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Diagnosis of amyloidosis by abdominal fat aspiration. Analysis of four years' experience.

Abdominal fat aspiration samples from 443 consecutive patients were examined for amyloid after Congo red and hematoxylin staining. Of the aspirates from 83 patients known to have systemic amyloid disease prior to the biopsy, 70 (84 percent) were found to yield positive results. The results for four aspirates from patients with localized amyloid disease were negative. Of the aspirates from 356 patients of unknown clinical status referred for analysis by outside physicians, 26 (7 percent) yielded positive results for amyloid. On review of the clinical records of these 26 patients, 11 had proved systemic amyloidosis demonstrated on biopsy of another site; all had a clinical course consistent with amyloid disease. In no case was amyloid found in a fat aspiration sample from a patient without clinical evidence suggestive of systemic amyloid disease. This study supports the proposal that abdominal fat aspiration is the diagnostic procedure of choice in the evaluation of amyloidosis since it requires no specialty consultation or technical expertise, causes minimal patient discomfort, and is accompanied by virtually no risk of morbid complication. A positive result has a high predictive value of amyloid disease in patients of unknown clinical status.

Abdomen↗

Prenatal karyotyping of twins by ultrasonically guided amniocentesis.

Twins were diagnosed with ultrasound in two women who had been referred because of a higher than normal risk of having malformed children. Amniocentesis was carried out under the guidance of ultrasound and amniotic fluid from both fetuses was removed for diagnostic procedures. Injection of Congo red proved that the amniocentesis needle was not re-entering the same amniotic cavity at repeated puncture. In both mothers the fetuses were found to be of different sexes. Mixture of maternal cells was excluded by means of quinacrine staining, allowing evaluation of chromosome markers.

Adult↗

Protein AA and lattice corneal dystrophy.

A 73-year-old woman underwent corneal transplantation because of lattice dystrophy. Histopathologic examination of the excised host cornea disclosed eosinophilic deposits that stained positively with Congo red and showed green birefringence with polarized light. Immunofluorescent examination showed protein AA and protein AP in the stromal deposits. To the best of our knowledge, this is the first report of protein AA and protein AP in the amyloid deposits of lattice corneal dystrophy.

Aged↗

Histopathologic and immunochemical features of lattice corneal dystrophy type III.

We examined seven corneas from five patients with a new form of lattice corneal dystrophy (designated lattice corneal dystrophy type III) by light and electron microscopy. Numerous amyloid deposits were scattered throughout the corneal stroma, some of which were much larger than those usually observed in either lattice corneal dystrophy type I or II; these were located predominantly midway between the epithelium and the endothelium. Image analysis disclosed that the cross-sectional size of the large stromal amyloid deposits was significantly greater than those in age-matched patients with lattice corneal dystrophy type I. All patients had a discontinuous band of amyloid (15 to 25 micron wide) in the superficial stroma beneath Bowman's layer, which usually had only one or two small disruptions. Descemet's membrane and the endothelium were normal. The stromal deposits, which were composed of 10-nm diameter fibrils typical of amyloid, stained positively with Congo red after the histologic sections were pretreated with dilute potassium permanganate. Immunohistochemical studies on formalin-fixed, paraffin-embedded tissue indicated that only some deposits reacted weakly with antibodies to amyloid protein AA. The deposits stained positively with antibodies to protein AP and negatively with antibodies to kappa and lambda immunoglobulin light chains.

Amyloid↗

Pros and cons of parietal cell versus truncal vagotomy.

The reliability of parietal cell vagotomy as a primary procedure for duodenal ulcer is still questioned by many, and several surgeons advocate pyloroplasty in certain subgroups. Since the opening of our hospital in 1972, a randomized, prospective study has been under way. Sixty-seven patients were randomized into three groups: truncal vagotomy and Jaboulay pyloroplasty (Group 1), parietal cell vagotomy and Jaboulay pyloroplasty (Group 2), and parietal cell vagotomy without drainage (Group 3). The overall operative mortality was zero, with an 18 percent morbidity. Postoperative Congo red testing revealed truncal vagotomy to be a more reliable vagotomy, with 25 percent of Group 1 patients noted to have some degree of incomplete vagotomy compared with 36 percent of patients in Group 3 (p less than 0.05). The ulcer recurrence in Group 1 was 4 percent, in Group 2 18 percent, and in Group 3 10 percent. No dumping or diarrhea was noted in Group 3 compared with Group 1 in which 4 percent of patients had dumping and 17 percent had diarrhea and Group 2 in which 14 percent of patients had dumping and 23 percent had diarrhea (p less than 0.05). The higher incidences of recurrence and postoperative side effects obviously related to the pyloroplasty made parietal cell vagotomy with pyloroplasty the least desirable operative procedure. Parietal cell vagotomy is technically a more difficult procedure, but if performed satisfactorily, results in greater patient satisfaction, with 81 percent of the patients symptom-free compared with 63 percent of those who had truncal vagotomy and pyloroplasty.

Adult↗

A method for the detection and differentiation of cellulase components in polyacrylamide gels.

Endoglucanase and exoglucanase components of cellulase can be detected and differentiated after polyacrylamide gel electrophoresis by performing activity stains. Endoglucanase activity was visualized in carboxymethyl cellulose agar replicas of gels by staining with Congo red. General beta-1,4-glucanase activity was located by soaking the gel in a solution of NaBH4-reduced cellulooligosaccharides, and detecting the formation of reducing sugars by reaction with triphenyl tetrazolium chloride. Endoglucanases are active in both assays, while exoglucanases can be distinguished by their activity in the cellulo-oligosaccharide assay only. This methodology has facilitated the purification and characterization of cellulase components from Trichoderma reesei and Microbispora bispora.

Cellulase↗

Amyloid-like properties of a synthetic peptide corresponding to the carboxy terminus of beta-amyloid protein precursor.

A synthetic peptide whose sequence corresponds to the 20 carboxy-terminal amino acids of beta-amyloid protein precursor (APP) was found to form fibrils in vitro. These fibrils showed birefringence in polarized light when stained with Congo red, fluoresced when bound with thioflavin S, were resistant to proteases, and had a cross-beta conformation. By contrast, peptides with other sequences from the intracellular domain of APP and a peptide corresponding to this entire domain did not exhibit the full range of beta-amyloid properties. These results suggest that a fragment from the C-terminus of the beta-amyloid protein precursor could bind to intraneuronal paired helical filaments and account for some of its amyloid-like properties.

Amino Acid Sequence↗

Inhibition of rat brain galactocerebroside sulfotransferase by triazine aromatic dyes: interaction with the 3'-phosphoadenosine 5'-phosphosulfate binding site.

The mechanism of inhibition of rat brain cerebroside sulfotransferase (EC 2.8.2.11) by a series of triazine aromatic dyes was examined. These dyes are putative site-specific probes of the "dinucleotide fold". All of the dyes examined were competitive inhibitors of cerebroside sulfotransferase with respect to 3'-phosphoadenosine 5'-phosphosulfate (PAPS) binding. In addition, the binding of the dye, Congo Red, to the sulfotransferase was associated with a red shift in its absorption spectrum. Based on these results, it is suggested that rat brain cerebroside sulfotransferase contains a "dinucleotide fold" as a structural feature of the protein.

Adenine Nucleotides↗

Immunohistochemical and immunoelectron microscopical characterization of cerebrovascular and senile plaque amyloid in aged dogs' brains.

Immunohistochemical and immunoelectron microscopical studies were carried out on 28 aged dogs' brains. Amyloid deposits were seen in the arteries and capillaries in the leptomeninges and in superficial areas of the cortices in 19 (67.9%) of the 28 dogs (10-22 years of age). Immunohistochemically, these amyloid deposits were reactive for anti-beta/A4 antibody. Additionally, a variable number of parenchymal deposits with diffuse beta/A4-immunoreactivity (diffuse plaques) was also noted throughout the cerebral cortex in 24/28 dogs (85.7%). However, these plaque lesions were undetectable in Congo red staining. Electron microscopically, amyloid fibrils, measuring 10 nm in width, were located mainly in the tunica media of the arteries, and in less involved vessels they tended to be present among collagen fibres in the adventitia and smooth muscle cells in the outer layer of the media. The plaque lesions appeared to contain sparse aggregations of amyloid fibrils. In immunoelectron microscopical examinations, all amyloid fibrils in both blood vessels and plaques were selectively labelled by gold particles. These findings indicate that aged dogs can provide a useful experimental model for research into the beta/A4-type of cerebral amyloidosis commonly seen in Alzheimer's disease.

Aging↗

Tangle-bearing neurons show more extensive dendritic trees than tangle-free neurons in area CA1 of the hippocampus in Alzheimer's disease.

To elucidate the pathogenetic significance of neurofibrillary tangles in Alzheimer's disease, the dendritic tree of tangle-bearing and unaffected pyramidal cells of area CA1 of the hippocampus was morphometrically examined. Golgi-stained neurons were assessed which were deimpregnated and counterstained with Congo red to visualize neurofibrillary tangles. The study revealed that tangle-bearing neurons have more extensive apical dendritic trees than tangle-free neurons. It is concluded that metabolic processes associated with the formation of neurofibrillary tangles may increase neurotrophic activity on a single cell level and counteract the cellular degeneration process.

Aged↗

Anti-inflammatory activity and conformational behavior of a branched (1 leads to 3)-beta-D-glucan from an alkaline extract of Dictyophora indusiata Fisch.

A (1 leads to 6)-branched (1 leads to 3)-beta-D-glucan (T-5-N), isolated from a M sodium hydroxide extract of the fruit bodies of Dictyophora indusita Fisch., markedly exhibited anti-inflammatory effects on both carrageenan-induced edema and scalded edematous hyperalgesia in rat's hindpaws. The activities of T-5-N (25 mg/kg i.p. X 2) were more potent than those of phenylbutazone (25-50 mg/kg i.p. X 2). The conformational behavior of T-5-N was studied. Its molecular weight in neutral solution was about three times that in 0.25M sodium hydroxide. This finding, in addition to the results of optical rotatory measurement and complex-formation with Congo Red, indicated that T-5-N has an ordered, triple-helical structure in neutral or slightly alkaline solution (less than 0.15M NaOH), and has single chains in highly alkaline solution (greater than 0.25M NaOH). The conformational transition occurs at concentrations of sodium hydroxide in the range of 0.15-0.25M.

Animals↗

Structure and antitumor activity of an alkali-soluble polysaccharide from Cordyceps ophioglossoides.

A water-insoluble extracellular glucan (CO-1) was isolated from the precipitate formed on incubation of the culture filtrate of Cordyceps ophioglossoides at 37 degrees for 19 h. CO-1 was homogeneous as judged by h.p.l.c., electrophoresis, and ultracentrifugation, and the average molecular weight was determined by h.p.l.c. to be 632,000. The 1H- and 13C-n.m.r. and the i.r. spectra indicated that the glucosidic linkages in CO-1 were beta. From the results of methylation analysis, Smith degradation, n.m.r. studies, and enzymic hydrolysis, it was concluded that CO-1 is composed of a backbone of (1----3)-linked beta-D-glucopyranosyl residues with a beta-D-glucopyranosyl group attached to O-6 of every second D-glucopyranosyl residue of the backbone. CO-1 strongly inhibited the growth of Sarcoma 180 solid-type tumor. CO-1 polyalcohol, which was prepared by Smith degradation of CO-1, exhibited more-potent antitumor activity than CO-1. The absorption maximum of Congo Red shifted significantly in the presence of CO-1.

Animals↗

Structural investigations of glucans from cultures of Glomerella cingulata Spaulding & von Schrenck.

Methylation analysis, enzymic digestion, n.m.r. spectroscopy, and Smith degradation showed that the major extracellular polysaccharide, isolated from cultures of the fungus Glomerella cingulata, was a (1----3)-beta-D-glucan with side chains of 1-4 (1----3)-linked beta-D-glucose residues attached to position 6. A (1----6)-beta-D-glucan was produced by the fungus in small proportions. Treatment of the (1----3,1----6)-beta-D-glucan (890,315) with greater than 0.05M NaOH at greater than 150 degrees, or Me2SO-H2O with a concentration of dimethyl sulfoxide of greater than 80%, irreversibly destroyed the highly ordered structure responsible for the high viscosity of aqueous solutions. The strong shift of the lambda max of aqueous solutions of Congo Red by the degraded glucan, the fact that the mol. wt. of the original glucan was approximately 4 times higher than that of the degraded polymer, and the suppression of the n.m.r. signals for C-3 indicated that the original glucan had a highly ordered structure, probably built up from single helices.

Ascomycota↗

Synthesis and antitumour activity of derivatives of curdlan and lichenan branched at C-6.

Derivatives of curdlan and lichenan, linear (1----3)-beta-D- and (1----3/1----4)-beta-D-glucans, respectively, have been synthesised having alpha-L-arabinofuranosyl, alpha-L-rhamnosyl, beta-D-glucosyl, and beta-gentiobiosyl side chains attached at positions 6. These water-soluble derivatives, obtained by condensation of the 2,4- and 2,4-/2,3-di-O-phenylcarbamoyl derivatives of curdlan and lichenan, respectively, with appropriate ortho esters followed by saponification, were characterised by methylation analysis, g.p.c., and interaction with Congo Red. The curdlan derivatives and the lichenan derivative with few glucosyl branches were active against the Sarcoma 180.

Animals↗

Elastolytic activity of human duodenal contents.

Elastolytic activity of human duodenal contents was determined using the new chromogenic substrate succinyl-trialanine-p-nitroanilide (Suc-Ala3-NAp). The mean output values after pancreatic stimulation with pancreozymin and secretin were significantly higher in controls than in subjects with impairment of other secretory values (volume, bicarbonate, amylase, lipase). Agar gel electrophoresis and chromatography on DEAE-Sephadex revealed one to two fractions which differed in mobility (cathodic and anodic fraction), elution with different NaCl concentrations (0.15 M, cathodic fraction; 0.3 M, anodic fraction), and in behaviour towards synthetic and natural substrate (Suc-Ala3-NAp) and elastin-Congo Red). The cathodic fraction cleaved both substrates, whereas the anodic fraction cleaved only Suc-Ala3-NAp. After trypsin and enterokinase treatment the anodic fraction behaved as the cathodic fraction on DEAE-Sephadex chromatography. The molecular weights (Sephadex G-100) and the Michaelis constants (Suc-Ala3-NAp) of both fractions were identical (24 500; 0.45 X 10(-3) M). These fractions represent probably diffenent activation forms of pancreatic elastase.

Cholecystokinin↗

Serum antielastase deficiency in tight-skin mice with genetic emphysema.

The tight-skin (Tsk) mouse is a model of genetically determined emphysema. The cause for the development of the lung lesion is unknown. In the present study we investigated the lung morphometry and the serum elastase inhibitory capacity (EIC) of Tsk mice. Mean interalveolar distance was significantly greater (+60%) in Tsk mice than in C57 Bl/6J, NMRI, and Balb/c mice, which have similar values. Serum of Tsk mice against mouse leukocyte elastase (MLE) has significantly lower EIC values than that of NMRI, Balb/c (-64%), and C57 Bl/6J (-50%) mice. Similar results were obtained when porcine pancreatic elastase (PPE) was used. Against human leukocyte elastase (HLE), however, there was no difference among the strains, all of which had high EIC values. Preincubation of mouse (C57 Bl/6J) serum with chloramine-T (CT) resulted in an almost complete inhibition of EIC against MLE and PPE but only in a 20% inhibition against HLE using a synthetic substrate. Using elastin Congo Red as substrate, CT inhibited EIC against MLE and PPE by approximately 70% but did not affect the EIC against HLE. These results indicate that (1) the Tsk mouse can be considered a model of severe inborn deficiency of serum antielastase activity which is associated with emphysema; and (2) MLE and PPE can be considered interchangeable in studies of serum EIC in the mouse. On the other hand, the differences between MLE and HLE preclude the use of HLE for EIC determination in this species.

Animals↗

Immunohistochemical identification of the AA protein in lattice dystrophy.

We examined the amyloid deposits of lattice dystrophy type I for common components of primary and secondary amyloid using the sensitive unlabelled antibody peroxidase-antiperoxidase technique. Tissue sections of formalin-fixed, paraffin-embedded specimens from three patients with lattice dystrophy were reacted with antisera specific for free immunoglobulin light chains, prealbumin, amyloid A (AA) protein, and amyloid P (AP) protein. The lattice amyloid was positive for the AA protein associated with secondary amyloid. The deposits were also stained with the protein AP antiserum in each case. We were unable to detect the presence of immunoglobulin light chains associated with primary amyloid or prealbumin associated with another heredofamilial form of amyloid. Sera from two patients with lattice dystrophy were tested for the presence of the serum amyloid A related protein, the apparent precursor of AA amyloid, by immunoelectrophoresis and immunodiffusion. The sera showed no reaction with the AA antiserum with these techniques. Lattice amyloid differed from secondary systemic amyloid in the reaction with potassium permanganate. Congo red staining of lattice deposits was not abolished by treatment with potassium permanganate. Our findings suggest that the amyloid proteins in lattice dystrophy are antigenically similar to those of secondary amyloid and the hereditary form associated with familial Mediterranean fever.

Amyloid↗

Elastinolytic activity in the rat aortic smooth muscle cells in culture.

Elastinolytic activity was examined in cultured rat aortic smooth muscle cells, using Congo Red elastin as a substrate. Elastinolytic activity was demonstrated in the soluble fraction of sonicated smooth muscle cells, with an optimal pH around 10.0. The soluble fraction also showed elastase-like esterolytic activity against the synthetic substrate, N-succinyl-trialanyl-paranitroanilide.

Animals↗