Treatment with an anabolic agent is associated with improvement in respiratory function in persons with tetraplegia: a pilot study.

BACKGROUND: Pulmonary complications are a major cause of morbidity and mortality among individuals with cervical spinal cord lesions. Strengthening of the respiratory musculature may reduce these complications. Anabolic steroids have been used to increase muscle mass and improve muscle performance. Oxandrolone, an anabolic steroid, may have beneficial effects on breathing in persons with tetraplegia. METHODS: The effect of one-month treatment with oxandrolone on weight gain and pulmonary function was studied in ten subjects with complete motor tetraplegia. Spirometry, maximal inspiratory and expiratory pressures, and resting self-rating of dyspnea (Borg Scale) were measured at baseline and repeated again at the end of one month of oxandrolone therapy (20 mg/day). Serum lipid profiles and liver function tests were performed before and after treatment. A paired t-test was used to determine pre- and post-treatment differences on the dependent variables. Percent change from baseline was calculated for each variable and tested using a one-sample t-test. RESULTS: On average, the subjects gained 1.4+/-1.5 kg, a 2+/-2% increase in weight (p=0.01). A significant, 9+/-2% improvement was found in the combined measures of spirometry (p<0.005). Maximal inspiratory pressure improved an average of 10+/-7% (p<0.001). Maximal expiratory pressure improved 9+/-13% (non-significant). Subjective self-rating of dyspnea decreased an average of 37+/-28% (p<0.01). CONCLUSIONS: In healthy subjects with tetraplegia, the use of oxandrolone was associated with significant improvements in weight and pulmonary function, and a subjective reduction in breathlessness. Therefore, oxandrolone may be indicated to strengthen respiratory musculature in individuals who have tetraplegia and ventilatory insufficiency aggravated by superimposition of pneumonia or other such conditions. However, long-term use of oxandrolone may not be indicated, due to the adverse complications associated with this class of agents.

Atherosclerosis and polyps of the colon. Quantification of precursors of coronary heart disease and colon cancer.

The prevalence of adenomatous and hyperplastic polyps of the colon and the degree of involvement of the aorta by atherosclerotic lesions were evaluated in 842 autopsies from New Orleans. A positive statistical association between the two variables was found in white males under 75 years of age. In black males a positive correlation between atherosclerotic lesions and adenomatous (but not hyperplastic) polyps was found. The most extensive involvement of the aorta by atherosclerosis was found in patients in whom adenomatous and hyperplastic polyps coincided. The possibilities that dietary factors may account for these findings and its relevance in relation to colon cancer and coronary heart disease are discussed.

Elastin VIII. A correlative study of the aging elastica of arteries and skin.

Nigrosin base in an acid alcohol solution and Gomori's aldehyde fuchsin gave excellent staining of the elastic fibers in the arteries and skin regardless of age. Neutral hydroalcohol solutions of alcohol soluble nigrosin stained the elastic fibers in the arteries and skin of humans above age 20. Clara's neutral hematoxylin stained the arterial elastica of children less than 10 years of age, but did not color the elastic fibers of the skin. By these staining procedures, it may be possible to obtain information about arterial elastica by a skin biopsy.

Reduction and azo coupling of quinones. A histochemical study of human cutaneous melanin and adrenochrome.

Cutaneous melanin in formol fixed skin and adrenochrome in dichromate fixed monkey adrenal after adequate bisulfite or dithonite reduction were found to give definite azo coupling reactions. Weaker reactions were obtained on unreduced material, and these disappeared on ferric chloride oxidation. Both cutaneous melanin and adrenochrome appear to exist in a quinhydrone status. Prolongation of dichromate treatment weakens or abolishes azo coupling capacity of adrenochrome. The findings support the concept of quinonization and reduction to prevent and restore azo coupling of enterochromaffin cells and noradrenaline islets of the adrenal. The most effective diazos for melanin were p-nitrodiazobenzene, fast black K and the diazosulfanilic acid, pH 1 pyronin B procedure, for adrenochrome. Diazosafranin and 2-chloro-4-nitrodiazobenzene were also useful. Blue and violet coupling products from toluidine blue and methylene violet RR fail to yield sufficient contrast to be convincing.

Formalin pigment (acid hematin) and related pigments.

Black to brown amorphous to microcrystalline granules are encountered in histologic sections prepared from tissues fixed in formalin having a low pH. This pigment is produced by acid acting upon hemoglobin and is known as formalin pigment or acid hematin. A similar pigment is also observed in sites of bleeding ulcers in areas of acid production such as the stomach. These pigments exhibit many physical and histochemical properties similiar to pigments produced by some animal parasites as in malaria, schistosoma and pulmonary mites. These parasites disintegrate erythrocytes in an unknown manner, and liberate an acid hematin-like pigment which is phagocytized by the reticuloendothelial system. Since formalin pigment can be considered as an artifact, confusion with other pigments can be avoided by the use of neutral buffered formalin for the fixation of tissues.

Mesothelioma of spermatic cord: electron microscopic and histochemical characteristics of its mucopolysaccharides.

A mesothelioma of the spermatic cord occurred at the site of multiple hernial repairs. The aggressive biologic behavior of this tumor is exhibited by its early lymph node invasion and extensive metastases to the pleural cavities, lungs, and spleen. These tumor cells contained a large amount of stable of stable glycogen-like carbohydrate insoluble in formalin and tolerating postmortem changes. Electron microscopy revealed features similar to those mesotheliomas arising from body cavities.

Elastin VII: aging effects on vascular elastica staining by oil soluble nigrosin dyes.

Neutral hydroalcoholic stains with spirit soluble nigrosin (C.I. 50415) and nigrosin base (C.I. 50415B) were applied to a series of human arteries from individuals ranging from newborn to 82 years of age for the demonstration of the selective staining by these dyes of the aging change in their elastica described by Lillie, Pizzolato and Donaldson (1974). The staining is absent in infants and children. It first appears in slight grade in some individuals at age 18. It increases in frequency and intensity with advancing age. It is often seen without obvious other histologic lesion and is regularly present when fibrous and fibroatheromatous plaques appear. In this series it was studied in the aorta of children and in grossly relatively normal areas of the superior mesenteric artery which was selected for the survey because of its usual rather slight involvement in arteriosclerosis. The intensity of the neutral nigrosin staining of the elastica of this artery appeared to be uninfluenced by the extent or severity of aortic lesions in the same individual. This nigrosinophilia appears to be an integral early phase in the development of the arteriosclerotic process and may precede appearance of fibrous or fibroatheromatous plaques by some years. The nigrosinophilia has been assigned (1974) to a lipoprotein alteration of arterial elastica. Prolonged storage in formol in plastic bags induced a strong neutral Solvent black 5 and 7 staining of arotic elastica in the normally negative 10-20 year age group. This reaction is presently considered artifactual, but is being studied further experimentally.

Nuclear stains with soluble metachrome metal mordant dye lakes. The effect of chemical endgroup blocking reactions and the artificial introduction of acid groups into tissues.

Following our study on the effect of deoxyribonucleic acid (DNA) extraction on nuclear staining with soluble metal mordant dye lakes covering 29 dye lakes we chose a series of lakes representing the three groups: (1) readily prevented by DNA removal, (2) weakened by DNA extraction but not prevented, (3) unaffected by DNA removal, for application of other endgroup blockade reactions. The lakes selected were alum and iron hematoxylins, iron alum and ferrous sulfate galleins, Fe2+ gallo blue E, iron alum celestin blue B, iron alum fluorone black and the phenocyanin TC-FeSO4 sequence. Azure A with and without an eosin B neutral stain, was used as a simple cationic (and anionic) dye control. Methylation was less effective than with simple cationic dyes, but did weaken celestin blue, gallo blue E and phenocyanin Fe2+ nuclear stains. These dyes also demonstrate other acid groups: acid mucins, cartilage matrix, mast cells, central nervous corpora amylacea and artificially introduced carboxyl, sulfuric and sulfonic acid groups. Alum hematoxylin stained cartilage weakly and demonstrated sulfation and sulfonation sites. The iron galleins, iron fluorone black and acid iron hematoxylin do not. A pH 4 iron alum hematoxylin gave no staining of these sites; an alum hematoxylin acidified with 1% 12 N HCl gave weaker results. Deamination prevented eosin and orange G counterstains but did not impair nuclear stains with any of the mordant dye lakes. The simple acetylations likewise did not alter mordant dye nuclear staining, the Skraup reagent gave its usual sulfation effect on other tissue elements, but did not alter nuclear stains by mordant dyes. The mordant dyes do not bind to periodic acid engendered aldehyde sites and p-toluidine/acetic acid and borohydride aldehyde blockades did not alter mordant dye lake nuclear staining. Nitration by tetranitromethane, which blocks azo coupling of tyrosine residues, did not alter nuclear staining by the mordant dye lakes. Benzil at pH 13, which prevents the beta-naphthoquinone-4-Na sulfonate (NQS) arginine reaction and the Fullmer reaction of basic nucleoprotein, did not affect iron gallein, iron or alum hematoxylin stains of nuclei or lingual keratohyalin.

Iron and aluminum lakes of Gallo blue E as nuclear and metachromatic mucin stains.

Gallo blue E, C. I. No. 51040, Mordant Violet 54, furnishes a blue black nuclear stain when applied to tissue sections in the form of its moderately stable iron lakes. This coloring combined well with such counterstains as orange G and eosin B. The Van Gieson stain tends to decolorize mucins, cartilage, and mast cells previously stained with this dye. Its aluminum lake solutions tend to gel in a few minutes to 24 hours depending on the solvent used and the amount of Al3+ present. Aluminum lake solutions give a moderately good blue to dark blue nuclear stain and a brilliant purplish red to dark purple stain to a variety of epithelial and connective tissue mucins. Acid dye counterstains are poorly tolerated. With either lake, nuclear staining is abolished by deoxyribonuclease digestion or relatively short mineral acid extraction of DNA.