Fine needle aspiration cytology of medullary thyroid carcinoma: a review of 18 cases

A series of 18 consecutive medullary thyroid carcinomas (MTC) diagnosed by fine needle aspiration cytology (FNAC) is described. The most important diagnostic cytologic criteria were the dispersed cell pattern, the polygonal appearance of the cells, binucleated cells and the presence of amyloid. Other less common cytologic features are reported and the variable microscopic appearance of MTC is pointed out. The possibility that this cytologic variability of MTC may be by itself an important diagnostic feature is proposed.

Genetic factors of recurrent abortions

A review of main genetic factors involved in pathogenesis of recurrent abortion is presented. The prevalence of chromosomal abnormalities in spontaneous abortions and the role of parental abnormalities of karyotype is pointed out, also in relation to many recent studies. The result of 354 karyotypes performed on couples with spontaneous abortion are presented; the prevalence of chromosomal abnormalities resulted 4.2%, with 73% of translocations, either reciprocal (40%) or robertsonian (33%), and 27% of inversions. The low number of minor abnormalities (0.8%) seems to confirm their poor clinical significance.

Some aspects of glycosylation in rat liver during pregnancy

The aim of the present report was to analyze the pattern of glycoprotein synthesis in rat liver on 19th and 22nd day of pregnancy by following the incorporation of 14C-glucosamine and 3H-galactose into isolated rat hepatocytes, the N-acetylglucosaminyl-1-P and galactosyl transferase activities, and the liver content of dolichol and dolichyl-phosphate. The data obtained show a decrease of precursor incorporation into glycoproteins during the last period of pregnancy; this decrease is independent of enzyme activities. The dolichol content increases and the dolichyl-phosphate content, usually considered as rate limiting for glycosylation, decreases. These results, present in other conditions of proliferation and differentiation of rat liver, could explain the differences in membrane organization, the increase of hepatic proteolysis and the alteration in secretory activity during the last phase of gestation.

Primary endobronchial actinomycosis

A male farmer referred for fever, cough and haemoptysis, presented, at bronchoscopic examination, a large mass occluding the middle lobe bronchus. No lung involvement was visible on chest X-ray. Histological examination showed an actinomycotic granule in the bronchial submucosa. The histological findings indicate that aspiration of contaminated material from the upper alimentary tract may have caused the disease.

Primary endobronchial actinomycosis

A male farmer referred for fever, cough and haemoptysis, presented, at bronchoscopic examination, a large mass occluding the middle lobe bronchus. No lung involvement was visible on chest X-ray. Histological examination showed an actinomycotic granule in the bronchial submucosa. The histological findings indicate that aspiration of contaminated material from the upper alimentary tract may have caused the disease.

Frog liver dolichols: separation and quantitative determination related to seasonality

1. The liver of female frogs shows a significantly higher dolichol content in May (134 micrograms/g) than in November (90 micrograms/g). The male frog liver (134 micrograms/g May; 119 micrograms/g November) does not show any significant change. 2. The rat liver does not show any significant change in dolichol content from May to November (30 micrograms/g). 3. The dolichyl-phosphate level was the same in male and female frog livers and in the rat liver. 4. Data is given of the distribution of dolichols according to the number of their isoprene residues.

Non-invasive electrophysiological evaluation of calcium antagonist long-term therapy

The evaluated effects of oral administration of verapamil, diltiazem, and nifedipine in patients with first degree A-V block by using a new noninvasive technique: signal averaged ECG. The study group consists of 5 females and 3 males ranging from 52 to 70 years old. All patients showed a first degree A-V block at surface ECG and an abnormal A-V time (suprahisian lengthening) during signal averaged ECG (SAECG). Verapamil 240 mg/daily, diltiazem 180 mg/day and nifedipine 30 mg/day were given separately for a week followed by a wash out period of 5 days before giving next drugs. An ECG and SAECG were performed before and after every administration. PR, A-H and H-V interval were evaluated in every recording. Verapamil and diltiazem induced a significant lengthening of A-V conduction (PR increase was 15.4% and 15.1%, respectively). No significant modification appeared after nifedipine. Our data, using a noninvasive technique, agreed with values of previous invasive evaluations. We suggest precaution in using verapamil and diltiazem in patients with BAV 1 degree and advise a selective use of calcium antagonist therapy.

[Cytogenetic study of 140 patients with changes in sexual features]

Cytogenetic studies on a group of 140 patients with alterations of sex features (sex uncertainty, gynecomasty, menstrual abnormality and so on) confirmed a high incidence of chromosome abnormalities (25%). Most frequent abnormal kariotypes were X0 and XXY. Furthermore, cytogenetic investigations showed a higher rate of heterochromatic polymorphism in patients (33.7%) than in controls (13.4%), the most frequent being 1qh, 9qh and 16qh. A possible role of heterochromatic polymorphism in determining sex chromosome abnormalities or, directly, sex diseases, and in possibly enhancing neoplastic risk, is suggested.

The relationship of injuries of the leg, foot, and ankle to proximal thigh strength in athletes

Rehabilitation programs designed to restore leg, ankle, and foot function following injury frequently ignore the proximal muscles. During athletics, these knee, hip, and trunk muscles derive much of their functional power from the foot and ankle. They also serve to integrate distal segment motions into a total movement pattern such as jumping, running, or kicking. The linkage system, which is a theoretical concept, describes the normal biomechanical and physiological interactions between proximal and distal musculoskeletal structures. Immobilization or injury of distal segments interrupts the normal generation, summation, and transmission of muscular forces across joints. Adequate measures must be taken to properly assess proximal structures for weakness and tightness and to prescribe specific exercises to prevent the migration of the effects of injury away from the involved segment.

Enhanced production of dolichol, but not dolichyl phosphate, in the earliest stages of rat liver regeneration

The regenerating liver presents a changed ability to use mevalonate 16 hr after partial hepatectomy. The dolichol content and its synthesis from mevalonate is increased, while no variation of dolichyl-P and ubiquinone parameters are detectable. The greater amount of mevalonate utilized to form dolichol, but not dolichyl-P, in this proliferating system, raises some questions about the physiological significance of these isoprenoid compounds and about their biosynthetic sequence.

Intra-articular transfer of the iliotibial tract. Two to seven-year follow-up results

A proximally based transfer of a composite structure of the iliotibial tract, its osseous insertion, the lateral retinaculum, and part of the vastus lateralis was used in 111 anterior cruciate-deficient knees that were followed for two to seven years. No other ligament procedures were performed simultaneously. The clinical results included a negative Lachman test in 81 per cent (ninety) of the knees, an anterior drawer test of 1+ or less in 84 per cent (ninety-three knees), and a negative pivot-shift sign in 94 per cent (104 knees). Subjectively, 74 per cent (eighty-two) of the knees were rated as excellent; 21 per cent (twenty-three), as good; and 5 per cent (six), as poor. A significant modification in surgical technique, consisting of a limited posterior dissection of the iliotibial band, yielded even better static stability than the original operation did. These results, sustained for as long as seven years, are consistent with the physiological aspects of this transfer. The surgical technique is reproducible and the immediate fixation of bone allows early motion of the knee and reasonable rehabilitation.

Immunohistological evidences of cortical and medullary differentiation in thymoma

The phenotypical characteristics of human epithelial and lymphoid cells have been studied with immunohistochemical methods on frozen sections of 12 thymomas. On the basis of the cytohistological characteristics of thymoma epithelial cells (EC) the thymomas were divided in cortical, medullary and mixed types, according to recently developed light microscopical criteria. When tested with a series of monoclonal antibodies, thymoma EC were all stained by the antibody Ki-M3 (as in the thymus), but reacted with anti-HLA-DR, anti-HLA-A,B,C and with a new monoclonal antibody to cortical EC, 21A6, to a lesser extent and with weaker, variable intensity in comparison with the normal thymus. Cortical type thymomas were most reactive and the medullary type almost negative. Thymomas, like normal thymus showed different immunoreactivity patterns with antibodies to prekeratins of different specificities. Cortical type thymomas and areas in mixed thymoma showed an EC staining with the antibody to non-squamous type keratin (35 beta H11) whereas medullary type thymomas and areas showed staining with antibodies to squamous-type keratin (34 beta E12-IV/82) in addition. Lymphoid cells with cortical (OKT6+, Leu 1 weakly+, Leu 2a+, Leu 3a+) or mature medullary (OKT6-, Leu 1 strongly+, Leu 2a or Leu 3a+) phenotype were found to colonize tumours with different EC types. These immunohistochemical findings largely confirm our earlier cytological distinction of thymoma EC. In addition important differences have been observed in neoplastic cortical EC concerning the HLA-DR and 21A6 immunoreactivity that may be intimately related to the neoplastic process and paraneoplastic immune phenomena.

Thymoma and thymic carcinoma. Relation of thymoma epithelial cells to the cortical and medullary differentiation of thymus

Based on the light microscopical features of normal thymic epithelial cells, human thymoma was divided in different types, namely cortical, medullary, and mixed ones, according to the epithelial cell (EC) type. Lymphoid cell populations with morphological features of either cortical or medullary thymocytes were found according to different types of EC in thymoma. The histological variation of the different types of thymoma are demonstrated. In a retrospective study of 58 thymomas and 13 thymic carcinomas, malignant invasive character as well as the occurrence of myasthenia gravis were both found to be related to the neoplastic proliferation of the cortical epithelial cells, whereas in the usual mixed type of thymoma and the medullary type no gross invasion or metastases were noticed. These results are discussed in view of recent concepts and immunological findings of thymus microarchitecture.

Brain ascorbic acid and block of the catecholamine synthesis induced by alpha-methyl-tyrosine

In brain medial-basal areas (midbrain, hypothalamus, striatum) ascorbic acid (AA) content is lower than in the rest of the brain. It has been hypothesized that AA may be involved in brain catecholamine metabolism. To test this hypothesis AA content in medial-basal areas and in the remaining brain areas was measured in rats pretreated with alpha-methyl-paratyrosine (alpha-MpT), a tyrosine hydroxylase inhibitor. The AA content, in brain medial-basal areas, had slightly decreased, without statistically significant differences, in rats treated with alpha-MpT in comparison with untreated animals. Therefore the role of AA in brain metabolism is not clear to.

[Electrophoresis of liver proteins from the rat under various physiological conditions]

The total protein and glycoprotein in electrophoretic patterns of rat liver endoplasmic reticulum we studied in peculiar physiological conditions as perinatal development, pregnancy and liver rigeneration. Previous work in these experimental systems showed a changed microsome lipid composition and modified activities of some ER membrane bound enzymes. The microsomes obtained from foetal and neonatal liver show a modified electrophoretic pattern of both total protein and glycoprotein of low weight with respect to the adult animal. As to the microsomes of 8h and 12h regenerating liver modifications are observed only in the pattern of glycoprotein in the molecular weight range.

New fluorochromes, compatible with high wavelength excitation, for flow cytometric analysis of cellular nucleic acids

The spectroscopic properties of three new dyes, EK4, VL772, and LL585, free and bound to nucleic acids, are presented, with particular emphasis on their potential use in flow cytometry. Two of these dyes, EK4 and LL585, exhibit red fluorescence, while dye VL772 exhibits yellow fluorescence. Dye LL585 exhibits specificity for DNA, relative to RNA, and a marked enhancement of fluorescence efficiency upon binding to DNA, needed for a red fluorescent DNA-specific stain for flow cytometry. The dye penetrates live cells, although uniformity of nuclear fluorescence, as evidenced by DNA flow histograms, is better if the cells are first permeabilized with Triton X-100. Dye VL772 exhibits yellow fluorescence and little DNA-RNA discrimination, but may prove useful in conjunction with dye LL585 when simultaneous assay of cellular RNA and DNA is desired. Dye EK4 shares properties of the other two dyes but fluoresces with much less efficiency. Dyes LL585 and VL772, used singly, as a pair, or in combination with blue-fluorescing DNA specific dyes, such as bisbenzimidazole derivatives, should permit new, convenient analyses of the content and organization of cellular nucleic acids.

[Clinical and cytogenetic staging of chronic myeloid leukemia. Philadelphia positive]

A cooperative study between clinical and cytogenetic steps in 44 patients with Ph'+ CGL is reported in order to verific the usefulness of the cytogenetic screening for the diagnosis and the right classification of the patients. The study of the clinical steps is carried out on the basis of the parameters suggested by Tura and coll.; in the one of the cytogenetic steps Sandberg classification modified by the Authors is adopted. In 40 cases the comparison shows a marrow correspondence between clinical and cytogenetic steps. In fact the overage survival in the classical true steps of the disease is almost the sance in the 1st and 2nd step. In the 3rd step the survival is strongly reduced meaning that the more chromosome alterations are observed the more survival is reduced.

Muscle strength and fiber typing

The authors discuss fiber typing and morphologic changes resulting from training and how these affect athletic performance. Also considered is the concept of strength, its measurement and development, and how strength affects athletic performance, activity, and injury.

Profiling swimmers

Don Schollander's world and Olympic record of 4:12.2 in the 1964 Olympics for the 400 meter freestyle would have placed him third in the 1976 games, in the women's race! Johnny Weissmuller's time for the 100 yard freestyle was 51 seconds. Today, it is swum in 41 seconds. Improved conditioning techniques and stroke mechanics have benefitted today's swimmers. Formal and highly organized age group swimming has given more children the opportunity to train, in addition to enhancing the process of natural selection. Research into the effects of swim training has generated more efficient turns, starts, and stroke mechanics based on biomechanical principles. Aerobic and anaerobic testing, muscle biopsy, and advanced strength measuring devices have identified the need for specificity in training sessions, which are based upon stroke and event. Coaches can no longer rely on the combination of talent and hard work to guarantee success but must prescribe individualized training programs based upon sound physiological principles.

[Glycosylated hemoglobin and raubasine in experimental streptozotocin diabetes]

Streptozotocin (Stz) diabetes was induced to study the changes of glycosylated hemoglobin in rats treated with raubasina (R), drug widely used in the vascular compliance of natural human diabetes. Raubasina reduced significantly the increase of glycosylated hemoglobin found in streptozotocin induced diabetes. These results support data obtained in clinical trials.

[Glycosylated hemoglobin in experimental streptozotocin diabetes]

Streptozotocin (Stz) diabetes was induced in rats to study the changes in glycosylated hemoglobin. An increase of glycosylated hemoglobin had been found since the first days of the experiment. These results suggest that such a model may be used for the study of changes of glycosylated hemoglobin in diabetes.

The efficacy of manual assessment of muscle strength using a new device

The purpose of this study was to compare the manual assessment of muscle strength with a small, handheld (by the examiner) force-measuring device developed by the Institute of Sports Medicine and Athletic Trauma (ISMAT). One hundred twenty-eight patients presented with a known lower extremity orthopaedic pathology. All patients were clinically evaluated for hip abductor and hip flexor weakness in standard positions using the "break test" technique. All 128 patients were then evaluated with the ISMAT Manual Muscle Tester, a small, hand-held device which recorded the peak force (kg) required to break a muscle contraction. Three bilateral measures of hip abduction and hip flexion were recorded, averaged, and compared to the subjective clinical evaluation using a chisquare analysis. Bilateral values which were within 5% of each other were not considered significant and therefore not included in the calculations. The average hip abduction and hip flexion scores measured by the ISMAT tester were consistent with the examiner's perception of muscle weakness (P less than 0.001). The results demonstrate consistent detection of muscle weakness by the ISMAT Manual Muscle tester over a broad range of testing conditions.

Human thymoma: immunologic characteristics of the lymphocytic component

Several immunologic parameters were investigated in the lymphocytic component of ten thymomas, characterized by a variable degree of lymphocytic infiltration. The majority of thymoma lymphocytes are T-cell in nature, as are lymphocytes from the normal thymus. Lymphocytes from six thymomas with moderate or predominant lymphocytic infiltrates were capable of forming stable E-rosettes, (mean percentage +/- SD: 78.0 +/- 5.2); binding peanut agglutinin (67.3 +/- 8.6); and exhibiting receptors for the Fc-portion of IgM (21.8 +/- 6.0) at percentages that were close to those found in the normal thymus. On the other hand, lower numbers of stable E-rosetting cells (26.8 +/- 8.7), PNA-positive cells (27.5 +/- 12.4), and remarkably higher percentages of cells with receptors for IgM (54.0 +/- 4.2) were demonstrated by the lymphocytic population of four thymomas with scant lymphocyte components. In addition, lymphocytes from tumors with scant lymphocyte components show a higher proliferative response to phytomitogen (PHA), therefore exhibiting immunologic features comparable to those of the more mature pool of normal medullary thymocytes. The observed immunologic similarities between the populations of lymphocytes from thymomas and from the normal thymus gland suggest an exclusively epithelial origin of the thymoma.

[Karyotype in chronic myeloid leukemia in a blastic crisis. I. Monosomy 16]

One case of Chronic Granulocytic Leukemia is reported, in which the patient showed, during a blastic crisis, an aneupolid cariotype 45, XX, t (9; 22) (q34; q11), -16. This paper emphasizes the rare involvement of the chromosome 16 in Leukemias, and stresses the high frequency of the alterations of the chromosome group E in the course of blastic crisis.

Cytologic respiratory changes in workers exposed to air pollution and cigarette smoking

Sputum specimens taken at random from 420 of 2,500 sweepers of Naples (369 male smokers, at least ten filter cigarettes daily for a minimum of ten years, and 51 male controls, nonsmokers) have been investigated. In the smokers group, 220 cases (59.6%) with nonspecific chronic inflammatory disease, 54 cases (14.6%) with regular squamous metaplasia, 13 (3.5%) with atypical squamous metaplasia, and one case (0.3%) of presumed carcinoma in situ have been identified. In the control group, 17 cases (35.3%) of nonspecific chronic inflammatory processes with occasional regular squamous metaplasia were the only found pathology. Based upon their results, the authors have been unable to demonstrate that air pollution may enhance the smoking effect on the respiratory tract.

[Evaluation of creatinine clearance in pediatric patients, excluding determination of creatininuria]

Here is presented a practical method for predicting creatinine clearance for pediatric patients from serum creatinine concentration and patients age without collection 24 h urine. Creatinine excretion rate (ER) can be predicted from the patients age, in years, by the formula: ER = (0.0463 x age) + 0.4049. Creatinine clearance can be predicted using the predicted excretion rate and serum creatinine concentration. There was a correlation (r = 0.66) between predicted and observed creatinine clearance in 101 subjects. This method allows renal function to be rapidly estimated.

[Chronic hepatitis caused by B virus (HBV)]

Following a short review of the viruses underlying viral hepatitis and those which, as a secondary factory in the clinical picture, may cause fleeting liver damge, the subdivision of chronic hepatitis conditions on histopathological bases is described. Particular attention is paid to pathogenesis, with a study of the elimination of B virus, correlated to particular histopathological types. A series of 27 PCH and 49 ACH cases is reported. Of special significance was the observation of 14 ACH out of 17 biopsied drug addicts. The therapeutic problem of chronic hepatitis is then tackled.

[Histopathology of the liver in patients with severe burns. Preliminary biopsy study]

Liver histobiopsy was carried out in 21 patients with burns of from 25 to 75 percent, between the 2nd and 125th day following trauma. The most frequent type of lesion encountered was albuminoid degeneration and hydropic ballooning of the cytoplasm to the point that the parenchyma assumed a "vegetable" appearance. No steatosis intervenes until the 6th-8th day after the burn and where it was not present previously, is a sign that the patient's condition is worsening. Total, or nearly total, disappearance of glycogen from the sections is an indication that the patient is worsening; in effect in patients who died, biopsy carried out shortly beforehand revealed the extreme paucity of PAS-positive material in the hepatocytes.