bluuebunny/crossref_metadata_2025 huggingface dataset:
Endocrine and cardiovascular late effects among adult survivors of childhood brain tumors
Authors: Gurney James G. , Kadan‐Lottick Nina S. , Packer Roger J. , Neglia Joseph P. , Sklar Charles A. , Punyko Judy A. , Stovall Marilyn , Yasui Yutaka , Nicholson H. Stacy , Wolden Suzanne , McNeil Dawn E. , Mertens Ann C. , Robison Leslie L.
Published: February 2003

BACKGROUND

Survivors of childhood brain tumors (CBTs) are at high risk for a variety of late adverse effects. Most research on long‐term effects of CBTs has been comprised of single‐institution case series without comparison groups. Research on CBT late effects often is focused on neurologic and sensory outcomes, with less emphasis on other potential targets such as the endocrine and circulatory systems. The current study was conducted to contrast the incidence of endocrine and cardiovascular conditions among CBT survivors as a function of treatment and to determine the risk of occurrence of these conditions relative to a sibling comparison group.

METHODS

As part of the Childhood Cancer Survivor Study (CCSS), treatment data were collected from medical records and self‐reported late effects were ascertained from a survey questionnaire of 1607 CBT patients who survived their disease for 5 or more years. For comparison purposes, questionnaire data were also collected from 3418 randomly selected siblings of participants in CCSS.

RESULTS

One or more endocrine conditions were reported by 43% of CBT survivors. Compared with siblings, CBT survivors had a significantly increased risk of late‐onset (≥ 5 years postdiagnosis) hypothyroidism (relative risk [RR] = 14.3; 95% confidence interval [95% CI] 9.7–21.0), growth hormone deficiency (RR = 277.8; 95% CI 111.1–694.9), the need for medications to induce puberty (RR = 86.1; 95% CI 31.1–238.2), and osteoporosis (RR = 24.7; 95% CI 9.9–61.4). One or more cardiovascular conditions were reported by 18% of CBT survivors, with an elevated late‐onset risk for stroke (RR = 42.8; 95% CI 16.7–109.8), blood clots (RR = 5.7; 95% CI 3.2–10.0), and angina‐like symptoms (RR = 2.0; 95% CI 1.5–2.7). Very few late effects were evident among those treated with surgery only, but risks were consistently elevated for those treated with radiation and surgery, and higher still for those who also received adjuvant chemotherapy.

CONCLUSIONS

Childhood brain tumor survivors are at a significantly increased risk for several adverse endocrine and cardiovascular late effects, particularly if they were treated with radiation and chemotherapy. Lifetime medical surveillance and follow‐up for potential toxicities are necessary because treatment‐related complications may occur many years after therapy. Cancer 2003;97:663–73. © 2003 American Cancer Society.

DOI 10.1002/cncr.11095
Frequency of gastrointestinal involvement and its clinical significance in mantle cell lymphoma
Authors: Romaguera Jorge E. , Medeiros L. Jeffrey , Hagemeister Frederick B. , Fayad Luis E. , Rodriguez Maria A. , Pro Barbara , Younes Anas , McLaughlin Peter , Goy Andre , Sarris Andreas H. , Dang Nan H. , Samaniego Felipe , Brown H. M. , Gagneja Harish K. , Cabanillas Fernando
Published: February 2003

BACKGROUND

The reported frequency of gastrointestinal (GI) tract involvement in patients with mantle cell lymphoma (MCL) is 15–30%. However, this figure most likely is an underestimate because most patients with MCL involving the GI tract previously reported were examined endoscopically only if they had GI tract symptoms. The impact of endoscopic assessment on the management of MCL patients is unknown.

METHODS

From March 1998 to May 2001 baseline upper and lower endoscopy of the GI tract was performed in consecutive untreated patients with MCL as part of a prospective therapeutic trial. Biopsies were performed on abnormal as well as macroscopically normal mucosa. Endoscopy was repeated during treatment and as part of follow‐up evaluations.

RESULTS

Only 26% of patients presented with GI symptoms at the time of diagnosis. MCL was present histologically in the lower GI tract of 53 of 60 patient (88%) and in the upper GI tract of 28 of 58 patients (43%). Microscopic evidence of MCL was found in 84% of patients with normal visual (macroscopic) findings by lower endoscopy and in 45% of patients with macroscopically normal findings by upper endoscopy. Despite this high frequency of GI tract involvement, the use of upper and lower endoscopy with biopsies in this group of patients resulted in changes in clinical management in only three (4%) patients.

CONCLUSIONS

Gastrointestinal tract involvement was found to be present in most patients with MCL, usually at a microscopic level involving macroscopically normal mucosa. The use of aggressive staging evaluation of the GI tract was found to have little impact on patient management decisions in the current study. Cancer 2003;97:586–91. © 2003 American Cancer Society.

DOI 10.1002/cncr.11096
A prospective study on glioblastoma in the elderly
Authors: Brandes Alba A. , Vastola Francesca , Basso Umberto , Berti Franco , Pinna Giampietro , Rotilio Antonino , Gardiman Marina , Scienza Renato , Monfardini Silvio , Ermani Mario
Published: February 2003

BACKGROUND

Elderly patients (age > 65 years) with glioblastoma multiforme frequently are excluded from clinical studies, and prospective trials for patients with this age group do not exist to date.

METHODS

The authors conducted a prospective trial in 79 consecutive elderly patients with glioblastoma who underwent surgery and received radiotherapy (59.44 grays in 33 fractions; Group A; n = 24 patients) or received the same radiotherapy plus adjuvant chemotherapy with procarbizine, lomustine, and vincristine (PCV; lomustine 110 mg/m2 on Day 1, procarbazine 60 mg/m2 on Days 8–21, and vincristine 1.4 mg/m2 on Days 8 and 29 every 42 days; Group B; n = 32 patients), or received the same radiotherapy plus adjuvant temozolomide (150 mg/m2 for 5 days every 28 days; Group C; n = 22 patients).

RESULTS

The median time to disease progression (TTP) and median survival MST were 7.2 months (95% confidence interval [95%CI], 6.34–8.64) and 12.5 months (95%CI, 11.6–14.8), respectively. The TTP was significantly better for Group C compared with Groups A and B (10.7 months vs. 5.3 months and 6.9 months, respectively; P = 0.0002). Karnofsky performance status (KPS) (P < 0.001) and temozolomide (P < 0.001) were the only independent prognostic factors. Overall survival was better in Group C compared with Group A (14.9 months vs. 11.2 months; P = 0.002), but there were no statistical differences found between Groups A and B or between Groups B and C. Only KPS (P < 0.001) was predictive of overall survival, even if temozolomide chemotherapy was very close to the significance level (P = 0.058). Hematologic Grade 3–4 toxicity was higher with the PCV chemotherapy regimen compared with the temozolomide chemotherapy regimen.

CONCLUSIONS

Age alone should not preclude appropriate treatment in elderly patients with good performance status, for whom definitive radiation therapy and adjuvant chemotherapy with temozolomide is advised. Cancer 2003;97:657–62. © 2003 American Cancer Society.

DOI 10.1002/cncr.11097
Treatment options for patients with acute myeloid leukemia with a matched sibling donor
Authors: Sung Lillian , Buckstein Rena , Doyle John J. , Crump Michael , Detsky Allan S.
Published: February 2003

BACKGROUND

The role of allogeneic bone marrow transplantation (BMT) in the consolidation of young adults with acute myeloid leukemia (AML) with matched sibling donors (MSD) is controversial. Although BMT is associated with increased event free survival compared with intensive chemotherapy (CT) consolidation, BMT also is associated with increased treatment‐related mortality and likely decreased quality of life and life expectancy in patients who do not develop recurrent disease.

METHODS

The authors used decision analysis to compare three strategies for maximizing quality‐adjusted life years (QALYs) in patients with AML in first remission with an MSD:BMT All,BMT None(consolidation CT only), or BMT in high‐risk patients, as defined by baseline cytogenetic testing (Teststrategy). A second decision‐analysis tree was then constructed that compared BMT with CT specifically for patients with intermediate cytogenetics.

RESULTS

Using expected QALYs as the outcome measure, theTest,BMT All, andBMT Nonestrategies were associated with 20.10 QALYs, 19.63 QALYs, and 18.38 QALYs, respectively. Thus, theTeststrategy, with CT for low‐risk patients and BMT for intermediate risk and high‐risk patients, was expected to be the optimal strategy. In the intermediate cytogenetic decision analysis, although the expected QALY for BMT recipients was higher compared with CT recipients (19.78 QALYs vs. 18.75 QALYs), because of uncertainty in variable estimates, the optimal choice was less clear.

CONCLUSIONS

CT consolidation is a reasonable option for patients with AML who have favorable cytogenetics, even if an MSD is available. This model provides a framework from which patients with AML and their physicians can make decisions about consolidation therapy. Cancer 2003;97:592–600. © 2003 American Cancer Society.

DOI 10.1002/cncr.11098
The predictive value of longitudinal neuropsychologic assessment in the early detection of brain tumor recurrence
Authors: Armstrong Carol L. , Goldstein Bram , Shera David , Ledakis George E. , Tallent Emily M.
Published: February 2003

BACKGROUND

Neuropsychologic tests are widely used to predict the course of progressive neurologic diseases, and recent research has demonstrated the specificity of cognitive measures, even in relatively diffuse diseases. However, the cognitive effects of brain tumors of similar histology and location are known to be highly variable. The authors used the specificity of cognitive function principle to compare two models for the early detection of low‐grade brain tumor recurrence prior to detection with clinically scheduled neuroimaging.

METHODS

To test the feasibility of these prediction models, 34 patients with supratentorial, low‐grade brain tumors prospectively were administered serial comprehensive neuropsychologic examinations; 11 patients developed recurrent tumors during the series and 23 patients did not. A general model based on tests sensitive to malignancy and white matter disease was compared with a tumor‐specific model based on indices related to each patient's tumor locus. A Cox proportional hazards model was used to identify the predictor variables that significantly changed immediately prior to recurrence.

RESULTS

Only the tumor‐specific model achieved statistical significance (P < 0.02). A tumor‐specific index decline of 1 standard deviation indicated a 5–fold increase in the probability of tumor recurrence.

CONCLUSIONS

Although this method needs to be tested with more frequent and regular observations and with a larger sample, these results provide evidence of the feasibility of the subject‐specific model as a predictor of recurrence. The evidence of the predictive value of a tumor‐specific model is consistent with studies that identify only limited, brain structure‐specific cognitive decline from broad neuropsychologic batteries. Cancer 2003;97:649–56. © 2003 American Cancer Society.

DOI 10.1002/cncr.11099
Cytotoxic/natural killer cell cutaneous lymphomas
Authors: Santucci Marco , Pimpinelli Nicola , Massi Daniela , Kadin Marshall E. , Meijer Chris J. L. M. , Müller‐Hermelink Hans Konrad , Paulli Marco , Wechsler Janine , Willemze Rein , Audring Heike , Bernengo Maria Grazia , Cerroni Lorenzo , Chimenti Sergio , Chott Andreas , Díaz‐Pérez José L. , Dippel Edgard , Duncan Lyn M. , Feller Alfred C. , Geerts Marie‐Louise , Hallermann Christian , Kempf Werner , Russell‐Jones Robin , Sander Christian , Berti Emilio
Published: February 2003

BACKGROUND

Cutaneous lymphomas expressing a cytotoxic or natural killer (NK) cell phenotype represent a group of lymphoproliferative disorders for which there is currently much confusion and little consensus regarding the best nomenclature and classification.

METHODS

This study analyzes 48 cases of primary cutaneous lymphoma expressing cytotoxic proteins and/or the NK cell marker, CD56. These cases were collected for a workshop of the European Organization for Research and Treatment of Cancer Cutaneous Lymphoma Task Force, to better clarify the clinical, morphologic, and phenotypic features of these uncommon tumors.

RESULTS

Several categories with different clinical and pathologic features were delineated: 1) aggressive, CD8+, epidermotropic, cytotoxic T‐cell lymphoma; 2) mycosis fungoides, cytotoxic immunophenotype variant; 3) subcutaneous panniculitis‐like T‐cell lymphoma; 4) NK/T‐cell lymphoma, nasal type; 5) CD4+, NK cell lymphoma; 6) blastoid NK cell lymphoma; (7) intravascular NK‐like lymphoma; and 8) cytotoxic, peripheral T‐cell lymphoma.

CONCLUSIONS

Our data show that primary cutaneous cytotoxic/NK cell lymphomas include distinct groups of diseases, clinically, histologically, and biologically. Because the finding of a cytotoxic phenotype often has prognostic significance, the routine use of cytotoxic markers in the diagnosis and classification of cutaneous lymphomas should be expanded. Cancer 2003;97:610–27. © 2003 American Cancer Society.

DOI 10.1002/cncr.11107
Moderate sun exposure and nevus counts in parents are associated with development of melanocytic nevi in childhood
Authors: Wiecker Tine Sander , Luther Heike , Buettner Petra , Bauer Jürgen , Garbe Claus
Published: February 2003

BACKGROUND

Melanocytic nevi have been identified as the most important risk factor for cutaneous melanoma. Sun exposure, sunburns, and light pigmentation have been found to be associated with their development in childhood. To the authors' knowledge, nevus proneness of parents and the exact type of ultraviolet (UV) exposure have not yet been investigated in this context. The authors' objective was to determine independent risk factors and their impact for nevus development in childhood.

METHODS

The current study was conducted by two university departments of dermatology in 49 public nursery schools in Stuttgart, Germany and in 38 public nursery schools in Bochum, Germany. The cross‐sectional study included 1812 children aged 2–7 years and their parents. Total body nevus counts in children, assessment of pigmentary features, and nevus counts on the arms of parents were performed. Parents underwent a standardized interview concerning national origin and lifestyle features, as well as habits and magnitude of sun exposure of children. Analysis was performed by multivariate linear regression analysis and by multiple logistic regression analysis.

RESULTS

The number of nevi was found to steadily increase with age from a median of 3 at age 2 years to 19 at age 7 years (P < 0.0001). High numbers of nevi in children were associated with the number of weeks on sunny holidays, outdoor activities at home, skin type, facial freckling, ethnicity of parents, and the number of nevi on the arms of parents. Previously experienced sunburns failed significance (P = 0.0620).

CONCLUSIONS

The authors found a strong association between nevus development in children and the number of parental moles, which most likely points to an inherited factor. Moderate sun exposure such as outdoor activities during a German summer without sunburns seemed to be sufficient for induction of melanocytic nevi. The authors believe that these findings will have direct impact on concepts for preventive strategies. Cancer 2003;97:628–38. © 2003 American Cancer Society.

DOI 10.1002/cncr.11114
A population‐based analysis of risk factors for a second primary cutaneous melanoma among melanoma survivors
Authors: Goggins William B. , Tsao Hensin
Published: February 2003

BACKGROUND

The results of several studies have provided evidence that patients diagnosed with cutaneous melanoma (CM) are at a higher risk of developing a second primary CM than the general population. In this study, the authors examined how the risk of a second primary tumor varied with time from diagnosis of CM and examined the patient‐specific factors that modify a CM patient's risk of developing a second primary tumor.

METHODS

Survival curves for time from first CM to second CM were calculated using the Kaplan–Meier method. The Cox proportional hazards model was used to determine which demographic‐ and disease‐related factors influence the risk of a second CM.

RESULTS

Approximately 0.5% of Surveillance, Epidemiology, and End Results (SEER) CM patients were found to have synchronous second primaries. The estimated cumulative probability of having a second primary CM was 0.99% at 1 year after initial CM diagnosis, 2.06% at 5 years, 3.17% at 10 years, and 5.34% at 20 years. Risk was significantly greater for males; older patients; patients with first CM on the face, neck, or trunk; those from the Atlanta, Hawaii, or Connecticut registries; and more recently diagnosed patients. Risk was lower for patients from the Utah registry and those with Stage IV disease.

CONCLUSIONS

The elevated risk for CM among CM survivors appears to be greatest in the first few months, and then subsequently declines. However, the risk for a second CM among CM survivors was found to remain substantially higher than the risk for a first CM in the general population throughout the observation period (> 20 years). Demographic‐ and disease‐related factors substantially modify the risk of a second primary CM. Cancer 2003;97:639–43. © 2003 American Cancer Society.

DOI 10.1002/cncr.11116
On reduced integration and locking of flat shell finite elements with drilling rotations
Authors: Geyer Sannelie , Groenwold Albert A.
Published: February 2003

In recent times, a number of assumed stress membrane finite elements with drilling degrees of freedom have been presented. These highly accurate elements are natural candidates for the membrane component of geometrically simple, yet accurate, flat shell finite elements. Depending on a mixed formulation, these assumed stress membranes are normally integrated using full integration. However, this is not necessarily optimal. Reduced integration using modified quadratures decreases the effects of membrane‐bending locking, while the accuracy and rank of the formulation is not impaired. Copyright ©2003 John Wiley & Sons, Ltd.
Conjugate filter approach for shock capturing
Authors: Gu Yun , Wei G. W.
Published: February 2003

This paper introduces a new scheme for the numerical computation involving shock waves. The essence of the scheme is to adaptively implement a conjugate low‐pass filter to effectively remove the accumulated numerical errors produced by a set of high‐pass filters. The advantages of using such an adaptive algorithm are its controllable accuracy, relatively low cost and easy implementation. Numerical examples in one and two space dimensions are presented to illustrate the proposed scheme. Copyright © 2003 John Wiley & Sons, Ltd.
A non‐linear fin design problem in determining the optimum shape of spine and longitudinal fins
Authors: Huang Cheng‐Hung , Hsiao Jan‐Hsiang
Published: February 2003

A non‐linear fin design algorithm is applied to estimate the optimum shapes for the spine and longitudinal fins by using the conjugate gradient method (CGM) based on the desired fin efficiency and fin volume. One of the advantages in using CGM in the inverse design problem lies in that it can handle problems having a large number of unknown parameters easily and converges very fast.

The validity of the present algorithm by using the CGM to solve the non‐linear fin design problem is justified based on numerical experiments. Results show that the optimum fin shapes can always be obtained. Copyright © 2003 John Wiley & Sons, Ltd.
Eigensolutions for matrices of special structures
Authors: Kaveh A. , Sayarinejad M. A.
Published: February 2003

In this article, a simple and efficient method is developed for calculating the eigenvalues and eigen vectors of matrices having special structures. This is achieved by decomposing the matrices into specific forms. The application is extended to the eigensolution of the Laplacian matrices of symmetric graphs. Copyright © 2003 John Wiley & Sons, Ltd.
Variational derivation of equilibrium equations of arbitrarily loaded pre‐stressed shear deformable non‐prismatic composite beams and solution by the DQEM buckling analysis
Authors: Chen Chang‐New
Published: February 2003

The generic equilibrium equations of arbitrarily loaded pre‐stressed non‐prismatic shear deformable composite beams can be derived. The buckling equilibrium equations can be obtained by simplifying the generic equilibrium equations. These equations can be used to develop the differential quadrature element method (DQEM) analysis model of the buckling of shear deformable beams. The DQEM uses the DQ to discretize the buckling equilibrium equation defined on each element, the transition conditions defined on the inter‐element boundary of two adjacent elements and the boundary conditions of the beam. Numerical results of the buckling of shear deformable bar structures solved by the developed numerical algorithm are presented. They prove that the DQEM buckling analysis model is efficient in comparison of convergence rate and numerical stability with the existing numerical techniques such as traditional FDM and some FEM models. Copyright © 2003 John Wiley & Sons, Ltd.
Demonstration of a simple method to satisfy homogenous boundary conditions in element‐free Galerkin method through the vibration problem of Timoshenko beam
Authors: Nair Rajeev G. , Rao G. Venkateswara , Singh Gajbir
Published: February 2003

A simple method to satisfy the homogeneous boundary condition in the element‐free Galerkin method is proposed in this paper. Effectiveness of the method is demonstrated, through free vibration problems of Timoshenko beams. Several case studies involving different slenderness ratios and end conditions are carried out. The results of the present study are compared with those obtained using classical Rayleigh–Ritz and conventional element‐free Galerkin method wherein Lagrangian multipliers are employed to satisfy boundary conditions. Eventhough, a one‐dimensional problem is considered in the present paper, the validity of the proposed method for the two‐dimensional problems is demonstrated theoretically. Copyright © 2003 John Wiley & Sons, Ltd.
Solitary parotid metastasis from columnar cell carcinoma of the thyroid: A diagnostic dilemma
Authors: Kini Hema , Pai Radha R. , Kalpana S.
Published: January 2003

A 65‐yr‐old woman presented in May 1998 with a left parotid mass of 2 yr duration. The cytology and histopathology of the parotid lesion showed features of a columnar cell carcinoma. In November, 1967, she was diagnosed to have a classic papillary thyroid carcinoma (PTC). Ultrasound examination revealed a persistent thyroid nodule, the aspiration cytology of which confirmed columnar cell variant of papillary thyroid carcinoma (CCV‐PTC). CCV‐PTC is a recently described rare tumor of the thyroid that has been associated with an aggressive clinical course. Our case was peculiar in that the patient presented with an isolated metastasis in the parotid gland. Second, after an indolent course following the initial diagnosis of usual PTC 31 yr ago, she had now developed a more aggressive variant of the tumor. Diagn. Cytopathol. 2003;28:72–75. © 2003 Wiley‐Liss, Inc.
Diagnostic value of eosinophils in pleural effusion: A prospective study of 26 cases
Authors: Matthai Smita Mary , Kini Usha
Published: January 2003

Eosinophilic pleural effusions (EPFs), defined as the presence of 10% or more eosinophils in the pleural fluid, are relatively rare. Their diagnostic and prognostic significance, however, remains controversial, as most of the studies are based almost entirely on retrospective case studies. This prospective study examines 26 eosinophilic pleural effusions from among 444 consecutive pleural effusions investigated at this tertiary health care center from October 1999 to April 2002. This study was attempted to unravel the diagnostic and prognostic significance of these eosinophilic effusions and assess their clinical implications, if any. Koss and Light's criteria were applied in the analysis, which comprised macroscopic, biochemical, cytological, and microbiological examinations. Of the 26 EPFs studied, five were associated with tuberculosis and three with metastatic disease. Nineteen patients had significant associated lymphocytosis. Twenty‐four patients have been followed up and are in good health to date and have had no recurrence of effusion. Thus, EPF could be associated with inflammatory, benign, and malignant conditions. Hence, a closer search for a definite etiological agent is warranted in the setting of such an effusion, especially in populations endemic for tuberculosis, as in a developing country like India and in populations with a high prevalence of malignancy. Diagn. Cytopathol. 2003;28:96–99. © 2003 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of splenic hamartoma
Authors: Lee Sheng‐Huang
Published: January 2003

Bench‐top fine‐needle aspiration biopsy (FNAB) following splenectomy and nephrectomy from a 21‐yr‐old female of tuberous sclerosis with right renal angiomyolipoma and splenic hamartoma was performed for the correlation of the cytologic features with histologic findings and, along with the immunopathologic studies, for the establishment of a challenging preoperative diagnosis of splenic hamartoma. The postoperative bench‐top aspirate of splenic hamartoma yielded small and large clusters of plump, spindly to polygonal cells in the blood‐stained background with scattered small lymphocytes, comparable with the preoperative echo‐guided FNAB. The histopathology and immunopatholgy of the splenic hamartoma from the bench‐top aspirate cytoblock and splenectomy tissue were comparable, unveiling the red pulp tissue consisting of wider cord stromal tissue than its normal counterpart with sinus‐like vascular channels lined by endothelial cells which were positive for CD8, CD34, factor VIII‐related antigen, vimentin, as well as negative for muscle‐specific actin, CD21, CD68, and cytokeratin, scattered dispersed CD3‐ and CD45RO‐positive T‐lymphocytes, and small clusters of CD20‐positive B lymphocytes, with a dearth of fibrous trabeculae and organized white‐pulp lymphoid tissue. A combination of cytologic features and immunopathologic results from the aspirate cytoblock along with the salient clinical information should enable an accurate preoperative diagnosis of splenic hamartoma. Diagn. Cytopathol. 2003;28:82–85. © 2003 Wiley‐Liss, Inc.
Fine‐needle aspiration cytology of chondroblastoma of soft parts: Case report and differential diagnosis with other soft tissue tumors
Authors: Granados Rosario , Martín‐Hita Ana , Rodríguez‐Barbero José María , Murillo Nieves
Published: January 2003

Chondroblastoma is a benign tumor arising in the epiphysis of long bones. The extraskeletal presentation is most unusual. We report the first cytological description of a soft tissue chondroblastoma. It was a subcutaneous mass in the leg of a 62‐yr‐old man. Fine‐needle aspiration (FNA) rendered a highly cellular material with grouped and single polygonal or round cells with a uniform, sometimes eccentric nucleus. Microvacuolated cytoplasm and hemosiderin pigment were frequent findings. There were rare nuclear grooves and mitoses. A metachromatic, focally calcified stroma was present, occasionally surrounding the cells. There were also numerous multinucleated osteoclast‐like giant cells. Histological evaluation was diagnostic of chondroblastoma. The tumor was locally aggressive. A review of other soft tissue masses with similar cytological findings is included in the discussion. FNA cytology is very helpful in the diagnosis of soft tissue chondroblastoma, but additional studies may be necessary for a definitive diagnosis. Diagn. Cytopathol. 2003;28:76–81. © 2003 Wiley‐Liss, Inc.
Cell cannibalism: Diagnostic marker of malignancy
Authors: Gupta Kirti , Dey Pranab
Published: January 2003

In this study, we tried to find out the cytological relevance of cannibalism as a dependable feature of malignancy in effusion and urine cytology. We randomly selected a total of 40 cases consisting of 10 each of malignant effusion, benign effusion, malignant urine samples, and benign urine samples. These smears were assessed for the presence of cell cannibalism. The number of cannibalistic cells/100 tumor cells was counted. The cannibalistic cells were seen more commonly in malignant effusion cases (3.4/100 cells) compared with malignant urine cases (2/100 cells). There was not a single cannibalistic cell in benign conditions. The finding of an increased number of cannibalistic cell was highly significant in malignant versus benign samples (P > 0.0000, Student's t‐test). The present study highlights the significance of cannibalism in malignant urine and effusion cytology. We suggest that cell cannibalism is a dependable cytological feature of malignancy. Diagn. Cytopathol. 2003;28:86–87. © 2003 Wiley‐Liss, Inc.
Correlation of number of intrathyroid lymphocytes with antimicrosomal antibody titer in Hashimoto's thyroiditis
Authors: Pandit Ajita Avinash , Vijay Warde Maya , Menon Padma S.
Published: January 2003

The variants of Hashimoto's thyroiditis (classic, florid, and fibrotic types) differ in clinical manifestations, laboratory tests, and morphology. The titers of autoantibodies correlate with the degree of thyroidal lymphocytic infiltration (Wislon et al., 19985) It appears that the density of lymphocytes is inversely proportional to antimicrosomal antibody (AMA) titer. The aim of the present study is to determine the precise relationship between the number of lymphocytes and AMA titer. It may be useful to predict the onset of the disease in subclinically hypothyroid patients. In 62 cases of cytologically confirmed Hashimoto's thyroiditis, the number of lymphocytes per high‐power field was counted and correlated with AMA titer. The grading of lymphocytes was done as 1 (<10/HPF), 2 (11–20/HPF), and 3 (≥21/HPF). The results showed no correlation between lymphocyte number and AMA titer. Diagn. Cytopathol. 2003;28:63–65. © 2003 Wiley‐Liss, Inc.
Vitreous cytology in asteroid hyalosis and observations on interpretation of cytologic findings in specimens of the posterior (vitreous) compartment of the eye
Authors: Zaharopoulos Paul , Schnadig Vicki
Published: January 2003

Cytologic methods have been used in the pathologic investigation of the posterior (vitreous) compartment of the eye in specimens obtained by fine‐needle aspiration, as well as by surgical procedures. The vitreous body, which is in a semiliquid gel state, lends itself to pathologic investigation by cytologic methods. We report on a case of reparative eye surgery for complications of previous cataract extraction; vitrectomy was performed for vitreous opacities, which, by cytologic examination, were diagnostic of asteroid hyalosis, a relatively uncommon condition affecting the elderly. The cytologic findings diagnostic of this disease are described. Observations are made on the cytologic findings commonly encountered in specimens obtained from the posterior (vitreous) compartment of the eye. Diagn. Cytopathol. 2003;28:88–91. © 2003 Wiley‐Liss, Inc.
Fine‐needle aspiration biopsy of a cystic pleomorphic adenoma with extensive adnexa‐like differentiation: Differential diagnostic pitfall with mucoepidermoid carcinoma
Authors: Brachtel Elena F. , Pilch Ben Z. , Khettry Urmila , Zembowicz Artur , Faquin William C.
Published: January 2003

Although fine‐needle aspiration biopsy (FNAB) is a highly accurate tool for the diagnosis of pleomorphic adenomas, even this common salivary gland neoplasm can be diagnostically challenging and cause pitfalls in cytodiagnosis. In particular, the presence of either cystic degeneration or squamous and mucinous metaplasia can lead to a false positive diagnosis of malignancy. Here we present the case of a 16‐year‐old female who presented with a painless, slowly growing mass in the superficial lobe of the right parotid gland. Magnetic resonance imaging of the parotid demonstrated a mass with heterogeneous postcontrast enhancement and a central, nonenhancing area suggestive of necrosis. FNAB of the lesion yielded proteinaceous debris and numerous whorls of keratin, small cohesive clusters of basaloid and squamoid epithelial cells, and many vacuolated and foamy cells. Initially and after consultation at an outside institution, the FNAB was reported as an “atypical neoplasm, cannot exclude mucoepidermoid carcinoma.” A total, nerve‐sparing parotidectomy and level II neck dissection revealed a pleomorphic adenoma with central cystic degeneration and extensive mixed appendageal differentiation. While foci of squamous metaplastic changes may occur in pleomorphic adenomas, the combination of cystic degeneration and extensive appendageal differentiation with numerous keratotic cysts is rare, and it presents the potential for misinterpretation of the FNAB as indicative of malignancy in general, and mucoepidermoid carcinoma in particular. Diagn. Cytopathol. 2003;28:100–103. © 2003 Wiley‐Liss, Inc.
Fine‐needle aspiration of adult rhabdomyoma: A case report with review of the literature
Authors: McGregor David K. , Krishnan Bhuvaneswari , Green Linda
Published: January 2003

The cytologic features of adult rhabdomyoma, a rare benign tumor of skeletal muscle origin, have been infrequently reported in the literature. We present here a case of a rhabdomyoma involving the floor of the mouth of a 78‐year‐old man initially diagnosed by fine‐needle aspiration cytology. Cytologic features seen on Papanicolaou‐stained smear preparation included cohesive clusters of skeletal muscle cells having abundant eosinophilic cytoplasm and often peripherally located nuclei. Although cross‐striations and elongated intracytoplasmic inclusions were not identified in the smears, they were noted in the cell block preparation of the aspirated specimen and in the touch preparation and histologic sections of the surgically resected specimen. The cytologic differential diagnosis of this tumor is discussed. Diagn. Cytopathol. 2003;28:92–95. © 2003 Wiley‐Liss, Inc.
Distribution of subtypes of metastatic renal‐cell carcinoma: Correlating findings of fine‐needle aspiration biopsy and surgical pathology
Authors: Mai Kien T. , Alhalouly Tahany , Lamba Manisha , Yazdi Hossein M. , Stinson William A.
Published: January 2003

Clear‐cell (CRCC), papillary (PRCC), and chromophobe (CHRCC) renal‐cell carcinoma (RCC) are the three most frequent subtypes of RCC. The rate and distribution of their metastatic lesions have not been well studied in cytopathological materials. Sixty‐two fine‐needle aspiration biopsy cases of metastatic RCC were studied and correlated with surgical pathology of RCCs with and without metastasis. Special stains for glycogen and immunostaining for cytokeratins, vimentin epithelial membrane antigen (EMA), and carcinoembryonic antigens, and electron microscopic studies were performed. Fifty‐nine cases of CRCC and three of PRCC subtypes were retrieved from the cytopathology files at the Ottawa Hospital in a period of 10 years. Of these cases, 10 metastatic CRCC and one metastatic PRCC were diagnosed prior to the diagnosis of the primary tumor. CHRCC and sarcomatoid RCC were not represented in cytopathological specimens. CRCC displayed characteristic filmy cytoplasm and nuclei with prominent nucleoli. PRCC was characterized by dense cytoplasm, large nuclei with prominent nucleoli, and papillary architectures. In addition, all RCCs were characterized by the presence of glycogen and the absence of mucin by using histochemical techniques and electron microscopic studies and positive reactivity for cytokeratins (CK) and vimentin (VIM). In the same period, there were a total of 380 patients with RCC divided into 310 CRCCs, 55 PRCCs, and 15 CHRCCs associated with metastases in 142, 9, and 1 case, respectively. CRCC is by far the most common subtype found in metastases sampled in cytopathology. PRCC, CHRCC, and sarcomatoid RCC were underrepresented. Awareness of this propensity of RCC and the characteristic cytopathological, histochemical, immunohistochemical, and ultrastructural features are helpful in the diagnosis of metastatic RCC. Diagn. Cytopathol. 2003;28:66–70. © 2003 Wiley‐Liss, Inc.
Integrating the environment into strategic decision‐making: conceptualizing policy SEA
Authors: Sheate William R. , Dagg Suzan , Richardson Jeremy , Aschemann Ralf , Palerm Juan , Steen Ulla
Published: February 2003

Strategic environmental assessment (SEA) is seen as an important tool for integrating the environment into decision‐making, e.g. at plan and programme levels where it is being used with increasing regularity. At the policy and most strategic decision levels, however, it is less clear how SEA can best be used or what methodologies are appropriate in what are inevitably highly politicized contexts. This paper reports on a study carried out for the European Commission to review the mechanisms of integration at strategic decision levels and to examine the role of SEA in helping to achieve better integration. This was undertaken by first reviewing integration and SEA in all EU member states and in a range of other countries and international financing organizations, and then analysing in detail 20 SEA and integration case studies at various strategic decision levels, primarily policy and plan levels. What is clear is that SEA at the most strategic level needs to be flexible in relating to the policy‐making process, but can bring significant advantages by providing a more systematic approach to the consideration of environmental issues. Existing institutional mechanisms may already provide elements of SEA that can be harnessed together in a more systematic process. At the most strategic levels qualitative, participation and communication processes become much more important than technical methodologies. SEA should be seen as complementary to the newly emerging tool of sustainability appraisal, although the exact relationship will depend upon the preferred interpretation of sustainable development. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment.
Financial incentives to improve environmental performance: a review of Nordic public sector support for SMEs
Authors: Clement Keith , Hansen Malin
Published: February 2003

European governments offer various forms of financial assistance to support small and medium‐sized enterprises (SMEs) in aspects of environmental improvement. Such subsidies can be controversial, but it is generally accepted that economic instruments must be used in working towards environmental policy goals.

Through a comparative analysis, this article reviews 15 environmental incentives for SMEs in the Nordic countries of Denmark, Finland, Norway and Sweden. Four broad themes identified in incentive coverage comprise environmental management, environmental technology, environmental employment and energy. The associated objectives range from launching research and development through to implementing environmental technology, raising awareness and skills, creating jobs and competing in the specialist environmental sector. In comparison with Europe‐wide survey data, the Nordic countries have recently used a greater proportion of grants.

Issues of research significance include the lack of clarity regarding company perception of environmental incentives, the impact of incentives on SME environmental performance and whether these subsidies ultimately contribute to economic competitiveness. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment.
Environmental NGOs and the Biosafety Protocol: a case study on political influence
Authors: Arts Bas , Mack Sandra
Published: February 2003

It is not only governments which play an important role in securing international agreements, but environmental non‐governmental organizations (ENGOs) as well. This is reflected in the ever‐growing body of literature concerning this topic. This article deals with the political influence of ENGOs on the Biosafety Protocol, a protocol linked to the UNEP Convention on Biological Diversity. It concludes that these organizations did have an impact on the final agreement that was made, with one example being the inclusion of the precautionary principle in the final protocol (although not exclusively determined by ENGOs). They were particularly able to influence policy outcomes by lobbying government delegates, by co‐operating with developing countries and by mobilizing public pressure. With regard to the time frame of the biosafety negotiations, ENGOs succeeded in exercising most of their influence in the so‐called ‘pre‐negotiation’ phase. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment.
Classification of emissions trading scheme design characteristics
Authors: Mavrakis Dimitrios , Konidari Popi
Published: February 2003

The analysis of existing emission trading schemes leads to the classification of their characteristics into four categories: (i) objectives, (ii) target groups, (iii) rules–influencing mechanisms and (iv) implementation network. This classification is applied for the design of a Hellenic emissions trading scheme and for exploring policy interactions between the Hellenic scheme and other Hellenic climate policy instruments. The results of this procedure confirm that the proposed classification facilitates the definition of the elementary Hellenic scheme characteristics and the specification of its distinctions from other national regimes. Conclusively the proposed classification systematizes and facilitates the integrated design of an emissions trading scheme. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment.
Elastohydrodynamics of tensioned web roll coating process
Authors: Carvalho M. S.
Published: February 2003

Coating process is an important step in the manufacturing of different products, such as paper, adhesive and magnetic tapes, photographic films, and many other. The tensioned web roll coating is one the several methods used by different industries. It relies on the elastohydrodynamic action between the fluid and the tensioned substrate for transferring and applying the liquid. The main advantage of this method is its ability to apply very thin liquid layers with less sensitivity to mechanical tolerance at relative small cost. Despite its industrial application, theoretical analysis and fundamental understanding of the process are limited. This work analyses this elastohydrodynamic action by solving the differential equations that govern the liquid flow, described by the Navier–Stokes equation, and the web deformation, modelled by the cylindrical shell approximation. The goal is to determine the operating conditions at which the process is two dimensional and defect free. The equations are discretized by the Galerkin/finite‐element method. The resulting non‐linear system of equations is solved by Newton's method coupled with pseudo‐arc‐length continuation in order to obtain solutions around turning points. The theoretical results are used to construct an operating window of the process that is in agreement with limited experimental data. Copyright © 2003 John Wiley & Sons, Ltd.
A finite volume method for multicomponent gas transport in a porous fuel cell electrode
Authors: Stockie John M. , Promislow Keith , Wetton Brian R.
Published: February 2003

We present a mathematical model for multicomponent gas transport in an anisotropic fuel cell electrode.The model couples the Maxwell–Stefan equations for multicomponent diffusion along with Darcy's law for flow in a porous medium. The equations are discretized using a finite volume approach with the method of lines, and the resulting non‐linear system of differential equations is integrated in time using a stiff ODE solver. Numerical simulations are performed to validate the model and to investigate the effect of various parameters on fuel cell performance. Copyright © 2003 John Wiley & Sons, Ltd.
Linear stability analysis of flow in a periodically grooved channel
Authors: Adachi1 T. , Uehara H.
Published: February 2003

We have conducted the linear stability analysis of flow in a channel with periodically grooved parts by using the spectral element method. The channel is composed of parallel plates with rectangular grooves on one side in a streamwise direction. The flow field is assumed to be two‐dimensional and fully developed. At a relatively small Reynolds number, the flow is in a steady‐state, whereas a self‐sustained oscillatory flow occurs at a critical Reynolds number as a result of Hopf bifurcation due to an oscillatory instability mode. In order to evaluate the critical Reynolds number, the linear stability theory is applied to the complex laminar flow in the periodically grooved channel by constituting the generalized eigenvalue problem of matrix form using a penalty‐function method. The critical Reynolds number can be determined by the sign of a linear growth rate of the eigenvalues. It is found that the bifurcation occurs due to the oscillatory instability mode which has a period two times as long as the channel period. Copyright © 2003 John Wiley & Sons, Ltd.
LES of the flow past a rectangular cylinder using the immersed boundary concept
Authors: Grigoriadis D. G. E. , Bartzis J. G. , Goulas A.
Published: February 2003

Incompressible turbulent flow past a long square cylinder is investigated using large eddy simulations (LES). Results are presented and compared with available experimental databases for a Reynolds number Red=22000. The problem served as one of the validation cases for the development of a numerical code designed for efficient, parallel, three‐dimensional N‐S computations in complex geometrical configurations. In contrast with previous studies, the geometrical definition of the problem is established by the immersed boundary concept (IMB) while pressure solution is performed by a fast, fully parallel direct pressure solver. Calculations were performed with the widely applied Smagorinsky turbulence model and the filtered structure function model (FSF) which has not been previously applied to the flow case under consideration. In order to assess the potential of LES at its lowest (RANS), and highest (DNS) limit, different numerical resolutions were examined. Depending on the available resolution, either no‐slip conditions or a modified Werner and Wengle approximate wall boundary condition was used. The predicted mean velocity and fluctuation profiles, force statistics and Strouhal numbers were found to be in very good agreement with the experimental data sets. Analysis of the results indicates that for time varying bluff‐bodies flows that involve complex flow phenomena, successful large eddy simulations are not just possible, but can also achieve an excellent quality of results at a relatively low cost. Copyright © 2003 John Wiley & Sons, Ltd.
Bulk viscosity damping for accelerating convergence of low Mach number Euler solvers
Authors: Mazaheri Karim , Roe Philip L.
Published: February 2003

In solution of the Euler equations in the steady state external flows, error or residual waves are blamed for decelerating the convergence. These waves may be damped by adding a bulk viscosity term to the momentum equations. We analyse effects of this term on the linearized differential equations, and study its explicit and implicit implementation in one and two space dimensions. Optimum values of the bulk viscosity damping (BVD) are discussed. After generalization to two space dimensions, its performance both alone and in combination with a soft wall boundary condition and residual smoothing in central differencing codes is reviewed. It is shown that BVD is complementary to them, and acts independently of them. Finally, application of BVD in solution of low Mach number flows is considered, to show how it can strongly stabilize and accelerate these low Mach number computations. Copyright © 2003 John Wiley & Sons, Ltd.