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Clinical Microbiology Reviews Apr 2017Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection with , a bacterium that may be more common than... (Review)
Review
Whipple's disease is a rare infectious disease that can be fatal if left untreated. The disease is caused by infection with , a bacterium that may be more common than was initially assumed. Most patients present with nonspecific symptoms, and as routine cultivation of the bacterium is not feasible, it is difficult to diagnose this infection. On the other hand, due to the generic symptoms, infection with this bacterium is actually quite often in the differential diagnosis. The gold standard for diagnosis used to be periodic acid-Schiff (PAS) staining of duodenal biopsy specimens, but PAS staining has a poor specificity and sensitivity. The development of molecular techniques has resulted in more convenient methods for detecting infections, and this has greatly improved the diagnosis of this often missed infection. In addition, the molecular detection of has resulted in an increase in knowledge about its pathogenicity, and this review gives an overview of the new insights in epidemiology, pathogenesis, clinical manifestations, diagnosis, and treatment of infections.
Topics: Anti-Bacterial Agents; Humans; Tropheryma; Whipple Disease
PubMed: 28298472
DOI: 10.1128/CMR.00033-16 -
JAAD Case Reports Jun 2022
PubMed: 35774223
DOI: 10.1016/j.jdcr.2022.05.013 -
Experimental and Therapeutic Medicine Dec 2022Lipomembranous fat necrosis (LFN) is an uncommon but distinct form of fat necrosis, which is characterized by eosinophilic, crenulated and/or serpiginous membranes. LFN... (Review)
Review
Lipomembranous fat necrosis (LFN) is an uncommon but distinct form of fat necrosis, which is characterized by eosinophilic, crenulated and/or serpiginous membranes. LFN exhibits macrocystic, microcystic and/or crushed features. LFN is routinely detectable on hematoxylin and eosin (H&E)-stained sections, and is present both in the acute phase and in the later or fibrous stage of necrotic fatty lesions. Smaller crushed LFN embedded within fibrous tissues may be difficult to recognize on H&E-stained sections, but can be highlighted by some staining techniques, including Masson trichrome, periodic acid-Schiff, orcein, long Ziehl-Neelsen stain, silver impregnation, phosphotungstic acid-hematoxylin and luxol fast blue staining. LFN was initially considered a specific feature of Nasu-Hakola disease, but has since been identified in various subcutaneous or intraabdominal lesions related to ischemic conditions or venous insufficiency. In addition, LFN is detectable in intra-articular loose bodies and aortic valves with or without dysfunction, suggesting that LFN is also associated with ischemia-like hypoxic conditions or malnutrition. LFN is considered to be a histological hallmark of hidden ischemic or hypoxic/malnourished conditions in various diseases; however, the exact mechanisms of LFN remain poorly understood. The present review described the clinicopathological features of this interesting, but poorly characterized, condition.
PubMed: 36561978
DOI: 10.3892/etm.2022.11695 -
Genes & Diseases Nov 2022All-trans retinoic acid (ATRA) can reverse the malignant behaviors of hepatocellular carcinoma (HCC) cells, thereby exerting anti-HCC effect; however, the underlying...
All-trans retinoic acid (ATRA) can reverse the malignant behaviors of hepatocellular carcinoma (HCC) cells, thereby exerting anti-HCC effect; however, the underlying mechanism is yet to be understood. This study aimed to demonstrate that ATRA is vital to ferroptosis in HCC. Ferroptosis-related genes exhibit different expression in patients with HCC compared to that in healthy individuals. A total of 20 amino acid products were detected in HepG2 cells, the expression level of 5 was decreased after ATRA treatment. ATRA improved the levels of lipid ROS, MDA, and NAPD/NADPH, and reduced the mt-DNA copy number and changed the structure of mitochondria, in HepG2 and Hep3B cells. We found the expression of genes positively correlated with ferroptosis to increase and those negatively correlated to decrease with ATRA treatment. Inhibition of ferroptosis by Ferrostatin-1 reversed ATRA-inhibited proliferation of HCC cells, along with cell migration and invasion. GSH synthesis was blocked by ATRA, accompanied by decreased cystine content and increased glutamate content, and downregulation of the expression of GSH synthesis-related genes. Our findings suggested that ATRA inhibited the malignancy of HCC cells by improving ferroptosis, and that inhibition of GSH synthesis contributed to ATRA-induced ferroptosis.
PubMed: 36157492
DOI: 10.1016/j.gendis.2022.04.011 -
Frontiers in Oncology 2023The prevalence of gastric cancer has markedly declined, but due to the high mortality rates associated with gastric cancer, it is still a serious disease. The preferred... (Review)
Review
The prevalence of gastric cancer has markedly declined, but due to the high mortality rates associated with gastric cancer, it is still a serious disease. The preferred classification of gastric cancer is according to Lauren into either the intestinal type, which has a glandular growth pattern, or the diffuse type, which does not have glandular structures. Both types have been classified as adenocarcinomas, with the latter type based on periodic acid-Schiff (PAS) positivity presumed to reflect mucin. However, the presence of mucin in the diffuse type, in contrast to neuroendocrine/enterochromaffin-like (ECL) cell markers, has not been confirmed by immunohistochemistry and hybridization. The ECL cells are probably prone to becoming cancerous because they do not express E-cadherin. Gastric cancer is unique in that a bacterium, , is thought to be its main cause. predisposes infected individuals to cancer only after having caused oxyntic atrophy leading to gastric hypoacidity and hypergastrinemia. No single factor has been convincingly proved to be carcinogenic. It is probable that gastrin is the pathogenetic factor for gastric cancer due to , autoimmune gastritis, and long-term prolonged inhibition of gastric acid secretion. Hypergastrinemia induces ECL cell hyperplasia, which develops into neuroendocrine tumors (NETs) and then into neuroendocrine carcinomas in rodents, a sequence that has also been described in humans. During carcinogenesis, the tumor cells lose specific traits, requiring that sensitive methods be used to recognize their origin. Gastric cancer occurrence may hopefully be prevented by eradication at a young age, and by the reduced use of inhibitors of acid secretion and use of a gastrin antagonist in those with previous long-term infection and those with autoimmune gastritis.
PubMed: 37941554
DOI: 10.3389/fonc.2023.1176673 -
Kidney International Jun 2016
Topics: Biopsy; Collagen Type III; Creatinine; Diagnosis, Differential; Female; Fluorescent Antibody Technique; Glomerular Mesangium; Hematuria; Humans; Kidney Diseases; Middle Aged; Nail-Patella Syndrome; Periodic Acid-Schiff Reaction; Proteinuria; Rare Diseases
PubMed: 27181787
DOI: 10.1016/j.kint.2015.12.056 -
Cureus Jul 2023Whipple's disease is a rare systemic disease caused by a infection. Although older literature reports a low rate of incidence, case reports continue to rise due to...
Whipple's disease is a rare systemic disease caused by a infection. Although older literature reports a low rate of incidence, case reports continue to rise due to increased awareness of the disease. Classic Whipple's disease presents as weight loss, diarrhea, and arthralgia and may involve the heart, central nervous system (CNS), or any other organ system. Some patients with Whipple's disease do not have the classic signs and symptoms of the disease. We present a case of Whipple's disease in a patient with poor appetite, weight loss, and granulomatous inflammation of various organs, including the kidneys and spleen, mimicking sarcoidosis. She had presented three years earlier with acute kidney injury (AKI) and hypercalcemia. The renal biopsy revealed diffuse granulomatous interstitial nephritis. Both AKI and hypercalcemia resolved with prednisone; however, her weight loss and decreased appetite continued. The initial positron emission tomography (PET) scan showed increased fluorodeoxyglucose (FDG) avidity in the spleen and large intestine, and the splenic biopsy revealed non-caseating granulomas. A diagnosis of sarcoidosis was made, and she was started on methotrexate with prednisone. Nevertheless, the weight loss and poor appetite were relentless. A repeat PET scan showed increased FDG avidity in loops of the small and large intestines. A small intestinal biopsy revealed positive periodic acid-Schiff (PAS) and negative acid-fast bacilli (AFB) revealing the diagnosis of Whipple's disease. Whipple's disease should be considered in the differential diagnosis of sarcoidosis, especially in those patients worsening on standard immunosuppression.
PubMed: 37575808
DOI: 10.7759/cureus.41839 -
Ocular Oncology and Pathology Sep 2021The goal of this study was to histopathologically evaluate the appearance of degrading MIRAgel scleral buckles so that they can be reliably distinguished by ophthalmic...
INTRODUCTION
The goal of this study was to histopathologically evaluate the appearance of degrading MIRAgel scleral buckles so that they can be reliably distinguished by ophthalmic pathologists from other foreign materials.
METHODS
Retrospective chart review and histopathologic study with special stains, including Alcian blue, periodic acid-Schiff, Masson's trichrome, and Perls' Prussian blue for iron, of 4 cases between 2017 and 2019.
RESULTS
Hydrolyzed MIRAgel scleral buckles from 4 patients had a consistent histopathologic appearance. They had a honeycomb structure with the walls of the lattice ranging from distinct to poorly defined. The walls of the lattice were positive for Alcian blue, while the contents of each cell contained periodic acid-Schiff-positive material. Other special stains were not as valuable in highlighting the material.
DISCUSSION
Although the capsules of MIRAgel scleral buckles have been well studied, the material itself has not been. While clinical history and radiographic appearance are often diagnostic of a hydrolyzed MIRAgel scleral buckle, there are instances of preoperative ambiguity where histopathologic confirmation can be useful.
CONCLUSIONS
MIRAgel scleral buckles have a distinct histopathologic appearance that can be readily distinguished from that of other foreign materials.
PubMed: 34604200
DOI: 10.1159/000514299 -
Journal of Parasitic Diseases :... Sep 2022The nematode parasite () has a global distribution and is commonly reported in rodents (definitive host), dogs, cats and wild animals. Humans especially children are...
The nematode parasite () has a global distribution and is commonly reported in rodents (definitive host), dogs, cats and wild animals. Humans especially children are more susceptible to the parasitic infection. This paper documents an incidental finding of hepatic calodiosis with cirrhosis in a stray dog and discusses the zoonotic implications. A non descript dog was brought for necropsy examination to the Department of Veterinary Pathology, Madras Veterinary College, Tamil Nadu, India. Liver appeared dark brown, mottled with multifocal random variably sized, grey white flat firm areas. Histopathologically, liver tissue revealed multiple random encysted large collection of eggs surrounded by mild inflammation with a few lymphocytes, macrophages and fine fibrosis. The eggs had characteristic barrel shape, bipolar ends, bilayered wall, cross striations between the walls, and yolk. Periodic acid Schiff stain demonstrated the glycolic wall of ova. Marked portal to portal fibrosis was demonstrated by Masson's trichrome (for collagen) and by Warthin-Starry (for reticulin) stains. The stage of parasitic infection was diagnosed as intermediate to chronic due to fibrosis. A need to study the prevalence of the disease in rodents, human and animals is emphasized. Improper burial of carcasses of rodents and dogs may contribute to spread of infection. Pets and stray animals may transmit infection to human and pose health risk.
PubMed: 36091291
DOI: 10.1007/s12639-022-01501-6 -
Archives of Pathology & Laboratory... Oct 2022There is no standardized process for utilization of periodic acid-Schiff during intraoperative frozen sections to identify fungal organisms.
CONTEXT.—
There is no standardized process for utilization of periodic acid-Schiff during intraoperative frozen sections to identify fungal organisms.
OBJECTIVE.—
To develop a rapid staining process for fresh tissue with periodic acid-Schiff during intraoperative consultation and develop an appropriate control block.
DESIGN.—
Muscle tissue was inoculated with 2 species of fungus (Aspergillus fumigatus and Paecilomyces spp) and grown at 3 different temperatures for 72 hours. Inoculated tissue was embedded in optimal cutting temperature compound, cut, and stained using a modified periodic acid-Schiff stain. The optimal control was determined for future use as the standard control. Multiple control slides were cut and stained, using successively shorter time intervals for each step. The staining process that provided accurate results in the shortest amount of time was deemed ultra-rapid periodic acid-Schiff. This method was validated by carryover studies and clinical specimens.
RESULTS.—
Paecilomyces spp incubated at 30°C for 72 hours was the most optimal positive control, with numerous yeast and hyphal forms. The fastest staining process involved 2 minutes of periodic acid and Schiff reagent and 10 dips of light green solution. Tap water was as effective as distilled water. Validation was successfully achieved. Clinical cases all stained identical to formalin-fixed, paraffin-embedded tissue stained with hematoxylin-eosin and periodic acid-Schiff.
CONCLUSIONS.—
Ultra-rapid periodic acid-Schiff provides fast and reliable identification of fungal organisms on fresh tissue. Development of a concurrent positive control allows for quality control and validation.
Topics: Coloring Agents; Eosine Yellowish-(YS); Formaldehyde; Frozen Sections; Fungi; Hematoxylin; Humans; Methyl Green; Periodic Acid; Staining and Labeling; Water
PubMed: 35104313
DOI: 10.5858/arpa.2021-0273-OA