bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of novel N‐glycosylation sites in the B‐cell receptor of lymphomas associated with immunodeficiency
Authors: Forconi Francesco , Capello Daniela , Berra Eva , Rossi Davide , Gloghini Annunziata , Cerri Michaela , Muti Giuliana , Morra Enrica , Paulli Marco , Magrini Umberto , Lucioni Marco , Rambaldi Alessandro , Lauria Francesco , Carbone Antonino , Stevenson Freda K. , Gaidano Gianluca
Published: December 2004

Novel N‐glycosylation sites are introduced by somatic mutation into the V genes of the majority of follicular lymphomas. Sites are positively selected and rare in normal memory B cells, indicating a potential role in tumour survival in the germinal centre (GC). The incidence of c. 40% in diffuse large B‐cell lymphomas (DLBCL) parallels the known heterogenity of the disease. Immunodeficiency‐related non‐Hodgkin's lymphomas (NHL) include post‐transplant lymphoproliferative disorders (PTLD) and acquired immunodeficiency syndrome‐related NHL (AIDS‐NHL). Most PTLD derive from B cells that carry mutated VH genes and that have completed the GC reaction. All AIDS‐NHL carry mutated VH genes and variable features of GC or post‐GC cells. To determine if N‐glycosylation is a feature of immunodeficiency‐related lymphomas, we analysed the VH genes of 19 PTLD and 36 AIDS‐NHL. Novel sites were rare in PTLD (4/19), similar to memory B cells (P = 0·15). AIDS‐NHL, including DLBCL and Burkitt's lymphomas (BL), showed heterogeneity with 16 of 36 (44%) having novel sites. The findings indicate no selection of N‐glycosylation sites in PTLD, consistent with post‐GC features. The variable incidence of N‐glycosylation sites in AIDS‐NHL mirrors that in DLBCL and sporadic BL of immunocompetent hosts, supporting the known heterogeneity of these disorders, and possibly pointing to distinct routes of tumour development.
Initial design for a fish bioenergetics model of Pacific saury coupled to a lower trophic ecosystem model
Authors: ITO SHIN‐ICHI , KISHI MICHIO J. , KURITA YUTAKA , OOZEKI YOSHIOKI , YAMANAKA YASUHIRO , MEGREY BERNARD A. , WERNER FRANCISCO E.
Published: December 2004

A fish bioenergetics model coupled with an ecosystem model was developed to reproduce the growth of Pacific saury. The model spatially covers three different oceanographic spatial domains corresponding to the Kuroshio, Oyashio, and interfrontal (mixed water) regions. In this coupled model, three (small, large, and predatory) zooplankton densities which were derived from the lower trophic level ecosystem model were input to the bioenergetics model of saury as the prey densities. Although certain model parameters were imposed from other species’ bioenergetics, several model parameters were estimated from observational data specific to Pacific saury. The integrated model results reproduced appropriate growth rates of Pacific saury. Model sensitivities to water temperature and prey density are examined and observational methods to evaluate the model parameters are discussed.
Variations in patterns of daily changes in otolith increment widths of 0+ Pacific saury, Cololabis saira, off Japan by hatch date in relation to the northward feeding migration during spring and summer
Authors: KURITA YUTAKA , NEMOTO YUTAKA , OOZEKI YOSHIOKI , HAYASHIZAKI KEN‐ICHI , IDA HITOSHI
Published: December 2004

Daily changes in otolith increment widths from the core to the edge in 0+ Pacific saury, Cololabis saira, were examined. There appeared a first peak of increment width at 22.9 ± 9.6 (73) [mean ± SD (sample number)] days old, followed by the bottom of the first trough [88.6 ± 25.3 days old (73)] and a second peak [143.8 ± 24.6 days old (62)]. The ages at the second peak formation were strongly related to the estimated hatch dates from 30 October to 7 April (N = 62, r2 = 0.661) with a negative coefficient of elapsed days from 30 September, corresponding to the beginning of the spawning season. Thus, fish hatched earlier in the spawning season formed the second peak at an older age. The second peak was estimated to occur from 23 April to 14 August, mainly in June and July, at 152.5–216.8 mm (excluding one exception of 96.9 mm) in the earlier period (before 15 June) and at 87.5–177.5 mm in the later period (after 17 June). The peak of otolith increment width is concluded to approximate the peak of daily growth because the relationship between otolith radius and body size was expressed as an allometric curve. The occurrence of the second peak of increment width (growth) can be theoretically explained by descending temperature and ascending feeding condition, which Pacific saury experiences through the northward feeding migration from the warm and food‐poor Kuroshio (subtropical) waters to the cold and food‐rich Oyashio (subarctic) waters during spring and summer. The clear relationship between the age at the second peak and hatch date suggests the possibility of estimating hatch dates even of fish that have translucent zones in their otoliths by examining the increment widths from the core to the inner edge of the first translucent zone and specifying the age at the second peak.
Movement of juvenile walleye pollock, Theragra chalcogramma, from a spawning ground to a nursery ground along the Pacific coast of Hokkaido, Japan
Authors: HONDA SATOSHI , OSHIMA TATSUKI , NISHIMURA AKIRA , HATTORI TSUTOMU
Published: December 2004

The movement of juvenile walleye pollock, Theragra chalcogramma, from the Funka Bay spawning ground to the Doto nursery ground along the Pacific coast of Hokkaido was observed during spring through summer of 2000 and 2001. A positive relationship between the size of the juveniles and the position of the eastern front of their distribution indicated a relationship between the hatching period and the timing of the eastward movement of juveniles toward the Doto area. Based on the bathymetric distribution of juvenile pollock on the continental shelf in Hidaka Bay, the coastal current is suggested to play a role in the easterly movement of juveniles. However, further supporting evidence from physical and biological oceanographic studies is necessary to confirm this hypothesis.
Loneliness as a predictor of quality of life among older caregivers
Authors: Ekwall Anna K. , Sivberg Bengt , Hallberg Ingalill R.
Published: December 2004

Aim.  This paper reports a study investigating quality of life in relation to loneliness, caregiving, social network, gender, age and economic status among caregiving men and women in a population‐based sample aged 75 years or older.

Background.  Because of demographic changes, in the future more care for older people will be given by informal caregivers who are themselves older. Being old and caring for another older person may affect various aspects of life, such as physical and emotional health and decreased time for respite, which may affect social life and quality of life.

Method.  A postal questionnaire including the Short Form Health Survey was used. The sample consisted of 4278 people, aged 75 years and over, living in Sweden. Of these, 783 (18%) were caregivers.

Findings.  Caregivers had a larger social network and reported feelings of loneliness less often than non‐caregivers. Forty per cent of caregivers helped every day. There were gender differences in experiences of loneliness during the last year, with the frequency of intense feelings of loneliness being higher among women. Loneliness and a small or non‐existent network were significantly associated with low quality of life among caregivers, as well as in the total sample. The results showed significant association between loneliness, weak social network and low mental quality of life.

Conclusions.  The fact that loneliness was the most important factor predicting low quality of life among caregivers, as well as older people in general, indicates that it is crucial in the care of older people. From a nursing perspective, the findings indicate the advantage of helping older people to keep up and develop their social networks. Nursing care should involve steps to maintain the social network before an older person becomes too weak, since decreased health status makes social contacts more difficult.
Morning glory syndrome associated with posterior pituitary ectopia and hypopituitarism
Authors: Pierre‐Filho Paulo de Tarso P. , Limeira‐Soares Paulo H. , Marcondes Ana Maria
Published: December 2004

Purpose:  To report a patient with morning glory syndrome in combination with posterior pituitary ectopia and to emphasize the need for early recognition of this syndrome as an important step towards the diagnosis and treatment of the systemic anomalies that may be associated with it.

Methods:  We present a 7‐year‐old boy who showed short stature, nystagmus, inward deviation and low vision. Ophthalmological and general physical examinations, further endocrine evaluation and magnetic resonance imaging (MRI) of the brain and sella turcica were performed.

Results:  Both fundi showed symptoms of morning glory syndrome. The discs were pink and deeply excavated, and were surrounded by a ring of chorioretinal pigmentary disturbance. Magnetic resonance imaging revealed the absence of the infundibulum and posterior pituitary ectopia. Growth hormone studies confirmed the diagnosis of growth hormone deficiency. Therapy with recombinant human growth hormone was initiated.

Conclusions:  Although most cases of morning glory syndrome occur as isolated ocular abnormalities, it may occur in association with systemic anomalies, including posterior pituitary ectopia and hypopituitarism. A complete general physical examination and growth evaluation is important for early detection and treatment, resulting in benefit for these patients.
Prevalence of pseudoexfoliation syndrome in Ethiopian patients scheduled for cataract surgery
Authors: Teshome Tiliksew , Regassa Kefyalew
Published: December 2004

Purpose: To evaluate the prevalence of pseudoexfoliation syndrome (PEX) among Ethiopian patients with age‐related cataract scheduled for surgery.

Patients and methods: In a prospective study, 229 consecutive eyes with age‐related cataract scheduled for surgery were evaluated for the prevalence of PEX, type of cataract, intraocular pressure (IOP) and glaucoma.

Results: The mean age of the 229 patients was 62.1 ± 10.5 years (range 47–91 years). The prevalence of PEX was 39.3% (90 of 229 eyes). Pseudoexfoliation syndrome was bilateral in 62.2% (56/90) of cases. The mean age of those with PEX (63.7 ± 10.7 years) was significantly more than that of those without PEX (60.3 ± 9.2 years) (p = 0.01). The prevalence of PEX significantly increased with age (p = 0.02). Patients with hypermature cataract had significantly more PEX (p < 0.001). Mean IOP was significantly higher in eyes with PEX (18.4 ± 3.2 mmHg) than in those without PEX (15.8 ± 3.6 mmHg) (p < 0.001). Significantly more eyes in the PEX group had IOP > 21 mmHg (p < 0.01) and established glaucoma (p < 0.05). An incidence of PEX was found in all major ethnic groups in Ethiopia. There was no significant difference in the prevalence of PEX between the different ethnic groups (p > 0.5).

Conclusions: The prevalence of PEX among Ethiopian patients with cataract is high and occurs at a relatively younger age when compared to previous reports from Europe. Pseudoexfoliation syndrome has been found to be significantly associated with hypermature cataract, higher mean IOP, IOP > 21 mmHg and glaucoma. Population‐based studies are recommended to evaluate the prevalence of PEX in the general population and its association with cataract and glaucoma.
Colour blindness in everyday life and car driving
Authors: Tagarelli Antonio , Piro Anna , Tagarelli Giuseppe , Lantieri Pasquale Bruno , Risso Domenico , Olivieri Rosario Luciano
Published: December 2004

Purpose:  The aim of the present work was to ascertain, through the administration of a psychosocial questionnaire, the difficulties that subjects with defective colour vision experience in carrying out everyday tasks and work, including driving a car with a driver's licence held for no more than 3 years.

Methods:  Subjects with defective colour vision (n = 151) and subjects with normal vision (n = 302) completed a psychosocial questionnaire regarding the difficulties associated with congenital colour vision deficiency in daily life, work and driving a car. Subjects were diagnosed as colour‐blind using the Ishihara test.

Results:  Statistically significant differences between the two samples were found for daily life activities. Subjects with defective colour vision preferred daytime driving. At night, subjects with defective colour vision had difficulty identifying reflectors on the road and the rear signal lights of cars ahead of them.

Conclusion:  Colour‐blind Calabrian subjects admitted to experiencing colour‐related difficulties with a wide range of occupational tasks and leisure pursuits. In particular, colour‐blind Calabrian subjects preferred daytime driving, and fewer drove regularly, compared to orthochromatics, who were indifferent to night or daytime driving.
Comparison of survival of exfoliative glaucoma patients and primary open‐angle glaucoma patients: impact of acetazolamide use
Authors: Ritland J. S. , Egge K. , Lydersen S. , Juul R. , Semb S. O.
Published: December 2004

Purpose: To compare the survival rates of patients with exfoliative glaucoma (XFG) and those with primary open‐angle glaucoma (POAG), and to establish whether the use of acetazolamide has any influence on survival.

Methods: The survival data, including date and cause of death, for 1147 patients with XFG or POAG who were ultimately hospitalized at the Eye Department, National Hospital, Oslo, between 1961 and 1970, were analysed retrospectively. The Cox proportional hazard model was used in the survival analyses.

Results: No statistically significant differences in survival were found between patients with XFG and those with POAG (p = 0.85). As expected, female gender and younger age at diagnosis were associated with longer survival periods. Surprisingly, we found that patients with more recent birth dates had relatively lower survival rates than patients with earlier birth dates; when this was included in the analyses, the use of acetazolamide was found to be associated with reduced survival (n = 492, p = 0.02).
16S rDNA PCR analysis of infectious keratitis: a case series
Authors: Rudolph Thiemo , Welinder‐Olsson Christina , Lind‐Brandberg Lena , Stenevi Ulf
Published: December 2004

Purpose:  To discuss the value of polymerase chain reaction (PCR) in the management of bacterial infectious keratitis.

Methods:  Corneal scrapings of four patients with severe infectious keratitis were analysed by culture and PCR of 16S ribosomal DNA (rDNA), followed by direct sequencing of the resulting amplicon. The medical history of the patients included laser‐assisted in‐situ keratomileusis (LASIK), penetrating keratoplasty (PKP) and trauma.

Results:  Using PCR we were able to identify a possible pathogen in all four cases, while bacterial cultures were either negative or did not correspond to the clinical picture. The identified bacteria were a Pseudomonas species, Abiotrophia defectiva, Stenotrophomonas maltophilia and Porphyromonas gingivalis.

Conclusions:  Analysis of corneal scrapings by 16S rDNA PCR should be considered as a supplement to standard microbiological procedures. However, the results of this relatively new method have to be interpreted carefully.
Influence of microparticle formulation on immunogenicity of SYI, a synthetic peptide derived from Streptococcus mutans GbpB
Authors: Peacock Z. S. , Barnes L. A. , King W. F. , Trantolo D. J. , Wise D. L. , Taubman M. A. , Smith D. J.
Published: December 2004

Subcutaneous immunization with SYI, a peptide construct based on Streptococcus mutans glucan binding protein B (GbpB) residues 113–132, significantly reduces experimental dental caries. Since mucosal immunization may be preferred for human vaccine applications, the present objective was to determine what formulation of SYI combined with polylactide‐coglycolide microparticles could give rise to significant levels of salivary IgA antibody reactive with the native GbpB protein. A comparison of the SYI construct, loaded into or mixed with polylactide‐coglycolide revealed the SYI‐loaded microparticles to induce significant and sustainable levels of salivary and nasal wash IgA antibody to the peptide and the native protein. SYI mixed with unloaded microparticles was less effective in mucosal antibody response induction. These studies indicate that mucosal immunization with the SYI construct can induce salivary IgA antibody to a pathogenesis‐associated component of S. mutans if delivered within polylactide‐coglycolide microparticles, suggesting that this approach could successfully induce protective salivary immunity to dental caries caused by S. mutans.
Retinoic acid‐inducible gene‐I is induced by interleukin‐1β in cultured human gingival fibroblasts
Authors: Sakaki H. , Imaizumi T. , Matsumiya T. , Kusumi A. , Nakagawa H. , Kubota K. , Nishi N. , Nakamura T. , Hirashima M. , Satoh K. , Kimura H.
Published: December 2004

Retinoic acid‐inducible gene‐I (RIG‐I) is a member of the DExH box family protein, and details of its biological function are not known. We have studied the mechanism of the interleukin‐1β (IL‐1β)‐induced RIG‐I expression in human gingival fibroblasts in culture. We also addressed the possibility of enhanced expression of COX‐2, RANTES and galectin‐9 in fibroblasts overexpressed RIG‐I. We stimulated cultured human gingival fibroblasts with IL‐1β and examined the expression of RIG‐I mRNA and protein by reverse transcriptase‐mediated polymerase chain reaction and Western blot analysis. The effect of cycloheximide, a protein synthesis inhibitor, on the IL‐1β‐induced expression of RIG‐I was examined. The expression of COX‐2, RANTES, galectin‐9 and monocyte chemoattractant protein‐1 in gingival fibroblasts transfected with RIG‐I cDNA was also examined. IL‐1β stimulated the expressions of mRNA and protein for RIG‐I, in cultured fibroblasts, in a time‐ and concentration‐dependent manner. Cycloheximide did not suppress the IL‐1β‐induced RIG‐I expression. Introduction of RIG‐I cDNA into fibroblasts resulted in enhanced expression of COX‐2 mRNA, and slightly enhanced the expression of mRNA for RANTES and galectin‐9. In contrast, RIG‐I overexpression did not alter the level of mRNA for monocyte chemoattractant protein‐1. We conclude that IL‐1β stimulates RIG‐I expression in human gingival fibroblasts.
Recognition and phagocytosis of multiple periodontopathogenic bacteria by anti‐Porphyromonas gingivalis heat‐shock protein 60 antisera
Authors: Choi J.‐I. , Choi K.‐S. , Yi N.‐N. , Kim U.‐S. , Choi J.‐S. , Kim S.‐J.
Published: December 2004

The present study has been performed to evaluate Porphyromonas gingivalis heat shock protein (HSP) 60 as a candidate vaccine to protect against multiple putative periodontopathic bacteria. Mouse anti‐P. gingivalis HSP antisera demonstrated the elevated IgG antibody titers against the multiple bacteria tested and cross‐reacted with heat‐induced bacterial proteins of the target bacteria. The antisera also demonstrated a significantly higher opsonophagocytosis function against all the target bacteria than the control sera (P < 0.01). We concluded that P. gingivalis HSP 60 could potentially be developed as a vaccine against multiple periodontopathic bacteria.
Bone mineral status in children with cow milk allergy
Authors: Jensen Vagn Brændholt , Jørgensen Inger Merete , Rasmussen Kirsten Brændholt , Mølgaard Christian , Prahl Palle
Published: December 2004

To investigate bone mineral status in children with verified cow milk allergy for more than 4 yr compared with a large reference population of 343 local healthy controls. Whole body bone mineral content (BMC), projected bone area and bone mineral density (BMD) were determined by dual energy x‐ray absorptiometry in nine children (8–17 yr old, one girl and eight boys). All children had cow milk allergy for more than 4 yr. All children had asthma and was treated with corticosteroids. BMC and BMD were reduced for age (p < 0.01). Height for age was significantly reduced (p < 0.01), indicating ‘short’ bones. BMC for bone area was borderline reduced (p = 0.05), indicating reduced bone mineralization. The growth of the children was reduced compared with there parents and siblings (p < 0.01), and the bone age was retarded (mean 1.4 yr, p < 0.01). Calcium consumption calculated from food intake was about 25% of the recommended. All laboratory tests were normal. Short bones were the main reason for reduced BMC and BMD for age in children with cow milk allergy, but a borderline low BMC for bone area indicated reduced bone mineralization of the bones. A supplementation of calcium to children with cow milk allergy is recommended.
A randomized, single‐blind and crossover study of an amino acid‐based milk formula in treating young children with atopic dermatitis
Authors: Leung Ting Fan , Ma Kwok Chiu , Cheung Lorena T. F. , Lam Christopher W. K. , Wong Eric , Wan Helene , Hon Ellis K. L.
Published: December 2004

Cow's milk and soy protein allergies are commonly associated with atopic dermatitis (AD) in young children. Amino acid (AA)‐based elemental milk formula may improve AD control in these patients. This study investigates the efficacy of AA‐based formula in treating young AD patients irrespective of their food allergy status. AD patients younger than 3 yr old were eligible. Sensitization to food allergens was ascertained by skin prick tests and allergen‐specific immunoglobulin E (IgE) assay. Patients were then randomly allocated to take either active treatment or pre‐existing formulae (placebo) for 6 wk. They were allowed a 6‐wk washout period before crossed over to the other intervention for another 6 wk. Fifteen AD patients, with median (interquartile range, IQR) age of 1.4 (0.6–2.6) yr, were recruited. Their median (IQR) SCORAD score was 23.9 (10.5–29.7). Seven of them were sensitized to cow's milk or soybean. Among 11 patients who completed the study, the median changes for all scores and urinary eosinophil protein X (EPX) concentration were not statistically significant. There was also no evidence of carry‐over effects for SCORAD and its various components and global health score, except for urinary EPX concentration (p = 0.05). Our results do not support the use of AA‐based elemental milk formula in treating young children with AD irrespective of their food allergy status.
Asthma and allergic diseases in schoolchildren: third cross‐sectional survey in the same primary school in Ankara, Turkey
Authors: Demir Ahmet U. , Karakaya Gül , Bozkurt Bülent , Şekerel Bülent E. , Kalyoncu Ali F.
Published: December 2004

We investigated prevalence and determinants of asthma and allergic diseases in a cross‐sectional survey of schoolchildren aged 6–14 in 2002. This was the third of a series of cross‐sectional surveys, conducted in 1992 and 1997, in the same school in Ankara, Turkey. Questionnaire including information on house characteristics, dietary habits, past and current exposures and diseases were distributed to 1064 children (523 boys, 541 girls) and filled by the parents at home. Percentage of children having a pet was significantly higher (1992: 7.9, 1997: 22.9, 2002: 21), but that of passive smoking was significantly lower (1992: 74, 1997: 64, 2002: 64.1) in 1997 and 2002 when compared with 1992. Current prevalence percentage of asthma (1992: 8.3, 1997: 9.8, 2002: 6.4), wheeze (1992: 11.9, 1997: 13.3, 2002: 6.4), hay fever (1992: 15.4, 1997: 14.1, 2002: 7.2), and eczema (1992: 4, 1997: 4.3, 2002: 1.8) were significantly lower in 2002 compared with 1992. Multiple logistic regression analysis model for current wheeze included ingestion of cow's milk (no regular ingestion: reference, ORs and 95% CIs, <1 glass/day: 0.5, 0.3–1.0; at least 1 glass/day: 0.3, 0.2–0.7), ingestion of red meat (2.2, 1.2–3.8), and currently holding a dog (6.1, 1.6–23.4). Multiple logistic regression analysis model for current hay fever included ingestion of red meat (1.8, 1.1–2.9) and father's education (none of the parents finished secondary school: reference, secondary school to university: 0.5, 0.2–1.0). Our findings suggested that current prevalence of asthma and allergic diseases decreased among schoolchildren in Ankara, in the last 10 yr, and ingestion of milk and red meat could have a role in the occurrence of asthma and hay fever. Detailed assessment of dietary habits is required to test this hypothesis.
An occupational focus on falls with serious injury among older women in Australia
Authors: Mackenzie Lynette , Byles Julie , Mishra Gita
Published: December 2004

Falls prevention and recovery programs have been developed on a predominantly medical model of understanding falls risk. In this cross‐sectional study, data from 12 900 community‐dwelling women participating in the Australian Longitudinal Study on Women's Health were analysed using multiple stepwise regression to identify if factors related to occupational functioning were independently associated with participants who self‐reported serious falls (n = 655) in the previous year. Four variables were significantly associated with reports of serious falls: poor physical health summary scores (SF‐36); higher scores on a life events scale; higher scores on a ‘feeling dejected’ subscale; and taking medications for ‘nerves’. These variables are directly connected with occupational functioning, and were significantly associated with serious falls despite medical falls risk factors being included in the regression model. Results indicate a need to address the occupational background of participants in the design and delivery of both falls injury prevention and falls recovery programs, especially for community‐dwelling women.
Cloning and characterization of the tomato karyopherin α1 gene promoter
Authors: Mizrachy Liat , Dabush David , Levy Yael , Aloni Roni , Altman Arie , Gafni Yedidya
Published: December 2004

The karyopherin α1 (LeKAPα 1) gene of tomato (Lycopersicon esculentum) encodes a receptor involved in nuclear import. To analyze the expression pattern of this gene, a genomic clone containing its upstream region was isolated and sequenced. To study the promoter functionality, a 2170 bp fragment (LM1), was fused to glucuronidase (GUS) and introduced into petunia cells by particle bombardment. For further characterization of the promoter, one inverse and three deletion constructs were studied in cell suspension. To follow its expression in tobacco leaves, transgenic plants expressing GUS under the control of the LM1 promoter were made. Expression of LM1–GUS was largely restricted to actively growing leaf regions, suggesting possible involvement of active cell division and plant growth regulators in LeKAPα 1 expression.
Successful reconstitution of the non‐regenerating adult telencephalon by cell transplantation in Xenopus laevis
Authors: Yoshino Jun , Tochinai Shin
Published: December 2004

The South African clawed frog (Xenopus laevis) can regenerate the anterior half of the telencephalon only during larval life, but such regeneration is no longer possible after metamorphosis. In order to gain a better understanding of differences between larvae and adults that are potentially related to regeneration, several experiments were conducted on larvae and froglets after the partial removal of the telencephalon. As a result, it was found that the cells in the brain proliferated actively, even in non‐regenerating froglets, just as was observed in regenerating larvae after the partial removal of the telencephalon. Moreover, it was shown that although the structure was usually imperfect, even isolated single cells derived from the frog brain were able to reconstitute the lost portion when the cells were transplanted to the partially truncated telencephalon. It is therefore likely to be critical for massive organ regeneration that ependymal layer cells promptly cover the cerebral lateral ventricles at an initial stage of wound healing, as is the case observed in larvae. However, in froglets, these cells strongly adhere to one another, and they are therefore unable to move to seal off the exposed ventricle, which in turn is likely to render the froglet brain non‐regenerative.
Potential errors and their prevention in operating room teamwork as experienced by Finnish, British and American nurses
Authors: Silén‐Lipponen Marja , Tossavainen Kerttu , Turunen Hannele , Smith Ann
Published: December 2004

This study describes how the potential sources of errors and error prevention in operating room (OR) teams are experienced by Finnish, American and British nurses. The data were collected by interviews and analysed using a qualitative content analysis. Results consisted of categories demanding teamwork practice, shared responsibility in teams and organized teamwork. The demanding practice category included fear of errors, turnover in teams, overtime work and emotional distress as potential factors leading to errors in OR teamwork. Shared responsibility emphasized how the familiar teams, safety control and formal documentation of errors prevented errors. At the organizational level, the prevention of errors required scheduling of work, good management, competency and a reasonable physical environment. In order to improve safety in OR teams, recognition should be given to the balance of error‐making and learning from them. More effective ways in reporting incidents should be adopted and overall reporting systems should be developed in Finnish OR teams.
Arterial flow induces changes in venous endothelium which are modified by calcium channel blockers
Authors: Golledge Jonathan
Published: December 2004

Introduction:  Adaptation of saphenous vein to arterial flow may be critical to the results of bypass. The present paper summarizes work recently presented as a Hunterian Lecture. Work includes in vitro investigation of the response of saphenous vein endothelium to arterial flow and assessment of its clinical importance using a cohort of patients undergoing vein bypass surgery.

Methods:  Freshly excised human saphenous vein segments were placed in an in vitro flow circuit to simulate arterial and venous flow conditions. Changes in the endothelial expression of proteins were assessed using a combination of immunohistochemistry and Western blotting. The role of ion channels in the changes seen induced by arterial flow in the saphenous vein endothelium was assessed by addition of ion channel blocking medication to the medium perfusing vein segments. A cohort of patients undergoing vein bypass surgery were followed to assess graft patency and the influence of prescribed medication on its outcome.

Results:  After arterial flow conditions, the staining area for the endothelial adhesin ICAM‐1 and nitric oxide synthase were increased, while that of the anticoagulant protein thrombomodulin was decreased. The concentration of the important stimulant of the clotting cascade tissue factor was unaffected by arterial flow. These changes were modulated by the addition of ion channel blocking drugs to the vein perfusate. In particular, nifedipine abolished the reduction in thrombomodulin, but increased the amount of tissue factor. In a series of 236 patients undergoing primary infra‐inguinal vein grafts, prescription of calcium channel blocker was associated with improved primary patency.

Conclusions:  Important changes in the venous endothelium are induced by arterial flow. Ion channel blocking drugs have the potential to modulate these responses.
Colorectal cancer patterns of care in the Western Sydney and Wentworth Area Health Services
Authors: Barton Michael B. , Gabriel Gabriel Sam , Miles Sharon
Published: December 2004

Introduction:  Colorectal cancer is a leading cause of morbidity and mortality in Australia. Recent clinical trials show that the recurrence of colorectal cancer decreases with chemotherapy and/or radiotherapy in advanced disease. The present study aimed to document the patterns of care by the type of treatment, document the preoperative investigations and provide results to the Area Health Services.

Methods:  A prospective data collection was initiated in May 1994 and ended in May 1996 in the Western Sydney and Wentworth Area Health Services of New South Wales. Deaths and recurrences were followed up until July 2002.

Results:  There were 253 colon cancers, 107 rectal cancers and 10 patients with tumours in both the colon and rectum. Forty‐one surgeons performed 299 curative procedures with 78% of them performing one to four procedures annually. One hundred and twenty‐two patients had non‐fatal complications and six (2%) died postoperatively. Twenty‐eight per cent of rectal cancer patients underwent abdomino‐perineal resection and 56% underwent low anterior resection. Forty‐five per cent of rectal cancer patients and 51% of colon cancer patients who were potentially eligible received appropriate adjuvant therapy. Ninety‐one per cent of patients who received chemotherapy had no or mild toxicity. By the end of follow‐up period, 30% of rectal cancer patients and 24% of colon cancer patients had developed recurrence. At last follow up, 197 patients had died. Median overall survival from time of diagnosis was 73 months. Overall 5‐year survival for colonic and rectal cancers was 50% and 57%, respectively. For the 299 patients who had curative procedures, the 5‐year survival was 63% and 62% for colonic and rectal cancers, respectively.

Conclusion:  Colorectal cancer patients who were eligible for and received adjuvant therapy had significantly better survival. Rectal cancer patients whose tumours only required low anterior resection had a better survival than those who needed an abdomino‐perineal resection. High‐volume surgeons have less postoperative complications than low‐volume surgeons. The high proportion of late presentations seen in colon cancer patients supports the need for screening to improve early detection.
Complications of intercostal catheter insertion using EMST techniques for chest trauma
Authors: Heng Kenneth , Bystrzycki Adam , Fitzgerald Mark , Gocentas Robert , Bernard Stephen , Niggemeyer Louise , Cooper David James , Kossmann Thomas
Published: December 2004

Background:  The purpose of the present study was to determine the complication rates associated with intercostal catheter insertion (ICI) performed using Early Management of Severe Trauma (EMST) guidelines on trauma patients admitted through The Alfred Trauma Centre.

Methods:  The Alfred Trauma Registry identified demographic and clinical data for patients who underwent ICI in the Alfred hospital following admission for trauma. The medical histories were subsequently reviewed for complications resulting from ICI.

Results:  There were 211 ICI performed on 173 trauma patients at The Alfred Trauma Centre between July 2001 and June 2002. The mean injury severity score was 34. Mean age was 38 (range 15−82 years), with 77% of the patients being men. Chest injury was the result of blunt trauma in 90.2% and penetrating trauma in 9.8%. ICI occurred in the Trauma Centre (84%), operating theatre (6%), intensive care unit (9%) and in the general ward (1%). Eighty per cent of patients had a unilateral ICI. The indications for ICI were pneumothorax (45.7%), haemothorax (15.0%), haemopneumothorax (28.3%) and tension pneumothorax (7.5%). There were no insertional and 11 (5.2%) positional complications. The infection rate was 2.4% comprising two superficial and three deep (empyema thoraces) infections. No statistically significant association was found between infective complications and age, injury severity score (ISS), haemothorax, penetrating trauma, prehospital needle thoracostomy and time to ICI. There was no mortality arising from ICI complications.

Conclusion:  Intercostal catheter insertion for chest trauma performed in accordance with EMST guidelines has a low complication rate. Prehospital prophylactic chest decompression for ventilated patients with chest trauma, using a lateral rather than an anterior approach, may decrease the incidence of untreated tension pneumothorax.
Laparoscopic adrenalectomy for phaeochromocytoma: with caution
Authors: Thomson Benjamin N. J. , Moulton Carol‐Anne , Davies Michael , Banting Simon W.
Published: December 2004

Introduction:  Laparoscopic adrenalectomy is well described and many series include patients with phaeochromocytoma. Our aim was to establish whether laparoscopic adrenalectomy for phaeochromocytoma was a safe and feasible technique at our institution.

Methods:  Patients requiring adrenalectomy were entered into a prospective database that included patient details, operative data, hormone excretion, tumour size, hospital stay and complications. All operations were performed under the supervision of a single surgeon. Analysis was performed for those patients with a diagnosis of phaeochromocytoma.

Results:  Of 60 patients having laparoscopic adrenal surgery, 18 had phaeochromocytoma as the indication. Seventeen (89%) of 19 tumours in these 18 patients were successfully removed laparoscopically. Median operative time was 180 min (range 130−300 min) and this was significantly longer compared with other adrenal pathology. The median tumour size was 6 cm which was significantly larger than other adrenal tumours. Seven (38%) patients developed complications and median postoperative inpatient stay was 5 days (range 3−8 days).

Conclusions:  The postoperative stay was equivalent to other laparoscopic series and laparoscopic removal was successful in 89%. The laparoscopic approach to the adrenal gland in phaeochromocytoma is safe and effective treatment.
Effect of total hip arthroplasty on recreational and sporting activity
Authors: Chatterji Urjit , Ashworth Mark J. , Lewis Peter L. , Dobson Peter J.
Published: December 2004

Background: Common concerns of patients undergoing total hip arthroplasty are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present paper describes preoperative and postoperative activities, the numbers participating and the time to resume these activities.

Methods: Between 1 and 2 years after total hip arthroplasty, 216 patients, who had undergone a total of 235 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability. Their preoperative and postoperative activity along with the time to resume was recorded. A general hip score and estimate of physical activity was also collected.

Results: The number of patients participating in sport increased from 188 preoperatively to 196 postoperatively. Patients stated that the surgery had a beneficial effect on their performance of sporting activities although the number of sporting events decreased. By multiplying individuals by the number of sports they participated in, there were 434 occurrences of sport preoperatively giving a mean for the group of 1.9 sports per patient. Postoperatively this had reduced to 382, giving a mean of 1.7. Five sports showed a significant change for individual patients from pre to postoperation. Those which showed an increase were exercise walking, where 38 patients (16.8%) who did not walk before surgery took up walking afterwards (P < 0.0001) and aqua aerobics, where 15 took up this activity postoperatively for the first time (P = 0.002). There were three sports which decreased significantly from pre to postoperation. They were, golf where 13 out of 39 (P = 0.005), tennis 13 out of 14 (P = 0.01) and jogging where six out of seven (P = 0.01) patients stopped participating.

Conclusion: This study has shown that patients are adopting lower impact activities to participate in after total hip arthroplasty. The total number of patients performing a sport increases postoperatively but the total amount of sport played decreases. These data will help to counsel patients.
Indications for operative management of abdominal aortic aneurysms
Authors: Shakibaie Faraz , Hall John C. , Norman Paul E.
Published: December 2004

The increasing incidence of abdominal aortic aneurysms, along with the more frequent use of screening techniques, has resulted in greater numbers of patients with small abdominal aortic aneurysms. The questions of frequency of surveillance and timing of intervention are the two most controversial issues faced by surgeons dealing with this condition. Most management decisions are based on the size of the aneurysm but other factors must also be considered. This review makes recommendations on the management of small abdominal aortic aneurysms according to the current available evidence.
Cancer: communicating in the team game
Authors: Boyle Frances M. , Robinson Emma , Heinrich Paul , Dunn Stewart M.
Published: December 2004

There is increasing evidence that effective communication is a critical means by which surgeons can assist their patients to achieve the best outcomes. This paper examines the processes and outcomes of effective communication by surgeons in cancer teams, and includes: (i) strategies that promote collaborative relationships with patients and lead to more effective treatment; (ii) strategies to improve multidisciplinary team performance; and (iii) methods to minimize the risk of error and litigation. The experience of a cancer diagnosis involves radical changes in patients’ lives, somewhat akin to suddenly finding yourself in the middle of a rugby scrum for the first time. The analogy of rugby throws fresh light on such critical factors in communication as prematch preparation, orientation to the game and the team, a good kick off, sizing up the opposition, creative plays and optimizing teamwork to promote quality of life and survival.
Emergency sclerotherapy for control of acute oesophageal variceal bleeding using 3% aqueous phenol: a 15‐year experience
Authors: Desai Chirag S. , Shah Sudeep R. , Mathur S. K.
Published: December 2004

Background:  The purpose of the present study was to compare the efficacy of emergency endoscopic variceal sclerotherapy (EVS) using 3% aqueous phenol as an initial procedure to control acute oesophageal variceal bleed.

Methods:  One hundred and ninety‐five consecutive patients presenting with acute variceal bleed were included in the study. Protocol based endoscopic sclerotherapy and management of bleeding oesophageal varices was done. Immediate cessation of bleeding, re‐bleeding within the first 72 h, success of first injection, final success of EVS, short‐term mortality, influence of aetiology of portal hypertension and severity of liver disease on these results were studied.

Results:  Immediate cessation of bleeding was obtained in 191 out of 195 patients (97.9%). Twenty‐seven (13.8%) patients re‐bled within 72 h. On re‐injection final success of EVS was 87.2% (170/195 patients). There was no significant difference between final success rate in cirrhotic versus non‐cirrhotic patients (103/118 (87.3%) vs. 67/77 (87%)). Success of first sclerotherapy session was significantly higher than that of second sclerotherapy session. Surgical rescue was required in 25 (12.8%) patients. Mortality was 3.6%. Failure of EVS and mortality was significantly higher in Child's C group (P = 0.04, Relative risk = 0.5, confidence interval 0.22−1.16).

Conclusion:  EVS remains an effective and cost effective modality of treatment to control acute variceal bleeding irrespective of aetiology of portal hypertension provided strict protocol based management is followed. With timely surgical rescue for the failures, the overall mortality can be reduced to less than 5%.
Quantifying symptoms in men with interstitial cystitis/prostatitis, and its correlation with potassium‐sensitivity testing
Authors: Parsons C. Lowell , Rosenberg Matt T. , Sassani Pejvak , Ebrahimi Kamyar , Koziol James A. , Zupkas Paul
Published: December 2004

OBJECTIVE

To determine whether men previously diagnosed with prostatitis also have pathology originating in the bladder.

PATIENTS, SUBJECTS AND METHODS

We administered the pelvic pain and urgency/frequency (PUF) questionnaire and the potassium‐sensitivity test (PST) to 50 patients with prostatitis presenting in urological and primary care, and to 14 controls. In a separate control group of 22 men, the urethra was irrigated with KCl or NaCl (11 each) before and after experimental injury of the urethral mucosa.

RESULTS

All 50 patients with prostatitis had PUF scores of ≥ 7; 77% were positive for the PST. All 14 controls had PUF scores of 1 or 0 and a negative PST. In the urethral irrigation study in controls, KCl but not NaCl provoked urethral pain after mucosal injury. Before injury, neither KCl nor NaCl caused symptoms.

CONCLUSION

The high rate of positive PST in patients with ‘classic’ prostatitis indicates that pathology originating in the bladder may be an important source of symptoms in most. In patients with prostatitis and female patients with interstitial cystitis, symptoms may arise not from separate disease entities but from a continuum of epithelial dysfunction and potassium cycling that may be present throughout the lower urinary tract.
Groin pain after a tension‐free vaginal tape or similar suburethral sling: management strategies
Authors: Duckett Jonathan R.A. , Jain Smita
Published: December 2004

OBJECTIVE

To review different treatment strategies for women with groin pain after tension‐free vaginal tape (TVT) or similar suburethral sling procedures.

PATIENTS AND METHODS

The series comprised 450 women who had a TVT procedure, with a follow‐up of 3–50 months. Five women (1%) reported significant groin pain and were offered further treatment. In addition, one woman was referred from another centre and received treatment.

RESULTS

Women with pain were initially treated conservatively, and in most the pain resolved and required no further treatment. Persistent or severe discomfort was treated with a combined steroid (methyl prednisolone, 2 mL, 80 mg) and local anaesthetic (bupivacaine, 10 mL, 0.5%) injection in four women. There were no side‐effects from the treatment. One woman was relieved of her pain and required no further treatment. In one woman the local injections failed to improve her symptoms but the pain was not severe enough to warrant further treatment. Two women developed recurrent pain after an initially successful injection, and in these women the TVT was excised. One woman referred from another centre was primarily treated with TVT excision. In the three women treated with distal tape excision, the mean pain scores decreased from 8.7 before excision to 0.7 afterward. One woman is awaiting tape excision.

CONCLUSION

If conservative management fails to relieve the symptoms of groin pain it can be treated by injecting a mixture of steroid and local anaesthetic. However, local injection failed to provide long‐term relief in three of four women. More severe symptoms might require TVT mesh dissection and excision, which provided significant pain relief.