bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of ricin on primary pulmonary alveolar macrophages
Authors: Guo Zhendong , Wang Zhongyi , Meng Shanyu , Zhao Zongzheng , Zhang Chunmao , Fu Yingying , Li Jiaming , Nie Xin , Zhang Cheng , Liu Linna , Lu Bing , Qian Jun 
Published: June 2019

Objective We systematically investigated the cytotoxic effects of ricin in primary pulmonary alveolar macrophages (PAMs). Methods Primary PAMs were isolated from BALB/c mice. The cytotoxic effects of ricin were investigated in vitro by optical and transmission electron microscopy, detection of the inflammatory cytokine response, proteomic analysis, and subsequent biological functional analysis. Results Ricin induced shrinkage, apoptosis, vacuolization, and multi-organelle lesions in primary PAMs as demonstrated by optical and transmission electron microscopy. Ricin also induced a pronounced pro-inflammatory cytokine response in primary PAMs, including induction of tumor necrosis factor-α, interferon-γ, interleukin (IL)-1, IL-2, IL-6, IL-12, C-C motif chemokine ligand 2, and C-X-C motif chemokine ligand 2, while the anti-inflammatory cytokines IL-4 and IL-10 were less affected. Proteomic analysis and subsequent biological functional analysis identified eight proteins that were up/downregulated by ricin treatment and which might thus contribute to ricin toxicity. These proteins were involved in various functions, including redox, molecular chaperone, glycolysis, protein translation, and protein degradation functions. Conclusion The results of the present study further our understanding of the pathogenic mechanism of inhalational ricin poisoning.
Hydrogen sulfide-mediated endothelial function and the interaction with eNOS and PDE5A activity in human internal mammary arteries
Authors: Yuan Chao , Hou Hai-Tao , Chen Huan-Xin , Wang Jun , Wang Zheng-Qing , Chen Tie-Nan , Novakovic Aleksandra , Marinko Marija , Yang Qin , Liu Zhi-Gang , He Guo-Wei 
Published: June 2019

Objective To investigate the role of hydrogen sulfide (H2S) in human internal mammary arteries (IMA) and its interaction with endothelial nitric oxide synthase (eNOS) and phosphodiesterase (PDE)5A activity. Methods Human IMA segments from patients undergoing coronary artery bypass grafting (CABG) were studied by myography for acetylcholine and sodium hydrosulfide (NaHS)-induced relaxation. Locations of 3-mercaptopyruvate sulfurtransferase (3-MPST) and cysteine aminotransferase (CAT) were examined immunohistochemically. Levels of H2S, eNOS, phosphorylated-eNOSser1177, and PDE5A were measured. Results In IMA segments from 47 patients, acetylcholine-induced relaxation (resistant to NG-nitro-L-arginine and indomethacin) was significantly attenuated by aminooxyacetic acid or L-aspartate (CAT inhibitors), iberiotoxin (large-conductance calcium-activated K+ channel blocker), TRAM-34 plus apamin (intermediate- and small-conductance Ca2+-activated K+ channel blockers) or glibenclamide (ATP-sensitive K+ channel blocker). 3-MPST and mitochondrial CAT were found in endothelial and smooth muscle cells while cytosolic CAT was located only in endothelial cells. Acetylcholine significantly increased the H2S levels. The H2S donor, NaHS, increased eNOS phosphorylation and down-regulated PDE5A. Conclusions Human conduit artery endothelium releases H2S under basal and stimulated conditions, involving the 3-MPST/CAT pathway, eNOS phosphorylation, PDE5A activity, and potassium channels. These findings may provide new therapeutic targets for treating vasospasm in CABG grafts and facilitate the development of new vasodilator drugs.
Mixed adenoneuroendocrine carcinoma of the extrahepatic bile duct: a case report
Authors: Zhang Hai-Wen , Kou Kai , Qi Jun , Xie En-Bo , Wang Meng , Li Yan , Lv Guo-Yue , Wang Guang-Yi 
Published: June 2019

Background The concept of mixed adenoneuroendocrine carcinoma (MANEC) was introduced in the 2010 World Health Organization classification of digestive neuroendocrine neoplasms. Bile duct invasion by MANEC is exceptionally rare. We herein report a case of MANEC with invasion of multiple bile ducts. Case presentation: A 60-year-old man presented with a 7-day history of upper abdominal pain, and a mass in the cystic duct was suspected based on computed tomography findings. The patient underwent resection of the extrahepatic bile ducts with concomitant radical lymphadenectomy and Roux-en-Y cholangiojejunostomy. Large cell neuroendocrine carcinoma was detected in a component of the resected tumor. According to the pathological and immunohistochemical features of the tumor, the final histopathological diagnosis was a biliary MANEC, tumor stage T2N0M1 (Stage IIIC). The patient recovered uneventfully and was discharged from the hospital 10 days after surgery. Conclusions We have described a rare case of extrahepatic MANEC invading multiple bile ducts, with particular emphasis on the physician’s awareness of MANEC and its optimal treatment. MANEC arising from extrahepatic bile ducts is rare, and surgical resection is the most effective treatment method.
Effect of Medial Open-Wedge High Tibial Osteotomy on the Patellofemoral Joint According to Postoperative Realignment
Authors: Yoon Tae-Hwan , Choi Chong Hyuk , Kim Sung-Jae , Kim Sung-Hwan , Kim Nam-Hoo , Jung Min 
Published: June 2019

Background:No study has yet assessed the effect of medial open-wedge high tibial osteotomy (MOWHTO) on the patellofemoral joint according to postoperative alignment.Purpose:To evaluate the effect of MOWHTO on the patellofemoral joint according to postoperative alignment by comparing the cartilage status before and after surgery and assessing the clinical and radiological outcomes.Study Design:Cohort study; Level of evidence, 3.Methods:A total of 135 patients who underwent MOWHTO were retrospectively investigated. The patients were divided into 3 groups according to the postoperative weightbearing line ratio (WBLR): undercorrection (WBLR <58.3%, lowest quartile), acceptable correction (WBLR of 58.3%-66.3%, middle 2 quartiles), and overcorrection (WBLR >66.3%, highest quartile). The postoperative change in the cartilage status was assessed arthroscopically during implant removal at 2 years after MOWHTO. The clinical and radiological outcomes were evaluated at a mean follow-up of 52.1 months. A regression analysis was performed to identify the factors affecting the deterioration of the patellofemoral joint cartilage status. A receiver operating characteristic curve was employed to identify the cutoff point for the postoperative WBLR associated with the deterioration of the cartilage status in the patellofemoral joint.Results:Of all patients, progression of cartilage degeneration was noted in 39.3% for femoral trochlea and 23.7% for patella. The incidence of cartilage progression was significantly higher in the overcorrection group than in the undercorrection and acceptable correction groups (femoral trochlea: undercorrection group = 30.3%, acceptable correction group = 32.4%, and overcorrection group = 61.8% [ P = .008]; patella: undercorrection group = 15.2%, acceptable correction group = 17.7%, and overcorrection group = 44.1% [ P = .005]). The functional outcomes, including Lysholm knee score, Knee injury and Osteoarthritis Outcome Score (Pain, Symptoms, and Activities of Daily Living subscales), and Shelbourne and Trumper score, were significantly worse in the overcorrection group. The regression analysis showed that only the postoperative WBLR had a significant effect on cartilage deterioration. The cutoff point for the postoperative WBLR associated with progression of the International Cartilage Repair Society grade was 62.1% for the femoral trochlea (sensitivity = 61.5%, specificity = 62.7%, accuracy = 66.2%) and 62.2% for the patella (sensitivity = 59.4%, specificity = 60.2%, accuracy = 67.8%).Conclusion:The patellofemoral joint was adversely affected by MOWHTO. Overcorrection causing excessive valgus alignment led to further progression of degenerative changes in the patellofemoral joint and inferior clinical outcomes. The postoperative WBLR can be used as a predictive factor for deterioration of the cartilage status in the patellofemoral joint after MOWHTO.
Improvement in inflammation and airway remodelling after acupuncture at BL13 and ST36 in a mouse model of chronic asthma
Authors: Nurwati Ida , Purwanto Bambang , Mudigdo Ambar , Saputra Koosnadi , Prasetyo Diding Heri , Muthmainah Muthmainah 
Published: June 2019

Background: Asthma is a chronic inflammatory disease that affects millions of people worldwide. Chronic asthma is commonly resistant to steroid therapy. Acupuncture has an anti-inflammatory effect and has been widely used as an add-on therapy for asthma. Objective: To evaluate the effects of acupuncture on the inflammatory response and airway remodelling in the bronchioles of an asthma mouse model. Methods: A chronic asthma model was produced in female BALB/c mice by ovalbumin (OVA) sensitisation. 32 mice were randomised into four groups: control; asthma (OVA); OVA+BL13; and OVA+BL13+ST36. OVA was administered by intraperitoneal injection on days 0 and 14 followed by aerosol exposure of 1% OVA three times a week for 6 weeks. Manual acupuncture (MA) was performed three times a week for 6 weeks at BL13 alone, or BL13 in combination with ST36, in the two MA-treated groups. At the end of the experiment, blood samples were collected to determine eosinophil and neutrophil counts and lung tissue was prepared for histological examination. Results: A pronounced reduction in the neutrophil count was achieved after MA at BL13+ST36 (P=0.005) while the eosinophil count was lowered after MA both at BL13 (P=0.007) and BL13+ST36 (P=0.006). Reduction in the bronchiolar epithelial and smooth muscle thickness and the number of goblet cells was observed after MA at BL13 (P=0.001, P=0.001 and P=0.002, respectively) and BL13+ST36 (P=0.001, P=0.002 and P=0.001, respectively). Conclusion: Acupuncture can reduce the inflammatory response and prevent airway remodelling in a chronic asthma mouse model.
Adherence to human epidermal growth factor receptor-2 testing and adjuvant trastuzumab treatment guidelines in Ontario
Authors: Marshall Deborah A , Ferrusi Ilia L , Trudeau Maureen , Leighl Natasha B , Hoch Jeffrey S , Grazziotin Luiza R , Khong Hoa , Pullenayegum Eleanor , Earle Craig C 
Published: June 2019

Objectives We evaluated adherence of human epidermal growth factor receptor-2 testing using immunohistochemistry and fluorescence in situ hybridization, as well as adjuvant trastuzumab treatment according to Canadian guidelines, and predictors of trastuzumab use in early-stage breast cancer in Ontario. Methods Retrospective cohort of early-stage breast cancer patients identified in the Ontario Cancer Registry. Human epidermal growth factor receptor-2 test type, sequence, result(s), tumor grade, and hormone receptor status were abstracted from Ontario Cancer Registry pathology reports. Trastuzumab treatment was determined from provincial cancer agency records. Other variables were determined from administrative data sources. Logistic regression models were used to estimate adjusted odds ratios for factors associated with guideline adherence. Results The first human epidermal growth factor receptor-2 test result was the strongest predictor of confirmatory testing ( p < 0.05). Human epidermal growth factor receptor-2 testing by immunohistochemistry accounted for the majority of documented first tests (94%; n = 8249). Overall, 27% ( n = 2360) of tested patients received a second test by fluorescence in situ hybridization (46%) or immunohistochemistry (49%) assay. Most human epidermal growth factor receptor-2 equivocal patients (89%; n = 784) received a confirmatory test. Among human epidermal growth factor receptor-2-positive patients, only 57% ( n = 385) received trastuzumab treatment within the study period. Human epidermal growth factor receptor-2 status was the strongest predictor of trastuzumab use. Younger patients (<70 years at diagnosis) and negative hormone receptor status had higher odds of trastuzumab treatment ( p < 0.05) compared to older and positive hormone receptor status patients. Conclusions Immunohistochemistry use as a first test was largely consistent with Canadian guidelines; however, immunohistochemistry was frequently used as a confirmatory test, which is not guideline-concordant. Monitoring these testing and treating patterns is necessary to optimize health outcomes associated with trastuzumab.
The incidence and risk factors of thrombosis and the need for thromboprophylaxis in lymphoma and leukemia patients: A 9-year single-center experience
Authors: Yıldız Abdulkerim , Albayrak Murat , Pala Çiğdem , Afacan Öztürk Hacer B , Maral Senem , Şahin Osman , Cömert Pınar 
Published: June 2019

Background Patients with cancer are at increased risk of thromboembolic complications. There is no evidence-based guideline on the use of routine prophylaxis in hematological malignancies except in patients with multiple myeloma. The purpose of this study was to determine the incidence and risk factors of thrombosis and suggest a rationale for primary thromboprophylaxis in acute leukemia and lymphoma patients. Patients and methods A retrospective study was conducted on newly-diagnosed acute leukemia and lymphoma patients who presented at our institution from November 2009 to March 2018. The study included a total of 157 patients with acute leukemia and 238 patients with lymphoma. The groups were analyzed to determine the incidence and risk factors of thromboembolic complications. Results The incidence of all thrombotic complications was 10.12% (40/395) including 11.4% (18/157) in patients with acute leukemia and 9.2% (22/238) in patients with lymphoma. The majority of events occurred in the first 6 months. Acute leukemia patients with thrombosis had a higher number of comorbidities than those without thrombosis ( p < 0.05). Lymphoma patients with thrombotic complications had significantly higher beta-2-microglobulin and lactate dehydrogenase levels compared to those without thrombosis ( p < 0.05). Major bleeding events developed in five (3.1%) acute leukemia patients and two (0.8%) lymphoma patients. All the major bleeding events occurred when the patients were thrombocytopenic (platelet < 50,000/mm3). Conclusions Acute leukemia patients with any comorbidity and lymphoma patients with higher lactate dehydrogenase and beta-2-microglobulin are at high risk of developing thromboembolic complications. The prophylactic use of anticoagulant should be considered for those patients especially in the first 6 months.
Experience with ambulatory high-dose methotrexate administration as CNS prophylaxis in patients with non-Hodgkin lymphoma
Authors: Pampín Rubén , Labeaga Yoar , Rodríguez Belén , Fernández Beatriz , Fernández Rubén , Carbajales Mónica 
Published: June 2019

Background We describe the feasibility and safety of an oral administration schedule of hydration, alkalinization and leucovorin rescue with an ambulatory high-dose methotrexate regimen. Methods Single-centre prospective observational study conducted within a tertiary hospital where all patients have received systemic high-dose methotrexate (3.5 g/m2). Patients were instructed to keep an adequate ambulatory oral hydration and alkalinization to monitor urine pH and to adjust bicarbonate according to our institution's treatment protocol. High-dose methotrexate was infused over 4 h. Urine pH was checked before high-dose methotrexate administration, and for any value less than 7 a sodium bicarbonate bolus was given. Leucovorin at a standard dose was begun 24 h after high-dose methotrexate. methotrexate serum concentrations were monitored daily from 24 h after administration until clearance (level ≤ 0.1 µmol/L). Results From January 2016 to June 2018, 49 ambulatory high-dose methotrexate courses were given to 18 patients. No dose reduction was required afterwards. All patients completed succesfully the planned three doses in an outpatient basis, except four patients, one of them due to pneumonitis. Previous to methotrexate infusion, urinary pH > 7 was achieved in 35 (79.5%) cycles. Methotrexate clearance was achieved by 72 h in 35 courses (71.4%), and by 96 h in 100%. Neutropenia/trombocytopenia grades III/IV were observed in four cycles (8.16%) and two (4.08%) cycles, respectively. Around 20.40% were associated with stomatitis, 14.20% vomiting, 10.20% asthenia, 8.16% diarrhea and 6.12% with renal toxicity. Conclusions Ambulatory administration of high-dose methotrexate as CNS prophylaxis is safe and feasible following the described approach, allowing us to optimize healthcare resources.
Successful treatment of refractory metastatic neuroblastoma with panobinostat in combination with chemotherapy agents and iodine-131-meta-iodobenzylguanidine therapy
Authors: Zareifar Soheila , Shakibazad Nader , Zekavat Omid Reza , Bordbar Mohammadreza , Shahriari Mahdi 
Published: June 2019

Introduction Neuroblastoma commonly required multimodal therapy containing surgery, chemotherapy, radiotherapy, and immunotherapy. Case report In our case, who had refractory metastatic neuroblastoma, we use histone deacetylase inhibitor (panobinostat) in combination with chemotherapy agents and iodine-131-meta-iodobenzylguanidine (MIBG) therapy. Management and outcome This approach leads to successfully treat the patient. MIBG scan and bone marrow examination after therapy revealed no evidence of tumor. Now, she underwent autologous transplantation six months ago and free of tumor. Conclusion Panobinostat can cause apoptosis induction in refractory metastatic neuroblastoma in combination with MIBG therapy and chemotherapy.
Endophthalmitis after dropless (Tri-Moxi injection) cataract surgery
Authors: Ng Caleb , Chalam Kakarla V 
Published: June 2019

Introduction: A case of endophthalmitis after dropless cataract surgery with intravitreal Tri-Moxi associated with severe vision loss. Case summary: An 82-year-old male developed severe vision loss in the left eye 24 days after dropless cataract surgery with intravitreal Tri-Moxi injection. Best corrected visual acuity was hand motion in the left eye. Intraocular pressure was 13, with inferior keratic precipitates, 4 + cell with 1 mm layered hypopyon, and a plaque on the posterior capsule that blocked direct exam of the posterior segment. Ultrasonography revealed extensive vitritis without retinal or choroidal detachments. Conclusion: Endophthalmitis resolved and vision improved after management with vitreous tap, intravitreal and fortified topical antibiotics, and subsequent prompt pars plana vitrectomy. Vitreous sample grew fluoroquinolone-resistant staphylococcus epidermidis.
Dissociated optic nerve fiber layer in a case of Terson syndrome
Authors: Tripathy Koushik 
Published: June 2019

Purpose: To report a case of Terson syndrome who developed dissociated optic nerve fiber layer appearance after pars plana vitrectomy. Case report: The author reports a young male patient with Terson syndrome who developed bilateral vitreous hemorrhage and sub-internal limiting membrane hemorrhage after road traffic accident. He underwent pars plana vitrectomy and removal of the already detached internal limiting membrane and the sub-internal limiting membrane hemorrhage in both eyes. In both eyes, dissociated optic nerve fiber layer was appreciated and left eye had a peculiar resemblance to the appearance of cystoid macular edema. Conclusions: Dissociated optic nerve fiber layer appearance may be noted following vitrectomy and removal of detached internal limiting membrane in patients with vitreous hemorrhage and sub-internal limiting membrane bleed due to Terson syndrome.
Risk factors for Barrett’s esophagus in young adults who underwent upper gastrointestinal endoscopy in a health examination center
Authors: Wu Pin-Chieh , Chen Yan-Hua , Wu Fu-Zong , Lin Kung-Hung , Hsu Chiao-Lin , Chen Chi-Shen , Chen Yu-Hsun , Lin Po-Hsiang , Mar Guang-Yuan , Yu Hsien-Chung 
Published: June 2019

Background: Barrett’s esophagus (BE) is a premalignant condition with increased incidence worldwide both in old and young individuals. However, the role of certain potential risk factors remains unclear in young adults (< 50 years). We aimed to determine the risk factors of BE in young adults. Methods: A total of 4943 young adults who underwent upper gastrointestinal endoscopy at our health check-up center were enrolled. The diagnosis of BE was based on histological confirmation. We analyzed demographic factors, laboratory data, potential risk factors such as smoking, alcohol consumption, presence of gastroesophageal reflux disease (GERD) symptoms, and metabolic syndrome for the risk of BE by using binary logistic regression analysis. Results: The prevalence of BE was 1.8% (88/4943). Male sex, the presence of GERD symptoms, and smoking were three significant risk factors related to BE. Furthermore, participants who had smoked for 10 pack-years or more had increased risk of BE with dose-dependent phenomenon ( p trend < 0.001). The proportion of BE in male participants with both GERD symptoms and a smoking history of 10 pack-years or more was as high as 10.3% (16/155). Conclusions: Significant risk factors of BE in young adults are male sex, the presence of GERD symptoms, and smoking. The risk also increases with an increase in cumulative exposure to smoking.
Morbidity and mortality in patients with rheumatoid arthritis compared with an age- and sex-matched control population: A nationwide register study
Authors: Løppenthin Katrine , Esbensen Bente Appel , Østergaard Mikkel , Ibsen Rikke , Kjellberg Jakob , Jennum Poul 
Published: June 2019

Objective: The aim of this study was to examine the prevalence of morbidity and mortality in patients with seropositive rheumatoid arthritis (RA). Methods: Data were obtained from national population-based registries in the period 1998–2009. Prior to the seropositive RA diagnosis (International Classification of Disorders 10th revision M05), we identified a total of 21,558 patients and 87,384 age- and sex-matched control subjects. Odds for morbidity were calculated before and after the RA diagnosis. We estimated the overall survival based on the Kaplan–Meier method. Results: Patients with RA had statistically significantly higher odds for a number of co-morbidities prior to the onset of RA including diseases of the musculoskeletal system (odds ratio (OR) 3.10, 95% confidence interval (CI) 3.00–3.21), diseases involving the immune system (OR 1.45, 95% CI 1.29–1.64), endocrine diseases (OR 1.09, 95% CI 1.01–1.17), diseases of the circulatory system (OR 1.08, 95% CI 1.03–1.14) and diseases of the respiratory system (OR 1.30, 95% CI 1.22–1.38), compared with age- and sex-matched control subjects. After the RA diagnosis, the same trend was seen with higher odds for the same co-morbidities. We found a 5-year survival of 80% (95% CI 78–81%) for patients with RA, while for control subjects it was 88% (95% CI 88–89%). Conclusion: Compared with age- and sex-matched controls, patients with seropositive RA have higher odds for several co-morbidities prior to and, particularly, after the diagnosis of RA. Furthermore, patients with RA have a lower overall survival compared with age- and sex-matched controls.