Vascular system of the human spinal cord in the prenatal period: a dye injection and corrosion casting study.

The vascularization of the spinal cord was investigated in 50 human fetuses aged from 10 to 28 gestational weeks using dye injection methods and corrosion casting accompanied by scanning electron microscopy. In the investigated period of fetal development, the general vascular architecture of the spinal cord, corresponding to that described postnatally, seemed to be already established. The observed changes included: (1) remodeling of the supplying (extrinsic) arterial branches, (2) transformation of the posterior anastomotic chain into two distinct posterior spinal arteries, and (3) development of the capillary networks in the gray and white matter. The remodeling of the radicular arteries supplying the spinal cord was accompanied by a decrease in their number and transition from regular to irregular distribution (appearance of intersegmental differences in their frequency). The anterior spinal artery and regular array of the central arteries were already present in the youngest fetuses examined, but the final remodeling of the posterior anastomotic chain into two posterior spinal arteries occurred between 15th and 20th week of fetal life indicating that the vascularization of the anterior region of the spinal cord in the investigated period of fetal life was more advanced as compared with that of the posterior region. The capillary network of the gray matter in the youngest fetuses had the form of discrete glomerular plexuses supplied by groups of central arteries and mainly vascularizing the anterior horns. Successively, the plexuses fused to form a continuous system along the anterior columns and the system expanded to fully vascularize the posterior horns. The white matter in the earlier fetal period seemed to be partially avascular, later the density of capillaries vascularizing those areas was still much lower than in the gray matter. The veins showed considerably greater variability than the arteries, as far as their topography and distribution was concerned. High tortuosity characterized the superficial veins, especially in the younger fetuses, although the degree of tortuosity differed even between individual fetuses. Only anterior spinal and central arteries were usually accompanied by their venous counterparts, the other veins seemed to have no regular topographical relations with the arteries.     

Role of MRI in the valuation of ambiguous genitalia

Diagnostic accuracy of magnetic resonance imaging (MRI) interpretation was assessed prospectively in patients with ambiguous genitalia or intersex problems. MRI depiction of the uterus was possible in 93%, the vagina in 95%, the penis in 100%, the testis in 88%, and the ovary in 74% of patients. The strength of MRI lies in the multiplanar capability and tissue characterization by means of T1- and T2-weighted sequences. MRI contributes to accurate morphologic evaluation of müllerian duct structures, the gonads, and the development of the phallus, all of which are essential for appropriate gender assignment and planning of surgical reconstruction.     

Cancer-associated retinopathy in patients with breast carcinoma

Introduction: Cancer-associated retinopathy (CAR) is a paraneoplastic neurological syndrome resulting in progressive loss of vision and clinical signs of retinal degeneration. It is associated with various types of cancer and is also considered to be an autoimmune disorder that involves cross-reaction between autoantibodies and retinal proteins. The aim of this study was to establish whether immunoreactivity to retinal antigens (RAs) observed in patients with breast cancer is accompanied by any visual impairments. Materials and Methods: Sera of 295 patients with diagnosed breast cancer were screened for the presence of anti-RAs antibodies using immunoblotting. Cellular immunoreactivity to RAs present in retinal extracts and to purified recoverin and arrestin was determined by means of a lymphocyte proliferation assay. Six patients with high-titer antibodies to RAs then underwent ophthalmic and neurological examinations. Results: Four serum samples contained high-titer antibodies to a 46-kDa protein, most probably retinal α-enolase, three had antibodies to a 48-kDa protein identified as retinal arrestin, while 56-, 43-, 41-, and 34-kDa antigens were recognized only by one serum sample each. Moreover, weak cellular response to all the RAs tested was observed in one patient and another patient responded only to retinal extract. Two of the examined patients displayed symptoms of CAR. Conclusions: Immunoreactivity to RAs in patients with breast cancer may also be present in cases without clinical signs of CAR.     

Differential diagnosis of malignant lymphomas and related disorders by specific pattern of expression of immunophenotypic markers revealed by multiparameter flow cytometry (Review)

The introduction of monoclonal antibodies (mAbs) for cell immunophenotyping and use of flow cytometry with the progressively improving software for multivariate analyses have revolutionized the diagnosis and influenced the classification of hematologic neoplasms. In this review we focus on the practical application of flow cytometry in the diagnosis and classification of malignant lymphomas and related lymphoproliferative disorders with special emphasis on differential diagnosis. A general approach to the utilization of flow cytometry (FC) in hematopathology with an algorithm to diagnose the most common neoplasms is presented. We discuss precursor B-cell neoplasms, mature B-cell neoplasms (SLL/CLL, mantle cell lymphoma, marginal zone lymphoma, hairy cell leukemia, diffuse large B-cell lymphoma, plasma cell dyscrasias and lymphomas with plasmacytic differentiation), precursor T-lymphoblastic leukemia and mature (peripheral) T-cell neoplasms, including T-SLL/PLL, anaplastic cell lymphomas and large granular cell leukemia/lymphoma. The text is accompanied by characteristic FC scatterplots of the discussed entities.     

CD30-positive T-cell lymphomas co-expressing CD15: an immunohistochemical analysis

The characteristic histologic features and immunophenotype are usually diagnostic and allow distinguishing CD30 positive T-cell lymphoma (including anaplastic large cell lymphoma) from classical Hodgkin's lymphoma. The latter differs by expression of CD15 and lack of CD45, pan-T antigens and ALK expression. We report nine cases of large cell hematopoietic neoplasms in which the neoplastic cells co-expressed CD30 and CD15, and had immunophenotypic and morphologic features of T-cell lymphoproliferative process. The average age of the CD15-positive group was 61.9 years; 6 cases occurred in men and 3 in women. The tumors were located in lymph nodes in 8 cases, and in liver in 1 case. Two cases expressed ALK protein. There were no statistically significant differences in phenotypic parameters between the CD15-positive and CD15-negative neoplasms (p>0.05). However, the CD15-positive group appeared to show a minor trend toward less positivity for EMA (44% versus 72%), ALK protein (22% versus 51%), and CD45RO (33.3% versus 83.3%, p=0.07), when compared to the typical CD15-negative neoplasms. In summary, although the co-expression of CD30 and CD15 is typical for classical HL, it may be also present in a subset of peripheral T-cell neoplasms including ALK-positive anaplastic large cell lymphoma. Combined and sensible use of morphology and a broad immunophenotypic panel in cases with limited material and/or those with overlapping histologic patterns will best discriminate between HL and ALCL. It is incumbent upon the pathologist to distinguish between these two clinicopathologic entities, since treatment options and clinical outcomes differ.     

The pharmacologic activity of complexes and mixtures with copper and salicylates or aminopyrine following oral dosing in rats

Cu(II) complexes with salicylates or aminopyrine were administered to rats with local inflammation (acute paw oedema elicited with carrageenan) to determine their anti-inflammatory activity and ulcerogenic effects following oral administration.The complexes were more effective than the parent ligands or appropriate mixtures of these ligands with Cu(II) as anti-inflammatory agents. All complexes indicated low ulcerogenity.The differences in pharmacologic activity between the complexes and mixtures in question are discussed.     

Residual silicone detection using mri following previous breast implant removal: Case reports

The current controversy surrounding the safety of silicone gel breast implants has resulted in an increasing number being removed. Although previous reports have suggested that remnants of the implant capsule are reabsorbed after explantation surgery, the persistence of the capsule in fact may be associated with implant fragments and silicone gel leakage. In this study we have used magnetic resonance imaging (MRI) to identify residual silicone gel and silicone granulomas following the removal of silicone gel breast implants. Four representative clinical case reports are presented. These patients, who had residual silicone present in their bodies, presented to us with breast pain, palpable masses, or abnormal calcific mass densities apparent on a mammogram. High-resolution MRI images were found to be helpful in identifying local and remote collections of silicone gel, silicone granulomas, and residual capsules that were incompletely removed from previous explantation surgery. MRI breast images demonstrated high resolution and provided the accurate anatomical locations of residual silicone gel and silicone granulomas in all the regions of breast parenchyma, chest wall muscles, and axillae. Patients with persistent local symptoms following explantation surgery may benefit from an evaluation of the breast using MRI.     

Open reduction internal fixation after displacement of a previously nondisplaced acromial fracture in a multiply injured patient: case report and review of literature.

SUMMARY: A twenty-eight-year-old multiple trauma patient had a nondisplaced acromion fracture that was not detected until after it had displaced. Open reduction internal fixation was performed without complication and the patient achieved excellent shoulder abduction strength. Nondisplaced acromion fractures may displace if not protected. Open reduction internal fixation of displaced acromion fractures should be considered if deltoid muscle strength is important to the patient.