BACKGROUND: There are few descriptions of the cytologic features of subependymoma because this neoplasm is rare and most commonly encountered incidentally at autopsy. Here we report a surgical case of subependymoma occurring in the lateral ventricle and provide the first documentation of the crush cytologic features of this tumor. CASE: A 34-year-old woman was found to have a tumorous lesion in the right lateral ventricle. At surgery, a 2-cm-diameter tumor was detected in the anterior horn. Histologic examination during surgery revealed that the mass was composed of loose,fibrillary networks and clusters of nuclei showing mild pleomorphism. A number of microcystic formations were evident. Histologically, the neoplasm was considered benign--specifically, a subependymoma. Papanicolaou- or Giemsa-stained crush specimens and imprint smears were also prepared. The cytologic morphology was fundamentally the same as the histologic. In the crush specimens, microcystic formations were readily visible. Moreover, details of the cellular morphology were more easily recognized in the cytologic slides than in the frozen sections. CONCLUSION: Cytologic examination, particularly crush cytology, appears to be useful for the rapid diagnosis of subependymoma during surgery in combination with the examination of frozen histologic sections.

Adult↗

PubMedDate not supplied

Effect of misonidazole in preoperative irradiation for bladder cancer followed by total cystectomy.

Between 1980 and 1984, 44 patients were treated for bladder cancer by preoperative irradiation of 40 Gy to the pelvic region followed by total cystectomy. These patients were prospectively divided into two groups at random. In 23 cases, 500 mg of misonidazole (MISO) was administered four hours prior to irradiation. Twenty-one patients were preoperatively treated by radiation alone. Most patients had histopathological grading of G3-4, and the distribution of T-factors in the two groups was comparable. Thirty-seven patients out of 44 underwent total cystectomy within three weeks after irradiation. pT-factors were carefully examined in resected specimens. Survival rates were calculated by the Kaplan-Meier method. The 5 year survival rate for T3 patients in the group treated by MISO combined with radiotherapy was 59%, while that for T3 patients in the radiation only group was 43%. A reduction in T-factors was observed in 9 of 17 T3 cases treated by MISO combined with radiation, and in one of 14 T3 cases treated by radiation alone. This finding was significant on chi-square test (p = 0.02). Since the survival rate of T3 patients with a reduction in T-factors by preoperative irradiation was superior to that of cases without reduction (70% vs. 43%), the combined use of MISO in preoperative irradiation seems to be useful for the treatment of T3 bladder cancer.

Aged↗

PubMedDate not supplied

Concerted regulation of early enterocyte differentiation by insulin-like growth factor I, insulin, and transforming growth factor-beta1.

To clarify the roles of insulin on the proliferation and differentiation of intestinal epithelial cells (IECs), we examined the effect of insulin-like growth factor-I (IGF-I) and insulin for the growth and differentiation of IEC-6 cells, a crypt cell line derived from rat small intestine. IGF-I (100 nM) stimulated the proliferation of IEC-6 cells, and insulin (1-100 nM) antagonized the IGF-I effect and caused the cells' G1-arrest, resulting in differentiated characteristics of IECs, such as increased general protein synthesis and the formation of microvilli. To clarify the mechanisms of these phenomena, cell surface [125I]insulin binding and the content of immunoreactive insulin receptors were analyzed by Western blotting. Insulin receptors transiently appeared on the cell surface during the early G1 phase after the IGF-I stimulation. Under those conditions, the concomitant presence of insulin stimulated the appearance of active transforming growth factor-beta1 (TGF-beta1) in the media, and then TGF-beta1 antagonized the IGF-I-induced cell proliferation. Such a TGF-beta1 effect was blunted by a neutralizing antibody against TGF-beta1, indicating that the insulin effect was in part mediated through the autocrine-paracrine secretion of TGF-beta1. These results suggest that the regulation of the proliferation of IECs are an early step in those cells' differentiation that may accompany hormonal changes during nutrient intake and may be caused by the sequential effects of IGF-I, insulin, and TGF-beta1.

Animals↗