bluuebunny/crossref_metadata_2025_split huggingface dataset:
Type‐I cryoglobulinemia‐like histopathologic changes in tick bites: a useful clue for tissue diagnosis in the absence of tick parts
Authors: M. Stefanato Catherine , Phelps Robert G. , Goldberg Lynne J. , Perry Ann E. , Bhawan Jag 
Published: March 2003

Background:  The histopathologic findings of localized reactions to tick bites may present as diagnostic dilemmas, especially if there is no history of a tick bite, or if the tick's mouthparts are not present in the biopsied skin.Objective:  Skin biopsies of patients with a clinical history of a tick bite were selected and reviewed with the aim of detecting a common histopathologic denominator which could serve as a useful clue to the diagnosis, especially when the tick's mouthparts are absent.Methods:  Hematoxylin and eosin‐stained slides of 15 skin biopsies of tick bites were retrieved from three dermatopathology and pathology laboratories. Where additional paraffin‐embedded tissue was available, additional sections were also stained with periodic acid‐Schiff (PAS) and phosphotungstic acid‐hematoxylin (PTAH).Results:  In every case in which adequate tissue was available (13/15 biopsies), the capillaries and postcapillary venules of the superficial and deep vascular plexi adjacent to the attachment's site were filled with thrombi. Fibrin thrombi were seen in association with other more numerous thrombi characterized by homogeneous eosinophilic hyaline material similar to the cryoprecipitate present in type I (monoclonal) cryoglobulinemia. All thrombi were positive for PAS and PTAH; however, the latter staining was minimally present in the hyaline thrombi. In most cases, the site of the tick bite showed ulceration, with an underlying wedge‐shaped superficial and deep perivascular and occasionally interstitial mixed lymphohistiocytic infiltrate. In addition, there were eosinophils, numerous neutrophils and extravasated erythrocytes. Other findings included suppurative necrosis (7/15) cases, giant‐cell reaction (one case), fat necrosis (one case) and eccrine gland necrosis (one case).Conclusions:  Vascular eosinophilic hyaline thrombi were found to be a frequent histologic manifestation of a tick bite. This finding may be related to the secretory products of the tick's saliva during inoculation. We believe that a tick bite should be suspected when focal intravascular hyaline occlusion is observed, and that it should be included in the differential diagnosis of type I (monoclonal) cryoglobulinemia, even if there is no history of a tick bite or if tick parts are not present in the skin biopsy specimen.
Congenital composite hemangioendothelioma: case report and reappraisal of the hemangioendothelioma spectrum
Authors: Reis‐Filho Jorge S. , Paiva Maria Emília , Lopes José Manuel 
Published: March 2003

Background:  Composite hemangioendothelioma is the most recently described entity of the hemangioendothelioma (HE) spectrum. To the best of our knowledge, only eight cases of this entity have been hitherto described. All of the previous cases affected adults; local recurrences were observed in three cases, and one case showed lymph node metastasis. We herein describe a new and previously unreported congenital case of this rare vascular tumor, arising on the acral extremity of the left forearm, which was diagnosed when the patient was 23 years old.Results:  The histological examination disclosed a heterogeneous vascular neoplasm composed of retiform HE‐like (80%), spindle cell hemangioma‐like (15%), cavernous hemangioma‐like (∼3%), epithelioid HE‐like (∼2%) areas, and rare foci with an angiosarcoma‐like pattern (< 1%). A distinctive and unique finding of the present case was the presence of large granular eosinophilic macrophages filling some vessels of the retiform HE‐like areas. A below‐elbow amputation was performed. The patient is alive and well, without evidence of residual or metastatic disease 7 years after the treatment.Conclusions:  The authors expand the concept of composite hemangioendothelioma by adding a congenital case and provide a reappraisal of the hemangioendothelioma spectrum.
CD30 antigen expression in cutaneous inflammatory infiltrates of scabies: a dynamic immunophenotypic pattern that should be distinguished from lymphomatoid papulosis
Authors: Gallardo Fernando ,   Carlos Barranco, Toll Agustí , Pujol Ramon M. 
Published: March 2003

Background: Expression of CD30 antigen is a distinct marker of lymphocyte activation that was originally described in the Reed–Sternberg cells of Hodgkin's disease. The observation of CD30+ cells has been considered a diagnostic feature of cutaneous CD30 lymphoid proliferations. However, CD30 expression has also been reported in some cutaneous benign inflammatory infiltrates. Methods: Eleven skin biopsies from patients with scabies were double‐blindly and retrospectively analysed. A panel of histopathological parameters and immunophenotypic expression of CD4, CD8, CD30 and S‐100 antigens was studied. CD30 and S‐100 antigens expression were related to clinical features. Results: Large CD30+ cells were demonstrated in eight (8/11) biopsies, corresponding to patients with long‐standing lesions (3 months or longer). However, no expression of the CD30 antigen was observed in all biopsy specimens (3/11) corresponding to early lesions (2 months or less). The presence of S‐100 positive cells in the papillary dermis was an almost constant feature. Conclusions: CD30+ large cells seem to be a common feature in long‐standing infiltrates of scabies. CD30 expression in scattered cells of a cutaneous lymphoid infiltrate cannot be assessed as a strong diagnostic argument of neoplastic cutaneous CD30+ lymphoid proliferation (lymphomatoid papulosis/cutaneous CD30+ lymphoma). Therefore, the possibility that large atypical CD30+ cells may be also present in several benign inflammatory diseases should be always considered.
MMP‐2, TIMP‐2 and MT1‐MMP are differentially expressed in lesional skin of melanocytic nevi and their expression is modulated by UVB‐light
Authors: Krengel S. , Alexander M. , Brinckmann J. , Tronnier M. 
Published: March 2003

Background:  In malignant melanoma, recent studies have demonstrated an important role of matrix‐metalloproteinase 2 (MMP‐2), its co‐activating enzyme membrane‐type matrix‐metalloproteinase 1 (MT1‐MMP), and the endogenous inhibitor of MMP‐2, tissue‐inhibitor of matrix metalloproteinase 2 (TIMP‐2). Melanocytic nevi are benign neoplasms of the melanocytic lineage, but may exhibit dysplastic features that can be difficult to distinguish from early stage melanoma. As shown in earlier studies, nevi show important morphological and phenotypical changes in response to ultraviolet light (UVB) irradiation.Objective:  To clarify the role of MMP‐2, TIMP‐2 and MT1‐MMP in UVB‐irradiated vs. non‐irradiated melanocytic nevi.Methods:  Immunohistochemical comparison of the MMP‐2, TIMP‐2 and MT1‐MMP expression pattern.Results:  MMP‐2 is expressed by lesional keratinocytes and its expression is up‐regulated by UVB‐irradiation. MMP‐2 expression was not observed in melanocytic cells. TIMP‐2, by contrast, is predominantly expressed by melanocytic nevus cells, and its expression is in part down‐regulated by UVB‐irradiation. MT1‐MMP is expressed by basal keratinocytes and to a weaker extent by melanocytic nevus cells.Conclusions:  MMP‐2 expression by keratinocytes in nevi probably represents the result of activation of keratinocyte turnover in lesional epidermis. MMP‐2 could play a role in the downward movement of junctional nevus cells into the dermis. The reduction of TIMP‐2 expression in melanocytic cells by UV‐light together with the enhanced expression of MMP‐2 in the adjacent epidermis may promote basement membrane degradation. The expression pattern of MT1‐MMP in close proximity to epithelial–mesenchymal interfaces underlines the synergistic role of MT1‐MMP in this process.
Predicting Patterns of Mammography Use: A Geographic Perspective on National Needs for Intervention Research
Authors: Legler Julie , Breen Nancy , Meissner Helen , Malec Don , Coyne Cathy 
Published: March 2003

Objective.To introduce a methodology for planning preventive health service research that takes into account geographic context.Data Sources.National Health Interview Survey (NHIS) self‐reports of mammography within the past two years, 1987, and 1993–94. Area Resource File (ARF), 1990. Database of mammography intervention research studies conducted from 1984 to 1994.Design.Bayesian hierarchical modeling describes mammography as a function of county‐level socioeconomic data and explicitly estimates the geographic variation unexplained by the county‐level data. This model produces county use estimates (both NHIS‐sampled and unsampled), which are aggregated for entire states. The locations of intervention research studies are examined in light of the statewide mammography utilization estimates.Data Extraction.Individual level NHIS data were merged with county‐level data from the ARF.Principal Findings.State maps reveal the estimated distribution of mammography utilization and intervention research. Eighteen states with low mammography use reported no intervention research activity. County‐level occupation and education were important predictors for younger women in 1993–94. In 1987, they were not predictive for any demographic group.Conclusions.Opportunities exist to improve the planning of future intervention research by considering geographic context. Modeling results suggest that the choice of predictors be tailored to both the population and the time period under study when planning interventions.
Understanding Team‐based Quality Improvement for Depression in Primary Care
Authors: Rubenstein Lisa V. , Parker Louise E. , Meredith Lisa S. , Altschuler Andrea , DePillis Emmeline , Hernandez John , Gordon Nancy P. 
Published: March 2003

Objective. To assess the impacts of the characteristics of quality improvement (QI) teams and their environments on team success in designing and implementing highquality, enduring depression care improvement programs in primary care (PC) practices.Study Setting/Data Sources. Two nonprofit managed care organizations sponsored five QI teams tasked with improving care for depression in large PC practices. Data on characteristics of the teams and their environments is from observer process notes, national expert ratings, administrative data, and interviews.Study Design. Comparative formative evaluation of the quality and duration of implementation of the depression improvement programs developed by Central Teams (CTs) emphasizing expert design and Local Teams (LTs) emphasizing participatory local clinician design, and of the effects of additional team and environmental factors oneach type of team. Both types of teams depended upon local clinicians for implementation.Principal Findings. The CT intervention program designs were more evidence‐based than those of LTs. Expert team leadership, support from local practice management, and support from local mental health specialists strongly influenced the development of successful team programs. The CTs and LTs were equally successful when these conditions could be met, but CTs were more successful than LTs in less supportive environments.Conclusions. The LT approach to QI for depression requires high local support and expertise from primary care and mental health clinicians. The CT approach is more likely to succeed than the LT approach when local practice conditions are not optimal.
Issues in Conducting Randomized Controlled Trials of Health Services Research Interventions in Nonacademic Practice Settings: The Case of Retail Pharmacies
Authors: Weinberger Morris , Murray Michael D. , Marrero David G. , Brewer Nancy , Lykens Michael , Harris Lisa E. , Jeffrey Newell A. , Collins Joyce , Tierney William M. 
Published: March 2003

Objective. To describe unexpected challenges and strategies to overcome them when conducting randomized controlled trials (RCT) of health services research interventions in retail pharmacies.Study Setting. Thirty‐six retail drug stores in Indianapolis.Study Design. We conducted an RCT to evaluate the effectiveness of an intervention to increase pharmacists’ involvement in caring for customers. We describe: (1) our RCT as originally designed, (2) unexpected challenges we faced; and (3) how we resolved those challenges.Data Collection/Extraction Methods. Randomized controlled trial.Principal Findings. Major modifications in research design were necessitated by factors such as corporate restructuring, heightened sensitivity to patient confidentiality, and difficulties altering employees’ behavior. We overcame these barriers by conducting research that is consistent with corporate goals, involving appropriate corporate administrators and technical personnel early in the process, and being flexible.Conclusions. Health services researchers should conduct RCTs in a variety of nonacademic practice settings to increase generalizability and better reflect the true impact of interventions. Pragmatic problems, although significant, can be successfully overcome.
Localized amyloidosis of the glans penis: a case report and literature review
Authors: Ritter Marylynn , Nawab Rehana A. , Tannenbaum Myron , Hakky Said I. , Morgan Michael B. 
Published: March 2003

Background:  Primary localized cutaneous amyloidosis is an uncommon lesion with a varied pathogenesis.Methods:  We report the case of a 67‐year‐old‐male discovered to have a localized amyloid lesion of the glans penis.Results: Biopsy of the lesion revealed dermal deposits of amorphous eosinophilic material which stained positive with Congo red and amyloid P protein. Additional stains, including kappa and lambda light chains, amyloid A, and transthyretin, were negative. The lesion has remained asymptomatic, with no evidence of systemic disease identified, and no further treatment has been necessary.Conclusions: This is the sixth reported case of localized amyloidosis of the glans penis. Based on the clinical behavior and pathologic characteristics, this type of lesion is best classified as primary localized cutaneous amyloidosis, in the same family as the macular/lichenoid type lesions.
Computing facilities available to final‐year students at 3 UK dental schools in 1997/8: their use, and students’ attitudes to information technology
Authors: Grigg P. , Macfarlane T. V. , Shearer A. C. , Jepson N. J. A. , Stephens C. D. 
Published: March 2003

Objective: To identify computer facilities available in 3 dental schools where 3 different approaches to the use of technology‐based learning material have been adopted and assess dental students’ perception of their own computer skills and their attitudes towards information technology.Design: Multicentre cross sectional by questionnaire.Subjects: All 181 dental students in their final year of study (1997–8).Results: The overall participation rate was 80%. There were no differences between schools in the students’ self assessment of their IT skills but only 1/3 regarded themselves as competent in basic skills and nearly 50% of students in all 3 schools felt that insufficient IT training had been provided to enable them to follow their course without difficulty.There were significant differences between schools in most of the other areas examined which reflect the different ways in which IT can be used to support the dental course.Conclusions: 1. Students value IT as an educational tool. 2. Their awareness of the relevance of a knowledge of information technology for their future careers remains generally low. 3. There is a need to provide effective instruction in IT skills for those dental students who do not acquire these during secondary education.
Haematopoietic progenitor cells from the common marmoset as targets of gene transduction by retroviral and adenoviral vectors
Authors: Hibino Hitoshi , Tani Kenzaburo , Sugiyama Hajime , Suzuki Shuzo , Wu Ming‐Shiuan , Izawa Kiyoko , Hase Hidenori , Nakazaki Yukoh , Tanabe Tsuyoshi , Ooi Jun , Izeki Toru , Tojo Arinobu , Saitoh Izumu , Tanioka Yoshikuni , Asano Shigetaka 
Published: March 2003

Abstract: To establish a new non‐human primate model for human cytokine and gene therapy, we characterized lymphocytes and haematopoietic progenitor cells of the small New World monkey, the common marmoset. We first assessed the reactions of marmoset bone marrow (BM) and peripheral blood (PB) cells to mouse anti‐human monoclonal antibodies (mAbs) for the purpose of isolating marmoset lymphocytes and haematopoietic progenitor cells. Both cell fractions stained with CD4 and CD8 mAbs were identified as lymphocytes by cell proliferation assay and morphological examination. Myeloid‐specific mAbs such as CD14 and CD33 did not react with marmoset BM and PB cells. No available CD34 and c‐kit mAbs could be used to purify the marmoset haematopoietic progenitor cells.Furthermore, we studied the in vitro transduction of the bacterial β‐galactosidase (LacZ) gene into CFU‐GM derived from marmoset BM using retroviral and adenoviral vectors. The transduction efficiency was increased by using a mixed culture system consisting of marmoset BM stromal cells and retroviral producer cells. It was also possible to transduce LacZ gene into marmoset haematopoietic progenitor cells with adenoviral vectors as well as retroviral vectors. The percentage of adenovirally transduced LacZ‐positive clusters was 15% at day 4 (multiplicity of infection=200), but only 1–2% at day 14. The differential use of viral vector systems is to be recommended in targeting different diseases. Our results suggested that marmoset BM progenitor cells were available to examine the transduction efficiency of various viral vectors in vitro.
Sustained remission of platelet counts following monoclonal anti‐CD20 antibody therapy in two cases of idiopathic autoimmune thrombocytopenia and neutropenia
Authors: Faurschou Mikkel , Hasselbalch Hans C. , Nielsen Ove J. 
Published: March 2003

Abstract: Idiopathic autoimmune thrombocytopenia and neutropenia (ITN) is a primary haemocytopenic disorder clinically characterised by recurrent mucocutaneous bleeding episodes and infections. Unlike in simple idiopathic thrombocytopenic purpura, the platelet deficiency of ITN tends to be chronic and difficult to treat. We describe two patients with ITN who obtained sustained remission of their platelet counts after therapy with the chimeric monoclonal anti‐CD20 antibody Rituximab. In one of two cases, Rituximab also induced prolonged normalisation of the neutrophil count and disappearance of auto‐antibodies.Our observations indicate that disturbed B‐cell function plays a central role in the pathogenesis of ITN. Anti‐CD20 antibody therapy seems to constitute a safe and efficient alternative to corticosteroids for the management of ITN patients with chronic thrombocytopenia.
High Serum Interleukin‐8 Levels in Afro‐Caribbean Women with Pre‐eclampsia. Relations with Tumor Necrosis Factor‐α, Duffy Negative Phenotype and Von Willebrand Factor
Authors: Velzing‐Aarts Francien V. , Muskiet Frits A.J. , Van Der Dijs Fey P.L. , Duits Ashley J. 
Published: March 2003

Velzing‐Aarts FV, van der Dijs FPL, Muskiet FAJ, Duits AJ. High serum interleukin‐8 levels in Afro‐Caribbean women with pre‐eclampsia. Relations with tumor necrosis factor‐α, Duffy negative phenotype and von Willebrand factor. AJRI 2002; 48:319–322 © Blackwell Munksgaard, 2002PROBLEM: Pre‐eclampsia is characterized by neutrophil activation. Interleukin‐8 (IL‐8) is a strong neutrophil chemo‐attractant and activator.METHOD OF STUDY: We measured serum IL‐8 in 13 pre‐eclamptic Afro‐Caribbean women and 13 gestational age‐, race‐ and parity‐matched normotensive and non‐proteinuric controls. We also determined serum tumor necrosis factor‐α (TNF‐α), the phenotypes of the IL‐8 binding Duffy blood group antigen receptor and the von Willebrand factor (vWF) plasma levels.RESULTS: Serum IL‐8, TNF‐α, Duffy negative phenotype frequency and plasma vWF were higher in pre‐eclamptic women compared with controls. IL‐8 correlated positively with both TNF‐α and vWF in the entire study group.CONCLUSIONS: Higher IL‐8 levels in pre‐eclampsia may result from increased production (secondary to increased TNF‐α levels) and/or reduced clearance (related to a high frequency of Duffy negative phenotype).
Dominant IL‐10 and TGF‐β mRNA Expression in γδT Cells of Human Early Pregnancy Decidua Suggests Immunoregulatory Potential
Authors: NAGAEVA OLGA , JONSSON LENA , MINCHEVA‐NILSSON LUCIA 
Published: March 2003

PROBLEM: To examine the cytokine gene expression in γδT‐cells from human early pregnancy decidua.METHOD OF STUDY: The cytokine messenger RNA (mRNA) expression in isolated decidual T‐cell receptor (TCR)γδ+/CD56+and TCRγδ single positive cells was investigated with a panel of cytokine primers and probes selected to distinguish between T helper (Th)1, Th2, Th3 and regulatory T‐cells (Tr1) type of immune response using real‐time quantitative reverse transcriptase‐polymerase chain reaction (RT‐PCR).RESULTS: TCRγδ+/CD56+cells express almost exclusively the immunosuppressive cytokines interleukin‐10 (IL‐10) and transforming growth factor (TGF)‐β. The TCRγδ single positive cells enhance their transcription of IL‐10 and TGF‐β, compared with the TCRγδ+/CD56+cells and additionally express mRNA for IL‐1β and IL‐6.CONCLUSIONS: The present findings suggest that γδT cells in normal pregnancy create a cytokine milieu promoting immunotolerance to the fetus. We hypothesize that through the production of the immunosuppressive cytokines IL‐10 and/or TGF‐β the γδT cells could function directly as regulatory T cells or induce the differentiation of Th0 TCRαβ+cells into regulatory/suppresser cells.
In Vitro Modulation of Protective Antibody Responses by Estrogen, Progesterone and Interleukin‐6
Authors: Canellada Andrea , Blois Sandra , Gentile Teresa , Margni Idehu Ricardo A. 
Published: March 2003

Canellada A, Blois S, Gentile T, Margni Idehu RA. In vitro modulation of protective antibody responses by estrogen, progesterone and interleukin‐6. AJRI 2002; 48:334–343 © Blackwell Munksgaard, 2002PROBLEM: We have previously demonstrated that the addition of placental interleukin‐6 (IL‐6) to murine hybridomas increased asymmetric antibody synthesis. Here we analyze whether progesterone (Pg) and estrogen (E2) affect asymmetric antibody synthesis by modulating IL‐6 production in hybridoma cells.METHOD OF STUDY: Hybridoma 112D5 B cells were cultured with E2, Pg or recombinant IL‐6. Cell proliferation was assessed by 3H‐thymidine incorporation, and asymmetric antibodies were measured in culture supernatants by Con A fixation and enzyme‐linked immunusorbant assay (ELISA). E2 and Pg‐receptors (ER and PR) were evaluated in whole cell extracts by Western blot. IL‐6 was measured in culture supernatants by ELISA.RESULTS: 112D5 expressed both PR and ER, which were differentially regulated. At 48 hr, Pg and E2 slightly decreased cell proliferation whereas IL‐6 did not. As well as IL‐6, 10–10 M Pg but not E2 induced asymmetric antibody production. Interestingly, Pg at 10–6 M decreased asymmetric antibody synthesis by hybridoma cells. Finally, mainly Pg but also E2 increased IL‐6 synthesis, although IL‐6 levels did not correlate with asymmetric antibodies synthesized in the presence of E2 or Pg.CONCLUSIONS: In cells expressing both ER and PR, we could demonstrate that steroids participate in humoral immune responses by modulating asymmetric antibody synthesis. IL‐6 proved to be only partially involved. Other possible mechanisms involved in the effect of Pg on blocking antibody responses and their contribution to a successful pregnancy are discussed in the paper.