Epithelioid hemangioendothelioma of bone--a clinicopathologic and immunohistochemical study of 7 cases

Epithelioid hemangioendothelioma is a rare vascular tumor of bone. Between 1987-1999, seven cases of epithelioid hemangioendothelioma were recorded. The histopathological evaluation was done with hematoxylin and eosin stain and immunohistochemical stains along with the analysis of clinical data and X-ray findings. There were 4 males, 3 females between 15 to 48 years of age with complaints of pain and swelling. Long bones were involved in five of the seven patients and one was multifocal. Radiologically all seven patients showed osteolytic lesions. The histologic hall mark was the presence of eosinophilic, epithelioid cells with intracytoplasmic vacuoles. The tumor may be histologically confused with metastatic carcinoma, chondromyxoid fibroma and osteogenic sarcoma. Immunohistochemical reactivity was as follows: Vimentin (6/6 cases), Factor VIII related antigen (4/6 cases), Ulex Europeaus (5/6 cases), CD31 (3/5 cases), CD34 (3/5 cases), epithelial membrane antigen (1/6 cases), cytokeratin (none). Treatment comprised curettage (4 cases), wide excision (2 cases), below knee amputation (1 case) and post operative radiotherapy (2 cases). At follow-up, (available in 4 patients) two were without disease at 18 months and 120 months. Of the remaining two, one developed local recurrence after 36 months; while the other died of lung metastasis (18 months). A lytic bone shadow, the presence of plump eosinophilic often vacuolated cells on a myxoid background and immunohistochemistry together help in the correct recognition of this tumor.     

Cross-reactions in cell mediated immunity induced by atypical mycobacteria

Cross-reactivity in the delayed hypersensitivity response to mycobacteria of different Runyon groups was tested in Swiss white mice immunised with live mycobacteria. All the strains tested gave cross-reactions and, generally, slow growers gave stronger cross-reactions with other slow growers than with rapid growers and vice versa. Sonicates of cross-reacting mycobacteria were also tested for their ability to generate activated macrophages in mice immunised with Mycobacterium avium. All the mycobacterial sonicates generated activated macrophages but a sonicate of Salmonella typhi did not. The sonicate of M. tuberculosis H37Rv also generated activated macrophages, which indicates that there might be protective cross-reactions between M. tuberculosis and atypical mycobacteria.     

Galectin-3, fibronectin-1, CITED-1, HBME1 and cytokeratin-19 immunohistochemistry is useful for the differential diagnosis of thyroid tumors.

The diagnosis of thyroid tumors is critical for clinical management; however, tumors with follicular architecture often present problems. We evaluated the diagnostic use of the protein expression of four genes that were found to be upregulated in papillary thyroid carcinoma compared to normal thyroid (LGALS3, FN1, CITED1 and KRT19), and of the mesothelial cell surface protein recognized by monoclonal antibody HBME1 in thyroid tumors. Tissues from 85 carcinomas (67 papillary, six follicular, eight Hürthle cell and four anaplastic) and 21 adenomas were evaluated by immunohistochemistry for the expression of these gene protein products, for example, galectin-3 (GAL3), fibronectin-1 (FN1), CITED1, cytokeratin-19 (CK19) and HBME1. Non-neoplastic thyroids (29 adenomatous and 14 thyrotoxic hyperplasia, and 59 normal) were also studied. The expression of all five proteins was significantly associated with malignancy, and highly specific (> or = 90%) for carcinoma compared to adenoma. GAL3, FN1 and/or HBME1 expression was seen in 100% of carcinomas (85/85) and in 24% of adenomas (5/21). Coexpression of multiple proteins was seen in 95% of carcinomas and only 5% of adenomas (P<0.0001). Coexpression of FN1 and GAL3 (FN1+ GAL3+, 70/85) or FN1 and HBME1 (FN1+ HBME1+, 53/85) was restricted to carcinomas, while their concurrent absence (FN1- GAL3- or FN1- HBME1-, 18/21 adenoma) was highly specific (96%) for benign lesions. Among non-neoplastic thyroids, adenomatous hyperplasia frequently expressed GAL3 (n=16), CK19 (n=9) and CITED1 (n=7), but the expression was predominantly focal in contrast to the diffuse expression in carcinomas. An immunohistochemical panel consisting of GAL3, FN1 and HBME1 may be useful in the diagnosis of follicular cell-derived thyroid tumors.     

Antibiotics sensitivity pattern of N. gonorrhoeae with special emphasis on norfloxacin and ciprofloxacin

The current study is carried out to find the in-vitro susceptibility of N. gonorrhoeae to Ciprofloxacin, Norfloxacin, Gentamycin etc. in 110 isolates obtained from acute gonococcal urethritis confirmed by smear examination. The isolates obtained are from the patients attending the Skin and STD Clinic of a teaching hospital, clinically diagnosed as suffering from acute gonococcal urethritis. Antibiotic susceptibility test was done by Kirby Bauer disc diffusion technique. Four to five similar well isolated colonies of the gonococcal strains were picked up with a wire loop and transferred to 5 cc of sterile trypticase soya broth (TSB). Tubes were incubated at 36 degrees C. GC agar base plates were inoculated with suspensions using a sterile cotton swab. Antibiotic discs were placed on these plates. The plates were incubated at 35 degrees C for 18-24 hours in a candle jar with 5-10% CO2. The plates were then observed to note the zones of inhibition around the discs. 87.27% of isolated strains were inhibited by norfloxacin at an MIC of 0.06 mu gm/ml; 89.08% of the strains were inhibited by ciprofloxacin at an MIC of 0.025 mu gm/ml. All the strains (110) were inhibited by ciprofloxacin at a concentration of 0.2 mu gm/ml. Gentamycin sensitivity was 86.36%. Out of 110 patients, 85 were treated with norfloxacin of which 81 (95.29%) were cured. Twenty five were treated with ciprofloxacin of which 24 (96%) were cured. This study shows high sensitivity of N. gonorrhoeae to norfloxacin and ciprofloxacin.     

Regulation of secretion of IL-4 and IgG1 isotype by melatonin-stimulated ovalbumin-specific T cells

In the present study, we describe the potential role of melatonin, a pineal hormone, in regulating the activation of the antigen-specific T cell response. Melatonin encouraged the proliferation of Th cells and improved their ability to secrete IL-4, but down-regulated the levels of IL-2 and interferon-gamma (IFN-γ). Melatonin, however, could not exert any influence on the T cells of unprimed mice. On studying the regulation of subclass of IgG isotype, melatonin specifically enhanced the secretion of antigen-specific IgG1 antibodies and decreased the yield of IgG2a isotype. The results suggest that melatonin possibly acts by selectively activating a Th2-like immune response.     

The involvement of TGFβ1 in early avian development: gastrulation and chondrogenesis

We examined the effects of transforming growth factor-β1 (TGFβ1) and a neutralizing monoclonal antibody on two phases of early chick embryo development: gastrulation and chondrogenesis. We carried out experiments in vivo and in vitro on mesoderm cells from the gastrulating embryo at day 1, and on sclerotome cells from day 3 embryos, having previously shown that this factor is present among these cells at these stages of development. Addition of the antibody to cultures of these cells produced a dose-dependent decrease in cell outgrowth and spreading and concomitantly reduced fibronectin deposition. In vivo studies of the effects of TGFβ1 on mesoderm during gastrulation were carried out by grafting beads carrying this agent into gastrulating embryos. We used beads of ion-exchange resin as well as hydrolysed polyacrylamide, and found that the grafts produced an accumulation of mesoderm cells around the implant and, at later stages, the formation of enlarged somites. There was no effect on embryonic axis formation. Studies of bromodeoxyuridine (BrdU) incorporation indicated that the mesoderm accumulation was due, at least in part, to an increase in cell proliferation. However, examination of the effect of TGFβ1 on BrdU incorporation by mesoderm during gastrulation and sclerotome cells in vitro indicated in inhibition of cell proliferation, an inconsistency explained in terms of the variation between the in vivo and in vitro conditions. We conclude that TGFβ1 is both appropriately located, and is able, to influence cell proliferation among the mesodermal cell populations during early development, and that this effect contributes to the overall control of mesodermal morphogenesis. Chondrogenesis was studied in vitro using micromass cocultures of sclerotome cells with notochordon a permeable substratum. Under these conditions, the addition of TGFβ1 caused an increase in the deposition of Alcian blue-stainable material, indicating a stimulation of chondrogenesis. We suggest that this result, coupled with the previous demonstration that TGFβ1 is present among the sclerotome cells in the embryo at this time, supports the contention that this factor exerts a regulatory effect on sclerotome cell differentiation.     

In vitro calcification and in vivo biocompatibility of the cross-linked polypentapeptide of elastin

The in vitro calcifiability and molecular weight dependence of calcification of the polypentapeptide, (L X Val1-L X Pro2-Gly3-L X Val4-Gly5)n, which had been gamma-irradiation cross-linked have been determined when exposed to dialyzates of normal, nonaugmented fetal bovine serum. The material was found to calcify: calcifiability was found to be highly molecular weight dependent and to be most favored when the highest molecular weight polymers (n approximately equal to 240) had been used for cross-linking. The in vivo biocompatibility, biodegradability, and calcifiability of the gamma-irradiation cross-linked polypentapeptide were examined in rabbits in both soft and hard tissue sites. The material was found to be biocompatible irrespective of its physical form and to be biodegradable but with n of 200 or less it was not shown to calcify or ossify in the rabbit tibial nonunion model.