Giant-cell tumor-like proliferation associated with a papillary transitional cell carcinoma of the renal pelvis.

A 56-year-old man with painless hematuria was found to have a papillary transitional cell carcinoma of the renal pelvis with an accompanying nodule composed of multinucleated and mononuclear cells, resembling a giant cell tumor of bone. The nodule was well demarcated from the carcinoma and most likely represents a response to hemorrhage into a cystic cavity. A classification composed of four groups is proposed for extraosseous tumors having features resembling giant cell tumors of bone. This grouping should help in predicting prognosis and avoid the overdiagnosis of sarcoma or undifferentiated carcinoma.

Inflammatory pseudotumors of the lung: progression from organizing pneumonia to fibrous histiocytoma or to plasma cell granuloma in 32 cases.

Clinicopathologic findings in 32 cases of inflammatory pseudotumor of the lung are described. Depending on the major histopathologic features, the cases are divided into three groups: Organizing pneumonia type (44%), fibrous histiocytoma type (44%), and lymphoplasmacytic type (12%). Organizing pneumonia type has intraalveolar lymphohistiocytic inflammation which converts to intraalveolar fibrosis peripherally and interstitial fibrosis centrally because of a proliferation of fibroblasts. Fibrous histiocytoma type has a predominant proliferation of spindle cells and histiocytes in storiform pattern, with loss of alveolar architecture. Lymphoplasmacytic type has a predominance of lymphocytes and plasma cells with little fibrosis. There is considerable histologic overlap among the three types. All cases have regions of organizing pneumonia. Most or all cases of inflammatory pseudotumor are believed to originate as organizing pneumonia.

Prevalence of intrinsic factor antibodies and vitamin B12 malabsorption in older patients admitted to a rehabilitation hospital.

It is possible that the commonly measured serum level of vitamin B12 may miss some cases when used to detect vitamin B12 malabsorption and deficiency in older persons. Serum levels of vitamin B12 and intrinsic factor antibody (IFAB) were determined on 250 consecutive patients over the age of 70 admitted to a rehabilitation hospital. Patients with abnormal results on either test were given the standard Schilling test when possible. Eight patients had documented B12 malabsorption. Of these, five had a low serum B12 level alone and one had a low serum B12 level and a positive IFAB level; however, two patients had positive IFAB and normal serum B12 levels. Serum IFAB level may serve as a useful adjunct to serum B12 level in detecting vitamin B12 malabsorption in older patients.

Statistical approach to antigen screening.

Pretransfusion testing includes screening the serum of patients for clinically significant antibodies. When discovered, attempts are made to identify the antibody in the hopes of providing the patient with compatible blood that lacks the corresponding antigen. The statistical relationships among the probability of finding the desired number of units, the number of units screened, and the antigen frequency will be discussed. Graphic presentations highlight the relationships and provide a convenient method of assessing the likelihood of finding the desired number of units. A program to perform the necessary calculations on a microcomputer is discussed and is available upon request from the author.

Microcomputer interpretation of red blood cell panels.

The interpretation of red blood cell panels and identification of alloantibodies can be a difficult and time-consuming task. PANEL-IZER, a computer program that performs this interpretation, is described. The panel analysis is based on a matrix algebra algorithm that is presented in detail. Conditional probability logic supplements the analysis by searching for unexpected reactive cells or other possibilities such as the presence of autoantibodies or antibodies to low- or high-frequency antigens. The program considers phases of reactivity, dosage effects, and reaction strengths to aid in antibody identification. Probability levels for antibody identification based on Fisher's "exact" method are calculated. The program also can help suggest a "select cell" panel. This program can be a valuable tool in blood banks to aid in the interpretation of panels, to check technologists' interpretations, to generate "select cell" panels, and to help teach students and residents antibody identification.

Therapeutic support of the patient with thrombocytopenia.

This article provides an update on the methods of collection, preservation, storage, and administration of platelet concentrates. The current indications for platelet transfusions are reviewed, and current knowledge concerning alloimmunization and its prevention is summarized. In addition, the ongoing controversies related to prophylactic administration of platelets versus therapeutic administration are reviewed.

Conditioned suppression of sexual behavior in stallions and reversal with diazepam.

Sexual behavior dysfunction unaccompanied by detectable physical or endocrine abnormality is an important cause of reproductive failure among domestic stallions. Several authors have suggested that such dysfunction may be psychogenic, related to negative experience associated with intense handling and training. An experimental model of experience-related dysfunction was developed by exposing pony stallions to erection-contingent aversive conditioning. This resulted in rapid, specific suppression of sexual arousal and response similar to spontaneously occurring dysfunction. Subsequently, treatment with a CNS-active benzodiazepine derivative (diazepam) reversed these effects.

Novel environment suppression of stallion sexual behavior and effects of diazepam.

Pony stallions were given sexual behavior trials in experimental "home" and "novel" environments, similar in all major features except location. In the novel environment, erection latency was increased and erection time decreased. Treatment with an anxiolytic benzodiazepine derivative (diazepam) appeared to block these effects.

Gonadotropin releasing hormone (GnRH) affects precopulatory behavior in testosterone-treated geldings.

Twelve pony geldings with (n = 6) and without (n = 6) testosterone replacement (200 micrograms/kg testosterone propionate in oil, SC every 48 hours) received either gonadotropin releasing hormone (GnRH; 25 micrograms SC every 3 hours) or control treatment. Sexual behavior was recorded during 4-minute exposure to an estrous mare, 3 times weekly for 2 weeks before treatment, 3 weeks during treatment, and 3 weeks after treatment had been discontinued. The group receiving testosterone and GnRH (n = 3) exhibited significantly greater flehmen response frequency and attention duration and significantly lower vocalization frequency and erection duration than the group receiving only testosterone (n = 3). GnRH had no apparent effect on sexual behavior in geldings without testosterone replacement (n = 3). These results support an hypothesis of testosterone-dependent, CNS-mediated effects of GnRH on precopulatory behavior in the stallion.

Imipramine-induced erection, masturbation, and ejaculation in male horses.

Imipramine hydrochloride was administered to five male horses (400-500 kg b.wt.): one experienced young stallion, two mature normal breeding stallions, one 5-year-old stallion with erection and ejaculatory dysfunction, and one long-term castrated male horse. Oral imipramine treatment (100 to 600 mg, twice daily) led to frequent erection and masturbation while at rest in the stall in a nonsexual context. Intravenous imipramine treatment over a range of doses (50 to 1000 mg) similarly induced erection and masturbation in all animals. Erection typically occurred within 10 minutes after injection, and the erection and masturbation continued intermittently for 1 to 2 hours. These erections proceeded as during sexual excitement to a normal firmness and eventual engorgement of the glans penis. Two stallions ejaculated while masturbating. Mild ataxia and drowsiness appeared at the higher doses, but the animals remained responsive to auditory, visual, and tactile stimuli. Erection and masturbation were often interrupted by activities about the barn or the approach of the handler, suggesting cortical inhibitory control of the erection. When tested in a sexual context immediately following IV treatment (500 mg), the two mature breeding stallions bred normally. The 5-year-old stallion, which had not ejaculated over several months of breeding attempts, spontaneously ejaculated following IV imipramine treatment. Subsequently, this stallion has ejaculated during copulation while on low dose oral (100 mg. twice daily) imipramine treatment. Plasma total androgens increased during treatment in these stallions. The long-term castrate showed erection and masturbation following IV imipramine treatment, suggesting that the effect of imipramine is not testosterone dependent.

Poisoning with N-3-pyridylmethyl-N'-p-nitrophenylurea (Vacor). Immunoperoxidase demonstration of beta-cell destruction.

A 49-year-old woman ate N-3-pyridylmethyl-N'-p'nitrophenylurea (PNU; Vacor) and was admitted to the hospital 12 hours later with a blood glucose level of 940 mg/dl and an anion-gap metabolic acidosis. Her diabetes was successfully treated, but she contained to manifest severe orthostatic hypotension. A painless ileus developed, followed by cecal perforation and death. Immunoperoxidase staining of paraffin-embedded pancreatic tissue obtained during postmortem examination clearly demonstrated the pancreatic beta-cell destruction. Results of this same staining technique also suggested that fewer alpha cells were present.

The relationship of increased susceptibility of sperm DNA to denaturation and fertility in the stallion.

The relationship between fertility and susceptibility of sperm DNA to denaturation was determined in a group of 84 actively breeding, clinically fertile stallions. Susceptibility of DNA to denaturation was determined using the sperm chromatin structure assay (SCSA). The SCSA measures, mean of alpha-t (mean alpha t), standard deviation of alpha-t (SD alpha t), and the COMP of alpha-t (cells outside the main population)] were significantly correlated with the percentage seasonal pregnancy rate (SPR; mean alpha t, r = -0.24, P < or = 0.05; % COMP alpha t, r = -0.27, P < or = 0.05); percentage pregnant per first cycle (FCP; SD alpha t, r = -0.30, P < or = 0.01; % COMP alpha t, r = -0.42, P < or = 0.0001); and the percentage pregnant per cycle (PC; mean alpha t, r = -0.31, P < or = 0.01; SD alpha t, r = -0.32, P < or = 0.01; % COMP alpha t, r = -0.41, P < or = 0.0001). This study describes detectable intrinsic variation in sperm chromatin structure among fertile stallions (SPR, mean = 83%; FCP, mean = 58%; PC, mean = 57%) in an active breeding population (number of mares bred/stallion/year, mean = 37), in the absence of overt reproductive abnormalities and apparent diseases such that an increase in the susceptibility of sperm DNA to denaturation is associated with reduced fertility, both in terms of efficiency of reproduction (FCP and PC) and seasonal pregnancy rate (SPR). Both COMP alpha t and mean alpha t were useful indicators of fertility, with COMP alpha t being the only SCSA value able to identify mean differences between fertility groupings for SPR and FCP, and overall it was the most reliable indicator of fertility in this group of stallions. The SCSA is able to evaluate a compartment of the spermatozoa which is different from that of traditional tests for sperm quality such as motility and morphology.

Unilateral hydrosalpinx and absence of the infundibulum in a mare.

Both ovaries and associated oviducts were removed from a mare via colpotomy. The right oviduct was greatly enlarged and filled with fluid. No infundibulum could be identified; rather, the blind distended end of the oviduct adhered to the ovary at the ovulation fossa. Two cysts were attached to the exterior of the oviduct a few centimeters from the fossa. Histologic examination of the oviduct and cysts revealed a dilated lumen, a decreased infolding of the wall into the lumen, and a lack of a defined muscle layer. Congenital absence of the infundibulum resulting in a blind ampullar terminus is proposed as the cause of the hydrosalpinx.

Aspiration of oocytes from mature and immature preovulatory follicles in the mare.

Two experiments were conducted to investigate methods for aspirating oocytes from immature preovulatory follicles in the mare. In Experiment 1, the ovary was manipulated per rectum and the follicle was punctured by a needle introduced through the flank. Suction was provided by either a syringe or by a vacuum pump connected to the needle via tubing. The preovulatory follicle was aspirated when it reached a diameter of 32 +/- 2 mm (Group A); 37 +/- 2 mm (Group B); or 42 +/- 2 mm (Group C). There was no significant difference in oocyte recovery rates between the two methods (7/24 vs 3/19). Oocyte recovery rates were higher for Groups B and C (5/14 and 4/12, respectively) than for Group A (1/17; P < 0.05). In Experiment 2, the ovary was held against the internal abdominal wall by the hand inserted into the abdomen via a vaginal incision, and the follicle was flushed after aspiration. Recovery rates were 9/13 (69%) for mares treated with human chorionic gonadotrophin (hCG) and 15/21 (71%) for unstimulated mares. This difference was not significant. The oocyte recovery rate for unstimulated follicles (average diameter 39.7 mm) in Experiment 2 was significantly higher than those for Group B and Group C in Experiment 1 (P < 0.05).

Use of altrenogest to prepare ovariectomized mares as embryo transfer recipients.

Altrenogest was administered to ovariectomized mares to determine if treatment would enable establishment and maintenance of pregnancy after transfer of a 7-d embryo. Three different treatment regimens were used: Group A received 22 mg altrenogest daily starting 5 d before transfer, Group B received 66 mg altrenogest daily starting 6 days before transfer, Group C received 300 mg progesterone in oil intramuscularly daily starting 5 d before transfer. Intact, ovulation-synchronized recipients were used as controls for transfer technique. Pregnancy rates were 1 6 , 2 6 , 2 5 , and 13 19 for Group A, Group B, Group C, and controls, respectively. The pregnancy rate in Group A was significantly different from controls and Group A mares had poor uterine and cervical tone. These results show that ovariectomized mares treated with altrenogest are capable of establishing pregnancy after embryo transfer. Treatment with 22 mg altrenogest appears to be insufficient for optimal pregnancy rates after transfer in ovariectomized recipients.

Periparturient events in ovariectomized embryo transfer recipient mares.

Ovariectomized mares treated with progesterone have established and maintained pregnancy after embryo transfer. This study evaluated the ability of ovariectomized embryo transfer recipients to successfully undergo parturition, raise a foal, and return to a useful reproductive status. Periparturient events in three ovariectomized embryo transfer recipient mares and three intact mares were compared. All mares foaled normally. Mammary scores were similar for both groups and all mares produced sufficient colostrum and milk to allow normal growth of healthy foals. Plasma progesterone levels decreased to < 5 ng/ml by Day 4 post partum in both groups. Progesterone concentrations continued to decrease and remained at <1 ng/ml in ovariectomized mares, but increased after the first postpartum ovulation (Day 9 to 15) in intact mares. Endometrial involution as determined by histological evaluation was complete in ovariectomized mares by Day 10 post partum and in intact mares by Day 11 post partum. As assessed by palpation per rectum and clearance of bacteria from the uterus, uterine involution was similar in all mares. The three ovariectomized mares subsequently received embryos by transcervical transfer and two of them established pregnancy. These results indicate that normal parturition, lactation, maternal behavior and uterine involution are independent of ovarian function.

Use of an androgenized mare as an aid in detection of estrus in mares.

A study was conducted over a 2-mo period to compare estrus detection results obtained using an androgenized teaser mare with those obtained with a stallion, using the same group of 10 normally cyclic mares. The teaser mare was androgenized by administration of boldenone undecylenate (500 mg i.m. every 1 to 2 wk), and allowed to run loose with the mare group. Estrus was determined by observation of the group for a 30-min period daily. In the second month of the experiment, a marking harness was used on the androgenized mare to help detect mares mounted when in estrus. Estrous periods detected by each teasing method were 1) first month: stallion, 18; androgenized mare, 5; 2) second month: stallion, 16; androgenized mare, 9. There were no estrous periods detected by the androgenized mare that were not also detected by the stallion. Under these conditions, the androgenized mare was not an adequate estrus detection aid. Also discussed are the successful results of an independent trial on a breeding farm using an androgenized mare as an estrus detection aid.

Surgical repair of the lacerated cervix in the mare.

Surgery was performed to repair lacerations which prevented cervical closure in thirteen mares. All lacerations involved the portion of the cervix that protrudes into the vagina. There did not appear to be a predisposition for lacerations to occur in any one position about the perimeter of the cervix. Nine mares had one laceration and four mares had two lacerations. Although the lacerations were presumed to have occurred at parturition, they apparently were not associated with dystocia. The method of surgical repair is described. Eight mares were bred after surgery, and five conceived.

Investigation of the representativeness of a single endometrial sample and the use of trichrome staining to aid in the detection of endometrial fibrosis in the mare.

The uteri of five mares were removed and endometrial samples were procured from 12 specific locations in the uteri and the samples were processed and duplicate sections were stained with hematoxylin and eosin (H&E) or Masson's trichrome stains. The samples were interpreted in a blind manner by one person, and pathologic changes were classified according to Kenney (1). An assessment of stromal fibrous connective tissue and focal periglandular fibrosis or fibrotic nests was made. There were no significant differences in luminal epithelial cell heights or in the occurrence and severity of stromal fibrous connective tissue, focal periglandular fibrosis, or lymphatic lacunae among locations (P > 0.05). There was an effect of location on the occurrence and severity of inflammation (P < 0.05). If only inflammation was considered in categorization, this would have resulted in changing the category in 9 of 60 samples. There was no increase in tendency for inflammation, fibrosis or lymphatic lacunae to occur in the horns versus the body of the uterus, nor of the dorsal versus the ventral uterus (P > 0.05). There was no effect (P > 0.05) of type of stain on the ability to detect incidence and severity of focal periglandular fibrosis. There was an effect (P < 0.05) of type of stain on the ability to detect the incidence and severity of stromal fibrous connective tissue. The use of the trichrome stain showed slightly increased distribution of stromal fibrous connective tissue.

Effects of semen fractionation and dilution ratio on equine spermatozoal motility parameters.

Two experiments were conducted to examine the effects of semen fractionation and dilution ratio on motility parameters of stallion spermatozoa. In Experiment 1, three ejaculates from each of three stallions were divided into sperm-rich (SR) and sperm-poor (SP) fractions to determine the difference in sperm concentration. Mean sperm concentration in SR fractions (349.5 x 10(6)/ml) was greater (P < 0.001) than that of SP fractions (96.9 x 10(6)/ml). In Experiment 2, three ejaculates from each of two stallions were divided into SR and SP fractions. Fifty percent of the original volume of SR fractions was combined with 50% of the original volume of SP fractions for each ejaculate to represent total ejaculates. SR and total ejaculates were diluted with skim milk-glucose semen extender as follows: 1) no dilution, or dilution to 2) 100 x 10(6)sperm/ml, 3) 50 x 10(6)sperm/ml, or 4) 25 x 10(6)sperm/ml. Semen samples were evaluated at 0.5, 3, 6, 12, and 24 h postejaculation (25 degrees C storage temperature) for percentages of total spermatozoal motility (TSM) and progressive spermatozoal motility (PSM). Mean TSM was greater (P < 0.05) in SR ejaculates than total ejaculates at 12 and 24 h postejaculation. Mean TSM of undiluted semen was lower (P < 0.05) than other dilution ratios over all periods. Mean TSM was greater (P < 0.05) at a 25 x 10(6)sperm/ml dilution ratio than a 50 x 10(6)sperm/ml dilution ratio at 12 and 24 h postejaculation, and greater (P < 0.05) than a 100 x 10(6)sperm/ml dilution ratio from 3 to 24 h postejaculation. Similar patterns were found for PSM. Collection of SR ejaculates and dilution to 25 x 10(6)sperm/ml improved longevity of spermatozoal motility.