Acinar-endocrine cell tumor of the pancreas. Report of a pancreatic tumor containing both zymogen and neuroendocrine granules

A case of pancreatic tumor with features of both an acinar cell and an endocrine cell tumor is presented. The histologic appearance of the tumor by light microscopy was consistent with the appearance of either an islet cell tumor or an acinar cell tumor. Electron microscopy revealed two distinct populations of membrane bound granules within the same tumor cells; namely, a small granule measuring 100-200 nanometers in diameter with a narrow halo separating it from the granule membrane, and a large granule measuring 400-500 nanometers in diameter and having a closely applied membrane. The smaller granules have the characteristic appearance of gastroenteropancreatic (GEP) endocrine-cell granules. The large granules are greater in size than neuroendocrine granules, their morphologic structure is most consistent with that of zymogen granules, and a positive lipase stain supported the presence of zymogen granules within the tumor. The occurrence of both neuroendocrine and zymogen granules within the same cell has been previously described in the "intermediate cell" of the pancreas, but not to our knowledge in a tumor of the pancreas. The finding of both endocrine and exocrine granules within a single cell indicates a histogenetic relationship between the pancreatic endocrine and exocrine cells, and may represent the first reported case of a neoplastic proliferation of intermediate cells.

In vitro stimulation of phosphate uptake in isolated chick renal cells by 1,25-dihydroxycholecalciferol

Renal cells isolated from vitamin D-deficient chicks had an increased Na+-dependent phosphate uptake when preincubated with 1,25-dihydroxycholecalciferol [1,25-(OH)2D3]. Phosphate uptake in the absence of Na+ and methyl alpha-glucoside uptake dependent on Na+ were not affected. Phosphate uptake was stimulated 15% by 0.010 pM 1,25-(OH)2D3. Maximal enhancement of 30% was obtained with 100 pM. The uptake when fully stimulated by preincubation in vitro approximated the uptake of cells isolated from chicks that were previously repleted with 1,25-(OH)2D3 in vivo. Cells from repleted chicks were not stimulated additionally when preincubated with 1,25-(OH)2D3 in vitro. The increase in phosphate uptake could be measured after a 1-hr preincubation period; full response required at least 2 hr. Phosphate uptake induced by 1,25-(OH)2D3 was blocked by cycloheximide and actinomycin D. Enhancement of phosphate uptake was relatively specific for the 1,25-(OH)2D3 analog of vitamin D3. The potency order was 1,25-(OH)2D3 greater than 25-(OH)D3 = 1-(OH)D3 greater than 24,25-(OH)2D3 greater than D3. Kinetically, 1,25-(OH)2D3 increased the Vmax of the phosphate uptake system; the affinity for phosphate was unaffected. 3H-Labeled 1,25-(OH)2D3 was taken up by the isolated renal cells. It was estimated that the stimulation of phosphate uptake might be initiated by very few molecules of 1,25-(OH)2D3 per cell. It is proposed that 1,25-(OH)2D3 contributes importantly to the mechanisms by which phosphate transport is regulated in the kidney.

Effects of 1,25-(OH)2D3 administered in vivo on phosphate uptake by isolated chick renal cells

Renal cells from Vitamin D-deficient and 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]-repleted chicks were isolated by a collagenase-hyaluronidase procedure. Exclusion of trypan blue and respiratory measurements indicate that the cells were functionally intact and metabolically active. The uptakes of phosphate and alpha-methylglucoside were stimulated markedly by Na+ in the extracellular medium. Phosphate uptake in the presence of Na+ was saturable with respect to phosphate concentration; half-maximal activity was obtained with approximately 0.2 mM. Three hours after 1,25-(OH)2D3 was injected into vitamin D-deficient chicks the Na+-dependent phosphate uptake by the isolated cells had increased about 40%, i.e., 2.00 compared with 1.44 nmol.min-1.mg protein-1. Phosphate uptake in the presence of K+ in the extracellular medium and alpha-methylglucoside uptake in the presence or absence of Na+ were unchanged. In a secondary response found 17 h after 1,25-(OH)2D3 injection, Na+-dependent phosphate uptake decreased. Serum concentrations of phosphorus and calcium were not measurably changed in the 3-h repleted bird, but both levels were increased 17 h after treatment. Administration of phosphate into vitamin D-deficient chicks, so that the serum concentration of phosphorus was raised to that of the 17-h 1,25-(OH)2D3 repleted animal, effected a comparable decrease in phosphate uptake. Serum calcium levels were not altered by this treatment. The actions of parathyroid hormone in stimulating adenylate cyclase and in inhibiting phosphate uptake were notably blunted in the vitamin D-deficient chick. Sensitivity to parathyroid hormone was not restored until several days after 1,25-(OH)2D3 repletion. These findings suggest that the initial response to 1,25-(OH)2D3, to increase renal phosphate uptake, and the secondary response, to decrease phosphate uptake, were by parathyroid hormone-independent processes. The results also indicate that the isolated renal cell represents an excellent model for studying the mechanism by which 1,25-(OH)2D3 regulates phosphate transport in the kidney.

Chronic active hepatitis of hepatitis B and non-A, non-B etiology

Sixty-six consecutive liver biopsies demonstrating chronic hepatitis (CAH) were stained for the presence of HBsAg using the three-step peroxidaseantiperoxidase technique. Only cases of CAH thought to be attributable to either hepatitis B or non-A, non-B hepatitis were included in this series. Twenty-three of 30 biopsies taken from 24 patients with HBsAg-positive serum stained positively. None of the HBsAg sero-negative cases stained postively. Hepatocytes staining positively for HBsAg were generally few in number and randomly distributed within the liver lobules. Three cases of membranous staining were noted. After grading both the degree of inflammatory activity and the amount of HBsAg staining, we found that a statistically significant inverse relationship exists. The biopsies of six of the GBsAg sero-positive patients who had received steroid therapy for their liver disease did not stain differently from the biopsies of the remaining 18 HGsAg sero-positive patients. Stains for HBsAg may help in distinguishing acute hepatitis B (HB) superimposed on preexisting liver disease from hepatitis B-CAH (CAHB). This distinction may be possible because tissue staining almost always is negative in acute HB, whereas it often is focally positive in CAHB. This application of immunoperoxidase may be especially useful in patients who are drug addicts.

Sodium gradient-dependent phosphate transport in renal brush border membrane vesicles. Effect of an intravesicular greater than extravesicular proton gradient

A H+ gradient (intravesicular greater than extravesicular), in the absence of a Na+ gradient (extravesicular greater than intravesicular) stimulated phosphate uptake by renal brush border membrane vesicles and provided the driving force to effect the transient accumulation of phosphate against its concentration gradient. The H+ gradient-dependent uptake of phosphate had an absolute requirement for Na+. The rates of uptake and peak accumulation were functions of the delta pH and the concentration of H+ in the intravesicular medium. The H+ gradient-energized Na+-phosphate cotransport system was not affected by valinomycin- or carbonyl cyanide p-fluoromethoxyphenylhydrazone-induced ion diffusion potentials. Therefore, it was independent of the membrane potential, i.e. an electroneutral process. Amiloride, which inhibited the H+-Na+ exchange reaction and prevented the efflux of H+ from the intravesicular medium, enhanced the uptake of phosphate. A model is proposed by which the H+ gradient mediates the uphill transport of phosphate. It is suggested that a similar process may operate in more physiologically intact preparations and may provide one mechanism by which acid-base balance regulates renal phosphate transport.

Development of new mitomycin C and porfiromycin analogues

New mitomycin C and porfiromycin analogues were prepared by treating mitomycin A and N-methylmitomycin A with a variety of amines, including aziridines, allylamines, propargylamines, chloroalkylamines, hydroxyalkylamines, glycine derivatives, aralkylamines, and heterocyclic amines. All analogues were evaluated against P-388 murine leukemia and selected ones were examined for their leukopenic properties. Certain analogues were found to be superior to mitomycin C in potency, efficacy, and therapeutic ratio in the P-388 assay. The most active substituents at the mitosane 7 position included aziridine, 2-methylaziridine, propargylamine, furfurylamine, methyl glycinate, and 3-aminopyridine. Mitomycin A and the 7-aziridino, 7-(2-methylaziridino), and 3-aminopyridine analogues were less leukopenic than mitomycin C. Certain other analogues, including propargylamino and methyl glycinate, were highly leukopenic. The three compounds tested against B-16 melanoma in mice were significantly more effective than mitomycin C in this assay. Previously established structure--activity relationships were found inadequate to account for all of the new data.

Sodium gradient- and sodium plus potassium gradient-dependent L-glutamate uptake in renal basolateral membrane vesicles

A membrane preparation enriched in the basolateral segment of the plasma membrane was isolated from the rat renal cortex by a procedure that included separation of particulates on a self-generating Percoll gradient. The uptake of L-glutamate by the basolateral membrane vesicles was studied. A Na+ gradient (Na+]o greater than [Na+]i) stimulated the uptake of L-glutamate and provided the driving force for the uphill transport of the acidic amino acid, suggesting a Na+-L-glutamate cotransport system in the basolateral membrane. A K+ gradient ([K+]i greater than [K+]o) increased the uptake additionally. This effect was specific for K+(Rb+). The action of the K+ gradient in enhancing the uptake of L-glutamate had an absolute requirement for Na+. In the presence of Na+, but in the absence of a Na+ gradient. i.e., [Na+]o = [Na+]i, the K+ gradient also energized the concentrative uptake of L-glutamate. This effect of the K+ gradient was not attributable to an alteration in membrane potential. The finding of a concentrative uptake system for L-glutamate energized by both Na+ ([Na+]o greater than [Na+]i and K+ ([K+]o) gradients in the basolateral membrane, combined with previous reports of an ion gradient-dependent uphill transport system for this amino acid in the brush border membrane, suggests a mechanism by which L-glutamate is accumulated intracellularly in the renal proximal tubule to extraordinarily high concentrations.

In vitro effects of parathyroid hormone on kidney cortical slices: cAMP responses and concomitant inhibition of the Na+ gradient-dependent uptake of phosphate by brush border membrane vesicles isolated from the renal slices

Mouse renal cortical slices were incubated with parathyroid hormone (30 U/ml) for 2 min. Brush border membrane vesicles isolated from the treated slices had a decreased Na+ gradient-dependent uptake of phosphate. Concomitantly, the hormone elicited the activation of adenylate cyclase, the increase in tissue level of cAMP, and the enhancement of cAMP-dependent protein kinase.

Gentamicin uptake by renal tubule brush border membrane vesicles

The uptake of [3H]gentamicin by isolated rabbit renal proximal tubule brush border membrane vesicles was studied. Uptake was biphasic, with an initial rapid uptake followed by a prolonged slower phase. Approximately half of the total uptake represented binding; the other half represented transport into an intravesicular space. Scatchard analysis indicated the presence of two binding sites, differing in affinity (8 X 10(3) and 0.9 X 10(3) M-1) and number of sites per milligram of protein (1.2 and 3.7 nmol/mg of membrane protein, respectively). [3H]Gentamicin uptake was not affected by a Na+ electrochemical gradient, a valinomycin-generated (inside negative) K+ diffusion potential or the presence of phlorizin and D- of L-glucose. These findings indicate that the mechanism of uptake of the aminoglycoside was distinct from those of sugar and amino acids. Uptake of [3H]gentamicin was inhibited and reversed by the unlabeled aminoglycoside and by spermine. Spermine, on a molar basis, was as effective as gentamicin. These results suggest that gentamicin and spermine may have a common polyamine transport system and demonstrate the feasibility of further investigations to prevent aminoglycoside accumulation and possibly subsequent nephrotoxicity.

Pheochromocytoma in rats: incidence, etiology, morphology and functional activity

The incidence of spontaneous pheochromocytoma in rats varies with the strain, sex, age and diet of the animals. Treatment with growth hormone, estrogens, or radiation is associated with the occurrence of pheochromocytoma in the rat. Histological evidence and transplantation studies indicate that pheochromocytoma in rats possesses a low grade of malignancy. A transplantable radiation-induced pheochromocytoma model has been shown to be functionally active.

Urinary tract calculi in man and laboratory animals: incidence, composition, and etiology

Calculi in the urinary tract is a disease which afflicts not only man, but also experimental animals. The incidence of human stone disease varies widely according to the geographical area. With the advent of sophisticated physicochemical techniques, the elucidation of structure and the quantification of mineral components of urinary calculi have been greatly facilitated. In addition to calcium oxalate and calcium phosphate, more than ten other minerals and a large number of trace elements have been identified to date. Matrix material consists of such macro-molecules as proteins and mucopolysaccharides. The etiology of urinary calculi is varied; diet, drugs, chemicals, bladder implants, infections, metabolic derangements, and environmental influences are some of the factors that can contribute to the pathogenesis of stones. The literature findings reflect the complexity of urolithiasis as a clinicopathological problem.

Distribution and environmental synchronization of the marine insect, Halobates robustus, in the Galapagos islands

The following three aspects of the biology of the marine insect Halobates robustus were studied, during a two week observation period, at several sites in the Galapagos Islands: distribution, aggregation behaviour and rhythmicity of locomotory activity. H. robustus occurred in highest numbers on the water surface at shores fringed with mangroves. The aggregations of H. robustus varied according to their location and density. Copulating adults formed dense, floating aggregations, which tended to be close to rocks or mangroves. Late instar nymphs were less aggregated and, in lagoons (where there was some shelter from direct tidal forces), were furthest from the shore. In two types of habitat (mangrove-fringed, sandy shores and rocky shores) the aggregations of H. robustus showed a pronounced ability to maintain a floating station in relation to the surrounding environment, irrespective of tidal movements (in one case at 34 m from the nearest fixed objects). Evidence of the ability of the aggregations to maintain station on the water surface was also obtained by comparing the movements of H. robustus with those of floating polystyrene particles, which move passively with wind and tide. Laboratory observations and experiments indicated no clear periodicity in locomotory movements throughout a 24 h period. However, the frequency of encounters between individuals showed two daily peaks, post-dawn and pre-dusk, with fewer encounters during the day and only occasional encounters during the night. By shifting the light-dark cycle it was demonstrated that the daily bimodal rhythm of encounters is triggered by dawn and, since it is not maintained in constant light or dark, an 'hour-glass' mechanism is suggested. The contributions of single adults, of copulating pairs and of immature stages to the overall pattern of activity were also determined. Immature stages did not affect the overall rate of encounters significantly and the interactions between single and copulating pairs of adults appear to have been responsible for the bimodal pattern.

Who does what? Role definition in a psychiatric hospital

This is a report of an interdisciplinary workshop which was held to define the roles of different disciplines within a psychiatric unit. While the report emphasizes the medicolegal responsibility of the psychiatrists, we found, in a review of the knowledge background of the several disciplines, potentials for a further utilization of the knowledge which is acquired during their training. Meeting the patient's needs is the prime factor in determining the roles of the disciplines. The needs of the patient have expanded. Each discipline has both an exclusive role and an inclusive role. One important result of the workshop was the warmth and the esprit de corps that was felt afterwards.

The Münchausen syndrome as a psychiatric condition

In this presentation of two cases it is suggested that many Münchausen syndrome patients present with psychiatric symptoms. This syndrome, however, should be differentiated from other clinical psychiatric conditions.