Zytologische Beobachtungen an der hyperplastischen Nebennierenrinde des Menschen

Summary Clinical observations and the light and electron microscopic appearance of the adrenal cortex are described in a case of Cushing's disease associated with adrenocortical hyperplasia and a basophilic adenoma of the pituitary gland. The electron microscopic investigation concentrates upon the occurrence of osmiophil material in the different cytoplasmic compartments of the cell type rich in organelles and relatively poor in paraplasmic inclusions. It seems that the observation of osmiophil material in the perinuclear space, the mitochondrial matrix, Golgi vacuoles, and cytoplasmic vesicles has been made possible by a rather long fixation in Wohlfarth-Bottermann's chromium-osmium fixative. Mitochondria and related particles (named X-Einschlüsse) may contain a light center with a few dense filaments and masses resembling those described by other authors as being of deoxyribonucleic acid nature. Relatively large Golgi complexes are found, sometimes in close topographic relation with a centriole. A large population of osmiophil bodies (lipid droplets, pigment granules, microbodies) is described. Apart from these findings the cytoplasmic organization in the tissue studied is similar to that of the adrenal cortex as described in other mammals. The observations are discussed with respect to hypotheses about lipid droplet formation and to the possibility of artifacts due to preparation procedures.

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Herrn Prof. Dr. med. W. Bargmann zum 60. Geburtstag gewidmet. — Herrn Prof. Dr. E. Uehlinger, Direktor des Pathologischen Instituts der Universität Zürich, danken wir für die Überlassung des Materials und für die freundlicherweise zur Verfügung gestellte pathologisch-anatomische Diagnose, dem Schweizerischen Nationalfonds für die Unterstützung und Frau Jäger, Mlle. Challamel und Herrn Krieger für die Ausführung der histologischen und photographischen Arbeiten.     

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Declining incidence of AIDS dementia complex after introduction of zidovudine treatment.

OBJECTIVE--To assess the incidence of the AIDS dementia complex and the presence of HIV I p24 antigen in cerebrospinal fluid in relation to zidovudine treatment. DESIGN--Retrospective study of a consecutive series of patients with AIDS from 1982 to 1988. SETTING--An academic centre for AIDS. PATIENTS--196 Patients with AIDS and neurological symptoms examined from 1982 to 1988. INTERVENTIONS--Zidovudine treatment, which was introduced to The Netherlands on 1 May 1987 for patients with severe symptoms of HIV infection (Centers for Disease Control groups IVA, B, C, and D). MAIN OUTCOME MEASURES--Diagnosis of AIDS dementia complex and presence of HIV I p24 antigen in cerebrospinal fluid. RESULTS--The AIDS dementia complex was diagnosed in 40 of the 196 (20%) patients with AIDS. Thirty eight of 107 patients with AIDS (36%) not taking zidovudine developed the AIDS dementia complex compared with two of the 89 (2%) taking the drug (p less than 0.00001). The incidence of the AIDS dementia complex increased to 53% in the first half of 1987, after the introduction of zidovudine in May 1987, decreasing to 10% in the second half of 1987 and to 3% in 1988. Dementia was diagnosed before definition of the AIDS dementia complex (1986) according to DSM-III criteria and there was good agreement between diagnosis before and after 1986. Sixteen of 61 samples of cerebrospinal fluid (26%) from patients with AIDS (10 with the AIDS dementia complex) not taking zidovudine were positive for HIV I p24 antigen, whereas none of 37 cerebrospinal fluid samples from patients with AIDS (two with the AIDS dementia complex) taking zidovudine were positive. CONCLUSIONS--The incidence of AIDS dementia complex in patients with AIDS declined after the introduction of systematic treatment with zidovudine; the AIDS dementia complex might be prevented by inhibiting viral replication in the central nervous system.     

Molecular and serologic analysis of IgG1 deficiency caused by new forms of the constant region of the Ig H chain gene deletions

Selective IgG1 deficiency is a rare disease. We report a familial form of IgG1 deficiency, in which IgG1 was undetectable in a 5-yr-old girl with a history of asthma and respiratory tract infections. Her father had an IgG1 level that was one-third of the mean amount found in normal healthy controls. The defect in the proband was caused by a homozygous deletion of the structural gene for C gamma 1. A Southern blot analysis demonstrated that the maternal haplotype contained a deletion encompassing C gamma 1, C psi epsilon 1, C alpha 1, C psi gamma, and C gamma 2, whereas the deletion on the paternal haplotype was confined to the C gamma 1 gene. Neither of these deletions has previously been reported. IgG1 normally constitutes the dominant isotype for antibodies directed against protein Ag, including viral proteins. We have analyzed the immune response to a number of different protein and polysaccharide Ag in the patient and her parents. In the proband, antiviral antibodies were restricted to the IgG3 and IgG4 subclasses. However, the total amount of IgG directed against several viruses was below the concentration found in normal seropositive individuals. The father and the paternal grandfather, both with low serum IgG1 levels, also had asthma, thus indicating a possible causal relationship.     

Functional and morphological identification of FSH- and LH-producing cells in the pituitary gland

The identification of pituitary FSH and LH cells in states of pharmacological treatment influencing the pituitary FSH and LH production was performed by histological staining at the isoelectric points of these hormones in the cat. The intensity of the stained material in the hormone-producing cells was determined by a microphotometric technique. As a physiological control, the FSH and LH levels in blood were measured by a radioimmunoassay.     

Rat liver microsomal progesterone metabolism: evidence for differential troleandomycin and pregnenolone 16 alpha-carbonitrile inductive effects in the cytochrome P-450 III family

The effect of Troleandomycin (TAO) and pregnenolone 16 alpha-carbonitrile (PCN) on the hepatic microsomal progesterone metabolism in the rat is evaluated. Over thirteen hydroxylated progesterone derivatives are detected, including the novel 6 beta, 21-, 6 beta, 16 alpha-, 6 beta, 16 beta- and 2,21-dihydroxy derivatives, suggesting the induction of several cytochrome P-450 isozymes. PCN treatment results overall in an augmented production of progesterone metabolites whereas TAO treatment both induces and represses specific hydroxylase activities. Progesterone metabolism with purified isozymes isolated from liver microsomes from TAO and PCN treated rats differs significantly from that observed with intact microsomes, reflecting the complexity of the induction pattern of the cytochrome P-450 III family.