bluuebunny/crossref_metadata_2025 huggingface dataset:
Key Issues in Handling and Reporting Radical Prostatectomy Specimens
Authors: Srigley John R.
Published: February 2021

Context.—Patients with prostatic adenocarcinoma commonly undergo radical prostatectomy, and it is often difficult and time consuming to handle the resulting specimens and to report the findings. Pathologic information derived from the radical prostatectomy specimen is used for selecting adjuvant therapy, such as radiotherapy and hormone therapy, and for determining a patient's prognosis. The prostate specimen must be handled in a systematic fashion to derive the appropriate prognostic parameters.

Objective.—To review the prognostic factors of relevance in classifying radical prostatectomy specimens, using the College of American Pathologists categorization system, including a detailed survey of the morphologic-based factors but excluding other factors such as DNA ploidy and novel phenotypic and genotypic markers.

Conclusions.—Gleason score, pathologic stage, and margin status are considered category 1 prognostic factors, which are of proven prognostic significance and are useful in patient management. Factors such as tumor volume (intraglandular extent) and tumor subtype are considered category 2 prognostic factors, which show significant promise but require validation in multivariate analysis. Lymphovascular space invasion is a promising category 3 prognostic factor that needs additional study. Perineural invasion is an almost ubiquitous finding in radical prostatectomy specimens and is considered a category 3 prognostic factor.

After prognostic factors have been analyzed at the histologic level, it is critical to report the findings in a clear and unambiguous fashion. The synoptic style of reporting is ideal for describing complex cancer resection specimens. A synoptic report based on an evidence-based checklist, such as the one developed by the College of American Pathologists, effectively communicates complex cancer-related data, such as radical prostatectomy specimen findings. This information is used not only for individual case management with respect to treatment and prognostication but also for purposes such as education, research, quality monitoring, and system planning.
Gliosarcoma With Liposarcomatous Differentiation: The New Member of the Lipid-Containing Brain Tumors Family
Authors: Vlodavsky Eugene , Konstantinesku Marius , Soustiel Jean F.
Published: February 2021

Gliosarcoma is a rare malignant, biphasic brain tumor composed of glioblastoma multiforme and sarcomatous components. Various types of sarcomatous differentiation are described in this tumor: fibrosarcomatous, malignant fibrous histiocytoma-like, chondrosarcomatous and osteosarcomatous types. We report an extremely unusual variant of liposarcomatous differentiation in gliosarcoma in 72-year-old woman. Fat cells were presented by atypical multivacuolar and monovacuolar lipoblasts, stained positive for S100. p53 that was positive in both glial and mesenchymal cells of the tumor were negative in the lipoblasts. To the best of our knowledge, this is the first report in the literature of liposarcomatous differentiation in gliosarcoma.
Basal Cell–Signet-Ring Squamous Cell Carcinoma of the Eyelid
Authors: Proia Alan D. , Selim M. Angelica , Reutter Jason C. , Michon John J.
Published: February 2021

A 93-year-old woman developed a mass on her right lower eyelid that was present for more than 6 months but underwent rapid expansion during several weeks prior to her ophthalmological evaluation. Examination revealed an approximately 1.8 cm in diameter, fleshy, fungating growth involving more than 60% of the right lower eyelid. Excisional biopsy disclosed a neoplasm arising from the epidermis composed of adjoining basal cell and signet-ring squamous cell carcinoma, without a transition zone. The cells comprising the basal and squamous cell carcinomas were distinct immunophenotypically, with only the basal cell carcinoma reacting with Ber-EP4 and CAM 5.2 antibodies. To our knowledge, this case represents the first example of a collision tumor composed of basal cell and signet-ring squamous cell carcinoma.
Lipomatous Hypertrophy of the Interatrial Septum: An Overview
Authors: O'Connor Siobhan , Recavarren Rosemary , Nichols Lawrence C. , Parwani Anil V.
Published: February 2021

Lipomatous hypertrophy of the interatrial septum is a rare, but increasingly recognized, anomalous developmental or neoplastic lesion of the heart. This entity was first described in 1964 at autopsy and is identified before death based on its distinctive characteristics on echocardiography, computed tomography, and magnetic resonance imaging. Although it is often asymptomatic, the mass has been associated with supraventricular arrhythmias and sudden death. In rare patients who experience intractable symptoms, surgical excision of the lesion may provide relief. Therefore, lipomatous hypertrophy of the interatrial septum is of interest to the pathologist when a cardiac mass is received for evaluation or at autopsy when a patient has experienced sudden death from an unknown cause.
Review of Pediatric Autopsies Performed at a University Hospital in Ribeirão Preto, Brazil
Authors: Peres Luiz Cesar
Published: February 2021

Context.—Autopsy continues to provide important data for quality assurance, teaching, scientific purposes, and health planning, especially if performed according to a comprehensive protocol.

Objective.—To describe and analyze data from all perinatal and pediatric autopsies performed at a university hospital in Brazil.

Design.—Review of data from 1716 autopsies performed between April 1993 and April 1999, consisting of age at death, congenital defects, gender, and cause of death.

Results.—Age at death distribution: early neonatal deaths, 31.7%; stillbirth, 25.7%; 1 to 11 months, 19.6%; 1 to 5 years, 10.3%; late neonatal deaths, 6.3%; 11 to 15 years, 4%; 6 to 10 years, 2.5%. Cause of death: perinatal conditions, 51%; congenital malformation(s), 24.4%; infection, 11.9%; neoplasm, 3%; hematologic/immunologic, 2.3%; neurologic, 1.6%; gastrointestinal, 1.5%; cardiovascular, 0.7%; respiratory, 0.6%; genitourinary, 0.3%; other disorders, 0.5%. Gender distribution: male, 54.31%; female, 45.22%; indeterminate, 0.41%; data unavailable, 0.06%. Congenital anomalies were found in 31.5% of the autopsies and were the cause of death in 24.41% of the autopsies.

Conclusions.—High autopsy rates, combined with a comprehensive autopsy protocol, allowed the characterization of perinatal and pediatric deaths. The high proportion of perinatal deaths and stillbirths indicates the need for improvement in the prenatal care program. Congenital anomalies were highly prevalent because few pregnancies are interrupted in Brazil. The low number of cancer cases autopsied was attributed to the fact that most patients die at home, and to the high level of trust between the oncology team and the family, with the erroneous assumption that no relevant information would be provided.
Molecular Pathology: Future Issues
Authors: Kiechle Frederick L. , Zhang Xinbo , Holland Carol
Published: February 2021

Context.—The field of molecular pathology is expanding in complexity. To achieve competency, vigilance is required.

Objective.—To review the advances in clinically useful molecular biologic techniques and to identify their applications in clinical practice, as presented at the 13th Annual William Beaumont Hospital DNA Symposium.

Data Sources.—The 4 manuscripts submitted were reviewed and their major findings were compared with the literature on the same or related topics.

Study Selection.—Manuscripts address the use of molecular or immunophenotyping by flow cytometry to evaluate the origin or presence of sepsis, respectively; the use of imatinib mesylate to treat chronic myeloid leukemia and the nature of resistance to imatinib; and the use of 9 and 10 fluorochromes during clinical flow cytometric studies.

Data Synthesis.—The epidemiologic evaluation of a septic outbreak may be monitored using molecular techniques that track the relatedness of isolates. A potential biomarker for the presence of early sepsis is CD64. Intracellular signal transduction pathways are altered in malignancy. Imatinib mesylate inhibits the BCR-ABL kinase created by translocation of the long arms of chromosomes 9 and 22 in chronic myeloid leukemia. Resistance to imatinib may be secondary to mutation in the BCR-ABL kinase domain or residual leukemic stem cells that imatinib does not kill. The use of 9 or 10 fluorochromes simultaneously during flow cytometry has many clinical advantages; however, software for data analysis is needed.

Conclusion.—The current postgenomic era will continue to emphasize the use of microarrays and database software for genomic, transcriptomic, proteomic, nutrigenomic, and pharmacogenomics screening to search for a useful clinical assay. The number of molecular pathologic techniques will expand as additional disease-associated mutations are defined.
Mycobacterial Synovitis Caused by Slow-Growing Nonchromogenic Species: Eighteen Cases and a Review of the Literature
Authors: Olsen Randall J. , Cernoch Patricia L. , Land Geoffrey A.
Published: February 2021

Context.—Slow-growing nonchromogenic mycobacterial species are an infrequent cause of soft tissue infection. Because these organisms are rare, they are not often initially considered in the differential diagnosis of synovitis.

Objective.—To evaluate the clinical and pathologic characteristics of patients with synovitis resulting from slow-growing nonchromogenic mycobacterial species.

Design.—A 20-year retrospective review of records from The Methodist Hospital Microbiology Laboratory identified 18 culture-positive cases of synovitis that resulted from slow-growing nonchromogenic mycobacteria, including 14 caused by Mycobacterium avium complex, 1 caused by Mycobacterium malmoense, 1 caused by Mycobacterium haemophilum, and 2 caused by Mycobacterium nonchromogenicum isolates. In addition, a comprehensive literature search revealed an additional 48 cases of synovitis caused by slow-growing nonchromogenic mycobacteria.

Results.—The historic literature described the majority of the 48 patients as previously healthy, elderly individuals with a several-month history of monoarticular pain and swelling in the small joints of the upper extremity. In contrast, the current series demonstrated the probable role of multiple chronic coexisting medical conditions in promoting disease susceptibility. These patients were also unique in their significantly younger age distribution and diversity of infection sites. Histologic examination and direct acid-fast bacteria stains generally did not aid the diagnosis. Amputation was performed in 2 patients because of delayed identification of disease.

Conclusions.—The current series demonstrates that difficult identification and infrequent occurrence cause these organisms to be overlooked by physicians and laboratory personnel. A heightened clinical suspicion for slow-growing nonchromogenic mycobacterial species is necessary when routine culture and histopathologic findings do not readily isolate an organism, or when the patient does not respond to antibiotic and anti-inflammatory treatment.
Cruella: Developing a Scalable Tissue Microarray Data Management System
Authors: Cowan James D. , Rimm David L. , Tuck David P.
Published: February 2021

Context.—Compared with DNA microarray technology, relatively little information is available concerning the special requirements, design influences, and implementation strategies of data systems for tissue microarray technology. These issues include the requirement to accommodate new and different data elements for each new project as well as the need to interact with pre-existing models for clinical, biological, and specimen-related data.

Objective.—To design and implement a flexible, scalable tissue microarray data storage and management system that could accommodate information regarding different disease types and different clinical investigators, and different clinical investigation questions, all of which could potentially contribute unforeseen data types that require dynamic integration with existing data.

Design.—The unpredictability of the data elements combined with the novelty of automated analysis algorithms and controlled vocabulary standards in this area require flexible designs and practical decisions. Our design includes a custom Java-based persistence layer to mediate and facilitate interaction with an object-relational database model and a novel database schema. User interaction is provided through a Java Servlet–based Web interface.

Results.—Cruella has become an indispensable resource and is used by dozens of researchers every day. The system stores millions of experimental values covering more than 300 biological markers and more than 30 disease types. The experimental data are merged with clinical data that has been aggregated from multiple sources and is available to the researchers for management, analysis, and export.

Conclusion.—Cruella addresses many of the special considerations for managing tissue microarray experimental data and the associated clinical information. A metadata-driven approach provides a practical solution to many of the unique issues inherent in tissue microarray research, and allows relatively straightforward interoperability with and accommodation of new data models.
High Proliferative Activity Excludes Dermatofibroma: Report of the Utility of MIB-1 in the Differential Diagnosis of Selected Fibrohistiocytic Tumors
Authors: Hanly Andrew J. , Jordà Mercè , Elgart George W. , Badiavas Evangelos , Nassiri Mehdi , Nadji Mehrdad
Published: February 2021

Context.—Dermatofibroma is a benign fibrohistiocytic tumor composed of a mixture of fibroblastic and histiocytic cells. The diagnosis of this tumor is generally uncomplicated; however, rare variants may be difficult to distinguish from malignant fibrohistiocytic tumors. Deep penetrating dermatofibroma may be difficult to distinguish from dermatofibrosarcoma protuberans, and pseudosarcomatous dermatofibroma and dermatofibroma with monster giant cells share morphologic similarities with malignant fibrous histiocytoma and atypical fibroxanthoma.

Objective.—To find an immunohistochemical marker or markers that differentiate between fibrohistiocytic lesions of skin.

Design.—We evaluated the immunophenotypic characteristics of 83 fibrohistiocytic tumors (36 typical dermatofibromas, 16 cases of dermatofibrosarcoma protuberans, 16 malignant fibrous histiocytomas, and 15 atypical fibroxanthomas) using antibodies against MIB-1 (Ki-67), factor XIIIa, CD34 (HPCA-1), HHF35 (muscle-specific actin), 1A4 (smooth muscle actin), cytokeratin (AE1/AE3, CAM 5.2, and 34βE12), S100 protein, and desmin.

Results.—A high proliferative index detected by MIB-1 staining excluded the possibility of dermatofibroma and was diagnostically useful in separating this entity from dermatofibrosarcoma protuberans, malignant fibrous histiocytoma, and atypical fibroxanthoma. A low proliferative index, however, could not differentiate dermatofibroma from dermatofibrosarcoma protuberans. Factor XIIIa reactivity was not helpful for the diagnosis of dermatofibroma, whereas CD34 reactivity was statistically significant in the diagnosis of dermatofibrosarcoma protuberans. The sensitivity of these 2 markers is low and therefore of questionable practical diagnostic value.

Conclusion.—Evaluation of the proliferative index may further assist in distinguishing dermatofibroma from dermatofibrosarcoma protuberans, atypical fibroxanthoma, and malignant fibrous histiocytoma.
Quantification of the Morphologic Features of Fibroepithelial Tumors of the Breast
Authors: McKenna Ann Marie , Pintilie Melania , Youngson Bruce , Done Susan J.
Published: February 2021

Context.—Phyllodes tumors of the breast are uncommon, comprising 0.3% to 0.9% of female primary breast tumors. Owing in part to their rarity, definitive, objective, reproducible morphologic criteria that reliably distinguish benign from low-grade malignant or malignant phyllodes tumors have yet to be established.

Objective.—To use image analysis to quantitate and compare morphologic features of different groups of fibroepithelial tumors (FETs) of the breast.

Design.—Hematoxylin-eosin–stained sections of 41 FETs previously identified as fibroadenoma, benign phyllodes, low-grade malignant phyllodes, or high-grade malignant phyllodes were blinded and studied using a Leica DMRA2 microscope and OpenLab Image Analysis software. Features measured included mitotic rate per 10 high-power fields, stromal cellularity, nuclear size, stromal overgrowth, and the largest and smallest stromal-epithelial surface area ratios. Epithelial appearance was measured on a semiquantitative basis. Features of each case including tumor size, margin status, and the presence of necrosis or heterologous elements were also considered; these data were retrieved from surgical pathology reports.

Results.—Quantitative measures of stromal cellularity, stromal-epithelial ratio, mitotic rate, stromal overgrowth, and mean nuclear diameter were developed and found to stratify a population of FETs by the current classification system of fibroadenoma, benign, and low-grade or high-grade malignant phyllodes tumor.

Conclusions.—Quantitative morphologic features of FETs can be used to stratify these tumors by subtype. Use of these quantitative criteria could reduce interrater variability in histologically identifying FETs by subclass.
Laboratory Reporting of the International Normalized Ratio: Progress and Problems
Authors: Olson John D. , Brandt John T. , Chandler Wayne L. , Van Cott Elizabeth M. , Cunningham Mark T. , Hayes Timothy E. , Kottke-Marchant Kandice K. , Makar Robert S. , Uy Arby B. , Wang Edward C.
Published: February 2021

Context.—The international normalized ratio (INR) is widely used to monitor oral anticoagulation and to evaluate patients with coagulation disorders.

Objective.—To examine the variability of the performance and reporting of the INR and to evaluate laboratory calculation of the INR.

Design.—Between 1993 and 2003, laboratories participating in proficiency testing were surveyed. Participants provided the international sensitivity index and the mean normal prothrombin time used to calculate the INR. The INR was calculated from the data provided and compared with the INR reported to determine if the calculation was correct.

Results.—Survey data regarding the INR collected between 1993 and 2003 demonstrate an improvement in reporting, using appropriate anticoagulant, using lower international sensitivity index reagents, and matching international sensitivity index and prothrombin time method. The all-method coefficient of variation of the INR improved from 18% to 5.8%. Among 3813 laboratories studied in 2002 and 2003, 4.1% miscalculated INR. Of 29 laboratories that reported investigation of the INR miscalculation, 11 (38%) reported correcting an INR that was being reported in patient results and that this error was corrected as a result of the study. Since beginning grading of the INR calculation, miscalculation of the INR has fallen to less than 1%.

Conclusions.—Recommendations for change in laboratory practice made by consensus conferences are implemented during the course of many years. Difficulty calculating the INR was documented, and both the calculation and the variability in the reporting of the INR showed improvement. Proficiency testing, when closely evaluated and acted on, can have a direct impact on the quality of patient care.
Best Practices in Diagnostic Immunohistochemistry: Hepatocellular Carcinoma Versus Metastatic Neoplasms
Authors: Kakar Sanjay , Gown Allen M. , Goodman Zachary D. , Ferrell Linda D.
Published: February 2021

Context.—Immunohistochemistry plays a crucial role in the diagnosis of hepatocellular carcinoma and in its distinction from other primary and metastatic neoplasms. Because limited tissue is available with fine-needle and core biopsies, appropriate selection of antibodies is imperative.

Objective.—To review the antibodies used for the diagnosis of hepatocellular carcinoma and to outline an immunohistochemical approach in commonly encountered clinical situations.

Data Sources.—Our experience and review of research articles published in the English literature between 1987 and 2006.

Conclusions.—Hep Par 1 and polyclonal carcinoembryonic antigen are the most reliable markers for hepatocellular differentiation, but they have low sensitivity for poorly differentiated cases. Immunohistochemistry for glypican-3 shows promise for the diagnosis of poorly differentiated hepatocellular carcinoma and for its distinction from benign processes such as hepatic adenoma. Further studies with a large number of cases are required before it can be widely used. The combination of Hep Par 1 and MOC-31 will allow for the diagnosis of hepatocellular carcinoma in most cases and will guide the selection of immunohistochemical markers for further workup.
Glomerular Volume and Clinicopathologic Features Related to Disease Severity in Renal Biopsies of African Americans and Whites in the Southeastern United States
Authors: Hughson Michael D. , Samuel Terence , Hoy Wendy E. , Bertram John F.
Published: February 2021

Context.—African Americans have a 4-fold greater risk than whites for developing end-stage renal disease. Glomerulomegaly, possibly related to obesity, has been identified in high-risk populations and is suggested to be a marker for end-stage renal disease risk.

Objective.—To investigate differences in glomerular size and patient clinical characteristics at the time of renal biopsy for the major diseases contributing to end-stage renal disease.

Design.—Mean glomerular tuft volumes were estimated by the Weibel-Gomez method (1964) in native renal biopsies of 203 African American and 100 white patients 18 years of age and older by point counting on a stereologic grid. Glomerulosclerosis was graded on individual glomeruli from 0 to 4, and a glomerular sclerosis index was calculated for each biopsy. Relationships between the mean volume of nonsclerotic glomeruli, age, sex, race, sclerosis index, cortical fibrosis, estimated glomerular filtration rate, body mass index, and disease diagnosis were analyzed.

Results.—Racial differences in mean volume of nonsclerotic glomeruli and body mass index were not significant in any disease category, and African Americans had more severe disease as determined by sclerosis index, cortical fibrosis, and estimated glomerular filtration rate only in focal segmental glomerulosclerosis. For all patients, increased sclerosis index and cortical fibrosis and lower estimated glomerular filtration rate were best predicted by increased age (P < .001).

Conclusions.—For approximately the same severity of disease, African Americans were 10 years or more younger than whites with the difference being seen in all disease categories except membranous glomerulonephritis and diabetes. Glomerulomegaly relative to whites was not a distinguishing feature of African American renal biopsies.
Relevance of Specific Immunoglobulin M and Immunoglobulin G for Parvovirus B19 Diagnosis in Patients With Acute Lymphoblastic Leukemia Receiving Chemotherapy: Prospective Study
Authors: El Sayed Zaki Maysaa
Published: February 2021

Context.—Immunocompromised patients suffer from prolonged viral infections often without detectable immune response. However, even if the immune response occurs, can it clear the virus completely?

Objective.—To detect parvovirus B19 DNA and its antibodies in bone marrow cells and in serum by polymerase chain reaction (PCR) in children with acute lymphoblastic leukemia receiving chemotherapy to highlight the relation of humoral immune response to the presence of viremia. Also, to evaluate the optimal diagnostic test(s) for a correct diagnosis of parvovirus B19 disease in immunocompromised patients.

Design.—Forty-eight children with acute lymphoblastic leukemia receiving maintenance chemotherapy were included in the study in addition to 20 healthy children with matched age and sex. Study for parvovirus B19 was performed by serologic determination of specific immunoglobulin (Ig) M and IgG, and viral DNA was determined by PCR in both serum and bone marrow aspiration.

Results.—Parvovirus B19 DNA was detected in both serum and bone marrow in 20% of patients. Specific IgG was found in 40% and IgM in 26.7%. Two cases (10%) in the control group were positive for IgG. The agreement between IgG and positive results of PCR in the bone marrow was 33.3%, and the agreement for IgM and PCR in the serum was 33.3%.

Conclusions.—Parvovirus B19 is considered a common viral infection in children with acute lymphoblastic leukemia receiving chemotherapy. We must use our full potential to exclude such infection, which can mimic the side effects of chemotherapy in these patients. In immunocompromised patients, there are immunologic discrepancies in humoral immune responses for both IgM and IgG between individuals with parvovirus B19 persistence and healthy individuals, findings that may reflect both failed immunity and antigenic exhaustion. The contemporaneous determination of parvovirus B19 DNA by PCR in both bone marrow and peripheral blood and specific serologic markers appears to be the most appropriate diagnostic protocol for the correct laboratory diagnosis of parvovirus B19 infection in these patients.
Critical Values Comparison: A College of American Pathologists Q-Probes Survey of 163 Clinical Laboratories
Authors: Wagar Elizabeth A. , Friedberg Richard C. , Souers Rhona , Stankovic Ana K.
Published: February 2021

Context.—Critical laboratory values are values that may be indicative of life-threatening conditions requiring rapid clinical intervention. Designation of critical values by clinical laboratories is required by the Clinical Laboratory Improvement Amendments and regulatory agencies. The development of critical values often involves consultation with clinical services. Also, questions are frequently asked about how critical values compare between institutions.

Objective.—To examine and compare critical value ranges for selected common critical value analytes. Additional specific questions addressed the source of these values, the inclusion of specific items on a critical values list, and the procedures for establishing such lists.

Design.—A total of 163 clinical laboratories provided critical values for potassium, calcium, magnesium, thyroid-stimulating hormone, hemoglobin, platelet count, and activated partial thromboplastin time. Collected data were subjected to analysis for statistical variation. A questionnaire regarding demographic characteristics, institutional practices, and critical values management was also completed by participants.

Results.—There was slight variation in pediatric and adult critical values used by the central 80% of study laboratories. Three areas of interest were noted: (1) 27% of laboratories allowed nonpractitioners to accept inpatient critical value reports, (2) there was nonconsensus regarding the handling of outpatient critical values during weekday versus evening/weekend hours, and (3) only 56% of respondents had a written critical values policy or procedure.

Conclusions.—Pediatric and adult critical values for the selected analytes were consistent in a comparison between the 163 clinical laboratories. Several weaknesses in current critical values management were identified. A consensus critical values list that may be of value to other institutions was assembled.
Phosphorylated Histone H3, Ki-67, p21, Fatty Acid Synthase, and Cleaved Caspase-3 Expression in Benign and Atypical Granular Cell Tumors
Authors: Kapur Payal , Rakheja Dinesh , Balani Jyoti P. , Roy Lonnie C. , Amirkhan Robin H. , Hoang Mai P.
Published: February 2021

Context.—Granular cell tumors (GCTs) are classified as benign when none of the following features is present: spindling of the tumor cells, necrosis, diffuse pleomorphism, prominent nucleoli, high nuclear-cytoplasmic ratio, and mitotic rate >2 per 10 high-power fields. It has been suggested that a GCT be classified as atypical when 1 or 2 of these features are seen and as malignant when 3 or more of these are present. In our practice, we do not classify GCTs as malignant in the absence of metastasis.

Objective.—To compare immunohistochemical staining for phosphorylated histone H3 (PHH3), Ki-67 (MIB-1), p21, fatty acid synthase, and cleaved caspase-3 in histologically classified benign and atypical GCTs.

Design.—We reviewed 25 cases of GCT from our archives and classified 14 as atypical based on histologic features. Immunohistochemical staining for PHH3, Ki-67, p21, fatty acid synthase, and cleaved caspase-3 was performed using standard methods. The number of positive cells for Ki-67, p21, and PHH3 was calculated in 10 consecutive high-power fields in a hot spot. Fatty acid synthase and cleaved caspase-3 cytoplasmic expression was graded from 1 to 3.

Results.—Ki-67 and PHH3 scores were significantly higher in atypical GCTs. The expression of p21, fatty acid synthase, and cleaved caspase-3 was not significantly different between atypical and benign GCTs.

Conclusions.—This study shows that histologic features are reliable in identifying GCTs that have a higher proliferative potential as shown by higher immunoreactivity for Ki-67 and PHH3. These immunostains may help in classifying GCTs in cases where a thorough histologic evaluation is precluded by the small size of a biopsy specimen.
The Face of Pathology in Afghanistan in 2006–2007
Authors: Deck John H. N.
Published: February 2021

The current state of the practice of pathology in Afghanistan is described on the basis of visits made by the author to a nongovernmental organization hospital in Kabul, for 6 months between October 2006 and March 2007, and a second visit for 6 weeks at the end of 2007.
The 2010 Haiti Earthquake: A Pathology Perspective Aboard the USNS Comfort
Authors: Hussey Sean M , Dukette Phillip J , Dunn Scott H , Evans Toinette J , Oakes Natalie Y , Gleeson Todd D , Donahue Timothy F
Published: February 2021

The US Navy hospital ship USNS Comfort played an integral role in the initial phases of Operation Unified Response–Haiti following the devastating earthquake that struck near Port-Au-Prince, Haiti, on January 12, 2010. Deployed to Haiti from its home in Baltimore, Maryland, just 4 days after the earthquake, the USNS Comfort would become the region's primary tertiary casualty receiving center for 6 weeks. The pathology and laboratory department staff onboard the ship helped support the mission and experienced unique mass casualty/disaster relief scenarios while underway. This article reviews the accounts of the core laboratory, microbiology, anatomic pathology, and blood bank divisions on the USNS Comfort from the chaotic first few weeks to the final patient discharge 40 days after Operation Unified Response–Haiti began.
Body schema(tism) and the logos of life: a phenomenological reconsideration
Authors: Butnaru Denisa
Published: February 2021

Body image and body schema are two phenomenological concepts which generated a revival of Maurice Merleau-Ponty’s philosophical heritage. In the present text I intend to inquire on the relation between these two concepts and that of Logos of life, another challenging point in the Merleau-Pontyan thought.In order to delineate the correlation between body schema, body image and my understanding of a logic of life, I will first explore how what I term “schematism of the body” is connected to an inherent model of life and living and how this schematism is reflected in the body image. I will turn further to the relation between body and world and highlight how the life of the body defines itself as meaningful in the context of both the surrounding world (Umwelt) and the lifeworld (Lebenswelt). In a third part of my analysis I shall point out how the relation between body schematism and motile intentionality redefines corporeal inten-tionality. I shall conclude by noting the role of the Logos of life, through which corporeity, in its position of meaning project, is instituted as body schematism.Los conceptos fenomenológicos de imagen corporal y esquema corporal han dado lugar a un resurgimiento del legado filosófico de Maurice Merleau-Ponty. En este texto pretendo investigar la relación entre estos dos conceptos y el de Logos de la vida, otro elemento estimulante del pensamiento Merleau-Pontiano.Con el fin de trazar la correlación entre es-quema corporal, imagen corporal y mi interpretación de la lógica de la vida, exploraré en pri-mer lugar cómo el término “esquematismo del cuerpo” está conectado con un modelo inheren-te de vida y de vivir, y cómo este esquematis-mo se refleja en la imagen corporal. Consideraré después la relación entre cuerpo y mundo y remarcaré cómo la vida del cuerpo se define como significativa en el contexto tanto del mundo circundante (Umwelt) como del mundo de la vida (Lebenswelt). En la tercera parte de mi análisis señalaré cómo la relación entre esquematismo corporal e intencionalidad moto-ra redefine la intencionalidad corporal. Concluiré destacando el papel del Logos de la vida, a través del cual la corporeidad, en su posición de proyecto significativo, se instituye como esquematismo corpora
Ontological Difference and Indeterminacy of Interpretation
Authors: Ginev Dimitri
Published: February 2021

At issue in this paper is the unfinished dialogue between hermeneutic phenomenology and hermeneutic logic. The paper touches upon two historical contexts of this dialogue. In scrutinizing them I discuss the relationship between philosophical hermeneutics and non-representationalist epistemology. The view gets spelled out that the norms of truthfulness, objectivity, empirical adequacy, and other epistemological characteristics of interpretation become generated within characteristic hermeneutic situations. By elaborating on Heidegger’s nexus between projected understanding and interpretative articulation, the notion of hermeneutic forestructuring of interpretative practices is introduced. Scrutinizing this notion allows one to circumscribe characteristic hermeneutic situations.El tema de este artículo es el diálogo inacabado entre la fenomenología hermenéutica y la lógica hermenéutica. El artículo toma dos contextos históricos de este diálogo. Al investigarlos, discuto la relación entre la hermenéutica filosófica y la epistemología no-representacionalista. Esta visión explica que las normas de veracidad, la objetividad, la adecuación empírica y otras características epistemológicas de la interpretación llegan a generarse dentro de situaciones hermenéuticas características. Al elaborar el nexo de Heidegger entre la comprensión proyectada y la articulación interpretativa, se introduce la noción de preestructuración hermenéutica de las prácticas interpretativas. Investigar esta noción permite circunscribir situaciones hermenéuticas características.
Reason and Life. Phenomenological Interpretations of Don Quixote
Authors: Jonkus Dalius
Published: February 2021

Don Quixote is not only a novel which represents Spanish culture, but a hero that reveals the relation between life and reason. I will compare two interpretations of Don Quixote. The first phenomenological interpreta-tion belongs to Ortega Y Gasset, and the second to Lithuanian philosopher Algis Mickūnas. The interpretations of Don Quixote are related to the question about an ideal. What is the role of ideals in culture? Are ideals principles con-structed by reason? Do these principles deny the reality of life, or are ideals related to the self life-world rationality? Then what does the idealism of Don Quixote mean? Does it represent a utopian rationality or does it seek to show values that are not reduced to circumstance? Ortega criticizes Don Quixote as an idealist, who can’t find any ideal values in the nearest environment. Mickūnas suggests interpreting Don Quixote’s idealism as a phenomenological bracketing, which allows one to doubt the blind dependence on this life-world and question its value.Don Quijote no es únicamente una novela que representa la cultura española, sino también un héroe que revela la relación entre vida y razón. Compararé dos interpretaciones de Don Quijote. La primera interpretación fenomenológica pertenece a Ortega y Gasset y la segunda al filósofo lituano Algis Mickūnas. Las interpretaciones de Don Quijote se relacionan con la cuestión acerca de los ideales. ¿Cuál es el papel de los ideales en la cultura? ¿Son los ideales principios construidos por la razón? ¿Niegan tales ideales la realidad de la vida o bien se encuentran los ideales relacionados con la racionalidad misma del mundo de la vida? ¿Qué significa entonces el idealismo de Don Quijote? ¿Representa acaso una racionalidad utópica o trata más bien de mostrar valores que no se hallan reducidos a la circunstancia? Ortega critica a Don Quijote como un idelista, que no es capaz de encontrar valores ideales en su entorno más próximo. Mickūnas propone inter-pretar el idealismo de Don Quijote como un poner entre paréntesis de tipo fenomenológico, que nos permite dudar de la ciega dependencia del mundo vital y cuestionar su valor.
El dolor de los marcianos. Un análisis fenomenológico contra Rorty
Authors: Serrano de Haro Agustín
Published: February 2021

Mi ensayo trata de mostrar que es insostenible la ficción de Rorty de una civilización avanzada científicamente cuyos habitantes no sintieran el dolor como una vivencia sufrida en primera persona y que únicamente lo captaran como una excitación objetiva de su sistema nervioso. Entre otras dudas relativas a que esa captación objetiva y exacta se hallaría en indefinida reconstrucción teórica y a que ella no puede ser la experiencia primera del dolor ni siquiera en esa otra galaxia, aduzco que tener un estado fisiológico no equivale por principio a captarlo y que captar determinados rasgos objetivos no puede equivaler por principio a sufrir, a padecer. Concluyo señalando que Rorty, en su empeño por impugnar las representaciones mentales, pierde de vista cómo la experiencia del dolor manifiesta sobre todo la condición originaria del cuerpo vivido.My paper tries to show that Rorty’s fiction of a scientifically developed civilization whose inhabitants should not feel pain as a first-person experience, but would grasp it rather as an objective state of their nervous system, is unsustainable from a phenomenological point of view. I point out several doubts concerning the facts that such an objective apprehension would be in an indefinite process of theoretical reconstruction, and that even in that other galaxy it could not be valid as the original pain situation (for example, among children). But then I focus on the principles that to have a physiological state cannot be equiva-lent to grasping it, and second that to grasp several objective features cannot be equivalent to suffering or to undergoing pain. I conclude by suggesting that Rorty’s eagerness to discard mental representations made him neglect the lived body as implied in everyday experience: the body, not the mind, comes to the fore in the experience of pain.
Heretical Dimensions of Self Responsability by Jan Patočka
Authors: Tusa Ilea Laura
Published: February 2021

Jan Patočka’s account of responsibility, as developed in Heretical Essays in the Philosophy of History, is configured through the philosopher’s entire model of history, seen less as a scale of progress, but rather as a rupture. Responsibility is possible only for a very specific form of humanity, centered on history, problematicity and selfdisclosure. This type of historic humanity is in profound contrast with the prehistoric one, focused on “daimonic participation.” Responsibility involves the passage from prehistory to history. Despite the fact that it requires an intense “discipline of the soul,” the passage to responsibility cannot become pure and transparent, which in turn means that history is repeatedly threatened by falling back into prehistory. The positive involved in this assumption is that responsibility is not taken for granted; it is not a matter of following metaphysical principles, but rather a matter of a practical, “heretical” decision of embracing history, with its shaken problematicity, and of resisting the temptation of prehistory.La comprensión de Jan Patočka de la responsabilidad, tal como se desarrolladen Ensayos eréticos de filosofía de la Historia, viene configurada por el modelo completo de Historia, vista más como una ruptura que como una escala de progreso. La responsabilidad es posible sólo para una forma muy concreta de humanidad, centrada en la historia, la problematicidad y el autodescubrimiento. Este tipo de humanidad histórica se halla en profundo contraste con el tipo prehistórico, focalizado sobre la “participación demónica”. La responsabilidad implica el tránsito de la prehistoria a la historia. Pese a requerir una intensa “disciplina del alma”, el tránsito a la responsabilidad no puede tornarse puro y transparente, lo que a su vez significa que la historia está constantemente amenzada por una recaída en la prehistoria. El lado positivo que esta asunción envuelve es que la responsabilidad no se da por garantizada; no es una cuestión de seguir principios metafísicos, sino más bien cuestión de una decisión práctica, “herética”, de abrazar la historia, con su problematicidad conmovida, y de resistir la tentación de la prehistoria.
Réduction lévinasienne de la philosophie moderne à travers les vécus marginalisés
Authors: Baba Tomokazu
Published: February 2021

On considère souvent Lévinas comme philosophe de l’Autre. Mais on sait également que son premier concept emblématique est l’il y a. Comment peut-on expliquer l’absence de l’Autre dans la première pensée de Levinas? Notre étude propose de mettre en relation celle-ci et sa critique de la philosophie moderne y inclut la phénoménologie.Face à la faille virtuelle de la phénoménologie, le jeune Lévinas était déjà conscient de la limite de la philosophie moderne supposant toujours un sujet pensant inébranlable. Les thématiques que le jeune Levinas a choisi d’analyser comme nausée, honte, etc étaient en effet les vécus ignorés par la tradition philosophique de la conscience lucide. En réduisant le sujet pensant à l’état d’il y a, Lévinas tente de montrer la nécessité de l’Autre. La réduction du sujet pensant par le concept d’il y a est la première étape pour arriver à cette nécessité.Se suele considerar a Lévinas como el filósofo del “Otro” (Autre). Pero es sabido igualmente que su primer concepto emblemático es el “hay” (il y a). ¿Cómo se puede explicar la ausencia del “Otro” en la primera etapa del pensamiento de Levinas? Nuestro estudio pro-pone ponerlo en relación con su crítica de la filosofía moderna incluyendo la fenomenología.Frente al virtual fallo de la fenomenología, el joven Levinas era ya consciente del límite de la filosofía moderna, que suponía siempre un sujeto pensante inquebrantable. Las temáticas que el joven Levinas decide analizar, como la náusea, la vergüenza, etc., constituían en efec-to vivencias ignoradas por la tradición filosófica de la conciencia lúcida. Al reducir el sujeto pensante al estado de “hay”, Lévinas intenta mostrar la necesidad del “Otro”. La reducción del sujeto pensante por el concepto de “hay” es la primera etapa para llegar a esta necesidad.
A Fundamental Difference: Husserl and Heidegger on the Grounding of Ethics
Authors: Nenon Thomas
Published: February 2021

This essay begins by retracing the relationship between the early Heidegger and Edmund Husserl during the period when Heidegger’s thought was still closely aligned with Husserl’s phenomenological project. It then shows how a fundamental difference emerged over the question of what the ultimate grounds for action. When Heidegger says that Husserl has failed to address the real question about the meaning of Being, he is referring to the meaning of Dasein. Whereas Husserl maintains that willing and action must remain grounded in the intention/fulfillment structure of reason, Heidegger comes to the view that Dasein must resolutely accept its calling as the groundless ground of significance that is ulti-mate source of meaning in the world.El presente ensayo empieza retrocediendo hacia la relación del Heidegger temprano con Edmund Husserl, en el periodo en el que el pensamiento heideggeriano estaba todavía alineado con el proyecto fenomenológico de Husserl. A continuación, se muestra cómo a raíz de la pregunta por el sustrato último de toda acción emerge una diferencia fundamental. Cuando Heidegger dice que Husserl no ha conseguido hacer la verdadera pregunta acerca del sentido del ser, se refiere al sentido del Dasein. Mientras Husserl mantiene que la voluntad y la acción tienen que perma-necer fundamentadas en la estructura de intención/cumplimiento propia de la razón, Heidegger llega a la postura de que Dasein tiene que aceptar con determinación la llamada del fundamento abismático del significado, la últi-ma fuente del significado en el mundo.
Vida y filosofía. Aprendiendo la humildad hermenéutica
Authors: Monteagudo Cecilia
Published: February 2021

En el 51 aniversario de la publicación de Verdad y método (1960) de Hans-Georg Gadamer, este ensayo abordará la articulación entre el proyecto hermenéutico ―inicialmente formulado como una investigación que tiene como objetivo repensar el fenómeno de la com-prensión en la medida en que se refiere a toda nuestra experiencia vital― y su caracterización como filosofía práctica en las categorías de la pluralidad, el diálogo y la responsabilidad. En otras palabras, vamos a mostrar cómo Gada-mer, en el contexto de nuestros tiempos tecnológicos y bajo una influencia fenomenológica, define la hermenéutica como la “praxis” de la comprensión del otro. Este “praxis” debe ser concebida a la vez como un “aprendizaje de humildad”, capaz de ayudarnos a construir “un mundo razonablemente ordenado y comprensible, donde estamos obligados a vivir”. Para ello nos concentraremos en la rehabilitación de Gadamer de algunos temas de la filosofía griega que le permiten formular su concepto de “praxis” en oposición a su significado moderno, así como a la cultura de expertos de la sociedad contemporánea.At the 51st anniversary of the publication of Hans-Georg Gadamer’s Truth and method (1960), this paper will approach the articulating thread between the hermeneutical project—initially formulated as an investigation that aims to rethink the phenomenon of understanding in as much as it concerns to all our vital experience—and its characterization as practical philosophy under the categories of plurality, dialogue and responsibility. In other words, we will show how Gadamer, in the context of ours technological times and under a phenomenological influence, defines hermeneutics as the “praxis” of understanding the other. This “praxis” must be conceived at the same time as a “learning of humility”, capable of helping us to construct “a reasonably ordered and comprehensible world where we are bound to live”. To this extend we will concentrate ourselves in Gadamer’s rehabilitation of some topics of Greek philosophy, that will allow him formulate his concept of “praxis” in opposition to its modern meaning as well as to the expert culture of contemporary society.