Telomerase activity and expression of human telomerase RNA component and human telomerase reverse transcriptase in lung carcinomas

The aim of this study was to evaluate the usefulness of determination of telomerase activity and expression of human telomerase RNA component (hTERC) and human telomerase reverse transcriptase (hTERT) for the diagnosis of lung carcinomas. The tissues studied consisted of 115 carcinomas and adjacent nonneoplastic lung, which were removed surgically without previous chemotherapy or radiotherapy. Telomerase activity was determined using a semiquantitative polymerase chain reaction-based telomeric repeat amplification protocol (TRAP) assay. The results obtained were classified into high and low telomerase groups. Localization of expression was examined by using in situ hybridization and immunohistochemistry. The correlation between telomerase activity in lung carcinoma and clinicopathologic features, including prognosis, was investigated. Telomerase activity in lung carcinomas was detected in 107 of 115 (93%) lung carcinomas, but not in any adjacent noncancerous tissues, and was significantly higher in small cell carcinoma than in any other histologic type. This activity also was significantly higher in poorly differentiated than in well-differentiated squamous cell carcinomas and adenocarcinomas. The overall survival rate (P =.020) was significantly lower in the high telomerase group. Messenger RNAs for hTERC and hTERT were mainly detected in the cytoplasm of cancer cells by in situ hybridization, and TERT protein was localized in the nuclei of these cells by immunohistochemical staining. Determinations of telomerase activity by in situ hybridization, immunohistochemistry, and TRAP assay are useful for evaluating the diagnosis and prognosis of lung carcinomas.

Defining a common region of DNA amplification at 22q11.2-12 in head and neck squamous cell carcinomas by quantitative FISH analysis

By comparative genomic hybridization (CGH) with 17 head and neck squamous cell carcinoma (HNSCC) cell lines, we previously detected an amplified region as a distinct peak at 22q11.2-12 in 3 cell lines. Because the possible presence of an oncogene was strongly suggested, the region was mapped in more detail by defining the minimum region that was commonly amplified by using fluorescence in situ hybridization (FISH) with a series of cosmids. Eighteen cosmid clones on 22q11.2-12 were assigned to their locations as a fractional length map and hybridized to cells from three HNSCC cell lines. The three cosmid clones, cHKA-118, cHKAD-26, and D22S938, showed the highest levels of amplification, and the size of the amplicon was calculated to be approximately 1.7 Mb in the OM1 and HSC6 cell lines. Several genes related to oncogenesis, including PRKM1, map to this locus. Thus, the definition of the common region with the highest level of copy number increases by FISH provides a starting point for identifying the gene that may play an important role in the development of HNSCC.

Mucin histochemistry in primary adenocarcinoma of the urinary bladder (of urachal or vesicular origin) and metastatic adenocarcinoma originating in the colorectum

In order to evaluate the mucin histochemistry of primary adenocarcinomas (PA) of the urinary bladder and metastatic adenocarcinoma (MA) originating in the colorectum, 52 PA and nine MA were examined. It was determined that the percentage of cases in which more than 25% of the tumor was stained by each of the following: (i) Alcian blue pH 2.5 periodic acid-Schiff (AB-PAS); (ii) high iron diamine-AB (HID-AB); (iii) periodic acid-sodium borohydride-potassium hydroxide-PAS (PA-SB-PH-PAS); (iv) galactose oxidase- Schiff (GOS); and (v) paradoxical concanavalin A stain (PCS). For PA, the values obtained were: 75% of cases (blue, AB-PAS), 85% (magenta, AB-PAS), 71% (black, HID-AB), 75% (blue, HID-AB), 0% (PA-SB-PH-PAS), 19% (GOS), 8% (class II concanavalin A (Con A)-reactive mucin)), and 0% (class III Con A-reactive mucin). For MA, the corresponding values were 33, 22, 0, 11, 0, 0, 11, and 0%, respectively. A higher percentage of PA than MA cases showed staining in AB-PAS for acidic and neutral mucins, in HID-AB for sialo- and sulfomucins, and in GOS for terminal beta-galactose and beta-N-acetylgalactosamine. PA and MA were significantly different in terms of both frequency of staining with AB-PAS and frequency of staining with HID-AB. However, the overlap was such that in practice, it might be difficult, if not impossible, to use mucin histochemistry to inform a differential diagnosis. In view of the differences in AB-PAS and HID-AB positivity between PA and MA, we speculate that MA (originating in the colorectum) may have undergone structural distortion affecting the production and/or secretion of neutral mucins and acidic mucins (sialo- and sulfomucins) during metastasis or invasion.

Expression of telomerase mRNA component (hTR) in transitional cell carcinoma of the upper urinary tract

BACKGROUND

Telomerase is a ribonucleoprotein enzyme that synthesizes telomeric repeats onto chromosomal ends using a segment of its RNA component as a template. Its activity has become an established indicator of the diagnosis, biologic behavior, and prognosis of several tumors. However, to the authors' knowledge, no previous study has investigated the diagnostic and prognostic importance of the expression of telomerase RNA component (hTR) in transitional cell carcinoma of the upper urinary tract (TCC-UUT).

METHODS

The authors investigated hTR expression using in situ hybridization in 130 cases of TCC-UUT, and also its relation to proliferating cell nuclear antigen (PCNA) immunoreactivity, immunoreactivity for p53 oncoprotein, clinicopathologic parameters, and clinical outcome.

RESULTS

Positive hTR expression was recognized in 98.4% of the samples and was apparent within the cytoplasm of tumor cells. In normal urothelium, its expression was restricted to the basal cell layers, whereas in the dysplastic lesions of TCC-UUT it was detected with the same intensity and distribution as in the tumor itself. No correlation was found between hTR expression and clinicopathologic findings, PCNA index, or the expression of p53 oncoprotein, although hTR score did tend to increase with disease stage. In univariate and multivariate analyses of disease free and overall survival rates, high hTR expression was associated with significant decreases in both rates.

CONCLUSIONS

The expression of hTR appears to be a useful indicator of prognosis for patients with TCC-UUT. In addition, evidence of up-regulation of hTR may also be useful in the diagnosis of this disease.

Expression of endothelin-1 in rats developing hypobaric hypoxia-induced pulmonary hypertension

Experimental pulmonary hypertension induced in a hypobaric hypoxic environment (HHE) is characterized by structural remodeling of the heart and pulmonary arteries. Endothelin-1 (ET-1), a 21-amino acid peptide, is a novel and long-lasting vasoconstrictor that increases pulmonary arterial pressure in both in vivo and in vitro experiments. To study the effects of HHE on ET-1 activity in the lungs, 59 male rats were subjected to the equivalent of an altitude of 5500 m for 1 to 4 weeks. In rats exposed to HHE, the mean pulmonary arterial pressure increased significantly from 15.2+/-0.3 (ground level) to 30.6+/-1.5 mm Hg (5500-m level) at 4 weeks, whereas their mean systemic arterial pressure remained normal. The levels of ET-1 mRNA and protein, measured respectively by Northern blot analysis and enzyme immunoassay, increased rapidly in the lungs on exposure to HHE. By in situ hybridization and immunohistochemistry, respectively, ET-1 mRNA and protein were detected in control rats in nonciliated bronchiolar epithelial cells and alveolar epithelial cells, as well as in the endothelial cells of pulmonary arteries, but minimally in the smooth muscle cells of pulmonary arteries. ET-1 mRNA- and protein-reactive smooth muscle cells in pulmonary arteries and ET-1 mRNA-reactive airway epithelial cells were significantly more abundant in rats exposed to HHE than in ground level controls. These results suggest the possibility that in smooth muscle cells in pulmonary arteries and airway epithelial cells, ET-1 may play an autocrine or paracrine role in the remodeling of blood vessels during the development of the pulmonary hypertension that is induced by HHE.

Expression of C-type natriuretic peptide during development of rat lung

C-type natriuretic peptide (CNP), recently found to be secreted from vascular endothelial cells, is now viewed as a novel endothelium-derived relaxing peptide. However, the distribution and expression of CNP during cardiopulmonary development is unclear. To follow changes in the expression of CNP during lung development, we examined rat embryos and neonates using Northern blot analysis and in situ hybridization for CNP mRNA and radioimmunoassay and immunohistochemistry for CNP protein. A substantial expression of CNP mRNA was first detected on postnatal day 2, and it thereafter remained fairly steady. The level of CNP protein also increased rapidly after postnatal day 1, reaching a settled level on postnatal day 4. CNP protein and mRNA were detected in the endothelium and smooth muscle cells of blood vessels and in bronchial airway and alveolar epithelia. Immunoreactivity for CNP protein in the endothelium of blood vessels increased to an intense level after the saccular stage. These results suggest that the changes in CNP levels may be related to the occurrence of pulmonary vasodilation after birth.

Studies of glomerular permeability factor (GPF) in focal segmental glomerular sclerosis and the relationship between GPF and vascular permeability factor (VPF)

BACKGROUND

We previously demonstrated that the supernatants of cultured concanavalin-A (con-A) stimulated peripheral blood mononuclear cells (PBMC) from patients with minimal change nephrotic syndrome (MCNS) increased the urinary protein excretion in injected rats and suggested that PBMC released a factor, which we called glomerular permeability factor (GPF), changes in the glomerular permeability and thus resulted in proteinuria in MCNS.

MATERIAL AND METHODS

In this study we investigated the GPF activity in focal segmental glomerular sclerosis (FGS) and other conditions of chronic glomerulonephritis (CGN), and also the relationship between GPF and vascular permeability factor (VPF). In experiment 1 the supernatants of the cultured con-A stimulated PBMC from patients with 10 FGS, 5 other CGN and 10 controls were tested regarding their ability to produce GPE The GPF activity was defined as positive when the 8-hour urinary protein excretion after the injection of the supernatant in Sprague-Dawley rats exceeded the mean value plus 2 standard deviations (M + 2 SD) of that before injection.

RESULTS

Three out of 10 FGS patients and 1 membranous nephropathy patient out of the 5 other CGN patients were positive for GPF activity. In experiment 2 the relationship between GPF and VPF was analyzed using culture supernatants of PBMC from 10 nephrotic MCNS patients and 15 controls. The VPF activity was measured following the method developed by Ovary [1975]. All 7 cases that were positive for GPF activity were simultaneously positive for VPF activity. On the other hand, 16 cases that were positive for VPF activity were not always positive for GPF activity (7 cases were positive and 9 were negative for VPF activity).

CONCLUSION

Experiments 1 and 2 thus suggested that GPF was not active in MCNS alone, but also in other CGN conditions and it was therefore not considered to be the same factor/substance(s) as VPF.

Thrombopoietin expression in normal and hypobaric hypoxia-induced thrombocytopenic rats

Thrombopoietin (TPO) is important as the physiologic regulator of platelet production. High-altitude hypoxia is a well-known cause of polycythemia and thrombocytopenia in animals. Fifty-two Wistar rats were housed for 0.5 to 21 days in a mechanical chamber in an environment equivalent to that found at 5500 m to determine (a) the cellular localization of TPO and (b) whether the decreased platelet and megakaryocyte counts in rats exposed to a hypobaric hypoxic environment (HHE) are associated with an altered TPO mRNA expression. In normal rats, there were high levels of TPO mRNA in the liver and kidney, intermediate levels in the brain and large intestine, and low levels in the skeletal muscle and small intestine. TPO mRNA and protein were expressed in Purkinje cells and neuronal cells in the brain, in proximal tubular cells and the mesangial cells of the glomeruli in the kidney, in hepatocytes and biliary duct epithelial cells, in absorptive epithelial cells in the large intestine, in the epidermis, and in the lung. The platelet count in the blood and megakaryocyte counts in the bone marrow and spleen were all decreased significantly after 5 or more days of exposure to HHE. In major producers such as the liver and kidney and in minor producers such as the brain, TPO mRNA levels, which tended to be decreased after 0.5 to 3 days of exposure to HHE, had returned to normal by about Day 5 or 7. Thus, during the HHE period with a decreased platelet count, no changes in TPO mRNA levels were detected in these three organs. In conclusion, we have demonstrated that TPO production occurs in various types of cells. In HHE, however, factors other than TPO may be involved in hypobaric hypoxia-induced thrombocytopenia in rats.

Tissue factor is associated with the nonbacterial thrombotic endocarditis induced by a hypobaric hypoxic environment in rats

High-altitude hypoxia causes a hypercoagulable state. In our previous study on the blood coagulation system in rats, nonbacterial thrombotic endocarditis (NBTE) developed after 4-12 weeks' exposure to the equivalent of 5500 m in altitude. We hypothesized that TF (tissue factor)-producing cells in the cardiac valves might be induced by the hypobaric hypoxic environment (HHE) and then trigger NBTE. A total of 170 male Wistar rats were housed in a chamber at the equivalent of 5500 m altitude for 1-12 weeks. We measured TF activity in the plasma and studied morphological changes in the mitral valves using immunohistochemical and immunoelectrical methods for TF protein and in situ hybridization for TF mRNA. After 4 weeks or more of exposure to HHE, 28 of the 56 surviving rats had developed NBTE. After 4-8 weeks' exposure to HHE, the plasma TF activity level was significantly higher than in control rats. There was a significant correlation between plasma TF activity and the incidence of NBTE. After 1 weeks' exposure to HHE, immunoreactivity for TF protein was detected in foamy macrophages and stromal cells in the cardiac valves. In rats with NBTE, TF protein was present in foamy macrophages and spindle stromal cells and focally present in the extracellular matrix. TF mRNA was detected in some foamy macrophages within the thrombus, TF protein was localized to the rough endoplasmic reticulum and plasma membrane of many macrophages, some fibroblasts, and a few endocardial cells. TF is associated with the pathogenesis of the NBTE induced by exposure to HHE. The accumulation of TF-producing macrophages during exposure to HHE may be responsible for initiating thrombus formation.

Expression of bcl-2 oncoprotein in transitional cell carcinoma of the upper urinary tract

We investigated the immunoreactivity for bcl-2 oncoprotein in 154 cases of transitional cell carcinoma of the upper urinary tract (TCC-UUT) and its relation with the immunoreactivity for p53 oncoprotein and proliferating cell nuclear antigen (PCNA) immunoreactivity. Immunohistochemically, bcl-2 oncoprotein was recognized as positive in 29.2% of the samples. The immunoreactivity for bcl-2 oncoprotein was significantly (P < 0.05) correlated only with stage, though there was a borderline correlation (P = 0.050) with PCNA immunoreactivity. Furthermore, in invasive TCC the immunoreactivity for bcl-2 oncoprotein was associated with PCNA immunoreactivity (P < 0.041). The 5-year disease-free and overall survival rates were 55.7% and 71.5%, respectively. A univariate analysis of survival revealed that stage, grade, pattern of growth, immunoreactivity for p53 oncoprotein, and PCNA immunoreactivity each had a significant effect on disease-free and overall survival rates, whereas the immunoreactivity for bcl-2 oncoprotein had no significant effect on either rate. In the final models of the multivariate analysis, stage was found to be the only prognostic factor for disease-free survival and for overall survival. Detection of immunoreactivity for bcl-2 oncoprotein appears to be of no real value in deciding the prognosis of TCC-UUT.

Argyrophilic nucleolar-organizer region counts and DNA status in bronchioloalveolar epithelial hyperplasia and adenocarcinoma of the lung

Few studies have investigated more than one cell-biological parameter in bronchioloalveolar epithelial hyperplasia (BEH) and bronchioloalveolar carcinoma (BAC). The authors have examined argyrophilic nucleolar-organizer regions (AgNORs) and DNA status in surgically resected formalin-fixed paraffin-embedded specimens, 27 BEH and 62 well-differentiated adenocarcinomas, including 30 BAC. The authors measured the mean AgNOR count in 200 nuclei from sections of these regions. The authors also quantified DNA distribution in more than 200 cancer cells from sections of these regions, stained with 4',6-diamidino-2-phenylindole, using a microspectrophotometer. Fourteen lesions were interpreted as atypical BEH. The mean number of AgNORs per nucleus in BEH was 1.25 to 2.63. The mean number of AgNORs was significantly lower in both typical and atypical BEH than in either the bronchial surface epithelial type or the bronchial gland cell type of well-differentiated adenocarcinoma (P < .05). The mean number of AgNORs in atypical BEH was intermediate between that in typical BEH and that in BAC. Quantitative DNA image analysis showed DNA aneuploidy in 2 of 18 BEHs and 18 of 52 well-differentiated adenocarcinomas. The incidence of DNA aneuploidy increased in this order: typical BEH (0%, none out of 10 lesions) through atypical BEH (25.0%, 2 out of 8 lesions), to adenocarcinoma (34.6%, 18 out of 52 cases). Thus, the incidence of DNA aneuploidy in atypical BEH (25.0%) was intermediate between typical BEH (0%) and BAC (30.0%). These results suggest that atypical BEH may be closely related to BAC.

Urokinase-type plasminogen activator, its inhibitor, and its receptor in patients with upper urinary tract carcinoma

BACKGROUND

Urokinase-type plasminogen activator (uPA) is a serine protease involved in tumor invasion and metastasis. Its activity during metastasis may be regulated by a plasminogen activator inhibitor (PAI). Furthermore, uPA exerts its action by binding to a membrane-bound receptor (uPAR). The authors attempted to examine the immunohistochemical expression of uPA, uPAR, and PAI-1 in patients with transitional cell carcinoma of the upper urinary tract (TCC-UUT).

METHODS

Formalin fixed, paraffin embedded tumor tissues from 154 patients were analyzed using immunohistochemical staining.

RESULTS

There was moderate to strong cytoplasmic staining for uPA, PAI-1, and uPAR in 57.8%, 96.1%, and 88.3%, respectively, of tumor epithelial cells, and in 22.7%, 53.9%, and 24.7%, respectively, of stromal cells at the tumor/stroma interface. Examination of the relationship between immunoreactive score and clinicopathologic findings revealed that the uPA score for stromal cells significantly correlated with the stage and pattern of growth of the tumors. The PAI-1 score for tumor epithelial cells and the uPAR score for stromal cells both correlated with stage, grade, and pattern of growth. The PAI-1-score for stromal cells correlated with stage and grade. The uPAR-score for tumor epithelial cells correlated with stage. When only the immunoreactive scores that were classified as "high" (if the score was > or = 5 or > or = 1, for tumor epithelial and stromal cells, respectively) were considered, univariate analysis revealed that a "high" PAI-1 score for tumor epithelial cells and a "high" uPAR score for stromal cells both were significantly associated with poor disease free and overall survivals, particularly early period survival. In the final models of the multivariate analysis, only stage (all periods, disease free survival and overall survival), and grade (12 months, overall survival) were found to be progressive or prognostic factors.

CONCLUSIONS

Detection of immunoreactivity for plasminogen activator parameters appears to be of little or no value in determining the prognosis of patients with TCC-UUT, although some parameters were found to be associated with high stage or high grade of the tumors.

Expression in lung carcinomas of platelet-derived growth factor and its receptors

Platelet-derived growth factor (PDGF) is synthesized and secreted by mesenchymal cells. We used immunohistochemistry and in situ hybridization to determine whether immunoreactivity for PDGF and PDGF receptor (PDGF-R) might be a prognostic indicator in lung carcinoma. We compared these results with those of immunohistochemistry for anti-proliferating cell nuclear antigen (anti-PCNA). Indirect immunohistochemistry and in situ hybridization were performed for PDGF B-chain, PDGF-R beta and PCNA antibodies, and PDGF B mRNA on frozen, paraffin-embedded sections of 92 surgically resected lung carcinomas (39 squamous cell carcinomas, 47 adenocarcinomas, 2 large-cell carcinomas, 2 adenosquamous carcinomas, and 2 double carcinomas). Clinicopathologic data (sex, age, stage, survival period, histologic type, and degree of cell differentiation) were evaluated using a statistical analysis system. PDGF reactivity was positive in tumor cell cytoplasm in some cases of squamous cell carcinoma (64%) and adenocarcinoma (55%) and in all cases of large-cell carcinoma, adenosquamous carcinoma, and double carcinoma. PDGF-R reactivity was detected only in tumor stroma. Positive PDGF staining was associated with a poor prognosis in patients with lung carcinoma, independent of age, sex, stage, and degree of cell differentiation (risk ratio = 2.53, p = 0.03). PDGF B mRNA was detected in 100% of PDGF-positive squamous cell carcinomas and in 85% of adenocarcinomas. There was no correlation between PDGF expression and PCNA index in lung carcinomas. Together, these results suggest that immunohistochemistry for PDGF B-chain may predict the outcome for lung carcinoma patients.

E-cadherin expression in upper-urinary-tract carcinoma

Carcinoma of the upper urinary tract is a relatively rare neoplasm, and few studies have dealt with clinicopathological findings and prognosis in a large number of cases. The purpose of our investigation was to look for a possible relation between E-cadherin (E-CD) immunoreactivity and clinicopathologic findings or clinical outcome in transitional-cell carcinoma of the upper urinary tract (TCC-UUT). To this end, we investigated E-CD immunoreactivity in 154 cases of TCC-UUT. E-CD immunoreactivity was recognized as being of "normal" pattern in 29.2% of samples. The relationship between E-CD immunoreactivity and clinicopathologic findings was significant for stage, grade and pattern of growth. The 5-year disease-free rate for 147 cases and 5-year overall survival rate for 154 cases were 55.7% and 71.5%, respectively. A univariate analysis of survival revealed that stage, grade, pattern of growth and E-CD immunoreactivity all had a significant effect on disease-free and overall survival rates. In the final models of multivariate analysis, however, we found that, for disease-free survival and for overall survival, only stage was a factor for progression or prognosis. Detection of E-CD immunoreactivity appears to be of limited value in deciding the prognosis of TCC-UUT.

Displacement of gold marker in immunoelectron microscopy of human respiratory cilia

Preembedding immunogold electron microscopy was performed to evaluate the position of outer arm dynein heavy chains in normal human respiratory cilia. Anti-dynein antibody (AD2), which is specific for sea urchin sperm flagellar dynein heavy chains, was used as primary antibody. Direct cross-sections of cilia were selected, and the distance between the center of a cilium and the center of a colloidal gold particle attached to the cilium (X) was measured. The distance between the center of a cilium and the farthest edge of an outer dynein arm of the cilium was measured by ordinary electron microscopy (Yo) and by immunoelectron microscopy (Yi). X was significantly longer than Yo and Yi. If it is assumed that the structure of respiratory cilia is dense and that antibodies are located at the outer side of the actual position of the heavy chains, then the average distance difference of approximately 90-120 A may represent the length of two conjugated antibodies. This length should be kept in mind when performing immunoelectron microscopy. The data suggest that AD2 recognizes the outer arm dynein heavy chains of normal human respiratory cilia.

E-cadherin expression in upper-urinary-tract carcinoma

Carcinoma of the upper urinary tract is a relatively rare neoplasm, and few studies have dealt with clinicopathological findings and prognosis in a large number of cases. The purpose of our investigation was to look for a possible relation between E-cadherin (E-CD) immunoreactivity and clinicopathologic findings or clinical outcome in transitional-cell carcinoma of the upper urinary tract (TCC-UUT). To this end, we investigated E-CD immunoreactivity in 154 cases of TCC-UUT. E-CD immunoreactivity was recognized as being of "normal" pattern in 29.2% of samples. The relationship between E-CD immunoreactivity and clinicopathologic findings was significant for stage, grade and pattern of growth. The 5-year disease-free rate for 147 cases and 5-year overall survival rate for 154 cases were 55.7% and 71.5%, respectively. A univariate analysis of survival revealed that stage, grade, pattern of growth and E-CD immunoreactivity all had a significant effect on disease-free and overall survival rates. In the final models of multivariate analysis, however, we found that, for disease-free survival and for overall survival, only stage was a factor for progression or prognosis. Detection of E-CD immunoreactivity appears to be of limited value in deciding the prognosis of TCC-UUT.

Expression of platelet-derived growth-factor B-chain mRNA and tumor angiogenesis in invasive transitional cell carcinoma of the upper urinary tract

In several types of carcinoma, angiogenesis is associated with metastasis and might be a prognostic indicator. Platelet-derived growth factor (PDGF) is one of several growth factors known; it is involved in the regulation of cell migration and proliferation. There have been few reports, however, dealing with the expression of PDGF B-chain mRNA and angiogenesis in transitional cell carcinoma. We evaluated both the expression of PDGF B-chain mRNA and angiogenesis in transitional cell carcinoma of the upper urinary tract and examined their interrelation with metastasis, patient prognosis, and other established clinicopathologic parameters. For this purpose, formalin-fixed, paraffin-embedded tumor tissues from 91 patients with invasive tumors were analyzed with in situ hybridization for PDGF B-chain mRNA and immunohistochemical staining of Factor VIII-related antigen to assess angiogenesis. The expression of PDGF B-chain mRNA was positive in 59 (66%) of the 91 patients. Microvessel density was significantly increased in positive PDGF B-chain mRNA cases (P < .0001). There was no significance, however, in any relationship between the expression of PDGF B-chain mRNA or between the microvessel density and the clinicopathologic findings, metastasis, or prognosis. Assessment of the expression of PDGF B-chain mRNA and microvessel density seems to be of no real value in predicting either the risk of metastasis or the prognosis in transitional cell carcinoma of the upper urinary tract.

Immunoreaction at 43 kDa with anti-ubiquitin antibody in breast neoplasms

Protein ubiquitination has been implicated in ATP-dependent protein turnover and normal cell proliferation. To investigate whether the ubiquitin-mediated system is functionally involved in the cancerous state, we examined changes in protein ubiquitination in 52 surgically resected primary breast tumors. Immunohistochemically, ubiquitin (Ub) was identified in the cytoplasm of cancer cells, which were stained more strongly than adjacent normal ductal epithelium. Corresponding immunoblot analysis of normal and neoplastic regions of human breast showed that the immunoreaction for Ub at about 43 kDa was increased in all of the tumors (100%), regardless of the clinical stage or histologic grade. This protein, which gave a single spot on two-dimensional gel electrophoresis, had partial amino acid sequences which were identical to those of actin family members. Our results suggest that ubiquitination of this 43-kDa protein may be involved in the carcinogenesis or biological characteristics of human breast neoplasms.

Hypercoagulable state in a hypobaric, hypoxic environment causes non-bacterial thrombotic endocarditis in rats

High-altitude hypoxia causes polycythaemia and a hypercoagulable state in humans and animals. This study examines the effects of a hypobaric, hypoxic environment (HHE) on the blood coagulation system in rats. A total of 170 male Wistar rats were housed in a chamber at the equivalent of 5500 m in altitude for 1-12 weeks. After 2 weeks of exposure to HHE, platelet counts decreased significantly; after 4 weeks, the prothrombin and activated partial thromboplastin times were significantly prolonged, compared with those of control rats. In addition, individual coagulation factors (VII, IX, X, XI, and XII) were significantly decreased at 8 weeks (P < 0.05). Levels of anti-thrombin III and alpha 2-plasmin inhibitor also decreased (between 4 and 8 weeks). After 4-12 weeks of exposure to HHE, 30 of 56 rats (54 per cent) developed (i) non-bacterial thrombotic endocarditis (NBTE) or (ii) infarction of the myocardium or kidney, or both (i) and (ii). The incidence of NBTE increased from 33 per cent (5/15 rats) at 4 weeks to 100 per cent (7/7 rats) at 12 weeks. Electron microscopy showed detached endothelial cells in the mitral valves at 1 week; platelets adhered to the subendocardial matrix and platelet aggregation with thrombus formation was seen at 2 weeks of exposure. The results suggest that exposure to HHE induces a hypercoagulable state and causes an NBTE in rats that may result in consumption coagulopathy.

Fatal diffuse alveolar damage from bird fanciers' lung

A 68-year-old man, who had continuing exposure to budgerigars, developed fatal acute respiratory failure following years of slowly progressive pulmonary deterioration. His lung function was characterized first by mild airflow obstruction and later by progressive loss of lung volume. Computed tomography showed progressive development of pulmonary fibrosis and honeycombing. His serum disclosed precipitins to pigeon antigen. During his final illness his chest radiograph showed widespread patchy consolidation. At autopsy, his lungs revealed left lower lobe bronchopneumonia, fibrosis and honeycombing at the bases and widespread evidence of diffuse alveolar damage with organized exudate in some alveoli. To our knowledge, this is the second reported fatality due to acute alveolar injury in bird fanciers' lung.

Immunohistochemical evaluation of p53 oncoprotein in transitional cell carcinoma of the upper urinary tract

The p53 gene, which is located on human chromosome 17, encodes for a nuclear phosphoprotein and is thought to regulate cell growth and proliferation. Although the immunoreactivity for p53 oncoprotein in transitional cell carcinoma (TCC) of the urinary bladder has been shown to correlate with clinicopathologic findings and prognoses, there have been no such reports on TCC of the upper urinary tract (TCC-UUT). The present study investigated the prognostic value of p53 oncoprotein in TCC-UUT. Formalin-fixed, paraffin-embedded tumor tissues from 149 TCC-UUT patients were analyzed using immunohistochemical staining. Immunohistochemically, p53 oncoprotein was recognized as positive in 26.8% of the samples. The immunoreactivity for p53 oncoprotein was significantly (P < .05) correlated with both stage, grade, and pattern of growth. The 5-year disease-free and overall survival rates were 58.4% and 69.7%, respectively. A univariate analysis of survival showed that stage, grade, pattern of growth, and the immunoreactivity for p53 oncoprotein have a significant effect on disease-free and overall survival rates. In the final models of multivariate analysis, only stage for disease-free survival, and stage and the immunoreactivity for p53 oncoprotein for overall survival were found to be progressive or prognostic factors. Detection of immunoreactivity for p53 oncoprotein appears to be of real value in deciding the prognosis of TCC-UUT.

Pulmonary, vascular responses in rats exposed to chronic hypobaric hypoxia at two different altitude levels

High altitude hypoxia is known to cause pulmonary hypertension in humans. Altitudes of 5500 m and 4000 m above sea level are considered to be the upper limits for short-term human survival and long-term human residence, respectively. To study the effects of hypobaric-hypoxic environments on pulmonary vascular beds, the physiologic and morphometric differences occurring in the pulmonary arteries of rats at the equivalent of these two altitude levels were compared. One hundred and ninety male rats were housed in a double-roomed mechanical chamber and subjected for 12 weeks to hypobaric-hypoxic environments equivalent to an altitude level of 5500 m or 4000 m. After 6-8 weeks, mean pulmonary arterial pressure (PAPm) was significantly higher in rats at the 5500 m level than in those at 4000 m. The external diameter of muscular arteries (M) and of partially muscular arteries (PM) in the lungs of rats at 8 and 12 weeks, and those of nonmuscular arteries (NM) around the alveolar sacs at 2 and 8 weeks were each significantly less in rats exposed to the 5500 m level than in those at 4000 m. At 4 weeks, the ratio of medial thickness to external diameter for M and PM around the alveolar ducts and alveolar sacs were greater in rats exposed to the 5500 m level than in those at 4000 m. Erythrocyte count, hemoglobin and hematocrit tests showed polycythemic patterns during the initial hypobaric period in both 5500 m-, and 4000 m-level rats. However, from 4 to 12 weeks, the hematologic values of the 4000 m-level rats declined progressively toward the upper end of the normal range. This study suggests (i) that elevated PAPm in rats exposed to hypobaric-hypoxic environments results from structural remodeling of all M, PM and NM within the lobule, and (ii) that an environment equivalent to the 5500 m level causes more severe pulmonary vascular changes than one equivalent to the 4000 m level. The hematologic results suggest that rats exposed to the equivalent of the upper limit for long-term human residence can acquire acclimatization, but not those exposed to the equivalent of the upper limit for short-term human survival.

Bronchogenic squamous cell carcinomas with invasion along alveolar walls

In bronchogenic squamous cell carcinoma, a growth pattern along the alveolar walls of the peripheral lung parenchyma is unusual. In order better to understand the way tumour cells invade the peripheral lung parenchyma, we studied two cases of squamous cell carcinoma with invasion along the alveolar walls (in 30% to 40% of the area surrounding the tumour). We used immunohistochemical staining with antibodies against pulmonary surfactant, apoproteins (PE-10) and collagen type IV, and electron microscopy. Tumour cells invading the peripheral lung tissue were located between one layer of type II alveolar epithelial cells and the basement membrane of the alveolar walls. These results suggest that the cells of a squamous carcinoma (unlike an adenocarcinoma) have the ability to spread along the basement membrane of the alveolar walls without destroying pre-existing normal peripheral lung parenchyma.

Prognostic factors in urachal adenocarcinoma. A study in 41 specimens of DNA status, proliferating cell-nuclear antigen immunostaining, and argyrophilic nucleolar-organizer region counts

Few studies have investigated the prognostic value of a variety of cell-biological parameters in cases of urachal adenocarcinoma, a rare neoplasm. The authors examined three cell-biological parameters--DNA status, proliferating cell-nuclear antigen (PCNA) immunostaining, and argyrophilic nucleolar-organizer region (AgNOR) counts--in surgically resected, formalin-fixed, paraffin-embedded urachal adenocarcinomas from 41 patients. The authors quantified DNA distribution in 200 cancer cells from a section of each tumor, stained with 4',6-diamidino-2-phenylindole, using a microspectrophotometer. The authors also measured the number of PCNA immunostaining cells in 1,000 nuclei, and AgNORs counts in 200 nuclei, from sections of each tumor. There were eight specimens with group 1 DNA distribution (defined as a DNA content of under 4c in >90% of the cells), 21 of group 2 DNA distribution (more than 4c in >10% of the cells and more than 6c in <10% of the cells), and 12 of group 3 DNA distribution (more than 6c in >10% of the cells). The percentage of PCNA-positive cells was 19% to 91% (median, 59.5%), and the mean AgNOR count was 2.2 to 8.8 (median, 5.3) granules per nucleus. The 5-year survival rate for all 41 patients was 50.2%. Initial univariate analyses indicated that tumor stage, histological differentiation, and DNA status had a significant effect on survival. In the final models using multivariate analysis, only tumor stage and histological differentiation were found to be prognostic factors. These investigations confirm the vital importance of tumor stage and histological differentiation as predictors of patient survival. The three cell-biological parameters the authors studied do not appear to be important parameters for predicting survival.

Growth factors and oncogene products in transitional cell carcinoma

Epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha) stimulate cellular proliferation, whereas epidermal growth factor receptor (EGFR) and c-erb-B-2 oncoprotein are involved in the regulation of cellular growth. Although the immunoreactivity for growth factors and oncogene products in transitional cell carcinoma (TCC) of the urinary bladder has been shown to correlate with clinicopathologic findings and prognoses, there have been no such reports on TCC of the upper urinary tract (TCC-UUT). The present study investigated the prognostic value of these growth factors (EGF and TGF-alpha) and oncogene products (EGFR and c-erb-B-2) in TCC-UUT. Formalin-fixed, paraffin-embedded tumor tissues from 133 patients with TCC-UUT were analyzed using immunohistochemical staining. Immunohistochemically, EGF was recognized as positive in 50.4% of the samples, TGF-alpha in 27.8%, EGFR in 41.3%, and c-erb-B-2 oncoprotein in 6.8%. The immunoreactivity for EGF and c-erb-B-2 oncoprotein was significantly (P < 0.05) correlated with both stage and grade, whereas TGF-alpha correlated only with stage and EGFR only with grade. The 5-year survival rate for all cases taken together was 66.7%. Univariate analysis revealed that patients with EGF- and c-erb-B-2 oncoprotein-positive tumors had a worse clinical course than patients with EGF- and c-erb-B-2 oncoprotein-negative tumors, whereas in the final models of multivariate analysis, stage was found to be the only prognostic factor. Detection of immunoreactivity for growth factors and oncogene products does not appear to be of any real value in deciding the prognosis of TCC-UUT.

Immunohistochemical analysis of rat and human respiratory cilia with anti-dynein antibody: comparison between normal cilia and pathological cilia in primary ciliary dyskinesia

Wistar Imamichi rat and human respiratory cilia were examined with anti-dynein antibody (AD2), which is specific for sea urchin sperm flagellar dynein. AD2-labelled fresh-frozen normal rat and human cilia stained clearly by immunofluorescence and the peroxidase-antiperoxidase (PAP) technique. On immunoelectron microscopy, AD2 labelled the outer dynein arms of normal human cilia. Paraffin-embedded normal human cilia also stained by immunofluorescence, although not always clearly. Neither the cilia of WIC-Hyd male rats, an animal model of Kartagener's syndrome, nor human cilia from patients with primary ciliary dyskinesia (PCD) reacted positively by the immunofluorescence or PAP technique. Western blots of normal rat cilia yielded a single band of about 450 kDa. In conclusion, AD2 recognizes the outer arm dynein heavy chains of healthy cilia and may be useful in diagnosing and classifying PCD light microscopically especially when only paraffin-embedded specimens are available. This approach may be of potential use for better defining and classifying PCD.

[Clinicopathological examination of the relation between Clara cells and smoking]

The relations between the number and cell area of Clara cells and smoking were examined in the lung tissue of 71 subjects by immunohistochemistry, using an anti-protein 1 antibody, which is a marker of Clara cells. The smokers showed significantly lower numbers of Clara cells than the non-smokers (p < 0.05). Although the mean non-smoking time in the ex-smokers was as long as 9 years, the ex-smokers showed a somewhat lower number of Clara cells than the non-smokers. The cell area of Clara cells was the same for smokers and non-smokers. We found that smoking reduces the number of Clara cells.

Papillary cystadenoma of the epididymis. An ultrastructural and immunohistochemical study

Papillary cystadenoma of the epididymis is a rare neoplasm that is sometimes associated with von Hippel-Lindau's syndrome. Electron microscopic study of the present case revealed that neoplastic cells contained abundant glycogen granules and large lipid droplets, but a few organelles. On the apical surface there were numerous microvilli and a few single cilia, but no ciliated cells. Subepithelial basal lamina was noted, but it was occasionally disrupted. Furthermore, microvilli sprang from the circumference of the small tumor-cell nest and became associated with matrix components (microvillus-matrix associations). On immunohistochemical study, neoplastic cells showed epithelial characteristics, but positive reactivity for S-100 protein. These findings resembled those of the epithelial cells of the efferent ductules of the epididymis. In the stroma, prominent vasculature was characteristic and fenestrated-type capillaries were found in the peripheral portion of the tumor. Papillary cystadenoma of the epididymis may originate from non-ciliated epithelial cells of the efferent ductules.

Protein 1 and Clara cell 10-kDa protein distribution in normal and neoplastic tissues with emphasis on the respiratory system

Thirty-six different normal tissues and 13 different malignant epithelial tumours, were examined immunohistochemically for the presence of protein 1 (P1) and Clara cell 10-kDa protein (CC10). Adenocarcinomas of the lung were also examined for the expression of pulmonary surfactant apoprotein using a monoclonal antibody (PE-10). The staining results of P1 and CC10 were almost identical both in normal tissues and in malignant tumours. In normal lung, Clara cells were strongly positive for both P1 and CC10. In addition, some goblet cells and non-ciliated non-mucus cells in the upper airways were moderately positive for both proteins. In the malignant tumours, some lung cancers were positive for P1 and CC10, both of which were positive in the same tumour cells on sequential sections. In 117 lung cancers, P1 and CC10 were positive in 10.2% of adenocarcinomas, 20.5% of squamous cell carcinomas, and 12.5% of large cell carcinomas. PE-10 stained positively in 65.3% of adenocarcinomas, a frequency significantly higher than that of P1 and CC10 (P < 0.01). These results suggest that P1 and CC10 are nearly identical proteins, that both are useful markers of Clara cells, and that many pulmonary adenocarcinomas express surfactant apoprotein rather than Clara cell proteins.

Epithelial myoepithelial tumour of the tracheal gland

A case of epithelial myoepithelial tumour originating from the tracheal gland in a 57 year old woman is described. The tumour was removed by segmental tracheal resection and end-to-end anastomosis. Histologically, the tumour comprised clear cells and presented a monophasic pattern. Immunohistochemical analysis showed that the tumour cells were positive for both S-100 protein and smooth muscle actin. suggesting that this tumour resembles a subtype of epithelial-myoepithelial carcinoma described in the 1990 WHO international classification of salivary glands. Although some reports describe a clear cell dominant epithelial myoepithelial carcinoma, in this case local invasiveness or regional lymphnode metastasis was not proved through investigation. It is therefore concluded that this was an epithelial myoepithelial tumour rather than a carcinoma.

Immunohistochemical identification of aggregated actin filaments in formalin-fixed, paraffin-embedded sections. I. A study of infantile digital fibromatosis by a new pretreatment

Some authors have claimed that actin is not immunostained in characteristic intracytoplasmic inclusions of infantile digital fibromatosis, whereas others have claimed that it is. Formalin-fixed specimens were used in the former studies; specimens fixed in alcohol used in the latter studies. Actin at other sites, such as the rim of the inclusions, was distinctly immunostained even in the formalin-fixed specimens. Such phenomena make it difficult to accept the loss of antigenicity of actin as a result of formalin fixation. The use of usual pretreatment with trypsin provided the same results. We were able to immunostain actin distinctly and strongly in the inclusions for the first time in formalin-fixed specimens by combining KOH in 70% ethanol and trypsin. This successful staining results from the adequate etching effect of trypsin, which occurs because of a loosening of proteins in the inclusions due to KOH. These phenomena suggest that steric hindrance of antigen determinant has occurred only in the inclusions as a result of intramolecular cross-linkage, because of extremely dense accumulation of actin filaments in the inclusions.

Primary non-AIDS related brain lymphoma. Patterns of failure following radiotherapy

Thirteen patients with primary brain lymphoma (PBL) were treated with radiotherapy. Three patients also had ocular involvement with retinal masses at initial presentation. All but one patient received conventional whole brain irradiation and, in addition, spinal irradiation, intrathecal methotrexate or orbital irradiation were given in two, two and four patients respectively. The radiation doses for involved sites ranged from 40 to 65 Gy, and for prophylactic sites from 30 to 50 Gy. After radiotherapy, all patients had complete regression of the tumor on computed tomography. Nine patients relapsed, 5 of them with brain recurrence. Two patients had ocular recurrence exclusively as their first relapse. The remaining two relapsing patients had bone lesions. One patient died intercurrently. As a result, only three patients are alive and free of disease after 16 to 36 months and all three received some adjuvant treatment in addition to whole brain irradiation.

Crystalloids in angiomyolipoma. 1. A previously unnoticed phenomenon of renal angiomyolipoma occurring at a high frequency

We present a description of unique crystalloids in renal angiomyolipoma that have not previously been reported. The crystalloids cannot be identified by hematoxylin-and-eosin staining. Detailed observation after diastase treatment followed by PAS staining revealed needle- and rod-like crystalloids, which were clearly seen even by light microscopy, in 11 of 17 patients. Their appearance was characterized by the following phenomena: (a) They appeared mainly in large epithelioid smooth-muscle cells; (b) they appeared at a relatively high frequency at sites where smooth-muscle cells showed diffuse proliferation and where a hemangiopericytic pattern was observed; (c) they were often detected easily even at a site with a sarcomatous appearance; and (d) PAS-positive, diastase-resistant granules were often observed by light microscopy in the vicinity of crystalloids in all 17 patients. Electron-microscopic observation of one patient also revealed characteristic crystalloids. Prior to our study, only one patient had been reported to show crystalloids by electron microscopy, and the crystalloids were interpreted as renin. However, our study used Bowie's staining and immunohistochemistry to prove they were not renin. The nature of the crystalloids still needs to be elucidated. The fact that they closely resemble structures seen in alveolar soft part sarcoma provides one clue to their identification.

Nine Japanese patients with immotile-dyskinetic cilia syndrome: an ultrastructural study using tannic acid-containing fixation

Respiratory cilia and sperm flagella of nine Japanese patients with immotile-dyskinetic cilia syndrome were studied ultrastructurally by using a tannic acid-containing fixative. Respiratory cilia from two female patients with Kartagener's syndrome and one male patient with situs inversus and sinobronchitis were completely immotile and lacked both dynein arms. However, approximately 30% of the spermatozoa from the male patient were weakly motile. In four patients with immotile cilia syndrome without Kartagener's triad, immotile respiratory cilia generally lacked the inner dynein arms. Two clinically unusual cases, an 11-year-old boy and a 29-year-old woman with prolonged saccharin test, recurrent bronchitis, and bronchiectasia, possessed motile respiratory cilia. Ultrastructurally, both dynein arms were normal, but numerous defective central pairs (more than 50% and 70%, respectively) were seen, and the defect in the second case was similar to the transposition of microtubules reported by Sturgess et al (N Engl J Med 303:318-322, 1980). However, defects in the first case were unique and may be congenital. We propose a new type of dyskinetic cilia syndrome with defective central pairs. Additionally, nasal cilia from a 35-year-old man with immotile cilia syndrome contained excess large singlets within ciliary axonemes consisting of 17 protofilaments.

Confronting cisternae and ciliated cells in malignant pleural mesothelioma: an ultrastructural study

The incidence of malignant mesothelioma of the pleura has recently increased in Japan, and ultrastructural and immunohistochemical studies can help in the histopathologic diagnosis. Confronting cisternae consist of dense laminae between the cisternae of rough endoplasmic reticula. Cylindric confronting cisternae have recently been found in patients with acquired immunodeficiency syndrome. The pathologic significance of this unusual structure is still obscure, but it has been proposed that trapped ribosomes on the confronting unit membranes of rough endoplasmic reticula produce the dense laminae. In this study, prominent confronting cisternae were found in more than half the tumor cells, and accumulation of an electrondense fine granular substance surrounded by Golgi vesicles (so-called vesicular rosettes) were noted and found to be continuous with the dense laminae. The nature and origin of the vesicular rosettes are important with regard to the formation and significance of confronting cisternae. Oligocilia have been found in various metaplastic and neoplastic cells and are thought to be nonspecific. There has been only one report of ciliated cells and confronting cisternae in a malignant peritoneal mesothelioma, however, indicating that these unusual cytoplasmic structures might be related to some epithelial-type mesotheliomas.

Multiple pulmonary hyalinizing granulomas associated with systemic idiopathic fibrosis

A 41-year-old man with progressive nodular infiltration of the lung of about 2 years' duration died of cardiac and respiratory failure. Autopsy revealed bilateral multiple pulmonary hyalinizing granulomas (PHGs) diagnosed on the basis of the characteristic dense hyaline collagen bundles with nonspecific inflammatory infiltration. Constrictive pericarditis, retroperitoneal fibrosis, mediastinal fibrosis, fibrous thickening of the peritoneal and pleural surfaces, and fibrosis of soft tissue of the neck, flank, and hepatic hilar region were present, therefore, a diagnosis of systemic idiopathic fibrosis was made. The patient had anti-thyroglobulin and anti-thyroid microsomal antibodies and lymphocytic thyroiditis. The inflammatory process of PHG of the present case was active and the clinical course was progressive. PHG seems to be a lesion belonging to the systemic idiopathic fibrosis complex. Immunologic abnormalities may be related to PHG and systemic idiopathic fibrosis.

Tumorlets of the lung--an ultrastructural study

A tumorlet of the lung is a minute tumorlike lesion found in damaged lungs in close association with the bronchioles. Histochemical and ultrastructural studies identify proliferating cells in the tumorlets as Kultschitzky-type cells. However, the pathological significance of the tumorlets, whether they are hyperplastic or neoplastic, is still controversial. Previous ultrastructural studies on the tumorlets have been carried out on formalin-fixed lung tissues. The case examined in this study was of typical tumorlets found in a so-called middle lobe syndrome of the lung of a 52-year-old woman. Tumorlets were located within the bronchiolar mucosa surrounded directly by a basal lamina and by the bronchiolar nonendocrine epithelial cells. There were no signs of invasion into the surrounding connective tissues or into lymphaticlike spaces. Between the covering bronchiolar epithelial cells and the subjacent proliferating Kultschitzky cells, specific sites of cell-to-cell attachment were noted. This finding, in addition to previously reported clinicopathological characteristics, indicates that the proliferating Kultschitzky-type cells in the tumorlets might be non-neoplastic and that tumorlets are due to hyperplasia of pure Kultschitzky-type cells, thus resembling neuroepithelial bodies of the lung.

Expression of blood group-related antigens and Helix pomatia agglutinin in malignant pleural mesothelioma and pulmonary adenocarcinoma

In an attempt to differentiate malignant pleural mesothelioma from pulmonary adenocarcinoma by histochemical and immunohistochemical means, the glycoconjugate profiles of five reactive mesothelial lesions, 29 mesotheliomas (20 epithelial, three biphasic, and six fibrous types), and 38 well-differentiated pulmonary adenocarcinomas (34 papillary, two tubular, and two bronchioloalveolar types) were tested with ABH blood group-related antigens (BGR-Ag) antibody and Helix pomatia agglutinin (HPA) which agglutinates human type A erythrocytes. Formalin-fixed, paraffin-embedded sections were stained by the avidin-biotin-peroxidase complex method. Reactive mesothelial lesions and malignant mesothelioma of the pleura were not stainable with BGR-Ag antibody or HPA, irrespective of the blood group type. In pulmonary adenocarcinoma, however, the test with BGR-Ag antibody showed a high positive rate with the compatible blood group type, especially in type O cases (83%). Using HPA, reactions of adenocarcinoma with types A and AB also demonstrated high positive results (94% and 100%, respectively), but even with types B and O positive reactions occurred in 80% and 33% of cases, respectively. The findings suggest that positive reactions with either BGR-Ag antibody or HPA can be indicative of pulmonary adenocarcinoma.

Ultrastructure of respiratory cilia of WIC-Hyd male rats. An animal model for human immotile cilia syndrome

The WIC-Hyd rat is a mutant from the Csk: Wistar-Imamichi rat, with spontaneous hydrocephalus. In male rats, the hydrocephalus is severe and about one half of hydrocephalic male littermates possess situs inversus totalis. Ependymal cilia in these animals are immotile, and this defect is regarded as a mechanical cause of hydrocephalus. This paper presents the ultrastructural features of respiratory cilia in these rats in comparison with those in human immotile cilia syndrome. The respiratory cilia in these rats also are immotile and the dynein arms are missing, as in human cases. Previously only eight dogs with immotile cilia syndrome and a mutant hydrocephalic-polydactyl mouse were reported with respect to these phenomena. However the WIC-Hyd rat is the first useful animal model for human immotile cilia syndrome, and further studies may serve to clarify the genetic background of this condition.

A case of massive true thymic hyperplasia with non-Hodgkin's lymphoma

A case of massive true thymic hyperplasia with non-Hodgkin's lymphoma of the mediastinum is reported in a 14-year-old boy. Computed tomographic scan of the chest showed a mass of the anterior mediastinum and conspicuous swelling of the lymph nodes in the upper and lower mediastinum. They were grossly resected. The tumor of the anterior mediastinum was histologically diagnosed as true thymic hyperplasia. All of the mediastinal lymph nodes were diagnosed as non-Hodgkin's lymphoma, diffuse, mixed small and large cell type.

[Central and peripheral type small cell carcinoma of the lung--histologic, immunohistochemical, and clinical analyses]

In 17 cases of resected small cell carcinoma of the lung, there were 4 cases of central type and 13 cases of peripheral type. Histologic subtypes were classified into oat cell carcinoma (OAT), intermediate cell type (INT), and small cell carcinoma with large cell component (SC/LC). SC/LC was divided according to the criteria of Radice et al. Immunohistochemically, gastrin-releasing peptide (GRP) and neuron specific enolase (NSE) were used as markers for neuroendocrine cells, and keratin and secretory component (SC) were used as markers for epithelial and gland epithelial cells, respectively. Histologically, 4 cases of the central type were divided into 3 cases of INT and one case of SC/LC. Thirteen cases of the peripheral type were divided into 3 cases of OAT, 6 cases of INT, and 4 cases of SC/LC. SC/LC was more frequently seen in the peripheral type than in the central type. Immunohistochemically, there was no difference in the frequency of positive staining for GRP and NSE between the central and peripheral types, but positive staining for keratin and SC were more frequent in the peripheral type than in the central type. Three cases who survived more than 3 years were histologically divided into two cases of INT and one case of SC/LC. Immunohistochemically, these 3 cases showed positive staining for GRP or NSE, but also showed positive staining for keratin or SC. Our results showed that some of the peripheral type small cell carcinoma of the lung had histologic and immunohistochemical features which were different from those of typical small cell carcinoma. Long survival time after resection in some of the peripheral cases might be due to these features.

So-called minute chemodectoma of the lung. An electron microscopic and immunohistochemical study

So-called minute pulmonary chemodectoma is a curious, small lung tumour found mainly in women. The nature and origin of the proliferating cells are still obscure. In the first report on the tumour, the component cells were described as resembling chemoreceptor cells and the tumour was named chemodectoma. However, electron microscopic studies of the tumour have revealed no evidence of neuronal characteristics and have shown a close resemblance to meningothelial cells. In this study, the electron microscopic findings were similar to those previously reported but in one of the two cases, tumour cells were filled with abundant cytofilaments, giving them an occasional dense, patch-like appearance. Immunostaining for myosin and vimentin was positive in all tumour cells, but epithelial membrane antigen staining was not seen. These findings indicate that the tumour might have its origin from muscle cells.

Thyroid carcinoma infiltrating the trachea: clinical, histologic, and morphometric analyses

Forty-five patients with papillary or follicular thyroid carcinomas with tracheal infiltration were examined by clinical, histologic, and morphometric analyses. Twenty-four patients with completely encapsulated carcinomas (encapsulated cases) and 26 patients with carcinomas confining within the thyroid capsule (nonencapsulated cases) were examined as controls. Patients with tracheal infiltration were significantly more often male and older than the patients without (P less than 0.01 and P less than 0.05, respectively). The histologic grade of differentiation did not correlate with tracheal infiltration. The nuclear area of tumor cells was significantly larger in the cases with tracheal infiltration than in the cases without (P less than 0.01). In 12 recurrent cases with tracheal infiltration, the nuclear area of recurrent tumors was significantly larger than those of their own primary tumors (P less than 0.01). These results confirm that thyroid carcinomas with tracheal infiltration were more frequent in male and older patients and had more significant nuclear atypia than the tumors without tracheal infiltration.

A case of multiple thymoma: the possibility of intra-thymic metastasis

A case of multiple thymoma is reported. The patient was a 28-year-old woman who came to us with myasthenia gravis. There were two separate thymoma in the anterior mediastinum: one measured 70 x 30 x 30 mm, while the other was 1.5 mm in diameter and situated in the surrounding thymic tissue. A histological study revealed that both thymoma consisted of epithelial cells with abundant cytoplasm, round-to-oval nuclei and inconspicuous nucleoli. Morphometric analysis showed the nuclear size of the epithelial cells to be similar in both tumors. The likelihood of positive Leu7 and keratin immunohistochemical staining was also similar for the two tumors. The two thymoma had similar histological, morphometric and immunohistochemical characteristics. These findings suggest the possibility of intra-thymic metastasis rather than a multicentric thymoma development. Extended thymectomy should be performed for thymoma to prevent postoperative tumor recurrence.

Ciliated cells in the human gastric mucosa. Evidence of metaplastic change

In the gastric mucosa of Japanese patients, ciliated cells were found in association with intestinal metaplasia. The cells occurred frequently in the pyloric mucosa of nearly half of the cases examined but rarely in the cardiac mucosa of total 12 cases, but never adjacent to the chief cells of gastric glands. The ciliated cells were always found in the basal part of cardiac and pyloric glands, but never in the surface or in the foveolar epithelium. Furthermore, ciliated cells containing a few small mucus granules and simultaneously possessing numerous cilia and basal bodies were noted. Ciliated cells in the gastric mucosa have been found mainly in elderly Japanese patients, but were also observed exceptionally in one Chinese, two Swedes and one American. These ciliated cells are not present in the normal human gastric and intestinal mucosa, and therefore a new term, "ciliated metaplasia", is proposed for their occurrence.

Small mucus-granule-containing ciliated cells in the human gastric mucosa: a transitional form to metaplastic ciliated cells

Ciliated cells were found in the gastric mucosa in close association with intestinal metaplasia, mainly in the pyloric mucosa, of Japanese patients. The occurrence of ciliated cells is believed to be an acquired phenomenon and is considered to be a type of metaplasia; the term "ciliated metaplasia" is used to describe this phenomenon. Ciliated cells are found in the basal part of the glands among normal-looking mucous cells, mucous neck cells and neuroendocrine cells, but never on the surface or in foveolar epithelium. In ciliated cell-containing glands, mitoses were noted in the neck region and the ultrastructural features of these cells were identical to those of undifferentiated neck cells. However, cell metaplasia from undifferentiated cells to metaplastic ciliated cells has never been demonstrated previously. The small mucus-granule-containing ciliated cells found in our present study may arise subsequent to division of undifferentiated neck cells into mucous cells with some daughter cells then exhibiting differentiation characteristics specific to ciliated cells. Thus they contain a mixture of both small mucus granules and numerous basal bodies and cilia, at the same time as a transitional form.

[Morphometrical and immunohistochemical analysis of cortical and medullary thymoma: its correlation with invasiveness and association with myasthenia gravis]

Forty-seven thymomas were histologically classified to 28 cases of cortical type, 13 cases of medullary type, and 6 cases of mixed type. They were analyzed morphometrically and immuno-histochemically, and the results were examined with their invasiveness and association with myasthenia gravis (MG). Thirty-seven resected thymic tissues were used as controls. Cortical thymomas were more often invasive ones and associated with MG than the medullary type, with significant difference. Epithelial cell nuclei of the cortical thymomas were significantly larger than those of the medullary ones. Epithelial cell nuclei of cortical and medullary thymomas were significantly larger than those of thymic cortex and medulla, respectively. Morphometrical results showed that the cortical thymomas were more malignant than the medullary ones. Immunohistochemically, all cases of thymomas were positive for Leu7 and keratin, but stainability of them were variable among each subtype. In thymic tissues epithelial cells in outer cortex were positive for Leu7 and keratin, whereas those in inner cortex and medulla were negative for Leu7 and positive for keratin.

Alveolar soft part sarcoma: an electron microscopic study especially of uncrystallized granules using a tannic acid-containing fixative

Electron microscopic observation of alveolar soft part sarcoma reveals crystalline structure as well as granules that are only partially composed of crystalloids. The uncrystallized part has been observed only as a dense amorphous substance by the conventional fixation method with glutaraldehyde or osmium tetroxide (or both). Some investigators have explained the uncrystallized areas as artifacts due to the fixation method and as being essentially crystallized; other investigators consider the dense amorphous material the prodromal state of crystallization. In this study, however, which used the fixation method most appropriate for the intracytoplasmic filaments (fixation in tannic acid-containing glutaraldehyde and postfixation in osmium tetroxide) after increasing the permeability of the filaments to the fixative by pretreatment with a nonionic detergent (Triton X-100), the uncrystallized part was revealed to consist of an aggregation of many uncrystallized filaments with the same diameter (6 nm) as that of the crystallized filamentous structures. That is, the uncrystallized part was found to have been present as the prodromal state of crystallization and as filaments.