bluuebunny/crossref_metadata_2025_split huggingface dataset:
Staff development in the electronic library: lessons for the health sector from the IMPEL2 eLib project
Authors: Walton Graham , Edwards Catherine 
Published: March 2003

This paper proposes that the health sector has much to learn from higher education as regards information provision in the electronic age. Information Technology for Library and Information Services is less developed in the NHS than in higher education. Staff training and development is identified as a key issue in supporting the transition to electronic delivery of Library and Information Services.The Electronic Libraries Programme (eLib), developing electronic services in higher education, is outlined, with emphasis on the IMPEL2 Project and its methodology. Findings from the Staff Training and Development strand of IMPEL2 are presented. This study identified that attention should be most keenly focused on two areas, IT skills and skills to support changing roles. A number of success factors in training and development are highlighted.The paper concludes that release of resources from eLib to support staff development must be paralleled in the health sector if effective electronic services are to be developed.
Evidence in seconds? Format and design considerations in the provision of reliable information to support evidence‐based practice
Authors: Weightman Alison Lesley , Mann Mala Kanthi 
Published: March 2003

AbstractEvidence‐based practice is gaining support amongst health professionals. However, the major barrier remains the lack of time to read the literature. There are also problems with the take‐up and use of evidence‐based information sources such as Cochrane reviews and Effective Health Care bulletins. If such evidence is to be incorporated into local guidelines and used in day‐to‐day practice, practitioners request that these and other reliable publications be further summarized in short packages and available within seconds. The Health Evidence Bulletins Wales offer a model for this approach. The Bulletins have gone through several developmental stages leading to a novel two‐column format. In the first column, brief statements summarize the best available evidence within a topic area. In the second, full details are provided of the supporting publications (and the evidence type, or research design) with links to the full text of documents, where possible from the electronic versions of each Bulletin. Results from a questionnaire study using a random sample and unsolicited feedback suggest that this ‘two‐tier’ approach to information provision is valued by users and has implications for information services currently under development to support clinical governance.
Local information for Primary Care: the St Albans WAX Project (STAPCIS)
Authors: Rousseau Naomi 
Published: March 2003

AbstractThe St. Albans Primary Care Information Service (STAPCIS) is a database of locally focused information designed to be of use for GPs and the Primary Care team as a whole in a particular area. It is currently being used by practices in the St. Albans, Dacorum and Watford & Three Rivers Primary Care Groups. STAPCIS developed from a project initiated in late 1997 to pilot the use of the WAX software to improve access to directory‐type and full‐text material needed for easy access by primary care staff and traditionally difficult to manage. The database is updated centrally by the STAPCIS Librarian who distributes the new editions to the practices. The WAX software itself was developed by the Cambridge Centre for Clinical Informatics. *STAPCIS contains locally and nationally produced relevant information from a variety of sources, including full‐text clinical guidelines and directories of Trusts. Decisions on new content are made by a Steering Group and the GPs and Primary Care teams are particularly encouraged to make suggestions regarding new content. The service is financially supported by the three primary care groups. The STAPCIS Librarian is project‐managed by the Library & Information Development Unit (North Thames < http://www.nthames‐health.tpmde.ac.uk/rliu/ntrliu.htm >), which also provides additional equipment and expertise.A new software company, WaX Info Ltd (< http://www.waxinfo.com/>), will soon be releasing a new version of the software, WaX. WaX consists of a WaX client and WaX ActiveLibrary server software. With the new version, the ‘books’ of information will still be stored on the user’s PC, retaining the speed of access, but the server will enable users to ‘borrow’ books from remote locations and will provide automatic updates of all books. The new software will improve the management and distribution processes of STAPCIS once all of the practices have Internet connectivity.
Knowledge Management in the NHS: positioning the healthcare librarian at the knowledge intersection
Authors: Keeling Carole , Lambert Sian 
Published: March 2003

AbstractThis paper defines what is meant by Knowledge Management, investigates how it interlinks with new ways of delivering health care and gives a synopsis of a study that investigated issues around implementation of Knowledge Management across a sample of healthcare librarians.Areas of investigation that are related to Knowledge Management include: HSG(97)47, evidence‐based medicine, clinical governance, information and communication technologies, and the changing role of the healthcare librarian.A diagram is included in this paper which illustrates how the healthcare librarian interacts with resources, staff and practices, so contributing to the knowledge base of health care.The paper concludes that Government policy, new technologies and the push towards the practice of information age medicine are forcing changes throughout the NHS. Recognition of Knowledge Management is still in its infancy in the NHS—it calls for major change in organizational thinking and acceptance by the librarian that their service must also be subject to continuous improvement.
Using metadata to create navigation paths in the HealthInsite Internet gateway
Authors: Deacon Prue , Smith Jill Buckley , Tow Stephanie 
Published: March 2003

AbstractThe objective of this study was to evaluate the HealthInsite topic query technique, which uses a dynamic database search to assign resources to a topic. It is an alternative to the explicit classification technique, which relies on the classification of each resource using a predefined classification scheme.We performed a recall‐precision analysis on all topics within the broad topic area of Child Health. Recall and precision errors were checked to determine which part of the information retrieval process was at fault. We then compared the topic query technique with the explicit classification technique.The results show errors or problems at every stage of the information retrieval process. This has initiated a review of all the tools used in the process, from indexing guidelines to the search engine. While many errors could be corrected, there were still features of the explicit classification technique that could not be achieved by the topic query technique.In conclusion, the topic query technique has the advantage of flexibility, but close co‐operation between the different information retrieval specialists is needed to get the best results. The HealthInsite topic navigation structure should be regarded as an organized set of predefined searches rather than a full classified listing.
Breast development gives insights into breast disease
Authors: Osin P P , Anbazhagan R , Bartkova J , Nathan B , Gusterson B A 
Published: March 2003

Aims: Studies of developing human breasts are essential for understanding the organogenesis as well as molecular pathogenesis of benign and malignant breast diseases. In this study we have examined the distribution of TGF‐α, TGF‐β1, tenascin‐C and collagen type IV with the aim of starting to build a picture of the profile of molecules that may be involved in the development of the human breast.Methods and resultsTen fetal breasts (16 to 23 weeks of gestation) and 45 infant breasts, ranging in age from newborn to 2 years, were used in this study. Paraffin sections from these samples were immunostained with antibodies for these proteins and for Ki67 to elucidate the level of proliferative activity in different stages of breast development. TGF‐α immunoreactivity was observed both in the stromal and the epithelial cells within fetal and infant breasts up to 25 days. TGF‐β1 immunoreactivity was localized in the extracellular matrix. Tenascin‐C was found around the neck of the developing breast bud and in the extracellular matrix of the infant with peaks in the newborn at 6–12 weeks. The immunoreactivity for type IV collagen was more intense in the region of the breast bud neck in the fetal breasts and reduced around the tips of lobular and terminal‐end buds within the infant breasts.ConclusionsThe distribution of the growth factors and extracellular matrix proteins within the developing human breast indicates that they play a significant role in different cellular compartments during morphogenesis and provides insights into breast disease.
Apoptotic index and apoptosis influencing proteins bcl‐2, mcl‐1, bax and caspases 3, 6 and 8 in pancreatic carcinoma
Authors: Virkajärvi N , Pääkkö P , Soini Y 
Published: March 2003

AimsTo study the expression of bcl‐2, bax and mcl‐1 and caspases 3, 6 and 8 and apoptosis in pancreatic carcinoma.Methods and resultsEighty‐seven pancreatic carcinomas were studied immunohistochemically with antibodies to bcl‐2, mcl‐1, bax and caspases 3, 6 and 8. Apoptosis was detected by the TUNEL method. bcl‐2 and mcl‐1 positivity was observed in 13% and 86% of the cases, while bax was observed in all of them. The bax immunoreactivity was weak in 30% of the tumours. Caspase 3, 6 and 8 immunoreactivity was observed in 80%, 80% and 74% of the cases, respectively. The staining was mainly cytoplasmic and diffuse, but sometimes also fragmented granular (mainly caspase 6) or membrane‐associated (mainly caspase 8) staining was seen. The mean apoptotic index in pancreatic carcinomas was 0.69%. The apoptotic index in bcl‐2 positive cases was lower (0.35%) than in cases showing no immunoreactivity (0.64%) (P = 0.013). The apoptotic index was higher in tumours with strong bax immunoreactivity (0.70%) than in the other cases (0.34%) (P = 0.002). There was no significant association between the apoptotic index and the expression of mcl‐1 or caspases 3, 6 and 8.ConclusionsBoth bcl‐2 and bax influence the extent of apoptosis in pancreatic carcinoma. The strong expression of caspases 3, 6 and 8 in pancreatic carcinoma is evidence of the activation of the apoptotic machinery in malignant cells in pancreatic carcinoma and shows that the genes of these proteins are often upregulated in them.
Neurotrophins and neurotrophin receptors in some neural crest‐derived tumours (ganglioneuroma, phaeochromocytoma and paraganglioma)
Authors: Pello  , Guate  , Naves  , Escaf  , Vega  
Published: March 2003

AimThis study analyses the occurrence and distribution of neurotrophins and their receptors in some types of tumours of neural‐crest derived cells.Methods and resultsLight microscopy immunohistochemistry associated with quantitative image analysis was used to study the expression of neurotrophins (nerve growth factor, brain‐derived neurotrophic factor and neurotrophin (NT)‐3) and their cognate receptors (p75LNGFR, TrkA, TrkB and TrkC) in histologically defined ganglioneuroma, phaeochromocytoma and paraganglioma. The material was fixed in 10% formaldehyde, paraffin‐embedded and processed for indirect peroxidase immunohistochemistry using a battery of poly‐ and monoclonal antibodies to detect neurotrophins and their receptors, as well as some neuronal, endocrine and glial cell markers. A subpopulation of cells in phaeochromocytomas and ganglioneuromas expressed NT‐3, but not other neurotrophins, while in paragangliomas no neurotrophins were detected. Regarding neurotrophin receptors, all tumours lacked p75LNGFR, except for the ganglionic part of a case of mixed phaeochromocytoma, whereas they displayed TrkA (two of two ganglioneuromas, six of nine phaeochomocytomas and three of four paragangliomas). Furthermore, TrkC was regularly detected in a neuronal subpopulation in ganglioneuroma. Interestingly, the percentage of neurones expressing TrkA and TrkC was increased with respect to normal tissues in ganglioneuromas, as well as the percentage of the area occupied by TrkA‐immunoreactive cells in the phaeochromocytomas.ConclusionThe pattern of expression of neurotrophins and neurotrophin receptors in the analysed tumours basically matches that of sympathetic neurones, adrenal chromaffin cells and paraganglionic cells, and suggests responsiveness of these cells to neurotrophins. Nevertheless, the function of TrkA and TrkC in regulating the biology of these tumours, if any, remains to be elucidated.
Benign lymphangiomatous papules of the skin following radiotherapy: a report of five new cases and review of the literature
Authors: Diaz‐Cascajo  , Borghi  , Weyers  , Retzlaff  , Requena  , Metze  
Published: March 2003

AimsThe aim of this report is to summarize the clinicopathological findings of five cases of a pseudosarcomatous vascular proliferation of the skin at the site of radiotherapy following surgery for carcinoma of the breast and carcinoma of the endometrium. To our knowledge, only five cases of this presumably rare pseudomalignant proliferation have been reported previously.Methods and resultsAll patients were females ranging in age from 44 to 70 years. The lesions appeared as solitary or multiple papules or vesicles localized to the field of radiation. Microscopically, they were composed of vascular spaces that exhibited atypical features without qualifying for a diagnosis of angiosarcoma.ConclusionsOur cases provide additional evidence supporting the benign nature of this atypical vascular proliferation, not recurring, never developing metastases and being cured readily by local excision. Clinical, histopathological and ultrastructural findings suggest a lymphatic origin. Whether these lesions represent a neoplastic or a reactive condition secondary to radiotherapy is unclear. The name ‘benign lymphangiomatous papules of the skin following radiotherapy’ is proposed.
MIB‐1 proliferation index correlates with survival in pleural malignant mesothelioma
Authors: Comin  , Anichini  , Boddi  , Novelli  , Dini  
Published: March 2003

AimsThe purpose of this study was to establish whether the cell proliferation index assessed by the monoclonal antibody MIB‐1 would correlate with survival in pleural malignant mesothelioma.Methods and resultsWe studied a series of seven long‐term survivors with pleural malignant mesothelioma and a group of control cases with short‐term survival. All cases showed MIB‐1 positive cells, and labelling indices were expressed as percentage of cells with positive nuclear immunostaining by randomly counting 1000 tumour cells. A statistically significant difference was found between MIB‐1 values in the long‐term survival group and the control cases with short‐term survival.ConclusionsOur results indicate that the differences in biological behaviour of malignant mesothelioma in long‐term and short‐term survivors may be explained in part by differences in tumour growth fraction and that proliferation index could represent an important prognostic parameter for this tumour.
Leiomyosarcomas of the oral cavity: an unusual topographic subset easily mistaken for nonmesenchymal tumours
Authors: Dry  , Jorgensen  , M Fletcher  
Published: March 2003

AimsOral leiomyosarcoma is rare and poorly documented. We aimed to characterize these lesions clinicopathologically in order to facilitate their distinction from other spindle cell neoplasms in the oral cavity.Methods and resultsTen cases of oral leiomyosarcoma were retrieved and studied histologically and immunohistochemically. Clinical data were obtained from referring pathologists and prior literature concerning 46 comparable cases was reviewed. Nine out of 10 cases occurred in adults; 50% arose in the jaws and four showed bone involvement. Histological appearances were similar to leiomyosarcomas elsewhere. In addition to myogenic markers, two cases were also keratin‐positive. Four patients developed local recurrence or metastatic disease and three died of tumour (median follow‐up 37 months).ConclusionsLeiomyosarcoma is under‐recognized in the mouth, often being mistaken for a spindle‐celled epithelial neoplasm. Aside from an unusual but infrequent tendency to spread to lymph nodes and a location‐specific differential diagnosis, its clinicopathological features are comparable to leiomyosarcomas at other locations.
Paratesticular liposarcoma with smooth muscle differentiation mimicking angiomyolipoma
Authors: Womack  , Turner  , Fisher  
Published: March 2003

AimsTo discuss the differential diagnosis of a case of well‐differentiated liposarcoma which had areas resembling angiomyolipoma—a feature which, to our knowledge, has not been reported previously.Methods and resultsA tumour in the paratesticular region had apparently been present for 40 years, but had grown recently. A fat component containing lipoblasts was admixed with areas resembling angiomyolipoma, i.e. desmin positive, but HMB45‐negative smooth muscle proliferation with atypia and thick‐walled blood vessels devoid of elastin.ConclusionThe diagnosis of liposarcoma, rather than angiomyolipoma with adipose atypia, in this case is based on the fact that smooth muscle differentiation is documented in liposarcoma, lack of HMB45 staining and recent clonality studies which suggest that the fat in angiomyolipoma is not neoplastic.
Monotypic epithelioid angiomyolipoma of the liver
Authors: Yamasaki  , Tanaka  , Fujii  , Matsumoto  , Okuda  , Watanabe  , Suda  
Published: March 2003

AimsMonotypic epithelioid angiomyolipoma is a recently recognized renal tumour, which is composed purely of epithelioid cells coexpressing markers of both smooth muscle differentiation and melanogenesis (HMB45). We report here the first case of monotypic epithelioid angiomyolipoma arising in the liver.Case detailsA 30‐year‐old woman without tuberous sclerosis complex (TSC) was incidentally found to have a hepatic mass by ultrasonography. Grossly, the resected tumour showed a nodule‐in‐nodule appearance, with large areas of haemorrhagic necrosis. Microscopically, the tumour was composed of pleomorphic epithelioid cells with clear, eosinophilic cytoplasm. Neither adipocytes nor abnormal vessels were recognized in the tumour. Immunohistochemically, the tumour cells were strongly positive for HMB45 and S100 protein, focally positive for desmin, vimentin and smooth muscle actin, and negative for epithelial markers (cytokeratins, EMA). Ultrastructural analysis showed numerous dense granules with some striated ones resembling melanosomes, myofilaments and pinocytic vesicles in the cytoplasm. Molecular analysis showed no allelic loss of the TSC2 region or 12 other chromosomal regions. The patient is free of disease over 1 year after the operation.ConclusionWe consider that this hepatic tumour is closely related to angiomyolipoma, and a counterpart of renal monotypic epithelioid angiomyolipoma.
Multinucleated stromal cells of the anal mucosa: a common finding
Authors: Groisman  , Amar  , Polak‐Charcon  
Published: March 2003

AimsTo document the presence, morphology, immunophenotype and ultrastructure of multinucleated stromal cells within the anal mucosa and to discuss possible pathogenetic mechanisms for this occurrence.Methods and resultsMultiple sections of normal anal mucosa from 30 abdominoperineal resection specimens were analysed by light microscopic, electron microscopic and immunohistochemical methods. Multinucleated stromal cells were found in 22 cases (73%). They contained two to five nuclei, arranged in a linear fashion or in a rosette or grape‐like pattern. They stained positive for vimentin and negative for actin, desmin and oestrogen/progesterone receptors. Ultrastructural examination confirmed their fibroblastic lineage. Mast cells were frequently observed in the immediate vicinity of mono‐ and multinucleated cells.ConclusionsMultinucleated stromal cells are a common occurrence in the normal anal mucosa. They should not be misinterpreted as neoplastic cells. Mast cells may play a role in their morphogenesis.
Expression of promyelocytic leukaemia protein in thyroid neoplasms
Authors: Yu E , Lee K W , Lee H J 
Published: March 2003

AimsPromyelocytic leukaemia protein (PML) is an oncoprotein involved in the pathogenesis of acute promyelocytic leukaemia and is localized in distinct PML nuclear bodies. Our previous observation of overexpression of the PML in hormone‐sensitive normal tissues and malignant solid tumours, including the thyroid, led to this analysis of the PML expression in various thyroid neoplasms to characterize the importance of the PML in thyroid carcinogenesis.Methods and resultsImmunohistochemistry was performed on paraffin‐embedded tissue samples from 106 thyroid neoplasms after antigen retrieval by microwave. Immunoblotting was done with fresh frozen tissues in a few tumours. The PML was strongly expressed in all papillary carcinomas in diffuse or ball‐shaped patterns. In the follicular neoplasms, the PML expression was variable, but there was no significant difference between adenomas and carcinomas. In the medullary carcinomas, the PML expression was either not detectable or was lower than in non‐neoplastic thyroids. Quantitatively different expression of the PML in various thyroid neoplasms was confirmed by immunoblotting.ConclusionA significant difference of the PML expression according to the type of thyroid neoplasms suggests that the PML is important in papillary thyroid carcinomas, and furthermore, that PML expression may be used in differential diagnosis of thyroid neoplasms.
Predictive value of liver cell dysplasia for development of hepatocellular carcinoma in patients with non‐cirrhotic and cirrhotic chronic viral hepatitis
Authors: Libbrecht L , Craninx M , Nevens F , Desmet V , Roskams T 
Published: March 2003

Predictive value of liver cell dysplasia for development of hepatocellular carcinoma in patients with non‐cirrhotic and cirrhotic chronic viral hepatitisAims: Hepatocellular carcinoma (HCC) frequently develops in patients with chronic viral hepatitis, especially in the cirrhotic stage. We retrospectively studied whether the presence of the putative preneoplastic lesions large liver cell dysplasia (LLCD) and/or small liver cell dysplasia (SLCD) in a needle liver biopsy of these patients are a risk factor for the development of HCC.Methods and results: The presence of LLCD and SLCD in the needle liver biopsy taken at the initial work‐up of 115 patients with chronic hepatitis B or C was assessed retrospectively. LLCD and SLCD were present in the initial biopsy of, respectively, 35 (30%) and 25 patients (22%). During a mean follow‐up of 107 months, 16 patients (14%) developed HCC and this occurred significantly more frequently in patients with cirrhosis, age ≥ 55 years, LLCD or SLCD. Cirrhosis and LLCD were independent risk factors for HCC development.Conclusions: Our findings indicate that the presence of LLCD in a needle liver biopsy of patients with viral‐induced chronic liver disease is an independent risk factor for the development of HCC. If these results are confirmed, the presence of LLCD can be used to identify a subgroup of patients at high risk for HCC requiring more intensive screening.