bluuebunny/crossref_metadata_2025 huggingface dataset:
International Staging System for Multiple Myeloma
Authors: Greipp Philip R. , Miguel Jesus San , Durie Brian G.M. , Crowley John J. , Barlogie Bart , Bladé Joan , Boccadoro Mario , Child J. Anthony , Avet-Loiseau Hervé , Kyle Robert A. , Lahuerta Juan J. , Ludwig Heinz , Morgan Gareth , Powles Raymond , Shimizu Kazuyuki , Shustik Chaim , Sonneveld Pieter , Tosi Patrizia , Turesson Ingemar , Westin Jan
Published: April 2005

Purpose

There is a need for a simple, reliable staging system for multiple myeloma that can be applied internationally for patient classification and stratification.

Patients and Methods

Clinical and laboratory data were gathered on 10,750 previously untreated symptomatic myeloma patients from 17 institutions, including sites in North America, Europe, and Asia. Potential prognostic factors were evaluated by univariate and multivariate techniques. Three modeling approaches were then explored to develop a staging system including two nontree and one tree survival assessment methodologies.

Results

Serum beta2-microglobulin (Sβ2M), serum albumin, platelet count, serum creatinine, and age emerged as powerful predictors of survival and were then used in the tree analysis approach. A combination of Sβ2M and serum albumin provided the simplest, most powerful and reproducible three-stage classification. This new International Staging System (ISS) was validated in the remaining patients and consists of the following stages: stage I, Sβ2M less than 3.5 mg/L plus serum albumin ≥ 3.5 g/dL (median survival, 62 months); stage II, neither stage I nor III (median survival, 44 months); and stage III, Sβ2M ≥ 5.5 mg/L (median survival, 29 months). The ISS system was further validated by demonstrating effectiveness in patients in North America, Europe, and Asia; in patients less than and ≥ 65 years of age; in patients with standard therapy or autotransplantation; and in comparison with the Durie/Salmon staging system.

Conclusion

The new ISS is simple, based on easy to use variables (Sβ2M and serum albumin), and recommended for early adoption and widespread use.
Allogeneic Stem-Cell Transplantation May Overcome the Adverse Prognosis of Unmutated VH Gene in Patients With Chronic Lymphocytic Leukemia
Authors: Moreno Carol , Villamor Neus , Colomer Dolors , Esteve Jordi , Martino Rodrigo , Nomdedéu Josep , Bosch Francesc , López-Guillermo Armando , Campo Elías , Sierra Jorge , Montserrat Emili
Published: April 2005

Purpose

To investigate whether allogeneic stem-cell transplantation (allo-SCT) may overcome the negative impact of unmutated VH genes in the outcome of patients with chronic lymphocytic leukemia (CLL).

Patients and Methods

We analyzed the outcome of patients who underwent SCT according to their VH mutational status.

Results

Thirty-four patients (14 allo-SCT and 20 autologous SCT [auto-SCT]) presented unmutated VH genes and 16 patients presented mutated VH genes (nine allo-SCT and seven auto-SCT). Tumoral burden pre-SCT was significantly higher in the allo-SCT patients independent of the VH mutational status. The risk of relapse was significantly higher after auto-SCT (5-year risk, 61%; 95% CI, 44% to 84%) than after allo-SCT (5-year risk 12%, 95% CI, 3% to 44%; P < .05). In the unmutated group, 13 of 20 auto-SCT and two of 14 allo-SCT patients experienced disease progression, with a risk of relapse at 5 years of 66% (95% CI, 48% to 93%) v 17% (95% CI, 5% to 60%), respectively (P = .01).

Conclusion

These results show that allo-SCT may overcome the unfavorable effect of unmutated VH genes in patients with CLL.
Impact of Three Courses of Intensified CHOP Prior to High-Dose Sequential Therapy Followed by Autologous Stem-Cell Transplantation As First-Line Treatment in Poor-Risk, Aggressive Non-Hodgkin's Lymphoma: Comparative Analysis of Dutch-Belgian Hemato-Oncology Cooperative Group Studies 27 and 40
Authors: van Imhoff Gustaaf W. , van der Holt Bronno , MacKenzie Marius A. , van′t Veer Mars B. , Wijermans Pierre W. , Ossenkoppele Gerrit J. , Schouten Harry C. , Sonneveld Pieter , Steijaert Monique M.C. , Kluin Philip M. , Kluin-Nelemans Hanneke C. , Verdonck Leo F.
Published: April 2005

Purpose

Timing, appropriate amount, and composition of treatment before high-dose therapy and autologous stem-cell transplantation (ASCT) in patients with poor-risk, aggressive non-Hodgkin's lymphoma (NHL) are still unknown. We conducted two consecutive multicenter phase II trials with up-front, high-dose, sequential chemotherapy and ASCT in poor-risk, aggressive NHL. Both trials had identical inclusion criteria and only differed in amount and duration of induction treatment before ASCT.

Patients and Methods

Between 1994 and 2001, 147 newly diagnosed, poor-risk, aggressive NHL patients, age ≤ 65 years with stage III to IV and lactate dehydrogenase (LDH) more than 1.5× upper limit of normal (ULN), entered the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON) -27 and HOVON-40 trials. Treatment in HOVON-27 consisted of two up-front, high-dose induction courses followed by carmustine, etoposide, cytarabine, and melphalan plus ASCT in responding patients. In HOVON-40, the same treatment was preceded by three intensified courses of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP).

Results

Patient characteristics in both trials were comparable: 80% had diffuse large B-cell lymphoma, 77% had stage IV disease, and median LDH levels were 3.1× ULN. Complete remission (CR) in both trials was 45% to 51%. Before ASCT, CR was 14% in HOVON-27 versus 28% in HOVON-40 (P = .03). Treatment failure was similar (27%). Four-year survival estimates in HOVON-27 compared with HOVON-40 were overall survival, 21% v 50% (P = .007); event-free survival, 15% v 49% (P = .0001); and disease-free survival, 34% v 74% (P = .008). This different outcome favoring HOVON-40 remained highly significant when correcting for competing risk factors in multivariate analysis.

Conclusion

In patients with poor-risk, aggressive NHL, addition of intensified CHOP before up-front, high-dose, sequential therapy and ASCT significantly improved the duration of response and survival.
Synthesis of Fine Mg1−xCaxFe2O4 Ferrite Powder Having High Heat Ability under AC Magnetic Field
Authors: Aono Hiromichi , Hirazawa Hideyuki , Ochi Takayuki , Naohara Takashi , Mori Kensaku , Hattori Yasumasa , Maehara Tsunehiro , Kikkawa Hiroyuki , Watanabe Yuji
Published: April 2005

Fine Mg1−xCaxFe2O4 ferrite powders for local thermal coagulation therapy were synthesized by a reverse coprecipitation method. The enhancement of temperature under an AC magnetic field was improved by the partial Ca2+ substitution. A high heat ability was obtained for the samples calcined at 300 and 800 °C.
“Sorp‐vection”: An unusual membrane‐based separation
Authors: Damle Shilpa , Koros W. J.
Published: April 2005

A nonstandard membrane process is described that involves highly selective sorption of a compound “A” at a large absolute weight fraction ωA, coupled with a significant diffusionally induced flux of a second component “B.” The flux of B convectively moves A from a dilute external mass fraction relative to component B upstream to an enriched mass fraction downstream. The general form of the process has potential applications involving dilute feeds where current membranes processes perform poorly for such removal as a result of excessive solubility of the smaller component B. The most important widespread application is expected to be the separation of small organic solutes from supercritical carbon dioxide to facilitate the recycling and reuse of CO2 while minimizing costly and energy‐intensive recompression steps. We consider the utility of this concept by modeling the separation efficiency of phenol from supercritical carbon dioxide. © 2005 American Institute of Chemical Engineers AIChE J, 2005
Molecular characterization of a 14q deletion in a boy with features of Holt–Oram syndrome
Authors: Le Meur Nathalie , Goldenberg Alice , Michel‐Adde Christine , Drouin‐Garraud Valérie , Blaysat Gérard , Marret Stéphane , Amara Saad Abu , Moirot Hélène , Joly‐Hélas Géraldine , Mace Bertrand , Kleinfinger Pascale , Saugier‐Veber Pascale , Frébourg Thierry , Rossi Annick
Published: April 2005

Holt–Oram syndrome, the major “heart–hand” syndrome is defined by the association of radial defects or triphalangeal thumbs and septal heart defects. The transmission is autosomal dominant and the causative gene has been shown to be TBX5, located on 12q24.1, which encodes a transcription factor. Genetic heterogeneity has been suggested by several reports. We identified a 14(q23.3 ∼ 24.2q31.1) deletion in a boy presenting severe bilateral asymmetrical radial aplasia, congenital heart defects, and developmental delay. This deletion, whose size could be estimated to be 9.6–13.7 Mb, was shown to be inherited via his mother's interchromosomal insertion. This is the second report of a chromosome 14 interstitial deletion associated with clinical features of Holt–Oram syndrome. These observations suggest the existence of a new “heart–hand” locus on chromosome 14q. © 2005 Wiley‐Liss, Inc.
Subtelomere deletions and translocations are frequently familial
Authors: Adeyinka Adewale , Adams S. Annie , Lorentz Cindy P. , Van Dyke Daniel L. , Jalal Syed M.
Published: April 2005

In recent years, strategies have been developed to investigate the possible role of chromosomal subtelomere regions in genetic disorders. The present study was to determine the incidence of familial subtelomeric abnormalities among individuals with developmental delay, idiopathic mental retardation, or non‐specific congenital abnormalities. A review was conducted for patients and their relatives on whom subtelomeric DNA fluorescence in situ hybridization (telo‐FISH) studies were performed. Patients were identified through a search of the Mayo Genetics System (MGS) database. Of 2,170 consecutive telo‐FISH index case studies completed in our laboratory between January 2002 and December 2003, 121 or 5.6% had abnormalities of the subtelomere region. The present report includes 18 other abnormal index cases seen prior to 2002 to yield a total of 139 abnormal index cases. This represents 71 index patients with deletions, 53 index patients with derivative chromosomes, and 15 index patients with balanced rearrangements. A familial abnormality was identified in 29 (51.8%) of 56 families in whom parents and/or sibs were available for testing. Among 28 patients with deletions, 9 (32%) had an inherited deletion, whereas 19 (68%) were de novo. Family members of 20 index patients with derivative chromosomes were tested. Of these, 13 (65%) patients inherited the abnormality from a parent (12 from a parent who had a balanced translocation and 1 from a parent with the same abnormality), while 7 (35%) apparently arose de novo. Seven (88%) of 8 with balanced translocations inherited the translocation from one parent. The most common familial abnormalities involved 8pter deletion or rearrangement. The incidence of familial subtelomeric abnormalities is significantly high making parental telo‐FISH studies an essential part of the investigation of patients with subtelomeric chromosome abnormalities. © 2005 Wiley‐Liss, Inc.
A novel MGP mutation in a consanguineous family: Review of the clinical and molecular characteristics of Keutel syndrome
Authors: Hur David J. , Raymond Gerald V. , Kahler Stephen G. , Riegert‐Johnson Douglas L. , Cohen Bernard A. , Boyadjiev Simeon A.
Published: April 2005

Keutel syndrome (KS) [OMIM 245150] is a rare autosomal recessive condition, characterized by abnormal cartilage calcification. Mutations in the matrix Gla protein gene (MGP) have been previously reported in three unrelated KS families. MGP is an extracellular matrix protein that acts as a calcification inhibitor by repressing bone morphogenetic protein 2 (BMP2). Loss‐of‐function mutations of MGP result in abnormal calcification of the soft tissues, a cardinal feature of KS. We report the fourth MGP mutation (IVS2 + 1G > A) in a consanguineous Arab family, which results in the loss of the consensus donor splice site at the exon 2–intron 2 junction. In addition to the typical manifestations, we observed abnormalities in the white matter of the brain, optic nerve atrophy, and mid‐dermal elastolysis in the affected individuals of this family. This report broadens the clinical phenotype observed in patients with KS. The effect of the IVS2 + 1G > A mutation is consistent with the previously reported loss‐of‐function mutations of MGP. © 2005 Wiley‐Liss, Inc.
Physician exposure to and attitudes toward advertisements for genetic tests for inherited cancer susceptibility
Authors: Vadaparampil Susan Thomas , Wideroff Louise , Olson Lorayn , Viswanath K. , Freedman Andrew N.
Published: April 2005

Commercial marketing materials may serve as a source of information for physicians about genetic testing for inherited cancer susceptibility (GTICS) in addition to medical guidelines, continuing education, and journal articles. The primary purposes of this study were to: (1) determine the percentage of physicians who received advertisements for GTICS early in the diffusion of commercial GTICS (1999–2000); (2) assess associated characteristics; and (3) measure the perceived importance of commercial advertisements and promotions in physicians' decisions to recommend testing to patients. A nationally representative, stratified random sample of 1,251 physicians from the American Medical Association (AMA) Physician Masterfile completed a 15–20 min mixed mode questionnaire that assessed specialty, previous use of genetic tests, practice characteristics, age, and receipt of advertising materials (response rate = 71%). Overall, 27.4% (n = 426) had received advertisements. In multivariate analysis, factors associated with receipt of advertisements included: specialties in obstetrics/gynecology, oncology, or gastroenterology; past GTICS use, and age 50+. One of four felt that advertisements would be important in their decision to recommend GTICS. Study results indicate that physicians, particularly in oncology, obstetrics/gynecology, and gastroenterology, began receiving GTICS advertisements commensurate with the early diffusion of commercially available tests into clinical practice. At that time, one‐quarter of the physicians considered advertisements to play an important role in their clinical decision making, suggesting attention to other sources of information and additional factors. Published 2005 Wiley‐Liss, Inc.
An unusual reciprocal translocation detected by subtelomeric FISH: Interstitial and not terminal
Authors: Riegel Mariluce , Baumer Alessandra , Süss Jochen , Schinzel Albert
Published: April 2005

An 11‐month‐old boy with a pattern of dysmorphic signs, an atrial septal defect, right inguinal hernia, bilateral undescended testes, bilateral urinary reflux, right renal dysplasia, and developmental delay had an abnormal chromosome 11 with additional material of unknown origin attached to the long arm in his karyotype. The paternal karyotype was normal 46,XY, while the mother's karyotype was 46,XX,t(2;11)(q35;q24.2). Thus, a reciprocal terminal exchange was assumed resulting in duplication of distal 2q material and a small subterminal 11q deletion. However, application of subtelomeric fluorescence in situ hybridization (FISH) probes indicated that the translocation was not a terminal reciprocal exchange, but was interstitial at least for one of the chromosomes, which would be highly unusual since most interstitial translocations are non‐reciprocal. Based on the results of FISH and microsatellite marker examinations, the designation of the breakpoints and thus of the deleted and duplicated segments had to be revised. The findings have implications for karyotype‐phenotype correlation. © 2005 Wiley‐Liss, Inc.
Phenotypes with GATA4 or NKX2.5 mutations in familial atrial septal defect
Authors: Hirayama‐Yamada Kayoko , Kamisago Mitsuhiro , Akimoto Kaoru , Aotsuka Hiroyuki , Nakamura Yoshihide , Tomita Hideshi , Furutani Michiko , Imamura Shin‐ichiro , Takao Atsuyoshi , Nakazawa Makoto , Matsuoka Rumiko
Published: April 2005

Recently, GATA4 and NKX2.5 were reported as the disease genes of atrial septal defect (ASD) but the relationship between the locations of their mutations and phenotypes is not clear. We analyzed GATA4 and NKX2.5 mutations in 16 familial ASD cases, including four probands with atrioventricular conduction disturbance (AV block) and two with pulmonary stenosis (PS), by PCR and direct sequencing, and examined their phenotypes clinically. Five mutations, including two GATA4 and three NKX2.5 mutations, were identified in 31.3% of the probands with ASD, and three of them were novel. The two GATA4 mutations in the probands without AV block were S52F and E359Xfs (c.1075delG) that was reported previously, and three NKX2.5 mutations in the probands with AV block were A88Xfs (c.262delG), R190C, and T178M. Additionally, we observed some remarkable phenotypes, i.e., dextrocardia with E359Xfs (c.1075delG) and cribriform type ASD with R190C, both of which are expected to be clues for further investigations. Furthermore, progressive, most severe AV block was closely related with a missense mutation in a homeodomain or with a nonsense/frame‐shift mutation of NKX2.5 for which classification has not been clearly proposed. This pinpoints essential sites of NKX2.5 in the development of the conduction system. © 2005 Wiley‐Liss, Inc.
Familial variable expression of dilated cardiomyopathy in Alström syndrome: A report of four sibs
Authors: Hoffman J.D. , Jacobson Z. , Young T.L. , Marshall J.D. , Kaplan Paige
Published: April 2005

Alström syndrome is an autosomal recessive disorder comprised of progressive vision loss (nystagmus, photophobia, and pigmentary retinopathy), progressive sensorineural hearing loss, morbid obesity, male hypogonadism, insulin resistant diabetes, renal failure, and dilated cardiomyopathy. We report on four sibs with Alström syndrome with intra‐familial variability in onset, severity, and spectrum of manifestations; the most serious manifestation being dilated cardiomyopathy. This report emphasizes the difficulty of recognizing this constellation of symptoms as Alström syndrome at an early age, the seriousness of cardiac involvement, and the intra‐familial variability of phenotypic expression. © 2005 Wiley‐Liss, Inc.
Craniofacial defects of blastogenesis: Duplication of pituitary with cleft palate and orophgaryngeal tumors
Authors: Slavotinek Anne , Parisi Melissa , Heike Carrie , Hing Anne , Huang Eric
Published: April 2005

Duplications of organs and/or tissues are rare in morphogenesis and have frequently been attributed to incomplete twinning. To further elucidate the phenotypes associated with organ duplications, we present three infants with duplication of the pituitary gland (DPG). A review of previously reported cases with DPG showed that the commonest additional findings were hypothalamic enlargement, a broad or duplicated sella, cleft palate, hypertelorism, oropharyngeal tumors, agenesis or hypoplasia of the corpus callosum, and abnormalities of vertebrae. DPG and additional malformations constitute a distinct and recognizable pattern of anomalies, which may constitute a polytopic field defect due to splitting of the notochord. However, the precise inductive mechanism resulting in DPG remains unknown. © 2005 Wiley‐Liss, Inc.
Split hand malformation, hypospadias, microphthalmia, distinctive face and short stature in two brothers suggest a new syndrome
Authors: García‐Ortiz Jose E. , Banda‐Espinoza Felipe , Zenteno Juan C. , Galván‐Uriarte Luz M. , Ruiz‐Flores Pablo , García‐Cruz Diana
Published: April 2005

Split hand/foot malformation (SHFM) is a genetically heterogeneous limb malformation that may be isolated or associated with other malformations. More than 50 recognizable entities with SHFM have been described and at least 5 mapped genetic loci have been implicated. Two brothers with intrauterine growth retardation, short stature, distinctive face, microphthalmia, genital anomalies, and SHFM are described. Molecular analyses of TP63, HOXA13, and HOXD13 genes were normal. We propose this pattern to be a newly recognized SHFM syndrome. © 2005 Wiley‐Liss, Inc.
Amino acid recognition by Venus flytrap domains is encoded in an 8‐residue motif
Authors: Acher Francine C. , Bertrand Hugues‐Olivier
Published: April 2005

A motif foramino acid recognition by proteins or domains of the periplasmic binding protein‐like I superfamily has been identified. An initial pattern of 5 residues was based on a multiple sequence alignment of selected proteins of that fold family and on common structural features observed in the crystal structure of some members of the family [leucine isoleucine valine binding protein (LIVBP), leucine binding protein (LBP), and metabotropic glutamate receptor type 1 (mGlu1R) amino terminal domain)]. This pattern was used against the PIR‐NREF sequence database and further refined to retrieve all sequences of proteins that belong to the family and eliminate those that do not belong to it. A motif of 8 residues was finally selected to build up the general signature. A total of 232 sequences were retrieved. They were found to belong to only three families of proteins: bacterial periplasmic binding proteins (PBP, 71 sequences), family 3 (or C) of G‐protein coupled receptor (GPCR) (146 sequences), and plant putative ionotropic glutamate receptors (iGluR, 15 sequences). PBPs are known to adopt a bilobate structure also named Venus flytrap domain, or LIVBP domain in the present case. Family 3/C GPCRs are also known to hold such a domain. However, for plant iGluRs, it was previously detected by classical similarity searches but not specifically described. Thus plant iGluRs carry two Venus flytrap domains, one that binds glutamate and an additional one that would be a modulatory LIVBP domain. In some cases, the modulator binding to that domain would be an amino acid. © 2005 Wiley Periodicals, Inc. Biopolymers (Pept Sci), 2005
Enzymatic incorporation of orthogonally reactive prenylazide groups into peptides using geranylazide diphosphate via protein farnesyltransferase: Implications for selective protein labeling
Authors: Rose Matthew W. , Xu Juhua , Kale Tamara A. , O'Doherty George , Barany George , Distefano Mark D.
Published: April 2005

Protein farnesyltransferase (PFTase) catalyzes the attachment of a geranyl azide moiety to a peptide substrate, N‐dansyl–Gly–Cys–Val–Ile–Ala–OH. The resulting azide‐containing peptide was derivatized with a triphenylphosphine‐based reagent to generate an O‐alkyl imidate‐linked product, rather than the amide‐linked material expected via a Staudinger reaction. Since the CAAX box recognition motif (where the internal A residues are aliphatic amino acids) modified by PFTase can be incorporated into the C‐terminus of virtually any polypeptide, this two‐step procedure provides a general method for incorporating a diverse range of chemical modifications specifically near the C‐terminus of proteins. © 2005 Wiley Periodicals, Inc. Biopolymers (Pept Sci), 2005
Medium-term results of vertical reduction rectoplasty and sigmoid colectomy for idiopathic megarectum
Authors: Gladman M A , Williams N S , Scott S M , Ogunbiyi O A , Lunniss P J
Published: April 2005

Background

Vertical reduction rectoplasty (VRR) was devised specifically to address the physiological abnormalities present in the rectum of patients with idiopathic megarectum (IMR). This study evaluated the medium-term clinical and physiological results of VRR.

Methods

VRR and sigmoid colectomy was performed in ten patients with IMR and constipation (six women). Patients were evaluated before and a median of 60 (range 28–74) months after surgery by assessment of symptoms using scoring systems and anorectal physiological measurements. Independent, detailed postoperative evaluation of rectal diameter, compliance, and sensory and evacuatory function was performed.

Results

There were no deaths or late complications. Symptoms recurred necessitating permanent ileostomy formation in two patients. Median (range) constipation scores improved from 22 (18–27) before to 10 (0–24) after surgery (P = 0·016). Median (range) bowel frequency increased from 1·5 (0·2–7) to 7 (0·5–21) per week (P = 0·016). Rectal diameter, compliance and sensory function were normal in seven of eight patients after surgery. Evacuatory function and colonic transit were each normalized in two of eight patients after VRR.

Conclusion

VRR corrected rectal diameter, compliance and sensory function in most patients, and clinical benefit was sustained in the medium term. The procedure was associated with a low morbidity, and no mortality and should be considered in the surgical management of IMR.
Effect of supervised surgical training on outcomes after resection of colorectal cancer
Authors: Renwick A A , Bokey E L , Chapuis P H , Zelas P , Stewart P J , Rickard M J F X , Dent O F
Published: April 2005

Background

The process of training surgeons in technique for resection of colorectal cancer should not compromise patient care or outcomes. The aim of this study was to compare morbidity, mortality and survival rates after resection performed by trainees with those for a consultant surgeon.

Methods

Outcomes for 150 patients operated on by a single colorectal surgeon at a private hospital were compared with those of 344 patients admitted under the same surgeon and operated on by closely supervised trainee surgeons in a public teaching hospital between 1995 and 2002.

Results

Co-morbidity was significantly more common in patients operated on by trainees; their American Society of Anesthesiologists grades were higher and tumours were more advanced. Of 16 postoperative complications evaluated, only respiratory and cardiac problems were significantly more common in patients operated on by trainees. There was no difference in operative mortality, local recurrence or 2-year survival rate after adjustment for age and tumour stage.

Conclusion

Outcomes after resection for colorectal cancer did not differ between the consultant and trainees in the context of a closely supervised training programme.
Risk-adjusted predictive models of mortality after index arterial operations using a minimal data set
Authors: Prytherch D R , Ridler B M F , Ashley S
Published: April 2005

Background

Reducing the data required for a national vascular database (NVD) without compromising the statistical basis of comparative audit is an important goal. This work attempted to model outcomes (mortality and morbidity) from a small and simple subset of the NVD data items, specifically urea, sodium, potassium, haemoglobin, white cell count, age and mode of admission.

Methods

Logistic regression models of risk of adverse outcome were built from the 2001 submission to the NVD using all records that contained the complete data required by the models. These models were applied prospectively against the equivalent data from the 2002 submission to the NVD.

Results

As had previously been found using the P-POSSUM (Portsmouth POSSUM) approach, although elective abdominal aortic aneurysm (AAA) repair and infrainguinal bypass (IIB) operations could be described by the same model, separate models were required for carotid endarterectomy (CEA) and emergency AAA repair. For CEA there were insufficient adverse events recorded to allow prospective testing of the models. The overall mean predicted risk of death in 530 patients undergoing elective AAA repair or IIB operations was 5·6 per cent, predicting 30 deaths. There were 28 reported deaths (χ2 = 2·75, 4 d.f., P = 0·600; no evidence of lack of fit). Similarly, accurate predictions were obtained across a range of predicted risks as well as for patients undergoing repair of ruptured AAA and for morbidity.

Conclusion

A ‘data economic’ model for risk stratification of national data is feasible. The ability to use a minimal data set may facilitate the process of comparative audit within the NVD.
Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic vertical banded gastroplasty for obesity
Authors: Olbers T , Fagevik-Olsén M , Maleckas A , Lönroth H
Published: April 2005

Background

Laparoscopic techniques have been developed for performing Roux-en-Y gastric bypass (LRYGBP) and vertical banded gastroplasty (LVBG) in patients with morbid obesity. It is not certain, however, which is the better technique in non-superobese patients (body mass index less than 50 kg/m2).

Methods

Eighty-three patients (LRYGBP 37, LVBG 46) were assessed in a randomized clinical trial. Perioperative complications were recorded together with preoperative and postoperative respiratory function and mobilization rate. Patients were monitored for 2 years after operation with regard to weight change and the need for remedial surgery.

Results

There were no conversions to open surgery. The mean operating time was longer for LRYGBP than LVBG (138 versus 105 min). Five early reoperations were performed after LRYGBP (three for haemorrhage, one for ileus and one suspected leak) and one after LVBG (suspected leak). There were no differences in postoperative respiratory function or mobilization. Weight reduction was greater after LRYGBP (excess weight loss 78·3 versus 62·9 per cent 1 year after surgery, P = 0·009; 84·4 versus 59·8 per cent at 2 years, P < 0·001). Remedial surgical intervention was required in eight patients after LVBG (conversion to Roux-en-Y gastric bypass) and none after LRYGBP.

Conclusion

LRYGBP and LVBG were comparable in terms of operative safety and postoperative recovery, but weight reduction was better after LRYGBP.
Percutaneous treatment of superior vena cava obstruction following transvenous device implantation
Authors: Bolad Islam , Karanam Sree , Mathew Dilip , John Roy , Piemonte Thomas , Martin David
Published: April 2005

The aim of this study is to assess the feasibility and safety of percutaneous treatment of superior vena cava (SVC) obstruction following transvenous device implantation. SVC obstruction is an uncommon but serious complication that can occur following permanent pacemaker or cardioverter defibrillator implantation utilizing transvenous endocardial leads. The treatment has traditionally been surgical but with the advent of stents, percutaneous approach is becoming popular. We report on the prevalence of SVC obstruction and the safety of its percutaneous catheter‐based treatment. This is a retrospective study of SVC obstruction following device implantation in our institution from January 1993 through November 2003. A total of 1,850 permanent pacemaker and 1,200 implantable cardioverter defibrillator initial implants were performed during that period. Three patients developed SVC obstruction following implant (prevalence, 1/1,000 implant). Two patients were males and the mean age at implant was 57 ± 13 years. Laser lead extraction and SVC angioplasty with or without stenting were performed in all patients. In two of them, this was followed by reimplantation of new systems. There were no procedural complications or mortality. The patients remain free of SVC obstruction symptoms 24 ± 19 months after treatment. SVC obstruction prevalence after device implantation is low. Percutaneous treatment of SVC obstruction can be safely performed and appears to be effective in maintaining medium‐term patency. © 2005 Wiley‐Liss, Inc.
Simultaneous kissing drug‐eluting stent technique for percutaneous treatment of bifurcation lesions in large‐size vessels
Authors: Sharma Samin K.
Published: April 2005

Treatment of bifurcation lesions is associated with high procedural complications and restenosis rate due to plaque shift, suboptimal angiographic results, difficulty in crossing the stent struts, and incomplete coverage of the side‐branch ostium. The simultaneous kissing stent (SKS) technique involves two stents, one in main vessel (MV) and one in the side branch (SB) with overlapping stents in the MV proximally, extending proximally the carina of bifurcation. We analyzed our first 200 consecutive patients (202 lesions) who underwent SKS technique for true bifurcation lesions using sirolimus eluting stents, with a minimum follow‐up of 6 months. Procedural success was 100% for MV and 99% for SB using SKS technique, with clinical success rate of 97%. In‐hospital and 30‐day major adverse cardiac events were 3% and 5%, respectively, with a procedure time of 36 ± 14 min. At mean follow‐up of 9 ± 2 months, the incidence of target lesion revascularization was 4% in the entire group. Therefore, SKS technique using sirolimus‐eluting stents may become an effective treatment strategy for large‐size bifurcation lesions. However, in order to establish its superiority, SKS technique needs to be compared in a randomized manner with conventional stent techniques. © 2005 Wiley‐Liss, Inc.
Intramolecular Versus Intermolecular Induction of Helical Handedness in Pyridinedicarboxamide Oligomers
Authors: Maurizot Victor , Dolain Christel , Huc Ivan
Published: April 2005

A new convergent synthetic scheme has been developed to prepare oligoamides of 2,6‐diaminopyridine and 4‐decyloxy‐2,6‐pyridinedicarboxylic acid. These compounds adopt stable single helical conformations in solution. NMR and circular dichroism studies show that intramolecular and intermolecular chiral induction of handedness in these helices is possible. Intramolecular induction is effected by attaching a single chiral group to the end of an oligomer. Intermolecular induction results from various noncovalent interactions between chiral carboxylic or sulfonic acids and the terminal residues of the oligoamides. Intramolecular induction appears to be more efficient than intermolecular induction. When both effects compete, intramolecular induction prevails. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Towards In‐Plane Delocalized 4N/7e Radical Cations and 4N/6e Dications – One‐/Two‐Electron Oxidation of Proximate‐Parallel Bis(N,N'‐bicyclic)‐bishydrazines
Authors: Exner Kai , Heizmann Markus , Yang Fushun , Kegel Markus , Keller Manfred , Knothe Lothar , Großmann Birgit , Heinze Jürgen , Prinzbach Horst
Published: April 2005

In the pursuit of novel bishomoconjugated (σ‐bishomoaromatic) 4N/7(6)e bonding motifs, (bisseco)pagodane/isopagodane and dodecahedrane‐like, caged, proximate‐parallel bishydrazines have been designed as suitable host skeletons. The derived radical cations and dications are characterized by calculations as cyclically in‐plane delocalized (σ‐bishomoaromatic) species (4N/7(6)e). However, the synthetic approaches based on a pool of half‐caged proximate‐parallel bisdiazenes/bishydrazines and on strategies in part elaborated in the pagodane area have not led to the target structures. Half‐caged, rather flexible bis(N,N'‐bicyclic) bishydrazines (9,10) evolved as the structurally closest synthetically accessible model compounds. Whilst CV (PE, ESR)measurements were not suggestive of significant through‐space interaction in the respective radical cations and dications, DFT calculations (B3LYP/6‐31G*) identified a singlet dication (102+) as proximate, cyclically in‐plane delocalized species, which, however, relaxed into a more stable, more distant triplet. In an Appendix, selected examples are presented for the synthetic utilization of proximate‐parallel bisdiazenes (bishydrazines) in the area of more or less preorganized, semi‐ to fully caged tetra(hexa)azapolycyclic molecules. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Synthesis and Characterization of Some Aza[5]helicenes
Authors: Bazzini Cristina , Brovelli Sergio , Caronna Tullio , Gambarotti Cristian , Giannone Matteo , Macchi Piero , Meinardi Francesco , Mele Andrea , Panzeri Walter , Recupero Francesco , Sironi Angelo , Tubino Riccardo
Published: April 2005

A systematic study on the synthesis and properties of aza‐[5]helicenes bearing one or two nitrogen atoms in selected ring positions is reported for the first time. This photochemical approach can be conveniently applied to the preparation of either mono‐ or diaza[5]helicenes. The aza[5]helicenes were characterized by NMR spectroscopy, X‐ray crystallography, emission spectroscopy, and luminescence lifetime. The extremely long triplet lifetime observed (in the range of seconds) makes these molecules promising candidates for practical applications in photo‐ and optoelectronics. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
The Effect of Charge‐Transfer Complexation/π‐Stacking Interactions in Lowering the Activation Barrier of the Bergman Cyclization
Authors: Basak Amit , Bag Subhendu Sekhar , Das Amit K.
Published: April 2005

To elaborate the concept of weak interactions and their effect on Bergman Cyclization (BC), several 1,2‐dikynyl benzenes incorporating various combinations of donor and acceptor units in the two arms of the enediynes were designed and synthesized, and their charge‐transfer interactions followed by UV/Vis spectroscopy. The thermal reactivities, as studied by DSC, show an increase in reactivity for the donor/acceptor or donor/donor combinations relative to the acceptor/acceptor pair. Such an increase in reactivity can be explained on the basis of intramolecular charge transfer and π‐stacking interactions between the two arms, which may lower the distance between the two acetylenic ends. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Iridium‐Catalyzed H/D Exchange
Authors: Krüger Jens , Manmontri Boripont , Fels Gregor
Published: April 2005

The scope and limitation of an iridium‐catalysed H/D exchange reaction has been investigated. Our results suggest a general mechanism for specific labelling at aromatic and non‐aromatic double bonds by D2O if an electron‐donating group is in a 1,4‐relation with the carbon where the H/D exchange takes place. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Organolithium/Chiral Lewis Base/BF3: a Versatile Combination for the Enantioselective Desymmetrization of meso‐Epoxides
Authors: Vrancken Emmanuel , Alexakis Alexandre , Mangeney Pierre
Published: April 2005

BF3 can be used in combination with organolithium/strong Lewis base complexes for the enantioselective nucleophilic ring‐opening or the carbenoidic rearrangement of various meso‐oxiranes with excellent yields and ee values of up to 87 %. Mechanistic aspects of these reactions are considered. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Asymmetric Dihydroxylation with Recoverable Cinchona Alkaloid Derivatives: A Warning Note and an Improved, Insoluble Polymer‐Bound Ligand Architecture
Authors: Mandoli Alessandro , Pini Dario , Fiori Massimo , Salvadori Piero
Published: April 2005

The nature of catalytic asymmetric dihydroxylation (AD), in particular the problem of ligand leaching from insoluble polymer‐bound (IPB) Cinchona alkaloid derivatives, has been investigated. An upper limit to the amount of dissolved ligand, and methods for its evaluation, which assure a basically heterogeneous character of the observed AD reaction, are presented. A new copolymer architecture, which meets the established stability requirements and allows the highly enantioselective (87–99 % ee) IPB‐AD of representative alkene substrates, is also described. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
DNA Binding of a Molecular‐Scale Receptor in the Presence of Zinc(II) Ions
Authors: Benniston Andrew C. , Harriman Anthony , Lawrie Donald J. , Mehrabi Maryam
Published: April 2005

The properties of a tritopic artificial biological probe are described. This probe consists of a luminescent pyrene–thiophene unit connected by an ethynylene group to a 2,2':6',2‐terpyridine (terpy) cation binding site. The pyrene unit, as evidenced by fluorescence spectroscopy under illumination at 400 nm, is capable of intercalating into double‐stranded calf‐thymus DNA in H2O (buffered, pH = 7.0) at 25 °C. The binding constant K was calculated to be 6.0 × 105M–1. Titration of zinc(II) ions in an aqueous (pH = 7.0) solution containing the intercalated probe results in fluorescence quenching which again is a consequence of the zinc(II) ions binding to the terpy site. The DNA‐bound probe has also been shown to undergo singlet energy transfer to intercalated ethidium bromide with a rate constant of 9.4 × 109 s–1. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Recent Advances in the Total Synthesis of Piperidine Azasugars
Authors: Pearson Morwenna S. M. , Mathé‐Allainmat Monique , Fargeas Valérie , Lebreton Jacques
Published: April 2005

Since the discovery of nojirimycin, a glycosidase inhibitor, polyhydroxylated piperidines (also called azasugars: the ring O‐atom of a carbohydrate is replaced by nitrogen) have attracted considerable attention and have been the target of numerous synthetic strategies during the last decade. The efficient synthesis of naturally occurring azasugars and their analogs is of considerable importance due to their potential glycosidase inhibitor properties. Some of them have been widely investigated as candidates for drugs to treat a variety of carbohydrate‐mediated diseases such as diabetes, viral infections, including HIV, cancer metastasis, hepatitis, and Gaucher’s disease. This microreview focuses on recent syntheses of azasugars. In addition, the biology of these compounds is briefly considered. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Novel Approach to the (–)‐Sparteine‐Mediated Synthesis of Kainoids:Total Synthesis of (–)‐α‐Kainic Acid by (–)‐Sparteine‐Mediated Deprotonation
Authors: Montserrat Martínez M. , Hoppe Dieter
Published: April 2005

We report a new synthesis of kainoids via allyllithium compounds using an intramolecular cycloalkylation as the key step. Preparation of different substituted pyrrolidines was carried out by using carbamates, that react with the chiral base n‐BuLi/(–)‐sparteine with strong selection between the diastereotopic protons adjacent to the carbamate group in favour for the pro‐S proton. (–)‐α‐Kainic acid was synthetized from D‐serine methyl ester hydrochloride, based on a (–)‐sparteine‐mediated asymmetric deprotonation of an intermediate carbamate that, by stereospecific anti‐SN′SE′ intramolecular cycloalkylation, leads to the pyrrolidine ring precursor of (–)‐α‐kainic acid, in high yield and diastereoselectivity. Related approaches, starting from L‐glutamic acid failed. The intermediate pyrrolidine was further transformed to (–)‐α‐kainic in three steps. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2005)
Cover Picture: Synthesis and Characterization of Some Aza[5]helicenes (Eur. J. Org. Chem. 7/2005)
Authors: Bazzini Cristina , Brovelli Sergio , Caronna Tullio , Gambarotti Cristian , Giannone Matteo , Macchi Piero , Meinardi Francesco , Mele Andrea , Panzeri Walter , Recupero Francesco , Sironi Angelo , Tubino Riccardo
Published: April 2005

The cover picture shows the structure of 5‐aza[5]helicene (top) and the crystal packing (single enatiomers, bottom). This is one of the aza[5]helicenes reported in the paper that were synthesized by photochemical ring closure of suitable ethenyl derivatives. The photophysical properties (very long triplet‐state lifetime) and crystal packing (columnar arrangement) were studied and shown to be dependent on the nitrogen position. These molecules may be suitable for studies on π−π interactions and complexation with metal ions. The extremely long triplet lifetime that was observed (in the range of seconds) makes these molecules promising candidates for practical applications in photo‐ and optoelectronics. Details are discussed in the article by T. Caronna et al. on p. 1247 ff.
Polyimide Electrolyte Membranes Having Fluorenyl and Sulfopropoxy Groups for High Temperature PEFCs
Authors: Zhou H. , Miyatake K. , Watanabe M.
Published: April 2005

A series of novel polyimide electrolyte copolymers (SPPI‐X) containing fluorenyl and sulfopropoxy groups were synthesized. The copolymer composition (X: molar percentage of the fluorenyl groups) was set from 0–60 mol% so that the ion exchange capacity of the electrolyte membrane ranged from 1.3 to 2.9 meq g–1. Tough and flexible membranes, with the typical polyimide brown colour, were obtained by casting from the polymer solution. The SPPI membranes are thermally stable up to 220 °C without glass transition, melting, and decomposition under a dry nitrogen atmosphere. Sulfopropoxy groups are effective at improving oxidative stability in Fenton's reagent since the main polymer chains are separated from sulfonic acid groups and are less susceptible to hydrophilic attack by the oxidative radical species. A high mechanical strength, with 53 MPa of the maximum stress at break and 15% of strain, was confirmed for SPPI‐30 membrane. The proton conductivity of the SPPI membranes was higher than 0.1 S cm–1 at temperatures from 40 to 120 °C. The long term proton conductivity stability (ca. 1,000 h) was also confirmed at 120 °C, to prove the possible availability of the membrane materials for high temperature PEFC applications.
Plasma‐Polymerised Proton Conductive Membranes for a Miniaturised PEMFC
Authors: Mahdjoub H. , Roualdès S. , Sistat P. , Pradeilles N. , Durand J. , Pourcelly G.
Published: April 2005

Thin films, containing fluorocarbons and sulphonic acid groups, were prepared by plasma polymerisation of 1,3‐butadiene/CF3SO3H and styrene/CF3SO3H mixtures using two different types of plasma discharges. The morphology, density, and chemical composition of the synthesised plasma polymers were examined by SEM, small‐angle X‐ray reflectometry, and FTIR and XPS analyses, respectively. Proton conductivity was measured with electrochemical impedance spectroscopy. The prepared films are relatively uniform and free from defects. Plasma materials exhibiting higher sulphonic acid group contents and lower densities are those formed, from the styrene/CF3SO3H mixture, in the after glow discharge configuration; which proves that the kind of discharge and the nature of the monomer mixture have a large influence on the microstructure of plasma materials. Consequently, plasma films, prepared in the after glow discharge from the styrene/CF3SO3H mixture, show proton conductivities (up to 9.8 × 10–2 mS cm–1) about one order of magnitude higher than films prepared in the glow discharge (up to 2.2 × 10–3 mS cm–1 and 2.5 × 10–3 mS cm–1 for films prepared from 1,3‐butadiene/CF3SO3H and styrene/CF3SO3H mixtures, respectively). When compared to the commercially available Nafion®, the reference electrolyte polymer in the PEMFC, our most competitive plasma polymers are intrinsically 100 times less conductive. Nevertheless, due to their thinness (about 1 μm), these plasma films show specific resistances (about 1.0 Ω cm2), which are lower than that of the Nafion® membrane (1.9 Ω cm2 specific resistance). This explains their potential significance as polymer electrolyte membranes in a miniaturised PEMFC.