In a survey of all malignant soft tissue tumors in the extremities and limb girdles in Finland between 1960 and 1969, only one alveolar soft part sarcoma was found among 246 tumors (0.4%). Another alveolar soft part sarcoma, diagnosed in 1976, was more thoroughly studied. There was evidence that the characteristic crystals of alveolar soft part sarcoma are formed from the dense granules. Both were PASM-positive at ultrastructural level. No monoamines were detected in the cells by formaldehyde-induced fluorescence. This is a further fact to nullify the theory of the paraganglionic origin of alveolar soft part sarcoma, but the question of the histogenesis of the tumor still remains open.

Forty-five patients with presumed acute bacterial conjunctivitis were treated in an investigator-masked randomized multicenter study with either lomefloxacin 0.3% or fucidic acid 1% eye drops twice daily. Clinical signs and symptoms were rated by slit-lamp examination and conjunctival swab cultures were performed to evaluate clinical and microbiological efficacy. A total of 57 ocular isolates were tested for susceptibility to nine antibiotics. A significant decrease in clinical symptomatology was achieved by both treatments with a gradual improvement over the treatment period of 7-9 days. Bacteriological recovery was frequently achieved already at the first control visit (day 3-5), but the recovery rate was statistically significant (p = 0.014) only in the lomefloxacin group. The relatively high in vitro resistance rate (46%) to fucidic acid was not reflected by lower clinical efficacy. Two unrelated adverse events (one in each treatment group) and minimal local intolerance problems were observed in both treatment groups. A significantly higher incidence of burning sensation was observed with fucidic acid than with lomefloxacin (p < 0.01). All four treatment failures in the study occurred in the fucidic acid group. Lomefloxacin 0.3% ophthalmic solution demonstrated a high efficacy and good tolerance in the management of acute bacterial conjunctivitis.

No abstract

Two cases are presented with a long clinical history of multiple sclerosis (MS) before the diagnosis of an intracranial brain tumor. In the subsequent brain autopsy, however, both cases presented a diffusely growing anaplastic astrocytoma, only, and no changes similar to MS were seen. Diffuse tumor growth was noted in periventricular brain tissue and extended down to pons or medulla. Immunohistochemically, a positive staining for glial fibrillar acidic protein was observed in both cases and in the second case, which presented an increased amount of cerebrospinal fluid IgG, also a positive staining for immunoglobulins was seen. These case histories and subsequent neuropathological findings are presented as examples of diagnostic difficulties in MS, especially in cases with diffusely growing gliomas.

Prolactin (PRL) among other pituitary hormones has been detected in human cerebrospinal fluid (CSF) (2.,7.,8.). The normal CSF prolactin concentration is about 1 ng/ml (2.,3.). Patients with prolactin secreting hvpophyseal tumor have elevated PRL levels both in their blood and cerebrospinal fluid. The suprasellar extension of prolactinoma can brinq about higher prolactin concentration in the CSF than that in the serum ( 5 . , 9 . ) .Under physiological conditions serum and CSF prolactin concentrations are linearly correlated ( 2 . ) . This correlation prevails also at slightly elevated serum prolactin levels. In order to further investigate the interrelationship of the serum and CSF prolactin strictly normoprolactinemic neurological patients were chosen to this study. 107 non-endocrine neurological patients could be included to this study when a serum prolactin normal level criterion of 20 ng/ml (maximum) was used. The diagnostic neurological workuus of the patients were done in the departments of neurology, University of Turku and Tampere, Finland. The mean age of the patients was 50 5 14 (SD) years. Simultaneous serum and lumbar CSF samples were obtained as routine diaqnostic laboratory specimens. Paired serum and CSF samples were kept frozen (-20%) until analyzed by human prolactin radioimmunoassay. The assay reagents were a donation from the National Pituitary Agency, N.I.H., Bethesda, Md. to dr. M.T.Hyy~pa. The sensitivity limit of this assav was 0 , 5 ng/ml. The interassay variation was 12 % and the intra-assay variation 3 %. The mean serum prolactin concentration in this normoprolactinemic patient group was 6,2 2 3,5 (SD) ng/ml. The simultaneous level in cerebrospinal fluid was 1,O 2 0,4 (SD) nq/ml. After intraindividual comparisons the mean CSF-PRL / S-PRL ratio proved to be 0,20 2 0,lO (SD) . This is in accordance with the data of earlier study (2.). In that pioneer study of Assies et al. a highly significant and linear correlation (r = 0,9097) between CSF and Serum concentrations was found. Therefore a suggestion of a bulk transport mechanism for hormone from the blood to the CSF space was presented. We,however, found in this study a tendency for CSF prolactin level to remain relatively constant also at lower serum prolactin concentrations (see Table I.). TABLE I. With low normal serum PRL concentrations the CSF PRL concentration remains at the same level as in the high normal grouu of normoprolactinemic patients. (mean 2 SD) Patient groupSerum PRL ng/ml CSF PRL ng/ml S-PRL > 5 ng/ml 8,5 f 3,2 1,l 2 0,4 S-PRL < 5 ng/ml 3 , 5 2 0,6 1,0 2 0 , 5 P < 0,001 P > 0,lO (mean 2 SD) n = 4 9 n = 5 8