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Cureus Jan 2024Whipple's disease (WD) is a chronic multisystemic infection caused by . It is a rare condition with a wide spectrum of clinical presentations, necessitating a high...
Whipple's disease (WD) is a chronic multisystemic infection caused by . It is a rare condition with a wide spectrum of clinical presentations, necessitating a high clinical suspicion to arrive at the diagnosis. We present the case of a 65-year-old woman who experienced chronic, intermittent, and migratory polyarthralgia, weight loss, anorexia, and pyrosis. She was admitted due to bilateral deep vein thrombosis (DVT). She exhibited lymphadenopathy without hepatosplenomegaly, and lymph node biopsy revealed reactive lymphadenitis with intrahistiocytic bacilli that reacted positively to periodic acid-Schiff staining. This led to the suspicion of WD, which was subsequently confirmed through small bowel biopsies. She initiated treatment with ceftriaxone and experienced rapid clinical improvement. WD poses a diagnostic challenge. The signs and symptoms are often nonspecific and can result in misdiagnosis as a rheumatic or neoplastic disease. The presentation with DVT, while unusual, has been reported as a manifestation of WD.
PubMed: 38344639
DOI: 10.7759/cureus.51991 -
The American Journal of Surgical... Jun 2020Brown bowel syndrome (BBS) is a rare condition associated with vitamin E deficiency and defined by prominent lipofuscin deposition in the muscularis propria. Eight...
Brown bowel syndrome (BBS) is a rare condition associated with vitamin E deficiency and defined by prominent lipofuscin deposition in the muscularis propria. Eight unique cases of BBS were identified: 5 men and 3 women (mean age=58.6 y). Pertinent comorbidities included bariatric surgery=2, malnourishment=2, Crohn=2, cystic fibrosis=1, alcohol and cocaine abuse=1, and prior small bowel resections=1. Presenting symptoms included abdominal pain=3, bleeding=1, nausea and vomiting=1, and nonresponsiveness=1. Imaging studies were often abnormal: thickened bowel wall=3 (1 with a mass), small bowel obstruction=2, and edematous and dilated bowel wall=2. Most specimens were surgical resections (n=7, autopsy=1): extended right colectomy=2, small bowel only=5 (terminal ileum=3, jejunum=2). Two specimens were grossly described as mahogany, and 1 case contained a perforation. Histologic sections of all cases showed finely granular, brown cytoplasmic pigment in smooth muscle cells on hematoxylin and eosin. This pigment was most conspicuous in the muscularis propria (small bowel>colon), and it was not identified in the mucosa. The pigment was reactive with Fontana-Masson, carbol lipofuscin, Periodic acid-Schiff, and Periodic acid-Schiff with diastase, and electron microscopy was compatible with lipofuscin. The mean clinical follow-up was 208 weeks: 1 patient died of complications of encephalitis, the others were alive and well. BBS is important to recognize because it is linked with malnutrition, specifically vitamin E deficiency, and it can (rarely) clinically simulate malignancy. The diagnosis is based on the identification of the lipofuscin pigment in the cytoplasm of smooth muscle cells, which is most easily seen in the muscularis propria of the small bowel.
Topics: Aged; Colon; Female; Humans; Intestinal Diseases; Lipofuscin; Male; Middle Aged; Muscle, Smooth; Syndrome
PubMed: 31985498
DOI: 10.1097/PAS.0000000000001443 -
Carbohydrate Polymers May 2020Foods rich in cereal β-glucan are efficient dietary tools to help reduce serum cholesterol levels and hence the risk of cardiovascular diseases. However, β-glucan...
Foods rich in cereal β-glucan are efficient dietary tools to help reduce serum cholesterol levels and hence the risk of cardiovascular diseases. However, β-glucan undergoes various reactions during food processing, which alter its viscous properties and interactions with components of the gastrointestinal tract. It has been proposed in the literature that oxidation and partial hydrolysis increase β-glucan's bile acid-binding activity, and therefore its effectiveness in lowering cholesterol. Here, the passage kinetics of a bile salt mix across a dialysis membrane was studied with or without oat and barley β-glucan extracts, native or modified (partial hydrolysis and oxidations by sodium periodate or TEMPO (2,2,6,6-tetramethylpiperidine-1-oxyl)). Bile acid-retention turned out to be purely a function of viscosity, with the most viscous native extracts exhibiting the strongest retardation of bile acid permeation. Opposite of what was suggested in the literature, oxidation and molecular weight reduction do not seem to increase the bile acid-binding capability of β-glucan.
Topics: Avena; Bile Acids and Salts; Cyclic N-Oxides; Diffusion; Hordeum; Hydrolysis; Kinetics; Oxidation-Reduction; Periodic Acid; Viscosity; beta-Glucans
PubMed: 32172850
DOI: 10.1016/j.carbpol.2020.116034 -
Frontiers in Toxicology 2022To protect developing brain from any unfavorable effects, it is necessary to construct experimental techniques that can sensitively detect and evaluate developmental...
To protect developing brain from any unfavorable effects, it is necessary to construct experimental techniques that can sensitively detect and evaluate developmental toxicity. We have previously shown that brain perivascular tissues, especially perivascular macrophages (PVMs), respond sensitively even to weak stimuli by foreign toxicants such as low-dose exposure to nanoparticle. This paper shows the protocol of a novel staining method that enables easy detection and rapid evaluation of brain perivascular abnormalities. As weak stimulus, low-dose of carbon black nanoparticle (95 μg/kg) or titanium dioxide nanoparticle (100 μg/kg) was intranasally administered to pregnant mice at gestational days 5 and 9. The offspring brains were used to confirm the properties of PVMs and to find suitable protocols for the detection and evaluation of the mild denaturation of PVMs. Furthermore, various procedures of novel combinational double staining including periodic acid-Schiff (PAS) staining and immunohistochemistry were examined. In addition, we checked the alterations in neurotransmitter levels and the behaviors of the offspring. Maternal exposure to low-dose of nanoparticle at levels where no significant effects on the brain were observed, such as abnormal behavior, alteration of neurotransmitter levels, or microglial activation, resulted in mild denaturation of the PVMs, which was captured by PAS staining. However, it was difficult to detect and determine slight histopathological alterations. Therefore, we established PAS-immunohistochemical double-staining method for the brain. This double staining method enabled easy detection and rapid evaluation of brain perivascular abnormalities and the relationship between PVMs and the surrounding cells. In addition, this double staining allows evaluation of the histopathological denaturation of the PVMs and the associated abnormalities in the surrounding tissues in the same section. The slight responses of brain perivascular tissues, such as mild denaturation of PVMs, were sensitively and easily determined by the PAS-immunohistochemical double-staining method. This double staining method is a powerful tool to assess brain perivascular injuries including PVM denaturation and the relationship between the expression of various molecules and the morphology of PVMs. We propose that the observation of the tissue around brain blood vessels using the double staining provides potential endpoints to evaluate developmental neurotoxicity.
PubMed: 35391824
DOI: 10.3389/ftox.2022.825984 -
Archives of Pathology & Laboratory... Dec 2021
Topics: Humans; Melanoma; Nevus; Nevus, Pigmented; Periodic Acid; Skin Neoplasms; beta Catenin
PubMed: 34818422
DOI: 10.5858/arpa.2021-0301-LE -
Internal Medicine (Tokyo, Japan) Apr 2018
Topics: Diabetes Mellitus, Type 1; Gastrointestinal Diseases; Glycogen; Humans; Liver Diseases
PubMed: 29279470
DOI: 10.2169/internalmedicine.0051-17 -
Frontiers in Medicine 2022The relationship between infection and tumors has attracted increasing attention. spp. are often isolated from tumors. However, their potential role remains unclear. We...
BACKGROUND
The relationship between infection and tumors has attracted increasing attention. spp. are often isolated from tumors. However, their potential role remains unclear. We recently reported the isolation of from a patient with pulmonary spindle cell carcinoma that was confirmed as primary infection by application of laser capture microdissection and polymerase chain reaction. To explore whether the strain is pathogenic and whether it can cause atypical cell proliferation and infiltration of NK cells and T cells, we designed a mouse infection experiment.
METHODS
Twelve ICR mice were randomly separated into three groups. Cyclophosphamide was used to inhibit the immunity of mice. A mouse model of Trichoderma infection was successfully established by intracutaneous injection on the back skin with a suspension of strain PKUT180420015. The pathological manifestations of Trichoderma infection and the interaction between immune cells and fungi were observed by histopathology, immunohistochemistry and intensive fungal staining. Reisolation of the fungus was observed by infected tissue culture. The inoculated sites exhibited swelling 3 days after inoculation, and ulcers developed at approximately 14 days. Skin specimens were obtained and then cultured at 3, 7, and 14 days after inoculation. We selected mice 14 days after inoculation in Group 3, whose ulcers were the most typical, for histological analysis.
RESULTS
Inflammation, angioinvasion and necrosis were observed. Immunohistochemistry showed positive markers of Ki67, CD3, CD56, GZMB, and PRF. Periodic acid-Schiff staining, periodic acid-silver methenamine staining, and Calcofluor staining showed fungal spores in the vascular lumen, vascular walls and around the blood vessels.
CONCLUSIONS
Our studies showed that a strain (PKUT180420015) isolated from a biopsy specimen in a patient with pulmonary spindle cell carcinoma could induce atypical hyperplasia, with the expression of Ki67, CD3, CD56, GZMB, and PRF in mice. These data indicate that the fungus may be involved in inducing atypical hyperplasia or tumorigenesis.
PubMed: 35573005
DOI: 10.3389/fmed.2022.865722 -
Investigative Ophthalmology & Visual... Nov 2020To determine whether patients with amyotrophic lateral sclerosis (ALS) show retinal axon pathology.
PURPOSE
To determine whether patients with amyotrophic lateral sclerosis (ALS) show retinal axon pathology.
METHODS
Postmortem eyes from 10 patients with ALS were sectioned and compared with 10 age-matched controls. Retinal sections were evaluated with periodic acid Schiff and phosphorylated (P-NF) and nonphosphorylated (NP-NF) forms of neurofilament with SMI 31 and 32 antibodies. Spheroids identified in the retinal nerve fiber layer were counted and their overall density was calculated in central, peripheral, and peripapillary regions. P-NF intensity was quantified. Morphometric features of ALS cases were compared with age-matched controls using the exact Wilcoxon matched-pairs signed-rank test.
RESULTS
Distinct periodic acid Schiff-positive round profiles were identified in the retinal nerve fiber layer of patients with ALS and were most commonly observed in the peripapillary and peripheral retina. The density of periodic acid Schiff-positive spheroids was significantly greater in patients with ALS compared with controls (P = 0.027), with increased density in the peripapillary region (P = 0.047). Spheroids positive for P-NF and NP-NF were detected. P-NF-positive spheroid density was significantly increased in patients with ALS (P = 0.004), while the density of NP-NF spheroids did not differ significantly between ALS and control groups (P > 0.05). P-NF immunoreactivity in the retinal nerve fiber layer was significantly greater in patients with ALS than in controls (P = 0.002).
CONCLUSIONS
Retinal spheroids and axon pathology discovered in patients with ALS, similar to hallmark findings in spinal cord motor neurons, point to disrupted axon transport as a shared pathogenesis. Retinal manifestations detected in ALS suggest a novel biomarker detectable by noninvasive retinal imaging to help to diagnose and monitor ALS disease.
Topics: Aged; Aged, 80 and over; Amyotrophic Lateral Sclerosis; Axons; Biomarkers; Cell Count; Female; Humans; Male; Middle Aged; Nerve Fibers; Retinal Ganglion Cells; Spheroids, Cellular
PubMed: 33226405
DOI: 10.1167/iovs.61.13.30 -
Journal of Cutaneous Pathology Nov 2020The American Society of Dermatopathology has established an Appropriate Use Criteria (AUC) Committee with the intention of establishing evidence-based recommendations... (Review)
Review
The American Society of Dermatopathology has established an Appropriate Use Criteria (AUC) Committee with the intention of establishing evidence-based recommendations regarding the appropriateness of various ancillary tests commonly utilized by dermatopathologists. Periodic acid Schiff (PAS) and Grocott (or Gomori) methenamine silver (GMS) stains represent some of the most commonly employed ancillary tests in dermatopathology. The utility of these tests was targeted for evaluation by the AUC. This literature review represents a comprehensive evaluation of available evidence for the utility of PAS and/or GMS staining of skin and nail biopsies. In concert with expert opinion, these data will be incorporated into future recommendations by the AUC for PAS and GMS staining in routine dermatopathology practice.
Topics: Dermatology; Humans; Methenamine; Pathology; Periodic Acid-Schiff Reaction; Skin Diseases; Staining and Labeling
PubMed: 32515092
DOI: 10.1111/cup.13769 -
World Journal of Gastrointestinal... Mar 2024The Alcian blue (AB) and periodic acid Schiff (PAS) stains are representative mucus markers in gastric signet ring cell carcinoma (SRCC). They are low-cost special...
BACKGROUND
The Alcian blue (AB) and periodic acid Schiff (PAS) stains are representative mucus markers in gastric signet ring cell carcinoma (SRCC). They are low-cost special staining methods used to detect acidic mucus and neutral mucus, respectively. However, the clinical importance of the special combined AB and PAS stain is unclear.
AIM
To investigate AB expression, PAS expression and the AB-to-PAS (A/P) ratio in gastric SRCC patients and to assess patient prognosis.
METHODS
Paraffin-embedded sections from 83 patients with gastric SRCC were stained with AB and PAS, and signet ring cell positivity was assessed quantitatively. Immunohistochemical staining for Ki67, protein 53 (P53) and human epidermal growth factor receptor 2 (HER2) was performed simultaneously. The cancer-specific survival (CSS) rate was estimated Kaplan-Meier analysis. Cox proportional hazards models were used for univariate and multivariate survival analyses.
RESULTS
Kaplan-Meier survival analysis revealed that the 3-year CSS rate was significantly greater in the high-PAS-expression subgroup than in the low-PAS-expression subgroup ( < 0.001). The 3-year CSS rate in the A/P ≤ 0.5 group was significantly greater than that in the A/P > 0.5 group ( = 0.042). Univariate Cox regression analysis revealed that the factors affecting prognosis included tumor diameter, lymph node metastasis, vessel carcinoma embolus, tumor stage, the A/P ratio and the expression of Ki67, P53 and the PAS. Cox multivariate regression analysis confirmed that low PAS expression [hazard ratio (HR) = 3.809, 95% confidence interval (CI): 1.563-9.283, = 0.003] and large tumor diameter (HR = 2.761, 95%CI: 1.086-7.020, = 0.033) were independent risk factors for poor prognosis.
CONCLUSION
A/P > 0.5 is potentially a risk factor for prognosis, and low PAS expression is an independent risk factor in the prognosis of gastric SRCC. PAS expression and the A/P ratio could help in predicting the clinical prognosis of patients with SRCC.
PubMed: 38577442
DOI: 10.4251/wjgo.v16.i3.687