Sinonasal undifferentiated carcinoma: immunohistochemical profile and lack of EBV association

The role of Epstein-Barr virus (EBV) in the development of sinonasal undifferentiated carcinoma (SNUC) remains unresolved. Reports of EBV-positivity in SNUC may reflect inclusion of lymphoepithelioma-like carcinomas within this group. In addition, SNUC have been incompletely characterized immunohistochemically, and their undifferentiated appearance often requires such ancillary studies to aid in their distinction from other high-grade neoplasms. To address these two issues, 25 cases of SNUC diagnosed between the years 1983 and 1999 were selected from our files. EBER in situ hybridization (ISH) was performed on the paraffin-embedded tissue by using 3H-labeled EBER-1 RNA probes. Neoplasms with sufficient tissue (22 of 25) were evaluated immunohistochemically for Ki-67, p53, chromogranin, synaptophysin, placental alkaline phosphatase (PLAP), CD99, carcinoembryonic antigen (CEA), epithelial membrane antigen (EMA), neuron-specific enolase (NSE), and latent membrane protein-1 (LMP-1). The median patient age was 58 years (range, 20-81 years), with a male-to-female ratio of approximately 3:1. The most common tumor location was the nasal cavity (18 cases), followed by the ethmoid and maxillary sinuses. Median survival was 18 months. All 25 tumors were negative for EBER-I by ISH. Ki-67 was negative in one case, 1+ in nine, 2+ in six, 3+ in five, and 4+ in one. P53 was negative in nine, 1+ in five, 2+ in two, 3+ in none, and 4+ in six. CD99 expression was strongly positive in 3 of 22 (14%) and completely negative in the remainder. Variably intense focal staining for EMA was present in 4 of 22 (18%). NSE faintly stained 4 of 22 (18%). Chromogranin, synaptophysin, PLAP, CEA, and LMP-1 were negative (0 of 22). Our results suggest that EBV does not play a role in the development of SNUC. Strict histologic criteria are necessary to avoid confusion with lymphoepithelioma-like carcinoma or other high-grade malignancies in this region. The finding of occasional CD99-positive cases adds SNUC to the growing list of CD99-positive neoplasms.

Nonneoplastic endometrial signet-ring cells. Vacuolated decidual cells and stromal histiocytes mimicking adenocarcinoma

We describe 5 patients (mean age, 50 years; all had uterine bleeding) whose routine endometrial biopsy and curettage specimens contained prominent signet-ring cells. Each specimen contained loose aggregates of signet-ring cells scattered within the endometrial stroma that were characterized by peripherally displaced, small, uniform nuclei with indistinct nucleoli and showed no mitotic activity. The central portion of the cytoplasm was occupied by single or multiple cytoplasmic vacuoles. In all cases, the signet-ring cells were reactive for vimentin and negative for epithelial membrane antigen and cytokeratin. Four cases were focally positive for muscle-specific actin or smooth muscle actin and negative for CD68, Mac387, periodic acid-Schiff, mucicarmine, and alcian blue. In these 4 cases, the surrounding endometrial stroma showed decidual changes, and the signet-ring cells demonstrated a morphologic continuum with more typical decidualized stroma. As such, the signet-ring cells in these cases were vacuolated, decidualized endometrial stromal cells. In the remaining case, the vacuolar contents of the signet-ring cells were periodic acid-Schiff-positive and resistant to diastase predigestion, and the cells reacted with Mac387 and CD68. The surrounding stroma showed no decidual reaction. Thus, the signet-ring cells in this case were of histiocytic differentiation. Endometrial stroma occasionally may contain nonneoplastic signet-ring cells that closely mimic adenocarcinoma. At least 2 directions of differentiation, decidual and histiocytic, are possible.

Mammary lipogenic enzyme activity, trans fatty acids and conjugated linoleic acids are altered in lactating dairy cows fed a milk fat-depressing diet

The objectives of the present study were to examine the effect of a milk fat-depressing (MFD) diet on: 1) the activity of mammary acetyl-CoA carboxylase (ACC) and fatty acid synthase (FAS), 2) ACC mRNA relative abundance and 3) distributions of conjugated linoleic acids (CLA) and trans-18:1 fatty acids (tFA) in milk fat. Twelve lactating Holstein cows were used in a single reversal design. Two diets were fed: a control diet (60:40% forage/concentrate) and an MFD diet (25:70% forage/concentrate, supplemented with 5% soybean oil). The MFD diet decreased (P: < 0 0.001) milk fat by 43% and ACC and FAS activity by 61 and 44%, respectively. A reduced ACC mRNA relative abundance (P: < 0.001) corresponded with the lower ACC activity. The fatty acids synthesized de novo were decreased (P: < 0. 002), whereas tFA were increased from 1.9 to 15.6% due predominantly to a change in trans-10-18:1 isomer (P: < 0.001). With the MFD diet, the trans-7, cis-9 and trans-10, cis-12 CLA isomers were elevated (P: < 0.001), in contrast to the decrease in trans-11-18:1 (P: < 0. 001) and cis-9, trans-11-18:2. The data were consistent with a dietary effect on mammary de novo FA synthesis mediated through a reduction in ACC and FAS activity and in ACC mRNA abundance. The results were compatible with a role of trans-10, cis-12 CLA in milk fat depression, but alterations noted in tFA and other CLA isomers suggest that they also may be important during diet-induced milk fat depression.

The dental unit waterline controversy: defusing the myths, defining the solutions

BACKGROUND AND OVERVIEW

This article reviews the literature on the subject of dental unit waterline contamination. It has been expanded from the text of a lecture given at the Scientific Frontiers in Dentistry program sponsored by the National Institute for Dental and Craniofacial Research in Bethesda, Md., in July 1999. The author examines the underlying biological causes of waterline colonization by microorganisms, the evidence of potential health consequences and possible means of improving the quality of dental water. He also describes examples of devices currently marketed to improve and maintain the quality of dental treatment water.

CONCLUSIONS

Microorganisms colonize dental units and contaminate dental treatment water. While documented instances of related illness are few, water that does not meet potable-water standards is inappropriate for use in dentistry.

CLINICAL IMPLICATIONS

Exposure to water containing high numbers of bacteria violates basic principles of clinical infection control. Dentists should consider available options for improving the quality of water used in dental treatment.

Pathology residents' use of a Web-based tutorial to improve Gleason grading of prostate carcinoma on needle biopsies

Little is known about pathology residents' ability to Gleason grade or their ability to learn surgical pathology using Internet-based technology. A free Web-based program (available at www.pathology. jhu.edu/prostate) was developed that consisted of 20 pretutorial images for grading, 24 tutorial images, and the same 20 posttutorial images for Gleason grading. The grading images were selected from cases that had a consensus Gleason grade from 10 uropathology experts. In 2.5 months, 255 residents visited the website, and 151 (59%) completed it. Of those who completed the website, their year in training was known in 85 (56%): 1st year, 25.8%; 2nd year, 20%; 3rd year, 22.3%; 4th year, 14.1%; 5th year, 15.3%; and 6th year, 2.4%. Eighty percent learned Gleason grading in residency versus being self-taught, and 66% were male. In a multivariate analysis, higher pretutorial scores were associated with both their year in training (P = .001) and their hospital size (P = .003). Improvements in grading posttutorial were not related to the residents' year in training. Overall, the website significantly improved grading in 11 of 20 images and had no effect in 9 of 20 images. Improvements were noted in 1 of 1 Gleason score 4; 2 of 7 Gleason score 5 to 6; 2 of 6 Gleason score 7; and 6 of 6 Gleason score above 7 tumors. In summary, a Web-based tutorial improved Gleason grading accuracy by pathology residents to an equal extent regardless of their year in training. It is more difficult to teach residents to grade Gleason scores 5 to 7 tumors, and additional training should be concentrated in this area.

Expression of the porcine beta2-adrenergic receptor in Chinese hamster ovary cells

The gene for the porcine beta2-adrenergic receptor (pbeta2AR) was transfected into Chinese hamster ovary (CHO) cells for expression. Fourteen stable cell lines were obtained and exhibited receptor densities ranging from 12 to 2,371 fmol/mg membrane protein. The receptor density was not correlated with estimates of gene copy number obtained by Southern hybridization. The pbeta2AR in CHO cells exhibited saturable binding of [125I]CYP (Kd = 14.5 pM) and stereospecificity for (-)- and (+)-isoproterenol. The relative affinities for (-)-isoproterenol (ISO), (-)-epinephrine (EPI), and (-)-norepinephrine (NEPI) were ISO > EPI > NEPI, which are characteristic of beta2AR. The affinity values for these ligands were similar to those in other species. Binding of ISO, EPI, and NE revealed two affinity states of the betaAR; the high-affinity state was eliminated by adding Gpp(NH)p, a nonhydrolyzable GTP analogue. Binding of the antagonist propranolol modeled to only one affinity state, and Gpp(NH)p did not affect binding. Multiple affinity states are characteristic of agonist-induced coupling of betaAR with G-proteins, and the data suggest that the cloned pbetaAR is functionally competent. Data confirm that the pbeta2AR is the pig version of beta2AR. Stable CHO cell lines will be useful for characterization of pbeta2AR and screening and designing potential drugs that may be used to enhance pig production.

Delayed death owing to blunt cardiac injury

Two cases of blunt myocardial injury to the region of the anterior descending branch of the left coronary artery causing death are described. In one case, direct injury appeared to have resulted in myocardial infarction, whereas in the other, cardiac arrhythmia (possibly secondary to coronary artery spasm) was implicated. Although apparently uncommon, deaths following blunt injury to the coronary arteries may cause death, but are difficult to predict and prevent.

Further analysis of maize C(4) pyruvate,orthophosphate dikinase phosphorylation by its bifunctional regulatory protein using selective substitutions of the regulatory Thr-456 and catalytic His-458 residues

In C(4) plants such as maize, pyruvate,orthophosphate dikinase (PPDK) catalyzes the regeneration of the initial carboxylation substrate during C(4) photosynthesis. The primary catalytic residue, His-458 (maize C(4) PPDK), is involved in the ultimate transfer of the beta-phosphate from ATP to pyruvate. C(4) PPDK activity undergoes light-dark regulation in vivo by reversible phosphorylation of a nearby active-site residue (Thr-456) by a single bifunctional regulatory protein (RP). Using site-directed mutagenesis of maize recombinant C(4) dikinase, we made substitutions at the catalytic His residue (H458N) and at this regulatory target Thr (T456E, T456Y, T456F). Each of these affinity-purified mutant enzymes was assayed for changes in dikinase activity. As expected, substituting His-458 with Asn results in a catalytically incompetent enzyme. Substitutions of the Thr-456 residue with Tyr and Phe reduced activity by about 94 and 99%, respectively. Insertion of Glu at this position completely abolished activity, presumably by the introduction of negative charge proximal to the catalytic His. Furthermore, neither the T456Y nor inactive H458N mutant enzyme was phosphorylated in vitro by RP. The inability of the former to serve as a phosphorylation substrate indicates that RP is functionally a member of the Ser/Thr family of protein kinases rather than a "dual-specificity" Ser-Thr/Tyr kinase, since our previous work showed that RP effectively phosphorylated Ser inserted at position 456. The inability of RP to phosphorylate its native target Thr residue when Asn is substituted for His-458 documents that RP requires the His-P catalytic intermediate form of PPDK as its protein substrate. For these latter studies, synthetic phosphopeptide-directed antibodies specific for the Thr(456)-P form of maize C(4) PPDK were developed and characterized.

Dental unit waterline antimicrobial agents' effect on dentin bond strength

BACKGROUND

In response to concerns of bacterial biofilm colonization of dental unit waterlines, a wide range of commercial intermittent and continuous chemical treatments for dental unit waterlines have been developed and marketed. There has been little research on the possible effect of continuous chemical treatment regimens on dentin-bonding agents. The authors evaluate the effect of four proposed antimicrobial agents used in dental unit waterlines on dentin bond strength.

METHODS

The authors used a fifth-generation dentin-bonding agent to bond composite cylinders to molar dentin surfaces. They then used selected antimicrobial agents as rinsing agents after conditioning. The composite cylinders were shear tested, and their fracture strengths were compared statistically.

RESULTS

All proposed antimicrobial agents reduced dentin bond strength. Proposed waterline treatment regimens of a diluted mouthrinse and chlorhexidine significantly reduced dentin bond strength compared with sodium hypochlorite and citric acid regimens.

CONCLUSION

Dental professionals should be aware of potential interactions between dental unit waterline antimicrobial agents and dentin-bonding agents. Further research in this area is warranted, as the clinical implications are uncertain at this time.

CLINICAL IMPLICATIONS

Dental unit waterline antimicrobial agents may adversely affect dentin bonding strength.

Regulation of porcine adipocyte metabolism by insulin and adenosine

The acute effects of insulin and adenosine on rates of lipolysis and lipogenesis in pig adipocytes were investigated to determine what limits the expression of the insulin response in vitro. Adenosine and insulin independently inhibited isoproterenol-stimulated lipolysis. Adenosine, acting through the pertussis toxin-sensitive G-protein Gi, was more effective than insulin and could completely inhibit lipolysis. Fatty acid synthesis from glucose was increased by both adenosine and insulin. Neutralization of endogenous adenosine with adenosine deaminase decreased basal rates of lipogenesis and increased the insulin response from 30 to 60% above basal. Neutralization of Gi with pertussis toxin further decreased the basal rate and increased the insulin response to 160% above basal. These data indicate that Gi, and the ligands that signal through Gi, stimulate glucose incorporation into fatty acids and can attenuate the insulin response. It seems likely that an exaggerated rate of glucose metabolism in the absence of insulin contributes to the inconsistent insulin responses exhibited in pig adipose tissue in vitro. These data also demonstrate that insulin and adenosine have major roles in regulating pig adipose tissue metabolism.

Combining periodic and continuous sodium hypochlorite treatment to control biofilms in dental unit water systems

BACKGROUND

This study evaluated the efficacy of combined intermittent and continuous treatment with diluted sodium hypochlorite, or NaClO, to improve dental unit water quality in a clinical setting.

METHODS

In this prospective study, 10 dental units were fitted with separate water reservoir systems. Dental units were maintained with weekly rinses with 1:10 NaClO. Treatment water consisted of 750 milliliters of tap water and one drop of undiluted commercial bleach. Bacterial contamination in the effluent coolant water was assayed via microbiologic culture on a weekly basis. At the end of the study, scanning electron microscopy of the inner surfaces of the dental unit waterlines corroborated the results.

RESULTS

All 10 dental units consistently delivered water with less than 10 colony-forming units per milliliter, or CFU/mL, with a mean bacterial contamination of less than 1 CFU/mL. Baseline scanning electron microscopy demonstrated biofilm formation. Scanning electron microscopy at the end of the study demonstrated the lack of features consistent with biofilm formation. Although tri-halomethanes were detected in output water, all samples were below Environmental Protection Agency limits for drinking water.

CONCLUSIONS

Weekly treatment with 5.25 percent NaClO diluted 1:10, and concomitant use of chlorinated treatment water (3 parts per million chlorine) consistently attained the proposed American Dental Association goal of fewer than 200 CFU/mL in the unfiltered output. The effects of continuous treatment on dentin and enamel bond strength may require further evaluation.

CLINICAL IMPLICATIONS

The success of this protocol suggests that optimal attainment of dental water quality goals may require a combination of approaches.

Postoperative/posttraumatic spindle cell nodule of the skin: the dermal analogue of nodular fasciitis

Spindle cell proliferations of the skin are diverse, both morphologically and mechanistically. The authors have encountered four examples of a distinctive reactive/reparative cutaneous spindle cell lesion that shows homology with ones seen in the genitourinary tract and oral cavity and that is known as "postoperative/posttraumatic spindle cell nodule" (PSCN). These occurred in the skin of the face and scalp (2 cases), arm (1 case), and vulvar skin (one case), and were clearly related historically to prior episodes of trauma. The proliferations were characterized by variably-apposed and cytologically-bland spindle cells with numerous mitotic figures, set in a highly vascular stroma containing extravasated erythrocytes and inflammatory cells. All lesions were immunoreactive for vimentin, actin, and desmin, with no labeling for keratin. Postoperative/posttraumatic spindle cell nodule of the skin is a significant pseudoneoplastic lesion that is related (and perhaps identical pathogenetically) to nodular fasciitis; as such, it may be mistaken for a sarcoma or a spindle cell carcinoma. Careful attention to clinicopathologic and histologic details should result in its accurate recognition.

Histologic transformation of polymorphous low-grade adenocarcinoma of salivary gland

Polymorphous low-grade adenocarcinoma of salivary gland origin (PLGA) was initially described in 1984 and has since become an established clinicopathologic entity. Owing to the indolent nature of PLGA and its relatively recent description, the full clinicopathologic spectrum of this entity has not been elucidated fully. Transformation to a histologically different-appearing lesion or progression to a higher histologic grade has not been reported. We describe 2 PLGAs arising in the palate and associated with multiple locoregional recurrences that were treated with excision and radiation therapy. This was followed by histologic transformation to a higher grade neoplasm after 17 and 26 years, respectively. The histologic appearance after transformation was characterized by a predominantly solid and cystic growth pattern, nuclear atypia with prominent nucleoli, and foci of necrosis. High-grade transformation of PLGA may occur after a protracted clinical course with multiple recurrences of typical PLGA. The possible role of radiation therapy as an initiator of this transformation merits further study. Tumors with these histologic features should not be included under the rubric of typical PLGA. Segregation of these neoplasms will allow further study of their biologic potential, particularly with regard to possible increased rates of local recurrence and metastasis.

Inhibin is not an immunohistochemical marker for hepatocellular carcinoma. An example of the potential pitfall in diagnostic immunohistochemistry caused by endogenous biotin

Inhibin is a heterodimeric glycoprotein originally detected in gonadal tissues. One report described inhibin immunopositivity in 17 of 19 hepatocellular carcinomas (HCCs) and the hepatocytes of the surrounding nonneoplastic parenchyma. The reported immunohistochemical method, which used avidin-biotin complex, did not describe blocking endogenous biotin. Since liver tissue may contain high levels of biotin, endogenous biotin may result in false-positive immunostaining. We wondered whether this reported immunopositivity represented a false-positive result due to unblocked endogenous biotin. By using a similar antigen retrieval technique and the same specificity, titer, and clonal source of primary antibody as the aforementioned study, we performed immunostaining for inhibin with and without an endogenous biotin blocking step on 23 cases of HCC and the surrounding cirrhotic liver. In all cases, the HCC and the hepatocytes in the cirrhotic nodules were negative for inhibin when the endogenous biotin blocking step was used. When the blocking step was omitted, apparent immunostaining was noted in 20 of 23 HCCs and in the hepatocytes in all cases. Accordingly, HCC and the hepatocytes of the surrounding cirrhotic liver are immunohistochemically negative for inhibin. The previously reported immunopositivity of HCC and nontumoral hepatocytes for inhibin represents a false-positive result due to endogenous biotin.

Incidence of loss of heterozygosity at p53 and BRCA1 loci in serous surface carcinoma

Serous surface carcinoma (SSC) is a neoplasm histologically indistinguishable from typical serous carcinomas that arise from the ovary but has a distinct clinical presentation. It is characterized by widespread peritoneal dissemination at presentation, but the ovaries are grossly normal in size and shape. If the carcinoma involves the ovaries microscopically, the tumor is confined to the surface or is minimally invasive. The recognition of this entity is important, because in some studies it appears to have a poorer prognosis than stage-matched serous cancers of the ovary. Loss of heterozygosity (LOH) of the p53 (17p) and BRCA1 (17q) tumor suppressor genes has been frequently identified in sporadic ovarian carcinomas. Although 17p LOH is correlated with common p53 gene mutations, inactivating mutations of the BRCA1 gene are uncommon in sporadic ovarian cases. In contrast, germline BRCA1 mutations are responsible for some hereditary forms of ovarian cancer, where it has been suggested that germline BRCA1 mutations confer a more favorable prognosis. In this study, 12 sporadic SSC were assessed for the presence of allelic deletions on the p53 and BRCA1 gene loci. DNA from both tumor and normal cells was obtained for LOH studies using tissue microdissection. Polymerase chain reaction (PCR) amplification was performed with the polymorphic DNA markers TP53 (17p13.1/p53 gene) and D17S579 (17q/BRCA1 gene). LOH in the p53 and BRCA1 loci was detected in 62.5% and 66.6% of the cases, respectively. In 50% of tumors informative for both markers, it is possible that an entire chromosome may be lost. In conclusion, we have shown that LOH of the p53 and BRCA1 loci is a frequent event in sporadic SSC, similar to what has been described in the usual form of serous ovarian carcinoma. Mutational analysis will be necessary to determine the exact role of these genes in this group of tumors.

Determination of optimal freezing parameters of human prostate cancer in a nude mouse model

BACKGROUND

We sought to determine whether more than one freeze/thaw cycle is required and what minimum temperature reliably kills prostate cancer in vivo.

METHODS

Two human prostate cancer cell lines (LNCaP and PC3) were implanted subcutaneously in male nude BALB/c mice. Tumors were frozen with contemporary cryosurgery equipment and monitored for temperature, size, and serum prostate-specific antigen (PSA) measurements. The tumors were subjected to one or two freeze/thaw cycles through a wide range of temperatures from 0 - -80 degrees C.

RESULTS

These experiments show that a single freeze/thaw to a temperature < -40 degrees C is adequate to kill most tumor cells in this mouse model of prostate cancer.

CONCLUSIONS

Freezing prostate cancer to < -40 degrees C and ensuring that the entire tumor is frozen is more important than additional freeze/thaw cycles in this experimental model.

Comparison of methods to enumerate bacteria in dental unit water lines

Millipore HPC samplers are simple, self-contained test devices that can be used by personnel in dental offices who do not have microbiologic training to easily and economically monitor dental unit water quality without laboratory support. This study evaluated the correlation of HPC samplers to R2A agar for enumerating planktonic bacteria in dental unit treatment water. Eight different dental units were sampled. Five replicates were performed for each media at each dilution. The Pearson correlation coefficient between the R2A agar and HPC sampler is 0.89. These data suggest HPC samplers correlate with conventional laboratory-based R2A culture techniques for determining dental unit water line contamination.

Detection of the alpha-subunit of inhibin in trophoblastic neoplasia

Placental trophoblasts are the primary source of serum inhibin during pregnancy. We sought to characterize inhibin immunolabeling in trophoblastic neoplasms and compare the results with those for established markers of trophoblastic differentiation. Formalin-fixed, paraffin-embedded tissues from three normal term placentas, 13 hydatidiform moles (HM), five choriocarcinomas (CC) (three gestational, one testicular, one mediastinal), and five placental site trophoblastic tumors (PSTT) were immunolabeled with antibodies to the alpha-subunit of inhibin, hPL, and beta-hCG. Additionally, six first-trimester placentas were immunolabeled with antibody to inhibin alone. Trophoblastic subpopulations were assessed for the number of positive cells (1% to 24% = 1+,25% to 49% = 2+,50% to 74% = 3+, 75% to 100% = 4+). Immunolabeling in term placenta and HM was similar, because beta-hCG was the most sensitive marker (4+) of syncytiotrophoblasts followed by inhibin (3-4+) and hPL (2-3+). Immunolabeling of syncytiotrophoblasts in CC was similar to that in term placenta and HM, except for negative hPL staining in two cases. In HM, inhibin labeling of intermediate trophoblasts (2-3+) was less than that for hPL (3-4+). In CC, inhibin and hPL labeling of intermediate trophoblasts was more variable with negative hPL reactivity in two cases. Inhibin and hPL did not stain cytotrophoblasts. In PSTT, inhibin immunolabeling was a better marker than hPL in two cases, inferior in two, and similar in one. Inhibin labeling of syncytiotrophoblasts was less than that for beta-hCG, but did not have the often marked background staining that was present with beta-hCG. Immunolabeling of trophoblast subpopulations for inhibin was similar between first-trimester placenta, term placenta, and HM. We conclude that inhibin is a useful immunohistochemical marker of trophoblastic neoplasia and should be included in the antibody panel with beta-hCG and hPL.

Expression of androgen receptors in nasopharyngeal angiofibroma: an immunohistochemical study of 24 cases

Angiofibromas are uncommon benign tumors that typically occur in the lateral portion of the nasopharynx of adolescent boys. Numerous reports showed indirect evidence for the presence of sex-hormone receptors, i.e., androgen (AR), estrogen (ER), and progesterone (PR) receptors, in these tumors. The goal of the current study was to show direct evidence of sex hormone receptor expression in angiofibromas with use of sensitive immunocytochemical techniques and to document which cell populations express the receptor. Twenty-four nasopharyngeal angiofibromas were obtained from archived tissue, and immunocytochemical studies were performed with antibodies to AR, PR, and ER. Positive stromal and endothelial nuclear immunostaining, implying the presence of ARs, was seen in 18 (75%) of 24 cases, whereas 2 (8.3%) of 24 cases were positive with antibodies to PR. None of the 24 cases examined was positive with antibodies to ER. These results provide the first direct evidence for the presence of ARs in angiofibromas, which might help to explain the unique clinicopathologic features of these tumors.

Independent effects of food intake and insulin status on insulin-like growth factor-I in young pigs

The independent effects of decreased food intake and diabetic hyperglycemia on serum GH, serum IGF-I and tissue IGF-I expression were examined in young streptozotocin-diabetic pigs. Each of three treatments (control, diabetic, and insulin-treated diabetic) were represented within three levels of regulated food intake (FI) provided as three meals per day equivalent to 100, 50, and 10% of the voluntary FI consumed by the untreated diabetics. Reduction of food intake was associated with decreased body weight gains, decreased serum IGF-I concentrations, and increased serum GH concentrations. Nutrient restriction also tended to decrease the relative abundance of IGF-I mRNA in liver and skeletal muscle. Diabetic pigs with hyperglycemia and hypoinsulinemia had higher serum concentrations of IGF-I than pair-fed controls, but exogenous insulin treatment of these diabetic pigs increased serum IGF-I even further and also tended to increase the relative abundance of IGF-I mRNA in liver and skeletal muscle. When the statistical effects of reduced FI were eliminated, neither the present form of diabetes nor exogenous insulin affected serum GH. In summary, diabetes-induced changes in IGF-I in these pigs depended primarily on the reduced level of food intake occurring in these hypoinsulinemic, hyperglycemic subjects.

Pulmonary clear cell carcinoid tumor: another entity in the differential diagnosis of pulmonary clear cell neoplasia

A clear cell variant of primary pulmonary carcinoid tumor is described. The tumor arose in a 53-year-old woman who was incidentally found to have a solitary pulmonary nodule in the left upper lobe during routine chest roentgenography. Histologically, the tumor was composed of predominantly clear to lightly eosinophilic, polygonal cells with bland nuclei arranged in sheets and nests. Nuclear pleomorphism, necrosis, vascular invasion, and mitotic figures were not seen. The tumor cells were negative for oil-red-O and periodic acid-Schiff stains with and without diastase pretreatment on frozen and formalin-fixed sections, respectively. During immunohistochemical evaluation, the tumor cells were focally positive for cytokeratin and diffusely positive for neuron-specific enolase and chromogranin. Electron microscopy performed on paraffin block-retrieved tissue showed the presence of electron-dense, neurosecretory-type granules and variably sized vacuolated areas within the cytoplasm. the nature of which remained unclear. Intracytoplasmic glycogen or lipid were not identified. To our knowledge, this is the first report of pulmonary clear cell carcinoid tumor.