bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metastatic adenocarcinoma of the esophagus to the skin: new patterns of tumor recurrence and alternate treatments for palliation
Authors: Smith Kathleen J. , Williams John , Skelton Henry 
Published: March 2003

Background: Esophageal cancer, particularly adenocarcinoma of the esophagus (ACE), has been steadily increasing in incidence in the United States. In the past, patients usually died rapidly with locoregional disease that leads to inanition and aspiration. However, today when patients with ACE are treated successfully with induction chemotherapy and radiation therapy, followed by surgical excision, ACE usually does not recur locally, but presents with metatastic disease. We present a 62‐year‐old white male with ACE, which was treated with induction chemotherapy and radiation therapy followed by surgical excision. After approximately 1 year with no evidence of locoregional recurrence, the patient presented with diffuse cutaneous metastatic disease.Methods: In addition to routine staining immunohistochemical stains for CK(AE1/AE3), CK7, CK 20, EMA, α‐smooth muscle (SM) actin, S‐100 protein, CD34, P53, Bcl‐2, c‐erbB‐2 were performed.Results: The immunohistochemical profile was consistent with an esophageal origin showing positive staining with CK20 and CK7 as well as AE1/AE3 and EMA. In addition, there was marked nuclear expression of p53, as well as membrane expression of c‐erb‐B2; consistent with progression of the disease and poor response to further cytotoxic therapeutic regimes.Conclusions: With new therapeutic protocols, we can expect to see more metastatic disease with recurrences of ACE. The histopathologic features and the immunohistochemical profile of the recurrent tumors may be helpful in determining alternate forms of therapy that either alone or in combination could be useful in palliation and delaying progression.()
Loss of tuberin, the tuberous‐sclerosis‐complex‐2 gene product is associated with angiogenesis
Authors: Nguyen‐Vu Phuong‐Anh , Fackler Ingrid , Rust Adelheid , DeClue Jeffrey E. , Sander Christian A. , Volkenandt Matthias , Flaig Michael , Yeung Raymond S. , Wienecke Ralf 
Published: March 2003

Background: Tuberous sclerosis complex (TSC) is an autosomal dominantly inherited disorder associated with an alteration of the TSC2 tumor suppressor gene which encodes for the protein product tuberin. The disease is characterized by the development of hamartomas, e.g. cutaneous angiofibromas which consist of vascular cells, interstitial cells, and normal components of the skin. The Eker rat model, an animal model of inherited cancer, has been shown to carry a mutation of TSC2.Methods: Immunohistochemical analyses of human angiofibromas were performed using antibodies directed against tuberin and angiogenic growth factors. Proliferation of human dermal microvascular endothelial cells (HDMEC) was determined after incubation with the supernatants of TSC2 (+/+) and TSC2 (−/−) rat embryonic fibroblasts (REF) that were derived from the Eker strain.Results: Loss of the expression of tuberin was observed in the interstitial cells of 13 of 39 angiofibromas. The expression of tuberin was retained in the vascular cells. In all analyzed angiofibromas, the angiogenic factors bFGF, PD‐ECGF, VEGF and angiogenin were detected in the interstitial cells and/or vascular cells. Expression of PDGF‐B and TGF‐β1 was weak. Tissue culture supernatants from TSC2 (−/−) REF stimulated the growth of HDMEC significantly more than supernatants from TSC2 (+/+) REF.Conclusion: A functional loss of tuberin may stimulate vascular growth.
Primary chondroid melanoma
Authors: Ackley Christopher D. , Prieto Victor G. , Bentley Rex C. , Horenstein Marcelo G. , Seigler Hilliard F. , Shea Christopher R. 
Published: March 2003

Background: Malignant melanoma is notorious for the wide range of histologic patterns it can assume, among the least frequent of which is chondroid melamona.Methods: Two cases of primary chondroid melanoma of the distal lower extremity were studied. Tissue for light microscopy was fixed in formalin, embedded in paraffin, and processed routinely. In one case, transmission electron microscopy and immunohistochemical evaluation were performed.Results: Both cases exhibited melanoma in‐situ, a conventional (non‐chondroid) invasive component, and areas of chondroid differentiation, as confirmed by strongly positive staining with Alcian blue at pH 2.5 and Safranin O. Immunohistochemically, one case expressed S‐100 protein and vimentin, and did not express gp100 (HMB‐45), tyrosinase, MART‐1, the Mel‐5 antigen, the NKI/C3 antigen, CD45Ro, cytokeratin, or desmin. Electron microscopy of the chondroid component revealed occasional tumor cells with rare, membrane‐bound, electron‐dense organelles; the extracellular compartment showed amorphous ground substance consistent with cartilaginous differentiation.Conclusions: Chondroid change in the absence of osteogenic differentiation is extremely rare in malignant melanoma. Melanoma should be considered in the differential diagnosis of primary cutaneous neoplasms exhibiting cartilaginous differentiation.
Absence of Borrelia burgdorferi DNA in cutaneous B‐cell lymphomas from the United States
Authors: Wood Gary S. , Kamath Nandan V. , Guitart Joan , Heald Peter , Kohler Sabine , Smoller Bruce R. , Cerroni Lorenzo 
Published: March 2003

Background: An association between Borrelia burgdorferi and cutaneous B‐cell lymphoma (CBCL) has been made in several European countries. The evidence in favor of such an association has recently been based on more definitive tests for the pathogenetic role of B. burgdorferi in CBCL, including positive cultures or polymerase chain reaction (PCR) amplification of borrelial DNA from lesional skin. However, there is only one report of B. burgdorferi in four North American cases of B‐cell lymphoma.Methods: We retrieved 38 cases of primary and secondary CBCL from different geographic regions of the United States. Two separate techniques were used to detect borrelial DNA by PCR, a nested PCR method to amplify a B. burgdorferi‐specific gene as well as a borrelial chromosomal Ly‐1 clone amplification method. Southern blot hybridization was used for confirmation of the PCR results.Results: No B. burgdorferi‐specific DNA was detected in any of the 38 CBCL cases, whereas detectable PCR products were obtained with our positive controls.Conclusions: Our findings, in light of previous studies, suggest that B. burgdorferi plays a minimal role in the development or pathogenesis of CBCL in the United States. The findings also suggest that the geographic variations in the clinical manifestations of B. burgdorferi are indeed real and may be secondary to the genetic and phenotypic differences between B. burgdorferi strains present in Europe and North America.
CD‐34 and Ki‐67 staining patterns of basaloid follicular hamartoma are different from those in fibroepithelioma of Pinkus and other variants of basal cell carcinoma
Authors: Naeyaert J. M. , Pauwels C. , Geerts M. L. , Verplancke P. 
Published: March 2003

Background and aims: Basaloid follicular hamartoma is a rare disorder regarded as a developmental malformation. It may be solitary or generalized, linear or regionalized, and is sometimes associated with myasthenia gravis or alopecia. We compared immunohistochemical staining patterns of selected markers in order to differentiate this hamartoma from fibroepithelioma of Pinkus, a basal cell carcinoma variant it can be confused with.Methods: The expression of three immunohistochemical markers – CD‐34, Ki‐67, bcl‐2 – was studied in a basaloid follicular hamartoma and in a fibroepithelioma of Pinkus. Two basal cell carcinomas, a nodular and a fibrosing type, and a trichoepithelioma were included as controls.Results: Basaloid follicular hamartoma shows a low proliferation index and an at least focally circumferential expression of CD‐34 around the epithelial strands. This compares to the findings in trichoepithelioma. In contrast, fibroepithelial tumor of Pinkus and two other basal cell carcinoma subtypes display a high proliferative index and an absence of CD‐34 expression around the epithelium. These findings support the non‐neoplastic nature of basaloid follicular hamartoma.
Primary cutaneous lymphoblastic lymphoma presenting in an 8‐week old infant
Authors: Trupiano Jacqueline K. , Bringelsen Karen , Hsi Eric D. 
Published: March 2003

Background:  We report a case of primary cutaneous lymphoblastic lymphoma (LBL) presenting in an 8‐week‐old infant.Methods:  Histopathology and flow cytometric analysis confirmed the diagnosis of a lymphoblastic lymphoma. The cells expressed CD19, CD20, CD34 and surface immunoglobulin (sIg).Results:  The cells were negative for TdT and CD99. This unusual immunophenotype has been described as “transitional pre‐B‐cell”, in that the cells express both immature markers (CD34) and mature markers (sIg).Conclusions:  To our knowledge, only five other cases of sIg positive precursor B‐cell LBL have been reported in the literature. This may represent the youngest reported case of primary cutaneous LBL, occurring at 8 weeks of age.
Simultaneous detection of receptor mRNA and ligand protein in human skin tissues
Authors: Fischer Tanja C. , Dinh Q. Thai , Peiser Christian , Löser Christoph , Fischer Axel , Groneberg David A. 
Published: March 2003

Background:  In situ hybridization techniques allow a cell‐type‐specific messenger RNA (mRNA) analysis in complex tissues such as human skin.Methods: To evaluate both the expression of mRNA and protein within the same tissue section, we developed a protocol of combined non‐radioactive in situ hybridization and immunohistochemistry for use in dermatohistopathology. To validate the technique, we assessed the distribution of vasoactive intestinal polypeptide (VIP) protein and its receptor, VPAC2 mRNA, in human skin samples.Results: Simultaneous detection of VPAC2 mRNA and VIP immunoreactivity led to abundant staining for both signals in a variety of cell types. There was marked staining for VPAC2 mRNA in epidermal cells, with most pronounced hybridization signals found in keratinocytes of the basal layer and in glandular cells surrounded by VIP‐immunoreactive nerve fibers. Hair follicle cells next to VIP‐positive fibers also exhibited hybridization signals. Specific staining was also detected in endothelial and mononuclear cells. The findings of simultaneous in situ hybridization and immunohistochemistry were identical to results obtained by the single application of both methods.Conclusions:  The combination of in situ hybridization and immunohistochemistry appears to be a promising technique to assess the expression of both protein and mRNA in skin samples and may be used for various purposes in experimental and clinical dermatopathology.
Cutaneous Destombes–Rosai–Dorfman disease: absence of detection of HHV‐6 and HHV‐8 in skin
Authors: Ortonne N. , Fillet A. M. , Kosuge H. , Bagot M. , Frances C. ,   Janine Wechsler
Published: March 2003

Background:  We report three new cases of cutaneous Destombes–Rosai–Dorfman disease (DRDD). Two were skin‐limited, and one was associated with systemic involvement. In all cases typical large S100 positive macrophages with emperipolesis were present, but different patterns were seen. A viral etiology has long been suspected in DRDD.Methods:  Thus, all cases were investigated for presence of HHV‐6 major capcid protein gene by polymersae chain reaction (PCR), and for presence of HHV‐8 latency‐associated nuclear antigen 1 by immunohistochemistry.Results:  All results were negative. HHV‐6 antibody tests were positive for IgG but not for IgM in one case. With regard to HHV‐6, previous studies supplied inconclusive results while, to our knowledge, HHV‐8 has never been investigated in DRDD.Conclusion:  This study suggests that HHV‐8 is not involved in the pathogenesis of cutaneous DRDD. However, this should be confirmed by further studies. We can postulate three hypotheses in regard to HHV‐6 role in DRDD pathogenesis: 1) its presence in lesionnal tissues is fortuitous, 2) HHV‐6 plays a role in promoting more agressive diseases and 3) various causes, including HHV‐6, are implicated in the pathogenesis of DRDD.
Benign lichenoid keratoses with histologic features of mycosis fungoides: clinicopathologic description of a clinically significant histologic pattern
Authors: Al‐Hoqail Ibrahim A. , Crawford Richard I. 
Published: March 2003

Background: Benign lichenoid keratosis (BLK) is a well‐known clinicopathologic entity and several histopathologic patterns havebeen described. Features mimicking mycosis fungoides (MF) in clinically typical BLKs have not yet been emphasized. The aim of this study was to confirm the occurrence of an MF‐like pattern of BLK. Methods: A retrospective survey was conducted on cases diagnosed as BLK over a 9‐month period in a regional dermatopathology service. Seven histologic parameters, previously confirmed as diagnostically suggestive of MF, were applied. Inclusion criteria were: three or more MF‐related histologic features and a size less than 2 cm. The clinical features were reviewed. Results: Fifteen cases of MF‐pattern BLK were identified. The number of MF‐like parameters present in individual cases exceeded the inclusion criteria by variable amounts. Pautrier microabscesses and alignment of lymphocytes along the basal layer were the most frequent (14/15). The age of the patients ranged from 28 to 83 years, with a mean of 50. The size of the lesions ranged from 0.2 to 1.8 cm, with a mean of 0.6 cm. The upper trunk was the favored site. Most of the lesions had been removed because of suspicion of cutaneous malignancy; basal cell carcinoma was the most frequent clinical diagnosis. Conclusion: We describe an MF‐like histologic pattern of BLK. Pathologists and dermatopathologists should be aware of this novel histologic pattern to facilitate distinction between the two disorders.
The value of molecular analysis by PCR in the diagnosis of cutaneous lymphocytic infiltrates
Authors: Holm Niels , Flaig Michael J. , Yazdi Amir S. , Sander Christian A. 
Published: March 2003

The diagnosis and classification of cutaneous lymphomas remain a challenge for the clinician and dermatopathologist. This diagnostic dilemma is mainly encountered in the distinction between an early malignant lymphoma and a benign reactive lymphocytic infiltrate (pseudolymphoma). Until the beginning of the 1980s, our diagnostic tools were limited to the clinical presentation, course, and histopathology in diagnosis and classification of lymphocytic infiltrates. Advances in immunology and, in particular, in molecular genetics with the introduction of the Southern blot technique and the polymerase chain reaction (PCR) have revolutionized the diagnosis of lymphocytic infiltrates by determination of clonality. In some series, more than 90% of cutaneous T‐cell lymphomas have a clonal rearrangement of the T‐cell receptor γ‐chain gene, as opposed to very low percentages of rearrangement in T‐cell pseudolymphomas.However, the presence of clonality does not necessarily imply malignancy. Cases of pseudolymphomas, lichen planus and pityriasis lichenoides et varioliformis acuta were reported with clonal lymphocytic proliferations. Therefore, care should be exercised in the evaluation of the results of molecular analysis, and these should always be correlated with the clinical, histological and immunophenotypic picture to arrive at the correct diagnosis. It may be expected that the molecular methods for diagnosis of lymphocytic infiltrates will be improved and refined in future, and that sensitivity and specificity will increase.
Physician Referral Patterns and Race Differences in Receipt of Coronary Angiography
Authors: LaVeist Thomas A. , Morgan Athol , Arthur Melanie , Plantholt Stephen , Rubinstein Michael 
Published: March 2003

Objective. This study addresses the following research questions: (1) Is race a predictor of obtaining a referral for coronary angiography (CA) among patients who are appropriate candidates for the procedure? (2) Is there a race disparity in obtaining CA among patients who obtain a referral for the procedure?Study Setting. Three community hospitals in Baltimore, Maryland.Study Design. We abstracted hospital records of 7,927 patients from three hospitals to identify 2,653 patients who were candidates for CA. Patients were contacted by telephone to determine if they received a referral for CA. Logistic regression was used to assess whether racial differences in obtaining a referral were affected by adjustment for several potential confounders. A second set of analyses examined race differences in use of the procedure among a subsample of patients that obtained a referral.Principal Findings. After controlling for having been hospitalized at a hospital with in‐house catheterization facilities, ACC/AHA (American College of Cardiology/American Heart Association) classification, sex, age, and health insurance status, race remained a significant determinant of referral (OR=3.0, p<.05). Additionally, we found no significant race differences in receipt of the procedure among patients who obtained a referral.Conclusions. Our results demonstrate that race differences in utilization of CA tend to occur during the process of determining the course of treatment. Once a referral is obtained, African American patients are not less likely than white patients to follow through with the procedure. Thus, future research should seek to better understand the process by which the decision is made to refer or not refer patients.
Instructional multimedia programs for self‐directed learning in undergraduate and postgraduate training in orthodontics
Authors: Aly M. , Willems G. , Carels C. , Elen J. 
Published: March 2003

Objectives:  The objectives of this study were to develop and evaluate an interactive multimedia courseware package in orthodontics and to provide dental undergraduate and postgraduate students with an interactive means of self‐study and self‐evaluation.Methods:  A commercially available software authoring system was used to develop the courseware package. The courseware was presented for evaluation through a questionnaire to four different groups of undergraduate and postgraduate students. Each group consisted of 25 students. The first three groups were third, fourth, and fifth year of dental curriculum at the Katholieke Universiteit Leuven, Belgium. The fourth group comprised postgraduate students. A one‐way ANOVA was carried out in order to check for statistical differences, whereas a Scheffe's test was used in order to locate the statistical differences between groups. The p value was set at 0.05.Results:  The majority of undergraduate and postgraduate students in this study were very enthusiastic about this form of educational approach (74/100) because it was experienced as very helpful in understanding the orthodontic curriculum more efficiently (98/100).Conclusions:  The program provides both undergraduate and postgraduate dental students with a useful interactive means of self‐study and self‐evaluation.
CyclOBEAP (cyclophosphamide, vincristine, bleomycin, etoposide, doxorubicin, prednisolone) regimen with granulocyte colony‐stimulating factor (G‐CSF) for patients with aggressive non‐Hodgkin's lymphoma: a pilot study
Authors: Niitsu Nozomi , Okamoto Masataka , Kuraishi Yasuaki , Nakamura Shinobu , Kodama Fumio , Hirano Masami 
Published: March 2003

Abstract: We conducted a multi‐institutional collaborative study to examine the usefulness and safety of third‐generation chemotherapy CyclOBEAP (cyclophosphamide, vincristine, bleomycin, etoposide, doxorubicin, prednisolone) combined with granulocyte colony‐stimulating factor (G‐CSF) in the treatment of aggressive non‐Hodgkin's lymphoma (NHL). Subjects included patients with aggressive NHL who were 60 yr of age or younger and had been diagnosed as having a low–intermediate, high–intermediate, or high risk using the International Prognostic Index (IPI). A total of 24 patients were enrolled in the study between May 1997 and March 1998, including 9 low–intermediate‐risk cases, 13 high–intermediate‐risk cases and 2 high‐risk cases. Although all 24 patients were originally enrolled in the study, one adult T‐cell leukemia/lymphoma case was subsequently excluded. Thus, in the end, 23 cases were evaluated. Evaluation of the efficacy of therapy revealed complete remission in 20 patients (87%). Of these 20 patients, 8 were low–intermediate‐risk cases (89%) and 12 were either high–intermediate‐ or high‐risk cases (86%). Partial remission was achieved in 2 patients (8.7%). The 2‐yr survival rate was 91.3%, and the 2‐yr disease‐free survival rate was 81.8%. Grade 3 or higher adverse reactions were granulocytopenia (87%), thrombocytopenia (17.4%) and liver dysfunction (4.3%). CyclOBEAP therapy has been associated with a high remission rate for aggressive NHL. When combined with G‐CSF, a high relative dose intensity was maintained for each drug administered (0.94–0.97). Furthermore, although the observation period was short, both the survival rate and disease‐free survival rate were good. Hence, we concluded that there were no problems associated with the procedure in terms of safety.
Characteristics of haemopoietic progenitor cells related to CD34 epitope class expression
Authors: Steen Rita , Tjønnfjord Geir E. , Grøseth Lill Anny Gunnes , Egeland Torstein 
Published: March 2003

Abstract: Haemopoietic progenitor cells (HPCs) express the CD34 molecule, a heavily glycosylated transmembrane protein displaying three main classes of epitopes. The CD34 epitope class expression may vary between different subsets of HPCs. The aim of this study was to characterise the subsets of HPCs expressing CD34 class II and III epitopes. The cells were studied for coexpression of activation‐, lineage‐ and adhesion‐associated molecules, and their clonogenic ability and morphological features were examined.CD34+ HPCs expressing class III epitopes outnumbered those expressing class II. Class III expressing HPCs were enriched for CFU‐GM and BFU‐E and cells coexpressing CD13, CD33, c‐kit and CD71 compared to class II expressing HPCs. CD34+ cells exclusively expressing class III epitopes uniformly displayed CD13 and CD33; they had a high clonogenic capacity and morphological characteristics of promyelocytes and myelocytes.The data show that class III epitopes are distributed more broadly on CD34+ HPCs than are class II epitopes, and that lack of class II epitopes is confined to CD34+ HPCs at a late stage of myeloid differentiation. The higher number of class III expressing HPCs coexpressing c‐kit and CD71 suggests that these cells exhibit a higher proliferative or differential potential than do HPCs expressing class II epitopes.