Telomeric restriction analysis of vascular smooth muscle cells following balloon angioplasty in rabbits.

Intimal hyperplasia due to smooth muscle cell proliferation and migration has been reported to be responsible for the pathogenesis of atherosclerosis and restenosis, manifested following balloon angioplasty. In this study, we employed the balloon angioplasty model to study telomere length regulation in proliferating vascular smooth muscle cells. Our results showed that balloon angioplasty in iliac arteries resulted in intimal hyperplasia due to proliferation of the smooth muscle cells and small size telomeric restrictional fragments were evident in injured arteries.

Inhibition of vascular endothelial growth factor-induced retinal neovascularization by retinoic acid in experimental retinopathy of prematurity.

Vascular endothelial growth factor (VEGF) has an important role in the pathogenesis of retinopathy of prematurity (ROP) and inhibition of VEGF expression in the neovascular phase might prevent destructive neovascularization in ROP. It is suggested that retinoids exert a highly potent antiangiogenic activity by inhibiting VEGF expression. The aim of this study was to demonstrate the preventive effect of retinoic acid (RA) on the VEGF-induced retinal neovascularization in a rat model of ROP. Wistar albino rats were placed into incubators at birth and exposed to an atmosphere alternating between 50 % and 10 % O(2) every 24 hours. After 14 days, the animals were removed to room air and received either an intraperitoneal injection of RA (5 mg/kg/day) (n=9) or saline (n=4) daily for six days, and sacrificed at 21 days. Other rats (n=4) were raised in room air and served as age-matched controls. The globe of each eye was cut through the cornea and embedded in paraffin. Serial sections were stained with hematoxylin-eosin for quantification of neovascular nuclei. The avidin-biotin peroxidase method was performed for evaluation of VEGF expression. The average number of neovascular nuclei was significantly lower in the control group compared to that in the ROP groups. In addition, it significantly decreased in the RA-treated ROP group compared to that of the saline-administrated ROP group. VEGF immunostaining was overall negative in room air-exposed rats. The VEGF immunostaining score significantly decreased in the RA-treated ROP group compared to that in the saline-administered ROP group. RA treatment might be beneficial in preventing neovascularization resulting from oxygen-induced retinopathy by downregulation of VEGF expression.

Prognostic value of CD44 expression in colorectal carcinomas.

BACKGROUND: CD44 has diverse functions in cell-cell and cell-matrix interactions and its expression appears to be an indicator of invasive and metastatic behaviour in carcinomas. However, contradictory data have been reported about the correlation between CD44 expression and prognosis in colorectal carcinomas. We aimed (i) to establish whether immunohistochemically detectable CD44 expression is related to tumor aggressiveness, (ii) to correlate CD44 expression with the degree of tumor differentiation and (iii) to determine the relationship between CD44 expression and patient survival and other conventional clinicopathological features. PATIENTS AND METHODS: The immunohistochemical expression of CD44 in a series of 111 colorectal carcinomas was examined using the monoclonal mouse anti-human phagocytic glycoprotein-1, CD44 (clone DF 1485) in correlation with clinicopathological variables. To achieve a reliable semi-quantitative evaluation, not only the staining intensity but also the distribution of positive tumor cells were analyzed. RESULTS: CD44 staining was high-grade positive in 42 and low-grade positive/negative in 69 tumor tissues. There was no association between CD44 expression and tumor size, histological differentiation, depth of invasion, lymph node involvement, clinical stage of the disease, or the radicality of surgical resection. CD44 expression was not correlated significantly with recurrence and distant metastases. Multivariate analysis showed that only the modified Astler-Coller (MAC) staging system was an independent prognostic factor of recurrence (HR=15.267; 15.267-6.808, 95% CI; p=0.001) and survival (HR=37.064; 13.309-103.220, 95% CI; p=0.001). Kaplan-Meier curves showed that there was no significant association between CD44 expression and recurrence and overall survival in either MAC B or C colorectal cancer. CONCLUSION: Expression of CD44 was not associated with any conventional clinicopathological features. CD44 cannot be considered as a prognostic predictor of recurrence, metastasis and overall survival.

Pigmented villonodular synovitis of the knee presenting as a popliteal cyst.

Pigmented villonodular synovitis is a locally aggressive tumor of the synovium of joints and tendon sheaths. It is commonly seen in the synovial lining of the flexor tendons of the hand and in the synovium of the knee and less commonly in other joints. A case of pigmented villonodular synovitis of the knee in a 60-year-old man, with an intra-articular origin extending extra-articularly, is presented. The interesting point is that the initial diagnosis was a Baker cyst.

Epithelioid angiomyolipoma: a case report.

Epithelioid angiomyolipoma is a recently recognized tumor entity. We report a case of epithelioid angiomyolipoma of the kidney that occurred in a 70-year-old female. The patient presented with massive abdominal hemorrhage and shock. There was no history of tuberous sclerosis complex. The tumor consisted of smooth muscle, adipocytes, small-to-medium-sized hyalinized blood vessels and numerous pleomorphic epithelioid cells with clear to eosinophilic cytoplasm. Mitosis was exceptional and no glandular pattern was recognizable. Immunohistochemically the epithelioid cells were strongly positive for HMB45 and CD68, focally positive for S-100, actin and vimentin, and negative for epithelial markers including epithelial membrane antigen and cytokeratins. Previous reports in the English literature suggest that epithelioid angiomyolipoma may have malignant potential. In our case, at six months from surgery the patient is alive and well without evidence of relapse or metastasis.

Goldston syndrome: report of a case.

Cerebrohepatorenal malformation is a rare familial disorder characterized by typical renal lesions combined with Dandy-Walker malformation, and congenital hepatic fibrosis. In this case report, a male premie with the diagnosis of cerebrorenal syndrome or so called Goldston syndrome is presented. Besides the rarity of this syndrome, this case is the second reported patient diagnosed prenatally.

Papular acantholytic dyskeratosis of the anogenital area with positive direct immunofluorescence results.

Acantholytic dyskeratosis is a distinct histological pattern characterized by hyperkeratotic and parakeratotic epidermis with intraepidermal clefts harbouring acantholytic and dyskeratotic keratinocytes. This histopathological pattern is uncommon in dermatoses of the anogenital region. We report a 30-year-old woman who had numerous smooth whitish papules on the labia majora, perineum and perianal region, which coalesced into plaques in some areas. Microscopically, the lesions showed prominent suprabasal and intraspinous acantholysis with dyskeratotic keratinocytes. Direct immunofluorescence examination revealed intercellular Ig G and C(3) within the epidermis. We were unable to find a similar case of papular acantholytic dyskeratosis of the anogenital area with positive direct immunofluorescence findings reported in the literature, thus in this report, the clinicopathological features of a unique case are presented.

Evaluation of dermoscopic and histopathologic features and their correlations in pigmented basal cell carcinomas.

BACKGROUND: Because of their clinical similarities, pigmented basal cell carcinomas (BCCs) can be confused with melanocytic pigmented lesions especially with melanoma. Since special dermoscopic features have been described for pigmented BCCs, dermoscopy is accepted as a useful tool for the diagnosis of pigmented BCCs. OBJECTIVE: To investigate dermoscopic and corresponding histopathologic features of BCCs and to evaluate their correlations in pigmented BCCs. METHODS: In this study, 32 pigmented BCCs in 30 patients whose diagnoses were confirmed with clinical and histopathologic features were included. Before the histopathologic evaluation, the lesions were analysed for dermoscopic features. Histopathologic correlations of dermoscopic features of BCCs and the localization of pigment accumulation in tumour mass were investigated. RESULTS: In addition to ulceration, large grey-blue ovoid nests, multiple grey-blue globules, maple leaf areas and arborizing telangiectasia; dermoscopically yellow-brown, whitish-yellow, and black-dark brown colour showed statistically significant correlation with their histopathologic counterparts (P < 0.05). Whitish veil, which is among dermoscopic features of BCCs, did not show significant correlation with its histopathologic counterpart (P > 0.05). It was histopathologically determined that pigmentation is found within the tumour mass as well as in the tumour stroma and in the hyperplastic epidermal melanocytes. CONCLUSIONS: Ulceration, large grey-blue ovoid nests, multiple grey-blue globules, maple leaf-like areas and arborizing telangiectasia, which are specific dermoscopic features for the diagnosis of pigmented BCC, were found to correlate with their histopathologic counterparts. In conclusion, dermoscopy can be described as a valuable tool for the diagnosis of pigmented basal cell carcinomas.

Differentiation of phyllodes tumors versus fibroadenomas.

PURPOSE: To determine if mammographic and sonographic findings allow discrimination between phyllodes tumor and large sized fibroadenoma, which mimic each other in the clinical, radiologic and histopathologic appearances. MATERIAL AND METHODS: Thirty-one histopathologically proven masses including 12 phyllodes tumors and 19 fibroadenomas 3 cm or greater in diameter were compared. In total 28 women were retrospectively evaluated by mammography and pre-operative sonography. RESULTS: Mammography revealed a high-density mass compared with surrounding fibroglandular breast tissue to be present in 9 of the 12 (75%) phyllodes tumors and 7 of the 19 (37%) fibroadenomas. At sonography a mass, which had a round or lobulated shape, marked posterior acoustic enhancement and intramural cystic areas, were statistically significantly more likely to be phyllodes tumors than fibroadenomas. None of the other mammographic or sonographic characteristics proved to be useful in differentiating phyllodes tumors and fibroadenomas. CONCLUSION: Although masses of high density at mammography, circumscribed border associated with posterior acoustic enhancement and internal cystic areas at sonography should suggest the diagnosis of phyllodes tumors rather than large sized fibroadenomas, there was a substantial overlap in the mammographic and sonographic characteristics of these two tumors. Therefore, an excisional biopsy would be necessary for equivocal masses.

Mammographic and sonographic findings in the diagnosis of idiopathic granulomatous mastitis.

The aim of this study was to describe the mammographic and sonographic findings of idiopathic granulomatous mastitis which is a rare inflammatory disease of the breast of unknown etiology. The clinical, radiologic, and pathologic features of 12 cases with idiopathic granulomatous mastitis were retrospectively reviewed. Mammography was performed in all cases, 8 of which showed a focal asymmetric density, 3 had a mass with irregular margins, and 1 had no abnormality. Sonography was performed in 10 cases, and a focal area with inhomogeneous and hypoechoic pattern was depicted in 6 cases, 4 of which were associated with internal tubular hypoechoic structures. One case revealed a hypoechoic mass consistent with malignancy. In 1 case sonography showed an edematous pattern involving nearly the entire breast. Two patients had normal sonograms. If a focal asymmetric density is seen in mammography and inhomogeneous hypoechogenity with internal hypoechoic tubular structures accompany ultrasonographically, these findings should suggest the possibility of idiopathic granulomatous mastitis; however, very often idiopathic granulomatous mastitis mimics a breast carcinoma clinically and the final diagnosis should be reached histopathologically due to high false-positive and false-negative mammographic appearances.

Comparison of mammographic and sonographic findings in typical and atypical medullary carcinomas of the breast.

AIM: The aim of this study was to describe the contribution of mammographic and sonographic findings to the discrimination of typical and atypical histopathologic groups of medullary carcinomas of the breast. MATERIALS AND METHODS: Imaging findings were retrospectively assessed in 33 women with medullary carcinomas (15 typical medullary carcinomas and 18 atypical medullary carcinomas) identified during pre-operative mammography. Twenty-nine of these women also had ultrasound and these findings were reviewed. RESULTS: Mammography showed a well circumscribed mass in 10 of the 15 (67%) typical medullary carcinomas and in four of the 17 (24%) atypical medullary carcinomas (P < 0.02). One small tumour in a woman with atypical medullary carcinoma was missed on mammography and was shown only on sonography. Sonographically, an irregular margin surrounding the whole mass or part of it was seen in three out of 14 (21%) patients with typical medullary carcinoma and in nine out of 15 (60%) patients with atypical medullary carcinomas (P < 0.05). Posterior acoustic shadowing was more often observed in the typical medullary carcinoma group than in atypical medullary carcinoma and the difference was found to be statistically significant (P < 0.05). None of the other mammographic and sonographic findings were sufficiently characteristic to allow for a differentiation between two groups. CONCLUSION: When typical medullary carcinomas were compared with atypical medullary carcinomas according to imaging features, they tended to be well circumscribed masses on both mammography and sonography, and a posterior acoustic shadow was not found on sonography. However, the imaging findings in these two subgroups often resembled each other and histopathology will always be required to confirm the diagnosis.

Telomeric restriction analysis of vascular smooth muscle cells following balloon angioplasty in rabbits

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Intimal hyperplasia due to smooth muscle cell proliferation and migration has been reported to be responsible for the pathogenesis of atherosclerosis and restenosis, manifested following balloon angioplasty. In this study, we employed the balloon angioplasty model to study telomere length regulation in proliferating vascular smooth muscle cells. Our results showed that balloon angioplasty in iliac arteries resulted in intimal hyperplasia due to proliferation of the smooth muscle cells and small size telomeric restrictional fragments were evident in injured arteries (AU)