bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thiotepa-Based High-Dose Chemotherapy With Autologous Stem-Cell Rescue in Patients With Recurrent or Progressive CNS Germ Cell Tumors
Authors: Modak Shakeel , Gardner Sharon , Dunkel Ira J. , Balmaceda Casilda , Rosenblum Marc K. , Miller Douglas C. , Halpern Steven , Finlay Jonathan L. 
Published: May 2004

Purpose To evaluate the efficacy and toxicity of high-dose chemotherapy (HDC) followed by autologous stem-cell rescue (ASCR) in patients with relapsed or progressive CNS germ cell tumors (GCTs). Patients and Methods Twenty-one patients with CNS GCTs who experienced relapse or progression despite having received initial chemotherapy and/or radiotherapy were treated with thiotepa-based HDC regimens followed by ASCR. Results Estimated overall survival (OS) and event-free survival (EFS) rates for the entire group 4 years after HDC were 57% ± 12% and 52% ± 14%, respectively. Seven of nine (78%) patients with germinoma survived disease-free after HDC with a median survival of 48 months. One patient died as a result of progressive disease (PD) 39 months after HDC, and another died as a result of pulmonary fibrosis unrelated to HDC 78 months after ASCR without assessable disease. However, only four of 12 patients (33%) with nongerminomatous germ cell tumors (NGGCTs) survived without evidence of disease, with a median survival of 35 months. Eight patients with NGGCTs died as a result of PD, with a median survival of 4 months after HDC (range, 2 to 17 months). Patients with germinoma fared better than those with NGGCTs (P = .016 and .014 for OS and EFS, respectively). Patients with complete response to HDC also had significantly better outcome (P < .001 for OS and EFS) compared with patients with only a partial response or stable disease. There were no toxic deaths because of HDC. Conclusion Dose escalation of chemotherapy followed by ASCR is effective therapy for patients with recurrent CNS germinomas and might be effective in patients with recurrent NGGCTs with a low tumor burden.
Dogmas and controversies in the handling of nitrogenous wastes: Ureotely and ammonia tolerance in early life stages of the gulf toadfish,Opsanus beta
Authors: Barimo John F. , Steele Shelby L. , Wright Patricia A. , Walsh Patrick J. 
Published: May 2004

SUMMARYThe marine gulf toadfish (Opsanus beta) is an unusual teleost fish as it is able to switch between ammoniotelism and ureotelism in response to a variety of laboratory conditions. The present study integrates field work conducted in Biscayne and Florida Bays, USA with laboratory studies to examine ureotelism during the early life history stages of O. beta. Adult toadfish voluntarily nested in artificial shelters placed amongst seagrass beds and were found to be predominantly ureotelic under natural conditions as the internal shelter water had mean urea and ammonia concentrations(N=51) of 14.2±1.6 μmol N l–1 and 8.9±0.9 μmol N l–1, respectively. Toadfish successfully spawned in shelters, providing eggs, larvae and juvenile toadfish for laboratory study. In the lab, juvenile toadfish were also ureotelic and urea was excreted in pulsatile events that accounted for 62.0±5.9% of total urea-N excreted. Excretion rates of urea-N and ammonia-N were 1.018±0.084 μmol N h–1 g–1 and 0.235±0.095 μmol N h–1 g–1,respectively. Field-collected eggs, larvae and juveniles expressed significant levels of the ornithine–urea cycle enzymes carbamoyl-phosphate synthetase III, ornithine transcarbamylase and arginase and the accessory enzyme glutamine synthetase, all of which increased in activity as toadfish developed through early life stages. In juveniles, the ammonia 96-h LC50 value was 875 μmol N l–1 and there was a 3-fold increase in ornithine transcarbamylase activity in the 1000 μmol N l–1 NH4Cl treatment. The results are discussed in the context of the causal factor(s) for ureotelism in toadfish. Furthermore,the results of this study suggest it is unlikely that the adaptive significance of ureotelism in toadfish is a means to prevent fouling nests with ammonia and in turn poisoning offspring; however, additional study is warranted.
Structural colouration of mammalian skin: convergent evolution of coherently scattering dermal collagen arrays
Authors: Prum Richard O. , Torres Rodolfo H. 
Published: May 2004

SUMMARYFor more than a century, the blue structural colours of mammalian skin have been hypothesized to be produced by incoherent, Rayleigh or Tyndall scattering. We investigated the colour, anatomy, nanostructure and biophysics of structurally coloured skin from two species of primates – mandrill(Mandrillus sphinx) and vervet monkey (Cercopithecus aethiops) – and two species of marsupials – mouse opossum(Marmosa mexicana) and wooly opossum (Caluromys derbianus). We used two-dimensional (2-D) Fourier analysis of transmission electron micrographs (TEMs) of the collagen arrays in the primate tissues to test whether these structural colours are produced by incoherent or coherent scattering (i.e. constructive interference). The structural colours in Mandrillus rump and facial skin and Cercopithecus scrotum are produced by coherent scattering by quasi-ordered arrays of parallel dermal collagen fibres. The 2-D Fourier power spectra of the collagen arrays from Mandrillus and Cercopithecus reveal ring-shaped distributions of Fourier power at intermediate spatial frequencies,demonstrating a substantial nanostructure of the appropriate spatial frequency to produce the observed blue hues by coherent scattering alone. The Fourier power spectra and the observed reflectance spectra falsify assumptions and predictions of the incoherent, Rayleigh scattering hypothesis. Samples of blue Marmosa and Caluromys scrotum conform generally to the anatomy seen in Mandrillus and Cercopithecus but were not sufficiently well preserved to conduct numerical analyses. Colour-producing collagen arrays in mammals have evolved multiple times independently within the two clades of mammals known to have trichromatic colour vision. Mammalian colour-producing collagen arrays are anatomically and mechanistically identical to structures that have evolved convergently in the dermis of many lineages of birds, the tapetum of some mammals and the cornea of some fishes. These collagen arrays constitute quasi-ordered 2-D photonic crystals.
Putting an Ecstasy Test Kit to the Test: Harm Reduction or Harm Induction?
Authors: Murray Rebecca A. , Doering Paul L. , Boothby Lisa A. , Merves Michele L. , McCusker Rachel R. , Chronister Chris W. , Goldberger Bruce A. 
Published: May 2004

Objective. To evaluate the DanceSafe Complete Adulterant Screening Kit for Ecstasy with regard to its accuracy in identifying 3,4‐methylenedioxymeth‐amphetamine (MDMA) and methylenedioxyamphetamine (MDA) derivatives and its ability to detect certain contaminants.Methods. In part I, 39 street‐grade tablets purported to be MDMA were tested with the Marquis, Mecke, and Simon's reagents provided by the DanceSafe testing kit. The tablets then were submitted to gas chromatography‐mass spectrometry for identification of active ingredients. In part II, seven known drugs of abuse were tested with the Marquis, Mecke, and Simon's reagents. These drugs were codeine, dextromethorphan, dihydrocodeine, ketamine, MDMA, morphine, and d‐norpropoxyphene.Results. The Marquis, Mecke, and Simon's reagents did not differentiate pure MDMA from adulterated forms. They lacked both sensitivity and specificity for the purpose of MDMA identification when tested by persons unfamiliar with these reagents. Also, experienced toxicologists using this unfamiliar procedure generated false‐positive results.Conclusions. Neither the Marquis, Mecke, nor Simon's reagents should be used by the public for harm reduction purposes. These agents do not help identify pure MDMA tablets. Gas chromatography‐mass spectrometry remains the most sensitive and specific testing method for identifying MDMA and its contaminants.
Impact of an Alcohol Withdrawal Syndrome Practice Guideline on Surgical Patient Outcomes
Authors: Stanley Karen M. , Amabile Celene M. , Simpson Kit N. , Couillard Deborah , Norcross E. Douglas , Worrall Cathy L. 
Published: May 2004

Study Objective. To standardize treatment of alcohol withdrawal syndrome (AWS) in surgical patients using an AWS practice guideline with a symptom‐triggered approach.Design. Prospective interventional (pilot group) and retrospective (comparison group).Setting. University teaching hospital.Patients. Thirty‐eight trauma, orthopedic, and general surgery patients identified at risk for AWS in the pilot group, and 34 patients who were managed using nonstandardized approaches.Interventions. At‐risk patients in the pilot group were assessed using the AWS Type Indicator. They received lorazepam, clonidine, or haloperidol, based on AWS Type Indicator assessment and AWS practice guideline criteria.Measurements and Main Results. A standardized symptom‐triggered approach to managing AWS was expected to decrease the use of benzodiazepines, avoid undertreatment of adrenergic hyperactivity and delirium, decrease the need for sitters and physical restraints, and reduce hospital length of stay. Pilot patients received a mean of 23 mg less benzodiazepine (p=0.01), 0.1 mg more clonidine (p=0.01), and 20 mg less haloperidol (p=0.06) than comparison patients. Pilot patients also required significantly fewer sitter hours (p=0.04) and hours of restraint use (p=0.09) than comparison patients. No significant differences were found between groups for length of stay (p=0.77).Conclusions. This pilot project suggests that trauma, orthopedic, and general surgery patients at risk for AWS can be safely and effectively managed with a standardized, symptom‐triggered approach. Moreover, this approach decreased the amounts of benzodiazepines and haloperidol administered to patients at risk for AWS.
Assessment of Medication Errors That Involved Drug Allergies at a University Hospital
Authors: Jones T. Aaron , Como Jackson A. 
Published: May 2004

Objectives. To determine the reporting accuracy of true patient‐related allergies to drugs in a large teaching institution (908 licensed beds), and to identify factors contributing to medication errors that involved drug allergies. Of particular interest was the accuracy of allergy information in the medical record and the occurrence of medication errors that involved penicillin antibiotics.Methods. From a sample population of 340 patients, 50 adult patients admitted to our university‐affiliated hospital who met criteria and had an allergy to selected drugs that was documented in the hospitalwide computer system were randomly selected and interviewed to determine the timing, nature, and extent of the reaction. Furthermore, data were collected from identified Medication Error Reports when an agent was prescribed for a patient with a reported allergy to that agent or class. Prospective data collection was conducted from November 2000‐February 2001. Using the information obtained by the patient interview and chart documentation, we assessed the reported allergy. In addition, contributing factors for medication errors that involved drug allergies were identified.Results. Of the sample population, 133 patients (39%) reported allergies to at least one drug. Allergies to β‐lactams, sulfonamides, and opioid narcotics were reported in 12.6% (43 patients), 9.1% (31), and 14.4% (49) of the sample population, respectively. Most agents involved in medication errors were β‐lactam antibiotics, with an overwhelming number of these errors due to piperacillin‐tazobactam (51.4%, 36 errors). Other drugs involved were ampicillin (10%, 7 errors), other β‐lactams (24.3%, 17 errors), opioid narcotics (10%, 7 errors), and sulfonamides (4.3%, 3 errors). Most contributing factors were classified as “MD [prescribing physician] not aware of allergy.”Conclusion. These results suggest a need for ensuring that prescribers review each patient's allergy profile before order entry.
Thiazolidinedione Safety and Efficacy in Ambulatory Patients Receiving Hemodialysis
Authors: Manley Harold J. , Allcock Nicole M. 
Published: May 2004

Study Objectives. To determine whether thiazolidinediones cause significant changes in intravascular volume, anemia, or chronic heart failure; to determine which thiazolidinedione, rosiglitazone or pioglitazone, has a greater propensity to cause these adverse effects; and to evaluate thiazolidinedione efficacy in patients with diabetes mellitus and end‐stage renal disease who require hemodialysis.Design. Retrospective chart review.Setting. Ambulatory hemodialysis clinic.Patients. Forty ambulatory patients receiving hemodialysis.Measurements and Main Results. Of the 40 patients (26 men, 14 women, mean ± SD age 64.8 ± 11.5 yrs), diabetes mellitus was the cause of end‐stage renal disease in 37 (92.5%). The men were older than the women (mean ± SD age 67.65 ± 11.43 yrs and 59.58 ± 10.6 yrs, respectively, p=0.03). Additional demographic data collected were start date and cause of end‐stage renal disease, comorbid conditions, drug profile, hospitalization dates, and reason for admission. Laboratory values were obtained for hematocrit, iron indexes (transferrin saturation and ferritin), mean corpuscular volume, and hemoglobin A1c (A1C); body weight before and after dialysis, and predialysis systolic and diastolic blood pressures were measured. All monitoring parameters were evaluated for 3 months before and after the start of therapy. Three patients were hospitalized for new or worsening chronic heart failure (two were receiving rosiglitazone therapy, one pioglitazone, p=0.555). Changes in A1C values were reviewed to determine thiazolidinedione efficacy; no statistical difference was observed between thiazolidinedione agents prescribed. Combined thiazolidinedione data yielded nonsignificant effects for all clinical and laboratory findings except A1C (‐0.61%, p=0.05) and blood pressure (systolic −5.57 ± 12.09 mm Hg, p=0.01; diastolic −3.24 ± 6.17 mm Hg, p=0.002).Conclusion. Thiazolidinedione therapy is safe and effective for ambulatory patients receiving hemodialysis. However, as we found that these drugs reduced systolic and diastolic blood pressure, further investigation into this drug effect is warranted.
Coadministration of Milk Thistle and Indinavir in Healthy Subjects
Authors: DiCenzo Robert , Shelton Mark , Jordan Kelly , Koval Christine , Forrest Alan , Reichman Richard , Morse Gene 
Published: May 2004

Study Objective. To determine if milk thistle (silymarin) alters the pharmacokinetics of indinavir.Design. Sequential crossover trial.Setting. General clinical research center.Subjects. Ten healthy subjects.Intervention. Indinavir 800 mg 3 times/day was given for four doses on days 1 and 2. Silymarin 160 mg 3 times/day was given on days 3–15. On day 16 and for one dose on day 17, both drugs were given at the same dosages.Measurements and Main Results. Indinavir's pharmacokinetic parameters were evaluated at steady state both before and after administration of 14 days of silymarin. Blood samples were collected −0.25, 0.5, 1, 2, 3, 4, and 5 hours after indinavir dosing and assayed by high‐performance liquid chromatography. The final pharmacokinetic model had first‐order absorption after a lag time, and two compartments with first‐order elimination from the central compartment. When given alone and combined with silymarin, respectively, the geometric mean (95% confidence interval [CI]) steady‐state indinavir area under the plasma concentration‐time curve was 20.7 hr·mg/L (15.3–28.2 hr·mg/L) and 19.4 hr·mg/L (15.8–23.6 hr·mg/L) and the trough plasma concentration was 0.340 mg/L (0.232–0.497 mg/L) and 0.232 mg/L (0.129–0.419 mg/L).Conclusion. Silymarin has no apparent effect on indinavir plasma concentrations.
Angiotensin‐Converting Enzyme Inhibitors and Type 2 Diabetic Nephropathy: A Meta‐Analysis
Authors: Hamilton Robert A. , Kane Michael P. , Demers Jason 
Published: May 2004

Objective. To perform a meta‐analysis on studies evaluating the effect of angiotensin‐converting enzyme (ACE) inhibitors on diabetic nephropathy in patients with type 2 diabetes mellitus.Methods. A computerized literature search was conducted for articles of studies comparing ACE inhibitors with a control in patients with diabetes, in which measurement of albuminuria or proteinuria was an outcome. Each article was abstracted by two of the authors. Data from the articles were presented as geometric or arithmetic means. The data were summarized separately by using standard techniques for meta‐analysis.Main Results. Statistically significant reductions in albuminuria were observed regardless of whether data were described with geometric or arithmetic means. Both were associated with significant heterogeneity. When studies reporting geometric means were stratified and analyzed, the heterogeneity was lost and statistically significant reductions in albuminuria were observed. The same procedure was repeated for studies reporting arithmetic means, but heterogeneity remained.Conclusion. The ACE inhibitors produce statistically significant reductions in albuminuria associated with significant heterogeneity of effect. Stratification reduces the heterogeneity and supports treatment with ACE inhibitors to reduce the progression of nephropathy in patients with type 2 diabetes mellitus.
A reliable control for the ammonia loop facing limit‐cycle and snowball effects
Authors: Rovaglio Maurizio , Manca Davide , Cortese Francesco 
Published: May 2004

AbstractAutothermal catalytic reactors may show limit cycle behavior because of the simultaneous presence of inverse response and thermal feedback actions. In this study, a classical ammonia reactor (two beds, radial flow) was considered, and simulated together with the overall synthesis loop. Oscillations, caused by feed gas temperature disturbances, have been confirmed, whereas a pressure dependent hysteresis pattern appeared when the temperature is reset to the original design value. A more sensitive dynamic behavior is highlighted for the synthesis loop compared with the reactor alone, because of energy and material recycles. Finally, a control strategy extended to the overall synthesis loop has been tested in order to avoid dangerous dynamics and undesired reactor shutdown. The proposed control configuration, applied to the overall synthesis loop, is able to face and avoid both “snowball” effects and dangerous limit cycle conditions. © 2004 American Institute of Chemical Engineers AIChE J, 50: 1229–1241, 2004
FISH characterization of a dicentric Yq (p11.32) isochromosome in an azoospermic male
Authors: Codina‐Pascual M. , Oliver‐Bonet M. , Navarro J. , Starke H. , Liehr T. , Gutiérrez‐Mateo C. , Sánchez‐García J.F. , Arango O. , Egozcue J. , Benet J. 
Published: May 2004

AbstractThe most common structural rearrangements of the Y chromosome result in the production of dicentrics. In this work, we analyze an abnormal Y chromosome, detected as a mosaic in an azoospermic male ascertained for infertility. FISH with seven different DNA probes specific for Y chromosome sequences (Y α‐satellite, Y α‐satellite III, non‐α‐satellite centromeric Y, SRY gene, subtelomeric Yp, subtelomeric Yq, and PNA‐tel) and CGH analysis were performed. FISH results showed that the abnormal Y chromosome was a dicentric Yq isochromosome and that the breakpoint was distally in band Yp11.32. Lymphocyte chromosomes showed a mosaicism with 46,X,idicY(qter→p11.32::p11.32→qter) (51.7%), 46,XY (45.6%), and other cell lines (2.7%). In oral interphase cells, the mosaicism was 46,XidicY (62.8%), 46,XY (25.7%), 45,X (6.6%), and others (4.9%). The possible origin of this dicentric Yq isochromosome is discussed. Finally, we compare differences in mosaicism and phenotype among three reported cases with the breakpoint at Yp11.32 © 2004 Wiley‐Liss, Inc.
Gastropod egg mass deposition on a temperate, wave‐exposed coastline in New South Wales, Australia: implications for intertidal conservation
Authors: Benkendorff K. , Davis A.R. 
Published: May 2004

Abstract
The identification and protection of known breeding grounds is a high priority for the conservation of marine biodiversity. Here, we examine the intertidal habitats used by marine gastropods for the deposition of benthic egg masses along a wave‐exposed coastline in New South Wales, Australia.
A total of 200 surveys were conducted on 13 intertidal reefs. The egg masses of 46 species were identified, with a further eight distinct types recorded but remaining unidentified. Over half of the gastropods were found to deposit egg masses exclusively on the underside of boulders. Other intertidal substrata used for gastropod egg mass deposition included vertical and horizontal exposed rock surfaces, algal fronds and sand. Only eight species were found to attach their egg masses to more than one type of substratum.
Twelve reefs were classified into three categories according to exposure to wave action and habitat diversity. The mean number of species found depositing egg masses was compared using a standard eight surveys from each site. Sub‐maximally wave‐exposed reefs with maximal habitat diversity were found to support a significantly higher species richness of gastropod egg masses, compared with maximally wave‐exposed reefs with either maximal or sub‐maximal habitat diversity (p=0.000).
Gastropods that deposit egg masses on the underside of boulders were more likely to be found on sub‐maximally wave‐exposed reefs, whereas species that deposit egg masses in all other microhabitats were equally likely to be found breeding on sub‐maximally or maximally exposed reefs.
Gastropods with pelagic larvae tended to occur at a greater number of sites than those that hatch post‐metamorphosis. A significant difference was found between species grouped according to these two developmental modes for the mean number of sites at which egg masses were recorded (p=0.008).
Variation in the species richness of gastropods found depositing egg masses on different intertidal reefs appears to be influenced by the availability of suitable boulders and exposure to wave action. These factors should be taken into consideration during the selection of locations for intertidal protected areas.
Copyright © 2004 John Wiley & Sons, Ltd.