Significant Histopathological Findings Research Articles

Incidental breast carcinoma in reduction mammoplasty

Aim: The objective of this study was to analyze the incidence and treatment options of occult cancer or atypical lesions found in the histopathological examination of reduction mammoplasty (RM) specimens. The role of preoperative mammography and systematic histopathological examination are discussed.Methods: We performed a retrospective single-center database review of all patients who underwent a RM between January 2005 and December 2014. Preoperative examination, histopathological findings and follow-up were documented.Results: A total of 1045 patients underwent RM, of which 97% were bilateral (1021). All patients received a mammography and routine clinical examination to exclude cancer preoperatively. The overall mean patient age was 40.2 years (14.2–73.4). A total of 19 patients (1.18%) had significant histopathological findings, all of whom were over 40 years of age. There were 4 incidental carcinomas (0.38%), of which 2 were DCIS (0.19%) and 2 invasive ductal carcinomas (0.19%).Conclusions: Incidence of postoperative diagnosis of occult breast cancer in RM specimens remains low, but poses significant therapeutic challenges. While emphasis should lay on preoperative diagnostics, routine histological analysis of RM specimens is recommended.

Neuropathogenesis of Zika Virus in a Highly Susceptible Immunocompetent Mouse Model after Antibody Blockade of Type I Interferon.

Animal models are needed to better understand the pathogenic mechanisms of Zika virus (ZIKV) and to evaluate candidate medical countermeasures. Adult mice infected with ZIKV develop a transient viremia, but do not demonstrate signs of morbidity or mortality. Mice deficient in type I or a combination of type I and type II interferon (IFN) responses are highly susceptible to ZIKV infection; however, the absence of a competent immune system limits their usefulness for studying medical countermeasures. Here we employ a murine model for ZIKV using wild-type C57BL/6 mice treated with an antibody to disrupt type I IFN signaling to study ZIKV pathogenesis. We observed 40% mortality in antibody treated mice exposed to ZIKV subcutaneously whereas mice exposed by intraperitoneal inoculation were highly susceptible incurring 100% mortality. Mice infected by both exposure routes experienced weight loss, high viremia, and severe neuropathologic changes. The most significant histopathological findings occurred in the central nervous system where lesions represent an acute to subacute encephalitis/encephalomyelitis that is characterized by neuronal death, astrogliosis, microgliosis, scattered necrotic cellular debris, and inflammatory cell infiltrates. This model of ZIKV pathogenesis will be valuable for evaluating medical countermeasures and the pathogenic mechanisms of ZIKV because it allows immune responses to be elicited in immunologically competent mice with IFN I blockade only induced at the time of infection.

Pathological diagnosis of porcine circovirus-2 associated reproductive failure in pigs of Mizoram

Porcine circovirus type 2 is the primary causative agent of porcine circovirus associated disease which is characterised by acute systemic illness of the dam, abortion, mummified foetus, stillborn piglets or weak born piglets. The present study was conducted to investigate and better understand the presence of PCV-2 in the pig population in Mizoram. Detailed pathological examination on 18 aborted cases, 9 stillbirth cases and 5 neonatal cases revealed a significant gross lesions and histopathological findings. Based on Polymerase Chain Reaction analysis, 18.7% (6 out of 32 tissue samples collected from aborted, stillborn and weak born piglets) were found to be positive for the presence of PCV2.

Histological evaluation of 400 cholecystectomy specimens

Background: A majority of gallbladder specimens show changes associated with chronic cholecystitis; however few harbour a highly lethal carcinoma. This study was conducted to review the significant histopathological findings encountered in gallbladder specimens received in our laboratory.Materials and Methods: Four hundred cholecystectomy specimens were studied over a period of five years (May, 2002 to April, 2007) received at department of pathology, Kasturba Medical College, Mangalore, India. Results: Gallstones and associated diseases were more common in women in the 4th to 5th decade as compared to men with M: F ratio of 1:1.33. Maximum number of patients (28.25%) being 41 to 50 years old. Histopathologically, the most common diagnosis was chronic cholecystitis (66.75%), followed by chronic active cholecystitis (20.25%), acute cholecystitis (6%), gangrenous cholecystitis (2.25%),xanthogranulomatous cholecystitis (0.50%), empyema (1%), mucocele (0.25%), choledochal cyst (0.25%), adenocarcinoma gallbladder (1.25%) and normal gallbladders (1%).Conclusion: All lesions were found more frequently in women except chronic active cholecystitis. Gallstones were present in (80.25%) cases, and significantly associated with various lesions (P value 0.009). Pigment stones were most common, followed by cholesterol stones and mixed stones. Adequate sectioning is mandatory in all cases to assess epithelial changes arising from cholelithiasis and chronic cholecystitis as it has been known to progress to malignancy in some cases.

Wedge Versus Core Biopsy at Time Zero: Which Provides Better Predictive Value for Delayed Graft Function With the Remuzzi Histological Scoring System?

BackgroundHistopathological features on time-zero renal biopsies correlate with graft outcome after renal transplantation. With increasing numbers of marginal donors, assessment of pre-implantation graft quality is essential. The clinician's choice of wedge or core biopsy is performed without evidence of efficacy or safety. This study aims to compare the information derived from wedge biopsy versus core biopsy. MethodsProspective evaluation of 37 wedge biopsies and 30 core biopsies was performed. Histopathological data were collected on number of glomeruli and arterioles observed, and Remuzzi scoring for glomerulosclerosis, tubular atrophy, interstitial fibrosis, and arteriolar narrowing was performed. Clinical data on delayed graft function (DGF) were also collated. Sensitivity, specificity, and positive and negative predictive values for DGF were compared. ResultsPatient demographics between the two cohorts were comparable. No complications of biopsies occurred; 81% of wedge biopsies versus 50% of core biopsies had >10 glomeruli (P = .01), whereas 32% of wedge biopsies and 57% of core biopsies had >2 arterioles (P = .02). Wedge biopsies were more likely to identify pathology with more glomerulosclerosis, tubular atrophy (P < .01), and interstitial fibrosis (P < .01). There was a non-significant trend toward high Remuzzi scores in wedge biopsy (22% versus 7% with Remuzzi ≥4; P = .12). The sensitivity and positive predictive value of Remuzzi ≥4 for predicting DGF was better on wedge biopsy (45.5% versus 0%; P < .01 and 62.5% versus 0%; P < .01, respectively). ConclusionsWedge biopsies were safe and superior to core biopsies for identifying clinically significant histopathological findings on pre-implantation renal biopsy. We believe that the wedge biopsy is the method of choice for time-zero biopsies.

Acute Brucella melitensis M16 infection model in mice treated with tumor necrosis factor-alpha inhibitors.

There is limited data in the literature about brucellosis related to an intracellular pathogen and anti-tumor necrosis factor alpha (anti-TNFα) medication. The aim of this study was to evaluate acute Brucella infections in mice receiving anti-TNFα drug treatment. Anti-TNFα drugs were injected in mice on the first and fifth days of the study, after which the mice were infected with B. melitensis M16 strain. Mice were sacrificed on the fourteenth day after infection. Bacterial loads in the liver and spleen were defined, and histopathological changes were evaluated. Neither the liver nor the spleen showed an increased bacterial load in all anti-TNFα drug groups when compared to a non-treated, infected group. The most significant histopathological findings were neutrophil infiltrations in the red pulp of the spleen and apoptotic cells with hepatocellular pleomorphism in the liver. There was no significant difference among the groups in terms of previously reported histopathological findings, such as extramedullary hematopoiesis and granuloma formation. There were no differences in hepatic and splenic bacterial load and granuloma formation, which indicate worsening of the acute Brucella infection in mice; in other words, anti-TNFα treatment did not exacerbate the acute Brucella spp. infection in mice.

Association of Histophilus somni with spontaneous abortions in dairy cattle herds from Brazil.

This study investigated the participation of infectious agents in spontaneous abortions and reproductive problems at eight dairy cattle herds from three geographical regions of Brazil. Fourteen aborted fetuses and the organ sections of one cow with history of repeated abortions were received for pathological evaluations and molecular diagnostics. PCR/RT-PCR assays targeted specific genes of abortifacient agents of cattle: bovine viral diarrhea virus (BVDV), bovine herpesvirus 1 (BoHV-1), Listeria monocytogenes, Neospora caninum, Leptospira spp., Brucella abortus, and Histophilus somni. Six fetuses were adequate for pathological investigations; one of these did not demonstrate remarkable pathological alterations. Significant histopathological findings included vasculitis, hemorrhage, and fibrinous thrombosis of the cerebrum (n = 4); necrotizing myocarditis (n = 3); and hemorrhagic enteritis (n = 3). The placenta and uterus of the cow as well as the kidney, pancreas, and liver of her aborted fetus contained H. somni DNA and demonstrated histopathological evidence of histophilosis. All fetuses contained H. somni DNA in multiple organs. Coinfections of H. somni with B. abortus (n = 2), N. caninum (n = 2), BVDV (n = 1), and BoHV-1 (n = 1) were identified; two fetuses demonstrated three pathogens. These findings suggest that H. somni was associated with the spontaneous abortions and reproductive problems of these herds. However, the exact cause of fetal death might not be attributed only to H. somni in all aborted fetuses, since some of these were infected with other abortifacient agents.

High virulence in hamsters of four dominant Leptospira serovars isolated from rats in the Philippines

Leptospirosis is caused by pathogenic species of Leptospira. The aim of this study was to determine and characterize the pathogenicity of four dominant Leptospira isolates prevailing among rats in the Philippines. The isolates were Leptospira interrogans serovar Manilae strain K64, L. interrogans serovar Losbanos strain K37, L. interrogans serovar Ratnapura strain K5 and Leptospira borgpetersenii serovar Javanica strain K6. Pathogenicities were studied using hamsters, which reproduce severe human leptospirosis. The minimum lethal doses were 10(0) ( = 1) leptospires for K64, K37 and K5, and 10(1) leptospires for K6. Weight loss amongst the Leptospira-infected hamsters was observed from 1 day before death (K64-, K37- and K5-infected hamsters) to as much as 1 week before death for K6-infected hamsters. Similar and varied gross and microscopic lesions were observed amongst infected hamsters, even for strains belonging to the same species (i.e. L. interrogans). The most significant and common histopathological findings were congestion of the glomerulus, disarrangement of hepatic cords and erythrophagocytosis. Other findings were foamy splenic macrophages for K6, severe petechial pulmonary haemorrhage for K64, and hematuria and severe pulmonary congestion for K37. Immunostaining and culture revealed the presence of leptospires in different organs of the infected hamsters. Based on these results, Leptospira isolates from rats in the Philippines were shown to be highly virulent, causing pulmonary haemorrhage, severe hepato-renal damage and death in hamsters even at lower doses. The present findings on experimental leptospirosis support clinical data showing that patients with severe manifestations of leptospirosis, such as pulmonary haemorrhage, are increasing in the Philippines. These findings may serve as a basis to strengthen the early diagnosis and treatment of human leptospirosis.

Cardiac histopathological and immunohistochemical changes due to electric injury in rats

It has been a puzzling forensic task to determine the cause of death as a result of electric shock in the absence of recognizable skin marks or definite postmortem morphological findings. In forensic pathology, while classical macroscopic and microscopic morphology remain core procedures to investigate deaths, a variety of subsidiary measures has been developed and incorporated to detail that pathology. C-fos, one of a small group of genes called primary response genes and its protein product, fos, are crucial elements of complex signaling mechanisms believed to be responsible for cell response to stimulation. It has been found that c-fos plays a significant role in myocardial lesions, and has close relation to injury repair of the molecule. The aim of this study was to detect the histopathological findings in the myocardium after fatal and non-fatal electrical injury in rats and to investigate the potential role of c-fos expression using immunohistochemistry to distinguish antemortem from postmortem electrocution. Forty adult female rats were implemented and randomly divided into four groups (A, B, C and D). Group (A) rats were subjected to instantaneous antemortem electricity and their hearts were collected either immediately (A1) or after an hour (A2) before being subjected to cervical dislocation. Group (B) rats were electrically injured instantaneously postmortem, hearts were collected immediately (B1) or an hour later (B2) while Group (C) rats were electrified up to death, and their hearts were also gathered either immediately (C1) or after an hour (C2) from electrocution. Lastly, another group of rats served as a control group (Group D). Subgroup (D1): rats were clamped but not electrified, before death and another group of rats were clamped but not electrified, after being killed by cervical dislocation. Sections from the hearts of all groups were fixed in formalin and routinely processed. The c-fos oncogene expression was evaluated in all groups by immunohistochemistry. Significant histopathological findings were detected in groups A and C. Few c-fos oncogene protein positive cardiomyocyte nuclei were seen in rats of groups (A1) and (B1). Additionally, increased expression in rats of groups C1, C2 and A2 were observed. On the other hand, no c-fos protein expression was seen either in the control (groups D1 and D2) or in group B2. Significant differences (p < 0.001) in c-fos expression were observed among rats of groups with antemortem electric injury (A1, A2) and those of postmortem injury (B1 and B2). Thus, in addition to classical histopathological methods, c-fos can be regarded as a target in identifying electrical injury, and can be used as an indicator to distinguish antemortem from postmortem electric shock.

English

AIMS: Colonoscopic examination is important in the diagnosis and treatment of various suspected colonic diseases. The procedure is used to look for early signs of colorectal cancer. The aims of this study were to correlate colonoscopic findings with the histopathological diagnosis obtained and also to study histopathological features of colonoscopic biopsy specimens. MATERIAL AND METHODS: The study was a retrospective analysis of data between April 2012 and June 2013. 507 colonoscopies were performed during this period. Colonoscopic biopsies showed significant findings on histopathology in 107 patients and were included in the study. The more severe diagnosis was used for analysis when there was more than one colonoscopic finding. All the colonoscopic biopsy specimens were immediately fixed and then routinely processed and embedded. Serial sections were prepared and stained with Hematoxylin and Eosin. Special stains like PAS and Van Gieson stains were used wherever necessary. RESULTS: The clinically significant findings seen on colonoscopy included colorectal cancers, IBD, colonic tuberculosis, strictures, solitary rectal ulcers and polyps. Other relevant findings seen were GI bleed and extrinsic compressions from contiguous structures. Among 107 biopsies, 82 biopsies were non-neoplastic, 25 biopsies were neoplastic. Overall 17 malignant lesions were picked up on histopathology. No significant histopathological findings were detected in biopsies from clinically not relevant colonoscopies. CONCLUSION: Chronic diarrhea and bleeding per rectum were the most common presenting complaints. IBD and malignancy were detected in a significant number of the biopsies. Histopathological diagnosis correlated well with the colonoscopy diagnosis offered. Colonoscopic screening can detect early colonic neoplasms in asymptomatic patients.

Molecular confirmation of ovine herpesvirus 2-induced malignant catarrhal fever lesions in cattle from Rio Grande do Norte, Brazil

Molecular findings that confirmed the participation of ovine herpesvirus 2 (OVH-2) in the lesions that were consistent with those observed in malignant catarrhal fever of cattle are described. Three mixed-breed cattle from Rio Grande do Norte state demonstrated clinical manifestations that included mucopurulent nasal discharge, corneal opacity and motor incoordination. Routine necropsy examination demonstrated ulcerations and hemorrhage of the oral cavity, corneal opacity, and lymph node enlargement. Significant histopathological findings included widespread necrotizing vasculitis, non-suppurative meningoencephalitis, lymphocytic interstitial nephritis and hepatitis, and thrombosis. PCR assay performed on DNA extracted from kidney and mesenteric lymph node of one animal amplified a product of 423 base pairs corresponding to a target sequence within the ovine herpesvirus 2 (OVH-2) tegument protein gene. Direct sequencing of the PCR products, from extracted DNA of the kidney and mesenteric lymph node of one cow, amplified the partial nucleotide sequences (423 base pairs) of OVH-2 tegument protein gene. Blast analysis confirmed that these sequences have 98-100% identity with similar OVH-2 sequences deposited in GenBank. Phylogenetic analyses, based on the deduced amino acid sequences, demonstrated that the strain of OVH-2 circulating in ruminants from the Brazilian states of Rio Grande do Norte and Minas Gerais are similar to that identified in other geographical locations. These findings confirmed the active participation of OVH-2 in the classical manifestations of sheep associated malignant catarrhal fever.

A novel papillomavirus isolated from proliferative skin lesions of a wild American beaver (Castor canadensis)

Cutaneous papillomatosis was diagnosed in an adult American beaver (Castor canadensis). Gross lesions included numerous exophytic, roughly circular, lightly pigmented lesions on hairless areas of fore and hind feet and the nose. The most significant histopathologic findings were multifocal papilliform hyperplasia of the superficial stratified squamous epithelium, with multifocal koilocytes, and multiple cells with large, darkly basophilic intranuclear inclusion bodies. A virus with properties consistent with papillomavirus (PV) was recovered by virus isolation of skin lesions, utilizing rabbit and feline kidney cell lines. The presence of the virus was confirmed by PV-specific polymerase chain reaction. The partial sequences of E1 and L1 genes did not closely match those of any PVs in GenBank, suggesting that this might be a new type of PV. Partial E1 and L1 nucleotide sequences of the beaver papillomavirus (hereafter, ARbeaver-PV1) were used to create a phylogenetic tree employing the complete E1 and L1 open reading frame nucleotide sequences of 68 PVs. The phylogenetic tree placed the ARbeaver-PV1 in a clade that included the Mupapillomavirus (HPV1 and HPV63) and Kappapapillomavirus (OcPV1 and SfPV1) genera. The present article confirms the papillomaviral etiology of cutaneous exophytic lesions in the beaver.

Gross and histopathological findings in Cercopithecus aethiops with experimental Cyclospora infection in Kenya

Gross and histopathological findings in Cercopithecus aethiops with experimental Cyclospora infection in Kenya Purity N Nguhiu1, Claire N Wamae2,3, Japheth K Magambo4, Paul G Mbuthia5, Daniel C Chai6, Dorcas S Yole61Department of Veterinary Services, Kabete, Ministry of Livestock Development, Nairobi, 2Directorate of Research and Development, Kenya Methodist University, Meru, 3Kenya Medical Research Institute, Nairobi, 4Meru University College of Science and Technology, Meru, 5Department of Veterinary Pathology, Microbiology and Parasitology, University of Nairobi, 6Department of Tropical Infectious Diseases, Institute of Primate Research, Karen, Nairobi, KenyaAbstract: In 2009, experimental Cyclospora infections were established in two juvenile female and two adult male Cercopithecus aethiops (African green monkeys) at Nairobi&#39;s Institute of Primate Research (IPR). The study animals were humanely sacrificed, and gross and histopathological evaluation was done at seven weeks post-infection. On gross examination, the juveniles had no abnormalities except for a slight enlargement of the mesenteric lymph nodes, while the adults displayed more pathology of enlarged lymph nodes, hemorrhagic gastrointestinal tracts, widespread necrotic foci of the liver, and enlarged spleens. Significant histopathological findings were observed in both the juveniles and adults, which ranged from mild inflammatory reactions in the stomach and intestines to intense cellular infiltrations with mitotic activity and lymphocytic infiltrations around the periportal area of the livers. The lymph nodes had extensive hyperplasia with many mitotic cells.Keywords: Cyclospora spp., cyclosporiasis, nonhuman primates, pathological findings, histopathological findings, African green monkeys

The pathology associated with visceral toxicosis of catfish

Visceral toxicosis of catfish (VTC) syndrome was recognized in the late 1990 s and recently has been associated with exposure to Clostridium botulinum type E neurotoxin. Tentative diagnosis is based on clinical presentation and gross findings, and is confirmed by bioassay. In April 2009, channel catfish (Ictalurus punctatus) from 2 different farms presented with abnormal swimming behavior and mortalities. Nine fish were submitted to the Aquatic Research and Diagnostic Laboratory (Stoneville, Mississippi) for evaluation. Bacterial cultures from these fish were negative. Necropsy findings included intestinal intussusceptions, ascites, pale proximal intestines with engorged serosal blood vessels, splenic congestion, and a reticular pattern to the liver. Significant histopathologic findings were limited to cerebral, splenic, and hepatic congestion, splenic lymphoid depletion and perivascular edema, vascular dilation and edema of the gastrointestinal tract, and perivascular edema in the anterior and posterior kidneys. Intoxication from C. botulinum type E neurotoxin was suspected based on the clinical signs and lack of gross and microbiological evidence of an infectious disease process. The toxicosis was confirmed with a positive bioassay using serum collected from the submitted fish.

Ileal biopsy: Clinical indications, endoscopic and histopathologic findings in 10,000 patients

Background Ileal biopsies are often reported as having a low yield. Data from endoscopy practices in the private setting are lacking. Aims To correlate the frequency of histologic abnormalities in ileal biopsies with clinical indications and ileoscopic appearances. Methods Retrospective analysis of clinical, endoscopic, and histopathologic data from a large database. Results We studied 9785 unique adult patients (median age 46 years, 61.4% women) with ileal biopsies. The most common symptoms were diarrhoea (52.2%) and abdominal pain (37.1%). Ileoscopy was reported as being normal in 75.1% patients. Subjects screened for cancer had the highest prevalence of abnormal endoscopic findings (63.3%); patients with known or suspected Crohn's had the highest prevalence abnormal ileal histology (36.4%). Overall, 5.0% of ileal biopsies obtained from patients with normal endoscopy and 47.4% of biopsies from patients with an endoscopically abnormal ileum had significant histopathologic findings. Conclusions In adults, biopsies from the endoscopically normal ileum rarely provide clinically relevant information and cannot be recommended. In contrast, half of the adult patients with an endoscopically abnormal ileum have significant histopathologic findings in ileal biopsies. Therefore, ileoscopy associated with a sensible use of the ileal biopsy is a valuable complement to the colonoscopy.

Aortic Aneurysm with Severe Aortic Regurgitation in a Patient with Systemic Lupus Erythematosus

A 37-year-old man was admitted to our hospital for precordial chest pain. He had taken prednisolone (5 mg/day) for systemic lupus erythematosus (SLE) and had been symptom free for the past 12 years. Echocardiography and contrast-enhanced CT of chest showed an enlarged ascending aortic aneurysm, which is rarely seen in SLE. Severe aortic regurgitation was also present, and surgical replacement of the ascending aorta and aortic valve was successfully accomplished by the Bentall procedure. Medial cystic necrosis in the ascending aorta, which is rarely seen in SLE angiopathy, was confirmed by histology. There were no significant histopathological findings in the aortic valve.

Use of Capecitabine to Prevent Acute Renal Allograft Rejection in Dog Erythrocyte Antigen‐Mismatched Mongrel Dogs

To assess efficacy and toxicity of a capecitabine (CAP)-based regimen for preventing rejection of renal allografts in dog erythrocyte antigen (DEA)-mismatched mongrel dogs. Prospective, pilot study. Eight healthy, unrelated, DEA mismatched, adult mongrel dogs. All dogs received CAP, starting at 50 mg/m2 PO b.i.d. 4 days preoperatively, increasing to 200 mg/m2 PO b.i.d. by the day of surgery. All dogs received cyclosporine-A (CsA) and prednisolone starting 2 days preoperatively. Standard heterotopic renal transplantation with native nephrectomy was performed. After 90 days, surviving dogs were euthanatized and histopathologic examination was performed. Two of 8 dogs developed acute neurotoxicity leading to death or euthanasia within 5 days of surgery. For the 6 remaining dogs, there were no statistically significant changes in complete blood count or serum biochemical values. No opportunistic infections developed during the study period. Five of 6 dogs had no to minimal evidence of graft rejection. Two of 6 dogs developed superficial and pigmentary keratitis. Significant histopathologic findings in all dogs included mild lymphoplasmacytic gastroenteritis, steroid hepatopathy, and corneal epithelial thinning. One dog had moderate interstitial nephritis and pyelitis. In this experimental model, a CAP-CsA-prednisolone immunosuppressive regimen was effective in preventing rejection of allografts in DEA-mismatched dogs. Severe, unpredictable neurotoxicity and variable ocular toxicity significantly limit clinical applications at this time. A CAP-CsA-prednisolone protocol is an effective, oral immunosuppressive regimen for prevention of allograft rejection in DEA-mismatched mongrel dogs. For clinical application, identification of patients susceptible to toxic side effects would be necessary.

Incidence of unusual and clinically significant histopathological findings in routine discectomy

Routine histopathological examination of discectomy specimens remains common practice in many hospitals, although it rarely detects unsuspected clinically significant disease. Controversy exists as to the effectiveness of this practice. The objectives of this study were to compare the authors' experience with a review of the literature. In a retrospective database analysis the authors identified all intervertebral disc specimens obtained during spinal procedures over an 8-year period (1996-2004). Cases of benign (nonneoplastic and noninfectious) indications for surgery were included in the study, whereas cases of nonbenign indications were excluded. The final pathological diagnoses were reviewed, and a chart review was performed to determine whether any unexpected findings affected subsequent patient care. A total of 1858 discectomy specimens were identified: 1775 of these were obtained in 1719 routine discectomy procedures. Unexpected histopathological findings were identified in four cases, and none was clinically significant. Routine histopathological examination of disc specimens is not justified. The decision to send specimens for pathological examination should be determined on a case-by-case basis after consideration of the clinical presentation, results of laboratory and imaging studies, and intraoperative findings.

Tissue response to in situ polymerization of a new two‐solution bone cement: Evaluation in a sheep model

A two-solution bone cement (2-SC) was evaluated in a non-load bearing sheep model that simulated insertion of a cemented total joint replacement. A commercial powder-liquid bone cement formulation (Palacos R) was used as the control. The systemic response to the two cements was determined by monitoring changes in arterial blood pressure (ABP) and serum concentrations of methyl methacrylate monomer at intervals after insertion of the cement. The short-term tissue response to the two cements was assessed by quantifying histomorphometric parameters of new bone formation at 2, 4, and 12 weeks postsurgery. Intraoperatively, injection and pressurization of bone cement were well tolerated, with no significant changes in ABP in either group and no detectable circulating monomer in any animal. Several interesting trends were identified in the histomorphometry data. In the trabecular specimens, new bone formation immediately adjacent to the cement mantle was apparently suppressed in the first 2 weeks postsurgery, increased dramatically at 4 weeks, and then returned to baseline values by 12 weeks. This pattern was seen with both Palacos and 2-SC. In the cortical specimens, new bone formation was reduced on the endosteal surface when compared with the periosteal surface, with this effect being more noticeable at 2 and 4 weeks than at 12 weeks. There were no significant histopathological findings in either the bone or the draining lymph nodes. These data indicate that the biological response to 2-SC is substantially equivalent to that of Palacos R. Additional testing in a functional, load-bearing animal model is now recommended to more fully characterize the long-term biological response to 2-SC and to determine the mechanical performance of this new cement in vivo.

Influence of diets with cereal grains contaminated by graded levels of two Fusarium toxins on selected enzymatic and histological parameters of liver in gilts

Feeding experiments with diets containing Fusarium toxin-contaminated wheat were conducted to clarify the pathogenesis of enzymatic and histopathological effects of Fusarium toxins on porcine liver cells. A total of 36 prepuberal gilts were divided into four groups and fed diets with increasing proportions of Fusarium toxin-contaminated wheat at a total wheat proportion of 40% over a period of 35 days. The concentrations of the indicator toxins deoxynivalenol (DON) and zearalenone (ZON) which were analyzed by HPLC methods were 210/4, 3070/88, 6100/235, and 9570/358 μg/kg in the diets fed to groups I–IV, respectively. The feeding of mycotoxin-contaminated diets did not cause gross pathological findings in the livers of the animals. Liver tissues were subjected to enzymatic, histological, and ultrastructural examinations. The percentages of the stained areas in periodic acid-Schiff (PAS), Berlin-Blue, and Masson Goldner’s trichrome stainings were calculated using the AnalySIS 3.4-system. Significant histopathological findings of alterations with varying degrees in glycogen reduction and increase of hemosiderin particles were found in the liver cells of groups II, III and IV. The thickness of interlobular connective tissue septum in liver cells was significantly increased in groups III and IV. Qualitative ultrastructural alterations were observed in hepatocytes of gilts in groups III and IV. Dependent upon the mycotoxin concentration in the diet, the hepatocytes developed a dose-dependent, extensive, smooth endoplasmic reticulum, exhibited loss of ribosomes, and acquired an increased number of fatty and autophagic vacuoles. However, liver damage as measured by prominent elevated transaminase activities in serum was not detected. Together, the histopathological results provide evidence of liver dysfunction in the absence of clinical signs, especially in pigs fed higher concentrations of Fusarium toxin-contaminated wheat.