Histopathologic comparison of normal and hyperplastic condyles

OBJECTIVE: The aim of this study was to compare normal and hyperplastic mandibular condyles using two different histopathologic staining techniques. STUDY DESIGN: Nine cases of condylar hyperplasia and 13 normal cases were studied after hematoxylin and eosin and silver staining. RESULTS: There was a significant difference between the two groups in the thickness of the hyperplastic cartilage layer of condylar soft tissue (P = 0.017). Also, the number of argyrophilic nucleolar organizer regions was significantly higher in the condylar hyperplasia case group (P = 0.0001). No significant differences could be demonstrated in cartilage island frequency, penetration depth, and distribution in the cancellous bone of condyles. CONCLUSION: The thickness of the hyperplastic cartilage layer appears significantly increased in condylar hyperplasia. In addition, argyrophilic nucleolar organizer region count may be useful in histopathological identification of condylar hyperplasia.     

Local Recurrence After Laparoscopic Radiofrequency Thermal Ablation of Hepatic Tumors

Background: Since we first described laparoscopic radiofrequency ablation (LRFA) of liver tumors, several reports have documented technical and safety aspects of this procedure. Little is known, however, about the long-term follow-up of such patients.Methods: From January 1996 to February 1999, we performed LRFA on 250 liver tumors in 66 patients. Triphasic spiral computed tomographic scanning was obtained preoperatively and at 1 week, and every 3 months postoperatively. Lesion diameter was measured in the x- and y-axes and the volume estimated; 181 lesions in 43 patients for whom computed tomographic scans available were included in the study. The tumor types were as follows: 64 metastatic adenocarcinomas, 79 neuroendocrine metastases, 27 other metastases, and 11 primary liver tumors.Results: One week postoperatively, the ablated zone was larger than the original tumor in 178 of 181 lesions, which suggests ablation of the tumor and a margin of normal liver tissue. A progressive decline in lesion size was seen in 156 (88%) of 178 lesions, followed for at least 3 months (mean, 13.9 months; range, 4.9–37.8 months), which suggests resorption of the ablated tissue. Fourteen definite local treatment failures were apparent by increase in size and change in computed tomographic scan appearance, and eight lesions were scored as failures because of multifocal recurrence that encroached on ablated foci (22 total recurrences). Predictors of failure include lack of increased lesion size at 1 week (2 of 3 such lesions failed), adenocarcinoma or sarcoma (18 of 22 failures; P < .05), larger tumors (failures, M < 18cm³ vs. successes, M < 7cm³; P < .005) and vascular invasion on laparoscopic ultrasonography. By size criteria, 17 of 22 failures were apparent by 6 months. Energy delivered per gram of tissue was not significantly different (P < .45).Conclusions: LRFA has a 12% local failure rate, with larger adenocarcinomas and sarcomas at greatest risk. Failures occur early in follow-up, with most occurring by 6 months. LRFA seems to be a safe and effective treatment technique for patients with primary and metastatic liver malignancies.Presented at the 52nd Annual Meeting of the Society of Surgical Oncology, Orlando, Florida, March 4–7, 1999     

The influence of feeding linoleic,gamma-linolenic and docosahexaenoic acid rich oils on rat brain tumor fatty acids composition and fatty acid binding protein 7 mRNA expression

Background  

Experimental studies indicate that gamma linolenic acid (GLA) and docosahexaenoic acid (DHA) may inhibit glioma cells growth but effects of oral consumption of these fatty acids on brain tumor fatty acid composition have not been determined in vivo.     

Perioperative Primary Stroke: Is Aspirin Cessation to Blame?

Background. There are a number of reports in the literature of patients developing thrombotic events after stopping medically necessary antiplatelet and antithrombotic agents.
Objective. The objective was to determine whether discontinuation of aspirin taken for primary prophylaxis contributes to the development of thrombotic complications in patients undergoing dermatologic surgery.
Methods. A case is reported and the literature is reviewed.
Results. We present the first reported case of a postoperative thrombotic event following dermatologic surgery in a patient withholding aspirin that was taken for primary prophylaxis.
Conclusion. We believe that the available data make it difficult to implicate aspirin discontinuation in the development of each thrombotic event, given the high baseline risk of thrombotic events in the Mohs surgery patient population and the low risk of developing such events when medications are withheld perioperatively.     

Recurrent anterior glenohumeral instability with onset after forty years of age: the role of the anterior mechanism

Recurrent instability in patients over forty years of age is felt to occur primarily as a result of an associated rotator cuff tear. This is often referred to as the "posterior mechanism." We reviewed our patients over the age of forty who underwent an anterior shoulder repair to identify the incidence of capsulolabral detachments and the role of an "anterior mechanism" in this patient population. A retrospective review of all patients from 1985 to 2000 was performed to identify patients who had surgery for recurrent instability that began after forty years of age. Of the 265 patients records reviewed, 11 patients were identified who fulfilled the inclusion criteria. Of the 11 patients identified, 9 patients underwent anterior capsulolabral reconstruction for recurrent instability; the remaining two patients underwent repair of large rotator cuff tears. All 9 patients had a capsulolabral detachment, 4 had a rotator interval defect, 2 had anterior and inferior capsular redundancy, 1 had a small rotator cuff tear and 1 had an anterior capsular avulsion from the humeral head. At minimum follow-up of 32 months none of the patients reported episodes of instability. The reported incidence of rotator cuff tears in patients over the age of forty following an initial traumatic anterior glenohumeral dislocation ranges from 35% to 100%. When recurrent instability occurs, it is postulated to occur via a "posterior mechanism" (i.e., secondary to a significant full-thickness rotator cuff tear). However, all of our patients had an anterior capsulolabral detachment as the "common lesion" associated with recurrent instability. Although small, this series emphasizes the role of the "anterior mechanism" in patients who develop recurrent instability after the age of forty. A high rate of success was achieved by addressing the pathoanatomic changes identified.     

Safety, Complications, and Satisfaction of Patients Undergoing Submuscular Breast Augmentation via the Inframammary and Endoscopic Transaxillary Approach

Background Since its introduction, augmentation mammaplasty has gained widespread popularity, as demonstrated by the fact that an estimated 2 million women in the United States have received implants. During recent decades, several surgical approaches have evolved in terms of implant placement or site of access to the surgical plane. Debate has existed concerning the questionable superiority of a particular technique for achievement of optimal results. Thus, the inframammary approach, an established and widely accepted technique for breast augmentation, and endoscopically assisted transaxillary breast augmentation were retrospectively compared in terms of safety and aesthetic outcome, as measured, respectively, by the rate of postoperative complications and patient satisfaction. Methods This study analyzed 78 patients undergoing augmentation mammaplasty between 1997 and 2004. Only patients seeking primary augmentation mammaplasty solely for aesthetic reasons were included in the study. Previously performed breast surgery and simultaneously conducted ipsilateral mastopexy were among the exclusion criteria. Patient satisfaction was assessed using the client satisfaction questionnaire (CSQ-8) because of its easy applicability. Results The complication rate was low in both patient subsets, thus confirming the safety of the transaxillary approach, as compared with the more common submammary technique. However, a higher level of satisfaction was detected in the former patient group, indicating a more favorable aesthetic outcome with the transaxillary augmentation mammaplasty. Conclusion Endoscopically assisted transaxillary augmentation mammaplasty is a safe method with predictable results associated with a high level of patient satisfaction. If applied in the setting of appropriate indications, it is an excellent tool for use with patients who prefer to have an incision at a distant site.     

Physiological response to organophosphate residues in field workers

The physiologic response of 21 male agricultural field workers exposed to foliage-borne Guthion residues was monitored during routine peach-thinning operations in a northern California orchard. Surveillance included daily venipuncture and urine collection to determine whole blood cholinesterase (CHE) activity and level of dialkylphosphate excretion for 3 baseline (nonexposed) and 5 normal work days. Foliage samples were obtained to measure dislodgeable and total Guthion residues. A decrease in group-mean CHE activity by 15% over the surveillance period was found. Apart from one worker who showed a consistent decrease in CHE activity, reaching a maximum of 30% below baseline at the end of the work week, daily changes in individual CHE activity were erratic. Group-mean dialkylphosphate excretion levels provided a semiquantitative indication of exposure to Guthion. Medical examination before and after the exposure period revealed an absence of clinical signs of organophosphate intoxication.     

Computer-aided dermoscopy for diagnosis of melanoma

Background

Recently, it has been observed that Video Display Terminals (VDTs) usage for long periods can cause some dermatological manifestations on the face. An analytical cross-sectional study was designed in order to determine this relationship.

Methods

In this study, 600 office workers were chosen randomly from an organization in Tehran (Iran). The subjects were then divided into two groups based on their exposure to VDTs. 306 workers were considered exposure negative (non VDT user) who worked less than 7 hours a week with VDTs. The remainders 294 were exposure-positive, who worked 7 hours or more with VDTs. The frequency of dermatologic manifestations was compared in these two groups.

Results

In the exposure-positive and exposure-negative groups, the frequency of these dermatologic manifestations were 27 and 5 respectively. After statistical analysis, a P.value of < 0.05 was obtained indicating a statistically significant difference between these two groups for dermatological manifestations.

Conclusion

According to our study, there is a relationship between dermatologic manifestations on the face and exposure to VDTs.