Nuclear image analysis of immunohistochemically stained cells in breast carcinomas

Hitherto, the relationship between malignancy-associated morphological features in single tumour cells and the expression of markers indicating functional properties of these cells remained widely unknown. This study was aimed at describing differences in the size, shape and chromatin structure between tumour cells with different marker expression for progesterone receptors (PgR) and p53. Two series of breast cancers, consisting of 50 PgR-positive, and 39 p53-negative and 49 p53-positive mammary carcinomas, were investigated. The immunohistochemical staining was performed on paraffin sections using 3-amino-9-ethylcarbazole as the chromogenic substrate. By means of a cytometry workstation equipped with a computer-controlled motorised scanning stage, about 500 positive and negative tumour cells in each case were localised in the microscope and categorised by a scoring system for their staining intensity. After destaining, the tissue sections were Feulgen-stained. Then, all the tumour cells were relocated automatically and analysed by high resolution image cytometry. Among the numerous size, shape, and texture features used in the system, several variables of the nuclear contour and chromatin structure were found to be significantly different between the positive and negative tumour cell populations. Nuclei without PgR had more malignancy-associated morphological features than PgR-positive cells. Whereas p53-negative nuclei had a higher degree of regularity, their positive counterparts exhibited higher DNA ploidy values.

Coming to terms: parents' response to a first cancer recurrence in their child

The purpose of this study was to explore, using grounded theory, the process experienced by parents who are dealing with the first recurrence of cancer in their child. The sample of 33 guardians (27 mothers, 1 grandmother, and 5 fathers) was drawn from three pediatric oncology settings. Data were collected through interviews, observations, and medical record review. Thirteen parents were interviewed to validate first the evolving and, later, the complete study findings. Four interactive components emerged: regulating shock, situation monitoring, alternating realizations, and eyeing care-limiting decisions. The overall organizing construct induced from these components was labeled "coming to terms." This construct represents the parents' efforts to overcome shock and despair to make wise decisions about treatment while accepting that the outcome if beyond their control, and to help their child have the optimal chance for cure while preparing for the child's possible death.

Concordance of clinical and environmental isolates of Cryptococcus neoformans var. gattii by random amplification of polymorphic DNA analysis and PCR fingerprinting

Sixty-one clinical and forty-nine environmental isolates of Cryptococcus neoformans var. gattii from Australia and the United States were analyzed by random amplification of polymorphic DNA (RAPD), using 12- to 22-mer primers in pairs, and/or PCR fingerprinting with a single primer derived from the microsatellite core sequence of the wild-type phage M13 (5' GAGGGTGGCGGTTCT 3'). Three major genetic profiles were identified by both typing techniques. A single RAPD profile (VGI) predominated among clinical isolates (44 of 48, 92%) and isolates from host eucalypts (45 of 45, 100%) from Australia. Of the 94 Australian isolates, 4 (3 clinical and 1 environmental) were assigned to profile VGII; 2 of these were recovered from patients and one was recovered from plant debris from Western Australia. Only one Australian clinical isolate was assigned to profile VGIII. A different distribution of RAPD profiles (four VGIII, two VGII, and one VGI) was found among four clinical and three environmental isolates from the United States. RAPD profiles of 8 of the 101 isolates studied revealed minor genetic variants, 4 of profile VGI and 4 of profile VGII. Genetic concordance between the majority of clinical and environmental isolates in Australia is consistent with the hypothesis that human disease is acquired from exposure to host eucalypts. Profiles of clinical isolates were independent of body site of infection, and profiles of all isolates were stable over time. Analysis by PCR fingerprinting confirmed the RAPD results. A second RAPD profile (VGII) was associated with infection in southwest Western Australia, where the two host eucalypts do not occur naturally. This raises the possibility of an alternative and as yet unidentified natural habitat of C. neoformans var. gattii. Our results indicate that RAPD analysis is a sensitive and useful method for investigating environmental sources of human infection with this biotype.

Demonstration of NADPH-diaphorase (NO-synthase) in sebaceous glands of the mammalian integument, with remarks on the glandular capillary net

The study demonstrates weakly to strongly positive reaction staining for NADPH-diaphorase/NO- synthase in the peripheral cells of sebaceous glands in the hairy skin of domesticated mammals. Additionally, the structure of the blood capillary system surrounding these glands is better elucidated. The results obtained are discussed in view of a modulatory action of NO generated by these enzyme activities, implying a direct influence of this substance on the contractile elements of gland-associated blood capillaries. In this way, a simple and self-regulatory mechanism to couple blood flow and glandular metabolism can be proposed.

'Blind' multicenter evaluation of the prognostic value of DNA image cytometric and morphometric features in invasive breast cancer

The prognostic value of classical prognosticators in 92 invasive breast cancers with long follow-up has been compared with a number of DNA-related image cytometric features (2c deviation index (2cDI)), Auer (histogram) type, 5c exceeding rate (5cER), DNA malignancy grade (MG), and the morphometrically assessed mitotic activity index (MAI) and mean nuclear area (MNA). The quantitative analyses were carried out without knowledge of the outcome nor of clinicopathological features. The cytometric analyses and assessments of MNA were performed on Feulgen stained, 4-microns thick tissue sections in Dresden. The MAI was assessed in Amsterdam. Thereafter, the survival data were matched with the classical variables, the cytometric features, the MAI and the MNA in univariate and multivariate analyses. Lymph node status (LN) and tumour stage were significantly different, tumour stage being the strongest discriminator between survivors and non-survivors (Mantel-Cox value = MC = 30.7, P < 0.0001). Grade was (just) significant (P = 0.05). The cytometric features, the MAI and the MNA were all highly significant prognosticators. The strongest cytometric feature was the Auer type followed by the 5cER, and the 2cDI. The MNA was also significant. The MAI was the strongest single prognostic factor in this blind analysis (MC = 50.8, P < 0.0001), and the MAI combined with the lymph node status, tumour stage and the cytometric features Auer type and 2cDI was the best multivariate combination (MC = 94.0). Separate analyses of the lymph node negative (LN-, n = 39) and positive (LN+, n = 53) groups showed that the 5cER and MAI were the most important in the LN- and the MAI in the LN+ patients.

Rapid identification of Candida species by DNA fingerprinting with PCR

DNA polymorphisms in different species and strains of the genus Candida were assessed by amplifying genomic DNA with single nonspecific primers. This PCR method employed an arbitrary primer (the 10-mer AP3), a primer derived from the intergenic spacer regions (T3B), and the microsatellite primers (GTG)5 and (AC)10. Distinctive and reproducible sets of amplification products were observed for 26 different Candida and 8 other fungal species. The numbers and sizes of the amplification products were characteristic for each species. All yeast species tested could be clearly distinguished by their amplification patterns. With all primers, PCR fingerprints also displayed intraspecies variability. However, PCR profiles obtained from different strains of the same species were far more similar than those derived from different Candida species. By comparing species-specific PCR fingerprints of clinical isolates with those of reference strains, clinical isolates could be identified to the species level even if they could not be identified by routine biochemical methods.

[Comments on the suitability of swine skin as a biological model for human skin]

The use of porcine skin as a biomedical model for the human integument is discussed with reference to the literature. The epidermis and dermis can be used as a model as there are clear structural, functional and biochemical similarities with human skin layers. The actual utilization of porcine skin in dermatological research is reviewed. Practical difficulties are emphasized: in particular, the conditions required for use of porcine skin in experimental research, the most suitable breeds, and restrictions on biological interpretation of the results.

[Lymph- and haemangiosis carcinomatosa--an important prognostic factor in non-small-cell bronchial carcinoma (NSCLC)]

Between 1 Jan 1984-1 Jan 1990, 199 patients underwent curative (R0) surgery for non-small cell lung cancer. The pathohistological findings showed that a carcinomatous lymphangiosis and haemangiosis (L/H pos.) were present in 26 patients. In six patients, no lymph node metastases were detected. The median (22 mo. vs. 74 mo.) and 5-year survival (25% vs. 41%) were significantly (p < 0.001) higher compared to patients with and without lymphangiosis and haemangiosis carcinomatosa (L/H neg.). There were also significant (p < 0.05) differences in the survival time between pNO L/H neg. and pNO L/H pos. patients (median 74 mo. vs. 15 mo.-5 years 43% vs. 0%).

Immunohistochemical demonstration of adenohypophyseal hormones during postnatal ontogenesis in the Gray Short-tailed Opossum, Monodelphis domestica (marsupialia)

Antibodies against human FSH, LH, TSH, ACTH, GH, PRL, and MSH were applied to paraffin sections of newborn (< 1) and pouch-young individuals with the age of 1, 2, 3, 4, 5, 6, 7, 8, 10, 11, 13, 14 days, respectively (D1, D2,...). In the pouch-young, the antibody reactions occurred only in the pars distalis of the adenohypophysis. The D < 1 individuals included, the reactions were strong for ACTH, moderate/strong for GH, and moderate for MSH. Reactivity for TSH was recorded first in D2 specimens, for LH in D3 animals, for FSH and PRL in D8 animals. There was a remarkable regional distribution of reactive cells within the pars distalis: reactions for ACTH were localized mainly in the rostral area, those for GH were most prominent caudally. The chronological sequence of appearance of the specific hormone-producing cells in the pouch-young generally is in accordance with the characteristic pattern known in other mammalian species. The late onset of differentiation of some cell types indicates the research possibilities that postnatal Monodelphis domestica can offer in the field of ontogenetic studies on the mammalian endocrine system.

Remarks on specific adaptive scale structure of the hair cuticle in some European bats

Specific regional variation of scale structure of the hair cuticle was demonstrated by scanning electron microscopy in five vespertilionid bat species. Only the tip region of hairs here showed unequal hastate coronal scales with long free parts (blades), and free edges that were distinctly dentate or narrow lobate. This regional peculiarity of the hairs could be explained as an adaptive help to maintain a turbulent boundary layer of air around the body to aid hovering or gliding flight.

Polymerase chain reaction fingerprinting in fungi using single primers specific to minisatellites and simple repetitive DNA sequences: strain variation in Cryptococcus neoformans

Minisatellites and simple repetitive DNA sequence motifs are used as conventional oligonucleotide probes in DNA-hybridization-based fingerprinting. The same oligonucleotides can be used as single primers in the polymerase chain reaction (PCR) to generate individual PCR fingerprints. In this study, the simple repetitive sequences, (CA)8, (CT)8, (CAC)5, (GTG)5, (GACA)4 and (GATA)4, and a minisatellite core sequence derived from the wild-type phage M13 (5' GAGGGTGGCGGTTCT 3') were used as specific, single primers to amplify hypervariable repetitive DNA sequences during PCR analysis. The potential applications of this techniques are demonstrated with clinical isolates of the human pathogenic yeast, Cryptococcus neoformans. PCR fingerprint patterns have remained stable after long-term in vitro passage ( > 2 1/2 years to date). Hybridization of the primers to blots of electrophorectically separated chromosomes demonstrated that the target sequences recognized by most of the primers are dispersed through the entire yeast genome. Sequence analysis of the cloned bands obtained by PCR fingerprinting indicated that if the same or extremely similar, inversely oriented tandem repeats are located close to each other, when only one repeat-specific primer is used in the PCR, the region between these repeats is amplified. PCR fingerprinting has a wide range of current and potential applications to fungi, such as clarifying taxonomic questions, facilitating epidemiological studies and improving the diagnosis of mycotic diseases.

[Psychosomatic aspects of hypertension treatment]

The outlines of doctor-patient relationship are important for the integration of non-drug therapy and drug-therapy in hypertension. Reliable cooperation between patient and physician is an important goal in treatment of hypertensive patients, which implies listening to the patient and a sufficient amount of time. This is especially important for the motivation of these hypertensives, which eventually will take psychotherapy or--and this is the larger group--look for a talk with the doctor and situational relief. An often practised part of this doctor-patient relationship is relaxation therapy.

Immunohistochemical demonstration of non-muscle myosin in the developing porcine epidermis

Using an immunohistochemical technique, the study demonstrates for the first time non-muscle myosin stress fibres in fetal mammalian epidermis, with special regard to cellular development during integumentary ontogenesis in the sparsely haired domesticated pig. The results obtained are discussed in view of possible cytoskeletal functions of the cytofilaments.

Efficacy of school reentry programs

Evaluation of school reentry programs are rarely reported, and statements of the value of reentry programs are usually based on anecdotal information. No known reports of empiric data support claims of positive benefit for burned children. This article reports a multifaceted effort to evaluate the effectiveness of one reentry program involving three approaches: (1) questionnaire answered by the school contact person after reentry program, (2) interviews with a random sample of patients (n = 58) and parents (n = 44) 1 to 5 years after burn, and (3) assessment of patients' behavior problems by teachers on a standardized behavior checklist comparing 10 patients who had a school reentry program involving videos to introduce them to their classmates with 10 patients who were matched for age, sex, and total body surface area burned and had no reentry program beyond phone contact. Results indicate that school reentry programs are popular with teachers and parents. This pilot effort involving empiric data failed to demonstrate a positive effect on the adjustment of the child.

Increase of precision and accuracy of DNA cytometry by correcting diffraction and glare errors

In recent TV-based image cytometers considerable disproportionalities exist between the IOD values of reference cells, as well as diploid, tetraploid, and octoploid analysis cells compared with their theoretical IOD ratios. An important source of these deviations is the limited spatial resolution of the microscopic objectives, based on the effects of diffraction. Compared to these influences the glare is less important. A correcting method is given for reducing both effects on the DNA measurements, which considers a narrow region along the nuclear contour to be optically disturbed. The correction of this mean optical density (MOD)- and size-dependent geometric resolution error is applicable to any cell type. The method was tested on 25 rat liver imprints and 29 fine needle aspirates from breast cancers. The resulting stemline ratios are close to the theoretical ones. A further improvement was then reached by a glare correction. The slide-by-slide variations of stemline ratios, remaining after the corrections, were considered in a test statistic for defining the aneuploidy of a given stemline. Statistically based clear-cut decision rules were obtained for DNA histogram interpretation.

Characterization of the phosphodiesterase inhibition by 2-(3-methoxy-5-methylsulfinyl-2-thienyl)-1H-imidazo-(4,5-c)-pyridine HCl and its sulfide- and sulfone derivatives in myocardial preparations from failing human hearts

The effects of HN-10200 (2-(3-methoxy-5-methylsulfinyl-2-thienyl)-1H-imidazo(4,5-c)-pyridine HCl) and its derivatives HN-10201-sulfide and HN-10202-sulfone on the activities of the phosphodiesterase (PDE) isoenzyme activities isolated from ventricular myocardium of failing human hearts (end-stage myocardial failure, NYHA IV) were investigated. Four PDE isoenzymes (PDE I-IV) were separated by DEAE-sepharose chromatography. Milrinone, 3-isobutyl-1-methylxanthine (IBMX), and a derivative of pimobendan (2-(4-hydroxyphenyl)-5-(5-methyl-3-oxo-4,5-dihydro-2H-6-pyridazinyl)- benzimidazole HCl, PiD) were studied for comparison. Furthermore, the influence of HN-10200 on force of contraction and cAMP content of ventricular trabeculae of these hearts were determined. HN-10200 inhibited the activities of PDE I-IV concentration-dependently. The IC50 values were (mumol/l): 218.7, 283.1, 119.6, and 85.8 for PDE I-IV, respectively. The IC50 values of its derivatives were in the same range, i.e. the parent compound or its derivatives inhibited the PDE isoenzymes nonselectively. IBMX also inhibited PDE I-IV nonselectively, but was about ten times more potent based on IC50 values. In contrast, PiD was the most selective and potent PDE III inhibitor tested. Milrinone inhibited both, PDE III and IV, up to two orders of magnitude more potently than PDE I and II, HN-10200 (30 mumol/l) only marginally and insignificantly increased force of contraction and cAMP content of the ventricular trabeculae. Thus, HN-10200 and it's derivatives HN-10201-sulfide and HN-10202-sulfone are nonselective inhibitors of myocardial PDE I-IV. HN-10200 revealed only neglectable positive inotropic effects in preparations from failing human heart.

Cataracts after bone marrow transplantation: long-term follow-up of adults treated with fractionated total body irradiation

PURPOSE

To determine the risk of, and risk factors for, developing cataracts after bone marrow transplantation.

METHODS AND MATERIALS

Four hundred and ninety-two adults who underwent bone marrow transplantation in Seattle were followed for 2 to 18 (median, 6) years. Before transplantation, patients received a preparative regimen of chemotherapy plus total body irradiation (TBI) (n = 407) or chemotherapy alone, without TBI (n = 85). TBI was administered in a single dose of 10 Gy (n = 74) or in fractionated doses totaling 12-15.75 Gy (n = 333). The risk of cataracts was determined for groups of patients with respect to the type of preparative regimen received and other pretransplant and posttransplant variables.

RESULTS

One hundred and fifty-nine patients (32%) developed cataracts between 0.5 to 11 (median, 2.3) years after transplantation. The probability of cataracts at 11 years after transplantation was 85%, 50%, 34%, and 19% for patients receiving 10 Gy of single-dose TBI, > 12 Gy fractionated TBI, 12 Gy fractionated TBI, and no TBI, respectively (p < 0.0001). Among those developing cataracts, the severity was greater in patients after single-dose TBI (59% probability of surgical extraction) than after > 12 Gy fractionated TBI, 12 Gy fractionated TBI, or no TBI (33%, 22% and 23%, respectively). Patients given corticosteroids after transplant had a higher probability of cataracts (45%) than those without steroids (38%) (p < 0.0001). In a proportional hazards regression model, the variables that were correlated with an increased probability of cataracts were single-dose TBI (relative risk (RR) = 2.46) and steroid therapy (RR = 2.34), while a decreased probability of cataracts was correlated with a nonTBI preparative regimen (RR = 0.41). The yearly hazard of developing cataracts in recipients of single-dose TBI was highest during the third year after transplantation, while in recipients of fractionated TBI, the hazard was distributed among years one through seven. The probability of cataracts in all groups reached a plateau at 7 years after transplantation, after which the development of cataracts was extremely unlikely.

CONCLUSION

TBI is the major risk factor for developing cataracts after BMT. Single-dose TBI results in the highest risk of cataracts. However, the risk of cataracts in recipients of fractionated-TBI is significantly higher than in patients who receive no TBI. In addition to TBI, steroid therapy is an independent risk factor for cataracts after BMT.

[Psychophysical stress reactions during a psychoanalytic interview]

In 37 young volunteers analytically oriented interviews were taken and their effects being compared to those of conventional stressors using mental arithmetic. Because of their similarity to day-to-day stressors we expected higher cardiovascular reactions (blood pressure, heart rate and catecholamines) under interview situations than in mental arithmetic. Conforming this hypothesis, we found higher reactions in blood pressure regulation, while heart rates were not higher under interview situations compared to laboratory stressors. Epinephrine showed a qualitative difference: Only in interview situations we found a significant rise of 27%. Plasma cortisol also showed a rise in interview situations, however, smaller. We therefore suggest, that analytically oriented interviews are an adequate method to investigate cardiovascular reagibility in young hypertensive-prone persons.

Pentoxifylline and ciprofloxacin in patients with myelodysplastic syndrome. A phase II trial

Tumor necrosis factor (TNF) inhibits hematopoietic cell proliferation. The combination of pentoxifylline (PTX) and ciprofloxacin (Cipro) has been previously shown to reduce circulating serum levels of TNF. In this Phase II trial 14 patients with advanced myelodysplastic syndrome were treated with PTX (2,000 mg/day) and Cipro (1,000 mg/day) in order to determine tolerability and effect on peripheral blood cell counts, progenitor cell responsiveness to cytokines and circulating serum levels of interleukin-6 (IL6) and TNF. Toxicity attributed to PTX and Cipro were limited to nausea in 4 patients. Peripheral blood cell counts, platelet transfusion requirements and red blood cell transfusion requirements did not change during administration of PTX and Cipro (daily for 28 days). Marrow progenitor cells of patients entered into trial were less responsive to stimulation with cytokines in vitro at baseline and during the trial compared to normal volunteers. Eight patients had elevated IL6 levels before treatment with PTX and Cipro these levels did not change during therapy. Five patients had elevated TNF levels at baseline. There was a suggestion of decreased TNF levels during treatment with PTX and Cipro (P = .09). In conclusion, PTX and Cipro was well tolerated but no evidence of efficacy was observed.

Purification, cloning, and sequencing of archaebacterial pyrophosphatase from the extreme thermoacidophile Sulfolobus acidocaldarius

Cytoplasmic pyrophosphatases are indispensible for the function of cellular bioenergetics. From the extreme thermoacidophilic archaeon Sulfolobus acidocaldarius, situated at one of the lowest branches of the phylogenetic tree, a cytosolic pyrophosphatase has been isolated and purified 200-fold to electrophoretic homogeneity by combining ion-exchange and gel-exclusion chromatography. The native enzyme consists of a homotetramer of 71 kDa apparent molecular mass; the subunit displays an apparent molecular mass of 17 kDa on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The enzyme has an absolute requirement for divalent cations (Mg2+) and a temperature optimum of 75 degrees C coinciding with the growth optimum of the organism; the apparent estimated activation energy is 79.5 kJ/mol. A large variety of cytosolic extracts from other archaebacteria has been probed with a polyclonal antiserum raised against the purified protein; surprisingly, except for an extremely weak signal with S. solfataricus none of the other organisms showed any cross-reactivity. Also, Escherichia coli PPase does not cross-react. Based on N-terminal sequencing the gene has been cloned and sequenced. It codes for a 173-amino-acid protein with a calculated molecular mass of 19,365 kDa. Alignment with known eucaryotic and procaryotic PPases reveals invariant conservation of all residues presently assumed to be involved in metal and substrate binding. Unexpectedly, the highest similarity is found with the enzyme from the phylogenetically extremely distant eubacterium E. coli, but immunological cross-reactivity is absent. Similarity to the only known other archaebacterial PPase is much weaker. Using the 3D structure of the Thermus thermophilus enzyme as a scaffold an energy-minimized structural model is presented, deviating only minimally from the former. The structural features are discussed. The enzyme provides an excellent model for studies of thermostability and folding dynamics since heterologous overexpression has been achieved and genetically mutated forms become accessible.