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Histologic Sections (histologic + section)
Selected AbstractsMulticenter Study of the Safety and Efficacy of a 585 nm Pulsed-Dye Laser for the Nonablative Treatment of Facial RhytidesDERMATOLOGIC SURGERY, Issue 1 2005T. S. Jeffrey Hsu MD Objective The objective of this study was to assess the safety and efficacy of a 585 nm flashlamp pulsed-dye laser for the nonablative treatment of facial rhytides. Methods A multicenter prospective randomized controlled study on 58 volunteers was performed. A split-face approach was adopted, with one periorbital region acting as a control and the other receiving either one or two treatments. Patients were photographed and imaged three-dimensionally before and after treatment. Histologic sections were analyzed. Results Three-dimensional topographic evaluation showed improvements of 9.8% (p= .0022) and 15% (p= .0029) in surface roughness for single and double treatments, respectively. Histology revealed an increase in type I collagen messenger ribonucleic acid expression, type III procollagen, chondroitin sulfate, and grenz zone thickness. Two treatments resulted in greater improvement than one treatment. Conclusion Clinical improvement was achieved following a single treatment. Further improvement was observed following a second treatment. The subjective evaluation of clinical improvement was consistent with both histologic and topographic quantitative measurements. SUZANNE KILMER, MD, AND JAY BURNS, MD, RECEIVED THE USE OF THE LASER FOR RESEARCH AND A DISCOUNTED PURCHASE AGREEMENT. THEY BOTH ACKNOWLEDGE RECEIVING HONORARIA FOR LECTURING FROM THE MANUFACTURER. BRIAN ZELICKSON, MD, RECEIVED RESEARCH GRANTS FROM ICN. [source] Fine needle aspiration biopsy of epithelioid hemangioendothelioma of the oral cavity: Report of one case and review of literatureDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2006Guo-Xia Tong M.D., Ph.D. Abstract Epithelioid hemangioendothelioma (EHE) is an uncommon vascular tumor with biological behavior intermediate between hemangioma and angiosarcoma. It rarely occurs in the oral cavity. We report a case of an 81-yr-old woman with a 2-mo history of a 2 × 2 cm2 submucosal buccal mass. Fine needle aspiration (FNA) smears were paucicellular and showed mainly single atypical large epithelioid cells in a bloody background. The atypical cells had abundant dense cytoplasm, some with fine vacuoles. Occasionally, cells with large cytoplasmic lumina were seen. Cytology preparations from fresh tissue received for frozen section revealed numerous neoplastic cells with large intracytoplasmic lumina, some of which contained red blood cells. In addition, cells with distinct intranuclear inclusions were present. Histologic sections and immunohistochemical stains confirmed the diagnosis of EHE. Although the histologic features of EHE are well recognized, reports of FNA cytology findings are sparsely existent in the literature as several case reports. The characteristic cytological features of EHE are reviewed in this report. We believe that the diagnosis of this rare tumor can be suggested when an adequate FNA specimen is obtained. Diagn. Cytopathol. 2006;34:218,223. © 2006 Wiley-Liss, Inc. [source] Vascular fractal dimension and total vascular area in the study of oral cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 3 2009Lampros P. Goutzanis DDS Abstract Background Microvessel quantification has been studied extensively as a factor reflecting angiogenesis in various malignant tumors. The aim of our study was to evaluate the vascular fractal dimension and the immunohistochemically positive total vascular area in oral cavity carcinomas in order to assess their potential value as factors reflecting angiogenesis. Methods Histologic sections from 48 carcinomas and 17 nonmalignant mucosa specimens were evaluated by image analysis using fractal analysis software. Total vascular area was also quantified. Results Carcinomas presented higher mean values of vascular fractal dimension and total vascular area compared to normal mucosa. The difference for the vascular fractal dimension was statistically significant. Conclusions This study provides evidence that vascular fractal dimension could be used as a reliable factor reflecting angiogenesis in oral squamous cell carcinoma and that there are several statistically significant correlations among total vascular area, vascular fractal dimension, nuclear size, and clinicopathologic factors. © 2008 Wiley Periodicals, Inc. Head Neck, 2009 [source] Increasing cyclooxygenase-2 (cox-2) gene expression in the progression of Barrett's esophagus to adenocarcinoma correlates with that of Bcl-2INTERNATIONAL JOURNAL OF CANCER, Issue 4 2006Daisuke Shimizu Abstract Previous studies from our laboratory and others have suggested that increased expression of cox-2 is important in the genesis of esophageal adenocarcinoma. In vitro studies suggest that cox-2 regulates expression of the anti-apoptotic protein bcl-2, thus possibly accounting for reduced apoptosis in carcinogenesis. The aim of this study was to investigate the relationship of these 2 genes in the development of Barrett's-associated adenocarcinoma. Histologic sections from endoscopic biopsies or esophagectomy specimens were classified as non-dysplastic Barrett's (n = 30), intraepithelial neoplasia (n = 12) and adenocarcinoma (n = 48). The desired tissue was isolated by laser capture microdissection and expression levels of cox-2 and bcl-2 were measured by quantitative real-time PCR (Taqman®). Gene expression levels were compared to samples of the distal esophageal squamous epithelium (n = 55) and reflux-esophagitis (n = 25), without Barrett's or cancer. Expression of both bcl-2 and cox-2 were increased in non-dysplastic Barrett's (p = 0.0077, p = 0.0037), intraepithelial neoplasia (p = 0.0053, p = 0.0220) and adenocarcinoma (p < 0.0001, p < 0.0001) compared to squamous epithelium or reflux-esophagitis. Furthermore, there is a significant correlation between these two genes, especially in carcinoma (p < 0.0001). © 2006 Wiley-Liss, Inc. [source] Rippled-pattern trichoblastoma with apocrine differentiation arising in a nevus sebaceus: report of a case and review of the literatureJOURNAL OF CUTANEOUS PATHOLOGY, Issue 11 2009Brian L. Swick A 36-year-old man developed a papular growth in a portion of a nevus sebaceus on the post-auricular scalp. Excision showed typical histologic changes of nevus sebaceus including epidermal papillomatosis with reduced numbers of hair follicles as well as numerous sebaceous glands high in the dermis that focally emptied directly to the overlying epidermis. Histologic sections of the papular growth at the superior pole of the nevus sebaceus showed a proliferation of cytologically bland basaloid epithelial tumor lobules both in the superficial dermis, with multiple connections to the epidermis, and within the deeper dermis in a nodular growth pattern demonstrating papillary mesenchymal bodies. Ductal structures with apocrine-type decapitation secretion were present. There was prominent palisading of nuclei in rows parallel to one another, alternating with bands of homogenous eosinophilic stromal material forming a ripple pattern resembling the Verocay bodies of schwannoma. The histologic features resembled those of rippled-pattern trichoblastoma with apocrine differentiation arising in a nevus sebaceus, an association not previously described. We discuss this case as well as review the literature on rippled-pattern trichoblastoma. [source] The Effect of a Constant Electrical Field on Osseointegration after Immediate Implantation in Dog Mandibles: A Preliminary StudyJOURNAL OF PROSTHODONTICS, Issue 5 2007Yadollah Soleymani Shayesteh DDS Purpose: The long time span between insertion of implants and functional rehabilitation often inconveniences patients. Accelerating bone growth around dental implants can shorten this time span. This in vivo study evaluated the effect of a constant electrical field on bone growth around dental implants. Materials and Methods: Four mongrel dogs were used in this study. Sixteen dental implants were placed immediately after extraction of the first premolar and molar teeth. A constant electrical field (CEF) generator was placed in the mucoperiostal pouch created from the subperiostral dissection under the inferior border of the dog's mandible and connected to the experiment side fixtures. CEF provided 3 V of electrical potential during osseointegration. Histologic sections were stained with hematoxylin,eosin and observed under light microscopy. The sections were analyzed histomorphometrically to calculate the amount of newly formed bone. Statistical analysis was performed with SPSS 11.0 computer software (,= 0.05). Results: At the end of the first stage of the osseointegration (90 days) CEF group sections showed enhanced growth of the trabeculae compared with the control group. Statistical analysis revealed significant differences between experimental and control groups. Bone contact ratio was statistically significant in the experimental group (p= 0.001). An increase in the local bone formation and bone contact ratio was observed with direct electrical stimulation of the implant and the bone area around the implant. Conclusion: Minimal direct electrical current, which can produce an electrical field around the implant, can increase the amount of bone formation and decrease the time of osseointegration. [source] Perianal Bowen Disease in a Child with Human Immunodeficiency VirusPEDIATRIC DERMATOLOGY, Issue 2 2010Kathleen A. Carroll M.D. A majority of these cancers have been reported in adult patients; few reports are available regarding anogenital HPV-associated carcinomas developing in children. We report a case of perianal Bowen disease in an HIV-positive child. An 8-year-old HIV-positive boy with a history of perianal verrucous lesions presented to a clinic in Lesotho because his caregiver noted his lesions were changing in color, texture, and extent. Histologic sections revealed squamous cell carcinoma in situ. Several cases of anogenital condyloma in HIV-positive children have been reported, but very few cases of HPV-associated cancer. Children with vertically transmitted HIV may be uniquely susceptible to persistent infection with strains of HPV acquired perinatally. While the introduction of highly active antiretroviral therapy has resulted in immune restoration, decreased opportunistic infection, and increased life expectancy for children and adults with HIV, it has not affected the incidence of HPV-related cancers in these patients. The increased life expectancy of children with HIV may actually put them at risk for developing an HPV-related anogenital cancer. [source] Tumor-associated macrophages infiltrate plasmacytomas and can serve as cell carriers for oncolytic measles virotherapy of disseminated myeloma,AMERICAN JOURNAL OF HEMATOLOGY, Issue 7 2009Kah-Whye Peng In multiple myeloma, some of the neoplastic plasma cells are diffusely dispersed among the normal bone marrow cells (bone marrow resident), whereas others are located in discrete, well-vascularized solid tumors (plasmacytomas) that may originate in bone or soft tissue. Interactions between bone marrow-resident myeloma cells and bone marrow stromal cells (BMSCs) are important determinants of myeloma pathogenesis. However, little is known of the factors sustaining myeloma growth and cell viability at the centers of expanding plasmacytomas, where there are no BMSCs. Histologic sections of 22 plasmacytomas from myeloma patients were examined after immunostaining. Abundant CD68+, CD163+, S100-negative macrophage infiltrates were identified in all tumors, accompanied by scattered collections of CD3+ T lymphocytes. The CD68+ tumor-associated macrophages (TAM) accounted for 2,12% of nucleated cells and were evenly distributed through the parenchyma. The TAM generally had dendritic morphology, and each dendrite was in close contact with multiple plasma cells. In some cases, the TAM were strikingly clustered around CD34+ blood vessels. To determine whether cells of the monocytic lineage might be exploitable as carriers for delivery of therapeutic agents to plasmacytomas, primary human CD14+ cells were infected with oncolytic measles virus and administered intravenously to mice bearing KAS6/1 human myeloma xenografts. The cell carriers localized to KAS6/1 tumors, where they transferred MV infection to myeloma cells and prolonged the survival of mice bearing disseminated human myeloma disease. Thus, TAM are a universal stromal component of the plasmacytomas of myeloma patients and may offer a promising new target for therapeutic exploitation. Am. J. Hematol. 2009. © 2009 Wiley-Liss, Inc. [source] Loss of cartilage structure, stiffness, and frictional properties in mice lacking PRG4ARTHRITIS & RHEUMATISM, Issue 6 2010Jeffrey M. Coles Objective To assess the role of the glycoprotein PRG4 in joint lubrication and chondroprotection by measuring friction, stiffness, surface topography, and subsurface histology of the hip joints of Prg4,/, and wild-type (WT) mice. Methods Friction and elastic modulus were measured in cartilage from the femoral heads of Prg4,/, and WT mice ages 2, 4, 10, and 16 weeks using atomic force microscopy, and the surface microstructure was imaged. Histologic sections of each femoral head were stained and graded. Results Histologic analysis of the joints of Prg4,/, mice showed an enlarged, fragmented surface layer of variable thickness with Safranin O,positive formations sometimes present, a roughened underlying articular cartilage surface, and a progressive loss of pericellular proteoglycans. Friction was significantly higher on cartilage of Prg4,/, mice at age 16 weeks, but statistically significant differences in friction were not detected at younger ages. The elastic modulus of the cartilage was similar between cartilage surfaces of Prg4,/, and WT mice at young ages, but cartilage of WT mice showed increasing stiffness with age, with significantly higher moduli than cartilage of Prg4,/, mice at older ages. Conclusion Deletion of the gene Prg4 results in significant structural and biomechanical changes in the articular cartilage with age, some of which are consistent with osteoarthritic degeneration. These findings suggest that PRG4 plays a significant role in preserving normal joint structure and function. [source] Placental Anomalies in Children with Infantile HemangiomaPEDIATRIC DERMATOLOGY, Issue 4 2007Juan Carlos López Gutiérrez M.D., Ph.D. We investigated the pathogenic significance of placental features and their relationship to the development of infantile hemangioma in order to obtain a better understanding of its cause. Placental specimens were reviewed from 26 singleton pregnancies of women whose offspring weighed less than 1500 g. A group of 13 neonates who developed infantile hemangioma in the immediate neonate period were compared with 13 healthy preterm infants of comparable postconception age who had no infantile hemangioma. Pathologic placental changes were analyzed in both groups. Gross lesions with disturbance of the utero-placental circulation were found in all placentas from children who developed infantile hemangioma, including massive retroplacental hematoma in two infants, extensive ischemic infarction in seven, and large dilatated vascular communications, severe vasculitis, chorioamnionitis and funiculitis in four. Placental features included percentages greater than 25% of avascular villi, platelet and fibrin aggregates, and multifocal disease involving more than one histologic section. Examination of 13 placentas of low-birth-weight infants without infantile hemangioma only showed abnormal placentation in one and isolated villous dismaturity in two. The higher ratio of placental pathologic findings in patients with infantile hemangioma suggests that reduced placental oxygen diffusive conductance contributes to fetal hypoxic stress and that hypoxic/ischemic changes in the placenta could be related to infantile hemangioma development via vascular endothelial growth factor and placental growth factor expression, among others, within the villious vessels and throphoblasts. [source] Septation of the anorectal and genitourinary tracts in the human embryo: Crucial role of the catenoidal shape of the urorectal sulcusBIRTH DEFECTS RESEARCH, Issue 4 2002Daniel S. Rogers Background Previous studies of the tracheoesophageal sulcus and the sulci of the developing heart have suggested that the catenoidal or saddle-shaped configuration of the sulcus had mechanical properties that were important to developmental processes by causing regional growth limitation. We examined the development of the human perineal region to determine if a similar configuration exists in relation to the urorectal septum. We wished to re-examine the controversial issue of the role of the urorectal sulcus in the partitioning of the cloaca. Methods Digitally scanned photomicrographs of serial histologic sections of embryos from Carnegie stages 13, 15, 18, and 22, obtained from the Carnegie Embryological Collection were used. Each image was digitally stacked, aligned, and isolated using image-editing software. Images were compiled using 3-D image-visualization software (T-Vox), into full 3-D voxel-based volume renderings. Similarly, digital models were made of the urogenital sinus, anorectum, cloaca, allantois, mesonephric ducts, ureters, and kidneys by isolating their associated epithelium in each histologic section and compiling the data in T-Vox. Methods were developed to create registration models for determining the exact position and orientation of outlined structures within the embryos. Results Models were oriented and resectioned to determine the configuration of the urorectal sulcus. The results show that the urorectal sulcus maintains a catenoidal configuration during the developmental period studied and, thus, would be expected to limit caudal growth of the urorectal septum. Conclusion The observations support the concept that the urorectal septum is a passive structure that does not actively divide the cloaca into urogenital and anorectal components. Teratology 66:144,152, 2002. © 2002 Wiley-Liss, Inc. [source] Atlas of the developing inner ear in zebrafishDEVELOPMENTAL DYNAMICS, Issue 4 2002Michele Miller Bever Abstract This report provides a description of the normal developing inner ear of the zebrafish, Danio rerio, with special focus on the pars inferior. Zebrafish specimens, ranging in age from 3 to 30 days postfertilization (dpf), were processed for standard histologic sections or with a paint-fill method to show three-dimensional morphogenesis of the membranous labyrinth. Adult zebrafish (age 2 years) were also processed for inner ear paint-fills. Although development of the semicircular canals occurs rapidly (by 3 dpf), the pars inferior develops more gradually during days 5,20 postfertilization. A rudimentary endolymphatic duct emerges by 8 dpf. Differentiated hair cells of the lagenar macula are evident by 15 dpf, in a chamber located lateral and posterior to the saccule. By 20 dpf, the saccule itself is separated from the utricle, but remains connected by means of the utriculosaccular foramen. The maculae neglectae, each with differentiated hair cells, lie on the floor of the utricle near this foramen. A medial connection between the sacculi of right and left ears, the transverse canal, is also complete by 20 dpf. A ridge of mesenchyme, previously undescribed, bisects the saccule in zebrafish fry at 20,30 dpf. The images in the paint-fill atlas should provide a baseline for future studies of mutant zebrafish ears. © 2002 Wiley-Liss, Inc. [source] Pleomorphic adenoma: Cytologic variations and potential diagnostic pitfallsDIAGNOSTIC CYTOPATHOLOGY, Issue 1 2009Uma Handa M.D. Abstract The diverse morphological features encountered in pleomorphic adenoma (PA) may cause diagnostic errors in fine needle aspiration cytology (FNAC). The present study was performed to evaluate the variations in the cytological features of pleomorphic adenoma and to assess the efficacy of FNAC in its diagnosis. Fifty cases diagnosed as PA on FNAC were retrieved from the records of the Pathology Department. Cytologic smears and sections were reviewed and the cytologic diagnoses were compared with the definitive histologic diagnoses. In cases correctly diagnosed on aspiration, morphological variables like patterns of the epithelial component, type and extent of the mesenchymal matrix, metaplastic cells, hyaline globules, cystic change, giant cells, crystalline deposits, nuclear inclusions/grooves, and nuclear atypia were evaluated. The extreme diversity in morphologic features seen in histologic sections was reflected in the smears of PA. Metaplastic changes were observed more frequently in sections, while nuclear changes like inclusions/grooves were more commonly seen in smears. Other morphological features like cylindromatous pattern, giant cells and crystalline deposits were observed with equal frequency in smears and sections. Cytohistologic agreement was present in 45 of the 50 cases (90%). In 5 cases diagnosed as pleomorphic adenoma on FNAC, the histology revealed 1 case each of schwannoma, perineurioma, ectomesenchymal chondromyxoid tumor of tongue, adenoid cystic carcinoma and mucoepidermoid carcinoma. FNAC is a fairly accurate pre-operative procedure for the diagnosis of PA. The cytopathologist needs to be aware of the cytologic variations in pleomorphic adenoma so as to avoid diagnostic errors. Diagn. Cytopathol. 2009. © 2008 Wiley-Liss, Inc. [source] Absence of microfollicular basement membrane: A new indicator in the diagnosis of follicular carcinoma thyroidDIAGNOSTIC CYTOPATHOLOGY, Issue 7 2008Maheswar Sahoo M.D. Abstract The thyroid follicles represent a biological continuum. Each follicle is closely related to the follicle that is next to it. The important feature of a follicular carcinoma is a microfollicular pattern. We report a case of follicular carcinoma in a 48-year-old female that demonstrates microfollicles which are larger in size and contain more number of follicular cells in cytologic smears (20,29 cells) in contrary to the literature definition of microfollicles containing approximately 6,12 cells. We also demonstrate absence of basement membranes in these microfollicles in histologic sections by Silver Methanamine Stain, which may be an indicator to search for vascular and capsular invasion. This case report also describes postoperative positron emission tomography scan findings. Diagn. Cytopathol. 2008;36:519,522. © 2008 Wiley-Liss, Inc. [source] Solid renal masses in adults: Image-guided fine-needle aspiration cytology and imaging techniques,"Two Heads Better Than One?"DIAGNOSTIC CYTOPATHOLOGY, Issue 1 2008José García-Solano M.D. Abstract We have compared the diagnostic accuracy of image-guided 25G-FNA (fine-needle aspiration) and imaging modalities in a group of 31 patients with solid space-occupying renal lesions. All patients had undergone total nephrectomy and histologic sections were available for review. By FNA there were 24 malignant diagnoses, I benign diagnosis, and 6 cases with yield inadequate for diagnosis. The FNA accuracy for malignancy was 100% with no false positive cases; cancer typing by FNA matched the final histologic diagnoses in 91.6% of cases. Sensitivity, specificity, positive predictive value, and negative predictive value were 80%, 14%, 80%, and 14%, respectively. Radiologically there were 26 diagnoses of malignancy, I of benignity, and 4 indeterminate lesions (IL). Accuracy for malignancy was 100%, with one false positive case; cancer typing matched the final histologic diagnoses in 84%. Sensitivity of imaging modalities was 86%, specificity 17%, positive predictive value 83%, and negative predictive value 20%. Four IL corresponded to renal cell carcinoma in the final histologic report: two IL had a previous diagnosis of malignancy by FNA, and the yield of two was inadequate for cytologic diagnosis. Both techniques have 100% accuracy for the diagnosis of malignancy. The sensitivity, specificity, positive predictive value, and negative predictive value of imaging techniques are slightly higher than those obtained by FNA. Imaging techniques and FNA of solid renal masses complement each other in IL and in nondiagnostic FNAs. Diagn. Cytopathol. 2008;36:8,12. © 2007 Wiley-Liss, Inc. [source] Cytohistologic correlations in schwannomas (neurilemmomas), including "ancient," cellular, and epithelioid variantsDIAGNOSTIC CYTOPATHOLOGY, Issue 8 2006Jerzy Klijanienko M.D. Abstract Schwannoma accounts for one of the most common benign mesenchymal neoplasms of soft tissues. Although it is well defined in the cytology literature, particular histologic subtypes such as "ancient," cellular and epitheliod variants could be a source of diagnostic difficulties. We have reviewed cytology aspirates and corresponding histologic sections from 34 schwannomas diagnosed at Institut Curie. Histologically, 24 cases were classic, 5 were "ancient," 4 were cellular, and 1 was epithelioid schwannomas. No example of melanotic schwannoma was recorded. Original cytologic diagnosis was schwannoma in 13 (38.2%) cases, benign soft tissue tumor in 11 (32.4%), pleomorphic adenoma in 2 (6%) cases, angioma in 1 (2.9%) case, nodular fasciitis in 1 (2.9%) case, suspicious in 3 (8.8%) cases, and not satisfactory in 3 (8.8%) cases. There were no major differences between classical, "ancient," cellular, and epithelioid variants on cytology smears. Myxoid stroma, mast cells, and intranuclear inclusions were limited to classical subtype. Similarly, cyto-nuclear atypia was more frequent in classical subtype than in other subtypes. Schwannoma should be differentiated from well-differentiated malignant peripheral nerve sheath tumor, neurofibroma, and pleomorphic adenoma, in the last instance particularly for head and neck lesions. Diagn. Cytopathol. 2006;34:517,522. © 2006 Wiley-Liss, Inc. [source] Adenocarcinoma in colonic brushing cytology: High-grade dysplasia as a diagnostic pitfallDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2001Gordon H. Yu M.D. Abstract Cytologic evaluation of brushing specimens obtained from the colon may be useful in the diagnosis of neoplastic and inflammatory lesions, as previous studies have reported favorable sensitivity and specificity figures for this procedure. In this study, we report our experience with 80 colonic brushings examined over a 5-yr period. Thirty cases received an atypical or malignant cytologic diagnosis. Nineteen of 20 cases diagnosed cytologically as adenocarcinoma revealed adenocarcinoma on biopsy; one case showed only adenomatous epithelium on biopsy and subsequent resection. Cases diagnosed cytologically as "atypical" or "adenomatous" showed adenocarcinoma, adenoma, and inflammatory conditions upon biopsy. Slides from 30 atypical/malignant cases were retrospectively reviewed for a number of cytomorphologic features and were correlated with the histologic diagnosis. Cases from histologically confirmed adenocarcinoma tended to show greater degrees of altered nuclear polarity, nuclear pleomorphism, membrane irregularities, and chromatin pattern alterations than those from histologically proven adenomatous or inflammatory lesions. The most likely cause of a false-positive diagnosis in this setting is sampling of an adenoma with high-grade dysplasia which fails to meet histologic criteria for adenocarcinoma (invasion of the underlying muscularis mucosae). Thus, in the second part of the study, we examined histologic sections from surgically excised adenomas to determine the frequency with which profound nuclear atypia is at least focally present, potentially resulting in a false-positive cytology diagnosis upon brushing. Slides from 51 cases were reviewed; cytologic atypia beyond that typically observed in adenomas was not observed in 43% of cases. However, profound nuclear atypia was present in 6% of cases; cytologic evaluation of a brushing specimen from these lesions may have resulted in a false-positive diagnosis of adenocarcinoma, despite the histologic diagnosis of adenoma with severe dysplasia. The remaining cases demonstrated intermediate degrees of atypia. These findings serve to quantitate the frequency with which cytohistologic discrepancies might be expected for mass lesions of the colon. Diagn. Cytopathol. 24:364,368, 2001. © 2001 Wiley-Liss, Inc. [source] Topographic Anatomy of the Inferior Pyramidal Space: Relevance to Radiofrequency Catheter AblationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2001DAMIÁN SÁNCHEZ-QUINTANA M.D. Inferior Pyramidal Space and Ablation.Introduction: Radiofrequency catheter ablation carried out in the vicinity of the triangle of Koch risks damaging not only the AV conduction tissues but also their arterial supply. The aim of this study was to examine the relationship of the AV nodal artery to the inferior pyramidal space, the triangle of Koch, and the right atrial endocardial surface. Methods and Results: We studied 41 heart specimens, 24 by gross dissections and 17 by histologic sections. The proximity of the AV nodal artery to the surface landmarks of the triangle of Koch was variable, but it was notable that in 75% of specimens the artery passed close to the endocardial surface of the right atrium and within 0.5 to 5 mm of the mouth of the coronary sinus. In all specimens, the mean distance of the artery to the endocardial surface was 3.5 ± 1.5 mm at the base of Koch's triangle. The location of the compact AV node and its inferior extensions varied within the landmarks of the triangle. At the mid-level of Koch's triangle, the compact node was medially situated in 82% of specimens, but it was closer to the hinge of the tricuspid valve in the remaining 18% of specimens. In 12% of specimens, the inferior parts of the node extended to the level of the mouth of the coronary sinus. Conclusion: The nodal artery runs close to the orifice of the coronary sinus, the endocardial surface of the right atrium, the middle cardiac vein, and the specialized conduction tissues in most hearts. The nodal artery and/or the AV conduction tissues can be at risk of damage when ablative procedures are carried out at the base of the triangle of Koch. [source] Canal Wall Reconstruction with Mimix Hydroxyapatite Cement: Results in an Animal Model and Case Study,THE LARYNGOSCOPE, Issue 12 2003John Dornhoffer MD Abstract Objective/Hypothesis To assess Mimix hydroxyapatite cement for its applicability in canal wall reconstruction using the gerbil as a canal wall model. A case is presented to illustrate a novel technique of canal wall reconstruction using Mimix on the basis of the findings of our animal research. Study Design This was a preclinical study. Methods Ten Mongolian gerbils were implanted with Mimix, with the left side used to simulate mastoid obliteration and the right side used to simulate canal wall reconstruction. Pre- and postsurgery auditory-evoked brainstem responses were used to assess ototoxicity, and hematoxylin-eosin staining of histologic sections was used to assess inflammatory and foreign-body response and new bone formation. Results Rapid wound healing was achieved with each of the nine animals evaluated, with no erythema, edema, or drainage. Inspection of the ear canal at the time of sacrifice revealed no signs of otitis media and no middle ear effusions. Microscopic examination showed no inflammatory response or foreign-body reaction, good mucosalization on the side of the implant facing the bulla, and minimal fibrosis adjacent to the skin. Eight of nine specimens showed new woven bone ingrowth at the bone implant interface, with active osteoblasts and viable lacunae cells. There were no apparent fractures in the implanted material. Conclusions Mimix hydroxyapatite cement is biocompatible and suitable for canal wall reconstruction in the animal model. The characteristics of this cement, namely its ability to set quickly in a moist environment, offer advantages over previously used cements for canal wall reconstruction. [source] Unique Susceptibility of the Fetal Thymus to Feline Immunodeficiency Virus Infection: An Animal Model for HIV Infection In Utero1AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 5 2001CALVIN M. JOHNSON PROBLEM: Human infants infected in utero with HIV develop thymus insufficiency and progress to AIDS sooner than infants infected peripartum. However, direct analysis of the thymus is difficult due to limited tissue access and variable timing of vertical transmission. METHOD OF STUDY: Fetal and neonatal cats were inoculated with feline immunodeficiency virus (FIV) at an equivalent infectious dose. The thymus, blood, and lymph nodes were harvested and compared at 23 and 46 days post-inoculation (p.i.) and also compared to sham-inoculated, age-matched controls. Lymphocyte phenotypes were analyzed by flow cytometry and virus burden was quantified in histologic sections and by virus isolation from plasma. RESULTS: Fetal cats inoculated with FIV had acute thymus atrophy at birth, which coincided with peak viremia. At 46 days p.i., thymus size and cell composition rebounded and supported increased productive infection. In contrast, neonatal cats inoculated with FIV developed chronic thymus atrophy and degeneration, which was associated with decreasing productive infection and low-level viremia. CONCLUSIONS: The fetal thymus is uniquely vulnerable to acute, transient depletion and high-level productive infection. The neonatal thymus is less vulnerable to acute changes, and responds through progressive atrophy and declining productive infection. Reduced immune competence, as reflected by the failure to control virus replication, may contribute to the accelerated progression of FIV and HIV infections in utero. [source] In Vivo Diagnosis of Nasopharyngeal Carcinoma Using Contact RhinoscopyTHE LARYNGOSCOPE, Issue 8 2001Martin Wai Pak FRCSEd(ORL) Abstract Objectives To evaluate the potential use of contact endoscopy for the diagnosis of nasopharyngeal carcinoma (NPC). Study Design Prospective study to examine the nasopharynx of 30 patients with nasopharyngeal carcinoma and 18 subjects with normal nasopharynx in a clinic setting using contact rhinoscopes (Karl Storz, Tuttlingen, Germany, 7215 AA, 00 and 7215 BA, 300; 23 cm long; 4 mm in diameter). Methods The superficial cells of the normal nasopharynx and the nasopharyngeal tumors were stained with 1% methylene blue and examined with contact rhinoscopes at high magnifications (×60 and ×150). The areas under examination were then biopsied. The contact endoscopic images were compared with the corresponding hematoxylin and eosin-stained histologic sections of the biopsied tissues. Results Sixty-six procedures were performed in 48 patients. The images of normal pseudostratified ciliated epithelium and squamous epithelium were readily recognized by contact endoscopy in all subjects with normal nasopharynx (10 men and 8 women; mean age, 51.9 y). Twenty-six of 30 patients with NPC (86.6%; 18 men and 8 women; mean age, 50.6 y) were successfully examined by contact endoscopy under local anesthesia. In these 26 patients, two patterns of malignant cells were identified with contact endoscopy. The patterns of contact endoscopic images corresponded well with the histologic findings. Conclusion Contact endoscopy is an accurate and reliable office-based procedure, which allows for in-vivo diagnosis of nasopharyngeal carcinoma. [source] Gene deletion of either interleukin-1,, interleukin-1,,converting enzyme, inducible nitric oxide synthase, or stromelysin 1 accelerates the development of knee osteoarthritis in mice after surgical transection of the medial collateral ligament and partial medial meniscectomyARTHRITIS & RHEUMATISM, Issue 12 2003Kristen M. Clements Objective To investigate the development of osteoarthritis (OA) after transection of the medial collateral ligament and partial medial meniscectomy in mice in which genes encoding either interleukin-1, (IL-1,), IL-1,,converting enzyme (ICE), stromelysin 1, or inducible nitric oxide synthase (iNOS) were deleted. Methods Sectioning of the medial collateral ligament and partial medial meniscectomy were performed on right knee joints of wild-type and knockout mice. Left joints served as unoperated controls. Serial histologic sections were obtained from throughout the whole joint of both knees 4 days or 1, 2, 3, or 4 weeks after surgery. Sections were graded for OA lesions on a scale of 0,6 and were assessed for breakdown of tibial cartilage matrix proteoglycan (aggrecan) and type II collagen by matrix metalloproteinases (MMPs) and aggrecanases with immunohistochemistry studies using anti-VDIPEN, anti-NITEGE, and Col2-3/4Cshort neoepitope antibodies. Proteoglycan depletion was assessed by Alcian blue staining and chondrocyte cell death, with the TUNEL technique. Results All knockout mice showed accelerated development of OA lesions in the medial tibial cartilage after surgery, compared with wild-type mice. ICE-, iNOS-, and particularly IL-1,,knockout mice developed OA lesions in the lateral cartilage of unoperated limbs. Development of focal histopathologic lesions was accompanied by increased levels of MMP-, aggrecanase-, and collagenase-generated cleavage neoepitopes in areas around lesions, while nonlesional areas showed no change in immunostaining. Extensive cell death was also detected by TUNEL staining in focal areas around lesions. Conclusion We postulate that deletion of each of these genes, which encode molecules capable of producing degenerative changes in cartilage, leads to changes in the homeostatic controls regulating the balance between anabolism and catabolism, favoring accelerated cartilage degeneration. These observations suggest that these genes may play important regulatory roles in maintaining normal homeostasis in articular cartilage matrix turnover. [source] Monosodium urate monohydrate crystal,induced inflammation in vivo: Quantitative histomorphometric analysis of cellular eventsARTHRITIS & RHEUMATISM, Issue 6 2002C. Schiltz Objective To quantify the inflammatory cell response in rat air pouch pseudosynovial membrane during monosodium urate monohydrate (MSU) crystal,induced inflammation. Methods In the rat air-pouch model, we used a computer-assisted histomorphometric method to quantify cell distributions, based on cell linear densities, in histologic sections of membranes from pouches injected with MSU or saline. The volume, white blood cell (WBC) count, and histamine content of the pouch exudates were determined at several time points. Results Injection of 10 mg of MSU crystals into the pouch produced an acute exudate. After peaking at 24 hours, the exudate volume and WBC count decreased spontaneously over the next 3 days, simulating the self-limited course of acute gout. Membrane thickness followed a parallel course. Membrane polymorphonuclear cell (PMN) linear densities were closely correlated with exudate WBC counts, suggesting PMN recruitment from the subintimal synovial membrane. Both monocyte/macrophage and mast cell linear densities increased in the subintimal layer 2 hours after crystal injection (P = 0.038 and P = 0.03, respectively, versus controls), whereas PMN linear densities showed 2 peaks, one at 4 hours and the other 24 hours. The exudate histamine content peaked 6 hours after crystal injection, when mast cell linear densities were minimal in the membranes, suggesting mast cell degranulation. Conclusion An increase in monocyte/macrophage and mast cell densities in the membrane preceded the PMN influx in the pouch membrane and exudate, suggesting that mast cells may be involved in the early phase of MSU crystal,induced inflammation, at least in this rat model. [source] Septation of the anorectal and genitourinary tracts in the human embryo: Crucial role of the catenoidal shape of the urorectal sulcusBIRTH DEFECTS RESEARCH, Issue 4 2002Daniel S. Rogers Background Previous studies of the tracheoesophageal sulcus and the sulci of the developing heart have suggested that the catenoidal or saddle-shaped configuration of the sulcus had mechanical properties that were important to developmental processes by causing regional growth limitation. We examined the development of the human perineal region to determine if a similar configuration exists in relation to the urorectal septum. We wished to re-examine the controversial issue of the role of the urorectal sulcus in the partitioning of the cloaca. Methods Digitally scanned photomicrographs of serial histologic sections of embryos from Carnegie stages 13, 15, 18, and 22, obtained from the Carnegie Embryological Collection were used. Each image was digitally stacked, aligned, and isolated using image-editing software. Images were compiled using 3-D image-visualization software (T-Vox), into full 3-D voxel-based volume renderings. Similarly, digital models were made of the urogenital sinus, anorectum, cloaca, allantois, mesonephric ducts, ureters, and kidneys by isolating their associated epithelium in each histologic section and compiling the data in T-Vox. Methods were developed to create registration models for determining the exact position and orientation of outlined structures within the embryos. Results Models were oriented and resectioned to determine the configuration of the urorectal sulcus. The results show that the urorectal sulcus maintains a catenoidal configuration during the developmental period studied and, thus, would be expected to limit caudal growth of the urorectal septum. Conclusion The observations support the concept that the urorectal septum is a passive structure that does not actively divide the cloaca into urogenital and anorectal components. Teratology 66:144,152, 2002. © 2002 Wiley-Liss, Inc. [source] Expression of Integrin ,v,3 in Gliomas Correlates with Tumor Grade and Is not Restricted to Tumor VasculatureBRAIN PATHOLOGY, Issue 3 2008Oliver Schnell MD Abstract In malignant gliomas, the integrin adhesion receptors seem to play a key role for invasive growth and angiogenesis. However, there is still a controversy about the expression and the distribution of ,v,3 integrin caused by malignancy. The aim of our study was to assess the extent and pattern of ,v,3 integrin expression within primary glioblastomas (GBMs) compared with low-grade gliomas (LGGs). Tumor samples were immunostained for the detection of ,v,3 integrin and quantified by an imaging software. The expression of ,v,3 was found to be significantly higher in GBMs than in LGGs, whereby focal strong reactivity was restricted to GBMs only. Subsequent analysis revealed that not only endothelial cells but also, to a large extent, glial tumor cells contribute to the overall amount of ,v,3 integrin in the tumors. To further analyze the integrin subunits, Western blots from histologic sections were performed, which demonstrated a significant difference in the expression of the ,3 integrin subunit between GBMs and LGGs. The presented data lead to new insights in the pattern of ,v,3 integrin in gliomas and are of relevance for the inhibition of ,v,3 integrin with specific RGD peptides and interfering drugs to reduce angiogenesis and tumor growth. [source] Scaling the structure,function relationship for clinical perimetryACTA OPHTHALMOLOGICA, Issue 4 2005Ronald S. Harwerth Abstract. Purpose:,The full ranges of glaucomatous visual field defects and retinal ganglion cell losses extend over several orders of magnitude and therefore an interpretation of the structure,function relationship for clinical perimetry requires scaling of both variables. However, the most appropriate scale has not been determined. The present study was undertaken to compare linear and logarithmic transformations, which have been proposed for correlating the perimetric defects and neural losses of glaucoma. Methods:,Perimetry, by behavioural testing, and retinal histology data were obtained from rhesus monkeys with significant visual field defects caused by experimental glaucoma. Ganglion cell densities were measured in histologic sections of retina that corresponded to specific perimetry test locations for the treated and control eyes. The linear (percentage) and logarithmic (decibel) relationships for sensitivity loss as a function of ganglion cell loss were analysed. Results:,With decibel scaling, visual sensitivity losses and ganglion cell densities were linearly correlated with high coefficients of determination (r2), although the parameters of the functions varied with eccentricity. The structure,function relationships expressed as linear percentage-loss functions were less systematic in two respects. Firstly, the relationship exhibited considerable scatter in the data for small losses in visual sensitivity and, secondly, visual sensitivity losses became saturated with larger losses in ganglion cell density. The parameters of the percentage-loss functions also varied with eccentricity, but the variation was less than for the decibel-loss functions. Conclusions:,Linear scaling of perimetric defects and ganglion cell losses might potentially improve the structure,function relationship for visual defects associated with small amounts of cell loss, but the usefulness of the relationship is limited because of the high variability in that range. With log,log co-ordinates, the structure,function relationship for clinical perimetry is relatively more accurate and precise for cell losses greater than about 3 dB. The comparatively greater accuracy and precision of decibel loss functions are a likely consequence of the logarithmic scale of stimulus intensities for perimetry measurements and because the relationship between visual sensitivity and the number of neural detectors is a form of probability summation. [source] Optical Coherence Tomography: A Noninvasive Method to Assess Wound ReepithelializationACADEMIC EMERGENCY MEDICINE, Issue 5 2007Adam J. Singer MD BackgroundAccurate assessment of wound healing may require invasive tissue biopsies, limiting its clinical usefulness in humans. Optical coherence tomography (OCT) is a novel, high-resolution method using light reflection to obtain noninvasive cross sectional imaging of biological tissues. ObjectivesTo evaluate the utility of OCT for assessing wound reepithelialization in a porcine model. MethodsThe authors conducted an animal study with two domestic pigs. Excisional cutaneous wounds were created over the ventral surface of the animals using an electric dermatome set at a depth of 600 ,m. The wounds were excised two or three days later and precisely marked to guide initial OCT and subsequent tissue slicing and microscopy. Comparing hematoxylin and eosin,stained histologic sections and the corresponding OCT images from each tissue sample permitted identification of the correlative micromorphology. Scatter and Bland,Altman plots were used to present the data. The primary measure of agreement was the standard deviation of the pairwise differences in percent reepithelialization between OCT and histology together with a 95% confidence interval. ResultsIn normal skin, the epidermis was characterized by a thin, bright layer indicating a high degree of light scattering on OCT. The dermis below was characterized by a thicker, darker area indicating less scattering of light. All fresh excisional wounds lacked an outer bright layer of epidermis immediately after injury. At days 2 and 3, the wounds were partially reepithelialized. A new bright layer with intense light scattering was present on OCT corresponding to the neoepidermis on hematoxylin and eosin,stained sections. The correlation between percent reepithelialization measured with OCT and histology was 0.66 (p < 0.001), and the standard deviation of the differences was 11.0% (95% confidence interval = 8.4% to 16.1%). ConclusionsOCT accurately detects the presence or absence of the epidermal layer of skin, allowing noninvasive tracking of wound reepithelialization. [source] | ||||||||||||||||||||||||||||