Heat SHOCK proteins in equine spermatozoa: Expression and correlation to kinetic and environmental parameters

Heat Shock Proteins are chaperones primary involved in the repair of cellular damages induced by temperature. The harmful effect of temperature on the male gonad is well known, on the contrary knowledge on the effects of the environment on semen quality are still insufficient. The aim of this paper was to learn more about the role of HSPs and the environment in modulating the physiology of equine male gonads. We showed a detailed analysis of equine semen characteristic and the expression level of three HSPs (60-70-90) over a one-year period analyzing the effects of temperature and humidity and the correlation among the different variables. We showed also that the interpretation of results depends strongly on the way in which data are assembled and analyzed, therefore we compared results obtained from three different ways of grouping: according to single months, to weather seasons and to mare reproductive periods. Results showed that the expression of the three HSPs is correlated to the environment through temperature and humidity and that it reaches the highest level in the breeding season and in summer. We found also that HSPs expression is correlated to some variables describing the quality of equine semen (concentration) and the kinetic of spermatozoa (total motility-MOT, %, average path velocity -VAP, μm/s- and lateral head displacement -ALH, μm). No correlation was found between HSPs expression and the mitochondrial membrane potential; while viability and HSP90 expression resulted positively correlated. The month-by-month analysis evidenced that in February equine semen has the highest kinetic characteristics (increased linearity -LIN, %-, straightness -STR, % -and average path velocity -VAP, μm/s) with the highest number of motile, progressive motile and rapid cells. These results may have a great impact in the comprehension of functional aspects of the physiology of equine semen and may have potential implications for breeders who want to understand the period (and/or month) of the year in which equine semen reaches the best characteristics with increased chances for better results in reproductive practice.

Localization and functional modification of L-type voltage-gated calcium channels in equine spermatozoa from fresh and frozen semen

It is well known that insemination of cryopreserved semen always results in lower fertility when compared with fresh semen, but there is an increased interest and demand for frozen equine semen by the major breeder associations because of the utility arising from semen already "on hand" at breeding time. In this article, we report that equine sperm cells express L-type voltage-gated calcium channels; their localization is restricted to sperm neck and to the principal piece of the tail in both fresh and frozen-thawed spermatozoa. We also studied the causes of cryoinjury at the membrane level focusing on the function of L-type calcium channels. We report that in cryopreserved spermatozoa the mean basal value of [Ca(2+)]i is higher than that of spermatozoa from fresh semen (447.130 vs. 288.3 nM; P < 0.001) and L-type channels function differently in response to their agonist and antagonist in relation to semen condition (fresh or frozen-thawed). We found that on addition of agonist to the culture medium, the increase in intracellular calcium concentrations ([Ca(2+)]i) was greater in frozen semen than in fresh semen (Δ[Ca(2+)]i = 124.59 vs. 16.04 nM; P < 0.001), whereas after the addition of antagonist the decrease in [Ca(2+)]i was lower in frozen semen than in fresh semen (Δ[Ca(2+)]i = 32.5 vs. 82.5 nM; P < 0.001). In this article, we also discuss the impact of cryopreservation on sperm physiology.

The expression of leptin receptor in the ovary of the queen: leptin receptor expression in queen ovary

Leptin is a Ob gene product secreted mainly by adipose tissue. Several reports showed leptin production by other tissue including the ovary. The action of leptin is mediated upon binding to its receptor widely expressed in reproductive tissues in different species. In fact, there are growing evidences that leptin plays an important role in the modulation of reproductive functions. Therefore, the aim of this study was to evaluate in the queen, the expression of leptin receptor during the functional ovarian cycle and pregnancy. We found that the ovaries of the queen express leptin receptor in all the examined phases. The highest leptin receptor expression was found in the luteal phase (pseudopregnancy, pregnancy) compared to other phases of the cycle (anestrus, proestrus, estrus). The variations in the expression of leptin receptor suggest a likely implication of leptin in the modulation of ovarian activity, in the examined species.

Leptin and queen ovary: new insights about ovulation

Leptin has been proven to be crucial in the ovulatory process. Aims of this study are to assess the expression of leptin receptor (Ob-R) in the ovaries of queens at estrus and to evaluate the capability of leptin in modulating ovarian contractility in vitro. Right ovaries underwent immunoblot analysis. Left ovaries were mounted in an organ bath under physiological condition and exposed to murine leptin (10(-6) M). Immunoblot analysis showed that the queen ovary expresses leptin receptor at estrus. Leptin at the dose of 10(-6) M significantly reduced the contractile activity of the ovary. The presence of ovarian Ob-R and leptin inhibitory effects on ovarian contractility suggest leptin implication in the modulation of ovarian activity, as well as in ovulatory disorders.

Expression of the micro-opioid receptor on Malassezia pachydermatis and its effect in modulating phospholipase production

Malassezia spp. may act as opportunistic skin pathogens in humans and animals. Malassezia pachydermatis proliferation and phospholipase production may play a pathogenic role in the occurrence of skin lesions in dogs. This study investigates the presence of mu-opioid receptor (MOR) in M. pachydermatis strains isolated from healthy dogs and dogs with skin lesions and its effects on phospholipase activity (p.a.). P.a. of 64 M. pachydermatis isolates was evaluated using different concentrations of naloxone (Nx), a MOR antagonist. Isolates were divided into Group A (i.e., 40 isolates from 26 dogs with dermatitis) and Group B (i.e., 24 isolates from 12 healthy dogs). The MOR expression was analyzed by Western blot and immunofluorescence. A statistically higher p.a. than that of the controls was found with isolates in Group A at a Nx concentration of 10(-6) M (P<0.05). No isolate in Group B displayed p.a. in either control samples or in the presence of any Nx concentration. Immunoblotting revealed two positive MOR immunoreactive bands of approximately 65 and 98 kDa. MOR expression and localization was also demonstrated by immunofluorescence in isolates from Groups A and B. This study provides the first evidence of MOR expression on M. pachydermatis cell membranes pointing to its possible role in modulating p.a. production in isolates from dogs with skin lesions.

Expression of the mu opioid receptor and effects of the opioid antagonist naloxone on in vitro maturation of oocytes recovered from anoestrous bitches

The mu-opioid receptor (MOR) is expressed in bovine, human, equine and canine oocytes, and in seasonal breeders, it is expressed with higher intensity during the anoestrous phase. Supplementation of in vitro maturation (IVM) medium with opioid agents, agonists or antagonists, was shown to affect oocyte maturation in several species such as rat, bovine and equine. This study reports the effects of supplementing IVM medium with naloxone (Nx), an opioid antagonist, on nuclear and cytoplasmic maturation rate of oocytes recovered from anoestrous bitches. Cytoplasmic maturation was examined in terms of mitochondrial (mt) distribution. In order to confirm the receptor-mediated action of Nx, in oocytes of anoestrous bitches, MOR expression was analyzed by Western blot. Cumulus-oocyte complexes, recovered from the ovaries of bitches in anoestrous, were cultured in vitro and Nx was added at the concentrations of 1 x 10(-6), 1 x 10(-8) and 1 x 10(-10) M. The rate of oocytes resuming meiosis after culture in presence of 1 x 10(-6) M Nx (29%) was significantly higher than that of oocytes of control group (12%; p < 0.05). However, treatment with Nx did not affect mt distribution pattern. In denuded oocytes and in corresponding cumulus cells, a doublet of 65 and 50 kDa was observed. We conclude that, in oocytes of anoestrous bitches, MOR is expressed and Nx significantly improves nuclear maturation rate. Further studies should be performed to elucidate the expression of other opioid receptors, such as delta and kappa, and possible interactive effects of their antagonists on canine oocyte maturation.

The presence of the mu-opioid receptor in the isthmus of mare oviduct

The presence of the mu-opioid receptor and the type of glycosylation in the third extra-cellular loop of this receptor was investigated in the isthmus of mare oviduct during oestrus by means of immunoblotting and immunohistochemistry combined with enzymatic (N-glycosidase F and O-glycosidase) and chemical (beta-elimination) treatments. Immunoblotting analysis showed that the mu-opioid receptor consists of two peptides with molecular weights of around 65 and 50 kDa. After N-deglycosylation with N-glycosidase F an additional immunoreactive peptide was observed at around 30 KDa. The cleavage of O-glycans by O-glycosidase failed in immunoblotting as well as in immunohistochemistry investigations, revealing that the third extra-cellular loop of the mu-opioid receptor expressed in mare isthmus oviduct contains some modifications of the Galbeta(1-3)GalNAc core binding to serine or threonine. Immunohistochemistry revealed the mu-opioid receptor in the mucosal epithelium, some stromal cells, muscle cells and blood vessels. In ciliated cells the mu-opioid receptor showed N-linked glycans, since the immunoreactivity was abolished after N-glycosidase F treatment, whereas it was preserved in the apical region after beta-elimination. Most non-ciliated cells expressed the mu-opioid receptor with both N- and O-linked oligosaccharides, as revealed by the abolition of immunostaining after N-glycosidase F and beta-elimination. Stromal cells, endothelial and muscle cells of blood vessels expressed the mu-opioid receptor containing both N- and O-linked oligosaccharides. Myosalpinx myocytes expressed the mu-opioid receptor with O-linked oligosaccharides. The immunopositive myocytes formed a circular coat in the intrinsic musculature, whereas they were arranged in some isolated, oblique bundles in the extrinsic musculature. In conclusion, the mu-opioid receptor could have a role in the production and the movement of isthmus lumen content that contributes to ensuring the effective condition of the sperm in the mare oviduct.

185 EXPRESSION AND LOCALIZATION OF µ-OPIOID RECEPTOR IN CANINE OOCYTES

Endogenous opioid peptides (EOP), through G-protein-coupled receptors, control metabolism and many physiological and pathological conditions. Once EOP are linked to their receptors, above all µ-opioid receptor (MOR), a block of the Ca2+ channel occurs (Sciorsci et al. 2000 Immunopharm. Immunotox. 22, 575–626). The disruption of Ca2+ homeostasis interferes with many Ca2+-mediated/dependent actions. Our previous studies demonstrated the presence of MOR in human, bovine, and equine oocytes, in sperm cells of several species (equine, canine, etc.), in mare's tube, in ovine, bovine and mouse embryos. The presence of MOR on the male canine gamete lets us hypothesize its presence on the female gamete, too. In this study we demonstrated the presence of MOR on canine oocytes by immunofluorescence (IF) and western blot (WB) analysis, and we speculate on its possible functional role. Canine ovaries were obtained from healthy bitches randomly chosen among those arriving at our veterinary hospital for surgical ovariectomy without considering the period of their reproductive cycle. Oocytes were collected by ovary slicing and tested to check for the presence of MOR. For IF, oocytes were washed in 100 mm glycine in PBS and incubated for 30 min in PBS-1% BSA. Control oocytes were incubated with primary rabbit polyclonal antibody against the rat 3rd extracellular loop of MOR (Chemicon, Temecula, CA, USA). All oocytes were incubated for 2 h at room temperature with a FITC-conjugated anti-rabbit IgG-secondary antibody diluted 1:200 in Evans blue/PBS, washed, and visualized by laser scanning confocal microscope. For the WB, crude plasma membranes were obtained from pools of oocytes. They were lysed in Laemli buffer and loaded on sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) gels. After electrophoresis, proteins were electrotransferred (semi-dry apparatus, BioRad, Milano, IT) to Immobilon-P membranes (Millipore, Bedford, MA, USA). Filters were blocked for 1 h and blotted overnight at 4�C against the same primary antibody used for IF, diluted 1:7500 in blocking buffer. After washing, membranes were incubated with a 1:10 000 dilution of peroxidase-conjugated goat anti-rabbit IgG secondary antibody for 2 h at room temperature. Reactive bands were visualized by Supersignal West Pico Chemiluminescent substrate (Pierce, Milano, IT). A negative control was performed. The IF highlighted, by clear brilliant green, the MOR's localization on canine oocytes. The negative control did not present any fluorescent region or spotted coloring. The WB revealed the presence of one immunoreactive band of approximately 65 kDa, thus confirming the results obtained by IF. No reactivity was evident when the primary antibody was adsorbed with an excess of immunizing peptide. The presence of MOR on canine oocytes indicates its possible role in the modulation of oocyte metabolism. These data strongly confirm previous evidence from our research unit on the involvement of the opioidergic system during gamete development and interaction, thus allowing us to speculate on a primary role of MOR in controlling key events of the reproductive activity.

Relationship of body mass index to early complications in knee replacement surgery

BACKGROUND

The purpose of this study was to evaluate the relationship between body mass index and early complications following knee replacement.

METHODS

Five hundred and twenty-seven patients who underwent primary knee replacement were recruited. All these patients were subjected to a pre-operative assessment and follow-up at 6 weeks and 1 year following surgery. Any complication occurring during this period was recorded. Complications were grouped into systemic and local, minor and major.

RESULTS

12.1% (N = 64) patients had an early complication following knee replacement surgery; 9.2% (N = 48) patients had a major complication. Overall BMI did not seem to influence significantly the rate of complication with a P-value of 0.338. A stronger correlation was found between the surgeon and presence of complication with a P-value of 0.004.

CONCLUSIONS

BMI has a weak correlation to early complications following joint replacement surgery. The operating surgeon seems to have a stronger correlation to early complications as compared with BMI.

Relationship of body mass index to early complications in hip replacement surgery : study performed at Hinchingbrooke Hospital, Orthopaedic Directorate, Huntingdon, Cambridgeshire

The purpose of this study was to evaluate the relationship between body mass index and early complications following total hip replacements. Five hundred and fifty patients who underwent primary total hip replacement were recruited. All these patients were subjected to a pre-operative assessment and follow-up at 6 weeks and 1 year following surgery. Any complications occurring during this period were recorded. Complications were grouped into systemic and local, both subdivided into minor and major depending on the risk involved. Fifty-six patients (10.2%) had an early complication following hip replacement surgery. Forty-four patients (8%) had a major local complication. Overall, there did seem to be a weak correlation between BMI and the rate of complications, with a p value of 0.104. A correlation was also found between the surgeon and presence of complications with a p value of 0.736. There is a weak correlation between BMI and early complications following hip replacement surgery, and there also seems to be a correlation between the operating surgeon and early complications, but this is not statistically significant.

Opioid agonist/antagonist effect of naloxone in modulating rabbit jejunum contractility in vitro

Opioid peptides are the most effective drugs in controlling pain; their action is elicited by binding to specific membrane receptors. The gastrointestinal tract represents, after the nervous system, the site in which the opioid receptors are expressed at high levels. The opioid agonist morphine has a significant inhibitory effect on intestinal motility, this action is blocked by naloxone an opioid antagonist mainly active at mu and kappa receptors. In this study the presence of mu opioid receptor on rabbit jejunum was investigated by western blot. The effects of beta-endorphin, the endogenous opioid peptide with the highest affinity to the mu opioid receptor and those of naloxone on spontaneous rabbit jejunum contractions were evaluated. Beta-endorphin (10(-6) M) showed a relaxant effect on jejunum contractility while naloxone showed a dual effect inducing an increase of spontaneous contractility at low concentrations (10(-6) M, 10(-7) M, 10(-8) M) and a decrease when high concentrations (10(-3) M, 10(-4) M, 10(-5) M) were utilized. The obtained results demonstrate that mu opioid receptor is expressed in rabbit jejunum and suggest that this receptor may be involved in mediating the effects of both opioid agonist and antagonist on jejunum contractions.

301 NEW APPROACHES TO CONTRACEPTION IN DOGS USING GnRH ANALOGUES, CALCIUM, AND NALOXONE

The continuous administration of GnRH leads to the desensitization and down-regulation of GnRH receptors on pituitary gonadotropes (Parker and Schimmer 2001 in Goodman & Gilman's The Pharmacological Basis of Therapeutics, New York: McGraw-Hill, 1541–1562). In this study, we combined the use of a GnRH analogue with calcium/naloxone association (Sciorsci et al. 2000 Immunopharmacol. Immunotoxicol. 22, 575−626) to obtain a desensitizing effect on LH receptors in an attempt to regulate spermatogenesis in dogs. Eight post-pubertal mixed breed dogs were divided into two groups: (A) four subjects were pharmacologically treated with a 30 day administration of buserelin acetate (Suprefact Aventis Pharma, Italy) 0.3 mg/each s.c. TID, associated with 0.1-mL/kg/bw i.m. injection SID of calcium gluconate 20% (New ICC, Upjohn, Italy) in which 0.4 mg/mL of naloxone hydrochloride (Diosynth, The Netherlands) was dissolved; (B) four subjects received placebo (NaCl 0.9% s.c. TID for 30 days). At the end of the treatment, hemiorchidectomy was performed and 4 months later the second testis was removed. Clinical examination of the genital tract was done by ultrasound monitoring. Before and after pharmacological treatment and until total orchidectomy, semen was collected and evaluated for macroscopic and microscopic parameters. Plasma testosterone concentration was measured twice a week by RIA. Testicular specimens were fixed in formalin solution, embedded in paraffin wax and stained with hematoxylin–eosin. The presence of germ cells and the testicular tubule diameters were analyzed using a computer assisted image analyzer (MONO system, Italy). Data were analyzed by the ANOVA test. In the treated group, all dogs showed a reduction in testicular and prostatic diameters compared to the control group. Transient elevations in testosterone concentrations were observed in response to the early injections and reached baseline levels after 8–10 days. The testosterone decline resulted in lower ejaculate volume and, at the end of treatment, azoospermia was observed. At the end of treatment, testosterone values had progressively regained normal values over 2 months and, when measured immediately before total orchidectomy, sperm concentration and motility had returned to normal. At the histological observation, seminiferous tubules showed the block of spermatogenesis at the level of spermatocytes with a statistically significant cell reduction in spermatides and spermatozoa (P < 0.001) whereas the seminiferous tubular morphometry was normal. Total orchidectomy demonstrated that a normal histological testicular structure had been restored. In the control group, no modifications were observed. As observed in a previous study (Aiudi et al. 2005 Reprod. Fert. Dev. 17(2), 280–281), GnRH induced suppression of the reproductive function in male dogs. In this study, we demonstrated that GnRH analogue associated with calcium and naloxone induces the same effect in a shorter time and that this effect is reversible. These devices designed for the shutdown of gonadal steroidogenesis and spermatogenesis would be useful for treating sex hormone-dependent syndromes such as malignant and benign prostatic tumors.

261 FERTILITY CONTROL BY GnRH ANALOGUES IN DOGS

GnRH plays a pivotal role in reproduction by stimulating the release of gonadotrophins. Chemical substitutions in the GnRH molecule lead to analogues possessing antagonist or agonist activity (Paramo RM et al. 1993 J. Reprod. Fertil. Suppl. 47, 387–397). The highly potent agonist analogue, Buserelin, with up to 20 times of potency, by increasing binding affinity, desensitizing competitive receptors, and resisting metabolic degradation, shuts down rather than stimulates reproductive function (Bertschinger HJ et al. 2001 J. Reprod. Fertil. Suppl. 57, 275–283). In man, Buserelin is employed in several gonadal hormone-dependent diseases and for prostatic cancers. We suppress gonadal function in male dogs using Buserelin. Eight intact male German sheep dogs 20 months old were divided into two groups; A, 4 subjects treated for pharmacological castration (Buserelin acetate, 0.3 mg/each, s.c., every 8 h for 30 days) (Suprefact-Aventis Pharma, Italy); B, 4 subjects treated with placebo (NaCl, 0.9%, s.c., every 8 h for 30 days). Plasma testosterone concentrations were measured twice a week by RIA using commercial kits (Coat-A-Count, Los Angeles, USA). Clinical examination of the male genital tract was conducted by ultrasound monitoring. Before and after the pharmacological treatment, semen was collected and evaluated for macroscopic and microscopic parameters. After treatment, testicular specimens were collected by orchiectomy, fixed in Bouin's solution, and embedded in paraffin wax. Thin sections were cut and stained with hematoxylin/eosin. The presence of germ cells (spermatogonia to spermatozoa, Sertoli and Leydig cells number) were analyzed. Randomly selected fields of transverse and longitudinal sections of seminiferous tubules were observed and analyzed using a computer assisted image analyzer (MONO system, Italy). The images acquired were segmented and binarized in order to obtain the masks of the tubular profiles; the mean values of the area, major and minor axes, mean diameter, and perimeter occupied by the testicular tubules were calculated automatically. Data were analyzed by ANOVA test. After Buserelin, all dogs (group A) showed a reduction in testicular and prostatic diameters compared to group B. Azoospermia was observed in group A. Histological examination revealed a statistically significant cell reduction of the germinal line (spermatogonia and spermatocytes, P < 0.05; spermatids and spermatozoa, P < 0.001). GnRH pharmacological treatment induced a cessation of normal spermatogenesis at the spermatocyte level while no statistical difference in morphometric parameters of seminiferous tubules were observed. The basic testosterone level (3.2 ± 1.3 ng/mL) rose to 12 ± 3.7 ng/mL (21° day) and than shut down to 0.5 ± 0.3 ng/mL (30° day), giving a long-term suppression. The present study demonstrates that Buserelin is an anti-fertility agent that gives suppression of reproductive function in male dogs. The method may have a clinical application. The utilization of a Buserelin depot will be a successive step.

Effects of beta-endorphin and Naloxone on in vitro maturation of bovine oocytes

Bovine cumulus-oocyte complexes (COCs) and mural granulosa cells express the mRNA coding for the micro-opioid receptor. The addition of beta-endorphin (beta-end) to oocytes cultured in hormonally-supplemented in vitro maturation (IVM) medium had no effect on the rates of oocytes reaching the metaphase II (MII) stage, but significantly decreased the maturation rate (P < 0.05) and arrested oocytes at metaphase I (MI) after culture in hormone-free medium (P < 0.001). Naloxone (Nx) reverted this inhibitory effect of beta-end. Moreover, Nx "per se" showed a dose-dependent dual effect. When added at high concentration (10 x (-3) M), it significantly reduced the rate of oocytes in MII (P < 0.001), thus increasing the rate of oocytes arrested in MI. However, Nx added at low concentration (10 x (-8) M) significantly increased oocyte maturation (P < 0.001). High concentration of Nx induced an increase in both intracellular calcium concentration ([Ca(2+)](i)) and in the activity of the mitogen-activated protein kinase (MAPK) also called extracellular-regulated kinase (ERK) in cumulus cells of bovine COCs. Blocking the rise in [Ca(2+)](i) with the calcium chelator acetoxymethylester-derived form of bis (o-aminophenoxy) ethane-N,N,N',N'-tetraacetic acid (BAPTA-AM) reversed the Nx-dependent inhibition of meiotic maturation observed at high Nx concentrations. Whereas blocking ERK with the MAPK/ERK kinase (MEK) inhibitor, PD98059, had no effect on this process. Therefore, we concluded that the mocro-opioid receptor, by inducing [Ca(2+)](i) increase, participates in the cumulus-oocyte coupled signaling associated with oocyte maturation.

Naloxone inhibits A6 cell Na(+)/H(+) exchange by activating protein kinase C via the mobilization of intracellular calcium

The opioid receptor antagonist, naloxone, has been shown to have beneficial effects in the kidney and to be implicated in renal salt and water balance. In the present study the signal transduction pathways utilized by naloxone were studied in an epithelial cell line model of the cortical collecting duct, A6 cells. We found that naloxone has a dual effect depending on the concentration used: at a low concentration (10(-6) M) it antagonized the beta-endorphin-dependent increase in cytoplasmic calcium [Ca(2+)](i), while at higher concentrations (>10(-5) M) it increased [Ca(2+)](i) and intracellular inositol phosphate levels. While naloxone-induced increases in [Ca(2+)](i) occurred in the absence of external calcium, it was significantly stimulated by increasing the external calcium concentration, suggesting that naloxone increases [Ca(2+)](i) via both calcium release and calcium influx. In polarized A6 cell monolayers naloxone inhibited the activity of the Na(+)/H(+) exchanger (NHE) only when added to the basolateral cell surface. This inhibition of the NHE was prevented by pretreatment of the cells with either the intracellular calcium chelator, BAPTA or with the protein kinase C inhibitor, calphostin C. These findings demonstrate that naloxone induces a rapid increase in intracellular calcium which inhibits the NHE via the calcium-dependent protein kinase C regulatory pathway.

Immunohistochemical reactivity of anti-melanoma monoclonal antibody 225.28S in human breast cancer biopsies

The high molecular weight melanoma-associated antigen, defined by murine monoclonal antibody (IgG1) 225.28S is largely expressed by melanoma cells and weakly expressed by other human tumors originating from neural crest. In this study, we analyzed the immunohistochemical reactivity of MoAb 225.28S in human breast cancer biopsies. A total of 92 breast cancer biopsies (66 infiltrating lobular and 26 infiltrating ductal carcinomas) were initially tested along with 26 melanomas (positive controls), 23 gastric/colonic adenocarcinomas and 13 neuroendocrine tumors. Forty-four out of 66 lobular breast carcinomas showed positive immunostaining with 225.28S MoAb as well as only 6 out of 26 infiltrating ductal histotype and 12 out of 26 melanomas. Conversely, gastric and colonic adenocarcinomas and neuroendocrine tumors were completely negative. The pattern of positivity in breast carcinomas was associated with malignant cells, rather than with the stroma or histiocytes infiltrating the lesions. Nonspecific cross-reactivity of 225.28S with breast carcinomas was excluded using a similar murine antithyreoglobulin MoAb, which gave negative staining in all biopsies. These results indicated that HMW-MAA or a similar sequence recognized by 225.28S MoAb is often expressed by lobular breast carcinomas but rarely by ductal adenocarcinomas. This seems to suggest that lobular breast carcinoma has common "ancestor" antigens with melanoma.

Characterisation of CAH alleles with non-radioactive DNA single strand conformation polymorphism analysis of the CYP21 gene

The major cause of congenital adrenal hyperplasia (CAH), a common recessive genetic disease, is the deficiency of steroid 21-hydroxylase (21OH), a microsomal enzyme encoded by the CYP21 gene. Although several CAH causing mutations have been identified in the CYP21 gene of patients with 21OH deficiency, genotyping of the 21OH locus is quite complex because of the high frequency of gene conversion and the presence of multiple mutations on single CAH alleles. In order to perform the complete characterisation of the CYP21 gene coding region more simply, we developed a highly sensitive, non-radioactive method allowing DNA single strand conformation polymorphism (DNA-SSCP) analysis. This method was applied to the characterisation of all the exons and intron-exon junctions of the CYP21 gene in five patients affected by the simple virilising form and one affected by the salt wasting form. In all samples showing SSCP signals, direct sequence analysis showed the presence of more than one single sequence variant. In particular, four mutations which are already known to cause the disease, 16 polymorphisms, and one newly identified C to T transition at position 849 were detected. A random sequence analysis, performed on 31 out of 81 exons showing a normal SSCP pattern, shows the method to be highly sensitive: no sequence variant was detected, thus confirming the validity of this non-radioactive DNA-SSCP analysis in characterising the CYP21 gene in patients with steroid 21OH deficiency. Notwithstanding the complete characterisation of all exons and exon/intron junctions of the CYP21 gene, no complete genotype/phenotype correlation was found in the panel of patients analysed, thus suggesting that characterisation of CAH alleles must be extended to outside the coding region of the CYP21 gene, most probably into the promoter region.

Tubular adenoma of the breast: an immunohistochemical study of ten cases

Ten cases of so-called "tubular" adenoma and six cases of fibroadenoma of the breast have been investigated with an immunohistochemical technique with the aim of providing both more details on their immunophenotype and of ascertaining the possible relationships between tubular adenoma and fibroadenoma. Smooth Muscle Actin, Cytokeratin 14, GFAP, S-100 Protein and Vimentin immunoreactivity have clearly demonstrated that cells with myoepithelial immunophenotype are one of the major cell components in breast adenomas. Epithelial Membrane Antigen (EMA), Human Milk Fat Globule II (HMFG II), Estrogen and Progesterone receptors have been detected in adluminal epithelial cells exclusively. Furthermore, Smooth Muscle Actin and Vimentin highlighted an abundant myofibroblastic component, intermingled with tubular structures in both tumor types. A low percentage (10-22%) of adluminal cells and of myofibroblasts showed Ki-67 immunoreactivity in tubular adenomas and in fibroadenomas, whereas only rare myoepithelial cells demonstrated Ki-67 positivity in both tumor types. These data seem to indicate that several cell components of both epithelial and mesenchymal origin (epithelial cells, myoepithelial cells, myofibroblasts) are involved in the genesis of tubular adenomas. The morphological and immunohistochemical features of tubular adenomas closely resemble, in some areas of the tumors, those of fibroadenoma. Therefore, they may represent histogenetically related neoplasms with exuberant ductular component in tubular adenomas and predominant stromal component in fibroadenoma.

Polymerase chain reaction in liposomes

BACKGROUND

Compartmentalization of biochemical reactions within a spherically closed bilayer is an important step in the molecular evolution of cells. Liposomes are the most suitable structures to model this kind of chemistry. We have used the polymerase chain reaction (PCR) to demonstrate that complex biochemical reactions such as DNA replication can be carried out inside these compartments.

RESULTS

We describe the first example of DNA amplification by the PCR occurring inside liposomes composed of 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (POPC), or of a mixture of POPC and phosphatidylserine. We show that these liposomes are stable even under the high temperature conditions used for PCR. Although only a very small fraction of liposomes contains all eight different reagents together, a significant amount of DNA is produced which can be observed by polyacrylamide gel electrophoresis.

CONCLUSIONS

This work shows that it is possible to carry out complex biochemical reactions within liposomes, which may be germane to the question of the origin of living cells. We have established the parameters and conditions that are critical for carrying out this complex reaction within the liposome compartment.

[Adenolymphoma of the salivary glands. The anatomicoclinical, epidemiological and therapeutic aspects of 76 cases]

A series of 76 cases of adenolymphoma (Warthin's tumor) of the salivary glands is presented with emphasis on its epidemiological, clinico-pathological and therapeutic features; together with the analysis of the clinical records and of the epidemiological data, this study has reevaluated the histopathological features of the 76 cases of Warthin's tumor on hematoxylin-eosin stained slides. On these bases, the authors underline the frequent multifocality and/or bilaterality of Warthin's tumor (11.3% of cases), its frequent association with tumors of other sites (11.3% of cases), the prevalence in males (M:F ratio = 24:1) and in adults (mean age: 57 years) of this type of tumor. Furthermore, this study confirms the parotid gland as the elective site for Warthin's tumor and the possibility to categorize this entity into four different histological types. The latter finding should be kept in mind especially when fine needle aspiration (FNA) is used as a preoperative diagnostic procedure for Warthin's tumor to avoid misleading diagnosis and overtreatment. From the analysis of the results the authors underline the need for a complex and multidisciplinary approach to the diagnosis of Warthin's tumor in order to allow conservative surgery with preservation of the facial nerve.

[Immunohistochemical identification of secretory component (SC) in activated mesothelial cells]

Twenty-two cytoblocks from serous effusions very rich in activated mesothelial cells were immunohistochemically tested to indicate about the presence of synthesis of Secretory Component and transport of IgA Antibodies across mesothelium; the tests were positive for S.C., while failed in order to demonstrate intracytoplasmic IgA. Authors hypothesize that association between Secretory Component synthesis and IgA transport may be not necessary absolute and that Secretory Component may play another unknown role related to glandular epithelial specialisation.

An exploration of the variables involved when instituting a do-not-resuscitate order for patients undergoing bone marrow transplantation

Written do-not-resuscitate (DNR) orders can facilitate the transition from aggressive care to supportive care in patients undergoing bone marrow transplantation who are critically ill. The DNR decision often is complicated by clinical and ethical problems. To assist nurses in analyzing these complex situations, a retrospective review was conducted on medical records of 40 patients who died on an eight-bed bone marrow transplant unit in which a formal DNR policy was in place. A review of specific variables for patients designated DNR and non-DNR showed that the groups did not vary in age, diagnosis, disease, or type of transplant. The non-DNR group developed life-threatening complications earlier in their transplant course, whereas multisystem failure was the common factor among the patients with DNR designation. The few ethical problems documented in the medical records did not appear to reflect the complexity of the DNR decision.

[Identification of mucin-secretion characteristics in cells from serous effusions: consideration of histochemical and immunohistochemical aspects]

Fourty-two cell-blocks of serous effusions (thirty malignant and twelve reactive) were tested by anti Secretory Component Ab (policlonal) using the s.-Ab method, and by histochemical tests: PAS, PAS Diastase and Alcian blue pH 2.5. Immunohistochemical and histochemical features were compared to identify their meaning and correlation in epithelial mucin detection. This study suggests the evident correlation between SC and PAS diastase (better than between SC and Alcian blue) and possibility to replace the old traditional test of PAS diastase with anti SC antibody (much more sensible than PAS diastase) in routine mucin detection histochemical tests.

[Ileal stenosis caused by chronic granulomatous inflammation secondary to a foreign body simulating Crohn disease]

A case of ileal stenosis due to foreign body induced chronic granulomatous inflammation simulating Crohn's disease with onset on an ileo-ileostomy carried out 23 years before due to iatrogenic rupture of ileal loop following clandestine abortion is reported. After noting the problem of attributing to the foreign body alone responsibility for the stenosis, the hypothesis that it might have been an acute occurrence of Crohn's disease or the expression of an association of Crohn's disease and granulomatous inflammation due to surgical material is advanced. This for the moment is the only plausible cause. It is concluded that for accurate nosological classification and, therefore, definitive clinical diagnosis, prolonged clinical control of the patient is indispensable.

[Right temporo-occipital ganglioglioma in a 10-year-old patient]

Authors describe an operated case of ganglioglioma of the right temporo-occipital region in a ten year old patient. After case presentation and an analysis of the literature, the diagnostic pre-operative problems are discussed analysing the CT aspects of the lesion.

Functionless non-chromaffin retroperitoneal paraganglioma causing cauda equina compression

The authors describe a case of functionless non-chromaffin paraganglioma of the retroperitoneal space, that invaded the spinal canal causing a cross section syndrome of the cauda equina. The case is described because of the unusual clinical evolution of the tumour in question, never previously described.