bluuebunny/crossref_metadata_2025 huggingface dataset:
Trunk Control as an Early Predictor of Comprehensive Activities of Daily Living Function in Stroke Patients
Authors: Hsieh Ching-Lin , Sheu Ching-Fan , Hsueh I-Ping , Wang Chun-Hou
Published: October 2002

Background and Purpose—

Prediction of activities of daily living (ADL) functions at an early stage after a stroke is critical because it enables clinicians to set treatment programs and goals. The objective of this study was to assess the relationship between trunk control at an early stage and comprehensive ADL function (as assessed by combining basic ADL and instrumental ADL [IADL]) in patients at 6 months after stroke.

Methods—

A total of 169 stroke patients participated in this prospective study. Trunk control was measured with the use of the trunk control items of the Postural Assessment Scale for Stroke Patients (PASS-TC). In addition to the PASS-TC score, age, sex, type of stroke, side of hemiparesis, urinary incontinence, limb paresis (measured by the Fugl-Meyer motor test), balance (measured by the Fugl-Meyer balance test), and basic ADL (measured by the Barthel Index) were also selected as predictor variables. These variables were assessed at 14 days after stroke or earlier. The Barthel Index and Frenchay Activities Index (measuring IADL) were administered at 6 months after stroke. The sum of the standardized Barthel Index and standardized Frenchay Activities Index scores was used to assess comprehensive ADL function.

Results—

Multivariable stepwise linear regression analysis showed that PASS-TC score, age, Fugl-Meyer motor test score, and Barthel Index score (listed by the order of forward selection) were the strongest predictors of comprehensive ADL function. These results were internally validated with the use of the bootstrap resampling technique. The PASS-TC score alone accounted for 45% of the variance in predicting comprehensive ADL function. Results also indicated that the PASS-TC score had slightly more power in predicting comprehensive ADL function than either the Fugl-Meyer motor test score or Barthel Index score.

Conclusions—

The findings of this study provide strong evidence of the predictive value of trunk control on comprehensive ADL function in stroke patients. The results imply that early assessment and management of trunk control after stroke should be emphasized.
Prediction of Length of Stay of First-Ever Ischemic Stroke
Authors: Chang Ku-Chou , Tseng Mei-Chiun , Weng Hsu-Huei , Lin Yin-Hui , Liou Chia-Wei , Tan Teng-Yeow
Published: October 2002

Background and Purpose—

Accurate information about hospital resource utilization is necessary for management of healthcare service. The purpose of this study was to determine the demographic and clinical predictors of length of hospital stay (LOS) of acute care hospitalization for first-ever ischemic stroke patients.

Methods—

A group of 330 patients who suffered from first-ever ischemic stroke and were consecutively admitted to a medical center in southern Taiwan were followed prospectively. Because our intention was to identify the major predictors of LOS from the information available at admission, we evaluated only those factors that could be assessed at the time of admission. Univariate analysis and multiple regression analysis were used to identify the main predictors of LOS.

Results—

The median LOS was 7 days (mean, 11 days; range, 1 to 122 days). Among the prespecified demographic and clinical characteristics, National Institutes of Health Stroke Scale (NIHSS) score at admission, the quadratic term of the initial NIHSS score, modified Barthel Index score at admission, small-vessel occlusion stroke, sex, and smoking were the main explanatory factors for LOS. In particular, for each 1-point increase in the total score of NIHSS, LOS increased approximately 1 day for patients with mild or moderate (score 0 to 15 points) neurological impairments, while LOS decreased approximately 1 day for patients with severe (score >15 points) neurological impairments.

Conclusions—

The severity of stroke, as rated by the total score on NIHSS, is an important factor that influences LOS after acute stroke hospitalization.
Course of Platelet Activation Markers After Ischemic Stroke
Authors: Marquardt Lars , Ruf Andreas , Mansmann Ulrich , Winter Ralph , Schuler Matthias , Buggle Florian , Mayer Horst , Grau Armin J.
Published: October 2002

Background and Purpose—

The aim of this study was to evaluate the time course of platelet activation after ischemic stroke and to investigate whether platelet activation and inflammation are correlated with each other.

Methods—

We serially determined expression of p-selectin (CD62p) and lysosome-associated membrane protein (CD63) by platelets using flow cytometry at 10 time points between days 1 and 90 in patients after ischemic stroke (n=50), in healthy subjects (n=30), and in risk factor control subjects (n=20). Furthermore, we correlated leukocyte count, C-reactive protein, and fibrinogen levels with platelet activation markers.

Results—

CD62p and CD63 expression was higher on day 1 after stroke than in both control groups (
P
<0.005 for both). CD62p expression rapidly declined, whereas CD63 expression remained significantly elevated until day 90. Stroke severity and different medication for secondary stroke prevention did not influence CD62p or CD63 expression. Platelet activation markers and inflammatory parameters were not correlated with each other at any time point after stroke.

Conclusions—

The initial increase in both CD62p and CD63 expression by platelets is followed by a differential regulation of both parameters after stroke. The rapid decrease in CD62p expression may be caused by shedding from the cell surface. Its persistent elevation makes CD63 a good candidate for studies on predictors for stroke recurrence. Our findings suggest that the expression of CD62p and CD63 by platelets is regulated independently from inflammatory indexes.
Sildenafil (Viagra) Induces Neurogenesis and Promotes Functional Recovery After Stroke in Rats
Authors: Zhang Ruilan , Wang Ying , Zhang Li , Zhang Zhenggang , Tsang Wayne , Lu Mei , Zhang Lijie , Chopp Michael
Published: October 2002

Background and Purpose—

We tested the hypothesis that sildenafil, a phosphodiesterase type 5 (PDE5) inhibitor, promotes functional recovery and neurogenesis after stroke.

Methods—

Male Wistar rats were subjected to embolic middle cerebral artery occlusion. Sildenafil (Viagra) was administered orally for 7 consecutive days starting 2 or 24 hours after stroke onset at doses of 2 or 5 mg/kg per day. Ischemic rats administered the same volume of tap water were used as a control group. Functional outcome tests (foot-fault, adhesive removal) were performed. Rats were killed 28 days after stroke for analysis of infarct volume and newly generated cells within the subventricular zone and the dentate gyrus. Brain cGMP levels, expression of PDE5, and localized cerebral blood flow were measured in additional rats.

Results—

Treatment with sildenafil significantly (
P
<0.05) enhanced neurological recovery in all tests performed. There was no significant difference of infarct volume among the experimental groups. Treatment with sildenafil significantly (
P
<0.05) increased numbers of bromodeoxyuridine-immunoreactive cells in the subventricular zone and the dentate gyrus and numbers of immature neurons, as indicated by βIII-tubulin (TuJ1) immunoreactivity in the ipsilateral subventricular zone and striatum. The cortical levels of cGMP significantly increased after administration of sildenafil, and PDE5 mRNA was present in both nonischemic and ischemic brain.

Conclusions—

Sildenafil increases brain levels of cGMP, evokes neurogenesis, and reduces neurological deficits when given to rats 2 or 24 hours after stroke. These data suggest that this drug that is presently in the clinic for sexual dysfunction may have a role in promoting recovery from stroke.
Atrial Fibrillation, Stroke, and Acute Antithrombotic Therapy
Authors: Hart Robert G. , Palacio Santiago , Pearce Lesly A.
Published: October 2002

Background—

Strokes in patients with atrial fibrillation (AF) are typically larger, are associated with higher early mortality, and occur in older patients versus strokes in patients with sinus rhythm. Until recently, the value of antithrombotic therapies for acute stroke management has been based on empiric evidence.

Summary of Review—

We present a critical review of 3 randomized clinical trials testing aspirin, heparin/heparinoid, or both involving 5029 patients with AF and acute stroke. Early recurrent ischemic stroke occurred in about 5% of patients during the 2 to 4 weeks after initial stroke. Data conflict about whether early use of heparin/heparinoid reduced early recurrent ischemic stroke but are consistent regarding its lack of overall benefit on long-term functional outcome. Modest benefits for reduction of early recurrent stroke and functional outcome were associated with aspirin use, based largely on subgroup analysis from a single, large, unblinded trial.

Conclusions—

No benefit of heparin has been demonstrated for acute stroke patients with AF; whether selected subgroups would respond differently remains to be proven. Aspirin followed by early initiation of warfarin for long-term secondary prevention is reasonable antithrombotic management.
Bilateral Symmetry of Human Carotid Artery Atherosclerosis
Authors: Adams Gareth J. , Simoni Darlene M. , Bordelon Cassius B. , Vick G. Wesley , Kimball Kay T. , Insull William , Morrisett Joel D.
Published: October 2002

Background and Purpose—

Atherosclerosis is a principal cause of stroke and myocardial infarction. The carotid arteries provide a site at which progression of atherosclerosis can be monitored reproducibly and noninvasively. This study was conducted to determine the similarity of atherosclerotic plaques in the left and right carotid arteries. This question was explored with the use of perfusion-fixed cadaveric carotid arteries and 2 noninvasive clinical imaging techniques, MRI and electron-beam CT.

Methods—

Fifty pairs of carotid arteries from cadaveric donors (aged 48 to 98 years) were imaged with MRI and electron-beam CT. Thirty-eight of the pairs met the criteria for rigorous analysis. Carotid artery wall volumes were measured from the MRI images, and calcification scores were computed from the electron-beam CT images.

Results—

Total wall volumes of the left (972.5±241.6 mm
3
) and right (1016.3±275.0 mm
3
) carotid arteries were moderately correlated (concordance correlation coefficient [
r
c
]=0.71). Calcification scores were highly correlated, with
r
c
=0.95 for the Agatston scores and
r
c
=0.94 for the calcium volume scores.

Conclusions—

Total wall volume and plaque calcification in the left and right human carotid arteries are substantially similar. These results suggest that atherosclerosis of the human carotid arteries is generally a bilaterally symmetrical disease. This evidence of symmetry suggests that diagnostic information about atherosclerotic plaque in one carotid artery can be used to infer information about the composition and volume of atherosclerotic plaque in the contralateral artery.
Masking Interrupts Figure-Ground Signals in V1
Authors: Lamme Victor A. F. , Zipser Karl , Spekreijse Henk
Published: October 2002

In a backward masking paradigm, a target stimulus is rapidly (<100 msec) followed by a second stimulus. This typically results in a dramatic decrease in the visibility of the target stimulus. It has been shown that masking reduces responses in V1. It is not known, however, which process in V1 is affected by the mask. In the past, we have shown that in V1, modulations of neural activity that are specifically related to figure-ground segregation can be recorded. Here, we recorded from awake macaque monkeys, engaged in a task where they had to detect figures from background in a pattern backward masking paradigm. We show that the V1 figure-ground signals are selectively and fully suppressed at target-mask intervals that psychophysically result in the target being invisible. Initial response transients, signalling the features that make up the scene, are not affected. As figure-ground modulations depend on feedback from extrastriate areas, these results suggest that masking selectively interrupts the recurrent interactions between V1 and higher visual areas.
Modality-Specific Deterioration in Naming Verbs in Nonfluent Primary Progressive Aphasia
Authors: Hillis Argye E. , Tuffiash Elizabeth , Caramazza Alfonso
Published: October 2002

A longitudinal study of oral and written naming and comprehension of nouns and verbs in an individual (M. M. L.) with nonfluent primary progressive aphasia (PPA) is reported. M. M. L. showed progressive deterioration of oral naming of verbs well before deterioration of written naming of verbs and before deterioration of oral or written naming of nouns. Her comprehension of both nouns and verbs remained intact, at least relative to oral naming of verbs. Her performance is compared to that of two other individuals with nonfluent PPA, who were tested at two time points. These patients showed similar patterns with respect to grammatical word class (verbs more impaired than nouns) and modality (spoken production more impaired than written production), but somewhat different courses of deterioration. The modality-specific nature of the observed verb production deficits rules out a semantic locus for the grammatical class effects. The results provide a new source of evidence for the hypothesis that there are distinct neural mechanisms for accessing lexical representations of nouns and verbs in language production.
Transcranial Magnetic Stimulation of the Human Frontal Eye Field: Effects on Visual Perception and Attention
Authors: Grosbras Marie-Hélène , Paus Tomáš
Published: October 2002

When looking at one object, human subjects can shift their attention to another object in their visual field without moving the eyes. Such shifts of attention activate the same brain regions as those involved in the execution of eye movements. Here we investigate the role of one of the main cortical oculomotor area, namely, the frontal eye field (FEF), in shifts of attention. We used transcranial magnetic stimulation (TMS), a technique known to disrupt transiently eye-movements preparation. We hypothesized that if the FEF is a necessary element in the network involved in shifting attention without moving the eyes, then TMS should also disrupt visuospatial attention.

For each volunteer, we positioned the TMS coil over the probabilistic anatomical location of the FEF, and we verified that single pulses delayed eye movements. We then applied TMS during a visuospatial attention task. In this task, a central arrow directed shifts of attention and the subject responded by a keypress to a subsequent visual peripheral target without moving the eyes from the central fixation point. In a few trials, the cue was invalid or uninformative, yielding slower responses than when the cue was valid. We delivered single pulses either 53 msec before or 70 msec after target onset.

Contrary to our prediction, the main effect of the stimulation was a decrease in reaction time when it was applied 53 msec before target onset. TMS over the left hemisphere facilitated responses to targets in the right hemifield only and for all cueing conditions, whereas TMS over the right hemisphere had a bilateral effect for valid and neutral but not invalid cueing. Thus, TMS interfered with shift of attention only in the case of right hemisphere stimulation: it increased the cost of invalid cueing.

Our results suggest that TMS over the FEF facilitates visual detection, and thereby reduces reaction time. This finding provides new insights into the role of the human FEF in processing visual information. The functional asymmetry observed for both facilitation of visual detection and interference with shifts of attention provides further evidence for the dominance of the right hemisphere for those processes. Our results also underline that the disruptive or facilitative effect of TMS over a given region depends upon the behavioral context.
DOES 'INNÂ DENOTE RAPE? A SEMANTIC ANALYSIS OF A CONTROVERSIAL WORD
Authors: Van Wolde Ellen
Published: October 2002

The widespread opinion that the verb 'innâ in the Pi'el refers to "rape" or "sexual abuse" is not acceptable. It suffers from a lack of analysis of all the biblical material and of the distribution of 'innâ with a female object in the Hebrew Bible. A semantic analysis of the lexical collocations, of the word order and of the textual occurrences in which 'innâ functions shows that this verb is used as an evaluative term in a juridical context denoting a spatial movement downwards in a social sense and should be translated as "debase". By implication, the verb 'innâ in Gen. xxxiv 2 does not describe Shechem's rape or sexual abuse of Dinah, but evaluates Shechem's previously described actions as a debasement of Dinah from a social-juridical point of view.
AMBIGUITY AND WORDPLAY IN PROVERBS XI
Authors: Kselman John
Published: October 2002

The prepositional phrase ûberis'ātô in Prov. xi 5 and the contested meaning of hawwat in xi 6 can both be explained as instances of deliberate ambiguity and wordplay.
Cerebellar responses during anticipation of noxious stimuli in subjects recovered from depression
Authors: Smith Katharine A. , Ploghaus Alexander , Cowen Philip J. , McCleery Jenny M. , Goodwin Guy M. , Smith Stephen , Tracey Irene , Matthews Paul M.
Published: October 2002

Background

Subjects recovered from depression have a substantial risk for recurrence of depression, suggesting persistent abnormalities in brain activity.

Aims

To test whether women recovered from depression show abnormal brain activity in functional magnetic resonance imaging (fMRI) during a conditioning paradigm with a noxious pain stimulus.

Method

Ten unmedicated women who had recovered from major depression and eight healthy control women each received either noxious hot or non-noxious warm stimuli, the onset of which was signalled by a specific coloured light during 3-tesla echo planar imaging-based fMRI.

Results

Similar patterns of brain activation were found during painful stimulation for both patients and healthy controls. However, relative to healthy controls, subjects recovered from depression showed a reduced response in the cerebellum during anticipation of the noxious stimulus compared with anticipation of the non-noxious stimulus.

Conclusions

Our data suggest that abnormal cerebellar function could be a marker of vulnerability to recurrent depression. This could provide a new target for therapeutic interventions.
Diagnosis of lupus anticoagulant in the lupus anticoagulant‐hypoprothrombinemia syndrome: Report of two cases and review of the literature
Authors: Baca Vicente , Montiel Guadalupe , Meillón Luis , Pizzuto Javier , Catalán Teresa , Juan‐Shum Luis , Nieva Beatriz
Published: October 2002

We report a severe hemorrhagic disorder in two pediatric patients with lupus anticoagulant (LA) associated to acquired factor II (prothrombin) deficiency. In both patients, hemorrhagic symptoms resolved after corticosteroid therapy. Serial coagulation studies showed that Staclot LA® assay was more sensitive than DVVconfirm® and Staclot PNP® tests to confirm the presence of LA when associated with severe factor II deficiency. Both patients had non‐neutralizing anti‐prothrombin antibodies and their titers inversely correlated with factor II activity (r = −1.0, P < 0.0001). Associated findings in these patients included positive immunologic tests for systemic lupus erythematosus, a positive anti‐cardiolipin antibody, and anti‐β2 GPI antibodies in one case. Our findings point out the difficulty in diagnosing LA associated with acquired factor II deficiency and suggest that, in confirmation of its phospholipid dependency, the inclusion of a source of normal human plasma in the test sequence to correct for any factor deficiency and a confirmatory step utilizing hexagonal (II) phase phospholipids may be crucial to the diagnosis of LA in some patients with LA‐hypoprothrombinemia syndrome. Am. J. Hematol. 71:200–207, 2002. © 2002 Wiley‐Liss, Inc.
Sustained molecular remission in a patient with CML in blastic crisis receiving dose‐reduced hematopoietic stem‐cell transplantation followed by early withdrawal of cyclosporine and prophylactic use of interferon‐α
Authors: Hamaki Tamae , Kami Masahiro , Momomura Shin‐ichi , Mineishi Shin , Kusumi Eiji , Kanda Yoshinobu , Ueyama Jun‐ichi , Miyakoshi Shigesaburo , Morinaga Shin‐ichi , Takaue Yoichi , Mutou Yoshitomo
Published: October 2002

A 54‐year‐old man with chronic myelocytic leukemia in blastic phase received reduced‐intensity transplantation (RIST) from an HLA‐identical unrelated donor. The preparative regimen consisted of busulfan, fludarabine, and anti‐thymocyte globulin. Graft‐versus‐host disease (GVHD) prophylaxis was cyclosporine alone. Because he had a high risk of relapse, we discontinued cyclosporine on day 37, but he did not develop any signs of acute GVHD. To induce GVHD and augment a graft‐versus‐leukemia effect, we initiated interferon‐α therapy on day 80 to a maximum dosage of three million units five times a week. He achieved molecular remission on day 94 followed by the development of extensive chronic GVHD the severity of which paralleled to the dose of interferon‐α GVHD gradually subsided after discontinuation of interferon‐α and the patient remains in molecular remission 18 months after transplantation. This case suggests that early withdrawal of cyclosporine and the prophylactic use of interferon‐α are promising in RIST for high‐risk leukemia. Am. J. Hematol. 71:196–199, 2002. © 2002 Wiley‐Liss, Inc.
Hydroxyurea (HU) for prevention of recurrent stroke in sickle cell anemia (SCA)
Authors: Sumoza Abraham , de Bisotti Renate , Sumoza David , Fairbanks Virgil
Published: October 2002

Cerebrovascular accident (CVA) is a major cause of morbidity and death in sickle cell anemia (SCA). Transfusion of packed erythrocytes is widely used to prevent this complication. However, chronic transfusion may lead to iron overload, alloimmunization, or infections. Cost and compliance may compromise transfusion therapy. A possible alternative, the prophylactic use of hydroxyurea (HU), has not been tried to determine whether it may prevent recurrent stroke. We used HU in five children with SCA who had suffered stroke, in three of them after a first episode and in the other two after a second CVA. Four had infarctive stroke and one a transient ischemic attack (TIA). Four patients took HU at a dose of 40 mg/kg/d, one patient at 30 mg/kg/d. None of the patients had recurrent stroke during 42–112 months of observation. None experienced pain crises. In all, HbF increased significantly and was maintained above 14.7% during treatment. The total Hb concentration increased 19.5 g/L (median) above the value before treatment. HU was well tolerated. None of the five children had leukopenia or thrombocytopenia during therapy. HU appears to prevent recurrence of stroke in SCA without risk of major toxicity. Am. J. Hematol. 71:161–165, 2002. © 2002 Wiley‐Liss, Inc.
CD4−CD8− T‐cell polymyositis in a patient with chronic active Epstein‐Barr virus infection
Authors: Tsutsumi Sachiko , Ohga Shouichi , Nomura Akihiko , Takada Hidetoshi , Sakai Shuji , Ohshima Koichi , Sumimoto Kotoko , Hara Toshiro
Published: October 2002

We describe a 17‐year‐old woman with chronic active Epstein‐Barr virus infection (CAEBV), who developed EBV+CD4−CD8− T‐cell polymyositis. At 14 years of age, CAEBV was diagnosed with fever, cytopenia, liver dysfunction, and hepatosplenomegaly. Despite the transient remission of interferon‐α therapy, migratory lesions emerged in back and extremities. MRI indicated polymyositis. Biopsy specimens revealed intramuscular infiltration of CD3+, CD4−, CD8−, CD56−, and EBV‐encoded RNA 1+ cells. Circulating CD4−CD8−Vδ2/Vγ9 cells increased. γδT‐cells contained 20–200 times higher EBV‐DNA (2 × 104 copies/μgDNA) than αβT‐cells or NK‐cells. The ominous polymyositis might denote the musculotropic invasion of EBV+γδT‐cell lymphoproliferative disease as a consequence of CAEBV. Am. J. Hematol. 71:211–215, 2002. © 2002 Wiley‐Liss, Inc.
Myxedema ascites in the posttransplant setting: Case report
Authors: McDonough Colleen H. , Lee Linda , de Beur S. Jan , Arai Sally , Vogelsang Georgia B.
Published: October 2002

Ascites is a rare but important complication of hypothyroidism. Because of the rarity of the disease and the inconsistency of symptoms associated with hypothyroidism, patients often go undiagnosed for months. Institution of thyroid replacement hormone results in rapid and complete resolution of ascites. Here we present a case of myxedema ascites that presented in a 52‐year‐old man 4 months after allogeneic bone marrow transplant (BMT). Diagnoses initially considered in the differential included the common post‐BMT complications, namely, hepatic veno‐occlusive disease, graft vs. host disease, and infection. However, posttransplant patients are also at risk for illnesses unrelated to their underlying diagnosis or transplant procedure, including hypothyroidism. This case illustrates the importance of considering a broad differential diagnosis in posttransplant patients, especially those in whom the clinical course is atypical. Am. J. Hematol. 71:216–218, 2002. © 2002 Wiley‐Liss, Inc.
In vitro production of anti‐RBC antibodies and cytokines in chronic lymphocytic leukemia
Authors: Barcellini W. , Montesano R. , Clerici G. , Zaninoni A. , Imperiali F.G. , Calori R. , Cortelezzi A. , Zanella A.
Published: October 2002

B‐chronic lymphocytic leukemia (B‐CLL) patients have a high prevalence of autoimmune phenomena, mainly autoimmune hemolytic anemia (AIHA). Immunoregulatory cytokines play a role in the regulation of both autoimmunity and leukemic B‐cell growth. Mitogen‐stimulated direct antiglobulin test (MS‐DAT) is a recently described test able to disclose latent anti‐RBC autoimmunity in AIHA. We investigated the prevalence of anti‐RBC autoimmunity by MS‐DAT and the pattern of cytokine production by PHA‐stimulated whole blood cultures from 69 B‐CLL patients and 53 controls. Results showed that anti‐RBC IgG values in unstimulated, PHA‐, PMA‐, and PWM‐stimulated cultures were significantly higher in B‐CLL patients compared with controls. In B‐CLL, the prevalence of anti‐RBC autoimmunity was 28.9% by MS‐DAT, compared with 4.3% by the standard DAT. Production of IFN‐γ, IL‐2, IL‐13, TNF‐α, sCD23, and sCD30 was significantly increased in all B‐CLL patients compared with controls, whereas there was no difference in IL‐4, IL‐6, IL‐10, and TGF‐β production. Multivariate analysis showed that IL‐4 was significantly increased in MS‐DAT‐positive compared with ‐negative patients. Patients with autoantibody positivity displayed greater IFN‐γ production than negative patients. These data are in line with the hypothesis that autoimmune phenomena in B‐CLL are associated with an imbalance towards a Th‐2‐like profile. The elevated prevalence of anti‐RBC autoimmunity found by MS‐DAT suggests that an underestimated latent autoimmunity exists in B‐CLL. Am. J. Hematol. 71:177–183, 2002. © 2002 Wiley‐Liss, Inc.
Pregnancy and successful labor in the course of chronic lymphocytic leukemia
Authors: Gürman Günhan
Published: October 2002

Pregnancy and leukemia are difficult to manage. Protecting the mother from hemorrhage and infection and the fetus from developmental failure are the main aims. Chronic lymphocytic leukemia (CLL) has been seen very rarely with pregnancy. In this article, the successful labor of a 43‐year‐old woman with CLL is reported. She was not a candidate for chemotherapy at that time. She was without symptoms when she got pregnant. In the 30th gestational week she was found to have urinary tract infection and preterm labor and she was stabilized. Gestational diabetes and preeclampsia were also determined after that period and managed. The patient was delivered by cesarean section in the 39th gestational week. Cord blood was collected and preserved. No postpartum complication was seen in either the patient or the infant. This is one of the rare cases presenting CLL with pregnancy in the literature. Am. J. Hematol. 71:208–210, 2002. © 2002 Wiley‐Liss, Inc.
Occurrence of multiple myeloma in both donor and recipient after bone marrow transplantation
Authors: Kumar Arun , Styler Michael J. , Topolsky David L. , Crilley Pamela A. , Przybysz Thomas M. , Gladstone Douglas E.
Published: October 2002

The transplantation of malignant cells during allogeneic transplant is a rare occurrence. 27 months after donating progenitor cells, a diagnosis of multiple myeloma was made in a 6/6 HLA‐phenotypically matched unrelated donor. The 42‐year‐old recipient transplanted for chronic phase chronic myeloid leukemia developed IgA myeloma 40 months after transplantation. Serum electrophoresis and bone marrow investigations established the diagnosis of IgA K multiple myeloma in both. This case illustrates the natural history and biology of multiple myeloma. Am. J. Hematol. 71:227–228, 2002. © 2002 Wiley‐Liss, Inc.
Is the relationship between numbers of references and paper lengths the same for all sciences?
Authors: Abt Helmut A. , Garfield Eugene
Published: October 2002

In each of 41 research journals in the physical, life, and social sciences there is a linear relationship between the average number of references and the normalized paper lengths. For most of the journals in a given field, the relationship is the same within statistical errors. For papers of average lengths in different sciences the average number of references is the same within ±17%. Because papers of average lengths in various sciences have the same number of references, we conclude that the citation counts to them can be inter‐compared within that accuracy. However, review journals are different: after scanning 18 review journals we found that those papers average twice the number of references as research papers of the same lengths.
State digital library usability: Contributing organizational factors
Authors: Xie Hong (Iris) , Wolfram Dietmar
Published: October 2002

Usage and user feedback about a state digital library, in which the developers/designers, content providers, different types of libraries and their staffs, and a variety of user groups represent a loose federation of separate organizations with diverse expectations and needs, are investigated. Through corroboratory evidence from usage statistics of Internet‐based database services available through the digital library, responses to a statewide‐administered library survey, and a Web‐based survey of end users, the authors identify contributing factors for the organizational usability of state digital libraries. The authors refine and enhance an organizational usability model for the unique environment of state digital libraries and identify three modes of interaction (influence, communication, activity) and the challenges each interaction presents: in addressing diverse player needs and expectations; the unequal awareness and training in using state digital libraries; and the lack of sufficient communication channels among players. In addition, the findings highlight the double‐edged impact of physical libraries on the state digital library.
A high‐performance liquid chromatography method using ultraviolet detection for the quantitation of flavopiridol from human plasma
Authors: Zhai Suoping , Sausville Edward , Figg William D.
Published: October 2002

Flavopiridol is an inhibitor of cyclin‐dependent kinase, a key regulator of cell cycle, and is currently under clinical trials. We developed and validated an HPLC assay method for the quantitation of flavopiridol in human plasma samples. The sample preparation consisted of protein precipitation with acetonitrile. Separation was accomplished on a C18 column and a C18 precolumn insert utilizing a gradient profile consisting of ammonium acetate and methanol. Ultraviolet detection was set at 268 nm for flavopiridol and 323 nm for umbelliferone, the internal standard. The method was validated over flavopiridol concentration range of 0.025–3.0 µg/mL using 250 µL of plasma. The assay was linear over this concentration range with a coefficient of variation less than 10% for inter‐ and intra‐assay. The retention times were around 6.2 min for umbelliferone and 9.8 min for flavopiridol. The recoveries of flavopiridol and umbelliferone were 88.6 ± 1.0% and 97.1 ± 3.7%, respectively. This method is suitable for quantifying flavopiridol in plasma samples and further characterizing the clinical pharmacology of this compound. Copyright © 2002 John Wiley & Sons, Ltd.
Determination of lamivudine/stavudine/efavirenz in human serum using liquid chromatography/electrospray tandem mass spectrometry with ionization polarity switch
Authors: Fan Bin , Bartlett Michael G. , Stewart James T.
Published: October 2002

A high‐performance liquid chromatography/tandem mass spectrometry (LC‐MS‐MS) method with ionization polarity switch was developed and validated in human serum for the determination of a lamivudine (3TC)/stavudine (d4T)/efavirenz combination HIV therapy. Solid phase extraction (SPE) was used to extract these anti‐HIV drugs and internal standard aprobarbital. A gradient mobile phase consisting of acetonitrile and 20 mM ammonium acetate buffer with pH adjusted to 4.5 using glacial acetic acid was utilized to separate these drugs on a hexylsilane column (150 × 2.0 mm i.d.). The total run time between injections was 18 min. The precursor and major product ions of these drugs were monitored on a triple quadrupole mass spectrometer in the multiple reactions monitoring (MRM) mode. Ionization polarity was switched in the middle of the LC run allowing these anti‐HIV drugs with different physicochemical properties to be detected simultaneously. The effect of ion suppression from human serum was studied and no interference with the analysis was noted. The method was validated over the range of 1.1–540 ng/mL for 3TC, 12.5–6228 ng/mL for d4T and 1.0–519 ng/mL for efavirenz. The method was shown to be accurate, with intra‐day and inter‐day accuracy less than 14.0% and precise, with intra‐day and inter‐day precision less than 13.1%. The extraction recoveries of all analytes were higher than 90%. Copyright © 2002 John Wiley & Sons, Ltd.
Development of a new assay for the screening of hypochlorous acid scavengers based on reversed‐phase high‐performance liquid chromatography
Authors: Gatto Maria Teresa , Firuzi Omidreza , Agostino Roberta , Grippa Eleonora , Borsò Angela , Spinelli Francesca , Pavan Lucia , Petrolati Marzia , Petrucci Rita , Marrosu Giancarlo , Saso Luciano
Published: October 2002

A new assay for the screening of hypochlorite/hypochlorous acid (XOCl) scavengers, based on the reversed‐phase high performance liquid chromatographic analysis of human serum albumin (HSA, 0.2% in 100 mM sodium phosphate, pH 7), before and after oxidation by XOCl (1.6 mM), was developed. XOCl induced a significant decrease of the area under the chromatographic peak of HSA at 280 nm due to the oxidation of the aromatic amino acids tryptophan and tyrosine, as suggested by the literature and by the chromatographic analyses and the electrochemical study performed here. The assay was validated by testing known XOCl scavengers such as ascorbic acid, cysteine, glutathione, S‐methylglutathione and α‐lipoic acid and other antioxidants such as carnosine and chlorogenic acid, which inhibited the oxidation of HSA. Quantitative activities were calculated using an original formula based on the changes of the area of the albumin peak. Electrochemical data collected here in a homogeneous medium showed that the anodic potentials of the antioxidants tested are less positive (ascorbic acid, chlorogenic acid and cysteine) or similar (α‐lipoic acid) compared with those of the aromatic residues (tryptophan and tyrosine) of HSA oxidized by XOCl. However, as expected, carnosine, glutathione and S‐methylglutathione were inactive at a glassy‐carbon, gold or platinum electrode. Copyright © 2002 John Wiley & Sons, Ltd.
A preliminary evaluation of the functional significance of alpha‐1‐acid glycoprotein glycosylation on wound healing
Authors: French Deborah , Watson John , McCahill Breeda , Taggart Ian , Smith Kevin D.
Published: October 2002

The laying down of collagen and fibrous tissue is a key process in wound healing, however excessive collagen (and glycoprotein) deposition causes hypertrophic and keloid scars, eg after burns. Collagen synthesis is increased in these scars compared with normal healing, as is collagenase activity, which controls the degradation pathway of collagen. The processes of wound healing are inextricably linked to those of the acute‐phase response (APR): α‐1‐acid glycoprotein (AGP), a plasma glycoprotein that undergoes both an increase in concentration and an alteration in its glycosylation pattern during the APR. This study determined that AGP isolated from the plasma of burns patients was of an increased concentration and altered glycosylation pattern compared with normal plasma and was capable of directly interacting with type I collagen. It also had a profound effect on both collagen fibril formation and collagenase activity, to a degree dependent upon the percentage body surface area burned. Additionally, the results obtained provided the basis for predicting the formation of hypertrophic scars. Copyright © 2002 John Wiley & Sons, Ltd.
Semi‐micro liquid chromatography of aromatic amino acid metabolites using isocratic elution and Column switching
Authors: Hanai Toshihiko , Kaneko Kazuko , Homma H.
Published: October 2002

The concentrations of catecholamine‐related compounds in body fluids reflect sympathetic nerve functions. Measuring the enzyme activity of these metabolic pathways will improve diagnosis since a variety of symptoms are reported. An isocratic elution system with two column switching valves was developed using three types of semi‐micro columns for fast chromatographic analysis of catecholamine related compounds. Columns are a pentyl‐bonded phase, 50 × 2.1 mm i.d., a phenylhexyl‐bonded phase, 100 × 2.1 mm i.d. and an octadecyl‐bonded phase, 100 × 2.1 mm i.d. The separation of 20 standard compounds was achieved within 25 min using reversed‐phase ion‐pair liquid chromatography with an electrochemical detector. This new system was applied for analysis of catecholamine‐related compounds in pig brain, since pigs are a widely used animal model for transgenic manipulation of neural genes, and MHPG (or VMA), DOPAC, DOPA, NE, EP, DA, 5HTP and 5HIAA were quantified. Copyright © 2002 John Wiley & Sons, Ltd.
Beyond peripheral arteries in Buerger's disease: Angiographic considerations in thromboangiitis obliterans
Authors: Hoppe Bobbi , Lu Jonathan T. , Thistlewaite Patricia , Yi Eunhee S. , Mahmud Ehtisham
Published: October 2002

Thromboangiitis obliterans is an inflammatory peripheral vascular disease that is strongly associated with smoking. It predominantly affects distal small‐ and medium‐sized blood vessels of both the upper and lower extremities. We present histological evidence of this disease process affecting the internal mammary arteries. This can be of paramount clinical significance for patients with Buerger's disease who present with obstructive coronary artery disease and require coronary artery bypass grafting surgery (CABG). Internal mammary arteries involved with thromboangiitis obliterans cannot be utilized as arterial conduits during CABG and other alternatives have to be used. Therefore, we recommend preoperative angiography of both internal mammary arteries in patients with Buerger's disease requiring CABG to prevent extensive intraoperative dissection of diseased internal mammary arteries. Cathet Cardiovasc Intervent 2002;57:363–366. © 2002 Wiley‐Liss, Inc.
Photodynamic therapy: Applications in atherosclerotic vascular disease with motexafin lutetium
Authors: Chou Tony M. , Woodburn Kathryn W. , Cheong Wai‐Fung , Lacy Steven A. , Sudhir Krishnankutty , Adelman Daniel C. , Wahr Dennis
Published: October 2002

Photodynamic therapy (PDT) has been approved as a tissue‐specific light‐activated cytotoxic therapy for many diseases. The ability of PDT to destroy target tissues selectively is especially appealing for atherosclerotic plaque. Biotechnology has developed a new generation of selective photosensitizers and catheter‐based technological advances in light delivery have allowed the introduction of PDT into the vasculature. The largest experience to date is with motexafin lutetium (MLu, Antrin), an expanded porphyrin (texaphyrin) that accumulates in plaque. The combination of the motexafin lutetium and endovascular illumination, or Antrin phototherapy, has been shown to reduce plaque in animal models. Antrin phototherapy generates cytotoxic singlet oxygen that has been shown to induce apoptosis in macrophages and smooth muscle cells. The safety, tolerability, and preliminary efficacy of Antrin phototherapy has been assessed in a phase 1 dose‐ranging clinical trial in subjects with peripheral artery disease and is currently being examined in a phase 1 study in subjects with lesions of the native coronary arteries undergoing stent implantation. The preliminary results suggest that Antrin phototherapy is safe, well tolerated, and nontraumatic. Cathet Cardiovasc Intervent 2002;57:387–394. © 2002 Wiley‐Liss, Inc.
In vitro analysis of the origin, migratory behavior, and maturation of cortical pyramidal cells
Authors: Hatanaka Yumiko , Murakami Fujio
Published: October 2002

During development neurons migrate from their site of origin to their final destinations under a variety of mechanisms. Although evidence has been accumulating that the cells from cortical ventricular zone (VZ) migrate radially and produce pyramidal cells, evidence that directly links the origin and the terminal phenotype of radially migrating cells has been limited. Further, the relation between the migratory behavior of these cells and their mature morphology remains obscure. To address these issues, we developed an in vitro preparation that enables visualization of cells derived from the cortical VZ. VZ cells of a rat cortex at embryonic days 18 to 19 were labeled by injecting green fluorescent protein (GFP)‐encoding plasmid into the lateral ventricle, followed by electroporation. The cortex was then sliced and cultured organotypically. After 1 day, GFP+ cells exhibited neural progenitor and radial glial cell natures. Over the next few days, many GFP+ cells migrated toward the pial surface, extending leading processes toward the pial surface and leaving a thin trailing process that almost reached the VZ. The leading processes of these neurons were positive for microtubule‐associated protein 2, and some transformed into dendritic arbor–like structures by day 5 or 6, and their trailing processes exhibited morphologic features indicative of prospective axons. Time‐lapse analysis confirmed extension of the trailing processes. Expression of molecular markers and morphologic analysis demonstrated that the vast majority of the migrated GFP+ cells differentiated into excitatory neurons with pyramidal cell–like morphology. These results strongly suggested that cells derived from the cortical VZ generate neurons that migrate radially. These neurons appeared to extend prospective dendrites in front and leave prospective axons behind, subsequently differentiating into pyramidal cells. J. Comp. Neurol. 454:1–14, 2002. © 2002 Wiley‐Liss, Inc.
Distribution of thyrotropin‐releasing hormone immunoreactivity in the brain of the dogfish Scyliorhinus canicula
Authors: Teijido Oscar , Manso María Jesús , Anadón Ramón
Published: October 2002

To improve knowledge of the peptidergic systems of elasmobranch brains, the distribution of thyrotropin‐releasing hormone‐immunoreactive (TRHir) neurons and fibers was studied in the brain of the small‐spotted dogfish (Scyliorhinus canicula L.). In the olfactory bulbs, small granule neurons richly innervated the olfactory glomeruli. In the telencephalic hemispheres, small TRHir neurons were observed in the superficial dorsal pallium, whereas TRHir fibers were widely distributed in pallial and subpallial regions. In the preoptic region, TRHir neurons formed a caudal ventrolateral group in the preoptic nucleus. In the hypothalamus, the most conspicuous TRHir populations were associated with the lateral hypothalamic recess, but small TRHir populations were found in the posterior tubercle and ventral wall of the posterior recess. The preoptic region and hypothalamus exhibited rich innervation by TRHir fibers. TRHir fibers were observed coursing to the neurohypophysis and the neuroepithelium of the saccus vasculosus, but not to the neurohemal region of the median eminence. Some stellate‐like TRHir cells were observed in a few cell cords of the neurointermediate lobe of the hypophysis. The thalamus, pretectum, and midbrain lacked TRHir neurons. Further TRHir neuronal populations were observed in the central gray and superior raphe nucleus of the isthmus, and a few TRHir cells were located in the nucleus of the trigeminal descending tract at the level of the rostral spinal cord. In the brainstem, the central gray, interpeduncular nucleus, secondary visceral region of the isthmus, rhombencephalic raphe, inferior olive, vagal lobe, and Cajal's commissural nucleus were all richly TRHir‐innervated. Comparison of the distribution of TRHir neurons observed in the dogfish brain with that observed in teleosts and tetrapods reveals strong resemblance but also interesting differences, indicating the presence of both a conserved basic vertebrate pattern and a number of derived characters. J. Comp. Neurol. 454:65–81, 2002. © 2002 Wiley‐Liss, Inc.
Digital necrosis associated with squamous cell carcinoma of the tonsil
Authors: Wright Jim R. , Gudelis Susan
Published: October 2002

Background

Digital necrosis is an uncommon paraneoplastic syndrome. Fewer than 50 cases have been sporadically reported through the literature over the last 30 years.

Case Report

We describe the unfortunate case of a 62‐year‐old woman with a locally advanced squamous cell carcinoma of the tonsil. She was admitted to the hospital for symptomatic hypercalcemia and was found to have metastatic disease. She subsequently had digital necrosis develop. Despite numerous attempts to control the rapidly progressive ischemia, little objective evidence of response was noted. Her primary disease did not respond to palliative radiation, and her general condition rapidly deteriorated.

Conclusions

A review of the literature provided some insight into the possible etiology of this unique complication of malignancy. Unfortunately, the treatment options suggested were of limited value, because there was no discernible benefit with any directed treatment. A brief summary and discussion of the literature follows. © 2002 Wiley Periodicals, Inc. Head Neck 24: 1019–1021, 2002
Approach for predicting the wetting front depth beneath a surface point source: theory and numerical aspect
Authors: Moncef Hammami , Hedi Daghari , Jelloul Balti , Mohamed Maalej
Published: October 2002

Using experimental data, the continuity and the cumulative infiltration equations, a new expression for predicting the wetted soil depth was described. Knowing soil hydraulic conductivity K(hf), initial and wetting front water content, this method enables us to calculate the maximum front depth Zf(t), beneath an emitter, by only measuring its radius Rf(t) on the soil surface.

To test this, we used the ADI finite difference method to solve Richards' equation for axisymmetrical water infiltration from a point source on the soil surface. To simulate the evolution of the wetted soil volume dimensions (Rf(t) and Zf(t)), proper conditions were fixed for the wetting front boundaries.

The Zf(t) predicted values were compared with those computed and measured during an axisymmetric water infiltration test on a silty soil for three different discharge rates. The results obtained showed good agreement between predicted, computed and measured data. Copyright © 2002 John Wiley & Sons, Ltd.