Vaso-nervorumitis: responsible for pain in Buerger’s disease?

Bahare Fazeli,1,2 Mahdi Farzadnia,3 Hossein Taheri41Immunology Research Center, Inflammation and Inflammatory Diseases Division, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 2Vascular Independent Research and Education, European Foundation, Milan, Italy; 3Department of Pathology, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran; 4Surgery Department, Farabi Hospital, Mashhad, IranAbstract: Buerger’s disease (BD) is an episodic, inflammatory, and occlusive peripheral vascular disease with unknown etiology, which can lead to tissue or limb loss. BD patients usually present neurological symptoms from the early stages of the disease including numbness, cold sensation, and allodynia as the disease progresses. Pain in the late stages of BD is very severe, almost resistant to opioid pain killers, and sometimes compels the patient to pursue major amputation. Therefore, pain management in BD patients is one of the most important and, at the same time, challenging issues since its main etiology is not well understood. Recently, a 39-year-old male smoker with a diagnosis of BD underwent a below-knee amputation in his left leg. Oddly, we found that the vasa-nervorum of the sural nerve had the pathological changes usually observed in BD, including inflammation and proliferation of endothelial cells. Notably, the inflammation was limited to the vasa-nervorum and did not extend to the nerve fascicles. Our findings could provide a clue to taking the approach of managing pain in BD as if it were vasculitis neuropathy; and the inflammation of the vasa-nervorum individually might be responsible for the pain characteristic of BD. In addition, our findings could indicate that BD is a systemic vasculitis of microcirculation and, hence, a different treatment approach for BD might be needed in addition to antithrombotic and vasodilator.Keywords: thromboangiitis obliterans, Buerger’s disease, vasa-nervorum, pain, pathophysiolog

Establishment of a Pcr Technique for Determination of Htlv-1 Infection in Paraffin-Embedded Tissues

Introduction: HTLV-1 , the first known human retrovirus belongs to oncovirus subfamily of retroviruses. The major characteristic of HTLV-1 is its highly restricted geographic prevalence. Northern part of Khorasan is an endemic region of HTLV-1 infection. Epidemiological studies can help in designing preventive programs for HTLV-1 infection. The aim of this study was the establishment of a PCR technique for determination of HTLV-1 infection in paraffin-embedded tissues. Methods: In this experimental laboratory study for establishment of a technique, PCR was initially optimized using Beta-actin primers on various formalin fixed paraffin-embedded tissues from liver, spleen, skin and lymph nodes. The optimized concentration of Mgcl2 was 2mm, primer was 8 pmol. Optimized concentration of DNA was different according to the kind of tissue. HTLV-1 infection was determined by applying tax, pol, env and LTR primers on 50 paraffin-embedded lymph node tissues . The reporoducibility of this technique was shown for skin and lymph node tissues infected with HTLV-1. Resuls: In 50 lymph node tissues, one case with pathologic diagnosis of NHL was positive with all 5 sets of primers (tax, Pol, env and LTR primers) and the other case was positive with only two sets of tax primers but was negative with pol, env and LTR primers. The prevalence of infection was 2% among lymph node specimens. (1 of 50 specimens ) and if the second case is considered, the prevalence would be 4%. Conclusion: Comparison of the results of this study with another study on blood specimens (seroprevalence2.3%) was not statistically significant thus confirming the results of one another. (P=0.883

Microsatellite Instability in Young Women with Endometrioid type Endometrial Cancer

"nBackground: This study was designed to determine the frequency of Microsatellite Instability (MSI) in young Iranian pa­tients with endometrial carcinoma and to evaluate its association with histopathologic and clinical features of disease."nMethods: Microsatellite status was analyzed in 23 patients with endometrioid type endometrial cancer who were less than 55 years. Clinicopathologic characteristics such as age, International Federation of Gynecology and Obstetric (FIGO) grad­ing and staging of tumor, family history of Hereditary Non-polyposis Colorectal Cancer (HNPCC), oral conception (OC) consump­tion, number of pregnancies, fertility, menstrual cycles and underlying disease were considered. Chi-square and Fisher exact tests were used to find the significant relationships."nResults: MSI analysis showed 8 patients (34.8%) were MSS (Microsatellite Stable), 15 patients (62.5%) were MSI positive. Among cases with MSI phenotype, 4 cases (17.4%) had low instability (MSI-L) and 11 cases (47.8%) had high instability (MSI-H). Three cases with MSI-H had family history of HNPCC related cancers. Five cases (21.7%) had infertility in which 4 of them (80%) had MSI phenotype. There was no statistically significant relationship between MSI phenotype and tumor grade and stage."nConclusion: Few studies reported high frequency of MSI among young patients. Some studies mentioned similar results in endo­metrioid type of tumor. This study showed even higher frequency (65%) when MSI analyzed in young endometrioid type endometrial patients. Most cases with infertility had MSI-H phenotype. It may suggest that beside women with family his­tory of HNPCC, EC screening using MSI would be beneficial in infertile women too. &nbsp

Effect of nanoclay on durability and mechanical properties of flax fabric reinforced geopolymer composites

The main concern of using natural fibres as reinforcement in geopolymer composites is the durability of the fibres. Geopolymers are alkaline in nature because of the alkaline solution that is required for activating the geopolymer reaction. The alkalinity of the matrix, however, is the key reason of the degradation of natural fibres. The purpose of this study is to determine the effect of nanoclay (NC) loading on the mechanical properties and durability of flax fabric (FF) reinforced geopolymer composites. The durability of composites after 4 and 32 weeks at ambient temperature is presented. The microstructure of geopolymer matrices was investigated using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). The results showed that the incorporation of NC has a positive impact on the physical properties, mechanical performance, and durability of FF reinforced geopolymer composites. The presence of NC has a positive impact through accelerating the geopolymerization, reducing the alkalinity of the system and increasing the geopolymer gel. © 2017 The Ceramic Society of Japan and the Korean Ceramic Society