Dispersion and characterisation of mast cells from human skin

A technique is described for the enzymatic dispersion of mast cells in high yield from human infant foreskin. Dispersed mast cells exhibit high viability as assessed by light microscopy, low spontaneous histamine release, and survival in culture. Dispersed mast cells release histamine in response to immunological stimulation and synthetic secretagogues including ionophore A23187, compound 48/80 and poly-L-lysine. Reactivity to these stimuli indicates that cutaneous mast cells differ in their properties from human pulmonary mast cells.     

Dissociated human foreskin mast cells degranulate in response to anti-IgE and substance P.

Human skin mast cells release histamine in response to both immunologic stimulation mediated by anti-IgE and IgE-independent mechanisms of which substance P is a prototypical secretagogue. We compared the ultrastructural changes produced in dissociated foreskin mast cells by these two stimuli with histamine release. Mast cells were isolated and pooled from the foreskins of 2- to 7-year-old boys in four separate experiments and comprised 25 to 60% of the total dissociated cells. The secretory granules in resting mast cells comprised 47.5% of the extranuclear cell volume and contained crystalline structures, namely, scrolls, gratings, and lattices, in an electron-dense matrix. Stimulation with either anti-IgE or substance P resulted in a net histamine release of 10.2 +/- 1.7% or 21.4 +/- 4.0%, respectively. After either secretagogue, about 75% of the cells underwent compound exocytosis, with fusion of the granule membranes with one another and with the plasma membrane to produce large degranulation channels that opened to the extracellular space. The granules lost their crystalline structure and electron density during secretion but retained the round shape of the original granule as a core that subsequently formed a fibrillar residue. Degranulation channels occupied 30 to 60% of the cytoplasmic volume after substance P stimulation and 10 to 40% after anti-IgE, which compared well with the greater histamine release measured after substance P. The rapid increase in the volume of the degranulation channels after substance P was accompanied by a decrease in cytoplasmic volume, suggesting water moved from the cytoplasm into the granules after stimulation. This study shows that secretion produced in dissociated human foreskin mast cells by two different stimuli, anti-IgE and substance P, which act through different membrane receptors and have distinct secretory characteristics, is similar morphologically.     

Evaluation of families wherein a single male manifests a phenotype of X-linked lymphoproliferative disease (XLP)

The Epstein-Barr virus (EBV)-induced diseases of males with X-linked lymphoproliferative disease (XLP) include fatal infectious mononucleosis (IM), non-Hodgkin lymphoma (ML), agammaglobulinemia, and aplastic anemia. These phenotypes also occur as sporadic cases in families, and EBV seronegative males in these families must be considered at risk for XLP until they seroconvert normally to EBV. Given that 50% of males inheriting the defective XLP gene die following primary EBV infection, it is vital that they be identified pre-EBV infection. Here we report result using molecular genetic techniques to provide information as to the relative risks of EBV negative males and potential carrier females in ten families wherein a single male had died of IM. © 1993 Wiley-Liss, Inc.     

Importance of serrated polyps in colorectal carcinogenesis

Colorectal cancer is an invasive neoplasm of the glandular epithelium of the colon and rectum that begins in a precursor lesion and expands to replace its lesion of origin. The majority of colorectal cancers arise from an adenoma, and the ‘adenoma to carcinoma’ pathway has been acknowledged for decades. More recently, another precursor lesion has been recognized: the serrated polyp. Serrated polyps are characterized by a sawtooth appearance of the crypt epithelium resulting from failure of apoptosis and a build‐up of aging colonocytes. Although initially felt to be innocent of involvement in colorectal carcinogenesis, some types of serrated polyp are being increasingly recognized as precursor lesions, prone to develop into cancer, and likely to be a cause of ‘missed’ or interval cancers after colonoscopic screening. It is essential that gastrointestinal specialists appreciate the clinical significance of these lesions and what that means for colorectal cancer screening, and prevention. The purpose of this review is to highlight the importance serrated lesions of the colon and rectum, and to summarize current opinion on their natural history, diagnosis, surveillance and treatment.     

Avalon catheters in pediatric patients requiring ECMO: Placement and migration problems

Purpose

The Avalon dual-lumen venovenous catheter has several advantages, but placement techniques and management have not been adequately addressed in the pediatric population. We assessed our institutional outcomes and complications using the Avalon catheter in children.

Gastrointestinal mucosal development and injury in premature lambs supported by the artificial placenta

Background

An Artificial Placenta (AP) utilizing extracorporeal life support (ECLS) could revolutionize care of extremely premature newborns, but its effects on gastrointestinal morphology and injury need investigation.

Histamine release upon adenosine 5'-monophosphate (AMP) nasal provocation in allergic subjects

BACKGROUND: Nasal provocation with adenosine 5'-monophosphate (AMP) elicits nasal symptoms in subjects with rhinitis. Histamine released from mast cells may play a part in AMP induced nasal responses. METHODS: Symptoms of rhinitis were recorded and histamine release in the fluid obtained by nasal lavage after AMP, guanosine 5'-monophosphate (GMP), and placebo instillations was measured in nine subjects with allergic rhinitis and nine non-allergic controls in a double blind, randomised, placebo controlled study. RESULTS: No symptoms or significant increases in histamine were observed after GMP and placebo challenge. Significantly higher levels of histamine were seen in the nasal lavage fluids of allergic subjects following AMP challenge than in nonallergic controls, the median (range) histamine concentration increasing from the baseline value of 1.62 (0.44-6.99) ng/ml to 6.45 (0.81-16.17) ng/ml at three minutes. No increase in histamine levels was seen in the non-allergic subjects in whom the median histamine concentration was 1.13 (0.29-4.25) ng/ml at baseline and 0.97 (0.31-5.89) ng/ml three minutes after AMP challenge. CONCLUSIONS: AMP elicits an immediate rise in histamine levels in the nasal lavage fluid of allergic subjects compared with non-allergic individuals. These findings indicate that the exaggerated nasal response to adenosine may reflect mast cell priming in vivo, thus supporting its application as a potential new marker of allergic inflammation.     

Speech-controlled generation of radiology reports

Voice entry has been successfully employed to generate radiology reports with a word recognizer with a 1,000-word lexicon capacity. About 50% of reports were able to be dictated with a single 900-word lexicon. This was split into five sections by anatomic or subspecialty application. Each was augmented to 900 words. By switching from one lexicon to another, it was possible to dictate more than 70% of reports. With exclusive use of three lexicons in subspecialty areas (gastrointestinal radiology, neuroradiology, and mammography), and with further modification of the respective vocabulary, it has been possible to employ the system 88% of the time. Twelve percent of cases included wording that was beyond the scope of the lexicon. Computer subsets that allow different translations of some words when used in different contexts have been used. Some of these are used as triggers that will print whole lines, sentences, or even complete reports. Dictation times with voice entry take about 20% longer. Recognition reliability has been greater than 95%.