Modulation of type III collagen synthesis in bovine corneal endothelial cells

Bovine corneal endothelial cells in culture synthesize predominantly type III collagen, unlike rabbit corneal endothelial cultures which synthesize type IV collagen. In an attempt to document whether this type III collagen synthesis by bovine cells is a tissue culture-specific phenomenon, collagens synthesized by organ culture of bovine Descemet's membrane/corneal endothelium complex were compared with those of subsequent tissue culture cells, up to the eighth passage. The biosynthetically labeled collagens were analyzed on SDS electrophoresis. The soluble fractions of tissues extracted with neutral salt followed by pepsin digestion contained only type I collagen; no other radiolabeled collagens were detected in organ culture. When pepsin treatment was eliminated, type IV collagen was identified in the tissue extract by immunoblot analysis using monoclonal antibody; type III collagen failed to show a positive band by immunoblot analysis. The pepsin-treated medium fraction of the primary culture contained types I, III and V collagen; type IV collagen was identified by either the characteristic electrophoretic mobility or by immunoblot analysis only prior to the proteolysis step. The subsequent subcultures continued to synthesize types I, III and V collagen, but type IV collagen was no longer detectable from the third passage on. No substantial quantitative changes in the expression of individual collagens were observed during subculture. From the primary culture, type I collagen accounted for 30%, type III for 60% and type V for 10%. Enhanced expression of type III collagen was observed in the eighth passage and in primary cultures grown on type I collagen matrix.(ABSTRACT TRUNCATED AT 250 WORDS)

Allergic bronchopulmonary candidiasis: case report and suggested diagnostic criteria

A patient with an illness consistent with allergic bronchopulmonary candidiasis is described. The patient had asthma, atelectatic pulmonary infiltrates on three occasions, immediate cutaneous reactivity as low as 10(-7) (wt/vol) to Candida albicans extract, and precipitating antibody to this organism. C. albicans was the only organism cultured from two bronchial lavage specimens. Total serum IgE was elevated to 5745 ng/ml and decreased rapidly with corticosteroid therapy. Serologic studies were not consistent with allergic bronchopulmonary aspergillosis. Serum IgE to C. albicans, measured by ELISA after adsorption of IgG from the serum samples by incubation with staphylococcal protein A, was found to be 575% to 650% above control values. The serum IgE antibody activity against Candida decreased with clinical improvement after corticosteroid therapy.

Incidence of squamous metaplasia in large bronchi of Japanese lungs: relation to pulmonary carcinomas of various subtypes

The incidence of bronchial squamous metaplasia in Japanese lungs was investigated in order to clarify the significance of this lesion for the development of lung cancer of various histological subtypes. The bronchi of 104 and 32 lungs resected, respectively, for primary or metastatic tumors were step-sectioned and examined histologically. The incidence of squamous metaplasia was particularly high (83% of cases, 8-11% of sections) in male lungs bearing primary squamous or small cell carcinoma whereas it was low (43% of cases, 3% of sections) in lungs of both sexes with adenocarcinoma, the latter figures being about the same as those for lungs with secondary metastatic tumors. Although the overall incidence of lung squamous metaplasia in Japanese is much lower than in the U.S., the present data demonstrate a high level in association with squamous or small cell carcinoma, directly comparable to that of Americans. However, atypical metaplasia, or dysplasia, was encountered much less frequently than in the U.S. A topographical study of 7 minute or small squamous cell carcinomas revealed 3 to have adjacent and 2 to have nearby areas of squamous metaplasia. However, 2 cases were found to be completely free of squamous metaplastic lesion. Thus, squamous metaplasia may be associated with the development of squamous cell carcinoma but would appear not to be an obligatory step in the development of this neoplasm.

Colchicine reverts cell shape but not collagen phenotypes in corneal endothelial cells modulated by polymorphonuclear leukocytes

The authors have shown previously that polymorphonuclear leukocytes (PMN) modulate rabbit corneal endothelial cells (CEC) into cells that irreversibly acquire the characteristics of fibroblasts, including multilayering of spindle-shaped cells and deposition of interstitial extracellular matrix composed predominantly of type I collagen. In an attempt to determine if the changes in cell shape caused by the disruption of cytoskeleton are correlated with the alteration of collagen phenotypes in fibroblastic corneal endothelial cells (FCEC), colchicine and cytochalasin B (CB) were used. A series of dose-response studies were performed, and correlated with exposure time. When cells were exposed to the drugs (ranging from 0.01-4.0 micrograms/ml) 24 hr after plating, the majority of cells treated with colchicine dramatically changed from fibroblastic to polygonal shape: cells became flattened and cytoplasmic processes disappeared. Conversely, no apparent changes were observed in the CB-treated cells. On removal of colchicine, the cells resumed fibroblastic morphology within 24 hr; most of the cells again developed cytoplasmic processes. When collagen phenotypes were analyzed by electrophoresis, types I, III, and V collagen were present in either the colchicine or CB-treated cells, regardless of the concentration of drug used. However, synthesis of type I trimer and type III collagen was significantly increased in the cells treated with colchicine at concentrations greater than or equal to 1.0 microgram/ml; the alpha 1:alpha 2 ratio was approximately 4.5, and type III accounted for 35-40% of the total collagen. CB did not induce a similar alteration. These observations indicate that changes in cell shape are not related to the switch of collagen phenotypes in FCEC.(ABSTRACT TRUNCATED AT 250 WORDS)

[Spindle cell squamous carcinoma of the lung--two case reports]

Two cases of spindle cell squamous carcinoma of the lung are presented. Both cases were female heavy smokers aged 73 and 55. The carcinomas, 7.5 and 6.0 cm in diameter respectively, were located at the peripheral portion of the right lower lung lobes. Direct invasion to the diaphragma and metastasis to the chest wall were observed in the first case but no metastasis was observed in the second case. Histologically, both carcinomas showed a biphasic appearance due to the presence of a squamous cell carcinoma component and a spindle cell sarcomatous component with marked cellular pleomorphism, but no neoplastic bone, cartilage or muscle. Transitional area of two components were seen in the second case.

[The influence of smoking on the development of various subtypes of pulmonary carcinoma]

The influence of smoking on the development of pulmonary carcinoma of various histological subtypes was analyzed in 244 primary and 84 metastatic lung cancer patients. The new WHO classification was used for histological diagnosis. The relative risk was calculated by the odds ratio. It was found that all the squamous, small-and large-cell carcinomas were derived from smokers with relative risks of 27.8, 7.5 and 5.6, respectively. On the other hand, adenocarcinoma had very little, if any, relationship with smoking, the relative risk being 1.5 in men and 1.3 in women. The high-risk group for squamous cell carcinoma in men was defined with a regression line of y (duration of smoking) on x (number of cigarettes per day) as y = -0.24 x + 48.6.

[Influence of pregnancy on HB virus carriers]

Liver function tests (GOT, GPT) were performed on 269 female HB virus carriers during pregnancy and puerperium with the following results: Pregnancy in HB virus carriers did not result in any deterioration in liver function, but was rather associated with its gradual normalization particularly in symptomatic carriers. At 1 month of puerperium, in contrast, the occurrence or rebound flare-up of hepatitis was frequently observed among the virus carriers, notably with overt liver dysfunction being seen in 43% of those positive for e antigen. Of 28 e antigen-positive carriers in whom a follow-up study was extended to the next pregnancy, 12 whose liver function was normal during puerperium had normal liver function during the next pregnancy and was positive for e antigen. In the other 16 carriers showing deteriorated liver function during puerperium, liver function during the next pregnancy was abnormal in 6 and normal in 10, with seroconversion and negativity for e antigen being observed in 2 and 4, respectively, of these 16. It is inferred that fluctuations in liver function and e antigen during pregnancy and puerperium might be consequent on increased secretion of corticoids during pregnancy.

[Pulmonary malignant lymphoma--a case report]

A case of pulmonary malignant lymphoma is reported. A 65-year-old woman had no complaint. But chest roentgenography and CT revealed an infiltrating shadow with marked airbronchogram in the left S3. TBLB revealed marked subepithelial lymphocytic infiltration of the bronchial wall. Because the shadow had gradually enlarged, malignancy was suspected and lobectomy was performed. The resected specimen showed a 60 X 56 X 30 mm greyish-yellow, medullary tumor with intrapulmonary metastasis. Microscopically, well-differentiated small lymphocytic tumor cells severely infiltrated the pulmonary parenchyma, pleura and bronchial cartilage. There was no lymph node metastasis or extrapulmonary involvement. Immunohistochemical study proved the monoclonality of the K chain. She was treated with chemotherapy postoperatively.

Inflammatory effects of acetylglycerylether phosphorylcholine: vascular permeability increase and induction of pleurisy in rats

AGEPC-induced vascular permeability increase in the skins of rats, guinea pigs and rabbits was assessed by the leaked dye method, in which the dye was extracted from the skin sites injected with AGEPC after intravenous injection of pontamine sky blue. The activity was the most potent in the dorsal skin of rats and followed by guinea pigs and then rabbits. The vascular effect in rat skin was not affected by pretreatment with mepyramine and methysergide, but partially reduced by indomethacin and significantly suppressed by dexamethasone. Synergism was observed between AGEPC and bradykinin, histamine, 5-hydroxytryptamine, PGE1, PGI2 or PGD2, when each agent was simultaneously injected with AGEPC into the skin. Pleurisy was induced by intrapleural injection of 1 ug of AGEPC into rats. Pleural fluid accumulation and leukocytes migration were observed. The exudate volume was not suppressed by pretreatment with indomethacin but significantly reduced by intravenous injection of CV-3988, a novel antagonist of AGEPC.

[Experimental-morphologic study of depressed fracture of the skull. Experimental model]

Experimental skull bone models were made and depressed fractures were created. The morphological reactions of the skull bone models were observed to be the same as in human skulls, that is, that the fractures of the inner side were always larger than those of the outer side as a result of the direction of the impacting forces (a so-called classical type of reversed "V" form). The reason for the reversed "V" form of the depressed human skull fractures was discovered by means of these model studies. The reversed "V" form is due to the "HSH" morphological structure. It will be now be necessary to correct the error in textbooks regarding the depressed fractures, especially morphological illustrations.

A case of biliary cystadenocarcinoma with recurrent jaundice. Diagnostic evaluation of computed tomography

A 73-year-old male patient with biliary cystadenocarcinoma and episodes of recurrent jaundice is reported. This very rare tumor was suggested as a possible diagnosis by the computed tomographic findings showing intrahepatic cystic masses with septations and papillary projections. The diagnosis of the mucin-producing tumor was supported by aspiration of mucinous bile with a cannule inserted endoscopically via the major duodenal papilla. The computed tomographic findings and the diagnosis were verified by pathologic studies made on the material obtained surgically. The mucinous bile is assumed to have been responsible for the recurrent jaundice.

Cervical injury from skiing

A retrospective study of 18 patients with cervical spine injuries from skiing accidents is presented. Four patients were treated surgically because of instabilities. Twelve patients had associated head injuries, two of whom were operated on. One patient died from severe craniocervical injury caused by collision with another skier. The causes of the cervical spine injuries are analyzed and the possibilities for preventing them are presented.

[Head injuries in childhood caused by skiing and their optimal prevention]

During the last three skiing seasons we have treated a total of 105 children in our clinical wards for skull-brain injuries caused by skiing accidents. 25 of these cases (25.2%) were operated on, mostly because of a depressed fracture (92%) with or without brain lesion/bleeding, which the children incurred by colliding with various obstacles. Uncontrolled excessive speed and careless skiing methods are the main reasons for these injuries. However, the responsibility for the increasing number of skisport-connected skull-brain injuries does not lie with the children alone, but more so with us grown-ups, i.e. the parents, teachers and physicians, as long as we do not preach and emphatically insist on the implementation of indirect and direct specific measures of accident prevention. Based on an analysis of typical injuries and their many causes we come to the conclusion that, aside from the usual precautions, only one simple, sensible and effective prevention of skull-brain injuries is feasible, namely the "protection helmet". Similar to the existing crash-helmet law for motorcylists and just like for the professional skiracers, whom the children try to imitate more and more with regard to style and speed, we earnestly urge legislation to make the wearing of a protective helmet compulsory for all skiers up to 17 years of age.

[Exeresis in occipital neuralgia]

31 patients, suffering from an occipital neuralgia, were treated surgically by section of the n. occipitalis major or minor. The retrospective study of these cases extends over a period of one to nine years. In 26 patients (84%) a good result was achieved initially, and 16 patients (52%) are completely free of any complaint up to the present. In five patients (16%) no improvement has occurred. In two of these five patients an epipharyngeal cancer was discovered later; in one of the patients trigeminal neuralgia was established later on. Contrary to earlier published intradural rhizotomy this operation is simple and without risk (it is performed under local anaesthesia), and in long-standing, obstinate and tormenting cases very good results can thus be achieved. The unclear aetiology of the neuralgia was observed anatomically by the atypical course of the nerves. Other methods for the treatment of occipital neuralgia were not considered here.

Clinical and experimental morphological study of depressed skull fracture

Ninety-eight cases of depressed skull fractures, caused by various accidents, were treated. The morphological structures of the fractures were studied. Thirty-four depressed fractures were established experimentally, and a comparable study was performed. Clinically and experimentally I confirmed the same morphological reactions, that is, that the fractures of the inner region were always larger than those of the outer side, as a result of the direction of the impacting forces. The human skull suffers depressed fractures only because it has "HSH" (hard-soft-hard) histological structures. It is naturally disadvantaged.

Effective extraction and radioimmunoassay of chorionic gonadotropin in human urine

A single-step procedure for extracting and concentrating hCG from 24hr urine samples was developed. The procedure involves the adsorption chromatography with Vitachange (Permutit). Its hCG recovery was improved to be more than 90% compared with about 50% of a standard kaolin-acetone method. Nonspecific urinary protein concentration in extracts was also reduced. Thus, partial purification and concentration of urinary hCG by this procedure with subsequent RIA using antisera against the unique carboxyl-terminal peptide of hCG beta subunit provides a sensitive and specific method for detecting hCG in urine. In urine samples obtained from normal persons, the upper limit of hCG-immunoreactivity detected by this new system was 1.1 IU/24hr. However, 93% of subjects gave values lower than 0.5 IU/24hr. The urinary hCG level of lower than 1.1 IU/24hr may be designated as normal. This new assay system now provides reliable potentiality in the strict management of patients who are undergoing treatment for gestational trophoblastic neoplasia.

Depressed skull fracture in skiing and its experimental study

During the last seven skiing season, 57 patients were treated surgically for head injuries caused by skiing accidents. A typical type of injury was observed, namely the "depressed fracture" in 84% of the cases, accompanied by brain contusions or hematomas. The mechanism of the accidents was analyzed. A depressed fracture is caused by direct local force application, often as the result of high or not properly adjusted speed. Through this impressive observation of depressed fracture with or without brain damage, experimental impact mechanisms of human skull depressed fractures were studied. In the present study, a tolerance threshold of about 1 to 2 kN (can be compared to an impact of about 16 km/h) was observed for a depressed fracture in the temporal region, which often is the area of severe damage in skiing. This clinical and experimental examination should aid in preventing head injuries in skiing accidents because head injuries are mostly the result of depressed fractures, accompanied by brain contusions or hematomas. From these analyses, it can be shown that the wearing of helmets is in fact an effective possibility for the prevention of head accidents in skiing. It should be recommended particularly for children and young people.