bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mixed‐type autoimmune hemolytic anemia: differential diagnosis and a critical review of reported cases
Authors: Mayer Beate , Yürek Salih , Kiesewetter Holger , Salama Abdulgabar 
Published: June 2008

BACKGROUND: Autoimmune hemolytic anemia (AIHA) is usually classified as either warm or cold type. During the past few decades, mixed types (Mxs) have also been described in a number of cases (6%‐8% of AIHA), often without serologic data to support the diagnosis. In this study, we demonstrate that the incidence of Mx AIHA in our institution is extremely rare.STUDY DESIGN AND METHODS: Between August 1998 and August 2007, all in‐ and outpatients with detectable warm autoantibodies (WABs) were included in this study. Serologic testing was performed using standard techniques for the detection of red blood cell antibodies.RESULTS: From a total of 2194 patients with detectable WABs, only 2 patients (<0.1%) developed both WABs and cold agglutinins (CAs), which in the presence of clinical evidence of hemolytic anemia, satisfies the criteria for Mx AIHA. Only 1 of these patients, however, showed cold and warm hemolysis. Insignificant CAs at temperatures of not more than 24°C were found in 242 patients.CONCLUSION: There is evidence that the presence of CAs with high thermal amplitude and WABs may lead to confusion and misdiagnosis in some patients with AIHA. This study demonstrates that Mx AIHA is less common than previously reported.
Endothelial permeability is increased by the supernatant of peripheral blood mononuclear cells stimulated with HLA Class II antibody
Authors: Wakamoto Shinobu , Fujihara Mitsuhiro , Sakagawa Hisako , Takahashi Daisuke , Niwa Koichi , Morioka Masanobu , Sato Shinichiro , Kato Toshiaki , Azuma Hiroshi , Ikeda Hisami 
Published: June 2008

BACKGROUND: The generation of inflammatory mediators from monocytes activated by HLA Class II antibodies is thought to play important roles in the etiology of nonhemolytic transfusion reactions. Increased permeability of endothelial cells contributes to the pathogenesis of rash, urticaria, angioedema, and pulmonary edema, which are symptoms of transfusion reactions.STUDY DESIGN AND METHODS: We investigated whether inflammatory mediators released from monocytes upon stimulation by HLA Class II antibodies could increase endothelial permeability. Human endothelial cell monolayers were incubated with cell‐free supernatants of peripheral blood mononuclear cells (PBMNCs) stimulated with HLA Class II antibody–containing plasma (anti‐HLA‐DR plasma), which has been implicated in severe nonhemolytic transfusion reactions. The permeability of endothelial cells to dextran was measured.RESULTS: The supernatants of PBMNCs stimulated with the anti‐HLA‐DR plasma in corresponding antigen‐antibody combinations were able to increase endothelial permeability. At least 3 hours of exposure of PBMNCs to anti‐HLA‐DR plasma was required to produce a supernatant that could induce a significant increase in permeability. Simultaneous addition of tumor necrosis factor α (TNF‐α) and interleukin 1β (IL‐1β) neutralizing antibodies to the activated PBMNC supernatant significantly reduced the increase in permeability. Treatment of the endothelial cells with an inhibitor of nuclear factor κB (NF‐κB), but not inhibitors of apoptosis, significantly prevented the increase in permeability.CONCLUSION: Both TNF‐α and IL‐1β, generated from PBMNCs by anti‐HLA‐DR plasma in a corresponding antigen‐antibody–dependent manner, led to an increase in endothelial permeability. The activation of monocytes by the HLA‐DR antibodies and the resultant inflammatory mediators could contribute to the pathogenesis of rash, urticaria, angioedema, and pulmonary edema after transfusion.
A New Vascular Closure Device for the Transradial Approach: The D Stat Radial System
Authors: KORN HUBERTUS V. , OHLOW MARC A. , YU JIANGTAO , HUEGL BURKHARD , SCHULTE WALTER , WAGNER ANDREAS , HABERL KAI , GRUENE STEFAN , LAUER BERNWARD 
Published: June 2008

Background:

The transradial approach is associated with low complication rates. The D Stat Radial® vascular closure system offers hemostatic pressure locally at the puncture site with residual venous flow.
Methods:

We prospectively included 113 consecutive patients presenting between August 2006 and December 2006. Diagnostic coronary procedures were performed using 4 Fr or 5 Fr sheaths, while 6 Fr devices were used for PCI. In every case at least 5.000 IU heparin was given. Compression with the retention strap was planned for ∼3 hours before the pad was fixed using a medical strip. All data were entered into a database after a two‐dimensional ultrasound examination study of the puncture site.
Results:

The mean age was 65 years (±SD 10.3), with 62% being male. Patients presenting with acute coronary syndrome amounted to 6.2%, where 5r F sheaths were usually used with these patients (64.6%). PCI was carried out in 21.2% of cases. The system was applied successfully in all patients. The mean duration of compression was 4.6 hours (±SD 1.4). Bleeding after removal of the system occurred in 18.6% of cases, which resulted in prolonged compression in 17.7%. A hematoma >5 cm was seen in 4.4% of the sample. Ultrasound examinations revealed closure of the radial artery in 6.2%.
Conclusions:

We conclude that this new device operates efficiently, but bleeding occurred in 18.6%. Compression time should be extended to 6 hours.
Localized lymphedema (elephantiasis): a case series and review of the literature
Authors: Lu Song , Tran Tien Anh , Jones David M. , Meyer Dale R. , Ross Jeffrey S. , Fisher Hugh A. , Carlson John Andrew 
Published: June 2008

Background:  Lymphedema typically affects a whole limb. Rarely, lymphedema can present as a circumscribed plaque or an isolated skin tumor.Objective:  To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema.Methods:  Case–control study of skin biopsy and excision specimens histologically diagnosed with lymphedema and presenting as a localized skin tumor identified during a 4‐year period.Results:  We identified 24 cases of localized lymphedema presenting as solitary large polyps (11), solid or papillomatous plaques (7), pendulous swellings (4), or tumors mimicking sarcoma (2). Patients were 18 females and 6 males with a mean age of 41 years (range 16–74). Anogenital involvement was most frequent (75%) – mostly vulva (58%), followed by eyelid (13%), thigh (8%) and breast (4%). Causative factors included injury due to trauma, surgery or childbirth (54%), chronic inflammatory disease (rosacea, Crohn’s disease) (8%), and bacterial cellulitis (12%). Eighty‐five percent of these patients were either overweight (50%) or obese (35%). Compared with a series of 80 patients with diffuse lymphedema, localized lymphedema patients were significantly younger (41 vs. 62 years old, p = 0.0001), had no history of cancer treatment (0% vs. 18%, p = 0.03), and had an injury to the affected site (54% vs. 6%, p = 0.0001). Histologically, all cases exhibited dermal edema, fibroplasia, dilated lymphatic vessels, uniformly distributed stromal cells and varying degrees of papillated epidermal hyperplasia, inflammatory infiltrates and hyperkeratosis. Tumor size significantly and positively correlated with history of cellulitis, obesity, dense inflammatory infiltrates containing abundant plasma cells, and lymphoid follicles (p < 0.05). A history of cellulitis, morbid obesity, lymphoid follicles and follicular cysts predicted recurrent or progressive swelling despite excision (p < 0.05).Conclusions:  Localized lymphedema should be considered in the etiology of skin tumors when assessing a polyp, plaque, swelling or mass showing dermal edema, fibrosis and dilated lymphatics on biopsy. A combination of lymph stasis promoting factors (trauma, obesity, infection and/or inflammatory disorders) produces localized elephantiasis.
Immunohistochemical differentiation of four benign eccrine tumors
Authors: Missall Tricia A. , Burkemper Nicole M. , Jensen Sarah L. , Hurley Maria Yadira 
Published: June 2008

Background:  The histogenesis and differentiation of eccrine tumors, including cylindroma, poroma, spiradenoma and syringoma, remains controversial. This controversy may be because of sporadic and incomplete studies of these neoplasms.Methods:  Ten examples each of normal eccrine structures and of four benign eccrine tumors are analyzed with antibodies to cytokeratin (CK) 7, CD34, CK6, CK10, smooth muscle actin (SMA) and CD10. These markers represent two different immunohistochemical stains for each part of the eccrine structure; CK7 and CD34 stain the secretory coil, CK6 and CK10 stain the straight duct and SMA and CD10 stain the myoepithelial cells. This redundancy in staining is performed on four benign eccrine tumors to better interpret the existing literature.Results:  We find that CK7 is a sensitive marker for the secretory coil; both cylindromas and spiradenomas express CK7. We also find that CK6 is a marker for the inner ductal cells, while CK10 is a marker for the middle ductal cells; syringomas express both these markers. SMA appears to be a more specific marker for myoepithelial cells surrounding normal eccrine coils, and none of the studied tumors express SMA or CD10.Conclusions:  Our studies suggest that syringomas are tumors of the eccrine duct, while cylindromas and spiradenomas are tumors of the secretory coil.
A histopathologic study of arthropod bite reactions in 20 patients highlights relevant adnexal involvement
Authors: Miteva Maria , Elsner Peter , Ziemer Mirjana 
Published: June 2008

Background:  Insect bites produce diverse skin reactions. Although quite common, the histopathologic features of arthropod assaults have not ever been studied systemically.Materials and methods:  Twenty biopsies from cases, clinically diagnosed as arthropod bite reactions between January 2003 and June 2007 were reviewed retrospectively. The aim of the study was to verify as to whether reliable histopathologic criteria could be established based on the frequency of findings observed.Results:  Epidermal spongiosis (present in 16 of 20 cases), in particular spongiosis of the infundibular epithelium and acrosyringia as well as eosinophilic spongiosis, emerge as relevant diagnostic clues. A moderately dense, superficial and deep infiltrate consisting mainly of lymphocytes and eosinophils was prevalent in the dermis, with eosinophils tending to interstitial and periadnexal distribution. Of note, 19 of 20 (95%) cases revealed periadnexal involvement, whereas 16 of 20 (80%) had the infiltrate extending particularly along the sweat ducts and the coiled glands. In three biopsies, concomitant involvement of sweat glands, hair follicles and sebaceous glands was noted.Conclusion:  A practical histopathologic algorithm of arthropod bite recognition is proposed. The involvement of the sweat glands in the pattern of arthropod bite reaction is suggested as a new reliable diagnostic clue.
Paraneoplastic pemphigus with negative direct immunofluorescence in epidermis or mucosa but positive findings in adnexal structures
Authors: Barnadas Maria A. , Curell Román , Alomar Agustín , Gelpí Carmen 
Published: June 2008

Introduction:  Paraneoplastic pemphigus (PNP) is considered an autoimmune, multiorgan disease caused by antiplakin antibodies. We present three PNP patients who had negative epithelial direct immunofluorescence (DIF) findings in one or more biopsies.Patients:  An early lip biopsy of uninvolved oral epithelia in patient 1 was negative. A later biopsy from foreskin showed intense intercellular immunoglobulin G (IgG) deposits in the epithelia. In the early phase of the disease in patient 2, the intercellular fluorescence was negative in the epidermis, while intercellular IgG and C3 were observed in the sweat ducts. A later biopsy showed weak intercellular epidermal IgG and C3 fluorescence. Patient 3 showed intercellular IgG and/or C3 in follicular, sebaceous and sweat duct structures in several biopsies. No intercellular IgG or C3 was observed in the epithelia.Discussion:  The presence of immunoreactants in adnexal structures suggests that desmoplakins can be more strongly expressed in adnexa than in the epidermis, facilitating visualization of antibody deposits.Conclusions:  Negative DIF findings in epithelia do not rule out the diagnosis of PNP, and the presence of IgG and/or C3 at the intercellular level of adnexal structures can help establish this diagnosis.
Immunohistochemical clues at aging of the skin microvascular unit
Authors: Quatresooz Pascale , Piérard Gérald E. 
Published: June 2008

Background:  Skin aging is a multifaceted process influenced by various factors affecting at variable degree at different body sites. This study focused on the aging process affecting dermal dendrocytes and the microvasculature. We also explored the effect of substance P released by capsaicin because this neuropeptide is known to affect the microvasculature environment.Methods:  The first part of the present study was undertaken in two groups of 35 men who were younger than 30 years and older than 65 years, respectively. A skin biopsy was taken from the intact skin of a thigh during orthopedic surgical intervention after road accident. The second part of the study was performed on 30 men aged 65–68 years. They applied once daily a 0.05% capsaicin gel and the vehicle in a randomized design on the volar forearms. A skin biopsy was taken at inclusion and after a 5‐month treatment phase. Immunohistochemistry was performed using a panel of antibodies. Dermal cells were distinguished according to the presence of factor XIIIa, CD34 or thrombomodulin. Blood and lymphatic vessels were studied by Ulex europaeus agglutinin‐1, human podoplanin, human vascular endothelial growth factor‐C (H‐VEGF‐C) and α‐actin immunoreactivities.Results:  In the study phase 1, a significant decrease in thrombomodulin‐positive cells and vascularity were evidenced in the aged group. In the study phase 2, capsaicin appeared to boost the factor XIIIa‐positive dendrocytes, the thrombomodulin‐positive cells and the blood vessel network as well.Conclusions:  Specific subsets of the dermal dendrocyte populations and the blood microvasculature appear affected by aging. Capsaicin may limit these aging effects.
Significance of thrombomodulin release from gingival epithelial cells in periodontitis patients
Authors: Matsuyama T. , Tokuda M. , Izumi Y. 
Published: June 2008

Background and Objective:  Thrombomodulin, a cell transmembrane glycoprotein, binds to thrombin and converts it from a procoagulant protease to an anticoagulant enzyme that activates protein C. Thrombomodulin is very important in regulating the function of thrombin. Elevated soluble thrombomodulin is present in the gingival crevicular fluid of subjects with periodontitis. The objective of the present study was to investigate the mechanisms about the elevated soluble thrombomodulin in gingival crevicular fluid.Material and methods:  Gingival sections from six patients with chronic periodontitis and from three periodontally healthy subjects were immunostained for thrombomodulin detection. Thrombomodulin levels were investigated in the gingival crevicular fluid of 11 subjects with chronic periodontitis. The effects of neutrophil enzymes on thrombomodulin release and on thrombomodulin in the gingival crevicular fluid were examined by an enzyme‐linked immunosorbent assay or by Western blotting.Results:  The expression of gingival epithelial thrombomodulin was lost or decrease near infiltrating neutrophils. Thrombomodulin was rapidly released from gingival epithelial cells by neutrophil enzymes, and gingival crevicular fluid with periodontitis included the proteolytic cleavage thrombomodulin using immunoblotting analysis. The thrombomodulin release was not caused by rapid cell damage, on lactate dehydrogenase assay. There were significant differences in thrombomodulin content between gingival crevicular fluid samples from healthy and diseased sites, regardless of the degree of probing depth.Conclusion:  Neutrophil enzymes induced rapid thrombomodulin release from the membrane surface of gingival epithelial cells. This might explain the thrombomodulin increase in gingival crevicular fluid with local diseased gingiva. Elevation of thrombomodulin in gingival crevicular fluid may be a potential marker of epithelial cell membrane injury.
Cell death and quantitative reduction of rests of Malassez according to age
Authors: Gonçalves J. S. , Sasso‐Cerri E. , Cerri P. S. 
Published: June 2008

Background and Objective:  Rests of Malassez are clusters of epithelial cells that remain in the periodontal ligament throughout life. However, it has been reported that the number of these structures decreases with age, and some epithelial cells undergo apoptosis in rests of Malassez of young and adult rats. Therefore, the purpose of the present study was to investigate the incidence of epithelial cell death and the quantitative changes in the rests of Malassez in rat molars of different ages.Material and Methods:  Fragments containing the upper molars of rats aged 29, 45 and 120 d were fixed, decalcified and embedded for analysis by light microscopy. In the sections stained by hematoxylin and eosin, the number of rests of Malassez and the number of nuclei of these epithelial structures were obtained. Moreover, the nuclei exhibiting typical features of cell death were also counted in each rest of Malassez. The terminal deoxynucleotidyl transferase‐mediated dUTP nick end labeling (TUNEL) method for detection of cell death was also carried out.Results:  In all groups examined, some rests of Malassez exhibited epithelial cell nuclei with typical features of apoptosis and some of them were also TUNEL positive. From 29 to 120 d of age in rats, the quantitative analysis showed a significant decrease in the total number of rests of Malassez in the cervical, middle and furcation regions of the periodontal ligament. Moreover, a significant decrease of epithelial cell nuclei was concomitant to an increase in the frequency of cell death in the oldest rats.Conclusion:  These results suggest that epithelial cell death by apoptosis may be, at least in part, responsible for the reduction in the number of rests of Malassez according to age.
Oral malodorous compound causes apoptosis and genomic DNA damage in human gingival fibroblasts
Authors: Yaegaki K. , Qian W. , Murata T. , Imai T. , Sato T. , Tanaka T. , Kamoda T. 
Published: June 2008

Background and Objective:  Volatile sulfur compounds are the main cause of halitosis. Hydrogen sulfide is one of these volatile sulfur compounds and the principal malodorous compound in physiological halitosis. Periodontally pathogenic activities of hydrogen sulfide have been previously reported. Hydrogen sulfide induces apoptotic cell death in aorta smooth muscle cells and in other tissues. Apoptosis plays an important role in the onset and progress of periodontitis. The objective of this study was to determine whether hydrogen sulfide causes apoptosis in human gingival fibroblasts.Material and methods:  Necrotic cells were detected using a lactate dehydrogenase assay. Apoptosis was ascertained using a histone‐complexed DNA fragment assay and flow cytometry. The level of caspase 3, a key enzyme in apoptotic signaling, was also measured, and the effects of hydrogen sulfide on reactive oxygen species and superoxide dismutase were assessed. DNA damage caused by hydrogen sulfide was examined by means of single‐cell gel electrophoresis.Results:  After 72 h of incubation with 100 ng/mL of hydrogen sulfide, necrosis was found in less than 10% of human gingival fibroblasts, whereas apoptosis was significantly increased (p < 0.05). Superoxide dismutase activity was strongly inhibited, and reactive oxygen species production was enhanced, after 48 and 72 h of incubation. Caspase 3 activity was also increased after 72 h of incubation (p < 0.01). Tail length, percentage of DNA in tail, and tail moment, measured by single‐cell gel electrophoresis, were also intensified after 72 h of incubation (p < 0.001).Conclusion:  Hydrogen sulfide caused apoptosis and DNA damage in human gingival fibroblasts. An increased level of reactive oxygen species stimulated by hydrogen sulfide may induce apoptosis and DNA strand breaks.
Inhibition of the formation of oral calcium phosphate precipitates: the possible effects of certain honeybee products
Authors: Hidaka S. , Okamoto Y. , Ishiyama K. , Hashimoto K. 
Published: June 2008

Background and Objective:  We studied the effects of honeybee products on the in vitro formation of calcium phosphate precipitates.Material and Methods:  Screening tests of the in vitro formation of calcium phosphate precipitates using 20 types of honey and four types of propolis were carried out using the pH drop method.Results:  The inhibitory effect on the rate of amorphous calcium phosphate transformation to hydroxyapatite and on the induction time varied greatly among the 20 types of honey and four types of propolis. We classified them according to their effects on decreasing the rate of amorphous calcium phosphate transformation to hydroxyapatite and/or increasing the induction time. Two of the 20 honeys showed little or no inhibition, either on the rate of amorphous calcium phosphate transformation to hydroxyapatite or on the induction time. Six of the honeys reduced the rate of amorphous calcium phosphate transformation to hydroxyapatite by 12–35% and with a 2.5‐ to 4.4‐fold increase in the induction time. The remaining 12 honeys showed even greater activity. Because four of these 12 honeys had an inhibitory effect on the rate of amorphous calcium phosphate formation, they were excluded as candidates for anticalculus agents. Furthermore, three of the four types of propolis showed an inhibitory effect that was the same as or greater than 1‐hydroxyethylidene‐1,1‐bisphosphonate.Conclusion:  These results suggest that eight honeys and three types of propolis may have potential as anticalculus agents in toothpastes and mouthwashes.