Cytometric analysis of testicular seminoma and spermatocytic seminoma

DNA analysis of testicular seminoma (typical seminoma [TS] and anaplastic seminoma [AS]) and spermatocytic seminoma (SS) was performed to evaluate the relationship between the proliferative activity and clinical outcome, and also to determine the proliferative characteristics of SS. Nuclear DNA contents of 15 cases of TS, 17 of AS and three of SS were measured by flow cytometry. Cytofluorometric DNA analysis was performed on three cases of every tumor. All 35 cases showed aneuploidy in the flow cytometry. In comparison with TS, AS tended to have a higher percentage of G2M phase in one cell cycle, having more cell cycle numbers and containing cells of various DNA values. Many mitotic figures with larger atypical cells that characterize AS could be explained by these results. In SS, the diploid formation by the small cells and the appearance of large cells with a maximum DNA value of 40C were demonstrated. These ploidy characteristics were considered to result in the morphological expression of large, small and intermediate cells. The application of both flow cytometry and cytofluorometry to the same cases was beneficial.     

Paraneoplastic demyelinating disorder in the brain of a patient with seminoma

OBJECTIVE: To evaluate the estrogen and progesterone receptor status of glassy cell carcinoma of the cervix to assess the possible implications of hormone replacement therapy in these patients. METHODS: The estrogen and progesterone receptor status of 13 glassy cell carcinomas was evaluated by immunohistochemistry using commercial monoclonal antibodies and a streptavidin-biotin detection system. RESULTS: No immunohistochemically detectable estrogen or progesterone receptor protein was present in tumor cells, although both receptors were identified in the adjacent normal cervical tissue. CONCLUSION: The absence of estrogen and progesterone receptors in glassy cell carcinoma suggests that this tumor would not be hormonally responsive and that these patients can be safely treated with hormone replacement therapy. Further studies are indicated to confirm this observation.     

Differential diagnosis of acute testicular pain using color-coded duplex ultrasonography: difference between testicular torsion and epididymitis

OBJECTIVE: To assess retrospectively the accuracy of colour-coded duplex sonography (CCDS) in distinguishing testicular torsion from epididymitis as the cause of acute testicular pain. PATIENTS AND METHODS: The results of CCDS were analysed for all 81 patients (mean age 27.2 years [6 weeks to 60 years]), admitted between 1.1.1995 and 30.6.1996 with the diagnosis of acute testicular pain. Testicular torsion was diagnosed when CCDS failed to detect perfusion in one testis. Regular arterial and venous perfusion of both testes excluded torsion. Epididymitis was diagnosed when hyperperfusion of the epididymis was demonstrated by CCDS. RESULTS: 20 of 22 cases of torsion, subsequently diagnosed at surgery, had been correctly diagnosed by CCDS (sensitivity 90.9%, specificity 98.3%). 55 patients had epididymitis, confirmed by the clinical course and follow-up having excluded torsion. Other causes (trauma, tumour, inguinal hernia) were found in the remainder of patients. CONCLUSION: With a positive predictive value of 95.2% and a negative one of 96.6% CCDS is a highly suitable method for recognizing or excluding testicular torsion and thus clarifying the cause of acute testicular pain.     

Radiotherapy in stage IIA and IIB testicular seminoma with reduced portals: a prospective multicenter study

PURPOSE: A prospective multicenter study was carried out to estimate the treatment outcome of radiotherapy in Stage II seminoma after the application of modern staging and radiotherapy techniques. The lower margin of the iliac field was positioned on the upper rim of the acetabulum to reduce the amount of scattered irradiation to the remaining testicle. METHODS AND MATERIALS: The study was carried out in 25 centers in Germany. Patients with pure seminoma, negative AFP-values, and retroperitoneal lymph node metastases of less than 5 cm in diameter were entered into the study. All patients received a ventrodorsal opposed field irradiation of the para-aortic and the ipsilateral iliac lymph nodes. The fields extended from the top of the 11th thoracic vertebra to the top of the acetabulum. Patients in Stage IIA (lymph nodes <2 cm ) received 30 Gy, and patients with Stage IIB (lymph nodes between 2 and 5 cm) 36 Gy total dose. RESULTS: 39 patients in Stage IIA and 19 patients in Stage IIB were evaluated. After a median observation time of 37 months all patients are alive and disease free. Recurrence free survival in stage IIA was 100%. Two patients in Stage IIB experienced a recurrence 10 and 17 months after the end of radiotherapy. The actuarial recurrence free survival estimate in Stage IIB was 94.1% for 1 year and 87.4% for 2 years. One recurrence in Stage IIB occurred in the mediastinum, one in the mediastinum, and one the lung. Both patients could be salvaged by chemotherapy. There were no pelvic recurrences. The treatment was well tolerated, with nausea being the most common side effect (56.9% Grade 1, 15.5% Grade 2, and 8.6% Grade 3). Diarrhea occurred in 15.5% (Grade 1), 15.5% (Grade 2), and 5.2% (Grade 3) of the patients. CONCLUSIONS: The outcome of para-aortic and ipsilateral iliac irradiation in Stage IIA/B testicular seminoma is excellent with the currently available staging methods and treatment facilities. The treatment is well tolerated. The lower margin of the iliacal field can be placed at the acetabulum.     

Postsurgical policy in stage I testicular seminoma: cost and benefit of prophylactic irradiation in a long-term experience

The definitive cure rate for clinical stage 1 testicular seminoma is very close to 100%, and prophylactic irradiation of the regional lymph nodes is associated with a low morbidity. Nevertheless, in recent years a "wait-and-see" policy has been proposed by some researchers. We analysed the cost/benefit ratio of radiotherapy (RT) by review of the case histories of 299 patients treated at the Department of Radiotherapy of the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan from January 1968 to December 1989. The 5-year overall survival was 99% (97.5% at 10 years), while the 10-year disease-free survival was 96%. The recurrence rate was 2.3%, but no patient relapsed in the irradiated areas. Acute toxicity was very moderate with only 4 (1.3%) serious radiation sequelae occurring 6 to 27 years after treatment. However, 9 second malignancies (3%) were observed. Lastly, we have calculated the costs for our National Health Service comparing surveillance policy and prophylactic irradiation.     

Paraneoplastic digital clubbing and hypertrophic osteoarthropathy

Previous work has shown that exposure to many non-mutagenic stresses causes greater UV resistance in Escherichia coli K12 via an error-free, excision repair-dependent process. Induction of the latter should enhance liquid holding recovery in the bacteria. The results in this paper show that this is the case and that the increased UV-resistance is due entirely to an increase in the capacity of the cells for DNA excision repair. The latter arises wholly or in part from an increase in the intracellular level of the key enzyme of the pathway, UvrABC endonuclease.     

Spermatocytic seminoma: a clinicopathological review of ten patients

This study explores the relationship between Arterial Ketone Body Ratio (AKBR = acetoacetate/3-hydroxybutyrate) and the patients state after partially liver resections. Enzymatic methods of Mellanby and Williamson for the determination of ketone bodies (acetoacetate and 3-hydroxybutyrate) were used. Twelve surgical patients (8 women and 4 men) were examined. The control group consisted of 5 persons. Ketone bodies were measured in samples of arterial blood taken before operation and in the postoperative period. Then AKBR values were calculated. Patients were classified into three groups. Group A patients (8 subjects) had AKBR value higher than 0.7, group B patients had AKBR between 0.4 and 0.7 (2 cases), and group C patients had AKBR below 0.4 (2 cases). We observed that incidence of postoperative complications increased with the decrease of AKBR value. No postoperative complications and good general conditions of patients were observed in group A only. Group B patients had postoperative complications, whereas group C patients decreased in the postoperative period. These results indicate that Arterial Ketone Body Ratio is a good indicator for prognosis of postoperative survival of patients after partially liver resections.     

Laparoscopic cholecystectomy and lithiasis of the common bile duct: prospective study on the importance of preoperative endoscopic ultrasonography and endoscopic retrograde cholangiography

OBJECTIVES: Laparoscopic cholecystectomy is the standard treatment of symptomatic gallstones. At present, no consensus has been reached on the diagnostic and therapeutic methods of concomitant common bile duct stones. Systematic preoperative endoscopic ultrasonography followed, if necessary, by endoscopic retrograde cholangiography and sphincterotomy during the same anesthetic procedure could be a diagnostic and therapeutic alternative for common bile duct stones making possible a laparoscopic cholecystectomy without intraoperative investigation of the common bile duct. METHODS: One hundred and twenty-five patients underwent a prospective endoscopic ultrasonographic evaluation prior to laparoscopic cholecystectomy for symptomatic gallstones. Fourty-four patients (35%) had at least one predictive factor for common bile duct stones. Endoscopic ultrasonography and cholecystectomy were performed on the same day. Endoscopic ultrasonography was followed by endoscopic retrograde cholangiography and sphincterotomy by the same endoscopist in case of common bile duct stones on endoscopic ultrasonography. Patients were routinely followed up between 3 and 6 months and one year after cholecystectomy. RESULTS: Endoscopic ultrasonography suggested common bile duct stones in 21 patients (17%). Endoscopic ultrasonography identified a stone in 17 of 44 patients (38.6%) with predictor of common bile duct stones and only in 4 of 81 patients (4.9%) without predictor of common bile duct stone. Among these 21 patients, one patient was not investigated with endoscopic retrograde cholangiography because of the high risk of sphincterotomy, 19 patients had a stone removed after sphincterotomy, one patient had no visible stone neither on endoscopic retrograde cholangiography, nor on exploration of the common bile duct after sphincterotomy. Endoscopic ultrasonography was normal in 104 patients (83%). However, two patients in this group were investigated with endoscopic retrograde cholangiography because endoscopic ultrasonography was incomplete in one case and because endoscopic ultrasonography was normal in the second case but a stone in the left hepatic duct was detected by ultrasonography. A stone was removed after endoscopic sphincterotomy in these two patients. In the group of 102 patients without stone, 91 out of 92, continued to be asymptomatic during a median follow-up of 8.5 months. One patient with symptoms one month after cholecystectomy underwent endoscopic sphincterotomy but no stone was found. CONCLUSIONS: Systematic preoperative endoscopic ultrasonography followed, if necessary with endoscopic retrograde cholangiography and sphincterotomy is a diagnostic and therapeutic alternative for common bile duct stones making possible a laparoscopic cholecystectomy without intraoperative investigation of the common bile duct for all patients. This alternative is only justifiable in patients with predictor of common bile duct stones.     

Anaplastic variant of spermatocytic seminoma

Four examples of spermatocytic seminoma with a predominant anaplastic component occurred in men 33 to 43 years of age, without histories of cyptorchidism. The seminomas presented with painless testicular masses recognized 3 to 18 months before orchiectomy. Preoperative serum measurements of human chorionic gonadotropin and alpha-fetoprotein were negative. All tumors contained areas (10% to 30% of the tumor) in which the three cell types characteristic of conventional spermatocytic seminoma could be identified under light microscopy. The predominant anaplastic component also contained the three cell types, but the nuclei had prominent nucleoli with granular and filamentous chromatin. In addition, sheets of cells with vesicular nuclei and prominent nucleoli superficially resembling embryonal carcinoma were found. There were numerous large mononuclear and multinucleated giant cells with bizarre nuclei and prominent nucleoli, but no sarcomatous elements. Many normal and abnormal mitotic figures were present. Tunical and vascular invasion and extensive necrosis were constant features. Immunohistochemistry documented p53 protein overexpression in two tumors, but neoplastic cells were negative with immunostains for placenta-like alkaline phosphatase, leukocyte common antigen, neuron-specific enolase, alpha-fetoprotein, human chorionic gonadotropin, vimentin, and cytokeratins. Ultrastructural examination of the anaplastic component showed large rope-like nucleoli, but the cytoplasmic features were similar to those of conventional spermatocytic seminoma. Despite the presence of a major anaplastic component, no patient has developed metastasis. Larger series and longer follow-up are needed to understand the natural history of these neoplasms.     

Paraneoplastic neurologic syndrome--neoplasms and neuroimmune system

Although the relationship between hyoid bone shape and fracture pattern figures prominently in forensic investigations of strangulation, few quantitative data exist on age and sex differences in hyoid morphology. An image analysis system was used to take a series of 30 measurements on digitized radiographs of 315 hyoid bones from people of known age and sex. The degree of fusion of the greater cornua to the hyoid body was also recorded. Statistical analysis of these data shows that there is a continuous distribution of hyoid bone shapes and the most bones are highly symmetrical. Based on smaller samples, previous researchers have suggested that non-fusion is more common in women than in men. In contrast, our data suggest that men and women have similar non-fusion rates. Analysis of sexual dimorphism shows that the greatest length differences are in the greater cornua. There are also significant sex differences in hyoid shape. For example, the distal ends of the greater cornua of women are significantly longer than those of men.     

Paraneoplastic cerebellar degeneration--characterization of anti-Yo antibody and underlying cancer

A group of patients with paraneoplastic cerebellar degeneration (PCD) have shown to produce autoantibody to both neurons and tumor cells (anti-Yo antibody). More than 60% of these patients have shown neurological symptoms and anti-Yo antibody production before the underlying cancers were found, which suggests that the test for anti-Yo antibody is important for the early detection and treatment of cancer. Originally, anti-Yo antibody has been characterized as 1) labelling the cytoplasm of cerebellar Purkinje cells immunohistochemically, 2) binding to the 62 and 34kDa bands on immunoblots of Purkinje cell extracts, 3) being present in female patients with gynecological or breast cancers. Recently, the common binding-epitope of anti-Yo antibody has been reported as leucine-zipper protein. In order to detect the anti-Yo antibody precisely, we examined the immunohistochemical and western blot characters of the recombinant leucine-zipper protein-reactive (anti-Yo) antibody. The results were, 1) sera containing leucine-zipper protein-reactive antibody labels both cerebellar Purkinje cells but some sera might contain other antibodies together with anti-Yo that confuse the immunostaining character of anti-Yo antibody, 2) the antibody binds to 58 kDa band and sometimes co-binds to 34kDa on immunoblots of cerebellar tissue extracts. The underlying cancers are mainly adenocarcinoma in the ovary, fallopian tube, uterus, or breast but occasionally large cel lung and bile duct cancers have been found. Interestingly, a male patient had an antibody similar in character to be anti-Yo antibody immunohistochemically and on immunoblots, that did not recognize leucine-zipper protein and the underlying carcinoma was small cell lung cancer. These results suggest that 1) the diagnosis of anti-Yo antibody should be based on the antibody's reactivity with leucine-zipper protein, 2) some sera with the anti-Yo antibody label other tissues besides the Purkinje cell cytoplasm because of the co-existence of other antibodies seen immunohistochemically and on immunoblots, 3) the search for underlying cancers should not be limited to gynecological or breast carcinomas.     

Carcinoma in situ and seminoma in equine testis

The presence of atypical germ cells resembling carcinoma in situ of human testis is reported for the first time in an unilaterally cryptorchid stallion. These cells were found in association with developing intratubular seminoma indicating they represented carcinoma in situ.     

Control of avian encephalomyelitis: a historical account

Avian encephalomyelitis control methods were not developed until the 1950s although the disease had been discovered and described over 20 yr earlier. Inability to transmit the infection by other than intracerebral inoculation, lack of suitable immunologic methods, the unknowing use of immune chickens or embryos for experimental studies, and reliance on a highly adapted strain of virus rather than fresh field isolates were the main reasons for a general lack of progress. In the absence of supportive experimental data, at least two commercial breeding organizations turned to the use of a crude chicken brain-propagated virus for vaccination of breeder replacement flocks in the 1950s. This control procedure turned out to be practical and efficacious. Development of suitable embryo infection methods and immunologic tests and the chance finding that antibody-free flocks were essential for experimental studies led to the development of embryo-susceptibility tests to identify immune breeder flocks and formed the basis for another commercially applied control program, the testing and selection of only immune flocks for hatching purposes. The application of the new testing methods coupled with a switch from the adapted Van Roekel strain of virus to fresh field isolates for experimentation resulted in a rapid unraveling of the epizootiology and pathogenesis of the disease and also to the development of a safe and effective vaccine that was licensed for administration to breeder replacements in 1962.     

Judgments of similarity are psychological: The importance of importance.

Comments on the article by J. S. Hyde (see record 2005-11115-001), which concluded that males and females are similar on most psychological variables. Zuriff suggests that Hyde missed the fact judgments of similarity and difference are psychological, not scientific, and that Hyde was dismissive of dismissal of any gender difference that is dependent on context or is consistent with social-role theory. Zuriff argues that the important fact is that in a wide variety of important contexts, males and females behave, think, and feel very differently, and this observation yields the psychological judgment that males and females are vastly different. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hyperphenylalaninaemia and experimental allergic encephalomyelitis

Previous suggestions to the effect that a reduced proportion of long chain and unsaturated fatty acids in the CNS as induced by experimental hyperphenylalaninaemia in young rats may alter the biochemical reactivity and stability of the myelin have been examined using experimental allergic encephalomyelitis (EAE). Lewis rats treated chronically with phenylalanine during development showed a higher susceptibility to EAE and a more severe course of the disease than their medium-treated litter mates. The possible implications of this observation for EAE as an experimental model of multiple sclerosis (MS) is discussed briefly in the light of the decreased levels of unsaturated fatty acids found in the CNS of MS patients.