Obesity Affects Collagen Fibril Diameter and Mechanical Properties of Tendons in Zucker Rats

Obesity is currently considered to be a world epidemic and one of the major public health problems in many countries, whose incidence is increasing at alarming rates. Genetically obese Zucker rats are used as a model of obesity and were employed in the present study. Tendons transmit contractile force from muscles to bone, thus permitting articular movement. The objective of our study was to analyze the ultrastructural, biochemical, and biomechanical alterations that occur in the deep digital flexor tendon of obese Zucker rats compared to lean animals. Ultrastructural analysis showed differences in collagen fibril diameter distribution and mass-average diameter between obese and lean animals. Regarding mechanical parameters, there was a significant difference in maximum displacement and strain. Hydroxyproline content was higher in obese animals. In view of the excess weight and peculiar conditions to which the tendon of obese animals is submitted, we concluded that obesity provokes alterations in the composition and organization of tendon extracellular matrix components. These alterations might be related to organizational and structural modifications in the collagen bundles, influencing the mechanical properties of the tendon and the progression to a pathological state.     

Post-operative spindle cell nodule of the vulva

A case of post-operative spindle cell nodule arising in the vulva of a 33-year-old woman is reported and the relevant literature reviewed. This is an uncommon, benign lesion which develops soon after a surgical procedure and which is composed of mitotically active spindle cells, causing possible confusion with sarcoma. Knowledge of the clinical history and an awareness of the existence of such lesions is necessary in order to avoid misinterpretation.     

Extracellular matrix modifications in the interdigital spaces of the chick embryo leg bud during the formation of ectopic digits

In previous studies we have observed that the interdigital mesenchyme of the chick leg bud, in the stages preceding the onset of cell death, retains a significant regulatory potential, forming ectopic extra digits under a variety of surgical manipulations. Most evidence suggests that interdigital extra digits are caused by the abolition of local antichondrogenic effects operating in the interdigital spaces under normal conditions rather than by modifications of the signalling mechanisms accounting for the normal patterning of the digits in early stages of development. The interdigital spaces exhibit a complex scaffold of extracellular matrix with well-defined domains of spatial distribution of type I and type VI collagens, tenascin, fibronectin, laminin and elastic matrix components that have been proposed to play a role in the establishment of the non-chondrogenic fate of the interdigital tissue in situ. In an attempt to analyze this possible role of the interdigital extracellular matrix (ECM), in the present work we have studied changes in the pattern of ECM distribution associated with the formation of extra digits. Extra digits were induced by making a T-cut in the third interdigital space of the leg but of stage 29 HH chick embryos. Subsequent modifications of the ECM were detected immunohistochemically in whole-mount specimens using laser confocal microscopy. Our results reveal that in the first hours after the operation, changes in the ECM apparently related to the healing of the wound cause a significant reorganization of the normal ECM scaffold of the interdigit. In addition, chondrogenesis of the interdigital tissue is preceded by disappearance of elastin fibers in the interdigital mesenchyme subjacent to the wound and by an intense deposition of tenascin. Tenascin deposition and loss of the elastin fibrillar scaffold were also observed preceding chondrogenesis in fragments of interdigital tissue explanted to culture conditions. The significance of these observations in relation to the establishment of the skeletal elements of the autopodium is discussed.     

Clinicopathological study of a hilar nodule in the livers of long-term survivors with biliary atresia

With the application of liver transplantation for patients with biliary atresia (BA), we have had the opportunity to review the clinicopathologic features of the native livers from 10 transplanted BA patients. A single large nodule at porta hepatis (hilar nodule) was noted in three of 10 patients, and an ill-defined nodule-like lesion at porta hepatis was present in two other patients. The three BA patients with hilar nodules were long-term survivors, compared to the patients with nodule-like and those without nodules. The hilar nodules measured between 5.0 cm and 8.0 cm and histologically, they were partly surrounded by fibrous septa with relatively well-preserved liver architectures and fewer inflammatory cells at the portal triads when compared to the surrounding cirrhotic lesions. No nuclear or cellular atypia was observed. Proliferating cell nuclear antigen labeling index was higher in the surrounding cirrhotic lesions than the hilar nodules. The nodule-like lesions at porta hepatis also showed similar light microscopic and immunohistochemical features as the hilar nodules. These hilar nodules did not seem to contain any malignant potential. The benign histology with relatively well-preserved liver architecture and the preferential site of occurrence at porta hepatis where bile seemed to flow more smoothly, suggested possible residues of less-affected hepatic tissues.     

Median nodule of the upper lip: An autosomal dominant trait

We describe a total of 18 individuals, in 3 families, with a median nodule of the upper lip. In family 1, the proposita, an 8-month-old infant girl, was otherwise phenotypically normal except for a median nodule of the upper lip. The proposita's elder brother and mother, both phenotypically normal, also had the similar nodule of the upper lip. On the mother's side, the proposita's greatgrandmother, great-grandaunt, grandfather, greataunt, two aunts, and one female cousin all had a median nodule of the upper lip. In family 2, the proposita, proposita's mother and maternal grandfather had a median nodule of the upper lip. In family 3, the proposita, proposita's father, paternal grandfather, paternal uncle, and cousin had a median nodule of the upper lip. Analysis of 3 families indicates that the condition is an autosomal dominant trait. © 1994 Wiley-Liss, Inc.     

Graded Arrangement of Collagen Fibrils in the Equine Superficial Digital Flexor Tendon

By using ultramorphological and biochemical methods, we analyzed the regional differences between the three parts of the equine superficial digital flexor tendon (SDFT), namely, the myotendinous junction (MTJ), middle metacarpal (mM), and osteotendinous junction (OTJ). Cross-sectional images showed unique distributions of collagen fibrils of varying diameters in each region. Small collagen fibrils (diameter <100 nm) were distributed predominantly in the MTJ region, and the OTJ region was relatively rich in large collagen fibrils (diameter >200 nm). In the mM region, the collagen fibrils were intermediately distributed between the MTJ and OTJ. The results indicate a graded arrangement of collagen fibrils in the tendon. Type V collagen was detected preferentially in the MTJ region. Since type V collagen is believed to be one of the collagens regulating collagen fibril formation, its possible functionality in the MTJ region in terms of fibril formation and fibril arrangement in the tendon has been discussed here.     

Lung adenocarcinoma manifesting as subsolid nodule potentially represents tumour in the equilibrium phase of immunoediting

Lung adenocarcinomas manifesting as subsolid nodules (SSN-LUADs) possess distinct dormant behaviour. This study was designed to compare the immune landscapes of normal lungs (nLungs), SSN-LUADs and LUADs manifesting as solid nodules (SN-LUADs) so as to better understand the status of anti-tumour immunity in SSN-LUADs. Mass cytometry by time-of-flight analysis was performed on 299, 570 single cells from nLung, SSN-LUAD and SN-LUAD tissues. The immune cells were identified by phenotype, and the percentages of different immune cell subclusters were compared between SSN-LUADs, SN-LUADs and nLungs. Elevated percentage of CD8⁺ T cells were identified in SSN-LUADs compared with in nLungs and SN-LUADs. Elevated CD56^bright NK cells and decreased CD56^dim NK cells were identified in both SSN-LUADs and SN-LUADs compared with in nLungs. The immune landscape of SSN-LUAD fits the theory of equilibrium phase of immunoediting, thus functional adaptive anti-tumour immunity but impaired innate anti-tumour immunity potentially contributes to the maintaining of its dormant behaviour.     

高频超声联合萤火虫成像技术在甲状腺结节良恶性诊断中的应用价值

目的:探讨高频超声联合萤火虫成像技术在甲状腺结节良恶性诊断中的应用价值。方法:回顾性研究。纳入2019年9月—2020年9月蚌埠医学院第一附属医院甲状腺结节患者100例(126个结节),其中男42例、女58例,年龄19～56岁。患者术前均行高频超声和萤火虫成像检查,术后均行病理组织学检查并确诊结节的良恶性。观察指标：(...     

Huge solitary necrotic nodule of the liver: a rare case report with review of literature

Solitary necrotic nodule of the liver (SNNL) is an uncommon disease in clinical practice, and its pathogenesis is still unclear. Here, we report the case of a 35-year-old woman. After physical examination, the patient was found to have a liver neoplasm, and there were no other physical complaints. Abdominal contrast-enhanced computed tomography (CT) showed the presence of a hypodense lesion. The patient opted for surgery to eliminate the lesion. Pathologic examination revealed an isolated necrotic nodular lesion with a size of 12 cm×10 cm×10 cm. The patient had a history of hepatitis B infection. To our knowledge, this is the largest SNNL ever reported and the first case with a history of hepatitis B infection.     

胸膜凹陷征量化分析在外周孤立性肺结节CT定性诊断中的应用价值

目的：通过量化分析的方法,探讨胸膜凹陷相关切迹( NNPI)在孤立性肺结节( SPN) CT定性诊断中的应用价值。方法回顾性分析2009年1月—2013年12月在复旦大学附属华东医院诊治的90例CT发现有NNPI的SPN患者的病例资料,其中男42例,女48例;年龄31~76岁,平均58岁。 SPN均经手术或穿刺活检病理证实。应用GE 4.4工作站后处理软件测算SPN及NNPI相关参数：SPN体积( V)、NNPI牵拉程度最大的横断面积( Smax)以及结节所在 Smax的横断面中心与NNPI顶点连线的距离( d)。应用Pearson相关分析分析三者之间的相关性,计算结节的牵拉系数K=( Smax × d)/V。分别计算出良恶性结节的K值,应用两独立样本秩和检验判断其统计学差异。作出K值的ROC曲线,计算其在判断良恶性结节中的最佳敏感性、特异性、阳性预测值、阴性预测值及准确率,并与两名有经验的影像科医师采用盲法阅片所得出的敏感性、特异性、阳性预测值、阴性预测值及准确率进行纵向比较。结果通过Pearson相关分析证实Smax、V及d三者具有相关性,Smax与V具有中等程度正相关性(r=0.65,P<0.05),与d存在高度负相关(r=-0.83,P<0.05)。腺癌的K值高于炎性肉芽肿、结核、真菌性肉芽肿、错构瘤等良性 SPN 的 K 值,差异均有统计学意义( Z =-3.57、-4.09、-3.19、-2.97,P值均<0.01);而炎性肉芽肿、结核、真菌性肉芽肿、错构瘤之间的K值差异均无统计学意义(P值均>0.05)。 ROC曲线分析得出K值的cut-off值为0.052,曲线下面积为0.852,通过K值法判断结节的良恶性所得出的最佳敏感性、特异性、阳性预测值、阴性预测值及准确率分别为78.0%、92.5%、92.8%、77.1%、84.4%,而医师直观阅片所得出的敏感性、特异性、阳性预测值、阴性预测值及准确率分别为64.0%、82.5%、82.1%、64.7%、72.2%,K值法得出的各项数据均高于医师形态学判断方法。结论 K值法对于SPN良恶性的鉴别有临床应用价值,准确性高于医生形态学判断方法。     

肝孤立性坏死结节1例报告并文献复习

目的：探讨肝孤立性坏死结节的临床、病理形态学特点、影像学及其鉴别诊断,以期对此疾病进行更加深入的理解。方法：收集临床资料并结合影像学及病理形态学检查结果,运用光镜及特染技术研究1例肝孤立性坏死结节并系统进行相关文献复习。结果：影像学、B超、CT、MRI检查均表现为边界尚清楚的低回声、低密度、低信号结节,且增强扫描后内部不强化。MRI增强后病灶环形强化。镜下结节为一粉染无结构的非干酪样坏死物构成,其内未见细菌、寄生虫等病原体入侵。结节周围可见透明变性纤维包膜包绕。病变周围为正常肝组织。病理诊断：肝孤立性坏死结节。结论：肝孤立性坏死结节有特异影像学和病理组织学表现,临床治疗方案为病灶切除,术后预后良好,不易复发。     

The three-dimensional architecture of collagen fibrils in the lamina cribrosa and the anterior part of the optic nerve

The three-dimensional architecture of the collagen fibrillar network forming the lamina cribrosa of the optic disc and the associated septal plates of the anterior part of the optic nerve was investigated using monkey eyeballs treated by the NaOH cell-maceration procedure and scanning electron microscopy. Arising from the scleral collagen fibrils branches joined together to form thick bundles of collagen in lamina plates encompassing hundreds of pores. More than ten plates were observed stacked on top of each other forming the pore channels. Adjacent piled up plates were interconnected with branching collagen fibrils. Septal plates derived from pia mater collagen fibrils were formed by radially and obliquely arranged thick bundles of collagen piled up longitudinally in the optic nerve and merging into the most posterior lamina plate. In the septal plates many ovally shaped windows were observed, suggesting branching and regional irregularity in the shape of the myelinated nerve fiber bundle. Pia mater and dura mater collagen fibrils of the optic nerve merged into the outer layer of the scleral collagen fibris. The present results suggest that the observed three-dimensional network of collagen fibrils constitutes the skeletal framework of these tissues maintaining their morphological specificity and providing a suitable microenvironment for their physiological functions. This study was presented at the 25th Annual Meeting of the Clinical Electron Microscopy Society of Japan, Matsumoto, September 28–30, 1993.     

The evolution of collagen expression in sarcomatoid renal cell carcinoma

The development of a sarcomatoid morphotype is recognized as an extreme form of dedifferentiation in renal cell carcinoma and is associated with a poor prognosis. Although sarcomatoid renal cell carcinoma shows pronounced spindle cell morphology, clear cell renal cell carcinoma may show early spindle cell change with cellular elongation, and the prognostic significance of this is debated. To determine the relationship between sarcomatoid renal cell carcinoma and clear cell renal cell carcinoma showing early spindle cell change, we have investigated collagen expression using immunohistochemistry in these 2 tumor types. Both sarcomatoid renal cell carcinoma and early spindle cell change tumors showed pericellular interstitial expression of collagen types I and III, whereas sarcomatoid renal cell carcinoma also showed cytoplasmic expression of these collagen types. Expression of these collagen types in typical clear cell renal cell carcinoma was, in occasional cases, limited to faint and patchy staining in a pericellular interstitial distribution. Tumor cells did not stain for collagen type IV in sarcomatoid renal cell carcinoma, early spindle cell change, or typical clear cell renal cell carcinoma. In sarcomatoid renal cell carcinoma, there was diffuse pericellular expression of collagen type V and patchy pericellular expression of collagen type VI, whereas early spindle cell change tumors showed patchy pericellular staining with antibodies to collagen type V. Collagen type VI expression in early spindle cell change was largely confined to the vascular adventitia and areas of scarring, although very occasional foci of faint interstitial staining were also seen. In typical clear cell renal cell carcinoma, staining of collagen types V and VI was limited to the vascular adventitia and foci of desmoplasia, whereas no staining of tumor cell cytoplasm were seen. This study has shown that collagen expression of sarcomatoid renal cell carcinoma differs from that of early spindle cell change and provides validating evidence that these 2 morphotypes should not be considered together for classification purposes.     

透明质酸在去细胞异体神经移植中对瘢痕的影响

BACKGROUND:In terms of the histocompatibility, immune rejection and scar formation after repair, acellular nerve allograft is closer to autologous nerve cells. At present, hyaluronic acid has been applied for autologous peripheral nerve repair; however, research on the nerve allograft is rarely reported. OBJECTIVE: To explore the effect of hyaluronic acid on the anastomotic scar in acellular nerve allograft repair of rat sciatic nerve defect. METHODS: Thirty-six Sprague-Dawley rats were randomly divided into three groups (n=12 per group). The rat model of nerve defect of 10 mm was established by cutting the sciatic nerve of the left hind leg and then given nerve allograft combined with the injection of hyaluronic acid at anastomosis (experimental group), only nerve allograft (control group) and autologous nerve graft (nerve autograft group), respectively. Afterwards, the healing of the proximal anastomosis was observed and scar components were assessed. RESULTS AND CONCLUSION:Gross observations showed that the rat skin and muscle fascia had no significant differences in healing among groups, while the surrounding tissue adhesion in the experimental group was milder than that in the control group (P < 0.05). Masson staining found that collagen deposition in the epinerium could be observed in each group. In the experimental group, a small amount of collagen fibers arranged orderly in the epineurium; in the control group numerous collagen fibers accumulated and arranged irregularly; in the nerve autograft group, sparse epineurial collagen fibers appeared in an order arrangement. The gray value of collagen type I in the experimental group was higher than that in the control group (P < 0.05), while the gray value of collagen type III was lower than that in the control group (P < 0.05). No significant differences were found in the sum gray values of collagen type I and III among groups (P > 0.05). These findings indicate that in the peripheral nerve repair, hyaluronic acid abrogates the scar formation by increasing the deposition of collagen type III and reducing the deposition of collagen type I. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

超声造影在肝硬化背景下鉴别增生性结节与肝细胞性肝癌的应用价值

目的：探讨超声造影(contrast-enhanced ultrasound,CEUS)在肝细胞性肝癌(hepatocellular carcinoma，HCC)与肝硬化增生结节诊断和鉴别诊断中的应用价值。方法：采用Sono Vue 实时灰阶超声造影,对32例肝硬化背景下的16个肝细胞性肝癌结节与29个肝硬化增生性结节进行超声造影检查，造影时记录并观察其动脉相、门脉相和实质相的动态造影变化及TIC曲线变化，并与手术或穿刺病理诊断结果进行对照。结果：肝细胞性肝癌患者中93.75%(15/16)的病灶具有造影剂的快进快出的特点,超声造影剂在肝细胞性肝癌中快进快出，即动脉相快速增强,门脉相或实质相快速消退。肝硬化增生结节患者中89.66%(26/29)造影后可根据动脉期无明显增强,实质期无明显退出的诊断标准排除恶性。结论：超声造影在肝硬化增生结节与肝细胞性肝癌的鉴别诊断中具有重要的临床意义和应用价值。     

Ultrastructural evidence for intracellular formation of amyloid fibrils in macrophages

Summary Early amyloid deposition in the spleen was studied by immunoelectron microscopy following the administration of rapid amyloid-inducing agents to mice.Two days after the injection of an amyloidenhancing factor and casein solution, a small amount of amyloid material was observed at the border of the white pulp and the marginal zone (perifollicular area) and also within the white pulp. At this stage, amyloid fibrils were seen mainly in an extracellular distribution along the cytoplasmic processes of reticular cells and also in the cytoplasmic invaginations of macrophages. By immunoelectron microscopy, gold particles labelled fibrillar structures in lysosome-derived organelles in some macrophages as well as dense bodies consisted of a homogeneous, granular matrix not having any recognizable fibrillar structures. Similar immunolabelled organelles were also observed in the amyloid resorption stage, although, at that stage, they commonly contained other phagocytized materials as well.From these findings, we suggest that at least some amyloid fibrils are polymerized in the cytoplasm of the macrophages by the proteolytic cleavage of previously pinocytized serum amyloid A protein (SAA).This work was supported by a Grant-in-Aid for Scientic Research of the Ministry of Education [C62570164] and a Research Grant for Scientific Disease from the Ministry of Health and Welfare     

Postoperative spindle cell nodule of the breast: Pseudosarcomatous myofibroblastic proliferation following endo‐surgery

Despite the frequent use of fine‐needle aspiration, core biopsy and surgery, postoperative spindle cell nodule (PSCN) is a rare pathological complication that may be diagnostically treacherous. Presented herein is the case of a 52‐year‐old woman who developed a 7 mm mammary nodular lesion 66 days after removal of an area of columnar cell hyperplasia involving cellular and architectural atypia, performed with the Mammotome Breast Biopsy System. The lesion was highly cellular and composed of intersecting fascicles of plump spindle cells with blunt‐ended elongated nuclei and nucleoli easily visible. Interspersed mononuclear cells and hemosiderin‐laden macrophages were evident. PSCN is a reactive, benign myofibroblastic proliferation. Differential diagnosis includes benign and malignant spindle cell lesions of the breast. Recognition of this reactive lesion will avoid overdiagnosis of spindle cell malignant tumor. Attention to clinicopathological and histological features should result in accurate recognition of this lesion.