Immunocytochemical identification of Rochalimaea henselae in bacillary (epithelioid) angiomatosis, parenchymal bacillary peliosis, and persistent fever with bacteremia.

We report the immunocytochemical identification of Rochalimaea henselae, a newly recognized fastidious, Gram-negative, Warthin-Starry-positive organism, as the common pathogen in bacillary angiomatosis (BA), bacillary peliosis (BP) of the liver and spleen, and persistent fever with bacteremia in immunocompromised patients. Immunogenic proteins of the R. henselae strain isolated from the blood of a febrile immunocompromised patient with BP of the liver were used to produce primary immune serum in rabbits.

Presymptomatic testing using DNA markers for individuals at risk for familial multiple endocrine neoplasia 2A.

The carrier status of 39 at-risk individuals in 6 multiple endocrine neoplasia 2A families was determined using a DNA based test. We were able to calculate a virtual diagnosis (probability greater than 95%) for 77% of the individuals and a probable diagnosis (probability greater than 90%) for 90% of the individuals. This study points out some of the problems of specific pedigree structures that can affect the risk calculation.

Junctional zone of the uterus: correlation of MR imaging and histologic examination of hysterectomy specimens.

High-resolution magnetic resonance (MR) images of 12 hysterectomy specimens were correlated with results of light microscopy, image analysis, and immunohistochemical studies to investigate the histologic counterpart of the low-signal-intensity band, or junctional zone (JZ), that surrounds the bright central uterine stripe. All specimens were imaged with a 1.5-T superconducting magnet within 21/2 hours (on average) after hysterectomy.

Pulmonary meningiomas: a report of two cases.

Two intraparenchymal lung tumors exhibiting the histopathologic and immunophenotypic characteristics of an intracranial meningioma are presented. The meningiomas presented as solitary asymptomatic nodules in elderly individuals. Both patients survived longer than 3 years following resection, and neither displayed clinical or radiographic evidence of a central nervous system tumor, suggesting that these are primary lung tumors.

The histology of interstitial cystitis.

Several studies have reported histologic findings in interstitial cystitis (IC) bladder biopsy specimens. However, these studies used a variety of criteria to define IC, which may explain the variation noted in the histologic changes. Clinical experience shows that these biopsy specimens are often not helpful in confirming the diagnosis.

The POU-specific domain of Pit-1 is essential for sequence-specific, high affinity DNA binding and DNA-dependent Pit-1-Pit-1 interactions.

Pit-1 is a member of a family of transcription factors sharing two regions of homology: a highly conserved POU-specific (POUS) domain and a more divergent homeodomain (POUHD). Analysis of mutant Pit-1 proteins suggests that, while the POUHD is required and sufficient for low affinity DNA binding, the POUS domain is necessary for high affinity binding and accurate recognition of natural Pit-1 response elements. Pit-1 is monomeric in solution but associates as a dimer on its DNA response element, exhibiting DNA-dependent protein-protein interactions requiring the POUS domain.

Aberrant hormone production from ovarian neoplasms: strategies for diagnosis and therapy.

Syndromes involving peptide or nonsex steroid hormone secretion due to aberrantly located tumors are rare. We report a collected series of 16 patients with ectopic hormone production from ovarian neoplasms, including 3 patients recently encountered at our institution as well as 13 additional cases identified in the recent literature. These tumors included 2 insulin-producing ovarian carcinoids, 1 ACTH-producing pituitary adenoma within a benign ovarian cystic teratoma, 2 cortisol-producing ovarian neoplasms, 8 gastrin-producing ovarian cystadenomata or cystadenocarcinomata, and 3 thyroxine-producing ovarian strumal carcinoids.

Myocardial characteristics of thyroxine stimulated hypertrophy. A structural and functional study.

The effects of thyroxine-stimulated hypertrophy (TSH) were studied in the porcine left ventricular myocardium. Hypertrophy was produced in six adult pigs by administration of triiodothyronine (1 mg/kg; i.v.

Primary malignant melanoma of the lung.

Primary malignant melanoma of the lung is a rare neoplasm; to date, there have been approximately 20 cases reported in the literature. Extensive clinical and postmortem examinations are necessary to exclude the possibility that the lung tumor does not represent a metastasis from an occult cutaneous or extracutaneous melanoma. We present a case of a 62-yr-old man who appears to have had a primary melanoma of the left upper lobe of the lung.

Pseudorevertants of a lac promoter mutation reveal overlapping nascent promoters.

Four pseudorevertants of a -10 region lacP mutation were isolated. Three of these mutations were found to activate nascent promoters. These mutations were: a -2 G/C----A/T change (-2A) promoting transcription at position +11, a +1 A/T----T/A change (+1T) promoting transcription initiation at position +13, and a +10 C/G----A/T change (+10A) promoting transcription initiation at a complex series of positions.

Bleomycin, vincristine, mitomycin C, and cis-platinum in gynecologic squamous cell carcinomas: a high incidence of pulmonary toxicity.

Twenty-three patients with gynecologic squamous cell carcinomas (20 cervical, 2 vulvar, 1 ovarian) were treated with bleomycin, vincristine, mitomycin-C, and cis-platinum. Twenty-one patients had prior radiation therapy. Of the 21 evaluable patients, the response rate was 48% with a median duration of 4 months.

Poorly differentiated ("insular") carcinoma of the thyroid gland: an aggressive subset of differentiated thyroid neoplasms.

Four patients with a histologically distinctive thyroid carcinoma--which recently has been referred to as poorly differentiated ("insular") carcinoma--are reported. This study confirms the previous conclusions that patients with this neoplasm often experience an aggressive clinical course, with focal recurrences and distant metastases common, which results in death in the majority of patients. Such aggressive behavior may occur even when the insular component accounts for only a small percentage of an otherwise well-differentiated carcinoma, as seen in one of our patients.

A tissue-specific transcription factor containing a homeodomain specifies a pituitary phenotype.

Multiple related cis-active elements required for cell-specific activation of the rat prolactin gene appear to bind a pituitary-specific positive transcription factor(s), referred to as Pit-1. DNA complementary to Pit-1 mRNA, cloned on the basis of specific binding to AT-rich cell-specific elements in the rat prolactin and growth hormone genes, encodes a 33 kd protein with significant similarity at its carboxyl terminus to the homeodomains encoded by Drosophila developmental genes. Pit-1 mRNA is expressed exclusively in the anterior pituitary gland in both somatotroph and lactotroph cell types, which produce growth hormone and prolactin, respectively.

Sudden death six weeks after a myocardial infarct.

A 56-year-old man died suddenly at Yale-New Haven Hospital six weeks after experiencing a myocardial infarct and subsequent left ventricle aneurysm formation. Clinical course, treatment, radiologic data, and pathologic findings are examined. Differential diagnosis for this patient's sudden demise include cardiac rupture with cardiac tamponade, extension of the myocardial infarct, and massive pulmonary embolus, among others.

Intrapulmonary localized fibrous tumor. Intraparenchymal so-called localized fibrous mesothelioma.

This report describes three cases of intrapulmonary fibromas which are histologically identical to localized fibrous tumors of pleura (localized fibrous mesothelioma). Morphologically these tumors are characterized by a haphazard proliferation of cytologically bland spindle cells separated by variable amounts of wavy hyalinized collagen. Entrapped bronchiolar and alveolar epithelium is common.

Autoimmune thyroid disease: immunological, pathological, and clinical aspects.

Autoimmune thyroiditis, most notably Hashimoto's thyroiditis, appears to be increasing in prevalence and is now more easily detected by sensitive laboratory tests and more invasive procedures such as fine needle aspiration. During the last decade, marked progress has been made in the understanding of these diseases. There is a greater awareness of the interaction between the humoral and cell-mediated arms of the immune system in autoimmune thyroiditis.

Alleles at the PRH1 locus coding for the human salivary-acidic proline-rich proteins Pa, Db, and PIF.

We cloned and sequenced the entire exon and intron structures of Db and Pa genetic determinants at the PRH1 locus. Their derived amino acid sequences and that previously determined for the PIF protein completely explain the electrophoretic phenotypes of the acidic proline-rich proteins (PRPs) Pa, Db, and PIF. Thus, the Cys substitution near Arg 106 in the Pa protein sterically interferes with proteolytic cutting at Arg 106 and accounts for the single-banded phenotype.

Type A behavior in married couples in a family practice population.

Type A behavior is characterized by status insecurity, hyperaggressiveness, free-floating hostility, time urgency, and self-destructive tendencies. In this cross-sectional study, a sample of 72 married couples from a family practice residency patient population completed self-administered questionnaires assessing the relationship between behavior type and perceived stress, social support, health perceptions, psychosomatic symptoms, health habits, marital discord, and family function. Type A men slept less, had more headaches, and reported more job stress than type B men.

Mast cell involvement in interstitial cystitis.

A prospective study was designed to examine the relationship of mast cells, and eosinophilic leukocyte density and mediator levels to clinical and histological parameters of interstitial cystitis. Interstitial cystitis and control patients underwent bladder biopsy with histological examination, and quantification of intact and degranulated mast cell and eosinophilic leukocyte density. In addition, bladder tissue histamine content, urinary prostaglandin E2 excretion rates, and serum and urinary major basic protein levels were determined.

A thyromimetic that decreases plasma cholesterol levels without increasing cardiac activity.

A number of agents that mimic the ability of the thyroid hormone, T3, to decrease plasma cholesterol levels are described; one is as effective as T3 at reducing cholesterol levels and stimulating liver function, but has very little effect on cardiac function and is thus less likely to be toxic. The agent may be useful in the treatment of atherosclerosis.

The efficacy of simultaneous fine-needle aspiration and large-needle biopsy of the thyroid gland.

Fine-needle aspirations and cutting needle biopsies were performed on 415 patients with solitary thyroid nodules. All nodules were considered hypofunctioning by scintiscans. Specimens were adequate in 399 patients.