Quantitative evaluations of gap junctions in old rat brown adipose tissue after cold acclimation: a freeze-fracture and ultra-structural study

The morphological and functional modifications of brown adipose tissue (BAT), the tissue responsible for non-shivering thermogenesis, are well established during the phases of active stimulation (i.e. neonatal period and cold acclimation) in young animals. The 'active' brown adipocytes are filled with numerous small lipid vacuoles and large mitochondria packed with cristae rich in the protonophore uncoupling protein (UCP), whereas the 'quiescent' cell shows larger, confluent vacuoles and smaller mitochondria with rarefied cristae poor of the uncoupling protein. It is well known from literature that also gap junctions (gjs), responsible for the electrical coupling among adjacent adipocytes, modify their size following the physiological stimulus in young animals. This is in agreement with the morphology of the functionally active brown adipocyte, i.e. the multilocular, UCP-positive cell. Although the presence of the BAT in old animals is well documented, less is known about its reactivity to physiological stimuli. The present work demonstrates that after cold acclimation brown adipocytes of old rats (2 years) change their ultrastructure in a similar way as in young rats. A quantitative analysis of gap junction areas on replicas obtained by the freeze fracture technique, showed that gj increase in size (mean area 53.2 vs 110.4 x 10(-3) microns2, p = 0.003). All these morphological modifications are quite similar to those observed in BAT of young and young adult rats, supporting the hypothesis of a physiological role of brown adipose tissue at every age.

Analysis of the pituitary-thyroid axis in bilaterally adrenalectomized or adrenal transplanted rats

The percentage, distribution, shape, intensity of staining and morphometrical parameters of the pituitary TSH immunoreactive cells and the histological features of the thyroid glands, were compared between adult rats with intact adrenals, without adrenals and biadrenalectomized animals with neonatal adrenal grafts. After the removal of the adrenal glands, TSH immunoreactive cells increased in percentage and exhibited a higher complexity of the cellular outline, than that of the intact animals. The nuclear, cytoplasmic and cell areas were significantly increased. However the bigger enhancement of the cytoplasmic area relative to the nuclear area, produced a decrease in the nuclear/cell area ratio. The thyroid glands showed some histological evidences of activation. After the transplantation of neonatal adrenal glands to adult rats, several adrenocortical nodules were present in the lumen of the small bowel segment. These adrenal masses induced a great decrease in the TSH cell area, which coupled with a smaller but significant variation of the nuclear area, led to an increase in the nuclear/cell area ratio relative to that observed in adrenalectomized animals. In addition, the distribution, shape and intensity of the immunoreactive material was similar to that observed in intact animals. In this experimental group, thyroid histology was observed to be similar to that of the intact animals.

Increased collagen synthesis in skin fibroblasts from patients with primary hypertrophic osteoarthropathy. Evidence for trans-activational regulation of collagen transcription

OBJECTIVE

To investigate collagen synthesis in skin fibroblasts from patients with primary hypertrophic osteoarthropathy (HOA), a disorder characterized clinically by skin thickening.

METHODS

Collagenase-digestible protein, messenger RNA (mRNA) levels, and transcriptional activity of the alpha 1(I) procollagen gene were assessed in skin-derived fibroblast lines.

RESULTS

Compared with fibroblasts from uninvolved skin, fibroblasts from involved skin had elevated levels of collagen synthesis and alpha 1(I) procollagen mRNA, and increased transcriptional activity of the alpha 1(I) procollagen promoter.

CONCLUSION

Abnormalities of collagen synthesis in fibroblasts from patients with primary HOA can be accounted for, at least in part, by a trans-activated up-regulation of collagen transcription.

Immunogold labelling of leukemic hairy cells with the B-ly7 monoclonal antibody: an SEM and TEM study

Two cases of hairy cell leukemia have been studied by immuno-TEM and immuno-SEM after immunogold labelling of the cell surface antigen recognized by the B-ly7 monoclonal antibody. Most hairy cells appeared significantly labeled, although the density of the expression of the antigen, as demonstrated by immunogold labelling, seems variable from cell to cell. Moreover, some cells with the morphology of hairy cells and which could not be identified as monocytes were not labeled. Labelling for the antigen identified by the B-ly7 mAb does not seem to correlate with the presence of ribosome lamellae complexes which were present only in one of the two cases studied. Rare lymphocytes of unidentified lineage were labeled. Monocytes were significantly absent from the samples of peripheral blood of the two patients studied. In one normal control sample, monocytes were observed unlabelled. The results are discussed in reference to the pathogenesis of hairy cell leukemia, its surprisingly low mitotic rate, and its distinct response to chemotherapy.

Active hepatitis C virus infection in bone marrow and peripheral blood mononuclear cells from patients with mixed cryoglobulinaemia

The presence of hepatitis C virus (HCV) genomic sequences was checked in plasma, liver, peripheral blood mononuclear cells (PBMC) and bone marrow cells from 11 patients with mixed cryoglobulinaemia positive for anti-HCV antibodies, and from 11 patients with chronic HCV hepatitis without serological evidence of cryoglobulinaemia. HCV RNA sequences were demonstrated by reverse transcription polymerase chain reaction in seven plasma samples, in six PBMC samples, and in seven bone marrow cell samples from the 11 cryoglobulinaemic subjects; otherwise, viral specific nucleic acids were detected in 10 plasma samples, in one PBMC sample, and in two bone marrow cell samples from the 11 patients with chronic hepatitis. The HCV replicative intermediate was evidenced in four of the six PBMC and in five of the seven bone marrow aspirate HCV RNA-positive samples. Analysis of subpopulations isolated from bone marrow and peripheral blood samples showed HCV RNA sequences in mononuclear cells belonging either the CD2+ subset or to the CD19+ subpopulation or to the adherent cells. Finally, we compared the nucleotide sequences of a large portion (-270 to -59) of the HCV 5'-untranslated region from five patients with mixed cryoglobulinaemia and from seven patients with chronic hepatitis without cryoglobulinaemia; the degree of heterogeneity, compared with the prototype HCV sequence, was similar in both groups. These findings from two groups of HCV-infected patients indicate that transient or permanent active HCV infection of bone marrow and PBMC is frequent in anti-HCV-positive patients with mixed cryoglobulinaemia, and suggest that extra-hepatic infection may play a major role in influencing the pathophysiology of this infection as well as the viral persistence.

Healing of protein losing hypertrophic gastropathy by eradication of Helicobacter pylori--is Helicobacter pylori a pathogenic factor in Ménétrier's disease?

Hypertrophic gastropathy--that is, Ménétrier's disease--was found, in a retrospective analysis, to be associated with Helicobacter pylori in more than 90% of patients. It is proposed that hypertrophic gastropathy represents a special form of H pylori gastritis in these patients. A case is described of a 28 year old woman with Ménétrier's disease associated with proved protein loss from the stomach. Treatment with cimetidine for more than three years had little benefit when colonisation by H pylori was detected. Density of H pylori colonisation and activity of gastritis, which was also present in the first biopsy specimens taken five years ago, were more pronounced in the body than in the antrum, which is in agreement with the characteristics of H pylori gastritis found in other cases with Ménétrier's disease. A 14 day antibacterial treatment course with 750 mg amoxicillin three times a day combined with 40 mg omeprazole three times a day was started in April 1991. This resulted in eradication of H pylori and the return to normal of giant folds and the mucosal histology. Serum protein concentrations returned to normal within six weeks and remained normal at two endoscopies during a two year follow up. This case report suggests that a subgroup of the patients with Ménétrier's disease may be healed by the eradication of H pylori.

Microvascular lesions in reflux oesophagitis and Barrett's oesophagus

In 30 patients with reflux oesophagitis, the mucosal microvessels have been studied by transmission electron microscopy. The aim of the study was to test the hypothesis that a microvascular injury is involved in reflux oesophagitis, and to clarify if the epithelial metaplasia is correlated with a contemporaneous modification of the microvasculature in Barrett's oesophagus. In squamous epithelium-lined mucosa, signs of microangiopathy were found in all patients and capillaries regularly showed an interrupted, duplicated, or thickened basal lamina. In areas of columnar metaplasia, capillaries showed an ectatic lumen and a thin basal lamina without duplications or interruptions; endothelial cells had a thin rim of cytoplasm with many fenestrations. These findings demonstrate that microangiopathy is associated with epithelial damage in reflux oesophagitis.

Characterization of the novel brown adipocyte cell line HIB 1B. Adrenergic pathways involved in regulation of uncoupling protein gene expression

The HIB 1B cell line, derived from a brown fat tumor of a transgenic mouse, is the first established brown adipocyte cell line capable of expressing the brown fat-specific mitochondrial uncoupling protein (UCP). UCP gene expression, which was virtually undetectable under basic conditions, was stimulated by acute catecholamine or cyclic AMP treatment to levels comparable to primary cultures of brown adipocytes. Elevation of UCP mRNA levels following stimulation was very rapid but transient, decreasing after about 4 hours with a half-life between 9 and 13 hours. Immunoblotting showed the presence of UCP in HIB 1B mitochondria, but expression was much lower than observed in BAT or primary cultures of brown adipocytes. Upon transfection of HIB 1B cells with a reporter gene containing the UCP promoter, the activity of the transgene was regulatable by cAMP and norepinephrine. Investigation of the possible adrenergic receptors involved in UCP stimulation showed that specific beta 3-adrenergic agonists were much less effective than nonspecific beta-adrenergic agonists and that mRNA levels of the atypical, fat-specific beta 3-adrenoceptor were lower than those observed in brown adipocytes differentiated in primary culture. From pharmacological evidence we conclude that beta 3-adrenergic receptors account for approximately 30–40% of catecholamine induced UCP gene stimulation, whereas about 60–70% is stimulated via the classical beta 1/2 adrenergic pathway. We conclude that HIB 1B cells represent a functional system for the study of mechanisms related to brown adipose thermogenesis.

Ultrastructural pathology of parathyroid glands in hyperparathyroidism: a report of 69 cases

The ultrastructural features of 69 parathyroid glands from 43 patients with hyperparathyroidism were studied to distinguish between different parathyroid lesions causing hyperparathyroidism. Samples came from 44 cases of hyperplasia, 21 of adenoma, 3 of carcinoma, and 1 from a histologically normal gland. To establish the diagnosis we took into account intraoperative findings during surgery as well as light microscopic examination. Ultrastructural features, evaluated on a semiquantitative scale, were correlated with diagnostic, clinical, and biochemical parameters. Neoplastic glands were heavier than nonneoplastic ones, and carcinomatous glands were heavier than adenomatous glands. Our findings suggest that the cellular membrane of adenomatous glands shows more folding than that of hyperplastic glands, mainly in the capillary pole. Carcinomatous glands show the greatest degree of irregularity, with the formation of microvilli-like projections. Hyperplastic glands, in turn, are richer in glycogen deposition. Secretory granules appear in higher amounts when the serum calcium level is high. These findings are not of diagnostic value by themselves, but they can be taken in consideration to aid in differential diagnosis.

Ultrastructural changes in rat mammotropes following incubation with dopamine

Cultured mammotropes incubated with dopamine for one hour exhibited changes in ultrastructure indicative of actively depressed biosynthetic and secretory activity. Peripheral relocation of rough endoplasmic reticulum appeared to create a barrier to secretory granule release by exocytosis. A decrease in the numbers of secretory granules indicated a decrease in prolactin production and enhanced lysosomal activity.

Presence of the brown fat-specific mitochondrial uncoupling protein and iodothyronine 5'-deiodinase activity in subcutaneous adipose tissue of neonatal lambs

Subcutaneous adipose tissue of neonatal lambs has been examined for the presence of markers diagnostic of thermogenic brown fat. Uncoupling protein, uncoupling protein mRNA, and iodothyronine 5'-deiodinase activity were each detected in subcutaneous adipose tissue, as well as in the major internal fat depot (perirenal), of newborn lambs. These brown fat markers were not present, however, in adipose tissue of adult sheep. It is concluded that subcutaneous fat in newborn lambs is functionally 'brown', and similar to the internal fat; subcutaneous and internal adipose tissues follow a similar developmental path--from 'brown' to 'white'.

Differentiation of brown adipose cells in three-dimensional collagen gel culture

Brown adipose cells are heat-producing cells through non-shivering thermogenesis by intramitochondrial "thermogenin". This specific protein is a marker for their cellular differentiation. It has long been known that cultured brown adipose cells in monolayer rapidly lose the thermogenin bioactivity. In this study, we cultured brown adipose cells in three-dimensional type I collagen gel matrix. Under this culture condition, they were able to survive, and differentiated morphologically and functionally for a long period of time, especially exhibited the characteristic immunohistochemical activity of thermogenin. These findings suggest that brown adipose cells differentiate in type I collagen gel. In this condition, cholera toxin or BRL 37344, one of beta 3-adrenoceptor agonists, specifically stimulated the brown adipose cells.

Intravascular immunoglobulin crystalloids in monoclonal cryoglubulinemia-associated dermatitis: ultrastructural findings

A 46-year-old woman developed polyarthritis, purpuric skin rashes, nasal septal perforation and marginal furrowing of corneas in 1980. Monoclonal IgG, kappa cryoglobulinemia was found in the patient's serum. No underlying lymphoproliferative disorder has been found in ten years since her original diagnosis. In 1991, she developed palpable purpura on both lower extremities with subsequent necrosis and ulceration. A skin biopsy revealed fibrin thrombi within capillaries in the papillary dermis, and immunofluorescence studies showed IgG and light chain kappa within the fibrin thrombi. An electron microscopy study showed intravascular immunoglobulin crystalloid structures with a mean diameter of 80.3A degrees (8.03 nm), mixed with fibrin and red blood cells. The exclusive vascular location of these crystalloids may have implication in the pathogenesis of skin lesions.

Parathyroid glands in primary hyperparathyroidism: an ultrastructural morphometric study of 25 cases

In parathyroid glands removed from patients with primary hyperparathyroidism (pHPT), hyperplasias and adenomas cannot be distinguished from one another by light microscopy when only one gland is available for examination. When a second gland is available, it is necessary to establish whether it is normal, suppressed, or hyperplastic. This distinction may be difficult, and the main criterion is the amount of cytoplasmic lipid in the parenchymal cells. If the lipid is abundant, the gland is considered normal or suppressed, and if it is scanty, the gland is interpreted as hyperplastic. We have performed a morphometric ultrastructural study to test the reliability of this criterion. Twenty-five adenomatous glands removed from patients with pHPT, when compared with glands of normal size from euparathyroid patients, showed a significant increase in the parameters indicative of metabolic activity, namely the size of the Golgi apparatus, the amount of rough endoplasmic reticulum, and the length of plasmalemmas. In addition, the amount of cytoplasmic lipid was significantly reduced. Furthermore, 25 glands of normal size removed from the same patients with pHPT showed an amount of lipid similar to that of normal glands from euparathyroid patients. However, all the parameters indicative of metabolic activity were significantly higher than those in glands from euparathyroid patients and comparable to those found in adenomatous glands. These results suggest that in pHPT, normal-size glands are as active as adenomatous glands, regardless of a higher lipid content.

Malignant fibrous histiocytoma of the brain in a six-year-old girl

We have prepared karyotypes from a malignant fibrous histiocytoma (MFH) of the brain of a 6-year-old girl. Sporadic cases of MFH in the central nervous system have been reported. However, to our knowledge, this is the first central nervous system tumor to be subjected to cytogenetic analysis. The tumor demonstrated a complex karyotype, with a variety of numerical and structural abnormalities. Although no specific cytogenetic abnormality was observed, the karyotype of this case was similar to those reported for adult MFH of soft tissues.

Comment to Shinohara et al. (1991) FEBS Letters 293, 173-174. The uncoupling protein is not expressed in rat liver

Using Northern blot analysis, immunoblotting with purified antibodies and Polymerase Chain Reaction analysis, we were unable to detect the Uncoupling Protein-UCP or its mRNA in liver of control, cold-exposed or newborn rats. The unique expression of this protein in brown adipocytes was confirmed. These data refute the surprising recent report on UCP expression in rat liver (Shinohara (1991) FEBS Lett. 293, 173-174). Moreover we report that the hybridization signal obtained by these authors is probably non-specific and due to the 3' non-coding domain of the UCP cDNA probe.

Pituitary adenylate cyclase activating polypeptide (PACAP): discovery and current status of research

For last 2 years since PACAP was first discovered, many important findings on PACAP have been reported. cDNAs encoding the precursor proteins of PACAP in sheep, human and rat were cloned, and the precursor proteins characterized. PACAP was found in a high concentration in the central nervous system, adrenal medulla and testis. Immunohistochemical study indicated that PACAP containing neural fibers are present throughout the brain, including both internal and external zones of the median eminence. In the hypothalamus many PACAP positive cell bodies were demonstrated in the supraoptic nucleus and the paraventricular nucleus in various species. Four types of high affinity PACAP receptor were demonstrated. PACAP receptors in the central nervous system, pituitary, adrenal medulla and germ cells of the testis are highly specific for PACAP, and not shared with VIP. The PACAP receptor was solubilized and cross-linking of 125I-PACAP27 with the binding protein suggest that the molecular weight of the receptor is around 57,000. Various biological actions of PACAP were reported, but the physiological cellular events linked with PACAP-induced activation of adenylate cyclase remain to be investigated.

Intercellular communication within the rat anterior pituitary gland: IV. Changes in cell-to-cell communications during pregnancy

Cell-to-cell communication by gap junctions was investigated in the female rat anterior pituitary gland from 9 through 21 days of pregnancy and subsequently on days 2 and 20 of the lactational period. Compared with intact estrus females, the major morphological characteristics of the pituitary gland during pregnancy were remarkably developed prolactin cells and gonadotrophs. A close relationship of both cell types was clearly evident. Gap junctions were present at each of the time intervals studied; however, they were noted only between adjacent folliculo-stellate cells. No remarkable changes were noted in the number of gap junctions during the middle stage of pregnancy (day 9 through day 15), with the relative number resembling that found in intact, 90-day-old controls during estrus (0.47 +/- .01 junctions/follicle-control vs. 0.50 +/- 0.08--day 15 of pregnancy). In the later stages of pregnancy (day 17 through day 21), a demonstrable increase was observed (0.64 +/- 0.10--day 17, 0.79 +/- 0.11--day 19 and 0.72 +/- 0.12--day 21), whereas during the lactation, this pattern returned to that seen at midpregnancy. Since both prolactin and the gonadal steroid hormones dramatically fluctuate during pregnancy and lactation, it is postulated that they may have an active role in gap junction formation during these two phases of reproductive life.

Parathyroid hyperplasia in multiple endocrine neoplasia type 1: a pathological and immunohistochemical reappraisal

Twenty-nine parathyroid glands from nine patients with multiple endocrine neoplasia type 1 (MEN 1) syndrome were examined histopathologically and immunocytochemically to characterize better the nature of the accompanying parathyroid hyperplasia. The parathyroids showed varying degrees of nodular and diffuse (partial and total) hyperplastic involvement as well as apparently normal tissue. The nodules were usually multiple within any one gland and showed a varied cytoarchitectural pattern. All glands studied showed both cellular argyrophilia and parathyroid hormone immunoreactivity. The staining pattern for parathyroid hormone ranged from negative or weak to strong and from patchy to diffuse in hyperplastic tissue from different glands and within the same gland. Apparently normal areas usually showed the strongest positive reaction. Amyloid material was observed within glandular lumens from hyperplastic areas in over half of the studied cases and stained positively for parathyroid hormone. This suggests that the hormone could be the precursor molecule of parathyroid amyloid as occurs with hormone-derived amyloid from other endocrine tumours. The overall findings indicate that the most striking feature of the parathyroid glands in MEN 1 is their variability, both morphological and functional, as indicated by their parathyroid hormone immunoreactivity.

S-100 protein immunopositivity in human nontumorous hypophyses and pituitary adenomas

The presence, distribution, and morphological appearance of S-100 protein-immunoreactive cells in the human hypophysis were studied by immunocytochemistry. One hundred and twelve nonadenomatous pituitaries from fetuses to adults and pituitaries affected by several lesions including metastases, acute infarcts, and lymphocytic hypophysitis, as well as 115 pituitary adenomas were examined.S-100 protein immunoreactivity was detected in neurohy-pophyseal pituicytes and stellate cells of the pars distalis from 5 months following birth. In adults, S-100 protein-immunopositive cells displayed a preferential topographical association with growth hormone-, follicle-stimulating hormone-, luteinizing hormone-, and alpha-sub-unit-immunoreactive cells and with capillary walls. Colloid-containing follicles were mainly lined by hormone-containing cells, although scattered S-100 protein-immunoreactive processes or cell bodies were also observed forming their walls.No major changes in S-100 protein-immunoreactive cells were observed in the pituitary parenchyma bordering metastatic, inflammatory, necrotic, or adenomatous tissues. Eighteen of 115 pituitary adenomas contained a variable number of S-100 protein-immunoreactive cells. No preferential association of these cells with any type of pituitary adenoma was found.We propose that S-100 protein expression in the nontumorous adenohypophysis and pituitary adenomas may constitute a dynamic process and that S-100 protein-positive cells may constitute a heterogeneous cell population composed of pure, fully differentiated stellate cells and of transdifferentiated follicular cells.

Bone abnormalities and severe arthritis in pachydermoperiostosis

Two patients with pachydermoperiostosis were studied in whom the predominant features at presentation were severe and disabling knee and ankle joint pain in association with distal long bone pain. Analysis of synovial fluid from the knee joints showed non-inflammatory changes. In one patient a bicortical iliac crest bone biopsy specimen, taken after labelling with demeclocycline, showed appositional rates which were increased in cortical bone but reduced in trabecular bone. This mismatching resulted in trabecular osteoporosis, which occurred in association with increased numbers of osteoclasts, findings which suggest differential functional changes affecting the two bony envelopes.

Cancer family syndrome associated with multiple malignant melanomas and a malignant fibrous histiocytoma

A 64-year-old female with the cancer family syndrome suffered from multiple malignant melanomas and a malignant fibrous histiocytoma. She has shown unusually long survival which is a feature of these patients.

Intercellular communication within the rat anterior pituitary gland. III. Postnatal development and periodic changes of cell-to-cell communications in female rats

Cell-to-cell communication by gap junctions was investigated in the female rat anterior pituitary gland from 10 through 45 days of postnatal development and in 60-day-old animals. Gap junctions initially appeared between adjacent folliculo-stellate cells on day 25. Their appearance in female rats was 5 days later than that observed in males (Soji et al., 1990). Gap junction number increased until the animals became 40 days of age, when they reached a level that resembled that found in adults. In addition, a correlation was evident between the frequency of gap junctions and stages of the estrous cycle, where they were most numerous during either proestrus or estrus. These results along with those previously published suggest that gap junction formation within the female rat hypophysis is in part modulated by both gonadal steroid hormones as well as prolactin.

Response to autoimmune enteropathy to cyclosporin A therapy

Small bowel enteropathies that are associated with an autoimmune process are often resistant to treatment. Two children with autoimmune enteropathy were treated with cyclosporin A for eight months. Both improved, as assessed by growth, small intestinal mucosal morphology, and carbohydrate absorption. Cyclosporin A is useful in the treatment of autoimmune enteropathy. This report also suggests that T cell activation (which is suppressed by cyclosporin A) is important in the pathogenesis of this condition.

Gastrointestinal manifestations of type 1 neurofibromatosis (von Recklinghausen's disease)

Gastrointestinal involvement in von Recklinghausen's disease occurs in three principal forms: hyperplasia of the submucosal and myenteric nerve plexuses and mucosal ganglioneuromatosis which leads to disordered gut motility; gastrointestinal stromal tumours showing varying degrees of neural or smooth muscle differentiation; and a distinctive glandular, somatostatin-rich carcinoid of the periampullary region of the duodenum that contains psammoma bodies and which may be associated with phaeochromocytoma. This review describes the histopathological features of these lesions and discusses potential pitfalls in their differential diagnosis. Their accurate identification has significant implications for clinical management and may even provide the first pointer to the diagnosis of neurofibromatosis.

Lipid-rich rhabdomyosarcoma--a potential source of diagnostic confusion

Rhabdomyosarcoma is an often primitive tumor capable of diverse morphologic manifestations. The article describes three cases of childhood rhabdomyosarcoma in which a significant population of lipid-rich tumor cells was present. The lack of specificity and potentially confusing nature of this feature are discussed, and the ultrastructural diagnosis of rhabdomyosarcoma is briefly reviewed.

Ptosis caused by pachydermoperiostosis

Pachydermoperiostosis is a rare inherited disorder which presents with finger clubbing, facial enlargement, and periostitis. A case is described in which surgery for ptosis was performed and the differential diagnosis of the condition is discussed. The histological and ultrastructural appearances of the eyelids show sebaceous gland hyperplasia and excessive deposition of mucin in the dermis and would suggest that pachydermoperiostosis may be an example of a cutaneous mucinosis.

Histopathology, hormone products, and clinicopathological profile of endocrine tumors of the upper small intestine: A study of 44 cases

Forty-two duodenal and 3 upper jejunum tumors from 44 patients were investigated. All tumors were tested immunohistochemically for gastroenteropancreatic hormones and general endocrine cell markers. Twenty-eight of the 45 tumors (62%) proved to be gastrin cell tumors, with (12 cases) or without (16 cases) associated Zollinger-Ellison syndrome. Zollinger-Ellison syndrome was part of type 1 multiple endocrine neoplasia syndrome in 3 cases. Twenty-three of the 28 gastrin cell tumors (82%) were from proximal duodenum, 2 were from the second part of the duodenum, and 3 were from the upper jejunum. Seven cases were somatostatin cell tumors, 6 of which were from the ampullary region; 5 cases were associated with biliary tract disease and 2 with associated cutaneous neurofibromatosis. Four ganglioneuromatous paragangliomas, from the ampullary region or nearby duodenum, showed somatostatin cells, coupled with pancreatic polypeptide cells in 2 cases. Two serotonin-producing argentaffin carcinoids were also identified. In addition to the main cell type, 30 tumors showed one or more, usually minor, cell populations producing somatostatin, serotonin, cholecystokinin, pancreatic polypeptide, insulin, neurotensin, or the alpha chain of human chorionic gonadotropin. Only 3 tumors lacked hormone immunoreactivity. Some correlation has been noted between histological structure and hormone content of tumor cells, with prevalence of broad gyriform trabeculae and vascular pseudorosettes among gastrin cell tumors, tubuloacinar patterns among somatostatin cell tumors, thin parallel trabeculae among PP cell growths, and a solid nest pattern among argentaffin carcinoids. Deep infiltration of the intestinal wall was observed in 22 tumors, 6 of which also had metastases to local lymph nodes. All metastatic cases were among ZES tumors or ampullary somatostatin cell tumors. Ganglioneuromatous paragangliomas and nonfunctioning gastrin cell tumors had essentially benign behavior, even when involving deep strata of the intestinal wall. Post operative follow-up study of 36 cases, including all metastatic tumors, showed no evidence of tumor-related death or progressive tumor disease.

Ultrastructural morphology of folliculo-stellate cells in human pituitary adenomas

Fifty-six pituitary adenomas were studied by electron microscopy in a search for the presence of folliculo-stellate cells (FSCs) with the aim of evaluating their prevalence and ultrastructural morphology. FSCs were scattered in two adenomas (one oncocytoma and one densely granulated GH cell adenoma) and were numerous in a sparsely granulated GH cell adenoma; their overall prevalence was 5.4%. Ultrastructural examination of the three neoplasms revealed that FSCs were hypertrophic element with abundant cytoplasm and organelles (in contrast to FSCs of the normal pituitary) and no obvious signs of neoplastic transformation. Junctional complexes between FSCs were similar to those described in the normal gland. Numerous follicular structures were lined by FSCs. FSCs in pituitary adenomas are probably nonneoplastic, reactive cells showing signs of hyperactivity, similar to FSCs found during pituitary hypersecretion and in estrogen-induced tumor.

Lack of binding between cryoimmunoglobulins, immunoglobulins and fibronectin: implications for immune complex vasculitis

Immune-complex-mediated vasculitis is a frequent complication of rheumatoid arthritis and systemic lupus erythematosus. The mechanism of deposition of immune complexes within the vessel wall in these diseases remains unknown, but probably involves other proteins. Fibronectin is a likely candidate since it possesses the ability to bind to collagen, endothelial cells, and possibly immunoglobulins and immune complexes. In this study, the binding of fibronectin to IgG and IgM cryoglobulins, cold soluble IgM, IgG, IgG subclasses and IgG fragments was investigated in the solution phase. Static light scattering, fluorescence anisotropy, fluorescence intensity, and PEG precipitation studies were used to investigate binding under different conditions of temperature and ionic strength. These studies failed to demonstrate significant binding between fibronectin and IgM, IgG, IgG subclasses and IgG fragments under the conditions studied. These findings argue against solution phase binding of fibronectin and immunoglobulins contributing to immune complex vasculitis. The possibility of important surface interactions between these proteins has not been ruled out.

Spermatic cord liposarcoma: ultrasound for diagnosis and follow-up. Case report

A case of spermatic cord liposarcoma is described in a 48-year-old man. Following local excision, the tumour recurred after 3 years, leading to funiculoorchiectomy. The case is presented, the literature reviewed and the role of ultrasound in the diagnosis discussed.

The pituitary gland in pregnancy: a clinicopathologic and immunohistochemical study of 69 cases

A histologic and immunocytochemical study of 69 autopsy-obtained pituitaries from women who died during pregnancy, after abortion, or in the postpartum period revealed an accumulation of large chromophobic to slightly acidophilic and periodic acid-Schiff-negative pregnancy cells that were immunoreactive for prolactin but not for other pituitary hormones. This increase in the number of prolactin cells was confirmed by cell counts. Thus, pregnancy cells are capable of prolactin production. The finding of mitotic figures in such cells supports the view that they arise by multiplication from preexisting prolactin cells. With use of "mirror section" techniques, no mammosomatotrophs (cells immunoreactive for growth hormone and prolactin) were identified. Hyperplasia of prolactin cells was evident at 1 month of pregnancy and gradually disappeared within several months after delivery or abortion; the process of involution seemed to be retarded in the one lactating patient investigated. In some pituitaries, the accumulation of prolactin cells was so extensive that the hyperplastic foci resembled microadenomas. Another striking change in the pituitaries of pregnant women was appreciable reduction of immunostaining of gonadotropic cells, a process that was reversible as soon as 1 month after delivery. Among the 69 pituitaries studied, 8 noninvasive microadenomas (12%) were encountered (7 contained prolactin only and 1 was plurihormonal). Prolactin-producing adenomas were no more numerous or larger than were similar tumors encountered in nonpregnant women or normal men; thus, pregnancy neither initiates formation of pituitary adenomas nor accelerates their growth. In the pituitaries that harbored prolactin-producing adenomas, massive pregnancy cell hyperplasia was evident outside the tumor; thus, prolactin production by adenoma cells did not seem to suppress the proliferation of prolactin-containing pregnancy cells.

Limited joint mobility in insulin dependent childhood diabetes

Limited joint mobility (LJM), beginning typically in the fifth finger and moving radially, affecting interphalangeal, metacarpal-phalangeal, and large joints, is the earliest clinically apparent complication of diabetes in childhood and adolescence. It is painless and not disabling. Approximately 50% of post-adolescent patients with more than 5 years duration of diabetes are affected, with age being more important than duration of diabetes, as is the case with other complications. Growth failure is more frequent in the presence of LJM, although correlations with diabetic control have not been found. Variations in frequency in various reports, including high prevalence in controls or relatives, appear to be related to the quality of the examination; simple inspection with hands pressed flat on the table top or together in the prayer position is inadequate; passive extension must be performed. Although differential diagnosis from other conditions causing limitation of the fingers in diabetes would appear simple, LJM has been confused with other conditions which can be distinguished by the presence of pain or paresthesias, neurologic findings, disability, finger-locking, swelling, muscle atrophy, palmar skin or fascial thickening, absence of typical distribution, calcification of the vessels and, particularly, the age group affected. That the periarticular thickening found on examination and demonstrated on roentgenograms reflects generalized abnormalities is suggested by association with thick tight waxy skin, decreased pulmonary function, and association with retinopathy, nephropathy, and neuropathy, independently of duration of diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)

Allo-activated CD4+ and CD8+ lymphocyte subsets: new ultrastructural findings based on computer-assisted image analysis

Primary allo-stimulation induces substantial and differentiated modifications in the development of cytoplasmic organelles of peripheral T-lymphocyte subsets. The present computer-assisted image analysis provides evidence that the CD4+ subset undergoes significant increase in organelle density after stimulation, while the CD8+ subset exhibits a post-stimulation organelle development proportional to the cell size. Each immunological subset contains two distinct patterns of cytoplasmic organization, here defined as type I (containing a few cytoplasmic organelles) and type II (with well-developed synthesis and storage organelles). On the basis of these findings cytologic parameters could be ascribed to a heterogeneous proliferation of functionally distinct T-cell clones in CD4+ and CD8+ subsets.

Postnatal appearance of uncoupling protein and formation of thermogenic mitochondria in hamster brown adipose tissue

Brown adipose tissue of developing hamster was characterized by western blotting, enzyme activity measurements and immunoelectron microscopy. During the first postnatal week the tissue contained significant amounts of differentiating mitochondria and comparable quantities of active cytochrome oxidase and ATP synthase. The uncoupling protein appeared on the 7/8th day and its specific content increased 80-times between day 8 and day 17. In parallel, the specific content and activity of cytochrome oxidase increased 3-times but ATP synthase decreased 2-times. The total content of uncoupling protein and of cytochrome oxidase in interscapular brown adipose tissue increased 360- and 11-times, respectively. Analysis of isolated mitochondria showed that the observed differences result mainly from changes of the enzymic equipment of the mitochondrial membrane. During the same interval, propylthiouracil-insensitive "type II' thyroxine 5'-deiodinase activity in brown adipose tissue increased 10-times. It was concluded that the thermogenic function of the hamster brown adipose tissue develops after the first postnatal week due to highly differentiated synthesis of mitochondrial proteins leading to replacement of preexisting, uncoupling protein-lacking nonthermogenic mitochondria by thermogenic ones, similarly as shown in brown adipose tissue of the embryonic mouse and rat (Houstĕk, J., et al. (1988) Biochim. Biophys. Acta 935, 19-25).

Morphometric evaluation of intracytoplasmic lipid in normal and pathological parathyroid glands

The chief morphological criterion for classifying parathyroid glands as 'normal', 'suppressed', or 'activated' is the lipid content of the cytoplasm. In particular, cytoplasm lipid deposit is scanty in the active parathyroid cell, according to many authors. In this paper we present the results of a morphometrical study of ten normal parathyroid glands from patients undergoing thyroidectomy, 20 enlarged 'adenomatous' glands from patients with primary hyperparathyroidism, and 20 glands of normal size from the same hyperparathyroid patients. We aimed at assessing the content of intracytoplasmic lipid of secretory cells in all these conditions. The results show that secretory cells of adenomatous glands have less lipid than those from normal glands; however, there was considerable overlapping of the data in the two groups. The mean lipid content of cells in glands of normal size taken from hyperparathyroid patients was not significantly different from the mean value of normal cells, even when ultrastructural evidence of activation was present in the former. These data suggest that caution has to be exercised in assessing the functional status of parathyroid glands on the basis of lipid content of secretory cells, mainly when differentiating between adenoma and hyperplasia.

Isolation of a novel 38 residue-hypothalamic polypeptide which stimulates adenylate cyclase in pituitary cells

A novel neuropeptide which stimulates adenylate cyclase in rat anterior pituitary cell cultures was isolated from ovine hypothalamic tissues. Its amino acid sequence was revealed as: His-Ser-Asp-Gly-Ile-Phe-Thr-Asp-Ser-Tyr-Ser-Arg-Tyr-Arg-Lys-Gln- Met-Ala- Val-Lys-Lys-Tyr-Leu-Ala-Ala-Val-Leu-Gly-Lys-Arg-Tyr-Lys-Gln-Arg-Val-Lys-Asn-Lys - NH2. The N-terminal sequence shows 68% homology with vasoactive intestinal polypeptide (VIP) but its adenylate cyclase stimulating activity was at least 1000 times greater than that of VIP. It increased release of growth hormone (GH), prolactin (PRL), corticotropin (ACTH) and luteinizing hormone (LH) from superfused rat pituitary cells at as small a dose as 10(-10)M (GH, PRL, ACTH) or 10(-9)M (LH). Whether these hypophysiotropic effects are the primary actions of the peptide or what physiological action in the pituitary is linked with the stimulation of adenylate cyclase by this peptide remains to be determined.

Intracerebral malignant fibrous histiocytoma at site of a previously excised low grade glioma

The case of a 42-year-old patient is reported who developed an intracerebral malignant fibrous histiocytoma at the site of an oligoastrocytic mixed glioma which had been excised 2 1/2 years previously. Reasons for the extreme rarity of intracranial malignant fibrous histiocytomas, the probability of a traumatic aetiology of this particular tumour, and the possible significance of intratumoural cells positive for glial fibrillary acidic protein (GFAP) are discussed.

S-100 protein in white preadipocytes: an immunoelectronmicroscopic study

Differentiation of adipocytes from their precursor cells (preadipocytes) is an important problem in the study of the pathogenesis of obesity. Unfortunately, among the immature stages of adipocytes, only relatively differentiated forms can be identified by their fine structure; because early preadipocytes cannot be distinguished from fibroblasts solely on the basis of their morphology, it is impossible to assess the size of the preadipocyte population. S-100 protein has been identified in various mammalian tissues and recently mature adipocytes have been shown to be positive for this protein. Because fibroblasts are negative for S-100 protein, the present study tested the S-100 immunoreactivity of preadipocytes by the peroxidase-antiperoxidase (PAP) preembedding method at the ultrastructural level both in vivo and in culture. Mature adipocytes and early preadipocytes, including fibroblast-like cells devoid of lipid droplets, were positive both in vivo and in culture. Endothelial cells and pericytes were negative; but flattened, lipid-free, fibroblast-like cells surrounding the pericytes were positive. True fibroblasts both in vivo and in culture were negative. Therefore, S-100 protein can be a useful biochemical marker in distinguishing fibroblasts from early preadipocytes.

Spindle cell and pleomorphic lipoma: an immunohistochemical study and histogenetic analysis

Twenty-two spindle cell lipomas and seven pleomorphic lipomas were investigated immunohistochemically in order to study the differentiation of the non-adipocytic elements. In all cases, neither spindle cells nor pleomorphic cells reacted with antibodies to a monocyte/macrophage antigen (MAC-387), fibronectin, laminin or type IV collagen. The absence of demonstrable basement membrane material argues against the possible prelipoblastic nature of these cells. With the antibody to S-100 protein, spindle cells were immunonegative, whereas pleomorphic cells sometimes revealed an intracytoplasmic weak to moderate staining reaction. In the light of what is known about the development of adipose tissue, our results would support the hypothesis of Bolen and Thorning (Am J Surg Pathol 1981; 5: 435-441) that spindle cell lipoma is composed of adipocytes and non-fat storing immature mesenchymal cells. It would appear that pleomorphic lipoma is similarly derived but that in some cases adipocytic differentiation is also abnormal. The characteristic clinical distribution of these two types of tumour may be of relevance in determining the cause of these unusual benign patterns of differentiation.

Brown adipocytes differentiated in vitro can express the gene for the uncoupling protein thermogenin: effects of hypothyroidism and norepinephrine

Expression of the gene for the brown-fat specific uncoupling protein thermogenin was investigated in cell cultures by hybridization of isolated RNA with a cDNA clone corresponding to mouse thermogenin. The RNA was isolated 3-4 days after confluence from cells differentiated in culture from precursors isolated from the interscapular brown adipose tissue of 5-week-old mice. Very low thermogenin mRNA levels were found in cells derived from untreated mice, and there was only little effect of added norepinephrine on thermogenin gene expression in these cells. However, in cells derived from hypothyroid (methimazole-treated) mice there was a higher expression of thermogenin, and norepinephrine had a marked augmenting effect on the thermogenin mRNA level in these cells. These effects of thermogenin mRNA levels were specific, in that they contrasted with the effects of hypothyroidism and norepinephrine on the level of other mRNA species in these cells (coding for beta-actin, lipoprotein lipase, cytochrome-c oxidase, and glycerol-3-phosphate dehydrogenase). It was concluded that brown-fat cells in culture can reach a differentiated state, sufficiently advanced that the unique properties of these cells can be expressed, and that thermogenin gene expression (i.e., the level of thermogenin mRNA) is under direct control of norepinephrine.

Ectopic endocrine pancreatic tumour simulating splenic angiosarcoma

A case of ectopic endocrine pancreatic tumour that had developed within the spleen of a 46-year-old man is reported. The tumour was highly vascularized through the splenic artery, angiographically simulating an angiosarcoma. The histological pattern was typical of an endocrine tumour, and its nature was confirmed by a positivity for keratin, chromogranin A and somatostatin. Foci of atrophic pancreatic tissue were detected in the tumour capsule.