Progress on electron microscopy diagnosis on Banff classification for renal allograft pathology / 器官移植

With the development of organ transplantation in clinical practice, allograft pathology has been constantly developing and advancing. The convening of Banff conference on allograft pathology and the establishment of Banff classification on allograft pathology (Banff classification) are pivotal milestones in the development of international allograft pathology. Since then, Banff classification on pathological diagnosis of various transplant organs have been continually updated and improved. Ultrastructural pathological observation by electron microscope plays an irreplaceable role in the early diagnosis of antibody-mediated rejection, recurrent disease and de novo disease of renal allograft. Early detection and rational treatment help to maintain the long-term survival of renal allograft and reduce the failure of renal allograft. In this article, the basic definition of electron microscope and the ultrastructural pathological diagnosis, the research history and main progress on electron microscope diagnosis on Banff classification for renal allograft pathology were introduced, and typical pathological changes, specific terminology and diagnostic criteria of electron microscope diagnosis on renal allograft biopsy were summarized, aiming to provide reference for clinical and basic research of organ transplantation.

Collagenofibrotic glomerulopathy – A rare disease diagnosed with the aid of transmission electron microscopy

Collagenofibrotic glomerulopathy (CFG) is a rare idiopathic kidney disease characterized by abnormal deposition of atypical Type III collagen fibers in the glomerulus causing subendothelial and mesangial expansion, manifesting as progressive renal dysfunction accompanied by proteinuria. The majority of CFG cases reported in literature are from Japan where this disease entity was initially recognized. There is an increased awareness and diagnosis of this rare renal disease in India with the recent increase in utilization of electron microscopy (EM) in clinical diagnostic settings. We describe a 28-year-old Bangladeshi woman who presented with hypertension and nephrotic range proteinuria not amenable to treatment with steroids and cyclophosphamide, whose renal biopsy demonstrated diagnostic ultrastructural features of CFG. This illustrative case is presented to highlight the role of EM analysis for diagnostic accuracy in renal biopsy evaluation in addition to demonstrating the unusual renal biopsy findings of this rare entity.

Approach to the patient with primary hypothyroidism accompanied by pituitary hyperplasia and increased serum creatine kinase level / 中华内分泌代谢杂志

Pituitary hyperplasia may be found in patients with primary hypothyroidism as the decreased thyroid hormone level attenuates negative feedback effect.Sometimes the enlarged pituitary may be misdiagnosed as a pituitary tumor.Patients with long term untreated hypothyroidism often have extremely high level of serum creatine kinase and thus may be misdiagnosed as suffering from myositis.In order to increase the awareness of the nonspecific symptoms of primary hypothyroidism,this article introduces the diagnosis and treatment of a patient with primary hypothyroidism with raised serum creatine kinase level and pituitary hyperplasia.

MRI and Ultrastructural Pathology on Acute Myocardial Infarction / 实用放射学杂志

Objective To study the MRI features and its ultrastructural pathology basis in different myocardial injury areas after acute infarction.Methods 10 rabbits were given ligation of left anterior descending branch 24 hours to make pathologic models.All animals underwent conventional MRI,contrast media dynamic enhancement MRI,cine-MRI and dobutamine stress test.Myocardial blood flow was measured with radioactive micropheres to define risk regions.Ischemic and infarcted regions were defined as Even's blue and 2,3,5triphenyltetrazolium chloride(TTC)negative regions respectively,and made electron microscopy specimens to observe the changes of mitochondria and myofibril.The myocardial ultrastructural injury was scored and graded.Results There were no significant change on T 1WI,but the signal intensity on T 2WI increased significantly after AMI.The diseased myocardium became thinning were seen in 40% cases,and the abnormal flowing high signal were seen in 60% cases.The dynamic enhancement time-signal intensity curves were different in normal,ischemic and infarcted regions.Cine-MRI showed the cardiac wall movement impairing and the wall thick thinning,but the wall movement reinforcing and the wall thick thickening after dobutamine stress.The water content of ischemic and infracted myocardium were marked higher than normal myocardium.The myocardial blood flow in diseased regions were decreased significantly than that in normal regions.The volume density and numerical density of mitochondria in different injury regions showed significant differences.Conclusion MRI appearances of AMI were associated with the injury degree of myocardial ultrastructure and the residual myocardial blood flow.

EXPERIMENTAL STUDY OF PATHOLOGICAL CHANGES IN PULMONARY VESSELS AND THEIR MECHANISMS UNDERLYING HYPOXIC PULMONARY HYPERTENSION IN RATS / 解放军医学杂志

A model of hypoxic pulmonary hypertension (HPH) was reproduced in rats by exposing them to chronic hypoxia environment corresponding to 5km level. At 10d,20d, 30d after hypoxia in hypoxia groups and control group, the pulmonary vascular structural changes were observed with optical microscope, histochemistry and electronic microscope. The changes in hypoxia groups were as follows: ①the wall of small pulmonary arteries of every calibre showed marked thickening compared with that in control group, and the main changes involved smooth muscle cells(SMC)proliferation and collagen deposition in the vessels wall; ② SMC proliferation, muscularization of non myocytic arteries and partial myocytic arteries were observed in intra acinar pulmonary arteries, so the counts of muscular arteries significantly increased compared with control group( P

Ultrastructural Pathology of Experimental Encephalitis B and Morphogenesis and Release of Encephalitis B Virus in Mice / 第三军医大学学报

An animal model of encephalitis B was successfully established with Jin Wei Yan I strain virus in mice,which made it possible to study the ultrastructural pathology as well as the morphogenesis and release of encephalitis B exerimentally.The ultrapathological changes occurring to the brain tissues especially in the neuron cells were described systematically.A preliminary hypothesis about the morphogenesis and release of encephalitis B virus (Jin Wei Yah I strain) was proposed on the basis of these changes.Replication of the virus was also found to occur in the oligodendroglia but not in the microglia,which maintained its phagocytic function.This fact evidently shows that the micrioglia is not controlled by the mRNA of the virus.According to the literature available to the authors,it seems that the ultrastructural pathological changes of encephalitis B with typical histological lesions in animals had not been reported previously.

Ultrastructural Pathology of Neurons in Mouse Brain Infected with B Encephalitis Virus / 第三军医大学学报

The animal model for the study of B encephalitis was established by injecting Jin Wei Yan 1 strain of B encephalitis virus into the peritoneal cavity of mice. All the mice injected demonstrated the histological features of the disease. Special attention was paid to the ultrastructural changes of the granular cells, the Purkinje cells and the Golgi cells in the cerebellum, and the findings in these cells were compared with those of the nerve cells in the cerebral cortex, dience-phalon and tnesencephalonIt was found that endoplasrnic reticulum could appear in the nerves infected by B encephalitis virus. A radiating structure was-usually formed by the viral replication multivesicular bodies with microvesiculo-tubular body as its center. The morphological changes and the developmental sequence as well as the significance of this radiating structure were discussed.In the late stage of the infection, viral particles were found in the nuclei of a part of the necrotic cells. It was likely that the viral particles entered the nuclei by way of cytoplasm. Our observation confirmed the Chen Liming's hypothesis that viral particles can be formed in the perinuclear space. The way that the viral particles were evacuated from the infected nerve cells observed in this study was in agreement with that reported by Chen Liming, but most of the viral particles left the infected nerve cells through the axons.