bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of long‐term culture on the expression of antigens and adhesion molecule in single porcine pancreatic endocrine cells
Authors: Edamura Kazuya , Nasu Koko , Iwami Yukiko , Nishimura Ryohei , Ogawa Hiroyuki , Sasaki Nobuo , Ohgawara Hisako
Published: June 2005

Abstract:  Background:  Changes in the expression of galactose (Gal) α1‐3Gal, swine lymphocyte antigen (SLA) class II and intracellular adhesion molecule (ICAM)‐1 of single porcine pancreatic endocrine (PE) cells during the culture period were investigated.

Methods:  Cultured porcine PE‐cells were fixed in 10% buffered formalin for histological evaluation. At 1, 3, 6, 9 and 12 weeks of culture, mRNA was obtained from porcine PE‐cells so that the expression of SLA class II and ICAM‐1 genes could be examined by reverse transcriptase‐polymerase chain reaction.

Results:  The rates of Galα1‐3Gal and SLA class II‐positive cells did not decrease during the culture period, but the rates of Galα1‐3Gal and SLA class II strongly positive cells significantly decreased. ICAM‐1‐positive cells were scarcely observed during the culture period. SLA class II and ICAM‐1 mRNAs were detected at 1 and 3 weeks of culture, but were not detected after 6 weeks of culture.

Conclusions:  These results suggest that partial reduction in the expression of these antigens could be obtained by a long‐term culture.
Reducing Gal expression on the pig organ – a retrospective review
Authors: Ezzelarab Mohamed , Cooper David K.C.
Published: June 2005

Abstract: The rejection caused by the presence of Galα1,3Gal (Gal) on the pig vascular endothelium and of natural anti‐Gal antibodies in human blood has recently been prevented by the breeding of pigs that do not express Gal, achieved by knocking out the gene for the enzyme,α1,3‐galactosyltransferase. However, prior to the introduction of nuclear transfer/embryo transfer techniques, a major effort was directed towards reducing Gal expression on pig cells by other methods, such as by cleaving Gal from the underlying substrate, or replacing Gal with an alternative, innocuous oligosaccharide by a process that has been termed ‘competitive glycosylation’. Gal has been cleaved byα‐galactosidase or endo‐β‐galactosidase C. Competitive glycosylation has largely targeted replacement of Gal by insertion of a gene for a fucosyltransferase or a sialyltransferase, or by insertions of the gene for N‐acetylglucosaminyltransferase III to reduce cell‐surface expression of several oligosaccharides. The results of these approaches to render the pig cells less immunogenic to the human immune system are summarized. With regard to the problem provided by Gal expression, the above approaches may be considered by some to be largely obsolete, but the principles underlying them may prove valuable when other antigen targets for human antibodies are definitively identified, if these prove to be carbohydrates.
Guillain–Barré syndrome in childhood
Authors: Ryan Monique M
Published: June 2005

Abstract:  The Guillain–Barré syndrome (GBS) is characterized by the acute onset of rapidly progressive, symmetric muscle weakness with absent or decreased muscle stretch reflexes. GBS is the most common cause of acute flaccid paralysis in childhood, with an incidence in Australia of 0.8 per 100 000 children per year. Recent advances in this field have included identification of a number of clinical and neurophysiologic subtypes of GBS, enabling improved characterization of etiology and improved prognostication in this disorder.
Review of tongue‐tie release at a tertiary maternity hospital
Authors: Amir Lisa Helen , James Jennifer Patricia , Beatty Joanne
Published: June 2005

Objective:  To review the first 12 months of assessment and release of lingual frenulum (frenotomy) at a breast‐feeding clinic in a tertiary maternity hospital (August 2002 to end of July 2003) and to report on the breast‐feeding outcomes and parental satisfaction.

Methods:  A structured telephone interview was conducted with the mother at least 3 months after the assessment. Data were collected about the presenting problem and the effect of release of the tongue‐tie (if performed). Parents were also asked about their satisfaction with the procedure and of problems following the release.

Results:  Sixty‐six babies were assessed in 12 months. If infants were assessed as: (i) having impaired lingual function (using the Hazelbaker assessment tool for lingual frenulum function); (ii) the frenulum visualized to be a thin membrane; and (iii) the parent(s) gave informed consent, the frenulum was released. Initial and follow‐up data are available on 46 infants. Infants had a mean age of 18 days (range 3–98), 63% were male infants and most had difficulties with attachment to the breast. Frenotomy was performed on 35 infants and breast‐feeding improved in 83%. Parents reported high levels of satisfaction with the frenotomy procedure and no complications were reported.

Conclusion:  Frenotomy is a safe and easy procedure. Infants with a significant tongue‐tie that is interfering with breast‐feeding have shown an improvement with breast‐feeding following frenotomy.
Randomized, controlled trial of division of tongue‐tie in infants with feeding problems
Authors: Hogan Monica , Westcott Carolyn , Griffiths Mervyn
Published: June 2005

Objective:  To determine whether, in infants with a tongue‐tie and a feeding problem, the current medical treatment (referral to a lactation consultant) or immediate division works best and enables the infants to feed normally.

Methods:  Between March and July 2002, all the babies in the district of Southampton with tongue‐ties were followed in order to see if they had any feeding problems. If they developed problems, the mothers gave written consent and were enrolled in an ethics committee approved, randomized, controlled trial, comparing 48 h of intensive lactation consultant support (control) with immediate division.

Results:  A total of 201 babies had tongue‐tie, of whom 88 had breast‐feeding or bottle‐feeding problems. Thirty‐one were not enrolled, so 57 were randomized. Of the 29 controls, one improved (3%) and breast‐fed for 8 months, but 28 did not. At 48 h, these 28 were offered division, which all accepted, and 27 improved (96%) and fed normally. Of the 28 babies who had immediate division, 27 improved and fed normally but one remained on a nipple shield (P < 0.001). Twenty‐four mothers breast‐fed for 4 months (24/40, 60%). Overall, division of the tongue‐tie babies resulted in improved feeding in 54/57 (95%) babies.

Conclusions:  This randomized, controlled trial has clearly shown that tongue‐ties can affect feeding and that division is safe, successful and improved feeding for mother and baby significantly better than the intensive skilled support of a lactation consultant.
Assessment and follow‐up of suspected child abuse in preschool children with fractures seen in a general hospital emergency department
Authors: Ziegler David S , Sammut John , Piper Anne C
Published: June 2005

Objective:  To evaluate the emergency department assessment and follow‐up of possible child abuse in children with fractures.

Methods:  A retrospective audit was conducted of children up to 3 years of age who presented with a fracture to a general hospital emergency department over a 2‐year period.

Results:  In the 98 cases included, there was no documentation of complete physical examination in 57% of cases, whether the injury was witnessed in 54%, or time of injury in 18%. In 27% of cases the history documented was too brief to assess consistency of the injury with the history. Seventy‐five per cent of children with known prior injuries did not have their past history documented. In 80% of all cases there was no indication that the emergency department doctor had considered the possibility of child abuse. Emergency doctors did not recognize four out of 16 cases (25%) with inconsistent histories. There was poor follow‐up of patients in whom abuse was suspected: 46% of children less than 2 years had neither a skeletal survey nor bone scan. Patients referred to a paediatrician by the emergency department were significantly more likely to have a skeletal survey performed and to have the diagnosis of child abuse confirmed.

Conclusions:  Emergency department staff in a general hospital do not document or assess for all of the indicators of child abuse in a high‐risk population and they do not document consideration of the diagnosis in the majority of cases. Emergency department staff need more training and more resources to allow for full assessment of child abuse. Suspected child abuse cases should be referred to a paediatrician to improve investigation and follow‐up.
Digital imaging does not improve localization of percutaneously inserted central lines in neonates
Authors: Webster Nicola J , Page Bernadette , Kuschel Carl A , Battin Malcolm R
Published: June 2005

Objective: To determine whether the use of digital imaging improves the localization of percutaneously inserted central (PIC) line tips compared to standard radiographs, with contrast being used in both cases.

Methods: Digital radiographs taken for localization of PIC lines between October 2002 and September 2003 were identified from the neonatal database. Two reporters independently reviewed the radiographs and stated (i) whether the tip could confidently be seen and (ii) the position. The observers were encouraged to use all the image modification modalities available. The formal radiology report was taken as the third ‘reporter’.

Results: Overal 117 digital radiographs from 98 infants were reviewed. Reporter 1 identified the tip in 83 (71%); reporter 2 in 84 (72%); and the radiologist in 95 (81%), although all agreed that the tip could be identified in only 55 (47%) radiographs. In radiographs where the reporters agreed that the tip could be identified, they agreed on the position in 37 (67%) cases. In 61 (52%) radiographs the reporters did not agree that the tip could be seen, but they agreed on its position in 36 (59%) cases. The kappa coefficient for agreement on line position was 0.63. The level of agreement between reporters in this study using digital imaging was not significantly different from our previous findings using standard radiography with contrast (74/117, 63% vs 57/96, 59%).

Conclusion: The use of digital imaging, with its ability to manipulate images in order to identify PIC line tips, is not significantly better than using standard radiography with contrast.
Adolescents and sexually transmitted infections: Knowledge and behaviour in Italy
Authors: Trani Francesca , Gnisci Francesca , Nobile Carmelo GA , Angelillo Italo F.
Published: June 2005

Objective:  Sexually transmitted infections (STI) among adolescents continue to be an important public health problem for many industrialized and developing countries. This study evaluated knowledge and behaviour in adolescents regarding prevention of STI.

Methods:  Information was obtained by using self‐reported questionnaire from a random sample of 644 undergraduate students at university and at public high schools aged 14–20 years in Catanzaro (Italy).

Results:  Only 14.2% of respondents knew about the main STI and that they can be transmitted through sexual intercourse with HIV seropositive partners; this knowledge was significantly higher among adolescents who had had a higher number of sexual partners in their lifetime and who had received information from physicians about STI. A total of 33.8% reported having had sexual intercourse at least once and the mean age at first intercourse was 16 years. Older males and adolescents with employed mothers were more likely to have reported having had a sexual experience. The prevalence of using condoms every time during sexual intercourse was 51.8% and such behaviour was more likely in younger adolescents and males. The prevalence of condom use on the last occasion of sex was 71.9%. Younger adolescents, those with a higher perception of the risk of contracting STI and those with lesser knowledge about STI were independent predictors for using condoms. The mean total score of the respondents' perception of a risk of contracting STI was 5.8.

Conclusions:  Evidence to develop and implement strategies with the hope of improving adolescents' level of knowledge and reducing unsafe sexual practices.
Risks of seroconversion of hepatitis B, hepatitis C and human immunodeficiency viruses in children with multitransfused thalassaemia major
Authors: Lee Way Seah , Teh Chee Meng , Chan Lee Lee
Published: June 2005

Objectives:  To estimate the risks of seroconversion of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency viruses (HIV) in children with multitransfused thalassaemia at a thalassaemic clinic in Kuala Lumpur, Malaysia.

Methods:  Seventy‐two children (39 males, median age 11.3 years, 2.5th–97.5th centile: 1.4–19.2 years) with thalassaemia major were studied. The risks of seroconversion of HBV, HCV and HIV were estimated by comparing the seroprevalences of hepatitis B surface antigen (HBsAg), anti‐HCV and anti‐HIV between a defined starting point and an end point. The end point was the point when latest serological results were available while the starting point was when regular transfusion was commenced, or approximately 5 years before the end point when the duration of transfusion was longer.

Results:  The median duration of the study was 49 months (range 8–69 months, total 2953 patient‐months). There were 2605 transfusion episodes and 4154 units of blood transfused (0.88 transfusion episode/patient per month, 1.41 units of blood transfused/patient per month). There were three new seroconversions for anti‐HCV but none for HBsAg and anti‐HIV. The risk of seroconversion for HCV was one in 1384 units of blood transfused (95% CI: 4000–472). The seroprevalence rates at the starting and end points were: HBsAg (1%, 1%), anti‐HCV (10%, 13%) and anti‐HIV (0%, 0%), respectively.

Conclusions:  The estimated risk of acquiring HCV infection in children receiving multiple blood transfusions in this study is surprisingly higher than the generally accepted estimated risk. Other routes of transmission may be important. A prospective, multicentre study to estimate such risks more precisely is needed.
Infective endocarditis: Experience of a paediatric emergency department
Authors: Lewena Stuart
Published: June 2005

Objectives:  To determine the clinical features at presentation of children with infective endocarditis to a tertiary centre and review the role of the emergency department in these cases. The subsequent course and outcomes are briefly discussed.

Methods:  Retrospective audit of children with endocarditis presenting to a tertiary children's hospital over a 16‐year period.

Results:  Twenty‐three cases of infective endocarditis were identified. Initial presentation via the paediatric emergency department occurred in 78% of cases and was associated with the least delay to commencement of appropriate treatment. The average duration of illness at the time of presentation was 6 days. Prior medical care had been sought in 65% of the cases, with antibiotics prescribed for an alternate diagnosis in 73%. Children with and without cardiac anomalies were equally represented. Of the group with normal cardiac anatomy, 45% presented without a murmur. Staphylococcus aureus was the most frequent causative organism (43%) and accounted for 64% of cases in children with no pre‐existing cardiac abnormalities. Permanent sequelae were more likely to occur with S. aureus. The overall mortality rate was 9%.

Conclusions:  Infective endocarditis is a rare illness in children and represents a diagnostic challenge. The majority of cases will present via the paediatric emergency department with a non‐specific febrile illness, having frequently commenced antibiotics for an alternate diagnosis. Specific expertise in paediatric emergency care can assist in early diagnosis and management. Morbidity remains significant, particularly in cases caused by S. aureus.
Long‐term outcomes of seriously injured children: A study using the Child Health Questionnaire
Authors: Davey Tamzyn M , Aitken Leanne M , Kassulke Desley , Bellamy Nicholas , Ambrose Jane , Gee Travis , Clark Michele
Published: June 2005

Objective:  To assess the health‐related quality of life (HRQoL) in children 1–2 years after they had sustained an injury.

Methods:  Parents of all children who were identified by the Queensland Trauma Registry during their admission to either of the two paediatric specialty hospitals in Brisbane, Australia, for the treatment of an injury, were invited to participate in this study. Parents who consented to participation received a copy of the Child Health Questionnaire (CHQ) that required them to provide information regarding their child's HRQoL following injury. The CHQ scores for the study respondents were compared with those of the Australian norms. This study was approved by the relevant ethics committees.

Results:  Two hundred and forty‐one completed questionnaires were returned. The majority of cases were male (65%) and there was even representation across all age groups. The majority of injuries were considered to be minor (81%) and were predominantly the result of falls and cycling accidents causing mainly fractures and intracranial injury. On the majority of subscales of the CHQ, study participants recorded scores that were statistically significantly below those of the Australian norms. None of the relevant variables collected by the Queensland Trauma Registry were found to predict scores on the CHQ in this study (for those children hospitalized for >24 h).

Conclusion:  Injured children are worse off than their Australian counterparts in terms of HRQoL even up to 2 years following an injury. Further research needs to be undertaken to identify factors that predict lower HRQoL in order to reduce the burden of injury on children and their families.
The world's longest surviving paediatric practices: Some themes of Aboriginal medical ethnobotany in Australia
Authors: Pearn John
Published: June 2005

Abstract:  Contemporary paediatric practices of Australian Aboriginal men and women, in more than 100 Aboriginal Language Groups, comprise a living discipline whose origins predate Western medicine by tens of millennia. The history of paediatrics acknowledges this surviving continuum of the world's oldest child‐care practices. Because of the inextricable nexus between Aboriginal men and women and the land in which they live, medical ethnobotany forms a major part of the medical aspects of Aboriginal child care. Traditional tribal healers, called ‘Nungungi’ in some language groups of Central Australia, are identified as such whilst still young children and are given special education in the healing arts, especially that of medical ethnobotany, by older healers. Distinct from this specialized role, all Aboriginal men and women (and in particular grandmothers) in traditional communities use a sophisticated botanical materia medica in the treatment of sick and injured children.

In cultures in transition, medical ethnobotanical practices may persist long after the local use of flora as sources of traditional food, weaponry, totemic identity and religious rites have disappeared. Some selected botanical ‘cures’ were adopted by early European settlers and a number of such relict uses have become part of mainstream Western life today, particularly as this applies to self‐medication. Drugs and medicaments used in the treatment of children are obtained from leaves, bark, roots and flowers, usually as fresh preparations. They are prepared as infusions, decoctions and macerations and may be enjoined with emollients such as emu or kangaroo fat for topical application. Botanical drugs and medicaments are usually prepared fresh for each administration and are rarely stored. Contemporary Australian ethnobotany exploits the medicinal properties of more than 100 genera – using such extracts as antiseptics, analgesics, astringents, antipyretics, sedatives, hypnotics, expectorants and carminatives. Their widespread use, by the world's oldest surviving cultures, reflect perhaps 50 millennia of acute observation and clinical interpretation, trial and error, serendipidity and experimentation.

Australian medical ethnobotany generally, and that used specifically for children, is characterized by several features including (i) the multipurpose or ‘broad‐spectrum’ use of many floral species; (ii) a paradigm of the use of botanical material to treat symptoms and symptom‐complexes rather than disease‐based treatment; (iii) the widespread and universal medical knowledge of botanical remedies by all members of local Aboriginal communities, not only traditional community or tribal healers and (iv) the use of botanical material in the context of preventive medicine. Seventy per cent of the world's population uses traditional herbal remedies in the treatment of sick or injured children. In this context, the detailed and extensive ethnobotanical pharmacopoeia of the Aboriginal Peoples of Australia holds an important place.
Coeliac disease presenting as dermatitis herpetiformis in infancy
Authors: Lemberg Daniel , Day Andrew S , Bohane Timothy
Published: June 2005

Abstract:  The incidence of reporting and diagnosis of coeliac disease (CD) in children is increasing with the improvement in sensitivity and specificity of screening markers. This in turn has led to an increasing awareness of gluten‐sensitive enteropathy and associated disorders. We report the unusual case of an 8‐month‐old child presenting to his general practitioner with pruritic skin lesions, subsequently proven to be dermatitis herpetiformis (DH) as the first sign of gluten‐sensitive disease. This infant is the youngest child presenting with DH who could be identified from published report dating from 1966 onwards. Dermatitis herpetiformis is the commonest associated pathology of CD, although rare in infancy, it should be considered in any child presenting with failure to thrive and atypical, chronic rash not responding to simple measures.
Double aortic arch presenting as severe bronchiolitis in a 2‐week‐old infant
Authors: Griffiths Amanda L , Massie John , South Mike
Published: June 2005

Abstract:  A 2‐week‐old female infant was transferred from a regional hospital for mechanical ventilation after developing severe respiratory distress. Stridor had been present since the age of 1 week and was complicated by coryzal illness. Mechanical ventilation was difficult with marked inspiratory and expiratory flow obstruction recorded by the ventilator. Echocardiogram showed a normal heart. Flexible bronchoscopy revealed mid‐tracheal extrinsic compression (unchanged with positive end‐expiratory pressure) and advancement of the endotracheal tube by 2 cm completely corrected the flow obstruction. Repeat echocardiogram showed a double aortic arch. This case report emphasizes the importance of clinical history, examination findings and interpretation of the ventilator waveforms in the differential diagnosis of a difficult‐to‐ventilate infant with bronchiolitis.
Severe hyperbilirubinaemia in a Chinese girl with type I Crigler–Najjar syndrome: First case ever reported in Mainland China
Authors: Nong Shao‐Han , Xie Yan‐Ming , Chan Koon‐Wing , Cheung Pik‐To
Published: June 2005

Abstract:  Jaundice is common in ethnic Chinese infants, but to our knowledge Crigler–Najjar syndrome (CN syndrome) type I has never been reported in China. A Chinese girl with severe jaundice was recently diagnosed to have CN syndrome type I by analyzing the bilirubin‐uridinediphospho (UDP)‐glucuronosyltransferase gene (UGT1A1). The patient was homozygous for a nonsense mutation that replaced glutamine (CAG, amino acid 239) with stop codon (TAG) at nucleotide number 715 (715C→T) in exon 1. No mutation was found in exons 2–5. Her parents were heterozygous for the same mutant. The patient had an average bilirubin level of 300–500 μmol/L and a peak of 701 μmol/L. Daily phototherapy for 15 h was required to keep the bilirubin levels within 280–320 μmol/L. The unconjugated hyperbilirubinaemia apparently resulted from homozygous nonsense mutation of UGT1A1, which could completely abolish the UGT activity towards bilirubin (hepatic glucuronidation) and result in CN syndrome type I. Identification of the genetic defect is very useful for gene therapy, especially for DNA/RNA chimera therapy, and can be used as an antenatal screening test to identify the affected offsprings.
Reye's syndrome developing in an infant on treatment of Kawasaki syndrome
Authors: Wei Chih‐Ming , Chen Huey‐Ling , Lee Ping‐Ing , Chen Chong‐Ming , Ma Chun‐Yi , Hwu Wuh‐Liang
Published: June 2005

Abstract:  Aspirin is commonly used as an anti‐inflammatory therapy for Kawasaki syndrome. Early initiation with high dose aspirin (80 to >100 mg/kg per day), followed by low‐dose therapy at the afebrile stage, has been often used to reduce morbidity and mortality in coronary complications. We report a 10‐month‐old infant who was diagnosed with Kawasaki syndrome. Sudden onset of poor activity, poor appetite, lethargy, tachycardia, tachypnea, hepatomegaly, increased AST/ALT, coagulopathy and hyperammonemia developed 3 days after the high‐dose aspirin therapy. His histopathological and ultrastructural findings from the liver biopsy were compatible with Reye's syndrome. He recovered completely, and there was no recurrence.
An innovative treatment programme for Anorexia Nervosa
Authors: Court John , Carr‐Gregg Michael , Bergh Cecilia , Brodin Ulf , Callmar Monica , Ejderhamn Jan , Södersten Per
Published: June 2005

Abstract:  We present the case of an Australian girl with severe anorexia nervosa who had previously been resistant to treatment, and who was subsequently treated successfully by an innovative programme at the Karolinska Institute in Stockholm. The programme is based on a distinctive concept of causation of eating disorders in which it is postulated that they develop as a consequence of starvation rather than a primary mental disorder. The treatment focuses on relearning how to eat and perceive satiety using a unique feed‐back system, together with provision of warmth, limitation of exercise and facilitating social adaptation.
Expression pattern of keratin subclasses in pancreatoblastoma with special emphasis on squamoid corpuscles
Authors: Nishimata Shigeo , Kato Keisuke , Tanaka Mio , Ijiri Rieko , Toyoda Yasunori , Kigasawa Hisato , Ohama Yokatsu , Nakatani Yukio , Notohara Kenji , Kobayashi Yasutsugu , Horie Hiroshi , Hoshika Akinori , Tanaka Yukichi
Published: June 2005

Expression patterns of keratins (K), both simple epithelia‐type (K7, K8, K18, K19) and complex/stratified epithelia‐type (K1, K4, K5/6, K10, K13, K14, K15, K16, K17), and epithelial membrane antigen (EMA) were immunohistochemically studied in six pancreatoblastomas (PBL). In all six tumors, areas with overt acinar differentiation (AA), solid areas without any specific differentiation (SO), and squamoid corpuscles (SC) were diffusely positive for K8, K18, and K19. The AA and SO in all the tumors were diffusely positive for K7, but the SC were negative or displayed only scattered reactivity for K7. In three tumors, the AA and the SC showed scattered reactivity for K5/6. No reactivity for other complex/stratified epithelia‐type K was found in any of the examined tumor. All tumors were reactive for EMA with consistent predominancy in the SC. Ultrastructurally, well‐developed desmosome‐tonofilament complexes were only partially observed in tumor cells comprising the SC. These results implied that (i) the SC usually lack a character of complete squamous metaplasia; and (ii) the SC have a characteristic phenotype (K8/K18/K19/EMA‐positive, K7‐negative or scatteredly positive) that can potentially be useful to delineate the SC in PBL.
Aberrant methylation and loss of expression of O6‐methylguanine‐DNA methyltransferase in pulmonary squamous cell carcinoma and adenocarcinoma
Authors: Furonaka Osamu , Takeshima Yukio , Awaya Hirokazu , Kushitani Kei , Kohno Nobuoki , Inai Kouki
Published: June 2005

O6‐Methylguanine‐DNA methyltransferase (MGMT) is a DNA repair protein that protects cells against the carcinogenic effects of alkylating agents. The methylation status of the MGMT gene was investigated by methylation‐specific polymerase chain reaction (PCR) and expression status was investigated by immunohistochemistry in 70 cases of pulmonary squamous cell carcinoma (pulmonary SqCC), including 23 cases of the central type and 47 cases of the peripheral type, and in 53 cases of the peripheral type of pulmonary adenocarcinoma (AC). The frequency of MGMT methylation was 36% in SqCC and 42% in AC. Cases with MGMT methylation correlated significantly with T factor in SqCC (P = 0.047) and AC (P = 0.03). In SqCC, the frequency of MGMT methylation was 26% in the central type and 40% in the peripheral type; a significant correlation was not found (P = 0.29). In AC with mixed subtypes showing MGMT methylation, the level of MGMT expression in the bronchioloalveolar carcinoma (BAC) area (non‐invasive status) was significantly higher than that in the papillary or acinar AC area (invasive status; P = 0.0002). This trend was not found in AC with mixed subtypes showing no MGMT methylation (P = 0.10). These findings suggest that MGMT inactivation is an event that occurs in the late carcinogenic process in SqCC and AC, and that AC progress from non‐invasive status to invasive status with MGMT inactivation induced by the promoter DNA methylation.
Comparison between immunohistochemistry and chromogenic in situ hybridization in assessing HER‐2 status in breast cancer
Authors: Todorović‐Raković Nataša , Jovanović Danica , Nešković‐Konstantinović Zora , Nikolić‐Vukosavljević Dragica
Published: June 2005

Human epidermal growth factor receptor‐2 (HER‐2) is usually determined as a potential target for breast cancer therapy. The purpose of the present study was to compare chromogenic in situ hybridization (CISH) with immunohistochemistry (IHC) in determination of HER‐2 status, in metastatic breast cancer patients screened for the clinical study of chemotherapy ± herceptin. It was possible to assess both CISH and IHC in 56 cases, using CISH Detection Kit (Zymed) and HercepTest (DakoCytomation), respectively. HER‐2 was amplified by CISH in 32 cases (57%) while 33 (59%) were HER‐2‐positive by IHC. A concordance between HER‐2 status determined by CISH and IHC was noted in 43 of 56 cases (77%; P = 0.00008). Gene amplification was observed in 6/16 cases (37.5%) in IHC‐negative subgroup (1+), while no amplification was observed in 5/10 cases (50%) in the IHC‐positive subgroup (2+). These results suggest that there was a greater heterogeneity on the genetic level and that simple IHC classification was not sufficient. It is suggested that CISH could be considered as a useful additional method to IHC in determining HER‐2 status in breast cancer patients, with a recommendation for testing not only the 2+ but also the 1+ subgroup of patients.
Expression of survivin and of antigen detected by a novel monoclonal antibody, T332, is associated with outcome of diffuse large B‐cell lymphoma and its subtypes
Authors: Watanuki‐Miyauchi Rumiko , Kojima Yasushi , Tsurumi Hisashi , Hara Takeshi , Goto Naoe , Kasahara Seiji , Saio Masanao , Moriwaki Hisataka , Takami Tsuyoshi
Published: June 2005

Although diffuse large B‐cell lymphoma (DLBCL) is the most common type of non‐Hodgkin lymphoma, it is both clinically and morphologically heterogenous. The present study investigates the significance of survivin and a novel monoclonal antibody (MAb), T332, immunohistochemically for predicting the prognoses of DLBCL and its subtypes classified as germinal center B‐cell‐like type (GCB) and non‐GCB type (NGCB) based on the expression profiles of CD10, bcl‐6, and MUM1. A total of 60 cases of DLBCL (GCB, n = 22; NGCB, n = 38) were examined for the expression of survivin and T332 antigen. Survivin+ DLBCL had a significantly worse prognosis (P = 0.01) than survivin– cases, as already reported, while survivin+ GCB or NGCB tended to have poor prognoses (P = 0.06 and 0.07, respectively). However, T332+ DLBCL and NGCB had significantly more unfavorable prognoses than T332– cases (P = 0.01 and 0.02, respectively) while there was no significant survival difference between the T332+ and T332– groups of GCB (P = 0.11). Interestingly DLBCL coexpressing survivin and T332 (n = 13) had a significantly worse prognosis (P = 0.009) than the remaining single positive and double negative cases (n = 31). In conclusion, survivin and the novel MAb, T332, might be a good predictor of DLBCL and its subtypes.
Adenoid glioblastoma arising in a patient with neurofibromatosis type‐1
Authors: Miyata Shiro , Sugimoto Tetsuaki , Kodama Takao , Akiyama Yutaka , Nakano Shinichi , Wakisaka Shinichiro , Itoh Hiroshi , Kataoka Hiroaki
Published: June 2005

An unusual case of glioblastoma with adenoid structures arising in a 30‐year‐old Japanese woman with neurofibromatosis type‐1 (NF1) is reported. The patient was admitted to University of Miyazaki Hospital, complaining of headache, nausea and vomiting. From the neuroradiological findings the patient was diagnosed as having glioblastoma, and the tumor was surgically resected. Histologically, the tumor consisted mainly of dark basophilic cells showing prominent tubular or glandular structures surrounded by large eosinophilic cells, in addition to the typical glioblastoma features in the periphery of the tumor. Both cells showed strong stainability with glial fibrillary acidic protein (GFAP) and S‐100 protein immunohistochemically, so that the tumor was classified as adenoid glioblastoma. Several cases of glioblastoma have been reported to reveal the adenoid or epithelioid differentiation. The patients with NF1 are prone to develop malignant tumors including glioblastoma, but no cases representing adenoid glioblastoma associated with NF1 have been reported. This report is considered to be the first case of adenoid glioblastoma arising in a patient with NF1. The recognition of the existence of epithelial features of glioblastoma would be important in differential diagnosis of epithelioid tumors of the brain including metastatic carcinomas.
Histiocytoid breast carcinoma: Solid variant of invasive lobular carcinoma with decreased expression of both E‐cadherin and CD44 epithelial variant
Authors: Fujiwara Masachika , Horiguchi Miwa , Mori Satoshi , Yokoyama Koichi , Horiguchi Hisashi , Fukazawa Masakatsu , Fujiwara Hiromi , Yano Yukiko , Satoh Hiroaki , Kamma Hiroshi
Published: June 2005

Histiocytoid breast carcinoma (HBC) is a rare type of breast carcinoma with morphologic characteristics resembling those of histiocytes. Described herein are cytological and histological findings in a case of HBC. Fine‐needle aspiration cytology revealed numerous loosely cohesive tumor cells with abundant foamy to granular cytoplasm and bland‐appearing nuclei. The resected tumor exhibited a solid growth pattern instead of classic invasive lobular patterns observed in most reported cases of HBC. However, distinct intracytoplasmic lumina and Pagetoid extension to ducts suggested that this tumor was a variant of invasive lobular carcinoma. To determine the cause of the loose cellular cohesiveness of this HBC, its expression of the epithelium‐related cell adhesion molecules E‐cadherin and CD44v8‐10 (CD44 epithelial variant) was examined. Immunohistochemically, E‐cadherin was not detected, similar to most lobular carcinomas. Furthermore, competitive reverse transcription–polymerase chain reaction (RT‐PCR) analyses among alternatively spliced variants of CD44 revealed that the ratio of expression of CD44v8‐10 to that of CD44v10 (dominant variant in leukocytes) was lower than that for the reference breast carcinoma samples. It is concluded that the present case of HBC was a solid variant of invasive lobular carcinoma exhibiting foamy to granular cytoplasmic change. Decreased expression of both E‐cadherin and CD44 epithelial variant may be responsible for the loose cellular cohesiveness observed in HBC.
Composite distal nephron‐derived renal cell carcinoma with chromophobe and collecting duct carcinomatous elements
Authors: Kawano Naomi , Inayama Yoshiaki , Nakaigawa Noboru , Yao Masahiro , Ogawa Toru , Aoki Ichiro , Kitamura Hitoshi , Nakatani Yukio , Nagashima Yoji
Published: June 2005

Chromophobe renal cell carcinoma (RCC) and collecting duct carcinoma (CDC) are derived from the collecting duct epithelia, although their morphology, molecular biologic characteristics and clinical behaviors are quite different. Herein is presented a case of RCC possessing the chromophobe RCC and CDC elements occurring in a 64 year‐old Japanese woman. The patient was referred to Yokohama City University Hospital with complaints of persistent back pain and fever. Radiologic examinations revealed a left renal tumor, and radical nephrectomy was performed. The patient died with multiple metastases, 8 months after the operation. The resected tumor showed an invasive growth, and its cut surface was heterogenous with hemorrhage and necrosis. Histologically, the tumor was composed of chromophobe elements with dedifferentiation, and CDC elements. The chromophobe and CDC elements had obvious histological transition. Lectin histochemistry and immunohistochemistry confirmed that this tumor was derived from the distal nephron. c‐KIT, p53 and Ki67 antigen showed differential localization between the chromophobe and CDC elements, even in the transitional areas. Along with the previous reports, the present case seemed to be composite RCC derived from the collecting duct, which might present clues to elucidate carcinogenesis in the distal nephron.
Primary mucinous adenocarcinoma of the vagina: Possibility of differentiating from metastatic adenocarcinomas
Authors: Saitoh Maki , Hayasaka Tadashi , Ohmichi Masahide , Kurachi Hirohisa , Motoyama Teiichi
Published: June 2005

Primary vaginal adenocarcinomas are rare neoplasms. Herein is reported a case of primary vaginal mucinous adenocarcinoma with an interesting mucin profile, presumably arising from a lesion of adenosis in a patient without in utero exposure to diethylstilbesterol (DES). The patient, a 44‐year‐old woman, had undergone vaginal total hysterectomy 10 years previously for myoma uteri corporis. The histological features of the vaginal intramural tumor found in this patient resembled those of mucinous adenocarcinoma of the endocervical type. Therefore, it was necessary to determine whether or not the tumor was metastatic from an occult cervical adenocarcinoma. However, the adenocarcinoma cells of the present case did not contain sulfomucin at all, being different from most mucinous adenocarcinoma cells of the endocervical type. Moreover, there were foci of adenosis adjacent to the adenocarcinoma foci, which also did not contain sulfomucin. These findings indicate that the mucinous adenocarcinoma arose from vaginal adenosis. Further studies are necessary to investigate whether lack of sulfomucin expression is a characteristic feature of vaginal adenosis.
Accumulation of cytoplasmic β‐catenin correlates with reduced expression of E‐cadherin, but not with phosphorylated Akt in esophageal squamous cell carcinoma: Immunohistochemical study
Authors: Zhang Guo , Zhou Xiaobo , Xue Liyan , Quan Lanping , Wang Yihua , Zhou Cuiqi , Lu Ning , Wang Quanhong , Zhu Hongxia , Xu Ningzhi
Published: June 2005

Accumulation of β‐catenin in cytoplasm occurs frequently during the pathogenesis of esophageal squamous cell carcinoma (ESCC). The mechanism leading to this alteration, however, is largely unknown. In the present study, immunohistochemistry was performed for β‐catenin, E‐cadherin and Ser473 phosphorylated Akt (P‐Akt) in 44 tissue samples of ESCC and corresponding normal esophageal epithelium. Exon 3 of the β‐catenin gene was analyzed by using single‐strand conformation polymorphism and direct sequencing. In addition to the reduced expression of E‐cadherin and membranous β‐catenin observed in 65.9% and 68% of ESCC tested, respectively, cytoplasmic accumulation of β‐catenin was also detected in 68% (30/44) cases. However, only two cases were found to have the same β‐catenin gene mutation. The data showed that cytoplasmic accumulation of β‐catenin was significantly associated  with  reduced  expression  of  E‐cadherin  (P < 0.05) and that of membranous β‐catenin (P < 0.05). Furthermore, cytoplasmic β‐catenin was correlated significantly with lymph node metastasis (P < 0.05). In contrast, although strong staining of P‐Akt occurred in 14 of 44 cases (32%), there was no significant correlation between the positive staining of P‐Akt and cytoplasmic β‐catenin. Taken together these results suggest that the lost membranous β‐catenin might translocate to cytoplasm depending on reduced expression of E‐cadherin, while Akt seems unlikely to play a role in this process.
Pulmonary involvement in Erdheim‐Chester disease
Authors: CHUNG Jae H. , PARK Moo S. , SHIN Dong H. , CHOE Kyu O. , KIM Se K. , CHANG Joon , KIM Sung K. , KIM Young S.
Published: June 2005

Abstract:  Erdheim–Chester disease is a disseminated non‐Langerhans’ cell histiocytosis involving multiple organs with characteristic sclerotic musculoskeletal lesions. This is the report of the case of a 53‐year‐old woman with extensive and progressive pulmonary disease. Computed tomography scans revealed diffuse infiltrative lung disease. Thoracoscopic lung biopsy and a biopsy of the right femur lesion were performed. The histopathology revealed that she had non‐Langerhans’ cell histiocytosis; Erdheim–Chester disease. The characteristic lesions of Erdheim–Chester disease, including involvement of the orbit, pericardium, periaorta, and bone were detected. This helped to further confirm that the patient had Erdheim–Chester disease with associated pulmonary involvement. As Erdheim–Chester disease is a rare non‐Langerhans’ cell histiocytosis that may be misdiagnosed as interstitial lung disease or other pulmonary disorders, this diagnosis should be considered in the differential diagnosis of such lung lesions.
Successful treatment of invasive pulmonary aspergillosis in an immunocompetent host
Authors: POLAT Gülru , ÜRPEK Gülcan , YILMAZ Ufuk , BÜYÜKŞIRIN Melih , KARADAĞ POLAT Serpil , ULUER Servet , TİBET Gültekin
Published: June 2005

Abstract:  Immunocompromised individuals are susceptible to pulmonary Aspergillus infection, but invasive Aspergillus infection is extremely rare in the presence of normal immunity. A case of invasive pulmonary aspergillosis in an immunocompetent 57‐year‐old female who was successfully treated with liposomal amphotericin‐B is reported here.
Pneumocystis carinii pneumonia infection in a patient with known chronic mucocutaneous candidiasis
Authors: M cKEON Damian J. , WHITE William , SINCLAIR David , GOLDMAN John M.
Published: June 2005

Abstract:  Chronic mucocutaneous candidiasis is a disorder of the skin, nails or mucous membranes in the absence of another cause of the infection. It is also associated with autoimmune endocrinopathies in 40% of patients. It is thought to be due to a T‐cell defect, although no precise mechanism has been elucidated. There have been two previous cases of Pneumocystis carinii pneumonia reported with this condition. We report a fatal case in a 34‐year‐old male.
High resolution CT and bronchial reversibility test for diagnosing COPD
Authors: KURASHIMA Kazuyoshi , TAKAYANAGI Noboru , SATO Nagato , KANAUCHI Tetsu , HOSHI Toshiko , TOKUNAGA Daido , UBUKATA Mikio , YANAGISAWA Tsutomu , SUGITA Yutaka , KANAZAWA Minoru
Published: June 2005

Background:  COPD is defined by airflow limitation that is not fully reversible and is associated with relevant risk factors. The diagnosis requires that other causes of chronic airflow limitation (CAL) be excluded. We assessed the diagnostic utility of high resolution thoracic CT (HRCT) and bronchodilator reversibility to assist in making a diagnosis of COPD.

Methodology:  We investigated 516 consecutive patients whose FEV1/FVC was less than 70% after inhalation of bronchodilator. HRCT was performed on all subjects and a final diagnosis was made only after 3 months of treatment and repeated spirometry.

Results:  Of 516 cases, 54.3% had COPD, 19.8% had asthma plus emphysema, and 13.2% had chronic asthma. The remaining 12.7% of patients with CAL had diffuse panbronchiolitis, bronchiectasis, bronchiolitis obliterans, or other miscellaneous diseases. In these minor diseases HRCT was essential in making a definitive diagnosis. The sensitivities of emphysema on HRCT and of absence of bronchodilator response for the diagnosis of COPD were 81% and 90%, respectively, and the specificities of the tests were 57% and 37%, respectively. In addition, HRCT revealed considerable heterogeneity of COPD. Emphysema was not recognized on HRCT in 18.6% of COPD patients. HRCT also revealed that 17.5% of COPD patients had other pulmonary complications including lung fibrosis compatible with usual interstitial pneumonia in the lung bases.

Conclusions:  HRCT and the bronchial reversibility test had reasonable sensitivities but low specificities for diagnosing COPD. HRCT has some additional advantages in detecting heterogeneity and concomitant lung diseases in COPD.
Antioxidant enzyme activities in healthy Chinese adults: influence of age, gender and smoking*
Authors: HO Siu P. , CHAN‐YEUNG Moira , CHOW Kathy K.M. , IP Mary S.M. , MAK Judith C.W.
Published: June 2005

Objective:  Specific antioxidant enzymes play a vital role in regulating and maintaining oxidant species. The aim of this study was to determine these antioxidant enzyme activities (i.e. catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx)) in erythrocytes from a group of healthy Chinese subjects and to study the influence of age, gender and smoking habits on the enzyme activities.

Methodology:  Chinese healthy subjects (n = 276) were grouped according to their age range, gender differences and smoking habits. Antioxidant enzyme activities were measured spectrophotometrically using standard kinetic methods.

Results:  There was a significant decrease in erythrocyte GPx activity in ever‐smokers compared with non‐smokers (47.10 ± 1.33 mU/g haemoglobin (Hb) vs. 51.41 ± 1.64 mU/g Hb, P < 0.05). Age‐related significant increases in erythrocyte CAT and SOD activities were found in non‐smokers but not in ever‐smokers. There was no age‐related difference in erythrocyte GPx activity in either non‐smokers or ever‐smokers. Among those >60 years old, erythrocyte CAT and GPx activities were significantly lower in ever‐smokers than in non‐smokers (29.70 ± 3.07 mU/g Hb vs. 41.63 ± 4.92 mU/g Hb (P < 0.05), and 47.55 ± 2.00 mU/g Hb vs. 55.30 ± 3.60 mU/g Hb (P < 0.05), respectively). It was also found that females had higher erythrocyte GPx activity than males but this difference did not reach significance in non‐smokers.

Conclusion:  From the results of this study, it is concluded that oxidative stress seems to be present in elderly ever‐smokers among the Chinese population.