Bronchioloalveolar carcinoma: a new cancer in Peutz-Jeghers syndrome

Besides gastrointestinal hamartomatous polyposis and melanin spots in the skin and mucosa, patients with the Peutz-Jeghers syndrome (PJS) have repeatedly been observed with a variety of tumours, including lung cancer. Available data indicate an increased cancer risk among PJS patients, which suggests that the gene involved in PJS, STK11 on chromosome 19p13.3, may be a tumour suppressor gene. Herein, bronchioloalveolar carcinoma (BAC) of mucinous type is reported in a 22-year old male PJS patient with a novel germline frameshift insertion in exon 2 at codon 118 of the STK11 gene. Molecular studies of his BAC indicated loss of heterozygosity (LOH) in the region of STK11 on chromosome 19p13.3. This observation supports the hypothesis that STK11 is a tumour suppressor gene which is involved in the development of lung adenocarcinoma.

Surfactant proteins in pulmonary alveolar proteinosis in adults

Pulmonary alveolar proteinosis (PAP) is a rare disorder characterised histologically by an intra-alveolar accumulation of fine granular eosinophilic and periodic acid-Schiff positive material. In a retrospective study, the composition of the intra-alveolarly accumulated material of adult patients with PAP was analysed by means of immunohistochemistry and Western blotting. In patients with PAP, the current authors found an intra-alveolar accumulation of surfactant protein (SP)-A, precursors of SP-B, SP-B, variable amounts of mono-, di-, and oligomeric SP-C forms, as well as SP-D. Only in one patient was a precursor of SP-C detected. By means of immuno-electron microscopy, the current authors identified not only transport vesicles labelled for precursors of SP-B and SP-C, but also transport vesicles containing either precursors of SP-B or SP-C in type-II pneumocytes in normal human lungs. It is concluded that pulmonary alveolar proteinosis in adults is characterised by an intra-alveolar accumulation of surfactant protein A, precursors of surfactant protein B, and surfactant proteins B, C and D. The current data provide evidence that not only an impairment of surfactant clearance by alveolar macrophages, but also an abnormal secretion of transport vesicles containing precursors of surfactant protein B (but not surfactant protein C) and an insufficient palmitoylation of surfactant protein C, which may lead to the formation of di- and oligomeric surfactant protein C forms, play a role in the pathogenesis of pulmonary alveolar proteinosis.

A comparative study of clinically well-characterized human atherosclerotic plaques with histological, chemical, and ultrastructural methods

Atherosclerotic plaques (six cases) with well-documented clinical history were analysed using histology, scanning electron microscopy (SEM), transmission electron microscopy (TEM), energy-dispersive X-ray (EDX) spectroscopy, infrared spectroscopy (IR), thermogravimetry (TG), and high-resolution synchrotron X-ray diffraction. All samples contained about 60-70 wt% biological carbonated apatite (in dry state) in a nanocrystalline form with particle sizes of about 20 nm. Structurally, there are strong similarities to bone mineral. Ultrastructural investigations documented typical calcospherites, mineralisation processes starting at collagen fibrils and ring-shaped crystalline mineralised structures. There were no significant ultrastructural or chemical differences between the calcifications of individual patients.

Elementanalytische Untersuchungen von Tatowierungsfarbstoffen - Besteht eine potentielle Gefahrdung durch Tatowierungsfarbstoffe? Elemental analysis of tattoo dyes - is there a potential risk from tattoo dyes?

BACKGROUND

Tattoo dyes in current use can cause foreign body reactions.

METHODS

There are no rules regulating the composition of tattoo dyes. We performed elemental analysis on a series of dyes obtained from tattoo studios to determine if any dangerous materials were present. The composition of the dyes was determined using scanning electron microscopy in combination with energy dispersive X-ray microanalysis (EDS). This technique demonstrates bets the presence of elements of the sodium family and proves the presence of various metals. It provides no insight in chemical structures or bonds.

RESULTS

Elemental analysis revealed multiple metallic components in the dyes; these materials may be responsible for persistent foreign body reactions even years after being placed in the skin. Silicon, aluminium, titanium and copper were found in various yellow, green and red dyes. The composition of various dyes of the same colour from different sources was highly variable.

CONCLUSIONS

The tattoo dyes currently in use contain a number of components which cannot be regarded as "tissue inert". Chronic foreign body reactions can be expected even after many years.

Does interferon-gamma improve pulmonary function in idiopathic pulmonary fibrosis?

Idiopathic pulmonary fibrosis (IPF) is a disease with progressive and devastating deterioration of lung function and a fatal prognosis, despite aggressive therapeutic attempts, which, in the majority of cases are futile. Recently, a preliminary study of long-term treatment with interferon (IFN)-gamma1b and low-dose prednisolone in patients with IPF suggested that IFN-gamma1b treatment may improve lung function parameters of patients with IPF. Ever since, specialists in respiratory medicine who treat patients with IPF, are called by patients demanding treatment with IFN-gamma1b. Therefore, the authors here present another prospective investigation of IFN-gamma1b in five patients with IPF. According to the previously published design, patients received 200 microg IFN-gamma1b subcutaneously three-times per week and 10 mg prednisolone orally for 12 months. Two patients stopped IFN-gamma1b treatment after 4 months due to side-effects and further lung function deterioration and one patient died 3 months after commencement of therapy. In total, pulmonary function improved in only one patient during IFN-gamma1b treatment, while four patients deteriorated. To conclude, this small series of idiopathic pulmonary fibrosis cases treated with interferon-gamma1b and corticosteroids does not support previous data that this treatment improves pulmonary function or alters the natural course of idiopathic pulmonary fibrosis. Furthermore, in the authors' experience, side-effects of interferon-gamma1b treatment can significantly reduce patients' quality of life.

[Inflammatory aortic aneurysm after vascular-prosthetic treatment. Morphological findings after years of incorporation]

Until now the causal and formal pathogenesis of the inflammatory aortic aneurysm is poorly known. This report shows the pathological- anatomical findings of surgical and autoptical preparations, on the one hand 78 months and on the other hand 82 months, after vascular-prosthetical treatment of inflammatory aneurysms in the abdominal and thoracal part of the aorta. By morphological studies it was possible to reveal, the over years existing disease, the typical picture of inflammatory aneurysm, focal destruction of the genuine aortic wall and partial substitution by inflammatory-fibrous, less qualitative granulation tissue. Even 6 1/2 years past the implantation of the Dacron-prosthesis, there is still no complete ingrown. In addition to the known findings of the transprosthetical organization with a variable development of the outer connective-tissued coat and neointima, the incorporated granulation-tissue was overlapped by a strong inflammation according to the basic disease. In several parts of the inflammatory destructed aortic wall, there is still no fixed incorporation of the prosthesis after 7 years, so that "hypermobile-prosthetic-parts" can be found as a result.