bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flat adenoma–carcinoma sequence with high‐malignancy potential as demonstrated by CD10 and β‐catenin expression: a different pathway from the polypoid adenoma–carcinoma sequence
Authors: Koga Y , Yao T , Hirahashi M , Kumashiro Y , Ohji Y , Yamada T , Tanaka M , Tsuneyoshi M 
Published: March 2008

Aims:  CD10+ colorectal carcinomas have a high risk of giving rise to liver metastasis. The aim was to examine phenotypic expression in colorectal neoplasia and to elucidate changes in such expression through the adenoma–carcinoma sequence.Methods and results:  We examined the expression of various proteins immunohistochemically in 111 flat [non‐polypoid growth (NPG)] colorectal neoplasms, categorized into 28 low‐grade (NPG‐LGN), 44 high‐grades (NPG‐HGN) and 39 cases of invasive neoplasia (NPG‐IN), as well as in 96 polypoid [polypoid growth (PG)] neoplasms, categorized into 26 PG‐LGN, 39 PG‐HGN and 31 PG‐IN according to the Vienna classification. CD10 was more frequently expressed in NPG than in PG neoplasia. MUC2 and MUC5AC were more frequently expressed in PG than in NPG neoplasias. Nuclear β‐catenin was more frequently expressed in NPG‐LGN than in PG‐LGN. No difference in p53 expression was found between NPG and PG neoplasia.Conclusions:  From the viewpoint of the expression of CD10 and β‐catenin, it would appear that NPG‐LGN differs significantly from PG‐LGN, thereby indicating that NPG‐LGN is a precursor of CD10+ carcinoma. It is important to ensure that NPG neoplasia is not overlooked if cases of CD10+ carcinoma are to be detected at an early stage.
Nodal T/NK‐cell lymphoma of nasal type: a clinicopathological study of six cases
Authors: Takahashi E , Asano N , Li C , Tanaka T , Shimada K , Shimada S , Yoshino T , Kojima M , Hara K , Eimoto T , Nakamura S 
Published: March 2008

Aims:  To investigate the clinicopathological features of six unusual cases of nodal CD56+ and Epstein–Barr virus (EBV)+ T/natural killer (NK)‐cell lymphoma, a putative nodal counterpart of nasal NK/T‐cell lymphoma (nodal T/NK‐cell lymphoma of nasal type) in comparison with nasal NK/T‐cell lymphoma with secondary lymph node involvement (n = 24) and peripheral T‐cell lymphoma (PTCL) of cytotoxic molecule (CTM)+ and EBV+ type (n = 21).Methods and results:  All cases of nodal T/NK‐cell lymphoma of nasal type exhibited diffuse infiltration of pleomorphic medium‐sized to large tumour cells, reminiscent of those in CTM+ EBV+ PTCL. The tumour cells had a typical phenotype of nasal NK/T‐cell lymphoma: CD2+, CD3ε+, CD4−, CD5−, CD56+, T‐cell intracellular antigen‐1+, granzyme B+, perforin+ and EBV+. However, four of six cases demonstrated clonal T‐cell receptor γ‐gene rearrangement on polymerase chain reaction analysis, unlike nasal NK/T‐cell lymphoma. Comparison of clinical parameters and overall survival among the three groups demonstrated only minor differences.Conclusions:  Nodal T/NK‐cell lymphoma may occupy the grey zone between extranodal nasal‐type NK/T‐cell lymphoma and nodal CTM+ PTCL in a spectrum of NK to T‐cell lymphomas that are EBV+. The close relationship between NK/T‐cell lymphomas and cytotoxic T‐cell lymphomas was also substantiated.
Use of intraoperative stereomicroscopy for preventing loss of metastases during frozen sectioning of sentinel lymph nodes in breast cancer
Authors: Varga Z , Rageth C , Saurenmann E , Honegger C , Von Orelli S , Fehr M , Fink D , Seifert B , Moch H , Caduff R 
Published: March 2008

Aims:  Optimal detection of metastases in sentinel lymph nodes (SLN) remains controversial. To determine the reliability of intraoperative frozen sections, SLN protocol with one frozen section was compared with macroscopic SLN evaluation with consecutive complete SLN embedding.Methods and results:  SLN from 135 consecutive breast cancer patients were analysed under a sereomicroscope. Frozen sections were performed in suspicious or clearly involved SLN on cut surface. One control group (n = 143) underwent one intraoperative frozen section on each SLN. The second control group (n = 90) was subjected to stereomicroscopy and one intraoperative frozen section on each SLN. A conventional SLN protocol with cytokeratin immunohistochemistry was performed postoperatively in all cases. All groups were statistically comparable. In the study group metastases were suspected in 21 SLN (16%) under the stereomicroscope and all were confirmed histologically. The negative SLN rate was significantly lower in the study group than in the main control group (47% versus 64%, P = 0.008), suggesting loss of metastases during frozen sections. More macrometastases were detected in the study group (30% versus 15%, P = 0.006); there were no differences in isolated tumour cells or micrometastases. The false‐negative rate was significantly lower in the control groups (29% versus 13% and 12%, P = 0.001).Conclusions:  Frozen sections potentially lead to loss or reduced size of metastatic deposits in SLN. Avoiding intraoperative frozen sections on grossly inconspicuous SLN may therefore be justified.
Toll‐like receptor‐4 and mitogen‐activated protein kinase signal system are involved in activation of dendritic cells in patients with acute coronary syndrome
Authors: Wang Lei , Li Dazhu , Yang Keping , Hu Yingfeng , Zeng Qiutang 
Published: March 2008

SummaryAtherosclerosis is an inflammatory disease in which dendritic cells have been suggested to play an essential role. The underlying signalling mechanisms are unknown thus far. The family of Toll‐like receptors (TLRs) initiates innate immune responses, and Toll‐like receptor‐4 (TLR4) has been considered to be an important player in the initiation and progression of atherosclerotic disease. The highly conserved mitogen‐activated protein kinase (MAPK) family is one of the major kinase families that regulate cells by transducing extracellular into cellular responses. Three important members of this family are the extracellular signal‐regulated kinase (ERK), p38, and c‐Jun N‐terminal kinase (JNK). The aim of the study was to investigate the expression of TLR4 and MAPK families on dendritic cells (DC) in patients with coronary arteriosclerosis disease. We have examined the expression of TLR4 protein and mRNA by flow cytometry and real‐time quantitative reverse transcription polymerase chain reaction (RT–PCR). In addition, the expression of MAPK family proteins have been determined by Western blot analysis. We examined the expression level of CD80 to value the maturation state of DC. We compared the levels of cytokines in DC in response to lipopolysaccharide (LPS). The results showed that the expression of TLR4 and MAPK families are increased in the patients with acute coronary syndrome (ACS), compared with it in the patients with stable angina and controls. DC in ACS are activated evaluated by its mature marker and cytokine secreting responding to LPS. We suggest that TLR4 and MAPK families maybe involved in activation of circulating DC of ACS patients.
The dietary histone deacetylase inhibitor sulforaphane induces human β‐defensin‐2 in intestinal epithelial cells
Authors: Schwab Markus , Reynders Veerle , Loitsch Stefan , Steinhilber Dieter , Schröder Oliver , Stein Jürgen 
Published: March 2008

SummaryAntimicrobial peptides like human β‐defensin‐2 (HBD‐2) play an important role in the innate immune system protecting the intestinal mucosa against bacterial invasion. The dietary histone deacetylase (HDAC) inhibitors sulforaphane (SFN) and butyrate have received a great deal of attention because of their ability to simultaneously modulate multiple cellular targets involved in cellular protection. In this study the influence of SFN and butyrate on HBD‐2 expression as well as the molecular pathways involved in SFN‐mediated induction of HBD‐2 were scrutinized. Treatment of Caco‐2, HT‐29 and SW480 cells with SFN led to a time‐ and dose‐dependent upregulation of HBD‐2 mRNA expression as determined by semi‐quantitative reverse transcription–polymerase chain reaction. Moreover, HBD‐2 protein production increased in response to SFN, measured by enzyme‐linked immunosorbent assay. Induction of HBD‐2 was also observed in response to butyrate. Immunofluorescence analysis revealed that the protein was localized in the cytosol. Coincubation of SFN with a vitamin D receptor (VDR), or an extracellular‐regulated kinase 1/2 or a nuclear factor‐κB inhibitor all reduced HBD‐2 mRNA upregulation. In contrast, transfection of cells with a dominant‐negative peroxisome proliferator‐activated receptor γ (PPARγ) mutant vector to inhibit PPARγ wild‐type action and inhibition of p38 mitogen‐activated protein kinase (MAPK) signalling did not affect SFN‐mediated upregulation of HBD‐2 mRNA. Moreover, SFN induced the expression of VDR, PPARγ and phosphorylated ERK1/2 but did not affect p38 MAPK activation. The data clearly demonstrate for the first time that the dietary HDAC inhibitor SFN is able to induce antimicrobial peptides in colonocytes. In this process HBD‐2 expression is regulated via VDR, mitogen‐activated protein kinase kinase/extracellular‐regulated kinase and nuclear factor‐κB signalling.
Patients waiting for a hip or knee joint replacement: is there any prioritization for surgery?
Authors: McHugh Gretl A. , Campbell Malcolm , Silman Alan J. , Kay Peter R. , Luker Karen A. 
Published: March 2008

AbstractObjective  To investigate whether patients are prioritized for joint replacement surgery on the basis of severity of osteoarthritis, pain and physical functioning.Method  A total of 105 patients on the waiting list for primary total knee or hip replacement from a UK regional orthopaedic centre were interviewed at baseline and followed up at 3, 6 and 9 months or until joint replacement. Measurement tools were the visual analogue scale (VAS), Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and the Oxford hip or knee score.Results  Most participants (81, 77%) were categorized on the waiting list as ‘routine’, despite having high levels of pain according to the measurement scales. There was no significant correlation between the waiting list categorization and the actual waiting time for a hip or knee joint replacement operation (Kendall’s tau = 0.17; P = 0.062) and the waiting list categorization did not appear to ensure that patients were operated upon earlier. There were also no significant differences in measures (VAS pain, WOMAC and Oxford hip or knee scores) between those individuals who had their operations earlier (before 6 months) compared with those participants who had their operations later (6 months or greater) or even not at all. Of the 105 patients who were listed for joint replacement, 24 (25%) patients did not have their operation due to: a medical delay (14); self‐delay/cancellation (7); arthroscopy instead (2); and death (1).Conclusion  With the expected increase in demand for joint replacement, there needs to be a re‐examination of assessment procedures of patients listed for joint replacement. The use of measurement tools to assess symptoms such as pain and physical function would be one way forward.
Economic burden of chronic kidney disease
Authors: Khan Samina , Amedia Chester A. 
Published: March 2008

AbstractObjectives  To define the cost of care and evaluate interventions associated with improving outcomes and delaying the progression of chronic kidney disease (CKD).Methods  Using the PubMed database, a systematic review of the literature was conducted describing (i) the cost of care associated with treating earlier stages of CKD, and (ii) the role of early referral, erythropoiesis‐stimulating proteins and anti‐hypertensive agents in improving clinical outcomes and reducing the cost of CKD.Results  The higher costs associated with treatment of the CKD population are largely due to higher rates and duration of comorbidity‐driven hospitalizations. Studies suggest that early referral to a nephrologist, use of erythropoiesis‐stimulating proteins and anti‐hypertensive agents may be associated with better outcomes and lower costs. In some instances, however, higher target haemoglobin levels could have harmful effects in CKD patients.Conclusion  The substantial costs incurred during earlier stages of CKD increase markedly during the transition to renal replacement and remain elevated thereafter. An increase in awareness among health care providers may result in more timely interventions. More proactive management, in turn, can lead to improved clinical and economic outcomes through the slowing of disease progression and prevention of comorbidities.
Doctor training and practice of acupuncture: results of a survey
Authors: Yeh Gloria Y. , Ryan Mary Anne , Phillips Russell S. , Audette Joseph F. 
Published: March 2008

AbstractRationale, aims and objectives  Although courses in acupuncture are increasingly available to doctors, little is known about educational outcomes, or the impact on doctor practices. We sought to characterize doctors who seek acupuncture training, and describe acupuncture practice and referral patterns after training.Methods  Using a self‐administered survey of doctors completing a 300‐hour acupuncture course at Harvard Medical School between 2000 and 2005, we obtained information regarding doctor characteristics, reasons for seeking training, subsequent practice and referral patterns, perceived efficacy, and barriers to using acupuncture.Results  Overall, 80 doctors (78%) responded to the survey. Their mean age (±SD) was 45 (±9) years; most were in private practice (44%) or at an academic center (26%). The most common medical specialties were internal medicine (25%), anaesthesia/pain management (20%), family practice (14%) and physical medicine/rehabilitation (11%). Most took the course to gain a clinical skill (97%). After training, doctors felt able to integrate acupuncture into clinical practice (91%), but only half did so (n = 40, 50%). Time constraints (58%) and reimbursement issues (44%) were barriers to acupuncture practice. The most common condition treated was musculoskeletal pain (37%) and perceived efficacy was high. Referral rates to non‐doctor acupuncturists increased (54% to 70%) after training.Conclusions  Among doctors enrolling in an acupuncture training programme, half encountered barriers that prevented use in clinical practice. Those who did use acupuncture found it to be helpful for treatment of pain. Given the expanding pool of doctors trained in acupuncture in the USA, outcomes research is needed to further evaluate medical acupuncture practice.
Comparison of two methods for performing treatment reviews by pharmacists and general practitioners for home‐dwelling elderly people
Authors: Denneboom Wilma , Dautzenberg Maaike G. H. , Grol Richard , De Smet Peter A. G. M. 
Published: March 2008

AbstractRationale, aims and objectives  There is room for improvement in pharmacotherapy for elderly outpatients. Studies have shown that collaborating health care professionals [e.g. pharmacists in cooperation with general practitioners (GPs)] are able to resolve prescription‐related pharmaceutical care issues by means of treatment reviews. The aim of the study was to describe the feasibility of two methods for treatment review (results were given to the GP either in case conferences or in written feedback), and to determine if and how the process of treatment review can be improved.Setting  Local pharmacists and GPs cooperated in performing treatment reviews for outpatients aged 75 years or more who were using five or more medicines chronically.Method  Written questionnaires, structured telephone interviews and analysis of various features of the treatment reviews that were recorded during the intervention study were used.Results  The pharmacists in the case conference group made more recommendations to the GPs (non‐significant). Significantly more recommendations were identified by the pharmacists themselves in the case conference group. Health care professionals accepted an intervention with personal contact in case conferences better than an intervention with feedback in writing. They were more positive about the process of treatment review presented personally, although there were not always as many medication changes as they had hoped for. They also had concrete suggestions for improving the intervention, such as using a combination of written feedback and case conferences, and reserving the case conferences for the most complex cases.Conclusions  Treatment reviews for the elderly in normal primary care are feasible. Health care professionals agree that the process for treatment review can be improved.
Fathers' play with their Down Syndrome children
Authors: De Falco S. , Esposito G. , Venuti P. , Bornstein M. H. 
Published: March 2008

AbstractBackground  In children with Down Syndrome (DS), as in other groups of special needs children, development depends crucially on the degree to which parents provide appropriate stimulation and effective support. The majority of recent studies investigating interactions between parents and children with DS have been conducted on mothers.Method  Through observation of child solitary play, child collaborative play with their father, and father play with their child, the current study focused on paternal contributions to child play in association with the effective quality of father–child interactions. A total of 19 children (M chronological age = 35.32 months, SD = 10.35; M mental age = 19.58, SD = 5.43) with DS and their fathers participated in the study. Two 10‐min sessions, of child solitary play and collaborative play with their father, were videorecorded. A coding system for exploratory and symbolic play was applied to both sessions, and the Emotional Availability (EA) Scales were independently applied to the collaborative play session as a measure of the effective quality of the father–child interaction.Results  Children showed more symbolic play during collaborative sessions compared with solitary sessions. Bivariate correlations showed positive associations between father play and child exploratory and symbolic play. Cluster analysis identified dyads in low, medium and high EA groups, which differed in terms of each partner's play. Specifically, both fathers and children of high EA dyads were more likely to show more symbolic play and less exploratory play than those with low EA dyads.Conclusions  Our findings enrich the theoretical perspective that dyadic interactions based on emotional involvement may lead to enhanced cognitive functioning in children with DS.
Observations on a vestigial organ: a potential surrogate for enteric neuromesenchymal disease
Authors: Knowles C. H. , De Giorgio R. 
Published: March 2008

Abstract  Abnormalities of enteric nerves, interstitial cells of Cajal (ICC) and smooth muscle are often associated with severe gastrointestinal motility disorders. In this context, full‐thickness biopsy of the gut may provide important diagnostic and prognostic clues as well as some possible therapeutic implications. Nonetheless, the unavoidable risk to further worsen prognosis evoked by laparotomy, and the unclear yield of histopathological analysis has hampered full‐thickness gut sampling in patients with severe dysmotility. However, recent advances in minimally invasive surgery have refuelled enthusiasm in gastrointestinal neuromuscular pathology. In this issue of Neurogastroenterology and Motility, Miller et al. provide novel and exciting evidence that the appendix might be used as a surrogate tissue to analyse changes to enteric nerves, ICC and smooth muscle cells in patients with diabetic gastroenteropathy. The objective of this short review was to place this very important work in the context of current understanding of enteric neuromuscular dysfunction.
Haemonchus contortus calreticulin binds to C‐reactive protein of its host, a novel survival strategy of the parasite
Authors: SUCHITRA S. , ANBU K. A. , RATHORE D. K. , MAHAWAR M. , SINGH B. P. , JOSHI P. 
Published: March 2008

SUMMARY Calreticulin (CalR), a Ca2+ binding multifunctional protein, is secreted by the parasitic nematode Haemonchus contortus. We have earlier observed binding of this protein to a 24‐kDa polypeptide (p24) present in an enriched preparation of prothrombin. In the present study, the identity of p24 was established as a C‐reactive protein (CRP) by several criteria. CalR binding to CRP is an elegant strategy devised by the parasite to survive in the host. The secreted CalR may achieve this either by limiting the free concentration of CRP, which has antiparasite activity or inhibit the activation of the classical complement pathway triggered on binding of CRP to C1q protein. CalR binding to CRP would also ensure a check on the procoagulant activity of the CRP enabling parasite to feed on the host blood. Thus, targeting CalR could be a novel strategy to tackle this parasite, which has developed resistance to many anthelmintics.
Control of Toxoplasma gondii infection by athymic LEW‐Whnrnu rats
Authors: SEPULVEDA‐ARIAS J. C. , KEMPF M. C. , WIEHR S. , WEDEKIND D. , HEDRICH H. J. , GROß U. , HERRMANN T. 
Published: March 2008

SUMMARY In immunocompetent rats and humans infection with Toxoplasma gondii remains mostly without overt clinical symptoms, but can be fatal, if the T‐cell response is impaired. For a better understanding of the lack of control of T. gondii infection under immunosuppressed conditions, congenitally athymic rats were used as the experimental model. Whereas athymic F344‐Whnrnu (F344 nude) rats die from a generalized infection during the first 3 weeks after peritoneal inoculation with 106 tachyzoites of T. gondii strain NTE, LEW‐Whnrnu (LEW nude) rats and euthymic LEW rats infected with a 10‐fold higher number of parasites developed chronic infection. To identify underlying mechanisms of LEW rats resistance to T. gondii infection and to investigate a possible contribution of residual T‐cells to LEW‐Whnrnu rat resistance, we characterized the immune response of LEW rats by determination of cellularity and composition of lymphocyte population, antigen‐specific IgG2b response as well as assays of antigen‐specific proliferation and production of IL‐2, IFN‐γ and TNF‐α. As only euthymic LEW rats developed production of antigen‐specific IgG and cellular in vitro responses, these results strongly suggest that the genetic background of LEW rats permits a control of the infection independent of an adaptive immune response.