bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparison of the organization of longitudinal and circular contractions during pendular and segmental activity in the duodenum of the rat and guinea pig
Authors: Lentle R. G. , De Loubens C. , Hulls C. , Janssen P. W. M. , Golding M. D. , Chambers J. P. 
Published: April 2012

AbstractBackground  Little is known of the spatiotemporal organization of pendular duodenal contractions.Methods  We used longitudinal and radial spatiotemporal mapping to examine and compare pendular and segmental contractile activity in the proximal duodenum of the rat and guinea pig when the lumen was perfused with saline or micellar decanoic acid.Key Results  Isolated phasic longitudinal contractions occurred along the rat duodenum with a frequency of 36 ± 2 cpm and strain rate amplitude of 26.8 ± 8.0% s−1. These contractions occurred at fixed locations along the duodenum forming columns on the longitudinal strain rate map. The strain rate activity had local maxima at 4–6 points spaced at 7.7 ± 4.0 mm intervals along the duodenum and were uncoordinated between neighboring domains. Similarly disposed, less distinct, longitudinal contractions occurred in the guinea pig duodenum at a frequency of 25.2 ± 6.6 cpm with amplitude 6.8 ± 3.6% s−1 but these were generally accompanied by numerous circular contractions that were distributed over 4–5 fixed locations and occurred with a frequency of 9 ± 3 cpm. Isolated static circular muscle contractions also occurred but at a lower rate in the rat than the guinea pig. Both types of contractions propagated after dosage with tetrodotoxin, lidocaine, atropine, or apamin.Conclusions & Inferences  Localized contractions during segmental and pendular activity had some features of the spike patches that are normally associated with slow wave propagation. However, the commencement of propagation following administration of neural blocking agents and cholinergic inhibitors indicates their localization is maintained by inhibitory elements of the enteric nervous system.
Reduced hyperpolarization of endothelial cells following high dietary Na+: effects of enalapril and tempol
Authors: Bondarenko Alexander , Panasiuk Olga , Stepanenko Lubov , Goswami Nandu , Sagach Vadim 
Published: April 2012

Summary

High dietary Na+ is associated with impaired vascular endothelial function. However, the underlying mechanisms are not completely understood. In the present study, we investigated whether the endothelial hyperpolarization response to acetylcholine (ACh) exhibited any abnormalities in Wistar rats fed a high‐salt diet (HSD) for 1 month and, if so, whether chronic treatment with the angiotensin‐converting enzyme inhibitor enalapril or the anti‐oxidant tempol could normalize the response. Membrane potential was recorded using the perforated patch‐clamp technique on the endothelium of rat aorta.
Acetylcholine (2 μmol/L) produced a hyperpolarization sensitive to TRAM‐34, a blocker of intermediate‐conductance Ca2+‐sensitive K+ channels (IKCa), but not to apamin, a blocker of small‐conductance Ca2+‐sensitive K+ channels (SKCa). NS309 (3 μmol/L), an activator of SKCa and IKCa channels, produced a hyperpolarization of similar magnitude as ACh.
In the HSD group, the ACh‐evoked hyperpolarization was significantly attenuated compared with that in the control group, which was fed normal chow rather than an HSD. Similarly, the hyperpolarization produced by NS309 was weaker in tissues from HSD‐fed rats.
Combination of HSD with chronic enalapril treatment (20 mg/kg per day for 1 month) normalized endothelial hyperpolarizing responses to ACh. Chronic tempol treatment (1 mmol/L in tap water for 1 month) prevented the reduced hyperpolarization to ACh.
The results of the present study indicate that excess in dietary Na+ results in a failure of endothelial cells to generate normal IKCa channel‐mediated hyperpolarizing responses. Our observations implicate oxidative stress mediated by increased angiotensin II signalling as a mechanism underlying altered endothelial hyperpolarization during dietary salt loading.
Could an advance practice nurse improve detection of alcohol misuse in the emergency department?
Authors: O'Brien Anthony , Leonard Louise , Deering Daryle 
Published: April 2012

ABSTRACTAlcohol misuse is a prevalent problem in New Zealand society, and one that exacts a considerable cost in terms of health, social cohesion, and economic productivity. Despite the burden of alcohol misuse, screening, brief assessment, and interventions for alcohol problems are frequently poorly performed within general health services. In this paper we explore the response to alcohol problems in a New Zealand emergency department and discuss difficulties encountered in improving rates of detection by emergency department personnel. We report the results of a clinical audit of alcohol screening and brief assessment and a staff education programme designed to improve practice in this area, but which met with limited success. The potential role for an advanced practice nurse providing a clinical consultation and liaison service to the emergency department staff is explored. We argue that such a role has potential to reduce the health and social costs of alcohol misuse, and to meet the national policy objective of providing a treatment response to people with alcohol‐related problems in contact with health services.
Flavokawain B, a novel, naturally occurring chalcone, exhibits robust apoptotic effects and induces G2/M arrest of a uterine leiomyosarcoma cell line
Authors: Eskander Ramez N. , Randall Leslie M. , Sakai Toshinori , Guo Yi , Hoang Bang , Zi Xiaolin 
Published: April 2012

AbstractAim:  To examine the effects of flavokawain B (FKB), a novel kava chalcone, on the growth of uterine leiomyosarcoma (LMS) cells and investigated its utility in the treatment of uterine LMS.Material and Methods:  Uterine leiomyosarcoma (SK‐LMS‐1), endometrial adenocarcinoma (ECC‐1) and the non‐malignant, human endometrium fibroblast‐like (T‐HESC) cell lines were cultured and treated with different concentrations of FKB. Cell viability was determined by MTT assays and the IC50 was estimated. Fluorescent‐activated cell sorting (FACS) analysis of apoptosis and cell cycle was performed. Real‐time reverse‐transcription polymerase chain reaction and western blot analysis were utilized to evaluate differences in the expression of apoptotic markers.Results:  FKB preferentially inhibited the growth of SK‐LMS‐1 and ECC‐1 cells compared to T‐HESC control cells. FKB significantly increased both early and late apoptosis in SK‐LMS‐1 and ECC‐1 cells relative to control. Cell cycle analysis illustrated an increase in the G2/M fraction in treated cell lines relative to control. Furthermore, FKB induced the expression of pro‐apoptotic death receptor 5 (DR5), Bim, and Puma, and decreased expression of an inhibitor of apoptosis, survivin. FKB also acted synergistically when combined with docetaxel and gemcitabine (combination index = 0.260).Conclusion:  FKB treatment results in cell cycle arrest and a robust induction of apoptosis in SK‐LMS‐1 and ECC‐1 cell lines. This natural product deserved further investigation as a potential therapeutic agent in the treatment of uterine LMS.
N‐acetylcysteine as an adjuvant to clomiphene citrate for successful induction of ovulation in infertile patients with polycystic ovary syndrome
Authors: Salehpour Saghar , Akbari Sene Azadeh , Saharkhiz Nasrin , Sohrabi Mohammad Reza , Moghimian Fatemeh 
Published: April 2012

AbstractAim:  The aim of this study was to evaluate the effect of oral N‐acetylcysteine (NAC) administration as an adjuvant to clomiphene citrate (CC) on induction of ovulation outcomes in patients with polycystic ovary syndrome (PCOS).Material and Methods:  In this placebo‐controlled double‐blind randomized clinical trial, 180 PCOS infertile patients were randomly divided into two groups for induction of ovulation. Patients in group 1 received CC 100 mg/d plus NAC 1.2 g/d and patients in group 2 received CC plus placebo for 5 days starting at day 3 of the cycle. On the 12th day of the menstrual cycle in the presence of at least one follicle with an 18–20‐mm diameter in ultrasound evaluation, 10 000 U hCG was injected intramuscularly and timed intercourse was advised 36 h after hCG injection. Serum β‐hCG level was measured on the 16th day after hCG injection.Results:  The number of follicles >18 mm and the mean endometrial thickness on the day of hCG administration were significantly higher among the CC+NAC group (P‐value = 0.001). The ovulation and pregnancy rates were also significantly higher in the CC+NAC group (P‐value = 0.02 and 0.04, respectively). No adverse side‐effects and no cases of ovarian hyperstimulation syndrome were observed in the group receiving NAC.Conclusion:  NAC as a safe and well‐tolerated adjuvant to CC for induction of ovulation can improve the ovulation and pregnancy rates in PCOS patients. It may also have some beneficial impacts on endometrial thickness.
Candidate gene study of genetic thrombophilic polymorphisms in pre‐eclampsia and recurrent pregnancy loss in Sinhalese women
Authors: Dissanayake Vajira H. W. , Sirisena Nirmala D. , Weerasekera Lakshini Y. , Gammulla Chumithri G. , Seneviratne Harshalal R. , Jayasekara Rohan W. 
Published: April 2012

AbstractAim:  Genetic thrombophilias are known to contribute to adverse pregnancy outcomes. Studies in Western populations show that 5, 10‐methylenetetrahydrofolate reductase (MTHFR) 677C>T and Factor V (F5) 1691G>A (Leiden) polymorphisms are commonly associated with pre‐eclampsia and recurrent spontaneous pregnancy loss. The objective of this study was to investigate the association of MTHFR 677C>T (rs1801133); 1298A>C (rs1801131) and F5 1691G>A (rs6025); 4070A>G (rs1800595) polymorphisms with pre‐eclampsia and recurrent pregnancy loss among Sinhalese women in Sri Lanka.Material and Methods:  Genotype and allele frequencies at each polymorphic site in the MTHFR and F5 genes and the haplotypes defined by them were determined in 175 Sinhalese women with pre‐eclampsia, 171 normotensive controls, 200 Sinhalese women with two or more recurrent pregnancy losses and 200 controls with two or more living children and no pregnancy losses. Genotyping was done by polymerase chain reaction/restriction fragment length polymorphism. Odds ratios and χ2‐testing were performed to compare genotype/haplotype frequencies at each polymorphic site for both cases and controls.Results:  The genotype frequencies at each polymorphic site in the MTHFR 677C>T; 1298A>C; F5 1691G>A and 4070A>G genes and the haplotypes defined by them were not significantly associated with either pre‐eclampsia or recurrent pregnancy loss. There was no significant association of genetic thrombophilia with either early or late pregnancy losses.Conclusions:  The MTHFR and F5 polymorphisms and the haplotypes defined by them were not significantly associated with either pre‐eclampsia or recurrent pregnancy loss in this group of Sinhalese women.
Gestational bodyweight gain among underweight Japanese women related to small‐for‐gestational‐age birth
Authors: Harita Nobuko , Kariya Masatoshi , Hayashi Tomoshige , Sato Kyoko Kogawa , Aoki Takuya , Nakamura Kimihiko , Endo Ginji , Narimoto Katsuhiko 
Published: April 2012

AbstractAim:  The prevalence of underweight women, who have an increased risk for small‐for‐gestational‐age (SGA) birth, is increasing in Japan. We examined the associations of pre‐pregnancy body mass index and gestational weight gain (GWG) with SGA birth among Japanese women.Material and Methods:  We conducted a prospective cohort study of 1391 women who delivered full‐term singleton babies. SGA was defined as below the 10th percentile of birthweight at each gestational age, baby sex, and parity. We calculated the 5th percentile of birthweight in the same way for another threshold for SGA. According to pre‐pregnancy body mass index, we divided the participants into three groups: underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), and overweight and obese (≥25.0 kg/m2).Results:  SGA birth was observed most frequently among the underweight group (13.8%). Underweight was associated with an increased risk of SGA birth. The multiple‐adjusted odds ratio for underweight was 1.96 (95% confidence interval, 1.23–3.11) compared with normal weight. Sufficient GWG reduced the incidence and the multiple‐adjusted odds ratio for 1‐kg increase of GWG was 0.86 (0.81–0.92). The same tendency was observed for the delivery of infants below the 5th birthweight percentile. Women with underweight and normal weight who had 9.0 kg or less of GWG had a significantly higher risk of SGA birth than women with normal weight who had 9.1–11.0 kg of GWG.Conclusions:  Underweight and poor GWG were associated with a higher incidence of SGA birth. However, the incidence of SGA birth among underweight women was not increased significantly if they had sufficient GWG.
Total laparoscopic hysterectomy in 1253 patients using an early ureteral identification technique
Authors: Kobayashi Eiji , Nagase Toko , Fujiwara Kazuko , Hada Tomonori , Ota Yoshiaki , Takaki Yoshihiro , Kanao Hiroyuki , Andou Masaaki 
Published: April 2012

AbstractAim:  The aim of this study was to determine the incidence of perioperative complications and evaluate risk factors for the major complications of total laparoscopic hysterectomy (TLH) using an early ureteral identification technique. We describe the technique we standardized and used for TLH, without exclusion criteria.Material and Methods:  A retrospective study was carried out at Kurashiki Medical Center, Japan, based on 1253 TLH procedures performed from January 2005 to March 2009. We reviewed records to identify the major perioperative complications, including bladder, ureteral, and intestinal injuries, and incidences of reoperation. Risk factors for major complications were analyzed using multivariate logistic regression models.Results:  A total of 24 patients encountered major complications (1.91%). Complications included 10 intraoperative urologic injuries, five cases of postoperative hydronephrosis, five cases of vaginal dehiscence, one bowel injury, one postoperative hemorrhage, one bowel obstruction, and one ureterovaginal fistula. All 11 cases of intraoperative visceral injury were recognized during the surgery and repaired during the same laparoscopic surgical procedure. Of the risk factors analyzed, a history of abdominal surgery was the only one associated with the occurrence of major complications, with an odds ratio of 2.48 (95% confidence interval 1.23–6.49).Conclusion:  While complications are inevitable, even in the hands of the most skilled surgeon, they can be minimized without conversion to laparotomy by a sufficiently developed suturing technique and a precise knowledge of pelvic anatomy. The presented data indicate that our method allows for safe TLH and minimization of ureteral injury, without the use of stringent exclusion criteria.
Comparison of 90‐day re‐admission rates between open retropubic radical prostatectomy (RRP), laparoscopic RP (LRP) and robot‐assisted laparoscopic prostatectomy (RALP)
Authors: Chung Shiu‐Dong , Kelle Joseph J. , Huang Chao‐Yuan , Chen Yi‐Hua , Lin Herng‐Ching 
Published: April 2012

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?With the increased use of laparoscopic radical prostatectomy (LRP) and robot‐assisted laparoscopic prostatectomy (RALP), a growing number of publications have sought to compare these more advanced techniques to retropubic RP (RRP). Many studies have found RALP and LRP to be associated with lower blood loss, postoperative pain, and hospital stay when compared with RRP.The present study showed that, after adjusting for potential confounders, patients undergoing RALP had a lower risk of 90‐day re‐admission than patients undergoing RRP. However, there was no significant difference in the odds of being re‐admitted ≤90 days after RP between patients undergoing a LRP and RRP.OBJECTIVE
To examine the risk of 90‐day re‐admission among patients undergoing retropubic radical prostatectomy (RRP), laparoscopic RP (LRP), and robot‐assisted laparoscopic prostatectomy (RALP) in Taiwan.
PATIENTS AND METHODS
We identified 2741 hospitalised patients who underwent a RP. Of these 2741 cases, 1773 patients underwent RRP, 694 LRP, and 274 RALP.
We performed a conditional (fixed‐effect) logistic regression model to explore the odds of 90‐day re‐admission from RP among patients undergoing RRP, LRP, and RALP.
RESULTS
In all, 257 of the 2741 (9.4%) sampled subjects were re‐admitted ≤90 days of the index RP.
Patients undergoing a RALP had a significantly lower incidence rate of 90‐day re‐admission than patients undergoing a RRP or LRP (3.6% vs 10.7% vs 8.2%, P < 0.001).
Compared with patients undergoing a RRP, the odds ratio (OR) of 90‐day re‐admission for patients undergoing a RALP was only 0.35 (95% confidence interval [CI] 0.19–0.68) after adjusting for patient age, geographic region, year of surgery, Charlson Co‐morbidity Index score, and surgeon age and the number of RP cases/year.
However, there was no significant difference in the odds of being re‐admitted ≤90 days of RP between patients undergoing a LRP and RRP.
The adjusted odds of 90‐day re‐admission for patients undergoing a RALP were 0.46 (95% CI 0.23–0.94) those of patients undergoing a LRP.
CONCLUSIONS
Our study shows that patients undergoing a RALP had a lower adjusted risk of 90‐day re‐admission than patients undergoing RRP. However, no significant differences were identified between LRP and RRP.
Modulation of bladder afferent signals in normal and spinal cord‐injured rats by purinergic P2X3 and P2X2/3 receptors
Authors: Munoz Alvaro , Somogyi George T. , Boone Timothy B. , Ford Anthony P. , Smith Christopher P. 
Published: April 2012

What's known on the subject? and What does the study add?It is well known that urinary bladder sensation requires the activation by ATP of ionotropic purinergic P2X3/P2X2/3 receptors located in bladder afferent C‐fibres. Furthermore, in rat models of neurogenic bladder hyperactivity the release of ATP from the bladder urothelium is greater than ATP release in neurally intact rats. Therefore, the activation of purinergic receptors in bladder sensory fibres seems to be a sentinel event for the development of bladder hyperactivity after spinal cord injury.We found that inhibition of P2X3/P2X2/3 purinergic receptors decreased the frequency of sensory field potentials evoked by activation of bladder noxious pathways. At the same time, the pharmacological blockade of these receptors significantly decreased the frequency of non‐voiding contractions in rats with neurogenic bladder hyperactivity. The present study uncovers sensory purinergic receptors as potential therapeutic targets to treat neurogenic bladder hyperactivity, especially when the release of ATP from the urothelium is elevated.OBJECTIVE
To evaluate the role of bladder sensory purinergic P2X3 and P2X2/3 receptors on modulating the activity of lumbosacral neurones and urinary bladder contractions in vivo in normal or spinal cord‐injured (SCI) rats with neurogenic bladder overactivity.
MATERIALS AND METHODS
SCI was induced in female rats by complete transection at T8–T9 and experiments were performed 4 weeks later, when bladder overactivity developed. Non‐transected rats were used as controls (normal rats).
Neural activity was recorded in the dorsal horn of the spinal cord and field potentials were acquired in response to intravesical pressure steps via a suprapubic catheter. Field potentials were recorded under control conditions, after stimulation of bladder mucosal purinergic receptors with intravesical ATP (1 mm), and after intravenous injection of the P2X3/P2X2/3 antagonist AF‐353 (10 mg/kg and 20 mg/kg).
Cystometry was performed in urethane‐anaesthetised rats intravesically infused with saline. AF‐353 (10 mg/kg) was systemically applied after baseline recordings; the rats also received a second dose of AF‐353 (20 mg/kg). Changes in the frequency of voiding (VC) and non‐voiding (NVC) contractions were evaluated.
RESULTS
SCI rats had significantly higher frequencies for field potentials and NVC than NL rats. Intravesical ATP increased field potential frequency in control but not SCI rats, while systemic AF‐353 significantly reduced this parameter in both groups.
AF‐353 also reduced the inter‐contractile interval in control but not in SCI rats; however, the frequency of NVC in SCI rats was significantly reduced.
CONCLUSION
The P2X3/P2X2/3 receptors on bladder afferent nerves positively regulate sensory activity and NVCs in overactive bladders.
Minimally invasive percutaneous nephrolitholapaxy (PCNL) as an effective and safe procedure for large renal stones
Authors: Abdelhafez Mohamed F. , Bedke Jens , Amend Bastian , ElGanainy Ehab , Aboulella Hassan , Elakkad Magdy , Nagele Udo , Stenzl Arnulf , Schilling David 
Published: April 2012

Study Type – Therapy (case series)Level of Evidence 4What's known on the subject? and What does the study add?The minimally invasive percutaneous nephrolitholapaxy (MIP) has shown high efficacy and safety for the management of small renal stones. It was initially developed to overcome a gap between the minimally invasive extracorporeal shockwave lithotripsy and invasive conventional percutaneous nephrolitholapaxy (PCNL) in the management of low stone burden but there is debate as to whether the MIP is also effective for larger stones.The present study shows the high efficacy and safety of MIP, which is comparable to conventional PCNL in the treatment of stones of >20 mm, including complex staghorn stones.OBJECTIVE
To evaluate the safety and efficacy of minimally invasive percutaneous nephrolitholapaxy (MIP) in the management of large and complex renal calculi.
PATIENTS AND METHODS
From January 2007 to March 2011, 73 patients with 83 renal units with large renal stones (>20 mm in diameter) were retrospectively evaluated.
Stones were classified into simple (isolated renal pelvis or isolated calyceal stones) or complex (partial or complete staghorn stones, renal pelvis stones with accompanying calyceal stones).
Stone‐free rate, complications according to the modified Clavien system, decrease in haemoglobin, creatinine level, operative duration and hospital stay were compared for simple and complex renal calculi.
RESULTS
The mean (sd) stone size was 36.7 (23.37) mm and mean operative duration was 99.2 (48.3) min.
In all, 65 cases (78.3%) were stone‐free after the first procedure and another 14 needed an auxiliary procedure (four second‐look percutaneous nephrolitholapaxy, nine ureterorenoscopy, and one extracorporeal shockwave lithotripsy) to become stone‐free, resulting in a 95.2% stone‐free rate.
Complications occurred in 22 procedures (26.5%), 17 of them were Clavien Grade 1 or 2 (20.5%), five were Grade 3 (6%). There were no Grade 4 or 5 complications.
The only significant difference between complex and simple stones was the stone‐free rate (96.9% vs 66.7%, P= 0.001).
CONCLUSION
The MIP technique is effective and safe for larger stones with low morbidity, good success rate and reasonable operative duration.