bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modulation of T‐Cell CD3‐Zeta Chain Expression in Early Pregnancy*
Authors: EBLEN ABBY C. , GERÇEL ‐TAYLOR ÇIÇEK , NAKAJIMA STEVEN T. , TAYLOR DOUGLAS D. 
Published: March 2003

PROBLEM: To assess the modulation of T‐cell CD3‐zeta chain expression by a factor in the sera of women, prior to egg retrieval and 14 days after an in vitro fertilization (IVF) and to delineate the mechanism of this modulation.METHOD OF STUDY: In this prospective study, blood samples were obtained from 17 patients during an IVF cycle, prior to human chorionic gonadotropin (hCG), and 14 days after embryo return. Serum was incubated with cultured T‐lymphocytes (Jurkat cells) for 96 hr and expression of CD3‐zeta chain was evaluated.RESULTS: Eight patients had a positive serum hCG titer 14 days after retrieval, while nine patients had a negative hCG titer. Serum from pregnant patients significantly suppressed CD3‐zeta chain expression as compared with their sample prior to retrieval (85.6 ± 6.2%), while subjects not becoming pregnant failed to suppress zeta expression (99.1 ± 0.9%, P < 0.0001).CONCLUSION: A factor capable of suppressing TcR/CD3‐zeta expression can be detected in the sera of pregnant women 14 days after embryo retrieval. Loss of zeta chain was associated with the induction of apoptosis.
Sperm Immobilizing Antibodies in the Sera of Infertile Women Cause Low Fertilization Rates and Poor Embryo Quality In Vitro
Authors: TANEICHI AKIYO , SHIBAHARA HIROAKI , HIRANO YUKI , SUZUKI TATSUYA , OBARA HIROMI , FUJIWARA HIROYUKI , TAKAMIZAWA SATORU , SATO IKUO 
Published: March 2003

PROBLEM: The effects of sperm immobilizing antibodies in the sera of infertile women on fertilization and embryo quality in vitro were investigated.METHOD OF STUDY: Before the introduction of sperm immobilization test (SIT) as a routine test for female infertility, 85 oocytes were collected in nine in vitro fertilization (IVF) cycles from four infertile women who were afterward found having had sperm immobilizing antibodies in their sera and the oocytes were inseminated with swim‐up sperm in a medium containing the patient's serum. Fifty oocytes were collected in five IVF cycles from five infertile women possessing the antibodies in their sera and the oocytes were inseminated with swim‐up sperm in a medium supplemented with human serum albumin (HSA).RESULTS: In the former group, 41 of 85 oocytes were fertilized, giving a fertilization rate of 48.2%. In the latter group, 43 of 50 oocytes were fertilized, giving a fertilization rate of 86.0%. There was a significant difference of the fertilization rate between the groups (P < 0.0001). Embryo quality was assessed by the Veeck's classification. The grade 1 and grade 2 embryos were considered good quality. Using this classification, 16 (39.0%) of 41 embryos incubated in the medium containing the patient's serum were good quality, while 34 (79.1%) of 43 embryos incubated in the medium supplemented with HSA were good quality. There was also a significant difference between the groups (P=0.0003).CONCLUSIONS: These findings might indicate that sperm immobilizing antibodies in the sera of infertile women cause low fertilization rates and poor embryo quality in vitro. It is suggested that SIT in the sera of infertile women should be performed at least before proceeding IVF. The manipulation of gametes and embryos from patients having sperm immobilizing antibodies should be carefully carried out especially to avoid contaminating patient's serum and follicular fluid in the culture medium in order to have a better IVF result.
Regulation of the epididymal receptor tyrosine kinase ros by the protein tyrosine phosphatase SHP‐1
Authors: Pusch Rico , Böhmer Annette , Biskup Christoph , Benndorf Klaus , Lindenau Jörg , Böhmer Frank‐D. 
Published: March 2003

The SH2 domain PTP SHP‐1 was recently identified as a potent negative regulator of the orphan receptor tyrosine kinase Ros, an important regulator of epidimys differentiation (Keilhack et al. J Cell Biol 2001; 152:325–334). Phosphorylated Ros strongly and directly associates with SHP‐1 in yeast‐two‐hybrid, GST pull‐down, and coimmunoprecipitation experiments. Catalytically inactive SHP‐1C455S exhibits greatly elevated binding to phosphorylated Ros. Direct Ros–SHP‐1 interaction is mediated by the SHP‐1 N‐terminal SH2 domain and Ros phosphotyrosine 2267. Overexpression of SHP‐1 results in Ros dephosphorylation and effectively down‐regulates Ros‐dependent proliferation and transformation. Elevated phosphorylation of Ros in ‘viable motheaten (me‐v)’ mice which, have strongly reduced SHP‐1 activity, suggests that Ros signaling is under control of SHP‐1 in vivo. Thus sterility of male me‐v mice seems to be related to dysregulation of Ros. A synthetic phosphopeptide derived from the Ros sequence around Y2267 potently activates recombinant SHP‐1 in vitro but is not a good substrate for SHP‐1. In contrast, phosphorylation sites in the activation loop of Ros are effectively dephosphorylated. Based on these observations we propose a mechanistic model of Ros–SHP‐1 interaction. Using fusion proteins of SHP‐1 variants and of Ros with GFP‐proteins of different spectral characteristics the interaction of Ros and SHP‐1 can be visualized in intact cells by different microscopic techniques.
Malignant mixed mullerian tumour of the ovary: Prognostic factor and response of adjuvant platinum‐based chemotherapy
Authors: Inthasorn Perapong , Beale Philip , Dalrymple Christopher , Carter Jonathan 
Published: March 2003

AbstractObjectives: The purpose of the present study was to analyse retrospectively the data of a series of patients presenting to our unit with malignant mixed mullerian tumour (MMMT) of the ovary to identify the prognostic factors and relate them to survival. The role of platinum‐based chemotherapy in the adjuvant treatment of this tumour was also evaluated.Methods: All patients diagnosed with MMMT of the ovary from 1987 to 2000 were identified from the gynaecological tumour registry of King George V Hospital, Australia. The effect of clinical and histopathological variables on survival was analysed. The response of platinum‐based adjuvant chemotherapy after surgery was also evaluated.Results: Twenty patients with MMMT of the ovary were identified. Of the six patients with measurable disease, two (33%) had complete response after adjuvant platinum‐based chemotherapy. The median survival of all patients was 8 months, while that of the patients receiving adjuvant platinum‐based chemotherapy was 23 months. Women who were older (>65 years) had a significantly worse survival rate than those who were younger (P = 0.02). The patients with optimal debulking had a better median survival than those with suboptimal debulking, but this difference was not statistically significant (P = 0.21). Sarcomatous component (homologous vs heterologous) was not found to be a significant prognostic factor for predicting survival.Conclusions: Malignant mixed mullerian tumour of the ovary is a rare and aggressive gynaecological tumour. The current study indicates that patient age was a significant prognostic factor for survival and surgical cytoreduction combined with platinum‐based chemotherapy is the most effective management regimen identified to date to treat MMMT of the ovary.
Incidence of fetal macrosomia and birth complications in Chinese immigrant women
Authors: Westerway Susan Campbell , Keogh John , Heard Rob , Morris Jonathan 
Published: March 2003

AbstractObjective: To compare rates of fetal macrosomia (birthweight >4000 g) and birth complications in both Chinese women immigrants and Caucasian women for two time periods: 1992 and 1999–2000.Population: Chinese women immigrants and Caucasian women attending the Royal North Shore Hospital and Hornsby Ku‐Ring‐Gai Hospital in Sydney's northern health region.Methods: Data used were extracted from the Northern Suburbs Area Health Service OBSTET database. Significance of trends were assessed using χ2 test.Results: The results show a rise in macrosomic babies born to Chinese immigrants from 4% of total Chinese births in 1992 to 9.8% in 1999–2000 (P = 0.02).There was no significant difference in the rate of macrosomia among Caucasian women with respective rates of 11 and 14% for the same periods. The incidence of post‐partum haemorrhage increased significantly in both Chinese immigrants and Caucasian women (P < 0.001).Conclusion: Australia has a multicultural population and yet the normal ranges defined for many obstetric investigations do not adjust for ethnicity. The application of values derived from a Caucasian population to other ethnic populations may be inappropriate and conceal important pathologies.
Management of 155 patients with benign liver tumours
Authors: Charny C K , Jarnagin W R , Schwartz L H , Frommeyer H S , DeMatteo R P , Fong Y , Blumgart L H 
Published: March 2003

Abstract

Background
Benign hepatic tumours continue to represent a diagnostic and therapeutic challenge. This study evaluates the indications and results of resection compared with observation in patients with benign hepatic tumours.

Methods
Patients with a primary diagnosis of benign liver tumour were identified from a prospective database and evaluated retrospectively.

Results
From January 1992 to June 1999, 155 patients with benign hepatic tumours were evaluated. The diagnoses included haemangioma (n = 97), focal nodular hyperplasia (FNH) (n = 42), hepatic adenoma (n = 12) and cystadenoma (n = 4). Sixty-eight patients (44 per cent) underwent resection because of symptoms (n = 36), inability to exclude a malignancy (n = 31) or enlargement on serial imaging (n = 11). The operative morbidity and mortality rates were 21 per cent and zero respectively. Thirty patients had a preoperative percutaneous needle biopsy, 19 of which were either incorrect or indeterminate. Overall, 39 of 42 patients with symptoms attributed to the tumour were asymptomatic after resection and 18 of 21 patients with symptoms considered unrelated to the tumour were asymptomatic after a period of observation and/or treatment of unrelated conditions (median follow-up 16 months).

Conclusion
When indicated, resection of benign liver tumours can be performed safely. Symptomatic patients with a small FNH or haemangioma can be observed because their symptoms are unlikely to be related to the liver tumour. Percutaneous needle biopsy rarely changes management.
Percutaneous endoscopic gastrostomy in patients with ventriculoperitoneal shunts
Authors: Taylor A L , Carroll T A , Jakubowski J , O'Reilly G 
Published: March 2003

Abstract

Background
Percutaneous endoscopic gastrostomy (PEG) may be required in neurosurgical patients with a persistently depressed neurological status or severe lower cranial nerve palsies. Such patients may have a coexisting hydrocephalus requiring cerebrospinal fluid (CSF) diversion. Despite the risk of infection resulting from exposure to oropharyngeal flora by the pull-through PEG technique and the secondary pneumoperitoneum seen in one-third of patients, simultaneous peritoneal placement of CSF shunt catheters with PEG is the current practice. The aim of the study was to determine the frequency of CSF diversionary procedures in neurosurgical patients undergoing PEG insertion and the occurrence of infective complications in patients with simultaneous placement of a PEG and a ventriculoperitoneal (VP) shunt.

Methods
This was a retrospective review of all neurosurgical patients undergoing PEG. The presence of hydrocephalus, mode of CSF diversion and the development of subsequent infection in those having coexistent distal peritoneal catheter placement and PEG were determined.

Results
PEGs were placed in 42 neurosurgical patients (9·3 per cent of all PEGs inserted), of whom 21 had a coexisting hydrocephalus. Eight of 16 shunts with distal catheter placement in the peritoneal cavity developed infection requiring revision. Infections occurred with greater frequency in patients with a tracheostomy. There were no shunt infections requiring revision in a second group of 21 patients who had a coexisting shunt and tracheostomy without PEG.

Conclusion
Simultaneous placement of a PEG and a VP shunt should be avoided in the acute phase of a patient's hospital admission.
In-hospital mortality from abdominal aortic surgery in Great Britain and Ireland: Vascular Anaesthesia Society audit
Authors: Bayly P J M , Matthews J N S , Dobson P M , Price M L , Thomas D G 
Published: March 2003

Abstract

Background
The mortality rate associated with elective aortic aneurysm repair is widely assumed to be in the region of 5 per cent. This figure does not take into consideration the effect of pre-existing risk factors. The Vascular Anaesthesia Society of Great Britain and Ireland conducted a large audit to estimate the in-hospital mortality rate associated with non-emergency infrarenal aortic surgery throughout the British Isles, and to determine the influence of risk factors on mortality rate.

Methods
This was a multicentre, prospective audit of 177 hospitals throughout the UK and Ireland. Data were collected by questionnaire to include all patients undergoing elective or urgent surgery for infrarenal abdominal aortic aneurysm or aortoiliac occlusive disease over 4 months.

Results
Nine hundred and thirty-three patients were recruited into the audit. The overall mortality rate was 7·3 per cent. Factors increasing the risk of death by up to fivefold included age over 74 years, urgent surgery, operation for occlusive disease, limited exercise capacity, a history of severe angina or cardiac failure, the presence of ventricular ectopics and abnormalities suggesting ischaemic heart disease on electrocardiography.

Conclusion
Although the in-hospital mortality rate was similar to previously published figures, the rate increased considerably when commonly encountered risk factors were present.
Provocation of experimental aortic inflammation and dilatation by inflammatory mediators and Chlamydia pneumoniae
Authors: Tambiah J , Franklin I J , Trendell-Smith N , Peston D , Powell J T 
Published: March 2003

Abstract

Background
The macrophage appears to have a key role in the inflammation and proteolysis associated with the growth and development of abdominal aortic aneurysms. The role of inflammatory mediators and Chlamydia pneumoniae in stimulating the influx of macrophages and dilatation of the abdominal aorta was investigated in an experimental model.

Methods
Periaortic application of calcium chloride solution (and monocyte chemoattractant protein (MCP) 1, a cocktail of cytokines or C. pneumoniae) to the abdominal aorta of New Zealand White rabbits was performed at laparotomy. Some animals were fed a cholesterol-rich diet. The diameter of the aorta was measured by ultrasonography and after perfusion fixation, 3 weeks after laparotomy. Aortic sections were stained with RAM-11 to identify macrophages for counting. The presence of C. pneumoniae DNA was confirmed using the polymerase chain reaction.

Results
Aortic macrophage influx in response to MCP-1, thioglycollate or C. pneumoniae was more than doubled in the cholesterol-fed animals. In response to human recombinant MCP-1 (1 µg) the mean(s.d.) macrophage count increased from 79(19) to 340(215) per unit area (P &lt; 0·02). Even in cholesterol-fed animals, application of MCP-1 (recombinant human or rabbit form) was not associated with aortic dilatation. Application of thioglycollate 0·1 mol/l, or live or formalin-inactivated C. pneumoniae (0·5 × 108 organisms), was associated with a similar increase in macrophages to that caused by MCP-1 and a significant (approximately twofold) increase in aortic diameter after 3 weeks.

Conclusion
Macrophage influx into rabbit abdominal aorta, without macrophage activation, is insufficient to cause experimental aortic dilatation. C. pneumoniae antigens appeared to stimulate aortic dilatation, probably by specific activation of macrophages.
Non-operative management of haemobilia
Authors: Moodley J , Singh B , Lalloo S , Pershad S , Robbs J V 
Published: March 2003

Abstract

Background
The aim was to evaluate a non-operative approach to the management of haemobilia.

Methods
This was a retrospective analysis of patients presenting over 10 years with haemobilia. All patients had upper gastrointestinal endoscopy, abdominal ultrasonography and digital subtraction angiography. Superselective coil and/or Gelfoam embolization was done as close as possible to the bleeding site. Completion angiography was performed routinely to confirm adequate embolization.

Results
There were 23 patients with liver trauma and six with inflammatory conditions. All patients required resuscitation with fluids and blood transfusion, and had the haemobilia controlled successfully by angiographic embolization. There was one death from fulminant hepatic sepsis.

Conclusion
This series attests to the efficacy of a non-operative approach to haemobilia using radiological diagnosis and intervention.
Experience with laparoscopic ultrasonography for defining tumour resectability in carcinoma of the pancreatic head and periampullary region
Authors: Taylor A M , Roberts S A , Manson J McK 
Published: March 2003

Abstract

Background
Computed tomography (CT) is currently the most widely available staging investigation for pancreatic tumours. However, the accuracy of CT for determining tumour resectability is variable and can be poor. Laparoscopic ultrasonography (LUS) is potentially a more accurate method for disease staging. The authors' experience of LUS for staging carcinoma of the pancreatic head and periampullary region is described.

Methods
Fifty-one patients with potentially resectable pancreatic tumours defined at CT underwent further investigation with LUS. Twenty-seven patients subsequently had an open laparotomy. The evaluations of tumour resectability at CT and LUS were compared with the operative findings.

Results
At LUS, 24 patients were considered to have resectable tumours, 21 non-resectable tumours and six patients were shown to have no pancreatic tumour mass. Twenty-two patients deemed to have a resectable tumour at LUS underwent surgery. Twenty patients were confirmed to have resectable disease and two patients had non-resectable disease. A further five patients underwent surgery. In all five the ultrasonographic diagnosis was confirmed at surgery (four patients with non-resectable disease and no pancreatic tumour in one patient). LUS prevented unnecessary extensive surgery in 53 per cent of patients. For the 22 patients who underwent surgery for potentially resectable disease, the positive predictive value of LUS for defining tumour resectability was 91 per cent.

Conclusion
LUS is an accurate additional investigation for defining tumour resectability and directing management in patients with potentially resectable carcinoma of the pancreatic head or periampullary region.
Randomized clinical trial of stapled versus Milligan—Morgan haemorrhoidectomy
Authors: Shalaby R , Desoky A 
Published: March 2003

Abstract

Background
The introduction of a stapling technique for the treatment of haemorrhoids has the potential for less postoperative pain, a short operating time and an early return to full activity. The outcome of stapled haemorrhoidectomy was compared with that of current standard surgery in a randomized controlled study.

Methods
Two hundred patients were randomized to either stapled haemorrhoidectomy (n = 100) or Milligan–Morgan haemorrhoidectomy (n = 100) between March 1997 and December 1998. Each patient received standardized postoperative analgesic and laxative regimens, and completed a linear analogue pain score every 6 h during the first day after operation, after the first motion and daily until the end of the first week. Operating time, frequency of postoperative analgesic intake, hospital stay, time to return to normal activity and postoperative complications were also recorded.

Results
The mean(s.d.) age of patients in the stapled and surgical groups was 44·1(3·2) and 49·1(12·2) years respectively. The stapled group had a shorter operating time, less frequent postoperative analgesia intake, shorter hospital stay and earlier return to normal activity. Early and late complications, and functional outcome were better in the stapled group.

Conclusion
Use of a circular stapler in the treatment of haemorrhoidal disease was safe, and was associated with fewer complications than conventional haemorrhoidectomy.
Effect of Helicobacter pylori eradication on the ulcer recurrence rate after simple closure of perforated duodenal ulcer: retrospective and prospective randomized controlled studies
Authors: Kate V , Ananthakrishnan N , Badrinath S 
Published: March 2003

Abstract

Background
The possible advantage of eradication of Helicobacter pylori in patients with perforated duodenal ulcer is unknown. This study was planned to assess the prevalence of H. pylori after simple closure of a perforated duodenal ulcer and to study the effect of H. pylori eradication on ulcer persistence and recurrence.

Methods
Some 202 patients were followed prospectively for 2 years after simple closure of a perforated duodenal ulcer (prospective group). A second group of 60 patients was reviewed 5 years or more after perforation closure (retrospective group). The prevalence of H. pylori in patients with perforated duodenal ulcer was compared with that in controls. Patients in the prospective group were randomized to receive either ranitidine alone or quadruple therapy (ranitidine, colloidal bismuth subcitrate, metronidazole and tetracycline) after operation. The incidence of H. pylori infection after the two treatments and the association with residual or recurrent ulcer were studied. In the retrospective group long-term ulcer recurrence was correlated with H. pylori status.

Results
The prevalence of H. pylori in patients with perforated duodenal ulcer was not significantly different from that in controls. At every interval of follow-up in the prospective group and in the retrospective group the H. pylori infection rate was significantly higher in patients who had recurrent or residual ulcers.

Conclusion
Eradication of H. pylori after simple closure of a perforated duodenal ulcer should reduce the incidence of residual and recurrent ulcers.
Randomized study comparing cardiac response in endovascular and open abdominal aortic aneurysm repair
Authors: Cuypers P W M , Gardien M , Buth J , Peels C H , Charbon J A , Hop W C J 
Published: March 2003

Abstract

Background
The aim was to compare the cardiac response and the incidence of adverse cardiac events during and after endovascular (EVAR) and open (OR) repair of abdominal aortic aneurysms (AAAs).

Methods
Seventy-six patients with an AAA suitable for EVAR, and in a general condition allowing open surgery were randomized to EVAR (57 patients) or OR (19 patients). The analysis was on an intention-to-treat basis. Haemodynamic variables were assessed intraoperatively before, during and after aortic occlusion. During the procedure myocardial ischaemia was identified with use of electrocardiography (ECG) and transoesophageal echocardiography (TEE). After operation, cardiac complications were diagnosed by clinical observation, 12-lead ECG at 1 h, 1 day and 7 days, echocardiography at 1 month and measurement of cardiac enzymes.

Results
After aortic occlusion, a greater decrease in systemic vascular resistance compared with baseline was observed with OR than with EVAR (− 396 and −70 dyne s/cm5 respectively; P = 0·03). The stroke work index, as a direct measure of myocardial performance, demonstrated a decrease during OR and an increase during EVAR during aortic occlusion (− 6·6 and +1·7 g m/m2 respectively; P = 0·03) as well as after aortic occlusion (− 7·6 and +3·4 g m/m2 respectively; P &lt; 0·01), compared with baseline. The incidence of postoperative clinical cardiac complications was comparable in the two study groups; however, myocardial ischaemia, as observed by ECG and TEE, was observed more frequently in the OR group (ten of 19 versus 15 of 57 patients; P = 0·05).

Conclusion
Haemodynamic changes were less severe and there was a lower incidence of myocardial ischaemia during EVAR than during OR. Studies are needed to demonstrate whether this may reduce the operative mortality rate.