Wednesday, March 28, 2018

Bone-in-the-Nose Medicine "Finds" New Organ Underlying Taoist Alchemy/Chi


Nature |  Confocal laser endomicroscopy (pCLE) provides real-time histologic imaging of human tissues at a depth of 60–70 μm during endoscopy. pCLE of the extrahepatic bile duct after fluorescein injection demonstrated a reticular pattern within fluorescein-filled sinuses that had no known anatomical correlate. Freezing biopsy tissue before fixation preserved the anatomy of this structure, demonstrating that it is part of the submucosa and a previously unappreciated fluid-filled interstitial space, draining to lymph nodes and supported by a complex network of thick collagen bundles. These bundles are intermittently lined on one side by fibroblast-like cells that stain with endothelial markers and vimentin, although there is a highly unusual and extensive unlined interface between the matrix proteins of the bundles and the surrounding fluid. We observed similar structures in numerous tissues that are subject to intermittent or rhythmic compression, including the submucosae of the entire gastrointestinal tract and urinary bladder, the dermis, the peri-bronchial and peri-arterial soft tissues, and fascia. These anatomic structures may be important in cancer metastasis, edema, fibrosis, and mechanical functioning of many or all tissues and organs. In sum, we describe the anatomy and histology of a previously unrecognized, though widespread, macroscopic, fluid-filled space within and between tissues, a novel expansion and specification of the concept of the human interstitium.

Independent |  The team behind the discovery suggest the compartments may act as “shock absorbers” that protect body tissues from damage.

Mount Sinai Beth Israel Medical Center medics Dr David Carr-Locke and Dr Petros Benias came across the interstitium while investigating a patient’s bile duct, searching for signs of cancer.

They noticed cavities that did not match any previously known human anatomy, and approached New York University pathologist Dr Neil Theise to ask for his expertise.

The researchers realised traditional methods for examining body tissues had missed the interstitium because the “fixing” method for assembling medical microscope slides involves draining away fluid – therefore destroying the organ’s structure.  

Instead of their true identity as bodywide, fluid-filled shock absorbers, the squashed cells had been overlooked and considered a simple layer of connective tissue.

Having arrived at this conclusion, the scientists realised this structure was found not only in the bile duct, but surrounding many crucial internal organs.

“This fixation artefact of collapse has made a fluid-filled tissue type throughout the body appear solid in biopsy slides for decades, and our results correct for this to expand the anatomy of most tissues,” said Dr Theise.


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