Enhancing metabolite coverage in MALDI-MSI using laser post-ionisation (MALDI-2).

Matrix-assisted laser desorption/ionisation mass spectrometry imaging (MALDI-MSI) of metabolites can reveal how metabolism is altered throughout heterogeneous tissues. Here negative ion mode MALDI-MSI has been coupled with laser post-ionisation (MALDI-2) and applied to the MSI of low molecular weight (LMW) metabolites (

Intraductal proliferations of the breast: a review of histologic criteria for atypical intraductal hyperplasia and ductal carcinoma in situ, including apocrine and papillary lesions.

The proliferation of intraductal mammary epithelium forms a continuum that begins with intraductal hyperplasia and ends with ductal carcinoma in situ. Atypical intraductal hyperplasia is the midpoint between the benign and malignant poles of this proliferative continuum. By defining the histological criteria for atypical intraductal hyperplasia, distinction from ordinary intraductal hyperplasia and the noncomedo forms of ductal carcinoma in situ becomes easier. Histopathologic criteria for atypical intraductal hyperplasia, ductal carcinoma in situ, and intraductal hyperplasia and their relative risks for the development of invasive breast carcinoma are reviewed. Related topics of intraductal apocrine and papillary proliferative lesions also are discussed.

Dental management of the anticoagulated patient.

Most anticoagulated patients can be safely managed for routine dental treatment in the outpatient setting by following appropriate guidelines. Management should be based on the present level of anticoagulation as assessed by tests, in particular the international normalised ratio (INR), which should be carried out as close to the intervention as possible. A philosophy of minimal, if any, alteration to the level of anticoagulation should be adopted. This is particularly true for procedures producing minimal bleeding such as scaling and cleaning which, in the past, have resulted in patients having their INR lowered, with its attendant risks. The patient's anticoagulation is potentially life-saving and, where at all possible, should be maintained at therapeutic levels when therapy for non-threatening conditions is planned.

Mature teratoma of the uterine cervix with pulmonary differentiation.

Teratomas of the uterus are very rare, and a uterine teratoma with pulmonary differentiation has not, to our knowledge, been described previously. In this article, we report such a case in a 33-year-old woman, who presented with heavy vaginal bleeding and a polypoid mass of the uterine cervix. The cervical lesion was composed entirely of mature lung tissue, including bronchial, bronchiolar, and alveolar structures. The presence of well-differentiated respiratory epithelial cells, ie, Clara cells and alveolar type II cells, is confirmed by immunohistochemistry. The patient had no history of dilatation and curettage; therefore, implantation of fetal tissue could be excluded from the differential diagnoses. Since this is a newly developed mass in an adult individual, we favor a neoplastic process over heterotopia and interpret the lesion as unilateral lung development in an extragonadal mature teratoma.

The use of the kidney biopsy to predict allograft loss in a pediatric transplant population.

Forty-seven biopsy specimens of renal allografts from pediatric transplant recipients were evaluated by light microscopy using a 117 item survey of histopathologic changes. The presence and distribution of immunofluorescent staining were also evaluated. Histopathologic findings associated with irreversible allograft rejection were determined using statistical methods and then correlated with one another. The effect on allograft survival when several of these features were present on the same specimen was assessed. Glomerular, arteriolar and small artery changes were associated with irreversible rejection. When several of these histologic findings occurred on the same biopsy specimen the allograft was always lost. Interstitial and tubular changes generally not predictive of rejection and immunofluorescent staining was not associated with graft loss.

Serial hippuran renograms to detect the late onset of renal allograft rejection in pediatric transplant recipients.

Serial hippuran renograms were performed in pediatric allograft recipients in an effort to detect the onset of rejection following the initial 3 month post transplant period. The plots of the normalized effective renal plasma flows (NERPF) were compared with reciprocal of the serum creatinines. A strong correlation was noted between both values. NERPF could be predicted from the serum creatinine utilizing a logarithmic equation. However, there was no detectable difference between the onset of changes in the slopes of either variable. Therefore, serial hippuran renograms were no better than monitoring serum creatinine in detecting allograft dysfunction when performed at the frequency of the study.