bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vascular Pattern and Spectral Parameters of Power Doppler Ultrasound as Predictors of Malignancy Risk in Thyroid Nodules
Authors: Bakhshaee Mehdi , Davoudi Yasamin , Mehrabi Mostafa , Layegh Parvin , Mirsadaee Saadat , Rad Masoud Pezeshki , Leyegh Parvaneh 
Published: November 2008

AbstractIntroduction: Determination whether spectral Doppler ultrasound parameters, including resistance index (RI) and pulsatility index (PI), or vascular pattern can be used to distinguish malignant from benign thyroid nodules.Materials and Methods: We prospectively examined 85 thyroid nodules in patients undergoing surgery. The flow pattern seen via power Doppler examination was ranked for each nodule on a scale of 0 to 4 as follows: absent, perinodular alone, mixed with perinodular prominency, mixed with intranodular prominency, and exclusively intranodular, respectively. For each nodule, the RI and PI values were recorded as the average of the recordings obtained. Pathological examination were used as a proof of final diagnosis to categorize all nodules as benign or malignant.Results: The malignant nodules had a mean RI of 0.72 ± 0.13. These values were significantly higher than those associated with benign nodules (0.60 ± 0.08) (P = .000). Malignant nodules had a mean PI of 1.15 ± 0.33 that were also significantly different from those associated with benign nodules (0.91 ± 0.19) (P = .000). Shifting to intranodular vascularization had a significant correlation with malignancy (P = .001).Conclusion: Spectral parameter and vascular pattern are useful to distinguish malignant from benign thyroid nodules, especially for those with suspicious or undetermined fine‐needle aspiration biopsy.
Desmopressin responsiveness in children with Ehlers‐Danlos syndrome associated bleeding symptoms
Authors: Mast Kelley J. , Nunes Mark E. , Ruymann Frederick B. , Kerlin Bryce A. 
Published: November 2008

SummaryEhlers‐Danlos Syndrome (EDS) is caused by heritable collagen defects and may be associated with bleeding symptoms. Desmopressin has been described in case reports to decrease bleeding times in these patients. This study sought to assess bleeding time responsiveness to desmopressin therapy in a cohort of children with EDS‐associated bleeding manifestations. A retrospective chart review of children with EDS referred for bleeding symptoms was utilized. Twenty‐six children were included; 19 (73%) had a desmopressin challenge. The mean bleeding time was 11·26 (±4·39) min, decreasing to 5·95 (±2·41) min with treatment (P < 0·01). Desmopressin normalizes bleeding times in children with EDS.
Efficacy of a combination of human recombinant erythropoietin + 13‐cis‐retinoic acid and dihydroxylated vitamin D3 to improve moderate to severe anaemia in low/intermediate risk myelodysplastic syndromes
Authors: Ferrero Dario , Darbesio Antonella , Giai Valentina , Genuardi Mariella , Dellacasa Chiara Maria , Sorasio Roberto , Bertini Marilena , Boccadoro Mario 
Published: November 2008

SummaryThe efficacy of human recombinant erythropoietin (rEPO) in myelodysplastic syndromes (MDS) has generally been best in untransfused patients with ‘refractory anaemia’ according to the World Health Organization (WHO). We treated 63 MDS patients [excluding refractory anaemia with excess blasts, type 2 (RAEB2)] with a previously tested combination of 13‐cis‐retinoic acid and dihydroxylated vitamin D3 ± 6‐thioguanine in addition to rEPO. Most patients were categorized as refractory cytopenia with multilineage dysplasia and RAEB1, with intermediate 1 International Prognostic Scoring System (IPSS) score; all had Hb <95 g/l, and 70% required regular erythrocyte transfusions. Treatment was well tolerated, and erythroid response rate according to new International Working Group criteria was 60%: 50% in RAEB1 and 64% in non‐RAEB patients (P = 0·383). Response rate was not affected by transfusion requirement (63%; 58% in untransfused), IPSS and WHO Prognostic Scoring System scores, and weekly rEPO dosage (30–50 000 U vs. 80 000 U). Median response duration was 16 months. Median survival reached 14 months for RAEB1 and 55 months for non‐RAEB patients, with a significant difference in the latter between responders and non‐responders (median 82 months vs. 44 months; P = 0·036). Our combined therapy, independent of rEPO dosage, achieved in patients with unfavourable response predictors, a rate of anaemia improvement comparable to the best obtained in lower risk patients by high‐dose rEPO.
Dysregulated repair in asthmatic paediatric airway epithelial cells: the role of plasminogen activator inhibitor‐1
Authors: Stevens P. T. , Kicic A. , Sutanto E. N. , Knight D. A. , Stick S. M. 
Published: November 2008

SummaryBackground
Asthma is associated with structural changes to airways such as extracellular matrix deposition and epithelial damage. Evidence suggests that asthmatic airway epithelial repair is abnormal and that elevated plasminogen activator inhibitor‐1 levels observed in asthma may be involved in the epithelial repair process and in excessive matrix accumulation.Objective
To assess the ability of asthmatic airway epithelial cells (AECs) to repair mechanically induced wounds and to investigate the role that plasminogen activator inhibitor‐1 plays in the repair process.Methods
AECs were isolated from atopic asthmatic and healthy non‐atopic children by bronchial brushing, subcultured and wound repair experiments were performed. Plasminogen activator inhibitor‐1 gene expression was assessed using real‐time PCR while protein activity was measured in cell lysates as well as plasma. The role of plasminogen activator inhibitor‐1 in epithelial proliferation and wound repair was investigated using siRNA.Results
Cells from asthmatic children have a significantly longer repair time in comparison with cells from otherwise healthy donors. Plasminogen activator inhibitor‐1 mRNA expression was up‐regulated 68‐fold in freshly isolated asthmatic cells compared with normal cells, and protein levels were also significantly elevated in the asthmatic cell lysates, but plasma levels were similar in both groups. Plasminogen activator inhibitor‐1 cells expression increased in both cohorts during culture. Gene silencing substantially reduced the rate of proliferation in asthmatic and healthy cells. Mechanical wounding of epithelial monolayers induced plasminogen activator inhibitor‐1 expression in asthmatic and non‐asthmatic cohorts, while gene silencing delayed wound repair of healthy cell, with minimal effect on those from asthmatics.Conclusion
Asthmatic AECs are inherently dysfunctional in their ability to repair wounds; plasminogen activator inhibitor‐1 mRNA and protein activity are constitutively up‐regulated in asthmatic epithelium and play functional roles in both proliferation and repair of healthy cells. In asthmatic cells, elevated plasminogen activator inhibitors‐1 levels fail to stimulate epithelial repair.
Immunomodulatory therapy of eosinophil‐associated gastrointestinal diseases
Authors: Stone K. D. , Prussin C. 
Published: November 2008

SummaryEosinophil‐associated gastrointestinal disorders (EGIDs), including eosinophilic esophagitis (EE) and eosinophilic gastroenteritis (EG), are a spectrum of increasingly recognized inflammatory diseases characterized by gastrointestinal symptoms and eosinophilic infiltration of the gastrointestinal tract. Significant morbidity is associated with the development of esophageal strictures in some patients. Immune‐mediated reactions to food allergens appear to drive the inflammation in a subset of patients, especially those with solitary EE, but dietary interventions remain difficult in EE and are less effective in EG. Despite the increasing incidence of these disorders and their increased recognition by physicians, there are currently no medications that either United States or European Union regulatory agencies have specifically approved for use in EGIDs. This lack of safe and effective therapies for EGIDs is a major obstacle in the care of these patients and underscores the need for new therapeutic approaches. This review briefly discusses the currently available ‘off label’ drug treatments for EGIDs, most notably topical and systemic corticosteroids. Pathogenesis studies of EGIDs suggest possible therapeutic targets, and conversely, clinical trials of mechanistically‐targeted therapeutics give insight into disease pathogenesis. Thus, EGID pathogenesis is discussed as an introduction to mechanistically‐targeted immunotherapeutics. The two biologic categories that have been used in EGIDs, anti‐IgE (omalizumab) and anti‐IL‐5 (SCH55700/reslizumab and mepolizumab), are discussed. Because there are similarities in the pathogenesis of EGIDs with asthma and atopic dermatitis, biologic therapeutics currently in early trials for asthma management are also briefly discussed as potential therapeutic agents for EGIDs. Given the deficiencies of current therapeutics and the rapidly advancing knowledge of the pathogenesis of these disorders, EGIDs are an ideal model for translating recent advances in understanding immunopathogenesis into mechanistically‐based therapeutics. Further understanding of the early events in pathogenesis is also needed to develop preventive and disease‐modifying treatments.
Clinical Immunology Review Series: An approach to the patient with angio-oedema
Authors: Grigoriadou S , Longhurst H J 
Published: November 2008

SummaryARTICLES PUBLISHED IN THIS CLINICAL IMMUNOLOGY REVIEW SERIESallergy in childhood, allergy diagnosis by use of the clinical immunology laboratory, anaphylaxis, angioedema, management of pulmonary disease in primary antibody deficiency, recurrent infections in childhood, recurrent infections in adulthood, recurrent oro-genital ulceration, recurrent superficial abscesses, SLE and Sjögren's syndrome, urticaria, vasculitis/CTDAngio-oedema is a common reason for attendance at the accident and emergency department and for referral to immunology/allergy clinics. Causative factors should always be sought, but a large proportion of patients have the idiopathic form of the disease. A minority of patients represent a diagnostic and treatment challenge. Failure to identify the more unusual causes of angio-oedema may result in life-threatening situations. Common and rare causes of angio-oedema will be discussed in this article, as well as the diagnostic and treatment pathways for the management of these patients. A comprehensive history and close monitoring of response to treatment are the most cost-effective diagnostic and treatment tools.
Short-term anti-CD25 monoclonal antibody administration down-regulated CD25 expression without eliminating the neogenetic functional regulatory T cells in kidney transplantation
Authors: Wang Z , Shi B-Y , Qian Y-Y , Cai M , Wang Q 
Published: November 2008

Summary
CD4+CD25+ forkhead box P3 (FoxP3)+regulatory T (Treg) cells are generated and play a key role in the induction and maintenance of transplant tolerance in organ recipients. It has been proposed that interleukin (IL)-2/IL-2 receptor (IL-2R) signalling was essential for the development and proliferation of antigen-activated T cells that included both effector T cells and Treg cells. Basiliximab (Simulect™), a chimeric monoclonal antibody directed against the α-chain of the IL-2R (CD25), can be expected to not only affect alloreactive effector T cells, but also reduce the number and function of Treg cells. We therefore examined the effect of basiliximab induction therapy on the number and function of the Treg cells in renal recipients. Basiliximab decreased the percentage of CD4+CD25+T cells, but failed to influence the percentage of CD4+FoxP3+ Treg cells. The cellular CD25 expression was decreased significantly by basiliximab injection, but CD4+CD25+ T cells was not depleted from the circulating pool through monoclonal antibody activation-associated apoptosis. Functional analysis revealed that inhibitory function of Treg cells from recipients with basiliximab injection was not significantly different from recipients without injection. These data indicate that the functional Treg population may not be influenced by short-term basiliximab treatment.
Myocardial perfusion defects in Bartter and Gitelman syndromes
Authors: Scognamiglio R. , Calò L. A. , Negut C. , Coccato M. , Mormino P. , Pessina A. C. 
Published: November 2008

ABSTRACTBackground  Normotensive hypokalaemic tubulopathies (Bartter and Gitelman syndromes (BS/GS)) are genetic diseases that are considered benign. However, QT prolongation, left ventricular dysfunction and reduction of cardiac index upon exercise leading to arrhythmias and sudden cardiac death have been reported in these patients. Hence, we aimed to verifying whether an isometric exercise could represent a useful tool for the identification of patients at risk for future cardiac events.Patients and methods  Myocardial function (MF) and perfusion, evaluated as myocardial blood flow (MBF) of 10 BS/GS patients and 10 healthy controls, were investigated at rest and during isometric exercise. MF and MBF were evaluated using quantitative two‐dimensional and myocardial contrast echocardiography.Results  BS/GS patients had normal baseline MF and MBF. During exercise in BS/GS patients, corrected QT (QTc) was prolonged to peak value of 494 ± 9·1 ms (P < 0·001). In controls, MF increased from resting to peak exercise (left ventricular ejection fraction: 65 ± 4% to 78 ± 5%, P < 0·003) while in seven BS/GS patients (Group 1) it declined (64 ± 5% to 43 ± 9%, P < 0·001). Myocardial perfusion increased upon exercise in controls as shown by changes of its markers: β (a measure of myocardial flow velocity; 0·89 ± 0·12 vs. 0·99 ± 0·12, P < 0·001) and myocardial blood volume (14·4 ± 2 vs. 20·2 ± 0·25, P < 0·001), while in Group 1 BS/GS it decreased (0·87 ± 0·15 vs. 0·67 ± 0·15, P < 0·001; and 14·5 ± 1·9 vs. 8·3 ± 0·22, P < 0·001, respectively).Conclusions  Our results document for the first time that exercise induce coronary microvascular and myocardial defects in BS/GS patients. Therefore, this may challenge the idea that BS/GS are benign diseases. In addition, the diagnostic approach to these syndromes should include an in‐depth cardiac assessment in order to identify patients at higher risk.
The prognostic relevance of preoperative transcatheter arterial chemoembolization (TACE) and PCNA/VEGF expression in patients with Wilms’ tumour
Authors: Liu W.‐G. , Gu W.‐Z. , Zhou Y.‐B. , Tang H.‐F. , Li M.‐J. , Ma W.‐X. 
Published: November 2008

ABSTRACTBackground  Wilms’ tumour is the most frequent renal tumour in children. Based on the SIOP strategy, children with Wilms’ tumour may benefit from preoperative chemotherapy, but few publications address the effect of preoperative transcatheter arterial chemoembolization (TACE) on patients with Wilms’ tumours. The aims of this study were to investigate the prognostic relevance of preoperative TACE followed by tumour resection, proliferating cell nuclear antigen (PCNA) and vascular endothelial growth factor (VEGF) expression in patients with Wilms’ tumours.Materials and methods  Two therapeutic strategies including tumour resection only and TACE, followed by tumour resection were conducted in a cohort of 44 patients with Wilms’ tumours. Clinical and follow‐up data was analysed. Immunohistochemistry staining was used to explore PCNA and VEGF expression in the Wilms’ tumour.Results  Two years tumour‐free survival of the patients in the TACE group was significantly higher than that of the patients in the control group (P < 0·001) and recurrence and cases of death within one year in the TACE group was markedly lower than that in the control group (P < 0·001). Fifty‐five percent of patients in the control group were PCNA‐positive vs. 4·17% of patients in the TACE group (P < 0·001). Fifty percent of patients in the control group were VEGF‐positive vs. 29·17% of patients in the TACE group (P > 0·05).Conclusions  Patients with Wilms’ tumours benefited from preoperative TACE treatment. PCNA expression was significantly lower in patients in the TACE group than those in the control group. There was no significant difference on VEGF expression between the patients in TACE and control groups.
Delayed complete remission in a patient with multiple myeloma
Authors: Ria R. , Vacca A. , Mangialardi G. , Dammacco F. 
Published: November 2008

AbstractWe report a strikingly positive, late response to bortezomib in conjunction with pegylated liposomal doxorubicin in a 79‐year old woman with multiple myeloma (MM). The patient obtained a partial remission after eight courses of therapy and a complete remission about 10 months after the end of therapy.This delayed complete remission may be similar to the spontaneous regression reported for other malignancies such as melanoma or lymphoma. We postulate that the immune response and a persistent anti‐angiogenic effect of bortezomib could well explain the delayed complete remission in our patient.
Cardiac performance during exercise in patients with Fabry's disease
Authors: Spinelli L. , Nicolai E. , Acampa W. , Imbriaco M. , Pisani A. , Rao M. A. E. , Scopacasa F. , Cianciaruso B. , De Luca N. , Cuocolo A. 
Published: November 2008

ABSTRACTBackground  Fatigability and dyspnoea on effort are present in many patients with Fabry's disease. We assessed the determinants of cardiac performance during exercise in patients with Fabry's disease and preserved left ventricular ejection fraction at rest.Materials and methods  Sixteen patients with Fabry's disease and 16 control subjects underwent radionuclide angiography at rest and during exercise, tissue Doppler echocardiography and magnetic resonance imaging at rest.Results  The exercise‐induced change in stroke volume was +25 ± 14% in controls and +5·8 ± 19% in patients with Fabry's disease (P < 0·001). In 10 patients (group 1), the stroke volume increased (+19 ± 10%), and in 6 patients (group 2) it decreased (–16 ± 9%) with exercise. Patients of group 2 were older, had worse renal function, higher left ventricular mass and impaired diastolic function compared to group 1. The abnormal stroke volume response to exercise in group 2 was associated with a decrease in end‐diastolic volume (P < 0·001) and a lack of reduction of end‐systolic volume (P < 0·01) compared with both controls and group 1. The ratio of peak early‐diastolic velocity from mitral filling to peak early‐diastolic mitral annulus velocity was the only independent predictor of exercise‐induced change in stroke volume (B –0·44; SE 0·119; β–0·70; P < 0·005).Conclusions  The majority of patients with Fabry's disease were able to augment stroke volume during exercise by increasing end‐diastolic volume, whereas patients with more advanced cardiac involvement may experience the inability to increase cardiac output by the Frank Starling mechanism.
Dissolved organic carbon and nitrogen dynamics in temperate coniferous forest plantations
Authors: Jones D. L. , Hughes L. T , Murphy D. V. , Healey J. R. 
Published: November 2008

SummaryDissolved organic matter (DOM) plays a central role in driving many chemical and biological processes in soil; however, our understanding of the fluxes and composition of the DOM pool still remains unclear. In this study we investigated the composition and dynamics of dissolved organic carbon (DOC) and nitrogen (DON) in five temperate coniferous forests. We subsequently related our findings to the inputs (litterfall, throughfall, atmospheric deposition) and outputs (leaching, respiration) of C and N from the forest and to plant available sources of N. With the exception of NO3−, most of the measured soil solution components (e.g. DOC, DON, NH4+, free amino acids, total phenolics and proteins) progressively declined in concentration with soil depth, particularly in the organic horizons. This decline correlated well with total microbial activity within the soil profile. We calculated that the amount of C lost by soil respiration each day was equivalent to 70% of the DOC pool and 0.06% of the total soil C. The rapid rate of amino acid mineralization and the domination of the low molecular weight soluble N pool by inorganic N suggest that the microbial community is C‐ rather than N‐limited and that C‐limitation increases with soil depth. Further, our results suggest that the forest stands were not N‐limited and were probably more reliant on inorganic N as a primary N source rather than DON. In conclusion, our results show that the size of the DON and DOC pools are small relative to both the amount of C and N passing through the soil each year and the total C and N present in the soil. In addition, high rates of atmospheric N deposition in these forests may have removed competition for N resources between the plant and microbial communities.
Vegetative growth and development of irrigated forage turnip (Brassica rapa var. rapa)
Authors: Neilsen J. E. , Rowe B. A. , Lane P. A. 
Published: November 2008

AbstractField and greenhouse experiments were conducted to identify visual markers and predictors of changes in the vegetative growth rate of forage turnip (Brassica rapa var. rapa) as a potential tool to improve the timing of inputs of N and irrigation to periods of maximum demand. The onset of root expansion, which was associated with a colour change and the death of cotyledons, was identified as a critical marker for the beginning of the rapid growth of the crop and the accumulation of starch in the storage root but indicators of subsequent changes in vegetative growth rate were not identifiable. The results suggested that management inputs can be more readily targeted to the beginning of the exponential growth phase but targeting of later vegetative growth stages will remain arbitrary. The vegetative growth and development of the crop was also studied to elucidate the process of leaf emergence and senescence (turnover) as they affected both leaf and root yield. The sequential senescence of leaves, which began immediately after cotyledon death, and translocation of carbohydrate to the storage root, coupled with high leaf area index (LAI), probably account for the high growth rates of 220 kg ha−1 day−1 maintained for periods of 10 weeks after the onset of root expansion. High yields can be expected if high LAI is maintained by ensuring that leaf emergence rates are not limited by nutrient or water deficiencies and leaves are protected from insect pests. Forage turnip is particularly robust because new leaf continues to emerge as older and damaged leaves senesce and carbohydrate is stored as starch in the storage root.