bluuebunny/crossref_metadata_2025_split huggingface dataset:
Promoting library services to qualified nurses: towards a market‐led approach
Authors: HERNANDO SALLY 
Published: March 2003

This article summarizes a research project carried out with the nursing staff of South Buckingham‐shire NHS Trust. A ‘communityprofde’ looked at nurses’ use of library and information services forpatient care purposes and found that only a small proportion ofall categories of qualified staff were library users.A postal questionnaire was used to investigate why nurses sought information, what they used it for, where they obtained itfrom and how valuable they perceived it to be. The results show that personal and departmental collections were used quite frequently and the information was widely disseminated by the nurses to patients and their families, to colleagues and to students. The overall messagefrom the survey was that the information obtained is valued highly and is used for various important purposes in health care delivery, such as educating patients and their families and revising treatment plans. However, nurses have diffculty in accessing libraries, which are judged to contain the most accurate, reliable and up‐to‐date information.The data from the community projle and questionnaire were further analysed using soft systems methodology, in order to identify problems in the traditional model of information delivery to nurses via a conventional library and information service. These were then investigated further and a series of recommendations for action drawn up.
How much should it cost? An introduction to management use of costing information
Authors: COOPER LARRAINE 
Published: March 2003

With the introduction of the internal market the health service is changing rapidly and health libraries must change with it. Many libraries are requested to cost their services. The demand comes from external customers and from their own organizations. This paper discusses the various reasons for costing services and how costing information can influence our management decision making.The paper challenges librarians to move costing processes away from a mechanistic approach, towards a means of demonstrating the worth of a library resources unit in cost and qualitative terms. Using costing information for cost control purposes, comparison of cost with other providers, setting prices or determining future service delivery levels is discussed, as well as considering the question of external provision of library services.Use of information on fixed and variable costs and assessing break‐even levels of service provision is illustrated as a helpful guide to library survival.
Expression of vascular endothelial growth factor in digestive neuroendocrine tumours
Authors: Terris  , Scoazec  , Rubbia  , Bregeaud  , Pepper  , Ruszniewski  , Belghiti  , FLÉjou  , Degott  
Published: March 2003

Aims:Angiogenesis is a complex multistep process essential for tumour growth. Vascular endothelial growth factor (VEGF) is a potent endothelial cell mitogen and vascular permeability‐inducing agent. Recent studies have shown that VEGF expression is correlated to microvessel density and tumour progression. The aim of this study was to analyse VEGF expression in a series of gastrointestinal neuroendocrine tumours.Methods and results:Surgical specimens from 28 gastrointestinal carcinoids and 20 pancreatic endocrine tumours were examined for VEGF expression by immunohistochemistry. Intense cytoplasmic staining for VEGF was observed in several cells of the islets of Langerhans and in neuroendocrine cells of normal digestive mucosa. All midgut carcinoids showed strong VEGF expression in tumoral cells. Positive VEGF immunostaining was observed in 16 of 20 neuroendocrine pancreatic tumours but it was usually much lower than in midgut carcinoids. Western blotting analysis in eight cases identified a major band at 30–32 kDa. No correlation between VEGF expression and tumour stage was found.Conclusions:This study demonstrates that neuroendocrine cells are a major source of VEGF, particularly in midgut carcinoids. This finding suggests that the presence of VEGF may be required to maintain the differentiated state of capillary vessels in these hypervascular tumours. Such secretion, in conjunction with the other growth factors synthesized by these neuroendocrine tumours, may have an important role in tumour growth.
Expression of E‐cadherin, α‐catenin and β‐catenin in normal ovarian surface epithelium and epithelial ovarian cancers
Authors: Davies  , Worsley  , Ponder  
Published: March 2003

Aims:To study the expression of the epithelial adhesion molecule E‐cadherin and its associated proteins α and β catenin in paraffin sections of normal ovaries, benign cystadenomas and ovarian carcinomas, and in immortalized normal ovarian surface epithelial cells and ovarian carcinoma cells in culture.Methods and results:Immunocytochemistry was used to to study expression of the proteins in paraffin sections and western blotting was used to determine levels of expression of the proteins in cell extracts. E‐cadherin expression was found to be absent in ovarian surface epithelial cells in culture and infrequently expressed in normal ovarian surface epithelial cells in vivo, although apical punctate staining was occasionally seen. Seven of nine benign cystadenomas and 29/34 epithelial ovarian carcinomas showed some expression of E‐cadherin, but expression was absent in poorly differentiated tumours. Expression of α and β catenin was consistently detected on the lateral membranes of normal ovarian epithelium and benign cystadenomas. α and β catenin expression was lost in 18% and 21% of ovarian carcinomas, respectively; other ovarian carcinomas expressed these proteins at a reduced level. A small number of these tumours showed a diffuse cytoplasmic rather than membranous staining. Reduced staining for α and β catenin appeared to correlate with a more spindly, less adhesive morphology and increased invasive potential in matrigel.Conclusions:The results suggest that E‐cadherin expression is generally induced in well differentiated ovarian cancers. In contrast, α and β catenins are consistently expressed in the normal ovarian surface epitheium and benign tumours, but are sometimes reduced or absent in ovarian carcinomas. It is likely that the catenins associate with membrane proteins other than E‐ cadherin in ovarian epithelium, and they may possibly function as tumour suppressors in this epithelium.
Myoepithelial carcinoma (malignant myoepithelioma): first report of an occurrence in the maxillary sinus
Authors: Graadt Van Roggen  , Baatenburg‐De Jong  , Verschuur  , Balhuizen  , Slootweg  , Van Krieken  
Published: March 2003

Aim:We document for the first time the occurrence of a malignant myoepithelioma at a site other than within the major and minor salivary glands.Methods and results:A 67‐year‐old male presented with progressive symptoms and signs of a space‐occupying lesion in the right maxillary sinus. An initial biopsy identified a malignant (myo)epithelial lesion and a radical maxillectomy was performed. Histology, supplemented by immunohistochemistry, confirmed the prescence of a malignant myoepithelioma.Conclusion:Malignant myoepithelioma is a very rare tumour composed almost exclusively of myoepithelial cells and, to date, has only been described arising in the the major and minor salivary glands. A variety of tumours of salivary tissue have been reported within the head and neck area at sites outside the major and minor salivary glands, probably arising within accessory salivary tissue. We report the first case of a malignant myoepithelioma occurring in the maxillary sinus, also presumably arising in accessory salivary tissue in this location.
Maintenance of polarity and a dual cell population in adenoid cystic carcinoma of the breast: an immunohistochemical study
Authors: Kasami  , Olson  , Simpson  , Page  
Published: March 2003

Aims:Adenoid cystic carcinoma (ACC) of the breast, although quite uncommon, is histologically distinct and has an excellent prognosis. Our purpose was to characterize molecular markers of cellular differentiation and polarity to define better the role that these combined features might play in the excellent prognosis of ACC in this site.Methods and results:We performed immunohistochemical stains for expression of vimentin (VM), cytokeratin (CK), smooth muscle actin (SMA), laminin (LAM), E‐cadherin (E‐cad), β‐catenin (β‐cat) and fodrin in 14 examples of ACC. Two types of intercellular lumens and defining lining cells were detected: true epithelial lumens were lined by CK positive cells that maintained the normal glandular luminal cells with an intact polarity and basolateral membrane compartment indicators: fodrin, E‐cad and β‐cat. The second type of intercellular space was a pseudolumen, surrounded by myoepithelial cells that were strongly positive for VM and SMA, and lined by LAM. Double staining for VM and CK, VM and SMA, and CK and SMA detected occasional cytoplasmic co‐expression of these markers in the myoepithelial cell compartment, but VM and SMA did not stain epithelial lumenal cells.Conclusions:ACC of the breast is characterized by the presence of two types of intercellular lumens, one conserving basolateral markers of normal polarity (epithelial) with the other containing basement membrane material (abutted by myoepithelial cells). Dominance of VM staining may be a hallmark of ACC, along with maintained epithelial and myoeithelial compartments. This status of advanced, normal differentiation despite local invasion may be responsible for lack of distant metastasis.
A comparative evaluation of immunohistochemical markers for the differential diagnosis of malignant pleural tumours
Authors: Garcia‐Prats  , Ballestin  , Sotelo  , Lopez‐Encuentra  , Mayordomo  
Published: March 2003

AimsTo determine the value of immunocytochemistry in differentiation of malignant pleural mesothelioma from carcinoma in a pleural biopsy using commercially available monoclonal antibodies.Methods and resultsA panel of monoclonal antibodies against keratins, epithelial membrane antigen (EMA), epithelial antigen Ber‐EP4, carcinoembryonic antigen (CEA), tumour‐associated glycoprotein (B72.3), Leu‐M1, CD30 (Ber‐H2), vimentin and desmin, was applied to 40 cases of malignant pleural mesothelioma and 23 cases of carcinoma metastatic to the pleura (16 pulmonary and seven extrapulmonary). Positivities for Ber‐EP4, CEA, B72.3 and Leu‐M1 were found to have the highest nosologic sensitivities (87.0%, 65.2%, 52.5% and 43.5%, respectively) and specificities (97.5%, 97.5%, 100% and 95%, respectively) for carcinoma. Positive staining for vimentin had the highest sensitivity (87.5%) with 95.7% specificity for mesothelioma. Positive staining for desmin was found in 45% of mesotheliomas and 0% of carcinomas. Diagnostic sensitivity and diagnostic specificity (P‐values) were calculated for these markers. In respect to the diagnostic power defined by the clinically relevant predictive values of positive and negative tests, we found that a two‐marker panel of antibodies including vimentin and Ber‐EP4 is most useful for the histopathological distinction between carcinoma (pulmonary or extrapulmonary) and malignant pleural mesothelioma.ConclusionsA combination of Ber‐EP4 and vimentin provides the most sensitive and specific pair of markers for distinguishing between malignant pleural mesothelioma and carcinoma metastatic to the pleura. The prevalence of the tested tumours should be taken into account when evaluating the clinical value of ancillary techniques in pathology.
Nerve sheath tumours with hybrid features of neurofibroma and schwannoma: a conceptual challenge
Authors: Feany  , Anthony  , Fletcher  
Published: March 2003

AimsTo characterize and delineate a subset of rare nerve sheath tumours showing hybrid features of neurofibroma and schwannoma.Methods and resultsNine lesions were identified in the authors' files showing predominant features of neurofibroma with distinct, often nodular regions of classical schwannomatous differentiation. Most patients were adults, eight out of nine were male. Of the nine lesions, two were dermal, two were subcutaneous and five were subfascial. Five lesions had a plexiform architecture and one patient had overt neurofibromatosis. One out of six patients with follow‐up developed local recurrence. Schwannoma‐like regions displayed strong S100 staining, in contrast to more varied and limited S100 reactivity in neurofibromatous areas. The Antoni A areas could be quite cellular with high MIB‐1 proliferation indices. No lesion underwent malignant change.ConclusionsOur results demonstrate that some nerve sheath tumours may contain histologically clear components of both neurofibroma and schwannoma, suggesting that (despite evident and well‐defined clinicopathological differences) these two lesions may be even more closely related than previously recognized. Whether this phenomenon results from a localized microenvironmental change or from a clonal genetic alteration remains unknown.
Massive lymphocytic infiltration of uterine leiomyomas associated with GnRH agonist treatment
Authors: Bardsley V , Cooper P , Peat D S 
Published: March 2003

AimsTo report two unusual cases of massive lymphocytic infiltration of uterine leiomyomas, following GnRH agonist treatment. Previous reports have described a variety of alterations in leiomyoma histology following such therapy.Methods and resultsThese cases were studied using haematoxylin and eosin stains, and immunohistochemistry for B and T‐cell markers (CD20/CD79a and CD3/UCHL‐1) was performed. Leiomyomas were heavily infiltrated predominantly by mature lymphocytes of T‐cell phenotype. Associated myocyte degenerative changes were present.ConclusionMassive lymphocytic infiltration of leiomyomas may occur as a result of GnRH agonist treatment, although the mechanism is unclear.
Epithelioid sarcoma: presence of vascular‐endothelial cadherin and lack of epithelial cadherin
Authors: Smith M E F , Brown J I , Fisher C 
Published: March 2003

AimsTo evaluate the pattern of cadherin expression in epithelioid sarcoma.Methods and resultsSeven epithelioid sarcomas were immunostained by a polyclonal antibody that detects all cadherin subtypes and by monoclonal antibodies that detect epithelial cadherin (E‐cadherin) and vascular‐endothelial cadherin (VE cadherin). In addition, the tumours were immunostained for a variety of epithelial (cytokeratin, EMA, AUA1) and endothelial (Factor VIII‐related antigen, CD34, CD31) markers. Tumour cells of all seven epithelioid sarcomas expressed cadherins. Surprisingly, E‐cadherin was not detected in any of the sarcomas. VE‐cadherin was detected in five of seven cases. All seven tumours expressed cytokeratins and EMA but none expressed AUA1. CD34 was detected in six of seven cases and CD31 was detected in a single case. No case expressed Factor VIII‐related antigen.ConclusionsMost epithelioid sarcomas strongly express cadherins, a feature which may contribute to their epithelioid appearance. The absence of detectable E‐cadherin suggests that epithelial differentiation in these tumours is, at most, incomplete. The expression of VE‐cadherin by the majority of cases, in the absence of E‐cadherin, is consistent with an element of mesenchymal differentiation, possibly endothelial or perineurial. The additional presence of other markers such as CD34 and CD31 in some cases favours endothelial differentiation.
Expression of c‐erbB‐2 oncoprotein in human thyroid tumours
Authors: Utrilla  , Martín‐Lacave  , San Martín  , Fernández‐Santos  , Galera‐Davidson  
Published: March 2003

Aimsc‐erbB‐2 expression has been found to be a potential marker of aggressive biological behaviour in some tumours, but the role played by this oncoprotein in the development and maintenance of thyroid tumours is still controversial. Therefore our objective was to determine whether c‐erbB‐2 was overexpressed in a large retrospective series of human thyroid tumours, including both from follicular and C‐cell differentiation.Methods and resultsWe have studied 67 thyroid tumours (10 follicular adenomas, 11 follicular carcinomas, three anaplastic carcinomas, 25 papillary carcinomas and 18 medullary carcinomas and 16 metastases) by immunohistochemistry using an antigen retrieval method for paraffin‐embedded material and a specific polyclonal antibody against the intracytoplasmic part of c‐erbB‐2 oncoprotein. There are marked differences in the pattern of c‐erbB‐2 immunoreactivity depending on the type of thyroid tumour. Thus, no expression of the oncoprotein has been found in follicular adenomas, follicular carcinomas and anaplastic carcinomas, but 52% of papillary carcinomas (membranous and diffuse cytoplasmic patterns) and all medullary carcinomas (granular cytoplasmic pattern) are immunopositive.ConclusionsOur results indicate that overexpression of c‐erbB‐2 oncoprotein is easily identifiable by immunohistochemistry in paraffin sections of certain thyroid tumours after applying an antigen retrieval method. This study suggests that c‐erbB‐2 oncoprotein may play some role in disease progression in papillary and medullary thyroid carcinomas, but the significance of the different immunohistochemical patterns merits further investigations.
Criteria for grading in the Ljubljana classification of epithelial hyperplastic laryngeal lesions. A study by members of the Working Group on Epithelial Hyperplastic Laryngeal Lesions of the European Society of Pathology
Authors: Hellquist  , Cardesa  , Gale  , Kambic  , Michaels  
Published: March 2003

AimsTo validate histological criteria for the grading of epithelial hyperplastic laryngeal lesions (EHHL) (dysplastic laryngeal lesions), we used a system that had been devised and tested in Ljubljana, Slovenia over many years and was felt to be more appropriate to laryngeal pathology than is the commonly‐used model of intraepithelial neoplasia in the cervix.Methods and resultsVocal cord biopsies of 45 patients with a broad spectrum of EHLL were reviewed. Detailed histological criteria were formulated for each of the four grades of EHLL in the Ljubljana classification, comprising simple hyperplasia (benign spinous layer augmentation), abnormal hyperplasia (benign basal and parabasal layer augmentation), atypical hyperplasia (risky for malignancy) and carcinoma in situ (actually malignant, but without invasion).ConclusionsUsing these criteria a high degree of concordance of histological diagnoses of grading levels for the Ljubljana classification was achieved between the pathologists of the Working Group. The system was found to be more precise for routine diagnostic work than the others in vogue. The different grades of the Ljubljana classification correspond to significantly different levels yielded in each grade by the semi‐objective methods of quantitative morphometry and immunohistochemistry.
Association of Epstein–Barr virus infection with p53 protein accumulation but not bcl‐2 protein in nasopharyngeal carcinoma
Authors: Murono  , Yoshizaki  , Park C‐S , Furukawa  
Published: March 2003

AimsThe aim of this study was to investigate the association of Epstein–Barr virus (EBV) infection with status of p53 protein expression in nasopharyngeal carcinoma (NPC). The expression of EBV gene and gene product, p53 protein and bcl‐2 protein in NPC was histopathologically studied.Methods and resultsIn‐situ hybridization using oligonucleotide probe to EBV‐encoded small RNAs (EBERs) and immunohistochemistry using monoclonal antibodies against EBV latent membrane protein 1 (LMP1), p53 protein and bcl‐2 proteins were performed in 56 primary NPCs. EBERs were detected in 46 (82%) cases and LMP1 in 17 (30%) cases. While 30 of 32 (94%) cases in differentiated nonkeratinizing carcinoma (NKC, WHO type 2) and 16 of 17 (94%) cases in undifferentiated carcinoma (UC, WHO type 3) showed EBERs expression, neither five cases of keratinizing squamous cell carcinoma (KSCC, WHO type 1) nor two cases of adenocarcinoma showed EBERs. bcl‐2 protein was detected in 50 (89%) cases, but its expression did not depend on expression of LMP1. p53 protein was detected in 31 (55%) cases, and there was a correlation between expression of EBERs and p53 protein (P < 0.05) but not between LMP1 and p53 protein.ConclusionIn this study, close association of NKC and UC but not KSCC with the latent infection with EBV was demonstrated. The induction of bcl‐2 protein by LMP1, as shown in vitro, was not demonstrated. The association between overexpression of p53 protein and the presence of EBV suggests that some EBV‐encoded protein, which may be different from LMP1, may play a role for nuclear accumulation of p53 protein.
Primary synovial sarcoma of the lung: report of two cases confirmed by molecular detection of SYT‐SSX fusion gene transcripts
Authors: Hisaoka  , Hashimoto  , Iwamasa  , Ishikawa  , Aoki  
Published: March 2003

AimsPrimary pulmonary sarcoma is rare, and frequently creates diagnostic challenges. We describe two cases of primary pulmonary spindle cell sarcoma in which a molecular approach using archival paraffin‐embedded tissue was proved to aid diagnosis.Methods and resultsBoth patients had huge masses replacing the upper and middle lobes of the lung, respectively, without any primary extrapulmonary neoplastic lesions. Microscopically, the lesions showed a solid hypercellular nodular or lobular growth of atypical short spindle cells in variably intersecting fascicles or in a haphazard fashion, together with focal areas displaying a prominent haemangiopericytoma‐like pattern. Immunohistochemically, a small number of the tumour cells were positive for epithelial markers such as cytokeratin and epithelial membrane antigen. In both cases, a reverse transcription‐polymerase chain reaction using RNA extracted from formalin‐fixed, paraffin‐embedded tissues detected SYT‐SSX fusion gene transcripts, which are characteristic of synovial sarcoma.ConclusionOn the basis of the morphological and molecular findings, these tumours are considered to be rare examples of monophasic synovial sarcoma of the lung. Our molecular assay detecting the SYT‐SSX fusion transcripts is useful for the final diagnosis of synovial sarcoma arising at such an unusual anatomical site.
bcl‐2 protein expression is associated with better prognosis in colorectal cancer
Authors: Leahy  , Mulcahy  , O'Donoghue  , Parfrey  
Published: March 2003

AimsTo investigate the expression of bcl‐2 in colorectal carcinoma and to examine its association with mediators of apoptosis (p53 and mdm‐2), clinicopathological features and long‐term outcome.Methods and resultsWe determined by immunohistochemistry the expression of bcl‐2 in 102 colorectal carcinomas with 10‐year follow‐up. In 66 of these cases in which we had previously assessed p53 status, no correlation was seen between bcl‐2 and p53. The mdm‐2 protein was not detected in any of the 66 cases. Cytoplasmic staining of the bcl‐2 gene product was seen in the tumour cells of 22 cases (22%). Using a polymerase chain reaction technique we showed that overexpression of bcl‐2 was not due to rearrangement of the bcl‐2 gene. Expression of bcl‐2 protein was related to tumour grade but was unrelated to patient age, sex, tumour site, tumour size or Dukes' stage. There was a trend towards increased survival in those whose tumours expressed bcl‐2 protein (P = 0.055). When entered into a multivariate analysis, this survival difference was independent of tumour stage (P = 0.05).ConclusionsThese results suggest that bcl‐2 expression in colorectal carcinoma is associated with a better long‐term prognosis.