Airway inflammation and bronchial remodelling in toluene diisocyanate-exposed BALB/c mouse model

Toluene diisocyanate (TDI), a highly reactive industrial chemical, is one of the leading causes of occupation-related asthma in industrialized countries. The pathogenesis of TDI-induced asthma, however, remains not fully understood, in part due to lack of appropriate animal models. Twenty five female BALB/c mice (age: 8 weeks) were randomly divided into 5 groups: Ovabumin (OVA); OVA peptide amino acid residues No. 323-339 (Pep); TDI; alum and physiological saline. Mice were intraperitoneally injected with 25 microg OVA or pep absorbed on 300 microg alum, 300 microg alum or saline on days 0, 7 and 14. For the TDI group, mice were sensitized subcutaneously with 20 microl neat TDI on day 0; 20 microl of TDI in olive oil (1:10) on days 7 and 14; on days 21-23. Then each group was challenged intranasally with 20 microl of 1% OVA, 1% Pep, 1% TDI, 10% alum and saline respectively. On day 28, mice were killed under pentothal anesthesia. The results demonstrated that neutrophil-dominant inflammation with a few eosinophil infiltration occurred in the peri-bronchial and peri-vascular regions of the lungs. This was accompanied by hyperplasia/hypertrophy of cells lining the airways and mucus production as shown by HE staining. Positive immunohistochemical MBP staining in parenchyma was also shown. Th2 cytokine IL-4 and IgE production were significant increased 5 days after last challenge while IFN-gamma level was below the detection limit.

CONCLUSION

the clear elevation of IL-4 and IgE could allow to conclude a possible Th2-like dominated allergic response in TDI-exposed BALB/c mouse model.

Myofibroblasts are responsible for the desmoplastic reaction surrounding human pancreatic carcinomas

BACKGROUND

The cell type responsible for the desmoplastic reaction surrounding human pancreatic carcinoma is unknown. Hepatic stellate cells, which activate to a myofibroblast-like form, are responsible for collagen deposition in cirrhosis and around hepatocellular carcinomas. Recently, pancreatic stellate cells have been described and implicated in the fibrosis of chronic pancreatitis. We sought to determine whether these cells are responsible for the scirrhous reaction surrounding pancreatic adenocarcinomas.

METHODS

Archival formalin-fixed, paraffin-embedded pancreatic tissues from 10 patients undergoing pancreaticoduodenectomy for ductal adenocarcinoma and from 2 patients with pancreatic islet cell tumors were examined immunohistochemically for alpha-smooth muscle actin (alpha-SMA), smooth muscle myosin heavy chain (SMMHC), procollagen I, collagen IV, and endothelial cell markers, von Willebrand factor and cluster of differentiation 31.

RESULTS

In non-neoplastic areas, staining for alpha-SMA and SMMHC was confined to interlobular septal regions. In contrast, the desmoplastic reaction surrounding all 10 pancreatic adenocarcinoma specimens displayed intense interstitial staining for alpha-SMA, SMMHC, and collagen IV but no staining for von Willebrand factor and cluster of differentiation 31. Procollagen I staining localized intracellularly to fibroblast-shaped cells within this alpha-SMA/SMMHC-positive scirrhous region. Islet cell tumors demonstrated an increase in alpha-SMA staining, although this was not as marked as in ductal adenocarcinomas.

CONCLUSIONS

A massive increase in myofibroblast activity, compatible with the activation of stellate cells, is associated with the deposition of collagen types I and IV in the desmoplastic reaction around pancreatic adenocarcinomas.

The value of ultrasonography in predicting autoimmune thyroid disease

Ultrasonography (US) may demonstrate a diffuse reduction in thyroid echogenicity (low-amplitude echoes) in autoimmune thyroid disease (AITD), which includes chronic lymphocytic thyroiditis and Graves' disease, as well as in subacute thyroiditis. The reported occurrence of this finding in AITD varies from 19% to 95%. To assess the validity of diffuse reduction in thyroid echogenicity as a predictor of AITD, 3,077 patients referred for US of the thyroid were examined prospectively with regard to reduced versus normal thyroid echogenicity. The most frequent reasons for referral were goiter, thyroid dysfunction, neck discomfort, and/or difficulty in swallowing. Ultrasonography demonstrated diffuse reduction in thyroid echogenicity in 485 patients. Of these, 452 patients had available records of fine-needle aspiration biopsy (FNAB), and were included in the study. From the remaining patients, with normal thyroid echogenicity, 100 consecutive patients were selected as controls. In 411 of the 452 study patients (90.9%) there was at least one laboratory finding consistent with possible AITD: cytology indicating lymphocytic thyroiditis, 287 of 363 patients (79.1%) with diagnostic specimens; elevated levels of peroxidase antibodies (TPOAb), 225 of 337 (66.8%); elevated thyrotropin (TSH) levels, 290 of 450 (64.4%); or low TSH levels, 79 of 450 (17.6%). The final diagnosis was: chronic autoimmune (Hashimoto's) thyroiditis in 352 patients; Graves' disease in 47 patients; subacute (granulomatous) thyroiditis in 7 patients; toxic nodular goiter in 3 patients; and toxic adenoma in 2 patients. In the remaining 41 patients, those without laboratory results consistent with AITD, the final diagnosis was colloid goiter in 37 and thyroid cancer in 4 patients. In the 100 controls, laboratory results were consistent with possible AITD in 14 patients: elevated TPOAb levels in 5 of 49 patients with retrieved antibody results; lymphocytic thyroiditis in 2 patients; elevated TSH levels in 2 patients; and low TSH levels in 2 patients. In these controls, the final diagnosis was: chronic autoimmune thyroiditis in 7; toxic nodular goiter in 6 patients, and toxic adenoma in 1 patient. The corresponding positive and negative predictive values of reduced thyroid echogenicity as an indicator of AITD were 399 of 452 (88.3% [95% CI, 85% to 91%]), and 93 of 100 (93.0% [95% CI, 88% to 98%]), respectively. Thus, diffuse reduction in thyroid echogenicity was a valid predictor of AITD.

Human pheochromocytoma: different patterns of catecholamines and chromogranins in the intact tumour, urine and serum in clinically unsuspected cases

Clinically unsuspected pheochromocytoma is usually discovered either at autopsy or during surgical intervention for unrelated conditions, despite often enormous neoplastic masses producing and storing catecholamine (CA). In order to assess whether these tumours share some common features we have compiled data for six patients admitted to hospital without previous diagnosis of their pheochromocytoma. The clinical variables and the morphological and immunohistochemical characteristics of the tumours revealed that these cases represented quite different expressions of adrenomedullary neoplasms. They differed not only with respect to nuclear ploidity and overall cytoplasmic morphology but also in catecholamine storage and expression of immunoreactive chromogranin A sequences in the intact tissue. In two of the patients hypertension had been overlooked as a diagnostic indicator of their CA-producing tumours. There was no clear relationship between the mean arterial pressure, the tumour content of CA and the serum levels of CA. Processed chromogranin A dominated in the serum of the two hypertensive cases. The 24-h urine values of CA and its main metabolite (vanillin mandelic acid) were, together with the serum values of chromogranin A and B, proportional to tumour mass and provided the most reliable diagnostic indicators for the non-hypertensive as well as the hypertensive cases.

Frequency of pulmonary embolism in patients with circulatory disturbances of the lower limb or intestine. An autopsy study

The frequency of pulmonary embolism in patients with circulatory disturbances in the lower limbs (CDLL) or intestine (CDI) were investigated in an autopsy series. Pulmonary embolism was seen more frequently in patients with CDLL than in patients with CDI. This difference was maintained irrespective of duration of last admission. Patients with CDLL had pulmonary embolism in 36% of the cases when they stayed in the hospital for more than 5 days prior to death, versus 12% in CDI patients. Pulmonary embolism occurred with approximately equal frequency in all age-groups. Surgery had little influence on the occurrence of pulmonary embolism in patients with CDLL. In 85% of the CDLL cases, pulmonary embolism (n = 81) was considered the immediate cause of death at autopsy. The awareness of this life-threatening disease is poor as only 12% had been diagnosed prior to death.

[Fine needle aspiration cytology of the breast. A simple method?]

During the period 1981-85, 3,743 fine-needle aspiration cytologies of breast tissue from 3,188 patients were reported by the Gade Institute, Department of pathology. Subsequent histologic examination was performed in the case of 798 patients. Among 421 histologically proven carcinomas after previous fine-needle aspiration, there were no false positive and 13 false negative cytological diagnoses. The specificity was 100% and, depending on the criteria used, the sensitivity 77.9 or 96.4%. Altogether 223 doctors performed the aspirations. This high number was probably the main reason for an unacceptably high proportion of inadequate smears. In experienced hands the proportion of inadequate smears was less than 4-7% in patients with carcinomas.

[Breast sarcoma. Diagnostic and therapeutic problems]

From 1981 to 1988 six patients, five females and one male, with breast sarcoma were treated in the Department of Surgery, University Hospital, Bergen. Four of them had phyllodes tumour, one a malignant myoepithelioma and one a liposarcoma. Metastases to axillary lymph nodes or distant metastases were not observed. Sarcomas account for about 1% of malignant breast tumours in our department. The cases demonstrate diagnostic and therapeutical problems in dealing with breast sarcomas.

Circannual variations of circadian periodicity in murine colony-forming cells

The circadian and circannual rhythms of committed stem cells (CFUc) were investigated by using the agar colony technique. There was a marked circadian rhythmicity, with variations between maximum and minimum colony yields of 2-5.5 times; such variations could also be seen throughout the year. A phase shift was observed for the plating efficiency during the year, with the maximum (acrophase) found at different times of the day. At specific times the plating efficiency varied considerably from month to month, with almost no variations at 4:00 P.M. to highly significant variations at other times, e.g., 4:00 A.M. Such changes in proliferation should be taken into consideration especially in long-term studies of hematopoiesis.

Circadian variations in mouse bone marrow

Circadian variations in mouse hemopoiesis were investigated in the early spring and summer using spleen colony assay, agar colony technique and differential counting. The multipotent stem cells and committed stem cells as well as the numbers of myelopoietic cells/femur underwent strong circadian variations with similar type of rhythmicity. In both types of stem cells (CFUS, CFUC) the rhythm was correlated to the variations in the numbers of myeloid cells/femur. Highest value (acrophase) was found at 1300 (MET). The amplitudes for CFUS and CFUC were between 50 and 80% of the 24 h mean values (mesor), whereas the variations in the other compartments of the bone marrow were less pronounced. For the CFUC the circadian rhythms were reproducible both at two different times of the year and over 48 h. Changes were found in erythroid cells as well, but the rhythm was not so pronounced.

Circadian variations in the committed stem cell responsiveness to granulopoiesis inhibitory factor (chalone) in vitro

The effect of inhibitory extracts of human granulocytes (chalone) on the circadian rhythm of myelopoietic colony formation in soft agar (CFUc) was studied over one year. Normally, the number of bone marrow CFUc shows a strong circadian rhythm. Preincubation of the cells with the extracts before plating modulated this rhythm with phase shifts and modifications of amplitude. The effects of the extracts oscillated between significant inhibition and stimulation over a 24 h period. No significant seasonal variations in the inhibitory effects were found.

Biological properties of partially purified granulocyte extract (chalone) assayed in soft agar culture

The inhibitory effects of partly purified low molecular weight granulocyte extracts (GE) from human peripheral blood were investigated on mouse myelopoietic cells in agar cultures. By repeated freezing and thawing the inhibitory effect of the extract was lost, and instead a stimulatory effect was seen. The stimulation was seen mainly as an increase of colonies and clusters from the sixth day of culture. The degree of inhibition depended on the length of the preincubation time. After half an hour a stable and lasting inhibition was found. The biological effects of the extracts were temperature dependent. Inhibition or stimulation was seen when the target cells were exposed to GE at 37 degrees C and not at 4 degrees C. Colony formation in agar showed circannual variation with maxima in spring and autumn and minima in summer and winter. The data indicated that the inhibitory effect of GE did not show circannual variations.

Sequential flow cytometric analysis of cellular DNA-content in peripheral blood during treatment for acute leukaemia

Sequential flow cytometric analysis (FCM) of relative nuclear DNA content per cell was done in peripheral blood of 12 patients during treatment for acute leukaemia. A marked increase of cells with S-phase DNA-content during the first hours of treatment was found in patients responding favorably to treatment. One patient with increase of 'S-phase cells' died before clinical improvement could be evaluated. However, lack of S-phase increase at one treatment cycle did not exclude a favorable response in the next. Two cases with probable aneuploid leukaemia showed gradual disappearance of abnormal cells during therapy. The value of FCM analysis of peripheral blood seems to be in predicting the response to treatment before clinical signs appear.

Inhibition of agar colony formation by partially purified granulocyte extracts (chalone)

Granulocytic extracts (GE) of different sources, presumably containing the granulocytic chalone, were prepared in different laboratories and purified to some extent. They specifically inhibited the formation of granulocyte and macrophage colonies in agar. The effect was however most pronounced on granulocyte and mixed granulocyte-macrophage colonies, and less on macrophage types. Addition of GE to bone marrow cells at the time of plating in agar, as well as short incubation of the cells together with GE prior to plating, inhibited subsequent colony formation. The inhibitory effect could easily be reversed by washing the cells with an excess of medium prior to plating during the first hour of preincubation, but not after five hours. Increasing the doses of colony stimulating activity (CSA) (at low doses of GE) released the inhibitory effect, but not at high doses of GE. The inhibitory effect of GE on colony formation was dose dependent down to almost 100% inhibition. No apparent cytotoxic effect of GE on bone marrow cells could be found and lymphoblastic cells were not inhibited. Extracts containing a specific inhibitor of erythropoiesis (EIF) stimulated myelopoietic colony formation in agar.

Atraumatic rupture of the kidney. A case report with autopsy

A case of atraumatic rupture of the parenchyma of the right kidney with gross retroperitoneal haemorrhage is reported in an old woman. The underlying vascular lesion was probably arteriosclerotic and associated with hypertension.