bluuebunny/crossref_metadata_2025_split huggingface dataset:
Left Heart Pump‐Assisted Myocardial Revascularization Favorably Affects Neutrophil Apoptosis
Authors: Stassano Paolo , Di Tommaso Luigi , Monaco Mario , Mastrogiovanni Generoso , Musumeci Antonino , Contaldo Antonio , Pepino Paolo 
Published: December 2009

AbstractObjectivesGranulocyte apoptosis is a key control process in the clearance of neutrophils from inflammatory sites, and its rate is modulated by a number of inflammatory mediators. In this study, we investigated whether the use of left ventricular‐assisted technique (LVA) in beating heart myocardial revascularization would exert less impact on neutrophil apoptosis compared with conventional cardiopulmonary bypass (CPB).MethodsForty consecutive patients who underwent myocardial revascularization were randomly assigned to LVA (group A, 21 patients) or CPB (group B, 19 patients). Blood samples for detection of interleukin‐6, interleukin‐8, and tumor necrosis factor‐α were measured at baseline and at various time points postoperatively. Neutrophil apoptosis was detected by light microscopy as well as by the annexin‐V assays together with the activity of caspase 3 on postoperative samples.ResultsPreoperative clinical and demographic data did not differ between the two groups. The two groups also were similar with respect to mortality, number of grafts performed, duration of extracorporeal circulation, and need for inotropes. However postoperatively, spontaneous apoptosis was significantly delayed in neutrophils from CPB patients compared with LVA patients. Neutrophils were activated, as indicated by increased surface expression of CD11b. Caspase 3 activity was found to be significantly reduced in neutrophils from CPB patients after 18 and 24 hours of culture.ConclusionsPatients who underwent beating heart myocardial revascularization with LVA show a better preserved neutrophil apoptosis than patients treated with the CPB.
Poor Late Survival After Surgical Treatment of Pleural Empyema
Authors: Mikkola Reija , Kelahaara Janna , Heikkinen Jouni , Lahtinen Jarmo , Biancari Fausto 
Published: December 2009

AbstractBackgroundWe have evaluated the outcome of patients who underwent surgical treatment of parapneumonic pleural empyema.MethodsThis study included 143 consecutive patients older than 18 years who were operated on for parapneumonic pleural empyema.ResultsThe overall survival at 30 days, 3 months, 5 years, and 10 years was 97.2, 92.3, 80.6, and 61.9%, respectively. Serum albumin (OR = 0.78, 95% CI = 0.65‐0.94), cerebrovascular disease (OR = 30.49, 95% CI = 1.35‐689.05), pulmonary embolism (OR = 984.63, 95% CI = 7.81‐124206.8), and Thoracoscore (OR = 1.61, 95% CI = 1.10‐2.35) were independent predictors of 3‐month overall survival. Age (RR = 1.08, 95% CI = 1.03‐1.14), serum albumin (RR = 0.89, 95% CI = 0.82‐0.98), chronic obstructive pulmonary disease (COPD) (RR = 5.14, 95% CI = 1.3319.84), and cerebrovascular disease (RR = 6.76, 95% CI = 1.33‐34.34) were independent predictors of pneumonia/pleural empyema‐related death. Twenty‐two patients required 33 reinterventions after the primary procedure: 19 patients after primary thoracoscopy and 3 patients after primary thoracotomy. Reintervention did not have any significant impact on 30‐day mortality (4.5% vs. 2.5%, p = 0.49), but it affected 3‐month mortality (26.1% vs. 4.2%, p < 0.0001). Reoperation was an independent predictor of late overall survival (at 10 years: 35.5% vs. 67.4%, RR = 2.95, 95% CI = 1.33‐6.57) and freedom from pneumonia/pleural empyema‐related death (at 10 years: 73.9% vs. 91.3%, RR = 4.40, 95% CI = 1.24‐15.66).ConclusionsSurgical treatment of pleural empyema can be associated with good immediate results, but longer follow‐up showed that pneumonia/pleural empyema‐related mortality and all‐cause mortality are rather poor.
The Benefits of Computed Tomographic Colonography in Reducing a Long Colonoscopy Waiting List
Authors: Behrens Carola , Stevenson Giles , Eddy Richard , Pearson David , Hayashi Allen , Audet Louise , Mathieson John 
Published: December 2009

Purpose The Radiology Department, Royal Jubilee Hospital, Victoria, BC, with the support of gastroenterologists and surgeons, was awarded a BC Innovation fund to run a pilot project of computed tomographic colonography to reduce an unacceptably long 2-year colonoscopy waiting list. Funds were approved in April 2007 for a 1-year project, which was completed on March 31, 2008. Methods This article describes the challenges of delivering a high-volume computed tomographic colonography program at a busy community hospital, with discussion of the results for the 2,005 patients who were examined. Results Colonoscopy was avoided in 1,462 patients whose computed tomographic studies showed no significant lesions. In the remainder of patients, only lesions larger than 5 mm were reported, with a total of 508 lesions identified in 433 patients. There were 57 cancers of which 52 were reported as either definite or possible cancers, whereas 5 were not seen on initial scans. Some of the patients with cancer had been on the colonoscopy waiting list for 2 years. In addition, there were 461 patients with significant extracolonic findings, including 84 who required urgent or semi-urgent further management for previously unsuspected conditions, such as pneumonia, aneurysms larger than 5 cm, and a range of solid renal, hepatic, and pancreatic masses. There were no procedural complications from the computed tomographic colon studies. Conclusions We have shown that it is feasible to run a high volume CTC service in a general hospital given hospital support and funding. The benefits in this group of over 2000 patients included avoidance of colonoscopy in over 70% of patients, detection of significant polyps or cancer in approximately 20% of patients, and identification of clinically important conditions in 7%–18% depending on the definition used. The estimated costs including capital, operating, and professional fees were in the range of $400.
Magnetic Resonance Cisternographic Evaluation of Glossopharyngeal, Vagus, and Accessory Nerves
Authors: Hatipoglu Hatice Gul , Durakoglugil Tugba , Sakman Bulent , Yuksel Enis 
Published: December 2009

Purpose The individual visualization of the glossopharyngeal, vagus, and accessory nerves has been a troublesome issue. After the recent developments in the microsurgical field, the detailed knowledge of the relationship of these nerves and the tumour has gained importance. The purpose of this study is to compare the visibility of each of these nerves. Methods Thirty patients (M/F: 14/16; mean age 52.46 years) with complaints of vertigo, tinnitus, and hearing loss were examined with routine temporal magnetic resonance imaging (MRI) study. The imaging protocol consisted of 3-dimensional fast imaging with steady state acquisition in axial and sagittal oblique planes in addition to routine sequences. These images were transferred to a workstation and reformatted. Visibility of the nerves was evaluated by consensus of 2 radiologists who used an evaluation scale of 2 (excellently visible), 1 (partially visible), to 0 (not visible). Results In 26 patients, both sides were scanned; in 4 patients, only one side was scanned. A total of 168 nerves were investigated. The rates for visualization for each nerve were as follows: glossopharyngeal nerve, 100% and 100%; vagus nerve, 67.9% and 100%; and accessory nerve, 10.8% and 83.85% on axial and sagittal oblique 3-dimensional fast imaging with steady state acquisition, respectively. Conclusions Glossopharyngeal, vagus, and accessory nerve assessment improved when images were obtained in the sagittal oblique plane to the jugular foramen.
Use of Chinese herbal medicine among menopausal women in Taiwan
Authors: Chen Lih‐Chi , Wang Bi‐Ru , Chen I‐Chin , Shao Chun‐Hui 
Published: December 2009

AbstractObjectiveTo assess the patterns of use of Chinese herbal medicine (CHM) used by women in Taiwan to treat menopausal symptoms.MethodsA retrospective review of the records of women who received CHM therapies for menopausal symptoms at the Traditional Medicine Center, Veterans General Hospital, Taipei, between January 2003 and December 2006. The average number of therapies per prescription, dosage, and duration of the prescription were recorded. The most commonly prescribed herbs and formulae were also recorded. Data were analyzed using descriptive statistics.ResultsThe records of 3432 women who were administered a total of 19370 CHMs to treat symptoms of the menopause were reviewed. The average number of drugs per prescription was 5.64. Most of the prescriptions (97.1%) were prescribed to be taken 3 times a day. The most commonly prescribed Chinese herb was Leonurus heterophyllus. Jia‐Wey‐Shiau‐Yau‐San was the most commonly prescribed Chinese herbal formula.ConclusionCHM is commonly used in Taiwan for the treatment of menopausal symptoms. The efficacy and safety of CHM drugs used for the management of menopausal symptoms require further study.
Determination of biotypes ofDactylopius tomentosus(Hemiptera: Dactylopiidae) and insights into the taxonomic relationships of their hosts,Cylindropuntiaspp.
Authors: Mathenge C.W. , Holford P. , Hoffmann J.H. , Zimmermann H.G. , Spooner-Hart R. , Beattie G.A.C. 
Published: December 2009

AbstractHost specialization to form biotypes is common among phytophagous insects, and it has been hypothesised that biotypes ofDactylopius tomentosusL. (Hemiptera: Dactylopiidae) occur.D.tomentosusis an important biological control agent forCylindropuntiacacti when they occur as weeds. Additionally, there is uncertainty surrounding the taxonomic status of some species ofCylindropuntia. This study aimed to confirm the existence ofD. tomentosusbiotypes and to assess whether host specialization can help to resolve this systematic uncertainty. For this study, the host specificity and performance of ten provenances ofD. tomentosuscollected fromC. cholla,C. fulgidavar.fulgida,C. imbricata,C. f. var.mamillata,C. roseaandC. tunicataand reared onC. cholla,C. fulgidavar.fulgida,C. imbricataandC. roseawere investigated. Five life-history parameters were measured including: crawler development time and survival, female development time, and the weight and number of eggs produced by females. Results revealed significant variation in host specificity with provenances either thriving, surviving or dying on the different hosts, thus demonstrating the existence of biotypes. Also, host specificity was related to host species and not to the geographic locality from which either the host or provenance was sourced. These findings suggest that the characteristics ofCylindropuntiaspecies may differ sufficiently, there by presenting different selection pressures that induce and sustain distinct biotypes ofD. tomentosus. The observed host use patterns of the biotypes separated the plant species into two groups that accorded with known phylogenetic relationships amongCylindropuntiaspecies, suggesting that biotypes can be used to elucidate their taxonomic relatedness. Besides advancing our knowledge of the ecology and evolution ofD. tomentosus, these novel findings have important implications for the biological control ofCylindropuntiaspecies.
Aggregation in insect communities colonizing cattle-dung
Authors: Wall R. , Lee C.M. 
Published: December 2009

AbstractRuminant dung is a highly ephemeral, patchily distributed resource, which is used by a diverse community of invertebrate species. In such environments, high levels of insect aggregation may be important in facilitating stability and coexistence across patchily distributed populations. The aim of the present work was to quantify the aggregation of the insects colonising cow-dung in cattle pasture in southwest England and to test the hypothesis that the dung-pat community assemblage observed was the result of stochastic colonization. This was examined using batches of ten standardised, 1.5 kg, artificial cow pats placed out in cattle pastures in each of 24 weeks between May and October in 2001. Pats were left exposed in the field for seven days before being brought back to the laboratory, where any insect colonizers were collected and identified. Individual pats contained, on average, only half the number of insect taxa present in an entire batch put out at any one time. All larval coleopteran taxa, 20 of the 22 adult coleopteran taxa and 22 of the 23 dipteran taxa, showed significant aggregation, with the abundance of most taxa within pats approximating a negative binomial distribution. A simulation analysis was used to show that the observed relative frequency of taxa within pats did not differ from that expected by chance if colonisation is a random binomial event in which each species colonises a pat independently of all other species. Aggregated populations, of even highly abundant insects, may be more susceptible to the deleterious effects of insecticidal contaminants in dung than if they were evenly distributed, if by chance they colonize a pat containing insecticidal residues from a recently treated animal.
Ectopic cervical thymus: case report and review of pathogenesis and management
Authors: Ahsan F , Allison R , White J 
Published: December 2009

AbstractObjective:Ectopic cervical thymus is a rare anomaly, and 50 per cent of cases occur in children. The aim of this report was to remind clinicians of this rare condition, which is part of the differential diagnosis of a paediatric neck lump.Method:Case report together with literature review of the pathogenesis and management of ectopic cervical thymus.Results:The ectopic cervical thymus is a rare cause of a benign neck mass, and is thus usually misdiagnosed as lymphadenopathy or neoplasia. We discuss its embryology, aetiology, presentation, histopathology, radiology and management, with reference to the reported case.Conclusion:Ectopic cervical thymus should always be considered in the differential diagnosis of a paediatric neck lump. The diagnosis can often be confirmed by cytology and radiology prior to surgical excision.
Congenital cholesteatoma of mastoid region manifesting as acute mastoiditis: case report and literature review
Authors: Hidaka H , Ishida E , Kaku K , Nishikawa H , Kobayashi T 
Published: December 2009

AbstractObjectives:We report an extremely rare case of congenital cholesteatoma of the mastoid region, presenting as acute mastoiditis. We also review the 16 previously reported cases of congenital cholesteatoma of the mastoid region.Case report:A 65-year-old man presented with left-sided, post-auricular swelling and pain. Acute mastoiditis was diagnosed, with computed tomography demonstrating destruction of the bony plates of the posterior cranial fossa and sigmoid sinus. Initial surgery revealed a cholesteatoma in the mastoid, with no extension into the aditus ad antrum or attic. These findings were confirmed by pathological and immunohistochemical analysis of the surgical specimen, the latter using involucrin. The cholesteatoma matrix was completely removed in a second operation.Conclusions:Including this case, only four of the 17 reported cases of congenital cholesteatoma of the mastoid region showed post-auricular pain or swelling, indicating acute mastoiditis. Clinicians should bear in mind that congenital cholesteatoma may be present in patients presenting with mastoiditis, particularly adults.
Stridor in Parkinson's disease: a case of ‘dry drowning’?
Authors: Gan E C , Lau D P , Cheah K L 
Published: December 2009

AbstractObjectives:(1) To present a rare case of stridor secondary to prolonged laryngospasm in a patient with Parkinson's disease, and (2) to review the literature on stridor in Parkinson's disease.Methods:We report a 73-year-old Parkinson's disease patient who developed acute stridor due to prolonged laryngospasm triggered by overspill of excessive secretions. The literature was reviewed, following a Medline search using the keywords ‘Parkinson's disease’ and ‘stridor’ or ‘airway obstruction’ or ‘laryngospasm’ or ‘laryngeal dystonia’ or ‘bilateral vocal cord palsy’.Result:Only 12 previously reported cases of stridor in Parkinson's disease patients were identified. Causes included bilateral vocal fold palsy (eight cases), laryngospasm (five), and dystonia of the jaw and neck muscles (two). The mechanism of laryngospasm in our patient was similar to ‘dry drowning’, and has not previously been described.Conclusion:Laryngospasm can be triggered in Parkinson's disease by excessive secretions entering the larynx. The mechanism is similar to ‘dry drowning’. Treatment focuses on reducing secretions. The use of botulinum toxin to reduce spasm is inappropriate in this situation. This case emphasises the importance of recognising different causes of stridor in Parkinson's disease patients, as this affects management.
Endoscopic, endonasal decompression of spinal stenosis with myelopathy secondary to cranio-vertebral tuberculosis: two cases
Authors: Puraviappan P , Tang I P , Yong D J , Prepageran N , Carrau R L , Kassam A B 
Published: December 2009

AbstractBackground:Tuberculosis can cause extensive osseo-ligamentous destruction at the cranio-vertebral junction, leading to atlanto-axial instability and compression of vital cervico-medullary centres. This may manifest as quadriparesis, bulbar dysfunction and respiratory insufficiency.Aim:We report two patients presenting with spinal stenosis and cord compression secondary to cranio-vertebral tuberculosis, who were successfully decompressed via an endoscopic, endonasal approach.Study design:Two case reports.Methods and results:Both patients were successfully decompressed via an endoscopic, endonasal approach which provided access to the cranio-vertebral junction and upper cervical spine.Conclusion:An endoscopic, endonasal approach is feasible for the surgical management of cranio-vertebral junction stenosis; such an approach minimises surgical trauma to critical structures, reducing post-operative morbidity and the duration of hospital stay.
Does antrochoanal polyp present with epistaxis?
Authors: Sayed R H , Abu-Dief E E 
Published: December 2009

AbstractObjective:To compare the gross and microscopic appearance of antrochoanal polyps associated with recurrent epistaxis, with those with a more typical presentation.Design:Prospective, controlled study.Methods:All patients underwent clinical and endoscopic examination, computed tomography scanning, and examination under anaesthesia, in order to detect the gross diagnostic criteria for antrochoanal polyp. Histological findings on light microscopy were compared for polyps presenting with epistaxis versus those without. The number of predominant inflammatory cells in the corium was determined in both groups and statistically compared using the Studentt-test.Results:Recurrent epistaxis was a presenting symptom in 10/84 (11.9 per cent) patients with gross diagnostic criteria for antrochoanal polyp. Grossly, these patients' polyps had a reddish, vascular surface in parts. Histologically, these polyps showed a highly vascular stroma with multiple dilated blood vessels, the typical appearance of an angiomatous antrochoanal polyp. Thrombi at different stages of development were detected, with no infarcts. The remaining cases (88.1 per cent) had no history of epistaxis; histologically, these patients' polyps showed an oedematous connective tissue core with few inflammatory cells. Plasma cells were predominant in the angiomatous polyps, being significantly more prevalent than in the ordinary antrochoanal polyps (p < 0.00).Conclusions:It would appear that only angiomatous antrochoanal polyps present with epistaxis. Detection of the characteristic gross appearance of these polyps may help avoid unwanted surgery. Histopathological analysis confirms the diagnosis. A significantly increased number of plasma cells may be the underlying cause of the histological changes seen in angiomatous antrochoanal polyps.
Inferior vestibular neuritis: a novel subtype of vestibular neuritis
Authors: Zhang D , Fan Z , Han Y , Yu G , Wang H 
Published: December 2009

AbstractObjective:To report eight cases of inferior vestibular neuritis, in order to raise awareness of this new subtype of vestibular neuritis.Materials and methods:We retrospectively analysed 216 patients (104 males and 112 females; age range 10–64 years; mean age 38.4 years) with full clinical documentation who had attended our hospital's vertigo clinic between May 2007 and December 2008. All patients underwent systematic investigation, including hearing tests, radiology, caloric testing and vestibular evoked myogenic potential testing.Results:Of 216 patients with vestibular neuritis, eight cases were diagnosed as inferior vestibular neuritis, based on comprehensive analysis of test data. The clinical features of these eight patients were consistent with the characteristics of vestibular neuritis. The results of pure tone audiometry and caloric testing were normal, and the possibility of central lesions was excluded by cerebral computed tomography or magnetic resonance imaging on admission. Six cases had unilateral loss of vestibular evoked myogenic potentials, whereas two had a unilateral lower amplitude of vestibular evoked myogenic potentials.Conclusions:Inferior vestibular neuritis is a novel subtype of vestibular neuritis, which involves the inferior vestibular nerve alone. Vestibular evoked myogenic potential testing is a useful aid to the diagnosis of inferior vestibular neuritis.
Vestibular schwannoma: role of conservative management
Authors: Suryanarayanan R , Ramsden R T , Saeed S R , Aggarwal R , King A T , Rutherford S A , Evans D G , Gillespie J E 
Published: December 2009

AbstractObjective:To assess the outcome of conservative management of vestibular schwannoma.Study design:Observational study.Setting:Tertiary referral centre.Patients:Four hundred and thirty-six patients with vestibular schwannoma (490 tumours), including 327 sporadic tumours and 163 tumours in 109 patients with neurofibromatosis type two.Main outcome measures:The relationship of tumour growth to tumour size at presentation, and to certain demographic features.Results:The initial tumour size was significantly larger in the neurofibromatosis type two group (11 mm) than in the sporadic vestibular schwannoma group (5.1 mm). In both groups, 68 per cent of tumours did not grow during follow up (mean 3.6 years; range one to 14 years). The mean growth rate was 1.1 mm/year (range 0–15 mm/year) for sporadic tumours and 1.7 mm/year (range 0–18 mm/year) for neurofibromatosis type two tumours. The tumour growth rate correlated positively with tumour size in the sporadic tumour group, and correlated negatively with age in the neurofibromatosis type two group.Conclusion:Two-thirds of vestibular schwannomas did not grow. Radiological surveillance is an acceptable approach in carefully selected patients. Once a sporadic vestibular schwannoma reaches 2 cm in intracranial diameter, it is likely to continue growing. We do not recommend conservative management for sporadic tumours with an intracranial diameter of 1.5 cm or more. Vestibular schwannoma management is more complex in patients with neurofibromatosis type two.