Modes of adherence of Helicobacter pylori to gastric surface epithelium in gastroduodenal disease: A possible sequence of events leading to internalisation

We have investigated various modes of adherence of Helicobacter pylori to the human gastric epithelium, using transmission electron microscopy, in biopsies from nine patients with peptic ulcer disease and from four patients with chronic active gastritis. H. pylori was demonstrated in abundance in all cases within the surface mucous layer. In all ulcer- and in one out of four gastritis patients H. pylori was shown in close proximity to the gastric epithelium, with concurrent alterations in the configuration of microvilli and the apical cytoplasmic region of gastric cells. Previously described modes of H. pylori adherence were confirmed, such as loose attachment with fibrillar-like strands, firm attachment with pedestal formation, invasion in the intercellular spaces, and invagination with cup formation. Moreover, in many cases a fusion between the bacterial outer layer and gastric cell membranes was evident. In four cases (31; three with active and one with past ulcer disease) viable H. pylori was found in the cytoplasm of gastric mucous cells. Our results support the hypothesis that the different modes of adherence of H. pylori represent a stepwise, possibly sequential, process which in a significant number of cases leads to internalisation of the organism. The invariable occurrence of adhesion and more frequent internalisation of H. pylori in ulcer patients may suggest a link with the pathogenesis of peptic ulcer disease

Electron Microscopy in Diagnostic Pathology with Reference to Mesenchymal Tumors

The experience acquired over a period of 15 years of diagnostic electron microscopy of fine needle aspirates and surgical specimens constitutes the base for this thesis. Some of the tumors analyzed represent rare soft tissue tumors, and consequently not very often ultrastructurally described. In locations where sarcomas are rare and unexpected, electron microscopy may contribute to a correct tumor classification when type specific structures are present. Electron microscopic examination is a suitable method to confirm presence of mesenchymal tumor cells in cultures and to compare the morphology in cultures and fresh tumor tissue provided that the ultrastructural features are specific for the tumor in question. Fine needle aspiration together with the use of electron microscopy is a reliable combination in the typediagnosis of small round cell malignant tumors of childhood and adolescence and spindle cell tumors as peripheral nerve sheath tumors, leiomyosarcoma and synovial sarcoma, especially of the monophasic variant. Electron microscopy contributes to the understanding of successive morphologic changes in the dermal microvasculature of Kaposi´s sarcoma. This thesis presents examples that highlight the value of electron microscopy in the multidisciplinary management of musculoskeletal tumors

Primary ciliary dyskinesia: a review.

The entity sinusitis, bronchiectasis, and situs inversus is since long named Kartagener syndrome. Nowadays the designation used is primary ciliary dyskinesia (PCD), which implies cilia with decreased or total absence of motility, which may result in sinusitis, chronic bronchitis, bronchiectasis, and male infertility. A large number of deficiencies detectable on the ultrastructural level give rise to PCD. There may also be aberrations not detected up to the present. The normal left-right asymmetry of the body is thought to be due to the beating of the cilia in the embryonic (Hensen's) node. Total immotility of the cilia should therefore result in random asymmetry of the body that is situs inversus in 50% of the cases. It has also been claimed that 50% of cases with PCD have situs inversus. However, several deficiencies apparently do not cause total immotility, and all ultrastructural variants are not associated with situs inversus in 50% of the cases. Several of the deficiencies are difficult to detect. Optimal fixation and handling are therefore obligatory. The genetic changes behind the variants are now being studied in several laboratories. Patients with PCD have very low levels of nasal nitric oxide, which is of increasing diagnostic importance. Other established diagnostic methods are the saccharine test and determination of ciliary beat frequency

Diagnostic value of electron microscopy in a case of juvenile neuronal ceroid lipofuscinosis

Neuronal ceroid lipofuscinoses (NCLs) represent a large group of inherited neurodegenerative disorders characterized by an abnormal accumulation of lipopigment in neuronal and extraneuronal cells. The authors present a case of juvenile neuronal ceroid lipofuscinosis in a 7-year-old boy. Ultrastructural examination of a skin biopsy disclosed deposits of curvilinear profiles and fingerprint-like structures in epithelial cells of sweat glands, endothelial cells, peripheral nerve endings, and fibroblasts, These findings allowed specific confirmation of the assumed diagnosis of juvenile neuronal ceroid lipofuscinosis. Due to the genotypic and phenotypic variability within the group of NCLs, the clinical investigation may be long and complicated. With the NCL disorders in mind, an accurate diagnosis based on ultrastructural examination of a skin biopsy may shorten this investigation, thus benefitting the patient

Speciallärare i samundervisning och samplanering En aktionsstudie om speciallärares möjligheter att arbeta förebyggande inom språk-, skriv- och läsundervisning

Syfte: Speciallärarens arbetsuppgifter tenderar att i huvudsak vara reparativa och det förebyggande arbetet har fått ett allt för litet utrymme. Syftet med studien är att undersöka hur speciallärare genom samundervisning och samplanering kan bidra med sin kompetens och vara med och utveckla undervisning som främjar lärandet hos eleverna samt hur speciallärare kan stödja det professionella lärandet. Teori: Studiens aktioner analyseras mot tre lärandeteorier, sociokulturell lärandeteori, variationsteori och teorin om formativ bedömning för att nå hög evidens. Några centrala begrepp från varje lärandeteori hjälper oss att få syn på om lärandet främjas under samundervisningen. För att utveckla undervisning som ger effekt på elevernas lärande krävs ett professionellt lärande hos lärarna. Teorin om det professionella lärandet blir i arbetet ett analysverktyg för att synliggöra var vi befinner oss i det professionella lärandet samt vilka tecken vi kan se på detta. Metod: För att söka svar på våra forskningsfrågor har vi använd oss av aktionsforskning. Aktioner i samundervisning och samplanering har iscensatts för att undersöka speciallärarens möjligheter till ett förebyggande arbete. Resultat: Resultatet visar att det finns goda möjligheter för speciallärare att nå ett förebyggande arbete genom att utveckla undervisningen med hjälp av samundervisning och samplanering i varierande grad. Studien bidrar med kunskap om en alternativ yrkesroll för speciallärare

Malacoplakia and spermatic granuloma complicating vasectomy

Malacoplakia is a granulomatous disease with a histiocytic infiltrate containing calcified structures called Michaelis-Gutmann bodies. These structures are considered to represent an abnormal response to infection involving defective lysosomes and abnormal microbubular assembly. The disease most frequently involves urinary and genital tracts, but has also been described from most other organs. Here we present the first case of malacoplakia only involving the vas deferens