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Objective:This study aimed to evaluate the role of 3 Tesla magnetic resonance imaging in predicting tongue tumour thickness via direct and reconstructed measures, and their correlations with corresponding histological measures, nodal metastasis and extracapsular spread.Methods:A prospective study was conducted of 25 patients with histologically proven squamous cell carcinoma of the tongue and pre-operative 3 Tesla magnetic resonance imaging from 2009 to 2012.Results:Correlations between 3 Tesla magnetic resonance imaging and histological measures of tongue tumour thickness were assessed using the Pearson correlation coefficient: r values were 0.84 (p < 0.0001) and 0.81 (p < 0.0001) for direct and reconstructed measurements, respectively. For magnetic resonance imaging, direct measures of tumour thickness (mean ± standard deviation, 18.2 ± 7.3 mm) did not significantly differ from the reconstructed measures (mean ± standard deviation, 17.9 ± 7.2 mm; r = 0.879). Moreover, 3 Tesla magnetic resonance imaging had 83 per cent sensitivity, 82 per cent specificity, 82 per cent accuracy and a 90 per cent negative predictive value for detecting cervical lymph node metastasis.Conclusion:In this cohort, 3 Tesla magnetic resonance imaging measures of tumour thickness correlated highly with the corresponding histological measures. Further, 3 Tesla magnetic resonance imaging was an effective method of detecting malignant adenopathy with extracapsular spread.

Ischemic colitis with colonic necrosis is one of the uncommon gastrointestinal complications of systemic lupus erythematosus. In the few reported cases, only the abdominal part of the colon was involved with rectal sparing. This is the first report of gangrenous ischemic colitis isolated to the rectum, due to systemic lupus erythematosus vasculitis.

To find out if clearance of surgical colectomy specimens with xylene gave a higher yield of lymph nodes and more accurate staging than the traditional step-sectioning technique.Consecutive open study.Private hospital, United States.84 specimens from colonic resections, 4 of which were total colectomies and the remaining 80 segmental resections.The first 41 (2 colectomies and 39 segmental resections) were cleared by step-sectioning alone (to establish baseline values). The remainder (n = 2 and 41, respectively) were step-sectioned, the lymph nodes were removed, and then the residual tissue was cleared with xylene.The number of lymph nodes found, and if the diagnosis was changed by the finding of additional nodes.The baseline values in the two total colectomy specimens were 76 and 101, and the mean (range) after segmental colectomy was 21 (1-98). The values after total colectomy in the second group were 33 and 73, and after xylene clearance an additional 12 and 17 nodes were found. After segmental colectomy a mean (range) of 13 (0-43) was found, and an additional 4 (0-12) were found after xylene clearance. No additional nodes containing metastases were found in total colectomy specimens after xylene clearance, and only 6 additional nodes after segmental resection contained metastases. These changed the histological stage of the disease in only 2 patients.Xylene clearance offers little advantage over careful traditional step-sectioning of specimens, but may be of value if the histopathologist does not do routine meticulous step-sectioning.

The distinction of lymphomatous or leukemic lymphocytes from reactive lymphocytes in the cerebrospinal fluid (CSF) is of great clinical significance and is usually readily accomplished on morphologic grounds. However, the "malignant" lymphocytes of chronic lymphocytic leukemia (CLL) are mature and therefore closely resemble reactive lymphocytes in cytocentrifuged CSF preparation. We recently studied a patient with CLL [white blood cell (WBC) count of 30,700/μL with 72% lymphocytes] who developed a prominent lymphocytosis in the CSF (WBC, 1,700 μL with 98% lymphocytes). The morphology of the CSF lymphocytes suggested leukemic involvement of the central nervous system (CNS); however, immunologic analysis was not confirmatory. The peripheral blood lymphocytes were demonstrated to be monoclonal for kappa light chains consistent with a B-cell lymphoproliferative disorder, whereas 95% of the lymphocytes in the CSF were positive for T11 antigen, a marker for mature T-cells. This report demonstrates the utility of immunophenotyping studies as an adjunct to the differential diagnosis of neoplastic versus nonneoplastic involvement of the CNS in disorders such as CLL in which morphologic differentiation may be difficult.

This report describes a method for the direct preparation of chromosomes from the hepatocytes and bone marrow of the same Chinese hamster (Cricetulus griseus). The technique is a modification of that described by Becker et al. (J. natl. Ca. Inst. 46: 1261–69, 1971) for rat hepatocytes, with the following significant differences: (1) a less extensive partial hepatectomy is employed to initiate hepatocyte regeneration, (2) the use of a larger initial dose of colchicine (4 mg/K) 46–48 hours after hepatectomy instead of 1 mg/K 24 hours after hepatectomy, (3) the use of 0.075 M KCl as hypotonic solution instead of fetal calf serum diluted 1 : 7 with distilled water and (4) flame or blaze drying of chromosome preparations instead of air drying. The combination of the above modifications gave abundant, clear and well-spread chromosomes.

Prostacyclin (PGI2) has been used extensively in human clinical trials and animal studies, but because of its instability, knowledge of its pharmacokinetics has progressed slowly. We assayed plasma PGI2 concentrations with a quantitative chromatographic method following bolus intravenous injection and during continuous infusion in rabbits. Blood pressure response was correlated with plasma PGI2 concentrations and compared with the concentrations necessary to inhibit platelet aggregation in vitro. A two-compartment model was used to analyze the elimination kinetics for PGI2 after a single injection. The half-life of the terminal elimination phase was 2.7 minutes. The calculated systemic clearance and whole body volume of distribution were 93 ml/kg/min and 357 ml/kg, respectively. During continuous infusion, steady-state plasma concentrations were reached within 15 minutes and increased linearly with increasing infusion rate from 4.2 to 604 ng/kg/min, which resulted in PGI2 concentrations of 0.06 +/- 0.01 to 7.6 +/- 2.1 ng/ml, respectively. At steady-state plasma concentrations of PGI2 greater than 0.1 ng/ml, the mean arterial blood pressure decreased in a concentration-dependent manner, reaching a decrease of 45 mm Hg when the plasma concentration was 7.6 ng/ml. Prostacyclin caused a concentration-dependent inhibition of adenosine diphosphate-induced platelet aggregation in vitro with 10% inhibition at 0.4 ng/ml. These results indicate that in the rabbit the level of PGI2 at which the onset of hypotension occurs coincides with the inhibition of platelet aggregation.

Unequivocal establishment of the correct diploid chromosome number in 1956 started the modern era of human cytogenetics. The next impetus came when the peripheral blood leukocyte culture technique for the chromosome preparation was described in 1960. Discovery of special staining procedures - banding techniques - in early seventies not only saved it from early senescence but played decisive roles in broadening the horizons of modern human cytogenetics.

The purpose of this investigation was to study the effects of a selective thromboxane A2 (TXA2) synthetase inhibitor U.K. 38,485 (TSI) upon the evolution of cerebral infarction in the cat.

Factor VIII assays are the most common specific coagulation factor assay performed in the United States. Interlaboratory proficiency studies have documented persistent problems with variation in results between laboratories. The Coagulation Resource Committee of the College of American Pathologists conducted a workshop to analyze variables that may affect performance of the one-stage factor assay. The results indicate that accuracy of the assay can be improved by uniform standardization of reference plasma samples and that reproducibility can be enhanced through appropriate choice of reagents and instruments. Optimizing performance of this assay should lead to more reproducible interlaboratory results.

Fluorescein is a reliable indicator of mucosal viability in dogs. This fact is probably applicable to humans. The Doppler device was not a reliable predictor of intestinal nonviability, and in the instance of mesenteric venous occlusion, with ischemic intestine, it was totally inaccurate in assessing intestinal viability. Short segments of intestine failing to take up fluorescein stain will retain viability, owing to the lesser nutrient requirements of resting smooth muscle. However, segments should not be used for anastomoses, since the mucosa will, to some degree be ischemic.

We describe briefly and comment upon the salient strengths and limitations of the major published theories that purport to explain the mechanism of contrecoup cerebrocortical contusions. Through the application of mechanical principles, we then present a modification, clarification, and expansion of selected aspects of several theories. Our final formulation emphasizes the injurious potential of nonuniform compressive stress and the relationship between brain lag and rotationally induced injury. The resulting theory remains faithful to the laws of physics while explaining the location and distribution of cerebrocortical contusions opposite the site of a moving head impact.

The VA Hospital in Columbia, MO, and the University of Missouri Medical Center conduct the largest shared laboratory service in the VA hospital system. Sharing has enabled these institutions to eliminate unnecessary duplication of resources, develop new laboratory capabilities in subspecialties, handle additional routine procedures, better use the expertise of senior staff pathologists, develop uniform standards, enhance quality assessment, and expand training programs.

Fifty-eight patients with clinical inflammatory breast carcinoma and 15 patients with "occult" inflammatory cancer (dermal lymphatic carcinomatosis without clinical inflammation) are grouped and reviewed to determine whether diagnosis is pathologic or clinical. All cases represent a retrospective study of records from the Ellis Fischel State Cancer Hospital, Columbia, Missouri. Lesions of clinically apparent and occult inflammatory carcinoma demonstrate similar gross and microscopic growth patterns, histologic types, axillary involvement and early widespread metastases. Regardless of pathologic evidence of dermal lymphatic tumor, patients with clinical inflammation had rapid deterioration. Cases with only a pathological diagnosis were slightly less fulminant in progression. Either clinical or pathologic criteria justify use of the term "inflammatory breast carcinoma" to indicate short-term prognosis despite available treatment.

Twenty-two patients were selected from a group of 33 patients who underwent recombinant human tissue-type plasminogen activator (rt-PA) thrombolysis for thrombosed infrainguinal bypass grafts of the lower extremity and were compared with 38 matched patients who had undergone surgical thrombectomy during the same period. The proportion of persons with diabetes mellitus, smokers, and types of bypass grafts was similar in both groups. More patients in the rt-PA-treated group had hypertension (p = 0.01). To evaluate the different lengths of follow-up, Kaplan-Meier survival analysis was used with a log-rank test to compare the proportion of persons with patent grafts in the two treatment groups. At 30 days, 86% of the rt-PA-treated grafts were still patent compared with 42% of the surgically treated grafts (p = 0.001). When risk factors on the Kaplan-Meier curves were compared, there was no statistical difference with regard to graft patency among the groups. According to simultaneous Cox regression analysis, no risk factor was significantly associated with graft patency. When amputation was evaluated between treatment groups simultaneously with other risk factors in a logistic regression analysis, smoking and age of the graft were marginally significant (p = 0.07), whereas all other factors were clearly not significant. In 91% of the rt-PA-treated patients, a secondary surgical procedure was required to maintain patency of the graft segment. Eighty-nine percent of the surgically treated patients required similar graft revisions. Two patients in the surgical group and one patient in the rt-PA-treated group had major complications.(ABSTRACT TRUNCATED AT 250 WORDS)

During protein depletion produced by plasmapheresis and a very low protein diet there is a proportionately greater decrease in extravascular, extracellular fluid protein than in plasma protein. A shift in the normal ratio of protein in these 2 compartments, approximately 1 to 1 in the dog, to over 2 to 1 as a result of depletion indicates an important, labile source of reserve protein for the plasma in the interstitial fluids. This reserve source is limited since a maximum drop of 50 per cent in the total exchangeable pool and of 75 per cent in the extravascular, extracellular protein occurred after both shorter and longer periods of depletion. Under the rigid conditions of these experiments additional plasma protein removal was associated with loss of weight despite adequate caloric intake. Investigation of the status of the interstitial fluid proteins in other conditions associated with disturbed protein metabolism seems warranted.