bluuebunny/crossref_metadata_2025_split huggingface dataset:
LVAD Inflow Cannula Covered with a Titanium Mesh Induces Neointimal Tissue with Neovessels
Authors: Miyamoto Takuma , Nishinaka Tomohiro , Mizuno Toshihide , Tatsumi Eisuke , Yamazaki Kenji 
Published: August 2015

Background Thrombus formation at the interfaces of inflow cannulas and left ventricular apexes is considered to be one of the predominant sources of thromboembolic complication. Use of a fine titanium mesh-covered inflow cannula is expected to prevent such thrombus formation by inducing neointimal tissue around the cannula. Methods Titanium pins (20 mm long, 3 mm diameter) covered with a fine titanium mesh (wire dia. 85 μm; volumetric porosity 40–70%) were developed to mimic the inflow cannulas of left ventricular assist devices (LVADs). Smooth-surface pins of the same size were also designed. The pins were implanted into the left ventricular apexes of rabbits. The rabbits were bled without anticoagulation for between 1 week and 1 year. The tissues around the pins were evaluated histologically. Results 28 rabbits (mesh group, 15; smooth group, 13) were evaluated. The mesh-covered pins inhibited thrombus formation to a remarkable degree throughout the entire observation period. The tissues around the mesh-covered titanium pins appeared to be in the process of conversion from thrombus formation to granulation, resulting in the replacement of fibrotic tissue containing myofibroblasts with endothelialized and angiogenic tissue. On the surface of the mesh-covered pins, endothelial cells were arranged without platelet adhesion. The tissue formed around the smooth-surface pins was partially organized into a thrombus without angiogenesis. Conclusions The titanium-mesh surface modification prevented thrombus formation with formation of neointimal tissue with endothelialization and angiogenesis. This surface modification could prevent wedge thrombus formation among patients supported by LVADs.
A comparison of mammography, ultrasonography, and far-infrared thermography with pathological results in screening and early diagnosis of breast cancer
Authors: Yao Xiaoli , Wei Wen , Li Juanjuan , Wang Lijun , Xu ZhiLiang , Wan Yingwen , Li Kaiyang , Sun Shengrong 
Published: August 2015

Abstract
Background: Many breast-imaging techniques have been developed as primary clinical methods for identifying early-stage breast cancers and differentiating them from benign breast tumors. For the large population of China, any screening method that is rapid, economical, and accurate is worthy of evaluation.
Objective: To compare the effectiveness of mammography, color Doppler ultrasonography, and far-infrared thermography in the screening and early diagnosis of breast cancer.
Methods: Data from 2036 women with breast disease between January 2007 and May 2011 were included in this study. All patients underwent mammography, ultrasonography, and far-infrared thermography imaging. The diagnostic accuracy of the three methods was determined using postoperative pathological results as the diagnostic criterion standard.
Results: There were 480 patients found to have breast malignancies on pathological examination. The lesion diameter was <2 cm in 853 cases. Among them, breast cancer was found in 73 patients and carcinoma in situ in 22 patients. There was no difference in the accuracy of mammography and ultrasonography (96.1% versus 95.8%). However, there were significant differences between the accuracy of far-infrared thermography (97.1%) and ultrasonography and mammography. The sensitivity and specificity of far-infrared thermography was superior to that of mammography and ultrasonography in lesions <2 cm in diameter.
Conclusion: Far-infrared thermography is more accurate for breast cancer screening than ultrasonography and mammography for lesions <2 cm. It has comparable diagnostic accuracy to ultrasound and better diagnostic accuracy than mammography for lesions >2 cm in diameter.
Early decompressing craniectomy in patients with traumatic brain injury and cerebral edema
Authors: Gong Jiang-Biao , Wen Liang , Zhan Ren-Ya , Zhou Heng-Jun , Wang Fang , Li Gu , Yang Xiao-Feng 
Published: August 2015

Abstract
Background: Decompressing craniectomy (DC) is an important method for the management of severe traumatic brain injury (TBI).
Objective: To analyze the effect of prophylactic DC within 24 hours after head trauma TBI.
Methods: Seventy-two patients undergoing prophylactic DC for severe TBI were included in this retrospective study. Both of the early and late outcomes were studied and the prognostic factors were analyzed.
Results: In this series, cumulative death in the first 30 days after DC was 26%, and 28 (53%) of 53 survivors in the first month had a good outcomes. The factors including Glasgow Coma Score (GCS) score at admission, whether the patient had an abnormal pupil response and whether the midline shift was greater than 5 mm were most important prognostic factors for the prediction of death in the first 30 days and the final outcome at 6 months after DC.
Conclusion: Prophylactic DC plays an important role in the management of highly elevated ICP, especially when other methods of reduction of ICP are unavailable.
Unusual clinical manifestations of dengue infection in children in a tertiary care hospital in northeast Thailand
Authors: Duangmala Tanaporn , Lumbiganon Pagakrong , Kosalaraksa Pope 
Published: August 2015

Abstract
Background: Dengue virus infection has been a public health concern in Thailand. In the past decades, there has been recent interest concerning unusual clinical manifestations in both dengue fever (DF) and dengue hemorrhagic fever (DHF).
Objective: We described the unusual clinical manifestations and outcomes of children with dengue admitted to a tertiary care hospital in northeast Thailand.
Materials and Methods: A study was conducted on the 73 patients with serologically confirmed dengue infection admitted to Srinagarind Hospital, a tertiary care facility in northeast Thailand between January 2007 and August 2011.
Results: Of the 73 children examined, 42 (57%) were boys and 31 were girls. Their age ranged from 8 months to 14 years (median 11 years). Nine patients developed neurological symptoms, 6 patients had altered consciousness, and 3 patients convulsion. Among 9 patients with neurological symptoms, 1 patient had acute kidney injury, 1 had hepatic failure, and 1 had kidney and liver involvement, mostly associated with fluid resuscitation or prolonged shock. Apart from neurological symptoms, one patient developed infection associated hemophagocytic syndrome and was treated with intravenous immunoglobulin. Two patients died from multiple organ failure, and 1 patient was brought back home in a moribund condition. The other patients recovered completely.
Conclusion: Altered consciousness was the most commonly observed unusual neurological manifestation. Patients who did not develop acute kidney injury or liver failure had mild clinical courses and recovered from neurological symptoms without sequelae. Acute kidney injury was associated with fluid overload and/or prolonged shock. Careful fluid management and close monitoring for complications resulted in favorable outcomes.
Delayed presentation of congenital tibial pseudarthrosis and neurofibromatosis: a difficult union
Authors: Hatton Maxim J. , Ly Tho , Noor Saqib , Gollogly James G. 
Published: August 2015

AbstractBackground: A new case of congenital pseudarthrosis of the tibia (CPT) presents yearly to CSC, but treatment is prolonged, and not always successful.Objective: To study the outcomes of treatment, and to determine whether a relationship with neurofibromatosis (NF) was of significance.Methods: A review of the medical records at our centre revealed 11 cases of CPT, 5 of which were associated with neurofibromatosis.Results: Most patients had multiple operations for their case of CPT, which did finally lead to union in 6 out of 6 cases with no NF, but in only 1 case out of 5 when NF was present.Conclusion: Late presentation and severe deformity can be overcome, and union can be achieved, but NF has a deleterious effect on obtaining union.
Risk factors of delirium in elderly patients with hip fracture
Authors: Suwanpasu Sunee , Grinslade Susan , Wu Yow-Wu B. , Porock Davina 
Published: August 2015

Abstract
Background: Delirium is a leading cause of death and disability in the elderly with hip fracture. Identifying reliable risk factors for delirium is critical to support optimal outcomes for prevention and reducing delirium.
Objective: To quantify the reported factors associated to delirium for patients with hip fracture.
Methods: Electronic databases were searched (including Medline, Pub Med, CINAHL, EMBASE, Evidence Based Medicine Reviews, Cochrane Review, Web of Science, and PsycINFO) to identify all studies, published in English language that evaluated the risk factors of delirium hospitalized people with hip fracture. Two reviewers independently assessed methodology quality and extracted relevant data. The data from the included studies were summarized, and pooled estimates were calculated for 12 risk factors.
Results: Thirty-seven studies were included in the review and 25 in the meta-analysis. The incidence of delirium was 32.4% (95% confidence interval [CI] = 25.9%-39.5%). Six predisposing and four precipitating factors predicted delirium among older patients with hip fracture confirmed. The predisposing factors included advanced age (ES = 1.06, 95% CI = 1.03-1.09), male sex (ES = 1.34, 95% CI = 1.08-1.68), impairment of cognition (ES = 2.91, 95% CI = 1.91-4.42), and function (ES = 1.75, 95% CI = 1.39-2.2), comorbidity (ES = 1.59, 95% CI = 1.30-1.96), and health problems (ES = 2.64, 95% CI = 2.04-3.42). Precipitating factors were hypo- or hypernatremia (ES = 1.73, 95% CI = 1.14-2.64), depression (ES = 4.07, 95% CI = 1.95-8.49), more than three prescribed drugs (ES = 1.28, 95% CI = 1.10-1.49), and drugs including opioids (ES = 2.13, 95% CI = 1.42-3.18) and anticholinergic agents (ES = 2.10, 95% CI = 1.60-2.75).
Conclusion: This meta-analysis result provides evidence that these risk factors have a significant impact on delirium in elders with hip fracture during hospitalization. Developing formal screening, and effective preventive and management strategies for delirium is important.
Molecular mechanisms for NG-nitro-L-arginine methyl ester action against cerebral ischemia–reperfusion injury-induced blood–brain barrier dysfunction
Authors: Wang Hanghui , Song Yixin , Hao Dingjun , Du Lianfang 
Published: August 2015

Abstract
Background: Ischemic stroke, an acute neurological injury lacking an effective therapy, is a leading cause of death worldwide. The unmet need in stroke research is to identify viable therapeutic targets and to understand their interplay during cerebral ischemia-reperfusion (I/R) injury.
Objective: To explore the protective effects and molecular mechanism of NG-nitro-L-arginine methyl ester (L-NAME) in cerebral ischemia-reperfusion injury-induced blood-brain barrier (BBB) dysfunction.
Methods: Two hundred fifty-six rats were randomly assigned to a sham operation group, I/R group, and I/R with L-NAME treatment group. Brain water content was determined by calculating dry/wet weight. The permeability of the BBB was observed using an electron microscope and by determining the Evans Blue leakage from brain tissue on the ischemic side. The expression of brain MMP-9 and GFAP was determined using an immunohistochemical method. The expression of ZO-1 protein was determined by western blotting.
Results: We found that L-NAME remarkably attenuated the permeability of the BBB after I/R as assessed by Evans Blue leakage and brain water content (p < 0.05). This was further confirmed by examination of the ultrastructural morphology of the BBB using a transmission electron microscope. Furthermore, we found that expression of the zonae occludens-1 (ZO-1) was decreased in endothelial cells, and expression of MMP-9 and GFAP was increased in the basement membrane and astrocyte end-feet in vehicle control groups, respectively, but these changes could be prevented by L-NAME pretreatment.
Conclusion: These results suggested that the neuroprotective effects of L-NAME against BBB damage induced by I/R might be related to the upregulation of tight junction proteins and inhibition of MMP-9 and GFAP expression. L-NAME can be used as a potential MMP-9-based multiple targeting therapeutic strategy in cerebral I/R injury.
Acute effect of Russell’s viper (Daboia siamensis) venom on renal tubular handling of sodium in isolated rabbit kidney
Authors: Chaiyabutr Narongsak , Vasaruchapong Taksa , Chanhome Lawan , Rungsipipat Anudep , Sitprija Visith 
Published: August 2015

Abstract
Background: The common complication in cases of poisoning by Russell’s viper (Daboia siamensis) venom (RVV) is acute renal failure, but the pathogenesis involved in the alteration of kidney function is still not well understood.
Objective: To clarify the role of RVV in the pathogenesis of renal damage, the present study examines the functional short-term alterations acutely induced by RVV in isolated perfused rabbit kidney.
Methods: Effects of RVV on renal tubular handling of sodium including mean perfusion pressure (PP), the renalvascular resistance (RVR), the glomerular filtration rate (GFR), the urinary flow (V) and osmolar clearance (Cosm) were studied in two groups of isolated perfused rabbit kidneys; each group had four isolated rabbit kidneys. RVV was added to the perfusion system to obtain the final concentration of 10 ⃞g/ml.
Results: Immediate decreases in PP and RVR caused by the venom were significantly apparent (p < 0.05) in the first 15 min after RVV administration. A gradual rise in both PP and RVR occurred 15 min after the initial reduction of the first phase, but its remained below pretreatment values. The GFR, V, and Cosm decreased significantly throughout experiments after venom perfusion (p < 0.05). The total fractional sodium excretion increased significantly after venom perfusion throughout experiments, while significant reductions (p < 0.05) of renal tubular handling of sodium were apparent for proximal absolute reabsorption of sodium and proximal fractional reabsorption of sodium including marked reductions of distal absolute reabsorption of sodium and distal fractional reabsorption of sodium of the venom treated kidney. Optical microscopy of treated kidney tissue showed acute tubular necrosis at the end of experiment.
Conclusion: The present study suggests that an administration of RVV in the isolated rabbit kidney causes direct acute nephrotoxicity and acute alterations of main functional parameters that are probably mediated by either the direct action of venom components or an indirect effect from vasoactive mediators released from renal cells of the RVV-treated kidney.
Precipitating causes and outcomes of chronic obstructive pulmonary disease exacerbation at a tertiary care center in northeast Thailand
Authors: Reechaipichitkul Wipa 
Published: August 2015

Abstract
Background: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a leading cause of hospitalization and economic burden. Frequent exacerbations impair quality of life and effect decline of lung function.
Objective: We evaluated characteristics of COPD patients with frequent exacerbations. The precipitating causes, outcomes, hospital stay, and cost of admission were also determined.
Methods: The study population included COPD patients admitted because of acute COPD exacerbation at Srinagarind Hospital between 1 January 2006 and 31 December 2010.
Results: Over the 5-year period, 183 patients were admitted. Their mean age was 74.9 (SD 9.28) years and the male to female ratio was 170:13. Most patients (144; 79%) had one exacerbation per year and 39 (21%) had more than one per year. The group with more exacerbations, had a higher stage of the disease than those with only one exacerbation (p = 0.023), but there was no significant difference in the mortality rate (18% vs 14%, p = 0.53). A total of 245 episodes of acute exacerbation of COPD occurred in 183 patients. The mean duration of symptoms was 4.1 (SD 3.46) days. Forty-seven percent presented with Anthonisen type III, 42.4% with Anthonisen type II, and 10.6% with Anthonisen type I exacerbations. For 44 exacerbations (18%), the precipitating causes were not determined. The most common precipitating cause was pneumonia, which occurred in 90 episodes (36.7%). The second common was bronchitis (27.8%); followed by heart failure (8.2%), infected bronchiectasis (5.3%), diarrhea (1.2%), acute urinary retention (0.8%), unstable angina (0.4%), pneumothorax (0.4%), urinary tract infection (0.4%), atrial fibrillation (0.4%) and drug induced cough (0.4%). The organisms responsible for respiratory tract infection were identified in 31% cases of pneumonia and 18% of bronchitis cases. The top three common pathogens for pneumonia were Pseudomonas aeruginosa (9%), Acinetobacter baumannii (8%), and Klebsiella pneumoniae (8%). The top three common pathogens for bronchitis were P aeruginosa (7%), Haemophilus influenza (6%), and K pneumoniae (4%). About one quarter (25.3%) of acute exacerbations were complicated by respiratory failure. The mean duration of admission was 17.3 days (range 1-682 days). The mean cost of admission per exacerbation was 80,010 Thai baht (US $2,666) (range, 2,779-3,433,108 baht). The total cost for 245 exacerbations was 19.6 million baht ($653,000).
Conclusion: Respiratory tract infections were common causes of COPD exacerbation and one quarter of which developed respiratory failure. Preventive measures such as vaccination, smoking cessation, lung rehabilitation, and appropriate drug use are helpful.
Bioequivalence study of cefepime intramuscular injection
Authors: Jullangkoon Monchana , Jaruratanasirikul Sutep , Aeinlang Nanchanit 
Published: August 2015

Abstract
Background: Cefepime, a fourth generation cephalosporin, is a broad spectrum antibiotic effective against both Gram positive and Gram negative bacteria. It is available from several pharmaceutical firms in southeast Asia. We studied bioequivalence of two products.
Objective: To assess the bioequivalence of two cefepime formulations: Cefamax 1 g intramuscular (Siam Pharmaceutical, Bangkok, Thailand) as the test formulation and Maxipime 1 g (Bristol-Myers Squibb, Bangkok, Thailand) as the reference formulation.
Methods: The study was conducted as an open, randomized, two-period crossover trial with a 1 week washout period in 18 healthy volunteers. Each subject received a single dose of 1 g intramuscular injection of the test or reference formulation. Blood samples were collected via an intravascular catheter at several time points over a 12 h period. Plasma cefepime concentrations were quantified by HPLC with photodiode array detection at 280 nm. The statistical comparisons for pharmacokinetic parameters were made using a paired t test.
Results: There was no significant difference in the logarithmically transformed values of Cmax, AUC0-12, and AUC0-∞ between Cefamax and Maxipime using an analysis of variance (ANOVA). The 90% confidence intervals (CIs) of Cmax, AUC0-12, and AUC0-∞ between the two formulations were 91.17-105.78, 90.29-97.63, and 88.89-96.57, respectively. All subjects had good tolerance and no serious adverse events were observed.
Conclusion: Cefamax 1 g intramuscular formulation is bioequivalent to Maxipime 1 g intramuscular formulation based on 90% CIs for Cmax, AUC0-12, and AUC0-∞ within 80%-125%.
Surveillance of marine fish for ciguatera toxin at fish markets in Bangkok, Thailand
Authors: Sintunawa Chirapol , Wacharapluesadee Supaporn , Saraya Abhinbhen , Hemachudha Thiravat 
Published: August 2015

Abstract
Background: Ciguatera intoxication is a form of food poisoning. It is caused by the consumption of certain warm-water fish that have accumulated ciguatera toxin (CTX) through the marine food chain. Ciguatera fish poisoning (CFP) is a global disease, which although common, has been largely ignored in Thailand. This may be attributed to lack of confirmatory tests and seemingly nonspecific clinical presentations.
Objective: We studied CTX contamination in marine fish sold at Bangkok markets.
Methods: A surveillance of CTX in fish using the Cigua-Check assay has been conducted in Bangkok, the center of seafood marketing in Thailand. Here, there are several types of fish. Some come from domestic fishing and others are imported from Indonesia, Myanmar, or India.
Results: A random survey at three fish markets in Bangkok revealed two samples possibly contaminated with ciguatera toxin from a total 227 fish samples (of 21 fish species). This is the first report of finding CTX contamination in fish meat sold in Bangkok.
Conclusion: It is possible that these CTX-positive fish were caught from other countries. Even though the positivity (0.88%) is lower when compared with studies of other endemic areas (5.0% in Hawaii and Pacific Islands), this finding should raise awareness of the possibility of facing rare CFP intoxication from fish obtained at local Thai markets.
High glucose enhances CD39 expression in vascular endothelial cells
Authors: Kongkhum Sudawadee , Fungkrajai Mudtika , Prajan Sompoch , Bordeerat Narisa Kengtrong , Piumngam Kanyanath , Siripurkpong Pilaiwan 
Published: August 2015

Abstract
Background: Diabetes mellitus (DM) patients lose their ability to control normal blood glucose levels, resulting in high blood glucose levels (hyperglycemia). Hyperglycemia causes DM complications. This involves responses of vascular endothelial cells (VECs) to hyperglycemia, affecting inflammatory process and platelet activity. Ecto-enzyme CD39 is expressed on VECs, catalyzing the hydrolysis of ATP and ADP to AMP and, consequently, regulating inflammatory process and platelet activation.
Objective: We studied whether high glucose concentration has an effect on CD39 expression on VECs.
Methods: Cultured human umbilical vein endothelial cells (HUVEC) were used as a model of study. HUVEC were cultured in different glucose conditions (4, 9, 24, and 34 mM) for 24 hours. Cell viability was assessed using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)-based assay and expression of CD39 was examined by using SDS-PAGE and western blot techniques.
Results: HUVEC were cultured in normal (4 and 9 mM) or high (24 and 34 mM) glucose concentrations for short term (24 hours). The results showed that high glucose (24 and 34 mM) reduced cell viability to 89.5 ± 11.3 and 86.3 ± 13.5 (mean ± SD), compared with control (4 mM), respectively. High glucose also induced increases in CD39 expression in HUVEC.
Conclusion: High glucose decreases cell viability and increases CD39 expression in HUVEC, suggesting involvement of CD39 in cell responses to high glucose.