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European Journal of Ophthalmology Nov 2022To describe the clinical features, histopathological findings, and prognosis of conjunctival Teddy bear granuloma (TBG) diagnosed in a Mexican ophthalmologic referral... (Review)
Review
PURPOSE
To describe the clinical features, histopathological findings, and prognosis of conjunctival Teddy bear granuloma (TBG) diagnosed in a Mexican ophthalmologic referral center in a period of 64 years.
METHODS
We reviewed clinical and histopathological material from all patients with documented conjunctival TBG. Patient's age, gender, location, clinical signs and symptoms, duration, treatment and, specimen size, were evaluated. Formalin-fixed paraffin embedded 5 microns hematoxylin-eosin stained slides and periodic acid-Schiff special stain as well as examination under polarized light microscopy were performed in all cases.
RESULTS
A total of 5 conjunctival TBG were collected. The ages of the patients ranged between 2 and 11 with a mean of 6 years. Female to male ratio was 4:1. The right inferior fornix was involved in 4 cases (80%) with clinical diagnosis of conjunctival mass of unknown etiology. Treatment consisted of surgical removal by slit-lamp biomicroscopy (3 cases) and in the operating room (2 cases). No complications were informed in a short follow-up period. Histopathologically, numerous cross-sections of synthetic and non-synthetic fibers surrounded by multinucleated foreign body giant cells, epithelioid histiocytes, lymphocytes, plasma cells and sparse neutrophils were seen. Polarization light microscopy demonstrated numerous birefringent colorful foreign fibers. The follow-up period of the patients ranged between 1 and 32 weeks with a mean of 10 weeks.
CONCLUSIONS
Most patients with TBG are children with vague, non-specific symptoms troubling precise clinical diagnosis. Treatment of choice involves surgical excision of the foreign body granuloma followed by topical corticosteroids. All surgical specimens obtained must be sent for histopathological examination. Special awareness is recommended during COVID-19 pandemic lockdown to prevent potential exposure to fibers that may cause conjunctival TBG.
Topics: Adrenal Cortex Hormones; COVID-19; Child; Child, Preschool; Cicatrix; Communicable Disease Control; Conjunctival Diseases; Conjunctivitis; Eosine Yellowish-(YS); Female; Formaldehyde; Granuloma, Foreign-Body; Hematoxylin; Humans; Male; Pandemics; Periodic Acid
PubMed: 35230194
DOI: 10.1177/11206721221083135 -
World Journal of Stem Cells Oct 2021End-stage liver disease is a global health complication with high prevalence and limited treatment options. Cell-based therapies using mesenchymal stem cells (MSCs)...
BACKGROUND
End-stage liver disease is a global health complication with high prevalence and limited treatment options. Cell-based therapies using mesenchymal stem cells (MSCs) emerged as an alternative approach to support hepatic regeneration. preconditioning strategies have been employed to strengthen the regenerative and differentiation potential of MSCs towards hepatic lineage. Chemical compounds of the triterpene class; glycyrrhizic acid (GA) and 18β-glycyrrhetinic acid (GT) possess diverse therapeutic properties including hepato-protection and anti-fibrosis characteristics. They are capable of modulating several signaling pathways that are crucial in hepatic regeneration. Preconditioning with hepato-protective triterpenes may stimulate MSC fate transition towards hepatocytes.
AIM
To explore the effect of GA and GT on hepatic differentiation of human umbilical cord-MSCs (hUC-MSCs).
METHODS
hUC-MSCs were isolated and characterized phenotypically by flow cytometry and immunocytochemistry for the expression of MSC-associated surface molecules. Isolated cells were treated with GA, GT, and their combination for 24 h and then analyzed at three time points; day 7, 14, and 21. qRT-PCR was performed for the expression of hepatic genes. Expression of hepatic proteins was analyzed by immunocytochemistry at day 21. Periodic acid Schiff staining was performed to determine the functional ability of treated cells.
RESULTS
The fusiform-shaped morphology of MSCs in the treatment groups in comparison with the untreated control, eventually progressed towards the polygonal morphology of hepatocytes with the passage of time. The temporal transcriptional profile of preconditioned MSCs displayed significant expression of hepatic genes with increasing time of differentiation. Preconditioned cells showed positive expression of hepatocyte-specific proteins. The results were further corroborated by positive periodic acid Schiff staining, indicating the presence of glycogen in their cytoplasm. Moreover, bi-nucleated cells, which is the typical feature of hepatocytes, were also seen in the preconditioned cells.
CONCLUSION
Preconditioning with glycyrrhizic acid, 18β-glycyrrhetinic acid and their combination, successfully differentiates hUC-MSCs into hepatic-like cells. These MSCs may serve as a better therapeutic option for degenerative liver diseases in future.
PubMed: 34786159
DOI: 10.4252/wjsc.v13.i10.1580 -
Journal of Oral Biology and... 2021Hyalinization is a process of conversion of stromal connective tissue into a homogeneous, acellular translucent material. Nevertheless, hyalinization could provide... (Review)
Review
BACKGROUND
Hyalinization is a process of conversion of stromal connective tissue into a homogeneous, acellular translucent material. Nevertheless, hyalinization could provide insights into the biologic behaviour and prognosis of pathological lesions. Few studies with limited sample size have intended to assess the correlation of hyalinization and biologic behaviour in oral lesions.
AIM
The current review aims to comprehensively appraise the mechanism of hyalinization in pathological oral hyalinizing lesions (OHL) and its clinical implications with emphasis on differential stains employed.
METHODS
An electronic search was performed in the PubMed database (from year 2000-2020) using the keywords "special stains in oral hyalinizing lesions", "significance of hyalinization in oral lesions" and "hyalinization and biologic behaviour". Original research articles analyzing the effect of hyalinization on biologic characteristics of the lesion were evaluated in this review. Narrative review articles that provided insights into the mechanism of hyalinization and maturity of collagen fibers were also considered for analysis.
CONCLUSION
The presence of hyalinization does seem to have a significant effect on the biologic behaviour of pathological lesions. There is substantial scope to further investigate the process of hyalinization on larger samples and its correlation with the aggressive behaviour of OHLs. Special stains and advanced investigations such as immunohistochemistry for stromal markers would define the nature of hyalinized material and validate the correlation.
CLINICAL SIGNIFICANCE
The prediction of the biologic behaviour of a lesion established through assessment of hyalinization would prevent unwanted over or under treatment leading to a better prognosis.
PubMed: 34094841
DOI: 10.1016/j.jobcr.2021.05.002 -
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 -
Dental Research Journal 2023Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture; its prevalence is escalating worldwide and among all age groups. Guidelines...
BACKGROUND
Diabetes mellitus is a dominant metabolic disorder in the current fast paced culture; its prevalence is escalating worldwide and among all age groups. Guidelines recommend universal screening for diabetes; however, the uptake of these tests in individuals suggests challenges owing to invasive nature of blood collection. Thus, there arises the need for a noninvasive investigation for diabetes screening with a minimum paraphilia and for all medical settings.
MATERIALS AND METHODS
We have thus conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, to quantify the association between diabetes and effectiveness of periodic acid-Schiff staining of exfoliative cytology as a screening method. MEDLINE, EMBASE, Cochrane, Scopus, Web of science, CINAHL, and Google Scholar were searched systematically for publications dated till July 20, 2022. Six studies (case-control cross-sectional) were selected and evaluated in depth. The statistical evaluation was done with a forest plot with odds ratio and weightage examined.
RESULTS
It was proved that exfoliative cytology with periodic acid-Schiff (PAS) staining can be used as a screening test for diabetic status evaluation. The findings suggest that the aforesaid noninvasive test is a conclusive screening practice for diabetics.
CONCLUSION
This systematic review and meta-analysis suggest that PAS staining in exfoliative cytology can be used as a noninvasive screening in diabetic individuals to assess the current level of blood glucose. Given the increased risk of diabetes worldwide, higher quality prospective evidence is suggested in larger sample sizes with other metabolic disorders, ethnicity, and oral disorders to further evaluate the plausibility of the results.
PubMed: 37483895
DOI: No ID Found -
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 -
Journal of Ophthalmology 2020The purpose of this study was to confirm the presence of specific patterns of epithelial response in corneal buttons from keratoconus patients.
PURPOSE
The purpose of this study was to confirm the presence of specific patterns of epithelial response in corneal buttons from keratoconus patients.
METHODS
This was a retrospective and descriptive study. 90 penetrating keratoplasty specimens obtained from patients diagnosed with keratoconus were evaluated using bright-field microscopy. Morphologically identifiable characteristics including epithelial cell density and epithelial thickness were analyzed on hematoxylin and eosin- (H&E-) and periodic acid of Schiff- (PAS-) stained slides.
RESULTS
Three distinctive patterns of epithelial alteration of the central cornea were established. Pattern 3, in which the central epithelium was as thick as peripheral epithelium, was the commonest (44.4%), followed by the pattern 2, defined as central epithelium thinner than periphery epithelium (38.9%), and the uncommonest pattern was number 1, with central epithelium thicker than the periphery (16.7%).
CONCLUSIONS
Three distinctive histologic patterns that could potentially have a diagnostic and prognostic value in keratoconus patients were found.
PubMed: 32802486
DOI: 10.1155/2020/1468258 -
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