bluuebunny/crossref_metadata_2025_split huggingface dataset:
GBV‐C/HGV and HCV infection in mixed cryoglobulinaemia
Authors: Crovatto Marina , Mazzaro Cesare , Mishiro Shunij , Santini Gianfranco , Baracetti Stefano , Zorat Francesca , Pozzato Gabriele 
Published: March 2003

Recently, a new, suspected hepatotropic virus has been identified. Named GBV‐C/HGV, this virus shares with the hepatitis C virus (HCV) routes of transmission and molecular organization. Indeed, a proportion of HCV‐infected patients (10–25%) are also carriers of GBV‐C/HGV. Since mixed cryoglobulinaemia (MC) is closely associated with HCV infection, the aim of this study was to determine the prevalence of GBV‐C/HGV infection in MC patients, and to investigate whether the double infection influenced the clinical and/or laboratory aspects of the disease.52 patients affected by MC were studied. 100 patients affected by HCV‐positive chronic liver disease (CLD) without MC were used as control group. To determine the prevalence of GBV‐C/HGV infection in general population, 150 blood donors were studied, as well as 80 patients affected by non‐A–E CLD.Among the MC patients, only five (9.6%) were positive for both HCV and GBV‐C/HGV infection. No difference was found between patients with and without double infection as regards main clinical and laboratory aspects. Among HCV‐positive CLD cases, 27 were positive for double infection. Among blood donors, the prevalence of GBV‐C/HGV infection was 8.0%, whereas in cases with cryptogenetic CLD the prevalence was 5.0%.In conclusion, these data show that GBV‐C/HGV infection does not play any role in the pathogenesis of MC.
Use of the haemopoietic progenitor cell count of the Sysmex SE‐9500 to refine apheresis timing of peripheral blood stem cells
Authors: Pollard Y. , Watts M. J. , Grant D. , Chavda N. , Linch D. C. , Machin S. J. 
Published: March 2003

The Sysmex SE‐9500 automated cell counter provides an estimate of immature cells referred to as ‘haemopoietic progenitor cells’ (HPC). The aim of this study was to relate the HPC count to CD34+ cell levels in mobilized peripheral blood and to determine whether the HPC count was valuable in predicting apheresis yields of CD34+ cells. Studies were performed on 114 samples from 67 patients undergoing progenitor cell mobilization.HPC cells were undetectable in the steady state. On the day of apheresis the HPC and CD34 counts were weakly correlated, with the median HPC count being 2.3‐fold greater than the CD34+ cell count. The HPC count did not include the CD34+ cells as immunomagnetic depletion of CD34+ cells did not significantly reduce the HPC count. CD34+ cell counts predicted for apheresis yield (r = 0.773) on that day as did the HPC count (r = 0.623). The optimal strategy to prevent unnecessary harvesting while minimizing the risk of missing an adequate harvest, and minimizing laboratory investigations, was to screen all samples for HPC and limit CD34+ cell measurements to those with an HPC count <10 × 106/l (19/114 samples). If the CD34+ cell count was also <10 × 106/l then harvesting should not be carried out.
Acute lymphoblastic leukaemia occurring as second malignancy: report of the GIMEMA Archive of Adult Acute Leukaemia
Authors: Pagano Livio , Pulsoni Alessandro , Tosti Maria Elena , Annino Luciana , Mele Alfonso , Camera Andrea , Martino Bruno , Guglielmi Cesare , Cerri Raffaella , Di Bona Eros , Invernizzi Rosangela , Castagnola Carlo , Bassan Roberto , Mele Luca , Todeschini Giuseppe , Leone Giuseppe , Mandelli Franco 
Published: March 2003

Between July 1992 and June 1996, 901 new cases of adult acute lymphoblastic leukaemia were recorded in the GIMEMA Archive of Adult Acute Leukaemia; 21 of them (2.3%) had a previous primary malignancy (PM). We found that secondary acute lymphoblastic leukaemia cases (sALL) presented with older age, a high incidence of pre‐pre‐B immunophenotype and a significantly higher prevalence of cancer among relatives compared to de novo ALL.The leukaemogenic activity of the cytotoxic drugs employed for the treatment of PM may have played a potential role in only a proportion of patients, opening the possibility that some sALL patients may have developed two or more malignancies due to individual predisposing factors.
Chronic myelogenous leukaemia with p185BCR/ABL expression: characteristics and clinical significance
Authors: Ravandi Farhad , Cortes Jorge , Albitar Maher , Arlinghaus Ralph , Qiang Guo Jie , Talpaz Moshe , Kantarjian Hagop M. 
Published: March 2003

We investigated the significance of p185BCR/ABL expression in patients with chronic myelogenous leukaemia (CML) in relation to disease features, therapy and outcome. Results of Western blot analysis for 1384 patients referred with a diagnosis of CML to our institution from 1989 to 1997 were reviewed. Clinical characteristics, results of cytogenetic analysis and RT‐PCR for BCR rearrangement were analysed. Five patients with Ph‐positive CML expressing the p185BCR/ABL hybrid protein were identified. By RT‐PCR, bone marrow specimens of these patients were confirmed to have an e1a2 junction. The median age at diagnosis of these patients was 55 years (range 43–76). All had elevated white cell counts at diagnosis (median 50 × 109/l, range 11.7–163 × 109/l). Four patients had monocytosis (range 10–16%) with a low neutrophil/monocyte ratio in the peripheral blood (range 3.4–5.7). Patients presented with various stages of the disease (two in chronic–phase CP, two in accelerated–phase AP, and one in blastic‐phase BP). The clinical course and therapy of the patients varied, with one patient receiving hydroxyurea only, three patients receiving hydroxyurea followed by interferon‐α based regimens and bone marrow transplantation. The patient presenting in BP was treated with combination chemotherapy. The clinical outcome of the patients was also varied with one patient alive and in complete remission (with complete cytogenetic remission after transplant) and four patients dead after progression to more advanced stages.We conclude that patients with Ph‐positive p185BCR/ABL CML frequently present with monocytosis and a low neutrophil/monocyte ratio in the peripheral blood, aiding the speculation that the presence of the p185BCR/ABL hybrid protein may contribute to a phenotype intermediate between CML and CMML. Of interest, the only other specific clinical feature identified was the absence of splenomegaly in four of five patients. There was no definite association with transformation to lymphoid blast phase.
Long‐term outcome of individualized prophylactic treatment of children with severe haemophilia
Authors: Van Den Berg H. M. , Fischer K. , Mauser‐Bunschoten E. P. , Beek F. J. A. , Roosendaal G. , Van Der Bom J. G. , Nieuwenhuis H. K. 
Published: March 2003

The development of arthropathy is a serious complication of severe haemophilia. With the use of prophylaxis, bleeds can be prevented and arthropathy delayed. We investigated whether an individually tailored prophylactic regimen can prevent arthropathy and whether it had a similar effect on orthopaedic outcome compared with that of a high‐dose regimen. Efficacy was determined clinically and by radiographs of six major joints. Prophylaxis was started in 70 patients at a mean age of 4·1 years. Mean follow‐up was 15·6 years (range 8–24·5 years). The mean factor VIII consumption was 2319 IU/kg/year. The mean number of joint bleeds was 3·5/year and the mean clinical score (maximum score 90) was 1·0, with a mean Pettersson joint score (maximum score 78) of 3·0 at a mean age of 13·5 years. In conclusion, long‐term, early‐onset, individualized prophylaxis in haemophilia is feasible and prevents arthropathy.
Characterization of protein C receptor expression in monocytes
Authors: Galligan Leeona , Livingstone Wendy , Volkov Yuri , Hokamp Karsten , Murphy Ciaran , Lawler Mark , Fukudome Kenji , Smith Owen 
Published: March 2003

Many sequelae associated with endotoxaemic‐induced shock result from excessive production of the cytokine mediators, tumour necrosis factor alpha (TNF‐α), interleukin 1 (IL‐1) and IL‐6 from lipopolysaccharide (LPS)‐activated monocytes. Protein C (PC)/activated protein C (APC) has potent cytokine‐modifying properties and is protective in animal models and human clinical trials of sepsis. The precise mechanism by which this anti‐inflammatory response is achieved remains unknown; however, the recently described endothelial protein C receptor (EPCR) appears to be essential for this function. The pivotal role that monocytes play in the pathophysiology of septic shock led us to investigate the possible expression of a protein C receptor on the monocyte membrane. We used similarity algorithms to screen human sequence databases for paralogues of the EPCR but found none. However, using reverse transcription–polymerase chain reaction (RT–PCR), we detected an mRNA transcribed in primary human monocytes and THP1 cells that was identical to human EPCR mRNA. We also used immunocytochemical analysis to demonstrate the expression of a protein C receptor on the surface of monocytes encoded by the same gene as EPCR. These results confirm a new member of the protein C pathway involving primary monocytes. Further characterization will be necessary to compare and contrast its biological properties with those of EPCR.
Genetic pathways involved in the progression of Barrett's metaplasia to adenocarcinoma
Authors: Jenkins G J S , Doak S H , Parry J M , D'Souza F R , Griffiths A P , Baxter J N 
Published: March 2003

Abstract

Background
The prediction of which patients with Barrett's metaplasia will develop cancer is difficult. Better genetic characterization of the condition may aid clinicians in devising more effective management and follow-up strategies.

Methods
A review was undertaken of the accumulated genetic data relating to the progression of squamous epithelium to adenocarcinoma. The normal functions of a number of cancer-related genes are described and an explanation is given of how alterations in these genes interfere with normal cell processes and lead to cancer.

Results and conclusion
The main genetic alterations accompanying the progression through dysplasia to adenocarcinoma were collated from 135 papers. The principal genetic changes implicated are the loss of p16 gene expression (by deletion or hypermethylation), the loss of p53 expression (by mutation and deletion), the increase in cyclin D1 expression, the induction of aneuploidy and the losses of the Rb, DCC and APC chromosomal loci.
Use of the St Gallen classification for patients with node-negative breast cancer may lead to overuse of adjuvant chemotherapy
Authors: Boyages J , Chua B , Taylor R , Bilous M , Salisbury E , Wilcken N , Ung O 
Published: March 2003

AbstractBackgroundThe 1998 St Gallen classification was devised to guide clinicians in the use of adjuvant systemic therapy for women with early breast cancer. In this study, the classification was applied to a historical group of patients with node-negative breast cancer who were treated without adjuvant therapy.MethodsThe St Gallen classification was applied to 421 women with breast cancer treated with conservative surgery and radiotherapy alone between 1979 and 1994. Primary tumour characteristics were reviewed centrally.ResultsWhen the most stringent version of the St Gallen classification was applied (grade 2 or 3 tumours classified as ‘high risk’), only 10 per cent of patients were ‘low risk’, with a 10-year distant relapse-free survival (DRFS) rate of 100 per cent, and 15 per cent were at ‘intermediate risk’ (10-year DRFS rate of 94 per cent). The high-risk group (75 per cent of women) had a 10-year DRFS rate of 77 per cent (P &lt; 0·01). If the St Gallen classification had been applied to all patients in this series who were aged less than 70 years, up to 91 per cent would have been recommended to have chemotherapy.ConclusionThe St Gallen classification is an inaccurate measure of prognosis for patients with node-negative breast cancer and should be used with caution.
Consequences of axillary recurrence after conservative breast surgery
Authors: Fredriksson I , Liljegren G , Arnesson L-G , Emdin S O , Palm-Sjövall M , Fornander T , Holmqvist M , Holmberg L , Frisell J 
Published: March 2003

AbstractBackgroundThe aim was to study the incidence, time course and prognosis of patients who developed axillary recurrence after breast-conserving surgery, and to evaluate possible risk factors for axillary recurrence and prognostic factors after axillary recurrence.MethodsIn a population-based cohort of 6613 women with invasive breast cancer who had breast-conserving surgery between 1981 and 1990, 92 recurrences in the ipsilateral axilla were identified. Risk factors for axillary recurrence were studied in a case–control study nested in the cohort, and late survival was documented in the women with axillary recurrence.ResultsThe overall risk of axillary recurrence was 1·0 per cent at 5 years and 1·7 per cent at 10 years. The risk of axillary recurrence increased with tumour size (P = 0·033) and was highest in younger women (odds ratio (OR) 3·9 for women aged less than 40 years compared with those aged 50–59 years). Radiotherapy to the breast reduced the risk of axillary recurrence (OR 0·1 (95 per cent confidence interval 0·1 to 0·4)). The breast cancer-specific survival rate after axillary recurrence, as measured from primary treatment, was 78·0 per cent at 5 years and 52·3 per cent at 10 years. Tumour size and node status had a statistically significant effect on death from breast cancer.ConclusionAxillary recurrence is rare, although more common in younger women with large tumours. Radiotherapy to the breast was protective. Tumour size and node status were the most important prognostic factors in women with axillary recurrence.
The surgeon as a prognostic factor after the introduction of total mesorectal excision in the treatment of rectal cancer
Authors: Martling A , Cedermark B , Johansson H , Rutqvist L E , Holm T 
Published: March 2003

Abstract

Background
With conventional blunt surgical resection of rectal cancer, local recurrence rates are high and the individual surgeon putatively influences patient outcome. With total mesorectal excision (TME) local recurrence rates have been reduced and intersurgeon variability may be less important. The ‘TME project’ was a collaborative project that included surgical workshops in Stockholm between 1994 and 1997. The aim of this study was to assess the impact of the project on the practice of rectal cancer surgery in Stockholm and to analyse whether surgeon case volume and participation in the workshops influenced patient outcome.

Methods
All 652 patients who had an abdominal resection for rectal cancer in Stockholm between 1995 and 1997 were included. Outcome was compared in patients operated on by teams that included high-volume surgeons (more than 12 operations per year) with teams that included low-volume surgeons (12 operations or fewer per year), as well as between teams that including workshop participants and non-participants.

Results
Forty-six surgeons operated on the 652 patients. Five high-volume surgeons operated on 48 per cent of the patients. In these, outcome was significantly better than in patients treated by low-volume surgeons (local recurrence rate 4 versus 10 per cent (P = 0·02); rate of rectal cancer death 11 versus 18 per cent (P = 0·007)). Twenty-six surgeons were workshop participants and performed 93 per cent of the operations. Radiotherapy, TME and sphincter-preserving surgery were more common among patients treated by workshop participants.

Conclusion
The TME project has had an impact on rectal cancer surgical practice in Stockholm. Variability in patient outcome was mainly related to case volume, with better results obtained in patients treated by high-volume surgeons.
Endoscopic resection of large sessile colonic polyps by specialist and non-specialist endoscopists
Authors: Brooker J C , Saunders B P , Shah S G , Williams C B 
Published: March 2003

Abstract

Background
Patients with large sessile colonic polyps for which endoscopic resection might be feasible are often referred directly for operation. The aim of this study was to determine the outcome of patients with such polyps diagnosed by specialist and non-specialist colonoscopists.

Methods
Patients with large (greater than 2 cm) sessile polyps detected at colonoscopy from January 1995 to July 2000 were identified. Resection technique and clinical and endoscopic outcomes were recorded. Two of the colonoscopists (B.P.S., C.B.W.) are recognized as specialists.

Results
Some 130 polyps were identified, 100 detected by either of two specialist endoscopists (including 14 cancers) and 30 by 14 non-specialist endoscopists (including ten cancers). Endoscopic resection of benign polyps was attempted by experts in 80 (93 per cent) of 86 cases and by non-experts in 15 of 20 cases (P = 0·03), with successful management by endoscopy alone in 61 (76 per cent) of 80 and in six of 15 cases respectively (P = 0·01). Complications occurred following three polypectomies performed by an expert (bleeding, two; pain, one) and one by a non-expert (bleeding). The estimated end-cost of management by specialists was less than half of that by non-specialists.

Conclusion
Endoscopic resection of large sessile colonic polyps is feasible in the majority of patients and should be considered as first-line therapy. Prompt referral to a specialist endoscopist may improve outcomes by avoiding operation or enabling complete excision at a single endoscopy session.
Anorectal functional disorders in the absence of anorectal inflammation in patients with Crohn's disease
Authors: Mueller M H , Kreis M E , Gross M L , Becker H D , Zittel T T , Jehle E C 
Published: March 2003

Abstract

Background
Histological alterations in the enteric nervous system (ENS) have been described in patients suffering from Crohn's disease (CD). The aim of this study was to investigate whether patients with CD without rectal inflammation have abnormal anorectal function compared with healthy volunteers.

Methods
Fifty-four patients with CD and 26 healthy volunteers were examined by anorectal manometry and answered a standardized questionnaire. No patient had active CD in the rectum as determined by endoscopy.

Results
Maximum anal resting and squeeze pressures did not differ between patients and healthy volunteers. The rectoanal inhibitory reflex was absent in 24 of 54 patients and two of 26 healthy volunteers (P &lt; 0·05). The first sensation to distension of the rectal balloon was reported at mean(s.e.m.) 57·9(4·4) ml by patients and 37·5(2·2) ml by healthy volunteers (P &lt; 0·01). The standardized interview revealed additional disorders of anorectal function in patients with CD.

Conclusion
Anorectal function appears to be altered in many patients with CD even in the absence of macroscopic anorectal disease. This may be due to a disorder of the ENS.
Pain from primary inguinal hernia and the effect of repair on pain
Authors: Page B , Paterson C , Young D , O'Dwyer P J 
Published: March 2003

Abstract

Background
No previous study has attempted to quantify pain from a primary inguinal hernia. The aim of this study was to quantify patients' pain from inguinal hernia at rest and on moving, and to assess the effect of hernia repair on the pain.

Methods
Linear analogue pain scores at rest and on moving were recorded before operation and at 1 year after surgery in a consecutive series of patients undergoing elective repair of a primary inguinal hernia.

Results
During the study period 323 patients underwent inguinal hernia repair. Eighty-six patients (26·6 per cent) recorded no pain at rest from the hernia, and 174 (53·9 per cent) had mild pain only (score less than 10). On moving, 53 patients (16·4 per cent) had no pain and 137 (42·4 per cent) had mild pain on moving. Only 1·5 per cent experienced severe pain (score greater than 50) at rest, and 10·2 per cent had severe pain on moving. There was no association between pain and hernia type, direct or indirect, or patient occupation. One year after operation only 24·5 per cent of patients had no pain from the hernia repair site at rest, and 21·6 per cent had no pain from the site on moving. Overall there was a significant reduction in pain score at rest (mean(s.e.m.) decrease from baseline −2·9(1·2), P = 0·019) and on moving (−9·2(1·8), P = 0·001) compared with preoperative values, and this was due mainly to the large effect observed in patients with high preoperative values. Patients who had no pain at rest before operation had significant pain scores at rest at 1 year (P = 0·001).

Conclusion
Clinical trials are required to evaluate hernia repair in patients with an asymptomatic inguinal hernia. Results from such trials should help to determine whether repair is the treatment of choice for these patients.
Clinical experience in continuous graft monitoring with microdialysis early after liver transplantation
Authors: Nowak G , Ungerstedt J , Wernerman J , Ungerstedt U , Ericzon B-G 
Published: March 2003

Abstract

Background
Early detection of impaired graft function after transplantation is essential. Microdialysis permits continuous monitoring of metabolic changes by mimicking the passive function of a capillary blood vessel by perfusion of a tubular semipermeable membrane introduced into the tissue. Based on the results of animal experiments, a clinical pilot study was undertaken.

Methods
Ten consecutive patients undergoing whole-organ orthotopic liver transplantation were studied. Intrahepatic implantation of a microdialysis catheter was performed at the end of the operation. A reference catheter was placed in the subcutaneous tissue over the right pectoral area immediately after abdominal closure. Consecutive serial samples were collected at 1-h intervals for 3 days after the operation. Glucose, lactate, pyruvate and glycerol concentrations were measured.

Results
During the first 24 h, the glucose level was higher in the liver than in reference tissue. Initially, increased mean(s.e.m.) levels of lactate (7·0(1·9) mmol/l) were observed in the liver, with a rapid decrease (to 2·7(0·3) mmol/l) over 24 h. A decrease in, and later stabilization of, the lactate: pyruvate ratio in the liver, from 18·7(4·2) to 10·0(1·1), was observed within 24 h after transplantation. Liver glycerol levels decreased from 62·3(7·4) to 24·3(7·5) µmol/l within the first 16 h after reperfusion and remained stable thereafter.

Conclusion
Microdialysis allows continuous monitoring of tissue metabolism in the transplanted liver. The procedure is easy to perform and safe. The specific detection and monitoring of pathological changes in the liver graft (e.g. arterial and portal vein thrombosis, or early rejection) with microdialysis should be addressed in further studies.