Uremia associated with erythrophagocytosis by small intestine epithelial cells: a case report.

BACKGROUND: Anemia is a frequent finding in patients with uremia due to chronic renal failure. Two factors contribute to the decrease in the red blood cell count and worsen the patient's general status: depression of erythropoiesis and shortening of the red blood cell lifespan. CASE: A novel response mechanism to erythrocyte loss took place in a uremic patient with gastrointestinal hemorrhage. In an autopsy case of an 80-year-old woman dying of uremia, analysis of an intestinal fluid smear revealed small intestine epithelial cells engulfing complete erythrocytes. CONCLUSION: This cytologic finding could account for a potential response mechanism to counteract the massive erythrocyte loss that occurs in hemorrhagic anemia with a uremic background.

Novel nanocomposite biomaterial to differentiate bone marrow mesenchymal stem cells to the osteogenic lineage for bone restoration.

BACKGROUND/OBJECTIVE: As the bone engineering field moves away from nonviable implants to more biocompatible and natural structures, nanomedicine has emerged as a superior tool for developing implantable materials. METHODS: Here, we describe the fabrication and testing of a nanocomposite structure composed of chitosan and a biocompatible thermoplastic (PMMA). RESULTS: Our nanocomposite material displayed morphologically similar characteristics to an extracted murine femur during microscopic and spectroscopic analysis as seen through SEM and FTIR. Crosslinking our nanocomposite enhanced structural and strength characteristics significantly above the noncrosslinked sample, mimicking the strength of an extracted mammalian bone. When cocultured with bone marrow mesenchymal stem cells, the composite material proved to be osteoinductive and osteogenic via DAPI and actin staining, differentiating BMSCs into the osteogenic lineage and promoting mineral deposition. Nodule formation, indicative of mineralization during BMSC differentiation, was confirmed spectroscopically via FTIR and autofluorescence of the nodule. CONCLUSION: These encouraging results show promise for in vivo implantation of our novel scaffold that is both biocompatible and biomimetic in strength and composition.

Ultrasonographic autopsy (echopsy): a new autopsy technique.

Autopsy has been one of the most important techniques for the development of modern medicine, mainly during the nineteenth century and the first half of last century. However, in the last few years, the number of autopsies performed in hospitals has dramatically decreased all over the world. This loss of interest can be attributed both to important advances in other diagnostic and therapeutic techniques and to the fear of malpractice suits. Several groups have tried to overcome this problem, developing different autopsy techniques, one of which is needle autopsy. Most authors using this technique have acknowledged that it is difficult to obtain material from certain organs and lesions, which makes its diagnostic reliability worse than that of conventional autopsy. To overcome this drawback, our team has recently developed a modification of needle autopsy, called ultrasonographic autopsy or echopsy, in which samples are obtained under ultrasonographic control. We report the results of the first 100 cases of echopsy performed in our hospital, comparing this technique with conventional autopsy performed on all the corpses. The concordance rate for the cause of death and the main pathological diagnosis between echopsy and classical autopsy was 83% in our series, which makes echopsy a feasible and reliable alternative to conventional autopsy in cases in which families refuse to give their consent for classical autopsy or in cases of infectious diseases.

The role of postmortem study in the diagnosis of the cause of death in a young man: a rare case of Ehlers-Danlos syndrome type IV.

Diagnosis of the cause of death in young people is a challenge to both the clinician and the pathologist. Ehlers-Danlos syndrome (EDS) type IV is an inherited connective tissue disorder. It is characterised by thin translucent skin, abnormal fragility of blood vessels, and a typical facial appearance. The cause of death is usually due to large arterial rupture. We describe an unusual case of a 23-year-old man clinically diagnosed with myocarditis, who suffered from recurrent pulmonary haemorrhage and died of massive myocardial haemorrhage and ischaemia without coronary artery disease. Diagnosis of EDS type IV was made by autopsy. To our knowledge, this is the first such report in the literature. Delay in diagnosing this syndrome is common even when clinical features are typical, and the condition often goes unrecognised until necropsy. The diagnosis of EDS should be considered in young people who seek medical attention because of arterial rupture.