bluuebunny/crossref_metadata_2025 huggingface dataset:
Artifactual Hyperbilirubinemia Due to Paraprotein Interference
Authors: Pantanowitz Liron , Horowitz Gary L. , Upalakalin Jan N. , Beckwith Bruce A.
Published: January 2021

Context.—Paraprotein interference in automated chemistry is uncommon. We describe 2 patients with paraproteinemia and elevated total bilirubin levels measured erroneously using the Roche total bilirubin assay.

Objectives.—To explain the mechanism of this artifactual hyperbilirubinemia and to determine its frequency in patients with monoclonal or increased immunoglobulins.

Materials and Methods.—The assay was performed manually using serum from 2 index patients and from control patients (without M proteins). Total bilirubin was also determined using another manufacturer's assay. A prospective study was then undertaken using serum from 100 consecutive patients with various monoclonal gammopathies and from 13 patients with polyclonal hypergammaglobulinemia and cryoglobulins. For all patients, serum immunoglobulin (Ig) G, IgA, IgM, total and direct bilirubin, creatinine, and a direct spectrophotometric assessment of icterus were measured.

Results.—After the addition of assay reagents, a white precipitate formed in the reaction mixtures containing serum from the index patients, but not in other samples. This turbidity, rather than the expected color change to pink, increased the absorbance and falsely elevated the total bilirubin value. Serum from both index patients was anicteric, their direct bilirubin measurements were unaffected, and total bilirubin measured using an alternate assay was normal. Among the 113 patients studied, no additional spurious total bilirubin values were detected.

Conclusion.—Paraprotein interference with the Roche automated total bilirubin assay is caused by precipitate formation. This interference is rare and probably idiosyncratic. Spurious hyperbilirubinemia from paraprotein interference may cause clinical confusion. If artifactual elevation of total bilirubin is suspected, the laboratory should examine the specimen for icterus (manually or by spectrophotometry) or measure total bilirubin using a different method.
Interpretative Problems and Preparative Technique Influence Reliability of Intraoperative Parathyroid Touch Imprints
Authors: Yao Davis X. , Hoda Syed A. , Yin Diana Y. , Kuhel William I. , Harigopal Malini , Resetkova Erika , DeLellis Ronald A.
Published: January 2021

Context.—Identification of parathyroid tissue (PT) is crucial during parathyroid and thyroid surgery. Touch imprint preparation (TIP) examination is potentially a more time-effective and less labor-intensive approach than frozen section examination for identification of PT during intraoperative consultation. However, the reliability of PT-TIP remains controversial, and this fact has hindered its adoption as a replacement for frozen section examination.

Objective.—To assess the factors contributing to the relative lack of reliability of TIP in a retrospective study.

Methods.—Fifty randomly selected, alcohol-fixed, hematoxylin-eosin– and/or Diff-Quik–stained TIPs of specimens that had been submitted to confirm PT during intraoperative consultation were retrospectively reviewed by 5 observers. The observers were blinded to the final interpretation (based on hematoxylin-eosin–stained permanent sections), which included PT in 39 (78%) of the 50 specimens, thyroid in 9 (18%), lymph node in 1 (2%), and adipose tissue 1 (2%). Cases in which a unanimous diagnosis was not attained were re-reviewed by 3 observers.

Results.—Of 50 TIPs reviewed, a unanimous diagnosis was rendered in 33 cases (66%), including 27 (69%) of 39 PT cases, 5 (56%) of 9 thyroid cases, and the 1 lymph node case. Cytologic features observed in the TIPs that were unanimously accepted as being diagnostic of PT included the presence of small uniform cells in isolation or in small groups, round to oval nuclei, salt-and-pepper chromatin, occasional naked nuclei, and delicate vacuoles both within the cytoplasm and in the background. Re-review of the 17 remaining TIPs cases, in which diagnostic unanimity was not achieved, demonstrated that factors hindering assessment of the TIPs included hypocellularity (n = 5 cases), air-drying effect (n = 4), hemorrhagic background (n = 4), and presence of PT cells in follicular (thyroid-like) arrangements (n = 4).

Conclusions.—The major factors influencing reliability of TIP of PT during intraoperative consultation are related primarily to interpretative problems and preparative technique. Awareness of interpretative problems and attention to preparation of TIPs may further enhance the accuracy of TIP during intraoperative consultation.
Concept-Match Medical Data Scrubbing
Authors: Berman Jules J.
Published: January 2021

Context.—In the normal course of activity, pathologists create and archive immense data sets of scientifically valuable information. Researchers need pathology-based data sets, annotated with clinical information and linked to archived tissues, to discover and validate new diagnostic tests and therapies. Pathology records can be used for research purposes (without obtaining informed patient consent for each use of each record), provided the data are rendered harmless. Large data sets can be made harmless through 3 computational steps: (1) deidentification, the removal or modification of data fields that can be used to identify a patient (name, social security number, etc); (2) rendering the data ambiguous, ensuring that every data record in a public data set has a nonunique set of characterizing data; and (3) data scrubbing, the removal or transformation of words in free text that can be used to identify persons or that contain information that is incriminating or otherwise private. This article addresses the problem of data scrubbing.

Objective.—To design and implement a general algorithm that scrubs pathology free text, removing all identifying or private information.

Methods.—The Concept-Match algorithm steps through confidential text. When a medical term matching a standard nomenclature term is encountered, the term is replaced by a nomenclature code and a synonym for the original term. When a high-frequency “stop” word, such as a, an, the, or for, is encountered, it is left in place. When any other word is encountered, it is blocked and replaced by asterisks. This produces a scrubbed text. An open-source implementation of the algorithm is freely available.

Results.—The Concept-Match scrub method transformed pathology free text into scrubbed output that preserved the sense of the original sentences, while it blocked terms that did not match terms found in the Unified Medical Language System (UMLS). The scrubbed product is safe, in the restricted sense that the output retains only standard medical terms. The software implementation scrubbed more than half a million surgical pathology report phrases in less than an hour.

Conclusions.—Computerized scrubbing can render the textual portion of a pathology report harmless for research purposes. Scrubbing and deidentification methods allow pathologists to create and use large pathology databases to conduct medical research.
A Regional Centralized Microbiology Service in Calgary for the Rapid Diagnosis of Malaria
Authors: Church Deirdre L. , Lichtenfeld Angelika , Elsayed Sameer , Kuhn Susan , Gregson Daniel B.
Published: January 2021

Context.—A regional centralized laboratory service for the rapid diagnosis of malaria was implemented 3 years ago in May 1999 within the Division of Microbiology, Calgary Laboratory Services.

Objective.—To describe the design and performance of this unique microbiology laboratory service.

Design.—Blood specimens must arrive at the central laboratory within 2 hours of collection. Thin blood smears are read and reported from suspected acute cases within 1 hour of receipt, 24 hours per day, 7 days a week, by trained and experienced microbiology technologists. All positive malaria smears are reviewed by a medical microbiologist and confirmed by polymerase chain reaction at a reference laboratory.

Setting.—Calgary Laboratory Services provides integrated laboratory services to the Calgary Health Region, an urban area of more than 1 million people.

Main Outcome Measures.—Performance of the service has been continuously monitored by measuring preanalytic and analytic test turnaround times, test accuracy, clinical relevance, and the results of proficiency testing.

Results.—More than 90% of blood specimens for malaria from community locations have consistently arrived within 2 hours of collection, and hospitals have reached this target within the past year. Although polymerase chain reaction was more sensitive at detecting the presence of malaria, the expert microscopists were as accurate at determining the type of Plasmodium infection. More than 95% of all positive smear results are consistently reported within 2 hours of receipt of a blood specimen.

Conclusions.—Implementation of a regional centralized microbiology service has improved our ability to make a rapid and accurate diagnosis of malaria in this region.
Microsatellite Instability in Colorectal Carcinoma
Authors: Rigau Valérie , Sebbagh Nicole , Olschwang Sylviane , Paraf François , Mourra Najat , Parc Yann , Flejou Jean-François
Published: January 2021

Context.—Microsatellite instability (MSI) due to defective mismatch repair (MMR) genes has been reported in the majority of colorectal tumors from patients with hereditary nonpolyposis colorectal cancer syndrome and in 10% to 15% of sporadic colorectal cancers. The identification of cancers associated with MSI requires classical molecular testing as the gold standard.

Objective.—The aim of this study was to evaluate the role of immunohistochemistry with antibodies directed against 4 MMR proteins as a screening tool for carcinomas with MSI.

Methods.—In this study, 204 formalin-fixed, paraffin-embedded colorectal carcinomas were examined for MMR protein expression (hMLH1, hMSH2, hMSH6, and hPMS2) and analyzed for MSI (MSI-H indicates at least 2 of 6 markers affected). These results were correlated with histopathologic parameters.

Results.—Immunohistochemical analysis revealed that loss of expression of at least 1 protein was present in 17% of cases. One hundred percent of carcinomas that showed high instability (MSI-H) showed loss of expression of hMLH1, hMSH2, or hMSH6. Loss of expression of 2 proteins was present in 59.4% of MSI-H cases, with only 2 combinations, namely, hMLH1/hPMS2 and hMSH2/hMSH6. Isolated loss of hMSH6 expression was present in 2 MSI-H cases.

Conclusions.—These findings confirm that examination of MMR protein expression by immunohistochemistry is a simple method to diagnose colorectal cancer with MSI. Our data suggest that the study of hMSH6 may be useful, in addition to hMLH1 and hMSH2. Moreover, immunohistochemistry could represent a screening method with which to direct research on the mutations of MMR genes observed in hereditary nonpolyposis colorectal cancer syndrome.
Rapid Polymerase Chain Reaction–Based Confirmation of Cat Scratch Disease and Bartonella henselae Infection
Authors: Margolis Ben , Kuzu Isinsu , Herrmann Marille , Raible Michele D. , Hsi Eric , Alkan Serhan
Published: January 2021

Context.—Cat scratch disease (CSD) commonly occurs secondary to Bartonella henselae infection, and the diagnosis has traditionally been made by microscopic findings, the identification of organisms by cytochemistry, and clinical history. However, cytochemical analysis tends to be very difficult to interpret, and histology alone may be insufficient to establish a definitive diagnosis of CSD.

Objective.—To demonstrate the presence of B henselae in tissue suspected of involvement by CSD, using a novel polymerase chain reaction (PCR) assay.

Design.—Isolates of B henselae (American Tissue Culture Collection 49793) and Afipia felis (American Tissue Culture Collection 49714) were cultured on blood agar and buffered charcoal yeast extract agar, respectively. DNA was isolated from these organisms and from formalin-fixed, paraffin-embedded tissue sections with involvement by CSD (8 patients). Negative controls included water, human placental tissue, and lymph node specimens from 6 patients with reactive lymphoid hyperplasia and from 2 patients with granulomatous lymphadenitis. A primer complementary to B henselae citrate synthase gltA gene sequence was designed to perform a seminested PCR amplification. For restriction fragment length polymorphism analysis, PCR products were digested by TaqI restriction enzyme and analyzed by gel electrophoresis.

Results.—Seminested PCR analysis of the cultured isolates of B henselae, but not of A felis, showed specific amplification. However, nonnested PCR did not provide consistently positive results in tissue sections with CSD. Therefore, we used a seminested PCR, which revealed positivity in all of the cases with clinicopathologic diagnoses of CSD. None of the negative controls showed positivity. Restriction enzyme provided confirmation of the specific PCR amplification of the B henselae sequence.

Conclusions.—Since the amplification product has a low molecular size (<200 base pairs), this assay is useful for detection of B henselae in formalin-fixed, paraffin-embedded tissues. The seminested PCR protocol described here can be used for rapid and reliable confirmation of B henselae in samples that are histologically suggestive of CSD.
Xanthomatous Pseudotumor
Authors: Tan Kong-Bing , Thamboo Thomas Paulraj , Raju Gangaraju C.
Published: January 2021

Neoadjuvant chemotherapy has become an integral part of the treatment for locally advanced breast cancer. It facilitates tumor resectability and also provides an opportunity for the assessment of therapeutic response and prognosis. We report a case in which a large primary breast carcinoma was significantly reduced in size clinically and replaced by a mass lesion that was composed almost entirely of foamy histiocytes. This peculiar phenomenon is described in detail, together with a brief review of the other known postchemotherapy histologic features that include tumor necrosis, tumor cell cytoplasmic vacuolation and marked nuclear atypia, accompanying chronic inflammatory cellular infiltrate, fibrosis, and ductal-lobular atrophy.
Indeterminate Cell Histiocytosis
Authors: Rodríguez-Jurado Rodolfo , Vidaurri-de la Cruz Helena , Durán-Mckinster Carola , Ruíz-Maldonado Ramón
Published: January 2021

Indeterminate cell histiocytosis is a rare disorder involving altered homing mechanisms of the cutaneous histiocytic/dendritic system. It has been described predominantly in adults, with less than a dozen cases in children. A 13-year-old adolescent girl presented with a 4-year history of asymptomatic erythematous nodules and plaques, measuring from 1 to 5 cm in diameter, that were located mainly on the trunk and proximal portions of her limbs. A skin biopsy showed dermal diffuse infiltration of histiocytic cells. Most of the histiocytic cells were strongly positive for S100 protein. No Birbeck granules were found. Treatment with topical steroid was ineffective. After 6 months of pure coal tar and 5% 5-fluorouracil cream, an almost total clearing of lesions was observed. An accurate diagnosis of this condition is mandatory in order to avoid unnecessary treatments. Conservative management is also discussed.
Electronic Medical Devices; A Primer for Pathologists
Authors: Weitzman James B.
Published: January 2021

Context.—Electronic medical devices (EMDs) with downloadable memories, such as implantable cardiac pacemakers, defibrillators, drug pumps, insulin pumps, and glucose monitors, are now an integral part of routine medical practice in the United States, and functional organ replacements, such as the artificial heart, pancreas, and retina, will most likely become commonplace in the near future. Often, EMDs end up in the hands of the pathologist as a surgical specimen or at autopsy. No established guidelines for systematic examination and reporting or comprehensive reviews of EMDs currently exist for the pathologist.

Objective.—To provide pathologists with a general overview of EMDs, including a brief history; epidemiology; essential technical aspects, indications, contraindications, and complications of selected devices; potential applications in pathology; relevant government regulations; and suggested examination and reporting guidelines.

Data Sources.—Articles indexed on PubMed of the National Library of Medicine, various medical and history of medicine textbooks, US Food and Drug Administration publications and product information, and specifications provided by device manufacturers.

Study Selection.—Studies were selected on the basis of relevance to the study objectives.

Data Extraction.—Descriptive data were selected by the author.

Data Synthesis.—Suggested examination and reporting guidelines for EMDs received as surgical specimens and retrieved at autopsy.

Conclusions.—Electronic medical devices received as surgical specimens and retrieved at autopsy are increasing in number and level of sophistication. They should be systematically examined and reported, should have electronic memories downloaded when indicated, will help pathologists answer more questions with greater certainty, and should become an integral part of the formal knowledge base, research focus, training, and practice of pathology.
Survivin in Glioblastomas
Authors: Kleinschmidt-DeMasters B. K. , Heinz David , McCarthy Paul J. , Bobak Joanna B. , Lillehei Kevin O. , Shroyer A. Laurie W. , Shroyer Kenneth R.
Published: January 2021

Context.—Survivin is a novel inhibitor of apoptosis that acts via a pathway independent of bcl-2. Little is known about its distribution in brain tumors or how it correlates with other biomarkers of malignancy, such as telomerase, an enzyme that plays a critical role in cellular immortalization and cancer biology.

Objectives.—To assess survivin protein expression in gliomas and to compare expression with that of telomerase.

Design.—Immunohistochemical staining for survivin protein expression was performed using an antibody developed in our laboratory. Quantitative survivin messenger RNA (mRNA) levels were assessed by reverse transcriptase-polymerase chain reaction. In selected cases, survivin results were compared with quantitative telomerase values analyzed by polymerase chain reaction–based telomerase repeat amplification protocol (TRAP) assay. Twenty-five tumor tissue samples from 16 cases of glioblastoma multiforme (GBM; including multiple tissue samples in 6 patients), 2 grade II gliomas, 4 grade III gliomas, and 3 control temporal lobectomy specimens were studied.

Results.—Nuclear immunoreactivity for survivin protein and survivin mRNA were detectable in most glioma samples, regardless of grade. Glioblastoma multiforme demonstrated moderate protein expression and survivin mRNA levels compared to epithelial malignancies previously tested in our laboratory. Although the association of survivin mRNA with the levels of telomerase within the GBM cases did not reach statistical significance, most GBMs also expressed survivin. The quantitative score for survivin mRNA was higher in GBMs than in grade II and III gliomas (P = .02), after accounting for multiple specimens per patient.

Conclusions.—Quantitative survivin mRNA analysis, but not immunohistochemistry, distinguished GBMs from lower grade gliomas. Mechanisms that promote both cell proliferation (telomerase expression) and cell survival (survivin expression) are often activated in GBMs.
Development and Validation of a Molecular Beacon Probe–Based Real-Time Polymerase Chain Reaction Assay for Rapid Detection of Methicillin Resistance in Staphylococcus aureus
Authors: Elsayed Sameer , Chow Barbara L. , Hamilton Nina L. , Gregson Daniel B. , Pitout Johann D. D. , Church Deirdre L.
Published: January 2021

Context.—A rapid, real-time, duplex, fluorescent molecular beacon probe–based polymerase chain reaction (PCR) assay was recently developed for the detection of methicillin-resistant Staphylococcus aureus.

Objective.—To describe the development and validation of this unique assay.

Design.—Prospective laboratory analysis.

Setting.—Urban health region/centralized diagnostic microbiology laboratory.

Bacterial Strains.—One hundred eighty-one previously characterized clinical and American Type Culture Collection isolates, including 50 strains each of methicillin-resistant and methicillin-sensitive S aureus, plus 50 strains of coagulase-negative staphylococci and 31 nonstaphylococcal isolates to ensure assay specificity.

Intervention.—Assays were performed on purified genomic DNA extracted from growing bacterial colonies. Two sets of oligonucleotide primers were used to specifically amplify the mecA and nuc genes, followed by detection of amplicons using fluorophore-labeled molecular beacon probes. Assays were performed on the Mx4000 Multiplex Quantitative PCR System (Stratagene Inc, La Jolla, Calif).

Main Outcome Measures.—(1) Assay sensitivity and specificity, and (2) analytical sensitivity.

Results.—The assay demonstrated 100% sensitivity and 100% specificity, and accurately characterized isolates as methicillin-resistant S aureus, methicillin-sensitive S aureus, or methicillin-resistant coagulase-negative staphylococci, with test results available in 2.5 hours. The analytical sensitivity of the assay was determined to be between 6 and 60 genomic equivalents.

Conclusions.—This assay is rapid, accurate, easy to perform, and is compatible with other real-time PCR instruments, making it a suitable alternative to conventional PCR methodologies.
Left-Sided Splenorenal Fusion With Marked Extramedullary Hematopoiesis and Concurrent Lithium Toxicity
Authors: Yuan Shan , Vaughan Matthew , Nicholas Agoff S.
Published: January 2021

Occasionally, heterotopic splenic tissue can occur in the renal fossa secondary to splenosis following splenic trauma or splenectomy. More rarely, it can represent a developmental anomaly secondary to the fusion of splenic and renal tissues. Splenorenal fusion can present as a renal mass, mimicking primary or secondary renal neoplasms on imaging studies, and patients can also present with symptoms of hypersplenism (anemia). We report a case of splenorenal fusion in a 51-year-old woman who initially presented with lithium toxicity, anemia, thrombocytosis, and a large renal mass that mimicked a primary renal neoplasm. The possible embryologic origin of splenorenal fusion, effects of lithium toxicity, and utility of various imaging modalities are discussed. The literature on renal heterotopic splenic tissue is also briefly reviewed.
Anaplastic Large Cell Lymphoma Arising in a Silicone Breast Implant Capsule: A Case Report and Review of the Literature
Authors: Sahoo Sunati , Rosen Paul P. , Feddersen Richard M. , Viswanatha David S. , Clark Douglas A. , Chadburn Amy
Published: January 2021

Anaplastic large cell lymphoma is a rare type of primary breast lymphoma. We report a case of anaplastic large cell lymphoma, T-cell phenotype, occurring in the periprosthetic capsule of a silicone breast prosthesis 9 years after implantation for augmentation mammoplasty. This case is unique for its unusual presentation.
Diffuse Neuroendocrine Differentiation in a Morphologically Composite Mammary Infiltrating Ductal Carcinoma: A Case Report and Review of the Literature
Authors: David Odile , Bhattacharjee Meena
Published: January 2021

Neuroendocrine differentiation has been reported in both in situ and infiltrating breast cancers. The prognostic significance of neuroendocrine differentiation in mammary carcinoma is unclear. We report a case of infiltrating ductal carcinoma in which there was a morphologically conventional-appearing infiltrating ductal component admixed with nests of cells that resembled a carcinoid tumor and initially mimicked the appearance of intraductal carcinoma. Immunohistochemical stains for synaptophysin and chromogranin demonstrated diffuse, strong positivity uniformly throughout the tumor, even in the more conventional-appearing areas. Electron microscopic examination of tissue retrieved from paraffin blocks was attempted unsuccessfully. We concluded that this was an infiltrating ductal carcinoma with morphologic and immunohistochemical evidence of neuroendocrine differentiation. The case is discussed with a review of the literature and a discussion of nomenclature for tumors of the breast showing variable degrees of neuroendocrine differentiation.
Duodenal Gangliocytic Paraganglioma With Lymph Node Metastasis: A Case Report and Review of the Literature
Authors: Sundararajan Vanitha , Robinson-Smith Toni M. , Lowy Andrew M.
Published: January 2021

A case of duodenal gangliocytic paraganglioma (DGP) in a 67-year-old woman is presented. The DGP arose in the second part of the duodenum. Although most of the reported cases of DGP are considered benign, in the present case, we found regional lymph nodes containing metastatic tumor. Previous reports have documented metastases containing only epithelioid cells. The current case demonstrates metastatic tumor in regional lymph nodes containing all 3 of the DGP components (spindle cells, ganglion-like cells, and epithelioid cells).
Natural Killer–like T-Cell Lymphoma of the Small Intestine With a Distinct Immunophenotype and Lack of Association With Gluten-Sensitive Enteropathy
Authors: Yuan Constance M. , Stein Steven , Glick John H. , Wasik Mariusz A.
Published: January 2021

We report the case of a large natural killer (NK)–like T-cell lymphoma that involved the ileum and displayed a distinct immunophenotype and complex karyotype. The patient exhibited no evidence of gluten-sensitive enteropathy (celiac disease) or any other type of enteropathy as determined by clinical history, endoscopy, and serology for immunoglobulin A (IgA) antiendomysial and IgG antigliadin antibodies. Molecular studies demonstrated a clonal T-cell receptor γ chain gene rearrangement. Immunophenotype analysis showed expression of intestinal epithelium-homing receptor CD103, CD7, cytoplasmic CD3ɛ, CD56, and CD16 but no other T- or NK-cell markers. Cytogenetic analysis of the malignant cells revealed multiple chromosomal abnormalities indicative of a biologically advanced, high-grade lymphoma. A novel subset of normal intestinal intraepithelial lymphocytes, bearing a similar phenotype, has been described; moreover, this subset diminishes, rather than expands, in gluten-sensitive enteropathy. This case supports the notion that lymphomas involving the small intestine represent a heterogeneous group of lymphomas with diverse pathogenetic mechanisms.
Infection byDipylidium caninumin an Infant
Authors: Molina Claudia P. , Ogburn James , Adegboyega Patrick
Published: January 2021

Dipylidium caninum, the dog tapeworm, is a cosmopolitan parasite of dogs and cats and occasionally causes human infection in the United States. Diagnosis is made by observing the characteristic rice grain–like proglottids in stool specimens and the pathognomonic egg packets in the gravid uterus in histologic sections of the parasite. There have been few reported cases of human infection with this parasite, and very little information on the pathology of this zoonotic disease is available in the English language. This report of a case of D caninum infection in a 6-month-old infant highlights the diagnostic features of this disease. To our knowledge, this is the first case to be reported in the American pathology literature during the last 36 years (MEDLINE database, 1966–2002).
Rosai-Dorfman Disease
Authors: Cocker Rubina S. , Kang John , Kahn Leonard B.
Published: January 2021

To the best of our knowledge, this is the only reported case of isolated involvement by Rosai-Dorfman disease (RDD) of small, anterior cervical-midline lymph nodes, clinically presenting as a thyroid mass. Thyroid parenchymal involvement by RDD has been reported in only 3 cases in the literature. The present case shows involvement of RDD of a pretracheal and thyroid isthmic lymph node in a 38-year-old woman. The progressively enlarging, anterior neck mass was diagnosed as “lymph node” on a fine-needle aspiration biopsy specimen and subsequently interpreted to be an isthmic cyst on ultrasonography. A magnetic resonance imaging scan revealed foci of nodularity in the thyroid isthmus and pretracheal lymph node. Excisional biopsy of the 2 masses revealed typical features of sinus histiocytosis with massive lymphadenopathy in the lymph node. Review of the patient's previous fine-needle aspiration biopsy specimens also revealed the presence of similar features. Currently, the patient is well and has no other manifestation or recurrence of RDD.
Mediastinal Epithelioid Solitary Fibrous Tumor
Authors: Marchevsky Alberto M. , Varshney Dolly , Fuller Clark
Published: January 2021

We describe the case of a 74-year-old man with a mediastinal tumor composed predominantly of epithelioid cells exhibiting histopathologic and immunohistochemical features intermediate between those of a solitary fibrous tumor and those of a cellular adenomatoid tumor. We discuss the differential diagnosis and possible histogenesis of this unusual neoplasm, and we propose the term epithelioid solitary fibrous tumor for this entity.
Plasma Cell Granuloma—An Enigmatic Lesion
Authors: Buccoliero Anna Maria , Caldarella Adele , Santucci Marco , Ammannati Franco , Mennonna Pasquale , Taddei Antonio , Taddei Gian Luigi
Published: January 2021

We present an unusual case of intracranial plasma cell granuloma in a 70-year-old man with a 6-month history of progressive visual disturbance. The lesion extensively involved the cranial base, extended into the frontal region, and reached the floor of the third ventricle in the suprasellar area. Microscopic examination of multiple diagnostic transsphenoidal biopsies showed an inflammatory proliferation with a predominance of cells that were immunohistochemically determined to be polyclonal plasma cells. Ultrastructural analysis confirmed the presence of numerous mature plasma cells in a mixed inflammatory proliferation. In situ hybridization for Epstein-Barr viral RNA revealed no evidence of viral expression. The patient was treated with steroid therapy and radiotherapy, without any appreciable reduction of the lesion's size. He is alive with persistent severe visual disturbance 14 months after the diagnosis. We discuss the etiopathogenetic, diagnostic, and therapeutic issues related to this entity, and review the literature.
Fulminant Adenovirus Hepatitis Following Bone Marrow Transplantation
Authors: Wang Wei Hua , Wang Hanlin L.
Published: January 2021

Adenovirus infections are frequently encountered in immunocompromised patients and transplant recipients. However, fulminant hepatic failure due to adenovirus infection as a fatal complication in bone marrow transplant recipients is extremely rare. We report a case of fulminant adenovirus hepatitis in a 21-year-old allogeneic bone marrow transplant recipient who subsequently died of the disease. The diagnosis was established by histologic and immunohistochemical examination of a liver biopsy and was confirmed by liver tissue and blood cultures.
Two Cases of Epithelioid Angiosarcoma Involving the Thyroid and a Brief Review of Non-Alpine Epithelioid Angiosarcoma of the Thyroid
Authors: Goh Seng Geok Nicholas , Chuah Khoon Leong , Goh Hood Keng Christopher , Chen Yun Yin Cosmas
Published: January 2021

Epithelioid angiosarcoma involving the thyroid is a rare entity, more often described in the Alpine region. Two cases of epithelioid angiosarcoma that affected the thyroid in patients from a non-Alpine location were diagnosed during a 10-year period in our department. The first case occurred in an 89-year-old Chinese man with a history of longstanding goiter, whereas the second case involved a 74-year-old Chinese man with a history of angiosarcoma of the scalp. On histologic examination, both thyroid tumors were composed of plump epithelioid cells with vesicular chromatin and prominent nucleoli, forming vascular structures and solid sheets. Positive staining for CD31 and factor VIII–related antigen confirmed endothelial differentiation in both cases. Both patients died within 5 months following the diagnosis of thyroid disease. The relationship of the scalp angiosarcoma and thyroid disease of the second patient is unclear. A brief review of non-Alpine primary thyroid epithelioid angiosarcoma is presented.
Rosai-Dorfman Disease Presenting in the Gastrointestinal Tract
Authors: Anders Robert A. , Keith Jeanette Newton , Hart John
Published: January 2021

Rosai-Dorfman disease (RDD) rarely presents a diagnostic challenge. However, unusual sites of presentation can cause confusion. We present a case of RDD of the colon in a symptomatic 51-year-old woman. The gastrointestinal tract is the organ system least commonly affected by RDD, with only 11 cases reported. Most cases have been found incidentally or at autopsy. The widespread use of endoscopic procedures makes it more likely that this entity will be encountered. Most patients with gastrointestinal tract involvement have evidence of widespread extranodal disease and have a protracted clinical course.
Involvement of Meckel Diverticulum in Crohn Disease Associated With Pancreatic Heterotopia
Authors: Mourra Najat , Tiret Emmanuel , Caplin Scott , Gendre Jean-Pierre , Parc Rolland , Flejou Jean-Francois
Published: January 2021

Although the association of Crohn disease and Meckel diverticulum has been widely reported, the direct involvement of a Meckel diverticulum by Crohn disease is less common and is usually the result of contiguous spread. The presence of heterotopic tissues in an affected diverticulum is rare and most often consists of gastric mucosa. We report herein the presence of Crohn disease within a Meckel diverticulum, with a normal small bowel immediately adjacent to the diverticulum, associated with pancreatic heterotopia.
Correlation between permeability and porosity with other properties of concrete
Authors: Salman Al-lami
Published: January 2021

Most of concrete properties such as strength, permeability, density and absorption are significantly affected by the porosity of its internal microstructure. Many researchers studied the relationships between permeability, porosity and other properties of concrete, but in the author's opinion, the subject still needs more researching works. The purpose of this research is to investigate the possible correlations between concrete porosity and permeability with other properties such as compressive strength, absorption and density. Helium Gas Pores meter was used to measure porosity and Nitrogen Gas Permeate device was used to measure permeability. The investigated variables were the aggregate to cement ratio (A/C) and water to cement ratio (W/C). Based on regression analysis of test results, mathematical relationships between tested properties were suggested. The higher correlations were observed for mixes with constant water to cement ratio and variable aggregate to cement ratio.
La recepción y traducción de unidades fraseológicas en el discurso político. Análisis de un corpus ad hoc (EN, FR > ES)
Authors: López Ruiz María del Carmen
Published: January 2021

El objetivo de este trabajo es investigar las UFS más habituales en los discursos políticos partiendo de las premisas que se han abordado hasta el momento en este lenguaje de especialidad en relación con la fraseología (Coseriu, 1987; Van Dijk, 1996; Navarro, 2002; Fuentes et al., 2002). Adoptando una visión traductológica, mostraremos las UFS halladas en un corpus de trabajo compuesto por discursos políticos en inglés y en francés con su correspondiente traducción hacia el español. La intención es clasificar las UFS para obtener resultados cuantitativos en lo referente a la fraseología del discurso político, tanto en el corpus de discursos en inglés como en el de francés, para así poder obtener una visión más completa de los diferentes tipos de UFS que se hallan en el discurso político y sus porcentajes correspondientes. El resultado de nuestra investigación nos permitirá elaborar un glosario trilingüe cuya finalidad es servir de referencia durante el proceso de documentación de otros especialistas en el tema.
COMPARATIVE ANALYSIS OF FOREIGN PRACTICE OF JUSTIFICATION OF THE INITIAL MAXIMUM PRICE OF THE CONTRACT IN THE PUBLIC ORDER PLACEMENT SYSTEM
Authors: Ахматов Хусей Ахматович , Коновалов Олег Александрович
Published: January 2021

The paper highlights the main aspects of the formation and justification of the maximum price when placing a state order by participants in the contract system of foreign countries. The analysis of the best practices in public procurement is described on the example of countries such as the USA, Canada, UK, France, Brazil, Australia. Differences in comparison with the domestic practice of justifying the initial maximum price are revealed, associated with the obligatory survey of participants in the procurement procedure by government customers, with explanations of the decision taken by the commission of the government customer. The work reflects foreign analogues of the concept of the initial maximum contract price used in Russian practice, which are subject to the principles of agreeing a reasonable and fair price, as well as the open and hidden nature of the reserve price. The essence of the concept of the preliminary price of a state contract mentioned in the directives and guidelines of the European Union is revealed. The article reveals the factors enshrined in foreign regulations that prevent the formation of an equilibrium market price in the system of placing a government order, associated not only with a conflict of interest, but also with the unjustified provision of cost and non-cost benefits
Reconciling Macroeconomic Determinants with Stock Market Performance in Selected Sub-Saharan African Countries: an ARDL Approach
Authors:   Southwestern University, Okun-Owa, Nigeria, Arikewuyo Kareem Abidemi , Adeyemi Akeem Adekunle ,   Olabisi Onabanjo University, Ago-Iwoye, Nigeria, Omodara Eunice Titilayo ,   Olabisi Onabanjo University, Ago-Iwoye, Nigeria, Yunusa Lateef Adewale ,   Olabisi Onabanjo University, Ago-Iwoye, Nigeria
Published: January 2021

Prior studies have adduced unstable macroeconomic factors to stock price movement overtime but the relationship between the duo remained unsettled. Autoregressive Distributed Lag (ARDL) technique was used to reconcile the macroeconomic determinants with performance of stock markets in selected Sub-Saharan Africa (SSA) covering the period of 1999:1–2017:4. It was found that macroeconomic indicators were essential in determining stock market performance in Nigeria while South African stock market did not show any predictable linkage but the contemporaneous effect of oil price changes on stock market performance in selected SSA. The study, therefore, recommended that countries in SSA should reduce overdependence on oil to minimize external influence in order to promote stability of the stock markets.
GDP growth as a bank loan quality determinant
Authors:   University of Szczecin, Rachuba Joanna
Published: January 2021

Past financial crises and recessions have revealed the importance of the economy’s condition for the loan quality. Macroeconomic determinants of the non-performing loans have been attracting considerable attention in recent years. The aim of this paper is to organize and summarize studies examining the role of GDP growth and its impact on bank loan quality. This approach reveals the research problem which is to specify if there exists a statistically significant relationship between economic growth and the level of non-performing loans. It is equally important to determine the direction of this link. By appealing to common knowledge, the research hypothesis states that an increase in economic activity results in improving loan quality. To verify the hypothesis, the analysis of the relevant literature and the methods of verbal as well as tabular description have been applied. Empirical results on the link between the macroeconomic environment and the level of non-performing loans appear to be quite conclusive. It has been found that an economic expansion generally improves the loan quality. This broadly proven relationship is in line with many studies which confirm the borrowers’ increased willingness to repay debts in a favourable economic environment. Far less frequently, the macroeconomic activity leads to future bank losses. Additionally, some studies do not provide any statistically significant effect of GDP growth on the loan quality.
Algunas nuevas sobre Alphonso Hordognez
Authors: Paolini Devid
Published: January 2021

En un artículo reciente, Gesiot (2019) ha mostrado cómo buena parte de la dedicatoria de la traducción italiana de Celestina es una adaptación, refundición y traducción de dos obras principales: el Decamerón y el Tirant lo Blanch. A las partes señaladas por el estudioso, indicamos algún pasaje más junto con unas consideraciones generales sobre lo que este descubrimiento significa con respecto al traductor de la obra maestra española.
Hacia un censo completo unificado de los ejemplares conservados de Celestina (I): ejemplares de ediciones en castellano localizables en línea
Authors: Saguar García Amaranta
Published: January 2021

En una época en la que las bibliotecas no dejan de volcar nuevos catálogos en la red y de actualizar los antiguos, en la que los catálogos colectivos regionales no dejan de sacar a la luz y de hacer accesibles colecciones que de otra manera pasarían desapercibidas para los investigadores, en la que los catálogos y metacatálogos digitales permiten consultar de una sola vez decenas de fondos repartidos por el mundo, el redescubrimiento de ejemplares de Celestina perdidos o no consignados hasta el momento no debería sorprender a nadie. Estas especiales circunstancias han hecho que mantener un censo completo y actualizado de ejemplares localizados de Celestina requiera la revisión periódica de dichos recursos digitales con el objetivo de incorporar nuevos ejemplares, corroborar la existencia de otros y corregir los posibles ejemplares fantasma de versiones anteriores. El presente trabajo quiere ofrecer un punto de partida para esta revisión periódica reuniendo por escrito y en un mismo lugar todos los ejemplares conservados de ediciones en castellano de Celestina anteriores a su prohibición inquisitorial localizables en línea a 1 de noviembre de 2020.
Gaspar Gómez de Toledo y la búsqueda de la fama
Authors: Esteban Martín Luis M.
Published: January 2021

Gaspar Gómez de Toledo, con su Tercera parte de la tragicomedia de Celestina, pretende no solo continuar la obra precedente, la Segunda Comedia de Celestina, de Feliciano de Silva, y entrar así en el ciclo celestinesco iniciado con la publicación de Celestina, sino convertirse en el autor con el que dicho ciclo quede cerrado definitivamente, de ahí que vaya concluyendo episodios inconclusos en la obra de Silva y que acabe definitivamente con la vieja alcahueta Celestina resucitada por Silva. Esta intención de cerrar un ciclo viene motivada por el deseo de fama, de pasar a la posteridad como el autor que culminó las aventuras de la alcahueta de Fernando de Rojas y, por tanto, gozar del éxito que el público otorgó a las dos obras que le precedieron.
La educación en tiempos virales: el caso de Portugal
Authors: Abrantes Pedro
Published: January 2021

Este artículo presenta una contribución para comprender los efectos de la pandemia de COVID-19 en la educación (básica y secundaria). Se centra en el proceso de confinamiento y la consiguiente transición hacia un modelo de enseñanza a distancia vivido en Portugal entre marzo y junio de 2020. Para ello, se empieza por buscar un marco teórico adecuado que permita comprender un fenómeno novedoso, imprevisible y que cuenta con un trasfondo biológico, pero que ha accionado un conjunto complejo de dinámicas políticas, económicas, sociales y culturales. A continuación, se discuten algunos informes internacionales relevantes. En la segunda parte, tras algunas notas metodológicas, se analizan los principales resultados de un cuestionario aplicado a los directores de escuela en Portugal, en tres sucesivos momentos, lo que permite entender tendencias y evoluciones durante el periodo analizado. La conclusión central es que las escuelas portuguesas han podido garantizar a la gran mayoría de sus alumnos una oferta educativa en línea, a través de un proceso intensivo de aprendizaje de los maestros, de desarrollo organizativo y de una colaboración sin precedentes entre los diversos actores educativos. A pesar de una notable diversidad de soluciones, la tendencia dominante fue la “migración” temporal del modelo educativo tradicional hacia escenarios digitales “estandarizados” y, por ende, no ha sido posible involucrar a una parte de niños y jóvenes en condiciones más vulnerables, ni desarrollar de forma consistente un modelo pedagógico más creativo, inclusivo e innovador.
Bonnéry, Stéphane y Douat, Étienne (dir.), L’éducation aux temps du coronavirus. París: La Dispute.
Authors: Rujas Javier
Published: January 2021

Reseña de Bonnéry, Stéphane y Douat, Étienne (dir.), L’éducation aux temps du coronavirus. París: La Dispute.
Memorabilia: o lado espacial da memória (na esteira de Merleau-Ponty)
Authors: Umbelino Luís António
Published: January 2021

O livro trata de um tema específico: a dimensão espacial da memória. Mais especificamente, o oriente deste trabalho é o de ponderar a que ponto e de que modo(s) o tema da memória, que nos habituamos a considerar do lado do tempo, comporta (e por ventura originariamente) um lado espacial definidor, uma dimensão constitutivamente espacial.
DNA damage—how and why we age?
Authors: Yousefzadeh Matt , Henpita Chathurika , Vyas Rajesh , Soto-Palma Carolina , Robbins Paul , Niedernhofer Laura
Published: January 2021

Aging is a complex process that results in loss of the ability to reattain homeostasis following stress, leading, thereby, to increased risk of morbidity and mortality. Many factors contribute to aging, such as the time-dependent accumulation of macromolecular damage, including DNA damage. The integrity of the nuclear genome is essential for cellular, tissue, and organismal health. DNA damage is a constant threat because nucleic acids are chemically unstable under physiological conditions and vulnerable to attack by endogenous and environmental factors. To combat this, all organisms possess highly conserved mechanisms to detect and repair DNA damage. Persistent DNA damage (genotoxic stress) triggers signaling cascades that drive cells into apoptosis or senescence to avoid replicating a damaged genome. The drawback is that these cancer avoidance mechanisms promote aging. Here, we review evidence that DNA damage plays a causal role in aging. We also provide evidence that genotoxic stress is linked to other cellular processes implicated as drivers of aging, including mitochondrial and metabolic dysfunction, altered proteostasis and inflammation. These links between damage to the genetic code and other pillars of aging support the notion that DNA damage could be the root of aging.
Pervasive duplication of tumor suppressors in Afrotherians during the evolution of large bodies and reduced cancer risk
Authors: Vazquez Juan M , Lynch Vincent J
Published: January 2021

The risk of developing cancer is correlated with body size and lifespan within species. Between species, however, there is no correlation between cancer and either body size or lifespan, indicating that large, long-lived species have evolved enhanced cancer protection mechanisms. Elephants and their relatives (Proboscideans) are a particularly interesting lineage for the exploration of mechanisms underlying the evolution of augmented cancer resistance because they evolved large bodies recently within a clade of smaller-bodied species (Afrotherians). Here, we explore the contribution of gene duplication to body size and cancer risk in Afrotherians. Unexpectedly, we found that tumor suppressor duplication was pervasive in Afrotherian genomes, rather than restricted to Proboscideans. Proboscideans, however, have duplicates in unique pathways that may underlie some aspects of their remarkable anti-cancer cell biology. These data suggest that duplication of tumor suppressor genes facilitated the evolution of increased body size by compensating for decreasing intrinsic cancer risk.