bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental health professionals’ attitudes towards people who have experienced a mental health disorder
Authors: Hugo M.
Published: March 2003

The aim of this study was to gain information about the attitudes of mental health professionals towards people who have experienced a mental illness. The study involved a survey of 266 mental health professionals employed in a range of mental health treatment settings. Respondents were administered a questionnaire based on one of two vignettes describing a person with schizophrenia or depression. Attitudes were represented as beliefs about prognosis and long‐term outcomes in relation to the two vignettes. Professional groups were found to be less optimistic about prognosis, and less positive about likely long‐term outcomes, when compared with the general public. Medical staff were less optimistic about outcomes than other professional groups, with mental health nurses generally most optimistic. Most professionals based their attitudes on their experiences of working with people with mental health problems.
Loss of heterozygosity and microsatellite instability in epithelial hyperplasia of the breast
Authors: Kaneko Mayumi , Arihiro Koji , Takeshima Yukio , Fujii Satoshi , Inai Kouki
Published: March 2003

We evaluated loss of heterozygosity (LOH) and microsatellite instability (MSI) in epithelial hyperplasia of the breast by the PCR method using microsatellite markers. Seven loci of 16q, 17p, 17q, and 18q were examined in 35 lesions of epithelial hyperplasia observed in non‐neoplastic breast tissue of eight breast carcinoma cases, and 29 lesions were observed within 19 fibroadenomas. These hyperplastic lesions were classified by standard criteria into three groups, namely, mild, moderate and atypical ductal hyperplasia (ADH). In the breast carcinoma cases, the frequency of loss of heterozygosity was 40% in mild, 50% in moderate, and 100% in ADH; while in the fibroadenoma cases, the frequency was 10% in mild, 27% in moderate, and 25% in ADH; total frequency of LOH was statistically higher in carcinoma cases than in fibroadenoma cases. On the other hand, the frequency of microsatellite instability was higher in fibroadenoma cases (28%) than in breast carcinoma cases (11%). Furthermore, we analyzed two cases of noninvasive ductal carcinoma arising in fibroadenoma, which had various types of hyperplasia along with carcinoma in situ, and many hyperplasias showed LOH at several of the same markers as carcinoma in situ. From those results, we speculated that LOH at these markers is an early event in mammary tumorigenesis, and some of the hyperplastic lesions with LOH have precancerous natures.
Loss of growth factor sensitivity and development of mitoxantrone resistance in transplanted recurrent SA7HD myeloid leukaemia
Authors: Abubakar Aminu A.
Published: March 2003

Recurrent SA7HD leukemia cells have also “lost” the response to stimulation by L‐929‐conditioned medium (L‐929‐CM) and indeed were significantly insensitive to proliferative stimulation by combinations of WEHI‐conditioned medium (WEHI‐CM) and L‐929‐CM (P=0.04) in contrast to untreated SA7HD leukemia, which displayed dose‐dependent stimulation by L‐929‐CM and exhibited synergistic proliferative response to combinations of the two growth factors. This altered growth‐factor sensitivity, which was a function of both the route of leukemia inoculation and drug administration, was detected by both the colony and the tritiated thymidine (3HTdR) incorporation assays. In contrast to transplant in normal mice, recurrent leukemia transplanted in mitoxantrone pretreated mice remained growth‐factor insensitive. In addition, no growth delay of the recurrent leukemia occurred during this passage in pretreated mice. However, recovery of growth‐factor sensitivity still occurred after a single subsequent transplant in normal mice. The magnitude of resistance developed by the recurrent leukemia was not increased by passage in mitoxantrone pretreated mice. Rather, the extent of resistance was a function of the dose of mitoxantrone employed in the treatment of the leukemia before recurrence. These data interpreted along with previously published observations suggest that the development of altered growth‐factor sensitivity by SA7HD recurrent leukemia was directly linked to the presence of mitoxantrone. In addition, this phenomenon possibly confers survival advantage to the leukemia cells and this probably accounts for the observation that most of the drug‐treated mice ultimately developed recurrent disease despite adequate treatment.
Potato virus X: a model system for virus replication, movement and gene expression
Authors: Batten Jeffrey S. , Yoshinari Shigeo , Hemenway Cynthia
Published: March 2003

Considerable research has focused on the cis‐ and trans‐acting components required for various aspects of the potato virus X (PVX) infection process. In addition, the development of PVX‐based vectors has facilitated analyses of the PVX infection process and provided diverse technological applications. As a result, the PVX system will continue to serve as a model for analyses of processes such as virus movement, RNA replication, and gene silencing, and as a tool for protein expression.
Users of biomedical libraries*
Authors: CARMEL MICHAEL
Published: March 2003

Traditional demands on library services by established medical users have over the last decade been joined by new and wide ranging information requirements articulated by nurses, the paramedical professions and those involved in community health care including general practitioners. Research into user needs in the health care professions in Britain is described briefly, and lessons are drawn from current trends for health care librarians involved in developing and running services in changing times.
Practice Libraries: managing printed information and meeting the information needs of staff in general practice
Authors: BRYANT SUE LACEY
Published: March 2003

Librarians and GPs share an interest in exploring different approaches to providing information to general practice and improving information management within it. Describing the aims, policy, collections, enquiries and services of three Practice Libraries in the Aylesbury area, this paper demonstrates that an information professional can make a significant impact on the management of printed information whilst facilitating access to external sources. A wealth of opportunities lie ahead for those willing to apply information handling skills to general practice. Medical librarians will need to strike a careful balance between providing direct access to sources and the development of information services tailored to meet the needs of primary health care workers.
Communicating with deaf people: deaf awareness for librarians
Authors: FORREST MARGARET E. S.
Published: March 2003

Recent legislation in Britain and elsewhere has implications for librarians and others serving people with disabilities. This paper considers one type of disability: the communication and information needs of deaf people. A review of the literature indicates that the professional development of both health professionals and librarians is not preparing them for communication with deaf people. A growing recognition of the need for deaf awareness training among library staff is discussed. A number of training resources are mentioned with a checklist of good communication skills.
Information for trained nurses in remote areas: do electronically networked resources provide an answer?
Authors: FARMER JANE , RICHARDSON AMANDA
Published: March 2003

This paper reports on a research project which examined the potential of the Internet, and other networked information resources, to improve access to information for trained nurses working in remote areas. This paper provides a review of current literature in the field. It describes the research carried out, presents a summary of the research findings and discusses the implications of these findings. The paper concludes that the Internet and networked resources do have considerable potential to improve access to information for nurses working in remote and rural areas. However, information skills, along with professional guidance, are also required.
Library and information services to support the education and development of nurses: the management of co‐operation and change—a clash of two cultures?
Authors: CAPEL SUE , BANWELL LINDA , WALTON GRAHAM
Published: March 2003

This paper reports on the findings of research conducted by the Department of Information and Library Management and the Information Services Department at the University of Northumbria at Newcastle on behalf of the LINC Health Panel. It aims to investigate the organization and funding of library and information services to the nursing profession since the move of nurse education into higher education. The paper focuses on the lack of co‐operation and communication between the National Health Service and higher education cultures in the provision of services to nurses. A brief review of the literature includes the views of experts in the field on library and information services and education for nurses as they are now, and ideas for possible developments for the future. This is followed by a description of the main research findings and the five key issues identified by information professionals in a questionnaire survey as vital for future consideration and action. Finally, the conclusions drawn from the findings have been developed into recommendations for the direction of the future discussion, research and action which is needed to further improve library and information services for all nurses.
Challenges and strategies in getting evidence‐based practice into primary health care—what role the information professional?
Authors: ROSE STEVE
Published: March 2003

Recent years have seen a drive towards evidence‐based practice in health care, whereby decisions are made based on the best available evidence from research. Concerning the drive towards a primary careled NHS, this article examines the particular features of primary care, with reference to recent literature, which may mean that an evidence‐based approach is more difficult to achieve than it is in secondary care. Initiatives underway that attempt to address some of these difficulties are highlighted, and the future role of the information professional in achieving the adaptation of evidence‐based practice in primary health care is considered. This article has been developed from a presentation given at Under One Umbrella 4, UMIST, on 29 June 1997.
Meeting the information needs of clinicians for the practice of evidence‐based healthcare
Authors: Pyne Tanya , Newman Karin , Leigh Susie , Cowling AlaN. , Rounce Katherine
Published: March 2003

This article reports on clinicians’ use of library resources and the competencies they require to access information necessary for the practice of evidence‐based healthcare. It is based on the results of a study commissioned by North Thames Region to identify the training needs of clinicians for the adoption and practice of evidence‐based healthcare. Participants in this qualitative research study included librarians, clinicians (doctors, nurses and PAMs) and managers from four Acute and Community Trusts in and around London.

The research indicates that the majority of clinicians recognize the need to keep up‐to‐date with changes in their specialty and many visit their libraries on a frequent basis, however, few appear to be searching for information with which to inform their immediate clinical decisions. Our sample acknowledged their low usage of journals such as Bandolier, the Health Effectiveness Bulletin and Journal of Evidence‐Based Medicine. Similarly, low use of electronic databases, such as Cochrane and Cinahl, were reported. Examination of skill and self‐efficacy levels in accessing and using information databases revealed wide variations across professions, specialities and Trusts. Qualitative research methods were employed to elicit the key competencies required to access clinically relevant research evidence, and a framework for integrating these competencies is presented.
Skill mix in primary care—creating a bibliography
Authors: Sergison Michelle
Published: March 2003

Skill mix in primary care should be governed by research‐based evidence of how skills may best be distributed among health professionals in order to optimize the cost‐effectiveness of health service delivery. There is a dearth of research in this area, yet many changes in skill mix within primary care have still to be adequately researched. Existing evidence of the nature and cost‐effectiveness of skill mix change is scattered across the specialist literature of many different disciplinary groups, making it difficult to form a coherent overview of service provision. This paper reports on a project that sought to create a comprehensive database bringing together specialist literature relating to skill mix in primary care, as resource for health services researchers, providers and purchasers in the UK.
Information needs analysis to inform the development of a library and information service at the Marie Curie Centre, Newcastle upon Tyne, England
Authors: Bailey Pam , Banwell Linda , Kinghorn Shaun , McFarlane Helen , Walton Graham
Published: March 2003

In the summer of 1997 the Marie Curie Centre, Newcastle approached the libraries of the Universities of Newcastle and Northumbria at Newcastle to assist in developing a library and information service (LIS) strategy. It was acknowledged that before the LIS strategy could be established preparatory investigation was needed to ensure the effective and efficient allocation of resources. A user needs analysis was conducted over a 3‐month period, including a literature search, questionnaire and interviews. The findings, which indicated that the appointment of a professional librarian was crucial, have ensured that the LIS being developed is underpinned by a strong evidence base.
No evidence for c‐erbB‐2 overexpression in gastric carcinogenesis
Authors: Blok  , Craanen  , Dekker  , Offerhaus  , Tytgat
Published: March 2003

Aims:

Conflicting data on c‐erbB‐2 overexpression in gastric carcinomas can be found in the literature with regard to overall prevalence, prognostic significance and the histological type according to Lauren. The majority of these studies have focused on advanced gastric carcinomas whereas data on c‐erbB‐2 overexpression in early gastric carcinomas, especially of Caucasian origin, are relatively sparse. We therefore examined a series of Caucasian early gastric carcinomas to assess overall c‐erbB‐2 overexpression and to correlate c‐erbB‐2 overexpression, if any, with the type of growth pattern and the Lauren type.

Methods and results:

Forty‐five paraffin‐embedded gastrectomy specimens from early carcinomas were examined for the presence of chronic active gastritis, chronic atrophic gastritis, subtypes of intestinal metaplasia and dysplasia. The Lauren type and the type of growth pattern were reassessed for all early carcinomas. c‐erbB‐2 overexpression was assessed with monoclonal antibody 3B5 and polyclonal antibody A485. Complete absence of c‐erbB‐2 overexpression was observed in chronic active gastritis, chronic atrophic gastritis, subtypes of intestinal metaplasia, and dysplasia. Moreover, c‐erbB‐2 overexpression was found absent in both intestinal‐type (n = 20) and diffuse‐type early gastric carcinomas (n = 25), irrespective of growth type.

Conclusions:

c‐erbB‐2 overexpression does not play a role in the progression from normal to neoplastic gastric mucosa and should be considered as a late event in gastric carcinogenesis. Moreover, c‐erbB‐2 overexpression does not discriminate between intestinal and diffuse type early gastric carcinomas of Caucasian origin. Finally, it appears that mechanisms other than c‐erbB‐2 overexpression underlie the reported differences in biological behaviour of early gastric carcinomas with different types of growth pattern.
Translocation 2;11 in a fibroma of tendon sheath
Authors: Dal Cin  , Sciot  , De Smet  , Van Den Berghe
Published: March 2003

Aims

To determine whether fibromas of tendon sheath represent a reactive fibrosing process or whether they are neoplastic, we investigated the chromosomes of the proliferating cells. A clonally occurring karyotypic abnormality would be an argument in favour of these fibromas being neoplastic.

Methods and results

A biopsy specimen of a fibroma of tendon sheath was cultured after collagenase exposure leading to dissociation of the tissue. The cultured cells were harvested after 4 days and chromosome analysis done according to standard procedures. Ten out of 20 karyotyped cells showed an identical chromosome abnormality characterized by a t(2;11)(q31–32;q12). The other 10 cells showed a normal 46,XX karyotype.

Conclusion

The clonally occurring chromosome abnormality found in this fibroma of tendon sheath suggests that this proliferation is neoplastic and not a reactive fibrosing process.
Appendiceal inflammation in ulcerative colitis
Authors: Scott I S , Sheaff M , Coumbe A , Feakins R M , Rampton D S
Published: March 2003

Aims

Previous uncontrolled reports have suggested that appendiceal inflammation may occur as a discontinuous lesion in ulcerative colitis. This study aims semiquantitatively to compare the prevalence and histological features of appendiceal inflammation in patients with ulcerative colitis and Crohn's disease, using colonic carcinoma and acute appendicitis specimens as controls.

Methods and results

Surgical pathology records and original histological slides for the period 1980–1994 were examined. The prevalence of appendiceal inflammation in ulcerative colitis (24/50, 48%), was higher than in colonic carcinoma (5/65, 8%, P < 0.001), but was similar to that in Crohn's disease (14/27, 52%). Appendiceal inflammation with caecal sparing was seen in nine out of 24 specimens with ulcerative colitis (37%), two out of nine (22%) with Crohn's disease and five out of 65 (8%) with colonic carcinoma. Inflamed appendixes from patients with inflammatory bowel disease showed histological features typical of ulcerative colitis and Crohn's disease rather than acute appendicitis and were significantly less likely to have transmural inflammation. There had been a previous appendicectomy in 3% of ulcerative colitis patients compared with 8% of colonic carcinoma specimens and 21% (P < 0.01) Crohn's disease controls.

Conclusion

In ulcerative colitis, as in Crohn's disease, appendiceal inflammation commonly occurs as a skip lesion and histologically resembles the colonic disease rather than acute appendicitis. The low prevalence of appendicectomy supports the hypothesis that the appendix itself may have a central role in the pathogenesis of ulcerative colitis.
Immunophenotypic and prognostic analysis of E‐cadherin and β‐catenin expression during breast carcinogenesis and tumour progression: a comparative study with CD44
Authors: Bànkfalvi  , Terpe  , Breukelmann  , Bier  , Rempe  , Pschadka  , Krech  , Lellè  , Boecker
Published: March 2003

Aims

This study was performed to investigate whether immunohistochemical expression of E‐cadherin (E‐cad) and β‐catenin (β‐cat) in conjunction with CD44 may correlate with the clinical evolution and prognosis of breast cancer.

Methods and results

One‐hundred and forty‐two routinely processed breast tissue samples including normal breast, benign lesions, in situ and invasive carcinomas were investigated. E‐cad and β‐cat were strongly expressed by luminal and basal cells in normal glands, benign proliferative and early neoplastic intraductal lesions. Contrarily, CD44 was expressed exclusively by myoepithelial cells in normal breast, whereas different isoform expression patterns were observed in premalignant and malignant lesions. Simultaneous lack of E‐cad/β‐cat expression was detected in in situ and invasive lobular carcinomas in contrast to ductal lesions, in which the differential loss of the molecules was associated with poorer differentiation, irrespective of CD44 immunophenotype. Reduced E‐cad (P = 0.003), β‐cat (P = 0.03) and increased CD44v4 (P = 0.05) and v7 (P = 0.007) expression were significantly associated with positive lymph node status. Decreased E‐cad and lack of CD44v6 expression correlated with poor survival. There was no difference between the expression of either molecule in in situ and invasive components within the same tumour.

Conclusions

Our results indicate that changes in E‐cad, β‐cat and CD44 expression occur early in breast carcinogenesis; they are involved in tumour differentiation, but events additional to their deranged expression are needed to acquire an invasive phenotype.
Cathepsin D in host stromal cells is associated with more highly vascular and aggressive invasive breast carcinoma
Authors: González‐Vela  , Garijo  , Fernández  , Buelta  , Val‐Bernal
Published: March 2003

Aims

To determinate the relationship between tumoral angiogenesis and cathepsin D (CD) expression in tumour and host stromal cells of invasive breast carcinoma, and to examine its association with classical prognostic factors such as lymph node status, histological grade, tumour size, mitotic rate, peritumoral lymphovascular invasion and oestrogen receptor (ER) status.

Methods and results

Sections from 102 invasive breast carcinoma were cut from the archival formalin‐fixed, paraffin‐embedded tissue blocks and stained using immunohistochemistry for the endothelial cell adhesion molecule (CD31) and CD. Microvessel density was assessed by counting vessels in the three most vascular areas at × 400 field. The counts were expressed as the highest counts within any × 400 field. The evaluation of immunostaining for CD was performed separately in both the parenchymal and stromal cells. Microvessel density was correlated positively with histological grade and peritumoral lymphovascular invasion, and correlated inversely with ER status. Positive CD staining of tumour cells was more frequent in positive ER tumours and was not significantly associated with the other classical prognostic factors. However, moderate to strong staining of host cells was correlated with higher histological grade, higher mitotic index and lack of ER protein. There was a statistically significant association between CD expression of host stromal cells and higher vessel count.

Conclusions

CD in host stromal cells is associated with more aggressive tumours and with a higher intratumoral microvessel density. Evaluation of CD in combination with angiogenic activity may be of some help in more accurately predicting the biological behaviour of breast carcinoma.
Clear cell change in colorectal adenomas: its incidence and histological characteristics
Authors: Domoto  , Terahata  , Senoh  , Sato  , Aida  , Tamai
Published: March 2003

Aims

The aim of our investigation was to clarify the histological characteristics and biological significance of clear cell change in colorectal adenomas.

Methods and results

We found three cases (0.086%) of tubular adenomas with clear cell change in a review of 3486 cases of colorectal adenoma. These three cases occurred in male patients and were located in the left‐sided colon. To investigate the nature and biological significance of the clear cells, we conducted histochemical staining (periodic acid–Schiff (PAS) with or without diastase digestion, alcian blue pH 2.5) and immunohistochemical staining (using antibodies against carcinoembryonic antigen (CEA), alpha‐fetoprotein, p53 protein and Ki67 antigen) and also mitotic counts. Histologically, the changed area was characterized by pyknotic and randomly arranged nuclei with PAS‐negative clear and vacuolated cytoplasm. Immunoreactivity for CEA was diffuse and strong in the clear cells, but not in the tumour cells in the ordinary portion of the adenomas. The Ki67 labelling index and the mitotic activity were both higher in the clear cell portion than in the ordinary portion.

Conclusions

This is the first study to indicate the incidence of clear cell change among colorectal adenomas. It has confirmed high proliferative activity within the clear cell portion of colorectal adenomas.
Tenascin labelling in colorectal biopsies: a useful marker in the diagnosis of collagenous colitis
Authors: Anagnostopoulos  , Schuppan  , Riecken  , Gross  , Stein
Published: March 2003

Aims

This study was undertaken to clarify whether immunohistological detection of tenascin (TN), an extracellular matrix glycoprotein that is expressed during stromal remodelling, may allow a more precise diagnosis of collagenous colitis.

Methods and results

We studied multiple colorectal biopsies specimens from 15 patients with clinically suspected collagenous colitis for TN expression by using a monoclonal antibody. Biopsies from further 15 patients without symptoms and signs of collagenous colitis served as controls. In seven of the 15 cases with clinically suspected collagenous colitis a prominent and selective subepithelial tenascin expression was identified. The TN expression pattern closely correlated with the conventional detection of a subepithelial collagen band diagnostic of collagenous colitis. The immunohistological labelling for TN allowed a quicker and more precise measurement of the thickness of the diagnostic collagen deposits than conventional staining. By this approach one further case could be reclassified as collagenous colitis.

Conclusions

Our data show that immunohistological detection of TN allows a more correct and easy diagnosis of collagenous colitis.
Acidic fibroblast growth factor is progressively increased in the development of oesophageal glandular dysplasia and adenocarcinoma
Authors: Soslow R A , Nabeya Y , Ying L , Blundell M , Altorki N K
Published: March 2003

Aims

To determine by immunohistochemistry and amplification of cDNA the relationship between fibroblast growth factor (FGF) expression and progressive changes in Barrett's oesophagus associated with oesophageal adenocarcinoma (OA). The FGFs are potent mitogens that possess angiogenic properties and the capability to regulate growth and differentiation of various cell types. They have also been implicated in the development and progression of numerous solid tumours, including some carcinomas of the aerodigestive tract, such as nasopharyngeal carcinoma and pancreatic adenocarcinoma.

Material and results

We studied the expression of the two prototypic FGFs, acidic FGF (FGF‐1) and basic FGF (FGF‐2), in OA and OA precursor lesions, including intestinal metaplasia (IM), low‐grade dysplasia (LGD) and high‐grade dysplasia (HGD). Fresh tissue from 10 OAs and four associated HGDs was available for the determination of FGF‐1 and FGF‐2 mRNA expression accomplished by the PCR amplification of cDNA. Using immunohistochemistry, we studied the expression of the FGF‐1 and FGF‐2 proteins in archival, paraffin‐embedded tissue that was available from 17 oesophageal resection specimens that included OAs and OA precursor lesions. As compared to gastric fundic mucosal controls, OAs and HGDs showed significantly enhanced expression of FGF‐1 mRNA and protein. IMs and LGDs showed significantly lesser degrees of FGF‐1 immunoreactivity that were not increased over controls. In contrast, both the overall percentage of FGF‐2‐reactive OAs and the overall FGF‐2 protein expression, assessed using an immunoreactivity score, are comparable to FGF‐2 expression in controls.

Conclusions

It appears that FGF‐2 is ubiquitously expressed in OA and in normal oesophageal and gastric mucosa while significant FGF‐1 expression is essentially restricted to HGD and OA. Our data also suggest that FGF‐1 is sequentially upregulated in the progression from metaplasia to dysplasia and adenocarcinoma.
Successful application of indirect in‐situ polymerase chain reaction to tissues fixed in Bouin's solution
Authors: Li Vigni R , Bianchi U A , Carosi G , Lomini M , Falchetti M , Callea F , Pecorelli S
Published: March 2003

Aims

To evaluate the value of polymerase chain reaction‐in situ hybridization (PCR‐ISH) for the detection of human papillomaviruses (HPV) in paraffin sections of cervical biopsies fixed either in 10% formalin or in Bouin's solution.

Methods and results

We analysed 40 biopsies from Italian women infected with the human immunodeficiency virus type 1 (HIV 1). In‐situ hybridization techniques were performed with commercial biotinylated probes. The PCR‐ISH was carried out by the ‘hot start modification’. Cervical intraepithelial neoplasia (CIN) was found in 23 of 40 patients (57.5%); eight cases showed condylomatous features. Human papillomavirus was detected in 42.5% by ISH and in 65% by PCR‐ISH. Sixty‐nine per cent of positive biopsies contained HPV 16, 18, 31 and 33. HPV 6 and 11 were found only in condylomata acuminata samples.

Conclusions

The results point to a high incidence of HPV infection as well as of CIN in HIV‐positive patients. Human papillomavirus type 16 appears to be most frequently associated with CIN. Polymerase chain reaction‐ISH is more sensitive than ISH in the detection and typing of HPV DNA both in clinical and in ‘latent’ infections. The two techniques yielded the same results with either formalin‐ or Bouin's‐fixed material.
Polyester fibre prosthetic anterior cruciate ligament implant rupture: necrosis of ingrown connective tissue
Authors: Keen C E , Amis A A
Published: March 2003

Aims

To describe the histopathological and microanalytical features in seven cases of ruptured Apex® polyester (Terylene®) fibre anterior cruciate ligament prosthesis.

Methods and results

Transmitted and polarized light microscopy was performed in all cases; one case was investigated by immunohistochemistry, transmission electron microscopy and scanning electron microscopy, with backscatter and X‐ray detectors for elemental microanalysis. For comparison we also studied synovial biopsy material and unused polyester fibres. In the excised ligaments there was much ingrowth of fibrous tissue accompanying a florid giant cell reaction to the individual intact polyester fibres throughout the ligaments. Phagocytosis of particles of prosthesis‐derived material was demonstrated and a striking finding was of necrosis of the ingrown connective tissue in the central portions of the ligaments. Hyalinized areas and ‘neoligament growth’ were less striking. A consistent finding in the polyester fibres was of small particles containing antimony, used as a catalyst in the manufacturing process.

Conclusions

The pattern of reaction to the prosthetic material and the presence of necrosis differ from previous descriptions in animal and human explants of this and other prosthesis types. The mechanical effect of the necrosis is unlikely to be of significance with this ligament, which is load‐bearing ab initio.
Intraneural angiosarcoma and angiosarcoma arising in benign and malignant peripheral nerve sheath tumours: clinicopathological and immunohistochemical analysis of four cases
Authors: Mentzel T , Katenkamp D
Published: March 2003

Aims

Angiosarcomatous differentiation represents the least common form of heterologous differentiation in malignant peripheral nerve sheath tumours (MPNST), and is seen most frequently in patients with neurofibromatosis type 1. More rarely, it has been reported in patients without stigmata of neurofibromatosis, or in benign nerve sheath tumours and peripheral nerves. This study was undertaken to confirm this rare association.

Methods and results

Four cases of angiosarcoma arising in a peripheral nerve, in a long‐standing schwannoma and in two MPNST are described. Immunohistochemical studies were performed on paraffin sections with the alkaline phosphatase–antialkaline phosphatase method. An intraneural high‐grade epithelioid angiosarcoma arose in the left posterior tibial nerve of a 78‐year‐old man, a well to moderately differentiated angiosarcoma was seen in an ancient schwannoma of the lateral neck in a 73‐year‐old women, and an angiosarcoma of varying grades of differentiation developed in a recurrent MPNST in the thigh of 38‐year‐old man. In addition a high‐grade MPNST in the axillary region of a 30‐year‐old man showed foci of heterologous high‐grade angiosarcomatous differentiation. The neural and endothelial lines of differentiation were confirmed in each case by positive immunohistochemical staining for neural and endothelial markers, respectively. In all cases tested, the neural differentiated cells stained immunohistochemically positive for antibodies against vascular endothelial growth factor.

Conclusions

This study confirms the rare association of angiosarcoma arising in peripheral nerves, as well as in benign and maligant peripheral nerve sheath tumours.
Mucinous epithelial cysts of the spleen associated with pseudomyxoma peritonei
Authors: Du Plessis  , Louw  , B Wranz
Published: March 2003

Aims

We report two rare cases of neoplastic pseudomyxoma peritonei associated with splenic mucinous epithelial cysts and review previously reported cases of splenic mucinous lesions in order to investigate the extent and implications of such an association.

Methods and results

The majority of mucinous lesions of the spleen appear to be associated with pseudomyxoma peritonei. The clinicopathological profile of these cases conforms to that of neoplastic pseudomyxoma peritonei, showing a similar age of onset, outcome and histological features. Most of the cases were associated with a confirmed or suspected appendiceal primary. The immunophenotype (cytokeratin 7 negative; cytokeratin 20 and CEA positive) of the lesions of both our cases, including those in the ovary, was suggestive of a gastrointestinal origin.

Conclusions

Splenomegaly due to cystic intrasplenic mucinous epithelial lesions may occasionally be the presenting feature of pseudomyxoma peritonei or herald tumour recurrence. Mucinous epithelial cysts of the spleen may also precede the development of pseudomyxoma peritonei. All cases of pseudomyxoma peritonei should be investigated for splenic involvement and, conversely, a primary mucinous neoplasm sought elsewhere in the abdomen in all cases of splenic mucinous cysts.
Delayed appearance of decorin in healing burn scars
Authors: Sayani  , Dodd  , Nedelec  , Shen  , Ghahary  , Tredget  , Scott
Published: March 2003

Aims

We have previously shown that hypertrophic scar tissue from burn patients contains abnormally high amounts of the proteoglycans versican and biglycan and reduced amounts of decorin, in comparison with normal dermis or mature scar. The lack of decorin may account for the poor organization of collagen fibrils in the nodular areas of these scars. Decorin has also been reported to neutralize the fibrogenic growth factor TGF‐β1. This study was conducted to monitor the time‐course of expression of decorin in healing burn wounds by in‐situ hybridization to determine whether its absence from hypertrophic scars could result from reduced synthesis.

Methods and results

Scar tissue from 19 patients and normal dermis from six patients, was fixed in paraformaldehyde, embedded in paraffin and sectioned. Digoxigenin‐labelled cRNA probes were prepared from a plasmid containing a 622‐bp insert of human decorin cDNA and used for in‐situ hybridization. Total numbers of connective tissue cells and cells positive for decorin mRNA were counted in 10 random fields in the upper (papillary), middle and lower (reticular) one‐thirds of the dermis. In all regions the number and percentages of cells with decorin mRNA were low during the first 12 months after injury (eight samples), much higher between 12 and 36 months (seven samples) and low and similar to those in normal skin after 36 months (five samples). The differences between intermediate and early or late stage samples were statistically significant (one‐way anova). Immunohistochemistry showed little staining for decorin in early stage samples and much stronger staining in mid‐stage. Late stage tissue showed intense staining for decorin, almost comparable to that in normal dermis.

Conclusion

Expression of decorin in burn wounds is suppressed for about 12 months and then increases at a time when resolution of hypertrophic scarring is generally considered to occur.
Expression of thyroid transcription factor‐1 in pulmonary and extrapulmonary small cell carcinomas and other neuroendocrine carcinomas of various primary sites
Authors: Kaufmann  , Dietel
Published: March 2003

Aims

The thyroid transcription factor‐1 (TTF‐1) is a highly specific immunohistochemical marker for the identification of pulmonary adenocarcinomas and non‐neuroendocrine large cell carcinomas, especially in patients presenting with metastatic carcinomas of unknown primary site. In this study we tested if anti‐TTF‐1 can also be used to verify a pulmonary origin of neuroendocrine carcinomas, placing emphasis on the discrimination of pulmonary small cell carcinomas (SCCs) from extrapulmonary SCCs and the distinction of SCCs from Merkel cell carcinomas of the skin.

Methods and results

We studied 37 pulmonary SCCs, 15 SCCs of extrapulmonary origin, 4 pulmonary large cell neuroendocrine carcinomas (LCNECs), four extrapulmonary LCNECs, six medullary thyroid carcinomas, 16 Merkel cell carcinomas, and a total of 32 carcinoids/low‐grade neuroendocrine carcinomas of pulmonary (12 cases) and extrapulmonary (20 cases) origin. Using the commercially available monoclonal antibody 8G7G3/1, TTF‐1 was immunohistochemically detectable in 81% of pulmonary SCCs but also in 80% of extrapulmonary SCCs. Furthermore, anti‐TTF‐1 showed a positive staining in 50% of all pulmonary carcinoids, in one gastric carcinoid, in 2/4 of pulmonary, and 1/4 of extrapulmonary LCNECs. All medullary thyroid carcinomas were also TTF‐1‐positive. Merkel cell carcinomas were consistently TTF‐1‐negative.

Conclusions

Our results suggest that in contrast to non‐neuroendocrine carcinomas, anti‐TTF‐1 cannot be used to prove or to exclude a pulmonary origin of SCCs or LCNECs of unknown or uncertain primary site. Therefore, before using anti‐TTF‐1 as a marker for pulmonary carcinomas one should be sure to have excluded SCC and LCNEC. On the other hand, anti‐TTF‐1 might be used to specifically discriminate SCCs of various origin from Merkel cell carcinomas.
Polymorphous low‐grade adenocarcinoma and adenoid cystic carcinoma: distinct architectural composition revealed by collagen IV, laminin and their integrin ligands (α2β1 and α3β1)
Authors: Loducca S V L , Raitz R , S Araújo N , Araújo V C
Published: March 2003

Aims:

Polymorphous low‐grade adenocarcinoma (PLGA) and adenoid cystic carcinoma (ACC) are malignant salivary gland tumours bearing many similar histological patterns. This study was undertaken to show how the presence and distribution of collagen IV and laminin, and their ligands (integrin α2β1 and α3β1 components), can reveal histoarchitectural differences which distinguish these two entities.

Methods and results:

Five cases of ACC and five cases of PLGA from the archives of the Oral Pathology Department of the School of Dentistry of the São Paulo University were submitted to immunostaining with the antibodies to collagen IV, laminin, and integrins α2β1 and α3β1 using the streptavidin–biotin–peroxidase technique. Positive and negative controls were included. PLGA showed a thin line of collagen IV and laminin surrounding structures composed of a single cell layer. Integrins were expressed as a widespread and granular pattern. A thick line of collagen and laminin was observed around the neoplastic structures of ACC. Both integrins were expressed in intercellular spaces and around luminal spaces of tubular structures.

Conclusions:

Collagen IV and laminin, and their integrin ligands, are useful in demonstrating that neoplastic ductal units of PLGA are composed of a single cell layer, being distinct from ACC which contains structures composed of two layers of neoplastic cells.
Arteriolitis in renal transplant biopsies is associated with poor graft outcome
Authors: Bellamy C O C , Randhawa P S
Published: March 2003

Aims: The Banff 1997 classification of renal allograft pathology identifies arteriolitis as a finding of uncertain significance. We sought to improve our understanding of arteriolitis by correlating its occurrence with histopathological and clinical parameters.

Methods and results

Twenty allograft kidney biopsies from 19 patients, showing arteriolitis, were identified. Arterioles were defined as small vessels with: (1) wall thickness of 1–3 myocytes; (2) diameter less than one‐third of an adjacent glomerulus; and (3) discontinuous or absent elastica. Arteriolitis was defined as mural infiltration by lymphocytes. Other histological findings were categorized according to the Banff 1997 working formulation. Ten biopsies (50%) showed type IIA rejection, seven (35%) showed type I rejection, and three (15%) showed borderline change. Two patients with borderline change had acute rejection in the next biopsy. None of the seven patients with type I rejection had previous or subsequent type II rejection on biopsy. A total 11/20 biopsies (10/19 patients) showing arteriolitis had type IIA rejection in the index or next biopsy. On follow‐up, graft loss due to rejection occurred in 5/19 (26%) patients (median 126 days); all had shown type IIA rejection on a previous biopsy. Chronic allograft nephropathy developed in a further 4/19 (21%) patients (median 157 days), of whom three had shown only type I rejection on biopsy.

Conclusion

Arteriolitis is associated with acute rejection, often type II rejection, and is associated with poor graft outcome. Other causes of arteriolitis were not encountered in this series.
All infiltrating T‐lymphocytes in Hodgkin's disease express immunohistochemically detectable T‐cell receptor ζ‐chains in situ
Authors: Dukers D F , Oudejans J J , Jaspars E H , Gras M , Vos W , Middeldorp J M , Meijer C J L M , Bloemena E
Published: March 2003

Aim: We studied the expression of TCR ζ‐chain on tumour‐infiltrating lymphocytes in EBV‐positive and EBV‐negative cases of Hodgkin's disease (HD), to assess whether downregulation of TCR ζ‐chain on tumour‐infiltrating lymphocytes might be a mechanism for immune escape of the neoplastic cells.

Methods and results

By immunohistochemistry we investigated tissue of 27 cases of primary HD, both paraffin embedded and frozen, for the presence of T‐cell receptor complex ζ‐chain and other T‐cell markers on the reactive cells. Strong membranous staining of TCR ζ‐chain was present in all cases in frozen tissue. In contrast, in paraffin‐embedded material substantial loss of TCR ζ‐chain was detected in old (> 6 years) tissues. However, no differences in either the number of positive cells or their staining intensity were observed in EBV‐positive and negative cases of HD as detected in frozen tissue. Storage of paraffin‐embedded tissue leads to a rapid and substantial loss of TCR ζ‐chain reactivity compared to frozen material of the same HD cases. Staining reactivity of other T‐cell markers (CD3, CD4 and CD8) on paraffin‐embedded material remained unaffected. Immunofluorescent double‐staining confirmed colocalization and coexpression of TCR ζ‐chain and CD3.

Conclusions

In frozen biopsies of primary HD TCR ζ‐chain was expressed on all reactive CD3‐positive cells, both in EBV‐positive and EBV‐negative cases. This suggests that ζ‐chain downregulation is not a likely mechanism whereby neoplastic cells of HD can escape immune surveillance.
Distinction between coeliac disease and refractory sprue: a simple immunohistochemical method
Authors: Patey‐Mariaud de Serre N , Cellier C , Jabri B , Delabesse E , Verkarre V , Roche B , Lavergne A , Brière J , Mauvieux L , Leborgne M , Barbier J P , Modigliani R , Matuchansky C , Macintyre E , Cerf‐Bensussan N , Brousse N
Published: March 2003

Aims

We recently showed that refractory sprue is distinct from coeliac disease, the former being characterized by abnormal intraepithelial T‐lymphocytes expressing a cytoplasmic CD3 chain (CD3c), lacking CD3 and CD8 surface expression, and showing TCRγ gene rearrangements. To take advantage of the abnormal phenotype of CD3c + CD8 − intraepithelial lymphocytes (IEL) in refractory sprue we developed a simple method to distinguish coeliac disease from refractory sprue.

Methods and results

Comparative immunohistochemical studies using anti‐CD3 and anti‐CD8 antibodies were applied on paraffin‐embedded and frozen biopsy specimens in refractory sprue (n = 6), coeliac disease (n = 10), healthy controls (n = 5) and suspected refractory sprue (n = 6). Comparable results were obtained on fixed and frozen biopsy specimens. In four of the six patients with suspected refractory sprue, abnormal CD3c + CD8 − IEL and TCRγ gene rearrangements were found, as in refractory sprue; the remaining two patients had normal (CD3 + CD8 +) IEL and no TCRγ gene rearrangements. Both patients had coeliac disease, as one failed to comply with a gluten‐free diet, while the other was a slow responder.

Conclusion

This simplified immunostaining method using anti‐CD3 and anti‐CD8 antibodies on paraffin sections can distinguish active coeliac disease from refractory sprue and should prove useful in clinical practice.
Bone marrow manifestations of infections and systemic diseases observed in bone marrow trephine biopsy
Authors: Diebold J , Molina T , Camilleri‐Broët S , Le Tourneau A , Audouin J
Published: March 2003

Bone marrow modifications resulting from infections and systemic diseases can be studied by analysis of morphology and aetiology. Two types of lesions or modifications can be observed, those occurring in the connective tissue comprising inflammatory processes, acute and chronic, as well as immune reactions, and those involving the normal haematopoietic cell lines, with possible hyperplastic or aplastic changes in one or more cell lines. The main lesions are described (oedema, haemorrhage, necrosis, suppuration, granulomas, lymphoid nodules and hyperplasia, immunoblastic or plasmacytic hyperplasia), as well as the main aetiologies. In association, the three main haematopoietic cell lines show hyperplasia, hypoplasia, aplasia of one or all of the cell lines, sometimes with dysmyelopoiesis. The stroma and vessel reactions comprise myelofibrosis, gelatinous transformation or amyloid deposits.

The methods for identifying aetiological agents are emphasized. It should also be stressed that malignant neoplasias of different types involving the bone marrow can be responsible for such inflammatory or immune reactions.
Expression of CD34 and bcl‐2 in phyllodes tumours, fibroadenomas and spindle cell lesions of the breast
Authors: Moore T , Lee A H S
Published: March 2003

Strong expression of CD34 and bcl‐2 has been described in solitary fibrous tumours. It has been proposed that these lesions arise from long‐lived mesenchymal cells. We tested the hypothesis that spindle cell lesions of the breast arise from similar mesenchymal cells in the mammary stroma.

Sections of phyllodes tumours (26), fibroadenomas (15), myofibroblastomas (two), pseudoangiomatous hyperplasia (five) and myoid hamartoma (one) were stained immunohistochemically for CD34 and bcl‐2. Conventional mammary carcinoma is known to be CD34‐negative: we therefore stained 11 spindle cell carcinomas and one adenosquamous carcinoma. The mammary stroma, particularly around lobules, stained for CD34. All the lesions (except the carcinomas) showed spindle cell staining for CD34. There was more staining in fibroadenomas than in phyllodes tumours (especially malignant tumours). The staining in phyllodes tumours was typically patchy. In some there was increased or decreased staining adjacent to the epithelium. There were occasional spindle cells positive for bcl‐2 in the normal perilobular stroma. bcl‐2 was frequently expressed in spindle cells in fibroadenomas, phyllodes tumours and pseudoangiomatous hyperplasia, and rarely in the other lesions.

The combined expression of CD34 and bcl‐2 suggests that fibroadenomas, phyllodes tumours and pseudoangiomatous hyperplasia may arise from long‐lived bcl‐2‐positive mesenchymal cells in the breast in a manner similar to that proposed for solitary fibrous tumours. The absence of CD34 staining in spindle cell carcinomas is of potential diagnostic value in the distinction from malignant phyllodes tumours in difficult cases.