bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myelodysplastic syndrome in transformation to acute myeloid leukemia presenting with diabetes insipidus: due to pituitary infiltration association with abnormalities of chromosomes 3 and 7
Authors: Müller Claudia I. , Engelhardt Monika , Laubenberger Jörg , Kunzmann Regina , Engelhardt Rupert , Lübbert Michael 
Published: March 2003

Abstract:A 31‐yr‐old woman with myelodysplastic syndrome (MDS) in transformation to acute myeloid leukemia (AML) presented with initial symptoms of polyuria and polydipsia. Cytogenetics revealed monosomy 7 and translocation (3;3)(q21;q26). The initial symptoms, in conjunction with a low serum level of anti‐diuretic hormone (ADH) and magnetic resonance imaging (MRI) findings demonstrating loss of the ‘bright spot’ of the neurohypophysis, indicated diabetes insipidus (DI), e.g. caused by leukemic infiltration of the neurohypophysis. After induction chemotherapy the patient's bone marrow revealed blast persistence, and following a second course of chemotherapy and normalisation of MRI, an allogeneic peripheral blood stem cell transplantation (PBSCT) from the patient's HLA‐identical brother was performed, resulting in ongoing complete remission. Recently, Lavabre‐Bertrandet al.reported an association of AML with DI, elevated platelet counts, and monosomy 7 and chromosome 3 abnormalities in three patients (Eur. J. Haematol.2001: 66: 66–69). Our report of an MDS with trilineage dysplasia and these karyotypic changes associated with DI indicates that this new entity may also include preleukemic cases.
Cytokine therapy in dermatology
Authors: Asadullah K. , Sterry W. , Trefzer U. 
Published: March 2003

Abstract: Cytokines have been in the focus of scientific interest for some years now. Analysing their expression permitted a better understanding of the pathogenesis of various diseases, including in dermatology. Moreover, they are now far beyond the stage when they were of interest only to the pathophysiological research sector: some cytokine therapies are already being employed as part of the clinical practice.In fact, several cytokines are used for the treatment of malignant, inflammatory and infectious skin diseases. Their stage of development ranges from advanced, already approved and well established therapies (e.g. IFN‐α and IL‐2 for melanoma) to early explorative trials (e.g. IL‐4 and IL‐10 for psoriasis). Some of the new approaches currently under investigation will actually lead to registration of new drugs for dermatological treatment and to supplement existing therapeutic options. Beside this, the results of clinical trials with cytokines are significantly contributing to our understanding of the pathophysiology of diseases. They will give a better insight into which mechanisms play a greater or lesser part in their development and may generate momentum for still better targeted pharmacological approaches. Here we would like to give an overview about the current stage of cytokine therapy and the prospects for dermatological indications. The terminology and immunobiology of cytokines are also briefly discussed, since for a sensible interpretation of the relevant findings a basic knowledge of these biologically highly active messenger substances is essential.
Correlation of Local Interleukin‐1beta Levels with Specific IgA Response Against Gardnerella vaginalis Cytolysin in Women with Bacterial Vaginosis
Authors: CAUCI SABINA , DRIUSSI SILVIA , GUASCHINO SECONDO , ISOLA MIRIAM , QUADRIFOGLIO FRANCO 
Published: March 2003

PROBLEM: Mucosal immune system activation may represent a critical determinant of adverse sequelae correlated with bacterial vaginosis, as HIV sexual transmission, upper genital tract infections, cervicitis, endometritis, postsurgical infections, and adverse pregnancy outcomes as preterm delivery (PTD), low birth weight (LBW).METHOD OF STUDY: Levels of interleukin‐1beta (IL‐1beta), anti‐Gardnerella vaginalis hemolysin (Gvh) IgA, pH, Nugent score, and number of leukocytes were measured in vaginal fluids of 60 fertile women with bacterial vaginosis and of 64 healthy controls.RESULTS: Vaginal IL‐1beta levels were nearly 13‐fold higher in women with bacterial vaginosis (BV) and were associated with anti‐Gvh IgA response. IL‐1beta was positively correlated with leukocyte counts in the smear both in healthy and bacterial vaginosis positive women.CONCLUSIONS: Induction of the proinflammatory cytokine IL‐1beta may be a necessary event to elicit an innate immune response to control anaerobic genital tract infections. High levels of vaginal IL‐1beta are associated with mounting of an antigen‐specific mucosal immune response in women with bacterial vaginosis. Parallel induction of innate and adaptive immune response may be associated with protection from ascent of micro‐organisms to the upper genital tract, and from acquiring viral infection through the vaginal tract.
Prospect for Immunocontraception using the NH2‐terminal Recombinant Peptide of Human Zona Pellucida Protein (hZPA)
Authors: KOYAMA KOJI , HASEGAWA AKIKO , GUPTA SATISH K. 
Published: March 2003

PROBLEM: The zona pellucida is a feasible candidate for contraceptive vaccine. Our previous study showed that a human zona pellucida (ZPA) recombinant protein produced antiserum that inhibited human in vitro fertilization in rabbits. The objective of this study is to examine whether the human recombinant protein produce fertilization‐blocking antiserum in a non‐human primate.METHOD OF STUDY: The amino terminal regions consisting of pig (198 amino acids) and human (206 amino acids) zona pellucida proteins were prepared by Escherichia coli to produce antisera in bonnet monkeys (Macaca radiata). Antibody production was assessed by immunofluorescent staining and enzyme‐linked immunosorbent assay (ELISA). Fertilization‐blocking test was carried out using human oocytes that had failed in intracytoplasmic sperm injection (ICSI) treatment under patient's informed consent.RESULTS: Both antisera against pig and human recombinant proteins recog‐nized native human zona pellucida by immunofluorescent staining. However, anti‐recombinant human ZPA reacted to native pig zona protein more strongly than pig zona pellucida by ELISA. When human oocytes were treated with antisera before insemination, anti‐human ZPA antiserum inhibited human sperm binding to human zona pellucida, but anti‐pig ZPA antiserum did not.CONCLUSIONS: Bonnet monkey produced fertilization‐blocking antibody by immunization with human recombinant ZPA. The homologous or highly similar sequence is effective for developing a contraceptive vaccine when using recombinant peptides.
Evolutionary Genetics and Infertility
Authors: GILL III THOMAS J. 
Published: March 2003

PROBLEM: Mapping the human genome and advances in human evolution indicate a critical role for genetics in the study of reproduction.METHOD OF STUDY: Literature in human evolution, genetics and reproduction.RESULTS: This paper will focus on three points: (1) the course of primate evolution, (2) implications of this course for reproduction in humans, and (3) evolutionary mechanisms. Reproduction is the driving force of evolution, and sex selection is the important factor in determining reproductive activity. The hypothesis will be presented that the reproductive inefficiency of Homo sapiens (one of four pregnancies succeeds) is the consequence of the development of genetic isolation from other species of Homo that was necessary to drive the evolution of Homo sapiens. This hypothesis is based on the evidence that Homo sapiens and Homo neanderthalensis are separate species and that intermating would not yield fertile offspring (Haldane's Rule). This mating barrier involves zoological and linguistic differences and genetic mechanisms preventing fertile interspecies mating (chromosomal incompatibilities, disruption of genomic imprinting and recessive lethal defects).CONCLUSIONS: The medical and philosophical implications of modern reproductive technologies that may circumvent mating barriers must be addressed prospectively: propagation of genetic defects that would be eliminated by natural selection; the specter of `genetic enhancement'; human cloning; and attempts to control the future direction of the evolution of Homo sapiens.
Macrophage Migration Inhibitory Factor in Human Pregnancy and Labor
Authors: Ietta F. , Todros T. , Ticconi C. , Piccoli E. , Zicari A. , Piccione E. , Paulesu L. 
Published: March 2003

PROBLEM: Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine involved in reproduction. Presently there is no information on the possible involvement of MIF in the onset of labor.METHODS: Macrophage migration inhibitory factor was assayed, by enzyme‐linked immunosorbent assay (ELISA), in maternal serum (MS) and amniotic fluid (AF) both, at midtrimester and at term, as well as in cord serum (CS) at birth. Extraembryonic membranes were analyzed by immunohistochemistry.RESULTS: Amniotic fluid MIF concentrations were significantly higher at term (median 62.10 ng/mL) than at midtrimester (median 20.07 ng/mL) and reached a peak in term labor (median 258.80 ng/mL). The AF/MS ratio varied from a median of 4.34 at midtrimester and 33.7 at term labor. The MS/CS ratio was 0.4. Migration inhibitory factor immunoreactivity was found in different cell layers of the extraembryonic membranes.CONCLUSIONS: The increased secretion of MIF in AF at term, particularly at term labor, suggests that MIF contributes to the inflammatory events leading to labor.
Antiprothrombin Antibodies are Associated with Pregnancy Loss in Patients with the Antiphospholipid Syndrome
Authors: von Landenberg P. , Matthias T. , Zaech J. , Schultz M. , Lorber M. , Blank M. , Shoenfeld Y. 
Published: March 2003

OBJECTIVE: To document the clinical association between the history of pregnancy loss in patients with the diagnosis of primary or secondary antiphospholipid syndrome (APS) and the presence of different antiprothrombin antibody subtypes [immunoglobulin G (IgG), IgM and IgA] in a cohort of patients with APS.METHODS: Records of 170 female patients with primary APS, or APS secondary to systemic lupus erythematosus (SLE) or secondary to other autoimmune diseases were studied.RESULTS: In female APS patients with IgG antiprothrombin antibodies (n = 105) significant associations to pregnancy loss (p < 0.0001), early pregnancy loss (p < 0.0001) and a negative association to thrombocytopenia (p < 0.01) could be identified. In the group of patients with IgG antiprothrombin antibodies and at least one pregnancy (n = 84) a significant association with pregnancy loss (p < 0.005) and especially with early pregnancy loss (p < 0.0001) was demonstrated. No association with other immunoglobulin subtypes of antiprothrombin antibodies could be documented. In the subgroup of patients with primary APS and at least one pregnancy in the history, pregnancy loss (p < 0.005) and early pregnancy loss (p < 0.0001) were found to be highly associated with the presence of IgG antiprothrombin antibodies. IgG antiprothrombin antibodies represent the highest independent risk factor for pregnancy loss with an odds ratio of 4.5. There was no statistically significant association with venous or arterial thrombosis in all IgG antiprothrombin antibody positive patientsCONCLUSION: The results of this study document the association of IgG antiprothrombin antibodies with pregnancy loss and in particular early pregnancy loss in a large and well‐characterized cohort of patients. We would recommend routine testing for antiprothrombin antibodies in young female patients with APS.
Effect of Intravenous Immunoglobulin Treatment on the Th1/Th2 Balance in Women with Recurrent Spontaneous Abortions
Authors: Graphou Olga , Chioti Athanasia , Pantazi Ageliki , Tsekoura Christina , Kontopoulou Virginia , Georgiadou Eleftheria , Balafoutas Christos , Koussoulakos Stavros , Margaritis Loukas H. , Varla‐Leftherioti Marighoula 
Published: March 2003

PROBLEM: The way by which intravenous immunoglobulin (IvIg) acts to prevent immunlogically mediated recurrent spontaneous abortions (RSA) has not been clarified. In the present study, a possible effect of IvIg on the T helper cell (Th1/Th2) balance was investigated in abortions of either alloimmune or autoimmune abnormalities.METHOD OF STUDY: The study included 21 women treated with IvIg before conception because of a history of RSA characterized by alloimmune abnormalities (n = 15) or associated with anti‐phospholipid antibodies (APA) (n = 6). Peripheral blood samples, collected before and 5 days after the first IvIg infusion, were stimulated, and Th1 and Th2 cells were detected by flow‐cytometric analysis using a combination of monoclonal antibodies against T‐cell surface markers and intracellular interferon (IFN)‐γ and interleukin (IL)‐4. The percentage of IFN‐γ‐producing (Th1) and IL‐4‐producing (Th2) cells and the Th1/Th2 ratio were compared between pre‐ and post‐infusion samples.RESULTS: A decrease of Th1 percentage in 66.6% of the cases and a concurrent Th2 percentage increase (47.61%) resulted in a decrease in the Th1/Th2 ratio in most of the cases (76.1%) (p < 0.01). Similar results were found in Group A (Th1/Th2 decreased in 60% of the cases, p < 0.05), while in Group B the effect of IvIg was not clear (Th1/Th2 increased in three and decreased in another three cases).CONCLUSION: Our finding suggests that IvIg administration in women with alloimmune RSA enhances Th2 polarization. This is not always the case with APA‐associated abortions.
Intravenous Immunoglobulin Treatment in Women with Recurrent Abortions: Increased Cytokine Levels and Reduced Th1/ Th2 Lymphocyte Ratio in Peripheral Blood
Authors: Yamada Hideto , Morikawa Mamoru , Furuta Itsuko , Kato Emi H. , Shimada Shigeki , Iwabuchi Kazuya , Minakami Hisanori 
Published: March 2003

PROBLEM:  The aim of this study was to investigate changes in peripheral blood Th1/Th2 cytokine levels and lymphocyte ratios after massive intravenous immunoglobulin (MIVIg) treatment for women with recurrent spontaneous abortion (RSA) of unexplained etiology.METHOD OF STUDY:  Serum Th1 (IFN‐γ, TNF‐α) and Th2 cytokine (IL‐4, IL‐10) levels were assessed by ELISA methods (n = 9) and peripheral blood Th1/Th2 lymphocyte ratios (n = 4) by flow cytometry before and after MIVIg treatments in women with four or more consecutive RSA.RESULTS:  Pre‐treatment serum IFN‐γ (0.06 ± 0.09 pg/mL, mean ± SD), TNF‐α (0.21 ± 0.45 pg/mL), IL‐4 (0.70 ± 1.16 pg/mL), and IL‐10 (1.12 ± 1.67 pg/mL) increased to 0.17 ± 0.16 pg/mL, 0.77 ± 0.28 pg/mL, 1.82 ± 0.89 pg/mL, and 3.44 ± 0.48 pg/mL, respectively, after MIVIg treatments (P < 0.05). CD4‐positive IFN‐γ/IL‐4 lymphocyte ratios (17.3 ± 9.1) were reduced to 11.5 ± 7.1 after treatment (P < 0.05).CONCLUSIONS:  Massive intravenous immunoglobulin treatments increased peripheral blood cytokine levels and decreased Th1/Th2 lymphocyte ratios; thus, MIVIg treatments modify the peripheral Th1/Th2 balance.
Percutaneous dilational tracheostomy: a safer technique  of airway management using a microlaryngeal tube
Authors: Fisher L. , Duane D. , Lafreniere L. , Read D. 
Published: March 2003

SummaryManagement of the airway in an intubated patient during formation of a tracheostomy can be hazardous. The usual method involves withdrawal of the tracheal tube, which has been providing a secure airway, prior to inserting the tracheostomy tube. A method of airway management, using a microlaryngeal tube, has been devised with the aim of maintaining full tracheal intubation and ventilation until the correct position of the tracheostomy tube can be verified. An audit of 250 successive cases of percutaneous tracheostomy demonstrated this method to be safe and effective.
Role of perineal sonography in the evaluation of patients with stress urinary incontinence
Authors: Sendag Fatih , Vidinli Halit , Kazandi Mert , Itil Ismail M. , Askar Niyazi , Vidinli Berna , Pourbagher Ali 
Published: March 2003

AbstractObjective: The aim of the study was to determine the role of perineal sonography in diagnosis of stress urinary incontinence.Materials and methods: Thirty patients with stress urinary incontinence and 17 age‐matched control patients were included in the study. Perineal sonography was carried out in both groups to evaluate the role of this technique in the diagnosis of stress urinary incontinence. By using the posterior edge of the symphysis pubis as a reference point, posterior urethra‐vesical angle (beta angle) and the angle between the vertical axis and urethral axis (alpha angle) were measured at rest and on straining. Bladder neck mobility was evaluated only at the cephalocaudal plane by measuring the desensus diameter.Results: Posterior urethro‐vesical angle (beta angle) was found to be significantly different between the study and control groups both at rest and on straining (P < 0.05). The angle between the vertical axis and urethral axis (alpha angle) was found to be significantly different between study and control groups only on straining (P < 0.05). Cephalocaudal distance (desensus diameter) was longer in patients with stress urinary incontinence (P < 0.05).Conclusion: Perineal sonography has an important role in diagnosing patients with stress urinary incontinence.
Antenatal pelvic organ mobility is associated with delivery mode
Authors: Dietz Hans P. , Moore Kate H. , Steensma Anneke B. 
Published: March 2003

AbstractObjective: Relaxation of pelvic ligaments may facilitate parturition in certain animal species. Biomechanical properties of pelvic connective tissue may also influence progress of labour in the human female. This study was designed to test whether peripheral joint mobility or pelvic organ mobility as measures of connective tissue biomechanical properties are associated with progress in labour and delivery mode.Design: Prospective clinical observational study.Setting: Tertiary obstetric service.Sample: 200 nulliparous women recruited in antenatal clinic.Methods: Translabial ultrasound was used to obtain data on third trimester pelvic organ mobility. Upper limb joint mobility was assessed clinically.Main outcome measures: Gestational length, length of first and second stage of labour, delivery mode.Results: Pelvic organ mobility was significantly associated with total length of second stage (P = 0.034 to P = 0.002). This was mainly due to the length of passive, not active second stage. There also was a statistically significant association between delivery mode and pelvic organ descent (P = 0.007 to P = 0.001), with the lowest mobility seen in women who required a Caesarean section in second stage. Joint mobility did not correlate with delivery data.Conclusion: Third trimester pelvic organ mobility is associated with duration of second stage and delivery mode.
Cellular copper content modulates differentiation and self‐renewal in cultures of cord blood‐derived CD34+ cells
Authors: Peled Tony , Landau Efrat , Prus Eugenia , Treves Abraham J. , Fibach Eitan 
Published: March 2003

Summary.  Several clinical observations have suggested that copper (Cu) plays a role in regulating haematopoietic progenitor cell (HPC) development. To further study this role we used an ex vivo system. Cord blood‐derived CD34+ cells were cultured in liquid medium supplemented with Kit‐	ligand, FLt3, interleukin 6 (IL‐6), thrombopoietin and IL‐3. Under these conditions, Cu content, measured by atomic absorption, was 7 ng/107 cells. Modulation of intracellular Cu was achieved by supplementing the cultures with the Cu chelator tetraethylenepentamine, which reduced cellular Cu (4 ng/107 cells), or ceruloplasmin or Cu sulphate that elevated cellular Cu (18 and 14 ng/107 cells respectively). The results indicated that low Cu content delayed differentiation, as measured by the surface antigens CD34, CD14 and CD15, colony‐forming unit (CFU) frequency and cell morphology, while high Cu accelerated differentiation compared with Cu unmanipulated cultures. As a result, expansion of total cells, CFU and CD34+ cells in low Cu was extended (12–16 weeks), and in high Cu was shortened	(2–4 weeks), compared with control cultures (6–8 weeks). These effects required modulation of intracellular Cu only during the first 1–3 weeks of the culture; the long‐term effects persisted thereafter, suggesting that the decision process for either self‐renewal or differentiation is taken early during the culture. This novel method of controlling cell proliferation and differentiation by copper and copper chelators might be utilized for ex vivo manipulation of HPC for various clinical applications.
Effect of chronic renal failure on mortality rate following arterial reconstruction
Authors: Gerrard D J , Ray S A , Barrio E A , Wood C H , Scoble J E , Taylor P R 
Published: March 2003

Abstract

Background
There is some evidence that patients with renal failure who have arterial procedures may have a poor outcome. This study compared the hospital mortality rate of arterial surgery in patients with chronic renal failure and those with normal renal function.

Methods
A consecutive series of 1718 patients undergoing arterial reconstructive surgery (excluding amputation) was entered prospectively on to a computerized database. Chronic renal failure was defined as a serum creatinine level over 400 µmol/l, or dialysis (either peritoneal or haemodialysis), or a successful renal transplant. Mortality was assessed at 30 days or in hospital.

Results
There were 69 patients (4·0 per cent) who were defined as having chronic renal failure. The mortality rate in this group was 23 per cent (16 patients) compared with 7·3 per cent (120 patients) of the 1649 patients without renal failure. The mortality rate was highest in patients undergoing urgent or emergency surgery and in those undergoing reconstruction for lower limb occlusive disease. The main causes of death were related to the cardiovascular system.

Conclusion
Patients with chronic renal failure undergoing arterial surgery have a poor outcome compared with those with normal renal function.
Phase I study of percutaneous cryotherapy for colorectal liver metastasis
Authors: Huang A , McCall J M , Weston M D , Mathur P , Quinn H , Henderson D C , Allen-Mersh T G 
Published: March 2003

Abstract

Background
The aim was to determine the safety and feasibility of percutaneous cryotherapy for treating irresectable colorectal liver metastases.

Methods
Liquid nitrogen cryoprobes were inserted percutaneously into metastases using the Seldinger technique under computed tomographic guidance. Single-probe treatments were performed with either 3·6- or 6·3-mm cryoprobes (ice-ball volumes 18 and 59 cm3 respectively), or dual-probe treatments with two adjacent 6·3-mm probes (ice-ball volume 205 cm3). Treatment involved a single freeze–thaw cycle.

Results
Fifteen patients received 25 single-probe treatments and seven patients received 14 dual-probe treatments. The treatment-related mortality rate was zero and complications occurred after six of 39 treatments. Liver metastasis growth was significantly delayed for 2 months after dual-probe but not single-probe treatment. Metastasis cryotherapy stimulated an immediate rise, followed by a fall, in serum carcinoembryonic antigen (CEA) level, associated with immune upregulation that was significantly greater after dual-probe treatments.

Conclusion
Ablation zones that were approximately four times larger than those produced by previously described percutaneous techniques delayed the growth of metastases, reduced serum CEA concentration, and induced detectable inflammatory and T-lymphocyte responses. Percutaneous cryotherapy for treatment of colorectal liver metastases is feasible and may have a place in conjunction with chemotherapy.