Immunolocalization of basement membrane molecules in the stroma of salivary gland pleomorphic adenoma

In order to determine the participation of basement membrane molecules in formation of its characteristic stroma, 30 cases of salivary gland pleomorphic adenoma were examined by immunohistochemical staining for type IV collagen, laminin, heparan sulfate proteoglycan, and entactin. The stroma was histopathologically classified into four types: hyaline, fibrous, myxoid, and chondroid. Immunohistochemically, type IV collagen and laminin were more intensively localized in hyaline, fibrous and chondroid types of stroma, whereas heparan sulfate proteoglycan was more prominent in myxoid areas. The results suggest that the stroma contains these basement membrane components, which are possibly biosynthesized by epithelial tumor cells, and that histological variety of the stroma depends on proportion of local contents of each basement membrane molecule.

Reduced GABA-mediated chloride flux in entorhinal cortex-kindled rat brains

Gamma-aminobutyric acid (GABA)-mediated chloride uptake was determined in synaptoneurosomes prepared from the brains of entorhinal cortex-kindled and paired control rats. Subjects were sacrificed either 24 h or 28 days after the experimental animals had exhibited their sixth stage 5 convulsion. In the cortex and cerebellum, no difference was observed between kindled and control animals at either time period. In the brain-stem, however, a significant reduction (approximately 50%) in chloride uptake was observed in kindled subjects both 24 h and 28 days after the last seizure. These findings are consistent with the hypothesis that the 'kindled state' results from a long-lasting decrease in GABA-mediated inhibitory activity.

Ultrastructural comparative study on endometrium of Chinese women using intrauterine devices of stainless steel ring, copper T220, and releasing levonorgestrel: morphometry of microvessels

An electron microscopic morphometric study was performed for three kinds of IUDs, the stainless steel ring (SS), the copper T220 (TCu) and the WHO levonorgestrel IUD (LNG), for comparison of their effects on microvessels of the endometrium of women wearing the devices. The morphometry of plasmolemmal vesicles (PV) of the endothelial cell as well as the contracted and degenerated endothelial cell were undertaken. The results showed that all three IUDs led to significant changes in blood vessels, i.e., a higher percentage of contracted and degenerated cells than in the control group (p less than 0.01), and an increase in PV after insertion of the devices (p less than 0.01). The TCu caused more contracted endothelial cells than the SS (p less than 0.01) and the LNG (p less than 0.05). The levonorgestrel-releasing IUD resulted in a higher increase of PV than the SS and the TCu. For the differences between bleeding and non-bleeding groups, only the TCu showed a higher percentage of contracted cells (p less than 0.05).

Homozygous deletion of the retinoblastoma gene in an acute lymphoblastic leukemia (T) cell line

Human leukemia cell lines were examined for the status of the retinoblastoma (RB) protein by immunoblotting analysis using antibodies raised against the TrpE-RB fusion protein. One of 16 cell lines examined, the T-cell acute lymphoblastic leukemia (ALL) line HSB-2, lacked the 110-Kd RB protein. Southern blot analysis of genomic DNA extracted from HSB-2 cells showed a large homozygous deletion of the RB gene, stretching from exon 18 beyond exon 27. Northern blot analysis showed multiple, abnormal RB transcripts in HSB-2. A truncated protein (72 Kd) was detected with 35S-methionine labeling but not with 32P-orthophosphate labeling of the HSB-2 cells. The genomic deletion of greater than 85 kb DNA at the RB locus (13q14) was not detectable in the karyotype of the HSB-2 cells. Among the 16 human leukemia cell lines examined for the status of the RB gene, only one, the HSB-2 line, showed an abnormal RB protein. Further study of primary leukemia and lymphoma samples appears to be warranted.

Autoantibodies to keratin in Sjögren's syndrome

In order to determine which components of the salivary duct cells are recognized by the antisalivary duct antibodies, sera of patients with Sjögren's syndrome were screened for immunoreactivity to keratin by using an ELISA test and a Western blot analysis. The autoantibodies which reacted with keratin were demonstrated in 8 of 9 definite cases of Sjögren's syndrome and in 3 of 6 probable cases, and they reacted with different keratin peptides in each case. The results suggest that the antisalivary duct antibodies include antibodies against keratin, which exists ubiquitously as a cytoskeleton in the salivary gland epithelial cells. Detection of antikeratin antibody might be a useful aid for diagnosis of Sjögren's syndrome.

Endoscopic placement of expandable metal stents for biliary strictures--a preliminary report on experience with 33 patients

The main problem with palliative treatment of extrahepatic cholestasis with an endoscopic biliary endoprosthesis is clogging. One of the factors thought to be of importance is the diameter of the stent. In order to avoid being limited by the size of the instrumentation channel of the endoscope, expandable stents have been developed. In this article we report on our preliminary clinical experience with an endoscopically placed expandable metal stent ("Wallstent") in 33 patients with extrahepatic bile duct stenoses. When fully expanded, the stent has a diameter of 30 F and a length of 6.7 cm. It was possible to successfully place a stent in every patient. Clinical improvement was achieved in all patients except one. Two patients underwent elective surgery, while one died of renal failure. Another died of septic shock after 5 weeks, but no autopsy was performed. In conclusion, our initial experience with this stent shows that at least in the short term biliary drainage was excellent, with no complications of pancreatitis or hemorrhage. Longer follow-up than our 4 weeks is necessary to establish the position of this stent in comparison with the conventional endoprosthesis in the management of obstructive jaundice.

The effect of intrauterine devices (stainless steel ring, copper-T220 and levonorgestrel) on the DNA content in isolated human endometrial cells

The effect of three different intrauterine devices on the DNA content in human endometrial cells has been studied in 29 women before and after the insertion of an IUD; a stainless steel ring (9 subjects), Copper-T220 (11 subjects) and a medicated IUD releasing levonorgestrel at a rate of 2 micrograms/day (9 subjects). The material was grouped into "bleeders" (having more than 8 days of bleeding and spotting per month) and "non-bleeders" (having less than 8 days of bleeding and spotting per month). The DNA content was assessed on isolated endometrial cells smeared from thin biopsies and the amount of DNA per cell nucleus was measured by means of a Feulgen microspectrophotometric method. No significant difference was found between the "bleeders" and the "non-bleeders" as to the DNA content. Nevertheless, when the total number of subjects were pooled together, a significant increase in the DNA content was found in the post-insertion specimens in the groups of women using the SS and the T-Cu IUDs. Furthermore, a significant decrease in the DNA content was also found when the specimens obtained after the insertion of the LNG IUD were compared with those obtained after 24 months' use of the stainless steel ring and the Copper-T220 device (p less than 0.01 and p less than 0.002, respectively). It is concluded that the insertion of an inert IUD or an T-Cu IUD, induces significant alterations in the DNA content of the human endometrium adjacent to the device, whereas the use of the LNG device does not significantly modify the DNA synthesis when used for 3-10 months. No correlation was found between the DNA content per cell and the number of days of bleeding and spotting.

Analysis of submandibular gland sialograms in Sjögren's syndrome

We report here the sialographic appearances of the submandibular gland in both primary and secondary Sjögren's syndrome (SS). In order to compare these with those of the parotid gland, we defined new criteria for the staging for SS based on the degree of depiction of the peripheral ducts. In 24 out of 74 cases the submandibular sialogram showed more advanced, destructive disease compared with the parotid. This study suggests that although SS involves the parotid gland first, it progresses in the submandibular gland more rapidly.

The effect of intrauterine devices, the stainless steel ring, the copper T220, and releasing levonorgestrel, on the bleeding profile and the morphological structure of the human endometrium--a comparative study of three IUDs. A morphometric study of 96 cases

Thirty-four women using the stainless steel ring (SS), 43 women using the Copper T220 (TCu), and 19 women using levonorgestrel-releasing intrauterine devices (LNG) were admitted to the study. The light microscopic biopsy material was subjected to morphometric studies including 8 indices of endometrial activity before (Control) and after 24 months of exposure to the SS and TCu device and 3-10 months of exposure to the LNG device. The women were grouped into subjects with and without intermenstrual and prolonged bleeding. The results revealed that there were highly significant differences between the IUDs at the endometrial level as displayed by morphometry. However, the difference between bleeders and non-bleeders was not significant in any of the three types of IUDs. Although the mode of action of these IUDs at the endometrial level is different, the mechanism responsible for the irregular endometrial bleeding needs to be further investigated.

Cyclosporin in the treatment of severe aplastic anemia: report of one case

According to recent reports, cyclosporin (CsA) has been proven to be a cure for some patients with severe aplastic anemia (SAA). The use of CsA to treat SAA is based on both experimental and clinical evidences showing that this disease is sometimes caused by immune-mediated mechanisms. This report describes a fourteen-year-old boy who recovered from SAA after being treated with CsA, together with to a lesser extent prednisolone. In June of 1986, when he failed to improve after receiving six months of corticosteroid treatment, CsA was introduced. Following three weeks of CsA therapy no further blood transfusion was needed. Danazol was added on the 28th day of CsA therapy. On the 105th day the blood counts began to improve, and on the 375th day bone marrow aspirate revealed normal hematopoiesis. Along with these improvements, however, some side effects from the CsA treatment were observed. These included: hirsutism, hypertension and gingival hyperplasia, all of which eventually subsided on tapering and finally terminating CsA. For the time being, no side effects have been observed in the six-months period since CsA was stopped and the patient is leading a normal life.

Heat stroke: a clinical review of 27 cases

Heat stroke is the most serious entity amongst the heat disorders. Whilst potentially fatal, it is preventable and salvageable. A retrospective study involving 27 patients admitted for exertional heat stroke to the Medical Unit, Toa Payoh Hospital, Singapore from January, 1984 to January, 1987 was carried out. These patients presented with a rectal temperature of greater than 40 degrees C and central nervous system disturbances. All were males and, except for three, were local born. All except two were below thirty years old. The patients were treated with a standard regime of IV fluids and sponging in the ICU. 19 patients (70.4%) presented in coma whilst abnormal behaviour, e.g. aggression and mental confusion was seen in the remainder. Fits were seen in only 5 patients (18.5%). Metabolic acidosis was seen in 93.3%. Hypokalaemia was present in 3 patients (11.1%). Of the enzymes, creatinine phosphokinase was elevated in all except 1 patient (mean: 4868.8, range: 146-28850). There were no deaths recorded in this series. Complications include reversible DIVC (3 instances), oliguric renal failure (4 instances) and residual neurological deficit (2 instances). 9 patients (39.1%) took more than 4 hours for the rectal temperature to attain 37.5 degrees C. All the above complications except for 1 instance of DIVC occurred in this group with delayed cooling. Heat stroke is a serious condition with serious complications and require prompt treatment.

Vagal stimulation decreases rate of left ventricular relaxation

We determined the effects of vagal stimulation on the time constant (tau) of left ventricular isovolumic pressure decay and on the maximum rates of left ventricular pressure change (dP/dt) during contraction and relaxation in anesthetized dogs. In each dog, the atria were paced at a constant rate of 150 beats/min. We recorded left ventricular pressure waveforms in the absence (control) and in the presence of vagal stimulation at frequencies of 1, 2, and 3 Hz. During the control periods and during vagal stimulation at each frequency, we determined tau, the maximal rate of contraction, and the maximal rate of relaxation from left ventricular pressure waveforms recorded at medium (100 mmHg), high (130 mmHg), and low (73 mmHg) afterloads. Vagal stimulation at a frequency of 3 Hz increased tau by 23%. This effect of vagal stimulation on tau was most pronounced at the high afterload. Vagal stimulation at 3 Hz decreased the maximal rate of relaxation by 19%, but it decreased the maximal rate of contraction by only 8%. Thus vagal stimulation significantly decreased the rate of left ventricular relaxation and had a greater depressant effect on ventricular relaxation than on contraction.

Post-treatment calcification of mesenteric non-Hodgkin lymphoma: CT findings

We report the clinical course, plain radiographic, and CT findings in two cases of post-treatment calcification in non-Hodgkin lymphoma. A peripheral curvilinear pattern of calcification appears to be characteristic.

In situ correlative immuno-identification of mononuclear infiltrates and invasive bacteria in diseased gingiva

The purpose of this study was to identify and quantify mononuclear cells and invasive bacteria in consecutive histological sections in diseased gingiva. Gingival biopsies were obtained from sites displaying evidences of severe periodontitis (pocket depth greater than 5 mm, bleeding on probing) in six patients. Specimens were frozen and serially sectioned at 8 micron in a cryostat. Monoclonal antibodies (mAb) directed against membrane markers of mononuclear infiltrate cells and rabbit polyclonal sera against specific bacteria shown to be invasive in association with an immunoperoxidase technique and specific point quantification were used. The mAb panel included Leu 1 (Pan T), Leu 2a (T suppressor/cytotoxic), Leu 3a (T helper/inducer), Leu 6 (Langerhans/dendritic), Leu 7 (NK/K), Leu M3 (monocyte/macrophage), and B7 (B cell). This methodology allows for in situ per cent quantification of mononuclear cell subsets along with identification and quantification of invasive bacteria in the same gingival tissue site. This may be a practical approach to establish the relationship between bacterial invasion and cellular immune response by the host. This technique enabled the characterization of the mononuclear infiltrate in relationship to specifically identified invasive bacteria in diseased gingiva.

Brain neurotransmitters in glycine encephalopathy

We measured neurotransmitter markers in autopsied brain of infants with glycine encephalopathy (GE). Because patients with GE develop intractable seizures, special attention was devoted to those neurotransmitter systems implicated in human epilepsy. Mean levels of glycine in the frontal cortex of GE patients were three times higher than control values. No abnormalities were observed for concentrations of gamma-aminobutyric acid (and related receptors), other major neurotransmitter amino compounds, or activities of cholineacetyltransferase and aspartate aminotransferase. Mean acetylcholinesterase activity was significantly elevated by 46%. As experimental data suggest, glycine markedly potentiates the action of the excitatory neurotransmitter glutamic acid. To the extent that the brain seizures in patients with GE can be explained by this mechanism, pharmacotherapy with excitatory amino acid antagonists may represent a new approach to the treatment of GE.

[Histamine and lung cancer. II. Human lung cancer cell line and histamine]

Using tissue culture and biochemical technique, the effects of autacoid-histamine and histamine H-2 receptor's antagonist-cimetidine on human lung cancer cell line were studied. It was shown that histamine at the concentration of 1.8 x 10(-7) M stimulated proliferation of the lung cancer cells, but histamine at the concentration of 1.8 x 10(-4) M or cimetidine at 1.76 x 10(-7) M inhibited growth of the lung cancer cells. Relation between histamine, histidine decarboxylase, histamine formation capacity and tumor proliferation is discussed.

Increased heart rate accelerates norepinephrine washout from normal myocardium

We determined whether a change in heart rate affected the decay of the ventricular inotropic response to sympathetic stimulation in an experimental group and in a control group of anesthetized dogs. We induced complete heart block in each animal and paced the ventricles at rates of 90, 120, and 150 min-1 during two observation periods. In the experimental group, desipramine hydrochloride was given during the second period to block the neuronal uptake mechanism. The control animals did not receive desipramine during either period. The time required for the ventricular inotropic response to decay by 50% after cessation of a 2-min train of sympathetic stimulation was used as an index of the rate of norepinephrine washout from the myocardial interstitium. As we increased the pacing rate over the range of 90-150 min-1 in the experimental group, the mean decay half times (+/- SE) decreased by 36 +/- 4% (P less than 0.001) before desipramine and by 26 +/- 6% (P less than 0.001) in the presence of desipramine. These decrements in the decay half times were not significantly different from each other. The mean decay half times decreased by 36 +/- 4% (P less than 0.001) in the control dogs; the effects did not change appreciably from the first to the second observation period. We conclude that an increase in pacing frequency facilitates the washout of norepinephrine from the ventricular myocardium; this facilitation is equally pronounced regardless of whether the neuronal uptake mechanism is intact or suppressed.

Growth of myoblasts in lipoprotein-supplemented, serum-free medium: regulation of proliferation by acidic and basic fibroblast growth factor

BC3Hl myoblast cells seeded at low density on gelatin-coated dishes and exposed to a 1:1 (vol/vol) mixture of Dulbecco's modified Eagle's medium and Ham's F12 medium, proliferate actively when exposed to high density lipoproteins (HDL), transferrin, insulin, and basic or acidic fibroblast growth factor (FGF). This serum-free medium combination supported cell multiplication at a rate equal to that of serum-supplemented medium, and at low cell input (10(3) cells/35-mm dish). It also allowed serial transfer of the cultures under serum-free conditions. HDL seems to promote cell survival and to act as progression factor allowing cells to divide when exposed to either basic or acidic FGF. When the potency of basic and acidic FGF were compared, acidic FGF was 20-fold less potent than basic FGF.

Surgery for neglected congenital torticollis

Nineteen patients were operated on for congenital muscular torticollis after the age of 1 year. Tenotomy gave good results below 5 years of age and resection of the sternocleidomastoid muscle was satisfactory in most of the older children.

Inhibition of excitatory neurotransmission with kynurenate reduces brain edema in neonatal anoxia

Excitatory amino acid neurotransmitters have been implicated in fostering brain edema and neuronal death in ischemia. As both of these processes are involved in nervous system damage during neonatal anoxia, the effect of blockade of cell excitation with kynurenate upon brain water was studied following anoxic-ischemic brain injury in neonatal rats. Such treatment attenuated brain edema immediately after, and 24 h following anoxia-ischemia.