ABSTRACT
It has been suggested by some studies of human and animal lungs that the products of pulmonary endocrine cells, particularly gastrin-releasing peptide, might play a role in fibrogenesis, but more recent detailed studies of fibrotic human lungs have failed to confirm this. We have made a detailed quantitative examination of a series of fibrotic human lungs to see if we could determine whether there was any relationship between endocrine cells and fibrosis. Using immunocytochemistry, we investigated the morphology, content, distribution and number of pulmonary endocrine cells in 15 pairs of fibrotic lungs from coal miners, and compared their features with those of equivalent cells in age-matched controls. Proliferation of endocrine cells was seen in the lungs of just two miners, in which it was focal and associated with acute bronchitis and bronchopneumonia. There was no difference between the miners and controls in the appearance (mostly solitary cells), content (predominantly gastrin-releasing peptide and calcitonin), distribution (mainly in small bronchi and bronchioles), or number (4.5 vs 4.1 cells per 10,000 epithelial cells, respectively) of endocrine cells. It seems unlikely that the substances secreted by these cells play any role in stimulating fibrosis in human lungs, but rather that they have a function in the inflammatory response to pulmonary injury.
Subject(s)
Anthracosilicosis/pathology , Lung/pathology , Neurosecretory Systems/pathology , Aged , Aged, 80 and over , Anthracosilicosis/metabolism , Calcitonin/metabolism , Calcitonin Gene-Related Peptide/metabolism , Cell Count , Gastrin-Releasing Peptide , Gastrointestinal Hormones/metabolism , Humans , Immunohistochemistry , Lung/metabolism , Male , Middle Aged , Neurosecretory Systems/metabolism , Peptides/metabolismABSTRACT
This paper gives an overview on the use of Diagnosis Related Groups (DRGs) for internal hospital management. Some figures derived from a comparative study between 3 university hospitals in Belgium are used to illustrate specific points. Attention is given to cost accounting and cost control on the one hand, and utilization review and quality assurance testing on the other. Costs have been approximated by billed charges. It is concluded that DRGs can effectively be used for hospital management, in addition to hospital financing for which some pressure also exists in Europe.
Subject(s)
Diagnosis-Related Groups/economics , Financial Management, Hospital/methods , Financial Management/methods , Accounting , Belgium , Costs and Cost Analysis/statistics & numerical data , Data Collection , Fees and Charges/statistics & numerical data , Quality Assurance, Health Care/economics , Utilization ReviewABSTRACT
Using immunofluorescence forty-nine sera giving striational staining of skeletal and cardiac muscle have been tested on glycerinated myofibrils. By comparing immunofluorescence and phase contrast it has been found that these antibodies are rather heterogeneous but at least three different staining patterns can be identified. Some patterns may be associated with the presence of a thymoma or may be induced by penicillamine treatment of patients with rheumatoid arthritis. Routine screening for antistriational antibodies may lead to the recognition of undiagnosed myasthenia gravis and thymoma. Antistriational autoantibodies may be useful in the further study of the structure and function of the sarcomere.
