Novel technique of development of human derived acellular dermal matrix.

Reconstructive surgery techniques have evolved exponentially in last decades. From regional flaps to free tissue transfer, tissue movilization has become the gold standart treatment in many reconstructive procedures. Main disadvantage from these techniques lies in the possibility of sequels in donor zone. Furthermore, raising comorbidities in general population and growing indications for reconstructive surgery in elder people, have triggered the development of new biomaterials which can offer support in the reconstruction while elicit donor zone morbidity. Advances in tissue decellularization techniques have brought numerous matrices which have shown effectivity in many reconstructive procedures. Use of acellular dermal matrices may become an eligible solution for many reconstructive procedures. From breast reconstruction assisted by matrices to complex wound coverage passing throught tendon repair techniques, acellular dermal matrices have shown effectiveness in last studies. Local production of this biomaterial leads to cost minimization derived from harvesting and manufacturing matrices in our centre and avoid out-of-stock and storage issues. Current original protocol proposed by our group include all steps from harvesting samples from cadaveric donors till matrix storage after decellularization proccess. The result is a high valued biomaterial in terms of biocompatibility and security profile available.

[Minimally invasive percutaneous musculoskeletal biopsy performed by Interventional Pathologist for myopathy study. Twenty years of experience]. / Biopsia percutánea muscular mínimamente invasiva realizada por patólogo intervencionista en el estudio de miopatías. Veinte años de experiencia.

INTRODUCTION: Muscle biopsy plays a major role in the final diagnosis of myopathies. Open muscle biopsy is the benchmark procedure, although minimally invasive percutaneous muscle biopsy (MIPMB) has demonstrated comparable diagnostic performance at a lower cost and can be carried out by interventional pathologists. MATERIALS AND METHODS: Muscle biopsies performed from 1997 to 2017 were reviewed and classified according to the type of procedure, whether carried out by an interventional pathologist or another specialist, the diagnosis and the effectiveness of the procedure. RESULTS: 738 muscle biopsies were performed; 32% were open biopsies and 68% MIPMB carried out by pathologist. The muscle most often biopsied was the femoral quadriceps and the most frequent diagnosis was inflammatory myopathies. In only 39 cases (20 open biopsies and 19 MIPMB) was there insufficient tissue for diagnosis. CONCLUSIONS: Muscle biopsy proved highly effective as a diagnostic tool as 90% yielded adequate tissue samples. The results obtained with MIPMB performed by interventionist pathologists were comparable to those of open muscle biopsy.

Miositis de células gigantes asociada a miastenia gravis y timoma / Giant cell myositis associated with myasthenia gravis and thymoma

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Aplicación práctica de métodos estereológicos renales en modelos animales experimentales / Practical application of stereological methods in experimental kidney animal models

Los riñones son órganos vitales que realizan funciones de excreción, equilibrio hidroelectrolítico y producción de hormonas. La nefrona es su unidad estructural y funcional. El número, tamaño y distribución de los componentes de la nefrona contienen información relevante sobre la función renal. La estereología es una rama de la morfometría que permite, aplicando reglas matemáticas, obtener información tridimensional de estructuras biológicas a partir de cortes microscópicos bidimensionales, seriados, paralelos y equidistantes. Ante la complejidad de los estudios estereológicos y la carencia de una bibliografía clara sobre el desarrollo de los mismos, el objetivo de este trabajo es explicar de forma sencilla y con ejemplos, utilizando un modelo animal, los conceptos básicos de estereología, así como el cálculo de los principales parámetros estereológicos renales y que estos puedan ser aplicados en futuros estudios experimentales (AU)

The kidneys are vital organs responsible for excretion, fluid and electrolyte balance and hormone production. The nephrons are the kidney's functional and structural units. The number, size and distribution of the nephron components contain relevant information on renal function. Stereology is a branch of morphometry that applies mathematical principles to obtain three-dimensional information from serial, parallel and equidistant two-dimensional microscopic sections. Because of the complexity of stereological studies and the lack of scientific literature on the subject, the aim of this paper is to clearly explain, through animal models, the basic concepts of stereology and how to calculate the main kidney stereological parameters that can be applied in future experimental studies (AU)

Practical application of stereological methods in experimental kidney animal models. / Aplicación práctica de métodos estereológicos renales en modelos animales experimentales.

The kidneys are vital organs responsible for excretion, fluid and electrolyte balance and hormone production. The nephrons are the kidney's functional and structural units. The number, size and distribution of the nephron components contain relevant information on renal function. Stereology is a branch of morphometry that applies mathematical principles to obtain three-dimensional information from serial, parallel and equidistant two-dimensional microscopic sections. Because of the complexity of stereological studies and the lack of scientific literature on the subject, the aim of this paper is to clearly explain, through animal models, the basic concepts of stereology and how to calculate the main kidney stereological parameters that can be applied in future experimental studies.

Brain death effects on catecholamine levels and subsequent cardiac damage assessed in organ donors.

BACKGROUND: Brain death (BD) causes hemodynamic and neuroendocrine alterations including a catecholamine surge, which in turn causes histologic lesions in cardiac muscle such as contraction bands, focal mononuclear cell infiltrates and cardiomyocyte necrosis. These changes are likely to compromise heart function and could therefore also affect the graft response after heart transplantation. This study was designed to examine the catecholamine surge, the catecholamine release pattern and the histologic lesions traditionally described as characteristic of BD in hearts procured from BD donors. METHODS: After BD diagnosis, specimens were taken from the left ventricle (n = 50) for histologic examination. Arterial blood samples were collected from 40 of the donors at different time-points (1 hour before BD; on BD diagnosis; and 1, 2, 3 and 4 hours after BD) to determine catecholamine levels by high-performance liquid chromatography (HPLC). RESULTS: The three hormones examined showed above-normal levels (epinephrine 2.36-fold, norepinephrine 8.56-fold, dopamine 54.76-fold). Release patterns included epinephrine and dopamine peaks at the time of BD and a norepinephrine peak 1 hour later. Fifty percent of the BD donors showed contraction bands and 62% displayed cardiomyocyte necrosis, which was associated with focal mononuclear cell infiltrates in 18% of cases. In 40% of donors, colocalized apoptotic and necrotic damage was observed. CONCLUSIONS: Differing extents of BD-associated cardiac lesions were observed in the donors, and >50% also showed apoptotic damage. The expected catecholamine peak at the time of BD was only detected for epinephrine and dopamine. Hormone increases were below those described in the literature, except for dopamine.

72 year-old man with new seizure while dancing.

Metastasis of an extracranial malignant neoplasm to a meningioma is a rare event.We report a case of a 72-year-old man who presented abruptly with a grand mal seizure. Neuroradiological examination revealed an extraaxial lesion located in the posterior right frontal convexity with poorly defined boundaries. Histological and immunohistochemical examination showed that the lesion was a meningothelial meningioma harboring metastatic renal cell carcinoma.The MRI could be indicative but not specific of this type of lesion.Some cases of intracranial meningiomas containing metastatic carcinomas have been published, but to our knowledge only five cases of renal cell carcinoma metastasizing to a meningioma have been reported. Possible explanations for this type of "tumor in tumor" lesion are reviewed.

A molecular approach to apoptosis in the human heart during brain death.

BACKGROUND: Brain death induces changes in tissues and organs destined for transplant at the cell, molecular, and endocrine level including cell death through apoptosis. This study was designed to examine apoptotic damage in cardiac tissue obtained from brain dead donors. METHODS: Fifty tissue specimens from the left ventricles of individual donors were processed to evaluate changes in the expression levels of five genes involved in apoptosis (BAX, BCL2, CASPASE 3, CYTOCHROME C, and FAS) using the real time-polymerase chain reaction technique. Expression levels were quantified by the relative standard method and results normalized to the levels recorded for the endogenous control peptidylprolyl isomerase A. The HIF1alpha gene was also determined to check for the possibility of hypoxic damage. Control ventricular tissue specimens were obtained from patients undergoing mitral valve replacement. RESULTS: Using a mixed linear model it was determined that the sample type (donor vs. control patient) significantly affected (P<0.0001) expression levels of the genes examined reflected by their Ct values. Three of the genes (BAX, CASPASE 3, and FAS) showed significantly higher (Student's t test, P<0.05) expression levels (4.89-, 7.85-, and 12.14-fold endogenous control values, respectively) in donors compared with control patients (2.31-, 2.64-, and 3.57-fold endogenous control values, respectively) indicating the activation of apoptosis during brain death. CONCLUSION: Our findings suggest the possibility of using antiapoptosis agents to prevent cardiac injury and improve posttransplant behavior.

Histologic findings and comparison with sputum smears in pulmonary aspiration of vegetable particles in syringomyelia: a case report.

BACKGROUND: Pulmonary aspiration of vegetable matter may be a serious cause of lung damage, requiring, almost always, the help of a histopathologic examination. CASE: We report the case of a 55-year-old woman with a granulomatous pneumonitis due to repeated pulmonary aspiration of vegetable particles and affected by a syringomyelia. Histologic findings from a lobectomy section are shown and compared with those observed in different cytologic sputum samples. CONCLUSION: The recognition of uncommon morphologic structures, and their comparison with others already known, both in histologic sections and in cellular smears, may be useful when it comes to establishing a sure diagnosis.

Aplicación de los Tissue Microarrays en el estudio inmunohistoquímico de los tumores / Applying Tissue Microarrays in tumor immunohistochemistry studies

Los tissue microarrays (TMAs) hacen posible agruparmás de 1.000 tumores en una sola laminilla, y ser utilizadospara el análisis de numerosos marcadores de interés diagnóstico,pronóstico o de ayuda en la decisión terapéutica yselección de estudios moleculares. Así hace posible ladetección y estudio de DNA y RNA (por hibridación in situo FISH) y proteínas (inmunohistoquímica).El objetivo de este estudio fue comprobar la representatividadde los TMAs en el estudio morfológico de diferentestumores y valorar los TMAs como herramienta para elestudio inmunohistoquímico. Los TMA se realizaron enadenocarcinomas de pulmón, adenocarcinomas de colon,carcinomas escamosos y oat-cell pulmonares, en el HospitalUniversitario Central de Asturias. Pudimos comprobarque los TMAs con tres cilindros por cada caso, son representativosdel tumor, tanto cuantitativamente como cualitativamente.La utilización de esta técnica tiene grandes ventajas quehacen posible efectuar un estudio en un tiempo escaso. Ellose halla motivado por una rápida velocidad en el procesamientode las muestras, la posibilidad de análisis simultáneoy estandarizado de múltiples muestras y la existencia de unárea de tamaño suficiente para analizar

Tissue microarrays (TMAs) allow the congregation ofmore than 1000 tumors in a single microscope slide. It canbe used for diagnostic and/or prognostic biomarker analysisthat permits the evaluation of therapeutic strategies or selectionof molecular studies. The TMAs allow the detection ofDNA and RNA by fluorescent in situ hybridization and proteindetection by immunohistochemistry.The purpose of this study was to evaluate the ability ofTMAs to differentiate tumors in morphologic studies and toassess the potential of the TMAs as a tool for immunohistochemistry.The TMAs were performed in lung adenocarcinoma,colon adenocarcinoma, squamous carcinomas andlung oat-cell carcinoma. The study was carry out on theHospital Universitario Central de Asturias in Spain. Wefound that 3 cylinder cuts of each sample provided a quantitativeand qualitative representation of each tumor. Thequick processing time of the samples, the ability to analyzemultiple samples at the same time, and wide area for analysisare the advantages of this technique. In conclusion theTMAs is a promising tool for investigation that will help ingetting results in a shorter period of time

Fine needle aspiration cytology of focal myositis: a case report.

BACKGROUND: Focal myositis is an unusual inflammatwy lesion of the skeletal muscle first described by Heffizer. It is a benign condition and usually involves the muscles of the limbs. CASE: A man presented with a palpable mass in the left leg of 6 months' duration. Nuclear magnetic resonance of the leg showed a mass in the tibial muscle; the presumptive diagnosis was sarcoma of the muscle. Smears showed inflammatory cells, skeletal muscle fibers with degenerative and regenerative changes, and fibrous tissue, suggesting a diagnosis of focal myositis. An incisional muscle biopsy was performed, confirming the diagnosis. CONCLUSION: Focal myositis should always he considered when aspirating muscle masses because it is a clinical mimic of a neoplasm. The prognosis is good, and all cases reported in the literature were self-limiting and gradually resolved.