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Macroscopic Examination (macroscopic + examination)
Selected AbstractsA case of renal mucinous tubular and spindle cell carcinomaINTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2009Manabu Kato Abstract A 33-year-old man was hospitalized for treatment of a left renal tumor. The radiological findings were consistent with those of a left renal cell carcinoma (RCC). Subsequently, a radical nephrectomy was carried out. Macroscopic examination showed that a well-demarcated tumor measuring 2.9 × 2.6 × 2.5 cm was present in the middle portion of the resected kidney. The cut surface of the tumor was grayish-white in color. Pathological examination of the resected specimen showed a mucinous tubular and spindle cell carcinoma of the kidney (MTSCC-K). MTSCC-K is a low-grade renal epithelial neoplasm that has recently been recognized as a specific entity in the World Health Organization 2004 classification of RCC. To our knowledge, 17 cases of MTSCC-K in Japan have been reported by Japanese investigators. To avoid administration of excessive adjuvant treatment to patients, pathologists and urologists should consider this newly recognized low-grade malignancy when diagnosing renal tumors. [source] Lumbar osteosarcoma in a chinchilla (Chinchilla laniger)JOURNAL OF SMALL ANIMAL PRACTICE, Issue 9 2008S. Simova-Curd An 11-year-old male chinchilla was presented for investigation of progressive weight loss, apathy, anorexia, changes in faecal quality and alopecia on the tip of the tail. On clinical examination, a stiffness of the back legs was noted. Abdominal palpation revealed a hard immobile, irregular structure in the region of the last lumbar vertebrae. Subsequent radiography and ultrasonography suggested the presence of neoplasia. The following day the chinchilla was showing hindlimb paralysis, and there was severe self-trauma to the distal 5 cm of the tail. In view of the rapid clinical deterioration, the chinchilla was euthanased with the owner's consent. Macroscopic examination supported the clinical suspicion of neoplasia. Histopathological examination revealed a reactive osteoblastic osteosarcoma. To the author's knowledge, this is the first report of osteosarcoma in chinchillas. [source] Do supervised colorectal trainees differ from consultants in terms of quality of TME surgery?COLORECTAL DISEASE, Issue 9 2006S. Maslekar Abstract Objective, The quality of surgical excision is held to be a major determinant of outcome following surgery for rectal cancer. Macroscopic examination of the excised mesorectum allows for reproducible assessment of the quality of surgery. We aimed to determine whether quality of excision undertaken by colorectal trainees under supervision was comparable with that performed by consultants, as measured using mesorectal grades. Method, A total of 130 consecutive patients undergoing potentially curative resection for primary adenocarcinoma of the rectum in our centre from 2001 to 2003 were included in the study. The pathologists graded the excised mesorectum according to staged classification proposed by Quirke. The outcome (quality of mesorectal excision and secondary outcomes including local recurrence and overall recurrence) of operations performed by consultants was compared with that of trainees. Statistical significance was tested using Pearson ,2 test. Results, Eighty-nine operations were performed by consultants and 41 by senior colorectal trainees with consultant supervision. Forty-four patients (49%) had good mesorectum when operated by consultants in comparison with 17 (41.5%) by the trainees. There was no statistically significant difference (P = 0.717) between the two groups in terms of quality of mesorectum excised after potentially curative resection. Furthermore, there were seven local recurrences in patients operated by consultants (7.8%) when compared with four in the trainee group (9.5%) and once again there was no statistical significance between the two groups (P = 0.719). Conclusion, We conclude that the quality of rectal cancer excision, as defined by mesorectal grades, achieved by supervised colorectal trainees is comparable with that achieved by consultants. [source] "The probable industrial origin of archaeological daub at an Iron Age site in northeast Thailand" (Parr and Boyd, 2002): A comment on the inappropriate application of geophysical and geochemical techniques to an archaeological questionGEOARCHAEOLOGY: AN INTERNATIONAL JOURNAL, Issue 8 2003Maria Cotter Parr and Boyd (2002) used colorimetric analysis in combination with geophysical and geochemical techniques to estimate firing temperatures for archaeological daub from an Iron Age site in Thailand. They suggest that the daub was fired at high temperatures and, therefore, is indicative of kiln utilization and increased industrialization during that period in Thailand. They argue that the adoption of a multimethod analytical approach in which the combination of data derived from ICP-MS, X-ray diffraction, and magnetic susceptibility analyses of daub samples, coupled with microscopic and macroscopic examination of samples, enhances the accuracy of their interpretations. While they should be commended for attempting to substantiate their claims using many geophysical and geochemical techniques, their arguments are flawed by the misapplication of the techniques described and/or over-interpretation of the data generated by such techniques. Therefore, Parr and Boyd's (2002:285) point about methodology ("that the combined interpretation of independent measures provides a better estimate of the original firing temperatures of the archaeological material than has hitherto been possible") is made redundant by the lack of scientific rigor applied to the independent measures used for this study. © 2003 Wiley Periodicals, Inc. [source] Protection against Fas-induced liver apoptosis in transgenic mice expressing cyclooxygenase 2 in hepatocytes,HEPATOLOGY, Issue 3 2007Marta Casado Cyclooxygenase-2 (COX-2) is upregulated in many cancers, and the prostanoids synthesized increase proliferation, improve angiogenesis, and inhibit apoptosis in several tissues. To explore the function of COX-2 in liver, transgenic (Tg) mice were generated containing a fusion gene (LIVhCOX-2) consisting of human COX-2 cDNA under the control of the human ApoE promoter. Six lines were developed; all of them expressed the LIVhCOX-2 transgene selectively in hepatocytes. The Tg mice exhibited a normal phenotype, and the increased levels of PGE2 found were due to the constitutively expressed COX-2. Histological analysis of different tissues and macroscopic examination of the liver showed no differences between wild-type (Wt) and Tg animals. However, Tg animals were resistant to Fas-mediated liver injury, as demonstrated by low levels of plasmatic aminotransferases, a lesser caspase-3 activation, and Bax levels and an increase in Bcl-2, Mcl-1, and xIAP proteins, when compared with the Wt animals. Moreover, the resistance to Fas-mediated apoptosis is suppressed in the presence of COX-2,selective inhibitors, which prevented prostaglandin accumulation in the liver of Tg mice. Conclusion: These results demonstrate that expression of COX-2,dependent prostaglandins exerted a protection against liver apoptosis. (HEPATOLOGY 2007;45:631,638.) [source] Gastric diverticulum preoperatively diagnosed as one of two left adrenal adenomasINTERNATIONAL JOURNAL OF UROLOGY, Issue 1 2006AKIHIRO ARAKI Abstract, A 47-year-old man was diagnosed with primary aldosteronism due to two left adrenal adenomas, suggested on computed tomography (CT) to be located at the upper and lower adrenal portion. However, adosterol scintigraphy revealed negligible uptake at the upper portion of the left adrenal. Laparoscopic left adrenalectomy was performed, but macroscopic examination of the specimen revealed only one adrenal tumor. Continued surgical exploration detected another mass between the spleen and the stomach, which was demonstrated to be continuous with the stomach and was eventually diagnosed as a gastric diverticulum. Postoperatively, aldosteronism resolved and repeat CT revealed staining of the adrenal pseudotumor when oral contrast was administered. Since organs located near the adrenals can simulate adrenal tumors, caution must be exercised in interpreting suprarenal masses on CT. To our knowledge, this is the first reported case of concurrent pseudotumor and true tumor of the ipsilateral adrenal. [source] Judgement of hygienic quality of roughage in horse stables in SwitzerlandJOURNAL OF ANIMAL PHYSIOLOGY AND NUTRITION, Issue 4 2008B. Wichert Summary In 46 horse farms all over Switzerland, the hygienic quality of the roughage (including silages) was investigated. Therefore, a macroscopic examination as well as the microbial counts (bacteria, yeasts and moulds) was carried out. Further, the contents of lipopolysaccharides (LPS) and the contamination with deoxynivalenol (DON) were determined. In all roughages, the dry matter (DM) content was measured and in silages additionally the pH was measured. Predominantly, the straw showed a lower hygienic quality than hay and silages. The LPS contents were significantly higher in straw than those in hay samples. The macroscopic examination and the microbial counts showed a tendency in the same direction. Eight straw samples and one hay sample with DON contamination were found. The silages showed a DM content with a median of 65.8%. The pH of those silages was between 4.3 and 5.9. Despite the high values of DM and pH, the silages showed mainly a high hygienic quality. In total, the hygienic standard of straw was worse than that of hay. This should be taken into account also in straw used as bedding as much as the hygienic quality of hay. [source] Preliminary assessment of miniprobe sonography in the diagnosis of gastric varices and evaluation of treatment with HistoacrylJOURNAL OF DIGESTIVE DISEASES, Issue 1 2001Zhu Qi OBJECTIVE: In comparison with conventional endoscopy, the clinical value of miniprobe sonography (MPS) was assessed both in the diagnosis of gastric varices (GV) and in the evaluation of its treatment with the tissue adhesive agent Histoacryl. METHODS: Twelve patients with liver cirrhosis and portal hypertension caused by hepatitis B in nine cases and hepatitis C in three cases were examined by MPS to verify the presence of gastric fundic varices before and after endoscopic treatment with Histoacryl. Curative efficacy of Histoacryl treatment was defined by the finding of variceal lumen obliteration characteristics in the ultrasonic image. RESULTS: Gastric fundic varices were detected in 10 patients by using MPS, however, only seven cases were detected by using conventional macroscopic examination. For gastric fundic varices, the diagnostic accuracies of standard endoscopy and MPS were 75% (9/12) and 100% (12/12), respectively. Furthermore, MPS was able to produce a practical ultrasonic image of complete or incomplete variceal vessel lumen obliteration for use in the assessment of the efficacy of endoscopic treatment with Histoacryl. CONCLUSIONS: Miniprobe sonography was found to be significantly superior to conventional macroscopic diagnosis in both the detection of fundic varices and the evaluation of the efficacy of endoscopic therapy. Moreover, MPS could play an important role in follow up and in evaluation of the need for further treatment. Therefore, MPS appears to be a safe and very useful clinical technique in evaluating patients with portal hypertension with respect to the detection of fundic varices and may help in selecting patients for appropriate therapy. [source] Enteritis necroticans ,pigbel' in a Japanese diabetic adultPATHOLOGY INTERNATIONAL, Issue 9 2007Tomomichi Matsuda Enteritis necroticans ,pigbel' is caused by Clostridium perfringens type C but has rarely been reported in developed countries. A 50-year-old Japanese man with untreated diabetes mellitus (DM) presented with diarrhea and abdominal pain. Intraoperative endoscopic and macroscopic examination disclosed segmental annular mucosal lesions characteristic of clostridial enteritis. Clostridial infection type C was verified on pathological, and immunohistochemical analysis. Although rare, the disease is likely to be underdiagnosed. Hence, the pathology and immunohistochemistry of segmental enteritis with annular mucosal lesions should be examined to establish a diagnosis of enteritis necroticans even in mildly affected patients, and especially those with DM. [source] Quantification of Greenland halibut serum vitellogenin: a trip from the deep sea to the mass spectrometerRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 7 2009Alejandro M. Cohen This paper focuses on the sequential steps involved in developing a technique for quantifying Greenland halibut vitellogenin, a serum protein biomarker, using a comprehensive mass spectrometric approach. In the first phase of this study, in-gel trypsin digestions of serum proteins separated by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) were analyzed by matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS). A characteristic band around a molecular mass of 185,kDa, present in the mature female specimens, but absent in the male samples, was identified as vitellognin according to the peptide mass fingerprint obtained by MALDI-MS. Subsequently, MALDI and electrospray ionization tandem mass spectrometry (ESI-MS/MS) analyses were performed on the digest of the vitellogenin band for de novo sequencing. From these studies, a characteristic 'signature' peptide (sequence: FFGQEIAFANIDK) was selected from a list of candidate peptides as a surrogate analytical standard used for quantification purposes. Sample preparation for vitellogenin quantification consisted of a simple one-step overnight trypsin digestion. Samples were spiked with an isotopologue signature peptide standard and analyzed by high-performance liquid chromatography (HPLC) coupled in-line to an electrospray quadrupole-hexapole-quadrupole tandem mass spectrometer, operated in selective reaction monitoring mode. Transitions [(m/z 750.0,,,1020.4 and 750.0,,,1205.4) and (754.8,,,1028.6 and 754.8,,,1213.2)] were monitored for the signature peptide and the internal standard, respectively. Samples obtained from the field showed that vitellogenin levels were in accordance with fish maturity determined by macroscopic examination of the gonad, proving this technique suitable for measuring vitellogenin as a serum protein biomarker for reproductive maturity in female fish. Copyright © 2009 John Wiley & Sons, Ltd. [source] Missed lesions in synchronous multiple gastric cancerANZ JOURNAL OF SURGERY, Issue 4 2010Tae Kyung Ha Abstract Background:, The aims of this study were to define differences between synchronous multiple gastric cancer (MGC) and solitary gastric cancer (SGC) and to evaluate the characteristics of missed lesions in MGC so as to improve the detection rate of missed lesions during perioperative procedure. Methods:, The authors retrospectively analysed data on 9157 gastric cancer patients who underwent gastrectomy for gastric cancer in a single hospital. The characteristics of 8893 SGC and 264 MGC patients were evaluated. The characteristics of missed lesions in MGC were compared with those of diagnosed lesions found in preoperative endoscopy. Results:, Of the 9157 gastric patients, 264 patients with MGC showed a total of 565 cancer lesions, 70 of which were missed at endoscopy. The patients with MGC demonstrated different characteristics compared with those with SGC in terms of sex, age, type of operation, depth of tumour, lymph node metastasis, tumour size, tumour location and curability (P < 0.05). The characteristics of the missed lesions (n= 70) were a small size (P < 0.05), a middle one-third location (P < 0.001) and a flat type by macroscopic examination (P < 0.05) as compared with detected lesions (n= 495). No survival difference was detected between patients with and without missed lesions over a mean follow-up of 36.0 ± 22.7 month. Conclusions:, Preoperative gastroscopy should be performed meticulously in the entire stomach, especially in older men, in order to identify the presence and locations of cancer lesions that might otherwise be missed. [source] Extent of mesorectal invasion is a prognostic indicator in T3 rectal carcinomaANZ JOURNAL OF SURGERY, Issue 7 2002Malcolm C. A. Steel Background: The aim of this study was to determine if local recurrence (LR) rates in patients with minimally invasive and advanced T3 rectal cancer are different. This may influence the use of adjuvant therapy. Methods: Consecutive patients with T3 rectal cancer undergoing curative surgery were classified into minimally invasive or advanced groups. Minimally invasive T3 was defined as a tumour that had invaded beyond the muscularis propria on microscopic examination only, whereas advanced T3 tumours had invasion beyond the muscularis propria that was obvious on macroscopic examination and confirmed histologically. Local recurrence rates of the two groups were compared by construction of Kaplan,Meier curves. The log-rank test was used to determine equivalence, and Cox regression to estimate the hazard ratio. The Grambsch, Therneau test and graphical comparison of predicted and observed Kaplan,Meier curves was used to test the proportional hazards assumption. Results: There were 222 patients in total, 74 in the minimally invasive group and 148 in the advanced. The overall LR rate was 11.2%. The LR rates in the minimally invasive and advanced groups were 5.4% and 14.2%, respectively. The log-rank test gives a P value of 0.042 for equivalence, with the minimally invasive patients doing significantly better. The hazard ratio estimated by Cox regression was 0.35 (early relative to advanced), 95% confidence intervals (0.12, 1.0). There was no evidence of confounding by age at surgery, pathology type, gender or postoperative adjuvant therapy. Conclusions: The extent of invasion into the mesorectum appears to be an independent prognostic variable. If oncologically sound surgical techniques are employed, the LR rate of patients with minimal invasion is low. Adjuvant therapy may not confer additional benefit in this group. [source] Some new aspects of the pathology, pathogenesis, and aetiology of disseminated lung lesions in slaughter pigsAPMIS, Issue 5 2003CAMILLA H. LILJEGREN From 40 pigs rejected for human consumption at slaughter due to an apparent presence of pyemic lung lesions (defined as disseminated processes containing pus and/or necrotic material), the lungs, spleen, liver, and kidneys were subjected to an extended macroscopic examination. Several lung lesions were sampled from each animal for histological and bacteriological examination. Samples from the kidneys and spleens were also subjected to bacteriological examination. At gross level, four groups of lung lesions were identified: 1) disseminated foci with contents of pus and/or necrotic material (n=26); 2) disseminated or multifocally located ecchymoses with a central area of fibroplasia (n=9); 3) non-pneumonic lesions, i.e., disseminated areas of atelectasis (n=1) or haemorrhagic areas developing due to the process of slaughter (n=1); and 4) suppurative lesions without a disseminated distribution pattern (n=3). Histologically, the disseminated suppurative/necrotic foci were identified as: A) abscesses (n=10); B) necrotic lesions (n=6); and C) ectatic or ectatic-like bronchioles with contents of pus and necrotic material (n=10). The macroscopic observation of disseminated centres of fibroplasia with peripheral ecchymoses (n=9) was confirmed histopathologically. The livers of five pigs contained multiple areas of chronic interstitial fibrosis related to migration of Ascaris suum larvae ("milk spotted liver"). Such hepatic lesions were significantly (p<0.01) related to the simultaneous occurrence of disseminated pulmonary ecchymoses with a central area of fibroplasia. Generally, all lung lesions of each individual animal contained identical monocultures of bacteria following this pattern: Staphylococcus aureus (abscesses); Actinomyces hyovaginalis (necroses); S. aureus, A. hyovaginalis, and Arcanobacterium pyogenes (ectatic and ectatic-like bronchioles). Areas with fibrosis were sterile or contained bacteria considered to be a result of contamination. Apart from one kidney, from which S. aureus was cultured, all other organs were sterile. It is concluded that difficulties exist in differentiating pulmonary pyemic lesions from non-pyemic lesions at the gross level. Thus, it was not possible to distinguish between abscesses/necroses and ectatic bronchioles, the pathogenesis of the latter being uncertain. However, the chronic non-pyemic lesions related to the migration of A. suum larvae should be identified by the absence of pus/necrosis. S. aureus was predominantly isolated from abscesses, whereas, and most surprisingly, A. hyovaginalis was the dominant bacterium isolated from the pulmonary necroses. [source] Validation of macroscopic maturity stages according to microscopic histological examination for European anchovyMARINE ECOLOGY, Issue 2009Rosalia Ferreri Abstract The identification and classification of macroscopic maturity stages plays a key role in the assessment of small pelagic fishery resources. The main scientific international commissions strongly recommend standardizing methodologies across countries and scientists. Unfortunately, there is still a great deal of uncertainty concerning macroscopic identification, which remains to be validated. The current paper analyses reproductive data of European anchovy (Engraulis encrasicolus L. 1758), collected during three summer surveys (2001, 2005 and 2006) in the Strait of Sicily, to evaluate the uncertainty in the macroscopic maturity stage identification and the reliability of the macroscopic adopted scale. On board the survey vessels, the maturity stage of each fish was determined macroscopically by means of an adopted maturity scale subdivided in six stages. Later, at the laboratory, the gonads were prepared for histological examination. The histological slides were analysed, finally assigning the six maturity stages for macroscopic examinations. A correspondence table was obtained with the proportion and number of matches between the two methods. The results highlight critical aspects in the ascription of macroscopic maturity stages, particularly for the present research aim. Different recommendations were evaluated depending on the scope of the study conducted on maturity (e.g. daily egg production, fecundity and maturity ogive computation). The most interesting results concern the misclassification of stage IV and stages III and V (the most abundant), which confirms their macroscopic similarity. Although the results are based on a small number of samples, the advantages and disadvantages of macroscopic and histological methods are discussed with the aim to increase the accuracy of correct identification and to standardize macroscopic maturity ascription criteria. [source] | |||||||||||||