We studied the relationship between fatty degeneration in the supraspinatus muscle after rotator cuff tear and muscle atrophy and tendon retraction in 41 cadaveric shoulders. Eighteen shoulders had a supraspinatus tendon tear. Transverse sections of the supraspinatus muscle were made at the proximal end of the scapular notch. The tendon fiber areas were stained red and the muscle fiber areas were stained yellow by the van Gieson method. Areas of fatty degeneration were stained orange-red by the Sudan three method. These areas were measured with a computer color image analysis system. There were many areas of the fatty degenerative change in the supraspinatus muscles associated with a cuff tear, mainly around the tendon fibers and the vessels. The fatty degeneration in the supraspinatus muscle after cuff tear was found to have a strong association with the degree of retraction of the tendon fibers rather than the reduction of muscle volume.

Adipose Tissue↗

PubMedDate not supplied

Incomplete tears of the subscapularis tendon associated with tears of the supraspinatus tendon: cadaveric and clinical studies.

This study was undertaken to evaluate incomplete tears of the subscapularis tendon that occur in conjunction with small or medium-sized tears of the supraspinatus tendon. Fifty-two shoulders were examined in 26 embalmed cadavers. The average age at the time of death was 76.3 years. Rotator cuff tears were observed in 32 (61.5%) shoulders. Six (11.5%) shoulders had massive rotator cuff tears and were excluded from the study, leaving 46 shoulders for study. Twenty shoulders had a tear of the supraspinatus tendon, and 17 had a tear of the subscapularis tendon. All tears of the subscapularis tendon were articular-side incomplete tears. On histologic examination most pathologic changes of the subscapularis tendon were observed on the articular side of the upper portion. Lesions of the long head of the biceps brachii were identified in 14 (30.4%) shoulders. A statistically significant correlation was found between tears of the subscapularis tendon and the presence of lesions of the long head of the biceps brachii (P=.0014). In addition, the results of preoperative magnetic resonance imaging of 15 patients (average age, 62.9 years) with a surgically confirmed diagnosis of incomplete tears of the subscapularis tendon in conjunction with tears of the supraspinatus tendon were also evaluated. Incomplete tears of the subscapularis tendon could be identified on magnetic resonance imaging as an area of high signal intensity on axial T2-weighted images in all 15 shoulders studied.

Aged↗

PubMedDate not supplied

Sentinel lymph node identification for patients with breast cancer using large-size radiotracer particles: technetium-99m-labeled tin colloids produced excellent results.

Sentinel lymph node (SLN) biopsies using radioactive tracers have been reported to detect the metastatic status of the axillary lymph nodes in breast cancer patients. However, the optimal radioactive tracer particle sizes remain to be determined. In this study, identification of SLNs with large radiolabeled tin colloid particles was evaluated. Seventy-five patients with T1-2, N0 breast cancer were enrolled. Two hours prior to surgery, 1 to 2.5 mL technetium-99m-labeled tin colloid particles were injected around the tumor under ultrasonographic guidance. Immediately before the operation, dye fluids were also injected around the tumor to increase the interstitial pressure. After axillary dissection, lymph nodes with x100 or more uptake of radioactivity than the mean of the other lymph nodes are considered to be SLN. All lymph nodes from the axillary dissections were pathologically investigated, and the characteristics of SLNs were evaluated. SLNs were clearly identified in 74 of 75 patients (98.7%). Of 37 patients without SLN metastasis, pathological investigation revealed no further involvement of the remaining non-SLNs. The SLNs tended to be larger in size, and more than 50% were located in the lower medial site of the axilla. This is the first study to show that SLNs could successfully be identified with radiolabeled tin colloid particles. When SLNs were negative for metastases, non-SLNs were always negative.

Breast Neoplasms↗

PubMedDate not supplied

Sinonasal teratocarcinosarcoma: ultrastructural and immunohistochemical evidence of neuroectodermal origin.

The authors report a case of sinonasal teratocarcinosarcoma in a 37-year-old man, which was located in the anterior skull base and extended to the right nasal cavity and paranasal sinuses. The tumor was surgically resected twice, but it could not be removed completely. Microscopically, it was mainly composed of primitive cell nests within a moderately cellular stroma. The components of squamous cell epithelia with focal teratoid appearance and adenocarcinomatous differentiation were observed. There were many rhabdomyoblasts scattered in the nests and stroma. Ultrastructurally, the primitive cells had many neural processes with parallel microtubules, resembling olfactory neuroblastoma. Rhabdomyoblasts showed various degrees of skeletal muscle differentiation. Some of the stromal spindle cells had actin filaments with dense patches and dense core granules. Immunohistochemically, the primitive cells were positive for epithelial markers, neuron-specific enolase, synaptophysin, and myogenic regulatory proteins. The rhabdomyoblasts showed immunoreactivity for myoid markers, cytokeratin, epithelial membrane antigen, and synaptophysin. Most of the stromal spindle cells were positive for smooth muscle actin, neuron-specific enolase and synaptophysin. The immunohistochemical and ultrastructural findings suggest that primitive cells had the most primitive phenotype of placodes, and support the possibility that sinonasal teratocarcinosarcoma is essentially a neuroectodermal tumor with divergent differentiation.

Adult↗

PubMedDate not supplied

Renal oncocytoma with intracytoplasmic lumina: a case report with ultrastructural findings of "oncoblasts".

The authors present a case of renal oncocytoma with numerous intracytoplasmic lumina in a 45-year-old woman, with an emphasis on the ultrastructural findings of so-called oncoblasts. The tumor was located in the upper pole of the left kidney, measuring about 3.3 cm in diameter. Histologically, it was composed of solid nests or acinar growths of so-called oncocytic tumor cells with numerous intracytoplasmic lumina and scattered foci of so-called oncoblasts. The luminal surface was positive for Hale's colloidal iron stain. A very small number of glycogen-containing cells were found scattered in a few nests. Immunohistochemically, tumor cells were positive for cytokeratin and epithelial membrane antigen, but negative for vimentin and carcinoembryonic antigen. The Ki-67 labeling index was 1.2%. All of the Ki-67-positive cells were oncocytes. So-called oncoblasts were negative for Ki-67. Ultrastructural examination revealed that the predominant tumor cells had cytoplasm packed with round mitochondria and the mitochodria had lamellar long cristae. So-called oncoblasts showed scant cytoplasm with a moderate number of small mitochondria. Some of them showed pyknosis which can be regarded as mitochondrial involution. The authors believe that so-called oncoblasts are damaged or involuted oncocytes rather than precursors of oncocytes.

Adenoma, Oxyphilic↗

PubMedDate not supplied

CT demonstration of fibrous stroma in chronic pancreatitis: pathologic correlation.

Fibrous stroma found in two patients with chronic pancreatitis was investigated. The helical CT-pathologic correlation confirmed that fibrous stroma found in the subcapsular zone of the pancreatic parenchyma corresponded to the area that was identified as a hypodense zone in the early phase by spiral CT and became isodense with the internal parenchyma in the delayed phase. These CT findings have an important implication for the diagnosis of chronic pancreatitis.

Aged↗

PubMedDate not supplied

Trichoblastoma of the skin occurring in the breast. A case report.

BACKGROUND: Trichoblastoma is a rare benign skin appendage tumor constituted mostly of follicular germinative cells. It can arise on any part of the body except the palms, soles, nail units and mucosal membranes. No case of it in breast skin has been reported before. Furthermore, fine needle aspiration cytology findings on this lesion have not been described before. CASE: A 76-year-old female presented with a firm nodule in her left breast. The tumor was well demarcated, about 1.5 cm in diameter. Fine needle aspiration cytology revealed clusters composed of relatively uniform cells with a high nuclear/cytoplasmic ratio. In the midst of some clusters, the tumor cells had a more abundant cytoplasm. Fibrocellular interstitium or dense cyanophilic acellular material occasionally was attached to them. The tumor cells had oval or fusiform nuclei that had fine, evenly dispersed chromatin. To exclude a diagnosis of breast cancer, it is important to recognize that the clusters are composed of basaloid cells with focal squamous eddies and that there is at least focally peripheral palisading. The histopathologic diagnosis was trichoblastoma. CONCLUSION: Fine needle aspiration cytology can distinguish trichoblastoma from malignant diseases of the breast and may be used to diagnose the lesion in conjunction with clinical findings.

Aged↗

PubMedDate not supplied

Staining for dipeptidyl aminopeptidase IV activity in nodular thyroid diseases.

OBJECTIVE: To determine the effectiveness of staining for dipeptidyl aminopeptidase IV (DAP IV) activity in thyroid nodular diseases. STUDY DESIGN: Imprint smears were made in 76 cases of papillary carcinoma, 10 of follicular carcinoma, 32 of follicular adenoma and 48 of adenomatous goiter after surgery, and staining for DAP IV activity was performed in all cases. RESULTS: All papillary carcinomas stained positively, and most adenomatous goiter cases were negative. Follicular carcinoma and follicular adenoma cases exhibited various degrees of positivity, though the former tended to be stained more than the latter. Of the total 166 cases of thyroid nodules, 53 showed negative staining; of those 53, all except 1 were benign. Follicular carcinoma cases that had vascular invasion tended to show a high DAP IV staining pattern, but no statistically significant difference between it and follicular carcinoma that did not show vascular invasion was found. CONCLUSION: DAP IV activity staining might reveal malignant potential and could have some value in the preoperative diagnosis between thyroid nodular diseases. The DAP IV method is a reliable indicator of benign disease if negative results are obtained.

Adenoma↗

PubMedDate not supplied

Possible involvement of bcl-2 suppression in wild-type p53 gene-dependent cell growth repression in rat osteosarcoma cells.

We recently obtained 3 cloned cell lines demonstrating the p53 mutation from a lung metastatic nodule of a rat transplantable osteosarcoma. In this study, we applied wild-type p53 gene transfer to the rat osteosarcoma cells by lipofection to investigate the effects on cell growth, expression of genes such as waf1/p21, bcl-2, and bax, and nucleosomal DNA fragmentation due to apoptosis. Reconstitution of the p53 gene inhibits cellular growth, and this growth-suppressive effect is partly due to apoptosis involving bcl-2 gene suppression in this tumor type. This rat osteosarcoma model is similar in biologic behavior to human cases and thus is very suitable for further investigation of tumorigenesis and gene therapy for osteosarcoma.

Animals↗