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Dissociation of Cortisol and Adrenal Androgen Secretion in the Hypophysectomized, Adrenocorticotropin-Replaced Chimpanzee
156
METABOLISM, ENDOCRINOLOGY AND IMMUNOLOGY
weights. The ultrasonically estimated length was longer than the measured length and the estimated width was less than the actual width. G. W. K. 3 figures, 1 table, 3 references
Percutaneous Venography and Occlusion in the Management of Spermatic Varicoceles B.
MORAG, Z. J. RUBINSTEIN, B. GOLDWASSER, A. YERUSHALMI AND B. LUNNENFELD, Departments of Diagnostic Radiology, Urology and Endocrinology, Sackler School of Medicine, Tel-Aviv University, Chaim Sheba Medical Center, Tel-Hashomer, Israel
Amer. J. Roentgen., 143: 635-640 (Sept.) 1984 The authors performed spermatic venography in 140 patients with subfertility and abnormal spermatogenesis. The first 108 patients were examined via a right femoral vein, while the last 32 were examined via a right internal jugular vein with a slightly curved end-hole or an H 1 cerebral catheter (Cook). The optimal site for occlusion was assessed according to the venogram and multiple coils were used. Of the 140 patients examined 27 had normal spermatic veins, 33 had bilateral varicoceles, and 71 had left and 9 had right varicoceles. Of these patients 26 had undergone prior surgical ligation of the left spermatic vein. The incompetent spermatic vein was occluded successfully in 97 of the 104 patients with a left varicocele, while 7 were unable to be catheterized owing to vein spasm in 2 and the presence of multiple small proximal veins that filled the varicocele in 5. Of the 42 patients with a right varicocele 31 had sucessful occlusion, while in 9 of the remainder adequate catheterization via the femoral approach was prevented owing to acute angulation between the spermatic vein and vena cava. Since the jugular vein approach was used 18 right varicoceles were demonstrated in 32 patients. With the femoral approach catheterization of the right spermatic vein occasionally was difficult, which accounted for most of the therapeutic failures in patients with right varicoceles. No major complications were encountered in any patient. Because of the frequency of bilateral subclinical varicoceles the authors recommend spermatic venography and percutaneous embolization in all men with subfertility and oligoteratoasthenospermia. The jugular approach is preferred because it is simple, safe and reliable, and can be performed with local anesthesia for the diagnosis and treatment of testicular varicocele. F. T. A. 9 figures, 1 table, 19 references
MET ABLISM, ENDOCRINOLOGY AND IMMUNOLOGY Dissociation of Cortisol and Adrenal Androgen Secretion in the Hypophysectomized, AdrenocorticotropinReplaced Chimpanzee B. D. ALBERTSON, w. C. HOBSON, B. S. BURNETT, P. T. TURNER, R. V. CLARK, R. J. SCHIEBINGER, D. L. LORIAUX AND G. B. CUTLER, JR., Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, Primate Research Center, New Mexico State University, Holloman Air Force Base, New Mexico and Deparment of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
J. Clin. Endocr. Metab., 59: 13-18 (July) 1984 The authors examined serum dehydroepiandrosterone, dehydroepiandrosterone sulfate and androstenedione following infusion of adrenocorticotropic hormone in hypophysectomized and castrated chimpanzees. Adrenocorticotropic hormone infusion maintained normal plasma cortisol levels in the experimental animals. By 40 days postoperatively plasma levels of the adrenal androgens dehydroepiandrosterone and dehydroepiandrosterone sulfate were much lower than the controls and did not increase in response to adrenocorticotropic hormone infusion. On the contrary, androstenedione levels were unaffected by hypophysectomy, castration and adrenocorticotropic hormone infusion. The authors speculate that the adrenal production of the androgens dehydroepiandrosterone and dehydroepiandrosterone sulfate may be dependent on a separate pituitary adrenal-stimulating hormone. The authors speculate further that the androstenedione pathway is subject to adrenocorticotropic hormone independent regulation. G. F. S. 5 figures, 1 table, 26 references
Acquired Immune Deficiency Syndrome: Postmortem Findings L. A. GUARDA, M. A. LUNA, J. L. SMITH, JR., P. w. A. MANSELL, F. GYORKEY AND A. N. ROCA, Departments of Pathology and Cancer Prevention, The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston, Department of Pathology, Veterans Administration Hospital at Houston, and Department of Pathology, Memorial at Houston, Houston, Texas Amer. J. Clin. Path., 81: 549-557 (May) 1984 Acquired immune deficiency syndrome (AIDS) has reached epidemic proportions since discovery of the first case in 1979. The syndrome affects young homosexual men, Haitian refugees, intravenous drug abusers, hemophiliacs and sexual partners of patients with AIDS. Despite the high lethality of the syndrome, there are no detailed reports concerning autopsy findings except in the form of 1 short abstract. For this reason, the authors reviewed their experience with 13 autopsies. The autopsies of 13 male homosexuals with AIDS were reviewed. All patients had laboratory evidence of cellular immune dysfunction. The most common diagnoses were disseminated cytomegalovirus infection in 12 patients and Kaposi's sarcoma in 10. All patients infected with cytomegalovirus had pulmonary compromise. Also, the adrenal glands and gastrointestinal tract often were involved by cytomegalovirus. Cytomegalovirus infection of organs affected uncommonly, such as the heart, meninges, cerebrum and peripheral nerves, was documented in 2 patients. Skin was involved most frequently by Kaposi's sarcoma, followed by the gastrointestinal tract and lymph nodes. Two patients had visceral and/or nodal Kaposi's sarcoma with no skin compromise. Other important diagnoses were Pneumocystis carinii pneumonia, cryptosporidiosis, fungal infections, toxoplasmosis and brain lymphoma. The cause of death was owing to 1 or more infections in most patients. Kaposi's sarcoma did not contribute substantially to the cause of death, except in 1 patient with massive multifocal and multiorgan involvement. The spectrum of pathological changes in AIDS is vast and pathologists must be aware of this fact to diagnose the lesions accurately. The morphological lesions are neither unique nor specific for the syndrome but are characteristic in this clinical and immunologic, setting. W. W. H. 4 figures, 4 tables, 55 references
METABOLISM, ENDOCRINOLOGY AND IMMUNOLOGY
weights. The ultrasonically estimated length was longer than the measured length and the estimated width was less than the actual width. G. W. K. 3 figures, 1 table, 3 references
Percutaneous Venography and Occlusion in the Management of Spermatic Varicoceles B.
MORAG, Z. J. RUBINSTEIN, B. GOLDWASSER, A. YERUSHALMI AND B. LUNNENFELD, Departments of Diagnostic Radiology, Urology and Endocrinology, Sackler School of Medicine, Tel-Aviv University, Chaim Sheba Medical Center, Tel-Hashomer, Israel
Amer. J. Roentgen., 143: 635-640 (Sept.) 1984 The authors performed spermatic venography in 140 patients with subfertility and abnormal spermatogenesis. The first 108 patients were examined via a right femoral vein, while the last 32 were examined via a right internal jugular vein with a slightly curved end-hole or an H 1 cerebral catheter (Cook). The optimal site for occlusion was assessed according to the venogram and multiple coils were used. Of the 140 patients examined 27 had normal spermatic veins, 33 had bilateral varicoceles, and 71 had left and 9 had right varicoceles. Of these patients 26 had undergone prior surgical ligation of the left spermatic vein. The incompetent spermatic vein was occluded successfully in 97 of the 104 patients with a left varicocele, while 7 were unable to be catheterized owing to vein spasm in 2 and the presence of multiple small proximal veins that filled the varicocele in 5. Of the 42 patients with a right varicocele 31 had sucessful occlusion, while in 9 of the remainder adequate catheterization via the femoral approach was prevented owing to acute angulation between the spermatic vein and vena cava. Since the jugular vein approach was used 18 right varicoceles were demonstrated in 32 patients. With the femoral approach catheterization of the right spermatic vein occasionally was difficult, which accounted for most of the therapeutic failures in patients with right varicoceles. No major complications were encountered in any patient. Because of the frequency of bilateral subclinical varicoceles the authors recommend spermatic venography and percutaneous embolization in all men with subfertility and oligoteratoasthenospermia. The jugular approach is preferred because it is simple, safe and reliable, and can be performed with local anesthesia for the diagnosis and treatment of testicular varicocele. F. T. A. 9 figures, 1 table, 19 references
MET ABLISM, ENDOCRINOLOGY AND IMMUNOLOGY Dissociation of Cortisol and Adrenal Androgen Secretion in the Hypophysectomized, AdrenocorticotropinReplaced Chimpanzee B. D. ALBERTSON, w. C. HOBSON, B. S. BURNETT, P. T. TURNER, R. V. CLARK, R. J. SCHIEBINGER, D. L. LORIAUX AND G. B. CUTLER, JR., Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, Primate Research Center, New Mexico State University, Holloman Air Force Base, New Mexico and Deparment of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico
J. Clin. Endocr. Metab., 59: 13-18 (July) 1984 The authors examined serum dehydroepiandrosterone, dehydroepiandrosterone sulfate and androstenedione following infusion of adrenocorticotropic hormone in hypophysectomized and castrated chimpanzees. Adrenocorticotropic hormone infusion maintained normal plasma cortisol levels in the experimental animals. By 40 days postoperatively plasma levels of the adrenal androgens dehydroepiandrosterone and dehydroepiandrosterone sulfate were much lower than the controls and did not increase in response to adrenocorticotropic hormone infusion. On the contrary, androstenedione levels were unaffected by hypophysectomy, castration and adrenocorticotropic hormone infusion. The authors speculate that the adrenal production of the androgens dehydroepiandrosterone and dehydroepiandrosterone sulfate may be dependent on a separate pituitary adrenal-stimulating hormone. The authors speculate further that the androstenedione pathway is subject to adrenocorticotropic hormone independent regulation. G. F. S. 5 figures, 1 table, 26 references
Acquired Immune Deficiency Syndrome: Postmortem Findings L. A. GUARDA, M. A. LUNA, J. L. SMITH, JR., P. w. A. MANSELL, F. GYORKEY AND A. N. ROCA, Departments of Pathology and Cancer Prevention, The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston, Department of Pathology, Veterans Administration Hospital at Houston, and Department of Pathology, Memorial at Houston, Houston, Texas Amer. J. Clin. Path., 81: 549-557 (May) 1984 Acquired immune deficiency syndrome (AIDS) has reached epidemic proportions since discovery of the first case in 1979. The syndrome affects young homosexual men, Haitian refugees, intravenous drug abusers, hemophiliacs and sexual partners of patients with AIDS. Despite the high lethality of the syndrome, there are no detailed reports concerning autopsy findings except in the form of 1 short abstract. For this reason, the authors reviewed their experience with 13 autopsies. The autopsies of 13 male homosexuals with AIDS were reviewed. All patients had laboratory evidence of cellular immune dysfunction. The most common diagnoses were disseminated cytomegalovirus infection in 12 patients and Kaposi's sarcoma in 10. All patients infected with cytomegalovirus had pulmonary compromise. Also, the adrenal glands and gastrointestinal tract often were involved by cytomegalovirus. Cytomegalovirus infection of organs affected uncommonly, such as the heart, meninges, cerebrum and peripheral nerves, was documented in 2 patients. Skin was involved most frequently by Kaposi's sarcoma, followed by the gastrointestinal tract and lymph nodes. Two patients had visceral and/or nodal Kaposi's sarcoma with no skin compromise. Other important diagnoses were Pneumocystis carinii pneumonia, cryptosporidiosis, fungal infections, toxoplasmosis and brain lymphoma. The cause of death was owing to 1 or more infections in most patients. Kaposi's sarcoma did not contribute substantially to the cause of death, except in 1 patient with massive multifocal and multiorgan involvement. The spectrum of pathological changes in AIDS is vast and pathologists must be aware of this fact to diagnose the lesions accurately. The morphological lesions are neither unique nor specific for the syndrome but are characteristic in this clinical and immunologic, setting. W. W. H. 4 figures, 4 tables, 55 references