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Biopsy
Kinds of Biopsy Terms modified by Biopsy Selected AbstractsSAFETY AND ADEQUACY OF NATIVE RENAL BIOPSYNEPHROLOGY, Issue 3 2000Jardine M [source] INDETERMINATE RESULTS IN CORE BIOPSIES OF BREAST FROM MAMMOGRAPHICALLY DETECTED LESIONS: OUTCOMES OF EXCISION BIOPSYPATHOLOGY INTERNATIONAL, Issue 12 2001Harvey J INTRODUCTION: Protocols for excision of mammographically detected lesions following core biopsy include all diagnoses of atypical ductal hyperplasia (ADH) or intraductal atypia of uncertain significance (AUS). The aims of this study were to look at: i) the prevalence of reporting ADH and AUS, ii) the proportion of cases where excision revealed breast carcinoma, iii) whether any cases could be downgraded to hyperplasia on review. METHODS: Breast core biopsy reports from the SCGH Breast Centre for the years 1999,2000 were retrieved. The results of excision biopsy were obtained and slides reviewed. RESULTS: There were 1048 core biopsies from 911 women. Breast carcinoma was diagnosed in 197 samples (18.8%) including 88 with invasive carcinoma (8.4%), 109 with ductal carcinoma in situ (10.4%) and 3 samples (2.9%) suspicious of invasive carcinoma. The suspicious cases all proved to be invasive carcinomas. There were 53 samples (5.1%) with a diagnosis of ADH or AUS. 46 were excised, showing 7 invasive carcinomas 15 DCIS, 11 ADH, 2 lobular carcinoma in situ (LCIS), 1 mucocoele-like lesion, 1 fibroadenoma and 9 fibrocystic change (FCC). The 22 malignancies represented 47.8% of the excised lesions. At review, 8 of the 53 original diagnoses were downgraded to benign hyperplasia; 5 underwent excision; 2 showed ,incidental' invasive carcinomas, 1 ,incidental' LCIS, 1 ADH and 1 FCC. CONCLUSIONS: There was a low prevalence of reporting of ADH and AUS in core biopsies (5.1%) and a high rate of carcinoma (47.8%) in subsequent excision biopsies. Very few diagnoses of ADH/AUS were downgraded at review. Current protocols for excision of lesions with a core biopsy diagnosis of ADH/AUS appear to be justified. [source] DIAGNOSTIC VALUE OF THORACOSCOPIC PLEURAL BIOPSY FOR PLEURISY UNDER LOCAL ANAESTHESIAANZ JOURNAL OF SURGERY, Issue 8 2006Motoki Sakuraba Background: We find pleural effusion in clinical practice frequently. However, it is difficult to make a diagnosis definitively by thoracocentesis or closed pleural biopsy. We directly examine the thoracic cavity by thoracoscopy under local anaesthesia, carry out pleural biopsy and make a definitive pathological diagnosis in pleurisy. Method: A retrospective study of 138 patients who had been diagnosed by thoracoscopy in our hospital was carried out between January 1995 and January 2005. Results: The patients were 114 men and 24 women, ranging in age from 21 to 85 years, with a mean of 59 years. The right side was involved in 83 patients and the left side in 55. The operations took 11,145 min, with a mean of 46 min. Thoracoscopy directly without thoracocenteses was carried out in 28 of 138 patients. Lung cancer with pleural dissemination was diagnosed in 27, malignant pleural mesothelioma in 10, tuberculous pleurisy in 32, non-specific pleurisy in 58, other tumour in 2 and pyothorax in 9 patients. The overall diagnostic efficacy was 97.1% (134/138). The diagnostic efficacy in the cases of carcinoma was 92.6% (25/27), in malignant pleural mesothelioma it was 100% (10/10) and in tuberculosis it was 93.8% (30/32). No major complications occurred during the examination. Conclusion: Pleural biopsy by thoracoscopy under local anaesthesia should be actively carried out in patients with pleurisy, because the technique has a high diagnostic rate and can be easily and safely carried out. [source] CURRENT STATUS OF SENTINEL NODE BIOPSY IN BREAST CANCERANZ JOURNAL OF SURGERY, Issue 2 2000PETER STANTON No abstract is available for this article. [source] REPEAT DYNAMIC SENTINEL NODE BIOPSY IN LOCALLY RECURRENT PENILE CARCINOMABJU INTERNATIONAL, Issue 12 2010Yao Zhu No abstract is available for this article. [source] A RANDOMIZED CONTROLLED TRIAL OF TOPICAL GLYCERYL TRINITRATE BEFORE TRANSRECTAL ULTRASONOGRAPHY-GUIDED BIOPSY OF THE PROSTATEBJU INTERNATIONAL, Issue 6 2007Simon Brewster No abstract is available for this article. [source] Irritant threshold and histological response of epidermis to irritant applicationCONTACT DERMATITIS, Issue 5-6 2004H. R. Smith Individuals vary in their ability to react to irritants, which can be demonstrated for sodium lauryl sulfate (SLS) using the irritant threshold (IT) test. We aimed to study whether the histological and immunohistochemical features of the skin following SLS exposure varied with subject's IT. 8 subjects were recruited. Their IT was measured. Biopsies were taken after 2 hr and 4 hr of occlusion with 20% SLS and control. The specimens were stained with haematoxylin and eosin and for Langerhans cells. At 4-hr, low-threshold subjects developed changes to a greater extent than high-threshold subjects. The relationship of histological reaction to IT could be related to a differential pro-inflammatory cytokine response in subjects. Low IT has been previously associated with a tumour necrosis factor alpha promoter region polymorphism. [source] THE MOLECULAR FUTURE IN CYTOLOGYCYTOPATHOLOGY, Issue 2006M. Salto-Tellez Molecular diagnosis is the application of molecular biology techniques and knowledge of the molecular mechanisms of disease to diagnosis, prognostication and treatment of diseases. Molecular Diagnosis is, arguably, the fastest growing area of diagnostic medicine. The US market for molecular testing generated $1.3 billion in 2000, which was predicted to increase to about $4.2 billion by 2007.1 We proposed the term Diagnostic Molecular Cytopathology to define the application of molecular diagnosis to cytopathology2. Diagnostic Molecular Cytopathology is essential for the following reasons: (i) Molecular testing is sometimes indispensable to establish an unequivocal diagnosis on cell preparations; (ii) Molecular testing provides extra information on the prognosis or therapy of diseases diagnosed by conventional cytology; (iii) Molecular testing provides genetic information on the inherited nature of diseases that can be directly investigated in cytology samples, by either exfoliation or by fine needle aspiration; (iv) Sometimes the cytopathology sample is the most convenient (or the only available) source of material for molecular testing; (v). Direct molecular interrogation of cells allows for a diagnostic correlation that would otherwise not be possible. Parallel to this direct diagnostic implication, cytopathology is increasing important in the validation of biomarkers for specific diseases, and in therefore of significant importance in the overall translational research strategies. We illustrate its application in some of the main areas of oncology molecular testing, such as molecular fingerprinting of neoplasms,3 lymphoreticular diseases,2 sarcomas4 and lung cancer,5 as well as translational research using diagnostic cytopathology techniques. The next years will see the consolidation of Diagnostic Molecular Cytopathology, a process that will lead to a change of many paradigms. In general, diagnostic pathology departments will have to reorganize molecular testing to pursue a cost-efficient operation. Sample preparation will have to take into account optimal preservation of nuclear acids. The training of technical staff and the level of laboratory quality control and quality assurance would have to follow strict clinical (not research) laboratory parameters. And, most importantly, those pathologists undertaking molecular diagnosis as a discipline would have to develop their professional expertise within the same framework of fellowships and professional credentials that is offered in other sub-specialties. The price to pay if this effort is not undertaken is too important for the future of diagnostic pathology in general. The increasing characterization of molecular biomarkers with diagnostic, prognostic or therapeutic value is making the analysis of tissue and cell samples prior to treatment a more complex exercise. If cytopathologists and histopathologists allow others to take charge of molecular diagnosis, our overall contribution to the diagnostic process will be diminished. We may not become less important, but we may become less relevant. However, those within the discipline of diagnostic pathology who can combine the clinical background of diseases with the morphological, immunocytochemical and molecular diagnostic interpretation will represent bona fide diagnostic specialists. Such ,molecular cytopathologists' would place themselves at the centre of clinical decision-making. Reference:, 1. Liz Fletcher. Roche leads molecular diagnostics charge. Nature Biotechnol 20, 6,7; 2002 2. Salto-Tellez M and Koay ESC. Molecular Diagnostic Cytopathology - Definitions, Scope and Clinical Utility. Cytopathology 2004; 15:252,255 3. Salto-Tellez M, Zhang D, Chiu LL, Wang SC, Nilsson B, and Koay ESC. Immunocytochemistry Versus Molecular Fingerprinting of Metastases. Cytopathology, 2003 Aug; 14(4):186,90. 4. Chiu LL, Koay SCE, Chan NL and Salto-Tellez M. Molecular Cytopathology: Sequencing of the EWS-WT1 Gene Fusion Transcript in the Peritoneal Effusion of a Patient with Desmoplastic Small Round Cell Tumour. Diagnostic Cytopathology, 2003 Dec; 29(6): 341,3. 5. TM Chin, D Anuar, R Soo, M Salto-Tellez, WQ Li, B Ahmad, SC Lee, BC Goh, K Kawakami, A Segal, B Iacopetta, R Soong. Sensitive and Cost-Effective deptection of epidermal growth factor Receptor Mutations in Small Biopsies by denaturing High Performance Liquid Chromatography. (In press). [source] Fractional Photothermolysis for Photoaging of HandsDERMATOLOGIC SURGERY, Issue 1 2008MING H. JIH MD BACKGROUND Laser treatment for photoaging of the hands should ideally address pigmentary alteration as well as associated skin roughness and wrinkling. Fractional resurfacing has been previously shown to effectively treat facial rhytids and dyschromia. OBJECTIVE We examined the effect of fractional resurfacing for photoaging of the hands. METHODS AND MATERIALS Ten patients (skin phototypes II to IV) with hand photodamage were randomized to receive five treatments with a 1,550-nm diode-pumped erbium fiber laser (Fraxel SR, Reliant Technologies) laser on either the right or left hand. Treatments were performed at settings of 8 to 9 mJ/microscopic treatment zone and density of 2,500 microscopic treatment zones/cm2. Subjective assessments by the patients and investigator were performed for skin roughness, wrinkling, and pigmentation using a 5-point scale. Skin biopsies were taken at baseline and at 1 and 3 months. RESULTS Patient subjective assessment and physician clinical assessment at 1 and 3 months revealed a mean 51% to 75% improvement in skin pigmentation and 25% to 50% improvement in skin roughness and wrinkling. Biopsies of the skin showed increased density of dermal collagen. Patients experienced transient erythema and edema and none had scarring or other adverse effects. LIMITATIONS This was a small study. CONCLUSION Fractional resurfacing appears to be an effective and safe treatment modality for correcting both the pigmentary and the textural aspects of photoaging of the hand. [source] Human Papillomavirus and Overexpression of P16INK4a in Nonmelanoma Skin CancerDERMATOLOGIC SURGERY, Issue 3 2004Ingo Nindl PhD Background. P16INK4a overexpression has been identified as a specific biomarker in high-risk human papillomavirus (HPV),infected cervical (pre)cancer lesions. Objective. To evaluate the overexpression of this cyclin-dependent kinase inhibitor in skin tumors depending on HPV infections, we analyzed normal skin, benign skin disease, and skin cancer specimens. Methods. Biopsies of 23 patients with normal histology (3), psoriasis (2), verrucae vulgaris (2), actinic keratoses (5), squamous cell carcinoma (SCC) in situ (3), Bowen's carcinoma (1), and SCC (7) were analyzed. Specimens of 23 patients were immunostained using the monoclonal antibody E6H4 specific for p16INK4a. HPV status was assessed by a polymerase chain reaction (PCR) system to detect all currently known HPV types. MY (MY09/MY11 and MYN9/MYN10)-, CP (CP65/CP70 and CP66/CP69)-nested PCR, and three single PCR methods CN1, CN3, and CN4 were used in a first step, and HPV typing was performed by restriction fragment length polymorphism analysis. Only ,-globin,positive patients were included in this study. Results. HPV DNA was detected in all actinic keratoses, SCC in situ, Bowen's carcinoma, and SCC, in 50% (one of two) of verrucae vulgaris, in 66% (two of three) of normal skin, and in none of two psoriasis. P16INK4a expression was not detected in normal skin, psoriasis, and verrucae vulgares. Overexpression of p16INK4a was detected in a subset of dysplastic cells (10% to 80%) of all skin (pre)cancer lesions such as actinic keratoses, SCC in situ, Bowen's carcinoma, and SCC infected with HPV independent of sun exposure. Conclusion. P16INK4a appears to be overexpressed in a portion of dysplastic cells from actinic keratoses and SCC. Further studies to examine the association of HPV infection and the overexpression of p16INK4a are warranted. [source] Combined Excimer Laser and Topical Tacrolimus for the Treatment of Vitiligo: A Pilot StudyDERMATOLOGIC SURGERY, Issue 2 2004Adam Z. Kawalek BA Background. Vitiligo is an acquired skin disorder that is characterized by well-defined, often symmetric white patches. Although current therapeutic modalities are directed toward increasing melanocyte melanin production, few treatment modalities address the immunologic nature of the disease. Objective. To determine whether excimer laser, a known therapeutic modality, in combination with tacrolimus, a topical immunomodulator, accelerate response time and/or improve the degree of response in patients with this disorder. Methods. Eight subjects diagnosed with vitiligo were recruited to participate in this institutional review board,approved double-blind, placebo-controlled study. Twenty-four symmetric vitiliginous patches (elbows, knees) from eight subjects received excimer laser treatment three times per week for 24 treatments or 10 weeks. Additionally, topical tacrolimus 0.1% ointment (Protopic) and placebo (Aquaphor) were applied to randomized patches (left or right) twice daily throughout the length of the trial. Vitiliginous patches were monitored with photographs at baseline, every 2 weeks, and 6 months after treatment. Biopsies were performed on subjects with significant results. Results. Twenty vitiliginous patches from six subjects qualified for evaluation. Fifty percent of patches treated with combination excimer laser and tacrolimus achieved a successful response (75% repigmentation) compared with 20% for the placebo group. Subjects who responded successfully repigmented faster (19%) with combination therapy compared with excimer laser alone. Additionally, three subjects experienced transient hyperpigmentation in lesions treated with combination therapy. Conclusion. Combining topical immunomodulators with known phototherapeutic modalities may represent a key advancement in the treatment of disease. [source] Frequency of Seborrheic Keratosis Biopsies in the United States: A Benchmark of Skin Lesion Care Quality and Cost EffectivenessDERMATOLOGIC SURGERY, Issue 8 2003Maria I. Duque MD Background. Most seborrheic keratoses may be readily clinically differentiated from skin cancer, but occasional lesions resemble atypical melanocytic neoplasms. Objective. To evaluate the frequency, cost, and intensity of procedures performed that result in the removal and histopathologic evaluation of seborrheic keratoses. Methods. Episodes of surgical removal of lesions that were identified as seborrheic keratoses by histologic identification were determined using Medicare Current Beneficiary Survey data from 1998 to 1999. These episodes were defined by a histopathology procedure code that is associated with a diagnosis code for seborrheic keratosis. We then identified what procedure(s) generated the histopathology specimen. Biopsy and shave procedures were considered "low intensity," whereas excision and repair procedures were considered "high intensity." Results. Dermatologists managed 85% of all episodes of seborrheic keratoses. Dermatologists managed 89% of seborrheic keratosis episodes using low-intensity procedures compared with 51% by other specialties. For nondermatologists, 46% of the treatment cost ($9 million) to Medicare was generated from high-intensity management compared with 15% by dermatologists ($6 million). Conclusion. There is a significant difference in the management of suspicious pigmented lesions between dermatologists and other specialists. This affects both the cost and quality of care. [source] A strategy for efficient handling of fresh tumor needle biopsies that allows histological and cytopathological assessmentDIAGNOSTIC CYTOPATHOLOGY, Issue 5 2008C.C.P.M., Marta C. Cohen M.D. Abstract Neo-adjuvant chemotherapy prior to surgery is used in the management of many pediatric solid tumors, and diagnosis is therefore valuable and is frequently made by percutaneous needle biopsy. We describe a method that enhances tissue preservation and obtains a sample for rapid cytopathological assessment. Biopsies are placed in Ham's F10 culture's medium in theatre and transferred to pathology. The biopsies are retrieved from the medium and dealt as before (submit to cytogenetics; fix in glutharaldheyde; snap frozen at ,80°C and routine histology). An equal amount of 90% alcohol is then added to the Ham culture's medium fluid received from theatre before performing a cytospin preparation and a cell clot. We used this method in the diagnosis of 16 tumors demonstrating that this allows a more efficient handling of the biopsy, makes possible a same day diagnosis, enhances the quality of the immunohistochemistry and maximizes the amount of tissue available for diagnosis. Diagn. Cytopathol. 2008;36:285,289. © 2008 Wiley-Liss, Inc. [source] Association of ablation of Barrett's esophagus with high grade dysplasia and adenocarcinoma of the gastric cardiaDISEASES OF THE ESOPHAGUS, Issue 4 2006R. E. Sampliner SUMMARY., There has been increasing application of endoscopic ablation therapy for patients with high-grade dysplasia (HGD) and Barrett's esophagus (BE). Three cases are reported in which the patient developed adenocarcinoma of the gastric cardia after thermal ablation of HGD. A definition of BE including endoscopic abnormality and intestinal metaplasia by biopsy was used. Strict and standardized criteria were utilized for the endoscopic landmarks. Three cases are reported with long-segment BE and a nodule or mass in the endoscopic cardia post-thermal ablation. Biopsies documented adenocarcinoma of the gastric cardia. The development of adenocarcinoma of the cardia is unexpected. Speculation is offered as to the potential of increased proliferation and mutations at the new squamocolumnar interface after endoscopic ablation therapy to explain this association. [source] Utility of esophageal biopsy in the diagnosis of nonerosive reflux diseaseDISEASES OF THE ESOPHAGUS, Issue 3 2003R. I. Narayani SUMMARY This study evaluated the accuracy of esophageal biopsy for the diagnosis of nonerosive reflux disease (NERD) in adults. Thirty-five patients with reflux symptoms and a normal endoscopy were prospectively evaluated using esophageal biopsies, 24-h ambulatory pH monitoring and symptomatic response 4 weeks after an increase in antireflux therapy. Biopsies were scored for the total number of typical histologic reflux features seen. Patients were considered to have NERD if both pH-metry was positive and step-up therapy was successful. Biopsies were then compared to this predefined gold standard. Biopsy was most sensitive (62%) but poorly specific (27%) when one or more histologic reflux features were seen. A threshold of three or more histologic features improved the specificity (91%) but reduced sensitivity (31%). Response to step-up therapy was associated with 100% sensitivity and 100% negative predictive value when compared to biopsy and pH-metry as an alternate combined gold standard. In conclusion, biopsy is insensitive in diagnosing NERD but reasonably specific if three or more typical histologic reflux features are present. [source] Influence of liver copper status of mare and newborn foal on the development of osteochondrotic lesionsEQUINE VETERINARY JOURNAL, Issue 1 2003P. R. van WEEREN Summary Reason for performing study: To elucidate the highly contentious role of copper in the pathogenesis of osteochondrosis. Hypothesis: There would be no relationship between liver copper concentration of mares and foals and incidence of radiographically detectable osteochondrotic lesions in foals and yearlings was tested. Methods: Liver copper concentration was assessed in biopsies taken within 4 days after birth from both mares and foals and from the same foals at age 5 months. Biopsies were taken in the standing, sedated animal under ultrasonographic guidance. Radiographs were taken of both hocks (lateromedial, dorsoplantar and dorsomedial-plantarolateral oblique views) and stifles (lateromedial and caudolateral-craniomedial oblique views) at ages 5 and 11 months and scored for the presence and severity of osteochondrotic lesions. Results: Copper concentrations in newborn foals were high with a large variation (351 ± 201 mg/kg DM). They declined until reaching values comparable to those in mature animals at 5 months (20 ± 8 mg/kg DM; mares: 19 ± 20 mg/kg DM). Radiographic osteochondrotic lesions decreased in number and severity from 5 to 11 months. This pattern was more predominant in the stifle than in the hock, as has been described previously. Conclusions: There was no relationship between foal or mare liver copper concentration and osteochondrosis status at either 5 or 11 months. However, osteochondrotic lesions in foals with low-level copper status at birth decreased significantly less in number and severity than those in foals with high-level copper status at birth. Potential relevance: It is concluded that copper is not likely to be an important factor in the aetiopathogenesis of osteochondrosis, but this study indicates that there may be a significant effect of high copper status on the natural process of repair of early lesions. [source] In vitro determination of active bile acid absorption in small biopsy specimens obtained endoscopically or surgically from the human intestineEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 2 2002K-A. Ung Abstract Background In the construction of a Kock reservoir for continent urinary diversion, 70 cm of the distal ileum are used. Impaired absorption of bile acids in these patients might cause diarrhoea. Data on the absorption of bile acids in different parts of the human intestine are limited. Methods Biopsies were taken during endoscopy from the duodenum, the terminal ileum or the right colon, and during surgery 10, 50, 100 and 150 cm proximally to the ileo-caecal valve using standard endoscopy biopsy forceps. The biopsy specimens were incubated in vitro with radio-labelled taurocholic acid at 37 °C for 22 or 45 min The radioactivity was determined using the liquid scintillation technique. Results A linear increase in the uptake was observed, with increased concentrations of taurocholic acid between 100 and 500 µm in all specimens tested, that represented passive uptake or unspecific binding. The active uptake could be calculated from the intercept of the line representing passive uptake with the ordinate. The active uptake in the terminal ileum was 3,4 times greater than 100 cm proximal to the valve. Conclusions The active absorption of bile acids in humans can be determined in small biopsy specimens taken using standard biopsy forceps during endoscopy or surgery. This method is suitable for clinical studies of bile acid absorption. Active uptake of bile acids not only takes place in the very distal part of the ileum but also to a considerable degree 100 cm proximally to the ileo-colonic valve. This should be taken into account when selecting the ileal segment for continent urinary diversion. [source] Apoptosis in oral lichen planusEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 5 2001Evelyn Neppelberg Apoptotic cell death may be a contributory cause of basal cell destruction in oral lichen planus (OLP). Therefore, the purpose of this study was to investigate the rate of apoptosis in OLP and the expression of two proteins (FasR and FasL) regulating this process. Biopsies from 18 patients with histologically diagnosed OLP were investigated, with comparison to normal oral mucosa of healthy persons. For visualisation of DNA fragmentation, the TUNEL method was used. In order to characterise the infiltrating cell population (CD3, CD4, CD8) and expression of FasR and FasL, we used an immunohistochemical technique. The results showed that T cells dominated in the subepithelial cell infiltrate. Within the epithelium the apoptotic cells were confined to the basal cell layer, and more apoptotic cells were seen in areas with basal cell degeneration and atrophic epithelium. There was a prominent expression of FasR/FasL in OLP, with a rather uniform distribution throughout the inflammatory cell infiltrate. In the epithelium, the FasR/FasL expression was more abundant in the basal cell area compared to the suprabasal cell layer. In conclusion, apoptosis within the epithelium is significantly increased in situ in OLP compared to normal oral mucosa, and seems to be related to the epithelial thickness. [source] Sodium lauryl sulphate alters the mRNA expression of lipid-metabolizing enzymes and PPAR signalling in normal human skin in vivoEXPERIMENTAL DERMATOLOGY, Issue 12 2009Hans Törmä Abstract:, Detergents irritate skin and affect skin barrier homeostasis. In this study, healthy skin was exposed to 1% sodium lauryl sulphate (SLS) in water for 24 h. Biopsies were taken 6 h to 8 days post exposure. Lipid patterns were stained in situ and real-time polymerase chain reaction (PCR) was used to examine mRNA expression of enzymes synthesizing barrier lipids, peroxisome proliferator-activated receptors (PPAR) and lipoxygenases. The lipid pattern was disorganized from 6 h to 3 days after SLS exposure. Concomitant changes in mRNA expression included: (i) reduction, followed by induction, of ceramide-generating ,-glucocerebrosidase, (ii) increase on day 1 of two other enzymes for ceramide biosynthesis and (iii) persistent reduction of acetyl-CoA carboxylase-B, a key enzyme in fatty acid synthesis. Surprisingly, the rate-limiting enzyme in cholesterol synthesis, HMG-CoA reductase, was unaltered. Among putative regulators of barrier lipids synthesis, PPAR, and PPAR, exhibited reduced mRNA expression, while PPAR,/, and LXR, were unaltered. Epidermal lipoxygenase-3, which may generate PPAR, agonists, exhibited reduced expression. In conclusion, SLS induces reorganization of lipids in the stratum corneum, which play a role in detergents' destruction of the barrier. The changes in mRNA expression of enzymes involved in synthesizing barrier lipids are probably important for the restoration of the barrier. [source] Green tea extract reduces induction of p53 and apoptosis in UVB-irradiated human skin independent of transcriptional controlsEXPERIMENTAL DERMATOLOGY, Issue 1 2009Christian D. Mnich Abstract:, Ultraviolet (UV) irradiation plays a pivotal role in human skin carcinongenesis. Preclinically, systemically and topically applied green tea extract (GTE) has shown reduction of UV-induced (i) erythema, (ii) DNA damage, (iii) formation of radical oxygen species and (iv) downregulation of numerous factors related to apoptosis, inflammation, differentiation and carcinogenesis. In humans, topical GTE has so far only been tested in limited studies, with usually very high GTE concentrations and over short periods of time. Both chemical stability of GTE and staining properties of highly concentrated green tea polyphenols limit the usability of highly concentrated green tea extracts in cosmetic products. The present study tested the utility of stabilized low-dose GTE as photochemopreventive agents under everyday conditions. We irradiated with up to 100 mJ/cm2 of UVB light skin patches which were pretreated with either OM24® -containing lotion or a placebo lotion. Biopsies were taken from both irradiated and un-irradiated skin for both immunohistochemistry and DNA microarray analysis. We found that while OM24® treatment did not significantly affect UV-induced erythema and thymidine dimer formation, OM24® treatment significantly reduced UV-induced p53 expression in keratinocytes. We also found that OM24® treatment significantly reduced the number of apoptotic keratinocytes (sunburn cells and TUNEL-positive cells). Carefully controlled DNA microarray analyses showed that OM24® treatment does not induce off-target changes in gene expression, reducing the likelihood of unwanted side-effects. Topical GTE (OM24®) reduces UVB-mediated epithelial damage already at low, cosmetically usable concentrations, without tachyphylaxis over 5 weeks, suggesting GTE as suitable everyday photochemopreventive agents. [source] The porcine snout , an in vitro model for human lips?EXPERIMENTAL DERMATOLOGY, Issue 2 2005U. Jacobi Abstract:, The morphology and histology of test sites commonly used to study the penetration of lip products differ significantly from those of the human lip itself. The aim of this study was to investigate whether the porcine snout could serve as an equivalent in vitro model for human lips. The lips of human test subjects and biopsies of porcine snout tissue were compared using histological and microscopic techniques. Using a dermatological laser scanning microscope, the penetration of topically applied fluorescent sodium fluorescein was investigated in vivo on human lips and in vitro on the porcine snout. Biopsies from the in vitro experiments were studied using fluorescence microscopy. Some parts of the porcine snout show a similar morphology and histology as human lips. The stratum corneum (SC) and the epidermis of the porcine snout are thicker than those of human tissue. Both in vivo and in vitro, the topically applied fluorescent dye was detected only on the skin surface and within the uppermost SC layer. These results indicate that porcine snout can be used as an in vitro model for human lips in penetration studies. Both human and porcine tissues exhibit an efficient barrier against the penetration of topically applied substances. [source] Helicobacter pylori Stimulates a Mixed Adaptive Immune Response with a Strong T-Regulatory Component in Human Gastric MucosaHELICOBACTER, Issue 3 2007Rasmus Goll Abstract Background:, Host factors play an important role in the pathophysiology of Helicobacter pylori infection and development of gastritis and related disease. The established opinion is that the T-cell-mediated immune response to H. pylori infection is of Th1 type. Our earlier immune cell phenotype studies indicate a mixed Th1,Th2 profile of the effector cells. Therefore, an extensive adaptive and regulatory cytokine gene expression profile was conducted by quantitative real-time polymerase chain reaction (qPCR). Materials and Methods:, Biopsies from gastric mucosa of 91 patients diagnosed as H. pylori negative, H. pylori positive with gastritis, or H. pylori positive with peptic ulcer were obtained by endoscopy. Gene expressions of nine cytokines and CagA status were measured by qPCR. Results:, All cytokine genes showed higher expression levels in the presence of H. pylori when compared to H. pylori- negative samples (fold increase: IL8: × 11.2; IL12A: × 2.4; TNF-,: × 5.2; IFN-,: × 4.3; IL4: × 3.6; IL6: × 14.7; and IL10: × 6.7). Patients infected with CagA-positive strains had higher expression of IL1-, and IL18 compared to patients infected with CagA-negative strains (× 1.6 for IL1-, and × 2.0 for IL18). Patients with duodenal ulcer had a lower antral Th1/Th2 ratio than other H. pylori -positive patients. Conclusions:, The cytokine profile of H. pylori -infected gastric mucosa shows a mixed Th1,Th2 profile. Furthermore, a high IL10 expression may indicate that also regulatory T cells play a role in the chronic phase of H. pylori infection. [source] Impact of Helicobacter pylori on the Development of Vitamin B12 Deficiency in the Absence of Gastric AtrophyHELICOBACTER, Issue 6 2002Ender Serin Abstract Background. Cobalamin (vitamin B12) deficiency is associated with Helicobacter pylori infection. This study examined how serum vitamin B12 levels relate to gastric mucosa H. pylori density and histology, and to hematological findings in patients with minimal or no gastric atrophy. A second aim was to confirm that H. pylori eradication therapy increases serum B12. Materials and Methods. Biopsies of the gastric mucosa from a population of dyspeptic patients were graded for level of chronic inflammation, neutrophil activity, atrophy, and H. pylori density. A total of 145 H. pylori -infected patients with minimal or no atrophy were included in the study. Serum cobalamin level, hemoglobin level, and mean corpuscular volume were measured in the 145 patients before eradication therapy, and in 65 of the subjects after treatment. The hematologic findings before and after eradication therapy and correlations between serum vitamin B12 level and histologic parameters, hematologic findings, and patient age were statistically analyzed. Results. There was no significant correlation between serum cobalamin level and patient age. Before treatment all the histopathological scores were inversely correlated with serum vitamin B12 level (p < .01) on univariate analysis. Only H. pylori density was significantly associated with B12 level on multivariate analysis. Serum hemoglobin and cobalamin levels were significantly increased after treatment, regardless of H. pylori eradication status (p < .001). Conclusion. The findings provide strong evidence that H. pylori infection is associated with cobalamin deficiency, and show that this is true even in patients with nonulcer dyspepsia and minimal or no gastric atrophy. [source] Graft fibrosis after pediatric liver transplantation: Ten years of follow-up,HEPATOLOGY, Issue 3 2009Rene Scheenstra Previously we reported the presence of portal fibrosis in 31% (n = 84) of the grafts in protocol biopsies 1 year after pediatric liver transplantation (LTx). To assess the natural history of graft fibrosis after pediatric liver transplantation, we extended the analysis of graft histology in follow-up protocol biopsy specimens obtained 5 and 10 years after transplantation. We correlated histological results with clinical parameters at the time of LTx and during follow-up, to allow identification of risk factors for the development of fibrosis. From 1 year to 5 years after LTx, the prevalence of fibrosis increased from 31% to 65% (n = 66) but remained stable thereafter (at 10 years, 69%, n = 55). At 10 years after LTx, however, the percentage of patients with severe fibrosis had increased from 10% (at 5 years) to 29%. Of the 69% of children without fibrosis at 1 year post-transplantation, 64% (n = 39) had developed some degree of fibrosis at 10 years. Fibrosis was strongly related to transplant-related factors such as prolonged cold ischemia time, young age at the time of transplantation, high donor/recipient age ratio, and the use of partial grafts (P < 0.05). Fibrosis was not significantly related to rejection, chronic hepatitis, or the nature of the immunosuppressive therapy. Conclusion: Biopsies after pediatric LTx show that most grafts developed fibrosis within 5 years. At 10 years after LTx, the graft fibrosis had progressed to severe fibrosis in at least 25% of the patients. Development of fibrosis, starting either before or after the first year post-LTx, was strongly related to transplant-related factors, indicating the importance of these factors to long-term graft prognosis. (HEPATOLOGY 2008.) [source] Local and systemic interleukin-18 and interleukin-18-binding protein in children with inflammatory bowel diseaseINFLAMMATORY BOWEL DISEASES, Issue 1 2008Steven T. Leach Abstract Background: Interleukin-18 (IL-18) is increased in the inflamed mucosa of patients with Crohn's disease (CD). The balance between this pleiotropic proinflammatory cytokine and its natural inhibitor, IL-18-binding protein (IL-18BP), may contribute to the pathogenesis of inflammatory bowel disease (IBD). Methods: Serum and mucosal biopsies were collected from children with IBD, from children with celiac disease, and from controls. Biopsies were maintained in culture for 24 hours, and supernatant was collected. Serum and supernatant IL-18 and IL-18BPa concentrations were measured by immunoassay. Disease activity score (PCDAI) and standard serum inflammatory markers (albumin, platelets, ESR, and CRP) were recorded. Results: Serum IL-18 was greater in children with CD (537 pg/mL) than in controls (335 pg/mL; P < 0.05) but not in children with ulcerative colitis (UC) or IBD type unclassified (IBDU). Mucosal IL-18 was greater in children with CD and UC/IBDU than in controls (P < 0.01). Serum IL-18BPa was increased in children with CD compared with that in controls (3.9 versus 2.6 ng/mL; P < 0.05), but was not elevated in children with UC/IBDU. Furthermore, calculated free-serum IL-18 was elevated in CD, but not UC/IBDU, compared with that in controls (P = 0.001). Total and free-serum IL-18 were elevated in severe CD relative to in mild/moderate disease. Conclusions: IL-18, produced in the colons of children with IBD, may contribute to local inflammatory changes. Systemic IL-18 level may be a useful indicator of gut inflammation. Furthermore, free IL-18 is greatly elevated in children with CD, suggesting that compensatory increases in IL-18BPa are insufficient. Further exploration of the role of this cytokine in the pathogenesis of IBD is now required. (Inflamm Bowel Dis 2007) [source] Increased bacterial permeation in long-lasting ileoanal pouchesINFLAMMATORY BOWEL DISEASES, Issue 8 2006Anton J. Kroesen MD Abstract Background and Aims: Bacterial overgrowth appears to play an important role in the pathogenesis of ileoanal pouches. Therefore, the capability of bacterial permeation and its determinants is of great interest. The aim of this study was to examine bacterial permeation in the ileoanal pouch and to correlate the results with the degree of inflammation, the epithelial resistance, the mucosal transport function, and the age of the ileoanal pouches. Materials and Methods: Biopsies were taken from 54 patients before colectomy (n = 13; preileal pouch-anal anastomosis [IPAA]), and closure of ileostomy (n = 7; deviation), <1 year after closure of ileostomy (n = 8; intact pouch I), >1 year after closure of ileostomy (n = 16; intact pouch II), in the case of pouchitis (n = 11), and in 11 controls. Tissues were mounted in a miniaturized Ussing chamber. Escherichia coli was added to the mucosal side of the Ussing chamber, and the permeation was proven by serosal presence of E. coli. Epithelial and subepithelial resistance was determined by transmural impedance analysis. Active Na+ -glucose cotransport and active Cl, secretion were measured. Specimens were analyzed by fluorescent in situ hybridization with oligonucleotide probes targeting the bacterial 16s ribosomal RNA. The bacteria in and on the tissue were enumerated. Results: Bacterial permeation occurred in 2 of 13 pre-IPAA, 2 of 7 deviations, 0 of 8 intact pouch I, 9 of 16 intact pouch II, 5 of 11 pouchitis specimens, and 0 of 11 ileum controls. The frequency of bacterial permeation in the intact pouch II group is higher than in the intact pouch I group (P < 0.001). Epithelial resistance, mannitol fluxes, electrogenic chloride secretion, sodium-glucose cotransport of the bacterially permeated specimens versus nonpermeated of the intact pouch II group, and the pouchitis group and subepithelial resistance remained unchanged. Intramural bacteria could be detected by fluorescence in situ hybridization mainly in long-lasting pouches, but there was no correlation with bacterial permeation. Conclusions: The long-lasting ileoanal pouch is associated with increased bacterial permeability. This is not correlated with a disturbed function of the pouch mucosa but could be a precursor of pouchitis. [source] Inflammatory infiltrate of chronic periradicular lesions: an immunohistochemical studyINTERNATIONAL ENDODONTIC JOURNAL, Issue 7 2003S. Liapatas Abstract Aim, To determine the cellular profile of human chronic periradicular lesions using immunohistochemical methods in order to study the differences in the cell infiltrate of periradicular granulomas and cysts. Methodology, The study population consisted of 45 individuals without any systemic disease. Biopsies were obtained during periradicular surgery. Paraffin-embedded sections were stained by the avidin,biotin complex method (ABC), whilst cryostat tissue sections were stained using the alkaline phosphatase antialkaline phosphatase assay (APAAP). These methods are highly valid and sensitive using a panel of specific monoclonal antibodies: CD4, CD8, CD3, CD10, HLADR, CD20, CD45RO, CD68 and CD57. The 45 specimens were characterized by the use of both techniques. Results, The 45 specimens were histologically diagnosed as: 25 periradicular granulomas, 17 periradicular cysts and 3 scar tissues. No statistically significant differences were detected in the inflammatory infiltrate between periradicular granulomas and cysts. Observation of the sections showed that the majority of inflammatory cells consisted of T and B lymphocytes and macrophages. T and B lymphocytes were equally distributed in 60% of the cases. The T4/T8 ratio ranged approximately from 1 to 3 and greater, being consistent with inflammation of periradicular tissues. The final differentiation of B lymphocytes to plasma cells was also detected, whilst natural killer (NK) cells were found in only 10 cases (22%). Moreover, antigen presenting cells and T suppressor/cytotoxic cells were found to be associated with both pre-existing and newly formed epithelium. Conclusions, Periradicular granulomas and cysts represent two different stages in the development of chronic periradicular pathosis as a normal result of the process of immune reactions that cannot be inhibited. [source] Testicular carcinoma in situ in subfertile Danish menINTERNATIONAL JOURNAL OF ANDROLOGY, Issue 4 2007Inge A. Olesen Summary Carcinoma in situ (CIS) testis is the precursor stage for the majority of testicular germ cell tumours (TGCT). Infertility is one of the conditions known to predispose to TGCT, but based on scarce existing data, the prevalence of CIS in this risk group was estimated at only approximately 1%. To establish more objective data, we investigated retrospectively the prevalence of CIS based on testicular biopsies performed in a well-defined group of subfertile males. We included 453 patients who had testicular biopsies performed for infertility reasons during 1995,2005 at the Copenhagen University Hospital (Rigshospitalet). Biopsies were evaluated by two experienced observers independently. CIS was detected in 10 individuals, of whom three had bilateral CIS, corresponding to a prevalence of 2.2% (95% CI 1.1,4.0%). This is greater than the estimated risk of 0.45% for the age- and birth cohort-matched general Danish population. All patients with CIS testis had severe oligozoospermia (,2.06 million/mL). We confirmed that a thorough examination of men suffering from subfertility/infertility can identify those with an increased risk for testicular neoplasia and recommend performing bilateral biopsies, especially in the subpopulation of men with atrophic testicles, severe oligozoospermia and/or irregular ultrasonic pattern of their testicles. [source] Progressive macular hypomelanosis in Singapore: a clinico-pathological studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 6 2006Sujith Prasad W. Kumarasinghe MBBS Introduction, Progressive macular hypomelanosis (PMH), a condition of uncertain etiology, is characterized by asymptomatic hypopigmented macules predominantly located on the trunk. To date, there are no reports from South-East Asia concerning this condition. We sought to record the clinical features of PMH in Asian patients, identify etiologic factors, and study the structural and ultrastructural features of melanocytes in this disorder. Methods, Patients who presented to the National Skin Center with acquired, hypopigmented macules on the trunk, without a history of inflammation or infection, were recruited. Erythrocyte sedimentation rate (ESR), complete blood count, fasting blood glucose, liver function tests, skin scrapings for fungi, and skin biopsy specimens (from lesional and normal skin) were obtained. Biopsies were stained with hematoxylin and eosin (H&E), Fontana Masson, an immunohistochemical panel for identification of melanocyte differentiation antibodies (HMB 45, Melan A, and S100) and CD 68. Electron microscopy (EM) was also performed. The patients were evaluated every 3 months. Results, During a 9 month period, eight patients (all Chinese) presented with hypopigmented, ill-defined, confluent macules involving the lower aspect of the trunk. There were four men and four women, and the mean age was 25.9 years (range 19,45 years). Skin scrapings were negative for fungi and laboratory tests were normal. Microscopic evaluation of skin biopsy speciments showed reduced pigmentation of lesional as compared with normal appearing skin, but H&E-stained sections revealed only minimal histologic differences between lesional and normal skin. EM demonstrated a statistically significant (P = 0.047, Wilcoxon Signed Rank Test, Wilcoxon 95% CI 0.02,0.62) higher ratio of stage IV and late stage III (dark) melanosomes in normal vs. lesional skin. Conclusions, PMH may occur among young adults in Singapore. Its etiology is uncertain. The melanin content of lesional skin appears to be less than that in normal sites. EM shows a higher ratio of immature melanosomes in lesional vs. normal skin. [source] Necrobiotic xanthogranuloma with paraproteinemia; an atypical caseJOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 1 2008Yoshiyuki Ito Summary Necrobiotic xanthogranuloma (NXG) is a rare marker for paraproteinemia. An 86-year-old woman had a one year history of large red-yellow to brown annular plaques involving all limbs. Biopsies showed a non-palisading granuloma with numerous multinucleated giant cells showing prominent elastophagocytosis and extensive areas of necrobiosis throughout the entire dermis. Complete loss of elastic fibers was observed in the central atrophic area of an annular plaque. Small vascular thromboses were also present. Laboratory findings revealed paraproteinemia of IgG-lambda type. Immunohistochemical staining detected the presence of roughly equal numbers of IgG-lambda-and IgG-kappa-staining plasma cells in the dermis. We diagnosed NXG with paraproteinemia with monoclonal gammopathy (IgG-lambda type) of unknown significance. [source] |