Histopathological correlation to MRI findings during and after laser-induced thermotherapy in a pig pancreas model.

RATIONALE AND OBJECTIVES: To investigate whether percutaneous laser-induced thermotherapy (LITT) with continuous magnetic resonance (MR) monitoring of thermal effects within the pancreas is feasible in a porcine model. METHODS: Laser applicators were placed in the pancreas of 15 female pigs. A temperature-sensitive (thermo--fast low-angle shot) sequence was used for continuous monitoring of thermal effects during LITT at 1.5 T. Follow-up MR images were acquired, the pigs were observed for 7 days, and then a pathological examination was performed after sacrifice. RESULTS: Continuous MR monitoring visualized thermal effects in pancreatic tissue and thermal damage of the spleen (n = 1), the left kidney (n = 1), and peripancreatic fat (n = 4) but missed the thermal damage of the duodenum (n = 2). Thermal-induced lesions (10--32-mm diameter) were clearly visualized on contrast-enhanced T1-weighted images. CONCLUSIONS: Laser-induced thermotherapy of pancreatic tissue was feasible in this porcine model, and online monitoring was practicable. Further studies are necessary to increase the accuracy of online MR imaging of thermal effects.

Osteochondroma of the mandibular condyle: a case report.

A case of osteochondroma of the right mandibular condyle in a 47-year-old woman is presented. Instead of condylectomy, surgical resection was performed, resulting in fewer functional changes and less dysfunction of the temporomandibular joint but recurrence within 12 months after surgery.

[Ruthenium 105-applicator for radiation treatment of carcinoma in situ of the cornea and conjunctiva]. / Ruthenium 106-Applikator zur Radiatio eines Carcinoma in situ der Kornea und Konjunktiva.

Intraepithelial neoplasias of cornea and conjunctiva are rare epibulbar tumors. In this report we describe the cases of two male patients, aged 37 and 80 years, each with histologically confirmed carcinoma in situ of the cornea and conjunctiva affecting one eye. Both carcinomas recurred in spite of complete surgical excision of the tumor. One patient had additional cryotherapy. Both recurrences were treated once with radiotherapy using a conventional 106Ru applicator. The applicator was fixed to the sclera adjacent to the corneal limbus. A 100 Gy radiation dose was delivered with 2mm tissue penetration. No complications were observed post-operatively. The 2-year follow-up examinations showed no further recurrences. Brachytherapy with 106 Ru applicator was thus effective in achieving local tumor control. These findings suggest brachytherapy of the anterior segment using the 106 Ru applicator as the first-line procedure in the early stages of epithelia dysplasia or carcinoma in situ.

Expanded human meniscus-derived cells in 3-D polymer-hyaluronan scaffolds for meniscus repair.

Treatment options for lesions of the avascular region of the meniscus using regenerative medicine approaches based on resorbable scaffolds are rare. Recent approaches using scaffold-based techniques for tissue regeneration known from cartilage repair may be a promising treatment option for meniscal tears. The aim of the study was the investigation of meniscus matrix formation of in vitro expanded human meniscus-derived cells in a three-dimensional (3-D) bioresorbable polymer graft for meniscal repair approaches. Cultivation of the human meniscus cells was performed in a resorbable scaffold material made of polyglycolic acid (PGA) and hyaluronic acid, stabilized with fibrin glue. Cell viability and distribution of human meniscus cells in PGA-hyaluronan scaffolds were evaluated by fluorescein diacetate and propidium iodide staining. Verification of typical meniscal extracellular matrix molecules like type I and type III collagen was performed histologically, immunohistochemically and by gene expression analysis. In results, 3-D scaffold-based meniscus cultures showed high cell viability over an observational period of 21 days in PGA-hyaluronan scaffolds. On the protein level, type I collagen and proteoglycans were evident. Gene expression analysis confirmed the re-expression of meniscus-specific markers in PGA-hyaluronan scaffolds. This study demonstrated that in vitro expanded human meniscus cells allow for formation of meniscal matrix components when cultured in 3-D PGA-hyaluronan scaffolds stabilized with fibrin. These results encourage scaffold-based approaches for the treatment of meniscal lesions.

[Carcinoma in situ of the conjunctiva bulbi. Clinical and histopathologic findings]. / Carcinoma in situ der Conjunctiva bulbi. Klinische und pathohistologische Befunde.

The present paper communicates clinical and pathohistologic findings in a case of carcinoma in situ of the conjunctiva (Bowen's disease) with a five-year course. Initially, there are clinical similarities between Bowen's disease and Mooren's ulcer; the diagnosis can be established on the basis of the histologic findings. In this case the clinical picture at first resembled that of Mooren's ulcer. An epithelial dysplasia was confirmed histologically following perilimbal conjunctivectomy. A year later the dysplasia was found to have progressed and was treated by diathermy coagulation. At the check-up examination three months later the tumor had diminished in size. Four years later, however, it had redeveloped. As a rule, tumor excision is the treatment of choice. In the case described here it was first coagulated by diathermy because of its great extent, but this only brought the tumor to a temporary standstill.

Use of endorectal surface coil magnetic resonance imaging for diagnosis of a multicystic seminal vesicle with ipsilateral renal agenesis.

We report a symptomatic multicystic seminal vesicle with ipsilateral renal agenesis in a 37-year-old man. Preoperatively the diagnosis could be suggested by different imaging modalities, including endorectal surface coil magnetic resonance imaging. To our knowledge, we present the 1st case of seminal vesicle cyst to be evaluated by magnetic resonance imaging using a rectal coil. The value of different imaging modalities is discussed.

Differential expression of apoptosis, Bcl-x and c-Myc in normal and malignant lymphoid tissues.

Bcl-x and c-Myc have an important role for the immune response by regulating the programmed cell death (apoptosis) of lymphocytes. Dysfunction of these selection processes can lead to the development of malignant lymphoma. The present study aimed at defining the differential expression of apoptosis, Bcl-x and c-Myc in normal and in malignant lymphoid tissues. Follicular centre lymphoma (FCL-F) and mantle cell lymphoma (MCL) contained the lowest apoptotic indices (AIs), whereas Burkitt's lymphoma (BL) had the highest AIs. The AIs correlated significantly with the growth rates of the tumours and with the extent of Bcl-x expression. Bcl-x was expressed in almost all BL cells, but in few tumour cells in FCL-F and in MCL. c-Myc, in contrast, was found in the majority of the tumour cells in FCL-F and in MCL, but not in BL. Whereas the extent of Bcl-x expression correlated positively with the growth rates, an inverse correlation was observed between the percentages of c-Myc-positive tumour cells and the growth rates of the tumours. We conclude that normal and malignant lymphoid tissues have a distinct pattern of apoptosis and that expression of Bcl-x and c-Myc in B cell lymphoma is differentially regulated.

Role of F18-FDG PET for monitoring of radiochemotherapy -- estimation of detectable number of tumour cells.

BACKGROUND: FDG-PET has been proven to be useful for the diagnosis of pancreatic cancer. However, no quantitative data exist concerning its sensitivity for treatment monitoring or early diagnosis. CASE REPORT: We report on a 61-year-old patient with locally advanced cancer of the pancreas head who received sequential radiochemotherapy including gemcitabine and 5-FU/FA. Under this regimen, MR and CT showed a partial remission with a residual mass which seemed to allow surgical treatment for this patient. A pre-operative FDG-PETScan displayed a count rate close to the detection limit of vital residual tumour. An R0 resection was performed successfully. However, histopathology revealed residual tumour at the core of the resected mass that had gone undetected by all imaging modalities. CONCLUSION: The number of vital tumour cells within this specimen was estimated to be 10(6)-10(7). The detection threshold for FDG-PET in pancreatic carcinoma appears to be within this range.