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Biomedical subjects

B Corrin

Publications and source records attributed to B Corrin.

At least 127 records · Page 7Linked to original sources

Apocrine secretion in the terminal bronchiole of mouse lung.

The question of the existence of apocrine secretory activity by the Clara cells of the mouse lung terminal bronchiole has been investigated in depth. The overall superiority of 1--2 micrometer plastic sections for light microscopy was demonstrated. The preservation of the anatomy of the terminal bronchiole was shown to be adversely affected by slow killing methods, by post mortem delays before fixation, and by the instillation of fluids via the trachea. The use of collapsed lungs removed from rapidly killed animals is probably the best method for the study of the small bronchioles of the lung. Apocrine secretion takes place as originally described by Clara in 1937. The reason why the phenomenon has received so little attention in the literature is probably because the tracheal or vascular perfusion of fixative, and delays before fixation, all prevent apocrine droplets from being preserved.

Animals↗

Cholesterol in the lungs of heavy cigarette smokers.

Electron microscopy of "normal" lung tissue from four heavy cigarette smokers showed acicular crystal clefts thought to represent cholesterol in the cytoplasm of virtually every type II pneumocyte. Similar but less pronounced changes were found in two cases of obstructive pneumonia distal to bronchial tumours, a condition characterised by excess cholesterol. Cholesterol pneumonitis is particularly prevalent in smokers, and the changes in our smokers' lungs possible represent an early stage in a process that if progressive would lead to this disease. The cholesterol may represent a degenerative change in type II pneumocytes or a byproduct of increased surfactant synthesis stimulated by cigarette smoke.

Cholesterol↗

Degenerative processes in the pathogenesis of pulmonary alveolar lipoproteinosis.

Electron microscopy in an infant of 4 months with pulmonary alveolar lipoproteinosis showed filling of the alveoli with osmiophilic lamellar bodies. Similar structures were present in the cytoplasm of type I alveolar epithelial cells and to a lesser extent in the capillary endothelium and interstitium. These changes represent widespread degenerative processes in the lung caused by an unidentified cytotoxic agent. In this patient the disease is comparable to the drug-induced cytotoxic animal model and differs from the dust-induced hypersecretory animal model.

Epithelium↗

Streptozotocin-induced renal tumours in rats.

Forty-six separate renal tumours developed in 36/80 Wistar male rats given a single i.v. dose of streptozotocin (25 mg/kg body wt) to induce diabetes mellitus. Fourteen of the tumours were epithelial in type, 8 were wholly mesenchymal and 24 were largely mesenchymal but also contained epithelial elements. The purely epithelial tumours correspond to the renal adenomas and adenocarcinomas seen in man. The mesenchymal tumours were composed either of undifferentiated spindle cells or of a mixutre of poorly differentiated mesenchyme and epithelial glands. Microscopically, the mixed tumours resembled the nephroblastomas seen in man; both elements appeared to be malignant, but in the absence of metastases this remains unproven. The management of the diabetic state did not influence the incidence of tumours, but insulin appeared to enhance tumour growth.

Animals↗

Lung tumours and ACTH production.

ACTH levels measured by N- and C-terminal immunoassays and cytochemical bioassay, were measured in fourteen lung tumours not associated with the ectopic ACTH syndrome and in macroscopically normal lung tissue taken from the same patients at thoracotomy. Significant concentrations of immunocative (greater than 3 ng/g wet weight) and bioactive (greater than 0.2 ng/g wet weight) ACTH were found in all the carcinoid and oat cell tumours (n=9), a combined tumour (poorly differentiated adenocarcinoma with large cell carcinoid elements), and a poorly differentiated squamous cell tumour. All the carcinoid tumours contained more C- than N-terminal ACTH immunoactivity. The squamous cell tumours (n=2), anaplastic tumours (n=2) and adenocarcinoma contained insignificant ACTH levels. There was a good correlation between the ACTH levels and the presence of secretory granules in the tumours examined ultrastructually. All the macroscopically normal samples of lung tissue contained immuno and bioactive ACTH-like material, the levels of which correlated well with ACTH levels in the tumour tissue. It is suggested that all lung tumours of carcinoid or oat cell type synthesize ACTH-like materials although clinical evidence of the ectopic ACTH syndrome may be absent. The presence of ACTH-like materials in non-tumorous lung tissue in patients with lung cancer may indicate a low level of ACTH production throughout the lung or sequestration of ACTH containing granules secreted by the tumour.

Adenocarcinoma↗

Ultrastructural immunocytochemical localisation of lysozyme in human bronchial glands.

An immunocytochemical unlabelled antibody method using rabbit antihuman lysozyme, antirabbit immunoglobulin, and soluble rabbit antihorseradish peroxidase/horseradish peroxidase complexes was used to study the fine structural distribution of lysozyme in human bronchial glands. None was identified in mucous cells but there was heavy staining of the serous cell granules. The serous cell granules were not stained uniformly, suggesting the presence of other secretory products but lysozyme secretion appears to be a major function of these cells. The pathological implications of this are discussed.

Bronchi↗

Progressive airway obliteration in adults and its association with rheumatoid disease.

Six patients with rapidly progressive airway obliteration in the absence of chronic bronchitis or emphysema are reported. Because this pattern of lung disease is very uncommon and five of the six patients had classical rheumatoid arthritis an association between the two diseases is suggested. The patients presented with rapidly developing breathlessness, and râles and a high-pitched mid-inspiratory squeak were heard over the lung fields. Chest radiographs showed distended lungs but were otherwise normal. Tests of lung fuction showed airflow obstruction, most marked at low lung volumes, with air trapping. The carbon monoxide gas transfer coefficient, maximum static recoil pressure and static compliance were normal. In spite of treatment with antibiotics, bronchodilators and corticosteroids, five died in respiratory failure five to 18 months after first becoming breathless. Post-mortem examination in four patients showed an obliterative bronchiolitis but no mucous gland hypertrophy or significant emphysema.

Adult↗

Pulmonary lymphangiomyomatosis: three new cases studied with electron microscopy.

Three cases of pulmonary lymphangiomyomatosis are described, with emphasis on the ultrastructural changes. The clinicopathologic features corresponded to those previously described. Each patient was a female in the reproductive years; breathlessness and recurrent pneumothoraces were the predominant clinical features. Histologically, the lungs showed a focal interstitial infiltrate of short, spindle-shaped mononuclear cells compatible with primitive smooth muscle, which was associated with irregular emphysema and hemosiderosis. Electron microscopy confirmed the smooth muscle nature of the pulmonary infiltrate and showed the presence of cells intermediate between smooth muscle and fibroblasts. Abnormalities were also noted in the pulmonary connective tissue that are possibly related to the fragility of the lung in this condition.

Adult↗

Acromegaly caused by pulmonary carcinoid tumours.

Two patients are described whose acromegaly was cured by removal of a bronchial carcinoid tumour. One had an enlarged pituitary fossa and evidence is presented that in this patient the tumour was not secreting growth hormone. The evidence available suggests that the tumour was producing a growth hormone releasing substance. It is suggested that some cases of the pluriglandular syndrome may be secondary to small bronchial carcinoid tumours that produce substances as yet unidentified, that stimulate the growth and hyperactivity of other endocrine tissue.

Acromegaly↗

Necrotizing 'sarcoidal' angiitis and granulomatosis of the lung.

A case of necrotizing sarcoid angiitis and granulomatosis (NSG) presenting as a peripheral lung 'tumour' in a 63-year-old man is recorded, and the clinical and pathological features are compared with those of Liebow's original cases. Resection may be avoided if the diagnosis is made by biopsy as the disease is possibly steroid responsive and the prognosis appears favourable. The aetiology is obscure but an immune disturbance is suspected.

Arteritis↗

Diagnosis and management of alveolar proteinosis: the rôle of electron microscopy.

The diagnosis and management of three cases of pulmonary alveolar proteinosis are described. The electron microscopic appearances of lung biopsy material, lung washings, and sputum and the value of this method of sputum examination in extremely ill patients are demonstrated. The practical details of controlled volume bronchial lavage are described and the good clinical and physiological response of patients reported. The findings have been compared with those of experimental pulmonary alveolar proteinosis, and the pathogenesis of the condition is discussed.

Adult↗

Pulmonary lymphangiomyomatosis. A review.

Anatomic and clinical observations of 28 cases, including 23 previously unpublished, of pulmonary lymphangiomyomatosis are recorded and discussed. This brings the total reported to 57. All patients were women in the reproductive age group with the major complaint of breathlessness. This was usually progressive, and death from pulmonary insufficiency resulted within 10 years. Functional changes were obstructive or restrictive, or both. Pneumothorax, chylous effusions and hemoptysis were frequent complications. Radiographically the lesions initially appear as fine, linear and nodular, predominantly basal densities, and progress to a pattern of bullous change, or honeycombing, involving all portions of the lungs not sparing the region of the costophrenic sinuses as is typical of eosinophilic granuloma. There may be associated pleural effusions. A progressively increasing lung volume is characteristic. The lesions consist of an irregular, nodular or laminar "irrational" proliferation of smooth muscle within all portions of the lung, with loss of parenchyma leading to honeycombing. Proliferated muscle can obstruct bronchioles (with air trapping and formation of bullae often complicated by pneumothorax), venules (with pulmonary hemorrhage and hemosiderosis accompanied clinically by hemoptysis) and lymphatics (with chylothorax or chyloperitoneum). Both thoracic and abdominal lymph nodes and the thoracic duct can also be involved in the myoproliferative process with formation of subsidiary minute channels and obstruction. Renal or perirenal angiomyolipomas can also occur, as exemplified by 2 patients in the present series. Identical pulmonary lesions occasionally occur in tuberous sclerosis. Especially since these patients usually have no neurologic disturbances and are almost women, the possibility of a relationship between tuberous sclerosis and lymphangiomyomatosis must be considered. One feature of note in pulmonary lesions of tuberous sclerosis is the presence of adenomatoid proliferations of epithelium. Such changes were also observed in 2 patients of the present series, and it is remarkable that both of these women had "retarded"children. At present the question of whether by lymphangiomyomatosis is a forme fruste of tuberous sclerosis must be considered as unresolved. It may yield to further investigation, possibility including chromosomal studies.

Adolescent↗