Healing and Long-Term Viability of Grafts in the Venae Cavae Reconstruction

The need for superior vena cava (SVC) or inferior vena cava (IVC) recon struction is not uncommon: lung cancer, mediastinal tumors, or retroperitoneal neoplasms are the most frequent indications for caval replacement. Since auto genous veins, which represent the most satisfactory venous substitute, have not been applicable to caval replacement, because of the lack of suitable length and caliber, many types of materials have been tested in the venous system. The present study was planned to compare the potential of expanded polytetrafluoroethylene (e-PTFE) and glutaraldehyde-tanned human umbilical vein (HUV) grafts as caval substitutes.

Patch (4 x 5 cm) reconstruction of the SVC was carried out in 10 dogs, tubu lar (3 x 10 mm) reconstruction of the SVC in 5 dogs, and patch (1 x 2 cm) recon struction of the IVC in 8 dogs. In the patch reconstruction groups, HUV grafts were used in half of the cases and 30 μm pore sizes e-PTFE grafts in the other half, while in the tubular SVC replacement group, only e-PTFE grafts were employed. The grafts were removed fifteen to thirty days after IVC patch re construction, thirty to two hundred seventy days after SVC patch reconstruc tion, and thirty-three to forty-one months after SVC tubular replacement. In every instance, specimens were obtained for light microscopy (LM) and scan ning electron microscopy (SEM).

HUV patches implanted in the SVC showed hemorrhagic foci at their central portion and marked constriction at the anastomotic regions. On the contrary, the inner surface of e-PTFE patch grafts was covered with a uniform and glis tening neointima. By LM, e-PTFE patches showed a smooth and regular lumi nal surface, while the inner surface of HUV patches was irregular, with hemorrhagic areas in the underlying layers. By SEM, e-PTFE patches revealed a more rapid and orderly endothelialization of their inner surface than HUV patches did. Tubular SVC reconstruction showed the good long-term viability of the e-PTFE neointima (as long as forty-one months after grafting). Only spotty areas revealed neointima alterations, such as fibrinoid degeneration, fo cal necrosis, or minor thrombotic foci. In the IVC patch reconstruction model, HUV grafts showed an exuberant fibrin deposition on their inner surface and delayed endothelialization patterns, as compared with e-PTFE grafts. Since rapid healing with rapid endothelialization is accepted as the most important factor providing the graft luminal surface with the best antithrombotic proper ties, the present study demonstrated that e-PTFE is a more suitable material than HUV for SVC and IVC reconstruction.

[Dynamic MR hepatocholangiography with the SIP Fast GRE (saturation inversion projection fast gradient echo) method]

The purpose of this study was to assess the utility of dynamic MR hepatocholangiography with the Gd-EOB-DTPA enhanced SIP Fast GRE sequence in the hepatobiliary system. The SIP Fast GRE sequence was used for sequential imaging of the hepatobiliary system with a frame rate of 3 sec in a 256 x 192 matrix. Dynamic sequential acquisition was performed for 51 min before and after the injection of 30 mu mol/kg of Gd-EOB-DTPA in a rabbit. Dynamic images of the hepatobiliary system were obtained in the rabbit study. Dynamic MR hepatocholangiography provides better functional information than conventional MR cholangiography.

[Trial of analysis of esophageal wall motion using optical flow method on esophagogram]

Several studies have indicated that the analysis of esophageal motion provides a valid means of identifying esophageal diseases. Although this motion can be seen on esophagogram, its quantification leaves much room for improvement. This study presents a computer method to quantify the apparent motion (optical flow) observed on sequences of esophagogram. This method computes at every point of a sequence of digitized images the two-dimensional velocity vector which characterized its motion from one image to the next image. The information on motion of the esophagus can be displayed by superimposing the local velocity vector on the original image.

Assessment of breast cancer with dynamic gadolinium-enhanced MR imaging combined with magnetization transfer contrast using a newly developed breast surface coil for the supine position

To assess the value of dynamic gadolinium-enhanced MR imaging combined with magnetization transfer contrast (MTC) of breast cancer by SPGR sequence, 15 patients with breast cancer were imaged in the supine position with the newly developed breast coil in a 1.5 Tesla imager. Dynamic gadolinium-enhanced MR imaging combined with MTC (10 cases) and conventional dynamic gadolinium-enhanced MR imaging (5 cases) were performed after the administration of Gd-DTPA (0.2 ml/kg). Sagittal images were obtained every 22 seconds during the first 264 seconds. Thus, a total of 15 images were obtained in each lesion. The signal intensity ratio (SIR) of lesion to mammary glarid was calculated for each image as follows: (SI lesion/SI mammary gland)/(SI (pre)lesion/SI (pre)mammary gland). Dynamic gadolinium-enhanced MR imaging with MTC always allowed better SIR at 88 seconds than conventional dynamic gadolinium-enhanced MR imaging after bolus injection (p < 0.01). Dynamic gadolinium-enhanced MR imaging with MTC improved detection of the boundary of the lesion and mammary gland.

New monoclonal antibodies directed against mouse follicular dendritic cells

The follicular dendritic cells (FDC) in B-lymphoid follicles are unique reticular cells that retain immune complexes on their surfaces. We developed new monoclonal antibodies (MAb), SKY01, 28, 41, and 49, against mouse FDC without useful cell markers. Immunohistochemical study of spleen and lymph node tissues from Balb/c, C3H, and C57BL/6 mice revealed that SKY01 and 49 were highly specific for FDC, whereas SKY28 and 41 reacted with other stromal components as well as FDC. On immunoelectron microscopy (IEM), reaction products for all MAb were localized on the surfaces of FDC. In ontogenetic study of Balb/c spleen, FDC precursors were not immunodetected with any of the MAb at 1 week after birth. The FDC that first appeared as immune complex-retaining cells at 2 weeks were a subpopulation of SKY01-, 49-, 28+, and 41+ reticular cells. At 3 weeks, FDC were positive for all MAb, like adult spleen. These results indicate that our MAb recognize differentiation antigens of FDC. Comparative immunohistochemical studies of spleen from athymic nude and severe combined immunodeficiency mice suggested that B-cells may be required for the differentiation of FDC. Consequently, these MAb are considered useful tools for research on FDC.

[Establishment and characterization of a CA125-producing human ovarian clear cell carcinoma cell line]

A human ovarian cancer cell line designated "KK" was established from ascites of a patient with ovarian clear cell carcinoma. This cell line was grown for more than 2 years and over 140 passages in medium RPMI1640 containing 10% FCS. Doubling time of this cell line at passage 70 was approximately 4 days and saturation density was 1.1 x 10(5)/cm2. Plating efficiency was approximately 23%. Chromosome analysis revealed aneuploidy with a model number of 67. PAS-positive substances were present in the cytoplasm. CA125 and SLX were detected in both the original tumor and the cultured cells. This cell line is less sensitive to cisplatin than KF cells and IC50 was 0.95 microM.

[Establishment of a cisplatin-resistant human ovarian cancer cell line]

A human ovarian cancer cell line designated "MH" was established from ascites of a patient with ovarian serous cystadenocarcinoma treated with cisplatin. This cell line was grown for more than 2 years and over 100 passages in medium RPMI1640 containing 10% FCS. The cell doubling time, saturation density and plating efficiency was approximately 6.3 days, 5.5 x 10(4)/cm2, and 42%, respectively. Chromosomal analysis revealed aneuploidy with a modal number of 72 and 14-19 types of marker chromosomes. CA125 was detected in both the original tumor and the cultured cells. This cell line is cisplatin-resistant (IC50: 3.28 microM) and has high protein kinase C activity.

Clinicopathologic studies on human epithelial autografts and allografts

We compared the survival of cultured epithelial allografts and epithelial autografts applied to donor sites for split-thickness skin grafts. Before grafting, cultured epithelium was devoid of Langerhans cells (LCs) or lymphoid cells by immunohistochemical and electron microscopic examinations. The autografts attached to the wounds permanently, without any clinical evidence of rejection. In contrast, allografts, which were mismatched for MHC and blood-type antigens, appeared to adhere firmly only until day 7. By the second week, signs of graft rejection were apparent: The graft changed color, and the underlying dermis underwent "microerosion" and denudation. By the third week, the area formerly occupied by the allograft had the same coloration as ungrafted wounds and apparently had undergone reepithelialization by the host. Immunohistochemical and ultrastructural studies clearly demonstrated that host Langerhans-like cells (without Birbeck granules) appeared in both autografts and allografts. However, these cells were numerous and distributed widely throughout allografts, whereas they were scarce and confined to the basal layer of autografts. Typical Langerhans cells (containing Birbeck granules) were present in the prickle-cell layer of autografts by day 7. The present study strongly indicates that allografts of cultured epithelium are rejected. Furthermore, given the known ability of Langerhans-like cells to function as accessory cells in T-cell activation, our results point to a role for host Langerhans-like cells in immunologically mediated rejection of the epithelial allografts.

[An autopsy case of malignant rheumatoid arthritis (MRA) which was difficult to distinguish from polyarteritis nodosa (PN)]

We encountered a patient who was diagnosed as rheumatoid arthritis (RA) at 15 years old and developed malignant RA (MRA) within one year. He suffered from mononeuritis multiplex and cutaneous infarction. Despite of treatment including steroid pulse therapy, neuritis progressed. Lung infiltration, pancreatitis and intestinal bleeding were accompanied. He died of disseminated intravascular coagulation on 153 days after admission. Autopsy revealed systemic rheumatoid vasculitis in coronary artery, pancreas, liver, small and large intestine, kidney and lung. These severe vasculitis occurred in young RA patient are rare case and it is important to consider the therapy and prognosis.

Is the follicular dendritic cell a primarily stationary cell?

The cell nature of follicular dendritic cells (FDC), a member of dendritic cell group, was examined to see whether or not they are recirculating cells on splenic implantation study. Slices of BALB/c mouse spleen were implanted into C57BL/6 mice neonatally thymectomized and reconstructed by F1 (BALB/c x C57BL/6) thymus grafting. On H-2 class I immunohistology 6 months later, host spleens consisted of only the cells including FDC of host (C57BL/6) type. On the other hand, FDC of regenerated splenic grafts were of splenic donor (BALB/c) origin and haematogenic cells including germinal centre lymphocytes were of the host (C57BL/6) origin. The fact that the FDC in the regenerated splenic grafts reside irrespective of the replacement by host recirculating cells indicates that FDC belong primarily to stationary cell populations but not recirculating cell populations.

Basic fibroblast growth factor promotes proliferation of rat glomerular visceral epithelial cells in vitro

Glomerular visceral epithelial cells (vGEC) play an important role in the synthesis of the glomerular basement membrane (GBM), and together with glomerular endothelial cells and the GBM, in glomerular ultrafiltration. Therefore clarification of the properties of vGEC is essential to investigations of glomerular morphology and function in both physiologic and pathologic conditions. This article demonstrates that basic fibroblast growth factor (bFGF) is mitogenic to vGEC in vitro. Its effect was found at concentrations as low as 1.25 ng/ml, and was synergistic with epidermal growth factor (EGF). In contrast, EGF by itself had no demonstrable mitogenic effect at concentrations of 1.25-100 ng/ml. In addition, mRNA for bFGF was identified in cultured vGEC by the method of reverse transcriptase polymerase chain reaction and the immunoreactivity of bFGF was found in GEC of the Sprague-Dawley rat kidney. These results suggest that bFGF stimulates the proliferation of vGEC in an autocrine manner in vivo. A unique relationship similar to that observed in endothelial cells may also exist among bFGF, vGEC, and the extracellular matrix (ECM). In a word, bFGF may be produced by vGEC and stored in the ECM, that is the GBM, and may be one factor that stimulates vGEC to proliferate when vGEC are injured and lost in vivo.

A serial observation of coronary thrombi in vivo by a new percutaneous transluminal coronary angioscope

This study was undertaken to observe coronary thrombus formation serially from an antegrade perspective by means of a new thin flexible angioscope that has an inflatable balloon at the distal tip and an angulation mechanism. To test its capabilities, thrombi were induced in the left anterior descending coronary artery of 11 dogs by copper coils, and the thrombi were then observed through this angioscope, which had been introduced into the coronary artery by a guide catheter. Five minutes after insertion of the copper coil, fibrin-like material and white components of the thrombi were seen massing around the copper coil. Then, thin, mixed thrombotic white and red components formed around the copper coil. At fifteen minutes after the copper coil insertion, the thrombi grew in size. Ten minutes later, the thrombi finally obstructed the coronary lumen in most dogs. The red and white appearance of these thrombi was confirmed macroscopically, and the microscopic findings of these occluding thrombi revealed a fibrinous network with platelet aggregates and blood cell coagulation. Though ordinary angiography cannot reveal the precise features of the various coronary thrombi, this new angioscope was able to discern them from the antegrade perspective. The capabilities of this angioscope, which enabled these findings, should prove helpful in evaluating the stages of human coronary thrombosis. Of additional benefit, this angioscope can be used clinically for cardiac catheterization.

Development of capillary networks from rat microvascular fragments in vitro: the role of myofibroblastic cells

A new model useful for studying capillary growth in vitro is described. When the microvessel fragments and accompanying single cells (myofibroblastic cells) from rat epididymal fat pads were co-cultivated, the myofibroblastic cells initially began to grow and reached confluence. A few days later, endothelial cells started to sprout from the vessel fragments, forming cellular cord networks on and in the multilayered myofibroblastic cells. Ultrastructurally, the lumina, surrounded by the endothelial cells having intercellular junctions, were observed at cross-sectioned cellular cords. The growth of cellular cords from the fragments always occurred after the myofibroblastic cells had reached confluence. The medium conditioned to isolated rat myofibroblastic cells stimulated not only the proliferation of the endothelial cells from the bovine capillary and human vein but also the migration of bovine capillary endothelial cells in vitro. Moreover, the extracellular matrix produced by rat myofibroblastic cells modulated the morphology of bovine capillary endothelial cells to a cordlike shape. These observations strongly suggest that the formation of the capillary in vitro is induced by myofibroblastic cells.

A serial section study of tubular confronting cisternae (so-called 'test-tube and ring-shaped forms') in AIDS

A serial section study was executed on a lymph node from a case of AIDS (acquired immune deficiency syndrome) to determine the true three-dimensional morphology and mode of genesis of tubular confronting cisternae which are found in the lymphocytes in this condition. Serial sections from over a hundred such structures show that these are tubular structures and that the 'test-tube and ring-shaped' forms described in the literature are no more than profiles one expects to see when a tubular structure is sectioned. The view at times expressed in the literature that these structures are truly test-tube-shaped (i.e. one end closed) appears to be erroneous, for our serial section study did not reveal a single instance where one end was closed; all were tubular structures with both ends open. We found that tubular confronting cisternae develop by a process of twisting and spiralling of ribbon-shaped confronting cisternae, and that at one stage of development there is a spiralling groove on the wall of this structure. Microtubuloreticular structures were seen in several lymphoid cells, sometimes they were found in cells containing tubular confronting cisternae. At times microtubules (similar to those seen in microtubuloreticular structures) were seen lying within and/or outside the profiles of dense lamina of tubular confronting cisternae.

A serial section study of nuclear pockets containing nuclear material

A serial section study of leukaemic lymphocytes was carried out to elucidate the three dimensional morphology of nuclear pockets containing nuclear material and their mode of genesis. From this and a previous study on nuclear pockets containing cytoplasmic material we conclude that these are two distinct lesions each with its own mode of genesis and one does not evolve from the other. Hence we propose that the common nuclear pocket containing cytoplasmic material be designated 'type I nuclear pocket' and the nuclear pocket containing nuclear material as the 'type 2 nuclear pocket'. Our serial section study also showed that some type 2 nuclear pockets are open, (i.e. there is continuity between the material in the pocket and the contents of the nucleus) while others are closed (i.e. the material in the pocket is completely separated from the material in the nucleus). At times one sees profiles suggesting that small satellite nuclei occur in leukaemic cells. Our serial section studies show that such profiles can be produced by fortuitous sections through type 2 nuclear pockets.

A serial section study of nuclear pockets and loops

A serial section study of nuclear pockets in a lymphoma of the stomach showed that: 1) no tumour cell nucleus was free of pockets; 2) approximately 10 to 50 pockets occur on a nucleus; and 3) the pockets show a focal rather than a diffuse distribution on the nucleus. In most pockets cytoplasmic material is completely sequestrated and no channel of communication remains between the cytoplasm and the contents of the pocket. While most pockets contain cytoplasmic material, a few contain nuclear material. It would appear that these are two distinct and different lesions and that one does not evolve from the other. A serial section study of the so-called 'chromatin loops' shows that they are no more than fortuitous sections through pockets. The idea that 'chromatin loops' are cast off from the nucleus receives no support from our studies.

[Toxicological studies on dibekacin for intravenous injection use. II. Chronic toxicity in rats (author's transl)]

The toxic effects of dibekacin sulfate (DKB) in male and female rats were examined in chronic toxicity test (intraperitoneal injection), and the following results were obtained. 1) No death was noted in both male and female. 2) In general conditions, the excretion of soft or diarrheal stool was noted in groups of more than 20 mg/kg of either sex. The mean body weight was less than the control during a certain period in the male group of 40 mg/kg and in the female group of 20 mg/kg. But, in the food intakes, no particular change was noted in each group of either sex. 3) In the auricle reflex, no abnormality was noted in each group of either sex. 4) In the hematological test, the findings such as an increase of BUN, anemia, etc. were noted in the groups more than 10 mg/kg of male and more than 20 mg/kg of female. 5) In the histopathological study, evident degenerative changes of renal tubular epithelia were noted in the groups which were administered more than 20 mg/kg of DKB in both male and female, but no evident pathological findings due to the renal failure were noted in the groups of less than 10 mg/kg. Several slight changes of the thyroid gland noted in a few rats of DKB administration group of both male and female seemed to be artifact, and inflammatory changes owing to intraperitoneal injection were occasionally noted in the peritoneum of DKB injected animals. 6) Considering the above results, "the maximal non effective dose" was estimated to be 10 mg/kg in both male and female.

A new preparation method for several histopathological examinations on a single block

A new method of specimen preparation is described permitting several studies such as routine staining, histochemistry, enzyme histochemistry, immunohistochemistry, and electron microscopy on a single block of biopsy specimens. Tissues are immersed in the fixative, which primarily stabilizes carbohydrate moieties, and embedded in the mixture of JB-4, methylmethacrylate and divinylbenzene. The resin is polymerized at 4 C. Thin sections (1-2 microns) are obtained with a sliding microtome, and ultrathin sections (60-90 millimicrons) with a ultramicrotome. The sections are stained directly with various conventional procedures without removing the embedding resin. This preparation method offers a potentially useful tool for histopathological studies on biopsy specimens.

Morphological characterization of two established cell lines, T24 and MGH-U1, derived from human urinary bladder carcinoma

Two cell lines, T24 and MGH-U1, established from human urinary bladder carcinoma showed typically epithelial features. Although the proliferating cell population presented a polymorphic appearance including polygonal and elongated cells, ultrastructural studies failed to identify different types of cells in each cell line. Extensive cytoplasmic organelles, microvilli on the cell surface and cell continuity with the junctional complex were common findings in both the cell lines. Virus-like particle was not detected. Chromosome numbers of these cell lines were distributed from hypertriploidy to hypertetraploidy. T24 cell line contained a large number of elongated cells and well developed microvilli as compared with MGH-U1 cell line. The present results suggest that T24 cell line has been transformed to a relatively uniform cell population during the long-term culture as referred to in a previous report.