MALIGNANT CHEMODECTOMA (PARAGANGLIOMA) OF THE LARYNX A Case Report with Electron Microscopy and Biochemical Assay

This report presents a case of malignant chemodectoma In the epiglottic region of a 47-year-old man. His initial complaint was laryngeal discomfort and he expired from generalized metastases of the tumor about one year after operation. The tumor was detected by laryngoscopy and laryngogram. The yellow parenchymatous tumor, 2.8×2.5×1.5 cm in size, was resected together with two enlarged regional lymph nodes. The mass was subjected to a histopathological study and biochemical assay. Microscopically, the tumor was located in the submucosa of the epiglottis and showed an alveolar growth pattern of comparatively uniform tumor cells. Neurosecretory granules were clearly demonstrated by Grimelius'method and by electron microscopy. The biochemical assay revealed that the tumor contained small amounts of serotonine, epinephrine, norepinephrine, and dopamine. The distribution of paraganglia as the source of these tumors, the clinicopathological review of the previous reports and significance of neurosecretory granules are discussed.     

Experimental Evaluation of Myocardial Preservation Techniques: V. A Membrane-Stabilizing Agent,Procaine Hydrochloride

The protective effects of procaine hydrochloride on the anoxic heart were investigated using the papillary muscle contractility of an isolated, blood-perfused rabbit heart as an index of myocardial function. Fifty-four experiments were divided into nine groups of six experiments each, in which anoxic periods (30, 45, 60 minutes) and concentration of procaine (solution 1 or control, no procaine; solution 2, 0.03%; and solution 3, 0.3%) were the variables. The hearts arrested significantly faster with solution 3 compared with solution 2 or 1 (p < 0.01). After 30 minutes of anoxia, the recovery of the contractility was 81.1 ± 4.2% with solution 1, 90.7 ± 3.4% with solution 2, and 90.6 ± 3.3% with solution 3. After 45 minutes of anoxia, the recovery was 31.8 ± 19.0% with control, 67.5 ± 15.8% with 0.03% procaine, and 58.1 ± 22.8% with 0.3% procaine. After 60 minutes of anoxia, the recovery was 2.2 ± 2.7% with control, 18.7 ± 14.1% with 0.03% procaine, and 5.0 ± 7.3% with 0.3% procaine. After each anoxic period, the best recovery occurred with those hearts arrested by solution 2. Although the difference in recovery between the procaine groups was not statistically significant, a longer time was required for the hearts arrested with solution 3 to reach full functional recovery.This study indicated that procaine per se has a protective effect on the anoxic hearts and that although high concentration (0.3%) of procaine arrests the heart rapidly, it delays the recovery of contractions. We recommend the use of 0.03% procaine in cardioplegic solution.     

A case of vertebral dissecting aneurysm manifesting as subarachnoid hemorrhage following nuchal pain]

We report a case of subarachnoid hemorrhage (SAH) from vertebral dissecting aneurysm 4 days after first nuchal pain. The patient was a 46-year-old man with a sudden onset of nuchal pain. There were no obvious abnormalities detected on MR images in another hospital. Four days later, however, he was admitted to our hospital because of severe re-attack of nuchal pain. CT demonstrated moderate SAH and cerebral angiograms revealed right vertebral dissecting aneurysm. Proximal occlusion of the vertebral artery including its aneurysmal dilatation was performed using detachable coils. We strongly suspected that his initial symptom of nuchal pain was due to dissection of the vertebral artery itself, since the aneurysmal dilatation accompanied by intramural hematoma had been observed retrospectively in the initial MR imaging. The incidence of the vertebral dissecting aneurysm presenting with nuchal pain alone due to dissection is reported to be 7% in the literature. The prognosis of non-hemorrhagic vertebral dissecting aneurysm followed by delayed SAH is considered to be fatal. Therefore, careful investigations for differential diagnosis should be taken into account since the diagnostic possibility exists that non-hemorrhagic vertebral dissecting aneurysm would be manifested by a symptom of headache/nuchal pain alone.     

Cutaneous malignant lymphoma and HLA in the southwestern area of Japan

Recently, classification of malignant lymphoreticular tumors have been reevaluated and various new disease entities have been proposed. Patients with T cell lymphoma, including adult T cell leukemia/lymphoma (ATLL), are very frequent in the southwestern area of Japan. To investigate the role of genetic factors in patients with cutaneous malignant lymphoma (CML), which has a T cell nature, from an endemic area of ATLL, we studied the association between HLA and CML within this area. The frequency of AW24 in CML patients was reduced. AW33 and BW61 were increased in frequency in these patients. However, none of the P values mentioned remained significant after correction for the number of antigens tested. Haplotypes of AW24-BW61, AW26-BW61 and AW33-BW61 were increased in frequency in CML patients.     

Human Platelets Effectively Kill K-562 Cells, a Chronic Myelogenic Leukemia Cell Line, in vitro

The cytotoxic effect of isolated human platelets on leukemic cells has been examined in order to investigate the role of platelets in host defense systems. K-562 cells (a chronic myelogenic leukemia cell line) showed significant change in their morphology and were killed when they were incubated with platelets in serum-free medium for several hours at 37°C, a condition where no killing of normal peripheral lymphocytes occurred. Some protease inhibitors inhibited the cytotoxicity of platelets against K-562 cells. Our results suggest that platelets may be involved in host defense against neoplasia and that certain proteases are implicated in the cytotoxic effect of platelets.     

Effect of intracerebroventricular administration of chlorpromazine on the serum level of free fatty acids in rats

The effect of intracerebroventricular administration of chlorpromazine (CPZ) on the serum level of free fatty acid (FFA) was studied in rats. Injection of CPZ into the lateral ventricle caused a transient decrease in serum FFA, showing the lowest level after 30 min. This decrease in serum FFA caused by CPZ was significantly inhibited by simultaneous injection of dopamine or apomorphine, although noradrenaline and serotonin had no effect. The dopaminergic blocking agent haloperidol caused a rapid decrease in serum FFA. After central chemical sympathectomy with the intracerebroventricular injection of 6-hydroxydopamine, the response to CPZ of serum FFA was completely abolished; but after peripheral sympathectomy by i.v. injection of 6-hydroxydopamine, a partial inhibition of the action of CPZ was shown. These results suggest a possible involvement of the central dopaminergic mechanism in the decrease in serum FFA after intracerebroventricular injection of CPZ.