bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intraoperative radiotherapy in women with early breast cancer treated by breast‐conserving therapy
Authors: Chua Boon H. , Henderson Michael A. , Milner Alvin D. 
Published: August 2010

AbstractBackground:  Previous studies demonstrated the feasibility of intraoperative radiotherapy (IORT) to the primary tumour bed using a miniature electron beam driven X‐ray source for early breast cancer. This study aimed to evaluate the feasibility of IORT as a tumour bed boost after whole breast irradiation (WBI) in breast conserving therapy.Methods:  This was a single‐arm prospective trial for women with breast cancer measuring <3 cm. After breast‐conserving surgery, a single IORT dose of 5 Gray (Gy) prescribed to 10 mm from the applicator surface was delivered to the breast tissues using 50 kV X‐ray followed by standard WBI. The feasibility rate of protocol therapy was defined as the percentage of all women who completed both IORT and WBI. A desirable completion rate was >90%. The protocol therapy would be considered unsuitable for further development if the completion rate was <75% or severe acute toxicity occurred in >15% of women who received IORT.Results:  Sixty patients were recruited for the study. IORT and WBI were delivered in 58 and 55 patients, respectively. Thus, the feasibility rates of IORT alone and both IORT and WBI were 97% (95% confidence interval (CI), 89–99%) and 92% (95% CI, 83–97%), respectively. A severe surgical complication or grade 3 or 4 acute radiation toxicity were identified in 10% (6/58) of women who had IORT.Conclusion:  Tumour bed boost using IORT in women with early breast cancer treated with conservative surgery and WBI was shown to be feasibly consistent with previous studies.
Ethical issues with the disclosure of surgical trial short‐term data
Authors: Allardyce Randall A. , Bagshaw Philip F. , Frampton Christopher M. , Frizelle Francis A. , Hewett Peter J. , Rieger Nicholas A , Smith J. Shona , Solomon Michael J. , Stevenson Andrew R. L. 
Published: August 2010

AbstractBackground:  This paper describes the distinctions between major surgical and pharmaceutical trials and questions the application of a common ethical paradigm to guide their conduct and reporting.Methods:  Surgical trials differ from other trials in cumulative therapeutic effects, operator dependence, the clinical setting, interdependence of short‐ and long‐term outcomes, and equipoise. A principal tenant of randomized controlled trial management is the maintenance of interim data confidentiality. Its application to complete surgical short‐term data is examined across a variety of common clinical trial circumstances that influence data integrity and the reliability of conclusions regarding the benefit‐to‐risk profile of experimental interventions.Results:  Complete perioperative results describe important treatment ends that cannot influence primary outcomes. These short‐term results may inform patient consent, teaching and provide valuable procedural insights to surgeons outside trial precincts.Conclusion:  Structured experimentation standards are necessary. But, the common paradigm applied across all clinical trials and the prohibition on short term data reporting may not serve the achievement of safe and effective advancements in surgery.
Strategies in cardiac tissue engineering
Authors: Tee Richard , Lokmic Zerina , Morrison Wayne A. , Dilley Rodney J. 
Published: August 2010

AbstractIn heart failure, post‐myocardial infarction and some congenital cardiac anomalies, organ transplantation is the only effective cure. Shortage of organ donors and complications of orthotopic heart transplant remain major challenges to the modern field of transplantation. Tissue engineering using cell‐based strategies presents itself as a new way of generating functional myocardium. Engineering functional myocardium de novo requires an abundant source of cells that can form cardiomyocytes. These cells may be used with biocompatible scaffold materials to generate a contractile myocardium. Lastly, to sustain the high metabolism of the construct, a functional vasculature needs to be developed with the forming cardiac tissue. This review provides an update on the progress of stem cell research in the context of cardiac tissue development, types of biomaterials used in cardiac tissue engineering (CTE) and currently employed strategies for vascularization in CTE. In addition, a brief overview of strategies utilized in CTE is provided.
Evaluating the safety of the Harmonic Scalpel around the recurrent laryngeal nerve
Authors: Jiang Hang , Shen Hongliang , Jiang Daozhen , Zheng Xiangmin , Zhang Wei , Lu Lei , Jiang Zhiguo , Qiu Ming 
Published: August 2010

AbstractBackground:  The Harmonic Scalpel (HS) is widely used in thyroidectomy. Determining the safety margin of using the HS near the recurrent laryngeal nerve (RLN) is helpful in preventing the injury to this nerve during thyroidectomy.Methods:  The parameters of evoked electromyography (EEMG) of vocal muscles before and after using the HS at a power level of 3 were recorded in a rabbit model. Masson staining was used to determine lateral injury caused by incisions using the HS.Results:  After the activated tip of the HS made contact with the RLN for ≥1 s or was placed 1 mm from the nerve for 3 or 5 s or 2 mm from the nerve for 5 s, significant changes were observed in the minimal stimulus current intensity threshold, the optimal stimulus current intensity threshold, the onset latency and the wave amplitude of EEMG. After the activated HS tip touched the RLN or was placed 1 mm to the nerve for ≥1 s or 2 mm to the nerve for 5 s, significant changes were found in peak latency. The thickness of injured lateral tissue was <1, 1–2 and >2 mm when using HS for 1, 3 and 5 s, respectively.Conclusion:  When used near the RLN at a power level of 3, the activated HS tip should be ≥2 mm from the nerve and the duration of incision should be ≤3 s.
Dissociating the role of the caudate nucleus and dorsolateral prefrontal cortex in the monitoring of events within human working memory
Authors: Provost Jean‐Sebastien , Petrides Michael , Monchi Oury 
Published: August 2010

AbstractThere is evidence that the dorsolateral prefrontal cortex is involved in the monitoring of information held in memory whether it is self‐ordered or externally triggered. However, the functional contribution of the caudate nucleus in the monitoring of events has not yet been studied. We have previously proposed that the striatum is involved when a novel self‐initiated action needs to be generated. The present study aimed to test the hypothesis that the caudate nucleus is significantly more required when the monitoring is self‐ordered as opposed to externally triggered. Self‐ordered monitoring refers to keeping track of which items have been selected so far in order to perform the current selection. Externally triggered monitoring refers to keeping track of which items have been selected by an outside source. Thirteen healthy young adults were scanned using functional magnetic resonance imaging while performing a monitoring task with three conditions: self‐ordered, externally triggered and recognition. As predicted, a significant increase of activity was found in the dorsolateral prefrontal cortex bilaterally when the self‐ordered and externally triggered conditions were compared with the recognition condition. Most importantly, significantly increased activity was found in the right caudate nucleus when comparing the self‐ordered with the recognition condition or with the externally triggered condition, but not when comparing the externally triggered with the recognition condition. We suggest that the caudate nucleus is involved in the planning of a self‐initiated novel action, especially when no clear indication is given for the response choice, and that this may be the case across different domains of cognition.
DIAGNOSIS OF CARCINOMA OF PROSTATE
Authors: MIMPRISS T. W. 
Published: August 2010

SUMMARY1. Histological proof of the diagnosis of carcinoma of prostate should be obtained if possible. Biopsy techniques are discussed.2. There is no entirely satisfactory method of biopsy.3. The cytological diagnosis of smears of prostatic secretion is by no means reliable and is open to serious objections. Moreover, it is useless in the diagnosis of the early case.4. Transrectal biopsy is a more reliable method and can be used in the diagnosis of the early case and suspicious nodule.5. By using transrectal biopsy an occasional patient suitable for radical operation can be selected.
PROSTATECTOMY: An Analysis of the Factors contributing to Mortality and Morbidity after Prostatectomy and a Description of a Personal Technique
Authors: JEEJEEBHOY H. 
Published: August 2010

SUMMARY1. The factors contributing to mortality and morbidity after prostatectomy are discussed.2. It is concluded that the ideal operation would be a modification of the Freyer technique so designed as to eliminate its disadvantages of slow healing, and occasional bladder‐neck stenosis, while at the same time retaining its advantages of simplicity and safety.3. An operative technique is described and the results in a consecutive unselected series of twenty‐eight cases are presented.Some of these operations were performed while I was in England. My thanks are due to the various surgeons under whose care the patients were admitted for permission to perform the operations. The remainder were performed in Bombay, and my thanks are due to the Superintendent, J.J. Group of Hospitals, Bombay, for permission to include the cases operated on at that hospital.One of my past House Surgeons, Dr A. Khambatta, M.B., B.S., drew the illustrations, and to him I tender my sincerest gratitude.
A TECHNIQUE OF VASECTOMY FOR THE PREVENTION OF EPIDIDYMITIS AFTER PROSTATECTOMY
Authors: BROOKE BRYAN N. , WALKER FRANK C. 
Published: August 2010

SUMMARYThe incidence and aetiology of acute epididymitis following prostatic operations are discussed with reference to the advent of antibiotics.Techniques of vasal interruption are summarised and a further method is described with mention of its advantages.
DOUBLE BLADDER AND RELATED ANOMALIES: CLINICAL AND EMBRYOLOGICAL ASPECTS AND A CASE REPORT
Authors: ABRAHAMSON JACK 
Published: August 2010

SUMMARY1. Reduplication and similar abnormalities of the urinary bladder and associated anomalies are classified and described.2. The literature on this subject is reviewed.3. The embryology, clinical features, diagnosis, treatment, and prognosis are discussed.4. A case report is given of a female aged 9 years presenting with lower urinary tract obstruction and failing renal function, found to have a bladder with a complete sagittal septum with the closed and distended left‐sided chamber obstructing the right‐sided chamber. Bilateral hydro‐ureter and right hydronephrosis were present. The left kidney was hypoplastic. Other associated anomalies were sacral agenesis and an abnormal first lumbar vertebra. Besides the uramia, hypertension, a bleeding tendency, ansmia, uremic pericarditis, and cardiac failure were also present.5. Some features of the case are discussed.I wish to record my gratitude to Mr D. Innes Williams for permission to publish this case and for his encouragement and help in the preparation of this paper. Thanks are also due to Mr D. Martin and Mr G. Lyth of the Departments of Clinical Photography and Medical Illustration, The Hospital for Sick Children, Great Ormond Street, London, for the photographs and drawings.
UNUSUAL VESICAL CALCULI
Authors: STEWART J. O. R. , O'CONNELL N. D. 
Published: August 2010

SUMMARYAn unusual case is reported, in which “ jackstone ” calculi were associated with an enlarged prostate and papilloma of the bladder. The literature is reviewed and a note added on treatment.We wish to thank Mr B. McN. Truscott for permission to treat and publish this case, Dr F. R. Berridge for permission to reproduce the X‐ray films, and Mr S. W. Vince of the Department of Medical Photography, United Cambridge Hospitals, for the photographs.
ANALYSIS OF NEUROGENIC DYSFUNCTION OF THE LOWER URINARY TRACT1
Authors: MURPHY JOHN J. , SCHOENBERG HARRY W. , TRISTAN THEODORE A. 
Published: August 2010

SUMMARYAnalysis of lower urinary tract dysfunction due to neurological disease by means of combined simultaneous cinefluorographic cysto‐urethrography and direct cystometry indicates that patients with reflex neurogenic bladders have high resting intravesical pressures with further increase at the time of reflex contraction and that this contraction is not sustained. The high pressures result from hypertonicity of the detrusor and lack of co‐ordination of the outlet mechanism. Abdominal straining and suprapubic pressure produce high intravesical pressures and may lead to the sequela? of bacteremia and ascending urinary tract infection when used to effect emptying of autonomous‐type neurogenic bladders. As a result of these findings, methods of management which remove the danger of high intravesical pressures are recommended.
LIPID GRANULOMATA OF THE TESTIS AND EPIDIDYMIS1
Authors: PHILLIPS D. E. H. 
Published: August 2010

SUMMARYIn summary it may be stated that a lipid has been demonstrated to be liberated from spermatozoa during the tissue reactions resultant upon extravasation, and that a similar lipid has been demonstrated to be present in the lesions of granulomatous orchitis. There are good reasons for believing that the granulomatous reaction in these conditions is a specific response to the presence of the lipid, and, from the similarities in this lipid histochemically, it seems likely that it is identical in the two conditions, suggesting that the original source of the lipid in the case of granulomatous orchitis is probably disintegrating spermatozoa within the seminiferous tubules.
TWO CASES OF COMPLETE DOUBLE FUNCTIONAL URETHRA WITH A SINGLE BLADDER1
Authors: BOISSONNAT PIERRE 
Published: August 2010

SUMMARYTwo unusual cases of complete double functional urethra, one in a male and the other in a female, with a single bladder (and a single penis in the male case) are presented. No cases exactly like these could be found in the literature. The treatment and aetiology are discussed and the past literature is reviewed.
SUPERVOLTAGE X‐RAY THERAPY AND THE MANAGEMENT OF BLADDER CANCER1
Authors: NEWALL JOSEPH 
Published: August 2010

SUMMARYThe results of treatment of bladder cancer in Edinburgh are reviewed. The best results are obtained from small localised tumours in which localised interstitial irradiation can be given. The results in those patients in whom spread outwith the bladder has occurred are disappointing and the salvage both by irradiation and surgery appears to be small. The real problem is the patient with extensive disease confined to the bladder, and it is suggested that such patients should be treated in the first instance by supervoltage X‐ray therapy, but that if no obvious response is obtained within a short period after completion of the course of therapy then consideration should be given to radical surgery.
THE QUANTJTATION OF RENAL BLOOD FLOW USING I125HIPPURAN
Authors: Chisholm G. D. , Evans K. , Kulatilake A. E. 
Published: August 2010

SUMMARYExperimental studies of renal blood flow have been made with radio‐Hippuran I125using isolated perfused canine kidneys. These studies were made in two groups. First, the renogram curve was analysed by applying theoretical equations and it was shown that quantitative values could be obtained for the effective renal blood flow. In the second group of experiments the analysis of the rate of disappearance of the isotope from the blood showed a definite relationship with directly measured renal blood flow, but this could not be resolved into a quantitative value.The authors' thanks are due to Professor Ralph Shackman for his encouragement and guidance in this work, to Mr E. Gains and his technical staff for their help, to the Department of Photography and Medical Illustration of the Post‐graduate School for their assistance in drawing of the charts, and to Mr Ole Kalnaes, Radiofysisk laboratorium, Arhus Kommunehospital, for his help with mathematical equations.The expenses incurred in these experiments were defrayed by a grant to one of us (A. E. K.) from the Medical Research Council.
EXPERIENCE AND RECENT CONTRIBUTIONS IN SACRAL NERVE STIMULATION FOR VOIDING IN BOTH HUMAN AND ANIMAL1
Authors: Habib HenryN. 
Published: August 2010

SUMMARYPreliminary investigations on sixty‐four dogs and five human paraplegics in the past three years have led to the location of neural trigger points, which in the human were found to be the third and fourth sacral nerves at their exit from the sacral foramina anteriorly. Successful voiding was induced with reproducible results for four to five months using an electrical current about 80 to 100 times smaller than the one used for stimulation of the muscle directly.An interesting by‐product of this chronic stimulation led to the discovery of a neural trigger point which, when stimulated, causes immediate and sustained erection of the penis in paraplegic patients. We plan to try our methods in cases of impotence caused by a nerve lesion proximal to the point of electrical nerve excitation.The present work consists mainly in improving our surgical approach in the human and designing electrodes of special configuration with material well insulated. The electronic exciting mechanism is also being developed in miniature size for prolonged use. Special precautions are being developed to minimise as much as possible the inflammatory reaction of nerve tissue to the electrodes.
THE DIAGNOSIS OF PROSTATIC CANCER: CYTOLOGICAL AND BIOCHEMICAL STUDIES USING THE FRANZEN BIOPSY NEEDLE
Authors: Williams J. P. , Still BessM. , Pugh R. C. B. 
Published: August 2010

SUMMARYExperience of trans‐rectal biopsy, using a fine needle, as a means of diagnosing carcinoma of the prostate is described. Emphasis is laid on the minor nature of the procedure, its cytological reliability and on the useful supporting evidence of malignancy afforded by enzyme estimation of the aspirate. The technique is considered to be a valuable diagnostic method in prostatic disease.
Prescription drug misuse: Is technology friend or foe?
Authors: NIELSEN SUZANNE , BARRATT MONICA JANE 
Published: August 2010

Abstract
Introduction and Aims. Prescription drug misuse and related harms have been increasing considerably over the past decade. At the same time, there has also been rapid growth in the use of online and Internet technologies. Thus, it is important that we understand the role online and Internet technologies play in prescription drug misuse. Design and Methods. Published work addressing the role of technology in prescription drug misuse is explored. Topics include: Internet supply, online monitoring of prescription drug use trends and electronic prescription monitoring. Results. Little is known about the prevalence of acquiring prescription drugs from online pharmacies. Prescription drugs are easily accessible through vendor websites, and ‘rogue’ no‐prescription websites have proven difficult to control. There has so far been limited application of real‐time monitoring to prevent overuse of prescription medications. Online monitoring of drug use trends may also prove to be a useful and timely source of information about new methods of ‘off‐label’ prescription drug use. Discussion and Conclusions. Technology has the potential to play a more prominent role in facilitating drug acquisition, while also enhancing the monitoring and prevention of prescription drug misuse. As technology becomes more ubiquitous in everyday life, the continued investigation of its relationship with prescription drug misuse becomes even more important.[Nielsen S, Barratt MJ. Prescription drug misuse: Is technology friend or foe? Drug Alcohol Rev 2009;28:81–86]
Web‐based screening and advice for hazardous drinkers: Use of a Spanish site
Authors: RODRÍGUEZ‐MARTOS A. , CASTELLANO Y. 
Published: August 2010

Abstract
Introduction and Aims. A website for implementing screening and brief intervention on alcohol was launched in Barcelona, Spain, in October 2006. Its aim was to reach hazardous drinkers who probably would not ask for advice. This article describes use of the site, profiles users and discusses limitations concerning screening. Design and Methods. The website included screening, advice and information. Demographic and self‐screening data (typical weekly consumption and the Alcohol Use Disorders Identification Test, AUDIT) were examined. Results. In a 12 month period, 12 138 visitors entered the website, 2574 started self‐assessment, 1342 completed the table and 724 of these participants completed the AUDIT. These users had a mean age of 27.6 years, one‐third of them drank above recommended weekly limits and 84.1% of those who completed the AUDIT (n = 724) scored positive (≥5); a total of 70.3% of identified at‐risk drinkers entered the advice section. Among visitors to the site, risk factors for hazardous drinking were: being male,≥35 years of age, and drinking heavily at weekends. Discussion and conclusions. The percentage of hazardous drinkers accessing the site was high, and visitors reported that they liked the design, that it was easy to use and that it provided relevant information. Most of those who had sought advice considered it to be helpful. The website seems to be an accessible and useful tool for young people and might be used in youth centres as well as in health‐care settings, such as primary care and emergency centres, where it could contribute to health promotion and constitute an easier alternative to screening and brief intervention given by the staff.[Rodríguez‐Martos A, Castellano Y. Web‐based screening and advice for hazardous drinkers: Use of a Spanish site. Drug Alcohol Rev 2009;28:54–59]
Development of a Web‐based alcohol intervention for university students: Processes and challenges
Authors: HALLETT JONATHAN , MAYCOCK BRUCE , KYPRI KYPROS , HOWAT PETER , MCMANUS ALEXANDRA 
Published: August 2010

Abstract
Introduction and Aims. Despite growing evidence of the efficacy of electronic screening and brief interventions for reducing unhealthy alcohol use, there is no published work describing the development of such interventions. We describe the process of developing and implementing an electronic screening and brief intervention in a large university population. Design and Methods. Thematic analysis of seven focus groups, involving a total of 69 students, informed the content and design of THRIVE (Tertiary Health Research Intervention Via Email). Pilot testing was conducted through usability analysis with a further 16 students. A random sample of 13 000 undergraduates was invited to complete screening and hazardous drinkers were randomised to receive Web‐based assessment and feedback or screening alone. Participants' use of THRIVE was examined through server log analysis and responses to questions on instrument design/usability during follow‐up assessment 6 months later. Results. A total of 7237 students (56% of those invited) completed screening; 2435 (34%) screened positive for unhealthy drinking; 1251 were randomly assigned to receive the intervention; and 1184 served as controls. In total, 99% of participants found THRIVE easy to complete, 76% said it provided personally relevant information and 55% said they would recommend it to a friend with a drinking problem. Thirty per cent sought additional information on support services through the site. Discussion and Conclusions. Key design elements include ease of access (e.g. via an emailed hyperlink), length (<10 min), clear, non‐judgmental language, personalised normative feedback and links to appropriate services. The study demonstrates the potential reach of a carefully implemented intervention in a high‐risk, non‐treatment‐seeking population group.[Hallett J, Maycock B, Kypri K, Howat P, McManus A. Development of a Web‐based alcohol intervention for university students: Processes and challenges. Drug Alcohol Rev 2009;28:31–39]