Subepineural pacinian corpuscle: a cause of digital pain

A patient is presented who had chronic digital pain as a result of an abnormally located subepineural pacinian corpuscle. The patient had complete relief of her symptoms and return of normal digital function following removal of the pacinian corpuscle. A review of the literature concerning this entity revealed very few reported cases. However, these cases shared many of the same symptoms, as well as both physical and operative findings. It is suggested that patients suffering from digital pain of unknown etiology with a previous history of direct or indirect trauma may benefit from a localized operative exploration of the digit to remove an abnormally located pacinian corpuscle affecting the digital nerve.     

The effect of cholinergic substances on individual mechanoreceptors--Pacinian corpuscles]

Acetylcholine and nicotine application to the intact pacinian corpuscle failed to stimulate the spike activity, but changed the sensitivity to the mechanical stimulation: low concentration (1.10(-6) g/ml) increased the sensitivity and high concentration (1.10(-4) g/ml) decreased it. This influence can be attributed to the action of these substances on the structures which generate the action potentials. Acetylcholine application to decapsulated pacinian corpuscles stimulated the appearance of the spike activity. This reaction was possibly connected with the acetylcholine influence on the mechanoreceptive zones proper. Tubocurarine or hexonium application of decapsulated pacinian corpuscles led to depression of the sensitivity of the receptor to the mechanical stimulation that can also be explained by the participation of acetylcholine in the process of adequate receptor stimulation.     

Role of the Sympathetic Innervation of the Pacinian Corpuscle

An investigation was made into the nature of the role played by the noradrenergic innervation of the pacinian corpuscle. Corpuscles of the cat mesentery and mesocolon were used in all experiments. Blockade of noradrenergic beta receptors by dichloroisoproterenol and interference with norepinephrine release by reserpine are each capable of reversibly blocking mechanoelectric transduction by the pacinian corpuscle. The monoamine oxidase inhibitors iproniazid and phenelzine are capable of protecting the transducer from the blocking effects of reserpine. It is concluded that the presence of norepinephrine, as maintained by sympathetic tonus, is required for the afferent nerve terminal of the pacinian corpuscle to be mechanosensitive.     

Dupuytren's disease: physiologic changes in nodule and cord fibroblasts through aging in vitro

The pathogenesis of the fibrotic disease Dupuytren's contracture remains unclear. The disease process includes two structurally distinct fibrotic elements, the nodule and the cord. It has been proposed that as the disease progresses, nodules develop into cords. To corroborate that hypothesis, the authors took advantage of cultured fibroblast differences found between gap junction intercellular communication and fibroblast-populated collagen lattice contraction. Paired fibroblast cell lines of nodules and cords derived from four patients with Dupuytren's disease were maintained in culture for at least eight passages. The presence of gap junction intercellular communication in nodule- and cord-derived fibroblasts was documented and reported as a coupling index. The contraction of free-floating nodule- or cord-derived collagen lattices was also documented and reported. Early passage (passage 4) cord-derived fibroblasts showed a significant increase in coupling index compared with passage 4 nodule-derived fibroblasts (4.0 +/- 0.4 versus 2.5 +/- 0.3, respectively), where p < or = 0.01. However, late passage (passage 8) nodule- and cord-derived fibroblasts were equivalent in their coupling index (4.1 +/- 0.4 versus 4.4 +/- 0.4, respectively). Early passage nodule-derived fibroblast-populated collagen lattices contracted by 64 percent, whereas late passage nodule-derived lattices showed less contraction, at only 40 percent. Early and late passage cord-derived lattices contracted 46 and 37 percent, respectively. All nodule- and cord-derived cell lines were statistically equivalent at lattice contraction by passage 8. These in vitro studies support the hypothesis that fibroblasts derived from Dupuytren's contracture nodules change their phenotype after undergoing repeated cell passage, acquiring a cord-like fibroblast phenotype. Dupuytren's nodules represent the early, active form of fibrosis in which cells are more proliferative, better at fibroblast-populated collagen lattice contraction, and display less gap junction intercellular communication. The speculation is that alterations in gap junction intercellular communication may be involved in the progression of Dupuytren's nodules to cords as the disease progresses.     

Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

Dupuytren's disease, (DD), is a fibroproliferative condition of the palmar fascia in the hand, typically resulting in permanent contracture of one or more fingers. This fibromatosis is similar to scarring and other fibroses in displaying excess collagen secretion and contractile myofibroblast differentiation. In this report we expand on previous data demonstrating that POSTN mRNA, which encodes the extra-cellular matrix protein periostin, is up-regulated in Dupuytren's disease cord tissue relative to phenotypically normal palmar fascia. We demonstrate that the protein product of POSTN, periostin, is abundant in Dupuytren's disease cord tissue while little or no periostin immunoreactivity is evident in patient-matched control tissues. The relevance of periostin up-regulation in DD was assessed in primary cultures of cells derived from diseased and phenotypically unaffected palmar fascia from the same patients. These cells were grown in type-1 collagen-enriched culture conditions with or without periostin addition to more closely replicate the in vivo environment. Periostin was found to differentially regulate the apoptosis, proliferation, α smooth muscle actin expression and stressed Fibroblast Populated Collagen Lattice contraction of these cell types. We hypothesize that periostin, secreted by disease cord myofibroblasts into the extra-cellular matrix, promotes the transition of resident fibroblasts in the palmar fascia toward a myofibroblast phenotype, thereby promoting disease progression.     

Matrix metalloproteinases and tissue inhibitors of metalloproteinases in sera and tissue of patients with Dupuytren's disease

Dupuytren's contracture is a fibroproliferative disorder characterized by progressive deposition of mature collagen fibers. In other fibrotic diseases affecting organs such as the liver, lung, heart, and skin, matrix metalloproteinases (MMPs) and their natural inhibitors, the tissue inhibitors of metalloproteinases (TIMPs), play an important role. In this study, serum concentrations of MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 were determined in 22 patients (five women and 17 men; average age, 67 +/- 11 years) with Dupuytren's disease using an enzyme-linked immunosorbent assay. Tissue samples were obtained for standard histological and immunohistochemical analyses. Sera and samples of palmar fascia from 20 patients (13 women and seven men; average age, 60 +/- 15 years) who had undergone hand surgery for carpal tunnel syndrome were used as the control group. Statistical analysis was performed using the Mann-Whitney test. Patients with Dupuytren's contracture presented with a TIMP-1 concentration of 437 +/- 160 ng/ml, a significantly higher TIMP-1 concentration than that seen in the control patients, who had a concentration of 321 +/- 70 ng/ml (p < 0.05). Patients with a proliferative active disease (n = 14) had a significantly higher TIMP-1 concentration (525 +/- 136 ng/ml) than patients (n = 8) with a contracture in the late involutional and residual phase (286 +/- 41 ng/ml; p < 0.05). There were no significant differences in the TIMP-2, MMP-1, MMP-2, and MMP-9 serum concentrations between patients with palmar fibromatosis and the control group. Patients with Dupuytren's disease had a significantly lower MMP-to-TIMP ratio (1.1 +/- 0.3; p < 0.05) than the control group (1.5 +/- 0.35). Patients with an active palmar fibromatosis presented a significantly (p < 0.05) reduced ratio (1 +/- 0.2) compared with those in later phases (1.4 +/- 0.3). TIMP-1 and TIMP-2 could be detected in tissue of patients with Dupuytren's contracture, with an accumulation in proliferative areas. MMPs could be detected locally in Dupuytren's tissue in a few patients, with less positive staining than for TIMPs. In the control group, there was just little or no staining for TIMPs and MMPs. The data indicate that the physiological balance between MMPs and their natural inhibitors is disturbed in patients with a proliferative active Dupuytren's disease. The decrease in the systemic MMP-to-TIMP ratio can cause increased synthesis and deposition of collagen, leading to palmar fibromatosis.     

Abnormal behavior of cultured fibroblasts from nodule and nonaffected aponeurosis of Dupuytren's disease

Vimentin-positive, desmin-negative cells were established in culture from the nodule and from apparently normal palmar aponeurosis of a patient with Dupuytren's disease and compared with normal human embryonic and adult fibroblasts or sarcomatous cells. Cells from the nodule display in vitro biological properties that are intermediate between those expressed by normal fibroblasts and sarcoma cells or cells from the nodule transformed with SV40 virus. Thus, they represent an interesting in vitro model of partially transformed human cells. This behavior is not evolutive and justifies the classification of Dupuytren's disease among the benign mesenchymal tumors. The production of high level of plasminogen activator probably explains the local reactive pathology, and could act as a mitogenic stimulus for the proliferation of the nodule itself. Cultures derived from the apparently normal palmar aponeurosis show some but not all the abnormal growth properties of cells from nodules; this may help to explain the onset of local recurrences. Our results suggest that Dupuytren's disease is not strictly local and limited to the nodules, but affects, at least partially, the whole aponeurosis. Dupuytren's nodules could be considered as a model of tumor progression in a benign situation.     

The ultrastructure of sensory corpuscles in the skin in the hedgehog snout

The ultrastructure of sensory nerve endings was examined in the snout skin in 3 adult hedgehogs (Erinaceus europaeus). The material was taken intravitally under total anaesthesia and processed in a usual way for the electron microscopy. The corpuscles were evaluated in the individual sections and series sections made through the whole corpuscle. In the superficial layers of the dermis simple sensory corpuscles and free endings were found. The simple sensory corpuscles can be divided into three types. a) Corpuscles containing a greater number of lamellae in the inner core, the lamellae are arranged regularly and are separated by two opposite clefts. The capsule is formed by only several lamellae undoubtedly of fibrocytic origin. b) Corpuscles containing a smaller number of wider lamellae in the inner core situated often at random. The clefts are also irregular and are often closed in the superficial layers of the inner core. The capsule is quite simple mostly formed by a single lamella of fibrocyte which often fails to form a continuous coat of the corpuscle. c) The third type is typical of its inner core being formed by few lamellae arranged irregularly. These corpuscles have no connective tissue capsule and are separated from the environments only by the basement membrane of superficial lamellae of the inner core. The corpuscles of the second type resemble considerably the developmental stages of simple sensory corpuscles as described in the literature in the cat. They are the same in size or smaller than the corpuscles of the first type. The free nerve endings occurred in two forms. a) Flattened (lanciform) nerve terminals. The axon is rich in mitochondria. The sides of the flattened terminal is lined with one to three wide lamellae while the axon reaches as far as the surface of the formation which is covered only with the basement membrane. b) Typical free endings rich in mitochondria which are embedded in the cytoplasm of Schwann cells or occasionally are covered only with the basement membrane. The lanciform endings which are not linked up with the hairs here may represent a transition from free endings to simple sensory corpuscles.     

Co-culture of osteoblasts with immature dural cells causes an increased rate and degree of osteoblast differentiation

For decades surgeons have exploited the ability of infants to reossify large calvarial defects. To demonstrate the role of dura mater-osteoblast communication during the process of calvarial reossification, the authors used a novel in vitro system that recapitulates the in vivo anatomic relationship of these cell populations. Primary cultures of osteoblast cells from 2-day-old Sprague-Dawley rat pups were grown on six-well plates, and cultures of immature, non-suture-associated dura mater cells from 6-day-old Sprague-Dawley rat pups were grown on Transwell inserts. When the osteoblast and dura mater cell cultures reached confluence, they were combined. This Transwell co-culture system permitted the two cell populations to grow together in the same well, but it prevented direct cell-to-cell contact. Therefore, the authors were able to determine, for the first time, whether paracrine signaling from immature, non-suture-associated dura mater could influence the biologic activity of osteoblasts.Osteoblasts co-cultured with dural cells proliferated significantly faster after 2 days (2.1 x 10(5) +/- 2.4 x 10(4) versus 1.4 x 10(5) +/- 2.2 x 10(4), p < or = 0.05) and 4 days (3.1 x 10(5) +/- 5 x 10(4) versus 2.2 x 10(5) +/- 4.0 x 10(4), p < or = 0.01) than did osteoblasts cultured alone. After 20 days, co-cultured osteoblasts expressed greater amounts of mRNA for several markers of osteoblast differentiation, including collagen I alpha I (4-fold), alkaline phosphatase (2.5-fold), osteopontin (3-fold), and osteocalcin (4-fold), than did osteoblasts cultured alone. After 30 days, co-cultured osteoblasts produced bone nodules that were significantly greater both in number (324 +/- 29 nodules versus 252 +/- 29 nodules per well, p , < or = 0.04) and total area of nodules (65 +/- 11 mm(2) versus 24 +/- 1.6 mm(2), p < or = 0.003) than osteoblasts cultured alone.To begin to understand how dural cells effect changes in osteoblast gene expression, the authors compared the expression of candidate genes, transforming growth factor beta 1 and fibroblast growth factor 2, in dural cells and osteoblasts before and after 5 days of culture. Interestingly, the dura mater produced marked amounts of these osteogenic cytokines compared with osteoblasts.The described co-culture system demonstrated that co-cultured osteoblasts proliferated more rapidly and experienced an increased rate and degree of cellular maturation than did osteoblasts cultured alone. The authors hypothesize that this effect was due to paracrine signaling (e.g., transforming growth factor beta 1 and fibroblast growth factor 2) from the dura mater, and they are investigating those mechanisms in ongoing experiments. Collectively these data verify that immature, non-suture-associated dura mater can influence the biologic activity of osteoblasts. Moreover, the production of cytokines derived from the dura mater (e.g., transforming growth factor beta 1 and fibroblast growth factor 2), and they may begin to explain why immature animals and infants with intact dura mater can reossify large calvarial defects.     

THE FINE STRUCTURE OF MEISSNER's TOUCH CORPUSCLES OF HUMAN FINGERS

Thin slices of the finger pads of six individuals were fixed in buffered 1 per cent osmic acid, embedded in deaerated, nitrogenated methacrylate, and cut into thin sections for electron microscopic study. Before embedding, the slices were trimmed so as to include several digital tactile corpuscles. Some thin sections were stained in 10 per cent aqueous phosphotungstic acid solution. The principal part of Meissner's corpuscle is made up of flattened laminar cells stretching across the corpuscle in irregular layers. The perinuclear cytoplasm of these cells contains numerous small mitochondria, a sparse granular endoplasmic reticulum, and a large number of small vesicles. Nerve fibers enter the side or base of the corpuscle, lose their myelin sheaths, and follow a meandering course between the laminar cell plates. The nerve endings enter into a close appositional relationship with the flattened portions of the laminar cells. In some areas the apposed axolemma and cell membranes are slightly thickened with small vesicles located along the cell membrane or on both surfaces. These regions are interpreted as synapses. The most prominent feature of the nerve endings is an extraordinary accumulation of small mitochondria which vary in size and internal density. The nerve endings also contain vacuoles, groups of dense concentric membranes, and small dense vesicles of irregular distribution. The laminar cells are separated from one another by a dense intercellular substance of uniform thickness which also envelops the entire corpuscle. This material contains randomly oriented collagen fibers and fine fibrils bound together by a dense material at nodal points recurring at regular intervals of approximately 120 mµ. These findings are discussed in relation to the problems of the function of Meissner's corpuscle, neural material loss and replacement, and the presence of synapses.     

PS-100 and NF 70-200 double immunolabeling for human digital skin meissner corpuscle 3D imaging.

For detailed study of complex structures such as corpuscular mechanoreceptors, confocal microscopy can be used with multiple immunolabeling that identifies specifically different subcomponents. In addition, anatomic interpretation is enhanced by three-dimensional reconstruction. Confocal laser micrographs, reconstructed from serial images 1 microm thick of human skin Meissner corpuscles simultaneously immunostained for neurofilaments (NF 70-200) and protein S-100 (PS-100), clearly reveal the complex 3D relationship between Schwann-related lamellar cells immunoreactive for PS-100 and the nerve fibers marked by NF 70-200. The nerve fiber, after branching into the corpuscle, divides into several ramifications, presenting discoidal expansions and flattened fringed sections. The mean nerve diameter was 4 microm +/- 1 (2-5 microm) and the mean size of the discoidal expansions was 15 microm +/- 1 (7-30 microm). Corpuscle size varied from 30-140 +/- 1 microm in length and from 20-60 +/- 1 microm in diameter. This study confirms the presence of neural discoidal areas in Meissner's corpuscles, which are probably involved to some extent with the transduction process. Despite the accuracy of immunolabeling and imaging, an extracorpuscular neural network was never observed in the vicinity of corpuscles, thus giving doubt as to their existence. (J Histochem Cytochem 48:295-302, 2000)     

Dermatan sulfate remodeling associated with advanced Dupuytren's contracture

Dermatan sulfate (DS) widespread as a component of extracellular matrix proteoglycans, is characterized by great bio-reactivity and remarkable structural heterogeneity due to distinct degrees of sulfation and glucuronosyl epimerization and different polymerization degrees. However, DS metabolism under various biological conditions is poorly known. Dupuytren's contracture is a benign fibromatosis leading to complex remodeling of the palmar fascia structure and properties. However, it remains unclear whether the disease affects the structure of DS, which is the major tissue glycosaminoglycan. Thus the aim of the study was to examine the structure of the total DS in Dupuytren's fascia. DS chains were extracted from 5 samples of normal fascia and 7 specimens of Dupuytren's tissue by papain digestion followed by fractionation with cetylpyridinium chloride. Then, DS structure analysis was performed comprising the evaluation of its molecular masses and sensitivity to hyaluronidase and chondroitinase B. Dupuytren's contracture is associated with significant remodeling of DS chain structure revealed by (1) a distinct profile of chain molecular masses characterized by the appearance of long size components as well as the increase in the content of small size chains; (2) a different glucuronosyl epimerization pattern connected with the enhanced content of glucuronate disaccharide blocks; (3) chain oversulfation. These structural alterations in total DS may modify the GAG interactions especially affecting collagen fibrillogenesis and growth factor availability. Thus, Dupuytren's contracture associated DS remodeling may promote the phenomena typical for advanced disease: apoptosis and reduction in cell number as well as the appearance of dense pseudotendinous collagen matrix.     

家鸽Herbst小体对振动的反应特征

鸟类的Herbst小体是一种形态特殊的感觉性神经末梢器官.本文利用电生理学方法,研究了家鸽腿部胫骨-腓骨之间的Herbst小体对振动刺激的反应特征.这种小体对振动刺激非常敏感,当振动频率在600—800赫时,它们有反应的最低阈值约为0.3微米.不同的Herbst小体的反应阈值与频率的关系曲线表明:这种小体具有明显的带通滤波的特征,对振动反应的最佳频率范围为400—1000赫.在适宜频率、超阈值强度的振动刺激下,Herbst小体能以1:1的方式作出反应,即相对于每次正弦波振动刺激都有一个锁相的神经脉冲产生.在背根脊神经节内的细胞外记录表明:对振动敏感的神经节细胞具有和Herbst小体完全相似的反应特征.     

Corpuscular bodies in the palate of the rat. 1. Morphology and distribution

The morphology and the frequency distribution of corpuscular bodies in the palate was studied in rats using light and electron microscopy. The study extended from the day of birth through 180 days after birth. The corpuscles appeared as round (diameter 35-50 microns) to ovoid (width 40-60 microns, height 60-90 microns) bodies intercalated within the epithelium of the incisal papilla and the soft palate. A subepithelial nerve plexus surrounded the base of a corpuscle. For types of cells were identified within the corpuscle: basal, type I (dark), type II (pale) and type III cells. Some cells bore microvilli which protruded through a pore into the oral cavity. Numerous nerve endings terminated in close relation to the latter three types of cells. Two distinct types of membrane specializations were found representing axosomatic and axo-axonal contacts. On morphological grounds we interpret the structures described as receptors of taste. At birth, a mean total of 21 corpuscles was observed in the entire palate of which 31% was located on the incisal papilla and 68% was found in the soft palate. During the first 2 weeks (16 days) of postnatal life, the number of corpuscles increased. Thereafter, a significant decrease in corpuscle number occurred with increasing age. We speculate that the corpuscles are associated with the learning process of food selection.     

Water-soluble proteins of Pacinian corpuscles

The composition of water soluble proteins has been investigated in different parts of Pacinian corpuscles. The Pacinian corpuscles fluid proteins have been compared with the receptor homogenate proteins and blood serum of a cat. It is supposed that proteins of the Pacinian corpuscle fluid are produced from the blood system on the whole. The composition of the Pacinian corpuscle fluid as well as a great variety of glycoproteins in it allows to suppose that the Pacinian corpuscles fluid perform a transport function.     

Degeneration of the laminated corpuscles (of Vater--Pacini) following colchicine application to a nerve]

Laminated pacinian corpuscles from the cat mesentery have been studied morphologically and morphometrically after nerve section and colchicine application to the nerve and the results obtained are represented. Similar interventions in the nerve produce changes in the receptors resembling those of wallerian type degeneration, degeneration rate after sectioning being higher than after colchicine application. At early stages after colchicine application the internal cone and its nuclei increase in size. The data obtained suggest the nuclei of the internal cone to be under neurotrophic control of the sensory neuron that might be realized via axoplasmic transport of substances.     

Development of a fluorescence stereomicroscope and observation of Bong-Han corpuscles inside blood vessels

A fluorescence stereomicroscope system was developed in order to observe in situ the distribution of nuclei in intravascular Bong-Han ducts and corpuscle tissues by injecting acridine orange, which stained specifically nuclei. Intravascular Bong-Han corpuscles, connected with Bong-Han ducts could be detected in the aortas of rats, mice, and rabbits.     

Dupuytren's disease metabolite analyses reveals alterations following initial short-term fibroblast culturing

Dupuytren's disease (DD) is an ill-defined fibroproliferative disorder affecting the palm of the hand, resulting in progressive and irreversible digital contracture. In view of the abnormal gene dysregulation found in DD, and its potential effect on metabolites at a functional level, we chose to examine the metabolic profile involved in DD. Using Fourier transform infrared (FT-IR) spectroscopy to generate metabolic fingerprints of cultured cells, we compared the profiles of DD cords and nodules (1) against the unaffected transverse palmar fascia (internal control), (2) against carpal ligamentous fascia (external control), and (3) against fibroblasts from fat surrounding the nodule and skin overlying the nodule (environmental control). We also determined the effects of serial passaging of the cells on DD fingerprints. Subsequently, gas chromatography-mass spectrometry (GC-MS) was employed for metabolic profiling in order to identify metabolites characteristic of the DD tissue phenotypes. We developed a robust metabolomic analysis procedure of DD using cultured fibroblasts derived from DD tissues. Our carefully controlled culture conditions, combined with assessment of metabolic phenotypes by FT-IR and GC-MS, enabled us to demonstrate metabolic differences between DD and unaffected transverse palmar fascia and between DD and healthy control tissue. In early passage (0-3) the metabolic differences were clear, but cells from subsequent passages (4-6) started to lose this distinction between diseased and non-diseased origin. The dysregulated metabolites we identified were leucine, phenylalanine, lysine, cysteine, aspartic acid, glycerol-3-phosphate and the vitamin precursor to coenzyme A. Early passage DD cells exhibit a clear metabolic profile, in which central metabolic pathways appear to be involved. Experimental conditions have been identified in which these DD data are reproducible. The experimental reproducibility will be useful in DD diagnostics and for DD systems biology.     

Dupuytren's disease: history, diagnosis, and treatment

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe the clinical features of the disease. 2. Describe the pathoanatomical structures in Dupuytren's disease. 3. Outline the various factors associated with Dupuytren's disease. 4. Describe the modalities for surgical and nonsurgical treatment of the condition. 5. Outline recent biomolecular knowledge about the basis of Dupuytren's disease. SUMMARY: Dupuytren's disease is characterized by nodule formation and contracture of the palmar fascia, resulting in flexion deformity of the fingers and loss of hand function. The authors review the historical background, clinical features, and current therapy of Dupuytren's disease; preview treatment innovations; and present molecular data related to Dupuytren's disease. These new findings may improve screening for Dupuytren's disease and provide a better understanding of the disease's pathogenesis.