Fluoride stimulation of the rat parathyroid gland: an ultrastructural study

The parathyroid glands of rats given 150 ppm fluoride in the drinking water for 10 weeks are evaluated ultrastructurally and compared to the parathyroid glands of untreated rats. As a result of fluoride ingestion, the majority of the parathyroid cells are dark chief cells, indicating that these cells are in the active stages of the secretory cycle. More significantly, in the fluoride-treated rats, the cytoplasmic organelles of the dark chief cells are even more developed that those seen in the dark chief cells of untreated rats. The dark cells contain an electron-dense cytoplasm with abundant lamellar arrays of rough endoplasmic reticulum, spiral aggregations of free ribosomes, multiple dilated Golgi complexes, and increased numbers of secretory granules. The cells are at a minimum dimension with maximum tortuosity of the plasma membranes; and, as a result, large intercellular spaces are often seen between contiguous cells. Based on these observations, it is suggested that, in the fluoride-treated rat, a type of secondary hyperparathyroidism develops resulting in an increase in the organelles involved in protein synthesis and secretion.     

Primary hyperparathyroidism sustained by a giant adenoma of the parathyroid gland

A case of primary hyperparathyroidism sustained by an unusually large parathyroid adenoma is presented. The tumor affected a 45-year-old woman with a 15-year history of nephrolithiasis and presented as a palpable neck mass. On the basis of clinical findings and ultrasound examination, it was initially misdiagnosed as a thyroid nodule. CT scan and transesophageal endosonography gave a correct definition of the tumor, which was located behind the left thyroid lobe and expanded posterior to the pharynx and the esophagus in the prevertebral space. At surgery a parathyroid tumor measuring 8 x 7 x 3 cm and weighing 90 g was successfully removed. No signs of malignancy were observed by both morphological and cell kinetic analyses.     

Pachydermoperiostosis. An ultrastructural study

BACKGROUND: Pachydermoperiostosis (PDP) is a rare genetically determined disease belonging to the group of hypertrophic osteoarthropathies. Its aetiopathogenesis remains unclear. Most hypotheses favour an exogenous stimulation of fibroblasts. METHODS: A clinically typical patient with PDP was studied by electron microscopy with particular reference to the dermis and its cellular constituents. Fibroblasts from involved skin were cultured and studied in comparison with control cells. RESULTS: Remarkable modifications of the structure of the dermis were observed, encompassing irregular caliber of collagen fibres, extracellular deposits of microfibrils and of amorphous granular substance corresponding to the Alcian blue positive deposits seen by conventional histochemistry. The in vitro growth of fibroblasts was normal. CONCLUSION: Authors reviewed aetiopathogenic hypotheses. Our data suggest a genetically determined alteration of extracellular matrix production by fibroblasts as a possible explanation for the development of PDP.     

Papillary eccrine adenoma: an ultrastructural and immunohistochemical study

OBJECTIVE: Our specific aim in the 16 year prospective NHANES I epidemiologic follow-up study (NHEFS) was to assess the important roles of modifiable dietary and behavioral factors in causation and prevention of deaths and hospitalizations for coronary heart disease (CHD). METHODS: Using NHEFS 16 year follow-up data (1971 to 1987), we studied 5811 subjects, 1958 with and 3853 without CHD events, using logistic regression. RESULTS: In age groups 40 to 49, 50 to 59, 60 to 69, and 70 to 74 years (at study entry in 1971-4), the numbers of men and women were respectively 597 and 1019, 570 and 619, 932 and 1042, and 486 and 546. The following factors were independently positively associated (p < .05) with CHD: age, serum cholesterol, body mass index, cigarette use, and region (Midwest, Northeast). The following factors were independently negatively associated (p < .05) with CHD: gender (female), race (black), fish intake, alcohol, high school education, moderate exercise, and moderate and heavy habitual physical activity. Subjects with serum cholesterol > 249 mg/dl benefitted less (p = .04) from fish intake than those with 209 to 249 or < 209, and benefitted less (p = .03) from alcohol intake (CHD incidence [%]): [see text] CONCLUSIONS: These associations emphasize the important role of modifiable dietary and behavioral factors in the causation and prevention of CHD.     

Chloroquine-induced achromotrichia. An ultrastructural study

BACKGROUND: Electron microscopy examination of scalp biopsies from a patient with chloroquine achromotrichia gave elements concerning the pathogenesis of chloroquine-induced achromotrichia. CASE REPORT: A 21-year old light brown-haired patient developed achromotrichia after four months of treatment with chloroquine for subacute lupus erythematosus. Hair bleaching completely regressed 5 months after discontinuing chloroquine despite replacement with hydroxychloroquine. During the achromatrichia phase, many ultrastructural anomalies were observed in the hair root melanocytes: the nuclei were small and densified, and there was an accumulation of immature melanosomes in the cytoplasm; these melanosomes, mainly in stage II, were rarely transferred to keratinocytes. After recovery from the achromotrichia, melanocytes displayed a normal aspect. DISCUSSION: Pathophysiological disturbances leading to chloroquine induced achromotrichia are still unclear. The ultrastructural study of hair follicles in our patient show that under chloroquine action melanocytes become unable to perform complete melanin synthesis and to produce normally melanized melanosomes which may be transferred to keratinocytes. Non-melanized or poorly melanized melanosomes accumulate in the melanocytes which finally become inactive cells. These findings suggest that achromotrichia is induced by a toxic effect of chloroquine on the melanocyte.     

Development of the thyroid gland in the rat fetus in vivo. An ultrastructural and radioautographic study

A study of the differentiation of the thyroid follicles was carried out in rat fetuses between day 14 of pregnancy, when cellular polarization begins and day 18, when completely formed follicular lumina are differentiated. After day 18, only the shape and the size of the lumina undergo modifications. The mechanism of folliculogenesis involves the participation of several structures. At 14 days of pregnancy, adherens type contact zones with membrane densification appear between the cells. These junctional zones spread out and form infoldings which deeply penetrate the cytoplasm. Golgi vesicles migrate to these zones and they fuse among themselves and with the contact membranes : follicular cavities result which can be recognized as soon as day 16 of pregnancy. A radioautographic study showed the beginning of iodide organification at 17 days 11 hours of pregnancy. From this time onward silver grains were seen over the follicular cavity, even it is still incompletely formed.     

Venous hemangioma. An immunohistochemical and ultrastructural study

OBJECTIVE: To elucidate the roles of integrins in tumorigenesis, progression, differentiation, invasiveness and metastasis, and the role of the integrin alpha 5 subunit in hepatocellular carcinoma (HCC). METHODS: 79 formalin-fixed sections of hepatocellular carcinoma (HCC) were obtained. The integrin alpha 5 subunit was measured by immunohistochemistry assay (ABC method). RESULTS: In 79 cases of HCC, cancerous tissues had lower expression than their adjacent non-tumor tissues (32.9% vs 81.0%, P < 0.01). The alpha 5 positive rate in small HCC (= < 5 cm in diameter) was higher than large HCC > 10 cm in diameter), being 55.6% and 10.0% respectively. Well-differentiated HCC expressed higher alpha 5 than poorly differentiated ones. The alpha 5 positive rates were lower in highly invasive HCC than those to low invasive ones. CONCLUSION: Our study indicated that expression of the integrin alpha 5 subunit is correlated with growth, differentiation, invasiveness and metastasis of HCC. It is possible that alpha 5 subunit is a negative regulator to these biological parameters of HCC.     

An ectopic parathyroid adenoma revealed by L-thyroxine side effect on bone. Case report

Yersinia was isolated from imported raw meat and fowl products by HeLa cell treatment and conventional KOH-treatment, to obtain information on the origin of pathogenic Yersinia in Japan. Forty-one strains of Yersinia enterocolitica and one strain of Yersinia pseudotuberculosis, serotype 4b were isolated from 38 (3.0%) of 1278 samples of pork, two (0.3%) of 612 samples of beef and two (0.3%) of 615 samples of chicken. Y. enterocolitica isolates belonged to B:4/O:3 (biotype/serotype, 15 strains), B:3/O:3 (two strains) and B:3 variant/O:3 (17 strains) and B:3/O:5.27 (seven strains). The B:4/O:3 which is globally prevalent among humans and animals was isolated from pork samples from Denmark and the US and from beef samples from Australia, the B:3/O:3 from pork samples from Canada, the B:3 variant/O:3 from pork samples from Taiwan and from chicken samples from Thailand, the B:3/O:5.27 from pork samples from the US and Taiwan and Y. pseudotuberculosis, serotype 4b from pork samples from Canada. These findings suggest that pathogenic Y. enterocolitica strains can be introduced into Japan by the import of pork from pig producing countries. The HeLa cell treatment was found to be superior to the conventional method.     

Papillary cystadenoma of the epididymis. An ultrastructural and immunohistochemical study

Papillary cystadenoma of the epididymis is a rare neoplasm that is sometimes associated with von Hippel-Lindau's syndrome. Electron microscopic study of the present case revealed that neoplastic cells contained abundant glycogen granules and large lipid droplets, but a few organelles. On the apical surface there were numerous microvilli and a few single cilia, but no ciliated cells. Subepithelial basal lamina was noted, but it was occasionally disrupted. Furthermore, microvilli sprang from the circumference of the small tumor-cell nest and became associated with matrix components (microvillus-matrix associations). On immunohistochemical study, neoplastic cells showed epithelial characteristics, but positive reactivity for S-100 protein. These findings resembled those of the epithelial cells of the efferent ductules of the epididymis. In the stroma, prominent vasculature was characteristic and fenestrated-type capillaries were found in the peripheral portion of the tumor. Papillary cystadenoma of the epididymis may originate from non-ciliated epithelial cells of the efferent ductules.     

Eosinophilic granular ceels in oligodendrogliomas. An ultrastructural study

In three cases of oligodendrogliomas, atypical cells rich in eosinophilic cytoplasm, resembling plump astroyctic or astroblastic cells, were studied under the electron microscopy. These cells showed finely granular cytoplasm with routine hematoxylin-eosin preparation; ultrastructurally, they exhibited abundant, round cytoplasmic bodies of autophagic-vacuole type, in addition to other fine structures characteristic of oligodendroglioma cells.     

Comparitive study of three images examination in preoperative localization of parathyroid adenoma

The ability to localize parathyroid adenoma with B ultrasound, CT scan and thal-lium-technetium scanning (TTS) was eraluated in 41 randomly selected patients with parathyroid adenoma proved pathologically from May, 1985 to May, 1993. The results indicated that the sensitivity was 92.86%, 73.91% and 33.3%; the specificity, 95.65%, 94.2% and 100%; and the accuracy, 95%, 89.1%, 83.3% in above three images examinations. Therefore, the predictable positive rates were 86.6%, 80.95 and 100%; the predictable nagative rates were 97.78%, 91.55%, 0%. There was no significant difference between B ultrasound and CT scan (P > 0.05) in the detection of the location of adenomas. We suggest that B ultrasound could be the first choice in the detection of the location of parathyroid adenoma before surgery, and the CT scan be applied for the unascertained patents who had B ultrasound exam, or surgical exploration, and those with suspected mediastinal adenoma.     

An ultrastructural pathological study of pterygium

OBJECTIVE: To study the ultrastructural changes of pterygium. METHOD: The pathological ultrastructure of pterygium was studied by Hu-12A transmission electron microscopy in 14 specimens. RESULTS: The result indicated that normal and abnormal elastic fibers and collagenous fibers existed in the pterygium. As hyperplastic fibers intruded into the corneal subepithelium, Bowman's membrane was broken. To a certain extent, blood vessel multiplication and degeneration were found in the pterygium. One of the important factors was blood vessel multiplication and degeneration which affected the occurrence and development of pterygium. CONCLUSION: Multiplication and degeneration of elastic and collagenous fibers were the prominent pathological changes, and the pre-elastic fibers and denatured elastic fibers were the main compositions of pterygium.     

Developmental study of ultrastructural and biochemical changes in isolated chick brain microvessels

Expression of progesterone receptor (PR) in various organs of sexually immature chickens and after estrogen treatment was studied by immunohistochemical and Western blotting analyses. Constitutive PR expression was observed in the mesothelium and stroma of the esophagus, proventriculus, liver, spleen, pancreas, heart and lung. In the urogenital tract, PR was expressed in the mesothelial and stromal cells and smooth muscle of blood vessels. Estrogen treatment induced PR expression in the stroma and smooth muscle of the gall bladder and in the epithelium and stroma of the trachea. In the ovary of immature chickens PR was localized in the epithelium, stroma and smooth muscle and was induced in the granulosal cells by estrogen. In most tissues there was more PR-B than PR-A expression and this PR-B dominance remained after estrogen treatment. These results suggest that progesterone and estrogen may have physiological effects on many organs outside the genital tract not previously known as steroid-target tissues.     

Goblet cell carcinoid of the appendix. An ultrastructural and histochemical study

In a patient with a goblet cell carcinoid tumor of the appendix, light and electron microscopical studies demonstrated mucinous material and enterochromaffin granules within the same cell. Transitions between cells containing primarily mucin and cells containing numerous argentaffin granules were observed. Fluorescence studies demonstrated that the tumor cells contain biogenic amines.     

Triphenyltin acetate toxicity: a biochemical and ultrastructural study on mouse thymocytes

Eighty-five subjects at various stages of human immunodeficiency virus (HIV-1) infection and 39 seronegative controls underwent neurological and neuropsychological evaluation to assess the relationship between cognitive test results and subjective complaints (cognitive, affective, motor, and other). The effect of psychiatric disorders on the association between cognitive performance and complaints of the patients was also examined. Patients with symptomatic infection had higher frequency of complaints than subjects at asymptomatic stage. Detailed neuropsychological examination confirmed a strong association between poor verbal memory and cognitive complaints. Poor performance on cognitive speed and flexibility was associated with motor complaints and motor abnormalities. These associations were not explained by psychiatric disorders or elevated depression questionnaire scores. Our observations indicate that, especially in symptomatic HIV-1 infection cognitive changes reported by patients often reflect "objective" cognitive decline, and may be the earliest signs of HIV-1 associated cognitive disorder. No direct relationship was observed between "subjective" complaints and neuropsychological performance of asymptomatic subjects. Understanding the significance of reported cognitive changes have important therapeutic implications.     

99m-Tc-MIBI SPECT parathyroid gland scintigraphy for the preoperative localization of small parathyroid gland adenomas

AIM: It was the of this study to assess the value of the 99mTc-MIBI scintigraphy in SPECT technique in the preoperative lateral location of small parathyroid adenoma (PTA). METHODS: 25 consecutive patients (8 male, 17 female, mean age 63 +/- 13 years) with the established diagnosis of primary hyperparathyroidism and non-diagnostic ultrasonography were scanned preoperatively. After a thyroid examination to exclude radionuclide accumulating thyroid adenoma, planar and tomographic images were acquired 20 min. and 120 min. after i.v. injection of 740 MBq 99mTc-MIBI using a 3 head gamma camera (Picker Prism 3000). The first 10 patients underwent an additional 201Tl/99mTc subtraction scintigraphy in a 2 days protocol. RESULTS: All patients had small, solitary PTA (< 1 g). 201Tl/99mTc subtraction scintigraphy (n = 10) showed only a sensitivity of 50%. Using planar MIBI-scintigraphy lateral location of PTA was possible in 18 cases (sensitivity: 72%). There was an increase in sensitivity up to 96% using the SPECT technique and the 3D display (volume-rendered reprojection). CONCLUSION: In contrast to 201Tl/99mTc subtraction scintigraphy, which showed only a low sensitivity, a reliable lateral location of small PTA was obtained using the tomographic 99mTc-MIBI scintigraphy. This method offers e.g. the possibility for the surgeon to perform an unilateral parathyroidectomy.     

Development of the human fetal visceral pleura. An ultrastructural study

OBJECTIVE: To develop a method to predict long-term outcome after head injury and determine if outcome can be accurately predicted 24 hours after injury. DESIGN: A retrospective review was performed on a study cohort of 672 head-injured patients admitted in coma (Glascow Coma Scale score < or = 8) who remained comatose for at least 6 hours, survived more than 24 hours, and had 6-month outcome data available. Stepwise logistic regression analysis was used to determine which clinical variables predicted 6-month outcome. Statistically significant clinical predictors were combined into a single examination variable (MPX score), which reflected a rank-ordering of examinations from worst to best, which was then further weighted by patient age. The relation between 6-month outcome and MPX score at admission and 24 hours was plotted and analyzed. MEASUREMENT AND MAIN RESULTS: Age, best motor score, and pupillary reactivity at admission and 24 hours were significant predictors of outcome; extraocular motility was predictive at 24 hours only. Age was the most important independent predictor, followed by best motor score, pupillary reactivity, and extraocular motility. Combining these predictors into MPX score resulted in a set of graphs that reliably predicted long-term outcome. The 24-hour MPX data were better predictors of 6-month outcome and were more specific in predicting negative outcomes than admission data. CONCLUSIONS: The method is simple to use, relying on bedside neurologic examination and a single graph, but appears to predict long-term outcome accurately as early as 24 hours after head injury. If validated on other large series of patients, this method could provide an objective and practical basis for terminating care in patients unlikely to survive a head injury.     

Ectopic parathyroid adenoma. Two cases treated with video-assisted thoracoscopic surgery

In recurrent or persistent hyperparathyroidism, accurate location of the abnormal gland is essential before further surgery, but the variety of available imaging techniques suggests that no one procedure is universally reliable. We report two cases in which clear preoperative visualization of adenoma with double-phase 99mTc-MIBI scintigraphy and exact high-resolution CT location permitted successful minimally invasive surgery.