bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pearls and myths in pleural fluid analysis
Authors: PORCEL José M. 
Published: June 2010

ABSTRACTVirtually all patients with a newly discovered pleural effusion should undergo thoracentesis to aid in diagnosis and management. The routine pleural fluid (PF) evaluation usually includes the following: cell count and differential; tests for protein, LDH, glucose, adenosine deaminase, cytology and, if infection is a concern, pH and bacterial and mycobacterial cultures. Distinguishing transudates from exudates with Light's criteria is a pragmatic first step. If the effusion is an exudate, various PF tests have proven diagnostic utility: adenosine deaminase levels >35 IU/L usually indicate tuberculosis in lymphocyte‐predominant PF; pH < 7.2 or glucose less than 60 mg/dL allow the clinician to identify complicated parapneumonic effusions; and conventional cytology may reveal malignant cells in 60% of the patients with malignant effusions. A number of optional PF tests may complement the diagnostic approach to an undiagnosed pleural effusion. For example, natriuretic peptide assays significantly improve the accuracy of a diagnosis of cardiac pleural effusion, whereas PF mesothelin levels greater than 20 nmol/L are highly suggestive of mesothelioma.
Video‐assisted thoracoscopic surgery using single‐lumen endotracheal tube anaesthesia in primary spontaneous pneumothorax
Authors: CHENG Yeung‐Leung , HUANG Tsai‐Wang , LEE Shih‐Chun , WU Ching‐Tang , CHEN Jen‐Chih , CHANG Hung , TZAO Ching 
Published: June 2010

ABSTRACTBackground and objective:  Primary spontaneous pneumothorax (PSP) is a common condition that typically affects young adults. With recent advances in techniques, VATS is now a safe and accepted procedure for treating PSP. Lung isolation techniques have been commonly used to facilitate surgical procedures in the past. The purpose of this study was to evaluate the feasibility of using a single‐lumen endotracheal tube for thoracoscopic surgery in patients with PSP.Methods:  A series of 121 consecutive patients with PSP, who underwent VATS using a double‐lumen or single‐lumen endotracheal tube between January 2000 and December 2002, were assessed retrospectively. The clinical features, operation times, complications, hospital stays and recurrences of PSP in these patients were recorded and analysed.Results:  There were no significant differences in gender, BMI, smoking habits, blebs/bullae on CT, duration of surgery or recurrence of PSP between the two groups. Patients in the single‐lumen endotracheal tube group had a shorter duration of anaesthesia (15.4 ± 2.6 vs 25.6 ± 3.2 min, P < 0.001), lower early complication rates, lower costs and shorter hospital stays (3.6 ± 3.0 vs 4.5 ± 2.8 days, P = 0.02) compared with those in the double‐lumen endotracheal tube group. The follow‐up period was 40–68 months (mean 54 months). There were two recurrences in each group (3.1% vs 3.4%).Conclusions:  VATS for the treatment of PSP was easily performed using a single‐lumen endotracheal tube, and resulted in lower intubation‐related costs, fewer complications and equivalent outcomes, compared with procedures performed using double‐lumen endotracheal tube anaesthesia.
ENDOSCOPIC BALLOON DILATATION USING DOUBLE‐BALLOON ENDOSCOPY IS A USEFUL AND SAFE TREATMENT FOR SMALL INTESTINAL STRICTURES IN CROHN'S DISEASE
Authors: Hirai Fumihito , Beppu Takahiro , Sou Suketo , Seki Takehiko , Yao Kenshi , Matsui Toshiyuki 
Published: June 2010

Background:  Endoscopic balloon dilatation (EBD) is a therapeutic option for intestinal strictures of Crohn's disease (CD). Double‐balloon endoscopy (DBE) enables EBD to be performed even for deep‐situated strictures of the small intestine. The aim of this study was to clarify the efficacy and safety of EBD using DBE for small bowel strictures in patients with CD.Patients and Methods:  The subjects comprised 25 patients with CD who underwent EBD using DBE for small intestinal strictures for which a colonoscope or gastrointestinal scope could not be inserted. All subjects had obstructive symptoms due to strictures that were confirmed using small intestinal enteroclysis. They were observed for at least 6 months after the initial EBD. The short‐term success rate of EBD using DBE, the complication rate and the long‐term outcome were investigated.Results:  This procedure was successful with regard to short‐term dilatation in 18 of the 25 CD patients (72%). Long strictures measuring more than 3 cm were seen in six out of seven (85.7%) of the unsuccessful EBD cases, compared with two out of 18 (11.1%) of the successful EBD cases (P = 0.001). Complications were encountered in two of the 25 patients (8%). The cumulative surgery‐free rate for all the subjects was 83% and 72% at 6 and 12 months, respectively.Conclusion:  EBD using DBE is a useful and safe procedure for small intestinal short strictures in CD patients. We conclude that this procedure is a therapeutic option that should be attempted before resorting to surgical therapy.
ADVANTAGES OF USING THIN ENDOSCOPE‐ASSISTED ENDOSCOPIC SUBMUCOSAL DISSECTION TECHNIQUE FOR LARGE COLORECTAL TUMORS
Authors: Uraoka Toshio , Ishikawa Shin , Kato Jun , Higashi Reiji , Suzuki Hideyuki , Kaji Eisuke , Kuriyama Motoaki , Saito Shunsuke , Akita Mitsuhiro , Hori Keisuke , Harada Keita , Ishiyama Shuhei , Shiode Junji , Kawahara Yoshiro , Yamamoto Kazuhide 
Published: June 2010

Background:  Our purpose was to evaluate the effectiveness of a newly developed non‐invasive traction technique known as thin endoscope‐assisted endoscopic submucosal dissection (TEA‐ESD) procedure for the removal of colorectal laterally spreading tumors (LST).Patients and Methods:  A total of 37 LST located in the rectum and distal sigmoid colons of 37 patients were eligible for outcome analysis. Twenty‐one LST were treated with TEA‐ESD and were then retrospectively compared to 16 LST that had previously been treated with standard ESD. Tumor size, en bloc resection rate, procedure time, combined number of different electrical surgical knives used during each procedure and associated complications were evaluated in this case–control study.Results:  There was no statistically significant difference in tumor size between the TEA‐ESD group and the ESD control group (43.6 ± 16 mm and 42.4 ± 14 mm, respectively). All LST were successfully resected en bloc in both groups. Procedure duration was shorter for the TEA‐ESD group than the ESD control group, although the difference was not statistically significant (96 ± 53 minutes vs 116 ± 74 minutes; P = 0.18). The percentage of cases in which only one electrical surgical knife was used during the entire procedure was significantly higher in the TEA‐ESD group compared to the ESD control group (85.7% vs 31.3%; P = 0.0005). There were no perforations in the TEA‐ESD group while the ESD control group experienced one perforation. At the present time, TEA‐ESD is limited to the rectum and distal sigmoid colon.Conclusion:  It was technically easier, safer and more cost‐effective to perform ESD for LST in the rectum and the distal sigmoid colon using the newly developed TEA‐ESD traction technique.
Clinical utility of molecular and flow cytometric markers in chronic lymphocytic leukaemia
Authors: Sulda M. L. , Kuss B. J. , Hall R. K. , Bailey S. , Macardle P. J. 
Published: June 2010

AbstractBackground: Chronic lymphocytic leukaemia (CLL) is a clinically heterogeneous disease. While immunoglobulin variable region heavy chain (IgVH) mutational status remains the ‘gold standard’ in molecular prognostication, a range of additional markers is increasingly being used in clinical trials. As awareness of trial data increases, requests to determine these prognostic markers for new CLL patients are becoming more prevalent in Australia.Aim: To explore the clinical utility of currently available prognostic markers for CLL in an Australian cohort.Methods: IgVH mutational status and gene usage was determined and compared with other reported immunophenotypic markers, cytogenetics and clinical outcome as defined by treatment‐free survival (TFS), lymphocyte doubling time and clinical stage in a cohort of 65 CLL patients.Results: An unmutated IgVH gene, high expression of CD38, ZAP‐70, CD25, CD49d, CD54 or low expression of CD49c was associated with shorter TFS indicating an adverse clinical prognosis in our cohort. High expression of each of CD38, ZAP‐70, CD49d and CD54 was significantly associated with an unmutated IgVH gene; however, associations were not absolute. IgVH and CD25 expression retained their significance in multivariate analysis. Concordant CD25high/IgVH unmutated CLL patients had the shortest median TFS interval (40 months) in our cohort.Conclusions: Molecular and immunophenotypic markers remain useful as adjuncts to clinical prognostication; however, as single parameters they are unable to dictate the timing of therapeutic intervention. The combined use of CD25 and IgVH mutational status may be clinically relevant to CLL prognostication while also providing insight into the biological pathways involved in disease progression.
Reduction of measured toughness due to out‐of‐plane constraint in ductile fracture of aluminium alloy specimens
Authors: MOSTAFAVI M. , SMITH D. J. , PAVIER M. J. 
Published: June 2010

ABSTRACTIt is generally believed that a lower bound on the fracture toughness of a material is obtained from a standard test, particularly in metals where yielding occurs prior to fracture. The understanding is that in such a test the material around the crack tip is highly constrained hence reducing the extent of yielding. In this paper, we report the results of fracture tests where a tensile load is applied to a biaxial aluminium alloy specimen in the direction parallel to the crack front in addition to the fracturing load normal to the crack surface. We show that in this case a lower fracture toughness is measured than that obtained from a standard test. Indeed, for the highest value of tensile load used in our tests the J‐integral at fracture was half the value measured in a standard test. It is also shown that the volume of the plastic region can be used to measure the effect of constraint, irrespective of the manner in which the constraint arises. This approach suggests an even lower fracture toughness may be obtained than that measured here in certain loading conditions.
Discovering a new identity after brain injury
Authors: Lorenz Laura S. 
Published: June 2010

AbstractAcquired brain injury (ABI) is one example of the chronic conditions that people of varying socioeconomic status must bear. Concerns with identity and self are endemic to surviving brain injury. For this study, a brain tumour survivor injured 17 years earlier, took photographs of her life with brain injury and discussed them with other brain injury survivors and the author. Narrative analysis methods were used to analyse her photographs and interview, and generate a visual illness narrative with four photographs and their accompanying interview text. Her visual illness narrative reveals discovery of a post‐brain injury identity whose multiplicity of self‐definitions includes chef, brain injury survivor, gardener, and self‐advocate. Study findings reveal that identity issues of importance to brain injury survivors can include (1) learning the new, post‐brain injury self, and (2) building a new identity whose multiple, partial identities include (a) the new brain injured self, (b) an old self (with its residual strengths), and (c) a self who does meaningful activities (e.g.parenting, partnering, art, gardening, volunteering, helping others, or paid work). Study results suggest that using visual research methods can help to put biographical disruption such as brain injury into perspective as a life lived.
Predicting Snow Velocity in Large Chute Flows Under Different Environmental Conditions
Authors: Rougier Jonathan , Kern Martin 
Published: June 2010

SummaryObservations, model evaluations and expert judgements are combined to make predictions of snow velocity in large chute experiments. Different experimental variables, namely the environmental conditions snow density and snow surface temperature, affect all aspects of this inference. We show how the effect of these two variables can be incorporated in our judgements regarding the uncertain parameters of the physical model, the discrepancy between the physical model and reality and the observation error. We adopt a Bayes linear approach to avoid the necessity of fully probabilistic belief specifications and demonstrate visual tools for statistical validation. Our results represent an important first step in improving the specification of uncertainty in model-based avalanche hazard mapping.
Longitudinal Image Analysis of Tumour–Healthy Brain Change in Contrast Uptake Induced by Radiation
Authors: Zhang Xiaoxi , Johnson Timothy D. , Little Roderick J. A. , Cao Yue 
Published: June 2010

SummaryThe work is motivated by a quantitative magnetic resonance imaging study of the differential tumour–healthy tissue change in contrast uptake induced by radiation. The goal is to determine the time in which there is maximal contrast uptake (a surrogate for permeability) in the tumour relative to healthy tissue. A notable feature of the data is its spatial heterogeneity. Zhang and co-workers have discussed two parallel approaches to ‘denoise’ a single image of change in contrast uptake from baseline to one follow-up visit of interest. In this work we extend the image model to explore the longitudinal profile of the tumour–healthy tissue contrast uptake in multiple images over time. We fit a two-stage model. First, we propose a longitudinal image model for each subject. This model simultaneously accounts for the spatial and temporal correlation and denoises the observed images by borrowing strength both across neighbouring pixels and over time. We propose to use the Mann–Whitney U-statistic to summarize the tumour contrast uptake relative to healthy tissue. In the second stage, we fit a population model to the U-statistic and estimate when it achieves its maximum. Our initial findings suggest that the maximal contrast uptake of the tumour core relative to healthy tissue peaks around 3 weeks after initiation of radiotherapy, though this warrants further investigation.
Estimating the Prevalence of Sensitive Behaviour and Cheating with a Dual Design for Direct Questioning and Randomized Response
Authors: Hout Ardo van den , Böckenholt Ulf , Van Der Heijden Peter G. M. 
Published: June 2010

SummaryRandomized response is a misclassification design to estimate the prevalence of sensitive behaviour. Respondents who do not follow the instructions of the design are considered to be cheating. A mixture model is proposed to estimate the prevalence of sensitive behaviour and cheating in the case of a dual sampling scheme with direct questioning and randomized response. The mixing weight is the probability of cheating, where cheating is modelled separately for direct questioning and randomized response. For Bayesian inference, Markov chain Monte Carlo sampling is applied to sample parameter values from the posterior. The model makes it possible to analyse dual sample scheme data in a unified way and to assess cheating for direct questions as well as for randomized response questions. The research is illustrated with randomized response data concerning violations of regulations for social benefit.
Treatment efficiency of combining photodynamic therapy and ionizing radiation for Bowen’s disease
Authors: Nakano A , Watanabe D , Akita Y , Kawamura T , Tamada Y , Matsumoto Y 
Published: June 2010

AbstractBackground  Topical 5‐aminolevulinic acid photodynamic therapy (ALA‐PDT) is widely used for treating Bowen’s disease (BD), but recurrence and tumour cell persistence after ALA‐PDT is sometimes problematic. Radiation therapy (RT) is also effective for BD, but is limited by its side‐effects, such as refractory ulcers.Objective  The objective of the study was to observe a synergic effect of combination therapy with ALA‐PDT and RT for BD cases that did not respond effectively to prior ALA‐PDT.Methods  Subjects were BD patients whose lesion did not show complete remission or showed recurrence after prior ALA‐PDT. A total of four cases involving four lesions were studied (three male and one female, mean age 69.5). ALA ointment (20%) was applied to the lesions. After 4 to 6 h, subjects received combination therapy consisting of excimer‐pumped dye laser radiation at 630 nm (50 J/cm2) followed by electron‐beam radiation (3 Gy). The combination therapy was repeated every 2 to 3 days for a total of four treatments. The lesions were evaluated clinically or histologically after the final combination therapy session.Results  Following combination therapy, all of the lesions disappeared. Recurrence was not detected during the observations periods, which averaged 14.0 months in duration.Conclusion  Our results indicate that the cure rate of BD could be improved by combination therapy with ALA‐PDT and RT. Compared with conventional RT, the synergetic effect of this therapy might reduce the dose of radiation required, thereby also reducing skin side‐effects such as refractory ulcers.
Spectrum and Frequency of SLC26A4 Mutations Among Czech Patients with Early Hearing Loss with and without Enlarged Vestibular Aqueduct (EVA)
Authors: Pourová Radka , Janoušek Petr , Jurovčík Michal , Dvořáková Marcela , Malíková Marcela , Rašková Dagmar , Bendová Olga , Leonardi Emanuela , Murgia Alessandra , Kabelka Zdenek , Astl Jaromír , Seeman Pavel 
Published: June 2010

SummaryMutations in SLC26A4 cause Pendred syndrome (PS) – hearing loss with goitre – or DFNB4 – non‐syndromic hearing loss (NSHL) with inner ear abnormalities such as Enlarged Vestibular Aqueduct (EVA) or Mondini Dysplasia (MD). We tested 303 unrelated Czech patients with early hearing loss (298 with NSHL and 5 with PS), all GJB2‐negative, for SLC26A4 mutations and evaluated their clinical and radiological phenotype. Among 115 available HRCT/MRI scans we detected three MD (2.6%), three Mondini‐like affections (2.6%), 16 EVA (13 bilateral – 19.2% and 15.6% respectively) and 61 EVA/MD‐negative scans (73.4%). We found mutation(s) in 26 patients (8.6%) and biallelic mutations in eight patients (2.7%) out of 303 tested. In 18 of 26 (69%) patients, no second mutation could be detected even using MLPA. The spectrum of SLC26A4 mutations in Czech patients is broad without any prevalent mutation. We detected 21 different mutations (four novel). The most frequent mutations were p.Val138Phe and p.Leu445Trp (18% and 8.9% of pathogenic alleles respectively). Among 13 patients with bilateral EVA, six patients (50%) carry biallelic mutations. In EVA ‐negative patients no biallelic mutations were found but 4.9% had monoallelic mutations. SLC26A4 mutations are present mostly in patients with EVA/MD and/or progressive HL and those with affected siblings.
Inflammatory chemokine release of astrocytes in vitro is reduced by all‐trans retinoic acid
Authors: Van Neerven Sabien , Regen Tommy , Wolf Dhana , Nemes Andrei , Johann Sonja , Beyer Cordian , Hanisch Uwe‐Karsten , Mey Jörg 
Published: June 2010

J. Neurochem. (2010) 114, 1511–1526.AbstractThe production of chemokines by astrocytes constitutes an important component of neuroinflammatory processes in the brain. As the transcriptional activator retinoic acid (RA), used for chemotherapy and dermatological applications, exerts anti‐inflammatory effects on monocytes and lymphocytes, we have tested whether the physiologically occurring isomer, all‐trans RA, affects chemokine expression by astrocytes. Under control conditions, primary cultures of murine cortical astrocytes expressed no or very low levels of CCL and CXCL chemokines. After treatment with bacterial lipopolysaccharides to simulate inflammation in vitro, we detected a strong increase in the release of CCL2 (to > 4 ng/mL in cell culture supernatant), CCL3 (> 20 ng/mL), CCL5 (> 25 ng/mL), CXCL1 (> 30 ng/mL) and CXCL2 (> 20 ng/mL). Although simultaneous exposure to RA did not significantly affect this response, 12 h pre‐treatment with 0.1 μM all‐trans RA strongly suppressed mRNA expression and protein release of all chemokines. The anti‐inflammatory activity of RA engaged RA and retinoid X receptors and correlated with a decreased expression of the lipopolysaccharides co‐receptor CD14. A minor reduction of nuclear NF‐κB was observed but not significant, activation of Jun amino‐terminal kinase, p38 and signal transducer and activator of transcription 3 were not altered by RA. The results suggest that retinoids should be further investigated as candidates for the treatment of neuroinflammation.
Development of a grape seed polyphenolic extract with anti‐oligomeric activity as a novel treatment in progressive supranuclear palsy and other tauopathies
Authors: Pasinetti Giulio Maria , Ksiezak‐Reding Hanna , Santa‐Maria Ismael , Wang Jun , Ho Lap 
Published: June 2010

J. Neurochem. (2010) 114, 1557–1568.AbstractA diverse group of neurodegenerative diseases – including progressive supranuclear palsy (PSP), corticobasal degeneration and Alzheimer’s disease among others, collectively referred to as tauopathies – are characterized by progressive, age‐dependent intracellular formations of misfolded protein aggregates that play key roles in the initiation and progression of neuropathogenesis. Recent studies from our laboratory reveal that grape seed‐derived polyphenolic extracts (GSPE) potently prevent tau fibrillization into neurotoxic aggregates and therapeutically promote the dissociation of preformed tau aggregates [J. Alzheimer’s Dis. (2009) vol. 16, pp. 433]. Based on our extensive bioavailability, bioactivity and functional preclinical studies, combined with the safety of GSPE in laboratory animals and in humans, we initiated a series of studies exploring the role of GSPE (Meganatural‐Az® GSPE) as a potential novel botanical drug for the treatment of certain forms of tauopathies including PSP, a neurodegenerative disorder involving the accumulation and deposition of misfolded tau proteins in the brain characterized, in part, by abnormal intracellular tau inclusions in specific anatomical areas involving astrocytes, oligodendrocytes and neurons [J. Neuropathol. Exp. Neurol. (2002) vol. 61, pp. 33]. In this mini‐review article, we discuss the biochemical characterization of GSPE in our laboratory and its potential preventative and therapeutic role in model systems of abnormal tau processing pertinent to PSP and related tauopathies.