SOME ALDOSTERONE-PRODUCING ADRENAL TUMOURS ALSO SECRETE CORTISOL, BUT PRESENT CLINICALLY AS PRIMARY ALDOSTERONISM

1. Two patients with angiotensin-responsive aldosterone-producing adenoma (APA) and one with adrenal cortical carcinoma demonstrated autonomous secretion of cortisol as well as of aldosterone. 2. The response of cortisol and of aldosterone to ACTH did not differentiate between the two APA which secreted cortisol and the eight which demonstrated normal suppression with dexamethasone. 3. Concurrent autonomous secretion of cortisol as well as aldosterone may occur in patients who present clinically with primary aldosteronism. 4. Biochemical distinctions between adenomas may reflect differences in their cellular composition.     

甲状旁腺素对人成骨肉瘤细胞株SaOS-2内cAMP,IP3,Ca~(2+)的作用研究

目的通过研究ｈＰＴＨ（１～３４）对人成骨肉瘤细胞株ＳａＯＳ－２胞浆内ｃＡＭＰ、ＩＰ３、Ｃａ２＋的影响，来阐明ＰＴＨ与其膜上特异受体结合后的胞浆内主要信息传递途径。方法利用蛋白竞争结合法测定胞浆内ｃＡＭＰ，以Ｆｌｕｏ－３／ＡＭ作为荧光指示剂，激光共聚焦显微系统显示ＳａＯＳ－２内［Ｃａ２＋］ｉ的变化，离子交换层析法测定ｈＰＴＨ（１～３４）作用下胞浆内ＩＰ３的改变。结果ｈＰＴＨ（１～３４）可使ＳａＯＳ－２胞浆内ｃＡＭＰ明显升高且与其浓度呈正相关，其最佳作用时间为１０ｍｉｎ。ｈＰＴＨ（１～３４）能迅速提高ＳａＯＳ－２内［Ｃａ２＋］ｉ，而且作用３０ｓ时ＳａＯＳ－２胞浆内ＩＰ３升高即达最高峰，未发现百日咳毒素对此现象有抑制作用。结论ｃＡＭＰ及ＩＰ３／Ｃａ２＋两条信息途径均参与ｈＰＴＨ（１～３４）对成骨细胞的调节作用     

VITAMIN A AND CALCIUM-REGULATORY HORMONES

Excess vitamin A decreases bioactive serum parathyroid hormone and 1, 25-(OH)₂D₃ concentrations in the rat.     

Myoepithelioma of the head and neck: case report and review

The clinical, light, and ultrastructure features of a myoepithelioma occurring on the hard palate of a 24-year-old woman are presented and compared with 41 myoepithelioma of the head and neck described in the English literature. These 42 tumors (39 benign and 3 malignant) occurred in individuals from 14 to 81 years of age, affected both sexes about equally, and most often presented as a slowly enlarging, asymptomatic mass. The parotid gland and palate were the most common sites of occurrence. The tumors are typically circumscribed and encapsulated, vary from 1 to 5 cm in the greatest dimension, and are composed of spindled and/or plasmacytoid myoepithelial cells. Prognosis correlates with histologic appearance and parallels that of the pleomorphic adenoma. Conservative excision with a margin of uninvolved tissue is curative. The differential diagnosis and histogenic relationship with other closely related neoplasms are discussed.     

Functional classification of pituitary adenomas

Summary Results of clinical, endocrinological, and ultrastructural studies of 60 cases of pituitary tumours are presented. A functional classification of such tumours that would: allow a clear correlation between clinical symptoms and the adenoma type, is discussed together with data available from the literature.A case of pituitary adenoma secreting more than two hormones is presented.     

Parathyroid hormone-related protein-secreting uterine endometrioid adenocarcinoma

The diagnosis of parathyroid hormone-related protein (PTHrP)-secreting metastatic uterine endometrioid cancer was made in a 32-year-old Japanese woman with humoral hypercalcemia of malignancy. The primary endometrial cancer had been removed, and the tumor was diagnosed as Grade 1 endometrioid adenocarcinoma with shallow myometrial invasion. Salvage chemotherapy (paclitaxel and calboplatin) was started from 5 months after surgery when recurrent tumors were detected in the peritoneum and liver. Despite the salvage chemotherapy, the tumor progressed and hypercalcemia became evident with elevated PTHrP whereas no bone metastasis was identified. To the best of our knowledge, this is the first reported case of hypercalcemia due to PTHrP secretion in uterine endometrioid adenocarcinoma.     

Does a selective cyclooxygenase-2 inhibitor (tiracoxib) induce clinically sufficient suppression of adenomas in patients with familial adenomatous polyposis? A randomized double-blind placebo-controlled clinical trial

Background There have been few placebo-controlled randomized double-blind studies of the clinical effects of selective cyclooxygenase-2 (COX-2) inhibitors on the regression of colorectal tumors. This study was designed to examine the regressive effect of a selective COX-2 inhibitor, tiracoxib (JTE-522), on colorectal polyps in patients with familial adenomatous polyposis (FAP), and its safety. Methods Sixty-one patients with FAP diagnosed by Japanese criteria were assigned randomly to receive placebo or JTE-522, at either 150 mg or 200 mg, once daily orally for 26 weeks. Prior to and at the end of the medication period, endoscopy was performed. Adenomas located near an india-ink tattoo injected at the first colonoscopy were identified and measured. The response variables were the percent changes from the baseline in polyp numbers and in specified polyp diameters. Any adverse events that appeared in at least four persons were taken into consideration and compared between the JTE-522 treatment groups and the placebo group. Results No change in polyp number (median, 0) was observed in any of the three groups. There were no differences between the placebo group and the two treatment groups in the change in polyp size. JTE-522 was well tolerated. Conclusion Our findings, in keeping with other reports on COX-2 inhibitors, indicated that the inhibition of a COX-2 with a moderate dose of a selective COX-2 inhibitor did not induce clinically sufficient regression of adenomas in patients with FAP in a limited (6-month) medication period. Additional institutions and investigators participating in the study are listed in the Appendix.     

Immunoprofile of reactive salivary myoepithelial cells in intraductal areas of carcinoma ex-pleomorphic adenoma

The myoepithelial cell (MC) is a component of various secretory glands, including salivary glands. Besides its function, a tumor suppressor and a tumor facilitating functions have been attributed to this cell. We investigated the immunoprofile of benign MC in intraductal areas of carcinoma ex-pleomorphic adenoma (CXPA), comparing them with the MC in duct-like areas of pleomorphic adenoma, origin of the malignant tumor. Antibodies against myoepithelial markers—CK14, -SMA, calponin, P63, CD10, and D2-40—plus laminin and maspin was applied in four selected cases of intracapsular and minimal invasive CXPA with only luminal differentiation presenting areas of intraductal carcinoma. The immunohistochemical reactions of all the antibodies showed stronger staining in benign MC surrounding the malignant epithelial cells than in benign MC in duct-like areas of pleomorphic adenoma, thus revealing that in the malignization process the benign MC become differentiated and produce important proteins related to the tumor suppressor function.     

Regulation of hormone(PTH and PGE1)-stimulated adenylate cyclase by renal cytosolic factors

Cytosolic factors in a 50–75% (NH₄)₂SO₄ fraction of the 105 000 × g supernatant of the renal cortex modulated adenylate cyclase activity in membrane preparations enriched in renal tubular cell basal-lateral membranes. The crude factor preparation had no effect on basal activity but it contained components that augmented the stimulation of the enzyme by NaF, parathyroid hormone (PTH), prostaglandin e₁ (PGE₁), and inhibited the activation of the enzyme by GMP-PNP. The factor(s) potentiating the stimulation by the hormones was partially purified (13-fold) by DEAE-cellulose and Sephadex G-75 chromatography. During purification, the component(s) that increased hormone-stimulated adenylate cyclase was separated from those affecting the activity in the presence of NaF and GMP-PNP. The factor(s) enhanced the PTH- and PGE₁-stimulated enzyme at all concentrations of hormone, suggesting that the affinity for the hormone was not affected. The factor(s) was heat-stable. Partial proteolysis with chymotrypsin greatly reduced the ability of the factor(s) to enhance hormonal responsive adenylate cyclase. However, the factor(s) was resistant to trypsin digestion. The effect of the factor was not due to GTP, nor was GTP necessary for its action. Ca²⁺ was not needed for the enhancing activity of the factor(s). These findings suggest the presence in the cytosol of the kidney cortex of a protein(s) that regulates the response of renal adenylate cyclase to hormones. The relationship between this kidney cytosolic factor and those reported in other tissues remains to be established.     

Intraventricular hemorrhage from pituitary apoplexy

The case of a patient with a massive intraventricular hemorrhage arising from a pituitary chromophobe adenoma is described. This rare and disastrous complication was ascribed to the large suprasellar extension of the tumor and its close proximity to the floor of the third ventricle. Hemorrhage in the tumor extended along the path of least resistance and ruptured into the third ventricle. A partially treated hyperviscosity syndrome and chemotherapy for an unrelated malignancy (multiple myeloma) may have predisposed the patient to the necrosis and hemorrhage in the pituitary tumor.