Malignant transformation of a Hürthle cell tumor: case report and survey of the literature

Hürthle cell carcinoma is a relatively uncommon type of well-differentiated thyroid carcinoma. Its diagnosis has been controversial due to the difficulty in separating Hürthle cell adenoma from Hürthle cell carcinoma, thus the term Hürthle cell tumor is often used to describe both lesions. The present case of anaplastic giant-cell carcinoma in an 81-yr-old woman arose in a Hürthle cell tumor. This case illustrates the propensity of Hürthle cell tumor to undergo "malignant transformation" and argues for a more aggressive approach to such tumors.     

Limitations of the clonal agar assay for the assessment of primary human ovarian tumour biopsies.

114 biopsy specimens from 70 patients with ovarian carcinoma at all stages of disease were submitted for assessment of clonogenic capacity in agar. A highly significant correlation was found between agar clonogenicity and patient survival after biopsy. However, problems related to inherent tumour heterogeneity, quality of sample and tissue disaggregation indicate that this technique may have limited applicability in the routine assessment of patients. Only 41 biopsy specimens (36%) from 31 patients (44.3%) complied with the prerequisite criteria for agar clonogenic assessment, namely: (a) the confirmed presence of malignant cells in the biopsy, (b) the ability to prepare a single-cell suspension, and (c) adequate viable cell numbers for assay. Furthermore, although the dominant patterns of agar clonogenic growth could be identified and correlated with stage of disease, the heterogeneity in both initial clonogenic capacity and "self-renewal" capacity assessed by the ability of primary clones to propagate in liquid culture and reclone in agar was too inconsistent for the assay to be used as a prognostic index for the individual patient.     

Neurons of the lateral and basolateral amygdaloid nuclei: a Golgi study in the rat

Neurons in the lateral and basolateral nuclei of the rat amygdala were studied using Golgi-Kopsch and rapid Golgi techniques. According to differences in perikaryal, dendritic, and axonal morphology, three main neuronal classes are recognized. Class I neurons, the predominant cell type in both nuclei, are large, spiny neurons that vary in size in different subdivisions of the lateral and basolateral nuclei. These neurons often have a pyramidal shape, exhibiting one or two thick "apical" dendrites and several thinner "basal" dendrites. Axons of class I neurons, which appear to pass out of the nucleus of origin, usually give off several collaterals that arborize modestly in the vicinity of the cell. Class II neurons are smaller, ovoid cells that comprise approximately 5% of impregnated neurons. These neurons are characterized by spine-sparse dendrites and fairly dense local axonal arborizations. Class II neurons may be classified as multipolar, bitufted, or bipolar, depending on dendritic branching pattern. Another type of class II neuron, the amygdaloid chandelier cell, is recognized by virtue of its distinctive axon. The chandelier cell axon gives off numerous collaterals that form nestlike entanglements exhibiting clusters of axonal varicosities. Isolated chandelierlike axons of undetermined origin were observed forming multiple contacts with initial segments of class I axons. Several small, spherical class III neurons with short, varicose dendrites were observed. Axons branch profusely to form a dense tangle of collaterals in the vicinity of the cell. Both axons and dendrites establish numerous contacts with class I dendrites. This investigation, the first detailed Golgi study of the basolateral amygdala of the rat, reveals that the cytoarchitecture of this brain region in the rat is basically similar to that of the opossum and other mammals. Morphologic details described in this report should be useful in the interpretation of ultrastructural, immunocytochemical, and electrophysiological studies of the basolateral amygdala.     

Experimental vitreous haemorrhage: Echographic appearances

Summary Vitreous haemorrhages were induced in rabbits and the echographic appearances on A and B scan were correlated with the gross and histologic appearances over a period of twenty weeks. In all cases, visible vitreous opacities produced distinct echo patterns. As the haemorrhages cleared, the echo amplitudes became progressively weaker. Several patterns of vitreous membranes on B scan were also observed. Pathological examination revealed that such membranes were composed of red cells, macrophages and condensed vitreous collagen. It is suggested that haematogenous vitreous membranes of this type are readily diagnosed by combined A- and B-scan ultrasonic examination, and are probably amenable to surgery.     

Effect of basal ganglia injury on central dopamine activity in Gulf War syndrome: correlation of proton magnetic resonance spectroscopy and plasma homovanillic acid levels

BACKGROUND: Many complaints of Gulf War veterans are compatible with a neurologic illness involving the basal ganglia. METHODS: In 12 veterans with Haley Gulf War syndrome 2 and in 15 healthy control veterans of similar age, sex, and educational level, we assessed functioning neuronal mass in both basal ganglia by measuring the ratio of N-acetyl-aspartate to creatine with proton magnetic resonance spectroscopy. Central dopamine activity was assessed by measuring the ratio of plasma homovanillic acid (HVA) and 3-methoxy-4-hydroxyphenlyglycol (MHPG). RESULTS: The logarithm of the age-standardized HVA/MHPG ratio was inversely associated with functioning neuronal mass in the left basal ganglia (R(2) = 0.56; F(1,27) = 33.82; P<.001) but not with that in the right (R(2) = 0. 04; F(1,26) = 1.09; P =.30). Controlling for age, renal clearances of creatinine and weak organic anions, handedness, and smoking did not substantially alter the associations. CONCLUSIONS: The reduction in functioning neuronal mass in the left basal ganglia of these veterans with Gulf War syndrome seems to have altered central dopamine production in a lateralized pattern. This finding supports the theory that Gulf War syndrome is a neurologic illness, in part related to injury to dopaminergic neurons in the basal ganglia.     

Posttraumatic stress two years after the Oklahoma City bombing in youths geographically distant from the explosion

This article describes Posttraumatic Stress Disorder (PTSD) symptomatology in 69 sixth-grade youths who resided within 100 miles of Oklahoma City at the time of the 1995 bombing of the Alfred P. Murrah Federal Building. These youths neither had any direct physical exposure nor personally knew anyone killed or injured in the explosion. A survey conducted two years after the bombing assessed exposure, PTSD symptoms, and functioning. PTSD symptom frequency was measured with the Impact of Event Scale--Revised. Our BCD criteria for defining PTSD caseness was modeled after DSM-IV B, C, and D criteria requiring one reexperiencing, three avoidance/numbing, and two arousal symptoms for diagnosis. Those who met our BCD criteria had significantly higher PTSD symptom scores than those who did not. Both increased mean PTSD symptom score and meeting our caseness definition were associated with increased functioning difficulties. Media exposure and indirect interpersonal exposure (having a friend who knew someone killed or injured) were significant predictors of symptomatology. These findings suggest that children geographically distant from disaster who have not directly experienced an interpersonal loss report PTSD symptoms and functional impairment associated with increased media exposure and indirect loss.     

Alcohol exposure and breast cancer: results of the women's contraceptive and reproductive experiences study.

OBJECTIVES: To explore associated biological outcomes and clarify the role of timing of exposure in the alcohol-breast cancer relationship.METHODS: In a population-based study of 4,575 women ages 35 to 64 years diagnosed with invasive breast cancer between 1994 and 1998 and 4,682 controls, we collected details of lifetime alcohol use and factors that could confound or modify the alcohol-breast cancer relationship. We used conditional logistic regression to compute the odds of breast cancer among drinkers relative to nondrinkers at all ages and at ages 35 to 49 and 50 to 64 years separately.RESULTS: Recent consumption (at reference age minus two) of >/=7 drinks per week was associated with increased risk [odds ratio (OR), 1.2; 95% CI, 1.01-1.3] and evidence of dose response was observed. Most of the excess was observed among women ages 50-64 years (OR 1.3; 95% CI, 1.1-1.6), although the test for age interaction was not statistically significant. Exposure later in life seemed more important than early exposure. Excess breast cancer associated with recent consumption was restricted to localized disease. When outcome was examined according to tumor hormone receptor status, highest risks were observed for estrogen receptor-positive/progesterone receptor-negative tumors (OR 1.6; 95% CI, 1.2-2.3).CONCLUSIONS: The effect of timing of alcohol exposure on breast cancer risk is complicated and will require additional study focused on this one issue. Further work is needed to explain how alcohol exposure, sex hormones, and tumor receptor status interact.