bluuebunny/crossref_metadata_2025_split huggingface dataset:
BCL6 gene translocation in follicular lymphoma: a harbinger of eventual transformation to diffuse aggressive lymphoma
Authors: Akasaka Takashi , Lossos Izidore S. , Levy Ronald 
Published: May 2003

Abstract
Follicular lymphoma (FL) is characterized by a relatively indolent clinical course, but the disease often transforms into a more aggressive large cell lymphoma with a rapidly progressive clinical course. In the present study, we analyzed 41 cases of FL known to have subsequently transformed to aggressive lymphoma and an additional 64 FL samples from patients not subsequently transformed. We studied BCL6 gene rearrangement by the methodology of long-distance inverse polymerase chain reaction (LDI-PCR). Of the 41 cases known to transform, 16 (39.0%) harbored BCL6 translocation or deletion at the time of FL diagnosis. Among 64 cases not known to transform, BCL6 translocation was detected in 9 (14.1%). The prevalence of BCL6 translocation in the group known to transform was significantly higher (P = .0048). Among the transformation cases, the partners of the BCL6 translocation were identified in 13 cases and included IGH, CIITA, U50HG, MBNL, GRHPR, LRMP, EIF4A2, RhoH/TTF, and LOC92656 (similar to NAPA), whereas in the control group the BCL6 partners were IGH, CIITA, SIAT1, and MBNL. In 13 cases paired specimens before and after transformation were available. Among these paired specimens, a loss (3 cases) or a gain (1 case) of BCL6 translocation was observed after the transformation. Analysis of clonality showed that all of these cases represented the evolution of a subclone of the original tumor population. Our study demonstrated that BCL6 translocation is not necessary for transformation but that BCL6 translocation in FL may constitute a subgroup with a higher risk to transform into aggressive lymphoma.
Contribution of β-2 microglobulin levels to the prognostic stratification of survival in patients with myelodysplastic syndrome (MDS)
Authors: Gatto Simona , Ball Greg , Onida Francesco , Kantarjian Hagop M. , Estey Elihu H. , Beran Miloslav 
Published: May 2003

AbstractProspective analysis of the importance of the plasma levels of β-2 microglobulin (B2M) in 553 patients with myelodysplastic syndrome (MDS) found that B2M is an independent prognostic variable for survival with weighted significance second only to the karyotype. The incorporation of the B2M covariate into risk assessment of MDS patients added significantly to the power of the IPSS to stratify MDS patients into risk categories. Our results further document that the 2 objectively measured covariates that display the highest power to predict survival, that is, karyotype and B2M, can alone be used for risk stratification. While the results must be verified in an independent and comparable population, our data strongly recommend routine measurement of B2M in patients with MDS.
Rapid and complete donor chimerism in adult recipients of unrelated donor umbilical cord blood transplantation after reduced-intensity conditioning
Authors: Barker Juliet N. , Weisdorf Daniel J. , DeFor Todd E. , Blazar Bruce R. , Miller Jeffrey S. , Wagner John E. 
Published: May 2003

AbstractReduced-intensity conditioning may reduce transplantation-related mortality in high-risk adults undergoing hematopoietic transplantation. We investigated unrelated donor umbilical cord blood (UCB) transplantation after such conditioning in 43 patients (median age, 49.5 years; range, 22-65 years) with a primary end point of donor engraftment. The first 21 patients received busulfan 8 mg/kg, fludarabine 200 mg/m2, and 200 cGy of total body irradiation (Bu/Flu/TBI). Subsequent patients (n = 22) received cyclophosphamide 50 mg/kg, fludarabine 200 mg/m2, and 200 cGy TBI (Cy/Flu/TBI). UCB grafts (93%) were 1-2 HLA antigen–mismatched with the recipient and contained a median cryopreserved cell dose of 3.7 × 107 (range, 1.6 × 107-6.0 × 107) nucleated cells per kilogram of recipient body weight (NC/kg). Graft versus host disease (GVHD) prophylaxis was cyclosporin A to day 180 plus mycophenolate mofetil to day 30. The cumulative incidence of sustained donor engraftment was 76% (95% confidence interval [CI], 56%-96%) for Bu/Flu/TBI recipients and 94% (95% CI, 84%-100%) for Cy/Flu/TBI recipients. The median day of neutrophil recovery (at least 0.5 × 109/L) for engrafting Bu/Flu/TBI recipients was 26 days (range, 12-30 days) and for Cy/Flu/TBI recipients was 9.5 days (range, 5-28 days). Incidence of grades III-IV acute GVHD was 9% (95% CI, 1%-17%), and survival at 1 year was 39% (95% CI, 23%-56%). These data demonstrate that 0-2 antigen mismatched UCB is sufficient to engraft most adults after reduced-intensity conditioning and is associated with a low incidence of severe acute GVHD.
Functional comparison of DCs generated in vivo with Flt3 ligand or in vitro from blood monocytes: differential regulation of function by specific classes of physiologic stimuli
Authors: Jefford Michael , Schnurr Max , Toy Tracey , Masterman Kelly-Anne , Shin Amanda , Beecroft Tina , Tai Tsin Yee , Shortman Ken , Shackleton Mark , Davis Ian D. , Parente Phil , Luft Thomas , Chen Weisan , Cebon Jonathan , Maraskovsky Eugene 
Published: May 2003

AbstractDendritic cells (DCs) are a family of leukocytes that initiate T- and B-cell immunity against pathogens. Migration of antigen-loaded DCs from sites of infection into draining lymphoid tissues is fundamental to the priming of T-cell immune responses. In humans, the major peripheral blood DC (PBDC) types, CD1c+ DCs and interleukin 3 receptor–positive (IL-3R+) plasmacytoid DCs, are significantly expanded in vivo with the use of Flt3 ligand (FL). DC-like cells can also be generated from monocyte precursors (MoDCs). A detailed comparison of the functional potential of these types of DCs (in an autologous setting) has yet to be reported. Here, we compared the functional capacity of FL-expanded CD1c+ PBDCs with autologous MoDCs in response to 3 different classes of stimuli: (1) proinflammatory mediators, (2) soluble CD40 ligand trimer (CD40L), and (3) intact bacteria (Escherichia coli). Significant differences in functional capacities were found with respect to changes in phenotype, migratory capacity, cytokine secretion, and T-cell stimulation. MoDCs required specific stimuli for the expression of functions. They responded vigorously to CD40L or E coli, expressing cytokines known to regulate interferon-γ (IFN-γ) in T cells (IL-12p70, IL-18, and IL-23), but required prostaglandin E2 (PGE2) during stimulation to migrate to chemokines. In contrast, PBDCs matured in response to minimal stimulation, rapidly acquired migratory function in the absence of PGE2-containing stimuli, and were low cytokine producers. Interestingly, both types of DCs were equivalent with respect to stimulation of allogeneic T-cell proliferation and presentation of peptides to cytotoxic T lymphocyte (CTL) lines. These distinct differences are of particular importance when considering the choice of DC types for clinical applications.
In vitro generation of T lymphocytes from embryonic stem cell–derived prehematopoietic progenitors
Authors: de Pooter Renée F. , Cho Sarah K. , Carlyle James R. , Zúñiga-Pflücker Juan Carlos 
Published: May 2003

AbstractEmbryonic stem (ES) cells can differentiate into most blood cells in vitro, providing a powerful model system to study hematopoiesis. However, ES cell–derived T lymphocytes have not been generated in vitro, and it was unresolved whether such potential is absent or merely difficult to isolate. Because the latter case might result from rapid commitment to non–T-cell fates, we isolated ES cell–derived prehematopoietic precursors for reconstitution of fetal thymic organ cultures. We found a transient Flk1+CD45– subset of these precursors generated T lymphocytes in vitro, and the use of reaggregate thymic organ cultures greatly enhanced reconstitution frequency. These findings reveal that ES cells can exhibit in vitro T-cell potential, but this is restricted to early stages of ES cell differentiation. Moreover, the results support the notion that the thymic microenvironment can induce T-cell differentiation from a subset of prehematopoietic progenitors and suggest deficient migration into intact thymi hindered previous attempts to generate T cells in vitro from ES cell–derived progenitors. These findings demonstrate that a defined subset of ES cells has the potential to generate T cells in vitro and could contribute to greater understanding of the molecular events of hematopoietic induction and T-cell lineage commitment.
Factors associated with strain in co-resident spouses of patients following stroke
Authors: Blake Holly , Lincoln Nadina B 
Published: May 2003

Objective: To identify the factors associated with carer strain following stroke. Design: Co-resident spouses of stroke patients were sent questionnaire measures of their perceptions of strain, stress, mood, handicap, adjustment, social support, life satisfaction and personality, and patient's mood and independence in activities of daily living. Setting: Stroke spouses were identified from the stroke register at City Hospital, Nottingham. Results: In a sample of 222 carers, 37% had significant strain. Strain was highly correlated with negative affectivity on the Positive and Negative Affectivity Scale, carer mood on the General Health Questionnaire-12 (GHQ-12) and carer's perceptions of patient's independence in activities of daily living on the Extended Activities of Daily Living Scale (EADL). Logistic regression analysis of 96 of these carers supported the correlations and showed three factors, carer GHQ-12, patient EADL and negative affectivity, were independently associated with carer strain. Conclusion: The relationship between these factors and strain needs to be tested prospectively. Early identification of carers who may be at risk of strain later on will enable services to be targeted at prevention rather than cure.
Treatment of hemiplegic shoulder pain in the Netherlands: results of a national survey
Authors: Snels Ingrid AK , Beckerman Heleen , Lankhorst Gustaaf J , Bouter Lex M 
Published: May 2003

Objective: To describe the methods of treatment applied by physiotherapists, occupational therapists, rehabilitation physicians, nursing-home physicians and neurologists for hemiplegic shoulder pain, and to investigate their beliefs about the effectiveness of triamcinolone acetonide injections for this diagnosis. Design: Postal questionnaire with structured and open-ended questions. If necessary, a written reminder was sent after 2–3 weeks. Subjects: One hundred physiotherapists, 100 occupational therapists, 100 rehabilitation physicians, 100 nursing-home physicians and 100 neurologists in the Netherlands. These healthcare workers were all active in the rehabilitation of stroke patients. Results: The response was 351 (70.2%), ranging from 58% (neurologists) to 83% (physiotherapists). Fifty-four different (combinations of) treatments were mentioned and were classified into eight treatment groups. The frequency of the first choice of treatment was: physiotherapy (32%), prevention/ instruction/education (22%), oral medication (8%), local injection (7%), sling (4%), referral (3%), other therapies (4%), and different combinations (20%). In total, 86 respondents had applied local injections: 70 rehabilitation physicians, 10 nursing-home physicians and 6 neurologists. The injections used were: corticosteroids alone (51.2%), in combination with a local anaesthetic (37.2%) or a local anaesthetic only (9.3%). Belief in the effectiveness of triamcinolone injections, measured on a 0–100 point scale, was: physiotherapists median 62.5 (IQR 29.75–71.75), occupational therapists median 50.0 (IQR 43.0–63.0), rehabilitation physicians median 70.0 (IQR 56.5–80.0), nursing-home physicians median 35.0 (IQR 21.0–64.5), neurologists median 47.0 (IQR 20.0–63.0). Conclusions: As preventive measures and physiotherapy, or a combination of both, were found to be the favourite methods of treatment for hemiplegic shoulder pain in this survey, it seems that most physicians and therapists rely on a mechanical approach to hemiplegic shoulder pain. Rehabilitation physicians used additional local (anti-inflammatory) injections.
Ground reaction force after a sideways push as a measure of balance in recovery from stroke
Authors: Holt R R , Simpson D , Jenner J R , Kirker S G B , Wing A M 
Published: May 2003

Objective: To investigate if measuring ground reaction force after a sideways push at the hips gives a measure of standing balance in stroke subjects. Methods: Fifteen control subjects and 13 right hemiparetic subjects who were able to stand independently stood with their feet on a single forceplate. Horizontal sideways pushes of 3% body weight were delivered to each side of the pelvis with the subjects held firmly in a semi-rigid belt. Measurements were made of lateral pelvic displacement (sway) and the lateral sheer component of ground reaction force (GRF). Results: Right hemiparetic subjects showed significantly greater sway after a sideways push ( p < 0.01) and later onset of GRF ( p < 0.01) when pushed to their weak side compared with control subjects. There was also a positive correlation between sway after a sideways push and the onset latency of GRF in both strokes (0.41) and controls (0.61). The hemiparetic subjects swayed more ( p < 0.01) when pushed to their weak side compared with their stronger side and their GRF latency was longer, but this latter measurement failed to reach statistical significance. No difference was seen between sides in sway or GRF latency in controls. Conclusions: The latency of GRF onset after a push at the hips in controls and in stroke subjects is related to sway and both measurements increase after a stroke. This test offers a method of measuring balance after a stroke, and serial testing of an individual after a stroke may prove a useful measure of an individual's recovery of balance.
Prevalence of apraxia among patients with a first left hemisphere stroke in rehabilitation centres and nursing homes
Authors: Donkervoort M , Dekker J , van den Ende E , Stehmann-Saris J C 
Published: May 2003

Objective: To investigate the prevalence of apraxia in patients with a first left hemisphere stroke. Subjects: Left hemisphere stroke patients staying at an inpatient care unit of a rehabilitation centre or nursing home and receiving occupational therapy (n = 600). Measures: A short questionnaire on general patient characteristics and stroke-related aspects was completed by occupational therapists for every left hemisphere stroke patient they treated. A diagnosis of apraxia or nonapraxia was made in every patient, on the basis of a set of clinical criteria. Results: The prevalence of apraxia among 492 first left hemisphere stroke patients in rehabilitation centres was 28% (96/338) and in nursing homes 37% (57/154). No relationship was found between the prevalence of apraxia and age, gender or type of stroke (haemorrhage or infarct). Conclusions: This study shows that approximately one-third of left hemisphere stroke patients has apraxia.
An optimization of the Waterlow score using regression and artificial neural networks
Authors: Anthony Denis , Clark Michael , Dallender Janie 
Published: May 2003

Objectives: To optimize the ability of the Waterlow Scale to predict individuals vulnerable to developing pressure ulcers. Design: Prospective cohort study. Setting: Two acute care UK National Health Service (NHS) providers. Subjects: Four hundred and twenty-two inpatients across five specialities (general medicine, general surgery, orthopaedics, oncology and rehabilitation). Interventions: Waterlow scores recorded weekly for 14 days post admission to hospital. Main outcome measure: Development of a pressure ulcer. Results: Nonlinear analysis using neural networks did not outperform linear methods. Only five items out of 11 in the Waterlow Scale appeared to have any classification ability in this patient population. Conclusions: The Waterlow score when modelled as a linear equation appears as effective as more complicated nonlinear mappings using neural networks. Only a subset of the variables of the Waterlow Scale have predictive value in this patient population, but this is a different subset to those found in a previous study of a different client group (wheelchair users).
Longitudinal changes in bone in men with spinal cord injury
Authors: de Bruin Eling D , Dietz Volker , Dambacher Maximilian A , Stüssi Edgar 
Published: May 2003

Introduction: Quantitative bone assessment today is primarily based on the analysis of bone mineral density (BMD). The geometric and structural properties of bone, which are important parameters for skeletal strength, are generally not considered in the routine clinical assessment of spinal cord injury-related osteopenia. Objective: To study changes in structural and geometric properties of tibia bone longitudinally by means of peripheral quantitative computerized tomography and a biomechanical test method (bone stiffness measurement device Swing) in 12 subjects with spinal cord injury. Design: Measurements were conducted in the 5th week and around the 104th week after the spinal cord injury in a university hospital. Results: Paired Student's t-tests showed a significant decrease in trabecular ( p < 0.05) and cortical bone ( p < 0.05), as well as a significant decrease in geometric properties of tibia bone ( p < 0.05) within two years after the spinal cord injury. Phase velocity propagation changed in three subjects within two years following the spinal cord injury. Conclusions: This study indicates that beside changes in tissue composition, changes in bone geometric indices and in structural properties occur in the lower extremity after a spinal cord injury. In the tibia, consideration of geometric and biomechanical parameters of bone combined with bone mineral density measurements could result in an improved screening for spinal cord injury-related osteopenia and the prediction of fracture risk in spinal cord injury.
Criterion validity of lower extremity Motricity Index scores
Authors: Cameron Denise , Bohannon Richard W 
Published: May 2003

Objective: To examine the criterion validity of lower extremity Motricity Index scores. Design: Retrospective cross-sectional comparison of lower extremity Motricity Index scores and hand-held dynamometer measurements obtained from 15 patients with stroke. Results: For individual actions (ankle dorsiflexion, knee extension and hip flexion) and all actions combined, Pearson correlations were good to excellent ( r = 0.78–0.91), significant ( p < 0.001), and of high power (9%). Conclusions: The findings of this study support the criterion validity of the lower extremity Motricity Index.
The Frontal Lobe Score: part II: evaluation of its clinical validity
Authors: Wildgruber Dirk , Kischka Udo , Faßbender Klaus , Ettlin Thierry M 
Published: May 2003

Objective: To evaluate the ability of the Frontal Lobe Score (FLS) to differentiate patients with frontal lobe lesions from those with nonfrontal lesions and normal controls. Design: In a prospective, blind setup, the sensitivity and specificity of the Frontal Lobe Score was compared with the Wisconsin Card Sorting Test (WCST) and the Stroop Test. Patients: A sample of 108 subjects (26 patients with cerebral lesions confined to the frontal lobes, 28 patients with cerebral lesions without involvement of the frontal lobes, 31 patients with mixed frontal/nonfrontal lesions, 23 controls without cerebral lesions) was examined. Measures: Frontal Lobe Score, Wisconsin Card Sorting Test, Stroop Test. Results: The Frontal Lobe Score detected pure frontal lesions with a sensitivity of 92.3%. It discriminated patients with frontal lesions from normal controls with a specificity of 100%; differentiation from patients with nonfrontal lesions was obtained with a specificity of 75.0%. For the WCST, sensitivity for detection of pure frontal lesions was 65.4%, while specificity was 60.9% compared with normal controls and 53.6% compared with nonfrontal lesions. The Stroop Test showed a sensitivity of 30.8%, a specificity compared with normal controls of 95.7% and compared with nonfrontal lesions of 92.9%. Conclusion: The Frontal Lobe Score has clinical usefulness for screening of effects of frontal lobe damage superior to that of the WCST and the Stroop Test.
Inter-rater reliability of the Nottingham method of stereognosis assessment
Authors: Gaubert C S , Mockett S P 
Published: May 2003

Objective: To investigate the inter-rater reliability of stereognosis assessment in stroke patients, as measured by the Nottingham Sensory Assessment (NSA). Subjects: Twenty stroke patients consented to participate in the study. The subjects were aged between 40 and 93 years, and were no more than three months post stroke. Design: The stereognostic ability of the subjects was assessed by two of three examiners within a 24-hour period. The method laid out by the NSA was followed throughout the study. Analysis: Point to point agreement of scores and therefore reliability levels were assessed between examiners using the kappa coefficient of agreement. Results: The majority of subjects ( n = 13) were found to have impaired stereognosis on their affected side. A good level of reliability was found for the majority of items ( n = 32), with kappa values being rated as substantial or higher for most of the objects tested. In eight cases the reliability was fair or moderate. These cases included the glass, biro and 10p coin when the affected side was assessed by examiners 1 and 2, and the pencil when the same side was assessed by examiners 1 and 3. These levels of reliability were acceptable, but were not as high as the researchers had hoped. Conclusion: It is concluded that the Nottingham method of stereognosis assessment is a reliable assessment tool between raters.
What is the association between the different components of stroke rehabilitation and health outcomes?
Authors: Alexander Helen , Bugge Carol , Hagen Suzanne 
Published: May 2003

Objectives: To describe the rehabilitation input stroke patients received from health professionals during the early post stroke period and to explore possible associations between health outcomes and these rehabilitation inputs. Design: Community-based study with prospective identification of stroke patients from a random sample of 24 general practices stratified by geographical area and practice size. Setting: Ayrshire and Arran Health Board area, West of Scotland. Interventions: All physiotherapy, occupational therapy, dietetics, podiatry, speech and language therapy and community nursing inputs given to stroke patients in the course of normal treatment were recorded. Outcome measures: Barthel Index and Medical Outcomes Study Short Form-36 (SF-36). Both recorded at one, three and six months post stroke. Results: Of the 152 people providing data, more had received physiotherapy than any other rehabilitation input at all three follow-ups (81%, 47%, 39%), with occupational therapy being the next most common service (65%, 44%, 25%). Amount of rehabilitation input was significantly negatively correlated with health outcomes measured at each discrete time point: those patients with the poorest outcomes received greatest input. However, regression analysis of change in outcome scores showed that increasing amounts of rehabilitation input were significantly associated with a reduction in disability, particularly between one and three months post stroke. Conclusions: Not only have we shown that those stroke patients with poorest outcomes received most rehabilitation input, but, from analysis of the individual rehabilitation inputs, we have identified some rehabilitation inputs that significantly predict improved outcomes. This suggests that there would be merit in further investigation of these associations.