Argyrophil crystalloids in adenocarcinoma of the prostate

Considering the advantages provided by the study of glandular secretions in proliferative diseases of the prostate, we carried out a study of 100 consecutive cases of benign hyperplasia (68), glandular dysplasia (12), and carcinoma (20). Samples were predominantly obtained by transurethral resection from patients whose mean ages were 64, 67, and 73.5 years, respectively. The paraffin embedded material was sectioned and stained with hematoxylin-eosin, PAS-diastase, PAS-Alcian blue, methenamine silver, and Masson trichrome. Intraglandular secretion in normal, hyperplastic, and even neoplastic samples was predominantly neutral mucin, but in 2 cases of atypical adenomatous hyperplasia, and in all the carcinomas, we found acid mucin secretion. Holmes crystalloids were present in one case of nodular hyperplasia (1.4%), 2 cases of dysplasia (16.6%), and in 5 carcinomas (25%). As another manifestation of altered secretion, we also saw numerous needle-shaped argyrophilic and isotropic crystalloids, not previously described, in 12 of the 20 carcinomas (60%). These crystalloids were exclusively found in the carcinomas, reached a size of 50 μ, and were completely differentiated from the Holmes crystalloids by their odd needleshape and their staining characteristics. © 1993 Wiiey-Liss, Inc.     

Case report 217

Five cases of fibrous dysplasia isolated to the facial bones and mandible are presented. A review of the clinical and roentgen features of facial fibrous dysplasia are described.     

The prostatic epithelial cell in dysplasia: an ultrastructural perspective.

The histologic features of prostatic duct-acinar dysplasia have been difficult to analyze ultrastructurally, because of the difficulty in properly selecting and processing such small, randomly situated grossly invisible lesions. We have succeeded in identifying dysplastic foci by examination of the cut surfaces of tissue slices under low magnification. Dysplasia foci were excised from the slices and were compared to adjacent normal tissue by both light and electron microscopy. By electron microscopy (EM), normal secretory cells were filled with myriad tiny clear vacuoles, which were markedly diminished to absent in the cytoplasm of dysplastic cells. Both apocrine and eccrine secretion characterized normal epithelium and were diminished in dysplasia. EM showed striking features of nuclear abnormality more prominently than light microscopy, and qualitative basement membrane abnormalities were revealed. By EM analysis, dysplastic epithelium resembled that of invasive carcinoma more than normal epithelial cells.     

Classification of patellofemoral disorders

Patellofemoral disorders represent a large portion of the average orthopedist's practice. Despite the improvements in patellofemoral radiographs and arthroscopic diagnostic techniques, these disorders are too frequently misunderstood and frustrating to treat. This report proposes a clinical classification for patellofemoral disorders that, it is hoped, will aid our understanding and improve our results of treatment. A major feature of this classification is the recognition that a developmental and familial abnormality, patellofemoral dysplasia, is the etiology for most patellofemoral disorders. Equally important is the assignment of chondromalacia patellae to a secondary position for the most part. Other causes of anterior knee pain and disability are included to complete the classification.     

Multiple epiphyseal dysplasia complicated by severe osteochondritis dissecans of the knee

Two families are described which appear to contain examples of multiple epiphyseal dysplasia. In both families a striking incidence of severe osteochondritis of the knees was encountered. It is suggested that this was caused by the fragmented and maldeveloped epiphyses characteristic of epiphyseal dysplasia.     

High Resolution Anoscopy in the Planned Staged Treatment of Anal Squamous Intraepithelial Lesions in HIV-Negative Patients

Anal dysplasia (low-grade squamous intraepithelial lesions, LSIL; high-grade squamous intraepithelial lesions, HSIL) is a challenging disease for the surgeon. We reviewed 42 patients that underwent high-resolution anoscopy (HRA)-targeted surgical therapy of anal dysplasia in the past 10 years. Patients were followed up in the Anal Neoplasia Clinic with physical examination, cytology, HRA, and biopsy if indicated. Patients with disease amenable to local therapy were treated with office-based HRA-directed therapies. There were 30 men (mean age 39 years, range 21–63) and 12 women (mean age 50 years, range 31–71) included in the study. HSIL was present in 33, with four undergoing planned staged treatment due to circumferential disease. HSIL recurred in 45%, and most were re-treated successfully in-office. Progression to HSIL was seen in one patient with LSIL and to squamous cell carcinoma in one patient with HSIL despite therapy. No patients with LSIL had dysplasia at last follow-up. Minor complications occurred in three patients. HRA-targeted surgical therapy coupled with surveillance and re-treatment with office-based therapies offered an effective method in controlling anal dysplasia in the immunocompetent patient. Morbidity is minimal, and our progression to cancer rate is low (2.4%). Presented at the 48th Annual Meeting of the Society for Surgery of the Alimentary Tract, Washington DC, May 21, 2007.     

Segmentation anomalies of the vertebras and ribs: A developmental field defect: Epidemiologic evidence

Opitz has defined developmental field defects (DFD) as “any dysmorphogenetically reactive unit of the developing organism that leads to final structure.” We have incorporated in our coding system specific codes to identify individual DFDs in each child, irrespective of the cause or type of the MCA pattern (i.e., chromosomal, mendelian, environmental, or unknown). Using this approach, we can analyze the group of defects included in the expression of each DFD as a discrete unit. To confirm our hypothesis that vertebral and rib anomalies constitute a DFD, we have studied all of our cases with segmentation anomalies of the spine and ribs, including hemivertebrae, fused or absent vertebrae, and “crab-like” thorax, all of which fall into the loosely defined groups of spondylothoracic dysplasia, costovertebral dysplasia, Jarcho-Levin syndrome, and others. The study was performed using the 18,743 malformed children from the ECEMC data files, 110 of them having vertebral/rib anomalies. © 1994 Wiley-Liss, Inc.     

全髋关节置换结构性植骨治疗髋臼发良不良伴股骨头坏死

目的：评价全髋关节置换、结构性植骨治疗髋臼发育不良伴股骨头坏死的近期手术效果。方法：对9例髋臼发育不良伴股骨头坏死患者行全髋关节置换、结构性植骨术的治疗，髋臼杯置于真臼，之后行髋臼结构性植骨。结果：平均随访3．5年，除1例患者夜间睡眠时发生髋关节后脱位，其余病例均未出现脱位。术后3个月X线片提示结构性植骨块愈合良好，假体无移位，患髋活动灵活。结论：全髋关节置换、结构性植骨治疗髋臼发育不良伴股骨头坏死近期手术效果良好。     

Isolated congenital tricuspid valve dysplasia: A rare condition mimicking persistent pulmonary hypertension of the newborn

ABSTRACT Isolated congenital tricuspid valve dysplasia is a rare and potentially lethal congenital heart disease that can be easily confused with persistent pulmonary hypertension of the newborn. We describe a neonate with isolated congenital tricuspid valve dysplasia who did not respond to mechanical ventilation but improved by tolazoline. Clinicians should be aware that the initial fulminant course of this condition may be reversed by reducing the pulmonary vascular resistance, thereby allowing time for spontaneous recovery.     

Analysis of aberrant neuronal migrations in the hereditary cerebellar vermis defect (CVD) rat using bromodeoxyuridine immunohistochemistry

The hereditary cerebellar vermis defect rat (CVD) is a new neurological mutant characterized by cerebellar vermis defect and a dysplastic cerebellum, especially in the cerebello-pontine junctions. In this study, the cytokinetics of neuronal migrations in the CVD were analyzed using 5-bromo-2′-deoxyuridine (BrdU) as a labeling marker. From embryonic day 21, the CVD cerebellum was small in size with retarded foliation, but no significant differences were detected in the migration pattern of the BrdU-labeled cells between the unaffected controls and the CVD during the prenatal period. On postnatal day 0 (P0), heterotopic Purkinje cells, demonstrable by calbindin immunohistochemistry, were seen in the dorsal pons of the CVD. From P4, BrdU-positive external granule cells (EGCs), which were labeled by BrdU injection on P2, began to penetrate the pons. From P5, the EGCs aggregated around the blood vessels, leading to a disturbance of the cerebellar lamination both in the cerebello-pontine junctions and in the cerebellar hemispheres. Thereafter, the BrdU-labeled cells in the perivascularly aggregated EGCs migrated radially, and formed internal granular layers around the vessels, indicating an aberrant perivascular migration of the EGCs. These findings suggest that the EGC dislocation was preceded by an aberrant settlement of the Purkinje cells, and that the perivascularly aggregated EGCs resulted in cerebellar dysplasia in the CVD. Received: 8 July 1997 / Revised, accepted: 19 September 1997