bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of intramucosal gastric carcinoma with lymph node metastatic disease
Authors: Song S Y , Park S , Kim S , Son H J , Rhee J C 
Published: December 2004

Aim:  Recent trends in treatment strategy for early gastric cancer (EGC) are towards minimal surgical procedures, such as endoscopic mucosal resection and laparoscopic partial resection. There is a possibility of incomplete removal of regional lymph nodes in minimal procedures, which may subsequently decrease the chance of a cure. Therefore, it is essential to be able to predict lymph node status and to make careful selection of candidates for mucosal resection.Methods and results:  We studied the relationship between lymph node status and various pathological parameters including macroscopic appearance, location, size, differentiation, presence of ulceration, vascularity, presence of gastritis cystica profunda‐like glandular proliferation, disruption of the muscularis mucosae and invasion into the muscularis mucosae, using age‐ and sex‐matched samples of 40 node‐positive and 80 node‐negative tumours to define the characteristics of intramucosal EGCs. Histological differentiation (P < 0.001), increased submucosal vascularity (P < 0.05), breakdown of the muscularis mucosae (P < 0.05), and invasion of tumour cells into the muscularis mucosae (P < 0.05) were correlated with the lymph node status of intramucosal gastric carcinoma. Furthermore, diffuse type histology (P < 0.001) and deep invasion into the muscularis mucosae (P < 0.05) were indicators of node‐positive intramucosal EGCs.Conclusions:  These histological indicators are easily accessible and seem to predict lymph node metastatic disease in limited surgical specimens. Patients should be carefully selected despite the recent trend toward less invasive resection of EGCs, especially for those apparently confined to the mucosa.
Microinvasive germ cell tumour (MGCT) adjacent to testicular germ cell tumours
Authors: Von Eyben F E , Jacobsen G K , Rorth M , Von Der Maase H 
Published: December 2004

Aims:  To examine the occurrence and prognostic significance of intratubular germ cell neoplasia (IGCN) and microinvasive germ cell tumour (MGCT) in tissue adjacent to testicular germ cell tumours (TGCT) in adults.Methods and results:  The study was based on two Danish studies of adult patients with stage I TGCT and included 255 patients. Of 106 patients with seminoma, 75 [71%, 95% confidence interval (CI) 61, 79] had IGCN without MGCT and nine (8%, CI 4, 15) had both IGCN and MGCT. Of 149 patients with non‐seminoma, 62 (42%, CI 34, 50) had IGCN without MGCT, and 32 (22%, CI 15, 29) had both IGCN and MGCT. Non‐seminomas with a seminoma component were more often associated with MGCT (23 of 54 testes, 43%, CI 29, 57) than were non‐seminomas without this component (nine of 95 testes, 10%, CI 4, 17) (P < 0.000 05, Fisher's exact test). Relapse‐free survival was not influenced by the concomitant presence of the two precursor stages in the testes (P = 0.36, and P = 0.19, log rank test, respectively).Conclusions:  MGCT was a relatively frequent finding in testes adjacent to a macroscopic TGCT. However, neither IGCN nor MGCT predicted relapse for patients with stage I TGCT.
High‐grade carcinomas of the breast showing patterns of mixed ductal and myoepithelial differentiation (including myoepithelial cell‐rich carcinoma of the breast)
Authors: Coyne J D , Dervan P A , Barr L 
Published: December 2004

Aims:  To assess the clinical, morphological and immunophenotypic characteristics of breast carcinomas showing patterns of mixed epithelial and myoepithelial differentiation.Methods and results:  Included in the study were four carcinomas containing a mixed population of epithelial and myoepithelial cells identified using morphological features at the light microscopic level which were found amongst a review of 500 archival cases and two recently accessioned cases. The carcinomas varied in size from 20 to 38 mm and all were grade 3 ductal carcinomas. Most showed nodular and sheet‐like cellular aggregates, although one case showed small solid cell aggregates with duct formation. The cells were large, round, polygonal or spindle‐shaped and had areas of clear or eosinophilic cytoplasm in variable proportions. Foci of metaplasic carcinoma were present in three cases. All cases showed strong, patchy positivity for cytokeratin (CK)14, calponin, smooth actin and muscle specific actin. Epithelial membrane antigen and CK8 were positive in a similar proportion of cells. One patient died 23 months following diagnosis with metastatic carcinoma, another patient died of unrelated disease and four patients are alive with follow‐up ranging from 18 months to 25 years.Conclusions:  High‐grade carcinomas of the breast showing patterns of mixed ductal and myoepithelial differentiation may show additional morphological features such as foci of metaplasia and appear to have a good prognosis similar to myoepithelial cell‐rich carcinomas. However, young age and lymph node metastasis may portend a worse prognosis.
British Division of the International Academy of Pathology
Authors: Van Den Tweel J , Howat A J , Shepherd N A , Francis N , Harris C 
Published: December 2004

Spring 2004 Symposium on Dermatopathology. Brussels, Belgium10‐‐15 October 2004 XXVth International Congress. Brisbane, Australia26‐‐27 November 2004 Symposium on Pulmonary Pathology. London, UK
CD10 immunostaining of bile canaliculi in liver biopsies: change of staining pattern with the development of cirrhosis
Authors: Shousha S , Gadir F , Peston D , Bansi D , Thillainaygam A V , Murray‐Lyon I M 
Published: December 2004

Aims : This study was prompted by published observations concerning the absence of normal bile canalicular CD10 staining in some cases of primary liver cell carcinoma. Our aim was to investigate the possibility that this loss of staining occurs prior to the development of cancer.Methods and results : The study comprised 164 liver biopsies, including 96 from patients with hepatitis C infection of various grades and stages including nine cases with cirrhosis, 24 other cases of cirrhosis of other aetiology, five cases of primary liver carcinoma, 12 cases of metastatic carcinoma, as well as biopsies with a variety of other liver diseases. CD10 was demonstrated in paraffin sections using the avidin–biotin immunoperoxidase technique. In hepatitis C cases, a significant loss of the canalicular pattern was seen in four out of 41 (10%) biopsies with stages 0–1 compared with 25 out of 55 (45%) with stages 2–6 (P < 0.001). There was also a significant difference (P < 0.001) between biopsies with stage 2–3 and those with stage 4–6, where marked pattern loss was seen in 9/37 (24%) and 16/18 (89%), respectively. Marked loss of the pattern was also seen in 16 out of the 24 (67%) other cirrhotic biopsies, as well as in cases with severe lobular inflammation and cholestasis and liver cell dysplasia and carcinoma. In hepatitis C biopsies, no relationship was noted between the reduction in the canalicular pattern and the necroinflammatory score.Conclusions : CD10‐stained bile canalicular pattern in liver biopsies is preserved in cases with mild fibrosis and inflammation, but it becomes increasingly reduced with the advance of fibrosis or the presence of severe lobular inflammation or extensive metastases. Further investigations into the relationship between the changes in CD10 staining pattern and liver function tests may be useful in explaining test results.
The pathology associated with therapeutic procedures in malignant mesothelioma
Authors: Attanoos R L , Gibbs A R 
Published: December 2004

Aims : To describe iatrogenic pathological lesions in malignant pleural mesothelioma.Methods and results : All cases of malignant pleural mesothelioma confirmed by antemortem pleural biopsy and undergoing post mortem examination over a 7‐year period (1995–2001) formed the study group. This comprised 48 malignant pleural mesotheliomas [epithelioid (n = 21), biphasic (n = 14) and sarcomatoid (n = 13)]. Twenty‐eight of 48 (58%) had received chemical (talc) pleurodesis, 30/48 (63%) palliative localized radiotherapy, 6/48 (13%) chemotherapy, and 14/48 (30%) surgery [12/48 (26%) pleural decortication and 2/48 (4%) pleuropneumonectomy].Conclusions : Talc pleurodesis induces a marked pseudosarcomatous fibroblastic proliferation which may impart a biphasic pattern to the neoplasm. In more chronic cases, paucicellular fibrosis with a foreign body giant cell reaction is noted. The talc is polarizable and deposited in linear fashion within the tumour. In 2/28 (7%) pleurodesis cases platyform ferruginous bodies were seen in the peripheral alveolated lung parenchyma and these mimicked asbestos bodies. An awareness of this is important to prevent false attribution to asbestos. Talc could be identified by transmission electron microscopic mineral analysis in 5/15 (33%) cases examined. Tumour nodules developing subjacent to iatrogenic wound sites were noted in 8/48 (17%) cases. In 6/8 (75%) of these cases, comparative assessment of the locally irradiated subcutaneous chest wall tumour, with background pleural mesothelioma, showed no morphological difference in architectural tumour growth pattern, extent of necrosis, cytological or nuclear pleomorphism, mitotic activity or tumour immunophenotype. In 2/8 (25%) cases the locally irradiated tumour showed prominent bizarre multinucleated tumour giant cells and intense mixed inflammation, a feature not seen in the background (non‐irradiated) tumour. All six malignant pleural mesotheliomas receiving chemotherapy appeared refractory to treatment in that chemotherapy did not appear to have any significant effect on the tumour morphology, cytonuclear pleomorphism, mitotic activity, extent of necrosis or immunophenotype. In the 12 decortication specimens and two pleuropneumonectomy resections, post mortem examination identified evidence of residual malignant mesothelioma of similar morphological subtype and immunophenotype to the resected tumour.
Apoptosis and proliferation in lungs of human fetuses exposed to chorioamnionitis
Authors: May M , Marx A , Seidenspinner S , Speer C P 
Published: December 2004

Aims : To determine whether chorioamnionitis has an impact on the extent of apoptosis and proliferation in fetal lungs. Fetuses exposed to chorioamnionitis have an increased risk of aquiring lung tissue damage in utero.Methods and results : Lung tissue sections from 35 stillborn fetuses were used in this study. Chorioamnionitis‐exposed fetuses were subdivided depending on whether pneumonia was diagnosed (n = 13) or not (n = 10); 12 unaffected fetuses served as controls. Apoptotic and proliferating cells were determined by in‐situ terminal deoxytransferase‐mediated dUTP nick end labelling (TUNEL) assay and by anti‐Ki67 immunohistochemistry, and quantified. The median apoptotic index in lungs of chorioamnionitis‐exposed fetuses increased 2.4‐fold compared with chorioamnionitis‐negative stillborn controls (P = 0.043) and rose 21.6‐fold when chorioamnionitis‐exposed fetuses additionally developed pneumonia (P < 0.001). Compared with the proliferation index of the control group (PI =2.3), the median percentage of proliferating cells in the lungs of chorioamnionitis‐exposed fetuses decreased (PI = 1.4) (P = 0.036), but increased 1.8‐fold (P = 0.036) in fetal lungs of the chorioamnionitis/pneumonia group. By double labellings combining the TUNEL assay or the Ki67 antigen with cell marker proteins, we identified distal airway epithelial cells as the cell type undergoing apoptosis in chorioamnionitis‐exposed fetal lungs, while epithelial, endothelial and smooth muscle cells proliferated. Immunolabellings of cleaved caspases ‐8 and ‐9 revealed that apoptosis is mediated via initiator caspase‐8.Conclusion : Chorioamnionitis induces apoptosis of distal airway epithelial cells via the caspase‐8 pathway and interferes with the normal proliferative activity of epithelial, endothelial, and smooth muscle cells in fetal lungs. Thus, apoptosis and proliferation are an important feature of chorioamnionitis‐associated lung injury in utero.
Adenocarcinomas of the nasal cavity and paranasal sinuses: a clinicopathological and immunohistochemical study of 14 cases
Authors: Abecasis J , Viana G , Pissarra C , Pereira T , Fonseca I , Soares J 
Published: December 2004

Aims : To evaluate the clinicopathological profile of 14 cases of nasal and paranasal sinusal adenocarcinoma, and to assess the usefulness of immunohistochemistry in the differential diagnosis of primary and metastatic intestinal‐type adenocarcinoma.Methods and results : Fourteen cases of nasal and paranasal adenocarcinoma, treated at IPOFG, Lisbon, between 1976 and 2002, were studied. Clinical records were reviewed and expression of cytokeratin (CK)7 and CK20 and of neuroendocrine markers was evaluated. The male : female ratio was 3 : 1, and the mean age of the patients was 65.3 years. Ten cases occurred in the paranasal sinuses. There was a history of professional exposure to dust in three patients. Twelve cases were high‐grade intestinal type adenocarcinomas (ITAC) and two were low‐grade. CK7 was present in 2/9 ITAC cases and CK20 in 8/9 ITAC and in cases of mixed and mucinous histology. All high‐grade cases showed neuroendocrine differentiation. Seven of the 12 patients with high‐grade adenocarcinoma died of the disease, with a mean follow‐up of 47.4 months.Conclusions : Nasal and paranasal adenocarcinoma mostly occurs in men in the 7th decade. ITAC is the most frequent histological type. The pattern of CK7/CK20 was not useful in the distinction between primary and metastatic intestinal adenocarcinoma. However, in the former, neuroendocrine differentiation proved to be a valuable tool in that distinction.
Intra‐abdominal synovial sarcoma: a clinicopathological study
Authors: Fisher C , Folpe A L , Hashimoto H , Weiss S W 
Published: December 2004

Aims : To evaluate a series of synovial sarcomas arising in the abdomen, pelvic cavity, or retroperitoneum. Synovial sarcoma is rare within the abdomen. In this location, it can be confused with other biphasic tumours and with other spindle and round cell sarcomas.Methods and results : Cases were retrieved from archives. There were 11 intra‐abdominal tumours among 300 synovial sarcomas in two referral practices (3.7%). Three were pelvic (two midline, one sidewall) and eight were retroperitoneal. They occurred in six males and five females aged from 25 to 75 years (mean 49 years, median 46 years), and ranged in diameter from 65 to 470 mm (mean 210 mm, median 150 mm). Six examples were biphasic, five were monophasic and seven had poorly differentiated areas. Monophasic tumours displayed at least one epithelial marker. One biphasic tumour had a SYT‐SSX2 fusion gene. Seven sarcomas were high‐grade and four of intermediate grade malignancy. Follow‐up data were available in 10 patients. In all but one case, tumour recurred or metastasized within the abdomen. The pelvic sarcomas also metastasized outside the abdomen. Eight of 10 patients (80%) died of disease with survival from 4 to 36 months (mean 17 months, median 18 months). Two patients were alive with disease at 43 and 48 months.Conclusions : Synovial sarcomas rarely arise within the abdomen and pelvis. They occur mainly in middle age, attain a large size, are difficult to excise and recur locally. Pelvic tumours metastasize distantly. Retroperitoneal tumours remain confined to the abdomen and, unlike synovial sarcomas elsewhere, do not metastasize remotely, although mortality is high.
Extramedullary haematopoiesis in massive hepatic necrosis
Authors: Craig C E H , Quaglia A , Dhillon A P 
Published: December 2004

Aims:  To determine the frequency of extramedullary haematopoiesis (EMH) in massive hepatic necrosis (MHN).Methods and results:  Explanted livers of 11 adult patients transplanted consecutively for MHN were examined histologically and immunohistochemically for the presence of EMH. The aetiology of the liver damage was unknown in seven cases and drug induced in four. The presence of stem cell markers (CD34, c‐kit), erythroid precursors (glycophorin A), myeloid precursors (myeloperoxidase) and megakaryocyte precursors (CD31) was investigated by immunohistochemistry. Erythroid, myeloid and megakaryocyte precursors were observed in all cases. Morphologically, haematopoietic blast cells were clustered in areas of collapse, separating islands of regenerating ductules and scattered between ductules, in a similar distribution to immunohistochemically identified c‐kit‐positive putative stem cells. No CD34+ cells other than endothelial cells were seen. All 11 patients were anaemic at the time of transplantation.Conclusions:  EMH is a frequent finding in patients undergoing liver transplantation for MHN. This may be a consequence of the anaemia associated with this condition. Alternatively, the possibility that intrahepatic haematopoiesis is linked with hepatopoiesis is an additional, intriguing possibility that deserves further study.
Ultrasonic condensation of gutta‐percha: the effect of power setting and activation time on temperature rise at the root surface – an in vitro study
Authors: Bailey G. C. , Cunnington S. A. , Ng Y.‐L. , Gulabivala K. , Setchell D. J. 
Published: December 2004

AbstractAim  To determine the effect of power setting and duration of activation on the temperature rise at the root surface during root canal obturation by ultrasonic condensation of gutta‐percha.Methodology  A human maxillary canine was used in an in vitro split tooth model to allow repeated obturation of the root canal system using an ultrasonic device to thermocompact gutta‐percha. Combinations of power settings (1, 3 and 5) and durations of activation (4, 10 and 15 s) were used to test their effect on temperature rise at the root surface using eight K‐type thermocouples at the mid‐root and apical levels. At the end of each obturation, the tooth was disassembled to remove the gutta‐percha in preparation for the next obturation (n = 10 for each combination). Multiple linear regression models were used to investigate the effects of power setting, duration of activation and thermocouple location on the maximum temperature rise recorded.Results  Only one combination of power setting (5) and duration of activation (15 s) resulted in temperature rise in excess of 10 °C. The maximum temperature rise at the mid‐root level was significantly (P < 0.001) greater than that recorded apically. It is also significantly affected by the combination of power setting and duration of activation.Conclusions  Temperature rises at the root surface during ultrasonic condensation of gutta‐percha in excess of 10 °C were evident in only one combination of power (5) and time (15 s) settings at the mid‐root level.
Laser Doppler flow measurements of pulpal blood flow and severity of dental injury
Authors: Emshoff R. , Emshoff I. , Moschen I. , Strobl H. 
Published: December 2004

AbstractAim  To evaluate laser Doppler flowmetry (LDF) measurements of pulpal blood flow (PBF) and severity of dental injury.Methodology  The relationship between adverse outcomes and PBF measurements was analysed in 94 permanent maxillary incisors of 71 consecutive dental trauma patients. The diagnostic adverse outcome group was comprised of 72 incisors in 52 patients with a type I (loss of sensitivity), type II (loss of sensitivity and periapical radiolucency), or type III (loss of sensitivity, periapical radiolucency and grey discoloration of crown) diagnosis. The nonadverse outcome group consisted of 22 incisors in 19 patients with the finding of an absence of an adverse outcome. At each session, when an injured permanent maxillary incisor was recorded, a contralateral homologous tooth was used as a control. An ordinal stepwise regression was completed to assess the degree of association between PBF measurements and adverse outcomesResults  Using chi‐square analysis for pairwise comparison, a significant relationship between PBF measurements and types of adverse outcomes (χ2 =119.635, d.f. = 12, P = 0.000) was observed. PBF measurements that were significantly associated with more severe outcome were PBF levels of ≤3 perfusion units (PU) (119.1 odds ratio) (P = 0.000), and those of >3 PU and ≤6 PU (12.7 odds ratio) (P = 0.000).Conclusions  PBF measurements were related to the severity of adverse outcomes. Further studies are required to evaluate whether PBF measurements can predict dental injuries that progress to adverse treatment outcomes.
The role of parental influence and additional factors in the determination of food choices for pre‐school children
Authors: Taylor Lindsay J. , Gallagher Marie , McCullough Fiona S.W. 
Published: December 2004

AbstractEvery pre‐school child requires an adult to purchase and provide a variety of foods, to help ensure a balanced selection is included in the diet to avoid any nutritional deficiencies. Children under 5 years have a greater demand for nutrients and energy to support the body's requirements for growth and development than at any other time throughout their life cycle. The paper critically reviews the main factors that influence food choices made by parents on behalf of their pre‐school child. Dietary deficiencies in inner city areas remain a challenge for the government, educators and health professionals. A particular concern is iron deficiency as the prevalence of anaemia is common especially in British pre‐school children from various family backgrounds. Poor parenting skills often exacerbate the problem, especially the early introduction of pasteurized cow's milk, poor weaning practices and lack of dietary knowledge. Therefore, improving education and understanding about the importance of iron could potentially improve dietary iron intake. Phase 1 of the study was completed in West Bridgford area of Nottingham in the UK. This part of the study aimed to determine parental knowledge with regards to the feeding of their pre‐school child. A questionnaire and a 3‐day diet history method were employed. These methods enabled the diet adequacy of the pre‐schoolers to be analysed by NetWISP software. This study highlighted that iron deficiency remains a cause for concern and should be further addressed. The Sure Start programme is a possible means of education as it has the potential to access parents from all socio‐economic classes. The programme can support and empower parents to become healthier consumers. Good dietary habits, established early in life, contributes to a positive start, and can be advantageous to individuals throughout their lifetime. Such long‐term changes will help contribute to a healthier nation that the government envisages for the future.