Sakda Waraasawapati

Monosodium Glutamate (MSG) Consumption Is Associated with Urolithiasis and Urinary Tract Obstruction in Rats

Background The peritoneal injection of monosodium glutamate (MSG) can induce kidney injury in adult rats but the effects of long-term oral intake have not been determined. Methods We investigated the kidney histology and function in adult male Wistar rats that were fed ad libitum with a standard rat chow pellet and water with or without the addition of 2 mg/g body weight MSG/day in drinking water (n=10 per group). Both MSG-treated and control animals were sacrificed after 9 months when renal function parameters, blood and urine electrolytes, and tissue histopathology were determined. Results MSG-treated rats were more prone to kidney stone formation, as represented by the alkaline urine and significantly higher activity product of calcium phosphate. Accordingly, 3/10 MSG-treated rats developed kidney stones over 9 months versus none of the control animals. Further, 2/10 MSG-treated rats but none (0/10) of the controls manifested hydronephrosis. MSG-treated rats had significantly higher levels of serum creatinine and potassium including urine output volume, urinary excretion sodium and citrate compared to controls. In contrast, MSG-treated rats had significantly lower ammonium and magnesium urinary excretion. Conclusion Oral MSG consumption appears to cause alkaline urine and may increase the risks of kidney stones with hydronephrosis in rats. Similar effects in humans must be verified by dedicated studies.

Monosodium Glutamate Dietary Consumption Decreases Pancreatic β-Cell Mass in Adult Wistar Rats

Background The amount of dietary monosodium glutamate (MSG) is increasing worldwide, in parallel with the epidemics of metabolic syndrome. Parenteral administration of MSG to rodents induces obesity, hyperglycemia, hyperlipidemia, insulin resistance, and type 2 diabetes. However, the impact of dietary MSG is still being debated. We investigated the morphological and functional effects of prolonged MSG consumption on rat glucose metabolism and on pancreatic islet histology. Methods Eighty adult male Wistar rats were randomly subdivided into 4 groups, and test rats in each group were supplemented with MSG for a different duration (1, 3, 6, or 9 months, n=20 for each group). All rats were fed ad libitum with a standard rat chow and water. Ten test rats in each group were provided MSG 2 mg/g body weight/day in drinking water and the 10 remaining rats in each group served as non-MSG treated controls. Oral glucose tolerance tests (OGTT) were performed and serum insulin measured at 9 months. Animals were sacrificed at 1, 3, 6, or 9 months to examine the histopathology of pancreatic islets. Results MSG-treated rats had significantly lower pancreatic β-cell mass at 1, 6 and 9 months of study. Islet hemorrhages increased with age in all groups and fibrosis was significantly more frequent in MSG-treated rats at 1 and 3 months. Serum insulin levels and glucose tolerance in MSG-treated and untreated rats were similar at all time points we investigated. Conclusion Daily MSG dietary consumption was associated with reduced pancreatic β-cell mass and enhanced hemorrhages and fibrosis, but did not affect glucose homeostasis. We speculate that high dietary MSG intake may exert a negative effect on the pancreas and such effect might become functionally significant in the presence or susceptibility to diabetes or NaCl; future experiments will take these crucial cofactors into account.

Overexpression of lactate dehydrogenase A in cholangiocarcinoma is correlated with poor prognosis

Lactate dehydrogenase A (LDHA), a key metabolic enzyme, plays a crucial role in the final step of anaerobic glycolysis. Overexpression of LDHA is observed in many human malignancies in association with tumor progression. The purpose of this study was to investigate LDHA expression pattern during carcinogenesis, its clinico-pathological association, and evaluate the prognostic value of LDHA in CCA patients. LDHA expression was investigated using immunohistochemistry technique in both hamster- (n=60) and human-CCA tissues (n=82). Plasma LDH from healthy control (n=40) and CCA patients (n=29) were determined using an enzymatic based assay. The association of LDHA expression with clinico-pathological findings and prognostic value were evaluated by statistical analysis. In the CCA hamster model, an increase of LDHA expression was associated with the progression of CCA-genesis. Higher LDHA overexpression was associated with shorter survival of CCA patients. Multivariate analysis indicated that LDHA expression including histological type and N stage of tumor were independent prognostic risk factor of patients survival. However, there was no difference in plasma LDH level between CCA patients and healthy controls. LDHA expression is involved in cholangiocarcinogenesis. Overexpression of LDHA can be a marker of poor prognosis in CCA patients and it might be a potential target for CCA treatment.

Anthelmintic, anti-inflammatory and antioxidant effects of Garcinia mangostana extract in hamster opisthorchiasis.

Administration of praziquantel for treatment of liver fluke infection may affect the host, with mild and severe effects after treatment caused by host immune response. Therefore, we focused on the antioxidant property, inflammatory and anthelmintic effects of the traditional folk medicine, G. mangostana pericarp extract, in hamster opisthorchiasis. Syrian hamsters were divided into four groups: normal (control) (N); administered G. mangostana alone (GM); infected with Opisthorchis viverrini alone (OV); and infected with O. viverrini and administered G. mangostana extract for 1.5 months (OVGM). Hamster livers were collected 45 days after infection to determine histopathological changes, i.e. aggregation of inflammatory cells. The morphology of adult O. viverrini (body size and sizes of reproductive organs) was analyzed, as well as worm burden, eggs per worm and eggs per gram of feces. Toxicity was tested by kidney function (blood urea nitrogen and creatinine); the results demonstrated that G. mangostana had no renal toxic effect. ABTS radical-scavenging assay indicated that the extract had antioxidant property. Reduction in aggregation of inflammatory cells surrounding the hepatic bile duct, especially at the hilar region, was found in the OVGM group. Worm burden was similar in both infected groups (treated or untreated with G. mangostana), but the average size of adults in the OV group was larger than in the OVGM group; moreover, eggs per worm and eggs per gram of feces were also comparatively higher. The present study suggests that G. mangostana extract possesses anti-inflammatory and antioxidant properties and can interfere with parasite development by affecting adult size and egg production. This may be useful for controlling the spread of OV infection and other parasites in endemic areas.

Extramedullary hematopoiesis in pyogenic granuloma

Extramedullary hematopoiesis (EMH) suggests the presence of hematopoietic stem cells (HSC) outside bone marrow. EMH has been reported, albeit rarely, in pyogenic granuloma (PG), a polypoid lobular capillary hemangioma. However, statistical data have hitherto been lacking on the actual incidence of EMH in PG. Therefore, we here reviewed 157 consecutive cases using routine diagnostic surgical slides and found unequivocal EMH in 17 (10.8%). This indicates that EMH is a rather common finding in PG, which could thus have strong potential to be an important resource for the study of HSC.

Hematidrosis: a report with histological and biochemical documents.

Hematidrosis is an extremely rare condition. The manifestations of this phenomenon consist of bloody sweat from non-trauma of the skin and sometimes present with tear blood or bloody otorrhea. The patient has to be ruled out from other bleeding tendency conditions, which can cause spontaneous bleeding episodes. The etiology remains unclear; however, stress and some psychiatric problems were considered the cause of this phenomenon by stimulating the sympathetic nervous system in some studies in the literature. As there was a possibility of involving the sympathetic nervous system, the use of propranolol had been reported as the successful treatment option; however, it has also been described as self-limiting requiring no treatment. Here, we report another case of self-limiting hematidrosis in children with histological and biochemical documents.

Preoperative MRI evaluation of meningioma consistency: A focus on detailed architectures

OBJECTIVES Meningioma is one of the most common primary intracranial tumors. Diagnosis by imaging is not difficult. However evaluation of tumor consistency is an important factor affecting the surgical outcomes. The purpose of our study is to discover the relationship of different findings on pre-operative MRI, with a focus on detailed architectures, and different degrees of intra-operative stiffness of meningioma. Consistency of meningioma is also analyzed in compression to semi-quantitative pathological grading of fibrosis. PATIENTS AND METHODS Sixty patients who underwent pre-operative MRI and primary surgery at our hospital were included in prospective fashion. Pre-operative MRI parameters, including general data and detailed internal architectures, were recorded. Intra-operative grading of tumor consistency was performed by the neurosurgeon. Pathological report according to WHO 2007 was performed with additional semi-quantitative grading of fibrosis. This study is focused on correlation of operative grade and MRI findings. RESULTS Meningioma with hard consistency shows significant correlation with several features including en plaque appearance (p = 0.0427), higher ADC value (p = 0.0046) and ratio (p = 0.0016), absent of prominent enhanced rim (p = 0.0306), absent of enostotic spur (p = 0.0040) and absent of vascular core (p = 0.0133) in univariate analysis but no significant correlation is found in multivariate analysis in all except ADC ratio. Higher ADC ratio increase relative risk of hard consistency of meningioma by a factor of 41.22 (ORs = 41.22; 95%CI = 1.19-1426.24, P = 0.04). Good to very good inter-rater agreements are found. No significant correlation between tumor consistency and WHO grading was shown (p = 0.606). However, near significant p-value (p = 0.055) is found with increase degree of fibrosis in pathology as increase degree of tumor consistency. CONCLUSION We found that en plaque appearance, higher ADC value and ADC ratio, absent of prominent capsular enhancement and absent of vascular core were suggestive of hard consistency in univariate analysis but not independent factors. Additionally, semi-quantitative pathological grading of fibrosis showed near significant correlation with tumor consistent.

Multiple yellow-red papules on the head and neck in a 3-month-old boy

A 3-month-old boy presented to the pediatric dermatology clinic with a 1 month history of lesions on the scalp, face and neck. He was otherwise healthy with normal growth and development. On examination he had multiple firm yellowish– brownish papules on the scalp, face, neck and trunk (Fig. 1). On dermoscopy the papules were yellow–orange in color and measured 0.3–0.7 cm in diameter (Fig. 2). Diagnostic skin biopsy indicated Touton giant cells, the classic foamy histiocytes typically seen in juvenile xanthogranuloma (JXG; Fig. 3). Immunohistochemistry was positive for CD68, and negative for S100 as well as CD1a, further confirming the diagnosis of JXG. The patient was sent for ophthalmological evaluation to investigate ocular involvement, which is frequently seen in association with cutaneous JXG. The result was negative in this case. The lesions slowly regressed and some had disappeared by 2 year follow up. No medication was given. Juvenile xanthogranuloma is a benign, self-healing disorder characterized by solitary or multiple yellow–red nodules on the skin. It occurs predominantly during infancy or early childhood, with the classic presentation of yellow–red papular or nodular eruption, usually on the head and neck area. Diagnosis is readily made in typical cases, but may be more difficult in atypical presentations. In general the patient’s health is not impaired and usually there is normal growth and development.

Kimura disease masquerading as soft tissue tumor of the elbow

Kimura disease is a rare chronic inflammatory disorder of unknown etiology, characterized as painless subcutaneous mass which is rarely found outside head and neck region. We report an unusual presentation of Kimura disease of a 50-year-old man who presented with a progressive large non-tenderness right elbow mass for one year. Physical examination revealed a 10 cm soft tissue mass at the medial side of his right elbow. The Laboratory investigation showed peripheral eosinophilia. The clinical diagnosis was a soft tissue tumor. It also included the differential diagnosis of a parasitic infection. Surgical excision had been performed and the histology demonstrated a nodular lymphoid hyperplasia with prominent germinal centers, a large infiltration of eosinophils with a foci of eosinophilic micro-abscess and vascular proliferation which compatible with Kimura disease. Following surgery the patient visited again with the following symptoms, a left post auricular mass with multiple cervical lymph node enlargements. The excisional biopsy revealed the same histology as the elbow.

Cytological diagnosis of diffuse large B-cell lymphoma in vitreous aspiration by cell block cytology preparation

In 2012, a 51-year-old female patient first presented with blurred vision. The physical examination revealed bilateral visual acuity impairment. Clinical diagnosis was SLE with chronic panuveitis both eyes. After that, the fine needle aspiration from vitreous was sent for cytology (conventional smear). Cell block cytology preparation and immunohistochemistry has been performed and the cytological diagnosis was concluded as diffuse large B-cell lymphoma. The cell block cytology preparation is a useful method in cytological technique that makes the cytological specimen available for ancillary tests such as immunohistochemistry.