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IV
Kinds of IV Terms modified by IV Selected AbstractsDistribution of ,-tocopherol in fillets of turbot (Scophthalmus maximus) and Atlantic halibut (Hippoglossus hippoglossus), following dietary ,-tocopheryl acetate supplementationAQUACULTURE NUTRITION, Issue 2 2004N. Ruff Abstract The present study investigated the distribution of , -tocopherol (vitamin E) in fillets of turbot (Scophthalmus maximus) and Atlantic halibut (Hippoglossus hippoglossus). Turbot and Atlantic halibut were fed commercial diets, supplemented with different levels of , -tocopheryl acetate at the dietary target levels of 100, 500 and 1000 mg , -tocopheryl acetate kg,1 diet. The actual levels were 72, 547 and 969 for turbot, while halibut received 189, 613 and 875 mg , -tocopheryl acetate kg,1 diet. Turbot were fed the diets for 24 weeks, while Atlantic halibut were fed for 20 weeks prior to slaughter. At the end of the feeding periods fish had reached a final weight of around 1 kg. Fish were slaughtered and filleted. From the four fillets obtained per fish, 22 samples were taken from designated areas and analysed for their , -tocopherol content. The average concentrations of , -tocopherol incorporated in turbot and Atlantic halibut increased with increasing levels of , -tocopheryl acetate in the diet. Atlantic halibut had significantly (P < 0.05) more , -tocopherol in positions 2/II and 1/I than in position 9/IX. Turbot had significantly (P < 0.05) more , -tocopherol in position 2/II than in positions 1/I, 4/IV and 11/XI. By mapping , -tocopherol concentrations in fish fillets, a high degree of quality prediction may be established. Moreover, this study may help scientists in their choice of sampling position, when investigating if , -tocopheryl acetate supplementation resulted in successful , -tocopherol incorporation. [source] Visualization of Surface-specific Antigens in Various Strains of Enterotoxigenic E. coliANATOMIA, HISTOLOGIA, EMBRYOLOGIA, Issue 2005S. Lüdi Proteinaceous surface antigens of enterotoxigenic E. coli (ETEC) appear as pili, and are important virulence factors as they allow bacteria to attach to the small intestinal mucosa. Surface antigens are classified as colonization factor antigens (CFA) and coli surface antigens (CS). Known groups include CFA/I, CFA/II (consisting of CS1, CS2 and CS3), CA/III and CFA/IV (consisting of CS4, CS5 and CS6). The goal of the present study was to examine the morphology of pili by transmission electron microscopy (TEM) and to localize specific surface antigens by immunolabelling. Using different strains of E. coli grown under various culture conditions, pili were visualized by negative staining and corresponding surface antigens were demonstrated by immunogold-labelling using both polyclonal and monoclonal antibodies. Expression of pili was dependent on culture conditions and sample handling. In contrast to CFA/I and CS3, CS6 pili were not detectable after negative staining. Selected antibodies, however, allowed surface antigens to be demonstrated unequivocally. These results will be of value in investigating the expression of colonizing factors in genetically modified bacterial strains. [source] Dopaminergic signalling in the rodent neonatal suprachiasmatic nucleus identifies a role for protein kinase A and mitogen-activated protein kinase in circadian entrainmentEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 2 2002Irina L. Schurov Abstract The circadian clock of the suprachiasmatic nuclei (SCN) of perinatal rodents is entrained by maternally derived cues. The SCN of neonatal Syrian hamsters express high-affinity D1 dopamine receptors, and the circadian activity,rest cycle of pups can be entrained by maternal injection of dopaminergic agonists. The present study sought to characterize the intracellular pathways mediating dopaminergic signalling in neonatal rodent SCN. Both dopamine and the D1 agonist SKF81297 caused a dose-dependent increase in phosphorylation of the transcriptional regulator Ca2+/cyclic AMP response element (CRE) binding protein (CREB) in suprachiasmatic GABA-immunoreactive (-IR) neurons held in primary culture. The D1 antagonist SCH23390 blocked this effect. Dopaminergic induction of pCREB-IR in GABA-IR neurons was also blocked by a protein kinase A (PKA) inhibitor, 5,24, and by the MAPK inhibitor, PD98059, whereas KN-62, an inhibitor of Ca2+/calmodulin-dependent (CAM) kinase II/IV was ineffective. Treatment with NMDA increased the level of intracellular Ca2+ in the cultured primary SCN neurons in Mg2+ -free medium, but SKF81297 did not. Blockade of CaM kinase II/IV with KN-62 inhibited glutamatergic induction of pCREB-IR in GABA-IR neurons, whereas 5,24 was ineffective, confirming the independent action of Ca2+ - and cAMP-mediated inputs on pCREB. SKF81297 caused an increase in pERK-IR in SCN cells, and this was blocked by 5,24, indicative of activation of MAPK via D1/cAMP. These results demonstrate that dopaminergic signalling in the neonatal SCN is mediated via the D1-dependent activation of PKA and MAPK, and that this is independent of the glutamatergic regulation via Ca2+ and CaM kinase II/IV responsible for entrainment to the light/dark cycle. [source] Liver histology after current intensified therapy for childhood acute lymphoblastic leukemia: microvesicular fatty change and siderosis are the main findingsPEDIATRIC BLOOD & CANCER, Issue 3 2003Päivi Halonen MD Abstract Background During modern intensified therapy for childhood acute lymphoblastic leukemia (ALL) serum liver enzymes reach fairly high levels. Since no recent data on liver histopathology after therapy are available, we conducted a study of the subject. Procedure Liver biopsy specimens were evaluated and serum liver function tests and lipid profiles measured from 27 consecutive children, aged 3.5,17.6 years, treated according to the regimens for standard (SR) and intermediate risk (IR) ALL. Results None of the patients had entirely normal liver histology. Fatty infiltration was detected in 25 out of 27 (93%) and siderosis in 19 out of 27 patients (70%). Fourteen (52%) had both. Three (11%) also had mild portal and/or periportal fibrosis in addition to fatty change and siderosis. Fatty change was mainly microvesicular. Siderosis was in most cases grade II/IV to III/IV (in 16/19 or 84%). No hepatitis or cirrhosis was found. Serum total and LDL-cholesterol levels were higher in the patients with fibrosis than in the patients with fatty change (P,=,0.036, P,=,0.042) or with siderosis,±,fatty change (P,=,0.036, P,=,0.042). In serial ALT measurements a value of 300 U/L or more was oftener reached in the fibrosis than in the fatty change or siderosis groups (in 33 vs. in 12 or in 4% of the measurements, respectively, P,=,0.014, in Kruskall,Wallis test). Conclusions Microvesicular fatty change and siderosis are the main liver findings after current therapy for childhood ALL. Fibrosis occurs rarely. High values in serial serum ALT measurements repeatedly or a disturbed serum lipid profile may facilitate decisions about the need for a liver biopsy. Med Pediatr Oncol 2003;40:148,154. © 2003 Wiley-Liss, Inc. [source] The Atrial Fibrillation Paradox of Heart FailureCONGESTIVE HEART FAILURE, Issue 1 2010Rhidian J. Shelton MRCP Congest Heart Fail. 2010;16:3,9. ©2009 Wiley Periodicals, Inc. The prevalence of atrial fibrillation (AF) in patients with heart failure (HF) is high, but longitudinal studies suggest that the incidence of AF is relatively low. The authors investigated this paradox prospectively in an epidemiologically representative population of patients with HF and persistent AF. In all, 891 consecutive patients with HF [mean age, 70±10 years; 70% male; left ventricular ejection fraction, 32%±9%] were enrolled. The prevalence of persistent AF at baseline was 22%. The incidence of persistent AF at 1 year was 26 per 1000 person-years, ranging from 15 in New York Heart Association class I/II to 44 in class III/IV. AF occurred either at the same time or prior to HF in 76% of patients and following HF in 24%. A risk score was developed to predict the occurrence of persistent AF. The annual risk of persistent AF developing was 0.5% (0%,1.3%) for those in the low-risk group compared with 15% (3.4%,26.6%) in the high-risk group. Despite a high prevalence of persistent AF in patients with HF, the incidence of persistent AF is relatively low. This is predominantly due to AF coinciding with or preceding the development of HF. The annual risk of persistent AF developing can be estimated from clinical variables. [source] Improved treatment outcome in Chinese children and adolescents with Burkitt's lymphoma and large cell lymphoma by using the modified B-non-Hodgkin's lymphoma-Berlin-Frankfurt-Münster-90 protocolEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2006Xiao-Fei Sun Abstract:,Objectives:,This study was designed to evaluate the efficacy and toxicity of the modified B-Non-Hodgkin's Lymphoma (NHL)-Berlin-Frankfurt-Münster (BFM)-90-based protocol in Chinese children and adolescents with Burkitt's lymphoma and large cell lymphoma. Methods:,From September 1997 to August 2005, 55 untreated patients (age less than 20 yr) from a single institution were enrolled. The patients were stratified by risk factors (stage, LDH level and chemotherapy response). All patients were treated with a modified B-NHL-BFM 90 protocol. Results:,The median age of the patients was 8 yr (range 1.5,20 yr). Of these patients, 22 (40%) had Burkitt's lymphoma (BKL), 22 (40%) had diffuse large B-cell lymphoma (DLBL) and 11 (20%) had anaplastic large T-cell lymphoma (ALCL). Complete remission (CR) occurred in 45 patients (83%), partial remission (PR) in eight patients (14.5%), and progressive disease (PD) in one patient (1.8%). At a median follow up of 24 months, the event free survival (EFS) for all patients was 85% ± 5% with 100% for group R1, 84% ± 7% for group R2 and 72% ± 13% for group R3, and most notably, 80% ± 6% for stage III/IV at diagnosis. There was no statistically significant difference (P = 0.96) in EFS among BKL and DLBL and ALCL. The major toxicity complications were myelosuppression and mucositis, but these conditions were tolerated and manageable. Conclusions:,This modified NHL-BFM-90 protocol is very effective for Chinese children and adolescents with BKL and large cell lymphomas, and represented an increase in the cure rates in childhood NHL in China. [source] Prognostic factors in salvage surgery for recurrent oral and oropharyngeal cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 2 2006Ivan Marcelo Gonēalves Agra MD Abstract Background. Therapeutic decisions in recurrent oral and oropharyngeal squamous carcinoma (SCC) remain controversial. Methods. Two hundred forty-six consecutive patients who underwent salvage surgery for recurrent squamous cell carcinoma (SCC) of the oral cavity and oropharynx were studied. The tumor sites were lip, 33 cases; oral cavity, 143; oropharynx, 70. The previous treatment was surgery in 73 patients, radiotherapy in 96, combined surgery and radiotherapy in 76, and chemotherapy in one. The clinical stage of recurrence was I/II in 51 cases and III/IV in 195 cases. The disease-free interval (DFI) was less than 1 year in 156 cases and greater than 1 year in 90 cases. Results. The rate of recurrence was 54.9%, and the overall 5-year actuarial survival rate was 32.3%. The significant prognostic factors in multivariate analysis were restage (p = .049) and DFI (p = .045). Conclusion. Patients with recurrent oral and oropharyngeal SCC at initial clinical stages (rCS I and II) and with a DFI greater than 1 year had a favorable prognosis. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Neoadjuvant chemotherapy for squamous cell carcinoma of the oral tongue in young adults: A case seriesHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 9 2005Erich M. Sturgis MD Abstract Background. Squamous cell carcinoma of the oral tongue (SCCOT) in the young population has emerged as a growing worldwide health problem. Standard therapies, consisting primarily of surgery with possible adjuvant radiotherapy, have resulted in only modest improvements in survival in recent decades, whereas the treatments for SCCOT continue to impair oral function. With the increased use and improved functional results of neoadjuvant chemotherapy in the treatment of squamous cell carcinoma of other upper aerodigestive tract sites, we have reviewed our experience with neoadjuvant chemotherapy in young patients with SCCOT. Methods. A retrospective review was conducted of all patients younger than 45 years (N = 49) with previously untreated SCCOT evaluated at a comprehensive cancer center from July 1995 to August 2001. Charts were reviewed to obtain demographic data, comorbidities, nutritional status, tumor status, treatment and response information, and follow-up data. Results. Fifteen patients were identified who received neoadjuvant chemotherapy with taxane-based regimens before undergoing glossectomy and neck dissection. Thirteen of these patients (87%) exhibited stage III or IV disease at presentation, and all exhibited at least a partial response at the primary site. Pathologically positive nodes were identified in only six patients (40%), although 13 (87%) had clinically or radiographically suspicious nodes at presentation. Adjuvant radiation therapy was administered to seven patients (47%). With a median follow-up of 39 months, no patient has had local or regional recurrence, although three patients (20%) have had distant metastases develop; one patient with an isolated distant metastasis was successfully salvaged with radiation. By comparison during the same period, 34 young adult patients with SCCOT were treated with surgery with or without postoperative radiotherapy but without the use of chemotherapy. Although these patients had lower T classifications (18% vs 67% T3/T4; p = .0007), incidence of nodal metastases (15% vs 87% N+; p < .0001), and overall disease stage (24% vs 87% stage III/IV; p < .0001) than the neoadjuvant chemotherapy group, the overall survival (82%), disease-specific survival (88%), and recurrence-free survival (82%) of the surgery-first group was similar to that of the neoadjuvant chemotherapy group (87%, 87%, and 80%, respectively). Conclusions. This retrospective investigation demonstrates that neoadjuvant chemotherapy with taxane-based regimens may play a role in the successful treatment of SCCOT in young adult patients. Ultimately, this treatment plan may lead to improved functional outcomes in young patients with SCCOT by allowing function-sparing surgery and avoiding postoperative radiotherapy, without sacrificing disease control and survival, but a prospective trial is needed. We have initiated a prospective clinical trial to further investigate the impact of neoadjuvant chemotherapy in patients younger than 50 with SCCOT. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX,XXX, 2005 [source] Post-cholecystectomy biliary strictures: Not always benignJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7pt2 2008Ajay Sharma Abstract Background:, Post-cholecystectomy malignant biliary obstruction masquerading as benign biliary stricture (BBS) has not been reported in the literature; it presents a diagnostic and management challenge. Methods:, Of the 349 post-cholecystectomy BBS managed at a tertiary care hospital in northern India between 1989 and 2004, 11 patients were found to have biliary malignancy. Records of these 11 patients were analyzed retrospectively for the purpose of this study. Results:, Mean age of patients with malignant biliary strictures was significantly higher (52 vs 38 years, P = 0.000); they were more likely to have jaundice (100% vs 78%, P = 0.008) and pruritus (82% vs 48%, P = 0.03). Unlike most patients with BBS referred from elsewhere to us, they had had a smooth postoperative course uncomplicated by bile leak, had a longer cholecystectomy-presentation interval, and were more likely to have high strictures ((Bismuth type III/IV) 91% vs 49%, P = 0.008). Conclusions:, Post-cholecystectomy biliary obstruction is not always benign. High bilirubin levels and hilar strictures, especially after an uneventful cholecystectomy, in a middle-aged patient should raise a suspicion of underlying missed malignancy. [source] Tumor necrosis factor- , and transforming growth factor- , reflect severity of liver damage in primary biliary cirrhosisJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 2 2002MANUELA NEUMAN Abstract Background and Aims The pathogenesis of primary biliary cirrhosis (PBC) is unknown. The role of cytokines such as tumor necrosis factor-, (TNF-,) and transforming growth factor-, (,GF-,), and the effect of ursodeoxycholic acid (UDCA) in modifying the cytokine environment in patients with PBC has remained largely unstudied. Our aims were to determine: (i) the relationship between serum levels of TNF-, and TGF-, and the severity of PBC; and (ii) the effects of UDCA therapy on TNF-, and TGF-, levels in patients with PBC. Methods We studied 90 patients who had been treated with UDCA (53 patients) or placebo (37 patients) for 2 years as part of a randomized, double-blind, controlled trial. Patients were divided into histological stage I/II or stage III/IV disease. Serum TNF-, and TGF-, levels were quantified by enzyme-linked immunoabsorbent assay. Results Baseline levels of TNF-, were significantly greater in patients with stage III/IV compared to stage I/II disease. After 2 years of treatment with UDCA, patients showed a significantly greater decrease in TNF-, levels and progression risk score compared to placebo-treated patients. TNF-, and TGF-, levels were significantly reduced compared to baseline levels in the UDCA-treated group after 2 years, while there was no significant change in the levels of placebo-treated patients. Conclusions Serum TNF-, and TGF-, levels may reflect severity of disease in patients with PBC. The beneficial effects of UDCA therapy may be explained by lowering serum levels of these two cytokines. [source] Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up studyALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2010M. RUGGE Aliment Pharmacol Ther,31, 1104,1111 Summary Background, Intestinal-type gastric cancer (GC) still ranks among the high-incidence, highly lethal malignancies. Atrophic gastritis is the cancerization field in which GC develops. The current histological reporting formats for gastritis do not include any (atrophy-based) ranking of GC risk. Aim, To test the gastritis OLGA-staging (Operative Link for Gastritis Assessment) in prognosticating neoplastic progression. Methods, Ninety-three Italian patients were followed up for more than 12 years (range: 144,204 months). Clinical examinations, pepsinogen serology, endoscopy and histology (also assessing Helicobacter pylori status) were performed both at enrolment (T1) and at the end of the follow-up (T2). Results, All invasive or intra-epithelial gastric neoplasia were consistently associated with high-risk (III/IV) OLGA stages. There was a significant inverse correlation between the mean pepsinogen ratio and the OLGA stage (test for trend; P < 0.001). OLGA-staging at T1 predicted both the OLGA stage (Kaplan,Maier log-rank test, P = 0.001) and the neoplasia at T2 (Kaplan,Maier log-rank test, P = 0.001). Conclusions, This long-term follow-up study provides the first evidence that gastritis OLGA-staging conveys relevant information on the clinico-pathological outcome of gastritis and therefore for patient management. According to OLGA-staging and H. pylori- status, gastritis patients could be confidently stratified and managed according to their different cancer risks. [source] Expression patterns of 5-lipoxygenase in human brain with traumatic injury and astrocytomaNEUROPATHOLOGY, Issue 2 2006Lei Zhang 5-Lipoxygenase (5-LOX) is a key enzyme in the metabolism of arachidonic acid to leukotrienes. The levels of leukotrienes increase after brain injury and when tumors are present. It has been reported that 5-LOX is widely expressed in the brain and that 5-LOX inhibition provides neuroprotection. However, there is still no information available for the expression patterns of 5-LOX in human brain following trauma or with astrocytomas. We investigated its expression patterns by immunohistochemistry. We found that 5-LOX is normally expressed in neurons and glial cells. In neurons, it was expressed in two patterns: in the cytosol and nucleus or only in the cytosol. In traumatic brain injury, 5-LOX expression increased in glial cells and neutrophils. Double-labeling immunohistochemistry showed that part of the 5-LOX-positive glial cells were GFAP positive. No 5-LOX expression was found in brain microvessel endothelia, except in the regenerated endothelia of a patient 8 days following brain trauma. Furthermore, 5-LOX expression increased and showed a granular pattern in high-grade (grade III/IV) astrocytoma. These results indicate that 5-LOX has multiple expression patterns, and can be induced by brain injury, which implies that 5-LOX might have pathophysiological roles in the human brain. [source] Sites of recurrence in oral and oropharyngeal cancers according to the treatment approachORAL DISEASES, Issue 3 2003AL Carvalho OBJECTIVE: The purpose of this study is to evaluate the rates and the sites of tumour recurrence in patients with oral and oropharyngeal carcinomas. DESIGN: This is a retrospective study of a series of cases treated in a single institution. PATIENTS AND METHODS: A series of 2067 patients with oral and oropharyngeal squamous carcinoma, treated from 1954 to 1998 were analysed. The treatment approach was: surgery, 624 cases (30.2%); radiotherapy alone, 729 cases (35.3%); radiotherapy and surgery, 552 cases (26.7%) and radiotherapy and chemotherapy, 162 cases (7.8%). MAIN OUTCOME MEASURES: Tumour recurrence was observed in 1079 patients (52.2%): 561 cases of local recurrences (27.1%); 168 neck recurrences (8.1%); 252 locoregional recurrences (12.2%); 59, distant metastasis (2.9%) and 39 (1.9%), combination of distant metastasis with local, neck or locoregional recurrence. RESULTS: The rates of recurrence varied significantly according to the treatment performed. Oral cavity cancer patients undergoing radiotherapy alone or in combination with chemotherapy presented the highest rates of neck recurrences (22.5 and 40.0%, respectively) for clinical stage (CS) I/II and of local (41.2 and 30.1%) and locoregional (21.7 and 31.1%) recurrences for CS III/IV; yet, for CS III/IV, surgery without neck dissection was associated with the highest rates of neck recurrences (20.7%), but no differences were observed in the rates of local or locoregional recurrences for CS I/II patients. For oropharynx cancer patients with CS I/II there was no difference in the rate of locoregional failures according to the treatment. However, patients with CS III/IV undergoing radiotherapy present a highest rate of local (42.3%) and locoregional (28.8%) failures. CONCLUSION: The results suggest that surgery should be the first option for initial clinical stage oral and oropharyngeal cancers. For advanced cases independently of the site of the tumour, surgery and postoperative radiotherapy should be the standard of care because it is associated with the lowest rates of locoregional recurrence. [source] Which Patients with Congestive Heart Failure May Benefit from Biventricular Pacing?PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 1p2 2003NESTOR O. GALIZIO GALIZIO, N.O., et al.: Which Patients with Congestive Heart Failure May Benefit from Biventricular Pacing?Background: Biventricular pacing improves the clinical status and ventricular function in patients with congestive heart failure (CHF) and intraventricular conduction delay. However, patient selection criteria including NYHA functional class, rhythm, PR interval, QRS duration (QRSd), left ventricular ejection fraction (LVEF), left ventricular diastolic diameter (LVDD), and other variables are not clearly defined. Objective: To determine which and how many patients referred for an initial cardiac transplantation evaluation may be eligible for biventricular pacing (BP) according to the criteria of recently completed trials of cardiac resynchronization therapy (CRT). Methods: This was a retrospective review of 200 patients, whose mean age was51 ± 13years (173 men). Sinus rhythm was present in 88% of the patients, 107 had a QRSd >120 ms, and 38% had left bundle branch block. LVDD was72.5 ± 12 mmand LVEF21.7 ± 9.3%; 54% had mitral regurgitation. Results: When NYHA class, electrocardiographic, and ventricular function criteria were considered separately, a high proportion of patients appeared to be candidates for CRT: 70.5% were in NYHA functional class III/IV, 34% had QRSd ,150 ms, 60% had LVDD ,60 mm and 53.5% LVEF ,35%. However, the proportions of patients eligible for CRT were different according to the selection criteria of recently completed trials: 18% of the patients with InSync criteria, 13% of the patients with MUSTIC SR criteria, 0.5% with MUSTIC AF criteria, 27% of patients with MIRACLE criteria, and 35% of the patients with CONTAK CD criteria (without considering indications for implantable cardioverter defibrillator). Conclusion: In this population-based study, a wide range of patients (13% to 35%) would have been candidates for CRT, according to the selection criteria of different completed trials.(PACE 2003; 26[Pt. II]:158,161) [source] Liver histology after current intensified therapy for childhood acute lymphoblastic leukemia: microvesicular fatty change and siderosis are the main findingsPEDIATRIC BLOOD & CANCER, Issue 3 2003Päivi Halonen MD Abstract Background During modern intensified therapy for childhood acute lymphoblastic leukemia (ALL) serum liver enzymes reach fairly high levels. Since no recent data on liver histopathology after therapy are available, we conducted a study of the subject. Procedure Liver biopsy specimens were evaluated and serum liver function tests and lipid profiles measured from 27 consecutive children, aged 3.5,17.6 years, treated according to the regimens for standard (SR) and intermediate risk (IR) ALL. Results None of the patients had entirely normal liver histology. Fatty infiltration was detected in 25 out of 27 (93%) and siderosis in 19 out of 27 patients (70%). Fourteen (52%) had both. Three (11%) also had mild portal and/or periportal fibrosis in addition to fatty change and siderosis. Fatty change was mainly microvesicular. Siderosis was in most cases grade II/IV to III/IV (in 16/19 or 84%). No hepatitis or cirrhosis was found. Serum total and LDL-cholesterol levels were higher in the patients with fibrosis than in the patients with fatty change (P,=,0.036, P,=,0.042) or with siderosis,±,fatty change (P,=,0.036, P,=,0.042). In serial ALT measurements a value of 300 U/L or more was oftener reached in the fibrosis than in the fatty change or siderosis groups (in 33 vs. in 12 or in 4% of the measurements, respectively, P,=,0.014, in Kruskall,Wallis test). Conclusions Microvesicular fatty change and siderosis are the main liver findings after current therapy for childhood ALL. Fibrosis occurs rarely. High values in serial serum ALT measurements repeatedly or a disturbed serum lipid profile may facilitate decisions about the need for a liver biopsy. Med Pediatr Oncol 2003;40:148,154. © 2003 Wiley-Liss, Inc. [source] Use of intrapulmonary percussive ventilation (IPV) in the management of pulmonary complications of an infant with osteogenesis imperfectaPEDIATRIC PULMONOLOGY, Issue 11 2009Gustavo Nino MD Abstract Osteogenesis imperfecta (OI) is a genetic disorder characterized by abnormal collagen formation and short stature. These patients present with frequent vertebral, rib, and long bone fractures. There are many respiratory complications associated with OI including pneumonia, the most common cause of mortality in the severe forms of the disease. We present a case of an infant with OI (type III/IV) and significant tracheobronchomalacia who had required multiple hospitalizations for recurrent atelectasis and respiratory failure in the setting of acute respiratory infections. External chest percussion and vibration were avoided because of the risk of rib fractures. intrapulmonary percussive ventilation (IPV) was initiated during an acute illness with good effect, and continued successfully after discharge from hospital. We conclude that IPV represents a safe and effective alternative to airway clearance in infants with OI. Pediatr Pulmonol. 2009; 44:1151,1154. ©2009 Wiley-Liss, Inc. [source] Outcome of patients after treatment for a squamous cell carcinoma of the oropharynxTHE LARYNGOSCOPE, Issue 3 2009Christof Röösli MD Abstract Objectives: This study evaluates the oncologic outcome with regard to survival and locoregional tumor control in a cohort of patients with oropharyngeal squamous cell carcinoma (OPSCC) treated according to a uniform algorithm. Study Design: Retrospective chart review. Methods: A total of 427 consecutive patients with OPSCC were treated from 1990 to 2006. Treatment modalities were surgery alone (n = 102), surgery with adjuvant radio(chemo)therapy (n = 159), and primary radio(chemo)therapy (n = 166). Study endpoints were the five-year overall survival (OS) and disease-specific survival (DSS) stratified for primary tumor subsite, stage, T and N category, and age. Results: The five-year OS and DSS for the entire cohort were 57.9% and 68.6%, respectively. OS and DSS for surgery alone were 70.3% and 76.5%, for surgery with radiation 66.6% and 78.9%, and for primary radiation 40.8% and 52.6%, respectively. Survival was significantly better for low stages (stage I/II vs. III/IV), small tumors (T1/2 vs. T3/4), limited nodal involvement (N0/1 vs. N2/3), and younger age at diagnosis. Conclusions: Together with our previous study on quality of life, we were able to show that our selection process gives excellent oncologic outcome in combination with high levels of function and quality of life. Surgery alone for early OPSCC and surgery followed by radiation for advanced OPSCC remain valuable treatment options. Primary radiochemotherapy is a strong alternative for patients who are not candidates for function-preserving surgery. Laryngoscope, 119:534,540, 2009 [source] Quality of Life Correlates After Surgery for Laryngeal Carcinoma,,THE LARYNGOSCOPE, Issue 10 2007Julian Bindewald Abstract Objectives: To assess the correlation of operation mode, postoperative radiotherapy, and disease stage factors with the health-related quality of life (HRQL) measures after surgery for laryngeal carcinoma. Study Design: Reanalysis of data of two multi-institutional cross-sectional studies. Patients and Methods: We interviewed 218 laryngectomees and 153 partial laryngectomy patients in and near Leipzig, Germany, in two cross-sectional studies, using the general and the head- and neck-specific quality of life questionnaires of the European Organization for the Research and Treatment of Cancer (EORTC QLQ-C30 and EORTC QLQ-H&N35). Multifactorial univariate and multivariate models were calculated, with laryngectomy vs. partial laryngectomy, radiotherapy (irradiated or not), and disease stage (International Union Against Cancer [UICC] stages I/II vs. III/IV) as influencing factors and the HRQL scales and items as dependent variables. Analyses were adjusted for the patient's age and the time elapsed since the operation. Results: Laryngectomees were more affected in their sense of smell (P , .000). Among irradiated patients, functioning levels and many symptom scales showed worse results (P , .05). Both operation mode and postoperative radiotherapy were independently associated with head- and neck-specific HRQL in multivariate analysis. Differences between disease stage groups, however, were not significant. Patient's age was an influencing factor on HRQL, but time since operation was not. Conclusions: Postoperative radiotherapy seems to have the greatest impact on patients' HRQL independent of other clinical factors following surgery for laryngeal carcinoma. Aftercare of irradiated laryngeal carcinoma patients should focus more on the patient's quality of life. [source] Significance of CD 105 expression for tumour angiogenesis and prognosis in endometrial carcinomasAPMIS, Issue 11 2003HELGA B. SALVESEN Angiogenesis is a key process in tumour growth and metastasis, and Factor-VIII microvascular density has been found to influence prognosis among endometrial carcinoma patients. The CD105/endoglin antibody has been reported to preferentially bind to activated endothelial cells in tissues participating in angiogenesis, and we therefore wanted to compare the prognostic significance of CD105/endoglin to that of Factor-VIII. In a population-based endometrial carcinoma study with long (median 11.5 years) and complete patient follow-up, mean intratumour microvascular density (MVD) assessed using CD105/endoglin was investigated and compared with previous data for MVD assessed using Factor-VIII. MVD by CD105/endoglin was significantly correlated with MVD by Factor-VIII (p=0.001). However, tumours within the two groups defined by the upper and lower quartiles for CD105/endoglin-MVD were both significantly more often metastatic (FIGO-stage III/IV; p=0.03), with high tumour cell proliferation by Ki67 (p=0.007) and with reduced survival (p=0.036) as compared with the intermediate groups. In Cox regression analysis, CD105/endoglin-MVD showed independent prognostic influence when analysed together with patient age, FIGO stage, histologic subtype, histologic grade and Factor-VIII-MVD, while the latter lost its prognostic impact when CD105/endoglin was included. In the subgroup with high MVD, there was a tendency towards improved response to radiation therapy. In conclusion, CD105/endoglin-MVD is significantly associated with FIGO stage, tumour proliferation and prognosis in endometrial carcinoma, indicating that this is a better angiogenic marker in these tumours. [source] Expression of the stem cell marker nestin in peripheral blood of patients with melanomaBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2010A. Fusi Summary Background, There is continued interest in markers indicative of circulating melanoma cells. Nestin is a neuroepithelial intermediate filament protein that was found to be expressed in melanoma and in various cancer stem cells. Objectives, We investigated expression of nestin in peripheral blood of patients with melanoma. Methods, We analysed nestin expression by flow cytometry and by quantitative reverse transcription,polymerase chain reaction both in tissues (n = 23) and in blood samples (n = 102) from patients with American Joint Committee on Cancer stage III,IV melanoma. Forty-six negative controls were also added. Results, Flow cytometry did not reveal nestin-expressing cells in peripheral blood of healthy volunteers. In patients with melanoma, however, nestin protein was expressed in a proportion of melanoma cells enriched from peripheral blood by immunomagnetic sorting. In melanoma tissue samples a significant correlation was found between mRNAs coding for nestin and tyrosinase (P = 0·001) and melan-A (P = 0·002), whereas in blood a significant correlation was observed only for tyrosinase (P = 0·015), but not for melan-A (P = 0·53). Nestin expression was higher in stage IV patients compared with stage III/IV with no evidence of disease, in patients with high tumour burden, and was positively correlated to expression of tyrosinase and melan-A. Conclusions, Nestin was found to be an additional marker of interest for circulating melanoma cells. Prospective studies should investigate its potential added informative value in comparison with markers already in use for melanoma cell detection. [source] Shortened intensified multi-agent chemotherapy and non-cross resistant maintenance therapy for advanced lymphoblastic lymphoma in children and adolescents: report from the Children's Oncology GroupBRITISH JOURNAL OF HAEMATOLOGY, Issue 2 2008Minnie Abromowitch Summary Pediatric lymphoblastic lymphoma (LL) has utilized treatment strategies similar to childhood acute lymphoblastic leukaemia (ALL) with prolonged maintenance chemotherapy. We report the results of a pilot study to estimate the feasibility, toxicity and efficacy of a 12-month aggressive multi-agent chemotherapy regimen in children and adolescents with advanced LL. Between July 1994 and June 1997, 85 eligible children and adolescents with advanced LL (Stage III/IV) were enrolled on this pilot study. Patients achieving a complete response following induction and consolidation received six cycles of maintenance chemotherapy for a total duration of 12 months. Grade III/IV toxicities included: hematological (80%), infections (20%), stomatitis and elevated transaminases, (29%). There were a total of 19 events, 13 relapses, two secondary acute myeloid leukaemia and four toxic deaths (5%). The 5-year event-free survival (EFS) and overall survival (OS) was 78 ± 4·5% and 85 ± 3·9%, respectively. Relapsed patients had a 5-year OS of only 33 ± 14%. Multivariate analysis failed to demonstrate age, gender, lactate dehydrogenase level, presence of marrow and/or central nervous system disease to have independent prognostic value. These results suggest that this experimental approach is safe and results in similar outcomes as more prolonged childhood ALL regimens. [source] Pilot study of reduced-intensity conditioning followed by allogeneic stem cell transplantation from related and unrelated donors in patients with myelofibrosisBRITISH JOURNAL OF HAEMATOLOGY, Issue 5 2005Nicolaus Kröger Summary A prospective pilot study was performed to evaluate the effect of reduced-intensity conditioning with busulphan (10 mg/kg), fludarabine (180 mg/qm) and anti-thymocyte globulin followed by allogeneic stem cell transplantation from related (n = 8) and unrelated donors (n = 13) in 21 patients with myelofibrosis. The median age of the patients was 53 years (range, 32,63). No primary graft failure occurred. The median time until leucocyte (>1·0 × 109/l) and platelet (>20 × 109/l) engraftment was 16 (range, 11,26) and 23 d (range, 9,139) respectively. Complete donor chimaerism on day 100 was seen in 20 patients (95%). Acute graft- versus -host disease (GvHD) grades II,IV and III/IV occurred in 48% and 19% of cases and 55% of the patients had chronic GvHD. Treatment-related mortality was 0% at day 100 and 16% [95% confidence interval (CI): 0,32%] at 1 year. Haematological response was seen in 100% and complete histopathological remission was observed in 75% of the patients and 25% of the patients showed partial histopathological remission with a continuing decline in the grade of fibrosis. After a median follow-up of 22 months (range, 4,59), the 3-year estimated overall and disease-free survival was 84% (95% CI: 67,100%). [source] Mantle Cell Lymphoma in the Ocular RegionACTA OPHTHALMOLOGICA, Issue 2008S HEEGAARD Purpose To characterize the clinicopathological features of mantle cell lymphoma (MCL) in the ocular region. Methods All lymphoid lesions were retrieved searching the Danish Ocular Lymphoma Database 1980-2007. Specimens were collected from Danish pathology departments and re-evaluated with a panel of monoclonal antibodies. For all patients with confirmed MCL the complete clinical files were collected and reviewed. Results Twenty-one patients with MCL were identified comprising nine percent (21/230) of all lymphomas in the ocular region. There were 18 male and three female patients with an age range from 60 to 90 years (median 75 years). Ocular region MCL as first presenting symptom included 67% of the patients. Of these, 71% had bilateral involvement and all had lymphoma in more than one site within the ocular region. The orbit (71%) and eyelids (64%) were the most commonly affected sites. At the time of diagnosis 93% of the patients were in Ann Arbor stage III/IV, with bone marrow involvement (79%) and B-symptoms (50%). Median overall survival (OS) was 30 months and the five-year OS rate was 21%. Patients receiving anti-CD20 (Rituximab)-containing chemotherapy had a significant better 5-year OS rate (80 %) (p < 0,027) than patients in treatment regimes without Rituximab (5-year OS rate, 29%). Conclusion MCL presenting in the ocular region has a male predominance and affects elderly patients. The orbit and eyelids were frequently involved. Patients with ocular region MCL as first presenting symptom had a high proportion of bilateral affection. Patients had advanced stage disease at diagnosis, multiple relapses and a low 5-year OS rate similar to systemic MCL. Treatment with Rituximab-containing chemotherapy improved survival significantly. [source] Minor neurological dysfunction, cognitive development and somatic development at the age of 3 to 11 years in very-low-birthweight infants with transient periventricular echodensitiesACTA PAEDIATRICA, Issue 12 2006JOERG KUTSCHERA Abstract Aim: To determine, using strict exclusion criteria, whether transient periventricular echodensities (TPE) in very-low-birthweight infants lead to minor neurological dysfunction and problems in cognitive and somatic development in children without major neurological impairments. Methods: 23 children with TPE were matched to 23 children without TPE. Exclusion criteria were small for gestational age, microcephaly at birth, diplegia, asphyxia, psychomotor retardation, intraventricular haemorrhage grade III/IV, major surgical interventions and malformations. The Kaufman Assessment Battery for Children, Draw-a-Man Test and neuropaediatric examination were used for evaluation. Results: There were no differences in demographic data, growth and socio-economic status. Significant differences with lower results in the TPE group were found in fine motor skills and in the Draw-a-Man Test. In the Kaufman Assessment Battery for Children, all subscales were below average in the TPE group, except the sequential processing scale. In the control group, all subscales were within the average range. Conclusion: By using strict exclusion criteria to eliminate other risk factors for minimal neurological dysfunction and poor cognitive development, we were able to focus on the effect of TPE. TPE seem to affect cognitive development and cause minor neurological dysfunction. [source] Colorectal carcinoma in young adults: a retrospective study on Indian patients: 2000,2008COLORECTAL DISEASE, Issue 10Online 2010S. Gupta Abstract Aim, To highlight an increased incidence of colorectal cancer (CRC) amongst young Indian adults. Method, A retrospective study of 305 cases of CRC admitted to SSKM Hospital, Kolkata, India during 2000,2008 was carried out. Results, The ratio (0.64) of under-40 to above-40 CRC patients reported in this study is comparable to those from premier Oncology Centers in India (,0.52) and is higher than those in the Indian National Cancer Registry (,0.20) and international average (0.07). Distinctive tumour characteristics in younger patients including left-sided lesion (69.7%), presentation at an advanced (III/IV) stage (60%), poor histological differentiation (50%) and predominance of mucin-secreting adenocarcinoma (80%) are similar to those reported in the international literature. Some features are suggestive of hereditary non polyposis colorectal cancer syndrome, which may be a possible reason for the high proportion of young CRC patients. Conclusion, A high index of suspicion for CRC among young Indian adults is necessary. [source] Microalbuminuria in Nondiabetic and Nonhypertensive Systolic Heart Failure PatientsCONGESTIVE HEART FAILURE, Issue 5 2008Estźvćo L. Figueiredo MD The American Diabetes Association and the National Kidney Foundation define microalbuminuria as an albumin (,g)/creatinine (mg) ratio (ACR) between 30 and 300 ,g/mg regardless of sex. Microalbuminuria is associated with increased cardiovascular risk. The authors evaluated the prevalence of microalbuminuria in nondiabetic and nonhypertensive systolic heart failure (SHF) patients. Twenty-seven SHF patients, 18 years and older, with New York Heart Association functional classes II through IV and left ventricular ejection fraction ,40%, who were nondiabetic and nonhypertensive and not receiving angiotensin-converting enzyme inhibitors, were selected. Twenty-seven healthy individuals, paired according to sex, ethnicity, and age, were used as controls. Early-morning midstream urine was used. Data are expressed as medians. Excretion of albumin in SHF patients (39 ,g/mL urine) was significantly higher than in controls (26 ,g/mL urine). Creatinine excretion was not significantly different between patients and controls. ACR was significantly higher in patients (54 ,g/mg) than in controls (24 ,g/mg). The results indicate that microalbuminuria was significantly present in nondiabetic and nonhypertensive SHF patients. [source] Developing an attitude towards bullying scale for prisoners: structural analyses across adult men, young adults and women prisonersCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2009Jane L. Ireland Background,Few studies have attempted to explore attitudes towards bullying among prisoners, despite acknowledgement that attitudes may play an important role. Aim,To evaluate the structure of a new attitudinal scale, the Prison Bullying Scale (PBS), with adult men and women in prison and with young male prisoners. Hypotheses,That attitudes would be represented as a multidimensional construct and that the PBS structure would be replicated across confirmatory samples. Method,The PBS was developed and confirmed across four independent studies using item parceling and confirmatory factor analysis: Study I comprised 412 adult male prisoners; Study II, 306 adult male prisoners; Study III, 171 male young offenders; and Study IV, 148 adult women prisoners. Results,Attitudes were represented as a multidimensional construct comprising seven core factors. The exploratory analysis was confirmed in adult male samples, with some confirmation among young offenders and adult women. The fit for young offenders was adequate and improved by factor covariance. The fit for women was the poorest overall. Conclusion,The study notes the importance of developing ecologically valid measures and statistically testing these measures prior to their clinical or research use. Implications,The development of the PBS holds value both as an assessment and as a research measure and remains the only ecologically validated measure in existence to assess prisoner attitudes towards bullying. Copyright © 2009 John Wiley & Sons, Ltd. [source] Synthesis, crystal structure and vibrational characterization of bis-,-peroxo-hexacarbonatodicerate(IV) complexes of rubidium and cesiumCRYSTAL RESEARCH AND TECHNOLOGY, Issue 11 2008N.-P. Pook Abstract The new compounds Rb8[Ce(O2)(CO3)3]2 · 12 H2O (1) and Cs8[Ce(O2)(CO3)3]2 · 10 H2O (2) were obtained from the reaction of hydrogen peroxide and Ce(III) in saturated alkali carbonate solutions. The crystal structures and the unit cell parameters of (1) triclinic, P-1 with a = 8.973(2) Å, b = 10.815(2) Å, c = 11.130(3) Å, , = 66.992(2)°, , = 68.337(2)°, , = 74.639(2)°, VEZ = 914.7(4) Å3, Z = 2, and (2) orthorhombic, Pbca, a = 19.3840(16) Å, b = 18.528(2) Å, c = 10.487(3) Å, VEZ = 3766.4(13) Å3, Z = 8, were determined. Both compounds contain the bis-µ-peroxo-hexacarbonatodicerate(IV)-ion, [(CO3)3Ce(O2)2Ce(CO3)3]8- . IR and Raman spectra were measured and discussed. (© 2008 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] When monocytes and platelets compete: The effect of platelet count on the flow cytometric measurement of monocyte CD36,CYTOMETRY, Issue 2 2010W.H. Dzik Abstract Background: Flow cytometric measurement of monocyte surface CD36 is relevant to several conditions including diabetes, cardiovascular disease, lipid disorders, platelet isoimmunization, and susceptibility to P falciparum malaria. CD36 is also strongly expressed on platelets where it is also known as platelet glycoprotein IV. Methods: Whole blood samples, containing identical monocyte concentrations, were adjusted to contain platelets ranging from 20,000/uL to 600,000/uL, were stained with fluorescent-labeled anti-CD36, and analyzed by flow cytometry. Results: CD36 median fluorescent intensity (MFI) observed on monocytes decreased as the platelet concentration in the sample increased with more than a 50% decline in monocyte MFI over the normal range of platelet values. The effect was not abolished by using larger volumes of monoclonal antibody and was observed with different clones of reagent anti-CD36. The findings were most consistent with competition by platelets for the CD36 reagent. Similar findings were observed with antibody to class I HLA. Under defined assay conditions, monocyte CD36 MFI declined with rising platelet concentration in a predictable fashion following an inverse linear relationship. Conclusions: Measurement of CD36 expression on monocytes by flow cytometry in whole blood samples is affected by the sample platelet count. When comparing the monocyte CD36 expression among different individuals, our approach can be used to adjust measured monocyte CD36 expression for the effect of the platelet concentration in the sample. Competition by platelets for monoclonal reagents may occur in other settings when whole blood assays are used and when the target antigen is strongly expressed on both platelets and leukocytes. © 2009 Clinical Cytometry Society [source] NON-GYNAECOLOGICAL CYTOLOGY: THE CLINICIAN'S VIEWCYTOPATHOLOGY, Issue 2006I. Penman There is increased recognition of the importance of accurate staging of malignancies of the GI tract and lung, greater use of neoadjuvant therapies and more protocol-driven management. This is particularly important where regional lymph node involvement significantly impacts on curability. Multidetector CT and PET scanning have resulted in greater detection of potential abnormalities which, if positive for malignancy, would change management. There is also a greater recognition that many enlarged nodes may be inflammatory and that size criteria alone are unreliable in determining involvement. In other situations, especially pancreatic masses, not all represent carcinoma as focal chronic pancreatitis, autoimmune pancreatitis etc can catch out the unwary. A preoperative tissue diagnosis is essential and even if unresectable, oncologists are increasingly reluctant to initiate chemotherapy or enroll patients into trials without this. The approach to obtaining tissue is often hampered by the small size or relative inaccessibility of lesions by percutaneous approaches. As such novel techniques such as endoscopic ultrasound (EUS) guided FNA have been developed. A 120cm needle is passed through the instrument and, under real-time visualisation, through the gastrointestinal wall to sample adjacent lymph nodes or masses. Multiple studies have demonstrated the safety and performance of this technique. In oesophageal cancer, confirmation of node positivity by has a major negative influence on curative resection rates and will often lead to a decision to use neoadjuvant chemotherapy or a non-operative approach. Sampling of lymph nodes at the true coeliac axis upstages the patient to M1a status (stage IV) disease and makes the patient incurable. In NSCLC, subcarinal lymph nodes are frequently present but may be inflammatory. If positive these represent N2 (stage IIIA) disease and in most centres again makes the patient inoperable. Access to these lymph nodes would otherwise require mediastinosocopy whereas this can be done simply, safely and quickly by EUS. Overall the sensitivity for EUS , FNA of mediastinal or upper abdominal lymph nodes is 83,90% with an accuracy of 80,90%. In pancreatic cancer performance is less good but pooled analysis of published studies indicates a sensitivity of 85% and accuracy of 88%. In a recent spin-off from EUS, endobronchial ultrasound (EBUS) instruments have been developed and the ability to sample anterior mediastinal nodes has been demonstrated. It is likely that this EBUS , FNA technique will become increasingly utilised and may replace mediastinoscopy. The development of techniques such as EUS and EBUS to allow FNA sampling of lesions has increased the role of non-gynaecological cytology significantly in recent years. Cytology therefore remains important for a broad range of specialties and there is ongoing need for careful and close co-operation between cytologists and clinicians in these specialties. References:, 1. Williams DB, Sahai AV, Aabakken L, Penman ID, van Velse A, Webb J et al. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut. 1999; 44: 720,6. 2. Silvestri GA, Hoffman BJ, Bhutani MS et al. Endoscopic ultrasound with fine-needle aspiration in the diagnosis and staging of lung cancer. Ann Thorac Surg 1996; 61: 1441,6. 3. Rintoul RC, Skwarski KM, Murchison JT, Wallace WA, Walker WS, Penman ID. Endobronchial and endoscopic ultrasound real-time fine-needle aspiration staging of the mediastinum ). Eur Resp J 2005; 25: 1,6. [source] | |||||||||||||||||||||||||||||||||||||||||||