The development of squamous cell metaplasia in human bronchial epithelium by light microscopic morphometry

EFFECTIVE DOSE COEFFICIENTS FOR RADON AND PROGENY: A REVIEW OF ICRP AND UNSCEAR VALUES

The International Commission on Radiological Protection (ICRP) publishes guidance on protection against radon exposure in homes and workplaces. ICRP Publication 137 recommends a dose coefficient of 3 mSv per mJ h m-3 (~10 mSv WLM-1) to be used in most circumstances of radon exposure, for workers in buildings and in underground mines. Recently, United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) reviewed radon epidemiology and dosimetry and concluded that its established dose coefficient of 1.6 mSv per mJ h m-3 (5.7 mSv WLM-1) should be retained for use in its comparisons of radiation exposures from different sources in a population. This paper explains and compares the reviews of the scientific evidence from UNSCEAR and ICRP. It is shown that the UNSCEAR and ICRP reviews are consistent and support the use of the ICRP reference dose coefficients for radiation protection purposes. It is concluded that the ICRP dose coefficient should be used to calculate doses to workers.

Histomorphometric parameters and fractal complexity of the equine placenta from healthy and sick foals

Computer-based digital image analysis of tissue samples shows promise both to reduce the subjectivity of traditional manual tissue assessments and potentially to shorten the time required to analyze each sample. The present study used digital image analysis to investigate the histomorphometric parameters and fractal complexity of the equine placenta from healthy and sick foals. We hypothesized that the placentas of sick foals could have a different growth pattern and complexity that could be objectively estimated by their fractal dimension (FD). Fourteen placentas from 30 mares were selected in the 2013 breeding season and divided into two groups: seven mares with normal pregnancy, eutocic delivery, and healthy foals (group 1) and seven mares with normal or high-risk pregnancy, eutocic delivery and sick foals (group 2). Four mares in group 2 were classified as having a high-risk pregnancy on the basis of anamnesis and/or ultrasound findings. Clinical diagnosis of group 2 foals included perinatal asphyxia syndrome (n = 4), prematurity/dysmaturity (n = 2), and both diagnoses (n = 1). Seven out of fourteen placentas showed diffuse gross abnormalities. Grossly abnormal placentas were observed in one out of seven (14.28%) animals in group 1 and in six out of seven (85.72%) animals in group 2. Digital image analysis proved to be reliable and efficient in segmentation, calculation, outline extraction of villi as also resulted in sampled test images. The placentas of group 1 foals displayed a uniform and homogeneous villi development, as revealed by geometric parameters and FD. These results can be interpreted as a harmonic growth pattern of microcotyledons throughout the placenta in healthy foals. By contrast, the placentas of group 2 foals showed a nonuniform growth pattern and complexity with more villi and more developed villi in pregnant horn (PH) and nonpregnant horn (NPH) compared with body (B) and higher FD in NPH than in the other areas. This finding can be interpreted as a compensatory growth with increased complexity. Our results show that morphometric analysis, particularly FD measurement, can be proposed as an ancillary histological tool for equine placenta evaluation. Chorionic villi tend to have greater branching and complexity in sick than in healthy foals, particularly in the NPH. This could represent an attempt to increase the exchange area between fetal and maternal compartments of the equine placenta, and merits further investigation.

Lung dosimetry for inhaled radon progeny in smokers

Cigarette smoking may change the morphological and physiological parameters of the lung. Thus the primary objective of the present study was to investigate to what extent these smoke-induced changes can modify deposition, clearance and resulting doses of inhaled radon progeny relative to healthy non-smokers (NSs). Doses to sensitive bronchial target cells were computed for four categories of smokers: (1) Light, short-term (LST) smokers, (2) light, long-term (LLT) smokers, (3) heavy, short-term (HST) smokers and (4) heavy, long-term (HLT) smokers. Because of only small changes of morphological and physiological parameters, doses for the LST smokers hardly differed from those for NSs. For LLT and HST smokers, even a protective effect could be observed, caused by a thicker mucus layer and increased mucus velocities. Only in the case of HLT smokers were doses higher by about a factor of 2 than those for NSs, caused primarily by impaired mucociliary clearance, higher breathing frequency, reduced lung volume and airway obstructions. These higher doses suggest that the contribution of inhaled radon progeny to the risk of lung cancer in smokers may be higher than currently assumed on the basis of NS doses.

The prognostic significance of morphometry for squamous cell hyperplasia of the laryngeal epithelium

Laryngeal biopsies of squamous cell hyperplasia with atypia were graded by means of morphometry, using five non-correlated nuclear parameters preselected with linear discriminant analysis, and were tested for their prognostic significance, in a follow-up study. Fifty-two biopsy specimens were obtained from 18 patients who were merely followed and if necessary underwent a repeated biopsy examination. The lesions of 10 patients progressed to invasive carcinoma. In 8 patients the second or further biopsies were again classified as squamous cell hyperplasia with atypia. For both groups the mean follow-up period was 7.2 years (range: 3 1/2-11). In the progressive group 73% of the biopsies were morphometrically classified as prognostically unfavourable, whereas the clinical outcome on the basis of the last biopsy was correctly predicted for 6 out of the 10 cases (mean probability: 94%), the other 4 cases were 'mis-classified', although for 3 cases with a low probability (mean: 60%). For a valuable morphometrical classification of lesions of individual patients, the results as presented are still insufficient. Morphometrical classification probabilities may be improved when the numbers of untreated patients with squamous cell hyperplasia with atypia do increase.

Karyometry of pseudostratified, metaplastic and dysplastic nasal epithelium by morphometry and stereology. 2. Automated image analysis (IBAS) of the basal layer of nickel workers

A mathematical model for the stereological analysis of parallel-oriented, spheroidal nuclei has been applied to the basal layers of respiratory, metaplastic and dysplastic nasal epithelia. Nuclear profiles seen on tissue sections were measured with an automatic image analyser (IBAS). Nuclear profile area distributions were used to assess possible polyploidies. The result are compared to the histopathological grading, consisting of pseudostratified (respiratory), cuboidal, mixed cuboidal/squamous, squamous, and dysplastic epithelia. The estimated nuclear axis lengths, volumes, surface areas and volume/surface ratios are, in the great majority of cases, significantly smaller in pseudostratified or cuboidal epithelium than in squamous metaplasia and dysplasia. Correspondingly, the numerical density of the nuclei is lower in the latter cases, in which is also noted a smaller nuclear eccentricity. No significant difference is found between the nuclei of squamous and dysplastic epithelia. There is a clear correlation between the mean profile areas and the stereologically estimated volumes of the nuclei. When classifying the mean profile areas into four classes, a progressive shift from the smaller towards the larger size classes is observed when passing from pseudostratified to dysplastic epithelia, through the different metaplastic stages. The nuclear profile area plots often show several peaks, even in some pseudostratified and cuboidal epithelia, probably reflecting polyploidy. There is a marked tendency towards larger profile areas in squamous metaplasia and dysplasia. One histopathologically typical dysplasia showed only small-sized nuclei and another had a notable contribution of those in its profile area plot, in contrast with all the other dysplasias and squamous metaplasias, which displayed practically no small nuclei. The possible implications of the existence of "small-sized-nuclei-dysplasias" are discussed. The literature dealing with nuclear volumes or DNA quantities in putative preneoplastic situations in reviewed. Our method adds some valuable objective criteria to those used in classical histopathological grading. It should be possible to apply this method to other epithelial tissues.

Histogenesis of benzo(a)pyrene-induced lesions in tracheal explants

Cytokinetic and histogenic alterations associated with the development of benzo(a)-pyrene (BP) induced epidermoid metaplasia were studied in tracheal explants derived from normal hamsters. Treatment of the explants with BP induced hyperplasia in both the basal and mucous cells. The hyperplasia of the basal cells persisted throughout the duration of the experiment whereas the hyperplasia of the mucous cells subsided between 7 and 10 days after treatment. This was accompanied by stimulation of ciliated cell differentiation and aberrant ciliogenesis which was not limited to the surface cells since some basal cells were observed differentiating into ciliated cells. Subsequently, the differentiation of basal cells into mucous cells was inhibited. Instead, the basal cells differentiated into metaplastic cells. With the progression of the lesions, the mucociliary surface layer was sloughed into the lumen due to the population pressure from the underlying actively proliferating metaplastic cells and their subsequent epidermoid differentiation. Approximately 50% of the explants exhibited focal areas of squamous metaplasia at 7 days after the treatment and extensive epidermoid metaplasia was present in approximately 90% of the explants at 10 days. These results support the hypothesis that BP induced epidermoid metaplasia of tracheal explants originates from the basal cells.

Discrimination of various epithelia by simple morphometric evaluation of the basal cell layer. A light microscopic analysis of pseudostratified, metaplastic and dysplastic nasal epithelium in nickel workers

This study presents a simple morphometric method for objective classification of pseudostratified, various types of metaplastic, and dysplastic epithelium by evaluation of cellular features in the basal layer only. Fifty-four biopsy specimens were taken for diagnostic reasons from the nasal mucosa of nickel workers, and semithin toluidine-blue-stained sections were analysed. The most sensitive parameters in distinguishing between the various types of epithelium were: (i) the transverse nuclear diameter, (ii) the size of the nucleoli and (iii) the basal cell width expressed as an index weighted towards the cell profiles with the broadest attachment face on the basal lamina. A combination of these three parameters allows a clear separation between dysplastic, metaplastic and pseudostratified epithelium. The sequential increase in these parameters from pseudostratified epithelium through two histologically distinguishable stages of metaplasia (stratified cuboidal and mixed stratified cuboidal/stratified squamous epithelium) to fully developed squamous epithelium supports the concept that metaplasia develops gradually. The continuous increase in these parameters from metaplasia to dysplasia further suggests that metaplasia is a necessary step in the development of nasal epithelial dysplasia. This morphometric model appears especially useful in monitoring small sequential epithelial changes, and might also be used for evaluating other types of epithelia.

A simple and efficient method for objective discrimination between pseudostratified, metaplastic and dysplastic nasal epithelium

Morphologic features may sometimes be interpreted differently by different pathologists. By introducing objective methods in the histological evaluation the subjectivity of the judgement is reduced and a higher degree of consistency achieved. In the present study three linear parameters of nasal epithelial basal cells: the largest transversal nuclear diameter, the sum of the longitudinal and transversal nucleolar axes and the basal cell width, i.e. the width of the attachment face to the basement membrane, were classified by means of three-class rulers. From this classification weighted indices were made which were then given equal weight and transformed, so that when added up their sum, the joint index (Q) to the largest possible extent was consistent with pseudostratified/stratified cuboidal, stratified squamous and dysplastic epithelium when Q less than or equal to 1, 1 less than Q less than or equal to 2 and Q greater than 2 respectively. Tested prospectively we found 91% agreement between the morphometric and histological classification. The method presented is extremely simple and rapid to perform, and appears to have diagnostic potential in distinguishing various types of epithelial alterations of the nasal mucosa. The method may also be useful in approaching similar problems in other epithelia.

Recovery of bronchial epithelium on stopping smoking

Bronchial biopsy specimens were studied from 19 patients, comprising five non-smokers, eight current smokers, and six people who had given up smoking between two and 16 years previously. By using a recently developed morphometric technique the structural state of the bronchial epithelium was assessed and described by a score, which specifies the extent to which the epithelial histology departs from the normal, through the changes of mucous-cell hyperplasia and squamous-cell metaplasia. The epithelium was nearer normal in former smokers than current smokers in each of six pairs matched for smoking history. The numerical scale permitted statistical analysis with a precision that is not possible with data based on subjective diagnosis alone: the results of comparing histology with pack-years of cigarette consumption were consistent with the hypothesis that structural recovery occurs in bronchial epithelium in people who stop smoking for over two years.