bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elucidation of the relationship between synovitis and bone damage: A randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritis
Authors: Conaghan Philip G. , O'Connor Philip , McGonagle Dennis , Astin Paul , Wakefield Richard J. , Gibbon Wayne W. , Quinn Mark , Karim Zunaid , Green Michael J. , Proudman Susanna , Isaacs John , Emery Paul 
Published: January 2003

AbstractObjectiveTo simultaneously image bone and synovium in the individual joints characteristically involved in early rheumatoid arthritis (RA).MethodsForty patients with early, untreated RA underwent gadolinium‐enhanced magnetic resonance imaging (MRI) of the second through fifth metacarpophalangeal joints of the dominant hand at presentation, 3 months, and 12 months. In the first phase (0–3 months), patients were randomized to receive either methotrexate alone (MTX) or MTX and intraarticular corticosteroids (MTX + IAST) into all joints with clinically active RA. The MTX‐alone group received no further corticosteroids until the second phase (3–12 months), when both groups received standard therapy.ResultsIn the first phase, MTX + IAST reduced synovitis scores more than MTX alone. There were significantly fewer joints with new erosions on MRI in the former group compared with the latter. During the second phase, the synovitis scores were equivalent and a similar number of joints in each group showed new erosions on MRI. In both phases, there was a close correlation between the degree of synovitis and the number of new erosions, with the area under the curve for MRI synovitis the only significant predictor of bone damage progression. In individual joints, there was a threshold effect on new bone damage related to the level of synovitis; no erosions occurred in joints without synovitis.ConclusionIn early RA, synovitis appears to be the primary abnormality, and bone damage occurs in proportion to the level of synovitis but not in its absence. In the treatment of patients with RA, outcome measures and therapies should focus on synovitis.
Reduced arterial elasticity in rheumatoid arthritis and the relationship to vascular disease risk factors and inflammation
Authors: Wong Melinda , Toh Ling , Wilson Andrew , Rowley Kevin , Karschimkus Connie , Prior David , Romas Evange , Clemens Laurence , Dragicevic George , Harianto Harry , Wicks Ian , McColl Geoff , Best James , Jenkins Alicia 
Published: January 2003

AbstractObjectiveRheumatoid arthritis (RA) is associated with increased rates of cardiovascular disease. Reduced small artery elasticity (SAE) and large artery elasticity (LAE) and increased systemic vascular resistance (SVR) have been found in other high‐risk groups. In the present study, we sought to determine whether arterial elasticity was reduced and SVR was increased in RA patients compared with controls matched for coronary artery disease (CAD) status, and to relate the results to vascular disease risk factors, including measures of inflammation.MethodsArterial elasticity was assessed by pulse wave analysis in RA patients with (n = 15) and without (n = 38) CAD, and in controls matched 1:1 for age, sex, and CAD status. Vascular risk factors, including high‐sensitivity C‐reactive protein (hsCRP), soluble vascular cell adhesion molecule 1 (sVCAM‐1), and serum amyloid A (SAA) levels, were assessed.ResultsSAE and LAE were significantly lower and SVR was significantly higher in RA patients than in controls. RA patients also had higher levels of hsCRP, SAA, and sVCAM‐1. SAE and LAE values were inversely correlated with markers of inflammation. Associations of SAE and LAE with RA were independent of conventional risk factors, but were dependent on markers of inflammation.ConclusionVascular function is abnormal in RA, with reduced SAE and LAE and increased SVR relative to controls. Arterial elasticity is inversely associated with measures of inflammation. These measures may be clinically useful in the detection and monitoring of vascular disease in RA.
High‐dose cyclophosphamide without stem cell transplantation in systemic lupus erythematosus
Authors: Petri Michelle , Jones Richard J. , Brodsky Robert A. 
Published: January 2003

AbstractObjectiveHigh‐dose chemotherapy followed by hematopoietic stem cell transplantation is increasingly being studied as a treatment for severe autoimmune disorders, such as systemic lupus erythematosus (SLE). High‐dose cyclophosphamide, the foundation of virtually all conditioning regimens for stem cell transplantation, is not myeloablative; therefore, when high‐dose cyclophosphamide is used alone, autografting, with its potential for reinfusing autoreactive effector cells, is not required. We undertook this study to investigate the safety and efficacy of high‐dose cyclophosphamide without stem cell transplantation in refractory SLE.MethodsWe treated 14 patients with moderate‐to‐severe SLE that had been refractory to corticosteroids and one or more additional immunosuppressive drugs. All patients received 50 mg/kg of cyclophosphamide for 4 consecutive days followed by 5 μg/kg granulocyte colony‐stimulating factor until the neutrophil count was 1 × 109/liter for 2 consecutive days. Patients were followed up monthly for disease activity using the physician's global assessment, SLE Disease Activity Index, and assessment of functioning of involved organs. The Responder Index for Lupus Erythematosus was used to define partial or complete response.ResultsThe median time to achieve a neutrophil count of 0.5 × 109/liter was 14 days (range 11–22 days) after the last dose of cyclophosphamide. Patients required a median of 2 units (range 2–5) of packed red blood cells, and a median of 16 days (range 0–23 days) elapsed from the last dose of cyclophosphamide to the last platelet transfusion. There were no deaths or fungal infections. Significant improvements in physician's global assessment (mean difference 1.4; P < 0.0001), SLE Disease Activity Index (mean difference 4.1; P = 0.0039), and prednisone dosage (mean difference 14.9 mg/day; P = 0.002) were observed. Responses, including 5 durable complete responses, were observed in all organ systems (renal, central nervous system, and skin) with involvement that had led to patient enrollment.ConclusionHigh‐dose cyclophosphamide without stem cell transplantation leads to rapid hematopoietic reconstitution and has significant clinical benefit in patients with refractory SLE. Therefore, this approach deserves further study.
Jaccoud's arthropathy in systemic lupus erythematosus: Differentiation of deforming and erosive patterns by magnetic resonance imaging
Authors: Ostendorf Benedikt , Scherer Axel , Specker Christof , Mödder Ulrich , Schneider Matthias 
Published: January 2003

AbstractObjectiveTo evaluate alterations of the soft tissues, tendons, and bones as detected by magnetic resonance imaging (MRI) in patients with systemic lupus erythematosus (SLE)–associated arthritis of the finger joints.MethodsBoth hands of 14 patients with SLE of various activities and durations and with arthritis and/or deformities of the finger joints were examined by MRI and conventional radiography. Coronal T1‐weighted spin‐echo (with and without gadolinium contrast), axial T2‐weighted turbo spin‐echo, coronal fat‐suppressed short tau inversion recovery, and 3‐dimensional double‐echo steady‐state sequences were acquired and analyzed, and the findings were compared with those from conventional radiographs.ResultsMRI detected periarticular capsular swelling in all 14 patients, joint effusion in 7, edematous tenosynovitis in 6, proliferative tenosynovitis (flexor and/or extensor tendons) in 4, and intraarticular signs of synovial membrane hypertrophy in 10 patients, 9 of whom showed enhancement after administration of contrast medium. Bony erosions were identified in 8 patients by MRI; conventional radiography missed these erosions in 2 of the 8 patients. Four of the 14 patients were designated as Jaccoud's arthropathy index–positive, and all 4 showed severe edematous tenosynovitis and capsular swelling, but no signs of bony erosions despite longstanding disease (mean 21.5 years). Four of the 10 patients with mild deformity exhibited prominent soft tissue pathology, with minimal destruction of bone; the other 6 patients had bony alterations that resembled rheumatoid arthritis.ConclusionIn SLE patients with arthritis of the finger joints, MRI detects characteristic signs of soft tissue pathology (e.g., capsular swelling, edematous and proliferative tenosynovitis, synovial hypertrophy) and bony alterations (e.g., erosions, some of which are missed by conventional radiography). MRI thus helps to distinguish different types of lupus arthritis/Jaccoud's arthropathy, which allows more differentiated treatment strategies and monitoring.
Arthropathy in juvenile hemochromatosis
Authors: Vaiopoulos George , Papanikolaou George , Politou Marianna , Jibreel Iyad , Sakellaropoulos Nikos , Loukopoulos Dimitris 
Published: January 2003

AbstractObjectiveTo evaluate whether arthropathy is associated with juvenile hemochromatosis and, if so, to assess the relationship between this feature and other clinical features of the disease.MethodsClinical, laboratory, and radiologic evidence of arthropathy was studied in 8 Greek patients with genetically proven juvenile hemochromatosis. Osteopenia and osteoporosis were assessed by bone mineral density measurement.ResultsSeven of the 8 patients had articular manifestations. The main affected joint was the metacarpophalangeal joint, and the arthritis was progressive independent of phlebotomy therapy. Osteopenia was observed in 2 patients, and osteoporosis in 2 patients.ConclusionArthropathy may be present in patients with juvenile hemochromatosis, with features similar to those found in patients with hemochromatosis type 1.
A comparison between anti‐Th/To– and anticentromere antibody–positive systemic sclerosis patients with limited cutaneous involvement
Authors: Mitri Ghaith M. , Lucas Mary , Fertig Noreen , Steen Virginia D. , Medsger Thomas A. 
Published: January 2003

AbstractObjectiveTo compare anti‐Th/To–positive and anticentromere antibody (ACA)–positive patients with limited cutaneous systemic sclerosis (lcSSc).MethodsWe reviewed the medical records of 107 anti‐Th/To–positive patients and 365 ACA‐positive patients who were first evaluated during 1985–2000. ACA was detected by indirect immunofluorescence on HEp‐2 cell substrate, and anti‐Th/To was detected by RNA immunoprecipitation with K562 cell extracts. Patients were included if they had a clinical diagnosis of lcSSc, and excluded if they had >1 SSc‐associated serum autoantibody.ResultsThe final study groups comprised 87 lcSSc patients with anti‐Th/To antibodies and 306 with ACAs. Anti‐Th/To–positive patients were younger (P < 0.04) and had a shorter disease duration at their first evaluation (P < 0.003). Patients with anti‐Th/To antibodies had more subtle skin changes, less severe vascular involvement, and less frequent distal esophageal hypomotility. Both groups had a higher frequency of “intrinsic” pulmonary hypertension than has been previously reported in the literature (28% and 19% of anti‐Th/To–positive and ACA‐positive patients, respectively), perhaps due to referral bias. Patients in the anti‐Th/To group more often had radiographic evidence of interstitial lung disease (48% versus 13% of the ACA group; P < 0.0001). Scleroderma renal crisis was uncommon (4 cases), but occurred exclusively in the anti‐Th/To group. Survival among the anti‐Th/To–positive patients was reduced compared with that in the ACA group (P < 0.02).ConclusionPatients with anti‐Th/To and those with ACA most often develop lcSSc and have a high frequency of “intrinsic” pulmonary hypertension. Compared with the ACA patients, anti‐Th/To lcSSc patients have more subtle cutaneous, vascular, and gastrointestinal involvement, but more often have certain features typically seen in diffuse scleroderma, such as pulmonary fibrosis and scleroderma renal crisis, as well as reduced survival.
High‐cell‐density fed‐batch cultivation of the docosahexaenoic acid producing marine alga Crypthecodinium cohnii
Authors: De Swaaf Martin E. , Sijtsma Lolke , Pronk Jack T. 
Published: January 2003

AbstractThe heterotrophic marine alga Crypthecodinium cohnii is known to produce docosahexaenoic acid (DHA), a polyunsaturated fatty acid with food and pharmaceutical applications, during batch cultivation on complex media containing sea salt, yeast extract, and glucose. In the present study, fed‐batch cultivation was studied as an alternative fermentation strategy for DHA production. Glucose and acetic acid were compared as carbon sources. For both substrates, the feed rate was adapted to the maximum specific consumption rate of C. cohnii. In glucose‐grown cultures, this was done by maintaining a significant glucose concentration (between 5 and 20 g/L) throughout fermentation. In acetic acid‐grown cultures, the medium feed was automatically controlled via the culture pH. A feed consisting of acetic acid (50% w/w) resulted in a higher overall volumetric productivity of DHA (rDHA) than a feed consisting of 50% (w/v) glucose (38 and 14 mg/L/h, respectively). The rDHA was further increased to 48 mg/L/h using a feed consisting of pure acetic acid. The latter fermentation strategy resulted in final concentrations of 109 g/L dry biomass, 61 g/L lipid, and 19 g/L DHA. These are the highest biomass, lipid, and DHA concentrations reported to date for a heterotrophic alga. Vigorous mixing was required to sustain aerobic conditions during high‐cell‐density cultivation. This was complicated by culture viscosity, which resulted from the production of viscous extracellular polysaccharides. These may present a problem for large‐scale industrial production of DHA. Addition of a commercial polysaccharide‐hydrolase preparation could decrease the viscosity of the culture and the required stirring. © 2003 Wiley Periodicals, Inc. Biotechnol Bioeng 81: 666–672, 2003.
Potential inhibitors from wet oxidation of wheat straw and their effect on ethanol production of Saccharomyces cerevisiae: Wet oxidation and fermentation by yeast
Authors: Klinke H. B. , Olsson L. , Thomsen A. B. , Ahring B. K. 
Published: January 2003

AbstractAlkaline wet oxidation (WO) (using water, 6.5 g/L sodium carbonate and 12 bar oxygen at 195°C) was used as pretreatment method for wheat straw (60 g/L), resulting in a hydrolysate and a cellulosic solid fraction. The hydrolysate consisted of soluble hemicellulose (8 g/L), low‐molecular‐weight carboxylic acids (3.9 g/L), phenols (0.27 g/L = 1.7 mM) and 2‐furoic acid (0.007 g/L). The wet oxidized wheat straw hydrolysate caused no inhibition of ethanol production by Saccharomyces cerevisiae ATCC 96581. Nine phenols and 2‐furoic acid, identified to be present in the hydrolysate, were each tested in concentrations of 50–100 times the concentration found in the hydrolysate for their effect on fermentation by yeast. At these high concentrations (10 mM), 4‐hydroxybenzaldehyde, vanillin, 4‐hydroxyacetophenone and acetovanillone caused a 53–67% decrease in the volumetric ethanol productivity in S. cerevisiae compared to controls with an ethanol productivity of 3.8 g/L. The phenol acids (4‐hydroxy, vanillic and syringic acid), 2‐furoic acid, syringaldehyde and acetosyringone were less inhibitory, causing a 5–16% decrease in ethanol productivity. By adding the same aromatic compounds to hydrolysate (10 mM), it was shown that syringaldehyde and acetovanillone interacted negatively with hydrolysate components on the ethanol productivity. Fermentation in WO hydrolysate, that had been concentrated 6 times by freeze‐drying, lasted 4 hours longer than in regular hydrolysate; however, the ethanol yield was the same. The longer fermentation time could not be explained by an inhibitory action of phenols alone, but was more likely caused by inhibitory interactions of phenols with carboxylic acids, such as acetic and formic acid. © 2003 Wiley Periodicals, Inc. Biotechnol Bioeng 81: 738–747, 2003.
Current practice of emergency vagotomy and Helicobacter pylori eradication for complicated peptic ulcer in the United Kingdom
Authors: Gilliam A D , Speake W J , Lobo D N , Beckingham I J 
Published: January 2003

Abstract

Background
The aim was to assess the current opinion of surgeons, by subspecialty, towards vagotomy and the practice of Helicobacter pylori testing, treatment and follow-up, in patients with bleeding or perforated duodenal ulcer.

Methods
A postal questionnaire was sent to 1073 Fellows of the Association of Surgeons of Great Britain and Ireland in 2001.

Results
Some 697 valid questionnaires were analysed (65·0 per cent). Most surgeons did not perform vagotomy for perforated or bleeding duodenal ulcer. There was no statistical difference between the responses of upper gastrointestinal surgeons and those of other specialists for perforated (P = 0·35) and bleeding (P = 0·45) ulcers. Respondents were more likely to perform a vagotomy for bleeding than for a perforated ulcer (P &lt; 0·001). Although more than 80 per cent of surgeons prescribed H. pylori eradication treatment after operation, fewer than 60 per cent routinely tested patients for H. pylori eradication. Upper gastrointestinal surgeons were more likely to prescribe H. pylori treatment and test for eradication than other specialists (P &lt; 0·01).

Conclusion
Most surgeons in the UK no longer perform vagotomy for duodenal ulcer complications.
Effect of antiadhesive agents on peritoneal carcinomatosis in an experimental model
Authors: Pucciarelli S , Codello L , Rosato A , Del Bianco P , Vecchiato G , Lise M 
Published: January 2003

Abstract

Background
Auto-crosslinked polysaccharide hyaluronan-based solution (Hyalobarrier®-gel) prevents postoperative adhesions. However, its effect on tumour growth is still unknown. The aim of the present study was therefore to investigate the impact on survival of intra-abdominally administered Hyalobarrier®-gel, native hyaluronan (HA) and hyaluronan/carboxymethylcellulose (HA/CMC), after intraperitoneal tumour implantation.

Methods
After receiving an intraperitoneal inoculum of the human HT29 colorectal cell line, 615 athymic nude mice were assigned randomly to five groups: groups 1 and 2 received Hyalobarrier®-gel 20 mg/ml (n = 124) and 40 mg/ml (n = 126) respectively; groups 3 and 4 received HA (n = 120) and HA/CMC film (Seprafilm™) (n = 123) respectively. The survival of each treated group was compared with that of group 5, the control, which had no treatment (n = 122).

Results
As 34 of the 615 mice were not eligible, 581 animals were considered for the analysis. At 120 days, 136 animals (23·4 per cent) were still alive. At autopsy there was macroscopic absence of tumour in 75 cases (12·9 per cent). No statistically significant differences were found between the treatment and the control groups with respect to postoperative death and absence of tumour implantation. There was no difference in survival rate between the control group and groups treated with Hyalobarrier®-gel, HA or HA/CMC.

Conclusion
Hyalobarrier®-gel, HA and HA/CMC had no negative impact on the survival rate in mice that received an intraperitoneal implantation of HT29 colorectal human tumour cells.
Lymphoedema and reduced shoulder function as indicators of quality of life after axillary lymph node dissection for invasive breast cancer
Authors: Voogd A C , Ververs J M M A , Vingerhoets A J J M , Roumen R M H , Coebergh J W W , Crommelin M A 
Published: January 2003

Abstract

Background
The aim was to explore measurements of arm circumference and shoulder abduction as indicators of quality of life after axillary lymph node dissection for invasive breast cancer.

Methods
Differences in arm circumference and shoulder abduction were measured in 465 consecutive women who underwent axillary lymph node dissection. These women received a treatment-specific questionnaire on the severity of physical disability and the effects on their daily life and well-being.

Results
The questionnaire was returned by 400 women (86 per cent). Of these 400, only the 332 women who did not receive axillary radiotherapy were included in the analysis. Their mean time since axillary lymph node dissection was 4·2 (range 0·3–28) years. For 86 patients (26 per cent) there was a difference in arm circumference of 2 cm or more, or a difference in abduction of 20° or more. These patients found it more difficult to do household chores, were more likely to have given up hobbies, felt more disabled and were more likely to be treated by a physiotherapist. However, complaints also occurred among the women with smaller differences in arm circumference and shoulder abduction, although the frequency and severity of their complaints were similar to those in women without swelling of the arm or without restricted shoulder abduction.

Conclusion
Measuring arm circumference and shoulder abduction during control visits identifies only some of the women whose daily life and well-being is affected by the side-effects of axillary lymph node dissection.
Combined evaluation of mucin antigen and E-cadherin expression may help select patients with gastric cancer suitable for minimally invasive therapy
Authors: Tanaka M , Kitajima Y , Sato S , Miyazaki K 
Published: January 2003

Abstract

Background
MUC1 mucin is known to be highly expressed in carcinomas that show invasive growth and poor prognosis. Impairment of adhesion molecule E-cadherin expression has been widely accepted as a critical event for cancer invasion and metastasis. The present study evaluated the combination of mucin and E-cadherin status as a possible predictor of patients suitable for minimally invasive therapy for gastric cancer.

Methods
Two hundred and nine paraffin-embedded specimens of gastric carcinoma (141 early, 68 advanced) were examined by immunohistochemical staining using monoclonal antibodies against MUC1 mucin (MUC-1-CORE, DF3), MUC2 mucin (Ccp58) and E-cadherin (anti-E-cad).

Results
Gastric carcinoma with MUC1-positive expression demonstrated malignant characteristics. Normal E-cadherin expression showed an inverse correlation with MUC1 expression. Patients with early gastric carcinoma who had a combination of normal E-cadherin and MUC1-negative expression had no recurrence and a favourable prognosis. Moreover, cancers with normal E-cadherin/MUC1-negative expression were not found at an advanced stage in differentiated-type carcinoma.

Conclusion
A normal E-cadherin/MUC1-negative expression pattern in gastric cancer is a favourable marker. Preoperative estimation of the E-cadherin and MUC1 status of an endoscopic biopsy specimen may help select appropriate patients for minimally invasive treatment of gastric cancer.
Prospective randomized study of steroids in the preventionof ischaemic injury during hepatic resection with pedicle clamping
Authors: Muratore A , Ribero D , Ferrero A , Bergero R , Capussotti L 
Published: January 2003

AbstractBackgroundThe major drawback of hepatic pedicle clamping is ischaemia–reperfusion injury with impairment of liver function. Perioperative steroid administration has been advocated to reduce liver damage. The aim of this prospective, randomized study was to determine whether steroid administration can reduce liver injury and improve short-term outcome.MethodsFifty-three patients undergoing liver resection were randomized to a steroid group (group 1) or to a control group (group 2); patients in group 1 received methylprednisolone 30 mg/kg 30 min before liver resection whereas those in group 2 did not. Serum levels of interleukin (IL) 6, total bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and prothrombin time (PT) were measured. Length of stay, and type and number of complications were recorded.ResultsSerum IL-6 levels were significantly lower in the steroid group than in the control group 24 h after surgery. Steroid administration significantly modified AST, ALT and PT levels only in patients with chronic liver disease. Overall and lung-related morbidity were not significantly different between the two groups.ConclusionsSteroid administration suppresses serum IL-6 levels, but has no effect on short-term outcome.