Sonoelastography of the Common Flexor Tendon of the Elbow with Histologic Agreement: A Cadaveric Study.

Purpose To determine the correlation of the results of conventional B-mode ultrasonography (US) and compression sonoelastography with histologic results in common flexor tendons of the elbow in human cadavers. Materials and Methods Twenty-five common flexor tendons were evaluated in 16 fresh, unembalmed cadavers of 11 women with a median age of 85 years (range, 71-101 years) and five men with a median age of 78 years (range, 70-88 years). Informed consent was provided according to the last will of the donors. B-mode US results were classified as grade 1, normal tendon with homogeneous fibrillar pattern; grade 2, tendon thickening or hypoechoic areas and/or calcifications in less than 30% of the tendon; or grade 3, hypoechoic areas and/or calcifications greater than 30% of the tendon. Sonoelastographic results were grade 1, blue (hardest) to green (hard); grade 2, yellow (soft); and grade 3, red (softest). The intraclass correlation coefficient was calculated to determine agreement with histologic findings for each B-mode US, sonoelastographic, and combined B-mode US and sonoelastographic examination. Histologic results were grade 1, normal, with parallel fibrillar pattern; grade 2, mild tendinopathy, with cellular infiltration, angiogenesis, or fatty vacuoles; or grade 3, severe tendinopathy, with loss of parallel collagen structure and necrosis. Results Histologic alterations were detected in 44% (11 of 25) of biopsy specimens. Intraclass correlation with histologic results was 0.57 for B-mode US, 0.68 for sonoelastography, and 0.84 for the combination of the two approaches. Conclusion The addition of sonoelastography to B-mode US provided statistically significant improvement in correlation with histologic results compared with the use of B-mode US alone (P \u3c .02). (©) RSNA, 2016 Online supplemental material is available for this article

Oncogenic role of miR-155 in anaplastic large cell lymphoma lacking the t(2;5) translocation.

Anaplastic large cell lymphoma (ALCL) is a rare, aggressive, non-Hodgkin's lymphoma that is characterized by CD30 expression and disease onset in young patients. About half of ALCL patients bear the t(2;5)(p23;q35) translocation, which results in the formation of the nucleophosmin-anaplastic lymphoma tyrosine kinase (NPM-ALK) fusion protein (ALCL ALK(+)). However, little is known about the molecular features and tumour drivers in ALK-negative ALCL (ALCL ALK(-)), which is characterized by a worse prognosis. We found that ALCL ALK(-), in contrast to ALCL ALK(+), lymphomas display high miR-155 expression. Consistent with this, we observed an inverse correlation between miR-155 promoter methylation and miR-155 expression in ALCL. However, no direct effect of the ALK kinase on miR-155 levels was observed. Ago2 immunoprecipitation revealed miR-155 as the most abundant miRNA, and enrichment of target mRNAs C/EBPβ and SOCS1. To investigate its function, we over-expressed miR-155 in ALCL ALK(+) cell lines and demonstrated reduced levels of C/EBPβ and SOCS1. In murine engraftment models of ALCL ALK(-), we showed that anti-miR-155 mimics are able to reduce tumour growth. This goes hand-in-hand with increased levels of cleaved caspase-3 and high SOCS1 in these tumours, which leads to suppression of STAT3 signalling. Moreover, miR-155 induces IL-22 expression and suppresses the C/EBPβ target IL-8. These data suggest that miR-155 can act as a tumour driver in ALCL ALK(-) and blocking miR-155 could be therapeutically relevant. Original miRNA array data are to be found in the supplementary material (Table S1).This work was supported by the SCRI-LIMCR GmbH, the “Jubiläumsfond der Österreichischen Nationalbank” (grant-no. 14856 to O.M.), R.G. was supported by grant SFB P021 from the Austrian Science Funds (FWF), L.K. was supported by grant FWF, P26011, R.M. was supported by FWF grants SFB F28 and SFB F47. S.D.T. is a Senior Lecturer supported with funding from Leukemia and Lymphoma Research.This is the final version of the article. It first appeared from Wiley via http://dx.doi.org/10.1002/path.453

Lumbar plexus and psoas major muscle: not always as expected

Conflicting definitions concerning the exact location of the lumbar plexus have been proposed. The present study was carried out to detect anatomical variants regarding the topographical relation between the lumbar plexus and the psoas major muscle as well as lumbar plexus anatomy at the L4-L5 level. Sixty-three lumbar plexuses from 32 embalmed cadavers were dissected to determine the topographical relation between lumbar plexus and psoas major muscle. At the L4-L5 levels variability in the course of the femoral as well as obturator nerve were described. The lumbar plexus was situated within the psoas major muscle in 61 of 63 cases. In 2 of 63 cases the entire plexus was localized posterior to the psoas major muscle. In the 61 of 63 cases in which the lumbar plexus was situated within the psoas major muscle, emergence of the individual nerves most often occurred on the posterior or posterolateral surface. Our results synthesize contrasting assumptions in previous literature, by demonstrating that both locations of the lumbar plexus may be encountered in clinical practice: within and posterior to the psoas major muscle. However, the latter situation represents a minor variant. At the level of L4-L5 the femoral nerve, showing a remarkable degree of branching, as well as the obturator nerve, were found within the psoas major muscle in the vast majority of specimen

In cadavers, directly measured mucosal pressures are similar for the Unique and the Soft Seal laryngeal mask airway devices

We compare the Soft Seal and Unique single-use, plastic laryngeal mask airway devices with respect to intracuff pressure, directly measured mucosal pressure and in vitro elastance. Ten fresh male cadavers were studied. Microchip pressure sensors were attached to the following locations: A) the anterior middle part of the cuff side; B) the posterior tip of the cuff; C) the anterior base of the cuff; D) the posterior middle part of the cuff side; E) the backplate; and F) the posterior tube. The size 5 Unique and size 5 Soft Seal were inserted in random order using laryngoscope-guidance. Intracuff pressure and mucosal pressure were documented at 0 to 40 mL cuff volume in 10 mL increments. In vitro elastance was determined between 20 to 40 mL cuff volume. For both devices, mucosal pressure increased with cuff volume at most locations. Intracuff pressures and in vitro elastance (5.2 +/- 0.7 cm H(2)O/mL vs 3.8 +/- 0.4 cm H(2)O/mL, P <0.0001) were higher for the Unique than the Soft Seal (P <0.0001), but there were no differences in mucosal pressures at any location or cuff volume. Intracuff pressures and in vitro elastance are higher for the Unique than the Soft Seal, but mucosal pressures are similar suggesting that the airway morbidity will be simila