Ki-67 immunolabeling in pre-malignant lesions and carcinoma of the prostate. Histological correlation and prognostic evaluation

The antigen Ki-67, which is associated with cell proliferation, has been demonstrated to be useful in predicting the development of human tumors. The objective of this study was to evaluate the prognostic utility of this biomarker in pre-malignant and malignant lesions of the prostate. A total of 162 prostate biopsies taken from patients diagnosed for benign prostatic hyperplasia (BPH, n=49), low grade prostatic intraepithelial neoplasia (LGPIN, n=53), high grade prostatic intraepithelial neoplasia (HGPIN, n=25) and carcinoma (CAR, n=35), were studied. Immunohistochemistry for Ki-67 was carried out on all the samples and the number of labeled cells was semi-quantitatively evaluated (weak, moderate or intense). In the non-invasive lesions, the presence of Ki-67-positive cells in the luminal layer of the epithelium was evaluated qualitatively as positive or negative. The correlation between the immunolabeling for Ki-67 and the histological diagnosis showed highly significant differences between BPH and CAR, LGPIN and CAR and HGPIN and CAR, with no significant differences being found among the other groups. Analysis of the immunolabeling in luminal cells of non-invasive lesions showed an increase in accordance with the increase in the degree of histological lesion, the greatest percentage being obtained in the HGPIN lesions (88.0%), with significant differences among all the groups. Bearing in mind that Ki-67 is a prognostic biomarker for cell proliferation, our results demonstrating the immunolabeling of Ki-67 in the luminal compartment of non-invasive lesions having the potential to evolve to malignancy, may have prognostic implications.     

Congenital aortic stenosis: follow-up of surgical management

We have reviewed the cases operated upon for correction of congenital aortic stenosis at l''Hôpital Ste-Justine between 1959 and 1969.Twenty-five of the 26 patients were readmitted for complete clinical, radiological and hemodynamic investigation. Fourteen had a valvular stenosis, eight a diaphragmatic subvalvular lesion, and three had mixed lesions.The results lead us to believe that the surgical treatment of this malformation is justified. The indications for surgery must take into account all available clinical, radiological, electrocardiographic and hemodynamic data.     

Effects of pectin-induced passive linkage of gastric H+ on the gastric acid secretion on the development of ethanol- and salicylate-induced gastric mucosal lesions in rats.

The aim of this study was to evaluate the effects of intragastrically given pectin-induced physicochemical properties and actions on active gastric acid secretion and on the development of ethanol- and aspirin-induced gastric mucosal lesions. The observations were carried out on CFY-strain rats, fasted for 24 h before the experiments with water ad libitum. The observations were carried out in two experimental series. A) The gastric mucosal lesions were produced by intragastrically given 96% ethanol or aspirin prepared with 0.2 M HCl. Different doses of pectin (100, 50 and 25 mg x kg(-1), respectively) were administered intragastrically 30 min before giving necrotizing agents. The number of gastric lesions was noted 1 h after the administration, while the severity of gastric mucosal lesions was scored by semi-quantitative scale. B) The effects of pectin were studied on the volume and H+ secretion of the stomach in 4-h pylorus-ligated rats. It has been found that: 1) the gastric mucosal lesions could be produced in 100% of rats by the application of both necrotizing agents. 2) Pectin in doses of 50-100 mg x kg(-1) increased the number of gastric mucosal lesions in both models, while no increase was produced by the application of 25-mg x kg(-1) dose. 3) The severity of mucosal lesions increased significantly after the administration of all doses of pectin. 4) The pectin-induced increase of gastric lesions (number) showed a dose-response effect. 5) The pectin produced a significant increase in the volume of gastric secretion and gastric H+ secretion. It has been concluded that: a) pectin-induced physicochemical changes are able to enhance the aggression to gastric mucosa produced by ethanol and aspirin; b) a positive correlation exists between the linkage of H+ to pectin and significant active metabolic response in the rat stomach; c) pectin alone stimulates the active metabolic process of the gastric H+ secretion.     

The effects of a glycerin-based blood analog on the testing of bioprosthetic heart valves

Detailed comparisons of aortic valvular flow using saline, with that using a glycerin-based blood analog in a pulse duplicator are reported. The experiments were carried out to determine whether exposure to glycerin caused stiffening of bioprosthetic valve leaflets. For two pericardial bioprostheses and for a mechanical valve we observed a fluid-dependent systolic volume flow, a fluid-dependent regurgitation volume, and fluid-dependent systolic pressure differences. Volume flow changes, both forward and reverse, are independent of valve type. The observed pressure differences, while proportional to fluid density for the mechanical valve, are fluid dependent in a more complicated way for the pericardial valves. However, no trend of changing valvular performance was observed over as much as 80 days of glycerin exposure, indicating that it is unlikely that the fluid-dependent performance was caused by glycerin absorption by the valve leaflets. We conclude that valid performance comparisons between mechanical and bioprosthetic valves may be made using a glycerin-based fluid. Furthermore, it appears that any detailed analysis of the physical mechanisms of valvular flow dissipation will require a properly matched blood analog.     

What's new in cardiovascular surgery

Advances in the treatment of congenital cardiovascular lesions have led to a renewed interest in the treatment of acquired heart disease. Although this field could best be served by the perfection of the extracorporal heart, such devices are as yet not ready for human application. Meanwhile, various approaches through the ventricles and left atrium have been developed to treat valvular stenosis. Refinements in diagnostic tests and in methods of physiological investigation are of great aid in the proper evaluation of patients.     

Comparative Evaluation of Rheumatic Activity—A Study of Relationship Between Histologic Changes and Serologic Test Results in Cardiac Surgical Patients

Atrial or ventricular myocardium from patients with surgically corrected rheumatic valvular disease was studied for rheumatic lesions in 86 cases. Histologically active Aschoff bodies were found in 20 per cent of the cases. A slight, but statistically not significant relationship was demonstrated in comparison of elevated serologic tests for rheumatic activity with the presence of Aschoff bodies.     

Mitomycin C, 4-nitroquinoline-1-oxide and ethyl methanesulfonate induced long-lived lesions in DNA which result in SCEs during successive cell cycles in human lymphocytes

The present study was carried out in order to analyze how persistent the lesions in DNA are which elicit sister-chromatid exchanges (SCEs), induced by three different chemical agents, mitomycin C (MMC), 4-nitroquinoline-1-oxide (4NQO) and ethyl methanesulfonate (EMS), in proliferating human lymphocytes. Cells were exposed to the mutagens for 1 h just before starting bromodeoxyuridine substitution and SCEs were examined in third-cycle metaphases showing three-way-differential staining, by means of our previously standardized method. The results show that, in spite of the fact that these three compounds have different modes of action, the lesions induced by all of them seem to be capable of persisting in DNA and eliciting SCEs for at least three successive cell cycles.     

Genetic predisposition to calcific aortic stenosis and mitral annular calcification

Valvular calcification precedes the development of valvular stenosis and may represent an important early phenotype for valvular heart disease. It is known that development of valvular calcification is likely to occur among members of a family. However, the knowledge about the role of genomic predictive markers in valvular calcification is still elusive. Aims of this review are to assess the impact of gene polymorphisms on risk and severity of aortic stenosis and mitral annular calcification. According to the results of the investigations carried out, all polymorphisms may be divided into the three groups conferring the level of evidence of their association with valvular stenosis. It is possible to conclude that apoB (XbaI, rs1042031, and rs6725189), ACE (rs4340), IL10 (rs1800896 and rs1800872), and LPA (rs10455872) gene polymorphisms may be associated with valvular calcific stenosis with a relatively high level of evidence. A number of other polymorphisms, such as PvuII polymorphism within the ORα gene, rs1042636 polymorphism within the CaSR gene, rs3024491, rs3021094, rs1554286, and rs3024498 polymorphisms within the IL10 gene, rs662 polymorphism within the PON1 gene, rs2276288 polymorphism within the MYO7A gene, rs5194 polymorphism within the AGTR1 gene, rs2071307 polymorphism within the ELN gene, rs17659543 and rs13415097 polymorphisms within the IL1F9 gene may correlate with a risk of calcific valve stenosis with moderate level of evidence. Finally, rs1544410 polymorphism within the VDR gene, E2 and E4 alleles within the apoE gene, rs6254 polymorphism within the PTH gene, and rs1800871 polymorphism within the IL10 gene may be associated with aortic stenosis with low level of evidence.     

腱鞘巨细胞瘤的影像学诊断

目的:分析腱鞘巨细胞瘤的影像学表现以提高对该病的认识。方法:回顾性分析10例经手术病理证实的腱鞘巨细胞瘤的X线平片及MRI表现,其中10例行X线平片检查,8例行MRI平扫及增强扫描。结果:X线平片显示局部稍高密度软组织肿块影,邻近骨质未见明显异常或轻度侵蚀破坏。MRI表现为相应部位软组织肿块影,T1WI多呈较低信号,内可见条片状更低信号影,增强后强化明显;T2WI呈高低混杂信号影;病灶与邻近肌腱关系密切,其中一例包绕指屈肌腱蔓状生长;局部骨皮质可受侵。结论:腱鞘巨细胞瘤的影像学表现具有一定的特征性。     

Survey of Alimentary Radiology Findings in the North-east of Scotland Region (1967-70)

This report describes a survey of all barium contrast radiological examinations carried out in the years 1967-70 by the unit that serves 99% of the adult population of North-east Scotland. The survey method used yields useful estimates, not otherwise available, of the occurrence of some forms of alimentary lesions within a whole community. Rates of occurrence by age and sex were recorded for all lesions. The data on peptic ulceration, were compared with those from South-east and from North England, and this showed that duodenal, but not gastric, ulceration is much commoner in North-east Scotland. Occurrence rates for most lesions have been nearly unchanged throughout the four years of survey. The data provide a measure of the work load for these radiological examinations for a given population.     

Screening for cervical cancer: a new scope for general practitioners? Results of the first year of colposcopy in general practice.

A survey was carried out over one year of all the women who attended a colposcopy clinic in a general practice. During the year 1254 women underwent cytological screening in the practice and 197 of these underwent colposcopy. Of 79 women with abnormal smears that suggested cervical intraepithelial neoplasia, 62 (79%) were confirmed by biopsy to have cervical premalignancy. In addition, the remaining 118 women with normal or inflammatory smears underwent colposcopy either because of their history or because they requested the investigation. A general underestimate of cervical intraepithelial neoplasia when cytology alone was used was discovered. Seven out of 28 women with inflammatory smears were found to have important cervical premalignancy. Mildly dyskaryotic smears led to a falsely reassuring estimate of the degree of severity of cervical lesions. Seven out of 13 patients who underwent colposcopy because they were thought to be at high risk of neoplasia because of a history of genital warts, unexplained recurrent cystitis, heroin abuse, or immunosuppression had cervical intraepithelial neoplasia proved at biopsy. This report shows that both in screening for and in the follow up of known cervical disease a normal smear cannot guarantee normal pathology. Diagnostic colposcopy is a valuable complementary investigation that could be carried out in a general practice.     

Aortic Valvular Replacement: Clinical Experience With 13 Cases

Acquired aortic disease is now currently corrected by total prosthetic replacement of the aortic valve. Aortic valve replacement was performed in 13 cases at the Montreal Heart Institute in 1963. In the first four cases, Bahnson aortic leaflets were used; in the remaining nine, the Starr-Edwards semirigid aortic valve prosthesis. The surgical technique employed is described. There were two operative deaths and two late deaths. The results have been excellent in all of the survivors but one. They have returned to full-time activities and four of them to strenuous physical work. It is the contention of the authors that aortic valve replacement is a surgical procedure with acceptable risks, offering hope for a near-normal life to patients crippled by severe aortic valvular lesions.     

Distribution of radiation induced lesions in human chromosomes and dose-effect relation analysed with G-banding

Summary Human female lymphocytes were exposed to X-rays in vitro at 7 different doses between 40–280 R. In 830 metaphases chromosome analyses were carried out with either conventional staining or G-banding, respectively. 486 breakpoints are non-randomly distributed between chromosomes and chromosome arms. An excess of lesions was present in chromosomes 1 and 5 or in lp. 85% of the lesions were located in G-negative bands (pale G-bands). 29% of all lesions appeared in either the last terminal pale band (21%) or in the centromere region (8%).With regard to an application of G-banding for a biological dose-estimation, the dose-response relations of dic and ace were analysed. Although G-banding enables detailed analysis of the whole karyotype it cannot be recommended for cytogenetic routine analyses in medical radioprotection monitoring, without suitable automated scoring techniques. Dose estimations based on the frequency of dic and carried out with conventional staining cannot be essentially improved at present with banding. Nevertheless, by banding criteria for a correct evaluation of other aberration types, e.g. ace, can be provided. This is a prerequisite for the calculation of representative dose-effect curves.     

Islet transplantation in experimental diabetes of the rat. XII. Effect on diabetic retinopathy. Morphological findings and morphometrical evaluation

Digest-preparations of rat retinal vasculature were examined with respect to single capillary alterations and diffuse changes in cellular composition. Retinas of streptozotocin-diabetic rats revealed single micro-aneurysms, degenerated capillaries, strand formation, microthromboses and further lesions, occurring sooner than previously described. A severe loss of pericytes and a slight increase in endothelial cell number resulting in an increase in E/P-ratio were observed, all effects becoming more pronounced with longer duration of diabetes. Syngeneic islet transplantation could prevent all of the described alterations if carried out soon after diabetes induction. If performed six months later it was able to almost restore the normal cellular composition while pathomorphological lesions could be arrested or reversed only partially.     

The response of skeletal muscle to alcohol abuse: Gender differences

A gender analysis has been carried out to analyze changes in intracellular signaling pathways that lead to the development of chronic alcoholic myopathy. It is known that acute or chronic alcohol intoxication can result in alcohol-induced lesions in skeletal muscles. Chronic alcoholic myopathy occurs much more frequently and can develop either independently or in combination with other forms of alcoholic disease (liver and heart lesions, malabsorption syndrome, or alcohol polyneuropathy). This disease is manifested by atrophy of skeletal muscles and a performance decrement. Most of the studies on the pathogenesis of chronic alcoholic myopathy have been carried out on male patients. Studies on alcoholic myopathy-induced muscle damage in females have not been previously reported.     

In vitro nucleotide misinsertion opposite the oxidized guanosine lesions spiroiminodihydantoin and guanidinohydantoin and DNA synthesis past the lesions using Escherichia coli DNA polymerase I (Klenow fragment)

The low redox potential of 8-oxo-7,8-dihydroguanine (OG), a molecule regarded as a marker of oxidative damage in cells, makes it an easy target for further oxidation. Using a temperature-dependent method of synthesis, the oxidation products of OG, guanidinohydantoin (Gh) and/or its isomer iminoallantoin (Ia) as well as spiroiminodihydantoin (Sp), have been site-specifically incorporated into DNA oligomers. Single nucleotide insertion and primer extension experiments using Escherichia coli Kf exo(-) DNA polymerase were carried out under "standing start" and "running start" conditions in various sequence contexts. dAMP and dGMP were found to be inserted opposite these OG oxidation products. Steady-state kinetic studies show that the Gh/Ia.G base pair yields a lower K(m) value compared to the Sp.G pair or X.A (X = Gh/Ia or Sp). Running start experiments using oxidized and unoxidized OG-containing templates showed enhanced full extension in the presence of all four dNTPs. A sequence preference for efficiency of extension was found when Gh/Ia and Sp are present in the DNA template, possibly leading to primer misalignment. Full extension is more efficient for the templates containing two Gs immediately 3' to the lesions compared to two As. Although these lesions cause a significant block for DNA elongation, results show that they are more easily bypassed by the polymerase when situated in the appropriate sequence context. UV melting studies carried out on duplexes mimicking the template/primer systems were used to characterize thermal stability of the duplexes. These experiments suggest that both Gh/Ia and Sp destabilize the duplex to a much greater extent than OG, with Sp being most severe.     

Natriuretic peptide system gene expression in human coronary arteries.

The natriuretic peptides (NPs) ANF, BNP, and CNP have potent anti-proliferative and anti-migratory effects on vascular smooth muscle cells (SMCs). These properties make NPs relevant to the study of human coronary atherosclerosis because vascular cell proliferation and migration are central to the pathophysiology of atherosclerosis. However, the existence and cytological distribution of NPs and their receptors in human coronary arteries remain undetermined. This has hampered the development of hypotheses regarding the possible role of NPs in human coronary disease. We determined the pattern of expression of NPs and their receptors (NPRs) in human coronary arteries with atherosclerotic lesions classified by standard histopathological criteria as fatty streak/early atherosclerotic lesions, intermediate plaques, or advanced lesions. The investigation was carried out using a combination of immunocytochemistry (ICC), in situ hybridization (ISH), and semi-quantitative polymerase chain reaction (PCR). Both by ICC and ISH, ANF was found in the intimal and medial layers of all lesions. BNP was highly expressed in advanced lesions where it was particularly evident by a strong ISH signal but weak ICC staining. CNP was demonstrable in all types of lesions, giving a strong signal by ISH and ICC. This peptide was particularly demonstrable in the endothelium, as well as in the SMCs of the intima, media, and vasa vasorum of the adventitia and in macrophages. By ISH, NPR-A was not detectable in any of the lesions but both NPR-B and NPR-C were found in the intimal and the inner medial layers. By RT-PCR, mRNA levels of all NPs tended to be increased in macroscopically diseased arteries, but only the values for BNP were significantly so. No significant changes in NPR mRNA levels were detected by PCR. In general, the signal intensity given by the NPs and their receptors by ICC or ISH appeared dependent on the type of lesion, being strongest in intermediate plaques and decreasing with increasing severity of the lesion. This study constitutes the first demonstration of NPs and NPR mRNAs in human coronary arteries and supports the existence of an autocrine/paracrine NP system that is actively modulated during the progression of atherosclerotic coronary disease. This suggests that the coronary NP system is involved in the pathobiology of intimal plaque formation in humans and may be involved in vascular remodeling.     

Effects of pectin-induced passive linkage of gastric H on the gastric acid secretion and on the development of ethanol- and salicylate-induced gastric mucosal lesions in rats

The aim of this study was to evaluate the effects of intragastrically given pectin-induced physicochemical properties and actions on active gastric acid secretion and on the development of ethanol- and aspirin-induced gastric mucosal lesions. The observations were carried out on CFY-strain rats, fasted for 24 h before the experiments with water ad libitum. The observations were carried out in two experimental series. A) The gastric mucosal lesions were produced by intragastrically given 96% ethanol or aspirin prepared with 0.2 M HCl. Different doses of pectin (100, 50 and 25 mg.kg^–1, respectively) were administered intragastrically 30 min before giving necrotizing agents. The number of gastric lesions was noted 1 h after the administration, while the severity of gastric mucosal lesions was scored by semi-quantitative scale. B) The effects of pectin were studied on the volume and H⁺ secretion of the stomach in 4-h pylorus-ligated rats. It has been found that: 1) the gastric mucosal lesions could be produced in 100% of rats by the application of both necrotizing agents. 2) Pectin in doses of 50–100 mg.kg^–1 increased the number of gastric mucosal lesions in both models, while no increase was produced by the application of 25-mg.kg^–1 dose. 3) The severity of mucosal lesions increased significantly after the administration of all doses of pectin. 4) The pectin-induced increase of gastric lesions (number) showed a dose-response effect. 5) The pectin produced a significant increase in the volume of gastric secretion and gastric H⁺ secretion. It has been concluded that: a) pectin-induced physicochemical changes are able to enhance the aggression to gastric mucosa produced by ethanol and aspirin; b) a positive correlation exists between the linkage of H⁺ to pectin and significant active metabolic response in the rat stomach; c) pectin alone stimulates the active metabolic process of the gastric H⁺ secretion.     

Time-dependent biaxial mechanical behavior of the aortic heart valve leaflet

Despite continued progress in the treatment of aortic valve (AV) disease, current treatments continue to be challenged to consistently restore AV function for extended durations. Improved approaches for AV repair and replacement rests upon our ability to more fully comprehend and simulate AV function. While the elastic behavior the AV leaflet (AVL) has been previously investigated, time-dependent behaviors under physiological biaxial loading states have yet to be quantified. In the current study, we performed strain rate, creep, and stress-relaxation experiments using porcine AVL under planar biaxial stretch and loaded to physiological levels (60 N/m equi-biaxial tension), with strain rates ranging from quasi-static to physiologic. The resulting stress-strain responses were found to be independent of strain rate, as was the observed low level of hysteresis ( approximately 17%). Stress relaxation and creep results indicated that while the AVL exhibited significant stress relaxation, it exhibited negligible creep over the 3h test duration. These results are all in accordance with our previous findings for the mitral valve anterior leaflet (MVAL) [Grashow, J.S., Sacks, M.S., Liao, J., Yoganathan, A.P., 2006a. Planar biaxial creep and stress relaxatin of the mitral valve anterior leaflet. Annals of Biomedical Engineering 34 (10), 1509-1518; Grashow, J.S., Yoganathan, A.P., Sacks, M.S., 2006b. Biaxial stress-stretch behavior of the mitral valve anterior leaflet at physiologic strain rates. Annals of Biomedical Engineering 34 (2), 315-325], and support our observations that valvular tissues are functionally anisotropic, quasi-elastic biological materials. These results appear to be unique to valvular tissues, and indicate an ability to withstand loading without time-dependent effects under physiologic loading conditions. Based on a recent study that suggested valvular collagen fibrils are not intrinsically viscoelastic [Liao, J., Yang, L., Grashow, J., Sacks, M.S., 2007. The relation between collagen fibril kinematics and mechanical properties in the mitral valve anterior leaflet. Journal of Biomechanical Engineering 129 (1), 78-87], we speculate that the mechanisms underlying this quasi-elastic behavior may be attributed to inter-fibrillar structures unique to valvular tissues. These mechanisms are an important functional aspect of native valvular tissues, and are likely critical to improve our understanding of valvular disease and help guide the development of valvular tissue engineering and surgical repair.