Three different consecutive manifestations of morphoeic BCC in the same patient: presenting first as ectropion, then entropion, and finally medial canthal dystopia with epicanthus inversus.

Morpheaform basal cell carcinoma (BCC) can cause diagnostic difficulty due to an atypical clinical presentation. Successful treatment requires a high index of clinical suspicion together with an early confirmatory biopsy. We present the case of an 81-year-old lady with a delayed diagnosis of morphoeic BCC due to an unusual presentation of evolving lid malposition, and we highlight the limitations of a punch biopsy in diagnosing atypical lesions. An appropriate biopsy technique is vital, with consideration for repeat biopsies when necessary, especially if the clinical picture is changing over time.

Preferential release of newly synthesized, exportable neuropeptides by insect neuroendocrine cells and the effect of ageing of secretory granules.

The release of newly synthesized neuropeptides was studied in an in vitro system using the adipokinetic hormone (AKH)-producing cells of an insect (Locusta migratoria) as a model system. Tritiated phenylalanine incorporated into three hormonal neuropeptides, AKH I, II and III, was used to distinguish newly synthesized hormones from older, preexisting ones. After pulse-chase labeling experiments of varying duration, the secretion of AKHs by the AKH cells was stimulated. Both hormones released into the incubation medium after stimulation and non-released hormones extracted from the tissue were separated by reversed-phase high performance liquid chromatography. Their radioactivity was measured by scintillation counting of the column eluate. The ratio between the specific radioactivities of the released and the non-released neuropeptides was always greater than 1.0, which indicates that the newly synthesized peptides are preferentially released. The percentages of newly synthesized (radioactive) AKHs which are released, increased until 8 1/4 h and decreased thereafter. The results indicate that after the packaging of the prohormones into secretory granules and their processing to bioactive AKHs, some further maturation of the secretory granules is required before they can release their content. After an 8 1/4 h incubation, secretory granules with radioactive AHKs enter a non-releasable pool consisting of older secretory granules.

The adipokinetic cells in the corpus cardiacum of Locusta migratoria preferentially release young secretory granules.

The influence of flight activity on the release of secretory granules from the adipokinetic cells in the corpus cardiacum of Locusta migratoria was studied. Two labeling methods, an enzymatical and a radioactive one, were used to label young, newly synthesized secretory granules and so distinguish them from older, preexisting granules. Both methods demonstrated that the ratio between the numbers of labeled and unlabeled secretory granules was lower in flight-stimulated adipokinetic cells than in unstimulated cells. This ratio was lower in both the cell bodies and the cell processes of flight-stimulated cells. After flight there was no detectable change in the total number of secretory granules, which indicates that the synthesis of new secretory granules is not inhibited by flight activity. Rather, the tendency of flight-stimulated cells to have more trans-Golgi networks labeled with wheat-germ agglutinin-conjugated horseradish peroxidase suggests that the synthesis of new secretory granules was enhanced by flight. The results led to the conclusion that young secretory granules were preferentially released over older secretory granules.

Nasal secretions from patients with polyps and healthy individuals, collected with a new aspiration system: evaluation of total protein and immunoglobulin concentrations.

This study was designed, first, to test a new system for aspiration of human nasal secretions and, secondly, to evaluate protein and immunoglobulin concentrations in these secretions at different levels of secretory activity. The direct aspiration system combines the advantages of minimal irritation of the nasal mucosa with the facility to determine concentrations per gram of secretion. The total protein and immunoglobulin concentrations were inversely related to the amount of secretion obtained. Variations in fluid secretion throughout the day may be responsible for this relationship. The inverse relationship was much more significant in patients with nasal polyps, in which much higher concentrations were found, than in healthy subjects. Ratios of immunoglobulin to total protein were independent of the amount of secretion obtained. Compared to the controls, the ratios of IgM and IgG to protein in the secretions of the patients were significantly increased. The secretory immunoglobulin A to total protein ratios were only slightly higher in the patients' secretions.

Two deaths resulting from apparent parenteral injection of strychnine.

Large amounts of strychnine were found in the bodies of two drug abusers, presumable as a result of injection of "street drugs" adulterated with strychnine. Current therapeutic research with this drug, if widely accepted into medical practice, may lead to its greater availability and hence an increased poisoning incidence potential.

Family of prohormone convertases in Lymnaea: characterization of two alternatively spliced furin-like transcripts and cell-specific regulation of their expression.

The majority of neuropeptides in Lymnaea stagnalis are proteolytically processed from larger precursors at sites composed of single or multiple basic amino acid residues. Previous studies have identified several putative prohormone convertases in the brain of Lymnaea. To characterize the complete family, we undertook three independent approaches: reverse-transcribed polymerase chain reaction screening, and low-stringency cDNA and genomic library screenings. The central nervous system cDNA library screening yielded two cDNAs encoding Lfurin1 and its variant form, Lfurin1-X. Both proteins show the characteristic organization of (human) furin with a putative catalytic domain, a P domain, a Cys-rich domain, a transmembrane domain, and a cytoplasmic tail. Lfurin1 and Lfurin1-X are identical, apart from a putative alternatively spliced noncatalytic luminal protein domain, which is present exclusively in Lfurin1-X. In situ hybridization revealed that the Lfur1 gene is expressed throughout the Lymnaea brain, but that the level varies considerably from one neuron to another. Quantitative analysis of the expression level of the two alternatively spliced transcripts revealed that it is neuron type-specifically regulated. This probably indicates the functional importance of noncatalytic luminal protein domains in these enzymes. In addition, our findings suggest that apart from the identified convertases LPC2, Lfurin1/Lfurin1-X, and Lfurin2, additional prohormone convertase diversity is either not present or present only at low levels in the Lymnaea brain. Alternatively, additional prohormone convertases could exist with a lower degree of sequence conservation than the other Lymnaea prohormone convertase members. From our findings, it appears that the majority of prohormone processing in Lymnaea is carried out by the three thus far identified types of Kex2-related prohormone convertases despite the large number of neuropeptide precursors and diverse multiple basic cleavage sites hydrolyzed.