Cytopathological and chemico-physical analyses of smears of mucosa surrounding oral piercing.

OBJECTIVE: The aim of this comparative study was to analyze cytopathologically and chemico-physically the mucosa surrounding oral piercing to correlate results with adverse tissue signs. MATERIALS AND METHODS: The tongue superficial mucosa of 15 young subjects (control group) and the superficial mucosa surrounding oral piercing of 15 young subjects (test group, TG) were smeared on slides, Papanicolaou stained and analyzed under the optical microscope. Some smears were prepared for (back-scattered) scanning electron microscope (SEM) and X-ray microanalysis to study piercing fragments. RESULTS: Smears of TG displayed a variable extent of bacterial cytolysis of epithelial cells, fungi, hyperkeratosis, parakeratosis, granulocyte infiltration, calcium formations and bacterial flora; the four last statistically significant (P < 0.05). Foreign bodies surrounded by keratinocytes were detected under both light and SEM. X-ray microanalyses highlighted piercing alloy aggression, ion release and an inverse gradient of ion concentration inside keratinocytes. CONCLUSIONS: The pathological findings in smears correlated with adverse effects of oral piercing. Ion release may be related to direct toxic effects and belated reactions because of metal sensitization. A strict regulation of piercing is warranted.

Selective melanocortin MC4 receptor agonists reverse haemorrhagic shock and prevent multiple organ damage.

BACKGROUND AND PURPOSE: In circulatory shock, melanocortins have life-saving effects likely to be mediated by MC4 receptors. To gain direct insight into the role of melanocortin MC4 receptors in haemorrhagic shock, we investigated the effects of two novel selective MC4 receptor agonists. EXPERIMENTAL APPROACH: Severe haemorrhagic shock was produced in rats under general anaesthesia. Rats were then treated with either the non-selective agonist [Nle4, D-Phe7]-melanocyte-stimulating hormone (NDP--MSH) or with the selective MC4 agonists RO27-3225 and PG-931. Cardiovascular and respiratory functions were continuously monitored for 2 h; survival rate was recorded up to 24 h. Free radicals in blood were measured using electron spin resonance spectrometry; tissue damage was evaluated histologically 25 min or 24 h after treatment. KEY RESULTS: All shocked rats treated with saline died within 30-35 min. Treatment with NDP--MSH, RO27-3225 and PG-931 produced a dose-dependent (13-108 nmol kg-1 i.v.) restoration of cardiovascular and respiratory functions, and improved survival. The three melanocortin agonists also markedly reduced circulating free radicals relative to saline-treated shocked rats. All these effects were prevented by i.p. pretreatment with the selective MC4 receptor antagonist HS024. Moreover, treatment with RO27-3225 prevented morphological and immunocytochemical changes in heart, lung, liver, and kidney, at both early (25 min) and late (24 h) intervals. CONCLUSIONS AND IMPLICATIONS: Stimulation of MC4 receptors reversed haemorrhagic shock, reduced multiple organ damage and improved survival. Our findings suggest that selective MC4 receptor agonists could have a protective role against multiple organ failure following circulatory shock.

Age-related distribution of endocrine cells in the human prostate: a quantitative study.

A morphometric analysis was performed to obtain quantitative data on age-related changes in prostatic endocrine cell (PrEC) density. Sixty prostates from subjects aged 14-74 years were studied with a semi-automatic image analysis system (ASM 68K, Leitz) applied to sections immunostained for chromogranin A-reactive cells. The highest density of PrECs (0.366 cells/mm of epithelial length) was found in the 25-54 year age group, which was significantly different from that found in prostates of the younger (0.311 cells/mm) and the older (0.261 cells/mm) age groups. The data probably reflect the higher incidence of incompletely developed glandular units in the younger group and the formation of new alveoli related to the usual glandular hyperplasia that occurs with increasing age in the older group.

Neuroprotective effect of gamma-hydroxybutyrate in transient global cerebral ischemia in the rat.

The effect of gamma-hydroxybutyrate on the histological and behavioral consequences of transient brain ischemia was studied in the four vessel occlusion rat model. In saline-treated animals, 30 min ischemia caused a massive loss of neurons in the hippocampal CA1 subfield (normal neurons: 14%, 5%, 23% and 30% on the 3rd, 10th, 15th and 65th day after ischemia, respectively). gamma-Hydroxybutyrate - 300 mg/kg intraperitoneally (i.p.) 30 min before or 10 min after arteries occlusion, followed by 100 mg/kg i.p. twice daily for the following 10 days - afforded a highly significant protection (normal neurons on the 3rd, 10th, 15th and 65th day after ischemia: 88% and 91%, 80% and 80%, 91% and 90%, 72% and 71% in rats receiving the first dose before or after arteries occlusion, respectively). The ischemia-induced sensory-motor impairment was significantly attenuated in rats receiving the first dose of gamma-hydroxybutyrate before arteries occlusion. Finally, the ischemia-induced impairment in spatial learning and memory, evaluated starting 27 days after the ischemic episode, was significantly attenuated by gamma-hydroxybutyrate, either injected first at 30 min before or 10 min after arteries occlusion. Lower doses of gamma-hydroxybutyrate had no significant effect. In conclusion, these results indicate that gamma-hydroxybutyrate provides significant protection against both histological and behavioral consequences of transient global cerebral ischemia in rats.

Leptomeningeal carcinomatosis presenting as progressive multineuritis: clinical, pathologic, and MRI study.

Two patients developed a persistent illness characterized clinically and electrophysiologically by asymmetric involvement of spinal roots, of cranial and peripheral nerves. In the first case the disease was not discovered clinically but only after autopsy. The primary neoplasm remained undetected at autopsy. There was profound infiltration of the leptomeninges by tumor cells with features of metastatic adenocarcinoma. In the second patient onset of neurological symptoms occurred 16 years after surgery for breast cancer, which may be reasonably considered the primary malignancy-CSF cytology was positive only in the second patient in whom Gd-DTPA MRI supported the diagnosis. Our cases demonstrate that diagnosis in leptomeningeal carcinomatosis may be a challenging clinical problem.

Resistance to bacterial aggression involving exposed nonresorbable membranes in the oral cavity.

Bacterial colonies split implanted membranes that are exposed to oral biologic fluids as a consequence of dehiscence. The clinical and histologic behavior of 14 implanted polyurethane membranes was observed during the period of exposure to oral fluids for 2, 3, 4, and 6 weeks and without dehiscence (after 8 weeks). Statistical analysis indicated that the decrease in the number of neutrophils after 5 weeks, associated with the increase in the number of activated fibroblasts, cellular debris, giant cells, and aggression of bacteria, was statistically significant (from P < .05 and P < .01 for activated fibroblasts to P <.005 and P < .001 for neutrophilic cells). The increase in bacterial passage through the polyurethane membranes and in the number of giant cells and cellular debris after 8 weeks represents late dissolution of the membranes; the progressive increase of activated fibroblasts is significant because the longer the membrane resists, the better the cells can grow and give way to the process of tissue regeneration.

Immunohistochemical detection of cell-cycle associated markers on paraffin embedded and formalin fixed needle biopsies of prostate cancer: correlation of p120 protein expression with AgNOR, PCNA/cyclin, Ki-67/MIB1 proliferation-scores and Gleason gradings.

Paraffin embedded and formalin fixed needle biopsies of prostate cancer (PC) were used to immunocytochemically detect the p120 nucleolar protein in relation to the Gleason histological gradings (GHG), the labelling indices of proliferating nuclear immunocytochemical markers (PCNA/Cyclin, Ki-67/MIB1) and the argyrophilic nucleolar region (AgNOR) rate. The twenty-six cases of PC (6 from large histological samples and 20 from needle biopsies) were equally distributed into low (< or = 6) or high (> or = 7) GHG groups. The p120 nucleolar protein immunocytochemical reaction was randomly expressed in large histological sections but uniformly distributed without gaps in needle biopsy sections. Only on the latter were quantitative values of PCNA/Cyclin (23.2 in low and 45.3 in high GHG), Ki-67/MIB1 (13.8 in low and 43.3 in high GHG) and AgNOR (5.0 in low and 7.5 in high GHG) related to those of p120 nucleolar protein (0.8 in low and 3.8 in high GHG). The values of all these cell cycle markers increased from low to high GHG of PC, all four reaching high statistical significance between the two groups (ANOVA-two tailed p < 0.0001). The PCNA/Cyclin index showed a higher positivity than the Ki-67/MIB1 index in PC with low GHG but not in PC with high GHG. In conclusion, paraffin embedded and formalin fixed PC needle biopsies exhibit a higher diagnostic PCNA/Cyclin than Ki-67/MIB1 index for cases presenting differentiated features, whereas p120 nucleolar protein detection seems to be a suitable marker of poorer outcome of PC.

[Congenital hydrocephalus: clinico-pathological picture]. / L'idrocefalia congenita: quadri clinico-patologici.

The authors review the main pathologic causes of congenital hydrocephalus from ischemic-vascular injuries, embryofoetal infections and dysraphisms to genetic ones. Abundant illustrations of each condition are furnished and particular attention is paid to each situation, discussing the available pathogenetic mechanisms and hypothesis. Genetic "sine causa" hydrocephalus and X-linked hydrocephalus are mainly stressed, presenting some personal data. The clinic aspects of the varying forms of hydrocephalus are continuously kept in mind and a terminal paragraph details the clinical and neuroradiological means determinant in differential diagnosis versus similar conditions such as hydranencephaly, porencephaly, aracnoid cysts, holoprosencephaly and agenesis of corpus callosum.

[Neuropathology of the Turner syndrome]. / Neuropatologia della sindrome di Turner.

We report the neuropathologic examination of a neonatal case of Turner's syndrome (45,XO). We have found some mild irregularities in the cortical organization, notably in frontal and hippocampal regions. In the frontal cortex such anomalies affected particularly the more superficial layers essentially sparing the migrating process which was largely achieved in its fundamental phases. The hippocampal dentate gyrus appeared abnormally infolded. The cerebellum was hypoplasic and contained three types of abnormalities, at least: abundant paradentate matrix cell nests, a large mass of dysplastic cerebellar gyri along the ventral wall of the 4th ventricle and, finally, multiple voluminous heterotopias of macroneurons (possibly, Purkinje cells) in the subcortical white matter. In addition, there were two small olivary heterotopias in the medulla oblongata. The correct identification of all neuropathologic anomalies has been possible for having employed the method of whole brain serial sectioning. We have correlated such cortical, cerebellar and truncal abnormalities to those encountered in similar conditions as lissencephaly, Zellweger's disease and chromosomal trisomies. The pathogenetic mechanisms triggered by the absence of an X chromosome can affect the neuronal migration, but only after the cortical hemispheric one has been almost completely ended. This could explain why cerebellar and olivary neuronal migration are exclusively affected, being there the migration process chronologically slowed down during the normal neurogenesis. There means we might date after the 4th fetal months the neuronal migration trouble. Finally, we would suggest the soft cortical changes in such crucial regions as the frontal and hippocampal cortex to be possibly responsible for the degree of mental retardation seen in these patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Histological study on sinus lift grafting by Fisiograft and Bio-Oss.

The work aims to provide a histological investigation of Fisiograft, a PLA/PGA copolymer, used as filler for bone defects in humans. The study was performed on biopsies of sinus lifts where Bio-Oss and Fisiograft gel were applied as graft material. Bone regeneration was satisfactory in all sinus lifts, even when Fisiograft was applied alone. Due to remarkable osteoclast activity, Bio-Oss granules were cleared from the majority of biopsy cores. At histology, Fisiograft gel appeared as globes enveloped by fibroblasts, displaying an epithelial-like cell appearance. Due to its solubility in solvents, undegraded Fisiograft (recorded for 7 months or more) did not stain whereas degraded Fisiograft stained positive. The loose connective tissue, that surrounded Fisiograft and bone contained isolated mastocytes. Bone grew inside the loose connective and often reached the surface of Fisiograft by intervening cells. The results seem to indicate that Fisiograft may be considered both a polymer useful for fastening bone substitutes inside a defect and in addition a material capable of prompting bone regeneration, with or without the use of a bone substitute. In addition to space-former and space-maintainer functions, Fisiograft shows potential bone stimulation function, which may be labelled as osteopromotive capability.

A theoretical rationale on the histogenesis of premalignant lesions and early carcinoma of the prostate.

Several localized non-malignant and dysplastic glandular proliferations of the prostate mimick well-differentiated invasive prostatic microcarcinoma (PMC). However, the basal cell layer (BCL) is intact and evident in benign hyperplasias and lacking in PMC; consequently, immunohistochemical reactions for BCL, by means of keratin 903 antibody, are essential for distinguishing PMC from cribriform clear cell hyperplasia (CCCH), typical tubular hyperplasia and tubular transitional metaplasia, tubular, microtubular and cribriform basal cell hyperplasias, post-undeveloped prepuberal (PUPPUH), florid (FH) and mesonephric remnant hyperplasias. Moreover, the hyperplastic basal cells are also immunostained for prostatic specific antigen (PSA). The identification of myoepithelial cells (positive for keratin 903, actin and S100 protein antibodies) allow the diagnosis of prostatic sclerosing adenosis. Basement membrane (BM) and BCL are focally absent in post-atrophic hyperplasia (PAH), PUPPUH, FH and in extratubulo-alveolar gemmations of dysplasic lesions such as prostatic intraepithelial neoplasia (PIN), adenomatous atypical hyperplasia (AAH) and adenosis, where hypercromatic nuclei and enlarged nucleoli are the most important cytological criteria for defining malignant changes. Two putative oncogenic stages have been identified in the present work on these morphological grounds by critically examining the histogenetic hypoteses given in the literature on PMC precursors. The first is characterized by precancerous conditions such as PAH, PUPPUH, CCCH and FH that may become dysplastic though not necessarily; the second includes precancerous lesions, namely atypical tubulo-alveolar budding-in or budding-off as PIN and AAH, respectively, that may evolve towards PMC. The histogenesis of rare prostatic carcinomas are also considered. Basal cell and adenoid-cyst carcinomas seem to originate from atypical basal cell proliferations and metaplastic (transitional, adenosquamous, mucinous) carcinomas from basal and columnar-cells. Transitional and endometrioid carcinomas affect the mesonephric part of the prostate. Prostatic endocrine cells may give rise to carcinoid tumors, whereas some well-differentiated or anaplastic carcinomas may present more or less numerous endocrine cells and/or Paneth-like cells by means of a prosoplastic and ketaplastic process from neoplastic elements that underwent a stem cell backward differentiation.

Early (stage A) prostatic cancer. V. Stereotopography.

In 67 prostates, collected at autopsy, besides length, the following measures were taken or calculated (Leitz, ASM): width, thickness (antero-posterior axis) and correlative half-diameters, mean area and ratio area/perimeter. When prostatic microcarcinoma was present, the angle to the antero-posterior axis and the mean percent distance from the urethral barycentre were calculated; over 74% of all cancer foci were in the lateral sextants between iso-distances 50-90.

Meningeal melanocytoma of Meckel's cave associated with ipsilateral Ota's nevus.

A case of meningeal melanocytoma of the left Meckel's cave associated with ipsilateral Ota's nevus in a 43-year-old woman, was studied by light and electron microscopy. The cells of the tumor were characterized by the presence of dendritic cytoplasmic processes, melanosomes and premelanosomes; hence, they were deemed as neoplastic melanocytes. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic Schwannoma and primary meningeal melanoma. The prolonged clinical course was different from primary and metastatic malignant melanomas of the meninges. The best treatment appears to be radical excision, when possible; otherwise, the local or partial enucleation followed by radiation therapy has been found to be the best curative to date. On the whole, meningeal melanocytoma cannot be considered as entirely benign, given its morphologic patterns that resemble those of uveal melanoma, and its potential for recurrence. The association of this tumor with Ota's nevus is referred to as having a common origin from an arrested migration of melanoblasts at different stages.

Early (stage A) prostatic cancer. IV. Methodological criteria for histopathological diagnosis.

This study was performed in order to elucidate some of the problems of incidence, morphology and natural history concerned with Stage A prostatic cancer or prostatic microcarcinoma (PMC). The prostates of 100 patients, treated by subtotal prostatectomy for benign prostatic hyperplasia (BPH), were studied by comparing both routine and step-section techniques. The incidence of PMC was 41% by the former and 86% by the latter technique. Assessment of the size of PMC, as measured by the sum of the two main diameters, resulted in three groups: A1, A2, A3. The last of these may represent a frankly malignant condition, judged by size and the histological appearance. Radical prostatectomy is strongly suggested as appropriate therapy for this group.

Prostate cambial (stem)-zone and microcarcinoma: immunohistochemical and morphometric study approach.

30 surgically removed prostates were selected out of 200 for comparative histological, immunohistochemical and morphometric studies. The presence or the absence of keratin and the mean nuclear area of nuclear profiles are the main differential criteria in distinguishing atypical hyperplasia (cambial zone) from benign prostatic hyperplasia, microcarcinoma and other prostatic cancers.

Multinucleated giant cells in AIDS encephalopathy: an immunohistochemical study.

We report the neuropathological findings of 5 post-mortem cases of AIDS. The most common causes of the death were multiple opportunistic infections associated with cutaneous and/or visceral Kaposi sarcoma in two cases. Cerebral edema, demyelination and spongiosis of the white matter were present but the most remarkable finding was the presence of multinucleated giant cell (MGC) within and nearby microglial nodules. On immunohistochemical investigation MGC and microglial cells exhibit positive stain only for RCA I and Ferritin, while immunohistochemical markers for astrocytes, neurons, macrophages, histiocytes, lymphocytes and endothelial cells were negative. No microrganism, nor viral inclusions were detected. These results support the hypothesis that MGC may be derived from microglial cells.

Experimental acute hepatic vein occlusion: histological observations in the rat.

The histological consequences of hepatic venous outflow obstruction were studied in the rat. Circulatory changes as venous congestion and interstitial fluid accumulation are followed by signs of cellular damage progressing till hemorrhagic infiltration and focal necrosis. These are quite completely reversible in a period of 15 days.

Combined technique with polyethylene fibers and composite resins in restoration of traumatized anterior teeth.

Traumatized anterior teeth need quick esthetic and functional repair. Esthetic requirements of anterior teeth require the use of composite materials which, in the most complex cases, can be used in association with fibers so as to improve their mechanical resistance. Many kinds of fibers are available. The authors considered parameters such as physical properties, water absorption, ease of cutting and of laying. Polyethylene fibers appear to have the best properties in elasticity, translucency, adaptability, tenaciousness, resistance to traction and to impact. Fifteen children, between 7 and 13 years old, with crown fractures of the anterior sector were treated. In the case of a simple crown fracture, the missing part was restored by polyethylene fibers and composite resins. In the case of a complex crown fracture needing endodontic treatment, the fibers were used as a central core stump in order to restore the dental morphology. At control examinations, the teeth restored by this technique were acceptable, both in function and in aesthetics. Thus, the authors recommend this combined technique for predictable restoration of traumatized anterior teeth.