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D S Raso

Publications and source records attributed to D S Raso.

At least 19 recordsLinked to original sources
PubMed2001

Effectiveness of thin-layer preparations vs. conventional Pap smears in a blinded, split-sample study. Extended cytologic evaluation.

OBJECTIVE: To further evaluate the effectiveness of the AutoCyte PREP thin-layer slide preparation (TriPath Imaging, Inc., Burlington, North Carolina) as compared to conventional Pap smears. STUDY DESIGN: A split-sample, blinded evaluation of matched thin-layer preparations and conventional smears from 2,438 patients was performed. This material was enriched by including 260 cases of high grade squamous intraepithelial lesions (HSILs) and cancer cases from an earlier study. Many of these cases were difficult to diagnose, containing very few abnormal cells on one or both matching slides. The preparations were evaluated multiple times by both thin-layer-inexperienced and -experienced cytology professionals to better compare performance related to preparation quality alone. RESULTS: The initial evaluations of the slides by personnel with only brief training in thin-layer interpretation demonstrated equivalent performance for the two preparations. The reevaluation study by cytology professionals with several months of thin-layer experience demonstrated a statistically significant improvement in detection of both LSIL and HSIL lesions using AutoCyte PREP slides. There was also a statistically significant improvement in the number of satisfactory samples using the AutoCyte PREP method. CONCLUSION: The study demonstrated that the AutoCyte PREP thin-layer slide preparation is at least equivalent to conventional Pap smears in the detection of LSIL and HSIL, even when evaluated by cytology professionals who have been newly trained in the thin-layer method and that, with increased experience, the thin-layer AutoCyte PREP slide preparation method showed a statistically significant improvement in disease detection.

Female↗
PubMed1999

Elemental analysis and clinical implications of calcification deposits associated with silicone breast implants.

Calcification of the fibrous capsule surrounding silicone breast implants is a well-recognized occurrence that increases with time following implantation. These mineralized deposits potentially confound mammographic breast cancer surveillance already made difficult by the obscuring effects of silicone breast implants. The authors performed elemental analysis of silicone breast implant-associated calcifications to define better their chemical composition as related to mammographic and clinical significance. Electron probe microanalysis and infrared spectroscopy revealed all of the calcification deposits to be calcium complexed with tribasic phosphate. No evidence of calcium oxalate, calcium carbonate, silicone, or talc was observed. Caution must be employed in interpreting mammograms in women with silicone breast implants as well as those who have had their silicone breast implants removed. High-density mammographic calcifications indicative of calcium phosphate associated with a silicone breast implant may represent an accepted consequence of implantation or nearby carcinoma. We recommend baseline mammography on women who have had their silicone breast implants removed to prevent unnecessary fine-needle aspiration or tissue biopsy of retained breast capsule calcifications during subsequent routine surveillance for carcinoma.

Breast↗
PubMed1999

The clinical, histologic, and ultrastructural presentation of polyvinyl sponge (Ivalon) breast prostheses removed for massive fluid accumulation.

The current study describes what we believe is the first report of bilateral massive seromas associated with open-cell Ivalon sponges. Additionally, the gross, histologic, and ultrastructural features consistent with previous reports of polyvinyl alcohol prostheses are presented. Despite the reported chemical inertness of polyvinyl alcohol, this material may incite a biologic response in some patients, leading to dense fibrosis and occasional foreign-body giant-cell reaction. It is postulated that the molecular breakdown products of the polyvinyl alcohol polymer may create an osmotic gradient across the periprosthetic capsule, which may lead to intracapsular fluid accumulation, as presented in this case.

Aged↗
PubMed1998

Fine-needle aspiration cytology of a subareolar abscess of the male breast.

We report on the fine-needle aspiration (FNA) cytology of a subareolar abscess of the breast in a 45-yr-old man. The patient presented with a 1.5-cm mass in the subareolar region. FNA cytology demonstrated the presence of numerous anucleated squamous cells and a few small nucleated squamous cells as well as numerous neutrophils and some lymphocytes in the background. Histiocytes were also present, including some multinucleated foreign-body-type giant cells. No organisms were identified either with special stains or microbiologic cultures. The differential diagnosis of FNA of the male breast is presented, along with other lesions that can potentially contain either benign or malignant squamous cells in the aspirate. The correct FNA diagnosis of this unusual benign lesion involving the male breast should lead to the appropriate treatment. To the best of our knowledge, this is the first published report of FNA cytology of a subareolar abscess of the male breast.

Abscess↗
PubMed1998

Morphology and pathogenesis of Liesegang rings in cyst aspirates: report of two cases with ancillary studies.

Liesegang rings are laminated ring-like structures occasionally found in benign cysts and abscesses. They have been confused with parasites (especially eggs), algae, calcifications, and psammoma bodies. We examined Liesegang rings from fine-needle aspiration (FNA) biopsies of a benign cyst of the breast and a complex renal cyst. Liesegang rings were best observed with Papanicolaou, hematoxylin-eosin, Masson's trichrome, acid-fast (AFB), and Gram stains, which accentuate the concentrically laminated morphology. An amorphous electron-dense core and fibrillary lucent concentric rings were seen with transmission electron microscopy with no significant energy peaks by electron probe microanalysis or distinct diffraction patterns by X-ray diffraction. This investigation indicates that Liesegang rings are composed of organic substances most likely formed by periodic precipitation from a supersaturated solution within cystic fluid. Awareness of the Liesegang phenomenon within cystic lesions will decrease the possibility of erroneous misdiagnosis as another type of pathologic process.

Cyst Fluid↗
PubMed1996

Silicone deposition in reconstruction scars of women with silicone breast implants.

BACKGROUND: The possible association of silicone breast implants and disease is a subject of continuous debate and concern. OBJECTIVE: Our purpose was to examine microscopically and ultrastructurally the periprosthetic fibrous capsules and reconstruction scars of women with silicone breast implants. METHODS: Representative samples from the periprosthetic capsules and reconstruction scars from six women with silicone breast implants were examined by a variety of light microscopy techniques, transmission electron microscopy, and electron probe microanalysis. RESULTS: Silicone globules of various sizes were identified in every periprosthetic capsule and reconstruction scar. CONCLUSION: Extrusion and seeding of the incision tract during surgery most likely accounts for the presence of silicone in the reconstruction scar specimens. This observation suggests that the identification of silicone in the reconstruction scars of women with silicone breast implants does not necessarily implicate rupture of the silicone breast implant with systemic dissemination of silicone gel.

Breast Implants↗
PubMed1996

Caterpillar bodies of porphyria cutanea tarda ultrastructurally represent a unique arrangement of colloid and basement membrane bodies.

Caterpillar bodies are eosinophilic, periodic acid-Schiff (PAS)-positive globules arranged in a linear fashion in the epidermis overlying subepidermal blisters of porphyria cutanea tarda (Am J Dermatopathol 1993;15:199-202). We retrospectively studied by transmission electron microscopy nine cases of porphyria cutanea tarda (PCT) that demonstrated caterpillar bodies. We identified three components of the eosinophilic bodies: degenerating keratinocytes, colloid bodies, and basement membrane bodies. The colloid bodies consisted of whorled masses of filaments containing degenerating melanosomes, vacuoles, mitochondria, and desmosomes. Basement membrane bodies were composed of convoluted basement membrane material and associated collagen. Both colloid and basement membrane bodies were often associated with degenerating keratinocytes, were located both intra-and extracellularly, and were occasionally fused to one another. We believe that caterpillar bodies are a combination of degenerating keratinocytes, colloid bodies, and basement membrane bodies formed by repeated blistering and reepithelialization with transepidermal migration. Furthermore, we believe that caterpillar bodies are a diagnostic clue for the diagnosis of PCT.

Basement Membrane↗
PubMed1996

Immunolocalization of keratan sulfate, chondroitin-4-sulfate, and chondroitin-6-sulfate in periprosthetic breast capsules exhibiting synovial metaplasia.

The distribution of various proteoglycans and basement membrane components within 10 breast capsules with synovial metaplasia was assessed immunohistochemically. Immunoreactive keratan sulfate and chondroitin-4-sulfate were present in many of the synovial metaplasia lining cells, suggesting active secretion of these proteoglycans into the intraprosthetic space. In contrast, chondroitin-6-sulfate was confined to the extracellular matrix of the underlying supporting fibrous capsule. Type IV collagen and laminin were not associated with the synovial metaplasia lining, thus confirming the absence of a basement membrane, as previously indicated by morphologic analysis. As with tendon reconstruction, the development and maintenance of a synovial metaplasia lining that secretes lubricating factors such as proteoglycans may be beneficial for decreased capsular contracture.

Breast↗
PubMed1995

Synovial metaplasia of a periprosthetic capsule surrounding a polyurethane foam breast prosthesis.

A 43-year-old woman underwent two-stage bilateral reconstruction mammoplasty using silicone-filled, polyurethane foam-covered breast implants. The permanent implants were later removed. The periprosthetic capsule demonstrated synovial metaplasia by light and electron microscopy. Synovial metaplasia is believed to be induced by the physical and chemical characteristics of the prostheses and may have important clinical implications in reducing capsular contracture and increasing host acceptance of implantable biomaterials.

Adult↗
PubMed1995

Electron probe microanalysis of silicon and the role of the macrophage in proximal (capsule) and distant sites in augmentation mammaplasty patients.

Electron probe x-ray microanalysis was used to locate silicon (Si) within macrophages from 12 women who had previously undergone polymer prosthesis augmentation or reconstruction. Silicon was identified within macrophages and extracellularly in all fibrous breast capsules. In four women with arthritic joint pain and one woman with sclerodermatous skin lesions, silicon also was identified within macrophages residing in joint synovium and skin, respectively. It is suggested that the silicon-laden macrophages observed in the remote lesions may have accumulated silicon from other macrophages that had previously resided in the connective-tissue capsule around the silicone breast implants.

Adult↗
PubMed1994

Fatal suture embolism to the left anterior descending coronary artery. A case report and review of the literature.

A variety of emboli may be encountered at autopsy. While pulmonary thromboemboli are a relatively common cause of sudden "natural" death, the medical examiner may discover more exotic emboli during the postmortem examination. Other endogenous sources of emboli include the atheromatous debris, bone marrow, fat, liver, brain, trophoblast, and amniotic fluid. Exogenous ("foreign body") emboli may be introduced during medical/surgical procedures or following penetrating trauma. Fatal intravenous air and gas emboli are also well documented. This report details the first case of a fatal suture embolism to the left anterior descending coronary artery following mitral valve replacement. The role of the medical examiner in the investigation of iatrogenic fatalities is discussed.

Aged↗
PubMed1994

Distribution of beta-1 integrin in the developing rat heart.

Cell-cell and cell-matrix interactions play critical roles in various developmental processes including differentiation, proliferation, and migration. Members of the integrin family of cell surface components are important mediators of these cell-extracellular matrix (ECM) contacts or interactions. The ECM provides signals to individual cells essential for development and differentiation and plays essential roles in establishing and maintaining the complex structure of the vertebrate heart. Integrins provide a fundamental link for transduction of developmental signals to cells. Integrin expression by cardiac myocytes is altered during neonatal heart development and disease; however, little is known regarding the spatial and temporal patterns of integrin expression during embryonic and fetal heart development. Essential to understanding the role of integrins in the organization of the heart, the present studies have localized beta-1 integrin protein and mRNA in fetal and neonatal rat hearts. Beta-1 integrin is predominantly found in regions of remodeling (trabeculae) in the early heart (10-13 days of gestation). Later in development (15 days of gestation onward), beta-1 integrin is abundant in regions containing an elaborate ECM, such as the valves. These studies further support the hypothesis that the expressions of integrins and ECM are coordinately regulated in the developing heart.

Animals↗
PubMed1994

Suicidal cyanide ingestion as detailed in Final Exit.

Final Exit is an "informational aid" advocating the practice of active euthanasia and describing the proper method for the foolproof commission of suicide. Although it has been directed toward assisting the terminally ill patient who desires to terminate suffering, it has been suggested that the widespread availability of this book may result in its abuse. Specifically, there is growing concern that "do-it-yourself suicide manuals" could bring about the fruition of suicidal ideations that are relatively common among mentally ill patients and impressionable adolescents. Described is the suicidal ingestion of cyanide by a physically healthy 30-year-old man. His diary, found next to the body, contains a recipe for suicide copied verbatim from Derek Humphry's Final Exit. Although the decedent's history, the scene investigation, and the external examination strongly suggest an underlying psychiatric disorder, postmortem examination disclosed minimal underlying physical disease. This case graphically illustrates the abuse potential of this literary genre. To our knowledge, this is the first case of its kind to appear in the literature. We recommend that forensic pathologists and medical investigators familiarize themselves with the methods of suicide described in Final Exit.

Adult↗
PubMed1994

Light microscopy techniques for the demonstration of silicone gel.

Because of the difficulty in identifying silicone gel in histologic and cytologic specimens by means of conventional light microscopy, we investigated alternative light microscopy techniques, as well as specimen staining and preparation. Specimens from six periprosthetic capsules, one silicone granuloma specimen, and one synovial biopsy specimen obtained from women with silicone breast implants were cut at 4-, 10-, 20-, and 30-microns sections, stained with a variety of common stains, and correlated with electron probe microanalysis. In addition, a commercial silicone gel and silicone gel extracted from a previously implanted silicone breast prosthesis were smeared and examined unstained or stained with Papanicolaou and Diff Quik. Silicone was noted to be refractile, nonpolarizable, and nonstainable. Thicker sections prevented silicone "dropout" during processing and increased the contrast between stained tissue and unstained silicone (negative staining). The relative ease of silicone identification was greatly increased with non-Koehler, phase contrast, and darkfield microscopy. Staining the mounting media of hematoxylin-eosin-stained sections with a nonparticulate commercial ink allowed enhanced negative staining detection of silicone gel.

Breast↗