bluuebunny/crossref_metadata_2025_split huggingface dataset:
The focus group: a tool for programme planning, assessment and decision‐making—an American view*
Authors: Glitz Beryl , Hamasu Claire , Sandstrom Heidi 
Published: March 2003

AbstractThe objective of this paper is to describe the focus group process used with hospital librarians in the National Network of Libraries of Medicine, Pacific Southwest Region (NN/LM/PSR), in order to illustrate how focus groups can be effectively used in the library setting to plan programmes around identified needs.This paper explores the focus group methodology, a qualitative research technique, by discussing why it is used and the process involved in its use. Aspects of the methodology that are discussed include participant selection, question development, data analysis, and use of results in programme planning.The focus group findings assisted NN/LM/PSR in understanding the needs of hospital librarians related to integrating electronic resources into library services. The focus group data were used to determine the forum, content and speakers for a day‐long symposium and subsequent planning meeting.The use of the focus group technique to assess the needs of a specific group on a specific issue resulted in activities and programmes that met these needs successfully. Based on the experiences detailed in this paper, the authors are confident that focus groups are an effective tool for programme planning, needs assessment and decision‐making for all types of libraries.
A controlled vocabulary for nursing and allied health in Norway*
Authors: Flor Patricia , Jakobsson Arne , Mogset Ingrid , Taylor Solveig , Aasen Sigrun Espelien 
Published: March 2003

AbstractNursing and allied health libraries at educational institutions in Norway have generally indexed their book collections with uncontrolled terms. With the reorganization of higher education in 1994, the majority of these libraries joined BIBSYS, which is a joint library system for higher education and research in Norway. This has led to chaos when searching the joint catalogue for literature on nursing and related fields. A term such as ‘behaviour problems’ may have up to five synonyms. In an attempt to improve the quality of searching the health literature, BIBSYS appointed a working group in the Spring of 1999 to find a suitable controlled vocabulary for this subject area, and to see how this vocabulary could be integrated into BIBSYS. The group presented its recommendations in October 1999. The report has been well received by the BIBSYS Board and by user groups. There are no Norwegian vocabularies that are suitable for use in nursing and allied health, therefore it will be necessary to translate and combine existing thesauri. The group has looked at the Nordic Multilingual Thesaurus on Health Promotion, the Swedish Spriline Thesaurus, MeSH (Medical Subject Headings) and cinahl Subject Heading List. Other relevant thesauri are AMED/CATS Thesaurus, Bioethics Thesaurus (Bioethicsline) and the RCN thesaurus.The group recommends the development of a Norwegian thesaurus based on a translation of parts of MeSH and cinahl Subject Heading List.
Comparison of immunohistochemical staining of the novel antibody melan‐A with S100 protein and HMB‐45 in malignant melanoma and melanoma variants
Authors: Blessing  , Sanders  , Grant  
Published: March 2003

Aims:The staining pattern of the recently described antibody melan‐A was compared with those of S100 protein and HMB‐45 in a variety of melanocytic lesions to assess the specificity and sensitivity of these antibodies.Methods and results:Immunohistochemical staining of paraffin sections of a range of melanocytic lesions was carried out following a high temperature antigen retrieval technique. The pattern and intensity of staining was semiquantitatively scored. S100 remains the most sensitive marker of melanocytic differentiation being diffusely positive in all benign and all primary and secondary malignant lesions including naevoid melanomas, and in most desmoplastic/spindle cell melanomas. Of the two more specific melanocytic markers melan‐A stains the majority of benign and malignant lesions diffusely but with occasional patchy positivity only in some secondary melanoma deposits and with little staining of desmoplastic/spindle cell melanomas. HMB‐45 is the least sensitive of the three showing little positivity of benign mature naevus cells, only variable patchy positivity of primary and secondary melanoma cells and limited positivity in naevoid, desmoplastic and metastatic melanomas.Conclusions:Melan‐A is a useful addition to antibody panels as it is apparently specific for melanocytic lesions and is more sensitive than HMB‐45; however, it has less value than S100 in the detection of spindle cell and desmoplastic melanomas.
Pulmonary giant cell carcinoma: pathological entity or morphological phenotype?
Authors: Attanoos  , Papagiannis  , Suttinont  , Goddard  , Papotti  , Gibbs  
Published: March 2003

Aims:To evaluate the morphological spectrum and clinical significance of giant cell carcinoma and to assess the frequency of tumour giant cell production in a consecutive series of primary (non‐giant cell) lung tumours.Methods and results:Forty‐six cases of giant cell carcinoma of the lung were collated from two centres over a 12‐year period. Giant cell carcinoma was found to be associated with areas of clear cell carcinoma, spindle cell carcinoma and showed trophoblastic differentiation (syncytiotrophoblastic giant cells and β‐human chorionic gonadotrophin immunopositivity) in 57%, 34% and 26% cases, respectively. ‘Pure’ giant cell carcinoma was identified in five (11%) cases. Eleven of the tumours contained diastase‐resistant periodic acid–Schiff positive material and were separately designated as giant cell adenocarcinomas. Areas of squamous cell and neuroendocrine differentiation (as determined by chromogranin A and Leu‐7 immunopositivity) were not found. The median survival for giant cell carcinoma (excluding the giant cell adenocarcinomas) was 18 months. Median survival was not adversely affected by the extent of tumour giant cell formation or by the presence of trophoblastic differentiation. Of 200 consecutive non‐small cell lung carcinomas, tumour giant cells constituting < 10% of the tumour were identified in 32% of adenocarcinomas and 26% of squamous cell carcinomas.Conclusions:The presence of tumour giant cells in lung carcinoma does not, in itself, indicate a more aggressive tumour type. Giant cell carcinoma of the lung does not appear to be a distinct entity but a morphological phenotype expressed by a heterogenous group of tumours. We support and advocate the use of an encompassing term such as ‘pleomorphic’ or ‘anaplastic’ carcinoma for those tumours showing no specific differentiation pattern but which express diverse morphological features such as giant cell formation, clear or spindle cell change.
Localization of the cellular expression of inhibin in trophoblastic tissue
Authors: Mccluggage  , Ashe  , Mcbride  , Maxwell  , Sloan  
Published: March 2003

Aims:Inhibin is a peptide hormone which is normally produced by ovarian granulosa cells and which inhibits the release of follicle stimulating hormone from the pituitary gland, thus acting as a modulator of folliculogenesis. Serum inhibin levels are higher during pregnancy than during the normal menstrual cycle and the placenta is thought to be a source of circulating inhibin. Previous studies have yielded conflicting results as to the cellular localization of inhibin in the placenta and the aim of the present study was to investigate the immunohistochemical localization of the hormone in placental tissue. We also wished to investigate whether inhibin could be demonstrated in choriocarcinoma and in non‐gestational trophoblastic tissue.Materials and results:Immunohistochemical staining was performed using a monoclonal antibody against the α subunit of human inhibin. Specimens included in the study were intrauterine products of conception (n = 36), extrauterine products of conception (n = 4), decidualized endometrium (n = 15), extrauterine decidualized tissue (n = 3), hydatidiform mole (n = 5), uterine choriocarinoma (n = 2) and testicular embryonal carcinoma with syncytiotrophoblast giant cells (n = 6). In cases of products of conception, including hydatidiform mole, there was consistent strong positive staining of syncytiotrophoblast but no staining of cytotrophoblast with anti‐inhibin. Staining with anti‐inhibin highlighted trophoblastic cells within the placental bed. In a small number of cases there was focal weak positive staining of decidua. There was positive staining of the two cases of uterine choriocarcinoma and of syncytiotrophoblast giant cells in the six cases of testicular embryonal carcinoma.Conclusions:The study shows that immunohistochemically detectable inhibin α subunit in placental tissue is mainly localized within syncytiotrophoblast although in some cases there is also positive staining of decidua. Production of inhibin by these cells may account for raised serum levels during pregnancy. Inhibin can also be demonstrated in choriocarcinoma and in non‐gestational trophoblastic tissue. Inhibin is a sensitive marker of syncytiotrophoblast and staining with this antibody may prove useful in the diagnosis of choriocarcinoma and in the demonstration of trophoblastic cells in germ cell tumours.
Liver biopsy is a useful predictor of response to interferon therapy in chronic hepatitis C
Authors: Kaserer  , Fiedler  , Steindl  , Müller  , Wrba  , Ferenci  
Published: March 2003

AimTo evaluate the usefulness of easily assessable morphological parameters in liver biopsies in order to predict efficacy of interferon‐α (IFN) treatment in patients with chronic hepatitis C.Methods and resultsInflammatory activity and fibrosis (according to Scheuer), and the hepatic iron content (according to Rowe and DiBisceglie) were assessed in pre‐treatment liver biopsies of 73 de novo patients with chronic hepatitis C. Furthermore the presence of fat, lymphoid aggregates, and bile duct lesions was evaluated. With respect to IFN therapy patients were classified as responders alanine aminotransferase (ALT) normal and negative hepatitis C virus (HCV) RNA in serum at the end of treatment, n = 33) or non‐responders (n = 40). Non‐responders had more advanced fibrosis (P = 0.0001) and more extensive iron storage (P = 0.0008) than responders. In contrast absence of stainable iron was frequently (46%) associated with sustained response. Absence of fat droplets in hepatocytes was associated with response (P = 0.0001). Stepwise logistic regression analysis indicated that the stage of fibrosis, the hepatic iron grade, and the presence or absence of fat were independent predictors of response.ConclusionsLiver biopsy provides useful information for selection of patients with hepatitis C for IFN therapy.
Loss of bcl‐2 expression in ductal carcinoma in situ of the breast relates to poor histological differentiation and to expression of p53 and c‐erbB‐2 proteins
Authors: Quinn  , Ostrowski  , Harkins  , Rice  , Loney  
Published: March 2003

Aim: This study (1) investigates the incidence of bcl‐2 protein expression in a series of 108 cases of ductal carcinoma in situ (DCIS), including 25 with early invasive carcinoma, and (2) evaluates the relationship of bcl‐2 expression to the histological grade of DCIS and to the expression of oestrogen receptor (ER), c‐erbB‐2 and p53 proteins.Methods and resultsThe expression of bcl‐2, oestrogen receptor (ER), c‐erbB‐2 and p53 proteins was determined immunohistochemically. Cases were regarded as positive for individual antibodies when at least 10% of the DCIS cells showed positive staining. DCIS was graded histologically as well (n = 9), intermediately (n = 24), or poorly differentiated (n = 75). bcl‐2 expression was documented in 57 cases (53%) and was strongly associated with the histological grade of DCIS (P < 0.0001). All cases of well‐differentiated DCIS were bcl‐2 positive and loss of bcl‐2 expression was almost exclusively confined to poorly differentiated DCIS lesions. bcl‐2 expression was also closely associated with positive ER status (P < 0.0001). Forty‐seven of 57 (82%) bcl‐2 positive cases were ER positive while 49/51 (96%) bcl‐2 negative cases were ER negative. There was a significant inverse correlation between bcl‐2 expression and both p53 protein expression (P = 0.0004) and c‐erbB‐2 expression (P < 0.0001). Nineteen of 24 (79%) p53 positive cases and 38/45 (84%) c‐erbB‐2 positive cases showed loss of bcl‐2.ConclusionsLoss of bcl‐2 expression occurs in poorly differentiated DCIS and is related to negative ER status and to positive p53 and c‐erbB‐2 status. This pattern of bcl‐2 expression and its association with other biological markers in DCIS is similar to that reported in invasive breast carcinoma.
Hep Par 1 and selected antibodies in the immunohistological distinction of hepatocellular carcinoma from cholangiocarcinoma, combined tumours and metastatic carcinoma
Authors: S‐Y Leong A , Sormunen R T , Tsui W M S , Liew C T 
Published: March 2003

AimsTo examine the usefulness of Hep Par 1 together with selected antibodies in the separation of hepatocellular carcinoma (HCC) from cholangiocarcinoma (CC), combined tumours (HCC‐CC) and metastatic carcinoma.Methods and resultsAntibodies to Hep Par 1, CK19, CK20 and factor XIIIa were applied to 32 HCCs, 27 CCs, five HCC‐CCs and 19 metastatic carcinomas from a variety of sites. Hep Par 1 produced distinctive granular staining of all benign hepatocytes and stained 30 HCCs in a heterogeneous manner, irrespective of the degree of differentiation. While labelling all cases of combined HCC‐CC, the antibody also stained the mucus‐secreting cells of four cases of pure CC. Anti‐CK19 produced distinctive staining of bile ducts and CC but also decorated four HCCs and 10 metastatic tumours. Factor XIIIa was not found in normal, reactive or neoplastic hepatocytes. CK20 was found in some cases of HCC and CC and in all cases of metastatic carcinomas from the colon.ConclusionsHep Par 1 was a sensitive marker of hepatocytes but its variable staining in HCC may produce false negative results in small biopsies and it was occasionally found in CC. The highest diagnostic yield was obtained when anti‐Hep Par 1, CK19 and CK20 were used in a panel. Factor XIIIa staining has no role in the diagnosis of liver cancers.
Analysis of histopathological factors associated with prolonged survival of 10 years or more for patients with thick melanomas (> 5 mm)
Authors: Spatz A , Shaw H M , Crotty K A , Thompson J F , McCarthy S W 
Published: March 2003

AimsAlthough tumour thickness is the best predictor of melanoma prognosis in patients with localized cutaneous melanoma, prolonged survival occasionally occurs in patients with thick melanomas (> 5 mm). This study examined histological features which were associated with long‐term survival.Methods and resultsForty‐two patients with thick, vertical growth phase melanomas surviving 10 years or more after diagnosis were matched by clinical stage of disease, sex, age and anatomical site of the primary lesion with 42 patients with similar characteristics who died from their disease within 3 years of diagnosis. Fourteen histological factors were assessed in both groups. Tumours with spindle cell and Spitz‐like cell populations and those with low mitotic activity were significantly more frequently observed in long‐term survivors. There was also a significant excess of melanomas exhibiting desmoplasia and those lacking vascular invasion in the long‐term survivors.ConclusionsThese findings suggest that it may be useful to modify the current cutaneous melanoma classification on the basis of unusual cytological characteristics (as discussed at the recent 4th World Conference on Melanoma).
Blastic NK‐cell lymphoma expressing terminal deoxynucleotidyl transferase with Homer–Wright type pseudorosettes formation
Authors: Ko  , Kim  , Ree  
Published: March 2003

Aims: Rosette‐forming malignant lymphoma is very rare. We report a blastic NK‐cell lymphoma expressing terminal deoxynucleotidyl transferase (TdT) with formation of Homer–Wright type pseudorosettes.Methods and resultsAn 18‐year‐old boy presented with an enlarged inguinal lymph node. Histologically, the nodal architecture of the lymph node was diffusely effaced by small to medium sized monomorphic blastoid lymphoid cells which frequently formed Homer–Wright type pseudorosettes. Immunophenotyping of the tumour using immunohistochemistry and flow cytometry revealed LCA+, CD4+, CD56+, CD43+, TdT+, CD2−, cCD3−, CD8−, CD7−, CD34− and TIA‐1−. DNA analysis revealed no gene rearrangement of TCR β and γ genes. In situ hybridization for EBER 1 & 2 was negative. No azurophilic granules were found in the Wright stain. Complete remission was achieved with six cycles of chemotherapy with the CHOP regimen. The disease recurred in the paranasal sinuses and bone marrow 2 years later.ConclusionsImmunophenotypic and genotypic similarities of the present case to those of TdT‐negative blastic NK‐cell lymphoma suggest that these diseases might be categorized as one entity irrespective of expression of TdT.
Immunolocalization of BRCA1 protein in normal breast tissue and sporadic invasive ductal carcinomas: a correlation with other biological parameters
Authors: Lee  , Jin  , Chang  , Lin  , Su  
Published: March 2003

AimBRCA1, a nuclear phosphoprotein, normally functions as a negative regulator of the cell cycle and may be an active inhibitor of neoplastic progression. Mutation of the BRCA1 gene has been demonstrated in 80% of familial breast cancer. Decreased mRNA levels or aberrant subcellular locations of BRCA1 have been identified in breast cancer lines and in sporadic cases of breast cancer tissues. The expression of BRCA1 in large series of variously differentiated breast carcinomas with correlation with other biological parameters has not been clarified.Methods and resultsThe BRCA1 expression in normal breast tissue (n = 15) and in sporadic cases of invasive ductal carcinoma (n = 108) was determined using immunohistochemistry. BRCA1 expression was correlated with other prognostic parameters including p53, c‐erbB‐2, bcl‐2, oestrogen receptor (ER), histological grade, tumour size, axillary lymph node status and age. BRCA1 was exclusively (100%) localized in the nuclei of normal ductal and lobular epithelia. However, this nuclear expression pattern was variable in breast carcinoma (76.8%). Loss of nuclear BRCA1 expression (22 of 108 cases, 20.4%) correlated well with high histological grade (P < 0.025) and bcl‐2‐negative tumours (P < 0.05) and frequently in ER‐negative tumours.ConclusionBRCA1 nuclear expression could be considered to represent the normal or physiological phenotype. Complete loss of BRCA1 nuclear expression in breast cancer and its correlation with other poor prognostic markers suggest that BRCA1 expression may play an important role in the pathogenesis and prognosis of sporadic breast carcinoma. Altered BRCA1 phenotype may therefore provide an additional prognostic parameter for breast cancer.
Observer agreement on the grading of gastric atrophy
Authors: Offerhaus G J A , Price A B , Haot  , ten Kate F J W , Sipponen  , Fiocca  , Stolte  , Dixon M F 
Published: March 2003

AimsAssessment of lesser or doubtful degrees of gastric atrophy can be difficult, especially in the antrum, since well established criteria are lacking. At the Houston Working Party on Gastritis in 1994 a visual analogue scale was designed for the grading of histopathological parameters. This was done to promote uniformity in grading by acting as a reference. The purpose of the present study was to measure interobserver variation between pathologists familiar with the Houston visual analogue scale in a specifically selected set of biopsies from patients with lesser or doubtful degrees of atrophy.Methods and resultsThirty cases with biopsies of the antrum and corpus from a long‐term follow‐up study on Helicobacter pylori gastritis comprised the current study material. The cases were selected from that study because there had been uncertainty or disagreement on the presence of gastric atrophy. The study set of haematoxylin and eosin (H & E) slides was circulated amongst gastrointestinal pathologists familiar with the visual analogue scale who were unaware of the source of the study set nor had any other clinical information. Interobserver variability was analysed using kappa statistics. The overall agreement for the grade of atrophy in antral biopsies was 0.461; the kappa value was 0.18 (95% confidence limits 0.12–0.24), which is considered poor agreement. The kappa value was nevertheless statistically significant (P < 0.01). The overall agreement on the grade of atrophy in the corpus biopsies was apparently good (0.833), but the kappa which adjusts for chance agreement was only moderate (0.48; 95% confidence limits 0.42–0.55; P < 0.001).ConclusionThe studied series comprised a self‐selected sample in which there was doubt about the grade of atrophy and such a sample will produce lower kappa values than a random sample of gastric biopsies. The results nevertheless confirm that better guidelines and firm criteria are needed to properly diagnose and grade gastric atrophy. It is suggested that the use of two grades, low‐ and high‐grade atrophy, akin to that in use for grading inflammatory bowel disorder (IBD)‐ associated dysplasia, could improve agreement. Furthermore optimal biopsy quality with full thickness mucosa and proper orientation appears important for grading gastric atrophy.
Irreversible glomerular lesions induced by crystal precipitation in a renal transplant after foscarnet therapy for cytomegalovirus infection
Authors: Justrabo  , Zanetta  , Martin  , Assem  , Mousson  , Maurice‐Estepa  , Rifle  , Tanter  
Published: March 2003

AimsFoscarnet is an antiviral agent used to treat cytomegalovirus infection in AIDS patients and in transplant recipients. In most cases, foscarnet induces reversible tubulo‐interstitial lesions which can be avoided by correct hydration. We report the first case of crystal foscarnet precipitation within glomerular capillaries in a renal transplant.Methods and resultsThe recipient, a 49‐year‐old man, developed a nephrotic syndrome with haematuria and an acute renal failure after foscarnet therapy for cytomegalovirus (CMV) infection. The polarization examination of the first graft biopsy revealed the presence of birefringent crystals within glomeruli and tubules. Infrared analysis attested to the presence of trisodium foscarnet salts and mixed sodium calcium salts coloured by Von Kossa’s reaction. A second biopsy showed glomerular sclerosis, interstitial fibrosis, tubular atrophy and crystal vanishing. Polymerase chain reaction (PCR) in situ applied to this biopsy confirmed the diagnosis of cytomegalovirus infection.ConclusionsThese adverse effects might be the result of a toxic synergy between foscarnet and other drugs. In cases with crystalline precipitation, graft biopsy remains the best mean of diagnosis and follow‐up of glomerular damage.