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Since histologic changes are found in undescended testes after the second year of life, treatment is necessary. Often therapy with human choriongonadotrophin is successful, otherwise operative treamtnet is indicated. Infertility at a high rate is found in boys treated for maldescence of the testicles in later childhood. Therapy before the age of two years improves the prognosis.
Our results (light and electron microscopic study) show that both in chick embryos engrafted with fowl homologous spleen cells and in rat fetuses receiving blood cells from their own mother (homologous system) histologic changes occur in porta-biliary areas consisting in paravascular infiltrates (P.V.I.), bile ducts disorganization and periportal hepatocyte alterations. These modifications are closely similar to those described in other post-natal Graft Versus Host Reaction models. Yet, in both cases, the cells of the P.V.I. are chiefly of the granulocytic serie instead of the classical lymphoïd P.V.I.
Neuromyopathies developed in three patients with gluten-sensitive enteropathy, a long time after they had been cured of their digestive disease by following a gluten-free diet. These cases differed radically from typical deficiency neuropathies by the presence of microvascular inflammatory lesions in nerves and muscles. The semiological findings were similar in all 3 cases, and were distinguished by the association of signs eveking lesions of the largest myelinated nerves fibers to the posterior rami with lesions in the muscles. Corticotherapy improved the condition but did not affect its chronic course. Nerve and muscle biopsies revealed the presence of segmentary microrascularitis, mainly lymphohistiocytic. The probable mechanism of these histological changes is alterations in the circulating immune-complexes, usually found in gluten-sensitive enteropathy, producing various types of associated disorders. Some of these immune-complexes would not be related straight to digestive intolerance to gluten, but would persist during the gluten-free diet period, and could be responsible for the micro-angiitis.
At the present time the medical management of prostatic hyperplasia remains primarily in the investigative stage. Various prostatic inhibitory substances, primarily hormonal in nature, have been studied in animals and humans. The work of Scott with cyproterone acetate in a group of 13 patients with nodular hyperplasia demonstrated improvement of the obstructive symptoms in 11 patients, an increased flow rate in 9, reduction of residual urine in 8, decrease in prostatic size in 7, and epithelial histologic changes in 8. Nevertheless in spite of these and other encouraging preliminry results, the principal therapy for genign prostatic hyperplasia is surgical relief of bladder neck obstruction by prostatectomy which has a mortality rate of less than one per cent. The effects of medical therapy remain uncertain and are employed primarily in patients who are poor surgical risks.
Bleomycin has been shown to have a significant effect on squamous cell carcinomas, particularly on highly differentiated types. Applying combined bleomycin and x-rays simultaneously in an intermittent schedule, a synergistic effect was obtained. It was possible to lower the dosage of each and still achieve remarkable therapeutic responses. At the same time the side effects were reduced. The total dosages have been bleomycin 180 mg and x-rays 4.200 r skin dose, tumor dose approximately 2.500 r. Eighty-two laryngeal cases received such treatment. Altogether a complete regression was achieved in 62 per cent. Glottic tumors showed complete regression in 85 per cent. In six out of 10 inoperable cases, the tumor became surgically accessible by laryngectomy. In successfully treated patients characteristic histological changes were found, consisting in unusually large amounts of fully keratinized cells.
The tumorigenic effect of a diet containing the alpha-isomer of benzene hexachloride (alpha-BHC) on the liver of various animals was examined. It was found that alpha-BHC induced liver tumors in male and female mice but not in rats or hamsters in the present observations. Histological changes in the liver of mice induced by alpha-BHC were also much greater than those induced in rats or hamsters. Male animals were more susceptible to the tumorigenic action of alpha-BHC than females. Among different strains of mice, the DDY showed greatest susceptibility and the C57BL/6 showed the least. Induction oflpha-BHC was not inhibited by concomitant feeding of 1-naphthyl isothiocyanate or p- hydroxypropiophenone. However, 3-methylcholanthrene slightly inhibited their induction by alpha-BHC.
The encephalitogenic activity of different parts of bovine encephalitogenic protein (BEP) has been tested in guinea-pigs, mainly at a dose equimolar to 32 mug of intact protein. A high activity was found with complete protein and with region 89-169; both peptide 43-115, tyr (modified at the tyrosine residue 67) and HNB-89-169 (modified at the tryptophan residue 115) showed a moderate but clear-cut activity, whereas that of peptide 1-42 was very faint. No qualitative differences in the disease induced by the different peptides could be found; in only one animal out of 139 were clinical signs observed without evidence of histological disease. Slight histological changes, similar to those seen at EAE, were found in four out of 19 animals injected with Freund's complete adjuvant only.
Tritiated leucine was injected into the vitreous of rhesus monkey eyes to make it available for protein synthesis by the ganglion cells. The short posterior ciliary arteries were cut three hours later or several weeks prior to the leucine injection. A reduction of labeled protein within the retrolaminar optic nerve was seen in all eyes so treated. Autoradiography revealed a diffuse reduction of axoplasmic transport into these optic nerve heads. There was consistent evidence of focal obstruction of labeled protein at the interface between the lamina scleralis and retrolaminar optic nerve. Vacuoles appeared in the most severely affected areas. These histologic changes were followed by gliosis in the areas of ischemic damage. Glaucomatous cupping of the optic nerve head was not seen within six weeks following the induced ischemia.
Histopathological sections of anetoderma-like scars from 10 patients with acne vulgaris showed a selective absence of elastic fibers around pilosebaceous follicles. This finding is similar to the histologic changes of "perifollicular elastolysis" reported by Varadi. Bacteria isolated by anaerobic and aerobic cultures of swabs of the skin surface and pus of these 10 patients, 12 others with active acne vulgaris and 8 normal subjects were studied with particular attention to Staphylococcus epidermis and Propionibacterium acnes. These organisms were analysed for production of an elastolytic enzyme which might play a role in the observed selective loss of elastic fibers. No elastolytic activity was produced by S. epidermidis or P. acnes isolated from any of these individuals. Thus, we cannot attribute the perifollicular loss of elastic fibers in acne scarring to an elastase produced by organisms. The observed absence of elastic fibers might result from tissue necrosis produced by leukocytes during the inflammatory phase, followed by collagenous scar formation without regeneration of elastic fibers.
A 78-year-old woman is described, having systemic sarcoidosis for 15 years, involving the lungs, lymph nodes and the skin. Over the last 6 years she developed a progressive cicatricial alopecia with histologic changes of the granulomatous type of necrobiosis lipoidica surrounded by sarcoid granulomas.
A basic assumption of current guide lines to test drug therapy for benign prostatic hypertrophy is that the clinical disease is caused by bladder neck obstruction and its sequelae and complications. Asymptomatic non-prostatic hypertrophy, no matter how large the adenoma, is considered to be a pre-clinical phase of the disease as long as bladder trabeculation, impairment of the flow rate and residual urine are absent. The guide lines recognize that histological changes and gross anatomical enlargement of the prostate are the essence of the disease but objective signs of current therapeutic relief of symptoms lend themselves more practically to measurement of progression or remission, whereas no current drug has a clear enough effect on prostatic histology to predict subsidence of the clinical picture. Since no one criterion or single test serves this purpose a cluster of symptoms, with flow rate and residual urine, provides the hardest data. It would be preferable for each patient to serve as his own control in a prospective double-blind randomized study, since the literature shows no uniformity of approach, methodology, patient population or other useful data for clinical norms. Guide lines have been developed with the aid of clinical pharmacologists, biostatisticians, lawyers and government officials and approved by the Food and Drug Administration. Misconceptions outside of the profession of Urology need to be dispelled and further research in methodology, urodynamics, ultrasonic evaluation of the prostate, definition of symptoms, criteria for efficacy, etiology of the disease, and mode of action of drugs, placebo and surgery were highlighted. The literature does not have an overabundance of data but does contain evidence of definite but weak drug efficacy in the treatment of this condition.
Feeding of 260 ppm of leptophos to mallard ducklings caused delayed neurotoxicity similar to that reported for hens. Thus leptophos caused ataxia, with subsequent paralysis, loss of appetite, and slow-down in the growth rate of the treated birds. Spinal lesions were identical in morphology and distribution to those seen in hens following leptophos administration. The severity of histologic changes correlated both with the clinical condition and the duration of intoxication.
Sixty-five cases of proved cutaneous Leishmaniasis have been studied on clinical, histological and laboratory grounds. A new histological classification is proposed and emphasis is given to specific histological changes and their correspondence to distinct clinical signs.
We have developed a quantitative assay for experimental allergic encephalomyelitis (EAE) in the rat based on permeability of the spinal cord to 125I-human gamma-globulin (HGG). This assay is highly reproducible and eliminates many of the drawbacks of assaying for EAE on the basis of clinical and/or histologic criteria. Using the assay, we have shown a direct correlation between onset of histologic changes in the spinal cord and onset of permeability changes in the spinal cord. No rat without histologic lesions manifest permeability alterations, and all rats with histologic lesions did manifest increased permeability to 125I-HGG. Furthermore, strains of rats susceptible to EAE demonstrated permeability changes, whereas resistant rats did not. In addition, we demonstrated by permeability and histologic criteria that guinea pig myelin basic protein emulsified with incomplete Freund's adjuvant is encephalitogenic in the Lewis rat. We also demonstrated that recipients of passive transfer of sensitized cells develop permeability changes along with histologic lesions. We conclude that measuring permeability to 125I-HGG in the spinal cords of rats is a valid assay for EAE, and its improves upon current indices of EAE in that it is readily quantifiable.
Mice fed a diet containing 1% (w/w) 3-hydroxy-4(1H)-pyridone (DHP) developed goitre even with a diet high in iodine whereas mimosine (0.5% w/w) did not produce goitre even with a low-iodine diet. Thyroid enlargement was apparent (measured morphometrically) by the 7th week and was advanced by the 11th week. Histologically the goitre was hyperplastic in type. No marked histological changes were found in other organs of mice fed DHP or any organs of mice fed mimosine, except for some atrophy of hair follicles. A single intragastric dose of DHP inhibited the uptake of 125I by the thyroid in the rat but an equivalent dose of mimosine did not. Evidence is presented that the inhibition occurs at the iodine binding step, as with methyl thiouracil, rather than at the iodide trapping step, as with thiocyanate. Chronic treatment of mice with DHP, as with 6-methyl thiouracil, increased the avidity of the thyroid in taking up 125I. The major conjugated form of DHP in mammals, DHP-3-O-glucuronide, was almost as effective a goitrogen as the unconjugated compound when given by mouth but considerably less active than the free form in the blood stream. It was concluded that DHP is a potent antithyroid compound of the thiouracil type with low general toxicity, since mammals can tolerate a level of intake sufficient to produce goitre in spite of iodine supplementation.
The theoretical and practical problems posed by aneurysms of the ascending aorta with mucoid infiltration of the Media and the aortic leaflets are discussed with reference to two suggestive cases. These histological changes are not specific for Marfan's syndrome, the relation with which is very inconstant. Incomplete replacement of the affected tissues risks a recurrence which is especially serious when the sinus of Valsalva is involved. Therefore, total replacement of the ascending aorta with aortic valve replacement and reimplantation of the coronary arteries is generally indicated. Histology of the excised tissues should be performed routinely with specific stains for mucopolysaccharides. Close follow-up of operated patients with this condition is recommended, especially those with only partial replacements.
Alcoholic liver damage is associated with the development of portal hypertension quite early, as a result of increasing fibrosis. By means of laparoscopic transhepatic manometry (LTM) in the branches of the portal and hepatic veins, we measured the pressure levels in 15 patients with early and transitional-stage alcoholic injury extending to cirrhosis of the liver, and compared them with histological and laboratory investigation criteria. We discovered that parenchymal damage with portal and centrolobular fibrosis already gave rise to some portal hypertension which, compared to a group showing histological changes of remodelling or cirrhosis, constantly increased. In completely developed alcoholic cirrhosis (n = 41), the pressure levels reached a peak. Despite this fact, bleeding from oesophageal varices cannot be predicted. Over the period of observation of 33 months, 4 deaths occurred (portal vein pressure between 4.5 to 5 kPa = 34.0 to 38.8 mm Hg), and three variceal bleedings we were able to manage were seen (pressures between 3.6 to 4.3 kPa = 27.0 and 32.0 mm Hg). Compared to hepatitic cirrhosis the prognosis was slightly more favourable.
The breast and shoulder-blade muscles of a roe (Caprelous capreolus L.), shot in a hunting district in western Bohemia, were found to contain cysticerci with morphological characters and size corresponding to those of Cysticercus tarandi, which is a developmental stage of the tapeworm Taenia krabbei Moniez, 1879. The surface as well as deeper layers of muscle contained one to two cysticerci per 100 cm2 of area. The authors describe the larvocysts and histological changes in the site where the micro-organisms were found. The cysticerci are discussed as to the species to which they belong.