bluuebunny/crossref_metadata_2025_split huggingface dataset:
VACUUM‐ASSISTED BIOPSY: A SAFE AND ACCURATE ALTERNATIVE TO EXCISION
Authors: Chung C.K. , Kwong A. , Hung W.K. , Chan M.C.M. , Lau Y. , Yip A.W.C. 
Published: September 2009

Introduction: Image‐detected breast lesion is becoming a concern in surgery. After triple assessment, a suspicious or indeterminate lesion will usually require excision to rule out malignancy. Vacuum‐assisted biopsy is newly introduced as a minimally invasive alternative to operation in obtaining tissue for histological assessment. The early experience of this procedure in the Breast Centre of Kwong Wah Hospital is reviewed.Method: Vacuum‐assisted biopsy was performed for image‐detected breast lesions under local anaesthesia using the Mammotome. Lesions were either vaguely palpable or non‐palpable but well seen on ultrasound scan with fine needle aspirated indeterminate cytology or benign cytology in a high risk patient. Definitive surgery was performed if the biopsy result showed malignancy or upon patient’s request. Other patients were followed up six monthly with clinical examination and ultrasound scan. Excision was indicated if there was any increase in size. The pathology was assumed to be benign if there was no change in six months time.Result: From September 1998 to May 2000, 49 female patients were included. One of them had 2 lesions making a total of 50 cases. The mean age of the patients was 45.5 (22–58). The mean size of the lesion was 10.8mm (4–19). The procedure took 5–55 min (mean 16.6). It was successful in 49 cases (98%). Four lesions were found to be malignant. Three patients had definitive operations with the pathology confirmed while one patient defaulted follow up. Amongst the 45 benign lesions, 3 were excised upon request. The pathology were all benign. For the remaining 42 patients. 23 were followed up for 12 months and 19 patients for 6 months. Three patients were found to have enlarging lesions and excisions were performed which revealed benign histology. The breast lumps of the remaining 39 patients either remained unchanged or diminished size. There were no major complications (wound haematoma, infection). The average linear pain score (minimum 1, maximum 5) was 2.0.Conclusion: Vacuum‐assisted biopsy is an accurate diagnostic tool with the advantage of minimal morbidity.
Cataract in central Sri Lanka: cataract surgical coverage and self‐reported barriers to cataract surgery
Authors: Athanasiov Paul A , Edussuriya Kapila , Senaratne Tissa , Sennanayake Saman , Selva Dinesh , Casson Robert J 
Published: September 2009

AbstractPurpose:  To determine the cataract surgical coverage and investigate the barriers to cataract surgery in the Kandy District of central Sri Lanka.Methods:  A population‐based, cross‐sectional ophthalmic survey of the inhabitants of rural villages in central Sri Lanka was conducted; there were 1721 eligible subjects and 1375 participated (79.9% participation rate). The recorded data included age, gender, education, district, corrected visual acuity, dilated slit‐lamp examination and stereoscopic fundus examination. Lens opacity was graded using the Lens Opacities Classification System III. Participants with cataract‐induced visual impairment (acuity <6/18 in the better eye) were also invited to respond to a verbal questionnaire about barriers to cataract surgery.Results:  Cataract surgical coverage per individual for visual acuity cut‐offs of <6/18, <6/60 and <3/60 was 41.9%, 76.8% and 82.7%, respectively; and per eye was 34.0%, 60.3% and 65.2%, respectively. Cataract surgical coverage was higher for men than women, and two‐thirds refused referral for surgery, for the following reasons: no desire to improve vision, fear of surgery and lack of awareness were the most frequently reported barriers.Summary:  Cataract surgical coverage in central Sri Lanka is higher than that in neighbouring developing regions. Surgical uptake may be improved through better community education.
Comparison of the AcrySof SA60 spherical intraocular lens and the AcrySof Toric SN60T3 intraocular lens outcomes in patients with low amounts of corneal astigmatism
Authors: Statham Michael , Apel Andrew , Stephensen David 
Published: September 2009

AbstractBackground:  Toric intraocular lenses (IOLs) have been reported to be an effective method of reducing postoperative refractive astigmatism and spectacle dependence following cataract surgery. This study compares a series of patients with low corneal astigmatism implanted with either the AcrySof SA60 spherical IOL or the AcrySof Toric SN60T3 IOL in a quantitative fashion to establish the merit of toric IOLs in these cases.Methods:  A retrospective chart audit was undertaken of 12 patients receiving the AcrySof Toric SN60T3 IOL (1.5 DC, Alcon, Fort Worth) and 10 patients receiving the AcrySof SA60 IOL (Alcon, Fort Worth). Preoperative corneal astigmatism and postoperative refractive astigmatism were recorded and converted into a non‐signed Astigmatic Power Vector for statistical analysis. Postoperative vision (uncorrected visual acuity, UCVA) was also recorded for both groups. A statistical analysis was performed to examine for differences in outcomes between groups.Results:  The mean magnitude of the preoperative corneal Astigmatic Power Vector was not significantly different between the groups. The mean magnitude of the postoperative refractive vector was significantly smaller in the AcrySof Toric group. The mean UCVA was significantly better in the AcrySof Toric group compared with the AcrySof group.Conclusion:  The AcrySof Toric IOL provides a significant improvement in postoperative astigmatism and UCVA when compared statistically with its spherical counterpart for patients with low degrees of corneal astigmatism.
Amniotic membrane extraction solution for ocular chemical burns
Authors: Liang Lingyi , Li Wei , Ling Shiqi , Sheha Hosam , Qiu Weiqiang , Li Chaoyang , Liu Zuguo 
Published: September 2009

AbstractPurpose:  To evaluate the efficacy of amniotic membrane extract (AME) for ocular chemical burns.Methods:  Prospective non‐comparative interventional case series study. Consecutive 14 eyes of 11 patients with acute or chronic chemical burns, being recruited in one referral centre, received AME topically in combination with traditional treatment. Ocular discomfort, visual acuity, ocular surface inflammation, re‐epithelialization, corneal thickness, corneal neovascularization and symblepharon were evaluated.Results:  Symptom relieved and ocular surface inflammation reduced dramatically in all eyes. Epithelial defect healed in all eyes with acute burns, in which less than 7 clock hours of limbus was involved, after 16.6 days (1–44 days) AME treatment. AME failed to close the epithelial defect in all eyes with chronic chemical burn coexisting diffuse limbal stem cell deficiency; however, the area of epithelial defect decreased to 58% (11.1%–68.2%) at final visit. During a follow‐up period of 8.2 months (6–11 months), visual acuity improved in 12 eyes (86%). There was mild neovascularization in three eyes with grade III and IV acute burns, and slow progress of neovascularization in chronic burns. Mild symblepharon developed in two eyes with grade III and IV acute burns, whereas there was no significant progress of symblepharon in chronic cases.Conclusions:  Although it is a preliminary and uncontrolled study, topical application of AME is effective in reducing inflammation, promoting reepithelization in the treatment of chemical burns, especially for mild to moderate acute cases.
Role of cardiac magnetic resonance imaging in ischaemic heart disease
Authors: Wright J. , Bogaert J. 
Published: September 2009

AbstractCardiac magnetic resonance imaging is a new imaging method that has much to offer clinicians caring for patients with ischaemic heart disease. This article describes briefly the basic principles and practical aspects of cardiac magnetic resonance imaging, and summarizes the pathophysiology of ischaemic heart disease. Then it discusses in detail the use of cardiac magnetic resonance imaging for detection of coronary artery disease, and for assessment of acute and stable coronary syndromes.
Medicinal use of leeches in the texts of ancient Greek, Roman and early Byzantine writers
Authors: Papavramidou N. , Christopoulou‐Aletra H. 
Published: September 2009

AbstractBlood‐letting was a common therapeutic method in antiquity; many means were used to draw blood, including the application of leeches. In this paper, ancient Greek, Roman and Byzantine authors up to the 7th century AD were studied, a research that provided us with references that may be divided into two groups: those related to the medicinal use of leeches, and those related to cases in which leeches were swallowed and had to be removed. In the first group, detailed descriptions of the method of usage and of the diseases requiring leeching were found. In the second group, brief reference is made to the problems caused by swallowing leeches, and to the methods used to expel them from the human organism. The earliest references to the medicinal use of leeches may be found in the writings of Theocritus (3rd century BC), Nicander (2nd century BC) and Horace (1st century BC, while the phenomenon of swallowing a leech is first mentioned in one of the Epidaurian ‘iamata’ dating to the 4th century BC.
Fluoroquinolone‐induced immune thrombocytopenia: a report and review
Authors: Cheah C. Y. , De Keulenaer B. , Leahy M. F. 
Published: September 2009

AbstractFluoroquinolones are an emerging but underrecognized cause of drug‐induced thrombocytopenia. Due to their broad spectrum they are often used in empirical treatment of febrile neutropenic, thrombocytopenic patients following myelosuppressive chemotherapy. They are associated with a range of immunohaematopathology. A 76‐year‐old male developed severe thrombocytopenia following treatment with ciprofloxacin on two occasions for community‐acquired pneumonia. The temporal association, response to dechallenge, dramatic response to rechallenge and exclusion of other causes combined with detection of platelet‐reactive antibodies of the immunoglobulin G class against glycoprotein IIb/IIIa following ciprofloxacin rechallenge makes causality probable. We present a brief review of immunohaematopathology associated with fluoroquinolones and draw attention to the structural similarity between quinolones and quinine to explore potential mechanisms for the phenomenon. Fluoroquinolones can induce drug‐dependent, platelet‐reactive antibodies causing complement‐mediated destruction of platelets. The underlying mechanism to explain this is unclear; however, we hypothesize that the chemical similarities shared with quinine may be contributory. When using these agents clinicians should be aware of the possibility of drug‐induced thrombocytopenia or thrombotic thrombocytopenic purpura.
A case of uterine tumour resembling ovarian sex cord tumour responding to second‐line, single agent anastrazole
Authors: Blinman P. , Tattersall M. H. N. 
Published: September 2009

AbstractUterine tumour resembling ovarian sex cord tumour (UTROSCT) are a histological variant of endometrial stromal sarcomas (ESS). There is no established medical management of metastatic UTROSCT or ESS, although there is evidence supporting the use of hormonal therapy. Given the success of aromatase inhibitors in breast cancer, their potential role in ESS and UTROSCT is of current interest. We report the first case of response to second‐line, single agent anastrazole in a patient with metastatic UTROSCT.
Preventing healthcare‐associated infection: risks, healthcare systems and behaviour
Authors: Ferguson J. K. 
Published: September 2009

AbstractMore than 177 000 potentially preventable healthcare‐associated infections (HAIs) occur per annum in Australia with sizable attributable mortality. Organizational systems to protect against HAI in hospitals in Australia are relatively poorly developed. Awareness and practice of infection control by medical and other healthcare staff are often poor. These lapses in practice create significant risk for patients and staff from HAI. Excessive patient exposure to antimicrobials is another key factor in the emergence of antibiotic‐resistant bacteria and Clostridium difficile infection. Physicians must ensure that their interactions with patients are safe from the infection prevention standpoint. The critical preventative practice is hand hygiene in accord with the World Health Organization 5 moments model. Improving the use of antimicrobials, asepsis and immunization also has great importance. Hospitals should measure and feed back HAI rates to clinical teams. Physicians as leaders, role models and educators play an important part in promoting adherence to safe practices by other staff and students. They are also potentially effective system engineers who can embed safer practices in all elements of patient care and promote essential structural and organizational change. Patients and the public in general are becoming increasingly aware of the risk of infection when entering a hospital and expect their carers to adhere to safe practice. Poor infection control practice will be regarded in a negative light by patients and their families, regardless of any other manifest skills of the practitioner.
Structure of α6β3δ GABAAreceptors and their lack of ethanol sensitivity
Authors: Baur Roland , Kaur Kuldeep H. , Sigel Erwin 
Published: September 2009

AbstractDelta (δ) subunit containing GABAAreceptors are expressed extra‐synaptically and mediate tonic inhibition. In cerebellar granule cells, they often form a receptor together with α6subunits. We were interested to determine the architecture of these receptors. We predefined the subunit arrangement of 24 different GABAAreceptor pentamers by subunit concatenation. These receptors (composed of α6, β3and δ subunits) were expressed in Xenopus oocytes and their electrophysiological properties analyzed. Currents elicited in response to GABA were determined in presence and absence of 3α, 21‐dihydroxy‐5α‐pregnan‐20‐one and to 4,5,6,7‐tetrahydroisoxazolo[5,4‐c]‐pyridin‐3‐ol. α6‐β3‐α6/δ receptors showed a substantial response to GABA alone. Three receptors, β3‐α6‐δ/α6‐β3, α6‐β3‐α6/β3‐δ and β3‐δ‐β3/α6‐β3, were only uncovered in the combined presence of the neurosteroid 3α, 21‐dihydroxy‐5α‐pregnan‐20‐one with GABA. All four receptors were activated by 4,5,6,7‐tetrahydroisoxazolo[5,4‐c]‐pyridin‐3‐ol. None of the functional receptors was modulated by physiological concentrations (up to 30 mM) of ethanol. GABA concentration response curves indicated that the δ subunit can contribute to the formation of an agonist site. We conclude from the investigated receptors that the δ subunit can assume multiple positions in a receptor pentamer composed of α6, β3and δ subunits.
Sequestosome 1/p62 links familial ALS mutant SOD1 to LC3 via an ubiquitin‐independent mechanism
Authors: Gal Jozsef , Ström Anna‐Lena , Kwinter David M. , Kilty Renée , Zhang Jiayu , Shi Ping , Fu Weisi , Wooten Marie W. , Zhu Haining 
Published: September 2009

AbstractThe p62/sequestosome 1 protein has been identified as a component of pathological protein inclusions in neurodegenerative diseases including amyotrophic lateral sclerosis (ALS). P62 has also been implicated in autophagy, a process of mass degradation of intracellular proteins and organelles. Autophagy is a critical pathway for degrading misfolded and/or damaged proteins, including the copper‐zinc superoxide dismutase (SOD1) mutants linked to familial ALS. We previously reported that p62 interacted with ALS mutants of SOD1 and that the ubiquitin‐association domain of p62 was dispensable for the interaction. In this study, we identified two distinct regions of p62 that were essential to its binding to mutant SOD1: the N‐terminal Phox and Bem1 (PB1) domain (residues 1–104) and a separate internal region (residues 178–224) termed here as SOD1 mutant interaction region (SMIR). The PB1 domain is required for appropriate oligomeric status of p62 and the SMIR is the actual region interacting with mutant SOD1. Within the SMIR, the conserved W184, H190 and positively charged R183, R186, K187, and K189 residues are critical to the p62–mutant SOD1 interaction as substitution of these residues with alanine resulted in significantly abolished binding. In addition, SMIR and the p62 sequence responsible for the interaction with LC3, a protein essential for autophagy activation, are independent of each other. In cells lacking p62, the existence of mutant SOD1 in acidic autolysosomes decreased, suggesting that p62 can function as an adaptor between mutant SOD1 and the autophagy machinery. This study provides a novel molecular mechanism by which mutant SOD1 can be recognized by p62 in an ubiquitin‐independent fashion and targeted for the autophagy–lysosome degradation pathway.
Mechanism of abnormal growth in astrocytes derived from a mouse model of GM2 gangliosidosis
Authors: Kawashima Nagako , Tsuji Daisuke , Okuda Tetsuya , Itoh Kohji , Nakayama Ken‐ichi 
Published: September 2009

AbstractSandhoff disease is a progressive neurodegenerative disorder caused by mutations in the HEXB gene which encodes the β‐subunit of N‐acetyl‐β‐hexosaminidase A and B, resulting in the accumulation of the ganglioside GM2. We isolated astrocytes from the neonatal brain of Sandhoff disease model mice in which the N‐acetyl‐β‐hexosaminidase β‐subunit gene is genetically disrupted (ASD). Glycolipid profiles revealed that GM2/GA2 accumulated in the lysosomes and not on the cell surface of ASD astrocytes. In addition, GM3 was increased on the cell surface. We found remarkable differences in the cell proliferation of ASD astrocytes when compared with cells isolated from wild‐type mice, with a faster growth rate of ASD cells. In addition, we observed increased extracellular, signal‐regulated kinase (ERK) phosphorylation in ASD cells, but Akt phosphorylation was decreased. Furthermore, the phosphorylation of ERK in ASD cells was not dependent upon extracellular growth factors. Treatment of ASD astrocytes with recombinant N‐acetyl‐β‐hexosaminidase A resulted in a decrease of their growth rate and ERK phosphorylation. These results indicated that the up‐regulation of ERK phosphorylation and the increase in proliferation of ASD astrocytes were dependent upon GM2/GA2 accumulation. These findings may represent a mechanism in linking the nerve cell death and reactive gliosis observed in Sandhoff disease.
Women's Views of Different Models of Antenatal Care in Victoria, Australia
Authors: Laslett Anne‐Marie L. , Brown Stephanie , Lumley Judith 
Published: September 2009

Background: This study assessed women's views of care in pregnancy, contrasting the experiences and satisfaction of women using different models of care in Victoria, Australia. Methods: A statewide postal survey of women who gave birth during a 2‐week period in 1993 was carried out 6 to 7 months after birth.Results: Of 1336 women, 62.5 percent responded, and of these, 62.4 percent rated their antenatal care as very good, 27.7 percent as good, 8.2 percent as mixed, and 1.8 percent as poor or very poor. Although social factors, obstetric factors, and model of care had significant associations with satisfaction in univariate analyses, only model of care, mother's country of birth, and medical risk remained significant in a multivariate analysis using logistic regression. Women were most likely to be satisfied when antenatal care was provided by an obstetrician in private practice or a birth center. When comparisons were restricted to options available to women without private health insurance, using public hospital clinics as the baseline in a multivariate analysis, women were significantly more likely to be satisfied with birth center care, and significantly less likely to be satisfied with shared care. Contributing factors were waiting times, staff seeming rushed, and lack of continuity of caregiver.Conclusion: The expansion of shared antenatal care has not succeeded in improving satisfaction with antenatal care for women in the public health care sector. (BIRTH 24:2, June 1997)
A prospective study of multiple donor exposure blood recipients: surveillance value and limitations for hemovigilance
Authors: Zou Shimian , Wu Yanyun , Cable Ritchard , Dorsey Kerri , Tang Yanlin , Hapip Cheryl Anne , Melmed Russell , Trouern‐Trend Jonathan , Carrano Donna , Champion Melanie , Fujii Karen , Fang Chyang , Dodd Roger 
Published: September 2009

BACKGROUND: There have been few recent systematic studies of blood recipients for direct evidence of blood safety, especially for emerging pathogens that may pose a threat to the blood supply.STUDY DESIGN AND METHODS: Recipients who would likely require transfusion from multiple donors were recruited and a blood specimen was collected before their first study transfusion and at intervals after their study transfusion(s). Blood samples associated with the units that were transfused to enrolled recipients were also collected. Part of each recipient specimen and selected donor specimens was tested for the targeted blood‐borne agents, parvovirus B19 (B19) and Chlamydia pneumoniae (Cp), that were piloted in this study, and the remaining material was kept in a repository.RESULTS: Between April 2004 and December 2006, a total of 120 recipients were recruited with 4047 subsequent donor exposures. On average, each recipient was followed up seven times. Of recipients who were adequately followed up and were initially immunoglobulin G antibody negative, one in 31 and one to two in 49 seroconverted to B19 and Cp after a total of 922 and 1413 evaluable transfusions, respectively. The detection of seroconversion was complicated by passively acquired donor antibodies for these two seroprevalent agents. Negative results for nucleic acids of the agents limited our ability to further clarify the relationship of these seroconversions to transfusion‐transmitted infection.CONCLUSION: The risk of transfusion‐associated B19 infection appears to be low but no conclusion of transfusion transmission can be made for Cp. The approach piloted through this study offers added value beyond the current hemovigilance strategy in the United States.
Can dialyzer membrane selection affect outcomes in patients with acute kidney injury requiring dialysis?
Authors: DAVENPORT Andrew 
Published: September 2009

AbstractThe choice of dialyzer membrane may potentially affect not only solute clearances but also blood‐dialyzer interactions. Although on one hand alteration of the dialyzer surface or pore size to increase inflammatory mediator loss may potentially be beneficial for patients with acute kidney injury (AKI), dialyzer membrane interactions, which precipitate intradialytic hypotension, may worsen AKI. Several years ago cellulosic membrane dialyzers were shown to reduce both patient survival and renal recovery in patients with AKI. This review looks at the earlier studies of dialyzer membrane choice and outcomes in AKI, besides discussing the newer developments in membrane technology for patients with AKI.