bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Human Chorionic Gonadotropin– Related Components in Fresh Frozen Serum With the Proficiency Testing Material Used by the College of American Pathologists
Authors: Knight George J. , Palomaki Glenn E. , Klee George G. , Schreiber William E. , Cole Lawrence A. 
Published: February 2021

AbstractContext.—As part of a College of American Pathologists (CAP) proficiency testing survey, a comparison is made between human chorionic gonadotropin (hCG) results from an actual patient pool and a similarly targeted artificial sample. The goal is to gain insight into the possible source(s) of bias attributable to the proficiency testing material (PTM) with a view toward creating more appropriate survey materials.Objective.—To compare hCG and related variants in a pool of fresh frozen sera (FFS) with that found in PTM.Design.—The 2003 CAP K/KN-A Survey included a FFS specimen along with admixtures of PTM. The FFS (K-02) and 1 PTM admixture (K-01) had similar mean hCG values. Five hCG-related analytes were measured on these 2 samples by a reference laboratory.Participants.—Approximately 1800 clinical laboratories and diagnostic test kit manufacturers participated in the K/ KN-A Survey.Main Outcome Measures.—Method imprecision (coefficient of variation) and method bias (relative difference between peer group mean and all-method median) were computed for the 2 samples. Differences were evaluated with respect to hCG-related analytes levels.Results.—All-method hCG results were 12.9 mIU/mL (12.9 IU/L) for the PTM material and 21.6 mIU/mL (21.6 IU/L) for the FFS material. Method biases for 14 manufacturers were greater for PTM than for FFS (−40% to +35% and −16% to +23%). Twelve of 14 methods had higher coefficients of variation on PTM. Total hCG and free β hCG measurements by the reference laboratory were 14.1 mIU/ mL (14.1 IU/L) for the PTM material and 18.5 mIU/mL (18.5 U/L) for the FFS material (FFS), and 2.4 (PTM) and 0.7 (FFS) mIU/mL (2.4 and 0.7 IU/L), respectively. On a molar basis, free β represented 17% and 4% of the total hCG, respectively. Levels of hyperglycosylated hCG, nicked hCG, and β core fragment were not measurable in either sample.Conclusions.—It is unlikely that the hCG added to the PTM is the source of the increased bias and variability. The main difference is a 3-fold increase in free β found in the PTM, but methods previously found to strongly react with free β were not systematically elevated. The biases between manufacturers found for the FFS specimen are likely attributable to calibration differences.
The Openings of Uteroplacental Vessels With Villous Infiltration at Different Gestational Ages
Authors: Fujikura Toshio 
Published: February 2021

Abstract
Context.—The number of uteroplacental vessels flowing into the intervillous space in mature placentas has been reported in some studies to increase and in others to decrease. Both villous infiltration and proliferation in the vessels have been neglected in histologic examinations and need to be studied.
Objective.—To clarify these conflicting findings regarding villous infiltration and proliferation in the uteroplacental vessels.
Design.—A retrospective study was done using placental sections of different gestational ages. The openings of the vessels in each section were counted, noting if they were with or without villous infiltration. The frequency of openings per section was calculated, and the findings were grouped by gestational age.
Results.—The frequency of total openings was significantly lower in the 41 to 37 weeks group (1.2) than in the 36 to 30 weeks group (2.0), the 29 to 20 weeks group (2.2), and the 19 to 13 weeks group (2.4) (P &lt; .001). The frequency of openings with villous infiltration decreased similarly in mature placentas. Chorionic villi infiltrated the openings and proliferated in uteroplacental vessels. Differentiation between arteries and veins was difficult in the basal plate, because all vessels had veinlike structures.
Conclusions.—This decreasing frequency of openings in mature placentas suggests that the amount of intervillous blood flow is limited in full-term and postterm pregnancy. Villous infiltration into the vessels is considered a normal finding with gestation and can provide trophoblast for uteroplacental arteries. The relationship between placental development and villous proliferation in the vessels is presented.
Putative Precursors of Gallbladder Dysplasia: A Review of 400 Routinely Resected Specimens
Authors: Mukhopadhyay Sanjay , Landas Steve K. 
Published: February 2021

Abstract
Context.—Dysplasia is thought to be a precursor of invasive gallbladder carcinoma, but it is unsettled whether dysplasia arises from other precursor lesions.
Objective.—To ascertain the presence and nature of precursors of dysplasia in the gallbladder.
Design.—Four hundred consecutive cholecystectomy specimens were processed and stained routinely for diagnosis. We retrospectively reviewed these cases to look for the presence of epithelial changes, including antral-type metaplasia, intestinal metaplasia, and dysplasia.
Results.—Antral-type metaplasia, intestinal metaplasia, and dysplasia were found in 238 (59.5%), 39 (9.8%), and 20 (5.0%) cases, respectively. The mean patient age was 47.7 years (range, 15–93 years). The mean ages for patients with antral-type metaplasia, intestinal metaplasia, and dysplasia were 49.4, 50.9, and 52.6 years, respectively. Statistically significant associations were found between antral-type metaplasia and intestinal metaplasia (P = .007, χ2 test) and between intestinal metaplasia and dysplasia (P &lt; .001, χ2 test).
Conclusion.—These associations, along with the age gradient from antral-type metaplasia to dysplasia, suggest a progression from antral-type metaplasia to dysplasia via intestinal metaplasia.
Collision Tumor of the Stomach: A Rare Case of an Adenocarcinoma and Carcinoid Tumor
Authors: Morishita Yukie , Sugitani Masahiko , Sheikh Aleemuzzaman , Nemoto Norimichi , Fujii Masashi , Takayama Tadatoshi 
Published: February 2021

Abstract
We report a rare case of gastric collision tumor composed of moderately differentiated tubular adenocarcinoma and carcinoid in an 84-year-old woman. On endoscopic examination, an invasive tumor was noted at the cardia of the stomach, and a pathologic examination of the biopsy specimen revealed adenocarcinoma. After total gastrectomy, a thorough histopathologic examination of the resected tumor revealed the concurrent presence of moderately differentiated adenocarcinoma and a typical carcinoid tumor, which had a colliding pattern of tissue proliferation. There was no intermixing or transition area between the 2 components. The final pathologic diagnosis was collision tumor of the adenocarcinoma and carcinoid tumor. The presence of either tumor individually would not be especially noteworthy, but this collision-type tumor of both histopathologic types in the stomach is, to our knowledge, only the sixth such case in the literature.
Kidney and Urinary Tract Polyomavirus Infection and Distribution: Molecular Biology Investigation of 10 Consecutive Autopsies
Authors: Boldorini Renzo , Veggiani Claudia , Barco Diana , Monga Guido 
Published: February 2021

AbstractContext.—Distinct human polyomavirus genotypes cause different diseases in patients with renal transplants: BK virus (BKV) causes tubulointerstitial nephritis and ureteral stenosis, whereas both JC virus (JCV) and BKV are responsible for hemorrhagic cystitis. These findings could result from a selective infection of kidney and urinary tract segments by JCV or BKV.Objective.—To verify this hypothesis, 10 complete, unselected, consecutive autopsies from 9 immunocompetent patients and 1 patient affected by acquired immunodeficiency syndrome were investigated.Design.—Samples from kidneys (n = 80), renal pelvis (n = 20), ureter (n = 40), and urinary bladder (n = 30) obtained from 10 consecutive autopsies were investigated by means of multiplex nested polymerase chain reaction to detect polyomavirus DNA and to distinguish different species of the Polyomavirus genus. In situ hybridization and immunohistochemistry were also carried out to define the viral status of the infected tissues.Results.—Polyomavirus DNA was detected in all of the subjects (positive samples ranging from 2 to 7 samples), for a total of 43 of 170 samples (25.3%), distributed as follows: urinary bladder (10/30, 33%), renal pelvis (6/20, 30%), ureter (10/40, 25%), and kidney tissue (17/80, 21%). We found that JCV was most frequently detected overall (23/43 samples, 53.5%) and was also detected most frequently within the kidney (8/17 positive samples, 47%), the renal pelvis (5/6 positive samples, 70%), and the ureter (7/10 positive samples, 70%), whereas BKV was found in 14 samples (32.5%), and it was the prevailing genotype in urinary bladder (6/10 positive samples, 60%). Coinfection of BKV-JCV was found in 6 samples (14%). Immunohistochemistry and in situ hybridization returned negative results.Conclusions.—The viruses JCV and BKV latently persist randomly in kidney and urinary tract. Distinct diseases induced by them could be related more closely to molecular viral rearrangements than to the topographic distribution of latent viruses.
Measurement of Organochlorines in Commercial Over-the-Counter Fish Oil Preparations: Implications for Dietary and Therapeutic Recommendations for Omega-3 Fatty Acids and a Review of the Literature
Authors: Melanson Stacy Foran , Lee Lewandrowski Elizabeth , Flood James G. , Lewandrowski Kent B. 
Published: February 2021

Abstract
Context.—The consumption of fish high in omega-3 fatty acids is advocated by the American Heart Association to decrease the risk of coronary artery disease. However, fish contain environmental toxins such as mercury, polychlorinated biphenyls, and organochlorine pesticides, which may negate the beneficial cardiovascular effects of fish meals. Toxin levels vary depending on both the fish source and the specific toxin, and neither farm-raised nor wild fish are toxin free. Fish oil supplements also prevent the progression of coronary artery disease and reduce cardiovascular mortality. However, only sparse data exist on the level of toxins in fish oil. In a previous study we showed that the amount of mercury in 5 over-the-counter brands of fish oil was negligible.
Objective.—To determine the concentrations of polychlorinated biphenyls and other organochlorines in 5 over-the-counter preparations of fish oil.
Design.—The contents of 5 commercial fish oil brands were sent for organochlorine analysis.
Results.—The levels of polychlorinated biphenyls and organochlorines were all below the detectable limit.
Conclusions.—Fish oil supplements are more healthful than the consumption of fish high in organochlorines. Fish oils provide the benefits of omega-3 fatty acids without the risk of toxicity. In addition, fish oil supplements have been helpful in a variety of diseases, including bipolar disorder and depression.
The Internet for Pathologists: A Simple Schema for Evaluating Pathology-Related Web Sites and a Catalog of Sites Useful for Practicing Pathologists
Authors: Talmon Geoffrey , Abrahams Neil A. 
Published: February 2021

Abstract
Context.—With the increasing popularity of the Internet as a primary medical information source, it is critical for pathologists to be able to use and evaluate both general medical- and pathology-related Web sites. Several published models for evaluating Web sites prove cumbersome to use and often involve computer- or statistic-based algorithms.
Objectives.—To develop a simple group of scoring criteria to objectively evaluate medical Web sites and provide a list of the highest-scoring pathology-related sites that will be useful to the practicing pathologist.
Design.—Using 11 commonly used Internet search engines, the top 50 “hits” retrieved from the search term websites for pathologists were scored using 5 criteria, including accuracy, ease of navigation, relevance, updates, and completeness. A possible 6 to 12 points per area were awarded, and the total score was summated.
Results.—Scores obtained ranged from 12 to 21. Thirty-five Web sites, all scoring 15 or higher based on these criteria, were listed as most useful.
Conclusion.—A simple, easy-to-use, 5-category scoring system can prove useful in evaluating pathology- and medical-related Web sites.
Distinguishing Fibrovascular Septa From Vasculogenic Mimicry Patterns
Authors: Lin Amy Y. , Maniotis Andrew J. , Valyi-Nagy Klara , Majumdar Dibyen , Setty Suman , Kadkol Shri Hari , Leach Lu , Pe'er Jacob , Folberg Robert 
Published: February 2021

Abstract
Context.—Molecular analyses indicate that periodic acid–Schiff (PAS)–positive (laminin-rich) patterns in melanomas are generated by invasive tumor cells by vasculogenic mimicry. Some observers, however, consider these patterns to be fibrovascular septa, generated by a stromal host response.
Objective.—To delineate differences between vasculogenic mimicry patterns and fibrovascular septa in primary uveal melanomas.
Design.—Frequency distributions, associations with outcome, and thicknesses of trichrome-positive and PAS-positive looping patterns were determined in 234 primary uveal melanomas. Sequential sections of 13 additional primary uveal melanomas that contained PAS-positive/trichrome-negative looping patterns were stained for type I and type IV collagens, laminin, and fibronectin. Real-time quantitative polymerase chain reaction was performed on RNA from cultured uveal melanoma cells for the expression of COL1A1, COL4A2, and fibronectin.
Results.—Trichrome-positive loops were encountered less frequently than PAS-positive loops (10% vs 56%, respectively). Death from metastatic melanoma was strongly associated with PAS-positive (P &lt; .001) but not with trichrome-positive (P = .57) loops. Trichrome-positive loops were significantly thicker than PAS-positive loops (P &lt; .001). The PAS-positive patterns stained positive for laminin, type I and type IV collagens, and fibronectin. Type I collagen was detected within melanoma cells and focally within some PAS-positive patterns. Real-time quantitative polymerase chain reaction revealed 3-fold, 25-fold, and 97-fold increases, respectively, in expression of COL4A2, fibronectin, and COL1A1 by invasive pattern-forming primary melanoma cells compared with poorly invasive non– pattern-forming cells.
Conclusions.—Fibrovascular septa are rare and prognostically insignificant in uveal melanomas, whereas vasculogenic mimicry patterns are associated with increased mortality. Type I collagen, seen focally in some vasculogenic mimicry patterns, may be synthesized by tumor cells, independent of a host stromal response.
Ectopic Decidua of Pelvic Lymph Nodes: A Potential Diagnostic Pitfall
Authors: Wu Debbie C. , Hirschowitz Sharon , Natarajan Sathima 
Published: February 2021

Abstract
Ectopic decidua is one of several benign lymph node inclusions that have been increasingly documented in the literature, most often in postmortem examinations of pregnant woman and recently in pregnant women with cervical squamous cell carcinoma. Although lacking clinical significance of its own, the major diagnostic implication would be misdiagnosis as metastatic carcinoma in the lymph node. Intraoperative frozen sections are often performed prior to radical hysterectomy, leading to a potential alteration of therapy if metastatic carcinoma is identified in the lymph nodes. We report such a case of a pregnant woman with cervical squamous cell carcinoma requiring lymphadenectomy and hysterectomy, in which the intraoperative frozen section of a pelvic lymph node with ectopic decidual change was mistakenly identified as metastatic carcinoma. Its histologic resemblance to carcinoma and location within subcapsular sinuses, compounded with the fact that ectopic lymph node decidua is not commonly seen in routine practice, can lead to this diagnostic pitfall. We review the literature regarding ectopic decidua, its presence in lymph nodes, and its pathogenesis, as well as review the literature on benign lymph node inclusions.
Epithelioid Angiosarcoma Involving the Lungs
Authors: Lund Lidiya , Amre Ramila 
Published: February 2021

Abstract
Diffuse lung involvement by metastatic tumor from an unknown primary site often constitutes a diagnostic dilemma. Although cytologic features and pattern of metastatic spread can guide in narrowing the list of possible primary neoplasms, immunohistochemistry remains pivotal in determining the phenotype of metastatic disease. We report a case with extensive involvement of lung parenchyma by a metastatic epithelioid neoplasm exhibiting a variety of distinctive patterns with a predominance of intra-arterial and lymphangitic spread. Immunohistochemical studies showed no evidence of epithelial, melanocytic, or lymphoid differentiation. The neoplastic cells were strongly positive for vimentin and CD31 but negative for CD34 and factor VIIIR:Ag. Electron microscopy of formalin-fixed tissue revealed multiple Weibel-Palade bodies and pinocytosis, supporting the diagnosis of epithelioid angiosarcoma. Doppler studies performed after pathologic diagnosis was rendered demonstrated 2 discrete hypoechoic masses within the medial aspect of the left proximal calf musculature, suggestive of solid soft tissue neoplasm—a possible source of pulmonary metastatic disease.
Gastric Toxoplasmosis as the Presentation of Acquired Immunodeficiency Syndrome
Authors: Merzianu Mihai , Gorelick Steven M. , Paje Voltaire , Kotler Donald P. , Sian Corazon 
Published: February 2021

Abstract
We report a case of a 39-year-old West African man with unknown human immunodeficiency virus status diagnosed with gastric toxoplasmosis as the presenting manifestation of acquired immunodeficiency syndrome. Toxoplasma gondii is common in severely immunosuppressed patients and most frequently involves the central nervous system, followed by the eye, myocardium and skeletal muscle, lungs, bone marrow, and peripheral blood. For unclear reasons, gastrointestinal involvement is exceedingly rare and occurs in the context of severe immunosuppression and disseminated disease. To our knowledge, this is the first report in the English literature of a patient with isolated, manifest gastric toxoplasmosis without evidence of concomitant cerebral or extracerebral involvement. It is important for both the clinician and the pathologist to maintain a high index of suspicion for toxoplasmosis in immunosuppressed patients presenting with nonspecific symptoms of gastritis and radiologic and endoscopic presence of thickened gastric folds with or without ulceration.
Robustness of Validation Criteria in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology
Authors: Renshaw Andrew A. , Walsh Molly K. , Blond Barbara , Moriarty Ann T. , Mody Dina R. , Colgan Terence J. 
Published: February 2021

Abstract
Context.—Field validation of slides used in gynecologic cytology proficiency testing has surfaced as an important issue. Although the precision of diagnoses in peer-reviewed educational programs has been examined, the robustness of the validation criteria for specific types of interpretations used in proficiency testing has not been previously studied.
Objective.—To evaluate the robustness of validation criteria for slides entering an educational slide program.
Design.—We reviewed the results of the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology and compared the robustness of validation criteria for different reference diagnoses, using a total of 16 948 circulating slides.
Results.—Validation criteria could be divided into 2 significantly different groups. The criteria for herpes, Trichomonas, squamous cell carcinoma, and adenocarcinoma were significantly more robust than the diagnoses of unsatisfactory; negative for intraepithelial lesion and malignancy, not otherwise specified; low-grade squamous intraepithelial lesion; and high-grade squamous intraepithelial lesion (P &lt; .001).
Conclusions.—The validation criteria used in the College of American Pathologists Interlaboratory Comparison Program in Cervicovaginal Cytology show 2 different levels of robustness or redundancy. These results have implications for the design of fair proficiency tests. Proficiency testing can be designed with the necessary number of reviews needed for slide validation.
Implementation of a Redistribution System for Near-Outdate Red Blood Cell Units
Authors: Denesiuk Lisa , Richardson Trevor , Nahirniak Susan , Clarke Gwen 
Published: February 2021

Abstract
Context.—Many remote hospitals keep small on-site stocks of red blood cell (RBC) units for emergency use and to support patient care programs. In Canada, the blood supplier does not accept returned units into inventory. Discard rates can, therefore, be high.
Objective.—To transport near-outdate RBC units to a high-usage hospital site, which would reduce overall discard rates, thereby increasing overall stock levels available in the blood system.
Design.—A blood transportation system was developed and validated. The validation was presented to a high-usage site that agreed to accept near-outdate RBC units transported by this system. Stocks at the remote hospitals were optimized without increasing system-wide discard rates. The redistribution program was implemented in 4 remote sites in northern Alberta, Canada. The final disposition of each transported unit was tracked. Data from the first 2 years were analyzed.
Results.—Between April 1, 2003, and March 31, 2005, 106 RBC units were successfully transported to and transfused at the high-usage site. The majority of the units were group O. None of the transfused units were involved in any reported transfusion reactions. The success rate of the transportation system varied among the sites (59%–78% successfully transported and transfused). Changes to the transport system were implemented as problems were discovered. The use of a temperature monitor in each shipment allowed for concurrent revalidation after each change.
Conclusions.—Redistribution systems can be an effective way to reduce RBC unit discard rates. Even simple transportation systems have many factors affecting the RBC unit temperature. Novel temperature stabilizing materials may make future transportation of RBC units more reliable.
Gliosarcoma With Features of Osteoblastic Osteosarcoma: A Review
Authors: Barresi Valeria , Cerasoli Serenella , Morigi Federico , Cremonini Anna Maria , Volpini Mirco , Tuccari Giovanni 
Published: February 2021

Abstract
Context.—Gliosarcoma is a rare tumor of the central nervous system characterized by a biphasic histologic pattern, consisting of a gliomatous and a sarcomatous component, respectively. In most instances the sarcomatous component is represented by a fibrosarcoma, but other stromal malignancies have also been described. Osteosarcomatous differentiation in gliosarcoma has been rarely reported.
Objective.—To review characteristic radiologic and histopathologic features of this rare neoplasm, to debate about possible differential diagnoses that should be taken into consideration, and to provide an overview of the potential histopathogenesis of gliosarcomas.
Data Sources.—Relevant articles indexed in PubMed (National Library of Medicine) and reference medical texts.
Conclusions.—Recent molecular studies suggest that sarcomatous and gliomatous components of gliosarcoma might be derived from a single precursor cell clone, progressing in 2 subclones with distinct morphologic features during tumor evolution. Nonetheless, events determining splitting of the original clone into 2 histologic populations remain to be investigated.