Supporting the role of penile trauma and micro-trauma in the etiology of Peyronie's disease. Prospective observational study using the electronic microscope to examine two types of plaques.

OBJECTIVES: The etiopathogenesis of Peyronie's disease (PD) remains not clearly understood. The most accepted theory attributes the histological lesions of PD to the effects of trauma to the corpora cavernosum of the penis. The aim of our study is to verify whether similar histological features exist between these two tissues, providing new evidence in favor of the traumatic theory in the etiopathogenesis of Peyronie's disease. MATERIALS AND METHODS: A prospective observational study was carried out at our institution from January 2013 to June 2018, involving patients having undergone surgery for PD and those with delayed surgery for penile trauma. Both excised PD and post-traumatic plaques were analyzed by blind pathologists with an 80kV potential acceleration electron microscope. RESULTS: Five patients were identified with a post-traumatic plaque (Group 1) and therefore an equal number of PD patients were enrolled for Group 2. The ultrastructural characteristics of the two types of preparations were very similar. In all the samples we showed an inflammatory reaction of the structure of the tunica albuginea, a production of the disorganized extracellular matrix, a proliferation of inflammatory cells and fibroblasts. Furthermore, we have found an increase in the density and collagen deposits grouped in the extracellular space and within the fibroblasts. CONCLUSIONS: These findings support the theory that attributes lesions and symptoms typical of PD to the effects of cavernous body trauma.

Early effects of portal flow modulation after extended liver resection in rat.

INTRODUCTION: The incidence of small-for-size-liver-syndrome after liver transplantation and extended liver resection may be reduced by portal flow modulation. However, many aspects of the small-for-size-liver-syndrome pathogenesis are still unclear. In this experimental study we evaluated the early effects of portal flow modulation after 80% hepatic resection in rats. MATERIALS AND METHODS: Rats were randomised in: sham operation (G1), conventional hepatic resection (G2), splenectomy and hepatic resection (G3), splenic transposition followed by hepatic resection after three weeks (G4). Six hours after operation, oxygen saturation of hepatic vein blood, glutathione, and standard liver markers were measured from hepatic venous blood. Glutathione measurement and histopatological examination were performed in the remnant liver. RESULTS: Total bilirubin and liver glutathione did not show differences between groups. Aspartate aminotransferase and alanine aminotransferase significantly increased in G2-G4 groups. Blood glutathione and oxygen saturation of hepatic vein blood were lower in G2 than in other groups. A gradient of micro-vesicular degeneration was more severe in G2 compared with G3 and G4. Apoptosis, hemorrhagic necrosis, mitochondrial damage and leucocyte adhesion were evident in G2. CONCLUSION: The portal flow modulation induced by splenectomy or splenic transposition was effective in limiting early damage after extended liver resection.

Primary embryonal spindle cell cardiac rhabdomyosarcoma: case report.

Primary cardiac tumors are rare. Of all primary heart neoplasms, sarcomas account for around 10%, and of these, rhabdomyosarcomas (RMS) constitute a minority. A case of primary left atrial RMS, reminiscent of leiomyosarcoma, is reported herein. Histologically, the tumor was composed of tightly-packed spindle-shaped cells arranged in long fascicles. At immunohistochemistry, the tumor cells stained strongly and diffusely with vimentin, muscle-specific actin, desmin and myogenin, and focally with fast-myosin and sarcomeric actin. WT-1 showed diffuse and intense cytoplasmic staining. Staining for calponin was weak. Staining for alpha-SMA, H-caldesmon, CD34, epithelial membrane antigen (EMA), keratin wide-spectrum (CK w.s.), and S100 protein was negative. Electron microscopy revealed poorly differentiated spindle cells, containing contractile filaments with a "Z-band-like" appearance. The final diagnosis was embryonal RMS, spindle cell variant. Conclusively, spindle cell RMS is a well-recognized variant of embryonal RMS, typically occurring in soft tissue, with only rare cases described in visceral organs. This is the first case of primary cardiac spindle cell RMS ever described.