterized by pre- and postnatal overgrowth, characteristic face with apparent coarseness, dysplastic changes in several tissues, and mild intellectual impairment. This condition has been called the Golabi-Rosen syndrome; however, we agree that is the same entity as that described, in a milder form, by Simpson et al in 1975 and by Behmel et al in 1984. Therefore, we suggest that this entity be designated the Simpson-Golabi-Behmel syndrome. The manifestations in affected individuals suggest that this condition represents an X-linked encephalo-tropho-schisis syndrome.

The Opitz syndrome: a new designation for the clinically indistinguishable BBB and G syndromes

The BBB and G syndromes are multiple congenital anomaly (MCA) syndromes characterized by a developmental defect of the midline field. Prominent clinical manifestations are hypertelorism and, in males, hypospadias. Transmission is most likely autosomal dominant in both syndromes. Examination of two new cases and scrutiny of the literature led us to conclude that there are no discriminating qualitative differences between the two conditions. Therefore we propose that they both be designated by the common term "Opitz syndrome."

Growth hormone response to growth hormone releasing hormone 1-40 in Turner's syndrome

The response of growth hormone (GH) to acute administration of GH-releasing hormone 1-40 (GHRH) was evaluated in 12 patients with Turner's syndrome and in 12 prepubertal or early pubertal girls. In 7 of 12 patients GHRH induced a definite increase (greater than 10 ng/ml) of plasma GH levels. In 5 patients there was a poor GH rise after GHRH administration (less than 10 ng/ml). Overall, the mean GH response of patients was significantly lower than that of normal girls. Five out of 7 patients with a 45 X,O karyotype had a reduced GH rise after GHRH, while all patients with non X,O karyotype (mosaicism and/or 46 X,iX) had a normal GH response to GHRH. Although the cause of short stature in patients with Turner's syndrome is most likely multifactorial, a reduced pituitary GH reserve, as documented by the reduced GH response to GHRH in some of our patients, may contribute to the growth impairment in this disorder.

The spectrum of the so-called rigid spine syndrome: nosological considerations and report of three female cases

Three female cases of the "rigid spine" syndrome are reported and associated with different nosological entities. One patient was affected by congenital muscular dystrophy and one by a morphological pattern of fibre type disproportion with type I atrophy. The third patient showed very peculiar morphological changes on a muscle biopsy specimen resembling a vacuolar myopathy, which is rarely described in association with the rigid spine syndrome. The importance of an adequate investigation of the rigid spine syndrome and the recognition of the presence or absence of cardiomyopathy, if there is to be correct genetic counselling, is discussed.