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Objective@#To investigate the clinical and histological features, diagnosis and differential diagnosis of myofibroma/myofibromatosis.@*Methods@#The clinical data and pathology features of nine cases of myofibroma/myofibromatosis were collected from August 2011 to November 2016 in Affiliated Drum Tower Hospital, Nanjing University Medical School and Children′s Hospital of Nanjing Medical University. Immunohistochemistry(IHC), PDGFRB molecular analysis and ETV6-NTRK3 gene fusion were performed and relevant literature reviewed.@*Results@#There were 7 males and 2 females, with age ranging from 3 days to 18 years (mean 5 years). The tumors were located in head and neck (eight cases) and trunk (one case). Clinically, the tumors presented as freely movable nodules. Microscopically, they appeared biphasic with alternating light- and dark-staining areas. The light-staining area consisted mainly of plump myoid spindle cells with eosinophilic cytoplasm arranged in nodules, short fascicles, or whorls.The dark-staining area was composed of round or polygonal cells with slightly hyperchromatic nuclei or small spindle cells arranged around a distinct hemangiopericytoma-like vascular pattern. IHC showed the tumor cells in the light-staining area were strongly positive for vimentin and SMA, while cells in dark-staining area were strongly positive for vimentin, and weakly for SMA. Tumor cells were negative for desmin, S-100 protein, h-Caldesmon, CD34 and STAT6. Analysis of PDGFRB mutations was performed in seven cases. Two cases showed 12 exon point mutation c. 1681 c>T(p.R561C), one case showed 14 exon point mutation c. 1998C>G (p.N666K). ETV6-NTRK3 gene fusion was not detected by fluorescence in situ hybridization in four patients under three years old. All cases were followed for 6 to 68 months, with two recurrences.@*Conclusions@#Myofibroma/myofibromatosis is an uncommon benign myofibroblastic tumor of infancy and childhood. The tumor can appear biphasic, and may show PDGFRB point mutation which is of potential diagnostic value.
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Objective To evaluate the relationship between macrophage migration inhibitory factor ( MIF) expression and obese-induced abolition of sevoflurane preconditioning-induced cardioprotection in mice. Methods Forty-eight male C57BL∕6J mice, aged 4 weeks, were divided into 2 groups ( n=24 each) using a random number table method: normal diet group ( Lean group ) and high-fat diet group ( Obese group) . Lean group were fed a normal diet ( 10％ kcal) for 12 weeks, while Obese group were fed a high-fat diet ( 60％ kcal) for 12 weeks. The weight of mice was measured. Blood samples were collected from the tail vein for determination of blood glucose concentrations, and plasma concentrations of total cho-lesterol, triglyceride, insulin and leptin. After measurement of the parameters mentioned above, Lean group and Obese group were divided into 3 subgroups ( n=8 each) using a random number table method:sham operation groups (L-Sham group, O-Sham group), myocardial ischemia-reperfusion groups (L-IR group, O-IR group) and sevoflurane preconditioning groups (L-IR+Sev group, O-IR+Sev group). The mice were anesthetized and their hearts were immediately removed and retrogradely perfused in a Langendorff apparatus with an oxygenated K-H solution at 37 ℃. Hearts were continuously perfused with K-H solution for 115 min in L-Sham and O-Sham groups. Hearts were subjected to global ischemia for 25 min, followed by 60-min reperfusion after being retrogradely perfused with K-H solution in L-IR and O-IR groups. In L-IR+Sev and O-IR+Sev groups, hearts were subjected to 3 cycles of 5-min perfusion with sevoflurane-contai-ning K-H solution ( final concentration 0. 6 mmol∕L) and 5-min washout, and then hearts were subjected to global ischemia for 25 min, followed by 60-min reperfusion. Left ventricular developed pressure ( LVDP ) , left ventricular end-diastolic pressure ( LVEDP ) , and the maximum rate of increase or decrease in left ventricular pressure ( ±dp∕dtmax) were recorded at the end of reperfusion. Hearts were obtained at the end of reperfusion for determination of myocardial infarct size and expression of MIF ( by Western blot) . Results Compared with Lean group, the weight, blood glucose, levels of plasma total cholesterol, tri-glyceride, insulin and leptin were significantly increased in Obese group (P<0. 05). Compared with L-Sham group, the LVDP and +dp∕dtmax were significantly decreased, LVEDP and -dp∕dtmax were in-creased, myocardial infarct size was increased, and the expression of myocardial MIF was up-regulated in L-IR and L-IR+Sev groups, and the expression of myocardial MIF was up-regulated in O-Sham group ( P<0. 05) . Compared with L-IR group, LVDP and +dp∕dtmax were significantly increased, LVEDP and-dp∕dtmax were decreased, myocardial infarct size was decreased, and the expression of myocardial MIF was up-regulated in group L-IR+Sev, and the expression of myocardial MIF was significantly up-regulated in group O-IR (P<0. 05). Compared with O-Sham group, LVDP and +dp∕dtmax were significantly de-creased, LVEDP and-dp∕dtmax were increased, and myocardial infarct size was increased, and no signif-icant change was found in the expression of MIF in O-IR and O-IR+Sev groups ( P>0. 05) . Conclusion The mechanism by which obese abolishes sevoflurane preconditioning-induced cardioprotection may be relat-ed to inducing MIF over-expression in mice.
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To explore the application of controlled hypotension in cesarean section of pregnant women with high-risk hemorrhage. 75 cases were randomly divided into three groups: controlled hypotension Group 1 [Group H1], controlled hypotension Group 2 [Group H2] and normal blood pressure Group [Group N]. The preoperative general data, intraoperative conditions, postpartum concurrent Symptoms and other indicators of all the cases in three groups were compared. The Apgar score, umbilical arterial blood gas and other indicators of the newborns were detected. There was no significant difference in the preoperative general data, Apgar score at 1 min and 5 min, the level of PH, PaO2, PaCO2 among the three groups [P>0.05]. The intraoperative blood transfusion volume in group H1 and group H2 decreased significantly than that in-group N [P<0.05], but there was no significant difference between group H1 and group H2 [P>0.05]. Compared with group H1, the red cell transfusion volume in-group H2 was significantly reduced [P<0.05]. There was no significant difference in other intra-operative indexes such as bleeding volume, infusion volume, patient urine volume and hospitalization days among the three groups [P>0.05]. Controlled hypotension [within 5 min of MAP down to 70% of basal blood pressure] can reduce the incidence of hemorrhage and postpartum hemorrhage during cesarean section in high-risk bleeding pregnant women and which had no bad effects on the incidence of complications and umbilical arterial blood gas indicators compared with control group
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Objective@#To investigate the optimal strategy for immunohistochemical (IHC) staining in bone metastasis specimens from breast cancer.@*Methods@#Twenty-eight bone metastases specimens from breast cancers were divided into three groups and subjected to different decalcifying agents (group A-10% nitrate, group B-EDTA decalcification, and group C-imported decalcifying solution RapidCal). The effects of those on HE and IHC staining for Ki-67, ER, PR, GATA3, RANK, RANKL, HER2 and HER2 FISH results were assessed.@*Results@#There were no significant differences among three groups in HE morphology and IHC staining. Antigen content in the RapidCal group were all intact; the EDTA group showed a similar staining rate, which was better than the nitrate group (P<0.05). Nitrate group showed marked reduction in nuclear Ki-67 staining, but the loss of cytoplasmic antigens (RANK, RANKL) was less than cell membrane antigen (HER2). For FISH, the RapidCal group and EDTA group showed same results, concordant with IHC staining results. The expression of HER2 protein in the nitric acid group was significantly decreased and chromosome 17 labelling was lost (P<0.05).@*Conclusions@#RapidCal treated bone metastases specimens from breast cancer show excellent sample quality in morphological, IHC and FISH results compared with traditional decalcifying agents. Owing to the longer time of EDTA decalcification, the new decalcifying agent RapidCal plays an important role in quality control and clinical application.
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Objective To observe the effect of nitinol rib claws embracing in the treatment of multiple rib fractures and flail chest .Methods 43 patients who received nitinol rib fixation claw embracing treatment for multiple rib fractures,flail chest(the internal fixation group) and 41 cases with non-internal fixation(the non-internal fixation group) were chosen.The efficacy and complications were analyzed and compared .Results After 12 weeks, the results of X-ray showed that in the internal fixation group ,bone fractures were all healed ,1 case of pulmonary atelecta-sis,1 case of pneumonia ,no patients died;In the non-internal fixation group ,12 patients had pulmonary atelectasis , 19 cases of pneumonia,1 case died,the incidence rate of complications between the two groups had significant differ -ence(χ2 =5.64,P<0.05).The hospitalization periods,analgesics volume and respiratory support in fixation group were lower than the non-fixation group,the differences were statistically significant (t =4.86,6.75,6.88,all P<0.05).Conclusion The clinical effect of nitinol embracing claw rib fixation in the treatment of multiple rib frac-tures,flail chest is superior to non-internal fixation group ,with a high clinical value .
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<p><b>BACKGROUND</b>Giant cell interstitial pneumonia (GIP) was a rare form of pneumoconiosis, associated with exposure to hard metals, which had been reported mostly as isolated case reports. We described eight cases of GIP diagnosed in our hospital during the past seven years, with particular reference to new findings.</p><p><b>METHODS</b>Eight patients with GIP confirmed by biopsy in the Nanjing Drum Tower Hospital affiliated to Medical School of Nanjing University from 2005 to 2011 were retrospectively analyzed. For each patient, the occupy histories and medical records were thoroughly reviewed and clinic data were extracted. Two radiologists, without knowledge of any of the clinical and functional findings, independently reviewed the HRCT scans of all patients. Follow-up data were collected.</p><p><b>RESULTS</b>Among the eight patients, seven had a history of exposure to hard metal dusts, one denied an exposure history. The most common manifestations were cough and dyspnea. One patient initiated with pneumothorax and another pleural effusion, both of which were uncommon to GIP. The main pathologic appearances were the presence of macrophages and multinucleated giant cells in the alveolar space. The clinical symptoms and radiographic abnormalities were obviously improved after cessation of exposure and receiving corticosteroid treatments, recurrences were observed in two patients when they resumed work. In spite of exposure cessation and corticosteroid treatment, one patient developed pulmonary fibrosis at seven years follow-up.</p><p><b>CONCLUSIONS</b>Awareness of the patients' occupational history often provided clues to the diagnosis of GIP. Histopathologic examinations were necessary to establish the right diagnosis. Exposure cessation was of benefit to most patients; however, pulmonary fibrosis was possible in spite of exposure cessation and corticosteroid treatment. Better ways should be found out to improve the outcome and quality of life.</p>
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Adult , Female , Humans , Male , Middle Aged , Young Adult , Alloys , Toxicity , Cobalt , Toxicity , Lung , Pathology , Lung Diseases, Interstitial , Diagnosis , Pulmonary Fibrosis , Diagnosis , Retrospective Studies , Tungsten , ToxicityABSTRACT
<p><b>OBJECTIVE</b>To study the potential factors in influencing the performance of immunohistochemical testing for HER2 protein in gastric cancers.</p><p><b>METHODS</b>The HER2 protein expression status of 1 471 surgically resected archival gastric cancer cases in Drum Tower Hospital collected during two different periods was retrospectively analyzed. The materials included 957 cases tested during the period from 2007 to 2009 (group 1) and 514 cases from 2012 to 2013 (group 2). The test procedures and results observed during these two periods were compared.</p><p><b>RESULTS</b>The percentages of score 3 HER2 protein expression (14.4%, 74/514 versus 9.5%, 91/957) and score 2 or score 3 HER2 protein expression (27.2%, 140/514 versus 21.7%, 208/957) were both higher in group 2 than in group 1 (P < 0.05). In group 1, the cancer tissue was fixed in 10% formalin, stained manually with HER2 antibody A0485 (Dako) and assessed by different pathologists.In group 2, the tissue was fixed in 10% neutral buffered formalin (pH 7.2), stained using automated immunostaining system (Roche Benchmark XT) with HER2 antibody 4B5 (Ventana) and assessed by a specialized team of pathologists.</p><p><b>CONCLUSION</b>The results of HER2 immunostaining in gastric cancer are influenced by a number of factors including type of fixative, clone number of primary antibody, staining methods and experience of pathologists.</p>
Subject(s)
Humans , Antibodies, Monoclonal , Fixatives , Formaldehyde , Gene Expression Regulation, Neoplastic , Immunohistochemistry , Receptor, ErbB-2 , Metabolism , Retrospective Studies , Staining and Labeling , Stomach Neoplasms , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To explore the pathological features and prognosis of appendiceal mucinous neoplasms (AMN) based on WHO classification 2010.</p><p><b>METHODS</b>Seventy consecutive cases of AMN were classified into 5 groups according to WHO classification of digestive system tumors in 2010 including mucinous adenomas/cystadenoma (MA), low grade appendiceal mucinous neoplasms (LAMN), low grade pseudomyxoma peritoneum originated from appendix (PMP-L), invasive mucinous adenocarcinomas (MAC) and high grade pseudomyxoma peritoneum originated from appendix (PMP-H). Clinicopathological features, classification, treatment and prognosis of AMN were investigated retrospectively.</p><p><b>RESULTS</b>There were 11 cases of MA with neoplastic epithelium and mucin being defined in lumen and mucosa but without invasive lesions, and no relapse or death was found. In 41 LAMN cases, mucin was found in submucosa, muscularis proparis, or serosa of appendix, no or only scant mucinous epithelium with low grade dysplasia presented in mucinous pools in most cases (39/41). Among 41 LAMN cases, 3 developed relapse or PMP-L, and no death was observed. In 7 PMP-L cases, low grade dysplastic mucinous epithelium in mucinous pools could be found easily in 3 cases and was very scanty in 4 cases, with 1 relapse and 1 death. Eleven invasive carcinomas were found, including 7 MAC cases and 4 PMP-H cases, with local high grade dysplastic epithelium at least. In these invasive lesions, 4 cases recurred and 3 case died (including 2 recurred cases above). MA and LAMN were both non-invasive neoplasms histologically, however, PMP-L, MAC and PMP-H were regarded as adenocarcinomas according to their biological behavior.</p><p><b>CONCLUSION</b>AMN displays a relatively homogeneous group of neoplasms that pursues a predictable clinical course based on their nature, so it is necessary to diagnose and administrative accurately with consistently standards for these neoplastic entities.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Adenocarcinoma, Mucinous , Pathology , Appendiceal Neoplasms , Classification , Pathology , Myxoma , Pathology , PrognosisABSTRACT
Objective To evaluate the effects of moderate oxygen concentration (40％ O2) on A549 cells and expression of transforming growth factor-β1 (TGF-β1) mRNA and connective tissue growth factor (CTGF) mRNA in A549 cells.Methods Cultured A549 cells were seeded in 6-well plates (1 mYhole) or in 10 cm diameter dishes (5 ml/dish) with the density of 1 × 1O5 cells/ml and randomly divided into 3 groups (n =12 each) using a random number table:control group (group C),40％ oxygen concentration group (group 40％ O2),and 95％ oxygen concentration group (group 95 ％ O2).A549 cells were exposed to air,40 ％ O2 and 95 ％ O2 for 48 h in C,40％ O2 and 95％ O2 groups,respectively.The necrosis and expression of TGF-β1 mRNA and CTGF mRNA were detected at the end of culture.Results Compared with group C,the necrosis rate was significantly increased,while the expression of TGF-β1 mRNA and CTGF mRNA was up-regulated in 40％ O2 and 95％ O2 groups (P ＜ 0.05).Compared with group 95 ％ O2,the necrosis rate was significantly decreased,while the expression of TGF-β1 mRNA was down-regulated (P ＜ 0.05),and there was no significant difference in CTGF mRNA expression in group 40 ％ O2 (P ＞ 0.05).Conclusion Exposure to moderate oxygen concentration for a certain time can induce damage to A549 cells,but the severity is lighter than that caused by high oxygen concentration,and up-regulation of TGF-β1 and CTGF gene expression may be involved in the mechanism.
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Objective:To investigate the effects of interferon-? on bleomycin-induced pulmonary fibrosis in rats and to study the mechanism of its effects.Methods:60 SD rats were randomly divided into 3 groups of 20:normal control group(Group N), model control group(Group M) and interferon-?(IFN-?)treated group(Group R). The pulmonary fibrosis model was established by a single intratracheal injection of 5 mg/kg of bleomycin. The rats were sacrificed at days 3,7,14,28 after modeling in batch. Lung tissues were restored to analyze the pathological changes, the content of hydroxyproline,mRNA expression of IFN-? and transforming growth factor-?(TGF-?).Results:The scores of alveolitis in Group M and R were higher than that in Group N at each poin-in-time after modeling.The scores of alveolitis in Group R were higher than that in Group M. The scores of pulmonary fibrosis and the content of hydroxyproline in lung tissues in Group M and R were higher than that in Group N at day 14 and 28. The expression of IFN-? mRNA in lung tissues at day 3,7,14,28 and TGF-? mRNA at day 3 in Group R were higher than that in Group M(P