[Pregnancy and motherhood after liver transplantation in terminal autoimmune active hepatitis with primary amenorrhea]

We report the case of a young patient with end-stage auto-immune chronic active hepatitis and primary amenorrhea who became pregnant 18 months after orthotopic liver transplantation. She continued an uncomplicated pregnancy on treatment with ciclosporin A and spontaneously gave birth to a full term and healthy child.

Magnetically coupled crystal holder and liquid-helium cryostat for X-ray four-circle diffractometer studies between 5 and 300 K

A new low-temperature system for X-ray four-circle diffractometer studies down to 5 K has been developed. The crystal is mounted on a new holder which is magnetically coupled to the diffractometer. This coupling is achieved by mounting a master magnet in place of the classical goniometer head. This master magnet drives a slave magnet fixed on the new crystal holder, and therefore the crystal is indirectly oriented by the master magnet. This magnetically coupled crystal holder (MCCH) is enclosed in a helium-flow cryostat which remains stationary during the φ, χ and to movements. The χ value is limited to ±65° and ω to 40° for a 150 mm diameter χ circle. All the tests and data collections (from 5 to 15 d) gave accuracies on the intensities, cell parameters and atomic positions identical to those obtained with a classical goniometer head. No frost problem occurs with this apparatus. The MCCH may also have applications in controlled-atmosphere, high-pressure or vacuum investigations.

Comparative study of neuroma formation in the rat sciatic nerve after CO2 laser and scalpel neurectomy in combination with milliwatt CO2 laser "sealing"

Nerve transections of rat sciatic nerves were performed to compare scalpel neurectomy to CO2 laser neurectomy. Additionally, the effect of milliwatt CO2 laser application to the proximal nerve ending was studied. Animals were sacrificed at 1 to 9 weeks, and the neuromas were examined histologically and measured. Scalpel transections produced typical neuromas. Laser transections produced neuromas characterized by multinucleated giant cells and carbonaceous debris. There was no difference in the size of the neuromas produced by either method of transection. Milliwatt CO2 laser application to the proximal stump did not affect the size or histology of resultant neuroma formation regardless of the method of transection.

Purification and characterization of two distinct forms of rat adrenal cytochrome P450(11) beta: functional and structural aspects

It is generally accepted that the last three steps of aldosterone biosynthesis are catalyzed by a single enzyme, i.e., cytochrome P450(11) beta (P450XIB). We have previously reported that rat adrenal mitochondria may be capable of producing two forms of P450(11) beta which differ in molecular weight (49 and 51 kDa). In the present study we describe the purification, the enzymatic activities, and some structural properties of these two proteins. Using zona fasciculata mitochondria, the 51-kDa protein was purified to electrophoretic homogeneity by means of octyl-Sepharose chromatography. In a reconstituted system the protein catalyzed 18- and 11 beta-hydroxylation of deoxycorticosterone, but exhibited no 18-hydroxylation or 18-hydroxydehydrogenation of corticosterone. The 49-kDa protein was isolated from zona glomerulosa mitochondria of rats kept on a low-sodium, high-potassium regimen. Using octyl-Sepharose chromatography, it could be separated from the 51-kDa protein. A reconstituted eluate fraction, containing the 49-kDa protein, converted deoxycorticosterone not only to 18-OH-deoxycorticosterone and corticosterone, but also to 18-OH-corticosterone and aldosterone. These findings indicate that the rat adrenal cortex is capable of producing two distinct forms of active cytochrome P450(11) beta. A structural relationship of the 49- and 51-kDa proteins was indicated by experiments involving limited proteolysis. Thus, digestion with alpha-chymotrypsin and V8-protease yielded very similar peptide maps for both proteins. During potassium repletion of potassium-deficient rats, the disappearance of the active 51-kDa protein coincided with the appearance of the 49-kDa protein. These results are suggestive of a post-translational processing mechanism converting the 51-kDa protein into the smaller 49-kDa form. However, the 49-kDa protein might also be encoded by a distinct gene, regulated separately depending on the physiological conditions.

Regulation of mammalian melanogenesis by tyrosinase inhibition

Melanocyte stimulating hormone (MSH) specifically induces differentiation of mammalian melanocytes. To further define the biochemical events elicited by this stimulus, we have cloned murine melanoma cells which are either highly responsive or nonresponsive to MSH, and have examined their ultrastructural appearance, their melanogenic activities, and also their expression of tyrosinase. We have found that the basal levels of melanogenic activity in pigmented and nonpigmented cells correlate with expression of surface MSH receptors rather than with production of tyrosinase. Nonpigmented cells produce a potent, highly stable inhibitor of melanogenesis; this inhibitor acts directly on tyrosinase to dramatically and abruptly suppress melanin production. This posttranslational control of tyrosinase activity may represent a critical regulatory point in mammalian pigmentation.

Effect of stress from the glue on single-crystal X-ray intensities at high or low temperatures

For high- or low-temperature single-crystal X-ray data collection, the glues used to bind crystals to silica rods may induce strong modifications of the intensities. When an yttrium iron garnet (YIG) crystal was cooled, reflections which were equivalent at room temperature became different. This is explained by strong stresses of the glue on the crystal which lead to an anisotropic modification of the secondary extinction. At low temperatures, `glues' such as beeswax or paraffin do not exert stresses.

Respiratory epithelial cyst of the cerebellopontine angle

A case of a 29-year-old woman with a cystic lesion in the right cerebellopontine angle, who had three bouts of chemical meningitis in 1 year, is reported. The lesion proved to be a delicate, thin-walled cyst, in part with a squamous lining and in part with a respiratory epithelial (tall, columnar, ciliated, mucus-secreting) lining. Various possibilities to explain this unusual epithelium are explored.

Intramedullary spinal Histoplasma granuloma. Case report

While there have been several cases of cerebral histoplasmoma published in the literature, the occurrence of such a lesion in an intramedullary spinal location has not previously been reported. The authors present a patient with a Brown-Séquard lesion secondary to an intramedullary Histoplasma granuloma in the cervical region. The case was successfully managed with surgical removal of the lesion.

[A rare etiology of acute occlusion of the small intestine: anisakiasis. Review of the literature apropos of a case]

The authors report a case of acute small bowel occlusion related to anisakis. This parasitis is due to ingestion by man, an unusual host, of a nematode of "anisakis" type at larva stage, a parasite to be found in numerous species of raw or home-processed fish. The parasite whose symptomatology is aspecific, can be located on the whole digestive tube. Diagnosis suggested by medical inquiry along with eosinophily, can be confirmed by serology and discovery of the parasite after anatomo-pathologic analysis. Medical treatment consisting in associating anti-parasite medicines with corticoids in certain cases, is recommended in diffuse forms and allergic signs of disease. Surgical complications make the laparotomy necessary for appropriate diagnosis and curing of the patient. Increasing frequency of this pathology shows the importance of prophylactic measures such as: abstaining from raw or home-processed fish, cooking fish at a temperature of 60 degrees C, deep-freezing fish at a temperature of -20 degrees C for 24 h at least, before eating it raw.

Variability of cellular responsiveness to ADH stimulation in toad urinary bladder

The hydrosmotic response of toad bladder to antidiuretic hormone (ADH) is quantitatively linked to the induced fusion of aggrephores with, and the appearance of aggregates of tightly packed intramembrane particles in the luminal membrane of granular cells. We used these morphological indexes of hormonally induced cell activation 1) to assess the variability of individual cell responsiveness to a maximally stimulating concentration of ADH and 2) to compare cell response patterns in paired tissues where the extent of whole tissue stimulation, as evidenced by transtissue water flow, was either maximal or submaximal. The results indicate that individual cell responsiveness within the same tissue to standardized maximal ADH treatment varies between two- and sevenfold, depending on the morphological endpoint measured. Furthermore, based on skewness in endpoint distribution, this variability appears to reflect inherent heterogeneity of granular cell reactivity to hormone. In relation to proportional tissue responses elicited by different stimulating concentrations of ADH, our observations of luminal membrane aggregate incidence suggest that the responding cells, whatever their sensitivity, participate in a graded, rather than "all-or-none," "on-off" manner.

Combined 17-hydroxylase and 17,20-desmolase deficiencies: evidence for synthesis of a defective cytochrome P450c17

We studied in vivo and in vitro steroidogenesis in six phenotypic female children with 17-hydroxylase deficiency. The diagnosis was suspected as a likely cause of familial low renin hypertension and was confirmed by findings of reduced basal and ACTH-stimulated serum and urinary levels of cortisol and other 17-hydroxysteroids, together with hypergonadotropic hypogonadism in both 46,XY and 46,XX patients, and abnormally increased secretion of 17-desoxysteroids, such as progesterone, 11-deoxycorticosterone, and corticosterone. ACTH stimulation testing demonstrated a lesser degree of 17-hydroxylase deficiency in the obligate heterozygous parents; one father had increased basal serum 17-hydroxyprogesterone values, unresponsive to ACTH, suggesting partial Leydig cell 17,20-desmolase deficiency. In vitro kinetic analysis of testicular microsomal enzymes in the affected 46,XY male pseudohermaphrodites confirmed that both 17-hydroxylase and 17,20-desmolase activities were less than 2% of those in age-matched normal subjects. However, in spite of this virtual absence of both enzymatic activities of cytochrome P450c17, Northern blot analysis demonstrated abundant amounts of RNA in these tests that hybridized to a cDNA specific for this P450 enzyme. Moreover, immunoblot analysis of sodium dodecyl sulfate-polyacrylamide gel electrophoresis-resolved testicular microsomes showed an apparently normal content of an immunoreactive protein with a mol wt similar to that of authentic P450c17. These results suggest that these patients have a point mutation in the gene for P450c17; the mutant gene is transcribed, but gives rise to a protein defective in normal 17-hydroxylase and 17,20-desmolase activities.

Issues in research design in psychiatric hospitals

This paper is a review of the status of research pertaining to the hospital setting and a proposed design for a program of research for psychiatric hospitals. Assessment of patient status, treatment, hospital characteristics, and aftercare settings are reviewed in the first section. The second section presents some possible instruments to measure these factors. The third section deals with the various hypotheses that have been proposed in the literature. The hypotheses are categorized into an overall theory to be tested by a program of research. The final section proposes a research program to test those hypotheses.

Dexamethasone accelerates differentiation of A6 epithelia and increases response to vasopressin

When seeded heavily on a porous tissue culture dish, A6 cells, derived from the kidney of Xenopus laevis, form a highly differentiated epithelium within 4-6 days. When dexamethasone is added to the culture medium, morphological differentiation is completed by day 2, a time at which the control (untreated) is still a disorganized multilayer of cells. In addition to the morphologically evident monolayer of cuboidal cells, the accelerated differentiation is expressed as high transepithelial electrical resistance, short-circuit current, and adenylate cyclase response to vasopressin. When grown on impermeable plastic tissue culture dishes, A6 epithelia are less differentiated and do not respond to vasopressin. With the addition of dexamethasone at the time of seeding on a plastic tissue culture dish, vasopressin responsive adenylate cyclase activity is expressed, albeit at a slower rate than when grown on a porous surface. In addition, dexamethasone treatment of mature epithelia grown on a porous surface results, in hours, in an increase in the adenylate cyclase response to vasopressin. These results reveal two previously unrecognized interactions between adrenal steroid hormones and vasopressin, namely, accelerated differentiation and increased responsiveness of adenylate cyclase.

Expression and modulation of a retrovirus-associated antigen by murine melanoma cells

The antigen recognized by the monoclonal antibody MM2-9B6 is specific for melanomas originating in C57BL/6 mice. It is expressed by three melanomas of independent origin and not by normal or fetal tissues, by a wide variety of other nonmelanoma tumors in C57BL/6 mice, or even by melanomas syngeneic to other strains of mice. We have demonstrated that the expression of the relevant antigen is dependent on the replication and budding of a B-tropic ecotropic murine retrovirus. The relationship between the expression of this virus and carcinogenic progression may yield important insights into the cascade of events leading to neoplastic transformation.

Relationships between clinical features and distribution of mononuclear cells in muscle of patients with polymyositis

We examined the relationships between the clinical features and outcome of 43 patients with polymyositis-dermatomyositis (PM-DM) and muscle biopsy findings, with specific reference to the pattern of distribution of inflammatory cells. Perifascicular inflammation was associated with the presence of the rash of DM. No relationships were found between the other patterns of distribution of inflammatory cells in muscle and various clinical findings in patients with PM-DM, or the clinical course of the disease. Vasculitis of large vessels (greater than or equal to 20 micron) was seen in only 5 cases (11%) and was not present in childhood PM-DM.

Intracytoplasmic lumina in meningioma: an ultrastructural and immunohistological study

Three surgically removed meningotheliomatous meningiomas with hyaline inclusions or pseudopsammoma bodies were studied. Ultrastructurally, the lumina seemed to be predominantly intracytoplasmic, defined by a systemic unit membrane; they displayed abundant microvilli and contained granular or filamentous material, vacuoles, vesicular bodies, and lamellar structure. The cytoplasm surrounding the intracytoplasmic lumina was electron-dense and contained tonofilaments and desmosomal junctions. All three meningiomas showed expression of carcinoembryonic antigen, cytokeratin, and epithelial membrane antigen in the cells surrounding the hyaline bodies. Keratin, alpha-1-antitrypsin, and immunoglobulin M showed weak positive staining. There was widespread vimentin except in the cells with hyaline inclusions. Glial fibrillary acidic protein and S100 were negative. These results provide additional confirmation of immunohistochemical data that can serve as evidence for epithelial and secretory differentiation in meningiomas.

Acute fetal distress after fetal blood sampling (case report)

The authors report a case of acute fetal distress after fetal blood sampling, performed for fetal karyotype because of a precocious and symmetrical fetal growth retardation without maternal hypertension or ultrasonographic evidence of fetal malformation. A cesarean section performed because of acute fetal distress showed the newborn to be hypotrophic, with a major acidosis and a refractory hypoxemia. The new born died despite intensive care. Acute fetal anemia was assumed to be the cause of acute fetal distress. The authors emphasize the use of FHR in fetal survey after fetal blood sampling.

Dopamine in paragangliomas of the glomus jugulare

Glomus jugulare tumors have the ability to synthesize, store, and secrete biogenic amines. Although the majority of these tumors remain endocrinologically silent, on rare occasions they present either as a pheochromocytoma or with a carcinoid syndrome. We report a 20-year-old male with two intracranial tumors: an intrasellar neoplasm and a glomus jugulare tumor. Catecholamine catabolites in the urine were not increased, and blood pressure was always normal. The pituitary tumor was an adenoma, immunostaining positive for prolactin. The second patient, a 29-year-old hypertensive male, with a glomus jugulare tumor, had increased vanillylmandelic-acid excretion. In both cases, the paraganglioma tumor cells contained numerous dense-core vesicles (125 to 380 nm in diameter) in electron microscopy, and showed intense fluorescence by the sucrose-potassium phosphate-glyoxylic acid method. Using high-performance liquid chromatography and microspectrofluorometry we were able to establish the presence of large amounts of dopamine in the cytoplasm of the tumor cells.

Biochemical and ultrastructural study of Blastocystis hominis

This study was prompted by the paradox of strong presence of mitochondria in an anaerobic protozoan, recently reclassified from the yeasts. Stemming from publication in 1911 to 1912, Blastocystis hominis has been generally accepted as a harmless intestinal yeast of humans, with short standardized textbook (parasitology) descriptions, even to the present day. Reports since 1967 have changed the classification of B. hominis from yeast to protozoan (Sarcodina), and this has been followed by interest in B. hominis-caused disease, resulting in documentation of disease in humans and other primates. In this study of B. hominis, the basic ultrastructure of the mitochondria was shown by thin-section electron microscopy to be identical to that of an archetypical mitochondrion. There were hundreds of them in large B. hominis cells (100 to 200 microns in diameter). Mitochondria were confined to a peripheral ring of cytoplasm bounded by the outer cell membrane (there is no cell wall) and the membrane of the large, spherical, organelle-free central body that constitutes 75% of the cell's volume. Mitochondria tended to surround the cell's usual two to four nuclei. Rhodamine 123 stained the mitochondria selectively, visualized by fluorescence microscopy. The cell was devoid of cytochromes. Addition of 0.1% cytochrome c to the growth medium increased utilization of glucose by 34% and that of lactate by 17%. Furthermore, it markedly increased the number of mitochondrion-filled cells. At higher concentrations, cytochrome c inhibited the growth of the cells. Despite the presence of large numbers of mitochondria, activities of the mitochondrial enzymes pyruvate dehydrogenase complex, alpha-ketoglutarate dehydrogenase complex, isocitrate dehydrogenase, glutamate dehydrogenase, and cytochrome c oxidase were absent. Thus, the function of the mitochondria in B. hominis remains unknown. Considerable activities of aspartate aminotransferase and alanine aminotransferase were found. Aldolase activity was prominent. Pyruvate decarboxylase was present. Diaphorase and lactate dehydrogenase were detectable but in suspect quantities. Other missing enzymes were gamma glutamyl transpeptidase, alkaline phosphatase (a lysosomal marker), and creatine kinase isoenzymes.

[Cerebral Doppler technic during labor using signal monitoring at the level of the fetal scalp]

The purpose of modern obstetrics is to obtain tracers of the fetal cerebral risk during labor, enabling to deliver the child before cerebral ischemia occurs. Recording of the fetal heart and measurement of acid-base balance are remarkable tracers; however, a much better precision is desired to avoid unnecessary or too late caesarean sections. Blood velocity measurement by Döppler at the level of the vessels at the base of the fetal skull is technically possible during labor; this has been demonstrated in 8 fetuses. The major cerebral index D/S during labor is 0.40 +/- 0.04, i.e. slightly lower than the mean index measured at the cord (0.50 +/- 0.07). In case of decelerations, it decreases to a mean value of 0.22 +/- 0.02. These preliminary results permit to hope that long-term measurements with continuous Döppler, of the arterial fetal cerebral flow, provide a direct and accurate tracer of the risk of cerebral ischemia during labor.

gamma-Glutamyltransferase reference material: an example of international cooperation

The different steps in the preparation of a certified reference material for gamma-glutamyltransferase are described. A preparation of pig kidney gamma-glutamyltransferase, partly hydrolyzed with papain, was prepared and lyophilized in a matrix containing bovine serum albumin. The between-ampoule variability of gamma-glutamyltransferase was estimated to be 0.6%. The predicted degradation at -20 degrees C is 0.00% per year. The certification procedure involved 15 participating laboratories. The certified gamma-glutamyltransferase catalytic concentration of the reconstituted material, using the IFCC proposed method, is 86.8 U/1 with a 0.95 confidence interval of +/- 2.1 U/1.

Cyniclomyces guttulatus (Saccharomycopsis guttulata)--culture, ultrastructure and physiology

Organisms that form an essential extra inner lining of selected areas of the stomach mucosa occur in mice, rats and some other animals. The yeast Cyniclomyces guttulatus (Saccharomycopsis guttulata) was shown in this study to line the stomach of domestic and feral rabbits, guinea pigs, and chinchillas. The layer of yeast cells formed a loose barrier between lumen contents and mucosal surface. A rapid rate of multiplication in the stomach provided yeast cells that blended in with stomach lumen contents, passed through the gut, and were finally excreted in large numbers in fecal pellets. Ascospore formation occurred during passage through the large intestine. The layer of yeast cells lining the stomach had no evident salubrious nor deleterious effect on the animal. C. guttulatus grew rapidly from stomach contents or single fecal pellets in a new enriched semisolid medium. Growth was good at pH 1 through 8 on the solidified enriched medium. A very unusual characteristic of C. guttulatus is optimal growth at 38 degrees C, and growth at 42 degrees C, with failure to grow below 30 degrees C. TEM demonstrated a very thick, laminated cell wall which had a thick, filamentous external coating. There were mitochondria, polyribosomes, lipid droplets, and an unusually large central nucleus. The developing spore nucleus became extremely electron dense and encapsulated, along with condensed mitochondria, ribosomes, short membrane sections and other organelles, in a dense lamellar covering.