Showing papers on "Fibrosis published in 1982"

Pneumonitis and pulmonary fibrosis associated with amiodarone treatment: a possible complication of a new antiarrhythmic drug.

Abstract: Six patients are presented who developed pulmonary infiltrates of undetermined origin while being treated for severe ventricular arrhythmias with amiodarone hydrochloride. Biopsy material was available in four patients and revealed interstitial or alveolar fibrosis and pneumonitis. Four patients recovered and two died of severe cardiopulmonary decompensation; all of the patients who recovered received corticosteroid therapy. Pulmonary fibrosis is a previously unreported complication of amiodarone therapy.

Lung fibrosis and emphysema: divergent responses to a common injury?

Abstract: Cadmium chloride, administered intratracheally to golden Syrian hamsters, causes an acute lung injury which evolves into a lesion with functional and morphological features of diffuse fibrosis. With simultaneous feeding of a lathyrogen, beta-aminoproprionitrile, this same injury evolves into functional and morphological changes of bullous emphysema. These results suggest that the same lung injury might result in either fibrosis or emphysema, connective tissue synthesis during the healing phase being the critical determinant.

Oesophageal varices treated by sclerotherapy: a histopathological study.

Abstract: Of 31 cases of haemorrhage from oesophageal varices treated by sclerotherapy eight came to necropsy. The oesophagus and proximal stomach were studied by means of a serial block technique and the histopathological findings in each case were recorded on two full-scale maps: one representing superficial tissues including the submucosa and the other the deeper tissues. The patterns of thrombosis, ulceration, necrosis, and fibrosis were studied in relation to the time interval since injection. Thrombosis and tissue necrosis were present within 24 hours of sclerotherapy, ulceration after seven days, and fibrosis after a month. Fibrosis was sometimes associated with stricture formation, which readily responded to dilatation. Patients with fibrosis had a reduced incidence of rebleeding.

Ultrastructure of initial stages of perivenular fibrosis in alcohol-fed baboons.

Abstract: Perivenular fibrosis was studied in baboons pair-fed with alcohol containing or isocaloric control diets for up to 8.5 years, and biopsies were performed on the animals one to two times a year. The number and types of mesenchymal cells surrounding the terminal hepatic venules were examined at various stages of thickening of the rim of the terminal hepatic venules by light and electron microscopy. The number of mesenchymal cells increased with progression of fibrosis and showed good correlation with the thickness of the rim (r = 0.7435, P less than 0.001, n = 56). myofibroblasts were the most common mesenchymal cells. They were present around the terminal hepatic venules in the control animals and proliferated after alcohol. This was associated with increased deposition of collagen fibers around the terminal hepatic venules. This fibrotic process extended into the perisinusoidal space of the centrolobular areas, sometimes connecting with pericellular fibrosis and/or fat granuloma, which developed in the lobule. Thus, in baboons fed alcohol, perivenular fibrosis is associated with myofibroblast proliferation followed by collagen deposition. Myofibroblast proliferation appears to represent the earliest detectable precursor lesion leading to hepatic fibrosis in alcoholic liver injury.

Hepatocellular carcinoma arising in noncirrhotic and highly cirrhotic livers: a comparative study of histopathology and frequency of hepatitis B markers.

Abstract: Hepatocellular carcinoma (HCC) associated with cirrhosis and HCC developing in a noncirrhotic liver may have differing pathogeneses. To study this possibility, 425 autopsied cases of HCC were investigated. Of these, 45 livers were not cirrhotic, 50 were highly cirrhotic (liver weight less than 99 g), and the remaining 331 were cirrhotic but not so highly. The average age was significantly older in the highly cirrhotic group, suggesting a longer premalignant period of chronic liver disease. The liver weight in the noncirrhotic group was about 3.5 times that in the highly cirrhotic group. Hepatitis B surface antigen was positive in serum in only 9.3% and in liver tissue in 10% in the noncirrhotic cases, the positivity rate being much lower compared with other groups (P less than 0.005--0.01), yet antibody to HB core was positive in 90%. The antibody titers were low, however, indicating that these noncirrhotic patients had in the past had HB virus (HBV) infection with no residual chronic B hepatitis. Analysis of the grades of anaplasia of cancer tissue demonstrated an inverse correlation between the degree of fibrosis and grade of anaplasia, i.e., the more advanced the fibrosis, the less anaplastic the cancer. These data suggest that HCC arising in highly cirrhotic liver and in noncirrhotic livers have different pathogenetic backgrounds, and that HBV infection, even though transient, has a certain role in hepatocarcinogenesis. The generally held conjecture that HCC in a noncirrhotic liver is caused by nonviral carcinogens and HCC arising on the ground of cirrhosis is due to HBV seems untenable in such a simple concept.

The ultrastructure of human fibrosing alveolitis

Abstract: This report describes the ultrastructural findings in 37 patients who underwent open lung biopsy which yielded diagnoses of fibrosing alveolitis A spectrum of lesions are categorized for the capillary endothelium and its basement membrane, the interstitial space and its fibrocellular components, and the alveolar epithelium and its basement membrane The findings typify the different pulmonary cellular reactions to injury Evidence for cellular regeneration and death in both epithelial and endothelial cell populations include atypical epithelial cell proliferation, capillary basement membrane multilamination, decrease in capillary lumen size and prominent pericytic ensheathment of pulmonary capillaries Within the interstitium of the lung, proliferation of collagen and elastic fibers are documented, but in addition, abundant myofibroblasts and smooth muscle cells are present No ultrastructural evidence of immune complex deposition was found in this study The morphologic findings of fibrosing alveolitis further support the widespread concept that the lung responds to various injuries in a similar manner and undergoes a common reparative response regardless of etiology

Takayasu's truncoarteritis. Pulseless disease or aortitis syndrome.

Abstract: The etiology of Takayasu's truncoarteritis is still unknown, although recent studies have suggested the participation of immunogenetic factors in the pathogenesis of this disease. Based on the summary of autopsy findings and taking clinical features into consideration, the current criteria for the pathological diagnosis of this condition might be summarized as follows. 1) Non-syphilitic truncoarteritis frequently occurring in young females. 2) Frequent manifestation of pulseless syndrome, and occasional presence of specific eye-ground findings or hypertension. 3) Common involvement of cranial stem arteries, and frequent involvement of the entire aorta and pulmonary artery. 4) Lesions in the stem arteries initially develop in the form of mesoperiarteritis by way of the vasa vasorum, and this is followed by intense intimal and adventitial fibrosis and occasionally thrombus formation. 5) Inflammatory changes in the media and adventitia exhibit histologically granulomatous inflammation with giant cells, diffuse productive inflammation consisting of lymphocyte and plasma cell infiltration, diffuse or nodular fibrosis accompanied by disintegration and loss of elastic fibers. 6) Marked fibrosis of the affected stem artery causes stenosis or obliteration of the lumen, and leads to aneurysm formation or dilatation of the artery.

Postoperative retinal fibrosis — a controlled clinical study of systemic steroid therapy

Abstract: In a prospective clinical trial, the effect of systemic steroids on the incidence and severity of retinal fibrosis following retinal detachment surgery was tested against placebo. Several grades of retinal fibrosis of various degrees of severity were defined prior to the study. The maximum postoperative incidence of eyes with any signs of retinal fibrosis was 65% (75.4% in the placebo group, 63.3% in the steroid group). A set of fibrosis criteria was identified that had a tendency to respond to systemic steroids with a statistical significance increasing with time. The majority of these steroid-responsive criteria was of a mild degree and located at the posterior pole. The mean visual acuity was significantly lower in eyes with retinal fibrosis. The effect of systemic steroids on retinal fibrosis tested under clinical conditions was considerably weaker than that known from experimental conditions with intravitreal injections of triamcinolone acetonide.

Preliminary results of a phase III trial of spontaneous animal tumors to heat and/or radiation: early normal tissue response and tumor volume influence on initial response

Abstract: A Phase III randomized trial was initiated to test the relative efficacies of heat alone, radiation alone and heat plus radiation using spontaneous malignancies in pet animals. Heat alone was inferior to the other two treatment arms as demonstrated by a significantly higher non-response rate and shorter response duration. The ratio of complete response rates (CR) for heat plus radiation to radiation alone or the thermal relative risk (TRR) was greater for tumors > 10 cm 3 as compared to those 3 (TRR = 4.8 and 1.4, respectively). The overall TRR for complete responses was 2.3. The CR data for the combined therapy arm indicate at least an additive effect between heat and radiation for small tumors but most likely a synergistic effect in the larger tumor group. Based on the data currently available, no significant difference in response duration is observed between the two radiation arms, although a nonsignificant advantage to the combination therapy exists. Normal tissue effects were evaluated by incidence of full moist desquamation within the irradiated volume, late fibrosis and bone necrosis. Since the radiation skin dose depended upon the technique being used it was possible to estimate the dose to achieve moist desquamation in 50 % of the animals (DD50) by a logistic regression model as being 3728 |+- 344 rad for radiation alone. Significant lowering of the DD50 was not observed for the addition of heat to radiation. Low patient numbers where intact skin was heated prevented an accurate analysis of the effect, however.

Phenotypic differences among clinically isolated mucoid Pseudomonas aeruginosa strains.

Abstract: Mucoid strains of Pseudomonas aeruginosa isolated from patients with cystic fibrosis or urinary tract infections displayed many phenotypic differences. The ratios of D-mannuronosyl to L-guluronosyl moieties of the extracellular alginate-like polysaccharides produced by the 19 strains examined varied from 99 to 0.8; the acetyl content of the polymers varied from 0.38 to 0.02 mol per mole of uronosyl residue. The strains also differed with regard to the stability of the mucoid phenotype. Of 15 isolates from patients with cystic fibrosis, 7 displayed stable mucoid phenotypes; 8 isolates were unstable and reverted to the nonmucoid phenotype at high frequency. The four strains isolated from patients with urinary tract infections were also unstable. Strains from urinary tract infections expressed the mucoid phenotype on six different media, both minimal and complex, whereas cystic fibrosis-associated strains varied widely with regard to medium-dependent expression of the mucoid phenotype. Of 15 cystic fibrosis strains, 5 were mucoid on each of six different media, 4 were mucoid on five media, 1 was mucoid on four media, 4 were mucoid on three media, and 1 yielded mucoid colonies on only one of the six media tested. There was no obvious correlation among polysaccharide structure, stability of the mucoid phenotype, and medium-dependent expression of the mucoid phenotype for any of the 19 strains investigated. These data suggest that although mucoid strains of P. aeruginosa must share some common property related to their ability to colonize their host, this property seems to be unrelated to polysaccharide composition, medium-dependent expression of the mucoid phenotype, or stability of the mucoid phenotype.

Computed tomography in pulmonary pseudotumors and their relation to asbestos exposure.

Abstract: Twelve patients, nine of whom had histories of exposure to asbestos, were evaluated by chest roentgenography and computed tomography because of a pulmonary mass lesion. The lesion consisted of condensed atelectatic lung parenchyma surrounded by marked thickening of the pleura--a pulmonary pseudotumor. In most patients, the mass lesion was only part of a more extensive disease process with pleural plaques and parenchymal fibrosis. Computed tomography demonstrated the full extent of disease better than chest roentgenograms. Asbestos is stressed as a possible causative factor of these mass lesions.

Serial two-dimensional echocardiography in Duchenne muscular dystrophy.

Abstract: Patients with Duchenne muscular dystrophy (DMD) are known to have progressive epicardial fibrosis of the free wall of the left ventricle, but standard noninvasive M-mode echocardiographic tests of left ventricular function are relatively insensitive detectors of this cardiomyopathy. We therefore used two-dimensional echocardiography to record three short axis levels of the left ventricle in 13 Duchenne patients. Serial studies were separated by 2 years for most patients. The two-dimensional echocardiographic technique allows qualitative evaluation of segmental contraction of the left ventricle. Four general principles were found during this study: (1) Obvious contraction abnormalities of the left ventricle were present in most patients with DMD. (2) In most patients, the contraction deficit was first noted in the left ventricular posterior free wall behind the mistral valve. (3) Once a contraction deficit was observed, the area of abnormal contraction progressed inferiorly to include additional areas of the left ventricular posterior free wall. (4) Standard M-mode left ventricular function techniques were unreliable for detecting individuals with segmental contraction abnormalities.

Silicotic fibrogenesis: a concept of pulmonary fibrosis

Abstract: The accumulated evidence indicates that, after ingestion of quartz, macrophages form or release a factor which enables fibroblasts to produce excess hydroxyproline. Inhaled quartz stimulates type II epithelium to generate phospholipid, sometimes in such excess that alveolar lipidosis develops and inhibits fibrosis in rats mainly by isolation of quartz particles from macrophages. Extracted lipid administered parenterally to other rats provokes a marrow monopoiesis, as judged by population kinetics of promonocytes. Prostaglandins, released from stimulated alveolar macrophages, may facilitate monocytic emigration by increasing capillary permeability. Passage of monocytes from pulmonary interstitium to alveolar surface is likely to be simplified by disruption of the thin type I epithelium caused by quartz, a process which the chemotactic action of alveolar lipids could encourage. These interactions are integrated into a system that might be activated by agents other than silica and thus offer a wider concept of pulmonary fibrosis.

The compensated and the decompensated form of benign nephrosclerosis.

Abstract: Summary Decompensated benign nephrosclerosis, a disease which was briefly described by Theodor Fahr in 1925, defended by him in 1934, and then forgotten, is reported and differentiated from compensated benign nephrosclerosis Decompensated benign nephrosclerosis can be differentiated from compensated benign nephrosclerosis by the frequent appearance of interstitial cortical fibrosis and glomerular alterations in the sense of hypertensive glomerulopathy Hypertensive glomerulopathy results in ascending obliteration of the glomeruli, ie, their transformation into PAS-positive hyaline globules In compensated benign nephrosclerosis, interstitial fibrosis, if present at all, can usually be identified only in the subcapsular areas In decompensated benign nephrosclerosis, however, a pyramid-like structure with its base at the corticomedullary border is formed The severity of preglomerular vascular alterations does not differ in compensated and decompensated benign nephrosclerosis Clinically, there is no significant difference between the degree of hypertension and the development of the disease The nephritic symptoms are more pronounced in decompensated benign nephrosclerosis, which predominantly affects middle-aged men (male: female, 57: 1), than in compensated benign nephrosclerosis As a result, decompensated benign nephrosclerosis is frequently diagnosed and treated as chronic glomerulonephritis

Reversal of severe bone marrow fibrosis and osteosclerosis following allogeneic bone marrow transplantation for chronic granulocytic leukaemia

Abstract: Summary. Severe marrow fibrosis and osteosclerosis gradually disappeared after a 33-year-old woman received an allogeneic bone marrow transplantation (BMT) as experimental treatment for chronic granulocytic leukaemia. Serial biopsies demonstrate gradual resolution of dense reticulin fibrosis, collagen fibrosis and osteosclerosis, and restoration of normal marrow architecture after transplantation. These changes correspond with histological and cytogenetic evidence of normal marrow engraftment and sustained complete remission from chronic granulocytic leukaemia. In this case severe marrow infiltration with reticulin and collagen fibrosis as well as severe derangement of marrow architecture and obliteration of the medullary cavity by osteosclerosis was an entirely reversible process after allogeneic bone marrow transplantation, and did not prevent successful engraftment, haemopoietic and cytogenetic reconstitution and complete remission from chronic granulocytic leukaemia.

Immune response to connective tissue components of the basement membrane.

Abstract: The immune response to connective tissue components of basement membrane (type IV collagen and laminin) and to interstitial collagen (type I) has been examined in human and murine systems. We also examined the role that immunologic sensitization to autologous connective tissue components might play in inducing an inflammatory response resulting in pathologic sequelae. Mice receiving a single subcutaneous injection of 5 micrograms type IV or type I murine collagens, or murine laminin in complete Freund's adjuvant mount a delayed-type hypersensitivity response characterized by a mononuclear cell infiltrate when challenged in the footpad with the sensitizing antigen. Cell-mediated immunity to these connective tissue antigens can be transferred to normal syngeneic mice with sensitized T-lymphocytes. In addition, repeated immunizations with these homologous connective tissue components elicit antibody responses in mice. Our data demonstrate the immunogenic nature of types IV and I collagen, and of laminin in a syngeneic murine model. We have demonstrated autoantibodies to the basement membrane and interstitial collagens in the sera of patients with scleroderma (systemic sclerosis); ELISA ratios correlate directly with the extent of pulmonary fibrosis in these patients. Anti-type IV collagen autoantibodies were found to be primarily IgM and anti-type I collagen antibodies, primarily IgG. An antibody response to autologous connective tissue antigens could lead to complement activation, immune complex formation, and deposition of the complexes along vascular endothelium with recruitment of blood monocytes in situ, mirroring the early scleroderma lesion (perivascular mononuclear cell filtrates). In vitro we examined the role of human peripheral blood mononuclear cells in the activation of fibroblasts. Adherent human blood monocytes release mediators which stimulate fibroblast proliferation and collagen deposition. A model is presented for the induction of immunity to autologous connective tissue components, leading to mononuclear cell inflammation, fibroblast activation and fibrosis. Selective immunity to basement membrane collagens may influence the clinical expression of diffuse connective tissue syndromes such as scleroderma (systemic sclerosis).

Hepatoportal fibrosis in three young dogs.

Abstract: Three young dogs with a history of apathy, anorexia and weight loss were presented with severe ascites. Abnormal laboratory findings include hypoalbuminaemia and increased activities of alkaline phosphatase, serum aspartate amino-transferase, serum glutamic pyruvic transaminase and gamma-glutamyl transferase. Ammonia tolerance was also abnormal. At autopsy ascites and peripheral portosystemic collaterals were found. The livers were abnormally small and firm and their surfaces were irregular. Histologically, there was marked periportal fibrosis, increased numbers of bile ductules and arteriolae in the portal areas and an absence of normal portal vein tributaries. No inflammatory changes were found. These lesions are discussed in relation to the various causes of hepatic fibrosis.

Cytogenetic studies of peripheral myeloblasts and bone marrow fibroblasts in acute myelofibrosis.

Abstract: Chromosome analysis with giemsa-trypsin banding was performed on circulating myeloblasts and cultured bone marrow fibroblasts from a patient with acute myelofibrosis. Major karyotypic abnormalities were found in the myeloblasts involving chromosomes #1, 3, 5, 13, and 16; no chromosome abnormalities were detected in the fibroblasts. In addition, a pericentric inversion of number 7 was present in the circulating blasts but not the fibroblasts. Pericentric inversions have not previously been associated with acquired abnormalities of malignant cells. These findings support the concept that acute myelofibrosis is a primary malignancy of hematopoietic cells associated with secondary marrow fibrosis. The entity of acute myelofibrosis is discussed and the results of cytogenetic studies of previous reports are reviewed.