The case of the painful buttock.
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Adenocarcinoma↗
Biomedical subjects
R L Schelper
Publications and source records attributed to R L Schelper.
Purification of murine endothelial cell cultures by flow cytometry using fluorescein-labeled griffonia simplicifolia agglutinin.
Griffonia simplicifolia agglutinin (GSA) is a valuable histochemical tool in the identification of endothelium. In this study GSA labeled with fluorescein isothiocyanate (GSA-FITC) was used to purify cultures of murine cerebral microvascular endothelium. Cultures were stained with GSA-FITC, then sorted using a fluorescence-activated cell sorter (FACS). GSA-positive endothelial cells were collected, re-cultured, and subsequently re-analyzed by FACS using GSA-FITC. Cultures that initially contained 80 +/- 3 to 89 +/- 3% (X +/- SE) GSA-positive cells were purified to 98 +/- 1% positivity. Immunohistochemistry with an anti-muscle-action antibody confirmed that FACS sorting of GSA-FITC-stained cells effectively removed contaminating smooth muscle cells from endothelial cell cultures. Viability, proliferation, and prostaglandin production of the cells was unaltered by lectin staining and FACS sorting. Thus, GSA-FITC can be used in conjunction with flow cytometry to enhance the purity of murine endothelial cell cultures without adversely affecting cell viability, growth, or metabolism.
Actins↗
Autonomic, sensory, and motor dysfunction following intrathecal administration of three substance P antagonists.
Antagonists of the putative peptide neurotransmitter substance P have been found to produce pronounced cardiovascular effects when administered into the spinal subarachnoid space. These previous studies have not, however, provided any direct evidence that these effects result from interaction with substance P receptors. The present study was designed to characterize the modification of cardiovascular function resulting from administration of these compounds, and evaluate their effects on the integrity of spinal cord function. Intrathecal administration of two substance P antagonists produced a depressor response accompanied by a reduction of hindquarter vascular resistance. Following administration of a substance P antagonist, the integrated cardiovascular responses to electrical stimulation of the renal afferent nerves and ventrolateral medulla were markedly attenuated. Intrathecal administration to conscious rats of three substance P antagonists led to a variety of sensory and motor dysfunctions, including loss of spontaneous motor function, responsiveness to mechanical and thermal stimuli, and bladder function. No such effects were produced by administration of substance P, luteinizing hormone releasing hormone (LHRH), or LHRH antagonist. These effects from administration of a substance P antagonist were associated with a dose-dependent necrosis of spinal cord tissue. The necrosis may be secondary to ischemia since pretreatment with the vasodilator adenosine significantly delayed or blocked the sensory and motor dysfunctions. This conclusion was supported by the demonstration that cerebrovascular smooth muscle (pial vessels) was constricted by a SP antagonist. Taken together, these data suggest that substance P antagonists appear to non-specifically block transmission in the spinal cord, by mechanisms which may involve reduction of blood flow to the spinal cord.
Animals↗
beta-amyloid protein of Alzheimer's disease is found in cerebral and spinal cord vascular malformations.
Congo/Red deposition with birefringence to polarized light was demonstrated focally in cerebrovascular malformations removed surgically from 4 older patients (ages 85, 74, 74, and 63), and in a spinal cord vascular malformation in a 76-year-old patient. Lesser degrees of Congophilic change were observed in cerebrovascular malformations screened from 4 of 10 patients between the ages of 30 and 59. No Congophilic change was seen in 10 cerebrovascular malformations removed from patients under 30 years of age. Congophilic areas in all cases decorated with W-2 and 85/45 polyclonal antibodies raised to peptide sequences of cerebrovascular beta-amyloid and beta-amyloid of senile plaques from patients with Alzheimer's disease. Thus, the amyloid in these vascular malformations is immunologically related to beta-amyloid protein. This finding provides another indication that vascular beta-amyloid deposition is not specific for Alzheimer's disease and suggests that an existing abnormality of vessels may be a predisposing factor.
Adolescent↗
Brain microvascular smooth muscle expresses class II antigens.
Mouse (BALB/c) splenic lymphocytes co-cultured in vitro with syngeneic brain-derived microvascular smooth muscle (SM) proliferate and become activated. After subsequent transfer of the activated lymphocytes to a syngeneic host, a vasculitis develops in the host. Investigation of the possible antigen-presenting properties of the cultured SM has resulted in the demonstration of class II (Ia) antigens on the SM. Fluorescence-activated cell sorter analysis has shown that an average of 31% of unstimulated SM cells in culture were positive when stained with an anti-IE of the appropriate haplotype (H2d), and an average of 20% were positive with an anti-IA of the H2d haplotype. Controls consisting of irrelevant antibodies of the same isotype, as well as an anti-IA of the H2s haplotype, were negative. In contrast, BALB/c-derived brain microvascular endothelial cells showed considerably less class II antigen expression (7% for both IA and IE).
Animals↗
Warfarin-related purple toes syndrome and cholesterol microembolization.
The "purple toes syndrome" is a rare complication of oral anticoagulant therapy. Four patients who presented with "purple toes syndrome" several weeks after warfarin therapy was initiated are described. The diagnosis of cholesterol microembolization was made by biopsy in three cases. Malignant hypertension and renal failure developed in two patients who died within three to six months of onset of purple toes. Postmortem examination in one of these patients showed widespread cholesterol microembolization. Renal failure has not developed in the other two patients, who are doing well. These biopsy and autopsy results suggest that the warfarin-related "purple toes syndrome" is due to cholesterol microembolization.
Aged↗
Cytochemical demonstration of neuromelanin in black pigmented adrenal nodules.
Retrospective review of 363 consecutive autopsy reports in which adrenal examination was noted reveal 8 cases of pigmented adrenal nodules. Black pigmented adrenal nodules have been reported infrequently both as incidental autopsy findings and in association with Cushing's syndrome. The nature of the pigment in these lesions has been assumed to be lipofuscin. Gross and histologic study of seven cases and electron microscopic study of two cases suggest the presence of a neuromelanin component in the pigment, a previously unreported finding in the adrenal cortex. Review of the clinical records of the patients suggested no associations with specific underlying disorders. The prevalence the authors report (2.2%) is less than that of a previous prospective study.
Adolescent↗
Experimental autoimmune inflammatory myopathy.
We report an experimental model of autoimmune inflammatory myopathy. Splenic cells from two inbred murine strains (BALB/c and SJL/J) are activated (immunized) in vitro by co-culture with their respective syngeneic skeletal muscle myotubes. Subsequent injection of the activated splenocytes with or without B. pertussis into the respective syngeneic hosts results in inflammatory myopathy in the SJL/J mice but never in the BALB/c mice. The muscle inflammation is very similar in appearance to human autoimmune inflammatory myopathies. The myositis is not effector cell-skeletal muscle specific because splenocytes activated by co-culture with smooth muscle will also elicit skeletal muscle lesions. Both strains of skeletal muscle appear to express class II (Ia) antigens and the splenocytes from both strains appear to be equally activated. Thus we postulate that the difference in the expression of myositis between the two strains is in the effector phase of the disease. Since SJL/J mice have vasoactive amine sensitive vascular systems and BALB/c do not, it is likely that activated splenocytes emigrate from muscle microvessels in the SJL/J strain whereas they cannot do so in the BALB/c strain. The most significant contribution of this model may be in its potential for addressing a sine qua non of cellular autoimmune disease, i.e. lymphocyte migration from the vascular compartment into the target tissue. Finally, the data support a cellular more than a humoral pathogenesis in this model.
Animals↗
Isolated central nervous system angiitis first presenting as spontaneous intracranial hemorrhage.
Two cases of isolated central nervous system angiitis presenting as spontaneous intracranial hemorrhage are reported. The usefulness and limitations of cortical/leptomeningeal biopsy in this condition is described. Emphasis is placed on the clinical awareness of this unusual association to ensure early recognition and prompt management with immunosuppressive therapy.
Aged↗
Naming "malignant angioendotheliomatosis".
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Hemangioendothelioma↗
Brainstem subarachnoid respiratory epithelial cysts: report of two cases and review of the literature.
Two cystic lesions that were lined by pseudostratified ciliated columnar epithelium containing goblet cells are described. Both lesions were found in the subarachnoid space between the vertebrobasilar arterial system and the brainstem. One cyst was an incidental finding in a patient who died of orbital phycomycosis. The cyst was filled with clear mucinous material. The second cyst presented as a mass adjacent to the brainstem in a woman who had progressive brainstem dysfunction. This lesion showed transition from pseudostratified ciliated columnar epithelium with goblet cells to papillary stratified squamous epithelium, histologic features essentially identical to those of squamous papillomas of the nasal cavity. This lesion was filled with squamous debris. The proposed origin of these lesions is discussed.
Adult↗
Neoplastic angioendotheliomatosis: immunopathologic and morphologic evidence for intravascular malignant lymphomatosis.
Neoplastic angioendotheliomatosis (NAE) is a rare entity characterized by multifocal, intravascular proliferation of large pleomorphic cells within small vessels of most organs, with a particular affinity for the central nervous system. Clinically, patients with NAE present with focal neurologic signs and a progressive decline in mental status, followed by death in a few months. The histogenesis of NAE is controversial but has been previously thought to represent a malignant proliferation of endothelial cells. Three autopsy cases with clinical and histologic features of NAE were investigated by electron microscopic, standard histochemical, and immunohistochemical technics that included the use of three panleukocyte monoclonal antibodies (PLA), the endothelial-cell-specific reagents, FVIII-RAG anti-sera and Ulex europaeus agglutinin (UEA), and muramidase. The NAE cells in all three cases were stained positively by the PLA, whereas the adjacent endothelial cells and not the NAE cells were stained by FVIII-RAG and UEA. Muramidase by immunoperoxidase technic and nonspecific esterase (chloracetate) were not present in NAE cells. These results indicate that NAE is a leukocyte-derived neoplasm and not a malignant endothelial cell neoplasm. Based on these findings and on a review of the literature, it is proposed that NAE represents intravascular malignant lymphomatosis (IML). IML appears to be a primary manifestation and/or a major secondary form of disseminated malignant lymphoma. This would explain the spectrum of findings in previously reported cases.
Adult↗
Black thyroid syndrome: exaggeration of a normal process?
Coal-black thyroid discoloration usually is identified in patients receiving chronic minocycline therapy. This report concerns the use of light microscopic, electron microscopic, and energy dispersion spectroscopy of thyroid pigments in three separate situations: minocycline-associated black thyroid; idiopathic black thyroid; and normally pigmented thyroid glands. One of the pigments, which is found in each situation, is best described as neuromelanin. This melanin pigment, like lipofuscin, appears to accumulate with advancing age. Pigment accumulation, therefore, is a normal process in the thyroid gland. Accelerated pigment accumulation occurs with minocycline therapy but can uncommonly be seen without associated minocycline treatment. Possible mechanisms for the development of these pigments in normal and black thyroid glands are discussed. Minocycline-associated pigment is also described in substantia nigra and atherosclerotic plaques.
Adult↗
Monocytes become macrophages; they do not become microglia: a light and electron microscopic autoradiographic study using 125-iododeoxyuridine.
This light and electron microscopic autoradiographic study of stab injuries in the spinal cord of mice evaluated the ultrastructural characteristics of cells labeled by incorporation of the thymidine analogue 125I-5-iodo-2'-deoxyuridine (I-UdR), injected one day prior to injury. I-UdR was used instead of tritiated thymidine (H-TdR) because H-TdR can be reutilized and is therefore not a suitable pulse label for long-term studies of cell migration. Using serial thick and thin sections for autoradiography 614 labeled cells were identified. Labeled cells included 545 monocytes/macrophages, 50 lymphocytes, 17 pericytes, one endothelial cell, and one arachnoid cell. No labeled cell had the morphology of microglia. We concluded that macrophages in stab injuries of the spinal cord of mice are derived from blood monocytes. Blood-derived lymphocytes are also involved in the reaction to spinal cord stab injury. Microglia are not blood-derived and are not seen as a transitional form in the differentiation of monocytes to macrophages.
Affinity Labels↗
Computed tomographic and postmortem study of a nonhemorrhagic thalamic infarction.
A 70-year-old man had a stroke and became unconscious. High-resolution computed tomography (CT) with 5-mm cuts disclosed bilateral thalamic infarctions, larger on the left than the right. He died one week later, and a postmortem examination was performed. By plotting the CT on templates constructed to show the different vascular territories of the thalamus, the infarctions were predicted to be in the territories of the interpeduncular profunda arteries. Comparing sagittal reconstructions to the Schaltenbrand and Wahren atlas, the following thalamic nuclei were thought to be involved: dorsomedial, parafascicular, and centrum medianum bilaterally; and reticular, ventroanterior, and ventrolateral on the left. Pathologic study confirmed these findings. We believe that it is possible to predict the vascular territory of thalamic infarctions by plotting the CT on templates showing the different vascular territories of the thalamus. Sagittal reconstructions of CT scans also permit the determination of thalamic nuclei involved in a lesion.
Aged↗
Accuracy of CT scans in identifying tumor tissue.
The authors present their experience with stereotactic biopsy of brain tumors. Biopsies were obtained sequentially at different depths from the center of the tumor according to coordinates derived from computerized tomography (CT). Biopsies were obtained from 23 brain tumors: 17 gliomas, 5 metastases, and 1 lymphoma. In all a total of 137 biopsies were studied from both enhancing and nonenhancing areas. The tumor yield from these biopsies was 68 and 73%, respectively. It appears that tumor tissue may be obtained from both the enhancing periphery as well as the nonenhancing center of tumors.
Aged↗
Autoimmune vasculitis resulting from in vitro immunization of lymphocytes to smooth muscle.
Lymphocytes sensitized in vitro to syngenic microvascular smooth muscle and transferred to syngeneic recipients produced in vivo microvessel vasculitis characterized by mononuclear cells which adhered to endothelium, infiltrated the vessel wall, and formed a perivascular cuff. A granulomatous type of vascular inflammation was seen in 20% of the affected recipients in which the vessel smooth muscle appeared to be preferentially attacked. These lesions bear a striking resemblance to certain human vasculitides, and the model provides an important means of studying vasculitis as well as general cellular autoimmune disease mechanisms.
Animals↗