Comparison of androgen metabolites in benign prostatic hypertrophy (BPH) and normal prostate.

5 alpha-Dihydrotestosterone (DHT) and androstanediols (diols) have been measured in human prostate tissue. DHT levels in surgical specimens of prostate from 8 patients with BPH averaged 5.6 +/- 0.93 S.E. ng/g and were significantly greater than (P less than 0.01) values of 2.1 +/- 0.32 S.E. ng/g in 6 normal prostates obtained post-mortem from males less than 50 yrs old. Androstanediols averaged 2.3 +/- 0.35 S.E. ng/g in the BPH specimens compared to values of 10.2 +/- 2.4 S.E. ng/g in the normal prostates (P less than 0.01). This significantly higher (P less than 0.001) ratio of diols/DHT in the normal (5.1 +/- 0.93 S.E.) compared to the BPH prostate (0.45 +/- 0.08 S.E.) suggests that a decrease in 3-hydroxysteroid oxido-reductase, which converts DHT to diol, may be an important clue to the pathogenesis of BPH.

Thorotrast induced adhesive arachnoiditis associated with meningioma and schwannoma.

Adhesive arachnoiditis, a meningioma and a schwannoma were found at autopsy in a 56 year old man who had undergone Thorotrast myelography 33 years previously. Thorotrast was demonstrated in tissue sections by transmission and scanning electron microscopy, radioautography, and x-ray spectrometry.

Intervertebral disc abnormalities associated with vertebral metastasis: observations in patients and cadavers with prostatic cancer.

Abnormalities of intervertebral discs associated with vertebral metastasis from prostatic carcinoma are described in an investigation utilizing patient and cadaveric material. Radiographic and pathologic findings indicate that discal abnormality in this situation relates to three potential processes: intervertebral disc degeneration (intervertebral osteochondrosis); cartilaginous (Schmorl's) nodes; discal invasion by tumor. In most patients with vertebral metastasis, the adjacent intervertebral disc appears normal, a useful radiographic finding suggesting the presence of tumor rather than infection. Occasional patients with vertebral metastasis demonstrate roentgen abnormalities of the adjacent intervertebral disc indicating the occurrence of one or more of the above processes.

Safety of percutaneous fine-needle pancreatic biopsy: a porcine model.

Percutaneous fine-needle aspiration biopsy was performed on pigs with no complications. Pancreatic cells were retrieved in 73% of the biopsies. Thus, percutaneous biopsy with cytologic examination for pancreatic carcinoma can be performed in order to plan for appropriate therapy.

Degenerative disease of the sacroiliac joint.

Analysis of 46 sacroiliac joints removed in toto at random during routine autopsies was undertaken to define the pathologic and radiographic alterations of this joint in middle-aged and elderly patients. Each joint was sectioned, photographed and radiographed and large microscopic slides were prepared. Sacroiliac osteoarthrosis resulted in progressive cartilage degeneration, particularly on the ilial side of the joint, with eventual cartilaginous fusion. Para-articular bony ankylosis was produced by bridging osteophytes on the anterior and inferior surfaces. Sacroiliac intra-articular bony ankylosis was confined to cadavers with ankylosing spondylitis. In some patients radiographic differentiation of osteoarthrosis and ankylosing spondylitis may require tomography.

The plantar compartments of the foot: a roentgen approach I. Experimental observations.

The integrity of the plantar muscle compartments of the human foot were studied utilizing radiographic and anatomic techniques in an attempt to determine potential pathways for spread of soft tissue infection. One of three major plantar muscle compartments--medial, intermediate or lateral--in 24 unembalmed cadaveric feet was injected percutaneously under fluoroscopy with radiopaque Methyl-methacrylate using both manual and automatic injection techniques with pressure callibration. Following freezing, specimens were sectioned, radiographed, and dissected or partially macerated. Frequency and patterns of extravasation of contrast material were documented and recorded. The results obtained support the concepts that: a) there are three distinct plantar muscle compartments that are maintained by intermuscular septae; and b) there are potential communicating pathways provided by specific anatomic structures.

[Clinician-oriented and cytology-oriented autopsy. Part II. Hepato-biliary system].

The autopsy is performed with multiple purposes. The first purpose of the autopsy is a service for clinicians. The dissection technic should be determined to present the best clinical-pathological correlation of the lesions. Imprint (touch preparation) from the organ is most useful to make initial pathological diagnoses during autopsy examination. This preparation provides not only oncologic data (tumor identification), but also the presence of infections. Numerous photographs illustrate both the gross pathological lesions and infections of the hepato-biliary system.

[Clinician-oriented and cytology-oriented autopsy. III. The pancreas].

The autopsy is performed with multiple purposes such as medical education, searching direct cause of the death and researches. The first purpose of the autopsy is, however, a service for clinicians. The dissection technic should be determined to present the best clinical-pathological correlation of the lesions. In addition to the careful evaluation of the gross lesions of the pancreas, Smears (Imprints) of the lesions are most useful to make initial pathological diagnoses during autopsy examination. Multiple photographs illustrate both the gross pathological lesions and cytological data of the pancreas.

[Clinician-oriented and cytology-oriented autopsy, Part I. Respiratory system].

The autopsy is performed with multiple purposes. It is felt that the first purpose of the autopsy is a service for clinicians. Dissection technic should be determined to present the best clinical pathological correlation of the lesions. Touch preparation (imprint) from the organs is most useful to establish initial pathological diagnoses during autopsy examination. This provides not only oncologic data (identification of tumors), but also the presence of infectious complications such as opportunistic organisms. Multiple photographs illustrate both the gross pathological lesions and infections, demonstrated by the imprints of the respiratory system.

Intravertebral disk herniations: cartilaginous (Schmorl's) nodes.

Cartilaginous (Schmorl's) nodes are related to prolapses of intervertebral disk material into the vertebral body. These nodes can be produced by any process which weakens either the cartilaginous plate covering the superior and inferior surfaces of the vertebral body or the subchondral trabeculae of the vertebra. Such processes include juvenile kyphosis, trauma, metabolic and neoplastic disorders, and degenerative disk disease. Radiographic abnormalities include indentations of vertebral outline and radiolucencies within the vertebral body with varying degrees of sclerosis. These can be readily differentiated from other vertebral alterations such as "butterfly", "fish", and "H" vertebrae.

Carpal instability in rheumatoid arthritis and calcium pyrophosphate deposition disease. Pathogenesis and roentgen appearance.

The roentgen appearance and pathogenesis of carpal instability are described in an evaluation of patients and cadavers with rheumatoid arthritis and calcium pyrophosphate deposition disease. Dorsiflexion (16%) and palmar flexion (8%) instability occurs in rheumatoid arthritis, particularly in patients with moderate to advanced disease. Navicular-lunate dissociation frequently accompanies dorsiflexion instability and results from involvement of the interosseous ligament between the two bones by rheumatoid pannus. Carpal instability and navicular-lunate dissociation also accompany pyrophosphate arthropathy, resulting from calcific deposition and cystic degeneration of ligamentous structures.

Entheses and enthesopathy. Anatomical, pathological, and radiological correlation.

Entheses are sites of tendon and ligament attachment to bone, and enthesopathy is a disease process occurring at these sites. It may be inflammatory, degenerative, endocrine, metabolic, or traumatic in nature. Common sites of involvement include the pelvis, femoral trochanter, humeral tuberosity, patella, olecranon, and calcaneus as well as portions of the vertebral column. Specific radiographic features, including bone erosion, hyperostosis, fragmentation, and crystal deposition, may allow a precise diagnosis.

Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH).

The vertebral involvement of DISH is described from an evaluation of 215 cadaveric spines and 100 patients with the disease. Radiographic features include linear new bone formation along the anterolateral aspect of the thoracic spine, a bumpy contour, subjacent radiolucency, and irregular and pointed bony excrescences at the superior and inferior vertebral margins in the cervical and lumbar regions. Pathologic features include focal and diffuse calcification and ossification in the anterior longitudinal ligament, paraspinal connective tissue, and annulus fibrosis, degeneration in the peripheral annulus fibrosis fibers, L-T-, and Y-shaped anterolateral extensions of fibrous tissue, hypervascularity, chronic inflammatory cellular infiltration, and periosteal new bone formation on the anterior surface of the vertebral bodies.

Resorption of the undersurface of the distal clavicle in rheumatoid arthritis.

An elongated erosion on the undersurface of the distal clavicle, adjacent to the coracoid process, may be seen in the shoulder of a patient with rheumatoid arthritis. This finding is apparently related to inflammatory changes in the coracoclavicular ligament. Such an erosion may occur with or without additional radiographic alterations and, although not entirely specific, suggests rheumatoid arthritis.

Subchondral resorption of bone in renal osteodystrophy.

In a radiographic-pathologic study of the spine and several axial joints in a cadaver with renal osteodystrophy, subchondral resorption of bone is described as an important mechanism of osseous abnormality. Widening and irregularity of the sacroilliac and sternoclavicular joints and symphysis pubis are related predominantly to trabecular destruction beneath cartilage surfaces, substitutive fibrosis, and new bone formation. Subperiosteal abnormalities at these locations produce juxta-articular erosions. The presence of osteitis fibrosa cystica about multiple Schmorl's nodes within the thoracic vertebral bodies suggests that subchondral resorption beneath the cartilage end-plates of the spine may be associated with disk protrusions and represents one further example of hyperparathyroid joint disease.

On the nature and significance of bony proliferation in "rheumatoid variant" disorders.

Radiographic and pathologic abnormalities of the peripheral joints in a cadaver with ankylosing spondylitis are described. Bony proliferation about involved articulations is is characteristic of all "rheumatoid variant" disorders and results from subchondral bony hyperplasia and periosteal new bone formation. Such proliferation may be related to the presence of the histocompatibility antigen B27 in these diseases.