bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rapid detoxification from opioid dependence under general anaesthesia versus standard methadone tapering: abstinence rates and withdrawal distress experiences
Authors: KRABBE PAUL , KONING JEROEN , HEINEN NADIA , LAHEIJ ROBERT , VAN CAUTER RM VICTORY , DE JONG COR 
Published: November 2003

AbstractThe aim of this work was to study abstinence rates and withdrawal effects of rapid detoxification of opioid‐dependents under general anaesthesia (RD‐GA) compared to standard methadone tapering (SMT) using a prospective clinical trial with a follow‐up of 3 months, as a preliminary study at the Novadic addiction centre in St Oedenrode and St Joseph Hospital in Veghel, the Netherlands. Thirty opioid‐dependent patients took part. Outcome measures included urine toxicology screening for opiates to determine abstinence and presence of objective and subjective opioid withdrawal distress symptoms. Statistically significant differences in abstinence rate between RD‐GA and SMT were present after one (RD‐GA 100% vs. SMT 40%, p <0.01) and 2 months (RD‐GA 93% vs. SMT 33%, p <0.01). After 3 months the difference in abstinence was still substantial, but no longer statistically significant (RD‐GA 67% vs. SMT 33%, p =0.14). Objective and subjective withdrawal symptoms showed largely identical outcomes and were equally low in the two groups for those who remained in the study. There was a considerably higher percentage of abstinence in the RD‐GA group after 1, 2 and 3 months of follow‐up accompanied by relatively mild withdrawal symptoms of shorter duration. However, if one completes SMT the data suggest a greater chance of staying clean in the long term than those completing RD‐GA.
Bupropion‐induced somnambulism
Authors: KHAZAAL YASSER , KRENZ SONIA , ZULLINO DANIELE FABIO 
Published: November 2003

AbstractWhereas there are some case reports of bupropion‐induced vivid dreaming and nightmares, until now it has not been associated with somnambulism. A case is reported of a patient treated with bupropion as a smoking cessation medication, who developed somnambulism during nicotine withdrawal. Furthermore, the sleepwalking episodes were associated with eating behaviour. Amnesia was reported for all episodes. As, on one hand, bupropion is a noradrenergic and dopaminergic drug and nicotine withdrawal, on the other hand, is associated with alterations in monoaminergic functions, an interaction at the level of these neurotransmitters is suggested as the underlying mechanism.
Presentation, Prognostic Factors and Patterns of Failure in Adult Rhabdomyosarcoma
Authors: Simon James H. , Paulino Arnold C. , Ritchie Justine M. , Mayr Nina A. , Buatti John M. 
Published: November 2003

Purpose: The purpose of our study is to retrospectively review our institutional experience with adult rhabdomyosarcoma (RMS) to determine presentation, prognostic factors and patterns of failure in this disease.Materials and Methods: All patients ≥ 16 years with a diagnosis of rhabdomyosarcoma were retrospectively reviewed. Tumors were classified according to the Intergroup Rhabdomyosarcoma Study (IRS) staging and grouping system. Median follow‐up for surviving patients was 12.5 years.Results: A total of 39 patients (23 male, 16 female) were seen at our institution from 1961 to 1999. Median age was 45 years,
and age distribution showed a bimodal peak at the late teens to twenties and later in the sixties. Tumor in the extremity was
most common as seen in 15 (39%); this was followed by head and neck in 11 (28%), genitourinary in eight (20%), trunk/retroperitoneum in four (10%) and other in one (3%). Tumor stage was T1 in 21 (52%) while 26 (67%) were > 5 cm in size.
Pleomorphic histology was most common (36%) and increased in incidence according to age category: 0% for ages 16–19,
27% for ages 20–49 and 60% for ages ≥ 50 years old (P < 0.01). The median survival for the entire population was 2.25 years
with a 5‐year overall survival rate of 35%. Multivariate analysis identified early IRS stage (P < 0.001), non‐embryonal
histology (P < 0.009), favorable site (P = 0.024), female gender (P = 0.034), early T‐stage (P = 0.034) and absence of nodal
metastases (P = 0.037) as predictors of a better survival. The 5‐year progression‐free survival rate was 21%. Female gender
(P = 0.002), non‐embryonal histology (P = 0.009), early IRS stage (P = 0.02) and early T stage (P = 0.033) were found on
multivariate analysis to predict for improved progression‐free survival. The 5‐year local control rate was 51%, and
multivariate analysis found that only early T‐stage was predictive of better local control (P = 0.045). Five of six Group II
patients and five of eight Group III patients who received radiotherapy (RT) were locally controlled. Only one of five Group
III patients was locally controlled without RT.Conclusions: The overall prognosis of adult RMS is worse than reported in children, but age criteria within the adult
population did not further classify outcome. RT is an effective local modality providing local control in almost all Group II
and majority of Group III patients.
Phase II Study of Ifosfamide+Doxorubicin in Patients With Advanced Synovial Sarcomas (E1793): A Trial of the Eastern Cooperative Oncology Group
Authors: Edmonson John H. , Ryan Louise M. , Falkson Carla I. , Hicks David G. , Blum Ronald H. 
Published: November 2003

Purpose Because we had observed in the synovial sarcoma subgroup of a broad phase III advanced soft tissue sarcoma study a significantly greater objective regression rate from ifosfamide+doxorubicin (88%) than from doxorubicin alone (20%) (P = 0.02), the Eastern Cooperative Oncology Group (ECOG) decided to further assess this two drug combination in a subsequent Phase II study.Patients Between 1994 and 1999, twelve adult patients with advanced synovial sarcomas were enrolled to receive, as their initial chemotherapy, ifosfamide 7.5 gm/m2 plus doxorubicin 60 mg/m2, given intravenously over two consecutive days every 3 weeks.Methods Each day for 2 days doxorubicin 30 mg/m2 was infused over 5 min through a running i.v., followed by ifosfamide 3750 mg/m2 over 4 h. Continuous i.v. fluid was infused at 300 mL/h for 3 h on day 1, before chemotherapy was begun; then the infusion was continued at 100 mL/h for a total of 3 days. Mesna 750 mg/m2 was given 15 min before ifosfamide and at 4 and 8 h after ifosfamide on days 1 and 2 of each treatment cycle. Filgrastim (G‐CSF) 5 μg/kg was given subcutaneously each day for 14 days beginning on day 3 of each treatment cycle to limit the severity of neutropenia.Results Five of our 12 patients (42%) experienced partial regression of their advanced synovial sarcomas; however, this first stage result was borderline for proceeding to the second planned stage of accrual and our case accrual was quite poor. Thus, the study was closed after stage one accrual. Our patients received a median of four cycles of chemotherapy (range: 1 to 6). All patients experienced at least grade 3 neutropenia (grade 4 in nine of them), and one patient died of treatment‐related sepsis following the initial cycle of chemotherapy. Median survival was 11 months.
Hand‐Modelled Composite Prostheses after Resection of Peri‐Acetabular Bone Malignancies
Authors: Delepine G. , Delepine F. , Sokolov T. , Delepine N. 
Published: November 2003

Purpose: To improve function after pelvic resection involving the acetabulum, using an anatomic composite implant built with screws and cement.Material and method: Since 1990, 66 patients with peri‐acetabular bone malignancies have been treated by extensive resection followed by hand‐modelled innominate prosthesis with partially constrained total hip prosthesis.
The hand‐modelled innominate prosthesis was made of a titanium cup, a set of long titanium screws and two or three packs of
gentamycine‐loaded cement.Results: Many postoperative complications were observed: deep infection (14%), hip prosthesis dislocation (25%) and local recurrence (15%).
Sixteen patients (25%) had to be reoperated. Nevertheless, at last follow‐up, 62 patients still
had composite prosthesis. The mean functional result, rated according to a modified Enneking′s staging system, was 80% with unlimited walking without support, average hip flexion 100°, length discrepancy less than 1 cm.Discussion: These results were similar to those described in the literature for custom‐made innominate prostheses and much
better than those of alternative reconstructive procedures. Hand‐modelled composite prostheses are cheaper, easier, more
adaptable and enables better anchorage than custom‐made prostheses. Such a procedure can be used even after total iliac
wing resection.Conclusion: The advantages of such a procedure plead for its extensive use after acetabular resection. But long‐term follow‐up is necessary to validate indications.
A Phase II Study of Docetaxel in Patients with Relapsed and Refractory Ewing′s Tumours
Authors: Meyer T. , Mctiernan A. , Whelan J. 
Published: November 2003

Purpose. The prognosis for patients with Ewing′s tumours who have metastases at presentation or who are refractory to standard chemotherapy regimens remains poor. There is therefore a need to evaluate the role of new agents. This report describes the initial results of a prospective phase II trial of docetaxel in patients with progressive or refractory Ewing′s tumours.Patients and methods. Fourteen patients with Ewing′s tumours who had all relapsed or progressed after treatment with multi‐drug cytotoxic therapy were treated with docetaxel 100 mg/m2 infused over 1 h, three weekly for a maximum of six cycles. Nine patients received granulocyte colony‐stimulating factor with all cycles.Results. A partial response was observed in one patient and stable disease in two. The remaining patients progressed on treatment. The major toxicity was myelosuppression and infection with 36% patients experiencing grade 3 or 4 neutropenia and/or infection.Conclusion. Docetaxel appears to have some activity in Ewing′s tumours even in heavily pre‐treated patients. Further evaluation of its efficacy at an earlier stage of the disease is warranted.
Delayed auditory feedback in the treatment of stuttering: clients as consumers
Authors: Van Borsel John , Reunes Gert , Van den Bergh Nathalie 
Published: November 2003

AbstractPurpose: To investigate the effect of repeated exposure to delayed auditory feedback (DAF) during a 3‐month period outside a clinical environment and with only minimal clinical guidance on speech fluency in people who stutter. Method: A pretest‐post‐test design was used with repeated exposure to DAF during 3 months as the independent variable. Nine stuttering individuals aged between 18 and 45 years served as subjects. Videotaped samples from different speech tasks were collected before and after 3 months' exposure to DAF, each time under two conditions: first during non‐altered feedback (NAF) and subsequently during DAF.Results: Before the repeated exposure to DAF, the percentage of stuttered words was significantly higher during NAF than during DAF. After 3 months‘ exposure to DAF, the percentage of stuttered words during NAF had dropped to a non‐significant level in comparison with the DAF condition. Comparison of the percentage of stuttered words during NAF before and after repeated exposure to DAF showed significantly less stuttering after the repeated exposure to DAF. The percentage of stuttered words during DAF was generally somewhat higher, but not significantly so, after the 3 months’ repeated exposure to DAF than before the exposure to DAF.Conclusions: Results confirm that DAF is an effective means of reducing stuttering even when employed as the only treatment approach outside a therapeutic environment. They also suggest that DAF continues to promote fluency when used over a longer period, but also that length of exposure and fluency enhancement are probably not in a linear relationship.
Training volunteers as conversation partners for people with aphasia
Authors: Rayner Helen , Marshall Jane 
Published: November 2003

AbstractBackground: One of the most disabling consequences of aphasia is the way it excludes the person from conversation. A number of studies have attempted to tackle this problem by training the conversational partners of aphasic people. This study offers an evaluation of this approach.Aims: Six volunteers were trained in conversing with people with moderate or severe aphasia. The study aimed to evaluate whether training changed the volunteers' knowledge about aphasia and their interactions with aphasic people. It also explored whether changes in the volunteers were matched by improved participation of the aphasic people in conversation.Methods & Procedures: Volunteers were recruited from an aphasia group in Milton Keynes. They were trained as a group over three sessions (9 hours in total). The training drew on the techniques of Kagan (1998, 1999). It included presentation of information using different media, group discussions, viewing of videos and role play. The course aimed to improve (1) the volunteers‘ understanding of the nature of aphasia, (2) the volunteers' knowledge about communication strategies to use with aphasic people and (3) the skills of the volunteers in supporting aphasic people in conversation. An additional aim was to increase the aphasic subjects' participation in conversation. Two evaluation methods were employed. Specially designed questionnaires were administered before and after training to evaluate the volunteers’ knowledge and understanding. Volunteers were also videotaped in conversation with aphasic people before and after training. The videos were rated by speech and language therapists, using nine‐point rating scales, derived from Kagan (1999).Outcomes & Results: Significant improvements were seen on the questionnaire scores and in ratings of the volunteers' videos. The rating gains were attributed to the training course, since baseline scores were stable and improvements only occurred after the training period. There were comparable gains in the participation of the aphasic subjects, which again occurred after training.Conclusions: The study demonstrates that a short training course can change the knowledge and practice of experienced volunteers. The findings have implications for teaching generic skills to volunteers working with aphasic people.
Relationship between gestures and words in children with Down's syndrome and typically developing children in the early stages of communicative development
Authors: Iverson Jana M. , Longobardi Emiddia , Caselli M. Cristina 
Published: November 2003

AbstractBackground: Previous research has emphasized the importance of gesture in early communicative development. These studies have reported that gestures are used frequently during the first two years of life and may play a transitional role in the language acquisition process. Although there are now numerous descriptions of the relationship between gesture and the developing language system in typically‐developing (TD) children, relatively little is known about the nature and early development of the gesture‐language system in children with developmental disorders involving specific profiles of language delay and/or impairment.Primary objective: The aim of this study is to compare early word and gesture use in children with DS and in typically‐developing children to investigate potential differences in the relationship between gestural and verbal communication in early language development.Methods and Procedures: Ten children from upper‐middle class families participated in the study. The five children with DS (3 boys and 2 girls) had an average chronological age of 47.6 months, an average mental age of 22.4 months, and an average language age of 18 months. Each child with DS was matched to a typically developing child on the basis of gender, language age, and observed expressive vocabulary size. Children were videotaped for 30 minutes as they interacted spontaneously with their mothers. All communicative and intelligible gestures and words produced by the children were transcribed from the videotapes. Data analyses focused on: a) overall production of gestures and words (i.e., gesture and word tokens); b) the size of children's gestural and verbal repertoires (i.e., gesture and word types); and c) production and informational content of gesture‐word combinations.Main outcomes and results: Although children with DS had significantly smaller gestural repertoires than their language age‐matched peers, there was no reliable difference between the two groups in the overall use of gesture. In addition, with DS produced two‐element combinations (primarily gesture‐word combinations) and did so at a rate comparable to that observed among their TD counterparts. However, no two‐word combinations were observed among children with DS, and there were also group differences in the information contained in children's gesture‐word combinations.Conclusions: Taken together, these findings suggest that in addition to the well‐documented global delays in early communicative development, children with DS may exhibit additional pockets of delay, specifically in making the transition from one‐ to two‐word speech. Results are further discussed in terms of their implications for understanding the organization of the developing gesture‐language system and for the assessment of gesture in young children with communicative delays and disorders.
Markers for Risk of Type 1 Diabetes in Relatives of Alsacian Patients With Type 1 Diabetes
Authors: Ongagna Jean Claude , Sapin Remi , Pinget Michel , Belcourt Alain 
Published: November 2003

Background: The cytotoxic T lymphocyteassociated
antigen 4 gene (CTLA‐4) encode the
T cell receptor involved in the control of T cell
proliferation and mediates T cell apoptosis.
The receptor protein is a specific T lymphocyte
surface antigen that is detected on cells only
after antigen presentation. Thus, CTLA‐4 is
directly involved in both immune and autoimmune
responses and may be involved in the
pathogenesis of multiple T cell‐mediated
autoimmune disorders. There is polymorphism
at position 49 in exon 1 of the CTLA‐4 gene,
providing an A‐G exchange. Moreover, we
assessed the CTLA‐4 49 (Thr/Ala) polymorphism
in diabetic patients and first‐degree relatives
as compared to control subjects.Research design and methods: Three loci
(HLA‐DQB1, DQA1 and CTLA‐4) were analysed in 62 type 1 diabetic patients, 72 firstdegree
relatives and 84 nondiabetic control
subjects by means of PCR‐RFLP.Results: A significant enrichment in DQB1
alleles encoding for an amino acid different
from Asp in position 57 (NA) and DQA1 alleles
encoding for Arg in position 52 was
observed in diabetic subjects and first‐degree
relatives as compared to controls. The genotype
and allele frequencies of these polymorphisms
in type 1 diabetic patients and firstdegree
relatives differed significantly from
those of controls (p< 0.001 and 0.05 respectively).
CTLA‐49 Ala alleles frequencies were
75.8% in type 1 diabetic patients and 68.1% in
first‐degree relatives in comparison to 35.7% in
control subjects. The Ala/Ala genotype conferred
a relative risk of 18.8 (p < 0.001).Conclusion: The CTLA‐4 49 Ala allele confers
an increased risk of type 1 diabetes, independent
of age and HLA‐DQ genetic markers.
D‐Chiro‐Inositol – Its Functional Role in Insulin Action and its Deficit in Insulin Resistance
Authors: Larner Joseph 
Published: November 2003

In this review we discuss the biological significance
of D‐chiro‐inositol, originally discovered
as a component of a putative mediator of
intracellular insulin action, where as a putative
mediator, it accelerates the dephosphorylation
of glycogen synthase and pyruvate dehydrogenase,
rate limiting enzymes of non‐oxidative
and oxidative glucose disposal.Early studies demonstrated a linear relationship
between its decreased urinary excretion
and the degree of insulin resistance present.
When tissue contents, including muscle, of type
2 diabetic subjects were assayed, they demonstrated
a more general body deficiency.
Administration of D‐chiro‐inositol to diabetic
rats, Rhesus monkeys and now to humans
accelerated glucose disposal and sensitized
insulin action.A defect in vivo in the epimerization of myoinositol to chiro‐inositol in insulin sensitive tissues
of the GK type 2 diabetic rat has been elucidated.
Thus, administered D‐chiro‐inositol
may act to bypass a defective normal epimerization
of myo‐inositol to D‐chiro‐inositol
associated with insulin resistance and act to at
least partially restore insulin sensitivity and glucose
disposal.
Pancreatic β‐Cell Death, Regeneration and Insulin Secretion: Roles of Poly(ADP‐Ribose) Polymerase and Cyclic ADP‐Ribose
Authors: Takasawa Shin , Okamoto Hiroshi 
Published: November 2003

In the early 1980s, we proposed a unifying
model for β‐cell damage (The OKAMOTO
model), in which poly(ADP‐ribose) synthetase/
polymerase (PARP) activation plays an
essential role in the consumption of NAD+,
which leads to energy depletion and necrotic
cell death. In 1984, we demonstrated that the
administration of PARP inhibitors to 90% depancreatized
rats induces islet regeneration.
From the regenerating islet‐derived cDNA
library we isolated Reg (Regenerating Gene)
and demonstrated that Reg protein induces βcell
replication via the Reg receptor and ameliorates
experimental diabetes. More recently,
we showed that the combined addition of IL‐6
and dexamethasone induces the Reg gene expression in β‐cells and that PARP inhibitors
enhance the expression. In 1993, we found that
cyclic ADP‐ribose (cADPR), a product synthesized
from NAD+, is a second messenger for
intracellular Ca2+ mobilization for insulin secretion
by glucose, and proposed a novel mechanism
of insulin secretion, the CD38‐cADPR signal
system.Therefore, PARP inhibitors prevent β‐cell
necrosis, induce β‐cell replication and maintain
insulin secretion.In this paper, we would like to present a perspective
view based on our studies concerning
cell death, cell regeneration, and cell function,
especially on insulin‐producing pancreatic βcells,
in the processes of which poly(ADPribose)
synthetase/polymerase (PARP) and
cyclic ADP‐ribose (cADPR) are functioning.
Engineering of a Water-Soluble Plant Cytochrome P450, CYP73A1, and NMR-Based Orientation of Natural and Alternate Substrates in the Active Site
Authors: Schoch Guillaume A. , Attias Roger , Belghazi Maya , Dansette Patrick M. , Werck-Reichhart Danièle 
Published: November 2003

Abstract
CYP73A1 catalyzes cinnamic acid hydroxylation, a reaction essential for the synthesis of lignin monomers and most phenolic compounds in higher plants. The native CYP73A1, initially isolated from Jerusalem artichoke (Helianthus tuberosus), was engineered to simplify purification from recombinant yeast and improve solublity and stability in the absence of detergent by replacing the hydrophobic N terminus with the peptitergent amphipathic sequence PD1. Optimized expression and purification procedures yielded 4 mg engineered CYP73A1 L–1 yeast culture. This water-soluble enzyme was suitable for 1H-nuclear magnetic resonance (NMR) investigation of substrate positioning in the active site. The metabolism and interaction with the enzyme of cinnamate and four analogs were compared by UV-visible and 1H-NMR analysis. It was shown that trans-3-thienylacrylic acid, trans-2-thienylacrylic acid, and 4-vinylbenzoic acid are good ligands and substrates, whereas trans-4-fluorocinnamate is a competitive inhibitor. Paramagnetic relaxation effects of CYP73A1-Fe(III) on the 1H-NMR spectra of cinnamate and analogs indicate that their average initial orientation in the active site is parallel to the heme. Initial orientation and distances of ring protons to the iron do not explain the selective hydroxylation of cinnamate in the 4-position or the formation of single products from the thienyl compounds. Position adjustments are thus likely to occur during the later steps of the catalytic cycle.