Adrenocortical carcinoma in infancy. Report of a case with immunohistochemical and ultrastructural studies

A case of adrenocortical carcinoma associated with congenital heart defect in a 6-month-old Japanese girl is reported. A fist-sized tumor was incidentally noted in the right hypochondrium upon admission for cardiac surgery. No clinical endocrinopathy was evident in this case. The resected tumor was encapsulated with smooth surface and no invasion to adjacent tissues or organs was observed. Histologically, the tumor was composed of small cells with granular or clear cytoplasm, and occasional giant cells with single or multiple nuclei. By electron microscopy, the tumor cells showed various nuclear contours with distinct nucleoli and had a moderate amount of cytoplasm containing abundant rough endoplasmic reticulum and mitochondria with variable-sized electron-dense granules. Intercellular desmosome-like junctions were observed in some tumor cells. Immunohistochemically, the tumor cells contained granules positive for estriol, progesterone and cortisol. These morphological findings including electron microscopic features suggested that the tumor cells had a malignant character.

Hormone release by primary amniotic fluid cell cultures

Amniotic fluid cells have been widely used in prenatal diagnosis; however, there is great heterogeneity of the cells and their origin. In this study we analyze the karyotype and release of human chorionic gonadotropin (hCG), human chorionic somatomammotropin (hCS), free estriol (E 3), prolactin (PRL) and progesterone (P) of amniotic fluid cells from primary cultures of six normal and two anencephalic fetuses. In all the amniotic fluid samples there was release of hCG; in one amniotic fluid, in which several tetraploid colonies were found. PRL and P were also released. The heterogeneity of amniotic fluid cell morphology and their hormone release in culture was confirmed. The presence of hormones like hCG supports the trophoblastic origin of some amniotic fluid cells from normal and anencephalic fetuses. Other hormones, such as PRL and P could be used in the differential diagnosis between the karyotype of fetal membranes and the true fetal karyotype. Amniotic fluid cell cultures used in prenatal diagnosis yielded second trimester placental cells without any elaborate methods that could be used as cell models for hormone studies.

Saliva oestriol, oestradiol, oestrone and progesterone levels in pregnancy: spontaneous labour at term is preceded by a rise in the saliva oestriol:progesterone ratio

Saliva steroid levels reflect the unbound unconjugated (free, biologically active) plasma hormone levels. Saliva oestriol (E3), oestradiol (E2), oestrone (E1) and progesterone levels were estimated by radioimmunoassay in saliva samples obtained twice a week from 18 weeks gestation until 38 days before delivery and then daily until the spontaneous onset of labour at term from 20 normal pregnant women. The overall percentage increases in the median concentrations of E3, E2, E1 and progesterone were 718, 370, 80 and 214%, respectively, in the last 20 weeks and 149, 82, 24 and 41%, respectively, in the last 6 weeks of pregnancy. The median E3:progesterone ratio rose slowly from 0.65 at 20 weeks before delivery to 1.0 at 5 weeks before delivery and then rapidly to 1.65 one day before the spontaneous onset of labour. There was an increase in the E3:progesterone ratio from less than 1 to greater than 1 before labour in every subject.

Increased saliva oestriol to progesterone ratio before preterm delivery: a possible predictor for preterm labor?

Saliva oestriol, oestradiol, and progesterone concentrations were measured in 23 women who went into spontaneous preterm labour. The patients fell clinically and biochemically into two groups. The 13 who went into preterm labour with intact membranes had a saliva oestriol to progesterone ratio greater than one in every case and greater than the 95th centile for their length of gestation in 12 cases; by contrast, all those who went into spontaneous preterm labour after prolonged rupture of the membranes had an oestriol to progesterone ratio less than one and below the 50th centile for their period of gestation in the one to four days before delivery. Saliva oestradiol to progesterone ratios were randomly distributed throughout the normal range in both groups. It appears that preterm labour without prior prolonged rupture of the membranes is, like term labour, preceded by an increase in the saliva oestriol to progesterone ratio. It may therefore be possible to use this ratio to predict preterm labour.

Chemiluminescent labels for steroid immunoassays

During the last few years non-isotopic techniques have been developed to measure steroid hormones. One of these methods is the luminescence immunoassay. Three classes of substances have been found to yield reasonable results, i.e. aminophthalhydrazides, aminonaphthohydrazides and acridiniumesters. Examples of application are shown.

The use of disulfonatonaphthalimide fluorescent dyes for the fluorescence polarization immunoassay of steroids

A series of fluorescent disulfonatonaphthalimide derivatives of testosterone and estriol have been synthesized and their fluorescent properties investigated. The fluorescence lifetimes of these derivatives were higher than that of the unreacted fluorescent dye while the quantum yields were of the same order. The compounds were therefore compared in terms of their utilizability in steroid fluorescence polarization immunoassays. The assay sensitivity and precision with each compound is discussed in terms of the position, type, and length of the chemical "bridge" linking the steroid to the fluorescent dye. It is proposed that these fluorescent labels are highly appropriate to this type of immunoassay.

Hormone levels in the foetal and neonatal prostate

The prostates of 41 foetuses and neonates have been assayed for testosterone, 5 alpha-dihydrotestosterone (DHT), oestradiol and oestriol and the presence of these hormones has been demonstrated in all cases. Oestriol was found to be present in the highest concentration. A highly significant correlation was found between testosterone and DHT as well as between DHT and oestradiol. The correlation between oestriol and oestradiol was also significant. It has been pointed out that the presence of these hormones is essential for the growth and development of the prostate gland.

Immunocytochemical demonstration of steroid hormones in the granulosa cells of the medaka, Oryzias latipes

Immunocytochemical identification of steroid hormones was performed in granulosa cells isolated from large ovarian follicles of the medaka. The granulosa cells recovered from daily spawning females, 8.5 h after the onset of light, reacted with anti-progesterone and anti-17 alpha-hydroxyprogesterone antibody, while the granulosa cells treated 2.5 h after the onset of light did not. After 6 h stimulation with gonadotropin (PMS) in vitro, the isolated granulosa cells reacted with anti-progesterone antibody. The granulosa cells examined 8.5 h after the onset of light did not react with anti-estradiol or anti-estriol antibody. These results demonstrate that, in Oryzias latipes, progestins (progesterone and 17 alpha-hydroxyprogesterone) are synthesized in the granulosa cells which are directly stimulated by gonadotropin.

16 alpha-hydroxylation of estradiol: a possible risk marker for breast cancer

From these results we may conclude that estradiol 16 alpha-hydroxylation is highly correlated with tumor incidence, and that the reaction is partly regulated by MMTV and the rest by genetic influences. Elevated hydroxylation appears to be an autosomal dominant trait that is highly specific for estradiol. It is also pertinent that the product of the 16 alpha-hydroxyestrone reaction is a potent estrogen that is capable of binding covalently to amino acids and nucleotides, including the estrogen receptor molecule. The results obtained in these studies establish the usefulness of the mouse model for studying the interrelationship between enhanced 16-hydroxylation of estradiol and the incidence of mammary tumors.

Fate and residues of [4-14C]estradiol-17 beta after intramuscular injection into Holstein steer calves

Radiocarbon-labeled estra-1,3,5(10)-triene-3,17 beta-diol [4-14C-estradiol-17 beta; beta-estradiol] was suspended in commercial peanut oil and administered to each of three Holstein steer calves (142 to 170 kg body weight) by deep injection into neck muscle via 2.0 ml peanut oil carrier. The dosages were equivalent to .27 to .29 mg beta-estradiol/kg body weight. After dosing, radiocarbon was rapidly and almost totally eliminated in urine and feces. Most of the administered radiocarbon had been eliminated after 2 d, and by 11 d after treatment no radiocarbon was detectable in urine or feces of any calf. Of the total dose, 42.1 +/- 3.8% was excreted in urine and 57.7 +/- 5.2% was eliminated in feces. Analysis of noninjection site tissue samples (blood, brain, fat, kidney, liver and muscle) collected at sacrifice 14 d after treatment showed that none contained detectable radiocarbon residues, with the sensitivity limit for most tissues being 6 ppb beta-estradiol equivalent. Certain sections of muscle taken from the injection site area did contain detectable radiocarbon residues (as much as 69 ppb beta-estradiol equivalent), but total injection site area residues in each calf comprised less than .07% of the total administered dose. Radiocarbon in urine consisted primarily of alpha-estradiol, with much lesser amounts of estrone. Both compounds occurred as nonconjugates and as glucuronides. beta-Estradiol was not detected in urine. Radiocarbon in feces included primarily alpha-estradiol but also beta-estradiol and estrone, each in non-conjugated form. The fact that most of the intramuscular-administered beta-estradiol was eliminated in the feces strongly suggests a major role for biliary excretion in the disposition of this steroid by steer calves.

Salivary estriol as an index to fetal wellbeing

We adapted two commercially available kits for measuring serum estriol to use in assaying salivary estriol in the third trimester of pregnancy. Salivary estriol increases during gestation, as does unconjugated estriol in serum. With a meticulous collection protocol, fetal wellbeing can be monitored as successfully with saliva samples as with serum. A fetal demise was charted similarly by the salivary and the serum estriol assay. Inter- and intra-assay reproducibility (CV) of the saliva assay was 6.2%. Day-to-day CV, based on a fasting sample before breakfast but obtained 1 to 3 h after rising, was 14.8% (SD 5.8%). Values for salivary estriol obtained immediately after ingestion of food or drink dropped by 19.0% (SD 17.9%) and 32.1% (SD 21.9%), respectively, as compared with values determined immediately before intake of food or water.

Enzymeimmunoassay of unconjugated estriol in serum and saliva during pregnancy

An enzymeimmunoassay (EIA) for unconjugated estriol was developed. Estriol-6-CMO-BSA was used as antigen for the antiserum production with low cross reactivities to estrone (0.3%) and estradiol (0.17%). The enzyme conjugate (estriol-peroxidase) was prepared using the mixed anhydride reaction. The antibody bound estriol fraction was separated from the free fraction with the double antibody technique. The test requires a simple photometer for the measurement of enzyme label. The developed estriol-EIA needs a short incubation time (2 hrs). The normal values of estriol in serum were determined. The results are in good agreement with the results of RIA. Furthermore, we found an inverse diurnal rhythm of serum and salivary estriol in comparison to the cortisol level. Low estriol levels in the morning and high estriol concentration in the evening are indices of fetal health. Decreased estriol levels in the morning of several days were found in pathological pregnancies (intrauterine fetal death, fetal distress, hepatose).

Estriol and its conjugates in late pregnancy determined by extraction with Carbopack B and liquid chromatography with fluorometric detection

We report a method for measuring estriol and its intact conjugates in urine, serum, and amniotic fluid. A single assay can be done within about 50 min, eight samples assayed in less than 5 h. A 70-microL urine sample is diluted and the estriol conjugates are adsorbed from it onto graphitized carbon black (Carbopack B, Supelco). After two washings, the analytes are desorbed with chloroform/methanol (60/40, by vol) containing tetrapropylammonium bromide. After solvent evaporation, the residue is redissolved in 100 microL of water/acetonitrile and 20 microL is injected into the chromatograph. Or 1 mL of serum or 0.5 mL of amniotic fluid is deproteinized with cold methanol, then passed through the Carbopack column. After three washings, the estriol and its conjugates are desorbed and treated as for urine. Mean analytical recoveries of the analytes in any of these body fluids were within about 92-98%, except for estriol-3-sulfate-16 alpha-glucuronide in serum (mean recovery 88.3%). The limit of sensitivity is well below the concentrations of clinical interest, and the method is not susceptible to substantial interferences.

Steroid concentrations in human cervical tissue in relation to cervical ripening

Steroid concentrations in human cervical tissue were measured in order to study the mechanism of cervical ripening at term. Thirty-four women at 37 to 41 weeks of gestation were selected for the study and divided into two groups. Group A consisted of 21 cases with ripened cervix, and Group B consisted of 13 cases with non-ripened cervix. The condition of the cervix was judged by the Bishop's Score. Free and conjugated estrone (E1), estradiol (E2), estriol (E3), and dehydroepiandrosterone (DHA) concentrations in cervical tissue were measured by radioimmunoassay (RIA). Significantly higher concentrations of free E1, conjugated E2, E3 and DHA were found in Group A than in Group B. Cervical tissue during labor showed a further increase in the concentrations of these steroids. Pronounced increases of the steroid concentrations were noted following DHA-Sulfate (DHA-S) administration. These results suggest an intimate relationship between cervical ripening and steroid concentrations in cervical tissue during pregnancy.

Correlation of oestriol levels in saliva, plasma and urine of pregnant women

Unconjugated and total oestriol (E3) have been determined in saliva (S) and plasma (P) by radioimmunoassay using a highly specific antiserum against E3. Total oestrogens (E = E1 + E2 + E3) in urine were analysed by the Kober-Ittrich method. No correlation (P greater than 0.05) was found between unconjugated E3 (S) and total E (U) as well as total E3 (S) and total E (U). Total E3 (S) and unconjugated E3 (P), total E3 (S) and total E3 (P) correlated weakly (P less than 0.05 and greater than 0.01). The six remaining correlations were highly significant (P less than 0.001 or less than 0.0001).

An enzyme-linked immuno sorbent assay for salivary estriol during normal pregnancy

It has been recently demonstrated that the concentration of Estriol in saliva increases in the course of pregnancy, similarly to the plasmatic concentration of unconjugated and total Estriol. As an alternative to RIA, which is an expensive method and requires a highly specialized laboratory, there is now available a competitive, sensitive and rapid enzyme-linked immuno sorbent assay (ELISA) for Estriol in saliva and plasma. Aim of this study is to compare the levels of Estriol concentration, measured by RIA and by ELISA in saliva and plasma in seven women tested every week from the 30th week to the term of pregnancy.