Aims Many studies have previously reported a higher prevalence of papillary thyroid carcinomas (PTC) in patients with Graves' disease (GD). MicroRNAs (miRNAs) are small, non-coding RNAs that are upregulated in PTC compared with benign thyroid tissue. The objective of the study was to examine the miRNA expression of selected miRNAs that are known to be upregulated in PTC in patients with GD. Methods Paraffin embedded thyroid tissue from 159 patients with GD was screened for expression of the miRNAs 146b, 181b, 21, 221 and 222 by RT-PCR. The expression profiles of four normal thyroids, 50 PTCs without concomitant GD and 11 patients with untreated GD served as the controls. Results The expression pattern of these miRNAs in patients with GD is intermediate between that of benign thyroid tissue (p<0.001) and PTC (in three out of five miRNAs, p<0.001). This corresponds to a 15-fold change for GD versus PTC, and a 31-fold change for GD versus normal thyroid tissue. The miRNA expression in 11 papillary microcarcinomas found in our study (a prevalence of 0.07) was not different from that in PTC samples from patients without GD for four of five miRNA types. Furthermore, we found a significant difference in the expression of miRNA 221/222 between treated and untreated GD tissue. Conclusions In conclusion, we found an intermediate expression of specific miRNAs in thyroid tissue from patients with GD that fell between the expression levels found in normal thyroid glands and PTC, which suggests a possible influence of certain miRNAs on developing PTC in patients with GD.

Background. Surgery for recurrent parotid pleomorphic adenoma is a challenging problem.Methods. One hundred eight patients who underwent 134 reoperations for recurrent parotid pleomorphic adenoma (follow-up, 22 years) were evaluated for histopathologic features and risk factors for recurrence.Results. The number of reoperations for tumor recurrence ranged from 1 to 10. Twenty-seven patients(25%) developed permanent facial nerve weakness. The risks for clinically evident rerecurrence after 1, 5, and 15 years were 16%, 42%, and 75%, respectively. Female sex, young age at initial treatment, and enucleation instead of paroticlectomy for treatment of the first recurrence were significant risk factors for rerecurrence. The mean number of recurrent tumor nodules was 26.Conclusions. Surgery for recurrent parotid pleomorphic adenoma has a high rate of facial nerve morbidity. The chance of rerecurrence is high. Extended paroticlectomy seems to be the best approach for the reoperation to reduce the risk of rerecurrence. (c) 2007 Wiley Periodicals, Inc.

Embolic events during cardiac catheterization have been attributed to atherosclerotic aortic debris dislodged by catheter manipulation. We evaluated the frequency and the histologic morphology of atherothrombotic material retrieved during placement of coronary catheters in patients undergoing diagnostic or interventional cardiac procedures. Over a 4-year period, macroscopically visible aortic debris from coronary catheters, if present after advancement to the ascending aorta, was obtained for histologic examination. In 41 of 7,621 patients (0.54%), visible atherothrombotic material was present in the backflow of catheters. Debris occurred most frequently with 8 Fr guiding catheters (98%). Histologic examination showed foam cells, cholesterol crystals, and amorphic lipoid substance as markers of atheromatous material from atherosclerotic plaques in 38/41 patients (93%) with former plaque hemorrhage in 55% of them. In three patients, fresh thrombus material was observed (7%). None of these patients showed in-hospital ischemic complications. Although visible atheromatous material is a rare phenomenon in cardiac catheterization, an increased risk of scraping debris is associated with large-lumen guiding catheters. In order to avoid vascular embolization, the use of smaller guiding catheters and sufficient free backflow of catheters after advancement are recommended. (C) 2000 Wiley-Liss, Inc.

Zusammenfassung Hintergrund: Die Punktionszytologie ist in nur wenigen Kliniken Deutschlands routinemäßiger Bestandteil der präoperativen Diagnostik von Speicheldrüsenerkrankungen. Als Hauptargument gegen die Punktionszytologie wird deren fehlende therapeutische Konsequenz angeführt. Zielsetzung: Im Hinblick auf eine genauere Planung der Art der operativen Therapie wurde die Feinnadelpunktionszytologie in der Dignitätsbeurteilung von neoplastischen Erkrankungen der Ohrspeicheldrüse überprüft. Patienten und Methode: In einer von 1/92–10/95 retrospektiv durchgeführten Untersuchung wurden 336 Patienten mit Ohrspeicheldrüsentumor punktionszytologisch und histologisch untersucht. Ergebnisse: Die Sensitivität der Punktionszytologie lag bei 93,1%, die Spezifität bei 99,22%, das positive bzw. negative Befundgewicht bei 93,1 bzw. 99,22% und die Testeffizienz bei 98,59%. Komplikationen traten in weniger als 1% auf. Schlußfolgerung: Bei seltenen und nicht gravierenden Komplikationen überwiegen die Vorteile der Punktionszytologie insbesondere hinsichtlich der in der Therapieplanung wichtigen Informationen über die Dignität der punktierten Raumforderung. Für die nicht selten klinisch symtomlosen Malignome der Kopfspeicheldrüsen stellt die Punktionszytologie eine hoch spezifische und damit bei positivem Nachweis sehr verläßliche Methode zur präoperativen Dignitätsbestimmung dar.

Using perfluoromethylcyclopentane (FMCP; US patent no. 5,441,989, granted 1995) we have developed a new vitreous gas tamponade in a rabbit model that allows complete filling of the vitreous cavity without vitrectomy and without a significant increase in intraocular pressure. In humans this procedure would allow the blockage of inferior and posterior retinal holes without special positioning of the patient. Perfluoromethylcyclopentane (FMCP), a liquid perfluorocarbon with a boiling point slightly above body temperature, is injected in minute volumes into the vitreous cavity, where it vaporizes, thereby filling a gas volume approximately 500 times its liquid volume. FMCP was injected into the midvitreous in six rabbits (six eyes). After 2–3 days a complete gas tamponade was achieved in three eyes. Two eyes showed 75–90% filling, and one eye was filled only 50% with gas. Intraocular pressure was highest in the completely filled eyes, ranging from 26.6 to 38.8 mmHg. In all eyes the maximum expansion of the gas bubble lasted 2 weeks. One eye developed a retinal detachment. All eyes showed transient subcapsular cataracts. The results of this study showed that intravitreal injection of FMCP, a new perfluorocarbon liquid, results in a complete gas tamponade of the vitreous cavity which lasts 2 weeks without severe intraocular pressure rise and without vitrectomy. This procedure will be especially useful for eyes that have retinal detachment from inferior or posterior retinal holes. Injection of a conventional gas such as SF6 or C3F8 usually does not block retinal holes in inferior or posterior locations without tedious positioning and risk of (transient) glaucoma. Since the mechanism of transition of FMCP from liquid to gas in the vitreous is poorly understood, we are currently studying FMCP vaporization in an in vitro eye model.

The diabetogenic variant PV2 of encephalomyocarditis virus was cloned, and three recombinants differing in their 5' poly(C) tracts were analyzed. It is shown that the poly(C) region is not essential for infectivity in mice but does influence the virus load and degree of pathological lesions within the Langerhans' islets but not in the myocardium.

• Background: Fibrous histiocytomas of the corneoscleral limbus are rare tumors. We present an additional case and review the treatment approaches in the literature. So far, only light and electron microscopic studies have been performed. We used immunohistochemical stains to further characterize the cellular composition. • Methods: The excised lesion was routinely fixed and processed for light microscopy and immunohistochemical studies. For comparison, three dermal fibrous histiocytomas were also examined and processed similarly. • Results: The corneolimbal tumor was mainly composed of fibroblasts and histiocytes with a large amount of interstitial collagen, arranged in a storiform pattern. Immunohistochemical stains were positive for histiocytes, fibroblasts, and a marker for mesenchymal cells. The staining pattern of the dermal lesions was similar. • Conclusion: Fibrous histiocytomas of the corneolimbal region are morphologically benign, slowly growing and infiltrative tumors. Complete resection, especially of the deep margin, is suggested. The immunohistochemical staining pattern is similar to that of dermal fibrous histiocytomas, which behave in a benign manner.

The present study investigated whether functional, molecular, and biochemical alterations occurring in chronic heart failure can already be detected in compensated hypertensive cardiac hypertrophy. Force of contraction (isolated papillary muscle strip preparations), sarcoplasmic reticulum (SR) protein and myosin heavy chain isoform expression (Northern and Western blot analysis), myocardial fibrosis (collagen stains, hydroxyproline quantification), myocardial renin mRNA (RT-PCR), and angiotensin II levels and plasma aldosterone concentrations (radioimmunoassay) were studied in hypertrophied myocardium from transgenic rats harboring the mouse Ren-2d gene. Contraction and relaxation velocities of isolated papillary muscle strips were significantly reduced in cardiac hypertrophy. The beta-/alpha-myosin heavy chain ratio was significantly increased in the hypertrophied left ventricles, whereas SR Ca2+-ATPase (SERCA 2a) and phospholamban mRNA and protein levels were significantly decreased. The decrease in SERCA 2a was more pronounced than the decrease in phospholamban levels. There was no increased myocardial fibrosis. Left ventricular myocardial renin mRNA and angiotensin II concentrations, as well as plasma aldosterone levels, were higher in transgenic than in control rats. In hypertensive cardiac hypertrophy, myosin heavy chain isoform shift and reduction of SR protein levels are related to systolic and diastolic dysfunction, respectively. These alterations pre cede the development of myocardial fibrosis. Increased myocardial renin mRNA and angiotensin II concentrations suggest that an activated tissue renin-angiotensin system might contribute to these alterations. Since the alterations in compensated cardiac hypertrophy apparently precede those in chronic heart failure, they might accelerate the transition from hypertrophy to failure and could therefore be targets for pharmacological interventions.

Human herpesvirus 7 (HHV-7) was grown in a CD4+ lymphoblastic cell line (SupT1) and in cord blood mononuclear cells (CBMC). Virus infection was demonstrated by immunohistology with positive control sera, with monoclonal antibodies and by in situ hybridization for viral DNA. Cytopathic effects following HHV-7 infection generally resemble those after HHV-6 infection but are less pronounced. The ultrastructural appearance of HHV-7 and the replicative stages were similar to those described by Kramarsky and Sander for HHV-6. There were some minor discrepancies, including quite an extensive and space-filling tegument, a slightly different structure of the nucleoid, the frequent finding of nucleocapsids without any visible core and apparently scarce or delicate spikes on the envelope. These differences may suggest HHV-7 rather than HHV-6, but this finding needs confirmation. Mature HHV-7 particles measured 170 nm in diameter, with nucleocapsids of 90–95 nm and a tegument of about 30 nm.

• Background: The aim of the study was to investigate the histopathologic features of scar tissue which have proliferated at the site of trabeculectomy of surgical failures after procedures with and without the use of the antimetabolite mitomycin C (MMC).

BACKGROUND:Pyogenic granulomas are ulcerated vascular proliferations, often accompanied by inflammatory infiltrates, which rarely affect the eye. Only few reports on pyogenic granulomas of the cornea have been presented.METHODS:The enucleated globe containing the corneal tumor was examined histopathologically, and special immunohistochemical stains were performed.RESULTS:The lesion had a yellowish appearance with marked vascularization. The inflammatory infiltrate was mainly composed of mononuclear cells, with no multinucleated giant cells, and was located anterior to Bowman's layer, leaving the corneal stroma unaffected. Immunohistochemical studies outlined the high vascular content, even in dense cellular areas, and confirmed the inflammatory nature of the mononuclear infiltrates.CONCLUSIONS:Pyogenic granuloma of the cornea represents a clinical and morphological entity developing in a traumatized eye with corneal vascularization. Although the origin of these lesions remains obscure, there have been no signs of malignancy. Therefore, enucleation of an eye with a pyogenic granuloma should be avoided.

The encephalomyocarditis (EMC) virus-induced diabetes-like syndrome in mouse inbred strains was used as a model to study the insulin-dependent diabetes mellitus (IDDM). Our investigations were performed with two EMC virus variants, PV2 and PV7. After infection of SJL mice with 10(5) PFU of PV2 about 70% of the animals developed a diabetes-like syndrome, whereas the PV7 infected mice appeared healthy. Histological examination and in situ experiments revealed that the islets of Langerhans are a main target of PV2, whereas PV7 infection leads to only modest changes of the islets. Sequence analysis of both variants revealed one amino acid exchange within the capsid protein VP1. Hence, we describe the first diabetogenic and non-diabetogenic EMCV variants differing in only one single amino acid.

The quality of the morphological analysis of myocardial and coronary alterations depends essentially on the method chosen for the heart dissection. Even if previous postmortem coronary angioplasty is not feasible, the best results are obtained by transverse sectioning of the ventricles in a bread-loaf fashion subsequent to formalin-fixation and serial cross-sectioning of the coronary arteries, with decalcification in addition if necessary. The distribution pattern of disseminated myocardial necrosis, the longitudinal, circumferential and transmural extent of infarction, its age and sequelae and its correlation to the coronary supplying areas can be evaluated with better accuracy than by dissecting the heart chambers according to the flow of blood. Cross-sectioning of coronary arteries with preservation of their luminal shape allows proper examination of the degree and extent of luminal narrowing, plaque hemorrhage, parietal and occluding thrombi and the effects and complications of angioplastic procedures or bypass surgery. Transverse sectioning of the heart is a prerequisite for adequate examination following sudden cardiac death and short-term territorial ischemia. Full-thickness samples of the ventricular walls, taken systematically with respect to coronary narrowing and coronary supplying areas, enable identification of early myocardial damage.

Despite several attempts, balloon angioplasty of a slightly eccentric stenotic lesion in the proximal right coronary artery failed to result in any increase of luminal diameter. Following disruption and partial removal of a fibrous atherosclerotic cap using directional atherectomy, subsequent balloon angioplasty was highly successful.