bluuebunny/crossref_metadata_2025_split huggingface dataset:
SIHONSCORE: a scoring system for external quality control of leukaemia/lymphoma immunophenotyping measuring all analytical phases of laboratory performance
Authors: Kluin‐Nelemans J. C. , Van Wering E. R. , Van Der Schoot C. E. , Adriaansen H. J. , Van't Veer M. B. , Van Dongen J. J. M. , Gratama J. W. ,   on behalf of the Dutch Co‐operative Study Group on Immunophenotyping of Haematological Malignancies (SIHON)
Published: March 2003

For the diagnosis of leukaemia and leukaemic lymphoma, clinicians frequently have to rely on the results of immunophenotyping. To improve the quality of these results, the Dutch Foundation for Immunophenotyping of Haematological Malignancies (SIHON) initiated external quality rounds in 1986. Over a period of more than 10 years, this has led to improvements in the interpretation of immunophenotyping results. However, the evaluation of results focused mainly on the correctness of the interpretation of the immunophenotypical data, leaving the preceding analytical phases unevaluated. Therefore, in 1996 SIHON developed a more comprehensive scoring system, called SIHONSCORE, covering all three phases of immunophenotyping, namely the pre‐analytical (i.e. choice of the staining panels), analytical (i.e. the technical part consisting of sample preparation, data acquisition and analysis) and the post‐analytical phase (i.e. the interpretation) of the laboratory process. Here, we report how SIHONSCORE was successfully applied to three consecutive external quality rounds consisting of a total of nine different cases tested. For laboratory certification, participation in external quality control programmes is required. Evidently, criteria are needed to define the minimum acceptable performance of a certified laboratory. With SIHONSCORE, a useful instrument is obtained evaluating all phases of the performance of laboratories in leukaemia and lymphoma immunophenotyping.
The impact of attaining a minimal disease state after high‐dose melphalan and autologous transplantation for multiple myeloma
Authors: Davies Faith E. , Forsyth Peter D. , Rawstron Andrew C. , Owen Roger G. , Pratt Guy , Evans Paul A. S. , Richards Stephen J. , Drayson Mark , Smith Graeme M. , Selby Peter J. , Child J. Anthony , Morgan Gareth J. 
Published: March 2003

Initial studies with high‐dose therapy (HDT) in myeloma suggest some beneficial effects of attaining a complete response (CR); however, the effect on survival is difficult to assess owing to inconsistencies in the definition of response between studies. We have analysed 96 newly diagnosed patients aged less than 65 years who received HDT and assessed the effect of response on survival using electrophoresis, immunofixation and fluorescent IgH polymerase chain reaction (PCR) to define CR. Patients received induction chemotherapy with C‐VAMP (adriamycin, vincristine, methylprednisolone, cyclophosphamide) followed by melphalan 200 mg/m2 and reinfusion of peripheral blood stem cells. There was a high response to C‐VAMP [CR = 24%, partial response (PR) = 64%], with all but one patient improving the depth of response after HDT (CR = 69%, PR = 31%). The progression‐free survival (PFS) and overall survival (OS) were excellent at a median of 46·4 months and 72+ months. There was a trend towards an improved PFS in patients with an immunofixation‐negative CR compared with patients with a PR (49·4 months, 41·14 months; P = 0·26). This was not evident when electrophoresis was used to define CR. The method used to define CR did not impact on the overall survival and fluorescent IgH PCR failed to add any additional prognostic information. This study supports the widespread use of the European Bone Marrow Transplantation group (EBMT) response criteria and suggests that immunofixation should be performed on all patients who become electrophoresis negative.
Cord blood transplantation from HLA‐mismatched unrelated donors as a treatment for children with haematological malignancies
Authors: Ohnuma Kei , Isoyama Keiichi , Ikuta Koichiro , Toyoda Yasunori , Nakamura Junko , Nakajima Fumiaki , Tsuchida Masahiro , Ohira Mutsuro , Suminoe Aiko , Hara Toshiro , Nishihira Hirokazu 
Published: March 2003

Factors influencing the outcome for 39 children with haematological malignancy who were subjected to a cord blood transplantation (CBT) from genotypically HLA‐mismatched unrelated donors were analysed. This retrospective study included 21 children with acute lymphoblastic leukaemia, 15 with acute myelogenous leukaemia and one each with chronic myelogenous leukaemia, refractory anaemia with myelodysplastic syndrome (MDS) and juvenile myelomonocytic leukaemia (JMML). Those subjected to CBT during the first or second complete remission (CR) and MDS without blasts were assigned to the standard‐risk (SR) group (n = 16). Patients in third or subsequent remission, relapse or partial remission with refractory leukaemia at the time of CBT were considered to be in advanced phase, and placed in the high‐risk (HR) group (n = 11). JMML and the second CR after a relapse (n = 8), or bone marrow failure after a rejection (n = 3), following haematopoietic stem cell transplantation (HSCT) in the first CR were included in the high‐risk group. Kaplan–Meier estimates for neutrophil and platelet recovery were 83·7 ± 12·2 at d 60 and 55·4 ± 16·6% at d 100 respectively. The incidence of grades II–VI acute graft‐versus‐host disease was 58·5 ± 16·8%. The Kaplan–Meier estimate for 3‐year event‐free survival (EFS) was 49·2 ± 16·6. From multivariate analysis, the most important factor influencing EFS was disease status at CBT: SR patients had a 3‐year EFS of 75·0 ± 21·6%, compared with 29·6 ± 20·6% for those with HR disease (P = 0·013, RR 4·746, 95% CI 1·382–16·298). These data confirm that HLA‐mismatched, unrelated CBT is a feasible procedure to cure a significant proportion of children with leukaemia, especially if conducted in a favourable phase of the disease.
A dose of 75 μg/kg/d of i.v. anti‐D increases the platelet count more rapidly and for a longer period of time than 50 μg/kg/d in adults with immune thrombocytopenic purpura
Authors: Newman Gregg C. , Novoa Maria V. , Fodero Erin M. , Lesser Martin L. , Woloski B. M. R. , Bussel James B. 
Published: March 2003

Treatment with 75 μg/kg/d intravenous (i.v.) anti‐D was compared with 50 μg/kg/d in a prospective randomized study of 27 RhD‐positive, human immunodeficiency virus‐negative, adult, acute, non‐splenectomized patients with immune thrombocytopenic purpura (ITP) and platelet counts ≤ 30 × 109/l. The higher dose resulted in greater median d 1 (43 × 109/l vs. 7·5 × 109/l; P = 0·012) and d 7 (153 × 109/l vs. 64·5 × 109/l; P = 0·001) platelet increases despite no greater haemoglobin decrease. Children with acute ITP receiving 75 μg/kg/d had overnight platelet increases in seven out of nine cases. The duration of effect at the 75 μg/kg/d dose was 46 d vs. 21 d (P = 0·03). Adverse events were mild to moderate and ameliorated with prednisone and acetaminophen premedication.
Health and functional status of adult recipients 1 year after allogeneic haematopoietic stem cell transplantation
Authors: Socié Gérard , Mary Jean‐Yves , Esperou Hélène , Robert Dominique Vexiau , Aractingi Sélim , Ribaud Patricia , Devergie Agnès ,   Marie‐Elisabeth Toubert,, Boudou Patrice , Cathelinau Beryl , Gluckman Eliane , Vexiau Patrick 
Published: March 2003

Increasing numbers of patients are surviving after allogeneic haematopoietic stem cell transplantation (SCT). Among these patients, a number of late complications have been described but few data on the risk factors of these long‐term effects of SCT are available. We report the analysis on 105 adult patients, surviving free of haematological disease at a median time of 15 months after SCT. At the time of screening, 52% had returned to work, general health status was normal in 67% and 47% were sexually active. Female patient gender odds ratio (OR) 2·9 (P = 0·01) and age > 25 years (OR = 3·2, P = 0·02) were associated with non‐return to work. Decreased general status was associated with chronic graft‐versus‐host disease (GvHD) (OR = 3·2, P = 0·009) and irradiation (OR = 3·6, P = 0·004). Sexual inactivity was associated with younger age (OR = 7·0, P = 0·0002) and chronic GvHD (OR = 3·3, P = 0·006). Risk factors for altered pulmonary function tests included previous smoking habits, irradiation and chronic GvHD. Obstructive lung disease was associated with a previous history of asthma. Sicca syndrome and conjunctivitis were increased in patients with previous acute GvHD and cataracts were less frequent in patients with aplastic anaemia. Persistent impaired hair re‐growth was less frequent in patients who received irradiation (OR = 0·18, P = 0·002) but increased in patients with previous acute GvHD (OR = 5·3, P = 0·007). Microalbuminuria was more frequent in irradiated patients (OR = 9·4, P = 0·05). Raised cholesterol was associated with age (OR = 20·8, P < 0·001), previous acute GvHD (OR = 4·7, P = 0·03), steroid use (OR = 6·3, P = 0·001) and familial hypercholesterolaemia (OR = 4·4, P = 0·04). Decreased bone density was associated with chronic GvHD (OR = 3·9, P = 0·001). Thus, using routine tests in adult patients we were able to detect significant numbers of‐non‐symptomatic complications enabling early treatment.
Acute myeloid leukaemia M0: haematological, immunophenotypic and cytogenetic characteristics and their prognostic significance: an analysis in 241 patients
Authors: Béné Marie‐Christine , Bernier Michel , Casasnovas René Olivier , Castoldi Gianluigi , Doekharan Dew , Van Der Holt Bronno , Knapp Walter , Lemež Petr , Ludwig Wolf‐Dieter , Matutes Estella , Orfao Alberto , Schoch Claudia , Sperling Christian , Van′t Veer Mars B. ,   for the European Group for the Immunological Characterization of Leukaemias (EGIL)
Published: March 2003

Haematological, immunophenotypic and cytogenetic characteristics were analysed in 241 patients with acute myeloid leukaemia (AML) M0, including 58 children. Children < 3 years and adults between 60 and 70 years of age were most frequently affected. Immunophenotyping showed a heterogeneous phenotype. Anti‐myeloperoxidase was positive in about half of the patients. Cytogenetic data were available from 129 (54%) patients. A normal karyotype was found in only 24%. Most of the abnormalities were unbalanced and the chromosomes 5, 7, 8 and 11 were the most frequently affected. Survival data were available from 152 treated patients (63%). The median overall survival for all patients was 10 months, 20 months for children (n = 36), 10 months for the young adult group (n = 50) and 7 months for the elderly patients (n = 66) (P = 0·09). Karyotype was not a prognostic factor influencing survival. AML M0 shows the immunological characteristics of early progenitor cells, but the expression of the different markers and cytogenetic abnormalities is heterogeneous. The prognosis is poor compared with other de novo AML and similar to that of AML with multilineage dysplasia or AML following myelodysplastic syndromes.
Prognostic value of soluble interleukin 2 receptor levels in Langerhans cell histiocytosis
Authors: Rosso Diego A. , Roy Adriana , Zelazko Marta , Braier Jorge L. 
Published: March 2003

Summary. We investigated the prognostic significance of soluble interleukin 2 receptor (sIL‐2r) levels in the pre‐ and post‐treatment serum of paediatric patients with Langerhans cell histiocytosis (LCH). Serum levels of sIL‐2r from 32 LCH patients and 14 healthy controls were determined using enzyme‐linked immunosorbent assay. The LCH patients were classified, evaluated and treated according to the Histiocyte Society's protocols. The following clinical stages were considered: single‐system disease (A) divided into single‐site (A1; n=4), multiple‐site (A2; n=9), and multisystem disease (B) without organ dysfunction (B1; n=5) and with organ dysfunction (B2; n=14). Pretreatment concentrations of sIL‐2r were markedly increased at diagnosis in LCH patients compared with controls [in pg/ml, median (range) 9200 (1124–40000) versus 610	(343–800)], P < 0·0001. Levels differed significantly between stages A [3250 (1124–11000)] and B [22750 (3400–40000)], P < 0·05, and between substages A2 and B2, P < 0·05. There was a significant correlation between clinical stages and sIL‐2r serum levels, r=0·7996 (P < 0·0001). Patients with ≥ 17500 pg/ml of sIL‐2r had a 30‐month survival of 0·417 (SEM: 0·142) compared with those with levels < 17500 pg/ml, who presented a 30‐month survival of 0·848 (SEM: 0·100) (log‐rank, P < 0·0001). In multivariate analysis, sIL‐2r levels ≥ 17500 pg/ml were found to have greater predictive strength than other well‐known prognostic factors.
Function of the proximal stomach after Nissen fundoplication
Authors: Wijnhoven B P L , Salet G A M , Roelofs J M M , Smout A J P M , Akkermans L M A , Gooszen H G 
Published: March 2003

Abstract

Background
After Nissen fundoplication patients frequently report upper abdominal (dyspeptic) symptoms. Theoretically, these symptoms may be the result of changes in function of the proximal stomach as induced by fundoplication.

Methods
In this case–control study the response of the proximal stomach to both distension by an air-filled bag and a liquid meal were evaluated with the use of a barostat. In 12 patients after fundoplication and 12 healthy volunteers (age- and sex-matched) perception of symptoms was evaluated during both bag distension and liquid meal stimulus.

Results
The minimal distending pressure required to overcome the intra-abdominal pressure was significantly different between patients and controls (mean(s.e.m.) 9·34(0·26) versus 6·73(0·43) mmHg; P &lt; 0·001). There was no difference between groups in either the fasted state, volume–pressure curve (compliance) or total symptom score. After ingestion of the liquid meal the adaptive relaxation in the fundoplication group was significantly less than that in controls (mean(s.e.m.) 150(29·2) versus 244(34·8) ml; P = 0·04).

Conclusion
This study showed that after Nissen fundoplication compliance of the proximal stomach is no different from that in healthy volunteers. Postprandial relaxation of the proximal stomach is decreased and this abnormality may be involved in the pathogenesis of reported dyspeptic symptoms.
Blood supply of the right and left hepatic ducts
Authors: Stapleton G N , Hickman R , Terblanche J 
Published: March 2003

Abstract

Background
Increasing precision of liver resection and use of reduced liver grafts stimulated this study of the blood supply of the intrahepatic bile ducts.

Method
Corrosion casts of human liver were dissected to study the blood supply of the right and left hepatic ducts.

Results
The dissected casts showed that the ducts are surrounded by a vascular plexus supplied from the main right and left hepatic arteries, segmental arteries, gastroduodenal artery and accessory hepatic arteries. This plexus is closely associated with the arteries supplying the caudate lobe. They arise from both right and left in two general patterns. This plexus links the arterial supplies of the right and left livers. Segment IV and the central portion of the left hepatic duct are often supplied by the right arterial system.

Conclusion
This study provides further insights into bile duct blood supply. The caudate lobe and biliary plexus provide collateral connections between the right and left livers.
Timing of surgery for fulminating pseudomembranous colitis
Authors: Synnott K , Mealy K , Merry C , Kyne L , Keane C , Quill R 
Published: March 2003

Abstract

Background
With increasing antibiotic usage Clostridium difficile colitis is becoming more common. Surgery for fulminating C. difficile colitis, however, is rare because of the effectiveness of specific anticlostridial chemotherapy. Surgical outcome in five patients with fulminating C. difficile colitis involved in a recent outbreak of this disease is reported.

Methods
Five of 138 patients developed fulminating C. difficile colitis unresponsive to medical therapy. All patients had antibiotics in the preceding period. Indications for operation in those who underwent surgery were systemic toxicity with a pyrexia, marked leukocytosis and abdominal signs leading to progressive organ failure, despite appropriate anticlostridial antibiotic therapy.

Results
At operation all patients had a markedly oedematous colon with normal serosa but with acute mucosal colitis. All underwent subtotal abdominal colectomy and ileostomy. Progressive organ failure persisted in four, leading to death, giving a mortality rate of four in five in the operated group in comparison with 3·8 per cent (five of 133 patients) in those treated medically.

Conclusions
These results indicate that this increasingly common disease frequently leads to a fatal outcome in patients requiring surgery and implies that earlier surgical consultation may be necessary to improve survival in patients with fulminating C. difficile colitis unresponsive to antibiotic therapy.
Reduced total antioxidant capacity predicts ischaemia–reperfusion injury after femorodistal bypass
Authors: Spark J I , Chetter I C , Gallavin I , Kester R C , Guillou P J , Scott D J A 
Published: March 2003

Abstract

Background
Antioxidant defence systems are essential to protect the body from harmful free radicals released following ischaemia–reperfusion. The aim of this study was to examine the total antioxidant capacity (TAC) of patients with chronic critical leg ischaemia undergoing femorodistal bypass and to correlate this with lipid peroxidation, changes in capillary permeability and clinical outcome.

Methods
Twenty-five patients, 15 men and ten women of median age 71 (range 62–79) years, and 15 matched controls were studied. Blood was taken before operation and after reperfusion, with assays performed for malondialdehyde (a product of lipid peroxidation) and total antioxidant capacity. Changes in capillary permeability were measured by changes in the urinary albumin:creatinine ratio (ACR) following reperfusion of the ischaemic leg and expressed as a percentage increase from the preoperative value. Clinical outcome in terms of the systemic inflammatory response syndrome (SIRS) was recorded.

Results
Vascular patients who developed clinical evidence of a systemic inflammatory reaction following revascularization had a significantly reduced TAC compared with the controls (490 versus 860 µmol/l; P &lt; 0·01, Mann–Whitney U test). These patients also demonstrated an increase in lipid peroxidation (0·5 versus 0·25 µmol/l, P &lt; 0·05) and vascular permeability, as measured by the percentage increase in ACR (365 versus 130 per cent, P &lt; 0·01).

Conclusion
Vascular patients with a lower TAC developed increased capillary permeability as a result of ischaemia–reperfusion, which progressed to SIRS. TAC may provide a test to identify ‘at risk’ patients. It may be possible to augment their defence with exogenous antioxidants.
Matrix metalloproteinase 9 level predicts optimal collagen deposition during early wound repair in humans
Authors: Ågren M S , Jorgensen I N , Andersen M , Viljanto J , Gottrup P 
Published: March 2003

Abstract

Background
This study examined two matrix metalloproteinases (MMPs) and their association with deposition of collagen during wound repair.

Methods
In 15 hernia wounds, wound fluid was collected using two Cellstick devices, which were implanted adjacent to two expanded polytetrafluoroethylene (ePTFE) tubes. MMP-2 and MMP-9 levels were analysed 24 and 48 h after operation using specific enzyme-linked immunosorbent assays, and collagen deposition in the ePTFE tubes was measured 10 days after operation as hydroxyproline.

Results
The levels of both MMPs in wound fluid were increased compared with those of control serum, although MMP-9 decreased (P &lt; 0·01) in the wounds 24–48 h after operation. The MMP-9 level at 24 h correlated inversely and specifically to deposited collagen measured as hydroxyproline (rS = −0·80, P &lt; 0·01).

Conclusion
These results indicate that the level of MMP-9 in the early inflammatory phase can predict the amount of collagen deposited later in the wound healing process.
Prospective randomized double-blind trial of neurolytic coeliac plexus block in patients with pancreatic cancer
Authors: Polati E , Finco G , Gottin L , Bassi C , Pederzoli P , Ischia I 
Published: March 2003

Abstract

Background
In a randomized double-blind study the efficacy of neurolytic coeliac plexus block (NCPB) was compared with pharmacological therapy in the treatment of pain from pancreatic cancer.

Methods
Twenty-four patients were divided into two groups: 12 patients underwent NCPB (group 1) and 12 were treated with pharmacological therapy (group 2). Immediate and long-term efficacy, mean analgesic consumption, mortality and morbidity were evaluated at follow-up. Statistical analysis was performed with the unpaired t test, Mann–Whitney U test and Fisher's exact test.

Results
Immediately after the block, patients in group 1 reported significant pain relief compared with those in group 2 (P &lt; 0·05), but long-term results did not differ between the groups. Mean analgesic consumption was lower in group 1. There were no deaths. Complications related to NCPB were transient diarrhoea and hypotension (P not significant between groups). Drug-related adverse effects were constipation (five of 12 patients in group 1 versus12 of 12 in group 2), nausea and/or vomiting (four of 12 patients in group 1 versus 12 of 12 in group 2) (P &lt; 0·05), one gastric ulcer and one gluteal abscess in group 2.

Conclusion
NCPB was associated with a reduction in analgesic drug administration and drug-related adverse effects, representing an effective tool in the treatment of pancreatic cancer pain.
Correlation between blood loss and inferior vena caval pressure during liver resection
Authors: Johnson M , Mannar R , Wu A V O 
Published: March 2003

Abstract

Background
Blood loss and transfusion requirement are major determinants of mortality and morbidity following liver resection. This study was prompted by the observation that blood loss was excessive when the inferior vena cava (IVC) was distended, and determined whether a correlation exists between blood loss and pressure within the IVC during liver resection.

Methods
A 6-month prospective study was conducted on 20 consecutive patients undergoing liver resection in which two variables were measured, the pressure within the retrohepatic part of the IVC and blood loss during resection.

Results
It was observed that when the caval pressure was less than 6 mmHg the operating field was almost bloodless (mean blood loss 363 (range 305–465) ml). When the caval pressure was between 6 and 12 mmHg the liver became congested and bleeding from the liver surface became significantly greater (1259 (range 415–1789) ml). When caval pressure was greater than 13 mmHg bleeding became excessive (2703 (range 2360–3450) ml). Correlation between blood loss and caval pressure was strong (Pearson correlation coefficient 0·93, P &lt; 0·001).

Conclusion
This study suggests that one of the keys to decreasing blood loss and transfusion requirement during liver resection is to lower pressure within the IVC.