Electron microscopy of the morphological changes in rat viscera during experimental hyperthermic shock.

Hyperthermic shock is a thermoregulatory disorder that affects living organisms that are acutely or chronically exposed to high temperatures or when performing intense physical activity in a hot environment. In this paper, we will show the changes embodied in hyperthermic shock caused by multiple injuries to vital organs in Wistar rats that were suddenly exposed to high temperatures of up to 410 for about 10-15 minutes, their central temperature rising above 40.60C. This process resulted in multiple injuries of the vital organs, evidenced by electron microscopy. In addition, this suggested that most changes caused by hyperthermic shock are incompatible with life.

Morphological changes during acute experimental short-term hyperthermia.

Wistar rats have been exposed to progressively higher temperatures for 30 minutes to 40.5 degrees Celsius. The animals were sacrificed 30 minutes after cessation of exposure. Harvested organs (heart, lung, liver, pancreas, kidneys, and adrenal gland) show numerous vascular lesions. Massive red blood cells extravasation and vascular stasis partially fragments the myocardial fibers. Pulmonary capillary dilatation and red blood cells intra-alveolar extravasation cause a hemorrhagic alveolitis that tends to a red hepatization. The liver responds by dilating centrolobular veins, vessels in port area and by granulo-vacuolar dystrophy. Pancreas seems less affected. Vascular hyperemia is discrete while in kidney the vascular spaces are narrowed and the proximal and distal tubules cloudy intumescent appears. In suprarenal gland appear many interstitial capillary dilatation and blood cells extravasation among cell nests of medulla. All these changes induce functional organ failure.

[The long Telegraph nail for humeral fractures]. / Le clou Telegraph long dans les fractures de l'humérus.

PURPOSE OF THE STUDY: We present an anterograde nailing system for humeral shaft fractures: the long Telegraph(R) nail. This nail enables static or dynamic anteroposterior distal locking and is easy to insert with the special aiming device. MATERIAL AND METHOD: This study concerned 148 patients who underwent surgery between September 1998 and February 2005, 86 women, men age 68 years and 62 men, mean age 53 years. After excluding patients lost to follow-up and pathological fractures, we analyzed 104 files to determine the rate of nonunion as a function of distal locking or not and dynamic versus static locking. We also reviewed 56 patients measuring the Constant score at mean 2.7 years follow-up. RESULTS: There were no cases of iatrogenic radial palsy and no cases of infection. There were four cases of nail fracture. The overall rate of nonunion was 7.7%. Nonunion was never observed with dynamic distal locking (p=0.03). Regarding the effect of the nail on shoulder function, the mean weighted Constant score was 105.4% with preservation of mean joint motion and a pain free shoulder in 36/56 patients. DISCUSSION: The long Telegraph(R) nail enables anterograde nailing of the humeral shaft with a simplified system for dynamic or static distal locking. In this series, dynamic distal locking appeared to provide the best rate of nonunion. If installed correctly, the system does not appear to affect shoulder function.

Morphological study of congenital megaureter.

Congenital anomalies of the kidney and urinary tract are frequent. They can be detected once every 500 ultrasonography fetal examinations. Causes that determine a dilated ureter compared to the rest of the urinary tract are still partly unknown. If concerning the exploration and the clinical diagnosis of these anomalies important progresses have been made, the morphological research is still able to bring forth data that, together with genetic researches, may help reveal the pathogeny of the disease and may ease the planning of the screening genetic tests for early diagnosis. Material and methods. During the surgical operations realized in order to recalibrate the ureter, ureter fragments have been harvested, colored with 1% tionin, in sections thinner then 1 micron and examinated through immersion, ob. 100x. Other fragments have been prepared and examinated through electronic microscope. We have followed the structural modifications of the muscular tissue, nervous tissue, connective tissue and the rapports between these components. Results. Congenital megaureter presents qualitative and quantitative anomalies of the connective tissue and muscular tissue, and also structural modifications of the nervous tissue. Connective tissue. We have noticed the abundance of the connective tissue in congenital megaureter. Connective tissue, with an important representation of typical elements, such as fibroblasts, mastocytes and plasmocytes is partly hyalinated, dissociating muscular fiber bundles and nervous fiber bundles. Connective tissue/muscular tissue report is evidently increased. Muscular tissue. Muscular fibers are hypoplasic, smooth endoplasmic reticulum is present in the tubular form, rare mitochondria are vacuolized. Dense corps are increased in number, plasmatic membranes are folded. Sarcoplasm contains vacuolized organites. The nuclei are rigged with visible nucleoli. Nervous structures. We have noticed varied alterations of the axons and myelin. In some axons there are multiple cavities that may produce the opacifiation of the entire axonal structure. The proliferation of the myelin sheath under the nodular form or vortex form produces the destruction of the axonal structure. Mitochondria are condensed, partially vacuolized. The modifications in the axonal structure and those of the myelin sheath determine modifications of the nervous excitability and conductibility. All the lesions we have pointed out in congenital megaureter participate in compromising of the peristaltic. Nervous and muscular structures lesions indicate a process of incomplete development of the ureter. They are structures that do not achieve functional maturation. We may consider congenital megaureter as a digenesis with hypoplasia.

The histological changes of digestive organs in experimental decreases of hepatic venous outflow at the rat.

The hepatic venous outflow may be diminishing in right-sided heart diseases, constrictive pericarditis, obstruction of suprahepatic veins or an inferior vena cave. It was created an experimental model by obstruction of the suprahepatic veins lumen and inferior vena cave, too, at the adult Wistar rats. The animals were sacrificed in the 30 days after operation. At the iterative laparatomy it was found the liver more increased in volume, a little amount of ascites in peritoneal cavity, oedema of the digestive organs walls. Liver and stomach fragments were prelevated and were processed for optic microscopy and electronic microscopy. The morphological study using by usual technics has highlighted vascular stasis in gastric submucosa. In liver it is standed out the pericentrolobular vascular stasis, inflammatory lymphoplasmocytic infiltrate around the end of hepatic vein. In the gastric submucosa have found vascular stasis, and within the chorion mucosa, the high capillary hyperemia. There is a discreet vacuolar feature on epithelium surface of the gastric mucosal in pyloric region. In the other layers, at rats the epithelium multistratum keratinizated of the stomach is without changes, in this region is maintaining the hyperemia in mucosal chorion.

Ultrastructural features of blood cells in atherosclerosis.

Atherosclerosis is a complex process that affects specific tissues of the vasculature, susceptible to developing atherosclerosis. >From 10 patients with atherosclerosis, between 50-70 years, peripheral blood was prelevated and after the technical procedures the blood cells were studied using the electron microscopy. The most characteristic morphological modifications were observed in agranulocytes and platelets. The granulocytes polymorphs showed insignificant ultrastructural changes, and the erythrocytes presented weak anizocytosis and poikilocytosis.

Considerations on the sinus node microangioarchitecture.

The importance of the sinus node as the cardiac pacemaker is well known. The aim of the present study was to investigate the microangioarchitecture at the level of the sinus node. Ten human adult hearts were injected with India ink in the initial segments of the coronary arteries. Pieces were drawn and diaphanized. The results of the study can be summarized: (1) the sinus node is rather an irregularly shaped structure, with peripheral strands intermingling with strands of the atrial myocardium; at this level two vascular patterns can be recognized: (a) the myocardial capillary networks that parallels the muscular bundles, and (b) the peripheral nodal networks built upon dichotomizing arterioles; (2) it seems that while the thick and large sinus node artery does not branch in the nodal tissue, the blood supply of this tissue is ensured by the peripheral nodal networks; (3) characteristically, in the periphery of the nodal tissue are largely present glomeruli made by capillaries with pericellular dispositions. The results strongly suggest that the nodal tissue is mainly supplied from its periphery and the sinus node artery is rather a scaffold than a supplier of that tissue.

Considerations on the left papillary muscles microangioarchitecture.

The aim of the present study was to bring macroscopic and microscopic evidence on the left papillary muscles blood supply in human hearts. For the study were used human adult hearts from patients without clinically known cardiac ischemic history. Ten hearts were used for injecting China ink in the coronary arteries and other twenty hearts were dissected to evidence the characteristics of the main arteries of the left papillary muscles. Pieces - left papillary muscles - were drawn from the injected hearts and diaphanised. In all dissected hearts the left anterolateral papillary muscles were supplied by the left coronary system: anterior interventricular artery, second diagonal branch and left (obtuse) marginal artery. In 70% the left posteromedial papillary muscles were supplied by the right coronary system (posterior interventricular artery, left retroventricular artery) and in 30% by the left coronary system (circumflex artery). The left papillary muscles were supplied each by one or two main arteries that penetrated the muscles longitudinally. The ventricular wall attaching the papillary muscles was supplied by the subepicardial vessel sending the main arteries of the papillary muscles but also by neighbor subepicardial vessels distributed in that wall. The mural vessels were finer than the papillary muscles main arteries. Injected papillary muscles presented each with two systems of blood perfusion: one represented by segmental centers of arterial branching and distribution of the main arteries of the muscle and other represented by capillary extensions of the mural networks at that level. From the segmental branching centers were perfused the neighbor segments of the papillary muscles and intrasegmental anastomoses were recognized. The microvascular study of the left papillary muscles proves the usual overlapping of sources for segmental supply; this overlapping is reinforced by the high capillary density to ensure the vascularisation of the papillary muscles.

Novel type of interstitial cell (Cajal-like) in human fallopian tube.

We describe here--presumably for the first time--a Cajal-like type of tubal interstitial cells (t-ICC), resembling the archetypal enteric ICC. t-ICC were demonstrated in situ and in vitro on fresh preparations (tissue cryosections and primary cell cultures) using methylene-blue, crystal-violet, Janus-Green B or MitoTracker-Green FM Probe vital stainings. Also, t-ICC were identified in fixed specimens by light microscopy (methylene-blue, Giemsa, trichrome stainings, Gomori silver-impregnation) or transmission electron microscopy (TEM). The positive diagnosis of t-ICC was strengthened by immunohistochemistry (IHC; CD117/c-kit+ and other 14 antigens) and immunofluorescence (IF; CD117/c-kit+ and other 7 antigens). The spatial density of t-ICC (ampullar-segment cryosections) was 100-150 cells/mm2. Non-conventional light microscopy (NCLM) of Epon semithin-sections revealed a network-like distribution of t-ICC in lamina propria and smooth muscle meshwork. t-ICC appeared located beneath of epithelium, in a 10-15 microm thick 'belt', where 18+/-2% of cells were t-ICC. In the whole lamina propria, t-ICC were about 9%, and in muscularis approximately 7%. In toto, t-ICC represent ~8% of subepithelial cells, as counted by NCLM. In vitro, t-ICC were 9.9+/-0.9% of total cell population. TEM showed that the diagnostic 'gold standard' (Huizinga et al., 1997) is fulfilled by 'our' t-ICC. However, we suggest a 'platinum standard', adding a new defining criterion- characteristic cytoplasmic processes (number: 1-5; length: tens of microm; thickness: < or =0.5 microm; aspect: moniliform; branching: dichotomous; organization: network, labyrinthic-system). Quantitatively, the ultrastructural architecture of t-ICC is: nucleus, 23.6+/-3.2% of cell volume, with heterochromatin 49.1+/-3.8%; mitochondria, 4.8+/-1.7%; rough and smooth endoplasmic-reticulum (1.1+/-0.6%, 1.0+/-0.2%, respectively); caveolae, 3.4+/-0.5%. We found more caveolae on the surface of cell processes versus cell body, as confirmed by IF for caveolins. Occasionally, the so-called 'Ca2+-release units' (subplasmalemmal close associations of caveolae+endoplasmic reticulum+mitochondria) were detected in the dilations of cell processes. Electrophysiological single unit recordings of t-ICC in primary cultures indicated sustained spontaneous electrical activity (amplitude of membrane potentials: 57.26+/-6.56 mV). Besides the CD117/c-kit marker, t-ICC expressed variously CD34, caveolins 1&2, alpha-SMA, S-100, vimentin, nestin, desmin, NK-1. t-ICC were negative for: CD68, CD1a, CD62P, NSE, GFAP, chromogranin-A, PGP9.5, but IHC showed the possible existence of (neuro)endocrine cells in tubal interstitium. We call them 'JF cells'. In conclusion, the identification of t-ICC might open the door for understanding some tubal functions, e.g. pace-making/peristaltism, secretion (auto-, juxta- and/or paracrine), regulation of neurotransmission (nitrergic/purinergic) and intercellular signaling, via the very long processes. Furthermore, t-ICC might even be uncommitted bipotential progenitor cells.

Interstitial cells of Cajal in pancreas.

We show here (presumably for the first time) a special type of cell in the human and rat exocrine pancreas. These cells have phenotypic characteristics of the enteric interstitial cells of Cajal (ICC). To identify pancreatic interstitial cells of Cajal (pICC) we used routine light microscopy, non-conventional light microscopy (less than 1 mum semi-thin sections of Epon-embedded specimens cut by ultramicrotomy and stained with Toluidine blue), transmission electron microscopy (TEM), and immunocytochemistry. The results showed that pICC can be recognized easily by light microscopy, particularly on semi-thin sections, as well as by TEM. Two-dimensional reconstructions from serial photos suggest a network-like spatial distribution of pICC. pICC represent 3.3+/-0.5% of all pancreatic cells, and seem to establish close spatial relationships with: capillaries (43%), acini (40%), stellate cells (14%), nerve fibres (3%). Most of pICC (88%) have 2 or 3 long processes (tens of mum) emerging from the cell body. TEM data show that pICC meet the criteria for positive diagnosis as ICC (e.g. numerous mitochondria, 8.7+/-0.8% of cytoplasm). Immunocytochemistry revealed that pICC are CD117/c-kit and CD34 positive. We found pICC positive (40-50%) for smooth muscle alpha-actin or S-100, and, occasionally, for CD68, NK1 neurokinin receptor and vimentin. The reactions for desmin and chromogranin A were negative in pICC. At present, only hypotheses and speculations can be formulated on the possible role of the pICC (e.g., juxtacrine and/or paracrine roles). In conclusion, the quite-established dogma: "ICC only in cavitary organs" is overpassed.

[The repair of voluminous postoperative abdominal wall defects with synthetic mesh]. / Repararea defectelor parietale abdominale voluminoase postoperatorii cu plase sintetice.

Important postoperative abdominal wall defects, especially recurrent or multirecidivated ones, are raising multiple problems to the surgeon. We are presenting a homogeneous trial of 209 patients with such lesions, in which the abdominal wall repair was made with different kind of synthetic materials, with good results. In a single case the mesh was rejected, because a silent quiescent infection. In three patients undergoing iterative abdominal operations for other diseases we performed optical and electronic microscopical studies showing out that the material integration was done by normal biological reaction. This provides the materials' tolerability and a normal reaction of the organism.

Disseminated Langerhans cell histiocytosis: a case report with a light microscopic and ultrastructural study.

A case of disseminated Langerhans cell histiocytosis (L.C.H.) in a 9 month-old boy is reported. The clinical picture was characterized by severe multivisceral involvement with cutaneous and bone lesions. Histological examination of the skin biopsy revealed diffuse infiltration of large mononucleated histiocytes admixed with a small number of inflammatory cells. Ultrastructural examination confirmed the Langerhans cell (L.C.) phenotype by showing intracytoplasmic Birbeck granules in the proliferating histiocytes. We report the histological and ultrastructural characteristics of our case and review the diagnostic features of L.C.H. in the light of the criteria established by the Writing Group of the Histiocytic Society in 1987.

Some aspects of oxidative metabolism in human endometrium after long time of applying the intrauterine contraceptive device.

The paper intends to study the variation of oxidative metabolism of human endometrium (all the components) after applying the intrauterine contraceptive device for a long period of time. The results of the study show that modifications "in situ" of the oxidative enzymes vary according to the: type of the enzymes (NADH2-cytochrome-c-reductase, Lactatdehydrogenase), the hormonal cyclic stage (proliferative phase, or luteal phase), epithelial or connective tissue structures, time of resting the intrauterine contraceptive device (DIU) in uterus.

Study on the normal and pathologic structures of the hard dental tissues using the scanning electron microscope.

The recent use in biology of the Scanning Electron Microscope allows a new vision of the sample, completing the previous ones: the Optical Microscope (OM) and the Conventional Electron Microscope--CEM. The object is observed in space, in a direct way and, due to a system of variable sizes, the passage from a general image to the detailed tissue and cell study is permitted. The outer enamel surface with its perikymaties, its flaws and its changes caused by usage as well as by the internal enamel structure on the fractured area have been studied. On the occlusal surface of the decayed teeth, focal holes have been found; they resulted probably from creation disturbances due to some amelogenetic disorders that damage the ameloblast, matrix creation or its mineralization. These lacunar flaws are the favourite zones for the microbe plate accumulation and propitious to carious lesions initiation. The same clinical aspect, of profound enamel creation defects with an anfractuous crevass network aspect, having a variable expansion and depth, can be found in microscope with some healthy teeth. Regrouping in fascicles of the different prism directions can be found after structural analysis of the prismatic morphology of the parodontotic tooth enamel. An aspect of a more compact structure is thus obtained sectionally. This explains partially the increased resistance to decay of these teeth. In a comparative study of the fractioned area of some decayed and ruined temporary teeth, significant differences in prism arrangement can be found. The decayed teeth show expansions of the intraprismatic spaces, accusing reduced resistance against decay attack.

Congenital ichthyosiform erythroderma (C.I.E.)--ultrastructural evidences of abnormal stratum corneum retention.

Congenital ichthyosiform erythroderma (C.I.E.) is a skin disorder which has been considered as a hyperkinetic hyperkeratosis. This study was performed in order to demonstrate that C.I.E. pathogenesis includes both basal cell hyperplasia and abnormal stratum corneum retention. Electron microscopic studies were carried out on 5 cases of C.I.E., clinically and histopathologically diagnosed. The following pathological changes were found in stratum corneum and stratum granulosum: persistence of desmosomes in outer layers of stratum corneum, increased volume of intercorneocyte material, loss of lamellar pattern of Odland bodies, important variability in size and shape of keratohyaline granules, abnormal aggregation of tonofilaments. These constitute ultrastructural evidences of abnormal stratum corneum retention in C.I.E. pathogenesis.

Typical and atypical carcinoid tumors of lung: two distinct clinicomorphologic entities.

Thirty-six cases of bronchopulmonary carcinoid tumor were reviewed in order to identify the clinicomorphologic criteria whereby typical and atypical carcinoids can be classified as two distinct entities. This study indicates that bronchial typical carcinoids are tumors with very low malignancy, more often centrally located and occurring in relatively young patients. The prognosis is good, with a five year-survival rate of about 73%, although regional nodal metastases may occasionally develop. Atypical carcinoids are more frequently peripheral tumors, occurring in comparatively old patients and differing from typical carcinoids by a less favourable prognosis, with a five year-survival rate of about 25% and a higher incidence of nodal metastases. The morphological study of these tumors reveals the following criteria as most reliable for distinguishing between the two types of bronchial carcinoid: increased mitotic activity, cellular pleomorphism and tumor necrosis, which are best correlated with the agressiveness of atypical carcinoids.

Structural and ultrastructural evidence regarding immunologically mediated-pathogenesis in mucosal lichen planus.

Tissue samples from six patients suffering from lichen planus (L. P.), with oral and genital localization were examined by light and transmission electron microscopy, in order to better define the structural and ultrastructural changes that are correlated with L. P. and fit with immunologically mediated pathogenesis theory. Many of the classical histopathological features of L. P. were found: the hydropic degeneration of basal keratinocytes, presence of colloid bodies and heavy chronic chorionic inflamatory cell infiltrate. There were also observed several differences from skin localization of L. P. consisting in more frequent parakeratosis, obvious atrophy of the epithelium, pathological presence of granular layer. Ultrastructural studies confirm and clarify the light microscopic picture: basal lamina is frequently broken, basal keratinocytes are degenerated, presenting thickening, clumping and disorders of orientation of tonofilaments. There are many Langerhans cells. The inflammatory infiltrate is composed of interacting cells: many T-lymphocytes and activated macrophages, few B-lymphocites and plasma cells.