[Hürthle-cell thyroid neoplasms: a clinical enigma]. / Le neoplasie tiroidee a cellule di Hürthle: un enigma clinico.

Hürthle cell neoplasms represent a pathological entity whose diagnosis and therapy are still not defined. These neoplasms constitute from 1.5% to 10% of all thyroid tumors. Hürthle cell nodule is clinically indistinguishable from other nodular thyroid diseases and histologic features of the tumors do not always allow us to distinguish benign nodules from malignant ones. The authors, analyzing a segment of their own experience (335 surgical thyroid diseases), observed nine cases of Hürthle cell adenomas (0.03%). Because of concomitant presence of heterolobar thyroid disease, seven cases were treated with a total thyroidectomy, and two cases were treated with a lobo-isthmectomy. In a long-term follow-up study, there were not signs of Hürthle cells neoplastic disease. The authors suggest that the treatment of choice for patients with "surely benign" Hürthle cell nodule is lobo-isthmectomy. For malignant Hürthle cell tumors, total thyroidectomy is the most rational treatment associated with cervical lymphadenectomy in presence of metastatic nodes. In all cases, a long-term periodical check-up proves to be the best solution, also for patients treated for benign pathological Hürthle cell.

[An unusual case of orbital cellulitis and perforating scleromalacia]. / Cas insolite de cellulite orbitaire et scléromalacie perforante.

We report the case of a diabetic patient with refractory anemia with excess blasts (RAEB) who developed bladder infection followed by orbital cellulitis and nodular skin lesions. After a short remission, the clinical aspect was complicated by corneal ulceration, scleromalacia, bulbar perforation and lens luxation.

[Optic glioma in 3 patients with Recklinghausen disease]. / Optikusgliome bei drei Patienten mit Morbus von Recklinghausen.

BACKGROUND: Patients with neurofibromatosis demonstrate a very variable clinical picture with signs that are largely age dependent. Rarely a glioma is the first presenting sign of the disease. PATIENTS: Three patients with gliomas of the optic nerve and chiasm with neurofibromatosis 1 (NF1) were followed for 10-20 years. Clinical course and therapy are discussed. CONCLUSION: The correct diagnosis of exophthalmos, papilledema or optic atrophy in childhood is facilitated by family history and examination of an adult member of the family, who is likely to have already developed café-au-lait spots, neurofibromas of the skin, axillary freckles and Lisch nodules as clinical signs of neurofibromatosis.

Levels of ethanolamine intermediates in the human and rat visual system structures: comparison with neural tissues of a lower vertebrate (Mustelus canis) and an invertebrate (Loligo pealei).

Levels of ethanolamine intermediates in the retina and optic nerves of autopsied human donors and in the rat visual system (retina, optic nerve, lateral geniculate body, superior colliculus) were measured. Amounts were also obtained from the retina, optic nerve, and optic tectum of a primitive elasmobranch, the smooth dogfish Mustelus canis, and from the related nervous structures (retina, optic lobe, fin nerve, and stellate ganglia) of a marine invertebrate, the squid Loligo pealei. In all regions of the human and rat nervous system, the pool size of CDP-ethanolamine (values ranging between 10-31 nmol/g wet wt) was much smaller than that of free ethanolamine (values ranging between 197-395 nmol/g wet wt), whereas glycerophosphorylethanolamine was present in relatively high content (values ranging between 125-280 nmol/g wet wt). In nervous system regions of the dogfish and squid, the distribution of values followed the same general trend as observed for humans and rats, even if all regions had less ethanolamine intermediates compared to the mammalian counterpart. In dogfish and squid retina, glycerophosphorylethanolamine showed the highest pool size among the ethanolamine derivatives analyzed (16 and 44 nmol/g wet wt, respectively). The present study confirms the basic similarity of ethanolamine intermediate pool size patterns in the nervous system structures (with the exception of the retina) of animal species which have widely different phylogenetic positions. The data support the proposal that the levels reached by ethanolamine and its derivatives in the nervous tissue is the result of an ancient evolutionary development of metabolic pathways for the maintenance of phosphatidylethanolamine membraneous content.

Effects of Nd-Yag laser vitreolysis on lens and vitreous prostaglandins in the rabbit eye.

This study concerns the quantitative modifications of the prostaglandins, PGF alpha e PGE2, in the vitreous and in the lens following the application of Nd-Yag Laser. Five minutes after the Yag-laser treatment, an increase of PGF1 alpha concentration of PGE2 decreased in the lens and increased in the vitreous. These changes, similar to those occurring in the aqueous humor, may be related to the activation of specific enzymatic pathways of prostaglandin synthesis.

Bilateral papilledema in a patient with brucellosis.

The authors report bilateral papilledema in a 14 year old boy with brucellosis. Papilledema disappeared completely about one month after the clinical recovery of brucellosis, treated with rifampicin and minocicline, without associated steroids or non steroidal anti-inflammatory drugs.

A rare case of basosquamous carcinoma of the orbit invading the maxillary sinus.

A rare case of basosquamous carcinoma of the orbit invading the maxillary sinus is presented. The authors discuss clinical and pathological findings. Techniques for removal and reconstructive plastic surgery are reported.

Superoxide dismutase activity and reduced glutathione content in cataractous lens of patients with glucose-6-phosphate dehydrogenase deficiency.

In the present research we have assayed the glucose-6-phosphate dehydrogenase, superoxide dismutase activities and reduced glutathione content in human cataractous lenses of 83 Sicilian subjects. Five of 45 males were G6PD deficient, whereas eight of 38 females showed a significant reduction in G6PD by 50%. The five males hemizygous for G6PD defect showed undetectable G6PD activity and low GSH levels in their lenses when compared to cataractous patients without erythrocyte G6PD deficiency; on the contrary, the specific activity of lenticular total SOD was found to be significantly increased. The G6PD and SOD activities as well as GSH levels, in the lenses of eight females with intermediate erythrocyte G6PD levels, were not significantly different when compared to females with normal erythrocyte G6PD activity.

Hyperprolactinaemia increases intraocular pressure in humans.

Nine female and 2 male hyperprolactinaemic patients (plasma prolactin levels averaging 180-420 ng/ml) were subjected to measurements of intraocular pressure (IOP) either under basal conditions or after water load in comparison with 5 healthy volunteers. Basal values of IOP in hyperprolactinaemic patients were 37.8% higher than those of controls. Moreover, after water load hyperprolactinaemic patients showed a sustained increase in IOP that reached values of pathological significance. These results suggest that prolactin may contribute to the hormonal regulation of IOP in humans.

Familial optic atrophy with sex-influenced severity. A new variety of autosomal-dominant optic atrophy?

A family is described with 20 members in three successive generations affected by optic atrophy without other ocular or extraocular manifestations. The anomaly was transmitted as an autosomal-dominant character. There was a clearly bimodal distribution of severity: 4 male patients complained of severe impairment of vision since childhood while 16 other subjects (7 males and 9 females) were completely asymptomatic. This family could be an example of a new variety of autosomal dominant optic atrophy characterized by sex-influenced severity.

Penetration of 14C-methisoprinol into rabbit eyes with experimentally induced herpetic keratitis.

The authors studied the penetration of 14C-labelled methisoprinol into ocular tissues (cornea, aqueous humour and iris) in rabbits, in which herpetic keratitis had been experimentally induced. It has been demonstrated that the methisoprinol crosses the corneal barrier. The maximum concentration of the drug in the tissues examined was measured 30 min after the instillation of the drug into the conjunctival sac, and persisted for 60 min, although at a slightly lower level.

Glucose-6-phosphate dehydrogenase deficiency and incidence of cataract in Sicily.

The incidence of G6PD deficiency in red blood cells of 241 Sicilian cataractous patients (138 males and 103 females) and in the lens of 32 subjects (15 males and 17 females) of the same group was evaluated. The incidence of G6PD deficiency was significantly higher than expected (p less than 0.001), both in RBCs and in lens. The results suggest that G6PD deficiency is a risk factor for cataract both in hemizygous males and heterozygous females.

[Antiglaucomatous trabeculectomy (author's transl)]. / Antiglaukomatöse Trabekulektomie.

UNLABELLED: The case material covers 115 glaucoma patients in whom antiglaucomatous trabeculectomy had been performed. Observation times: between a maximum of 3 years (12 cases) and a minimum period of 6 months (18 cases). CLASSIFICATION: Open-angle glaucoma 28 cases (22.8%), narrow-angle glaucoma 22 cases (19.1%), air-block glaucoma 17 cases (14.75%), other types 16 cases (13.91%). Best results were obtained with the open-angle glaucoma; surgery had reduced the pressure to normal in 85.21% of the cases. In addition, normal pressure was achieved by drug therapy in 8.8% of the cases. Good results were also obtained in glaucomas with narrow angle of iris (pressure normalization in 86.3% of the cases), as well as in combined surgery when glaucoma and cataract occurred simultaneously. The mechanism of action of the surgical procedure consists in the formation of a fistulating excretory duct covered up by a scleroconjunctival wall, generally forming a flat seepage cushion.