Fine-needle aspiration cytology of subcutaneous fat necrosis of the newborn: the cytology spectrum with review of the literature

Subcutaneous fat necrosis of the newborn is a rare, transient panniculitis of full-term infants. Diagnosis is usually made clinically; however, a biopsy is sometimes required. Fine-needle aspiration biopsy (FNAB) offers an alternative to biopsy. The cytology shows a spectrum of changes ranging from clumped lobules of fat with opaque cytoplasm to necrotic aspirates with dispersed fat cells with opaque cytoplasm, foamy macrophages, multinucleated giant cells, lymphocytes, and neutrophils. Radially orientated, refractile, needle-shaped crystals are visible in the cytoplasm of the fat cells and loose lying in the necrotic background. FNAB offers an alternative to biopsy with good results.     

Membranous fat necrosis of the breast

To investigate the pattern and prevalence of membranous fat necrosis of the breast we examined 25 breast biopsies or mastectomy specimens performed for recurrent lumps following conservative surgery and radiation therapy. In addition, we examined 41 consecutive cases taken from our files coded as fat necrosis which were associated with several aetiologies. Our results demonstrate that membranous fat necrosis of the breast occurs in association with several aetiologies but in its florid form is most often due to radiation therapy.     

Fat cells and membranous fat necrosis of aortic valves: A clinicopathological study

We examined 152 aortic valves (AVs), which included 82 postmortem non‐dysfunctional AVs (nd‐AVs) and 70 surgically removed dysfunctional AVs showing aortic stenosis (AS), aortic regurgitation (AR), or combined AS and AR (AS‐R). Fat cells, membranous fat necrosis (MFN), and fat‐MFN‐related lesions composed of fat cells and/or MFN were found in 127 (83.6%), 110 (72.4%), and 140 (92.1%) of 152 AVs, respectively, and all were associated with older age (P = 0.010, P = 0.022, and P = 0.003, respectively). MFN was associated with fibrous thickening and calcification (both, P = 0.001). Nd‐AV fat cells and fat‐MFN‐related lesions were not correlated with body mass index. Compared with age‐ and sex‐matched control cases, MFN in AS and AS‐R cases was more frequent (P = 0.030 and P = 0.045, respectively), but MFN in AR cases showed no significant differences. Fat‐MFN‐related lesions, possibly representing true preceding fat cells, showed no differences in AVs with and without dysfunction or in dysfunctional types. These data suggest that AV fat cells are age‐related, obesity‐independent, and AV dysfunction‐unrelated common phenomenon. MFN is also age‐dependent and could be caused by AS and AS‐R, which is probably concerned with AV thickening and calcification.     

Ultrastructural observations on cell necrosis during formation of the neural tube in mouse embryos

Summary Spontaneous cell death in the developing brain of 8.5–9 day old mouse embryos has been investigated with the electron microscope. Before closure of the neural tube, areas of cell death are found at the neuro-somatic junction. After closure of the neural tube degenerating cells are found in the dorsal midline of the prospective diencephalon. Ultrastructurally, cell degeneration is marked by chromatin condensation, increase in electron density of the structures in the cytoplasm and, in later stages, by a marked pycnosis of the dying cell. After fragmentation, the necrotic material as well as entire pycnotic cells are phagocytized and digested by cells of the neuroepithelium. An invasion of macrophages has not been observed. The significance of cell necrosis is discussed in relation to the normal formation of the neural tube and to the occurrence of certain induced malformations (exencephalies).     

Lipomembranous fat necrosis in three cases of testicular torsion

AIMS: To describe for the first time a lesion termed lipomembranous fat necrosis (LFN) in three patients with spermatic cord torsion. METHODS AND RESULTS: We reviewed 386 testes and their epididymides and spermatic cords which had been removed for testicular infarction. For the three cases showing LFN, a battery of histochemical tests (including periodic acid-Schiff (PAS), orcein, Sudan black and Perls stains) was applied and clinical histories and laboratory data were also investigated. Findings were similar in the three specimens. The testes showed a central group of necrotic seminiferous tubules which were surrounded by granulation tissue consisting of macrophages, multinucleated giant cells, lymphocytes, plasma cells and fibrous connective tissue at the periphery of the lesion. The spermatic cord showed thrombosed veins surrounded by fat necrosis showing cystic cavities which were bounded by wavy hyaline membranes. These stained with Sudan black, PAS (before and after diastase digestion) and orcein and presented yellowish-green autofluorescence. CONCLUSIONS: Lipomembranous fat necrosis of the spermatic cord is a distinctive entity which seems to be related to spermatic cord torsion and the differential diagnosis of which should be established with regard to the presence of parasites, sclerosing lipogranuloma and granuloma evoked by rupture of a testicular prosthesis.     

Morphometry of medial necrosis of human intracerebral arteries

Medial necrosis is a preceding lesion to angionecrosis which may cause hemorrhage and lacunar infarct. We morphometrically studied the loss of smooth muscle cells in the media of human cerebral arteries and examined the occurrences of vasospasm. Medial necrosis of hypertensive cases was significantly more severe than that of non-hypertensive cases (p<0.001). The outer media was significantly more vulnerable than the inner one (p<0.001). Medial necrosis in the perforating artery was slightly more severe than that of the cortical branches. Vasospasms were identified electron microscopically in 4 of 18 cases. These findings may satisfactorily explain the possibility of vasospasm as a cause of medial necrosis. A part of this study was presented at the 25th Annual Meeting of the Clinical Electron Microscopy Society of Japan, Matsumoto, September 28–30, 1993.     

Rod-shaped bodies and crystalloid inclusions in ocular vascular endothelia of adult and developing Macaca mulatta

Summary In addition to the usual organelles, endothelial cells of ocular blood vessels and Scheemm's canal in adult and fetal Macaca mulatta, contain two types of inclusions: rod-shaped bodies and crystalloids. The rod-shaped bodies are similar to those first described in arterial endothelia of the rat. They are between 0.2 to 0.35 m in diameter, up to 2.5 m in length, and are membrane bounded. The crystalloid inclusions are up to 1.2 m in diameter and are associated with the granular endoplasmic reticulum. Their crystalline lattice consists of subunits, 28 nm in diameter, which are either arranged in rows separated by amorphous matrix or tightly packed in a honeycomb-like lattice. The rod-shaped bodies are much more numerous than the crystalloids; however, both kinds of inclusions are consistently found in both adult and fetal vessels. They represent normal components of ocular vascular endothelia which appear very early in the development of the eye.     

Cytologic diagnosis of fat emboli in peripheral blood during sickle cell infarctive crisis

A diagnosis of fat emboli can be suspected in a patient presenting with the typical symptoms of the fat embolism syndrome, but is rarely proved pathologically, except at autopsy. We described a 25-yr-old man with sickle cell anemia who developed an infarctive crisis complicated by unexplained fever, neurologic change, and respiratory abnormalities. Blood drawn from the femoral vein and examined cytopathologically yielded necrotic bone marrow elements admixed with fat. The cytologic finding of fat emboli from necrotic bone marrow provided the diagnosis and helped guide subsequent medical intervention. This simple test is recommended for patients at risk for fat emboli to aid in the clinical diagnosis. Diagn. Cytopathol. 17:54–56, 1997. © 1997 Wiley-Liss, Inc.     

Three protocols for measuring subcutaneous fat thickness on the upper extremities

Summary Three protocols for measuring subcutaneous fat thickness were compared and their level of association determined in young adults. Subjects included 21 men and 21 women, 18–24 years of age. Skinfold calipers, A- and B-mode ultrasound were used to measure the thickness of the subcutaneous fat layer overlying the anterior and posterior aspects of the upper arm. Each protocol was independently administered within a 30-min block of time in a randomly rotated sequence. Significant differences (p<0.05) between protocols were observed depending upon site of measurement and gender of the subject. At both the anterior and posterior sites for men, B-mode and halved skinfold were similar but significantly less than A-mode measurements. At the anterior site for women, A-mode and skinfold were similar but significantly greater than B-mode measurements. At the posterior site for women, all three measurements were similar. Correlations between the protocols were positive with men's levels ranging from 0.59 to 0.74, while women's levels were from 0.39 to 0.89. It was concluded that although skinfold calipers, A-mode ultrasound, and B-mode ultrasound may be used to obtain moderately associated measurements of upper-arm subcutaneous fat thickness in young adults, the three protocols yield inconsistently similar data.     

窒息后新生儿早期全血游离钙的动态分析

本文对９６例窒息后的足月钱的２８－３６孕周的早产儿０－７天的全血Ｃａ＾２＋的动态变化进行了观察，并与相对应的正常儿及非窒息的早产儿作比较，发现窒息后儿的全血Ｃ＾２＋的动态变化特征与其对照组类似，且窒息儿下降的更快，更低，差异显著。     

Regional differences in the lipolytic response of the subcutaneous fat depots to prolonged exercise and severe energy deficiency

Summary After five days of almost continuous strenuous combat exercise and energy deficiency, 12 well-trained young men had a mean body fat loss of 2.7 kg and the average fat cell size was reduced from 0.34 g to 0.24 g. No significant changes were found in the total number of fat cells. For the group as a whole, the decrease in fat cell size was most pronounced in the gluteal subcutaneous region, followed by the abdominal region. No significant decrease in fat cell size was encountered in tissue samples from the femoral site. Before the course, and on the last day, the subjects accomplished a short-term bicycle exercise at 50% of the individual's . On day 5, positive correlations were found between the fat cell weights estimated in the gluteal tissue samples and the pre-exercise free fatty acid (FFA) levels (r=0.87, p<0.01), and also with the plasma free glycerol obtained five minutes after the bicycle exercise (r=0.93, p<0.001). These correlations were not apparent in the control experiment performed before the course. Further, no such relationship was found between the plasma metabolites and the fat cell size of the other body sites investigated. This finding may indicate that gluteal fat deposits are more important for energy provision than abdominal and, especially, femoral deposits.     

维生素D3引起大鼠血管钙超载对血管L-精氨酸/NO途径的影响

目的：观察血管钙超载对Ｌ－精氨酸／ＮＯ途径的影响。方法：维生素Ｄ３（ＶｉｔＤ３）注射引起大鼠血管钙超载,检测血管ＮＯ生成、ｃＧＭＰ含量、Ｌ－瓜氨酸转化及Ｌ－精氨酸转运的变化,并与口服Ｌ－精氨酸治疗组大鼠比较。结果：大鼠血管钙含量（９４４±１８８）ｖｓ对照（１０７±１８）μｍｏｌ／ｇ干重,（Ｐ＜００１）,血管ＮＯ生成减少,组织ｃＧＭＰ含量降低,但Ｌ－瓜氨酸转化增高,Ｌ－精氨酸（Ｌ－Ａｒｇ）高和低亲和性转运的最大速率（Ｖｍａｘ）分别降低５０５％和４５８％（Ｐ＜００１）。口服Ｌ－Ａｒｇ治疗的大鼠血管ＮＯ生成和ｃＧＭＰ含量都较钙超载大鼠明显增高（Ｐ＜００１）,Ｌ－Ａｒｇ高、低亲和性转运的Ｖｍａｘ增加。结论：血管钙超载对Ｌ－Ａｒｇ／ＮＯ途径损伤的主要环节在Ｌ－Ａｒｇ的跨膜转运,补充ＮＯ前体Ｌ－Ａｒｇ可能减轻钙超载引起的血管损伤。     

虎杖甙对正常大鼠血管平滑肌细胞内游离钙浓度的影响

目的：观察虎杖甙（ＰＤ）对培养的大鼠血管平滑肌细胞（ＶＳＭＣ）内钙离子浓度的变化机理。方法：用Ｆｌｕｏ－３－ＡＭ标记培养的ＶＳＭＣ，在粘附式细胞仪上测定细胞内游离钙的变化。结果：实验结果表明，ＰＤ（００２～２０ｍｍｏｌ／Ｌ）可使大鼠ＶＳＭＣ内游离钙浓度升高，波形变宽，其引起的钙波形态与去甲肾上腺素（ＮＥ）及氯化钾所引起的高尖钙波不同，ＰＤ使ＶＳＭＣ产生一种剂量依赖性的、持续缓慢升高的钙波。ＰＤ引起的细胞内游离钙升高可被ＥＧＴＡ（２ｍｍｏｌ／Ｌ）及维拉帕米（５０μｍｏｌ／Ｌ）明显抑制。结论：以上结果提示ＰＤ既促进ＶＳＭＣ外钙离子进入细胞内，还能诱导细胞内钙离子释放；ＰＤ可能会提高正常ＶＳＭＣ的收缩性，增加正常血管的张力。     

脉冲电场对聚己内酯组织工程血管支架上细胞黏附的影响

目的检测在一定水平的脉冲电场刺激的作用下,细胞在支架上的黏附、生长情况,并与传统静态细胞培养下的细胞作比较,从而探究脉冲电场刺激对细胞的生长率、黏附率所产生的影响。方法构建聚己内酯（PCL）纳米纤维支架,将人内皮祖细胞接种于已缝有PCL的电刺激反应器上,按照0V、1V、2V、4V的电压分组,分别反应1h、2h,采用HE切片、电镜、MTT等方法,观察细胞在PCL上的黏附情况及细胞活力。结果通过脉冲电场刺激的方法,细胞黏附效率得以进一步提高,与传统静态培养下的细胞相比,经过脉冲电场刺激的细胞更易在PCL支架表面黏附与生长,而50Hz,2V／cm的条件即是诱导细胞黏附的最佳环境条件。结论脉冲电场刺激的应用在组织工程学方面具备良好的发展潜力。     

Organization and cytology of lymphoid tissue in the cynomolgus monkey conjunctiva

Background: Knowledge of the structure of conjunctival lymph follicles is limited in comparison with those of other mucosa. Consequently a thorough morphological study of the follicles was undertaken to see if they are similar to others or whether they have any unique features and to provide an adequate background for future experimental studies. Methods: Normal lymphoid tissue of the conjunctiva of one side of nine young adult cynomologus monkeys was examined using a whole mount method and light and electron microscopy. Results: Only the peripheral tarsal and orbital regions of the upper and lower palpebral conjunctiva contained lymph follicles. Lymphocytes, reticulocytes, macrophages including tingible body macrophages, putative follicular dendritic cells, and plasmacytes were indentified in the follicles and M-cells were present in the follicle associated epithelium. High endothelial venules (HEV) displaying evidence consistent with lymphocyte extravasation were present in both primary and secondary follicles. A majority were secondary follicles with a germinal center composed largely of lymphoblasts. Mitoses were found in secondary follicles, mostly confined to the germinal centers, and they were numerous in many. Increased cell density and virtual elimination of intercellular space adjacent to some high endothelial venules suggested a possible association of these vessels with germinal center development. Chains of follicles were linked by lymph vessels, an approaching lymphatic dividing to embrace a follicle and recombining beyond it and passing to the next in line; many conjunctival follicles there-fore have both afferent and efferent lymphatics. The vessels were in direct contact with the follicle perimeters; lymph capillaries were not present within the substance of most follicles. Numerous valves indicated drainage radially from the tarsal conjunctiva then laterally or medially from the orbital conjunctiva through the follicle chains towards the nearest canthus. Conclusions: Conjunctival lymph follicles are fundamentally similar in structure to those found elsewhere in the body. However, the beads on a chain-like arrangement of lymph vessels and follicles may be unique. The possible association of HEV with follicle foramtion could be a general characteristic of mucosal follicles. ©1995 Wiley-Liss, Inc.     

The effects of chronic papillary necrosis on acid excretion

Complete papillary necrosis in rats can be induced within 1 month following a single injection of 2-bromoethylamine hydrobromide (BEA) (50 mg, i.v.). Utilizing a combination of clearance and balance techniques the effects of complete absence of the papilla was examined as regards urinary acidification, whole kidney glomerular filtration rate (GFR), single nephron GFR, and morphology. Whole kidney GFR was not different from control, however, the percent filtering juxtamedullary nephrons was markedly diminished (87.2±2.1 vs. 31.5±3.6% filtering, control vs. BEA, respectively,P<0.001) and significantly reduced in the superficial nephrons (80.6±3.6 vs. 62.2±6.1% filtering, control vs. BEA, respectively,P<0.05). There was a significant decrease in juxtamedullary single nephron GFR and an increase in the superficial single nephron GFR as assessed by the quantitative Hanssen's technique in the animals with chronic papillary necrosis. Complete papillary necrosis was associated with normal arterial bicarbonate concentration, pH, and plasma electrolyte concentrations. At the same degree of acidemia (induced by NH₄Cl administration) minimal urinary pH, ammonium excretion, and titratable acid excretion were not different than seen in age matched controls. The response to Na₂SO₄ infusion and phosphate infusion was the same in both groups of animals. The urineblood (U-B)pCO₂, an index of urinary acidification, was identical in BEA and control animals. Scanning electron microscopy showed scarring of the juxtamedullary glomeruli one month after BEA. The papilla was sloughed and lying free in the renal pelvis in every experimental animal. These data demonstrate that complete papillary necrosis is not associated with acidosis nor a defect in urinary acidification.     

益生菌对单纯性肥胖儿童瘦素、脂联素及血脂水平影响的临床观察

目的 观察益生菌干预前后单纯肥胖症儿童血清中瘦素、脂联素、血脂、体重指数的变化,探讨其临床意义.方法 依据儿童单纯肥胖症诊断标准选取80名患儿,各40名,平均分为两组,均正常饮食,治疗组给予双歧杆菌,乳杆菌和嗜热链球菌口服15天.分别于治疗前及治疗后一个月计算患儿体重指数,检测血清瘦素、脂联素及血脂,SPSS16.0统计软件进行分析.结果 治疗组体重指数及甘油三酯,总胆固醇,低密度脂蛋白水平下降,高密度脂蛋白升高,差异无统计学意义（P＞0.05）;干预后治疗组瘦素水平降低（5.72 ±0.39比8.53 ±0.37）,脂联素水平增高（10.15±0.48比8.81±0.37）,两组之间差异有统计学意义（P＜0.05）.结论 益生菌能够降低瘦素水平,升高脂联素水平.益生菌口服可能成为治疗单纯性肥胖症的新方法.