Reassessment of histopathology and dermoscopy findings in 145 Japanese cases of melanocytic nevus of the sole: Toward a pathological diagnosis of early‐stage malignant melanoma in situ

Recently, dermoscopic visualization has been improved, allowing for the identification of malignant melanoma (MM) of the sole in situ. When the parallel ridge pattern is evident on dermoscopy, the proliferation of solitarily arranged melanocytes in the crista profunda intermedia should be examined histologically, since this may be a clue to the early diagnosis of MM in situ. We reviewed 145 Japanese cases of melanocytic nevus on the sole, and investigated several useful histological features for the diagnosis of MM in situ using a recent proposal as well as several standard histological criteria of MM in situ. Five cases were considered to be an early‐stage MM in situ out of 145 cases previously diagnosed as melanocytic nevi of the sole. These cases showed several specific features, including solitarily arranged melanocytes or melanocyte nests comprising fewer than four cells. Our findings indicate that early‐stage MM of the sole in situ can be diagnosed by using new dermoscopy‐related histological findings. They are (i) irregular distribution of solitary melanocytes at the crista profunda intermedia with or without small nests (up to three melanocytes) on the slope of rete ridges; and (ii) larger melanocytes with a halo around the nucleus.     

Bone dimensional variations at implants placed in fresh extraction sockets: a multilevel multivariate analysis

Aim: To use multilevel, multivariate models to analyze factors that may affect bone alterations during healing after an implant immediately placed into an extraction socket. Material and methods: Data included in the current analysis were obtained from a clinical trial in which a series of measurements were performed to characterize the extraction site immediately after implant installation and at re‐entry 4 months later. A regression multilevel, multivariate model was built to analyze factors affecting the following variables: (i) the distance between the implant surface and the outer bony crest (S‐OC), (ii) the horizontal residual gap (S‐IC), (iii) the vertical residual gap (R‐D) and (iv) the vertical position of the bone crest opposite the implant (R‐C). Results: It was demonstrated that (i) the S‐OC change was significantly affected by the thickness of the bone crest; (ii) the size of the residual gap was dependent of the size of the initial gap and the thickness of the bone crest; and (iii) the reduction of the buccal vertical gap was dependent on the age of the subject. Moreover, the position of the implant opposite the alveolar crest of the buccal ridge and its bucco‐lingual implant position influenced the amount of buccal crest resorption. Conclusions: Clinicians must consider the thickness of the buccal bony wall in the extraction site and the vertical as well as the horizontal positioning of the implant in the socket, because these factors will influence hard tissue changes during healing. To cite this article:
Tomasi C, Sanz M, Cecchinato D, Pjetursson B, Ferrus J, Lang NP, Lindhe J. Bone dimensional variations at implants placed in fresh extraction sockets: a multilevel multivariate analysis.
Clin. Oral Impl. Res. 21 , 2010; 30–36.     

'Coumadin ridge' in the left atrium demonstrated on three dimensional transthoracic echocardiography.

An echogenic band like structure was seen in the left atrium on two dimensional transthoracic echocardiography (2D TTE). Full volume three dimensional (3D) TTE and colour Doppler established the surrounding anatomical landmarks, and demonstrated the absence of obstruction related to this band. 3D TTE confirmed that this band like structure was consistent with the ridge between the left atrial appendage and left superior pulmonary vein ('warfarin/coumadin ridge').