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BACKGROUND: Prostasin is a serine protease predominantly expressed in normal prostate epithelial cells. The biological function of prostasin has not been determined. METHODS: Western blot and RT-PCR analyses were used to examine the expression of prostasin in prostate cancer cell lines. Immunohistochemistry was used to evaluate prostasin protein expression in human prostate cancer. An in vitro Matrigel invasion assay was used to test the invasiveness of prostate cancer cell lines forced to express recombinant prostasin. RESULTS: Both prostasin protein and mRNA were found to be expressed in normal human prostate epithelial cells and a non-invasive human prostate cancer cell line, the LNCaP, but neither was found in invasive human prostate cancer cell lines DU-145 and PC-3. Prostasin mRNA expression was absent in invasive prostate cancer cell lines of a transgenic mouse model. Immunohistochemistry analysis showed that prostasin protein expression is down-regulated in high-grade prostate cancer. Transfection of DU-145 and PC-3 cells with a full-length human prostasin cDNA restored prostasin expression and reduced the in vitro invasiveness by 68 and 42%, respectively. CONCLUSIONS: Our data indicate that prostasin may be implicated in normal prostate biology and is able to suppress prostate cancer invasion in vitro.

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Levels of 14 organochlorine pesticide residues--1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) group (p,p'-DDT, o,p'-DDT, p,p'-DDD, and p,p'-DDE), HCH isomers (alpha-, beta-, and gamma-HCH), hexachlorobenzene (HCB), aldrin, dieldrin, endrin, heptachlor, alpha-endosulfan, and endosulfan sulfate--were evaluated in 127 samples of medicinal plants collected in pharmacies (78 samples) and herb stores (49 samples) in 1996. Samples were divided between 15 national brands and 7 foreign brands. Most samples sold in pharmacies contained residues of gamma-HCH (51.3%). All residues were detected in analyzed samples, with exception of endrin in herb store samples. Detection frequency varied between 51.3% for gamma-HCH and 1.3% for endrin in pharmacy samples, and between 34.7% for HCB and 4.1% for endosulfan sulfate in herb store samples. Maximum residue levels were exceeded in 38 (48.7%) pharmacy samples and in 26 (53.1%) medicinal herb store samples.

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Some types of surgery performed on the tip of the nose, such as secondary rhinoplasty on cleft lip and palate (CLP) patients, may have an uncertain end-result due to the difficulty in maintaining the surgically created status constant over time. This is precisely the reason behind the multiple proposals and surgical techniques presented by various authors through the years, in order to produce a long lasting, valid, surgical result. The problem has been approached by implementing varied and creative methods and still remains partially unsolved. Experience has shown that the application of a dynamic nasal splint has contributed efficiently to maintaining the surgical results by opposing healing contraction.

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Occasionally patients with thyroid nodules to be evaluated by fine-needle aspiration (FNA) biopsy also present with regional cervical lymphadenopathy. Aspiration biopsies should be performed on both the thyroid and nodal lesions. This approach will yield important information about whether the lesions are related, with profound impact on further workup, management, prognosis, and staging.

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Four cases of anaplastic carcinoma of the thyroid were diagnosed in 1,519 thyroid aspirates. All patients had unilateral or diffuse nodular enlargement of the thyroid. One patient had a concurrent grade 1 mucinous carcinoma of the ovary. Cytologically, the neoplasms were characterized by pleomorphic giant or spindle cells with multilobulated, single or multiple nuclei. The chromatin pattern was clumped with prominent parachromatin clearing, and there were multiple prominent nucleoli. Associated papillary and follicular structures were recognized in two aspirates. All cytologic preparations were considered diagnostic of malignancy. Examination of histologic material revealed the same elements identified cytologically on the aspiration smears. Three patients died shortly after diagnosis due to massive local tumor growth in the neck. One patient, who received radiation therapy, had a prolonged survival of 30 mo, but died then of local neck recurrence. The cytologic features of anaplastic carcinoma parallel their histologic appearance. Histologic confirmation of cytologically diagnosed anaplastic carcinoma is not necessary.

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Twenty young adult patients with hand and digital ischemia were found to have obstructive arterial disease. All patients were surgically explored, and the occluded vessels were resected and by-passed. Eighteen patients had obstruction at the level of the distal ulnar artery and palmar arch, and 12 had obstruction of the common digital and digital proper arteries. Occlusive arteriosclerotic lesions were found in all patients; these lesions were characterized by prominent fibromuscular intimal plaques with superimposed thrombosis. Six patients had also thromboembolism to distal digital vessels. Vasculitis, calcifications, cholesterol deposits, and atheromatous emboli were not observed. Five patients had transmural neovascularization of the lesions in a similar manner to that described in coronary artery lesions. Obstructive lesions due to fibromuscular intimal proliferation with associated thrombosis and/or distal thromboembolization affecting arteries of hands and digits appear to be an important lesion that can affect young patients.

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Three-hundred and seventy intraoperative cytologies are presented and compared with synchronously performed frozen sections. Cytologic smears and frozen sections were misinterpreted in 1.6% and 0.8% of cases, respectively; the rate of diagnostic errors between the two techniques is comparable given the lack of experience with intraoperative cytology at the beginning of the study. Intraoperative cytology is a suitable technique for a variety of lesions, but it is most helpful in the field of neuro-oncological pathology, certain infectious diseases, lesions of the hematopoietic system, and most epithelial tumors. Cytologic smears afford better morphologic preservation and detail than frozen sections. Techniques are outlined and discussed. Diagnostic criteria of selected cases are presented, and pitfalls are analyzed.

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We tested a transcutaneous (tc) oxygen (O2) and carbon dioxide (CO2) sensor in 15 normal adults and in 20 patients on regular dialysis treatment (RDT). We compared the tc gas values (ptcO2, PtcCO2) with the gas tension values in arterial blood samples (PaO2, PaCO2), in normal adults and in RDT-patients at the end of a 30-min test and six times during RDT. During the test, PtcO2 correlated with PaO2 both in normal adults (r 0.72 p less than 0.01) and in RDT patients (r 0.41 p less than 0.05). PtcCO2 correlated with PaCO2 (r 0.59 in normal adults and r 0.76 in RDT). During 14 acetate dialyses the changes were expressed as % delta from time 0. % delta PaO2 was -12.7 at 60 min, + 4.8 at 240 min; % delta PtcO2 -6.0 at 60 min, + 9.7 at 240 min; % delta PaO2 -17.7 at 240 min, -1.8 1 h later; % delta PtcCO2 was -15.8 at 240 min, -3.2 1 h later. Both in normal adults and in RDT, patients there was a good relationship between PtcCO2 and PaCO2 values. In normal adults the absolute PtcO2 values were always lower than PaO2 (-14.4 +/- 10 mmHg); in RDT-patients this difference was more pronounced (-27.6 +/- 15.1) and is probably attributable to the lower Hb levels (6.7 +/- 1.1 vs 12.4 +/- 1.2). During RDT the pattern was the same between tc and gas tension values.(ABSTRACT TRUNCATED AT 250 WORDS)

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Rheumatoid pleural effusions are relatively uncommon. The cytologic examination of such effusions can be diagnostic of the underlying disease; this is of great clinical significance when the rheumatoid condition has not been diagnosed prior to the pleural involvement. The diagnostic cytologic abnormalities include large elongated and multinucleated giant cells and macrophages in a background of granular and necrotic debris. The cytologic characteristics parallel the histologic features of pleural rheumatoid nodules.

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A case of gangliocytic paraganglioma of the duodenum is reported, including light microscopic, ultrastructural, and immunohistochemical characteristics. The cytologic appearance, as might be seen in fine-needle aspiration smears, indicates a neoplasm with three cellular components (epithelioid, ganglion, and spindle cells) seen histologically by light and electron microscopy.

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We have implemented a fine needle biopsy program, evaluating 426 satisfactory biopsies in 436 patients with thyroid nodules. Benign disease was diagnosed in 345 patients (232 with benign nodular goiter, 98 with lymphocytic thyroiditis, three with granulomatous thyroiditis, and 12 with cysts). Neoplasm was diagnosed in 81 patients (61 with follicular neoplasm, 12 with papillary carcinoma, three with medullary carcinoma, three with anaplastic carcinoma, one with metastatic carcinoma, and one with lymphoma). Of the 43 patients who later proved to have cancer, 24 had follicular carcinoma, 12 papillary carcinoma, one medullary carcinoma, three anaplastic carcinoma, one metastatic carcinoma, and two lymphoma. (Eight patients refused surgery or were operated upon elsewhere and lost to follow-up.) Cancer was found in 54% of patients sent to surgery. Follicular carcinoma cannot presently be separated from follicular adenoma by needle biopsy, and surgery will continue to be required in these patients (14%); however, thyroid biopsy greatly decreased the need for surgery in other patients. Erroneous diagnoses, mainly due to inexperience, decreased after the first year. A multidisciplinary approach involving the thyroidologist and cytopathologist is important, as is the close clinical follow-up of patients with nodules thought to be benign. The safety of needle biopsy, its low cost, and the accuracy of the procedure when compared to other clinical tests for thyroid nodules make it well worth the effort to make this test more widely available.

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The cytopathologic characteristics of the inflammatory and lymphoid thyroid lesions as seen in fine-needle aspirate smears of 103 patients are reviewed, with emphasis on pitfalls and association with other neoplasms. The cytologic diagnoses were as follows: subacute thyroiditis, 3; Hashimoto's thyroiditis (HT) with or without Hürthle cell nodule, 77; HT and Hürthle cell tumor, 2; HT and follicular neoplasm, 3; HT and papillary carcinoma, 5; lymphoma, 3; HT and nodular colloid goiter, 10. Fourteen patients were operated. Five erroneous diagnoses were uncovered; inexperience was the main reason for the mistakes. The greatest diagnostic difficulties are encountered in cases of Hürthle cell nodules and malignant lymphoma, but mistakes are likely to disappear after reasonable experience. Thyroid antibodies are of no help in sorting diagnostic problems, because a positive titer is only corroborative evidence of underlying HT and does not rule out an associated tumor. Conversely, a negative titer does not discard the diagnosis of HT. The association of nodular colloid goiter and HT is depicted. Problems of sampling and staining technic are discussed.

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Five patients were shifted from acetate dialysis (AD) to biofiltration (BF); their pre-dialytic acid-base balance (ABB) was re-examined for six months before the start of BF. Samples for ABB were drawn at 0', 30', 60', 120' and 180' during three AD and 1, 2 and 3 hours after them (period A). The same procedure was then repeated two months (period B) and 12 months (period C) after the start of BF. From analysis of the data it is concluded that the correction of AD-acidosis is very rapid during the early two months of BF, but the post-BF ABB may be too alkalotic, with risks if respiratory alkalosis is superimposed. After one year of BF, there were fewer pCO2 falls and pH variations; no more post-BF alkalotic rebounds were observed.

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Twenty-six reactive lymph nodes and 5 malignant lymphomas from homosexual males were studied by acridine orange flow cytometry (AO-FCM) for determination of ploidy, proliferation, and RNA characteristics. Two reactive lymph nodes showed ploidy abnormalities as compared with none of 27 reactive lymph nodes from nonhomosexual patients. The homosexual-associated (HA) lymphadenopathy had a higher mean proliferative activity (11.2% versus 5.6%) and higher ribonucleic acid (RNA) content (1.11 versus 0.96) than non-HA counterparts. The proliferative activity of HA lymphadenopathy was also higher than follicular small cleaved cell lymphoma, and not dissimilar to that of follicular large cell lymphoma. These findings indicate that HA-reactive lymphadenopathy is a hyperproliferative state associated with high cellular RNA content and rare DNA-abnormal stemlines. One HA lymphoma had an abnormal stemline by AO-FCM, compared with 9 of 15 (63%) non-HA high grade lymphomas. This lymphoma also demonstrated an abnormal karyotype (47,XY, +12, t[8;22]) by classic cytogenetic studies. The mean proliferative activity and RNA content of HA lymphomas was higher than non-HA counterparts (37% versus 22.5% and 2.48 versus 1.73, respectively). The proliferation and RNA features of HA lymphoma were on higher planes than non-HA lesions histologically comparable. Thus, in addition to differences in clinical presentation, histologic subtype, stage distribution, and therapeutic response, HA lymphomas have DNA/RNA characteristics different from those of counterparts in the general population.

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Previous immunohistochemical studies of cardiac myxomas are few in number, limited in scope and, in part, discrepant. We studied the immunoreactivity of five cardiac myxomas for factor VIII-related antigen, Ulex europaeus agglutinin I, smooth-muscle myosin, alpha 1-antitrypsin, and alpha 1-antichymotrypsin. Positive staining was present in all five tumors with each cell marker used, but varied according to the area of tumor examined. The result of this study provides further evidence of the cellular heterogeneity in these tumors that probably originate by differentiation of multipotential mesenchymal cells.

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The ability of active specific immunotherapy to enhance immune responses to autologous tumor-associated antigens (TAA) and to prolong the disease-free interval was evaluated in patients with Dukes B2 and C colorectal carcinoma who had undergone potentially curative resections. Patients were sensitized in the early postoperative period with irradiated autologous adenocarcinoma cells mixed with bacillus Calmette-Guérin (BCG) to yield either a low-dose vaccine (3 X 10(6) tumor cells) or a high-dose vaccine (1 X 10(7) tumor cells). Six of seven patients who received the low-dose vaccine developed delayed-type hypersensitivity (DTH) responses to autologous tumor cells upon completion of the vaccination, whereas all four patients receiving high-dose vaccine displayed a positive DTH response. However, DTH responses to autologous TAA waned within 3 months in all patients receiving the low-dose vaccine; DTH responses persisted for 3 months in three of the four high-dose vaccine patients. In vitro lymphoproliferative responses to TAA correlated with DTH responses to autologous tumor cells. Active specific immunotherapy appeared to induce specific immune responses either in vitro or in vivo to autologous TAA because it did not induce responses to autologous mucosa cells. There were no complications caused by BCG or tumor cells. This series demonstrates that active specific immunotherapy is a nontoxic treatment that augments immunity to autologous TAA.

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Ten adult white patients (21-75 years old; six women, four men) presented with large cell lymphoma of the liver. Each complained of abdominal pain and/or an abdominal mass, and five had B-symptomatology of weight loss, fever (one patient), and night sweats (three patients). At laparotomy (eight patients) or by computerized tomography, liver-spleen scan and lymphangiogram (two patients with percutaneous liver biopsy only), the liver was the sole site of involvement, although subsequent staging procedures revealed bone marrow involvement in three patients. Initial biopsy interpretation was incorrect in four cases which were diagnosed as poorly differentiated carcinoma. Although uncommon, the differential diagnosis of primary liver lymphoma should be entertained when patients present with solitary (three cases) or multiple (six cases) liver defects, particularly when alpha-fetoprotein and carcinoembryonic antigen levels are normal. One patient had diffuse hepatomegaly. Treatment included biopsy (eight patients) or resection (two patients) followed by combination chemotherapy. All patients are alive from 0 to over 10 years (mean, 2.4; median, 1.8 years): six in complete remission, two with less than 6-months follow-up, and two with recurrent lymphoma. Examination of this group of patients along with 19 cases identified in the literature suggests that this is a more treatable disease than primary liver carcinoma.

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