bluuebunny/crossref_metadata_2025 huggingface dataset:
Interdependence in supply chains and projects in construction
Authors: Bankvall Lars , Bygballe Lena E. , Dubois Anna , Jahre Marianne
Published: August 2010

Purpose

The aim of this paper is to inquire into the management of construction supply chains by directing attention toward the different types of interdependencies that exist in such chains and in construction projects.

Design/methodology/approach

The paper is developed as part of two ongoing research projects on supply chain management (SCM) in construction. A case study approach is used for illustrating the production and subsequent delivery and installation of plasterboards to a specific construction project. This description reveals extensive coordination among a number of companies and features interesting examples of the consequences of the interdependencies identified.

Findings

The paper concludes that the strong emphasis on coordination of sequential interdependence within individual supply chains does not fit with the complex interdependencies present in and among supply chains and projects in construction. In addition to sequential interdependence it describes and illustrates pooled interdependence based on joint resource utilisation, reciprocal interdependence among activities undertaken at the construction site, and interdependence owing to synchronisation of many supply chains in relation to each and every construction project. The combined effects of these interdependencies challenge traditional SCM recommendations, such as moving activities from the site to the factory.

Originality/value

The main theoretical argument put forward in this paper is that the application of SCM models developed for other industrial contexts such as the automotive industry, are problematic to use in the construction industry. This is because these models emphasise integration of activities that are subject mainly to sequential interdependencies while the pattern of interdependence is very different in construction. A main implication for practice is that focusing on better planning in order to deal with activities that are mainly subject to sequential interdependence, is insufficient. The reciprocal interdependencies in construction require more frequent and direct interaction among the involved actors to enable mutual adjustments among the firms whose activities and resource use need to be coordinated.
Family ties and emotions: a missing piece in the knowledge transfer puzzle
Authors: Nelly Trevinyo‐Rodríguez Rosa , Bontis Nick
Published: August 2010

Purpose

The paper aims to develop a model of knowledge transfer that considers kinship ties and emotions in family‐based firms.

Design/methodology/approach

There exist several models, which show how information flows among individuals and within organizations. One school of thought is known as Cultural‐Historical Activity Theory (CHAT), which was initially formulated by Lev Vygotsky, the Founder of the school. However, when analyzing CHAT within the family business context, the model no longer holds true. This paper examines knowledge‐transfer mechanisms through the lens of family firms.

Findings

Family traditions, ties, and emotions, which are not considered in the original learning framework, affect knowledge transfer, commitment, and the motivation of family members.

Research limitations/implications

Based on CHAT and subsequently on other social networks theories, a more appropriate next generation learning model is developed which explains how intergenerational knowledge transfer takes place within family firms.

Practical implications

This paper improves the understanding of how family members' shared knowledge (i.e. traditions) may become sources of competitive advantages for the family firm (i.e. long‐term survival).

Originality/value

This paper is among the first known to examine knowledge‐transfer mechanisms specifically for family‐based businesses.
Indian agri‐seed industry: understanding the entrepreneurial process
Authors: Kumar Sushil , Ali Jabir
Published: August 2010

Purpose

The paper aims to discuss and analyse the entrepreneurial process in Indian seed business and factors affecting entrepreneurship in this sector.

Design/methodology/approach

The paper is based on in‐depth personal interviews with 40 entrepreneurs involved in 31 seed ventures belonging to five districts covering three states of India – Uttar Pradesh, Haryana, and Uttarakhand. These firms were selected following the convenient method of sampling. All major components of entrepreneurial process – personal traits and background of the entrepreneur, legal and financial environment, and market structure – were studied in detail. Descriptive and relational data‐analytic methods were adopted such as frequency distribution, cross tabulation, and correlation analysis.

Findings

Realizing the importance of availability of quality seed to the farming community in adequate quantity in the country, current government policies are geared towards promoting and fostering entrepreneurship in seed industry in India. The paper finds that the firms established during last five to ten years have shown continuous growth indicating attractiveness of the industry. Ability to build entrepreneurial team with complementary skills and knowledge and experience of the lead entrepreneurs are found to be the critical success factors in this industry.

Research limitations/implications

The findings of the paper is based on mainly qualitative data/information collected only from 40 entrepreneurs belonging to 31 seed ventures.

Practical implications

The study findings have implications for policy makers as well as for prospective entrepreneurs. It will help in designing appropriate policy instruments promote and foster entrepreneurship on one hand and provide suggestions for new entrepreneurs for creating sustainable new seed ventures on the other.

Originality/value

The paper is original and value loaded in the sense that this provides the practical implications for understanding the entrepreneurial process in a very critical segment of the agriculture sector.
Is the efficiency doctrine valid? An evaluation of US local exchange telecommunications company mergers
Authors: Majumdar Sumit K. , Moussawi Rabih , Yaylacicegi Ulku
Published: August 2010

Purpose

The purpose of this paper is to evaluate the impact of the various mergers of the local exchange companies in the USA.

Design/methodology/approach

The authors evaluate all of the mergers that took place between 1988 and 2001 on several measures of performance for the firms that have undergone the mergers.

Findings

The analysis reveals that the impacts of mergers on the several measures of efficiency that have been evaluated have all been negative.

Social implications

If the efficiency motive has been primary in influencing merger approvals, then the past mergers approved have led to inefficiencies, corresponding welfare losses for the American consumer, and the mergers of communication common carriers have not been in the public interest. On the other hand, given the inefficiency outcomes, views that the quiet life, hubris and a quest for possible market power have motivated the mergers cannot be discarded.

Originality/value

The results have considerable salience across industry segments and geographies where mergers are being considered and evaluated, since they call into question the strategic and public policy logic behind merger consummation.
Value in technology evolution: case mobile peer‐to‐peer communications
Authors: Heikkinen Mikko V.J. , Luukkainen Sakari
Published: August 2010

Purpose

Mobile peer‐to‐peer communications is an essential phase in the evolution of mobile communications technologies, motivating this research which aims to focus on how established industry stakeholders and new entrants can adapt themselves to the new situation.

Design/methodology/approach

Based on existing literature, the authors identified three distinctive evolution paths for mobile peer‐to‐peer communications and developed an analysis framework for their comparison. The authors validated the analysis by conducting a questionnaire study among domain experts, and analyzed its results using statistical analysis.

Findings

Internet‐driven evolution has high value proposition, is profitable and has subscription fees as an important revenue model. Telecom‐driven evolution creates value, leverages markets, leverages competence, is likely to encounter regulatory intervention and benefits all customer segments. Proprietary evolution has a successful revenue model, results in alliances of competitors and is competence‐enhancing to mobile device vendors.

Research limitations/implications

Future work consists mainly of analyzing quantitatively the implications of the new technologies when they become readily available and evaluating the value analysis framework in other applicable cases.

Practical implications

Internet‐driven evolution enables new business opportunities to independent service operators and equipment vendors by enabling opportunities in profiting from sales of advanced devices and networks. Telecom‐driven evolution benefits mostly incumbent mobile network operators. Proprietary evolution enables limited competition against incumbent actors by independent service operators.

Originality/value

This study is one of the first journal publications on mobile peer‐to‐peer communications from a holistic techno‐economic point of view, beneficial to both academics and practitioners.
Living Requirements Space
Authors: Adisa Femi , Schubert Petra , Sudzina Frantisek , Johansson Björn
Published: August 2010

Purpose

This paper aims to discuss a new tool for requirements gathering in the Web 2.0 era. It seeks to investigate the features that this kind of tool should have in order to be as widely applicable and useful as possible. Further, it aims to explore the extent to which business requirements for enterprise resource planning (ERP) systems can be collected and discussed collaboratively in a worldwide community of business process experts.

Design/methodology/approach

The paper is a combination of empirical research, hermeneutics and design research.

Findings

The proposed Living Requirements Space (LRS) platform has the potential of becoming an international forum for collecting and discussing business requirements for ERP systems.

Practical implications

The LRS platform will allow ERP developers, ERP systems implementers, and academics to better understand the evolution of business requirements for ERP systems. It will create a knowledge base of ERP business requirements, that is, a repository that guarantees open and unrestricted access to content. It will thus allow for more international ERP systems and far more comprehensive education on and understanding of business processes and ERP systems.

Originality/value

LRS is an open access tool that allows for the gathering of ERP systems requirements in a vendor‐ and project‐independent approach that is unbiased towards any geographic region.
The University of Alicante's institutional strategy to promote the open dissemination of knowledge
Authors: Llorens Faraón , José Bayona Juan , Gómez Javier , Sanguino Francisco
Published: August 2010

Purpose

Information and communication technologies have became pervasive in people's lives and in this changing world education cannot remain anchored in old‐fashioned models which ignore the evolution through which society is going. This paper seeks to present the gamble made by the University of Alicante (Spain) on the promotion of open knowledge.

Design/methodology/approach

The educational environment cannot continue to be fixed, closed and isolated, where students – assuming a basically passive role – receive standardised teaching. It must consequently experience a fast and decisive transformation which allows it, amongst other things, to respond to the new challenge posed by society: the need for all of us to share the knowledge we generate, so that further progress can be made.

Findings

The Institutional Repository (RUA) and the OpenCourseWare of the University of Alicante (OCW‐UA) were conceived from the very beginning as related projects that could constitute consecutive phases in the open publication of knowledge. In this way the aim of presenting the promotion of open knowledge not as a series of discrete projects but as a global strategic gamble of the institution was achieved. In addition to the most visible educational benefits, this policy has had the virtue of favouring the assumption by the University of its role as an online provider of quality (scientific and teaching) content.

Originality/value

RUA is the storage place of all the teaching materials published by the University of Alicante's teaching staff, which are retrieved from OCW‐UA, while OCW‐UA serves as an organisational model of teaching content self‐archived by the teaching staff in RUA. The connection between the projects has allowed the presentation of the promotion of open knowledge as a global strategic gamble of the University, which has contributed to a greater acceptance by the teaching staff. This work is original in that it shows a successful experience of involvement by one university and its members in the promotion of open knowledge.
DNA dataveillance: protecting the innocent?
Authors: Vartapetiance Salmasi Anna , Gillam Lee
Published: August 2010

Purpose

The purpose of this paper is to discuss the UK National DNA Database (NDNAD) and some of the controversies surrounding it with reference to legal and ethical issues, focusing particularly on privacy and human rights. Governance of this database involves specific exemptions from the Data Protection Act (DPA), and this gives a rise to concerns regarding both the extent of surveillance on the UK population and the possibility for harm to all citizens. This is of wider importance since every current citizen, and everybody who visits the UK, could become a record in the DNA database. Principally, the paper seeks to explore whether these exemptions would also imply exemptions for software developers from codes of practice and ethics of their professional societies as relate to constructing or maintaining such data and the database.

Design/methodology/approach

The paper makes a comparison between the principles of the DPA, as would need to be followed by all other organizations handling personal data, professional responsibilities‐based codes of ethics of professional societies, and the current reality as reported in relation to the NDNAD and the exemptions offered through the DPA.

Findings

Primarily, if NDNAD was not exempted from certain provisions in the DPA, the potential for the kinds of data leakages and other mishandlings could largely be avoided without the need for further considerations over so‐called “data minimization”. It can be seen how the lack of afforded protection allows for a wide range of issues as relate at least to privacy.

Originality/value

The paper provides the first evaluation of the combination of law, codes of ethics, and activities in the real world as related to NDNAD, with concomitant considerations for privacy, liberty, and human rights. Originality is demonstrated through consideration of the implications of certain exemptions in the DPA in relation to crime and taxation and national security and in relating the expected protections for personal data to widely reported evidence that such protections may be variously lacking. In addition, the paper provides a broad overview of controversies over certain newer kinds of DNA analysis, and other relatively recent findings, that seem generally absent from the vast majority of debates over this kind of analysis.
Stochastic logic computation based RBFNN with adaptive hidden layer structure
Authors: Joy Vasantha Rani S.P. , Aruna Prabha K.
Published: August 2010

Purpose

The purpose of this paper is to implement the hardware structure for radial basis function (RBF) neural network based on stochastic logic computation.

Design/methodology/approach

The hardware implementation of artificial neural networks (ANNs) has a complicated structure and is normally space consuming due to huge size of digital multiplication, addition/subtraction, non‐linear activation function, etc. Also the unavailability of ANN hardware at an attractive price limits its use for real time applications. In stochastic logic theory, the real numbers are converted to random streams of bits instead of a binary number. The performance of the proposed structure is analyzed using very high speed integrated circuit hardware description language.

Findings

Stochastic theory‐based arithmetic and logic approach provides a way to carry out complex computation with very simple hardware and very flexible design of the system. The Gaussian RBF for hidden layer neuron is employed using stochastic counter that reduces the hardware resources significantly. The number of hidden layer neurons in RBF neural network structure is adaptively varied to make it an intelligent system.

Originality/value

The paper outlines the stochastic neural computation on digital hardware for implementing radial basis neural network. The structure has considered the optimized usage of hardware resources.
An empirical analysis of factors impacting career decisions in South African construction industry
Authors: Chileshe Nicholas , Haupt Theodore C.
Published: August 2010

Purpose

The purpose of this paper is to investigate the perception of high school students on the factors impacting their career decisions and whether gender and grade have an influence on the decision‐making process.

Design/methodology/approach

Literature review was used to identify relevant factors which were incorporated into the design of the survey instrument. The questionnaire was administered via a postal survey and information collected from 599 male and 491 female high school students in the Western Cape Province. Survey response data were subjected to descriptive statistics and subsequently parametric tests.

Findings

Salary, working conditions, opportunities for promotion and lifelong learning were reported by both male and female students as the most important factors, whereas family tradition and peers were the least important factors according to the male and female high school students, respectively. Grade had a significant impact on the process with students in Grade 11 scoring higher on salary, working conditions and lifelong learning opportunities whereas Grades 12 and 10 scored higher on skills shortage and family tradition, respectively.

Research limitations/implications

The cross‐sectional data made it difficult to generalise the findings.

Practical implications

The findings are of particular importance to high school teachers and guidance counsellors who influence career choices amongst high school students. It is likely that teachers and counsellors themselves have been negatively influenced by the poor image of the construction industry. The identification of factors enables the development of viable strategies and balances the social dynamics of the male dominated environment.

Originality/value

There are few studies which try to investigate the career decision‐making process of high school students in an African environment. These results challenge the factors impacting career decision making among South African high school students and provide information rarely examined. Conclusively, the paper finds that control variables such as grade and gender are significant in the career decision‐making process of high school students. This paper contributes to bridging that gap.
Entrepreneurship education in the higher education institutions (HEIs) of post‐communist European countries
Authors: Varblane Urmas , Mets Tõnis
Published: August 2010

Purpose

The purpose of this paper is to map the current situation of entrepreneurship education in higher education institutions (HEIs) of 22 European transition economy countries.

Design/methodology/approach

The approach taken was an internet survey and analysis covering 774 HEIs of the region.

Findings

In 332 institutions, entrepreneurship‐oriented courses, modules or curricula are offered. Croatia and Slovenia are the leading countries in terms of the coverage of teaching entrepreneurship in universities and colleges, followed by the Baltic countries and the Czech and Slovak Republics. The highest entrepreneurship orientation is found in new and private universities and colleges. In a majority of schools, the theory of entrepreneurship is taught but practice‐oriented training in entrepreneurship is rather limited. The current number of centres of entrepreneurship in the region is small, and the research‐oriented model of entrepreneurship education is used in three to five institutions only.

Practical implications

The paper provides a useful source of information for entrepreneurship education researchers, developers and education policy makers.

Originality/value

The paper maps the HEIs entrepreneurship teaching in post‐communist European countries.
Resolving the paradox of enterprising communities in Eastern Europe
Authors: Todorovic Zelimir William , Ma Jun
Published: August 2010

Purpose

Attempts to “Westernize” post‐socialist economies of Eastern Europe resulted in little or no progress. This paper aims to incorporate the resource‐based view (RBV) paradigm to shed light on the present difficulties and challenges. A shortage of resources, many of which are taken for granted in the West, is identified as a reason why some “Western‐style” approaches did not work.

Design/methodology/approach

Reviews of literature in entrepreneurial orientation and RBV serve as a foundation of the development of conceptual arguments. The paper presents a framework elaborating on entrepreneurial development by focusing on the national resource base called enabling resources.

Findings

Richardian, functional‐regulatory, and tacit culturally based resources are credited with building national entrepreneurial activity and developing a unique national competency.

Research limitations/implications

The paper does not include empirical validation of its argument. Further empirical research should be done in different cultural contexts.

Practical implications

The paper informs policymakers and entrepreneurs alike towards a monumental task of rebuilding these new democracies. Developed framework provides a way of building resources necessary for sustained entrepreneurial growth unique to each post‐socialist economy.

Originality/value

By focusing on the unique national resource base, the economic development of post‐socialist economies of Eastern Europe may be improved and accelerated. This paper emphasizes the need to consider and examine available resources in the transformation and development of enterprising communities.
Local planning for sustainable development
Authors: Saunders Caroline , Dalziel Paul
Published: August 2010

Purpose

The purpose of this paper is to explore how a “capital‐based” framework can be used by a small local government to plan sustainable development to promote the social, economic, environmental and cultural well‐being of their communities.

Design/methodology/approach

This New Zealand case study develops a framework for local government action and applies it to measure stocks of human made, natural, human, social and cultural capital for a small rural district.

Findings

The conclusions find that it is possible to apply a capital‐based framework to local government planning, despite some data gaps, especially in the areas of social and cultural capital.

Practical implications

The framework for local government action developed in the paper provides a well‐structured guide for planning investment in capital to promote the well‐being of local communities.

Originality/value

Sustainable development indicator (SDI) frameworks are becoming commonplace at the national level; this paper shows how an SDI framework can be used to guide planning at the local government level.
Communitarian governance in social enterprises
Authors: Ridley‐Duff Rory
Published: August 2010

Purpose

Prevailing concepts of corporate governance that are based on external shareholder interests have been challenged by a number of authors over the last three decades. The purpose of this paper is to outline the core assumptions of communitarian philosophy and values, together with the way writers imagine these might be enacted in a social enterprise context. These assumptions are then explored using two case studies.

Design/methodology/approach

The paper was conducted using participatory action research which involves parties examining current actions together and seeking to improve on them. The value of this approach is based on the plausible, authentic and critical insights it generates into management practice.

Findings

Case evidence suggests that companies are able to adopt and operate effectively while deploying communitarian values and that these values lead to alternative business objectives expressed through new forms of corporate governance. Nevertheless, the adopting of common language does not necessarily mean that social enterprises share a common philosophy.

Originality/value

The key contribution of this paper is to evaluate the institutionalisation of governance and consider the relationship between the form and substance of practice. By considering the link between words and actions, the paper concludes that the adoption of a governance framework, or particular language, matters less than the capacity of company members to participate in the development of governance norms that enable them to act congruently with their own beliefs and values.
How can co‐operative banks spread the spirit of co‐operation in deprived communities?
Authors: Nakagawa Sachiko , Laratta Rosario
Published: August 2010

Purpose

In recent years, Japanese co‐operative banks have been attracting new interest among academics and the population generally as institutions through which deprived communities can be revitalized. They have been shown to be capable of promoting both social co‐operation and economical development through the financing of new social enterprises by investments coming mainly from local residents and existing social organizations. This paper aims to address the central questions of what Japanese co‐operative banks can do to encourage co‐operation among local residents and social enterprises so that they willingly invest their money in the development of their local community.

Design/methodology/approach

In order to explore these questions, two Japanese co‐operative banks are compared by means of a questionnaire survey and semi‐structured interviews with their investors and boards of directors. The main reason for focusing this investigation on these two banks was that despite the similarity of their political, economical and demographical backgrounds, one of them showed a steady growth in local investment while the other failed to produce a similar level of local engagement.

Findings

The findings of the paper clearly demonstrated that when a co‐operative bank acts as “community organizer”, undertaking tasks which are outside its usual sphere of activities as financier, and its board includes members of the social enterprise sector, its positive impact on community development is more effective. However, it also became clear that a vital feature of this kind of endeavour is the utilization of expertise derived from members of the local community.

Originality/value

The paper makes an important contribution to the understanding of co‐operative banks as community organizers. Its originality lies primarily in the fact that it was the first time that this type of research has been conducted on Japanese co‐operative banks.
Uncertainty, risk preference, and new‐venture strategies
Authors: Storrud‐Barnes Susan F. , Reed Richard , Jessup Leonard M.
Published: August 2010

Purpose

Conventional wisdom holds that the difference between entrepreneurs and managers is large, while uncertainty and risk are virtually interchangeable. Uncertainty and risk are treated as separate constructs and then real‐options thinking and prospect theory are drawn upon to determine how they affect the actions of entrepreneurs and managers. The purpose of this paper is to determine specifically, how the above constructs interact to affect the strategies entrepreneurs and managers are likely to adopt when undertaking new ventures.

Design/methodology/approach

The research uses deductive theorizing to build a theoretical model.

Findings

Contrary to conventional wisdom, it is concluded that the difference between entrepreneurs and managers is less than believed, while the effect of the difference between uncertainty and risk is larger. It is determined that entrepreneurs and managers use similar strategies when faced with similar conditions of uncertainty and when they have similar risk preferences. When environmental uncertainty is low, risk‐seeking entrepreneurs and managers will prefer licensing, whereas the risk averse will prefer wholly owned new ventures. When environmental uncertainty is neither high nor low, both risk‐averse and risk‐seeking entrepreneurs and managers will prefer alliances. When environmental uncertainty is high, risk‐averse entrepreneurs and managers will prefer licensing, whereas risk seekers will prefer wholly owned.

Originality/value

By separating uncertainty and risk, this research is able to show how their interactions become the drivers of strategic decisions by entrepreneurs and managers. This is new to the literature, and the work thus reveals an opportunity for further sophistication of strategy theory and an opportunity to reduce the barriers between theory on entrepreneurship and management theory.
Innovation in management system by Six Sigma: an empirical study of world‐class companies
Authors: Azis Yudi , Osada Hiroshi
Published: August 2010

Purpose

The purpose of this paper is to demonstrate the effectiveness of Six Sigma as an innovation tool in management system. In this regard, the comprehensive impact of Six Sigma is provided based on Osada's management system model in terms of driver, enabler, and performance. Then, the causal relationship diagram is drawn among critical success factors to show how Six Sigma innovates the management system. Finally, the comparison between Six Sigma and total quality management (TQM) is discussed to reveal the strength of Six Sigma as an innovation tool in management system.

Design/methodology/approach

An empirical study of world‐class companies was undertaken. Several of the companies were analyzed intensively namely Sony and Du Pont by interviewing and circulating questionnaires to the key actors of Six Sigma.

Findings

The paper confirms that Six Sigma has a positive and comprehensive impact on changing the management system. Six Sigma has been harmonizing and synergizing people and processes by establishing a clear linkage among critical factors. This linkage, as a critical strength in innovation, is described by a causal relationships diagram using the system dynamics principle. By comparing with TQM, this paper has identified that Six Sigma has additional features named as disseminating commitment and sustaining spirit.

Practical implications

The findings suggest that Six Sigma can potentially be used as an innovation tool for leveraging organizational performance. This paper provides a comprehensive perspective on how Six Sigma should be perceived and implemented to gain maximum potential. Hence, this paper is expected to provide a significant contribution to academia and practitioners in understanding the application of Six Sigma.

Originality/value

The paper analyzes the impact of Six Sigma in a more organized approach than previous report. This approach categorizes the impact based on driver, enabler, and performance through an empirical study. Additionally, the relationship diagram and the comparison between Six Sigma and TQM are established in this paper. It is believed that such study is rarely published in academic journals.
In Situ Hybridization is a Valuable Diagnostic Tool in Cutaneous Deep Fungal Infections
Authors: Abbott J.J. , Hamacher K.L. , Bridges A.G. , Ahmed I.
Published: August 2010

Dimorphic fungal infections (histoplasmosis, blastomycosis, coccidiomycosis, and cryptococcosis) can occur in immunocompromised and healthy individuals. Cutaneous involvement is often secondary and may be the presenting sign of systemic disease. These ominous infections are frequently clinically indistinct and their prognosis is influenced by their timely diagnosis and treatment. Morphological differentiation between these organisms is not definitive and tissue cultures represent the diagnostic gold standard in current day practice. However, not uncommonly tissue cultures are not obtained and merely represent an afterthought in seemingly unsuspecting cases. Furthermore, when performed, they may take several days to weeks for completion. In situ hybridization (ISH) utilizing oligonucleotide probes directed against fungal ribosomal RNA represents a rapid and accurate assay for the diagnosis of dimorphic fungi in paraffin‐embedded tissue sections. We present 7 patients in whom ISH both prospecitively and retrospectively confirmed the presence of a cutaneous infection (2 histoplasmosis, 2 blastomycosis, 1 coccidiomycosis, 2 cryptococcosis). In all of the skin sections analyzed, dimorphic fungi were morphologically apparent but not diagnostically discernable. In summary, ISH represents a valuable tool in the prompt diagnosis of cutaneous deep fungal infections.
Histologic Variants of Fibrous Papule
Authors: Bansal C. , Stewart D. , Li A. , Cockerell C.
Published: August 2010

Fibrous papule (FP), synonymous with angiofibroma, is a common lesion that is often biopsied to exclude carcinoma. Clinically, FPs are small, dome‐shaped, solitary, flesh colored papules arising on the nose and face of adults. Histologically, FPs are characterized by a dome‐shape, fibrotic collagenized stroma, sparse inflammatory cell infiltrate, and variably increased and dilated vascular spaces. The vast majority of FPs are readily diagnosable based on these clinical and histologic criteria. Rare histopathologic variants have been reported. Recognition of these variants may avoid misdiagnosis of this common benign lesion. We illustrate four rare variants of FP that can cause diagnostic uncertainty including: hypercellular, clear cell, pigmented, and pleomorphic variants. Cellular FP has a dense infiltrate of round fibroblasts that have a nevoid appearance. Clear cell FP has a proliferation of round clear cells, some with slightly foamy cytoplasm, resembling histiocytes or clear epithelial cells. Pleomorphic FP demonstrates bizarre, stellate fibroblasts like those seen in pleomorphic fibroma. Pigmented FP has prominent melanocytic hyperplasia and dermal melanophages that can be confused with a melanocytic lesion. It is important to recognize these unusual variants of FP in order to accurately diagnose this common benign lesion and avoid over treatment or rebiopsy.
CD44 and Hyaluronate in the Differential Diagnosis of Dermatofibroma and Dermatofibrosarcoma Protuberans
Authors: Calikoglu Emel , Augsburger Eric , Chavaz Pierre , Saurat Jean‐Hilaire , Kaya Gürkan
Published: August 2010

The histological distinction between dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP) may be difficult. CD34 and Factor XIIIa have been used to differentiate DF from DFSP, but there is a lack of specificity. CD44 is a membrane glycoprotein which has multiple isoforms generated by alternative splicing of variant exons. CD44 is the principal cell surface receptor for hyaluronate (HA). In this study we explored the expression of standard CD44 (CD44s) and its isoforms (CD44v3, CD44v4, CD44v5, CD44v6, CD44v7, CD44v7v8, and CD44v10), and HA in DF and DFSP. Immunohistochemistry was performed on the biopsy specimens of 15 cases of DF and 4 cases of DFSP, using antibodies for the CD44s and its isoforms, and hyaluronate binding protein (HABP). Tumor cells displayed a strong CD44s immunoreactivity in all cases of DF whereas a faint HA positivity was observed in the tumor stroma. DF cells were negative for CD44v3, CD44v4, CD44v6, CD44v7 and CD44v7v8 but they showed a strong reactivity for CD44v5 and CD44v10. CD44s expression was significantly reduced or absent in all DFSP lesions and the tumor stroma displayed a strong staining for HA. Our results indicate that CD44 and HA can be used as additional diagnostic markers to distinguish DF from DFSP.
Subcutaneous Nodules at Injection Sites: Histopathological Pitfalls in Diagnosis
Authors: Chaudhry I.H. , Chong H. , Brady K. , Metze D. , Calonje E.
Published: August 2010

Subcutaneous swellings uncommonly occur at vaccination or desensitization injection sites and may present long after the procedure. Such lesions can show a range of histopathological appearances that are not well recognized, often leading to erroneous diagnoses. We describe the clinicopathological features of 13 cases (12 adults, 1 child) with subcutaneous swellings presenting at injection sites (upper arm n12, thigh n1). In the cases studied the histological appearances were varied, although predominantly the subcutis was involved. Six cases showed a mixed panniculitis with focal fat necrosis and fibrosis. Four cases demonstrated a pseudolymphomatous pattern, mimicking a B cell lymphoma. One case was reminiscent of lupus profundus and 3 other cases resembled deep granuloma annulare. Importantly, all cases contained histiocytes with violaceous granular cytoplasm, representing ingested aluminium salts employed for adsorption of antigens in the injection preparations. Energy dispersive x‐ray microanalysis in 8 cases confirmed a positive aluminium peak. Electron microscopy in 3 cases showed crystalline material in the histiocytes. In conclusion, the spectrum of histological appearances in so called aluminium granuloma can be misleading and it is important to identify the characteristic histiocytes of this condition, for otherwise erroneous diagnoses, with serious clinical implications, can follow.
Acute Monocytic Leukaemia with Cutaneous Manifestation
Authors: Chen L. , Rodgers T. , Chaffins M. , Maeda K.
Published: August 2010

A 50‐year‐old Caucasian male presented with generalised skin rash. Gingival hyperplasia and hepatosplenomegaly were also noted. His laboratory data showed hemoglobin of 10.3 g/dL, white blood cell count of 203.6 K/uL and platelet count of 72 K/uL. Peripheral blood smears revealed that 67% of the white blood cells was monoblasts, 25% was promonocytes and atypical monocytes. Bone marrow aspirate smears showed that 97% of the nucleated cells were composed of monoblasts and promonocytes. Approximately 80% of the immature cells showed intense non‐specific butyrate esterase activity. The morphologic and cytochemical findings were compatible with a diagnosis of acute monocytic leukaemia. Skin biopsy taken from the left medial thigh revealed a Grenz zone and a dense infiltrate of atypical cells throughout the dermis. The cells were positive for KP1 (CD68) immunohistochemical stain. The findings were consistent with cutaneous manifestation of leukaemia (leukaemia cutis). The patient’s condition deteriorated rapidly despite chemotherapy and expired 10 days after initial presentation. Leukaemia cutis is more common in acute monoblastic/monocytic leukaemia (AMoL) than in other subtypes of leukaemia. Leukaemia gingival hyperplasia is another characteristic feature of AMoL. Dissemination to the skin is generally associated with a poor prognosis.
Multicentric Reticulohistiocytosis
Authors: Chiao N. , Tschen J.
Published: August 2010

A 38‐year‐old woman presented with nodules on the face, scalp, ears, hands and elbows. She also developed fevers, chills, fatigue, weakness, myalgia, joint pain, nausea and weight loss of 40 pounds in eight months. Histology revealed large histiocytes with smooth eosinophilic ground glass cytoplasm, consistent with multicentric reticulohistiocytosis. She was treated with methotrexate 25 mg IM per week and prednisone 10 mg PO QD, with relief of her symptoms and improvement in her skin. Multicentric reticulohistiocytosis is a rare histiocytic systemic disease, with facial and hand skin nodules and symmetric arthritis. Pathognomonic signs include “coral beads” and vermicular erythematous papules bordering nostrils. The histologic hallmark for this disease is a nodular infiltrate of histiocytic cells, including multinucleated giant cells containing an eosinophilic, ground glass cytoplasm. Immunohistiochemistry is positive for CD68 and CD3, and negative for B cell markers as well as Langerhans cell markers. Approximately twenty percent of patients with multicentric reticulohistiocytosis have concurrent malignancy, but there is no one predominant type. The disease usually waxes and wanes for many years, with 30% of patients developing arthritis mutilans. It often regresses approximately seven years after its first appearance.
Primary Cutaneous Lymphoblastic Lymphoma in Children– Comparison with its Mediastinal Component and Myeloid Sarcoma
Authors: Cotton J , Hood AF
Published: August 2010

Lymphoblastic lymphoma (LL) is the second most common subtype of non‐Hodgkin’s lymphoma in children. The majority of LL are derived from immature T cells and present with a mediastinal mass with or without bone marrow involvement. The incidence of subsequent leukemic conversion is high. LL presenting as an isolated tumor in the skin has rarely been described in children. In this study, we reviewed the literature and present four additional cases of childhood primary cutaneous lymphoblastic lymphoma (PCLL). We also contrasted PCLL with mediastinal LL and compared the clinical and prognostic features of PCLL with granulocytic sarcoma (GS). Most tumors occurred in the scalp. Histologically, all cases demonstrated a dense monomorphic dermal infiltrate of intermediate sized cells with scant cytoplasm and inconspicuous nucleoli. The majority of cases were of precursor B phenotype, in contrast to primary mediastinal LL. A number of patients demonstrated concomitant bone marrow involvement at presentation and concurrent or subsequent conversion to acute lympoblastic lymphoma. We believe there are many similarities between PCLL and GS, both in terms of clinical presentation and the association of acute leukemia. Recognition of this uncommon tumor is important so that appropriate clinical workup and therapy may be instituted.
CD30‐Positive Peripheral T‐Cell Lymphoma
Authors: Estrada S. , Anderson W.
Published: August 2010

A 47 year‐old female presented with a five‐month history of left lower extremity cellulitis which was refractory to oral antibiotics. Physical exam revealed focal erythema of the left lower extremity and left inguinal adenopathy. A left leg skin punch biopsy revealed a dense infiltrate present primarily within the deep dermis consisting of markedly atypical large cells with prominent nuclear pleomorphism and focal multinucleation. Many of the cells displayed “horseshoe shaped” or “donut shaped” nuclei, consistent with so‐called hallmark cells and/or wreath cells. Scattered mitoses were also observed. Imunohistochemical stains for CD45 and vimentin were positive. Stains for cytokeratins AE1/AE3, CK7, desmin, and S‐100 protein were negative. The CD45‐positive population was also positive for CD3, CD30, CD45 Ro, and epithelial membrane antigen. They were negative for CD20, CD15, and CD43. A biopsy of the left inguinal lymph nodes revealed involvement by a morphologically similar neoplasm with an identical immunohistochemical staining pattern. Additionally, a CD56 and ALK‐1 stain were performed on the lymph node biopsy, and both were negative. This neoplastic process represents a CD30‐positive peripheral T‐cell lymphoma. The differential diagnosis includes an ALK‐1‐negative anaplastic large cell lymphoma and a primary cutaneous CD30‐positive T‐cell lymphoproliferative disorder.
Cutaneous Langerhans Cell Sarcoma Associated with Mediastinal T‐Cell Acute Lymphoblastic Lymphoma: Clonally Related Neoplasms
Authors: Eudy G , Soon S , Shehata B , Mann K , Jaffe E , Solomon A
Published: August 2010

An 8‐year‐old male presented with several 1–4 cm, indurated, brownish‐red nodules with superficial, punctate hemorrhagic crusts localized to the groin, which developed over several weeks. An initial biopsy was consistent with Langerhans cell histiocytosis. A work up, including a chest and abdominal CT scan demonstrated a large mediastinal mass which was diagnosed as precursor T cell lymphoblastic lymphoma. Treatment with a chemotherapeutic protocol resulted in shrinkage of both the mediastinal and cutaneous lesions. Late in the course of treatment the cutaneous lesions rapidly recurred and spread to various sites. A second skin biopsy showed an extensive diffuse infiltrate of histiocytic‐appearing cells extending from the papillary dermis into the superficial subcutis. The cells had markedly pleomorphic, vesicular nuclei and abundant amphophilic cytoplasm. Numerous mitotic figures were present. The neoplastic cells were S‐100 protein and CD1a positive by immunohistochemistry. The histopathologic diagnosis was Langerhans cell sarcoma. Gene rearrangement studies demonstrated clonal rearrangement of the T cell receptor gamma gene in specimens from both the mediastinal mass and one of the recurrent cutaneous lesions. The sizes of the PCR products were identical demonstrating a clonal relationship between the two neoplasms.
Reactions to Penicillamine: A Case of Cutis Laxa, Elastosis Perforans Serpiginosa and “Pseudo” Pseudoxanthoma
Authors: Frankel S. , Ravis S. , Elgart G. , Kirsner R.
Published: August 2010

This patient was a 61‐year‐old white female who received several years of penicillamine therapy for the treatment of cystinuria. She subsequently developed penicillamine induced cutis laxa, elastosis perforans serpiginosa, and pseudoxanthoma elasticum like skin lesions. In addition, she suffered from numerous chronic bilateral lower extremity skin ulcerations. Her past medical history was also significant for end stage renal disease requiring hemodialysis and pulmonary fibrosis. She presented to the University of Miami Wound Care Center in 1/04 for treatment of her chronic ulcerations. On physical examination, the patient had multiple large hyperpigmented plaques with central ulcerations on her lower extremities. Some of the ulcers had overlying crust and others were covered with yellow fibrinous tissue. She also had generalized thickened, lax skin with multiple folds. On her neck, thighs, back and arms were violaceous, atrophic, serpiginous plaques with peripheral crusted erosions. A biopsy taken from the patients left thigh revealed dermal elastosis and the features of pseudo‐pseudoxanthoma. Two additional biopsies taken from the left thigh demonstrated elastosis perforans serpiginosa. This case highlights multiple skin manifestations of penicillamine therapy.
Cns Involvement From Mycosis Fungoides With CD 30 Transformation
Authors: Geraminejad P. , Vasef M. , Piette W. , Link B. , Stone M.
Published: August 2010

Mycosis fungoides with central nervous system (CNS) involvement is a rare event. Most cases evolve from progressive tumor stage skin disease or CD30 large cell transformation. Cases with CD 30 transformation can show CNS involvement without advanced skin disease. We report a 63 year‐old woman with 6 year history of mycosis fungoides with patch and plaque stage disease who developed a single 2.5 cm tumor on the left chest without lymphadenopathy. Histology revealed a dense infiltrate of small atypical lymphocytes with cerebriform nuclei. Immunohistochemistry showed CD 4+, CD 43+ and CD 30‐ staining. Within 2 weeks she developed ataxia and right‐sided weakness. Magnetic resonance imaging (MRI) revealed left frontal and brainstem masses. Stereotactic biopsy showed a dense infiltrate of atypical lymphocytes with large convoluted nuclei. The immunohistochemistry showed a population of CD 4+, CD 43+, Alk‐1‐ cells with CD 30+ transformation. Gene rearrangement studies for the gamma T cell receptor on the skin patch and tumor as well as brain tumor failed to reveal a monoclonal population in any of the specimens. No other areas of involvement were found on complete staging. This case is an example of tumor stage MF with CD 30 transformation and CNS involvement.