ABSTRACT
CIB1 (calcium and integrin binding protein 1) is a small intracellular protein with numerous interacting partners, and hence has been implicated in various cellular functions. Recent studies have revealed emerging roles of CIB1 in regulating cancer cell survival and angiogenesis, although the mechanisms involved have remained largely undefined. In investigating the oncogenic function of CIB1, we initially found that CIB1 is widely up-regulated across a diverse range of cancers, with this upregulation frequently correlating with oncogenic mutations of KRas. Consistent with this, we found that ectopic expression of oncogenic KRas and HRas in cells resulted in elevated CIB1 expression. We previously described the Ca2+-myristoyl switch function of CIB1, and its ability to facilitate agonist-induced plasma membrane localisation of sphingosine kinase 1 (SK1), a location where SK1 is known to elicit oncogenic signalling. Thus, we examined the role this may play in oncogenesis. Consistent with these findings, we demonstrated here that over-expression of CIB1 by itself is sufficient to drive localisation of SK1 to the plasma membrane and enhance the membrane-associated enzymatic activity of SK1, as well as its oncogenic signalling. We subsequently demonstrated that elevated levels of CIB1 resulted in full neoplastic transformation, in a manner dependent on SK1. In agreement with our previous findings that SK1 is a downstream mediator of oncogenic signalling by Ras, we found that targeting CIB1 also inhibited neoplastic growth of cells induced by oncogenic Ras, suggesting an important pro-tumorigenic role for CIB1. Thus, we have demonstrated for the first time a role for CIB1 in neoplastic transformation, and revealed a novel mechanism facilitating oncogenic signalling by Ras and SK1.
Subject(s)
Calcium-Binding Proteins/genetics , Neoplasms/genetics , Phosphotransferases (Alcohol Group Acceptor)/genetics , Proto-Oncogene Proteins p21(ras)/genetics , Calcium/metabolism , Carcinogenesis/genetics , Cell Line, Tumor , Cell Membrane/genetics , Cell Survival , Gene Expression Regulation, Neoplastic/genetics , Humans , Neoplasms/pathology , Proto-Oncogene Proteins p21(ras)/biosynthesisABSTRACT
Abstract We report six new occurrence records of the bush dog Speothos venaticus, a widely distributed South American carnivore that is threatened with extinction. These records are accompanied by notes on the places where the records were made, such as vegetation type, date and information about the protection of areas. The records, obtained over the last 17 years in Paraná state, southern Brazil, offer an improved understanding of the species geographic range and the threats it faces and can enable better assessments of the conservation status of the species in southern Brazil.
Resumo Apresentamos seis novos registros de ocorrência do cachorro-do-mato-vinagre Speothos venaticus, um carnívoro sul Americano de ampla distribuição geográfica, porém ameaçado de extinção. Os registros são acompanhados de notas sobre os locais onde foram obtidos, tais como: tipo de vegetação, datas e informações sobre a proteção das áreas. Os registros, obtidos ao longo dos últimos 17 anos no Estado do Paraná, na região sul do Brasil, oferecem uma maior compreensão acerca da distribuição geográfica e das ameaças que a espécie enfrenta, permitindo melhores avaliações sobre o status de conservação desta espécie no sul do Brasil.
Subject(s)
Animals , Endangered Species , Canidae , Brazil/epidemiology , Population Dynamics/statistics & numerical dataABSTRACT
We report six new occurrence records of the bush dog Speothos venaticus, a widely distributed South American carnivore that is threatened with extinction. These records are accompanied by notes on the places where the records were made, such as vegetation type, date and information about the protection of areas. The records, obtained over the last 17 years in Paraná state, southern Brazil, offer an improved understanding of the species geographic range and the threats it faces and can enable better assessments of the conservation status of the species in southern Brazil.
Subject(s)
Canidae , Endangered Species , Animals , Brazil/epidemiology , Population Dynamics/statistics & numerical dataABSTRACT
BACKGROUND AND STUDY AIMS: Limited data are available on the endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) characteristics of cystic pancreatic neuroendocrine tumors (CPanNets). The aims of this study were to describe the EUS and FNA characteristics of pathologically confirmed CPanNets and to compare these characteristics with mucinous cysts from matched patients. PATIENTS AND METHODS: From an EUS - FNA database (between 1999 and 2011), 19 patients with a pathologically confirmed CPanNet were identified. Patient characteristics, cyst fluid carcinoembryonic antigen (CEA) levels, pathology, and EUS findings were analyzed. For comparison, age- and sex-matched patients with mucinous cysts were randomly chosen from the same database. RESULTS: Of the 19 patients, two had multiple endocrine neoplasia type 1 and two had metastases. The median diameter of the lesions was 24 mm. EUS revealed unilocular lesions in 7 patients, thinly septated lesions with thin walls in 1, and mixed solid-cystic lesions in 11. EUS - FNA cytology confirmed neoplasm in 12 of the 19 patients (63.2 %). The median cyst fluid CEA level (n = 15) was 1.1 ng/mL (range 0.3 - 500 ng/mL). Compared with matched patients with mucinous cysts, the median cyst fluid CEA was lower (1.1 ng/mL vs. 400 ng/mL), thick walls were more common (66.7 % vs. 13.3 %), and diagnostic cytology was more likely (73.3 % vs. 20.0 %). CONCLUSIONS: Analysis of EUS and FNA results showed that the cyst fluid from CPanNets had a lower CEA concentration, a higher frequency of thick walls on EUS, and higher diagnostic cytology compared with mucinous cysts. These findings may aid in the diagnosis of CPanNets.
Subject(s)
Endoscopic Ultrasound-Guided Fine Needle Aspiration , Neoplasms, Cystic, Mucinous, and Serous/diagnostic imaging , Neuroendocrine Tumors/diagnostic imaging , Pancreatic Neoplasms/diagnostic imaging , Adult , Aged , Aged, 80 and over , Carcinoembryonic Antigen/metabolism , Endosonography , Female , Humans , Male , Middle Aged , Neoplasms, Cystic, Mucinous, and Serous/metabolism , Neoplasms, Cystic, Mucinous, and Serous/pathology , Neuroendocrine Tumors/metabolism , Neuroendocrine Tumors/pathology , Pancreatic Cyst/diagnostic imaging , Pancreatic Cyst/metabolism , Pancreatic Neoplasms/metabolism , Pancreatic Neoplasms/pathology , Statistics, NonparametricABSTRACT
BACKGROUND: Lymphangioma of the pancreas is an extremely rare benign tumour of lymphatic origin, with only four cases diagnosed by EUS-FNA reported to date. METHODS AND MATERIALS: Five cases of either cytologically or histologically diagnosed pancreatic lymphangioma with pre-operative cytological analysis by EUS-FNAC were reviewed. RESULTS: All patients were female, with a mean age of 56.4 years. By imaging, the cystic lesions ranged in size from 2 to 7 cm (mean 4.5 cm) and were mainly located in the head of the pancreas. All cysts had thin walls and no cyst demonstrated a mural nodule. Diagnosis based on imaging features was benign in all cases due to the absence of high-risk features. Four samples were sent for biochemical analysis, which showed low CEA levels (range, <0.5-19.4 ng/ml; mean, 5.45 ng/ml) and CA 19.9 and CA 72.4 levels within normal range. All cyst fluids showed numerous small lymphocytes with no atypia; no epithelial cells were present, including no gastrointestinal contamination. Flow cytometry in two cases showed T lymphocytes with a mature phenotype. Surgical resection in two patients confirmed the cytological diagnosis. Benign clinical follow-up was available in three patients at 2, 3 and 3.5 years. CONCLUSION: A multimodal approach to cytological diagnosis (combining clinical, radiological and cyst fluid gross, biochemical and cytological characteristics) can lead to the diagnosis of this cystic neoplasm and distinguish it from other more common cysts in the pancreas, potentially avoiding the need for unnecessary surgery.
Subject(s)
Cytodiagnosis , Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods , Lymphangioma/diagnosis , Pancreatic Neoplasms/diagnosis , Adult , Aged , Female , Flow Cytometry , Humans , Lymphangioma/pathology , Middle Aged , Pancreas/pathology , Pancreatic Neoplasms/pathology , Preoperative PeriodABSTRACT
FTY720 is a recently approved first line therapy for relapsing forms of multiple sclerosis. In this context, FTY720 is a pro-drug, with its anti-multiple sclerosis, immunosuppressive effects largely elicited following its phosphorylation by sphingosine kinase 2 and subsequent modulation of G protein-coupled sphingosine 1-phosphate (S1P) receptor 1 that induces lymphopenia by altering lymphocyte trafficking. A number of other biological effects of FTY720 have, however, been described, including considerable evidence that this drug also has anti-cancer properties. These other effects of FTY720 are independent of S1P receptors, and appear facilitated by modulation of a range of other recently described protein targets by nonphosphorylated FTY720. Here, we review the direct targets of FTY720 that contribute to its anti-cancer properties. We also discuss other recently described protein effectors that, in combination with S1P receptors, appear to contribute to its immunosuppressive effects.
Subject(s)
Multiple Sclerosis/drug therapy , Neoplasms/drug therapy , Phosphotransferases (Alcohol Group Acceptor)/metabolism , Propylene Glycols , Sphingosine/analogs & derivatives , Antineoplastic Agents/pharmacology , Apoptosis/drug effects , Fingolimod Hydrochloride , Humans , Immunosuppressive Agents/pharmacology , Lymphopenia/chemically induced , Lysophospholipids/metabolism , Phosphorylation , Propylene Glycols/adverse effects , Propylene Glycols/metabolism , Propylene Glycols/pharmacology , Receptors, Lysosphingolipid/metabolism , Sphingosine/adverse effects , Sphingosine/metabolism , Sphingosine/pharmacologyABSTRACT
Bladder cancer is a heterogeneous disease that offers a unique challenge for the patient and the physician as treatment paradigms are continually evolving. There are multiple factors that can influence how each individual is treated, including lymphovascular invasion, micropapillary histology, and p53 nuclear accumulation which have demonstrated a worse prognosis in patients with bladder cancer. They can influence the use of neoadjuvant and adjuvant chemotherapy, which in itself can affect the timing of extirpative surgery. This review will focus on the contemporary management and treatment of bladder cancer focusing on areas of clinical decision making.
Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Transitional Cell/drug therapy , Carcinoma, Transitional Cell/surgery , Cystectomy , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/surgery , Biomarkers, Tumor/blood , Carcinoma, Transitional Cell/blood , Carcinoma, Transitional Cell/pathology , Chemotherapy, Adjuvant , Humans , Neoplasm Staging , Patient Selection , Predictive Value of Tests , Preoperative Care , Prognosis , Sensitivity and Specificity , Survival Analysis , Treatment Outcome , Tumor Suppressor Protein p53/blood , Urinary Bladder Neoplasms/blood , Urinary Bladder Neoplasms/pathologyABSTRACT
This report of the Editorial Advisory Board of Cytopathology gives the results of a survey of medical practitioners in cytopathology, which aimed to find out their views on the current situation in undergraduate and postgraduate training in their institutions and countries. The results show that training in cytopathology and histopathology are largely carried out at postgraduate level and tend to be organized nationally rather than locally. Histopathology was regarded as essential for training in cytopathology by 89.5% of respondents and was mandatory according to 83.1%. Mandatory cytopathology sections of histopathology were reported by 67.3% and specific examinations in cytopathology by 55.4%. The main deficiencies in training were due to its variability; there were insufficient numbers of pathologists interested in cytology and a consequent lack of training to a high level of competence. Pathologists without specific training in cytopathology signed out cytology reports according to 54.7% of responses, more often in centres where training was 3-6 months or less duration. Although 92.2% of respondents thought that specialist cytology should not be reported by pathologists without experience in general cytopathology, that practice was reported by 30.9%, more often in centres with small workloads. The survey report recommends that 6-12 months should be dedicated to cytopathology during histopathology training, with optional additional training for those wanting to carry out independent practice in cytopathology. Formal accreditation should be mandatory for independent practice in cytopathology. When necessary, temporary placements to centres of good practice should be available for trainees intending to practise independently in cytopathology. There should be adequate numbers of pathologists trained in cytopathology to a high level of competence; some of their time could be released by training cytotechnologists and trainee pathologists to prescreen cytology slides and assess adequacy of fine-needle aspiration samples when immediate diagnosis was not required. The survey demonstrated a clear need for European and international guidelines for training in cytopathology.
Subject(s)
Cytodiagnosis , Education, Medical/statistics & numerical data , Health Care Surveys , Pathology/education , Pathology/statistics & numerical data , Periodicals as Topic , Curriculum , Education, Medical, Undergraduate , Educational Measurement , Geography , Surveys and QuestionnairesSubject(s)
Hemoglobin H/genetics , Hemoglobins, Abnormal/genetics , Hydrops Fetalis/etiology , Prenatal Diagnosis/methods , alpha-Globins/genetics , alpha-Thalassemia/diagnosis , DNA Mutational Analysis , Erythrocyte Indices , Female , Genetic Counseling , Hemoglobin H/isolation & purification , Hemoglobins, Abnormal/isolation & purification , Humans , Hydrops Fetalis/diagnostic imaging , Male , Mass Screening , Pedigree , Pregnancy , Ultrasonography , alpha-Globins/isolation & purification , alpha-Thalassemia/complications , alpha-Thalassemia/geneticsABSTRACT
Cytological evaluation of pancreatic masses and cysts is the preferred pre-operative diagnostic modality and is increasingly being performed by endoscopic ultrasound. This review focuses on the multimodal approach at the Massachusetts General Hospital that utilizes clinical, cytological, radiological and ancillary studies in rendering a final cytological diagnosis.
Subject(s)
Biopsy, Fine-Needle , Endosonography , Pancreatic Cyst/pathology , Pancreatic Neoplasms/pathology , Humans , Pancreatic Pseudocyst/pathology , Pancreatitis/pathologyABSTRACT
Activation of the leukemia inhibitory factor (LIF) receptor has been reported to promote gliogenesis and also to support neural stem cell (NSC) renewal. To investigate this paradox, we isolated NSCs and generated neurospheres from embryonic mice either wild-type, heterozygous, or homozygous null for LIF receptor (LIFR)-beta. Exogenous LIF abrogated neurosphere formation and promoted expression of GFAP by all cells in wild-type and heterozygous cultures. LIF also stimulated a twofold increase in the number of multipotential clones generated from these cultures in comparison with those pretreated with EGF and FGF-2 (E+F) alone. In contrast, the clonogenicity of low-density cultures of LIFR knockout cells was reduced in comparison with that of wild-type cells grown in E+F and was unaffected by LIF. Thus, although LIFR signaling is not necessary for NSC self-renewal, it enhances both the clonogenicity and the expression of GFAP by these multipotential cells.
Subject(s)
Neurons/cytology , Neurons/metabolism , Receptors, Cytokine/deficiency , Signal Transduction/physiology , Stem Cells/cytology , Stem Cells/metabolism , Animals , Cells, Cultured , Clone Cells , Glial Fibrillary Acidic Protein/biosynthesis , Glial Fibrillary Acidic Protein/genetics , Interleukin-6 , Leukemia Inhibitory Factor , Leukemia Inhibitory Factor Receptor alpha Subunit , Mice , Mice, Inbred C57BL , Mice, Knockout , Neurons/drug effects , Proteins/pharmacology , Receptors, Cytokine/biosynthesis , Receptors, Cytokine/genetics , Receptors, OSM-LIF , Signal Transduction/drug effects , Stem Cells/drug effectsABSTRACT
A three-dimensional field-based similarity search and alignment method for flexible molecules is introduced. The conformational space of a flexible molecule is represented in terms of fragments and torsional angles of allowed conformations. A user-definable property field is used to compute features of fragment pairs. Features are generalizations of CoMMA descriptors that characterize local regions of the property field by its local moments. The features are invariant under coordinate system transformations. Features taken from a query molecule are used to form alignments with fragment pairs in the database. An assembly algorithm is then used to merge the fragment pairs into full structures, aligned to the query. Key to the method is the use of a context adaptive descriptor scaling procedure as the basis for similarity. This allows the user to tune the weights of the various feature components based on examples relevant to the particular context under investigation. The property fields may range from simple, phenomenological fields, to fields derived from quantum mechanical calculations. We apply the method to the dihydrofolate/methotrexate benchmark system, and show that when one injects relevant contextual information into the descriptor scaling procedure, better results are obtained more efficiently. We also show how the method works and include computer times for a query from a database that represents approximately 23 million conformers of seventeen flexible molecules.
Subject(s)
Computer Simulation , Folic Acid/analogs & derivatives , Models, Molecular , Algorithms , Crystallography, X-Ray , Databases, Factual , Drug Design , Folic Acid/chemistry , Methotrexate/chemistry , Models, Chemical , Molecular Conformation , SoftwareABSTRACT
Malignant melanoma (MM), both primary and metastatic, may be associated with a prominent myxoid stromal reaction causing diagnostic confusion on fine-needle aspiration biopsy (FNAB), most often with sarcomas that demonstrate a myxoid stroma, particularly malignant peripheral nerve sheath tumor (MPNST). We present a case of a 32-yr-old man with no past medical history who presented with a unilateral neck mass clinically suspicious for lymphoma. FNAB produced a specimen composed of large sheets of anaplastic cells encased in a myxoid stroma that was S100 and vimentin-positive but HMB-45-negative. A diagnosis of MPNST was made. Excision demonstrated a metastatic MM of unknown primary, with a prominent myxoid stromal reaction. A repeat HMB-45 was again negative. Electron microscopy demonstrated intracytoplasmic melanasomes and cisternae of rough endoplasmic reticulum with intracisternal parallel tubules, confirming the diagnosis. Although HMB-45 is typically negative in both tumors, S100 should be strongly positive in myxoid MM and only focal in MPNST.
Subject(s)
Head and Neck Neoplasms/pathology , Melanoma/pathology , Adult , Biopsy, Needle , Diagnosis, Differential , Head and Neck Neoplasms/chemistry , Head and Neck Neoplasms/surgery , Humans , Immunohistochemistry , Liposarcoma, Myxoid/pathology , Lymphoma/pathology , Male , Melanoma/chemistry , Melanoma/surgery , Melanosomes/ultrastructure , Nerve Sheath Neoplasms/pathology , Peripheral Nervous System Neoplasms/pathology , S100 Proteins/analysis , Vimentin/analysisABSTRACT
The authors offer a critique of the privileging of subjectivity in psychoanalysis characteristic of what Hanly has called interactionism, with specific reference to the work of Renik. First, Renik's argument for the irreducible subjectivity of the analyst is explored and critiqued from a philosophical perspective. The need for and plausibility of a subtler notion of objectivity that takes into account the limitations of human subjectivity and that analysts can meaningfully pursue is defended. Second, Renik's 're-visioning' of psychoanalysis, which follows from his notion of irreducible subjectivity, is explored and critiqued. Renik's view of enactments is contrasted with a 'totalistic' perspective of countertransference that allows for important, finer conceptual distinctions. Renik's conceptualisation of countertransference enactments is characterised as a 'special case' of countertransference as a vice. Next, Renik's view of transference is critiqued for privileging the adaptive dimensions of transference, and for potentially sidelining archaic dimensions. Finally, Renik's conclusions and 're-visioning' of psychoanalysis are shown to follow from his modifying or jettisoning certain features of the analytic situation and process. These features and their implications are elaborated on. The conclusion outlines the extent to which the arguments presented can be extended to other advocates of interactionism.
Subject(s)
Ego , Psychoanalytic Theory , Humans , Interpersonal Relations , Psychoanalytic Interpretation , Transference, PsychologyABSTRACT
We retrospectively reviewed our experience with the fine-needle aspiration biopsy (FNAB) diagnosis of primary and recurrent lymphoma to assess the ability of cytomorphology with and without ancillary flow cytometry (FCM) analysis to diagnose and subclassify these tumors according to the Revised European-American Lymphoma/World Health Organization classifications. We reviewed 139 consecutive FNABS of 84 primary and 55 recurrent lymphomas. FCM was successful in 105 (75%) cases. The overall results, including cases without FCM, included 93/139 (67%) true positive, 7 (5%) false negative, and 39 indeterminate (27 [19%] suspicious and 12 [9%] atypical) diagnoses of lymphoma. In cases with FCM, there were 80/105 (77%) true positive, no false negative, and 25 indeterminate diagnoses (15 [14%] suspicious and 10 [9%] atypical). The overall results of the 84 primary lymphomas were 55 (67%) true positive, 5 (5%) false negative, and 24 indeterminate (14[16%] suspicious and 10 [12%] atypical) diagnoses for lymphoma. Of the 68 primary lymphomas analyzed with FCM, 50 [74%] were true positives, and 28 were indeterminate (11 [16%] suspicious and 7 [10%] atypical). There were no false negatives. Diagnostic accuracy varied among lymphoma subtypes. Subclassification of the positive cases were initially conclusive in only 55/93 cases (59%). However, a retrospective review of the morphologic together with FCM data in 15 of the 23 unclassified cases improved the overall subclassification of positive cases to 77%. Subclassification was best in small lymphocytic lymphoma/chronic lymphocytic leukemia, lymphoplasmacytic lymphoma, Burkitt's lymphoma, mantle cell lymphoma, and plasmacytoma (all 100%). Subclassification was poor in marginal-zone lymphoma (33%), and initially as well in diffuse large B-cell lymphoma (62%), but it improved on review (95%), as did subclassification of follicular lymphoma (77 to 100% on review). Hodgkin's disease was recognized as malignant in only 44% of the cases (7/16) and was classified as such based on morphology alone. This review of our early efforts to diagnose and subclassify lymphoma with FNAB and FCM indicates that although a diagnosis and proper subclassification of lymphoma can be made with certainty in the majority of cases, recurrent or primary, it requires close coordination of cytomorphology and immunophenotyping data, which often comes with close cooperation of cytopathologists and hematopathologists. A mere cytological diagnosis of positive for lymphoma is no longer acceptable if FNAB is to become an independent diagnostic tool for lymphoma.
Subject(s)
Flow Cytometry , Image Cytometry , Lymphoma/classification , Lymphoma/diagnosis , Biopsy, Needle , False Negative Reactions , False Positive Reactions , Humans , Lymph Nodes/pathology , Reproducibility of Results , Retrospective StudiesABSTRACT
BACKGROUND: Papillary thyroid carcinoma is the most common malignant neoplasm of the thyroid gland, and fine-needle aspiration biopsy (FNAB) often is the initial diagnostic method used in its detection. Prior studies have shown that immunohistochemical staining for various cytokeratins in general, and cytokeratin 19 (CK19) in particular, can be applied as an ancillary technique for diagnosing papillary thyroid carcinoma in histologic specimens. In the current study the authors assessed the diagnostic utility of CK19 to detect papillary carcinoma effectively in cytologic preparations of thyroid FNABs. METHODS: Immunocytochemical staining with CK19 was performed on cytologic aspirates from 37 papillary thyroid carcinomas and 36 other lesions of the thyroid (14 follicular adenomas, 10 multinodular goiters, 5 cases of Hashimoto thyroiditis, 6 oncocytic [Hürthle cell] neoplasms, and 1 follicular carcinoma). All cases included in the study had a corresponding histopathology specimen. RESULTS: Positive immunocytochemical reactivity for CK19 was identified in 34 of 37 papillary carcinomas and in 1 of 36 other thyroid lesions (sensitivity of 92% and specificity of 97%). Although the strongest reactivity was obtained in methanol fixed thin layer preparations, the antibody also was effective in detecting papillary carcinoma in alcohol fixed and air-dried smears. The single false-positive case was a follicular adenoma with focal areas of papillary hyperplasia. All other aspirates including those from cases of Hashimoto thyroiditis, multinodular goiter, follicular adenoma, oncocytic neoplasms, and follicular carcinoma were negative. CONCLUSIONS: CK19 is an effective, highly sensitive, and specific ancillary tool for the diagnosis of papillary carcinoma in thyroid FNABs.
Subject(s)
Biomarkers, Tumor/analysis , Biopsy, Needle , Carcinoma, Papillary/diagnosis , Keratins/analysis , Thyroid Neoplasms/diagnosis , Carcinoma, Papillary/chemistry , Cytodiagnosis , Humans , Immunohistochemistry , Sensitivity and Specificity , Thyroid Neoplasms/chemistryABSTRACT
Isolated posterolateral rotatory instability of the knee is an uncommon injury pattern that may result in significant degrees of functional disability. This injury complex can be a challenging diagnostic and therapeutic problem for the orthopaedic surgeon. The presence of associated ligamentous and soft-tissue injuries, resulting in combined instability patterns, further complicates management. The results of recent research have enhanced our understanding of the complex anatomy and biomechanics of the posterolateral aspect of the knee. Numerous surgical techniques have been described for both repair and reconstruction of the injured posterolateral structures; however, long-term functional results have been only moderately successful.