bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multivessel Awake Off-Pump Coronary Bypass Grafting Using Median Approach Technical Considerations
Authors: Watanabe Go , Ohtake Hiroshi , Tomita Shigeyuki , Yamaguchi Shojiro , Yashiki Noriyoshi , Kato Hiroki 
Published: February 2011

Objective Several reports of awake off-pump coronary artery bypass grafting (AOCAB) under high thoracic epidural anesthesia (TEA) for single-vessel grafts have been published, but few have described its application in multiple bypass procedures. We report the procedures and safety of AOCAB for multivessel disease. Methods Fifty-five multivessel AOCAB (52 men, 3 women; aged 68 ± 9.5 years) were performed at our hospital between 2003 and 2010. A medium sternotomy was made after TEA was established. During coronary artery anastomosis, a stabilizer and an apical suction device were used, and a coronary artery active perfusion system was used to maintain flow distal to the anastomosis. Pneumothorax due to pleural opening, when occurred, was repaired using Neoveil sheet and drainage tube. Results There was no operative death and no cerebral ischemia, cardiac arrhythmia, and chronic obstructive pulmonary disease. Operating time was 177 ± 35 minutes. Left internal thoracic artery was used in 55 anastomoses, right internal thoracic artery in 7, gastroepiploic artery in 17, radial artery in 48, and saphenous vein in 24. Time of anastomosis was 4.93 ± 0.92 minutes for left anterior descending coronary artery, 4.75 ± 1.21 minutes for circumflex artery, and 4.98 ± 1.02 minutes for right coronary artery. Intraprocedural pneumothorax occurred in 17 cases; 14 were repaired and nonintubated AOCAB was accomplished, 1 was intubated, and 2 had temporary assisted ventilation and laryngeal mask. Time to discharge was 15.5 ± 8.4 days. Conclusions Multivessel AOCAB under TEA is not only feasible but also safe. Multiple grafts can be harvested under TEA, and complete vascularization is possible under constant monitoring of blood pressure and consciousness.
Fluid Dynamic Investigation of the ATS 3F Enable Sutureless Heart Valve
Authors: Stühle Sebastian , Wendt Daniel , Hou Guojun , Wendt Hermann , Thielmann Matthias , Jakob Heinz , Kowalczyk Wojciech 
Published: February 2011

Objective Currently, sutureless heart valves (SHV) reveal good clinical results during aortic valve replacement. The aim of this study was to evaluate the fluid dynamics of the ATS 3F Enable SHV in the ascending aorta and their influence on the aortic wall in an in vitro setup. Methods A two-dimensional particle image velocimetry study with an image rate of 15 Hz was conducted to evaluate the fluid dynamics of the SHV in the aortic flow field. The prosthesis (diameter, 23 mm) was placed inside a silicone mock aorta under pulsatile flow conditions. Velocities, vorticity, and strain rate were obtained and calculated with a fixed frequency (70 Hz) at constant stroke volume (70 mL). Results 3F Enable showed a jet flow type profile with a maximum velocity of 1.01 ± 0.13 m/s during peak flow phase (PFP). The jet flow was surrounded by ambilateral vortices with a slightly higher percentage of clockwise than counterclockwise vorticity (377 ± 57/s vs 389 ± 76/s), strain rate (370 ± 79/s for elongation vs — 370 ± 102/s for contraction) was nearly similar. The point-of-interest analysis revealed a higher velocity for bottom compared with upper aortic wall (0.28 ± 0.07 m/s vs 0.31 ± 0.06 m/s, P = 0.024). All values were lower during acceleration and deceleration phase compared with PFP. Conclusions The peak flow of the 3F Enable SHV seems to be little higher compared with native aortic valves, thus simulating nearly physiologic conditions. Vorticity and strain rate are high during PFP and low during other phases and might have an influence on the aortic wall as well.
Environmental factors in drinking venues and alcohol‐related harm: the evidence base for European intervention
Authors: Hughes Karen , Quigg Zara , Eckley Lindsay , Bellis Mark , Jones Lisa , Calafat Amador , Kosir Matej , van Hasselt Ninette 
Published: February 2011

ABSTRACTAims  Reducing alcohol‐related harm in young people is a major priority across Europe. Much alcohol use and associated harm in young people occurs in public drinking environments. This review aims to identity environmental factors in drinking establishements that are associated with increased alcohol consumption and associated harm and to understand the extent of study in this area across Europe.Methods  A systematic literature search identified studies that had explored associations between physical, staffing and social factors in drinking environments and increased alcohol use or alcohol‐related harm.Results  Fifty‐three papers were identified, covering 34 studies implemented in nine countries. Most studies had been implemented in non‐European countries and many had collected data more than a decade prior to the review. The majority had used observational research techniques. Throughout the studies, a wide range of physical, staffing and social factors had been associated with higher levels of alcohol use and related harm in drinking environments. Factors that appeared particularly important in contributing to alcohol‐related problems included a permissive environment, cheap alcohol availability, poor cleanliness, crowding, loud music, a focus on dancing and poor staff practice. However, findings were not always consistent across studies.Conclusions  Drinking establishments, their management and the behaviours of the young people who use them vary widely across Europe. While international research shows that environmental factors in drinking settings can have an important influence on alcohol‐related harm, there is currently a scarcity of knowledge on the relevance and impacts of such factors in modern European settings. Developing this knowledge will support the implementation of strategies to create drinking environments in Europe that are less conducive to risky drinking and alcohol‐related harm.
Indicators of alcohol consumption and attributable harm for monitoring and surveillance in European Union countries
Authors: Rehm Jürgen , Scafato Emanuele 
Published: February 2011

ABSTRACTAims  Alcohol is a major risk factor for burden of disease and injury in Europe, and contributes markedly to between region differences in life expectancy. Monitoring and surveillance systems have shown to be a key factor in implementing effective policies. The aim of this paper is to propose a system of indicators for alcohol consumption and attributable harm which can be used as an over‐time monitoring tool at the country level as well as for comparisons between countries.Design  A systematic research in electronic data bases was conducted but most of the information was derived from ongoing international efforts to establish alcohol monitoring and surveillance systems.Setting  European Union.Participants  Countries.Measurements  Exposure to alcohol, mortality, burden of disease.Findings  Adult per capita alcohol consumption, prevalence of abstention, and frequency of drinking more than 60g pure alcohol in one occasion are proposed as a minimal set of alcohol exposure indicators, which can quickly be implemented in all EU countries. With respect to health harm indicators, the best minimal choice which can be implemented quickly in all countries of the EU would be alcohol‐attributable years of life lost due to premature death. In addition, country specific indicators could be added, when alcohol places specific burden on specific diseases.Conclusions  National and European Union‐wide monitoring systems for alcohol exposure and attributable harm to inform public health‐related policy decisions could be implemented easily. The establishement of such monitoring systems would follow the recent World Assembly resolution for a global strategy to reduce alcohol‐related harm.
Regulation of cytokine responses by seasonality of vitamin D status in healthy individuals
Authors: Khoo A-L , Chai L Y A , Koenen H J P M , Sweep F C G J , Joosten I , Netea M G , van der Ven A J A M 
Published: February 2011

SummaryThe immune modulating capacity of vitamin D3 is well-recognized. Ultra-violet (UV) exposure determines production of vitamin D3in vivo and varies through the course of the year, especially in temperate regions. However, it is not known whether the human innate immune response differs due to seasonality. To validate the seasonal effects of vitamin D3, the effect of 1,25(OH)2D3 on peripheral blood mononuclear cells (PBMC) cytokine response was first determined in vitro. 1,25(OH)2D3 decreased interleukin (IL)-6 and tumour necrosis factor (TNF)-α release by PBMC stimulated with tripalmitoyl-S-glycerylcysteine (Pam3Cys) or lipopolysaccharide (LPS). Subsequently, ex-vivo stimulation studies were performed in 15 healthy volunteers through the course of the four seasons of the year. PBMC were isolated and stimulated with Toll-like receptor (TLR)-2 and TLR-4 ligands Pam3Cys and LPS, respectively. Circulating concentrations of 25(OH)D3 and 1,25(OH)2D3 were higher during summer (P &lt; 0·05) and a down-regulation of TLR-4-mediated IL-1β, IL-6, TNF-α, interferon (IFN)-γ and IL-10 production in summer was observed compared to winter (P &lt; 0·05). The variation in cytokine response upon TLR-2 (Pam3Cys) stimulation was moderate throughout the four seasons. The repressed cytokine production during the summer months could be explained partly by the reduced cell-membrane expression of TLRs. Physiological variation in vitamin D3 status through the four seasons of the year can lead to alteration in the innate immune responses. Elevated vitamin D3 level in vivo is associated with down-regulation of cytokine response through diminished surface expression of pattern recognition receptors.
Changes in the expression of oestrogen receptors and E‐cadherin as molecular markers of progression from normal epithelium to invasive cancer in elderly patients with vulvar squamous cell carcinoma
Authors: Zannoni Gian F. , Prisco Maria G. , Vellone Valerio G. , De Stefano Ilaria , Scambia Giovanni , Gallo Daniela 
Published: February 2011

Zannoni G F, Prisco M G, Vellone V G, De Stefano I, Scambia G & Gallo D (2011) Histopathology58, 265–275 Changes in the expression of oestrogen receptors and E‐cadherin as molecular markers of progression from normal epithelium to invasive cancer in elderly patients with vulvar squamous cell carcinomaAims:  The most common vulvar squamous cell carcinoma (conventional SCC) occurs in elderly women and develops following a human papillomavirus (HPV)‐negative pathway. Because the highest incidence of conventional SCC is observed in patients with low oestrogen levels (postmenopausal women), the aim was to investigate whether hormonal factors could play a role in the development of cancer.Methods and results:  The expression profile of oestrogen receptor α (ERα), ERβ and progesterone receptor (PR) in a section containing both normal and tumour tissue, as well as the SCC‐associated vulvar lesion, was evaluated in 34 elderly patients. Also, as recent studies have identified E‐cadherin as a novel transcriptional target of oestrogen signalling, the modulation of this epithelial–mesenchymal transition (EMT) marker was studied. Finally, the expression of the proliferation marker Ki67 and of the apoptotic marker p53 was assessed. Results showed that changes in both ERα and ERβ expression characterize the transition from normal epithelium to cancer in patients with vulvar SCC: ERα was lost in cancer while ERβ decreased, mainly showing cytoplasmic localization. A reduction in the expression of E‐cadherin was also observed in tumours, compared to normal epithelium.Conclusions:  The data put the ER signalling pathway into the spotlight as a potentially important factor in vulvar carcinogenesis.
Sox10‐positive sustentacular cells in neuroendocrine carcinoma of the lung
Authors: Tsuta Koji , Raso Maria G , Kalhor Neda , Liu Diane C , Wistuba Ignacio I , Moran Cesar A 
Published: February 2011

Tsuta K, Raso M G, Kalhor N, Liu D C, Wistuba I I & Moran C A (2011) Histopathology 58, 276–285 Sox10‐positive sustentacular cells in neuroendocrine carcinoma of the lungAims:  Sustentacular cells are found in approximately half of pulmonary carcinoid tumours. However, most studies of sustentacular cells have used the less‐specific antibody to the S100 protein, and any correlation between the presence of sustentacular cells and other clinicopathological factors is unclear. The aim of this study was to analyse the significance of sustentacular cells in pulmonary neuroendocrine carcinomas (NECs).Methods and results:  A Sox10 antibody was used to investigate 113 pulmonary NECs. Sustentacular cells were observed in 66.7% of typical carcinoid (TC) and 58.3% of atypical carcinoid (AC) cases, but not in high‐grade NECs. Sustentacular‐rich tumours had a statistically significant correlation with peripheral locations. We found no statistical differences in age, gender, smoking history, overall survival, or the occurrence of lymph node metastasis. In all but one case, when sustentacular cells were present in the primary site, they were also present in the metastatic lymph nodes. The presence of sustentacular cells differed in morphological subtypes, with the spindle pattern being the most common subtype.Conclusions:  Sox10‐positive sustentacular cells were observed in carcinoid tumours but not in high‐grade NECs. Sustentacular‐rich carcinoid tumours did not show a correlation with the occurrence of lymph node metastasis or survival. The sustentacular cells found differed in morphological subtypes.
Distinct histological features characterize primary angiosarcoma of bone
Authors: Verbeke Sofie L J , Bertoni Franco , Bacchini Patrizia , Sciot Raf , Fletcher Christopher D M , Kroon Herman M , Hogendoorn Pancras C W , Bovée Judith V M G 
Published: February 2011

Verbeke S L J, Bertoni F, Bacchini P, Sciot R, Fletcher C D M, Kroon H M, Hogendoorn P C W & Bovée J V M G (2011) Histopathology 58, 254–264 Distinct histological features characterize primary angiosarcoma of boneAims:  To define the histological criteria of primary angiosarcoma of bone.Methods and results:  Forty‐two angiosarcomas of bone in 23 males and 15 females were studied. Histological criteria were related to patients’ outcome. Eleven patients had multifocal lesions. Lesions were located in the long and short tubular bones followed by the pelvis, spine and trunk. Tumour cells were positive for CD31 in 38 of 40, von Willebrand Factor in 21 of 35, CD34 in 15 of 38, smooth muscle actin in 22 of 36, D2–40 in 11 of 35 and keratinAE1AE3 in 27 of 39. Thirty‐nine tumours showed an epithelioid phenotype. One‐ and 5‐year survival rates were 55% and 33%, respectively. Survival analysis showed that a macronucleolus, three or more mitoses per 10 high‐power field (HPF) and fewer than five eosinophilic granulocytes per 10 HPF within a tumour was associated with an even worse survival compared to the overall group.Conclusions:  Because keratin positivity is seen in the majority of cases, pathologists should avoid misinterpretation as metastatic carcinoma. A macronucleolus, three or more mitoses per 10 HPF and fewer than five eosinophilic granulocytes per 10 HPF can be used to further define angiosarcoma of bone.
Increased mucin 1 expression in recurrence and malignant transformation of salivary gland pleomorphic adenoma
Authors: Soares Andresa Borges , Demasi Ana Paula Dias , Altemani Albina , de Araújo Vera Cavalcanti 
Published: February 2011

Soares A B, Demasi A P D, Altemani A & de Araújo V C (2011) Histopathology58, 377–382 Increased mucin 1 expression in recurrence and malignant transformation of salivary gland pleomorphic adenomaAims:  Pleomorphic adenoma (PA) is the most common salivary gland tumour with a tendency to recur (RPA) and a risk of malignant transformation. Mucin 1 (MUC‐1) plays a role in the progression of many tumours and may be a marker to predict RPA. The aim of this study was to evaluate MUC‐1 expression in different phases of the adenoma to carcinoma sequence.Methods and results:  Twenty‐one cases of PA, 18 cases of RPA, three cases of RPA with focal transformation (TRPA) and 11 cases of carcinoma ex‐pleomorphic adenoma (CXPA) were analysed immunohistochemically for MUC1 expression using an antibody to MUC1/DF3. MUC1 reactivity in RPA was stronger than that observed in PA and, in all the different carcinoma groups, MUC‐1 expression was significantly higher in carcinoma than in RPA and PA.Conclusion:  This study has confirmed that MUC‐1 is related to the recurrence of PA and that this molecule is associated with malignant transformation of PA with carcinoma cells overexpressing MUC‐1.
The retinoblastoma protein/p16INK4A pathway but not p53 is disrupted by human papillomavirus in penile squamous cell carcinoma
Authors: Stankiewicz Elzbieta , Prowse David M , Ktori Elena , Cuzick Jack , Ambroisine Laurence , Zhang Xiaoxi , Kudahetti Sakunthala , Watkin Nicholas , Corbishley Catherine , Berney Daniel M 
Published: February 2011

Stankiewicz E, Prowse D M, Ktori E, Cuzick J, Ambroisine L, Zhang X, Kudahetti S, Watkin N, Corbishley C & Berney D M (2011) Histopathology58, 433–439 The retinoblastoma protein/p16INK4Apathway but not p53 is disrupted by human papillomavirus in penile squamous cell carcinomaAims:  The pathogenesis of penile squamous cell carcinoma (PSCC) is not well understood. Human papillomavirus (HPV) may be involved in carcinogenesis, but few studies have compared cell‐cycle protein expression in HPV positive and negative cancers. The aim was to determine the extent of HPV infection in different histological subtypes of PSCC and its impact on the expression of key cell‐cycle proteins: p53, p21, p16INK4A and retinoblastoma (RB) protein.Methods and results:  One hundred and forty‐eight PSCC samples were examined immunohistochemically for RB, p16INK4A, p53 and p21 protein expression. One hundred and two cases were typed for HPV by PCR. HPV DNA was detected in 56% of tumours, with HPV16 present in 81%. Basaloid tumours were related strongly to HPV infection (10 of 13), while verrucous were not (three of 13). Fifty‐nine per cent (38 of 64) of usual type SCCs had HPV infection. RB protein correlated negatively (P < 0.0001) and p16INK4A (P < 0.0001) and p21 (P = 0.0002) correlated positively with HPV infection. p53 did not correlate with HPV infection.Conclusions:  HPV infection is present in more than half of penile cancers and it is responsible for RB pathway disruption. However, no link between HPV and p53 immunodetection was found. Only basaloid and half of usual‐type PSSCs correlate with HPV infection, confirming possible separate aetiologies for those tumours.
Pathological and immunohistological findings and genetic aberrations of intestinal enteropathy‐associated T cell lymphoma in Japan
Authors: Takeshita Morishige , Nakamura Shotaro , Kikuma Kanta , Nakayama Yoshifuku , Nimura Satoshi , Yao Takashi , Urabe Shogo , Ogawara Satoshi , Yonemasu Hirotoshi , Matsushita Yoshifumi , Karube Kennosuke , Iwashita Akinori 
Published: February 2011

Takeshita M, Nakamura S, Kikuma K, Nakayama Y, Nimura S, Yao T, Urabe S, Ogawara S, Yonemasu H, Matsushita Y, Karube K & Iwashita A (2011) Histopathology58, 395–407 Pathological and immunohistological findings and genetic aberrations of intestinal enteropathy‐associated T cell lymphoma in JapanAims:  To elucidate the clinicopathological findings of primary intestinal enteropathy‐associated T cell lymphoma (EATL) in Japan, a non‐endemic area for coeliac disease.Methods and results:  Of the 24 cases, four (17%) had large‐cell lymphoma (type I), and the remaining 20 (83%) had medium‐sized lymphoma (type II). Lymphoma cells of the three type I cases were CD56‐positive. Only one (4%) case showed typical CD56‐ and CD8‐negative and CD30‐positive type I EATL. In type II EATL, lymphoma cells of the 16 (80%) and 11 (55%) cases were positive for CD56 and CD8, respectively. Intramucosal tumour spreading and adjacent enteropathy‐like lesions were detected in 15 (71%) and 16 (76%) of 21 cases, with a severe increase of intraepithelial lymphocytes (IELs) in 12 (57%). IELs of enteropathy‐like lesions in five (24%) cases expressed T‐bet, with no cases of CD30‐positive IELs. Characteristic findings from comparative genomic hybridization of 15 cases indicated gains of 8q2 (47%), Xp (53%) and Xq (73%), but no gain of 9q3. Regarding, human leucocyte antigen (HLA) status, six cases examined did not express the DQB1*02 allele.Conclusions:  Japanese EATL exhibited different histology, cytogenetic findings and HLA status from those of typical type I EATL. The rare incidence of coeliac disease may influence the tumour cell characteristics of EATL and IELs.
Extensive retraction artefact predicts biochemical recurrence‐free survival in prostatic carcinoma
Authors: Tomas Davor , Spajić Borislav , Milošević Milan , Demirović Alma , Marušić Zlatko , Krušlin Božo 
Published: February 2011

Tomas D, Spajić B, Milošević M, Demirović A, Marušić Z & Krušlin B (2011) Histopathology58, 447–454 Extensive retraction artefact predicts biochemical recurrence‐free survival in prostatic carcinomaAims:  To determine whether the presence and extent of peritumoral retraction artefact could be used to predict biochemical recurrence‐free survival in prostatic carcinoma.Methods and results:  The study included 162 consecutive patients treated by radical retropubic prostatectomy and bilateral lymphadenectomy for clinically localized prostatic carcinoma. A variable degree of retraction artefact was present in all 162 analysed tumours. The extent of retraction artefact in prostatic carcinomas ranged from 5% to 55% with a median value of 15% (interquartile range 10–25%). We found no correlation between the extent of retraction artefact in the tumours and patient’s age (P = 0.608), preoperative (P = 0.362) and postoperative (P = 0.279) Gleason score or lymph node metastases (P = 0.084). In contrast, the extent of retraction artefact correlated with high preoperative prostate‐specific antigen (P  < 0.001), short follow‐up time (P  < 0.001), seminal vesicle invasion and/or extracapsular extension of the tumour (T3 stage tumours) (P  < 0.001) and positive surgical margins (P  < 0.001). Furthermore, extensive retraction artefact was associated with poor biochemical recurrence‐free survival in both univariate (P  < 0.001) and multivariate analyses (P = 0.013).Conclusion:  The presence of extensive retraction artefact in prostatic carcinoma correlates with tumour characteristics signifying aggressive behaviour and indicates poor biochemical recurrence‐free survival.