Histopathological Study of Endometrium in Patients of Perimenopausal Age Group in a tertiary care Hospital in West Bengal

Background: Menopause is an important event in women’s life and it marks the end of a woman`s reproductive life. Perimenopause is the interval in which a woman`s body makes a natural shift from regular cycles of ovulation & menstruation to irregular cycles and various forms of abnormal uterine bleeding. Dysfunctional uterine bleeding (DUB) is a very frequent complaint from women in the perimenopausal age group. The histological diagnosis of DUB and its proper management is very essential in this age group. Aims and Objective: Primary aim of our study was to identify the spectrum of histological changes that occur in the endometrium in perimenopausal age group and to identify the demographic pattern of each histological change. Materials and Methods: Fifty-two specimens of endometrial biopsy obtained from the patients in the perimenopausal age group of 40-50 years attending the Gynaecology and Obstetrics department were studied. Results: 71.15% cases of DUB was diagnosed amongst the 52 endometrial biopsy specimens in perimenopausal age group and Secretory endometrium is most common histological pattern. Conclusion: This study reflects a spectrum of endometrial histology present during perimenopausal age. This study has also highlighted the correlation of endometrial histology with final diagnoses of the patients, and this may help in diagnosis and treatment of gynaecological diseases of this specific age group in future.

Blocking of interleukin-1 suppresses angiotensin II-induced renal injury

Clinical hypertension (HT) is associated with renal inflammation and elevated circulating levels of proinflammatory cytokines. Interleukin (IL)-1 receptor antagonist (IL-1Ra) is one of the most important anti-inflammatory cytokines and plays a crucial role in inflammation. Inhibition of IL-1 may contribute to modulation of the Angiotensin II (Ang II)-induced HT response. The present study aimed to elucidate the effects of IL-1Ra and anti-IL-1β antibody (01BSUR) on Ang II-induced renal injury. To determine the contribution of IL-1Ra to Ang II-induced renal inflammation, male wildtype (WT) and IL-1Ra-deficient (IL-1Ra−/−) mice were infused with Ang II (1000 ng/kg/min) using subcutaneous osmotic pump for 14 days. We checked renal function, histological change, and several mRNA expressions 14 days after infusion. Fourteen days after infusion, systolic blood pressure (197 ± 5 vs 169 ± 9 mmHg, P<0.05) in IL-1Ra−/− mice significantly increased compared with WT mice. Furthermore, on day 14 of Ang II infusion, plasma IL-6 was 5.9-fold higher in IL-1Ra−/− versus WT mice (P<0.001); renal preproendothelin-1 mRNA expression was also significantly higher in IL-1Ra−/− mice (P<0.05). In addition, renal histology revealed greater damage in IL-1Ra−/− mice compared with WT mice 14 days after infusion. Finally, we administrated 01BSUR to both IL-1Ra−/− and WT mice, and 01BSUR treatment decreased Ang II-induced HT and renal damage (glomerular injury and fibrosis of the tubulointerstitial area) in both IL-1Ra−/− and WT mice compared with IgG2a treatment. Inhibition of IL-1 decreased Ang II-induced HT and renal damage in both IL-1Ra−/− and WT mice, suggesting suppression of IL-1 may provide an additional strategy to protect against renal damage in hypertensive patients.

Collagen I Induces Preeclampsia-Like Symptoms by Suppressing Proliferation and Invasion of Trophoblasts

Preeclampsia is a common obstetric disorder affecting 2-8% of pregnancy worldwide. Fibrosis is an important histological change occurring in preeclamptic placenta, and might depend on the excess deposition of collagen I. However, the role of fibrotic placenta and collagen I in the pathogenesis of preeclampsia remains unclear. Therefore, we analyzed the collagen deposition and the expression of Collagen I in human placenta by Masson staining, Sirius red staining and western blotting. Further, the role of collagen I in preeclampsia pathogenesis was studied in C57BL/6 mice. HTR-8/SVneo cells were used to investigate the mechanisms underlying the effects of collagen I in trophoblasts by transcriptome sequencing and pharmacological agonists. Human preeclamptic placenta exhibited a significantly higher degree of fibrosis in stem villi and terminal villi than normal placenta, and was characterized by collagen I deposition. In vivo, a single injection of collagen I on gestational day 0.5 led to an increase in systolic pressure of pregnant mice from gestational days 4.5–17.5, to a decrease in weight and number of embryos, and to enhanced placental collagen I expression and degree of fibrosis compared with control mice. In vitro, collagen I attenuated the proliferation and invasion of HTR-8SV/neo cells. This effect could be reversed by treatment with agonists of ERK and β-catenin. Moreover, transcriptome sequencing demonstrated that signaling pathways related to cell proliferation and invasion were significantly downregulated in HTR-8SV/neo cells. Thus, we propose that collagen I induced preeclampsia-like symptoms by suppressing the proliferation and invasion of trophoblasts through inhibition of the ERK phosphorylation and WNT/β-catenin signaling pathways. Our findings could pave the way to the discovery of small-molecule inhibitors for preeclampsia treatment and future studies with larger sample size are required.

Extreme growth plasticity in the early branching sauropodomorph Massospondylus carinatus

There is growing evidence of developmental plasticity in early branching dinosaurs and their outgroups. This is reflected in disparate patterns of morphological and histological change during ontogeny. In fossils, only the osteohistological assessment of annual lines of arrested growth (LAGs) can reveal the pace of skeletal growth. Some later branching non-bird dinosaur species appear to have followed an asymptotic growth pattern, with declining growth rates at increasing ontogenetic ages. By contrast, the early branching sauropodomorph Plateosaurus trossingensis appears to have had plastic growth, suggesting that this was the plesiomorphic condition for dinosaurs. The South African sauropodomorph Massospondylus carinatus is an ideal taxon in which to test this because it is known from a comprehensive ontogenetic series, it has recently been stratigraphically and taxonomically revised, and it lived at a time of ecosystem upheaval following the end-Triassic extinction. Here, we report on the results of a femoral osteohistological study of M. carinatus comprising 20 individuals ranging from embryo to skeletally mature. We find major variability in the spacing of the LAGs and infer disparate body masses for M. carinatus individuals at given ontogenetic ages, contradicting previous studies. These findings are consistent with a high degree of growth plasticity in M. carinatus .

Repeated Recurrences of Mucinous Prostate Carcinoma With Signet Ring Cells in the Urinary Bladder After Robotic-assisted Laparoscopic Radical Prostatectomy: a Case Report and Literatures Review

Background: Mucinous prostate carcinoma (PCa) and signet-ring-cell PCa are two rare variants of prostate cancer, but the transformation of mucinous PCa into mucinous PCa with signet ring cells was extremely uncommon, little data of therapy was available. Case presentation: We reported such a case that a man was pathologically considered as mucinous PCa after receiving transurethral resection of the prostate, then he underwent robotic-assisted laparoscopic radical prostatectomy (RARP), the pathological diagnosis was mucinous PCa (pT2cN0M0), without any adjuvant therapies, the man had received regular follow-up with serum total prostate-specific antigen level <0.003 ng/ml. Nevertheless, he received transurethral resection of bladder tumor (TUR-BT) at 13 months, 22 months and 31 months after RARP, respectively, the first TUR-BT specimens was mucinous PCa, where the two other present mucinous PCa with signet ring cells. Conclusions: We reviewed the literatures and discussed the differential diagnosis, immunohistochemistry, prognosis of this rare carcinoma, emphasized the rarity of the histological change and demanded fundamental research clarifying the confusion of this change, which may be helpful to search for therapeutic targets and improve prognosis.

The Dual Effect and Mechanism of (-)-epicatechin on Hypoxic-induced Proliferation and Apoptosis of Cardiac Fibroblasts

Objective: Cardiovascular diseases impose a considerable economic burden on health services and remain a threat to human being. (-)-Epicatechin [(-)-EPI], a traditional Chinese medicine is applied to treatment against the cardiovascular diseases. Herein, we aimed at investigating the underlying mechanism whereby (-)-EPI affects myocardial fibrosis (MF).Methods: The efficacy of (-)-EPI was determined in mouse models of acute myocardial infarction (AMI) and hypoxia-treated fibroblasts. Western blot and RT-qPCR analyses were conducted to determine TGF-β1, SMAD2 and SMAD3 expression, as collagen content was detected. CCK-8 assay and flow cytometry were carried out to detect fibroblast proliferation and apoptosis. HE and Masson staining reflected the histological change of myocardial tissuesResults: Compared to sham-operated mice, AMI group exhibited MF and hypoxia-treated cardiac fibroblasts proliferation was restrained and apoptosis was increased. Treatment with (-)-EPI significantly attenuated the MF condition and restored fibroblast proliferation and apoptosis, whereas these effects were abrogated by the TGF-β1 agonist HY-100347A. (-)-EPI administration caused a decline in TGF-β1, SMAD2 and SMAD3 expression. Mechanistically, (-)-EPI targeting TGF-β signaling inhibits collagen deposition and attenuates MF.Conclusion: Collectively, (-)-EPI could improve MF following AMI through down-regulation of TGF-β1 signaling, providing a novel insight into treatment against the cardiovascular diseases.

A case of giant retroperitoneal lymphangioma and IgG4-positive fibrosis: Causality or coincidence?

Several chronic inflammatory diseases have been found to be a subtype of IgG4-related disease, all of which have a typical clinical and histological change, which is based in particular on an overexpression of IgG4 and subsequent fibrosis. At least a part of the retroperitoneal fibrosis, which was originally classified as idiopathic, seems to be assigned to IgG4-related disease. Lymphangiomas are benign, cystic tumors that rarely occur in adults. However, there is no firm association with IgG4-related disease described in the literature to date. This report is about a patient suffering from acute renal failure due to a giant retroperitoneal cyst. Surgical resection remains incomplete in the iliac vessel area due to severe fibrosis and histology revealed features of both lymphangioma and IgG4+ fibrosis. The case description is followed by a brief overview of IgG4-related disease and a consideration of whether lymphangiomas might be assigned to this topic.

Treatment of esophageal cancer: surgical outcomes of 335 cases operated in a single center

ABSTRACT Objectives: the surgical approach persists as the main treatment for esophageal cancer. This study compares the patients of the same institution over time at three different times. Methods: this is a retrospective, observational, descriptive study comparing the surgical outcomes obtained by the Division of Surgical Oncology of Erasto Gaertner Hospital. The sample was divided into Period 1 (1987-1997), Period 2 (1998-2003) and Period 3 (2007-2015). Survival rates and disease-free survival were estimated by the Kaplan-Maier method. Survival predictors were identified with Cox regression. ANOVA test was used for comparison between groups. Data were analyzed with SPSS 25.0 and STATA 16, and p<0.05 was considered statistically significant. Results: a total of 335 patients underwent esophagectomy or esophagogastrectomy. When the clinical characteristics of the 3 groups were compared, there was no statistically significant difference. Neoadjuvance was significantly higher in Period 3 (55.4% of patients). We found a histological change in the diagnosis over time, with a significant increase in adenocarcinoma. Morbidity and mortality rates were higher in Period 3. The main complications were pulmonary and anastomotic fistulas. Overall survival in 5 years increased over time, reaching 59.7% in Period 3. Conclusions: better neoadjuvant treatment contributed to increase the global survival of patients, despite greater rate of immediate complications to surgery.

Heterotopic gastric mucosa in the gallbladder—a rare find

It is universally known and accepted that the development of a certain type of tissue outside its usual location, like in the gastrointestinal tract, can occur. This is a relatively common situation in the upper region of the gastrointestinal tract. However, the development of gastric mucosa in the gallbladder is a rare find. The following is the case of a 22-year-old male with an 18 mm gallbladder polyp, who electively underwent a laparoscopic cholecystectomy, having been diagnosed at a histopathological level with heterotopic gastric mucosa in the gallbladder. This brief article also aims to provide a reflection on the possible evolution of neoplasms from this histological change, based on the doubts raised in literature.