3039Vulnerability of carotid atherosclerosis: relationship with plaque location, plaque eccentricity and vessel remodeling patterns. Insight from the the MAGNETIC observational study

Conclusions

Carotid atherosclerotic plaque vulnerability seems to be independently associated with longitudinal location, plaque eccentricity and vessel positive remodeling.

Acknowledgement/Funding

Bayer AG, Leverkusen, Germany

Relationship between Doxorubicin-Induced Ecg Changes and Myocardial Alterations in Rats

The aim of the present study was to evaluate the dose- and time-dependence of the effect displayed by doxorubicin (DXR) on the electrocardiogram (ECG) and to establish the relationship between structural alterations of the myocardium and ECG changes in rats administered DXR, at a dose of 1.5 or 3.0 mg/kg, every 3 days for a total of three administrations. The most interesting findings consisted of a dose-dependent, but reversible prolongation of the QRS complex, and in a dose-dependent and progressive irreversible increase in QaT and, in particular, in SaT duration. Furthermore, animals treated with the higher DXR dose showed a slight increase in serum K+ concentration and a significant decrease in serum Ca2+ levels. A good correlation was found between the morphologic score indicating the degree of observed tissue damage and SaT prolongation. These results therefore support the usefulness of measuring this ECG parameter for monitoring the development of DXR-induced cardiotoxicity in rats.

The Rat Model in the Comparative Evaluation of Anthracyclines Cardiotoxicity

In the present investigation, the cardiotoxic effects of three anthracycline analogs (doxorubicin, 4′-epi-doxorubicin and 4′-deoxy-doxorubicin) were compared. For this purpose, 9.0 mg/kg of doxorubicin, divided into three closely spaced sub-doses, were injected intravenously in rats. The two derivatives were administered according to the same time schedule and their doses were chosen on the basis of the clinically adopted ratio, doxorubicin : 4′-epidoxorubicin : 4′-deoxy-doxorubicin = 1:1: 0.5. The degree of cardiomyopathy induced by the three anthracyclines was evaluated by ECG changes and morphological alterations. Doxorubicin was found to produce a significant degree of cardiotoxicity, thus confirming the validity of the experimental model adopted. Both 4′-substituted derivatives proved to be less cardiotoxic than the parent compound, although not completely devoid of this side effect.

Choroidal Angiography with Indocyanine Green Dye: Absorption and Fluorescence Techniques

The results of choroidal indocyanine green (I.C.G.) angiography by the absorption and fluorescence techniques are compared. Both techniques were done using the same apparatus, a modified fundus camera, an image intensifier coupled to a solid-state video camera and a U Matic video recorder. Both were performed with the same dye dilution in the same patients, at a 24-hour interval. The light source was the unmodified 50 Watt halogen light bulb of the fundus camera. The angiograms obtained by the absorption and the fluorescence techniques refer to the same chorioretinal area and the same angiographic phase. Comparison of all the angiograms shows that I.C.G. fluorescence angiography provides a better resolution of choroidal vascular details than the absorption technique.

Mid-infrared digital holography and holographic interferometry with a tunable quantum cascade laser

Mid-infrared digital holography based on CO2 lasers has proven to be a powerful coherent imaging technique due to reduced sensitivity to mechanical vibrations, increased field of view, high optical power, and possible vision through scattering media, e.g., smoke. Here we demonstrate a similar and more compact holographic system based on an external cavity quantum cascade laser emitting at 8 μm. Such a setup, which includes a highly sensitive microbolometric camera, allows the acquisition of speckle holograms of scattering objects, which can be processed in real time. In addition, by exploiting the broad laser tunability, we can acquire holograms at different wavelengths, from which we extract phase images not subjected to phase wrapping, at synthetic wavelengths ranging from hundreds of micrometers to several millimeters.

Imaging live humans through smoke and flames using far-infrared digital holography

The ability to see behind flames is a key challenge for the industrial field and particularly for the safety field. Development of new technologies to detect live people through smoke and flames in fire scenes is an extremely desirable goal since it can save human lives. The latest technologies, including equipment adopted by fire departments, use infrared bolometers for infrared digital cameras that allow users to see through smoke. However, such detectors are blinded by flame-emitted radiation. Here we show a completely different approach that makes use of lensless digital holography technology in the infrared range for successful imaging through smoke and flames. Notably, we demonstrate that digital holography with a cw laser allows the recording of dynamic human-size targets. In this work, easy detection of live, moving people is achieved through both smoke and flames, thus demonstrating the capability of digital holography at 10.6 μm.

[Fertility preservation among patients with cancer: report of a French regional practical experience]

OBJECTIVE

Improvement in cancer treatments has led to reconsider the importance of quality of life after cancer, especially concerning maintening the potential of fertility since it is often altered after healing. Our objective was to estimate the knowledge and practices of the physicians in the field of Oncology in a French Region (Provence Alpes- Côte d'Azur).

PATIENTS AND METHOD

Prospective survey, conducted between January and April 2012, amongst oncologists working in Provence Alpes Côte d'Azur region, through questionnaires distributed during multidisciplinary meetings in oncology.

RESULTS

Among 225 replies, 54% of the physicians had sent no patient to any oncofertility consultation during the previous six months (n=120). Besides, 33% of the oncologists (n=68) declared they had difficulties in addressing their patients to oncofertility consultation, and 58% of them (n=39) considered they lacked information on techniques and indications of fertility preservation.

CONCLUSION

This study provides an estimation of the current practices in PACA region concerning oncofertility and underlines the physicians' need of information. In this context, the regional oncology network has set up a regional network « cancer and fertility » in order to facilitate the access to fertility preservation prior to any potentially sterilizing treatment for all patients.

Histological evaluation of buccal penetration enhancement properties of chitosan and trimethyl chitosan

The aim of the present work was to compare the penetration enhancement properties of chitosan hydrochloride (HCS) both as a polymeric solution and as a nanoparticulate system with that of trimethyl chitosan hydrochloride (TMC) on buccal mucosa. The hydrophilic high molecular weight fluorescein isothiocyanate dextran (FD4; 4400 Da) was used as a macromolecule model. The mechanism involved in the HCS (solution and nanoparticles) and TMC solution penetration enhancement was investigated on pig buccal mucosa, characterized by having stratified epithelium and lacking in tight junctions. The permeation/penetration of FD4 and the change in morphology and histology of the mucosa after contact with the polymers were assessed: the experiments were performed ex-vivo by applying the formulations on excised porcine buccal tissue. For the morphology and the histology studies, the epithelial cell layers from freshly excised pig buccal mucosa were analysed with light microscopy by means of routine histopathology analysis (haematoxylin and eosin staining and Toluidine blue staining) and immunohistochemistry reactions. The organization of desmosomal junctions was assessed by means of an immunochemical reaction on desmosomes and transmission electron microscopy. Confocal laser scanning microscopy (CLSM) was used to find evidence of the location of FD4 in the tissue. Furthermore, the increase of the FD4 apparent permeability coefficient was quantified by means of Franz diffusion cells using isolated buccal epithelium to demonstrate the penetration enhancement properties of the polymer systems. Morphological analysis, performed by light microscopy, transmission electron microscopy and CLSM, suggests a similar mechanism of penetration enhancement for both HCS and TMC solutions and for HCS nanoparticles. Such a mechanism probably involves a repackaging of the epithelial cells up to the basal membrane and a partial disarrangement of desmosomes. The cell viability and the nuclear integrity indicated on the semi-thin section stained with Toluidine blue and by CLSM analysis, respectively, suggest that HCS as a polymer solution and a nanoparticulate system, and TMC polymer solution, do not cause cell damage. Trimethyl chitosan and chitosan nanoparticulate systems were able to increase FD4 permeation across buccal epithelium to a greater extent than the chitosan solution.

Characterizing dynamics with covariant Lyapunov vectors

A general method to determine covariant Lyapunov vectors in both discrete- and continuous-time dynamical systems is introduced. This allows us to address fundamental questions such as the degree of hyperbolicity, which can be quantified in terms of the transversality of these intrinsic vectors. For spatially extended systems, the covariant Lyapunov vectors have localization properties and spatial Fourier spectra qualitatively different from those composing the orthonormalized basis obtained in the standard procedure used to calculate the Lyapunov exponents.

FK778 does not impair intestinal allograft absorption in a preclinical model of total small bowel transplantation

Malononitrilamide 715 (FK778), a new low-molecular weight immunosuppressant, inhibits both T-cell and B-cell function by acting on the pathway for de novo pyrimidine biosynthesis. Pyrimidines are important for intestinal trophism; their inhibition may predispose to metabolic and functional impairments, such as diarrhea and malabsorption. In this study we assessed the absorptive capacity of intestinal allografts in a large-animal model of small bowel transplantation (SBTx) in pigs chronically treated with FK778. Ten outbred pigs underwent total orthotopic SBTx. Immunosuppression consisted of oral tacrolimus (trough levels 5-15 ng/mL) and oral FK778 (4 mg/kg per day) administered for 60 days. The D-xylose absorption test was performed at day 60 to evaluate carbohydrate absorption. Results were compared to normal controls. Eight of the 10 animals were alive and in good condition at day 60. All of their allografts were free of rejection. The animals had a mean maximal weight loss of 6.4% during the study period; the final weight was comparable to the initial weight (P > .05). Diarrhea was present in all animals (mean 16% of postoperative days). The D-xylose curves showed that absorption in the transplanted animals at day 60 was similar to that in the untreated controls (P > .05). The absence of differences was confirmed by the statistical analysis. In conclusion, our preclinical study in pigs showed that chronic treatment with FK778 in combination with tacrolimus did not impair carbohydrate absorption by the allograft after SBTx.

Nelfinavir in HIV-HCV coinfected patients: a 24-month follow-up in a cohort of 82 patients

This retrospective and longitudinal study evaluated the long-term hepatic tolerance of a nelfinavir (NFV)-antiretroviral combined regimen in 82 patients of the HCV-HIV Cohort of CISIH-Sud of Marseilles. Follow-up data (liver enzyme levels, CD4 cell count, HIV viral load, and metabolic parameters) of patients treated with NFV on inclusion or during the follow-up of the cohort were analyzed under treatment over 24 months. Comparisons were performed with X2 or Kruskal-Wallis tests. At baseline (n = 82), the median exposure to NFV was 4.1 months; 58 patients received NFV combined with NRTI and 24 with NNRTI. The median CD4 cell count was 337/mm3 [interquartile range (IR): 216-480) and 39.7% had an undetectable HIV RNA level. Qualitative HCV PCR was positive in 91% of the patients and 19/51 patients with liver biopsy were F3-F4. Median alanine and aspartate aminotransferase (ALAT, ASAT), gamma-glutamyltransferase (GT), and alkaline phosphatase (ALP) were 46 UI/liter (IR: 36-76), 55 UI/liter (IR: 32-97), 97 UI/liter (IR: 50-194), and 88 UI/liter (IR: 72-104), respectively, with 76% of the patients with ALAT/ASAT grade <2. Median follow-up was 23 months (IR: 13.8-37). No significant difference was observed in the distribution of ALAT, ASAT, GT, and ALP as well as of ALAT/ASAT grades over the 24-month study period. Patients treated with NFV + NNRTI had significantly higher GT and ALP levels at baseline with no significant increase during follow-up. Cholesterol, triglyceride, and glycemia distributions remained stable over time. In conclusion, this study showed a good hepatic and metabolic tolerance of a long-term NFV-combined regimen in HIV-HCV coinfected patients.

Reduction of oral acetaldehyde levels using a controlled-release chlorhexidine chip as a prevention strategy against upper digestive tract cancer

Increasing evidence indicates a strong relationship exists between harmful habits like smoking and alcohol drinking and upper digestive tract cancer. In addition, smokers and alcohol drinkers also exhibit high salivary levels of carcinogenic acetaldehyde, the first metabolite of alcohol. This compound has been indicated as a major cancer causing factor in the upper digestive tract, especially among alcohol drinkers. Interestingly, acetaldehyde is produced from alcohol present in the epithelia by mucosal alcohol dehydrogenases (ADH) in the upper digestive tract. However, much higher levels derive from the bacterial oxidation of alcohol by the oral microflora. In this respect, the reduction of oral microbes can become a fundamental factor in diminishing the risk of cancer. In this article, we hypothesize that the antimicrobial agent chlorhexidine, formulated as controlled-release chip, and fixed by a dental device, (i.e., a modified orthodontic bracket), may be the most rational strategy for reducing acetaldehyde production by microflora.

The volatile fraction of cigarette smoke induces alterations in the human gingival fibroblast cytoskeleton

Several in vitro investigations have indicated that the particulate phase of cigarette smoke, such as nicotine, affects many cell types, including gingival fibroblasts. However, few studies have been performed on the effects of the volatile fraction on the cellular structures that are involved in cell functions, such as adhesion and proliferation. Since the survival and reproduction of gingival fibroblasts are fundamental in maintaining the integrity of the oral connective tissue, as well as in wound healing, the effects on the cytoskeleton of acrolein and acetaldehyde, which are the volatile fractions of cigarette smoke, were examined in vitro for human gingival fibroblasts (HGFs). HGF strains that were taken from healthy subjects with non-inflamed-gingiva were utilized in this investigation. The cells were incubated in the presence of different concentrations of acrolein and acetaldehyde. Cell adhesion and viability were evaluated after incubation for 3 h and 5 days, respectively. The influence on cytoskeletal structures (tubulin, actin and vimentin intermediate filaments) was investigated with the indirect immunofluorescence technique. The results show that both substances produced similar effects, which resulted in a dose-dependent inhibition of HGF adhesion and viability. Disturbance of the HGF cytoskeleton consisted of disruption of the microtubules, actin filaments and vimentin microfilaments, which was accompanied by alterations to cell shape. Our experimental findings suggest that the volatile fractions of cigarette smoke, such as acrolein and acetaldehyde, have a cytotoxic effect on HGFs, with the result that they lose their capacity for adhesion and proliferation. The consequences of this could be impairment of the maintenance, integrity and remodelling of the oral connective tissue. According to our morphological evidence, these findings show that cigarette smoke can lead to the development and progression of periodontal disease, and indicate the need for appropriate therapy.

Human gingival fibroblast cytoskeleton is a target for volatile smoke components

BACKGROUND

Several in vitro investigations have indicated that the particulate phase of cigarette smoke as nicotine affects many cell types including gingival fibroblasts, but few studies have examined the effect of volatile fraction on cellular structures involved in cell functions such as adhesion and proliferation. Since gingival fibroblast survival and reproduction are fundamental to maintaining the oral connective tissue as well as to wound healing, the effects of acrolein and acetaldehyde, volatile fractions of cigarette smoke, on cytoskeleton were examined in human gingival fibroblasts (HGFs) in vitro.

METHODS

Human gingival fibroblast (HGF) strains from healthy subjects with non-inflamed gingiva were utilized. The cells were incubated in different concentrations of acrolein and acetaldehyde. Cell adhesion was evaluated after 3 hours. The influence of both substances on cytoskeletal structures, tubulin and vimentin intermediate filaments (VIF), was investigated using indirect immunofluorescence technique.

RESULTS

The results show that both substances produced similar effects, resulting in a dose-dependent inhibition of HGF adhesion. Disturbance of HGF cytoskeleton consisted of a disruption of microtubules and vimentin microfilaments with alterations in cell shape.

CONCLUSIONS

Our experimental findings suggest that volatile fractions of cigarette smoke such as acrolein and acetaldehyde, because their ability to bind and interact with the cytoskeleton, prevent HGF adhesion. Consequently the maintenance of the oral connective tissue and integrity and remodeling could be impaired. According to our morphological evidence, these findings confirm other clinical and epidemiological investigations reporting that volatile components of cigarette smoke could lead to the initiation and progression of periodontal disease.

Fast one-dimensional profilometer with a compact disc pickup

The use of compact disc (CD) pickups in optical profilometry is a well-established practice. The instruments currently available on the market are, however, expensive both to purchase and to maintain. This expense is mainly due to the high cost of the scanning system, and it makes the use of low-cost pickups fruitless. Moreover, translation stages are bulky, slow, and in most applications neither necessary nor desirable. We present a one-dimensional profilometer, which uses a CD pickup as both the sensor and the actuator. Beam scanning of the sample is in fact performed by the objective lens tracking motor. The device is cheap, fast, compact, light, and a valuable solution for fluid and hard-to-access surface profiling.

Microtubules and vimentin associated filaments (VIFs) in cultured human gingival fibroblasts (HGFs) after exposure to acrolein and acetaldehyde

Tobacco smoke, particularly its non-volatile fraction e. g. nicotine, is considered to be a major risk factor for the development and progression of periodontal disease. The purpose of this study has been to determine the effects of acrolein and acetaldehyde of the volatile fraction of tobacco smoking, on human gingival fibroblasts (HGFs) cultured in vitro with particular attention to cytoskeletal structures. A human gingival fibroblast strain derived from healthy gingiva was utilized in this study. The cells were exposed to acrolein and acetaldehyde at various concentrations. Control and treated cells were compared as regards their adhesion on cell culture dishes. Their cytoskeletal structures [tubulin and vimentin intermediate filaments (VIFs)] were examined by fluorescence microscopy. The results revealed that both substances produced similar effects resulting in a dose dependent decrease in cell adhesion and alterations of HGF cytoskeleton consisting of rearrangement and/or disruption of microtubules and vimentin associated filaments. Changes in cell shape and decrease in cell size were also seen. On the basis of this in vitro study, it appears that tobacco, through its volatile components, may directly affect the main functions of HGFs.

Ultrastructural changes in human gingival fibroblasts in vitro after exposure to vapour phase smoke components

Tobacco and some of its volatile and non-volatile components have been found to affect many types of cells including gingival fibroblasts. Because normal gingival fibroblast functioning is fundamental to the maintenance of the oral connective tissue as well as to wound healing, we examined the effect of two vapour phase smoke components (acrolein and acetaldehyde) on proliferation and ultrastructure of human gingival fibroblasts (HGFs) in culture. A human gingival fibroblast strain derived from healthy individuals was used in this study. The cells were incubated in the presence of different concentrations of acrolein and acetaldehyde and cell proliferation and fine morphology were evaluated. The results show that acrolein and acetaldehyde produced dose dependent inhibition of HGF viability and alteration of cytoplasmic organelles. The main ultrastructural finding for the HGF cytoplasm was the presence of vacuoles and lysosomal structures which became prominent with increasing concentration of acrolein and acetaldehyde. Our results suggest that the ultrastructural alterations we observed in HGFs may be due to the uptake and storage of acrolein and acetaldehyde by the cells.

Volatile components of cigarette smoke: effect of acrolein and acetaldehyde on human gingival fibroblasts in vitro

BACKGROUND

Tobacco and some of its volatile and non-volatile components have been found to affect many types of cells including gingival fibroblasts. Since normal gingival fibroblast functioning is fundamental to the maintenance of the periodontal connective tissue, as well as to wound healing, we examined the effect of acrolein and acetaldehyde, volatile components of cigarette smoke, on proliferation, attachment, and ultrastructure of human gingival fibroblasts (HGFs) in culture.

METHODS

Human gingival fibroblast (HGF) strains derived from healthy individuals with non-inflamed gingiva were used in this study. The cells were incubated in the presence of different concentrations of acrolein and acetaldehyde. Cell attachment and proliferation were evaluated after incubation for 3 hours and 5 days, respectively. In addition, the cells were examined with a transmission electron microscope in order to evaluate their morphology.

RESULTS

The results show that acrolein and acetaldehyde produced dose-dependent inhibition of HGF attachment and proliferation. The cytotoxic effect was, however, reversible when both substances were removed, after 3 days, from the medium. The main ultrastructural finding for the HGF cytoplasm was the presence of vacuoles and lysosomal structures that became prominent with increasing concentration of acrolein and acetaldehyde.

CONCLUSIONS

Our experimental data suggest that acrolein and acetaldehyde, volatile components of tobacco smoke, are detrimental to HGF survival and consequently to the oral connective tissue. According to our morpho-functional evidence, these findings corroborate clinical and epidemiological investigations demonstrating smoke as a risk factor in the development of periodontal disease.

Tobacco smoke in the development and therapy of periodontal disease: progress and questions

In recent years, epidemiological studies have pointed to a significant correlation between cigarette smoke and poor periodontal status. Cigarette smoking is a significant risk factor for the onset and development of periodontal disease, and an association between reduced healing response subsequent to periodontal therapies and cigarette smoking has been found. The epidemiological studies reported here are also supported by the results of an in vitro study on the cytotoxicity of two of the volatile components of cigarette smoke that we ourselves conducted, in which the investigated compounds were found to damage human gingival fibroblasts. We concluded that this damage would be reflected in periodontal health and could slow down wound healing. Patients should thus be alerted by clinicians to the risks smoking poses to oral and dental health.

Morphologic characteristics of initial lymphatics of the healthy and diseased human gingiva

Investigation was performed on healthy and inflamed human gingivae. In the healthy mucosa lymphatic vessels generally appeared as flattened channels with a reduced lumen. Only in very inflamed tissue were some more evident vessels with a distended wall detectable. Ultrastructurally, most of the vessels had the characteristics of capillaries and they were delimited by a thin and irregular endothelial wall with large intercellular spaces. These observations indicate that in the gingival tissues, which are continuously exposed to inflammatory agents and need a really efficient draining system, the pathway of interstitial exudation and cell migration may include both the lymphatic vessel system and the intercellular spaces of the permeable junctional epithelium.

Inhibition of prostanoid synthesis protects against neuronal damage induced by focal ischemia in rat brain

Changes in prostanoids concentration and effects of the non-specific COX inhibitor indomethacin on prostanoids levels and extension of tissue damage were studied following focal ischemia induction in the fronto-parietal region of rat brain. Ischemia was induced in animals bearing a transcerebral microdialysis probe by injection of Rose Bengal, a photosensitive dye, followed by light activation. Prostanoid levels were determined in the dialysate using immunoenzymatic techniques. PGD2 levels rose significantly up to 237+/-22 pg/ml compared to a basal level measured before ischemia induction which was below the detection limit. TXB2 changes were smaller and had a different time course. Treatment with indomethacin abolished the ischemia-induced PGD2 release and reduced the extent of injury to the area by 43+/-3.7%. These results suggest that prostanoid release may play an important role in neurodegenerative processes and that cyclooxygenase inhibitors may contribute to protect against cerebral tissue damage.

Localization of beta-D-galactosidase activity in semithin epon sections of embryonic tissues using differential interference contrast optics

In the present study we describe a method for the histochemical demonstration of beta-D-galactosidase activity on tissue sections processed for light microscopy at high resolution. 5-Bromo-indolyl-beta-D-galactopyranoside (Bluo-Gal) was utilized as an indigogenic method for the demonstration of Escherichia coli beta-D-galactosidase reporter gene activity whose expression was studied in a transgenic line where the enzyme, with a nuclear localization signal (nlacZ), is under the transcriptional control of a striated muscle-specific promoter. At the light-microscopic level, by using Differential Interference Contrast (DIC) optics, the reaction product was detected as precipitates in the form of fine birefringent crystals. These were located around and inside the nuclei of beta-gal-expressing cells. This simple method allows an easy and rapid identification of few or even one labeled cell(s) within large microscopic fields (whole embryos) and the labeled cell(s) can be evaluated both morphologically and quantitatively.

Structure of the initial lymphatics of the human urinary bladder with invasive urothelial tumors

The ability of urothelial tumors of the urinary bladder to metastasize via the lymphatic circulation and the extent of metastatic involvement of regional lymph nodes is an important parameter in the staging and prognosis of these neoplasms. Accordingly, we examined the site and morphology of initial lymphatic vessels in the mucosa of the human urinary bladder in patients with invasive transitional cell carcinoma. Lymphatics in the papillary tumoral mass was also examined. Endoscopic transurethral biopsies from the urinary bladder of 120 patients with invasive transitional cell papillary carcinoma were utilized for this study. Biopsy from the uninvolved lateral wall of the same patient was utilized as a control. On histopathology of biopsies of neoplastic tissues, initial lymph vessels were seen in the deeper region of the mucosa but not in the subepithelial layer nor in the stroma of the tumoral papillae. The latter were often associated with arteriolar and venular vessels. When edema and inflammation occurred in peritumoral regions, lymphatics showed a dilated lumen, non-indented wall with dissociated perivascular collagen and elastic fibers. Tumoral permeation or embolization of lymphatics was seen in 12% of patients with invasive tumors, and these lymphatic vessels did not display significant morphologic changes. The absence of initial lymphatics in the stroma of tumoral papillae and in infiltrated subepithelial regions of the urinary bladder may explain the absence of lymph node metastasis in early-stage invasive urothelial tumors.

Ultrastructural Localization of elastin-like immunoreactivity in the extracellular matrix around human small lymphatic vessels

The distribution of elastin-like immunoreactivity around small lymphatic vessels was investigated in three different human tissues (skin, heart and dental pulp) using high resolution immunocytochemistry. Quantitative assessment of the immunogold reaction was performed with an image analysis system. Intense and moderate elastin-immuno-reactivity was detected in the extracellular matrix around small lymphatic vessels of the skin and heart, respectively. By contrast, absence of immunostaining was observed around lymphatic vessels in the dental pulp. Although the staining was mostly detectable on the non-fibrillar amorphous component of the extracellular matrix, some microfibrils were also immunostained in close proximity to the lymphatic vessel wall. These findings support the concept that small lymphatic vessels may be heterogeneous with respect to the composition of the extracellular matrix around their wall. The observation that it is possible to observe small lymphatic vessels displaying low or no elastin-immunoreactivity in the adjoining matrix militates against the hypothesis that elastic fibers play a pivotal role in the mechanisms that regulate the function of small lymphatic vessels.

The lymphatic vessels and their relationship to lymph formation in the human urinary bladder

After endoscopic transurethral biopsies of normal human urinary bladder, an extensive network of small initial lymphatic vessels was depicted by means of light and electron microscopy. Using light microscopy, lymphatic vessels were seen in the mucosa and submucosa and formed a complex network in the detrusor muscular coat. These lymphatics were characterized by an irregular and attenuated wall and increased in number and size from the superficial to the deeper region of the bladder. Ultrastructurally, the lymphatic wall was characterized by endothelial cells joined together end-to-end or by complicated interdigitations. Often intercellular channels and gaps between two contiguous endothelial cells were present. A broad network of elastic and collagen fibers joined the lymphatic endothelial wall to the neighboring connective tissue. Nevertheless, as far as the fibrillar component was concerned, the vesical intramuscular lymphatic endothelial wall lacked elastic fibers. These anatomic variations were examined in reference to lymph formation in an organ (the urinary bladder) which undergoes continual changes in volume and pressure.

Morphological changes of dermal blood and lymphatic vessels in chronic venous insufficiency of the leg

Morphological changes of dermal blood and lymphatic microcirculation in skin biopsies from patients affected by Chronic Venous Insufficiency (CVI) associated with stasis dermatitis of the lower limbs, are reported here. Blood vessels are characterized by an occluded lumen, thickening and reduplication of the basement membrane. The structural changes in dermal lymphatic vessels are: (i) collapsed lumen of lymphatics located in the papillar dermis; (ii) numerous and complex interdigitations between contiguous endothelial cells and lack of open junctions; (iii) derangement of the anchoring filaments that normally pull the lymphatic lumen open. The connective matrix is characterized by fibrosis with formation of dense bundles of collagen and elastic fibers. These results suggest that the dermal lymphatic and blood microcirculation in CVI are connected to a reduced fluid exchange capacity because of the structural changes occurred in the vascular and lymphatic wall and in the surrounding connective tissue.

[Neuroradiology of infective diseases in the immunocompromised host]

Just like the lung, the brain and the spinal cord are target organs for opportunistic infections and tumors in immunocompromised patients. HIV infections and AIDS-related conditions represent the most common cause of immunodeficiency: other causes are hemoproliferative disorders and organ transplantation, but especially long-term drug and radiation therapies. Neurologic (focal, diffuse, meningeal or spinal) signs are the results of CNS infections and/or tumors or of treatment complications. Neuroimaging techniques (MRI better than CT) allow the infective or neoplastic causes of neurologic complications to be nearly always recognized and are therefore major tools for diagnosis and treatment. Lesions characterization is more difficult, since CT and MR patterns are definitely more affected by the evolutive phases of the lesions (encephalitis, cerebritis, abscess) and by their sites than by specific infective agents. However, the knowledge of the statistical possibility of brain and spine infections according to the type of immunocompromission is useful in many cases.

Lymphatic capillaries of the pig lung: TEM and SEM observations

Pulmonary lymphatic vessels extend within the connective tissue sheets surrounding airways and blood vessels. Frequently in this location they also border the lobular parenchyma, but not lymphatic vessels have been found within intralobular compartments between blood capillaries and alveoli. The presence and distribution of lymphatic vessels in pulmonary tissue are consistent with an important role for the lymphatic system in the clearance of interstitial fluids in the lung. Pulmonary lymphatic channels have structural characteristics of initial lymphatics; their walls are formed only by an endothelial layer, and no muscular cells are present. A network of anchoring filaments and collagen and elastic fibers surrounds the vessel walls. Because the lung is a mobile organ the tissue undergoes compression and distension during respiratory phases. These modifications could have a role in the mechanisms for lymph formation and flow.

[Stress myocardial scintigraphy in the pre- and postoperative diagnosis of ischemic cardiopathy. The correlations between the clinical aspects and the coronary angiographic picture]

With radioisotopes it is possible to study the heart obtaining complementary or substitutive informations to those provided by the most common noninvasive methods of myocardial assessment and by coronarography. This paper aim is to report experience with thallium 201 and 99mTc isonitrile in the diagnosis and followup of ischemic heart disease, in particular correlating clinical, coronarographic and scintigraphic findings. MATERIAL AND METHODS. During the biennium 1989-91 we have used the myocardial perfusion imaging with thallium 201 in 29 patients (20 male age ranging from 40 to 60 years) injecting 2 mCi at exercise peak with immediate planar mapping, followed by a second registration at rest 4 hours later (thallium 201). Imaging with 99mTc SESTAMIBI has been carried out in 6 patients (two of whom previously studied with thallium 201) injecting 20-22 mCi both at stress peak and at rest, with SPECT mapping 60'-90' later. All these patients presented specific problems for the diagnosis of myocardial ischemia. The exercise testing has been performed by a bicycle ergometer and with a standardized procedure increasing every two minutes the workload to the maximum tolerated according to the clinical conditions and to the response. All antianginal treatments were discontinued for at least 48 hours before testing and the patients were fasted for 6 hours. The images were obtained using a small field scintillation camera with a low-energy general purpose collimator. We divided the patients in 4 groups: Group A. Six patients who had an open heart operation: in 5 coronary revascularization was carried out (plus left ventricular aneurysmectomy in one and plus aortic valve replacement in another); in 1 patient an aortic valve replacement was performed on. Group B. Six patients have been evaluated after coronary angiography. Group C. Seventeen patients with doubtful diagnosis of myocardial ischemia on the base of the symptoms and/or non invasive testing as rest or stress electrocardiogram (ECG). Group D. In 6 more patients (2 of those previously studied with thallium 201) the myocardium has been assessed with SESTAMIBI. RESULTS. In one patient of the group A the thallium 201 images detected silent ischemia; in 5 removed the diagnostic doubts of the ECG findings owing to left ventricular overload or to old infarctions in 2 patients and to electrolytes disturbances or pharmacological effects in 3 patients. In group B patients the thallium 201 further on could assess the extent of ischemic and necrotic areas suggesting the final indications to angioplasty in 3 patients, medical treatment in 2 and surgery in 1. We could not find correlations between the extent of the disease predicted by the coronarography and the findings of the thallium 201 images. In the diagnosis of myocardial ischemia, group C, the Thallium 201 has been very useful and specific excluding an ischemic origin in 4 patients with arrhythmias, in 2 patients without symptoms of angina but with doubts at rest and exercise ECG findings and in 4 with atypical thoracoalgia and doubtful ECG. On the contrary, this test could give the final diagnosis of ischemia in 6 patients displaying its sensitivity in detecting coronary artery disease. Among the patients assessed with SESTAMIBI, in 2 this test has been essential in evaluating the myocardial contractility and the segmental wall motion. DISCUSSION. The usefulness of Thallium 201 imaging, as a very sensitive mean in detecting coronary artery disease and in the assessment of myocardial viability, is well known. Although the most common indications of this technique are well standardized, in the clinical practice there are many situations in which the thallium 201 can contribute to the diagnosis and to the management. (ABSTRACT TRUNCATED)

Effect of preoperative training on latissimus dorsi muscle for cardiomyoplasty. A morphometric study

Dynamic cardiomyoplasty is based upon the use of electrostimulated Latissimus Dorsi muscle (LDM) to reinforce the ventricular wall of heart in patients with end-stage heart failure. In the present study we induced a preoperative reinforcement of LDM in 3 male patients selected for cardiomyoplasty, by means of a physiokinesiologic training. The application of morphometric techniques was useful to analyze the modifications in fibre type diameter and composition, in number and distribution of mitochondria and in number of capillaries in LDM needle biopsies performed before and after training. The preoperative muscle training induces trophic modifications in muscle fibres with increase in fibre diameter, in capillarity and in number and size of mitochondria. These parameters indicate that a preoperative training of LDM before cardiomyoplasty may be useful for muscle reinforcement and for preparation to the electrostimulation program in the postoperative cardiac assistance.

[Dynamic magnetic resonance of the temporomandibular joint. Observations and findings]

Condylar movements can be executed only if the TMJ morphology can satisfy functional needs of the masticatory apparatus. Articular components have to be in good relation with dento-skeletal functional anatomy: if this does not occur, mandibular dynamics may establish some functional stresses on the condylar head and the articular eminence. These overloaded structures and particularly their functional surfaces react to this situation to be remodelling and deformation of the articular cavity. In our work we have used a new method to analyse condylar dynamics using MRI. The reconstruction of mandibular movements, using this instrumentation, permits to make some useful observations on the functional capability of TMJ to adjust itself to different maxillofacial morphologies and, consequently, how this joint can fall in a dysfunctional and pathological condition.

[Shoulder instability and pain. Computerized arthro-tomography assessment]

The growing interest in shoulder joint imaging comes from the ever-increasing demand for such an examination in orthopedics. Since more complete and detailed imaging of bone, capsuloligamentous and musculotendinous compartments is always needed, CT arthrography has necessarily become a widely used method. In this study, 282 patients were investigated with CT arthrography. Seventy per cent of them had anatomical instability, 17.3% had functional instability and the extant 12.7% had shoulder pain. In traumatic instability, the most often injured structures were the glenoid labra (91%) and the capsule (82%). Lesions in the two structures were nearly always associated. Moreover, high incidence (65.8%) of Hill-Sachs lesions of the humeral head was observed. In atraumatic instability, abnormal anteversion of the scapular glenoid was always detected. In the patients with shoulder pain, the most common causes were the impingement syndrome (30.5%), superior labrum lesions (16.7%), adhesive capsulitis (16.7%) and synovial osteochondromatosis (13.7%). With CT arthrography, labial abnormalities (detachments, tears, amputations, eversions and degeneration) can be identified, as well as capsular lesions (insertional detachment and laxity), rotator cuff conditions (bursitis, tendinitis and partial/complete tears), biceps tendon abnormalities and glenoid rim and humeral head fractures. Moreover, CT arthrography is minimally invasive and well tolerated. It exhibits 97.7% specificity, 91% sensitivity and 96% accuracy. Furthermore, it has been proven to be extremely useful in treatment and surgical planning.

Dermal lymphatics in myotonic dystrophy

Myotonic dystrophy is an hereditary disorder of several organ systems. Skeletal muscle is a principal target organ, but abnormalities also occur in the peripheral microcirculation. Because morphological and functional changes in the dermal blood microcirculation may affect interstitial fluid drainage of the skin, we examined dermal lymphatic morphology in adult patients with myotonic dystrophy. Skin biopsies were taken from the big toe from patients with myotonic dystrophy (age 18-50 years) and subjected to light and electron microscopy; five healthy subjects served as controls. The salient findings in myotonic dystrophy were ultrastructural changes of the lymphatic endothelial cells and the fibrillar elements that surround the lymphatic wall. These abnormal lymphatic findings are interpreted in light of changes in the blood microvasculature and loose connective tissue in this disorder.

[Heterotopic splenic autotransplantation: a therapeutic option in splenic trauma]

The Authors report two cases of splenectomy for trauma, followed by heterotopic autotransplantation of splenic tissue in omental pockets. A follow-up nuclear scan and ultrasonography showed function and growth of the splenic implants. The pertinent surgical literature is reviewed.

[The effect of superoxide dismutase and catalase on the delayed toxicity of doxorubicin]

The production of oxygen-free radicals has been proposed as a determinant of the delayed toxicity of doxorubicin. The aim of the present investigation was to evaluate the potential cardioprotective effect of superoxide dismutase (SOD) and catalase (CAT) against the delayed cardiomyopathy induced by doxorubicin (DXR) in a rat model. Female Sprague Dawley rats received 3 mg/kg of DXR intravenously weekly for 4 weeks. SOD or CAT were administered intravenously at the dose of 10000 U/kg 2 min before and 30 min after each DXR administration. Cardiac toxicity was monitored by means of electrocardiography (QaT interval) and by light and electron microscopy evaluation of left ventricle fragments. DXR treated rats showed, in comparison with control animals, a decrease of body weight gain, a progressive and irreversible prolongation of QaT and significant morphologic lesions consisting in myocyte vacuolization and myofibrillar loss. SOD significantly prevented the impairment of body weight gain and QaT prolongation. Moreover, morphologic lesions were significantly reduced in rats receiving DXR + SOD. On the contrary, CAT seems to be completely devoid of protective effect.

Lymphatic vessels of the human dental pulp in different conditions

The characteristics of the lymphatic vessel endothelial wall have been investigated in human normal and inflamed dental pulps. In normal pulps the endothelial wall is characterized by the presence of micropinocytotic vesicles and intraparietal channels. In the inflamed pulpal tissue, where an increase in interstitial fluid pressure occurs, the distended endothelial wall presents open junctions between endothelial cells and the openings of the intraparietal channels. Moreover the micropinocytotic vesicles disappear. The cytoplasm of the endothelial cells is characterized by the presence of numerous Weibel-Palade bodies, which increase in number in the dilated vessels. In the fibrillar apparatus surrounding the lymphatic vessel wall collagen fibrils are the prevalent component, while elastic fibers are not present. The different morphological properties of the lymphatic vessels are compared and discussed with regard to the variation of the functional conditions of the tissue.

[Rupture of the free wall of the left ventricle as the first manifestation of a myocardial infarct. A clinical case operated on with success]

A case of an undetected myocardial infarction in a patient with diabetes mellitus in which the first clinical sign was a syncope due to rupture of the left ventricular inferior wall is described. Survival was enhanced by a fast diagnosis (aided by the availability of an ECO 2D in the emergency room), by emergency pericardiocentesis with temporary haemodynamic stabilization and by prompt access to the Cardiosurgical Unit. A prompt diagnosis and treatment can allow the survival of patients, even in the extreme case that the ventricular wall rupture represents the first clinical manifestation of the myocardial infarction. The left ventricular free wall rupture in the course of myocardial infarction has a subacute pattern in about 30%, due to various mechanisms such as thrombosis or pericardial adherence over the ruptured wall.

HLA haplotype segregation and ultrastructural study in familial immotile-cilia syndrome

The immotile-cilia syndrome (ICS) is a congenital disorder characterized by dysmotility or even complete immotility of the cilia in the ciliated epithelia. The most frequent consequences include recurrent airway infections from early childhood. Neonatal asphyxia often occurs. Males are usually sterile, whereas females may be fertile or infertile. The disease is inherited as an autosomal recessive trait, but previous attempts to localize the ICS susceptibility gene have so far been unsuccessful. Here, we present the case of two sib pairs affected by ICS from two unrelated families. The electron microscopic investigation of nasal biopsies showed structural anomalies of the cilia, characterized by single microtubules or doublets, arranged randomly in the axoneme. Histocompatibility antigen (HLA)-genotyping of all family members revealed: 1) a significant association of ICS with the HLA-DR7; DQW2 haplotype, which is shared by all the affected sibs (P = 0.0099; RR = 25.94); 2) a possible linkage of the ICS susceptibility gene with HLA, both the affected sibs being HLA-identical, the healthy brother in family B being HLA-different (sib-pair analysis: P less than 0.001).