Sarah Kuruvilla

Sellar lesion: not always a pituitary adenoma.

Inflammatory lesions of the hypophysis account for 0.5% of all symptomatic diseases of the pituitary, which include lymphocytic hypophysitis, granulomatous hypophysitis with or without specific etiology and pituitary abscess. Sellar tuberculoma is a rare type of granulomatous hypophysitis. We document a case of a postmenopausal lady who presented with galactorrhea, headache and blurring of vision. Based on preliminary investigations, a clinical diagnosis of pituitary adenoma was made and the pituitary gland was surgically excised. Histopathological examination showed caseating granulomas, along with normal areas of preserved pituitary gland and a final diagnosis of tuberculous hypophysitis was made. This case is being documented due to the extremely rare involvement of the pituitary gland by granulomatous lesions such as tuberculosis and to emphasize the role of intraoperative consultation to obviate the need for radical surgery in such lesions.

Modulatory effect of Inula racemosa Hook. f. (Asteraceae) on experimental atherosclerosis in guinea-pigs

Objectives Inula racemosa Hook. f. is indicated for precordial chest pain in Ayurveda. In this study, the effects of a hexane (IrH) and an alcohol extract (IrA) of Inula racemosa on atherosclerosis induced by a high‐fat diet in guinea‐pigs were investigated.

Angiomatous meningioma: a diagnostic dilemma.

Angiomatous meningioma accounts for 2.1% of all meningiomas. It has features of a typical benign meningioma with many small or large vascular channels which may predominate over its meningothelial elements. We present here a series of three cases of angiomatous meningioma, which posed diagnostic difficulty to clinicians, radiologists, and pathologists. All the three cases showed a tumor entirely composed of thin-walled vascular channels and cells with bland morphology in the background. The diagnosis was confirmed by immunohistochemistry. We present series of three cases to highlight the histomorphological features of this uncommon variant of meningioma that could help in distinguishing it from hemangioblastoma and hemangiopericytoma.

Pathology of synovial lipomatosis and its clinical significance

Background: Synovial lipomatosis is a rare disorder of the synovium, commonly affecting the knee joint, resulting in joint pain, swelling, and effusion. The etiology of this condition still remains unclear. Aim: This was a study done to evaluate the disease process in synovial lipomatosis, with respect to the clinical parameters and pathological features. Materials and Methods: Case files of synovial lipomatosis diagnosed on histopathology between 2007 and 2009 were perused, to study the case history, and tissue sections were reviewed for the histomorphological changes. Results: Eight cases of synovial lipomatosis were diagnosed on histopathology from year 2007 to 2009, of which one occurred in the wrist joint and the rest were localized to the knee joint. Age ranged from one year to seventy-three years, with a male preponderance. Pain and swelling were major complaints. Three had a significant past history, one occurring post-trauma, one following chikungunya, and another with septic arthritis. Three of the cases had osteoarthritis. Body mass index was elevated in four cases and one case had protein energy malnutrition. On histopathological examination, all the cases showed villous proliferation of the synovium, with focal and diffuse infiltration by mature adipocytes. Four cases showed focal hyperplasia of the lining epithelium and five cases revealed variable fibrosis. Conclusion: Synovial lipomatosis may mimic tumorous, lesion-like synovial lipoma or hemangioma and its distinct histomorphology helps in distinguishing it from these lesions. It possibly represents a secondary phenomenon following the degenerative process of articular disease of the joints.

Electrospun type 1 collagen matrices preserving native ultrastructure using benign binary solvent for cardiac tissue engineering.

Electrospinning is a well-established technique that uses a high electric field to fabricate ultrafine fibrous scaffolds from both natural and synthetic polymers to mimic the cellular microenvironment. Collagen is one of the most preferred biopolymers, due to its widespread occurrence in nature and its biocompatibility. Electrospinning of collagen alone has been reported, with fluoroalcohols such as hexafluoroisopropanol (HFIP) and trifluoroethanol (TFE), but the resultant collagen lost its characteristic ultrastructural integrity of D-periodicity 67 nm banding, confirmed by transmission electron microscopy (TEM), and the fluoroalcohols used were toxic to the environment. In this study, we describe the use of glacial acetic acid and DMSO to dissolve collagen and generate electrospun nanofibers of collagen type 1, which is non-toxic and economical. TEM analysis revealed the characteristic feature of native collagen triple helical repeats, showing 67 nm D-periodicity banding pattern and confirming that the ultrastructural integrity of the collagen was maintained. Analysis by scanning electron microscopy (SEM) showed fiber diameters in the range of 200–1100 nm. Biocompatibility of the three-dimensional (3D) scaffolds was established by MTT assays using rat skeletal myoblasts (L6 cell line) and confocal microscopic analysis of immunofluorescent-stained sections of collagen scaffolds for muscle-specific markers such as desmin and actin. Primary neonatal rat ventricular cardiomyocytes (NRVCM) seeded onto the collagen scaffolds were able to maintain their contractile function for a period of 17 days and also expressed higher levels of desmin when compared with 2D cultures. We report for the first time that collagen type 1 can be electrospun without blending with copolymers using the novel benign solvent combination, and the method can be potentially explored for applications in tissue engineering.

Electrospun polycaprolactone matrices with tensile properties suitable for soft tissue engineering

The extracellular environment is a complex network of functional and structural components that impart chemical and mechanical stimuli that affect cellular function and fate. Cell differentiation on three dimensional scaffolds is also determined by the modulus of the substrate. Electrospun PCL nanofibers, which mimic the extra cellular matrix, have been developed with a wide variety of solvents and their combinations. The various studies have revealed that the solvents used influence the physical and mechanical properties, resulting in scaffolds with Youngs modulus in the range of 1.8–15.4 MPa, more suitable for engineering of hard tissue like bone. The current study describes the use of benign binary solvent-generated fibrous scaffolds with a Youngs modulus of 36.05 ± 13.08 kPa, which is almost 50 times lower than that of scaffolds derived from the commonly used solvents, characterized with myoblast, which can be further explored for applications in muscle and soft tissue engineering.

Gelatin electrospun nanofibrous matrices for cardiac tissue engineering applications

ABSTRACT The generation of in vitro tissue constructs using biomaterials and cardiac cells is a promising strategy for screening novel therapeutics and their effects on cardiac regeneration. Current cardiac mimetic tissue constructs are unable to stably maintain functional characteristics of cardiomyocytes for long-term cultures. The objective of our study was to fabricate and characterize nanofibrous matrices of gelatin for prolonged cultures of primary cardiomyocytes which previously has been used as copolymer or hydrogels. Gelatin nanofibrous matrices were successfully electrospun using a benign binary solvent, cross-linked without swelling and fusing and evaluated by scanning electron microscopy (SEM) and uniaxial tensile measurement. Scaffolds exhibited modulus 19.6 ± 3.6 kPa similar to native human myocardium tissue with fiber diameters of 200–600 nm and average porosity percentage of 49.9 ± 5.6. Myoblasts showed good cell adhesion and proliferation. Neonatal rat cardiomyocytes cultured on gelatin nanofibrous matrices showing synchronized contracting cardiomyocytes (beating) for 27 days were studied by video microscopy. Confocal microscopic analysis of immunofluorescence stained sections indicated the presence of cardiac specific Troponin T in long-term cultures. Semiquantitative RT-PCR analysis of 3D versus 2D cultures revealed enhanced expression of contractile protein desmin. Our studies show that the biophysical and mechanical properties of electrospun gelatin nanofibers are ideal for in vitro engineered cardiac constructs (ECC), to explore cardiac function in drug testing and tissue replacement. Together with stem cell techniques, they may be an ideal platform for prolongedin vitro studies in alternatives to animal usage for the pharmaceutical industry. GRAPHICAL ABSTRACT

Alveolar soft-part sarcoma of tongue

Alveolar soft-part sarcoma is a clinically and morphologically distinct soft-tissue sarcoma of adolescent and young adult patients. Though immunohistochemical stains implicate a myogenic origin, the histogenesis of this tumor has not yet been established. Its high vascular nature leads to dissemination of the tumor cells into the bloodstream and metastasis. It comprises less than 1% of all soft-tissue sarcomas and less than 0.1% of sarcomas of the head and neck, preferably involving the orbit (48%) and tongue (25%). Lingual involvement is very rare and only about 31 cases have been reported in English literature. Their deceivingly indolent clinical courses often lead to misdiagnosis and delayed treatment. The reported case indicates its asymptomatic nature and microscopic similarity to granular cell tumor, which is the common benign tumor of the tongue.

Collagen 3 D fleece as scaffold for cardiac tissue engineering

BackgroundThe limited ability of cardiac muscle to regenerate after myocardial infarction motivates studies aimed at curative treatment options through cell engraftment. The purpose of this study was to test woven collagen fibres for possible use as 3 D scaffold for cardiac tissue engineering.MethodsNeonatal ventricular rat Cardiomyocytes were isolated and characterized using specific antibodies by immunocytochemistry and confocal microscopy following which they were seeded on collagen scaffolds.ResultsCollagen fleece fabricated out of woven collagen fibres harbored metabolically active cardiomyocytes. The video of the beating cells on the scaffold is substantial evidence that the collagen fleece could be used for the preparation of tailor made cardiac tissue construct.ConclusionCollagen fleece possesses the necessary tensile strength as well as the elasticity for maintaining pulsating cardiomyocytes. Their flexibility and compatibility project them as promising candidates for use in tailor made cardiac tissue constructs.

Cytomegalovirus infection with lissencephaly.

Lissencephaly is a malformation of the brain in which the brain surface is smooth, rather than convoluted. Among the various causes of lissencephaly, infection by a virus during pregnancy plays an important role. Cytomegalovirus (CMV) is an important pathogen causing this anomaly. We present this case of a young female with 24-week-gestation diagnosed on ultrasound as carrying an anomalous fetus with lissencephalic features. At autopsy, there were multiple intra-nuclear CMV inclusions in the brain and the kidneys. This case is presented for its rarity and for the documentation of the tissue localization of CMV inclusions at autopsy.