HISTOMORPHOLOGICAL STUDY OF CHOLECYSTECTOMIES IN A TERITIARY CARE CENTER

Introduction: Cholecystectomy is the most common surgical procedure performed for cholelithiasis (gall stones). Cholelithiasis is one of the most common gastro intestinal disorder worldwide. Usually asymptomatic, but commonly encountered symptoms may be right upper quadrant pain, dyspepsia and belching. The incidence of cholelithiasis is 2-4 times more in women than in men. The aim of the present study is to identify various morphological patterns and frequency of gall bladder lesions in cholecystectomy specimens. The Materials And Methods: present study was a cross sectional descriptive study of all cholecystectomy specimens received in the department of pathology, NRI Institute of Medical Sciences, Sangivalasa, Visakhapatnam, Andhra Pradesh; conducted over a period of 12 months from September 2021 to August 2022. The relevant and detailed clinical history were taken and processing was done in these specimens for histopathological examination. A total of 80 cholecystectomy specimens were received in the Results: department. Out of which, 79 were in?ammatory gall bladder lesions and only one case was reported as malignancy. The most common age group affected were in 4th to 5th decade with female preponderance comprising of 47cases (58.75%) while the gall bladder carcinoma was reported in 72 years of age. Among the in?ammatory lesions, most common one was chronic cholecystitis comprising of 64 cases, 80.5% (63.6% associated with gall stones) were chronic cholecystitis, followed by 10 cases (12.5%) of acute cholecystitis (100% associated with gall stones), 2cases (2.5%) of polyps & Adenomyomatosis each. Only one case (1.25%) of each Cholesterolosis & gall bladder adenocarcinoma was reported. Chronic cholecystitis is the Conclusion: most common gall bladder disease for which cholecystectomies are being done. The present had reported various morphological patterns encountered in the cholecystectomy specimens received in the department

Dysfunction of cholesterol sensor SCAP under high phosphate condition promotes cholesterol accumulation in macrophage / 第二军医大学学报

Objective To explore the effects of high phosphate (Pi) condition on the cholesterol accumulation in macrophage and its underlying mechanisms. Methods The human monocytic cell line THP-1 derived macrophages were divided into control group (concentration of Pi being 1.0 mmol/L), high Pi exposure group (concentration of Pi being 3.0 mmol/L), phosphonoformic acid (PFA) treatment group (concentration of Pi and PFA being 1.0 mmol/L) and high phosphate plus PFA treatment group (concentration of Pi and PFA being 3.0 mmol/L and 1.0 mmol/L, respectively). Intracellular neutral lipids were observed by Oil Red O staining. Cholesterol contents were quantified by enzyme catalyzed colorimetry. qPCR was used to dectect the relative mRNA expressions of 3-hydroxy-3-methyl-glutaryl coenzyme A reductase(HMGCoAR), low density lipoprotein receptor (LDLR) and sterol regulatory element binding protein (SREBP) cleavage activating protein (SCAP), and their proteins and nuclear SREBP 2 (N-SREBP2) protein expressions were assessed by Western blotting. The translocation of SCAP from endoplasmic reticulum (ER) to Golgi body was observed by laser confocal microscope. Results Compared with the control group, the macrophages in the high Pi exposure group showed an obvious aggregation of neutral lipids and significantly increased contents intracellular cholesterol ester and total cholesterol (P0.05). Conclusion Under high Pi condition, sodium-phosphate transporter Pit-1 mediates the entry of phosphorus ions into the macrophages. High Pi concentration in macrophages up-regulates the protein level via an post transcriptional pathway and induces the dysfunction of SCAP, which facilitates the transport of SREBP2 from ER to Golgi body. SREBP2 in Golgi body is splitted, activited and releases N-SREBP2. The N-SREBP2 translocates into the nucleus and promotes the expressions of LDLR and HMGCoAR, increasing exogenous LDL uptake and endogenous cholesterol synthesis leading abnormal accumulation of intracellular cholesterol.

A Case of Cholesterosis Bulbi with Secondary Glaucoma Treated by Vitrectomy and Intravitreal Bevacizumab

We report on a case of cholesterosis bulbi concurrent with secondary glaucoma. A 36-year-old man, with a history of long-standing retinal detachment in his right eye after the irrigation and aspiration of a congenital cataract, presented with a clinical picture of elevated intraocular pressure and ocular pain. Upon slit-lamp examination, we found a ciliary injection and a pseudohypopyon of polychromatic crystals. Gonioscopic examination revealed a large amount of crystals deposited on the trabecular meshwork and mild rubeosis iridis, but the neovascularization of the angle could not be clearly confirmed due to the presence of so many crystals. Pars plana vitrectomy was performed to remove clusters of crystals and bevacizumab was injected intravitreally to treat iris neovascularization. Aqueous aspirate was examined by light microscopy and the typical highly refringent cholesterol crystals were identified. Intraocular pressure returned to a normal level after the bevacizumab injection, although severe cholesterosis was still evident in the anterior chamber. To our knowledge, this would be the first Korean case of cholesterosis bulbi combined with chronic retinal detachment and presumed neovascular glaucoma, which was treated by pars plana vitrectomy and intravitreal bevacizumab injection.