OBJECTIVETo evaluate the clinical effect of arthroscopic excision of the os subfibulare in anterior-lateral ankle pain.

METHODSFrom December 2005 to Augest 2014, 16 patients suffering from pain associated with an os subfibulare in the anterior-lateral side of their ankles were reviewed. Among the patients,11 patients were male and 5 were female, with a mean age of (33.5 ± 15.6) years old. The mean maximum diameter of os subfibulare was (0.70 ± 0.26) cm. All the patients underwent excision of the osseous fragments, and had anatomic reconstruction of the anterior talofibular ligament if the anterior-lateral ankle was instable. The average follow-up period was (18.0 ± 4.5) months. To analyze the surgical outcome, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot pain and function scales,visual analogue scale (VAS) and Tegner activity scale were assessed preoperatively and postoperatively.

RESULTSAOFAS scales were preoperative 60.15 ± 14.52 and postoperative 92.35 ± 5.73. There was a significant difference between them (t = -8.251, P = 0.000). The mean VAS score were preoperative 7.35 ± 0.46 and postoperative 2.45 ± 0.98. Statistical significance was also notable (t = 18.105, P = 0.000). Tegner score was significantly increased from preoperative 2.87 ± 1.12 to postoperative 5.78 ± 1.06 (t= -7.548, P = 0.000).

CONCLUSIONIrrespective of the size of os subfibulare, in patients with pain or instability associated with the os subfibulare, arthroscopic excision combined with reconstruction of ther anterior talofibular ligament or not was effective in restoring ankle function and eliminating pain.

Adult ; Ankle Injuries ; surgery ; Ankle Joint ; surgery ; Arthroscopy ; methods ; Female ; Fibula ; surgery ; Humans ; Lateral Ligament, Ankle ; surgery ; Male ; Middle Aged

OBJECTIVETo investigate the reliability, practicability and limitations of cytopathological scrape method in the diagnosis of superficial lesions of skin and mucosal membrane.

METHODSThe quantity of cells harvested by different collecting methods were compared in 18 cases of malignant tumors of the skin and mucosal membrane. The scrape method was performed in 456 cases, of which 148 cases had corresponding histological specimens.

RESULTSGlass slide scraping provides the most satisfactory cell numbers from the lesions of skin and mucosal membrane. The specificity for diagnosing benign lesion in 37 patients was 100% and that for diagnosing malignant tumors in 111 patients was 92.8% (103). The overall diagnostic accuracy was 94.6% (140/148). The false negative rate, false positive rate and the overall misdiagnostic rates were 7.2% (8/111) , 0, and 5.4% (8/148) respectively.

CONCLUSIONSFor cytopathological examination of superficial skin and mucosal membrane lesions, the glass slide scraping methodprovides broad applications with high diagnostic accuracy and advantages of simplicity, safety and efficiency. Certain limitations do exist, but can be resolved by histological examination of the lesion.

Biopsy, Needle ; Breast Neoplasms ; pathology ; Carcinoma, Basal Cell ; pathology ; Carcinoma, Squamous Cell ; pathology ; Cytodiagnosis ; Female ; Histocytological Preparation Techniques ; methods ; Humans ; Lip Neoplasms ; pathology ; Male ; Mouth Mucosa ; pathology ; Mouth Neoplasms ; pathology ; Neoplasms ; pathology ; Paget's Disease, Mammary ; pathology ; Skin Neoplasms ; pathology ; Tongue Neoplasms ; pathology

OBJECTIVETo study the rate of concordance between positive cervical cytologic interpretation based on liquid-based preparations and subsequent histologic diagnosis.

METHODSLiquid-based cervical cytology (SurePath) was carried out in 15,393 patients. Cases with the cytologic diagnosis of epithelial cell abnormality were further investigated by human papillomavirus (HPV) DNA testing (Hybrid Capture II) for the high-risk HPV DNA, colposcopic examination and multiple cervical biopsies. The 2001 version of The Bethesda System for reporting gynecologic cytology was applied. Positive cytologic diagnosis included atypical squamous cells of undetermined significance (ASC-US) or above. Histologic correlation was available in some of the patients. The rate of concordance between positive cytologic interpretation and subsequent histologic diagnosis was calculated.

RESULTSAmongst the 15,393 liquid-based cytology cases studied, the cytologic diagnosis of 7 cases squamous cell carcinoma were all concordance with histologic diagnosis, while the rates for high-grade and low-grade squamous intraepithelial lesions were 93.6% (103/110) and 82.0% (443/540), respectively. A positive correlation was also demonstrated between detection of high-risk HPV DNA, positive cytologic interpretation and positive histologic diagnosis.

CONCLUSIONLiquid-based cytologic preparation, when coupled with standardized reporting using the Bethesda System 2001, can achieve a high diagnostic accuracy of cervical epithelial abnormalities.

Carcinoma, Squamous Cell ; pathology ; Cervical Intraepithelial Neoplasia ; pathology ; Cervix Uteri ; pathology ; DNA, Viral ; analysis ; Female ; Humans ; Papillomaviridae ; isolation & purification ; Retrospective Studies ; Uterine Cervical Neoplasms ; pathology ; Vaginal Smears ; methods

OBJECTIVETo assess the utility of P504S immunohistochemistry in the diagnosis and differential diagnosis of prostatic adenocarcinoma.

METHODSLight microscopy and immunohistochemistry examinations (EnVision staining) were performed in 117 cases of prostatic adenocarcinoma, PIN, AAH, ASAP, BPH and normal prostatic tissue to correlate the morphology and protein expression of P504S, 34betaE12, and P63.

RESULTSSeventy-one of the 78 (91%) cases of prostatic adenocarcinoma stained positive for P504S, with strong cytoplasmic granular staining in most cases, and a weak or intense granular staining along the circumferential luminal and apical cell border membrane in a few cases. Negative P504S immunostaining was observed in 7 of 78 (9%) cases of prostatic adenocarcinoma, all of which were clear cell type prostatic adenocarcinoma. Cases of PIN (9 cases), AAH (6 cases) and ASAP (2 cases) showed various expression levels of P504S. Sixty-five of 68 (96%) cases of normal prostates and BPH were negative for P504S and basal cell hyperplasia cases were also negative.

CONCLUSIONSP504S is a useful marker for microscopic diagnosis of prostatic adenocarcinoma, and immunohistochemistry study using a combination of P504S and 34betaE12/p63 may be of greater benefit in aiding the differential diagnoses.

Adenocarcinoma ; diagnosis ; DNA-Binding Proteins ; Diagnosis, Differential ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Keratins ; analysis ; Male ; Phosphoproteins ; analysis ; Precancerous Conditions ; diagnosis ; Prostate ; enzymology ; Prostatic Hyperplasia ; diagnosis ; Prostatic Intraepithelial Neoplasia ; diagnosis ; Prostatic Neoplasms ; diagnosis ; Racemases and Epimerases ; analysis ; Trans-Activators ; analysis ; Transcription Factors ; Tumor Suppressor Proteins

OBJECTIVETo investigate the morphologic features, differential diagnosis, prognosis and histogenesis of papillary renal cell carcinoma (PRCC).

METHODSTumors composed of at least 50% papillae and > 1 cm in diameter were included in this study. Light microscopic observation, immunohistochemical assay of EMA, CK7, CD10, Vim, 34 beta E12 by tissue chip were performed.

RESULTSAmong 516 cases of renal epithelial tumors 33 cases of PRCC were detected. Grossly, hemorrhage, necrosis and multifocality were commonly seen. Besides typical papillae, inconspicuous papillary patterns, such as trabecular, tubular, micronodular and pseudostratified patterns could be seen. Foam cells and psammoma bodies in stroma, and hemosiderin in tumor cells were characteristic. Tumors were of two major types: basophilic type (n = 10), with small cuboid cell and pale cytoplasm (n = 10), 9 of them were low in Fuhrman grading; eosinophilic type (n = 22) with large columnar cells, rich in eosinophilic cytoplasm, 19 of them were high in Fuhrman grading. The remaining case was of clear cell type. The basophilic tumors were all positive for distal tubule marker EMA/CK7, none for proximal tubule marker CD10, 7 tumors positive for Vim. Eosinophilic tumors were positive for EMA/CK7 (9/22), CD10 (10/22) and Vim (6/22). All the tumors studied were negative for 34 beta E12. Follow-up data were available for 24 cases (mean 37 months) with 3-year survival rate of 64.3%, 5-year survival rate of 50%.

CONCLUSIONPRCC was a distinct malignant entity with unique pathological features. The prognosis of PRCC was worse than that of chromophobe renal cell carcinoma.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Papillary ; classification ; metabolism ; pathology ; Carcinoma, Renal Cell ; classification ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Keratin-7 ; Keratins ; metabolism ; Kidney Neoplasms ; classification ; metabolism ; pathology ; Kidney Tubules ; metabolism ; Male ; Middle Aged ; Mucin-1 ; metabolism ; Neprilysin ; metabolism ; Survival Rate ; Vimentin ; metabolism

OBJECTIVETo describe the relative frequency, morphologic features, immunophenotype and clinical data of different types of B-cell non-Hodgkin lymphoma (B-NHL) and to evaluate the practical application of the 2001 World Health Organization (WHO) classification of lymphoid neoplasms.

METHODS369 documented cases of B-NHL were further subtyped according to the 2001 WHO classification of lymphoid neoplasms, on the basis of hematoxylin and eosin staining, immunohistochemistry and in-situ hybridization techniques.

RESULTSAmongst the 369 cases of B-NHL studied, 353 cases could be further classified into 11 subtypes. Diffuse large B-cell lymphoma, extranodal marginal zone lymphoma and follicular lymphoma were the commonest subtypes, accounting for 51.2% (189 cases), 14.9% (55 cases) and 10.6% (39 cases) of all cases respectively. Tumors in lymph nodes were seen in 158 cases (42.8%) and in extra node in 211 cases (57.2%). B-cell prolymphocytic leukemia and hairy cell leukemia were not identified. When comparing the diagnosis based on morphologic examination alone with the diagnosis based on both morphology and immunophenotype, there was a 80% concordance rate. Immunohistochemical study was helpful in reaching the correct diagnosis in many cases and could improve the overall diagnostic accuracy by about 20%.

CONCLUSIONSAmongst cases of B-NHL, diffuse large B-cell lymphoma is the commonest subtype, followed by MALToma and follicular lymphoma. While morphologic examination forms the basis for lymphoma diagnosis, immunohistochemical study also plays an important role in further subtyping. A combination of both modalities are sufficient for arriving at an accurate diagnosis in most cases of B-NHL, in keeping with the recommendation of the 2001 WHO classification of lymphoid neoplasms.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; CD79 Antigens ; metabolism ; Child ; Female ; Humans ; Immunohistochemistry ; Leukosialin ; metabolism ; Lymphoma, B-Cell ; immunology ; pathology ; Lymphoma, B-Cell, Marginal Zone ; immunology ; pathology ; Lymphoma, Follicular ; immunology ; pathology ; Lymphoma, Large B-Cell, Diffuse ; immunology ; pathology ; Lymphoma, Non-Hodgkin ; classification ; immunology ; pathology ; Male ; Middle Aged ; World Health Organization

OBJECTIVETo investigate the clinical characteristics, morphologic and immunohistochemical features, diagnosis, differential diagnosis, histogenesis and prognosis of renal juxtaglomerular cell tumor (JGCT).

METHODSLight microscopic observation; immunohistochemical assay of CK8, E-cadherin/CK7, CD10, Vim, Actin, CD34, S100, HMB45, CD31, Chr, Syn and CD117, EM; and follow-up were done on all 4 surgically treated JGCT patients.

RESULTSAll 4 JGCT were observed in young adult with clinically uncontrolled severe hypertension. Grossly, the tumor was encapsulated and small in size. Microscopically, the tumor cells grew in sheets predominantly, but papillary and onion-like pattern could also be seen. The stroma contained prominent vasculature that consisted of numerous thin-wall vessels clustering around thick-walled vessels. Tumor cells were rather small, polygonal, with slightly eosinophilic cytoplasm and ill-defined cell border. Nuclei were uniform in size but nuclear atypia and mitosis could be seen. Numerous mast cells were scattered among the tumor cells, and tubules were identified in 3 of 4 cases with positive expression of distal tubule marker of E-cadherin/CK7. Tumor cells positively expressed Vim, Actin, calponin, and CD34. All cases presented ultrastructural features of distinct rhomboid-shaped crystal. There was no recurrence or metastasis but hypertension persisted in three during follow-up (mean 37 months) for all 4 JGCT patients.

CONCLUSIONJGCT, originating from the juxtaglomerular cell, has a distinct benign entity, and it is typically found in young adults with severe hypertension. It has a unique morphology and ultrastructure features and positive immunoreactivity to Vim, Actin, calponin and CD34.

Actins ; analysis ; Adolescent ; Adult ; Antigens, CD34 ; analysis ; Calcium-Binding Proteins ; analysis ; Female ; Humans ; Hypertension ; etiology ; Immunohistochemistry ; Juxtaglomerular Apparatus ; chemistry ; pathology ; ultrastructure ; Kidney Neoplasms ; chemistry ; pathology ; ultrastructure ; Male ; Microfilament Proteins ; analysis

One of the major circulatory changes that occur in human during space flight and simulated weightlessness is a cerebral redistribution of body fluids, which is accompanied by an increase of blood volume in the upper body. Therefore, atrial myocardium should increase the secretion of atrial natriuretic peptide (ANP), but the researches lack common conclusion until now. The present study was to investigate the expression level of ANP in simulated weightlessness rats, and to confirm the changes of ANP by observing the associated proteins of soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNAREs). The tail-suspended rat model was used to simulate weightlessness. Western blots were carried out to examine the expression levels of ANP and SNARE proteins in atrial and left ventricular myocardium. The results showed that ANP expression in atrial myocardium showed an increase in 4-week tail-suspended rats (SUS) compared with that in the synchronous control rats (CON). We only detected a trace amount of ANP in the left ventricular myocardium of the CON, but found an enhanced expression of ANP in left ventricular myocardium of the SUS. Expression of VAMP-1/2 (vesicle associated SNARE) increased significantly in both atrial and left ventricular myocardium in the SUS compared with that in the CON. There was no difference of the expression of syntaxin-4 (target compartment associated SNARE) between the CON and SUS, but the expression of SNAP-23 showed an increase in atrial myocardium of the SUS compared with that in the CON. Synip and Munc-18c as regulators of SNAREs did not show significant difference between the CON and SUS. These results suggest that the expression of ANP shows an increase in atrial and left ventricular myocardium of 4-week tail-suspended rats. Enhanced expression of VAMP-1/2 associated with ANP vesicles confirms the increased expression of ANP in atrial and left ventricular myocardium.
Animals ; Atrial Natriuretic Factor ; metabolism ; Heart Ventricles ; metabolism ; Myocardium ; metabolism ; Rats ; SNARE Proteins ; metabolism ; Vesicle-Associated Membrane Protein 1 ; metabolism ; Vesicle-Associated Membrane Protein 2 ; metabolism ; Weightlessness Simulation

OBJECTIVETo investigate the effect of antibiotics and a nonsteroidal anti-inflammatory agent on the level of total prostate specific antigen (PSA) and free PSA ratio (F-PSAR) in patients with chronic prostatitis IIIA.

METHODSA total of 228 outpatients diagnosed as with chronic prostatitis III A received 4-week antibiotic and anti-inflammatory treatment. The PSA level and F-PSAR were determined before and after the treatment, and the changes analyzed.

RESULTSSignificant variations were observed in the median PSA concentrations (3.51 microg/L and 2.75 microg/L) and F-PSAR (0.25% and 0.27%) 4 weeks after the treatment. Sixty-five of the patients (28.5%) presented with serum PSA greater than 4 ng/ml, the mean PSA decreased by 32.9%, from 6.24 microg/L before the treatment to 4.58 microg/L 4 weeks after the treatment (P < 0.05), and the serum PSA was normalized in 18 of the 65 patients (27.7%). The median variation of F-PSAR (0.16% and 0.22%) was greater than that of PSA. The variation indexes obtained 4 weeks after the treatment showed no statistical difference from those observed 8 weeks after the treatment.

CONCLUSIONChronic prostatitis IIIA appears to contribute to increased serum PSA levels in some men. Antibiotic and anti-inflammatory treatment could significantly reduce the PSA level and increase F-PSAR.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Chronic Disease ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; blood ; Prostatitis ; blood ; drug therapy

To develop a gene therapy strategy for treating bovine mastitis, a new mammary-specific vector containing human lysozyme (hLYZ) cDNA and kanamycin resistance gene was constructed for intramammary expression and clinical studies. After one time acupuncture or intracisternal infusion of healthy cows with 400 microg of the p215C3LYZ vector, over 2.0 microg/ml of rhLYZ could be detected by enzymatic assay for about 3 weeks in the milk samples. Western blotting showed that rhLYZ secreted into milk samples from the vector-injected cows had molecular weight similar to that of the natural hLYZ in human colostrums. Twenty days after the primary injection, the quarters were re-injected with the same vector by quarter acupuncture and even higher concentrations of rhLYZ could be detected. Indirect competitive ELISA of milk samples showed that the vector injection did not induce detectable humoral immune response against hLYZ. Clinical studies showed that twice acupuncture of quarters with the p215C3LYZ vector had overt therapeutic effect on clinical and subclinical mastitis previously treated with antibiotics, including disappearance of clinical symptoms and relatively high microbiological cure rates. These data provide a solid rationale for using the vector to develop gene therapy for treating bovine mastitis.
Acupuncture ; Animals ; Cattle ; Female ; Genetic Therapy ; methods ; veterinary ; Genetic Vectors ; genetics ; Mastitis, Bovine ; genetics ; therapy ; Milk ; chemistry ; Muramidase ; biosynthesis ; genetics ; metabolism