bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone Stress Injuries in Asymptomatic Elite Recruits
Authors: Kiuru Martti J. , Niva Maria , Reponen Anssi , Pihlajamäki Harri K. 
Published: December 2004

Background The occurrence and clinical significance of asymptomatic bone stress injuries is unknown. Hypothesis To evaluate by clinical and magnetic resonance imaging follow-up the occurrence of asymptomatic bone stress injuries, their clinical significance, and whether they all progress to stress fractures in subjects undergoing intensive physical training. Study Design Cohort study (prognosis); Level of evidence, 1. Methods Twenty-one male elite-unit military recruits voluntarily underwent clinical examination and magnetic resonance imaging before their intensive training period, 6 weeks into it, and on completion of the 5-month training program. Results Based on magnetic resonance imaging, a total of 75 bone stress injuries were detected. Only 40% (30/75) of the bone stress injuries had been symptomatic. Symptoms depended on location and magnetic resonance imaging grade of injury, with higher grades usually more symptomatic. Repeated clinical and magnetic resonance imaging assessment indicated that asymptomatic grade I bone stress injuries healed (21/25, 84%) or remained grade I and asymptomatic (3/25, 12%). The numbers of bone stress injuries, symptomatic cases, and recruits with bone stress injury increased toward the end of the intensive training period. Conclusions Asymptomatic grade I bone stress injuries seem common in subjects undergoing intensive physical training. Such bone stress injuries heal or remain asymptomatic grade I bone stress injuries even if intensive physical activity continues. They are therefore of no clinical significance. Only subjects who exhibit symptoms need undergo imaging studies. Subjects with an asymptomatic grade I bone stress injury may continue training but should be clinically monitored for symptoms.
Primary Anterior Cruciate Ligament Reconstruction Using Fresh-Frozen, Nonirradiated Patellar Tendon Allograft
Authors: Bach Bernard R. , Aadalen Kirk J. , Dennis Michael G. , Carreira Dominic S. , Bojchuk John , Hayden Jennifer K. , Bush-Joseph Charles A. 
Published: December 2004

Background There are conflicting reports of allograft performance, immune response, tissue incorporation, and rerupture rates when used for anterior cruciate ligament reconstruction. Purpose To evaluate the clinical outcome of a fresh-frozen, nonirradiated, patellar tendon allograft for primary anterior cruciate ligament reconstruction surgery. Study Design Case series; Level of evidence, 4. Methods Patients who underwent endoscopic primary anterior cruciate ligament reconstruction with allograft tissue a minimum of 2 years ago were evaluated with physical examinations, the KT-1000 arthrometer, functional testing, radiographic evaluation, subjective assessment, and outcomes tools. Results Fifty-nine patients (60 knees) were evaluated at an average of 51 months after surgery. Ninety-four percent of patients were mostly or completely satisfied. A negative pivot shift test result was noted in 90% of subjects. The KT-1000 arthrometer side-to-side differences were = 3 mm in 95% of patients, and no patient exceeded 5 mm. The mean International Knee Documentation Committee score was 78 (SD = 19), and the mean Lysholm score was 82 (SD = 17). There were no clinical symptoms consistent with graft rejection or infection. Radiographic evaluation demonstrated infrequent significant tunnel widening. Conclusions Use of a fresh-frozen, nonirradiated allograft for primary reconstruction of the anterior cruciate ligament is a successful procedure both subjectively and functionally for restoring stability in patients selected for allograft reconstruction. In the patients selected for this surgical procedure, clinical, arthrometric stability testing, and subjective satisfaction were comparable to our previously published cohort studies using patellar tendon autograft at similar postoperative follow-up.
Effect of Cyclic Loading on New Polyblend Suture Coupled with Different Anchors
Authors: De Carli Angelo , Vadalà Antonio , Monaco Edoardo , Labianca Luca , Zanzotto Edoardo , Ferretti Andrea 
Published: December 2004

Background Secure tendon-to-bone fixation is essential for successful rotator cuff repair. Biomechanical properties of devices used in rotator cuff repair should be better understood. Purpose To evaluate the response to incremental cyclic loading of 6 different anchor-suture complexes commonly used in rotator cuff repair. Study Design Controlled laboratory study. Methods Two absorbable anchors 5 mm and 6.5 mm in diameter and 1 metallic anchor, coupled with Ethibond or FiberWire, were tested on 5 pairs of fresh-frozen human cadaveric shoulders. An incremental cyclic load was applied until failure using a Zwich-Roell Z010 electromechanical testing machine. The ultimate failure load and mode of failure were recorded. An analysis of variance model was used for statistical analysis. Results The FiberWire suture coupled with both absorbable and metallic anchors provided statistically significantly stronger fixation. However, although the metallic anchors in most cases failed because of slippage of the anchor, absorbable anchors failed because of rupture of the eyelet. Conclusions The FiberWire seems to increase the strength of fixation devices under cyclic load using both absorbable and metallic anchors, with relevant differences in failure mode (slippage of the metallic anchor and eyelet failure in the absorbable anchor). Clinical Relevance Use of the FiberWire suture might change the mode of failure of the suture-anchor complexes.
American Collegiate Men's Ice Hockey
Authors: Flik Kyle , Lyman Stephen , Marx Robert G. 
Published: December 2004

Background Reported rates and types of ice hockey injuries have been variable. Ice hockey combines tremendous speeds with aggressive physical play and therefore has great inherent potential for injury. Purpose To identify rates and determinants of injury in American men's collegiate ice hockey. Study Design Prospective cohort study. Methods Data were collected from 8 teams in a Division I athletic conference for 1 season using an injury reporting form specific for ice hockey. Results There were a total of 113 injuries in 23 096 athlete exposures. Sixty-five percent of injuries occurred during games, although games accounted for only 23% of all exposures. The overall injury rate was 4.9 per 1000 athlete exposures (13.8 per 1000 game athlete exposures and 2.2 per 1000 practice athlete exposures). Collision with an opponent (32.8%) or the boards (18.6%) caused more than half of all injuries. Concussion (18.6%) was the most common injury, followed by knee medial collateral ligament sprains, acromioclavicular joint injuries, and ankle sprains. Conclusions The risk of injury in men's collegiate ice hockey is much greater during games than during practices. Concussions are a main cause for time lost and remain an area of major concern.
The Effect of Anterior Cruciate Ligament Reconstruction on Knee Joint Kinematics under Simulated Muscle Loads
Authors: Yoo Jae Doo , Papannagari Ramprasad , Park Sang Eun , DeFrate Louis E. , Gill Thomas J. , Li Guoan 
Published: December 2004

Background Numerous studies have investigated anterior stability of the knee during the anterior drawer test after anterior cruciate ligament reconstruction. Few studies have evaluated anterior cruciate ligament reconstruction under physiological loads. Purpose To determine whether anterior cruciate ligament reconstruction reproduced knee motion under simulated muscle loads. Study Design Controlled laboratory study. Methods Eight human cadaveric knees were tested with the anterior cruciate ligament intact, transected, and reconstructed (using a bone–patellar tendon–bone graft) on a robotic testing system. Tibial translation and rotation were measured at 0 °, 15 °, 30 °, 60 °, and 90 ° of flexion under anterior drawer loading (130 N), quadriceps muscle loading (400 N), and combined quadriceps and hamstring muscle loading (400 N and 200 N, respectively). Repeated-measures analysis of variance and the Student-Newman-Keuls test were used to detect statistically significant differences between knee states. Results Anterior cruciate ligament reconstruction resulted in a clinically satisfactory anterior tibial translation. The anterior tibial translation of the reconstructed knee was 1.93 mm larger than the intact knee at 30 ° of flexion under anterior load. Anterior cruciate ligament reconstruction overconstrained tibial rotation, causing significantly less internal tibial rotation in the reconstructed knee at low flexion angles (0 °-30 °) under muscle loads (P<. 05). At 30 ° of flexion, under muscle loads, the tibia of the reconstructed knee was 1.9 ° externally rotated compared to the intact knee. Conclusions Anterior cruciate ligament reconstruction may not restore the rotational kinematics of the intact knee under muscle loads, even though anterior tibial translation was restored to a clinically satisfactory level under anterior drawer loads. These data suggest that reproducing anterior stability under anterior tibial loads may not ensure that knee joint kinematics is restored under physiological loading conditions. Clinical Relevance Decreased internal rotation of the knee after anterior cruciate ligament reconstruction may lead to increased patellofemoral joint contact pressures. Future anterior cruciate ligament reconstruction techniques should aim at restoring 3-dimensional knee kinematics under physiological loads.
Haptoglobin modifies the hemochromatosis phenotype in mice
Authors: Tolosano Emanuela , Fagoonee Sharmila , Garuti Cinzia , Valli Linda , Andrews Nancy C. , Altruda Fiorella , Pietrangelo Antonello 
Published: December 2004

Abstract
Classic hereditary hemochromatosis (HH) is a common genetic disorder of iron metabolism caused by a mutation in the HFE gene. Whereas the prevalence of the mutation is very high, the clinical penetrance of the disease is low, suggesting that the HFE mutation is a necessary but not sufficient cause of clinical HH. Several candidate modifier genes have been proposed in mice and humans, including haptoglobin. Haptoglobin is the plasma protein with the highest binding affinity for hemoglobin. It delivers free plasma hemoglobin to the reticuloendothelial system, thus reducing loss of hemoglobin through the glomeruli and allowing heme-iron recycling. To gain insight into the role of haptoglobin as a modifier gene in HH, we used Hfe and haptoglobin double-null mice. Here, we show that Hfe and haptoglobin compound mutant mice accumulate significantly less hepatic iron than Hfe-null mice, thus demonstrating that haptoglobin-mediated heme-iron recovery may contribute significantly to iron loading in HH. (Blood. 2005;105:3353-3355)
Modulation of Epidermal Growth Factor Receptor Status by Chemotherapy in Patients With Locally Advanced Non–Small-Cell Lung Cancer Is Rare
Authors: De Pas Tommaso , Pelosi Giuseppe , de Braud Filippo , Veronesi Giulia , Curigliano Giuseppe , Leon Maria Elena , Danesi Romano , Noberasco Cristina , d’Aiuto Massimiliano , Catalano Gianpiero , Viale Giuseppe , Spaggiari Lorenzo 
Published: December 2004

Purpose To determine whether epidermal growth factor receptor (EGFR) expression in non–small-cell lung cancer (NSCLC) is modulated by chemotherapy and to assess the agreement of EGFR status between mediastinal nodes and the primary tumor after chemotherapy. Patients and Methods Patients with NSCLC stage IIIa/b pN2/3 confirmed by mediastinoscopy or mediastinostomy were treated with at least three cycles of chemotherapy before undergoing surgery. EGFR expression was evaluated on mediastinal nodes at the time of initial diagnosis and on both the primary tumor and residual metastatic nodes after treatment. Results EGFR expression determined on 138 of 164 patients who underwent mediastinoscopy or mediastinostomy was 0 (22 patients), 1+ (27 patients), 2+ (28 patients), and 3+ (61 patients). Fifty-four patients of 164 received chemotherapy followed by surgery. Of the 89 of 138 patients with EGFR score of 2+/3+ at the time of diagnosis, 34 patients underwent surgery after induction chemotherapy. None changed to zero EGFR immunoreactivity, with 29 patients (88%) maintaining a score of 2+/3+. Of the 22 of 138 patients with no EGFR expression at the time of diagnosis, six underwent surgical resection after induction chemotherapy. Of these six patients, four changed their EGFR expression from an EGFR score of 0 to 2+/3+. After treatment, the agreement of EGFR status between tumor and nodes in the subgroup of patients with EGFR score 2+/3+ was 89% to 92%. Conclusion Our data suggest a very good agreement of EGFR status before and after chemotherapy in EGFR-positive NSCLC. Induction chemotherapy can induce EGFR expression in occasional EGFR-negative tumors.
Randomized Parallel Study of Doxorubicin Plus Paclitaxel and Doxorubicin Plus Cyclophosphamide As Neoadjuvant Treatment of Patients With Breast Cancer
Authors: Diéras Véronique , Fumoleau Pierre , Romieu Gilles , Tubiana-Hulin Michèle , Namer Moïse , Mauriac Louis , Guastalla Jean-Paul , Pujade-Lauraine Eric , Kerbrat Pierre , Maillart Philippe , Pénault-Llorca Frédérique , Buyse Marc , Pouillart Pierre 
Published: December 2004

Purpose This randomized, noncomparative, parallel-group study was designed to evaluate the pathologic complete response (pCR) rate of combined doxorubicin plus paclitaxel (AP) and doxorubicin plus cyclophosphamide (AC) as neoadjuvant chemotherapy in patients with previously untreated breast cancer who were unsuitable for conservative surgery. Patients and Methods A total of 200 patients with T2-3, N0-1, M0 disease were randomly assigned in a 2:1 ratio to receive preoperative chemotherapy with either doxorubicin 60 mg/m2 plus paclitaxel 200 mg/m2 as a 3-hour infusion (AP) or doxorubicin 60 mg/m2 plus cyclophosphamide 600 mg/m2 (AC) every 3 weeks for 4 courses followed by surgery. Results A pCR (eradication of invasive carcinoma in tumor and in axillary lymph nodes) was found in 16% and 10% of patients in the AP and AC arms, respectively, by study center pathologists, and in 8% and 6% of patients, respectively, by independent pathologists. Patients with pCRs tended to have unifocal disease, tumors with negative hormonal receptor status, and less differentiation (Scarff, Bloom, and Richardson scale grade 3). Breast-conserving surgery was performed in 58% and 45% of patients in the AP and AC arms, respectively. An objective clinical response was achieved in 89% of patients in the AP arm and 70% in the AC arm. At a median follow-up of 31 months, disease-free survival (DFS) was higher in patients who reached pCR versus those without pCR (91% v 70%). Conclusion The encouraging pathologic and clinical responses of patients with breast cancer after neoadjuvant chemotherapy with doxorubicin plus paclitaxel warrant additional investigation of paclitaxel in the neoadjuvant setting of breast cancer management.
Chemotherapy Use, Outcomes, and Costs for Older Persons With Advanced Non–Small-Cell Lung Cancer: Evidence From Surveillance, Epidemiology and End Results–Medicare
Authors: Ramsey Scott D. , Howlader Nadia , Etzioni Ruth D. , Donato Bonnie 
Published: December 2004

Purpose There is limited published documentation regarding US community patterns of care for older patients with advanced non–small-cell lung cancer (NSCLC). Using the Surveillance, Epidemiology and End Results (SEER) –Medicare database, we examined community treatment patterns for advanced NSCLC, focusing on chemotherapy. Methods Patients with locally advanced or metastatic (TNM system stages IIIb and IV) NSCLC diagnosed between January 1, 1994, and December 31, 1999, were stratified based on chemotherapy agents received during the first 3 months following diagnosis. Cox proportional hazards models were used to compare survival, controlling for age, sex, race, noncancer comorbidity, stage at diagnosis, SEER region, and receipt of cancer-related surgery or radiation therapy in the first 3 months following diagnosis. Lifetime medical costs were calculated for each group. Results 14,875 patients met inclusion criteria: 7,411 (49.8%) stage III and 7,464 (50.2%) stage IV at diagnosis. Thirty-one percent received chemotherapy, 8% received surgery, and 53% received radiation therapy either as initial or adjuvant treatment. Persons ≥ 75 years of age, females, African Americans, and those with more than one comorbidity were significantly less likely to receive chemotherapy (P < .01). Survival was inferior for those who did not receive a platinum-containing agent (P < .01). Lifetime costs were highest for those receiving platinum + taxane combinations, exceeding other regimens by more than $10,000 per patient. Conclusion Chemotherapy prolongs survival in community settings, but is underutilized for persons with advanced NSCLC. Reasons for lower use in minorities and variation across regions deserve further study.
Prediction of TP53 Status for Primary Cisplatin, Fluorouracil, and Leucovorin Chemotherapy in Ethmoid Sinus Intestinal-Type Adenocarcinoma
Authors: Licitra L. , Suardi S. , Bossi P. , Locati L.D. , Mariani L. , Quattrone P. , Lo Vullo S. , Oggionni M. , Olmi P. , Cantù G. , Pierotti M.A. , Pilotti S. 
Published: December 2004

Purpose To assess the role of TP53 status in predicting pathologic complete remission after primary chemotherapy in patients with ethmoidal intestinal-type adenocarcinoma (ITAC). Patients and Methods Thirty patients with ethmoidal ITAC enrolled onto a phase II study received chemotherapy with cisplatin, fluorouracil, and leucovorin (PFL) followed by surgery and radiation. On surgical specimens, absence of viable tumor cells was defined as pathologic complete remission (pCR). TP53 status/p53 function, analyzed on pretreatment biopsies, were retrospectively correlated with pathologic results and patient outcome. Results Twelve patients achieved a pCR; 18 patients did not (overall response rate, 40%). In patients with wild-type (wt) TP53 or functional p53 protein, the pCRs were 83% and 80%, respectively; in patients with mutated TP53 or impaired p53 protein, pCRs were 11% and 0%, respectively (P ≤ .0001). At a median 55-month follow-up, all pCR patients were disease-free; 44% of nonresponding patients experienced relapse (P = .0061). Conclusion The results indicate the existence of two genetic ITAC subgroups, defined by differences in TP53 mutational status or protein functionality, that strongly influence pathologic response to primary chemotherapy and, ultimately, prognosis. PFL seems to be highly effective in terms of pCR and disease-free survival in the presence of a wt or a still-efficient p53 protein, even when encoded by a mutated TP53 gene (eg, early-stop codon mutation), but ineffective in ITACs carrying a disabled p53 protein. Whether this model is extensible to other head and neck cancers needs appropriate investigation.
Moderate Increase of Secondary Hematologic Malignancies After Myeloablative Radiochemotherapy and Autologous Stem-Cell Transplantation in Patients With Indolent Lymphoma: Results of a Prospective Randomized Trial of the German Low Grade Lymphoma Study Group
Authors: Lenz Georg , Dreyling Martin , Schiegnitz Eva , Haferlach Torsten , Hasford Joerg , Unterhalt Michael , Hiddemann Wolfgang 
Published: December 2004

Purpose An increased risk of therapy-related myelodysplastic syndrome (t-MDS) and acute myeloid leukemia (t-AML) after high-dose therapy and autologous stem-cell transplantation (ASCT) for malignant lymphoma has been described by several studies, reporting a highly variable incidence ranging from 1% to 12%. To assess this risk more precisely, the German Low Grade Lymphoma Study Group investigated the incidence of t-MDS/t-AML after ASCT on the basis of a randomized comparison of ASCT versus interferon alfa (IFN-α) maintenance in indolent lymphoma. Patients and Methods Between 1996 and 2002, 440 patients with indolent lymphoma were randomly assigned after a cyclophosphamide, doxorubicin, vincristine, and prednisone–like induction therapy regimen to myeloablative radiochemotherapy followed by ASCT or IFN-α. The incidence of secondary hematologic malignancies was determined by standardized follow-up of all study patients. Bone marrow samples from patients with proven or suspected t-MDS/t-AML were centrally reviewed. Results After a median follow-up of 44 months, 431 patients were assessable. Five of 195 patients developed a secondary hematologic malignancy after ASCT. Two of these patients developed a secondary AML. Accordingly, the estimated 5-year risk for secondary hematologic neoplasias after ASCT was 3.8%. In contrast, in the IFN-α arm, the 5-year risk of hematologic neoplasias was 0.0% (P = .0248). Conclusion The data of this randomized trial demonstrate an increased risk of secondary hematologic malignancies after myeloablative radiochemotherapy and ASCT compared with conventional chemotherapy. However, as ASCT significantly improves progression-free survival, it is currently not evident to what extent the higher rate of t-MDS/t-AML will diminish the benefit of ASCT in indolent lymphoma.
Feasibility and Response to Induction Chemotherapy Intensified With High-Dose Methotrexate for Young Children With Newly Diagnosed High-Risk Disseminated Medulloblastoma
Authors: Chi Susan N. , Gardner Sharon L. , Levy Adam S. , Knopp Edmond A. , Miller Douglas C. , Wisoff Jeffrey H. , Weiner Howard L. , Finlay Jonathan L. 
Published: December 2004

Purpose To evaluate the feasibility of and response rate to an intensified induction chemotherapy regimen for young children with newly diagnosed high-risk or disseminated medulloblastomas. Patients and Methods From January 1997 to March 2003, 21 patients with high-risk or disseminated medulloblastoma were enrolled. After maximal surgical resection, patients were treated with five cycles of vincristine (0.05 mg/kg/wk × three doses per cycle for three cycles), cisplatin (3.5 mg/kg per cycle), etoposide (4 mg/kg/d × 2 days per cycle), cyclophosphamide (65 mg/kg/d × 2 days per cycle) with mesna, and methotrexate (400 mg/kg per cycle) with leucovorin rescue. Following induction chemotherapy, eligible patients underwent a single myeloablative chemotherapy cycle with autologous stem-cell rescue. Results Significant toxicities of this intensified regimen, including gastrointestinal and infectious toxicities, are described. Among the 21 patients enrolled, there were 17 complete responses (81%), two partial responses, one stable disease, and one progressive disease. The 3-year event-free survival and overall survival are 49% (95% CI, 27% to 72%) and 60% (95% CI, 36% to 84%), respectively. Conclusion This intensified induction chemotherapy regimen is feasible and tolerable. With the majority of patients with disseminated medulloblastoma having M2 or M3 disease at diagnosis, the encouraging high response rate of this intensified induction regimen suggests that such an addition of methotrexate should be explored in future studies.