A histological investigation on early tissue response to titanium implants in a rat intramedullary model.

Miniature grade 1 titanium screws were inserted in the tibias of 12 mature Wistar rats. Animals were sacrificed at 4, 7, and 21 days postimplantation. A combination of two morphological approaches was used to examine the tissue response to implants. One part of the prepared tissue specimens was routinely embedded in paraffin after a weak decalcification in EDTA. In this case, the implant was mechanically removed before embedding. The remainder of the specimens were embedded in polymethylmethacrylate resin, and ground sections were realized according to Donath's method. New bone formation occurred soon after implantation. Initially, on the fourth day, the presence of osteoid could be observed near the implant surface. On the seventh day, well-mineralized bone tissue was apposed directly on the implant surface. On the 21st day, the bone tissue became a highly organized lamellar bone.

[Adenocarcinoma in an ileal duplication]. / Adénocarcinome dans une duplication intestinale grêle.

We describe a 54-year-old man with a history of multiple congenital abdominal malformations who developed an adenocarcinoma in a small intestinal duplication. To our knowledge this is the second reported case of an exceedingly rare complication of small intestinal duplication. The relevant literature is reviewed.

Expression and localization of tumor necrosis factor-alpha and its mRNA in idiopathic pulmonary fibrosis.

The expression of tumor necrosis factor alpha and its mRNA was investigated in surgical biopsies from idiopathic pulmonary fibrosis by immunohistochemistry, in situ hybridization, and Northern blotting. Normal areas of lungs resected for cancer were used as controls. Tumor necrosis factor alpha mRNA levels were higher in idiopathic pulmonary fibrosis than in normal lungs as determined by Northern blots. In normal lungs, tumor necrosis factor alpha and its mRNA were identified in alveolar and interstitial macrophages. In fibrotic lungs, tumor necrosis factor alpha was detected in macrophages and, to a greater extent, in epithelial cells (presumably type II cells) lining the thickened septae. Tumor necrosis factor alpha mRNA was found only in some interstitial cells and some of the cells lining the alveolar septae. An elevated concentration of tumor necrosis factor = alpha, particularly within the alveolar epithelium, might contribute to the alveolar damage and proliferation of interstitial cells in idiopathic pulmonary fibrosis.

Cytoskeletal features of alveolar myofibroblasts and pericytes in normal human and rat lung.

Frozen or paraffin-embedded human and rat lung specimens were stained with antibodies against total actin, alpha-smooth muscle (SM) actin, vimentin, desmin, or gelsolin. Alveolar interstitial myofibroblasts [i.e., contractile interstitial cells (CIC)] were labeled by total actin antibody but not by alpha-SM actin antibody. They stained for vimentin and gelsolin and, in rat lungs, most of them for desmin. Pericytes located around venules at the junction of three alveolar septa were always positive for alpha-SM actin and never for desmin. Tissue samples were also immunostained by an alpha-SM actin antibody and studied by electron microscopy. With this technique we confirmed that cells, identified as pericytes on the basis of their location, were intensely labeled by alpha-SM actin antibodies, whereas alveolar myofibroblasts were not. We conclude that in the lung interstitium pericytes and alveolar myofibroblasts have distinct cytoskeletal features, alpha-SM actin antibody staining being a simple method to distinguish between them. Furthermore, it appears that alveolar myofibroblasts have a peculiar pattern of cytoskeletal protein composition which, in the rat, is similar to that previously described for stromal cells in uterine submucosa, liver sinusoids (Ito cells), or the core of intestinal villi.

Cystic neoplasms of the exocrine pancreas.

Cystic neoplasms of the pancreas are rare and their diagnosis and treatment can be difficult. This report details 7 patients who had histologically proven serous cystadenoma, mucinous cystadenoma and cystadeno carcinoma. Computed tomography and sonography allowed excellent preoperative assessment but to attempt a distinction between the histological variants may be hazardous. Two tumours were only autopsy findings and 5 patients underwent laparotomy. It is confirmed that potentially malignant mucinous cystadenomas and cytadenocarcinomas should be resected whenever possible; serous cystadenomas are always benign and should therefore be resected only when the diagnosis is doubtful or if they cause symptoms.

[Whipple's disease. Involvement of the small intestine with submucosal presentation]. / Maladie de Whipple. Atteinte intestinale grêle à présentation sous muqueuse.

An unusual case of Whipple's disease is described; the involvement was restricted to the sub-mucosa of the large and small intestine, but the mucosa was spared. The involvement was characterized by the presence of large eosinophilic PAS positive histiocytic cells in the sub-mucosa. A Ziehl-Neelsen stain allowed to rule out an atypical mycobacterial infection. In the axillary lymph node removed previously, a retrospective survey demonstrated the presence of large histiocytic cells containing granular PAS positive material. The diagnosis of Whipple's disease of the large and small intestine with lymph node involvement was confirmed by the response to therapy followed by a new biopsy control. It appears from our observation that in Whipple's disease, an attentive examination of the sub-mucosal tissue may allow to discover more cases of this condition, even when the mucosa appears normal.

[Use of precipitins in the diagnosis of bird fancier's lung: apropos of 2 cases]. / Utilité des précipitines dans le diagnostic de la maladie des oiseleurs: à propos de deux cas.

Bird breeder's disease is a frequent diagnosis among the forms of extrinsic allergic alveolitis seen in the urban environment. We report two illustrative cases and discuss the respective roles of broncho-alveolar lavage cells and precipitating antibodies against avian antigens in the diagnostic work-up and the pathogenesis of the disease. In 1988 we evaluated over 100 sera from all over Switzerland with clinical suspicion of bird breeder's disease. In this cohort preliminary results show sensitivity of 85% and specificity of 92% for the presence of precipitins against avian antigens in the diagnosis of bird breeder's disease. The results suggest that this non-invasive test deserves revaluation as a diagnostic tool in bird breeder's disease.

[Cachexia, pain and muscle weakness in a 69-year-old woman]. / Cachexie, douleurs et faiblesse muscularies chez une femme de 69 ans.

The case is reported of a 69-year-old woman who for the last 2 years of her life had severe muscle weakness (with elevated muscular enzymes), thyroid abnormalities (autoantibodies and increase in TSH) and a slowly growing mass in the anterior mediastinum. She died in cardiogenic shock. The diagnosis of "nodular polymyositis" (painful nodules palpable in the muscles) with heart involvement was strongly suspected. The thyroid abnormalities were considered to be "biological thyroiditis" i.e. a "disease" frequent in normal females (5-10%) and, after differential diagnosis of anterior mediastinal masses, the diagnosis of thymoma was adopted in view of its frequent association with autoimmune diseases. Moreover, in rare cases of thymoma associated with polymyositis, histology has disclosed "giant cell polymyositis". Autopsy revealed giant cell polymyositis, a thymoma and lymphocytic infiltration of the thyroid.

Trichomonas tenax: ultrastructure of giant forms.

Trichomonas tenax is a parasitic flagellate of the human mouth. The morphology and the ultrastructure of the protozoan are identical to those of other trichomonads. Giant forms suddenly appeared in a strain maintained in culture for two years. The structure and the ultrastructure of these abnormal forms were studied at the light and electron microscope level. Several nuclei, groups of flagella, undulating membranes and Golgi complexes were observed. The significance of these forms is still unknown.

[Necrotic oophoritis due to cytomegalovirus]. / Ovarite nécrosante à cytomégalovirus.

In a 54-year-old woman with malignant lymphoma, cytomegalovirus oophoritis was disclosed at autopsy. The virus, which is recognized by its typical nuclear inclusions, reaches the cortical stroma of the ovaries and causes zones of necrosis there. Its presence is confirmed by ultrastructural and immunohistochemical examination. The real frequency of ovarian involvement is difficult to evaluate since histological examination of ovaries is not routinely performed at autopsy. As far as we know the present case is the seventh detailed observation of cytomegalovirus oophoritis published in the literature.

Unusual intestinal talcosis.

A case of intestinal talcosis in a 46-year-old man is reported. At the age of 27, the patient was treated for pulmonary tuberculosis with tablets containing talc (183 g talc per 2,670 g total drug intake) over a period of 28 months. Eighteen years later, the patient was hospitalized for abdominal pain that remained refractory to antacids; he subsequently underwent a right hemicolectomy. Light-microscopic examination revealed a prominent fibrosis of the intestinal wall in which birefringent particles were demonstrated by polarized light. Using energy-dispersive spectroscopy, an analysis of these particles showed that they were predominantly composed of silicon and magnesium as well as small amounts of phosphorus, sulphur, calcium, and iron--the spectrum typically associated with talc. We believe that the source of this talc is the tablets ingested by the patient during prior antituberculosis therapy.

Nonspecific inflammatory monoarthritis in the vicinity of bony metastases.

We describe a patient that presented with arthritis of a knee joint unresponsive to conventional treatment and who was found to have bony metastases of the distal femur from lung carcinoma. The presence of malignant cells could not be demonstrated in the synovial fluid or in the synovium. Our case illustrates the fact that malignant metastatic deposits in bone adjacent to a joint may cause a nonspecific synovial inflammation.

Immunohistochemical localization of fibronectin-like protein on the cell surface of the oral flagelatte Trichomonas tenax.

A protein immunologically related to fibronectin was demonstrated on the oral flagellate Trichomonas tenax. Two strains of T. tenax were used, the first freshly taken from ulcerative gingivitis and the second maintained in culture for 2 years. Initial investigations were made by established immunofluorescence staining procedures. Cells of the protozoa gave a positive fluorescence with anti-fibronectin anti-serum, while the controls were negative. Subsequently, indirect immunostaining procedures for electron microscopy were performed using the peroxidase procedure. Peroxidase deposits were detected on the outer layer of the cell membrane. Particularly intense labelling was localized in the contact areas between bacteria and protozoa, and sometimes within the marginal lamina of the undulating membrane. This fibronectin-like protein could potentially play an important role in the adhesion of Trichomonas tenax to gingival cells, connective tissue and in the phagocytosis of bacteria. The attachment of protozoa to gingival substrates could be the first step in the breakdown of periodontal tissues.

[Supplemental data to the ultrastructural study of Trichomonas tenax. Intra-cellular distribution of acid phosphatase]. / Données complémentaires ä l'étude ultrastructurale de Trichomonas tenax. Localisation intra-cellulaire de la phosphatase acide.

In scanning electron microscopy, the flagella come out from the cellular body following different configurations: either separately or in groups. The undulating membrane lasted up to 2/3 of the cell body: at its end the recurrent flagella seems to penetrate again into the cell. The costa starts from the cinetosome of the recurrent flagella: the two parabasal filaments start from two different cinetosomes and follow the costa for a small distance. The nucleus is surrounded by a membrane which is not always visible. The axostyle has a cylindrical shape in the posterior two thirds of the cell. Bacteria at different stages of phagocytosis have been observed. The acid phosphatase is localized in the saccules and vesicles of the Golgi apparatus, in the lysosomes and phagolysosomes and in the terminal lamina of the undulating membrane.

[Study of an oral protozoan Trichomonas tenax using scanning and transmission electron microscopy]. / Etude du protozoaire buccal Trichomonas tenax en microscopie électronique à balayage et en transmission.

The study with scanning and transmission electron microscopy of Trichomonas tenax gave morphological information on this protozoon. The oval-shaped cell body showed at the anterior pole four free flagella and a trailing flagellum which had an undulating membrane. The axostyle which consisted of microtubules and produced the cellular rigidity emerged at the posterior pole. An ovoid nucleus and a well-developed Golgi apparatus were located at the anterior pole. At the latter, a pelta consisting of horizontal microtubulus surrounding the kinetoplats from which started the flagella was also found. No mitochondria were observed: they were replaced by chromatin granules or hydrogenosomes. Numerous vacuoles and developing vesicles were found in the cytoplasm. Phagocytized bacteria were in an advanced stage of lysis. Others seemed intact showing even division phases.