Heterotopic bone formation in two cases of colon carcinoma.

Heterotopic bone formation is rare in the gastrointestinal tract. We here present the clinical and pathologic details of a 56-year-old male patient with mucinous adenocarcinoma of the colon and a 70-year-old male patient with colon metastasis previously operated on for signet-ring-cell carcinoma of the stomach who was treated with radiotherapy postoperatively. Both of them showed diffuse bone metaplasia. Heterotopic bone formation is usually present with mucin-producing benign or malignant tumors. The pathogenesis of osseous metaplasia is not well known; however, it is speculated that the extravasation of mucin may have a stimulatory role.

Griscelli's Syndrome: Clinical and Immunological Features of Two Siblings.

Two siblings diagnosed with Griscelli's syndrome (GS) are presented. The clinical features were partial albinism, silvery hair and absence of giant granules in the white blood cells. The diagnosis of GS was confirmed at the ages of nine months and two months by the demonstation of irregular clumps of pigment in the hair shaft, a finding characteristic of this syndrome. The patients had hepatosplenomegaly and bone marrow examinations revealed Iymphohistiocytosis. Immunological studies revealed normal serum immunoglobulin levels and normal T and B Iymphocyte counts. Skin tests were positive for phytohemagglutinin and PPD in the first patient. Phagocytosis was studied by flow cytometry using Mo Ab (DCFH, PMA oxidative burst, Coulter) in the second sibling and it was found as normal. Splenectomy was performed in the second sibling because of excessive splenomegaly at the age of six months but she died two months later. The first sibling died at the age of 18 months because of infection. Postmortem examination of the siblings revealed Iymphohistiocytosis in the liver and spleen.

Granulomatous interstitial nephritis in extrapulmonary sarcoidosis.

Sarcoidosis is a multisystem disorder in which the lungs or intrathoracic lymph nodes are involved in more than 90% of patients with the disease. It occasionally involves kidneys most commonly due to disordered calcium metabolism. Granulomatous interstitial nephritis is a distinct renal pathology in sarcoidosis. Renal dysfunction due to granulomatous interstitial nephritis is rare. We recently encountered a sarcoidosis patient without hypercalcemia and any evidence of pulmonary involvement which is distinctly unusual.

Lymphocytic hypophysitis in a patient with Graves' disease.

A case of lymphocytic hypophysitis is described in a patients with Graves' disease and diabetes mellitus. The 62-year-old man was admitted to hospital with the complaints compatible with hyperthyroidism in April 1993. His medical history, physical examination, thyroid function tests, thyroid scintigraphy and thyroid ultrasonography revealed Graves' disease. The patient had also suffered from diabetes mellitus for three years. After this, the patient's progress was not monitored for two years. The patient presented himself again in September 1995 with complaints of hypothyroidism, hypogonadism and hypoadrenalism. Hormonal investigation showed panhypopituitarism. A magnetic resonance imaging of the pituitary gland disclosed an enlarged pituitary and a thickened infundibulum. The high intensity signal of the neurohypophysis was absent. Transsphenoidal hypophysectomy was performed which revealed a grey-white, relatively avascular pituitary mass. Histology showed diffuse infiltration of the anterior pituitary by numerous lymphocytes. The neurohypophysis also showed evidence of lymphocytic infiltration. On the basis of these findings we suggest that lymphocytic hypophysitis may be associated with Graves' disease.

Neuroblastoma and Poland syndrome in a 15-year-old boy.

A 15-year-old boy with neuroblastoma associated with Poland syndrome is presented. He was admitted with a 2-month history of progressive back pain and a 3-day history of weakness of the lower extremities, encopresis and enuresis. On physical examination, in addition to paraplegia, absence of the pectoralis major muscle was diagnosed on the right side of his chest. A large heterogeneous mass in the right side of the thorax was revealed on computerized tomography. Neuroblastoma was diagnosed on histopathological analysis of the mass. To the authors' knowledge this is the first case of neuroblastoma associated with Poland syndrome in the literature.

Carcinoid syndrome due to a malignant somatostatinoma.

Somatostatinoma is one of the rarest tumours of the endocrine pancreas. Cardinal manifestations of a somatostatinoma include gallstones, mild diabetes mellitus, steatorrhoea, diarrhoea and dyspepsia. Like any other pancreatic islet cell carcinoma, a somatostatinoma may also produce several different hormones such as adrenocorticotropic hormone, calcitonin, vasoactive intestinal polypeptide, pancreatic polypeptide, gastrin, insulin, and glucagon. In many cases, the clinical picture is dominated by the effect of these other hormones. We present a patient with somatostatinoma in which an immunocytochemical study of the specimens from pancreas and liver showed a weak positive reaction for gastrin besides a strong positive reaction for somatostatin. Interestingly, this patient also showed the signs of carcinoid syndrome which was successfully treated with octreotide.

Fibrin glue and conventional sutured vasal anastomosis in the rat.

The present study was undertaken to evaluate the use of fibrin glue (Tisseel, Immune U.S., Inc) for vasovasostomy and to compare this technique to conventional sutured vasovasostomy. Thirty immature Sprague-Dawley rats, weighing from 60 to 80 g, were used in this study. A conventional one-layer sutured anastomosis (Ethilon 10-O) in 10 rats was compared to a fibrin glue technique of vasal anastomosis (10 rats). The fibrin glue technique was performed without sutures and was unstented. The biological glue was utilized to seal both ends of the vas. The contralateral vas was ligated with 5-O prolein. In the control group (10 rats) the left vas was ligated in the same way, and only the contralateral vas was explored. After 2 months, one male and two female rats were placed in a cage for a further 2 months. At the end of this period, the fertility rate was 80% (n = 8) of the control group, 60% (n = 6) of the conventional anastomosis, and 70% (n = 7) of fibrin glue groups, respectively. The testes and vasal specimens were evaluated for the presence of sperm granuloma, and histologic studies were performed. The incidence of sperm granuloma after vasovasostomy was 20% (n = 2) for the fibrin glue group and 30% (n = 3) for the sutured group. The sperms were seen in the proximal and distal side of the vasal anastomosis in 10 rats in the control group, in 8 in the glue group, and in 8 in the conventional sutured anastomosis group.(ABSTRACT TRUNCATED AT 250 WORDS)

Colonic subepithelial collagenous thickening in diabetic patients.

PURPOSE: This study was designed to investigate the effect of intestinal subepithelial collagenous thickening on diabetic diarrhea because one of the seven patients diagnosed with collagenous colitis was diabetic. METHODS: Rectosigmoidoscopic rectal biopsies were taken from 50 diabetic patients (8 with and 42 without diarrhea), 20 nondiabetic patients with diarrhea, and 10 healthy patients. Histopathologic examinations and measurements of subepithelial collagen layers were performed on these biopsies. RESULTS: In diabetic patients who had diarrhea, the subepithelial collagen layer (SCL) was thicker than it was in diabetics without diarrhea (P < 0.05). In diabetic groups, the SCL was thicker than it was in both nondiabetics with diarrhea and those without diarrhea (P < 0.05). There was no statistical difference between nondiabetics with diarrhea and those without (P > 0.05). There was no correlation between collagen thickness, age, and diabetes duration (P > 0.05). CONCLUSIONS: It was concluded that there was a thickening of the colonic SCL in diabetic patients.

Virginal hypertrophy. Case report.

A 13-year-old girl with virginal hypertrophy (bilateral extensive juvenile hypertrophy) of the breasts is presented. Her breasts began to grow rapidly after puberty and reached an enormous size within a year. On examination, both breasts were greatly enlarged. Routine blood chemistry and the endocrinological investigations were normal. The computerized tomography scan of the sella was unremarkable. A bilateral reduction mammaplasty was performed, and histological analysis of the breast tissue revealed the diagnosis of virginal hypertrophy. After four months her breasts began to grow again, and a second mammaplasty was performed. After this operation, tamoxifen citrate was given to prevent recurrence for four months, and during the follow-up period of 20 months, no recurrence was noted.

Infantile Cronkhite-Canada syndrome?--Case report.

This is a case report of juvenile gastrointestinal polyposis involving the gastrointestinal system from the stomach to the rectum. Only few cases have been reported and extra-intestinal manifestations of this syndrome include macrocephaly, hepatosplenomegaly, hypotonia, clubbing of fingers, anemia and protein-losing enteropathy. The disease usually has a poor prognosis, and the children rarely live more than 2 years.

Cervical spinal intramedullary myxoma in childhood. Case report.

A unique case is reported of a cervical intramedullary myxoma in an 18-month-old boy who presented with torticollis and monoparesis. Radical removal of the tumor by a planned two-stage procedure was curative.

An experimental evaluation of response to contrast media: Pantopaque, iopamidol, and iohexol in the subarachnoid space.

Myelography in dogs was performed with Pantopaque, iopamidol and iohexol. The effects of these agents were evaluated by histologic study of the brain, spinal cord, and meninges four months after the procedure. Retained Pantopaque was always accompanied by some degree of arachnoidal reaction, mild in the cervical cord segment and severe in the most caudal part of the cul-de-sac. No apparent protection against Pantopaque arachnoiditis was provided by either intrathecal or intramuscular methylprednisolone. We found no histologic evidence of arachnoiditis in animals examined with iopamidol and iohexol.

Effect of growth hormone on epiphyseal growth plates in zinc deficiency.

This study was carried out on 18 albino rats. The control group, consisting of six rats, was fed a normal diet and tap water. The other rats were given a zinc-deficient diet and deionized water. Two weeks later the latter group was again divided into two into smaller groups. The first of these groups was given an given an additional 100 ppm of zinc acetate. From the fifteenth day onwards, the human growth hormone (Nanormon) was injected intra-peritoneally to each group at a dose of 80 micrograms/day for two weeks. At the end of the experiment, it was found that body weights were markedly increased in the control and zinc-added groups compared with the zinc-deficient rats. In the zinc-deficient group, serum zinc, hair zinc levels, alkaline phosphatase activity and serum protein levels were lower than those of the control and zinc-added groups. The zinc-deficient group had narrower tibial epiphyseal growth plates than those of the control group. The count of hypertrophied cells was also less in the zinc-deficient group. Based on these data, our conclusion was that the growth hormone becomes ineffective under conditions of zinc deficiency. This means that zinc deficiency has multidimensional effects on growth hormone activity.

Peritoneal mesothelioma and malignant lymphoma in mice caused by fibrous zeolite.

Dust from the village of Karain containing the fibrous zeolite erionite, talc, and physiological saline were tested by intraperitoneal injection in 486 Swiss albino mice. Malignant tumours were found in 84 (41 mesotheliomas, 31 lymphomas, 1 peripheral epidermoid carcinoma, and 11 lymphomas and mesotheliomas together) of the 321 animals which died spontaneously within nine to 32 months after injection of Karain dust (26.1%). Three mesotheliomas and no lymphomas were found among 24 animals injected in the same way with talc during the same time (12.5%). In 46 control animals injected with physiological saline three mesotheliomas and one lymphoma were seen (8.7%). Thus Karain dust appears to be a potent carcinogen, causing both mesotheliomas and malignant lymphomas.