bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of staging systems to predict survival in hepatocellular carcinoma
Authors: Pascual Sonia , Zapater Pedro , Such José , García‐Herola Antonio , Sempere Laura , Irurzun Javier , Palazón José María , Carnicer Fernando , Pérez‐Mateo Miguel 
Published: June 2006

Abstract: Purpose: Some new staging systems in hepatocellular carcinoma (HCC) have been described in the last years. The aim of this study was to compare the survival‐predicting capacity of some variables and the prognostic classifications.Methods: Demographic, clinical, analytical variables and tumour characteristics were collected in a study including 115 patients with HCC. Predictors of survival were identified using the Kaplan–Meier test and the Cox model. Comparison between different staging systems was carried out.Results: The 1‐, 2‐ and 3‐year estimated survival was 65%, 45% and 30%, respectively. Child–Pugh score and α‐fetoprotein level greater than 400 UI/l were independent predictors of survival in the Cox model. Although all systems correctly differentiated between patients regarding survival (Kaplan–Meier, log rank <0.05 for all), the Barcelona Clinic Liver Cancer (BCLC) showed a better discriminatory ability than the other evaluated scores. In addition, the independent homogenizing ability and stratification value of BCLC was better than that of other systems. On the contrary, model for end‐stage liver disease (MELD) showed the worst results.Conclusions: Child–Pugh score and α‐fetoprotein levels were the only independent predictors of survival in patients with HCC. Child–Pugh score showed a better prediction value for survival when compared with MELD. BCLC is more accurate than the other prognostic models evaluated in this investigation.
Value of fusing PET plus CT images in hepatocellular carcinoma and combined hepatocellular and cholangiocarcinoma patients with extrahepatic metastases: preliminary findings
Authors: Nagaoka Sakae , Itano Satoshi , Ishibashi Masatoshi , Torimura Takuji , Baba Kenkichi , Akiyoshi Junji , Kurogi Junichi , Matsugaki Satoru , Inoue Kinya , Tajiri Nobuyoshi , Takada Akio , Ando Eiji , Kuromatsu Ryoko , Kaida Hayato , Kurogi Mina , Koga Hironori , Kumashiro Ryukichi , Hayabuchi Naofumi , Kojiro Masamichi , Sata Michio 
Published: June 2006

Abstract: Background/Aims: This study aimed to evaluate the usefulness of 18F‐fluoro‐2‐deoxy‐d‐glucose positron emission tomography (PET) and PET plus computed tomography (CT) fusion images for the detection of extrahepatic metastases of hepatocellular carcinoma (HCC) and combined hepatocellular and cholangiocarcinoma (combined HCC/CC).Methods: Twenty‐one patients with HCC and combined HCC/CC were enrolled in the study from December 2004 to February 2005. In all patients, PET and CT of the chest to pelvis region were performed. The sensitivity of PET plus CT fusion images was compared with the sensitivity of PET, CT, and bone scintigraphy.Results: In 14 patients, a total of 58 extrahepatic metastases were diagnosed. The detection rate of PET plus CT fusion images, PET, CT, and bone scintigraphy was 98.2% (57 of 58 metastases), 89.6% (52 of 58 metastases), 91.2% (52 of 57 metastases), and 68.7% (11 of 16 bone metastases), respectively. No extrahepatic metastases were detected in the other seven patients. The detection rate of PET was 10/18 (55.6%) for intrahepatic lesions of HCC and combined HCC/CC.Conclusions: The fusion of PET plus CT images is useful in detecting extrahepatic metastases in HCC and combined HCC/CC patients.
Hepatitis B virus genotypes, precore and core promoter variants among predominantly Asian patients with chronic HBV infection in a Canadian center
Authors: Fung Scott K. , Wong Florence S. H. , Wong David K. H. , Hussain Munira T. , Lok Anna S. F. 
Published: June 2006

Abstract: Background and Aims: The epidemiology of hepatitis B virus (HBV) infection in North America may be changing as a result of immigration from endemic countries. The purpose of this study was to determine the prevalence of HBV genotypes, precore (PC) and core promoter (CP) variants, and the proportion of patients meeting treatment criteria for HBV.Methods: A cross‐sectional study of consecutive HBV patients attending a Canadian tertiary liver center was conducted. HBV DNA was quantified by polymerase chain reaction assay. HBV genotypes and variants were determined using a line probe assay.Results: Two hundred and seventy‐two patients were enrolled; 200 were not receiving treatment at enrollment, of whom 116 were men and 84 women with a mean age 42±14 years. Among this group, 177 (88%) patients were Asian and 19 (10%) were Caucasian and 69 (35%) patients were hepatitis B e antigen (HBeAg) positive. Genotypes B and C were found in 42% and 50% untreated patients, respectively; while CP and PC were detected in 52% and 43% patients, respectively. Approximately 20% patients not receiving treatment (29% HBeAg positive, 14% HBeAg negative) met AASLD guidelines for antiviral therapy. If lower cutoff values for alanine aminotransferase and HBV DNA levels were used, 49% patients would qualify for treatment.Conclusions: The vast majority of patients at a Canadian tertiary referral center were Asian. Virological and clinical characteristics of these patients reflect their country of origin. Our findings highlight the need to monitor the changing patterns of HBV infection in countries with large immigrant populations.
Antiviral treatment withdrawal in viremic HCV‐positive liver transplant patients: impact on viral loads, allograft function and morphology
Authors: Kornberg Arno , Küpper Bernadett , Tannapfel Andrea , Thrum Katharina , Bärthel Erik , Settmacher Utz 
Published: June 2006

Abstract: Background: The aim of this study was to evaluate the clinical long‐term consequences of antiviral treatment discontinuation in viremic hepatitis C virus (HCV)‐positive liver transplant recipients.Methods: Twenty‐five HCV‐positive patients after liver transplantation were included in this study. After diagnosing recurrent hepatitis C, a combination therapy with interferon‐α2b and ribavirin for a minimum of 12 months was initiated. Viremia levels and allograft function were monitored continuously. Allograft biopsies were performed yearly, analyzing grading of inflammation and staging of fibrosis.Results: HCV recurrence rate was 100%. Up to 114 months post‐transplantation, sustained virological response rate was 64%. Treatment discontinuation in virological nonresponders led subsequently to a significant increase of viral loads and deterioration of allograft function (P<0.05) within 1 month. In three patients, a fibrosing cholestatic syndrome developed, resulting in one patient death. Antiviral retherapy was maintained for a mean of 33 months, leading to a significant decline of aminotransferases (P<0.05) as well as decreasing serum levels of bilirubin and HCV‐RNA within 6 months. In addition, development of severe allograft fibrosis was prevented despite persistent viral loads.Conclusion: Our study suggests that antiviral treatment withdrawal carries the risk of severe disease progression in persistently viremic HCV‐positive liver transplant patients.
Demonstration of PDC‐E1 subunits as major antigens in the complement‐fixing fraction M4 and re‐evaluation of PDC‐E1‐specific antibodies in PBC patients
Authors: Berg Christoph P. , Stein Gerburg M. , Klein Reinhild , Pascu Maria , Berg Thomas , Kammer Winfried , Priemer Martin , Nordheim Alfred , Schulze‐Osthoff Klaus , Gregor Michael , Wesselborg Sebastian , Berg Peter A. 
Published: June 2006

Abstract: Background: Primary biliary cirrhosis (PBC) is characterized by the presence of antimitochondrial antibodies (AMA). Autoantibodies specific for the mitochondrial M4 antigen can be detected by a complement fixation test (CFT) but not by immunoblotting. The aim of this study was to elucidate the identity of the M4 antigen.Patients and methods: M4 proteins were purified by affinity chromatography using IgG fractions of PBC marker sera being CFT positive (n=5) or negative (n=5) and identified by Western blotting, silver staining and sequence analysis. Further, a cohort of 57 PBC patients was tested for the reactivity to M4 and pyruvate dehydrogenase complex (PDC).Results: Two AMA patterns of the marker sera were visualized: CFT‐positive sera were defined as PDC‐E2+/E1+ and the CFT‐negative sera as PDC‐E2+/E1−. The major proteins in the M4 fraction could be related to the PDC‐E1 subunits. A clear‐cut association between anti‐M4 reactivity in the CFT and the reactivity to both PDC subunits could also be documented in the cohort of 57 PBC patients showing anti‐PDC‐E1α and E1β antibodies at a frequency of 74% and 67%.Conclusions: CFT reactivity against M4 antigens could be preferentially identified as a reaction against PDC‐E1. As PDC‐E1 subunits as compared with PDC‐E2 lack lipoyl‐binding sites, they probably have to be considered as an independent and important target.
Development and validation of Transfusion Risk Understanding Scoring Tool (TRUST) to stratify cardiac surgery patients according to their blood transfusion needs
Authors: Alghamdi Abdullah A. , Davis Aileen , Brister Stephanie , Corey Paul , Logan Alexander 
Published: June 2006

BACKGROUND:  Allogeneic blood transfusion is associated with transfusion reactions, infection transmission, and postoperative morbidity and mortality. The objective of this study was to develop and validate an accurate and simple clinical index to stratify cardiac surgery patients according to their blood transfusion needs.METHODS AND RESULTS:  Data on consecutive adult patients who underwent cardiac surgery at Toronto General Hospital (n = 11,113) and Sunnybrook and Women’s College Health Sciences Center (n = 5316) between May 1999 and June 2004 were collected for the development, validation, and external validation of the index. Primary outcome was the exposure to blood transfusion in the operative and first postoperative days. Multivariable logistic regression modeling techniques were used to determine the relationship between each independent variable and the exposure to allogeneic blood transfusion. Score assignment for each predictor variable was based on its regression coefficient. The predicted probabilities at each total score were compared to the observed proportions of patients exposed to blood transfusion. The clinical tool consists of eight preoperative variables: preoperative hemoglobin, weight, female sex, age, nonelective procedure, preoperative creatinine, previous cardiac surgical procedure, and nonisolated procedure.CONCLUSIONS: Based on the standards of measurement in clinical research, a valid clinical tool was developed for predicting the need for blood transfusion in patients undergoing cardiac surgery. The clinical tool was internally and externally validated, and the results suggest that it should perform well at other institutions.
Antithrombin reduces monocyte and neutrophil CD11b up regulation in addition to blocking platelet activation during extracorporeal circulation
Authors: Rinder Christine S. , Rinder Henry M. , Smith Michael J. , Fitch Jane C.K. , Tracey Jayne B. , Chandler Wayne L. , Rollins Scott A. , Smith Brian R. 
Published: June 2006

BACKGROUND:  Patients undergoing cardiac surgery requiring cardiopulmonary bypass develop a systemic inflammatory reaction. Antithrombin III (AT) has anticoagulant effects but also shows evidence of anti‐inflammatory activity. The aim of this study was to examine whether exogenous AT could reduce white blood cell activation (CD11b up regulation or elastase release), in addition to inhibiting platelet (PLT) activation and fibrin generation, during simulated cardiopulmonary bypass (sCPB), undertaken in the absence of endothelium.STUDY DESIGN AND METHODS:  sCPB was carried out with minimally heparinized (2 U/mL) human blood for 90 minutes in controls and with supplementation by low‐dose (1 U/mL) and high‐dose (5 U/mL) AT.RESULTS:  High‐dose AT blunted thrombin generation during sCPB (prothrombin fragment 1.2); both doses significantly inhibited thrombin activity (fibrinopeptide A). Complement activation (C3a and C5b‐9) was unaffected by AT. High‐dose AT inhibited PLT activation (P‐selectin expression and P‐selectin–dependent monocyte‐PLT conjugate formation). AT supplementation at the higher dose significantly abrogated monocyte and neutrophil CD11b up regulation and neutrophil elastase release.CONCLUSION:  In addition to anticoagulant and anti‐PLT effects, pharmacologic AT doses significantly blunted monocyte and neutrophil CD11b up regulation and neutrophil elastase release during sCPB, independent of endothelial effects. These data provide evidence for the direct anti‐inflammatory activity of AT that has clinical relevance for CPB complications.
Acute hepatitis B virus window‐period blood donations detected by individual‐donation nucleic acid testing: a report on the first two cases found and interdicted in Spain
Authors: González Rocio , Echevarria José Manuel , Avellón Ana , Barea Luisa , Castro Emma 
Published: June 2006

BACKGROUND:  Mathematical models predict that, in Spain, a significant number of blood units will be obtained during the window period of the hepatitis B virus (HBV) infection. Routine nucleic acid testing (NAT) on individual blood units may provide experimental data to evaluate such a theoretical risk.STUDY DESIGN AND METHODS:  Between February and July 2005, a total of 34,631 individual units were screened for HBV DNA by a multiplex transcription‐mediated amplification (TMA) test. Units that repeatedly reacted in the test, but did not react for HBV surface antigen (HBsAg), were submitted to additional testing by both molecular and conventional assays, and the donors were recalled for follow‐up studies and the collection of clinical and epidemiologic data.RESULTS:  Confirmatory testing and follow‐up studies identified 2 blood units donated during the HBV infection window period (1/17,316 units studied). Sequencing of amplification products obtained by nested polymerase chain reaction (n‐PCR) revealed two HBV strains from genotypes D/ayw3 and F/adw4q‐, but did not identify HBsAg mutants. The HBV DNA concentration in the index donations was estimated to be below the n‐PCR detection level (180 IU/mL), in both cases. One donor developed acute hepatitis 2 months after donating blood, but the other remained asymptomatic and displayed normal alanine aminotransferase levels at follow‐up.CONCLUSIONS:  The HBV infection window period is a real issue in the setting of Spanish blood transfusions. NAT of individual units by TMA would make a significant contribution to improving the safety of the blood supply in Spain. Additional studies involving a larger number of units and longer periods of time are required, however, to ascertain the true incidence of the problem in this country.
Reduction of transmissible spongiform encephalopathy infectivity from human red blood cells with prion protein affinity ligands
Authors: Gregori Luisa , Lambert Brian C. , Gurgel Patrick V. , Gheorghiu Liliana , Edwardson Peter , Lathrop Julia T. , MacAuley Claudia , Carbonell Ruben G. , Burton Steven J. , Hammond David , Rohwer Robert G. 
Published: June 2006

BACKGROUND:  There is a demonstrated risk of infection by transmissible spongiform encephalopathies (TSEs) through transfusion from asymptomatic donors. Currently, blood‐borne TSE infectivity cannot be detected with a diagnostic test, nor is it likely to be amenable to inactivation; however, its depletion with specific adsorp‐tive ligand resins is possible.STUDY DESIGN AND METHODS:  Six ligands that bind the prion protein, PrP, were selected by screening large solid‐phase combinatorial chemical libraries. The selected resins were placed in columns and challenged with a unit of leukoreduced human red blood cells (RBCs) spiked with hamster brain–derived scrapie infectivity. The performance of each ligand was assessed by comparing the TSE infectivity titer in the RBCs before and after passage through each of five resin columns in series.RESULTS:  Four resins were able to reduce infectivity titer by 3 to more than 4 log ID50 per mL. The reduction was not due to nonspecific matrix interactions since a chemical modification of the most effective ligand completely abolished its ability to bind infectivity (negative control). A small subfraction of the infectivity, 0.01 percent, could not be removed, even upon repeated passage through successive columns.CONCLUSION:  If endogenous TSE infectivity in RBCs binds to the ligands in the same proportion as brain‐derived infectivity spiked into RBCs, the four most effective ligands would remove 3 to 4 log ID50 per mL. A follow‐up experiment is in progress to test whether endogenous blood‐borne infectivity is also reduced.
Apparent hemolysis following intravenous antithymocyte globulin treatment in a patient with marrow failure and a paroxysmal nocturnal hemoglobinuria clone
Authors: Tran Minh‐Ha , Fadeyi Emmanuel , Scheinberg Phillip , Klein Harvey G. 
Published: June 2006

BACKGROUND: Antithymocyte globulin (ATG) is a commonly used medication in the treatment of aplastic anemia. Although serum sickness has been described with the use of ATG, few cases of acute intravascular hemolysis have been reported. We report a case of apparent ATG‐related hemolysis in a patient with aplastic anemia and a paroxysmal nocturnal hemoglobinuria (PNH) clone.CASE REPORT: A 62‐year‐old, group A, RhoD+ man with aplastic anemia and an 11.6 percent glycosylphosphatidylinositol (GPI)‐anchored protein–negative population of red cells (RBCs), representing approximately 190 mL of his RBC volume, and 90 percent GPI‐negative neutrophils were scheduled to receive equine ATG at 40 mg per kg per day for 4 days. After the first infusion, he developed a 1.6 g per dL decline in hemoglobin concentration and an increase in serum lactate dehydrogenase (normal, 113‐226 U/L) from 284 to 1127 U per L. The hemolytic process was complicated by acute renal failure characterized by an increase in serum creatinine from 0.9 to 4.2 mg per dL and the appearance of dark‐colored urine. Pre‐ and post‐ATG direct antiglobulin tests were negative.CONCLUSION: The temporal association of intravenous ATG to lysis of complement‐sensitive RBCs suggests a causal relationship. Although intravascular hemolysis after ATG administration appears to be uncommon, the clinical consequences may be severe, and determining the pathophysiology may yield clues to the mechanism of intravascular hemolysis.
Antenatal administration of Rh‐immune globulin causes significant increases in the immunomodulatory cytokines transforming growth factor‐β and prostaglandin E2
Authors: Branch Donald R. , Shabani Fariba , Lund Nicole , Denomme Gregory A. 
Published: June 2006

BACKGROUND: Production of specific cytokines in response to administration of Rh‐immune globulin (RhIG) was examined to assess the mechanism of inhibition of the anti‐D production and prevention of hemolytic disease of the newborn (HDN).STUDY DESIGN AND METHODS: Plasma levels of 17 different cytokines before and 48 hours after antenatal administration of anti‐D were measured in 10 women candidates for prophylaxis with RhIG.RESULTS: No striking changes were observed in levels of the cytokines interleukin (IL)‐1 sRII, IL‐12 p40, IL‐16, or monocyte chemoattractant protein‐1. Levels of IL‐4, ‐5, ‐10, ‐13, and ‐17; macrophage inflammatory protein‐1α; granulocyte‐macrophage–colony‐stimulating factor; tumor necrosis factor‐β; and interferon‐γ remained below detection levels both before and after testing. IL‐1ra levels, however, showed a slight to moderate decrease in 7 of 10 women after RhIG administration. In contrast, levels of TGF‐β1 increased more than 1.3‐fold in 7 of 10 women and more than 2‐fold in 4 of 10 women; in 1 instance the increase was more than 5‐fold and this woman also had a significant increase in TGF‐β2. In addition to TGF‐β, 5 of 10 women had a modest increase (>1.5‐fold) in prostaglandin E2 (PGE2). Analyses of the combined results of the 10 women showed that increases in both TGF‐β1 and PGE2 after RhIG were significant.CONCLUSION: These results indicate that RhIG prophylaxis can induce higher than baseline levels of two strongly immunomodulatory cytokines, TGF‐β and PGE2. These findings represent one possible mechanism for the inhibition of the primary immune response to the D antigen in women receiving RhIG prophylaxis for prevention of HDN.
Molecular basis of two novel high‐prevalence antigens in the Kell blood group system, KALT and KTIM
Authors: Lee Soohee , Debnath Asim K. , Wu Xu , Scofield Terry , George Terry , Kakaiya Ram , Yogore III Mariano G. , Sausais Laima , Yacob Michelle , Lomas‐Francis Christine , Reid Marion E. 
Published: June 2006

BACKGROUND: The Kell blood group system consists of 25 antigens that result from single‐nucleotide polymorphisms. Most polymorphic Kell antigens reside on the N‐terminal domain of Kell before the zinc‐binding catalytic motif, which is the major site for endothelin‐3–converting enzyme activity. Kell antigens are important in transfusion medicine owing to their strong immunogenicity, and the corresponding antibodies are clinically significant. Two probands were studied whose serum samples contained antibodies to different high‐prevalence Kell antigens.STUDY DESIGN AND METHODS: Standard hemagglutination methods were used for serologic testing of Proband 1 and Proband 2. DNA was prepared from both probands and family members. The 19 exons and the intron‐exon regions of KEL from both probands were amplified by polymerase chain reaction, and the sequences were compared with that of common KEL. The identified substitutions were located on a three‐dimensional model of Kell generated based on the crystal structure of neutral endopeptidase, a homolog of Kell.RESULTS: In Proband 1, a homozygous 1988G>A mutation (Arg623Lys) in Exon 17 was present. One sibling of Proband 1 was homozygous for 1988G>A. In Proband 2, a homozygous 1033G>A mutation (Asp305Asn) in Exon 8 was present. Three siblings of Proband 2 were heterozygous for 1033G>A.CONCLUSION: The identified KEL mutations of the two probands are novel and inherited. The antigen absent from the red blood cells (RBCs) of Probands 1 and 2 are named KALT and KTIM, respectively. KALT is unique in that it is the only Kell antigen sensitive to treatment of RBCs by trypsin.
Face‐to‐face interviewing in predonation screening: lack of effect on detected human immunodeficiency virus and hepatitis C virus infections
Authors: O’Brien Sheila F. , Fan Wenli , Ram Shefali S. , Goldman Mindy , Nair Rama C. , Chiavetta Jo Anne , Vamvakas Eleftherios C. 
Published: June 2006

BACKGROUND: Predonation screening has become more elaborate over the years, while human immunodeficiency virus (HIV)‐ and hepatitis C virus (HCV)‐positive donations have declined. The impact of face‐to‐face interviewing and of the format of the Donor Health Assessment Questionnaire (DHAQ) have not been evaluated.STUDY DESIGN AND METHODS: Canadian Blood Services DHAQ records between 1990 and 2004 were examined, and changes in them were tracked. The proportion of first‐time donors permanently deferred for HIV or HCV risk, and the HIV and HCV rates per 100,000 donations, were calculated annually. Time‐series analysis was used to determine whether major predonation screening changes had any effect on the HIV or HCV rates or permanent deferrals.RESULTS: In 1992, receiving money or drugs for sex was added to the DHAQ; otherwise, the content of high‐risk questions changed little between 1990 and 2004. In 1997, the method of administration of the DHAQ changed from donor‐completed to face‐to‐face interviewing for high‐risk questions. Permanent deferrals for HIV or HCV risk factors and HIV and HCV rates in first‐time donors decreased over this period. The HIV rates were close to 0 before 1997, whereas HCV rates decreased steadily through 2004. There was no interruption in rates in 1997 when the method of administration changed.CONCLUSION: Face‐to‐face interviewing for high‐risk questions had no effect on HIV or HCV rates in first‐time donations over 15 years of observation (during the latter 8 of which face‐to‐face interviewing was in place), and it did not increase permanent deferrals for HIV or HCV risk factors.