bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infarct Volume on Apparent Diffusion Coefficient Maps Correlates with Length of Stay and Outcome after Middle Cerebral Artery Stroke
Authors: Engelter Stefan T. , Provenzale James M. , Petrella Jeffrey R. , DeLong David M. , Alberts Mark J. 
Published: April 2003

<i>Background:</i> Diffusion-weighted MRI (DWI) can depict acute ischemia based on decreased apparent diffusion coefficient (ADC) values. ADC maps, unlike DWI (which have contributions from T2 properties), solely reflect diffusion properties. Recent studies indicate that severity of neurological deficit corresponds with degree of ADC alteration. <i>Purpose:</i> To determine whether infarct volume on ADC maps correlates with length of hospitalization and clinical outcome in patients with acute ischemic middle cerebral artery (MCA) stroke. <i>Study Population:</i> Forty-five consecutive patients with acute (≤72 h) MCA infarcts seen on DWI. <i>Methods:</i> Infarct volume was determined by counting pixels with ADC values >3 SDs below the average ADC value of a contralateral control region. Infarct volume was correlated with length of hospitalization and 6-month outcome assessed with Glasgow Outcome Scale (GOS), Modified Rankin Score (mRS), Barthel Index (BI) and a dichotomized outcome status with favorable outcome defined as GOS 1, mRS ≤1 and BI ≧95. <i>Results:</i> Infarct volume on ADC maps ranged from 0.2 to 187 cm<sup>3</sup> and was significantly correlated with length of hospitalization (p < 0.001, r = 0.67). Furthermore, ADC infarct volume was significantly correlated with GOS (r = 0.73), mRS (r = 0.68), BI (r = 0.67) and outcome status (r = 0.65) (each p < 0.001). Multiple logistic regression revealed a statistically significant correlation between ADC infarct volume and outcome status (p < 0.05), but none for Canadian Neurological Scale score, age and gender (p >0.05 each). <i>Conclusion:</i> Infarct volume measured by using a quantitative definition for infarcted tissue on ADC maps correlated significantly with length of hospitalization (as a possible surrogate marker for short-term outcome) and functional outcome after 6 months. ADC infarct volume may provide prognostic information for patients with acute ischemic MCA stroke.
Acute Fungal Pustulosis on a Bedridden Patient’s Back
Authors: Verneuil L. , Datry A. , Le Flour N. , Dompmartin A. , Derenne J.P. , Chosidow O. 
Published: April 2003

We report a particular dermatophytosis due to <i>Trichophyton rubrum. </i>A 61-year-old woman presented an eruption which quickly evolved within 48 h, consisting of papular annular patches surrounded by creamy white pustules, which sometimes coalesced. The eruption was exclusively located on the back. The rest of the body and skin examination was normal, and the patient had no temperature. The mycological sample revealed mycelial filaments in the direct microscopic examination and <i>T. rubrum </i>in the mycological culture. Only a few cases of pustular lesions due to <i>T. rubrum </i>are reported in the literature. The extensive character, the site and the inflammatory aspect of the lesions were very surprising. This clinical presentation is more frequent with geophilic and zoophilic organisms than with anthropophilic dermatophytes such as <i>T. rubrum.</i>
Dehydroascorbic Acid in Urine as a Possible Indicator of Surgical Stress
Authors: Kubin Andreas , Kaudela Karl , Jindra Rudolf , Alth Gerhart , Grünberger Werner , Wierrani Franz , Ebermann Robert 
Published: April 2003

<i>Background/Aim:</i><i>L</i>-Ascorbic acid (AA) is the predominant circulating form of vitamin C found in human blood. It has been hypothesized that surgical stress increases the vitamin C metabolite dehydroascorbic acid (DHAA). Vitamin C is mainly excreted through the kidneys. In this study, the ratio of AA to DHAA excreted in urine was determined in patients who had undergone total hip joint endoprosthesis surgery (n = 12), and the results were compared with data obtained from healthy controls (n = 12). <i>Methods:</i> All subjects received 1,000 mg sodium ascorbate intravenously three times a day (every 8 h) for 8 days, starting 2 days prior to surgery. Total urine was collected daily while subsequent determinations of AA and DHAA were performed photometrically. <i>Results:</i> Administration of vitamin C led to average daily excretions of the combined products AA + DHAA of 2,343 ± 438 mg/day (mean value ± confidence intervals). The initial average ratio DHAA/AA of all 24 probands was 0.064 (6% DHAA; 153 ± 76 mg/day). One day after surgery, an increase in the DHAA/AA ratio to 0.165 (15% DHAA; 332 ± 107 mg/day) was measured in the patients. The ratio decreased 2 days after surgery and returned to normal within 5 days. <i>Conclusion:</i> Our data indicate that surgery increases the oxidation of AA and urinary excretion of DHAA, as a result of the enhanced formation of free radicals.
Unoprostone Isopropyl Pretreatment Decreases Endothelin-1 Release and the Intra-Ocular Pressure Spike Induced by Laser Trabeculoplasty in the Rabbit
Authors: Holló Gábor , Visontai Zsuzsanna , Lakatos Péter , Vargha Péter 
Published: April 2003

<i>Purpose:</i> We have previously shown that the intra-ocular pressure (IOP) spike due to argon laser trabeculoplasty (ALT) is caused by an acute endothelin-1 (ET-1) release from the uveal tissue into the aqueous humour of rabbit eyes. In this study we investigated whether pretreatment with topical unoprostone isopropyl, a functional antagonist of ET-1, protects against the pressure spike due to ALT in the rabbit model. <i>Methods:</i> IOP of both eyes of 17 pigmented rabbits was measured with a TonoPen XL tonometer under general anaesthesia (baseline measurement). Then the right eyes were treated with topical unoprostone isopropyl 0.12% BID for 6 days, and the left eyes similarly received balanced salt solution (BSS) twice daily. After the last morning instillation, IOP for both eyes was measured under general anaesthesia after 2 h in group 1 and after 3 h in group 2 animals. Then, for both groups, ALT was performed on both eyes. Thirty minutes after laser treatment (and still under general anaesthesia), IOP was measured again. Then the aqueous humour was aspirated for measurement of ET-1 concentration. <i>Results:</i> Baseline<i></i>individual IOP differences (left eye minus right eye) were not significant in both groups: mean ± SD 0.25 ± 1.16 and –0.33 ± 0.71 mm Hg, respectively (paired t test, p > 0.05 for both groups). On day 6, 2 h (group 1) and 3 h (group 2) after the last instillation but before laser trabeculoplasty, the difference (BSS-pretreated left eye minus unoprostone-pretreated right eye) increased to 2.13 ± 2.10 mm Hg (p = 0.024) and 1.33 ± 0.71 mm Hg (p = 0.0005), respectively. Thirty minutes after ALT, the IOP difference was 2.63 ± 2.67 mm Hg in group 1 (p = 0.027), but no difference was seen in group 2 (0.67 ± 1.94 mm Hg, p = 0.332). In group 1, postoperative aqueous humour ET-1 concentration for the unoprostone-pretreated right eye was significantly lower than that for the BSS-pretreated left eye (paired t test, p = 0.01); but in group 2 no inter-ocular difference in ET-1 concentration was found (p = 0.976). <i>Conclusion:</i> Topical unoprostone pretreatment decreases laser-induced ET-1 release and diminishes the IOP spike caused by ALT in vivo within 2 h after instillation, when the concentration of unoprostone in the aqueous humour is high.
Ultrastructure of the Optic Nerve in Magnesium-Deficient Rats
Authors: Gong Huaqing , Takami Yumiko , Amemiya Tsugio 
Published: April 2003

<i>Purpose:</i> The ultrastructure of the optic nerves in magnesium (Mg)-deficient rats was studied to elucidate the function of Mg. <i>Methods:</i> After delivery, mother Wistar Kyoto rats were fed a low-Mg diet containing 0.1 mg Mg/100 g diet with all other nutrients and distilled and deionized water. Infant rats were suckled by their mothers for 21 days and then fed the same Mg-deficient diet. Control mother rats were fed commercial rat pellets containing 24 mg Mg/100 g diet and all other nutrients. The optic nerves were examined by electron microscopy at 6 weeks of age. <i>Results:</i> In the Mg-deficient rats, serum Mg levels were significantly lower and calcium levels higher than in the control rats. Ultrastructural findings were: significantly fewer myelinated axons and significantly thinner myelin sheaths in the Mg-deficient rats than in the control and pair-fed controls, and more numerous unmyelinated axons. There were multifocal areas of destruction and necrosis in the optic nerve of Mg-deficient rats. <i>Conclusions:</i> This study suggests that the optic nerve needs Mg for the development and maintenance of its cell structure.
Keratolytic Activity of Microemulsions
Authors: Gloor M. , Haus G. , Keipert S. 
Published: April 2003

<i>Objective:</i> To compare the keratolytic activities of a drug-free hydrophilic microemulsion (ME) and a drug-free lipophilic ME with water, and with regard to the hydrophilic ME also with a 5% salicylic acid gel on the sole of the foot. <i>Methods:</i> Twenty healthy volunteers had their plantar forefoot, midfoot, and rearfoot stratum corneum blackened with silver nitrate and a photographic developer, and a chromameter was used to determine the extent of removal of this black dye by a* value and L value measurement at 24 and 48 h. <i>Results:</i> Both drug-free MEs produced significantly greater increases in a* value and L value than water, and the hydrophilic ME was also more effective than 5% salicylic acid gel. <i>Conclusion:</i> The irritating effect of MEs is rather negligible on the sole of the foot because of the thick plantar stratum corneum. Both MEs therefore appear suitable for the elimination or prevention of plantar desquamative and hyperkeratotic skin changes.
Isolation, Characterization, and Functional Assessment of Oxidatively Modified Subfractions of Circulating Low-Density Lipoproteins
Authors: Yang Chao-yuh , Raya Joe L. , Chen Hsin-Hung , Chen Chu-Huang , Abe Yasunori , Pownall Henry J. , Taylor Addison A. , Smith Charles V. 
Published: April 2003

Objective—Current evidence suggests that oxidatively modified human plasma low-density lipoproteins (ox-LDLs) are proatherogenic and cytotoxic to endothelial and vascular smooth muscle cells. The present study describes a method using ion-exchange chromatography that is capable of large-scale subfractionation of LDL for adequate analyses of composition or bioactivities.Methods and Results—LDLs from normolipidemic (N-LDL) and homozygous familial hypercholesterolemic (FH-LDL) subjects were separated into 5 subfractions (L1 through L5) by high-capacity ion-exchange chromatography. The most strongly retained fraction from FH subjects, FH-L5, suppressed DNA synthesis in cultured bovine aortic endothelial cells and stimulated mononuclear cell adhesion to cultured endothelial cells under flow conditions in vitro. L5, which represented 1.1±0.2% and 3.7±1.7% of the LDL from N-LDL and FH-LDL, respectively, was more triglyceride-rich (17% versus 5%) and cholesteryl ester-poor (23% versus 33%) than were L1 through L4. Electrophoretic mobilities on agarose gels increased from L1 to L5. According to SDS-PAGE, apolipoprotein B-100 in N-LDL fractions L1 through L5 appeared as a single ≈500-kDa band. In contrast, the fractions isolated from FH-LDL showed substantial fragmentation of the apolipoprotein B-100, including bands between 200 and 116 kDa. Competitive ELISA analyses using a malondialdehyde-specific monoclonal antibody against Cu2+ox-LDL suggest that FH-L5 is malondialdehyde-modified.Conclusions—Relative to N-LDL, FH-LDL contains higher concentrations of a fraction, L5, that exhibits distinctive physicochemical properties and biological activities that may contribute to initiation and progression of atherogenesis in vivo.
Expansion of CMV-specific CD8+CD45RA+CD27- T cells in B-cell chronic lymphocytic leukemia
Authors: Mackus Wendelina J. M. , Frakking Florine N. J. , Grummels Annette , Gamadia Laila E. , de Bree Godelieve J. , Hamann Dörte , van Lier René A. W. , van Oers Marinus H. J. 
Published: April 2003

AbstractIn patients with B-cell chronic lymphocytic leukemia (B-CLL), the absolute number of T cells is increased. Although it has been suggested that these T cells might be tumor specific, concrete evidence for this hypothesis is lacking. We performed a detailed immunophenotypic analysis of the T-cell compartment in the peripheral blood of 28 patients with B-CLL (Rai 0, n = 12; Rai I-II, n = 10; Rai III-IV, n = 6) and 12 healthy age-matched controls and measured the ability of these patients to mount specific immune responses. In all Rai stages a significant increase in the absolute numbers of CD3+ cells was observed. Whereas the number of CD4+ cells was not different from controls, patients with B-CLL showed significantly increased relative and absolute numbers of CD8+ cells, which exhibited a CD45RA+CD27- cytotoxic phenotype. Analysis of specific immune responses with tetrameric cytomegalovirus (CMV)–peptide complexes showed that patients with B-CLL had significantly increased numbers of tetramer-binding CMV-specific CD8+ T cells. The rise in the total number of CD8+ cytotoxic T cells was evident only in CMV-seropositive B-CLL patients. Thus, our data suggest that in patients with B-CLL the composition of T cells is shifted toward a CD8+ cytotoxic cell type in an effort to control infections with persistent viruses such as CMV. Moreover, they offer an explanation for the high incidence of CMV reactivation in CLL patients treated with T cell–depleting agents, such as the monoclonal antibody (mAb) alemtuzumab (Campath; α-CD52 mAb). Furthermore, because in CMV-seronegative patients no increase in cytotoxic CD8+ T cells is found, our studies do not support the hypothesis that tumor-specific T cells account for T-cell expansion in B-CLL.
Soluble receptor activator of nuclear factor κB ligand–osteoprotegerin ratio predicts survival in multiple myeloma: proposal for a novel prognostic index
Authors: Terpos Evangelos , Szydlo Richard , Apperley Jane F. , Hatjiharissi Evdoxia , Politou Marianna , Meletis John , Viniou Nora , Yataganas Xenophon , Goldman John M. , Rahemtulla Amin 
Published: April 2003

Abstract
Interaction between receptor activator of nuclear factor κB ligand (RANKL) and RANK/osteoprotegerin (OPG) plays a dominant role in osteoclast activation and possibly in plasma cell survival in multiple myeloma (MM). We measured soluble RANKL (sRANKL), OPG, and bone remodeling markers in 121 patients with newly diagnosed MM to evaluate their role in bone disease and survival. Serum levels of sRANKL were elevated in patients with MM and correlated with bone disease. The sRANKL/OPG ratio was also increased and correlated with markers of bone resorption, osteolytic lesions, and markers of disease activity. The sRANKL/OPG ratio, C-reactive protein (CRP), and β2-microglobulin were the only independent prognostic factors predicting survival in multivariate analysis. We generated a prognostic index based on these factors that divided our patients into 3 risk groups. The low-risk group had a 96% probability of survival at 5 years, whereas the intermediate-risk and the high-risk groups had probabilities of survival of 52% and 0%, respectively. Not only do these results confirm for the first time in humans the importance of sRANKL/OPG in the development of bone disease, they also highlight the role of this pathway in the biology of plasma cell growth as reflected by its influence on survival.
Apoptotic-Regulatory and Complement-Protecting Protein Expression in Chronic Lymphocytic Leukemia: Relationship to In Vivo Rituximab Resistance
Authors: Bannerji Rajat , Kitada Shinichi , Flinn Ian W. , Pearson Michael , Young Donn , Reed John C. , Byrd John C. 
Published: April 2003

Purpose: Rituximab has clinical activity in patients with chronic lymphocytic leukemia (CLL) and has a variety of proposed mechanisms, including apoptosis, complement-dependent cell lysis (CDC), and antibody-dependent cellular cytotoxicity (ADCC). Here we examine pretreatment biologic features that promote resistance to apoptosis and CDC in CLL patients and correlate it with clinical outcome to rituximab-based therapy.Patients and Methods: Pretreatment samples from 21 CLL patients treated on a prospective, single-agent rituximab trial were examined for quantitative expression of apoptotic and CDC regulatory proteins, and the level of expression of these proteins was correlated with clinical outcome.Results: Of the 21 patents for whom samples were available, 10 attained a partial response and 11 failed to respond to rituximab therapy. The mean pretreatment expression of Bcl-2, Mcl-1, XIAP, and the ratio of Bcl-2/Bax were higher but not statistically increased in nonresponding patients versus those responding to treatment. In contrast, the pretreatment Mcl-1/Bax ratio was significantly elevated (0.82 ± 0.28 v 0.39 ± 0.29, P < .016) in nonresponding patients compared with patients responding to rituximab therapy. Although pretreatment expression of CD55 and CD59 was not associated with response to rituximab therapy, significantly higher levels of CD59 were observed in the CLL cells that were not cleared from the blood at completion of therapy than the level observed at baseline levels (P = .02).Conclusion: These data indicate that baseline expression of the Mcl-1/Bax ratio, but not CD55 and CD59, predict for clinical response to rituximab therapy in CLL patients. Further study of disrupted apoptosis in CLL as a potential mechanism of resistance to rituximab appears warranted.
Early Change in Patient-Reported Health During Lung Cancer Chemotherapy Predicts Clinical Outcomes Beyond Those Predicted by Baseline Report: Results From Eastern Cooperative Oncology Group Study 5592
Authors: Eton David T. , Fairclough Diane L. , Cella David , Yount Susan E. , Bonomi Philip , Johnson David H. 
Published: April 2003

Purpose: To determine the ability of longitudinal patient-reported health (PRH) scores to enhance prediction of clinical outcomes beyond baseline scores. Patients and Methods: In 573 advanced non–small-cell lung cancer patients enrolled in a phase III clinical trial, we used baseline and 6-week follow-up PRH scores to predict best response to treatment, disease progression, and survival. Using regression analyses, we tested the predictive ability of the five subscales of the Functional Assessment of Cancer Therapy–Lung (physical, functional, social/family, emotional well-being, and the lung cancer subscale) as well as the trial outcome index (TOI) aggregate score. Results: After clinical factors were controlled for, baseline physical well-being (PWB) and TOI scores predicted all three clinical outcomes. A higher baseline PWB score was associated with a better response to treatment (odds ratio, 1.09; P < .001) and lower risk of death (risk ratio, 0.95; P < .001). Higher baseline TOI score was associated with a lower risk of disease progression (risk ratio, 0.98; P < .001). These two baseline predictors (PWB and TOI) were then used along with 6-week change scores to classify patients into four groups: low baseline-declined, low baseline-improved, high baseline-declined, and high baseline-improved. Patients with low baseline-declined PWB scores showed the worst responses to treatment and survived the shortest duration. Patients with low baseline-declined TOI scores had the shortest time to progression. Conclusion: The physical aspects of baseline PRH and PRH change during chemotherapy are significant predictors of clinical outcomes in lung cancer. This has implications for patient stratification in clinical trials and may aid decision-making in clinical practice.
Randomized Trial of Dose-Dense Versus Conventionally Scheduled and Sequential Versus Concurrent Combination Chemotherapy as Postoperative Adjuvant Treatment of Node-Positive Primary Breast Cancer: First Report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741
Authors: Citron Marc L. , Berry Donald A. , Cirrincione Constance , Hudis Clifford , Winer Eric P. , Gradishar William J. , Davidson Nancy E. , Martino Silvana , Livingston Robert , Ingle James N. , Perez Edith A. , Carpenter John , Hurd David , Holland James F. , Smith Barbara L. , Sartor Carolyn I. , Leung Eleanor H. , Abrams Jeffrey , Schilsky Richard L. , Muss Hyman B. , Norton Larry 
Published: April 2003

Purpose: Using a 2 × 2 factorial design, we studied the adjuvant chemotherapy of women with axillary node–positive breast cancer to compare sequential doxorubicin (A), paclitaxel (T), and cyclophosphamide (C) with concurrent doxorubicin and cyclophosphamide (AC) followed by paclitaxel (T) for disease-free (DFS) and overall survival (OS); to determine whether the dose density of the agents improves DFS and OS; and to compare toxicities. Patients and Methods: A total of 2,005 female patients were randomly assigned to receive one of the following regimens: (I) sequential A × 4 (doses) → T × 4 → C × 4 with doses every 3 weeks, (II) sequential A × 4 → T × 4 → C × 4 every 2 weeks with filgrastim, (III) concurrent AC × 4 → T × 4 every 3 weeks, or (IV) concurrent AC × 4 → T × 4 every 2 weeks with filgrastim. Results: A protocol-specified analysis was performed at a median follow-up of 36 months: 315 patients had experienced relapse or died, compared with 515 expected treatment failures. Dose-dense treatment improved the primary end point, DFS (risk ratio [RR] = 0.74; P = .010), and OS (RR = 0.69; P = .013). Four-year DFS was 82% for the dose-dense regimens and 75% for the others. There was no difference in either DFS or OS between the concurrent and sequential schedules. There was no interaction between density and sequence. Severe neutropenia was less frequent in patients who received the dose-dense regimens. Conclusion: Dose density improves clinical outcomes significantly, despite the lower than expected number of events at this time. Sequential chemotherapy is as effective as concurrent chemotherapy.
Phase III Study Comparing Three Cycles of Infusional Carmustine and Cisplatin Followed by Radiation Therapy With Radiation Therapy and Concurrent Carmustine in Patients With Newly Diagnosed Supratentorial Glioblastoma Multiforme: Eastern Cooperative Oncology Group Trial 2394
Authors: Grossman Stuart A. , O’Neill Anne , Grunnet Margaret , Mehta Minesh , Pearlman James L. , Wagner Henry , Gilbert Mark , Newton Herbert B. , Hellman Richard 
Published: April 2003

Purpose: This phase III Eastern Cooperative Oncology Group-Southwest Oncology Group intergroup study was conducted to determine whether three 72-hour infusions of carmustine (BiCNU) and cisplatin administered monthly before external-beam radiotherapy would improve the survival of patients with newly diagnosed glioblastoma multiforme. The control arm consisted of radiation with standard adjuvant BiCNU. Patients and Methods: A total of 223 patients were accrued from 1996 to 1999. Of these, 219 patients were eligible; 109 were randomly assigned to the experimental arm, and 110 were randomly assigned to the control arm. Randomization was stratified by age, performance status, and extent of resection. Results: The median age of the patients was 55 years; 55% were male, 93% were white, 26% had a biopsy only, and 84% were ambulatory. Treatment arms were well balanced with respect to baseline characteristics. Median follow-up time of the 15 patients still alive at the time of analysis was 3.3 years (range, 2 to 5 years). Median survival times for the standard and experimental arms were 11.2 and 11.0 months (P = .33, two-sided log-rank test), and survival at 1 year was 45% versus 44%, respectively. Fifty-six percent of patients received all three cycles of BiCNU/cisplatin, 12% received two cycles, and 31% received only one cycle. Toxicity was primarily hematologic and was more common in the experimental arm (P < .01). Conclusion: This study demonstrates that 72-hour infusions of BiCNU and cisplatin followed by radiation do not improve median survival, survival at 1 year, or time to progression. Furthermore, this treatment requires more time in the hospital and is associated with more serious toxicities than standard therapy.