Effectiveness and limits of antimicrobial treatment on seminal leukocyte concentration and related reactive oxygen species production in patients with male accessory gland infection

To evaluate whether bacteriological cure, sperm outcome, spontaneous pregnancy rate and white blood cell (WBC)-related reactive oxygen species (ROS) production were related to the extent of the infection and to an intermittent and repetitive antimicrobial treatment, 122 patients with bacterial [>10(5) colony-forming units (CFU)/ml] male accessory gland infections (MAGI) were studied. According to ultrasound criteria, patients had prostatitis (PR, n = 52), prostatovesiculitis (PV, n = 32) or prostatovesiculoepididymitis (PVE, n = 38). Each group was further subdivided into two subsets: one subset (PR, n = 40; PV, n = 20; PVE, n = 25) was given ofloxacin or doxycycline for 14 consecutive days per month for 3 months; the other subset (PR, n = 12; PV, n = 12; PVE, n = 13) received no treatment. The female partners were also treated. All patients were evaluated before, during (1 and 3 months) and after (3 months) treatment. The bacteriological cure rate was the highest (92.5%) after the third antibiotic course in PR, followed by PV (70.4%), and the lowest in PVE (52.0%). At 3 months after therapy discontinuation, some sperm parameters, seminal WBC concentration and ROS generation (assessed in the 45% Percoll fraction) were ameliorated in PR and PV, whereas no improvement occurred in patients with PVE, except for the percentage of coiled tails. Antibiotic treatment in PR and PV patients led to positive effects on sperm output and spontaneous pregnancy rate (40%) by removing pro-oxidant noxae (microbial and/or WBC-related ROS production). The persistent infertility, dyspermia and sperm-derived ROS overproduction in PVE may relate to a significant percentage of antibiotic-independent re-infection and/or to low antioxidative epididymal properties, which persisted following antimicrobial treatment.     

Electrophysiological investigations on the central innervation of the rat and guinea-pig pineal gland

Summary The possible influence of central nervous structures on the electrical activity of single pineal cells was investigated in rat and guinea-pig.In the rat electrical stimulation of the hippocampal formation elicited both single cell responses with different latencies and mostly long-term excitations in single pineal cells, while stimulation of the habenular nuclei caused clear orthodromical responses with different latencies, alterations in the rate of spontaneous electrical activity and evoked discharges of silent units.In the guinea-pig electrical stimulation of the paraventricular nucleus influenced predominantly cells in the deeper layers of the posterior part of the pineal gland. Electrical stimulation of both the superior and inferior colliculi elicited field potentials with a constant latency, indicating a functional relationship between the corpora quadrigemina and the pineal organ.Intrapineal stimulation and recording in the guinea-pig indicate functional connections between anterior and posterior parts of the pineal organ and that information can be conducted in both directions of the pineal axis.The data from the rat pineal gland are part of a thesis presented by St. Reuss in partial fulfillment for the degree of Dr. rer. nat. Preliminary data have been presented at the NATO Symposion The pineal gland and its endocrine role, Sicily 1982 (cf. Semm, 1983) and at the 6th European Neuroscience Congress, Malaga 1982 (cf. Reuss andSemm, 1982). — Financial support of the Stiftung Volkswagenwerk is gratefully acknowledged.     

Immunohistochemistry of folliculo-stellate cells in normal human adenohypophyses and in pituitary adenomas

Summary Presence and distribution of S-100 protein (S-100), neuron-specific enolase (NSE), cytokeratin polypeptides, glial fibrillary acidic protein (GFAP), vimentin, actin, lysozyme and pituitary hormones (prolactin, hGH, ACTH, -FSH, -LH, -TSH, alpha subunit) in folliculo-stellate cells (FSC) were studied in seven normal human pituitary glands and 28 pituitary adenomas using peroxidase-antiperoxidase and the avidin-biotin immunohistochemical techniques. Approximately 5% of the cells of the adenohypophysis were agranular, non-hormon-producing FSC most of which showed a conspicuous and strong reaction with S-100 antibodies but some were, in addition, GFAP- and vimentin-positive. In contrast to endocrine cells (EC), FSC were not decorated by antibodies to NSE or cytokeratins. In addition to supportive functions, these cells, due to their close special relationship to EC, seem to have transport and other metabolic functions yet to be elucidated. By their S-100 reactivity and their distribution FSC are comparable to glial cells of the central and schwann and satellite cells of the peripheral nervous system (PNS) as well as to supportive cells in neuroendocrine organs and related tumors (e.g., pheochromocytomas, paragangliomas, carcinoids). With one exception, S-100 reactive FSC were not found in pituitary adenomas. The immunohistochemical demonstration of S-100 protein in pituitary tissue is, therefore, a reliable aid in the discrimination between adenomas and normal pituitary tissue, particularly in small and poorly preserved specimens. In one adenoma FSC were found in addition to ACTH-producing tumor cells. This seems to be an extremely rare event suggesting a combination tumor.Supported in part by Fonds zur Förderung der wissenschaftlichen Forschung (no. 4708) to H. Denk     

Salivary Intraductal Carcinoma Arising within Intraparotid Lymph Node: A Report of 4 Cases with Identification of a Novel STRN-ALK Fusion

Intraductal carcinoma (IDC) is a rare salivary gland tumor that is considered analogous to ductal carcinoma in-situ of the breast, demonstrating a complex neoplastic epithelial proliferation surrounded by a continuous layer of presumed non-neoplastic myoepithelial cells. It is subcategorized into intercalated duct, apocrine, and hybrid subtypes based on morphologic and immunohistochemical features, with frequent NCOA4-RET and TRIM27-RET fusions, respectively, seen in intercalated duct and hybrid tumors. However, as an expanding clinicopathologic spectrum of IDC has been documented, controversy has emerged as to whether this tumor type is best defined by its intraductal growth pattern or distinctive molecular and immunophenotypic differentiation. Here, we further explore the nature of IDC by evaluating four cases that arose within intraparotid lymph nodes. These intercalated-duct phenotype tumors with diffuse S100 protein expression demonstrated a crowded and complex epithelial proliferation arranged in cystic, cribriform, and micropapillary architecture, surrounded by an intact myoepithelial cell layer, and were completely intranodal. Of two tumors with tissue available for molecular analysis, one demonstrated a NCOA4-RET fusion and one harbored a STRN-ALK fusion that is novel to IDC. Not only does the intranodal presence of IDC present a challenging differential diagnosis, but the complex nature of this proliferation within lymph node tissue raises questions as to whether the myoepithelial component of IDC is actually non-neoplastic in nature. Furthermore, identification of a STRN-ALK fusion expands the genetic spectrum of IDC and adds to evidence of an emerging role for ALK in salivary gland tumors. Further attention to the nature of the myoepithelial cells and documentation of alternate fusion events in IDC may inform continued discussion about its appropriate classification.     

Case report of Brunner’s gland hyperplasia: A rare “mimic” of malignant pathology

IntroductionBrunner’s gland hyperplasia is a rare, benign lesion of the duodenum. The symptomology can range from asymptomatic (as an incidental finding on endoscopy) to gastrointestinal obstruction or haemorrhage.Case presentationWe report a case of a 60-year-old man presenting with post-prandial vomiting and weight loss. Inpatient evaluation led to the likely diagnosis of a duodenal malignancy for which the patient underwent a laparotomy and proximal duodenectomy.Clinical discussionBrunner’s gland hyperplasia is a rare, benign condition that can be overtreated due to the difficulty in obtaining an accurate pre-operative diagnosis. The literature has been reviewed to discuss the approach to diagnosis.ConclusionThis case highlights the potential for Brunner’s gland hyperplasia mimicking a malignancy.     

The superior laryngeal nerve loop and its surgical implications

Summary Based upon findings from 60 cadavers (120 sides), the incidence of superior laryngeal nerve loop, connecting the cervical sympathetic chain and the superior laryngeal nerve and its branches, the external and internal laryngeal nerve, was 98.3% (118 out of 120 sides). In most cases the loop connected the sympathetic chain and the external laryngeal nerve. The external laryngeal nerve was looped, and not linear as traditionally thought. The loop could be divided into three categories, V-shaped, U-shaped and mixed, and subdivided into 5 types and 17 subtypes according to morphological variation. The loop without exception innervated not only the cricothyroid muscle, but also the thyroid gland. The loop is one of the origins of the thyroid nerve. It seems that for thyroid surgery the loop, when lower in position, should be carefully separated from the superior thyroid vessels before the latter are ligated, in order to preserve a normal nerve supply to the muscle as well as to the part of the gland that remains after surgery.

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L'anse du nerf larynge supérieur, étude anatomique et applications chirurgicales

Résumé La fréquence d'une anse du nerf laryngé supérieur réalisant une anastomose entre la chaine sympathique cervicale et le nerf laryngé supérieur et/ou ses branches (rameau laryngé externe et ingerne), est de 98,3 % (118/120). Ce résultat s'appuie sur l'étude de 60 cadavres. Dans la plupart des cas, l'anastomose se fait entre la chaine sympathique cervicale et le rameau laryngé externe. Ce rameau laryngé externe a un trajet curviligne et non linéaire conformément aux données classiques. Il existe trois catégories d'anses : en "V", en "U" et mixte ; on peut également les subdiviser en 5 types et 17 sous-types en fonction des variations morphologiques. Cette anse innerve constamment non seulement le muscle cricothyroïdien mais aussi la glande thyroïde dont elle fournit une partie de l'innervation. Lors de la chirurgie thyroïdienne, si l'anse est en position basse, les nerfs doivent être soigneusement disséqués et séparés des vaisseaux thyroïdiens supérieurs avant ligature de ces derniers de façon à conserver l'innervation normale du muscle et de la partie restante de la glande.

     

Adrenal Medullary Nodules in Beckwith-Wiedemann Syndrome Resemble Extra-Adrenal Paraganglia

Clues to mechanisms regulating development and tumorigenesis may be provided by studies of unusual diseases. Beckwith-Wiedemann syndrome (BWS) is a rare congenital disorder apparently related to abnormal regulation of insulin-like growth factor-2 (IGF-2) production. IGF-2 mRNA has been previously localized to the chief cells of extra-adrenal paraganglia and to adult, but not fetal, adrenal medulla. Expression of IGF-2 by neuroblastomas has been hypothesized to reflect extra-adrenal paraganglionic differentiation. In the adrenals of a fetus with BWS, we have observed both increased numbers of chromaffin cells and organoid nodules resembling extra-adrenal paraganglia. Immunoreactive IGF-2 was observed in both cell types, but was also observed in chromaffin cells in the normal fetal adrenal. The findings suggest autocrine or paracrine influences of IGF-2 in regulating the number and phenotype of cells derived from sympathoadrenal precursors in the developing adrenal medulla as well as in extra-adrenal paraganglia. These results have implications for the interpretation of data from neuroblastoma studies.     

涎腺肿瘤抗凋亡基因 bcl-2表达产物的分布及意义

目的 :探讨抗凋亡基因bcl 2蛋白与涎腺肿瘤的关系。方法 :利用免疫组化LSAB法 ,检测4 2例腺样囊性癌、15例多形性腺瘤和 5例正常涎腺组织中bcl 2基因产物的表达与分布。结果 :4 2例腺样囊性癌 37例阳性 ,阳性率 88 1%。 15例多形性腺瘤阳性率 10 0 % ,但阳性细胞少 ,主要分布于上皮丰富的腺管样结构 ,而鳞状上皮及粘液软骨区为阴性。 5例正常涎腺组织中 ,导管上皮细胞少数散在阳性 ,腺泡细胞阴性。结论 :bcl 2蛋白在涎腺肿瘤组织不同的肿瘤细胞中具有不同的凋亡能力 ;在上皮成分中广泛过量表达 ,可能参与了涎腺肿瘤的形态发生。     

儿童体外循环心脏手术对甲状腺功能的影响

目的 观察儿童体外循环心脏手术前后甲状腺激素的变化,了解体外循环心脏手术对儿童甲状腺功能的影响并探讨其临床意义。方法 用放射免疫方法测定２５例外循环心脏手术儿童术前、术中、术后甲状腺激素和促甲状腺激素的含量。结果 体外循环期间血浆三碘甲状腺原氨酸（ｔｅｔｒｏｄｏｔｈｙｒｏｎｉｎｅ,Ｔ３）、游离三碘甲状腺原氨酸（ｆｒｉｉ ｔｒｉｉｏｄｏｔｈｙｒｏｎｉｎｅ,ＦＴ３）、四碘甲状腺原氨酸（ｔｅｔｒａｉｏｄ     

电磁脉冲对大鼠松果体及血浆中cAMP和cGMP的影响

目的 观察电磁脉冲（ＥＭＰ）照射大鼠后,松果体和血浆中ｃＡＭＰ,ｃＧＭＰ浓度的变化,探讨ＥＭＰ对大鼠昼夜节律的影响及机制。方法 采用放免分析法检测ＥＭＰ照射大鼠后松果体及血浆中ｃＡＭＰ和ｃＧＭＰ的含量。结果 照射组大鼠松果体中ｃＡＭＰ,ｃＧＭＰ和ｃＡＭＰ／ｃＧＭＰ的数值及昼夜波动幅度均有明显降低（Ｐ〈０．０５）,且位相发生移动;血浆中ｃＡＭＰ,ｃＧＭＰ位相也发生移动。结论 ＥＭＰ照射能影响大鼠松要