[Bladder neoplasm in a patient with panarteritis nodosa treated with cyclophosphamide]

Cyclophosphamide is used both in the treatment of malignant and non-malignant diseases. Urinary neoplasms secondary to its use have been described. We discuss the case of a patient with panarteritis nodosa treated with cyclophosphamide during 63 months, with a total dose of 210 grams, and that showed a bladder neoplasm 8 years after beginning of the treatment. In patients receiving a total dose of cyclophosphamide over 85 grams, a follow-up of ten years minimum should be performed aimed to the early detection of secondary neoplasms.

Amelioration of lapine osteoarthritis by treatment with glycosaminoglycan-peptide association complex (Rumalon)

The chondroprotective potential of glycosaminoglycan-peptide association complex (GP-C) was examined in the medial meniscectomy model of lapine osteoarthritis (OA). Prophylactic treatment with increasing doses of intramuscular GP-C (0.05-0.5 ml/kg) caused a significant reduction in OA lesion area and histologic scores, and the effect on disease activity appeared to be dose related. The DNA and uronic acid contents of OA tissue were unaffected by prophylactic treatment with GP-C. However, levels of hydroxyproline in OA cartilage increased to near control levels with prophylactic treatment. Cartilage levels of active and total metalloproteinases that digest proteoglycans were elevated in rabbits with OA; prophylactic treatment with low-dose GP-C (0.05 ml/kg) produced a significant reduction in active, but not total, enzyme. Cartilage levels of tissue inhibitor of metalloproteinases in animals with OA were comparable with control levels, but rose with increasing doses of GP-C. We also investigated GP-C as a therapeutic treatment in animals that had already developed OA lesions. Carbon black retention and histologic score returned to near-normal after therapeutic treatment with GP-C. Uronic acid and hydroxyproline levels were decreased in OA cartilage. Therapeutic treatment with GP-C had no statistically significant effect on uronic acid levels, but was associated with increased hydroxyproline content in the cartilage. The changes in metalloproteinase and metalloproteinase inhibitor were similar to those found in the studies of prophylactic treatment. The findings in this animal model may help explain some of the beneficial effects of GP-C in human OA.

Pathogenesis of Salmonella enteritidis infection in laying chickens. I. Studies on egg transmission, clinical signs, fecal shedding, and serologic responses

Laying hens were inoculated orally, intracloacally (IC), or intravenously (IV) with Salmonella enteritidis phage type 8 isolates from a human (E700-87) eggs (Y-8P2), or the ovary of a hen (27A). Oral or IV inoculation of 2 x 10(8) to 4 x 10(8) colony-forming units (CFU) of E700-87 caused depression, anorexia, reduced egg production, diarrhea, and some mortality. Lower doses resulted in milder clinical signs. S. enteritidis was cultured from the shells of a few eggs but not from egg contents. Fecal shedding persisted for up to 6 weeks in some birds. Isolate Y-8P2 (10(6) CFU) also caused anorexia, diarrhea, and a drop in egg production. Hens inoculated orally or IC were less severely affected than those inoculated IV. Fecal shedding was intermittent and lasted up to 18 days. Eggshells from the IC-inoculated birds had the highest rate of contamination, and S. enteritidis was isolated from the albumen of 11 and yolk of three of 726 eggs. Oral inoculation of 10(6) CFU of isolate 27A resulted in a bacteremic infection with seeding of the liver, spleen, peritoneum, ovule, and oviduct. However, the birds remained clinically normal with normal egg production. S. enteritidis was cultured from the yolk and albumen of a small number of eggs until 11 days postinfection. Antigen prepared from S. enteritidis detected antibody in more sera than did commercially available S. pullorum antigen in agglutination tests.

[Treatment with interferon of systemic Langerhans-cell histiocytosis in an adult]

We report an adult patient with systemic Langerhans' cell histiocytosis (LHX), who was refractory to multiple chemotherapy courses and in whom a partial clinical and biological 3-month remission was achieved with alpha-2-interferon. The patient's response was associated with an increase in the rate of natural killer cells and to a return to normal of the H/S T-lymphocyte ratio. Immunological abnormalities have been reported in this condition, and it is now accepted that the most important one is a decrease in suppressor lymphocytes. However, it is not known whether these abnormalities are endogenous or exogenous. The experience with modifiers of the biological response for the treatment of LHX is scanty, but the probable immunological pathogenesis of the condition justifies a therapeutic trial of those agents in patients not responding to conventional therapy.

Capillary microscopy is a potentially useful method for detecting bleomycin vascular toxicity

Capillary microscopy is an easy, noninvasive procedure to examine in vivo the dermis capillaries of the nailfold. It has demonstrated clinical use in the etiologic study of Raynaud's phenomenon. We consider a "vascular activity pattern" to be present at capillary microscopy when one of the following associations is observed: tortuous capillary vessels plus ramifications with or without loss of a moderate amount of capillaries. Capillary tortuousity alone is not considered pathologic. It is well known that bleomycin (BLEO) can occasionally induce vascular-associated diseases. To examine the vascular damage produced by BLEO, we performed capillary microscopic studies on 40 patients with neoplasia, 21 of whom had received BLEO during the previous year. The maximum accumulated doses ranged from 15 to 379 U. The other 19 patients had advanced neoplasia, and 10 of them had received antitumoral combinations that did not contain BLEO. No one had clinical signs attributable to vascular toxicity. Twenty-six patients had no pathologic patterns (11 received BLEO and 15 did not). In the group of 14 patients with activity patterns, 10 had received BLEO and 4 had not (P = 0.035). Ten of 11 patients treated with BLEO who had normal capillary microscopic studies received total doses of less than 100 U. We conclude that capillary microscopy may demonstrate the vascular damage induced by BLEO even in asymptomatic patients.

Ifosfamide + mitoxantrone in advanced breast cancer previously treated with anthracyclines

We treated 19 patients previously exposed to anthracyclines (progression during therapy or after discontinuation of therapy) with ifosfamide (IFO) 2 g/m2 i.v. in a 1-h infusion daily for 3 days with mesna uroprotection and mitoxantrone (MZT) 12 mg/m2 on day 1 of every 3-week cycle. The response rate was assessed after two cycles. A response to treatment was observed in 6 of 15 evaluable patients (40%), with no complete remission and 6 partial remissions. The median duration of response was 6+ months (3+ to 12+). The toxicity was acceptable, with three episodes of grade 3-4 myelosuppression (8%) and one case of congestive heart failure resulting from a fluid overload that responded to medical treatment. The IFO-MZT combination is an effective second-line regimen in advanced breast cancer previously treated with anthracyclines.

Epithelioid hemangioendothelioma of the liver with myocardial metastases

Epithelioid hemangioendothelioma is an unusual type of endothelial-derived vascular tumor located mainly in the soft tissues of the limbs. The present report describes a 48-year-old woman with an epithelioid hemangioendothelioma located in the liver with very unusual metastases to the myocardium. While the disease itself was controlled by adriamycin the patient died as a consequence of portal hypertension due to the abundant fibrotic component distinctive of this type of tumor. An epithelioid appearance can sometimes lead to a mistaken diagnosis of metastatic carcinoma, as happened initially in our case. The endothelial origin of the tumor must be confirmed by electron microscope identification of Weibel-Palade bodies or by immunohistochemical staining of factor VIII-related antigen. To the authors knowledge, this is the first case of myocardial metastases from an epithelioid hemangioendothelioma of the liver to be reported in English in the medical literature.

[Intracellular ATP content and nonactin biosynthesis]

The effect of potassium orthophosphate on growth of the mycelium, its ATP contents and biosynthesis of the macrotetrolide antibiotic nonactin by Str. chrysomallus var. macrotetrolidi was studied. Direct dependence of the ATP contents in the mycelium on the amount of the phosphate added to the medium and consumed by the developing actinomycete was shown. Changes in the intracellular content of ATP depended also on the mycelium age. It was characterized by two peaks. Hemin was detected in the actinomycete mycelium. Its levels were sufficiently high and depended on the mycelium age and cultivation conditions, in particular on the phosphate content in the medium. Higher levels of nonactin biosynthesis were characteristic of the mycelium with lower contents of ATP, proteins and hemin. Intensive production of the antibiotic proceeded at the background of decreasing levels of ATP in the mycelium.

Effect of the hypothyroidism on the levels of different metabolites in pregnant rats

The effect of gestational hypothyroidism on some maternal and foetal metabolites were studied on pregnant rats after 24 h fasting. Thyroidectomy induced a decrease in body weight in the pregnant rats. Their foetuses showed lower weights than the controls. No difference was found in circulating glucose levels in the thyroidectomized pregnant rats, although an increase was found in their foetuses. Hepatic glycogen and total serum lipids decrease in hypothyroid pregnant rats. Cholesterol concentration increases as a result of hypothyroidism. However, foetuses coming from thyroidectomized mothers show an increase in their total lipid levels. Hypothyroidism in pregnant rats affects foetal development and metabolic changes are greatly manifested in the starved condition.

NTP pyrophosphohydrolase in human chondrocalcinotic and osteoarthritic cartilage. II. Further studies on histologic and subcellular distribution

A nucleoside triphosphate (NTP) pyrophosphohydrolase was previously demonstrated in human chondrocalcinotic and osteoarthritic articular cartilage. In this study, grinding and enzymatic techniques for cartilage subcellular fractionation were compared. It was shown that this enzyme was concentrated in fractions enriched in plasma membranes. The enzyme had the same activity in cartilage slices as in triton X-100 extracts, and all of the activity was removed by preliminary treatment of cartilage slices with pronase. Histologic separation of cartilages into tangential and upper radial versus lower radial zones indicated no difference in concentrations of this enzyme. A role is postulated for this enzyme in metabolic chondrocytic plasma membrane responses to injury or destabilization from other causes, such as rapid synthesis or cell division.

NTP pyrophosphohydrolase in human chondrocalcinotic and osteoarthritic cartilage. I. Some biochemical characteristics

Nucleoside triphosphate pyrophosphohydrolase activity was first detected in articular cartilage in previous studies at our laboratory. In this report, the enzyme is partially characterized with respect to its pH optimum and Km. The enzyme was metal-dependent and was active in the presence of 1 mM Ca++. It was inhibited by several substances, including cysteine and dithiothreitol. Its activity was not inhibited by tetramisole at concentrations which inhibited 100% of the pyrophosphatase activity in the same extracts. It functioned most effectively on ATP, but also on UTP, CTP, and GTP. A role for scavenging nucleotides and production of pyrophosphate in osteoarthritic and chondrocalcinotic cartilage is postulated.

[Neonatal osteoarthritis. Report on 24 cases (author's transl)]

Twenty four neonates affected of osteoarticular infection, treated on the Neonatal Unit throughout a four and a half year period are analyzed. In the majority of instances they represent a complication in the course of neonatal sepsis. In more than half of them there was a previous umbilical vessel catheterization. "Staphilococcus aureus" was the most frequent etiologic agent. Involvement of the hip was the location more often seen and of worse prognosis. Treatment besides of supportative measures, and specific antibiotic therapy, included posterior arthrotomy in the 13 cases of hip arthritis, and diagnostic puncture and/or arthrotomy in the rest of locations. There was no mortality, and only 20% of the patients exhibits long-term residual defects of variable degree.