Hyperreactio luteinalis in normal singleton pregnancy

A case of hyperreactio luteinalis in a patient with normal singleton pregnancy is reported. The course of pregnancy had been normal until the 24th week of gestation, when the mother developed lower abdominal pain and signs of virilization. She delivered of a normal female infant at 39 weeks' gestation. The baby did not show any signs of masculinization. Serum testosterone, delta 4-androstene-dione, and 5 alpha-dihydrotestosterone of the mother were markedly elevated. They remained high after the delivery but returned to the normal ranges soon after the partial resection of the enlarged ovaries. Reported causes of hyperreactio luteinalis are reviewed. Their maternal serum androgen levels were compared with cases of luteoma of pregnancy.

Calcified chronic subdural hematoma with intracerebral rupture forming a subcortical hematoma. A case report

We report a calcified chronic subdural hematoma which ruptured intracerebrally forming an acute subcortical hematoma in the frontal lobe in a 59-year-old woman with long-standing liver cirrhosis. Both hematoma cavities communicated each other through a small defect within the inner membrane of the subdural hematoma. The content of both hematomas was identical and was of a clay-like clot. The inner membrane around this communication consisted of thick, very vascular granulation tissue with many hemosiderin deposits and was tightly adherent to the cortex. We speculated that a fresh bleeding into the granulation tissue resulted in formation of a subcortical hematoma through a rupture of the inner membrane. Disseminated intravascular coagulation likely played an important role in this unusual condition.

Clinicopathologic study of squamous cell carcinoma of the ovary

Clinicopathologic study was performed on 10 squamous cell carcinomas of the ovary. All four patients with stage II or III lesions had deteriorated within 1 year after the operation, and four of six patients with stage I lesions had survived over 5 years. Clinical findings of the patients with ovarian SCC, including age, chief complaint, clinical stage, and outcome of the patients, were similar to those of common epithelial cancer. The effectiveness of chemotherapy was not shown in this study. Histopathologic study revealed that squamous cell carcinoma may arise not only from epidermis, but also from squamous metaplastic epithelium of respiratory gland.

Carcinoma of the uterine cervix with variegated histological patterns and calcitonin production

This is a report of a calcitonin-producing cervical cancer with variegated histological patterns. The levels of calcitonin correlated with the clinical course. Multiple lung metastases were completely controlled by cisplatin/Adriamycin/cyclophasphamide combination chemotherapy, although only for a short period. Microscopically, the tumor showed dominant small cell carcinoma; however, it did show differentiation into large cell nonkeratinizing carcinoma, keratinizing carcinoma, adenocarcinoma, and possibly carcinoid. Ultrastructural study revealed a few dense core secretory granules. Multiple immunohistochemical studies were performed. It is presumed that the tumor originated from the totipotent, immature precursor cells in the cervix and differentiated into endocrine carcinoma, squamous cell cancer, and adenocarcinoma.

Squamous cell carcinoma arising in mature cystic teratoma of the ovary. Clinicopathologic and topographic analysis

Clinical and pathologic features of 28 patients with squamous cell carcinoma (SCC) arising in mature cystic teratoma (MCT) of the ovary were analyzed. The overall 5-year survival rate of these patients was 52%. Clinical staging (Stage I versus Stages II or more), histologic differentiation (well versus moderately or poorly differentiated SCC), and the presence of vascular invasion were factors affecting the prognosis of these patients. In 11 tumors, including 2 of the 4 examined in stepwise serial sections, the SCC was considered to have originated from a columnar epithelium (ciliated or nonciliated) or from a metaplastic squamous epithelium. On the other hand, no SCC was a direct transition from the ordinary epidermis of the teratomatous skin tissue. These results strongly support the proposal that SCC arising in MCT derives from the columnar epithelium.

[Clinical signification of localization of S protein and late components in the skin from lupus patients]

We studied frozen tissue of lesional skin and normal-appearing skin from SLE patients and DLE patients by immunofluorescence. S-protein and late components (C5, C7, C9) were localized at the dermal-epidermal junction of the lesional skin from SLE and DLE patients. All specimens of normal-appearing skin from patients with SLE were free of deposits of S-protein and late components. These results suggest that late components may play a role in the development of skin lesions of SLE and DLE.

Primary malignant lymphoma of the uterine corpus and cervix. Report of a case with immunocytochemical analysis

In a 69-year-old woman, a gynecologic smear was the first indication of the presence of a nonepithelial malignant tumor. While first thought to represent an adenocarcinoma, malignant lymphoma was later cytologically suspected because of the presence of isolated large malignant cells with macronucleoli. The initial clinical and histologic studies failed to indicate a malignancy. The malignant cells in postoperative tissue samples showed a positive immunohistochemical reaction for leukocyte-common antigen (LCA) and a negative reaction for epithelial membrane antigen, confirming the cytologic suggestion of a uterine lymphoma. Immunocytochemical staining subsequently performed on the destained cytologic specimen gave a positive immunoreactivity to LCA in the cytoplasm of the malignant cells.

Ovarian sarcoma with histologic features of telangiectatic osteosarcoma of the bone

A primary osteosarcoma occurred in the left ovary of a 47-year-old Japanese woman. The preoperative diagnosis, based on computerized tomography, was cystic teratoma. The excised tumor was composed of large multilocular cysts containing blood and associated with an area of solid tissue. Histologically, the tumor was a "pure" osteosarcoma that showed prominent cellular anaplasia and blood-filled spaces lined with tumor cells. The lesion resembled a telangiectatic osteosarcoma of bone. Serum alkaline phosphatase levels reflected progression of the disease. Despite aggressive adjuvant chemotherapy, the patient died 8 months later of a local recurrence and intra-abdominal spread of the tumor.

Adenomatoid tumor of the ovary: an immunohistochemical and ultrastructural study

A rare case of adenomatoid tumor arising in the ovary is presented. At autopsy on a 61-year-old woman, a soft, solid and cystic tumor, measuring 0.8 X 0.7 cm, was detected in the hilus of the left ovary. Light microscopic study showed characteristic features of adenomatoid tumor. Alcian blue stain, with and without hyaluronidase pretreatment, revealed the presence of hyaluronic acid on the luminal surface and in the vacuoles of the tumor cells. Immunohistochemical stains of tumor cells were positive for low-molecular-weight cytokeratin (PKKL), vimentin, and carbohydrate antigen (CA) 125, whereas they were focally positive for high-molecular-weight cytokeratin (34 beta E12). They were negative for factor VIII-related antigen (FVIII-RAG), Ulex europaeus I lectin (UEA I), carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA). Ultrastructural studies disclosed surface microvilli and bundles of tonofilaments. These observations strongly support the idea of this tumor being of mesothelial origin.

Rescue of cells from ras oncogene-induced growth arrest by a second, complementing, oncogene

Established REF52 cells (rat embryo fibroblasts) completely resist stable transformation by ras oncogenes, and simian virus 40 large tumor (T) antigen collaborates with ras to convert REF52 cells to tumorigenic state. A temperature-sensitive simian virus 40 large T antigen (encoded by tsA58) allowed the T24 Ha-ras oncogene to transform REF52 cells in a temperature-dependent manner. Two thirds of the clones transformed with tsA58 and ras became arrested in G2 or late S phase when shifted to a nonpermissive temperature for T antigen stability. Thus, ras induced growth arrest rather than stable transformation in the absence of a functional collaborating oncogene. These results indicate that collaborating oncogenes can regulate cellular responses to ras and have implications regarding therapeutic strategies to control tumor cells expressing activated ras oncogenes.

Choroidal epithelial cyst of the prepontine region: case report and ultrastructural study

A case of choroidal epithelial cyst of the prepontine region is reported. The cyst wall was studied using light and electron microscopy. Electron microscopy revealed that the lining of the cyst consisted of a single layer of epithelial cells resting on a basement membrane. The epithelial cells contained numerous club-shaped microvilli and occasional cilia. There were no coating materials on the surface of the microvilli. Tight junctions and interdigitations were present between contiguous cells. The blood vessels were fenestrated. These ultrastructural findings suggest that the epithelial cyst was derived from the choroidal epithelium rather than ependyma or endodermal tissue.

[Effect of tamoxifen on the treatment of pituitary adenomas with bromocriptine]

Administration of 2-Br- alpha-ergocryptine (bromocriptine = CB-154) in combination with an estrogen-receptor blocking agent tamoxifen were performed in two patients with prolactinoma and non-functioning adenoma, respectively. Case 1 was a 50-year-old male with hyperprolactinemia, impaired pituitary function and visual disorders, in whom a large invasive sellar mass lesion was disclosed by CT scans, which extended supra- and parasellarly and extracranially into paranasal sinuses and pterygopalatine fossa on the left side. As the effect of bromocriptine therapy was partial in tumor size reduction and decrease of serum PRL level and it could not be gained further improvement except for the well recovered visual acuity, tamoxifen was used together with bromocriptine resulting further reduction of tumor size and normalization of serum PRL level. Unexpectedly the medication was ceased during and after a couple of bypass surgery for angina pectoris, and it was followed by elevation of serum PRL level and regrowth of the sellar tumor as well as impairment of vision. By tamoxifen therapy the visual acuity showed some improvement, but the serum PRL level and the tumor size remained as before. Then the combination therapy with bromocriptine and tamoxifen was started again. Case 2 was a 38-year-old female with three children, who had secondary amenorrhea, galactorrhea, borderline level of serum PRL with impaired pituitary function and visual disorders. Under the diagnosis of a non-functioning pituitary adenoma with supra-sellar extension, a craniotomy was done and intracapsular partial removal of the tumor was made, revealing a chromophobe adenoma in light microscopy and undifferentiated cell adenoma in electron-micrographs.(ABSTRACT TRUNCATED AT 250 WORDS)

Synergistic effects of the myc and ras oncogenes on ganglioside synthesis by BALB/c 3T3 fibroblasts

The effects of oncogene activation on glycosphingolipid (GSL) synthesis by a mouse fibroblast clonal cell line were studied. A transfectant that expressed the activated ras gene showed a definite change in the composition of acidic GSLs, probably an increase in polysialoganglioside, while one that expressed the myc gene showed only a slight change. Neither transfectant grew in soft agar. However, another transfectant, which expressed both the myc and ras genes, and grew in soft agar, showed a more dramatic increase in the acidic GSL component. Thus, activations of the myc and ras oncogenes have a synergistic effect on GSL synthesis during transformation.

[Influence of immunopotentiators on the activation of 5-FU derivatives]

As it has been shown that various kinds of immunopotentiators inhibit the hepatic microsomal drug-metabolizing enzymes and reduce the activation of masked compounds such as tegafur, we investigated the influence of immunopotentiators (OK-432 and PSK) on the activation of carmofur (HCFU), which is known to be transformed spontaneously in to the tumor-active substance, 5-fluorouracil (5-FU), in vivo, and compared the results to those obtained for tegafur. After oral administration of tegafur, the area under the plasma concentration curves of 5-FU in rats pretreated with OK-432 and PSK were 72% and 79% of those in untreated rats, while in the case of HCFU almost similar plasma concentration curves for 5-FU were obtained in both treated and untreated rats. These results show that the activation of HCFU to 5-FU is not influenced by treatment with these immunopotentiators. Furthermore, our clinical investigation showed that the survival curves of cancer patients given combination therapy of tegafur with OK-432 tended to be lower than those given a single therapy of tegafur, supporting the above mentioned basic results.

[Intrauterine treatment of nonimmunologic hydrops fetalis associated with pleural effusion]

Four fetuses with nonimmunologic hydrops fetalis were treated in utero. The initial diagnosis was made between 27 and 32 weeks of gestation. All fetuses had generalized edema and pleural effusion at the time of diagnosis. In order to maintain plasma colloid osmotic pressure in the fetus, fetal transfusion of albumin was carried out. Because pleural effusion may inhibit fetal lung development, serial in utero thoracocentesis guided by ultrasonic tomography was carried out. In three of four fetuses, cord blood albumin concentration were within normal range. Urine volume in fetuses significantly increased after fetal transfusion of albumin. These results suggested that this procedure was useful in maintaining plasma colloid osmotic pressure in the fetus. Although pleural effusion was removed completely by in utero thoracocentesis, pleural effusion appeared within 1 hour after the procedure and rapidly increased thereafter until the 24th hour. There were no fatal trauma from the procedure. In all infants, generalized edema, ascites and pleural effusion were presented at birth, and Apgar scores at one minute were less than 7. All died of pulmonary insufficiency within 16 hours after delivery. At autopsy, their lungs were smaller than those of the other infants.

Dose-dependent pharmacokinetics of aprindine in healthy volunteers

The disposition of aprindine following a single oral dose can best be described by a two-compartment open model. The mean plasma half-life (t 1/2 beta) increased from 8.0 +/- 2.1 h (SD) after a 25 mg dose of 9.4 +/- 2.9 h after 50 mg and to 15.8 +/- 2.6 h after 100 mg, with a decrease in total plasma clearance (Cl/F) and volume of distribution at steady state (V dss/F) and during beta-phase (V d beta/F). The area under plasma concentration-time curve (AUC), maximum plasma concentration (C max) and the amount of unchanged aprindine excreted in the urine increased in a non-linear fashion with the increase in dose. The t 1/2 beta after multiple oral doses showed a 3-fold increase over the single dose value. These results indicate that aprindine shows dose-dependent non-linear kinetics.

A new tumor-promoting agent, dihydroteleocidin B, markedly enhances chemically induced malignant cell transformation

Teleocidin, which was isolated from mycelia of Streptomyces, is a potent tumor promoter in mouse skin. The catalytically hydrogenated compound dihydroteleocidin B markedly enhanced malignant cell transformation induced by 3-methylcholanthrene or ultraviolet radiation. Dihydroteleocidin B was at least 100 times more effective in enhancing transformation than 12-O-tetradecanoyl phorbol-13-acetate, the strongest promoter known until now, whereas both promoters showed equal capacities to induce early membrane effects and DNA synthesis.