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CSF protein, albumin and IgG concentrations in elderly male patients
ABSTRACTS OF A N N U A L MEETING
WHEN DID YOU LAST SEE A BLACK THYROID? H. D. ATTWOOD,X . DENNETTA N D W. Dr;ii’K~i)o Pathology, University of Melbourne, Puthology, Koyal Children ’.s Hosprlul, Melbourne, and Pathology, Westmead Centre, N . S. W . A blackening of the thyroid due to the accumulation of a melanin-like pigment was first reported in 1976.’ The pigment was derived from concentration of minocycline in the thyroid with subsequent oxidation to produce the pigment.* In the original report the patient was a 69 yr-old man dying from chronic respiratory failure. In 1982, a black thyroid was found in a 20 yr-old man who had been taking minocycline for acne and had died in a motorcycle a ~ c i d c n t . ~ Additional examples in patients treated with minocycline for acne have been described r e ~ e n t l y . ~ . ~ The display is designed to alert pathologists, particularly those involved in coronial work, to the anomaly and to encourage them to examine the thyroid carefully so that an incidence of pigmentation in young people with acne may be obtained. So far there i s no evidence in man thal the pigmentation causes hypothyroidism.
Scanning and transmission electron microscopy showed no normal spermatozoa; the nuclei had a circular outline and all lacked an acrosome. There was excess cytoplasm and organelles were disorganized. Without acrosomes the spermatozoa lack the intrinsic enzymes necessary for cumulus-ovum penetration and the patient is, therefore, sterile. Alternative methods of achieving a family must be considered and his wife is at present on a programme of artificial insemination by donor. Reference Holstein AF, Schirren C , Schirren CG. Human spermatids and spermatozoa lacking acrosomes. J Reprod Fertil 1973; 35: 489-91.
NEUROMUSCULAR AND VASCULAR HAMARTOMA OF SMALL BOWEL SUJATHA S. E. FERNANDO AND V i N c E N T J . MCGOVERNDepartment of Anatomical Pathology, The Liverpool Hospital, Liverpool, N.S. W . 21 70 Two examples of a hitherto undescribed hamartomatous condition of the small intestine are presented. They consist of fascicles of smooth muscle derived from the muscularis mucosae, bundles of unmyelinated nerve fibres with scattered ganglion cells and hemangiomatous vessels, occurring focally within a segment of the intestine and causing stenosis. The condition we have described consists of an aberrant, nonneoplastic arrangement of tissue normally occurring in the small intestine. Neither of our patients had any manifestation of multi-systemic disease such as neuro-fibromatosis or Sipple’s syndrome, in which neural tissue may participate. We have not found any similar case in the medical literature.
CSF PROTEIN, ALBUMIN AND IgG CONCENTRATIONS IN ELDERLY MALE PATIENTS PtiiLLiP KOSTOS A N D A N N W A R R E L LDepartment of Clinical Biochemistry, Repatriation General Hospital, Heidelberg There are many references in the literature which state that various CSF parameters, such as CSF protein, vary with age and sex. Reference values depend on methods used. Because of the preponderance of elderly males in our hospital population and recent changes in our methods for measuring CSF protein, albumin and IgG, we have recently established our own reference intervals. We present this work as there are few studies for such elderly patients using modern methods. The reference population was 48 patients having a spinal anesthetic for a transurethral resection. Only patients who were thought to be clinically normal apart from prostatic hypertrophy had CSF taken for the study. If histopathology showed malignancy and the bone scan was positive for bone secondaries, the samples were excluded from the study. Although these patients were not strictly healthy we feel they were fairly representative of our hospital clientele. The methods used were as follows: CSF protein TCA-Ponceau S method Beckman ICS Analyzer I1 CSF IgC and Albumin Beckman ICS Analyzer I1 Serum IgC and Albumin Results were as follows: No relationship to age was found in any of the parameters. The intervals are mean f 2SD. (If tolerance limits are used the intervals are larger.) CSF Protein 0.25-0.90 g/l CSF Albumin 0.12-0.49 g/l CSF IgG 0.013-0.056 g/l CSFlgG/CSF Alb 0.07-0.16 CSFIgG/CSF Alb 0.27-0.62 Se IgC/ Se Alb Only CSF protein values differ greatly from those generally quoted. The possible reasons will be discussed. We wish to thank members of the Department of Anaesthetics, Mrs. S. Jones and Mi-. G. Gardner for their assistance with this project.
673
References 1. Attwood HD, Dennett X . A black thyroid and minocycline Irealnient. Br bled
.I 1976; 1109-in. 2. Beniti KF, Roberts GK, Yusa A. Morphologic cffecls of minocycline in laboratory animals. Toxicol Appl Pharmacol 1967; 1 I : 150-70. 3. Delprado W . (In press). 4. White SW, Besanceney C . Systemic pigmentalion from tetracycline and minocycline therapy. Arch Dermatol 1983; 119: 1-2. 5. Reid JD. The black thyroid associated with minocycline tlieiapy. Am J C h i Palhol 1983; 79: 738-46.
MONOCHROMATIC ILLUMINATION OF VARIABLY DIFFERENTIATED PROSTATIC CARCINOMAS BY COMPUTERIZED LIGHT MICROSCOPY T. BRAIN*, A. EASTGATE* AND D. L Y T T O N t *university of Tasmania, G.P.O. Box 252C. Hobart, Tasmania 7001. ?The Royal Sourhern Memorial Hospital, P.O. Box 185, Caulfield South 3162 Prostatic cancer is a common disease in both mortality and incidence.’ Incidence rate per 100,000 males in Tasmania
Year 1978
35.3
3rd to skin and lung
1979
41.8
3rd to skin and lung
1980
37.0
3rd to skin and lung
Annual incidence rates per 100,000 males in Tasmania Year
Age 40
45
50
55
60
65
70
75
80
85 90+
1978
-
9.3 27.9 20.6 71.2 101 343 750 727 1563 -
1979
9
9.4
9.4 30.4 107 241
1980
-
-
-
~
29
95
393 646 738 1190 1190
189 469 498
626
-
-
The histopathological criteria for the diagnosis of latent prostatic carcinoma are subjective and the incidence varies from 16-30% of prostatic tissues examined depending upon the age group. For clinical prostatic cancer several systems are available for the grading classification of these tumours, yet within Australia there is no commonly accepted system for histopathological grading. Gleason’s, Mostofi’s, Gaeta’s, W.H.O., Broder’s and Mayo Clinic Systems are some of the available grading systems, many recognizing the importance of both acinar and cytological details. This study was undertaken to assess prostatic cancers objectively by monochromatic light at 470 nm, 535 nm and 587 nm on routine H &
WHEN DID YOU LAST SEE A BLACK THYROID? H. D. ATTWOOD,X . DENNETTA N D W. Dr;ii’K~i)o Pathology, University of Melbourne, Puthology, Koyal Children ’.s Hosprlul, Melbourne, and Pathology, Westmead Centre, N . S. W . A blackening of the thyroid due to the accumulation of a melanin-like pigment was first reported in 1976.’ The pigment was derived from concentration of minocycline in the thyroid with subsequent oxidation to produce the pigment.* In the original report the patient was a 69 yr-old man dying from chronic respiratory failure. In 1982, a black thyroid was found in a 20 yr-old man who had been taking minocycline for acne and had died in a motorcycle a ~ c i d c n t . ~ Additional examples in patients treated with minocycline for acne have been described r e ~ e n t l y . ~ . ~ The display is designed to alert pathologists, particularly those involved in coronial work, to the anomaly and to encourage them to examine the thyroid carefully so that an incidence of pigmentation in young people with acne may be obtained. So far there i s no evidence in man thal the pigmentation causes hypothyroidism.
Scanning and transmission electron microscopy showed no normal spermatozoa; the nuclei had a circular outline and all lacked an acrosome. There was excess cytoplasm and organelles were disorganized. Without acrosomes the spermatozoa lack the intrinsic enzymes necessary for cumulus-ovum penetration and the patient is, therefore, sterile. Alternative methods of achieving a family must be considered and his wife is at present on a programme of artificial insemination by donor. Reference Holstein AF, Schirren C , Schirren CG. Human spermatids and spermatozoa lacking acrosomes. J Reprod Fertil 1973; 35: 489-91.
NEUROMUSCULAR AND VASCULAR HAMARTOMA OF SMALL BOWEL SUJATHA S. E. FERNANDO AND V i N c E N T J . MCGOVERNDepartment of Anatomical Pathology, The Liverpool Hospital, Liverpool, N.S. W . 21 70 Two examples of a hitherto undescribed hamartomatous condition of the small intestine are presented. They consist of fascicles of smooth muscle derived from the muscularis mucosae, bundles of unmyelinated nerve fibres with scattered ganglion cells and hemangiomatous vessels, occurring focally within a segment of the intestine and causing stenosis. The condition we have described consists of an aberrant, nonneoplastic arrangement of tissue normally occurring in the small intestine. Neither of our patients had any manifestation of multi-systemic disease such as neuro-fibromatosis or Sipple’s syndrome, in which neural tissue may participate. We have not found any similar case in the medical literature.
CSF PROTEIN, ALBUMIN AND IgG CONCENTRATIONS IN ELDERLY MALE PATIENTS PtiiLLiP KOSTOS A N D A N N W A R R E L LDepartment of Clinical Biochemistry, Repatriation General Hospital, Heidelberg There are many references in the literature which state that various CSF parameters, such as CSF protein, vary with age and sex. Reference values depend on methods used. Because of the preponderance of elderly males in our hospital population and recent changes in our methods for measuring CSF protein, albumin and IgG, we have recently established our own reference intervals. We present this work as there are few studies for such elderly patients using modern methods. The reference population was 48 patients having a spinal anesthetic for a transurethral resection. Only patients who were thought to be clinically normal apart from prostatic hypertrophy had CSF taken for the study. If histopathology showed malignancy and the bone scan was positive for bone secondaries, the samples were excluded from the study. Although these patients were not strictly healthy we feel they were fairly representative of our hospital clientele. The methods used were as follows: CSF protein TCA-Ponceau S method Beckman ICS Analyzer I1 CSF IgC and Albumin Beckman ICS Analyzer I1 Serum IgC and Albumin Results were as follows: No relationship to age was found in any of the parameters. The intervals are mean f 2SD. (If tolerance limits are used the intervals are larger.) CSF Protein 0.25-0.90 g/l CSF Albumin 0.12-0.49 g/l CSF IgG 0.013-0.056 g/l CSFlgG/CSF Alb 0.07-0.16 CSFIgG/CSF Alb 0.27-0.62 Se IgC/ Se Alb Only CSF protein values differ greatly from those generally quoted. The possible reasons will be discussed. We wish to thank members of the Department of Anaesthetics, Mrs. S. Jones and Mi-. G. Gardner for their assistance with this project.
673
References 1. Attwood HD, Dennett X . A black thyroid and minocycline Irealnient. Br bled
.I 1976; 1109-in. 2. Beniti KF, Roberts GK, Yusa A. Morphologic cffecls of minocycline in laboratory animals. Toxicol Appl Pharmacol 1967; 1 I : 150-70. 3. Delprado W . (In press). 4. White SW, Besanceney C . Systemic pigmentalion from tetracycline and minocycline therapy. Arch Dermatol 1983; 119: 1-2. 5. Reid JD. The black thyroid associated with minocycline tlieiapy. Am J C h i Palhol 1983; 79: 738-46.
MONOCHROMATIC ILLUMINATION OF VARIABLY DIFFERENTIATED PROSTATIC CARCINOMAS BY COMPUTERIZED LIGHT MICROSCOPY T. BRAIN*, A. EASTGATE* AND D. L Y T T O N t *university of Tasmania, G.P.O. Box 252C. Hobart, Tasmania 7001. ?The Royal Sourhern Memorial Hospital, P.O. Box 185, Caulfield South 3162 Prostatic cancer is a common disease in both mortality and incidence.’ Incidence rate per 100,000 males in Tasmania
Year 1978
35.3
3rd to skin and lung
1979
41.8
3rd to skin and lung
1980
37.0
3rd to skin and lung
Annual incidence rates per 100,000 males in Tasmania Year
Age 40
45
50
55
60
65
70
75
80
85 90+
1978
-
9.3 27.9 20.6 71.2 101 343 750 727 1563 -
1979
9
9.4
9.4 30.4 107 241
1980
-
-
-
~
29
95
393 646 738 1190 1190
189 469 498
626
-
-
The histopathological criteria for the diagnosis of latent prostatic carcinoma are subjective and the incidence varies from 16-30% of prostatic tissues examined depending upon the age group. For clinical prostatic cancer several systems are available for the grading classification of these tumours, yet within Australia there is no commonly accepted system for histopathological grading. Gleason’s, Mostofi’s, Gaeta’s, W.H.O., Broder’s and Mayo Clinic Systems are some of the available grading systems, many recognizing the importance of both acinar and cytological details. This study was undertaken to assess prostatic cancers objectively by monochromatic light at 470 nm, 535 nm and 587 nm on routine H &