bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal death cases in the top referral hospital in Cambodia
Authors: Koum Kanal , Tiv Say , Sann Chan Soeung , Matsui Mitsuaki , Obara Hiromi , Kudo Yoshiko , Fujita Noriko 
Published: March 2003

AbstractObjective: To analyze maternal death cases and their risk factors at the top referral hospital in Cambodia in order to develop appropriate strategies to reduce the maternal mortality ratio (MMR) in Cambodia.Methods: A total of 47 maternal deaths among 6089 delivery cases were analyzed retrospectively through patient documents.Results: The MMR in the top referral hospital was 785 per 100 000 live births. Three main direct causes of maternal mortality were hemorrhage, infection and hypertensive disorders. Risk factors for maternal death were age (older than 35 years), parity (four or more), no antenatal care attendance and residence in the provinces. The major characteristic of cases of maternal death was delayed arrival at the referral hospital.Conclusions: Necessary strategies to reduce MMR are: (i) to avoid delayed arrival at the referral hospital (i.e. health promotion for awareness in the community, risk detection and early transfer by skilled personnel after competency based training); and (ii) provision of adequate health‐care facilities in the country with human resources and materials, including blood transfusion.
Concentrations of ovarian proteohormones as biological markers for the outcome of assisted reproductive technology
Authors: Casper Fritz W. , Seufert Rudolf J. , Schaffrath Michael , Pollow Kunhard 
Published: March 2003

AbstractObjective: To assess whether the ovarian proteohormones inhibin A and B, pro‐alpha‐C and activin A could act as direct biological markers of a poorer or better response to ovulation induction or clinical conception through assisted reproductive technology (ART).Methods: Seventy‐seven women who underwent ART were included in the study and were divided

into two groups: (i) 46 women with sonographically documented follicular maturation;

and (ii) 36 women who demonstrated inadequate follicle development. Blood samples

were analyzed for inhibin A, inhibin B, pro‐alpha‐C, activin A and estradiol (E2) at day 3 of stimulation with recombinant follicle‐stimulating hormone (rFSH) after pituitary downregulation.Results: Women with sonographically documented follicular maturation compared with those

with inadequate follicle development showed a highly significant (P < 0.001),

more than double, increase in inhibin B. The level of pro‐alpha‐C was 1.5‐fold as

high (P = 0.007), while E2, at a factor of 2.1‐fold, exhibited

a borderline significant increase (P = 0.028). Activin A and inhibin A levels exhibited no change under rFSH stimulation.Conclusions: The present study showed, in a small number of patients undergoing in vitro fertilization treatment with rFSH stimulation, that inhibin B acts as a reliable marker for biochemical monitoring at day 3 of stimulation with rFSH in ART.
Pneumomediastinum following esophageal rupture associated with hyperemesis gravidarum
Authors: Liang Shan‐Guang , Ooka Fumiko , Santo Akiko , Kaibara Manabu 
Published: March 2003

AbstractA patient was diagnosed with pneumomediastinum caused by an esophageal rupture during hyperemesis gravidarum. The woman, at 15 weeks’ gestation, presented with hyperemesis gravidarum complicated by an episode of chest pain and disturbance of consciousness. Radiological examination revealed pneumomediastinum and subcutaneous emphysema. They are normally caused by either pulmonary or esophageal rupture. The esophageal etiology was suspected as more likely because of the severe vomiting accompanied with it. Although the clinical feature was quite complicated and esophageal rupture is generally a life‐threatening disease, we chose conservative therapy which resulted in rapid recovery. The final diagnosis was confirmed by endoscopic examination performed after recovery. Pneumomediastinum during pregnancy is rare but it could be lethal. Careful and considerate assessments including surgical treatment should be necessary.
Laparoscopic excision of large ovarian cysts
Authors: Salem Hesham A.F. 
Published: March 2003

AbstractObjective: The aim of this study was to check the ability of operative laparoscopy to help in the management of large ovarian cysts that may reach above the level of the umbilicus.Material and methods: Fifteen cases oflarge ovarian cysts reaching above the level of the umbilicus were chosen. Clinical and ultrasonic diagnosis denied any signs of malignancy. Pneumoperitoneum and a 5 mm trocar were inserted safely in the left midclavicular line below the ninth costal margin. This trocar allowed us to inspect the peritoneal cavity thoroughly. Another 5 mm trocar was inserted suprapubically in the contralateral side of the cyst and better inspection of the cyst and peritoneal cavity was then done. In the case of an apparently benign cyst, aspiration of the cyst fluid was done after puncturing its wall, then the cyst was removed as usual.Results: In all of these cases, there was no laparoconversion and no other complications were recorded. Nine cases were mucinous and six were serous cystadenomas. The mean operation time was 53.66 ± 14.7 min.Conclusion: Laparoscopic excision of large ovarian cysts is possible, and safe in suitable conditions, with immediate laparoconversion at hand at any time.
A comparison between virus replication and abiotic stress (heat) as modifiers of host gene expression in pea
Authors: Escaler Margarita , Aranda Miguel A. , Roberts Ian M. , Thomas Carole L. , Maule Andrew J. 
Published: March 2003

AbstractPea embryonic tissues respond to active replication of pea seed‐borne mosaic potyvirus (PSbMV) by the down‐regulation of a range of genes and the induction of others. Both of these responses can be seen when tissues are subjected to abiotic stress, particularly heat. We have compared the effects of the two inducers to assess whether the host alterations following virus replication represent generic responses to stress, or more specific effects. Five classes of response were identified: (i) genes induced by both stresses (e.g. heat shock protein 70,hsp70); (ii) genes induced by virus replication but unaffected by heat (e.g. glutathione reductase 2,gor2); (iii) genes induced by heat but unaffected by virus replication (e.g. heat shock factor,hsf); (iv) genes down‐regulated by virus replication and unaffected by heat (e.g. vicilin,vic); and (v) genes unaffected by both inducers (e.g. actin,actand β‐tubulin,tub). A change in the appearance and organization of the endoplasmic reticulum (ER) was also seen in cells actively replicating PSbMV RNA. Heat treatment of pea embryonic tissues also produced altered ER, although the changes were different from those seen following virus infection. Collectively, these data show that, while there are some common features of the responses to virus infection and heat, there are also substantial differences. Hence, it appears that the host response to virus replication is not a general stress response.
Comparison between nuclear localization of nopaline‐ and octopine‐specific Agrobacterium VirE2 proteins in plant, yeast and mammalian cells
Authors: Tzfira Tzvi , Citovsky Vitaly 
Published: March 2003

SUMMARYIn a unique case of trans‐kingdom DNA transfer, Agrobacterium genetically transforms plants by transferring its DNA segment into the host cell nucleus and integrating it into the plant genome. One of the central players in this process is the bacterial virulence protein, VirE2, which binds the transported DNA molecule and facilitates its nuclear import. Nuclear import of VirE2 proteins encoded by two major Agrobacterium strains, nopaline and octopine, has been hypothesized to occur by different mechanisms, i.e. the nopaline VirE2 was imported only into the nuclei of plant cells while the octopine VirE2 also accumulated in the nuclei of animal cells. Here, this notion was tested by a systematic comparison of nuclear import of nopaline‐ and octopine‐specific VirE2 in dicotyledonous and monocotyledonous plants and in living mammalian and yeast cells. These experiments showed that nuclear import of both nopaline and octopine VirE2 proteins is plant‐specific, occurring in plant but not in non‐plant systems.
Location and activity of members of a family of virPphA homologues in pathovars of Pseudomonas syringae and P. savastanoi
Authors: Jackson Robert W. , Mansfield John W. , Ammouneh Hassan , Dutton Lindsay C. , Wharton Becky , Ortiz‐Barredo Amaya , Arnold Dawn L. , Tsiamis George , Sesma Ane , Butcher Diane , Boch Jens , Kim Young Jin , Martin Gregory B. , Tegli Stefania , Murillo Jesús , Vivian Alan 
Published: March 2003

Summary virPphA
is a major determinant of the pathogenicity of
Pseudomonas savastanoi
pv.
phaseolicola
to
Phaseolus
bean. A family of homologues of
virPphA
was detected in pathovars of
P
.
savastanoi
and
P
.
syringae
. We examined the structure and activity of alleles designated
virPphA
,
virPphA

Pgy

, and
virPphA

Psv

from
P
.
savastanoi
pathovars
phaseolicola
,
glycinea
, and
savastanoi
, respectively, and
avrPtoB
from
P
.
syringae
pv.
tomato
. Sequencing showed that the
virPphA

Pgy

homologue had a 48‐bp central deletion in the open reading frame (ORF) compared with
virPphA
and
virPphA

Psv

, but otherwise all three
P
.
savastanoi
alleles had > 98% identity at the DNA level. By contrast, AvrPtoB from
P
.
syringae
pv.
tomato
strain DC3000 was predicted to have only 51% amino acid similarity with VirPphA. All ORFs have an upstream
hrp
‐box promoter indicating potential regulation by HrpL. Each cloned homologue was introduced into the
P. savastanoi
pv.
phaseolicola
strain RW60, which lacks a native plasmid carrying
virPphA
as part of a pathogenicity island (PAI), and which is not pathogenic on bean. The homologues all restored virulence, as measured by the development of water‐soaked lesions in bean pods, and increased bacterial populations in leaves compared with RW60 alone. RW60 harbouring
virPphA
or
virPphA

Psv

elicited a strong hypersensitive reaction (HR) in soybean cv. Osumi; the presence of
avrPtoB
caused a weak HR, but
virPphA

Pgy

did not affect the null reaction observed in soybean with RW60 alone. A second effector gene,
avrPphD
, was detected on the genomic clones carrying
virPphA

Pgy

and
virPphA

Psv

.
avrPphD
was also present in both
P
.
savastanoi
pv.
phaseolicola
and
P
.
syringae
pv.
tomato
, but elsewhere in their genomes. Comparison of the genomic locations of
virPphA
and other effectors found in the
P. savastanoi
pv.
phaseolicola
PAI revealed the greatest divergence of the sequences surrounding
virPphA
to be in
P
.
syringae
pv.
tomato .
Who uses NHS libraries? Preliminary results from a survey of postgraduate medical libraries in North East Thames
Authors: HEWLETT JOHN 
Published: March 2003

Recent changes have made Regional Deans fund‐holders for postgraduate medical education. Allocations from the Dean's budget often fund NHS library infrastructure and associated costs arising from the information and study needs of junior medical staff. To provide adequate levels of stock and services for all library users requires funding from all appropriate sources.This paper describes a survey carried out in North East Thames to facilitate appropriate funding by and for user groups other than junior doctors.The wide variation in results is discussed. The survey is not seen as definitive, but as part of the beginning of the evolutionary process of allocating funds for libraries serving postgraduate medical education and other users. Further research is suggested, particularly in other Regions, to provide comparative data.
Type 1 protein tyrosine kinases in benign and malignant breast lesions
Authors: Suo  , Emilsen  , Tveit  , Nesland  
Published: March 2003

Aims: To determine their significance, we examined the expression pattern of the four epidermal growth factor receptor (EGFR) family members as well as the phosphotyrosine kinase activity in breast tumour tissues.Methods and resultsFifty‐three malignant breast tumours, four breast cancer cell lines, and 10 benign breast tumours were investigated. Fifty‐three per cent (28/53) of the malignant tumours expressed EGFR protein, and the majority of these positive tumours were strongly positive. Eighty per cent (8/10) of the benign tumours also expressed EGFR protein, but all in a lower or moderate level. An association between EGFR expression and increasing malignancy grade was found in the group of infiltrating ductal carcinomas. Of the malignant tumours, 35.8% (19/53) expressed c‐erbB‐2 protein and 17% (9/53) c‐erbB‐3 protein, while no expression of c‐erbB‐2 and c‐erbB‐3 proteins was found in the benign tumours. Contrary to previous reports, we observed c‐erbB‐4 receptor protein to be less expressed in the malignant breast tumours. The ‘normal’ breast epithelial cells adjacent to the malignant tumours and the benign tumours demonstrated intensified membrane staining for c‐erbB‐4, while a number of the malignant tumours demonstrated a weak cytoplasmic staining or were negative. However, several malignant tumours with strong membrane staining for the c‐erbB‐4 protein were also found. No simple association between the expression of the four receptors and phosphotyrosine kinase activity was found.ConclusionOur study has revealed a complex expression pattern of the EGFR family members in breast tumour cells. While the data about EGFR, c‐erbB‐2, c‐erbB‐3 and phosphotyrosine are largely in line with what has been reported, we found the c‐erbB‐4 protein expression to be decreased in the malignant tumours.
Ki67 labelling index correlates with stage and histology but not significantly with prognosis in thymoma
Authors: Pan C‐C , M‐T Ho D , Y‐K Chen W , Huang C‐W , Chiang H 
Published: March 2003

AimsThere have been several cell kinetic studies of thymoma, but the effectiveness of using Ki67 antibody as a tool to measure proliferative activity in this tumour was rarely evaluated. We carried out an immunohistochemical study using this antibody to assess the clinicopathological correlation and the prognostic significance of this technique.Methods and resultsNinety‐one cases of thymoma were collected. Double immunostaining with Ki67 and cytokeratin KL‐1 antibodies was performed on paraffin sections. Ki67 labelling index (LI) was expressed as a percentage of Ki67 immunopositive nuclei by counting at least 1000 epithelial cells. The LIs were correlated with stages, histological subtypes based on both Lattes–Bernatz and Müller–Hermelink–Kirchner classifications, and length of survival. There were statistically significant differences of LIs between stage I and stage III and between stage I and stage IV tumours. Histologically, statistically significant differences were identified between predominantly epithelial thymoma and every other subtype of the Lattes–Bernatz classification and between well‐differentiated thymic carcinoma and medullary or mixed thymomas of the Müller–Hermelink–Kirchner classification. Regarding the prognostic implication of Ki67 LI, although there appeared a trend that patients with tumours of higher LIs had slightly worse survival, the difference was not statistically significant in both univariate and multivariate survival analyses.ConclusionsWe have demonstrated the proliferative potential in thymoma is associated with stage and histology. However, its clinical usefulness is limited on account of the overlap of LIs and lack of prognostic significance.
Primary malignant peripheral nerve sheath tumour of the heart
Authors: Pauwels  , Dal Cin  , Sciot  , Lammens  , Penn  , Van Nes  , Kwee  , Van Den Berghe  
Published: March 2003

AimsMalignant peripheral nerve sheath tumour (MPNST) is an unusual sarcoma of the heart and should be differentiated from other spindle cell sarcomas.Methods and resultsWe combined morphological, immunohistochemical and cytogenetic techniques in the differential diagnosis, particularly from monophasic synovial sarcoma. The tumour consisted of dense fascicles, alternating with hypocellular, myxoid zones. There was a marked herniation of tumour cells into the vascular lumen. Immunohistochemically, the tumour cells expressed vimentin and focally S100 protein. There was no expression of cytokeratin or epithelial membrane antigen (EMA). Although we found a complex karyotype, the finding of involvement of 17q11, the loss of chromosome 22, and the absence of a t(X;18)(p11.2;q11.2), which characterizes synovial sarcoma, allowed us to the final diagnosis of malignant peripheral nerve sheath tumour.ConclusionMPNST of the heart can be diagnosed by combining morphological and immunohistochemical date. Cytogenetics can be useful in reaching a correct diagnosis, also by helping to rule out monophasic synovial sarcoma.
CA125 and thyroglobulin staining in papillary carcinomas of thyroid and ovarian origin is not completely specific for site of origin
Authors: Keen  , Szakacs  , Okon  , Rubin  , Bryant  
Published: March 2003

AimsA 70‐year‐old woman presented with metastatic psammoma body‐rich papillary carcinoma in a supraclavicular lymph node. No primary site was evident. The tumour showed strong staining for CA125 and weak staining for thyroglobulin. Prompted by this case we aimed to assess the reliability of immunostaining for CA125 and thyroglobulin in making the distinction between thyroid and ovarian papillary carcinoma.Methods and resultsNine papillary carcinomas of the thyroid and 17 serous papillary carcinomas of the ovary were stained for CA125 and thyroglobulin, as well as CAM 5.2, LP 34, carcinoembryonic antigen (CEA), S100 and diastase/periodic acid–Schiff. Nine of nine thyroid carcinomas stained for thyroglobulin; in addition CA125 was positive in four of nine. Normal surrounding thyroid also showed some reaction. Seventeen of 17 ovarian serous carcinomas were positive for CA125; in addition one case showed moderately strong staining for thyroglobulin. Mucin stains were positive in 14/17 ovarian serous carcinomas, but negative in all thyroid carcinomas. The other antibodies assessed showed no useful differences in staining frequency.ConclusionMany cases of papillary carcinoma of the thyroid show CA125 staining, and this feature therefore has little positive predictive value for an ovarian origin. Occasional cases of ovarian papillary carcinoma may show staining for thyroglobulin, and this result should therefore be interpreted cautiously.
Extra‐medullary myeloid tumour (granulocytic sarcoma) is often misdiagnosed: a study of 26 cases
Authors: Menasce  , Banerjee  , Beckett  , Harris  
Published: March 2003

AimsTo describe the clinicopathological and immunophenotypic features of 26 cases of extra‐medullary myeloid tumour (EMMT)/granulocytic sarcoma, which remains poorly recognized and is frequently confused with malignant lymphoma, and to discuss the main diagnostic problems experienced by the referring pathologist.Methods and resultsHaematoxylin and eosin (H & E) sections of 26 cases of EMMT were re‐examined. Immunostains for myeloperoxidase, lysozyme, neutrophil elastase, LCA, CD79a, CD20, CD43, CD45RO, CD3, CD30, CD15, CD68, MAC387, VS38C, MIC2, and the Leder stain for naphthol‐ASD‐chloroacetate esterase were performed on all cases. Clinical and follow‐up data were obtained through a questionnaire to the referring pathologist or from the notes of the patients where available. In the 10 cases with known myeloproliferative disease, the initial diagnosis was correct in 10 whereas all cases presenting with EMMT without a previous history of myeloproliferative disorder had an initial incorrect diagnosis. The most common suggested diagnosis was that of a non‐Hodgkin's lymphoma. The morphology of the tumours varied from well differentiated which included all stages of myeloid differentiation to poorly differentiated or blastic showing little or no evidence of myeloid differentiation. The proportion of positive cells for each stain varied. Chloroacetate esterase, myeloperoxidase and CD15 stained a large proportion of cells of the majority of the well differentiated tumours and a smaller proportion of the poorly differentiated/blastic tumours with very focal staining of some of the cases. Lysozyme and CD43 were the most sensitive of the markers staining a large proportion of cells of the majority of the tumours in both groups. Neutrophil elastase was the least sensitive of the markers of myeloid differentiation. CD79a, CD20, CD3 and CD30 were negative in all cases. CD43 was positive in all cases. CD68 stained a substantial number of cells in the majority of tumours. A smaller proportion of the tumours stained with MAC387. Four of the tumours showed positivity for MIC2. One tumour was positive for VS38C.ConclusionThis series documents continuing difficulties in the diagnosis of EMMT. Even well differentiated tumours are frequently mistakenly diagnosed as malignant lymphomas when they present without any history of antecedent myeloproliferative disorder. Careful evaluation of morphology for evidence of myeloid differentiation and a high index of suspicion when confronted with a less differentiated neoplasm are required to avoid this important diagnostic error. We suggest that a panel which includes chloroacetate‐esterase, myeloperoxidase, lysozyme and CD43, together with other B‐ and T‐lineage markers, in particular CD79a and CD3 should be used to confirm the diagnosis.
Benign vascular neoplasms of the spleen with myoid and angioendotheliomatous features
Authors: Kraus  , Dehner  
Published: March 2003

AimsTo present the clinical light microscopic and immunophenotypic features of a distinctive vascular neoplasm of the spleen.Methods and resultsTwo of the splenic lesions arose in children, and one was found in an adult. They ranged from 19 to 40 mm diameter and histologically were quite similar. Sheets of large epithelioid cells with a spectrum of nuclear configurations ranging from oval and vesicular to twisted and hyperchromatic were noted in each case. Distinct or prominent nucleoli were present in many cells, and occasional cells had nuclear pseudoinclusions. In two cases, bands of basophilic, fibroblast‐rich stroma with scattered chronic inflammatory cells were present. The mitotic rate ranged from 0/10 high‐power fields (HPF) to 0.5/10 HPF in these epithelioid cells. The vascular nature of these tumours was manifested as a sieve‐like array of round, erythrocyte‐filled spaces, most with attenuated and cytologically bland lining cells. The polygonal, epithelioid cells exhibited the following phenotype: smooth muscle actin (SMA)+, muscle specific actin (MSA)+, vimentin+, CD31−, CD34−, CD21−, CD8−, CD68− (2/3 cases), S100−, while the lining cells were CD34+, vimentin+ and SMA−, with variable CD31 and factor VIII related antigen expression. Elongated SMA+, MSA+ cell processes were evident in one case, reminiscent of previously characterized myoid elements of the normal spleen. An uneventful follow‐up was noted for all three patients.ConclusionsThe histology and immunophenotype set these neoplasms apart from classic hamartomas, haemangiomas and previously characterized (haem)angioendotheliomas of the spleen, and may represent proliferations of myoid elements native to the spleen.