Biopsy examination

In contrast to these rarer bone diseases, osteoporosis is a very common disease affecting men and women as they age. It is associated with a loss of bone (mainly trabeculae) and an increased risk of fracture. IR has enabled significant differences between normal and osteoporotic tissues to be identified. Osteoporotic animals and humans have fewer trabeculae, but in the trabeculae that are present the mineral content is reduced (Fig. 11.4(a)) while the crystallinity and collagen maturity are increased (Fig. 11.4(b) and (c)). Moreover, there is a distinct difference in the distribution of these parameters as a function of distance from the surface of the trabeculae. This is illustrated for four cases (three osteoporotic and one control) in which a line was drawn across the trabecular width to detect these parameters (Fig. 11.4(d)) but this is seen throughout every biopsy and in all biopsies examined for osteoporotic or normal control patients. 

The expression proteomics approach is highly adaptable for analysis and categorisation of drug influence and disease state as well as the influence of biological stimuli, identification of body fluids and tissue biopsies, examining PTMs and discovery of new disease markers. 

Although clinical examination provides important clues to diagnosis of congenital myopathies, ultrastructural and histochemical examination of muscle biopsies provides the key to definitive identification. Most of the congenital myopathies... 

Diagnosis is based on clinical features. Biopsy and histologic examination maybe useful when clinical appearance is not typical. 

The neuropathological analysis of HIV-associated neuropathies should include the different central and peripheral nervous system structures associated with sensory pathways, including spinal cord, dorsal root ganglia (DRG), peripheral nerve, and cutaneous nerve fibers (Pardo et al. 2001) (Fig. 4.1). The majority of studies have focused on the evaluation of the peripheral nerve, often from sural nerve biopsies and the DRG. Few studies have examined the pathology of sensory pathways in the... 

Ultrasound examination is used routinely to evaluate cirrhosis a small, nodular liver with increased echogenicity is consistent with cirrhosis. Liver biopsy is the only way to diagnose cirrhosis definitively, but it is often deferred in lieu of a... 

It is often difficult to differentiate ARF from acute rejection in the kidney transplant recipient, as both conditions may present with similar symptoms and physical examination findings. However, fever and graft tenderness are more likely to occur with rejection while neurotoxicity is more likely to occur with cyclosporine or tacrolimus toxicity. Kidney biopsy is often needed to confirm the diagnosis of rejection.42... 

Transrectal prostate needle biopsy to be done if the patient has areas of nodularity or induration on digital rectal examination tissue biopsy can document the presence of prostate cancer, which can also cause enlargement of the prostate... 

DQ is a 57-year-old man who came to the emergency room because of shortness of breath. A radiographic examination demonstrates a large mass pressing on the bifurcation of the main stem bronchus. A biopsy demonstrates an aggressive lymphoma a five-drug chemotherapy regimen with both intravenous and intrathecal chemotherapy will start today. 

Initial work-up for a woman presenting with a lesion or symptoms suggestive of breast cancer should include a careful history, physical examination of the breast, three-dimensional mammography, and possibly other breast imaging techniques such as ultrasound. Most (80% to 85%) breast cancers can be visualized on a mammogram as a mass, a cluster of calcifications, or a combination of both. Breast biopsy is indicated for... 

Biopsy Removal and pathologic examination of specimens in the form of small pieces of tissue from the living body... 

Endoscopy A procedure used to evaluate the interior surfaces of an organ by inserting a small scope into the body through it, one can directly examine almost any part of the intestinal tract. Biopsies can be obtained, polyps removed, and clear images obtained. 

Bladder tumor-associated antigen (BTA), a human complement factor H, is produced by bladder cancer cells (men two to three times as often as women). Cancer cells are sometimes seen in urine samples by microscope cytoscopy (examination of the bladder with an instrument inserted into the urethra), which can reveal abnormal areas. Biopsy is needed to confirm the diagnosis. Early stage cancer confined to the bladder wall can often be removed with a cytoscope. If several tumors are present, they are removed by infusing the bladder with a solution containing bacteria able to stimulate the immune system. 

Histopathological evidence of renal damage has been observed in lead-exposed workers. Renal ultrastructure and function were examined in five men with heavy occupational exposure to lead (Cramer et al. 1974). In addition, renal function was evaluated in two men from whom renal biopsies were not obtained. PbB levels ranged from 71 to 138 pg/dL. Renal function tests were normal in all except for a reduced glomerular filtration rate in one worker. Two subjects with relatively short exposure to lead (6 weeks and 8 months) and PbB levels of 89-129 pg/dL had intranuclear inclusions in the proximal tubules. Renal biopsies from workers with longer periods of lead exposure (4-20 years, PbB levels of 71-138 pg/dL) had diffuse interstitial or peritubular fibrosis. Glomeruli were normal in all subjects. 

Biopsy material for amebiasis should be processed for surgical pathology and then examined for ulcers containing amebae. The periodic acid-Schiff stain counterstained with hematoxylin is particularly helpful because amebae stain more positively with periodic acid-Schiff stain than do inflammatory cells, and amebae show typical amebic nuclei. Of course, there are no amebic cysts in tissue. 

Biopsy material for schistosomiasis is better examined in teased preparations than in sections, as the entire thickness can be examined at once, and the viability of eggs can be determined by observation of the movement of the larvae within the eggs. 

Biopsy or necropsy tissue may be examined by histology sections or impression smears. 

Biopsy or blood specimens may be cultured for Leishmania spp. or T. cruzi with Novy-MacNeal-Nicolle (NNN) medium. Biopsy specimens are ground in a small amount of saline. Biopsies from skin lesions or other tissues which may contain bacteria may have penicillin (0.1 ml of 1,000 U/ml) added to the medium with the inoculum. The inoculum is 1 drop of ground tissue or blood. Incubate the culture at room temperature (22°C), and at days 3 and 7, examine a direct mount of liquid from the bottom of the slant at x400 magnification. These cultured organisms are potentially infective for humans. 

Clinical specimens obtained for the recovery of dematiaceous fungi usually do not require extensive processing. If aspirated specimens contain a substantial amount of purulent material, this can be dissolved with N-acetyl-L-cysteine without sodium hydroxide. Tissue specimens and biopsy material should be homogenized in a tissue homogenizer after highly suspicious areas consisting of necrotic, purulent, or caseous material are selectively examined microscopically and inoculated onto isolation media. 

In a sense, therefore, there have been two conflicting views with respect to the suitability of formalin as a fixative, in the face of demands that biopsy tissues may be examined not only by traditional morphologic methods, but also by IHC, in situ hybridization (ISFI) and, following extraction procedures, by other molecular methods. Both views recognize that these newer methods do not perform well, or at all, on routinely processed FFPE tissues. One view advocates the development of new fixatives that are molecular friendly, the other view holds that AR-based methods may be employed to achieve accurate valid results of IHC, ISH, and other molecular methods using FFPE tissues. 

Deficiency of the muscle-specific myoadenylate deaminase (MADA) is a frequent cause of exercise-related myopathy and is thought to be the most common cause of metabolic myopathy. MADA catalyzes the deamination of AMP to IMP in skeletal muscle and is critical in the purine nucleotide cycle. It is estimated that about 1-2% of all muscle biopsies submitted to medical centers for pathologic examination are deficient in AMP deaminase enzyme activity. MADA is 10 times higher in skeletal muscle than in any other tissue. Increase in plasma ammonia (relative to lactate) after ischemic exercise of the forearm may be low in this disorder, which is a useful clinical diagnostic test in patients with exercise-induced myalgia... 

Histopathologic examination of tissue biopsies and culture of secretions should be used to identify B. dermatitidis. 

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