Vagal paraganglioma: the Jefferson experience.

Vagal paraganglioma is a rare tumor of neural crest origin. Although the literature is in agreement with regard to epidemiology, diagnosis, and tumor biology, there is some controversy over treatment modalities for these patients. We performed a nonrandomized retrospective study in a large single-institution series of patients (n = 19) in whom vagal paraganglioma was diagnosed. General statistics included age, male/female ratio, tumor size, and duration of follow-up. Other variables such as signs and symptoms at presentation, family history, multicentricity, metastatic disease, and secretion of catecholamines were included. CT scan, MRI, and angiography were used in combination for diagnostic purposes as well as for treatment planning. Preoperative embolization was performed in 5 of the more recently treated patients. Current issues regarding the use of preoperative embolization and choice of surgical approach were analyzed. In this article the possibility and sequela of vagus nerve-sparing procedures will be presented. Operative complications and postoperative morbidity related to cranial neuropathies will be discussed. The rationale for performing adjunct procedures, including cricopharyngeal myotomy and vocal fold medialization, to facilitate the rehabilitation of patients with postoperative cranial nerve deficits will be given. Our findings and recommendations will be compared with currently accepted treatment protocols in conjunction with a review of the literature.

The pretectum mediates rapid eye movement sleep regulation by light.

A variety of sensory stimuli (e.g., visual, auditory, and thermal) are known to induce rapid eye movement (REM) sleep in mammals. Studies have examined the induction of REM sleep in albino rats by light-to-dark transitions, a phenomenon referred to as REM sleep triggering. Recent research has demonstrated that aspiration lesions of the superior colliculus (SC) and pretectal area attenuated REM sleep triggering. To define more specifically the area or areas involved in mediating REM sleep responses to changes in illumination, fiber-sparing neurotoxic lesions were made to the pretectum (PT) or the SC. Lesions of the PT attenuated REM sleep triggering, whereas lesions of the SC did not. Thus, the role of the PT may be expanded to include the regulation of REM sleep in response to photic stimulation in albino rats. These findings provide a paradigm in which to study mechanisms of REM sleep generation and the effects of light on behavioral state.

Recurrence of haemolytic-uraemic syndrome in renal transplants: a single-centre report.

BACKGROUND: The incidence of recurrence of haemolytic-uraemic syndrome (HUS) in renal allografts appears to vary by centre, with the highest rates reported from the University of Minnesota. It is possible that the high rate of HUS recurrence at this institution reflects a transplant population skewed towards patients with a form of HUS that is more likely to recur in the allograft. METHODS: This study examined whether the initial episode of HUS in the native kidneys was preceded by a diarrhoeal prodrome ('classical HUS') or not ('atypical HUS'), and evaluated transplant outcomes in 24 patients who received 36 transplants at the University of Minnesota between 31 May 1972 and 31 December 1994. RESULTS: Eighteen of the 24 patients had atypical HUS, three had classical HUS, and in three patients the presence or absence of a diarrhoeal prodrome could not be determined. Recurrent HUS, defined as microangiopathic haemolytic anaemia, thrombocytopenia, renal insufficiency, and allograft biopsy findings compatible with HUS, occurred 16 times in 14 grafts in 11 patients. Nine of these patients had atypical HUS, one had classical HUS, and in one the nature of the prodrome could not be determined. Eleven of the 14 initial recurrences took place within 2 months of transplant. Recurrence was not more frequent in patients who received cyclosporin or antilymphocyte preparations. Actuarial analysis using matched controls showed poorer graft survival in patients with a primary diagnosis of HUS (P = 0.007), due to the high frequency of graft loss in HUS patients with recurrence. CONCLUSION: Based upon these data and a review of the literature, it can be concluded that the risk of recurrence of HUS in the allograft is confined almost entirely to patients with atypical forms of HUS.

Effect of water content in perchloric acid on the non-aqueous potentiometric titration of nitrogen-containing compounds.

In the United States Pharmacopeia (USP), 0.1 N perchloric acid in acetic acid volumetric solution (hereafter HClO4 VS) used for non-aqueous titration has specified a water content between 0.02 and 0.05%. Preparing this titrant with such a narrow range of water content is very time consuming, precludes the use of commercially available titrants, and, consequently, prompted an investigation to try and expand the range up to 0.5%. In this study, the titrimetric results obtained using HClO4 VS containing more water were very close to those obtained using the USP specified titrants. A maximum assay difference of 0.7% in the titrations of three selected nitrogen-containing compounds, clonidine hydrochloride, dipyridamole, and adenosine were observed. The titrimetric results obtained using these titrants were also precise with RSDs of not more than 0.4%. Therefore, a wider range of water content in HClO4 VS between 0.02 and 0.5% is suggested for the USP potentiometric titration of nitrogen-containing compounds.

Respiratory syncytial virus infections in pediatric renal transplant recipients.

Immunocompromised patients are considered at increased risk from respiratory syncytial virus (RSV) infection. We examined the incidence and outcome of RSV infection in pediatric renal transplant (Tx) recipients on chronic immunosuppressive therapy. Of 173 recipients transplanted between November 1985 and April 1993, 5 (3%) developed RSV infection (age range 11-39 months). Initial immunosuppression included prednisone, azathioprine, cyclosporine, and polyclonal antibody therapy. Time from Tx to onset of RSV infection was 1 day to 7 months. Symptoms included rhinorrhea, cough, tachypnea, retractions, fever, wheezing, and abnormal chest X-ray. Treatment included bronchodilator therapy, bronchial drainage, ribavirin, and mist tent. Azathioprine was transiently withheld for leukopenia during treatment in 2 recipients. Three recipients developed biopsy-proven acute rejection during (n = 2) or immediately following (n = 1) RSV infection; all responded to corticosteroid treatment. RSV infection is not commonly diagnosed in pediatric renal Tx recipients. The course of RSV infection in our patients did not differ from that reported in normal children. The possible association between RSV and acute rejection warrants further observation. When diagnosed early, RSV infection does not appear to be associated with increased mortality in pediatric renal Tx recipients. Larger numbers of recipients need to be studied to confirm these results.

Glomerular disease and lung transplantation.

Three patients with lung or heart/lung transplants developed nephrotic-range proteinuria 2 to 5 years posttransplantation. Kidney biopsy showed focal segmental glomerulosclerosis in two patients and probable focal sclerosis in the third. A retrospective review of postmortem kidney specimens from 18 lung transplant recipients who died did not indicate additional cases of glomerular disease. The three patients with glomerular disease after lung transplantation had very few clinical similarities other than nephrotic-range proteinuria and lung transplantation. Their underlying lung diseases were different, and their posttransplantation courses were very different in terms of pulmonary function, cyclosporine nephrotoxicity, and other complications. We did not find in the literature previous reports of de novo focal segmental glomerulosclerosis or other glomerular lesions after lung transplantation. We suspect that additional cases will be identified in the future.

Endometrial biopsy in Holstein-Friesian dairy cows. I. Technique, histological criteria and results.

Endometrial biopsies were taken for histological assessment from 97 cows which calved in a commercial dairy herd between April and August 1984. Sixty-two cows were biopsied at both day 26 and 40 postpartum, 23 cows at only day 26, and 12 at day 40 only. Subjective and quantitative histological criteria were assessed. Ninety-five percent of biopsies were adequate for at least subjective assessment. The distribution of criteria within each horn-day category, as well as combined readings by day and by gravid or nongravid horn were computed and significant differences noted. There was more severe inflammation and more segmented cells at day 26 than 40 postpartum, and in the gravid compared to the nongravid horn. The distribution patterns for the criteria examined provide an overview of histological characteristics in this group of postpartum cows.

Endometrial biopsy in Holstein-Friesian dairy cows. II. Correlations between histological criteria.

Endometrial biopsies were taken for histological assessment from 97 cows which calved in a commercial dairy herd between April and August 1984. The main objectives of this study were to analyze the interrelationships among histological criteria and to identify a shortlist of histological parameters to be included in subsequent analysis of associations with results of bacteriological culture, clinical findings and reproductive performance. Epithelial height and segmented cell counts were highly correlated within biopsy, between horns and between days. Subjective assessment of inflammation in the epithelium and/or stratum compactum generally identified biopsies which had any inflammation present. Cows which had inflammation in a biopsy from day 26 were likely to show inflammatory changes at day 40. Quantitative and subjective assessments of gland number, dilation and fibrosis were highly correlated. There was a positive association between the number of cross sections and the diameter of glands, and both of these criteria were negatively correlated with fibrosis and inflammatory changes. There may be different functional significance of the same histological finding at a different number of days postpartum.

Endometrial biopsy in Holstein-Friesian dairy cows. III. Bacteriological analysis and correlations with histological findings.

This study examines the results of bacterial culture from 159 endometrial biopsy samples from 97 commercial dairy cows and correlations between bacteriological and histological findings. Bacteria were isolated from approximately 80% of biopsies taken at day 26 and day 40 postpartum. Eleven percent of biopsies were positive for both aerobic and anaerobic culture. Streptococci, Escherichia coli and Actinomyces pyogenes were the most common isolates. Isolation of A. pyogenes from a biopsy at day 26 was positively correlated with isolation of anaerobic bacteria and segmented cell inflammation in the same biopsy, and with subsequent isolation of A. pyogenes at day 40. There was a strong association between isolation of A. pyogenes and anaerobes at day 26 with increased uterine lesions at day 40. Isolation of alpha hemolytic streptococci (AHS) was negatively correlated with isolation of A. pyogenes and with inflammation. Actinomyces pyogenes and AHS showed opposite associations with mononuclear cell inflammation and lymphocytic foci.

Estradiol-induced blockade of ovulation in the cow: effects on luteinizing hormone release and follicular fluid steroids.

Administration of 10 mg estradiol valerate (EV) to nonlactating Holstein cows on Days 16 of the estrous cycle prevented ovulation in 7 of 8 cows for 14 days post-injection. In these 7 cows, the timing of luteolysis and the luteinizing hormone (LH) surge was variable but within the normal range. At 14 days post-treatment, each of these cows had a large (greater than 10 mm) follicle, with 558 +/- 98 ng/ml estradiol-17 beta, 120 +/- 31 ng/ml testosterone, and 31 +/- 2 ng/ml progesterone in follicular fluid (means +/- SE). A second group of animals was then either treated with EV as before (n = 22), or not injected (control, n = 17) and ovariectomized on either Day 17, Day 18.5, Day 20, or Day 21.5 (24, 60, 96, or 132 h post-EV). Treatment with EV did not influence the timing of luteolysis, but surges of LH occurred earlier (59 +/- 8 h post-EV vs. 100 +/- 11 h in controls). The interval from luteolysis to LH peak was reduced from 44 +/- 6 h (controls) to 6.9 +/- 1.5 h (treated). Histologically, the largest follicle in controls tended to be atretic before luteolysis, but nonatretic afterwards, whereas the largest follicle in treated animals always tended to be atretic. Nonatretic follicles contained high concentrations of estradiol (408 +/- 59 ng/ml) and moderate amounts of testosterone (107 +/- 33 ng/ml) and progesterone (101 +/- 21 ng/ml), whereas atretic follicles contained low concentrations of estradiol (8 +/- 4 ng/ml) and testosterone (12 +/- 4 ng/ml), and either low (56 +/- 24 ng/ml) or very high (602 +/- 344 ng/ml) concentrations of progesterone. This study suggests that EV prevents ovulation by inducing atresia of the potential preovulatory follicle, which is replaced by a healthy large follicle by 14 days post-treatment.

Hereditary parakeratosis in shorthorn beef calves.

Parakeratosis was diagnosed in 9 Shorthorn beef calves over a 4-year period. When pedigrees of these calves were analyzed, familial associations were strong. Thirty-six coefficients of relationship among all possible combinations of the 9 affected calves ranged from 0.5 to 39.8% and averaged 15.6%. All affected calves were descendants of bull A. Of 9 affected calves, 6 had bull A in their paternal and maternal pedigrees. The 3 remaining affected calves had bull A in their sire's pedigree and were born to 2 full-sib dams. Seemingly, parakeratosis in this Shorthorn herd was hereditary with the mode of inheritance being that of a simple autosomal recessive.

Reproductive performance of dairy cows following treatment with cloprostenol 26 and/or 40 days postpartum: a field trial.

One hundred and seventy Holstein Friesian cows were randomly assigned to receive either 500 ug cloprostenol or saline placebo on Day 26 postpartum followed by 500 ug cloprostenol or saline on Day 40 postpartum. Four treatment groups were formed: Group 1-saline (Day 26)/saline (Day 40); Group 2-cloprostenol/(Day 26) saline (Day 40); Group 3-saline (Day 26)/cloprostenol (Day 40); Group 4-cloprostenol (Day 26)/cloprostenol (Day 40). Double blind techniques were used in administering treatments and in assessing the response to treatment. Palpation of the reproductive tract per tectum and uterine biopsies were performed on 92 cows prior to each treatment at Day 26 and Day 40 postpartum. Progesterone concentrations were determined on milk samples collected prior to treatment. There were no significant differences among treatment groups with respect to services per conception, number of heats detected before first service and culling for infertility. Cloprostenol treatment at Day 26 appeared to delay the first estrus, but it reduced the number of days to conception after the first service. Cows receiving cloprostenol at Days 26 and/or 40 had a decreased calving-to-conception interval compared to controls (P=0.01). Sequential therapy with two doses of cloprostenol resulted in slightly better reproductive performance than either treatment on Day 26 or 40 alone. Treatment with cloprostenol resulted in a decrease in the subsequent incidence of pyometra (P<0.05). It is concluded that in the herd studied, cloprostenol therapy at Day 26 and/or 40 postpartum was beneficial to reproductive performance. Although it was anticipated that cloprostenol would be more effective in cows with elevated progesterone levels, the opposite was observed at the Day 26 cloprostenol treatment. Uterine biopsy at Days 26 and/or 40 had a detrimental effect on subsequent reproductive performance.

A light and electron microscopical study of intranuclear cytoplasmic invaginations in interstitial cell tumours of dogs.

Intranuclear cytoplasmic invaginations, so-called "pseudoinclusions", were seen in all 7 interstitial cell tumours identified among 32 consecutive canine testicular tumours examined. The proportion of cells with intranuclear cytoplasmic invaginations varied from less than 1 per cent to 15 per cent. Similar "pseudoinclusions" were not seen in any other canine testicular tumours examined; this finding might be helpful in differential diagnosis, especially in less differentiated tumours. Histologically, the cytoplasmic invaginations appeared as round, eosinophilic, clearly demarcated intranuclear inclusions and stained with periodic acid-Schiff. Affected nuclei were enlarged. The process of progressive cytoplasmic invaginations into the nucleus and replacement of most of the nuclear volume of the neoplastic interstitial cells with cytoplasmic material was examined by transmission electron microscopy. Two or more cytoplasmic invaginations were sometimes present within a single nucleus. The nuclear membrane could be followed continuously around the cytoplasmic invaginations and nuclear pores were present in the membrane covering invaginations. The invaginations contained smooth and rough endoplasmic reticulum, vesicles, lipid vacuoles, myelin figures and disrupted membranous profiles. Bundles of interwoven cytoplasmic filaments were among the organelles seen in the invaginations in one tumour. Possible reasons for the formation of intranuclear cytoplasmic inclusions are discussed and maintenance of the normal ratio of nuclear surface to nuclear volume is suggested as the mechanism promoting formation of inclusions in interstitial cell tumours.

The effect of intrauterine inoculation with Ureaplasma diversum on bovine fertility.

To determine the influence of Ureaplasma diversum on bovine fertility 11 uninfected virgin heifers with normal ovarian cyclic activity were randomly allocated to test or control groups. At a synchronized estrus, five test heifers were given an intrauterine broth inoculum containing 1.09 x 10(8) to 1.4 x 10(9) colony forming units of U. diversum and six control animals were infused with sterile ureaplasma broth medium. All animals were artificially inseminated within one hour of infusion. Pregnancy was diagnosed in one of five test heifers and all of six controls by serum progesterone concentrations measured to 25 days postinsemination. The difference in pregnancy rates between the two groups was statistically significant (p = 0.0152). It was concluded that under the conditions of this experiment U. diversum is capable of causing infertility in cattle.

Hormonal changes in sows after induced porcine parvovirus infection in early pregnancy.

Hormonal changes, lesions, and virus isolation studies were determined in sows after uterine artery inoculation with porcine parvovirus [( PPV], strain NADL-8) in early pregnancy. Two sows were given PPV on days 14 or 16 and were euthanatized and necropsied on day 35 after twice daily plasma collection for hormone measurement. Parvovirus was given to 4 sows on day 14 and to 4 sows on day 21 with 5 times daily plasma samples collected for 1 week. Sows were examined on days 21 and 28, respectively. Four control sows in each group on days 14 and 21 were given a placebo injection and were similarly studied. All embryos in all but 1 sow given PPV were in various stages of resorption at necropsy. Normal embryos were present in all control sows. Estrone sulfate values increased logarithmically, progesterone values remained stable, and concentrations of 13, 14-dihydro-15-keto-prostaglandin (PG) F2 alpha (PGFM), a PGF2 alpha metabolite, were less than 200 ng/ml for sows given a placebo. In contrast, sows with resorbing embryos did not have an increase in estrone sulfate values. A decrease in plasma progesterone values occurred in 9 of 10 sows inoculated with PPV; this decrease was accompanied by greater than or equal to 1 marked increase in PGFM concentrations. Quantitative assessment of the uterus revealed significantly greater cytoplasmic density in endometrial and glandular cell (P less than 0.01), a greater glandular epithelium height (P less than 0.05), and twice the number of glands (P less than 0.05) in control sows, compared with values in sows inoculated with PPV.(ABSTRACT TRUNCATED AT 250 WORDS)

Translocation (1;17) in accelerating and blast phases of chronic myelogenous leukemia.

A translocation (1;17)(p11;q11) has been observed in two chronic myelogenous leukemia (CML) patients studied during the accelerated or acute stages of their diseases. In a review of the literature, four additional cases of t(1;17)(p11;q11) were identified, suggesting that this marker may be specific for the terminal phase of CML.

Inhibition of mammalian collagenases by thiol-containing peptides.

The following thiol-containing peptide analogues of the carboxyl side of the collagenase-sensitive bond of collagen were synthesized and tested as inhibitors of collagenases partially purified from homogenates of rabbit V-2 tumor and culture medium of pig synovium: HSCH2CH(CH3)CO-Ala-OEt (I), HSCH2CH(CH2Ph)CO-Ala-OEt (II), HSCH2CH[CH2CH(CH3)2]CO-Ala-OEt (III); HSCH2 CH-[CH2CH(CH3)2]CO-Ala-Gly-OEt (IV); HSCH2CH[CH2CH(CH3)2]CO-Ala-Gly-Gln (V). The compounds are listed in order of their inhibitory potency when assayed with nonfibrillar-acid-soluble calf skin collagen at pH 7.6, 35 degrees C. The best inhibitor (III) gave 50% inhibition between 1 and 4 microM. II was a competitive inhibitor with a Ki value of 75 microM. The enzymes preferred an isobutyl side chain at the 2-carbon position, and, where tested (III, IV), did not discriminate strongly between stereoisomers at the chiral 2-carbon. Increasing the length of the inhibitor did not markedly increase potency.

Primary cardiac granular cell tumor in a dog.

The histological, histochemical, and ultrastructural features of a granular cell tumor in the wall of the right atrium of the heart in a nine-year-old dog are described. The histologic appearance of the mass varied from areas of spindle-shaped cells to sheets of globoid cells with foamy granular cytoplasm. The globoid neoplastic cells contained numerous cytoplasmic granules which were variably positive to periodic acid-Schiff staining, with and without disastase digestion. Ultrastructurally, the globoid cells had numerous various-sized, heterogeneous lysosomes with pleomorphic content. A granular cell tumor originating in the heart has not been reported previously in animals. The support for a neural origin of these tumors by the recent identification of several nervous tissue specific proteins in their granular cells is discussed.