Mayer Milstoc

Aging changes in the liver of the male annual cyprinodont fish, Nothobranchius guentheri.

Abstract Histological studies were performed on the liver of the male annual cyprinodont fish, Nothobranchius guentheri between 3 and 18 months of age. The very young, but sexually mature fish, showed few changes. Beginning at 4–6 months of age the number of fish exhibiting histological changes increased, but reamined stable to 13–14 months. The prevalent changes were: vacuolization of hepatocytes and nodular degeneration progressing to cyst like formations. At 15–18 months, three new lesions were observed: swirl formations by endothelial cell proliferation, fibrosis with melanin pigmented cells and malignant transformation. Since annual fish have a relatively short lifespan, both in nature and in the laboratory, they have been used as a model for the aging process. Histological studies are critical in establishing aging patterns and allow for broader interpretation of physiological and biochemical changes.

An unusual site of ventricular pacing occurring during the use of the transvenous catheter pacemaker

Abstract A patient is presented who maintained the electrocardiographic pattern of an intraventricular conduction defect similar to a RBBB for 18 months after an artificial pacemaker was thought to have been placed transvenously into her right ventricle. At autopsy, the electrodes were found to have traversed the coronary sinus and entered the middle cardiac vein. This resulted in pacing from the epicardial surface of the left ventricle. To our knowledge, this abnormal location of a pacemaker electrode has not previously been reported. Electrocardiographic evidence for malpositioning is presented. The possible significance of a persistent RBBB in patients being paced from the right ventricle is discussed.

Rapidly progressive glomerulonephritis in a patient with rheumatoid arthritis during treatment with high-dosage D-penicillamine.

A patient with advanced rheumatoid arthritis and severe clinical manifestations of rheumatoid vasculitis died of acute renal failure after 30 months of treatment with high-dosage D-penicillamine. She had had no signs of adverse drug reactions until the terminal illness. Although streptococcal pharyngitis was diagnosed late in her disease, penicillamine-induced immune complex glomerular damage is considered more likely than poststreptococcal glomerulonephritis, because her microscopic hematuria preceded diagnosis of pharyngitis. Postmortem examination disclosed findings suggestive of rapidly progressive glomerulonephritis of immune complex pathogenesis. The short period of microscopic hematuria and the rapidity of development of renal failure before death emphasize the need for frequent monitoring of renal function and prompt discontinuation of D-penicillamine treatment upon detection of otherwise unexplained hematuria. There is urgent need for early immunological evaluation, renal biopsy, and vigorous therapeutic measures.

Anaplastic neuronal tumors of brain

A multicentric neuronal tumor of brain with unique morphologic features is described. It is compared with four other markedly anaplastic brain tumors containing neoplastic neurons. Demonstration of axon processes, which must be carefully distinguished from other similarly stained structures, is essential for the recognition of such tumors. Recent experience suggests that anaplastic neuronal tumors are more frequent than is generally realized. It is suggested that axon stains should be more widely employed in the investigation of atypical or highly pleomorphic gliomas.

Fatal Septicemia Due to Providence Group Bacilli

There has been an increase in the frequency and severity of infections due to Gram negative bacilli of the Providence group. Eight cases are presented in which these organisms caused septicemia; 6 of the 8 patients died. Infections with Providence bacilli are considered to be nosocomial or iatrogenic. The rapid appearance of resistant bacteria in this group requires more efficient therapeutic agents.

NEW PATHOLOGIC ASPECTS OF PRIMARY CARCINOMA OF THE PROSTATIC URETHRA

Two cases of an extremely rare tumor, the primary transitional‐cell carcinoma of the male prostatic urethra, are presented. The diagnostic problems of the 2 cases are emphasized in relation to a special group of elderly long‐term patients in a hospital for chronic diseases. In addition, one of the patients had two primary carcinomas and mixed widespread metastases. It is the first such case.

Gallstone obstruction of the second portion of the duodenum

SummaryGallstone obstruction of the duodenum, resulting from a cholecystoduodenal fistula and impaction of a large stone in the second portion of the duodenum, is described. This is the second case in which the descending portion of the duodenum is reported as the site of impaction of the stone. The diagnostic problems associated with this condition are discussed.