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Features Suggestive (feature + suggestive)
Kinds of Features Suggestive Selected AbstractsO-10 Endometrial cells in cervical smears: cytological features associated with clinically significant endometrial pathologyCYTOPATHOLOGY, Issue 2007R. N. Tiam Introduction:, To establish the significance of cytological features which could predict clinically significant endometrial pathology, and therefore guide reporting practice in cervical samples. Methods:, A retrospective review of SurePath liquid-based cytology (LBC) cervical samples between 2002 and 2006, obtained at screening and colposcopy. These smears contained normal endometrial cells present at inappropriate times of the menstrual cycle, endometrial cells with atypia (borderline change) and with features suspicious / diagnostic of endometrial carcinoma (glandular neoplasia). False negative and false positive cases detected on subsequent histology were also included. The control group comprised negative samples and a few abnormal smears. All smears were randomly assigned and blinded to menopausal status, age, use of oral contraceptive pill and hormone replacement therapy and presence of intrauterine device. Each smear was reviewed for 16 cytologic criteria and a cytological diagnosis was given for each. Results:, A total of 219 smears were available for review; 137 were negative, out of which 85 contained normal endometrial cells, 41 contained endometrial cells with atypia, 10 contained endometrial cells with features suggestive of adenocarcinoma and 31 contained endometrial cells with features diagnostic of adenocarcinoma. The feature most associated with benign endometrial cells is top hat with central cell condensation. In contrast, the features associated with malignant endometrial cells are smooth nuclear membrane, pale chromatin, small nucleoli and scalloped borders. Discussion:, The criteria identified in this study do not definitively define a neoplastic process, but appear to be helpful in individual cases. This study emphasises that endometrial changes should be always interpreted with the relevant clinical information, which would otherwise lead to overdiagnosis in premenopausal women. [source] Shifting ontological boundaries: how Japanese- and English-speaking children generalize names for animals and artifactsDEVELOPMENTAL SCIENCE, Issue 1 2003Hanako Yoshida Past research shows that young language learners know something about the different category organizations of animals, objects and substances. The three experiments reported here compare Japanese-speaking and English-speaking children's novel name generalizations for two kinds of objects: clear instances of artifacts and objects with ambiguous features suggestive of animates. This comparison was motivated by the very different nature of individuation in the two languages and by the boundary shift hypothesis that proposes that entities that straddle the individuation boundary of a language are assimilated toward the individuated side. The results of the three experiments support the hypothesis. An explanation in terms of mutually reinforcing correlations among language, perceptual properties and category structure is proposed. [source] Papillary thyroid carcinoma with atypical histiocytoid cells on fine-needle aspirationDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2009Manju Harshan M.D. Abstract Although papillary thyroid carcinoma (PTC) usually has classic cytological characteristics on fine-needle aspiration (FNA), it can present rarely with aberrant features resembling those of histiocytes in a cystic nodule. The aim of the current study was to describe PTC with atypical histiocytoid cells and distinguish it from benign histiocytes. A retrospective computerized search for FNAs with atypical features suggestive of PTC and cystic degeneration was performed, and if available, the corresponding resection specimens were compared. Four cases met the criteria for FNAs and three had surgical pathology follow-up, which showed PTC. One aspirate had some features typical of PTC, but the remaining FNAs had atypical histiocytoid cells, which had traits intermediate between those of PTC and histiocytes. Large cell size, pseudoinclusions, nuclear grooves, and multiple well-defined vacuoles in atypical histiocytoid cells favor PTC over benign histiocytes. Ancillary immunocytochemical studies can also be useful in confirming the diagnosis. Histiocytic cells are frequently present in thyroid aspirates, and occasionally, they have atypical features that represent an unusual presentation of PTC. Closer examination of these cells can provide diagnostic clues for preventing false-negative diagnosis of PTC. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] SUCCESSFUL ENDOSCOPIC SUBMUCOSAL DISSECTION FOR MUCOSAL CANCER OF THE DUODENUMDIGESTIVE ENDOSCOPY, Issue 1 2010Masahiro Shinoda We report a case of mucosal duodenal cancer in a 62-year-old woman, which was successfully removed en bloc by endoscopic submucosal dissection (ESD). The patient underwent an upper gastrointestinal endoscopy at our hospital, which revealed an elevated flat mucosal lesion (type IIa) measuring 10 mm in diameter in the second portion of the duodenum. Histopathological examination of a biopsy specimen revealed features suggestive of a tubulovillous adenoma with severe atypia. As the findings suggested that the lesion had an adenocarcinoma component but was confined to the mucosal layer, we decided to carry out ESD and successfully removed the tumor in one piece. The resected tumor was 20 × 15 mm in size. Histopathological examination revealed that the lesion was a well-differentiated mucosal adenocarcinoma with no lymphovascular invasion. Mucosal duodenal cancer is extremely rare, and ESD of a lesion in the duodenum requires a high level of skill. To the best of our knowledge, this case is the first report of successful ESD carried out in a case of mucosal duodenal cancer. [source] Operative Results without Invasive Monitoring in Patients with Frontal Lobe Epileptogenic LesionsEPILEPSIA, Issue 10 2001A. Mariottini Summary: ,Purpose: To further explore the still controversial issues regarding whether all or most candidates for epilepsy surgery should be investigated preoperatively with invasive long-term video-EEG monitoring techniques (ILTVE). Methods: We studied five patients with intractable seizures since early childhood using the same protocol: clinical evaluation, magnetic resonance imaging (MRI) with fluid-attenuated inversion recovery (FLAIR) sequences, long-term video-EEG (LTVE) monitoring with scalp electroencephalogram (EEG), interictal single photon emission computed tomography (SPECT), positron emission tomography (PET), and neuropsychological testing. The patients' seizures had clinical features suggesting a frontal lobe (FL) origin. MRI scans revealed focal cortical dysplasia (CD) in four patients and a probable gliotic lesion in the fifth. The findings in both PET and SPECT images were congruent with those of the MRI. Scalp LTVE failed to localize the ictal onset, although the data exhibited features suggestive of both CDs and FL seizures. On the basis of these results, surgery was performed with intraoperative corticography, and the cortical area exhibiting the greatest degree of spiking was ablated. Results: Histopathologic study of four of the resected specimens confirmed the presence of CD, whereas in the fifth, there were features consistent with a remote encephaloclastic lesion. There were no postoperative deficits. Seizures in three of the patients were completely controlled at 2,3.5 years of follow-up; a fourth patient is still having a few seizures, which have required reinstitution of pharmacotherapy, and the fifth has obtained 70% control. All patients have had significant improvement in psychosocial measures. For comparison, five patients with generally similar clinical and neuroradiologic features to the previous group underwent preoperative ILTVE monitoring. The surgical outcomes between the two groups have not differed significantly. Conclusions: We conclude that patients with FL epilepsies may be able to undergo successful surgery without preoperative ILTVE monitoring, provided there is high concordance between neuroimaging tests (MRI, SPECT, PET) and the seizure phenotypes, even when routine EEGs and scalp LVTE fail to localize ictal onset unambiguously. The surgical outcomes of these patients generally paralleled those of the other subjects who also had FL epilepsy but who were operated on only after standard ILTVE monitoring. [source] Management of gynaecomastia: an updateINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2007P. Gikas Summary Gynaecomastia, a benign enlargement of the male breast as a result of proliferation of the glandular component, is common, being present in 30,50% of healthy men. It may be an incidental finding, an acute unilateral or bilateral tender breast enlargement or a progressive painless enlargement of the male breast. A general medical history and careful physical examination, looking for features suggestive of breast cancer, often suffice for evaluation in patients without symptoms or those with incidentally discovered breast enlargement. If the gynaecomastia is of recent onset, a more detailed evaluation, including selected laboratory tests to search for an underlying cause is necessary. Treatment depends on the cause: an offending drug may need to be withdrawn or alternatively radiation, surgery and/or medical therapy may be necessary. The use of a combination of surgical excision and liposuction through a periareolar incision represents the surgical approach of choice. [source] Color doppler imaging in the sonohysterographic diagnosis of residual trophoblastic tissueJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2002Yaron Zalel MD Abstract Purpose The purpose of this study was to evaluate the role of color Doppler imaging during sonohysterography in the diagnosis of residual trophoblastic tissue. Methods This prospective cohort study involved 25 consecutive women with clinical and sonographic signs of an echogenic intrauterine mass who were referred to the sonography unit of our institution for evaluation. All women underwent saline infusion sonohysterography with color Doppler sonographic evaluation. An operative hysteroscopy with histologic examination was performed in 17 cases. Results Thirteen women (group A) had sonohysterographic features suggestive of residual tropho- blastic tissue (ie, an echogenic intrauterine lesion not detached from the uterine wall after introduction of saline). The initial diagnosis was confirmed by histologic analysis in all cases. Blood flow was detected within the intrauterine mass in 6 (46%) of these 13 women; the resistance indices were low in all 6 cases (mean ± standard error, 0.38 ± 0.01). Twelve women (group B) had sonohysterographic findings negative for retained tissue, and no blood flow was detected within any of the intrauterine masses in this group (p < 0.05). Conclusions Our results confirm the potential role of color Doppler sonography in the initial diagnosis of residual trophoblastic tissue. The detection of color Doppler signals, especially with low-resistance flow, within an intrauterine lesion should increase the confidence of the sonologist in the diagnosis of residual trophoblastic tissue. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30: 222,225, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.10059 [source] Epithelioid sarcoma with angiomatoid features: report of an unusual case arising in an elderly patient within a burn scarJOURNAL OF CUTANEOUS PATHOLOGY, Issue 3 2008Steven Kaddu Epithelioid sarcoma (ES) is a rare, aggressive soft tissue tumor with a characteristic predilection for adolescents and young adults, and a tendency to occur on distal extremities. We report a case of ES arising in an 80-year-old woman within a burn scar that histopathologically showed unusual ,angiomatoid' features. The patient presented initially with a solitary nodule on her right wrist arising at the site of a burn scar. Histopathologically, the tumor was composed of a proliferation of relatively bland, epithelioid and spindle cells focally arranged in a nodular pattern around areas of ,geographic' necrosis. In addition, there were prominent foci of hemorrhage and blood-filled spaces as well as tumor cells with intracytoplasmic vacuoles, features suggestive of an angiomatous process. Immunohistochemistry showed positivity of tumor cells for cytokeratins and epithelial membrane antigen (EMA) whereas all vascular markers tested were negative. The overall histopathologic features were consistent with a diagnosis of ES. Follow up showed multiple recurrences arising proximally along the right upper extremity. Our case underlines the clinical and histopathological heterogeneity of ES, emphasizing the unusual occurrence of ES with ,angiomatoid' features in the elderly. In this uncommon setting, this tumor should be especially distinguished from epithelioid hemangioendothelioma and epithelioid angiosarcoma. The significance of development of ES on a healed burn scar is uncertain, but may suggest a possible causal relationship. [source] Oral lichen planus: a condition with more persistence and extra-oral involvement than suspected?JOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 10 2008Marta Bidarra Background:, Lichen planus is a relatively common and often studied chronic mucocutaneous condition. Reports detailing certain aspects relevant to patients affected have been lacking or inconsistent. Methods:, A questionnaire-based survey was employed to assess the duration of oral lesions and the prevalence of self-reported potential extra-oral manifestations associated with oral lichen planus in 87 patients. All patients had recognized clinical features of oral lichen planus, and most had had histopathological confirmation following oral biopsy. Results:, We report the findings of a preliminary survey which assessed the duration of oral lesions and the prevalence of extra-oral lesions consistent with lichen planus in patients presenting with oral lesions. The study confirmed the chronic nature of oral lichen planus and the rarity of spontaneous resolution. Most subjects had experienced symptoms for one to ten years (66 patients; 75.8%). Approximately 40% (36 patients) of the sample reported clinical features suggestive of extra-oral manifestations of lichen planus by the time that their oral lesions were apparent. The most commonly reported extra-oral manifestations involved the nails (27.6%, 24 patients). 25.3% (22 patients) reported a persistently sore throat suggestive of oesophageal or pharyngeal involvement. Skin (17.2%, 11 patients), and genital (10.3%, 9 patients) involvement was relatively infrequently reported. Most patients reported extra-oral lesions at only one site. Conclusions:, The survey results suggest that in patients with oral lichen planus oral lesions persist for a prolonged period, and that extra-oral lesions may be more common than suspected. However, further studies involving specialists to examine extra-oral sites are required. [source] Intrathoracic gastric volvulus mimicking pyloric stenosisJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 2 2003JJ Munoz Abstract: A 5-week-old-infant presented to hospital following the acute onset of non-bilious vomiting with clinical and acid,base features suggestive of pyloric stenosis. A chest radiograph obtained because of intercurrent infection unexpectedly revealed a left-sided congenital diaphragmatic hernia. A barium meal demonstrated the presence of an intrathoracic gastric volvulus, requiring urgent surgical management. We discuss the presentation and management of this rare surgical cause of non-bilious vomiting in infancy. [source] Possible role of dermoscopy in the detection of a primary cutaneous melanoma of unknown originJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2006M Stante Abstract For 2,8% of patients with metastatic melanoma, cutaneous and mucosal clinical examination does not lead to diagnosis of the primary tumour, which remains unknown. We report the case of a 41-year-old male patient who had received a diagnosis of metastatic melanoma after histological examination of an enlarged axillary lymph node, without previous detection of the primary lesion at his first dermatological examination. No pigmented skin lesions located in the anatomical area potentially drained by the affected axillary basin showed clinical features suggestive of a melanoma. Neither did the so-called ,ugly duckling' sign help us to identify the melanoma, because of the presence of a large number of clinically similar, common or slightly atypical melanocytic lesions located in that area. After dermoscopic examination we were able to narrow the field of possible candidates for excision to four lesions, selected on the basis of their dermoscopic features. Histological examination revealed the primary melanoma (superficial spreading melanoma (SSM), level III, thickness 0.5 mm) , located on the back , and three naevi with atypia. Preoperative distinction of the melanoma from the other three lesions was not possible because of the lack of well-established features of malignancy, even at dermoscopic analysis (,featureless' melanoma). Dermoscopy may thus play a role in the detection of a clinically unknown primary melanoma by narrowing the field of lesions to be removed for histological examination, saving many unnecessary excisions that would otherwise be inevitable. [source] Isolated amyloidosis presenting with lumbosacral radiculoplexopathy: description of two cases and pathogenic reviewJOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 4 2006Shafeeq S. Ladha Abstract In this study, we present two cases of infiltrative, localized amyloidosis involving lumbosacral root and plexus, e.g., isolated amyloidomas. Rare and poorly understood amyloidomas may occur in both neurologic and non-neurologic tissues. The described cases emphasize potential for localized peripheral amyloidomas: (1) potential for associated , light chain lymphoplasmacytic lymphoma association; (2) e isolated amyloidosis without evidence for systemic plasma cell dyscrasia; (3) features suggestive of potential pathogenesis; and (4) discussion of treatment options including immunotherapy and resection. The limited literature and experience among other cases is described. [source] Experimental autoimmune cholangitis: a mouse model of immune-mediated cholangiopathyLIVER INTERNATIONAL, Issue 5 2000David E. J. Jones Abstract:Background: Primary biliary cirrhosis (PBC) is characterised by intra-hepatic immune-mediated cholangiopathy (non-suppurative destructive cholangitis (NSDC)). Although auto-reactive immune responses against pyruvate dehydrogenase complex (PDC) have been characterised in PBC, the lack of an animal model of the disease has limited study of the mechanisms of disease induction and the development of novel approaches to therapy. Aims: To develop and validate a mouse model of immune-mediated cholangiopathy relevant for future use in the study of the aetio-pathogenesis and therapy of PBC. Methods: Female SJL/J, C57BL/6, NOD and BALB/c mice were sensitised with PDC, its purified E2/E3BP component, and a PDC-E2 derived peptide p163 (a dominant T-cell epitope in humans) in complete Freund's adjuvant (CFA). Morphological changes were assessed under light microscopy by a hepatic histopathologist blinded to the experimental details. Antibody responses to PDC were studied by ELISA and PDC inhibition assay. Results: An initial series of experiments was performed to survey the susceptibility of female mice of a range of strains to the induction of NSDC by i.p. sensitisation with PDC, PDC-E2/E3BP or p163 in CFA. Although each animal showed a specific antibody response following sensitisation, it was found that NSDC development (assessed at 30 weeks post-sensitisation) was restricted to SJL/J mice following sensitisation with any of the mitochondrial antigen preparations. A subsequent series of experiments was performed to examine the specificity and aetiology of this disease. Significant bile duct lesions were only seen in SJL/J animals following sensitisation with CFA containing PDC, and were absent from CFA only and un-sensitised controls. Kinetic analysis revealed that this pathology developed slowly, but a high incidence of animals with severe lesions was observed after 30 weeks. Conclusions: We have described a model of experimental autoimmune cholangitis (EAC) with immunological (anti-PDC antibodies) and histological (immune-mediated cholangiopathy) features suggestive of PBC. This model may be useful in further defining the role of self-tolerance breakdown in the development of this condition. [source] Deep brain stimulation for the treatment of atypical parkinsonismMOVEMENT DISORDERS, Issue 15 2007Ludy C. Shih MD Abstract Deep brain stimulation (DBS) has gained widespread acceptance for improving motor function and disability in Parkinson's disease (PD). Patients with features suggestive of atypical parkinsonism (AP) usually have a poorer and less sustained response to levodopa and a poorer prognosis overall when compared with patients with PD. However, experience in the use of DBS with this group of patients is limited and evidence is lacking with regards to its efficacy and adverse effects. We review in detail the experience of DBS surgery in patients with several forms of AP including multiple system atrophy. On the basis of the limited available data reviewed here, DBS for patients with AP is not recommended. © 2007 Movement Disorder Society [source] Clinicopathological and immunohistochemical features of three pilomyxoid astrocytomas: Comparative study with 11 pilocytic astrocytomasPATHOLOGY INTERNATIONAL, Issue 2 2009Vishwa J. Amatya Pilomyxoid astrocytoma, first described by Tihan et al., was recently included as an established variant of pilocytic astrocytoma in the World Health Organization classification of CNS tumors. Histologically, it much resembles pilocytic astrocytoma, but monomorphic myxoid tumor of pilocytic cells with prominent angiocentric growth pattern without Rosenthal fibers or eosinophilic granular bodies is characteristic of pilomyxoid astrocytoma. Pilomyxoid astrocytoma is thought to be more aggressive with more frequent local recurrence as well as cerebrospinal spread. The authors recently encountered a case of pilomyxoid astrocytoma, therefore the purpose of the present study was undertake a retrospective review of pilocytic astrocytomas previously diagnosed during the past 10 years. Consequently, two of them were found to have histological features suggestive of pilomyxoid astrocytoma and both involved multiple recurrence, suggesting aggressive behavior in comparison to pilocytic astrocytoma. Therefore, knowledge of this entity is essential to surgical pathologists and clinicians for patient management. [source] Pemphigus Herpetiformis in ChildhoodPEDIATRIC DERMATOLOGY, Issue 5 2010Isabela B. Duarte M.D. The clinical features of this form of pemphigus resembles dermatitis herpetiformis, however, histological examination and immunofluorescence yield findings diagnostic for pemphigus. A 5-year-old female patient with clinical features suggestive of dermatitis herpetiformis is reported. Histopathological exam showed skin with subcorneous blisters, epidermal spongiosis containing predominantly neutrophils, few eosinophils and rare acantholytic cells. Direct immunofluorescence showed intercellular deposits of IgG and C3. The skin lesions responded poorly to dapsone associated with systemic corticosteroid therapy. A complete remission of bullous lesions was obtained with azathioprine and immunosuppressive doses of systemic corticosteroids (prednisone). A case of PH in childhood is reported here, emphasizing the rarity and young age of onset. [source] Large Atypical Melanocytic Nevi in Recessive Dystrophic Epidermolysis Bullosa: Clinicopathological, Ultrastructural, and Dermoscopic StudyPEDIATRIC DERMATOLOGY, Issue 4 2005Fernando Gallardo M.D. The lesion was clinically atypical and fulfilled the criteria for a malignant melanocytic proliferation. A complete surgical excision was performed. Histopathologic examination disclosed a compound melanocytic nevus without melanocytic atypia. Ultrastructural examination showed melanocytic cells located both at the roof and the floor of the blister. Several months later, three pigmentary lesions with a similar clinical appearance developed. Periodic clinical and dermoscopic examinations were recommended. Dermoscopic examination disclosed a globular pattern with brown globules and black dots distributed all over the lesions. The lesions also exhibited blue-greyish dots and multiple rounded white structures corresponding to milia-like cysts. No dermoscopic features suggestive of malignancy were noted. Acquired melanocytic nevi showing atypical clinical features have been reported to occur in areas of blistering in patients with epidermolysis bullosa. These nevi appear as large, asymmetrical pigmentary lesions with irregular borders. Initially, they are very dark in pigmentation, with color variegation and loss of pigment, and even becoming papillomatous over time. Histopathologic examination can show features of compound/junctional nevus as well as persistent/recurrent nevus. The concept of "epidermolysis bullosa nevus" has been proposed to define these peculiar lesions. The clinical, histopathologic and ultrastructural features of these nevi are reviewed. The usefulness of dermoscopic examination in the routine diagnosis and follow-up of these lesions are stressed. [source] Fulminant hepatic failure: Wilson's disease or autoimmune hepatitis?PEDIATRIC TRANSPLANTATION, Issue 1 2005Implications for transplantation Abstract:, Fulminant hepatic failure (FHF) accounts for 10,15% of pediatric liver transplants in the USA annually. Because the onset of FHF may be the first presentation of Wilson's disease (WD) and autoimmune hepatitis (AIH) in previously asymptomatic adolescents, determination of the etiology of FHF is critical as treatment and prognosis differ between these two entities. Patients with AIH may be salvaged by medical treatment. On the contrary, liver transplantation is currently the only life saving therapeutic option available for patients with WD who present with fulminant liver failure. To establish the diagnosis of WD and AIH in the setting of FHF remains challenging for diagnosticians and decisions regarding liver transplantation may be necessary before a diagnosis is firmly established. We report a previously asymptomatic patient who presented with FHF and clinical and laboratory features suggestive of both WD and AIH and who underwent successful therapeutic liver transplantation before the diagnosis of WD could be confirmed. [source] Management of cancer-associated thrombotic microangiopathy: What is the right approach?AMERICAN JOURNAL OF HEMATOLOGY, Issue 4 2007Theresa L. Werner Abstract A 49-year-old Caucasian woman presented with features suggestive of thrombotic microangiopathy (TMA). She did not respond to treatment with repeated plasma exchange and corticosteroids. A bone marrow biopsy revealed presence of metastatic carcinoma. A limited autopsy revealed presence of breast cancer with rib metastases. Though severe deficiency of von Willebrand factor-cleaving protease was initially proposed as a key pathogenetic factor for thrombotic thrombocytopenic purpura, subsequent studies involving patients with cancer-associated TMA did not find as severe a deficiency of von Willebrand factor-cleaving protease as is seen in idiopathic cases of thrombotic thrombocytopenic purpura. Here we address one approach of management of these patients with cancer-associated TMA. Am. J. Hematol., 2006. © 2006 Wiley-Liss, Inc. [source] Solar urticaria treated successfully with intravenous high-dose immunoglobulin: a case reportPHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 6 2008Isabel Correia Solar urticaria is an idiopathic, chronic and rare photodermatosis, characterized by the sudden onset of pruritic urticarial hives and plaques on the exposed areas of the skin, after a brief period of exposure to the natural sunlight or to an artificial light source. A Caucasian 27-year-old man presented with clinical features suggestive of solar urticaria was referred to our photodermatology unit, where phototesting confirmed the diagnosis of solar urticaria induced by visible light. As he was refractory to oral antihistamines and had slight improvement under UVA plus visible phototherapy, human high-dose intravenous immunoglobulin was administered, with an excellent clinical-sustained response. [source] The Pleural Curtain of the Camel (Camelus dromedarius)THE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 10 2010Gerald R. Buzzell Abstract The visceral pleura of the camel (Camelus dromedarius) possesses a fibrous curtain of pleural threads or extensions along its basal margins, which extends into the pleural cavity of the costophrenic recesses. These threads are lined by mesothelium and have a core or stroma, which is largely collagenous. Small threads are avascular and nearly acellular. In larger proximal threads, blood vessels in the stroma are often arranged in a branching network, with irregular endothelia surrounded by several incomplete basal laminae. Lymphocytes and other inflammatory cell types aggregate in the stroma near blood vessels. The threads are lined by typical mesothelium except in patches close to the main pleural surface. These patches consist of layers of loosely applied cells with numerous cellular processes and features suggestive of phagocytosis. The position of the pleural curtain in the costophrenic recess and the presence of possibly phagocytotic cells suggest that the pleural curtain stirs, samples, and cleans the pleural fluid. The pleural curtain appears to be a feature of camelids and has also been seen in giraffes. Anat Rec 293:1776,1786, 2010. © 2010 Wiley-Liss, Inc. [source] Sexual Function and Tunica Albuginea Wound Healing Following Penile Fracture: An 18-year Follow-Up Study of 352 Patients from Kermanshah, IranTHE JOURNAL OF SEXUAL MEDICINE, Issue 4 2009Javaad Zargooshi MD ABSTRACT Introduction., We present a study on the experiences of penile fracture in an Iranian population. Aim., To determine the long-term outcome of penile fracture. Methods., Between April 1990 and May 2008, 373 patients presented with clinical features suggestive of penile fracture. Of these, 11 declined surgery. The remaining 362 were operated upon using a degloving incision. Ten patients had venous injury and 352 had penile fracture. At follow-up visits, in addition to answering our questionnaire, the patients completed the International Index of Erectile Function (IIEF), Erection Hardness Grading Scale (EHGS), and global self-assessment of potency (GSAP). To enhance documentation and to promote transparency, with the patients' permission, their full name and hospital chart number was sent to the journal. Main Outcome Measures., Clinical findings and IIEF and EHGS scores. Results., Mean patients' age was 29.6 years. Mean duration of follow-up was 93.6 months. Diagnosis was solely clinical. At presentation, 278 (78.9%) reported no pain. Cavernosography, ultrasonography, or magnetic resonance imaging was not used in any of the patients. Penile fracture was due to taqaandan in 269 patients (76.4%). Patients were treated with surgical exploration and repair within 24 hours of admission, regardless of delay in presentation. A nodule was found at follow-up in 330 patients (93.7%). The painless, mostly proximal nodule was palpated at the floor of the corpora cavernosa, in a deep midline position above the corpus spongiosum. The non-expansive nodule was not associated with erectile dysfunction (ED) or Peyronie's disease. Postoperative complications included mild penile pain in cold weather (two patients), transient wound edema (one patient), mild chordee (four patients), and occasional instability of the erect penis (one patient). Postoperatively, of the 217 patients who had partners, 214 (98.6%) were potent. Mean IIEF ED domain score was 29.8 ± 1.1. The EHGS score was 4 in 203 and 3 in 11. The GSAP score was 0 in 204, 1 in 8, and 2 in 2. ED in the remaining three could not be explained by penile fracture. Of 10 nonoperated patients, eight (80%) developed ED. Conclusion., Pain is rare in penile fracture. Postoperatively, almost all patients develop a permanent, inconsequential, fibrotic nodule. Our time-tested approach provided excellent long-term sexual function. Zargooshi J. Sexual function and tunica albuginea wound healing following penile fracture: An 18-year follow-up study of 352 patients from Kermanshah, Iran. J Sex Med **;**:**,**. [source] Accuracy of preoperative ultrasound and ultrasound-guided fine needle aspiration cytology for axillary staging in breast cancerANZ JOURNAL OF SURGERY, Issue 4 2010Jinhyang Jung Abstract Background:, The aims of this study were to evaluate the accuracy of preoperative ultrasound and ultrasound-guided fine needle aspiration (FNA) cytology (US-FNAC) for detecting axillary metastases, and to assess how often sentinel node biopsy could be avoided. Methods:, Axillary ultrasound, as a part of routine preoperative staging, was performed in 189 patients with histologically proven breast cancer. US-FNAC was performed on all lymph nodes (LNs) with features suggestive of metastatic disease on ultrasound characteristics and LNs larger than 1 cm regardless of whether the nodes appear normal or abnormal. The cytologic results were compared with the final histological diagnosis. Results:, The sensitivity, specificity and positive and negative predictive values of the ultrasound alone of axillary LNs for metastatic breast cancer were 54, 91, 75 and 81%, retrospectively. For the US-FNAC, the respective values were 80, 98, 97 and 84%. Conclusions:, Preoperative axillary ultrasound in combination with US-FNAC provides a simple, minimally invasive and reliable approach to the initial determination of the axillary LN status. Those who are US-FNAC positive can be referred for axillary LN dissection without sentinel LN biopsy. [source] Does retroperitoneal lymph node dissection have a curative role for patients with sex cord,stromal testicular tumors?CANCER, Issue 4 2003Ashraf A. Mosharafa M.D. Abstract BACKGROUND Sex cord,stromal tumors account for < 5% of all adult testicular tumors, and 10% are malignant. Due to the limited reported experience, there is no agreement on the best management, especially in patients who have tumors with malignant pathologic features or who present with metastatic disease. The authors attempt to evaluate the role of retroperitoneal lymph node dissection (RPLND) in the management of patients with these malignant sex cord,stromal tumors. METHODS Reviewing the Indiana University testis cancer registry revealed 17 patients who underwent RPLND for sex cord,stromal tumors. Pathology was reviewed for features suggestive of malignancy. The data examined included clinical and pathologic stage, surgical procedure, additional therapy received, and outcome. RESULTS Pathology included Leydig tumors in six patients, Sertoli tumors in four patients, sex cord,stromal tumors in five patients, a granulosa cell tumor in one patient, and a poorly differentiated non,germ cell tumor in one patient. Nine patients had histologic features suggestive of malignancy. Clinical stage at surgery was Stage I in nine patients and Stage IIA,IIIA in eight patients. Patients underwent modified or bilateral RPLND. Nine patients had pathologic Stage I tumors, and the remaining eight patients and had pathologic Stage IIB,IIIA tumors. Follow-up ranged from 8 months to 11 years. Of the eight patients with Stage II,III disease, six patients eventually died of metastatic disease despite additional radiotherapy and/or chemotherapy. CONCLUSIONS Sex cord,stromal tumors have a potentially aggressive malignant behavior that is difficult to predict based on clinical and pathologic features. Although the therapeutic role of RPLND in patients with small-volume metastatic retroperitoneal tumors is unclear, RPLND remains an option to be performed immediately after orchiectomy, especially in patients who have tumors with malignant features and/or small-volume metastatic disease. Cancer 2003;98:753,7. © 2003 American Cancer Society. [source] Systemic anti-inflammatory fibrosis suppression in threatened trabeculectomy failureCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2004Brendan Vote FRANZCO Abstract Purpose:,To provide a rationale for the use of systemic anti-inflammatory fibrosis suppression in the postoperative management of threatened early trabeculectomy bleb failure. Methods:,A review of the literature and of the authors' own experiences was conducted. Results:,The most important cause of persistent elevation of intraocular pressure after trabeculectomy is unduly marked or persistent inflammation with deposition of fibrous tissue, which prevents the formation of an adequately draining bleb. It was found that a clinically useful degree of suppression of bleb inflammation and fibrosis can be obtained with a 4,6 week course of the combined systemic administration of prednisone (10 mg t.i.d.), a non-steroidal anti-inflammatory agent (e.g. diclofenac 100 mg SR daily) and colchicine (0.25 mg or 0.3 mg t.i.d.), which was termed anti-inflammatory fibrosis suppression. Topical atropine 1% t.i.d. and adrenaline 1% t.i.d. eye drops can also be considered in addition to routine postoperative topical steroids. Conclusions:,Despite advances in surgical techniques and methods to control fibrosis, anti-inflammatory fibrosis suppression is a valuable tool to have available in the postoperative period for management of trabeculectomies that threaten failure. This regime produces a diffuse bleb, which has a very low risk of late infection or bleb perforation. It is recommend that this regime be added to the list of therapies that are considered when clinical features suggestive of a failing bleb are confronted early in the postoperative course. [source] Toxocara canis: egg presence in Melbourne parks and disease incidence in VictoriaCLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 2 2003Susan M Carden FRANZCO Abstract Purpose:,Toxocara canis can cause blinding eye disease. This study assessed the presence of T. canis eggs in soil from parks in Melbourne and also the incidence of presumed ocular toxocariasis in Victoria. Methods:,One hundred and eighty soil samples were collected from nine suburban locations in Melbourne, Australia. These were analyzed for the presence of T. canis eggs. A search of laboratory records of T. canis serology requests from Victorian patients over an 8-year period was performed. Results:,Only one soil sample was positive for T. canis eggs. Positive T. canis serology was reported in 13 samples from patients. These patients all had ocular features suggestive of T. canis infection. Conclusion:,Toxocara canis eggs are rare in public parks in Melbourne and symptomatic ocular toxocariasis is uncommon in the Victorian population. The acquisition of the disease is unlikely to be from public parks. [source] | ||||||||||||||||||||||||||||