Morfofisiologia do tecido intertubular e das células de Leydig de jaguatirica (Leopardus pardalis) adulta / Morphophisiology of the intertubular tissue and Leydig cells in adult ocelots (Leopardus pardalis)

Estudou-se o espaço intertubular e descreveu-se seu arranjo em jaguatirica adulta (Leopardus pardalis). Para tal, colheram-se fragmentos dos testículos, de cinco jaguatiricas adultas, provenientes de cativeiro, obtidos por biópsia incisional. O compartimento intertubular correspondeu a 19,4 por cento do parênquima, sendo 3,9 por cento ocupado por células de Leydig. Estes se apresentaram uninucleados, com o núcleo arredondado e nucléolo único, e com grande quantidade de grânulos pigmentares no citoplasma. O compartimento intertubular apresentou padrão do tipo II, e o tecido conjuntivo foi o componente mais abundante do tecido intertubular. Observou-se pequeno percentual de células de Leydig na espécie estudada, e o número médio por grama de testículo, 33,39 x10(6), apresentou-se dentro da amplitude descrita para a maioria dos mamíferos.

The aim of this study was to do a quantitative investigation of the intertubular space and describe its arrangement in adult ocelots (Leopardus pardalis). In this experiment we used testicular fragments, obtained through biopsy from five adult ocelots maintained in captivity. The intertubular compartment corresponded to 19.4 percent of the testicular parenchyma, and 3.9 percent of this compartment was occupied by Leydig cells. The Leydig cells showed to be uninucleate, with rounded nuclei and single nucleoli, with a large amount of pigment granules in their cytoplasm. The intertubular compartment showed a clear pattern of type II and the conjunctive tissue was the most abundant component of the intertubular tissue. Despite the small unit volume of Leydig cells in adult ocelots, the average number per gram of testis (33.39 x106) was within the range described for most mammals.

Sclerosing stromal tumor in an accessory ovary.

BACKGROUND: An accessory ovary is an uncommon congenital anomaly of the female reproductive tract. Tumors arising in ectopic ovaries are extremely rare. CASE: This 18-year-old woman had a pelvic tumor attached to the right ovary which was solid cystic and lobulated and histologically and immunohistochemically showed the appearances of sclerosing stromal tumor, a benign entity. CONCLUSION: We present the first reported case of sclerosing stromal tumor that arose in an accessory ovary.

Primary carcinoma of the subglottic larynx.

Primary cancer of the subglottic region is very rare and delay in diagnosis often leads to a poor prognosis. We retrospectively reviewed 49 patients with primary cancer of the subglottic larynx observed from 1969 to 1993 in the ORL Clinic of the University of Florence. This number constitutes 1.6% of all laryngeal cancers observed during this period. Four (8.2%) patients were stage T1, 13 (26.5%) T2, 27 (55.1%) T3, and 5 (10.2%) T4. Forty-one patients were eligible for assessing the disease-free five-year survival rate, 17 of whom were treated with surgery alone, 6 with radiotherapy alone and 18 with combination therapy (surgery for the primary tumor and postoperative radiotherapy for cervical nodes). The five-year survival rate for the three treatment types was 47%, 0% and 83.3%, respectively. The overall survival rate was 56.1%. Combination therapy produced a significantly higher (P = 0.001) disease-free survival than surgery alone or radiotherapy alone.

Coughing in laryngectomized patients.

Ablation of the larynx implies withdrawal of afferent information from receptors involved both in the control of expiratory flow and in the genesis of protective airway reflexes including coughing. To investigate the effects of laryngectomy on the sensory and motor component of coughing, maximal voluntary cough (MVC) efforts as well as the reflex cough (RC) responses at threshold (T) and suprathreshold (1.8 x T, ST) levels induced by inhalation of progressively increasing concentrations of ultrasonically nebulized distilled water (fog) were analyzed in 10 laryngectomized patients and 10 control subjects. Cough intensity was indexed in terms of both the peak amplitude of the integrated electromyographic activity of abdominal muscles (IEMGP) and the ratio of IEMGP to the duration of the expiratory ramp (TEC), i.e., the rate of rise of IEMG activity (IEMGP/TEC). Cough peak flow was also recorded. Cough threshold was similar in patients and controls, as were IEMGP, TEC, and IEMGP/ TEC recorded during MVC and RCST. In contrast, during RCT, patients' IEMGP was significantly reduced (p < 0.05), thus leading to a significant decrease in IEMGP/TEC (p < 0.05) even in the absence of significant differences in TEC. Cough flow closely correlated with IEMG-related variables. Cough volume acceleration, i. e., the ratio of cough peak flow to the corresponding time to cough peak flow was also significantly reduced in the patients, especially during RCT (p < 0.01). The results suggest that the lack of signals arising from the larynx may result in a reduction of cough volume acceleration as well as in the intensity of abdominal muscle contractions during RCT. These factors may contribute to facilitate the onset and/or the persistence of chest infections in laryngectomized patients.

Parotid gland carcinoma: analysis of prognostic factors.

The histologic variety of parotid gland carcinomas, their different natural history, and the peculiar anatomy of the parotid region can make prognosis and therapeutic strategy quite controversial. The present study was designed to evaluate those prognostic factors able to affect the long-term results in a group of 167 consecutively treated parotid epithelial malignancies. The continuous or discrete covariants considered as potential prognostic factors are age, sex, histotype, grading, TNM and pTNM classification, facial nerve involvement, type of surgery on the tumor site and on nodes, facial nerve resection, and postoperative radiotherapy. All the material has been statistically analyzed and the results have been compared with the principal data published. According to the analysis, the most relevant prognostic factors in parotid gland carcinomas appear to be pTN staging, tumor grading, facial nerve involvement, and local extension. These factors could reliably predict the patient's chance for survival, and thus influence the therapeutic strategy.

Presence and location of endothelin and endothelin-binding sites in human nasal mucosa under normal and metaplastic conditions.

The presence and site of production of endothelin-1 (ET-1) was investigated in biopsies obtained from the nasal mucosa of 10 healthy human subjects and 10 patients affected by chronic rhinitis. The presence and localization of receptors for ET-1 was also investigated. Bioptic fragments were examined by scanning electron microscopy. ET-1 was present in the vessels and in the respiratory epithelium of normal subjects, whereas in patients affected by epithelial metaplasia induced by chronic rhinitis, it was absent in the metaplastic epithelium and present in the endothelium and vascular wall. Receptors for ET (A- and B-receptor subtypes) were localized in the vessels of the nasal mucosa, both in normal and in pathological subjects. In particular, A-receptors were identified in the vascular wall, whereas B-receptors were mainly distributed in the endothelium. We suggest that ET-1 is involved in the homeostasis of nasal blood flow (shunting the blood toward the deep cavernous plexus and inducing mucosal swelling) by an autocrine and/or paracrine mechanism. Normal epithelium seems to be important in this mechanism, since it is able to produce ET. However, when pathologic conditions induce squamous or cuboidal metaplasia, the epithelium is no longer able to play this role.

Multiple neurinomas of the parapharyngeal space.

The authors describe a rare case of three neurinomas arising in the parapharyngeal space. In spite of the large extension of the neoplasms, the only symptom reported by the patient was some dysphagia. Magnetic resonance imaging allowed us to identify the three masses and suppose their diagnosis. The therapeutic approach used is also reported.

Cyclooxygenase and lipoxygenase metabolite generation in nasal polyps.

A role of prostaglandins (PGs) and leukotrienes (LTs) in the pathogenesis of nasal polyps has been recently suggested. Cyclooxygenase (CO) products (thromboxane B2, PGE2 and 6-keto PGF1 alpha) and lipoxygenase (LO) products (LTB4 and LTC4) were investigated by radioimmunoassay in polyps, hypertrophic turbinates and nasal mucosa from 14 patients with non-allergic (n = 6), allergic chronic rhinitis (n = 6) and aspirin-sensitive asthma (ASA) (n = 2), who underwent polypectomy. In all tissues CO metabolite levels were found higher than LO products (P < 0.01). Nasal polyps showed a significantly lower (P < 0.05) arachidonic acid (AA) metabolism in comparison to nasal mucosa. In polyps of allergic patients significantly higher LTB4 levels (P < 0.001) and a tendency to produce higher amounts of CO products in comparison to non-allergic subjects were observed, whereas in turbinates of non-allergic patients LT levels were significantly higher in comparison to those of allergic ones (P < 0.01). In ASA patients a decreased CO/LO ratio was found supporting the hypothesis of an imbalance of AA metabolism in this syndrome. These findings seem to indicate that the occurrence of nasal polyps may represent the result of different chronic inflammatory stimuli, regulated in part by AA metabolites.

The human nasal mucous membrane during chronic inflammation, before and after muco-active therapy: a study using scanning electron microscopy.

Chronic inflammation seems to induce alterations in nasal mucosa morphology. The type and extent of these alterations seem to be directly correlated with the duration of the inflammation. This study was carried out to ascertain whether the administration of muco-active drugs could modify these alterations by inducing their total or partial regression. Ten healthy control subjects, and thirty patients affected with chronic rhinopharyngitis, at various levels of severity, were studied. All the forty subjects underwent biopsy of the posterior region of the medium turbinate. The bioptic samples were examined using Scanning Electron Microscopy (SEM). Patients with phlogosis underwent treatment which consisted of a single day administration of carbocysteine-sobrerol (1125 mg carbocysteine and 180 mg sobrerol day 20 days). This group underwent biopsy again and the fragments obtained were studied using the same method. Chronic inflammation, in the nasal epithelium, causes progressive degenerative phenomena, which are related to the duration and to the severity of the pathology. The response of the nasal mucosa principally results in damage to the muco- ciliary unit, loss of cilia and consistent modifications in the mucous secretion. In cases of persistent inflammation, the nasal epithelium becomes squamous. The therapy employed was able to alter the morphological signs of degeneration in the less severe cases, and to improve the overall pattern of the most severe and irreversible pathologies.

Scanning electron microscopic study of nasopharyngeal carcinoma.

The study has been carried out on biopsies taken from four patients affected by squamous cell carcinoma and four patients affected by undifferentiated carcinoma of nasopharyngeal type (UCNT). Three healthy volunteers have served as controls. All the specimens have been studied by SEM. The neoplastic conditions cause obvious alterations both in the mucosal surface and in the morphology of the cellular apex.

[Comparison of the results of surgery and radiotherapy in 175 cases of T2 glottic carcinoma: 116 operated and 59 irradiated cases]. / Confronto fra i risultati della chirurgia e della radioterapia in 175 carcinomi T2 glottici: 116 casi operati e 59 irradiati.

The results were analyzed of 175 patients with glottic squamous cell carcinomas who were treated with curative purposes (1970-1986). One hundred and sixteen of them underwent surgery at the Otolaryngology Department of the University of Florence, and 59 were treated by radiation therapy at the Florence University and Hospital Departments of Radiotherapy. In the surgical series 78 cases were treated with radical surgery and 38 with conservative surgery. All patients were staged according to TNM system (UICC 1978) as T2. Overall 10-year local control rates were 74% for the surgical series and 69% for the cases treated by radiation therapy. After salvage therapy 10-year survival rates were 83% and 76%, respectively. The analysis of the results showed no statistically significant difference. In the group treated by radical surgery 80% local control was observed, versus 66% in the cases treated with conservative surgery. 10-year survival rate was higher in the latter group (89% versus 81%) because of better results of salvage therapy: 7 of 10 recurrences were salvaged with the second treatment. Several prognostic factors were evaluated, i.e., T extent, anterior commissure involvement, subglottic invasion, vocal cord mobility impairment, and ventricular involvement. Anterior commissure involvement was the main factor affecting outcome in the surgical series: in the presence of this factor, 64% 10-year local control was observed versus 85% in the patients without commissure involvement. This factor proved more important in the patients treated with conservative surgery (10-year control: 42% versus 88%) than in those undergoing radical surgery (78% versus 85%). Anterior commissure involvement and the number of involved subsites were found to worsen prognosis in the series treated by radiation therapy: cases with anterior commissure involvement had 59% 10-year local control versus 83%. The cases with a deeper spread had 60% local control versus 75%. Vocal cord mobility impairment was a less important prognostic factor in both series. Our results suggest radiation therapy as a valuable method in the treatment of the small T2 laryngeal cancers which are not suitable for conservative surgery.

Beneficial effects of intranasal applications of capsaicin in patients with vasomotor rhinitis.

Capsaicin, a nonenamide derived from Capsicum plants, has proven useful in patients with vasomotor rhinitis. In the present study, we studied the effects of 15 micrograms capsaicin suspended in 100 microliters solution in patients with known vasomotor rhinitis. Drug was given 3 times/day for 3 days to each patient by means of a spray delivered to the nasal mucosa. Acute effects induced by the drug included painful sensation and secretion of nasal fluid but were no longer observed at the last capsaicin application. Patients recorded their symptoms over a 1-month period. The mean symptom score involving nasal obstruction and nasal secretion was markedly reduced by capsaicin treatment. We advance the hypothesis that the beneficial effect of drug treatment may be due to its specific action on the peripheral endings of primary sensory neurons leading to their functional blockade. Further randomized, double-blind, placebo-controlled trial is now needed.

[Scanning electronic microscopy study of nasopharyngeal carcinoma]. / Studio al microscopio elettronico a scansione del carcinoma rinofaringeo.

The nasopharyngeal carcinoma is a greatly interesting model of study. Its morphology has been studied in 8 patients affected by squamous cells carcinoma (4 cases) and by undifferentiated carcinoma (4 cases). By means of a fibre-optic pharyngoscope equipped with mechanical biopsy forceps, biopsies have been taken and subsequently studied by scanning electron microscopy (SEM). Squamous cells carcinoma is characterized by large, flattened elements, generally equipped with a network of microridges. Irregular microvilli or smooth apices have been observed too. Desquamating elements often accumulated in waves or vortices, as far as little cornified structures have been described. Undifferentiated carcinoma shows a great morpho-structural disorder. In a rugged surface, it is possible to observe element highly varying for size and shape. The apical plasmalemma is characterized by pleomorphic microvilli, while it must be emphasized the presence of little pseudopod-like extrusions of some cellular apices. Ciliated elements have been observed too, whose apical specializations are distorted or irregularly disposed. Necrotic zones are particularly frequent, in which bacteria or mycetes proliferate. The role of SEM in the study of this tumour is emphasized, because of the close relation between epithelial patterns and natural history of nasopharyngeal carcinoma.

Total parotidectomy--a routine treatment for parotid gland swellings?

The results of 25 years of quasi-routine total parotidectomy performance are shown. At the Department of Otolaryngology of the University of Florence, 582 patients were treated as follows: on 527 occasions by total parotidectomy with facial nerve preservation; 24 occasions by lateral lobectomy; 27 occasions by total parotidectomy with removal of the whole facial nerve; four times by enucleo-resection of the disease. Benign tumours were 378; primary and metastatic malignant tumours--100; non tumoral lesions--104. The benign tumours follow-up showed three recurrences only (two pleomorphic adenomas--one of them proved to be an adenoid-cystic carcinoma, and one monomorphic adenoma, which also proved to be an adenoid-cystic carcinoma), respectively 6, 6 and 8 years later. The malignant tumours were also treated by total parotidectomy with adequate management both of the facial nerve and the neck lymph nodes. The results thoroughly justify the nerve preservation, when preserved.

Study of the nasopharynx in man by scanning electron microscopy.

To date only few and often disagreeing studies about human nasopharynx are available. The present research has the purpose to give a contribution to the knowledge of nasopharyngeal epithelium using S.E.M. The study was carried out on biopsies taken from 20 healthy volunteers. The surface of nasopharynx is covered by ciliated cells, microvilli provided cells and goblet cells. Areas covered with squamous epithelium and presumably transitional epithelium were observed. The possibility that ciliated cells become microvilli provided cells is discussed.

Stability of cefonicid sodium in infusion fluids.

The chemical stability of cefonicid sodium in infusion fluids was analyzed. Cefonicid sodium vials were reconstituted and diluted with sterile water for injection and other commonly used intravenous fluids to concentrations of 325, 220, 40, 20, and 5 mg/mL. Cefonicid concentration was analyzed by high-performance liquid chromatography initially and after storage at room temperature and 5 degrees C. Reconstituted vials were frozen as long as eight weeks, thawed, and kept at room temperature and 5 degrees C and then analyzed. Cefonicid sodium reconstituted in each of the diluents studied exhibited no change in clarity and very little change in potency after 24 hours at room temperature and after 72 hours at 5 degrees C. Some vials with high concentrations became turbid between 72 and 96 hours at 5 degrees C. The thawed vials were chemically stable for 24 hours at room temperature and for 96 hours at 5 degrees C. When reconstituted with sterile water for injection and other commonly used intravenous fluids, cefonicid sodium vials and small-volume infusions are chemically stable for 24 hours at room temperature and for 72 hours at 5 degrees C. Reconstituted cefonicid sodium vials can be frozen and stored for as long as eight weeks, thawed, and then kept at room temperature for 24 hours or at 5 degrees C for 72 hours.

Reconstructive laryngectomy.

Reconstructive laryngectomy, the aim of which is to leave the patient without a tracheostoma, thus preserving the normal pneumophonic function relative to vocal articulation, is a link between the various techniques suggested for conservative laryngeal surgery and classic total laryngectomy. The aim of this technique is to restore continuity to the airways, so that the patient is able to breathe naturally and subsequently can speak without having to resort to the use of esophageal voice.