bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perfusion for cardiac transplantation
Authors: Wheeldon DR , Bethune DW , Gill RD 
Published: November 2007

The optimum support of patients undergoing cardiac or cardiopulmonary transplantation requires particular consideration of various aspects of perfusion management. Many of these patients have chronic low cardiac output and consequent renal, hepatic and pulmonary dysfunction. Cyclosporin A is now the cornerstone of most immunosuppressive regimes and a major side effect of this drug is it's nephrotoxicity. 1 A technique is described which is designed to optimize perfusion support for this group of patients. Cardiac transplantation does not usually present a difficult technical surgical challenge. The subsequent success of the procedure depends largely on appropriate donor and recipient selection and attention to the finer points of patient management, and in particular the fine tuning of immunosuppressive therapy. The provision of optimum perfusion support has a substantial influence on early postoperative progress, particularly in those patients with preoperative multiorgan failure, secondary to a low cardiac output.
Clinical evaluation of the Sarns membrane oxygenator
Authors: Zacour Richard K 
Published: November 2007

A new membrane oxygenator, developed by Travenol Laboratories, has been introduced by Sarns/3M. The oxygenator is constructed of microporous polypropylene hollow fibres wound into a gas transfer module with an effective surface area of 1.8m2 and a total priming volume of 320ml. This was made possible by using computer-aided design techniques. Blood flow is perpendicular over the fibre in the module while the gas flow is directed within the fibres. The unit contains an integral stainless steel heat exchanger mounted beneath the fibre module. A selection of collapsible venous reservoirs is available to fulfil various patient requirements. The oxygenator and venous reservoir bag are mounted on a wire frame holder that can be arranged in any direction on the heart lung machine. The circuit was primed with 1800ml of a balanced electrolyte solution, 200ml of 25% albumin and 200ml of 25% mannitol, to which 4000 units of beef lung heparin were added. The 1000ml reservoir was used in all cases. Seventeen consenting adult patients undergoing elective cardiac surgery participated in the clinical evaluation. Haematology and organ function studies indicated no significant changes attributable to the oxygenator. The mean postbypass plasma-free haemoglobin elevation was 8.2mg/dl. The mean postbypass haematocrit and platelet count reduction were 21 % and 27% respectively, indicating that platelet count tended to follow haemodilution with minimal loss. There were no gas exchange nor acid-base problems encountered. The mean PaO2 and PaCO 2 were 267mmHg and 42mmHg respectively with a maximum O2 transfer of 241 ml/min during the study.
Pulsatile compared with nonpulsatile perfusion using a centrifugal pump for cardiopulmonary bypass during coronary artery bypass grafting. Effects on systemic haemodynamics, oxygenation, and inflammatory response parameters
Authors: Driessen JJ , Dhaese H. , Fransen G. , Verrolst P. , Rondelez L. , Gevaert L. , van Becelaere M. , Scheistraete E. 
Published: November 2007

The present study investigated the influence of pulsatile or nonpulsatile flow delivery with a centrifugal pump for cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG) in two randomized groups of 19 patients each. All patients received a standard anaesthetic and surgical protocol. Pulsatile perfusion during CPB was created by accelerating the baseline pump speed of the Sarns centrifugal pump at a rate of 50 cycles per minute. Measurements included perioperative systemic haemodynamics and oxygen exchange, total haemolytic complement (CH 50), polymorphonuclear (neutrophil) granulocyte (PMN) count and plasma granulocyte elastase bound to α1-proteinase inhibitor (E-α 1-PI). Laboratory measurements were corrected for haemodilution. During and after CPB there were only a few significant differences between the groups in systemic haemodynamics and oxygenation, i.e. a lower mean arterial blood pressure after the end of CPB in the nonpulsatile group (65 mmHg, SD = 11 vs 76 mmHg, SD = 11) and a lower SvO2 during rewarming on CPB in the nonpulsatile group (62%, SD = 8 vs 67%, SD = 8). The decrease in percentage of PMNs in the total white blood cell count during CPB was greater in the nonpulsatile group than in the pulsatile group (from 61 to 46% vs 63 to 53% of prebypass value). The steep increase of PMN count at the end of CPB and postoperatively was comparable in both groups. The maximal decrease of CH50 levels, occurring after surgery, was significantly higher in the nonpulsatile group (70%, SD = 15 vs 79%, SD = 16, of baseline value), suggesting a greater complement activation. E-α1-PI levels increased significantly in both groups during and after CPB with higher peak levels, obtained at one hour after admission to an intensive care unit, in the nonpulsatile group (316 μg/l, SD = 102) than in the pulsatile group (247 μg/l, SD = 106). There was a partly inverse correlation between the peak postoperative elastase levels and the PaO2/FiO2 ratios at the first postoperative morning. This ratio was significantly lower in the nonpulsatile group (211, SD = 56) than in the pulsatile group (247, SD = 62). Postoperative respiratory tract infection was more frequent in the nonpulsatile group (n = 9) than in the pulsatile group (n = 2). Adding a pulsatile component to centrifugal blood pumping during CPB may have benefits with regard to the possibly detrimental whole body inflammatory response to CPB. Further studies are warranted to investigate whether these differences will affect clinical outcome.
Physical dependence of cancer patients at home
Authors: Beck-Friis Barbro , Strang Peter , Eklund Gunnar 
Published: November 2007

During the period 1977-1986, a total of 179 patients with terminal cancer were cared for by the hospital-organized home care programme in Motala. At the time of their registration, 78 patients needed assistance with 0-3 ADL (activities of daily living) functions and 101 needed help with 4-6 functions. Altogether 168 (94%) patients could be classified according to groups A-G in the ADL classification by Katz, whereas only 11 were classified to the 'Others' category. Consequently, the loss of function among the terminal cancer patients followed a predetermined, hierarchical order, as described by Katz. The mental stress, need of assistance and length of care required by the patients, as well as survival periods, correlated significantly with the ADL level. Neither age, sex, nor type of cancer diagnosis influenced the ADL status, which is thus a tangible measure of the function impairment of cancer patients.
Can home care maintain an acceptable quality of life for patients with terminal cancer and their relatives?
Authors: Hinton John 
Published: November 2007

This prospective study was designed to assess whether patients with terminal cancer, and their relatives, find that competent home care sufficiently maintains comfort and helps adjustment. A random sample from a home care service with readily available beds comprised 77 adults and their relatives who were able and willing to be interviewed separately each week. They were asked the nature and degree of current problems and regular assessments were made of some qualities of life including mood, attitude to the condition, perceived help and preferred place of care. These patients had 90% of their care at home; 29% died at home but 30% were finally admitted for one to three days and 41 % for longer. In the final eight weeks, tolerable physical symptoms were volunteered by a mean of 63% each week and psychological symptoms by 17%. Some distress was felt by 11 % of patients; this was usually from pain, depression, dyspnoea, anxiety or weakness, and generally did not persist. Relatives suffered grief, strain or their own ill health. Patients' and relatives' reports generally matched except for the strain on carers. Regular assessments found that 64% of patients thought death certain or probable, and 27% thought it possible. Various proportions coped by optimism, fighting their disease, partial suppression or denial, but 50% reached positive acceptance. Relatives were more aware and accepting. About three-quarters of patients and half the relatives were composed, often enjoying life. Serious depression affected 5% of patients and anxiety 4%, but relatives' manifest depression in the later stages increased to 17% and anxiety to 14%. Many consciously disguised their feelings. Treatment was usually praised but realistic preference for home care fell steadily from 100% to 54% of patients and 45% of relatives. At follow-up most relatives approved of where patients had received care and died.
The language of images in geography
Authors: Philips R.S. 
Published: November 2007

In the cities in which we live, all of us see hundreds of publicity images every day of our lives.... In no other form of society has there been such a concentration of images, such a density of visual messages (Berger, 1972: 129). My first image of the Canadian West was from a picture on a calendar in our farmhouse in southern Ontario. The image was of a field of golden wheat blowing in the wind under a sunny and azure sky (Francis, 1989: xv). A strong corporate image influences the predisposition to buy a company's products, speak favourably of it, believe its statements, apply for a job with it, and the like (Worcester, 1986: 604). The spectacle is capital to such a degree of accumulation that it becomes an image (Debord, 1977: thesis 34). With the emergence of a truly spectacular body of experiments, imagery is one of the hottest topics in cognitive science (Block, 1981: 1).
In vitro type-1 and type-2 cytokine production in systemic lupus erythematosus: lack of relationship with clinical disease activity
Authors: Barcellini W. , Rizzardi GP , Borghi MO , Nicoletti F. , Fain C. , Del Papa N. , Meroni PL 
Published: November 2007

Objective: to investigate the relationship between disease activity and in vitro cytokine, soluble(s)CD23 and polyclonal and anti-DNA antibody production by PBMC from patients with active systemic lupus erythematosus (SLE). Methods: cytokines, sCD23 and immunoglobulins were estimated by ELISA in unstimulated and polyclonal mitogen-stimulated culture supernatants. Results: PHA-induced IL-2 and IFN-y production were decreased, whereas spontaneous and PHA-induced IL-6 and IL-10 production were increased in cultures of SLE lympho cytes. Conversely, spontaneous and PHA-stimulated IL-4 and sCD23 production was com parable between patients and controls. Finally, we found an increase in in vitro spontaneous polyclonal and anti-DNA IgG secretion. Conclusions: We demonstrated an expanded type-2 cytokine profile with no correlation with parameters of disease activity.
Methotrexate use in systemic lupus erythematosus
Authors: Kipen Y. , Littlejohn GO , Morand EF 
Published: November 2007

Low dose pulse oral methotrexate (MTX) is a well established treatment for rheumatoid arthritis, and short term open studies have suggested beneficial effects of MTX in SLE. This study was designed to investigate MTX treatment maintenance rates in SLE using life table analysis, and to determine whether MTX use was associated with a dose reduction of concomitant steroid therapy. All SLE patients managed by physicians affiliated with a single centre were studied cross- sectionally. Information regarding disease variables and drug use were ascertained by interview and chart review. Drug therapy data including dates of treatment and indications for treatment were analysed using Kaplan-Keier life table methods. Among 101 subjects with SLE, 25 MTX treatment episodes were observed in 24 subjects. The period studied totalled 19 766 patient-days, with a median (range) duration of observed MTX treatment of 14.4 (5.1-41.6) months. The median (range) initial and peak MTX doses with 7.5 (2.5- 10)mg/wk and 10 (7.5-15)mg/week respectively. The principal indication for commencing methotrexate therapy was arthritis. Only two subjects terminated treatment for toxicity, with the most common reason for termination being remission. The cumulative probability of continuing treatment was 68% at 12 months and 61 % at 24 months, or 75% and 71 % respectively if cessations for remission were excluded. The median (interquartile range) monthly steroid intake during MTX therapy [279.4 (193.4-492.9) mg] was somewhat lower than during the 6 months prior to [298.1 (237.9-531.4)428.8) mg] MTX therapy, but this difference was not significant. A total of 36% of subjects reduced their steroid dose during MTX therapy, but this reduction was not significant. Treatment of SLE with MTX, predominantly for arthritis, was well tolerated over prolonged periods of observation. Toxicity of sufficient severity to lead to treatment termination was uncommon. A subset of subjects were able to reduce steroid intake during MTX therapy, but no overall reduction in steroid dose was observed.
A comparison of methods for fixed effects meta-analysis of individual patient data with time to event outcomes
Authors: Tudur Smith Catrin , Williamson Paula Ruth 
Published: November 2007

Background Alternative methods for individual patient data (IPD) meta-analysis of time-to-event outcomes have been established and utilized in practice. The most common approach is a stratified log-rank analysis. The IPD approach is considered to be the gold standard approach for meta-analysis and is becoming increasingly more popular but the performance of different methods has not been studied previously. Purpose To compare commonly used methods for fixed effects meta-analysis of individual patient time-to-event data. Methods The stratified log-rank analysis, an inverse variance weighted average of Cox model estimates, and the stratified Cox regression model are compared. First, a theoretical comparison of approaches is undertaken. Second, the bias and coverage are assessed for the pooled hazard ratio using simulated data under commonly encountered meta-analysis conditions. Finally, a comparison is presented using empirical data from four separate systematic reviews of anti-epileptic drug trials where IPD are available for two time-to-event outcomes. Results For hazard ratio close to 1 with minimal heterogeneity between trials, theoretical results suggest similar results should be expected from all the three methods. Results for empirical and simulated data are in keeping with the theoretical results and show all the three methods perform well under these conditions. When there is no heterogeneity and the proportional hazards assumption holds, the stratified Cox model and inverse variance weighted average produce similar estimates of the pooled treatment effect and are to be preferred to the stratified log-rank analysis when the underlying treatment effect is large. Coverage values diminish for all the three methods and are below 95% for low or moderate heterogeneity. The low coverage values highlight the need for models that appropriately account for or explore the between trial variation. Limitations Until larger simulations can be undertaken, conclusions based on the simulated and empirical data should only be applied to small meta-analyses of four or five trials. Conclusions These investigations suggest that under normal conditions all three methods provide similar results. For moderate heterogeneity coverage for all the three fixed effects models depreciates. Clinical Trials 2007; 4: 621—630. http://ctj.sagepub.com
The biographical impact of teenage and adolescent cancer
Authors: Grinyer Anne 
Published: November 2007

Objectives: This paper offers an overview of the findings of research into the experience of having cancer in adolescence and young adulthood, the aims of which were to understand how age and life stage affect the illness experience and impact upon biographies and life trajectories. Methods: The data were gathered primarily through the use of in-depth qualitative interviews with adolescents and young adults with cancer, but also through the submission of a small number of written narratives. Results: Acute and life-threatening illness at a transitional life stage on the threshold of adulthood can have a long-term, and therefore chronic, effect on the life trajectories and biographies of young adult cancer patients. Many aspects of the participants' lives were affected, including education, careers, life plans, friendship networks, appearance, sexuality and fertility. The economic effects could also be far-reaching and contribute to a loss of independence, which is very fragile in this age-group. Conclusions: While recognizing the potentially devastating impact of cancer at any age, the research findings suggest a distinct effect in adolescence and young adulthood resulting from a disrupted biography at a critical transitional moment in the life trajectory that can have a chronic effect after the acute stage of the illness is passed. An age-appropriate approach to the care of young people with cancer that takes into account the distinct effects of life stage in this age-group can mitigate the negative impact on life trajectories and maximize the chances of adherence and a return to normal life after recovery.
Characterization of the innate immune response to chronic aspiration in a novel rodent model
Authors: Appel James Z , Lee Sean M , Hartwig Matthew G , Li Bin , Hsieh Chong-Chao , Cantu Edward , Yoon Yonghan , Lin Shu S , Parker William , Davis R Duane 
Published: November 2007

Abstract

Background
Although chronic aspiration has been associated with several pulmonary diseases, the inflammatory response has not been characterized. A novel rodent model of chronic aspiration was therefore developed in order to investigate the resulting innate immune response in the lung.

Methods
Gastric fluid or normal saline was instilled into the left lung of rats (n = 48) weekly for 4, 8, 12, or 16 weeks (n = 6 each group). Thereafter, bronchoalveolar lavage specimens were collected and cellular phenotypes and cytokine concentrations of IL-1alpha, IL-1beta, IL-2, IL-4, IL-6, IL-10, GM-CSF, IFN-gamma, TNF-alpha, and TGF-beta were determined.

Results
Following the administration of gastric fluid but not normal saline, histologic specimens exhibited prominent evidence of giant cells, fibrosis, lymphocytic bronchiolitis, and obliterative bronchiolitis. Bronchoalveolar lavage specimens from the left (treated) lungs exhibited consistently higher macrophages and T cells with an increased CD4:CD8 T cell ratio after treatment with gastric fluid compared to normal saline. The concentrations of IL-1alpha, IL-1beta, IL-2, TNF-alpha and TGF-beta were increased in bronchoalveolar lavage specimens following gastric fluid aspiration compared to normal saline.

Conclusion
This represents the first description of the pulmonary inflammatory response that results from chronic aspiration. Repetitive aspiration events can initiate an inflammatory response consisting of macrophages and T cells that is associated with increased TGF-beta, TNF-alpha, IL-1alpha, IL-1beta, IL-2 and fibrosis in the lung. Combined with the observation of gastric fluid-induced lymphocyitic bronchiolitis and obliterative bronchiolitis, these findings further support an association between chronic aspiration and pulmonary diseases, such as obliterative bronchiolitis, pulmonary fibrosis, and asthma.
Differential gene expression profile in pig adipose tissue treated with/without clenbuterol
Authors: Zhang Jin , He Qiang , Liu Qiu Y , Guo Wei , Deng Xue M , Zhang Wei W , Hu Xiao X , Li Ning 
Published: November 2007

Abstract

Background
Clenbuterol, a beta-agonist, can dramatically reduce pig adipose accumulation at high dosages. However, it has been banned in pig production because people who eat pig products treated with clenbuterol can be poisoned by the clenbuterol residues. To understand the molecular mechanism for this fat reduction, cDNA microarray, real-time PCR, two-dimensional electrophoresis and mass spectra were used to study the differential gene expression profiles of pig adipose tissues treated with/without clenbuterol. The objective of this research is to identify novel genes and physiological pathways that potentially facilitate clenbuterol induced reduction of adipose accumulation.

Results
Clenbuterol was found to improve the lean meat percentage about 10 percent (P < 0.05). The adipose cells became smaller and the muscle fibers became thicker with the administration of clenbuterol. The mRNA abundance levels of 82 genes (ESTs) were found to be statistically differentially expressed based on the Student t-test (P < 0.05) in the microarray analyses which contained 3358 genes (ESTs). These 82 genes (ESTs) were divided into four groups according to their Gene Ontology Biological Process descriptions. 16 genes were cellular metabolism related genes (including five related to lipid metabolism such as apolipoprotein D and apolipoprotein R), 10 were signal transduction related genes, 45 were expressed sequence tags (ESTs) and 11 others were of various categories. Eleven of the 82 genes (ESTs) were chosen for real-time PCR analysis, with eight genes showing similar induction magnitude as that seen in the microarray data. Apolipoprotein R was also found to be up-regulated by the proteomic analysis.

Conclusion
Pig fat accumulation was reduced dramatically with clenbuterol treatment. Histological sections and global evaluation of gene expression after administration of clenbuterol in pigs identified profound changes in adipose cells. With clenbuterol stimulation, adipose cell volumes decreased and their gene expression profile changed, which indicate some metabolism processes have been also altered. Although the biological functions of the differentially expressed genes are not completely known, higher expressions of these molecules in adipose tissue might contribute to the reduction of fat accumulation. Among these genes, five lipid metabolism related genes were of special interest for further study, including apoD and apoR. The apoR expression was increased at both the RNA and protein levels. The apoR may be one of the critical molecules through which clenbuterol reduces fat accumulation.
Chondromyxoid fibroma of rib with a novel chromosomal translocation: a report of four additional cases at unusual sites
Authors: Armah Henry B , McGough Richard L , Goodman Mark A , Gollin Susanne M , Surti Urvashi , Parwani Anil V , Rao Uma NM 
Published: November 2007

AbstractBackgroundChondromyxoid fibromas (CMFs) are rare benign chondroid/myxoid matrix-producing tumors that occur in metaphyses of long tubular bones, and very rarely in small bones of hands and feet. Flat bone involvement is even more uncommon. Prior cytogenetic analyses have identified complex abnormalities involving chromosome 6 in the majority of cases.MethodsA search for CMF over an 8-year period (1999–2006) from the surgical pathology files of our institution yielded 16 cases. Four cases occurred in relatively unusual regions, three from the small bones of distal extremities and one from the rib. The rib lesion wassubmitted forroutinecytogenetic analysis.ResultsRadiographic studies revealed that all four lesions were well-defined expansile radiolucent lesions which expanded the bony cortices with lobulated margins, sclerotic rim, septation, and no calcification. Morphologically, all four lesions showed typical features of CMF and had low proliferative index with Ki-67. Cytogenetic analysis on the rib lesion revealed a novel chromosomal translocation, t(1;5)(p13;p13). None of the four patients had a recurrence after a mean duration of follow-up of 24 months.ConclusionCMF originating in unusual locations should be distinguished from chondrosarcomas, especially on small biopsies, and should be included in the differential diagnosis. As previously noted in the literature, the cells can be positive for actin but unlike conventional chondroid neoplasms can be negative for S-100. To our knowledge, this is the first report describing a novel chromosomal translocation, t(1;5)(p13;p13) in CMF.