Whole-slide imaging and automated image analysis: considerations and opportunities in the practice of pathology.

Digital pathology, the practice of pathology using digitized images of pathologic specimens, has been transformed in recent years by the development of whole-slide imaging systems, which allow for the evaluation and interpretation of digital images of entire histologic sections. Applications of whole-slide imaging include rapid transmission of pathologic data for consultations and collaborations, standardization and distribution of pathologic materials for education, tissue specimen archiving, and image analysis of histologic specimens. Histologic image analysis allows for the acquisition of objective measurements of histomorphologic, histochemical, and immunohistochemical properties of tissue sections, increasing both the quantity and quality of data obtained from histologic assessments. Currently, numerous histologic image analysis software solutions are commercially available. Choosing the appropriate solution is dependent on considerations of the investigative question, computer programming and image analysis expertise, and cost. However, all studies using histologic image analysis require careful consideration of preanalytical variables, such as tissue collection, fixation, and processing, and experimental design, including sample selection, controls, reference standards, and the variables being measured. The fields of digital pathology and histologic image analysis are continuing to evolve, and their potential impact on pathology is still growing. These methodologies will increasingly transform the practice of pathology, allowing it to mature toward a quantitative science. However, this maturation requires pathologists to be at the forefront of the process, ensuring their appropriate application and the validity of their results. Therefore, histologic image analysis and the field of pathology should co-evolve, creating a symbiotic relationship that results in high-quality reproducible, objective data.

Transglutaminase 1-deficient recessive lamellar ichthyosis associated with a LINE-1 insertion in Jack Russell terrier dogs.

BACKGROUND: Congenital, nonepidermolytic cornification disorders phenotypically resembling human autosomal recessive ichthyosis have been described in purebred dog breeds, including Jack Russell terrier (JRT) dogs. One cause of gene mutation important to humans and dogs is transposon insertions. OBJECTIVES: To describe an autosomal recessive, severe nonepidermolytic ichthyosis resembling lamellar ichthyosis (LI) in JRT dogs due to insertion of a long interspersed nucleotide element (LINE-1) in the transglutaminase 1 (TGM1) gene. METHODS: Dogs were evaluated clinically, and skin samples were examined by light and electron microscopy. Phenotypic information and genotyping with a canine microsatellite marker suggested TGM1 to be a candidate gene. Genomic DNA samples and cDNA generated from epidermal RNA were examined. Consequences of the mutation were evaluated by Western blotting, quantitative reverse transcription-polymerase chain reaction (RT-PCR) and enzyme activity from cultured keratinocytes. RESULTS: Affected dogs had generalized severe hyperkeratosis. Histological examination defined laminated to compact hyperkeratosis without epidermolysis; ultrastructurally, cornified envelopes were thin. Affected dogs were homozygous for a 1980-bp insertion within intron 9 of TGM1. The sequence of the insertion was that of a canine LINE-1 element. Quantitative RT-PCR indicated a significant decrease in TGM1 mRNA in affected dogs compared with wild-type. TGM1 protein was markedly decreased on immunoblotting, and membrane-associated enzyme activity was diminished in affected dogs. CONCLUSIONS: Based on morphological and molecular features, this disease is homologous with TGM1-deficient LI in humans, clinically models LI better than the genetically modified mouse and represents its first spontaneous animal model. This is the first reported form of LI due to transposon insertion.

Suppression of anchorage-independent growth and matrigel invasion and delayed tumor formation by elevated expression of fibulin-1D in human fibrosarcoma-derived cell lines.

Using differential display, we identified an mRNA that is markedly down-regulated in cell line 6A/SB1, derived from a fibrosarcoma formed in an athymic mouse following injection of carcinogen-transformed MSU-1.1 cells. The nontumorigenic parental cell strain, MSU-1.1, expresses high levels of this mRNA. Sequencing of the corresponding cDNA fragment revealed that it corresponded to an expressed sequence tag, which ultimately led to its identification as the fibulin-1D gene. Fibulin-1 is a cysteine-rich, calcium-binding extracellular matrix and plasma protein, which has four isoforms, A-D, derived from alternative splicing. Northern and Western blotting analysis of 16 cell lines established from tumors formed in athymic mice by MSU-1.1-derived cell strains independently transformed in culture showed that 44% exhibited low level or lack of expression of fibulin-1D mRNA and protein. In a similar analysis of 15 malignant cell lines derived from patients, 80% showed low level or no expression. To study the role of fibulin-1D in transformation, we transfected 6A/SB1 cells and a human fibrosarcoma-derived cell line (SHAC) with a fibulin-1D cDNA expression construct. Transfectants displaying high levels of fibulin-1D were isolated and characterized. Elevated expression of fibulin-1D led to reduced ability to form colonies in soft agar and reduced invasive potential as tested in a matrigel in vitro invasion assay. Furthermore, expression of fibulin-1D resulted in a markedly extended latency in tumor formation in athymic mice. These results indicate that low expression of fibulin-1D plays a role in tumor formation and invasion.

Comparative sequence analysis and radiation hybrid mapping of two epidermal type II keratin genes in the dog: keratin 1 and keratin 2e.

In order to extend knowledge of the process of cornification across species and to be better able to recognize inborn errors in keratin synthesis in the dog, we describe the organization and chromosome mapping of canine KRT1 and KRT2E and compare these results to human and murine sequence data. The coding regions of KRT1 and KRT2E are 1,860 bp and 1,902 bp respectively, distributed over nine exons. Both genes are localized on the canine radiation hybrid map to chromosome 27 in the type II keratin gene cluster close to polymorphic markers. These genes are highly conserved across species and based on both genomic and amino acid sequences, canine KRT1 and KRT2E share greater homology with humans than with mice.

T-cell receptor gene rearrangement in canine mycosis fungoides: further support for a canine model of cutaneous T-cell lymphoma.

Canine cutaneous T-cell lymphoma (CTCL) is a morphologic and immunophenotypic simulant of human mycosis fungoides (MF) characterized by an infiltrate of atypical, hyperconvoluted, epidermotropic T cells. To further support our hypothesis that canine MF is a useful model for the study of human CTCL, we have used Southern blotting to search for clonal T-cell proliferations in canine MF. Cellular DNA was extracted from normal dog buffy coat cells (n = 8), lesional canine MF skin (n = 8), canine MF buffy coat cells (n = 7), normal dog skin (n = 3), and normal human buffy coat cells (n = 5), digested with a panel of restriction enzymes and Southern blotted onto nylon membranes. All cases of canine MF were also immunophenotyped with anti-canine monoclonal antibodies to CD4, CD8, CD18, CD45RA, canine class II, T-cell activation antigens, and pan-B-cell antigens. Normal dogs gave reproducible digestion patterns in blood and skin, which differed from the human germline patterns when probed with a human T-cell receptor (TCR), beta chain constant region (C beta) cDNA. Common germline bands between the species included the 3.5-kb Eco RI, 3.4-kb Bam HI, 5.4-kb Sac I. These results confirmed that the TCR-beta gene is evolutionarily conserved between dog and man. Immunostaining revealed that 3/7 cases were CD4+ canine CTCL and 4/7 were CD8+ canine CTCL. Rearranged bands, deletion of germline bands, as well as minor alterations in electrophoretic mobility were observed in lesional DNA from seven of eight cases of canine MF, with at least two restriction digests in each case. Dog rearrangements were best detected with Bgl II, Eco RI, Eco RV, and Sac I, whereas deletions were detected with Bgl II, Sac I, Eco RV, and Bam HI. These studies demonstrate the presence of clonal TCR rearrangement in canine MF, further supporting the similarity of this tumor to human MF and its role as an animal model of CTCL.

Full-thickness skin grafts from flaky skin mice to nude mice: maintenance of the psoriasiform phenotype.

Flaky skin (fsn) is an autosomal recessive mouse mutation with papulosquamous disease features similar to human psoriasis. In fsn/fsn skin, one sees marked acanthosis and hyperkeratosis with focal parakeratosis, subcorneal pustules, dermal capillary dilation, and a marked diffuse dermal infiltration of mixed inflammatory cells, predominantly lymphocytes. To determine if these pathologic features are a characteristic of the skin or a chronic autoimmune attack, we placed full-thickness skin grafts from affected homozygous (fsn/fsn) and normal littermate control (+/?) mice on the dorsal skin of genetically athymic nude (nu/nu) mice. After 10 weeks of observation, the grafts maintained the histologic phenotype of the donor animal. In the fsn/fsn grafts, there was persistence of both epidermal proliferation and dermal inflammation, characteristics of the mutation. The fsn/fsn phenotype was also confirmed by immunohistochemical evaluation for specific mouse keratinocyte marker expression. Based on tritiated thymidine uptake, we found DNA synthesis rates elevated threefold or more in fsn/fsn epidermis compared to littermate control mouse skin. Elevated rates of DNA synthesis remained a feature of the fsn/fsn grafts but not that of littermate control skin grafts. This study demonstrates that the psoriasiform phenotype of this mouse mutation can persist independent of the host thymic-derived immune system.

Digging up the canine genome--a tale to wag about.

There is incredible morphological and behavioral diversity among the hundreds of breeds of the domestic dog, CANIS FAMILIARIS. Many of these breeds have come into existence within the last few hundred years. While there are obvious phenotypic differences among breeds, there is marked interbreed genetic homogeneity. Thus, study of canine genetics and genomics is of importance to comparative genomics, evolutionary biology and study of human hereditary diseases. The most recent version of the map of the canine genome is comprised of 3,270 markers mapped to 3,021 unique positions with an average intermarker distance of approximately 1 Mb. The markers include approximately 1,600 microsatellite markers, about 1,000 gene-based markers, and almost 700 bacterial artificial chromosome-end markers. Importantly, integration of radiation hybrid and linkage maps has greatly enhanced the utility of the map. Additionally, mapping the genome has led directly to characterization of microsatellite markers ideal for whole genome linkage scans. Thus, workers are now able to exploit the canine genome for a wide variety of genetic studies. Finally, the decision to sequence the canine genome highlights the dog's evolutionary and physiologic position between the mouse and human and its importance as a model for study of mammalian genetics and human hereditary diseases.

Characterization of natural occurring Pneumocystis carinii pneumonia in pigs by histopathology, electron microscopy, in situ hybridization and PCR amplification.

Macroscopic, histologic, ultrastructural, microbiologic, in situ hybridization (ISH) and PCR detection results in three 8-week-old pigs naturally infected with Pneumocystis carinii (PC) are described. All animals had a nonsuppurative interstitial pneumonia and intra-alveolar Pneumocystis organisms with foamy eosinophilic and PAS positive appearance. Ultrastructurally, PC trophozoites and cysts were observed in pigs No. 2 and No. 3, with the former being much more numerous. PC organisms were located on the alveolar surface or within the alveolar septa. Trophozoites had numerous filopodia and were thick-walled. Cysts had no or few filopodia, were thick-walled and contained intracystic bodies. Using non-isotopic ISH on formalin-fixed, paraffin-embedded lung tissue sections, PC DNA from pigs No. 2 and No. 3 hybridized with a probe specific for PC ribosomal RNA (rRNA). Using primers specific for mitochondrial rRNA gene (pAZ102-E/pAZ102-H), and for the internal transcriber spacers of ribosomal gene of PC, PCR methods amplified a product in the lung of pigs No. 2 and No. 3 using either frozen or formalin-fixed and paraffin-embedded lung tissue. DNA from Pig No. 1 samples did not amplify with any primer. This is the first time that molecular biology techniques (in situ hybridization and PCR) have been applied to the study of porcine pneumocystosis.

Polytetrafluoroethylene versus autogenous vein grafts for vascular reconstruction in contaminated wounds.

A high incidence of dissolution and disruption of infected autogenous vein grafts has been demonstrated. PTFE, on the other hand, has been shown to maintain its structural integrity in the presence of well-entrenched infection, with a relatively small incidence of anastomotic disruption related to host artery necrosis. In addition, PTFE performed as well as autogenous vein when antibiotics were administered. Therefore, PTFE graft material is advocated for controlled clinical trials in patients with contaminated vascular injuries.

Malignant transformation of human fibroblasts by ionizing radiation.

As one step in developing an assay for quantifying the induction of malignant transformation of human cells by ionizing radiation, we exposed cells from a non-tumorigenic, infinite life span, near-diploid fibroblast strain MSU-1.1 to 4.35 Gy 60Co radiation and assayed them for focus formation. The mean frequency of foci in the irradiated population was 6 x 10(-7) cells assayed. No foci were found in the control cells. Of four focus-derived cell strains studied in detail, two produced malignant tumours within 3-7 weeks. The other two did not produce tumours during the 12-month period of study. The tumours from one strain were classified as sarcomas composed exclusively of spindle-shaped cells. Tumours from the other strain were sarcomas consisting of a mixed population of round and spindle cells. Immunoprecipitation analysis of the status of the p53 gene in the focus-derived strains, using a mutant-specific anti-body (Pab240) and an antibody that recognizes both mutant and wild-type p53 protein (Pab421), showed that the tumorigenic strains were completely devoid of p53 protein. One non-tumorigenic strain expressed wild-type p53 protein, and the other expressed a lower molecular weight form of the protein. Karyotypic analysis showed that the tumour-derived cells from one tumorigenic strain had lost one copy of chromosome 6, 14, 16 and 17. The tumour-derived cells from the second strain had lost one copy of chromosome 7, 13, 14 and 17 and part of chromosome 6, as well as part of the other copy of chromosome 7 and 17. These results suggest that the common loss of one copy of chromosome 14, 17 and part of 6 plays a causal role in the malignant transformation of these cells. Furthermore, the results indicate that it will be possible to develop a system that uses near-diploid human fibroblasts to quantify radiation-induced malignant transformation.

A heritable keratinization defect of the superficial epidermis in norfolk terriers.

Although well-characterized in man, abnormal cornification secondary to heritable superficial keratin defects is rarely reported in animals. This report describes a mild cornification defect in seven related Norfolk terrier dogs. Lesions were present at birth and pedigree analysis suggested an autosomal recessive mode of inheritance. The affected dogs had hyperpigmented skin with scaling following mild trauma. The lesions were generalized but most prominent in the glabrous skin of the axillary and inguinal regions-areas where the epidermis is not protected by hair and is subject to frequent trauma. The most striking histological change was vacuolation in the upper epidermis, which often resulted in epidermolysis and blister formation. All of the affected dogs showed similar gross and histological changes. Ultrastructural changes included abnormal keratin filament clumping, prominent clear spaces in the cytoplasm of suprabasal keratinocytes, and abnormal keratohyaline granules. Immunohistochemical labelling for keratin 10 demonstrated a lack of expression in the superficial epidermis of affected dogs. All of the morphological changes noted in the Norfolk terriers were consistent with a mild form of a heritable defect in superficial keratin synthesis.

The effects of thyroid hormones on the skin of beagle dogs.

The effects of hypothyroidism on canine skin were determined by comparing morphologic, morphometric, and hair cycle differences in skin biopsy samples from 3 groups of age- and gender-matched Beagle dogs: (1) euthyroid dogs; (2) dogs made hypothyroid by administration of 131I; and (3) dogs made hypothyroid and maintained in a euthyroid state by treatment with synthetic thyroxine. After 10 months of observation, there was slower regrowth of hair 2 months after clipping in the untreated-hypothyroid dogs. Untreated-hypothyroid dogs had a greater number of follicles in telogen and fewer hair shafts (ie, a greater number of hairless telogen follicles) than did the control group. The control dogs had a greater number of telogen follicles but the same number of hair shafts as the treated-hypothyroid group. Treated-hypothyroid dogs had the greatest number of follicles in the growing stage of the hair cycle (anagen). This study suggests that, at least in Beagles, induced hypothyroidism does not affect the pelage as dramatically as has been described in naturally occurring disease. This is because normal Beagles retain hair shafts in follicles for long periods, and the alopecia of hypothyroidism appears to evolve slowly because of the prolongation of this haired telogen stage. The evaluation of thyroxine-treated hypothyroid dogs demonstrates that thyroid hormone supplementation of Beagle dogs with induced hypothyroidism stimulates hair growth.

Plasma alpha- and beta-mannosidase activities in caprine beta-mannosidosis.

Plasma alpha- and beta-mannosidase activities were measured in goats with beta-mannosidosis, a recently discovered, inherited deficiency of the glycohydrolase beta-D-mannosidase. Plasma beta-mannosidase activity in the affected animals was zero at 1 and 4 weeks after they were born. Enzyme values of age-matched, unaffected goats were between 66 and 222 nmol/hr/ml of plasma, alpha-Mannosidase activities were similar in both affected and unaffected animals. This investigation indicates that deficiency of plasma beta-mannosidases activity may be diagnostic of beta-mannosidosis.

Measurement of caprine plasma beta-mannosidase with a p-nitrophenyl substrate.

Experimental conditions for measuring caprine plasma beta-D-mannosidase activity are described with p-nitrophenyl-beta-D-mannopyranoside as a substrate. The plasma enzyme was stable for 3 months at -20 C or 1 week at 4 C. The optimal pH for activity was 5.0 in citrate-phosphate or acetate buffer. Enzyme activity was linear with time up to 24 hours at 37 C, but incubation of plasma at 56 C for 5 minutes resulted in loss of all activity. The apparent Michaelis-Menten constant (Km) for the plasma enzyme was 10.0 mM. Plasma beta-mannosidase from clinically normal and beta-mannosidosis carrier goats did not differ with respect to pH optimum, heat stability, or Km. The coefficient of variation for the assay, determined by assaying a plasma pool over a 3-month period, was 10.7% (mean: 115 nmole of p-nitrophenol formed/hour/ml of plasma). The assay described can be used to evaluate plasma beta-mannosidase measurements as a test for detecting carriers of caprine beta-mannosidosis, a newly described lysosomal storage disease.

Caprine alpha- and beta-mannosidase activities: effects of age, sex, and reproductive status and potential use in heterozygote detection of beta-mannosidosis.

Effects of age, sex, and reproductive status on caprine plasma alpha- and beta-mannosidase activities were studied. The potential use of these plasma assays was evaluated for heterozygote detection of caprine beta-mannosidosis in populations of control goats and a breeding herd composed of known and putative heterozygotes for beta-mannosidosis. In the control population, the mean plasma alpha- and beta-mannosidase activities decreased in both sexes with maturity. Male goats generally had higher plasma mannosidase activity than did females, and plasma beta-mannosidase activity was affected by the reproductive status of the goats examined. Although putative carriers in the beta-mannosidosis breeding herd could not be differentiated from age- and sex-matched controls, known carriers had plasma beta-mannosidase values intermediate between those of control and affected goats. The lack of any correlation between alpha- and beta-mannosidase activities excluded alpha-mannosidase as a reference enzyme for carrier detection, but there are still differences between known carriers and the control population with respect to the alpha- and beta-mannosidase ratio.

Bacterial population and histologic changes in dogs with perianal fistula.

Ages of 44 dogs with perianal fistula, ranged from 6 months to 13 years (mean, 5.2 years). German Shepherd Dogs and Irish Setters were statistically (P less than 0.01) over-represented compared with those breeds in a canine hospital population (n = 22,047) for the same period. There was a 2:1 male-to-female ratio, with 38 (86.4%) of dogs sexually intact and 6 (13.6%) of dogs neutered. Eleven types of bacterial organisms were recovered from deep perianal tissues of which Escherichia coli, Staphylococcus aureus, beta-hemolytic streptococci, and Proteus mirabilus were most common. Organisms were not recovered from 7 dogs. Of 93 isolates, 88.3% were susceptible to gentamicin, 80.5% to cephalothin, 79.2% to chloramphenicol, and 74% to trimethoprim-sulfamethoxazole. Fifty-one biopsy specimens from 44 dogs were classified as having early, intermediate-, and late-stage lesions based on the amount of fibrosis, severity of the inflammatory response, and, if present, depth of sinus tracts. In most biopsy specimens, all 3 stages were represented in the same histologic section. In 45 specimens, most inflamed lesions were in the dermis of the zona cutanea. Hidradenitis was present in 22 biopsy specimens and was associated with the formation of epithelial-lined sinus tracts.

Natural killer cell activity in untreated and treated dogs with lymphoma.

Natural killer (NK) cell activity and function were determined for 11 untreated and treated dogs with lymphoma. Concurrent chromium release and single cell binding assays, methods used to measure overall cytotoxic activity and that from individual cells, respectively, were performed at effector-to-target cell ratios of 50:1 and 100:1, with incubation periods of 12 and 16 hours. Significant reduction was achieved in overall activity for untreated dogs, using a 16-hour incubation period and an effector-to-target ratio of 100:1 (P less than 0.05). Decreased activity (P less than 0.025) was also achieved for those dogs that were administered combination chemotherapy, consisting of such drugs as cyclophosphamide, vincristine, prednisone, and doxorubicin. There was no significant difference in binding or cytotoxic activity by individual cells in the untreated or treated dogs, compared with the healthy controls. Short- or long-term treatment with glucocorticoids did not influence overall NK cll activity or individual cell cytotoxicity. The overall cytotoxic activity in untreated dogs was reduced, but these dogs had relatively normal numbers of NK cells compared with paracontrols. This suggests that a defect in recycling or the ability to kill targets repetitively, may be involved. A similar defect was found in NK cells of dogs treated aggressively with combination chemotherapy.

Congenital ichthyosis in a llama.

A 1-month-old male cria was examined because of diffuse hyperkeratosis and conjunctivitis that had existed since birth. The mucocutaneous junction of the nostrils as well as the neck, coronary bands, and axillary and inguinal regions were the most severely affected areas. Orthokeratosis involving the epidermis and follicular infundibula was observed on skin biopsy specimens. Electron microscopy revealed 4 to 6 granular layers and inter- and intracellular vacuolation in the stratum corneum; diagnosis of ichthyosis was established.

Seasonal flank alopecia in boxers and Airedale terriers: 24 cases (1985-1992).

Clinical and histologic features of seasonal flank alopecia in 12 Airedale Terriers and 12 Boxers were reviewed. Most of the affected dogs were spayed females; however, sexually intact females as well as sexually intact and neutered male dogs with the disease were identified. Mean (+/- SD) age of onset was 3.6 +/- 2.4 years.

Zinc-responsive dermatosis in northern-breed dogs: 17 cases (1990-1996).

OBJECTIVE: To determine the response rate of zinc-responsive dermatosis to zinc supplementation, the optimal dosage of zinc required for resolution of lesions, the rate of recurrence of lesions, and to develop recommendations for maintenance dosages of zinc to be administered to dogs with this type of zinc-responsive dermatosis. DESIGN: Retrospective case series. ANIMALS: 17 northern-breed dogs with a diagnosis of zinc-responsive dermatosis. PROCEDURE: Histologic evaluation of skin biopsy specimens and review of medical records. Additional information was obtained from veterinarians and owners via a telephone questionnaire. RESULTS: In 12 of 17 dogs, lesions were unilateral initially, then became symmetrical as the disease progressed. Pyoderma was evident in 5 of 17 dogs, whereas 10 were pruritic. Most lesions initially developed between September and April, and 12 of 17 dogs developed lesions in February, October, and November. Initial dosages of zinc supplement ranged from 0.8 to 4.6 mg/kg of body weight/d (0.36 to 2.09 mg/lb/d). Effective/ maintenance dosages ranged from 0.5 mg/kg (0.23 mg/lb), twice weekly, to 8.0 mg/kg/d (3.6 mg/lb/d). Fifteen of 17 dogs had complete resolution of lesions after zinc supplementation. Lesions recurred in 9 of 16 dogs. Approximately half of the recurrent lesions were a result of a missed dose or a decrease in dosage or frequency of zinc supplementation. CLINICAL IMPLICATIONS: An initial dosage of zinc supplement of 1.0 mg of elemental zinc/kg (0.45 mg of elemental zinc/lb), PO, every 24 hours is recommended. Treatment should be continued for 1 month to determine response to treatment, and the daily dosage should be increased by 50% if the initial dosage is not effective. Dogs are prone to recurrence of lesions if a dose of zinc is missed or the dosage or frequency is decreased.