bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards an in vivo morphologic classification of melanocytic nevi
Authors: Pellacani G. , Scope A. , Farnetani F. , Casaretta G. , Zalaudek I. , Moscarella E. , Casari A. , Cesinaro A. M. , Argenziano G. , Longo C. 
Published: May 2013

AbstractBackgroundNevi are common benign neoplasms and the main diagnostic entity in the differential diagnosis of melanoma. Reflectance confocal microscopy (RCM), a novel technique for skin imaging at cellular‐level magnification, has been shown to be useful for differentiating nevi from melanoma. However, systematic studies of the specific RCM features of nevi are still lacking.ObjectiveTo describe the characteristic RCM features of common melanocytic nevi and to correlate them with histopathology.MethodsA total of 180 biopsy‐proven nevi were imaged with RCM prior to excision. RCM images were evaluated for the overall nevus pattern and presence of specific RCM criteria. Upon histopathology, nevi were analysed for thickness using adapted Breslow depth and Clark's level grading.ResultsObserved RCM patterns varied according to anatomic depth of nevi. Junctional nevi were mainly characterized on RCM by a Ringed pattern, indicating a predominantly single cell proliferation of melanocytes; in contrast, the junctional component of compound nevi appeared on RCM as a Meshwork pattern, indicating a predominantly nested‐proliferation. In compound nevi, the size of dermal nests was related to the thickness of nevi. Moreover, nevi extending deeper into the dermis were more likely to display a junctional component that extended laterally beyond the dermal component and appeared on RCM as either Ringed or Meshwork pattern. Intradermal nevi showed on RCM, in almost all cases, large clods.ConclusionsThe possibility for in vivo histopathological classification of nevi may help in attaining a better understanding of the origin of nevi and of nevus‐related melanoma risk.
Venous and arterial disease in inflammatory bowel disease
Authors: Tan Victoria P , Chung Alvin , Yan Bryan P , Gibson Peter R 
Published: May 2013

AbstractAwareness is increasing that risk of venous thromboembolism and development of atherosclerosis is elevated in patients with some chronic inflammatory diseases. This review aimed to examine the risk of vascular disease in patients with inflammatory bowel disease (IBD) and to identify potential pathogenic mechanisms and therapeutic approaches. An extensive literature search was conducted using MEDLINE database, Cochrane Library and international conference abstracts for studies pertaining to venous and arterial thromboembolism in adult IBD patients. There is a 1.1–3.6 fold risk of venothromboembolism in IBD, affecting 0.55–6.15% of patients. Risks are increased during a flare or with chronically active inflammation. Evidence is building that there may be a modestly increased risk of arterial disease overall, despite evidence that traditional risk factors may be reduced. Multiple pathogenic factors have been identified including endothelial dysfunction, inflammation‐mediated calcium deposition in the media of arteries, hyperhomocysteinemia, platelet activation, and altered coagulation and fibrinolysis. The key to active and preventive therapy is to effectively treat inflammation. Recommendations for prophylaxis of venothromboembolism have followed guidelines where they exist and have been extrapolated from studies of other at‐risk conditions, as have those for arterial disease, where screening for risk factors and actively treating abnormalities is encouraged. In conclusion, patients with IBD are at considerably increased risk of venothromboembolism and probably of arterial disease, in particular mesenteric ischemia and ischemic heart disease. Increased penetration of gaps between this knowledge and clinical therapeutic action to prevent thromboembolic events into IBD clinical practice is needed.
Outcome of endoscopic therapy for cancer bleeding in patients with unresectable gastric cancer
Authors: Kim Young‐Il , Choi Il Ju , Cho Soo‐Jeong , Lee Jong Yeul , Kim Chan Gyoo , Kim Mi‐Jung , Ryu Keun Won , Kim Young‐Woo , Park Young Iee 
Published: May 2013

AbstractBackground and AimGastric cancer bleeding is not rare complication in patients with advanced gastric cancer (AGC). The aim of this study was to evaluate the efficacy and clinical outcomes of endoscopic therapy (ET) for upper gastrointestinal bleeding (UGIB) from unresectable AGC.MethodsData from 113 patients with UGIB from unresectable AGC who underwent ET at the National Cancer Center, Korea were analyzed retrospectively. Success rates of endoscopic hemostasis, rebleeding rates, mortality at 30 days, and overall survival (OS) rate after initial hemostasis were investigated.ResultsThe initial hemostasis rate was 92.9% (105/113). Electrocoagulation was the most common method used (92.0%, 104/113), and combination ET was required in 34 patients (30.1%). Rebleeding occurred in 43 patients (41.0%); 3‐day and 30‐day rebleeding rates were 18.1% and 29.5%, respectively. Multivariate logistic regression analysis showed that transfusion of packed red blood cells (> 5 units) was associated with early rebleeding (≤ 3 days after initial hemostasis) (odd ratio, 4.75; 95% confidential interval, 1.45–15.57; P = 0.010). ET was attempted in 18 patients with rebleeding; hemostasis was achieved in 88.9%. The 30‐day mortality rate after initial bleeding event was 15.9%. Median OS after initial hemostasis was 3.2 months. OS was lower for patients with early rebleeding than for those with late rebleeding (> 3 days after initial hemostasis) or without rebleeding (1.0, 3.1, and 4.3 months, respectively; P = 0.004).ConclusionsET, primarily endoscopic electrocoagulation, achieved a high initial hemostasis rate for UGIB in patients with unresectable AGC. However, rebleeding frequently occurred, and early rebleeding was associated with poor survival.
Addition of thiopurines can recapture response in patients with Crohn's disease who have lost response to anti‐tumor necrosis factor monotherapy
Authors: Ong David E H , Kamm Michael A , Hartono Juanda Leo , Lust Mark 
Published: May 2013

AbstractBackground and AimAnti‐tumor necrosis factor (TNF) antibodies are effective in maintaining remission in Crohn's disease. However, a significant proportion of patients lose response to these agents with time. This study aimed to determine whether the introduction of a thiopurine in patients who have lost response to anti‐TNF monotherapy results in regained response.MethodsFive patients (four males; aged 22–38 years) with active Crohn's disease, who had an initial response to anti‐TNF therapy but had lost response, were commenced on azathioprine or mercaptopurine at standard doses while continuing anti‐TNF therapy. All had previously failed thiopurine therapy prior to starting anti‐TNF treatment.ResultsAll patients experienced improved clinical symptoms within 2–6 months, with benefit sustained over a mean follow‐up of 19 months. Two patients with an elevated C‐reactive protein at the time of thiopurine addition demonstrated a fall in C‐reactive protein. Colonoscopy before and after thiopurine addition in four patients showed improvement in all, with mucosal healing achieved in two. No adverse effects of treatment were noted.ConclusionsAddition of a thiopurine in patients who have lost response to anti‐TNF monotherapy is an effective strategy to recapture response even if the patient has previously failed thiopurine therapy. Thiopurines may reduce immunogenicity or act synergistically with anti‐TNF therapy.
Comparison of clinical effectiveness of the emergent colonoscopy in patients with hematochezia according to the type of bowel preparation
Authors: Lim Dae Seop , Kim Hyun Gun , Jeon Seong Ran , Shim Kwang Yeun , Lee Tae Hee , Kim Jin‐Oh , Ko Bong Min , Cho Joo Young , Lee Joon Seong 
Published: May 2013

AbstractBackground and AimsColonoscopy (CFS) is a valuable diagnostic tool in patients with hematochezia. However, the optimal preparation method of emergent CFS for hematochezia has not been defined. We investigated the clinical effectiveness of bowel preparation of patients with hematochezia using polyethylene glycol (PEG) solution and glycerin or water enemas.MethodsThe medical records of the past 7 years were reviewed. Patients presenting with hematochezia that occurred within 24 h before admission were eligible for the study. All patients underwent CFS within 24 h after visiting the emergency room for hematochezia. Patients were classified into two groups according to the preparation method used (enema vs PEG).ResultsOverall, 194 patients (125 enema vs 69 PEG) were enrolled. The diagnostic rate of bleeding focus was lower in the enema group than in the PEG group (84% vs 97.1%, P = 0.008). Performance of endoscopic hemostasis at the initial CFS was more frequent in the enema group than in the PEG group (40.8% vs 10.1%, P < 0.001). The rate of repeated CFS was higher in the enema group than in the PEG group (44.0% vs 18.8%, P < 0.001). Post‐polypectomy bleeding (n = 33) was diagnosed during the initial study and was treated endoscopically. In cases of post‐polypectomy bleeding, CFS (93.9%) was performed after an enema in all but two cases.ConclusionsIn hematochezia patients, the PEG group showed a higher diagnostic rate and lower rate of repeated CFS. However, emergent CFS after an enema only seems to be useful in patients with severe hematochezia or if the bleeding focus can be presumed.
Maintenance of Th1 hepatitis C virus (HCV)‐specific responses in individuals with acute HCV who achieve sustained virological clearance after treatment
Authors: Flynn Jacqueline K , Dore Gregory J , Hellard Margaret , Yeung Barbara , Rawlinson William D , White Peter A , Kaldor John M , Lloyd Andrew R , Ffrench Rosemary A ,   ATAHC Study Group
Published: May 2013

AbstractBackground and AimT‐cell responses against hepatitis C are believed to be critical in achieving both natural and treatment‐induced clearance. However, rapid clearance of antigen with early treatment of primary infection may result in reduced or poorly sustained cellular immunity. This study longitudinally examined Th1 and Th2 hepatitis C virus (HCV)‐specific cytokine production and T‐cell effector function from subjects enrolled in the Australian Trial in Acute Hepatitis C comparing three groups: treatment‐induced clearance (sustained virological response [SVR]), treatment non‐response, and untreated spontaneous clearance.MethodsHCV‐specific T‐cell responses were characterized by HCV peptide ELISpot, in vitro cytokine production, and T‐cell flow cytometry assays.ResultsTreated subjects with a sustained virological response (SVR) displayed a better maintenance of HCV‐specific Th1 responses compared to treatment non‐responders (higher interferon [IFN]‐γ and interleukin (IL)‐2 magnitude at week 24, broader IFN‐γ responses at weeks 24 and 48, P < 0.05) and significantly increased IFN‐γ responses between screening and week 48 (magnitude P = 0.026, breadth P = 0.009). Treatment‐induced viral clearance was also associated with a trend toward decreased IL‐10 responses (screening to week 48, P = 0.070), higher expression of CD45RO (P = 0.042) and CD38 (P = 0.088) on CD4+ T cells, and higher IFN‐γR expression (CD56+IFN‐γR+ P = 0.033) compared to treatment non‐responders. Untreated subjects with viral clearance also displayed high magnitude and broad HCV‐specific IFN‐γ and IL‐2 responses early in infection; however, IFN‐γ responses were not as well maintained compared to treated subjects with a SVR (week 48 magnitude, breadth P = 0.064).ConclusionTreatment‐induced viral clearance of recent HCV infection is associated with maintenance of HCV‐specific Th1 responses.
N‐(3′, 4′‐dimethoxycinnamonyl) anthranilic acid alleviated experimental colitis by inhibiting autoimmune response and inducing CD4+CD25+ regulatory T cells production
Authors: Wen Quan , Zhou Liping , Chen Huan , Zhang Yan 
Published: May 2013

AbstractBackground and AimCrohn's disease treatments available today are not quite satisfactory. N‐(3′, 4′‐dimethoxycinnamonyl) anthranilic acid (3, 4‐DAA) has been proved to be effective in many autoimmune diseases. Therefore, we investigated the immunologic function of 3, 4‐DAA on trinitrobenzene sulfonic acid (TNBS) colitis and human Crohn's disease.MethodsMice with TNBS‐induced colitis were treated with 3, 4‐DAA or 1‐methyl‐tryptophan (1‐ MT). Colitis severity was assessed with clinical and histological scores. Cell proliferation, cytokine expression, and the percentage of CD4+CD25+ T cells were measured in both mice and human samples.ResultsIn mice treated with 3, 4‐DAA, the clinical and histological scores were decreased (P < 0.05); the proliferation of mesenteric lymph nodes (MLNs) cells and lamina propria mononuclear cells (LPMCs) were inhibited (P < 0.05); Th1 cytokine expressions were decreased (P < 0.05), and Th2 cytokine levels were increased (P < 0.05). 3, 4‐DAA also induced CD4+CD25+ T cells expression (5.88 ± 2.1 vs 11.03 ± 2.93, P < 0.05) in mice MLNs. Transfer of these cells into TNBS colitis mice resulted in the reduction of the disease activity index (DAI) and histological scores. In LPMCs isolated from human Crohn's disease, 3, 4‐DAA had the same effect. It can inhibit the cell proliferation, decrease Th1 cytokine expressions (P < 0.05), and increase Th2 cytokine levels (P < 0.05). The percentage of CD4+CD25+ T cells were also increased (1.60 ± 0.14 vs 2.45 ± 0.50, P < 0.05). 1‐MT treatment led to opposite outcomes.Conclusion3, 4‐DAA can alleviate the severity of colitis through inhibiting Th1 cells response, promoting Th2 cytokines expression and inducing CD4+CD25+ T cells expression.
Expression of genes for microRNA‐processing enzymes is altered in advanced non‐alcoholic fatty liver disease
Authors: Sharma Haveesh , Estep Michael , Birerdinc Aybike , Afendy Arian , Moazzez Amir , Elariny Hazem , Goodman Zachary , Chandhoke Vikas , Baranova Ancha , Younossi Zobair M 
Published: May 2013

AbstractBackground and AimRecently, microRNAs (miRNA) have been linked to the pathogenesis of non‐alcoholic fatty liver disease (NAFLD) and its progression to non‐alcoholic steatohepatitis (NASH). First transcribed as pri‐miRNA, these molecules are further processed by a complex of endonuclear and cytosolic RNA binding molecules to form mature miRNAs. The aim of this study is to investigate mechanisms of miRNA regulation in the visceral adipose of obese NAFLD patients via measuring expression of miRNA processing enzymes and pri‐miRNA.MethodsTotal RNAs were extracted from visceral adipose tissue (VAT) samples collected from patients undergoing bariatric surgery. All patients had biopsy‐proven NAFLD (NASH patients [n = 12] and non‐NASH NAFLD [n = 12]). For each patient, we profiled mRNA levels for three miRNA processing elements (Drosha, DGCR8, and Dicer1) and seven pri‐miRNAs (pri‐miR‐125b‐2, pri‐miR‐16‐2, pri‐miR‐26a‐1, pri‐miR‐26a‐2, pri‐miR‐7‐1, pri‐miR‐7‐2, and pri‐miR‐7‐3).ResultsExpression of Dicer1, Drosha and DGCR8 was significantly increased within the NASH cohort along with expression of pri‐miR‐7‐1. The presence of focal necrosis on the liver biopsy correlated significantly with levels of Dicer1 and DGRC8. Both NASH and ballooning degeneration of hepatocytes correlated negatively with the expression levels of hsa‐miR‐125b. Histologic NASH correlated positively with the expression levels of pri‐miR‐16‐2 and pri‐miR‐7‐1. The presence of the hepatocyte's ballooning degeneration in the liver biopsy correlated positively with pri‐miR‐26a‐1 and pri‐miR‐7‐1. The expression profile of pri‐miR‐125b‐2 also correlated positively with body mass index.ConclusionsOur findings support the hypothesis that VAT‐derived miRNA may contribute to the pathogenesis of NASH in obese patients.
Feasibility of sentinel node navigation surgery after noncurative endoscopic resection for early gastric cancer
Authors: Arigami Takaaki , Uenosono Yoshikazu , Yanagita Shigehiro , Matsushita Daisuke , Arima Hideo , Hirata Munetsugu , Uchikado Yasuto , Nakajo Akihiro , Okumura Hiroshi , Ishigami Sumiya , Hokita Shuichi , Natsugoe Shoji 
Published: May 2013

AbstractBackground and AimRecently, the use of additional surgery after noncurative endoscopic resection has gradually increased due to the rapid spread of endoscopic treatments in selected patients with early gastric cancer. Sentinel node navigation surgery (SNNS) has also been recognized as a minimally invasive surgery with personalized lymphadenectomy in early gastric cancer. Here, we assessed the feasibility of SNNS after noncurative endoscopic resection for early gastric cancer.MethodsSixteen patients with early gastric cancer, in whom additional surgery had been indicated due to noncurative endoscopic resection, were enrolled. They underwent a gastrectomy with standard lymphadenectomy. One day before surgery, 99mtechnetium‐tin colloid was endoscopically injected into the submucosa around the tumor. After surgery, the uptake of radioisotope in dissected lymph nodes was measured using Navigator GPS. Then, all dissected lymph nodes were investigated by hematoxylin‐eosin staining and immunohistochemistry using an antihuman cytokeratin monoclonal antibody.ResultsHematoxylin‐eosin staining demonstrated lymph node metastasis in two (12.5%) of 16 patients and in three (0.8%) of 382 nodes. However, immunohistochemistry showed that none of the patients had lymph node micrometastasis. Sentinel nodes (SNs) were identified in all patients. The mean number of SNs was 3.1 (range, 1–6). Among two patients with lymph node metastasis, the SNs, at least, contained positive nodes. Accordingly, the false‐negative and accuracy rates were 0% and 100%, respectively.ConclusionOur results indicate that SNNS may have potential as a further minimally invasive surgery in early gastric cancer patients after noncurative endoscopic resection.
Health and Aging: Development of The Irish Longitudinal Study on Ageing Health Assessment
Authors: Cronin Hilary , O'Regan Clare , Finucane Ciaran , Kearney Patricia , Kenny Rose Anne 
Published: May 2013

ObjectivesTo assist researchers planning studies similar to The Irish Longitudinal Study on Ageing (TILDA), concerning the development of the health assessment component, to promote use of the archived data set, to inform researchers of the methods employed, and to complement the accompanying article on normative values.DesignProspective, longitudinal study of older adults.SettingRepublic of Ireland.ParticipantsEight thousand five hundred four community‐dwelling adults who participated in wave 1 of the TILDA study.MeasurementsThe main areas of focus for the TILDA health assessments are neurocardiovascular instability, locomotion, and vision.ResultsThe article describes the scientific rationale for the choice of assessments and seeks to determine the potential advantages of incorporating novel biomeasures and technologies in population‐based studies to advance understanding of aging‐related disorders.ConclusionThe detailed description of the physical measures will facilitate cross‐national comparative research and put into context the normative values outlined in the subsequent article.
Reciprocal Pathways Between Autonomous Motivation and Affect: A Longitudinal Investigation of American and Chinese Early Adolescents
Authors: Pomerantz Eva M. , Qin Lili 
Published: May 2013

The current research examined the reciprocal pathways between children's autonomous motivation in school and affect over early adolescence in the United States and China. Beginning in the fall of 7th grade, 825 American and Chinese children (mean age = 12.73 years) reported on their autonomous (vs. controlled) motivation as well as unpleasant and pleasant affect every 6 months until the end of eighth grade. In both the United States and China, there were negative reciprocal pathways between children's autonomous motivation and unpleasant affect. Over time, heightened autonomous motivation predicted dampened unpleasant affect, which in turn predicted heightened autonomous motivation. Positive reciprocal pathways between children's autonomous motivation and pleasant affect were evident over time only in China.
Evaluation of Hemostatic Activity of Canine Frozen Plasma for Transfusion by Thromboelastography
Authors: Urban R. , Guillermo Couto C. , Cristina Iazbik M. 
Published: May 2013

BackgroundIn humans, fresh frozen plasma (FFP) loses factor V and VIII activities after 1 year. It then becomes frozen plasma (FP), and theoretically is unsuitable for use in patients with coagulopathies. These findings have not been reported for dogs.HypothesisCanine FP is hemostatically active after 5 years of storage.AnimalsFresh plasma (Group FsP; n = 15) and 5‐year‐old FP (Group FzP; n = 10) from blood bank donors.MethodsGroup FsP and Group FzP samples were evaluated by thromboelastography (TEG), one‐stage prothrombin time (OSPT), activated partial thromboplastin time (APTT), fibrinogen, and antithrombin. Fresh plasma (n = 6) and a subset of Group FzP (n = 8) were evaluated for clotting factor activities (V, VIII, IX, X). A 2nd experiment using short‐term storage of thawed FP under suboptimal conditions (refrigerated [4°C] or refrozen [−20°C]) by TEG was performed to simulate general practice storage capabilities.ResultsGroup FzP had shorter reaction time (P = .0007) and larger angle (P = .0004) compared with Group FsP by TEG, suggesting hypercoaguability. Factor VIII and X activities were lower in Group FzP (P = .02 and .005, respectively). Fibrinogen, OSPT, and APTT were significantly lower or longer for Group FzP than Group FsP (P < .05), but most values remained within reference intervals for dogs.Conclusions and Clinical ImportanceFive‐year‐old canine FP stored at −30°C is hemostatically active and should be clinically evaluated in patients with coagulopathies. If active, the monetary savings of using older plasma will be substantial.
Bradyarrhythmias and Pacemaker Therapy in Dogs with Chagas Disease
Authors: Saunders A.B. , Gordon S.G. , Rector M.H. , DeMaster A. , Jackson N. , Clubb F.J. , Fosgate G.T. , Miller M.W. 
Published: May 2013

BackgroundChagas disease (Trypanosomiasis) is a cause of myocarditis in the southernUnitedStates causing cardiac conduction abnormalities, arrhythmias, and heart failure.ObjectivesTo report clinical findings and outcome inChagas positive (CP) dogs requiring pacemaker implantation for bradyarrhythmias.AnimalsOne hundred and forty‐four client‐owned dogs requiring pacemaker implantation.MethodsRetrospective case series. Information regarding history, physical exam, laboratory and diagnostic imaging findings, treatment, and survival were obtained from medical records, with additional follow‐up information obtained by contacting referring veterinarians and owners.ResultsOf the 144 dogs requiring pacemaker implantation fromJanuary 2001 toMay 2010, 83 (57.6%) had aChagas titer performed and 9 (10%) wereCP. Concurrent ventricular arrhythmias (odds ratio 1.61,P = .005) or atrioventricular (AV) block (odds ratio 4.18,P < .001) increased the likelihood that aChagas titer was submitted. Median age forCPdogs was 6.2 years (range, 0.3–10); 7 were male. Bradyarrhythmias included high‐grade 2nd or 3rd degreeAVblock (n = 8) and sinus bradycardia with 1st degreeAVblock (n = 1); 5 had concurrent ventricular arrhythmias. A positiveChagas titer had a negative impact on survival (hazard ratio 4.04; 95%CI1.36–12.1,P = .012) with a reported median survival time of 365 days (interquartile range, 84–973 days).Conclusions and Clinical ImportanceBradyarrhythmias can result in clinical signs requiring pacemaker implantation inCPdogs, and although the diagnosis negatively impacts survival, pacemaker therapy is a viable treatment option.