bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibition by a CD14 monoclonal antibody of lipopolysaccharide binding to murine macrophages
Authors: Adachi Y. , Satokawa C. , Saeki M. , Ohno N. , Tamura H. , Tanaka S. , Yadomae T.
Published: June 2007

We have established an anti-CD14 mAb named 4C1 against murine macrophages. 4C1 can bind to thioglycolate-elicited peritoneal macrophages, bone marrow-derived macrophages and casein-induced peritoneal neutrophils. Immunostaining with 4C1 was inhibited by treatment of the cells with phosphatidylinositol specific phospholipase C, suggesting that the antigen is GPI-anchored. Immunoprecipitates from biotin-labeled RAW264.7 cell lysate with 4C1 were around 55 kDa and were visualized with rmC5-3, the only commercially available anti-murine CD14 mAb. 4C1 positively stained COS7 cells transfected with an expression vector containing cDNA of murine CD14. Pretreatment of macrophages with 4C1 reduced LPS-mediated production of TNFα, IL-6, and nitrite. The binding of FITC-LPS to RAW264.7 cells was blocked by pretreatment with 4C1 but not with rmC5. Pretreatment of cells with unlabeled 4C1 mAb but not unlabeled rmC5-3 reduced binding of FITC-4C1. These results suggest that the 4C1 epitope on murine CD14 plays an important role in LPS binding and is distinct from the rmC5-3 epitope.
LBP does not substitute for CD14 as a signaling membrane bound LPS receptor
Authors: Tapping Richard I. , Orr Sally L. , Tobias Peter S.
Published: June 2007

CD14 is well known as a receptor for LPS. However, the mechanism of signal transduction which LPS initiates upon binding to CD14 is not known. One theory is that CD14 presents LPS to another molecule which in turn initiates cellular activation [Ulevitch RJ, Tobias PS. Receptor-dependent mechanisms of cell stimulation by bacterial endotoxin. Annu Rev Immunol 1995; 13: 437]. In this context one may ask whether the postulated presentation function of CD14 is limited to simple concentration of LPS at the cell surface or whether CD14 performs some other more specific function. LPS binding protein (LBP) is able to bind and transfer LPS to a variety of acceptors [Wurfel MM, Wright SD. Lipopolysaccharide-binding protein and soluble CD14 transfer lipopolysaccharide to phospholipid bilayers: preferential interaction with particular classes of lipid. J Immunol 1997; 158: 3925] and, as such, is a candidate as an alternative to CD14 if the function of CD14 is simply to concentrate LPS at the cell surface. To address this, CHO and U373 cells were engineered to express a membrane anchored form of LBP (mLBP) for comparison with cells expressing membrane anchored CD14 (mCD14) as well as empty vector transfected cells. Activation of the cells by LPS was assessed using activation of NFκB (CHO and U373 cells), and surface expression of ICAM and secretion of IL-6 (U373 cells). Despite the observation that LBP did concentrate LPS at the cell surface, as assessed by binding of either fluorescein or tritium labeled LPS, the activation of LBP expressing cells was several orders of magnitude less efficient than activation of the mCD14 expressing cells and only minimally more efficient than activation of empty vector transfected cells. This slight effect is likely to be due to the presence of a small amount of soluble CD14 (sCD14) and the ability of mLBP to foster formation of LPS-sCD14 complexes which are agonistic for these cells. Thus LBP clearly cannot act as an efficient surrogate for CD14, and the function of CD14 is more complicated than the simple concentration of LPS at the cell surface.
Polysaccharide and lipid components of Bacteroides thetaiotaomicron lipopolysaccharide as stimulators of endothelial adhesion molecule expression
Authors: Rokosz Alicja , Meisel-Mikolajczyk Felicja , Malchar Cezary , Nowaczyk Maria , Górski Andrzej
Published: June 2007

Bacteroides thetaiotaomicron , a Gram-negative anaerobic rod and a member of the Bacteroides fragilis group (BFG) causes many systemic and local infections in humans, most of which are endogenous and suppurative. The microorganism produces two high-molecular weight, carbohydrate-containing cell-surface antigens, both of which have been implicated as virulence factors for this organism; these consist of lipopolysaccharide (LPS) and capsular polysaccharide (CPS). Adhesion molecules ICAM-1, VCAM-1 and E-selectin can be stimulated to be expressed on the surface of endothelial cells (ECs) by a variety of mediators of inflammation. The aim of this study was to assess the ability of polysaccharide (PS) and lipid (lipid A) components of three B. thetaiotaomicron LPS preparations to induce adhesion molecule expression on the surface of human vascular endothelial cells. The HMEC-1 cell line has been employed along with ELISA assays to examine the relative activity of B. thetaiotaomicron LPS. ELISA was performed using monoclonal mouse anti-human ICAM-1, VCAM-1 and E-selectin antibodies. The lipid A moieties of the three LPS revealed the ability to stimulate ICAM-1, VCAM-1 and E-selectin on endothelial cells. Their relative activities were similar and stronger than the biological activity of the lipid A-depleted polysaccharide (PS) components of LPS that were, nevertheless, significantly above background levels. In contrast, the PS moiety of LPS extracted from a reference strain B. thetaiotaomicron NCTC 10582 was totally unable to induce the expression of any adhesion molecule under investigation. The lipid A of B. thetaiotaomicron LPS is, therefore, and probably not unexpectedly, involved in the stimulation of adhesion molecules that are expressed on HMEC-1 to a greater extent than the PS moiety. Importantly, however, the PS components of the two LPS preparations tested manifest a weak but, nevertheless, significant activity in this process. It is possible that the PS moiety may modify the immunobiological effects of the complete LPS molecule.
Signal transduction pathways involved in lipopolysaccharide-induced production of PGE2 by human microvascular endothelial cells
Authors: Lucas Kimberly A. , Flynn John T.
Published: June 2007

Lipopolysaccharide induces the expression of prostaglandin H synthase-2 with subsequent production of PGE2 in human microvascular endothelial cells. In order to investigate the signaling pathways that are involved in the LPS-induced production of PGE2, the roles of several second messenger systems in this process were evaluated. Treatment of human microvascular endothelial cells with the tyrosine kinase inhibitors herbimycin A and genistein significantly inhibited LPS-mediated PGE2 production. Western blotting demonstrated that LPS induced the phosphorylation of p42, p44 and p38 MAP kinases. Both PD98059, an inhibitor of p42 and p44 MAP kinase activation, and SB203580, an inhibitor of p38 MAP kinase, blocked LPS-induced PGE2 production. Inhibition of PKC activity by staurosporine and GF109203X resulted in a potentiation of the LPS response. Treatment of the cells with SN50, an NF-κB inhibitor, resulted in inhibition of the LPS-mediated PGE2 production. These results suggest that LPS induces PGE2 production in human microvascular endothelial cells through sequential activation of tyrosine kinases, ERK and p38 MAP kinases and NF-κB. In addition, PKC activity exerts a feedback control of PGE2 production in LPS-stimulated microvessel-derived endothelial cells.
Group Personality Composition and Group Effectiveness
Authors: Halfhill Terry , Sundstrom Eric , Lahner Jessica , Calderone Wilma , Nielsen Tjai M.
Published: June 2007

This review examines relationships between group personality composition (GPC) and group effectiveness, focusing on four questions: (a) How have researchers operationalized GPC? (b) What criteria have been used as measures of group effectiveness? (c) Is GPC related to group effectiveness? (d) Under what conditions is GPC associated with group effectiveness? A review of 31 studies yielding 334 unique relationships distinguished task and relationship predictors and criteria. Findings indicate operational definitions of GPC are varied, variance scores correlate negatively with group effectiveness, and minimum scores predict as well as mean scores. GPC is related to group effectiveness, and the effect is stronger in field studies than lab studies. Implications are discussed.
Behavior Analysis in Child Welfare: Competency Training Caseworkers to Manage Visits Between Parents and Their Children in Foster Care
Authors: Kessler Maria Lynn , Greene Brandon F.
Published: June 2007

Objective: Two experiments were conducted in connection with training caseworkers of a state child protection agency to manage visits between parents and their children in foster care. Method: In the first experiment, the skills involved in managing visits were identified and assessed with two caseworkers. Results: These caseworkers subsequently participated in an individual training program that improved their ability to manage visits as assessed in role-play. In the second experiment, modifications in the training program were made to allow for group training. The group training program was as effective as individual training at enabling two caseworkers and their supervisor to conduct visits. However, data collected during actual visits were limited; they suggested that the effects of training did not fully generalize. Conclusion: The implications of the research for policy and current litigation in the area of child welfare were discussed.
Music thanatology: Prescriptive harp music as palliative care for the dying patient
Authors: Freeman Lindsay , Caserta Michael , Lund Dale , Rossa Shirley , Dowdy Ann , Partenheimer Andrea
Published: June 2007

Music thanatology represents an emerging area in which the raw materials of music, usually harp and/or voice, assist and comfort the dying patient. During prescriptive ”music vigils,“ the clinician-mnusician carefully observes physiological changes, cues, and breathing patterns, thereby synchronizing the music to reflect or support the patient physiology and overall condition. Using data collected from 65 patients, this study was designed to assess the effectiveness of prescriptive harp music on selected palliative care outcomes using a sample of de-identified data forms from past music vigils. Patients were administered a 25- to 95-minute intervention of prescriptive harp music. Data collected included vital signs and observational indicators before (Ti) and after (T2) the vigil. Patients were more likely to experience decreased levels of agitation and wakefulness while also breathing more slowly and deeply with less effort at the conclusion of the music vigil. Results from this study suggest that a prescriptive vigil conducted by a trained music thanatologist could provide an effective form ofpalliative care for dying patients.
Dehydration in the terminal patient: Perception of hospice nurses
Authors: Andrews Maria R. , Levine Alan M.
Published: June 2007

Recent discussion about the care of the terminally il patient has focused on the appropriateness of with holding and with drawing food and fluid and on the discomfort of the dehydrated state. Evidence is mounting that suggests that dehydration in this group of people is not painful, but rather may be more comfortable than hydration by means of IV fluids or enteral and parenteralfeedings.

This study examines the relationship between the experience of hospice nurses in observing terninal dehydration and their perception of this state. The scores for the degree of positive perception of dehydration are compared for the experienced and nonexperienced groups of nurses. This study suggests that those hospice nurses who have observed terminal dehydration have a more positive perception of this state than those who have not.
The prevalence and incidence of pressure ulcers in the hospice setting: Analysis of two methodologies
Authors: Hanson Darlene , Langemo Diane K. , Olson Bette , Hunter Susan , Sauvage Timothy R. , Burd Christine , Cathcart-Silberberg Tressa
Published: June 2007

Hospice patients may be at greater risk of pressure ulcer development than most patients. This descriptive study explored the prevalence and incidence of pressure ulcers in the hospice setting, utilizing both a prospective and retrospective methodological approach. Levine's theory of the four principles of conservation formed the theoretical basis for the study, and the Braden Scale for Predicting Pressure Ulcer Risk was used for data collection. Prevalence of pressure ulcers was noted to be 13 percent in the study. Incidence of pressure ulcers was found to be zero percent using prospective methodology and 13 percent using retrospective methodology. Five of eight ulcers (62 percent) occurred with Ain two weeks of patient death. Factors related to pressure ulcer development are presented, as well as a discussion of using research methodologies in the hospice setting. The article suggests the need for preventive protocols for skin care for patients who are at risk for pressure ulcer development.
Characteristics of hospice programs, directors, and selected staff in one western state
Authors: Sontag Mary-Ann
Published: June 2007

This article presents results from a study of all hospice programs in one western state conducted in 1992. Personal interviews and questionnaires were utilized to collect data about hospice programs, hospice directors, hospice nurses, social workers, and chaplains. Hospice programs were identified by type, affiliation, size, and Medicare certification status. Eighty-seven percent of hospice directors in the state were female, and nurses were the directors of 58 percent of the state's hospice programs. Approximately half of the hospice nurses, social workers, and chaplains, and 42 percent of the directors had no prior hospice experience before assuming their present positions.
Rhetorical Chemistry
Authors: Lippincott Gail
Published: June 2007

This article employs neoclassic and feminist rhetorical perspectives to investigate the persuasive strategies in two scientific articles written in the late nineteenth century by Ellen Swallow Richards. One of the first credentialed female scientists in the United States, Richards wrote about nutrition research she conducted in her experimental food laboratory, the New England Kitchen, to persuade two separate audiences—one predominantly male and the other predominantly female—of the scientific value of nutrition studies. The article adds complexity to our historical underpinnings by querying how gender—of the writer, of the audiences, and in the nature of the topic—contributed to the writer’s rhetorical burdens and provides evidence that women historically have been active knowers and users of science and technology.
Culture and Families of Children with Traumatic Injuries
Authors: Sperry Len , Fernandez M. Sylvia
Published: June 2007

Family counselors working cross-culturally with children with traumatic injuries and their families assist them through the psychosocial stages of adjustment from a developmental and cultural perspective. Combining a developmental and cultural focus in family counseling with traumatically injured children provides the family counselor with an effective framework for selecting appropriately timed interventions.
Molecular Insights into the Histogenesis and Pathogenesis of Gastrointestinal Stromal Tumors
Authors: Rubin Brian P. , Fletcher Jonathan A. , Fletcher Christopher D. M.
Published: June 2007

Gastrointestinal stromal tumors (GISTs) have long been problematic in terms of classification and determination of prognosis. Recent studies have suggested that GISTs differentiate toward a phenotype resembling the interstitial cells of Cajal. This has led to the important discovery that activating mutations in the KIT receptor tyrosine kiase play an important role in the pathogenesis of GISTs. These findings have helped clarify the distinction between GISTs and other mesenchymal neoplasms of the gasrointestinal tract and may translate into an improved ability to predict biologic behavior, as well as suggesting possible avenues for rational drug design for the treatment of GISTs.
Adhesion Molecules as Diagnostic Tools in Tumor Pathology
Authors: Ohene-Abuakwa Yaw , Pignatelli Massimo
Published: June 2007

Adhesion molecules are transmembrane glycoproteins mediating cell-cell and cell extracellular matrix interactions. They control a number of fundamental biological processes including cell migration, differentiation, proliferation, and apoptosis. In the last decade there has been an increasing interest in the exploitation of these molecules as diagnostic and/or prognostic markers in tumor pathology. For example, a large number of studies have shown that loss of E-cadherin expression correlates with high tumor grade and advanced tumor stage in a number of malignancies. The analysis of adhesion molecule profile in a routine clinical setting needs further investigation in prospective multicenter studies.
Primary Adenoidal Hodgkin's Disease
Authors: Sidhu Jagmohan S. , Rigotti Richard , Schotanus Peter
Published: June 2007

The nasopharyngeal lymphoid tissue (adenoids) is an uncommonly reported primary site for Hodgkin's disease. We report a case of primary adenoidal, interfollicular, epithelioid cell-rich variant of mixed cellularity Hodgkin's disease. The combination of an interfollicular pattern and richness of epithelioid histiocytes made it very difficult to make the diagnosis of Hodgkin's disease without the help of immunohistochemistry. To our knowledge, only 39 cases of Hodgkin's disease primarily involving the Waldeyer's ring have been reported in the English literature, 24 of these primarily involving the adenoids. Our case shows the difficulty encountered in making the diagnosis when a very unusual morphologic appearance of Hodgkin's disease is seen at a rare presentation site. The appropriate immunohistochemical work-up should be performed in unusual lymphohistiocytic proliferations involving the Waldeyer's ring.
Esophageal Plexiform Schwannoma
Authors: Cokelaere K. , Sciot R. , Geboes K.
Published: June 2007

We report a patient with a plexiform schwannoma located in the cervical part of the esophagus. A large pedunculated intraluminal polyp, originating in the postcricoid region and protruding into the oropharynx, was found in association with multiple submucosal nodules. Both the intraluminal polyp and submucosal nodules consisted of cellular schwannomatous tissue. The patient showed no signs of neurofibromatosis or schwannomatosis. Plexiform schwannomas are uncommon tumors, mainly confined to the dermis and subcutis of trunk, head, and neck region and upper extremities. Visceral examples are vanishingly rare, and a location in the esophagus has not yet been described. The intruiging mode of presentation in the present case, mimicking that of so-called giant esophageal fibrovascular polyp, probably relates to mechanical factors inherent to the unique esophageal location.
Intratubular Germ Cell Neoplasia: Associated Infertility and Review of the Diagnostic Modalities
Authors: Lifschitz-Mercer Beatriz , Elliott David J. , Schreiber-Bramante Letizia , Leider-Trejo Leonor , Eisenthal Avi , Maymon Batia Bar-Shira
Published: June 2007

The incidence of testicular neoplasia has increased, and its early detection has become a pressing clinical issue. The strong association between male subfertility and risk of testicular neoplasia is consistent with the existence of common pathogenetic factors. Most forms of testicular germ tumors are believed to stem from a common precursor, intratubular germ cell neoplasia (ITGCN), also known as testicular carcinoma in situ. Identification of ITGCN cells in testicular biopsies, however, is a diagnostic challenge and markers are sorely needed to assist in the accurate identification of the lesion.
Histologic Classification of Penile Carcinoma and Its Relation to Outcome in 61 Patients with Primary Resection
Authors: Cubilla Antonio L. , Reuter Victor , Velazquez Elsa , Piris Adriano , Saito Shiro , Young Robert H
Published: June 2007

A retrospective review of the clinical and pathologic features of 61 cases of penile squamous cell carcinoma (SCC), all treated by primary surgical resection at the Memorial Sloan Kettering Cancer Center during the period 1949-1992, was undertaken. Inguinal lymph node dissection material was evaluated in 40 cases. All carcinomas were of squamous cell type and were classified as follows: usual type, 36 cases (59%); papillary, not otherwise specified (NOS), 9 cases (15%), basaloid, 6 cases (10%); warty (condylomatous), 6 cases (10%); verrucous, 2 cases (3%), and sarcomatoid, 2 cases (3%). A high rate of nodal metastasis and poor survival were found for the basaloid and sarcomatoid neoplasms (5 of 7 patients with metastasis, 71%, and 5 of 8 dead of disease, 63%). Only 1 patient with a verruciform tumor (defined as a tumor of nonspecific papillary, warty, or verrucous type) had inguinal node metastasis and none died from penile cancer. An intermediate rate of metastasis and mortality (14 of 26, 54%, and 13 of 36, 36%, respectively) was found for typical SCC. Penile carcinomas are morphologically heterogeneous, and there is a correlation of histologic type and biologic behavior. This mandates accurate histologic subtyping by the pathologist.
Biovularity and “Coalescence of Primary Follicles” in Ovaries with Mature Teratomas
Authors: Muretto Pietro , Chilosi Marco , Rabitti Carla , Tommasoni Silvia , Colato Chiara
Published: June 2007

Several theories have been postulated regarding the origin of ovarian teratomas, including incomplete twinning, neoplastic proliferation of sequestered totipotent blastomeres or primordial cells, derepression of totipotent genetic information in the nuclei of somatic cells, and parthenogenetic development of germ cells. At present parthenogenetic development of ova is the most widely accepted theory, primarily because of the presence of a 46 XX karyotype in almost all mature teratomas. However, some authors have raised the possibility of fusion of ova in the mechanism of formation of ovarian teratomas. We report the results of a study on ovarian tissue adjacent to 31 teratomas to assess the frequency of biovularity, which could provide evidence favoring the last theory. On the whole we found biovularity in 26 ovaries of young patients (mean age, 27 years) with variable numbers of biovular follicles ranging from t in 4 cases to more than 10 in 2 cases; the number of biovular follicles depended on the quantity of ovarian tissue examined as well as on the total number of ova in the tissue. In multiple occasions 2 ova were included within a single follicle; in 24 ovaries the biovularity was correlated with coalescence of primary follicles characterized morphologically by an ovoid or hourglass-like shape that resulted from cohesion of 2 follicles. As control cases, 30 ovaries of patients with an average age of 28 years were examined (12 removed for endometriosis, 8 for serous cystadenoma, 7 for tubal pregnancy, and 3 for acute salpingo-oophoritis). Only 1 ovary with endometriosis contained a single biovular follicle. The results suggest that ovarian teratoma development may result from fusion of ova in ovaries containing biovularity and phenomena of coalescence of primary follicles.
Association of Lymphangioleiomyomatosis (LAM) with Endosalpingiosis in the Retroperitoneal Lymph Nodes: Report of Two Cases
Authors: Matsui Kazuhiro , Travis William D. , Gonzalez Raimundo , Terzian James A. , Rosai Juan , Moss Joel , Ferrans Victor J.
Published: June 2007

We report 2 patients in whom pulmonary lymphangioleiomyomatosis (LAM) affected the retroperitoneal lymph nodes and was associated with endosalpingiosis. These lesions were large, encapsulated masses with multiple cysts containing chylous fluid. Both were characterized by proliferating LAM cells that formed fascicles separated by slit-like channels. Some cysts were lined by ciliated epithelium resembling that of Fallopian tubes. Other cysts were lined either by flattened endothelial cells or by a mixture of these cells and epithelial cells. Many LAM cells gave a positive reaction with HMB-45 antibody. Most LAM cells in fascicles were reactive for o-smooth muscle actin and desmin. In 1 patient, many of the epithelial cells and some of the subjacent LAM cells were positive for estrogen and progesterone receptors. In conclusion, immunostaining with HMB-45 antibody and markers for smooth muscle cells can be helpful in the evaluation of problems in the differential diagnosis of lesions of extrapulmonary LAM, particularly those involving the genital system.
Infiltrating Ductal Carcinoma of the Breast with Rhabdoid Phenotype
Authors: Mogotlane L. , Chetty R.
Published: June 2007

Two cases of ductal cancers of the breast of no special type with a prominent rhabdoid component are presented. The mastectomy specimens showed the tumors to be composed of cells with a characteristic rhabdoid phenotype: Large cells with eccentric nuclei containing large inclusion like nucleoli and abundant eosinophilic cytoplasm. Immunohistochemistry showed typical immunoreactivity with cytoplasmic dot-like accentuation for epithelial markers as well as valentine. In case 1, although excision margins were clear, tumor recurrence, composed mainly of rhabdoid cells, occurred within 7 months, and the patient died 2 months later. The second case, unfortunately, was lost to follow-up. This report is the second documenting the occurrence of rhabdoid cells in breast cancer. In keeping with other epithelial malignancies that contain rhabdoid cells, aggressive biological behavior is noted.
Calcifying Fibrous Pseudotumor of Mesentery Presenting with Acute Peritonitis
Authors: Benlzhak Ofer , Itin Lev , Feuchtwanger Zeev , Lifschitz-Mercer Beatriz , Czernobilsky Bernard
Published: June 2007

Calcifying fibrous pseudotumor (CFP) is a benign soft tissue lesion composed of thick collagen bundles, scattered fibroblasts, and psammomatous and dystrophic calcifications, located most commonly in the extremities and trunk of children and young adults. The present case in a 36-year-old woman is to the best of our knowledge the first report of a large CFP confined to the mesentery, which, because of torsion, led to acute peritonitis and emergency laparotomy. The typical histologic features were accompanied by a prominent myfibroblastic proliferation along with inflammatory response at the periphery of the lesion. The spindle cells of the lesion were positive for vimentine and focally for CD34 and smooth-muscle acting. Review of the literature and discussion of differential diagnosis in this report focuses on abdominal CFP and other intraabdominal soft tissue lesions, some of which may be precursors of CFP.
Malignant Granular Cell Tumor of Soft Tissues
Authors: Cruz-Mojarrieta Julia , Navarro Samuel , Gomez-Cabrera Erasmo , Perez-Pefia Lourdes , Soriano Pilar , Peydro-Oyala Amando , Llombart-Bosch Antonio
Published: June 2007

We describe 2 cases of malignant granular cell tumor. A marked discrepancy exists concerning the criteria of malignancy of this rare entity, which was diagnosed in male patients aged 41 and 52 years, respectively. They presented with tumors measuring more then 3.5 cm; one arose in the dermis and subcutaneous tissue in the region of the scapula, whereas the other was situated in deeper soft tissue in the pelvis. One case, with previous diagnosis of benign granular cell tumor, presented local recurrence 2 years after the initial diagnosis. The other case presented a fascicular pattern of growth invading adjacent muscular tissue. Both neoplasms were composed of polygonal and spindle cells, showing abundant cytoplasm, vesicular nuclei with large nucleoli, high nuclear-to-cytoplasmic ratio, and polymorphism. Immunohistochemically, the neoplastic cells of both cases were positive for vimentin, S 100 protein, neuron-specific enclose (NSE), and CD68. In addition, high expression of p53 and MiB 1 (Ki67) was detected. Herein, we discuss the morphologic and immunohistochemical criteria of malignancy of granular cell tumors.
Mediastinal Immature Teratoma with Yolk Sac Tumor and MyelomonocyticLeukemia Associated with Klinefelter's Syndrome
Authors: Govender Dhirendra , Pillay Shunmugam V.
Published: June 2007

A 14-year-old male presenting with a short history of right subclavicular chest pain was found to have a mediastinal tumor. Hematologic investigations and bone marrow examination showed features of myelomonocytic leukemia. The mediastinal tumor was excised, but thesurgery was complicated by massive hemorrhage. The patient's condition deteriorated postoperatively and he died a week later. The histology of the mediastinal tumor showed the typical features of an immature teratoma with a yolk sac tumor. A prominent infiltrate of leukemic blast cells was present within blood vessels and in close proximity to the yolk sac component. The karyotypic analysis of leukemiccells isolated and cultured from the bone marrow showed 5OXXY, +8, +21, +iso G-group marker chromosome karyotype.
Uterine Adenomyoma with Uterus-like Features
Authors: Jung Woon-Yong , Shin Bong-Kyung , Kim Insun
Published: June 2007

Two uterine adenomyomas with unusual features are presented. Case 1 was a 43-year-old woman who had a 1-year history of menorrhagia and dysmenorrhea. The uterus showed a 3-cm-sized mass attached to the posterior wall of the lower uterine segment. On section, there was a well-circumscribed, submucosal cystic mass with a thick muscular wall. Histologically, the cavities were lined by well-developed secretory-phase endometrium and surrounded by smooth muscle, likeya small uterus. Case 2 was a 52-year-old woman who visited the hospital because of itching sensation on the vulva. On physical examination, the mass was found on the left side of the pelvis. The enlarged uterus had an 8-cm-sized protruding mass from the left side of the lower uterine segment. On section, the mass was cystic and solid. Histologically, the cysts were lined by thin basalis-type endometrial glands and stroma, and the solid portion was composed of smooth muscle and fat cells.
Diffuse Nodular Lymphoid Hyperplasia of the Large Bowel Without Hypogammaglobulinemia or Malabsorption Syndrome
Authors: Tomita Shigeki , Kojima Masaru , Imura Johji , Ueda Yoshihiko , Koitabashi Ayako , Suzuki Yasunaga , Nakamura Yuichi , Mitani Kinuko , Terano Akira , Fujimori Takahiro
Published: June 2007

Diffuse nodular lymphoid hyperplasia (DNLH) of the intestine is an extremely rare lymphoproliferative disorder occasionally associated with non-Hodgkin lymphomas. We report an unusual case of DNLH of the entire colon, which resembled malignant lymphoma (particularly low-grade B-cell lymphoma) both on clinical and pathologic grounds. The patient was a 62-year-old Japanese woman who was found to have multiple polypoid lesions along the entire large intestine by colonoscopy. Abdominal computed tomography revealed hepatosplenomegaly and multiple mesenteric lymphadenopathy. Histologically, the lesion was characterized by numerous lymphoid follicles with active germinal centers and a diffuse infiltrate of lymphoid cells in the mucosa and submucosa. The present case appears to be an essentially benign condition bearing a resemblance, both clinically and histologically, to malignant lymphoma, and from which it can be distinguished by use of immunohistochemical or molecular analysis.
Pancreatic Cystic Dysplasia (Dysgenesis) Presenting as a Surgical Pathology Specimen in a Patient with Multiple Malformations and Familial Ear Pits
Authors: Drut Ricardo , Drut Monica
Published: June 2007

A peculiar 6 x 5 x 3 cm, multilobed, septated, cystic tumor presented in the tail of the pancreas in a 5-month-old infant with left ear pit, bilateral cleft palate, brachydactyly type B, and familial ear pits. This combination was not found previously reported. The cysts were lined by attenuated epithelium and PAS-positive, mucus-containing cells. These were keratin 8-, 18-, and 19-positive and CA 19.9-negative. Ductuloinsular complexes were present in the adjacent pancreatic tissue. Pancreatic cystic dysplasia (dysgenesis) may associate with several malformation syndromes. A similar lesion may present isolated as a tumor in the first year of life and has been reported under a variety of names (hamartoma, cystadenoma, and cyst). The lesion does not fit with the criteria of cystadenomas as seen in adults.
Immunohistochemical Markers of Melanocytic Tumors
Authors: Yaziji Hadi , Gown Allen M.
Published: June 2007

While historically detection of premelanosomes by electron microscopic studies was the only means possible of confirming melanocytic lineage of a neoplastic process, advances in the field of immunohistochemistry have allowed for accurate and reliable diagnosis using antibodies to 1 of a number of melanocyte-restricted proteins. S-100 was the first such marker exploited by immunohistochemistry; subsequently, the HMB45 monoclonal antibody to gplOO became widely used as a sensitive and specific melanocytic marker. More recently, antibodies to other melanocytic proteins have become available, inciuding the MART-1 gene product and microphthalmia transcription factor. This article provides a brief overview of these markers in terms of their specificity and sensitivity and offers a discussion of tumors with partial melanocytic differentiation.
Double Immunolabeling by the RBM and the PLAP Markers for Identifying Intratubular (in Situ) Germ Cell Neoplasia of the Testis
Authors: Schreiber Letizia , Lifschitz-Mercer Beatriz , Paz Gedalia , Yavetz Haim , Elliott David J. , Kula Krzysztof , Slowikowska-Hilczer Jolanta , Maymon Batia Bar-Shira
Published: June 2007

Identification of intratubular germ cell neoplasia (carcinoma in situ, CIS) of the testis is a diagnostic challenge, and markers are sorely needed to assist in accurately identifying the lesion. RNA-binding motif (RBM) protein, encoded by the Y chromosome, is expressed exclusively and consistently in differentiated male germ cells, while it is absent in neoplastic germ cells. Another immunohistochemical marker, placental alkaline phosphatase (PLAP), is commonly used for the detection of undifferentiated germ cells. The current study demonstrates that simultaneous use of the immunohistochemical markers, RBM and PLAP, by double immunolabeling enhances the accuracy of diagnosing CIS, a preinvasive testicular neoplasm.
Angiogenesis Relates to Estrogen Receptor Negativity, c-erbB-2 Overexpression and Early Relapse in Node-Negative Ductal Carcinoma of the Breast
Authors: Koukourakis Michael I. , Manolas Costantinos , Minopoulos George , Giatromanolaki Alexandra , Sivridis Efthimios
Published: June 2007

Tumor angiogenic activity is an important process linked to tumor growth, metastasis, and invasion. In the present study we investigated whether intratumoral microvessel density (MVD), as assessed with immunohistochemistry, is of prognostic relevance in a series of 77 breast cancer patients with node-negative disease. The mean MVD in the hot spots ranged from 9 to 106 (median 31) vessels per x200 optical field. Patients were grouped into 3 categories of low (27 pts), medium (26 pts), and high (24 pts) MVD. Angiogenesis was not related to the primary tumor dimensions (T-stage) or the histology differentiation. An inverse association of MVD with estrogen receptor (ER) expression was noted (p=0.0007), while high MVD was directly related to c-erbB-2 overexpression (p=0.04) and high MIB 1 proliferation index (p=0.02). In univariate and multivariate analysis of relapse-free survival, MVD was the only variable significantly and independently linked to relapse. It is concluded that high intratumoral angiogenic activity is linked with early relapse in node-negative breast cancer.
Metastatic Pleural Mesothelioma Presenting with Solitary Involvement of the Tongue
Authors: Zanconati Fabrizio , Delconte Alessandro , Bonifacio-Gori Daniela , Falconieri Giovanni
Published: June 2007

We report a new case of mesothelioma that presented with an isolated lingual metastasis 14 months after initial diagnosis. The patient was a 71-year-old man with a history of pleural decortication and chemotherapy for epithelioid mesothelioma who recently complained of chronic bleeding from a nodular consolidation of tongue. There was no clinical or instrumental evidence of extrathoracic tumor spread. Microscopic examination of a lingual biopsy specimen revealed nests of atypical polygonal cells with moderate cytoplasm, immunopositive for keratins, epithelial membrane antigen, vimentin, thrombomodulin, and calretinin. This case provides additional evidence that mesothelioma could rarely, but not exceptionally, metastatize, to unusual sites such as the tongue. In that location it can mimic primary poorly differentiated squamous carcinoma or adenocarcinoma as well as a number of other metastatic malignancies. In addition to obvious medicolegal implication, metastatic mesothelioma should be correctly recognized so as to avoid useless radical treatment.
Correlation Between Histologic Staging, Hepatitis C Virus Genotypes and Clinical Features in HCV Chronic Hepatitis: Evidence of A New Pattern
Authors: Di Tommaso L. , Macchia S. , Morandi L. , Leoncini S. , Pession A. , Dal Monte P. R. , Foschini M. P.
Published: June 2007

Genome heterogeneity may be related to the wide variability of clinical and pathological features in hepatitis C virus (HCV)-related chronic liver disease. This paper addresses the possible association between HCV subtypes and clinical and histological features of chronically infected patients. Sixty-eight consecutive liver biopsies of chronic hepatitis constituted the basis of the study. HCV genotyping was performed on frozen tissue. Grading of necroinflammatory activity and staging of fibrosis were histologically assessed. Serologic HCV-RNA and liver function were assessed at the same time. All information was compared with clinical data including age, sex, HCV serology, and probable data and route of infection. Two cases were excluded as inadequate tissue was available. Five cases were negative to HCV-RNA in both serum and tissue. In 61 cases HCV RNA was present at the same time in serum and liver tissue. Forty-four patients were men (72%) and 17 (28%) were women. Two peaks of age were observed: 1 in the 4th decade of life, the 2nd in the 7th. The 2 groups had different HCV genotypes. Patients with genotypes lb (mean age 50.7 years), 2c (mean age 61.3 years), and a subgroup of coinfections (mean age 60 years) were older than patients with genotypes la (mean age 35.5 years), 3 (mean age 36 years), and a subgroup of coinfections (mean age 33 years). Patients with genotypes lb, 2, or 2c and a subgroup of coinfections more frequently had a history of blood transfusion and or surgical intervention dating up to 49 years previously. Patients with HCV la, 3, and a subgroup of coinfections frequently admitted a period of intravenous drug abuse. Patients with advanced liver disease, i.e., severe fibrosis and cirrhosis, showed the same 2 peaks of incidence: in the 4th and 7th decades of life, the first group mainly comprising patients with HCV types la and 3, the second, patients with HCV types lb and 2c. Both these groups shared a clinical history of a long-standing infection. Two profiles of patients emerged. The largest group was composed of elderly patients, infected by HCV genotypes lb or 2c, with a history of blood transfusion and/or surgery, presenting an advanced stage of liver disease (namely, severe fibrosis or cirrhosis). The second group was composed of younger patients, mainly in the 4th decade of life, infected by HCV types 3 or la, often presenting with chronic hepatitis in the stage of severe fibrosis or cirrhosis. The latter could be the profile of HCV infection in the near future
Microsatellite Analysis of Early Stage (la-Ilb) Uterine Cervical Squamous Carcinoma
Authors: Clarke B. , Gordon M. , Moodley M. , Naidoo R. , Chetty R.
Published: June 2007

Cervical cancer is the most common gynecologic malignancy of the developing world. The oncogenic role of human papilloma virus (HPV) is well known. Attention is now focusing on the complicit genetic changes, which allow progression of these tumors. Regarding these changes, deletion of tumor suppressor genes (loss of heterozygosity [LOH]) is the preferred pathway of progression with only a subset manifesting microsatellite instability (MSI). Implicated loci include 3pl4.1-22. Several studies suggest that the mutator phenotype in cervical cancer may correlate with higher grade tumors, more advanced disease stage, and poor outcome. Unlike colorectal cancer, in which an inverse relationship has been demonstrated between microsatellite instability and loss of heterozygosity, cervical cancers expressing MSI have been found to coexpress LOH at other loci. In this study we analyzed 8-microsatellite loci including p53, DCC, APC, the MMR gene hMLHI and 2 regions of interest on chromosome 3 in a high-risk population group in which HPV infection is endemic.
Pathologic Analysis of Right-Lobe Graft Failure in Adult-to-Adult Live Donor Liver Transplantation
Authors: Pantanowitz Liron , Pomfret Elizabeth A. , Pomposelli James J. , Lewis W. David , Gordon Frederic D. , Jenkins Roger L. , Khettry Urmila
Published: June 2007

Live donor adult liver transplantation (LDALT) utilizing right-lobe grafts is now acceptable as an alternative to cadaveric orthotopic liver transplantation (OLT). However, some LDALTs fail and require urgent OLT or result in recipient death. Our aim was to determine the basis of LDALT failure. Liver specimens from 49 LDALT recipients were evaluated and the findings correlated with clinical outcome. Ten patients (20.4%) had either early (< 1 month) or late (> 1 month) graft failure. Eight early failures, 7 of which occurred among our first 25 cases, were due to extensive liver parenchymal necrosis as a result of hepatic artery thrombosis (n=3), portal vein thrombosis (n= 1), hyperperfusion syndrome (n= 1), complete graft thrombosis (n= 1) with Factor V Leiden on a regimen of therapeutic heparin (n=1), sepsis and concomitant graft dysfunction with venous outflow tract injury (n=I), and venous outflow tract thrombosis and parenchymal thermal injury with sepsis (n=1). Preoperative, intraoperative, or postoperative severe vessel wall injury was evident in 6/8 early failures. TWo patients had late graft failure, 1 from recurrent hepatitis C and 1 with sepsis/multisystem organ failure. There were no significant differences in graft size, rejection episodes, or operative or ischemic times between patients with and without graft failure. In conclusion, LDALT failed in 10/49 (20%) of our patients, with 8/10 occurring within 1 month post-LDALT owing to vascular/thrombotic complications experienced during the early phase of our institutional experience. Perioperative vessel wall injury appeared to be a major factor in predicting early graft loss.
Renal Oncocytosis Presenting in Childhood: A Case Report
Authors: Chen Terina S. , McNally Melanie , Hulbert William , di Sant'Agnese P. Anthony , Huang Jiaoti
Published: June 2007

Renal oncocytosis is a rare condition in which a spectrum of oncocytic lesions, including oncocytomas, diffusely involve the kidney. Few cases have been reported and all were in adult patients. We report here such a case in a 12-year-old girl. In addition to the unusual age at presentation, this case is remarkable for its heterogeneous tumor morphology, with some areas containing chromophobe carcinoma-like cells. Electron microscopy, immunohistochemistry, Hale's colloidal iron staining, and cytogenetics were performed to further evaluate the different morphologic areas. Our results suggest that the cells in the chromophobe carcinoma-like areas do not fulfill all the diagnostic criteria of chromophobe carcinoma. We caution pathologists in making a malignant diagnosis in such cases, especially in younger patients.
Primary Intrapulmonary Spindle Cell Thymoma with Marked Granulomatous Reaction: Report of a Case with Review of Literature
Authors: Srivastava Amitabh , Padilla Osvaldo , Alroy Joseph , Ucci Angelo , Pilichowska Monika , Daley Benedict , Wolfe Hubert J.
Published: June 2007

Primary intrapulmonary thymoma is a rare lesion with around 20 cases reported so far in the literature. A pure spindle cell morphology in these lesions is rarer still with only a single case recorded to date. We report herein an interesting case of a 47-yearold-man, status post surgical resection and radiotherapy for a squamous cell carcinoma of the floor of mouth, who was being followed up for a radiologic opacity in the right lower lobe of the lung. The lesion remained stable in size for almost 5 years and then an increase in size was noted. A right lower lobectomy was performed with a preoperative suspicion of metastasis. Histologic and immunohistochemical evaluation revealed a primary intrapulmonary spindle cell thymoma that displayed a prominent granulomatous reaction, a phenomenon not described so far in the literature. We discuss the possible embryologic origins and the pitfalls in diagnosis of these rare neoplasms. The remarkable granulomatous response observed in the tumor raises the possibility that similar lesions might conceivably occur in the thymus as well.
“Stromatogenesis” and Tumor Progression
Authors: Sivridis Efthimios , Giatromanolaki Alexandra , Koukourakis Michael I.
Published: June 2007

“Stromatogenesis” is the formation of new stroma occurring, in parallel with the neoplastic process, at sites of active tumor invasion, i.e., at the free surface of a developing exophytic tumor, at the invading tumor front of an advancing endophytic tumor, and at sites of tumor metastasis, wherein the newly formed stroma disrupts the continuity of normal structures, cleaving paths for the invading tumor cells. Stroma is also present at the heart of the tumor, but only as a secondary event following tumor advancement and subsequent incorporation of its periphery into inner tumor areas. The new stroma, composed of stromal cells and extracellular matrix (ECM), is loose and edematous at the expanding tumor fronts, and rather dense in central tumor areas and sites of tumor metastasis. The stromal cells facing tumor invasion are intensely proliferating (high MIB-1 index) spindle-shaped cells, cc-smooth muscle actin positive, and loaded with thymidine phosphorylase (TP) and SPARC (secreted protein acidic and rich in cysteine). The associated ECM is rich in collagen III, SPARC, and new blood vessels (CD31) but is depleted of collagen I and fibronectin. These constitutional changes render stromatogenesis amenable to tumor cell invasion and are, in cases of incipient neoplasia, a prospective criterion of early stromal invasion. Other stromal cell or ECM constituents, such as the lactate dehydrogenase-5 (LDH-5), the acidic fibroblast growth factor (aFGF), the basic FGF (bFGF), and the collagens II and IV, remain unchanged, and others are negative: myosin, desmin, S-100 protein and epidermal growth factor receptor (EGFR). The mechanism of stromatogenesis is obscure but is probably stimulated by specific stromatogenic growth factors, released by neoplastic and inflammatory cells. It appears that the process is neither neoplastic nor reactive, but rather is a, hereto unexplained, phenomenon of host's complicity in tumor progression.
Tenascin C and Cathepsin D Expression in Adipocytic Tumors: An Immunohistochemical Investigation of 43 Cases
Authors: Sis Banu , Tuna Burcin , Yorukoglu Kutsal , Kargi Aydanur
Published: June 2007

Cathepsin D (CatD) and tenascin C (Tn-C) have been implicated in invasion and metastasis of carcinomas. However, little is known about CatD and Tn-C distribution in mesenchymal tumors. Therefore, we aimed to investigate the expression of Tn-C and CatD in adipocytic tumors. Tn-C and CatD expressions in 27 lipomas, 5 atypical lipomatous tumor/well-differentiated liposarcomas (ALT/WDLS) and 11 liposarcomas (LS) were evaluated by immunohistochemistry and scored semiquantitatively. CatD expression was higher in ALT/WDLS than in lipomas (p<0.001), and higher in LS than in ALT/WDLS (p=0.009). Stromal Tn-C expression was higher in ALT/WDLS than in lipomas (p=0.02), but no difference was observed between ALT/WDLS and LS (p>0.05). These results indicate that Tn-C and CatD may be markers of locally aggressive or malignant behavior in adipocytic tumors.