Diabetes induced with low doses of streptozotocin is mediated by V beta 8.2+ T-cells.

T-cells have been shown to cause insulitis and ultimately be responsible for the destruction of beta-cells in animal models of insulin-dependent diabetes mellitus (IDDM). In one murine model, insulitis and hyperglycemia occur after administration of five low doses of streptozotocin (STZ) (multidose STZ-induced diabetes mellitus [MDSM]). Insulitis can first be identified in the islets after the final (fifth) daily dose of STZ is given. We have studied the T-cells that infiltrate the islets of Langerhans during the early stages of diabetes by preparing Southern blots of T-cell receptor (TCR) beta-chain genes amplified by polymerase chain reaction (PCR) from islets from C57BL/KsJ mice given multiple doses of STZ. The relative abundance of TCR gene products in islets was compared with spleen cells stimulated with anti-CD3 monoclonal antibody (mAb). We found that after the fourth dose of STZ, there was a striking increase in the amount of V beta 8.2 TCR gene product (37 +/- 4% of total PCR signal) compared with T-cells in the spleen (9 +/- 2%, P < 0.01), which increased further 2 days after the final dose of STZ (47 +/- 5%, P < 0.001). We studied the heterogeneity of the size of the V beta 8.2 TCR CDR3 region and found primarily products with only two lengths compared with a heterogeneous population in the spleen. Treatment with anti-V beta 8 mAb, but not anti-V beta 9 and anti-V beta 13 mAbs, prevented development of hyperglycemia (P < 0.0001) and insulitis (P < 0.0005) after STZ administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Precision of radioimmunoassay with emphasis on curve-fitting procedures.

Direct curve-fitting methods using a digital computer have been employed to analyze the calibration curves of commercial kits for the assay of digoxin, digitoxin, insulin, B12, and renin activity (angiotensin). Inconsistencies have been revealed that suggest some improvements in the commercial kits are desirable. It is not suggested that the use of these kits would yield data of uncertain clinical value, but it is suggested that improvements in consistency would enhance the clinical utility.

Malignant melanoma in Meckel's diverticulum.

Meckel's diverticulum is a vestigial remnant of the omphalomesenteric duct, which is rarely affected by neoplasia. The authors report the first case of malignant melanoma in Meckel's diverticulum in a middle-aged man without skin or ocular lesions. Five other Meckel's diverticuli were evaluated histologically and by immunoperoxidase technics for neural crest elements, which could have given rise to this lesion.

Evaluation of operatively excised cardiac valves: etiologic determination of valvular heart disease.

Morphologic evaluation of operatively excised native cardiac valves can lead to an etiologic diagnosis in most instances using a simple 10-step approach. With few exceptions, histologic evaluation of excised cardiac valves provides little additional information beyond this proposed morphologic assessment.

The old-age heart: aging changes of the normal elderly heart and cardiovascular disease in 12 necropsy patients aged 90 to 101 years.

In this article, morphologic changes affecting the myocardium, chambers, valves, epicardial coronary arteries, and aorta in the elderly but otherwise normal heart are discussed and are compared with and differentiated from morphologic changes causing clinical cardiac dysfunction, death, or both.

Surgical treatment of total colonic aganglionosis: efficacy of aganglionic patch enteroplasty in the rat.

This study evaluates ileo endorectal pull-through (IEP) with and without an aganglionic colon patch in an experimental rat model for the surgical treatment of total colonic aganglionosis (TCA). Animals were randomly assigned to Group 1 (no patch, No. = 6), Group 2 (right colon patch, No. = 8), Group 3 (transverse colon patch, No. = 7), Group 4 (left colon patch; No. = 6), sham operation (SH, No. = 6), and unoperated controls (UC, No. = 10). Change in percent body weight at 4 weeks after operation was -30.9 +/- 3.68% in Group 1, +5.1 +/- 1.67% in Group 2, -3.4 +/- 3.96% in Group 3, -1.8 +/- 4.17% in Group 4, and +12.7 +/- 1.54% in SH (Group 1 v other groups: P less than .001). Restoration of initial body weight occurred in 100% in Group 2 and SH (8/8 and 6/6, respectively), 50% in Group 4 (3/6), 42.9% in Group 3 (3/7), and 0% in Group 1 (0/6). Transit time (stomach to anus) was significantly shorter in Group 1. All rats in patched groups had a prolonged transit time compared with Group 1. Manometric studies in IEP rats showed favorable anal canal pressures, which were slightly lower than SH and UC. Water and Na+ absorption were significantly greater in patched groups. Rats with a right colon patch (Group 2) showed slightly greater absorption at 4 weeks. These data suggest that an aganglionic colon patch may be an important adjunct in the surgical treatment of TCA.

Cytologic criteria for subclassification of Hodgkin's disease using fine-needle aspiration.

Hodgkin's disease (HD) is increasingly being evaluated by fine-needle aspiration (FNA); however, criteria to subclassify HD into its four subtypes--nodular sclerosis (NS), mixed-cellularity (MC), lymphocyte-depleted (LD), and lymphocyte-predominant (LP)--has not been established. In order to evaluate criteria for subclassification, all FNA cases of HD obtained over a 5-yr period at Indiana University Medical Center that had confirmatory surgical biopsies were reviewed. The number of Reed-Sternberg (RS) cells was quantitated in each cytologic case and statistically analyzed by subgroup, using analysis of variance (ANOVA). LD had the highest mean (means) number of RS cells (means = 51) with NS and MC having similar means (means = 7 and 6, respectively). Only one case of LP was identified and therefore could not be analyzed statistically. Fibrosis and the presence of RS variants were qualitatively assessed and were not helpful in distinguishing the subtypes of HD. Although the quantitation of RS cells may be used to identify LD types of Hodgkin's disease, MC and NS cannot be separated reliably on this criterion alone. Although FNA can be used to diagnose HD, stage a patient, or assess efficacy of chemotherapy, subtyping of HD should still be done on histologic sections of excised lymph nodes.

Giardia lamblia in peritoneal fluid.

Giardia lamblia is a flagellated protozoan that inhabits the upper portions of the small intestine; trophozoites are the usual stage seen in duodenal aspirates, biopsies of the duodenum and jejunum and, infrequently, in stools, in which cysts are more likely to be found. A unique occurrence of G lamblia cysts and trophozoites within the peritoneal fluid of a patient with a blunt abdominal trauma is reported. Cytotechnologists and pathologists should be aware that trophozoites and cysts of G lamblia may appear in peritoneal lavage fluid from patients with blunt abdominal trauma and duodenal injury, indicating a need for exploratory laparotomy.

Diagnosis of cervical chordoma by fine needle aspiration biopsy.

A case of cervical chordoma diagnosed by fine needle aspiration (FNA) is presented. The cytologic criteria for differentiating chordoma from chondrosarcoma and metastatic adenocarcinoma, the main diagnostic problems, include the finding of physaliferous cells and the presence of bland nuclear features. Significantly, chordomas lack true signet-ring cells. FNA of these rare midline vertebral neoplasms, which produce pain and spinal cord compression, can greatly facilitate diagnosis and optimal treatment.

Dietary examples. A practical approach to feeding athletes.

This article provides practitioners with meal plan samples at four calorie levels as a guide for planning athletes' food choices. Many good and practical publications are available for trainers and dietitians who assist athletes in their nutritional plans. The two primary needs of people with increased physical activity are increased energy and fluid intakes. As illustrated in this article, these energy needs can be met fairly easily at various calorie levels with a meal plan. For individual requirements, athletes should consult with health care professionals for calorie and fluid requirements.

[Chronic compartment syndrome in the lower leg]. / Kronisk kompartmentsyndrom i crus.

Chronic compartment syndrome (CCS) is characterized by recurrent pain in and functional disability of affected muscles, and is typically encountered in the lower leg. The condition is due to physical activity causing an increased intracompartmental pressure (ICP), which subsequently impedes blood flow and thereby compromises the metabolic demands of the tissues within the compartment. After ceasing of activity the symptoms gradually disappear. The incidence of CCS is uncertain. Diagnosis can be established by measuring the ICP before and after relevant physical activity. Treatment is either restriction in activity or fasciotomy, which in most cases is curative.

[Spontaneous infrapatellar tendon rupture in a patient with systemic lupus erythematosus]. / Spontan infrapatellar seneruptur hos patient med systemisk lupus erythematosus.

A case is described of a 33-year old woman with systemic lupus erythematosus (SLE) in longterm treatment with corticosteroids who experienced spontaneous rupture of the left patellar tendon. A comparative study of 28 previously reported cases of SLE patients with spontaneous tendon rupture in weight bearing joints is performed. It is suggested that renal disease may be an etiological factor for spontaneous tendon rupture in patients with systemic lupus erythematosus.

[Rare entity of a macroscopically visible tumor cone of squamous cell carcinoma in the greater veins of the head and neck]. / Seltene Entität eines makroskopisch sichtbaren Tumorzapfens eines Plattenepithelkarzinoms in den grossen Kopf-Hals-Venen.

Cones of malignant tumors are commonly known but only a few descriptions of cones in the head and neck area exist - as seen in a 91-year-old patient under our care. Cones of thymic and thyroid cancers are described in the literature. There are no descriptions of cones of head and neck squamous cell carcinomas. Metastases of squamous cell carcinoma in the head and neck area are very aggressive and have a high potential for vascular neogenesis. A vascular cone might be possible by vascular formation or by mechanical intrusion as described elsewhere.

Human pulmonary dirofilariasis.

A case of human pulmonary dirofilariasis is reported. This human infestation must be considered in the differential diagnosis of a pulmonary "coin" lesion, which lies adjacent to a pleural surface, especially where tissue sections reveal a pulmonary infarct.

Osteosarcoma of the uterine cervix associated with hyperplastic and atypical mesonephric rests.

The authors describe a unique case of osteosarcoma associated with atypical mesonephric rests occurring in the right lateral wall of the uterine cervix. The tumor was examined histologically, cytologically, immunohistochemically, and ultrastructurally and was compared with another osteosarcoma that filled an entire uterine cavity. Comparison with other neoplasms of the uterine cervix indicates that the lesion should be classified separately. Previously reported neoplasms associated with mesonephric rests within the cervix are also reviewed.

Testicular papillary cystadenomatous tumor of low malignant potential: a case report and discussion of the literature.

We report the fifth case of a rare testicular serous papillary cystadenomatous tumor of low malignant potential. All patients presented with a testicular mass. Histologically, the tumor can be differentiated from testicular papillary cystadenocarcinoma. The natural history of this rare tumor is yet to be determined.