bluuebunny/crossref_metadata_2025 huggingface dataset:
A Rapid Test for Heroin (3,6‐Diacetylmorphine) Based on Two Chemiluminescence Reactions
Authors: Agg Kent M. , Craddock Adrian F. , Bos Richard , Francis Paul S. , Lewis Simon W. , Barnett Neil W.
Published: August 2006

ABSTRACT: A rapid method for screening drug seizure samples for 3,6‐diacetylmorphine (heroin), which consists of a simple hydrolysis procedure and flow‐injection analysis with two chemiluminescence reagents, is described. Before hydrolysis, 3,6‐diacetylmorphine evokes an intense response with a tris(2,2′‐bipyridyl)ruthenium(III) reagent (prepared by dissolving the perchlorate salt in acetonitrile), and a relatively weak chemiluminescence response with a second reagent: potassium permanganate in an aqueous acidic polyphosphate solution. However, the permanganate reagent is extremely sensitive toward the hydrolysis products of 3,6‐diacetylmorphine (i.e., 6‐monoacetylmorphine and morphine). Some compounds commonly found in drug laboratories may cause false positives with tris(2,2′‐bipyridyl)ruthenium(III), but do not produce the markedly increased response with the permanganate reagent after the hydrolysis procedure. The combination of these two tests therefore provides an effective presumptive test for the presence of 3,6‐diacetylmorphine, which we have verified with 14 samples obtained from a forensic science laboratory.
Suicidal Asphyxiation by Inhalation of Automobile Emission without Carbon Monoxide Poisoning
Authors: DeRoux Stephen J.
Published: August 2006

ABSTRACT: Reported herein is the suicidal asphyxiation of a young man due to exhaustion of oxygen in the interior of a sealed automobile into which the exhaust emissions were diverted. His blood carboxyhemaglobin concentration was less than 5% saturation. The car was equipped with a catalytic converter and when tested, the exhaust carbon monoxide concentration was 0.01%.
Yield of Illicit Indoor Cannabis Cultivation in The Netherlands
Authors: Toonen Marcel , Ribot Simon , Thissen Jac
Published: August 2006

ABSTRACT: To obtain a reliable estimation on the yield of illicit indoor cannabis cultivation in The Netherlands, cannabis plants confiscated by the police were used to determine the yield of dried female flower buds. The developmental stage of flower buds of the seized plants was described on a scale from 1 to 10 where the value of 10 indicates a fully developed flower bud ready for harvesting. Using eight additional characteristics describing the grow room and cultivation parameters, regression analysis with subset selection was carried out to develop two models for the yield of indoor cannabis cultivation. The median Dutch illicit grow room consists of 259 cannabis plants, has a plant density of 15 plants/m2, and 510 W of growth lamps per m2. For the median Dutch grow room, the predicted yield of female flower buds at the harvestable developmental stage (stage 10) was 33.7 g/plant or 505 g/m2.
Phospho‐Stat3 expression and correlation with VEGF, p53, and Bcl‐2 in gastric carcinoma using tissue microarray
Authors: CHOI JUNG‐HYE , AHN MYUNG‐JU , PARK CHAN‐KUM , HAN HONG‐XIU , KWON SUNG‐JOON , LEE YOUNG‐YUEL , KIM IN‐SOON
Published: August 2006

The signal transducer and activator of the transcription (Stat)‐family of proteins are latent cytoplasmic transcription factors that transmit signals from cytokines and growth‐factor receptors to the nucleus. Stat proteins, especially Stat3 and Stat5, are constitutively activated in various solid tumors and hematological malignancies. However, the role of Stat3 signaling in gastric carcinoma has not yet been fully determined. This study was conducted to investigate the clinical value of phospho‐Stat3 expression in gastric carcinoma. Expression of phospho‐Stat3 (Tyr705), vascular endothelial growth factor (VEGF), p53, and Bcl‐2 was determined by immunohistochemical staining of tissue microarrays from 137 cases of resected gastric cancer specimens. We evaluated the relationships among phospho‐Stat3, VEGF, p53, and Bcl‐2 expression and the correlation between expression of these proteins and various clinicopathological factors, including overall survival. Phospho‐Stat3 nuclear expression was observed in 18.2% of the cases. Of the total number of cases, 68.6% were positive for VEGF, 40.1% for p53, and 11.7% for Bcl‐2. Phospho‐Stat3 expression correlated with VEGF (p=0.021) and Bcl‐2 (p=0.005) expression. Positive phospho‐Stat3 staining was significantly associated with poor pathological grade. However, there was no significant difference in other clinicopathological parameters, such as tumor stage (T, N, M), pathological type, relapse‐free survival, and overall survival between the phospho‐Stat3‐positive and ‐negative groups. Co‐expression of phospho‐Stat3 and VEGF was found in many patients with N3 and Stage IV disease. These results suggest that phospho‐Stat3 expression might be associated with angiogenesis, anti‐apoptosis, and tumor progression. Further studies are needed to determine the role of phospho‐Stat3 in gastric cancer.
Mutational analysis of the CASP6 gene in colorectal and gastric carcinomas
Authors: LEE JONG WOO , KIM MEE RAN , SOUNG YOUNG HWA , NAM SUK WOO , KIM SANG HO , LEE JUNG YOUNG , YOO NAM JIN , LEE SUG HYUNG
Published: August 2006

Failure of apoptosis is one of the hallmarks of cancer. As an execution‐phase caspase, caspase‐6 plays a crucial role during apoptosis. To explore the possibility that the genetic alterations of CASP, which encodes caspase‐6, might be involved in the development of human cancers, we analyzed the entire coding region and all splice sites of the human CASP6 gene for the detection of somatic mutations in 100 colorectal carcinomas and 50 gastric carcinomas. Overall, we detected three somatic mutations of the CASP6 gene, including two missense mutations and one splice‐site mutation. The mutations were observed in two of the 100 colorectal carcinomas (2.0%) and one of the 50 gastric carcinomas (2.0%). Of note, one colorectal carcinoma with the CASP6 mutation harbored CASP3 and CASP8 gene mutations as well. We also analyzed caspase‐6 expression by immunohistochemistry, and found that caspase‐6 was expressed in 60% of the gastric cancers and 90% of the colorectal cancers. This is the first report on CASP6 gene mutations in human cancers, and these data indicate that the CASP6 gene is occasionally mutated in gastric and colorectal carcinomas. Also, the data suggest the possibility that deficiency of caspase‐6 expression might contribute to the pathogenesis of gastric cancers.
High incidence of intravascular focus in nontyphoid Salmonella bacteremia in the age group above 50 years: a population‐based study
Authors: NIELSEN H. , GRADEL K. O. , SCHØNHEYDER H. C.
Published: August 2006

Questions regarding the relative frequency of vascular complications in nontyphoid Salmonella bacteremia are pending, and the true population‐based age‐related incidence is not known. We reviewed all cases of nontyphoid Salmonella bacteremia during a 10‐year period from 1994 through 2003 in a well‐defined population of 492,843 residents in North Jutland County, Denmark. 77 of a total of 111 cases occurred in patients >50 years old. In this age group, five cases of mycotic aneurysm and two cases of endocarditis were documented, corresponding to a 9% occurrence. The annual incidence rate of endovascular nontyphoid Salmonella infection in this age group was 4.4 per 1,000,000 person years. The mortality was 43% in cases with endovascular infection, and surgical procedures were important for survival. We conclude that in patients older than 50 years, detection of nontyphoid Salmonella bloodstream infection should be followed by examinations for mycotic aneurysms and endocarditis.
Application of virtual reality force feedback haptic device for oral implant surgery
Authors: Kusumoto Naoki , Sohmura Taiji , Yamada Shinichi , Wakabayashi Kazumichi , Nakamura Takashi , Yatani Hirofumi
Published: August 2006

Abstract:A novel support system for implant surgery was tried out, which involves manipulating a three‐dimensional (3‐D) computed tomography (CT) image of a jawbone with a virtual reality force feedback haptic device. Through this virtual system, the haptic experience of bone drilling with vibration and the sound of the contra‐angle handpiece could be realized. It is expected to be useful for training inexperienced dentists and educating dental students. The simulation of oral implant insertion was also focused on. A simple cylindrical implant model was inserted into a 3‐D image of the jawbone by operating the haptic device, with consideration of bone condition. A rectangular solid object that served as a bone‐supported surgical template was adopted, and the shapes of the bone and the implant were subtracted from the object. In this manner, the CAD of the surgical template with impressions of the bone and the implant guide holes for insertion was realized. The surgical template was milled with a computer‐controlled milling machine (CAM). Surgical template accuracy was examined with an edentulous gypsum bone model having six holes for implant insertion. Simulation of the oral implant insertion and CAD/CAM of the surgical template were conducted. The milled surgical template was fitted on the gypsum bone model, and CT images were taken. Cross‐sections of the guide holes in the surgical template were imaged, and misalignment between the guide holes of the surgical template and the drilled holes on the jawbone was measured. The average misalignment is less than 0.2 mm, and it indicates that the present system is potentially applicable to oral implant surgery.
Sinus histiocytosis with massive lymphadenopathy (Rosai‐Dorfman disease): case report with nodal and diffuse muco‐cutaneous involvement
Authors: Innocenzi D. , Silipo V. , Giombini S. , Ruco L , Bosman C. , Calvieri S.
Published: August 2006

Sinus histiocytosis with massive lymphadenopathy (SHML) (Rosai‐Dorfman disease) is a rare self‐limited histiocytic disorder of unknown origin, usually present with cervical lymphadenopathy, fever, elevated ESR and haematologic abnormalities. Extranodal lesions may occur as initial manifestations ofthe disease. In most cases skin lesions are associated with nodal or extranodal localization. A 54‐year‐old male is reported who, for a period of ten months, presented numerous slowly enlarging, rounded papular lesions on the face, neck, trunk as well as severe cervical lymphadenopathy without general and haematological disturbances. Thereafter a fungating mass developed in the nasal cavity. Histological, histochemical and immunohistochemical tests of skin, mucosal and lymph‐node lesions were consistent with a diagnosis of SHML. The immunohistochemical characterization of the cytophagocytic S‐100+ macrophages revealed that they were highly positive for the adhesion molecules Vitronectin receptor av/b3, which is used by tissue macrophages for removal of effete cells through phagocytosis.
Expression of basement membrane antigens in spindle cell melanoma
Authors: Prieto Victor G. , Woodruff James M.
Published: August 2006

Spindle cell melanoma (SCM) is an uncommon form of melanoma that may be confused histologically with other tumors, including malignant peripheral nerve sheath tumors (MPNST). Tumors with neural differentiation and melanocytic nevi may both show basement membrane immunohistochemically and at the ultra‐structural level. However, most ultrastructural studies of melanoma have failed to demonstrate well formed basement membrane around tumor cells. The presence of basement membrane has been used by some authors as evidence favoring MPNST, as opposed to SCM. To evaluate this distinction immunohistochemically, 22 primary and metastatic cutaneous melanomas having a spindle cell component (SCM) were studied using monoclonal antibodies against laminin and Type IV collagen. S100 protein and HMB45 antigen expression were also studied. All but one of the SCM were reactive for S100 protein in at least 25% of the cells. Thirteen of 20 tumors (65%) were focally reactive witb HMB45. Laminin was expressed in 42% of the tumors (only membranous pattern in 3; cytoplasmic and membranous in 5). Seventeen tumors (77%) expressed type IV collagen (only membranous pattern in 7; cytoplasmic and membranous pattern in 10). Laminin and type IV collagen, known components of basement membrane, are often found in SCM. Therefore, their detection cannot be used to distinguish SCM from MPNST.
Angiolymphoid hyperplasia with eosinophilia presenting multinucleated cells in histology: an ultrastructural study
Authors: Sakamoto F. , Hashimoto T. , Takenouchi T. , Ito M. , Nitto H.
Published: August 2006

A case of angiolymphoid hyperplasia with eosinophilia arising on the face of a woman is reported. Histologically, the uniqueness of this case is the presence of multinucleated cells (MNCs), besides the conventional dermal changes. Electron microscopy showed that some of the apparent MNCs are clusters of endothelial cells forming immature vascular lumens with numerous microvilli, and the other MNCs displayed the recognized features of fibrohistiocytic or myofibroblastic cells. Immunohistochemically, some MNCs were positive for Ulex europaeus agglutinin and Factor VIII‐related antigen. From these findings, some of the MNCs are histologically endothelial sprouts, and the others are fibrohistiocytic cells in the present case.
Extravulvar subcutaneous cellular angiofibroma
Authors: Garijo M. Francisca , Val‐Bernal J. Fernando
Published: August 2006

Cellular angiofibroma is a rare distinctive mesenchymal neoplasm of the vulva or perineal region. We report here one unique extravulvar case. A 43‐year‐old woman presented with an asymptomatic tumor, 7 cm in diameter, located in the subcutaneous tissue of the chest below the left submammary sulcus. Histologically, the lesion was composed of uniform spindled stroma cells, numerous thick‐walled vessels, and scarce mature adipocytes. An additional feature was the presence of prominent perivascular lymphoid aggregates. The stromal cells were positive for vimentin and negative for CD34 and muscle, epithelial, myoepithelial, or neural markers. Although nasopharyngeal angiofibroma or the group of acral angiofibromas have a concurrent heading, cellular angiofibroma should not be mistaken with them. Differential diagnosis of this distinctive tumor especially includes aggressive angiomyxoma, angiomyofibroblastoma, superficial angiomyxoma, vascular myxolipoma, and other tumors with spindle cells reminiscent of those in angiofibroma.
Cutaneous fibrous perineurioma
Authors: Smith Kathleen , Skelton Henry
Published: August 2006

Tumors of perineurial origin are rare. Three variants of perineuriomas have been described, a storiform perineurial fibroma, an intraneural perineurioma, and a recently described sclerosing perineurioma. We present two patients with cutaneous fibrous perineurioma located in acral areas. Both tumors had a deep circumscribed margin with a prominent vascular component. They contained small round cells and spindle cells that express EMA and show membrane staining for type IV collagen. Cutaneous fibrous perineuriomas fit within the spectrum of neurocristicly derived cellular proliferations.
Cutaneous Langerhans cell histiocytosis of the genitalia in the elderly: a report of three cases
Authors: Meehan Shane A. , Smoller Bruce R.
Published: August 2006

Langerhans cell histiocytosis (LCH) is a disease with a broad spectrum of clinical presentations. All of the variants have in common the proliferation of cells which are morphologically, biochemically, and immunophenotypically indistinguishable from Langerhans cells. A retrospective study of three eldetly patients revealed the unique presentation of cutaneous Langerhans cell histiocytosis limited to the genitalia. These cases produced a diagnostic challenge because of their unusual clinical presentation and their morphological similarity to certain other entities, including extramammary Paget's disease and malignant melanoma, which may also show S‐100‐positive atypical cells. All three cases showed infiltrates of histiocytic‐appearing cells with folded nuclei and moderate amounts of cytoplasm which involved the epidermis, dermis, or both. Immunoperoxidase studies using antibody to S‐100, CD1a and CD68 in each case showed positive staining.
Hermansky‐Pudlak syndrome: report of a case with histological, immunohistochemical and ultrastructural findings
Authors: Husain Sameera , Marsh Elizabeth , Saenz‐Santamaria M. Carmen , McNutt N. Scott
Published: August 2006

We report a 38‐year‐old female of Puerto Rican descent with Hermansky‐Pudlak syndrome and decreased levels of von Wille‐brand factor. Histologic and ultrastuctural findings of non‐sun‐exposed skin showed melanocytes with short dendritic processes and decreased numbers of melanosomes. Ultrastructutal examination of platelets revealed greatly reduced numbers of delta granules. Recognition of this syndrome is important because skin neoplasms, ceroid deposition and hemorrhagic manifestations can be causes of morbidity and of potential death in patients affected with this syndrome.
Subcutaneous panniculitis‐like T‐cell lymphoma: further evidence for a distinct neoplasm originating from large granular lymphocytes of T/NK phenotype
Authors: Dargent Jean‐Louis , Roufosse Candice , Delville Jean‐Pierre , Kentos Alain , Delplace Jérôme , Kornreich Anne , Cochaux Pascale , Hilbert Pascale , Pradier Olivier , Feremans Walter
Published: August 2006

We report the case of a 20 year‐old caucasian woman who presented a primary subcutaneous panniculitis‐like T‐cell lymphoma (SPTCL) as an invasive tumor of the chest wall. Herein, the neoplastic cells were found to express a CD3+CD8+ phenotype but also displayed variably the natural killer (NK)‐associated antigens CD56 and CD57 as well as granzyme B. On cytological examination, these cells showed a large granular lymphocyte (LGL)‐like morphology with presence of azurophilic granules in their cytoplasm. Electron dense and membrane bound granules like those found in cytotoxic T lymphocytes (CTL) were also demonstrated by electron microscopy. Neither rearrangement of the T‐cell receptor subunits nor Epstein‐Barr virus (EBV) genome was observed at the molecular level. The LGL‐like features of the neoplastic cells found in this case and the presence of NK‐associated antigens provide additional support to the cytotoxic derivation of most SPTCL.
DNA content and cell proliferation in giant congenital melanocytic naevi (GCMN)
Authors: Hankard G Fromont , Fraitag S. , Wolter M. , Brousse N. , Masood S.
Published: August 2006

GCMN may be precursors of melanoma, and it has been suggested that the presence of atypical foci could increase the risk of malignant transformation. In order to better define atypical GCMN, we analyzed DNA content and proliferative activity in 21 samples of GCMN, with (n=13) or without (n=8) cytologic atypia. Six benign acquired naevi (AN) and 6 malignant melanoma (MM) were used as controls. DNA content was determined with the CAS 200 image analyzer, and DNA histograms were classified according to the Auer classification. The proliferative indices (PI) were measured after Ki 67 immunostaining using the CAS 200 system. All AN and GCMN without atypia showed class I histograms (normal DNA content) and low PI (mean 1.9 and 2.1). Atypical GCMN showed in 10 cases an abnormal DNA content (class III or IV histograms) with low PI (mean 2.7), and in 3 cases a normal DNA content (class I histograms) with higher PI (mean 16.2). All MM displayed abnormal DNA content and high PI (mean 32.6). In conclusion, abnormal DNA content seems to correlate with cytologic atypia in GCMN. Atypical GCMN exhibit an overall pattern of DNA content and cell proliferation intermediate between non‐atypical naevi and MM.
Composite tumor consisting of dermatofibrosarcoma protuberans and myxoflbrosarcoma
Authors: Zámečník Michal , Michal Michal , Mukenšnábl Petr
Published: August 2006

A unique case of a composite tumor consisting of dermatofibrosarcoma protuberans and low‐grade myxofibrosarcoma is described. The myxofibrosarcoma component formed 70% of the lesion volume. Both components protruded above the skin, and equally both infiltrated the subcutaneous tissue in the base of the lesion. The interface between them was mostly sharp but some small areas of gradual transition were also seen. Beside fibrosarcoma arising in the dermatofibrosarcoma protuberans, myxofibrosarcoma seems thus to be another possible manifestation of the change into a more malignant tumor rarely seen in the dermatofibrosarcoma protuberans.
Basal cell carcinoma with prominent central palisading of epithelial cells mimicking schwannoma
Authors: Juan J. San , Monteagudo C. , Navarro P. , Terrádez J. J.
Published: August 2006

Basal cell carcinoma (BCC), the most common malignant neoplasm of skin, may show a wide spectrum of histologic appearances. The presence of peripheral palisades is a very characteristic feature of BCC but, to our knowledge, central nuclear palisading has never been described. We report two cases of BCC exhibiting striking central nuclear palisading with Verocaylike bodies, in a pattern reminiscent of schwannoma. Peripheral palisades and clefts were also present in most tumor nodules and lobules, giving the neoplasms the overall configuration of otherwise typical solid BCC. In addition, foci of conventional BCC could be found adjacent, and in transition, to schwannoid areas. The immunohistochemical study showed strong reactivity for keratins (AE1 and AE3) in tumor cells, whereas no immunostaining for S‐100 or muscle‐specific actin was found. This previously undescribed histological feature of BCC should lead us to include BCC in the list of tumors to be considered in the differential diagnosis of a cutaneous neoplasm with schwannoid features.
Primary invasive signet‐ring cell melanoma
Authors: Breier Friedrich , Feldmann Robert , Fellenz Christian , Neuhold Nikolaus , Gschnait Friedrich
Published: August 2006

The histopathological variants of malignant melanoma include the common type (lentigo maligna, superficial spreading melanoma, nodular melanoma, acrolentiginous melanoma), spindle cell, desmoplastic, balloon cell, pleomorphic (fibrohistiocytic), myxoid, small cell melanoma and malignant blue nevus. Recently, signet‐ring cell melanoma was introduced as an additional cytologic variant. We describe a 72‐year‐old patient with a primary signet‐ring cell melanoma of the skin located on the upper arm. Histopathologic examination disclosed a melanocytic tumor extending from the epidermis to the deep reticular dermis. Numerous pleomorphic tumor cells showed large, intracellular vacuoles and oval to spindle‐shaped nuclei at their periphery. Milotic figures and multinucleated melanocytes were also observed. Some of the signet‐ring cells exhibited cytoplasmatic periodic acid‐Schiff (PAS)‐positivity. Immunohistochemistry showed positive reaction of the tumor cells for S‐100, HMB‐45 protein and vimentin, confirming their melanocytic differentiation. Tumor cells were negative for cytokeratins, epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA). The signet‐ring cell melanoma disclosed an invasion to Clark Level IV and tumor thickness of 2.2 mm. Signet‐ring cell melanoma is a rare morphologic variant of melanoma. Its recognition is important for differentiation from other tumors featuring signet ring cells.
Intravascular angioleiomyoma
Authors: Sajben F. Paul , Barnette David J. , Barrett Terry L.
Published: August 2006

A 59‐year‐old man presented with a 6‐year history of a 2‐cm tender nodule on his left lateral elbow. Excisional biopsy led to the diagnosis of angioleiomyoma. However, unlike typical angioleiomyoma which demonstrate extravascular extension, this lesion demonstrated purely intravascular growth.
Differential expression of c‐Met in Kaposi's sarcoma according to progression stage and HIV infection status
Authors: Puig Llufs , Fernández‐Figueras María‐Teresa , Penín Rosa‐María , Esquius Mireia , Alomar Agustín , Ariza Aurelio
Published: August 2006

Several cytokines, growth factors and the HIV transactivator Tat have been shown to be involved in the pathogenesis of Kaposi's sarcoma (KS). Hepatocyte growth factor/scatter factor (HGF) is an angiogenic cytokine that stimulates proliferation of spindle cells cultured from human KS lesions. The receptor for HGF, the c‐Met protein, is expressed by endothelial cells, dermal dendrocytes and KS tumor cells both in vitro and in vivo. KS cells synthesize and secrete HGF and express the hepatocyte growth factor receptor (c‐Met), thus providing an autocrine loop for tumor proliferation and neovascularization which can be enhanced by proinflammatory cytokines. We studied the immunohistochemical expression of c‐Met in 40 cases of classical Kaposi's sarcoma (C‐KS) and AIDS‐associated cutaneous Kaposi's sarcoma (AIDS‐KS), including 22 plaque stage lesions (12 AIDS‐KS cases) and 18 tumor stage lesions (7 AIDS‐KS cases). Statistically significant differences in the average intensity of immunohistochemical staining according to the type of lesions (progression stages) and the serologic status ot the patients were identified. The staining intensity of c‐Met was stronger in tumors than in plaques. When only plaques were taken into consideration, the mean staining score was nearly twice as high in C‐KS as in AIDS‐KS.
An immunohistochemical study of the apocrine type of cutaneous mixed tumors with special reference to their follicular and sebaceous differentiation
Authors: Yamamoto Osamu , Yasuda Hiroshi
Published: August 2006

An immunohistochemical analysis of 8 cases of the apocrine type of cutaneous mixed tumor is reported. Histologically, 7 cases of the tumor were suggested to have follicular and/or sebaceous differentiation. Carcinoembryonic antigen (CEA), epithelial membrane antigen and gross cystic disease fluid protein‐15 were present in the inner surface and/or in the luminal cell bodies of the tubular structures. CEA and non‐specific cross‐reacting antigen were also detected in the keratinous cysts. Positive reactions for S‐100 protein and vimentin were observed in the solid nests, the outer layer of the tubular structures and some stromal cells. However, smooth muscle actin was only focally expressed in the outer cells of the tubular nests in one case. Involucrin was positive in the inner layers of the keratinous cysts. Various staining patterns were observed in the keratin immunohistochemistry. The solid nests showed heterogeneous expressions of CK1/5/10/14, CK7, CK10/11, CK14, CK8/18 and CK19. The inner cells of the tubular structures were constantly positive for CK7, CK8/18 and CK19, and heterogeneously for CK1/5/10/14, CK10/11 and CK14. The outer cells were heterogeneously positive for CK1/5/10/14 and CK14. The keratinous cysts showed positive reactions for CK1/5/10/14 throughout the whole cell layers, and for CK14 in the basal layer. The inner layers in some keratinous cysts expressed CK6, CK10/11 and CK17, but only CK10 in others. CK13 was positively stained in the transitional portion between the matricial structure and the column of shadow cells in the cyst wall in only one case. When compared with the immunohistochemistry of the normal skin, the apocrine type of cutaneous mixed tumor can show various immunophenotypical patterns similar to those of entire structures of hair follicles, sebaceous glands and all components of apocrine glands, that is to say, the folliculosebaceous‐apocrine unit.
Expression and localization of thymidine phosphorylase/platelet‐derived endothelial cell growth factor in skin and cutaneous tumors
Authors: Asgari Maryam M. , Haggerty John G. , McNiff Jennifer M. , Milstone Leonard M. , Schwartz Pauline M.
Published: August 2006

Thymidine phosphorylase/platelet‐derived endothelial cell growth factor (TPase/PD‐ECGF) is a catabolic enzyme that has been shown to be chemotactic for endothelial cells in vitro and angiogenic in vivo. TPase/PD‐ECGF expression is increased in a variety of tumors. In the skin, TPase is active in normal keratinocytes in vitro and in vivo. Our objective was to study the expression and localization of TPase/PD‐ECGF by immunohistochemical analysis in normal skin and cutaneous tumors and to correlate this information with enzymatic activity of TPase. TPase/PD‐ECGF expression was observed in keratinocytes with intense staining of the infundibulum of hair follicles but no staining of hair bulbs. Expression localized primarily to the nucleus of keratinocytes in the basal layer but was more intense and cytoplasmic in suprabasal keratinocytes. Increased expression of TPase/PD‐ECGF in differentiated cells was confirmed by in vitro studies of TPase activity. In cutaneous tumors, there was positive staining for TPase/PD‐ECGF in squamous cell carcinomas (10/10), eccrine poromas (3/4), eccrine syringomas (4/4), trichoepitheliomas (1/3), and tumors of the follicular infundibulum (2/3) and melanomas (5/8). There was no staining of any intradermal nevi (0/2), basal cell carcinomas (0/10) or Merkel cell carcinoma (0/1). We conclude TPase/PD‐ECGF is found throughout the epidermis and its expression increases with differentiation of keratinocytes. In cutaneous tumors, expression of TPase/PD‐ECGF may be linked to the cell of origin of the tumor as well as the tumor's degree of differentiation.
Mycosis fungoides and cutaneous Hodgkin's disease in the same patient: a case report
Authors: Geldenhuys L. , Radhi J. , Hull P. R.
Published: August 2006

We describe a case of a 34‐year‐old man who presented with a 10‐year history of mycosis fungoides and recent onset of inguinal lymphadenopathy, fever, and cutaneous nodules on the right hip. Biopsy of the inguinal lymph node showed mixed cellularity Hodgkin's lymphoma. Biopsy of the pre‐existing skin lesions showed mycosis fungoides, while that of the nodules on the hip revealed cutaneous Hodgkin's lymphoma. Immunohistochemical and molecular analysis demonstrated a null phenotype in the Reed‐Sternberg cells of the Hodgkin's disease lesions, and a T‐cell phenotype in the lymphoid cells of the mycosis fungoides lesions. He was treated with chemotherapy for Hodgkin's disease, which is in remission 11 years later. Topical nitrogen mustard and maintenance PUVA therapy have been used for the mycosis fungoides, which is also in remission.
Unilateral angiolymphoid hyperplasia with eosinophilia involving the left arm and hand
Authors: Arnold Michael , Geilen Christoph C. , Coupland Sarah E. , Krengel Sven , Dippel Edgar , Spröder J. , Goerdt Sergji , Orfanos Constantin E.
Published: August 2006

A case report of recurrent angiolymphoid hyperplasia with eosinophilia (ALHE) in an otherwise healthy 20‐year‐old female with manifestation of the disease limited to the left arm and hand is presented together with brief evaluation of the literature as well as the features distinguishing ALHE and Kimura's disease. Immunohistochemical investigations support the hypothesis that ALHE represents a reactive inflammatory lesion rather than a benign vascular neoplasm. A viral cause of ALHE (e.g., HHV8 or Epstein‐Barr virus (EBV); could not be demonstrated. The recurrent nature of the disease is shown by this cases which also demonstrates the need for frequent medical and surgical management.
Graduate students’ experiences with standardized patients as adjuncts for teaching pelvic examinations
Authors: Theroux Rosemary , Pearce Carole
Published: August 2006

Purpose: To explore graduate nurse practitioner students’ perceptions of their experiences when learning to perform pelvic examinations in the laboratory and performing them in subsequent clinical rotations. One group was taught by faculty with voluntary peer examination, and the other two groups were taught by standardized patients (SPs).

Data sources: Surveys with open‐ and closed‐ended (responses on Likert scales) items administered twice during 3 consecutive years to students enrolled in an advanced health assessment course.

Conclusions: All groups reported feeling anxious while learning pelvic exam techniques and in subsequent clinical experiences. SPs provided immediate feedback to students, decreased their feelings of anxiety, and increased their confidence in performing examinations. Students who were taught pelvic examination techniques by SPs rated their learning experiences more positively and reported a better understanding of exam techniques than students who learned to perform exams by voluntary examination of classmates.

Implications for practice: Graduate nursing programs should consider locating and using SP programs for teaching pelvic examinations in advanced health assessment courses. Although more cost‐effective, voluntary peer examination was a less effective teaching method.
Apocrine adenocarcinoma of possible sweat gland origin in a male rabbit
Authors: Miwa Y. , Mochiduki M. , Nakayama H. , Shibuya N. , Ogawa H. , Sasaki N.
Published: August 2006

A five‐year‐old, male crossbreed rabbit was referred for acute caudal abdominal swelling. On physical examination, the rabbit was slightly depressed and showed an enlarged subcutaneous cyst in the caudal abdomen and an adjacent small, ulcerated solid mass. A drainage tube was placed in the cystic area, and surgical resection of the solid mass was performed. The histopathological diagnosis of the mass was apocrine adenocarcinoma. To the authors’ knowledge, this report describes the first case of spontaneous apocrine adenocarcinoma of possible sweat gland origin in a male rabbit.
Prospective evaluation of a peripherally administered three‐in‐one parenteral nutrition product in dogs
Authors: Chandler M. L. , Payne‐James J. J.
Published: August 2006

Objectives: Peripheral parenteral nutrition is an option for short‐term nutritional support in dogs which cannot be supported with enteral nutrition. The objective of this study was to examine the use of a three‐in‐one, 840 mOsmol/l peripheral parenteral nutrition product containing amino acids, lipids and glucose in separate compartments in dogs.

Methods: Nine dogs were administered the three‐in‐one product, and two dogs were administered the amino acid part of the product, via a peripheral vein. Dogs were monitored for mechanical and metabolic complications.

Results: Mechanical complications (apparent thrombus or thrombophlebitis) caused failure of infusion at a median of 36 hours. None of the dogs appeared to develop catheter‐related sepsis. Using a 10‐hour infusion period appeared to decrease the incidence of line failure. Mild and clinically non‐significant hyperglycaemia was the only metabolic complication. In four of the dogs, serum folate, cobalamin and homocysteine concentrations were determined before and after peripheral parenteral nutrition administration. Oral and parenteral administration of methionine has been previously associated with lowered serum folate concentrations. Low serum folates and the subsequent hyperhomocysteinaemia have been associated with venous endothelial damage and venous thrombus in other species. Serum cobalamin also affects homocysteine metabolism. Median serum folate, cobalamin and homocysteine concentrations were not affected by the short‐term administration of this three‐in‐one product.

Clinical Significance: Using the product for 24 hours/day may require catheter replacement due to line failure. Other than line failure, which may be improved by 10‐ to 12‐hour infusion times, this product was found to be safe and practical for short‐term peripheral parenteral nutrition in dogs.
Anomalous Spiral Motion of Steps Near Dislocations on Silicon Surfaces
Authors: Hannon J. B. , Shenoy V. B. , Schwarz K. W.
Published: August 2006

We have used low-energy electron microscopy to measure step motion on Si(111) and Si(001) near dislocations during growth and sublimation. Steps on Si(111) exhibit the classic rotating Archimedean spiral motion, as predicted by Burton, Cabrera, and Frank. Steps on Si(001), however, move in a strikingly different manner. Thestrain-relieving anomalous behavior can be understood in detail by considering how the local step velocity is affected by the nonuniform strain field arising from the dislocation. We show how the dynamic step-flow pattern is related to the dislocation slip system.
MarA-Like Regulator of Multidrug Resistance in
Yersinia pestis
Authors: Udani Rupa A. , Levy Stuart B.
Published: August 2006

MarA47
Yp
from
Yersinia pestis
, showing 47% identity to
Escherichia coli
MarA in its N terminus, caused resistance to antibiotics and to organic solvents when expressed in both
E. coli
and
Y. pestis
. Resistance was linked to increased expression of the AcrAB multidrug efflux pump. In four of five spontaneous multidrug-resistant mutants of
Y. pestis
independently selected by growth on tetracycline, the
marA47
Yp
gene was overexpressed. The findings suggest that
marA47
Yp
is a
marA
ortholog in
Y. pestis
.
Frequent Emergence of Resistance in
Clostridium difficile
during Treatment of
C. difficile
-Associated Diarrhea with Fusidic Acid
Authors: Norén T. , Wullt M. , Åkerlund Thomas , Bäck E. , Odenholt I. , Burman L. G.
Published: August 2006

Samples from patients with
Clostridium difficile-
associated diarrhea (CDAD) that were randomized to fusidic acid (
n
= 59) or metronidazole (
n
= 55) therapy for 7 days were cultured for
Clostridium difficile
in feces on days 1, 8 to 13, and 35 to 40. Of the patients who were culture positive only before treatment, 77% (36/47) were permanently cured (no treatment failure and no clinical recurrence), compared to 54% (22/41) of those with persistence of
C. difficile
at one or both follow-ups (
P
= 0.03). A similar association between bacterial persistence and a worse outcome of therapy was seen in both treatment groups. Resistance to fusidic acid was found in 1 of 88 pretherapy isolates available, plus in at least 1 subsequent isolate from 55% (11/20) of patients who remained culture-positive after fusidic acid therapy. In 10 of these 11 patients, the resistant follow-up isolate(s) belonged to the same PCR ribotype as the susceptible day 1 isolate, confirming frequent emergence of resistance to fusidic acid during treatment. Despite this, 5 of these 11 patients were permanently cured with fusidic acid, relative to 5 of 9 patients with susceptible
C. difficile
at follow-up (
P
= 1.0). None of the 36 PCR ribotypes of
C. difficile
identified was associated with any particular clinical outcome or emergence of fusidic acid resistance. In conclusion, culture positivity for
C. difficile
was common after both fusidic acid and metronidazole therapy and was associated with treatment failure or recurrence of CDAD. Development of resistance in
C. difficile
was frequent in patients given fusidic acid, but it was without apparent negative impact on therapeutic efficacy in the actual CDAD episode.
In Vitro Activity of a Novel Antimicrobial Agent, TG44, for Treatment of
Helicobacter pylori
Infection
Authors: Kamoda Osamu , Anzai Kinsei , Mizoguchi Jun-ichi , Shiojiri Masatoshi , Yanagi Toshiharu , Nishino Takeshi , Kamiya Shigeru
Published: August 2006

Due to concerns about the current therapeutic modalities for
Helicobacter pylori
infection, e.g., the increased emergence of drug-resistant strains and the adverse reactions of drugs currently administered, there is a need to develop an anti-
H. pylori
agent with higher efficacy and less toxicity. The antibacterial activity of TG44, an anti-
H. pylori
agent with a novel structural formula, against 54 clinical isolates of
H. pylori
was examined and compared with those of amoxicillin (AMX), clarithromycin (CLR), and metronidazole (MNZ). Consequently, TG44 inhibited the growth of
H. pylori
in an MIC range of 0.0625 to 1 μg/ml. The MIC ranges of AMX, CLR, and MNZ were 0.0078 to 8 μg/ml, 0.0156 to 64 μg/ml, and 2 to 128 μg/ml, respectively. The antibacterial activity of TG44 against AMX-, CLR-, and MNZ-resistant strains was nearly comparable to that against drug-susceptible ones. In a pH range of 3 to 7, TG44 at 3.13 to 12.5 μg/ml exhibited potent bactericidal activity against
H. pylori
in the stationary phase of growth as early as 1 h after treatment began, in contrast to AMX, which showed no bactericidal activity at concentrations of up to 50 μg/ml at the same time point of treatment. TG44 at 25 μg/ml exhibited no antibacterial activity against 13 strains of aerobic bacteria, suggesting that its antibacterial activity against
H. pylori
is potent and highly specific. The present study indicated that TG44 possesses antibacterial activity which manifests quickly and is potentially useful for eradicating not only the antibiotic-susceptible but also the antibiotic-resistant strains of
H. pylori
by monotherapy.
High-Level Mupirocin Resistance within Methicillin-ResistantStaphylococcus aureusPandemic Lineages
Authors: Pérez-Roth Eduardo , López-Aguilar Celeste , Alcoba-Florez Julia , Méndez-Álvarez Sebastián
Published: August 2006

The methicillin-resistantStaphylococcus aureus(MRSA) population in the Hospital Universitario Nuestra Señora de Candelaria over a 5-year period (1998 to 2002) was marked by shifts in the circulation of pandemic clones. Here, we investigated the emergence of high-level mupirocin resistance (Hi-Mupr). In addition to clonal spread, transfer ofileS2-carrying plasmids played a significant role in the dissemination of Hi-Mupramong pandemic MRSA lineages.
Heteroresistance to Colistin in Multidrug-Resistant
Acinetobacter baumannii
Authors: Li Jian , Rayner Craig R. , Nation Roger L. , Owen Roxanne J. , Spelman Denis , Tan Kar Eng , Liolios Lisa
Published: August 2006

Multidrug-resistant
Acinetobacter baumannii
has emerged as a significant clinical problem worldwide and colistin is being used increasingly as “salvage” therapy. MICs of colistin against
A. baumannii
indicate its significant activity. However, resistance to colistin in
A. baumannii
has been reported recently. Clonotypes of 16 clinical
A. baumannii
isolates and ATCC 19606 were determined by pulsed-field gel electrophoresis (PFGE), and colistin MICs were measured. The time-kill kinetics of colistin against
A. baumannii
ATCC 19606 and clinical isolate 6 were investigated, and population analysis profiles (PAPs) were conducted. Resistance development was investigated by serial passaging with or without exposure to colistin. Five different PFGE banding patterns were found in the clinical isolates. MICs of colistin against all isolates were within 0.25 to 2 μg/ml. Colistin showed early concentration-dependent killing, but bacterial regrowth was observed at 24 h. PAPs revealed that heteroresistance to colistin occurred in 15 of the 16 clinical isolates. Subpopulations (<0.1% from inocula of 10
8
to 10
9
CFU/ml) of ATCC 19606, and most clinical isolates grew in the presence of colistin 3 to 10 μg/ml. Four successive passages of ATCC 19606 in broth containing colistin (up to 200 μg/ml) substantially increased the proportion of the resistant subpopulations able to grow in the presence of colistin at 10 μg/ml from 0.000023 to 100%; even after 16 passages in colistin-free broth, the proportion only decreased to 2.1%. This represents the first demonstration of heterogeneous colistin-resistant
A. baumannii
in “colistin-susceptible” clinical isolates. Our findings give a strong warning that colistin-resistant
A. baumannii
may be observed more frequently due to potential suboptimal dosage regimens recommended in the product information of some products of colistin methanesulfonate.
Transcriptomic and Functional Analysis of an Autolysis-Deficient, Teicoplanin-Resistant Derivative of Methicillin-ResistantStaphylococcus aureus
Authors: Renzoni Adriana , Barras Christine , François Patrice , Charbonnier Yvan , Huggler Elzbieta , Garzoni Christian , Kelley William L. , Majcherczyk Paul , Schrenzel Jacques , Lew Daniel P. , Vaudaux Pierre
Published: August 2006

The molecular basis of glycopeptide-intermediateS. aureus(GISA) isolates is not well defined though frequently involves phenotypes such as thickened cell walls and decreased autolysis. We have exploited an isogenic pair of teicoplanin-susceptible (strain MRGR3) and teicoplanin-resistant (strain 14-4) methicillin-resistantS. aureusstrains for detailed transcriptomic profiling and analysis of altered autolytic properties. Strain 14-4 displayed markedly deficient Triton X-100-triggered autolysis compared to its teicoplanin-susceptible parent, although microarray analysis paradoxically did not reveal significant reductions in expression levels of major autolytic genesatl,lytM, andlytN, except forsle1, which showed a slight decrease. The most important paradox was a more-than-twofold increase in expression of thecidABCoperon in 14-4 compared to MRGR3, which was correlated with decreased expression of autolysis negative regulatorslytSRandlrgAB. In contrast, the autolysis-deficient phenotype of 14-4 was correlated with both increased expression of negative autolysis regulators (arlRS,mgrA, andsarA) and decreased expression of positive regulators (agrRNAII and RNAIII). Quantitative bacteriolytic assays and zymographic analysis of concentrated culture supernatants showed a striking reduction in Atl-derived, extracellular bacteriolytic hydrolase activities in 14-4 compared to MRGR3. This observed difference was independent of the source of cell wall substrate (MRGR3 or 14-4) used for analysis. Collectively, our results suggest that altered autolytic properties in 14-4 are apparently not driven by significant changes in the transcription of key autolytic effectors. Instead, our analysis points to alternate regulatory mechanisms that impact autolysis effectors which may include changes in posttranscriptional processing or export.
Multicity Outbreak of Carbapenem-Resistant
Acinetobacter baumannii
Isolates Producing the Carbapenemase OXA-40
Authors: Lolans Karen , Rice Thomas W. , Munoz-Price L. Silvia , Quinn John P.
Published: August 2006

During 2005 we detected a multicity outbreak of infections or colonization due to high-level imipenem-resistant
Acinetobacter baumannii
(MIC, 64 μg/ml). One hundred isolates from diverse sources were obtained from seven acute-care hospitals and two extended-care facilities; 97% of the isolates belonged to one clone. Susceptibility testing of the first 42 isolates (January to April 2005) revealed broad resistance profiles. Half of the isolates were susceptible to ceftazidime, with many isolates susceptible only to colistin. The level of AmpC β-lactamase expression was stronger in isolates resistant to ceftazidime. PCR and subsequent nucleotide sequencing analysis identified
bla
OXA-40
. The presence of an OXA-40 β-lactamase in these isolates correlated with the carbapenem resistance. By Southern blot analysis, a
bla
OXA-40
-specific probe revealed that the gene was both plasmid and chromosomally located. This is the first time in the United States that such carbapenem resistance in
A. baumannii
has been attributable to a carbapenemase.
Antibiotic-Induced Enterococcal Expansion in the Mouse Intestine Occurs throughout the Small Bowel and Correlates Poorly with Suppression of Competing Flora
Authors: Laktic̀ová Viera , Hutton-Thomas Rebecca , Meyer Matthew , Gurkan Evren , Rice Louis B.
Published: August 2006

To test the hypothesis that establishing gastrointestinal colonization with multiresistant
Enterococcus faecium
(VRE) C68 results from expansion of the enterococcal population in the upper small bowel, we compared VRE quantities recovered from the proximal, middle, and distal segments of the small bowel from mice treated with different antimicrobial agents. Antibiotics associated with high-level VRE fecal colonization (cefotetan, ceftriaxone, clindamycin, and ticarcillin-clavulanic acid) increased VRE quantities in all small-bowel segments, whereas cefepime and piperacillin-tazobactam did not. Enterococcal expansion did not correlate with reductions in numbers of native gram-negative or anaerobic flora. Green fluorescence protein-expressing
E. faecium
bacteria were found adjacent to the small bowel epithelial lining in colonized mice. These data indicate that enterococcal bowel colonization begins within the proximal small bowel and does not correlate with inhibition of other cultivable flora. Host or enterococcal factors induced by exposures to certain antibiotics may play a role in facilitating
E. faecium
colonization of the mammalian gastrointestinal tract.