Incidence of Type 1 Diabetes in Children Aged Below 18 Years during 2013-2015 in Northwest Turkey

Objective

To assess the incidence of type 1 diabetes mellitus (T1DM) in children under 18 years of age in the northwest region of Turkey during 2013-2015.

Methods

All newly diagnosed T1DM cases were recorded prospectively during 2013-2015. Total, as well as gender and age group specific (0-4, 5-9, 10-14 and 15-17 age) mean incidences per 100,000 per year were calculated.

Results

There were 1,773 patients diagnosed during 2013-2015 (588 cases in 2013, 592 cases in 2014, 593 cases in 2015). Of these, 862 (48.6%) were girls and 911 (51.4%) were boys. The mean age at diagnosis was 9.2±4.2 years and it was not significantly different between girls (9.0±4.1 years) and boys (9.4±4.4 years) (p=0.052). The crude mean incidence was 8.99/100.000 confidence interval (CI) (95% CI: 8.58-9.42). Although mean incidence was similar between boys [8.98/100.000 (CI: 8.40 to 9.58)] and girls [9.01/100.000 (CI: 8.42 to 9.63)], there was male predominance in all groups except for 5-9 year age group. The standardized mean incidence was 9.02/100.000 according to the World Health Organization standard population. The mean incidence for the 0-4, 5-9, 10-14 and 15-17 age groups was 6.13, 11.68, 11.7 and 5.04/100.000 respectively. The incidence of T1DM was similar over the course of three years (p=0.95). A significant increase in the proportion of cases diagnosed was observed in the autumn-winter seasons.

Conclusion

The northwest region of Turkey experienced an intermediate incidence of T1DM over the period of the study.

Neonatal Diabetes: Two Cases with Isolated Pancreas Agenesis due to Homozygous PTF1A Enhancer Mutations and One with Developmental Delay, Epilepsy, and Neonatal Diabetes Syndrome due to KCNJ11 Mutation

Neonatal diabetes mellitus is a rare form of monogenic diabetes which is diagnosed in the first six months of life. Here we report three patients with neonatal diabetes; two with isolated pancreas agenesis due to mutations in the pancreas-specific transcription factor 1A (PTF1A) enhancer and one with developmental delay, epilepsy, and neonatal diabetes (DEND) syndrome, due to a KCNJ11 mutation. The two cases with mutations in the distal enhancer of PTF1A had a homozygous g.23508363A>G and a homozygous g.23508437A>G mutation respectively. Previous functional analyses showed that these mutations can decrease expression of PTF1A which is involved in pancreas development. Both patients were born small for gestational age to consanguineous parents. Both were treated with insulin and pancreatic enzymes. One of these patients’ fathers was also homozygous for the PTF1A mutation, whilst his partner and the parents of the other patient were heterozygous carriers. In the case with DEND sydrome, a previosly reported heterozygous KCNJ11 mutation, p.Cys166Tyr (c.497G>A), was identified. This patient was born to nonconsanguineous parents with normal birth weight. The majority of neonatal diabetes patients with KCNJ11 mutations will respond to sulphonylurea treatment. Therefore Glibenclamide, an oral antidiabetic of the sulphonylurea group, was started. This treatment regimen relatively improved blood glucose levels and neurological symptoms in the short term. Because we could not follow the patient in the long term, we are not able to draw conclusions about the efficacy of the treatment. Although neonatal diabetes mellitus can be diagnosed clinically, genetic analysis is important since it is a guide for the treatment and for prognosis.

EDUCATION TO REDUCE POTASSIUM LEVELS IN ADOLESCENT, HAEMODIALYSIS PATIENTS

A semi-experimental survey was carried out. The aims included assessing how knowledgeable adolescents undergoing haemodialysis treatment were regarding hyperkalaemia, and determining how effective an education programme in preventing hyperkalaemia would be. 31 volunteers (twelve girls and nineteen boys), who had two or three haemodialysis treatments a week, were included in the study. Data were obtained through a questionnaire, the answers to which were written down for each participant separately by the researcher. A manual was prepared with the aim of educating children in hyperkalaemia, the participants were taught lessons in groups of two to three at a time. The education programme was completed in eight sessions. At the end of the programme each participant was given a copy of the manual. A month after the education programme, participants were asked to refill the section of the aforesaid questionnaire. The scores in this section had increased, and blood potassium levels had significantly decreased (p = 0.02).

Immunophenotypic analysis of human spleen compartments

Microanatomical compartments of the human spleen are yet under evaluation as most of the present information comes from experiments on animals with different anatomical structures. Immune staining of stromal and blood-born cells by cell surface antigens facilitates the differentiation of functional microanatomical compartmentalization of immune organs, including the spleen. Twenty-two specimens from healthy adult subjects with the average age of 35.6 +/- 13.8 (Range 17 to 58) years were included in this study. Monoclonal antibodies used in this study were supplied from the 5th, 6th and 7th International Workshops and Conferences on Human Leukocyte Differentiation Antigens. Tetraspan antigens presented a rather unique staining pattern in the human spleen, suggesting special roles for each (CD9, CD53, CD63, CD151 and CD231) in certain locations. Sinus lining cells presented a distinctive antigenic profile, sharing both endothelial cell (CD31, CD36, CD54, CD62P, CD102, CD105, CD106 and CD146) and macrophage lineage characteristics. The sheathed capillaries were not restricted to the perifollicular zone alone. Extracellular matrix receptors (CD49 a, CD49 b, CD49 c, CD49 e, CD49f, CD29 and CD44) stained the penicillary arterioles and vascular smooth muscle. These molecules were also found on the vascular endothelium. Leukocyte antigens (CD11a, CD11b, CD22, CD43, CD45, CD45RB, CD45RO and CD50) were mainly expressed in the white and red pulp of the spleen at different intensities, excluding the penicillary arterioles. Activation antigens (CD26, CD71 and CD98) presented a diffuse and broad staining pattern. In conclusion, microanatomical compartmentalization, microcirculation and function of the human spleen were evaluated using a wide panel of monoclonal antibodies.

Neural cell adhesion molecule and neurothelin expression in human ameloblastoma

PURPOSE

The objective of the present study was to determine whether neural cell adhesion molecules (NCAM; CD56) and neurothelin (CD147) are expressed by adontogenic cells in the ameloblastoma.

MATERIALS AND METHODS

Frozen sections from ameloblastoma specimens (n = 7) were stained with monoclonal antibody-recognizing CD56 and CD147 molecules using indirect immunoperoxidase and indirect immunofluorescent techniques.

RESULTS

CD56 and CD147 molecules were strongly expressed by the peripheral columnar cells of the tumor nests. Neurothelin reactivity was also present in the stellate reticulum of the nests and in some stromal components.

CONCLUSIONS

The presence of these antigens in ameloblastoma supports the classic view about the neural crest origin of cells giving use to this tumor.

Changes in bladder of rabbits subjected to elevation of intraabdominal pressures

BACKGROUND/PURPOSE

An experimental study has been conducted to evaluate the effects of increased intraabdominal pressure (IAP) on the morphology of the bladder of rabbits.

METHODS

Experiments were performed on 20 adult male New Zealand rabbits. Six rabbits served as the control group (group I). Seven rabbits were subjected to increased IAP of 7 cm H2O for 10 days through installing air into the abdominal cavity (group II). Increased IAP was maintained for 60 days in another group of 7 rabbits (group III). Bladders were removed and fixed in 10% formalin for routine process. Paraffin sections of 5 to 7 microm were stained with H & E for light microscopic evaluation. Histopathologic parameters were scored, and the mean scores according to groups were compared by 1-way analysis of variance (ANOVA). The mean values of groups were compared separately by Tukey-Kramer multiple comparison test. In these tests, P value less than.05 was considered statistically significant.

RESULTS

All of the bladder strips obtained from animals subjected to 10 days of pressure increase (group II) showed mild to severe degree of vacuolation and desquamation of urothelium. Both vacuolation and desquamation of urothelium were present in all of the strips obtained from rabbits with 60 days pressure increase (group III). Additionally, there were infiltration and congestion of the urothelium together with vacuolation, suburothelial edema, and desquamation in 4 group III rabbits. Moderate or severe congestion in the lamina propria was present in bladder strips of group II rabbits. The congestion of the lamina propria was advanced, and additional moderate to severe inflammation was present in 4 rabbits of group III. Mean histopathologic scores of urothelium (P <.00001) and lamina propria (P =.002) differed significantly among groups. When the groups were compared one by one, the differences between the group I and group II and group II and III were significant (P <.05). Although serosa appeared normal in both group I and II, moderate congestion and infiltration of the serosa was present in the bladder strips of group III (P <.05).

CONCLUSION

Increases in IAP for even 10 days show damaging effects on the bladder. Extended period resulted in augmentation of the damage.

Ultrastructural deficiency in autonomic innervation in cremasteric muscle of boys with undescended testis

BACKGROUND/PURPOSE

The cremaster muscles (CM) associated with undescended testis reveal neurogenic alterations that mainly affect type 2 fibers. The ultrastructure of CM has been evaluated to define if further evidence to explain the alterations could be identified.

METHODS

CM of 8 boys with inguinal hernia and 8 boys with undescended testis at similar ages were biopsied. Samples were processed for electron microscopic evaluations. Semithin and thin sections were examined under an electron microscope.

RESULTS

The CM associated with inguinal hernia showed normal ultrastructure. However, some alterations were encountered in CM associated with undescended testis. Unmyelinated fibers were diminished in number, and myelinated fibers were outnumbering the unmyelinated fibers. Marked disorientation of myofibers, redundant sarcolemma, empty sleeves of basal lamina, disarray of myofibrils, densely packed myofilaments, Z disk streaming, dilated sarcoplasmic reticulum, and dense-irregularly shaped mitochondria were repeatedly encountered. Satellite cells appeared inactive. Most of the fibers were contracted.

CONCLUSIONS

The decrease in number of unmyelinated fibers appears to represent a decrease in autonomic nerve fibers. The alterations within muscle fibers may reflect a deficiency in autonomic innervation. Autonomic nervous system is highly responsive to circulating androgens. Factors decreasing the vulnerability of autonomic nervous system against androgenic effects may result in a CM with neurogenic alterations, thus inhibiting testicular descent. J Pediatr Surg 36:573-578.

Expression of beta 1 integrins in human dental pulp in vivo: a comparative immunohistochemical study on healthy and chronic marginal periodontitis samples

AIM

The objective of this study was to determine the tissue distribution of beta 1 integrin chains in sound human dental pulps and to compare the findings with connective tissue compartments of other organs and to pulp tissue in teeth extracted due to periodontal disease.

METHODOLOGY

Freshly frozen pulp tissue samples from teeth extracted for orthodontic reasons were examined and compared to samples from teeth extracted due to chronic (marginal) periodontitis. beta 1 integrin chains were determined using an indirect-immunoperoxidase technique. Seven monoclonal antibodies recognizing alpha 1, alpha 2, alpha 3, alpha 4, alpha 5, alpha 6 and beta 1 chains of Very Late Activation Antigen (VLA) integrins were used for this purpose.

RESULTS

VLA-1, VLA-2, VLA-3 and VLA-5 were expressed by vascular endothelium and vascular smooth muscle in varying intensities in both groups. VLA-6 reactivity was observed in the basal surfaces of arterial, venous and capillary endothelia. Our results indicate that there was no significant difference in the expression of VLA integrins in sound pulp tissue when compared to the samples from chronic (marginal) periodontitis and the connective tissue compartments of other viscera.

CONCLUSION

The present findings suggest that human dental pulp tissue is not different from other connective tissue compartments in the body with respect to VLA integrin expression, and chronic marginal periodontitis does not affect pulp tissue to a histopathologically detectable extent.

Unreported anatomical variation of septum pellucidum

During gross anatomy dissections of the brain, a developmental abnormality of the septum pellucidum was found in a 31-year-old male cadaver. Other parts of the central nervous system in this cadaver were normal in every aspect. Histological samples were taken from the neighboring areas of this abnormality, and they were examined under light microscope and scanning electron microscope. In this abnormality of the septum pellucidum, the two laminae of the septum pellucidum were fused together and there was a hole located 1 cm anterior to its apex. The maximum diameter of the hole was 0.5 cm in the sagittal plane and 0.6 cm in the vertical plane. In the light microscopic and scanning electron microscopic examinations, the free margin of this foramen was regular, and the surrounding tissue was intact and histologically unique to the septum pellucidum. Ependymal cells were present at the free margin of the foramen. Cavum vergae, cavum septum pellucidum, and agenesis of the septum pellucidum are described in the literature. These three abnormalities are seen in cadavers usually with histories of schizophrenia and other psychiatric or neurologic disorders. In a retrospective study, the cadaver with this abnormality had a history of schizophrenia and no history or signs of any kind of brain or head operation. As far as we could ascertain, the abnormality described here has not been reported previously.

CD45/isotypes expression in the immune cells of human periapical lesions

Expression of some leukocyte antigens (including CD45) and its isoforms (CD2, CD4, CD5, CD6, CD7, and CD8) was examined in the human periapical granulation tissue samples in the present study. The majority of the infiltrating cells expressed heavy molecular-weight isoforms of the CD45 antigen. Expression of CD2, CD5, CD6, and CD7 antigens was also detected, implying significant roles for these antigens in the immune reaction taking place in periapical lesions. This suggests that the immune response taking place at the periapical region is predominantly cellular and the humoral responses to antigenic challenge are conducted mainly by regional lymph nodes.

Endothelial cell and stromal antigens in human periapical granulation tissue

Periapical granulation tissue consists of vasculature of varying sizes and types, infiltrating cells, and other stromal elements. We examined the differential expression of endothelial and stroma antigens in this tissue to determine their tissue distribution in order to obtain hints on their functions. Some of the antigens examined were present only in the endothelial lining of vasculature, including high endothelial venules (e.g. CD31 and CD105), whereas others were more widely expressed by both vascular and stromal elements (e.g. CD29, CD63, CD44, and CD151). Immunohistochemical analysis using monoclonal antibodies specific to certain tissue compartments revealed the tissue architecture more precisely and the expression of certain antigens in the tissue suggested special roles for these antigens. Tissue distribution of CD63, CD143, CD147, and CD151 in periapical granulation tissue is first reported in the present study.

Vasculogenesis in early human placental villi: an ultrastructural study

In this study we examined the chorionic villi of 5 normal human placentas at 12-14 weeks of gestation ultrastructurally with regard to differentiation of the vascular components. The aim of the present report is to discuss the factors influencing vasculogenesis (in situ formation of blood vessels) at the ultrastructural level. Our observations have led us to think that the cytotrophoblast influences vasculogenesis in human chorionic villi. Mesenchymal-preendothelial cell groups were always found in very close association with the cytotrophoblast at the periphery of the villi, forming blood vessels. The cytotrophoblast probably attracts mesenchymal cells towards the margin of the villi by secreting vascular endothelial growth factor (VEGF). Once cells attach to the trophoblastic basement membrane they begin to differentiate into endothelial cells. This close structural relation between two cell types (cytotrophoblast and mesenchymal cells) may not be the only mechanism controlling vasculogenesis, but it seems to be one of the factors influencing the differentiation of mesenchymal cells into the endothelial cells of blood vessels in early human chorionic villi.

Endothelial cell adhesion molecules in human dental pulp: a comparative immunohistochemical study on chronic periodontitis

Migration of leukocytes to inflammation sites through vascular endothelium is controlled by the interactions of adhesion molecules expressed on both endothelial cells and leukocytes, most of which are already covered by cluster of differentiation (CD) codes. We examined the expression of a variety of endothelial cell adhesion molecules in human dental pulp vasculature to obtain further evidence on the tissue distribution and function of these molecules by using an indirect immunoperoxidase technique. We obtained the pulp tissue samples from teeth extracted due to orthodontic reasons as controls and compared with those extracted due to chronic periodontitis. In all samples, both CD31 and CD146 were expressed by arterial, venous, and capillary endothelia. There was no significant difference between the staining intensity of normal and inflamed pulp tissues. CD102 expression on the endothelium was significantly stronger in chronic periodontitis pulp samples. CD106, CD62-E, CD62-P, CD105, and CD54 were variably expressed in control and chronic periodontitis groups. Our results indicate that CD102 represents the major endothelial cell adhesion molecule probably involved in the inflammatory reactions in chronic periodontitis.

Cysts in human thymus: maturational forms of Hassal's corpuscles?

Presence of extracellular cystic cavities in the thymus of many vertebrates has long been known. Various forms of such structures in human thymus were observed and examined thoroughly on immunostained and serial semithin sections. We grouped these structures into five categories according to their most characteristic features. The lympho-epithelial content of the cysts clearly reflected the structural features and antigenic profile of thymic cortical parenchyma in both elongated and ovo-spherical cysts. Our findings suggest that the various types of cystic structures observed in human thymus may represent maturational stages of classical Hassal's corpuscles. Presence of cortical lympho-epithelial content and its gradual replacement with debris material also suggests a unique mechanism of thymocyte disposal.

Inguinal hernia revisited through comparative evaluation of peritoneum, processus vaginalis, and sacs obtained from children with hernia, hydrocele, and undescended testis

BACKGROUND/PURPOSE

Histological structures of peritoneum, processus vaginalis, and sacs obtained from girls with inguinal hernia and boys with inguinal hernia, hydrocele, and undescended testis have been compared through immunohistochemical features to evaluate if any clue descriptive for the etiology of inguinal hernia exists.

METHODS

Parietal peritoneums (n = 6), processus vaginalises (n = 4), female hernia sacs (n = 5), male hernia sacs (n 12), and sacs from hydrocele (n = 5) and undescended testis (n = 9) were stained with indirect immunoperoxidase method. Anti-CD9, CD26, CD29, CD31, CD36, CD44, CD49a, CD49b, CD49c, CD49d, CD49e, CD49f, CD54, CD55, CD56, CD62E & P, CD71, CD98, CD102, CD106, CD146, CD151 monoclonals and NFL-NPH, S-100 antiserums were used. The histological structures of each group of samples were identified and compared.

RESULTS

Smooth muscle layers have been encountered within the walls of hernia sacs of both boys and girls. Although the hydrocele sacs have shown smooth muscle bundles distributed as patchy areas, smooth muscle bundles have been observed infrequently among sacs from patients with undescended testis. Peritoneum and processus vaginalis samples have been free of smooth muscle.

CONCLUSIONS

Inguinal hernia during childhood seems to be related to the presence of smooth muscle within the wall of the sac. The smooth muscle bundles may have played a role both in prevention of obliteration and clinical outcome. Because the sacs associated with undescended testis are without smooth muscles, and herniation is not a frequent association, they may not share the same etiologic basis with inguinal hernia.

Light and electron microscopic examination of exocrine pancreas using zinc iodide-osmium tetroxide technique

Zinc iodide-osmium tetroxide (ZIO) fixation/staining technique is a metallophilic technique which has been used for the examination of various tissues and cell types. We examined the ZIO (+) cell types in rat exocrine pancreas to obtain further evidence for the significance of the reaction. Among mostly non-reactive pancreatic acinar cells there were ZIO (+) acinar cells of varying staining intensity. Zymogenic granules and centroacinar cells were completely non-reactive. Our electron microscopic findings support the view that the reactivity of the technique used is cell specific but not cell type or organelle specific.

Endoglin (CD 105) expression in human lymphoid organs and placenta

Endoglin (CD 105) is a cell surface antigen widely expressed on vascular endothelium, syncytiotrophoblast, some tissue macrophages, certain culture cells (including early leukemic B-lineage) and some endothelial cell lines. Though its relation to the transforming growth factor-beta (TGF-beta) receptor system is well documented, its function and detailed pattern of expression still remain to be clarified. We examined the differential tissue distribution of endoglin in human lymphoid organs and placenta with several anti-CD 105 monoclonal antibodies (mAbs) using an indirect immunoperoxidase technique, and performed semi-quantitative measurements using an image-analyzing system for comparison. Arterial, venous and capillary endothelia in these organs were reactive with anti-CD 105 mAbs at varying intensities. Interestingly, a distinctly stronger staining pattern was observed in the high endothelial venules (HEVs) which may indicate a special role for endoglin in lymphocyte trafficking. Syncytiotrophoblast expressed endoglin strongly on their apical cell membrane. Extravillous trophoblasts at certain locations selectively expressed endoglin on their cell membranes, suggesting a special role for this surface antigen during trophoblast differentiation.

Investigation of the ultrastructurel of different cells in lymph nodules by using zinc iodide osmium tetroxide technique

The zinc iodide -osmium tetroxide (ZIO) fixation/staining method was applied for neurocytological study and also to examine several other tissue samples including human blood and bone marrow on nerve endings in the median eminence, epidermal langerhans cells of lymphoid tissue. Although precise specificity can not be attributed to the staining reaction. Interesting staining patterns for different cell types in lymph node were observed by one of the ZIO staining solutions. The significance of ZIO positivity is briefly discussed.

Fine structure of the human coccygeal body: a light and electron microscopic study

There is only limited data on the microscopic structure of the coccygeal body in classical textbooks. Although there are several articles describing the light microscopic structure of the organ, the data presented are rather conflicting especially when comparing glomus tumors and normal coccygeal bodies. We therefore examined the pericoccygeal soft tissues histologically with the aim of obtaining further evidence. At the light microscopic examination, coccygeal bodies were distinguished as sections of several blood vessels encapsulated by a connective tissue capsule. Small arteries within the coccygeal bodies had an unusual endothelial lining, resembling pseudostratified epithelium or neuro-epithelium. We observed increased numbers of glomus cells in a few samples. A highly tortuous course run by the small arteries was observed in the serial sections. At their electron microscopic examination, endothelial cells exhibited the features of columnar epithelial cells, though some appeared to be vacuole rich. The basal surface of the cells showed basal infoldings, but not as extensive as those of absorptive cells. External lamina, subplasmalemmal vesicles, bundles of microfilaments, groups of membrane bound organelles including mitochondria and endoplasmic reticulum were observed in glomus cells. In conclusion, it is rather difficult to use the term tumor for the coccygeal bodies when relying solely on the number of cells observed, because some segments of the coccygeal bodies were rich in glomus cells. It is more likely that the coccygeal bodies show variability in different individuals. The characteristics of the endothelium of the small arteries in coccygeal bodies needs to be examined in a wider range of specimens in order to be validated as a unique entity.

The expression of VLA integrins in the human tonsilla palatina

The integrin receptors are a family of transmembrane glycoproteins comprising non-covalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement and other cell, while their intracellular domains interact with the cytoskeleton. They participate in cell-matrix and cell-cell adhesion in many physiologically important processes including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and in oncogenic transformation. This investigation was focused on the histological distribution of the beta 1-integrins in the human tonsil using an indirect immunoperoxidase method. Present data suggest that lymphocyte and antigen presenting cells (FDCs, IDCs, and macrophages) interact with each other following adhesion to extracellular matrix proteins (e.g. fibronectin) through their integrin receptors in order to carry out special immunological functions. In addition, stromal elements and epithelial components were shown to express VLA integrins providing interactions for tissue organization and compartmentalization.

Expression of beta-1 integrins in ganglionic and aganglionic segments of patients with Hirschsprung's disease

An immunocytochemical study was performed to assess the role of beta-1 integrins in the pathogenesis of Hirschsprung's disease. Fresh tissue samples from both aganglionic and ganglionic segments of five patients who were undergoing surgery for Hirschsprung's disease were obtained. Samples were rapidly frozen in liquid nitrogen. Sections were cut and stained using anti alpha-1, 2, 3, 4, 5, 6 and beta-1 monoclonals according to the indirect immunoperoxidase method. The evaluation did not reveal any significant change of pattern in the distribution of beta-1 integrins in the non-neural elements of both aganglionic and ganglionic segments of colon, such as the epithelium, muscularis mucosa, muscularis externa, connective tissues and blood vessels. Nerve fibres in both aganglionic and ganglionic segments strongly expressed the alpha-6 chain of very late activation antigen which led to their increase in the aganglionic segment. In addition to revealing the increase, alpha-6 monoclonals also had in situ positive control due to their presence in non-neural elements. Hence, immunostaining of the suction biopsies with anti alpha-6 monoclonals may be employed as a new and simple method in the diagnosis of Hirschsprung's disease. On the other hand, beta-1 integrins do not seem to play a role in the defective migration of ganglion cells occurring in Hirschsprung's disease.

Morphological changes in the myenteric plexus of rat ileum after transection and end-to-end anastomosis

Surgical interruption of the gastrointestinal tract is widely used for investigating the structure of the enteric nervous system and in the treatment of certain pathological conditions of the gastrointestinal tract. The effects of transection and end-to-end anastomosis and myotomy on nerve cells of the myenteric plexus were studied by light and electron microscopy, 1, 2 and 6 wk postsurgically. During the 1st wk, degeneration of some nerve cells was indicated by the dilation of the endoplasmic reticulum and dispersion of Nissl substance. The degenerative process (an early electron-dense lamellar degeneration and a late floccular degeneration) was accompanied by some regenerative changes during the recovery period. Quantitative light microscopic analysis demonstrated a significant decrease in the number of neurons located 1 and 5 mm from operation sites in the intestine.

An expert diagnostic system based on neural networks and image analysis techniques in the field of automated cytogenetics

In this study, we introduce an expert system for intelligent chromosome recognition and classification based on artificial neural networks (ANN) and features obtained by automated image analysis techniques. A microscope equipped with a CCTV camera, integrated with an IBM-PC compatible computer environment including a frame grabber, is used for image data acquisition. Features of the chromosomes are obtained directly from the digital chromosome images. Two new algorithms for automated object detection and object skeletonizing constitute the basis of the feature extraction phase which constructs the components of the input vector to the ANN part of the system. This first version of our intelligent diagnostic system uses a trained unsupervised neural network structure and an original rule-based classification algorithm to find a karyotyped form of randomly distributed chromosomes over a complete metaphase. We investigate the effects of network parameters on the classification performance and discuss the adaptability and flexibility of the neural system in order to reach a structure giving an output including information about both structural and numerical abnormalities. Moreover, the classification performances of neural and rule-based system are compared for each class of chromosome.

The expression of VLA integrins in the human thymus

The integrin receptors are a family of transmembrane glycoproteins comprising non-covalent heterodimers. They interact with a wide variety of ligands including extracellular matrix glycoproteins, complement and other cells while their intracellular domains interact with the cytoskeleton. They participate in cell-matrix and cell-cell adhesion in many physiologically important processes including embryological development, hemostasis, thrombosis, wound healing, immune and nonimmune defense mechanisms, and oncogenic transformation. This investigation is focused on the histological distribution of the beta 1-integrins in the human thymus, using an indirect immunoperoxidase method. With the exception of VLA-4, none of the beta 1 integrins were expressed on thymocytes which were strongly positive in the cortex and perivascular compartment, somewhat weaker in the medulla. Thymic epithelial cells were positive for VLA-1, VLA-2, VLA-3 and VLA-6, but the distribution pattern of these molecules in epithelial cells at certain locations was quite different. VLA-1 was weakly expressed by both cortical and medullary epithelial cells. VLA-2 was strongly positive in cortical epithelial cells forming a dense framework at the peripheral cortex. VLA-3 and VLA-6 selectively stained a single flattened epithelial cell layer (perilobular epithelial cells) demarcating the peripheral cortex from the surrounding perivascular compartment. VLA-1,3,5,6 were also demonstrated in the endothelial cells and subendothelial layer of the thymic vasculature.

IN CONCLUSION

the distribution of integrins in human thymus tissues is of special interest. Such distribution shows that the VLA integrins may have different functions in different areas. The data presented in this study may be important in evaluating the functional role of the VLA integrins in thymocyte maturation in different compartments of the thymus.

Image-directed color Doppler ultrasonography in the evaluation of superficial solid tumors

Image-directed color Doppler ultrasonography (ICDUS) studies of 86 patients with superficial solid masses yielded significantly lower resistive index (RI) values in acute inflammatory lesions, but no significant difference between the maximum systolic flow velocities (S) of the patient groups with malignant, benign, and acute inflammatory lesions. When analyzed separately, the malignant soft-tissue tumor subgroup was shown to have significantly higher mean RI compared to that of the malignant node subgroup. We conclude that RI may be useful in the differentiation of acute inflammatory masses from other pathological entities. Malignant soft-tissue tumors, especially sarcomas, may have different Doppler features from those of carcinomatous tumors.

A persistent functional artery connecting the thyrocervical trunk and the aortic arch. Embryonic remnant or important aortic vas vasorum?

During the dissection of the neck region of a 56 year old female cadaver an artery was found branching from the thyrocervical trunk as a fourth branch and entering the aortic arch on its superior posterior aspect between the brachiocephalic trunk and the left common carotid artery. Selective angiography revealed that this artery branched into several arterioles at its junction on the superior aspect of the aortic arch between the brachiocephalic trunk and the left common carotid artery. No similar structure could be found in the literature. Evaluation of this phenomenon according to our knowledge of the development of human arterial networks, it was concluded that the artery might be a persistent intersegmental artery, or an enlarged nutrient artery (vas vasorum) to the aortic arch.

New applications for the zinc iodide-osmium tetroxide technique

The zinc iodide-osmium tetroxide (ZIO) fixation/staining method was applied for neurocytological studies and also to examine several other tissue samples including epidermal Langerhans cells, blood and bone marrow cells and lymphoid tissue. Although precise specificity cannot be attributed to the staining reaction, interesting staining patterns for different cell types were observed by using one of the ZIO staining solutions. The significance of ZIO positivity is briefly discussed.