bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Liposome‐Encapsulated Hemoglobin on Human Immune System: Evaluation in Immunodeficient Mice Reconstituted With Human Cord Blood Stem Cells
Authors: Kawaguchi Akira T. , Kametani Yoshie , Kato Shunichi , Furuya Hiroyuki , Tamaoki Kenichi , Habu Sonoko 
Published: January 2009

AbstractAs preclinical evaluation in animals does not necessarily portray human responses, liposome‐encapsulated hemoglobin (LEH), an artificial oxygen carrier, was tested in immunodeficient mice reconstituted with human hematopoietic stem cells (cord blood‐transfused NOD/SCID/IL‐2Rγnull[CB‐NOG] mice). Changes in immunocompetent T‐cell and B‐cell composition in peripheral blood, spleen, and bone marrow were examined 2 and 7 days after 10 mL/kg of intravenous administration of LEH, empty liposome (EL), or saline using immunohistochemical and flow cytometrical techniques in wild‐type mice and CB‐NOG mice. Responses to intraperitoneal administration of toxic shock syndrome toxin‐1 (TSST‐1) under the absence or presence of LEH (10 mL/kg) were also determined 4 h and 3 days later in terms of lymphocyte composition and IL‐2 plasma level in wild‐type as well as CB‐NOG mice. When liposome (LEH or EL) was administered to wild‐type or CB‐NOG mice, the composition of B‐cells and T‐cells in the spleen or peripheral blood failed to show any consistent or significant changes. The responses to a bacterial antigen (TSST‐1) measured by IL‐2 production were comparable regardless of the presence or absence of LEH in wild‐type as well as in CB‐NOG mice. Cellularity, distribution, and maturation of these human cells in peripheral blood, spleen, and bone marrow were comparable among the groups. The results suggest that simple LEH administration may not change immune cellularity, and LEH presence may not largely affect the early T‐cell response to bacterial enterotoxins in murine as well as in reconstituted human immune systems.
HemoCD as an Artificial Oxygen Carrier: Oxygen Binding and Autoxidation
Authors: Kano Koji , Kitagishi Hiroaki 
Published: January 2009

AbstractDespite many attempts to construct completely artificial systems for carrying oxygen (O2) in aqueous solution, no successful example had been reported until quite recently except for picket fence porphinatoiron(II) embedded in liposomal membrane. We newly prepared a 1:1 complex (hemoCD) of 5,10,15,20‐tetrakis(4‐sulfonatophenyl)porphinatoiron(II) (Fe[II]TPPS) and a per‐O‐methylated β‐cyclodextrin dimer having a pyridine linker (Py3CD). HemoCD binds O2 reversibly in aqueous solution. The oxygen affinity corresponding to the partial O2 pressure, at which half of the hemoCD molecules are oxygenated, was 16.9 torr in phosphate buffer at pH 7.0 and 25°C. Oxy‐hemoCD was gradually autoxidized (t1/2 = 30.1 h) due to nucleophilic attack of a water molecule to the O2–Fe bond. Encapsulation of the iron center of Fe(II)TPPS by two cyclodextrin truncated cones is essential for binding of O2 to the ferrous center of the porphyrin. This manuscript reports the basic characteristics of hemoCD and the possible future utility of a totally artificial O2 carrier.
Which Providers Should Communicate Which Critical Information About a New Medication? Patient, Pharmacist, and Physician Perspectives
Authors: Tarn Derjung M. , Paterniti Debora A. , Williams Bradley R. , Cipri Camille S. , Wenger Neil S. 
Published: January 2009

OBJECTIVES: To investigate older patient, pharmacist, and physician perspectives about what information is essential to impart to patients receiving new medication prescriptions and who should provide the information.DESIGN: Qualitative focus group discussions.SETTINGS: Senior centers, retail pharmacies, and primary care physician offices.PARTICIPANTS: Forty‐two patients aged 65 and older, 13 pharmacists, and 17 physicians participated in eight focus groups.MEASUREMENT: Qualitative analysis of transcribed focus group interviews and consensus through iterative review by multidisciplinary auditors.RESULTS: Patient, pharmacist, and physician groups all affirmed the importance of discussing medication directions and side effects and said that physicians should educate about side effects and that pharmacists could adequately counsel about certain important issues. However, there was substantial disagreement between groups about which provider could communicate which critical elements of medication‐related information. Some pharmacists felt that they were best equipped to discuss medication‐related issues but acknowledged that many patients want physicians to do this. Physicians tended to believe that they should provide most new‐medication education for patients. Patients had mixed preferences. Patients aged 80 and older listed fewer critical topics of discussion than younger patients.CONCLUSION: Patients, pharmacists, and physicians have incongruent beliefs about who should provide essential medication‐related information. Differing expectations could lead to overlapping, inefficient efforts that result in communication deficiencies when patients receive a new medication. Collaborative efforts to ensure that patients receive complete information about new medications could be explored.
Hematopoietic engraftment of dimethyl sulfoxide–depleted autologous peripheral blood progenitor cells
Authors: Akkök Çiğdem A. , Holte Mette R. , Tangen Jon M. , Østenstad Bjørn , Bruserud Øystein 
Published: January 2009

BACKGROUND: Autologous stem cell transplantation with cryopreserved autografts is a prerequisite for high‐dose chemotherapy in treatment of several malignancies. Adverse effects due to the cryoprotectant dimethyl sulfoxide (DMSO) vary from mild to severe. DMSO‐associated adverse effects can be reduced by DMSO depletion before autograft infusion. The aim was to investigate whether DMSO depletion by manual single wash reduced frequency of adverse effects or had detrimental effects on the engraftment potential of peripheral blood progenitor cell (PBPC) autografts.STUDY DESIGN AND METHODS: Ten percent DMSO was used to cryopreserve PBPC autografts for a total of 53 patients with multiple myeloma (n = 41), non‐Hodgkin's lymphoma (n = 8), amyloidosis (n = 3), and polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes (POEMS) syndrome (n = 1). After high‐dose chemotherapy, 34 patients received unmanipulated autografts, whereas for 19 patients the autografts were manually washed before stem cell infusion. Adverse effects after the infusion as well as neutrophil (neutrophil count >0.5 × 109/L) and platelet (PLT) engraftment (PLT count >20 × 109/L) for these two groups were compared.RESULTS: DMSO depletion reduced the frequency of adverse effects significantly. Patients transplanted with DMSO‐depleted autografts had similar neutrophil engraftment time as patients receiving unmanipulated autografts. PLT engraftment time, however, was significantly prolonged and PLT transfusion requirements significantly increased for patients receiving DMSO‐depleted autografts, even though the numbers of infused CD34+ cells per kg did not differ between the groups.CONCLUSIONS: DMSO depletion through a manual single wash is a time‐consuming procedure that reduces adverse effects. Although the procedure leads to an increase of 2 days in PLT engraftment time, it can be recommended for selected patients with high risk of serious DMSO toxicity.
Long‐term in vitro reactivity for human leukocyte antigen antibodies and comparison of detection using serum versus plasma
Authors: Norris Philip J. , Lee Jar‐How , Carrick Danielle M. , Gottschall Jerome L. , Lebedeva Mila , De Castro B. R. , Kleinman Steven H. , Busch Michael P. 
Published: January 2009

BACKGROUND: Human leukocyte antigen (HLA) antibodies are a possible cause of transfusion‐related acute lung injury (TRALI), and fluorescent bead assays are often used for antibody detection. Serum is the manufacturer's recommended sample, but plasma may be easier to obtain for studies of HLA antibody prevalence and TRALI case investigations.STUDY DESIGN AND METHODS: Specimens were obtained from 44 multiparous females positive for the presence of HLA antibodies by lymphocytotoxicity testing at least 13 years prior and from 1000 contemporary blood donors. Screening tests were performed using a multiplex bead–based assay. In addition to comparing results obtained with paired plasma and serum samples, the effects of storage at 4°C for 1 week and of multiple freeze‐thaw cycles were evaluated.RESULTS: Of 42 evaluable subjects with HLA antibodies documented more than 13 years earlier, only 1 showed loss of detectable antibodies, with 39 (93%) positive in the screening assay for HLA Class I and 24 (57%) positive in the screening assay for HLA Class II antibodies. In 968 evaluable contemporary donors, 291 screened positive for the presence of HLA Class I and 206 for HLA Class II antibodies using a low assay cutoff. Screening test concordance using paired plasma and serum samples was high, particularly for subjects with higher‐level antibodies. Refrigeration of samples for 1 week did not significantly affect assay results, while repeated freeze‐thaw cycles caused a decrement in signal level.CONCLUSION: Serum and plasma samples gave concordant results in the majority of cases, particularly for specimens with higher‐level antibodies. High‐level HLA antibodies were present in most individuals for more than 13 years.
Serologic findings in autoimmune hemolytic anemia associated with immunoglobulin M warm autoantibodies
Authors: Arndt Patricia A. , Leger Regina M. , Garratty George 
Published: January 2009

BACKGROUND: Autoimmune hemolytic anemia (AIHA) associated with immunoglobulin M (IgM) warm autoantibodies is unusual but often severe, with more fatalities than other types of AIHA. Diagnosing this type of AIHA can be difficult because routine serologic data are not always informative.STUDY DESIGN AND METHODS: Forty‐nine cases of IgM warm AIHA in 25 years were studied by serologic methods.RESULTS: Routine direct antiglobulin tests (DATs) detected red blood cell (RBC)‐bound C3 in 90 percent of cases (65% had C3 but no immunoglobulin G [IgG] on their RBCs) and IgG in 24 percent. IgM was detected on 29 of 47 (62%) patients' RBCs; RBC‐bound IgM was detected in 14 of 47 cases by a tube DAT method and in an additional 15 of 21 (71%) cases using fluorescein isothiocyanate anti‐IgM and flow cytometry. Eighty‐one percent of eluates from patients' RBCs reacted. Warm autoagglutinins were present in 94 percent of serum samples; untreated and enzyme‐treated RBCs were hemolyzed at 37°C by 13 and 65 percent of serum samples, respectively. Most agglutinins were optimally reactive at 30 to 37°C. Patients' RBCs were spontaneously agglutinated in 78 percent of cases; washing with 37°C saline or treating RBCs with dithiothreitol resolved this problem. Clear specificity of autoantibody was defined in 35 percent of serum samples.CONCLUSION: IgM warm AIHA can be confused with cold agglutinin syndrome and “mixed/combined”‐type AIHA; a serologic workup by a specialist reference laboratory can help with the diagnosis.
Characterization of anti‐D monoclonal antibody reagents based on their reactivity with the weak D phenotype
Authors: Lai Marco , Grasso Cinzia , Boschi Ilaria , D'Onofrio Giuseppe , Pascali Vincenzo , Leone Giuseppe 
Published: January 2009

BACKGROUND: Anti‐D monoclonal antibody (MoAb) reagents have improved D typing in routine tests. However, they exhibit a wide range of reactivity with the weak D phenotype depending on the characteristics of the different MoAbs used. We analyzed the reactivity of immunoglobulin (IgM) anti‐D by cluster analysis to characterize MoAb that have similar reactivities with the weak D phenotype.STUDY DESIGN AND METHODS: We used 36 consecutive samples with weak D phenotype in routine testing and determined their reactivity with different IgM and IgG anti‐D MoAbs. The samples were characterized as belonging to a weak D type or category using commercial molecular biology kits.RESULTS: The various anti‐D MoAbs showed a wide grade of reactivity with the weak D samples. Similarities and dissimilarities in the behavior of the anti‐D MoAbs with the weak D phenotype samples were detected with cluster analysis and the multidimensional scaling analysis. These analyses indicated different families of MoAbs characterized as having a high degree of homogeneity in their reactivity with the weak D phenotype. Between these MoAb families, the most effective at reacting with the weak D phenotype were RUM‐1 and 175‐2.CONCLUSIONS: The results show that it is possible to classify the anti‐D MoAbs on the basis of their reactivity with the weak D phenotype. This provides information about different MoAbs' properties on the basis of their belonging to a given of anti‐D family.
A genetic strategy to control expression of human blood group antigens in red blood cells generated in vitro
Authors: Bagnis Claude , Chapel Sylvie , Chiaroni Jacques , Bailly Pascal 
Published: January 2009

BACKGROUND: The ability to generate red blood cells of a chosen blood group phenotype would be a major advance in transfusion when considering low‐ and high‐frequency blood group antigens.STUDY DESIGN AND METHODS: Cord blood CD34+ cells undergoing erythroid differentiation in vitro were genetically manipulated with human immunodeficiency virus Type 1–derived lentiviral vectors expressing hUT‐B1 cDNA (overexpression strategy) or bicistronic vectors expressing both enhanced green fluorescent protein and a short‐hairpin RNA (shRNA) designed to silence SLC14A1(JK) gene that encodes hUT‐B1 protein (silencing strategy). Resulting cell populations were analyzed by fluorescent‐activated cell sorting and gel affinity column assay.RESULTS: When transduced with hUT‐B1 cDNA lentiviral vectors encoding JK*B and JK*A alleles, respectively, CD34+ cell–derived erythroid populations from Jk(a+b−) and Jk(a−b+) donors exhibited a Jk(a+b+) phenotype different from the original phenotype. In concomitant tests, Jk(a+b+) donor cells transduced with lentiviral vectors carrying a shRNA designed to interfere with hUT‐B1 transcription showed a marked decrease in hUT‐B1 expression and were assessed as null for Jk antigen by a routine assay.CONCLUSION: In this work focusing on the Kidd blood group system that relies on expression of hUT‐B1 glycoprotein under the Jka or Jkb antigenic configurations, we demonstrated that hematopoietic progenitors could be genetically modified to exhibit a chosen Kidd phenotype. Beyond production of atypical Kidd phenotypes, this genetic strategy could allow generation of rare blood phenotypes from hematopoietic stem cells regardless of initial donor phenotype. Potential applications for genetically modified blood include production of control samples for immunohematologic testing and for resolution of antibody detection in multiply transfused patients.
Access to Capital, Capital Structure, and the Funding of the Firm
Authors: BRAV OMER 
Published: January 2009

ABSTRACTBased upon a large data set of public and private firms in the United Kingdom, I find that compared to their public counterparts, private firms rely almost exclusively on debt financing, have higher leverage ratios, and tend to avoid external capital markets, leading to a greater sensitivity of their capital structures to fluctuations in performance. I argue that these differences are due to private equity being more costly than public equity. I further examine the private firms subsample to show that private equity is more costly than its public counterpart due to information asymmetry and the desire to maintain control.
A Prospective Randomized Trial of Defibrillation Thresholds from the Right Ventricular Outflow Tract and the Right Ventricular Apex
Authors: CROSSLEY GEORGE H. , BOYCE KER , ROELKE MARC , EVANS JOSEPH , YOUSUF DALAL , SYED ZAFFER , VICARI RALPH 
Published: January 2009

Background: Right ventricular outflow tract (RVOT) pacing has been suggested to improve hemodynamics and to help prevent pacing‐induced cardiomyopathy. Pacing from the RVOT is feasible and equivalent in terms of sensing and stimulation threshold. However, physicians have been reluctant to use RVOT pacing because of concerns that defibrillation efficacy might be adversely affected. To date, there have been no randomized‐controlled trials published comparing the defibrillation threshold in leads implanted in the RVOT and the right ventricular apex (RVA).
Objective: The purpose of this study was to compare defibrillation thresholds (DFT) in the RVOT and RVA. Ventricular sensing and stimulation thresholds were also compared.
Methods: This prospective, randomized, multicenter study included 87 patients (70 males, age 69 ± 11 years). At implantation, the patient's ventricular implantable cardioverter‐defibrillator (ICD) lead position was randomized to either the RVOT or RVA. A four‐shock Bayesian up‐down method was used to determine the DFT. Patients were followed for 3 months postimplant.
Results: DFTs were not significantly different in leads implanted in the RVOT (median 8.8 J [6.28, 12.9] vs. 7.9 J [6.20, 12.6], P = 0.65). Threshold and impedance measurements were stable in both RVOT and RVA groups from implant to follow‐up. All ICD leads remained stable chronically at the 3‐month follow‐up.
Conclusion: DFTs in leads placed in the RVOT and RVA are comparable. RVOT ICD lead placement is safe and exhibits similar lead stability, threshold, and impedance measurements as the traditional RVA location.
Leadless Pacing of the Heart Using Induction Technology: A Feasibility Study
Authors: WIENEKE HEINRICH , KONORZA THOMAS , ERBEL RAIMUND , KISKER ERHARD 
Published: January 2009

Objectives: To develop a leadless pacemaker system based on induction technology and to investigate its feasibility and safety in the pig model.
Background: Despite tremendous technical advances during the last decades, cardiac pacing is still associated with a considerable rate of complications that can be primarily attributed to the leads.
Methods: The device consists of a transmitter unit implanted subcutaneously just above the heart and an endocardial receiver unit implanted in the apex of the right ventricle. The transmitter unit generates an alternating magnetic field that is converted into a voltage pulse by the receiver unit. In order to test feasibility, the receiver unit was attached to an electrophysiology catheter for signal recording and placed in the apex of the right ventricle of a pig. Subsequently, the receiver unit was implanted without external connection in the right ventricle.
Results: An alternating magnetic field of about 0.5 mT was generated by the transmitter unit in a distance of 3 cm. Voltage pulses with a duration of 0.4 ms and voltage amplitude of 0.6–1.0 V were generated. Using these pulse characteristics, a reliable stimulation of the heart could be achieved. A secure fixation of the receiver unit in the apex of the right ventricle could be obtained for the duration of this short‐term study by using screw fixation.
Conclusions: This study shows that induction technology is feasible for cardiac pacing. Typical voltage pulses could be generated by which an effectively stimulation in vivo could be achieved.
Radiofrequency Catheter Ablation of Atrial Flutter Induces the Release of Platelet and Leukocyte‐Derived Procoagulant Microparticles and a Prothrombotic State
Authors: JESEL LAURENCE , MOREL OLIVIER , PYNN SOPHIE , RADULESCU BOGDAN , GRUNEBAUM LELIA , FREYSSINET JEAN‐MARIE , OHLMANN PATRICK , BAREISS PIERRRE , TOTI FLORENCE , CHAUVIN MICHEL 
Published: January 2009

Background: To assess the extent of endothelium, platelet, and leukocyte damage and coagulation activation induced by radiofrequency catheter ablation (RF) of atrial flutter. In the vasculature, procoagulant microparticles (MPs) are reliable markers of vascular damage. They provide an additional phospholipidic surface, enabling the assembly of the enzyme complexes of blood coagulation and consequent thrombin generation.
Methods: MPs were measured in the venous blood of 33 patients with isthmus‐dependent atrial flutter undergoing RF before (RF0), immediately after (RF1), and at day 1 (RF2) thereafter. Concentrations of PAI‐1, vWF, and D‐dimers were simultaneously determined. MPs procoagulant activities were determined using a functional prothrombinase assay. RF induces an early rise of platelet‐derived MPs (platelet), vWF Ag, and D‐dimers levels, which is concomitant with the decrease of PAI‐1 concentrations. Conversely, no significant changes in endothelial‐derived MPs could be evidenced. At RF2, sustained elevation of leukocytes‐derived MPs, vWF, and D‐dimers testified to an ongoing prothrombotic status.
Conclusion: RF ablation of common flutter induces a prothrombotic state and the release of platelet and leukocyte‐derived procoagulant microparticles. Whereas this activation of blood coagulation could be viewed as clinically marginal in right‐sided procedures, its relevance in left‐sided procedures should be established.
Determinants of Lesion Dimensions during Transcatheter Microwave Ablation
Authors: TSE HUNG‐FAT , LIAO SONGYAN , SIU CHUNG‐WAH , YUAN LIU , NICHOLLS JOHN , LEUNG GEORGE , ORMSBY TED , FELD GREGORY K. , LAU CHU‐PAK 
Published: January 2009

Background: Transcatheter microwave ablation is a novel technique for treating cardiac arrhythmias.
Methods: We investigated the effects of catheter temperature, application duration, and antenna length on lesion dimensions during catheter‐based microwave ablation. In a swine thigh muscle preparation, microwave was delivered at targeted temperatures of 60°C (n = 18), 70°C (n = 27), 80°C (n = 43), or 90°C (n = 18) for 120 seconds with 10‐mm antenna; and at targeted temperatures of 80°C for 120 seconds (n = 22), 150 seconds (n = 18), 180 seconds (n = 18), 210 seconds (n = 18), and 240 seconds (n = 17) with 20‐mm antenna using 10 F catheter (MedWaves, San Diego, CA, USA) during parallel orientation. Conventional radiofrequency ablation (RF) using a 4‐mm tip electrode was performed as control.
Results: With 120‐second energy applications, lesion length and depth were significantly larger with targeted temperatures of 80°C and 90°C than 60°C (P< 0.05). Furthermore, lesion depth and width, but not length, were significantly increased by prolonging energy application duration from 120 to 240 seconds at targeted temperature of 80°C (P< 0.05). Compared to RF, microwave lesions were significantly longer but had comparable depth and width. A 20‐mm microwave antenna produced longer lesions than either a 10‐mm antenna or RF ablation catheter. Multivariate analysis demonstrated that targeted temperature ≥80°C, application duration ≥150 seconds, and use of 20‐mm antenna were independent predictors for lesion depth and width (P< 0.05). Surface dessication was observed in 4/18 (22%) lesions at 90°C, as compared with 1/136 (0.7%) at 80°C targeted tip temperature (P < 0.05).
Conclusions: This study demonstrated that lesions size with transcatheter microwave ablation can be controlled by adjusting targeted temperature, energy application duration, and antenna length. A targeted temperature of 80°C for more than 150 seconds should provide optimal lesion dimensions and lower risk of surface dessication or charring.