J. A. Rossner

Morphological studies in tissues surrounding alloarthroplastic joints

Histological, histochemical and ultrastructural studies were done on soft tissue surrounding alloarthroplastic joints. In 38 cases a prosthesis of the hip joint and in 2 cases of the knee had to be exchanged and replaced. In most of the cases the reoperation became necessary because the anchoring of the prosthetic parts in the bone loosened. Up to 18 months after the first operation infection was responsible for the malfunctioning in some cases. Other complications were luxation and material faults. The morphological changes are determined by the tissue reaction to the different alloplastic materials used and by the time interval they remained in the organism. The large polymerized acrylic cement particles are phagozytosed by multinucleated foreign body giant cells. About 12 months following the implantation of the artificial joints small double refractile particles appear and evoke characteristic morphological changes. These particles are abraded by the continuous friction of the moving alloplastic or metallic surfaces of the prostheses. Usually they are phagozytosed by histiocytes, which form large granulomas and undergo degenerative changes as is indicated by the ultrastructural and histochemical findings. These alterations are more pronounced and occur sooner in prostheses with parts (rotation ball or cup.) fabricated by polyester than in those made by polyethylene. The abraded particles not only are transported to the inguinal lymphnodes, but also to the tissue between prostheses and bone, where they induce the same morphological changes as in the capsule. Hence the fibrous membrane separating bone and prostheses increases in width, and the spongy bone is partially destroyed by the proliferating histiocytes. It is assumed that by impairing the anchoring this foreign body reaction to the abraded alloplastic particles is the leading cause of the loosening of this kind of artificial joints.

An effective morphometric method for electron microscopic studies on papillary muscles.

Morphometry was performed on the left ventricular posterior papillary muscles of seven Wistar rats. The volume densities of myocardial cells, interstitial space, myocardial nuclei, sarcoplasm, mitochondria, myofibrils, ground substance and T tubules, and the surface densities of myocardial cells, mitochondrial membranes and T tubules, were calculated. Though only 1 ultrathin section per animal was evaluated the low standard errors of the means indicate that the method described here will be adequate in most experimental studies. Due to the anisotropy of the surfaces within myocardial cells, the papillary muscles were cut at an angle of 32.4‡ to their longitudinal axis. This angle is derived from an equation published by Whitehouse (1974). The procedure to correct the loss of cristal membrane images from oblique sectioning is discussed.

A carcinoid occurring in the testis.

Carcinoids of the testis are rare tumours developing in three different ways: 1. It may differentiate within a teratoma, 2. it may be a metastasis of a “loco alieno” seated carcinoid and 3. it may represent a real primary carcinoid. The observation of a primary testicular carcinoid in a man aged 55 years afforded the opportunity to study such a tumor for the first time by electron microscopic and fluorescence microscopic methods. Thereby, it could be shown, that this testicular carcinoid corresponds to the carcinoids of the lower small gut. According to the specific ultrastructure of the intracytoplasmic granules it must derive histogenetically from an EC-cell. At the moment it cannot be decided whether the primary testicular carcinoid represents an autochthonous tumor of the male gonad or solely a teratoma with one-sided differentiation in the sense of a simplified teratoma. Carcinoide des Hodens sind selten. Für ihre Entstehung sind drei verschiedene Möglichkeiten gegeben: Erstens können sie Differenzierungsprodukte einer teratoiden Geschwulst darstellen; zweitens kann es sich um Metastasen loco alieno gelegener Carcinoide handeln und drittens können sie als echte primäre Carcinoide vorliegen. Die Beobachtung eines primären Carcinoids bei einem 55jährigen Mann gab uns die Gelegenheit, eine solche Geschwulst erstmals elektronenoptisch und fluorescenzoptisch zu untersuchen. Es zeigte sich, daß sie in ihrem Aufbau den Carcinoiden des unteren Dünndarms entspricht und histogenetisch von einer EC-Zelle abstammt. Eine endgültige Entscheidung darüber, ob das primäre testikuläre Carcinoid eine autochthone Geschwulst der männlichen Gonade oder einfach ein einseitig ausdifferenziertes Teratom im Sinne eines “simplified teratoma” darstellt, ist momentan jedoch noch nicht möglich.

Fermenthistochemische und elektronenmikroskopische Untersuchungen an der juvenilen Amaurotischen Idiotie des Hundes

ZusammenfassungAn zwei Hunden einer Sippe von englischen Settern, bei der es zum familiären Auftreten einer Glykosphingolipoidose kommt, wurden fermenthistochemische und elektronenmikroskopische Untersuchungen angestellt. Die Lipoidstoffwechselstörung dieser Tiere entspricht feingeweblich und bausteinhistochemisch der juvenilen Amaurotischen Idiotie des Menschen.In den Ganglienzellen lassen sich zwei Formen des Speichermaterials nachweisen. In Groß- und Kleinhirn speichern die Ganglienzellen vorwiegend ein grobscholliges, schwach PAS-positives, mit Markscheidenmethoden anfärbbares, cholesterinhaltiges Lipoidgemisch, in dem mit fermenthistochemischer Methodik 5′-Nucleotidase nachweisbar ist. Die motorischen Vorderhornzellen des Rückenmarkes enthalten hingegen in erster Linie feinkörniges, intensiv PAS-positives, alkohollösliches und neuraminsäurehaltiges Glykolipoid sowie Cholesterin. An Fermenten enthält das feinkörnige Speichermaterial außer 5′-Nucleotidase reichlich saure Phosphatase.Bei der elektronenmikroskopischen Untersuchung lassen sich an dem Speichermaterial verschiedene Strukturen erkennen. Die gespeicherten Substanzen weisen eine lamelläre Struktur auf, die teilweise dieselbe Periodik wie die Markscheide besitzt. Das Speichermaterial in den Ganglienzellen entspricht sowohl in seinem stofflichen Aufbau als auch in seiner Ultrastruktur den Lipoiden der Markscheide. Die typische Periodik der Markscheide kann auch intracellulär an gespeicherten Lipoidgemischen auftreten.

Morphometric observations on the rat heart after high-dose treatment with cortisol

Male Wistar rats were treated with high cortisol doses for 1 week. The dose administered daily was 15 mg per animal in group 1 (7 animals) and 30 mg in group 2 (7 animals). 7 rats served as control group. After cortisol treatment the body weights decreased due to skeletal muscle catabolism and the heart weights increased. Morphometric analysis of the left ventricular posterior papillary muscles gave evidence that the increased heart weights resulted from an increased number of mitochondria and an increased volume of the cytoplasm, whereas the myofibrillar mass was not affected. The surface area of inner mitochondrial membranes (+cristae mitochondriales) per myofibrillar unit volume increased from 15.7 μ2/μ3 to 21.3 μ2/μ3 in group 1 and 21.4 μ2/μ3 in group 2. Ultrastructural changes indicating myocardial cell damage were absent. Similar quantitative results have been reported to occur in the early phase of cardiac overload. For elucidating the hemodynamic effects of glucocorticoid a second experiment was performed: 7 Wistar rats were treated with cortisol in the same way as group 1, 7 others of the same body weight served as control. The systolic arterial pressure was significantly elevated in the cortisol group. Though myocardial tissue is known to be able to accumulate large quantities of glucocorticoids our results indicate that the application of high cortisol doses for a short time does not produce myocardial cell damage and does not suppress the myocardial adaption to the glucocorticoid-induced hypertension, i.e. hypertrophy. On the contrary, it seems to be possible that the adaption process is itself facilitated or accelerated by the presence of high cortisol concentrations in the heart. This thesis is supported by the considerably higher relative heart weights in the cortisol groups and is in agreement with observations reported by other authors.

Identification of soluble fibrinogen fibrin monomer complexes by non-enzymatic polymerisation in the tissue

In states of plasmic hypercoagulability and consumption coagulopathy ethanol favours the non-enzymatic polymerization of circulating soluble fibrinogen fibrin monomer complexes (FFMC) in vitro. The ethanolgelation test of Godal and Abildgaard makes use of this phenomenon, called paracoagulation. The present studies show that it is also possible to visualize soluble FFMC by means of ethanol-gelation. In the electron microscope, FFMC, polymerized non-enzymatically by ethanol in the spleen, are characterized by plump or slender mycelioid fibrillar precipitates that show a uniform rhythmic transverse striation, a period-coincidental filamentary arrangement and an average periodicity of 23 nm. The ultrastructure demonstrates these ethanol-induced filaments to be in vitro-polymerized fibrin monomer derivatives. Paracoagulation with ethanol allows the identification of soluble FFMC in the tissue prior to the formation of highly polymerized fibrin-rich microthrombi, the established equivalents of the DIC-syndrome. The electron microscope studies also show the existence of a second type of fibrillary structure in the tissue polymerized by ethanol. This second type lacks the characteristic periodicity of fibrin and the period-coincidental arrangement of the filamentary structures, but is characterized by closely packed or chain-like aligned, irregularly sized spherical bodies. There is some evidence that these spherical bodies in vitro represent non-enzymatically polymerized complexes of fibrin monomers and fibrin degradation products (FDP), the equivalent of a limited local or generalized fibrinolysis in vivo.

Transformationsvorgänge in der Frühphase der Entstehung des arteriellen Thrombus

Ultrastructural studies of thrombi were carried out on the common carotid artery of the rat using a method first described by Meng and Seuter (1977). Induction of thrombus formation in vivo was achieved by chilling of a small vessel segment under constant pressure and short-termed stasis. Disturbance of the blood flow was produced by a silver clip. The damaged vessel segments with the thrombotic deposits were removed 5, 10, 30 min, and 1, 4 and 24 h after stimulation of thrombosis. They were fixed and samples were studied as semithin and ultrathin sections morphologically using light and electronmicroscopy. In the maturation of thrombi exact time intervals could be determined. The most important histopathological characteristics for age determination of arterial thrombi in the early period of thrombogenesis were the cross stripes of fibrin fibres. They appeared after 5 min, reaching a maximum after 10 min and disappeared as a result of increasing fibre density after 1 h. After 4 h nearly complete retraction of fibrin fibres was found which led after 24 h to the formation of a corresponding frame walling in the corpuscular elements. Apart from this aggregation of thrombocytes, which were of two different types were observed, one showing a fibrin-poor aggregate in which the thrombocytes appeared densely packed with numerous pseudopods, and one showing a thrombocyte poor aggregate with abundant interposed fibrin fibres. Agglutination of platelets which occurred in the thrombocyte-rich aggregate in the centre of the thrombus after 5 min led to thrombocytorrhexis after 30 min. The resulting cellular waste stimulated phagocytosis by mononuclear cells and leucocytes. Because of this a massive leucocytosis was found as a result of the early thrombocytorrhexis after 4 h. After 24 h the “viscous metamorphosis” in the fibrin-rich and in the fibrin-poor aggregate was largely completed. Clumping and deformation of erythrocytes was observed in the middle of the thrombus after 5 min and at the periphery of the thrombus after 24 h. Haemolysis did not occur within this time interval. In unserer ultrastrukturell durchgeführten Studie wurden Thromben in der Arteria carotis communis von Ratten nach einer zuerst von Meng und Seuter (1977) beschriebenen Methode experimentell erzeugt. Induktion der Thrombusbildung erfolgte in vivo durch Unterkühlung eines kleinen Gefäßabschnittes unter konstantem Druck und kurzfristiger Stase. Eine Änderung des Blutflusses wurde durch einen Silberclip erzeugt. Die geschädigten Gefäßsegmente einschließlich der Thromben bzw. deren Vorstufen wurden nach 5, 10, 30 min und 1, 4 und 24 h nach der Thrombosestimulation entnommen und fixiert. Semidünnschnitte und Ultradünnschnitte wurden im Licht- und Elektronenmikroskop morphologisch untersucht. Den Transformationsvorgängen im Thrombus konnten exakte Zeitmarken zugeordnet werden. Als wichtigstes histopathologisches Merkmal für die Altersbestimmung arterieller Thromben in der Frühphase der Thrombogenese werteten wir die Querstreifung der Fibrinfasern. Diese trat bereits nach 5 min auf, erreichte nach 30 min ein Maximum und verschwand als Folge der zunehmenden Verdichtung der Fasern nach einer Stunde. Nach 4 h sahen wir eine weitgehende Retraktion der Fibrinfasern, die nach 24 h zur Bildung des Fibrinfasergerüstes mit Einmauerung korpuskulärer Elemente führte. Überdies beobachteten wir zwei Thrombocytenaggregate von differenter Struktur. Wir unterschieden ein fibrinarmes Aggregat, in dem die Thrombocyten dichtgepackt und pseudopodienreich erschienen von einem thrombocytenarmen Aggregat mit reichlich interponierten Fibrinfasern. Die nach 5 min im Zentrum des Thrombus auftretende Agglutination der Plättchen im thrombocytenreichen Aggregat führte nach 30 min zur Thrombocytorrhexis und ergab daher einen weiteren Anhalt für die Altersbestimmung des Coagulum. Der entstandene celluläre Abraum stimulierte mononucleäre Zellen und Leukocyten zur Phagocytose. Daher sahen wir nach 4 h eine massive Leukocytose als Folge der frühen Thrombocytorrhexis. Nach 24 h war die „viscöse Metamorphose“ im fibrinreichen und fibrinararmen Aggregat weitgehend abgeschlossen. Innerhalb des beobachteten Zeitraumes entstand eine Verballung und bizarre Deformierung der Erythrocyten, die bereits nach 5 min vom Zentrum des Thrombus ausging und nach 24 h die Peripherie erreichte. Eine Hämolyse der Erythrocyten war nach dieser Zeit noch nicht erkennbar.

[Experimental visualization of the ventricular conduction system of the heart intra vitam (author's transl)].

SummaryThe in-vivo tolerability of an in vitro in cow, calf and sheep hearts developed method for radiologic visualization of the left ventricular conduction system is tested in four animal experiments.The clinical in-vivo tolerability could be demonstrated on principle; however, it is to accent that hypertonic X-ray contrast dyes may be the cause of morphological changes in the micro- and ultrastructures of the specialised musculature of unknown dignity.ZusammenfassungIn form von vier Tierversuchen wird eine in vitro an Rinder-, Kälber-und Schafscherzen erarbeitete Methodik zur röntgenologischen Darstellung des linksventrikulären RLS des Herzens bezüglich ihrer In-vivo-Tolerabilität erprobt.Klinisch kann die In-vivo-Tolerabilität grundsätzlich nachgewiesen werden; wir müssen jedoch betonen, daß durch die Verwendung hypertonischer Röntgenkontrastmittel Veränderungen im Bereich der Mikro- und Ultrastrukturen der RLS-Zellen induziert werden können, deren Dignität momentan nicht sicher eingestuft werden kann.

[Experimental visualization of the ventricular conduction system of heart intra vitam (author's transl)].

A method for radiological presentation of the left ventricular conduction system was tested for in-vivo tolerability. In-vivo tolerability could be demonstrated clinically; however, we should emphasize that hypertonic X-ray contrast dyes may cause morphological changes of unknown significance in the micro- and ultrastructures of the specialized musculature. In Form von 4 Tierversuchen (Kälber) wird eine in vitro an Rinder-, Kälber- und Schafsherzen erarbeitete Methodik zur röntgenologischen Darstellung des RSL des Herzens bezüglich ihrer in-vivo-Tolerabilität erprobt. Klinisch kann die in-vivo-Tolerabilität grundsätzlich nachgewiesen werden; wir müssen jedoch betonen, daß durch die Verwendung hypertonischer Röntgenkontrastmittel Veränderungen im Bereich der Mikro- und Ultrastrukturen der RLS-Zellen induziert werden können, deren Dignität momentan nicht sicher eingestuft werden kann.