Martti Alavaikko

Improving the prognostic value of DNA flow cytometry in breast cancer by combining DNA index and S‐phase fraction: A proposed classification of DNA histograms in breast cancer

To optimize the prognostic value of DNA flow cytometry in breast cancer the authors calculated several parameters from the DNA histogram, including the DNA index, the size and number of aneuploid peaks as well as S‐phase and G2/M‐phase cell cycle fractions. Of these, DNA index and S‐phase fraction (SPF) proved to be the most valuable prognostic indices. DNA aneuploidy was associated with a threefold risk of death as compared to DNA diploidy (P < 0.0001). The highest risk of death was associated with hypertetraploid (>2.20) DNA index, whereas a tetraploid DNA index (1.80–2.20) was associated with a relatively low risk. The SPF had significant additional prognostic value in both DNA diploid (P = 0.0002) and DNA aneuploid (P = 0.02) tumors. By combining DNA index and SPF the authors defined three types of DNA histograms, which were associated with favorable, intermediate, and poor prognosis of the patients. DNA diploidy together with low (<7%) SPF (type I DNA histogram) was associated with very favorable prognosis, whereas DNA aneuploidy with high DNA index (>2.20) or high (>12%) SPF (type III DNA histogram) was related to the worst prognosis with approximately eight‐fold relative risk of death. In a Cox multivariate regression analysis the type of DNA histogram was an independent and most powerful prognostic indicator in breast cancer. The other independent factors in the Cox analysis were primary tumor size, nodal status, and progesterone receptor status.

Demonstration of immunoreactive acid cysteine-proteinase inhibitor in reticulum cells of lymph node germinal centres.

SummarySeven human lymph nodes showing different types of reactive change, were examined for the presence of acid cysteine-proteinase inhibitor (ACPI) by the peroxidase-antiperoxidase method. A clear positive reaction was found in the germinal centres. The staining pattern indicated immunoreactivity of the dendritic reticulum cells, but the possibility that other cells, particularly histiocytic reticulum cells, may also react with antiserum raised against ACPI cannot be excluded.

Immunohistochemical study of basement membrane proteins and type III procollagen in myelofibrosis

In this study the distribution of type IV collagen in the marrow is compared with that of laminin, another basement membrane protein. In addition, incompletely processed type III procollagen is identified with specific antibodies.

Sutureless colon anastomosis with fibrin glue in the rat

The only technique available for creating an intestinal anastomosis without tissue strangulation is gluing. Theoretically, this could lead to a higher hydroxyproline content and greater mechanical strength than in a sutured anastomosis. To test the hypothesis, 83 rats underwent left colon resection and inverted primary anastomosis with either one layer of sutures (NG group) or fibrin glue (FG group). Seven-day FG anastomoses showed less adhesions (P=.02) but one subclinical leakage and a further radiologic one, compared with a greater amount of adhesions but no leakages in the NG group. The mean bursting pressures (mmHg) in the FG and NG groups, respectively, were 25±20 (SD) and 63±23 (N.S.) 30 minutes after surgery, 107±33 and 115±30 after one day, 81±31 and 133±26 (P<.001) after four days, and 161±36 and 175±24 after seven days. The somewhat earlier rise in hydroxyproline content in the glued anastomoses did not lead to significant intergroup differences. The glued anastomoses were thus weak during the critical lag period of healing. Also, by preventing adhesion formation, the glue may reduce the extra blood supply from perianastomic vessels. The outcomes might have differed more under demanding experimental or clinical situations.

Familial occurrence of malignant lymphoepithelial lesion of the parotid gland in a Finnish family with dominantly inherited trichoepithelioma

A rare malignant lymphoepithelial lesion (MLEL) of the parotid gland is described in a mother and daughter within one Finnish family. Several cases of dominantly inherited trichoepithelioma were observed in the same family. This is the third published case of familial MLEL, and the first in whites. The simultaneous occurrence of MLEL with hereditary trichoepithelioma is a new finding and may suggest a common genetic background and/or etiology.

Effect of biliary tract procedures on duodenogastric reflux and the gastric mucosa.

The effect of alterations in the biliary tract on the gastric milieu was evaluated in gallstone disease and after cholecystectomy or biliary fenestration and compared with a control group. Endoscopic bile reflux was often found in gallstone patients (67%) and almost always after cholecystectomy (89%). Gastric bile acid concentrations were greater in the gallstone patients than in the control patients, were higher still after cholecystectomy, and were highest after biliary fenestration. The pH of the gastric fluid was more alkaline in the cholecystectomized groups. Lysolecithin concentrations were generally low and did not differ between the groups, nor was there any difference in scintigraphic reflux between the groups. Endoscopic erythematous gastritis correlated with the grade of bile reflux and was a common finding after biliary tract procedures. There were no consistent histologic findings associated with duodenogastric reflux. Helicobacter pylori colonization rates were similar in the various patient groups and were not affected by the reflux grade.

Distribution of basement membrane laminin and type IV collagen in human reactive lymph nodes

The location of two basement membrane components, laminin and the 7‐S domain of type IV collagen, was studied in human lymph nodes using the peroxidase‐antiperoxidase method. Basement membrane antigens were present on the walls of blood vessels and of marginal, trabecular and medullary sinuses. Thin, fragmented fibre‐like staining was present also in parenchyma outside the germinal centres, in a pattern overlapping with reticular fibres as seen on conventional reticulin stains. This finding suggests that basement membrane components are a part of the reticular fibres of lymph nodes, or are closely associated with them.

Basement membrane proteins in the spleen: immunohistochemical demonstration and relation to reticulin

In the present study imunohistochemical staining has shown that the ring fibres of the human spleen contain the major basement membrane components, type IV collagen and laminin. The superiority of immunohistochemical methods in demonstrating basement membrane material in the spleen is emphasized. The results are compared with the demonstration of reticular fibres by Gomoris reticulin stain. The findings provide further information about the relationship between basement membrane material and reticular fibres in human spleen. The nature of splenic ring fibres is discussed in the light of the scientific literature.

Tenascin in Reactive Lymph Nodes and in Malignant Lymphomas

Tenascin is an extracellular matrix protein which accumulates in the stroma of various malignant and some benign neoplasms. This has been verified in several immunohistochemical studies. The distribution of tenascin immunoreactivity in lymphatic tissues and neoplasias, however, has not been thoroughly studied. In this investigation we analyzed tenascin immunoreactivity in several benign and malignant lymphatic lesions, including both Hodgkins and non-Hodgkins lymphomas. In benign lymph nodes, faint reticular immunoreactivity could be observed in the lymphatic tissue. In benign reactive hyperplasias, a stronger reticular pattern of tenascin immunoreactivity was observed in the interfollicular and medullary areas, while the lymphoid follicles contained only a few positive fibers. A similar immunoreactivity was observed in malignant follicular lymphomas. In diffuse lymphomas, a diffuse meshwork of positively stained fibers was seen. This was also the case for the three cases of Hodgkins disease of the lymphocyte-predominance nodular subtype. There was no difference in the intensity of the immunoreactivity between benign and malignant disorders. However, in Hodgkins disease of the nodular sclerosis and lymphocyte-depletion subtypes, a much more pronounced immunoreactivity could be observed in the fibrous septa and the cords. This suggests that the tumor cells are possibly capable of synthesizing growth factors which stimulate fibroblasts to synthesize tenascin. The results indicate that tenascin does not accumulate in the stroma of malignant lymphoid neoplasms with the exclusion of some subtypes of Hodgkins disease. The distribution of tenascin immunoreactivity in lymphatic tissue is similar to that of the reticular fibers suggesting that the molecules are associated with these structures.(ABSTRACT TRUNCATED AT 250 WORDS)

Damage to secondary lymphoid follicles in AIDS-related persistent generalized lymphadenopathy, as revealed by the behaviour of dendritic reticulum cells possessing immunoreactive acid cysteine-proteinase inhibitor

SummaryIt has been shown previously that dendritic reticulum cells (DRC) in human secondary lymphoid follicles possess an immunoreactive acid cysteine-proteinase inhibitor (ACPI). In the present study, lymph nodes from 12 patients with AIDS-related persistent generalized lymphadenopathy (PGL) were investigated in order to detect whether or not any alterations occur in ACPI-immunoreactive DRC in this disorder.In the majority of PGL cases, profound alterations were found, the main characteristics of which were erosion, partial or total disruption of lymphoid follicles. However, similar though much less marked alterations were also found in some control cases. It is concluded that this type of follicular damage is a common and characteristic feature in PGL. It is not specific to PGL, however, but represents rather a special type of reaction in lymphatic tissue. The advantage of ACPI immunohistology for demonstrating the DRC pattern is that it can be performed on routinely fixed and paraffin-embedded tissues.