bluuebunny/crossref_metadata_2025_split huggingface dataset:
3 Tesla magnetic resonance imaging with and without corticotropin releasing hormone stimulation for the detection of microadenomas in Cushing’s syndrome
Authors: Erickson Dana , Erickson Bradley , Watson Robert , Patton Alice , Atkinson John , Meyer Fredric , Nippoldt Todd , Carpenter Paul , Natt Neena , Vella Adrian , Thapa Prabin 
Published: October 2009

SummaryObjective  We sought to determine if higher resolution 3 Tesla (T) magnetic resonance imaging (MRI) with or without ovine corticotropin releasing hormone (o‐CRH) stimulation would increase the sensitivity for detection of pituitary microadenomas in ACTH‐dependent Cushing’s syndrome (CS).Design and patients  We prospectively identified 23 patients over a 2‐year period with clinical and biochemical evidence of ACTH‐dependent CS with no lesion (n = 11) or equivocal lesion (n = 10) on 1·5T MRI. Subsequently, two additional MRIs were performed in random order: 3T nonstimulated MRI or 3T MRI with o‐CRH in all patients. Three neuroradiologists reviewed all examinations in a randomized blinded fashion. Patients were divided into four groups, depending on the outcome of their evaluation and treatment for CS. Two patients had to be excluded, and so we report on 21 subjects.Measurements and results  Both 3T MRI without (P < 0·016) and with o‐CRH stimulation (P < 0·013) was significantly more sensitive for detection of pituitary microadenomas than 1·5T MRI for Group 1 (definitive proof of Cushing’s disease, n = 10). Group 2 (those in group 1, plus three patients where dynamic/invasive testing suggested pituitary source) also showed a significant (P < 0·012) advantage for 3T. There was no difference between the 3T and the 3T o‐CRH examinations for any of the pulse sequences. We did not observe a statistically significant difference in other patient groups [patients with recurrent CD (n = 6) and patients with ectopic CS (n = 2)].Conclusions  The results of our prospective blinded studies suggest that 3T MRI of pituitary gland should be considered in evaluation of patients with ACTH‐dependent CD when 1·5T imaging is negative or equivocal.
Histogenesis‐specific expression of fibroblast activation protein and dipeptidylpeptidase‐IV in human bone and soft tissue tumours
Authors: Dohi Osamu , Ohtani Haruo , Hatori Masahito , Sato Elichi , Hosaka Masami , Nagura Hiroshi , Itoi Eiji , Kokubun Shoichi 
Published: October 2009

Aims:  Fibroblast activation protein (FAP)/seprase and dipeptidylpeptidase‐IV (DPP‐IV)/CD26 are serine integral membrane proteases. They are involved in tissue remodelling, cancer invasion and metastases, mechanisms that are controversial. The aim was to identify cell types that express FAP and DPP‐IV in human bone and soft tissue tumours, and to determine whether there are any correlations between the expression of FAP and DPP‐IV and the malignant potential of tumours.Methods and results:  This study analysed in situ expression in 25 malignant and 13 benign human bone and soft tissue tumours. Reverse transcriptase‐polymerase chain reaction analyses confirmed mRNA expression of FAP and DPP‐IV in all individuals. Immunohistochemistry using pre‐fixed frozen sections revealed that FAP was positive in low‐grade myofibroblastic sarcoma, the fibroblastic component of osteosarcomas, and malignant fibrous histiocytomas, but negative in Ewing’s sarcomas and rhabdomyosarcomas. DPP‐IV showed similar immunohistochemical results. Among benign tumours, non‐ossifying fibromas, desmoid tumours and chondroblastomas expressed both FAP and DPP‐IV. Giant cells expressed DPP‐IV in giant cell tumours.Conclusions:  Our data suggest that FAP and DPP‐IV are consistently expressed in bone and soft tissue tumour cells that are histogenetically related to activated fibroblasts and/or myofibroblasts, irrespective of their malignancy. DPP‐IV is also expressed in monocyte–macrophage lineage cells.
Breast cancer in the elderly: a histological assessment
Authors: Tse Gary M , Tan Puay‐Hoon , Lau Kin‐Mang , De Andrade Victor Piana , Lui Philip C W , Vong Joaquim S , Chaiwun Benjaporn , Lam Christopher C , Yu Alex M , Moriya Takuya 
Published: October 2009

Aims:  To understand the correlation between the expression status of different biological markers in breast cancers in the elderly.Methods and results:  Three hundred and ninety‐seven cases were evaluated for expression of hormone receptors [oestrogen receptors (ER) α and β, progesterone receptor (PR)], basal markers [p63, cytokeratin (CK) 5/6 and CK14] and others (HER2/neu, synaptophysin and chromogranin). The expression rates were 60, 29, 25, 6, 14, 8, 28, 17 and 5%, respectively, for these markers. The expression of ER α and β, PR, synaptophysin and chromogranin at any level correlated with low nuclear or tumour grades, whereas the expression of HER2/neu, CK5/6 and CK14 at any level correlated with high nuclear grade. By using hierarchical clustering, groups of HER2, luminal and basal types were identified. In addition, a neuroendocrine group was also identified, being characterized by expression of synaptophysin, chromogranin, ER and PR, but not HER2/neu, and other basal cytokeratins. This group was associated with lower nuclear grade, and hence better prognosis.Conclusions:  Breast cancer in the elderly shows similar molecular groupings as other breast cancers, with an additional neuroendocrine group that is associated with a favourable biological marker profile.
Tumour regression grade (TRG) analyses in patients with resectable gastro‐oesophageal adenocarcinomas treated with platinum‐based neoadjuvant chemotherapy
Authors: Fareed Khaleel R , Ilyas Mohammad , Kaye Philip V , Soomro Irshad N , Lobo Dileep N , Parsons Simon L , Madhusudan Srinivasan 
Published: October 2009

Aims:  Neoadjuvant chemotherapy followed by surgery is the standard of care for patients with gastro‐oesophageal adenocarcinoma. The aims were to validate the utility of the tumour regression grade (TRG) in patients who have received chemotherapy and to investigate if (i) TRG correlates with tumour downstaging and (ii) TRG could provide a comparative platform for future predictive biomarker investigations.Methods and results:  Three pathologists were blinded to the treatment approaches. Review included diagnosis, tumour grade, TNM staging, vascular invasion, perineural invasion, resection margin involvement and histopathological response to chemotherapy, as measured by TRG. In the neoadjuvant chemotherapy (CS) group (n = 84), 46.7% of gastric/gastro‐oesophageal junction adenocarcinomas, and 45.5% of lower third oesophageal adenocarcinomas had TRG 1, 2 or 3 compared with 13.7% in the primary surgery group (n = 124) (P < 0.001 and P = 0.006, respectively). In the CS group, responders (TRG 1, 2 or 3) showed significant tumour downstaging [early ypT‐stage disease (P = 0.002)]. In gastric cancers specifically, additional associations were seen with negative nodal disease (P = 0.044) and absence of vascular invasion (P = 0.027).Conclusions:  TRG may reflect response to chemotherapy. In addition, positive correlations between TRG and ypTNM staging were demonstrated that would suggest tumour downstaging.
The impact of the 2005 International Society of Urological Pathology (ISUP) consensus on Gleason grading in contemporary practice
Authors: Zareba Piotr , Zhang Jianguo , Yilmaz Asli , Trpkov Kiril 
Published: October 2009

Aims:  To investigate the impact of the 2005 International Society of Urological Pathology (ISUP) Gleason grading consensus in contemporary practice.Methods and results:  The Gleason scores (GS) were compared in two consecutive patient cohorts with matched biopsies and prostatectomies: (i) 908 patients evaluated before the ISUP consensus (July 2000–June 2004) and (ii) 423 patients evaluated after the ISUP consensus (October 2005–June 2007). All biopsies and prostatectomies were performed and scored in one institution and were sampled and processed identically. There was a higher percentage of biopsy and prostatectomy specimens with GS ≥ 7 after the ISUP consensus (GS ≥ 7 on biopsy in 32% before ISUP versus 46% after ISUP; GS ≥ 7 on prostatectomy in 53% before ISUP versus 68% after ISUP; P < 0.001). No significant difference in the complete and ±1 unit Gleason agreement was found before and after the ISUP consensus. There was a trend towards better complete agreement for GS ≥ 7 after the ISUP consensus.Conclusions:  There was a shift towards higher GS on biopsy and prostatectomy in our practice after the ISUP consensus, although – there was no significant impact on the biopsy–prostatectomy Gleason agreement. The significance of this shift for patient management and prognosis is uncertain.
Sperm characteristics and teratology in rats following vas deferens occlusion with RISUG and its reversal
Authors: Lohiya N. K. , Suthar R. , Khandelwal A. , Goyal S. , Ansari A. S. , Manivannan B. 
Published: October 2009

SummaryThe functional success of the reversal of vas occlusion by styrene maleic anhydride (RISUG), using the solvent vehicle, Dimethyl Sulphoxide (DMSO), has been investigated. Reversal with DMSO was carried out in Wistar albino rats 90 days after bilateral vas occlusion. The body weight, organ weight, sperm characteristics, fertility test and teratology, including skeletal morphology were evaluated in vas occlusion and reversal animals and in F1 progenies to assess the functional success of the occlusion and reversal. Body weight, organ weight and the cauda epididymal sperm characteristics of vas occlusion and reversal animals and of F1 progenies were comparable to control. Ejaculated spermatozoa in the vaginal smear showed detached head/tail, acrosomal damage, bent midpiece, bent tail and morphological aberrations in sperm head after vas occlusion, which returned to normal, 90 days after reversal. Monthly fertility test, post‐injection showed 0% fertility, which improved gradually and 100% fertility was achieved 90 days after reversal. The fertility/pregnancy/implantation record and skeletal morphology of the offspring were comparable to control. The results suggest functional success and safety of vas occlusion reversal by DMSO.
Adaptation, postpartum concerns, and learning needs in the first two weeks after caesarean birth
Authors: Weiss Marianne , Fawcett Jacqueline , Aber Cynthia 
Published: October 2009

Aims.  The purpose of this Roy Adaptation Model‐based study was to describe women’s physical, emotional, functional and social adaptation; postpartum concerns; and learning needs during the first two weeks following caesarean birth and identify relevant nursing interventions.Background.  Studies of caesarean‐delivered women indicated a trend toward normalisation of the caesarean birth experience. Escalating caesarean birth rates mandate continued study of contemporary caesarean‐delivered women.Design.  Mixed methods (qualitative and quantitative) descriptive research design.Methods.  Nursing students collected data from 233 culturally diverse caesarean‐delivered women in urban areas of the Midwestern and Northeastern USA between 2002–2004. The focal stimulus was the planned or unplanned caesarean birth; contextual stimuli were cultural identity and parity. Adaptation was measured by open‐ended interview questions, fixed choice questionnaires about postpartum concerns and learning needs and nurse assessment of post‐discharge problems. Potential interventions were identified using the Omaha System Intervention Scheme.Results.  More positive than negative responses were reported for functional and social adaptation than for physical and emotional adaptation. Women with unplanned caesarean births and primiparous women reported less favourable adaptation than planned caesarean mothers and multiparas. Black women reported lower social adaptation, Hispanic women had more role function concerns and Black and Hispanic women had more learning needs than White women. Post‐discharge nursing assessments revealed that actual problems accounted for 40% of identified actual or potential problems or needs. Health teaching was the most commonly recommended postpartum intervention strategy followed by case management, treatment and surveillance interventions.Conclusions.  Caesarean‐delivered women continue to experience some problems with adapting to childbirth. Recommended intervention strategies reflect the importance of health teaching following hospital discharge.Relevance to clinical practice.  Women who experience caesarean birth require comprehensive assessment during the early postpartum period. Nurses should devise strategies to continue care services for these women following hospital discharge.
Patient factors in the implementation of decision aids in general practice: a qualitative study
Authors: Bhavnani Vanita , Fisher Brian 
Published: October 2009

AbstractBackground  Decision aids (DAs) have been developed to help patients make treatment decisions. Research shows that they are effective in increasing patients’ knowledge of treatment options without raising anxiety or conflict. However, they have not been routinely adopted for use in general practice in the UK and there are few reports addressing strategies to introduce them.Objective  To examine patients’ views about a variety of DAs for different conditions (heart disease, osteoporosis, osteoarthritis and breast cancer) in order to inform a strategy to introduce them into general practice.Setting and participants  General practice patients over the age of 18 years being or having been treated for one of the conditions above.Methods  Qualitative study involving 12 focus groups with 77 patients evaluating decision aids relevant to their conditions. A semi‐structured interview guide was used to generate discussions about the applicability of the DAs in routine general practice.Results  Patients welcomed DAs for their educational and informational content. Reactions to the DAs were influenced by patients’ own personal desires for involvement. The main concerns were that the use of DAs would potentially shift the onus of decision making responsibility on to the patient and about the practical challenges to implementation.Conclusions  Clinicians will need to make explicit to patients that DAs are an adjunct to routine care and not a replacement, and therefore do not represent a derogation of responsibility. DAs need to be used as an integral part of the communication and support process for patients who want them.
Aragonite and omphacite‐bearing metapelite from Besshi region, Sambagawa belt in central Shikoku, Japan and its implication
Authors: Kouketsu Yui , Enami Masaki 
Published: October 2009

AbstractAragonite and omphacite‐bearing metapelite occurs in the albite–biotite zone of the Togu (Tohgu) area, Besshi region, Sambagawa metamorphic belt, central Shikoku, Japan. This metapelite consists of alternating graphite‐rich and graphite‐poor layers that contain garnet, phengite, chlorite, epidote, titanite, calcite, albite, and quartz. A graphite‐poor layer contains a 1.5‐cm ivory‐colored lens that mainly consists of phengite, calcite, albite, and garnet. Aragonite, omphacite, and paragonite occur as inclusions in the garnet of the ivory lens. The aragonite has a composition that is close to the CaCO3 end‐member: the FeCO3 and MnCO3 components are both less than 0.3 mol% and the SrCO3 component is about 1 mol%. The aragonite + omphacite + quartz assemblage in garnet indicates equilibrium conditions of P > 1.1–1.3 GPa and T = 430–550°C. Quartz grains sealed in garnet of the aragonite and omphacite‐bearing sample and other metapelites in the Togu area preserve a high residual pressure that is equivalent to the Sambagawa eclogite samples. These facts suggest that: (i) the Togu area experienced eclogite facies metamorphism; and (ii) thus, eclogite facies metamorphism covered the Sambagawa belt more extensively than previously recognized.
ORIGINAL ARTICLE: Lack of association between elevated mean red cell volume and haematological toxicity in patients receiving long‐term methotrexate for rheumatoid arthritis
Authors: White D. H. N. , Chapman P. T. , O'Donnell J. L. , James J. , Frampton C. , Stamp L. K. 
Published: October 2009

AbstractAims: It has been suggested that elevated mean red cell volume (MCV) may be a predictor of haematological toxicity in rheumatoid arthritis (RA) patients receiving methotrexate (MTX). We wished to identify whether there was an association between MCV, red cell folate and haematological toxicity in patients on MTX monotherapy for the long‐term management of RA.Methods: Evidence of haematological toxicity was sought by note review of patients recruited in a cross‐sectional study of MTX monotherapy in RA. Retrospective data included MCVs from before MTX initiation and after 3 and 6 months of treatment. Data were collected prospectively every 6 months for up to 2 years after enrolment. Any record of cytopenia or the development of haematological malignancy was recorded from commencement of MTX until the present day. Red cell folate concentrations were tested on enrolment to the study.Results: A total of 165 patients was included, 74.5% female, median disease duration 7 years (range 3 months–57 years). The median duration of MTX treatment was 74.9 months (range 10–241 months) giving 1030.2 patient‐years of MTX exposure. Twenty‐four patients (14.5%) had a MCV > 98 fL on study entry. Evidence of haematological abnormality was found in six patients (3.6%); chronic lymphocytic leukaemia (1), persistent lymphocytosis (1), persistent monocytosis (1) and neutropenia (3). There was no association between red cell folate or MCV and haematological toxicity.Conclusion: Neutropenia and pancytopenia are rare side‐effects of MTX therapy in this cohort. Elevated MCV or low mean red cell folate does not appear to be associated with haematological malignancy or toxicity in this cohort of patients on long‐term MTX therapy.
Prevalence of hepatitis B virus infection in non‐Hodgkin lymphoma: a systematic review and meta‐analysis
Authors: Nath A. , Agarwal R. , Malhotra P. , Varma S. 
Published: October 2009

AbstractBackground and aim: A recent meta‐analysis has demonstrated an association between hepatitis C virus and non‐Hodgkin lymphoma (NHL). There is also evidence on the association between hepatitis B virus (HBV) and NHL. The aim of this study was to evaluate this evidence using a meta‐analytic approach.Methods: We searched the MEDLINE database from 1962 to 2008 for case–control studies that have reported the association of HBV with NHL. We calculated the odds ratio (OR) and 95% confidence intervals (CI) to assess the prevalence of HBV infection and pooled the results using three different statistical models.Results: Our search yielded 12 studies with 11 studies (3262 NHL patients, 1 523 205 controls) evaluating HBV infection in NHL and one study (3888 HBV‐infected individuals, 205 203 controls) that had investigated for NHL in HBV infection. The OR of detecting HBV infection in NHL when compared with the control population was 2.56 (95% CI, 2.24–2.92) by the fixed effects model; 2.61 (95% CI, 2.29–2.98) by the exact method and 2.67 (95% CI, 2.04–3.49) by the random effects model suggesting a high prevalence of HBV carrier state in lymphoma. There was evidence of statistical heterogeneity which disappeared after exclusion of retrospective studies on sensitivity analysis.Conclusions: The results of this study suggest a possible causal relation between HBV infection and NHL which needs to be confirmed by experimental and epidemiological studies. In countries where prevalence of HBV infection is 1% or more, it may be prudent to screen patients with NHL for occult HBV infection.
Prognostic value of trisomy 8 in primary myelodysplastic syndrome
Authors: Ma Y. , Wang X. , Xu X. , Lin G. 
Published: October 2009

AbstractBackground:  According to the International Prognostic Scoring System (IPSS), sole +8 is categorized as intermediate cytogenetic subgroup. But as some myelodysplastic syndrome (MDS) patients with +8 perhaps progress quickly to acute leukaemia and have shorter survival, some reports have suggested that +8 should be categorized into poor risk cytogenetic group. The aim of this study was to clarify the prognostic role of +8 in MDS patients by comparing patients with normal karyotype, 20q‐ and ‐7/7q‐.Methods:  The consecutive samples of 435 MDS patients in Shanghai were collected by prospective methods and diagnosed according to World Health Organization classification. Cytogenetic analysis was performed using conventional G‐banding karyotyping and fluorescence in situ hybridization techniques. Prognosis was estimated by univariate Log‐rank method and multivariate Cox proportional hazard models.Results:  Of 424 cases completing the cytogenetic analysis, 71 (16.7%) had +8, including 38 patients with sole +8 (9.0%). No significant difference in median survival was observed between patients with sole +8 and that with +8 and one of other abnormalities. The +8 clone size was not linked to survival. The median survival of patients with +8, normal karyotype and complex karyotype was 25 months, 38.1 months and 5.9 months respectively. However, no significant difference was observed between patients with 20q‐ (21.4 months) and ‐7/7q‐ (25.8 months). Trisomy 8 was an independent prognostic factor by Cox regression model.Conclusion:  There is no significant difference in prognosis between patients with +8 and patients with 20q‐ or ‐7/7q‐. Trisomy 8, 20q‐ and ‐7/7q‐ are categorized as intermediate cytogenetic risk according to our primary study.
What is the role of invasive versus non‐invasive coronary angiography in the investigation of patients suspected to have coronary heart disease?
Authors: Chow C. K. , Sheth T. 
Published: October 2009

AbstractThe improved technology of multi‐slice cardiac CT angiography (CTA) has enabled production of high quality images of the coronary arteries. The sensitivity and specificity of the test in identifying patients with obstructive coronary lesions in 64‐slice and later generations of scanners is high. To enable effective use of CTA in the clinical setting, a better understanding of this technology, particularly in comparison to invasive coronary angiography, is needed. In this article we discuss the characteristics of CTA in comparison to invasive coronary angiography and discuss the role of CTA in the diagnosis of coronary artery disease (CAD). Newer CTA scanners and individualized scanning protocols can minimize radiation exposure from CTA. CTA can provide more information than invasive coronary angiography on the type and burden of atherosclerotic plaque in the coronary tree. CTA is most useful in those at intermediate risk of CAD.