bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymphocyte activation by granulocyte macrophage‐colony stimulating factor in human bladder cancer
Authors: Theano Toliou , Pelagia Stravoravdi , Konstantinos Natsis , Petros Kirtsis , Alfred Barich , Konstantinos Dimitriadis , Panagiotis Gigis
Published: March 2003

Objectives: The goal of this study was to investigate the ablative or reductive activity of granulocyte macrophage‐colony stimulating factor (GM‐CSF) instillations on transitional cell carcinoma marker lesions as well as its ability to increase and/or activate lymphocyte population.

Methods: Eleven patients (pts) with newly diagnosed cancer pTa–pT1 were studied. A well‐defined marker lesion (≤0.5 cm) was left after transurethral resection (TUR). All pts received eight weekly instillations of 300 μg of GM‐CSF after which cystoscopy with biopsies ± TUR was repeated. Specimens from adjacent to the lesion mucosa were obtained before and after GM‐CSF therapy and processed for ultrastructural study.

Results: The response was complete in six pts (55%), no change in two pts (18%), for a total of 73% response, and all pts were free of disease after one year. Progression was observed in three pts (27%) with no case of muscular invasion. Before treatment, the scarcely detected lymphocytes had morphological characteristics of resting cells. After treatment, the most impressive finding was the detection of lymphocytes with “hand mirror” morphology, suggesting an immunological activation. This finding has not been previously described in the bladder mucosa.

Conclusion: The present study led us to speculate on the use of GM‐CSF as a new alternative approach in the management of TCC through immunomodulation.
Effect of thalidomide in different tumors in rodents
Authors: Palencia Guadalupe , Arrieta Oscar , Ríos Camilo , Altagracia Marina , Kravzov Jaime , Sotelo Julio
Published: March 2003

This study investigated the effects of chronic administration of thalidomide on three different neoplasms of ectodermic origin in rodents: 1) chemically induced tumors of the nervous system of rats by transplacental exposure to ethylnitrosourea; 2) transplanted RPMI‐1846 melanoma in hamsters and 3) transplanted C6 glioblastoma in rats. No effects were seen on thalidomide‐treated rats on the frequency and time of tumor development induced by ethylnitrosourea. In contrast, a reduction in tumoral growth and mitotic‐index was obtained in animals treated with thalidomide in transplanted tumors, melanoma and glioblastoma, when compared with controls ( P < 0.001 and 0.025, respectively). These results suggest that, although thalidomide is not a cytotoxic drug for neoplastic cells, it might partially inhibit the tumoral growth through any of its pharmacological actions; by blockage of cell‐surface adhesion receptors induction of DNA oxidation, or inhibition of angiogenesis. Further investigations on the use of thalidomide perhaps associated to cytotoxic drugs, for treatment of ectodermic neoplasms seem guaranteed.
A single copy of a virus‐derived transgene encoding hairpin RNA gives immunity to barley yellow dwarf virus
Authors: Wang Ming‐Bo , Abbott David C. , Waterhouse Peter M.
Published: March 2003

Barley yellow dwarf virus–PAV (BYDV‐PAV) is the most serious and widespread virus of cereals worldwide. Natural resistance genes against this luteovirus give inadequate control, and previous attempts to introduce synthetic resistance into cereals have produced variable results. In an attempt to generate barley with protection against BYDV‐PAV, plants were transformed with a transgene designed to produce hairpin (hp)RNA containing BYDV‐PAV sequences. From 25 independent barley lines transformed with the BYDV‐PAV hpRNA construct, nine lines showed extreme resistance to the virus and the majority of these contained a single transgene. In the progeny of two independent transgenic lines, inheritance of a single transgene consistently correlated with protection against BYDV‐PAV. This protection was rated as immunity because the virus could not be detected in the challenged plants by ELISA nor recovered by aphid feeding experiments. In the field, BYDV‐PAV is sometimes associated with the related luteovirus Cereal yellow dwarf virus‐RPV (CYDV‐RPV). When the transgenic plants were challenged with BYDV‐PAV and CYDV‐RPV together, the plants were susceptible to CYDV‐RPV but immune to BYDV‐PAV. This shows that the immunity is virus‐specific and not broken down by the presence of CYDV. It suggests that CYDV‐RPV does not encode a silencing‐suppressor gene or that its product does not protect BYDV‐PAV against the plant’s RNAi‐like defence mechanism. Either way, our results indicate that the BYDV‐PAV immunity will be robust in the field and is potentially useful in minimizing losses in cereal production worldwide.
The inhibitory effects of Lactobacillus casei and Lactobacillus helveticus on Bacillus species isolated from raw milk in various salt concentrations
Authors: Uraz Guven , Simsek Hulya , Maras Yildiz
Published: March 2003

Nineteen strains of Bacillus were isolated and identified from 111 samples of raw milk. The inhibitory effects of

Lactobacillus casei and

Lactobacillus helveticus on strains of

Bacillus were studied. The inhibitory effects were evaluated (using the well diffusion method) on nutrient agar, with NaCl added at concentrations of 40, 45, 50, 55, 60 and 65 g/L.

Lactobacillus casei inhibited 16 strains of

Bacillus on nutrient agar without salt, and 18 strains in the presence of salt. When the salt concentration was 6.5%, the inhibitory effect decreased, and

L. casei inhibited only eight strains of

Bacillus (

Bacillus cereus,

Bacillus sphaericus,

Bacillus licheniformis,

Bacillus macerans,

Bacillus firmus,

Bacillus coagulans,

Bacillus polymyxa and

Bacillus stearothermophilus).

Lactobacillus helveticus formed the inhibitory zones against five strains of

Bacillus on nutrient agar without salt, but with 4% NaCl concentration, it showed an inhibitory effect on 13 strains; a further two strains were inhibited in the presence of 4.5 and 5.0% salt. In 5.5% NaCl, the same 15 strains were inhibited by

L. helveticus, whilst in 6 and 6.5% salt, the inhibitory effect decreased and only six and seven strains were affected, respectively. The maximum inhibitory effect with both

L. casei and

L. helveticus was observed in the presence of 4.5–5.5% salt.
A survey of the use of Withington Hospital Medical Library*
Authors: FREEDMAN HADASSA
Published: March 2003

Library use by the staff and students of a large teaching hospital was investigated by means of two questionnaire‐based surveys. The first survey aimed to identify the users and non‐users of the library, in order to assess to what extent the library fulfilled its role as a multidisciplinary library serving the information needs of all categories of hospital staff and students. In the second survey the use of library facilities was analysed with a view to establishing priorities for the future development of services. Although the library is popular with the majority of its users it became apparent during the investigation that the library could not hope to satisfy the growing information need of its users without the back‐up of an official regional library network in the North Western Regional Health Authority.
Training for library association chartering in health‐care libraries. Part III. Exercises for pre‐registration trainees
Authors: COOKE RACHEL , GILLESPIE IAIN , HARTLEY BARBARA
Published: March 2003

The background to the compilation of a series of exercises in support of the NHS Regional Librarians Group, and the University Medical School Librarians Group Joint Training Committee Training Programme for Pre‐registration trainees is outlined, and 56 exercises are presented.
Conservation and management of medical collections
Authors: SHAW JEAN
Published: March 2003

Papers given on this topic at a seminar organized under the auspices of the Standing Conference on National and University Libraries Advisory Committee on Medical Materials are described. The seminar was held at the Wellcome Institute for the History of Medicine on 12 April, 1988. Notes on useful organizations and a list of key references are appended.
Publications of the Medical Research Council*
Authors: WADE JENNY
Published: March 2003

This paper discusses the publications practice of the Medical Research Council during its 75‐year history, and indicates the changes that have taken place in recent years as less material has been published centrally and the link with HMSO has weakened. Sources of information on, and access to, current publications are indicated, together with those which are older and now out of print.
A comparison of the currency of secondary information sources in the biomedical literature. 1. Weekly current awareness services
Authors: GRAINGER FELICITY , LYON ELIZABETH
Published: March 2003

Three biomedical current awareness products which are distributed on floppy disc, were studied over a period of 3 months.

They were monitored for the speed with which primary journal issues were indexed, and for the coverage of the journals which were selected for study. Data on issues of 72 monthly journals (38 North American and 34 European) and nine weekly titles (four from North America and five from Europe) were recorded.

The time to elapse between publication date and arrival of hard copy in the British libraries and appearance in secondary sources varied enormously.

The findings suggest that monthly journal issues appear in the secondary sources on average 6–7 weeks after publication date and weekly journals appear after approximately 4 weeks. Indexing of North American monthy journals is 1 week ahead of European titles in the two products from the US, but the European service indexed European publications sooner.

One product, Current Contents on Diskette, contained all issues included in the 3‐month period covered by the study, but Reference Update omitted 9.1% of the issues and Medical Science Weekly 1.6%, including leading biomedical journals.
Staffing intelligence services: a survivor's guide
Authors: HEPWORTH JOHN B.
Published: March 2003

Work at the Department of Health on the information needs of District Health Authorities as purchasers demonstrates the need for co‐ordinated information services that handle both numeric and text data—termed intelligence. The DHA Project has built information implications into its health needs assessment protocol and has shown, through pilots, the steps involved in developing co‐ordinated provision. These developments contrast sharply with the long‐established NHS dichotomy between the roles of librarians—often narrowly perceived, and those of information officers—equally narrowly defined but with a greater command of resources. Consideration of how intelligence services are to be staffed raises issues which involve appreciating wider changes in information education. Most current courses no longer perpetuate the skills divide between those who will be at ease handling text information (librarians) and those who are able to create and use database management systems holding numeric data (information officers). Skills needed for the intelligence function cross the boundary. Some librarians are already able to encompass the required range of skills, but without retraining many will face unequal competition with the new generations of graduates from information mananagement and information science courses. Local training opportunities are essential, but there is also a growing number of higher degree courses which can be used for career enhancement and some of them are available oti a distance learning basis. The NHS Training Directorate has begun the process of assisting courses it deems relevant to NHS information management training, but the Department of Health should specify the staff competencies required as part of quality assurance standards for intelligence services.
Library audit: report of the process of undertaking the audit of library services of selected educational providers within the former Northern Region: July 1994
Authors: WALTON GRAHAM , SMITH CATHERINE
Published: March 2003

With the current purchaser/provider split in the NHS the purchaser has a responsibility to evaluate the quality of services provided by the provider. In the past year the Northern and Yorkshire Regional Health Authority expressed an interest in auditing library services supplied from selected education providers. This article attempts to given an account of the experience and focuses on the background, the rationale, the process and the outcomes.
Problem‐based learning and libraries: the Canadian experience
Authors: FITZGERALD DOROTHY
Published: March 2003

Canada is a vast country with a relatively small population of 29 million. There are 16 medical schools and of these 12 have introduced problem‐based learning or some variation of this approach to learning. The libraries supporting these medical schools have taken a variety of approaches to addressing this educational innovation and have specific recommendations to make based on their experiences in working to ensure that they meet the needs of a new curriculum successfully. A number of sites noted that the self‐directed learning component of the new curriculum, and the related emphasis on evidence‐based medicine, are of importance in terms of the impact on library usage. Most of the libraries reported the need to participate on curriculum committees, establish an information management component in the curriculum and have a computer training laboratory in the library.
International cooperation and the European Association for Health Information and Libraries
Authors: Shaw Jean , Petrak Jelka , HUSEM ELISABETH
Published: March 2003

This paper describes cooperation between European libraries: what EAHIL hopes to achieve, and how it may be done. Since its founding in 1987, EAHIL has been working for professional development and to improve cooperation and exchange of experience amongst its members. In 1995 a working programme entitled ‘EAHIL—Aims towards year 2000’ was approved, and it consolidates some of the most important aims of EAHIL. In this paper, only three of the six aims are referred to: conferences and workshops arranged by EAHIL, the development of an efficient network system in order to increase communication and information among members, and the establishment of agreements for cooperation with medical and health science libraries in Eastern and Central Europe in particular.
Attitudes to LIS education and academic–practitioner liaison: results of a survey of members of the Library Association Health Libraries Group
Authors: FARMER JANE , RICHARDSON AMANDA , PALMER JUDY
Published: March 2003

A questionnaire survey was conducted by the Library Association Health Libraries Group in October–December 1996. Information practitioners in the health care sector were asked what they considered were the education and research needs of the profession, their opinion of Library and lnformation Sciences education, and their views on practitioner input to education and research. They were also asked whether they would be prepared to give talks to students and to offer student placements. The results show that there is still a considerable gulf between academics and practitioners, and that although practitioners are enthusiastic about getting more involved in liaison, they are constrained by lack of time and resources. Practical solutions need to be found to encourage greater understanding and closer working relationships, to achieve the benefits of academic–practitioner liaison.
Using biomedical databases in everyday clinical practice: the Front‐Line Evidence‐Based Medicine project in North Thames
Authors: CUMBERS B. J. , DONALD A.
Published: March 2003

The aims of this project were to assess the feasibility of using biomedical databases in everyday clinical settings, and the infrastructure needed to support such practice.

Fourteen firms or units whose lead clinician was enthusiastic for the principles of evidence‐based medicine were provided with 24‐h access to databases in their clinics or offices. All members of the firms were trained in the principles of evidence‐based practice and in the use of databases for finding evidence. The firms were volunteers from a variety of specialties in both hospital and community Trusts in North Thames Region.

Assessment of changes in practice was carried out by questionnaire and interview. Also, any changes needed to improve the use of primary research data in everyday clinical settings was investigated. Seven firms found that the project had made their journal clubs and their clinical discussion meetings more structured and focused, with research evidence for and against interventions discussed. The use of evidence in a case‐related form was limited by the time available. The other seven firms were: dissatisfied with their training, dissatisfied with their computer facilities or lacked time. The changes necessary to improve the utilization of research data included: closer collaboration with librarians, continuing training and fast delivery of documents.

The limitations of this study are that initial data were not recorded and the assessments made were subjective.

Using biomedical databases in everyday clinical practice could be feasible provided that there is a co‐ordinated implementation strategy, which requires a significant commitment of time and resources from all parties involved (clinicians, other health care professionals, librarians and managers).
Genetic information resources: a new field for medical librarians
Authors: Norman Frank
Published: March 2003

The Human Genome Project is generating unprecedented quantities of new genetic information. The new discipline of bioinformatics has created many new molecular biology databanks to store the results of the Human Genome Project. This data is expected to be the information source for biomedical science in the 21st century. As molecular biology research moves out of the laboratory and becomes molecular medicine, a growing number of people need access to genetic information. Medical students, healthcare practitioners and patients need help in finding appropriate information. Medical librarians should know how to search key genetic information resources and should have a basic understanding of the type of information contained in each.
Continuing professional development in Australian health libraries
Authors: Fennessy Gabby
Published: March 2003

This article provides an outline to current issues in continuing professional development within the Australian health library sector. The role of the Australian Library and Information Association is explored, and other providers of CPD activities and their relevance to health librarians are discussed.
Apoptosis is associated with atypical or malignant change in meningiomas. An in situ labelling and immunohistochemical study
Authors: Ng  , Chen L
Published: March 2003

Aims: Although necrosis is an important phenomenon with implications for grading and prognostication in meningiomas, the alternate form of cell death, apoptosis, has not been extensively studied. In this series, we aimed to determine whether apoptosis in meningiomas correlated with histological types and grading. We also looked for a relationship between expression of apoptosis‐related genes bcl‐2, p53, c‐myc and apoptosis in meningiomas.

Methods and results

Fifty‐one meningiomas of diverse histological subtypes and grades were investigated with in‐situ end‐labelling of DNA fragments as well as immunohistochemical analysis of three apoptosis‐related genes: p53, bcl‐2 and c‐myc. Our results showed that the apoptosis index was significantly higher in high‐grade meningiomas (0.12%, n = 12) in than the benign meningiomas (0.023%, n = 39) (P = 0.001) but there was no difference among the different histological subtypes of the benign meningiomas (P = 0.125). There is no obvious relationship between p53, bcl‐2 and c‐myc staining and apoptosis index in this group of meningiomas.

Conclusion

We conclude that apoptosis is an important phenomenon in meningiomas and that it is associated with atypical or malignant changes in meningiomas. Apoptosis in meningiomas has no clearcut relationship with expression of p53, bcl‐2 and c‐myc.
Giant cell tumour of the retropharynx
Authors: Paulino A F G , Spiro R H , O'malley B , Huvos A G
Published: March 2003

Aims

Giant cell tumours of soft tissues are usually of tenosynovial origin and are benign, slow growing neoplasms that have the capacity for local recurrence. They occur most frequently in the fingers and only rarely in the head and neck region. Their occurrence in the retropharynx has not been reported. The differential diagnoses of head and neck lesions containing giant cells are discussed.

Methods and results

We describe a case of a retropharyngeal giant cell tumour of tenosynovial type in a 48‐year‐old man. The clinical, radiological and histological features are reviewed. Immunohistochemical studies point to a possible histiocytic origin based on reactivity for CD68.

Conclusions

Tenosynovial giant cell tumour should be considered in the differential diagnosis of tumours arising in the retropharyngeal soft tissues.
Embolization of mesothelial cells in lymphatics: the route to mesothelial inclusions in lymph nodes?
Authors: Suárez Vilela  , Izquierdo García
Published: March 2003

Aims: To provide evidence that lymphatic embolization is the mechanism for mesothelial inclusions in lymph nodes.

Methods and results

A 60‐year‐old man with alcoholic cirrhosis and ascites had an umbilical hernia resected. The herniorrhaphy specimen contained numerous dermal and submesothelial lymphatic vessels filled by cells similar to the cells that lined the hernia sac. Most of the cells in lymphatics were submesothelial reactive cells, whose cytoplasm stained with antibodies against cytokeratins (AE1–AE3; 8,18), smooth muscle actin, vimentin, desmin and tissue polypeptide antigen (TPA). Some cells seemed to be superficial mesothelial cells, being positive with high molecular weight anticytokeratin antibody 34βE12. On ultrastructural study submesothelial cells with intermediate cytoplasmic filaments, rough endoplasmic reticulum and primitive cell junctions, and scanty superficial mesothelial cells with microvilli, tonofilaments and desmosomes were found in the lymphatics.

Conclusions

Lymphatic dissemination of mesothelial and submesothelial cells is an uncommon and not well known phenomenon. Lymphatic dissemination is probably the route by which the mesothelial cells reach the lymphatic nodes. These cells may be mistaken for malignant cells.
Polymorphous low‐grade adenocarcinoma of minor salivary glands: a study of 17 cases with emphasis on cell differentiation
Authors: Perez‐Ordonez B. , Linkov I. , Huvos A.G.
Published: March 2003

Aims

The diagnosis of polymorphous low‐grade adenocarcinoma (PLGA) of salivary glands remains difficult for general surgical pathologists. In an effort to understand the morphological heterogeneity of these neoplasms and facilitate their recognition we reviewed the architectural patterns, cell differentiation and immunohistochemical features of 17 cases of PLGA.

Methods and results

There were 11 females and six males with a mean age of 58 years. Twelve tumours were located in the palate, two in the posterior third of the tongue, and one each in the upper lip, buccal mucosa and retromolar triangle. Two patients presented with neck metastases. The mean tumour size was 20 mm (range 6–50 mm). The tumour cells were arranged in five architectural patterns: tubules and small duct‐like structures; cords and trabeculae; solid nests; cribriform areas and papillae. Twelve (71%) cases were composed of a combination of tubules and small duct‐like structures, cords and trabeculae, and solid nests. Cribriform areas with pseudoluminal spaces were seen in six (35%) cases. A focal papillary pattern was evident in three cases and constituted 40% of the tumour in one. Perineural invasion was seen in 13 cases (76%). All cases studied were positive for CAM5.2, 34BE12, vimentin and S100 protein and showed overexpression of bcl‐2 protein. Rb protein was present in 13 cases whereas p53 expression was absent in all cases. The average proliferation index (PI) was 7% (range 1–17%). Three patients developed local recurrences with cervical lymph node metastases but no patient died as result of tumour. No morphological features were found to be prognostic for the development of local recurrences or lymph nodes metastases.

Conclusions

PLGA is a distinctive neoplasm of salivary glands formed by luminal and nonluminal tumour cells with limited patterns of architectural differentiation. The relative proportion of these cells seems to play a significant role in the morphogenesis of these tumours. The overexpression of the bcl‐2 protein and the low PI suggest that inhibition of programmed cell death may be involved in the oncogenesis of PLGA.
Cell density of adrenomedullin‐immunoreactive cells in the gastric endocrine cells decreases in antral atrophic gastritis
Authors: Kitani  , Asada  , Sakata  , Kitamura  , Sumiyoshi  , Eto
Published: March 2003

Aims

Adrenomedullin (AM) is a novel hypotensive and vasorelaxing peptide recently isolated from human phaeochromocytoma tissue, and is widely distributed in various organs. In this study we examined the localization of AM‐immunoreactive (IR) cells in the gastric mucosa and AM‐IR cell density in antral atrophic gastritis.

Methods and results

Gastric mucosal tissues were taken from the gastric body and antral mucosa of 52 patients (27 men, 25 women; mean age 56.0 (range 20–86) years). Immunohistochemical analysis revealed that AM‐IR cells were present in the pyloric glands, but not in the fundic glands, and that AM‐IR cells were stained positively for chromogranin A and gastrin. The percentage of AM‐IR cells vs chromogranin A‐ and gastrin‐IR cells was 42 and 56%, respectively. The number of AM‐IR cells decreased with the progression of severity of atrophic changes in the pyloric gland, and also of mononuclear cell infiltration. There was no correlation between the number of AM‐IR cells and the degree of neutrophilic infiltration. Similar findings were also obtained for gastrin‐IR cells.

Conclusion

AM‐IR cells are present in the endocrine cells including gastrin‐IR cells in the pyloric glands. These results suggest that AM may contribute to gastrin secretion in the pyloric glands.
Isolated diffuse hemangiomatosis of the spleen with Kasabach–Merritt‐like syndrome
Authors: Dufau  , Le Tourneau  , Audouin  , Delmer  , Diebold
Published: March 2003

Aims

Diffuse haemangiomatosis of the spleen is a rare benign vascular condition occurring as a manifestation of systemic angiomatosis or, less commonly, confined to the spleen. It is sometimes accompanied by severe disturbance of blood coagulation. The goal of this study was to characterize an additional case of isolated diffuse haemangiomatosis of the spleen and to determine the histogenesis of this lesion which remains obscure.

Methods and results

We describe a case of isolated diffuse haemangiomatosis of the spleen in which histological and immunohistological findings suggested the possibility of a malformative tumour‐like lesion. The pathological cavernous vessels were distributed randomly through the red pulp, without continuity with sinuses. The endothelial cells expressed vimentin, factor VIII related antigen and CD34, but not CD8. Some cells lining the sinus lumen expressed CD68, lysozyme and myeloperoxidase. In addition, trabecular veins presented with intimal thickening. These results allow making a diagnosis between diffuse haemangiomatosis and other tumours/tumour‐like lesions of the spleen, especially littoral cell angioma, splenoma and peliosis.

Conclusion

If diffuse haemangiomatosis is usually classified as a benign proliferation of endothelial cells, we suggest that diffuse haemangiomatosis, when confined to the spleen, could be a tumour‐like vascular lesion. In this hypothesis, the aetiology may be hamartomatous or malformative as is suspected in arterio‐venous haemangioma of the lower extremities. The histogenesis is still questionable and no definitive proof in favour of one or the other hypothesis has been reported.
Galectin‐3 and carcinoembryonic antigen expression in medullary thyroid carcinoma: possible relation to tumour progression
Authors: Cvejic D , Savin S , Golubovic S , Paunovic I , Tatic S , Havelka M
Published: March 2003

Galectin‐3 is a beta‐galactoside binding protein involved in multiple biological processes through interactions with complementary glycoconjugates. We analysed the expression and coexpression of galectin‐3 and carcinoembryonic antigen (CEA), one of the putative galectin‐3 ligands, in medullary thyroid carcinoma (MTC).

An immunohistochemical study using monoclonal antibodies was performed on paraffin sections of 20 cases of sporadic MTC comprising 10 cases without and 10 cases with lymph node metastases at the time of surgery. CEA expression was found in all tumours, distributed predominantly in the cytoplasm and occasionally at the cell surface. In the majority of cases (18/20) moderate to strong intensity of staining was found in most of the cells. Positive cytoplasmic staining for galectin‐3 was found in 16/20 cases, but varied in intensity and distribution from weak/focal (7/16) to moderate (7/16) or strong (2/16). More intense staining for galectin‐3 was mainly associated with MTC cases involving lymph node metastases. Eight out of these 10 cases showed moderate to strong galectin‐3 expression concomitant with CEA expression throughout the tumour tissue.

These findings suggest that galectin‐3 might play a role in the pathobiology of MTC. Simultaneous expression of galectin‐3 and CEA in the same tumour cells at an advanced stage of MTC indicates the possibility of their autocrine cooperation during tumour progression.
Basaloid carcinoma of the colon arising at the splenic flexure
Authors: Newell K J , Penswick J L , Driman D K
Published: March 2003

Basaloid carcinomas typically arise in the anal canal and there are only three well‐documented cases of this neoplasm reported outside the anal canal, none more proximally than the sigmoid colon. The first occurrence of a basaloid colonic carcinoma arising outside the sigmoid colon, at the splenic flexure, is presented.

A splenic flexure mass was resected from a 54‐year‐old man with a 3‐week history of abdominal discomfort, diarrhoea and weight loss. This tumour, like typical anal canal basaloid carcinomas, was composed of islands of basaloid cells with peripheral nuclear palisading; within many islands there was central necrosis and focal squamous differentiation. Ultrastructural and immunohistochemical studies confirmed the basaloid nature and focal squamous differentiation within this neoplasm. Basaloid carcinoma of the anal canal has been associated with human papilloma virus. Using in‐situ hybridization, HPV DNA was not detected in this case.

Outside the anal canal, it has been postulated that basaloid colonic carcinomas may arise from cloacogenic embryologic rests, squamous metaplastic epithelium, or totipotential basal cells. The location and pathological findings of this tumour suggest that this rare colonic neoplasm arises from a totipotential basal cell.
The ‘dark nucleus’ and disruptions of follicular architecture: possible new histological aids for the diagnosis of the follicular variant of papillary carcinoma of the thyroid
Authors: Bell C D , Coire C , Treger T , Volpe R , Baumal R , Fornasier V L
Published: March 2003

The ‘dark nucleus’ and disruptions of follicular architecture: possible new histological aids for the diagnosis of the follicular variant of papillary carcinoma of the thyroid

Aims: In order to facilitate the diagnosis of malignancy in solitary thyroid nodules which are non‐invasive low‐grade tumours, i.e. follicular variant of papillary carcinoma (FVPC) for which few histological discriminators exist, a search was made for additional diagnostically useful histological features.

Methods and results: Haematoxylin and eosin (H & E)‐stained sections of 70 resection specimens of solitary thyroid nodules were re‐evaluated by a panel of three pathologists, and their consensus and original diagnoses compared. In addition, H & E‐ and periodic acid–Schiff‐stained sections were evaluated for various histological features and sections were stained by various immunohistochemical markers to evaluate their discriminative powers. The above features were also assessed in a group of 24 papillary carcinomas of the thyroid (PTCs) associated with regional metastases. The finding of ‘Orphan Annie eye’ nuclei was the best indicator of malignancy, and was closely related to the presence of nuclear grooves and cells with dense, dark nuclei. In addition, distorted follicular architectural features, i.e. ‘interconnecting cell masses’ and ‘fenestration’, were also significant indicators of malignancy. Tumours diagnosed as FVPCs had a significantly lower incidence of associated lymph node metastases than the classical PTCs.

Conclusions: The use of optically clear nuclei as a diagnostic criterion when found only focally may not be sufficiently stringent in distinguishing FVPCs from follicular adenomas. When classical histological indicators of malignancy are equivocal, the diagnosis of FVPC may be facilitated by the above‐mentioned features.
Primary signet ring cell adenocarcinomas of the lung: a clinicopathological study of 15 cases
Authors: Castro C Y , Moran C A , Flieder D G , Suster S
Published: March 2003

Primary signet ring cell adenocarcinomas of the lung: a clinicopathological study of 15 cases

Aims: We describe the clinicopathological characteristics of 15 cases of primary signet ring cell adenocarcinoma of the lung and highlight the importance of recognizing that not all adenocarcinomas with signet ring cell features represent metastatic adenocarcinomas.

Methods and results: We evaluated the clinicopathological and immunohistochemical features of 15 cases of signet ring cell adenocarcinoma of the lung. The patients were 12 men and three women, age 30–75 years (mean 52.5 years). No evidence of a primary tumour elsewhere could be found on thorough clinical examination. Nine patients underwent resection and the remainder were biopsied. The tumours ranged from 18 to 80 mm in greatest dimension. Microscopically, two distinct patterns of growth were recognized: acinar and diffuse. The tumours were characterized by the presence of >75% signet ring cells. Periodic acid–Schiff and mucicarmine showed strong intracellular positive staining. Immunohistochemical stains for TTF‐1 (6/6) and CEA (9/9) showed strong positive reaction in all cases evaluated. Three out of six cases were also positive for cytokeratin 7. All the tumours (6/6) were negative for cytokeratin 20, ER, PR and GCDFP‐15. Follow‐up information was obtained in 11 patients; six patients died within 1 year and five patients were alive from 3 to 36 months after initial diagnosis.

Conclusion: These cases highlight an unusual histological growth pattern of primary lung adenocarcinoma that may be mistaken for a metastasis from an occult primary. The recognition of this pattern of lung tumours is important for proper treatment.
Loss of CD30 expression in metastatic embryonal carcinoma: the effects of chemotherapy?
Authors: Berney D M , Shamash J , Pieroni K , Oliver R T D
Published: March 2003

Loss of CD30 expression in metastatic embryonal carcinoma: the effects of chemotherapy?

Aims: CD30 has been shown to be consistently strongly expressed in embryonal carcinomas. Our aim was to examine changes in CD30 expression in embryonal carcinomas before and after treatment with chemotherapy.

Methods and results: One hundred and eighteen retroperitoneal lymph node dissections from patients with metastatic germ cell tumours were reviewed. Seventeen contained embryonal carcinoma deposits. In nine cases, the matching pre‐chemotherapy orchidectomy specimens were available. The cases were immunohistochemically stained for CD30. All nine pre‐ chemotherapy orchidectomy specimens showed embryonal carcinoma and stained strongly positively for CD30. However, only four out of nine of the matched post‐chemotherapy retroperitoneal lymph node dissection specimens and a total of six out of 17 (35%) with embryonal carcinoma deposits stained for CD30. Ten seminomas were negative for CD30. Loss of CD30 did not appear to influence the relapse rate of the patients.

Conclusions: Loss of CD30 expression occurs frequently in metastatic embryonal carcinomas after chemotherapy. This finding has implications in the use of CD30 in the diagnosis of metastatic non‐seminomatous germ cell tumours and suggests that chemotherapy may alter the immunophenotype of embryonal carcinoma while retaining its characteristic histological appearances.
Arthroplasty‐associated malignant fibrous histiocytoma: two case reports
Authors: Lucas D R , Miller P R , Mott M P , Kronick J L , Unni K K
Published: March 2003

Arthroplasty‐associated malignant fibrous histiocytoma: two case reports

Aims: Sarcoma localized to the site of an arthroplasty procedure is a rare occurrence, and detailed histological depictions and descriptions are limited. We report the clinicopathological findings in two cases of arthroplasty‐associated malignant fibrous histiocytoma (MFH) and review the literature.

Methods and results: The patients were an elderly man and woman. Medical histories, radiographs and slides were reviewed. Immunohistochemistry, electron microscopy, cytogenetics, and electron dispersion spectroscopy were performed in one case. Both were destructive femoral bone tumours that appeared 2 and 8 years post‐total hip arthroplasty, and pursued aggressive clinical courses. The histology was similar in both tumours, consisting of high‐grade, pleomorphic sarcoma with numerous osteoclastic giant cells, prominent phagocytic activity, and entrapped particles of bone cement. Literature review disclosed 14 previous reports of arthroplasty‐associated MFH, representing the most common phenotype. A number of materials and factors related to arthroplasty procedure, such as metal corrosion, wear debris, osteonecrosis, and chronic inflammation, have been implicated as causative agents.

Conclusions: Arthroplasty‐associated MFH is a rare and aggressive tumour. Although the aetiology remains unclear, the small number of arthroplasty‐associated sarcomas compared with the large number of joint replacement operations performed over the past four decades suggests a coincidental as opposed to a causal relation.
Mucinous (colloid) adenocarcinomas secrete distinct O‐acylated forms of sialomucins: a histochemical study of gastric, colorectal and breast adenocarcinomas
Authors: Sáez C , Japón M A , Poveda M A , Segura D I
Published: March 2003

Mucinous (colloid) adenocarcinomas secrete distinct O‐acylated forms of sialomucins: a histochemical study of gastric, colorectal and breast adenocarcinomas

Aims: Mucinous (colloid) adenocarcinomas represent a distinct group of tumours defined by the presence of large amounts of extracellular mucins. By using histochemical methods, we analysed mucins secreted by mucinous versus non‐mucinous adenocarcinomas and looked for differential secretion profiles.

Methods and results: Sixty‐four adenocarcinomas were studied (23 colorectal, 17 gastric, and 24 breast tumours). Thirty‐two tumours were of the colloid type. The following methods were applied to paraffin tissue sections: (i) Alcian blue (pH 2.5) and periodic acid–Schiff (PAS); (ii) high iron diamine and Alcian blue (pH 2.5); (iii) periodic acid borohydride, potassium hydroxide, and PAS; (iv) periodic acid–thionine Schiff, potassium hydroxide, and PAS; and (v) periodic acid–borohydride and PAS. Most adenocarcinomas secreted acidic mucins, with sialomucins predominating over sulfomucins, except for non‐mucinous adenocarcinomas of the breast which showed predominant neutral mucins. All mucinous adenocarcinomas contained C9‐O‐acyl sialic acid as mono, di(C8,C9)‐, or tri(C7,C8,C9)‐O‐acyl forms. Acidic mucins secreted by the majority of non‐colloid adenocarcinomas consisted of non‐O‐acylated sialomucins.

Conclusions: C9‐O‐acylation of sialic acid is a characteristic feature of mucinous adenocarcinomas and can be readily detected by histochemical methods.
A study of eleven cutaneous malignant melanomas in adults with small‐cell morphology: emphasis on diagnostic difficulties and unusual features
Authors: Hanson I M , Banerjee S S , Menasce L P , Prescott R J
Published: March 2003

A study of eleven cutaneous malignant melanomas in adults with small‐cell morphology: emphasis on diagnostic difficulties and unusual features

Aims: To describe the clinicopathological and immunohistochemical features of cutaneous malignant melanomas with a pure or mixed small‐cell pattern in 11 adult patients, and to discuss the diagnostic difficulties encountered.

Methods and results: Haematoxylin and eosin‐stained sections of each case of cutaneous small‐cell malignant melanoma, together with locally recurrent skin lesions and, where available, metastatic deposits, were re‐examined. Available immunohistochemical sections were evaluated. Clinical follow‐up data were obtained in each case. One patient presented with metastatic disease, the others presented with cutaneous lesions. Suggested initial diagnoses included malignant melanoma, non‐Hodgkin's lymphoma, Merkel cell carcinoma and sarcoma. All the tumours were in the vertical growth phase. Nine had a junctional component, often inconspicuous. The lesions showed either a pure small‐cell pattern or a mixed pattern with more conventional areas. In one case, there was colonization of a basal cell carcinoma by invasive malignant melanoma. Variable retention of small‐cell morphology in local recurrences and metastases was observed, although in some cases more typically pleomorphic cells were present. In the cases tested, there was strong immunostaining for S100 protein and NKI‐C3, and variable immunostaining for HMB45 and Melan‐A. Non‐melanocytic markers were negative.

Conclusions: The possibility of a small‐cell malignant melanoma should be considered in the assessment of cutaneous and non‐cutaneous small‐cell neoplasms. The correct diagnosis requires careful evaluation for junctional activity, melanin production and the use of a panel of melanocytic markers.
Subclassification of renal cell neoplasms: an update for the practising pathologist
Authors: Renshaw A A
Published: March 2003

The classification of renal cell neoplasms has been extensively studied in the last decade, and a standardized nomenclature adopted. Although this system is based on a combination of genetic, histological and immunohistological features, in most cases accurate classification can be based on histological features alone. This review summarizes the key features of the tumours included in this system, and then focuses on diagnostic difficulties that can arise when using this system, as well as reviewing several recently characterized tumours that are not yet included.
Classification of idiopathic interstitial pneumonias: making sense of the alphabet soup
Authors: Nicholson A G
Published: March 2003

Since Liebow and Carrington's original classification of idiopathic interstitial pneumonias, there have been controversies over which histological patterns should be included and how they relate to clinicopathological diseases such as cryptogenic fibrosing alveolitis/idiopathic pulmonary fibrosis (CFA/IPF). Because of these differences and the wealth of overlapping terminology, a consensus classification system has been proposed, devised by a group of clinicians, radiologists and pathologists. Seven histological patterns are recognized: usual interstitial pneumonia (UIP), non‐specific interstitial pneumonia (NSIP), diffuse alveolar damage (DAD), organizing pneumonia (OP), desquamative interstitial pneumonia (DIP), respiratory bronchiolitis (RB) and lymphocytic interstitial pneumonia (LIP), each with a clinicopathological counterpart, the most well defined being UIP and CFA/IPF. The system is applicable both in terms of the pathologist identifying histological patterns in isolation and in terms of the pathologist's role in contributing to the final clinicopathological diagnosis. It will probably provide greater consistency in diagnosis, early studies suggesting that the system is reproducible, and also identify purer cohorts for studies investigating causation. It also highlights the fact that the ‘gold standard for diagnosis’ is no longer a surgical lung biopsy in isolation but more the clinicopathological conference, when clinical, imaging and histological data are jointly discussed to produce the final clinicopathological diagnosis.
Effect of granulocyte–macrophage colony‐stimulating factor on the number of leucocytes and course of Listeria monocytogenes infection in naive and leucocytopenic mice
Authors: Buisman  , Langermans  , Van Furth
Published: March 2003

This study concerns the effect of recombinant murine granulocyte–macrophage colony‐stimulating factor (GM‐CSF) on the number of circulating leucocytes, activation of peritoneal macrophages and proliferation of Listeria monocytogenes in various organs of naive and leucocytopenic mice. Mice were rendered leucocytopenic by sublethal total body irradiation or cyclophosphamide treatment. GM‐CSF treatment enhanced the number of granulocytes and monocytes in peripheral blood during L. monocytogenes infection in naive mice, but not in irradiated or cyclophosphamide‐treated mice. In naive mice, irradiated and cyclophosphamide‐treated mice, GM‐CSF did not affect the course of L. monocytogenes infection in thigh muscle, spleen and liver. However, GM‐CSF treatment significantly increased the number of macrophages in the peritoneal cavity of naive mice during infection; these macrophages were more enlarged and showed a higher frequency of binucleated and multinucleated cells relative to non‐GM‐CSF‐treated mice. Together, these results demonstrated that GM‐CSF increased the number of circulating granulocytes and monocytes, and the number of peritoneal macrophages during infection with L. monocytogenes in naive mice, but did not affect the course of the infection in thigh muscle, spleen or liver of these mice. In leucocytopenic mice, however, GM‐CSF did not affect the number of circulating phagocytes, which explains that this factor had no effect on the proliferation of the bacteria in the various organs.
Monoclonal antibody anti‐NC‐2 identifies a second receptor on cells mediating natural cytotoxicity in mice
Authors: Shirzadeh  , Burton  , Brien  , Smart
Published: March 2003

We have previously reported the identification by the murine monoclonal antibody (mAb) 1C4 of the first leucocyte receptor which is involved in natural cytotoxicity (NC) against WEHI‐164; the NC‐1.1 receptor. We report herein the identification and characterization of a second leucocyte receptor which is involved in NC, NC‐2 (MW 50 000), identified by a rat anti‐mouse mAb D9 (immunoglobulin G2a; IgG2a). Flow cytometric analysis showed that NC‐2 was expressed on<6% of splenic leucocytes of different inbred mouse strains and 96% of the cells of a mast‐cell line which has high NC activity. In vitro treatment of splenic leucocytes with the D9 mAb blocked effector cell–WEHI‐164 target cell conjugation and NC by ≈ 50% without affecting natural killing (NK). Western blot analysis of affinity purified NC‐2 and NC‐1.1 using the D9 and 1C4 mAbs showed specific reactivity of the proteins with D9 and 1C4, respectively. Pretreatment of splenic leucocytes with both mAbs blocked NC 84%, a result which almost doubled that caused by either mAb alone. Flow cytometric screening of 16 different mouse cell lines showed that 19% of the cell lines expressed both receptors, 6% expressed only NC‐2, 44% expressed mainly or only NC‐1.1 and the remaining cells expressed neither receptor. These data indicate that D9 identifies a xeno‐antigen, NC‐2, which is expressed on cells mediating NC and not NK, and that it is not the previously described NC‐1.1 allo‐antigen. We conclude that NC‐2 is likely to be one of a number of receptor molecules on cells mediating NC against tumour cells.