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Kibur RT, Aavik A, Torga T, Arend A, Aunapuu M. Morphological study of incompetent saphenous veins: apoptosis and ultrastructural changes of smooth muscle cells. INT ANGIOL 2024; 43:229-239. [PMID: 38619205 DOI: 10.23736/s0392-9590.24.05107-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
BACKGROUND Varicose veins affect approximately 25% of people in industrialized countries. METHODS The study aimed at detecting apoptotic cells and histopathological changes in varicose vein walls. Patients (N.=41) with varicose veins and 30 control group patients were divided into two groups according to their age (younger and older than 50 years). Apoptosis was determined by the TUNEL assay, elastin and collagen IV expression by immunohistochemistry and ultrastructural changes by transmission electron microscopy. RESULTS The results show that the number of apoptotic cells in the layers of varicose veins increased, in particular in a group of patients aged over 50 years. In the varicose veins as compared to control veins the elastic fibers were found to be thinner, more fragmented and disorderly arranged. Elastin and collagen IV expression was found to decline in the intima and the media of varicose veins in both age groups. Electron microscopy demonstrated hypertrophy and degeneration of smooth muscle cells. Furthermore, cells with ultrastructural feature of apoptosis were noted. In the disorganized and expanded extracellular matrix membrane-bound vesicles, ghost bodies with different size and electron density were observed. Ghost bodies seem to bud off from smooth muscle cells and are likely to be involved in extracellular matrix remodeling as they are seen in close contact with collagen fibers. CONCLUSIONS The study demonstrates increase of apoptotic cells in the wall of varicose veins along with vein wall structural abnormalities including alterations of smooth muscle cells and decline of elastin and collagen IV expression.
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MESH Headings
- Humans
- Saphenous Vein/ultrastructure
- Saphenous Vein/pathology
- Saphenous Vein/metabolism
- Apoptosis
- Middle Aged
- Elastin/metabolism
- Varicose Veins/pathology
- Varicose Veins/metabolism
- Female
- Adult
- Male
- Myocytes, Smooth Muscle/ultrastructure
- Myocytes, Smooth Muscle/pathology
- Myocytes, Smooth Muscle/metabolism
- Aged
- Microscopy, Electron, Transmission
- Case-Control Studies
- Collagen Type IV/metabolism
- Muscle, Smooth, Vascular/ultrastructure
- Muscle, Smooth, Vascular/pathology
- Muscle, Smooth, Vascular/metabolism
- Immunohistochemistry
- Venous Insufficiency/pathology
- Venous Insufficiency/metabolism
- Young Adult
- Age Factors
- Elastic Tissue/ultrastructure
- Elastic Tissue/metabolism
- Elastic Tissue/pathology
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Affiliation(s)
- Ragnar T Kibur
- Department of Anatomy, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Asser Aavik
- Surgery Clinic of Tartu University Hospital, Tartu, Estonia
| | - Taavi Torga
- Department of Anatomy, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Andres Arend
- Department of Anatomy, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia
| | - Marina Aunapuu
- Department of Anatomy, Institute of Biomedicine and Translational Medicine, University of Tartu, Tartu, Estonia -
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Belkovsky M, Sarmento EO, Novaes LFC, Passerotti CC, Pontes Junior J, Maximiano LF, Otoch JP, DA-Cruz JAS. Bilateral inguinal transabdominal pre-peritoneal laparoscopic hernioplasty associated to bilateral laparoscopic varicocelectomy in the same intervention: a feasibility study. Rev Col Bras Cir 2023; 50:e20233468. [PMID: 36995836 PMCID: PMC10519696 DOI: 10.1590/0100-6991e-20233468-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/28/2022] [Indexed: 03/29/2023] Open
Abstract
INTRODUCTION Inguinal hernia and varicocele are common conditions in male population. Laparoscopy brings the opportunity to treat them simultaneously, through the same incision. However, there are different opinions about the risks for testicular perfusion of multiple procedures in the inguinal region. In this study, we assessed the feasibility of simultaneous laparoscopic procedures by studying clinical and surgical outcomes of patients undergoing bilateral inguinal hernioplasty using the transabdominal preperitoneal (TAPP) technique with and without concomitant bilateral laparoscopic varicocelectomy (VLB). METHODS a sample of 20 patients from the University Hospital of USP-SP with indirect inguinal hernia and varicocele with indication for surgical correction was selected. Patients were randomized into two groups, 10 undergoing TAPP (Group I) and 10 undergoing simultaneous TAPP and VLB (Group II). Data regarding total operative time, complications and postoperative pain was gathered and analyzed. RESULTS there was no statistical difference between groups regarding total operative time and postoperative pain. Only one complication (spermatic cord hematoma) was observed in Group I and no complications were observed in Group II. CONCLUSIONS simultaneous TAPP and VLB in was shown to be effective and safe, which provides a basis for conducting studies on larger scales.
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Affiliation(s)
- Mikhael Belkovsky
- - Faculdade de Medicina da USP, Técnica Cirúrgica e Cirurgia Experimental - Sâo Paulo - SP - Brasil
- - Hospital Alemão Oswaldo Cruz, Centro de Cirurgia Robótica - São Paulo - SP - Brasil
| | | | | | | | - José Pontes Junior
- - Faculdade de Medicina da USP, Técnica Cirúrgica e Cirurgia Experimental - Sâo Paulo - SP - Brasil
- - Hospital Alemão Oswaldo Cruz, Centro de Cirurgia Robótica - São Paulo - SP - Brasil
| | - Linda Ferreira Maximiano
- - Faculdade de Medicina da USP, Técnica Cirúrgica e Cirurgia Experimental - Sâo Paulo - SP - Brasil
| | - José Pinhata Otoch
- - Faculdade de Medicina da USP, Técnica Cirúrgica e Cirurgia Experimental - Sâo Paulo - SP - Brasil
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BELKOVSKY MIKHAEL, SARMENTO EDGAROLIVEIRA, NOVAES LUISFELIPECOUTO, PASSEROTTI CARLOCAMARGO, PONTES JUNIOR JOSÉ, MAXIMIANO LINDAFERREIRA, OTOCH JOSÉPINHATA, DA-CRUZ JOSEARNALDOSHIOMI. Hernioplastia inguinal pré-peritoneal transabdominal bilateral e varicocelectomia laparoscópica bilateral na mesma intervenção: um estudo de viabilidade. Rev Col Bras Cir 2023. [DOI: 10.1590/0100-6991e-20233468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
RESUMO Introdução: hérnia inguinal e varicocele são doenças comuns na população masculina. O advento da laparoscopia traz a oportunidade de tratá-las simultaneamente, pelo mesmo acesso. Entretanto, existem divergências sobre os riscos para a perfusão testicular de múltiplos procedimentos na região inguinal. Neste estudo, avaliamos a viabilidade de procedimentos laparoscópicos simultâneos estudando resultados clínicos e cirúrgicos de pacientes submetidos à hernioplastia inguinal bilateral pela técnica transabdominal préperitoneal (TAPP) com e sem varicocelectomia laparoscópica bilateral (VLB) concomitante. Métodos: uma amostra de 20 pacientes do Hospital Universitário da USP-SP com hérnia inguinal indireta e varicocele com indicação de correção cirúrgica foi selecionada. Os pacientes foram randomizados em dois grupos, sendo 10 submetidos à TAPP (Grupo I) e 10 submetidos à TAPP e VLB simultâneas (Grupo II). O tempo operatório total, complicações e dor pós-operatória foram coletados e analisados. Resultados: não houve diferença estatística entre os grupos com relação ao tempo operatório total e à dor pós-operatória. Apenas uma complicação (hematoma do cordão espermático) foi observada no Grupo I e não foram observadas complicações no Grupo II. Conclusões: no mesmo procedimento, submeter pacientes à TAPP e à VLB no mesmo procedimento se mostrou eficaz e seguro, o que fornece embasamento para a realização de estudos em maiores escalas.
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Sannikov AB, Shaydakov EV. Morphological restructuring of smooth muscles elements of the wallgreat saphenous vein of a person on the lower leg during the development of varicose transformation. AMBULATORNAYA KHIRURGIYA = AMBULATORY SURGERY (RUSSIA) 2022. [DOI: 10.21518/1995-1477-2022-19-2-160-175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction. Further study of the structural restructuring of the wall of the great saphenous vein throughout a person’s life with the development of chronic venous diseases is an urgent task of phlebology.The purpose of the study. Research of the morphological restructuring of smooth muscleselements of the human great saphenous vein wall on the calf in norm, ectasia and development of varicose transformation.Materials and methods. The study of morphological restructuring of the great saphenous vein wall on the calf was carried out in 3 comparison groups by light microscopy. In 1th group, the structure of the GSV wall was studied on autopsy material of people who died from various causes at the age of 5 to 80 years. In the 2nd and 3rd groups, fragments of GSV in the calf were taken by biopsy during the execution of the operations for varicose veins. All patients underwent ultrasound mapping before surgery to determine the presence and degree of ectasia, varicose transformation and retrograde blood flow. For histological analysis in the groups, 140 GSV fragments were removed in 1-group, 165 BPV fragments in 2-group, and 250 GSV fragments in 3-group.Results. The general morphological analysis of histological preparations made it possible to visually identify various variants of changes in smooth muscleselements inherent in the inner, middle and outer shells of the GSV wall. The selected variants of reconstruction of the smooth muscleselements were combined into 10 morphological types.Conclusion. Age-related morphological changes in the smooth muscleselements in the GSV wall on the calf, over the course of a person’s life, do not have the same character as changes occurring in its wall during the development of its ectasia and varicose transformation.
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Affiliation(s)
| | - E. V. Shaydakov
- Petrov National Medical Cancer Research Centre; Petrozavodsk State University
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Cortese K, Tagliatti E, Gagliani MC, Frascio M, Zarcone D, Raposio E. Ultrastructural imaging reveals vascular remodeling in migraine patients. Histochem Cell Biol 2022; 157:459-465. [DOI: 10.1007/s00418-021-02066-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/30/2022]
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Al-Falki Y, Al-Shraim M, Alsabaani NA, Eid RA, Radad K. Ultrastructural changes of extraocular muscles in strabismus patients. Ultrastruct Pathol 2019; 43:145-153. [PMID: 31570030 DOI: 10.1080/01913123.2019.1671927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Strabismus is an ocular disorder characterized by partial or complete inability to keep eye alignment. It represents a very common ocular problem at ophthalmology clinics worldwide. The current study aimed to show the most encountered ultrastructural changes in extraocular muscles (EOMs) collected from patients with different forms of strabismus. Nine specimens of EOMs were collected from five patients during strabismus correction surgery and processed for light and electron microscopy examinations. Histologically, skeletal muscle fibers in normal EOMs appeared tight and normally arranged with clear striations. In strabismic muscles, the fibers appeared disarranged, and atrophied, swollen and disintegrated in some situations. By transmission electron microscopy, normal EOMs were formed of skeletal muscle fibers with intact basal membrane and sarcolemma, tightly aligned myofibrils with well-arranged sarcomeres, Z line and H zone, and normally distributed mitochondria. On the other hand, strabismic EOMs revealed vacuolation and degeneration of myofibrils, accumulation of lipid droplets, subsarcolemmal inclusions and clustering of mitochondria. EOMs obtained from a Down syndrome patient with V-pattern infantile esotropia showed extensive vacuolation and disintegration of myofibrils, and extra- and intracellular deposition of collagen fibers. Interestingly, some skeletal muscle cells exhibited features of autophagic cell death with a trial of engulfing process by neighboring cells. In conclusion, our study traces some characteristic ultrastructural changes in strabismic EOMs, most notably, extensive vacuolation, clustering of mitochondria, degeneration of myofibrils and autophagic changes. These changes might be emphasized as possibly secondary to strabismus.
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Affiliation(s)
- Yahya Al-Falki
- Department of Surgery, Ophthalmology Division, College of medicine, King Khalid University, Abha, Saudi Arabia
| | - Mubarak Al-Shraim
- Department of Pathology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Nasser A Alsabaani
- Department of Surgery, Ophthalmology Division, College of medicine, King Khalid University, Abha, Saudi Arabia
| | - Refaat A Eid
- Electron Microscopy Unit, Department of Pathology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Khaled Radad
- Department of Pathology, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Aslan R, Erbin A, Celik S, Ucpinar B, Sahinalp S, Yıldızhan M, Eryilmaz R, Taken K. Evaluation of hemorrhoidal disease and lower extremity venous insufficiency in primary adult varicocele: A prospective controlled study. Phlebology 2019; 34:621-626. [PMID: 30836835 DOI: 10.1177/0268355519834426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background The study investigated the association between varicocele, lower extremity venous insufficiency and hemorrhoidal disease. Methods The study included 62 patients with varicocele and 60 voluntary subjects with no varicocele. Patients who were diagnosed as having varicocele on physical examination and Doppler ultrasonography were included in the study group. Examination of lower extremity venous insufficiency was performed by physical examination and Doppler ultrasonography. Examination of hemorrhoidal disease was performed by a general surgery specialist. Results The patients with varicocele had a statistically significant ( p < 0.05) higher rates of venous insufficiency of the lower extremities and had a borderline significant difference of higher hemorrhoidal disease rates ( p = 0.05). Therewithal incidences of hemorrhoidal disease and lower extremity venous insufficiency were significantly higher in body mass index > 25 and age > 30 years of varicocele patients. Conclusion There is a statistically significant relation between varicocele, lower extremity venous insufficiency, and hemorrhoidal disease. In particular, varicocele patients who are aged over 30 years and overweight are at higher risk.
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Affiliation(s)
- Rahmi Aslan
- Department of Urology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Akif Erbin
- Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Sebahattin Celik
- Department of General Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Burak Ucpinar
- Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Sahin Sahinalp
- Department of Cardiovascular Surgery, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Murat Yıldızhan
- Department of Radiology, Viransehir Medical Center, Sanliurfa, Turkey
| | - Recep Eryilmaz
- Department of Urology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
| | - Kerem Taken
- Department of Urology, Medical Faculty, Yuzuncu Yil University, Van, Turkey
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Dallak MA, Bin-Jaliah I, Albawardi A, Haidara MA, Sakr HF, Eid RA, Hassan WN, Al-Ani B. Swim exercise training ameliorates hepatocyte ultrastructural alterations in rats fed on a high fat and sugar diet. Ultrastruct Pathol 2018; 42:155-161. [PMID: 29419350 DOI: 10.1080/01913123.2017.1422581] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Mohammed A. Dallak
- Physiology Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ismaeel Bin-Jaliah
- Physiology Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Alia Albawardi
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - Mohamed A. Haidara
- Physiology Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Medical Physiology Department, Kasr Al-Aini Faculty of Medicine, Cairo University, Egypt
| | - Hussein F. Sakr
- Physiology Department, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Refaat A. Eid
- Pathology Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - W N. Hassan
- Medical Biochemistry Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Bahjat Al-Ani
- Physiology Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Qiu P, Zha B, Zhu H, Xie W, Si X, Tang D, Zhang C. Association between Clinical and Ultrasonic Characteristics of Varicocele and Lower Extremity Varicose Vein in Men. Ann Vasc Surg 2016; 38:298-304. [PMID: 27531086 DOI: 10.1016/j.avsg.2016.05.105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 04/03/2016] [Accepted: 05/08/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND The study investigated the association between lower extremity varicose veins in men and varicocele. METHODS A total of 100 patients who presented to the Department of Vascular Surgery in the First Affiliated Hospital of Anhui Medical University with the diagnosis of lower extremity varicose veins were included in the study group. A total of 100 adults without vascular disease were included as controls. The prevalence of varicocele between the study group and the control group was compared. We compared the prevalence of varicocele and the mean diameter of spermatic veins between the patients with and without reflux in the saphenofemoral junctions. We analyzed the association between the maximum spermatic vein diameter and the maximum diameter of lower extremity varicose veins in patients who had both lower extremity varicose vein and varicocele in the study group. According to their clinic signs, patients with lower extremity varicose veins were divided into C1-C6 by clinic sign grade of Clinical-Etiology-Anatomy-Pathophysiology (CEAP), and we investigated the trend of the incidence of varicocele and the mean diameter of spermatic veins in different grades. RESULTS The patients with lower extremity varicose veins had a statistically significant (χ2 = 20.05, P < 0.01) higher rate of varicocele when compared with controls. We compared the prevalence of varicocele and the mean diameter of spermatic veins between the patients with and without reflux in the saphenofemoral junctions and found no statistically significant differences between them (prevalence of varicocele P > 0.05, diameter P > 0.05). We found a linear correlation between the maximum spermatic vein diameter and the maximum diameter of lower extremity varicose veins in the patients who had both lower extremity varicose veins and varicocele in the study group (coefficient of rank correlation r = 0.4072, P < 0.01). The patients in the study group were classified into 6 grades by CEAP. After the analysis by trend chi-square, we found that the prevalence of varicocele had no statistical trend in different grades (χ2 = 0.8798, P > 0.05), and the mean diameter of spermatic vein also had no statistical trend in different grades (F = 1.59, P > 0.05). CONCLUSIONS In conclusion, we demonstrated that the prevalence of varicocele is higher in patients with varicose veins in lower extremity than the patients without vascular diseases. The reason for the association between varicose vein in lower extremity and varicocele remains uncertain.
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Affiliation(s)
- Peng Qiu
- Department of General Surgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Binshan Zha
- Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huagang Zhu
- Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
| | - Wentao Xie
- Department of Vascular Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaomao Si
- Department of General Surgery, The TCM Hospital of Nanling County Wuhu City, Wuhu, China
| | - Dongdong Tang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Chao Zhang
- Department of Radiology, Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, China
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Al-Shraim MM, Eid RA, Musalam AO, Radad K, Ibrahim AHM, Malki TA. Ultrastructural Changes of the Smooth Muscle in Esophageal Atresia. Ultrastruct Pathol 2015; 39:413-8. [PMID: 26548437 DOI: 10.3109/01913123.2015.1066913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Esophageal atresia (EA) with or without tracheo-esophageal fistula (TEF) is a relatively rare congenital anomaly. Despite the advances in the management techniques and neonatal intensive care, esophageal dysmotility remains a very common problem following EA/TEF repair. Our current study aimed to describe the most significant ultrastructural changes of the smooth muscle cells (SMCs) trying to highlight some of the underlying mechanisms of esophageal dysmotility following EA/TEF repair. Twenty-three biopsies were obtained from the tip of the lower esophageal pouch (LEP) of 23 patients during primary repair of EA/TEF. Light microscopic examination was performed with hematoxylin and eosin (HE), and Van Gieson's stains. Ultrastructural examination was done using transmission electron microscopy (TEM). Histopathological examination showed distortion of smooth muscle layer and deposition of an abundant amount of fibrous tissue in-between smooth muscles. Using TEM, SMCs exhibited loss of the cell-to-cell adhesion, mitochondrial vacuolation, formation of myelin figures, and apoptotic fragmentation. There were also plasmalemmal projections and formation of ghost bodies. Interestingly, SMCs were found extending pseudopodia-like projections around adjacent collagen fibers. Engulfed collagen fibers by SMCs underwent degradation within autophagic vacuoles. Degeneration of SMCs and deposition of abundant extracellular collagen fibers are prominent pathological changes in LEP of EA/TEF. These changes might contribute to the pathogenesis of esophageal dysmotility in patients who have survived EA/TEF.
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Affiliation(s)
- Mubarak M Al-Shraim
- a Department of Pathology , College of Medicine, King Khalid University , Abha , Saudi Arabia
| | - Refaat A Eid
- a Department of Pathology , College of Medicine, King Khalid University , Abha , Saudi Arabia
| | - Adel Osman Musalam
- a Department of Pathology , College of Medicine, King Khalid University , Abha , Saudi Arabia
| | - Khaled Radad
- a Department of Pathology , College of Medicine, King Khalid University , Abha , Saudi Arabia
| | - Ashraf H M Ibrahim
- b Department of Surgery, Division of Pediatric Surgery , Armed Forces Hospital Southern Region , Khamis Mushait , Saudi Arabia , and
| | - Talal A Malki
- c Department of Pediatric Surgery , College of Medicine and Medical Sciences, Taif University , Taif , Saudi Arabia
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