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Ruan X, Lei T, Xiang X, Liu F, Shi X. Insights on Moyamoya Disease: Vascular Inflammation and Nuclear Autoschizis in Cranial Arteries. Stroke 2024; 55:e5-e7. [PMID: 38018829 DOI: 10.1161/strokeaha.123.045064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Affiliation(s)
- Xiaoling Ruan
- Department of Neurosurgery, University of Pavia, Italy (X.R.)
| | - Ting Lei
- Department of Neurosurgery, Sanbo Brain Hospital (T.L., X.X., F.L.)
- Department of Neurosurgery, Fuxing Hospital, Capital Medical University, Beijing, China (T.L., X.S.)
| | - Xin Xiang
- Department of Neurosurgery, Sanbo Brain Hospital (T.L., X.X., F.L.)
| | - Fangjun Liu
- Department of Neurosurgery, Sanbo Brain Hospital (T.L., X.X., F.L.)
| | - Xiang'en Shi
- Department of Neurosurgery, Fuxing Hospital, Capital Medical University, Beijing, China (T.L., X.S.)
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Borțea CI, Enatescu I, Pantea M, Dima M, Iacob ER, Dumitru C, Popescu A, Stoica F, Heredea RE, Iacob D. The Molecular and Histopathological Assessment of Inflammatory Status in Very and Extremely Premature Infants: A Prospective Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020352. [PMID: 36832481 PMCID: PMC9954862 DOI: 10.3390/children10020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
Prematurity comes with a varying range of complications, implying a high prevalence of complications and mortality and depending on the severity of prematurity and the sustained inflammation among these infants, which recently sparked an important scientific interest. The primary objective of this prospective study was to establish the degree of inflammation in very (VPIs) and extremely preterm infants (EPIs) in association with the histology findings of the umbilical cord (UC), while the secondary objective was to study the inflammatory markers in the neonates' blood as predictors of fetal inflammatory response (FIR). A total of thirty neonates were analyzed, ten of them being born extremely premature (<28 weeks of gestation) and twenty very premature (28-32 weeks of gestation). The EPIs had considerably higher levels of IL-6 at birth than VPIs (638.2 pg/mL vs. 151.1 pg/mL). The CRP levels at delivery did not vary substantially across groups; however, after days, the EPIs had significantly higher CRP levels (11.0 mg/dL vs. 7.2 mg/dL). In contrast, the LDH was considerably higher in the extremely preterm infants at birth and four days after birth. Surprisingly, the proportions of infants with pathologically increased inflammatory markers did not differ between the EPIs and VPIs. The LDH increased considerably in both groups, although the CRP levels increased exclusively among the VPIs. The stage of inflammation in the UC did not vary substantially between the EPIs and VPIs. The majority of infants were identified with Stage 0 UC inflammation (40% in EPI vs. 55% in VPIs). There was a substantial correlation link between gestational age and newborn weight and a significant inverse correlation among gestational age and IL-6 and LDH levels. There was a strong negative association between weight and IL-6 (rho = -0.349) and LDH (rho = -0.261). The stage of the UC inflammation demonstrated a statistically significant direct connection with IL-6 (rho = 0.461) and LDH (rho = 0.293), but none with the CRP. Further studies involving a bigger population size of preterm newborns are required to validate the findings and analyze more inflammatory markers, while prediction models on inflammatory markers that are measured expectantly, before the onset of preterm labor, need to be created.
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Affiliation(s)
- Claudia Ioana Borțea
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Ileana Enatescu
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Manuela Pantea
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mirabela Dima
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Emil Radu Iacob
- Department of Pediatric Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
- Correspondence:
| | - Alin Popescu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Florina Stoica
- Department of Ophthalmology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Rodica Elena Heredea
- Department of Pathology, “Louis Turcanu” Children’s Clinical Emergency Hospital, 300041 Timisoara, Romania
| | - Daniela Iacob
- Department of Neonatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Hatano Y. Dissecting the Vitelline Vessel Remnant. Pediatr Dev Pathol 2022; 25:570-571. [PMID: 35588198 DOI: 10.1177/10935266221103065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yuichiro Hatano
- Department of Tumor Pathology, 38225Gifu University Graduate School of Medicine, Gifu, Japan
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Wright JR, Yu W, de Koning L. Author(s)' Reply - Vitelline Vessel Remnant - Derived Funisitis: Semantics, Severity, and Significance. Pediatr Dev Pathol 2022; 25:572-573. [PMID: 35822875 DOI: 10.1177/10935266221113450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- James R Wright
- Department of Pathology and Laboratory Medicine, Alberta Children's Hospital, Cumming School of Medicine, 2129University of Calgary ,Calgary, Alberta, Canada
| | - Weiming Yu
- Department of Pathology and Laboratory Medicine, Alberta Children's Hospital, Cumming School of Medicine, 2129University of Calgary ,Calgary, Alberta, Canada
| | - Lawrence de Koning
- Department of Pathology and Laboratory Medicine, Alberta Children's Hospital, Cumming School of Medicine, 2129University of Calgary ,Calgary, Alberta, Canada
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Giordano G, Petrolini C, Corradini E, Campanini N, Esposito S, Perrone S. COVID-19 in pregnancy: placental pathological patterns and effect on perinatal outcome in five cases. Diagn Pathol 2021; 16:88. [PMID: 34602071 PMCID: PMC8487453 DOI: 10.1186/s13000-021-01148-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 09/17/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION COVID-19, the disease caused by the novel coronavirus SARS-CoV-2, is a severe systemic thrombotic syndrome that emerged in 2019, with an ensuing pandemic. To evaluate the impact of this disease on placental tissue and perinatal outcome, histological, immunohistochemical and ultrastructural analyses of placental tissue were performed for five cases of pregnant women with COVID-19. CASE REPORTS All five pregnant women in this series developed COVID-19 in late pregnancy. Two patients experienced respiratory distress, and computed tomography revealed signs of pneumonia, with bilateral involvement, multiple lobular and subsegmental areas of consolidation and ground-glass opacities. Histological studies of placental tissue revealed the presence of slight signs of maternal vascular underperfusion (MVUs) or foetal vascular underperfusion (FVUs) lesions and mild inflammatory lesions. CD15 immunoreactivity in the placental tissue was low in all cases, demonstrating that in these cases there was not severe foetal hypoxia/asphyxia risk for newborns or distal vascular immaturity. In all cases examined, ultrastructural analyses showed spherical-like coronavirus particles with an electron intermediate-density core as well as projections from the surface as spike-like structures in the syncytiotrophoblasts. At term, all of the women delivered newborns who were negative for SARS-CoV-2 by nasopharyngeal testing in their first day of life. All newborns were exclusively breastfed and were discharged on the 3rd day of life. CONCLUSIONS In conclusion, placental patterns in pregnancy due to COVID-19 in the late stage of gestation indicate no evidence of vertical trans-placental SARS-CoV-2 transmission or a significant impact on the perinatal outcome of newborns, in both mild and more severe cases.
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Affiliation(s)
- Giovanna Giordano
- Department of Medicine and Surgery, Pathology Unit, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy.
| | - Chiara Petrolini
- Department of Medicine and Surgery, Neonatology Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - Emilia Corradini
- Department of Medicine and Surgery, Pathology Unit, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Nicoletta Campanini
- Department of Medicine and Surgery, Pathology Unit, University of Parma, Viale A. Gramsci, 14, 43126, Parma, Italy
| | - Susanna Esposito
- Department of Medicine and Surgery, Paediatric Clinic Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
| | - Serafina Perrone
- Department of Medicine and Surgery, Neonatology Clinic, Pietro Barilla Children's Hospital, University of Parma, Parma, Italy
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De Guzman JK, Yu W, Horn C, Brundler MA, Wright JR. Characterization of vitelline vessel remnant circulation in the umbilical cord. Placenta 2021; 111:97-104. [PMID: 34225217 DOI: 10.1016/j.placenta.2021.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/14/2021] [Accepted: 06/15/2021] [Indexed: 10/21/2022]
Abstract
The vitelline circulation normally regresses by about 10 weeks gestation. Vitelline vessel remnants (VVRs) are found in approximately 4-11% of umbilical cords. While these remnants retain an active fetal circulation, this has never been studied. Using an operating microscope, VVRs were catheterized, injected with ink, and then examined grossly and histologically. Over 90% of VVRs are paired thin-walled vessels with afferent and efferent circulation completed within the cord via capillary plexuses and bridging vessels; <10% are single thin-walled arterial vessels running the length of the cord to the placental disc, with their venous return circulation via allantoic umbilical vessels.
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Affiliation(s)
- John Kemuel De Guzman
- Department of Pathology & Laboratory Medicine, Alberta Children's Hospital, Alberta Precision Laboratories and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Weiming Yu
- Department of Pathology & Laboratory Medicine, Alberta Children's Hospital, Alberta Precision Laboratories and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada; Department of Pediatrics, Alberta Children's Hospital and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Christopher Horn
- Department of Pathology & Laboratory Medicine, Alberta Children's Hospital, Alberta Precision Laboratories and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada.
| | - Marie-Anne Brundler
- Department of Pathology & Laboratory Medicine, Alberta Children's Hospital, Alberta Precision Laboratories and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada; Department of Pediatrics, Alberta Children's Hospital and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada.
| | - James R Wright
- Department of Pathology & Laboratory Medicine, Alberta Children's Hospital, Alberta Precision Laboratories and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada; Department of Pediatrics, Alberta Children's Hospital and the University of Calgary Cumming School of Medicine, 28 Oki Drive NW, Calgary, Alberta, T3B 6A8, Canada.
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