Role of S-100 Immunostain as An Auxiliary Diagnostic Aid in Leprosy

INTRODUCTION

Histopathologic diagnosis of leprosy is difficult when Bacillary Index (BI) is zero and neural involvement are not easily identifiable on routine Hematoxylin and Eosin stain. This study was undertaken to study the role of S-100 immunostaining in demonstrating different patterns of nerve involvement in various types of leprosy.

METHODS

Thirty one skin biopsies with clinico-histopathologic diagnoses of leprosy over a period of two years were included in the study. Ten cases of non-lepromatous granulomatous dermatoses (including eight cases of lupus vulgaris and two cases of erythema nodosum) were used as controls. Tissue sections from all cases and controls were stained with Hematoxylin and Eosin (H&E) stain, Fite stain and S-100 immunostain. The H&E stained slides were used to study the histopathological features, Fite stained slides for Bacillary Index and S-100 for nerve changes.

RESULTS

Neural changes could be demonstrated in the entire spectrum of leprosy using S-100 immunostaining. The most common pattern of nerve destruction in the tuberculoid spectrum was fragmented and infiltrated whereas lepromatous spectrum showed mostly fragmented nerve twigs. Intact nerves were not detected in any of the leprosy cases.

CONCLUSIONS

S-100 immunostain is a useful auxiliary aid to the routine H&E stain in the diagnosis of leprosy especially tuberculoid spectrum and intermediate leprosy.

Disseminated Histiocytic Sarcoma in an African Hedgehog (Atelerix albiventris)

Disseminated histiocytic sarcoma (HS) was diagnosed on post-mortem examination of a 1.5-year-old African hedgehog (Atelerix albiventris) that was presented in poor physical condition and with diarrhoea. Leucocytosis and a hypoechoic abdominal mass were noted on haematological and ultrasonographical examinations. Gross pathological, histopathological, immunohistochemical and ultrastructural evaluation of the mass supported a diagnosis of disseminated HS. To our knowledge, this report represents the first documentation of disseminated HS in this species.

2016 Comprehensive Update of the Banff Working Group on Liver Allograft Pathology: Introduction of Antibody-Mediated Rejection

The Banff Working Group on Liver Allograft Pathology reviewed and discussed literature evidence regarding antibody-mediated liver allograft rejection at the 11th (Paris, France, June 5-10, 2011), 12th (Comandatuba, Brazil, August 19-23, 2013), and 13th (Vancouver, British Columbia, Canada, October 5-10, 2015) meetings of the Banff Conference on Allograft Pathology. Discussion continued online. The primary goal was to introduce guidelines and consensus criteria for the diagnosis of liver allograft antibody-mediated rejection and provide a comprehensive update of all Banff Schema recommendations. Included are new recommendations for complement component 4d tissue staining and interpretation, staging liver allograft fibrosis, and findings related to immunosuppression minimization. In an effort to create a single reference document, previous unchanged criteria are also included.

Application of silica gel-sintered plate to thin layer lipid chromatographic analysis

The merits and disadvantages of using the silica gel-sintered plate for lipid chromatographic analysis were investigated in detail. The commercially available sintered plate could be used repeatedly, employing the reconditioning procedure which involved chromic-sulfuric acid treatment and subsequent activation. The reconditioned sintered plate has now been used successfully 20 times, for lipid analysis without any deterioration of the excellent resolution power for complex lipid mixtures for all the solvent systems. Since the sintered plate is sturdy, the chromatogplate could be immersed directly in the liquid reaction mixture, so that spots on the chromatogram could be seen and impregnated plates prepared simply. The sintered plate was found to be much more economical than the silica gel-coated plate.

Quantitative analysis of the effect of pulsatile flow on vascular resistance

'Pulsatile flow' has been reported to reduce vascular resistance. In this study, the effect of pulsatile flow was assessed quantitatively, using perfusion of canine hindlimb. The perfusion circuit consisted of roller-type pulsatile pump (Cobe Inc., Stockert pump) and bubble oxygenator (Shiley Inc., S-070/s). Each flow curve was quantified with the mean flow rate (F) and pulse power index (PPI). PPI is derived by Fourier transformation of the flow curve and represents the degree of 'pulsation'. Vascular resistance was determined during perfusion with varied flow rate and PPI. The regression formula between vascular resistance (VR) and two parameters was obtained as follows:

VR(F,PPI) = 41600x(F-1.37) -0.95+913 - PPIx{(3.99x(F-1.33)-040_0.69}

where VR is measured in mmHg. min-1.kg.ml-1; F represents ml.min-1.kg -1 (range from 2.8 to 17.1); and PPI is dimensionless (range from 2.8 to 215.7).

Using this formula, vascular resistance at a fixed flow rate and wave form can be predicted. When the flow rate is 6.27 ml.min-1.kg-1 and the PPI is 1466, (measured values under perfusion with own beating heart) the vascular resistance perfused by own beating heart is obtained. The results indicate that the pulsation of own beating heart contributes to a reduction in vascular resistance to 80%. It is also shown that the value of PPI which is necessary to reduce the vascular resistance to 80% is more than 1300 under the normal flow rate range.

Traditional Chinese Medicine and Kampo: A Review from the Distant past for the Future

Traditional Chinese medicine (TCM) is a complete system of healing that developed in China about 3000 years ago, and includes herbal medicine, acupuncture, moxibustion and massage, etc. In recent decades the use of TCM has become more popular in China and throughout the world. Traditional Japanese medicine has been used for 1500 years and includes Kampo-yaku (herbal medicine), acupuncture and acupressure. Kampo is now widely practised in Japan and is fully integrated into the modern health-care system. Kampo is based on TCM but has been adapted to Japanese culture. In this paper we review the history and characteristics of TCM and traditional Japanese medicine, i.e. the selection of traditional Chinese herbal medicine treatments based on differential diagnosis, and treatment formulations specific for the ‘Sho’ (the patient's symptoms at a given moment) of Japanese Kampo - and look at the prospects for these forms of medicine.

Electrochemical performance of highly amorphous GeOx powders synthesized in different alcohols for use in Na- and Li-ion batteries

The large particle size of amorphous powders deteriorated the cycle performance of a Na-ion cell more than that of a Li-ion cell, due to large decomposition of the electrolyte.

Formation mechanism of plasmonic silver nanohexagonal particles made by galvanic displacement reaction

Multi-element XPS depth profile analysis made clear that Ag nanoscale hexagonal columns formed by newly-discovered galvanic displacement reaction are covered with Cu compounds which prevent Ag columns from fusion, resulting in stable hotspots.

Voxel-based morphometry of the marmoset brain: In vivo detection of volume loss in the substantia nigra of the MPTP-treated Parkinson's disease model

Movement dysfunction in Parkinson's disease (PD) is caused by the degeneration of dopaminergic (DA) neurons in the substantia nigra (SN). Here, we established a method for voxel-based morphometry (VBM) and automatic tissue segmentation of the marmoset monkey brain using a 7-T animal scanner and applied the method to assess DA degeneration in a PD model, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated animals, with tyrosine-hydroxylase staining. The most significant decreases of local tissue volume were detected in the bilateral SN of MPTP-treated marmoset brains (-53.0% in right and -46.5% in left) and corresponded with the location of DA neurodegeneration found in histology (-65.4% in right). In addition to the SN, the decreases were also confirmed in the locus coeruleus, and lateral hypothalamus. VBM using 7-T MRI was effective in detecting volume loss in the SN of the PD-model marmoset. This study provides a potential basis for the application of VBM with ultra-high field MRI in the clinical diagnosis of PD. The developed method may also offer value in automatic whole-brain evaluation of structural changes for the marmoset monkey.

IgA nephropathy: clinicopathology and immunopathology

In a total of 283 biopsies, 100 (35%) were found to be IgA nephropathy. The incidence reached 40% among primary glomerulonephropathies. On the basis of histopathologic changes in glomeruli, these biopsies were classified into 3 groups. The criteria employed correlated well with clinical, laboratory and immunofluorescent findings. Immune complex pathogenesis was discussed in relation to our findings.

IQ is an independent predictor of glycated haemoglobin level in young and middle-aged adults with intellectual disability

AIMS

Here we examined whether intellectual disability is independently associated with hyperglycaemia.

METHODS

We recruited 233 consecutive young and middle-aged adults with intellectual disability. After exclusion of subjects on medication for metabolic diseases or with severe intellectual disability (IQ < 35), 121 subjects were divided by IQ into a group with moderate intellectual disability (35 ≤ IQ ≤ 50), a mild intellectual disability group (51 ≤ IQ ≤ 70) and a borderline group (IQ > 70).

RESULTS

HbA1c level was higher in subjects with moderate intellectual disability (42 ± 9 mmol/mol; 6.0 ± 0.8%) than those in the borderline group (36 ± 4 mmol/mol; 5.5 ± 0.3%) and mild intellectual disability group (37 ± 5 mmol/mol; 5.5 ± 0.5%) groups. HbA1c level was correlated with age, BMI, blood pressure, serum triglycerides and IQ in simple linear regression analysis. Multiple regression analysis indicated that IQ, age, BMI and diastolic blood pressure were independent explanatory factors of HbA1c level.

CONCLUSIONS

An unfavourable effect of intellectual disability on lifestyle and untoward effect of hyperglycaemia on cognitive function may underlie the association of low IQ with hyperglycaemia.

Systematic review with meta-analysis: post-infectious functional dyspepsia

BACKGROUND

The prevalence of functional dyspepsia (FD) following infectious gastroenteritis has not been systematically reviewed.

AIM

To conduct a systematic review and calculate the summary odds ratio (OR) for the development of FD following infectious gastroenteritis, as compared to a control population.

METHODS

Published studies in PubMed, EmBASE, and Cochrane Database and abstracts from standard sources were screened for eligible studies. Data from studies meeting inclusion criteria were pooled for meta-analysis.

RESULTS

Nineteen studies were eligible for inclusion. The mean prevalence of FD following acute gastroenteritis (AGE) was 9.55% (FD, n = 909; AGE, n = 9517) in adult populations. The summary OR for the development of post-infectious FD was 2.54 (95% CI = 1.76-3.65) at more than 6 months after AGE, as compared to the prevalence in controls within the same population. This is compared with the summary OR (3.51; 95% CI = 2.05-6.00) for the development of post-infectious irritable bowel syndrome (IBS) in the same population at more than 6 months after AGE. There was significant statistical heterogeneity with an I(2) of 72.8% for the summary OR of post-infectious FD. Several pathogens, including Salmonella spp., Escherichia coli O157, Campylobacter jejuni, Giardia lamblia and Norovirus have been shown to be associated with post-infectious FD symptoms.

CONCLUSIONS

Infectious gastroenteritis is associated with an increased risk for subsequent dyspepsia as well as for irritable bowel syndrome. Post-infectious FD and post-infectious irritable bowel syndrome may represent different aspects of the same pathophysiology. Further studies will be needed to determine this.

An effective method to release human islets from surrounding acinar cells with agitation in high osmolality solution

INTRODUCTION

Islet purification is mainly performed by the density gradient method. However, purification of the embedded islets that are surrounded by exocrine tissue should be difficult, because their density is similar to exocrine tissue. In this study, we performed chart review to assess the relationship between the ratio of embedded islets and efficacy of purification. Then, we tested several conditions of a new method to free the islets from surrounded exocrine tissues using high osmolality solution with gentle agitation.

MATERIALS AND METHODS

First, we performed chart review of our human islet isolation. Second, embedded islet-enriched human islet fractions (embedded islets >50%) were suspended in University of Wisconsin (UW) solution (UW group, 320 mOsm/kg/H(2)0) or osmolality-adjusted UW solution (400, 500, and 600 mOsm/kg/H(2)0; 400 group, 500 group, and 600 group, respectively). Each tube was gently shaken at 4°C. The tissue samples were taken before shaking and after 15, 30, and 60 minutes. Islet yield, percentage of embedded islets, and viabilities were assessed.

RESULTS

The chart review revealed that high ratio of embedded islets deteriorated the efficacy of islet purification. The islet yield in all groups except for the 600 group did not change at 15 minutes, but it decreased in all groups at 60 minutes. The average percentage of embedded islets before shaking was 62.6%. Although percentage of embedded islets were decreasing in all groups, it was < 20% at 15 minutes in the 500 and 600 groups whereas it was >44% in the UW group, which indicated that higher osmolality would have a greater effect. Viability was >95% in all groups at 30 minutes.

CONCLUSIONS

The embedded islets deteriorated the efficacy of islet purification. Gentle agitation of embedded islets in high osmolality (500 mOsm/kg/H(2)O, 15 minutes) could release islets from surrounded exocrine tissue.

Usefulness of the secretory unit of islet transplant objects (SUITO) index for evaluation of clinical autologous islet transplantation

BACKGROUND

Assessing the engrafted islet mass is important in evaluating the efficacy of islet transplantation. We previously demonstrated that the average secretory unit of islet transplant objects (SUITO) index within 1 month of allogeneic islet transplantation was an excellent predictor of insulin independence. However, the usefulness of the SUITO index for evaluating autologous islet transplantation has not been explored. The purpose of the present study was to assess the relationship between the SUITO index and clinical outcomes after total pancreatectomy followed by autologous islet transplantation.

METHODS

We performed 27 total pancreatectomies followed by autologous islet transplantation from October 2006 to January 2011. Cases were divided into an insulin-independent group (IIG; n = 12) and an insulin-dependent group (lDG; n = 15). The SUITO index was calculated by the formula [fasting C-peptide (ng/mL)/fasting glucose (mg/dL) -63] × 1,500. The average SUITO index within the first month of transplantation except for days 0, 1, and 2, maximum SUITO index, and most recent SUITO index were calculated in each case, and values were compared between the IIG and the IDG.

RESULTS

The average SUITO index within 1 month was significantly higher in the IIG than in the IDG (24.6 ± 3.4 vs 14.9 ± 2.0, respectively; P < .02). The maximum SUITO indices were 45.7 ± 7.7 in the IIG and 30.1 ± 8.1 in the IDG (not significant), and the recent SUITO indices were 36.9 ± 6.7 in the IIG and 22.8 ± 6.1 in the IDG (not significant).

CONCLUSIONS

The average SUITO index within 1 month was an excellent predictor of insulin independence after total pancreatectomy followed by autologous islet transplantation.

Latent mesangial immunoglobulin A deposition in long-term functioning kidney does not correlate with disease progression and may exhibit fluctuating patterns

BACKGROUND

Latent mesangial immunoglobulin (Ig)A deposition in long-term functioning kidney does not correlate with disease progression and may exhibit fluctuating patterns Mesangial IgA deposition without urinary abnormalities (latent mesangial IgA deposition) is occasionally observed in non-episode biopsies of kidney allografts. However, the histologic features of latent IgA deposition have not been fully characterized.

METHODS

To better identify the clinicopathologic background of subclinical mesangial IgA deposition, we compared the clinical and histologic characteristics of long-term functioning kidney allografts with and without latent IgA deposition.

RESULTS

Among 29 patients with a posttransplant duration of >10 years, 37.9% exhibited latent mesangial IgA deposition. Biopsies indicated that renal function at the time of and 5 years before subclinical mesangial IgA deposition was generally similar. HLA-DR4 and HLA-Bw51 showed a nonsignificant trend to be more frequent in the IgA-positive group. Histologic investigation demonstrated no changes in disease scores based on the Banff 2009 classification between groups. Immunofluorescence revealed co-deposition of C3 at >1+ intensity in 72% IgA-positive patients. Immunohistochemical analysis revealed that IgA deposition per se did not cause notable increases in intraglomerular α-smooth muscle actin (SMA)-positive cells. One patient with subclinical IgA deposition demonstrated a waxing and waning pattern in the amount of IgA deposition.

CONCLUSION

This study suggests that subclinical IgA deposition in long-term functioning kidney allografts is not associated with progressive course in clinical and pathologic findings. Furthermore, the amount of subclinical IgA deposition may exhibit fluctuating patterns in some cases.

Evidence for instant blood-mediated inflammatory reaction in clinical autologous islet transplantation

A nonspecific inflammatory and thrombotic reaction termed instant blood-mediated inflammatory reaction (IBMIR) has been reported when allogenic or xenogenic islets come into contact with blood. This reaction is known to cause significant loss of transplanted islets. We hypothesized that IBMIR occurs in patients undergoing total pancreatectomy followed by autologous islet transplantation (TP-AIT) and tested this hypothesis in 24 patients and in an in vitro model. Blood samples drawn during the peritransplant period showed a significant and rapid increase of thrombin-anti-thrombin III complex (TAT) and C-peptide during islet infusion, which persisted for up to 3 h, along with a decreased platelet count. A concomitant increase in levels of inflammatory proteins IL-6, IL-8 and interferon-inducible protein-10 was observed. An in vitro model composed of pure islets plus autologous blood also demonstrated significantly increased levels of TAT (p<0.05), C-peptide (p<0.05), tumor necrosis factor-alpha (p<0.05) and MCP-1 (p<0.05), as well as strong tissue factor expression in islets. Islet viability decreased significantly but was rescued by the presence of low-molecular-weight dextran sulfate. In conclusion, AIT-induced elevation of TAT and destruction of islets suggests that IBMIR might occur during AIT. Modulating this process may help improve islet engraftment and the insulin independence rate in TP-AIT patients.