bluuebunny/crossref_metadata_2025_split huggingface dataset:
BIMODAL ELECTRIC TISSUE ABLATION: POSITIVE ELECTRODE STUDIES
Authors: Dobbins Christopher , Brennan Catriona , Wemyss‐Holden Simon A. , Cockburn John , Maddern Guy J. 
Published: June 2008

Background:  Bimodal electric tissue ablation is a novel variation to standard radiofrequency ablation that produces significantly larger ablations by the addition of a direct electrical current. The negative electrode is attached to the radiofrequency current and the positive electrode is placed nearby. It has been identified that an electrolytic injury can occur at the positive electrode site. It is suggested that by increasing the surface area that is in contact with the positive electrode, the risk of tissue injury is reduced. This hypothesis was tested in a pig model.Methods:  Thirty‐six ablations were carried out in the livers of six pigs (six ablations per pig). Two were standard radiofrequency ablation controls and two were carried out with positive electrode attached to a scalpel blade. Two were carried out with positive electrode attached to a grounding pad. After 48 h, liver was harvested and the ablation sizes were compared. Skin biopsies were taken from the scalpel site and one from the pad site and examined histopathologically.Results:  The scalpel blade ablations were significantly larger than controls and the grounding pad ablations (P < 0.001). The grounding pad ablation was significantly larger than controls. The scalpel blade skin site showed full‐thickness tissue injury. The grounding pad site appeared microscopically normal.Conclusion:  By increasing the surface area that connects to the positive electrode, significantly larger ablations can be carried out while minimizing the risk of associated tissue injury.
AN EASTERN PERSPECTIVE ON OESOPHAGEAL PERFORATION: A HIGH INCIDENCE OF INGESTED BONES
Authors: Sng Kevin K. , Koh Adrian J. H. , Tan Ngian‐Chye , Tan Su‐Ming , Tay Khoon‐Hean 
Published: June 2008

Background:  Oesophageal perforation is uncommon, with controversy surrounding its optimal management. Our local experience shows a high incidence of oesophageal perforation secondary to ingested bones.Methods:  Fourteen patients with oesophageal perforation treated at Changi General Hospital in Singapore between January 1996 and December 2006 were retrospectively reviewed.Results:  The median age was 52 years (16–79 years), with eight men and six women. There were 11 thoracic perforations and 3 cervical perforations. Ten perforations were the result of foreign body ingestion, three were spontaneous and only one was iatrogenic. The offending foreign body was a fish bone in five patients, a chicken bone in four and a tooth in one. Three of our 14 patients were treated surgically. The remaining 11 patients were treated non‐operatively. All nine patients with fish or chicken bone perforation were treated conservatively, except two in whom conservative therapy failed and they subsequently required surgery. The median length of hospital stay was 7 days (2–109 days). There was one death.Conclusion:  Oesophageal perforation requires prompt diagnosis and treatment. Most of our oesophageal perforations are secondary to ingested bones. Such cases can often be treated conservatively in our experience.
ENDOSCOPIC MANAGEMENT OF RECURRENT PRIMARY BILE DUCT STONES
Authors: Kohn Geoffrey P. , Hassen A. Sayed , Banting Simon W. , Mackay Sean , Cade Richard J. 
Published: June 2008

Background:  The management of recurrent choledocholithiasis today remains as challenging as in the pre‐endoscopic era. Between 2 and 7% of affected patients have historically required surgical intervention for the treatment of recurrent or retained choledocholithiasis and of these, as many as 24% develop biliary complications. To avoid surgery, repeated endoscopic management of the problem has been suggested. In this study, we evaluate our policy of repeated endoscopic management of recurrent primary bile duct stones.Methods:  This study examined a cohort of nine patients identified from a prospective database with recurrent choledocholithiasis. Demographic, clinical and investigative details were recorded and data were analysed. Complications were determined from a review of the patient’s file.Results:  There were nine patients and 66 procedures were carried out. Mean age at time of first endoscopy was 70.1 years (36–91 years). Three patients were of male sex (33.3%). The mean number of endoscopies carried out per patient was 7.3 (3‐13). Failure to completely clear the duct occurred in 36.4% of all endoscopies. There were no periprocedural complications.Conclusion:  Repeated endoscopic stone extraction by endoscopic retrograde cholangiopancreatography when required is a safe policy. However, this technique will only provide temporary relief from primary duct stones and repeated endoscopic treatment, again safe, will be required.
PREDICTORS OF POST‐TRAUMATIC STRESS DISORDER FOLLOWING MAJOR TRAUMA
Authors: Harris Ian A. , Young Jane M. , Rae Hamish , Jalaludin Bin B. , Solomon Michael J. 
Published: June 2008

Background:  Post‐traumatic stress disorder (PTSD) is a common sequel to physical trauma, but there is disagreement regarding the predictors of this condition. This study aims to examine the role of physical, psychosocial and compensation‐related factors in the development of PTSD following major trauma.Methods:  Participants were consecutive adult patients presenting to one major trauma centre with major trauma (Injury Severity Score 16 or higher). Baseline characteristics and clinical data were obtained from the hospital trauma database. The presence of PTSD (as measured by the PTSD Checklist, civilian version) and additional data were obtained from a questionnaire mailed to patients between 1 and 6 years after the injury. Multiple linear regression was used to identify significant independent associations with PTSD.Results:  Among 355 patients (61.0% response fraction), 129 (36.3%, 95% confidence interval 43.2–53.2%) were classed as having PTSD. Symptoms of PTSD were not significantly related to measures of injury severity, the time since the injury, education level, household income or employment status at the time of injury. PTSD was significantly associated with younger age (P < 0.0001), the presence of chronic illnesses (P < 0.0001), unemployment at the time of follow up (P < 0.0001), use of a lawyer (P < 0.0001), blaming others for the injury (P = 0.003) and having an unsettled compensation claim (P = 0.007).Conclusion:  Post‐traumatic stress disorder after major trauma was not related to measures of injury severity, but was related to other factors, such as blaming others for the accident and the processes involved in claiming compensation.
MANAGEMENT AND HOSPITAL OUTCOME OF THE SEVERELY HEAD INJURED ELDERLY PATIENT
Authors: Mitra Biswadev , Cameron Peter A. , Gabbe Belinda J. , Rosenfeld Jeffrey V. , Kavar Bhadrakant 
Published: June 2008

Introduction:  Severe traumatic head injury in the elderly has been associated with poor outcomes. However, there is currently no consensus to direct management in these patients. This study outlines the demographics, injury characteristics, management and outcome of the elderly trauma patients with severe head injury across a defined population.Materials and Methods:  A retrospective review of all elderly patients (age >64 years) with a Glasgow Coma Scale (GCS) score of 8 or less, and confirmed intracranial pathology or fractured skull, was undertaken over a period of 40 months from July 2001 to September 2005. Data on patient demographics, injury cause, presenting clinical features and interventions were collected. In‐hospital mortality was used as the primary outcome.Results:  There were 96 patients who met the inclusion criteria. One‐third of the patients were managed palliatively, one‐third supportively without surgery and another third underwent surgery. Overall mortality was 70.8% (n = 68). Older age and brainstem injuries were identified as independent predictors of mortality. Mortality was reported in all patients aged 85 years or older.Conclusions:  Although overall outcomes were poor, careful consideration should be given to active treatment as favourable outcomes were possible even in the presence of extremely low GCS scores. Prediction of outcome on the basis of age and anatomical diagnoses may help in this decision‐making.
HEPATOBILIARY SCINTIGRAPHY IN MANAGEMENT OF BILE LEAKS IN PATIENTS WITH BLUNT ABDOMINAL TRAUMA
Authors: Mittal Bhagwant R. , Sunil Hejjaji V. , Bhattacharya Anish , Singh Baljinder 
Published: June 2008

Background:  Hepatobiliary scintigraphy (HBS) is a useful diagnostic tool in detecting the presence and site of bile leaks.Methods:  We present a retrospective analysis of HBS carried out in 35 patients with blunt abdominal trauma over a period of 5 years from 2001 to 2006.Results:  Twenty‐three of 35 patients with blunt abdominal trauma had localized bile leaks and were managed conservatively. The bile leak was found to have completely resolved in the follow‐up HBS. Two patients did not show any evidence of bile leak. Remaining 10 of 35 patients with blunt abdominal trauma showed active bile leak and were subjected to surgical management. Follow‐up scans in these patients showed resolution of bile leaks and patent bilioenteric pathway. Clinical management decisions based on scintigraphic evidence led to less invasive drainage procedures over time and shorter hospital stay.Conclusion:  Our study thus suggests that HBS facilitates rapid and precise diagnosis of bile leaks.
NOVEL SURGICAL MANAGEMENT OF RENAL TRAUMA: INLINE RADIOFREQUENCY ABLATION COAGULATION
Authors: Yao Peng , Gunasegaram Aravin , Ladd Leigh A. , Morris David L. 
Published: June 2008

Background:  Renal injury accounts for 10% of all abdominal trauma. Low‐grade renal injuries can be managed without surgery. However, patients with grade IV or grade V injuries may require nephrectomy. In this study, InLine radiofrequency ablation device (ILRFA), which we developed for liver surgery was tested in the animal model of simulated renal injury.Methods:  A grade IV renal injury was induced in eight landrace pigs. Then treatment with ILRFA was compared to conventional diathermy and suture; totally 24 surgeries were carried out (12 ILRFA vs 12 control).Results:  No massive bleeding occurred and no animal died during the experiments. Immediately after surgery, the pigs were given euthanasia. The average of RFA coagulation time was 3.5 min. The mean intraoperative blood loss was 42 ± 16 mL in the ILRFA and 195 ± 58 mL in the control, a 78.5% reduction (P < 0.001). The mean blood loss per centimetre squared of resection area was 4.50 ± 2.84 mL/cm2 in the ILRFA compared with 18.73 ± 6.89 mL/cm2 in controls, the reduction was 76.0% (P = 0.001).Conclusion:  InLine RFA is efficient for the management of haemorrhage in renal trauma in an animal model and deserves clinical evaluation.
U‐SHAPED PROSTATOBULBAR ANASTOMOSIS FOR URETHRAL INJURY AFTER PELVIC TRAUMA
Authors: Mathur Raj K. , Aggarwal Himanshu , Odiya Sudarshan , Lubana P. S. 
Published: June 2008

Background:  We describe a technique of U‐shaped bulboprostatic anastomosis for urethral injury after pelvic trauma.Methods:  Sixty‐eight male patients were included in our study. Suprapubic cystostomy was carried out initially, followed by U‐shaped prostatobulbar anastomosis after 6–12 weeks. Follow ups were carried out at 6, 12 and 18 months by assessing patient satisfaction rates along with preoperative and postoperative urethrogram, uroflowmetry and labelled as good, fair and poor. The surgical technique used was as follows: after an inverted Y‐shaped skin incision, subcutaneous tissue and Colle’s fascia was opened. Bulbospongiosum was mobilized to gain access to the stricture membranous urethra, which was excised and the bulbar urethra freed. A sound was passed through the suprapubic cystostomy and complete resection of the scar over the tip of the sound was carried out. A silicon catheter was then passed into the bladder and the anastomosis was completed in a ‘U’ shape; that is, there were no stitches from the 10 to the 2 o’clock position.Results:  Good and fair results were considered as successful. Overall success rate was 97.05% immediately and after 6 months, but decreased to 95.6% at 12 months and 93.6% at 18 months.Conclusion:  U‐shaped end‐to‐end prostatobulbar anastomosis markedly decreases the chance of restenosis and impotence.
Inflammation reduces mechanical thresholds in a population of transient receptor potential channel A1‐expressing nociceptors in the rat
Authors: Dunham James P. , Kelly Sara , Donaldson Lucy F. 
Published: June 2008

AbstractInflammatory hypersensitivity is characterized by behavioural reductions in withdrawal thresholds to noxious stimuli. Although cutaneous primary afferent neurones are known to have lowered thermal thresholds in inflammation, whether their mechanical thresholds are altered remains controversial. The transient receptor potential channel A1 (TRPA1) is a receptor localized to putative nociceptive neurones and is implicated in mechanical and thermal nociception. Herein, we examined changes in the properties of single primary afferents in normal and acutely inflamed rats and determined whether specific nociceptive properties, particularly mechanical thresholds, are altered in the subpopulation of afferents that responded to the TRPA1 agonist cinnamaldehyde (TRPA1‐positive afferents). TRPA1‐positive afferents in normal animals belonged to the mechanonociceptive populations, many of which also responded to heat or capsaicin but only a few of which responded to cold. In acute inflammation, a greater proportion of afferents responded to cinnamaldehyde and an increased proportion of dorsal root ganglion neurones expressed TRPA1 protein. Functionally, in inflammation, TRPA1‐positive afferents showed significantly reduced mechanical thresholds and enhanced activity to agonist stimulation. Inflammation altered thermal thresholds in both TRPA1‐positive and TRPA1‐negative afferents. Our data show that a subset of afferents is sensitized to mechanical stimulation by inflammation and that these afferents are defined by expression of TRPA1.
The topography of activity transmission between lateral entorhinal cortex and subfield CA1 of the hippocampus
Authors: Vorobyov Nikolay A. , Brown Malcolm W. 
Published: June 2008

AbstractIt is important to establish how information is transmitted through the hippocampal formation because of the structure’s critical role in memory and spatial processing. Here we provide evidence that challenges the hypothesis that information is processed in parallel closed entorhinal‐CA1 loops. We tested the hypothesis by mapping, throughout hippocampal subfield CA1, field potentials evoked by stimulation of different sites in lateral entorhinal cortex in awake rats, thereby establishing the topography of electrophysiological transmission between the entorhinal cortex and CA1. The results established that antidromic and orthodromic responses evoked from the same entorhinal site occurred in spatially separated CA1 areas, with antidromic responses being located more septally than orthodromic responses. Thus, an entorhinal site receives information from a CA1 area located closer to the septal pole of the hippocampus and transmits it to the next CA1 area located closer to the temporal pole. Accordingly, processing in the hippocampal formation is by open rather than closed loops. Activation occurred first in CA1 close to its septal pole and spread towards its temporal pole. Four successively activated CA1 areas, oriented at an angle to the longitudinal axis of the hippocampus, were distinguished. Overall, the findings indicate that information can potentially be transmitted from the septal to the temporal end of the hippocampal formation via an ordered succession of hippocampal and entorhinal areas that form a three‐dimensional spiral pathway.
Spectro‐temporal sound density‐dependent long‐term adaptation in cat primary auditory cortex
Authors: Gourévitch Boris , Eggermont Jos J. 
Published: June 2008

AbstractSensory systems use adaptive strategies to code for the changing environment on different time scales. Short‐term adaptation (up to 100 ms) reflects mostly synaptic suppression mechanisms after response to a stimulus. Long‐term adaptation (up to a few seconds) is reflected in the habituation of neuronal responses to constant stimuli. Very long‐term adaptation (several weeks) can lead to plastic changes in the cortex, most often facilitated during early development, by stimulus relevance or by behavioral states such as attention. In this study, we show that long‐term adaptation with a time course of tens of minutes is detectable in anesthetized adult cat auditory cortex after a few minutes of listening to random‐frequency tone pips. After the initial post‐onset suppression, a slow recovery of the neuronal response strength to tones at or near their best frequency was observed for low‐rate random sounds (four pips per octave per second) during stimulation. The firing rate at the end of stimulation (15 min) reached levels close to that observed during the initial onset response. The effect, visible for both spikes and, to a smaller extent, local field potentials, decreased with increasing spectro‐temporal density of the sound. The spectro‐temporal density of sound may therefore be of particular relevance in cortical processing. Our findings suggest that low stimulus rates may produce a specific acoustic environment that shapes the primary auditory cortex through very different processing than for spectro‐temporally more dense and complex sounds.
Neurokinin 2 receptor‐mediated activation of protein kinase C modulates capsaicin responses in DRG neurons from adult rats
Authors: Sculptoreanu Adrian , Aura Kullmann F. , De Groat William C. 
Published: June 2008

AbstractPatch‐clamp techniques and Ca2+ imaging were used to examine the interaction between neurokinins (NK) and the capsaicin (CAPS)‐evoked transient receptor potential vanilloid receptor 1 (TRPV1) responses in rat dorsal root ganglia neurons. Substance P (SP; 0.2–0.5 μm) prevented the reduction of Ca2+ transients (tachyphylaxis) evoked by repeated brief applications of CAPS (0.5 μm). Currents elicited by CAPS were increased in amplitude and desensitized more slowly after administration of SP or a selective NK2 agonist, [Ala8]‐neurokinin A (4–10) (NKA). Neither an NK1‐selective agonist, [Sar9, Met11]‐SP, nor an NK3‐selective agonist, [MePhe7]‐NKB, altered the CAPS currents. The effects of SP on CAPS currents were inhibited by a selective NK2 antagonist, MEN 10,376, but were unaffected by the NK3 antagonist, SB 235,375. Phorbol 12,13‐dibutyrate (PDBu), an activator of protein kinase C (PKC), also increased the amplitude and slowed the desensitization of CAPS responses. Phosphatase inhibitors, decamethrin and α‐naphthyl acid phosphate (NAcPh), also enhanced the currents and slowed desensitization of CAPS currents. Facilitatory effects of SP, NKA and PDBu were reversed by bisindolylmaleimide, a PKC inhibitor, and gradually decreased in magnitude when the agents were administered at increasing intervals after CAPS application. The decrease was partially prevented by prior application of NAcPh. These data suggest that activation of NK2 receptors in afferent neurons leads to PKC‐induced phosphorylation of TRPV1, resulting in sensitization of CAPS‐evoked currents and slower desensitization. Thus, activation of NK2 autoreceptors by NKs released from the peripheral afferent terminals or by mast cells during inflammatory responses may be a mechanism that sensitizes TRPV1 channels and enhances afferent excitability.
fMRI reveals greater within‐ than between‐hemifield integration in the human lateral occipital cortex
Authors: Large Mary‐Ellen , Culham Jody , Kuchinad Anil , Aldcroft Adrian , Vilis Tutis 
Published: June 2008

AbstractEarly visual areas within each hemisphere (V1, V2, V3/VP, V4v) contain distinct representations of the upper and lower quadrants of the contralateral hemifield. As receptive field size increases, the retinotopy in higher‐tier visual areas becomes progressively less distinct. Using functional magnetic resonance imaging (fMRI) to map the visual fields, we found that an intermediate level visual area, the lateral occipital region (LO), contains retinotopic maps with a contralateral bias, but with a combined representation of the upper and lower visual field. Moreover, we used the technique of fMRI adaptation to determine whether neurons in LO code for both the upper and lower contralateral quadrants. We found that even when visual stimulus locations are equivalent across comparisons, the LO was more sensitive to location changes that crossed hemifields than location changes within a hemifield. These results suggested that within high‐tier visual areas the increasing integration of visual field information is a two‐stage process. The upper and lower visual representations are combined first, in LO, then the left and right representations. Furthermore, these results provided evidence for a neural mechanism to explain behavioral findings of greater integration within than between hemifields.
Expertise in dance modulates alpha/beta event‐related desynchronization during action observation
Authors: Orgs Guido , Dombrowski Jan‐Henryk , Heil Martin , Jansen‐Osmann Petra 
Published: June 2008

AbstractWe presented professional dancers and non‐dancers with videos of two movement styles, dance movements and everyday movements. Participants were asked to indicate by a button press to which category a movement belonged. We computed event‐related desynchronization (ERD) in alpha and beta frequency bands between 7.5 and 25 Hz relative to a visual baseline condition. Power in alpha and lower beta frequency bands was significantly reduced if dancers watched dance movements but not if non‐dancers watched dance movements, in particular between 1 and 2 s after movement onset. During observation of everyday movements no such group difference was evident. Thus, ERD in alpha and beta frequency bands was modulated by a participant’s expertise with a certain movement style. The results are discussed in light of a human observation–execution matching system similar to the macaque mirror neuron system and strengthen the idea of a functional relationship between such a system and rhythmical activity in the alpha and beta frequency bands.
On the development of human corticospinal oscillations: age‐related changes in EEG–EMG coherence and cumulant
Authors: James Leon M. , Halliday David M. , Stephens John A. , Farmer Simon F. 
Published: June 2008

AbstractChanges in coherence and cumulant calculated between electroencephalograph (EEG) recorded from the scalp over primary motor cortex and rectified surface electromyograph (EMG) recorded from the contralateral wrist extensor muscles have been studied during development in humans (48 subjects, age 0–59 years). Using the techniques of EEG–EMG coherence and cumulant analysis and pooled coherence and cumulant analysis we demonstrate that between childhood, adolescence and adulthood there are increases in the prevalence and magnitude of coherence at frequencies between 15 and 35 Hz with corresponding development of a tri‐phasic feature in the EEG–EMG cumulant. The results show for the first time that changes in the cortical ∼20 Hz oscillatory drive to human motoneurone pools take place during motor development.