A boy with atrophic thyroiditis of prepubertal onset,who was positive for TSH-binding inhibitor immunoglobulins

A 12 year old boy was admitted to our hospital because of short stature. From the age of 7, his growth velocity decreased and he manifested intolerance to low temperatures, hoarseness, dry skin, and slowness of thought and physical movement. On admission, his height was 129.8 cm (-3 s.d.) and his body weight was 43.2kg (-0.5 s.d.). His clinical features also included relaxation phase of tendon reflexes, periorbital puffiness and cold skin but no struma. His bone age was 9 years. His serum thyroxine (T₄), tri-iodothyronine (T₃), free T₄ and free T₃ were low, while his thyrotropin was high. He was positive for antithyroglobulin antibodies, antimicrosomal antibodies, and TSH-binding inhibitor immunoglobulins. He was diagnosed as having atrophic thyroiditis. We also determined the HLA haplotypes of his family members. His father's HLA haplotypes were A2, BW61(a) and A24, BW52(b), while his mother's haplotypes were A24, BW52(c) and A30, BW61(d). The HLA haplotypes of both the patient and his younger brother showed a and d, while the patient's elder brother's HLA haplotypes showed b and c. His family members all had normal thyroid function, but his father was positive for antimicrosomal antibodies. In summary, we describe a rare case where the onset of hypothyroidism was prepubertal, where the pathogenesis may have involved TSH-receptor blocking antibodies, and where the inheritance of the disease may have been from the paternal side of the family.     

MEDIAN RAPHE (PARAMEATAL) CYSTS OF THE PENIS

Purpose

Although median raphe cysts of the penis have been widely reported the pathogenesis is obscure. We describe the microstructural detection of 3 cases of median raphe to study the true pathogenesis.

Materials and Methods

Three patients presented to our clinic of plastic surgery complaining of abnormal shape of the penis or mass recurrence. High magnification light microscopy and electron microscopy were performed.

Results

Microstructural study revealed that all 3 cases had similar findings to those of the common urethral mucosa.

Conclusions

Median raphe cysts are derived from the external paraurethral ducts and contain features that to our knowledge have not been previously reported.     

A Human Sperm Coating Antigen Isolated From Sperm Cell Membrane

ABSTRACT: A human sperm cell membrane antigen that is highly specific to sperm and seminal plasma was isolated from plasma membrane fraction of spermatozoa using rabbit antiserum against human seminal plasma. In addition to the high specificity to sperm and seminal plasma, the isolated antigen showed the following characteristics: (1) It is a glycoprotein of approximately 12,000 daltons that has an affinity to lentil lectin; (2) it is distributed in human milk other than in sperm and seminal plasma, but is not found in any other organs and tissues including testis; (3) seminal plasma contains the largest amount of the antigen activity, 60-fold greater than spermatozoa and 900-fold greater than milk, suggesting that this antigen could be a sperm-coating seminal plasma antigen.     

Transient elevation of nerve growth factor content in the rat hippocampus and frontal cortex by chronic ethanol treatment

Abstract The nerve growth factor (NGF) content in the hippocampus and frontal cortex of chronic ethanol-treated rats was measured and compared with that of control rats, using a two-site enzyme immunoassay (EIA) system. The different time periods of chronic ethanol treatment caused transient elevation of the NGF content in both the hippocampus and frontal cortex. The NGF content in the hippocampus was significantly elevated in rats undergoing ethanol treatment of 2 weeks and 1 month. Nerve growth factor content of the 1 month treatment was higher than that of the 2 week treatment. However, a 3 month administration of ethanol reduced the NGF content to the control level. The NGF content in the frontal cortex increased significantly in the 2 week administration, but decreased to the control level in the 1 month administration. The increase of NGF may be caused by the proliferation of glial cells or the enhancement of neuronal production of NGF.     

Depressive Disorders in Japanese Primary Care Patients

In a sample of 276 Japanese adult patient attenders at two primarycare clinics affiliated with the Department of Hygiene and PreventiveMedicine at the Okayama University Medical School major depressionwas diagnosed in 5.8% and minor depression in 7.2% of patientsstudied. Functional impairment was significantly more severein patients with either major or minor depression than in thosenot affected. None of the 36 patients with major or minor depressionhad received a diagnosis of depression or had been given antidepressanttherapy. Possible explanations for the marked underdiagnosisof depression and lack of specific antidepressant therapy inthese patients include severe stigma associated with a diagnosisof mental disorders, focus of the mental health system on hospitalizationwith consequent trivialization of mental problems in ambulatorypatients, and the extraordinarily high work load of primarycare doctors.     

Thorotrast-Induced Multiple Primary Malignant Tumors of the Liver--Cholangiocarcinoma and Malignant Hemangioendothelioma

A case of multiple primary malignant tumors of the liver (cholangiocarci-nomaand malignant hemangioendothelioma) that developed 40 yearsafter Thorotrast administration is described, with radiologicaland autoradiographic findings. The estimated organ dose to theliver was approximately 580 rads.     

Esophageal Cancer in the Intermediate Stage

When we consider the prognosis of esophageal carcinoma, we cometo the conclusion that the less the invasion of the disease,the better the prognosis can be. It is quite reasonable that the prognosis of early cancer isthe most favorable. However, a relatively good prognosis wasalso found for the patients with a, cancer, in which the slightestinvasion into the adventitia had been detected, the incidenceof 5-yr survivors being 31.2%. Approximately 35% of these patientswhose cancers were resected by us were shown to have the diseasein this stage. Since there have not been many patients withearly carcinoma treated so far, we should initially aim at thedetection and treatment of the cancers in which the invasionis limited to the submucosa (sm) and the proprial muscular layer(mp), and those in which invasion reaches just to the adventitia(a, cases). However, if there has been any histological evidenceof lymph node metastasis, intravascular invasion or skip metastasisin such cases, the patients are most likely to die within 1or 2 yr after the operation because of recurrence. When thepatients show such findings postoperatively, they must be giventhe most effective systemic treatment.