Biomedical subjects
Publications and source records attributed to J Lindeman.
Fibrin microthrombi were demonstrated by an immunoenzymehistochemical method in the small blood vessels of the lung and, to a lesser extent, in the brain in rats after minor experimental head injury. It was concluded that intravascular coagulation is a common phenomenon in head injury.
An immunoenzyme histochemical study was conducted to localize fibrin degradation products (FDPs) in rat tissues during disseminated intravascular coagulation (DIC). Serial measurements of FDP levels in serum after thrombin-induced DIC showed peak levels to be found at 30 minutes; the FDPs were rapidly cleared from the circulation (half-life about one hour). Rat tissues obtained from 10 minutes to 3 hours after the induction of DIC were studied by means of immunohistochemistry. A method was developed to differentiate FDPs from fibrin in tissue sections. This method is based on the observation that, in paraplast-embedded tissues, FDPs can be demonstrated following ethanol fixation only, and that fibrin is demonstrable after both paraformaldehyde fixation and ethanol fixation. Moreover, FDPs will react to some of the antiserums employed only, while fibrin will react to all antiserum used (antiserums against fibrin monomer, against the constituent chains of fibrinogen, and against FDP-D and -E). At 10-20 minutes after the induction of DIC, FDPs were found in kidney proximal tubule epithelial cells. These FDPs could be demonstrated using antiserum against the constituent chains of fibrinogen, but not by antiserums against FDP-D or -E. At 30-90 minutes, FDPs were found inside liver macrophages. The FDPs in liver did not react to anti-chain antiserums, though they did react to antiserums against FDP-D and -E. Since no FDPs were found in other tissues, rat FDPs are apparently cleared by kidney (earlier phase) and liver (later phase) only. In human cases of DIC, FDPs, could be demonstrated in kidney proximal tubules cells and in liver macrophages as well.
It is found that fat and non-fatty tissue in dissected samples of the mamma differ in their T1/T2 ratios. This opens the possibility of locating tumours by n.m.r. imaging, because they have a lower fat content than their surroundings. By means of a sensitive point method, samples were scanned with a resolution of about 0.4 mm X 0.4 mm. The similarity between the shape of a tumour in an n.m.r. and in an X-ray image of a thin section of mamma tissue is quite convincing.
Immunoglobulin containing cells in rectal and sigmoid colonic mucosa in endoscopically obtained biopsies from 10 patients with ulcerative colitis and 10 patients with Crohn's disease were studied, using an indirect immunoperoxidase technique. These findings were compared with the immunoglobulin containing cell number in colonic biopsies from 10 control patients with no evidence of colitis. In biopsies from the 20 patients with inflammatory bowel disease a marked increase in area of the lamina propria per millimetre mucosa length was found. In ulcerative colitis a marked increase in number of IgG containing cells was observed. In Crohn's disease the increase in IgG containing cell number is dependent on the degree of activity of inflammation. In quiescent of active Crohn's disease of the colon we found a significant increase of the IgM containing cells. The number of IgM containing cells per millimetre mucosa length will differentiate the pathology of Crohn's disease from ulcerative colitis.
Patients with isolated ulcerative proctitis form a heterogeneous group. Some may develop ulcerative colitis, others have a limited, benign disease. Twelve patients with isolated proctitis with a mean course of seven years were studied. All patients had a typical clinical picture consisting of a mild and intermittent course of the disease with the presenting symptom of rectal blood loss. At endoscopic examination the inflammatory process was limited to the rectal and distal sigmoid colonic mucosa with a clear upper border beyond which the mucosa of the sigmoid colon was normal. Histologically the mucosal biopsy specimens of the affected rectum resembled those of ulcerative colitis. However, in contrast with proctitis on the base of ulcerative colitis or Crohn's disease, immunoperoxidase staining revealed a markedly increased number of IgE containing cells in the lamina propria of rectal mucosa biopsies. As an IgE-mediated immune mechanism was considered to play a role in this type of proctitis, eight of the 12 patients were treated with oral administration of disodium cromoglycate (DSCG). All patients were improved by the drug. The remaining four patients with mild proctitis did not require treatment. We concluded that, in patients with isolated proctitis on clinical and immunopathological criteria, a group can be separated which responds to DSCG, a condition for which we suggest the name 'allergic proctitis'.
Eight babies with cow's milk protein intolerance and malabsorption, ages ranging from 2 weeks to 6 months, and five adult patients with a history of food allergy were studied. In the jejunal biopsies of the eight children with cow's milk protein intolerance we found partial villous atrophy with an increased number of interepithelial lymphocytes as determined by morphometric analysis. In the five adult patients no morphological changes of the jejunal mucosa were found. However, immunoperoxidase staining revealed a markedly increased number of IgE containing cells in the lamina propria of all jejunal biopsies studied. This proved to be specific for young and adult patients with food allergy. It is concluded that immunohistochemistry of jejunal biopsy specimens is of considerable value in the diagnosis of food allergy.
A new microsurgical procedure for the induction of thrombosis in rat aorta is described. The method is based on the introduction into the vascular lumen of a small piece of the aortic wall, the so called "aortic flap". A long-lived, platelet-rich arterial thrombus invariably forms on the inserted aortic flap. These thrombi closely resemble human arterial thrombi in structure and subsequent development.
The body composition of 15 synchronized swimmers and 15 non-athletic female controls were compared. Body fat and lean body weight were calculated from body density measurements. Swimmers were ranked according to skill level and ability in an attempt to predict success in synchronized swimming from percent body fat or lean body weight. A student t-test revealed no statistically significant differences between groups for height, weight, percent body fat or lean body weight. Non-significant rank order correlations between ability ranking and percent fat (r = -.31) and lean body weight (r = -.18) point to the inability to predict success in synchronized swimming from these variables. These data were compared with female athletes of other sports.
The presence of calcitonin and of carcinoembryonic antigen (CEA) was studied in six cases of medullary carcinoma of the thyroid using an immunoperoxidase technique. In five cases the material was obtained surgically and in one at autopsy. Tissue from primary tumours as well as from metastases was studied. Calcitonin and CEA were identified within all the tumours studied, although their pattern of distribution and staining intensity varied both within the cells and within the tumour. Some parts of the tumour contained both CEA and calcitonin, while others stained positively only for one of these substances. In some parts of the tumour there was no positive staining for either substance. Within the cells, CEA showed a typical linear distribution along cell surfaces, while calcitonin showed a more even cytoplasmic distribution and the deposits were more granular. Normal tissue surrounding tumour deposits did not show positive staining. It is considered that cells of medullary carcinoma of the thyroid contain both calcitonin and CEA. Identification of CEA and calcitonin in tumour tissue can be used as a diagnostic aid to identify medullary carcinoma of the thyroid. Iit is considered that these substances are being produced by this tumour and can be used as tumour markers.
In nine out of 11 patients with herpes zoster and neurological symptoms varicella-zoster antigen was demonstrated in CSF cells by indirect immunofluorescent staining. Cerebrospinal fluid cytology was in most cases highly suggestive of viral infection. This study demonstrates the value of both immunofluorescent staining on CSF cells and CSF cytology, as corroboration of an otherwise exclusively serologically based virological diagnosis.
ECHO virus 25 focal encephalitis was documented for the first time in a 5-year-old boy with unequivocal hemichorea. Hemichorea caused by enterovirus CNS disease has never been reported. ECHO virus antigen in cerebrospinal fluid (CSF) cells was demonstrated by the indirect immunofluorescent technique and typed by a significant rise in neutralizing antibodies against ECHO virus 25. Sequential computerized tomographic (CT) studies with digital analysis demonstrated the evolution of a focal process in the head of the left caudate nucleus, ultimately leading to replacement of tissue by a CSF-containing cyst. In the unclarified pathogenesis of cerebral disease in enterovirus infection, this case suggests a focal inflammatory process rather than vasculitis, occlusion, and infarction. Finally, the near-complete recovery of our patient demonstrated that the mere loss of neostriatal tissue was not decisive in itself, because the tissue loss was permanent and the symptoms were transient.
The cellular infiltrate in the walls of resected ileum and colon specimens obtained from patients with Crohn's disease was analysed. Mononuclear cells in tissue sections were characterized by the use of surface membrane markers and immuno-histochemical and enzyme histochemical techniques. It was found that: [1] B cells, as judged by the presence of surface membrane immunoglobulin and C3 receptors and the absence of alpha-naphthylacetate esterase and acid phosphatase activity, were the predominant type of cells in the intestinal infiltrate often found in close relation with smaller numbers of non-B cells; [2] all types of immunoglobulin-containing cells were increased in number with a shift in the ratio of IgA/IgG/IgM-containing cells in favour of the IgG- and IgM-containing cells; and [3] the histopathological reaction of the regional draining lymph nodes showed hyperplasia of B-cell areas (follicles and medulla) and small or absent T-cell areas (paracortex), consistent with a B-cell response. Our results indicate that the inflammatory process in the bowel wall in Crohn's disease mainly reflects stimulation of the B-cell system.
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In tissue of rats with disseminated intravascular coagulation, fibrin microthrombi can be sensitively detected by immunohistochemical methods, using antisera against rat fibrinogen or fibrin monomer. An indirect immunoperoxidase procedure on paraplast-embedded sections yields best results with regard to the morphology of the thrombi and their localization in the tissue. Only fibrillar immunoreactive material, oriented lengthwise in the vessels, should be regarded as microthrombi formed in vivo.
In two cases of varicella-associated cerebellar ataxia, varicella-zoster antigens in CSF cells were shown by an indirect immunofluorescent technique. Direct viral invasion in CNS disease complicating varicella plays an important part in pathogenesis and rules out a single immune-mediated mechanism.
Malignant, benign, and normal breast tissues corrected for fat appeared to have similar nuclear magnetic proton spin-lattice relaxation times, contrary to previously published reports. However, due to a lower fat content, benign and malignant tumors relaxed more slowly than the surrounding normal tissue. This provides a possibility for locating them (but not for discriminating between them) in a breast by the nuclear magnetic resonance imaging technique zeugmatography.
Among 162 children referred with head injury (in a 3-year period) a viral meningoencephalitis was proven to be present in seven cases. Only one patient showed symptoms of infection before the accident. On admission classical signs of viral meningoencephalitis were absent or mixed with the complications of head injury. A diagnosis of viral meningitis/meningoencephalitis was documented by immunofluorescent demonstration of viral antigens in CSF cells and/or pattern of CSF cytology and/or conventional serological methods. Whether the trauma and the infection are coincidental or causally related can not be decided definitively. A hypothesis is presented suggesting diminished alertness in subclinical viral meningoencephalitis, leading to accident proneness.
The results of histological and immunohistochemical examination of gastric and duodenal biopsy specimens from 50 volunteers without a clinical history of gastrointestinal disease are reported. Multiple specimens of tissue from standard sites in the stomach and duodenum were carefully orientated, and serially sectioned for examination by light microscopy and for immunohistochemical characterisation of plasma cells within the lamina propria. The antrum and fundus were normal in 32 of the 50 subjects but the other 18 showed histopathological evidence of gastritis in either the antrum or fundus. The latter appeared to be age-related. There was considerable variation in the appearance of the surface epithelium of the duodenum within as well as among individual subjects. Superficial gastric metaplasia in one or more biopsy specimens from the duodenal bulb was found in 64% of individuals. Histopathological examination of the duodenum revealed signs of chronic inflammation in 12% of the subjects. In two individuals there was active inflammation but in only one of these was the diagnosis made on endoscopic appearances. Histological criteria important for the diagnosis of duodenitis are discussed. The number of plasma cells in different biopsy specimens from subjects not showing histological signs of inflammation was variable. The ratio IgA:IgG:IgM producing plasma cells was remarkably constant from subject to subject as well as from specimen to specimen.