Congenital granular cell epulis is a rarely reported lesion of unknown histogenesis with a strong predilection for the maxillary alveolar ridge of newborn girls. Microscopically, it demonstrates nests of polygonal cells with granular cytoplasm, a prominent capillary network, and attenuated overlying squamous epithelium. The lesion lacks immunoreactivity for S-100, laminin, chromogranin, and most other markers except neuron-specific enolase and vimentin. Through careful observation of its unique clinical, histopathologic, and immunohistochemical features, this lesion can be distinguished from the more common adult granular cell tumor as well as other differential diagnoses.

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Context.-Although fine-needle aspiration (FNA) practice by pathologists is now well established, it has been primarily performed by manual palpation. In recent years, pathologists have begun to venture into ultrasound-guided FNAs (UGFNAs). Reports on experiences with this relatively new technique for pathologists have shown promising results. However to date, there have been few studies in the literature comparing pathologist-performed UGFNA with the more traditional pathologist-performed palpation-guided FNA (PGFNA).Objective.-To compare UGFNA to PGFNA by cytopathologists at an academic medical center.Design.-A retrospective study of FNAs performed by cytopathologists within the University of California, Los Angeles (UCLA) pathology departmental FNA clinic was performed. Data collected included performance technique (UGFNA versus PGFNA), lesion site and size, adequacy status (nondiagnostic rate), and number of passes per procedure. Corresponding surgical pathology/ flow cytometric/cytogenetic result follow-up was compared to FNA results. Findings between UGFNA and PGFNA cases were compared.Results.-Of 1029 FNA cases during the study period, there were 449 UGFNA cases (43.6%) and 580 PGFNA cases (56.4%). Nondiagnostic rates with UGFNA and PGFNA were 6.7% (30 of 449 cases) and 20.7% (120 of 580 cases), respectively. Nondiagnostic rate was also significantly lower with UGFNA than with PGFNA for lesions within the thyroid (6.0% versus 33.3%), head and neck (6.6% versus 21.2%), and salivary gland (6.2% versus 17.1%), and across all nodule sizes. A total of 495 of 1029 FNA cases (48.1%) had follow-up. Discordance rate was significantly lower with UGFNA than with PGFNA (5.4% versus 12.8%).Conclusions.-This study shows improved performance characteristics of cytopathologist-performed UGFNA versus PGFNA.

Lipid A derived from Pseudomonas aeruginosa PAO1 contains a biphosphorylated 1-6-linked glucosamine disaccharide backbone. The reducing glucosamine has an unsubstituted glycosidically linked phosphate at C-1. The nonreducing glucosamine has an ester-bound phosphate at C-4' which is nonstoichiometrically substituted with 4-amino-4-deoxyarabinose. Induction of 4-amino-4-deoxyarabinose was dependent on cultural conditions. No pyrophosphate groups were detected. Acyloxyacyl diesters are formed by esterification of the amide-bound 3-hydroxydodecanoic acid with dodecanoic acid and 2-hydroxydodecanoic acids in an approximate molar ratio of 2:1. Dodecanoic and 3-hydroxydecanoic acids are esterified to positions C-3 and C-3' in the sugar backbone. All hydroxyl groups of the glucosamine disaccharide except C-4 and C-6' are substituted. Lipopolysaccharide chemical analyses measured glucose, rhamnose, heptose, galactosamine, alanine, phosphate, and glucosamine. The proposed lipid A structure differs from previous models. There are significant differences in acyloxyacyl diesters, and the proposed model includes an aminopentose substituent.Lipopolysaccharides (LPS) are major components of the gram-negative bacterial outer membrane and are essential for the assembly, organization, and functioning of this vital structure. LPS contributes to the pathophysiology of the notorious opportunistic pathogen Pseudomonas aeruginosa by functioning as a virulence factor and acting in consort with other outer membrane constituents to form a permeability barrier against antimicrobial agents (14).P. aeruginosa LPS is compositionally similar to enterobacterial LPS (12). These structural similarities include a biphosphorylated D-glucosamine disaccharide lipid A backbone, an oligosaccharide core, and serologically diverse 0 chains. However, P. aeruginosa LPS differs from enterobacterial LPS by having a large number of phosphate residues, by the presence of L-alanine in the core, and by the occurrence of unusual sugars and amino compounds in the 0 chain (15,20).Enterobacterial lipid A's have a number of features that serve to distinguish them from their pseudomonal counterparts. One such structure is 4-amino-4-deoxyarabinose (4-AraN), which is found in some but not all enteric lipid A's. The physiological function of 4-AraN is unresolved, although it has been suggested by Vaara et al. to play a role in resistance against selected antibiotics by substituting onto lipid A phosphate groups (28,29). In this capacity the cationic 4-AraN could facilitate resistance by either repulsing positively charged antimicrobial agents such as polymyxin B or by occupying their LPS attachment sites. Vaara et al. also proposed that resistance to polymyxin B is proportional to the number of lipid A phosphate groups substituted with 4-AraN. 4-AraN substitution in LPS has been previously reported in selected members of the family Enterobacteriaceae, in Chromobacterium violaceum, and in phototrophic bacteria (8,22,26,27 In this study we report the isolation and partial ...

Circulating tumor cells (CTCs) have a great potential as indicators of metastatic disease that may help physicians improve cancer prognostication, treatment and patient outcomes. Heterogeneous marker expression as well as the complexity of current antibody-based isolation and analysis systems highlights the need for alternative methods. In this work, we use a microfluidic Vortex device that can selectively isolate potential tumor cells from blood independent of cell surface expression. This system was adapted to interface with three protein-marker-free analysis techniques: (i) an in-flow automated image processing system to enumerate cells released, (ii) cytological analysis using Papanicolaou (Pap) staining and (iii) fluorescence in situ hybridization (FISH) targeting the ALK rearrangement. In-flow counting enables a rapid assessment of the cancer-associated large circulating cells in a sample within minutes to determine whether standard downstream assays such as cytological and cytogenetic analyses that are more time consuming and costly are warranted. Using our platform integrated with these workflows, we analyzed 32 non-small cell lung cancer (NSCLC) and 22 breast cancer patient samples, yielding 60 to 100% of the cancer patients with a cell count over the healthy threshold, depending on the detection method used: respectively 77.8% for automated, 60–100% for cytology, and 80% for immunostaining based enumeration.

Of the five cements tested, the most retrievable CAD/CAM restorations were luted with Temp Bond NE and Improv Temporary Cement. Resin-modified glass ionomer retentive forces were closer to those of the "temporary cements" than those of the permanent adhesive-resin cements. The abutment surface area became less important when using adhesive-resin cements. Retention of CAD/CAM all-ceramic restorations to prefabricated abutments has not been reported in the literature. This in vitro study demonstrated clinically significant variation among the selected cements used to retain all-ceramic CAD/CAM restorations to implant abutments. In addition, abutment size influenced the retention of all-ceramic CAD/CAM restorations.

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