bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Intraoperative Monitoring-Assisted Microneurosurgical Treatment for Anterior Circulation Cerebral Aneurysm
Authors: Lin J , Zhao J , Zhao Y , Zhang D , Wang R , Qiao H , Wang S
Published: February 2013

This study investigated the efficacy of multiple intraoperative monitoring techniques including indocyanine green angiography (ICGA), somatosensory evoked potential (SSEP) and motor evoked potential (MEP) in the clinical outcome of microneurosurgical treatment for anterior circulation cerebral aneurysm. Fifty-two anterior circulation cerebral aneurysms (Hunt and Hess [H&H] grades 0, 1 or 2) from 45 Chinese in-patients were completely clipped. In one patient, ICGA directed neurosurgeons to readjust aneurysmal clips in order to eliminate a residual aneurysm and restore patency of a branching artery. SSEP/MEP directed neurosurgeons to implement intervention measures in 12 patients for recovery of SSEP/MEP changes, and SSEP/MEP changes partially/totally recovered in 11 of these 12 patients (91.6%). Postoperative motor deficits were observed in three patients, two of which were Glasgow Outcome Scale level 3 (4.4%). In conclusion, for patients with anterior circulation cerebral aneurysm (H&H grade < 3), multiple intraoperative monitoring was beneficial for finding residual aneurysms, detecting ischaemic events in the perforating arteries and reducing severe postoperative motor deficiency.
Value of Diffusion-Weighted Imaging in Grading Tumours Localized in the Fourth Ventricle Region by Visual and Quantitative Assessments
Authors: Ji YM , Geng DY , Huang BC , Li YX , Ren G , Zhu L
Published: February 2013

This study investigated visual and quantitative assessment of diffusion-weighted imaging (DWI) for grading tumours localized in the fourth ventricle region. Patients were diagnosed histopathologically and classified into two groups: those with high-grade (World Health Organization [WHO] grades III and IV) and those with low-grade tumours (benign, WHO grades I and II). DWI signal intensity was described using a five-point scale. Minimum apparent diffusion coefficient (ADC) values were obtained from areas with the lowest signal. The mean signal intensity was significantly higher in high-grade than in low-grade tumours. The mean minimum ADC value was significantly lower in high-grade than low-grade tumours. Marked hyperintensity had sensitivity, specificity, positive predictive value and negative predictive value of 89.7%, 100%, 100% and 94.2%, respectively, when used as a diagnostic tool for high-grade tumours compared with 96.6%, 97.9%, 96.6% and 97.9%, respectively, when using a minimum ADC of 0.9 × 10−3 mm2/s as a diagnostic marker. It was concluded that DWI is helpful in predicting the grades of tumours in the fourth ventricle region.
Contrast-Enhanced Ultrasound for the Diagnosis of Hepatic Adenoma
Authors: Zhu XL , Chen P , Guo H , Zhang N , Hou WJ , Li XY , Xu Y
Published: February 2013

Nine hepatic adenomas (HA) diagnosed by contrast-enhanced ultrasound (CEUS) among 123 liver lesions (89 patients) were evaluated retrospectively; five were confirmed through pathological diagnosis. Time—intensity curves (TIC), contrast medium arriving time (AT), peak time (PT) and retrogression time (RT) for HA were compared with 30 hepatocellular carcinomas (HCC) and six focal nodular hyperplasias (FNH). Significant differences existed between HA and poorly-differentiated HCC in AT, PT and RT, and between HA and well-differentiated HCC in AT. Differential diagnosis between HA and FNH was determined only through their different perfusion and arterial morphological features: HA showed typical perfusion characteristic of ‘fast-in, slow-out’, with a centripetal or mixed-filling pattern in the arterial phase, while FNH showed a centrifugal filling pattern. In conclusion, CEUS was helpful for identifying HA but it may be relatively difficult to distinguish between HA and some well-differentiated HCC or FNH.
Anatomical Variations of the Posterior Intercostal Arteries and the Thoracic Vertebral Artery
Authors: Kocbek L , Krajnc I , Anderhuber F
Published: February 2013

This study evaluated the occurrence and frequency of the anatomical variations of the origin and course of the posterior intercostal arteries (PIA) in 44 human cadavers. During a classical anatomical dissection of each cadaver an anomalous course of the PIA, defined as a thoracic vertebral artery, was found in six (14%) individuals. Every dorsally coursing PIA was taken into account, regardless of its origin, and their different origins and course were described. A specific dorsal course for the PIA was found in nine cases, which was bilateral in two cases. The variations that were found and that have been schematically presented will provide new information about the anatomical variations of the PIA. Consideration of the potential for anatomical variation of the PIA is important in vascular and thoracic surgery and in diagnostic and interventional radiology such as spinal angiography.
Dynamic Changes of Echogenicity and the Size of the Papilla of Vater before and after Cholecystectomy
Authors: Skalicky M
Published: February 2013

This study investigated the changes in echogenicity, as measured by endoscopic ultrasound, and the surface area of the papilla of Vater (PV) and their relationship with postoperative symptoms in a group of 80 patients with symptomatic gallstones before and at 3 and 6 months after cholecystectomy. After cholecystectomy, 50 patients experienced early atypical symptoms characteristic of postcholecystectomy syndrome (PCS) and 30 patients were asymptomatic. The surface area of the PV was larger than normal prior to surgery and increased after surgery. The healthy PV is isoechogenic, but 48% of all patients were anisoechogenic preoperatively, increasing to 61% at 3 months after surgery, and decreasing to 25% at 6 months postsurgery. There was no significant difference between the two patient groups, suggesting that the changes observed in the PV do not explain the presence of the atypical symptoms of PCS.
Lipids, Waist Circumference and Body Mass Index in Haemodialysis Patients
Authors: Bevc S , Potočnik A , Hojs R
Published: February 2013

In the general population, dyslipidaemia and abdominal obesity are risk factors for cardiovascular disease, but less is known about their roles in patients on maintenance haemodialysis (HD). This study investigated the association between blood lipids and abdominal obesity, as determined by waist circumference (WAC), and body mass index (BMI) in 72 HD patients (32 women). Blood lipid levels were measured using routine laboratory methods. Abdominal obesity, based on the WAC measurement, was found in 62.5% of HD patients (75.0% of women; 52.5% of men). Triglyceride levels were higher in abdominally obese compared with abdominally non-obese men. According to BMI measurements, 34.7% of HD patients were overweight/obese and 9.7% were underweight. In men, WAC and BMI were positively correlated with triglyceride levels. In women, WAC was negatively correlated with high-density lipoprotein (HDL) cholesterol and apolipoprotein A levels. The results indicated that there was a negative association of abdominal obesity and BMI with HDL cholesterol in HD patients.
Non-Cirrhotic and Non-Malignant Acute Extrahepatic Portal Vein Thrombosis (PVT): Short- and Long-Term Results
Authors: Kobilica N , Skalicky M , Milotič F , Flis V
Published: February 2013

This observational cohort study reports the short- and long-term clinical outcomes of 31 patients admitted for acute non-malignant, non-cirrhotic portal vein thrombosis (PVT) over a 10-year period. Patients had a mean age of 43 years at admission and a mean duration of follow-up of 84 months. All patients were initially treated with anticoagulants. Complete recanalization occurred within 30 days after admission in 18 patients (58%), partially in nine patients (29%), and failed in four patients (13%). During follow-up, 10 patients (32%) had at least one episode of gastrointestinal bleeding. The probability of remaining bleed-free was 0.93 at 24 months and 0.61 at 48 months. Fundal varices were not controlled by endoscopic sclerotherapy, so all four patients underwent portosystemic shunt construction. To date, there has been no mortality. In conclusion, using a combination of different treatment options reduces the risk of death and late complications in patients with non-malignant, non-cirrhotic PVT.
Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator (rt-PA) in Acute Lower Limb Ischaemia
Authors: Flis V , Kobilica N , Bergauer A , Mrdža B , Milotič F , Štirn B
Published: February 2013

For various reasons some patients are unable to undergo intra-arterial thrombolysis for acute limb ischaemia. This interventional case series study prospectively evaluated the effect of thrombolytic treatment with 100 mg recombinant tissue plasminogen activator (rt-PA), administered intravenously, in patients with acute thrombosis of the lower limb arteries and onset of symptoms within 12 h prior to treatment. During a 3-year period (2007 – 2009), 18 of 86 patients satisfied the inclusion criteria and were included in the study (age range 65 – 80 years; 11 women). Complete and partial thrombolysis was observed in eight (44.4%) and six (33.3%) patients, respectively. All patients experienced clinical improvement. There were no amputations during the 36-month follow-up period and no haemorrhagic complications in the first 30 days post-treatment. Five patients died (27.8%) during follow-up from unrelated causes. This small study demonstrated that thrombolytic treatment with intravenous rt-PA in selected patients with acute limb ischaemia is feasible.
Marital Status and Risk for Late Life Depression: A Meta-Analysis of the Published Literature
Authors: Yan X-Y , Huang S-M , Huang C-Q , Wu W-H , Qin Y
Published: February 2013

This study assessed the relationship between marital status and the risk for depression in people ≥ 55 years old. Using the Medline™, EMBASE™ and Cochrane Library databases, clinical studies that published data on the association between marital status and risk of depression among individuals aged ≥ 55 years were identified. A quantitative meta-analysis of 24 cross-sectional and eight longitudinal studies was performed. Compared with married elderly people, unmarried elderly people had a higher risk for depression (odds ratio [OR], 1.55; relative risk [RR], 1.36). Compared with married elderly people, the widowed elderly people (OR 1.49; RR 1.71), divorced people (RR 2.14) and never-married people (OR 1.32) had a higher risk for depression. Among elderly unmarried people, widowed people had a higher risk for depression than those who never married (OR 1.51). In conclusion, being unmarried was an important risk factor for depression in elderly people.
Relationship between the Number of Outpatient Visits for Hypotension in the Springtime in Japan, Extracted from Clinical Electronic Records, and Global Solar Radiation Levels
Authors: Hoshino T , Hoshino A , Matsubara N , Matsuoka T , Kikuchi Y , Shimbo T , Shimizu T
Published: February 2013

Hypotension is commonly reported in springtime when health changes, such as autonomic imbalance, are common and its symptoms may cause difficulties in daily activities. In this study, medical data from 101 outpatient clinic attendees (mean age 43.9 years; 16 males) making their first visit for hypotension symptoms, were compared with meteorological data from the clinic's location. The main symptom of hypotension was giddiness on standing. The most common coexisting conditions were gastrointestinal; e.g. gastro-oesophageal reflux disorder and irritable bowel syndrome. The 7-day moving average of total global solar radiation correlated significantly with the 7-day moving average of the number of patients with hypotension. Discriminant analysis revealed an increase in hypotension consultations in the total global solar radiation moving average range 11 – 19 MJ/m2 consistent with the local spring season. Guidance — such as wearing compression stockings during springtime — may help to reduce the occurrence of clinical hypotension in susceptible patients.
New Serum Biomarkers for Detection of Endometriosis Using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry
Authors: Zheng N , Pan C , Liu W
Published: February 2013

This study used proteomic fingerprint technology, combining nano-sized magnetic beads with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI—TOF—MS), to screen for potential protein biomarkers for the diagnosis of endometriosis. Serum proteins from 126 patients with endometriosis and 120 healthy controls were profiled and compared. Biomarker pattern software identified 46 discriminating mass-to-charge m/z ratio peaks that were related to endometriosis. The model constructed by the software, based on three of these peaks ( m/z 5988.7, 7185.3 and 8929.8), generated excellent separation between the endometriosis and control groups. The sensitivity was 91.4% and the specificity 95.0%. Blind testing on a second series of serum samples from patients with endometriosis and healthy controls indicated a sensitivity of 89.3% and a specificity of 90.0%. Biomarkers for endometriosis can be discovered in serum by MALDI—TOF—MS in combination with nano-sized magnetic beads. The pattern of combined markers provides a powerful and reliable diagnostic method for endometriosis, with high sensitivity and specificity.
Evaluation of the Gastro-Oesophageal Junction: Defining the Incompetent Cardio-Oeosophageal Angle Non-Invasively with Ultrasound and Computerized Tomography
Authors: Yildirim D , Ekçi B , Gürses B , Oruç F
Published: February 2013

This study aimed to demonstrate the presence of gastro-oesophageal reflux disease (GORD) non-invasively using ultrasound (US) and computerized tomography (CT). Intra-abdominal oesophageal length (IAOL) and cardio-oesophageal angle (COA) were measured by US in 25 patients with known reflux and in 25 healthy subjects (control group). CT images of 42 patients with reflux disease and 44 controls were reviewed retrospectively, and IAOL and COA were measured on curved multiplanar format images. Using a cutoff value for IAOL of 20.5 mm, the sensitivity to detect GORD with US was 96% and the specificity was 80% and, with CT, the sensitivity was 95% and the specificity was 78%. A cut-off value of 138.5° for COA yielded sensitivity and specificity values for GORD detection of 76% and 72% with US and 83% and 80% with CT, respectively. In conclusion, with equivocal diagnostic findings, IAOL and COA are useful parameters that can be determined non-invasively by US or CT and may aid diagnosis and treatment choices for patients with suspected GORD.
The Effect of Ulinastatin on Postoperative Blood Loss in Patients Undergoing Open Heart Surgery with Cardiopulmonary Bypass
Authors: Song JE , Kang WS , Kim DK , Yoon TG , Kim TY , Bang Y-S , Kim SH
Published: February 2013

This prospective, randomized, double-blind study evaluated the effect of ulinastatin on postoperative blood loss and transfusion requirements of patients undergoing open-heart surgery with cardiopulmonary bypass (CPB) and aortic cross-clamping (ACC). CPB and ACC produce variable systemic inflammatory reactions that are associated with multiorgan dysfunction via leucocytes, especially polymorphonuclear neutrophils (PMNs). PMNs increase blood loss and transfusion requirements. Ulinastatin, a urinary trypsin inhibitor, inhibits PMN activity and reduces the systemic inflammatory response. Patients received either 5000 U/kg ulinastatin or the equivalent volume of normal saline (control group) before ACC. Postoperative blood loss and transfusion requirements were recorded. Duration of intubation and length of stay in the intensive care unit (ICU) were also noted. There were no statistically significant between-group differences in postoperative blood loss and transfusion requirements. Ulinastatin caused a non-significant decrease in duration of intubation. Patients who received ulinastatin had significantly shorter ICU stays than control patients.
Protective Effect of Lycopene against Radiation-Induced Hepatic Toxicity in Rats
Authors: Meydan D , Gursel B , Bilgici B , Can B , Ozbek N
Published: February 2013

The radioprotective effect of lycopene against liver damage was investigated in 80 female Sprague Dawley rats (10 per group). Early-group rats included: controls (group 1), lycopene (group 2), radiotherapy alone (group 3), and lycopene + radiotherapy (group 4). Lycopene (5 mg/kg per day) was administered orally for 7 days; single-fraction 8 Gy abdominopelvic radiotherapy was administered on day 8. Early-group rats were sacrificed on day 10. Late-group rats (groups 5 – 8) underwent treatment with the same regimens but, in groups 6 and 8, lycopene was administered until all rats were sacrificed, 60 days postradiotherapy. Liver malondialdehyde levels increased significantly and glutathione (GSH) levels, GSH-peroxidase (GSH-Px) and superoxide dismutase (SOD) activity decreased significantly in radiotherapy versus control groups. In lycopene + radiotherapy groups, malondialdehyde levels decreased significantly and GSH levels, GSH-Px and SOD activity increased significantly compared with radiotherapy groups. No significant between-group histopathological differences were observed in early groups; in late groups, histopathological changes increased significantly in the radiotherapy group versus control group. A significant decrease in histopathological changes occurred in the lycopene + radiotherapy group compared with the radiotherapy group. Lycopene supplementation significantly reduced radiotherapy-induced oxidative liver injury.
Correlation between Expression of S100A4 and VEGF-C, and Lymph Node Metastasis and Prognosis in Gastric Carcinoma
Authors: Feng L-Z , Zheng X-Y , Zhou L-X , Fu B , Yu Y-W , Lu S-C , Cao N-S
Published: February 2013

This semiquantitative immunohistochemical study investigated the clinical significance of S100A4 and vascular endothelial growth factor C (VEGF-C) protein expression in gastric carcinoma. Correlations between S100A4 and VEGF-C immunoreactivity and clinicopathological characteristics were evaluated using 108 gastric carcinoma specimens and 20 specimens of tissue adjacent to gastric carcinoma. S100A4 and VEGF-C expression in carcinoma was higher than that in adjacent tissues. S100A4 expression was significantly related to tumour size and lymph node metastasis, whereas VEGF-C expression was associated with invasion depth, lymph node metastasis and tumour, node, metastasis (TNM) stage. A significant correlation was found between S100A4 and VEGF-C expression. Patients expressing S100A4 or VEGF-C showed no significant reduction in 5-year survival rate compared with those not expressing these proteins. Sex, age, tumour size, invasion depth, lymph node involvement, TNM stage, S100A4 expression and VEGF-C expression had a common effect on carcinoma prognosis but none was an independent prognostic factor.
Transplantation of Schwann Cells Differentiated from Adipose-Derived Stem Cells Modifies Reactive Gliosis after Contusion Brain Injury in Rats
Authors: Yang L , Fang JS , Wang W , Chen RK , Shen CF
Published: February 2013

This study investigated whether transplantation of Schwann cells differentiated from adipose-derived stem cells (ADSC-SCs) of rats could promote functional improvement after contusion brain injury, with a focus on the effect on reactive gliosis. ADSCs were isolated and expanded from groin adipose tissue of Sprague—Dawley rats and then differentiated into Schwann cells. ADSC-SCs were transplanted into the contused rat brain. Immunofluorescence and Western blotting were used to analyse reactive gliosis, and locomotor function of the rats was assessed. Hemiparalysed rats transplanted with ADSC-SCs showed significant locomotor function recovery compared with rats transplanted with undifferentiated ADSCs or control rats injected with medium alone. Transplanted ADSC-SCs significantly reduced glial scar formation and neurocan protein levels compared with transplanted undifferentiated ADSCs. In conclusion, transplantation of ADSC-SCs can effectively promote locomotor functional recovery and reduce reactive gliosis after contusion brain injury in rats.
Increased Circulating Immunosuppressive CD14+HLA-DR−/Low Cells Correlate with Clinical Cancer Stage and Pathological Grade in Patients with Bladder Carcinoma
Authors: Yuan X-K , Zhao X-K , Xia Y-C , Zhu X , Xiao P
Published: February 2013

This study investigated CD14+HLA-DR−/low cells in peripheral blood mononuclear cells (PBMCs) from 64 patients with bladder carcinoma (BC) and 14 healthy controls. Cell phenotypes were determined and CD14+HLA-DR−/low cells, CD14+HLA-DR+ cells and PBMCs depleted of CD14+HLA-DR−/low cells were isolated. Proliferation of stimulated PBMCs and interferon-γ (IFN-γ) production after addition of CD14+HLA-DR−/low and CD14+HLA-DR+ cells at different ratios were measured. IFN-γ production was also measured after addition of l-arginine and/or antitransforming growth factor-β (TGF-β) neutralizing monoclonal antibody, and in PBMCs depleted of CD14+HLA-DR−/low cells. The proportion of CD14+HLA-DR−/low cells in BC patients was significantly higher than in controls. CD14+HLA-DR−/low cells significantly decreased T-cell proliferation and IFN-γ production in a dose-dependent manner. This suppressive activity was partially reversed by l-arginine or anti-TGF-β. Enhanced IFN-γ secretion was also seen in PBMCs depleted of CD14+HLA-DR−/low cells. The level of CD14+HLA-DR−/low cells was associated with gender, tumour size, number of tumours, cancer pathological grade and clinical stage. CD14+HLA-DR−/low cells may represent a subpopulation of myeloid-derived suppressor cells in BC patients.
Serum Detection of Epidermal Growth Factor Receptor Gene Mutations Using Mutant-Enriched Sequencing in Chinese Patients with Advanced Non-Small Cell Lung Cancer
Authors: Jiang B , Liu F , Yang L , Zhang W , Yuan H , Wang J , Huang G
Published: February 2013

Epidermal growth factor receptor gene ( EGFR) mutations are among the best predictive markers of the efficacy of EGFR tyrosine kinase inhibitor (EGFR-TKI) treatment. Mutations in the EGFR gene confer sensitivity to EGFR-TKIs in patients with advanced non-small cell lung cancer (NSCLC). This study determined the concordance rate of EGFR mutations in serum samples and tumour tissue from Chinese patients with advanced NSCLC and compared two detection methods: mutant-enriched polymerase chain reaction-based DNA sequencing and non-enriched sequencing. The EGFR mutation status in serum was consistent with that in paired tumour samples, with a concordance rate of 93.1% for mutant-enriched sequencing. In serum samples, mutant-enriched sequencing demonstrated sensitivity and specificity of 77.8% and 100%, respectively, and was more sensitive than the non-enriched assay. Mutant-enriched sequencing in serum may provide a non-invasive and sensitive method for detecting EGFR mutation status in patients with unresectable NSCLC.
Reliability of the Fukuda Stepping Test to Determine the Side of Vestibular Dysfunction
Authors: Zhang YB , Wang WQ
Published: February 2013

The Fukuda stepping test (FST) is widely used in neurology and for the diagnosis of vertigo-associated disease, but its reliability is disputed. This study assessed the accuracy of the FST in determining the side of vestibular dysfunction in 126 patients with unilateral vestibular lesion. Abnormal deviation towards the side of the lesion occurred in 50.0% of cases and towards the intact side in 24.6% of cases, with 25.4% of patients within the normal range (< 45° deviation). An equal percentage of patients with acute stage vertigo (0 – 3 days after onset) deviated towards the intact and lesion sides, however the percentage of patients deviating to the intact side decreased over time. A subset of patients who originally deviated towards the intact side gradually began to deviate towards the lesion side. Care should be taken when using the FST to determine the side of the lesion, particularly in acute stage vertigo.
Predictive Value of the POSSUM, p-POSSUM, cr-POSSUM, APACHE II and ACPGBI Scoring Systems in Colorectal Cancer Resection
Authors: Yan J , Wang Y-X , Li Z-P
Published: February 2013

This study investigated the ability of the Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM) scoring system to predict postoperative morbidity (complication rate) and compared the ability of POSSUM and four other scoring systems (Portsmouth POSSUM [p-POSSUM], colorectal POSSUM [cr-POSSUM], Association of Coloproctology of Great Britain and Ireland [ACPGBI] and Acute Physiology and Chronic Health Evaluation II [APACHE II]) to predict mortality within 30 days in 1695 patients undergoing surgery for colorectal cancer. Receiver operating characteristic (ROC) curve, Student's t-test and the χ2-test were used to estimate the predictive ability of these scoring systems. The observed complication rate of 38.7% was not significantly different to the rate of 36.3% predicted by the POSSUM scoring system (observed: expected [O: E] ratio 1.07). The observed mortality rate was 3.0%. For predicting mortality, POSSUM had an O: E ratio of 0.37, compared with p-POSSUM O: E ratio 1.00, cr-POSSUM O: E ratio 0.91, APACHE II O: E ratio 0.31 and ACPGBI O: E ratio 1.41. It was concluded that the POSSUM scoring system had high value for predicting the risk of morbidity following colorectal cancer resection. For predicting postoperative mortality, p-POSSUM, cr-POSSUM and ACPGBI were superior to POSSUM and APACHE II, however ROC curve analysis showed that cr-POSSUM and ACPGI discriminated best between survivors and non-survivors, so were more accurate predictors of postoperative mortality than the other three scoring systems.
Prevalence of Hepatic Pseudolesions around the Falciform Ligament in a Paediatric Population
Authors: Ucar A , Sahin D , Bulakci M , Bakan S , Yilmaz R , Yahyayev A , Yekeler E
Published: February 2013

This study investigated the prevalence and features of hepatic pseudolesions around the falciform ligament in 320 children undergoing contrast-enhanced abdominal multidetector computed tomography. Aberrant venous drainage was investigated using thin-section computed tomography images. Pseudolesions around the falciform ligament were detected in 63 patients (20%). The longest diameter was in the craniocaudal direction in 41 (65%) patients (lesions). An inferior vein of Sappey supplying the pseudolesions was seen in 11 patients (17%). Thirteen patients of the 63 patients (21%) with pseudolesions who had a history of extrahepatic malignancy were also examined by ultrasound; in two of the 13 patients the lesions were isoechoic and, in the remainding 11 patients, they were hyperechoic. It was concluded that hepatic pseudolesions around the falciform ligament occur frequently in the paediatric population on CT images. Detection of the longest diameter in the craniocaudal direction and the presence of an inferior vein of Sappey and fatty infiltration should be sufficient to exclude true lesions and make further evaluations unnecessary.
Does Near-Infrared Spectroscopy Provide an Early Warning of Low Haematocrit following the Initiation of Hypothermic Cardiopulmonary Bypass in Cardiac Surgery?
Authors: Sung TY , Kang WS , Han SJ , Kim JS , Chee HK , Shin JK , Kim SH
Published: February 2013

This study investigated 151 patients undergoing cardiac surgery to determine whether measurement of regional cerebral oxygen saturation (rScO2) using near-infrared spectroscopy (NIRS) can indicate a low haematocrit after initiation of hypothermic cardiopulmonary bypass (CPB). Haematocrit, rScO2, haemoglobin level, arterial partial pressures of carbon dioxide and oxygen, systemic blood pressure, and nasopharyngeal and rectal temperatures were determined 5 min after the initial administration of heparin for CPB and 90 s after completion of the first cardioplegic solution injection. Immediately after initiation of hypothermic CPB, rScO2, haemoglobin and haematocrit values were significantly lower than those before CPB. No significant correlations were found between the change in haematocrit and changes in left, right and mean rScO2; thus, changes in rScO2 before and after initiation of hypothermic CPB did not reflect changes in haematocrit values. This indicates that NIRS cannot provide early warning of a low haematocrit immediately after initiation of hypothermic CPB in cardiac surgery.
Beneficial Effect of Atorvastatin on Renal Function in Patients with Type 2 Diabetes
Authors: Tanaka M
Published: February 2013

Two studies investigated the effect of atorvastatin on glycaemic control and renal function in patients with type 2 diabetes. In study 1, 27 outpatients with hypercholesterolaemia (16 statin-naïve, 11 switched from another statin) took atorvastatin (10 mg once daily) for 3 months. After 3 months, low-density lipoprotein cholesterol (LDL-C) had decreased significantly in both groups, high-density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate had increased only in the statin-naïve group, and glycosylated haemoglobin (HbA1c) had not changed significantly in either group. Study 2 was a retrospective investigation of 87 outpatients with hyper cholesterolaemia who had been taking atorvastatin for at least 4 years. Compared with baseline (patients who had taken atorvastatin for at least 1 year), total cholesterol and triglyceride levels did not change over the study period, HDL-C increased significantly at 2 and 3 years, HbA1c was significantly decreased at 1, 2 and 3 years and serum creatinine was significantly decreased at 1 year. Atorvastatin lowered LDL-C concentration, did not worsen glycaemic control and might improve renal function in patients with type 2 diabetes.
Correlation between Ischaemia-Modified Albumin and Intermediate-Density Lipoprotein in Haemodialysis Patients with End-Stage Renal Disease
Authors: Kotani K , Kimura S , Kinugasa E , Ogata H , Caccavello R , Taniguchi N , Gugliucci A
Published: February 2013

This study investigated the association between ischaemia-modified albumin (IMA), a biomarker of cardiac ischaemia, and increases in the levels of intermediate-density lipoprotein (IDL), an atherogenic particle that can cause oxidative stress, in haemodialysis patients with end-stage renal disease (ESRD). Fasting levels of serum IMA and lipids/lipoproteins were analysed in 15 patients and 15 healthy control subjects. There was a close positive correlation between IMA and IDL levels in ESRD patients but no significant correlation between IMA and lipids/lipoproteins in control subjects. This suggests a possible link between the characteristic dyslipo-proteinaemia found in ESRD and levels of IMA and, if confirmed in studies with larger sample sizes, may lead to further studies on the potential of the relationship between IMA and IDL as a biomarker in haemodialysis patients with ESRD.
Primary Pancreatic Pleomorphic Leiomyosarcoma
Authors: Zhang Q-Y , Shen Q-Y , Yan S , Zheng S-S
Published: February 2013

Primary pancreatic leiomyosarcoma is a rare mesenchymal tumour that is believed to arise from the walls of the pancreatic blood vessels or the pancreatic duct. A 56-year-old female was referred with epigastric pain and abdominal mass. Preoperative computed tomography showed a large soft tissue mass in the pancreatic body and tail. Fine needle aspiration biopsy indicated a spindle cell type tumour. The patient received distal pancreatectomy with no adjuvant treatment. Histology revealed a pleomorphic spindle cell neoplasm with an immunoprofile suggestive of smooth muscle origin. The absence of other lesions in the body was consistent with the diagnosis of primary pleomorphic leiomyosarcoma. The patient was well and tumour-free 14 months after surgery. Detailed immunohistochemical analyses are necessary in the diagnosis of this highly malignant tumour. Radical resection offers the only chance of long-term survival.
Bilateral Knee Lipoma Arborescens Combined with Osteoarthritis in Elderly Patients
Authors: Xiao J , Xu Y , Wang J , Feng J , Shi Z
Published: February 2013

Here, three cases of combined lipoma arborescens (LA) — a rare neoplastic lesion of the synovium — and osteoarthritis (OA) with bilateral knee involvement in elderly patients are reported. The clinical, magnetic resonance imaging and histological characteristics of this rare condition are described. Limited by the similarity of symptoms between LA and OA and the low sensitivity of X-ray for discerning LA, it was found that a diagnosis of LA could be easily missed. Follow-up data suggested that the treatment of LA was not jeopardized even if the diagnosis was not made preoperatively, since the lesion is easily discerned intraoperatively. The definitive treatment of synovectomy can then be performed without recurrence of the lesion. Based on the evidence of the sequence of symptoms and the progression of untreated LA with static OA at follow up, it is suggested that the aetiology of LA is secondary to OA in elderly patients.
Relationship between Brain Natriuretic Peptide and Recurrence of Atrial Fibrillation after Successful Electrical Cardioversion: A Meta-Analysis
Authors: Tang Y , Yang H , Qiu J
Published: February 2013

A meta-analysis was undertaken to examine the relationship between plasma brain natriuretic peptide (BNP) levels and recurrence of atrial fibrillation (AF) after successful electrical cardioversion. The literature search was conducted using key inclusion criteria for papers published between January 1980 and March 2011 listed in the PubMed®/MEDLINE® database. Data were analysed using RevMan version 5.1 software; a manual search was also performed. Ten studies were finally included. Results showed that baseline BNP levels were higher in patients with AF recurrence than in those without recurrence, the standardized mean difference in plasma BNP level being −1.35 (95% confidence interval −2.17, −0.53, Z-score for overall effect 3.22). These results suggest that higher plasma BNP levels are associated with a greater risk of AF recurrence. BNP levels may predict AF recurrence after successful electrical cardioversion.
Low Prevalence of Human Papillomavirus (HPV) in Chinese Patients with Breast Cancer
Authors: Mou X , Chen L , Liu F , Shen Y , Wang H , Li Y , Yuan L , Lin J , Lin J , Teng L , Xiang C
Published: February 2013

This retrospective study investigated the presence of human papillomavirus (HPV) in Chinese women with breast cancer, and the correlation between HPV infection and carcinogenesis. Tumour and non-cancerous breast tissue samples were obtained from 62 female patients with breast cancer; normal breast tissue samples were obtained from 46 women without breast cancer. HPV DNA was detected by nested polymerase chain reaction using consensus primers; HPV subtypes were determined by reverse dot blot and pyrosequencing analyses. HPV was found in tumour tissue samples from four of the 62 patients (6.5%), while no HPV DNA was detected in either the non-cancerous samples from patients with breast cancer or from the normal breast tissue controls. Of the four HPV-positive cases, three were HPV 16 positive (75%) and one was HPV 18 positive (25%). The low frequency of HPV detected in this study suggests that this infection is not a major risk factor in breast cancer development.
The Role of HE4 in Ovarian Cancer: Inhibiting Tumour Cell Proliferation and Metastasis
Authors: Gao L , Cheng HY , Dong L , Ye X , Liu YN , Chang XH , Cheng YX , Chen J , Ma RQ , Cui H
Published: February 2013

As a promising biomarker, human epididymis protein 4 (HE4) has been widely used for the early detection and differential diagnosis of ovarian cancer. This study evaluated the function of HE4 in the carcinogenesis and progression of ovarian cancer. An enzyme immunometric assay, used to detect HE4 in the serum of ovarian cancer patients, showed that the protein could discriminate between malignant and benign ovarian tumours with high specificity. An exogenous HE4 gene was transfected into ovarian cancer cell lines and an immortalized ovarian epithelial cell line. Compared with the controls, HE4 overexpression significantly promoted cell apoptosis and adhesion. Overexpression of HE4 also led to significant inhibition of cell proliferation, migration and invasiveness in vitro, as well as xenograft tumour formation in vivo. This is the first report to demonstrate the functional importance of HE4 in multiple cellular processes and indicates that HE4 may play a protective role in the progression of ovarian cancer.
The Relationship between Mast Cell Density and Tumour Grade in Transitional Cell Carcinoma of the Bladder
Authors: Kim JH , Kang YJ , Kim DS , Lee CH , Jeon YS , Lee NK , Oh MH
Published: February 2013

This study investigated the relationship between mast cell numbers and the grade of bladder transitional cell carcinoma (TCC). Bladder TCC biopsies were obtained via transurethral resection and 45 stage T1 specimens were included in the study. Specimens were sorted into two groups, low grade (grade I) and high grade (grades II and III). Samples were stained using haematoxylin and eosin, toluidine blue and immunohistochemical staining for tryptase. Mast cells were examined by light microscopy and cell density was recorded. Mast cell density was significantly higher in high-grade TCC than low-grade TCC. There was also a significant relationship between the number of mast cells identified using toluidine blue staining or immunohistochemical staining for tryptase. Detailed studies of mast cell function will enable the development of more effective antitumour therapies via mast cell manipulation.
Silencing of X-Linked Inhibitor of Apoptosis Decreases Resistance to Cisplatin and Paclitaxel but Not Gemcitabine in Non-Small Cell Lung Cancer
Authors: Liu Y , Wu X , Sun Y , Chen F
Published: February 2013

Non-small cell lung cancer (NSCLC) is a highly lethal malignancy that often becomes resistant to chemotherapy. The effect of silencing the X-linked inhibitor of apoptosis gene (XIAP) on resistance to cisplatin, paclitaxel and gemcitabine was studied in the NSCLC cell lines A549 and H460. Transfection of these cells with small interfering RNA (siRNA) for XIAP blocked overexpression of the gene, suppressed cell proliferation, increased apoptosis and increased the cells' sensitivity to cisplatin and paclitaxel by preventing the binding of XIAP to caspase-3 and increasing the activity of this enzyme. There was no significant difference in resistance to gemcitabine between XIAP-silenced cells and non-transfected cells. Changes in chemoresistance were independent of the activity of caspase-9. Silencing XIAP with siRNA can decrease chemoresistance in NSCLC and may have a potential role in the treatment of this disease.
Glioma Growth Inhibition In Vitro and In Vivo by Single Chain Variable Fragments of the Transferrin Receptor Conjugated to Survivin Small Interfering RNA
Authors: Wang F , Bai H-R , Wang J , Bai Y-Z , Dou C-W
Published: February 2013

Inhibition of survivin by small interfering RNA (siRNA) can delay glioma growth. To enhance the effect of survivin-siRNA on intercranial glioma, a conjugate of siRNA-survivin and single-chain variable fragment (scFv) of the transferrin receptor (TfR) was constructed and its effects assessed in vitro and in vivo. Survivin-siRNA and the survivin-siRNA/scFv-TfR conjugate were constructed and used successfully to inhibit glioma U87 cell proliferation and enhance apoptosis in vitro. The molecular constructs were administered to an established U87 orthotopic mouse model. Western blot analysis and immunohistochemistry of the glioma tissues showed that survivin protein levels were strongly suppressed by the survivin-siRNA/scFv-TfR conjugate in vivo. Furthermore, survivin-siRNA/scFv-TfR prolonged the survival time of mice more than survivin-siRNA. In conclusion, the survivin-siRNA/scFv-TfR conjugate efficiently enhanced the effects of survivin-siRNA on glioma suppression in vivo, confirming the applicability of antibody-targeted molecular therapies for treating human brain tumours.
Maximum Thickness of Subarachnoid Blood is Associated with Mortality in Patients with Traumatic Subarachnoid Haemorrhage
Authors: Tu CJ , Liu JS , Song DG , Zhen G , Luo HM , Liu WG , Dong XQ
Published: February 2013

This study was designed to evaluate whether the maximum thickness of subarachnoid blood is an independent prognostic marker of mortality after traumatic subarachnoid haemorrhage. Multivariate analysis showed the maximum thickness of subarachnoid blood was an independent predictor of death versus survival 1 month after injury and was inversely associated with Glasgow Coma Scale (GCS) score. Receiver operating characteristic curve analysis showed that maximum thickness of subarachnoid blood > 6.7 mm immediately after non-surgical resuscitation predicted 1-month mortality with 83.9% sensitivity and 67.1% specificity; its predictive value was similar to that of the GCS score. Addition of maximum thickness of subarachnoid blood to the GCS score did not significantly improve predictive performance. Hence, the maximum thickness of subarachnoid blood is a new independent prognostic marker of mortality and might become an additional, valuable tool for risk stratification and decision making in the acute phase of traumatic subarachnoid haemorrhage.
Does the Model for End-Stage Liver Disease Score Predict Transfusion Amount, Acid-Base Imbalance, Haemodynamic and Oxidative Abnormalities during Living Donor Liver Transplantation?
Authors: Lee J , Chung MY
Published: February 2013

The model for end-stage liver disease (MELD) score is associated with the severity of liver failure in transplant patients. This study examined whether life-threatening stress factors during liver transplantation differed according to the patients' preoperative MELD scores. Forty-four patients who underwent living donor liver transplantation were divided into a high MELD group (MELD score ≥ 20) ( n = 25) and a low MELD group (MELD score < 20) ( n = 19). The volume of blood components transfused, acid-base homeostasis variables, and haemodynamic and oxidative variables were measured at each stage of the surgery. The systemic vascular resistance index was significantly lower in the high MELD group than in the low MELD group at all time points. The oxygen utility index and the oxygen extraction ratio were all significantly lower in the high MELD group than in the low MELD group only at the preanhepatic stage and not at later stages of surgery. Intraoperative transfusion volume and the severity of metabolic acidosis were not associated with the preoperative MELD score.
Effects of Electroacupuncture Pretreatment on Inflammatory Response and Acute Kidney Injury in Endotoxaemic Rats
Authors: Gu G , Zhang Z , Wang G , Han F , Han L , Wang K , Liu J , Li W
Published: February 2013

This study investigated the effect of electroacupuncture pretreatment on the lipopolysaccharide (LPS)-induced inflammatory response and on acute kidney injury in adult male pathogen-free Wistar rats. Rats received electroacupuncture at the Zusanli (ST36) and Neiguan (PC6) acupoints, or electrical stimulation at sham points, for 30 min before stimulation with either 5 mg/kg LPS intravenously or normal saline. Plasma cytokines, plasma nitrite, renal inducible nitric oxide synthase (iNOS) and nuclear factor κB (NF-κB) activity were assessed 240 min after LPS or normal saline injection. Blood urea nitrogen (BUN), creatinine (Cr) and histopathological score for renal tubular damage were also measured. Electroacupuncture pretreatment significantly decreased LPS-induced plasma tumour necrosis factor-α and interleukin (IL)-1β, increased plasma IL-10, and decreased plasma nitrite, renal iNOS and NF-κB activity. It also significantly decreased LPS-induced BUN, Cr and the renal histopathological score. These findings suggest that electroacupuncture pretreatment at the ST36 and PC6 acupoints attenuated the LPS-induced inflammatory response and mitigated acute kidney injury.
Anatomical Analysis of Computed Tomography Images for Determining the Optimal Oblique Fluoroscope Angle for Percutaneous Coeliac Plexus Block
Authors: Kim WH , Lee CJ , Sim WS , Shin BS , Ahn HJ , Lim HY
Published: February 2013

This retrospective study used abdominal computed tomography (CT) scan images to determine the optimal safe oblique angle for fluoroscopy in fluoroscope-assisted coeliac plexus block (CPB). Abdominal CT scans from 131 patients were included in the study: 42 patients with cancer of the pancreas head, 45 with cancer of the pancreas body and tail and 44 with chronic pancreatitis. The oblique angle and entry distance from the midline were measured at the T12 and L1 levels, and the safe angle range that avoided puncture of the organs was also measured. The optimal angle varied between the T12 and L1 levels, and between the right and left sides at the T12 level. There was no difference in the oblique angle between the patient groups. The optimal oblique angle for fluoroscopy was determined to be 17° for right T12, 18° for left T12, and 19° for both left and right L1.
Effect-Site Concentration of Remifentanil for Nasotracheal versus Orotracheal Intubation during Target-Controlled Infusion of Propofol
Authors: Kwak HJ , Min SK , Kim DH , Kang M , Kim JY
Published: February 2013

The concentration of remifentanil required for acceptable nasotracheal intubation in adults after target-controlled infusion (TCI) of propofol without neuromuscular blockade was compared with that required for orotracheal intubation. Twenty-five patients undergoing oral and maxillofacial surgery received nasotracheal intubation and 25 undergoing ear, nose and throat surgery received orotracheal intubation. Anaesthesia was induced with propofol TCI at a target effect-site concentration of 5.0 μg/ml. The 50% and 95% effective concentrations (EC50 and EC95, respectively) for remifentanil, calculated using isotonic regression, were 5.40 and 6.85 ng/ml, respectively, in the orotracheal group and 5.75 and 7.43 ng/ml in the nasotracheal group. The EC50 (± SD) values for remifentanil, calculated using a modified Dixon's up-and-down method, were 6.08 ± 0.75 and 5.58 ± 0.75 ng/ml for nasotracheal and orotracheal intubation, respectively. Effect-site remifentanil concentrations did not differ significantly between the two groups of patients. Coadministration of propofol and remifentanil can provide acceptable conditions for nasotracheal intubation without neuromuscular blockade.
Chronic Dietary Fiber Supplementation with Wheat Dextrin does not Inhibit Calcium and Magnesium Absorption in Premenopausal and Postmenopausal Women
Authors: Armas LAG , Rafferty K , Hospattankar A , Abrams SA , Heaney RP
Published: February 2013

This placebo-controlled, randomized, crossover clinical study examined the effect of chronic wheat dextrin intake on calcium and magnesium absorption. Forty premenopausal and postmenopausal women (mean ± SD age 49.9 ± 9.8 years) consumed wheat dextrin or placebo (15 g/day) for 2 weeks prior to 45calcium (45Ca) and 26magnesium (26Mg) absorption testing. After a standardized breakfast, serial blood and urine samples were obtained. The mean ± SD area under the curve from 0 to 9 h for 45Ca specific activity was 0.81 ± 0.21 for wheat dextrin and 0.82 ± 0.22 for placebo, showing that wheat dextrin had no effect on calcium absorption. The mean ± SD percentage excess of 26Mg/24Mg was 7.8% ± 2.1% for wheat dextrin and 7.9% ± 2.6% for placebo, showing that wheat dextrin had no effect on magnesium absorption. In conclusion, chronic wheat dextrin consumption did not inhibit calcium or magnesium absorption from the gastrointestinal tract in women.