Lamina Research Articles

A histopathological and ultrastructural study on experimental murine sarcocystosis

Objectives To study the experimental induction of Sarcocystis spp. infection in rats and to identify the Sarcocystis spp. through parasitological, histopathological, and electron microscopic studies. Background Sarcocystis spp. is an obligatory intracellular parasite of humans and animals. The genus Sarcocystis comprises about 130 species with differences in their life cycle and pathogenicity and represents important members of the cyst-forming coccidian. Materials and methods Macroscopic sarcocysts were isolated manually from 80 selected buffaloes that were slaughtered in Sirs Ellian City, Menoufia Governorate. The extracted sarcocysts samples were used to infect rats and were also preserved and prepared for species identification by histopathological and electron microscopic studies. Sixty rats were classified into six groups, with 10 rats/group (one control not infected and five infected groups), according to the date they were killed. Every rat was infected by feeding on 10 g of sarcocysts containing about 20 visible intact sarcocysts. Stool examination every day until the time they were killed and histopathological and electron microscopic studies for intestinal tissue specimens were performed. Results Histological and electron microscopic identification of sarcocyst specimens extracted from infected buffaloes revealed Sarcocystis fusiformis(thick wall 3.5 μm and cauliflower villar protrusions). A parasitological study of the infected rats' stools revealed excretion of Sarcocystis sporocysts (measuring 9–11 × 7 μm) in 40% of the infected rats at 1 week postinfection (group IV), in 60% at 2 weeks postinfection (group V), and continuous shedding of sporulated oocysts occurred in 40% of the rats at 1 month postinfection (group VI). Histopathological and transmission electron microscope examination of the infected rats' intestinal tissues revealed dividing oocysts (16 × 12.5 μm) with two sporocysts (11 × 7 μm) in the lamina propria of the small intestine in group V. Conclusion Rats could be considered as an experimental definitive host for S. fusiformis and could play a role in Sarcocystis spp. transmission to domestic animals.

Intramedullary melanotic schwannoma

Objective To study the clinicopathologic features, diagnosis, differential diagnosis, treatment and prognosis of intramedullary melanotic schwannoma (IMS). Methods and Results A 47-year-old male underwent an excision of thoracic intraspinal space-occupying lesion 6 years ago and was admitted to the hospital with a history of low back pain for one year. Spinal MRI revealed an intramedullary mass at the level of T 4-5 . Gross total resection of the tumor was done. Histological findings revealed that spindle or epithelioid cells were arranged in sheets, nests or intersecting bundles. The cytoplasms contained varying amounts of melanin pigments. The nuclei were round to oval with small nucleoli but no mitotic figures. Immunohistochemically, the tumor cells were positive for S-100 protein (S-100), HMB45, Melan-A, and Collagen Ⅳ. They were negative for epithelial membrane antigen (EMA), glial fibrillary acidic protein (GFAP), CD57, progestrone receptor (PR), desmin (Des) and myogen. Ki-67 labeling index was about 10%. Ultrastructural findings revealed that the tumor cells were surrounded by continuous basal lamina, and melanin granules in different stages of maturity were present in the cytoplasms. Final pathological diagnosis was IMS. No recurrence of tumor was found after follow-up for 18 months. Conclusions Intramedullary melanotic schwannom is a rare neoplasm. The diagnosis relies on its morphological characteristics, immunophenotype and ultra microstructure, and should be differentiated from melanoma, melanocytoma and pigmentary neurofibroma. The biologic behavior of the tumor is difficult to predict. It may occur local recurrence. Therefore, long-term follow-up is required. DOI: 10.3969/j.issn.1672-6731.2016.09.013

Age-associated histological changes of gastric fundal mucosa and ultrastructure of gastric chief cells in human and Beagle dogs

Objective To investigate the effect of aging on gastric pepsinogen secretion through observing histological changes of gastric fundal mucosa and ultrastructure of gastric chief cells in human and Beagle dogs at different ages. Methods Fifty middle-aged and elderly indigestion patients with gastroscopy were selected as study objects and divided into young and middle age group (age 20-59 years, n=19), junior elderly group (age 60-69 years, n=11), middle elderly group (age 70-79 years, n=10), and senior elderly group (no less than 80 years, n=10). In addition, nineteen healthy Beagle dogs were also selected as study objects and divided into young and middle age group (age between 1 to 5 years, n=8), junior elderly group (age six to eight years, n=5), and senior elderly group (no less than 9 years, n=6). The histology and morphology of gastric fundal mucosa of human and Beagle dogs were observed under light microscope. Then the thickness of lamina propria was measured and the number of gastric chief cells was counted. The ultrastructure of gastric chief cells was observed under electron microscope, and the area percentages of secretory granule(also called mucous granule)area in cytoplasm of chief cell was calculated.The data was analyzed by one-way analysis of variance. Results No significant histological and morphological changes of gastric fundal mucosa were observed in human and Beagle dogs at different ages.There was no significant difference in the thickness of lamina propria among different ages in human and Beagle dogs (all P>0.05). The number of human chief cells of young and middle age group, junior elderly group, middle elderly group and senior elderly group was 71.79±16.85, 52.73±16.60, 57.10±20.21 and 43.70±16.89/high power field (HPF), respectively, which decreased as age increased (F=6.431, P=0.001). The numbers of chief cells of young and middle age group, junior elderly group, and senior elderly group of Beagle dogs were 328.38±32.36, 341.20±42.49 and 225.67±52.19/HPF, respectively, which decreased as age increased (F=13.647, P<0.01). Aging-related degeneration was founded in ultrastructure of gastric chief cells in human and Beagle dogs including rough endoplasmic reticulum dilation, ribosomes missing, secretory granule decreasing and so on. The area percentages of secretory granule area in cytoplasm of human chief cells of young and middle age group, junior elderly group, middle elderly group and senior elderly group were (67.28±3.79)%, (66.88±4.84)%, (65.63±7.10)% and (56.25±8.47)%, respectively, which decreased as age increased (F=6.069, P=0.002). The area percentages of secretory granule area in cytoplasm of Beagle dogs′ chief cells of young and middle age group, junior elderly group, and senior elderly group were (58.83±3.07)%, (52.34±4.73)% and (39.89±4.46)%, respectively, which decreased as age increased (F=38.837, P<0.01). Conclusion As age increased, the ability of pepsinogen secretion of fundal gland decreased, which may be one of the reasons of functional dyspepsia in the eldly. Key words: Chief cells, gastric; Ultrastructure; Aging; Pepsinogens; Beagle dog

Clinical analysis of pin-shaped bipolar plasmakinetic electrode used in transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma

Objective To introduce the surgery procedure of pin-shaped bipolar plasmakinetic transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma and investigate the clinical outcomes. Methods 42 cases of non muscle-invasive bladder urothelial carcinoma who received bipolar plasmakinetic transurethral en bloc resection from May 2015 to March 2016 were recruited in the present study. Male 29 cases, female 13 cases, average age 52-82 years old, average (65.6±12.3) years old. Wide basal tumors were noticed by preoperative cystoscopy, bladder tumors were confirmed by tumor biopsy. Full-thickness specimens were obtained in procedures, including tumor, mucosa, lamina propria layer, muscular layer, to accurately assess tumor infiltration depth and staging. Results All 42 cases were done by this procedure successfully. A total of 65 pieces of tumors were excised: 36 in lateral wall, 19 in posterior wall, 10 in bladder triangle. Tumor diameter ranged from 0.5 to 3.5 cm, with an average (2.1±0.6) cm. Postoperative pathological stages were clear: 16 cases were Ta stage and 49 cases were T1 stage (of which 32 were T1G3). Intraoperative obturator nerve reflex happened in 2 cases. Followed up for 2-11 months, average 6 months. Tumor recurrence in 3 cases, no progression case. Conclusions Pin-shaped bipolar plasmakinetic electrode transurethral en bloc resection of non muscle-invasive bladder urothelial carcinoma is safe and reliable and should be recommended in management of non muscle-invasive bladder urothelial carcinoma. Full-thickness postoperative specimens can provide accurately judgement of the depth of tumor invasion and pathological staging. Key words: Non muscle invasive bladder tumor; Transurethral resection of bladder tumor(TURBT); En bloc resection; Bipolar plasmakinetic

Thermal Buckling, Vibration and Flutter of Composite Laminates Containing Two Non-uniformly Distributed Fibers

This study presents the first thermal buckling, vibration and flutter analyses of composite laminates with two different non-uniformly distributed fibers in a single lamina. The formulation of the location dependent stiffness matrix, geometric stiffness matrix and mass matrix due to nonhomogeneous material properties is derived. The effects of hybrid fibers distribution on the critical buckling temperature, natural frequencies and flutter boundary of composite laminates are discussed using the finite element method. The numerical results reveal that fiber redistribution can efficiently increase the critical buckling temperature, natural frequencies and flutter boundary. It is feasible to increase structural strength and reduce cost by the use of two different fibers in a single lamina of composite laminate.

Comparative proteome analysis of abdominal adipose tissues between fat and lean broilers.

BackgroundThe molecular mechanism underlying broiler fat deposition is still poorly understood.MethodCurrently, we used two-dimensional gel electrophoresis (2DE) to identify differentially expressed proteins in abdominal adipose tissues of birds at 4 week of age derived from Northeast Agricultural University broiler lines divergently selected for abdominal fat content (NEAUHLF).ResultsThirteen differentially expressed protein spots were screened out and identified by matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF-MS). The protein spots were matched to thirteen proteins by searching against the NCBInr database. These identified proteins were apolipoprotein A-I (Apo A-I), cytokeratin otokeratin, ATP synthase subunit alpha, peptidyl-prolyl cis-trans isomerase FKBP4 (PPIase FKBP4), aspartate aminotransferase, carbonic anhydrase II (CA-II), prostaglandin-H2 D-isomerase precursor, fibrinogen alpha chain, lamin-A (LMNA), superoxide dismutase [Mn] (MnSOD), heat shock protein beta-1 (HSPβ1) and two predicted proteins. These differentially expressed proteins are involved mainly in lipid metabolism, amino acid metabolism, signal transduction, energy conversion, antioxidant, and cytoskeleton. Differential expression of Apo A-I, PPIase FKBP4, and cytokeratin otokeratin proteins were further confirmed by Western blot analysis. Quantitative real-time RT-PCR analyses showed that, of these 13 differentially expressed proteins, only PPIase FKBP4 and cytokeratin otokeratin were differentially expressed at mRNA level between the two lines.ConclusionsOur results have provided further information for understanding the basic genetics control of growth and development of broiler adipose tissue.

Preliminary study of performance of peripheral absorbable magnesium alloy stent

Objective To investigate the performance and safety of domestic peripherally absorbable magnesium alloy stent. Methods Sixteen absorbable magnesium alloy stents were implanted in the bilateral iliac-femoral arteries of 8 Chinese Agricultural University minipigs selected randomly with computer.The mean weight was (21.19±1.93) kg. One pig was randomly selected by computer on 30th, 45th, 60th, 75th, 90th, 105th, 120th and 135th days after stent implantation and both stents were removed. The biochemical, imaging and histopathology index of the pig before and after stent placement were analyzed, t test was used to compare data collected before and after stenting. Results The biochemical index changes showed no statistical significance after stent implantation, the DSA indicated that vessel diameter was (4.39± 0.26) mm before stent implantation and (3.85±0.71) mm on the 30th to 135th day afterimplatation (t= 3.041, P= 0.008), the balance of vessel diameter before and after stenting ranged from 0 to 2.29 mm, with minimun on 30th day, and maximum on 90th day; HE and verhoeffvangieson showed significant stenosis of the arteries occurred on 60th, 90th and 120th day. From the 30th day to 135th day after stenting, the average diameter of residual lumen was (1.38±0.18) mm, the average area of residual lumen was (1.51±0.41) mm2, the average area of internal elastic lamina was (1.91±0.22) mm2, the average area of external elastic lamina was (4.79± 0.79) mm2, the average thickness of endothelium was (0.11±0.06) mm, the average area of new intima was (0.40±0.29) mm2, the average narrow area percentage was (21.96±16.48)%.The stent absorbed gradually, and not completely absorbed until 135th day after stenting. Endometrial cells completely covered stent surface, and the stent did not break or collapse at all. Conclusions The peripherally absorbable magnesium alloy stents is safe and effective in animal experiment. Application of this stent in human should be investigated with further studies. Key words: Iliac artery; Stents; Magnesium compounds; Graft occlusion, vascular; Animal experimentation

Origination, Variation, and Conservation of Animal Body Plan Development

Multicellular organisms develop from fertilized eggs or asexual propagules. In the case of animals the developmental processes by which their bodies take form originated in several phases beginning between 600 and 700 million years ago, in the Ediacaran period. Genes and signaling pathways, many of which were present in unicellular ancestors, came to mediate morphogenesis and cell pattern formation by virtue of bringing into play physical effects that were newly relevant on the scale of cell aggregates. Focusing on “liquid-like” properties of cell clusters and their capacity to act as “excitable media,” this review explores how the products of ancient and some novel genes of what became the “developmental toolkit” were variously employed to mobilize well-characterized physical effects and processes (cohesivity, phase separation and disaggregation, surface and shape polarization of cells, chemical oscillation, reaction–diffusion coupling) in the cell aggregates that eventually evolved into animal bodies and organs. This interplay of physics and genetics led to the generation of morphological motifs such as the tissue layering of gastrulation, lumen formation, body elongation, triploblasty, segmentation, and patterning of endoskeletal elements. Since not all founding lineages had identical sets of toolkit genes, not all morphogenetic and patterning processes were equally present in their descendents. These “physico-genetic” factors collectively account for the conservation and diversity of body plans seen in the present-day animal phyla. Keywords: “basal” metazoans; basal lamina; convergent extension; diploblasts; liquid tissue; lumen formation; multilayering; saltational evolution; segmentation; triploblasts; tetrapod limbs

MORPHOLOGICAL AND MOLECULAR CHARACTERIZATION OF SCLEROTIUM ROLFSII ASSOCIATED WITH LEAF BLIGHT DISEASE OF PSYCHOTRIA NERVOSA (WILD COFFEE)

Psychotria nervosa (Rubiaceae), commonly known as wild coffee was found affected by leaf blight disease in the forest regions of Mysore, Madikeri and Hassan districts of Karnataka state (India). Characteristic leaf blight symptoms were observed at the centre of leaf lamina of basal leaves and tiny sclerotial bodies entangled in mycelia were prominent on the adaxial leaf surface. The associated fungal pathogen was isolated and identified as Sclerotium rolfsii on the basis of morphological characters and sequence analysis of ITS region of rDNA. The sequences shared 100% similarity with reliable sequence of S. rolfsii retrieved from GenBank. The detached leaf assay produced leaf blight symptoms seven days after inoculation. S. rolfsii known to infects a wide range of host plants including forest tree species. This is the first report of S. rolfsii causing leaf blight disease of wild coffee in India.

Collagenous gastritis: A case report

Background: Collagenous gastritis is a rare disease defined histologically by the subepithelial deposition of collagen bands thicker than 10 μm and the infiltration of inflammatory mononuclear cells in the lamina propria. There are approximately 60 reported cases of collagenous gastritis in the English literature. Case report: We present a 41-year-old female patient with weight loss, postprandial abdominal discomfort, early satiety, flatulence and a change in bowel habits. Her current laboratory investigation reports showed mild sideropenic anemia. Esophagogastroduodenoscopy and corresponding histological examination showed findings, typical for collagenous gastritis. Gastric emptying scintigraphy and SPECT/CT of abdomen revealed gastroparesis. Conclusion: Collagenous gastritis is a diagnostically challenging disease and its exact etiology remains unclear. Even though collagenous gastritis is a histologic diagnosis, the combination of other key clinical and endoscopic findings should prompt consideration of this entity. No safe and effective treatment has been established. Therefore, better understanding of the disease and study of a larger number of patients will help to establish diagnostic criteria and therapeutic strategies.

Effects of Cobalt Nitrate on Histopathological and Morphometric Changes in Rat Femoral Artery Vasospasm Model.

To determine the effects of cobalt nitrate on the arterial wall in a rat femoral artery vasospasm model. Experimental study. Faculty of Medicine, Istanbul University, between November 2009 and September 2010. Twenty-four rats were separated into three groups named group 1 (n=8, sham-control); group 2 (n=8, vasospasm), and group 3 (n=8, vasospasm + cobalt nitrate treated). Group 3 rats were subjected to intraperitoneal administration of 0.1 mg/kg/day cobalt nitrate for 7 days, followed by histological and morphometric analyses. ANOVAand post hoc analyses were carried out. The mean vascular wall thickness of the group 1, 2 and 3 rats was found to be 133 ±13, 210 ±15 and 160 ±11 micron, respectively. The mean vascular lumen diameter of the group 1, 2 and 3 rats was 698 ±20, 240 ±15 and 540 ±22 micron, respectively. Arteries in the group 3 had thin smooth endothelium, thin mildly folded internal elastic lamina, and concentric smooth muscle cells. The mean vascular lumen diameter of the group 3 rats showed a significant decrease compared to the group 2 rats. Cobalt nitrate may potentially serve as an agent in preventing cerebral vasospasm after a hemorrhagic episode.

Anatomic and functional reconstruction of the spinal posterior column after resection of intraspinal neoplasms

Objective To investigate the operative outcomes of anatomic and functional reconstruction of the spinal posterior column after resection of intraspinal neoplasms. Methods From January 2010 through October 2014, we treated 32 patients with intraspinal neoplasm in the spine. They were 18 men and 14 women, 13 to 62 years of age (average, 38 years). The neoplasm was detected in the cervical spine in 10 cases, in the thoracic spine in 14 and in the lumbar spine in 8. All cases received expansive open door laminoplasty via the posterior approach for resection of the intraspinal neoplasm, followed by replantation and titanium plate fix-ation for anatomic and functional reconstruction of the spinal posterior column. The neural functional recovery, spinal motion and sagittal diameter of the spinal canal before and after operation, spinal stability and graft fusion were observed. Results The patients were followed up for 3 to 23 months (average, 13 months). All the intraspinal neoplasms were completely resected. The Frankel grading of neural functional recovery was improved differently in all the cases. By the final follow-ups, the spinal motion was normal in all the cases, without any significant limitation. Graft fusion and rigid internal fixation were achieved in all the cases. Short-term follow-ups revealed no signs of spondylolisthesis or spinal instability. At the final follow-ups, the 3-D CT reconstruction showed no significant shortening in the sagittal diameter of the same spinal canal before and after operation (P >0.05). Conclusions For intraspinal neoplasm in the spine, the whole vertebral lamina is opened or re-moved via the posterior approach to resect the neoplasm, followed by reduction of the vertebral lamina and mini titanium plate fixation to reconstruct the anatomy and function of the original spine. This is an ideal way to treat intraspinal neoplasms in the spine. Key words: Spine; Reconstructive surgical procedure; Treatment outcome; Posterior approach

Primary bile acid malabsorption. Histologic and immunologic study in three patients.

Three patients are presented with a history of chronic watery diarrhea due to bile acid malabsorption, proved by the tauro-23[75Se]selena-25 homocholic acid test and an unequivocal response to cholestyramine therapy. Fecal fat tests, Schilling tests, and barium studies of the small intestine and colon were all normal. Jejunal biopsies were normal but multiple biopsies of the terminal ileum, performed by retrograde ileoscopy, showed uniform crypt hyperplastic villous atrophy and features of colonic metaplasia with increased mononuclear infiltration of the lamina propria. All 3 patients demonstrated evidence of abnormal immune function, including the presence of serum autoantibodies, circulating immune complexes, and hypocomplementemia. One patient had Sjögren's syndrome. This disorder, which might be immunologically mediated, should be called primary bile acid malabsorption and should be distinguished from other ileal disorders.

Functional state of lymphocytes in colitis mice of BALB/c strain induced by dextran sulfate sodium

Objective To establish mice colitis model induced by dextran sulfate sodium (DSS) and analyze its immune profile. Methods 4% DSS was given to BALB/c mice for 9 days to establish acute colitis model. Drinking water without DSS was given in the following 7 days to establish recovery colitis model. Weight loss and hematochezia were monitored daily. The histological appearance of the colon and the number, phenotypes, and cytokine production of lymphocytes were evaluated. Results The total lymphocyte number [spleen: (90.1±15.2)×106 vs. (49.8±17.1)×106, P<0.01; MLN: (15.9±3.0)×106 vs. (5.5±2.2)×106, P<0.05] and the production of IL-2 [spleen: (3.9±0.7) ng/ml vs. (1.3±0.2) ng/ml, P<0.01; colonic lamina propria (CLP): (41.7±8.3) ng/ml vs. (2.0±0.2) ng/ml, P<0.01] and interferon (IFN)-γ [spleen: (12.7±1.7) ng/ml vs. (6.8±0.8) ng/ml, P<0.01; CLP: (47.9±6.2) ng/ml vs. (17.2±3.3) ng/ml, P<0.01] were decreased, while the ratio of CD4+ /CD8+ cells [spleen: 1.7±0.2 vs. 2.8±0.7, P<0.01; MLN: 2.5±0.5 vs. 4.0±0.5, P<0.01] was increased in acute DSS colitis. However, the production of IL-4 and IL-10 was unchanged. In addition, DSS inhibited the proliferation, while promoted the apoptosis of lymphocytes. Conclusion DSS caused the imbalance of Th1/Th2 response and altered the local and systematic immune state in mice. Key words: Inflammatory bowel disease; Ulcerative colitis; Dextran sulfate sodium; Cytokine

Anatomical studies on Scorzonera (Asteraceae) species, subgenera Podospermum and Pseudopodospermum in Iran

The genus Scorzonera with approximately 175 species is the largest genus within the Cichorieae tribe. This genus includes 55 species distributed in different parts of Iran, 17 species of which are endemic. Due to morphological similarity, the recognition of species is comparatively difficult, thus the anatomical characters can be taken into consideration. To study anatomical structure, the leaf samples were taken off from herbarium specimens and handmade cross-sections were prepared and stained with methyl green and carmine. Several slides were studied and photographed with light microscope. The results obtained from this research confirm the usefulness of leaf anatomy characters in the identification of most of the species studied. The study of anatomical characters of midrib and lamina of Podospermum and Pseudopodospermum subgenera confirms classification of the series and subgenera of this genus.

Dysplasia Involves Enteritis Cystica Profunda in the Setting of Crohn’s Disease

Enteritis cystica profunda is a rare non-neoplastic condition characterized by misplaced glands deep to the muscularis mucosae of the small bowel, likely as a result of trauma or inflammation such as Crohn’s disease, a disease with increased risk for small bowel adenocarcinoma. Clinically, enteric cystica profunda and adenocarcinoma can present with obstruction and/or stricture in patients with Crohn’s disease and should be differentiated from each other. Neoplastic involvement of enteritis cystica profunda by dysplasia has not been reported previously. Herein, we report a case of enteritis cystica profunda involved by high-grade dysplasia of gastric type. High-grade dysplasia and intramucosal adenocarcinoma of gastric type were also present in the overlying mucosa. Additionally, the adjacent mucosa demonstrated marked chronic active enteritis with pyloric gland metaplasia. The neoplastic epithelium showed diffuse and strong nuclear immunoreactivity for p53. The presence of lamina propria deep to the dysplastic epithelium-lined cysts/diverticula supported a non-invasive nature of this lesion. No metastatic disease was noted in 15 nodes identified. All surgical resections were free of neoplasm. The patient was doing well 9 months after surgery without evidence of cancer recurrence or metastasis on abdominal computed tomography. J Med Cases. 2016;7(6):202-207 doi: https://doi.org/10.14740/jmc2415w

FIRST REPORT OF DIAPORTHE PHASEOLORUM ON BACOPA MONNIERI IN INDIA

During a survey carried out in 2013-14 on crops of Bacopa monnieri (L.) Pennell in Barasat, North Parganas district of West Bengal (India), many plants were found showing a foliar shot hole disease characterized by the presence of brown-coloured spots on the upper and lower leaf lamina. Generally, each affected leaf showed 1-2 spots with minute depressions which, under conducive environmental condi- tions, expanded to 2-3 mm in diameter that formed holes with a dark brown border. From affected leaves of symp- tomatic twigs, a fungus was isolated on potato dextrose agar (PDA), whose morphological features matched the de- scription of Phomopsis reported by Domsch et al. (1980). In pathogenecity tests, symptoms were reproduced after one week on 1-month-old plants of B. monnieri that had been sprayed with a conidial suspension of the fungus. Control plants sprayed with sterilized water remained healthy. The internal transcribed spacer region of the fungal isolate was amplified using primers ITS 1/ITS 4 (White et al., 1990) and sequenced (GenBank accession No. KJ451621.1). BLAST analysis of the sequence showed 100% homology with that of Diaporthe phaseolorum (Cooke et Ellis) Sacc. (anamorph:Phomopsis sp.) strain CBS113425 (accession No. KC343174.1). D. phaseolorum can infect sunflower and soy- bean, causing stem cankers and seedling blight (Muntano- la-Cvetkovi et al., 1991). To our knowledge this is the first report of D. phaseolorum on Bacopa monnieri in India.

An Intramucosal Large Cell Neuroendocrine Carcinoma Arising Within a Tubulovillous Adenoma With High- Grade Dysplasia of the Rectosigmoid Colon Treated With Polypectomy

High-grade neuroendocrine carcinoma (NEC) has been previously reported to arise within preexisting adenoma but is usually at an advanced stage and carries a dismal prognosis and is almost always treated with surgical resection. Intramucosal NECs treated with polypectomy have not been reported. Herein, we report the first case of intramucosal NEC treated by polypectomy. An 87-year-old white male was referred to the Cleveland Clinic for a polyp detected in an outside hospital. A 40 mm sessile polyp was visualized in the recto-sigmoid colon using flexible sigmoidoscopy. Polypectomy was performed and histopathology revealed multiple fragments of tubulovillous adenoma (TVA) with extensive high-grade dysplasia (HGD). Notably, there was a focus (1 mm) of NEC confined to lamina propria and intimately related to the adenomatous component. This focus of intramucosal NEC was confirmed by its strong and diffuse synaptophysin and chromogranin A immunoreactivity and near 100% Ki-67 labeling index. Immunohistochemistry using a panel of antibodies against mismatch repair proteins was performed and both the adenomatous and NEC components had normal staining for MLH1, PMS2, MSH2, and MSH6. This, to the best of our knowledge, is the first case of intramucosal NEC treated with polypectomy reported to date. Patient was alive 1 year after polypectomy. Clinical behavior remains to be seen with long-term follow-ups. J Med Cases. 2016;7(5):174-177 doi: http://dx.doi.org/10.14740/jmc1996w

Does Sinus Surgery Increase the Risk of Orbital Fractures in Patients?

IntroductionThe orbit is bounded by thin bony walls that are prone to fracture in facial trauma. Despite its thin nature, the medial orbital wall, or lamina papyracea, is less likely to fracture than the orbital floor. This may be due to the uncinate process of the ethmoid bone, as well as the ethmoid bulla, acting as buttresses for the medial orbital wall. What is not understood is how functional endoscopic sinus surgery (FESS), and its associated uncinectomy and ethmoidectomy, affect the fragility of the bony orbit. Resection of the uncinate process and ethmoid bulla, as well as skeletonization of the lamina papyracea, may predispose a patient to post‐surgical fractures. We hypothesize that FESS will decrease the force required to induce a fracture in the medial orbital wall.Objectives/MethodsThe objective of this study was to establish the force required to induce orbital fractures in cadaveric specimens, while evaluating the occurrence, severity and pattern of post‐surgery fractures. Using fixed (n=4) cadaveric heads, a pilot study was conducted to test the protocol and narrow the range of force required to produce orbital fractures. Subsequent studies will be performed using fresh‐frozen (n=8) cadaveric heads. FESS has been performed on one side of the head for each fresh‐frozen specimen, while the other side serves as control. Pre‐operative CT scans have been performed on all heads. Heads will be potted in 4″ PVC pipes, with dental cement, for stability during testing. Globes will be reinflated with a viscous sodium hyaluronate injectable for standardization of pressure, confirmed with a tonometer. An impactor mass of 1.356 kg will be dropped from varying heights onto the orbit to induce fractures. The force of impact will be measured, via accelerometer, to compare operated and non‐operated sides. Post‐operative fractures within the orbital wall will be detected via cone‐beam CT.ResultsPilot study results indicate that the force required to fracture the orbital floor is lower than the force required to fracture the medial orbital wall and these forces are in line with published values (orbital floor: ≥ 2.08 J; medial wall: ≥ 4.90 J). The post‐surgical force testing and scanning has not been completed at this time.Discussion/Future DirectionsThis is the first study to look at the effect of sinus surgery on orbital fracture risk in patients. Subsequent studies will analyze whether FESS decreases the force required to induce fractures of the medial orbital wall. As the prevalence of post‐FESS patients increases, it is important to understand how the bony alterations of sinus surgery affect the stability of the orbit in order to counsel patients appropriately and obtain informed consent.

The relationship between the lamina and precipitation in the Lake Mokoto, Hokkaido, Japan

The relationship between the lamina and precipitation in the Lake Mokoto, Hokkaido, Japan