bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carcinoma of the Oropharynx: Factors Affecting Outcome
Authors: Sundaram Krishnamurthi , Schwartz Jerome , Har‐El Gady , Lucente Frank 
Published: September 2005

AbstractObjectives/Hypothesis: To assess the value of both patient‐ and tumor‐related factors of oropharyngeal squamous cell carcinoma in predicting patient outcome, with respect to the three primary subsites of the disease. It was hypothesized that the subsite has a significant impact on outcome.Study Design: Historical cohort study.Methods: A chart review was conducted of 126 patients diagnosed with squamous cell carcinoma of the oropharynx over a 10‐year period. The oropharynx was divided into the following subsites: 1) base of tongue, 2) tonsil and pillars, and 3) uvula, soft palate, and posterior pharyngeal wall. Patient‐related factors included age and gender. Tumor‐related factors included American Joint Committee on Cancer stage, T stage, N stage, and grade. These factors were compared using the end points of disease‐free survival and treatment response (complete response or partial response/no response).Results: Tumor‐related factors such as American Joint Committee on Cancer stage (P = .016) and T stage (P = .008) had a significant impact on treatment response. The American Joint Committee on Cancer stage (P = .030) and the T stage (P = .005) were also significant predictors of disease‐free survival. Base‐of‐tongue lesions responded significantly worse to treatment than did tonsil and pillar or uvula, soft palate, and posterior pharyngeal wall lesions (P = .014). The disease‐free survival for base‐of‐tongue cancer was significantly worse than for tonsil and pillar or for uvula, soft palate, and posterior pharyngeal wall cancer (P = .010).Conclusion: Patient‐related factors such as age and gender were not significant in predicting disease‐specific outcome. Important tumor‐related factors were the American Joint Committee on Cancer stage and the T stage. Among the oropharyngeal subsites, squamous cell carcinoma of the base of tongue was associated with the worst outcome.
Quantitative model of cellulite: three‐dimensional skin surface topography, biophysical characterization, and relationship to human perception*
Authors: Smalls L.K. , Lee C.Y. , Whitestone J. , Kitzmiller W.J. , Wickett R.R. , Visscher M.O. 
Published: September 2005

Regional Meeting of the International Society for Bioengineering and the Skin, Orlando, Florida, October 28–30, 2004.Gynoid lipodystrophy (cellulite) is the irregular, dimpled skin surface of the thighs, abdomen, and buttocks in 85% of post‐adolescent women. The distinctive surface morphology is believed to result when subcutaneous adipose tissue protrudes into the lower reticular dermis, thereby creating irregularities at the surface. The biomechanical properties of epidermal and dermal tissue may also influence severity. Cellulite‐affected thigh sites were measured in 51 females with varying degrees of cellulite, in 11 non‐cellulite controls, and in 10 male controls. A non‐contact high‐resolution three‐dimensional laser surface scanner was used to quantify the skin surface morphology and determine specific roughness values. The scans were evaluated by experts and naїve judges (n = 62). Body composition was evaluated via dual‐energy X‐ray absorptiometry; dermal thickness and the dermal‐subcutaneous junction were evaluated via high‐resolution 3D ultrasound and surface photography under compression. Biomechanical properties were also measured. The roughness parameters Svm (mean depth of the lowest valleys) and Sdr (ratio between the roughness surface area and the area of the xy plane) were highly correlated to the expert image grades and, therefore, designated as the quantitative measures of cellulite severity. The strength of the correlations among naїve grades, expert grades, and roughness values confirmed that the data quantitatively evaluate the human perception of cellulite. Cellulite severity was correlated to BMI, thigh circumference, percent thigh fat, architecture of the dermal‐subcutaneous border (ultrasound surface area, red‐band SD from compressed images), compliance, and stiffness (negative correlation). Cellulite severity was predicted by the percent fat and the area of the dermal‐subcutaneous border. The biomechanical properties did not significantly contribute to the prediction. Comparison of the parameters for females and males further suggest that percent thigh fat and surface area roughness deviation are the distinguishing features of cellulite.
The effect of a therapeutic trial of high‐dose rabeprazole on symptom response of patients with non‐cardiac chest pain: a randomized, double‐blind, placebo‐controlled, crossover trial
Authors: DICKMAN R. , EMMONS S. , CUI H. , SEWELL J. , HERNÁNDEZ D. , ESQUIVEL R. F. , FASS R. 
Published: September 2005

SummaryBackground:  Therapeutic trials with high‐dose lansoprazole and omeprazole have been shown to be sensitive clinical tools for diagnosing patients with gastro‐oesophageal reflux disease‐related non‐cardiac chest pain.Aim:  To determine the clinical value of a therapeutic trial of high‐dose rabeprazole over 7 days in detecting patients with gastro‐oesophageal reflux disease‐related non‐cardiac chest pain.Methods:  Double‐blind, randomized, placebo‐controlled, crossover study. Patients referred by a cardiologist after a comprehensive cardiac work‐up were enrolled into the study. Oesophageal mucosal disease was determined by upper endoscopy and 24‐h oesophageal pH monitoring assessed acid exposure. Patients were then randomized to either placebo or rabeprazole 20 mg am and 20 mg pm for 7 days. After a washout period of 1 week, patients crossed over to the other arm of the study for an additional 7 days. Patients completed a daily diary assessing severity and frequency of chest pain throughout the baseline, treatment and wash‐out periods. The rabeprazole therapeutic trial was considered as a diagnostic tool, if chest pain scores improved ≥50% from baseline.Results:  Of the 35 patients enrolled, 16 (46%) were diagnosed as gastro‐oesophageal reflux disease‐positive and 19 (54%) as gastro‐oesophageal reflux disease‐negative. Of the gastro‐oesophageal reflux disease‐positive patients, 12 of 16 (75%) had a significant symptom improvement on rabeprazole when compared with 3 of 16 (19%) on placebo (P = 0.029). Of the gastro‐oesophageal reflux disease‐negative group, only two of 19 (11%) improved significantly on the medication and four of 19 (21%) on placebo (P = 0.6599). The calculated sensitivity and specificity of the rabeprazole therapeutic trial was 75% and 90%, respectively.Conclusions:  A rabeprazole therapeutic trial is highly sensitive and specific for diagnosing gastro‐oesophageal reflux disease‐related non‐cardiac chest pain patients.
Personal view: passing the buck and taking a free ride – a game‐theoretical approach to evasive management strategies in gastroenterology
Authors: SONNENBERG A. 
Published: September 2005

SummaryBackground:  ‘Free‐riding’ physicians enjoy the status, prestige and income of their profession without fully contributing to its overall mission. By shifting the costs of potential medical complications and difficult patient encounters to other physicians, they reap the benefits of their profession without carrying its full weight.Aim:  To describe this phenomenon in terms of decision analysis and characterize the parameters affecting its occurrence.Methods:  The interaction between two physicians is modeled as a non‐zero‐sum game. Two strategies of either contributing to patient management or taking a free ride are available to both physicians. The four possible outcomes are arranged in a two‐by‐two game matrix.Results:  Physicians practice medicine because their personal benefit exceeds their cost. High cost to the physician results in a high probability of taking a free ride and copping out from potentially risky management. Increasing the benefit decreases the probability of free riding. As the number of possible encounters with other physicians increases, the probability of free riding increases and the probability for effective management by each individual physician decreases.Conclusion:  If individual gastroenterologists felt less threatened by administrative repercussions and medico‐legal consequences of untoward events, each one of them would contribute more to effective patient management.
Carriage of CARD15 variants and smoking as risk factors for resective surgery in patients with Crohn's ileal disease
Authors: LAGHI L. , COSTA S. , SAIBENI S. , BIANCHI P. , OMODEI P. , CARRARA A. , SPINA L. , CONTESSINI AVESANI E. , VECCHI M. , DE FRANCHIS R. , MALESCI A. 
Published: September 2005

SummaryBackground:  It is controversial whether CARD15 variants are truly associated with a more severe form of Crohn's disease. The relative role of CARD15 genotype and smoking in Crohn's disease progression is also debated.Aim:  To investigate the association between CARD15 variants and history of resective surgery in patients with Crohn's ileal disease, taking into account smoking as a possible confounding factor.Methods:  We originally assessed CARD15 genotype in 239 north Italian Crohn's disease patients (mean follow‐up: 10.1 ± 8.1 years). We then focused on 193 patients with proven ileal involvement, 70 of whom (36.3%) carried CARD15‐mutated alleles (G908R, R702W, L1007fs).Results:  Carriage of CARD15 variants was positively associated with family history and ileal‐only disease and negatively associated with uncomplicated behaviour at maximal follow‐up (P < 0.05). Ileal resection was the only variable independently associated with CARD15 variants at multivariate analysis (OR 3.8; 95% CI 1.6–9.2; P = 0.003). Kaplan–Meier analysis showed that ileal resection was favoured both by CARD15 variant‐carriage (P = 0.01) and by smoking (P = 0.05), but smoking did not affect progression to surgery in variant carriers (P = 0.31). Thirteen of 14 (93%) patients being resection‐free at 15‐year follow‐up, had CARD15 wild‐type genotype (P = 0.01), whereas only seven (50%) had never smoked (P = 1.0).Conclusions:  In summary, CARD15 variant‐associated Crohn's ileitis is virtually committed to stricturing and/or penetrating disease and, eventually, to resective surgery. Smoking accelerates progression to surgery in patients with wild‐type CARD15 genotype, but it seems to exert no additional effect in CARD15‐variant carriers.
Gender specific association of CYP2C9*3 with hyperlipidaemia in Chinese
Authors: Luo Chen‐Hui , Wang An , Zhu Rong‐Hua , Zhang Wei‐Xia , Mo Wei , Yu Bang‐Ning , Chen Guo‐Lin , Ou‐Yang Dong‐Sheng , Duan Xiao‐Hong , El‐Aty A. M. Abd , Zhou Hong‐Hao 
Published: September 2005

AimsTo investigate the association of CYP2C9*3 and *6 with hyperlipidaemia in Chinese.MethodsFour hundred and seventy‐six Chinese participated in the study, including 211 uncomplicated hyperlipidaemic patients and 265 healthy controls. PCR‐RFLP was used to identify CYP2C9*3 and *6.Results CYP2C9*6 was not detected in this study. The allelic frequency of CYP2C9*3 was 0.039 (95% CI 0.022, 0.056). A nonsignificant difference existed in CYP2C9*3 frequencies between males and females (P = 0.605, OR = 1.194, 95% CI 0.610, 2.336), patients and controls (P = 0.063, OR = 0.506, 95% CI 0.244, 1.049) in the total population. However, in the female group, CYP2C9*3 frequency in patients with hyperlipidaemia was significantly lower than that in controls (P < 0.0001, OR = 0.062, 95% CI 0.008, 0.476).ConclusionsThe association of CYP2C9*3 with hyperlipidaemia was specific for females in this Chinese population.
Usage of paracetamol‐containing combination analgesics remains high in primary care
Authors: Usher Cara , Teeling Mary , Bennett Kathleen , McGowan Bernie , Feely John 
Published: September 2005

AimsParacetamol‐containing combination analgesics are widely prescribed but the use of paracetamol/dextropropoxyphene (co‐proxamol) is particularly controversial. We aim to examine the prescribing patterns of the paracetamol‐containing analgesics in Ireland.MethodsA national primary care prescribing database was used to investigate patterns of usage. Twenty‐six thousand three hundred and eighteen patients who were new to therapy with paracetamol and paracetamol‐containing analgesics between January and June 2002 were identified as follows: no previous analgesic medication in the 6 months prior to enrolment into the study, and followed up for at least 12 months from the time of enrolment. Duration of therapy and the number of prescriptions received post enrolment were analyzed according to age. Odds ratios for receiving long‐term (>1 month) compared with short‐term (1 month) prescriptions for co‐proxamol, paracetamol only or a paracetamol combination‐type analgesic were calculated for women vs. men, and in those aged over 65 vs. those aged under 65 years.ResultsCo‐proxamol was the most commonly prescribed analgesic, accounting for 42% of all prescriptions dispensed during 2003. Long‐term use of paracetamol‐containing analgesic preparations was uncommon, with 56.7% receiving only 1 month's prescription during the study period. However, women (OR = 1.18, 95% CI 1.07, 1.28, P < 0.0001) and those over 65 years (OR = 1.71, 95% CI 1.57, 1.86, P < 0.0001) were more likely to receive a follow‐up prescription for co‐proxamol, but also for paracetamol (women, OR = 1.28, 95% CI 1.16, 1.39; over 65 year olds, OR = 2.67, 95%CI 2.44, 2.93) and the paracetamol combinations (women, OR = 1.33, 95% CI 1.20, 1.47; over 65 year olds, OR = 1.69, 95% CI 1.53, 1.87).ConclusionsCo‐proxamol was the most commonly prescribed paracetamol‐containing analgesic preparation in Ireland. The results may indicate inappropriate use in primary care.
Reduced in vivo oxidative stress following 5‐methyltetrahydrofolate supplementation in patients with early‐onset thrombosis and 677TT methylenetetrahydrofolate reductase genotype
Authors: Coppola Antonio , D'Angelo Armando , Fermo Isabella , Mazzola Giuseppina , Minno Matteo Nicola Dario Di , Cajani Alessia , Sala Angelo , Folco Giancarlo , Tremoli Elena , Minno Giovanni Di 
Published: September 2005

SummaryThe protective role of folate in vascular disease has been related to antioxidant effects. In 45 patients with previous early‐onset (at age <50 years) thrombotic episodes and the 677TT methylenetetrahydrofolate reductase genotype, we evaluated the effects of a 28d‐course (15 mg/d) of 5‐methyltetrahydrofolate (MTHF) on homocysteine metabolism and on in vivo generation of 8‐iso‐prostaglandin F2α (8‐iso‐PGF2α), a reliable marker of oxidative stress. At baseline, patients’ fasting total homocysteine (tHcy) was 11·5 μmol/l (geometric mean) and urinary excretion of 8‐iso‐PGF2α was 304 pg/mg creatinine, with the highest metabolite levels in the lowest quartile of plasma folate distribution (P < 0·05). After 5‐MTHF supplementation, plasma folate levels increased approximately 13‐fold (P < 0·0001 versus baseline); tHcy levels (6·7 μmol/l, P < 0·0001) and urinary 8‐iso‐PGF2α (254 pg/mg creatinine, P < 0·001) were both significantly lowered, their reduction being proportional to baseline values (r = 0·98 and r = 0·77, respectively) and maximal in patients with the lowest pre‐supplementation folate levels (P < 0·05). The effects on folate (P < 0·0001) and tHcy (P = 0·0004) persisted for at least up to 2 months after withdrawing 5‐MTHF. In parallel with long‐lasting tHcy‐lowering effects, a short‐course 5‐MTHF supplementation reduces in vivo formation of 8‐iso‐PGF2α in this population, supporting the antioxidant protective effects of folate in vascular disease.
Multicentre phase III trial on fludarabine, cytarabine (Ara‐C), and idarubicin versus idarubicin, Ara‐C and etoposide for induction treatment of younger, newly diagnosed acute myeloid leukaemia patients
Authors: Russo Domenico , Malagola Michele , de Vivo Antonio , Fiacchini Mauro , Martinelli Giovanni , Piccaluga Pier P. , Damiani Daniela , Candoni Anna , Michielutti Angela , Castelli Maurizio , Testoni Nicoletta , Ottaviani Emanuela , Rondoni Michela , Pricolo Giancarla , Mazza Patrizio , Zuffa Eliana , Zaccaria Alfonso , Raspadori Donatella , Bocchia Monica , Lauria Francesco , Bonini Alessandro , Avanzini Paolo , Gugliotta Luigi , Visani Giuseppe , Fanin Renato , Baccarani Michele 
Published: September 2005

SummaryFludarabine plus cytarabine (Ara‐C) and idarubicin (FLAI) is an effective and well‐tolerated induction regimen for the treatment of acute myeloid leukaemia (AML). This phase III trial compared the efficacy and toxicity of FLAI versus idarubicin plus Ara‐C and etoposide (ICE) in 112 newly diagnosed AML patients <60 years. Fifty‐seven patients received FLAI, as the first induction–remission course, and 55 patients received ICE. Post‐induction treatment consisted of high‐dose Ara‐C (HDAC). After HDAC, patients in complete remission (CR) received a second consolidation course (mitoxantrone, etoposide, Ara‐C) and autologous stem cell transplantation (auto‐SCT) or allogeneic (allo)‐SCT, according to the age, disease risk and donor availability. After a single induction course, CR rate was 74% in the FLAI arm and 51% in the ICE arm (P = 0·01), while death during induction was 2% and 9% respectively. Both haematological (P = 0·002) and non‐haematological (P = 0·0001) toxicities, especially gastrointestinal (i.e. nausea, vomiting, mucositis and diarrhoea), were significantly lower in FLAI arm. In both arms, relapses were more frequent in patients who were not submitted to allo‐SCT. After a median follow‐up of 17 months, 30% and 38% of the patients are in continuous CR in FLAI and ICE arm respectively. Our prospective randomised study confirmed the anti‐leukaemic effect and the low toxic profile of FLAI as induction treatment for newly diagnosed AML patients.
All‐trans retinoic acid‐induced downregulation of annexin II expression in myeloid leukaemia cell lines is not confined to acute promyelocytic leukaemia
Authors: Olwill Shane A. , McGlynn Hugh , Gilmore William S. , Alexander H. D. 
Published: September 2005

SummaryMost acute promyelocytic leukaemia (APL) patients suffer from disordered haemostasis. APL can be treated successfully in most instances by all‐trans retinoic acid (ATRA) therapy, which induces endpoint maturation of the leukaemic promyelocytes with the characteristic t(15;17). Annexin II (AnII), a profibrinolytic protein, has been implicated in the bleeding manifestation seen in APL. Our group has shown previously that high levels of AnII are expressed on other acute myeloid leukaemia subtypes that are sometimes associated with disordered haemostasis, albeit less frequently than APL. This study examined the effects of ATRA on AnII expression and cell differentiation, on myeloid leukaemia cell lines to determine whether a regulatory influence on AnII may contribute to the return of haemostatic stability in APL following treatment. The results confirmed that AnII expression in the APL cell line (NB4) was significantly downregulated in response to ATRA (P < 0·01), with associated morphological and immunophenotypical evidence of myeloid differentiation. ATRA also downregulated AnII expression on other myeloid cell lines, albeit to a lesser extent than observed on NB4 cells. The results provide evidence that ATRA may resolve the hyperfibrinolysis in APL by downregulation of AnII expression.
Titre and affinity of propylthiouracil-induced anti-myeloperoxidase antibodies are closely associated with the development of clinical vasculitis
Authors: Ye Hua , Gao Ying , Guo Xiao-Hui , Zhao Ming-Hui 
Published: September 2005

SummarySubstantial evidences suggested that propylthiouracil (PTU) could induced anti-myeloperoxidase (MPO) antibodies in sera from patients with hyperthyroidism, however, only a subgroup of the PTU-induced anti-MPO antibody positive patients developed clinical evident vasculitis. The aim of this study is to compare the titres and affinities of PTU induced anti-MPO antibodies in sera from patients with hyperthyroidism with and without clinical vasculitis. Anti-MPO antibody positive sera from patients diagnosed hyperthyroidism with (n = 13) and without (n = 14) clinical evident vasculitis were collected. The titre was determined by MPO-ELISA and expressed as logarithm value (lgT). The affinity constant (aK) of anti-MPO IgG was measured by antigen inhibition assay. The titre and aK values were compared between patients with and without vasculitis. In patients with vasculitis, the mean lgT of anti-MPO antibodies was 3·62 ± 0·66; the median aK was 4·47 × 107M−1. In patients without vasculitis, the mean lgT was 2·54 ± 0·29; the median aK was 0·14 × 107M−1, and both were significant lower than those in patients with vasculitis (t = 5·464; P = 0·000 & z = −4·373; P= 0·000, respectively). We concluded that the titre and affinity of anti-MPO antibodies might be associated with the development of clinical vasculitis in patients with PTU-induced ANCA.
Functional profile of human influenza virus-specific cytotoxic T lymphocyte activity is influenced by interleukin-2 concentration and epitope specificity
Authors: Boon A C M , De Mutsert G , Fouchier R A M , Osterhaus A D M E , Rimmelzwaan G F 
Published: September 2005

SummaryThe ability of influenza A virus-specific cytotoxic T lymphocytes (CTL) to degranulate and produce cytokines upon antigenic restimulation was studied in four HLA-A*0101 and HLA-A*0201 positive subjects. Peripheral blood mononuclear cells of these subjects were stimulated with influenza A virus in the presence of high or low interleukin (IL)-2 concentrations. CD8+ T cell populations specific for the HLA-A*0101 restricted epitope NP44-52 and the HLA-A*0201 restricted epitope M158-66 were identified by positive staining with tetramers of peptide major histocompatibility complexes (MHC) (NP-Tm and M1-Tm, respectively). Within these populations, the proportion of cells mobilizing CD107a, or expressing interferon (IFN)-γ and tumour necrosis factor-(TNF)-α upon short-term peptide restimulation was determined by flow cytometry. Independent of IL-2 concentrations, large subject-dependent  differences  in  the  mobilization  of  CD107a  and  expression  of  IFN-γ and TNF-α by both NP- and M1-specific T cells were observed. In two of the four subjects, the functional profile of NP-Tm+ and M1-Tm+ cells differed considerably. Overall, no difference in the proportion of NP-Tm+ or M1-Tm+ cells expressing CD107a was observed. The proportion of M1-Tm+ cells that produced IFN-γ (P &lt; 0·05) was larger than for NP-Tm+ cells, independent of IL-2 concentration. When cultured under IL-2hi concentrations higher TNF-α expression was also observed in M1-Tm+ cells (P &lt; 0·05). The IL-2 concentration during expansion of virus-specific cells had a profound effect on the functionality of both M1-Tm+ and NP-Tm+ cells.