[Obstruction of the Le Veen shunt: a new surgical solution]

The authors propose an alternative which has been proved valid in four cases of peritoneovenous shunt with an occluded Le Veen valve for venous thrombosis implanted in cirrhotic patients with refractory ascites. After having explored the various possibilities using the vessels adjacent to the superior cava branch, the authors resolved the problem of reimplanting the valve by using an access route through the saphenous vein and inferior vena cava. Using this technique it was possible to reactivate the shunt with a marked improvement in the recurrent ascitic state and above all shunt functionality, and consequently in the clinical conditions and quality of life of these patients.

Heterogeneity of metabotropic glutamate receptors in the striatum: electrophysiological evidence

In order to investigate the functional role of metabotropic glutamate receptors (mGluRs) in the striatum we performed extracellular and intracellular recordings from a corticostriatal brain slice preparation. The effects of L-2-amino-3-phosphopropionic acid (L-AP3), an antagonist of mGluRs, were studied both on long-term synaptic depression (LTD) and on presynaptic inhibition of excitatory postsynaptic potentials (EPSPs) induced by different agonists of mGluRs. L-AP3 produced a dose-dependent (3-30 microM) reduction of the LTD evoked in the striatum by the tetanic stimulation of the corticostriatal pathway. In contrast to this action, L-AP3 (10-100 microM) did not significantly affect the presynaptic inhibitory effect of 1-amino-cyclopentyl-trans-dicarboxylic acid (t-ACPD), an agonist of mGluRs, on corticostriatal transmission. Higher concentrations of L-AP3 (0.3-1 mM) reduced by themselves the EPSP amplitude. The inhibitory effect of t-ACPD on the cortically evoked EPSPs was mimicked either by the active stereoisomer 1S,3R-ACPD or by amino-4-phosphonobutyric acid (L-AP4), a glutamate autoreceptor agonist. In some neurons, these inhibitory actions were coupled with membrane depolarizations. The depression of synaptic transmission caused by t-ACPD, 1S,3R-ACPD and L-AP4 was not altered following the induction of LTD. Chronic lithium treatment of the animals (60-120 mg/kg i.p. for 10 days) blocked striatal LTD but not presynaptic inhibition mediated by mGluR agonists. The present findings show that the mechanisms underlying LTD and the presynaptic inhibition induced by different agonists of mGluRs exhibit functional and pharmacological differences. These data suggest heterogeneity of mGluRs in the striatum.

Production of basement membrane components by a reconstructed epidermis cultured in the absence of serum and dermal factors

A fully differentiated epithelium displaying features of human epidermis was obtained in vitro by culturing second-passage normal human keratinocytes for 14 days in defined medium and on an inert polycarbonate filter substratum at the air-liquid interface. Vertical sections stained for histology and indirect immunofluorescence studies showed that the 'basal' cells synthesize and secrete all major markers of hemidesmosomes and the lamina lucida. Components of the lamina densa are also expressed. Collagen VII is synthesized, but not secreted. Ultrastructural studies showed the presence of hemidesmosomes with major dense plaques and anchoring filaments, and a basement membrane-like structure was clearly identified. These results show that epidermal cells are able to produce hemidesmosomes and to secrete the major components of the dermo-epidermal junction in the absence of serum and dermal factors, suggesting that basement membrane synthesis and hemidesmosome assembly are not dependent on the presence of dermis.

Lithium treatment blocks long-term synaptic depression in the striatum

We have studied the effect of acute and chronic lithium treatment on the activity of striatal neurons recorded from corticostriatal slices. Under control conditions, tetanic stimulation of glutamatergic corticostriatal terminals caused long-term depression (LTD) of excitatory synaptic potentials. Acute lithium treatment did not affect the peak of the induction phase, but it reduced the following phases of LTD. LTD was completely blocked in slices obtained from rats chronically injected with LiCl. Lithium treatment failed to affect the intrinsic membrane properties of striatal neurons and the presynaptic inhibitory effects of carbachol and t-ACPD. We suggest that the lithium-induced blockade of LTD may contribute to the therapeutic action of lithium salts in mania and depression.

Atrophy of the soleus muscle in the albino rat induced by immobilization

The morphological changes in the soleus muscle, immobilized by means of a plaster cast applied to the posterior limb of albino rats was studied. The animals were sacrificed 20 and 30 days after immobilization. The Authors agree with the hypothesis put forth by Lazarides regarding the cytoskeleton model of striated muscle fiber: morphological changes of the sarcomeres and myofilaments are brought on by translateral and longitudinal bridge damage.

Peripherin, a neuronal intermediate protein, is stably expressed by neuroendocrine carcinomas of the skin, their xenograft on nude mice, and the corresponding primary cultures

The histogenesis of neuroendocrine carcinomas of the skin is still controversial. To determine the degree of neural differentiation of these neoplasias, we studied the expression of intermediate filament proteins in tumoral tissues. Expressions of peripherin, the neurofilament protein NF-L, vimentin, and cytokeratin 8 were analyzed by immunohistochemical methods on 12 human primary tumors and 3 tumor xenografts on nude mice. Peripherin was detected in 10 primary tumors by immunofluorescence. The protein and the corresponding messenger RNA were identified by two-dimensional gel electrophoresis and Northern analysis in extracts of an immunofluorescence-negative tumor. Peripherin, NF-L, and cytokeratin 8 were detected in tumoral cells, whereas vimentin was found exclusively in the stroma. The histological and ultrastructural properties of the original cells of neuroendocrine carcinomas of the skin, as well as coexpression of peripherin, cytokeratin 8, and neurofilament polypeptides, were preserved in tumor xenografts and their primary cultures in vitro. These results bring new elements to the knowledge of the biology of neuroendocrine carcinomas of the skin and indicate that peripherin constitutes a marker for tumor identification.

Kalinin is abnormally expressed in epithelial basement membranes of Herlitz's junctional epidermolysis bullosa patients

Kalinin is an extracellular adhesion molecule specific to epithelial basement membranes (BM) identified as a component of anchoring filaments of hemidesmosomes. This heterotrimeric protein is synthesized by cultured normal human keratinocytes and is involved in cell attachment. In indirect immunofluorescence studies, the epidermal BM of patients with junctional epidermolysis bullosa (JEB) of Herlitz's type were found not to be reactive with the anti-kalinin monoclonal antibodies ka146 and K140 and displayed a decreased immunoreactivity to two anti-kalinin antibodies cross-reacting with K-laminin, an anchoring filament component recently described. The intrinsic defect of JEB keratinocytes in the synthesis of kalinin was further documented by indirect immunofluorescence on in vitro cultures of these cells. In non-Herlitz JEB patients, staining of BM was constantly detected. Impairment of expression of kalinin correlated with the lack of reactivity to the monoclonal antibody GB3, which detects the BM component nicein/BM600. These results clearly demonstrate a defect of kalinin expression in epithelial basement membranes of Herlitz JEB patients and suggest that kalinin may play a role in the pathogenesis of the disease. Further studies are in progress to define possible relationships between kalinin and nicein.

Long-term synaptic depression in the striatum: physiological and pharmacological characterization

The effect of tetanic activation of corticostriatal glutamatergic fibers was studied in striatal slices by utilizing extracellular and intracellular recording techniques. Tetanic stimulation produced a long-term synaptic depression (LTD) (> 2 h) of both extracellularly recorded field potentials and intracellularly recorded EPSPs. LTD was not coupled with changes of intrinsic membrane properties of the recorded neurons. In some neurons, repetitive cortical activation produced a short-term posttetanic potentiation (1-3 min). Subthreshold tetanic stimulation, which under control condition did not cause LTD, induced LTD when associated with membrane depolarization. Moreover, LTD was not expressed in cells in which the conditioning tetanus was coupled with hyperpolarization of the membrane. Bath application of aminophosphonovalerate (30-50 microM), an antagonist of NMDA receptors, did not affect the amplitude of the synaptic potentials and the expression of LTD. Striatal LTD was significantly reduced by the pretreatment of the slices with 30 microM 2-amino-3-phosphonopropionic acid, an antagonist of glutamate metabotropic receptors. LTD was not blocked by bicuculline (30 microM), a GABA(A) receptor antagonist. Scopolamine (3 microM), an antagonist of muscarinic receptors, induced a slight, but significant, increase of the amplitude of LTD. Both SCH 23390 (3 microM), an antagonist of D1 dopamine (DA) receptors, and I-sulpiride (1 microM), an antagonist of D2 DA receptors, blocked LTD. LTD was also absent in slices obtained from rats in which the nigrostriatal DA system was lesioned by unilateral nigral injection of 6-hydroxydopamine. In DA-depleted slices, LTD could be restored by applying exogenous DA (30 microM) before the conditioning tetanus. In DA-depleted slices, LTD could also be restored by coadministration of SKF 38393 (3-10 microM), a D1 receptor agonist, and of LY 171555 (1-3 microM), a D2 receptor agonist. Application of a single class of DA receptor agonists failed to restore LTD. These data show that striatal LTD requires three main physiological and pharmacological conditions: (1) membrane depolarization and action potential discharge of the postsynaptic cell during the conditioning tetanus, (2) activation of glutamate metabotropic receptors, and (3) coactivation of D1 and D2 DA receptors. Striatal LTD may alter the output signals from the striatum to the other structures of the basal ganglia. This form of synaptic plasticity can influence the striatal control of motor activity.

Increased expression of tenascin in the dermis in scleroderma

The expression of tenascin, a recently discovered extracellular matrix protein, was studied by immunohistochemical techniques in scleroderma skin and compared with its distribution in normal skin. In progressive systemic sclerosis, a marked increase in tenascin content was observed in the superficial reticular dermis. In localized scleroderma, the deposition of tenascin was increased both in the superficial and deep dermis of involved skin, whereas in clinically uninvolved skin the distribution of tenascin was the same as in normal control skin, i.e. the papillary dermis and peri-appendiceal zone. The distribution of tenascin did not strictly parallel that of fibronectin. These findings and the current knowledge of tenascin biology suggest that the overproduction of tenascin in scleroderma dermis could be secondary to stimulation of fibroblasts by immune cell-derived cytokines, or could be due to abnormal fibroblasts, or a subpopulation of fibroblasts, producing high levels of this extracellular matrix protein.

The 6/2 (AA3) polyclonal antibody identifying a 37 kD keratinocyte protein reacts also with BM-600/nicein, the basement membrane component bound by the monoclonal antibody GB3

An unexpected finding concerning our previously reported polyclonal antibody raised against an extract from human amnion (pAb 6/2, also termed AA3), and which recognizes an epidermal keratinocyte protein, is presented in this study. Using the immunoblot technique, pAb 6/2 binds to a 37 kD intracellular protein antigen. We have subsequently found that, by radioimmunoprecipitation performed after metabolic labelling with 35S-methionine of cultured keratinocytes, pAb 6/2 recognizes the 600 kD epidermal basement membrane component (termed BM-600/nicein) which was reported to be bound by the monoclonal antibody mAb GB3. Specifically, pAb 6/2 reacts with immunoaffinity chromatography-isolated BM-600/nicein blotted onto nitrocellulose. The data suggest the existence of two immunological reactivities borne by pAb 6/2, each of them being directed against, respectively, the 37 kD (seen in immunoblots) and the 600 kD protein (seen in immunoprecipitations). The data further suggest possible independent expression of these two proteins in cell culture. In comparison with the staining pattern of normal skin, immunofluorescence was previously noted to be impaired (pAb 6/2) or absent (mAb GB3) in lethal junctional epidermolysis bullosa. Thus, we conclude that mAb GB3, rather than pAb 6/2, is a more appropriate probe for the comprehensive biochemical study of this genodermatosis.

Lethal junctional epidermolysis bullosa with normal expression of BM 600 and antro-pyloric atresia: a new variant of junctional epidermolysis bullosa?

A newborn girl is described with a lethal junctional epidermolysis bullosa (Herlitz form) (JEB) associated with a congenital localized absence of skin, and a pyloric atresia (PA). The post-mortem examination of the digestive tract showed a widespread cleavage between the epithelium and the chorion. Immunohistological and electron microscopical examination showed a cleavage occurring through the lamina lucida of the digestive basement membrane, as for the skin blisters. Despite the lethal character of this form of JEB, the BM 600 glycoprotein was normally recognized at the dermo-epidermal junction by the monoclonal antibody GB3. This rare association of lethal JEB-PA-localized absence of skin, with a quite unusual GB3 positive immunophenotype could correspond to a new variant of JEB.

Blood-brain barrier dysfunctions following systemic injection of kainic acid in the rat

Changes in blood-brain barrier (BBB) permeability and cerebral metabolic activity following intravenous injection of kainic acid (KA; 6, 12 mg/Kg) in rats were assessed by calculating respectively a blood-to-brain transfer constant (Ki) for [14C]alpha-aminoisobutyric acid and local cerebral glucose utilization (LCGU) values, at different times (1 h, or acute seizures phase, and 48 h, or chronic pathology phase) after the induction of seizures. A significant increase in the local permeability of the BBB was observed 1 h after the injection of KA 6 mg/Kg (eliciting no significant changes in cerebral metabolic activity, except within the frontal cortex and the hippocampus) and 12 mg/Kg (which induced a marked and widespread enhancement of LCGU). On the contrary, during the pathology phase, persistent regional increases in Ki values were evidenced in rats treated with the lowest dose of the convulsant, but not in rats injected with KA 12 mg/Kg (a dose able to cause extensive neuronal damage). Thus one can speculate that: 1) KA-induced regional changes in the permeability of the BBB are not correlated with changes in neuronal activity; 2) opening of the BBB is not reliably associated with neuronal injury.

Anatomical mapping of Merkel cells in normal human adult epidermis

The distribution of Merkel cells (MCs) in normal human skin and mucosa was studied using the mouse monoclonal antibody Troma-1, reacting specifically with component 8 of the Moll cytokeratin catalogue. The specificity of this antibody for MCs in human skin was assessed by double indirect immunofluorescence (IIF) and immunoelectron microscopy. Two-hundred and thirty 6-mm punch biopsies were obtained from 44 different sites from six human cadavers within 48 h post-mortem. IIF was performed with Troma-1 on EDTA-split epithelial sheets and the MCs were counted and the mean values per mm2 calculated for each site. Regions with greater than 50 MC/mm2 were the lips, hard palate, palms, finger pads, proximal nail fold, and dorsum of the feet. Three different patterns were observed in the epidermis or mucosa: MCs grouped in clumps, linear and arciform arrangements, and scattered MCs. In the hair follicles grouped MCs were observed in the bulb and scattered MCs were seen in the outer root sheath.

Monoclonal antibody GB3 defines a widespread defect of several basement membranes and a keratinocyte dysfunction in patients with lethal junctional epidermolysis bullosa

An antigen expressed at the dermal-epidermal junction as well as in some other human basement membranes (BM) has been detected by the use of a monoclonal antibody termed GB3. This antigen, synthesized by cultured normal human keratinocytes, has been identified as a 600-kilodalton glycoprotein different from other known components of BM. Using indirect immunofluorescence, GB3 was found to be not reactive with the epidermal BM in patients with lethal junctional epidermolysis bullosa. The present study demonstrates (by indirect immunofluorescence) that GB3 defines a widespread defect of several BM in these patients. Furthermore, it gives evidences for an intrinsic biologic defect of lethal junctional epidermolysis bullosa epidermal keratinocytes using in vitro culture of these cells. Whether the lack of GB3 reactivity is the consequence of a true absence of the antigen or an alteration of its molecular structure is not yet known. Nevertheless, GB3 is a useful probe for both rapid and prenatal diagnosis of lethal junctional epidermolysis bullosa, which will give new insights into the molecular comprehension of this disorder.

Emergency portosystemic shunt in patients with variceal bleeding

Thirty-five patients for whom emergency sclerotherapy or conservative treatment, or both, failed to arrest variceal bleeding, or who had early rebleeding and required emergency portosystemic shunts (EPSS) were studied. EPSS permanently controlled the variceal bleeding in all but one patient. In this patient, the shunt was patent as demonstrated by angiography. Esophageal varices disappeared in 18 patients and were reduced in 14. Three patients died before the endoscopic examination could be performed. The causes of death were hepatic failure in two and bleeding ulcerations of the gastric fundus in the other patient. One patient was classified in Child's category B and two in Child's category C. Thirty-two patients submitted to EPSS and were discharged alive. Twelve of these patients subsequently died, at an average of 11.2 months after undergoing the shunt procedure. Four of 12 patients died of hepatic failure; two patients died of hepatomas; two, other neoplasia; three, hemorrhaging duodenal ulcers, and one patient, renal failure. Analysis of actuarial survival rates showed that the five year survival rate was 43 per cent. The long term survival rates were fewer for patients with Child's category C than for those with combined Child's categories A and B (five year survival rates were 21 versus 55 per cent; p less than 0.05). During the follow-up period, none of the patients had variceal bleeding. Chronic encephalopathy developed in six, which was mild in three, moderate in one instance and severe in two. It developed soon after EPSS, with onset in the first month after discharge in three. Thus, when conservative treatment fails to arrest variceal bleeding, EPSS should be performed to guarantee definitive control of hemorrhage and prolong the survival period.

Flecainide excretion in human breast milk

Healthy human volunteers who intended not to breast feed were placed on a regimen of 100 mg oral flecainide every 12 hours for 5 1/2 days beginning 1 day after parturition. Milk and blood samples were collected during the dosing period and for 2 days after the last dose. Concentrations of flecainide in milk and plasma were assayed by HPLC. Apparent steady-state levels of flecainide in both milk and plasma were achieved in most cases by day 4 of the study. Highest daily average concentration of flecainide in milk ranged from 270 to 1529 ng/ml for the 11 subjects. Mean +/- SD milk to plasma flecainide ratios were 3.7 +/- 3.5, 3.2 +/- 2.3, 3.5 +/- 2.1, and 2.6 +/- 0.7 on study days 2, 3, 4, and 5, respectively. After the last dose of flecainide, peak milk levels of the drug occurred at 3 to 6 hours and then declined monoexponentially. The half-life for elimination of flecainide from milk was 14.7 +/- 3.5 hours and is very similar to the plasma elimination half-life of flecainide in healthy human subjects. The mean milk to plasma ratios for flecainide after the last dose were 2.3 +/- 1.0 and 2.9 +/- 1.1 at 24 and 48 hours after the dose, respectively. Based on the pharmacokinetics of flecainide in infants, the expected average steady-state plasma concentration of flecainide in a newborn infant consuming all of the milk production of its mother (approximately 700 ml/day) would not be expected to exceed about 62 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Angioscintigraphic assessment of hemodynamic effects of penbutolol in cirrhotics with portal hypertension. A double-blind, randomized, controlled study

This randomized double-blind controlled study analyzed the hemodynamic effects of penbutolol, a new levorotatory beta-blocker, using radionuclide angiography. Twenty cirrhotics with esophageal varices were randomized to two groups: 10 received 40 mg/day of penbutolol orally and the others placebo. Angioscintigraphy was performed before and after an 8-day treatment period. Three cases in the penbutolol group were lost due to software damage, hence the data of 17 patients were analyzed. The two groups were matched for age, sex, etiology of cirrhosis and hepatic function. The index of portal perfusion decreased significantly (-29%; p = 0.018) and the hepatic artery index increased significantly (+23%; p = 0.018), while no changes were observed after placebo. The heart rate decreased significantly after penbutolol (-9%; p = 0.028), while neither penbutolol nor placebo modified the ejection fraction. In conclusion, penbutolol decreased portal perfusion index (the compensatory increase in the hepatic artery index confirmed this change) without major modification of total hepatic blood flow or systemic hemodynamics. Angioscintigraphy is reasonably accurate, reproducible, safe and can be considered suitable for routine use in the assessment of liver hemodynamics.

[Use of synthetic resin cases for the scanning electron microscopic study of the kidney tubule system]

Aim of our present work was to investigate a new method to study the three-dimensional arrangement, the length and the diameter of the different parts of the renal tubules. The ureter was cannulated after blocking the urinary flow with a binding of the ureter itself at its intermediate third, and injected in it against flow a synthetic resin (Mercox) normally used for vascular corrosion casts. It was demonstrated that the binding maintained only for 24 hours is adequate for morphological studies of the urinary tracts from papillar ducts until the Henle's loop. On the contrary the binding maintained for 7 days induced marked changes in the tubular architecture similar to the first anatomo-pathological changes of the nephrosclerosis following a chronic obstructive nephropathy.

Decline in the exposure to hepatitis A and B infections in children in Naples, Italy

In May 1988, the hepatitis A antibody (anti-HAV) and hepatitis B virus (HBV) markers were studied by radioimmunoassay in 484 apparently healthy children between the ages of 7 and 12, attending a primary school in Naples, Italy. The overall anti-HAV prevalence was 11.2%, increasing from 5.2 in 7-year-old children to 28.2% in children between the ages of 11 and 12 years old. The overall prevalence of the hepatitis B surface antigen (HBsAg) and of other HBV markers were 0.8 and 6.8 respectively. Compared with a similar previous study conducted in Naples in 1980, the results show a significant reduction in the prevalence of anti-HAV in each of the two age-groups (P less than 0.01), in the prevalence of any HBV marker in the 11 to 12-year-old group, as well as in the total population (P less than 0.05). The findings of the present study indicate that today, children in Naples are less exposed to the hepatitis A virus than in the past, most likely because of improvements in both the socioeconomic conditions and in health education during recent years. These same reasons, as well as decreased family size and a lower prevalence of HBeAg among HBsAg carriers could explain the decline, although to a lesser degree, of exposure to HBV infection.

The biological evolution of the Leeds-Keio ligament in the human knee. A histological and ultrastructural study

The authors report their experience in the reconstruction of the anterior cruciate ligament using the Leeds-Keio ligament in 12 patients, 7 by open arthrotomy and 5 by an arthroscopic technique. The biological evolution of the new ligament was studied macroscopically and histologically in the first 6 cases treated by open arthrotomy. Arthroscopic monitoring and biopsy was carried out 4 to 10 months after operation. In 5 cases the new ligament appeared to be intact and histologically vital, with proliferation of new tissue along the new ligament. There were broken filaments of dacron hanging from the intercondylar cavity in only one case. The first macroscopic, histological and ultrastructural results show that despite a few limitations the Leeds-Keio ligament has the features required for replacement of the anterior cruciate ligament, although it will be necessary to wait 4 or 5 years before fully evaluating the durability and function of the ligament and the best operative method.

The new basement membrane antigen recognized by the monoclonal antibody GB3 is a large size glycoprotein: modulation of its expression by retinoic acid

Further biochemical investigations on the hemidesmosome-associated epidermal basement membrane component recognized by the monoclonal antibody GB3 are presented in this study. We previously found that the expression of this constituent is impaired in a severe genodermatosis termed lethal junctional epidermolysis bullosa. We demonstrate now that this factor is a very large glycoprotein (apparent molecular weight, 600 kDa) made up of polypeptides in the range of 93.5 to 150 kDa, and containing N-linked oligosaccharide chains. Both endo-beta-N-acetylglucosaminidases and neuraminidase hydrolysis, as well as concanavalin A binding experiments were performed on the GB3 radioimmunoprecipitated polypeptides from cultured human keratinocytes. They showed that the antigen subunits probably bear both 'high-mannose' and 'complex' type glycosidic chains. The chronic exposure of cultured human keratinocytes to retinoic acid (10(-8) to 10(-6) M) resulted in no apparent changes in the overall bulk of these glycosidic chains, but a dose-dependent increase of synthesis and secretion of the antigen was observed. A relative induction factor of 4 was obtained in cultures treated with 10(-6) M retinoic acid. This induction was also observed morphologically by indirect immunofluorescence at the basement membrane zone from cultured human keratinocytes grown on dead de-epidermized dermis. These results further emphasize the influence of glycoproteins in cell-cell and cell-substratum attachment. Furthermore, the ability to modulate this antigen may be relevant for the understanding of the molecular defect involved in lethal junctional epidermolysis bullosa.

Effect of chronic sun exposure on human Langerhans cell densities

This study evaluated the Langerhans cell density in chronically sun-exposed skin (hand) and non-exposed skin (buttock) in subjects that were divided into 4 age groups (20-40; 41-60; 61-80; greater than 81 years). Two markers (OKT-6 and anti-HLA-DR) were used to identify the Langerhans cells (LC), and their count was performed either on epidermal sheets (52 individuals) or skin sections (43 individuals). Three major findings result from this study: 1) there are more LC in the non-exposed skin than in the chronically sun-exposed area; 2) there were no age-related changes in LC counts, and 3) LC co-express the T6 and HLA-DR antigens.

Normal Merkel cells express a synaptophysin-like immunoreactivity

Synaptophysin (SY), a specific component of the membrane of presynaptic vesicles, has been reported as a novel marker for neurons, certain neuroendocrine cells and their neoplasms including neuroendocrine carcinomas of the skin. The origin of the Merkel cells (MC) being far from clear, this study was performed to establish if normal MC express SY. It is demonstrated by immunofluorescence and immunoelectron microscopy using a monoclonal antibody SY38 to this glycoprotein that normal MC in man, rabbit and pigs express an SY-like reactivity. Although immunoblotting identification of the immunoreactive material gave negative results, it is likely that normal MC contain SY. By immunoelectron microscopy, the staining was located at the surface of cytoplasmic vesicles. In view of the possible involvement of SY in the Ca2+-dependent neurotransmitter release, the observation of an SY-like immunoreactivity in MC supports the view that they are epithelial neuroendocrine cells and that they may possess a neurosecretory function.

Herpes gestationis factor reacts with the amniotic epithelial basement membrane

Sera from five patients with clinically and immunopathologically proven herpes gestationis were studied by complement fixing immunofluorescence and complement fixing immuno-electron microscopy using specimens of skin, amniochorion and placenta. The results demonstrated that the complement fixation antibody (herpes gestationis factor) could bind to the basement membrane zone of skin, amnion and chorion laeve but not to that of the placental syncytiotrophoblast. These data suggest that the herpes gestationis factor may be induced by the basement membrane zone antigens of extra-villous cytotrophoblasts.

Monoclonal antibody GB3, a new probe for the study of human basement membranes and hemidesmosomes

A monoclonal antibody, GB3, has been raised against human amnion. Not only does GB3 bind to amniotic basement membrane, but it also recognizes an antigenic structure expressed by epidermal as well as by some other human basement membranes. This antigen is synthesized (and excreted) by cultured normal human epidermal keratinocytes. It is expressed to a lesser extent by the A431 epidermoid carcinoma cell line, but is not expressed by the SV40 virus-transformed SVK14 keratinocyte cell line. In ultrastructural studies, this antigen was located in the epidermal basement membrane, both in the lamina densa and in the lamina lucida, associated with hemidesmosomes. It was identified as a protein by in vitro proteolytic cleavage studies. The radio-immunoprecipitates from cultured human keratinocytes, analysed by SDS-PAGE, showed that GB3 recognized five polypeptides of 93.5, 125, 130, 146 and 150 kD under reducing conditions. They were probably linked by disulfide bonds. The tissue distribution of the antigen and the molecular weights (MWs) of its constitutive polypeptides suggest that it is different from other known components of basement membranes. It may provide a biochemical marker for hemidesmosomes. Furthermore, GB3 represents an interesting and original clinical probe, since the antigenic structure recognized by GB3 is lacking in Junctional Epidermolysis Bullosa, a lethal genodermatosis in which a dermo-epidermal splitting occurs at the level of lamina lucida.

[The approach to Achilles tendinopathies in athletes. Echographic aspects]

The recent great diffusion of sports has significantly increased the traumatic pathology of Achilles tendon. Owing to the importance of a correct diagnosis and prognosis and of an adequate therapy (especially for professionals), a clinical and radiological study has been performed. Echotomography has been associated with xeroradiography in 185 athletes with painful symptoms; among these 79 were normal while 106 showed various types of tendinopathies. The main results can be summarized; peritendinitis: non uniform thickening; hyperechogenicity of Kager's triangle; insertional tendinopathies: thickening; calcifications; tendinosis: thickening; degeneration nodules; tendinous ruptures: rough contours of the rupture; degeneration nodules. The good echotomographic results allowed a correct diagnosis in about 85% of the 39 surgically treated patients.

Metallic foreign bodies in the stomach

We present a case of a patient who ingested 648 metallic objects that formed an intertwining mass within the stomach, requiring operative removal. Of interest was the absence of symptoms and complications after 11 years of continual ingestion. To our knowledge, this is the second heaviest accumulation of metallic foreign objects removed from the stomach of a living patient.