Osteosclerotic bone dysplasia (melorheostosis) of the mandible.

Melorheostosis is a linear bone dysplasia of unknown origin that may be associated with soft-tissue alterations. Although any part of the skeleton can be affected, this condition is rarely observed in the craniofacial region. Only seven cases of melorheostosis with craniofacial involvement have been reported and cranial manifestation only is even rarer. To the authors' knowledge, manifestation in the mandible only has not yet been documented. A patient with isolated melorheostosis of the mandible with characteristic symptomatic bone pain is presented. The clinical, radiological and histological findings are described and possible therapeutic options are discussed.

Somatostatin and vasoactive intestinal peptide receptors in human mesenchymal tumors: in vitro identification.

Somatostatin and vasoactive intestinal peptide (VIP) have been shown to be of diagnostic and therapeutic interest in several types of human epithelial tumors expressing the respective receptor. The present study evaluates the presence of somatostatin and VIP receptors in 64 primary or metastatic human mesenchymal tumors. In vitro receptor autoradiography on cryostat sections was performed using 125I-labeled [Tyr3]-octreotide as well as 125I-labeled [Leu8,D-Trp22,Try25]-somatostatin-28 as radioligands for somatostatin receptors and 125I-labeled VIP as radioligand for VIP receptors. Somatostatin receptors were identified in bone and vascular/perivascular tumors (3 of 3 osteosarcomas, 1 of 1 giant cell tumor, 2 of 2 angiosarcomas, and 4 of 4 hemangiopericytomas), in 2 of 2 synovial sarcomas, in 2 of 5 histiocytomas, and in several muscle cell tumors (1 of 2 leiomyomas, 2 of 4 leiomyosarcomas, and 3 of 5 rhabdomyosarcomas) but were absent in 4 liposarcomas, 3 mesotheliomas, 3 chondrosarcomas, 10 Ewing sarcomas, 11 schwannomas, and 5 Wilms' tumors. VIP receptors were identified in 3 of 3 differentiated liposarcomas, 2 of 2 angiosarcomas, 4 of 4 hemangiopericytomas, 2 of 2 synovial sarcomas, 3 of 3 mesotheliomas, 5 of 5 Wilms tumors, as well as in 2 of 5 histiocytomas, 1 of 2 leiomyomas, 2 of 4 leiomyosarcomas, 3 of 3 intermediately differentiated rhabdomyosarcomas, and 1 of 3 osteosarcomas but not in chondrosarcomas, Ewing sarcomas, schwannomas, or undifferentiated rhabdomyosarcomas. The receptors were located on neoplastic cells. The somatostatin receptors were of high affinity and of high specificity for biologically active somatostatin analogues with high affinity for somatostatin-14 and somatostatin-28 as well as for octreotide, thus representing the sst2 subtype; in a few cases of tumors having somatostatin receptors with low affinity for octreotide, in situ hybridization techniques identified preferentially sst1 mRNA. These data suggest that human mesenchymal tumors may be targets for somatostatin and/or VIP receptor in vivo imaging; they may also be potential targets for somatostatin or VIP analogue therapy.

Vasoactive intestinal peptide/pituitary adenylate cyclase-activating peptide receptor subtypes in human tumors and their tissues of origin.

The evaluation of peptide receptors in man is needed not only to discover the physiological target tissues of a given peptide but also to identify diseases with a sufficient receptor overexpression for diagnostic or therapeutic interventions. Vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating peptide (PACAP) receptors have been evaluated in human tumors and in their tissues of origin using in vitro receptor autoradiography with 125I-VIP or 125I-acetyl-PACAP-27 in tissue sections. The VIP/PACAP receptor subtypes VPAC1, VPAC2, and PAC1 were evaluated in these tissues by determining the rank order of potencies of VIP and PACAP as well as VPAC1- and VPAC2-selective analogues. The VIP/PACAP receptors expressed in the great majority of the most frequently occurring human tumors, including breast (100% receptor incidence), prostate (100%), pancreas (65%), lung (58%), colon (96%), stomach (54%), liver (49%), and urinary bladder (100%) carcinomas as well as lymphomas (58%) and meningiomas (100%), are predominantly of the VPAC1 type. Their cells or tissues of origin, i.e., hepatocytes, breast lobules and ducts, urothelium, prostate glands, pancreatic ducts, lung acini, gastrointestinal mucosa, and lymphocytes, also predominantly express VPAC1. Leiomyomas predominantly express VPAC2 receptors, whereas paragangliomas, pheochromocytomas, and endometrial carcinomas preferentially express PAC1 receptors. Conversely, VPAC2 receptors are found mainly in smooth muscle (i.e., stomach), in vessels, and in stroma (e.g., of the prostate), whereas PAC1 receptors are present in the adrenal medulla and in some uterine glands. Whereas the very wide distribution of VIP/PACAP receptors in the normal human body is indicative of a key role of these peptides in human physiology, the high VIP/PACAP receptor expression in tumors may represent the molecular basis for clinical applications of VIP/PACAP such as in vivo scintigraphy and radiotherapy of tumors as well as VIP/PACAP analogue treatment for tumor growth inhibition.

Protection of mice from whole body gamma irradiation by deuteration of drinking water: hematologic findings.

Partial deuteration of mice by ingestion of 29% heavy water for 12 days prior to irradiation lessened their susceptibility to lethal doses of whole body gamma irradiation from a 60Co source. Deuteration alone slightly reduced the number of nucleated bone marrow cells, blood leukocytes, and platelets. After exposure to 8.5 Gy, all mice drank tap water. Radiation-induced destruction of hemopoietic and lymphoid tissues was of equal degree in deuterated and control animals. Conversely, nucleated bone marrow cells, blood leukocytes and platelets, endogenous spleen colonies, and thymus of deuterated mice displayed signs of an accelerated and/or enhanced regeneration. The cytokinetic changes observed in deuterated animals were consistent with a protective effect for pluripotent stem cells at the time of irradiation.

Biodistribution of boronophenylalanine in patients with glioblastoma multiforme: boron concentration correlates with tumor cellularity.

Boron-10 (10B) concentrations were measured in 107 surgical samples from 15 patients with glioblastoma multiforme who were infused with 95 atom% 10B-enriched p-boronophenylalanine (BPA) intravenously for 2 h just prior to surgery at doses ranging from 98 to 290 mg BPA/kg body weight. The blood 10B concentration reached a maximum at the end of the infusion (ranging from 9.3 to 26.0 microg 10B/g) and was proportional to the amount of BPA infused. The boron concentrations in excised tumor samples ranged from 2.7 to 41.3 microg 10B/g over the range of administered BPA doses and varied considerably among multiple samples from individual patients and among patients at the same BPA dose. A morphometric index of the density of viable-appearing tumor cells in histological sections obtained from samples adjacent to, and macroscopically similar to, the tumor samples used for boron analysis correlated linearly with the boron concentrations. From that correlation it is estimated that 10B concentrations in glioblastoma tumor cells were over four times greater than concurrent blood 10B concentrations. Thus, in the dose range of 98 to 290 mg BPA/kg, the accumulation of boron in tumor cells is a linear function of BPA dose and the variations observed in boron concentrations of tumor specimens obtained surgically are largely due to differences in the proportion of nontumor tissue (i.e. necrotic tissue, normal brain) present in the samples submitted for boron analysis. The tumor:blood 10B concentration ratio derived from this analysis provides a rationale for estimating the fraction of the radiation dose to viable tumor cells resulting from the boron neutron capture reaction based on measured boron concentrations in the blood at the time of BNCT without the need for analysis of tumor samples from individual patients.

The comet assay of nasal epithelia: measurement of DNA damage for the assessment of genotoxic air pollution.

OBJECTIVES: The alkaline single cell gel electrophoresis or "comet" assay allows measurement of DNA damage in single cells with a high degree of sensitivity, e.g., for investigations of the effect of environmental agents with DNA-damaging potential. This study aimed to adapt this test to respiratory cells of the human nasal mucosa to examine the genotoxic effect of air pollution (cigarette smoke). STUDY DESIGN: In a prospective study, nasal epithelia of 16 cigarette smokers were examined by the adapted comet assay and the results were correlated with the results of the Papanicolaou-stained nasal cytology, carried out in a blinded fashion. The control group comprised 20 non-smoking men. All subjects under investigation were healthy office workers. METHODS: Nasal epithelia were harvested from the maxilloturbinates. One part of cells was Papanicolaou stained and evaluated by cytopathologists. The comet assay was performed on the other part of the cells. The examiners were blinded to the study and control groups. RESULTS: Among cigarette smokers, a significant correlation between cytopathological cell nucleus changes (metaplasia and dysplasia) and the DNA migration (tail lengths) in the comet assay was found as a sign of DNA damage. This was not found in nonsmoking control persons. CONCLUSIONS: These results confirm the sensitivity of the comet assay and the hypothesis that cell nucleus changes in conventional nasal cytology are associated with DNA damage.

The nose as bacterial reservoir: important differences between the vestibule and cavity.

UNLABELLED: The difference between the spectra of potential bacterial pathogens (PBPs) in the nasal vestibule and cavity has not been taken into account in clinical studies. PURPOSE: Since one can anticipate different flora in different kinds of mucosae, the authors compared bacterial species in the vestibule with those of the cavity. SUBJECTS AND METHOD: A total of 534 healthy male clerical workers in a downtown Lucerne office building were examined with fractionated swabs. RESULTS: PBPs, notably Staphylococcus aureus, were found in 412 subjects and surprisingly, differences in flora of the two sites were noted in 130 of them: PBPs were observed in the vestibule and not in the cavity in 85 of the subjects, and in 45 of them, the reverse was true. CONCLUSION: The practical implications of these findings are considerable regarding infection control in patients at increased infection risk.

Somatostatin (somatostatinlike) immunoreactive cells in the human inner ear.

Certain epithelia of the human inner ear and human endolymphatic sac display somatostatin and/or somatostatin-like immunoreactivity. Histologic sections from 13 human temporal bones and from 15 endolymphatic sacs were studied using the unlabeled antibody peroxidase-antiperoxidase technique. The somatostatin and/or somatostatin-like immunoreactive cells were located exclusively in the covering epithelium of the spiral prominence and in the epithelium of the intermediate and rugosal part of the endolymphatic sac. In the epithelium of the spiral prominence and endolymphatic sac, secretory granules of the same size and appearance as those of intestinal or pancreatic somatostatin-producing cells were demonstrated ultrastructurally. The findings are consistent with a local exocrine, paracrine, and/or endocrine system of the inner ear.

Abortion in woman caused by caprine Chlamydophila abortus (Chlamydia psittaci serovar 1).

On a farm housing cattle and goats an abortion storm occurred affecting 50% of the goats during the lambing season 2000/2001. In one of three investigated caprine abortions Chlamydophila abortus could be identified as aetiology. During this time a pregnant woman (pregnancy week 19/20) had contact with aborting goats. She developed a severe generalized infection and aborted. The placenta contained Chlamydophila abortus shown by immunohistochemistry and PCR. The aim of the present case report is to alert medical doctors about the potential zoonotic risk of ovine/caprine abortions.

Immunohistochemical characterization of the human endolymphatic sac and its associated cell populations.

The use of monoclonal and polyclonal antibodies as specific markers for the localization of tissue constituents in situ allows the characterization of cells according to their state of differentiation and the detection of cellular antigens related to the function of cells and tissues. Our studies focus on the immunohistochemical characterization of the human endolymphatic sac (ES) and its associated cell populations. A panel of 37 monoclonal and polyclonal antibodies were used on frozen sections and fixed material from 64 ES of 32 persons without any clinically known inner ear disorders. The ES were removed at the time of autopsy; case histories were available. The results of our studies on the extraosseous part of the human ES support the assumption that the epithelium is metabolically active and capable of both secretion and absorption. The reactivity of the epithelial cells with antibodies against neuron specific enolase, chromogranin and somatostatin, respectively, implies a paracrine activity of the ES. Further results obtained with antibodies specific for cells of the immune system indicate a possible role of the human ES in the inner ear immune defence and a functional relationship of the ES to the common mucosa-associated immune system.

Enlargement of salivary glands in bulimia.

We report a unusual case of bulimia nervosa with bilateral swelling of parotid and submandibular glands as the only symptom of the underlying behavioural disorder. Histologically, sialadenosis was diagnosed in a parotid biopsy. The parotomegaly in bulimia may be a diagnostic primer as these patients often deny their eating disorder. B-scan ultrasonography is an important diagnostic tool to assess the nature of the parotid enlargement. Hyperamylasaemia occurs commonly in bulimic patients and may help to confirm the diagnosis. All patients with suspected bulimia should have a thorough medical history and physical examination to rule out other aetiologies of asymptomatic parotid swelling. As the enlargement is usually transient surgical intervention is only rarely required.

[Tumor embolism with fatal cerebral infarct in pneumonectomy. Case report and review of the literature]. / Tumorembolie mit letalem Hirninfarkt unter Pneumektomie. Fallbericht und Literaturübersicht.

Carcinomas of the bronchi often infiltrate veins, particularly in advanced stages. Tumor propagation in pulmonary veins with intra-atrial extension has been reported. Systemic arterial tumor embolism is a potentially fatal hazard that is caused by surgery or it can be the initial manifestation of a bronchogenic carcinoma. The importance of early pulmonary venous ligation in lung cancer surgery, first stressed by Aylwin in 1951, is evident, particularly when intravenous tumor progression has been diagnosed preoperatively by echocardiography or CT scan. We report a case of lethal hemispheric brain infarction following tumor embolism during lobectomy for bronchus carcinoma. A review of the literature on this subject is presented; there were 38 cases of arterial tumor embolism because of primary lung neoplasms.

[Duodenal cancer. A clinical-pathological study]. / Das Duodenalcarcinom. Eine klinisch-pathologische Studie.

Seven primary carcinomas of the duodenum were observed from 1973 to 1976 at the University Hospital Hamburg; four in females and three in males with an age between 32 and 69 years of age. The interval between the first symptoms (epigastric pain, jaundice, pruritus, diarrhea, and loss of weight) and surgical therapy (duodeno-pancreatectomy) averaged four months. All carcinomas were resected radically from the macroscopic (intraoperative) aspect as well as from the histological findings. Local tumour recurrences which proved fatal occurred in five patients within nine to twenty-one months. One patient died of peritonitis and another of pancreatitis. The diagnostic mode has been changed since the introduction of endoscopy and retrograde cholangio-pancreaticography (ERCP). The consistent inclusion of the duodenum in routine gastroscopy leads to the hope that more carcinomas of the duodenum can be detected early.

[Castleman disease]. / Morbus Castleman.

BACKGROUND: The term "Castleman's disease" (angiofollicular lymph node hyperplasia) comprises a heterogeneous clinicopathologic entity among lymphoproliferative disorders. CASE REPORT: We present a rare case with retroperitoneal manifestations, and discuss several aspects of diagnosis, differential diagnosis, the clinical course and therapy of the disease. Finally, we summarize the actual knowledge about the pathogenesis of Castleman's disease.

Immunologic structures and functions of the gut.

The intestine is richly populated with lymphoid tissue capable of initiating and effecting a wide variety of immunologic reactions. These reactions have consequences not only for the gut itself but for the body in general, and have established the importance of the gut as an immunologic organ. Among the outer and inner surfaces of our body, the 200 to 300 m2 of the gut contrast with the 2 m2 of the skin, and the 80 m2 of the lung. At the inner surface of the intestine, our organism contacts intimately bacteria, parasites, enzymes, toxins, a wide variety of dietary substances and their breakdown products. The essential barrier against the permanent antigenic burden is the mucosa. Its integrity depends on the continual replication, maturation, and metabolism of its constituents. Additional defense functions are exerted by the mucus, lysozyme, phagocytes, other cells, humoral factors and biological response modifiers involved in inflammatory and immune reactions. Some of these factors are being produced very close to the surface at which they act. The sum of the mechanical, humoral, cellular, immunologic and non-immunologic defense factors of the intestinal mucosa constitutes the mucosal block. However, the block is not complete. Rather, a continuous antigenic uptake through the epithelial layer takes place. The specialized structures of Peyer's patches, solitary lymph follicles, appendix vermiformis and their associated epithelium allow a controlled antigen uptake (sampling). Because of the heavy antigenic load, the intestine can be described as the most important immunologic contact organ of our body. The antigens may give rise to local and systemic immune reactions with antibody production, or the suppression of systemic immunologic responses to ingested antigens ("oral tolerance").

[Abortion in humans caused by Chlamydophila abortus (Chlamydia psittaci serovar 1)]. / Abort beim Menschen durch Chlamydophila abortus (Chlamydia psittaci serovar1).

On a farm housing cattle and goats an abortion storm occurred affecting 50% of the goats during the lambing season 2000/2001. In one of three investigated caprine abortions Chlamydophila abortus could be identified as etiology. During this time a pregnant woman (pregnancy week 19/20) had contact with aborting goats. She developed a severe generalized infection and aborted. The placenta contained Chlamydophila abortus shown by immunohistochemistry and PCR. Aim of the present case report is to alert veterinarians about the potential zoonotic risk of ovine/caprine abortions.

[Health and illness from the viewpoint of natural sciences. The scientific basis of medicine]. / Gesundheit und Krankheit aus naturwissenschaftlicher Sicht. Zur naturwissenschaftlichen Grundlage der Medizin.

The scientific modes of thought and operation (scientification of factual experience) is first described as the rational basis of modern medicine. Delimitation from other views becomes hereby a necessity. The descriptions of the bionomic organism which is subjected to the highest degree to specific rules of order and organisation of its relation to the environment and of man as living being follow. Disorders in organisms are described as relative imperfections of biologic order or as inappropriate or deficient adaptation to the environment. Diseases are thus regarded as events of nature.

[Interactive tumor diagnosis: pathology and oncology]. / Interaktive Tumordiagnostik: Pathologie und Onkologie.

Biopsies will supply the best answers when the clinician submits a well-defined diagnostic problem to his pathologist before the biopsy is done, when he is aware of the limitations of the biopsy technique, when the pathologist makes optimal use of the available techniques as well as expertise and knows the limitations of a diagnosis based on morphology alone, and when treating physicians and pathologists keep up close communication before, during and after diagnostic procedures.

[Precancerous and early stage colorectal carcinoma: clinico-pathological implications]. / Vor- und Frühstadien des kolorektalen Karzinoms: klinisch-pathologische Implikationen.

With regard to the clinical implication and importance of carcinoma prevention, the histogenesis and pathobiology of the precancerous lesions and conditions of the colorectum are described. Polyps, dysplasia (with and without ulcerative colitis), adenomas and polyposis syndromes are defined, and their potential as markers for an increased risk for colorectal cancer is estimated. For the time being, the prevention of colorectal cancer is only possible by interrupting the multistage carcinogenesis in due course, i.e. during the precancerous stages. The exact knowledge of the latter is the rational of the clinical procedures.