Titanium particles identified by energy-dispersive X-ray microanalysis within the lungs of a painter at autopsy

A 72-year-old male painter, who complained of his "lungs burning" for 2 weeks, died suddenly. Autopsy examination revealed severe coronary atherosclerosis with plaque rupture as the cause of death. Examination of the lungs revealed emphysema, interstitial fibrosis, and multinucleated giant cells with intra- and extracellular brown-black, crystalline, polarizable foreign material. Energy-dispersive X-ray microanalysis showed the material to contain titanium, aluminum, silicon, and iron. An increased incidence of respiratory disease has been reported in professional painters. Titanium is widely used as a pigment in the manufacturing of commercial paints. Cases of pneumoconiosis and alveolar proteinosis have been described in painters in which analysis of lung tissue revealed increased levels of titanium. This case is presented as an example of a rarely reported phenomenon, which may have clinical implications for evaluation and management of lung disease in painters.     

Toxin A of Clostridium difficile is a potent cytotoxin.

Clostridium difficile is the cause of antibiotic-associated colitis in humans. The organism produces toxin A, which is generally known as the enterotoxin, and toxin B, which is known as the cytotoxin. Toxin A has been reported to have slight cytotoxic activity; in this study we show that cell lines (F9, OTF9-63, and P19) which express a carbohydrate to which toxin A binds are more sensitive to the toxin. These cell lines can be used as research tools for determining concentrations of biologically active toxin A and should also prove useful for studies of the mechanism of action of the toxin.     

Heterogeneity of human anti-MAG IgM as revealed by their reactivity on avian embryonic tissues

Monoclonal IgM from patients with peripheral neuropathies frequently have an antibody activity directed against myelin-associated glycoprotein (MAG). Reactivity of 19 of these sera with avian embryonic tissues was compared. Immunohistological studies allowed their classification into distinct groups according to the staining pattern. Both neural and non-neural cell lineages were recognized by these antibodies. The IgM specificities were also compared with those of the monoclonal antibodies HNK-1 and NC-1, which react with MAG and some cell adhesion molecules. Only one group displayed a pattern of staining similar to that observed with these monoclonals. The reactivity of these IgM paraproteins with two cell adhesion molecules, neural cell adhesion molecule and neuron-glia-cell adhesion molecule by immunoblotting confirmed the heterogeneity found in the histological study.     

The application of co-culture in assisted reproduction: 10 years of experience with human embryos

Co-culture techniques using fetal bovine uterine fibroblasts or bovine oviductal epithelial cells have improved embryonic development prior to replacement in humans. In initial co-culture trials, embryo development and implantation rates increased after just 1 day in culture. The most overt characteristics noted following co-culture were improved blastomere development and characteristics, reduced fragmentation, and the appearance of swollen blastomeres. In addition, an increase in the incidence of zona thickness variation was detected. Improved development of polyspermic and supernumerary embryos to the blastocyst stage was noted in initial trials. Retrospective analysis indicated that certain patient subgroups benefit the most from co-culture. As a result, co-culture is now applied routinely to patients that have previously failed attempts at in-vitro fertilization (IVF) and/or have endocrine imbalances such as polycystic ovarian syndrome and elevated day 3 concentrations of follicle stimulating hormone (FSH). The use of co-culture prior to or following cryopreservation has also proven to be beneficial to human embryos. The proposed beneficial mechanisms thought to improve embryonic development include a secretory and/or a scavenging role. Evidence describing the postulated benefits is discussed.     

Infertility: Enhancement of outcome from intracytoplasmic sperm injection: does co-culture or assisted hatching improve implantation rates?

In two separate prospectively randomized trials, intracytoplasmicsperm injection (ICSI) cycles were studied in a controlled mannerto monitor the effects of either bovine oviductal epithelialcell co-culture (n = 119) or assisted hatching by zona drilling(n = 100). In the first study, immediately following ICSI, alleggs were placed directly either onto partial monolayers ofbovine oviductal cells or into regular culture medium. Althoughthe embryo developmental rate was apparently compromised inpart by the presence of the co-culture cells, ultimately therewere no significant differences in either the viable pregnancyrate (31.6% co-culture versus 29.0% control) or the embryonicimplantation rate (11.4% co-culture versus 13.6% control). Assistedhatching also had no significant impact on ICSI cycle outcomein terms of either the viable pregnancy rate (30.0% assistedhatching versus 32.0% control) or the embryonic implantationrate (8.5% assisted hatching versus 13.5% control). However,in female patients aged 235 years, assisted hatching appearedto convey a marginally significant benefit in terms of boththe viable pregnancy rate (35.5% assisted hatching versus 11.1%control) and the embryonic implantation rate (103% assistedhatching versus 3.1 % control). It seems that the overall improvementof ICSI cycle outcome cannot be achieved by the general applicationof either co-culture or assisted hatching. Nevertheless, itis possible that there remain specific patient groups that mightbenefit from selected use of either of these modalities.     

Lung vascular smooth muscle as a determinant of pulmonary hypertension at high altitude.

The pulmonary hypertensive response to chronic hypoxia varies markedly among mammalian species. An explanation for this variability was sought by exposing seven species to hypobaric hypoxia (PB equal to 435 mmHg) for 19-48 days. Control animals were studied at 1,600 m (PB equal to 630 mmHg). The pulmonary hypertension that developed varied in the following order of decreasing severity: calf and pig (severe); rat and rabbit (moderate); sheep, guinea pig, and dog (mild). Right ventricular hypertrophy developed in proportion to the elevation in right ventricular systolic pressure. These interspecies variations in response were not correlated with the degree of arterial hypoxemia, degree of polycythemia, elevation in heart rate, or postnatal age. However, the medial thickness of the small pulmonary arteries in control animals was highly correlated with the development of pulmonary hypertension and right ventricular hypertrophy in hypoxic animals. Thus, the amount of lung vascular smooth muscle inherent within each species is a major determinant of the pulmonary hypertensive response to high altitude and contributes to the interspecies variability in this response.     

Regulation of murine hematopoiesis by arachidonic acid metabolites

Arachidonic acid metabolites have been shown to exert a variety of regulatory effects on cellular activation and proliferation. Recently, a role for these products as regulators of hematopoiesis was suggested and evidence provided that products of the lipoxygenase pathway, specifically leukotrienes, are essential for human myeloid colony formation in vitro. In this report the broader role of these metabolites in hematopoiesis was examined using murine bone marrow stem cell assays for both myeloid and lymphoid cell lines. The effects of lipoxygenase and/or cyclooxygenase pathway inhibitors on stem cell colony formation were evaluated and compared to qualitative and quantitative changes in arachidonic acid metabolism that occurred in similarly treated bone marrow cell cultures. Interruption of the lipoxygenase pathway by esculetin or nordihydroguaiaretic acid resulted in decreased colony formation in both lymphoid and myeloid stem cells. This inhibition of colony growth was partly reversed by the addition of leukotrienes and was particularly evident in B-cell progenitor cultures to which was added LTB4. Inhibition of the cyclooxygenase pathway by indomethacin or ibuprofen had a slight stimulatory effect on myeloid colony formation, while slightly inhibiting the formation of lymphoid colonies. These results support a direct role for lipoxygenase products in myeloid colony formation and lymphoid stem cell proliferation. A more complex role for cyclooxygenase metabolites in the hematopoietic process appears probable.     

Autosomal imbalance syndromes: Genetic interactions and the origin of congenital malformations in aneuploidy syndromes

In some autosomal imbalance syndromes an additional imbalance interferes with the occurrence of the anomalies typical of the syndrome itself. For example, polydactyly was found in patients with “pure” del(3p) more frequently (11/23) than in patients where these deletions were associated with different partial trisomies (2/28). The opposite situation was shown in del(7q) syndrome where various defects of the holoprosencephalic group were found to be rarer in patients with “pure” deletions, than in cases with simultaneous occurrence of various partial trisomies. It suggests the importance of gene interaction in determining the phenotypic picture of autosomal imbalance syndromes. © 1993 Wiley-Liss, Inc.