bluuebunny/crossref_metadata_2025_split huggingface dataset:
TRANSECTION OF METAL STENTS USING ARGON PLASMA COAGULATION
Authors: Tai Mayumi , Ichii Osamu , Watanabe Tatsuyuki , Ejiri Yutaka , Otsuki Makoto 
Published: September 2010

Background:  Placement of self‐expandable metallic stents has become the preferred palliative treatment for patients with unresectable malignant biliary obstruction. Metallic stents provide longer patency compared with plastic stents. Distal malposition or migration of metallic stents sometimes occurs, but it is often difficult to remove them. We evaluated the efficacy and safety of argon plasma coagulation (APC), and the optimum conditions for cutting metallic stents (Wallstent).Methods:  We wrapped porcine small intestines around a metallic Wallstent with and without silicon lining membrane (Permulume®), leaving the distal portion unwrapped to resemble the protrusion of the biliary metallic stent from the ampulla of Vater. APC irradiation was applied to the metallic stent at 1 cm from the edge of the wrapped small intestine at 30, 60 and 99 watts (W) for 3 or 6 s.Results:  Metallic Wallstent with the silicone‐based membrane Permalume® was cut at 30 W power, whereas more than 60 W power was required to cut the bare metallic wire. The irradiation of APC (flow rate at 2.0 L/min) at 30 W to the covered metallic stent transected the metallic mesh stent not only under dry but also under wet conditions (moisturized stent). Irradiation of APC caused no gross damage to the small intestines irrespective of the power applied and duration of irradiation.Conclusions:  Our results suggest that APC is efficacious and safe for endoscopic sectioning of wire mesh stents at low power (30 W) without gross damage to the surrounding pancreaticobiliary tissues.
MIXED INTESTINAL‐ AND DIFFUSE‐TYPE HISTOLOGY IS A RISK FACTOR FOR LYMPH NODE METASTASIS OF SUBMUCOSAL INVASIVE GASTRIC CANCER
Authors: Tsuji Naoko , Ishiguro Shingo , Umehara Yasuko , Kudo Masatoshi 
Published: September 2010

Background:  Endoscopic submucosal dissection is expected to increase the number of node‐negative submucosal invasive gastric cancers, particularly differentiated‐type adenocarcinomas that can be treated conservatively.Methods:  Two hundred and seven consecutive surgically treated cases of differentiated‐type early gastric cancer with submucosal invasion were analyzed clinicopathologically. Comparison was made between patients with node‐positive (n = 33) and node‐negative cancer (n = 174). Whole sections of surgical specimens were reviewed and reclassified as pure intestinal type or mixed type. The intramucosal and submucosal components were also described histologically, and the depth of invasion from the muscularis mucosae as well as the width of submucosal invasion was measured.Results:  Twenty‐four of 33 (73%) node‐positive cases were of the mixed type, whereas 71 of 174 (41%) node‐negative cases were of the mixed type (P < 0.01). As for the intramucosal histology, the ratio of mixed‐type was also higher in the node‐positive group (58% vs 34%; P < 0.05). Other factors associated with lymph node metastasis were larger tumor size (P = 0.003), deeper submucosal invasion (P < 0.001) and wider submucosal extension (P = 0.004), and lymphatic permeation (P < 0.001). Multivariate analysis demonstrated that lymphatic permeation (P = 0.001, OR 4.76), and mixed‐type histology (OR 2.56) were independent risk factors.Conclusions:  Histological heterogeneity is a risk factor for metastasis of submucosal invasive gastric cancer to lymph nodes. Heterogeneity of mucosal components is also a significant risk factor and thus a good predictor of lymph node metastasis, potentially useful in distinguishing patients ineligible for conservative therapy.
TOTAL THYROIDECTOMY: ITS ROLE IN THE MANAGEMENT OF THYROID DISEASE
Authors: Khadra M. , Delbridge L. , Reeve T. S. , Poole A. G. , Crummer P. 
Published: September 2010

Book reviews in this article:Of 7812 patients treated for thyroid disease in the Endocrine Surgical Unit at the Royal North Shore Hospital, 825 underwent total thyroidectomy as an initial procedure. One third of these patients (269) were operated on for malignancy and the remaining 556 were treated for benign conditions such as multinodular goitre (405), Graves' Disease (79) and thyroiditis (45). The rate of recurrent laryngeal nerve palsy was 0.5% while permanent hypoparathyroidism occurred in 0.6% of cases, the low complication rate being due to the technique of capsular dissection employed in the Unit. The number of total thyroidectomies performed as a percentage of all thyroid operations has risen from 4% in 1970 to more than 40% in 1990. The majority of this increase has been due to surgery for multinodular goitre where the proportion of patients treated by total thyroidectomy now exceeds 80%. A similar but smaller increase has been seen in an analysis of the New South Wales figures for all other public and private hospitals. It is concluded that the complication rate from total thyroidectomy can no longer be used to argue against its use as the definitive operation for malignant disease of the thyroid. Furthermore, in view of the risks of re‐operative surgery, total thyroidectomy should be considered the operation of choice for most benign disease affecting the whole thyroid gland such as multinodular goitre, thyroiditis, and in a significant number of goitres affected by thyrotoxicosis.
REGRESSION OF LIVER METASTASES FOLLOWING TREATMENT WITH YTTRIUM‐90 MICROSPHERES
Authors: Gray B. N. , Anderson J. E. , Burton M. A. , van Hazel G. , Codde J. , Morgan C. , Klemp P. 
Published: September 2010

Book reviews in this article:Selective internal radiation (SIR) therapy is a technique developed by our group for concentration of Yttrium‐90 microspheres into liver metastases. The technique involves laparotomy, insertion of the catheter into the hepatic artery, redistribution of liver blood flow with vaso‐active agents and incremental embolization of Yttrium‐90 containing microspheres (SIR spheres) into the liver.Twenty‐nine patients with non‐resectable liver metastases from primary adenocarcinoma of the large bowel were treated by this technique and followed for a minimum of three months to assess evidence of tumour regression. Response to treatment was measured by serial estimations of carcino‐embryonic antigen (CEA) and tumour volumes measured from serial computerized tomography (CT) scanning of the liver.There was a fall in the serum CEA level in all 26 patients in whom the serial estimations of CEA were performed following SIR therapy. The overall mean fall in CEA was 70% of pre‐treatment levels with 88% of patients (23 of 26) experiencing more than a 50% fall in pre‐treatment CEA levels.In 18 of 22 evaluable patients CT measured tumour volumes decreased following SIR therapy. In 48% of patients (10 of 22 patients) the decrease in tumour volume was more than 50%.SIR therapy results in a high rate of tumour regression in patients with liver metastases secondary to large bowel cancer.
NEUROGENIC CLAUDICATION SECONDARY TO VASCULAR DISEASE
Authors: Murphy M. A. , Denton M. J. , Scott D. F. 
Published: September 2010

Book reviews in this article:Neurogenic claudication is characterized by sensory symptoms which appear during exercise or while maintaining a fixed posture. They are paraesthetic in quality, may be associated with ‘march’ phenomena, and patients may have bowel and bladder disturbance. The problem is most commonly secondary to lumbar canal stenosis (LCS) but rarely due to aortic disease, as shown in this case report. This report concerns a 66 year old woman who presented with symptoms of paraesthesia radiating from the buttocks to the thigh and, intermittent loss of bladder and bowel function, all associated with walking. There were no associated symptoms of vascular claudication. Clinically, there was evidence of aorto‐iliac obstruction with absence of femoral pulses and a vascular index of 0.4 at both ankles. Neurological examination was normal at rest but the left ankle jerk was absent immediately after exercise. Myelogram and computerized tomographic (CT) scan were normal. An aortogram revealed a very tight irregular stenosis of the aorta at the level of the renal and mesenteric arteries. Very few lumbar vessels were seen. An aortic endarterectomy via a thoraco‐abdominal approach was performed and an aortobifemoral graft inserted. The patient's symptoms resolved following this procedure. We postulate that her symptoms were caused by a ‘steal’ from the blood supply to the cauda equinda due to the severe athromatous disease of her upper abdominal aorta.
CASE REPORT: Corneal papilloma associated with papillomavirus in a one‐humped camel (Camelus dromedarius)
Authors: Kılıç Nuh , Toplu Nihat , Aydoğan Ahmet , Yaygıngül Rahime , Özsoy Şule Yurdagül 
Published: September 2010

AbstractA 15‐year‐old male dromedary camel with a history of chronic severe keratoconjunctivitis and corneal mass in the left eye of 6 months’ duration was referred to the Veterinary Medical Teaching Hospital at Adnan Menderes University. A superficial keratectomy was performed and biopsy material submitted for histopathology. The diagnosis was corneal papilloma. There has been no recurrence of the neoplasm to date (6 months, 1 year). Corneal papilloma has not been reported previously in camels and seems to be associated with papillomavirus.
Electroretinography in the western gray kangaroo (Macropus fuliginosus)
Authors: Labelle Amber L. , Hamor Ralph E. , Narfström Kristina , Breaux Carrie B. 
Published: September 2010

AbstractObjective To perform electroretinography on normal anesthetized western gray kangaroos (Macropus fuliginosus).Animals studied Six captive western gray kangaroos.Procedures The kangaroos were anesthetized using a combination of ketamine and medetomidine via a remote drug delivery system, then were maintained on isoflurane after endotracheal intubation and reversal of the medetomidine with atipamazole. After a minimum of 20 min of dark adaptation, electroretinograms were obtained using a handheld electroretinography (ERG) machine using a single flash protocol at three light intensities: 10 mcd.s/m2, 3000 mcd.s/m2, 10 000 mcd.s/m2.Results At 10 mcd.s/m2the mean b‐wave amplitude and implicit time was 102.0 μV (SD ± 41.3 and 95% CI 68.9–135.1) and 78.4 ms (SD ± 8.3 and 95% CI 71.8–85.0). At 3000 mcd.s/m2the mean a‐wave amplitude and implicit time was 69.9 μV (SD ± 20.5 and 95% CI 53.5–86.3) and 17.6 ms (SD ± 1.5 and 95% CI 16.4–18.8) and the mean b‐wave amplitude and implicit time was 175.4 μV (SD ± 35.9 and 95% CI 146.7–204.1) and 74.1 ms (SD ± 3.5 and 95% CI 71.2–76.9). At 10 000 mcd.s/m2the mean a‐wave amplitude and implicit time was 89.1 μV (SD ± 27.1 and 95% CI 67.5–110.8) and 16.8 ms (SD ± 1.0 and 95% CI 16.0–17.0) and the mean b‐wave amplitude and implicit time was 203.7 μV (SD ± 41.4 and 95% CI 170.6–236.8) and 75.4 ms (SD ± 3.3 and 95% CI 72.8–78.1).Conclusion Electroretinography outside of the typical clinical setting is feasible using a portable ERG system and allows for quick analysis of retinal function in exotic species.
Anatomy of the California sea lion globe
Authors: Miller Sarah N. , Colitz Carmen M. H. , Dubielzig Richard R. 
Published: September 2010

AbstractObjective  This study analyzed the morphology of the California sea lion globe to determine what features may contribute to their characteristic visual abilities.Procedure  Globes from the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW) collection were examined from gross photographs and microscopic sections stained with hematoxylin and eosin, trichrome, smooth muscle actin, and alcian blue periodic acid–Schiff (PAS). Transmission electron microscopy of the cornea and iris was also performed.Clinical results  There was a round, flattened area ventromedial to the axial cornea. The pupil was tear‐drop shaped. Pectinate ligaments were visible without magnification. The retina was holangiotic, containing numerous spoke‐like venules and arterioles. The tapetum was green encompassing the entire fundus. The optic nerve was unmyelinated.Histological results  The sclera was thinnest equatorially and thickest at the limbus and posterior pole. Bowman’s layer was difficult to see by light microscopy but clear with transmission electron microscopy. The cornea had a thick epithelium, thin endothelium and Descemet’s membrane, and the stroma thinned axially. The dilator muscle was absent near the pupil, but enlarged and mingled with the sphincter muscle near the iris base. A large, wide ciliary cleft with prominent trabeculae and a single continuous pectinate ligament was present. The corneoscleral trabecular meshwork was discontinuous. A round lens attached to the ciliary body via direct attachment to ciliary processes and delicate zonular ligaments. There was a circumferential muscle at the base of the ciliary processes. A thick tapetum covered the entire fundus except peripherally. The retina was characterized by sparse, large ganglion cells.
Accuracy and reproducibility of the TonoVet®rebound tonometer in birds of prey
Authors: Reuter Anne , Müller Kerstin , Arndt Gisela , Eule Johanna Corinna 
Published: September 2010

AbstractObjective To examine the accuracy and reproducibility of intraocular pressure (IOP) measurements obtained by the TonoVet®rebound tonometer.Animals studied Freshly enucleated healthy eyes of 44 free‐ranging birds of prey out of the speciesHaliaeetus albicilla, Accipiter gentilis, Accipiter nisus, Buteo buteo, Falco tinnunculus, Strix aluco, Asio otusandTyto albaeuthanized because of unrelated health problems.Procedures IOP readings from the TonoVet®were compared with a manometric device, with IOP being set from 5 to 100 mmHg in steps of 5 mmHg by adjusting the height of a NaCl solution reservoir connected to the eye. Reproducibility of the TonoVet®readings was determined by repeated measurements.Results TonoVet®and manometer values showed a strong linear correlation. In the Accipitridae, the TonoVet®tended to increasingly overestimate IOP with increasing pressure, while in the other families, it increasingly underestimated it. In the Sparrowhawk, the values almost represent the ideal line. Reproducibility of TonoVet®values decreases with increasing pressure in the clinically important range from 5 to 60 mmHg.Conclusion IOP values measured with the TonoVet®demonstrated species specific deviation from the manometric measurements. These differences should be considered when interpreting IOP values. Using the regression formulae presented, corrected IOP values could be calculated in a clinical setting.
Association of steroid and xenobiotic receptor (SXR) and multidrug resistance 1 (MDR1) gene expression with survival among patients with invasive bladder carcinoma
Authors: Rioja Jorge , Bandrés Eva , Rosell Costa David , Rincón Anibal , López Ines , Zudaire Bergera Juan Javier , García Foncillas Jesús , Gil María Jesús , Panizo Angel , Plaza Luis , Rioja Luis Angel , Berián Polo José María 
Published: September 2010

What’s known on the subject? and What does the study add? SXR and MDR1 are known as responsible for chemo and radiotherapy resistance in some cancers, like kidney cancer (MDR1). Invasive bladder cancer is an aggressive disease, with different behaviour upon its tumoral stage, and also within the same tumoral stage, therefore molecular markers are sought.This study shows a new molecular marker, which has shown as a predictor for bad prognosis cancers, therefore, allowing us for a better patient selection for aggressive therapies.OBJECTIVE• To investigate the prognostic value of steroid and xenobiotic receptor (SXR) and multidrug resistance 1 (MDR1) gene expression in relation to survival among patients with invasive bladder cancer.PATIENTS AND METHODS• The prospective study included 67 patients diagnosed with invasive bladder cancer and treated with radical cystectomy at one of two institutions.• SXR and MDR1 gene expression was assessed by real‐time quantitative polymerase chain reaction (RT‐PCR) in tumoral and normal tissue from frozen surgical specimens.RESULTS• Patients were followed for a mean of 29 months; 31 patients (46%) had progression.• In univariate analysis, significant predictors of overall survival (OS) were pathological stage, lymph node (LN) status, histological grade, vascular‐lymphatic invasion, and SXR expression.• In multivariate analysis, independent predictors of OS were LN status (odds ratio [OR], 2.96; P= 0.034), vascular‐lymphatic invasion (OR, 2.50; P= 0.029), and SXR expression (OR, 1.05, P= 0.03).• Among the 51 patients with negative LNs (pN0), univariate predictors of OS were SXR expression, MDR1 expression, and pathological stage. In multivariate analysis, SXR expression (OR, 1.06; P= 0.01) and MDR1 expression (OR, 3.27; P= 0.03) were independently associated with survival.• Within the pN0 group, patients with SXR expression had shorter progression‐free survival than did those without expression (P= 0.004). This association persisted in the N0 subgroup with stage pT3–pT4 disease (P= 0.028). However, in the pN1 group SXR expression did not have any influence.CONCLUSIONS• For patients with invasive bladder cancer, SXR expression has value as a predictor of survival independent of the standard pathological predictors.• Its maximum importance appears to be in patients with stage pT3–pT4 pN0 disease.
Medical information about diabetes—how to keep up to date
Authors: Gadsby R. , Hall H. E. , Court R. A. 
Published: September 2010

Diabet. Med. 27, 1335–1340 (2010)AbstractThere is a vast amount of new medical information published on diabetes each year; the number of systematic reviews on diabetes is also increasing rapidly. It is therefore difficult for clinicians keep up to date with the new evidence. It is suggested that reading the full National Institute for Clinical Excellence (NICE) guidelines on diabetes will bring you up to date with information as at the date of the evidence cut‐off, which is usually approximately 1 year before publication. Also regularly visiting ‘NHS Evidence—diabetes’, an online resource that offers a foraging service, surveying the literature and alerting clinicians to all the new important and useful information, enables the busy clinician to manage information overload and help keep up to date.
The experience of home nurses with an electronic nursing health record
Authors: De Vliegher K. , Paquay L. , Vernieuwe S. , Van Gansbeke H. 
Published: September 2010

DE VLIEGHER K., PAQUAY L., VERNIEUWE S. & VAN GANSBEKE H. (2010) The experience of home nurses with an electronic nursing health record. International Nursing ReviewBackground:  Electronic records are currently being introduced in both the hospital and the home care setting. However, there are few studies focusing on the evaluation of an electronic nursing record (ENR) from applicability to technicality and soft‐ and hardware, and from the perspective of home nurses.Aim:  The study aims to evaluate home nurses' experiences with an ENR.Methods:  A qualitative, explorative study was used by means of 13 in‐depth interviews with home nurses, head nurses and Administrators, and four focus groups with a total of 24 home nurses. All participants were employees of the Wit‐Gele Kruis, an organization for home nursing in Flanders, Belgium.Findings:  This study revealed three levels that feature the implementation and integration of an ENR in home nursing: the preparation, the technicality of the ENR and the ‘user’ as an individual. Despite technical difficulties, the home nurses are willing to give the ENR a chance, because they believe in its value. But, at the same time, they are trying to find a balance between this belief and their capacity to learn to work with an IT device. This involves the need to integrate the ENR in their daily work, to meet their responsibility towards the patient and their belief that his care comes first, the impact of technical difficulties on their workload and the integration of the ENR in their personal lives.Conclusion:  This study provided insights in the necessity for a multilevel approach when implementing an ENR in home nursing.
PhD Away Days: a component of PhD supervision
Authors: McCarthy G. , Hegarty J. , Savage E. , Fitzpatrick J.J. 
Published: September 2010

MCCARTHY G., HEGARTY J., SAVAGE E. & FITZPATRICK J.J. (2010) PhD Away Days: a component of PhD supervision. International Nursing ReviewAim:  This paper describes a peer‐to‐peer and supervisor support and mentoring process that was implemented in one PhD programme in nursing in the Republic of Ireland.Background:  PhD Away Days are held once per year and attended by all enrolled PhD students and their academic supervisors. Positive evaluations were obtained both from students and supervisors as collective learning occurred and group cohesiveness developed. All participants expressed interest in continuing the PhD Away Days as they learned from others' experiences. In addition, the range of topics provided learning on topics of concern across content areas, e.g. conceptual and theoretical developments, research design, challenges in data collection, and analysis and publication plans. Most importantly, there was a feeling of togetherness among students, thus decreasing the feeling of being alone with the challenges of PhD work.Conclusions:  Plans for the future include the need to have the PhD Away Days continued structured around key topics of concern to both students and supervisors, and to implement content‐specific modules in the PhD programme.
The Response of the South Manchester Accident Rescue Team (SMART) to the Armenian Earthquake and Lockerbie Air Disaster: A Report to the Prime Minister's Office
Authors: REDMOND ANTHONY D. 
Published: September 2010

SummaryThe delay in receiving authorisation for the despatch of SMART significantly reduced our overall effectiveness. The majority of injured survivors were extracted during this time and our special expertise could have saved a significant number of lives.The episode has provided SMART with unique experience for a British medical team and this knowledge should not be wasted.In contrast to other major western countries the British response was fragmented. We have no central stockpile of equipment and no official response team. The British who responded were independent of each other even when from the same service.The quality of the individual British teams was as good as any and often better. However, the ability of other nations to coordinate their response centrally and draw from a pool of workers already used to working together, improved both their efficiency and effectiveness.There are great difficulties in communication during any disaster and these increase with the scale of the disaster. Incoming rescue workers were given false or misleading information and rumour was widespread.Even when few people were found alive rescue workers expressed a strong need for a medical presence in case they discovered an injured person or they them selves became ill or injured. We were told repeatedly by experienced rescuers that we were the first team of British senior doctors they had met at the front line of a disaster and they were extremely pleased to see us.Transport was a major problem both in terms of vehicles and local knowledge.It was not thought to be within the remit of a medical team to make provision for food and shelter and this was confirmed in Moscow prior to departure for Yerevan. In retrospect this was a mistake and reduced the time we could stay at the front line. If we had not equipped ourselves with special clothing we could not have gone to the front line.A medical team must be part of larger team of rescue workers. Within this unit there will be provision for food, shelter, transport and communication as well as medical and surgical equipment.