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Biomedical subjects

S P Kent

Publications and source records attributed to S P Kent.

At least 19 recordsLinked to original sources

Aldehyde pararosanilin (true aldehyde fuchsin) stains purified insulin, oxidized or not, following adequate fixation with either formalin or Bouin's fluid.

Gomori reported that aldehyde fuchsin stained the granules of pancreatic islet beta cells selectively and without need of permanganate pretreatment. Others adopted permanganate oxidation because it makes staining faster though much less selective. All aldehyde fuchsins are not equivalent, being made from "basic fuchsin" whose composition may vary from pure pararosanilin to one of its methylated homologs, rosanilin or a mixture. Mowry et al. have shown that only aldehyde fuchsin made from pararosanilin stained unoxidized pancreatic beta cells (PBC). Aldehyde fuchsins made from methylated homologs of pararosanilin stain PBC cells only after oxidation, which induces basophilia of other cells as well; these are less selective for PBC. Is the staining of PBC by aldehyde fuchsins due to insulin? Others have been unable to stain pure insulin with aldehyde fuchsins except in polyacrylamide gels and only after oxidation with permanganate. They have concluded that insulin contributed to the staining of oxidized but not of unoxidized PBC. This view denies any inherent validity of the more selective staining of unoxidized PBC cells as an indication of their insulin content. We describe here indisputable staining of unoxidized pure insulins by aldehyde fuchsin made with pararosanilin. Dried spots of insulin dissolved in the stain unless fixed beforehand. Spots of dried insulin solution made on various support media and fixed in warm formalin vapor were colored strongly by the stain. Insulin soaked Gelfoam sponges were dried, fixed in formalin vapor and processed into paraffin. In unoxidized paraffin sections, presumed insulin inside gel spaces was stained strongly by aldehyde pararosanilin. Finally, the renal tubules of unoxidized paraffin sections of kidneys from insulin-injected mice fixed in either Bouin's fluid or formalin were loaded with material stained deeply by aldehyde pararosanilin. This material was absent in renal tubules of mice receiving no insulin. The material in the spaces of insulin-soaked gels and in the renal tubules of insulin-injected mice was proven to be insulin by specific immunostaining of duplicate sections. The same material was also stained by aldehyde pararosanilin used after permanganate. So, this dye stains oxidized or unoxidized insulin if fixed adequately.

Acetates↗

Diabetic cardiomyopathy. A morphological study of intramyocardial arteries.

The mechanism of heart failure in patients with diabetic cardiomyopathy is not clear. Previous studies suggested that vascular lesions specific for diabetes mellitus were present and that the lesions could be the basis for impaired cardiac function. We have investigated the histologic and histochemical characteristics of intramyocardial vessels (20 to 500 microns) in a group of diabetics using comparable groups of patients with hypertension, patients with hypertension and diabetes mellitus, and, as controls, patients with neither hypertension nor diabetes mellitus. Analysis of multiple blocks taken from the 42 study patients disclosed no lesions specific for diabetes mellitus or hypertension. The discrepancy between our findings and earlier reports is probably due to a lack of controls and the use of non-perfusion-fixed material in the earlier studies.

Cardiomyopathies↗

Testicular lesions in Whipple's disease.

In two patients with Whipple's disease a variety of abnormalities were found in the testis. In both there was a thickened tunica albuginea containing macrophages filled with Schiff-positive bacilli, and both exhibited Whipple bacilli alone or in small clumps within the tunica media of the testicular arteries. One patient had focal inflammatory lesions among the Leydig cells. The most prominent abnormality in each was the abundance of Whipple bacilli within the epithelium of the seminiferous tubules. Some of these bacilli (which were free rather than within macrophages) appeared to be being shed into the tubular lumen; there was no associated inflammation. In some areas macrophages filled with bacilli appeared to migrate from the arterial adventitia toward the seminiferous tubules. Potential significance of these findings is discussed relative to a variety of testicular and prostatic diseases, as well as the possible (and arguable) relationship to the acquired immune deficiency syndrome.

Arteries↗

Vascular lesions of the gastrointestinal system in Whipple's disease.

In five cases of Whipple's disease the vessels in several organs of the gastrointestinal system were carefully examined for PAS-positive bacilli. Bacilli were particularly abundant in the arteries of the small intestinal serosa and the liver, but they were also present in stomach, colon, gallbladder and mesenteric lymph nodes. The predominant site of involvement was the arterial tunica media. In addition to focal degeneration and fibrosis in the tunica media, other local reactions included arteritis and intimal proliferation. Within the tunica media and less often the endothelium the bacilli were found alone or in small clumps, but in the tunica adventitia they were usually present within macrophages. The possible significance of this Whipple's arteriopathy is considered relative to unexplained gastrointestinal bleeding, focal ischemia due to arterial narrowing, and some role in the further dissemination of bacilli being shed from the endothelium.

Adult↗

Staining in normal and ischemic human myocardium. A study of myoglobin, IgG, glycogen, and diastase-PAS.

Using the indirect immunofluorescence technique, we studied the distribution of myoglobin in normal and ischemic human myocardium obtained at autopsy and at surgery. Glycogen, diastase-PAS staining of the sarcoplasm, and IgG were also studied and compared with the structure of the lesions and the distribution of myoglobin. The surgical material we used was largely free of autolysis and was the most satisfactory. Prolonged fixation of tissues in formaldehyde solution or perfusion fixation of autopsy specimens both proved to be unsatisfactory as myoglobin was absent from the myocardium. This loss presumably represents diffusion of myoglobin due to autolysis and the method of fixation. Another group of autopsy specimens that was briefly fixed by immersion in formaldehyde solution prior to processing was more satisfactory. Although they showed some extracellular diffusion of myoglobin, the autolyzed normal areas could still be clearly differentiated from the autolyzed ischemic areas.

Amylases↗

Intracellular diffusion of myoglobin. A manifestation of early cell injury in myocardial ischemia in dogs.

We produced myocardial ischemia in 18 mongrel dogs by ligating the left anterior descending coronary artery. The animals were killed 0.5 to 24 hours after the onset of ischemia to study the intracellular diffusion of myoglobin by immunofluorescence and electron microscopy employing colloidal gold particles coated with antibody to myoglobin. In areas that showed early ischemia (0.5, 1, and 2 hours), myoglobin had diffused into the nuclei and mitochondria of ischemic cells. This intranuclear diffusion of myoglobin was transient as it was not present in the 4-, 6-, 12-, and 24-hour areas of ischemia. This appearance and subsequent disappearance of intranuclear myoglobin may be useful in identifying early areas of myocardial ischemia that are not evident by histologic techniques. This pattern of diffusion may also be helpful in studying other types of cell injury.

Animals↗

Whipple's disease: pathogenetic considerations.

A typical case of Whipple's disease was manifested by malabsorption and nondeforming peripheral arthritis for five years. A definite diagnosis was made by duodenal mucosal biopsy which revealed the characteristic histologic features by light microscopy, intracellular and extracellular Whipple's bacilli by electron microscopy, and a typical immune cross-reactivity pattern by immunofluorescence technique. Whipple's bacilli apparently elicit no effective humoral and cellular immune response; macrophages thus play the key role in its pathogenesis. Antibiotic treatment resulted in a dramatic relief of symptoms and rapid restoration of body weight. We stress that in patients with nondeforming peripheral arthritis associated with malabsorption syndrome, Whipple's disease, despite its rarity, should be included in the differential diagnosis.

Diagnosis, Differential↗

Diffusion of myoglobin in the diagnosis of early myocardial ischemia.

Myocardial ischemia was produced in 12 dogs by ligation of the anterior descending branch of the left coronary artery. The animals were sacrificed 0.5, 1, 3, 6, 12, and 24 hours later. The ischemic area was compared with control tissue from the posterior aspect of the left ventricle as to the glycogen content, myoglobin content, intracellular diffusion of IgG, diastase resistant-periodic acid-Schiff (PAS) (D-PAS) staining material and basic fuchsin-staining material. In the earliest time period studied, 0.5 hours, glycogen loss marked a large area of ischemic change. Myoglobin loss, intracellular diffusion of IgG, D-PAS-staining material and basic fuchsin-staining material were also found but involved only a small area within the glycogen-depleted zone. As the length of ischemic period increased, the area occupied by these changes approached the size of the area of glycogen loss. In all animals, the area of myoglobin loss, intracellular diffusion of IgG, D-PAS staining and basic fuchsin staining were in the area of glycogen loss. The IgG, D-PAS, and basic fuchsin parameters, in turn, were within the area of myoglobin loss but usually did not completely fill it. That is, some fibers showing myoglobin loss did not show the other changes. Can any of these changes serve as early markers for irreversible ischemic injury? Glycogen loss clearly does not. Additional data are needed to determine whether the extracellular diffusion of myoglobin and the intracellular diffusion of IgG are markers of irreversible injury.

Animals↗

Antibody coated gold particles containing radioactive gold in the demonstration of cell surface molecules.

Gold particles of varying size which contain either 195Au of 198Au were prepared using white phosphorus or sodium citrate as the reducing agent. After coating with specific antibody to blood group A antigen or human IgG, these particles were used to determine the number of particles binding to the surface of A1 RBC's or rat RBC's to which human IgG had been attached. The number of particles binding to the surface of cells correlated with the number of antibody coated gold particles in the fluid bathing the cells as well as the number of antigen molecules on the cell surface. That is, the number of particles binding increased as the particle density of the suspension increased and as the cell surface antigen density increased. Under the conditions of the experiments, both blood group A antigen and human IgG appeared to be randomly distributed over the surface of the cells in TEM and SEM preparations. This approach permitted the quantitation of the number of gold particles bound per cell and at the same time, the examination of the distribution of the particles over the surface of the same cell population by TEM and SEM.

Animals↗

Specific identification of hemoglobin and myoglobin in renal tubular casts by the fluorescent antibody technic on fixed embedded tissues.

Hemoglobin and myoglobin have been identified in formalin-fixed paraffin-embedded sections of human autopsy material with the indirect fluorescent antibody technic. The sensitivity and specificity observed were comparable to those reported by other investigators who used fresh-frozen sections. When this approach was applied to archival autopsy tissue, it was possible to identify some pigmented renal tubular casts specifically as myoglobin or hemoglobin and to separate them from other pigmented casts such as bile or melanin. The data suggested that the hemeproteins, as they pass along the nephron, are progressively denatured, and that their reactivities with specific antisera, iron stains, and peroxidase substrates are altered. Intact hemeprotein molecules react with specific antibody and show peroxidase activity, but the iron is not demonstrable by traditional methods. In the proximal tubules, after filtration, they react with specific antibody, show peroxidase activity, and also have demonstrable iron. By the time they reach the collecting tubules, they show only peroxidase activity.

Female↗

Whipple's disease. Immunological and histochemical studies of eight cases.

Tissue from eight cases of Whipple's disease was studied by immunofluorescence and by histochemical methods. The histochemical and immunofluorescent reactions obtained in paraffin-embedded sections of tissues fixed in formaldehyde solution were as strong as that seen in fresh-frozen sections. So, archival cases can thus be satisfactorily studied by these methods. The pattern of reactivity of the polysaccharide with a variety of antisera is remarkably similar from case to case. This supports the hypothesis that the organism associated with Whipple's disease is the same from case to case. Possible explanations for the apparent tolerance of the patients to the polysaccharide are discussed.

Fluorescent Antibody Technique↗

Hepatitis B antigen and polymyositis.

Concomitant polymyositis diagnosed by muscle biopsy developed in a 51-year-old man with hepatitis B surface antigen (HBsAg) hepatitis. Findings from immunofluorescent studies showed deposits of gamma-globulins and complement in both muscle and liver. The HBsAg and HBsAg-antibody complexes were detected in the liver by immunofluorescence using fluorescein-labeled antibody to hepatitis Bs.

Antigen-Antibody Reactions↗

Steric hindrance as a factor in the reaction of labeled antibody with cell surface antigenic determinants.

The binding of rabbit anti-human IgG labeled with 125I, shellfish glycogen or ferritin to human IgG attached to the surface of rabbit RBC with chromic chloride was studied. Maximum binding was noted with 125I labeled antibody. Slightly but consistently less binding was found with shellfish glycogen labeled antibody. The binding of ferritin labeled antibody was strikingly reduced--usually one-third or less of that found with 125I labeled antibody alone. This suggests that under the conditions of these experiments, the attachment of large labels to antibody molecules results in reduced antibody binding to surface antigen. Steric hindrance is probably at least in part responsible for this reduced binding.

Animals↗

Whipple's disease: case report with immunological studies.

A patient with Whipple's disease is described whose small bowel biopsy demonstrated antigenicity to rabbit antisera to groups A, B, C, and G streptococci and Shigella flexneri, but not to antisera to pneumococcus or Shigella sonnei by immunofluorescent techniques. In addition, the patient's lymphocytes responded normally to phytohemagglutinin and to concanavalin A. These studies support the idea what Whipple's disease is mediated by a bacteria-like agent which shares certain antigenic similarities with groups A, B, C, and G streptococci and S. flexneri, and that T cell dysfunction does not appear to be an essential prerequisite for the disease.

Antibodies, Bacterial↗

Blood group A antigen in human erythrocytic membranes and membrane fractions.

Erythrocytic membranes from blood group A individuals were assayed for A antigen using a quantitative hemagglutination inhibition technique. The membranes were then extracted for lipid and glycoprotein. Although some A antigen was usually found in the glycoprotein fraction, most of the activity was in the lipid fraction. The sum of A antigen activity in the lipid, glycoprotein, and membrane residue fractions only occasionally was equal to the A activity in the erythrocytic ghosts. However, when certain lipid preparations with little or no A antigen (enhancement factors) were added to the glycolipid fractions, the amount of A antigen demonstrated was usually greatly increased. Under these conditions, the sum of the fractions often was much greater than the A antigen demonstrated in erythrocytic membranes. This suggests that the organization or arrangement of A antigenic determinants in the red cell membrane may not always permit a stoichiometric reaction with anti-A molecules.

ABO Blood-Group System↗