bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Analysis of Thyroid Cancer in Adult Patients Exposed to Ionizing Radiation due to the Chernobyl Nuclear Accident: 5‐Year Comparative Investigations Based on the Results of Surgical Treatment
Authors: Cherenko Sergiy M. , Larin Oleksandr S. , Gorobeyko Maksim B. , Sichynava Rivaz M. 
Published: October 2004

AbstractThe aim of study was to compare clinical and pathologic findings of surgically removed thyroid tumors in adults with or without history of irradiation due to the Chernobyl accident. From 1990 to 2003, 2363 adults with no evidence of radiation influence in their history (group A) have undergone operation for thyroid nodules. During the same period, 311 patients (born before 1969) with strict evidence of Chernobyl irradiation also underwent operation (group B). Both groups were similar in age, sex, and preoperative examination. Group B represented three of the four official categories of people affected by the Chernobyl accident: 1–recovery operation workers; 2–people evacuated from the restricted area; 3–inhabitants of contaminated areas. The rate of thyroid carcinoma among all cases of thyroid nodules was significantly higher in group B—32.8% (102 patients) versus 27.2% (644 patients) in group A (p < 0.05). But a more distinct difference was observed in 1 and 2 categories of group B patients (the rate of cancer was, correspondingly, 54.8% and 47.8%; p < 0.01). The percentage of the invasive form of cancer (T4) was significantly higher in irradiated patients–39% versus 23% (p < 0.05) as were regional metastases (N1a‐1b)—41% versus 19% (p < 0.01) and frequency of multifocality (33% versus 24%; p < 0.05). The most distinguished features were found in 1 category of group B: T4—in 47%, N1a‐1b —in 62%, multifocality—in 41%. Our results suggest the irradiation as a cause of thyroid cancer in adult victims of Chernobyl and confirm the increasing aggressiveness of such tumors.
Surgical Management of Amiodarone‐associated Thyrotoxicosis: Mayo Clinic Experience
Authors: Houghton Scott G. , Farley David R. , Brennan Michael D. , van Heerden Jon A. , Thompson Geoffrey B. , Grant Clive S. 
Published: October 2004

AbstractAmiodarone‐associated thyrotoxicosis (AAT) is often poorly tolerated owing to underlying cardiac disease, and it is frequently refractory to conventional medical treatment. The goal of this study was to describe the patient characteristics, management, and outcomes of all the patients treated surgically for AAT at a single institution. We conducted a retrospective chart review of all patients managed surgically for AAT (April 1985 through November 2002) at the Mayo Clinic in Rochester, Minnesota. Altogether, 29 men and 5 women, ages 39 to 85 years (median 60 years), treated with amiodarone for 3 to 108 months underwent near‐total or total thyroidectomy. Frequent symptoms were worsening heart failure, fatigue, weight loss, and tremor. Altogether, 12 patients failed medical management of their AAT, and 21 received no preoperative medical therapy. One patient had been successfully managed medically but required definitive treatment. Common indications for operation were the need to remain on amiodarone, cardiac decompensation, medically refractory disease, and severe symptoms, both hyperthyroid and cardiac, necessitating prompt resolution. The median ± SD American Society of Anesthesiologists (ASA) classification (1 = healthy through 5 = moribund) was 3.00 ± 0.58. A total of 27 specimens had histology consistent with AAT. Complications included death (n = 3), rehospitalization (n = 3), symptomatic hypocalcemia (n = 2), pneumonia (n = 2), cervical hematoma (n = 1), prolonged ventilatory wean (n = 1), and stroke (n = 1); one patient developed hypotension, adult respiratory distress syndrome, and sepsis. Of the 31 surviving patients, 25 (80%) remained on amiodarone postoperatively. The median follow‐up was 29 months, at which time all surviving patients were free of hyperthyroid symptoms. Thyroidectomy is an effective treatment for AAT but has a high incidence of perioperative morbidity and mortality. The cardiovascular co‐morbidities and high operative risk in this group of patients may account for the increased complication rate.
Predictive Factors for Recurrence from a Series of 74 Children and Adolescents with Differentiated Thyroid Cancer
Authors: Borson‐Chazot Francoise , Causeret Sylvain , Lifante Jean‐Christophe , Augros Marylin , Berger Nicole , Peix Jean‐Louis 
Published: October 2004

AbstractThe influence of clinical and treatment factors on the risk of recurrence was analyzed from a retrospective series of 74 children and adolescents with thyroid cancer (55 girls, 19 boys; age 2–20 years). Two groups, comparable in terms of age, sex, and previous radiotherapy, were compared according to the presence (group 1) or absence (group 2) of cervical lymph nodes identified by palpation or ultrasonography. Total thyroidectomy (TT) with lymph node dissection (LND) was performed in the 19 group 1 patients, whereas in group 2 patients (n = 55) lobectomy was performed in 29, TT in 26, and LND in 7. Pathology studies showed papillary thyroid carcinoma in 95% of cases. In group 1, tumors were more frequently multifocal (89% vs. 16% in group 2), invasive with extension beyond the thyroid capsule (68% vs. 5% in group 2), and of the diffuse sclerosing variety (63% vs. 4% in group 2) (p < 0.001). With a median follow‐up of 61 months, lymph node recurrence was seen in 53% of group 1 patients and in no patients in group 2. Three group 2 patients (10%) were reoperated for a local recurrence after lobectomy. Risk factors for reintervention were young age (< 15 years) (p < 0.01) and cervical lymph nodes (p < 0.001). Survivals without reintervention at 5 and 10 years were, respectively, 58% and 38% for group 1 and 94% and 90% for group 2 (p < 0.001). At the time of analysis, 68% of group 1 patients and 98% of group 2 patients were in remission. In conclusion, the presence of palpable cervical lymph nodes at diagnosis is associated with more invasive forms of malignancy and is a predictive factor of recurrence regardless of the extent of the initial surgery.
Preoperative Neck Ultrasonographic Mapping for Persistent/Recurrent Papillary Thyroid Cancer
Authors: BinYousef Hussam M. , Alzahrani Ali S. , Al‐Sobhi Saif S. , Al Suhaibani Hamed S. , Chaudhari Mohammed A. , Raef Hussain M. 
Published: October 2004

AbstractSurgical resection of persistent/recurrent (P/R) papillary thyroid cancer (PTC), when localized to the neck, is generally recommended; however, its impact on the course of the disease is not clear. We introduced a new technique in the form of preoperative neck ultrasonographic mapping (US‐M) to improve the outcome of the surgical resection of P/R PTC. A total of 19 patients had undergone regional (central, lateral, or both) neck dissection before introducing the current technique (group 1, or G1), and 26 patients (group 2, or G2) had limited lymph node resection guided by US‐M with findings accurately plotted on a standard diagram. All of the operations were performed by a single surgeon. The surgical outcomes of the two groups were compared. The resected lesions were positive for PTC in 17 patients (89.5%) in G1 and in 25 patients (96.2%) in G2. In G2, the intraoperative findings exactly matched the US‐M in 23 patients (88.5%). Postoperatively, neck US became negative in 50% in G1 and in 83.3% in G2 (p = 0.02). Thyroglobulin (Tg) became undetectable in 37.5% in G1 and 52.3% in G2 (p = 0.37). Whole‐body iodine scans (WBS) became negative in one of six patients (16.7%) in G1, and in three of four patients (75%) in G2, (p = 0.06). After a mean follow‐up of 23.8 ± 7.1 months in G1 and 9.8 ± 4.7 months in G2, 6 patients (31.6%) in G1 and 15 patients (62.5%) in G2 were in remission (p = 0.04), whereas the disease persisted in 13 cases (68.4%) in G1 and 9 (37.5%) in G2 (p = 0.04). In conclusion, US‐M improved the surgical outcome, as evidenced by the postoperative US, Tg, and WBS findings and the higher remission rate for the G2 patients than for the G1 patients.
Papillary Microcarcinoma of the Thyroid: How Should It Be Treated?
Authors: Ito Yasuhiro , Tomoda Chisato , Uruno Takashi , Takamura Yuuki , Miya Akihiro , Kobayashi Kaoru , Matsuzuka Fumio , Kuma Kanji , Miyauchi Akira 
Published: October 2004

AbstractWe previously demonstrated that (1) most papillary microcarcinomas can be followed without surgical treatment and (2) when surgery is performed, patients with lateral lymph node metastasis detected on preoperative ultrasonography (US) are more likely to develop recurrence. In this study, we further investigated the application of these strategies. To date, we have observed 211 patients (average follow‐up 47.9 months). In more than 70% of these patients the tumor size did not increase during the follow‐up period. There were no clinicopathologic features linked to tumor enlargement except in tumors ≥ 7 mm, which tended to enlarge in patients followed for 4 years. To evaluate not only whether observation can continue but also how to dissect the lymph nodes optimally at surgery, US diagnosis for lateral node metastasis is essential because the presence of US‐diagnosed lateral metastasis is an even stronger predictive marker for recurrence than the presence of pathologically confirmed node metastasis. The positive predictive value (PPV) was 80.6% for US but reached 100% if fine‐needle aspiration biopsy (FNAB) of nodes or FNAB‐thyroglobulin measurement is added. Furthermore, carcinomas occupying the upper region of the thyroid more frequently showed US‐diagnosed and pathologically confirmed lateral metastasis, and those measuring ≥ 7 mm were more likely to show pathologically confirmed lateral metastasis. These findings suggest that, for papillary microcarcinoma: (1) US‐diagnosed lateral metastasis is a strong marker predicting a worse relapse‐free survival; (2) FNAB of nodes and FNAB‐thyroglobulin measurement are useful tools for evaluating lymph node metastasis; and (3) careful US evaluation for lateral metastasis is necessary in patients with a tumor measuring ≥ 7 mm or that is located in the upper region of the thyroid both during observation and preoperatively.
Primary Hyperparathyroidism in the Young Age Group: Particularities of Diagnostic and Therapeutic Schemes
Authors: Cupisti Kenko , Raffel Andreas , Dotzenrath Cornelia , Krausch Markus , Röher Hans‐Dietrich , Schulte Klaus‐Martin 
Published: October 2004

AbstractPrimary hyperparathyroidism (pHPT) is a rare endocrine disease in children and young adults. The widespread use of new developments in pHPT surgery (i.e., unilateral and minimally invasive approaches) is based on the assumption that the solitary adenoma is the predominant intraoperative finding, but it has not been evaluated in the subgroup of young patients. From April 1986 to December 2002, a total of 1219 patients with pHPT have been operated on in our institution. The records of 64 patients (5.3%) younger than 30 years were extracted and compared to those of the older patients. The study group (median age 25 years, range 11–30 years) had significantly less bone pain, fewer signs of bone demineralization, and fewer neuropsychiatric symptoms. Eleven patients had hereditary disease. We found a solitary adenoma in only 32 of the 64 juvenile patients (p < 0.001), multiple gland disease in 25 patients (p < 0.001), and two suspected carcinomas. No adenoma could be identified in five patients. Follow‐up of 54 patients after a median of 6.1 years revealed 42 normocalcemic patients, 5 hypocalcemic patients, and 7 patients with hypercalcemia. Altogether, 16 juvenile patients underwent parathyroid reoperations (25%) compared to 105 older patients (9%) (p = 0.003). Problems and difficulties with parathyroid surgery are pronounced in younger patients. The high rate of multiple gland disease requires bilateral cervical exploration as the standard procedure in pHPT patients younger than 30 years of age.
Long‐term changes of c‐Fos expression in the rat spinal cord following chronic constriction injury
Authors: Jergova Stanislava , Cizkova Dasa 
Published: October 2004

AbstractThe expression of c‐Fos protein has been used as a relative marker of nociceptive neuronal activity in the spinal cord following various noxious stimuli. Experiments were conducted to examine c‐Fos expression in lumbar spinal cord (L3‐L6) following chronic constriction injury (CCI) in relation to nociceptive behavior over longer survival period up to 28 days. Development of mechanical allodynia was observed in the ipsilateral hind paw of CCI rats at day 3 and lasted up to 28 days. In contrast, the spinal c‐Fos expression in CCI rats appeared in a biphasic manner. The highest number of c‐Fos positive neurons occurred during the first week, followed by a decline at 7 and 14 days and reappearance at day 28 following injury. The early increase of c‐Fos expression correlated with allodynia development, however, at longer survival period (28 days) c‐Fos positivity become comparable in both CCI and sham groups despite their obvious behavior differences.Our results suggest that, at least in the CCI model, the c‐Fos protein expression should not be considered as a reliable index of pain sensation disorders.
The influence of non‐specific low back pain on pressure pain thresholds and disability
Authors: Farasyn André , Meeusen Romain 
Published: October 2004

AbstractThe purpose of this study was to investigate the pressure pain thresholds (PPTs) with respect to the Erector spinae and the hip muscles in 87 patients with subacute non‐specific low back pain (LBP) and to evaluate the relationship between the PPTs and disability.In order to establish reference values, 64 healthy subjects were examined with respect to PPTs and used as a control group against the group of LBP patients.The mean PPT values of the Erector spinae and the hip at all examined points of the LBP group were significantly lower (p< 0.001) in comparison to the PPT values of the healthy group. An exceptionally high difference (2.7 kg/cm2) was found at the L3 Erector spinae level. The correlation between having LBP or not in the whole group (n= 151) and PPT, was highest at the L3 level of the Erector spinae (r= −0.710,p< 0.001).When the group of patients with LBP was divided into two subgroups in terms of having an Oswestry disability index (ODI) lower than 40 (“moderate LBP disability”) or an ODI higher than 40 (“severe LBP disability”) it was surprising to notice that there was no significant difference between the PPTs of the Erector spinae and the hip musculature. This study has shown the possibility of the existence of muscular disorder in the lumbar part of the Erector spinae in patients with non‐specific low back pain, but also reveals the strong inter‐individual differences in muscular fibrosis sensitivity and pain behaviour related to gender.
Rapid phenotypic changes in passaged articular chondrocyte subpopulations
Authors: Darling Eric M. , Athanasiou Kyriacos A. 
Published: October 2004

AbstractArticular chondrocytes are often expanded in vitro and then used to assist in healing articular cartilage defects. We investigated the extent of dedifferentiation in monolayer‐passaged, zonal articular chondrocytes by using quantitative, real‐time PCR. The relative gene expressions for collagen type I and II, aggrecan, and superficial zone protein were analyzed for relevant passage numbers (P0–P4) to determine how the expansion of chondrocytes affects the expression of cartilage extracellular matrix proteins. Results reveal that dramatic changes occur as early as first passage. Furthermore, these changes are shown to persist even when the expanded cells are encapsulated in 3D, alginate beads. Successful tissue engineering and autologous cell transplantation procedures rely heavily on having a cell source that expresses the chondrocytic phenotype. The results of this study suggest that major problems exist at the front‐end of cartilage regeneration efforts. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.
Social adversity contributes to high morbidity in psychoses in immigrants – a national cohort study in two generations of Swedish residents
Authors: HJERN A. , WICKS S. , DALMAN C. 
Published: October 2004

Background. Recent reports have indicated that immigrants have an elevated risk of schizophrenia as well as an increasing tendency for social exclusion. The aim of this study was to compare rates of schizophrenia and other psychoses in immigrants and their children of different ethnic groups with the majority population in Sweden in relation to social adversity.Method. The study population consists of a national cohort of 1·47 million adults (born 1929–1965) and 1·16 million children and youth (born 1968–1979) in family households from the national census of 1985. Multivariate Cox regression analyses was used to study hospital discharge data during 1991–2000 in relation to socio-economic household indicators from 1985 and 1990 (single adult household, adults having received social welfare, parental unemployment, urban residency, housing and socio-economic status).Results. First as well as second generation immigrants had higher age and sex adjusted risk ratios for schizophrenia as well as for other psychoses (RRs 1·4–3·1 and 1·0–2·0 respectively) compared with the Swedish majority population. These risk ratios decreased considerably after adjusting for socio-economic indicators, for all groups, but particularly for the non-European immigrants. However, an elevated risk still remained in the Finnish and Eastern and Southern European study groups.Conclusions. A higher risk of schizophrenia and psychoses was found in two generations of immigrants of diverse ethnicity. The results indicate that social adversity contributes to the higher risk.
Cluster analysis of key diagnostic variables from two independent samples of eating-disorder patients: evidence for a consistent pattern
Authors: CLINTON DAVID , BUTTON ERIC , NORRING CLAES , PALMER ROBERT 
Published: October 2004

Introduction. The optimal classification of eating disorders has been a matter of considerable debate. The present paper tackles this issue using cluster analysis with large independent samples of eating-disorder patients.Method. Two samples of adult female patients from Sweden (n=631) and England (n=472) were classified on the basis of 10 key clinical variables of primary significance for diagnosing eating disorders. A separate series of cluster analyses were conducted on each sample.Results. Results suggested that a three-cluster solution was optimal in both samples. The first cluster (‘generalized eating disorder’) was characterized by high levels of eating-disorder psychopathology on all variables except weight and menstrual functioning. The second cluster (‘anorexics’) was typified by low weight, amenorrhoea and the absence of binge eating, and seemed to correspond to the clinical picture of anorexia nervosa. The third cluster (‘overeaters’) was characterized by high weight and moderate levels of binge eating and compensatory behaviour.Conclusions. Results suggest that patients presenting to eating-disorder services in different countries have clinical features that fall into very similar patterns. These patterns resemble, but are not identical to, existing diagnostic categories.
The associations between psychopathology and being overweight: a 20-year prospective study
Authors: HASLER G. , PINE D. S. , GAMMA A. , MILOS G. , AJDACIC V. , EICH D. , RÖSSLER W. , ANGST J. 
Published: October 2004

Background. Psychiatric disorders and being overweight are major health problems with increasing prevalence. The purpose of this study was to test the hypothesis that being overweight is associated with a range of psychiatric conditions including minor and atypical depressive disorders, binge eating, and aggression.Method. Prospective community-based cohort study of young adults (n=591) followed between ages 19 and 40. Information derived from six subsequent semi-structured diagnostic interviews conducted by professionals over twenty years. Outcomes were being overweight [body-mass index (BMI)>25] and average yearly weight change between ages 20 and 40 (BMI slope).Results. 18·9% of the participants were classified as being overweight. Being overweight turned out to be a stable trait: 77·7% of subjects were assigned to the same weight class at each interview. Atypical depression and binge eating were positively associated with both, increased weight gain and being overweight, while psychiatric conditions associated with aggressive behaviors (aggressive personality traits, sociopathy) were positively associated with being overweight, but were not related to the rate of weight change. Generalized anxiety disorder was negatively associated with overweight. These results persisted after controlling for substance use, levels of physical activity, demographic variables and family history of weight problems.Conclusions. This study shows relatively strong associations between eating-related and aggressive psychopathology and being overweight. Given the high prevalence rates of these conditions, this study encourages further research on the causality of psychopathology-overweight associations that might provide insight on novel preventive approaches for major health problems.
Abnormal response to metabolic stress in schizophrenia: marker of vulnerability or acquired sensitization?
Authors: MARCELIS M. , CAVALIER E. , GIELEN J. , DELESPAUL P. , VAN OS J. 
Published: October 2004

Background. Previous work suggests that individuals with schizophrenia display an altered homovanillic acid (HVA) response to metabolic stress. The present study replicated and extended this paradigm, including individuals with elevated genetic risk for schizophrenia.Method. Patients with psychosis (n=50), non-psychotic first-degree relatives of patients with psychosis (n=51) and controls without psychosis (n=50) underwent, in randomized order, double-blind administration of placebo and the glucose analogue 2-deoxy-D-glucose (2DG), which induces a mild, transient clinical state of glucoprivation. Plasma HVA and cortisol were assessed twice before the start of the 2DG/placebo infusion (baseline values), as well as four times post infusion. Data were analysed using multi-level random regression techniques.Results. During the stress condition, significant increases in plasma HVA and cortisol were found. The increase in plasma HVA level during the stress condition was significantly stronger in patients than in controls, whereas this was not the case in relatives v. controls. The increase in plasma cortisol during the stress condition was significantly less in patients than controls, but no significant difference in the increase of plasma cortisol during stress was found in the comparison between relatives and controls.Conclusions. Patients with psychosis, but not their non-psychotic first-degree relatives, show an altered neurobiological response to metabolic stress, suggesting that this dysregulation is not a genetically transmitted vulnerability, but an illness-related effect, possibly reflecting acquired sensitization of neuroendocrine systems by repeated environmental stressors or repeated stimulation with agonistic drugs.