Cobblestone Pattern Research Articles

Identification of specific glomerular cell types in culture by use of lectin and antibody binding

To characterize the outgrowth of cells from cultured rat glomeruli, we examined the cell morphology in relation to the expression of various antigenic determinants (factor VIII-related antigen, rat Thy 1.1, Heyman nephritogenic antigen, common leucocyte and Ia antigens) and lectin binding patterns. For this purpose, early (3-7 days) to late (4-5 weeks) glomerulus cultures, as well as subcultures of mesangial cells were used. In the early samples, the predominance of small round (type I) cells growing in a cobblestone pattern was noted. These cells failed to express specific binding for any of the antibodies or lectins tested. 5-10% of the outgrowing cells appeared single and morphologically of stellate shape (type II). These cells were reactive for Concanavalia ensiformis (ConA), Triticum vulgaris (WGA) and Ricinus communis (RCA I), and stained for rat Thy 1.1 antigen. Large round, single cells (type III), found mostly at the edges of the outgrowth bound only Bandeiraea simplicifolia (BSI-B4) and FVIII antibodies, a pattern consistent with endothelial cells. A fourth (type IV) cell type, elongated, with cells mostly found in bundles and growing on a layer consisting of other cells, was reactive for ConA, WGA, Limax flavus (LFA) and Maclura pomifera (MPA) lectins. In the late outgrowth (3-5 weeks after explant), the lectin and antibody binding patterns of each cell type remained essentially unchanged. However, considerable changes in the prevalence of the morphologic cell types were noted. Cells that had been subcultured to obtain pure 'mesangial' cells, exhibited the same morphology as the type II cells and expressed identical staining patterns with all probes used. The binding of lectins was likewise confirmed by staining frozen sections of rat kidneys.

Wertigkeit der Röntgenzeichen bei der Verlaufskontrolle des Morbus Crohn

The value of various radiological signs in the follow-up of Crohn's disease has been studied in 175 radiological examinations of the gastro-intestinal tract in 39 patients. Changes in the significant radiological signs in Crohn's disease, such as spicula, cobblestone pattern, stenoses and fistulas, provide information on the development of the disease and on the effect of treatment. The signs have a prognostic significance only insofar as their persistence excludes any improvement. Radiological follow-up is particularly useful for spotting complications and for the early recognition of recurrences.

Human sweat duct cells in primary culture. Basic bioelectric properties of cultures derived from normals and patients with cystic fibrosis

Human sweat duct cells from the coiled reabsorptive segment have been cultured successfully, free from fibroblasts, in a low serum, hormone-supplemented medium, Ham's F12. The cultured cells exhibited a typical epithelial cobblestone pattern, and microvilli-covered luminal cells were seen joined together with typical junctional complexes. In cultures derived from normals and patients with cystic fibrosis (CF), growth and morphologic characteristics were indistinguishable. When grown on a membranous support, and mounted in an Ussing chamber, vectorial electroconductive ion-transport could be identified. The epithelial preparations produced active mucosa to serosa-directed sodium flux via amiloride-sensitive, apical sodium channels and ouabain-sensitive sodium pumps located in the basolateral membrane, which also contained a potassium shunt. These findings are consistent with a polarized epithelium with properties similar to the intact organ. High transepithelial resistance and increased amiloride sensitivity were typical for cells derived from CF, indicating that principal normal as well as pathologic properties of the sweat duct are preserved in culture.

Recognising covert disease in women with chronic vulval symptoms attending an STD clinic: value of detailed examination including colposcopy.

A vulval colposcopy clinic was established in the sexually transmitted diseases (STD) clinic of St Mary's Hospital, London, to investigate patients with chronic symptoms (mean duration 3 1/2 years). Fifty patients with a mean age of 33 were studied for 12 months, and a specific diagnosis was established for many of them. Forty complained of pruritus vulvae, 33 of dyspareunia, and 30 of vulvodynia. One or more macroscopic abnormality was seen in 29 of the women, the most common being erythema, papules, plaques, and fissures. Colposcopic abnormalities, however, were identified in 45 of the women, the most common being acetowhite epithelium in a flat, papillary, or cobblestone pattern. Biopsy specimens were obtained from 33 of the patients, and all had abnormal histological features. Those of human papillomavirus (HPV) infection were the most common, and were found in 27 specimens; evidence of vulval intraepithelial neoplasia was seen in seven and that of dermatoses in 10. Further work is required, however, before concluding that HPV was necessarily responsible for the chronic symptoms.

Epithelial and mesenchymal layers of post-term placental and umbilical cord amnion as viewed by SEM

Scanning electron microscopic observations on the luminal aspect of the high-endothelial postcapillary venules (PCV) of lymph nodes of mice, rats, hamsters, and guinea pigs show that the surface topography of these venules differs considerably from that of other venules. Two types of surface relief occur: one in which the endothelial cells bulge deeply into the lumen, thus presenting the appearance of a “cobblestone” pattern and another in which the endothelial cell has plate-like lateral extensions which intertwine with similar extensions of other cells, thus presenting a surface relief of “interlacing plates.” Both patterns occur in the same PCV. The part of the PCV with the interlacing plate pattern is located distally from the section with the cobblestone pattern and continues directly into the smooth-walled larger venules. Lymphocytes enter the wall of the PCV through the cell body of the endothelial cells regardless whether the luminal relief has a cobblestone or an interlacing plate configuration. To a more limited extent, transmural passage of lymphocytes occurs through the walls of larger and smooth-walled venules with low endothelium. The direction of movement of lymphocytes at such sites is not known.

Nodular hyperplasia of Brunner's glands

A clinical, endoscopic, and histological study of 206 cases of nodular hyperplasia of Brunner's glands was carried out. Firm nodules with a reddened surface due to hyperplastic Brunner's glands were limited mainly to the first part of the duodenum and affected almost exclusively male patients. Gastric acid secretion after pentagastrin stimulation was significantly increased compared to normal. In most cases, biopsies of the nodule center revealed spreading of Brunner's glands from within the lamina propria to the surface epithelium, whereas in biopsies performed between nodules, Brunner's glands were limited to the deeper part of the mucosa. Thirty-six nodules completely removed by diathermy were composed almost entirely of Brunner's glands. The frequent association with duodenal ulcer, chronic gastric erosions, and cobblestone pattern of the gastric body mucosa, as well as the significant hypersecretory state, suggest that hyperacidity plays a role in the pathogenesis of nodular hyperplasia of Brunner's glands.

Feasibility of the peroral pneumocolon in evaluating the ileocecal region

Retrograde insufflation of air into the terminal ileum via a rectal tube (peroral pneumocolon) is a simple adjunct to the conventional gastrointestinal small-bowel follow-through examination. The purpose of this study was to determine the feasibility and diagnostic value of peroral pneumocolon in 170 patients who were being evaluated by upper gastrointestinal series with conventional small-bowel follow-through. Retrograde passage of air into the terminal ileum was successful in 87% of 140 patients with normal anatomic relations and in all 30 patients with small bowel-colonic anastomoses. In most cases, retrograde air insufflation yielded additional diagnostic information, particularly in detection of ulcerations, edematous mucosa, and cobblestone patterns. The length of the small bowel segment affected by pathologic changes could be determined more accurately in over 60% of the peroral pneumocolon examinations. No procedure-related complications were observed.

Glycogenic acanthosis of the esophagus: radiographic and pathologic features.

Diagnostic features of glycogenic acanthosis of the esophagus on air-contrast radiography, endoscopy, and histopathologic studies in 10 selected cases are presented. Glycogenic acanthosis of the esophagus is a common benign entity, characterized by multifocal plaques of hyperplastic squamous epithelium with abundant intracellular glycogen deposits. At esophagoscopy or on autopsy specimens these lesions appear as slightly raised grey-white plaques which are usually 2-10 mm in diameter and may be confluent. They cause a finely nodular or cobblestone mucosal pattern demonstrable on double-contrast views of the well-distended esophagus. The findings are not associated with mucosal ulcerations, luminal narrowing, or mobility disturbance, although some patients may have coexistent hiatal hernia and gastroesophageal reflux.

Port-wine stains. Morphologic variations and developmental lesions.

Studies have shown that port-wine stains (PWSs) probably represent a progressive ectasia of the superficial cutaneous vascular plexus. During examination of approximately 500 patients with PWSs, seven lesions were identified that could be categorized into two groups. In one group (two patients), the typical superficial PWS was accompanied by a proliferation and ectasia of thin-walled vessels in the deeper dermis, subcutaneous adipose tissue, and skeletal muscle (cavernous hemangioma). In the other group (five patients), single or multiple polypoid tumors arose that consisted of a proliferation of vessels with walls of varying thickness, and intervascular stroma (arteriovenous malformation). These tumors appear to arise in both young patients with flat lesions as well as the older patients with pronounced surface irregularities. Two patients were specifically chosen because they represented the typical PWS cobblestone pattern. This vascular abnormality represents a localized exaggeration of the ectasia process. We conclude that a small number of PWSs are associated with an underlying cavernous hemangioma. Furthermore, besides the surface irregularities that characterize the older PWS, de novo vascular tumors arise that can be categorized as arteriovenous malformations.

Surface topography of the female bladder trigone.

Cystoscopic biopsy specimens of the bladder trigone of young women with recurrent urinary infections were examined by scanning electron microscopy. The superficial cells of the thickened squamous epithelium of the trigone have either a microridged, microvillous, or mixed pattern. In one case, bacteria were found adherent to all these types of surface. Some cells have a microvillous surface and a cobblestone pattern with long, clubbed microvilli and resemble the cells found in malignant and premalignant states.

The anal transitional zone: a scanning and transmission electron microscopic investigation of the surface epithelium.

The ultrastructure of the anal transitional zone (ATZ) is described by means of scanning and transmission electron microscopy. The technique used permits histologic reexamination of the scanning electron microscopic biopsies. The surface of the ATZ shows, in addition to areas of normal colorectal mucosa and squamous epithelium, a characteristic picture: there are cells of varying size, arranged in a cobblestone pattern, and a surface covered with short microvilli that tend to form rows, indicating beginning microridge formation. This corresponds histologically to the so-called ATZ epithelium, and it is suggested that this might be metaplastic squamous epithelium rather than urothelium. The deepest part of the epithelium contains endocrinelike cells with granules of at least two types.

The endothelial structure of the postcapillary venules of the lymph node and the passage of lymphocytes across the venule wall

Scanning electron microscopic observations on the luminal aspect of the high-endothelial postcapillary venules (PCV) of lymph nodes of mice, rats, hamsters, and guinea pigs show that the surface topography of these venules differs considerably from that of other venules. Two types of surface relief occur: one in which the endothelial cells bulge deeply into the lumen, thus presenting the appearance of a “cobblestone” pattern and another in which the endothelial cell has plate-like lateral extensions which intertwine with similar extensions of other cells, thus presenting a surface relief of “interlacing plates.” Both patterns occur in the same PCV. The part of the PCV with the interlacing plate pattern is located distally from the section with the cobblestone pattern and continues directly into the smooth-walled larger venules. Lymphocytes enter the wall of the PCV through the cell body of the endothelial cells regardless whether the luminal relief has a cobblestone or an interlacing plate configuration. To a more limited extent, transmural passage of lymphocytes occurs through the walls of larger and smooth-walled venules with low endothelium. The direction of movement of lymphocytes at such sites is not known.

Gastrointestinal bleeding in the renal transplant patient.

Fifty-one of 235 renal transplant patients had an upper gastrointestinal series at some point after entering the transplant program; bleeding into the gastrointestinal tract was the most common indication for the examination. Gastroduodenal ulcerations were demonstrated roentgenographically in 15 patients. These ulcers occurred while steroid administration was greatest. Other features which also favor a steroid-induced origin included a lack of symptoms, a high incidence of multiple ulcerations, and a reversal of the usual gastroduodenal localization ratio of ulcers. A coarse, cobblestone pattern of the duodenal mucosa was seen much more frequently in dialysis and transplant ulcer patients than in the control group.

Cobblestone esophagus due to Monilial infection.

COBBLESTONE ESOPHAGUS DUE TO MONILIAL INFECTIONHENRY I. GOLDBERG, M.D. and WYLIE J. DODDS, M.D.Audio Available | Share