Differential mRNA degradation of two beta-tubulin isoforms correlates with cytosolic Ca2+ changes in glucan-elicited soybean cells.

Transgenic soybean (Glycine max) culture cells expressing apoaequorin, a Ca2+ indicator, were exposed to glucan fragments derived from Phytophthora sojae or to chitin oligomers. The effects of these elicitors on cytosolic Ca2+ concentrations and on mRNA levels of two beta-tubulin isoforms, tubB1 and tubB2, were investigated. The glucan elicitors, to which the cells are known to react with a biphasic cytosolic Ca2+ increase, induced a down-regulation of the tubB1 mRNA levels while the tubB2 mRNA level remained constant. The decrease of tubB1 mRNA level was observed after 1 hour of glucan treatment. In contrast, chitin oligomers, known to provoke a monophasic Ca2+ increase of short duration, did not affect the tubB1 mRNA level. Pre-incubation with 10 mM 1,2-bis(o-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid, an extracellular Ca2+ chelator, blocked the cytosolic Ca2+ increase as well as the decrease of tubB1 mRNA levels induced by glucan elicitors. Likewise, pre-incubation with 1 mM neomycin, which reduced only the second glucan-induced Ca2+ peak, blocked the decrease of tubB1 mRNA level. Experiments with cordycepin, a transcription inhibitor, indicated that glucan fragments induced the degradation of tubB1 mRNA. In conclusion, the glucan-induced cytosolic Ca2+ changes are correlated with a strong increase in tubB1 mRNA degradation.

[Maternal mortality at the Gynecologic-Obstetric Hospital of the Western National Medical Center, Mexico. A 12-year review]. / Mortalidad materna en el Hospital de Gineco-Obstetricia del Centro Médico Nacional de Occidente. Revisión de 12 años.

The aim of this study is to present the analysis of the leading causes of mortality found in all the cases of maternal death at the Hospital de Ginecobstetricia (HGO) and Hospital de Especialidades (HE) del Centro Médico Nacional de Occidente (CMNO), during a period of 12 years, to achieve a winder view and to find a solution to reduce maternal mortality (MM). We reviewed files and reports of the maternal mortality committee of 151 women who were hospitalized and died at the HGO and HE del CMNO in Gudalajara, Jalismo, México, between January first, 1985 and December 31, 1996. During this period the maternal death ratio was 64 per 100,000 live births. The main cause of maternal death was toxemia 25%, follow by hemorrhage 23%, pulmonary thromboembolism 16%, infection 13%, and anesthetic complications 6%. 73% were foreseen deaths and 23% were unforeseen deaths. At the patients arrival to the hospital 37% were avoidable deaths. 66% were direct obstetric deaths and 34% were avoidable deaths. 66% were direct obstetric deaths and 34% were indirects. In 50% of the cases the end of pregnancy was done by cesarean section. The professional responsibility existed in the 72% and the hospitalary in the 23%. We made an analysis related factors and we propose strategies to diminish the maternal mortality.

[Colonic polyps. Experience at a clinical center in Caracas]. / Polipos del colon. Experiencia en un centro clínico de Caracas.

After six years experience in the anatomopathological study and having checked 33.452 histological cases 772 corresponded to colon tumoral pathology. It was then decided to proceed with the epidemiological analysis of the polyps, it's anatomical distribution according to sex and age, it's histolopathological characteristics and the possible relationship with malignant transformation. We found a clear predominance mainly of adenomatosic neoplasic polyps, followed by hyperplasic polyps. 65% of the patients were male and more than half of the cases were between the ages of 50 and 70. Coincitentally, 86% of the atypical polyps were found within this age group.

[Colonic tumors: experience at a clinical center in Caracas]. / Tumores de colon: experiencia en un centro clínico de Caracas.

During a period of six years, 33.452 histopathological studies were reviewed among which were found 285 cases with malignant neoplasm of the colon. 69% of the patients were between fifty and sixty years of age. The diagnosis of colonic adenocarcinoma was positive in 90.17% of the cases. 58.9% of the tumors were localized in the rectum and sigmoid. The remaining 41.06% of the tumors were not subject to rectosigmoidoscopy. The epidemiological analysis was made. Most of the patients were found with locally advanced cancer with a predominance of poor differentiated tumours, which represents a complex challenge to the surgeon.

[Adenosquamous carcinoma of the colon. Report of 2 cases and review of the literature]. / Carcinoma adenoescamoso de colon. Reporte de dos casos y revisión de la literatura.

The adenosquamous carcinoma of colon is an uncommon neoplasia, it only represents 0.1% of all carcinomas of colon. We report two new cases, that are added to the 39 reported in the medical literature. The pathogenesis and the biologic behavior of this variety are revised.

Histoclinical basis for a new classification of hemorrhoidal disease.

The present classification of first, second, and third grade hemorrhoids only reflects variation in size of a normal human tissue and does not relate to "hemorrhoidal disease." Cross-sections and coronal sections of the anal canal in 32 fetuses, with ages ranging from 28 to 38 weeks of development, were studied and the following fundamental facts were found: in the lumen of the anal canals of fetuses, there are prominences of mucosa formed by conjunctive and muscular tissue, arterial and venous vessels and glands, arranged without following any particular pattern, which resemble similar formations found in the adult that protrude equally in the inside of the canal, known as hemorrhoids. The muscular tissue, smooth or striated, is grouped in bundles, and bunches of collagen fibers of homogeneous, nonfragmented, and regular aspect are found between them. Blood vessels have an ample lumen with a defined structure of collagen tissue as well as muscular tissue in its walls. Prominences of mucosa are connected to the remainder of the intestinal wall by defined conjunctive thick, nonfragmented fibers, that permit firm adherence. In healthy adults, the findings were similar but there was an evident degenerative process in the collagen fibers. In 100 surgical specimens of hemorrhoidectomies, the histologic investigation demonstrated a severe inflammatory reaction that especially affected the blood vessel wall and conjunctive tissue, which probably produced an ischemic lesion of the mucosa that could condition the onset of a vascular thrombosis, allowing displacement of the mucosa and its protrusion through the anus. The files of 815 patients suffering from hemorrhoidal disease were also studied. The main physical findings were bleeding, thrombosis of the internal hemorrhoidal plexus, prolapse of the anal cushions, or a combination of these. The authors propose to classify hemorrhoidal disease as bleeding, prolapsing, thrombotic, and mixed hemorrhoidal disease, aiming toward a rational treatment.

Association between neuroendocrine (Merkel cell) carcinoma and squamous carcinoma of the skin.

Among 32 neuroendocrine carcinomas of the skin, 11 were from patients with previous or concomitant squamous carcinoma. The medical records and pathologic material for these 11 cases were reviewed, and the diagnosis of neuroendocrine carcinoma was confirmed in each instance by electron microscopy. In two cases, the squamous and neuroendocrine carcinomas were admixed, but each preserved its identity and transition between the two was not identified. Despite the lack of evidence for origin from a single cell, the observations nevertheless indicate a common carcinogenetic influence for squamous and neuroendocrine carcinomas of the skin.

Aspergillus epiglottitis.

A 21-year-old woman with acute lymphocytic leukemia developed clinical and radiographic signs of epiglottitis. Premortem and postmortem histologic studies showed invasive aspergillosis; Aspergillus flavus was grown in culture. The necrotizing nature of this infection is explained by the predilection of Aspergillus sp. for invasion of blood vessels. The usual causative agents of epiglottitis are bacteria; the association with fungal infection has not been previously described.

Systemic amyloidosis associated with a benign mesenteric lymphoid mass.

This report describes the case of a patient with a mesenteric lymphoid mass with clinical and histologic features suggestive of giant lymph node hyperplasia (GLH) who died as a result of complications related to systemic amyloidosis. To our knowledge, this is only the second case of amyloidosis associated with a benign mesenteric lymphoid mass reported in the literature. The possible relationship of amyloid with GLH will be discussed.

In vivo steroid studies in luteoma of pregnancy.

Endocrine studies were performed in 2 cases of luteoma of pregnancy. Even though both luteomas were discovered incidentally at the time of postpartum tubal ligation and cesarean section, they were found to be functionally active, secreting several androgens. Steroid concentrations were measured in the ovarian vein blood draining the luteoma in one patient and in peripheral vein blood in both patients. Peripheral testosterone, androstenedione, and dihydrotestosterone concentrations were increased severalfold higher than the normal controls and were comparable to the concentrations reported previously in virilizing luteomas. Progesterone, 17 alpha-hydroxyprogesterone, and estradiol concentrations were increased as well. The concentrations in the ovarian vein were significantly greater than those in the peripheral vein, which indicates active secretion of these steroids by the luteoma. In spite of the high concentrations of androgens, neither the mothers nor the infants were virilized. Concentrations of androgenic steroids in the cord blood were in the normal range. Determination of steroid concentrations in the serum, taken at intervals post partum, indicated spontaneous regression of the luteomas.

Immunoblastic lymphoma of small intestine complicating late-onset immunodeficiency.

A malignant lymphoma of the small bowel developed in a 75-year-old woman who had severe late-onset hypogammaglobulinemia with intestinal malabsorption and nodular lymphoid hyperplasia. The tumor arose in the midst of the abnormal lymphoid follicles and appeared to be of B-immunoblastic type. Immunoperoxidase staining, however, failed to reveal immunoglobulins in the tumor cells. In vitro immunologic studies showed that immunoglobulin production by the patient's peripheral lymphocytes had decreased and that this decrease was mediated by hydrocortisone-sensitive suppressor cells. These findings suggest that nodular lymphoid hyperplasia of the intestine in the context of severe immunodeficiency is a premalignant condition.

The ultrastructure of glomerular haematoxylin bodies.

The ultrastructural features of haematoxylin bodies, present in a patient with active lupus glomerulonephritis, appear to include cellular elements, especially dense chromatin of probable neutrophil leucocyte origin and electron-dense, immune complex-like material. Although the participation of immune complexes in the formation of haematoxylin bodies has been previously proposed, this is the first reported demonstration of such deposits in haematoxylin bodies.

Clinical and hormonal studies in hyperthecosis of the ovaries.

Endocrine studies were performed in five women with ovarian hyperthecosis. Measurement of testosterone (T), dihydrotestosterone (DHT), androstenedione (A), 17 alpha-hydroxyprogesterone (17-OHP), progesterone (P), estradiol (E2), and estrone (E1) in the peripheral and ovarian vein serum obtained simultaneously at the time of surgery indicated that the hyperthecotic ovaries secreted large amounts of potent androgens T and DHT. There was a less marked increase in A secretion. Peripheral P and 17-OHP levels were elevated, with a significant peripheral ovarian gradient. E1 comes entirely from peripheral conversion, while at least a portion of E2 comes from direct secretion from the ovaries. Circulating FSH and LH levels were low or normal. The gonadotropin response to LH-RH was in the normal range. No patient ovulated with Clomid treatment. The hirsutism did not improve with ovarian suppression with birth control pills, possibly because of the absence of tonic elevation of LH. The hypothalamic pituitary physiology in hyperthecosis is different from that in polycystic ovarian disease.

Monstrous epithelial cells in human epididymis and seminal vesicles. A pseudomalignant change.

Peculiar monstrous epithelial cells simulating anaplastic malignant transformation were observed in human epididymis and seminal vesicles. In epididymis, scattered hyperchromatic giant epithelial cells were seen protruding into the lumina of ductuli efferentes in 12 of 43 specimens examined (28%). Eight cases were seen in cancer patients and four cases in noncancer patients. In seminal vesicles, epithelial cells exhibiting nuclear hypertrophy, hyperchromatism, and transformation into a variety of grotesquely shaped nuclei were observed in 24 of 32 specimens examined (75%). Fourteen cases were seen in cancer patients and 10 cases in noncancer patients. Since the peculiar epithelial changes were observed in both cancer and noncancer patients, this phenomenon represented a histologically pseudomalignant condition. In both organs, the group of patients without atypical epithelial changes were younger. Generally, the pseudomalignant changes were not seen in persons under the age of 20. There was no correlation to any particular systemic disease. The histogenesis remains speculative, but hormonal effects or degeneration due to aging seem to be contributory. The most important aspect of these observations, however, is that the changes described should not be mistaken for cancer. In addition, eosinophilic hyaline bodies were frequently observed in the muscle layer of seminal vesicles. The nature and the significance of their occurrence is unknown.

Hyperthecosis of the ovaries in acromegaly.

Clinical and endocrine features of a patient with ovarian hyperthecosis and a growth hormone-secreting pituitary tumor are reported. A 36-year-old nulliparous woman had a history of severe hirsutism and virilization of long duration. Ovarian catheterization studies at surgery confirmed an ovarian source of excessive androgen production. Ovarian pathology revealed stromal hyperthecosis. Growth hormone levels were elevated and could not be suppressed with glucose ingestion; a pneumoencephalogram revealed the presence of a pituitary tumor. The possible cause-and-effect relationship of these 2 relatively uncommon disorders is discussed.

Separate pancreatic gastrin cell and beta-cell adenomas: report of a patient with multiple endocrine adenomatosis type 1.

A patient initially showed symptoms of peptic ulcer disease in 1953 and was later found to have hypercalcemia and hyperparathyroidism. Peptic ulcer symptoms persisted after parathyroidectomy, and results of studies provided evidence of the Zollinger-Ellison syndrome. Evaluation of the patient's family showed a classic pattern of multiple endocrine adenomatosis type 1. The patient underwent total gastrectomy and excision of a gastrin cell adenoma in 1971 with relief of symptoms, but with persistent hypergastrinemia. He remained in good health until January 1976, when symptoms of hypoglycemia developed. Results of laboratory studies were compatible with the diagnosis of a pancreatic beta-cell adenoma. At the time of operation, an adenoma of the head of the pancreas was found. The tumor was excised; no other metastatic tumors were found. The tumor was compatible with a beta-cell adenoma and was found to contain high concentrations of insulin; there was no important amount of gastrin. Symptoms of hypoglycemia have entirely disappeared.

Uterine leiomyosarcoma.

A series of uterine leiomyosarcomas was reviewed in an attempt to assign prognostic significance to clinical and pathologic features. Extension of the sarcoma at the time of initial diagnosis was associated with a dismal outcome; no patient with disease beyond the confines of the uterus survived. Histologic grade was a useful prognostic feature, although low-grade sarcoma can be associated with metastases. Mitotic count was also useful in prognosis, although it did not correlate as well with clinical outcome as did histologic grade. There was no number of mitoses below which the diagnosis of leiomyosarcoma was excluded.

Papillary endothelial proliferation in cystic lymphangiomas. A lymphatic vessel counterpart of Masson's vegetant intravascular hemangioendothelioma.

Papillary endothelial proliferation similar to that of Masson's "vegetant intravascular hemangioendothelioma" of the blood vessels was observed in two cases of cystic lymphangiomas. They are believed to be the lymphatic vessel counterpart of Masson's entity. Twenty-five other specimens of various lymphangiomas examined (18 patients) did not contain the same change. As was emphasized previously for Masson's lesions, lymphangiomas containing similar endothelial changes should also not be mistaken for malignant vascular tumors, since in these two cases, no unusual clinical course supervened. Although the histogenesis of the lesion as proposed by Masson has been disputed, both primary and secondary endothelial proliferation seem to remain possible in the formation of these lesions.

Human pulmonary dirofilariasis presenting as a solitary pulmonary nodule.

A case of human pulmonary dirofilariasis had positive serologic testing postoperatively. Increased awareness of this entity as a cause of solitary pulmonary nodules may lead to preoperative serologic and intradermal testing, and to the possibility of arriving at a preoperative diagnosis.