Benign Pathological Conditions Research Articles

Expression of p53 protein in benign and malignant epidermal pathologic conditions

p53 is an oncogene and a tumor-suppressor gene whose gene product regulates the cell growth cycle. Mutations in p53 are the most common genetic alterations in human cancer. Our purpose was to define p53 expression and subcellular localization in normal and pathologic epidermis. We examined sections of normal skin, psoriasis, squamous cell carcinoma (SCC), basal cell carcinoma (BCC), keratoacanthoma, and cultured epithelial cell lines with five antibodies to p53. Monoclonal antibody MAb421 and MAb1801 stained the cytoplasm of normal basal keratinocytes, suggesting that subcellular localization or sequestration of wild-type p53 regulates its activity. Polyclonal antibody reacted throughout normal epidermis, suggesting heterogeneity of species or conformational forms of p53 protein. Cytoplasmic reactivity to MAb421 was similar in normal epidermis, psoriasis, and cultured keratinocytes but was, diminished in SCC, BCC, and keratoacanthoma. CM-1 reactivity persisted in these tumors. Putative p53 mutations detected by MAb240 reactivity were present in 44% of SCC specimens. Epidermis expresses p53 and the gene may regulate epidermal keratinocyte growth and carcinogenesis.

Ultrastructural localization of endogenous peroxidase activity in benign thyroid diseases.

Ultrastructural localization of endogenous thyroid peroxidase under benign pathological conditions such as toxic diffuse goiter, non-toxic multinodular goiter, and adenoma, and in normal tissue was studied. Peroxidase activity was visualized by a cytochemical reaction for electron microscopy. In toxic diffuse goiters and most non-toxic multinodular goiters, reaction product for peroxidase was observed not only in the cytoplasm but also at the external surface of microvilli of follicular cells. In normal thyroid tissues and adenomas, peroxidase was visualized only in the cytoplasm. Peroxidase activity at the external surface of microvilli of the follicular cells was found in the tissues obtained from the goiters which showed "hot" radioiodine scintigram. These findings suggest that follicles with peroxidase activity at the external surface of microvilli in non-toxic multinodular goiter are "autonomous follicles" and that peroxidase at the external surface of microvilli plays some role in active iodine uptake.

Cystic Supratentorial Gliomas: Natural History and Evaluation of Modes of Surgical Therapy

The management of cystic supratentorial gliomas is hampered by lack of documentation of the natural history of these lesions and by a lack of evaluation of modes of surgical therapy. We analyzed these factors in 25 patients with solitary cysts operated upon over a 20-year period. Two distinctive patterns of symptoms were seen: short duration (increased pressure and hemiparesis), most often heralding a malignant lesion, and long duration (commonly seizure disorder), associated more often with a benign pathological condition. Large solitary cysts were found in tumors of all histological grades. Surgical procedures included extirpation, biopsy/partial resection, cyst communication to ventricle or marsupialization, burr hole aspiration, aspiration via an indwelling reservoir, and cyst-peritoneal shunting. Radiotherapy, given in all cases, did not prevent cyst recurrence. Of the 25 patients, 76% are alive and remain cyst free at follow-up intervals of 1 to 16 years (mean, 3.2). Five patients died from their tumors, with a mean survival of 33 months after decompression. In 7 of 8 patients with cysts largely or entirely within the basal ganglia or thalamus, successful operative cyst control was achieved. Patients with solitary cystic gliomas seem to have a favorable prognosis, and vigorous efforts to control cyst recurrence and limit disability are warranted. Analysis of our data suggests that craniotomy for tumor resection, cyst decompression, and tissue diagnosis is the initial procedure of choice. Cyst recurrence without major solid tumor should be controlled by computed tomography-guided tap or shunt drainage. Reexploration is indicated when cyst reaccumulation is accompanied by clear regrowth of a solid component.

Differential mucin staining in colorectal neoplasms: Potential clinical application

Screening techniques that can identify histochemically different mucin production by colonic mucosa have been claimed to be able to identify early dysplastic changes in the colon and rectum. Controversy has arisen regarding interpretation of these changes, and this study has attempted to address this issue. Utilizing a high iron diamine-alcian blue staining technique, several benign and malignant pathologic conditions of the colon were evaluated. Significantly abnormal staining patterns were identified at the resection margins of all patients in whom either anastomotic recurrence or metachronous carcinomas developed compared with patients who were without recurrence for more than 5 years. It is postulated that this technique may be useful in prospectively identifying this group of patients at high risk for the development of recurrence.

Further Experience with the Ileocecal Segment in Urinary Reconstruction

In selected patients it is possible and desirable to reconstruct a normal or near normal method of urinary drainage after temporary ileal loop urinary diversion or after cystectomy for nonurothelial pelvic malignancy. Satisfactory results have been achieved in 20 of 23 patients, with followup as long as 10 years. Seven patients have undergone reconstruction after temporary ileal conduit urinary diversion for benign conditions. One patient underwent urinary reconstruction following prolonged ileal conduit urinary diversion for radiation-induced injury to the bladder as part of treatment for cervical carcinoma. In 11 patients the ileocecal segment was used as part of a planned urinary reconstructive procedure after cystectomy for nonurothelial pelvic malignancy or when correcting a benign lower urinary tract pathologic condition that resulted in a cutaneous fistula.The ileocecal segment is a surgical unit that allows replacement or augmentation of the bladder, with the ileum substituting for as much ureteral length as necessary. However, the ileocecal valve is not effective in the long-term prevention of reflux and use of a recently described ileal intussusception technique seems preferable.

Human Thyroid Peroxidase Activity in Benign and Malign Thyroid Disorders

Peroxidase activity in various human benign and malignant pathological conditions has been investigated. The activity was measured in vitro by oxidation of iodide and by iodination of bovine serum albumin (BSA). The deficiency of hormone synthesis observed in various diffuse benign thyroid disorders was certainly not due to a lack of peroxidase activity. In hyperthyroid patients treated with carbimazole and in a euthyroid state at surgery, iodide-peroxidase activity (24 patients) and DNA content (12 patients), both expressed per g of wet weight, were enhanced (288% and 122% increases over control, respectively) and the cellular enzyme activity was almost double than that of normal tissue. An increase in peroxidase activity when measured by iodination of BSA (11 patients) was also observed (350% increase over control). It is suggested that high cellular peroxidase activity might be due not to the treatment but to the disease. In euthyroid patients with diffuse sporadic goiter, the peroxidase activity measu...

The Controversy of Treatment of Asymptomatic Bacteriuria in Non-Pregnant Women—Resolved

Data derived from longitudinal studies demonstrate that asymptomatic bacteriuria in non-pregnant women without stones or obstructive uropathy is a benign pathological condition. Evidence has accumulated that untreated asymptomatic bacteriuria in otherwise healthy women does not result in hypertension and/or a decline in renal function, and that this condition requires neither detection nor antimicrobial therapy.

5-Nucleotidase activity in the human breast. Enzyme-histochemical studies.

Fresh‐frozen sections of human breast tissue (210 biopsy specimens) are examined for activity of 5‐nucleotidase in various benign and malignant pathological conditions. 5‐nucleotidase is found mainly in the fibroblasts and produce a characteristic stroma‐response. By nickel blocking of 5‐nucleotidase it is possible to distinguish the 5‐nucleotidase activity from that of the unspecific alkaline phosphatases. The technique is described. The two enzyme systems are both localized mainly in the fibroblasts, but at different sites.

Benign lesions of the esophagus; their surgical significance.

ONE SIDE-RESULT of the application of surgical treatment to neoplasm of the esophagus has been to bring the benign lesions into sharper focus. The conditions of the esophagus presented in this paper are collected from the case records of the last 10 years of the private practice of one of us (H. L. T.) and from the Los Angeles General Hospital. The conditions include leucoplakia, broncho-esophageal fistula, spontaneous perforation, benign esophageal stenosis, esophagitis, and peptic ulcer of the esophagus. The benign tumors of the esophagus are the subject of another paper. It is believed that the cases reported here illustrate the practical problems of diagnosis and treatment by surgical means. LEUCOPLAKIA It is our belief that any consideration of benign pathologic conditions of the esophagus must necessarily include leucoplakia. This is because the condition is encountered so frequently in symptomatic and asymptomatic esophageal disease. As is well known, leucoplakia is