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  • 1
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Introduction: Mutations of lamin A/C gene (LMNA) cause dilated cardiomyopathy (DCM) with atrioventricular (AV) conduction defect, although the electrophysiological and histological profiles are not fully understood. Methods and Results: We analyzed a large Japanese family (21 affected and 203 unaffected members) of DCM with AV block. The responsible LMNA mutation of IVS3–10A〉G was novel and caused an aberrant splicing. The first clinical manifestation was low-grade AV block or atrial fibrillation (AF), which developed in affected members aged ≥30 years. We observed that the AV block progressed to third-degree within several years. The electrophysiological study of the four affected members revealed an impairment of intra-AV nodal conduction. Because of advanced AV block, pacemakers were implanted in 14 out of 21 affected members at the mean age of 44 years. Three affected members died suddenly and two affected members died of heart failure and/or ventricular tachycardia (VT) even after the pacemaker implantation. Postmortem examination showed conspicuous fibrofatty degeneration of the AV node. Endomyocardial biopsies showed remarkably deformed nuclei and substantial glycogen deposits in the subsarcolemma. Conclusion: The clinical phenotype in this family was characterized by (1) the first manifestation of the prolonged PQ interval or AF in adolescence, (2) progressive intra-AV nodal block to the third degree in several years, and (3) progressive heart failure after pacemaker implantation. Histological study revealed preferential degeneration at the AV node area and novel cellular damages in the working myocardium.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1442-2042
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract A 71-year-old man was first diagnosed with primary transitional cell carcinoma of the prostate with a skip lesion on the distal urethra. The patient received three courses of intra-arterial chemotherapy of cisplatin (CDDP) and pirarubicin (THP-ADM) followed by a radical prostatectomy. Histopathologic examination of the prostatectomy specimen revealed adenocarcinoma invasion along the prostatic duct extending to the peripheral acini, which was diagnosed as ductal adenocarcinoma. The clinical and histopathologic features of this case are entirely different from usual adenocarcinomas of the prostate. This rare histopathologic feature should be recognized as ‘ductal carcinoma of the prostate’, to distinguish it from papillary adenocarcinoma or adenocarcinoma with endometrioid features. The patient has had no sign of recurrence 14 months after the operation. CDDP-based chemotherapy followed by radical prostatectomy may be one of the promising therapeutic modalities for this rare entity.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Copenhagen : Munksgaard International Publishers
    Journal of oral pathology & medicine 29 (2000), S. 0 
    ISSN: 1600-0714
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract: A case of clear cell odontogenic tumor with unusual histological features is presented. A 61-year-old Japanese man was admitted because of swelling of the left premolar-molar region of the mandible. Radiological examination revealed a multilocular radiolucency with irregular margins. Histological examination of the resected specimen showed infiltrative proliferation of both clear and eosinophilic cells into the adjacent soft tissue without encapsulation, suggesting the malignant potential of the tumor. The tumor cells sporadically formed cystic lesions. In addition, several tumor cell nests showed duct-like characteristics, and many eosinophilic dentin-like structures were attached to the tumor cell nests, suggesting the potential for epithelial-mesenchymal induction. Histochemically, the clear tumor cells possessed cytoplasmic glycogen granules. Both clear and eosinophilic tumor cells showed positive immunoreactivities for cytokeratin 19, epithelial membrane antigen and filaggrin, indicating an odontogenic epithelial origin.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of oral pathology & medicine 21 (1992), S. 0 
    ISSN: 1600-0714
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The clinical, morphologic and immunohistochemical features of 10 cases of the low-grade mucosa-associated lymphoid tissue (MALT) lymphoma of salivary glands are described. Although the initial histologic diagnosis in nine of these cases was myoepithelial sialadenitis, the diagnosis of primary salivary gland MALT lymphoma was based on the demonstration of light chain restriction and on morphologic characteristics. Histologic study showed a characteristic cytology, which included centocytoid cells (composed of small centrocytes and monocytoid B cells) and a varying degree of plasma cell differentiation; the occurrence of epithelial or acinar invasion by neoplastic centrocytoid cells; and the presence of reactive lymph follicles among the neoplastic cells. Furthermore, multinucleate giant cells resembling Warthin-Finkeldey cells were detected in seven cases. In the light of these findings, cases previously diagnosed as myoepithelial sialadenitis require careful assessment and nine out of 32 cases are, in reality, examples of primary salivary gland MALT lymphomas. Immunohistochemical analysis of paraffin sections revealed the following characteristic immunophenotype of Malt lymphoma: L26, KiB3 and LN2 positive, and a monotypic immunoglobulin pattern (predominantly IgM/K). It was of interest that salivary gland parenchyma, infiltrated by neoplastic centrocytoid cells, reacted with LN3 for cells expressing human leukocyte antigen-DR (HLA-DR) antigens. Whereas salivary gland epithelia devoid of a neoplastic invasion were invariably negative for LN3. This suggests a lymphocyte-mediated role in salivary epithelial HLA-DR expression. It appears that HLA-DR expression is an inducible phenomenon in MALT lymphomas of salivary gland.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1573-7217
    Keywords: breast cancer ; intraductal carcinoma ; intraductal papilloma ; atypical structure ; 3-D reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The basic architectural pattern of intraductal proliferative lesions of the breast was established by reconstructing serial sections of luminal spaces and interluminal areas of glandular structures. The materials were surgical specimens from twenty patients with intraductal carcinoma, papilloma, papillomatosis, or so-called borderline lesion. In papilloma and papillomatosis, the luminal spaces were tubular and interconnected forming a three-dimensional (3-D) network, whereas carcinoma was a porous structure with dispersed lumina. The latter represented 3-D atypical structure in intraductal carcinoma. In borderline lesion the architecture was an intermediate type, with separate lumina partially transformed into tubular shapes. It was also confirmed that the porous structure of carcinoma observed in 3-D reconstructions corresponded to the cribriform pattern seen in 2-D figures, while the network of papilloma produced a complex glandular pattern. A geometric parameter was devised to measure the different 3-D patterns of lumina and their 2-D expressions. It was concluded that the 3-D architectural pattern of intraductal proliferations was sufficiently characteristic to be of diagnostic value in differentiating these diseases.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Breast cancer research and treatment 4 (1984), S. 117-128 
    ISSN: 1573-7217
    Keywords: breast pathology ; duct papillomatosis ; intraductal papilloma ; three-dimensional reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Surgical specimens from fifteen patients with intraductal papilloma were reconstructed three-dimensionally from semi-serial sections to visualize the intraductal distribution of papillomas. Our results showed two basically different papillomas. In five patients, the papillomas were single and originated in the large ducts such as the segmental or subsegmental duct, but did not involve the terminal ductal-lobular units (TDLU); this type corresponded to the so-called solitary papilloma. In the remaining ten specimens, the papillomas were multifocal three-dimensionally; each had a root in the TDLU and spread into the large ducts, suggesting its purely peripheral origin. In view of this striking difference, and of possible canceration of ductal peripheries, a nomenclature of peripheral vs central papillomas is proposed instead of the conventional multiple vs solitary. Duct papillomatosis, invariably situated within the TDLU, was shown to be a continuation of peripheral papilloma and was regarded accordingly as a prepapillomatous condition.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0730-2312
    Keywords: Computer-assisted 3-D structural analysis ; morphometry ; intraepithelial glandular neoplasia ; multivariate analysis ; Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: To discriminate among intraepithelial neoplasms, we have been relying on tissue microscopy, but pathologists' subjectivity sometimes impairs diagnosis. Even an individual pathologist is sometimes unable to reproduce exactly his or her own previous diagnosis. Are various atypical lesions classifiable in a reproducible way, and if they are, how? The reliability of a diagnosis will be strengthened if we can define the “natural” categories inherent in cells or tissues. Morphometry and statistical analysis using a computer can provide answers.Atypia, a morphological feature of carcinoma, is essentially multivariate. Quantification of a tissue feature requires reducing it to a set of ten or more quantities, including size, shape and position of the nucleus, nucleolus, and the cell itself. The grade of aberration from the norm can be assessed only by a synthetic approach, using a computer for multivariate cluster analysis. This classification has been attempted in adenocarcinoma and related lesions of the lung and pancreas. The categories thus established are reproducible, because the lesions fall into distinct divisions according to their forms. We can also examine the organ distribution of intraepithelial neoplasms by three dimensional (3-D) computer-assisted mapping.To reach a higher level of reliability, as many meaningful features as possible should be taken into account. Particularly, we emphasize the significance of architectural pattern as a biomarker for intraepithelial glandular neoplasms. Computer-aided 3-D structural analysis visualizes the basic skeleton of these neoplasms around which the cells adhere. Instead of the dichotomous tree pattern of normal glands, the tumors basically harbor a 3-D network, tubular or porous, which increasingly deviates from the norm along with the transition from adenoma to well to moderately to poorly differentiated adenocarcinoma. This structural aberration, if recognizable on 2-D sectional images, will serve as a surrogate endpoint biomarker for glandular tumors.
    Additional Material: 5 Ill.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    New York, N.Y. : Wiley-Blackwell
    Journal of Cellular Biochemistry 59 (1995), S. 147-150 
    ISSN: 0730-2312
    Keywords: Aspiration cytology ; cluster analysis ; computer-assisted image analysis ; endometrial carcinoma ; morphometry ; multivariate analysis ; Life and Medical Sciences ; Cell & Developmental Biology
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Notes: Morphometric and multivariate statistical methods were used to discriminate endometrial carcinoma from bengin cells in cytologic studies. Clumps of epithelial cells that appeared most diagnostically relevant were selected from aspirated sample of 70 endometrial cancer patients. The cells'cytologic character was reduced to a combination of five quantitive parameters - nuclear size, degree of anisokaryosis, nuclear from index, homogeneity of nuclear chromatin texture, and regularity of nuclear arrangement. The 5-variate cluster analysis demonstrated that the 70 cases could be classified into three definite groups: Group A (17 cases) was characterzied by cells of small nuclear size, slight anisokaryosis, homogeneous chormatin texture and regular arrangment; Group C (12 cases) by cells of large nuclear size, marked anisokaryosis, heterogeneous chromatin texture, and irregular nuclear arrangement; and Group B (41 cases) by cells of parametere value. Group C was derived from 10 cases of adenocarcinoma and 2 of atypical hyperplasis, while groups A and B were not derived from any cases of malignancy. The computer-assisted morphometric statistical method can objectively classify the endometrials cells into malignant and begin, with improved validity and reproducibility. The cytopathologic finding, if detected by this mathod, may serve as a surrogate endpoint biomarker.
    Additional Material: 1 Ill.
    Type of Medium: Electronic Resource
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