Fluoxetine elevates allopregnanolone in female rat brain but inhibits a steroid microsomal dehydrogenase rather than activating an aldo-keto reductase

Background and Purpose

Fluoxetine, a selective serotonin reuptake inhibitor, elevates brain concentrations of the neuroactive progesterone metabolite allopregnanolone, an effect suggested to underlie its use in the treatment of premenstrual dysphoria. One report showed fluoxetine to activate the aldo-keto reductase (AKR) component of 3α-hydroxysteroid dehydrogenase (3α-HSD), which catalyses production of allopregnanolone from 5α-dihydroprogesterone. However, this action was not observed by others. The present study sought to clarify the site of action for fluoxetine in elevating brain allopregnanolone.

Experimental Approach

Adult male rats and female rats in dioestrus were treated with fluoxetine and their brains assayed for allopregnanolone and its precursors, progesterone and 5α-dihydroprogesterone. Subcellular fractions of rat brain were also used to investigate the actions of fluoxetine on 3α-HSD activity in both the reductive direction, producing allopregnanolone from 5α-dihydroprogesterone, and the reverse oxidative direction. Fluoxetine was also tested on these recombinant enzyme activities expressed in HEK cells.

Key Results

Short-term treatment with fluoxetine increased brain allopregnanolone concentrations in female, but not male, rats. Enzyme assays on native rat brain fractions and on activities expressed in HEK cells showed fluoxetine did not affect the AKR producing allopregnanolone from 5α-dihydroprogesterone but did inhibit the microsomal dehydrogenase oxidizing allopregnanolone to 5α-dihydroprogesterone.

Conclusions and Implications

Fluoxetine elevated allopregnanolone in female rat brain by inhibiting its oxidation to 5α-dihydroprogesterone by a microsomal dehydrogenase. This is a novel site of action for fluoxetine, with implications for the development of new agents and/or dosing regimens to raise brain allopregnanolone.

Electrowetting on liquid-infused film (EWOLF): complete reversibility and controlled droplet oscillation suppression for fast optical imaging

Electrowetting on dielectric (EWOD) has emerged as a powerful tool to electrically manipulate tiny individual droplets in a controlled manner. Despite tremendous progress over the past two decades, current EWOD operating in ambient conditions has limited functionalities posing challenges for its applications, including electronic display, energy generation, and microfluidic systems. Here, we demonstrate a new paradigm of electrowetting on liquid-infused film (EWOLF) that allows for complete reversibility and tunable transient response simultaneously. We determine that these functionalities in EWOLF are attributed to its novel configuration, which allows for the formation of viscous liquid-liquid interfaces as well as additional wetting ridges, thereby suppressing the contact line pinning and severe droplet oscillation encountered in the conventional EWOD. Finally, by harnessing these functionalities demonstrated in EWOLF, we also explore its application as liquid lens for fast optical focusing.

Experimental investigation on drag effect of sprinkler spray to adjacent horizontal natural smoke venting

Discharge rate of a horizontal adjacent smoke vent under sprinkler spray is experimentally investigated. Temperature of smoke layer and velocity of smoke venting were measured, under different sprinkler operating pressures and smoke venting areas. CO concentration at the smoke vent center and velocity of vent flow with fresh air outside were recorded in tests under different smoke venting conditions. Experimental results have shown that efficiency of smoke venting is controlled by a combination of smoke buoyancy and drag force of sprinkler spray. Only when buoyancy is greater than drag force the smoke could be extracted by venting. Velocity of smoke venting has shown to decrease as the operating pressure increases. Smoke venting logging, which represents the failure of smoke venting, was experimentally found from certain operating pressure called initial logging pressure. The CO concentration was found to increase after sprinkler was operated as the smoke is constrained in the spray region with horizontal momentum decreased. Negative pressure difference is caused at the vent when there is smoke venting logging, which might practically bring the exterior fresh air into the fire building. Additionally, experiments results have shown that the venting area has little influence on smoke flow under smoke venting logging.

Optical properties of Au/Ag core/shell nanoshuttles

Au/Ag nanoshuttles with sharp tips at both ends have been synthesized in glycine solution by chemically depositing silver on gold nanorods. Strong local field in the Au/Ag nanoshuttles enhanced by longitudinal surface plasmon resonance (LSPR) were investigated by theoretical calculations and experimental measurements. At the corresponding LSPR wavelengths, the extinction cross section and nonlinear refraction of the Au/Ag nanoshuttles are about 1.5 and 8.0 times of those of the original Au nanorods, respectively.

Interpopulation and intrapopulation maternal lineage genetics of the Lanyu pig (Sus scrofa) by analysis of mitochondrial cytochrome b and control region sequences

The Lanyu pig is an indigenous breed from the Lanyu Islet, which is southeast of Taiwan. Two herds of Lanyu pigs were introduced from the Lanyu Islet into Taiwan in 1975 and 1980. The current population of conserved Lanyu pigs consists of only 44 animals with unknown genetic lineage. The Lanyu pig possesses a distinct maternal genetic lineage remote from Asian and European pigs. The present study aimed to understand the phylogenetic relationship among conserved Lanyu, Asian, and European type pigs based on the cytochrome b coding gene, to ascertain the maternal lineage and genetic diversity within the conserved Lanyu pigs, and to address whether genetic introgression from exotic or Formosan wild pigs had occurred in the conserved Lanyu pigs. Entire mitochondrial genomes of both types of Lanyu pig comprised 2 ribosomal RNA, 22 transfer RNA, and 13 protein-coding genes. Only 2 haplotypes of the mitochondrial DNA (mtDNA) control region and cytochrome b were identified in the conserved Lanyu pig herds. When maximum likelihood trees were constructed, the Type I Lanyu mitochondrial genes formed a unique clade with a large pairwise distance of both cytochrome b and the control region from Asian and European type breeds, Formosan wild pigs, and exotic breeds. Significant loss of genetic diversity of mtDNA within the conserved Lanyu pigs was demonstrated by low haplotype and nucleotide diversities, supported by Fu and Li's D* neutrality test (1.44055; P < 0.05). The mtDNA control region sequences of extant pigs in the Lanyu Islet, however, showed high haplotype and nucleotide diversity, and clustered with exotic pigs. These results indicate no maternal lineage mtD-NA gene introgression from Formosan wild pigs and introduced exotic pigs to conserved Type I Lanyu pigs, and a severe loss of heterozygosity of mtDNA in conserved Lanyu pigs. The remaining extant pigs on the Lanyu Islet have been introgressed with exotic breeds. Strategies for future conservation of native Lanyu pigs are now even more urgent and important.

Effect of several Chinese natural health products of human cytochrome P450 metabolism

PURPOSE

Traditional Chinese medicines (TCM) are believed by many to be safe and used for self-medication without supervision. Although the risk appears to be low, certain TCM have been associated with a number of serious adverse reactions. A preliminary study was undertaken with 12 products using a human cytochrome P450 (CYP450) isozyme assay to determine if these products could affect human drug metabolism.

METHODS

Aliquots of samples were analyzed directly or as extracts for their potential to affect CYP450 2C9, 2C19, 2D6, and 3A4 mediated-metabolism of marker substrates using an in vitro fluorometric microtiter plate assay.

RESULTS

One product was found to be a Chinese Proprietary Medicine (CPM). Most aqueous extracts inhibited CYP450 mediated-metabolism of at least 3 isozymes (ranging from 25-100%). All liquid samples markedly inhibited the metabolism of all 4 isozymes. De le ke chuan kang and Rensheng dao were the strongest CYP450 inhibitors.

CONCLUSIONS

Our in vitro findings demonstrate that TCM can inhibit CYP450 2C9, 2C19, 2D6 and 3A4 mediated-metabolism. TCM need to be examined further under clinical settings to determine if potential interactions will occur that affect the safety and efficacy of conventional therapeutic products.

[Distribution of cholinergic efferent vestibular neurons]

OBJECTIVE

To investigate the effect and distribution of cholinergic efferent vestibular neurons in normal wistar rat.

METHOD

HPR retrograde tracer and Immunocytochemical techniques were used.

RESULT

Results show that AchT immunoreactive neurons locate in dorsolateral and dorsomedial to genu of the facial. Few neurons scatter in the parvocellular nucleus.

CONCLUSION

As a neural transmitter, acetylcholine distribute in efferent vestibular neurons and play an important role.

Study on facial motoneuronal death after proximal or distal facial nerve transection

BACKGROUND

Among the cranial nerves, the facial nerve is most liable to be damaged. Pathologic changes in the facial motor nucleus (FMN) after nerve injury are not well recognized, and the optimal time for facial nerve reconstruction after axotomy is controversial. In this study, to clarify the pathologic change in the FMN after axotomy and to determine the best time for surgery, facial motoneuronal death was investigated after facial nerve injury.

METHODS

Sixty Wistar rats were divided into proximal and distal groups. In the proximal group, the right facial nerve was transected at the porus of internal acoustic meatus. In the distal group, the nerve was cut at the stylomastoid foramen. The animals were sacrificed from day 3 to day 60 after surgery, and the brainstem was fixed with 4% paraformaldehyde. The FMN were then examined in serial sections stained with Cresyl Violet, and facial motoneurons were counted under a light microscope.

RESULTS

The death rate of facial motoneurons in the animals that underwent proximal axotomy was found to be higher and cell death occurred earlier than in the distal axotomy animals at every time point. Moreover, neuron death increased with time and peaked at 15 days after surgery.

CONCLUSIONS

The results indicate that the injury site was correlated with facial motoneuronal death, and suggest that reconstructive surgery should be performed as early as possible.

Relationship between electroacupuncture analgesia and dopamine receptors in nucleus accumbens

AIM

To study the roles of dopamine (DA) D1 and D2 receptors in nucleus accumbens in electroacupuncture analgesia (EAA) and the potentiation of EAA of rats induced by l-tetrahydropalmatine (l-THP), a dopamine receptor antagonist.

METHODS

SK&F-38393 and quinpirole hydrochloride (Qui), highly selective agonists of D1 and D2 receptors, respectively were injected into nucleus accumbens of rats.

RESULTS

SK&F-38393 (5 and 10 micrograms) attenuated the potentiation of EAA induced by l-THP, 10 micrograms SKF38393 attenuated EAA as well, while Qui (10 and 20 micrograms) had no effect on EAA and the potentiation of EAA induced by l-THP.

CONCLUSION

D1 but not D2 receptor in nucleus accumbens play an important role in EAA and the potentiation of EAA induced by l-THP.

Acromegaly in a woman presenting with diabetic ketoacidosis and insulin resistance

A 22-year-old Chinese woman presented with typical features of diabetic ketoacidosis. There was a family history of diabetes but she was not obese. Plasma glucose and bicarbonate levels were 27.0 mmol/l and 5 mmol/l, respectively. Significant insulin resistance was noticed: she needed up to 15 units of insulin per hour. She required up to 120 units daily for her diabetic control even after her acidosis had subsided. She was then noticed to have the clinical features of acromegaly. The diagnosis was confirmed, and a cranial CT scan confirmed the presence of a pituitary macroadenoma. She underwent uneventful trans-sphenoidal resection of the tumour and her insulin requirement gradually lessened. Acromegaly should be considered in the differential diagnosis of unexplained insulin resistance.

A patient with Graves' disease, thrombocytopenia and chronic hepatitis B

A 22-year-old Chinese man, a HBsAg carrier, presented with relapse of thyrotoxic Graves' disease complicated by thrombocytopenia and hepatitis. Platelet count and liver enzymes gradually improved following successful treatment of the thyrotoxicosis with radioactive iodine. Possible pathogenetic links and therapeutic implications are discussed.

Thyrotoxicosis and renal tubular acidosis presenting as hypokalaemic paralysis

A 34-yr-old Chinese woman presented with hypokalaemic periodic paralysis. She had a goitre and was biochemically thyrotoxic. However, she also had urinary potassium loss with a metabolic acidosis and reduced ability to acidify her urine. The co-existence of distal renal tubular acidosis (RTA) was confirmed. There was no evidence of xerostomia or xerophthalmia, although anti-Ro antibody and rheumatoid factor were positive. Paralytic attacks did not recur after the thyrotoxicosis was controlled with radioactive iodine. Possible pathogenic mechanisms for the association of these disorders are discussed. Female patients presenting with thyrotoxic periodic paralysis (TPP) should be thoroughly investigated for possible additional precipitating factors in view of the strong male predominance of TPP, particularly when there are atypical metabolic features.

C-fos expression in spinal cord and brainstem following noxious stimulation and electroacupuncture plus noxious stimulation

The present study was to trace the neuronal pathway in the spinal cord and brainstem following noxious stimulation and acupuncture plus noxious stimulation by using immunohistochemical technique to detect the expression of c-fos like protein. The results showed that in both the noxious stimulation group and acupuncture of Zusanli(St.36) and Lanwei(Extra 33) points plus noxious stimulation group a lot of Fos-like immunoreactive (FLI) cell nuclei appeared in the following structures: dorsal horn of lumbar and sacral spinal cord (Laminae I, II, V and X), n. reticularis lateralis, n. reticularis paragigantocellularis lateralis, area A1, n. tractus solitarii, n. raphe magnus, locus coeruleus, n. raphe dorsalis and the periaqueductal grey. In the control group no obvious c-fos expression was shown in the structures mentioned above. It was also shown that in the lumbar and sacral spinal cord the number of FLI nuclei in the acupuncture plus noxious stimulation group was more than that in the noxious stimulation group, but in locus coeruleus and the ventral part of the periaqueductal grey the number of FLI nuclei in the acupuncture plus noxious stimulation group was less than that of the noxious stimulation group. The results imply that acupuncture and noxious stimulation may activate the intrinsic pain modulating system through the spinal dorsal horn, then suppress the c-fos expression induced by noxious stimulation in the locus coeruleus and ventral part of the periaqueductal grey.

Optical parallel-access shared memory system: analysis and experimental demonstration

An optical implementation of a parallel-access shared memory uses a single photorefractive crystal and can realize the set of memory modules in a digital shared memory computer. This implementation uses two arrays of sources that are individually coherent but mutually incoherent from region to region across each array, and it permits incoherent/coherent double angular multiplexing of data in the crystal. A complete instruction set for its memory access consists of four operations, READ, WRITE, SELECTIVE ERASE, and REFRESH, which can be applied to any memory module independent of (and parallel with) instructions to the other memory modules. In addition, a memory module can execute a sequence of READ operations simultaneously with the execution of a WRITE operation to accommodate differences efficiently in optical recording and readout times common to optical volume storage media. An experimental shared memory system demonstrates two memory modules, each consisting of up to two 5-bit data blocks, implemented in a single Fe:LiNbO(3) crystal. The projected performance of the optical parallel-access shared memory system is analyzed and compared with conventional page-addressed volume holographic memories.

Iron enhances uptake of mineral particles and increases lipid peroxidation in tracheal epithelial cells

The factors that determine whether an exogenous mineral particle will be taken up by tracheobronchial epithelial cells are unclear. We have previously proposed that active oxygen species play a role in this process, most likely through iron-catalyzed formation of hydroxyl radical and subsequent lipid peroxidation of cell membranes. To further examine this hypothesis, we prepared rat tracheal explant cultures and exposed them for 1 h to suspensions of amosite asbestos or titanium dioxide (rutile) that had been preincubated with varying concentrations of a mixture of ferrous and ferric chloride. Explants were then maintained in organ culture in air/CO2 for 1 wk to allow particle or fiber uptake to occur. Particles or fibers in the tracheal epithelium were determined by light microscopic morphometry. Similarly treated explants were assayed for malondialdehyde as a measure of lipid peroxidation in the epithelial cells. Asbestos fibers without added iron caused lipid peroxidation, but this was not true of titanium dioxide particles. For both types of dust, increasing adsorbed iron concentrations were associated with increasing particle uptake and increasing lipid peroxidation. These observations suggest that cationic iron may play a major role in particle uptake by tracheobronchial epithelia, and that particle uptake is also related to iron-mediated lipid peroxidation.

The central effect of electro-acupuncture analgesia on visceral pain of rats: a study using the [3H] 2-deoxyglucose method

This study had the objective to understand the central effect of electro-acupuncture analgesia (EAA) on visceral pain of rats. We used the method of Sokoloff's 2-deoxyglucose (2-DG) auto-radiographic quantitative analysis to observe the changes of local cerebral metabolic rate of glucose (LCMRG) in rats given electrical stimulation of greater splanchnic nerve (GSN) followed by electro-acupuncture. From the results of this study, we found that the LCMRG had a significant difference between EAA group and pain group at some structures, such as the spinal thoracic and lumbar dorsal horns (segments T6-T8, L1-L3), locus coeruleus (lc), nucleus raphe magnus (rm), nucleus reticular gigantocellularis (rgi), periaqueductal gray (PAG) and habenulae lateralis (hl) of thalanum. The results combining reports by other investigators, suggest that these local cerebral structures might be the key nuclei in EAA on visceral pain.

Central expression of c-fos protein after peripheral noxious thermal stimulation in awake rats

This study applied immunohistochemistry method to examine the pattern of c-fos expression in the neuraxis following peripheral noxious thermal stimulation accomplished by immersion of tail of awake rat into hot water (50 degrees C). In unstimulated control rats, no obvious baseline expression of c-fos protein was found except in nucleus paraventricularis hypothalami and colliculus inferior, probably associated with restraint-induced stress and auditory stimulus, respectively. Noxious thermal stimulation resulted in the activation of c-fos expression, and bilateral increased nuclear immunostaining was counted in dorsal horn of lumbar and sacral segments of spinal cord (laminae I, II), nucleus raphe dorsalis, substantia grisea centralis (ventralis), nucleus paraventricularis thalami, nucleus anterior thalami, nucleus ventralis thalami, nucleus medialis thalami, nucleus reuniens, nucleus rhomboideus, nucleus habenulae lateralis, nucleus paraventricularis hypothalami, nucleus arcuatus, nucleus lateralis hypothalami, nucleus preopticus lateralis, nucleus septi lateralis, nucleus amygdala, nucleus striae terminalis, nucleus tractus diagonalis, and cortex cerebri. The results demonstrated that peripheral noxious stimulation induced central c-fos protein expression in a pattern of labeling nociresponsive cells.

[Changes of central glucose metabolism following caudate stimulation produced analgesia in the rat--an autoradiographic deoxyglucose A study]

Sokoloff's 2-deoxyglucose (2-DG) autoradiographic technique was used to identify changes of glucose metabolic rate in the rat brain following unilateral stimulation of the head of the caudate nucleus. The results were as follows. The local glucose metabolic rate after noxious stimulation was increased in the somatosensory cortex, cingulate cortex, ventroposterior and parafascicular nucleus of the thalamus, septal area, habenular nucleus, head of caudate nucleus, periaqueductal gray (PAG) and dorsal raphe nucleus (P < 0.05). After stimulating the head of the caudate nucleus, the local glucose metabolic rate of nucleus raphe magnus (rm) and nucleus paragigantocellularis (pgcl) was increased significantly and that of the PAG and dorsal raphe nucleus had a tendency to increase, while stimulation of the head of caudate nucleus could partially abolish the increased glucose metabolic rate in the somatosensory cortex, cingulate cortex, ventroposterior and parafascicular nucleus of the thalamus, septal area and habenular nucleus as induced by noxious stimulation. These results suggest that caudate stimulation is able to depress the activation of some brain structures related to nociception and to activate those related to antinociception. The pgcl, rm, PAG and dorsal raphe nucleus might be the key structures participating in the caudate stimulation produced analgesia.

Neuroprotective effects of phencyclidine on acute cerebral ischemia and reperfusion injury of rabbits

Acute cerebral ischemia and reperfusion injury of rabbits was produced by permanently occluding the vertebral arteries and temporarily clamping the common carotid arteries for 30 min. Phencyclidine [1-(phenylcyclohexyl)piperidine, PCP] 40-80 micrograms.kg-1 icv 30 min before ischemia significantly attenuated the decrease of the total power of electroencephalogram (EEG) within 30 min of ischemia and improved the recovery of brain electric activity following reperfusion. PCP 20-80 micrograms.kg-1 dose-dependently suppressed the creatine kinase (CK) release during cerebral ischemia and reperfusion, and PCP 40-80 micrograms.kg-1 reduced brain ischemic damage. These improvements indicated that PCP has protective effects on acute cerebral ischemia and reperfusion injury.

Carotid body chemoreceptor response to prolonged hypoxia in the rabbit: effects of domperidone and propranolol

1. The discharge of single afferent chemoreceptor fibres was recorded from the cut sinus nerve over periods of 60 or 90 min of constant, isocapnic hypoxia (arterial O2 pressure, Pa,O2, 3.13-5.25 kPa), in twenty anaesthetized rabbits, after dividing the sympathetic supply to the carotid body. 2. Under control conditions, discharge after 60 min of hypoxia adapted to a mean (S.E.M.) of 71.95 (2.75)% of that attained at 5 min of hypoxia in twenty-three hypoxic experiments. This adaptation was more pronounced when Pa,O2 was lower than 4 kPa (30 Torr). 3. Domperidone (1 mg kg-1 bolus + 1 mg kg-1 h-1 infusion I.V.), increased normoxic afferent discharge by a mean of 142%. In ten experiments, discharge after 60 min of hypoxia adapted to a mean (S.E.M.) of 56.22 (+/- 3.40)% of that attained at 5 min of hypoxia which was significantly different from control hypoxic runs (P = 0.006). 4. In seven experiments propranolol (1 mg kg-1 bolus + 1 mg kg-1 h-1 infusion I.V.) did not affect the normoxic discharge. The mean adaptation of discharge after 60 min of hypoxia was to 77.43 (3.97)% of discharge attained at 5 min of hypoxia, which was not significantly different from control hypoxic runs (P = 0.34). 5. Under control conditions plasma [K+] increased steadily during 60 min of hypoxia, in fourteen experiments, from a mean of 2.76 (0.14) to 2.85 (0.12) mmol l-1 but this was not significant (P = 0.21). Domperidone (n = 6) did not affect plasma [K+] at any time, but after propranolol (n = 6) it increased by a mean (S.E.M.) of 0.39 (0.09) mmol l-1 (P = 0.01) in normoxia and by a further 0.62 (0.28) mmol l-1 (P = 0.08) at 60 min of hypoxia. 6. The results suggest that the adaptation of chemoreceptor discharge to hypoxia in the rabbit is not mediated by changes in plasma [K+]; in addition, endogenous dopamine, but not noradrenaline, contributes to the maintenance of chemoreceptor discharge in prolonged hypoxia.

[Effect of electroacupuncture on electroconvulsive shock--an autoradiographic study for opioid receptors]

Radioreceptor-binding assay combined with autoradiography technique in the brain slices of rats was used to investigate cerebral areas related to electroconvulsive shock (ECS) and to analyze changes of opioid receptors of these areas in electroacupuncture (EA) anticonvulsion. The results from image processing and detection of optic density (O.D.) showed that repeated ECS resulted in an increase of opioid receptor densities in the caudate nucleus, hippocampus, habenulae nucleus and amygdala. In the group of EA plus ECS, however, the opioid receptor densities in the hippocampus, habenula nucleus and amygdala decreased as compared with that in ECS group. In addition, the receptor density in the caudate nucleus showed a decrease tendency. The results provided morphological evidence of the involvement of opioid receptors in these cerebral areas in the process of ECS and EA anticonvulsion.

[Change of preoptic opiate receptors after injection of 6-OHDA into sublocus coeruleus in the rabbit]

The formaldehyde histofluorescence method and receptor autoradiography were respectively used to investigate the distribution and densities of the catecholamine (CA) terminals and [3H]-etorphine binding sites, after 20 days of injection of 6-hydroxydopamine (6-OHDA) into N. subcoerulens of the rabbit. The results showed that both CA terminals and [3H]-etophine binding sites in the preoptic area, especially in the medial preoptic area, were reduced in 6-OHDA pretreated animals, thus suggesting the possible location of opioid receptors on the CA terminals.

[Effects of destruction of preoptic catecholaminergic nerve terminals on acupuncture analgesia]

The effect of microinjection of 6-hydroxydopamine into the preoptic area was studied to observe the effect of destruction of catecholaminergic terminals in the preoptic area on acupuncture analgesia. It was shown that the analgesic effect of acupuncture was significantly enhanced in 6-hydroxydopamine treated group on the second and fourth day after injection as compared with those before injection or those in control group. The fluorecence of catecholamine terminals in the preoptic area disappeared almost completely on the fourth day after injection, and did not restore on the tenth day. The data indicate that the reduction of catecholamine content in the preoptic area may enhance acupuncture analgesia.

[Roentgenological and pathological diagnoses of primary osseous alveolar sarcoma--report of 3 cases]

Three cases of primary osseous alveolar sarcoma are reported. The tumor was of two different types as shown on X-ray films. Osteolytic type: the lesions occurred in the flat and short tubular bones with areas of patchy osteolytic destruction. Mixed type: the lesions, located in the long tubular bones, appeared as irregular compact shadow in the bone marrow without periosteal reaction or soft-tissue swelling besides areas of patchy osteolytic destruction. The pathological diagnosis was made according to the following: (1) tumor cells aggregating to form solid nest-like or alveolar structures; (2) antidiastase PAS positive granules in the tumor cell cytoplasm; (3) specific crystals in the tumor cell cytoplasm.