bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Microcystic pattern’ should be recognised as part of the morphological spectrum of solid‐pseudopapillary neoplasm of the pancreas
Authors: Abe Atsushi , Ohishi Yoshihiro , Miyazaki Tetsuyuki , Ozono Keigo , Mochidome Naoki , Saeki Kiyoshi , Nakamura Masafumi , Oda Yoshinao 
Published: August 2017

AimSolid pseudopapillary neoplasm (SPN) is an uncommon pancreatic tumour characterised by solid and pseudopapillary growth patterns. We have observed SPNs can show a microcystic pattern (microcystic SPN), which has been poorly described and may be confused with microcystic neoplasms. We conducted the present study to clarify the clinicopathological and immunohistochemical features of microcystic SPNs.Methods and resultsWe examined a consecutive series of 44 SPNs and 10 serous cystadenomas (SCAs), and classified them into 13 microcystic SPNs (29.5%) and 31 conventional SPNs (70.5%). Clinicopathological analysis, immunohistochemical staining and mucin histochemistry were performed. Clear cell change, hyalinised stroma and haemorrhage were observed significantly more frequently in the microcystic SPNs compared to the conventional SPNs. Immunohistochemically, the microcystic SPNs showed significantly lower frequencies of CD10 (0%) and CD56 expression (62%) compared to the conventional SPNs (87%; P < 0.001, 90%; P < 0.0085, respectively). There were no significant differences in other clinicopathological and immunohistochemical features between the two groups (i.e. the nuclear expression of β‐catenin, E‐cadherin, progesterone receptor (PgR), lack of forkhead box (Fox)L2 and occasional oestrogen receptor (ER), AE1/AE3 expression). Microcystic SCAs lack such a characteristic immunophenotype. The myxoid stroma of microcystic SPNs contained hyaluronan revealed by Alcian blue stain with hyaluronidase digestion.ConclusionWe thus conclude that the microcystic pattern should be recognised as a part of the morphological spectrum of SPNs. Our findings may contribute to the correct diagnosis of the pancreatic neoplasms with the microcystic pattern. In addition, we speculate that stromal change caused by an accumulation of hyaluronan may contribute to the microcystic pattern of SPN.
Histopathological and genetic review of phosphaturic mesenchymal tumours, mixed connective tissue variant
Authors: Yamada Yuichi , Kinoshita Izumi , Kenichi Kohashi , Yamamoto Hidetaka , Iwasaki Takeshi , Otsuka Hiroshi , Yoshimoto Masato , Ishihara Shin , Toda Yu , Kuma Yuki , Setsu Nokitaka , Koga Yuki , Honda Yumi , Inoue Takeshi , Yanai Hiroyuki , Yamashita Kyoko , Ito Ichiro , Takahashi Mitsuru , Ohga Shouichi , Furue Masutaka , Nakashima Yasuharu , Oda Yoshinao 
Published: August 2017

AimsPhosphaturic mesenchymal tumour, mixed connective tissue variant (PMT‐MCT), is a tumour of uncertain differentiation, characterised by ‘smudgy/grungy’ calcification and vitamin D‐resistant phosphaturic osteomalacia. Fibroblast growth factor (FGF)23 is recognised as a reliable marker of PMT‐MCT, but quantitative evaluation has never been performed. We reviewed cases of tumour‐associated osteomalacia or histologically definitive PMT‐MCT without osteomalacia using histological, immunohistochemical and genetic methods and evaluated the diagnostic significance of these findings.Methods and resultsA total of 19 tumours from 14 cases diagnosed previously as PMT‐MCT were retrieved, on which immunohistochemical staining, reverse transcription–polymerase chain reaction (RT–PCR) and fluorescence in‐situ hybridisation (FISH) analysis were performed. Histologically, fibrous capsule, calcification and giant cell reaction tended to be observed in soft‐tissue PMT‐MCT, while PMT‐MCT of bone and multiple PMT‐MCT showed an infiltrative growth pattern. The immunohistochemical results were as follows: the tumour cells were positive for FGF23 (nine of 12, 75%), FGFR1 (11 of 11, 100%), CD56 (12 of 14, 85.7%) and E26 oncogene homologue (ERG) (5 of 13, 38.4%). The sole malignant tumour was positive for p53. FGF23 mRNA was detected in seven of 14 formalin‐fixed paraffin‐embedded (FFPE) specimens and all five frozen specimens by RT–PCR. The level of FGF23 mRNA, which was determined by real‐time PCR, varied among the phosphaturic cases. Two of 17 tumours were positive for FGFR1 gene rearrangement.ConclusionsIt was considered that PMT‐MCT is a histopathological entity with or without phosphaturia, with varying levels of FGF23 mRNA, and with or without fibronectin 1 (FN1)–FGFR1 fusion gene. The authors propose that the histology of PMT‐MCT differs depending on its location, such as bone or soft tissue, which could complicate the differential diagnosis.
PTEN allelic loss is an important mechanism in the late stage of development of oral leucoplakia into oral squamous cell carcinoma
Authors: Miyahara Ligia A N , Pontes Flávia S C , Burbano Rommel M R , Conte Neto Nicolau , Guimarães Douglas M , Fonseca Felipe P , Pontes Hélder A R 
Published: August 2017

AimThe aim of this study was to analyse allelic loss of the phosphatase and tensin homologue deleted on chromosome 10 (PTEN) gene and its protein immuno‐expression in dysplastic oral lesions and oral squamous cell carcinomas (OSCCs).Methods and resultsSamples were collected from 153 patients [20 ranulas used as a control (C); 30 leucoplakias with mild dysplasia (MD); 30 leucoplakias with moderate to severe dysplasia (MSD); 73 oral squamous cell carcinoma (OSCC)]. PTEN protein expression was investigated using immunohistochemistry, and PTEN allelic loss was analysed by fluorescence in‐situ hybridisation (FISH). Differences among groups were evaluated using the χ2 test. PTEN expression was higher in MSD (P = 0.002) and OSCC (P = 0.0259) compared with the C group; additionally, a higher expression was observed in MSD (P = 0.0035) and OSCC (P = 0.049) than MD. Regarding FISH analysis, a higher hemizygous (single copy) loss was observed in OSCC than in C (P = 0.0467) and in OSCC than in MD (P = 0.0175), as well as a higher homozygous deletion in OSCC compared with C (P = 0.0159) and OSCC than MD (P = 0.0145).ConclusionThe results of this work suggest that PTEN allelic loss is an important mechanism in the late stage of the development of oral potentially malignant lesions into oral cancer.
The extent of B‐cell activation and dysfunction preceding lymphoma development in HIV‐positive people
Authors: Shepherd L , Borges ÁH , Harvey R , Bower M , Grulich A , Silverberg M , Weber J , Ristola M , Viard J‐P , Bogner JR , Gargalianos‐Kakolyris P , Mussini C , Mansinho K , Yust I , Paduta D , Jilich D , Smiatacz T , Radoi R , Tomazic J , Plomgaard P , Frikke‐Schmidt R , Lundgren J , Mocroft A ,   EuroSIDA in EuroCOORD
Published: August 2017

ObjectivesB‐cell dysfunction and activation are thought to contribute to lymphoma development in HIV‐positive people; however, the mechanisms are not well understood. We investigated levels of several markers of B‐cell dysfunction [free light chain (FLC)‐κ, FLC‐λ, immunoglobulin G (IgG), IgA, IgM and IgD] prior to lymphoma diagnosis in HIV‐positive people.MethodsA nested matched case–control study was carried out within the EuroSIDA cohort, including 73 HIV‐positive people with lymphoma and 143 HIV‐positive lymphoma‐free controls. Markers of B‐cell dysfunction were measured in prospectively stored serial plasma samples collected before the diagnosis of lymphoma (or selection date in controls). Marker levels ≤ 2 and > 2 years prior to diagnosis were investigated.ResultsTwo‐fold higher levels of FLC‐κ [odds ratio (OR) 1.84; 95% confidence interval (CI) 1.19, 2.84], FLC‐λ (OR 2.15; 95% CI 1.34, 3.46), IgG (OR 3.05; 95% CI 1.41, 6.59) and IgM (OR 1.46; 95% CI 1.01, 2.11) were associated with increased risk of lymphoma > 2 years prior to diagnosis, but not ≤ 2 years prior. Despite significant associations > 2 years prior to diagnosis, the predictive accuracy of each marker was poor, with FLC‐λ emerging as the strongest candidate with a c‐statistic of 0.67 (95% CI 0.58, 0.76).ConclusionsFLC‐κ, FLC‐λ and IgG levels were higher > 2 years before lymphoma diagnosis, suggesting that B‐cell dysfunction occurs many years prior to lymphoma development. However, the predictive value of each marker was low and they are unlikely candidates for risk assessment for targeted intervention.
Cyclic fatigue resistance of R‐Pilot, HyFlex EDM and PathFile nickel‐titanium glide path files in artificial canals with double (S‐shaped) curvature
Authors: Uslu G. , Özyürek T. , Yılmaz K. , Gündoğar M. 
Published: August 2017

AbstractAimTo examine the cyclic fatigue resistances of R‐Pilot, HyFlex EDM and PathFile NiTi glide path files in S‐shaped artificial canals.MethodologyTwenty R‐Pilot (12.5/.04), 20 HyFlex EDM (10/.05) and 20 PathFile (19/.02) single‐file glide path files were included. Sixty files (n: 20/each) were subjected to static cyclic fatigue testing using double‐curved canals until fracture occurred (TF). The number of cycles to fracture (NCF) was calculated by multiplying the rpm value by the TF. The length of the fractured fragment (FL) was determined by a digital microcaliper. Six samples of fractured files (n: 2/each) were examined by SEM to determine the fracture mode. The NCF and the FL data were analysed using one‐way anova, post hoc Tamhane and Kruskal–Wallis tests using SPPS 21 software. The significance level was set at 5%.ResultsIn the double‐curved canal, all the files fractured first in the apical curvature and then in the coronal curvature. The NCF values revealed that the R‐Pilot had the greatest cyclic fatigue resistance, followed by the HyFlex EDM and PathFile in both the apical and coronal curvatures (P < 0.05).ConclusionsR‐Pilot NiTi glide path files, used in a reciprocating motion, had the greatest cyclic fatigue resistance amongst the tested NiTi glide path files in an artificial S‐shaped canal.
Moisture content of root canal dentine affects detection of microcracks using micro‐computed tomography
Authors: Rödig T. , Müller C. , Hoch M. , Haupt F. , Schulz X. , Wiegand A. , Rizk M. 
Published: August 2017

AbstractAimTo evaluate the effect of moisture content in root canal dentine on detection of microcracks using micro‐computed tomography.MethodologyTen roots with and without craze lines or cracks (each n = 5) were selected and scanned six times with different moisture conditions of root dentine using a micro‐CT scanner at a high resolution of 10.5 μm. Scanning conditions were as follows: (i) after 30‐day wet storage, (ii) after 2‐h dry time, (iii) after 48‐h wet storage, (iv) after 24‐h dry time, (v) after 48‐h wet storage, (vi) after 2‐h dry time. From each scan, cross‐sectional images were obtained at intervals of 1 mm (total n = 708) and evaluated for the presence of dentinal microcracks twice by five calibrated blinded observers. Statistical analysis was performed by nonparametric analysis of variance for longitudinal data (P < 0.05).ResultsIntra‐rater percentage agreement ranged between 92% and 98%, whereas inter‐rater percentage agreement was 81% and 83%, respectively. No significant differences between all wet groups as well as between both groups with 2‐h dry time were detected (P > 0.05). Almost no cracks were observed after wet storage with a significant increase of cracks after 2‐h dry time (P < 0.001). Significantly more microcracks were identified after 24 h than after 2‐h dry time (P < 0.004).ConclusionsMoisture content of dentine influenced detection of microcracks when evaluated using micro‐CT. Scanning should be performed on dried specimens to allow reliable identification of dentinal defects. Formation of new cracks during dry periods up to 24 h was disproved.
Histological, morphometric, protein and gene expression analyses of rat retinas with ischaemia–reperfusion injury model treated with sildenafil citrate
Authors: Zanoni Diogo S. , Da Silva Germana A. , Ezra‐Elia Raaya , Carvalho Márcio , Quitzan Juliany G. , Ofri Ron , Laus José L. , Laufer‐Amorim Renee 
Published: August 2017

SummaryThe aim of this study was to better understand the role of apoptosis in a retinal ischaemia–reperfusion injury model and to determine whether sildenafil citrate treatment can prevent retinal cell apoptosis. Thirty‐six rats were divided into a control group (n = 6) and two experimentally induced ischaemia–reperfusion groups (7 and 21 days; n = 15 per group). The induced ischaemia–reperfusion groups were treated with sildenafil for 7 and 21 days (n = 10 per group), and 10 animals were treated with a placebo for the same period (n = 5 per group). Paracentesis of the anterior chamber was performed with a 30‐G needle attached to a saline solution (0.9%) bag positioned at a height of 150 cm above the eye for 60 min. Intraocular pressure was measured by rebound tonometer (TonoVet®). The eyes were analysed by histology and morphometry, and by immunohistochemistry and qRT‐PCR for expression of Caspase‐7, Caspase‐6, Caspase‐9, Tnf‐r2, Fas‐l, Bcl‐2 and Bax. Sildenafil‐treated animals showed lower levels of histopathological changes (inflammatory, cellular and tissue) than their placebo‐treated counterparts at both 7 and 21 days. The retinal ganglion cell layer (RGC) was preserved in the sildenafil groups (SG), with a cell count closer to control than in the placebo groups (PG). Caspase‐7 expression was significantly higher in both treated groups at 7 days compared to controls. Gene expression levels in both treatment groups differed from the controls, but in SG Bax and Caspase‐6 expression levels were similar to control animals. These results suggest that the main mechanism of retinal cell death in this model is apoptosis, as there is an increase in pro‐apoptotic factors and decrease in the anti‐apoptotic ones. Also, sildenafil seems to protect the retinal ganglion cell layer from apoptosis. Cell survival was evident in the histological and morphometric analyses, and sildenafil treatment had a protective effect in the apoptosis pathways, with gene expression levels in SG similar to the controls.
Direct oral anticoagulant medications in calciphylaxis
Authors: King Brian J. , el‐Azhary Rokea A. , McEvoy Marian T. , Shields Raymond C. , McBane Robert D. , McCarthy James T. , Davis Mark D. P. 
Published: August 2017

AbstractBackgroundRecent studies suggest that calciphylaxis is a thrombotic condition in which arteriolar thrombosis leads to painful skin infarcts and consequent morbidity and mortality. Paradoxically, warfarin is implicated as a risk factor for calciphylaxis. Our objective is to report the use of oral direct thrombin and factor Xa inhibitors (termed direct oral anticoagulants [DOACs]) in patients with calciphylaxis.MethodsWe retrospectively reviewed records of 16 patients with calciphylaxis who received concomitant administration of novel anticoagulants. Patient data, including demographics, comorbidities, other treatments, and adverse events, were abstracted from the health records.ResultsEleven patients (69%) had chronic kidney disease (stage ≥3A), and eight (50%) received dialysis. Apixaban was the most frequently used agent (n = 11 [69%]). Dabigatran (n = 4 [25%]) and rivaroxaban (n = 2 [13%]) were reserved for patients with mild renal impairment (stage ≤2). One clinically relevant but nonmajor bleeding event occurred. There were no major bleeding events. Nine patients (56%) were alive at last follow‐up, and five (31%) had complete resolution of their calciphylaxis (mean follow‐up, 523 days; range, 26–1884 days).ConclusionDOACs were safe and well tolerated in patients with calciphylaxis, in this initial experience. Several patients had improvement or resolution of calciphylaxis in response to therapy that included DOACs. The degree of renal impairment should guide DOAC choice. Randomized trials are required to determine treatment efficacy.
Trichoscopy – a useful tool in the preliminary differential diagnosis of autoimmune bullous diseases
Authors: Sar‐Pomian Marta , Rudnicka Lidia , Olszewska Malgorzata 
Published: August 2017

AbstractBackgroundScalp is a common location of autoimmune bullous diseases. Trichoscopy is a noninvasive method for diagnosing hair and scalp diseases. Data on trichoscopy in autoimmune bullous diseases are limited to the studies on pemphigus including a small number of patients. Trichoscopic characteristics of bullous pemphigoid and dermatitis herpetiformis were not reported to date. The aim of the study was to determine the value of trichoscopy in the differential diagnosis of pemphigus vulgaris, pemphigus foliaceus, bullous pemphigoid, and dermatitis herpetiformis.MethodsTrichoscopy was used to evaluate scalp lesions in 68 patients (26 with pemphigus vulgaris, 17 with pemphigus foliaceus, 17 with bullous pemphigoid, and 8 with dermatitis herpetiformis). The working magnification was 20‐fold and 70‐fold.ResultsThe most frequent trichoscopic feature of autoimmune bullous diseases was extravasations. They occurred in 76.9% of patients with pemphigus vulgaris, 70.6% of patients with pemphigus foliaceus, 76.5% of patients with bullous pemphigoid, and 100% of patients with dermatitis herpetiformis. Yellow hemorrhagic crusts occurred in, respectively, 73.1%, 70.6%, 64.7%, and 35.5% of the cases. Yellow diffuse scaling and tubular scaling occurred more frequently in pemphigus foliaceus (52.9% and 41.2%, respectively). Clustered dotted vessels were characteristic for dermatitis herpetiformis (5/8, 62.5%). Dotted vessels with whitish halo were a hallmark of pemphigus vulgaris. A trichoscopic algorithm for the differential diagnosis of autoimmune bullous diseases was developed.ConclusionsAutoimmune bullous diseases present characteristic trichoscopic patterns. Trichoscopy can be regarded as a rapid in‐office preliminary diagnostic method in the differential diagnosis of these diseases.
Failure of initial disease control in bullous pemphigoid: a retrospective study of hospitalized patients in a single tertiary center
Authors: Kremer Noa , Zeeli Tal , Sprecher Eli , Geller Shamir 
Published: August 2017

AbstractBackgroundBullous pemphigoid (BP) is the most prevalent autoimmune blistering skin disease in Western countries and in Israel. Initial disease control is achieved in 60–90% of BP patients within 1–4 weeks of corticosteroid therapy. In the remainder of patients, recalcitrant disease is controlled with additional immunosuppressive treatment.ObjectivesWe aimed to evaluate the rate of BP patients who needed adjuvant therapy to achieve initial disease control and to identify potential predictors for recalcitrant disease.MethodsWe conducted a retrospective study of newly diagnosed BP patients who were hospitalized at the Tel Aviv Sourasky Medical Center between the years 2008–2014. We performed statistical analyses to assess the association between clinical factors and failure of initial disease control.ResultsAmong 114 hospitalized patients with newly diagnosed BP, 1.8% presented with oral mucosa involvement. Seven patients (6.1%) required systemic agents in addition to corticosteroids to achieve disease control. Hypertension (P = 0.048), involvement of the head region (P = 0.042), and metformin treatment (P = 0.02) were significantly more prevalent among patients with recalcitrant disease.ConclusionsThe low frequency of recalcitrant BP (6.1%) and the rarity of involvement of the oral mucosa (1.8%) in this study suggest that Israeli BP patients present a milder phenotype compared to similar patients from other geographic areas. Hypertension, head involvement, and metformin therapy were found to be significantly associated with the need for adjuvant therapy to achieve initial control, suggesting that these parameters may serve as predictors of treatment response in BP.
Predictive value of symptoms, signs and biomarkers on computed tomography pulmonary angiogram results
Authors: Sethwala Anver , Wang Xiaojie , Sturm Emma E. , Collins Kate L. , O'Donnabhain Ronan , Friedman Nadia D. 
Published: August 2017

AbstractBackgroundPulmonary embolism (PE) is associated with significant morbidity and mortality. PE is a heterogeneous entity that causes a wide variety of clinical presentations, making it imperative to establish which clinical symptoms, signs and biomarkers can influence the pretest probability of PE to aid clinicians and reduce over testing.AimTo analyse the clinical parameters used by clinicians to order a computed tomography pulmonary angiogram (CTPA) and establish which were associated with the presence of PE.MethodsMedical records of patients who underwent CTPA from December 2015 to March 2016 were extracted. Patient demographics, clinical symptoms, diagnostic and radiological results were analysed.ResultsThe study included 150 CTPA studies. Of the studies, 25 were positive for PE and 125 were negative. There was no significant relationship between the presence or character of chest pain and a positive CTPA result (P = 0.216). Previous history of venous thromboembolism (VTE) (P < 0.0001), one or more risk factors for VTE and positive troponin (P < 0.002) were all predictive of PE. None of the patients with a negative D‐dimer had a positive CTPA.ConclusionThis study supports the negative predictive value of the D‐dimer for excluding PE and demonstrates that the strongest pretest predictors of PE in our population are a prior history of VTE, risk factors for VTE and elevated troponin. None of the parameters that often generate requests for CTPA, including vital signs or the presence of chest pain, was associated with the presence of PE in our study population.
Physical activity, quality of life and successful ageing among community‐dwelling older adults
Authors: Choi M. , Lee M. , Lee M.‐J. , Jung D. 
Published: August 2017

AimTo identify the relationships between physical activity, quality of life and successful ageing among community‐dwelling older adults in South Korea.BackgroundWith increasing numbers of financially stable and active older adults, it has become imperative to understand successful ageing to promote well‐being in this population.MethodsQuestionnaire data were collected from senior welfare centres from August to November 2013. Participants were adults aged 65 years or older living in urban areas. Participants were asked to complete self‐report questionnaires assessing physical activity, quality of life and successful ageing. Data from 212 participants were analysed using descriptive statistics, independent t‐tests, ANOVAs with Scheffe tests and ordinary least square and quantile regression models using STATA 12.0.FindingsIn the ordinary least square model, the association between physical activity and successful ageing was not statistically significant, whereas quantile regression revealed significant associations within the 75th and 90th percentiles of successful ageing scores. Quality of life was significantly associated with successful ageing in the ordinary least square model and with the median and 75th percentiles of successful ageing in quantile regressions.ConclusionResults suggested that physical activity and quality of life were both in part significantly associated with successful ageing among Korean older adults.Implications for nursing and health policiesPhysical activity and quality of life play an important role in enhancing successful ageing. The development of an effective exercise programme advertised towards community‐dwelling older adults may be essential for maintaining their successful ageing.