bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Surgical and Orthotic Intervention on the Quality of Life of People with Profound Intellectual and Multiple Disabilities and Their Carers
Authors: Neilson Aileen , Hogg James , Malek Mo , Rowley David
Published: March 2003

The increasing analysis of quality of life issues for people with disabilities has not been paralleled in relation to people with profound intellectual and multiple disabilities (PIMDs). This is nowhere more the case than with regard to the impact of health status on their quality of life. In addition, people with PIMDs, and the interventions which they require, have not been included within wider considerations of the economics of healthcare and its relation to rational decision‐making regarding medical provision. The present exploratory study considered the impact of a wide range of surgical and orthotic interventions on the quality of life of 27 children and adults with PIMDs. These were explored on a pre–post‐test basis with respect to: (1) the economic costs associated with surgical and orthotic interventions; (2) clinical assessment of function and behaviour; (3) the participants' and carers' quality of life; and (4) carer satisfaction with the interventions. The results are presented with respect to these individual areas and the extent to which the findings are congruent. The need for the development of these measures to meet the specific requirements of this population and the development of a more formal model integrating these steps are considered.
Tomato spotted wilt virus—positive steps towards negative success
Authors: Adkins Scott
Published: March 2003

Taxonomy

: Tomato spotted wilt virus (TSWV) is the type member of the plant‐infecting Tospovirus genus in the family Bunyaviridae, a large group of predominantly vertebrate‐ and insect‐infecting RNA viruses.

Physical properties

: Virions are 80–120‐nm pleomorphic particles with surface projections composed of two viral glycoproteins, G1 and G2 ( Fig. 1). Virion composition is 5% nucleic acid, 70% protein, 5% carbohydrate and 20% lipid. The genome consists of three negative or ambisense ssRNAs designated S (2.9 kb), M (4.8 kb) and L (8.9 kb), with partially complementary terminal sequences that allow the RNA to adopt a pseudocircular or panhandle conformation. Each genomic RNA is encapsidated by multiple copies of the viral nucleocapsid (N) protein to form ribonucleoprotein structures also known as nucleocapsids. The nucleocapsids are enclosed in a host‐derived membrane bilayer along with an estimated 10–20 copies of the L protein, the putative RNA‐dependent RNA polymerase.

Transmission electron micrograph of isolated TSWV virions. Unfixed virion preparation stained with 1% (w/v) methylamine tungstate.

image

Hosts

: Over 800 plant species, both dicots and monocots, in more than 80 plant families are susceptible to TSWV ( Goldbach and Peters, 1994). The Solanaceae and Compositae families contain the largest numbers of susceptible plant species (
Prins and Kormelink, 1998). TSWV also replicates in its insect vector, thrips (Thysanoptera: Thripidae) (
Ullman et al., 1993
;
Wijkamp et al., 1993
).

Useful web site

: http://www4.ncbi.nlm.nih.gov/ICTVdb/ICTVdB/11050003.htm
Molecular characterization of Fusarium subglutinans associated with mango malformation
Authors: Steenkamp Emma , Britz Henriette , Coutinho Teresa , Wingfield Brenda , Marasas Walter , Wingfield Michael
Published: March 2003

Mango malformation is a serious disease of Mangifera indica in tropical and subtropical regions of the world. This disease is caused by Fusarium subglutinans, which is also associated with diseases on many other hosts, such as pineapple, pine, maize and sugarcane. The F. subglutinans strains associated with different hosts are virtually indistinguishable using morphological characters, but can be easily differentiated using histone and β‐tubulin gene sequencing, and some have subsequently been assigned to distinct species. The aim of this study was to characterize F. subglutinans isolates associated with mango malformation using histone H3 gene sequencing and to compare them with other isolates in the Gibberella fujikuroi complex. Analysis of histone sequence data revealed the presence of two phylogenetically distinct groups of F. subglutinans isolates associated with mango malformation. We also considered the identity of the two groups of isolates associated with mango malformation and determined their relatedness to other Fusarium spp. For this purpose, portions of the β‐tubulin gene were sequenced and compared with the β‐tubulin sequences deposited in the National Center for Biotechnology Information (NCBI) nucleotide database. This comparison to the NCBI database indicated that one group of F. subglutinans strains isolated from mango constitutes a unique lineage in the G. fujikuroi complex. Based on β‐tubulin and histone H3 sequencing, the second group of isolates is conspecific with the F. subglutinans strains previously reported to be the causal agent of mango malformation.
Genome analysis of the plant pathogenic ascomycete Leptosphaeria maculans; mapping mating type and host specificity loci
Authors: Cozijnsen Anton J. , Popa Kerryn M. , Purwantara Agus , Rolls Barbara D. , Howlett Barbara J.
Published: March 2003

A genetic and physical map has been developed for the loculoascomycete Leptosphaeria maculans, a pathogen of oilseed Brassicas. The genetic map was constructed from 58 F1 progeny and comprises 155 amplified fragment length polymorphic (AFLP) markers, three random amplified polymorphic DNA (RAPD) markers, the mating type locus and a host specificity locus conferring the ability to form lesions on Brassica juncea. Twenty‐one linkage groups, 5 pairs, and 18 unlinked markers were assigned, and the genome size was 1520 cM. Pulsed field gel electrophoresis experiments showed that the parental isolates each had 16 chromosomes and a genome size of about 33.5 Mb. Attempts to anchor a large number of markers to chromosomes were hampered by difficulties in converting AFLPs into RFLP markers, and because many markers bound to every chromosome, indicating that L. maculans has a high level of dispersed repetitive sequences. This fungus displays chromosomal length polymorphisms, but in the cross examined, the linkage and physical maps were essentially congruent and there was no evidence of translocations. The host specificity locus is 18 cM from the nearest AFLP marker and is located on a chromosome sized 1.85 Mb in the virulent parent. The mating type locus is on a chromosome sized 2.6 Mb and coincident on an AFLP marker amplified from the virulent parent. The derived amino acid sequence of part of this marker has some conserved amino acids present in the High Mobility Group DNA binding domain of MAT‐2 mating type genes of other ascomycetes.
The DspB/F protein of Erwinia amylovora is a type III secretion chaperone ensuring efficient intrabacterial production of the Hrp‐secreted DspA/E pathogenicity factor
Authors: Gaudriault Sophie , Paulin Jean‐Pierre , Barny Marie‐Anne
Published: March 2003

Erwinia amylovora is a Gram‐negative bacterium responsible for fire blight, a necrotic disease affecting plants of the Rosaceae family. E. amylovora virulence is dependent on a functional type III secretion system. To date, four proteins have been shown to travel through this secretion system: HrpN, HrpW, HrpA, and DspA/E. Next to dspA/E, dspB/F encodes a small acidic protein sharing features similar to those of type III secretion chaperones described in animal systems. Here, we show that DspA/E was not secreted in a dspB/F background, while other known type III secreted proteins (HrpN, HrpW, and HrpA) remained secreted to wild‐type level. A functional copy of dspB/F introduced in trans in a dspB/F background restored DspA/E secretion. Further analysis showed that DspA/E was not detected in a dspB/F background. This effect was post‐transcriptional as the expression of a dspA/E::uidA transcriptional fusion was not reduced in a dspB/F background. Affinity blot analysis experiments demonstrated that DspB/F specifically interacts with DspA/E in vitro. Therefore, DspB/F acts as a specific DspA/E chaperone and DspB/F prevents intrabacterial DspA/E degradation. dspB/F mutants were found to retain some pathogenicity to pear seedlings. This phenotype contrasts with the non‐pathogenic phenotype of the dspA/E mutant and suggests that the DspA/E protein still transits through the type III secretion machinery in a dspB/F mutant even though it is not detected in vitro.
Tomato yellow leaf curl virus, the intracellular dynamics of a plant DNA virus
Authors: Gafni Yedidya
Published: March 2003

Tomato yellow leaf curl virus
is a geminivirus, transmitted by whitefly (
Bemisia tabaci ) and causing the most destructive disease of tomato throughout the Mediterranean region, the Middle East and the tropical regions of Africa and Central America. Affected plants produce either no fruits or a few small fruits. Since it is an ssDNA virus which replicates in the host cell nucleus, the molecular mechanisms involved in the viral nuclear import have been the focus of our studies in recent years and results as well as prospects will be discussed.

Taxonomy: Tomato yellow leaf curl virus
(TYLCV) is a ssDNA plant virus, a member of the family
Geminiviridae
, of the genus
Begomovirus.

Physical properties:  TYLCV, like all members of Geminiviridae, has geminate (twinned) particles, 18–20 nm in diameter, 30 nm long, apparently consisting of two incomplete T = 1 icosahedra joined together in a structure with 22 pentameric capsomers and 110 identical protein subunits (Fig. 1).

Particles of TYLCV. Electron micrograph of purified, negatively stained TYLCV particles. Bar = 100 nm.

image

Disease symptoms:  Symptoms become visible in tomato in approximately 2–3 weeks after infection (Fig. 2). Leaf symptoms include chlorotic margins, small leaves that are cupped, thick and rubbery. The majority (up to 90%) of flowers abscise after infection, and therefore few fruits are produced. In Israel and elsewhere, weeds bridge the gap as potential perennial host and source of the virus between tomato growing seasons.

Tomato yellow leaf curl symptoms on tomato plant. Leaves show yellowing on the edges accompanied by upward curling.

image

Disease control:  Control of TYLCV is currently based on insecticide treatments and/or physical barriers against the insect vector (Bemisia tabaci), and on tomato breeding programs based on introgression of resistance or tolerance from wild species to cultivated tomato.

Useful website:  
Costing the library services. Cairns Library: a case study
Authors: FORREST MAUREEN , CAWASJEE ANNE‐MARIE
Published: March 2003

In the present climate libraries have to adopt a business approach to funding submissions; detailed management information must be produced in support of expenditure and to ensure that the services are cost‐effective. In addition to the grant from its parent body (the Faculty of Clinical Medicine, University of Oxford), the Cairns Library obtains funding from five other bodies, including National Health Service Hospital Trusts.

The Cairns Library has introduced an ongoing costing exercise covering the different services. The costs are divided into three categories: salary costs, other direct costs and indirect costs. Staff time has been identified from detailed time‐sheets kept by each member of staff; the time recorded is assigned to the individual services. The direct costs and the indirect costs have been identified and allocated/apportioned similarly.

The services are divided into five packages: core, current awareness, document delivery, enquiries and user education. The costs for each package have been apportioned to the funding bodies on the basis of the number of registered users from each body.
Using reading therapy with children
Authors: Schlenther Elizabeth
Published: March 2003

Through books, children can be helped to cope with health and life problems. Reading as therapy can be done on several levels, either by trained counsellors or by caring adults. This paper covers the research, methodology, possible counter‐indications and effectiveness of reading therapy with children. Further training should be a priority in librarianship as well as in other disciplines, and the establishing of a co‐ordinating body should be considered.
Staff development in the electronic library: lessons for the health sector from the IMPEL2 eLib project
Authors: Walton Graham , Edwards Catherine
Published: March 2003

This paper proposes that the health sector has much to learn from higher education as regards information provision in the electronic age. Information Technology for Library and Information Services is less developed in the NHS than in higher education. Staff training and development is identified as a key issue in supporting the transition to electronic delivery of Library and Information Services.

The Electronic Libraries Programme (eLib), developing electronic services in higher education, is outlined, with emphasis on the IMPEL2 Project and its methodology. Findings from the Staff Training and Development strand of IMPEL2 are presented. This study identified that attention should be most keenly focused on two areas, IT skills and skills to support changing roles. A number of success factors in training and development are highlighted.

The paper concludes that release of resources from eLib to support staff development must be paralleled in the health sector if effective electronic services are to be developed.
Evidence in seconds? Format and design considerations in the provision of reliable information to support evidence‐based practice
Authors: Weightman Alison Lesley , Mann Mala Kanthi
Published: March 2003

Evidence‐based practice is gaining support amongst health professionals. However, the major barrier remains the lack of time to read the literature. There are also problems with the take‐up and use of evidence‐based information sources such as Cochrane reviews and Effective Health Care bulletins. If such evidence is to be incorporated into local guidelines and used in day‐to‐day practice, practitioners request that these and other reliable publications be further summarized in short packages and available within seconds. The Health Evidence Bulletins Wales offer a model for this approach. The Bulletins have gone through several developmental stages leading to a novel two‐column format. In the first column, brief statements summarize the best available evidence within a topic area. In the second, full details are provided of the supporting publications (and the evidence type, or research design) with links to the full text of documents, where possible from the electronic versions of each Bulletin. Results from a questionnaire study using a random sample and unsolicited feedback suggest that this ‘two‐tier’ approach to information provision is valued by users and has implications for information services currently under development to support clinical governance.
Local information for Primary Care: the St Albans WAX Project (STAPCIS)
Authors: Rousseau Naomi
Published: March 2003

The St. Albans Primary Care Information Service (STAPCIS) is a database of locally focused information designed to be of use for GPs and the Primary Care team as a whole in a particular area. It is currently being used by practices in the St. Albans, Dacorum and Watford & Three Rivers Primary Care Groups. STAPCIS developed from a project initiated in late 1997 to pilot the use of the WAX software to improve access to directory‐type and full‐text material needed for easy access by primary care staff and traditionally difficult to manage. The database is updated centrally by the STAPCIS Librarian who distributes the new editions to the practices. The WAX software itself was developed by the Cambridge Centre for Clinical Informatics. *

STAPCIS contains locally and nationally produced relevant information from a variety of sources, including full‐text clinical guidelines and directories of Trusts. Decisions on new content are made by a Steering Group and the GPs and Primary Care teams are particularly encouraged to make suggestions regarding new content. The service is financially supported by the three primary care groups. The STAPCIS Librarian is project‐managed by the Library & Information Development Unit (North Thames < http://www.nthames‐health.tpmde.ac.uk/rliu/ntrliu.htm >), which also provides additional equipment and expertise.

A new software company, WaX Info Ltd (< http://www.waxinfo.com/>), will soon be releasing a new version of the software, WaX. WaX consists of a WaX client and WaX ActiveLibrary server software. With the new version, the ‘books’ of information will still be stored on the user’s PC, retaining the speed of access, but the server will enable users to ‘borrow’ books from remote locations and will provide automatic updates of all books. The new software will improve the management and distribution processes of STAPCIS once all of the practices have Internet connectivity.
Knowledge Management in the NHS: positioning the healthcare librarian at the knowledge intersection
Authors: Keeling Carole , Lambert Sian
Published: March 2003

This paper defines what is meant by Knowledge Management, investigates how it interlinks with new ways of delivering health care and gives a synopsis of a study that investigated issues around implementation of Knowledge Management across a sample of healthcare librarians.

Areas of investigation that are related to Knowledge Management include: HSG(97)47, evidence‐based medicine, clinical governance, information and communication technologies, and the changing role of the healthcare librarian.

A diagram is included in this paper which illustrates how the healthcare librarian interacts with resources, staff and practices, so contributing to the knowledge base of health care.

The paper concludes that Government policy, new technologies and the push towards the practice of information age medicine are forcing changes throughout the NHS. Recognition of Knowledge Management is still in its infancy in the NHS—it calls for major change in organizational thinking and acceptance by the librarian that their service must also be subject to continuous improvement.
Using metadata to create navigation paths in the HealthInsite Internet gateway
Authors: Deacon Prue , Smith Jill Buckley , Tow Stephanie
Published: March 2003

The objective of this study was to evaluate the HealthInsite topic query technique, which uses a dynamic database search to assign resources to a topic. It is an alternative to the explicit classification technique, which relies on the classification of each resource using a predefined classification scheme.

We performed a recall‐precision analysis on all topics within the broad topic area of Child Health. Recall and precision errors were checked to determine which part of the information retrieval process was at fault. We then compared the topic query technique with the explicit classification technique.

The results show errors or problems at every stage of the information retrieval process. This has initiated a review of all the tools used in the process, from indexing guidelines to the search engine. While many errors could be corrected, there were still features of the explicit classification technique that could not be achieved by the topic query technique.

In conclusion, the topic query technique has the advantage of flexibility, but close co‐operation between the different information retrieval specialists is needed to get the best results. The HealthInsite topic navigation structure should be regarded as an organized set of predefined searches rather than a full classified listing.
Breast development gives insights into breast disease
Authors: Osin P P , Anbazhagan R , Bartkova J , Nathan B , Gusterson B A
Published: March 2003

Aims: Studies of developing human breasts are essential for understanding the organogenesis as well as molecular pathogenesis of benign and malignant breast diseases. In this study we have examined the distribution of TGF‐α, TGF‐β1, tenascin‐C and collagen type IV with the aim of starting to build a picture of the profile of molecules that may be involved in the development of the human breast.

Methods and results

Ten fetal breasts (16 to 23 weeks of gestation) and 45 infant breasts, ranging in age from newborn to 2 years, were used in this study. Paraffin sections from these samples were immunostained with antibodies for these proteins and for Ki67 to elucidate the level of proliferative activity in different stages of breast development. TGF‐α immunoreactivity was observed both in the stromal and the epithelial cells within fetal and infant breasts up to 25 days. TGF‐β1 immunoreactivity was localized in the extracellular matrix. Tenascin‐C was found around the neck of the developing breast bud and in the extracellular matrix of the infant with peaks in the newborn at 6–12 weeks. The immunoreactivity for type IV collagen was more intense in the region of the breast bud neck in the fetal breasts and reduced around the tips of lobular and terminal‐end buds within the infant breasts.

Conclusions

The distribution of the growth factors and extracellular matrix proteins within the developing human breast indicates that they play a significant role in different cellular compartments during morphogenesis and provides insights into breast disease.
Apoptotic index and apoptosis influencing proteins bcl‐2, mcl‐1, bax and caspases 3, 6 and 8 in pancreatic carcinoma
Authors: Virkajärvi N , Pääkkö P , Soini Y
Published: March 2003

Aims

To study the expression of bcl‐2, bax and mcl‐1 and caspases 3, 6 and 8 and apoptosis in pancreatic carcinoma.

Methods and results

Eighty‐seven pancreatic carcinomas were studied immunohistochemically with antibodies to bcl‐2, mcl‐1, bax and caspases 3, 6 and 8. Apoptosis was detected by the TUNEL method. bcl‐2 and mcl‐1 positivity was observed in 13% and 86% of the cases, while bax was observed in all of them. The bax immunoreactivity was weak in 30% of the tumours. Caspase 3, 6 and 8 immunoreactivity was observed in 80%, 80% and 74% of the cases, respectively. The staining was mainly cytoplasmic and diffuse, but sometimes also fragmented granular (mainly caspase 6) or membrane‐associated (mainly caspase 8) staining was seen. The mean apoptotic index in pancreatic carcinomas was 0.69%. The apoptotic index in bcl‐2 positive cases was lower (0.35%) than in cases showing no immunoreactivity (0.64%) (P = 0.013). The apoptotic index was higher in tumours with strong bax immunoreactivity (0.70%) than in the other cases (0.34%) (P = 0.002). There was no significant association between the apoptotic index and the expression of mcl‐1 or caspases 3, 6 and 8.

Conclusions

Both bcl‐2 and bax influence the extent of apoptosis in pancreatic carcinoma. The strong expression of caspases 3, 6 and 8 in pancreatic carcinoma is evidence of the activation of the apoptotic machinery in malignant cells in pancreatic carcinoma and shows that the genes of these proteins are often upregulated in them.
Neurotrophins and neurotrophin receptors in some neural crest‐derived tumours (ganglioneuroma, phaeochromocytoma and paraganglioma)
Authors: Pello  , Guate  , Naves  , Escaf  , Vega
Published: March 2003

Aim

This study analyses the occurrence and distribution of neurotrophins and their receptors in some types of tumours of neural‐crest derived cells.

Methods and results

Light microscopy immunohistochemistry associated with quantitative image analysis was used to study the expression of neurotrophins (nerve growth factor, brain‐derived neurotrophic factor and neurotrophin (NT)‐3) and their cognate receptors (p75LNGFR, TrkA, TrkB and TrkC) in histologically defined ganglioneuroma, phaeochromocytoma and paraganglioma. The material was fixed in 10% formaldehyde, paraffin‐embedded and processed for indirect peroxidase immunohistochemistry using a battery of poly‐ and monoclonal antibodies to detect neurotrophins and their receptors, as well as some neuronal, endocrine and glial cell markers. A subpopulation of cells in phaeochromocytomas and ganglioneuromas expressed NT‐3, but not other neurotrophins, while in paragangliomas no neurotrophins were detected. Regarding neurotrophin receptors, all tumours lacked p75LNGFR, except for the ganglionic part of a case of mixed phaeochromocytoma, whereas they displayed TrkA (two of two ganglioneuromas, six of nine phaeochomocytomas and three of four paragangliomas). Furthermore, TrkC was regularly detected in a neuronal subpopulation in ganglioneuroma. Interestingly, the percentage of neurones expressing TrkA and TrkC was increased with respect to normal tissues in ganglioneuromas, as well as the percentage of the area occupied by TrkA‐immunoreactive cells in the phaeochromocytomas.

Conclusion

The pattern of expression of neurotrophins and neurotrophin receptors in the analysed tumours basically matches that of sympathetic neurones, adrenal chromaffin cells and paraganglionic cells, and suggests responsiveness of these cells to neurotrophins. Nevertheless, the function of TrkA and TrkC in regulating the biology of these tumours, if any, remains to be elucidated.
Immunostaining for cyclin D1 and the diagnosis of mantle cell lymphoma: is there a reliable method?
Authors: Chan
Published: March 2003

Immunostaining for cyclin D1 has become essential for the reliable diagnosis of mantle cell lymphoma (MCL). MCL is associated with a poor prognosis and its distinction from other small B‐cell lymphomas is clinically important. However, many diagnostic laboratories report problems in finding a reliable method. The following articles by Chan and by Miller, Munson & Isaacson discuss the common problems and describe successful methods with advice on diagnostic interpretation.
Benign lymphangiomatous papules of the skin following radiotherapy: a report of five new cases and review of the literature
Authors: Diaz‐Cascajo  , Borghi  , Weyers  , Retzlaff  , Requena  , Metze
Published: March 2003

Aims

The aim of this report is to summarize the clinicopathological findings of five cases of a pseudosarcomatous vascular proliferation of the skin at the site of radiotherapy following surgery for carcinoma of the breast and carcinoma of the endometrium. To our knowledge, only five cases of this presumably rare pseudomalignant proliferation have been reported previously.

Methods and results

All patients were females ranging in age from 44 to 70 years. The lesions appeared as solitary or multiple papules or vesicles localized to the field of radiation. Microscopically, they were composed of vascular spaces that exhibited atypical features without qualifying for a diagnosis of angiosarcoma.

Conclusions

Our cases provide additional evidence supporting the benign nature of this atypical vascular proliferation, not recurring, never developing metastases and being cured readily by local excision. Clinical, histopathological and ultrastructural findings suggest a lymphatic origin. Whether these lesions represent a neoplastic or a reactive condition secondary to radiotherapy is unclear. The name ‘benign lymphangiomatous papules of the skin following radiotherapy’ is proposed.
MIB‐1 proliferation index correlates with survival in pleural malignant mesothelioma
Authors: Comin  , Anichini  , Boddi  , Novelli  , Dini
Published: March 2003

Aims

The purpose of this study was to establish whether the cell proliferation index assessed by the monoclonal antibody MIB‐1 would correlate with survival in pleural malignant mesothelioma.

Methods and results

We studied a series of seven long‐term survivors with pleural malignant mesothelioma and a group of control cases with short‐term survival. All cases showed MIB‐1 positive cells, and labelling indices were expressed as percentage of cells with positive nuclear immunostaining by randomly counting 1000 tumour cells. A statistically significant difference was found between MIB‐1 values in the long‐term survival group and the control cases with short‐term survival.

Conclusions

Our results indicate that the differences in biological behaviour of malignant mesothelioma in long‐term and short‐term survivors may be explained in part by differences in tumour growth fraction and that proliferation index could represent an important prognostic parameter for this tumour.
Leiomyosarcomas of the oral cavity: an unusual topographic subset easily mistaken for nonmesenchymal tumours
Authors: Dry  , Jorgensen  , M Fletcher
Published: March 2003

Aims

Oral leiomyosarcoma is rare and poorly documented. We aimed to characterize these lesions clinicopathologically in order to facilitate their distinction from other spindle cell neoplasms in the oral cavity.

Methods and results

Ten cases of oral leiomyosarcoma were retrieved and studied histologically and immunohistochemically. Clinical data were obtained from referring pathologists and prior literature concerning 46 comparable cases was reviewed. Nine out of 10 cases occurred in adults; 50% arose in the jaws and four showed bone involvement. Histological appearances were similar to leiomyosarcomas elsewhere. In addition to myogenic markers, two cases were also keratin‐positive. Four patients developed local recurrence or metastatic disease and three died of tumour (median follow‐up 37 months).

Conclusions

Leiomyosarcoma is under‐recognized in the mouth, often being mistaken for a spindle‐celled epithelial neoplasm. Aside from an unusual but infrequent tendency to spread to lymph nodes and a location‐specific differential diagnosis, its clinicopathological features are comparable to leiomyosarcomas at other locations.
Paratesticular liposarcoma with smooth muscle differentiation mimicking angiomyolipoma
Authors: Womack  , Turner  , Fisher
Published: March 2003

Aims

To discuss the differential diagnosis of a case of well‐differentiated liposarcoma which had areas resembling angiomyolipoma—a feature which, to our knowledge, has not been reported previously.

Methods and results

A tumour in the paratesticular region had apparently been present for 40 years, but had grown recently. A fat component containing lipoblasts was admixed with areas resembling angiomyolipoma, i.e. desmin positive, but HMB45‐negative smooth muscle proliferation with atypia and thick‐walled blood vessels devoid of elastin.

Conclusion

The diagnosis of liposarcoma, rather than angiomyolipoma with adipose atypia, in this case is based on the fact that smooth muscle differentiation is documented in liposarcoma, lack of HMB45 staining and recent clonality studies which suggest that the fat in angiomyolipoma is not neoplastic.
Monotypic epithelioid angiomyolipoma of the liver
Authors: Yamasaki  , Tanaka  , Fujii  , Matsumoto  , Okuda  , Watanabe  , Suda
Published: March 2003

Aims

Monotypic epithelioid angiomyolipoma is a recently recognized renal tumour, which is composed purely of epithelioid cells coexpressing markers of both smooth muscle differentiation and melanogenesis (HMB45). We report here the first case of monotypic epithelioid angiomyolipoma arising in the liver.

Case details

A 30‐year‐old woman without tuberous sclerosis complex (TSC) was incidentally found to have a hepatic mass by ultrasonography. Grossly, the resected tumour showed a nodule‐in‐nodule appearance, with large areas of haemorrhagic necrosis. Microscopically, the tumour was composed of pleomorphic epithelioid cells with clear, eosinophilic cytoplasm. Neither adipocytes nor abnormal vessels were recognized in the tumour. Immunohistochemically, the tumour cells were strongly positive for HMB45 and S100 protein, focally positive for desmin, vimentin and smooth muscle actin, and negative for epithelial markers (cytokeratins, EMA). Ultrastructural analysis showed numerous dense granules with some striated ones resembling melanosomes, myofilaments and pinocytic vesicles in the cytoplasm. Molecular analysis showed no allelic loss of the TSC2 region or 12 other chromosomal regions. The patient is free of disease over 1 year after the operation.

Conclusion

We consider that this hepatic tumour is closely related to angiomyolipoma, and a counterpart of renal monotypic epithelioid angiomyolipoma.
Morphological and immunophenotypic variations in malignant melanoma
Authors: Banerjee  , Harris
Published: March 2003

A variety of cytomorphological features, architectural patterns and stromal changes may be observed in malignant melanomas. Hence, melanomas may mimic carcinomas, sarcomas, benign stromal tumours, lymphomas, plasmacytomas and germ cell tumours. Melanomas may be composed of large pleomorphic cells, small cells, spindle cells and may contain clear, signet‐ring, pseudolipoblastic, rhabdoid, plasmacytoid or balloon cells. Various inclusions and phagocytosed material may be present in their cytoplasm. Nuclei may show bi‐ or multi‐nucleation, lobation, inclusions, grooving and angulation. Architectural variations include fasciculation, whorling, nesting, trabeculation, pseudoglandular/pseudopapillary/pseudofollicular, pseudorosetting and angiocentric patterns. Myxoid or desmoplastic changes and very rarely pseudoangiosarcomatous change, granulomatous inflammation or osteoclastic giant cell response may be seen in the stroma. The stromal blood vessels may exhibit a haemangiopericytomatous pattern, proliferation of glomeruloid blood vessels and perivascular hyalinization. Occasionally, differentiation to nonmelanocytic structures (Schwannian, fibro‐/myofibroblastic, osteocartilaginous, smooth muscle, rhabdomyoblastic, ganglionic and ganglioneuroblastic) may be observed. Typically melanomas are S100 protein, NKIC3, HMB‐45, Melan‐A and tyrosinase positive but some melanomas may exhibit an aberrant immunophenotype and may express cytokeratins, desmin, smooth muscle actin, KP1 (CD68), CEA, EMA and VS38. Very rarely, neurofilament protein and GFAP positivity may be seen.
Multinucleated stromal cells of the anal mucosa: a common finding
Authors: Groisman  , Amar  , Polak‐Charcon
Published: March 2003

Aims

To document the presence, morphology, immunophenotype and ultrastructure of multinucleated stromal cells within the anal mucosa and to discuss possible pathogenetic mechanisms for this occurrence.

Methods and results

Multiple sections of normal anal mucosa from 30 abdominoperineal resection specimens were analysed by light microscopic, electron microscopic and immunohistochemical methods. Multinucleated stromal cells were found in 22 cases (73%). They contained two to five nuclei, arranged in a linear fashion or in a rosette or grape‐like pattern. They stained positive for vimentin and negative for actin, desmin and oestrogen/progesterone receptors. Ultrastructural examination confirmed their fibroblastic lineage. Mast cells were frequently observed in the immediate vicinity of mono‐ and multinucleated cells.

Conclusions

Multinucleated stromal cells are a common occurrence in the normal anal mucosa. They should not be misinterpreted as neoplastic cells. Mast cells may play a role in their morphogenesis.
Expression of promyelocytic leukaemia protein in thyroid neoplasms
Authors: Yu E , Lee K W , Lee H J
Published: March 2003

Aims

Promyelocytic leukaemia protein (PML) is an oncoprotein involved in the pathogenesis of acute promyelocytic leukaemia and is localized in distinct PML nuclear bodies. Our previous observation of overexpression of the PML in hormone‐sensitive normal tissues and malignant solid tumours, including the thyroid, led to this analysis of the PML expression in various thyroid neoplasms to characterize the importance of the PML in thyroid carcinogenesis.

Methods and results

Immunohistochemistry was performed on paraffin‐embedded tissue samples from 106 thyroid neoplasms after antigen retrieval by microwave. Immunoblotting was done with fresh frozen tissues in a few tumours. The PML was strongly expressed in all papillary carcinomas in diffuse or ball‐shaped patterns. In the follicular neoplasms, the PML expression was variable, but there was no significant difference between adenomas and carcinomas. In the medullary carcinomas, the PML expression was either not detectable or was lower than in non‐neoplastic thyroids. Quantitatively different expression of the PML in various thyroid neoplasms was confirmed by immunoblotting.

Conclusion

A significant difference of the PML expression according to the type of thyroid neoplasms suggests that the PML is important in papillary thyroid carcinomas, and furthermore, that PML expression may be used in differential diagnosis of thyroid neoplasms.
Predictive value of liver cell dysplasia for development of hepatocellular carcinoma in patients with non‐cirrhotic and cirrhotic chronic viral hepatitis
Authors: Libbrecht L , Craninx M , Nevens F , Desmet V , Roskams T
Published: March 2003

Predictive value of liver cell dysplasia for development of hepatocellular carcinoma in patients with non‐cirrhotic and cirrhotic chronic viral hepatitis

Aims: Hepatocellular carcinoma (HCC) frequently develops in patients with chronic viral hepatitis, especially in the cirrhotic stage. We retrospectively studied whether the presence of the putative preneoplastic lesions large liver cell dysplasia (LLCD) and/or small liver cell dysplasia (SLCD) in a needle liver biopsy of these patients are a risk factor for the development of HCC.

Methods and results: The presence of LLCD and SLCD in the needle liver biopsy taken at the initial work‐up of 115 patients with chronic hepatitis B or C was assessed retrospectively. LLCD and SLCD were present in the initial biopsy of, respectively, 35 (30%) and 25 patients (22%). During a mean follow‐up of 107 months, 16 patients (14%) developed HCC and this occurred significantly more frequently in patients with cirrhosis, age ≥ 55 years, LLCD or SLCD. Cirrhosis and LLCD were independent risk factors for HCC development.

Conclusions: Our findings indicate that the presence of LLCD in a needle liver biopsy of patients with viral‐induced chronic liver disease is an independent risk factor for the development of HCC. If these results are confirmed, the presence of LLCD can be used to identify a subgroup of patients at high risk for HCC requiring more intensive screening.
Hepatocellular carcinoma: an overview
Authors: Anthony P P
Published: March 2003

Hepatocellular carcinoma: an overview

Hepatocellular carcinoma remains widely prevalent in tropical Africa and south‐east Asia and is largely related to chronic hepatitis B virus (HBV) infection. Primary prevention by vaccination of infants at or near birth is effective but any reduction in tumour incidence cannot be expected for decades to come yet, even in those countries in which the necessary resources exist, as millions of adults remain chronically infected. Meanwhile, the incidence is rising in Japan, Mediterranean countries of Europe, Middle East and North Africa and in the USA, largely due to chronic hepatitis C virus (HCV) infection introduced by the indiscriminate use of unscreened blood and blood products in the recent past. Much has been learned from molecular biological studies on hepatocarcinogenesis incriminating the HBX gene of HBV, the core protein of HCV and a unique guanine to thymine transversion at codon 249 has been observed in cases due to aflatoxin exposure. The subject of precancerous lesions, notably adenomatous/dysplastic nodules and large‐cell/small‐cell change continues to be a source of much debate and the distinction of nodular lesions in cirrhosis from early carcinoma remains uncertain. Spontaneous regression of hepatocellular carcinoma is rare but it is probably immunologically mediated and treatment by activated T‐lymphocytes may reduce recurrence rates after surgery. The positive identification of hepatocellular carcinoma by a liver‐specific antibody has greatly facilitated the diagnosis in difficult cases.
Sclerosing haemangioma of the lung is positive for MIB‐1 in cell membrane and cytoplasmic staining pattern
Authors: Hattori H
Published: March 2003

Sclerosing haemangioma of the lung is positive for MIB‐1 in cell membrane and cytoplasmic staining pattern

Aims: MIB‐1 is a monoclonal antibody raised against the recombinant part of the Ki67 antigen, which is expressed in the nuclei of all the active part of the cell cycle. Recently, cell membrane and cytoplasmic pattern of staining with MIB‐1 in hyalinizing trabecular adenoma of the thyroid was reported. Sclerosing haemangioma of the lung is a tumour of uncertain histogenesis with a usually benign course. The tumour is mainly composed of cuboidal cells that line the papillary or tubular structure and pale cells that are found in the stroma.

Methods and results: We examined a cell membrane and cytoplasmic immunoreactive pattern for MIB‐1 antibody in sclerosing haemangioma. In all of the five cases examined, distinct cell membrane and cytoplasmic MIB‐1 positivity mainly in the pale cells was noted. None of the carcinomas of the lung showed this type of staining with MIB‐1.

Conclusion: This result shows that, although the staining may be a result of cross reaction, cell membrane and cytoplasmic MIB‐1 positivity is unique in that it could distinguish sclerosing haemangioma from other malignant epithelial tumours of the lung.
Biliary epithelial trefoil peptide expression is increased in biliary diseases
Authors: Srivatsa G , Giraud A S , Ulaganathan M , Yeomans N D , Dow C , Nicoll A J
Published: March 2003

Biliary epithelial trefoil peptide expression is increased in biliary diseases

Aims: Maintenance of the cellular integrity of the biliary epithelium may involve the production of mucins and mucin‐associated peptides. In the luminal gastrointestinal tract, mucins and the mucin‐associated trefoil peptides (TFF) are integral to cytoprotection and cellular repair of the mucosa.

Methods and results: Samples of normal and diseased human liver tissue were examined using histological and immunohistochemical techniques, for the expression of TFF and mucins. Bile ducts were classified as small, medium or large depending upon the number of biliary epithelial cells. TFF expression was demonstrated in biliary epithelial cells of both normal and diseased liver tissue. TFF expression was greatest in the large bile ducts. In normal liver tissue, expression of at least one TFF was demonstrated in 2–7% of small bile ducts, 5–31% of medium bile ducts and 31–85% of large bile ducts. Seventy‐seven percent of large bile ducts secreted mucins and all three TFF concurrently, compared with 3% of medium bile ducts and no small bile ducts. Biliary disease resulted in an increased expression of TFF1 and TFF3 in the medium bile ducts.

Conclusions: The biliary epithelial cells in normal and diseased human liver tissue express TFF, particularly in the larger bile ducts. TFF expression may be up‐regulated or induced in biliary diseases as a response to injury, as is seen in epithelial damage elsewhere in the gastrointestinal tract.
Primary monotypic epithelioid angiomyolipoma of bone
Authors: Insabato L , De Rosa G , Terracciano L M , Fazioli F , Di Santo F , Rosai J
Published: March 2003

Primary monotypic epithelioid angiomyolipoma of bone

Aims: Monotypic epithelioid angiomyolipoma is a distinct and definable variant of angiomyolipoma, composed of monomorphous epithelioid cells that show HMB45 immunoreactivity. Angiomyolipoma, including its morphological variants, belongs to the family of perivascular epithelioid cell tumour.

Methods and results: The tumour was examined using immunohistochemical staining and by transmission electron microscopy. Neoplastic cells showed a cytoplasmic granular positivity for HMB45.

Conclusions: Extrarenal angiomyolipomas are rare and, to the best of our knowledge, this is the first reported case of a primary monotypic epithelioid angiomyolipoma of bone in a patient without evidence of tuberous sclerosis.
Identifying BAC clones for diagnosis of conventional renal cell carcinoma by FISH
Authors: Heinze F , Kovacs G
Published: March 2003

Aims: The new classification of renal cell tumours relies on tumour‐specific genetic alterations, which can be detected by different techniques. For diagnosis of conventional renal cell carcinoma by FISH we have isolated BAC clones from the chromosomal regions of interest.

Methods and results: A BAC library was screened by microsatellites mapped to the smallest overlapping regions of loss of heterozygosity (LOH) at chromosomes 3p, 5q, 6q, 8p, 9p and 14q. Positive BACs were tested by carrying out FISH in normal cells for signal/noise ratio. Subsequently, 11 conventional and two papillary renal cell carcinomas were analysed by the new diagnostic BAC set and the results were compared with those obtained by microsatellite allelotyping. The diagnostic value of FISH was comparable to that of microsatellite analysis in nearly all tumours except those with extreme chromosomal polyploidization.

Conclusions: We conclude that both FISH and microsatellite analyses are helpful to strengthen the diagnosis of conventional renal cell carcinoma. However, both techniques may have some disadvantage in a special setting.
Differential regulation of expression of the MHC class II molecules RT1.B and RT1.D on rat B lymphocytes: effects of interleukin‐4, interleukin‐13 and interferon‐γ
Authors: Roos  , Schilder‐Tol  , Chand  , Claessen  , Lakkis  , Pascual  , Weening  , Aten
Published: March 2003

Susceptibility to induction of both T helper 1‐ (Th1) and Th2‐mediated autoimmunity is multifactorial and involves genetic linkage to the major histocompatibility complex (MHC) class II haplotype. Brown Norway (BN) rats exposed to mercuric chloride develop a Th2‐dependent systemic autoimmunity, whereas Lewis rats, which are highly susceptible to Th1‐mediated autoimmunity, develop immune suppression after mercuric chloride exposure. Exposure to mercuric chloride is known to enhance B‐lymphocyte expression of the MHC class II molecule RT1.B, predominantly in BN rats. We demonstrate that, in contrast, expression of RT1.D was unmodified on these B cells, whereas both RT1.B and RT1.D were up‐regulated on epithelial cells. Regulation of B‐cell MHC class II isotype expression was further studied in vitro, using BN rat lymph node (LN) cells. Interleukin‐4 (IL‐4) strongly enhanced B‐cell expression of RT1.B (2·8‐fold), whereas RT1.D expression was only slightly, although significantly, modified (1·2‐fold). B cells from Lewis rats showed a similar IL‐4‐induced enhancement of RT1.B expression (2·5‐fold), whereas, in contrast, RT1.D expression was unmodified. Exposure of LN cells from BN rats to interferon‐γ induced a moderate increase of B‐cell MHC class II expression, predominantly of RT1.B. Strong and rapid enhancement of B‐cell RT1.D expression was observed after stimulation by phorbol 12‐myristate 13‐acetate and ionomycin. Rat IL‐13 did not modify B‐cell MHC class II expression; however, it induced typical morphological changes in peritoneal macrophages. These experiments demonstrate isotype‐specific and strain‐dependent regulation of MHC class II expression on rat B lymphocytes, which may be of pathophysiological relevance for the strain‐dependent susceptibility for Th1‐ or Th2‐mediated autoimmunity.