Intralymphatic histiocytosis comprises M2 macrophages in superficial dermal lymphatics with or without smooth muscles

Intralymphatic histiocytosis represents a rare reactive disorder, which is characterized by the accumulation of macrophages within lymphatic vessels and observed predominantly in upper extremities. The infiltration and preferential M2 differentiation of macrophage are observed in chronic lymphedema, and lymphedema is considered a causative factor of intralymphatic histiocytosis. However, what causes accumulation of histiocytes in the lymphatic vessels remains unclear, and investigation regarding the characteristics of the macrophages has not been evaluated. We present a case of intralymphatic histiocytosis, in which immunohistochemical staining for both macrophages and lymphatic vessels was performed to evaluate the nature of macrophages within lymphatic vessels and to determine the causative factor. Aggregated macrophages were shown to be M2 macrophages positive for CD68, CD163 and CD206 but negative for inducible nitric oxide synthase. Thick lymphatic vessels positive for D2‐40 and α‐SMA in the superficial dermis were observed. We speculate that chronic lymphedema leads to hypertrophy of lymphatic vessels with smooth muscle in the superficial dermis, which may be a kind of malformation, and these lymphatic vessels produce some chemokines that induce intralymphatic aggregation of macrophages.     

Rheumatoid arthritis: Perioperative management of biologics and DMARDs

ObjectiveArthroplasty remains prevalent for patients with rheumatoid arthritis (RA), but outcomes are not equivalent to patients with osteoarthritis, and complications including infection are increased. The objective of this article is to review the current evidence supporting perioperative medication management. Challenges are discussed such as continuing potent disease-modifying therapy (DMARDs) and biologics, which may increase infection risk, versus withholding these medications, which may result in disease flares.MethodsPublished literature regarding arthroplasty in RA has been reviewed and discussed.ResultsSome DMARDs such as methotrexate and hydroxychloroquine appear safe in the perioperative period. Anti-TNFα biologics should be withheld due to increase in infection risk, while the impact of rituximab and abatacept on infection risk has not been as clearly defined.ConclusionThis article provides an overview of arthroplasty in RA, summarizes the evidence supporting perioperative medication management including corticosteroids, and identifies areas where further study is needed.     

Investigation on the Cyclic Response of Superelastic Shape Memory Alloy (SMA) Slit Damper Devices Simulated by Quasi-Static Finite Element (FE) Analyses

In this paper, the superelastic shape memory alloy (SMA) slit damper system as an alternative design approach for steel structures is intended to be evaluated with respect to inelastic behavior simulated by refined finite element (FE) analyses. Although the steel slit dampers conventionally used for aseismic design are able to dissipate a considerable amount of energy generated by the plastic yielding of the base materials, large permanent deformation may occur in the entire structure. After strong seismic events, extra damage repair costs are required to restore the original configuration and to replace defective devices with new ones. Innovative slit dampers fabricated by superelastic SMAs that automatically recover their initial conditions only by the removal of stresses without heat treatment are introduced with a view toward mitigating the problem of permanent deformation. The cyclically tested FE models are calibrated to experimental results for the purpose of predicting accurate behavior. This study also focuses on the material constitutive model that is able to reproduce the inherent behavior of superelastic SMA materials by taking phase transformation between austenite and martensite into consideration. The responses of SMA slit dampers are compared to those of steel slit dampers. Axial stress and strain components are also investigated on the FE models under cyclic loading in an effort to validate the adequacy of FE modeling and then to compare between two slit damper systems. It can be shown that SMA slit dampers exhibit many structural advantages in terms of ultimate strength, moderate energy dissipation and recentering capability.     

Radioembolization with yttrium-90 microspheres work up: Practical approach and literature review

Radioembolization (RE) is a selective internal radiotherapy technique in which yttrium-90 blended microspheres are infused through the hepatic arteries. It is based on the fact that primary and secondary hepatic tumors are vascularized mostly by arterial blood flow whereas healthy hepatocytes obtain their blood supply mostly from the portal network. This enables high radiation doses to be delivered, sparing the surrounding non-malignant liver parenchyma. Most of the complications are caused by unexpected particles passing into the gastrointestinal tract through branches originating from the main hepatic arterial supply. Knowledge of this hepatic arterial network and of its variations and the technical considerations this raises are required in preparation for treatment. This work describes the specific anatomical features and techniques for this anatomy through recent literature illustrated by cases from our own experience.     

Polymorphisms in P2X4R and CAMKK2 may affect TNFα production: Implications for a role in HIV-associated sensory neuropathy

Polymorphisms in P2X4R and CAMKK2 associate with susceptibility to HIV-associated sensory neuropathy (HIV-SN) – a condition likely mediated by TNFα. As single nucleotide polymorphisms (SNPs) and haplotypes of CAMKK2, and a neighbouring gene P2X4R, mark susceptibility to HIV-SN in South Africans living with HIV, we examined the relationship between P2X4R and CAMKK2 genotypes and TNFα production. Peripheral blood mononuclear cells from 129 healthy donors were stimulated with killed Escherichia coli, and concentrations of soluble TNFα were assessed. Their DNA was genotyped for 22 SNPs in P2X4R and CAMKK2. Three SNPs within P2X4R and two SNPs within CAMKK2 influenced concentrations of TNFα, but these SNP did not associate with risk for HIV-SN. This incongruence may reflect differences in P2X4R haplotypes present in Africans and Europeans. However some CAMKK2 haplotypes were found in both populations, so CAMKK2 polymorphisms may impact upon HIV-SN via effects of the protein on pathways other than TNFα.     

miR-145对血管平滑肌细胞生物活性及SM22α mRNA表达的作用*

目的：探究miR-145 对血管平滑肌细胞（VSMC）的生物活性及对SM22α mRNA 表达的作用。方法： VSMC分为3 组,增殖VSMC组（ 增殖组）、增殖VSMC + 转染miR-145-NC 组（ 空载体组）、增殖VSMC+转染 miR-145 组（ 增殖转染组）。采用RT-PCR 检测VSMC中SM22α mRNA、miR-145 的表达;免疫印迹检测cyclin E、p27 蛋白水平;Transwell 小室检测VSMC侵袭能力;MTT检测VSMC活力;流式细胞术检测VSMC凋亡率。 结果：增殖组VSMC中SM22α mRNA、miR-145 水平与空载体组相比数值较为接近;与增殖组及空载体组相比, 增殖转染组VSMC中miR-145、SM22α mRNA 表达升高。增殖组VSMC中cyclin E、p27 蛋白水平与空载体组相 比无差异;增殖转染组cyclin E 蛋白水平低于空载体组、增殖组,p27 蛋白水平高于空载体组、增殖组。增殖组 VSMC迁移数量与空载体组相比无差异;增殖转染组VSMC迁移数量明显低于空载体组、增殖组。增殖组与空载 体组VSMC在不同时间点的OD 值均较为接近;增殖转染组OD 值在不同时间点均低于空载体组、增殖组。增殖 组VSMC凋亡率与空载体组数值接近,组间比较差距较小;增殖转染组VSMC凋亡率较空载体组和增殖组升高。 结论：过表达miR-145 通过促进SM22α 水平增加,抑制血管平滑肌细胞的增殖,并促进其凋亡。     

Role of cell–matrix interactions on VIC phenotype and tissue deposition in 3D PEG hydrogels

Valvular interstitial cells (VICs) respond to 3D matrix interactions in a complex manner, but understanding these effects on VIC function better is important for applications ranging from valve tissue engineering to studying valve disease. Here, we encapsulated VICs in poly(ethylene glycol) (PEG) hydrogels modified with three different adhesive ligands, derived from fibronectin (RGDS), elastin (VGVAPG) and collagen‐1 (P15). By day 14, VICs became significantly more elongated in RGDS‐containing gels compared to VGVAPG or P15. This difference in cell morphology appeared to correlate with global matrix metalloproteinase (MMP) activity, as VICs encapsulated in RGDS‐functionalized hydrogels secreted higher levels of active MMP at day 2. VIC activation to a myofibroblast phenotype was also characterized by staining for α‐smooth muscle actin (αSMA) at day 14. The percentage of αSMA⁺ VICs in the VGVAPG gels was the highest (56%) compared to RGDS (33%) or P15 (38%) gels. Matrix deposition and composition were also characterized at days 14 and 42 and found to depend on the initial hydrogel composition. All gel formulations had similar levels of collagen, elastin and chondroitin sulphate deposited as the porcine aortic valve. However, the composition of collagen deposited by VICs in VGVAPG‐functionalized gels had a significantly higher collagen‐X:collagen‐1 ratio, which is associated with stenotic valves. Taken together, these data suggest that peptide‐functionalized PEG hydrogels are a useful system for culturing VICs three‐dimensionally and, with the ability to systematically alter biochemical and biophysical properties, this platform may prove useful in manipulating VIC function for valve regeneration. Copyright © 2013 John Wiley & Sons, Ltd.