[Sertoli-Leydig-cell ovarian tumor with a retiform pattern and heterologous elements: a rare cause of virilization]

The case is presented of a young female with virilization signs and total circulating testosterone levels above 4 ng/ml, without a concomitant increase in cortisol, 17 OH-progesterone, DHEA-S, or androstenedion levels. On CT scan exam a tumoral mass in the left ovary was observed with polycystic characteristics similar to those observed in ovarian cystadenoma, inspite of the fact that most androgenic ovarian tumors are solid. The pathological study revealed an ovarian Sertoli-Leydig tumor associated to a reticular pattern with heterologous chondroid and mucinoid elements of cystadenoma.

Primary hypothyroidism and human spermatogenesis

Spermatogenic function was studied in 10 patients, previously diagnosed as having primary hypothyroidism, in whom a state of hypothyroidism has been induced by discontinuation or a decrease in treatment with levothyroxine over at least one spermatogenic cycle. Most of the patients had fathered children before the study. When the results obtained in the hypothyroid state were compared with those from a group of 16 controls with proven fertility, slight anomalies were observed; these were characterized by a decrease in seminal volume (p less than 0.05), progressive forward motility (p less than 0.01), and the cumulative percentage of mobile forms (p less than 0.01). There were no anomalies in sperm density or in the percentage of spermatozoa with normal morphology. No alterations in circulating levels of testosterone and gonadotropins existed. Induction of hypothyroidism did not lead to seminal or hormonal modifications compared with the same patients in a situation of euthyroidism. Short-term postpuberal hypothyroidism did not cause seminal alterations sufficiently intense to induce male infertility.

Relations between circulating levels of testosterone, 17 beta-estradiol, androstenedione, dehydroepiandrosterone sulfate, and androgenic receptor content of cytosol in benign prostatic hyperplasia

Cytoplasmic androgen receptor content was determined in 26 patients with benign prostatic hyperplasia using methyltrienolone (R 1881) as the radioactive ligand. Their concentrations were compared with patient age, adenoma weight, and total circulating concentrations of testosterone, 17 beta-estradiol (17 beta-E2), androstenedione (A) and dehydroepiandrosterone sulfate (DHEA-S). Statistically significant inverse correlations were noted between adenoma weight and receptor content (p less than 0.05) and significant direct correlations between DHEA-S and receptor concentration (p less than 0.05), although the levels of this androgen were similar to those observed in a 'normal' population of the same age. The possible implications of these findings relative to the pathogenesis of the disease are discussed.

[Absence of increase of cyclic adenosine monophosphate (cAMP) in the cerebrospinal fluid of febrile patients (author's transl)]

Recent studies point toward the importance of cyclic adenosine 3',5'-monophosphate (cAMP) in the genesis of fever. Experimental fever induction in animals using bacterial pyrogens is accompanied with an increase of nucleotid concentration in the cerebrospinal fluid up to duplicate normal basal values. This aspect, however, has not been studied in human pathology. The concentration of cAMP in the cerebrospinal fluid of 11 patients with fever higher than 38.5 degrees C was studied. there were no significant differences between values found in these patients (14.03 +/- 5.82 pM/ml) and those corresponding to normality (15.44 +/- 3.36 pM/ml). We think that these results did not refute the role of cAMP in the pathogenesis of fever; they are only laboratory findings in discordance to experimental results.

[New enzymatic and endocrinological aspects in two cases of Werner's syndrome (author's transl)]

Results of endocrinological studies and of the investigation of intraerythrocytic glycolytic pathway carried out in two patients with Werner's syndrome are presented. An increase of glyceraldehyde 3-phosphate and 3-phospho-glycerokinase has been observed, but the significance of these original findings is still unknown. An hyperinsulinism after oral glucose overload has been demonstrated too. This finding, which has been reported by other authors, probably reflects a peripheral resistance to insulin action. Other endocrinological abnormalities were a decrease in the T3:T4 quotient and a slight delay in the FSH-LH peak to LH-RH.

[Cyclic adenosine monophosphate in the cerebrospinal fluid of patients with liver disease (author's transl)]

The concentration of adenosine 3':5'-cyclic monophosphate in the spinal fluid of ten patients with liver dysfunction was analyzed. Ages of the patients ranged from 31 to 75 years. The state of consciousness varied between normality and stupor. After a liver biopsy the diagnoses were as follows: cirrhosis in six cases, porphyria cutanea tarda in one case, hepatic metastases in two cases and Wilson's disease in one case. Mean values in these patients (22.91 +/- 4.18 pM/ml) have been significantly greater (p less than 0.0005) than those in ten control individuals (15.55n control individuals (15.44 +/- 3.66 pM/ml). Values corresponding to two patients in coma were still higher (52.62 and 36.50 pM/ml respectively). A previous lumbar puncture carried out in one of these patients when he was conscious showed a figure of 23 pM/ml. These results suggest a progressive rise of cyclic adenosine monophosphate in the spinal fluid in relation to clinical impairment, and may indicate a similar behaviour for this nucleotide to that of tryptophan, as reported by other authors. These findings point toward the role of the alteration of neurotransmitters in the pathogenesis of hepatic coma.