bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rituximab induces remission of cerebral ischemia caused by thrombotic thrombocytopenic purpura
Authors: Tsai Han‐Mou , Shulman Keith 
Published: March 2003

Abstract:Objective: This report describes the experience of a case of atypical thrombotic thrombocytopenic purpura (TTP) whose diagnosis was based on severe deficiency of the von Willebrand factor (vWF) cleaving metalloprotease ADAMTS13.Methods: The level of ADAMTS13 activity, the titer of the inhibitors of this protease and the size distribution of vWF multimers in plasma samples were analysed in a patient with recurrent episodes of dizziness and blurred vision.Results: In the absence of thrombocytopenia or microangiopathic hemolysis, diagnosis of TTP was established by demonstration of very low ADAMTS13 activity levels and the presence of inhibitors of this protease. After rituximab therapy decreased the inhibitor titer and increased the ADAMTS13 level, the patient has had no relapse of ischemic symptoms in the following 16 months.Conclusions: Acute neurological deficits may occur in TTP without concurrent thrombocytopenia or microangiopathic hemolysis. The role of rituximab for patients with TTP deserves further exploration.
Molecular Genetics of Male Infertility: Stem Cell Factor/c‐kit System
Authors: GRIMALDI PAOLA , ROSSI PELLEGRINO , DOLCI SUSANNA , RIPAMONTI CARLA B. , GEREMIA RAFFAELE 
Published: March 2003

PROBLEM: Infertility, affects about 5% of human males and genetic factors are recognized in approximately 30% of them. The mouse represents a good model to study autosomal genes that might play a role in spermatogenesis. In mice, mutations in the c‐kit gene and in the gene encoding stem cell factor (SCF) cause pleiotropic defects among which sterility. A possible involvement of the SCF/c‐kit system in human spermatogenesis was investigated.METHODS OF STUDY: A group of 65 idiopathic azoospermic patients was screened for the presence of mutations in the human c‐kit gene codon encoding tyrosine 721 (Y721), analogous to Y719 in the murine c‐kit gene (a residue known to be essential for a normal spermatogonial proliferation). Furthermore we have used a mouse model for studying the molecular mechanisms that regulate the transcription of the endogenous SCF gene.RESULTS: No mutations have been detected on codon encoding Y721 of the human c‐kit gene, in our group of infertile patients.CONCLUSIONS: A larger group of azoospermic patients, including preferentially patients affected by Sertoli‐cell‐only syndrome, should be screened in order to exclude a role of c‐kit mutations in Y721 in spermatogenesis defects.In this study we also show that the murine SCF promoter is transcriptionally active and stimulated by follicle stimulating hormone (FSH), 3′‐5′ cyclic adenosine monophosphate (cAMP) analogs, and IBMX in primary mouse Sertoli cells, and that the cAMP effect is cell‐specific, as the SCF promoter is not stimulated in other SCF‐expressing cell types tested.
Part II: Influence of Dimerization of a modified GnRH‐I Peptide Sequence on a Male Antifertility Vaccine
Authors: Ferro Valerie A. , Harvey Michael J. A. , Colston Angela , Stimson William H. 
Published: March 2003

Ferro VA, Harvey MJA, Colston A, Stimson WH. Part II: Influence of dimerization of a modified GnRH‐I peptide sequence on a male antifertility vaccine. AJRI 2002; 48: 372–380 © Blackwell Munksgaard, 2002PROBLEM: In the previous paper, we described how the tetanus toxoid (TT) conjugated monomer, CHWSYGLRPG‐NH2, induced high neutralizing antibody titres, which resulted in decreased levels of testosterone and subsequent antifertility. However, its counterpart HWSYGLRPGC, induced low avidity antibody titres. We wanted to know whether peptide dimerization would improve the efficacy of both peptides.METHOD OF STUDY: Male Sprague–Dawley rats were immunized with modified dimerized GnRH‐I peptides (HWSYGLRPGCCGPRLGYSWH and GPRLGYSWHCCHWSYGLRPG‐NH2), with or without conjugation to TT.RESULTS: The unconjugated dimers were not effective in causing castration, although the first peptide dimer did induce production of antibodies. When conjugated to TT, both dimers showed the same level of efficacy in causing castration as each other. However, there were differences in antibody binding to native GnRH.CONCLUSIONS: Dimerization and conjugation to a carrier improved the antifertility efficacy of HWSYGLRPGC, whereas the conjugated monomer CHWSYGLRPG‐NH2 showed a greater level of consistent castration than its conjugated dimer.
Remifentanil‐sevoflurane anaesthesia for laparoscopic cholecystectomy: comparison of three dose regimens
Authors: Van Delden P. G. , Houweling P. L. , Bencini A. F. , Ephraim E. P. , Frietman R. C. , Van Niekerk J. , Van Stolk M. A. , Verheijen R. , Wajer O. J. M. , Mulder P. G. H. 
Published: March 2003

SummaryThe objective of this study was to determine a dosing regimen for remifentanil‐sevoflurane anaesthesia that achieves an optimal balance between quality of anaesthesia and time to recovery. Patients undergoing elective laparoscopic cholecystectomy were randomly allocated to receive 0.4, 0.8 or 1.2 MAC (minimal alveolar concentration) of sevoflurane combined with remifentanil as required to maintain stable anaesthesia. For induction of anaesthesia, the remifentanil dose was 25 μg.kg−1.h−1 and the mean propofol dose which was required to obtain loss of consciousness was 1.59 mg.kg−1. During the maintenance phase, the mean remifentanil dose was 16.0, 14.1 and 13.0 μg.kg−1.h−1 for the 0.4, 0.8 and 1.2 MAC groups, respectively. The mean sevoflurane maintenance dose was 0.91, 1.24 and 2.1% end‐tidal for the 0.4, 0.8 and 1.2 MAC groups, respectively. The incidence of somatic responses was significantly higher in the 0.4 MAC sevoflurane group. Recovery times were significantly faster in the 0.4 compared to the 0.8 and 1.2␣MAC groups and in the 0.8 compared to the 1.2 MAC group. The combination of 14 μg.kg−1. h−1 remifentanil and 1.24% end‐tidal sevoflurane achieved the optimal balance between the quality, and recovery from anaesthesia.
Prospective ranking of the sonographic markers for aneuploidy: Data of 2143 prenatal cytogenetic diagnoses referred for abnormalities on ultrasound
Authors: Daniel Art , Athayde Neil , Ogle Robert , George Alice M. , Michael Jonathan , Pertile Mark d , Bryan Jennifer , Jammu Vapinder , Trudinger Brian J. 
Published: March 2003

AbstractObjective: To design a scheme to rank sonographic anomalies as indicators of aneuploidy and record the distribution of data from 2143 prenatal amniotic fluid/chorionic villous sample diagnoses referred for karyotyping because of fetal anomalies detected with ultrasound.Methods: In all cases the records of sonographic anomalies were obtained prior to karyotyping. A cascade of seven prospective categories of ultrasound anomalies was chosen and the data were included in the highest compatible sonography category. The categories were in descending order: (I) combined central nervous system (CNS)/cranial shape and cardiac anomalies (excluding spina bifida and anencephaly); (II) key anomaly present (exomphalos/intrauterine growth restriction/duodenal atresia/cystic hygroma/fetal hydrops/talipes – with other multiple anomalies); (III) CNS ± other abnormality (excluding choroid plexus cyst, spina bifida, anencephaly); (IVa) increased nuchal translucency – first trimester ± other abnormality; (IVb) increased nuchal thickening – second trimester ± other abnormality; (V) cardiac anomaly ± other abnormality; (VI) other markers of aneuploidy (pyelectasis/two vessel cord/echogenic bowel/short femur); and (VII) other (mostly isolated) malformations.Results: There were 412/2143 (19.2%) chromosome abnormalities detected in this sonographically abnormal group. Overall, the prevalence of aneuploidy significantly ranged from 51 to 3% according to the above I–VII ultrasound categories and from approximately 1–80% for individual ultrasound anomalies. Likelihood ratios were derived for many ultrasound anomalies for several aneuploidy groups: trisomies of 13; 18; and 21; 45,X and 45,X mosaics; triploidy; other autosomal duplications and/or deletions; and other (than 45,X) sex chromosomal aneuploidies.Conclusion: It is suggested this data could be used to assist pre‐procedural counselling of patients after the ultrasound scan in tertiary referral centres for prenatal cytogenetic diagnosis.
Incidence of deep vein thrombosis after colorectal surgery in a Chinese population
Authors: Lee Fung Yee , Chu Winnie , Chan Ricky , Leung Yee Fong , Liu Kin Hung , Ng Siu Man , Lai Paul B. S. , Metreweli Constantine , Lau Wan Yee 
Published: March 2003

Introduction:  Contemporary studies indicate that the incidence of deep vein thrombosis (DVT) is increasing in the Asian population. The present study aims to evaluate the incidence of postoperative DVT in Chinese patients undergoing surgery for colorectal ­malignancies.Methods:  Fifty‐one consecutive patients with carcinoma of the rectum or sigmoid colon scheduled for resection were included in the study. None of the study subjects were given any form of DVT prophylaxis. Serial duplex ultrasound of both lower limbs were examined in the preoperative and postoperative periods.Results:  Three patients were excluded from the study because of the presence of DVT noted preoperatively. A total of 20/48 (41.7%) patients developed asymptomatic calf vein thrombosis. One out of 20 patients required anticoagulation because of thrombus propagation. None of the subjects showed signs or symptoms of DVT or pulmonary embolism. A total of 7/20 thrombi resolved completely at 4 weeks after operation. Only old age and smoking were identified as being associated with a higher incidence of DVT. Disseminated disease, type of operation, duration of operation and postoperative complications did not appear to be risk factors for DVT.Conclusion:  A high incidence of asymptomatic calf vein thrombosis occurred after colorectal surgery for malignancies in Chinese. The majority did not progress even without anticoagulation.
Modified technique for varus derotation osteotomy of the proximal femur in children
Authors: Wilkinson Andrew J. , Nattrass Gary R. , Graham H. Kerr 
Published: March 2003

Background:  The results of a study in which the Richards’ intermediate hip screw and the AO (Association for the Study of­­Internal Fixation (ASIF)) 908 fixed‐angle blade plate were compared for use in proximal femoral osteotomy in children have previously been reported. In that study loss of position at the osteotomy site was reported as a specific complication associated with the use of the Richards’ intermediate hip screw.Methods:  The authors devised a simple modification of surgical technique using the Richards’ intermediate hip screw to enhance the stability of the fixation. In the present article the results of a prospective study of that modified technique are reported and compared with the results of the previous study.Results:  During a 2‐year period 24 proximal femoral osteotomies were performed on 12 children with cerebral palsy, using the modified technique by two surgeons. Only two of the 12 patients (16%) required postoperative immobilization in a hip spica cast. This represents a significant reduction in the level of spica casting when compared with the previous cohort study (61%).Conclusion:  A simple modification of surgical technique improves the stability of fixation in proximal femoral osteotomy in children who have cerebral palsy. This resulted in a decreased need for supplementary hip spica casting and may reduce morbidity.
Genetic polymorphisms in microsomal epoxide hydrolase  and susceptibility to adult acute myeloid leukaemia  with defined cytogenetic abnormalities
Authors: Lebailly Pierre , Willett Eleanor V. , Moorman Anthony V. , Roman Eve , Cartwright Ray , Morgan Gareth J. , Wild Christopher P. 
Published: March 2003

Summary.  Acute myeloid leukaemia (AML) cases with different chromosomal abnormalities may reflect different aetiologies. Benzene exposure, from a number of sources including smoking, is one risk factor for AML. Individual susceptibility to benzene may depend on differences in expression of metabolizing enzymes. We tested the hypothesis that smoking as well as genetic polymorphisms in the microsomal epoxide hydrolase gene (HYL1), an enzyme involved in benzene metabolism, could be risk factors for AML with defined chromosomal abnormalities. Twenty‐six AML cases with −7/del(7q) and 24 cases with t(8;21), as well as 43 cases with normal karyotype and 155 age‐, sex‐ and residence‐matched controls, were drawn from a large case–control study on adult acute leukaemia. Current smoking was significantly associated with the cytogenetic abnormalities t(8;21) or −7/del(7q) (OR = 4·9; 95%CI = 2·1–11·5) but not with a normal karyotype, relative to individuals who were not current smokers. A putative high activity HYL1 phenotype [exon 3, residue 113 (Tyr/Tyr) and exon 4, residue 139 (His/Arg or Arg/Arg)] was associated with a significantly increased AML risk in men with −7/del(7q) or t(8;21) (OR = 4·4; 95%CI	1·1–17·0) but not with a normal karyotype. This suggests that AML cases with defined chromosomal abnormalities could be related to specific carcinogen exposures and, furthermore, suggests that smoking and genetic polymorphisms in HYL1 could be risk factors for AML with −7/del(7q) or t(8;21).
Detection of micrometastases in lymph nodes from patients with breast cancer
Authors: Branagan G , Hughes D , Jeffrey M , Crane-Robinson C , Perry P M 
Published: March 2003

Abstract

Background
Sentinel node biopsy affords the opportunity of focused examination of lymph nodes, including the use of the reverse transcriptase–polymerase chain reaction (RT-PCR). The mammaglobin gene is expressed by breast cancers but has not been detected in histologically normal lymph nodes. This study compared mammaglobin RT-PCR with routine histology in the sentinel and non-sentinel nodes of patients with breast cancer.

Methods
Patients with breast cancer underwent tumour excision, sentinel node biopsy and axillary dissection. All nodes were bisected and half of each node was sent for routine histological examination. The other half underwent RNA extraction and mammaglobin RT-PCR.

Results
Sentinel node biopsy was successful in 50 (96 per cent) of 52 patients. Mammaglobin expression was detected in nine (8 per cent) of 119 histologically negative sentinel nodes (Clopper–Pearson 95 per cent confidence interval (c.i.) 4 to 14 per cent) and in 13 (5 per cent) of 247 histologically negative non-sentinel nodes (95 per cent c.i. 3 to 9 per cent). Mammaglobin expression was detected in four (13 per cent) of 31 patients with histologically negative sentinel nodes (95 per cent c.i. 4 to 30 per cent) and in six (14 per cent) of 44 patients with histologically negative non-sentinel nodes (95 per cent c.i. 5 to 27 per cent). The false-negative rate for sentinel node biopsy was zero using histology results and 10 per cent using RT-PCR.

Conclusion
RT-PCR screening of axillary nodes for mammaglobin expression increased the detection of breast cancer metastases compared with routine histology.
Risk-adjusted surgical audit with the POSSUM scoring system in a developing country
Authors: Yii M K , Ng K J 
Published: March 2003

AbstractBackgroundThe Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is an objective and appropriate scoring system for risk-adjusted comparative general surgical audit. This score was devised in the UK and has been used widely, but application of POSSUM to centres outside the UK has been limited, especially in developing countries. This prospective study validated its application in a surgical practice with a different population and level of resources.MethodsAll general surgical patients who were operated on under regional or general anaesthesia as inpatients over a 4-month period at Sarawak General Hospital in 1999 were entered into the study. All data (12 physiological and six operative factors) were analysed for mortality only with the POSSUM equation and the modified Portsmouth POSSUM (P-POSSUM) equation. Comparisons were made between predicted and observed mortality rates according to four groups of risk: 0–4, 5–14, 15–49 and 50 per cent or more using the ‘linear’ method of analysis.ResultsThere were 605 patients who satisfied the criteria for the study. Some 56·7 per cent of patients were in the lowest risk group. The POSSUM predictor equation significantly overestimated the mortality in this group, by a factor of 9·3. The overall observed mortality rate was 6·1 per cent and, again, the POSSUM predictor equation overestimated it at 10·5 per cent (P &lt; 0·01). In contrast, the observed and predicted mortality rates for all risk groups, including the predicted overall mortality rate of 4·8 per cent, were comparable when the P-POSSUM predictor equation was used.ConclusionThe POSSUM scoring system with the modified P-POSSUM predictor equation for mortality was applicable in Malaysia, a developing country, for risk-adjusted surgical audit. This scoring system may serve as a useful comparative audit tool for surgical practice in many geographical locations.
Late results of selective axillary surgery based on contact cytology in women with operable breast cancer
Authors: Burke M , Burke K I , Boyle S , Shah K , Price A B , Zammit C 
Published: March 2003

Abstract

Background
Interest in the possibility of intraoperative analysis of sentinel lymph nodes to select patients with operable breast cancer for immediate axillary clearance encouraged this review of a long-term experience of selective axillary surgery based on intraoperative contact cytology of conventionally sampled nodes. Survival was assessed as a potential marker for understaging.

Methods
Records of 437 patients who had surgery between 1991 and 1994 were reviewed to compare rates of axillary recurrence in patients who had contact cytology only with those who had contact cytology and axillary clearance.

Results
Axillary recurrence occurred in seven (3 per cent) of 219 patients who had negative contact cytology, three (4 per cent) of 75 patients who had positive contact cytology with axillary clearance and one (1 per cent) of 93 who had axillary clearance alone. In patients with positive contact cytology, 131 (78 per cent) of 168 positive nodes were in the sample specimen, which included all positive nodes on 19 occasions. Survival probability at 36, 72 and 96 months was 92, 87 and 84 per cent respectively for patients with negative contact cytology, and 85, 73 and 71 per cent for patients with positive cytology and axillary clearance.

Conclusion
A selective approach to axillary surgery based on intraoperative contact cytology of sampled lymph nodes gave good long-term control of axillary disease.
Activation and stabilization of α‐chymotrypsin by cationic additives
Authors: Spreti Nicoletta , Di Profio Pietro , Marte Luisa , Bufali Simone , Brinchi Lucia , Savelli Gianfranco 
Published: March 2003

α‐Chymotrypsin activity was tested with N‐glutaryl‐l‐phenylalanine p‐nitroanilide (GPNA) in aqueous media in the presence of synthetic surfactants, which differ in the flexibility of their bulky head groups. Superactivity can be ascribed to the presence of the tributylammonium residue on the surfactant head group, as in p‐octyloxybenzyltributylammonium bromide (pOOTBABr), while in the presence of a more rigid moiety, i.e. a cyclic one, no activation was found. A nonmicellizable quaternary ammonium salt, the tetrabutylammonium bromide (TBABr), which has a head group structure very similar to pOOTBABr, not only induces a remarkable superactivation, at a concentration 80‐fold higher than pOOTBABr, but also allows the enzyme to retain a high residual activity for long periods of time. The presence of a lipophilic chain, which by interacting with apolar residues on the enzyme surface, probably penetrates into hydrophobic pockets of the protein and causes a rapid inactivation.In 0.4 m TBABr, a 20‐fold increase both in kcat and Km values, with respect to buffer alone, was found. The increase of Km could be attributed either to a true decrease in affinity between enzyme and substrate or alternatively to the presence of TBA+ ions near the catalytic region. They could interact with protein residues around the active site and bind to negatively charged GPNA molecules, lowering the local substrate concentration.Spectroscopic experiments (CD and fluorescence) show minor changes of protein conformation in 0.4 m TBABr, while at 1 m a strong modification of both spectra was observed.
Structures of two O‐chain polysaccharides of Citrobacter gillenii O9a,9b lipopolysaccharide
Authors: Lipiński Tomasz , Zatonsky George V. , Kocharova Nina A. , Jaquinod Michel , Forest Eric , Shashkov Alexander S. , Gamian Andrzej , Knirel Yuriy A. 
Published: March 2003

Mild acid degradation of the lipopolysaccharide of Citro‐ bacter gillenii O9a,9b released a polysaccharide (PS), which was found to consist of a single monosaccharide, 4‐acetamido‐4,6‐dideoxy‐d‐mannose (d‐Rha4NAc, N‐acetyl‐d‐perosamine). PS was studied by methylation analysis␣and 1H‐NMR and 13C‐NMR spectroscopy, using two‐dimensional 1H,1H COSY, TOCSY, NOESY, and H‐detected 1H,13C heteronuclear correlation experiments. It was␣found that PS includes two structurally different polysaccharides: an α1→2‐linked homopolymer of N‐acetyl‐d‐perosamine [→2)‐α‐d‐Rhap4NAc‐(1→, PS2] and a␣polysaccharide composed of tetrasaccharide repeating units (PS1) with the␣following structure:→3)‐α‐d‐Rhap4NAc‐(1→2)‐α‐d‐Rhap4NAc‐(1→2)‐α‐d‐Rhap4NAc‐(1→3)‐α‐d‐Rhap4N Ac2Ac‐(1→where the degree of O‐acetylation of a 3‐substituted Rha4NAc residue at position 2 is ≈ 70%.  PS could be fractionated into PS1 and PS2 by gel‐permeation chromatography on TSK HW‐50S. Matrix‐assisted laser desorption ionization MS data indicate sequential chain elongation of both PS1 and PS2 by a single sugar unit, with O‐acetylation in PS1 beginning at a certain chain length. Anti‐(C. gillenii O9a,9b) serum reacted with PS1 in double immunodiffusion and immunoblotting, whereas neither PS2 nor the lipopolysaccharide of Vibrio cholerae O1 with a structurally related O‐chain polysaccharide were reactive.
Kinetic study of sn‐glycerol‐1‐phosphate dehydrogenase from the aerobic hyperthermophilic archaeon, Aeropyrum pernix K1
Authors: Han Jin‐Suk , Kosugi Yoshitsugu , Ishida Hiroyasu , Ishikawa Kazuhiko 
Published: March 2003

A gene having high sequence homology (45–49%) with the glycerol‐1‐phosphate dehydrogenase gene from Methanobacterium thermoautotrophicum was cloned from the aerobic hyperthermophilic archaeon Aeropyrum pernix K1 (JCM 9820). This gene expressed in Escherichia coli with the pET vector system consists of 1113 nucleotides with an ATG initiation codon and a TAG termination codon. The molecular mass of the purified enzyme was estimated to be 38 kDa by SDS/PAGE and 72.4 kDa by gel column chromatography, indicating presence as a dimer. The optimum reaction temperature of this enzyme was observed to be 94–96 °C at near neutral pH. This enzyme was subjected to two‐substrate kinetic analysis. The enzyme showed substrate specificity for NAD(P)H‐	dependent dihydroxyacetone phosphate reduction and NAD+‐dependent␣glycerol‐1‐phosphate (Gro1P) oxidation. NADP+‐dependent Gro1P oxidation was not observed with this enzyme. For the production of Gro1P in A. pernix cells, NADPH is the preferred coenzyme rather than NADH. Gro1P acted as a noncompetitive inhibitor against dihydroxyacetone phosphate and NAD(P)H. However, NAD(P)+ acted as a competitive inhibitor against NAD(P)H and as a noncompetitive inhibitor against dihydroxyacetone phosphate. This kinetic data indicates that the catalytic reaction by glycerol‐	1‐phosphate dehydrogenase from A. pernix follows a ordered bi–bi mechanism.