Traumatic pseudocyst of the spleen.

Four patients with pseudocyst of the spleen gave histories of abdominal trauma. In one patient the pseudocyst had ruptured, necessitating emergency splenectomy 34 years after the original injury. In a second patient the pseudocyst was discovered incidentally, and was managed by spleen-preserving excision; and the third and fourth presented with abdominal pain and had splenectomy and spleen-preserving surgery, respectively. All patients with conservatively treated splenic injury are at risk of developing a pseudocyst of the spleen, and the lesion can be detected by computed tomography or ultrasound. When there are no symptoms the natural history is unknown; but if surgery is necessary, splenectomy can sometimes be avoided.

A comparison of IgA in portal and peripheral venous blood.

A comparison of IgA in portal and peripheral venous blood was made to elucidate further any possible role of the liver in IgA functions in man. Over fifty paired samples of portal and peripheral blood were obtained from patients undergoing abdominal surgery. The samples were examined for total IgA and secretory IgA content, IgA immune complexes, and the proportion of polymeric IgA and IgA antibodies to Streptococcus mutans and Escherichia coli. No significant differences in the overall IgA concentration in portal and peripheral venous blood were found, but the concentration of secretory IgA was raised in portal blood (P less than 0.02). The IgA content of immune complexes (PEG precipitates) was significantly raised in portal sera compared with peripheral sera. Antibody levels to S. mutans or E. coli were not significantly different in the paired samples. A mean of 18.1% of the IgA in portal blood was greater than 7S in size compared with a mean of 15.3% in peripheral blood (P less than 0.01). Detectable differences between IgA in portal and peripheral venous blood could indicate some role of the liver in the transport of polymeric IgA and IgA complexes from serum to bile in man, but could represent increased production of these types of IgA in tissues drained by the portal vein.

Secretion of proteinases from malignant and nonmalignant human breast tissue.

Both malignant (adenocarcinomas) and nonmalignant (fibroadenomas and normal tissue) human breast tissues were maintained in organ culture for up to 10 days to study the secretion of lysosomal and neutral proteinases. Little difference was observed between the different tissue groups in the release of the lysosomal proteinase cathepsin D into the culture medium. Similar results were obtained when media were tested for plasminogen activator activity. The secretion of collagenolytic activity was investigated with fibroadenoma and adenocarcinoma explants and found to be very low for both tissue groups. The average accumulation of collagenase activity during a 2-day period was 0.002 units/microgram DNA for adenocarcinomas and 0.008 units/microgram DNA for fibroadenomas. The only proteinase that was secreted in substantially higher amounts from explants of malignant tissue was a cathepsin B-like thiol proteinase. Media from adenocarcinoma explants (n = 38) contained on the average 11 times more activity than did media from fibroadenoma (n = 20) and normal tissue explants (n = 8). Metastases of mammary adenocarcinomas (n = 7) secreted the thiol proteinase at about one third of the rate of primary tumors. The secretion of this enzyme is dependent upon protein synthesis as its release was completely inhibited 24 hr after the addition of cycloheximide. In some cases, it was also observed that the presence of sheep serum in the tissue culture medium reduced the accumulation of activity.

The effect of malignant disease on peritoneal healing in the rat.

A study of the healing of peritoneal defects in the rat in the presence of the Walker 256 tumour has been made. The healing process was investigated histologically, by autoradiography, and by hydroxyproline estimation of the healing peritoneal wound. There was no difference in the rates or quality of the healing process in the control or tumour bearing animals.