The temporal and spatial distribution of p21WAF expression in skin appendages

p21WAF is a cyclin-dependent kinase inhibitor which is widely expressed in epidermal structures. Using a combination of double immunocytochemical staining and combined in situ hybridization, we show that there is a striking exclusivity between the expression of Ki67 and p21WAF in the hair matrix. Some cells that are Ki67-positive also express p53, but as they exit the cell cycle they assume p21WAF-positive/p53-negative status. By contrast, cells in the interfollicular epidermis of psoriatic lesions, in the sebaceous gland, and in the outer root sheath are p21WAF-positive/p53-positive but Ki67-negative. These results suggest that in some anatomical parts of the epidermis, p21WAF expression can accompany p53 expression, whereas in other parts, the expression of these markers is reciprocal, suggesting that other pathways may be controlling p21WAF expression. In order to define, functionally, the presence of p53-independent p21WAF expression in skin, we examined lesions of Bowen's disease in which both alleles of p53 were inactivated. p21WAF expression was still observed, confirming a role for p53-independent expression of p21WAF in human skin in vivo.     

Intraatrial reentrant circuit in a patient with isomerism of the left atrial appendages and atrioventricular septal defect

An intraatrial reentrant circuit was identified using an electroanatomical mapping system and evaluation of postpacing intervals in a patient with isomerism of the left atrial appendages and atrioventricular septal defect. Intraatrial reentrant tachycardia was eliminated on the basis of our interpretation of the reentry circuit being dependent on a new anatomical obstacle consisting of a right-sided atrioventricular annulus and atrial septation patch. We must consider the possibility of arrhythmogenic obstacles changing, as a patient grows, long after congenital heart disease surgery. (PACE 2012; 35:e299-e301).     

ES细胞源性表皮干细胞与类真皮构成皮肤类似物的分化

【目的】以ES细胞源性表皮干细胞为种子细胞构建皮肤类似物，探讨其在皮下的分化潜能。【方法】Hoechst33342标记E14-ES细胞，经羊膜诱导4d后，形成表皮干细胞克隆，并以其作为种子细胞，取129胎鼠成纤维细胞与复合凝胶-明胶海绵复合，形成皮肤类似物，埋植于129小鼠皮下组织。术后2周、4周、6周、8周取材，做HE染色观察，B1整合素、CK15、CK19、CEA、CK18免疫组化荧光双标和免疫组化观察。【结果】术后2周和4周，植块内可见单层立方或柱状上皮构成的管状和泡状结构，6周和8周后，可见角化复层上皮、毛囊样、汗腺样、皮脂腺样等结构，免疫双标结果显示，植入2周和4周，带有蓝色核标记的细胞形成的管状或泡状结构呈B1整合素、CK15、CK19、CEA和CK18阳性，6周和8周后，HE染色中汗腺样结构呈CEA、CK18阳性。[结论]ES细胞源性表皮干细胞与类真皮构建的皮肤类似物。在同种小鼠皮下有分为角化复层上皮、汗腺样、毛囊样、皮脂腺样等结构的潜能。     

Disharmonious Ventricular Relationship and Topology for the Given Atrioventricular Connections. Contemporary Diagnostic Approach Using 3D Modeling and Printing

In the last issue, two case reports separately present examples of the extremely rare and complex congenital heart diseases that show concordant atrioventricular connections to the L-looped ventricles in the presence of situs solitus. Both cases highlight that the relationship between the two ventricles within the ventricular mass is not always harmonious with the given atrioventricular connection. Such disharmony between the connections and relationships requires careful assessment of the three basic facets of cardiac building blocks, namely their morphology, the relationship of their component parts, and their connections with the adjacent segments. 3D imaging and printing can now facilitate an otherwise difficult diagnosis in such complex situations. Rotation of either the 3D images or the models permit accurate assessment of the ventricular topologic pattern by creating the right ventricular en-face septal view, thus facilitating placement of the observer’s hands. As we now emphasize, an alternative approach, which might prove more attractive to imagers, is to rotate the ventricular mass to provide the ventricular apical view, thus permitting determination of the ventricular relationship without using the hands.     

双动脉瓣口平面对正常胎儿心耳的诊断价值（Y201308099）

目的 探讨中孕期正常胎儿心耳在双动脉瓣瓣口平面上的图像特征和显示情况。方法 回顾性分析164例19~28周正常胎儿心脏,分别观察并统计不同心尖方位时双动脉瓣瓣口平面上左右心耳的形态特征和显示率。结果 心尖四腔心和左侧横位四腔心时,左心耳的显示率均高于右心耳（85.2% vs 49.2%、90.9% vs 36.4%）。右侧横位四腔心时,左、右心耳显示率最高（97.1%、94.3%）,但二者无统计学差异。不同心尖方位条件,左心耳显示无统计学差异。右侧横位四腔心时,66例（94.3%）的双侧心耳可同时显示。胎儿左心耳形态以弯指状最为常见,形态狭长,基底部开口较小,内壁回声较光整。右心耳最为钝三角形,基底部开口较宽,顶部呈锯齿状,梳状肌较发达。结论 双动脉瓣瓣口平面基本显示出正常中孕期胎儿的左右心耳,二者形状及结构差别明显可辨。     

Digitate intravascular appendages and aneurysm of the vein of Galen

Peculiar intravascular appendages were found in a case of aneurysm of the vein of Galen. Such appendages consisted of finger-like polypoid growths which protruded within the lumen of ectatic cerebral veins and arteries. They were solid, relatively large, and non-branching. Histologically, their structure was comparable to that of a vessel wall, but was concentrically laminated around the longitudinal axis. Some appendages were associated with thrombi. It is suggested that appendages of this kind probably represent secondary vascular malformations, that they are likely to develop in reaction to abnormal hemodynamic strains upon the vessel walls, and that they might be thrombogenic and, therefore, potentially beneficial for patients with arteriovenous shunts. Received: 26 July 1995 / Revised, accepted: 26 September 1995     

功能性组织工程皮肤附属物再生对排汗和新陈代谢的意义

背景：排汗可将一些溶解于汗液的代谢产物带出体外,在排泄中起辅助作用。现代医学目前还无法恢复严重创伤或烧伤患者的汗腺,如何解决皮肤汗腺的再生及如何培养具有皮肤附属物的“功能性组织工程皮肤”问题已成为当今医学研究中的热点。目的：探讨机体的新陈代谢、汗液的代谢方式,分析组织工程皮肤功能性附属物汗腺再生研究的现状。方法：收集组织工程皮肤功能性附属物再生,特别是排汗的相关研究,分析机体的新陈代谢与排泄方式,汗液代谢的物质和方式,以及目前组织工程皮肤附属物汗腺再生研究的现状。结果与结论：汗液作为排泄系统中重要的一员在维持机体内部的动态平衡,防止代谢产物对身体的损害方面具有不可忽视的地位。理想的功能性组织工程皮肤应具有分泌汗液、排泄废物、调节体温和维持皮肤动态平衡的作用,在大面积烧伤后皮肤创伤修复和重建过程中起着至关重要的作用。已有研究将干细胞与汗腺细胞进行共培养,然后移植到瘢痕创面上进行重建汗腺组织,取得了一定的成功。     

Classifying Cardiac Anomalies in Right and Left Isomerism: Concordant and Discordant Patterns

Aims: Evidence is emerging that, in the setting of isomerism, the atrial and bronchial arrangement are not always concordant, nor are these patterns always harmonious with the arrangement of the abdominal organs. We aimed to evaluate the concordance between these features in a cohort of patients with cardiac malformations in the setting of known isomerism, seeking to determine whether it was feasible to assess complexity on this basis, in this regard taking note of the potential value of bronchial as opposed to appendage morphology. Methods and Results: We studied 78 patients known to have isomerism of the bronchuses, 43 with right and 35 with left isomerism. Appendage anatomy could be determined in 49 cases (63%), all but one of these being concordant with bronchial anatomy. When assessing abdominal features, in only 59 cases (76%) was splenic morphology in keeping with the thoracic findings. As expected, right isomerism was associated with greater complexity of cardiac malformations, with an odds ratio of 6.53, with confidence intervals from 2.2–19.3 (p < 0.001). The odds were slightly decreased with thoraco-abdominal disharmony, when lesions shown to carry higher risk were then found in the setting of left isomerism. Conclusion: Harmony is excellent between bronchial and appendage isomerism, but less so with the arrangement of the abdominal organs. Right isomerism in our cohort, was indicative of a six-fold increase in intracardiac complexity. When discordance was found between the systems, however, the cardiac anomalies were less typical of the anticipated findings for right vs. left isomerism of the appendages.     

Congenital accessory palpebral aperture – An addition to the spectrum of Delleman syndrome

Delleman syndrome (oculocerebrocutaneous syndrome, MIM 164180) is characterized by orbital cysts, microphthalmia/anophthalmia, focal skin defects, skin appendages and multiple cerebral malformations. We herein describe a case of an 8-month-old male child with features suggestive of Delleman syndrome along with a rare congenital lid anomaly – an accessory palpebral aperture, not reported so far to the best of our knowledge.     

Development and growth of the pelvic fin in the extant coelacanth Latimeria chalumnae

The ontogeny of the paired appendages has been extensively studied in lungfishes and tetrapods, but remains poorly known in coelacanths. Recent work has shed light on the anatomy and development of the pectoral fin in Latimeria chalumnae. Yet, information on the development of the pelvic fin and girdle is still lacking. Here, we described the development of the pelvic fin and girdle in Latimeria chalumnae based on 3D reconstructions generated from conventional and X-ray synchrotron microtomography, as well as MRI acquisitions. As in other jawed vertebrates, the development of the pelvic fin occurs later than that of the pectoral fin in Latimeria. Many elements of the endoskeleton are not yet formed at the earliest stage sampled. The four mesomeres are already formed in the fetus, but only the most proximal radial elements (preaxial radial 0–1) are formed and individualized at this stage. We suggest that all the preaxial radial elements in the pelvic and pectoral fin of Latimeria are formed through the fragmentation of the mesomeres. We document the progressive ossification of the pelvic girdle, and the presence of a trabecular system in the adult. This trabecular system likely reinforces the cartilaginous girdle to resist the muscle forces exerted during locomotion. Finally, the presence of a preaxial element in contact with the pelvic girdle from the earliest stage of development onward questions the mono-basal condition of the pelvic fin in Latimeria. However, the particular shape of the mesomeres may explain the presence of this element in contact with the girdle.