bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastric metastases originating from occult breast lobular carcinoma: diagnostic and therapeutic problems
Authors: Ciulla Antonio , Castronovo Gioacchino , Tomasello Giovanni , Maiorana Alfonso Maurizio , Russo Leila , Daniele Elio , Genova Gaspare 
Published: July 2008

Abstract

Background
Breast cancer is the most frequent malignant tumour to metastasize into the gastrointestinal tract in female and is second only to malignant melanoma. Nevertheless gastrointestinal metastases arising from breast cancer are quite rare. The upper gastrointestinal tract is more frequently involved and lobular infiltrating carcinoma has a greater predilection compared to the ductal type.

Case presentation
The authors describe the case of a 70 years old woman with a preoperative diagnosis of gastric undifferentiated medullary – type carcinoma, which was the first manifestation of an occult breast carcinoma. The primary site of carcinoma was identified with the use of a panel of selected immunohistochemical markers.

Conclusion
Our goal in this case report is to increase the awareness of surgeons and clinicians to rule out the possibility of mammary origin in circumstance of gastric cancer occurring in female, even in patients without a previous or concurrent history of breast carcinoma. Although not a particularly common event, it is, nevertheless, reported in the literature. The differentiation between primary gastric carcinoma and metastatic breast carcinoma is essential for planning the correct therapeutic approach, in order to avoid the patient unnecessary surgery.
Multi-visceral resection of pancreatic VIPoma in a patient with sinistral portal hypertension
Authors: Joyce David L , Hong Kelvin , Fishman Elliot K , Wisell Joshua , Pawlik Timothy M 
Published: July 2008

Abstract

Background
VIPomas are rare neuroendocrine tumors poorly described in the literature. Aggressive resection of patients with advanced VIPoma neuroendocrine tumors has rarely been reported.

Case presentation
A 46 year old women presented with abdominal pain and diarrhea. A three-dimensional (3-D) pancreas protocol computed tomography scan revealed an 18 × 12 cm pancreatic VIPoma abutting the liver, stomach, spleen, left adrenal, colon that also invaded the distal duodenum – proximal jejunum at the ligament of Treitz in association with sinistral portal hypertension. Following preoperative proximal splenic artery embolization, the patient with underwent successful en bloc resection of the locally advanced VIPoma in conjunction with a diaphragmatic resection, total gastrectomy, splenectomy, left adrenalectomy, as well as small and large bowel resection. The estimated blood loss was 500 ml. All margins were negative (R0 resection). The patient is alive and disease-free.

Conclusion
This case illustrates the role of aggressive resection of pancreatic neuroendocrine tumors and highlights several key technical points that allowed for successful resection.
Multiparameter flow cytometric analysis of CD4 and CD8 T cell subsets in young and old people
Authors: Koch Sven , Larbi Anis , Derhovanessian Evelyna , Özcelik Dennis , Naumova Elissaveta , Pawelec Graham 
Published: July 2008

Abstract

Background
T cell-mediated immunity in elderly people is compromised in ways reflected in the composition of the peripheral T cell pool. The advent of polychromatic flow cytometry has made analysis of cell subsets feasible in unprecedented detail.

Results
Here we document shifts in subset distribution within naïve (N), central memory (CM) and effector memory (EM) cells defined by CD45RA and CCR7 expression in the elderly, additionally using the costimulatory receptors CD27 and CD28, as well as the coinhibitory receptors CD57 and KLRG-1, to further dissect these. Although differences between young and old were more marked in CD8 than in CD4 cells, a similar overall pattern prevailed in both. Thus, the use of all these markers together, and inclusion of assays of proliferation and cytokine secretion, may enable the construction of a differentiation scheme applicable to CD4 as well as CD8 cells, with the model (based on Romero et al.) suggesting the progression N→CM→EM1→EM2→pE1→pE2→EM4→EM3→E end-stage non-proliferative effector cells.

Conclusion
Overall, the results suggest that both differences in subset distribution and differences between subsets are responsible for age-related changes in CD8 cells but that differences within rather than between subsets are more prominent for CD4 cells.
Widespread rape does not directly appear to increase the overall HIV prevalence in conflict-affected countries: so now what?
Authors: Anema Aranka , Joffres Michel R , Mills Edward , Spiegel Paul B 
Published: July 2008

Abstract
Background
Sub-Saharan Africa (SSA) is severely affected by HIV/AIDS and conflict. Sexual violence as a weapon of war has been associated with concerns about heightened HIV incidence among women. Widespread rape by combatants has been documented in Burundi, Sierra Leone, Rwanda, Democratic Republic of Congo, Liberia, Sudan and Uganda. To examine the assertion that widespread rape may not directly increase HIV prevalence at the population level, we built a model to determine the potential impact of varying scenarios of widespread rape on HIV prevalence in the above seven African countries.

Discussion
Our findings show that even in the most extreme situations, where 15% of the female population was raped, where HIV prevalence among assailants was 8 times the country population prevalence, and where the HIV transmission rate was highest at 4 times the average high rate, widespread rape increased the absolute HIV prevalence of these countries by only 0.023%. These projections support the finding that widespread rape in conflict-affected countries in SSA has not incurred a major direct population-level change in HIV prevalence. However, this must not be interpreted to say that widespread rape does not pose serious problems to women's acquisition of HIV on an individual basis or in specific settings. Furthermore, direct and indirect consequences of sexual violence, such as physical and psychosocial trauma, unwanted pregnancies, and stigma and discrimination cannot be understated.

Summary
The conclusions of this article do not significantly change current practices in the field from an operational perspective. Proper care and treatment must be provided to every survivor of rape regardless of the epidemiological effects of HIV transmission at the population level. Sexual violence must be treated as a protection issue and not solely a reproductive health and psychosocial issue. It is worth publishing data and conclusions that could be misconstrued and may not make much of a programmatic difference in the field. Data, if collected, analysed and interpreted carefully, help to improve our understanding of complicated and nuanced situations. Ultimately, our understanding of what the outcomes of such interventions can achieve will be more realistic. It also helps decision-makers prioritise their funding and interventions.
Normothermic treatment in acute clinical encephalitis: a case report
Authors: Terashima Mari , Kataoka Hiroshi , Hirai Katsuji , Ueno Satoshi 
Published: July 2008

Abstract

Introduction
Encephalitis is a common infection of the brain, associated with a high risk of mortality and morbidity despite intensive supportive therapy. This report describes a patient with acute clinical meningoencephalitis who responded dramatically when her body temperature was decreased to normothermia (36 to 37°C) in combination with barbiturate therapy.

Case presentation
A 15-year-old, previously healthy girl presented with a 2-day history of headache and meningeal stiffness and pyrexia. Cranial magnetic resonance imaging showed high-intensity signals in the splenium of the corpus callosum on T2-weighted and diffusion-weighted images. On day 4 of admission, the level of consciousness decreased and ataxic respiration and apnea appeared. After that, fever (body temperature >40°C) developed with remarkable tachycardia. The body temperature was decreased with the use of a forced-air-cooling blanket and head cooling. The core temperature, measured in the bladder, was maintained at between 36 and 37°C for 5 days. During the period of normothermia, thiopental sodium was given continuously for 3 days. After normothermia, the level of consciousness increased without the development of fever, and ventilatory support was withdrawn.

Conclusion
Our experience suggests that normothermic treatment in combination with barbiturate therapy may be an effective option for the management of brain swelling associated with acute meningoencephalitis, particularly when accompanied by a persistent high fever.
A spatially explicit whole-system model of the lignocellulosic bioethanol supply chain: an assessment of decentralised processing potential
Authors: Dunnett Alex J , Adjiman Claire S , Shah Nilay 
Published: July 2008

Abstract

Background
Lignocellulosic bioethanol technologies exhibit significant capacity for performance improvement across the supply chain through the development of high-yielding energy crops, integrated pretreatment, hydrolysis and fermentation technologies and the application of dedicated ethanol pipelines. The impact of such developments on cost-optimal plant location, scale and process composition within multiple plant infrastructures is poorly understood. A combined production and logistics model has been developed to investigate cost-optimal system configurations for a range of technological, system scale, biomass supply and ethanol demand distribution scenarios specific to European agricultural land and population densities.

Results
Ethanol production costs for current technologies decrease significantly from $0.71 to $0.58 per litre with increasing economies of scale, up to a maximum single-plant capacity of 550 × 106 l year-1. The development of high-yielding energy crops and consolidated bio-processing realises significant cost reductions, with production costs ranging from $0.33 to $0.36 per litre. Increased feedstock yields result in systems of eight fully integrated plants operating within a 500 × 500 km2 region, each producing between 1.24 and 2.38 × 109 l year-1 of pure ethanol. A limited potential for distributed processing and centralised purification systems is identified, requiring developments in modular, ambient pretreatment and fermentation technologies and the pipeline transport of pure ethanol.

Conclusion
The conceptual and mathematical modelling framework developed provides a valuable tool for the assessment and optimisation of the lignocellulosic bioethanol supply chain. In particular, it can provide insight into the optimal configuration of multiple plant systems. This information is invaluable in ensuring (near-)cost-optimal strategic development within the sector at the regional and national scale. The framework is flexible and can thus accommodate a range of processing tasks, logistical modes, by-product markets and impacting policy constraints. Significant scope for application to real-world case studies through dynamic extensions of the formulation has been identified.
Diffusion-negative MRI in acute ischemic stroke: a case report
Authors: Rathakrishnan Rahul , Sharma Vijay K , Chan Bernard PL 
Published: July 2008

Abstract

Background
Diffusion-weighted magnetic resonance imaging is a very sensitive tool for the early diagnosis of acute ischemic stroke. This is employed in some stroke centers as the primary screening tool to select patients eligible for thrombolysis.

Methods
We present the case of a 49-years old Chinese man whose diffusion-weighted magnetic resonance imaging performed 12 hours of symptom onset was negative.

Results
Although the initial diffusion-weighted magnetic resonance imaging was negative, the imaging repeated after 4 days despite static neurological symptoms and signs, could demonstrate an acute medullary infarction.

Conclusion
Diffusion-weighted imaging may not be100% sensitive in very early stages, especially in posterior circulation strokes. Our case serves as a reminder that clinical assessment still retains priority until a diagnostic modality offering 100% sensitivity and specificity is discovered.
Local adherent technique for transplanting mesenchymal stem cells as a potential treatment of cartilage defect
Authors: Koga Hideyuki , Shimaya Masayuki , Muneta Takeshi , Nimura Akimoto , Morito Toshiyuki , Hayashi Masaya , Suzuki Shiro , Ju Young-Jin , Mochizuki Tomoyuki , Sekiya Ichiro 
Published: July 2008

Abstract
Introduction
Current cell therapy for cartilage regeneration requires invasive procedures, periosteal coverage and scaffold use. We have developed a novel transplantation method with synovial mesenchymal stem cells (MSCs) to adhere to the cartilage defect.

Methods
For ex vivo analysis in rabbits, the cartilage defect was faced upward, filled with synovial MSC suspension, and held stationary for 2.5 to 15 minutes. The number of attached cells was examined. For in vivo analysis in rabbits, an autologous synovial MSC suspension was placed on the cartilage defect, and the position was maintained for 10 minutes to adhere the cells to the defect. For the control, either the same cell suspension was injected intra-articularly or the defects were left empty. The three groups were compared macroscopically and histologically. For ex vivo analysis in humans, in addition to the similar experiment in rabbits, the expression and effects of neutralizing antibodies for adhesion molecules were examined.

Results
Ex vivo analysis in rabbits demonstrated that the number of attached cells increased in a time-dependent manner, and more than 60% of cells attached within 10 minutes. The in vivo study showed that a large number of transplanted synovial MSCs attached to the defect at 1 day, and the cartilage defect improved at 24 weeks. The histological score was consistently better than the scores of the two control groups (same cell suspension injected intra-articularly or defects left empty) at 4, 12, and 24 weeks. Ex vivo analysis in humans provided similar results to those in rabbits. Intercellular adhesion molecule 1-positive cells increased between 1 minute and 10 minutes, and neutralizing antibodies for intercellular adhesion molecule 1, vascular cell adhesion molecule 1 and activated leukocyte-cell adhesion molecule inhibited the attachment.

Conclusion
Placing MSC suspension on the cartilage defect for 10 minutes resulted in adherence of >60% of synovial MSCs to the defect, and promoted cartilage regeneration. This adherent method makes it possible to adhere MSCs with low invasion, without periosteal coverage, and without a scaffold.
A crosstalk between intracellular CXCR7 and CXCR4 involved in rapid CXCL12-triggered integrin activation but not in chemokine-triggered motility of human T lymphocytes and CD34+ cells
Authors: Hartmann Tanja Nicole , Grabovsky Valentin , Pasvolsky Ronit , Shulman Ziv , Buss Eike C , Spiegel Asaf , Nagler Arnon , Lapidot Tsvee , Thelen Marcus , Alon Ronen 
Published: July 2008

AbstractThe chemokine CXCL12 promotes migration of human leukocytes, hematopoietic progenitors, and tumor cells. The binding of CXCL12 to its receptor CXCR4 triggers Gi protein signals for motility and integrin activation in many cell types. CXCR7 is a second, recently identified receptor for CXCL12, but its role as an intrinsic G-protein-coupled receptor (GPCR) has been debated. We report that CXCR7 fails to support on its own any CXCL12-triggered integrin activation or motility in human T lymphocytes or CD34+ progenitors. CXCR7 is also scarcely expressed on the surface of both cell types and concentrates right underneath the plasma membrane with partial colocalization in early endosomes. Nevertheless, various specific CXCR7 blockers get access to this pool and attenuate the ability of CXCR4 to properly rearrange by surface-bound CXCL12, a critical step in the ability of the GPCR to trigger optimal CXCL12-mediated stimulation of integrin activation in T lymphocytes as well as in CD34+ cells. In contrast, CXCL12-triggered CXCR4 signaling to early targets, such as Akt as well as CXCR4-mediated chemotaxis, is insensitive to identical CXCR7 blocking. Our findings suggest that although CXCR7 is not an intrinsic signaling receptor for CXCL12 on lymphocytes or CD34+ cells, its blocking can be useful for therapeutic interference with CXCR4-mediated activation of integrins.
Cardiotrophin-1 Is an Osteoclast-Derived Stimulus of Bone Formation Required for Normal Bone Remodeling
Authors: Walker Emma C , McGregor Narelle E , Poulton Ingrid J , Pompolo Sueli , Allan Elizabeth H , Quinn Julian MW , Gillespie Matthew T , Martin T John , Sims Natalie A 
Published: July 2008

Abstract
Cardiotrophin (CT-1) signals through gp130 and the LIF receptor (LIFR) and plays a major role in cardiac, neurological, and liver biology. We report here that CT-1 is also expressed within bone in osteoclasts and that CT-1 is capable of increasing osteoblast activity and mineralization both in vitro and in vivo. Furthermore, CT-1 stimulated CAAT/enhancer-binding protein-δ (C/EBPδ) expression and runt-related transcription factor 2 (runx2) activation. In neonate CT-1−/− mice, we detected low bone mass associated with reduced osteoblasts and many large osteoclasts, but increased cartilage remnants within the bone, suggesting impaired resorption. Cultured bone marrow (BM) from CT-1−/− mice generated many oversized osteoclasts and mineralized poorly compared with wildtype BM. As the CT-1−/− mice aged, the reduced osteoblast surface (ObS/BS) was no longer detected, but impaired bone resorption continued resulting in an osteopetrotic phenotype in adult bone. CT-1 may now be classed as an essential osteoclast-derived stimulus of both bone formation and resorption.
Proteins, Dietary Acid Load, and Calcium and Risk of Postmenopausal Fractures in the E3N French Women Prospective Study
Authors: Dargent-Molina Patricia , Sabia Sèverine , Touvier Mathilde , Kesse Emmanuelle , Bréart Gérard , Clavel-Chapelon Françoise , Boutron-Ruault Marie-Christine 
Published: July 2008

Abstract
Excess dietary proteins and “acid ash” diets have been suspected to increase the risk of osteoporosis, but experimental and epidemiological evidence is mixed. We aimed to determine whether the association between protein intake and the overall acid-base equilibrium of the diet (as renal net acid excretion [RNAE] estimate) and fracture risk vary according to calcium intake. During an average of 8.37 ± 1.73 yr of follow-up, 2408 women reported a fracture (excluding high-impact trauma) among 36,217 postmenopausal women from the E3N prospective study. We used Cox regression models to study the interaction between calcium and, respectively, proteins and RNAE, from the 1993 dietary questionnaire for fracture risk determination, adjusting for potential confounders. There was no overall association between fracture risk and total protein or RNAE. However, in the lowest quartile of calcium (&lt;400 mg/1000 kcal), high protein intake was associated with a significant increased fracture risk (RR = 1.51 for highest versus lowest quartile; 95% CI, 1.17–1.94). An increasing fracture risk with increasing animal protein intake was also observed (trend, p &lt; 0.0001). A similar pattern of interaction for fracture risk was observed between RNAE and calcium. In this Western population of postmenopausal women with normal to high protein intake and fairly high calcium intake, there was no overall association between total protein or RNAE and fracture risk. However, there was some evidence that high protein–high acid ash diets were associated with an increased risk of fracture when calcium intake was low (&lt;400 mg/1000 kcal).
IGF-1 and IGF-Binding Proteins and Bone Mass, Geometry, and Strength: Relation to Metabolic Control in Adolescent Girls With Type 1 Diabetes
Authors: Moyer-Mileur Laurie J , Slater Hillarie , Jordan Kristine C , Murray Mary A 
Published: July 2008

Abstract
Children and adolescents with poorly controlled type 1 diabetes mellitus (T1DM) are at risk for decreased bone mass. Growth hormone (GH) and its mediator, IGF-1, promote skeletal growth. Recent observations have suggested that children and adolescents with T1DM are at risk for decreased bone mineral acquisition. We examined the relationships between metabolic control, IGF-1 and its binding proteins (IGFBP-1, -3, -5), and bone mass in T1DM in adolescent girls 12–15 yr of age with T1DM (n = 11) and matched controls (n = 10). Subjects were admitted overnight and given a standardized diet. Periodic blood samples were obtained, and bone measurements were performed. Serum GH, IGFBP-1 and -5, glycosylated hemoglobin (HbA1c), glucose, and urine magnesium levels were higher and IGF-1 values were lower in T1DM compared with controls (p &lt; 0.05). Whole body BMC/bone area (BA), femoral neck areal BMD (aBMD) and bone mineral apparent density (BMAD), and tibia cortical BMC were lower in T1DM (p &lt; 0.05). Poor diabetes control predicted lower IGF-1 (r2 = 0.21) and greater IGFBP-1 (r2 = 0.39), IGFBP-5 (r2 = 0.38), and bone-specific alkaline phosphatase (BALP; r2 = 0.41, p &lt; 0.05). Higher urine magnesium excretion predicted an overall shorter, lighter skeleton, and lower tibia cortical bone size, mineral, and density (r2 = 0.44–0.75, p &lt; 0.05). In the T1DM cohort, earlier age at diagnosis was predictive of lower IGF-1, higher urine magnesium excretion, and lighter, thinner cortical bone (r2 ⩽ 0.45, p &lt; 0.01). We conclude that poor metabolic control alters the GH/IGF-1 axis, whereas greater urine magnesium excretion may reflect subtle changes in renal function and/or glucosuria leading to altered bone size and density in adolescent girls with T1DM.
Application of Cognitive Behaviour Therapy to Patients Who Have Advanced Cancer
Authors: Edelman Sarah , Kidman Antony D. 
Published: July 2008

AbstractPatients who are diagnosed with advanced cancer frequently experience high levels of anxiety and depression. Few of the studies that evaluated psychological interventions with this cohort have demonstrated improvements in psychological measures in the period following therapy. However, a recent study that evaluated the efficacy of a group cognitive behaviour therapy (CBT) intervention with patients who had advanced breast cancer found improved outcomes on measures of mood and self-esteem following the intervention. This paper describes some of the CBT techniques used in the intervention, which might also be useful in the treatment of patients with other types of terminal illness.
The Effects of Behavioural Contracting and Preferred Reinforcement on Appointment Keeping
Authors: Hayes Robert A. , Efron Lisa A. , Richman Gina S. , Harrison Kelley A. , Aguilera Elizabeth L. 
Published: July 2008

AbstractThe current study demonstrates the efficacy of using a behavioural contingency contract in conjunction with family-selected reinforcers to increase appointment keeping among low income families in a child and family therapy clinic. Three families with similar presenting problems participated. A multiple baseline across-subjects design with the addition of a reversal component was utilised. Upon treatment implementation, contracts were signed by family members stating that they would receive coupons valuing $30.00 after attending four consecutive clinic appointments. These coupons were selected by the family from a diverse menu. Results indicated increases in appointment keeping following implementation of the behavioural contract. The cost effectiveness of using a behavioural contract in conjunction with economic incentives with low-income families is discussed, and suggestions for future research on appointment keeping are made.