Of 935 consecutive patients referred with shoulder pain, 50 fitted the criteria for primary frozen shoulder. Twelve patients who failed to improve after conservative treatment and manipulation had excision of the coracohumeral ligament and the rotator interval of the capsule. The specimens were examined histologically, using special stains for collagen. Immunocytochemistry was performed with monoclonal antibodies against leucocyte common antigen (LCA, CD45) and a macrophage/synovial antigen (PGMI, CD68) to assess the inflammatory component, and vimentin and smooth-muscle actin to evaluate fibroblasts and myofibroblasts. Our histological and immunocytochemical findings show that the pathological process is active fibroblastic proliferation, accompanied by some transformation to a smooth muscle phenotype (myofibroblasts). The fibroblasts lay down collagen which appears as a thick nodular band or fleshy mass. These appearances are very similar to those in Dupuytren's disease of the hand, with no inflammation and no synovial involvement. The contracture acts as a check-rein against external rotation, causing loss of both active and passive movement.

Changes in MT activity reflect qualitative structural changes which this study reveals are extensive in the diabetic neuropathic foot. Fibrotic atrophy of the plantar fat pad may affect its ability to dissipate the increased weight-bearing forces associated with diabetic neuropathy.

This book is a comprehensive, well-written, beautifully and generously illustrated textbook. It strikes an excellent balance between basic science and diagnostic pathology. Like previous editions of the book it performs admirable service as a PRN reference text for the lesion that is on your microscope's stage. It also provides a course in liver anatomy, physiology, and pathology.It truly is an international effort. Its seven editors and 26 other contributors represent eight countries. The book is divided into 18 chapters; one is devoted to diseases of the bile ducts and one to diseases of the gallbladder. In the first two chapters, the review of anatomy and pathophysiology are a reminder as to why some of the sharpest clinicians and pathologists have a special interest in liver disease. The discussion on the evolving and overlapping concepts of the acinus are of particular interest. The chapters on developmental abnormalities, liver disease in children, and metabolic errors were comprehensive yet readable. The chapter on injury due to drugs and toxins left me wondering whether there were any chemicals or drugs that do not have the potential to damage the liver. The chapter on tumors of the liver was divided into two separate parts, one more clinically oriented, discussing etiology, epidemiology, and pathology, with the other directed towards pathogenesis encompassing a daunting array of metabolic, inherited, genetic, and infectious factors that are involved in hepatic neoplasia. There are also chapters devoted to iron storage diseases, alcoholic liver disease, viral hepatitis, autoimmune hepatitis, vascular disorders, cirrhosis, liver pathology associated with other exogenous or systemic diseases, and transplantation pathology. The last chapter covers diagnostic procedures and includes discussion of the roles of both core biopsy and fine-needle aspiration biopsy. A brief discussion of the differential diagnosis of primary hepatic versus metastatic carcinoma and hepatocellular carcinoma versus reactive and benign disorders is included. There are also encounters with cytopathology in various discussions of infectious diseases and tumors. While useful information on cytopathology is presented, this text is not a substitute for textbooks and monographs that specifically discuss the cytopathology of the liver.This edition encompasses many advances that have occurred since the third edition was published in 1994. These include molecular biology, classification of rejection, grading and staging of various types of hepatitis, stem cells, necrosis, and apoptosis. Negative criticisms are only detectable on an ultrastructural level. Inevitably in a textbook of such breadth, some sections are less up to date-at least once the text directs the reader to the wrong page for a discussion and the index contains a ghost or two from the previous edition. That being said, this is an excellent book that will help any pathologist whose work encompasses hepatopathology.

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