Lipohyperplasia of the ileocecal valve.

Submucosal lipohyperplasia of the ileocecal valve (ICV) is reportedly a rarely diagnosed lesion of uncertain significance. Eight cases of ICV lipohyperplasia diagnosed in surgical specimens (seven resections, one biopsy) are reviewed: three cases were associated with right lower abdominal quadrant pain and ICV mass on barium enema or operative examination, two were associated with ICV mucosal acute inflammation and necrosis, and three were incidental in resections for cecal, appendiceal, and sigmoid neoplasia. To evaluate the frequency of ICV lipohyperplasia and any associated processes, a series of 51 autopsies was studied. Regarding lipohyperplasia in these valves, 10 (19.6%) were determined to have none, 14 (27.5%) were mild, 20 (39.2%) were moderate, and 7 (13.7%) were marked cases. Degree of lipohyperplasia correlated statistically with degree of cardiac right ventricular fatty infiltration (p = 0.0001), pancreatic fatty infiltration (p = 0.0314), and greater body weight of patient (p = 0.0009). No definite correlation was demonstrated with left ventricular, adrenal, or lymph node fatty infiltration, or with hepatic fatty change, body height, age of patient, or blood glucose. Various gastrointestinal symptoms and lesions accompanied lipohyperplasia, but no definite causal relationship was identified, except for one case of marked lipohyperplasia associated with marked mucosal necrosis and acute inflammation of ICV. In conclusion, ICV lipohyperplasia is a common finding that occasionally may be associated with clinical symptoms and other valve pathology. It correlates to some extent with right ventricular and pancreatic fatty infiltration and with greater body weight.

Structural analysis of parathormone fragments elaborated by cells cultured from a hyperplastic human parathyroid gland.

Parathyroid cells were obtained by collagenase digestion of 2 g of human parathyroid tissue obtained at surgery from a patient with end stage renal failure and hypercalcemia. Cells were placed into monolayer culture in supplemented Waymouth's MB752/1. Secretion of parathyroid hormone (PTH) from monolayer cultures was inhibited for 3 weeks by 2.5 mM compared to 0.5 mM calcium. The inhibition was 50% on day 3 of culture, and decreased to 19% by day 21. When cultures were incubated with [3H]leucine, radioactive PTH and COOH-terminal PTH fragments were secreted. Sequence analyses were performed on material in radioactive and immunoreactive peaks following gel filtration and high performance liquid chromatography of media. The results indicated that cleavage of PTH or fragments thereof occurred at the 23-24, 27-28, and 33-34 peptide bonds. NH2-terminal fragments of PTH were not detected in media.

Calcification in atherosclerosis. II. Animal studies.

For comparison with our previous study on early calcification in human atherosclerosis, the aortas of rabbits and chickens with experimentally induced atherosclerosis were studied by gross examination, light microscopy and electron microscopy, including various cytochemical techniques. Nine male New Zealand white rabbits and nine male white leghorn chickens were fed an atherogenic diet of chow with 8% peanut oil and 2% cholesterol for one, two or three months. Six rabbits and six chickens, fed normal chow for one, two or three months, served as controls. The normal diet chickens were found to have lipid-negative spontaneous fibrous plaques in the abdominal aorta, which following atherogenic diet developed lipid deposition and increasing calcium deposition. The normal diet rabbits had no aortic lesions, but following an atherogenic diet developed highly lipid-positive foam cell intimal lesions which subsequently developed increasing amounts of smooth muscle cells and calcium. Ultrastructurally, the aortic plaques in normal diet chickens were composed of smooth muscle cells, collagen, elastic fibers, ground substance and a few small extracellular matrix vesicles bounded by a trilaminar membrane. In the atherogenic diet chickens, these vesicles increased in number as did their staining for calcium by the pyroantimonate technique. The membranes of vesicles were cytochemically positive for alkaline phosphatase and adenosine triphosphatase. Similar matrix vesicles were present in the interstitium of the media. In both intima and media, the vesicles appeared to be largely derived from degenerating smooth muscle cells. The aortas of atherogenic diet rabbits were similar to the chickens except for many more lipid-laden foam cells.(ABSTRACT TRUNCATED AT 250 WORDS)