bluuebunny/crossref_metadata_2025_split huggingface dataset:
What we call them: the nomenclature of head and neck paragangliomas
Authors: Martin T.P.C 
Published: May 2006

Keypoints• Historically, paragangliomas have been referred to by a number of different terms (‘glomus’ tumours of different sorts, ‘carotid body tumour’).• WHO classification (2005) refers to these tumours as paragangliomas, with further anatomical detail (‘vagal paraganglioma’, ‘carotid body paraganglioma’).• This system recognises the commonality between these tumours and aids understanding of their pathogenesis and clinical management.
Ultrasound guidance improves the adequacy of our preoperative thyroid cytology but not its accuracy
Authors: Mehrotra P. , Viswanathan H. , Johnson S. J. , Wadehra V. , Richardson D. L. , Lennard T. W. J. 
Published: May 2006

Aims:  Our thyroid cytology audit results of 1990–1995 showed an unsatisfactory rate of 43.1% and prediction of neoplasia with a sensitivity of 86.8%. Increasingly, ultrasound scan (USS)‐guided core sampling for cytology is proving a valuable tool instead of freehand fine needle aspiration (FNA) or following unsatisfactory freehand FNA. We present the results of freehand FNA and USS‐guided core samples for cytology in two separate patient groups in our centre.Methods:  Patients who had a thyroid resection and preoperative thyroid cytology in our institution between 1996 and 2002 were included. The histological diagnoses were correlated with the preceding cytology results.Results:  A total of 450 FNAs were performed on 394 patients. Freehand FNAs were performed for 348 (77.3%) samples and USS‐guided core for 102 (22.7%) samples; 121 (26.8%) were repeat aspirates performed on 45 patients. Using aspiration cytology (AC) grading, freehand FNA was cytologically inadequate (AC0 or AC1) in 34.8% cases whereas USS‐guided core was inadequate in 17.6% cases (P = 0.001). Freehand FNA (AC3, AC4, AC5) predicted neoplasia with a sensitivity of 83.2%, specificity of 46.6%, accuracy of 63.0%, positive predictive value of 56.0% and negative predictive value of 77.1%. USS‐guided core sample for cytology (AC3, AC4, AC5) predicted neoplasia with a sensitivity of 93.5%, specificity of 26.0%, accuracy of 51.9%, positive predictive value of 43.9% and negative predictive value of 86.7%.Conclusions:  Although USS‐guided core provides more satisfactory specimens than freehand FNA, in our centre it does not provide increased accuracy.
Review of cervical smears from 76 women with invasive cervical cancer: cytological findings and medicolegal implications
Authors: Coleman D. V. , Poznansky J. J. R. 
Published: May 2006

Objective:  To review cervical smears from 76 women which were taken prior to the diagnosis of invasive cervical cancer and to determine the appropriateness of the cytology reports issued on the smears.Methods:  Cervical smears, clinical records, cervical smear history and cytology reports from 76 women with invasive cervical cancer were reviewed. After microscopic review of the cervical smears, the cases were divided into two groups: Group 1 comprised 50 women who were found to have had at least one false‐negative (F/N) smear report prior to the diagnosis of invasive cervical cancer. Group 2 comprised 26 women for whom no evidence of F/N reporting was found.Results:  A total of 209 cervical smears from the 50 women in group 1 were available for review (range 2–12 smears per woman); 100 of the 209 smears were considered to have been reported appropriately. Ninety‐seven smears which had been reported originally as negative or inadequate were found, on review, to contain numerous severely dyskaryotic cells and were reclassified as F/N smears. All of the 50 women had at least one F/N smear and 29 had two or more. Twelve smears from eight women contained only a few (<200 severely dyskaryotic cells). Forty women developed invasive squamous carcinoma and 10 developed invasive adenocarcinoma. The stage at diagnosis ranged from 1A to stage 4. Seventy‐one smears from the 24 women in group 2 were available for review (range 1–15 smears per woman). In two cases included in group 2, no smears were provided for review as the smears had been lost or mislaid. Review of the 71 smears confirmed the accuracy of the original cytological classification of the smear. Nineteen women were diagnosed with squamous cancer, two microinvasive cancer, one glassy cell, two adenocarcinomas, and one with adenosquamous carcinoma. One women was found to have an embryonal rhabdomyosarcoma of the corpus uteri involving the cervix.Discussion/Conclusion: The medicolegal implications are discussed in the light of the above findings. Evidence of breach of duty of care was presented in all 50 cases in group I although causation was not established in every case. There was no evidence of failure of duty of care in terms of the standard of the cervical cytology reports issued or standard of clinical management in 17 of the 26 cases in group 2. However, in seven of the 26 cases in group 2, clinical management of the case was substandard due to failure to investigate symptoms of irregular bleeding regardless of a negative cytology report (two cases), failure to act upon a suspicious smear report or consecutive inadequate smear reports (two cases), failure of follow‐up after treatment of CIN3 (two cases) and histological misdiagnosis (one case).
Evaluation of 100% rapid rescreening of negative cervical smears as a quality assurance measure
Authors: Manrique E. J. C. , Amaral R. G. , Souza N. L. A. , Tavares S. B. N. , Albuquerque Z. B. P. , Zeferino L. C. 
Published: May 2006

Objective:  The objective of this study was to compare the performance of 100% rapid rescreening, 10% random rescreening and the review of smears selected on the basis of clinical criteria, as a method of internal quality control of cervical smears classified as negative during routine screening.Methods:  A total of 3149 smears were analysed, 173 of which were classified as positive and 2887 as negative, while 89 smears were considered unsatisfactory. The smears classified as negative were submitted to 100% rapid rescreening, 10% random rescreening, and rescreening based on clinical criteria. The rescreening stages were blinded and results were classified according to the Bethesda 2001 terminology. Six cytologists participated in this study, two of whom were responsible for routine screening while the other four alternated in carrying out rescreening so that no individual reviewed the same slide more than once.Results:  The 100% rapid rescreening method identified 92 suspect smears, of which 42 were considered positive at final diagnosis. Of the 289 smears submitted to the 10% rescreening method, four were considered abnormal but only one was confirmed positive in the final diagnosis. Of the 690 smears rescreened on the basis of clinical criteria, 10 were considered abnormal and eight received a positive final diagnosis.Conclusions:  The 100% rapid rescreening method is more efficient at detecting false‐negative results than 10% random rescreening or rescreening on the basis of clinical criteria, and is recommended as an internal quality control method.
Observer variation in immunohistochemical analysis of protein expression, time for a change?
Authors: Kirkegaard T , Edwards J , Tovey S , McGlynn L M , Krishna S N , Mukherjee R , Tam L , Munro A F , Dunne B , Bartlett J M S 
Published: May 2006

Aim : Immunohistochemical analysis of protein expression is central to most clinical translational studies and defines patient treatment or selection criteria for novel drugs. Interobserver variation is rarely analysed despite recognition that this is a key area of potential inaccuracy. Therefore our aim was to examine observer variation and suggest the revision of current standards.Methods and results : We analysed inter‐ and intra‐observer variation, by interclass correlation coefficient (ICCC) and κ statistics, in 8661 samples. Intra‐observer assessment of nuclear, cytoplasmic and membrane staining for seven proteins in 1323 samples resulted in an ICCC of 0.94 and a κ‐value of 0.787. Interobserver reproducibility, assessed on 28 proteins by seven observer pairs in 8661 carcinomas, gave an ICCC of 0.90 and a κ‐value of 0.70. No significant effect of either antibody or cellular compartmentalization was observed.Conclusion : We have demonstrated that ICCC is a consistent method to assess observer variation when a continuous scoring system is used, compared with κ statistics, which depends on a categorical system. Given the importance of accurate assessment of protein expression in diagnostic and experimental medicine, we suggest raising thresholds for observer variation: ICCC of 0.7 should be regarded as the minimum acceptable standard, ICCC of 0.8 as good and ICCC of ≥ 0.9 as excellent.
Unequivocal morphological diagnosis of fungi in morphologically abnormal nails
Authors: Cabral A , Berger T H D , Middag‐Broekman J H F F , Boon M E 
Published: May 2006

Aims : To analyse the prevalence of fungi in abnormal nails by morphological diagnosis. Prevalence studies of onychomycoses in temperate climate zones have yielded widely varying rates, possibly reflecting the confounding effects of referral bias, sampling specificity and intrinsic sensitivity of the diagnostic techniques employed.Methods and results : The method employed to identify fungi in nails entailed primary fixation using a non‐formaldehyde‐based coagulative fixative (BoonFix®; Finetec, Japan) and microwave‐enhanced processing to histology, followed by staining the paraffin sections with periodic acid–Schiff, using haematoxylin as a routine counterstain. The results of 990 nail samples were tabled for statistical analysis related to gender, patient age and diabetes mellitus status. In four of the 990 (< 1%) analysed cases the diagnosis was found to be equivocal using the method employed. These cases were jointly reviewed for definitive diagnosis. The overall prevalence of invasive hyphal structures was found to be 606/990 (≈ 61%). The relative risk for fungal infection in morphologically abnormal nails was found to be higher for persons < 20 years old or diabetic patients aged ≥ 71 years.Conclusions : The 61% positivity rate for fungi found justifies systematic direct submission of samples from abnormal nails for histological confirmation in order to avoid unwarranted treatment.
Invasive growth of hepatic angiomyolipoma; a hitherto unreported ominous histological feature
Authors: Nonomura A , Enomoto Y , Takeda M , Tamura T , Kasai T , Yosikawa T , Nakamime H 
Published: May 2006

Aims : Although histological features of hepatic angiomyolipoma (AML) are highly variable, true malignant change is extremely rare. The aim was to review the histological features of invasive growth and clinical outcomes in 39 cases of hepatic AML.Methods and results : An invasive growth pattern into surrounding hepatic parenchyma, portal triads and/or around hepatic veins was found in 24 of 39 tumours (62%). One variant showed tumour cells replacing hepatocytes within the liver cell cords. The other consisted of portal or perivascular invasive growth along blood vessels. In the former pattern, small isolated tumour cell clusters were occasionally found in the vicinity of the main mass, showing a sprouting pattern. Although these histological features suggest malignancy, distant metastases were not found in any of the cases within a mean follow‐up period of 6.8 years.Conclusions : A previously unrecognized histological feature of an invasive growth pattern, which suggests malignancy and might promote an erroneous diagnosis, was frequently found in hepatic AMLs. However, among about 180 reported hepatic AMLs, including the present cases, only one hepatic AML with distant metastasis has been reported to date and nearly all hepatic AMLs behave in a benign fashion. Therefore, pathologists should not overdiagnose malignancy based solely on the histological invasive growth patterns described in this paper.
Subcellular shift of the hepatic growth hormone receptor with progression of hepatitis C virus‐related chronic liver disease
Authors: Vespasiani Gentilucci U , Perrone G , Galati G , D'Avola D , Zardi E M , Rabitti C , Bianchi A , De Dominicis E , Afeltra A , Picardi A 
Published: May 2006

Aims : To evaluate the cytoplasmic and nuclear expression of hepatic growth hormone receptor (GHR) in different stages (S0, S1, S3 and S4, according to Knodell's classification) of chronic liver disease (CLD) and in hepatocellular carcinoma (HCC).Methods and results : Liver specimens from 31 patients with hepatitis C virus‐related CLD, five patients with HCC and nine controls were examined for expression of hepatic GHR by immunohistochemistry with MAb 263. Cytoplasmic and nuclear staining were evaluated as a percentage of positively stained cells. The cytoplasmic expression of GHR was comparable between normal liver and S0 hepatitis, while it progressively decreased in S1, S3 and S4 CLD (P < 0.01). Conversely, nuclear GHR showed increased expression in S3 and S4 CLD (P < 0.05). No differences were observed between HCC and normal liver in terms of GHR immunoreactivity.Conclusions : This is the first study to show that the subcellular expression of hepatic GHR changes with the progression of CLD. The increase in nuclear expression of GHR with advanced stages of CLD suggests that GH may act directly at the nuclear level to promote hepatocyte proliferation/regeneration.
Cell proliferation marker MCM2, but not Ki67, is helpful for distinguishing between minimally invasive follicular carcinoma and follicular adenoma of the thyroid
Authors: Mar K Cho , Eimoto T , Nagaya S , Tateyama H 
Published: May 2006

Aims : To compare cell proliferation markers, minichromosome maintenance protein 2 (MCM2) and Ki67, in minimally invasive follicular carcinoma (MIFC) and follicular adenoma (FA) of the thyroid and among MIFCs with different diagnostic criteria.Methods and results : Twenty‐two MIFCs and 20 FAs were immunohistochemically stained for MCM2 and Ki67. The MIFCs were subdivided into six Group 1 tumours with both capsular and vascular invasions, seven Group 2 tumours with vascular invasion only and nine Group 3 tumours with capsular invasion only. The MCM2 and Ki67 indices were calculated, counting more than 1000 tumour cells in the most frequently positive areas. In total and Groups 1–3 MIFCs and in FAs, the average MCM2 index was 26.7 ± 11.0, 28.4 ± 8.6, 26.3 ± 14.8, 25.9 ± 8.4 and 10.7 ± 4.5, respectively, whereas the average Ki67 index was 2.07 ± 1.65, 1.93 ± 2.02, 2.49 ±1.38, 1.84 ± 1.5 and 1.78 ± 0.92, respectively. There was a significant difference in the MCM2 index, but not in the Ki67 index, between each category of MIFCs and FA (P < 0.01). However, neither the MCM2 index nor the Ki67 index showed a statistically significant difference among the subgroups of MIFC.Conclusions : MCM2, but not Ki67, is a helpful marker for differentiating MIFC from FA. The tumour cell proliferative activity supports the histological criteria based on diagnosing MIFC by either capsular or vascular invasion only.
Ets‐1 is up‐regulated together with its target gene products matrix metalloproteinase‐2 and matrix metalloproteinase‐9 in atypical and anaplastic meningiomas
Authors: Okuducu A F , Zils U , Michaelis S A M , Michaelides S , Von Deimling A 
Published: May 2006

Aims : Matrix metalloproteinases (MMPs) are a pivotal enzyme system involved in extracellular matrix (ECM) degradation and are considered to be important in the development and invasion of human tumours. Little is known about the regulation of MMPs in meningioma development and prognosis. The transcription factor Ets‐1 is the main regulator of several MMPs, including MMP‐2 and ‐9. The aim of this study was to determine the relationship between the expression of Ets‐1, MMP‐2 and ‐9 and the malignant potential of meningiomas.Methods and results : Seventy‐four meningiomas of different histological grades were investigated immunohistochemically. Up‐regulation of Ets‐1, MMP‐2 and MMP‐9 expression was observed in atypical and anaplastic meningiomas. Invasive meningiomas showed increased immunohistochemical expression of these proteins compared with non‐invasive meningiomas. We also observed a correlation between the expression of Ets‐1 and of its target genes MMP‐2 and MMP‐9.Conclusions : Ets‐1 may be involved in the transcriptional regulation of MMP‐2 and MMP‐9 as well as in the invasive process in meningiomas. Evaluation of these expressions might be of prognostic value for meningiomas.
Human pancreatic mucinous cystadenoma is characterized by distinct mucin, cytokeratin and CD10 expression compared with intraductal papillary‐mucinous adenoma
Authors: Handra‐Luca A , Fléjou J‐F , Rufat P , Corcos O , Belghiti J , Ruszniewski P , Degott C , Bedossa P , Couvelard A 
Published: May 2006

Aims : To examine cytokeratin, epithelial glycoprotein (mucin) and glycoprotein CD10 expression in benign mucinous cystdenomas (MCAs) in comparison with intraductal papillary mucinous adenomas (IPMAs).Methods and results : Thirty MCAs of the pancreas were analysed for immunohistochemical expression of cytokeratin (CK) 7, CK20, MUC1, MUC2, MUC5AC and CD10 and were compared with 16 IPMAs. CK7 was expressed in all neoplasms. CK20 was significantly more frequent in MCAs compared with IPMAs (56.66% versus 18.75%, P = 0.027). MUC1 was more frequent in MCAs (40% versus 12.5%, P = 0.0915), whereas MUC5AC was significantly less frequent in MCAs (33.33% versus 100%). MUC2 was expressed in goblet cells of seven MCAs. In MCAs, CD10 was observed both in epithelial cells and in the ovarian‐type stromal cells (24/30). Epithelial expression of CD10 was significantly lower in IPMAs (66.66% versus 6.25%, p = 0.0001).Conclusions : MCA is characterized by a significantly greater frequency of expression of CK20 and CD10 when compared with IPMA, which preferentially expresses MUC5AC.
Iron‐induced mucosal injury to the upper gastrointestinal tract
Authors: Haig A , Driman D K 
Published: May 2006

Aims : To define the causes and associations of mucosal iron deposition in upper gastrointestinal biopsy specimens and to describe the morphological features of iron‐related injury.Methods : The histological pattern, intensity and distribution of iron in biopsies obtained from 1991 to 2005 were recorded and correlated with endoscopic and clinical findings.Results : Twenty‐five biopsies (16 gastric, four duodenal, five oesophageal) were accrued. Iron deposition was seen in two groups: 10 cases showed erosive injury, with brown‐black crystalline material overlying eroded epithelium. These patients were taking oral iron tablets. The remaining 15 cases showed variable iron deposition in the surface epithelium, lamina propria and glands. In nine patients, there was a history of oral iron intake and at least eight had had blood transfusions. The most intense iron deposition was noted in patients with end‐stage liver disease. The mean age of patients with erosive injury was 43% higher than in the iron overload group (76 versus 53 years). Iron stains were also performed on 15 normal gastric biopsies and five biopsies with chronic, non‐specific gastritis; all were negative for haemosiderin deposition.Conclusions : Iron‐related erosive injury is related to oral iron pill ingestion and occurs in older patients. Mucosal iron deposition is also associated with iron overload disorders.
Enhanced prolidase activity and decreased collagen content in breast cancer tissue
Authors: Cechowska‐Pasko Marzanna , Pałka Jerzy , Wojtukiewicz Marek Z. 
Published: May 2006

SummaryAdherent interactions between integrins and extracellular matrix (ECM) proteins play an important role in tumorigenicity and invasiveness. The major component of ECM is collagen that plays a central role in the interaction with integrins. The expression of certain collagenases (gelatinases) by tumour cells is one of the characteristic features of the so‐called metastatic phenotype, presumably by breaking down ECM barriers as well by altering the ECM–cell interaction. Although extracellular collagenases initiate the breakdown of collagen, the final step of collagen degradation is catalysed by intracellular prolidase. Collagen deposition, gelatinolytic and prolidase activities, expression of β1‐integrin receptor and their possible relationships were studied in seven operable breast cancer cases. In breast cancer tissue, we have found significant decrease in the amount of collagen. The decrease in collagen deposition in breast cancer tissue was accompanied by increase in the tissue gelatinolytic and prolidase activities. Simultaneously, a slight decrease in the expression of β1‐integrin receptor in breast cancer tissue was observed. These results suggest that alteration in collagen metabolism in breast cancer tissue may reflect tissue remodelling, characteristic for invasive phenotype of cancer cells. Increased gelatinolytic and prolidase activities in breast cancer tissue may enhance stromal matrix degradation and thus may promote metastatic dissemination. On the basis of the data, it seems that compounds endowed with gelatinolytic and prolidase inhibitory activities may be considered as a potential drug candidates for breast cancer therapy.
The freezer defrosting: global warming and litter decomposition rates in cold biomes
Authors: AERTS R. 
Published: May 2006

SummaryDecomposition of plant litter, a key component of the global carbon budget, is hierarchically controlled by the triad: climate > litter quality > soil organisms. Given the sensitivity of decomposition to temperature, especially in cold biomes, it has been hypothesized that global warming will lead to increased litter decomposition rates, both through direct temperature effects and through indirect effects on litter quality and soil organisms.A meta‐analysis of experimental warming studies in cold biomes (34 site‐species combinations) showed that warming resulted in slightly increased decomposition rates. However, this response was strongly dependent on the method used: open top chambers reduced decomposition rates, whereas heating lamps stimulated decomposition rates. The low responsiveness was mainly due to moisture‐limited decomposition rates in the warming treatments, especially at mesic and xeric sites. This control of litter decomposition by both temperature and moisture was corroborated by natural gradient studies.Interspecific differences in litter quality and decomposability are substantially larger than warming‐induced phenotypic responses. Thus, the changes in the species composition and structure of plant communities that have been observed in medium‐term warming studies in cold biomes will have a considerably greater impact on ecosystem litter decomposition than phenotypic responses.Soil fauna communities in cold biomes are responsive to climate warming. Moreover, temperature‐driven migration of the, hitherto absent, large comminuters to high‐latitude sites may significantly increase decomposition rates. However, we do not know how far‐reaching the consequences of changes in the species composition and structure of the soil community are for litter decomposition, as there is a lack of data on functional species redundancy and the species’ dispersal ability.Global warming will lead to increased litter decomposition rates only if there is sufficient soil moisture. Hence, climate scenario and experimental studies should focus more onbothfactors and their interaction. As interspecific differences in potential decomposability and litter chemistry are substantially larger than phenotypic responses to warming, the focus of future research should be on the former. In addition, more light should be shed on the below‐ground ‘darkness’ to evaluate the ecological significance of warming‐induced soil fauna community changes for litter decomposition processes in cold biomes.