Electron microscopic studies on the alveolar-capillary barrier in the patients of chronic pulmonary edema

Electron microscopic studies on the alveolar-capillary barrier were carried out in 13 patients of chronic pulmonary edema and/or congestion resulting from heart disease of various etiologies. The characteristic findings are tremendous proliferation of type II granular pneumocyte and irregular thickening of alveolar epithelial and capillary basement membrane. These ultrastructural changes correlated to the duration of heart failure and mean pulmonary arterial wedge pressure despite of disease groups and the age of the patients. In particular, lamination of capillary basement membrane with fragmentation was more specific finding which was observed only in patients with mean pulmonary arterial wedge pressure above 35 mmHg and duration of heart failure over 6 hears. There was no apparent relationship existed between the ultrastructural changes and pulmonary arterial pressure. In addition to these characteristic changes the remaining ultrastructural changes of the alveolar-capillary barrier were difficult to make a correlation to clinical course and cardio-pulmonary hemodynamics.

Antigen E content of pollen from individual plants of short ragweed (Ambrosia artemisiifolia)

A study was conducted to ascertain how much variation in allergenic potency of ragweed pollen occurs among individual plants and different plant populations in a restricted geographic area. Seeds of the short ragweed (Ambrosia artemisiifolia) were collected from 38 different sites in Champaign County, Ill. Plants from these seeds were grown under similar conditions, and antigen E (AgE) was determined on pollen samples harvested from individual plants. The populations from various sites in Champaign County differed by as much as severalfold with respect to mean AgE values. There were statistically significant differences among population means, although large variations occurred among plants within populations. Further research was conducted to learn whether the level of AgE was determined by genetic factors within the plants. Genetic regulation was indicated by the finding that 3 plants which had unusually low levels of pollen AgE all produced offspring with significantly lower mean AgE levels than those of control plants.

The pattern of liver diseases in Singapore. An autopsy study

This study is based on an analysis of 1839 consecutive necropsies. Liver diseases are common in Singapore. Of particular importance are cholelithiasis, cirrhosis and primary carcinoma of the liver. Gallstones are mainly of the pigment variety and a significant proportion are present in the bile ducts. The multiracial composition of the population is reflected in a difference in the pattern of liver diseases among the different ethnic groups. Indians are found to have more alcoholic hepatitis and cirrhosis which are often of the micronodular type, while the Chinese have significantly more macronodular cirrhosis and hepatocellular carcinoma. Clonorchiasis and schistosomiasis are confined to the immigrant Chinese. The pattern of liver diseases is changing. Cholangitis and cholangitic abscesses as a result of cholelithiasis are becoming more common while amoebic abscesses and hepatic ascariasis are definitely on the decline. This is attributable to improved sanitary conditions.

Longterm favorable effect of oxygen administration on a patient with primary pulmonary hypertension

A 17-year-old girl with primary pulmonary hypertension was treated with longterm administration of oxygen. Oxygen was delivered only at night for eight hours daily. Her clinical status has been improved for more than 17 months. Cardiac catheterization revealed almost 50 percent reduction of pulmonary vascular resistance. This is the first known report of successful treatment of primary pulmonary hypertension with oxygen administration.

Isolation of mouse hepatitis virus from infant mice with fatal diarrhea

An epizootic of fatal diarrhea occurred in mice which were approximately 10 days of age. The enteric lesions were similar to those reported in lethal intestinal virus of infant mice, but many diseased mice also had necrotic hepatitis. Mouse hepatitis virus antigen was demonstrated in the affected intestine and liver, and a virus that produced syncitium formation in mouse brain tumor cell culture was isolated from the intestines, livers, and brains. The virus was capable of producing intestinal and hepatic lesions similar to the naturally occurring disease after inoculation into suckling mice. Electron microscopy revealed viral particles within affected intestinal epithelial cells of the inoculated mice.

Electrophysiologic manifestations in so-called "sick sinus syndrome"

Electrophysiologic disorders in 17 patients with sick sinus syndrome (SSS) were assessed by recording of intracardiac electrograms, atrial overdrive pacing and extrastimulus technique. Significant suppression of the sinoatrial node (SAN) by overdrive pacing (maximum corrected SAN recovery time of longer than 560 msec) was noted in 14 or 16 patients studied. In nine patients, scanning with atrial extrastimuli, sinus rest was defined in all. In one patient there was a longer interpolation zone. Calculated sinoatrial conduction time (SACT) in individual patients varied considerably. The mean SACT was over 110 msec in 5 of 9 patients (56%). Sinus echo was demonstrated in 3; one manifested SAN- re-entrant tachycardia with rates of 72 to 77 beats/min. AV nodal echo was demonstrated in 3, two of them manifested AV nodal re-entrant tachycardia. Intracardiac electrograms revealed prolonged AV conduction time in 2 of 15 patients and prolonged His-Purkinje system conduction time in 2 of 17 patients studied. Two patients disclosed what we thought to be manifestation of intraatrial conduction disturbance. Both had considerable time interval between pacing impulse and atrial response. In one of them Mobitz type 1 and 2:1 intraatrial blocks were observed on atrial pacing and a possible internodal tract depolarization was also recorded. It is concluded that the electrophysiologic manifestations of patients with SSS cover a wide spectrum. The machanism of tachycardia can be due to either SAN or AV nodal re-entry.

Left ventricular performance in various heart diseases with or without heart failure:--an appraisal by quantitative one-plane cineangiocardiography

Quantitative one-plane cineangiocardiography in right anterior oblique position for evaluation of LV performance was carried out in 62 patients with various heart diseases and in 13 subjects with normal LV. Parameters for evaluating both pump and muscle performances were derived from volume and pressure measurements. Of 31 patients with either systolic hypertension or LV myocardial diseases (coronary artery disease or idiopathic cardiomyopathy), 14 had clinical evidence of LV failure before the study. It was found that mean VCF and EF were most sensitive indicators of impaired LV performance among the various parameters. There was a close correlation between mean VCF and EF, yet discordant changes of both parameters were noted in some patients. Furthermore, wall motion abnormalities were not infrequently observed in patients with coronary artery disease or primary cardiomyopathy. Therefore, assessment of at least three ejection properties (EF, mean VCF and wall motion abnormalities) are considered to be essential for full understanding of derangement of LV function in heart disease. This is especially true of patients with coronary artery disease. LV behavior in relation to different pathological stresses or lesions, such as chronic pressure or volume load, myocardial disease and mitral stenosis, was also studied and possible cause of impaired LV myocardial function in mitral stenosis was discussed.

Latent carcinoma of prostate at autopsy in seven areas. The International Agency for Research on Cancer, Lyons, France

A world-wide comparative study of the frequency and characteristics of latent carcinoma of the prostate was undertaken in seven areas, using standardized methods and "blind" microscopic evaluation in order to reduce selection and observer bias. The morphological features of 350 latent carcinomas found in 1,327 prostates were examined. Two Chinese populations, from Hong Kong and Singapore, showed a low frequency of latent carcinoma in comparison with western Europeans in Sweden and the Federal Republic of Germany and negroes from Jamaica; an intermediate position was found for Israelis and black Ugandans. The frequency of small latent carcinomas was about 12% in all the areas investigated and did not vary with age. Rates for larger latent carcinomas increased sharply with age ans showed an area-to-area variation resembling that of clinical carcinoma of prostate. The small carcinomas were almost exclusively situated in the outer half of the prostate and latent carcinomas of all sizes were evenly distributed between the anterior and posterior halves of the prostate and the right and left sides of the outer prostatic shell. Certain disagreements in diagnosis were noted when the sections from each area were evaluated independently by a different pathologist. Most of these disagreements were resolved by re-reading the sections; their occurrence had no significant effect on the geographical comparisons.

Hepatitis B antigen in the liver cells in cirrhosis and hepatocellular carcinoma

The demonstration of hepatitis B antigen in the liver cells in formalin fixed paraffin embedded tissues by Shikata's orcein staining method affords an opportunity to conduct retrospective studies on necrospy materials. Such a study in Singapore showed orcein-positive liver cells in 22 out of 52 (42.3%) and 37 out of 50 (74.0%) cases of cirrhosis of the liver and hepatocellular carcinoma respectively, while only 5 out of 113 (4.4%) 'normal' livers gave positive results. There is a significant difference in the frequency of hepatocellular carcinoma in orcein-positive and orcein-negative cirrhotic livers (28 out of 50, 10 out of 40 respectively). These results suggest a possible aetiological relationship between hepatitis B antigen and hepatocellular carcinoma.