bluuebunny/crossref_metadata_2025_split huggingface dataset:
Celiomesenteric trunk: Two variants of a rare anomaly
Authors: Petscavage JM , Maldjian P 
Published: August 2010

SUMMARYThe celiomesenteric trunk is a rare congenital vascular anomaly characterized by a common origin of the celiac axis and superior mesenteric artery. We report two variants: one in which the left gastric artery arises from a short common trunk and a second where the left gastric artery originates directly from the aorta above the common trunk. We discuss a possible embryologic mechanism for formation of these variants and the clinical implications. These cases also illustrate the ability of multidetector CT to provide quality images of such vascular anomalies.
Aberrant right hepatic duct presenting as empyema of the gall bladder
Authors: Pottakkat B , Sikora SS 
Published: August 2010

SUMMARYA 38‐year‐old male presented with recurrent right hypochondrial pain with history of acute cholecystitis. Ultrasonography of the abdomen showed distended gall bladder with dilated right hepatic duct with intrahepatic biliary dilatation in the right lobe of the liver. Endoscopic retrograde cholangiography showed non‐visualization of the right ductal system and gall bladder with extrinsic compression of the common hepatic duct. Contrast‐enhanced CT scan revealed a distended gall bladder with isolated dilatation of the intrahepatic biliary dilatation in the right lobe of the liver. Magnetic resonance cholangiography confirmed the same findings. At laparotomy, the right hepatic duct was seen directly inserted into the gall bladder body after a short extrahepatic course. The cystic duct provided the only route for biliary drainage through the gall bladder, but it was blocked. A cholecystectomy with a Roux‐en‐Y hepaticojejunostomy to the right hepatic duct was carried out. This case presents an extremely rare aberration affecting the extrahepatic biliary tree in which the right hepatic duct was directly inserted into the gall bladder.
Positron emission tomography‐Computerized tomography findings in a urinary bladder paraganglioma
Authors: Thambugala GM , Fulham MJ , Mohamed A 
Published: August 2010

SUMMARYWe present the staging fluorodeoxyglucose (FDG) positron emission tomography (PET‐CT) findings in a patient with a functional urinary bladder paraganglioma. The PET‐CT scan showed markedly increased FDG uptake into bilateral pelvic nodes that was consistent with regional nodal involvement. These findings were confirmed on histopathology. At present, there are no reports of PET‐CT findings in urinary bladder paragangliomas.
Intramedullary neurenteric cyst without concurrent malformation
Authors: Nagi S , Ghorbel D , Drissi C , Maatallah Y , Hammami N , Hamouda MB 
Published: August 2010

SUMMARYNeurenteric cysts (NECs) are dysraphic lesions. They are usually extramedullary, the intramedullary forms are very rare. To our knowledge, only 10 cases of isolated intramedullary NECs have been reported. We report a case of intramedullary NEC without any associated dysraphic lesion. The clinical findings were: cervical pain and left hemicorporal weakness which predominated at the upper limb. Neuroradiological evaluation was performed by means of MRI which revealed a cystic lesion at C3‐C4 level. A partial excision was performed and the diagnosis of NEC was established by histological study.
Ketotifen abrogates local and systemic consequences of rat intestinal ischemia–reperfusion injury
Authors: KALIA NEENA , BROWN NICOLA J , WOOD RICHARD F M , POCKLEY A GRAHAM 
Published: August 2010

AbstractBackground:  Mast cell‐derived vasoactive and pro‐inflammatory mediators, particularly histamine, might contribute to local tissue damage and multiorgan dysfunction induced by intestinal ischemia/reperfusion (I/R). The purpose of the present study was to evaluate the effects of the mast cell stabilizer, ketotifen, on leukocyte adhesion within, and tissue leakage from the mucosal villous microcirculation after intestinal I/R.Methods:  Superior mesenteric arteries of untreated and ketotifen‐pretreated (1 mg/kg orally twice daily for 3 days, and 90 min prior to ischemia) Piebald–Viral–Glaxo (PVG) rats were clamped for 30 min (n = 12 per group; sham operated controls n = 12). Mucosal surfaces of exteriorized ileal segments were visualized, and leukocyte adherence in, and macromolecular leakage (MML) from individual villi were followed for 2 h after clamp removal using in vivo microscopy. Blood pressure and heart rate were monitored, and lung tissue damage was assessed by histology.Results:  Ten untreated animals subjected to intestinal I/R failed to survive the reperfusion period, leukocyte adhesion (P < 0.001) and MML (P < 0.001) were increased at all time‐points and blood flow stasis eventually ensued. In contrast, all ketotifen‐pretreated I/R animals survived the duration of the study. Ketotifen abrogated I/R‐induced leukocyte adherence within the villus mucosal capillaries and supplying arterioles and largely prevented pulmonary injury, yet surprisingly had no effect on intestinal vascular leakage.Conclusions:  This is the first study to demonstrate that ketotifen is a powerful inhibitor of I/R‐induced leukocyte adhesion and can prevent localized and reduce remote organ damage after intestinal I/R injury. However, its effects are manifested in the absence of any influence on intestinal I/R‐induced vascular leakage.© 2005 Blackwell Publishing Asia Pty Ltd
Cytokeratin immunoreactivity patterns in short‐segment Barrett's esophagus in Japanese patients
Authors: YAGI KAZUYOSHI , NAKAMURA ATSUO , SEKINE ATSUO 
Published: August 2010

AbstractBackground:  The origin of intestinal metaplasia at the esophagogastric junction has clinical importance. However, it can be difficult to differentiate between intestinal metaplasia of short‐segment Barrett's esophagus and cardiac intestinal metaplasia due to Helicobacter pylori infection. Specific patterns of cytokeratin (CK)7 and CK20 have been detected in long‐segment Barrett's esophagus. The aim of the present study was to assess the immunostaining patterns associated with short‐segment Barrett's esophagus.Aims:  Paraffin‐embedded biopsy specimens were prepared from 128 patients with intestinal metaplasia of long‐segment Barrett's esophagus (n = 3), short‐segment Barrett's esophagus without H. pylori infection (n = 22), short‐segment Barrett's esophagus with H. pylori infection (n = 22), and cardiac mucosa (n = 49) and gastric mucosa from antrum and fundus (n = 44) with H. pylori infection. Sections were prepared and immunostained for CK7 and CK20.Result:  A Barrett's CK7/20 pattern was present in all three patients (100%) with long‐segment Barrett's esophagus, 21 of 22 patients (95%) with short‐segment Barrett's esophagus without H. pylori infection, and six of 22 patients (27%) with short‐segment Barrett's esophagus with H. pylori infection (P < 0.05).Conclusion:  Intestinal metaplasia of short‐segment Barrett's esophagus in patients without H. pylori infection is thought to be similar to that seen in long‐segment Barrett's esophagus.
Duodenal ulcer in South Africa: Home‐pounded versus milled maize
Authors: TOVEY FRANK I , HOBSLEY MICHAEL , SEGAL ISIDOR , JAYARAJ A PAUL 
Published: August 2010

AbstractBackground:  In South Africa there is suggestive evidence that home‐pounded maize protects against duodenal ulceration. Therefore the purpose of the present paper was to test, in an animal model, whether oil from home‐pounded maize gives protection against ulceration and whether this effect is present in commercially prepared maize oil.Methods:  Gastric ulceration was induced in rats with topical ethanol 1 h after giving oil prepared either from fresh‐pounded or from commercially treated maize. The lengths of the linear ulcers produced were measured with a planimeter and summed in each rat. Control observations were made using arachis oil (which is known not to be ulceroprotective) and horse gram lipid (which is known to be strongly ulceroprotective). Statistical comparisons were performed mainly with the Mann–Whitney U‐test, but also with reference to the normal distribution. Thin‐layer chromatography (TLC) was performed on the oil from fresh maize, and the fractions similarly investigated for ulceroprotective activity.Results:  Fresh maize oil was strongly ulceroprotective (P = 0.0039), commercial maize oil was not (P = 0.2864). The active ingredient in the fresh maize oil was located in the fraction near the solvent front.Conclusion:  These findings support the hypothesis that home‐pounded maize protects against duodenal ulceration.
Sulfasalazine inhibits activation of nuclear factor‐κB in patients with ulcerative colitis
Authors: GAN HUA‐TIAN , CHEN YOU‐QIN , OUYANG QIN 
Published: August 2010

AbstractBackground:  Although sulfasalazine is widely used to treat inflammatory bowel disease, its mechanisms of action remain unclear. Activation of transcription factor nuclear factor (NF)‐κB, which controls transcription of various pro‐inflammatory cytokine genes, has been shown to play a critical role in the pathogenesis of inflammatory bowel disease. The purpose of the present study was to determine whether sulfasalazine therapy affected NF‐κB activation and the expression of pro‐inflammatory cytokines in patients with ulcerative colitis.Methods:  A total of 38 patients with moderate ulcerative colitis were investigated. Twenty‐one patients received sulfasalazine. Seventeen patients did not receive any medication. Biopsy specimens were obtained from inflamed mucosa and analyzed for NF‐κB DNA binding activity, NF‐κBp65/IκBα protein expression and the levels of pro‐inflammatory cytokine mRNA using electrophoretic mobility shift assay, western blot analysis, immunohistochemical staining and reverse transcription–polymerase chain reaction (RT‐PCR) analysis, respectively.Results:  Increased activation of NF‐κB and high levels of the expression of interleukin (IL)‐1β mRNA and IL‐8 mRNA were detected in biopsy specimens from patients with ulcerative colitis. Therapeutic administration of sulfasalazine effectively downregulated the activation of NF‐κB and the expression of IL‐1β mRNA and IL‐8 mRNA while IκBα levels were stable.Conclusion:  The therapeutic benefits for ulcerative colitis of sulfasalazine might at least in part be attributed to its ability to inhibit NF‐κB activation, resulting in the downregulation of pro‐inflammatory cytokine mRNA expression.
Outcome of colorectal carcinoma in patients under 40 years of age
Authors: LIN JEN‐TSUN , WANG WEI‐SHU , YEN CHUEH‐CHUAN , LIU JIN‐HWANG , YANG MU‐HUA , CHAO TA‐CHON , CHEN PO‐MIN , CHIOU TZEON‐JYE 
Published: August 2010

AbstractAims:  Colorectal carcinoma in patients under 40 years of age usually has a poor prognosis. Controversies still exist regarding the features and the prognosis of colorectal cancer in young patients.Methods:  The records of 45 patients with histologically confirmed colorectal carcinoma treated between 1992 and 2002 at the Division of Oncology at Taipei Veterans General Hospital were reviewed. The relevance of sex, duration of symptoms, tumor site, histological type, lymph node involvement, Karnofsky performance status (KPS), carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) levels at the diagnosis and tumor stage to overall survival (OS) were determined by univariate analysis, and their independent significance were tested by multivariate analysis.Results:  Most patients presented with an advanced tumor stage (24% Dukes’ C and 66% Dukes’ D). Colon carcinoma constituted 76% of the colorectal tumors. Family history was present in two patients and did not affect the OS. Two patients were found to have colon carcinoma during pregnancy. The 5‐year survival rate in patients with Stage B, C, and D were 25, 16 and 0%, respectively. With aggressive treatment, patients with early stage carcinoma achieved longer survival. Eleven patients received resection of metastatic carcinoma of the liver, lung and ovary. Adjuvant chemotherapy with irinotecan/5‐fluoroucil‐based chemotherapy seemed to improve the OS in such patients, though the OS was still poorer than in patients with early stage tumors. In univariate analysis, KPS (P = 0.0001), lymph node involvement (P = 0.0024), CEA (P = 0.0423) and LDH levels (P = 0.0126) at the diagnosis and tumor stage (P = 0.0122) proved to be significant predictors of overall survival. Multivariate analyses revealed that KPS ≥70% (P = 0.007) and normal LDH levels at diagnosis (P = 0.004) were predictive of overall survival in this population.Conclusions:  The present study shows that performance status and preoperative LDH levels were the major determinants for survival in patients with colorectal carcinoma under 40 years of age and the present series also suggests that surgical resection of metastatic colorectal carcinoma followed by adjuvant chemotherapy might be beneficial in certain patients. The data also suggests that current treatment modalities for young patients with advanced colorectal cancer might not be effective and more effective therapeutic regimens might be needed. Thus, it is important for surgeons to recognize the potential for colorectal cancer in young patients and to take an aggressive approach to the diagnosis and early treatment of the disease.
Pre‐cutting using a noseless papillotome with independent lumens for contrast material and guidewire
Authors: UCHIDA NAOHITO , TSUTSUI KUNIHIKO , KAMADA HIDEKI , OGAWA MUTSUMI , FUKUMA HIROKI , EZAKI TORU , ARITOMO YUICHI , KOBARA HIDEKI , ONO MASAHIRO , MORISHITA ASAHIRO , MASAKI TSUTOMU , WATANABE SEISHIRO , NAKATSU TOSHIAKI , KURIYAMA SHIGEKI 
Published: August 2010

AbstractBackground:  The technical success of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) depends on selective cannulation into the bile duct. We have developed a new type of precut papillotome for selective cannulation.Methods:  The newly developed precut papillotome has been equipped not only with a lumen for contrast materials but also with an independent lumen for the guidewire. The operation of the guidewire and the injection of contrast material can be carried out simultaneously. The precut papillotome has a 20‐mm‐long knife and no leading tip. Half the proximal side of the knife is coated for insulation.Results:  Selective biliary cannulation failed in 26 of 293 patients (8.9%) in whom therapeutic ERCP was attempted. We applied the precut papillotome to these 26 patients and selective cannulation was successful in 24 of 26 patients (success rate: 92.3%). No major complications occurred, although mild bleeding, which did not require endoscopic hemostasis or blood transfusion, was observed only in one patient.Conclusions:  Although further studies with a large number of patients are needed to evaluate the efficacy of the papillotome, this papillotome may contribute to increase the safety and the success rate of precutting.
Multiple hepatic nodules: Rare manifestation of clonorchiasis
Authors: Liao Wei‐Chih , Wang Hsiu‐Po , Chiu Han‐Mo , Chang Chi‐Yang , Lin Jaw‐Town 
Published: August 2010

AbstractA 38‐year‐old man was admitted due to intermittent right upper quadrant pain for 1 month. Leukocytosis with marked eosionphilia and elevated serum alkaline phosphatase were noted. Stool examinations revealed no parasites or ova. Ultrasonography and computed tomography disclosed multiple hepatic tumors. Biopsy of the hepatic tumor was performed due to non‐conclusive imaging studies and revealed eosinophil infiltration in portal areas only. Endoscopic retrograde cholangiography showed mild dilatation with irregularity of bilateral intrahepatic ducts, compatible with chronic cholangitis. Bile was aspirated and biliary lavage with normal saline was performed during endoscopy‐guided biliary cannulation. Microscopic examination of the aspirate showed the characteristic ova of Clonorchis sinensis. The patient received Praziquantel therapy for 1 day. Abdominal pain reduced in intensity gradually. Eosinophilia and multiple hepatic lesions resolved after adequate treatment of Clonorchis sinensis. The rare manifestation of multiple hepatic tumors in Clonorchis sinensis should be differentiated from other primary or metastatic neoplasms, while biliary lavage for parasite ova is a valuable diagnostic tool when stool examination is negative.
Liver injury induced by a Japanese herbal medicine, sairei‐to (TJ‐114, Bupleurum and Hoelen Combination, Chai‐Ling‐Tang) R1
Authors: Aiba Tsuneo , Takahashi Toru , Suzuki Kenji , Okoshi Shogo , Nomoto Minoru , Uno Katsuji , Aoyagi Yutaka 
Published: August 2010

AbstractThe case is reported of a man who showed acute hepatitis with jaundice after he was given a Japanese herbal medicine, sairei‐to (TJ‐114, Bupleurum and Hoelen Combination, Chai‐Ling‐Tang). Unusually, the component thought to be responsible for the observed drug‐induced liver injury was able to be identified. Lymphocyte migration inhibition testing indicated that the tuber of the perennial herbage Pinellia ternate was the causative agent.
Representations of people with dementia – subaltern, person, citizen
Authors: Gilmour Jean A. , Brannelly Tula 
Published: August 2010

GILMOUR JA and BRANNELLY T. Nursing Inquiry 2010; 17: 240–247 Representations of people with dementia–subaltern, person, citizenThis study traces shifts in health professional representations of people with dementia. The concepts of subaltern, personhood and citizenship are used to draw attention to issues around visibility, voice and inclusion. Professional discourses and practices draw upon, and are shaped by historical and contemporary representations. Until recently, people with dementia were subaltern in nursing and medical discourses; marginalised and silenced. The incorporation of contemporary representations foregrounding personhood and citizenship into health professional accounts provide space for transformative styles of care. Privileging personhood centralises the person with dementia in social networks, focusing on their experiences and relationships. Respecting citizenship involves challenging discrimination and stigma: nursing from a rights‐based approach necessitates listening and being responsive to the needs of the person with dementia. Incorporating contemporary representations in health professional practice requires the discarding of the historically dominant elite and authoritarian accounts of dementia still apparent in some nursing texts along with, perhaps, the historically burdened term of dementia itself.
Ambivalence and the experience of China‐educated nurses working in Australia
Authors: Zhou Yunxian , Windsor Carol , Coyer Fiona , Theobald Karen 
Published: August 2010

ZHOU Y, WINDSOR C, COYER F and THEOBALD K. Nursing Inquiry 2010; 17: 186–196 Ambivalence and the experience of China‐educated nurses working in AustraliaThe last decade has seen an increase in research on the experience of immigrant nurses. There are two prevailing approaches in this body of work. One is a focus on the positive or negative aspects of the experience, and the other, a depiction of the experience as a linear movement from struggle to a comfortable state. Based on our study findings on the experience of China‐educated nurses working in Australia, this study proposes that the concept of ambivalence is more appropriate in portraying the experience of immigrant nurses. Several sources of ambivalence experienced by the participants are represented: a disparity between expectation and reality, conflicting social and cultural norms, the dual reference points of comparison, divergent interests within families, and a sense that although it is unsatisfactory, it is hard to go back. We argue that immigration generates various forms of ambivalence and immigrant nurses must live with more or less ambivalence. The notion of ambivalence can explain a range of behaviours and situations beyond the scope of rational‐choice explanations. To date, ambivalence as a theoretical concept in understanding the experience of immigrant nurses has been either ignored or insufficiently addressed in the literature.
Continuing nursing education policy in China and its impact on health equity
Authors: Xiao Lily Dongxia 
Published: August 2010

XIAO LD. Nursing Inquiry 2010; 17: 208–220 Continuing nursing education policy in China and its impact on health equityThe aim of this study was to evaluate the mandatory continuing nursing education (MCNE) policy in China and to examine whether or not the policy addresses health equity. MCNE was instituted in 1996 in China to support healthcare reform was to include producing greater equity in health‐care. However, the literature increasingly reports inequity in participation in MCNE, which is likely to have had a detrimental effect on the pre‐existing discrepancies of education in the nursing workforce, and thereby failing to really address health equity. Despite a growing appeal for change, there is lack of critical reflection on the issues of MCNE policy. Critical ethnography underpinned by Habermas’ Communicative Action Theory and Giddens’ Structuration Theory were used to guide this study. Findings are presented in four themes: (i) inaccessibility of learning programs for nurses; (ii) undervaluation of workplace‐based learning; (iii) inequality of the allocation of resources; and (iv) demands for additional support in MCNE from non‐tertiary hospitals. The findings strongly suggest the need for an MCNE policy review based on rational consensus with stakeholders while reflecting the principles of health equity.
Endoscopic lung volume reduction effectively treats acute respiratory failure secondary to bullous emphysema
Authors: SEXTON Paul , GARRETT Jeffrey E. , RANKIN Nigel , ANDERSON Graeme 
Published: August 2010

ABSTRACTEmphysema often affects the lungs in a heterogeneous fashion, and collapse or removal of severely hyperinflated portions of lung can improve overall lung function and symptoms. The role of lung volume reduction (LVR) surgery in selected patients is well established, but that of non‐surgical LVR is still being defined. In particular, use of endobronchial LVR is still under development. This case report describes a 48‐year‐old non‐smoker with severe bullous emphysema complicated by acute hypercapnic respiratory failure, who was successfully treated by endobronchial valve placement while intubated in an intensive care unit.
Correlated geographic variation in predation risk and antipredator behaviour within a wide‐ranging snake species (Notechis scutatus, Elapidae)
Authors: AUBRET FABIEN , MICHNIEWICZ RADIKA J. , SHINE RICHARD 
Published: August 2010

AbstractGeographic variation in antipredator behaviour within wide‐ranging species may be driven by both genetic and environmental influences. We quantified antipredator responses in neonatal (laboratory born,n = 555) and adult (field caught,n = 346) tiger snakes (Notechis scutatus) from 11 mainland and island sites in southern Australia. We used these data to test predictions from Bonnetet al.'s hypothesis that the vigour of antipredator responses in this species reflects behavioural plasticity (in turn, driven by an individual snake's exposure to predators during its lifetime) rather than by genetic variation in this trait. We used the number of predator taxa in each area as an index of predator risk. As predicted, adult snakes from predator‐rich areas had more vigorous defensive responses when handled, whereas neonatal behaviour (although also variable among populations) was unrelated to predator species richness. Adult males bit more readily than adult females (as expected from the greater predation exposure of males during mate searching) but no such sex difference was evident in neonates. Although alternative models remain possible, our data are most consistent with the hypothesis that geographic divergence in antipredator tactics within this species primarily reflects developmentally plastic responses to local predation risk.