bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Neck Length on the Safety of Percutaneous and Surgical Tracheotomy: a Prospective, Randomized Study
Authors: Tabaee Abtin , Geng Elvin , Lin Jerry , Kakoullis Stylianos , McDonald Brian , Rodriguez Hector , Chong David 
Published: September 2005

AbstractObjective: To investigate a correlation between neck length and the incidence of complications after both percutaneous and surgical tracheotomy (ST) and to compare the relative safety of the two procedures at our institution.Study Design: Prospective, randomized study of patients undergoing tracheotomy at a tertiary care center.Methods: Forty‐three patients evaluated for tracheotomy at our institution between the years 2003 and 2004 were enrolled in the study and were randomly assigned to receive either an ST or a percutaneous dilatational tracheotomy (PDT). All patients underwent standardized measurement of the cricosternal distance (CSD) in the neutral and extended positions before the procedure. Demographic and procedural variables were recorded, and the occurrence of postoperative complications was followed for 1 week.Results: PDT was performed in 29 patients and ST in 14 patients. The mean CSD of 2.7 cm increased to 3.7 cm after extension with a shoulder roll. PDT required less time (mean 8 vs. 23 minutes) and resulted in less blood loss compared with ST. A trend toward a higher incidence of complications with PDT (40%) compared with ST (7%) and in the first half of our series (learning curve) was noted. This, however, did not reach statistical significance. There was no correlation between the incidence of complications and neck length as determined by the CSD in either group of patients.Conclusions: We failed to demonstrate a correlation between CSD and tracheotomy related complications. Patients with short necks may be at no higher risk during either a PDT or ST. Experience, awareness of complications, and a dedicated team approach are necessary for the safe performance of PDT.
Effect of Growth Factors on Cell Proliferation, Matrix Deposition, and Morphology of Human Nasal Septal Chondrocytes Cultured in Monolayer
Authors: Richmon Jeremy D. , Sage August B. , Shelton Elliot , Schumacher Barbara L. , Sah Robert L. , Watson Deborah 
Published: September 2005

AbstractObjectives: Tissue engineering of septal cartilage provides ex vivo growth of cartilage from a patient's own septal chondrocytes for use in craniofacial reconstruction. To become clinically applicable, it is necessary to rapidly expand a limited population of donor chondrocytes and then stimulate the production of extracellular matrix on a biocompatible scaffold. The objective of this study was to determine favorable serum‐free culture conditions for proliferation of human septal chondrocytes using various concentrations and combinations of four growth factors.Study Design: Prospective, randomized, controlled study.Methods: Nasal septal chondrocytes from six patient donors were isolated by enzymatic digestion and expanded in monolayer culture in both serum‐free media (SFM) and 2% fetal bovine serum (FBS). Both of these groups were exposed to varying concentrations and combinations of transforming growth factor (TGF)‐β1, basic fibroblast growth factor (FGF)‐2 both at 1, 5, and 25 ng/mL, and bone morphogenetic protein (BMP)‐2 and insulin‐like growth factor (IGF)‐1, both at 5, 25, and 125 ng/mL in the medium during the expansion phase. Cell morphology was assessed throughout the culture duration. After 7 days of monolayer growth, cultures were assessed for cellularity and glycosaminoglycan (GAG) content.Results: The addition of low‐dose FBS in culture media consistently led to significantly greater cell proliferation and matrix deposition than the SFM cell cultures. FGF‐2 and TGF‐β1 both alone and in combination led to the greatest proliferative effect compared with the other growth factors. In contrast, BMP‐2 and IGF‐1 led to the least cell proliferation although was most effective in retaining chondrocyte cell morphology.Conclusions: With the addition of TGF‐β1 and FGF‐2 to culture media, the concentration of serum can be greatly decreased and possibly eliminated altogether without jeopardizing cell proliferation.
Prevention of Esophageal Strictures in a Caustic Burn Model Using Halofuginone, an Inhibitor of Collagen Type I Synthesis
Authors: Arbell Dan , Udassin Raphael , Koplewitz Benjamin Z. , Ohana Meir , Genina Olga , Pines Mark , Nagler Arnon 
Published: September 2005

AbstractObjective: Esophageal strictures caused by caustic injury continue to be a plaguing problem. Halofuginone (HF) has been proven to inhibit the formation of fibrosis in various animal models and human diseases. Its mechanism appears to be through the suppression of the production of collagen α1(I) and transforming growth factor‐β signaling pathway. We tried to assess whether HF would have an effect on the formation of strictures after inducing caustic esophageal.Materials and Methods: Esophageal injury was caused by injecting 25% NaOH to an isolated esophageal segment. Study group rats were treated with HF orally for 3 consecutive days before the injury and afterward. Control group rats received regular chow. The results were evaluated by upper gastrointestinal series (UGI) and through pathologic studies.Results: HF treatment resulted in marked improvement in the esophageal strictures. The UGI series showed esophageal patency of 73% (45%–100%) in the treated animals (n = 7) as compared with almost no patency, 11% (5–16%), in the controls (n = 4) (P = .018). The histologic examination showed significantly less stricture and scarring in the treated group. Whereas the ratio between the esophageal wall thickness to mucosal thickness was 2.34 ± 0.23 in the study group, the control group had a ratio of 9.56 ± 0.69 (P = .0044). Finally, whereas 86% of the study group survived, all the rats in the control group died by day 20.Conclusions: HF modulated the wound healing reaction caused by caustic injury of the esophagus in a rat model, resulting in increased esophageal patency, reduction in esophageal wall thickness, and increased survival.
Proton pump inhibitors reduce the bioavailability of dietary vitamin C
Authors: HENRY E. B. , CARSWELL A. , WIRZ A. , FYFFE V. , MCCOLL K. E. L. 
Published: September 2005

SummaryBackground : The gastric juice concentration of vitamin C is reduced in subjects with elevated intragastric pH. This is probably because of the fact that the vitamin is unstable at non‐acidic pH and undergoes irreversible denaturation.Aim : To determine whether elevation of intragastric pH reduces the bioavailability of dietary vitamin C.Methods : Plasma vitamin C was measured before and after a course of omeprazole 40 mg/day for 4 weeks in 14 Helicobacter pylori positive and 15 H. pylori negative subjects. Dietary intake of vitamin C was measured and intragastric pH monitored.Results : Compared with the H. pylori negative subjects, H. pylori positive subjects had a lower mean daily vitamin C intake (141.7 mg vs. 41.5 mg, P < 0.01) and also lower plasma vitamin C concentration (25.1 μg/mL vs. 17.4 μg/mL, P < 0.0001). After 28 days of 40 mg/day of omeprazole the mean plasma vitamin C level had fallen by 12.3% (P = 0.04). This fall affected both the H. pylori positive and negative subjects.Conclusions : We have shown that a short course of omeprazole will cause a reduction in the plasma vitamin C level of healthy volunteers. This decrease in plasma vitamin C is independent of dietary intake of the vitamin and indicates reduced bioavailability. The clinical significance of this is unclear but any adverse effects will be most apparent in H. pylori infected subjects who have a low pre‐treatment vitamin C status.
Helicobacter pylori‐associated ulcer bleeding: should we test for eradication after treatment?
Authors: POHL H. , FINLAYSON S. R. G. , SONNENBERG A. , ROBERTSON D. J. 
Published: September 2005

SummaryBackground : Eradication of Helicobacter pylori after peptic ulcer haemorrhage reduces the risk of recurrence. Because H. pylori treatment is very effective, it is unclear whether testing to confirm eradication is worthwhile.Aims : To examine whether patients with H. pylori‐associated peptic ulcer haemorrhage should be tested for successful eradication after completion of antibiotic therapy.Methods : A Markov cost‐effectiveness model was developed to compare testing vs. non‐testing of H. pylori eradication in peptic ulcer haemorrhage. Probability estimates and average costs were derived from published information.Results : Testing for H. pylori eradication resulted in a benefit of 0.07 quality‐adjusted life‐years and cost $836 less than the strategy of not confirming eradication. Testing remained the superior strategy when varying the model regarding age, the initial success of eradication, various test and retreatment strategies, and the rate and costs of recurrent bleeding. Assuming a high eradication rate (95%), the test strategy becomes more expensive only if the cost of H. pylori testing reaches $265; however, even under these conditions it remains cost‐effective.Conclusions : Patients with H. pylori‐associated peptic ulcer bleeding should be tested to confirm eradiation of H. pylori after completion of antibiotic treatment.
Antibiotic prophylaxis for percutaneous endoscopic gastrostomy for non‐malignant conditions: a double‐blind prospective randomized controlled trial
Authors: SAADEDDIN A. , FRESHWATER D. A. , FISHER N. C. , JONES B. J. M. 
Published: September 2005

SummaryBackground : The use of antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy insertion has been encouraged following development of guidelines by a number of professional societies within the past few years. However, not all evidence supports routine prophylaxis, particularly in patients with ‘benign’ disease indications for percutaneous endoscopic gastrostomy insertion.Aim : To identify whether prophylactic antibiotic usage is beneficial in patients undergoing percutaneous endoscopic gastrostomy insertion without malignant disease.Methods : Adult patients without malignant disease who were referred for percutaneous endoscopic gastrostomy insertion at our unit were assessed for participation in this prospective, double‐blind, randomized controlled study. Patients were randomized to receive either placebo or 2.2 g co‐amoxiclav (or 2 g cefotaxime if penicillin‐allergic) at time of percutaneous endoscopic gastrostomy insertion. Clinical endpoints studies were percutaneous endoscopic gastrostomy site or systemic infection and death within 7 days of percutaneous endoscopic gastrostomy insertion.Results : Ninety‐nine patients completed the study (51 antibiotics, 48 placebo). Outcomes in the antibiotic and placebo groups respectively were: percutaneous endoscopic gastrostomy site infection, 11% vs. 47% (P < 0.01); systemic infection, 16% vs. 38% (P < 0.05); and death, 8% vs. 15% (P = 0.5).Conclusions : Antibiotic prophylaxis prior to percutaneous endoscopic gastrostomy insertion reduces both percutaneous endoscopic gastrostomy site and systemic infections in patients without malignant disease.
Review article: bifidobacteria as probiotic agents – physiological effects and clinical benefits
Authors: PICARD C. , FIORAMONTI J. , FRANCOIS A. , ROBINSON T. , NEANT F. , MATUCHANSKY C. 
Published: September 2005

SummaryBifidobacteria, naturally present in the dominant colonic microbiota, represent up to 25% of the cultivable faecal bacteria in adults and 80% in infants. As probiotic agents, bifidobacteria have been studied for their efficacy in the prevention and treatment of a broad spectrum of animal and/or human gastrointestinal disorders, such as colonic transit disorders, intestinal infections, and colonic adenomas and cancer. The aim of this review is to focus on the gastrointestinal effects of bifidobacteria as probiotic agents in animal models and man. The traditional use of bifidobacteria in fermented dairy products and the GRAS (‘Generally Recognised As Safe’) status of certain strains attest to their safety. Some strains, especially Bifidobacterium animalis strain DN‐173 010 which has long been used in fermented dairy products, show high gastrointestinal survival capacity and exhibit probiotic properties in the colon. Bifidobacteria are able to prevent or alleviate infectious diarrhoea through their effects on the immune system and resistance to colonization by pathogens. There is some experimental evidence that certain bifidobacteria may actually protect the host from carcinogenic activity of intestinal flora. Bifidobacteria may exert protective intestinal actions through various mechanisms, and represent promising advances in the fields of prophylaxis and therapy.
Thirteen novel mutations in the factor VIII gene in the Nijmegen haemophilia A patient population
Authors: Boekhorst Jorien , Verbruggen Bert , Lavergne Jean Maurice , Costa Jean‐Marc , Schoormans Selene C. M. , Brons Paul P. T. , van Kraaij Marian G. J. , Nováková Irena R. O. , van Heerde Waander L. 
Published: September 2005

SummaryThe development of neutralising antibodies to factor VIII (FVIII) is a major complication of haemophilia A (HA) therapy. We aimed to construct an individual risk profile for the development of inhibitors in HA and started by screening for the causative mutation in our HA patient population. A total of 109 patients and 28 carriers were screened. The analysis revealed 38 different mutations in the FVIII gene, of which 13 have not been described on the Haemophilia A Mutation, Search, Test and Resource Site (HAMSTeRS). Twenty‐five mutations have been reported previously and all except two had a similar phenotype to what has been described. Three novel mutations were associated with severe HA: one non‐missense mutation, a small insertion in the A2 domain, and two missense mutations, a H256R mutation in the A1 domain and a L2025P substitution in the C1 domain. One novel mutation, Y156C, was associated with moderate HA. Nine novel mutations caused mild HA. The P130R, D167E and V278M mutations are located in the A1 domain. R439C, Y511H, A544G and Q645H in the A2 domain, L1758F in the A3 domain and a S2157R mutation in the C1 domain. In conclusion, the genotypic profile of our HA population was not different from others described and is suitable to study inhibitor formation.
Stomatin is mis‐trafficked in the erythrocytes of overhydrated hereditary stomatocytosis, and is absent from normal primitive yolk sac‐derived erythrocytes
Authors: Fricke Britta , Parsons Stephen F. , Knöpfle Gisela , von Düring Monika , Stewart Gordon W. 
Published: September 2005

SummaryThe 32 kD lipid‐raft‐associated membrane protein ‘stomatin’ is deficient from the erythrocyte membrane in the Na+–K+ leaky haemolytic anaemia, overhydrated hereditary stomatocytosis (OHSt). To date, no mutation in the gene coding for this protein has so far been found in OHSt. In this study, we have analysed the distribution of stomatin in both cultured erythroid cells from OHSt patients and in normal embryological and fetal erythroid development. In erythroid cell cultures from OHSt patients, stomatin‐immunoreactivity (stomatin‐IR) was present in progenitor cells but remained restricted to the area of the multivesicular complexes and the nucleus in the developing cells and was not seen in the plasma membrane. This could be consistent with the idea that stomatin is an innocent passenger in a more fundamental trafficking abnormality. In normal embryonic development, we found that, in extraembryonic (yolk sac) erythropoiesis, neither the nucleated red cells nor their enucleated mature derivatives displayed any stomatin‐IR. In contrast, all haemangiopoietic progenitor cells of intraembryonic haematopoiesis, starting with the mesodermal precursors in the aorta–gonad–mesonephros region, exhibited strong stomatin‐IR. The significance of this observation on these poorly understood cells is currently unclear.
The paradox of matrix metalloproteinases in infectious disease
Authors: Elkington P T G , O'Kane C M , Friedland J S 
Published: September 2005

SummaryMatrix metalloproteinases (MMPs) are a family of proteolytic enzymes that perform multiple roles in the normal immune response to infection. MMPs facilitate leucocyte recruitment, cytokine and chemokine processing, defensin activation and matrix remodelling. However, excess MMP activity following infection may lead to immunopathology that causes host morbidity or mortality and favours pathogen dissemination or persistence. Here, we review the normal functions of MMPs in immunity and then discuss viral and bacterial infections where excess MMP activity has been implicated in pathology, specifically examining HIV, HTLV-1, hepatitis B, endotoxin shock, Helicobacter pylori and Mycobacterium tuberculosis. Tissue destruction may be exacerbated further by bacterial-derived enzymes which activate the host pro-MMPs. Finally, the potential for therapeutic targeting of excess MMP activity in infection is considered.
Diagnosis ofMycobacterium tuberculosisinfection using ESAT-6 and intracellular cytokine cytometry
Authors: Hughes A J , Hutchinson P , Gooding T , Freezer N J , Holdsworth S R , Johnson P D R 
Published: September 2005

SummaryDiagnosis of infection with Mycobacterium tuberculosis (MTB) using tuberculin skin testing (TST) is often hampered by prior Bacille Calmette–Guérin (BCG) vaccination. ESAT-6 is a protein that is expressed by MTB but absent in BCG. It has been postulated that it might be useful in distinguishing MTB-specific immune responses. This study measured CD4 T cell responder frequencies specific for ESAT-6 and the TST reagent purified protein derivative (PPD) in patients with tuberculosis (n = 16), controls with non-tuberculous pneumonia (n = 8) and normal subjects (n = 7). Responses were identified using the intracellular cytokine staining technique and flow cytometry on whole blood samples, and performed blinded to the patient condition. Antigen-specific CD4 cells were defined by CD69 positivity and one or more cytokine [interleukin (IL)-2, IL-4, IL-10, interferon (IFN)-γ] and/or CD40L positivity. With ESAT-6 stimulation it was found that TB patients had significantly higher frequencies of IFN-γ and CD40L-positive CD4 T cells compared to the normal group, while no significant differences were measured with PPD stimulation. A responder frequency of 0·01% or higher for at least one of the measured cytokines/CD40L was defined as a positive response. Using this criterion to compare the two patient groups, PPD had 100% sensitivity but 0% specificity while ESAT-6 had 100% sensitivity and 88% specificity. Use of MTB-specific proteins such as ESAT-6 in combination with intracellular cytokine staining and flow cytometry has the potential to identify individuals with MTB infection.
T helper cell-mediated interferon-gamma expression after human parvovirus B19 infection: persisting VP2-specific and transient VP1u-specific activity
Authors: Franssila R , Auramo J , Modrow S , Möbs M , Oker-Blom C , Käpylä P , Söderlund-Venermo M , Hedman K 
Published: September 2005

SummaryHuman parvovirus B19 is a small non-enveloped DNA virus with an icosahedral capsid consisting of proteins of only two species, the major protein VP2 and the minor protein VP1. VP2 is contained within VP1, which has an additional unique portion (VP1u) of 227 amino acids. We determined the ability of eukaryotically expressed parvovirus B19 virus-like particles consisting of VP1 and VP2 in the ratio recommended for vaccine use, or of VP2 alone, to stimulate, in an HLA class II restricted manner, peripheral blood mononuclear cells (PBMC) to proliferate and to secrete interferon gamma (IFN-γ) and interleukin (IL)-10 cytokines among recently and remotely B19 infected subjects. PBMC reactivity with VP1u was determined specifically with a prokaryotically expressed VP1u antigen. In general, B19-specific IFN-γ responses were stronger than IL-10 responses in both recent and remote infection; however, IL-10 responses were readily detectable among both groups, with the exception of patients with relapsed or persisting symptoms who showed strikingly low IL-10 responses. Whereas VP1u-specific IFN-γ responses were very strong among the recently infected subjects, the VP1u-specific IFN-γ and IL-10 responses were virtually absent among the remotely infected subjects. The disappearance of VP1u-specific IFN-γ expression is surprising, as B-cell immunity against VP1u is well maintained.
Does soluble triggering receptor expressed on myeloid cells-1 play any role in the pathogenesis of septic shock?
Authors: Routsi C , Giamarellos-Bourboulis E J , Antonopoulou A , Kollias S , Siasiakou S , Koronaios A , Zakynthinos S , Armaganidis A , Giamarellou H , Roussos C 
Published: September 2005

Summary
In order to define the significance of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) upon progression from sepsis or severe sepsis to septic shock a prospective study was designed with 90 enrolled patients with septic syndrome due to ventilator-associated pneumonia. Blood was sampled on seven consecutive days upon initiation of symptoms and concentrations of tumour necrosis factor-alpha (TNFα), interleukin-6 (IL-6), IL-8 and sTREM-1 were estimated in serum by an enzymeimmunoassay. No differences in concentrations of TNFα, IL-6 and IL-8 were found between patients with sepsis, severe sepsis and septic shock on the first day of presentation of symptoms. Patients presenting with septic shock had concentrations of sTREM-1 significantly higher than both patients with sepsis and severe sepsis on the first day; no difference was found between patients with sepsis and severe sepsis. A positive correlation was detected between sTREM-1 and the white blood cell count. Serum levels of sTREM-1 were significantly lower in patients where VAP resolved compared to those where VAP did not resolve; similar findings were noted between patients who eventually survived and those who died. IL-6 followed the kinetics of sTREM-1 in correlation to patients's prognosis; levels of TNFα and IL-8 were unrelated to prognosis. It is concluded that sTREM-1 is particularly increased upon evolution from sepsis or severe sepsis to septic shock. Its sustained increase is an indication of poor outcome. The underlined pathophysiological role of sTREM-1 for the transition from sepsis or severe sepsis to septic shock might constitute a novel target for immunomodulatory therapy.