bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary study on DNA damage in non breast‐fed infants
Authors: DÜndaröz RuŞen , Aydin Halil İBrahim , Ulucan Hakan , Baltaci Volkan , Denli Metin , Gökçay Erdal
Published: March 2003

Background
: There are many advantages of human milk for infants, including protection against cancer development and the advantages have been emphasized in several studies. In this study, infants fed by human milk has been compared with those fed by cow’s milk concerning DNA damage.

Methods
: The level of genetic damage in the peripheral blood lymphocytes of infants who were fed mainly by cow’s milk and breast milk has been studied by sister chromatid exchange (SCE) analysis, which is a sensitive measurement of chromosomal damage. Each group consisted of 30 infants, whose ages ranged from 9 to 12 months.

Results
: A significant increase (P < 0.0001)
was found in the frequencies of SCE of infants not breast‐fed (n = 30,
mean SCE/cell ± SD: 8.66 ± 1.15)
compared to those who were breast‐fed (n = 30, mean SCE/cell ± SD: 4.93 ± 0.82).

Conclusion
: To our knowledge, there has been no published study investigating SCE ratio regarding DNA damage in infants not breast‐fed. Molecular mechanism of DNA damage caused by the absence of human milk protection is a subject of future investigations.
Pregnancy complicated with lactate dehydrogenase M‐subunit deficiency: The first case report
Authors: Anai Takanobu , Urata Kenichirou , Tanaka Yuichirou , Miyakawa Isao
Published: March 2003

A woman with lactate dehydrogenase M‐subunit deficiency underwent two cesarean sections because of the risk of dystocia due to decreased adenosine triphosphate production in anaerobic glycolysis including uterine muscles. Frequent pains with increased serum pyruvate levels were observed during the third trimester of her pregnancies.
Growing teratoma syndrome after chemotherapy for a mixed germ cell tumor of the ovary
Authors: Itani Yoshio , Kawa Motohiro , Toyoda Shinji , Yamagami Keizoh , Hiraoka Katsutada
Published: March 2003

A retroperitoneal enlarging mass was detected and resected in a 24‐year‐old nulliparous woman after fertility‐preserving surgery and adjuvant chemotherapy for a malignant germ cell tumor (MGCT) of the right ovary. This enlarging mass contained only a mature teratoma component. Alpha‐fetoprotein, which was elevated to 21236.6 ng/mL before the initial surgery, persisted within normal after the completion of adjuvant platinum‐based chemotherapy. The patient was diagnosed with growing teratoma syndrome. Growing teratoma syndrome originating from ovarian germ cell tumor is very rare. Only 15 cases have been reported. Surgical resection and histological confirmation of growing mass after MGCT treatment is essential before conducting salvage chemotherapy.
In‐vitro Fertilization and Embryo Transfer and Cellular Immunity: Study on Cytokines and T Lymphocyte subpopulations in IVF‐ET Cycles
Authors: Murakami Mitsutaka , Furuya Kenichi , Makimura Noriko , Kikuchi Yoshihiro , Nagata Ichiro
Published: March 2003

Objectives:

To determine whether peripheral T lymphocyte subpopulations and cytokines change during in‐vitro fertilization and embryo transfer (IVF‐ET) cycles and to evaluate them with regard to pregnancy status and types of infertility.

Methods:

Peripheral T lymphocyte subpopulations and cytokines in 33 consecutive cycles of IVF‐ET were examined. All the women were stimulated with purified FSH and hCG after pituitary suppression with GnRH agonist. Peripheral blood samples were collected before FSH administration, on the day of hCG administration, the day of ET (day 2), day 6 and day 15. We measured plasma estradiol and progesterone levels and plasma interferon‐γ, interleukin‐4 (IL‐4), IL‐10 and IL‐12 levels. Peripheral T lymphocyte subpopulations, T helper type 1 and 2 cells (Th1 and Th2) and T cytotoxic type 1 and 2 cells (Tc1 and Tc2), were analyzed with three‐color flowcytometry.

Results:

There were no changes in the plasma levels of the cytokines or in the proportions of Th1 and Th2 and the proportions of Tc1 and Tc2 in peripheral blood lymphocytes during the IVF‐ET cycles. In women with endometriosis, the ratios of Tc1 to CD8+ lymphocytes and the Tc1 to Tc2 ratios before FSH administration were much higher than in women without endometriosis. The ratios of Tc1 to CD8+ lymphocytes were significantly lower in the patients with endometriosis who became pregnant.

Conclusions:

Peripheral cellular immunity does not change during IVF‐ET cycles. In women with endometriosis, the peripheral Tc1 subpopulation is more predominant before ovarian stimulation, suggest‐ ing that the ratio of Tc1 before ovarian stimulation could be an indicator of fecundity for women with endometriosis.
Sonographic Determination of Fetal Size from 20 Weeks of Gestation Onward Correlates with Birth Weight
Authors: Yoshida Sho‐hei , Unno Nobuya , Kagawa Hideyuki , Shinozuka Norio , Kozuma Shiro , Taketani Yuji
Published: March 2003

Objective:
 To evaluate the clinical efficacy of ultrasonographic measurement of fetal weight, estimated fetal weight (EFW) was analyzed in relation to birth weight.

Methods:
 Data were collected retrospectively from the medical records of 548 term pregnancies unassociated with fetal malformations. The subjects underwent sonographic examinations from 20 to 23 weeks onward at 4 weeks intervals for the estimation of EFW. Subjects were divided into 6 subgroups based on birth weight deviation (BWD) (A: −3.0 ≤ BWD < −2.0; B: −2.0 ≤ BWD < −1.5; C: −1.5 ≤ BWD < −1.0; D: −1.0 ≤ BWD < −0.5; E: −0.5 ≤ BWD < +0.5 and F: + 0.5 ≤ BWD). Distribution and changes in EFW deviation (EFWD) with gestational age were analyzed related to BWD.

Result:
 A difference in fetal growth based on EFWD was noted in small for gestational age (SGA) cases compared to non‐SGA cases, and the difference was observed as early as 20–23 weeks. EFWD was significantly correlated with BWD from 20−23 weeks to term.

Conclusion:
 Sonographic determination of fetal growth from 20 weeks of gestation onward correlated with birth weight deviation, and this emphasized the clinical value of evaluating fetal growth during the latter half of pregnancy.
Developing A&E nursing responses to people who deliberately self‐harm: the provision and evaluation of a series of reflective workshops
Authors: Holdsworth N. , Belshaw D. , Murray S.
Published: March 2003

Accident & Emergency (A&E) departments and Medical Admission Units (MAUs) are an essential part of emergency mental health care in the UK. Deliberate self‐harm and attempted suicide are particular challenges to nursing staff in such departments. Two registered mental nurses with experience of education facilitated a series of workshops with nurses from four A&E departments, two Minor Injuries Units and two MAUs. These were focused upon the assessment and management of deliberate self‐harm and attempted suicide. During the workshops, participants provided systematic information on presentations of deliberate self‐harm and attempted suicide, and on their professional responses to such presentations. These accounts provided invaluable information on deliberate self‐harm and attempted suicide as seen by nursing staff in A&E and MAUs. Critical reflection upon nursing responses to these presentations revealed particular concerns nurses had relating to their experience with this client group which might inform future practice. Evaluation of the workshops indicated a subsequent decrease in work‐related stress, which was probably a consequence of improved professional coping responses by the nurses concerned.
A phase I trial of Depsipeptide (FR901228) in patients with advanced cancer
Authors: Marshall John L. , Rizvi Naiyer , Kauh John , Dahut William , Figuera Manuela , Kang Min H. , Figg William D. , Wainer Irving , Chaissang Christoff , Zhaoyang Li Megan , Hawkins Michael J.
Published: March 2003

Depsipeptide (FR901228) is a bicyclic peptide isolated from Chromobacterium violaceum that has demonstrated potent in vitro cytotoxic activity against human tumor cell lines and in vivo efficacy against human tumor xenografts. The primary mechanism of action is through inhibition of histone deacetylase. Initial development was halted due to significant cardiac toxicity. Subsequent studies performed at the National Cancer Institute demonstrated administration without cardiotoxicity was possible by varying the schedule of administration. A phase I trial was designed to determine the maximum tolerated dose and toxicity profile when administered as a 4‐hour infusion weekly × 3 with one week rest. 33 Patients with advanced, incurable cancers were enrolled into this trial and treated with doses of Depsipeptide ranging from 1 mg/m2 to 17.7 mg/m2. At doses above 5 mg/m2, we observed common symptoms of nausea, vomiting, fatigue, and anorexia. Subtle changes in ECGs were seen in several patients. However, no cardiac enzyme abnormalities or reduction in ejection fraction were observed. The MTD was defined as 13.3 mg/m2 with dose limiting toxicities being grade 3 thrombocytopenia and fatigue. Depsipeptide can be safely administered when given as a 4‐hour infusion and further clinical trials are warranted.
Cellular drug action profile paradigm applied to XK469
Authors: Subramanian Balanehru , Nakeff Alexander , Media Joseph , Wentland Mark , Valeriote Frederick
Published: March 2003

The cellular paradigm presented here defines the cellular action profile of new anticancer agents that complements our discovery and development paradigm. The main elements of this profile include a concentration clonogenicity response relationship on proliferating and plateau phase cells, flow cytometry studies assessing progression delay and apoptosis, macromolecular synthesis inhibition, and DNA damage assessment by the comet assay; other specific assessments then derive from these findings such as topoisomerase assays. XK469 is a new anticancer agent derived from the herbicide Assure that is the inactive parent compound of a family of quinoxaline analogs found to have anticancer activity in vivo. We have applied the described cellular action profile paradigm to XK469 to define a novel action at the cellular level. XK469 is a G2M phase‐specific, antiproliferative agent whose activity is related to the 7‐position of the chlorine ion in the benzene ring and expressed through a unique cellular action profile resulting in the irreversible increase in cyclin B1 (possibly by specific inhibition of its ubiquitination) and leading, in the absence of apoptosis, to the final mitotic arrest of HCT‐116 cells in prophase with subsequent loss of clonogenicity.
Gene therapy in cancer
Authors: Kellen John A.
Published: March 2003

Genetics have and will continue to have a strong and often controversial impact on our lives. Since the first human gene therapy in l989, data from some 400 officially approved trials have been reported; only a handful appears promising. Of course, one must discern between gene replacements that correct inherited genetic disorders for life and the specific replacement of mutant genes that initiate or maintain the malignant phenotype with a correct gene copy. A truly reliable, safe, and efficient gene delivery system is not yet available, and many techniques have serious limitations or may be outright dangerous. Nevertheless, strong scientific and economic forces keep driving genetic research in cancer, with the promise of immortal fame (and even greater monetary rewards).
Xanthomonas albilineans and the antipathogenesis approach to disease control
Authors: Birch Robert G.
Published: March 2003

Molecular studies into sugarcane leaf scald disease, caused by X. albilineans, revealed an unusual pathogenesis strategy, a new family of antibiotics, an extraordinary biosynthetic apparatus, and a new approach to disease control in plants and animals.

Taxonomy: Bacteria; Proteobacteria; gamma subdivision; Xanthomonadales; Xanthomonas group; X. albilineans (Ashby 1929) Dowson 1943.

Microbiological properties: Gram‐negative, slender rod‐shaped, nonsporing, aerobic, motile by a single polar flagellum; producing slow‐growing, pale yellow, nonmucoid colonies in culture; ecologically obligate plant parasite.

Host range: Monocotyledonous plants in the Poaceae family, including Saccharum spp. and other grasses. Causal agent of sugarcane leaf scald.

Disease symptoms: Characteristic white leaf stripes with necrotic zones at leaf margins, extensive chlorosis of emerging leaves, vascular reddening and cavity formation in invaded stems, production of side shoots, rapid wilting and death of plants. Prolonged latent infection can occur, necessitating detection by isolation or sensitive molecular assays.

Pathogenesis: Xylem‐invading pathogen, transmitted in cuttings, mechanically, and by wind‐blown rain. Produces albicidin toxins that block prokaryotic DNA replication and plastid development, causing chlorosis in emerging leaves. Albicidins interfere with host resistance mechanisms, allowing systemic invasion. Strains vary in virulence.

Agronomic importance and control: Sugarcane leaf scald is a widespread and devastating disease. Eradication is impractical because of alternative hosts. Measures to reduce inoculum sources and transmission can reduce losses. Long‐term control requires sugarcane varieties with introgressed resistance, thus limiting gains from breeding.

Antipathogenesis approach: By understanding key pathogenicity factors (such as albicidins), it may be possible to develop new control strategies, including novel resistance genes to rescue susceptible varieties.

Useful web site:
http://cygnus.tamu.edu/Texlab/Sugarcrops/Sugarcane/sugarc.html
Ralstonia solanacearum: secrets of a major pathogen unveiled by analysis of its genome
Authors: Genin Stéphane , Boucher Christian
Published: March 2003

Ralstonia solanacearum

Taxonomy:  Bacteria; Proteobacteria; β subdivision; Ralstonia group; genus Ralstonia

Microbiological properties:  Gram‐negative, aerobic, motile rod.

Disease symptoms:  Agent of bacterial wilt of solanaceous plants, which appears as a sudden wilt. Typically, stem cross‐sections ooze a whitish bacterial exudate. R. solanacearum is also the agent of the Moko disease of banana and brown rot of potato.

Disease control:  Pathogen‐free seed and transplants. Few resistant and tolerant plant lines. Sanitation and cultural rotations.

Useful web sites:  http://ibws.nexenservices.com/;
http://sequence.toulouse.inra.fr/R.solanacearum.html
Bipolaris sorokiniana, a cereal pathogen of global concern: cytological and molecular approaches towards better control‡
Authors: Kumar Jagdish , Schäfer Patrick , Hückelhoven Ralph , Langen Gregor , Baltruschat Helmut , Stein Elke , Nagarajan Subramaniam , Kogel Karl‐Heinz
Published: March 2003

Bipolaris sorokiniana
(teleomorph
Cochliobolus sativus
) is the causal agent of common root rot, leaf spot disease, seedling blight, head blight, and black point of wheat and barley. The fungus is one of the most serious foliar disease constraints for both crops in warmer growing areas and causes significant yield losses. High temperature and high relative humidity favour the outbreak of the disease, in particular in South Asia's intensive ‘irrigated wheat–rice’ production systems. In this article, we review the taxonomy and worldwide distribution, as well as strategies to counteract the disease as an emerging threat to cereal production systems. We also review the current understanding of the cytological and molecular aspects of the interaction of the fungus with its cereal hosts, which makes
B. sorokiniana
a model organism for studying plant defence responses to hemibiotrophic pathogens. The contrasting roles of cell death and H
2O2 generation in plant defence during biotrophic and necrotrophic fungal growth phases are discussed.
Structural and functional analysis of an oligomeric hydrophobin gene from Claviceps purpurea
Authors: Mey Géraldine , Correia Telmo , Oeser Birgitt , Kershaw Michael J. , Garre Victoriano , Arntz Claudia , Talbot Nicholas J. , Tudzynski Paul
Published: March 2003

Fungal hydrophobins are small hydrophobic proteins containing eight cysteine residues at conserved positions which have the ability to form amphipathic polymers. We have characterized a gene from the phytopathogenic ascomycete Claviceps purpurea, cpph1, which encodes a modular‐type hydrophobin. It consists of five units, each showing a significant homology to class II hydrophobins. The units are separated by GN‐repeat regions, which could form amphipathic α‐helices; the amino terminus contains a glycine‐rich region which could be involved in attaching the protein to the cell wall. The presence of long direct repeats within cpph1, and the high homology of the three internal modules suggest a recent generation of this gene from a tripartite precursor. Although sequencing of cDNA clones indicated that recombination could be mediated via the direct repeats, the majority of the transcripts appear to be full‐sized. This was confirmed by Northern blot analysis, which showed the presence of a full‐sized transcript in axenic culture. The high molecular weight pentahydrophobin was detected by Western blot analysis, indicating that CPPH1 is not processed into monomeric subunits. Targeted deletion of cpph1 did not lead to differences in morphology, growth rate, sporulation, or hydrophobicity of spores. Furthermore, the cpph1 deletion mutants showed no reduction in virulence on rye.
The role of milk in the British diet
Authors: Wells Anita S
Published: March 2003

Milk and foods made from milk have been part of the British diet for the last 3500 years. They constitute one of the four main food groups that together comprise a healthy balanced diet, providing significant amounts of protein and most micronutrients, including calcium, B‐group vitamins (particularly riboflavin and B12, but also thiamin, niacin, B6 and folate), vitamin A, iodine, magnesium, phosphorus, potassium and zinc. Milk and dairy foods can increase the nutrient density of the diet and play a pivotal role in ensuring that dietary intakes are nutritionally adequate. They can also help to improve bone and dental health and possibly protect against hypertension and colon cancer.
An alternative heat treatment for milk pasteurization in Cameroon
Authors: Kameni A , Imele H , Mbanya N J
Published: March 2003

In order to determine a suitable temperature and time combination for the proper pasteurization of milk under conditions in Cameroon, the destructive effects of heat on the peroxidase and micro‐organisms in local milk were studied. In the first step, fresh milk samples were heated at temperatures of 64–100°C for 1 min. Peroxidase was found to be sensitive to heat treatment at temperatures of 74–76°C and completely destroyed above 78°C. In the second step, fresh milk samples were heated to 74°C and held at that temperature for 15 s, 5 min, 10 min, 15 min or 20 min; microbiological analyses revealed that survival rates were 56.7, 1.5, 0.2, 0.06 and 0.05%, respectively. Peroxidase was completely destroyed after 10 min at this temperature. In terms of microbial quality, there were no significant differences (P < 0.001) between holding times of 10, 15 and 20 min. A heat treatment of 74°C for 10 min yielded milk free of peroxidase and with < 10 000 cfu/mL. It is recommended that raw milk be given at least this treatment to ensure safe milk supplies in Cameroon.
The Medical Information Research Unit, Leeds Polytechnic School of Librarianship
Authors: STRICKLAND‐HODGE BARRY
Published: March 2003

Since 1976 the Unit has undertaken a number of studies on the use of information sources by various groups, including genera1 practitioners and pharmacists. This work has indicated that although information was available these users seemed either unable or unwilling to retrieve it, possible reasons being lack of time or expertise or knowledge of its existence. Leeds Polytechnic School of Librarianship has concentrated research effort by the creation of a Medical Information Research Unit. The oyanizatiorl, aims and activities of the Unit are described.
Medical books publishing in traditional printed formats: current trends
Authors: DOODY DANIEL J.
Published: March 2003

An analysis of more than 1200 English language health sciences books bearing a 1996 copyright published by 95 publishers in 91 specialities indicates that the medical book industry is healthy, active and responsive to the shifting demands of the health sciences market‐place. Despite the gradual migration of authors, publishers and readers towards electronic formats, book publishing activity has not abated. In fact, the price, quality and quantity of books for health sciences professionals and students are all still on an upward slope.

These trends do not project into the future. With the twin pressures of health care reform and the revolution of information technology, the medical book is a potentially endangered species. While not threatened with extinction, the book will account for a dwindling percentage of the total revenues generated from new health sciences publications.

Although medical book publishing is dominated by books coming out ofthe United States, this paper also analyses the role and contribution of UK originated books.
A code of ethics for European health librarians: the points of departure
Authors: McSEÁN TONY , TSAFRIR JENNI
Published: March 2003

Codes of ethics are a classic mark of a profession, and their preparation is an important part of the work expected of a professional organization. EAHIL has recently embarked on drafting a code for European health librarians. This paper explains the background to EAHIL's decision, and reviews existing codes of ethical practice in the fields of both medicine and library and information work.
The librarian as a teacher: experiences from a problem‐based setting
Authors: FRIDÉN KERSTIN
Published: March 2003

The effects of problem‐based learning (PBL) and the expansion of information technology on library user education are discussed. To plan and to realize user education from a PBL approach will demand close collaboration with the faculty to fit user education into the syllabus. The objectives must be to create information literate students. Teaching skills will in the future be an integrated part of librarianship.
Reflections on a user education session with nursing students
Authors: MARTIN SUSAN
Published: March 2003

Within the nursing profession, the introduction of diploma level education has resulted in a high demand for a wide range of information resources. Hand in hand with this comes the need for nurses to be able to question, evaluate and reflect on existing practice. Against this background the author became actively involved in setting up a user education programme. This paper explains the reasons and structure of the package and finishes with an evaluation of the project, which proved to be beneficial to the students, the lecturers and the library staff themselves.
The roles of library liaisons in a problem‐based learning (PBL) medical school curriculum: a case study from University of New Mexico
Authors: ELDREDGE JONATHAN D. , TEAL JANIS B. , DUCHARME JUDITH C. , HARRIS REBECCA M. , CROGHAN LILLIAN , PEREA JAMES A.
Published: March 2003

The relationships between problem‐based learning (PBL) curricula and libraries have generated a substantial number of journal articles, but few have addressed the importance of the interaction between health science libraries and PBL curricula. This article attempts to contribute to this dimension through a description of the roles of library liaisons.* First we describe the evolution of the liaison roles beginning 2 years prior to the implementation of a PBL curriculum. We then describe the core responsibilities of liaisons at the University of New Mexico (UNM) with mention of other innovative roles developed by some liaisons.
Performance indicators in NHS libraries
Authors: HEWLETT JOHN
Published: March 2003

Performance indicators (PIs), workload statistics and accreditation are different ways to assess the quality of a library information service (LIS), and can be used together to give an overall picture of how well a LIS is performing its functions. PIs point out how something has been done. They are comparative values, often expressed partly as ratios or percentages, which indicate the quality or level of services and can be used to compare similar services, or the same service across time. PIs, performance ratios or performance standards are derived from performance measures, which show how much of it has been done.

This paper looks at some aspects of performance measurement and suggests other areas for statistics collection in order to make better use of existing data, and considers the usefulness and derivation of PIs in NHS LIS.
Partial or near‐total pancreatectomy for persistent neonatal hyperinsulinaemic hypoglycaemia: the pathologist's role
Authors: Rahier  , Sempoux  , Fournet  , Poggi§  , Brunelle  , Nihoul‐Fekete  , Saudubray  , Jaubert
Published: March 2003

Aims: To determine whether the presence of abnormal B‐cell nuclei predicts the existence of a focal or of a diffuse form of persistent neonatal and infantile hyperinsulinaemic hypoglycaemia in a series of 20 infants.

Methods and results:

Intra‐operative frozen sections were performed on small specimens from the pancreatic head, isthmus and tail. In 13 cases, abnormal B‐cell nuclei were identified, but even a near‐total pancreatectomy was insufficient to cure some of these patients, in whom no focal lesion was detected. On the other hand, abnormal insular B‐cell nuclei were not found in seven cases; based on the results of selective venous catheterization, a limited resection was performed, sufficient to cure each patient, and a focal adenomatous hyperplasia was found in each resected specimen.

Conclusions:

Intra‐operative examination of small pancreatic specimens taken from the different parts of the gland allows one to determine the type of lesion (focal or diffuse) in neonatal onset hyperinsulinaemic hypoglycaemia, and to decide on the most appropriate surgical treatment.
Affinity of four lectins for endocervical and endometrial non‐neoplastic and neoplastic glandular epithelium
Authors: Toda  , Sadi  , Egawa  , Atari  , Qureshi  , Nagai
Published: March 2003

Aims:

Endocervical and endometrial tissues were stained with four lectins to determine the difference in staining pattern between non‐neoplastic and neoplastic conditions of these tissues.

Methods and results:

The lectins used were Ulex europaeus agglutinin (UEA), Dolicho biflorus agglutinin (DBA), Concanavalin A (Con A), and Phaseolus vulgaris agglutinin (PHA). Endocervical tissues included normal endocervical glands, microglandular hyperplasia, minimal deviation adenocarcinoma and endocervical adenocarcinoma, well to poorly differentiated types. Endometrial tissues were collected from normal endometrium, simple glandular hyperplasia, complex hyperplasia, atypical hyperplasia and adenocarcinoma grades 1–3. Non‐neoplastic and neoplastic endocervical and endometrial glandular epithelium showed positive reaction for UEA, Con A and PHA. Non‐neoplastic glands showed mild to moderate intensity and apical and/polar type of staining pattern for all lectins. Endocervical adenocarcinoma including minimal deviation adenocarcinoma (MDC) and adenocarcinoma well to moderately differentiated type showed diffuse cytoplasmic type of staining pattern for all lectins, but poorly differentiated adenocarcinoma of endocervix showed only a stromal pattern for all lectins. Endometrial hyperplasia and adenocarcinoma grades 1–3 showed positive reaction for all lectins except for DBA. The staining pattern of endometrial hyperplasia was variable, but adenocarcinoma grades 1–3 showed diffuse type.

Conclusion:

Intensity and staining patterns of lectins are helpful in distinguishing between endocervical and endometrial non‐neoplastic and neoplastic lesions. Intense positive reaction of MDC, especially for Con A and PHA, can differentiate this lesion from normal endocervical glands. The stromal type of staining pattern of poorly differentiated endocervical adenocarcinoma can also have diagnostic significance. Negative reactions of DBA lectin for endometrial adenocarcinoma can be used for differentiating it from endocervical adenocarcinoma.
CD44v6 expression is related to progression in renal epithelial tumours
Authors: de Alava E , Panizo A , Sola I , Rodríguez‐Rubio F I , Javier Pardo‐Mindán F
Published: March 2003

Aims

Expression of CD44 variant isoform including exon 6 has been associated to tumour progression in several carcinomas. However, no studies have been performed to assess the prognostic value of the expression of this marker in renal cell tumours.

Methods and results

We studied 58 renal cell tumours. All patients were followed up for at least 3 years after nephrectomy. Tumours were analysed for expression of CD44v6 assessed by two isoform‐specific monoclonal antibodies. RT‐PCR was performed to detect CD44 variant transcripts in 10 cases in which immunohistochemistry was negative. Twenty‐two tumours showed reactivity in at least 1% cells for both antibodies with a strong membrane pattern. RT‐PCR did not show CD44v6 transcripts in any of 10 studied tumours. Immunohistochemical staining was more frequent in perivascular areas or in areas of vascular invasion. In fact, CD44v6 expression correlated well with nuclear grade (P = 0.009), stage at diagnosis (P = 0.04) and appearance of metastasis after nephrectomy (P = 0.007). Although univariate survival analysis showed stage (P < 0.001), grade (P = 0.009) and CD44v6 expression (P = 0.04) to be significant predictive factors, only stage remained significant (P = 0.0013) in the multivariate analysis.

Conclusions

CD44v6 expression, assessed immunohistochemically, is related to tumour progression. However, its prognostic value in renal cell tumours is dependent on tumour stage at diagnosis.
Multiple synchronous lung cancers and atypical adenomatous hyperplasia in Li–Fraumeni syndrome
Authors: Nadav Y , Pastorino U , Nicholson A G
Published: March 2003

Aim

We report a patient with Li–Fraumeni syndrome who developed multiple synchronous primary lung cancers together with atypical adenomatous hyperplasia, and discuss the pathogenesis of the lesions.

Case details

A 57‐year‐old woman with Li–Fraumeni syndrome and a history of smoking was diagnosed as having multiple synchronous primary lung tumours, all of which were treated by surgical excision. Histological examination showed three separate well‐differentiated adenocarcinomas and a single focus of atypical adenomatous hyperplasia. A constitutional mutation of the p53 gene had been identified, both in this patient and other members of her family.

Conclusion

Multiple synchronous primary lung tumours have not been reported before in association with this syndrome. With both smoking and Li–Fraumeni syndrome known to be associated with mutations in the p53 gene, a cumulative effect is suggested in this patient.
Peripheral primitive neuroectodermal tumour of the lung: report of two cases
Authors: Tsuji S , Hisaoka M , Morimitsu Y , Hashimoto H , Jimi A , Watanabe J , Eguchi H , Kaneko Y
Published: March 2003

Aims

We report two unusual cases of intrapulmonary small round cell tumour with evidence that they are primitive neuroectodermal tumours.

Methods and results

The patients were a 25‐year‐old woman and a 15‐year‐old man, in whom mass shadows were found by routine chest radiography. Both tumours were located in the pulmonary parenchyma, and there was no evidence of an extrapulmonary involvement by the tumour. The lesions showed morphological and immunophenotypic features consistent with peripheral primitive neuroectodermal tumour (pPNET). These features included a hypercellular diffuse growth pattern of closely packed small round cells occasionally forming abortive Homer–Wright‐type rosettes and intense immuroreactivities to neurone‐specific enolase and MIC2 gene product (O13). Unusual chondroid foci were present in one of the cases. This diagnosis was further supported by the cytogenetic and reverse transcriptase‐polymerase chain reaction (RT‐PCR) findings of the characteristic t(11;22) chromosomal translocation and EWS/FLI‐1 fusion transcripts, respectively, in one of the cases.

Conclusions

These morphological and cytogenetic findings substantiate pPNET as a subtype of intrapulmonary small round cell tumours.
The value of classifying interstitial pneumonitis in childhood according to defined histological patterns
Authors: Nicholson A G , Kim H , Corrin B , Bush A , Du Bois R M , Rosenthal M , Sheppard M N
Published: March 2003

Aims: Interstitial pneumonitis in children is very rare and most cases have been classified according to their counterparts in adults, although the term ‘chronic pneumonitis of infancy’ has recently been proposed for a particular pattern of interstitial lung disease in infants. We reviewed our paediatric cases of interstitial pneumonitis, first, to look at the spectrum of histological patterns found in this age group and, second, to determine whether the classification of such cases in childhood is both appropriate and worthwhile.

Methods and results

Twenty‐five of 38 open lung biopsies showed an overlapping spectrum of interstitial pneumonitis, including three cases that fulfilled the histological criteria for chronic pneumonitis of infancy. There were 11 cases of reactive pulmonary lymphoid hyperplasia (either lymphoid interstitial pneumonitis or follicular bronchiolitis), five of which were associated with abnormalities of the immune system. Four cases were classified as desquamative interstitial pneumonitis and the remaining seven cases were classified as non‐specific interstitial pneumonitis. There were no cases with the histological features of usual interstitial pneumonitis. Most patients responded to steroids but tended to have a residual deficit in lung function. Mortality appeared to be associated with presentation at a young age.

Conclusion

Classification of interstitial pneumonitis according to their adult counterparts is appropriate for this younger age group and can provide valuable information for the clinician. The term ‘chronic pneumonitis of infancy’ refers to a specific histological pattern, but whether it represents a separate disease or a reflection of pulmonary immaturity remains to be proven.
Grading and scoring in histopathology
Authors: Cross S S
Published: March 2003

In many areas of histopathology a nominal category, such as a diagnosis of breast carcinoma, does not give enough information for the referring clinician to make decisions about patient prognosis and treatment. Therefore scoring and grading systems have been developed which provide additional information. This article reviews the principles behind these systems with particular reference to the relationships between the natural clustering (or nonclustering) of cases and the imposition of arbitrary class boundaries on such distributions. The difference between real numbers and the ordinal categorical numeric labels, which are often produced by histopathology scoring systems, is discussed. The reproducibility of scoring and grading systems is reviewed and generic suggestions are given for developing new systems and for their validation.
MIB‐1 and p53 immunocytochemistry for differentiating pilocytic astrocytomas and astrocytomas from anaplastic astrocytomas and glioblastomas in children and young adults
Authors: Matsumoto T , Fujii T , Yabe M , Oka K , Hoshi T , Sato K
Published: March 2003

Aims

To establish whether MIB‐1 and p53 staining are useful for differentiating pilocytic astrocytomas and astrocytomas from anaplastic astrocytomas and glioblastomas. This study was restricted to children and young adults under 30 years of age because of the differences in p53 mutations between paediatric and adult astrocytomas.

Methods and results

Forty‐five astrocytic tumours, including 18 pilocytic astrocytomas, 14 astrocytomas, four anaplastic astrocytomas and nine glioblastomas, from 45 children and young adults, between 1 and 29 years (mean 11 years) of age, were examined pathologically, and sections from paraffin‐embedded blocks were used for MIB‐1 and p53 immunostaining. The MIB‐1 labelling index and the frequency and intensity of p53 staining in both the pilocytic astrocytoma and the astrocytoma group were significantly lower than in the anaplastic astrocytoma plus glioblastoma group (P < 0.001). In 11.1% (two of 18) of pilocytic astrocytomas and 42.9% (six of 14) of astrocytomas, immunoreactivity of either MIB‐1 or p53 staining was of almost the same intensity as that of anaplastic astrocytomas and glioblastomas. However, in these cases, results using both MIB‐1 and p53 stain differed from those for anaplastic astrocytomas and glioblastomas.

Conclusions

MIB‐1 and p53 co‐staining is very useful for differentiating pilocytic astrocytomas and astrocytomas from anaplastic astrocytomas and glioblastomas. However, MIB‐1 or p53 staining alone cannot differentiate pilocytic astrocytomas and astrocytomas from anaplastic astrocytomas and glioblastomas.
β2‐microglobulin amyloid deposition in hip revision arthroplasty tissues
Authors: Crawford R , Athanasou N A
Published: March 2003

Aims

Hip joint disease associated with progressive amyloid deposition in uraemic patients receiving chronic haemodialysis treatment often requires treatment by joint arthroplasty. The aim of this study was to determine whether β2‐microglobulin amyloid deposition occurred in the periprosthetic tissues of arthroplasties that had undergone aseptic loosening and required a revision procedure.

Methods and results

Sections of the pseudocapsule, acetabular and femoral pseudomembrane surrounding failed total hip replacements of five uraemic patients known to have β2‐microglobulin amyloid deposits at the time of primary joint replacement were examined for the presence of β2‐microglobulin amyloid deposition by Congo red staining and immunohistochemical staining for β2‐microglobulin and other amyloid proteins. Clinical and radiological features of each case, including postoperative history and extent of osteolysis, were also noted. In all cases evidence of β2‐microglobulin amyloid deposits were found in one or more of the above periprosthetic tissues. In three of these cases amyloid deposition was extensive.

Conclusions

This study shows that β2‐microglobulin amyloid deposition occurs in revision arthroplasty tissues. Accelerated loosening of the prosthesis is known to occur in uraemic patients and it is possible that β2‐microglobulin amyloid deposition may contribute to early arthroplasty failure in uraemic patients who remain on haemodialysis treatment.
Hepatic stellate cells (Ito cells) in veno‐occlusive disease of the liver after allogeneic bone marrow transplantation
Authors: Sato  , Asada  , Hara  , Marutsuka  , Tamura  , Hayashi  , Sumiyoshi
Published: March 2003

Aims

To evaluate the role of activated hepatic stellate cells (HSCs) in hepatic veno‐occlusive disease (VOD) after bone marrow transcription (BMT), we studied the distribution and area of activated HSCs by immunohistochemistry for α‐smooth muscle actin (SMA).

Methods and results

We examined the liver of seven autopsy cases with hepatic VOD or without VOD after allogeneic BMT and five autopsy cases without liver disease as a control both microscopically and immunohistochemically. In normal liver tissues, SMA‐positive cells were observed around the central veins, while they were more frequently noted along the sinusoidal walls as well as around the central veins in liver tissues with or without VOD after BMT. The area of activated HSCs increased significantly in zones 1 and 2, and more prominently in zone 3 of the liver tissues after BMT than normal liver tissues, and was much larger in zone 3 of liver tissues with VOD. The activated HSCs were immunohistochemically negative for the regulatory contractile proteins (heavy caldesmon and calponin).

Conclusions

These results indicated that the activated HSCs may play an important role in sinusoidal fibrosis and luminal narrowing or occlusion of the central veins in VOD after BMT.
The role of Helicobacter pylori in primary gastric MALT lymphoma
Authors: Bouzourene  , Haefliger  , Delacretaz  , Saraga
Published: March 2003

Aims

Helicobacter pylori has been claimed to be an important aetiological factor which raises the risk of mucosa‐associated tissue lymphoid (MALT) lymphoma. However, some studies on gastric MALT lymphoma revealed a low rate of H. pylori infection suggesting that not all gastric lymphomas are related to H. pylori infection. The aim of this study was to verify the H. pylori infection frequency in a series of patients with primary gastric MALT lymphomas and to examine the relationship between H. pylori and the pathological features of those lymphomas.

Methods and results

Thirty‐one cases of resected gastric lymphoma were analysed: 10 cases (32%) were low‐grade MALT lymphomas and 21 cases (68%) were high‐grade MALT lymphomas. Helicobacter pylori was found in only 18 of 31 (58%) cases. Helicobacter pylori infection was significantly correlated with the grade and depth of invasion of MALT lymphoma since 63% of superficial low‐grade MALT lymphomas were positive for H. pylori compared with 38% of advanced high‐grade MALT lymphomas (P = 0.02).

Conclusion

We confirmed the relationship between H. pylori infection and a subset of gastric MALT lymphoma. Our results also showed that not all low‐ and high‐grade gastric MALT lymphomas are H. pylori‐dependent. This suggests that H. pylori infection may play a promoter role in the development of MALT lymphoma, but its presence is not mandatory for the progression of the lymphoma in view of its low frequency in advanced high‐grade MALT lymphoma.
Expression of c‐kit (CD117) and Ki67 provides information about the possible cell of origin and clinical course of gastrointestinal stromal tumours
Authors: Seidal  , Edvardsson
Published: March 2003

Aims

Gastrointestinal stromal tumours (GIST) were analysed to determine their immunophenotype with emphasis on the expression of CD34 and c‐kit and to identify a possible cell of origin. Furthermore, the aim was to correlate clinical, histological and immunophenotypic parameters to their clinical course by means of statistical analysis.

Methods and results

An immunohistochemical analysis was performed on 64 cases of GIST. Three of the tumours displayed an immunohistochemical phenotype compatible with the diagnosis of leiomyomatous tumour. Almost half the tumours were stained positively for CD34 and 48 of 61 tumours were positive for c‐kit (CD117), a marker of haematopoietic progenitor cells, mast cells and the so‐called interstitial cell of Cajal (ICC). In most of the cases, the staining was strong and evenly distributed within the tumours. Statistical analysis on 31 cases with an appropriate follow‐up time, showed that the expression of Ki67 in the nuclei of the tumour cells was the most important prognostic factor.

Conclusions

Judging from the results of the immunohistochemistry, there would appear to be some justification for suggesting a label of ICC tumours for these c‐kit‐positive tumours without any other obvious phenotype. A discriminant function analysis allowed 90.3% of patients to be correctly classified in prognostic terms from data on Ki67 and CD34 expression, grade, size and patient age.
Reduced expression of APC and DCC gene protein in breast cancer
Authors: Ho  , Kalle  , Lo  , Lam  , Tang
Published: March 2003

Aims

To investigate if the adenomatous polyposis coli (APC) protein and the deleted in colorectal cancer (DCC) protein expression can be demonstrated by an immuno‐histochemical method and to study the role of APC and DCC gene inactivation in the development and progression of breast cancer using colorectal cancer as a control model.

Methods and results

The reduced or loss of protein expression of the APC and DCC genes was studied in 27 surgical specimens of primary breast cancer using an immunohistochemical method. Reduced or lost expression was identified in 11 out of 27 samples (40.7%) for the APC gene and 15 out of 27 samples (55.6%) for the DCC gene. No statistically significant difference was observed between the reduced or lost protein expression and the histological grading of breast tumour for both the APC and the DCC gene.

Conclusions

Both gene proteins can be demonstrated by the immunohistochemical method. Reduced or loss of APC and DCC gene product were observed in 40.7% and 55.6% cases of primary breast cancer respectively. Further work is required to investigate the significance of the finding.
Hybrid carcinoma of the salivary gland: salivary duct adenocarcinoma adenoid cystic carcinoma
Authors: Snyder  , G Paulino
Published: March 2003

Aims

Hybrid tumours of the salivary gland are rare neoplasms that have been described only in the parotid and palate. Their recognition is important particularly when the component tumours have different biological behaviours. The occurrence of a submandibular hybrid tumour has not been reported.

Methods and results

We describe a case of a 36‐year‐old woman with a hybrid carcinoma composed of salivary duct adenocarcinoma and adenoid cystic carcinoma of the right submandibular gland. There was no evidence of a pre‐existing or concurrent pleomorphic adenoma. The presence of the two components was verified by differential immunohistochemical staining using a panel of cytokeratin, vimentin, smooth muscle actin and S100. The patient subsequently developed metastases to the pelvis, lumbar, vertebra and wrist. The clinical course in this patient was consistent with the behaviour of the salivary duct adenocarcinoma component.

Conclusions

The histogenesis of hybrid tumours is largely unknown, but in this case it may represent diverging differentiation of luminal tumour cells. Because some histological features of different salivary gland tumours overlap, immunohistochemistry is a valuable tool especially when used to delineate the components of a hybrid tumour.
Electron microscopy for tumour diagnosis: is it redundant?
Authors: Mierau G W
Published: March 2003

The histopathological diagnosis of tumours has been transformed by immunohistochemistry. Used with experience and judgement, a panel of antibodies or antisera, combined when necessary with antigen retrieval, will enable the accurate typing of most problematic tumours. This has led many histopathologists to question whether the electron microscope has any residual utility for tumour diagnosis; the machines are large, costly to purchase and maintain, and will accept only minute samples of tissue. The following articles by Mierau and by Eyden, both strong advocates, comment on the current and future role of electron microscopy in tumour diagnosis.