Histopathologic approaches to chemical toxicity using primary cultures of dissociated neural cells grown in chamber slides.

Morphologic lesions have received only limited attention as in vitro endpoints of toxicity. In the present work, "tissue" and cell morphology of control and toxicant-treated primary dissociated cerebrocortical cell cultures from fetal mice were examined using phase-contrast and bright-field microscopy. In untreated control cultures, a reproducible sequence of developmental events included cellular reaggregation, intercolony bridging with cell migration, and neuronal apoptosis, with maturation yielding confluent monolayers containing both neurons and glia. Because even mature cultures had regions of varying differentiation, an understanding of the normal developmental sequence was essential when assessing toxicant-treated cultures for damage. Chemicals induced neuronotoxic, gliotoxic, and cytotoxic (i.e., nonspecific) patterns of morphologic damage in growing (< 6 day old) or mature (6-15 day old) cultures in both a concentration-dependent and cell type-specific manner. In addition, exposure to some toxicants consistently reduced the staining intensity for glial fibrillary acidic protein in the astrocyte carpet prior to the appearance of structural damage. These data indicate that histopathologic endpoints, including methods for neural-specific markers, represent potentially valuable criteria for in vitro assessments of neurotoxicity.

Proliferative and neoplastic lesions in the rodent nasal cavity.

Proliferative lesions in the rodent nasal cavity are reviewed; attempt was made to compare species affected, sex differences, strain differences, route of administration and tumor types occurring both spontaneously and after induction by different chemicals. This review is not meant to be all inclusive but to be representative of observed trends. Our general conclusions in this paper are that: 1) spontaneous nasal tumors in rodents are very rare; 2) spontaneous nasal tumors in rats are most often squamous cell tumors, whereas hemangiomas or respiratory adenomas predominate in mice and squamous cell tumors are rare; 3) rats are usually more susceptible to the induction of epithelial tumors of the nasal cavity than mice; 4) chemically-induced hemangiomas and hemangiosarcomas of the nasal cavity have only been reported in mice; 5) tumors of the olfactory epithelium are almost uniformly malignant and invasive, while nonsquamous tumors of the respiratory epithelium are typically less invasive; 6) chemically-induced tumors of the olfactory region, either mesenchymal or epithelial, do not always require an inhalation route of exposure but may occur by systemic targeting of this region; and 7) chemicals inducing tumors in the olfactory region often produce a variety of tumor morphologies in this location as well as squamous and polypoid tumors of the transitional region. More work will be needed to illucidate the mechanisms of nasal carcinogenesis and to further refine the current tumor classification system.

Histochemical localization of formaldehyde dehydrogenase in the rat.

Formaldehyde dehydrogenase (FDH) activity has been demonstrated biochemically in the olfactory and respiratory mucosae and in the liver of the rat, but the cellular localization of this enzyme has not been investigated. A histochemical procedure was developed to permit cellular localization of FDH. This allowed us to examine the relationship between distribution of FDH and formaldehyde-induced toxicity. Cold-processed glycol methacrylate embedded tissues were used to localize FDH activity in the rat respiratory tract, kidney, liver, and brain. Five- or ten-micrometer tissue sections were incubated in a reaction mixture containing formaldehyde (HCHO), glutathione (GSH), NAD+, nitroblue tetrazolium, pyrazole, and disulfiram. A blue formazan precipitate was formed at the site of FDH activity. Epithelial cell cytoplasm of both the respiratory and the olfactory mucosae of the nose stained for FDH, and olfactory sensory cell nuclei were also positive. Underlying Bowman's and seromucous glands were weakly positive. The lung had FDH activity located mainly in the Clara cells of the airways, with only diffuse weak activity in the lung parenchyma. Liver had activity in the cytoplasm of the hepatocytes, while in the kidney FDH was most prominent in the brush border of the P2 segment of the proximal tubules. Brain white matter stained strongly for FDH, while in gray matter only the neuropil exhibited weak activity. Corresponding tissue sections were stained for sulfhydryls; these sections indicated that GSH is likely to be present in all cells with FDH activity. For the respiratory tract these results demonstrate distinct differences between the location of FDH activity and previously reported nonspecific aldehyde dehydrogenase activity in the nose (M. S. Bogdanffy, H. W. Randall, and K. T. Morgan, 1986, Toxicol. Appl. Pharmacol. 82, 560-567). While high aldehyde dehydrogenase activities were found in tissues with low toxicities due to acetaldehyde exposure and vice versa, FDH activity was observed in tissues whether or not they exhibited a toxic response to inhaled HCHO. While not able to account for the localized toxicity of HCHO, the presence of FDH and glutathione in the epithelial layer of the nasal cavity presents a barrier to inhaled formaldehyde at low concentrations and may partially explain the observed nonlinearity of HCHO toxicity.

Nifedipine versus ritodrine for suppressing preterm labor.

Fifty-eight women in preterm labor were selected randomly to receive either oral nifedipine or intravenous ritodrine hydrochloride. In comparison to ritodrine, nifedipine had similar tocolytic efficacy with fewer adverse maternal and fetal side effects. On Doppler studies nifedipine had an insignificant effect on umbilical blood flow. Preliminary data suggest that nifedipine is a safe, effective and well-tolerated tocolytic agent. It may prove to be a suitable alternative to ritodrine hydrochloride, especially for women in whom beta-sympathomimetics are contraindicated.

Fetal intestinal obstruction: necessity for percutaneous umbilical blood sampling to assess the severity of Rh sensitization.

Investigation into the severity of hemolytic disease due to Rh isoimmunization may be complicated by concurrent amniotic fluid contamination with bile. We have presented a case in which a prenatal sonogram showed evidence of fetal intestinal obstruction, which was subsequently confirmed postpartum by exploratory laparotomy. Since intrauterine regurgitation of bile occurs with intestinal obstruction distal to the papilla of Vater, percutaneous umbilical blood sampling is necessary to discern the presence and severity of hemolytic disease as indicated by an abnormal spectrophotometric absorption pattern.

The ambulatory surgical management of Bartholin duct cysts.

Marsupialization of Bartholin duct cysts was performed in the emergency department (ED) under pudendal anesthesia. Nineteen symptomatic cysts were treated surgically using techniques suitable for outpatient facilities. Pudendal anesthesia was adequate in all but two patients in whom supplemental local infiltration was used. One-third of the patients experienced unilateral lower extremity numbness following the pudendal block. Symptoms had completely subsided approximately 20 minutes after the procedure, and there were no sequelae. The average length of time of the procedure was 25 minutes. All patients were discharged from the ED within 30 minutes of completion of the procedure. In all patients examined one week postoperatively, the residual pouch had shrunk to less than half its original size and the apertures were patent. There have been no problems with bleeding, infection, pain or dyspareunia. In a follow-up survey, no recurrent cysts were reported. This problem can be treated safely in the ED with good results.

Large area sectioning for morphologic studies of nonhuman primate nasal cavities.

The nasal region is important for studies in inhalation toxicology but is difficult to prepare for histological examination, especially in species as large as primates. A method for the histologic preparation of undecalcified, complete transverse sections of the nonhuman primate nasal cavity is summarized as follows. After removal of excess soft tissue, mandible and calvaria, the head is fixed in 10% neutral buffered formalin. The nasal region is transversely sectioned into serial 3-mm-thick blocks from the nares to the posterior aspect of the soft palate using a low speed saw with a water-cooled diamond-coated blade. The blocks are embedded in a mixture of glycol and methyl methacrylates, with polyethylene glycol-1500 and dibutylphthalate as plasticizers. The plastic blocks average 5.0 x 5.0 x 1.5 cm; 2-4 microns sections are cut on an automated sliding microtome. In spite of the size of the blocks, this technique yields complete transverse sections of the nasal cavities with excellent morphologic detail. The sections are amenable to a wide range of staining procedures. The procedure lends itself to autoradiographic studies. The embedding mixture is ideally suited for studies of undecalcified bone and teeth.

Enzyme histochemistry of the rat nasal mucosa embedded in cold glycol methacrylate.

The nasal passages are anatomically complex, and while there have been a number of descriptions of nasal structure in many species, there is very little information available on the distribution of enzymes in the nasal mucosa. In rodents, this delicate mucosa is the first site within the respiratory tract to be exposed during inhalation toxicology studies designed to assess human risks from such exposures. However, the nasal mucosa presents problems for histologic preparation because it is encased in brittle bones. Because of recent interest in the nose as a target site, and findings from biochemical studies which indicate that the nose is very active metabolically, studies were carried out to determine the value of cold glycol methacrylate (GMA) processing for localization of nasal enzymes. For these studies, liver and kidney were used as positive controls. Published histochemical procedures for acid and alkaline phosphatase, adenosine triphosphatase, glucose-6-phosphatase, gamma-glutamyl transpeptidase, and naphthyl butyrate esterase were applied, with modifications, to undecalcified nasal passages of Fisher-344 rats. Frozen sections exhibited excellent enzyme preservation but very poor morphology, while GMA gave good enzyme preservation and excellent morphology. For GMA, acetone fixation generally resulted in the best preservation of enzyme activity. It was concluded that cold GMA processing provides a useful approach to studies of nasal enzyme distribution and that this technique of value for inhalation toxicology studies. Details of enzyme distribution in the squamous, respiratory, and olfactory epithelia, associated glands, and other structures of the nose of the rat are described and discussed.

Biochemical quantitation and histochemical localization of carboxylesterase in the nasal passages of the Fischer-344 rat and B6C3F1 mouse.

Inhalation exposure of rats and mice to glycol ether acetates and acrylate esters causes degeneration of the olfactory epithelium but not of the respiratory epithelium. Since these compounds are metabolized via carboxylesterase to acids that are toxic to the olfactory epithelium, the activity and cellular distribution of carboxylesterase in the nasal passages of rats and mice were studied. Olfactory mucosal carboxylesterase in both rats and mice was found to have a Vmax value for the hydrolysis of p-nitrophenyl butyrate approximately 3 to 6 times larger than that for respiratory mucosa. Similarly, the second-order rate constant for binding and catalysis, V/K, was approximately four times greater in olfactory mucosa than in respiratory mucosa of both rats and mice. These data demonstrate that the olfactory mucosa of rats and mice hydrolyze carboxylesters more efficiently than the respiratory mucosae. Enzyme histochemistry was employed to identify the individual cells within the respiratory and olfactory mucosae which contain carboxylesterase activity. All cell types of the respiratory epithelium had some carboxylesterase activity, with varying intensities between individual cell populations. Ciliated and cuboidal epithelial cells were most active in this region. In the olfactory mucosa, however, Bowman's glands stained most intensely, sustentacular cells demonstrated moderate activity, and no activity was detectable in olfactory sensory cells. Together, these data quantitate carboxylesterase activity in nasal mucosal homogenates and localize the enzyme in individual cell types. The data suggest that olfactory mucosa may metabolize carboxylesters to acids more readily than respiratory mucosa. However, such metabolism does not occur in the target cell population, the olfactory sensory neurons, raising the possibility of intercellular migration of toxic acid metabolites.

Hydrocephalic fetus in an abdominal pregnancy.

We present an unusual case of an abortion at 20 weeks elected after a diagnosis of fetal hydrocephalus and spina bifida. Unsuccessful attempts at abortion with prostaglandin suppositories ultimately led to a diagnosis of abdominal pregnancy. This is the first reported case of an abdominal pregnancy discovered during an abortion that was elected because of an anomaly identified by ultrasound.

Histochemical localization of aldehyde dehydrogenase in the respiratory tract of the Fischer-344 rat.

Acetaldehyde, a nasal carcinogen and respiratory tract irritant, is metabolized by aldehyde dehydrogenase. The localization of aldehyde dehydrogenase in individual cells of the nasal passages, trachea, and lungs of the Fischer-344 rat was determined histochemically using a cold glycol methacrylate embedding procedure. Aldehyde dehydrogenase activity was detected principally in the nasal respiratory epithelium, especially in the supranuclear cytoplasm of ciliated epithelial cells while olfactory epithelium was almost devoid of enzyme activity. Epithelial cells of the trachea demonstrated little detectable aldehyde dehydrogenase activity, however, the Clara cells of the lower bronchioles showed remarkably high activity. These results corroborate previous biochemical findings and extend them by histochemically identifying particular aldehyde dehydrogenase-positive cell types within the nasal respiratory epithelium. The distribution of nasal lesions induced by acetaldehyde correlated with regional aldehyde dehydrogenase deficiencies suggesting that regional susceptibility to the toxic effects of acetaldehyde may be due, at least in part, to a lack of aldehyde dehydrogenase in the susceptible regions. Furthermore, aldehyde dehydrogenase activity in the Clara cells indicates a possible site for metabolism of aldehydes which penetrate to the lower airways.

Evaluation of amniotic fluid in preterm labor with intact membranes.

Amniotic fluid was obtained from 35 pregnant women in preterm labor with intact membranes. Their gestational ages ranged from 24 to 34 weeks. Bacteria were detected in only 1 (3%) of the 35 amniotic fluid samples. The anaerobic culture grew Bacteroides corrodens and Fusobacterium nucleatum. The L/S ratio was greater than 4.0 in six patients (17%), 2.5-4.0 in two (6%) and less than 2.5 in 23 (66%); the quantity of fluid was inadequate for L/S analysis in four (11%). None of the 35 newborns developed evidence of infection in the neonatal period. Only two women (6%) were febrile postpartum, and none experienced a prolonged hospital stay. Seven (20%) of the infants developed respiratory distress syndrome. Five (14%) developed hyaline membrane disease, and two (6%) had transient tachypnea of the newborn. Intrauterine infection may play a lesser role in preterm labor with intact membranes than previously postulated. Amniocentesis may provide useful information for directing management by permitting one to assess fetal pulmonary maturity and the presence of meconium.

Impairment of tissue defenses by vasoconstrictors in vaginal hysterectomies.

This paper examines the role of vasoconstrictors, specifically epinephrine, as an etiologic factor in the impairment of the host's defense mechanism. One hundred patients were injected circumferentially around the cervix with a dilute solution of epinephrine before vaginal hysterectomy; these patients were compared to a control group of 100 patients injected in the same manner with a normal saline solution. This randomized prospective study shows that vasoconstrictors significantly predisposed the vaginal cuff surgical site to infection compared to the matched control group. This study shows also that the use of a vasoconstrictor did not significantly reduce blood loss. Based on these data, it is recommended that a locally injected vasoconstrictor not be used during vaginal hysterectomy.