bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of body mass index and diabetes in the development of acute organ failure and subsequent mortality in an observational cohort
Authors: Slynkova Katarina , Mannino David M , Martin Greg S , Morehead Richard S , Doherty Dennis E 
Published: September 2006

Abstract
Introduction
Several studies have shown a correlation between body mass index (BMI) and both the development of critical illness and adverse outcomes in critically ill patients. The goal of our study was to examine this relationship prospectively with particular attention to the influence of concomitant diabetes mellitus (DM).

Methods
We analyzed data from 15,408 participants in the Atherosclerosis Risk in Communities (ARIC) study for this analysis. BMI and the presence of DM were defined at baseline. We defined 'acute organ failure' as those subjects who met a standard definition with diagnostic codes abstracted from hospitalization records. Outcomes assessed included the following: risk of the development of acute organ failure within three years of the baseline examination; in-hospital death while ill with acute organ failure; and death at three years among all subjects and among those with acute organ failure.

Results
At baseline, participants with a BMI of at least 30 were more likely than those in lower BMI categories to have DM (22.4% versus 7.9%, p < 0.01). Overall, BMI was not a significant predictor of developing acute organ failure. The risk for developing acute organ failure was increased among subjects with DM in comparison with those without DM (2.4% versus 0.7%, p < 0.01). Among subjects with organ failure, both in-hospital mortality (46.5% versus 12.2%, p < 0.01) and 3-year mortality (51.2% versus 21.1%, p < 0.01) was higher in subjects with DM.

Conclusion
Our findings suggest that obesity by itself is not a significant predictor of either acute organ failure or death during or after acute organ failure in this cohort. However, the presence of DM, which is related to obesity, is a strong predictor of both acute organ failure and death after acute organ failure.
Alternative protocol to initiate high-frequency oscillatory ventilation: an experimental study
Authors: Karmrodt Jens , David Matthias , Yuan Shying , Markstaller Klaus 
Published: September 2006

Abstract
Introduction
The objective was to study the effects of a novel lung volume optimization procedure (LVOP) using high-frequency oscillatory ventilation (HFOV) upon gas exchange, the transpulmonary pressure (TPP), and hemodynamics in a porcine model of surfactant depletion.

Methods
With institutional review board approval, the hemodynamics, blood gas analysis, TPP, and pulmonary shunt fraction were obtained in six anesthetized pigs before and after saline lung lavage. Measurements were acquired during pressure-controlled ventilation (PCV) prior to and after lung damage, and during a LVOP with HFOV. The LVOP comprised a recruitment maneuver with a continuous distending pressure (CDP) of 45 mbar for 2.5 minutes, and a stepwise decrease of the CDP (5 mbar every 5 minute) from 45 to 20 mbar. The TPP level was identified during the decrease in CDP, which assured a change of the PaO2/FIO2 ratio < 25% compared with maximum lung recruitment at CDP of 45 mbar (CDP45). Data are presented as the median (25th–75th percentile); differences between measurements are determined by Friedman repeated-measures analysis on ranks and multiple comparisons (Tukey's test). The level of significance was set at P < 0.05.

Results
The PaO2/FiO2 ratio increased from 99.1 (56.2–128) Torr at PCV post-lavage to 621 (619.4–660.3) Torr at CDP45 (CDP45) (P < 0.031). The pulmonary shunt fraction decreased from 51.8% (49–55%) at PCV post-lavage to 1.03% (0.4–3%) at CDP45 (P < 0.05). The cardiac output and stroke volume decreased at CDP45 (P < 0.05) compared with PCV, whereas the heart rate, mean arterial pressure, and intrathoracic blood volume remained unchanged. A TPP of 25.5 (17–32) mbar was required to preserve a difference in PaO2/FIO2 ratio < 25% related to CDP45; this TPP was achieved at a CDP of 35 (25–40) mbar.

Conclusion
This HFOV protocol is easy to perform, and allows a fast determination of an adequate TPP level that preserves oxygenation. Systemic hemodynamics, as a measure of safety, showed no relevant deterioration throughout the procedure.
Septic shock is correlated with asymmetrical dimethyl arginine levels, which may be influenced by a polymorphism in the dimethylarginine dimethylaminohydrolase II gene: a prospective observational study
Authors: O'Dwyer Michael J , Dempsey Felicity , Crowley Vivion , Kelleher Dermot P , McManus Ross , Ryan Thomas 
Published: September 2006

Abstract
Introduction
Asymmetrical dimethyl arginine (ADMA) is an endogenous non-selective inhibitor of nitric oxide synthase that may influence the severity of organ failure and the occurrence of shock secondary to an infectious insult. Levels may be genetically determined by a promoter polymorphism in a regulatory gene encoding dimethylarginine dimethylaminohydrolase II (DDAH II), which functions by metabolising ADMA to citrulline. The aim of this study was to examine the association between ADMA levels and the severity of organ failure and shock in severe sepsis and also to assess the influence of a promoter polymorphism in DDAH II on ADMA levels.

Methods
A prospective observational study was designed, and 47 intensive care unit (ICU) patients with severe sepsis and 10 healthy controls were enrolled. Serum ADMA and IL-6 were assayed on admission to the ICU and seven days later. Allelic variation for a polymorphism at position -449 in the DDAH II gene was assessed in each patient. Clinical and demographic details were also collected.

Results
On day 1 more ADMA was detectable in the ICU group than in the control group (p = 0.005). Levels subsequently increased during the first week in ICU (p = 0.001). ADMA levels were associated with vasopressor requirements on day one (p = 0.001). ADMA levels and Sequential Organ Failure Assessment scores were directly associated on day one (p = 0.0001) and day seven (p = 0.002). The degree of acidaemia and lactaemia was directly correlated with ADMA levels at both time points (p < 0.01). On day seven, IL-6 was directly correlated with ADMA levels (p = 0.006). The variant allele with G at position -449 in the DDAH II gene was associated with increased ADMA concentrations at both time points (p < 0.05).

Conclusion
Severity of organ failure, inflammation and presence of early shock in severe sepsis are associated with increased ADMA levels. ADMA concentrations may be influenced by a polymorphism in the DDAH II gene.
Comparative sequence analysis reveals an intricate network among REST, CREBand miRNA in mediating neuronal gene expression
Authors: Wu Jie , Xie Xiaohui 
Published: September 2006

Abstract
Background
Two distinct classes of regulators have been implicated in regulating neuronal gene expression and mediating neuronal identity: transcription factors such as REST/NRSF (RE1 silencing transcription factor) and CREB (cAMP response element-binding protein), and microRNAs (miRNAs). How these two classes of regulators act together to mediate neuronal gene expression is unclear.

Results
Using comparative sequence analysis, here we report the identification of 895 sites (NRSE) as the putative targets of REST. A set of the identified NRSE sites is present in the vicinity of the miRNA genes that are specifically expressed in brain-related tissues, suggesting the transcriptional regulation of these miRNAs by REST. We have further identified target genes of these miRNAs, and discovered that REST and its cofactor complex are targets of multiple brain-related miRNAs including miR-124a, miR-9 and miR-132. Given the role of both REST and miRNA as repressors, these findings point to a double-negative feedback loop between REST and the miRNAs in stabilizing and maintaining neuronal gene expression. Additionally, we find that the brain-related miRNA genes are highly enriched with evolutionarily conserved cAMP response elements (CRE) in their regulatory regions, implicating the role of CREB in the positive regulation of these miRNAs.

Conclusion
The expression of neuronal genes and neuronal identity are controlled by multiple factors, including transcriptional regulation through REST and post-transcriptional modification by several brain-related miRNAs. We demonstrate that these different levels of regulation are coordinated through extensive feedbacks, and propose a network among REST, CREB proteins and the brain-related miRNAs as a robust program for mediating neuronal gene expression.
Multicenter Phase II Study of Bortezomib in Patients With Relapsed or Refractory Mantle Cell Lymphoma
Authors: Fisher Richard I. , Bernstein Steven H. , Kahl Brad S. , Djulbegovic Benjamin , Robertson Michael J. , de Vos Sven , Epner Elliot , Krishnan Amrita , Leonard John P. , Lonial Sagar , Stadtmauer Edward A. , O'Connor Owen A. , Shi Hongliang , Boral Anthony L. , Goy André 
Published: September 2006

Purpose Evaluate response rate, duration of response (DOR), time-to-progression (TTP), overall survival (OS), and safety of bortezomib treatment in patients with relapsed or refractory mantle cell lymphoma (MCL). Patients and Methods Bortezomib 1.3 mg/m2 was administered on days 1, 4, 8, and 11 of a 21-day cycle, for up to 17 cycles. Response and progression were determined using International Workshop Response Criteria, both using data from independent radiology review and by the investigators. Primary efficacy analyses were based on data from independent radiology review. Results In total, 155 patients were treated. Median number of prior therapies was one (range, one to three). Response rate in 141 assessable patients was 33% including 8% complete response (CR)/unconfirmed CR. Median DOR was 9.2 months. Median TTP was 6.2 months. Results by investigator assessments were similar. Median OS has not been reached after a median follow-up of 13.4 months. The safety profile of bortezomib was similar to previous experience in relapsed multiple myeloma. The most common adverse events grade 3 or higher were peripheral neuropathy (13%), fatigue (12%), and thrombocytopenia (11%). Death from causes that were considered to be treatment related was reported for 3% of patients. Conclusion These results confirm the activity of bortezomib in relapsed or refractory MCL, with predictable and manageable toxicities. Bortezomib provides significant clinical activity in terms of durable and complete responses, and may therefore represent a new treatment option for this population with usually very poor outcome. Studies of bortezomib-based combinations in MCL are ongoing.
OM Forum—The Best Things in Life Were Free: On the Technology of Transactions
Authors: Zipkin Paul 
Published: September 2006

Radio-frequency identification (RFID) technology will reduce the costs of transactions to both customers and providers. This is a good thing, mostly. But it will be harder than people suppose, and it may have some adverse consequences. There are numerous technical and policy problems, including privacy and security issues. All these likely will be resolved, but only with time, experience, and money. Thus, it is unclear just how RFID will be used, just when various applications will become feasible. Also, as transaction costs decline, providers will be inclined to charge for things that are now free, such as public parks and congested roads. We may wait less at each transaction point, but such points may proliferate. Rather than obsess about this one technology, we should aim to think creatively about transactions and ways to improve them. Transactions affect our lives in many ways. A transaction is a process, not just an event. When people are involved, the process becomes intertwined with other intricate processes—product choice, social interaction, and the expression of power relations. RFID certainly offers the potential for improvement, but there are some lower-tech methods worth considering. This is not a systematic survey, but rather an essay, a sketch in broad strokes of an immense and varied landscape. Many topics are touched on lightly. The goal is to stimulate thought and discussion. More questions are raised than answered. In places the tone is personal, some might say eccentric.
A Closed-Form Approximation for Serial Inventory Systems and Its Application to System Design
Authors: Shang Kevin H. , Song Jing-Sheng 
Published: September 2006

We analyze a serial base-stock inventory model with Poisson demand and a fill-rate constraint. Our objective is to gain insights into the linkage between the stages to facilitate optimal system design and decentralized system control. To this end, we develop a closed-form approximation for the optimal base-stock levels. The development consists of two key steps: (1) convert the service-constrained model into a backorder cost model by imputing an appropriate backorder cost rate, and then adapt the single-stage approximation developed for the latter, and (2) use a logistic distribution to approximate the lead-time demand distribution in the single-stage approximation obtained in (1) to yield closed-form expressions. We then use the closed-form expressions to conduct sensitivity analyses and establish qualitative properties on system design issues, such as optimal total system stock, stock positioning, and internal fill rates. The closed-form approximation and most of the qualitative properties apply equally to the model with a backorder cost, although some differences do exist. Other results of this study include a bottom-up recursive procedure to evaluate any given echelon base-stock policy and lower bounds on the optimal echelon base-stock levels.
Gallium‐67 scanning in patients with head and neck cancer
Authors: Kashima Haskins K. , Mckusick Kenneth A. , Malmud Leon S. , Wagner Henry N. 
Published: September 2006

AbstractThis study was undertaken to evaluate the use of Gallium‐67 scanning in the management of patients with malignancies in the head and neck region. The principal findings are: 1. Gallium‐67 accumulates preferentially in the lacrimal and salivary glands in a high proportion of cases and, almost invariably, in the mid‐facial zone; 2. the uptake by the lacrimal and salivary glands is permanently enhanced by prior radiation therapy; 3. tumor identification is reliable, providing that the tumor focus measures at least 2 centimeters in diameter; 4. non‐specific inflammation also accumulates this isotope; and 5. tissue analysis reveals consistently elevated Gallium‐67 concentration in tumor. These characteristics of Gallium‐67 may lead to its eventual useful role in the evaluation of patients with head and neck cancers.
Actinomycosis masquerading as depression headache: Case report — management review of sinus actinomycosis
Authors: Per‐Lee John H. , Clairmont Albert A. , Hoffman James C. , McKinney Alexander S. , Schwarzmann Stephen W. 
Published: September 2006

AbstractDifferentiating an organic from a functional headache can be difficult; recognizing the unusual organic cause even more so. A unique case of actinomycosis centering on the clivus and sphenoid sinus is presented. This report reviews the history, diagnosis, and treatment of actinomycosis especially as they pertain to otolaryngology.
Papillomas of the larynx and pharynx: Two case reports
Authors: Wallenborn Peter A. 
Published: September 2006

AbstractTwo unusual cases of papillomas are presented: the first is that of a young boy with extensive papillomas of the larynx who was treated successfully without tracheotomy using endolaryngeal surgery and steroids at the time of each procedure. This case adds to the clinical evidence that the most probable cause of juvenile papillomas is a virus, since the mother had condyloma acuminata during pregnancy and at term.The second case is that of a young girl with rapidly recurring papillomas of the mouth and pharynx who was treated successfully with an autogenous vaccine and cryosurgery after other measures failed. This case demonstrates the effectiveness of cryosurgery in the treatment of papillomas and the possible efficacy of the autogenous vaccine suggests a viral etiology for papillomas of the pharynx and larynx.
Current adjuncts for surgery of the sphenoid sinus and pituitary gland
Authors: Calcaterra Thomas C. , Rand Robert W. 
Published: September 2006

AbstractSurgical intervention in the region of the sphenoid sinus pituitary gland requires extreme precision because of enveloping vital structures. The rhinologic approach to the pituitary gland, once abandoned due to limited visibility and the risk of meningitis, has experienced a renaissance as a result of recent medical and technical advances. Antibiotics have almost eliminated the risk of meningitis, and the operating microscope and televised radiofluoroscope now provide sufficient illumination, magnification, and orientation that injury to nearby structures can be avoided. A mid‐line rhinologic approach provides ample exposure and further minimizes operative hazards.
Nasal obstruction caused by a pituitary chromophobe adenoma
Authors: Summers Gordon W. 
Published: September 2006

AbstractNasal obstruction as the only clinical manifestation of a pituitary tumor is rare. A case is reported of a 58‐year‐old white male with obstruction of the nose and nasopharynx due to a massive pituitary tumor, which recurred 21 years after primary radiation treatment. At autopsy, extensive destruction of the sphenoid and base of the skull was noted. Final pathologic diagnosis was Chromophobe Adenoma. Common clinical features of chro‐mophobe adenomas are discussed.
Implantation of multiple intracochlear electrodes for rehabilitation of total deafness: Preliminary report
Authors: Chouard Claude H. , Macleod Patrick 
Published: September 2006

AbstractMany instances of total deafness are due to destruction of the organ of Corti but with partial or complete preservation of the function of the cochlear nerve. In such cases, it is possible to restore some hearing by electrically stimulating the fibers of the cochlear nerve with the help of implanted electrodes.Preoperative testing with electric shocks applied to the round window have aroused sensations of noise in 45 cases of total bilateral deafness with a great variety of etiologies. The only negative results were in two cases of operated acoustic neuromas.Our operation places up to eight intracochlear electrodes, each with a separate fenestration opening into an electrically isolated compartment of the scala tympani. Stimulation of each electrode yields a different sound sensation of a pitch that depends on its location along the cochlea. Electric filters direct different frequency bands to the appropriate electrodes, with the necessary compression of dynamic range.In three experimental cases of unilateral deafness, pitch matches to the normal ear were made. In seven therapeutic operations on adult cases of acquired total bilateral deafness, speech recognition was usually relearned within a month or two. Improvement of voice quality was also dramatic.The intracochlear electrodes have been well tolerated for months, but the method of connection to the external equipment still presents difficulties.
Histiocytic medullary reticulosis with involvement of the nose
Authors: Mogi Goro , Maeda Shoichi , Yoshida Toyoharu 
Published: September 2006

AbstractA case of histiocytic medullary reticulosis in which nasal involvement was predominant is reported. The patient was a 33‐year‐old woman with a 14‐month history of unilateral nasal stuffiness. The diagnosis was established by antemortem examination of films of bone marrow aspirates and by clinical features including fever, wasting, hepatosplenomegaly, anemia, and leukopenia. The histologic examination of autopsy specimens disclosed proliferation of histiocytes, which ingested nuclear debris and erythrocytes, in the necrotic lesion of the nose, sternal bone marrow, liver, spleen, thymus, uterus, ovali, and ileum. On reviewing literature on this subject, such a case of histiocytic medullary reticulosis which predominantly involves the nose is very rare.
Enhanced formation of non-phenolic androgen metabolites with intrinsic oestrogen-like gene transactivation potency in human breast cancer cells: a distinctive metabolic pattern
Authors: Pérez-Palacios Gregorio , Santillán René , García-Becerra Rocío , Borja-Cacho Elizabeth , Larrea Fernando , Damián-Matsumura Pablo , González Leticia , Lemus Ana E 
Published: September 2006

Breast cancer is a sex steroid hormone-dependent malignant neoplasia. The role of oestradiol in this malignancy has been well documented; however, the involvement of androgens has remained controversial. To determine the role of non-phenolic androgen metabolites in human breast cancer, we studied the metabolism of [14C] testosterone and [14C] androstenedione in oestrogen-dependent MCF-7 cells and non-oestrogen-dependent MDA-MB 231 cells, at different substrate concentrations (1–10 μM) and time periods (30 min–48 h). Cultured non-oestrogen-dependent HeLa and yeast cells served as controls. Metabolites were identified and quantified by reverse isotope dilution. A distinctive pattern of androgen metabolism was identified in MCF-7 cells, being the 5α-androstane-3α,17β-diol (3α,5α-diol) and its 3β epimer (3β,5α-diol), the major conversion products of testosterone (48.3%), with 5α-dihydrotestosterone as intermediary. The formation of 3α,5α-diol and 3β,5α-diol (diols) was substrate concentration- and time-dependent, and abolished by finasteride. In contrast, very little of any diol formation was observed in MDA-MB 231, HeLa and yeast cell incubations. Additional enzyme gene expression studies revealed an overexpression of 5α-steroid reductase type-1 in MCF-7 cells, as compared with MDA-MB 231 cells. The oestrogen-like activities of diols were assessed in HeLa cells co-transfected with expression vectors for α or β subtypes of the human oestrogen receptor (hER) genes and for an oestrogen-responsive reporter gene. The results show that 3β, 5α-diol and to a lesser extent 3α,5α-diol bind with high relative affinity to hERα and hERβ.
Both diols induced hER-mediated reporter gene transactivation in a dose–response manner, similar to that induced by oestradiol, though with lower potency, an effect that was abolished by ICI-182 780. Furthermore, 3β,5α-diol and to lesser extent 3α,5α-diol induced MCF-7 cell proliferation. The overall results demonstrated that MCF-7 cells exhibit enhanced expression and activity of androgen-metabolising enzymes, leading to rapid and large diol formation, and provide evidence that these androgen metabolites exert a potent oestrogen-agonistic effect, at genomic level, in oestrogen-dependent breast cancer cells. The data suggest that diols may act as in situ intracrine factors in breast cancer and that its formation can be pharmacologically inhibited.