Single cell transcriptomic analysis of HPV16-infected epithelium identifies a keratinocyte subpopulation implicated in cancer

Persistent HPV16 infection is a major cause of the global cancer burden. The viral life cycle is dependent on the differentiation program of stratified squamous epithelium, but the landscape of keratinocyte subpopulations which support distinct phases of the viral life cycle has yet to be elucidated. Here, single cell RNA sequencing of HPV16 infected compared to uninfected organoids identifies twelve distinct keratinocyte populations, with a subset mapped to reconstruct their respective 3D geography in stratified squamous epithelium. Instead of conventional terminally differentiated cells, an HPV-reprogrammed keratinocyte subpopulation (HIDDEN cells) forms the surface compartment and requires overexpression of the ELF3/ESE-1 transcription factor. HIDDEN cells are detected throughout stages of human carcinogenesis including primary human cervical intraepithelial neoplasias and HPV positive head and neck cancers, and a possible role in promoting viral carcinogenesis is supported by TCGA analyses. Single cell transcriptome information on HPV-infected versus uninfected epithelium will enable broader studies of the role of individual keratinocyte subpopulations in tumor virus infection and cancer evolution.

353 AIR Score Based Management of Appendicitis

Introduction

Appendicitis is the most common cause of an acute abdomen. Approximately 7% of the population will be affected at some point. The development of AIR has been developed to aid diagnosis and decreasing the number of negative appendectomies while also safely identifying those who have developed appendicitis.

Aim

This retrospective audit, which aims to assess the effects of the introduction of AIR score risk on the negative appendicectomy rate of patients admitted to Taranaki Base Hospital.

Method

All patients under General Surgery receiving open appendicectomy, laparoscopic appendicectomy or diagnostic laparoscopy for evaluation or treatment of appendicitis from January 1st 2017 – December 31st 2018.

Results

The negative appendicectomy rate dropped 11.1% after introduction of the AIR score, we also noted a decrease in CT scan use.

Discussion

Our results suggest that the Air score could be used as an adjunct to the clinical diagnosis of acute appendicitis.

Comparison of a human granular cell tumour (myoblastoma) with granular cell tumours (meningiomas) of the rat meninges--an immunohistological and ultrastructural study

A single human granular cell tumour (myoblastoma) was compared with seven rat granular cell tumours (meningiomas) of the meninges. The comparison was made histologically, ultrastructurally and using immunocytochemical markers. A selection of antibodies to histiocytic, muscle, neural, neural crest and mesenchymal antigens was used. Histogenesis of both the human and rat tumours from neural crest-derived cells was evident and it is suggested that the term 'meningioma' for these rat tumours is a misnomer.

Production of cytokines by bone marrow cells obtained from patients with multiple myeloma

Previous work with continuously cultured multiple myeloma lines suggested that cytokine production by tumor cells may mediate some of the medical complications of this disease. To further investigate this issue, we assayed freshly obtained bone marrow (BM) cells from myeloma patients for the in vitro production of cytokines and the presence of cytokine RNA. Production of cytokine protein was assessed by bioassays with the aid of specific neutralizing anticytokine antibodies. These assays detected interleukin-1 (IL-1) and tumor necrosis factor (TNF) secretion by myeloma BM cells, which was significantly greater than secretion from similarly processed BM cells of control individuals. In contrast, lymphotoxin and interleukin-2 (IL-2) production could not be detected. The levels of IL-1 and TNF produced in vitro peaked at 24 hours of culture and correlated with stage and the presence (or absence) of extensive osteolytic bone disease. Northern blot analysis demonstrated the presence of IL-1 beta and TNF RNA in uncultured myeloma BM cells but no detectable IL-1 alpha or lymphotoxin RNA. In addition, the amount of cytokine RNA correlated with protein production, being significantly greater in patients' BM cells than in control marrow. These data suggest a role for IL-1 beta and/or TNF in the pathophysiology of multiple myeloma and argue against a role for lymphotoxin or IL-2.

Age changes in the human female urethra: a morphometric study

Aging in the human female urethra can contribute towards urinary problems. To our knowledge the effect of age on urethral tissues has not been quantified previously. Histological sections were prepared from 8 regions along the length of the urethra from 26 women between 19 and 88 years old. Using quantitative morphological techniques the relative volume fractions of various tissue components were determined. As age increased there was a decrease in the relative volume of striated muscle and blood vessels, and an increase in the relative volume of connective tissue. There was no change in the smooth muscle components. These age changes in the human female urethra may lead to impairment of urethral function.

The epithelium in the female urethra: a quantitative study

Histological sections were prepared from 8 regions along the length of the urethra in 16 women 19 to 82 years old. The epithelium was examined under the light microscope at 4 points in each region and the type of epithelium was classified. Our results indicate that the human female urethra is lined by stratified squamous, pseudostratified columnar and, occasionally, transitional epithelium. There is a gradual change from squamous to columnar epithelium with advancing age. More squamous epithelium is present at the distal end of the urethra.

Scar adenocarcinoma of the lung: a light and electron microscopic study

Five well differentiated peripheral adenocarcinomas of the lung were investigated, using light and electron microscopy. Each tumour contained a central nidus of fibrous tissue and fulfilled the criteria for "scar cancer." One tumour also had a focus of lamellated collagenous tissue, suggestive of an old tuberculous granuloma. Electron microscopy showed the features of Clara cells, with characteristic dense bodies in the apical cytoplasm and scattered microvilli on the luminal surface. It was concluded that this variant of scar cancer was a carcinoma of Clara cells, which was sufficiently distinctive in appearance to be recognised on light microscopy alone. It remains uncertain, however, whether the central fibrous area is a desmoplastic response to tumour growth or a pre-existing scar.

Poorly differentiated squamous carcinoma of the bronchus: a light and electron microscopic study

As there is little published information on the ultrastructure of poorly differentiated squamous carcinoma of the bronchus 18 examples of this tumour were studied. On light microscopy 10 of the tumours contained foci of keratinisation or intercellular bridges and therefore fulfilled the World Health Organisation's diagnostic criteria. In eight these features were absent, but the overall appearance was sufficiently squamoid to preclude their placement in any other category. On electron microscopy many cells showed the characteristic desmosomes and tonofilament of of squamous carcinoma, but there were also areas of adenodifferentiation. The ultrastructure of both light microscopic groups was identical. In conclusion, this type of tumour is dimorphic with characteristics of adenocarcinoma and squamous carcinoma on electron microscopy. Keratinisation and bridges are not essential diagnostic criteria: the overall pattern and cellular morphology are more important.

Clear cell carcinoma of the lung

Six tumours of the lung initially classified as clear cell carcinoma, were studied. Examination of further material by light and electron microscopy showed adenocarcinomatous differentiation in three cases and squamous differentiation in two. One case showed the features of a large cell anaplastic carcinoma. The clear appearance of the cytoplasm in paraffin sections was due to accumulations of glycogen that were partially removed during processing. It is concluded that clear cell carcinoma is not a single and separate entity.

The larger bronchi in byssinosis: a morphometric study

The proportions of gland, muscle and cartilage were measured in the named bronchi of 43 byssinotics, and compared with the proportions in normal subjects and chronic bronchitics. The smoking habits and symptomatology of the byssinotics were also investigated. In the byssinotics the proportions of gland, muscle and cartilage were higher than in the normal, non-smoking subject at all levels in the bronchial tree, and were similar to those in chronic bronchitics. The increase was not confined to the lobar bronchi as the results of a previous investigation had suggested. It is concluded that although exposure to cotton dust is a factor in the pathogenesis of chronic byssinosis, anatomical changes in the bronchi of Lancashire cotton workers are non-specific, and are confounded by other environmental factors. Smoking has a deleterious effect on the natural history of the disease, but no morphological difference between smokers and non-smokers was found.

Structural variation in the named bronchi of the left lung. A morphometric study

In order to establish whether or not the named bronchi of the left lung differ structurally from each other, their proportions of cartilage, gland and muscle in normal and chronic bronchitic patients were measured. In the normal subject the lower lobe bronchus contains proportionally more muscle than either the upper lobe bronchus or the segmental bronchi. Its proportion of cartilage is less than that of the main and upper lobe bronchi, and in this respect it is similar to the segmental bronchi. The proportions of gland in the main, upper and lower lobe bronchi are the same. There is no difference between the tissue proportions of the segmental bronchi of the upper and lower lobes. In chronic bronchitics the proportion of gland is increased, and in many cases there is also an increase in muscle. The relatively high proportion of muscle in the lower lobe bronchus is no longer apparent, and its proportion of cartilage is greater than in the normal subject. The main and upper lobe bronchi contain a higher proportion of gland than the lower lobe bronchus and the segmental bronchi. The proportions of the components in the upper and lower segmental bronchi are again similar. It is concluded that in the left lung the tissue proportions of the named bronchi vary. In particular, the normal lower lobe bronchus is characterized by a relatively high percentage of muscle, and a similar cartilage content to the segmental bronchi. Care is therefore needed in selecting airways for morphometric studies.

The larger bronchi in cryptogenic fibrosing alveolitis: a morphometric study

In a morphometric study of the main, lobar, and segmental bronchi of the left lung in nine cases of cryptogenic fibrosing alveolitis the quantity of gland was found to be significantly greater than in a group of normal controls, and similar to that of a group of patients with chronic bronchitis. The quantity of muscle was also increased, amounts in the segmental bronchi being higher than in the bronchitic patients. The cause of these changes is uncertain, but they seem likely to be due to proximal extension of repeated and persistent infection of the lung parenchyma.