Background: The dysferlin gene has recently been shown to be involved in limb girdle muscular dystrophy type 2B and its allelic disease, Miyoshi myopathy, both of which are characterised by an active muscle degeneration and regeneration process. Dysferlin is known to play an essential role in skeletal muscle fibre repair, but the process underlying the pathogenetic mechanism of dysferlinopathy is not completely understood. Aims: To define both specific alterations of muscle fibres and a possible sequential mechanism of myopathy development. Methods: A histological, immunohistochemical, and ultrastructural analysis of 10 muscle biopsies from patients with molecularly diagnosed dysferlinopathy. Results: An inflammatory response was seen in most of the muscle biopsies. The immunohistochemical pattern demonstrated active regeneration and inflammation. Non-necrotic fibres showed alterations at different submicroscopic levels, namely: the sarcolemma and basal lamina, subsarcolemmal region, and sarcoplasmic compartment. In the subsarcolemmal region there were prominent aggregations of small vesicles, probably derived from the Golgi apparatus, which consisted of empty, swollen cisternae. In the sarcolemma there were many gaps and microvilli-like projections, whereas the basal lamina was multilayered. Conclusions: The histopathological, immunohistochemical, and ultrastructural data show that dysferlinopathy is characterised by a very active inflammatory/degenerative process, possibly associated with an inefficient repair and regenerative system. The presence of many crowded vesicles just beneath the sarcolemma provides submicroscopical proof of a defective resealing mechanism, which fails to repair the sarcolemma.
The asialoglycoprotein receptor (ASGP-R) is a glycoprotein present in large amount only on hepatocytes where it is expressed on the sinusoidal and lateral plasma membrane (Morell et al, 1968;Geffen and Spiess, 1992). ASGP-R binds and internalizes a broad range of molecules exposing galactose or N-acetyl-galactosamine residues. Following internalization the fate of ligand is lysosomal degradation (Morell et al, 1968;Geffen and Spiess, 1992).Taking advantage of this receptor a chemotherapeutic approach has been developed to reduce the extrahepatic side-effects of nucleoside analogues (NAs) used in chronic viral hepatitis (Fiume et al, 1979(Fiume et al, , 1997 Torriani et al, 1996). These drugs are coupled to galactosyl-terminating peptides. The conjugates selectively enter hepatocytes, where the lysosomal enzymes split the bond between the carrier and the drug, which becomes concentrated in liver cells. A similar strategy was suggested in order to increase the chemotherapeutic index of drugs inhibiting DNA synthesis in the treatment of human hepatocellular carcinoma (HCC) (Schneider et al, 1984;O'Hare et al, 1989;Di Stefano et al, 1998). This approach obviously requires the presence of the receptor in the neoplastic tissue and maintenance of its expression on DNA synthesizing cells.Few and conflicting data are available on the distribution of ASGP-R in human neoplastic hepatocytes. In a study in which the receptor was measured by a biochemical procedure, it was not found in HCC samples (Sawamura et al, 1984), whereas in an immunohistochemical investigation carried out on ten cases of HCC the presence of the receptor was demonstrated in the more differentiated forms (Hyodo et al, 1993). In the present study we have first assessed the frequency of ASGP-R expression in a large number of human HCCs. For this purpose, needle biopsy samples of sixty consecutive HCCs were analysed. Visualization of the receptor was obtained using an anti-ASGP-R monoclonal antibody applied after antigen retrieval procedure to routinely formalinfixed, paraffin-embedded liver samples. Since we found that the ASGP-R was present in 33 HCCs we also investigated whether the ASGP-R was maintained on the plasma membrane of DNA synthesizing cancer cells. For this purpose we incubated HCC tissue samples with bromodeoxyuridine (BrdU). The presence of ASGP-R on DNA-synthesizing cancer cells was immunohistochemically assessed using anti-BrdU and anti-ASGP-R antibodies on the same tissue section. Summary The expression of the asialoglycoprotein receptor (ASGP-R) on human hepatocellular carcinoma (HCC) cells might be exploited to reduce the extrahepatic toxicity of DNA synthesis inhibitors by their conjugation with galactosyl-terminating peptides. In the present study we first assessed the frequency of ASGP-R expression in 60 HCCs. Secondly, we investigated whether the receptor was maintained on the plasma membranes of DNA synthesizing cancer cells. Needle biopsies of HCC were evaluated. Diagnosis and grading of HCC were performed on routine haematoxyli...
Introduction Long term safety of testosterone (T) administration in women is still unknown. In particular few and discordant data exists on the effects of T on the endometrium. Aim The aim of this study was to investigate the effects of long-term T treatment on endometrium histology and proliferation in female to male transsexual subjects (FtM). We compared these endometria with those of young women in the proliferative phase (PM) of the cycle and with those of post menopausal women (M). Method Endometrial samples from 27 FtM treated with T (intramuscular injection of 100 mg Testoviron Depot /10 days for at least one year), 30 M undergoing vaginal hysterectomy, and 13 PM undergoing hysteroscopy for infertility problems were collected. Endometrial proliferation was evaluated on the basis of histopathology and expression of the proliferation marker Ki-67. Both M and PM women had not received any hormonal treatment for at least one year. Main Outcome Measure Circulating total testosterone (TT), estradiol (E), progesterone (P), insulin and glucose levels were measured in FtM and PM subjects. Results FtM had received T for 33.6 ± 21.3 months (mean ± SD). In FtM subjects, histological analysis found inactive endometrium similar to the atrophic menopausal endometrium. The expression of Ki-67 in the glands, stroma and glands and stroma together was significantly (p < 0.0005) lower in FtM than in PM women and was similar in the FtM and M groups. Small polyps were detected in 5 of the 27 FtM subjects. Conclusions In conclusion our data suggest that exogenous T administration does not stimulate endometrial proliferation in FtM transsexuals and indeed may have atrophic effects.
The presence of desmin is used to identify Ito cells in rat liver and to evaluate the purity of separated and cultured Ito cells. Heterogeneity of the normal Ito cell population has been suggested; this could include variations in the content of cytoskeletal components. For these reasons we decided to reevaluate the use of desmin staining as a phenotypical marker of Ito cells in normal rat liver. Our approach was to combine desmin staining with identification of vitamin A (autofluorescence), lipid droplets (Sudan III), vimentin, laminin and tenascin, using cryostat sections: Immunofluorescence, double-immunofluorescence or immunoperoxidase techniques were used. All the techniques described corroborate the existence of desmin-negative Ito cells, mainly located in pericentral areas. In fact, lobular desmin-positive cells showed uneven distribution because they were more frequent in periportal than in pericentral areas. On the contrary, Ito cells identified on the basis of morphological criteria or positivity for laminin were evenly distributed. Double immunofluorescence confirmed this observation, showing nearly complete codistribution of laminin and desmin in periportal areas. Outside this area, positivity for desmin was observed only in about 50% of laminin-positive cells. Our observations suggest that desmin cannot be viewed as a phenotypical marker but rather is a differentiation marker of Ito cells, possibly indicating a specific functional state.
Kindler syndrome is characterized by a generalized, progressive poikiloderma with cutaneous atrophy, congenital acral skin blistering, and photosensitivity. Since the first description, approximately 70 cases have been reported worldwide, but ultrastructural studies were performed in only five patients. In none of these patients were biopsies done at birth. In our patient ultrastructural studies were performed both of the blister at birth and of the poikilodermatous and atrophic skin at 6 years of age. Some ultrastructural features in the context of a bullous disease of the newborn that resembles epidermolysis bullosa, should alert investigators to the possibility of Kindler syndrome even in absence of the typical clinical signs.
In amyloidotic cardiomyopathy, amyloid deposition is highly heterogeneous. Different patterns of infiltration are identifiable, including diffuse, mainly segmental and mainly subendocardial. Awareness of this variability can help the interpretation of ECGs, echocardiograms and magnetic resonance imaging.
This is the first study on the validity of a quantitative analysis of internal MHC-I positive fibres for an IM diagnosis performed according to Standards for Reporting of Diagnostic Accuracy recommendations. The interobserver agreement was almost perfect, thus making the method reproducible. Applying an MHC-I cut-off above 50% is an optimal marker for polymyositis (PM) and dermatomyositis (DM) diagnosis.
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