bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intra‐epidermal and intra‐dermal sebocrine adenoma with cystic degeneration and hemorrhage
Authors: Mahalingam Meera , Byers H. Randolph 
Published: March 2003

Background: The ducts of eccrine glands may give rise to intra‐epidermal, confluent epithelial and intra‐dermal adenomas known as hidroacanthoma simplex, eccrine poroma, and dermal duct tumor, respectively. An apocrine and sebaceous counterpart of the eccrine poroma has been described by several authors as adnexal, poroma‐like adenoma with apocrine and sebaceous differentiation or sebocrine adenoma.Methods: Using clinical history and routine histologic techniques, we describe a new lesion with features similar to sebocrine adenoma but representing the intra‐epidermal and intra‐dermal counterparts with cystic degeneration and hemorrhage. Briefly, an 84‐year‐old female presented with a 6mm dark tan papule on the neck that clinically appeared as an unusual macular seborrheic keratosis with underlying hemorrhage.Results: Histopathological examination showed a benign dermal cystic appendage tumor with pale polygonal cells, occasional non‐keratinizing ducts, sebaceous differentiation and central hemorrhage with fibrin deposits. Serial sections did not reveal any epidermal connection. However, epithelioid cells with large nuclei in an intra‐epidermal pagetoid pattern were focally seen.Conclusion: These findings represent a new cystic, hemorrhagic variant of sebocrine adenoma.
The utility of cytokeratin 5/6 in the recognition of cutaneous spindle cell squamous cell carcinoma
Authors: Sigel Jessica E. , Skacel Marek , Bergfeld Wilma F. , House Nancy S. , Rabkin Michael S. , Goldblum John R. 
Published: March 2003

Background: Cutaneous spindle cell squamous cell carcinoma (SSCC) is a challenging diagnosis since it may be difficult to distinguish from spindle cell melanoma, leiomyosarcoma and atypical fibroxanthoma. Furthermore, it may be difficult to demonstrate epithelial differentiation by a traditional immunohistochemical panel. We performed an expanded immunohistochemical evaluation of ultrastructurally documented SSCC to assess its utility in diagnosing this entity.Methods: We identified 16 cases of SSCC that were composed predominantly of spindle‐shaped cells and with ultrastructural evidence of epithelial differentiation (i.e. at least rudimentary cell junctions). Immunohistochemical analysis using antibodies to a variety of cytokeratins (AE1/3, K903, CK5/6) and S‐100 protein was performed. The extent of immunostaining was graded on a scale of 0 to 4+ (0: no staining; 1+: ≤25%; 2+: 26–50%; 3+: 51–75%; 4+: >75%).Results: Of the 16 cases, 6 expressed AE1/3 (38%), 8 expressed K903 (50%) and 11 (69%) expressed CK5/6. Six cases were positive for all three CK markers and two cases were positive for both K903 and CK5/6 but negative for AE1/3. Three cases (19%) stained for CK5/6 without any staining for AE1/3 or K903. Five cases (31%) were negative for all epithelial markers. The extent of CK5/6 staining was either similar to or greater than K903 staining in 7 of 8 cases that stained with both markers. All 16 cases were negative for S‐100 protein.Conclusions: Including CK5/6 in the initial battery of immunostains performed on a cutaneous spindle cell neoplasm can help demonstrate epithelial differentiation in SSCC, even in the absence of AE1/3 or K903 staining. However, some cases of cutaneous SSCC can only be confirmed ultrastructurally, as up to one‐third may not show evidence of epithelial differentiation using an expanded immunohistochemical panel.
Vascular endothelium express CS‐1 fibronectin in allergic contact dermatitis
Authors: Martín A. P. , Ortiz S. , Cabalier M. E. D. , Frede S. , Burgos E. , Hliba E. , Serra H. 
Published: March 2003

Background: Allergic contact dermatitis (ACD) is a common human dermatosis in which not all the mechanisms involved in its pathogenesis have been elucidated. Objective: To study the expression of CS‐1 fibronectin, TARC and Th1‐associated chemokine receptors in biopsies from allergic patch test reactions. Material and methods: Thirteen patients already diagnosed with ACD were challenged on the back with the antigen responsible of the disease and macroscopic responses and biopsies taken after 48 h. Skin biopsies from negative control challenge sites, AD and ICD were also taken. Samples were fixed, embedded in paraffin wax and processed in order to perform histological and immunohistochemical studies. Results: All subjects with ACD showed a positive clinical response and a perivascular mononuclear cell infiltration at 48 h, which was not seen in the negative controls. The majority of skin‐infiltrating cells were CD4+ and CD8+ and up to 54% or 40% of them expressed CXCR3 or CCR5, respectively. We also showed expression of CS‐1 fibronectin in inflamed endothelial cells not only in ACD but also in AC and ICD. In contrast TARC was only expressed in ACD and AC. Conclusion: We showed for the first time that CS‐1 fibronectin is expressed in dermal vessels from allergic patch tests positive reactions, as well as irritant and atopic skin lesions.
Expression of polo‐like kinase (PLK1) in thin melanomas: a novel marker of metastatic disease
Authors: Kneisel Lucas , Strebhardt Klaus , Bernd August , Wolter Manfred , Binder Angelika , Kaufmann Roland 
Published: March 2003

Background: The maximum thickness of a primary malignant melanoma as measured by Breslow's method is currently the most important prognostic factor. However, some thin melanomas (≤ 0.75 mm), which should have an excellent prognosis according to Breslow, can be lethal due to their ability to metastasize. Methods: In our study, thin malignant melanomas (≤ 0.75 mm) from 36 patients were analyzed with immunohistochemical techniques using monoclonal antibodies directed against PLK1 and Ki‐67. The immunoreactivity of 22 melanomas which developed metastases within 5 years of follow‐up was compared with a group of 14 non‐metastasized melanomas. Two independent investigators evaluated stained sections. Differences of PLK1 and Ki‐67 indices between melanomas with and without metastases were tested statistically using the Mann–Whitney U‐test. Results: Malignant melanomas with metastases expressed PLK1 at markedly elevated levels compared to melanomas without metastases (median, 60.00% vs. 37.98%; p = 0.000053). The difference of the Ki‐67 index between both groups was not significant (median, 6.35% vs. 4.53%; p = 0.150473). Conclusions: Our results suggest that PLK1 expression in thin melanomas is a reliable marker to identify patients at high risk for metastases.
Strict correlation between uPAR and plakoglobin expression in pemphigus vulgaris
Authors: Lo Muzio Lorenzo , Pannone Giuseppe , Staibano Stefania , Mignogna Michele Davide , Rubini Corrado , Farronato Giampietro , Ferrari Francesca , Nocini Pier Francesco , De Rosa Gaetano 
Published: March 2003

Background:  Recent studies have reported nuclear delocalization of plakoglobin in acantholytic pemphigus vulgaris cells. The objective of this study was to evaluate the role of plakoglobin in the pathogenesis of acantholysis in pemphigus vulgaris (PV) and its relation with the urokinase‐type plasminogen activator receptor (uPAR) expression.Materials and methods:  Plakoglobin and uPAR expressions were evaluated by immunohistochemistry in 22 cases of PV at various stages of the disease, and as controls in 18 specimens of skin/oral mucosa from healthy patients.Results:  Healthy skin/normal oral mucosa showed strong plakoglobin expression in the basal and spinous layers with prevalent cellular membrane distribution; the intensity of staining progressively decreased toward the superficial layers of the epithelium. In PV patients, a progressive displacement of the plakoglobin signal toward the nucleus was found in 18/22 of the cases. Healthy skin/normal oral mucosa showed low uPAR expression with prevalent cellular membrane distribution. In the PV patients, strong uPAR expression was present in the acantholytic cells in 16/22 of the cases. There was direct correlation (p < 0.05) between the uPAR expression and nuclear plakoglobin.Conclusions:  The uPAR overexpression in acantholytic PV may be considered a direct consequence of plakoglobin abnormal distribution. Nuclear delocalization of plakoglobin, a direct consequence of plakoglobin‐Dsg‐3 dissociation induced by PV IgG, probably induces uPAR overexpression. This evidence suggests a central role for plakoglobin in PV pathogenesis because of its delocalization toward the nucleus, which is the probable cause of the uPAR gene expression.
The 2030 Problem: Caring for Aging Baby Boomers
Authors: Knickman James R. , Snell Emily K. 
Published: March 2003

Objective.To assess the coming challenges of caring for large numbers of frail elderly as the Baby Boom generation ages.Study Setting.A review of economic and demographic data as well as simulations of projected socioeconomic and demographic patterns in the year 2030 form the basis of a review of the challenges related to caring for seniors that need to be faced by society.Study Design.A series of analyses are used to consider the challenges related to caring for elders in the year 2030: (1) measures of macroeconomic burden are developed and analyzed, (2) the literatures on trends in disability, payment approaches for long‐term care, healthy aging, and cultural views of aging are analyzed and synthesized, and(3)simulations of future income and assets patterns of the Baby Boom generation are developed.Principal Findings.The economic burden of aging in 2030 should be no greater than the economic burden associated with raising large numbers of baby boom children in the 1960s. The real challenges of caring for the elderly in 2030 will involve: (1) making sure society develops payment and insurance systems for long‐term care that work better than existing ones, (2) taking advantage of advances in medicine and behavioral health to keep the elderly as healthy and active as possible, (3) changing the way society organizes community services so that care is more accessible, and (4) altering the cultural view of aging to make sure all ages are integrated into the fabric of community life.Conclusions.To meet the long‐term care needs of Baby Boomers, social and public policy changes must begin soon. Meeting the financial and social service burdens of growing numbers of elders will not be a daunting task if necessary changes are made now rather than when Baby Boomers actually need long‐term care.
An investigation into the use of a structured clinical operative test for the assessment of a clinical skill
Authors: Scott B. J. J. , Evans D. J. P. , Drummond J. R. , Mossey P. A. , Stirrups D. R. 
Published: March 2003

Aim: This study was designed to investigate the level of agreement between a group of assessors observing students undertaking a structured clinical operative test.Method: 3 assessors agreed a series of criteria to assess the performance of undergraduate students in the recording of a dental impression. Guidelines for assessing whether the students adequately performed in relation to each criteria were also agreed. Following preliminary validation between the assessors, 2 assessors independently scored the performance of each student by reference to the agreed criteria, and the levels of agreement between assessors were compared. The 3 assessors worked in pairs with each other on three groups of students who were in the early stages of their clinical course.Results: A total of 39 clinical dental students were assessed in the recording of a dental impression. The 3 pairs of assessors had satisfactory levels of agreement in the study with similar judgements being made on 90% or more of the 12 criteria assessed. Some differences existed between the pairs of assessors. Certain criteria were more easily judged than others and this was reflected in the level of agreement seen. For over 90% of the criteria, positive assessments were made by each of the 3 assessors, and although there were minor variations between the pairs of assessors, this may have reflected the ability of the groups of students studied.Conclusion: The study showed that different assessors were generally able to make agreed judgements on performance criteria in a structured clinical operative test. In setting up performance assessment it is necessary to have close collaboration between assessors to make clearly defined criteria so that judgements are not too subjective. Furthermore, for the assessment of more complex clinical skills, great care is needed in assembling criteria that can be used reproducibly, and sufficient preparation time for the assessors is critical.
The use of group participation and an enquiry‐based study guide with computer assisted learning
Authors: Botelho Michael 
Published: March 2003

Introduction: The aim of this investigation was to explore the use of group participation and an enquiry‐based study guide to enhance the learning experience when using a computer assisted learning (CAL) program.Materials and methods: Forty‐eight students were asked to complete a CAL program on resin bonded bridges in groups of 2–4 with an enquiry‐based study guide. An evaluation questionnaire of the learning experience was included with the study guide with paired positive and negative questions and open‐ended questions for students to complete and return. The responses were collated and the nature of the comments qualitatively analysed.Results: Thirty‐two questionnaires were returned. There were almost three times the numbers of positive to negative responses relating to the usefulness of the enquiry based study guide, group participation and the CAL program. The majority of these positive responses related to the usefulness of the study guide and group participation in highlighting and guiding learning and creating opportunities for discussion, problem solving and peer teaching. A small number of negative responses cited the target‐orientated nature of the study guide and the longer time needed for group work, due to the varying learning abilities of the participants and the need for discussion.Conclusion: The use of group participation and an enquiry‐based study guide was reported to enhance the learning experience of CAL.
Anti‐HPA‐1a‐mediated platelet phagocytosis by monocytes in vitro and its inhibition by Fc gamma receptor (FcγR) reactive reagents
Authors: Wiener E , Abeyakoon O , Benchetrit G , Lyall M , Keler T , Rodeck C. H. 
Published: March 2003

Abstract: The study was undertaken to delineate mechanisms of platelet destruction by phagocytosis during fetal/neonatal alloimmune thrombocytopenia (FAIT/NAIT) because of maternal antibodies against human platelet antigen 1a (HPA‐1a). By employing a platelet phagocytosis assay based on the ORPEGEN flow cytometric bacterial phagocytosis test, we measured monocyte ingestion of platelets mediated by anti‐HPA‐1a antibodies. Moreover, we tested, as potential therapeutic agents, FcγR reactive reagents, for their inhibition of this process.Four of six anti‐HPA‐1a sera tested mediated phagocytosis of HPA‐1a‐positive platelets in a concentration‐dependent manner. Monocyte ingestion of platelets was almost completely inhibited by cytochalasin D. No anti‐HPA‐1a‐mediated phagocytosis was observed with anti‐HPA‐1a‐negative platelets. The humanised anti‐FcγRI monoclonal antibody H22 at concentrations 1–100 μg/ml, completely inhibited anti‐HPA‐1a‐mediated phagocytosis as did similar concentrations of ivIg. By contrast, a mouse monoclonal anti‐FcγRII (IV.3, Fab) at 10 μg/ml caused little or no suppression of platelet phagocytosis mediated by two anti‐HPA‐1 sera. Furthermore, the addition of anti‐FcγRII (10 μg/ml) to sub‐optimal concentrations of H22 did not significantly increase the inhibitory effect of the latter compound. Monomeric IgG (0.1–10 μg/ml) failed to suppress anti‐HPA‐1 mediated platelet ingestion by the phagocytes, as did anti‐FcγRIII.To our knowledge this is a rare example of an assay that measures platelet phagocytosis in vitro. The results suggest that FcγRI plays a major role in anti‐HPA‐1a‐mediated platelet phagocytosis by monocytes while FcγRIIa, is of little or minor importance only. Moreover, the findings indicate the use of H22 as an alternative to interavenous Ig (ivIg) in the management of FAIT/NAIT.
The Effects of IgG Purified from Women with SLE and Associated Pregnancy Loss on Rat Embryos in Culture
Authors: Matalon S. T. , Shoenfeld Y. , Blank M. , Yacobi S. , Blumenfeld Z. , Ornoy A. 
Published: March 2003

Matalon ST, Shoenfeld Y, Blank M, Yacobi S, Blumenfeld Z, Ornoy A. The effects of IgG purified from women with SLE and associated pregnancy loss on rat embryos in culture. AJRI 2002; 48:296–304 © Blackwell Munksgaard, 2002PROBLEM: Recurrent fetal loss occurs in approximately 1% of women. Autoimmune causes have been suggested as a factor in some of these cases. High rates of intrauterine fetal growth retardation and increased incidence of prematurity is associated with systemic lupus erythematosus (SLE) and the anti‐phospholipid syndrome (APS). Autoantibodies from sera of SLE/APS patients affect reproductive outcome in pregnant mice, as was studied in vivo, where injection of immunoglobulin (Ig)G purified from patients with APS to mice caused fetal resorptions and growth retardation.METHODS: In order to investigate the direct effect of IgG purified from women with SLE or APS on the growth and viability of embryos, we cultured 11.5‐day old‐rat embryos in their yolk sacs in the presence of IgG purified from SLE and APS patients.RESULTS: IgG purified from SLE and recurrent pregnancy loss (RPL) patients affected directly the embryo and yolk sac reducing their growth. The purified IgG positive for anti‐cardiolipin/anti‐DNA antibodies reduced yolk sac and embryonic growth more than sera negative for these antibodies.CONCLUSION: Various antiphospholipid antibodies affect differently the growth and development of the embryo and the placenta.
Antiphospholipid Antibodies and Kininogens in Pathologic Pregnancies: A Review
Authors: SUGI TOSHITAKA , MAKINO TSUNEHISA 
Published: March 2003

PROBLEM: Recently, evidence has accumulated for the presence of the kallikrein–kinin system or plasma contact system in the fetoplacental unit. The Kallikrein–kinin system or plasma contact system consists of three essential plasma proteins. These are coagulation factor XII, prekallikrein and high molecular weight kininogen. Deficiencies of these proteins and antiphospholipid antibodies are frequent hemostasis‐related abnormalities found in unexplained recurrent aborters.METHOD OF STUDY: Review of existing data.RESULTS: Reports of antiphosphatidylethanolamine antibodies (aPE) with similar or identical pathogenic associations as those described for anticardiolipin antibodies (aCL) are found in the literature. We showed a strong association between recurrent pregnancy losses and aPE, the latter of which recognizes kininogens, and kininogen‐binding proteins, factor XI and prekallikrein. The reports of aPE are reviewed, the function of the kininogens are summarized, and their role in pregnancy is discussed.CONCLUSIONS: Because kallikrein–kinin system may play an important role in pregnancy especially in fetoplacental unit, disruption of this system may be a risk factor for early gestational losses.
Effect of an Endocrine Disruptor on Mammalian Fertility. Application of Monoclonal Antibodies against Sperm Proteins as Markers for Testing Sperm Damage
Authors: PEKNICOVÁ JANA , KYSELOVÁ VENDULA , BUCKIOVÁ DANA , BOUBELÍK MICHAEL 
Published: March 2003

PROBLEM:  To determine the influence of an endocrine disruptor [bisphenol‐A (BPA)] on the integrated reproductive process as well as on individual reproductive organs and gametes in order to select suitable markers for testing sperm damage.METHOD OF STUDY:  The effect of BPA on fertility in vivo in multigenerational studies in an outbred stock of mice was studied. Damage of reproductive organs was assessed by histochemical methods and damage of spermatozoa by means of a panel of monoclonal antibodies (MoAbs) against intra‐acrosomal sperm proteins.RESULTS:  BPA had a negative influence on offspring born of mice, on reproductive organs, and on acrosome integrity of mice spermatozoa. Selected MoAbs against intra‐acrosomal mammalian sperm proteins, cross‐reacted with mouse spermatozoa, were used for determination of the acrosome integrity. BPA had no effect on body weight and testicle weight of males.CONCLUSIONS:  The present results demonstrate that BPA has a negative effect on in vivo fertility of mice, with impact on spermatogenesis and sperm quality. Monoclonal antibodies against intra‐acrosomal sperm proteins can be used for detecting sperm damage.
A Th2 Chemokine, TARC, Produced by Trophoblasts and Endometrial Gland Cells, Regulates the Infiltration of CCR4+ T Lymphocytes into Human Decidua at Early Pregnancy
Authors: TSUDA HIROSHI , MICHIMATA TOSHIHIKO , HAYAKAWA SATOSHI , TANEBE KYOKO , SAKAI MASATOSHI , FUJIMURA MASAKI , MATSUSHIMA KOUJI , SAITO SHIGERU 
Published: March 2003

PROBLEM: A chemokine receptor, CCR4 preferentially expressed on type 2 helper T (Th2‐type) cells, and its ligand, thymus and activation regulated chemokine ‐(TARC/CCL)‐ play important roles in the recruitment of Th2‐type cells. We examined the distribution of CCR4 expressing CD4+ and CD8+‐T cells in human decidua at early pregnancy, and localized TARC in the decidual tissue and chorionic tissue.METHOD OF STUDY: Decidual tissue was obtained by legal abortion. The percentages of CCR4 expressing CD4+ and CD8+‐T cells were analyzed by flow cytometry. Localization of TARC protein was evaluated by immunofluorescence staining. The expression of TARC mRNA in the choriocarcinoma cell line and endometrial cell line was analyzed by reverse transcriptase polymerase chain reaction (RT–PCR).RESULT: The percentages of CCR4+ cells in CD4+‐T cells and CD8+‐T cells were significantly increased in human early pregnancy decidua compared with those in peripheral blood. An another marker of human Th2 and Tc2 cells, CRTH2 molecules was also expressed on CCR4+CD4+‐T cells and CCR4+CD8+‐T cells. In addition, we found that trophoblasts, uterine epithelial cells and endometrial gland cells produce TARC by immunohistochemical staining and the RT‐PCR method.CONCLUSION: Our findings imply that TARC secreted in decidua mediates the infiltration of CCR4+ T‐cell migration into the fetomaternal interface, decidua, resulting in the maintenance of pregnancy.