bluuebunny/crossref_metadata_2025_split huggingface dataset:
2 TOWARDS PAINLESS COLONOSCOPY: A DOUBLE BLIND RANDOMIZED CONTROLLED TRIAL ON CARBON DIOXIDE INSUFFLATION COLONOSCOPY
Authors: Wong J.C.H. , Yau K.K. , Cheung H.Y.S. , Wong D.C.T. , Chung C.C. , Li M.K.W. 
Published: May 2007

Background:  Colonoscopy is a useful screening and diagnostic tool. Yet, many patients fear it because of pain. Carbon dioxide (CO2) insufflation during examination was reported to result in reduced pain. However, data on CO2 insufflation colonoscopy are still limited.Objective:  The current study is a randomized controlled trial aiming to assess the safety and potential benefits of CO2 insufflating colonoscopy.Methods:  From January to April 2006, adult patients undergoing elective colonoscopy were recruited and randomized into CO2 insufflation (CO2i) or air insufflation (AIRi) groups. All examinations were performed by either one of the two designated endoscopists. Pain scores during examination and 30 min, 1 h and 2 h after were recorded using a visual analogue scale (VAS). Other outcomes measured included the caecal intubation rate, complication and caecal intubation time, defined as the time required to reach the caecum. By means of questionnaire, patient's satisfaction and acceptance of the endoscopic examination were assessed after the procedure.Results:  Over a 4‐month period, 96 patients were recruited and randomized. The age and gender ratio of the groups were matched. The caecal intubation rate was 96% and 98% in the CO2i group and the AIRi group, respectively. No complication occurred in the CO2i group whereas one patient from the AIRi group developed secondary haemorrhage after polypectomy. Patients in the CO2i group had a significantly lower pain score during (P < 0.01) and 30 min after (P = 0.02) the examination. Compared to the AIRi group, significantly more patients in the CO2i group reported the examination as painless (VAS 0) during the procedure (45% vs 14%, P < 0.01) and 30 min after (70% vs 51%, P = 0.05). In both groups, high satisfaction scores were recorded. Most of the patients (93% for the CO2 group and 98% for the air group) would accept another colonoscopy if indicated. Again, most of the patients (89% for the CO2 group and 96% from the air group) would recommend others to have colonoscopy as the method for colonic evaluation.Conclusion:  Our data suggest CO2 that insufflation colonoscopy is safe. Most importantly, compared to conventional air insufflation colonoscopy, it results in significantly less pain during the examination. CO2 insufflation colonoscopy holds the potential to be a painless screening tool in the community.
3 LONG‐TERM FOLLOW UP OF THE EFFICACY OF A MULTIDISCIPLINARY APPROACH TO THE MANAGEMENT OF CHRONIC CONSTIPATION
Authors: Leung R.W.C. , Meng W.C.S. , Fung B.K.Y. , Lee W.S. , Chan D. , Lau P.Y.Y. , Yip W.C. 
Published: May 2007

Introduction:  Standard measures for the management of constipation include adequate dietary fibre and fluid intake, regular exercise, and biofeedback training. However, there is no documentation on the effects of the above in Hong Kong.Purpose:  To evaluate the long‐term efficacy of the rehabilitative programme in the management of constipation in Hong Kong.Methods:  Patients diagnosed with chronic constipation using the Rome II criteria were recruited. A clinician, dietitian and physiotherapist assessed the patients. Anorectal physiology investigations and defecation proctography were performed prior to and after the treatment programme. The treatment programme involved consultation by the dietitian, postural re‐education, and pelvic floor re‐education on a proper defecation pattern. Patients were followed up in alternate weeks for the first 3 months and monthly for another 3 months. Telephone follow up was followed 3 years after the programme.Results:  24 patients completed the program in the years 2002 and 2003. The mean age was 48.1 ± 12.8 years. There were five males and 19 females, with a median follow up of 46 months (36–48). On completion of the programme, there was significant improvement in average straining time, median bowel frequency per week, Bristol score and fibre intake.

Pretreatment
Post‐treatment

Average straining time (min)
14.8 ± 2.2
10.6 ± 2.2
P = 0.029

Median bowel frequency per week
2.0 (0–42)
6.0 (0–42)
P = 0.027

Bristol score
2.0 ± 0.5
2.9 ± 0.4
P = 0.006

Fibre intake (g)
10.5 ± 4.0
15.5 ± 7.4
P = 0.007

Post‐treatment
Post‐treatment 3 years

Average straining time
10.6 ± 2.2
10.0 ± 2.6
P = 0.633

Median bowel frequency per week
6.0 (0–42)
4.5 (0–26)
P = 0.016

Bristol score
2.9 ± 0.4
3.4 ± 0.8
P = 1.000

Fibre intake
15.5 ± 7.4
8.46 ± 3.2
P = 0.001

Subjective improvement
45.2%
43.0%
P = 0.615

Conclusions:  Rehabilitative programme for constipation can significantly improve the symptoms of constipation including straining time, bowel frequency and Bristol score. This was a long‐term effect and the decrease in average straining time was persistent at 3 years post‐treatment. Change of lifestyle was more difficult. Hence, there was a tendency for patients to have decreased fibre intake again after the therapy and this contributed to the subsequent decrease in bowel frequency. Fortunately, the overall subjective improvement in constipation was persistent on long‐term follow up.
4 EMERGENCY LAPAROSCOPIC‐ASSISTED VERSUS OPEN RIGHT HEMICOLECTOMY FOR COMPLICATED CAECAL DIVERTICULITIS: A COMPARATIVE STUDY OF SHORT‐TERM OUTCOMES
Authors: Li J.C.M. , Ng S.S.M. , Lee J.F.Y. , Yiu R.Y.C. , Leung K.L. 
Published: May 2007

Aim:  The aim of this study was to compare the operative and short‐term clinical outcomes of emergency laparoscopic‐assisted versus open right hemicolectomy for complicated caecal diverticulitis.Methods:  Between September 2001 and June 2006, 18 consecutive patients with complicated caecal diverticulitis underwent emergency right hemicolectomy at out institution, six with the laparoscopic‐assisted approach and 12 with the open approach. Clinical data were prospectively recorded and compared between the two groups.Results:  There were no significant differences between the two groups with respect to age, gender, comorbidities, duration of symptoms, and Hinchey staging. There was no conversion in the laparoscopic‐assisted group. Compared to the open group, the laparoscopic‐assisted group had a slightly longer operative time (167.5 vs 150 min, P = 0.083) but significantly less blood loss (35 vs 100 mL, P = 0.041). Although the median time to first bowel motion was significantly shorter in the laparoscopic‐assisted group (3 vs 5 days, P = 0.041), the time to full ambulation and the duration of hospital stay were similar between the two groups. The postoperative complication rates (50% vs 33.3%), as well as the hospital readmission rates for complications (33% vs 0%), were higher in the open group than the laparoscopic‐assisted group, but the differences did not reach statistical significance.Conclusion:  Emergency laparoscopic‐assisted right hemicolectomy for complicated caecal diverticulitis is feasible and safe in the hands of experienced surgeons. Compared with the open approach, the laparoscopic‐assisted approach is associated with less blood loss and earlier return of gastrointestinal function.
5 LAPAROSCOPIC RESECTION FOR COLORECTAL CANCER IN OCTOGENARIANS: RESULTS OF A DECADE
Authors: Ling Y.H. , Cheung H.Y.S. , Wong J.C.H. , Yau K.K. , Chung C.C. , Li M.K.W. 
Published: May 2007

Objectives:  To evaluate the results of laparoscopic resection for colorectal cancer in octogenarians.Patients and method:  Patients aged 80 years or above who had undergone elective laparoscopic resection for colorectal cancer from 1 July 1996 to 30 June 2006 were recruited with the following exceptions: (i) patients who did not give informed consent; (ii) unfit for operation; (iii) surgical emergencies; (iv) multiple abdominal operations; or (v) locally advanced tumours. Main outcomes measures: operating data, length of hospital stay, mortality, morbidities, recurrence and survival.Results:  Over a 10‐year period, laparoscopic colorectal cancer resection was attempted in 101 octogenarians. The median age was 83 (range: 81–85) years. The median operating time was 110 (range: 87–130) min, with a median blood loss of 50 (range: 20–100) mL. Conversion was required in one case with a leakage rate of 3.3%. The overall morbidity and operative mortality rates were 17% and 3%, respectively. With a median follow up of 24 (range: 12–48) months, 24 patients developed recurrence. The overall 4‐year survival is 51%.Conclusions:  Laparoscopic colorectal cancer resection in selected octogenarians is safe and feasible. An aggressive attitude in treating octogenarians with colorectal cancer is justified and laparoscopic approach is the technique of choice.
In vitro evaluation of the accuracy of five different electronic apex locators for determining the working length of endodontically retreated teeth
Authors: Ebrahim Aqeel Khalil , Wadachi Reiko , Suda Hideaki 
Published: May 2007

AbstractThe aim of this study was to evaluate the accuracy of five electronic apex locators (EALs) in determining the working length (WL) of teeth after removal of the root canal obturation materials. A total of 32 extracted straight, single‐rooted teeth were used. The actual canal length (AL) was determined and the WL was established by subtracting 0.5 mm from the AL. The root canals were instrumented and divided into two groups. One group (n = 6) served as control, while the other group (n = 26) was the experimental group. In the experimental group, the root canals were obturated using vertically compacted gutta‐percha with AH 26 sealer. In both groups, the access cavities were restored with a provisional restoration and stored for 15 days at 37°C and 100% humidity. The root canal obturation material was removed, and the teeth were then mounted in an experimental apparatus. Five EALs were used: Dentaport ZXTM®, ProPex, Foramatron D10, Apex NRG and Apit 7. For the electronic measurement of canal length, a size 25 K‐file was used. During measurement, the canal was irrigated with 2.5% sodium hypochlorite. The difference (D) between the AL and the electronically determined length (EDL), AL–EDL, was calculated and recorded for each measurement. Data were analysed by two‐way anova and Fisher’s PLSD test. In both groups, statistically significant differences were found among the EALs (P < 0.01). In conclusion, the Dentaport ZXTM®, ProPex and Foramatron D10 were more accurate than the other two EALs in determining the WL in teeth after removal of the root canal obturation materials. However, the Apex NRG and Apit 7 were also reliable for determination of the WL in the majority of the cases.
Endodontic treatment of mandibular incisors with two root canals: Report of two cases
Authors: Kabak Yury S. , Abbott Paul V. 
Published: May 2007

AbstractThe root canal anatomy of mandibular incisors can present a number of variations, including multiple canals. Two case reports are presented to illustrate the serendipitous discovery and successful non‐surgical endodontic management of complex canal systems in mandibular incisors. In both cases, all four mandibular incisors had two canals each.
Rectus sheath hematoma complicating low‐molecular weight heparin therapy
Authors: DENARD P. J. , FETTER J. C. , ZACHARSKI L. R. 
Published: May 2007

SummaryRectus sheath hematoma (RSH) is an uncommon but serious bleeding complication of anticoagulant therapy that has received little attention in the literature. Two cases of RSH among recent admissions to an inpatient medicine service and four archival cases were reviewed. All six patients were on low‐molecular weight heparin (LMWH) therapy. Five of the six patients had a creatinine clearance of 40 ml/min or less, and five also had cough. Two patients with the most serious outcome were aged 90 and 92 years. RSH complicating LMWH therapy appears to constitute a clinical syndrome consisting of sudden onset of abdominal pain in the setting of renal insufficiency, advanced age and abdominal straining (e.g. cough). Risk of RSH may be reduced in patients receiving LMWH by assessing renal function, monitoring heparin levels (e.g. when the creatinine clearance is 40 ml/min or less) and adjusting the dose accordingly; by avoidance of abdominal strain (e.g. by treating cough); and by attention to technique when the abdominal wall is used as the injection site. Patients of advanced age may be at particular risk for RSH.
Novel chromosomal translocations in multiple myeloma: t(13;16)(q14;q24) and t(1;15)(q10;q26)
Authors: AKALIN I. , KUTLAY N. Y. , ILHAN O. , TUKUN A. 
Published: May 2007

SummaryMultiple myeloma (MM) is a malignant plasma cell disorder that involves multiple genetic abnormalities. Chimeric transcription factors, created by gene fusion as a result of chromosomal translocations, have been implicated in the pathogenesis of the disease. Here, we report the conventional cytogenetic analysis of a MM patient that showed a complex set of novel chromosomal rearrangements, including t(13;16)(q14;q24) and t(1;15)(q10;q26). This is probably the result of fusion of previously known genes, and would contribute to prognostic significance of the disease.
Assay of AVP, CRP, and LPS in leukemia
Authors: HAN D. M. , ZHANG Y. Q. , BAI Q. X. , CHEN X. Q. 
Published: May 2007

SummaryThe genesis and development of tumor are closely connected with immune system and neuroendocrine system. To investigate the changes of neuroendocrine and immune system in leukemia patients and their probable connection with leukemia, we studied five groups of patients including leukemia patients with normal temperature, leukemia patients with high temperature and infection (high‐leukocyte count group and low leukocyte count group), general patients with fever and healthy Chinese adult blood donors as control group. We determined their blood cell counts by blood count meter, determined their arginine vasopressin (AVP) levels in blood plasma by radioimmunoassay and their cross‐reacting protein (CRP), and lipopolysaccharide (LPS) levels by immunoturbidimetry. Then we studied the difference and association among these indexes. Our results revealed a significant increase of AVP, LPS, and CRP levels in the blood of leukemia patients with normal temperature vs. normal people; Individual leukemia patients had high AVP levels although they had normal LPS and CRP levels; In the group of leukemia patients with high temperature and low leukocyte counts, the CRP level is significantly higher than some of other groups, while there was no significant increase in its AVP level. We conclude that no matter the temperature is normal or not, there were always neuroendocrine disturbance, inflammation, and inapparent infection in leukemia patient; To the leukemia patients with low leukocyte counts, the relationship between inflammation and neuroendocrine is more complicated.
Population‐based platelet reference values for an Iranian population
Authors: ADIBI P. , FAGHIH IMANI E. , TALAEI M. , GHANEI M. 
Published: May 2007

SummaryThere are a few reports regarding the reference range for platelet indices in the populations of Iran and its neighbouring countries, but these studies were of small sample size. This study aimed at defining platelet reference values for medical research and practice. A cross‐sectional survey was performed on 19 993 young adult Iranians who participated in a compulsory pre‐marriage screening programme over a 6‐month period. Platelet indices were measured using an automated Technicon H2 cell counter. The platelet count [given as 95% reference interval (2.5 percentile–97.5 percentile) and mean ± standard deviation] were 145–356 × 109/l (237 ± 55.2); the platelet distribution width was 40.2–57.4% (46.9 ± 5.7) the Plateletocrit was, 0.13–0.32% (0.22 ± 0.05) and the mean platelet volume was 7.4–10.7 fl (9.2 ± 2.9). The first three indices showed significant differences between males and females. The reference values of platelet indices in Iranians were found to be different from international data; they were a little lower than those in Caucasians but higher than the indices found for Africans.
Occurrence of Antibiotic-Resistant Uropathogenic
Escherichia coli
Clonal Group A in Wastewater Effluents
Authors: Boczek Laura A. , Rice Eugene W. , Johnston Brian , Johnson James R. 
Published: May 2007

ABSTRACT

Isolates of
Escherichia coli
belonging to clonal group A (CGA), a recently described disseminated cause of drug-resistant urinary tract infections in humans, were present in four of seven sewage effluents collected from geographically dispersed areas of the United States. All 15 CGA isolates (1% of the 1,484 isolates analyzed) exhibited resistance to trimethoprim-sulfamethoxazole (TMP-SMZ), accounting for 19.5% of the 77 TMP-SMZ-resistant isolates. Antimicrobial resistance patterns, virulence traits, O:H serotypes, and phylogenetic groupings were compared for CGA and selected non-CGA isolates. The CGA isolates exhibited a wider diversity of resistance profiles and somatic antigens than that found in most previous characterizations of this clonal group. This is the first report of recovery from outside a human host of
E. coli
CGA isolates with virulence factor and antibiotic resistance profiles typical of CGA isolates from a human source. The occurrence of “human-type” CGA in wastewater effluents demonstrates a potential mode for the dissemination of this clonal group in the environment, with possible secondary transmission to new human or animal hosts.
Studies in target-based treatment
Authors: Kurzrock Razelle 
Published: May 2007

Abstract
In this issue, Molecular Cancer Therapeutics inaugurates a new feature—The Cutting Edge: Spotlight on Clinical Response—whose objective is the rapid publication of breaking discoveries regarding target- or mechanism-based clinical responses in cancer.
Targeted molecules are poised to alter the landscape of clinical cancer treatment. For example, because they can distinguish cancer cells from their normal counterparts, agents such as imatinib mesylate, a Bcr-Abl and Kit kinase inhibitor, can result in remarkable responses with minimal host toxicity in patients suffering from diseases characterized by abnormalities in the targeted kinases. Indeed, studies of imatinib mesylate in early-stage chronic myelogenous leukemia, whose hallmark is the aberrant Bcr-Abl, show response rates of more than 90%. Furthermore, gastrointestinal stromal tumors (GIST), a notoriously chemotherapy-refractory sarcoma, characterized by activating Kit kinase mutations, can show dramatic metabolic responses within days after initiation of treatment.
With the wealth of new knowledge in this field, and numerous novel targeted molecules entering clinical trials, the above examples are likely to represent the tip of the iceberg. Indeed, in this issue, a paper by Senzer et al. documents, for the first time, successful use of adenoviral p53 therapy to treat a tumor in a patient with Li Fraumeni Syndrome, a hereditary cancer syndrome caused by the mutation of the p53 tumor suppressor gene. Some of the features of this response, such as the early disappearance of metabolic activity on fluorodeoxyglucose–positron emission tomography scans, are reminiscent of those of GIST responses to imatinib. These findings have important implications for patients with this syndrome, who are prone to develop numerous tumors and often succumb at a young age. In addition, because mutations in p53 are one of the more common aberrations in cancer in general, identification of these mutations and exploration of this approach is warranted in patients with sporadic cancers.
In summary, the era of “molecular cancer therapeutics” has begun. Even so, results in the laboratory and in animals often do not translate into salutary effects in patients. However, when they do, it is important that the information be made quickly available to the investigative community. Molecular Cancer Therapeutics believes that providing a forum for the rapid dissemination of cutting-edge findings of successful, albeit early, clinical research should stimulate further study and will ultimately benefit patients with cancer.
On the Standardisation of the Twinning Rate
Authors: Fellman Johan , Eriksson Aldur W. 
Published: May 2007

AbstractIn many studies the twinning rate, being strongly dependent on maternal age (and parity), has been standardised according to the maternal age distribution. The direct method requires very informative twinning data for the target population. The indirect method is used when the data for the target population is not sufficiently informative or when the target population is small. We have earlier introduced an alternative indirect technique for standardising the twinning rate. Our technique requires even less of the twinning data. Besides maternal age, parity is an influential factor, and should, if possible, be taken into account. In this study we present the traditional standardisation methods based on both maternal age and parity, we propose a new direct standardisation method and we develop our standardisation methods so that they take into account both maternal age and parity. We apply these standardisation methods to data from Finland, 1953–1964, from St. Petersburg, Russia, 1882–92, from Canada 1952–1967, and from Denmark, 1896–1967. These methods all give results very similar to those for the Finnish data, but the effect of parity is strongest with the direct methods. This may be due to the fact that, among extramarital maternities, parity has a strongly increasing effect on the twinning rate. This may be attributed to a higher reproduction capacity among unmarried mothers. Standardisations of the Canadian and the Danish data also give reliable results. With the St. Petersburg data, however, the different standardisations show notable discrepancies. These discrepancies are compared with Allen’s findings.
Gene–Environment Interaction Effects on Behavioral Variation and Risk of Complex Disorders: The Example of Alcoholism and Other Psychiatric Disorders
Authors: Heath Andrew C. , Todorov Alexandre A. , Nelson Elliot C. , Madden Pamela A.F. , Bucholz Kathleen K. , Martin Nicholas G. 
Published: May 2007

AbstractThere have been few replicated examples of genotype x environment interaction effects on behavioral variation or risk of psychiatric disorder. We review some of the factors that have made detection of genotype x environment interaction effects difficult, and show how genotype x shared environment interaction (GxSE) effects are commonly confounded with genetic parameters in data from twin pairs reared together. Historic data on twin pairs reared apart can in principle be used to estimate such GxSE effects, but have rarely been used for this purpose. We illustrate this using previously published data from the Swedish Adoption Twin Study of Aging (SATSA), which suggest that GxSE effects could account for as much as 25% of the total variance in risk of becoming a regular smoker. Since few separated twin pairs will be available for study in the future, we also consider methods for modifying variance components linkage analysis to allow for environmental interactions with linked loci.