bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimization of Physiological Growth Conditions for Maximal Gamma‐linolenic Acid Production by Cunninghamella blakesleeana‐JSK2
Authors: Sukrutha S. K. , Adamechova Zuzana , Rachana Kunder , Savitha Janakiraman , Certik Milan 
Published: July 2014

AbstractEffects of various cultural conditions on biomass, lipid and Gamma‐linolenic acid (GLA) production were investigated in the oleaginous fungus Cunninghamella blakesleeana‐JSK2 isolated from soil. The GLA production was influenced by various factors such as growth condition (static and shaken), incubation time, pH, temperature, carbon and nitrogen sources. The results indicated that optimum GLA production (21 %) was obtained when the fungus was grown under shaken condition at 120 rpm for 6 days with optimum pH and temperature of 6 and 28 °C, respectively. Glucose and potassium nitrate enhanced the GLA production. Urea and sucrose were poor substances for biomass, lipid and GLA production.
Headache After Traumatic Brain Injury: A National Survey of Clinical Practices and Treatment Approaches
Authors: Brown Allen W. , Watanabe Thomas K. , Hoffman Jeanne M. , Bell Kathleen R. , Lucas Sylvia , Dikmen Sureyya 
Published: July 2014

AbstractBackgroundIndividuals with headache after traumatic brain injury (TBI) receive care in a wide variety of clinical locations by physicians trained in multiple specialties.ObjectiveTo understand current practice patterns and perceptions of treatment issues among clinicians managing headache after TBI.DesignNational survey of current clinical practice using a 20‐item questionnaire developed by the authors.ParticipantsSurvey respondents were members of the Central Nervous System Council list survey of the American Academy of Physical Medicine and Rehabilitation (N = 1782) and the American Headache Society membership (N = 1260).MethodsThe survey was sent electronically to potential participants and was followed by 2 biweekly reminders. The survey queried the physicians' clinical setting; their use of headache classification systems, headache diaries, checklists, and diagnostic procedures; the pharmacologic and nonpharmacologic treatments prescribed; and headache chronicity and associated symptoms and disorders among their patients with TBI.ResultsCompleted surveys were received from 193 respondents. The use of standardized classification systems and checklists was commonly reported. Respondents used nonpharmacologic and pharmacologic treatment approaches with similar frequency and modest perceived success rates. A high frequency of headache‐associated new sleep and mood disorders was reported. When response differences occurred between practice settings, they reflected a focus on headache diagnosis, classification, and pharmacologic treatment among neurology and specialty headache clinics, whereas a nonpharmacologic approach to management among TBI specialty and general rehabilitation clinicians was more commonly reported.ConclusionManagement strategies for treating headache after TBI vary widely among general and specialty clinical practices. This suggests that additional research is needed that would lead to an increase in the use of established headache classification and the development of standardized management approaches so that all practitioners who care for patients after TBI can provide consistent effective care.
Current and future cancer burden in Saudi Arabia
Authors: Ibrahim Ezzeldin , Sadiq Bakr M. Bin , Banjar Laila , Awadalla Saeed , Abomelha Mohammed S. 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Despite the low cancer incidence in Saudi Arabia, the country must be ready to face the challenge of a foreseeable increase in cancer burden mainly attributed to the growth and aging of the population. We designed this study to estimate the future cancer burden and to highlight the demands on prospective healthcare resources.

METHODS:
cancer statistics in saudi Arabia from 2000 to 2004 were examined. The Joinpoint regression program was used to identify changes in secular trends, while the GLOBOCAN 2002 software projected future burden. considering current trends and the growth and aging of the population, we projected the future burden.

RESULTS:
In 2004, the age-standardized rate (ASR) for incidence for all cancer sites, excluding basal and squamous skin cancer, was 57.2 per 100 000 (55.8 and 59.1 per in males and females, respectively). ASR trends showed a statistically significant increase in the annual percent change (APC) for both males and females, which was greatest from 2003 to 2004 (4.93% and 2.64%, respectively). By the year 2020 and 2030, there would be an approximately 6- and 10-fold rise among males as compared with the burden in 2004. the corresponding numbers for females would be 5- and 8-fold, respectively. The highest cancer burden would be expected for middle-aged and elderly saudis.

CONCLUSIONS:
In countries currently experiencing low cancer rates, the future cancer burden could increase considerably and place enormous demands on healthcare resources. The present study may provide an impetus to examine the future all or site-specific cancer burden, particularly in developing countries.
Malignant tumors of the minor salivary glands in northern Pakistan
Authors: Rahman Bushra , Mamoon Nadira , Jamal Shahid , Zaib Nadia , Luqman Mohammad , Mushtaq Sajid , Anwar Masood 
Published: July 2014

BACKGROUND:
Malignant tumors of the minor salivary glands comprise a small but significant proportion of oral cancers. We analyzed this group of tumors in our population.

METHODS:
The records of all cases of malignant minor salivary gland tumors diagnosed at the Armed Forces Institute of pathology (AFIP), Rawalpindi, pakistan, during a period of 10 years (1994-2003) are described. the institute receives biopsy material from armed forces and public and private sector hospitals in northern Pakistan as well as referrals for second opinion.

RESULTS:
A total of 21168 tumors were recorded at the AFIP Tumor Registry during the study period. these included 70 malignant minor salivary gland tumors. Twenty-three of these (32.8%) arose in the palate while the remaining tumors originated at other sites in the oral cavity. the commonest histological type was adenoid cystic carcinoma, constituting 30 cases (42.8%). The next most common type was mucoepidermoid carcinoma comprising 26 (37.1%) cases. The mean age of cases was 43.4 years and the male-to-female ratio was 1:1.4. There were 2 cases each of polymorphous low-grade adenocarcinoma and clear cell adenocarcinoma. The remaining cases included undifferentiated carcinomas, adenocarcinomas (not otherwise specified) and a few other rare tumors.

CONCLUSION:
Adenoid cystic carcinoma was the commonest malignant neoplasm of the minor salivary glands followed by mucoepidermoid carcinoma. The palate was the commonest location of these tumors.
A retrospective study of treatment and outcome in 39 cases of male breast cancer
Authors: Yoney Adnan , Kucuk Ahmet , Alan Omur , Unsal Mustafa 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Optimal management if male breast cancer (MBC) is not clearly established and treatment guidelines are scarce. We evaluated our own results in the treatment of male breast cancer patients with respect to local control (LC), overall survival (OS) and possible prognostic factors for survival.

PATIENTS AND METHODS:
Thirty-nine patients with MBC were retrospectively studied to evaluate the results in this type of tumor; 94.8% had invasive ductal carcinoma (IDC), 2.6% invasive papillary carcinoma (IPC) and 2.6% invasive lobuler carcinoma (ILC). The distribution according to stage was 12.8%, 46.2%, 30.7% and 1 0.3% in stages I, II, III and IV, respectively; 7.7% underwent radiotherapy (RT)± hormonotherapy (HT), 22.8% had chemotherapy (CT), 61.8% had chemoradiotherapy (CRT) ± HT and 7.7% had HT in addition to surgery.

RESULTS:
The distant metastases rate was 36% and the local recurrence rate was 5%. All the local recurrences and the distant metastases had occurred after the first two years. The 2-year disease free survival (DFS) and OS rates were 87.2% and 89.7%, respectively, and the 5-year DFS and OS rates were 65.8% and 80.1 %, respectively. in a univariate analysis for OS, statistical significance was found for lymph node metastases (P=.00001), stage (P=.0098) and age (P=.03), while presence of RT in the treatment modality (P=.6849), and tumor size (P=.4439) demonstrated no significance. The presence of lymph node metastases significantly impaired OS (P=.004) and DFS (P=.014) in the multivariate analysis.

CONCLUSION:
postoperative radiotherapy was important in the management of MBC to improve LC resulting in one local failure, but did not improve OS and DFS. The presence of lymph node metastases significantly impairedOS and DFS.
A retrospective comparison of concurrent bolus 5-fluorouracil or raltitrexed in preoperative chemoradiation for locally advanced rectal cancer
Authors: Yoney Adnan , Askaroglu Bulent , Hancilar Tayfun , Isikli Levent , Unsal Mustafa 
Published: July 2014

BACKGROUND:
5-fluorouracil (FU) is commonly used in preoperative chemoradiation in locally advanced rectal cancer, but not all patients cooperate in taking the 5-day continuous infusion regimen. Raltitrexed (RA), a thymidylate synthase inhibitor, is one of the agents used in place of FU in such cases. We retrospectively compared the toxicity, tumor downstaging, pathologic response and relapse rate with bolus FU or RA during concurrent radiotherapy (RT) to assess the role of RA in place of FU.

PATIENTS AND METHODS:
We conducted a retrospective analysis of response rates and toxicity data on 59 patients diagnosed with locally advanced rectal cancer and treated with surgery following preoperative chemo radiation with either concurrent FU or RA between January 1999 and December 2004.

RESULTS:
Median follow-up was 38 months (range, 1-70). Ten patients (10%) had grade 3 gastrointestinal (GIS) toxicity during chemoradiation. The pathologic complete response rates were 6% with Fu and 7% with RA (P=0.844), while 66.7% of patients treated with Fu and 37.1% with RA had downstaging of the T stage after chemoradiation (P=0.026). The sphincter preservation rates were 45.8% with Fu and 51.4% with RA (P=0.912). The 5-year local control rates were 79.2% for patients treated with RT+FU and 85.76% for patients treated with RT+RA (P=0.510).

CONCLUSION:
compared with the RT+RA regimen, the incidence of downstaging was greater with RT+FU, but RT+Fu was associated with a correspondingly greater rate of acute grade 2 GIS toxicity. However, no significant differences were seen in sphincter preservation, pathologic complete response, local control and distant recurrences rates among patients. Fu seems to be the best therapeutic choice, while RA seems to be as effective as bolus Fu.
Expression of CD66c and CD25 in acute lymphoblastic leukemia as a predictor of the presence of BCR/ABL rearrangement
Authors: Owaidah Tarek M. , Rawas Faisal I. , khayatt Mazen F. Al , Elkum Nasser B. 
Published: July 2014

BACKGROUND:
Expression of myeloid or T cell lymphoid in precursor B cell acute lymphoblastic leukemia (pre- B cell ALL), which is referred to as aberrant expression, is quite a common phenomenon. cD66c is a myeloid marker which has aberrant expression in pre-B cell ALL, with strong correlation with non-random genetic changes (BCR/ABL rearrangement). Another leukemia associated marker (CD25) is frequently expressed in pre-B cell ALL. The frequency of CD25-expressing lymphoblasts has been found to be significantly higher in BCR/ABL-positive vs. BCR/ABL-negative patients.

METHODS:
In a cohort of 1 03 patients diagnosed with pre-B cell ALL or biphenotypic leukemia and studied for expression of CD66c and CD25 at presentation, we evaluated the frequency of expression of either or both in BCR/ABL positive cases.

RESULTS:
Surface CD66c was expressed by 70 cases (68%) and CD25 was expressed by 33 cases (32%) while both were expressed together on 29 cases (28%). BCR/ABL was positive in 18/1 03 patients. All BCR/ABL positive cases were positive for surface CD66c and CD25.

CONCLUSION:
Positivity for both leukemia-associated antigens CD66c and CD25 in combination can predict the presence of BCR/ABL rearrangement in pre-B cell ALL. While this finding does not replace the detection of BCR/ABL abnormality by cytogenetic or molecular techniques, it does provide an early and handy tool for prediction and management of high-risk cases of pre-B cell ALL, especially in centers with limited laboratory facilities.
Long-term outcome of adult acute lymphoblastic leukemia in Lebanon
Authors: Charafeddine Khalil M. , Hatoum Hassan A. , Otrock Zaher K. , Mahfouz Rami A. , Salem Ziad M. , Shamseddine Ali I. , Taher Ali T. , El-Saghir Nagi S. , Bazarbachi Ali 
Published: July 2014

BACKGROUND AND OBJECTIVES:
The most important studies about outcome of acute leukemia come from developed countries, whereas most of the patients with this disease are in developing countries. We report predictive and prognostic factors in patients with acute lymphoblastic leukemia (ALL) in a tertiary care center in a developing country.

PATIENTS AND METHODS:
We retrospectively reviewed the records of adult patients with acute leukemia who were referred to the American university of Beirut Medical center between 1996 and early 2006.

RESULTS:
Of 105 patients, 36 (34%) patients were diagnosed with ALL, and included 19 (53%) males and 17 (47%) females with a median age of 34 years (range, 14-79 years). Induction chemotherapy with curative intent was administered to 34 (94%) patients. Twenty-seven patients received intrathecal chemotherapy as prophylaxis (n=24) or as treatment for CNS disease (n=3). Twenty-eight patients (82%) achieved complete remission (CR) after induction chemotherapy. The median overall survival (OS) time was 22 months and the five-year OS for ALL patients was 38%. The median disease-free survival (DFS) time was 12 months, while the five-year DFS was 38%. Multivariate analysis showed that age <40 years, WBG <30×109/L, achievement of CR after first induction, and CNS prophylaxis were predictive factors for OS and DFS.

CONCLUSION:
Despite limitations and the relatively low socioeconomic status of the Lebanese population, OS (38%) and DFS (38%) are quite similar to international data. Trends toward a higher CR and DFS in adults are due to intensified consolidation chemotherapy, the use of stem cell transplantation, and improvements in supportive care.
Hypopigmentation of the skin due to imatinib mesylate in patients with chronic myeloid leukemia
Authors: Aleem Aamer 
Published: July 2014

BACKGROUND:
Hypopigmentation is an infrequently reported adverse effect of imatinib mesylate (IM) in chronic myeloid leukemia (CML), but there are no reports from Arab or Saudi patients. Thus, we assessed the frequency and impact of hypopigmentation in patients with chronic myeloid leukemia (CML) taking IM in our institution in Riyadh.

PATIENTS AND METHODS:
We studied 24 adult CML patients taking IM and followed from March to June 2008. telephonic interviews with all the CML patients taking IM were conducted and case notes were reviewed. Findings were confirmed on a subsequent clinic visit by a physician. Demographic features, disease status, response to IM, presence and severity of skin changes and impact of these changes on the patients and the disease were noted.

RESULTS:
Eight (33%) patients (6 males, 2 females) developed hypopigmentation due to IM. All patients had newly diagnosed, chronic phase CML and received 400 mg IM daily. The median age of the affected group was 37 years (range 18-54 years). Hypopigmentation developed during the first 3 months of treatment in 5 patients and 6 months or later in 3 patients. it was generalized in 7 patients and involved the hands and face in one patient. No photosensitivity was reported and none had other significant side effects.

CONCLUSION:
Hypopigmentation of the skin can develop in about one third of CML patients taking IM. physicians taking care of CML patients should be aware of this and patients need to be warned before commencing iM, particularly in dark-skinned patients.
Improved compliance with adjuvant vinorelbine and cisplatin in non-small cell lung cancer
Authors: Aljubran Ali , Leighl Natasha , Pintilie Melania , Burkes Ronald 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Poor compliance has been a common feature in clinical trials of adjuvant chemotherapy for NSCLC with only 48% to 69% of patients completing all planned cycles. We retrospectively evaluated compliance and toxicity of platinum-based chemotherapy in the 2 years following recent reports of successful adjuvant chemotherapy trials for NSCLC.

PATIENTS AND METHODS:
Patients who received adjuvant chemotherapy after complete resection of NSCLC between May 2003 and May 2005 were analyzed retrospectively. Patient demographics, ECOG status, stage, pathologic subtype and type of surgery were recorded. The number of chemotherapy cycles, delays, dose reductions and change of chemotherapy were reported.

RESULTS:
Fifty patients were identified. The median age was 62 years (38% stage I, 18% stage II, 30% stage III and 14% had multiple primary tumors of variable stages). Twenty percent were ECOG PS2; only 12% had undergone pnemonectomy. Forty-one patients (82%) started cisplatin/vinorelbine (three switched to carboplatin because of nephrotoxicity, and one switched to carboplatin/paclitaxel because of fatigue and vomiting). Three patients received other cisplatin-based combinations; six received carboplatin-based treatment (one each because of advanced age and cardiac dysfunction and 4 because of preexisting neuropathy). Eighty percent completed all treatment; 40% required a dose reduction and 58% required delays in treatment. Six events of febrile neutropenia were reported in 5 patients and 5 patients required admission for toxicity. There were no toxic deaths. Multivariate analysis showed no effect of age, gender, extent of surgery or ECOG status on compliance, need for treatment modification or toxicity.

CONCLUSIONS:
compared to historical trials, adjuvant platinum-based chemotherapy for resected NSCLC is now accepted by patients and physicians with a high degree of compliance.
High efficacy and low toxicity of short-course oral valganciclovir as pre-emptive therapy for hematopoietic stem cell transplant cytomegalovirus infection
Authors: Saleh AJM , Mohareb Fahad Al , Rabiah Fahad Al , Chaudhri Naeem , Sharif Fahad Al , Zahrani Hazzaa Al , Mohamed Said Yousuf , Patel Moosa , Rasheed Walid , Nurgat Zubeir , Bakr Mohammad , Ahmed Shad , Zaidi Syed , Nassar Amr , Ibrahim Khaled , Abdely Hail Al , Aljurf Mahmoud 
Published: July 2014

BACKGROUND:
Cytomegalovirus (CMV) infection is a major infectious complication post-allogeneic hematoppoietic stem cell transplantation (HSCT). CM V seropositivity in Eastern Mediterranean and certain Asian counttries is reported to be close to 100%; hence, the need for effective pre-emptive treatment strategy that has low toxicity. Valganciclovir (VGC) is a prodrug of ganciclovir with high bioavailability.

PATIENTS AND METHODS:
HSCT patients with documented CMV infection (as defined by positive CM V antiggenemia) were treated as outpatients with VGC at a starting dose of 900 mg twice daily for 1 week. Those who were antigenemia negative after one week received 900 mg once daily for another week and treatment was subsequently discontinued. Those who were positive after one week of therapy continued on the twice daily treatment schedule for another week and changed to a daily schedule once they converted to antigenemia negativity.

RESULTS:
From January 2004 to December 2007, 47 HSCT patients received preemptive treatment with VGC for 61 episodes of CMV infection. The antigenemia range was 1 to 700 infected cells/slide. Complete responses were observed in 92% and 97% after the 1st and 2nd week of treatment, respectively. Three percent of the epissodes were considered refractory, requiring alternative therapy. No CM V disease was observed in this cohort.

CONCLUSION:
Neutropenia was the main observed toxicity, requiring granulocyte-colony stimulating factor in 8 episodes. Outpatient treatment of CM V infection with “short-course oral VGC” given as a one week twice daily treatment and one week once daily maintenance is a highly effective therapy with minimal toxicity. These results require validation in a larger, randomized study.
Improved survival with combined chemoradiotherapy in primary central nervous system lymphoma
Authors: Abdelsalam Mahmoud , El-Husseiny Gamal , Akhtar Saad , Khafaga Yasser , Al-Shabana Mohamed , AlHusaini Hamed , Weshi Amr El , Rahal Mohamed , Maghfoor Irfan 
Published: July 2014

BACKGROUND:
Primary CNS lymphoma (PCNSL) is an aggressive primary brain tumor. Cranial irradiation alone rarely results in long term disease control or prolonged survival. We retrospectively analyzed data on the effect of adding high-dose methotrexate (HDMTX) prior to whole brain irradiation (WBI).

METHODS:
All patients with PCNSL diagnosed and managed during 1991-2004 were identified and demoggraphic characteristics, prognostic factors, treatment and outcome were reviewed. Of 62 patients, 10 were exccluded (4 had WBI <40 Gy and 6 had no treatment). Radiation alone was considered curative with a dose > 40 Gy. Combined modality therapy included 3-4 cycles of HDMTX (3 g/m2) followed by WBI.

RESULT:
Of 52 patients analyzed for outcome, 36 had WBI (dose >40 Gy), 16 received 3-4 cycles of HDMTX followed by WBI (combined modality therapy [CMT]). Median age was 48.2 years; 42 years in the CMT group, 51 years in WBI . Patient characteristics were comparable between two groups except for higher multifocal tumor in the CMT group (92% vs. ×22%, P=.029). Median follow up was 12.83±6.4 months. The hazard rattio for an event was 0.64 (95% CI, 0.52-0.98) and for death 0.58 (95% CI, 0.48-0.92), both in favor of CMT . Univariate regression analysis using one-way analyses of variance (ANO VA) and multivariate Cox regression analysis for prognostic factors including age (<60 vs. >60), 50Gy) failed to identify any prognostic factor.

CONCLUSION:
This retrospective comparison supports phase II trial results that indicate that high-dose methottrexate followed by WBI in PCNSL improves outcome.
Human G-protein gamma 7 in extrahepatic cholangiocarcinoma and its clinicopathological significance
Authors: Wang Mei , Gong Biao , Li Yongmei , Wang Yajie 
Published: July 2014

BACKGROUND AND OBJECTIVES:
Several studies have found a down-regulated G-γ 7 gene in gastrointestinal tract cancers. We evaluated the expression and clinicopathological significance of the human G protein γ 7 (G-γ 7) in human extra-hepatic cholangiocarcinoma (EHCC).

METHODS
The expression of G-γ 7 expression was studied in 21 patients with EHCC. G-γ 7 mRNA expression was tested by using RealTime reverse transcription polymerase chain reaction (RT-PCR). To visualize the localization of G-γ 7, an immunohistochemistry study was also performed. The G-γ 7 expression was compared among cancer tissues, peri-cancerous bile duct tissues and normal bile duct tissues. The clinicopathological significance of G-γ 7 expression was also studied.

RESULTS
Expression of G-γ 7 mRNA and protein were significantly lower in EHCC tissue than in peri-cancerous bile duct tissue and normal bile duct tissues. G-γ 7 mRNA and protein expression were significantly lower in poorly differentiated EHCC tissues than in moderate differentiated and well differentiated EHCC tissues (P < .01). There was no significant correlation between G-γ 7 expression and host factors such as age, gender, clinical staging or the status of preoperative hepatic function

CONCLUSIONS
EHCC has a down-regulated expression of G-γ 7. Reduced expression of G-γ 7 is associated with the histological grade of EHCC and may prove to be a useful marker for predicting the prognosis of human EHCC.