bluuebunny/crossref_metadata_2025 huggingface dataset:
The mechanism of LPS-induced vascular endothelial cell and renal tubular cell injury in experimental disseminated intravascular coagulation (DIC)
Authors: Yokochi Takashi , Koide Naoki , Kato Yutaka , Sugiyama Tsuyoshi , Yoshida Tomoaki
Published: June 2007

The mechanism of LPS-induced tissue injury in experimental disseminated intravascular coagulation (DIC) was investigated. The generalized Shwartzman reaction (GSR) was used for an experimental murine DIC model. GSR was induced in mice by two consecutive injections of LPS. Vascular endothelial cells in various organs of those mice were stained positively by the in situ nick end labeling specific for fragmented DNA. Renal tubular cells were also stained with the nick end labeling. Fragmented nuclei were histologically detected on vascular endothelial cells and renal tubular cells in GSR-induced mice. It was suggested that apoptotic cell death might participate in development of vascular endothelial cell and renal tubular cell injury in GSR. Interferon-γ and ICAM-1 seemed to play an important role in the apoptosis of vascular endothelial cells. On the other hand, Fas and Fas ligand system seemed to be involved in the apoptosis of renal tubular cells. The detailed mechanism of vascular endothelial cell and renal tubular cell injury is discussed.
Implications for a general role of LPS-binding proteins (CD14, LBP) in combating bacterial infections
Authors: Schütt C. , Bernheiden M. , Grunwald U. , Stelter F. , Menzel R. , Müller H.P. , Fan X. , Jack R.S.
Published: June 2007

An invading pathogen must be held in check by the innate immune system until a specific immune response can be mounted. In the case of Gram-negative bacteria, the principal stimulator is LPS, a component of the outer membrane of the bacteria. In vitro LPS is bound by LBP and transferred to the LPS receptor CD14 on the macrophage surface. Binding to CD14 triggers an inflammatory response which is crucial for keeping an infection under control. In vitro, LBP mediates a response not only to LPS but also to intact Gram-negative bacteria. We show that whole Escherichia coli bacteria are recognised by CD14 on human monocytes, and subsequently may become phagocytosed. Although neither LBP nor CD14 interact with the heat inactivated, intact Gram-positive bacterium Bacillus subtilis both proteins form stable complexes with lipoteichoic acid derived from the bacterial cell wall. A brief exposure of B. subtilis to serum or antibiotics converts them into a form which can be recognised by CD14 in an LBP-dependent manner followed by phagocytosis. In preliminary experiments, it is shown that LBP is essential in vitro for the oxidative burst response of mouse macrophages induced by living Salmonella typhimurium as well as Staphylococcus epidermidis. Our results indicate that, in addition to CD14, LBP is also a pattern recognition element and is required to induce a rapid inflammatory response to Gram-negative as well as to Gram-positive bacteria and to initiate their phagocytosis.
Hyporesponsiveness in leukocytes in sepsis: in vitro models reveal paradoxical effects of IL-10
Authors: Cavaillon Jean-Marc , Adib-Conquy Minou , Marie Christelle , Fitting Catherine
Published: June 2007

Sepsis syndrome is linked with a systemic inflammatory response syndrome (SIRS). This severe inflammation is associated with an immune suppression as illustrated by the reduced capacity of circulating leukocytes to produce cytokines in response to in vitro activation. Non-infectious SIRS such as trauma, burn, hemorrhage or major surgery is also associated with a suppression of the immune system. This phenomenon has been recently termed CARS for compensatory anti-inflammatory response syndrome. We report in vitro experiments which suggest that a well-known anti-inflammatory cytokine, namely IL-10, may, in certain experimental conditions, prime the leukocytes finally leading to an increased cytokine production. We discuss the relevance of this in vitro model to the in vivo situations where immune suppression is limited to the blood compartment (or the hematopoietic organs) whereas, in inflammatory foci within the tissues, cytokine production is increased. Our data suggest that IL-10 may be a causative agent of concomitantly occurring SIRS and CARS.
Lipopolysaccharide-induced vacuoles in macrophages: Their origin is plasma membrane-derived organelles and endoplasmic reticulum, but not lysosomes
Authors: Yoshida Keiichiro , Ono Michio , Sawada Hajime
Published: June 2007

Lipopolysaccharide (LPS) is one of the potent activators of macrophages. LPS was shown to induce cell spreading and large vacuoles in the cytoplasm of a macrophage-like cell line, JY3. These vacuoles were negative for acid phosphatase histochemistry and did not take up Lucifer yellow added to the medium. Latex beads were incorporated into cytoplasmic vesicles distinct from the vacuoles. These results indicated that the vacuoles are neither phagosomes nor lysosomes.

DiIC18(3), a specific marker of endoplasmic reticulum (ER), stained the vacuoles intensely, and DiOC6(3) stained the vacuoles at a density similar to nuclear envelope, suggesting ER origin of their membrane. Glucose-6-phosphatase, however, was not detected histochemically.

Vacuoles were also stained with wheat germ agglutinin-horseradish peroxidase (WGA-HRP) or WGA-biotin, suggesting that the vacuoles originated from plasma membrane-endosome-trans Golgi network-secretory granule pathway. Golgi markers, TPPase or BODIPY-ceramide were not localized to the vacuolar membrane.

These results indicate that the vacuoles may have dual origins; ER and plasma membrane-derived organelles.
Co-ordinated regulation of TNF expression by multiple MAP kinase pathways
Authors: Wei Zhu  , Downey Jocelyn S. , Yingqiu Li  , Jiahuai Han
Published: June 2007

Four MAP kinase pathways are currently believed to be activated in LPS stimulated macrophages: the ERK, JNK/SAPK, p38 and BMK/ERK5 pathways. We have evaluated the effect of each MAP kinase pathway and the combinational effect of these MAP kinase pathways on TNF gene expression. By co-expressing dominant active mutants of different MAP kinase activators with a TNF reporter gene, we have demonstrated that activation of a signal MAP kinase pathway produces only a modest effect on TNF gene expression. Interestingly, a dramatic co-operative effect on TNF gene expression was observed when all of the four MAP kinase pathways were activated. We have shown that this MAP kinase-induced TNF gene expression is not mediated by known cis-elements such as Egr-1, CRE, kB, AP-1, or AP-2, but by, as yet unidentified, MAP kinase responsive elements in a 100 bp region immediately upstream of the transcription initiation site. In addition to their participation in the transcriptional control of TNF gene expression, activation of MAP kinases regulates TNF by overcoming the repressive effect of the AU-rich element (ARE) located in the 3′untranslated region. Thus, MAP kinase pathways co-ordinate with each other to regulate TNF gene expression at multiple levels.
Suppression of endotoxin-inducible cytokines in whole blood from human subjects following single dose of recombinant human interleukin-11
Authors: Reznikov Leonid L. , Puren Adrian J. , Fantuzzi Giamila , Hamner Gary R. , Schwertschlag Ullrich S. , Ryan John L. , Dinarello Charles A.
Published: June 2007

To determine whether a single injection of recombinant human interleukin-11 (rhIL-11) to human subjects would affect endotoxin-inducible cytokine production, 6 dialysis-dependent patients with renal failure and 4 healthy volunteers were subcutaneously injected with rhIL-11 (50 µg/kg). The circulating concentrations of rhIL-11 remained at a constant level of approximately 12 ng/ml for 0.25—6 h in healthy volunteers but were 2-fold higher in dialysis-dependent patients. Venous blood obtained before and after rhIL-11 was stimulated with 10 ng/ml of LPS for 24 h at 37°C and production of TNFα, IL-1β, and IL-8 determined. The maximum suppression of IL-1β, TNFα and IL-8 production (66%, 24% and 58%, respectively) was observed 1 h after rhIL-11 administration. After 24 h, when circulating concentration of rhIL-11 had decreased to near pre-injection levels, LPS-induced TNFα and IL-1β production remained suppressed (56 ± 17%, P < 0.05; 46 ± 4.7, P<0.01, respectively) but returned to baseline at 48 h. These findings suggest that there is a therapeutic benefit of single doses of rhIL-11 in reducing LPS-induced IL-1β and TNFα production.
Recombinant 21 kDa N-terminal fragment of human bactericidal/permeability-increasing protein (rBPI21): progress in the clinic
Authors: Scannon Patrick J.
Published: June 2007

rBPI21 is a recombinant 193 amino acid protein derived from human BPI, a naturally occurring 456 amino acid host defense molecule made in neutrophils. rBPI21 possesses multiple properties which include binding, clearing and neutralizing bacterial endotoxin, killing Gram-negative and Gram-positive bacteria, and enhancing bactericidal activity of a wide range of antibiotics. Neuprex ®, the intravenous formulation of rBPI21, has been evaluated in over 1700 patients to date in human volunteer studies and five Phase I/II indications, involving patients with meningococcemia, hemorrhagic trauma, complicated abdominal infections, partial liver resections and cystic fibrosis. The product has demonstrated an excellent safety profile and evidence of biological activity in every study completed to date. Thus far, two indications, meningococcemia and hemorrhagic trauma, have moved into Phase III trials.
The role of Helicobacter pylori LPS in the pathogenesis of H. pylori-related gastropathy
Authors: Jirillo E. , Pece S. , Pellegrino N.M. , Di Leo A. , Russo F. , Linsalata M. , Messa C. , Amati L. , Caradonna L. , Moran A.P. , Caccavo D.
Published: June 2007

Helicobacter pylori strains and/or their lipopolysaccharides (LPS) represent the trigger of different regional and systemic immune responses in the course of H. pylori-related gastropathy as indicated by the following: (i) in patients with chronic gastritis (CG) or duodenal ulcer (DU), eradication of H. pylori leads to a dramatic decrease of gastric mucosal content of various cytokines such as interleukin-1β and transforming growth factor-β1; (ii) gastric epithelial cells are activated by H. pylori organisms through tyrosine phosphorylation signaling events but H. pylori LPSs do not affect this signal transduction pathway; and (iii) in sera from patients with CG and DU, besides antibodies to S-form LPS, humoral IgG and IgA response against R-form LPS has been also detected. On the other hand, antibodies against synthetic polymeric Lewisx were found in a few patients with CG and in no patients with DU.
Analysis of structure activity relationships for LPS-mimetic activities of taxane analogs in murine macrophages
Authors: Perera Pin-Yu , Kadow John F. , Fairchild Craig R. , Johnston Kathy A. , Vogel Stefanie N.
Published: June 2007

The anti-tumor agent, paclitaxel (active ingredient of Taxol®), is best recognized for its ability to bind to microtubules and to block cell division. However, it has more recently been demonstrated to mimic the varied effects of bacterial lipopolysaccharide (LPS) in murine macrophages, actions that appear to be dissociable from its well-characterized β-tubulin binding capacity. Secretion of tumor necrosis factor alpha (TNFα) and induction of TNFα gene expression were assessed in macrophages treated with paclitaxel analogs. Two structural modifications resulted in elevated TNFα mRNA and protein secretion: (i) the presence of a cyclopropane carboxylate ester at C-4 rather than an acetate; or (ii) deoxygenation of the C-7 position. Certain modifications essentially eliminated activity: derivatization of the side chain 2′ hydroxy group to form an ethyl carbonate, the presence of a benzoate at C-4 rather than an acetate, or de-acetylization to leave a free hydroxy group at the C-10 position. Substitution of the phenyl group at the 3′ carbon position of the side chain with a 2-furyl group or the presence of a 2- or 3-pyridine carboxylate moiety at C-2 rather than a benzoate also resulted in a significant reduction in TNFα. These structure—activity relationships can be distinguished from those that affect the cytotoxic effects of paclitaxel which are attributable to its microtubule binding activity.
Perceptions of Turning Points and Dialectical Interpretations in Organizational Team Development
Authors: Erbert Larry A. , Mearns Gerri M. , Dena Samantha
Published: June 2007

This study examined perceptions of turning points and six dialectical contradictions for organizational team development. Sixty-three team members were interviewed utilizing a revised version of the Retrospective Interview Technique (RIT). After turning points were identified, a questionnaire was administered to determine the centrality or importance of six dialectical contradictions for each turning point. The six contradictions were autonomy versus connection, predictability versus novelty, openness versus closedness, team versus individual, dominance versus submission, and competence versus incompetence. Turning point types clustered around issues of cohesion, project development, socialization, member change, competence, workload, and conflict. Questionnaire results revealed that team versus individual and competence versus incompetence were rated as significantly more important and dominance versus submission was significantly less important than the other three contradictions.
Motivated Closed-Mindedness and Creativity in Small Groups
Authors: Chirumbolo Antonio , Mannetti Lucia , Pierro Antonio , Areni Alessandra , Kruglanski Arie W.
Published: June 2007

An experiment was conducted to investigate whether the need for cognitive closure affects the degree of creativity in small groups. Participants in groups of four performed a task in which they had to create advertising slogans for a given product. Some of the groups were composed of individuals with high dispositional need for closure, whereas other groups were composed of individuals with low need for closure. Results showed that ideational fluency, degree of elaboration, and creativity, as rated by independent judges, was lower in high (vs. low) need-for-closure groups. These results suggest that the tendencies to restrict the number of hypotheses generated and to produce conventional ideas, consequences of the need for closure, lower the degree of creativity in interacting groups.
Effectiveness of Social Work Treatment and Massage Therapy for Nursing Home Clients
Authors: Cheung Kam-fong Monit
Published: June 2007

Objective: An ABAB single-system design was employed to test the efficacy of a combined social work treatment with massage therapy to improve the physical functioning of nursing home clients. Method: Six clients ages 75 to 90 were randomly selected in three small-scale nursing homes to receive baseline measures and two 7-week treatment programs over a 28-week study period. Activities of Daily Living level and frequency of personal assistance were measured by the caretakers at the nursing homes. Observations were noted by both the massage therapist and the social worker, who worked as a team serving each client. Results: Although the outcome patterns varied from one individual to another, significant improvements were found in three individuals. Conclusion: The findings suggest that the improvement in physical outcomes among the age 75 years or more (75+) population is largely influenced by the individual's current state of physical and mental capabilities.
Building successfuli coalitions for promoting advance care planning
Authors: Marchand Lucille , Fowler Kathryn J. , Kokanovic Obrad
Published: June 2007

Advance care planning (ACP) has had few successful initiatives. This qualitative study explores the challenges and successes of an advance care planning coalition in Wisconsin called Life Planning 2000 using key informant interviews (n = 24) and grounded theory. Major themes included: commitment (the need for leadership, recruitment of key members, and funding); cohesiveness (disparate groups collaborating toward a common purpose); and outcomes (shift in paradigm from signing documents to process of advanced care planning, new-found collaborative relationships, and educational tool development). Coalitions need to define short-, intermediate-, and long-term goals that result in measurable outcomes and an evaluation process. Resources must be commensurate with goals. Strong leadership, paid staff, adequate funding, and the collaboration of diverse groups working toward common goals are the basic requirements of a successful coalition.
Hospice and palliative care: Attitudes and practices of the physician faculty of an academic hospital
Authors: von Gunten Charles F. , Von Roenn Jamie H. , Neely Kathy Johnson , Martinez Jeanne , Weitzman Sigmund
Published: June 2007

It has been suggested that physicians, particularly in academic hospitals, are resistant to the hospice approach to palliative care for terminally ill patients. It is of interest, therefore, to assess the attitudes and practices of the physician faculty of an academic hospital where a hospice program has been in existence for more than 10 years. This was assessed with two faculty surveys. All 966 physician faculty that were on staff at Northwestern Memorial Hospital in thefall of 1993 were sent a survey about their opinion of hospice care (Survey A). Then, all physicians who had referred patients to the hospice program between September 1993 and September 1994 at Northwestern Memorial Hospital received a survey letter after the death of their patient (Survey B). Seventy-seven percent of faculty physician respondents to Survey A had either referred patients, or knew of colleagues who had referred patients to a hospice program. Ninetyfour percent of those who answered “yes” to the question about referrals reported satisfaction with their care. Ninety-four percent would refer patients in the future and 96 percent thought the hospice program was a valuable resource to the medical center Of the respondents to Survey B, nearly 100 percent thought the referral had been handled in an “excellent”or “good”fashion, that communication with hospice staff was “excellent” or “good, “that symptom control was “excellent” or “good,” that their patients and families had received “excellent” or “good” psychosocial support, and that their patients and families were satisfied with the hospice care they received. When asked if their patients could have benefited from earlier referral, 29 percent said “definitely, ” 30 percent said “possibly,” 13 percent responded “doubtful” and 26 percent responded “no.” When asked if they would refer another patient to the hospice program, 95 percent responded “definitely” and 5 percent responded “possibly.” We conclude that a hospice program can be effectively utilized and valued by the attending physician faculty at an academic medical center
Quandary at the crossroads: Paternalism versus advocacy surrounding end of treatment decisions
Authors: Taylor Susan L.
Published: June 2007

The moral and ethical basis for promoting the patient as ultimate decivion-maker regarding his or her treatment plan is advanced. The practice implications of differing educational and historical backgrounds of physicians and nurses is addressed. Paternalism and maternalism are examined. These traditional roles are contrasted with the emerging provider role as patient advocate. Recommendations are suggested for improved physician/nurse/patient interaction in the resolution of ethical dilemmas in a highly complex health care arena.
Spiritual abuse
Authors: Purcell Boyd C.
Published: June 2007

Spiritual abuse is the act of making people believe—whether by stating or merely implying—that they are going to be punished in this life and/or tormented in hell-fire forever for failure to live life good enough to please God and thus earn admission to heaven. Spiritual terrorism is the most extreme form of spiritual abuse and may cause serious mental health problems. Those people who have not been spiritually terrorized have not necessarily been spared from spiritual abuse and therefore may still be in need of competent, spiritual counseling. Spiritual abuse, which may be active or passive, can best be conceptualized on a continuum from terroristic to zero abuse. Severity is determined by intensity, age of onset, duration, and individual reaction. The underlying issue in all forms of abuse is control.
Assessment of the Listening Styles Inventory
Authors: Pearce C. Glenn , Johnson Iris W. , Barker Randolph T.
Published: June 2007

This article describes the authors’ progress in establishing the validity and reliability of the Listening Styles Inventory (LSI) following their initial report in an earlier study (Barker, Pearce, and Johnson). The LSI provides managers with a self-administered tool for determining their own perceived listening effectiveness. The authors examined the data provided by 359 respondents in diverse managerial groups using factor analysis, Cronbach’s alpha, Spearman’s rank order coefficient, structured interviews, expert observation, the Statistical Analysis System General Linear Model (GLM) procedure (analysis of variance), and a Tukey Student Range (honestly significant difference or HSD) test. The results yielded further evidence of the validity and reliability of the LSI as a self-administered diagnostic listening tool. The authors conclude that the LSI in its present form can serve as a guide for assessing a manager’s perceived listening effectiveness, but further research is needed to refine the instrument and to test other managerial groups.
Rethinking the Articulation Between Business and Technical Communication and Writing in the Disciplines
Authors: Russell David R.
Published: June 2007

In a profound sense, the teaching of business and technical communication (BTC) is always already the teaching of writing in the disciplines (WID). Yet the WID dimension of BTC is often hard to see. The question this article addresses is, How might the North American tradition of BTC communication courses be more consciously—and effectively—articulated with the disciplines? The article reviews some of the research literature concerning the value of articulating BTC with WID in undergraduate education and program descriptions of such efforts to examine what BTC has done, is doing, and might do in the future to strengthen WID in BTC.
Reflexivity for Team Innovation in China
Authors: Tjosvold Dean , Tang Moureen M. L. , West Michael
Published: June 2007

Teams that can manage their internal functioning may be able to continue to work effectively so that they innovate. This study suggests that cooperative but not competitive or independent goals are a foundation for effective team reflexivity. Two hundred employees in 100 work teams in China completed measures of their team’s goal interdependence (cooperative, competitive, and independent) and reflexivity. The managers of these 100 teams rated their team’s innovation. Results support the theorizing that cooperative goals can contribute to team reflexivity. Structural equation analysis suggested that cooperative but not competitive or independent goals promote reflexivity that in turn results in team innovation. These results, coupled with previous research, were interpreted as suggesting that cooperative goals and reflexivity are complementary foundations for team innovation.
Dealing with Denial: A Systems Approach for Family Professionals Working with Parents of Individuals with Multiple Disabilities
Authors: Ho Kimberly M. , Keiley Margaret K.
Published: June 2007

Some parents of children with multiple disabilities appear to deny that their children have intellectual disabilities (i.e., mental retardation). This may be manifested in “shopping,” a continuous search for an alternate diagnosis or assistive technology that releases their children’s presumed intelligence. Health care professionals may be challenged in working with these parents during the assessment and intervention process. Historically, family professionals have viewed these families through a deficit-based perspective, which may inhibit a parent’s acceptance of their child’s intellectual disability. In this article, the collaborative-resource approach is introduced from family systems theory in which family professionals collaborate with the parents to facilitate the process of adapting to intellectual disability.
Body Dysmorphia, the Plastic Surgeon, and the Counselor
Authors: Renshaw Domeena C.
Published: June 2007

Trauma repair, deformity, and unsightly blemishes may cause social embarrassment and take thousands of individuals to plastic surgeons. A few persons have endless preoccupation with a slight, real, or perceived appearance defect. Some of either gender, age 10 to 80, seek cosmetic surgeons for aesthetic correction. However, a minority continues to have intense obsessive preoccupation with an imagined body defect. Their concern is excessive and causes significant distress in social, work, or study functions not due to another clinical condition such as anorexia nervosa, in which subjects reject their body as obese. Misperceived ugliness is called body dysmorphia or dysmorphophobia, often only diagnosed after several discontented return visits to the surgeon who refers the patient for counseling—rarely welcome referrals by the patient when they are convinced the problem is physical and not psychological. Careful listening and patient acceptance are essentials in management.
A Practical Approach to the Differential Diagnosis of Small Round Cell Tumors of Infancy Using Recent Scientific and Technical Advances
Authors: Gerald William L.
Published: June 2007

Scientific and technical advances have direct impact on the day to day practice of surgical pathology. Pathologists must learn to use new findings to improve diagnostic classification and add clinically useful information in a fiscally responsible manner. The undifferentiated tumors of young people (historically referred to as small round cell tumors of infancy) are a useful example of how new information has become an important part of routine practice. This article describes a practical approach to the differential diagnosis of small round cell tumors using immunophenotypic and genetic analysis as an aid to increase confidence and diagnostic accuracy.
Fibrous Lesions of the Breast
Authors: McMenamin Máirín E. , DeSchryver Katherine , Fletcher Christopher D. M.
Published: June 2007

Fibrous lesions of the breast are challenging for a number of reasons. They occur infrequently and there is significant clinical, radiologic, and histologic overlap between reactive and neoplastic lesions, as well as with some nonfibrous lesions. Pure fibrous lesions of the breast encompass reactive conditions, such as scars and nodular fasciitis, and neoplastic entities, such as the distinct benign mammary myofibroblastoma, locally aggressive fibromatosis, and rare true sarcomas. In this review, we focus on nodular fasciitis, mammary myofibroblastoma, and primary mammary fibromatosis. We also briefly discuss spindle cell metaplastic carcinoma because it represents the most important differential diagnosis through its ability to closely simulate nodular fasciitis and fibromatosis. Caution should be exercised in the interpretation of fibrous lesions of the breast, especially if the tissue sample is limited.
The Incidence of Apoptosis During Colorectal Tumorigenesis
Authors: Sugao Yoriaki , Koji Takehiko , Yao Takashi , Ueki Takashi , Tsuneyoshi Masazumi
Published: June 2007

Epithelial homeostasis in colorectal tumorigenesis is dependent not only on the rate of cell production but also on the rate of apoptosis, a genetically programmed process of autonomous cell death. Ideally, an analysis of cell kinetics should be carried out for both cell proliferation and death. We investigated the incidence of apoptosis in 3 5 colorectal neoplasms (1 5 adenomas and 20 carcinomas) using the DNA nick end labeling method (TUNEL). The expression of Ki-67 as a marker of proliferating activity and some kinds of oncogene products were analyzed immunohistochemically. When the TUNEL labeling index (TI) and the Ki-67 labeling index (KI) were determined, TI was found to be significantly higher in adenomas with high-grade dysplasia (TI: 2.5%) than in adenomas with low-grade dysplasia (TI: 0.6%) or carcinomas (TI: 1.4%). In contrast, KI increased with the progression of colorectal tumorigenesis. Moreover, TI of the carcinomas was significantly higher in c-Myc-positive cases than in c-Myc-negative cases (p<0.05). The results indicate that apoptosis plays an important role in the early stage of the adenoma-carcinoma sequence, permitting us to speculate that the increased tumor cell proliferation is negated by increased apoptosis at the stage of adenoma with high-grade dysplasia (or intramucosal carcinoma), while cell proliferation overwhelms cell death at the stage of invasive carcinoma.
Composite Large-Cell Neuroendocrine Carcinoma and Surface Epithelial-Stromal Neoplasm of the Ovary
Authors: Chen Karl T. K.
Published: June 2007

The clinicopathologic features of two cases of composite large-cell neuroendocrine carcinoma and surface epithelial-stromal neoplasm of the ovary are reported and those of eight previously published cases reviewed. The patients ranged in age from 22 to 77 years (mean, 56 years). The surface epithelial-stromal neoplasm was an endometrioid adenocarcinoma in one case, a mucinous cystadenoma in one case, and a mucinous adenocarcinoma in eight cases. The large-cell neuroendocrine carcinoma in these tumors may represent dedifferentiation of the neuroendocrine cells present in the surface epithelial-stromal tumor. This composite tumor type is highly aggressive. Of eight patients with follow-up information, all had died of disseminated tumor; six within 10 months, and two in 19 months and 3 years, respectively, after diagnosis. Only the neuroendocrine carcinoma component was found in the metastatic sites.
Allelic Deletion of VHL Gene Detected in Papillary Tumors of the Broad Ligament, Epididymis, and Retroperitoneum in von Hippel-Lindau Disease Patients
Authors: Shen Ting , Zhuang Zhengping , Gersell Deborash J. , Tavassoli Fattaneh A.
Published: June 2007

Although clinically associated with von Hippel-Lindau (VHL) disease, the pathogenesis of papillary tumors of the broad ligament, epididymis, and peritoneum arising in patients with VHL disease is not clear. The “classic” VHL-associated neoplasms, including hemangioblastoma and renal cell carcinoma, have been found to be associated with the inactivation of both VHL gene copies. It is not known whether a similar inactivation of the VHL gene is also responsible for the development of these uncommon VHL-associated lesions. The authors performed PCR (polymerase chain reaction) and PCR-based SSCP (single-strand conformation polymorphism) analysis on five predominantly papillary tumors in five VHL patients (one papillary cystadenoma of the broad ligament, one endometrioid cystadenoma of the broad ligament, two papillary cystadenomas of the epididymis, one papillary tumor of the retroperitoneum) with four polymorphic markers of VHL gene (D3S1038, D3S1110, D3S2452, 104/105). All five tumors showed allelic loss of VHL gene. The results provide the first genetic evidence for the role of VHL gene in the tumorigenesis of these rare benign neoplasms and confirm these tumors as phenotypic manifestations of VHL disease.
Melanotic Neuroectodermal Tumor of Infancy: Clinicopathologic Study of a Case, with Emphasis on the Chemotherapeutic Effects
Authors: Mello Roberto J. V. , Vidal Aurora K. L. , Fittipaldi Horacio M. , Montenegro Luciano T. , Calheiros Luiz M. C. , Rocha Getuilio I.
Published: June 2007

A case of melanotic neuroectodermal tumor of infancy (MNTI) in a 6-months-old white female child is presented. The tumor was located in the left half of the superior maxillary bone and affected the maxillary sinus, inducing large facial asymmetry. The histologic aspects of the tumor were typical for the entity: two cell populations, one pigmented melanocyte-like cell, the other small neuroblastic-like cell. After adjuvant chemotherapeutic treatment with a strong reduction of the tumor, the melanocytelike cell predominated, allowing a better result of the surgery and probably a better prognosis.
Histologic Types of Thymoma Associated with Pure Red Cell Aplasia: A Study of Five Cases Including a Composite Tumor of Organoid Thymoma Associated with an Unusual Lipofibroadenoma
Authors: Kuo Tseng-tong , Shih Lee-Yung
Published: June 2007

The histologic type of thymomas associated with pure red cell aplasia (PRCA) has generally been regarded to be predominantly the spindle cell type. The 5 thymomas associated with PRCA we studied showed various histologic types and none of them was a spindle cell thymoma. Some cases reported as spindle cell thymoma associated with PRCA in the literature might not be spindle cell type. The discrepancy could be due to the lack of consensus in the histologic classification of thymomas in the past. Our study showed that thymomas associated with PRCA lacked a strong correlation with a particular histologic type and the pathogenesis of PRCA associated with thymoma did not seem to be related to the histologic type. One of our cases was an unusual composite tumor of an organoid thymoma (WHO type B1) and a hitherto undescribed “lipofibroadenoma.” The clinical outcome was influenced by the invasive character and the histologic type of the thymoma.
Necrotizing Angiitis of the Small Intestine Related to AA-Amyloidosis: A Novel Association
Authors: Oweity Thaira , West A. Brian , Stokes M. Barry
Published: June 2007

A 71-year-old man with intestinal pseudo-obstruction was found to have a diffusely thickened adynamic small bowel with AA-amyloid in submucosal vessels and muscularis propria, foreign body giant cell reaction to amyloid, and necrotizing angiitis. The mucosa was unremarkable. Immunostains demonstrated numerous CD68+ monocyte/macrophages and CD8+ T cells associated with the amyloid deposits. The patient had no evidence of systemic vasculitis and no underlying cause for AA-amyloidosis was identified. Necrotizing angiitis coexistent with amyloid angiopathy has been reported in brain and temporal arteries, but not in the gastrointestinal tract and not with AA-amyloid. The inflammatory cell infiltrates in this case are consistent with a foreign-body and/or cell-mediated immunologic reaction to AA-amyloid, although a role for these cells in amyloid formation cannot be excluded.
Primary Angiocentric T-Cell Intestinal Lymphoma with Epstein-Barr Virus in a 5-Year-Old Boy
Authors: Drut Ricardo , Drut Rosa Mónica
Published: June 2007

A case of peripheral T-cell lymphoma affecting the small bowel of a 5-year-old boy is reported. The cells did not form a tumoral mass but infiltrated diffusely, arranged in an angiocentric pattern and associated with numerous ulcers, one of which perforated. Immunohistochemistry proved them to be CD45RO-, CD3-, and CD8-positive. CD20, CD4, and CD56 markers were negative. The presence of EBV in the lymphomatous cells was demonstrated by in-situ hybridization. Polymerase chain reaction study revealed T-cell receptor (TCR) gene rearrangement. Notably the hemophagocytic syndrome present on admission reverted after surgery. The authors are not aware of a previous report of intestinal T-cell lymphoma in a child.
Type 1 Protein Tyrosine Kinases in Chinese Breast Carcinomas
Authors: Suo Zhenhe , Yang Huihua , Mei Qiang , Skovlund Eva , Cui Jianguo , Nesland Jahn M.
Published: June 2007

Immunostaining for epidermal growth factor receptor (EGFR), c-erbB-2, c-erbB-3, c-erbB-4, ER, and PR was performed in 107 cases of primary breast carcinomas from Anyang, China. The expression rates of EGFR, c-erbB-2, c-erbB-3 and c-erbB-4 in this series were 43.9%, 36%, 27%, and 45.8%, respectively, and a stronger c-erbB-4 staining of “normal” glandular structures inside tumors and in the vicinity of tumor clusters was confirmed. Larger tumor size, lymph node metastases, and higher histologic grade in invasive ductal carcinomas were shown to be statistically valuable negative prognostic factors, and c-erbB-2 expression was also weakly associated with a poor prognosis no matter what the nodal status. The expressions of c-erbB-4 and ER in invasive ductal carcinomas were inversely associated with histologic grade of the tumors. Associations between the expression of c-erbB-4 and ER (p = 0.001) and the expression of ER and PR study (p = 0.004) were found in the present study. No significant associations between the expressions of EGFR, c-erbB-3, c-erbB-4, ER, and PR and overall survival were detected. The expression of c-erbB-4 in the node negative group was, however, associated with a better prognosis, indicating a different role of c-erbB-4 protein in breast tumor development than other EGFR family members have.
Giant Cell Reparative Granuloma
Authors: Yamaguchi Takehiko , Dorfman Howard D.
Published: June 2007

This study attempts to define the clinicopathologic aspects of extragnathic giant cell reparative granuloma (GCRG) by contrasting it with the much better recognized GCRG of jaw bones and highlights the manifestations that are unique to the extragnathic localization. Ninety-one GCRGs of 89 patients, 22 in jaw bones and 69 in the extragnathic bones, were examined. Females were affected twice as frequently as males in both groups. The age distribution of extragnathic GCRGs overlaps that of gnathic counterparts. Small bones of the hands (17 lesions) and feet (16 lesions) were the most common sites for extragnathic lesions. The radiographic findings were nonspecific. Histology of extragnathic lesions was closely similar to that of lesions affecting the jaw. These giant cell lesions should be distinguished from giant cell tumors.
Tenascin and Strictures in Inflammatory Bowel Disease: An Immunohistochemical Study
Authors: Geboes Karel , El-Zine Monya Yahia , Dalle Ignace , El-Haddad Salwa , Rutgeerts Paul , Van Eyken Peter
Published: June 2007

Tenascin is an extracellular matrix protein involved in morphogenesis of muscle tissue and in wound healing. In the present study we examined its distribution in tissue from patients with inflammatory bowel disease. Intestinal biopsies from 10 normal controls, 15 patients with Crohn's disease, and 6 with ulcerative colitis were studied. Samples were obtained both from uninvolved and involved areas. Mucosal tenascin is increased in ulcerative colitis and Crohn's disease, especially in areas of ulceration. In Crohn's disease, tenascin is also strongly expressed in the submucosa and in smooth muscle cells of the muscularis mucosae and propria, especially in areas of stricture. We conclude that tenascin is involved in stricture formation in Crohn's disease and that it is a marker of phenotypic change in smooth muscle cells.
Follicular Lymphoma of the Salivary Gland
Authors: Kojima Masaru , Nakamura Shigeo , Ichimura Koichi , Shimizu Kazuhiko , Itoh Hideaki , Masawa Nobuhide
Published: June 2007

To clarify the clinicopathologic, immunohistologic, and genotypic features of follicular lymphoma arising from the salivary glands, we examined 20 cases of operatively resected primary salivary gland lymphoma and identified 6 such cases. There were 4 women and 2 men with ages ranging from 38 to 64 years (median 50 years). The tumor arose from the parotid gland in 4 cases and the submandibular gland in the remaining 2. Four patients were stage IE and 2 were stage IIE-1. The median follow-up period was 49 months and all patients were alive and well at the time of going to press. Histologically, 5 patients were follicular lymphoma grade 2, and 1 was grade 3. In all specimens in noninfiltrating salivary gland tissue, there was periductal lymphocytic infiltration near the lymphoma. Moreover, myoepithelial sialoadenitis was noted in 2 lesions. An immunohistochemical study revealed all 6 cases were CD 10+, CD79a+, bcl-6+, CD3-, CD5-, CD21-, CD23-, and CyclinDI-. The tumor cells expressed bcl-2 in 3 cases and p53 oncoprotein in 4 cases. Two cases revealed clonal bands with polymerase chain reaction (PCR) assay for the immunoglobulin heavy (IgH) gene. The bcl-2/IgH translocation at the major breakpoint region was detected in 1 case (16%). We found a relatively high incidence of follicular lymphomas (30%) in salivary gland lymphomas. Among the mucosa-associated lymphoid tissue (MALT) system, follicular lymphomas appeared to occur frequently in the salivary glands as well as the duodenum and skin. Moreover, follicular lymphoma arising from the salivary glands appeared to have some of the characteristics of MALT-type lymphoma including indolent prognosis, presence of myoepithelial sialoadenitis, and rarity of the BCL-2 gene rearrangement.
Borderline Serous Cystadenocarcinoma with Coexistent Angiosarcoma: An Unusual Form of Ovarian Carcinosarcoma
Authors: Pillay K. , Essa A. S. , Chetty R.
Published: June 2007

A 45-year-old woman presented with a short history of abdominal distension and features of intestinal obstruction. Computed tomography examination of the abdomen revealed a solid and cystic mass in the region of the left ovary, but spread within the abdomen was also noted. The ovarian tumor was removed, and an omentectomy was also performed. Microscopic examination of the ovarian tumor and metastases within the omentum showed a carcinosarcoma composed of borderline serous papillary cystadenocarcinoma and angiosarcoma. The angiosarcomatous component was the dominant tumor within the omentum. This case documents an unusual combination of epithelial and sarcomatous elements in an ovarian carcinosarcoma. The tumor behaved aggressively because of the angiosarcomatous component, and since the patient was assessed as having stage IV disease, no further treatment was offered.
Primary Synovial Sarcoma of the Kidney
Authors: Chen Sheng , Bhuiya Tawfiqul , Liatsikos Evangelos N. , Alexianu Mihai D. , Weiss Gary H. , Kahn Leonard B.
Published: June 2007

We describe a case of primary renal synovial sarcoma (SS) in a 48-year-old man. The patient presented with hematuria and was found to have a large tumor in his left kidney on computed tomography scan. Histology revealed a highly cellular spindle cell neoplasm with minimal pleomorphism. The major differential diagnoses included leiomyosarcoma, hemangiopericytoma, and SS. The presence of focal areas with a biphasic pattern, uniformly positive immunostain for bcl-2, focally positive immunostains for epithelial membrane antigen and cytokeratin, and negative immunostains for CD-34, smooth muscle actin and S-100 established the diagnosis. This was subsequently confirmed by molecular testing for t(X;18) translocation. Since the existence of primary SS in the kidney was first suggested in 1999, to the best of our knowledge a total of 19 cases including the present case have been reported to date. Although primary renal SS is rare, these findings indicate that it should be included in the differential diagnosis of spindle cell tumors of the kidney.
Thyroid Microcarcinoma: Fine-Needle Aspiration Diagnosis and Histologic Follow-up
Authors: Yang Grace C. H. , LiVolsi Virginia A. , Baloch Zubair W.
Published: June 2007

The increased sensitivity of many imaging modalities (ultrasound, computed to mography scan, magnetic resonance imaging) has resulted in the identification of thyroid nodules, measuring 1 cm or less. Usually these small lesions are regarded as incidental and are not sampled by fine-needle aspiration (FNA). However, some of these lesionsundergo FNA because of suspicious radiology findings (multifocality, calcification, etc) or in patients with a history of radiation to the head and neck region. We present FNA findings and histologic follow-up of 39 thyrold nodules that measured 1.0 cm or less. All FNAs were performed under ultrasound guidance. The lesions ranged in size from 0.2 to 1.0 cm. Twenty-two lesions were diagnosed as papillary carcinoma (PTC), 4 as medullary carcinoma (MC), and 13 as suspicious for PTC on FNA. Histologic follow-up showed PTC in 3 5 and MCin 4cases; 11 PTC were multifocal (31%) and lymph node metastases were present in 8 (16%) cases. Ultrasound-guided FNA is effective in thesampling of thyroid cancers that are 1.0 cm or less. The present study shows that some of these lesions can be clinically significant.
Rhabdoid Epithelioid Leiomyosarcoma of the Uterine Corpus
Authors: Levine Pascale Hummel , Mittal Khush
Published: June 2007

A case of epithelioid leiomyosarcoma of the uterus with rhabdoid phenotype and early rhabdomyoblastic differentiation is described. A 72-year-old woman with a 5eek history of increased abdominal girth was found to have a large pelvic mass. The uterus revealed a large intramyometrial and left adnexal necrotic tumor that had spread to the small bowel mesentery and to the anterior abdominal peritoneum. The tumor was an epithelioid leiomyosarcoma with rhabdoid phenotype and focal early rhabdomyoblastic differentiation, as confirmed by immunohistochemical and ultratructural techniques. Also called composite extrarenal rhabdoid tumor (CERT), this lesion should be differentiated from malignant mixed mullerian tumor, rhabomyosarcoma, endometrial stromal sarcoma, and pure rhabdoid tumors of the uterus. The recognition of a rhabdoid phenotype is of clinical importance since these tumors are prone to be aggressive.
Long-Term Prognosis of Teenagers with Breast Cancer
Authors: Rivera-Hueto Francisco , Hevia-Vaizquez Alberto , Utrilla-Alcolea Jose C. , Galera-Davidson Hugo
Published: June 2007

We report 4 new cases of breast carcinoma in teenage girls diagnosed by use of histochemical and immunohistochemical methods. These cases of breast carcinoma in women under 20 years of age were found in the files of our department in the last 24 years (1976-2000). The patients had operable breast carcinomas corresponding to various histologic types (1 invasive ductal carcinoma associated with fibroadenoma, 2 secretory carcinomas, and 1 invasive lobular-type carcinoma). Simple mastectomy with low axillary lymph node dissection was performed in 2 postpubertal patients. Only 1 patient received adjuvant chemotherapy (case 4). After follow-up ranging from 76 to 126 months, 3 patients are alive and disease-free and 1 has disseminated metastatic disease. The correlations with prognosis-related risk factors (stage, age, previous benign lesions, family history, histologic types, hormonal receptors, and pregnancy) were examined.
Multifocal, Nascent, and Invasive Myoepithelial Carcinoma (Malignant Myoepithelioma) of the Breast: An Immunohistochemical and Ultrastructural Study
Authors: Jolicoeur Francine , Seemayer Thomas A. , Gabbiani Giulio , Robidoux Andre , Gaboury Louis , Oligny Luc L. , Schiirch Walter
Published: June 2007

This report describes the light microscopic (LM), immunohistochemical (IHC), and electron microscopic (EM) features of a multifocal, nascent, and invasive myoepithelial carcinoma of the breast. By LM, the spindle cells disclosed fibrillar acidophilic cytoplasm, mild nuclear atypia, and a low mitotic index. Myoepithelial differentiation was established through IHC (single- and double-labeling techniques) and EM: periductal and infiltrating spindle cells coexpressed total muscle actin, a-smooth muscle actin, vimentin, cytokeratin 14, and pankeratin, and their EM features were characteristic of myoepithelial cells, i.e., perinuclear tonofilaments, subplasmalemmal bundles of microfilaments with dense bodies, intermediate junctions, poorly developed desmosomes, pinocytic vesicles, and fragmented external lamina. No invasive epithelial cells disclosed luminal differentiation (by LM, IHC, EM), identifying, thus, this neoplasm as a pure spindle cell myoepithelial carcinoma of the breast.