bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ascorbic acid decreases the antifungal effect of fluconazole in the treatment of candidiasis
Authors: Wang Yan , Jia Xin‐Ming , Jia Jian‐Hui , Li Ming‐Bang , Cao Ying‐Ying , Gao Ping‐Hui , Liao Wan‐Qing , Cao Yong‐Bing , Jiang Yuan‐Ying 
Published: April 2009

Summary

The aim of the present study was to investigate the effects of ascorbic acid (AA) on the antifungal activity of fluconazole (FCZ) in a systemic murine candidiasis model as well as in vitro.
The murine model was established by infusion of Candida albicans via the tail vein. Control mice received no further treatment. Other groups of mice were injected with FCZ (0.5 mg/kg, i.p.) and then treated or not with 50 or 500 mg/kg AA intragastrically (i.g.) or i.p. In all groups, FCZ was administered i.p. 2 h after fungal inoculation, whereas AA was administered 6 h after fungal inoculation. Survival rate, kidney fungal burden and renal pathological changes were evaluated.
The in vitro effects of AA (5, 1 and 0.2 mmol/L) on the growth of various Candida strains in the presence of FCZ (0.125–64 µg/mL) were also investigated. The in vitro effects of two anti‐oxidants, namely N‐acetylcysteine (NAC; 5, 1 and 0.2 mmol/L) and reduced glutathione (GSH; 5, 1 and 0.2 mmol/L), on FCZ activity were evaluated to determine the mechanism of action of AA.
Intragastric administration of AA (50 or 500 mg/kg) significantly decreased the antifungal effect of 0.5 mg/kg FCZ. Although i.p. administration of AA (50 or 500 mg/kg) had no significant effect on the survival of mice, it dose‐dependently inhibited the activity of FCZ, with significant inhibition observed with 500 mg/kg AA.
In vitro, AA decreased the activity of FCZ against various Candida strains. Both NAC and GSH dose‐dependently decreased the activity of FCZ.
The results of the present study indicate that AA inhibits the antifungal activity of FCZ, suggesting that the two should not be used together clinically for the treatment of candidiasis.
Oral nitrate therapy does not affect glucose metabolism in healthy men
Authors: Henstridge Darren C , Duffy Stephen J , Formosa Melissa F , Ahimastos Anna A , Thompson Bruce R , Kingwell Bronwyn A 
Published: April 2009

SummaryPreviously, we demonstrated that nitric oxide (NO) may be an important mediator of peripheral glucose disposal. The aim of the present study was to determine whether acute oral nitrate therapy improves glucose metabolism in healthy individuals.Healthy men (n = 10), aged between 19 and 46 years, participated in a randomized cross‐over placebo‐controlled study. During Visit 1, participants received a dose‐graded intravenous infusion of sodium nitroprusside (SNP; titrated from a dose of 0.5 μg/kg per min to a maximum of 2 μg/kg per min and delivered at a rate of 2 mL/min over 30 min). On Visits 2, 3 and 4, participants received oral extended‐release isosorbide mononitrate (120 mg), pentaerythritol tetranitrate (160 mg) and placebo in a randomized Latin square design (one treatment per visit). The main outcome measures were plasma glucose and insulin levels and glucose tolerance determined by an oral glucose tolerance test following the SNP infusion and 3 h after nitrate/placebo administration. Exhaled NO, cGMP and pulmonary blood flow were also measured for 3 h after administration of nitrate/placebo and after SNP infusion.None of the nitrate interventions influenced measures of glucose metabolism. Following SNP infusion, there was no change in plasma glucose (P = 0.42) or insulin (P = 0.25) levels, and the response to a glucose load did not different from baseline (P = 0.46). Similarly, neither of the oral nitrates altered plasma glucose (P = 0.24) or insulin levels (P = 0.90) or glucose tolerance (P = 0.56) compared with placebo.In conclusion, these results indicate that acute oral nitrate therapy does not influence glucose metabolism. Studies using NO donors in a chronic setting are required to clarify the role of NO in mediating peripheral glucose uptake.
In Vitroelectrophysiological activity of nerispirdine, a novel 4‐aminopyridine derivative
Authors: Smith Craig , Kongsamut Sathapana , Wang Hongge , Ji Junzhi , Kang Jiesheng , Rampe David 
Published: April 2009

SummaryThe non‐selective K+channel blocker 4‐aminopyridine (4‐AP) has shown clinical efficacy in the treatment of neurological disorders such as multiple sclerosis. The clinical usefulness of 4‐AP is hampered by its ability to produce seizures. Nerispirdine, an analogue of 4‐AP, is currently under clinical investigation for the treatment of multiple sclerosis. In contrast with 4‐AP, nerispirdine is not proconvulsant, suggesting mechanistic differences between the two drugs.Using whole‐cell patch‐clamp electrophysiology, we compared the effects of 4‐AP and nerispirdine on the cloned human K+channels Kv1.1 and Kv1.2, expressed in Chinese hamster ovary cells, and on voltage‐dependent Na+channels recorded from human SH‐SY5Y cells.Nerispirdine inhibited Kv1.1 and Kv1.2 with IC50values of 3.6 and 3.7 μmol/L, respectively. 4‐Aminopyridine was approximately 50‐fold less potent at blocking these channels. Nerispirdine also inhibited voltage‐dependent Na+channel currents recorded from human SH‐SY5Y cells with an IC50of 11.9 μmol/L when measured from a –70 mV holding potential. In contrast, 4‐AP had no effect on Na+channel currents.The results demonstrate that nerispirdine, like 4‐AP, can inhibit axonal K+channels and that this mechanism may underlie the ability of the drug to enhance neuronal conduction. Unlike 4‐AP, nerispirdine can also inhibit neuronal Na+channels, a mechanism that may explain why nerispirdine lacks proconvulsant activity.
Do changes in the coupling between respiratory and sympathetic activities contribute to neurogenic hypertension?
Authors: Zoccal Daniel B , Paton Julian FR , Machado Benedito H 
Published: April 2009

Summary

It is well known that respiration markedly modulates the sympathetic nervous system. Interactions between pontine and medullary neurons involved in the control of sympathetic and respiratory functions are the main mechanism underlying the respiratory related oscillations in sympathetic nerve activity.
Recently, in rats treated with chronic intermittent hypoxia, we demonstrated that alterations in respiratory pattern may drive increased sympathetic outflow and hence the development of systemic hypertension. These experiments, performed in the in situ working heart–brain stem preparation, raise the possibility that enhanced central coupling between respiratory and sympathetic activities could be a potential mechanism underpinning the development and/or the maintenance of neurogenic hypertension.
In the present review, we discuss the neural basis of the enhanced entrainment between respiratory and sympathetic neurons in the brain stem that can be induced by chronic intermittent hypoxia and the possible implications of these mechanisms in the genesis of sympathetic overactivity and, consequently, hypertension.
EFFECTS OF 1400W AND/OR NITROGLYCERIN ON RENAL OXYGENATION AND KIDNEY FUNCTION DURING ENDOTOXAEMIA IN ANAESTHETIZED RATS
Authors: Johannes Tanja , Mik Egbert G , Klingel Karin , Goedhart Peter T , Zanke Christof , Nohé Boris , Dieterich Hans‐Jürgen , Unertl Klaus E , Ince Can 
Published: April 2009

SUMMARYThe pathogenesis of acute renal failure (ARF) in sepsis is multifactorial. The role of nitric oxide (NO) in septic ARF has been a source of controversy. We hypothesized that endotoxaemia‐induced exacerbation of inducible nitric oxide synthase (iNOS)‐related NO release impairs renal oxygenation and contributes to ARF in anaesthetized rats.In the present study, rats received lipopolysaccharide (2.5 mg/kg) for 30 min. Two hours later, fluid resuscitation was started (HES130; 5 mL/kg per h after a 5 mL/kg bolus) supplemented either by the NO donor nitroglycerin (NTG; 0.5 µg/kg per min after a 2 µg/kg bolus), the selective iNOS inhibitor 1400W (3 mg/kg per h after a 3 mg/kg bolus) or both. Systemic haemodynamics and renal microvascularPo2(µPo2) were recorded continuously. Furthermore, creatinine clearance, plasma NOx(nitrate + nitrite + S‐nitrosothiols) levels and the expression of iNOS mRNA were measured.Endotoxaemia reduced renal blood flow, decreased mean arterial pressure, resulted in anuria and was associated with an increase in plasma NOxlevels and renal iNOS expression. Renal µPo2deteriorated gradually during endotoxaemia and there was a significant decrease in renal O2delivery and consumption. Manipulation of NO levels had no beneficial effect on systemic haemodynamics, renal µPo2or creatinine clearance over standard fluid resuscitation. The application of 1400W+NTG significantly reduced plasma NOxlevels compared with fluid resuscitation and NTG alone.Neither iNOS inhibition, NO donation nor a combination of both showed beneficial effects on systemic haemodynamics, renal oxygenation and renal function compared with fluid resuscitation alone. Our results question the proposed key role of NO in the pathogenesis of septic ARF in rats.
Occurrence conditions of hyperpycnal flows, and their significance for organic‐matter sedimentation in a Holocene estuary, Niigata Plain, Central Japan
Authors: Yoshida Mamiko , Yoshiuchi Yuka , Hoyanagi Koichi 
Published: April 2009

AbstractRiver floods influence sedimentary environments and ecosystems from the terrestrial to the deep‐marine. This study documents the occurrence conditions of hyperpycnal flows generated by river floods and related organic‐matter sedimentation for Holocene sediments of the Niigata Plain, Central Japan, based on detailed sedimentary facies, total sulfur and total organic carbon content, diatom assemblages and organic‐matter composition. Holocene sediments of the Niigata Plain consist of sand, mud and gravel that were deposited in estuarine and fluvial systems during a sea‐level rise (15 000–6800 years BP) and stillstand (after 6800 years BP) following the Last Glacial Maximum. Hyperpycnites are present in the upper part of the estuarine lagoon sediments. The depositional age is considered to be about 5000 years BP. The hyperpycnites comprise two successions of a top fining‐up unit and a basal coarsening‐up unit, and include abundant terrigenous organic matter and freshwater diatoms. A large volume of freshwater is inferred to have flowed into the lagoon during deposition of the upper part of the lagoon sediments. In consequence, hyperpycnal flows may have readily formed in the lagoon, because the halocline was weak. The hyperpycnal flows also produced a layer of concentrated terrigenous organic matter in the uppermost part of the hyperpycnites. The abundant organic matter on the estuarine floor is inferred to have produced anoxic bottom conditions owing to oxidative decomposition by benthic bacteria.
BT02 LAPAROSCOPIC SLEEVE GASTRECTOMY AS A SINGLE‐STAGE BARIATRIC PROCEDURE
Authors: Sammour T. , Hill A. G. , Singh P. , Ranasinghe A. , Babor R. , Rahman H. 
Published: April 2009

Purpose:   Laparoscopic sleeve gastrectomy is increasingly being recognised as a stand‐alone procedure in bariatric surgery, with long term follow‐up data now emerging. We present our early experience patients with a mean BMI in the super‐obese range.Methodology:   Retrospective review of laparoscopic sleeve gastrectomies performed by two surgeons at Middlemore Hospital, between March 2007 and July 2008.Results:   One hundred and one patients were identified, with a mean age of 42.7 years (95% CI 40.9–44.5). Maori and Pacific Islanders made up 31% of the patient subset. Patients had a mean BMI of 50.2 kg/m2 (95% CI 48.8–51.7), and 45 patients were super‐obese. They had a median hospital stay of 2 days (1–7 days), and a mean follow‐up of 6.0 months. Mean excess BMI loss (excluding patients with a major complication) was 46% (95% CI 43.3–48.7). 64% of diabetics and 37% of hypertensives showed in an improvement in medication requirement. There was a major complication rate of 8%, including 3 staple line leaks (one of which required laparotomy), 2 staple line bleeds (one requiring laparotomy), 1 infected haematoma, and 1 critical stricture. There were no deaths.Conclusion:   Laparoscopic sleeve gastrectomy has achieved satisfactory weight‐loss results with an acceptable complication rate in the short to medium term.
BT03 SILASTIC RING MINI GASTRIC BYPASS FOR MORBID OBESITY: THE NEW ZEALAND EXPERIENCE
Authors: Wong K. C. , Booth M. 
Published: April 2009

Purpose:   The laparoscopic mini gastric bypass (LMGB) is purportedly a technically simpler, yet equally effective operation to the laparoscopic Roux‐en‐Y gastric bypass as treatment for morbid obesity. This study reports the early results of LMGB in a major New Zealand bariatric centre.Methodology:   Clinical data was prospectively collected on all patients undergoing LMGB over a two year period.Results:   142 patients were studied. 77% were females. Mean age was 43.8. Pre‐operative mean body weight and body mass index (BMI) were 121.3 kg and 45.4 kg/m2 respectively. Mean BMI at one and two years follow up had decreased to 27.35 and 25.72 kg/m2 respectively. 83% of patients reported obesity associated co‐morbidities pre‐operatively. Post‐operatively, 78% of patients reported a reduction in medication requirement. All surgery was performed laparoscopically. There were no anastomotic leaks and zero mortality. 8% of patients required further operations for complications or revision to a Roux‐en‐Y gastric bypass. 20% of patients required subsequent endoscopic interventions, the majority for investigation of vomiting and/or pain. 22% of patients required re‐admission. 14% of patients reported new onset reflux or worsening of pre‐existing reflux after LMGB. 82% of patients reported increased exercise capability post LMGB. 54% of patients required vitamin supplementation.Conclusion:   LMGB achieves significant weight loss and resolution of obesity related co‐morbidities with a low short term complication rate. LMGB should be considered as a safe and simple surgical option for morbid obesity.
BT04 LAPAROSCOPIC REVISION OF GASTRIC BAND SURGERY
Authors: Bardsley S. , Hopkins G. 
Published: April 2009

Aim:   To identify the outcome of laparoscopic revision of gastric band surgery with respect to percentage of excess weight lost (%EWL).Methods:   Analysis of a prospective database was performed and %EWL was plotted with respect to time from initial procedure and also time from revision procedure.Results:   All revision operations were performed laparoscopically. There were no patient deaths, but two serious complications. Percentage Excess Weight Loss after replacement of the band because of prosthetic failure or dysphagia was 57% at an average follow up of 19 months. For repositioning of the band due to slippage, the %EWL was 72% at an average of 15 months follow up for those who had the existing band repositioned, and 42% at an average of 23 months follow up for those who had a new band repositioned.Conclusion:   Revision laparoscopic gastric band surgery is a safe option for patients, and results in good %EWL at an average follow up period of 19 months.
BS10 POST‐SURGICAL CARE IN BREAST CANCER – PROCESS MAPPING CURRENT MODELS IN AUSTRALIA
Authors: Giles C. , Buckingham J. , Delaney G. , Pearce A. , Wilcoxon H. , Zorbas H. 
Published: April 2009

Purpose:   Evidence collated by National Breast and Ovarian Cancer Centre (NBOCC) suggests that recent reductions in length of stay (LOS) following early breast cancer surgery are influencing the care women receive. Process mapping (PM) identifies steps involved in a patient's pathway. This project utilises PM to identify successful components and gaps in current models related to LOS and highlight opportunities to improve the post‐surgical (PS) care of women with breast cancer in Australia.Methodology:   Nine Australian hospitals were selected for high level PM using seven criteria; public/private, metropolitan/regional, services (diagnostic, treatment and follow up), surgical caseload, patient management protocols, multidisciplinary care, information and support. PM includes a workshop with the multidisciplinary team and consumers, as well as interviews with key clinical informants from the PS care pathway.Results:   PM results in a series of flowcharts of the PS pathway. These inform a report on current models of care and their successful aspects, together with stakeholder perceptions. Differences between public/private and metropolitan/regional facilities are highlighted, along with the impact of different delivery models on the provision of information, clinical and supportive care for women.Conclusion:   PM allows a representation of the impact of LOS on women's PS care, and the extent to which information, clinical and supportive care are available within current models. These results, combined with other NBOCC collated data (including AIHW statistics, surveys of women and breast care nurses, and literature reviews) will inform recommendations on new delivery models.
BS12 SURGICAL OUTCOMES IN NEO‐ADJUVANT CHEMOTHERAPY FOR INFLAMMATORY AND LOCALLY ADVANCED BREAST CANCER EOVER 5 YEARS OF SINGLE INSTITUTION EXPERIENCE
Authors: Dean T. L. , Pitcher M. 
Published: April 2009

Purpose:   Examination of short and long term surgical outcomes and degree of pathological response in breast cancer patients who have undergone neo‐adjuvant chemotherapy surgery at Western Health from March 2003 – December 2008.Methods:   retrospective analysis of prospectively maintained breast cancer database as well as examination of medical records, pathology and radiology reports. 28 of the 535 patients in the database met criteria for inclusion.Results:   26/28 underwent mastectomy and axillary dissection +/− immediate reconstruction.Pathological response – 7.1% had no residual disease, 10.7% had in situ disease only. A reduction in maximum diameter of > 50% was found in 35.7%. 18.8% were minimally or unresponsive.The degree of clinical response did not correlate reliably with degree of pathological response.Wound infection was seen in 100% smokers and 19% non‐smokers.4 patients had evidence of metastatic disease at presentation. 5 of the remaining 24 (20.8%) developed distant metastases.4/28 suffered loco‐regional recurrence during the study period.4/28 patients died from their disease, 50% of whom had extensive metastases at diagnosis.Follow up range 6–69 months, average follow up 32 months.We found a relationship between post neo‐adjuvant chemotherapy AJCC stage and survival.Conclusions:   Neo‐adjuvant chemotherapy prior to surgery allows good local control and safe reconstruction in locally advanced and inflammatory breast cancer. Smoking cessation should be encouraged prior to surgery to decrease post operative morbidity due to wound complications. Continued follow up of this group would allow examination of and 10 year outcomes.
BS03 UPDATES FROM RACS NATIONAL BREAST CANCER AUDIT
Authors: Malycha P. L. 
Published: April 2009

RACS National Breast Cancer Audit (NBCA) began in 1998 when a Standing Committee of the House of Representatives indicated that RACS should establish it post haste.It started as a paper based audit using Windows Access in the College Office in Adelaide in 1998 and has grown into a web based audit under the management of ASERNIPS.It now has 80,000 patients enrolled and is beginning to close the audit loop by analyzing relevant key performance indicators (KPI).These indicators are the percentage of patients treated with breast conserving surgery referred for radiotherapy (>85%), the percentage of patients prescribed or referred for hormone therapy for ER+ patients (>85%), the percentage of patients undergoing axillary surgery for invasive breast cancer (KPI > 90%) and the percentage of patients who underwent breast conserving surgery undergoing no axillary surgery (>90%).New KPIs are being added and data tidied.The current numbers and analysis as well as plans for the audit will be presented.
BS06 INDICATIONS FOR SENTINEL LYMPH NODE BIOPSY IN PATIENTS WITH A PRE‐OPERATIVE DIAGNOSIS OF DUCTAL CARCINOMA IN SITU
Authors: Jones B. J. , Buckingham J. M. 
Published: April 2009

Purpose:   Ductal carcinoma in situ (DCIS) is non‐invasive so the use of sentinel lymph node biopsy (SLNB) in patients diagnosed with DCIS is questionable. DCIS has the potential to progress to invasive cancer, so SLNB would be useful in staging disease in patients at higher risk of invasion. This study aims to identify pre‐operative characteristics of DCIS that are predictors of invasive disease and thus provide a guide as to when to use SLNB.Methodology:   This study is a consecutive series of 374 patients that underwent SLNB, of whom 37 patients had a preoperative diagnosis of DCIS, treated by one surgeon between July 2001 and February 2008. The association between pre‐ operative clinical and pathological factors and a post‐operative diagnosis of invasive disease were analysed. Associations between final pathological diagnosis of DCIS or invasive disease and treatment parameters were also analysed.Results:   Of the 37 patients, 13 (35%) were found to have invasive disease post‐operatively. Analysis revealed that an initial suspicion of microinvasion, larger mammographic size, younger age, diagnosis with core biopsy, nipple discharge and presence of necrosis had statistically significant association with a post‐operative diagnosis of invasive cancer. Only patients with invasive disease had positive SLNs. Analysis of treatment with mastectomy or conservative surgery showed a link between mastectomy and a palpable lump.Conclusion:   SLNB is recommended for staging disease in patients with a pre‐operative diagnosis of DCIS who also have characteristics suggestive of invasive disease
BS07 MEDIUM‐TERM OUTCOME OF SCREEN‐DETECTED DCIS TREATED WITH WIDE EXCISION ALONE
Authors: Fong J. Y. , Kurniawan E. D. , Windle I. , Rose A. K. , Mann G. B. 
Published: April 2009

Purpose:   The optimal treatment for ductal carcinoma in situ (DCIS) remains controversial. Randomised trials have shown a 50% reduction in local recurrence (LR) with the addition of radiotherapy (RT) to Wide excision (WE) with no difference in overall survival. We used our database to assess the outcome of patients with screen‐detected DCIS treated primarily with WE only.Methodology:   All patients with DCIS detected through NorthWestern BreastScreen in Melbourne, Australia from 1988–2005 were identified. Demographic, pathological and outcome data were collected from BreastScreen databases, Medical Record review and the National Death Registry.Results:   490 patients were diagnosed with DCIS without invasive cancer. 3 opted out of the study. 46 were treated with mastectomy, and 45 were lost to follow‐up, leaving 396 patients for analysis. 5‐year breast cancer specific‐survival was 99.2%, and 5 year overall survival was 96.3%. There were 78 local recurrences, with a 5‐year LR rate of 15%. Factors potentially associated with LR including grade, size, margin status and age were analysed. No significant associations on Univariate or Multivariate analysis were found (p = 0.32–0.83). No sizeable subgroup with a very low risk of LR could be identified.Conclusion:   Our study confirms that treatment of screen‐detected DCIS with WE alone is associated with excellent breast cancer specific survival and a moderate rate of LR. We were unable to identify associations with low recurrence rate, nor subgroups with minimal recurrence risk. Decisions regarding RT must balance inconvenience and side effects of RT with higher LR rate.