bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi‐detector CT angiography for lower gastrointestinal bleeding: Can it select patients for endovascular intervention?
Authors: Foley PT , Ganeshan A , Anthony S , Uberoi R 
Published: March 2010

SummaryThis is a retrospective review of the results at our institution of using multi‐detector CT angiography (CTA) to localise lower gastrointestinal (GI) bleeding. We hypothesised that in our patient population: (i) CTA was unlikely to demonstrate bleeding in patients who were haemodynamically stable; (ii) in haemodynamically unstable patients in whom CTA was undertaken, the results could be used to select patients who would benefit from catheter angiography; and (iii) in haemodynamically unstable patients in whom CTA was undertaken, a subgroup of patients could be identified who would benefit from primary surgical treatment, avoiding invasive angiography completely. A retrospective review was conducted of the clinical records of all patients undergoing CTA for lower GI haemorrhage at our institution between 1 January 2005 and 30 June 2007. Out of the 20 patients examined, 10 had positive CTAs demonstrating the bleeding site. Nine were haemodynamically unstable at the time of the study. Four patients with positive CT angiograms were able to be treated directly with surgery and avoided invasive angiography. Ten patients had negative CTAs. Four of these were haemodynamically unstable, six haemodynamically stable. Only one required intervention to secure haemostasis, the rest stopped spontaneously. No haemodynamically stable patient who had a negative CTA required intervention. CTA is a useful non‐invasive technique for localising the site of lower GI bleeding. In our patient population, in the absence of haemodynamic instability, the diagnostic yield of CTA was low and bleeding was likely to stop spontaneously. In haemodynamically unstable patients, a positive CTA allowed patients to be triaged to surgery or angiography, whereas there was a strong association between a negative CTA and spontaneous cessation of bleeding.
Hepatocellular carcinoma with extrahepatic collateral arterial supply
Authors: Cheng LF , Ma KF , Fan WC , Yung AWT , Li TM , Wong CS 
Published: March 2010

SummaryHaepatocellular carcinoma (HCC) is the most common primary liver malignancy, representing the fifth most common cancer in the world. Without treatment, the median survival of HCC patients has been reported to be 8 weeks from symptomatic presentation. Transarterial chemoembolisation is widely used to manage unresectable HCCs. However, when a tumour is large or locates near the liver capsule, it may receive supplies from vessels other than hepatic arteries. In this paper, we discuss the anatomy of possible extrahepatic collateral arterial supplies of HCCs.
Effect of radiation therapy on the latest generation of pacemakers and implantable cardioverter defibrillators: A systematic review
Authors: Hudson F , Coulshed D , D'Souza E , Baker C 
Published: March 2010

SummaryThe increasing human lifespan and development of technology over the last number of decades has seen an increase in the number of pacemaker and implantable cardioverter defibrillator (ICD) implantations worldwide. Given the number of risk factors common to both heart disease and cancer, it is not uncommon for several of these patients to present for radiation therapy treatment each year. A systematic review was conducted using online databases Medline and Scopus. Results were grouped into in vitro and in vivo studies. In 1994, the American Association of Physicists in Medicine (AAPM) defined guidelines for the management of these patients, which have since been adopted by many radiation oncology departments internationally. More recently, a number of studies have reported an increase in radiation sensitivity of these devices (encompassing the coiled metal leads and generator unit) due to the incorporation of complementary metal oxide semiconductor circuitry. Further avenues of device failure, such as the effect of dose rate and scatter radiation, have only more recently been investigated. There are also the unexplored avenues of electromagnetic interference on devices when incorporating newer treatment technologies such as respiratory gating and intensity modulated radiation therapy. It is suggested that each radiation oncology department employ a policy for the management of patients with ICDs and pacemakers, potentially based upon an updated national or international standard similar to that released by the AAPM in 1994.
Amino acid imbalance in patients with chronic liver diseases
Authors: Michitaka Kojiro , Hiraoka Atsushi , Kume Misaki , Uehara Takahide , Hidaka Satoshi , Ninomiya Tomoyuki , Hasebe Aki , Miyamoto Yasunao , Ichiryu Misa , Tanihira Tetsuya , Nakahara Hiromasa , Ochi Hironori , Tanabe Atsushi , Uesugi Kazuhiro , Tokumoto Yoshio , Mashiba Toshie , Abe Masanori , Hiasa Yoichi , Matsuura Bunzo , Onji Morikazu 
Published: March 2010

Aim:  The aim of this study is to clarify the amino acid imbalance in patients with chronic hepatitis (CH) as well as those with liver cirrhosis (LC).Methods:  We assayed total branched‐chain amino acids (BCAA), tyrosine (Tyr) levels and their ratio (BTR) in sera of 101 patients with CH (37 in fibrosis stage F1, 23 in F2, 21 in F3) and 20 with LC (F4) who were diagnosed by liver biopsy. Their levels in relation to the staging of liver fibrosis were analyzed.Results:  The percentage of patients whose BTR was less than the normal range was 32.1% in CH and 75.0% in LC. The levels of BTR and BCAA were significantly lower (P < 0.001, P < 0.05, respectively) and that of Tyr was significantly higher (P < 0.001) in patients with LC than those in CH. The levels of BTR decreased according to the staging. The levels of Tyr increased according the staging, whereas the levels of BCAA deceased prominently in F4 (487 ± 103 in F1, 483 ± 122 in F2, 487 ± 111 in F3 and 423 ± 94 in F4).Conclusion:  A considerable number of patients not only with LC but also with CH showed lower levels of BTR. It has been clarified that amino acid imbalance of Tyr was found in the early stage of liver disease, whereas decrease of BCAA was found mainly in F4 stage.
Mistakes, misunderstandings and controversies in diabetes: A review and personal account
Authors: Mogensen Carl Erik 
Published: March 2010

AbstractA number of controversies in diabetes have had too little attention. I discuss the following issues: (i) drug therapy; (ii) genetics; (iii) antihypertensive treatment in patients with normoalbuminuria and with abnormal albuminuria; (iv) insulin analogs; (v) cancer in diabetes; (vi) hypophysectomy; (vii) renal biopsy; (viii) low protein diet; and (ix) glycated hemoglobin. A closer look at these items is required in order to have a more realistic picture of diabetes research. A scheme of other controversies is also provided. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2010.00012.x, 2010)
A diamond target for megavoltage cone‐beam CTa)
Authors: Sawkey D. , Lu M. , Morin O. , Aubin M. , Yom S. S. , Gottschalk A. R. , Bani‐Hashemi A. , Faddegon B. A. 
Published: March 2010

Purpose:To determine the properties of a megavoltage cone‐beam CT system using the unflattened beam from a sintered diamond target at 4 and 6 MV.Methods:A sintered diamond target was used in place of a graphite target as part of an imaging beam line (an unflattened beam from a graphite target) installed on a linear accelerator. The diamond target, with a greater density than the graphite target, permitted imaging at the lower beam energy (4 MV) required with the graphite target and the higher beam energy (6 MV) conventionally used with the tungsten/stainless steel target and stainless steel flattening filter. Images of phantoms and patients were acquired using the different beam lines and compared. The beam spectra and dose distributions were determined using Monte Carlo simulation.Results:The diamond target allowed use of the same beam energy as for treatment, simplifying commissioning and quality assurance. Images acquired with the diamond target at 4 MV were similar to those obtained with the graphite target at 4 MV. The slight reduction in low energy photons due to the higher‐ sintering material in the diamond target had minimal effect on image quality. Images acquired at 6 MV with the diamond target showed a small decrease in contrast‐to‐noise ratio, resulting from a decrease in the fraction of photons in the beam in the energy range to which the detector is most sensitive.Conclusions:The diamond target provides images of a similar quality to the graphite target. Diamond allows use of the higher beam energy conventionally used for treatment, provides a higher dose rate for the same beam current, and potentially simplifies installation and maintenance of the beam line.
MST (Molecular Serotyping Tool): a Program for Computer-Assisted Molecular Identification of
Escherichia coli
and
Shigella
O Antigens
Authors: Coimbra Roney S. , Artiguenave François , Jacques Leandro S. R. Z. , Oliveira Guilherme C. 
Published: March 2010

ABSTRACT

Escherichia coli
and
Shigella
O antigens can be inferred using the
rfb
-restriction fragment length polymorphism (RFLP) molecular test. We present herein a dynamic programming algorithm-based software to compare the
rfb
-RFLP patterns of clinical isolates with those in a database containing the 171 previously published patterns corresponding to all known
E. coli
/
Shigella
O antigens.
Longitudinal Genotyping of
Candida dubliniensis
Isolates Reveals Strain Maintenance, Microevolution, and the Emergence of Itraconazole Resistance
Authors: Fleischhacker M. , Pasligh J. , Moran G. , Ruhnke M. 
Published: March 2010

ABSTRACT

We investigated the population structure of 208
Candida dubliniensis
isolates obtained from 29 patients (25 human immunodeficiency virus [HIV] positive and 4 HIV negative) as part of a longitudinal study. The isolates were identified as
C. dubliniensis
by arbitrarily primed PCR (AP-PCR) and then genotyped using the Cd25 probe specific for
C. dubliniensis
. The majority of the isolates (55 of 58) were unique to individual patients, and more than one genotype was recovered from 15 of 29 patients. A total of 21 HIV-positive patients were sampled on more than one occasion (2 to 36 times). Sequential isolates recovered from these patients were all closely related, as demonstrated by hybridization with Cd25 and genotyping by PCR. Six patients were colonized by the same genotype of
C. dubliniensis
on repeated sampling, while strains exhibiting altered genotypes were recovered from 15 of 21 patients. The majority of these isolates demonstrated minor genetic alterations, i.e., microevolution, while one patient acquired an unrelated strain. The
C. dubliniensis
strains could not be separated into genetically distinct groups based on patient viral load, CD4 cell count, or oropharyngeal candidosis. However,
C. dubliniensis
isolates obtained from HIV-positive patients were more closely related than those recovered from HIV-negative patients. Approximately 8% (16 of 194) of isolates exhibited itraconazole resistance. Cross-resistance to fluconazole was only observed in one of these patients. Two patients harboring itraconazole-resistant isolates had not received any previous azole therapy. In conclusion, longitudinal genotyping of
C. dubliniensis
isolates from HIV-infected patients reveals that isolates from the same patient are generally closely related and may undergo microevolution. In addition, isolates may acquire itraconazole resistance, even in the absence of prior azole therapy.
Monocytes Regulate T Cell Migration through the Glia Limitans during Acute Viral Encephalitis
Authors: Savarin Carine , Stohlman Stephen A. , Atkinson Roscoe , Ransohoff Richard M. , Bergmann Cornelia C. 
Published: March 2010

ABSTRACTLeukocyte access into the central nervous system (CNS) parenchyma is tightly regulated by the blood-brain barrier (BBB). Leukocyte migration through the endothelial cell wall into the perivascular space is well characterized; however, mechanisms regulating their penetration through the glia limitans into the parenchyma are less well studied, and the role of monocytes relative to neutrophils is poorly defined. Acute viral encephalitis was thus induced in CCL2-deficient (CCL2−/−) mice to specifically abrogate monocyte recruitment. Impaired monocyte recruitment prolonged T cell retention in the perivascular space, although no difference in overall CNS accumulation of CD4 or CD8 T cells was detected by flow cytometry. Delayed penetration to the CNS parenchyma was not associated with reduced or altered expression of either matrix metalloproteinases (MMP) or the T cell chemoattractants CXCL10 and CCL5. Nevertheless, decreased parenchymal leukocyte infiltration delayed T cell-mediated control of virus replication as well as clinical disease. These data are the first to demonstrate that the rapid monocyte recruitment into the CNS during viral encephalitis is dispensable for T cell migration across the blood vessel endothelium. However, monocytes facilitate penetration through the glia limitans. Thus, the rapid monocyte response to viral encephalitis constitutes an indirect antiviral pathway by aiding access of effector T cells to the site of viral infection.
Syncytial Phenotype of C-Terminally Truncated Herpes Simplex Virus Type 1 gB Is Associated with Diminished Membrane Interactions
Authors: Chowdary Tirumala Kumar , Heldwein Ekaterina E. 
Published: March 2010

ABSTRACTThe cytoplasmic domain of glycoprotein B (gB) from herpes simplex virus type 1 (HSV-1) is an important regulator of membrane fusion. C-terminal truncations of the cytoplasmic domain lead to either hyperfusion or fusion-null phenotypes. Currently, neither the structure of the cytoplasmic domain nor its mechanism of fusion regulation is known. Here we show, for the first time, that the full-length cytoplasmic domain of HSV-1 gB associates stably with lipid membranes, preferentially binding to membranes containing anionic head groups. This interaction involves a large increase in helical content. However, the truncated cytoplasmic domains associated with the hyperfusion phenotype show a small increase in helical structure and a diminished association with lipid membranes, whereas the one associated with the fusion-null phenotype shows no increase in helical structure and only a minimal association with lipid membranes. We hypothesize that stable binding to lipid membranes is an important part of the mechanism by which the cytoplasmic domain negatively regulates membrane fusion. Moreover, our experiments with truncated cytoplasmic domains point to two specific regions that are critical for membrane interactions. Taken together, our work provides several important new insights into the architecture of the cytoplasmic domain of HSV-1 gB and its interaction with lipid membranes.
ORF157 from the Archaeal VirusAcidianusFilamentous Virus 1 Defines a New Class of Nuclease
Authors: Goulet Adeline , Pina Mery , Redder Peter , Prangishvili David , Vera Laura , Lichière Julie , Leulliot Nicolas , van Tilbeurgh Herman , Ortiz-Lombardia Miguel , Campanacci Valérie , Cambillau Christian 
Published: March 2010

ABSTRACTAcidianusfilamentous virus 1 (AFV1) (Lipothrixviridae) is an enveloped filamentous virus that was characterized from a crenarchaeal host. It infectsAcidianusspecies that thrive in the acidic hot springs (>85°C and pH <3) of Yellowstone National Park, WY. The AFV1 20.8-kb, linear, double-stranded DNA genome encodes 40 putative open reading frames whose sequences generally show little similarity to other genes in the sequence databases. Because three-dimensional structures are more conserved than sequences and hence are more effective at revealing function, we set out to determine protein structures from putative AFV1 open reading frames (ORF). The crystal structure of ORF157 reveals an α+β protein with a novel fold that remotely resembles the nucleotidyltransferase topology.In vitro, AFV1-157 displays a nuclease activity on linear double-stranded DNA. Alanine substitution mutations demonstrated that E86 is essential to catalysis. AFV1-157 represents a novel class of nuclease, but its exact rolein vivoremains to be determined.
Delivery of Cytokines by Recombinant Virus in Early Life Alters the Immune Response to Adult Lung Infection
Authors: Harker James A. , Lee Debbie C. P. , Yamaguchi Yuko , Wang Belinda , Bukreyev Alexander , Collins Peter L. , Tregoning John S. , Openshaw Peter J. M. 
Published: March 2010

ABSTRACTRespiratory syncytial virus (RSV) is the main cause of bronchiolitis, the major cause of hospitalization of infants. An ideal RSV vaccine would be effective for neonates, but the immune responses of infants differ markedly from those of adults, often showing a bias toward T-helper 2 (Th2) responses and reduced gamma interferon (IFN-γ) production. We previously developed recombinant RSV vectors expressing IFN-γ and interleukin-4 (IL-4) that allow us to explore the role of these key Th1 and Th2 cytokines during infection. The aim of the current study was to explore whether an immunomodulation of infant responses could enhance protection. The expression of IFN-γ by a recombinant RSV vector (RSV/IFN-γ) attenuated primary viral replication in newborn mice without affecting the development of specific antibody or T-cell responses. Upon challenge, RSV/IFN-γ mice were protected from the exacerbated disease observed for mice primed with wild-type RSV; however, antiviral immunity was not enhanced. Conversely, the expression of IL-4 by recombinant RSV did not affect virus replication in neonates but greatly enhanced Th2 immune responses upon challenge without affecting weight loss. These studies demonstrate that it is possible to manipulate infant immune responses by using cytokine-expressing recombinant viruses and that neonatal deficiency in IFN-γ responses may lead to enhanced disease during secondary infection.
Ethnic differences in glycated haemoglobin between white subjects and those of South Asian origin with normal glucose tolerance: Table 1
Authors: Likhari Taruna , Gama Rousseau 
Published: March 2010

ObjectiveTo determine whether ethnic differences exist in glycated haemoglobin between white subjects and those of South Asian origin with normal glucose tolerance (NGT)MethodsErythrocyte glycated haemoglobin (HbA1c) was compared between white subjects and those of South Asian origin with NGT defined by a 75 g oral glucose tolerance test (OGTT).Results139 subjects with NGT comprising 36 people of South Asian origin (20 female) and 103 white subjects (49 female) were compared. Subjects of South Asian origin were younger (p<0.001) and weighed less (p<0.001) than white subjects. Fasting and 2 h capillary plasma glucose concentrations were similar in subjects of South Asian origin and white subjects, but HbA1clevels were higher (p<0.05) in subjects of South Asian origin (6.11±0.58%) compared with levels in white subjects (5.90±0.40%).ConclusionIn subjects with similar fasting and postprandial glycaemia on OGTT, those of South Asian origin have higher HbA1clevels than white subjects. It is speculated that the higher glycaemia-independent HBA1clevels in people of South Asian origin could possibly contribute to their increase cardiovascular risk.
Natural killer cell cytotoxicity in patients with recurrent herpes infections: diagnostic utility of a flow cytometric assay
Authors: Devlin L A , Haughton D J , Crockard A D , Edgar J D M 
Published: March 2010

BackgroundPrimary immune deficiencies of natural killer (NK) cells have been described in patients with a susceptibility to herpes infections.AimsTo assess the diagnostic utility of measurement of NK cytotoxicity in patients with recurrent oral herpes infections.MethodsA retrospective audit was carried out on results obtained over an 18-month period, from 28 NK cell cytotoxicity assays (24 patients; all with a history of recurrent oral herpes infections), and 24 control samples (three healthy donors). Percentage specific cytotoxicity (PSC) was determined by measurement of the percentage of K562 target cells lysed by NK cells after incubation, using the NK TEST. Comparison of PSC was made with reference ranges provided.ResultsNo patient with absent NK/NKT cells or NK cell cytotoxicity was identified (95% CI 0 to 14.8%). Two patients had persistently low PSC. Two patients with reduced PSC showed PSC within the normal reference range on repeat testing. Patient and control samples were seen both above and below the reference ranges. A relationship was expected between NK cell percentage and PSC; however this correlation was not significant (rs=0.29, p=0.18, 95% CI −0.14 to 0.63).ConclusionsA deficiency of NK cell cytotoxicity has not been identified in this cohort. An apparent reduction in cytotoxicity may be due to normal interpersonal and intersample variability in NK cytotoxicity. Without reference ranges established from a large population of control samples to account for this, a reduction in PSC is difficult to define. Further studies are required to identify if a correlation exists between the percentage of NK cells and PSC.
The clinicopathological characteristics of ‘triple-negative’ epithelial ovarian cancer
Authors: Liu Naifu , Wang Xingwu , Sheng Xiugui 
Published: March 2010

Background‘Triple-negative’ is traditionally used to define a specific subtype of breast cancer with negative oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-type 2 (HER2) expressions. ER/PR and HER2 testing is also widely used in the informative classification of ovarian cancer.AimTo investigate whether a ‘triple-negative’ subtype also exists in ovarian cancer.MethodsER, PR and HER2 expressions in 116 Chinese women with primary epithelial ovarian cancer were reviewed. Triple-negative epithelial ovarian cancer (TNEOC) was defined based on negative ER, PR and HER2 expression. The clinicopathological characteristics and Ki-67, P53 and epidermal growth factor receptor (EGFR) expression in the TNEOC and non-TNEOC group were compared.Results15.5% of cases (18/116) were identified as TNEOC among 116 ovarian carcinomas. Histological grade 3 was found in a higher percentage of the TNEOC than of the non-TNEOC group (94.4% vs 62.2%). TNEOC also correlated with a high level of Ki-67 and p53 expression. EGFR overexpression and other clinicopathological characteristics were not significantly associated with TNEOC subtype. TNEOC was associated with a shorter progression free survival and overall survival in univariate and multivariate analyses.ConclusionsA novel subtype of ovarian carcinoma, which is negative for ER, PR and HER2 expression, has been identified; this specific ovarian subtype tends to have aggressive characteristics and a poor prognosis, which is similar to triple-negative breast cancer in most respects. TNEOC should be considered in future investigations of informative classification of ovarian cancer.