bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tracheolaryngeal Complications of Inherited Epidermolysis Bullosa: Cumulative Experience of the National Epidermolysis Bullosa Registry
Authors: Fine Jo‐David , Johnson Lorraine B. , Weiner Madeline , Suchindran Chirayath 
Published: August 2007

AbstractObjectives/Hypothesis: To accurately determine the frequency with which complications arise in the ears, noses, and throats of patients with inherited epidermolysis bullosa (EB) as well as the cumulative risk of tracheolaryngeal stenosis or stricture.Study Design: Cross‐sectional study (3,280 patients) with a nested, randomly sampled longitudinal subcohort (n = 450), representing data collection, stratified by major EB subtype, of the National EB Registry, an epidemiologic project focused on enrolling all EB patients within the continental United States from 1986 to 2002, to permit generalization of findings to the entire American EB population.Methods: Systematic epidemiologic case finding and data collection were performed throughout the continental United States, followed by subclassification of patients by EB subtype. ENT complications were quantified via contingency tables (as frequencies) and lifetable analyses. Frequencies of surgical procedures were also determined.Results: The most important clinical ENT complication in inherited EB was tracheolaryngeal stenosis or stricture, arising during early childhood and primarily within infants and children with junctional EB (JEB) (cumulative risk of 39.8% and 12.8% in Herlitz and non‐Herlitz JEB, respectively, by ages 6 and 9). Other uncommon complications included chronic otitis media, chronic otitis externa, and hearing loss.Conclusions: Given the potential risk for sudden airway occlusion and death, meticulous surveillance by a pediatric otolaryngologist is a critical part of the overall management of infants and children with EB, especially those with JEB and two rare subtypes of generalized EB simplex. Elective tracheostomy should be considered in EB infants and children with evidence of airway embarrassment.
Dysregulation of CD47 and the ligands thrombospondin 1 and 2 in multiple myeloma
Authors: Rendtlew Danielsen Jannie M. , Knudsen Lene Meldgaard , Dahl Inger Marie , Lodahl Marianne , Rasmussen Thomas 
Published: August 2007

SummaryCD47 and thrombospondin 1 and 2 (TSP1 and TSP2) expression were analysed by real‐time reverse transcription polymerase chain reaction in fluorescence‐activated cell sorted plasma cells (PCs) from patients at consecutive stages of multiple myeloma (MM) development. 80% of MM patients, but only 39% of patients with monoclonal gammopathy of undetermined significance (MGUS) expressed CD47; median expression level increased 10‐fold with progression from MGUS to MM. Elevated TSP1/TSP2 levels occurred in bone marrow cultures from MM patients compared with healthy donors. CD47 and TSP1/TSP2 may have a potential role in the pathophysiology of MM, probably in the interaction between MM PCs and the microenvironment.
Outcome of children with nodular lymphocyte predominant Hodgkin lymphoma – a Children's Cancer and Leukaemia Group report
Authors: Hall G. W. , Katzilakis N. , Pinkerton C. R. , Nicolin G. , Ashley S. , McCarthy Keith , Daw S. , Hewitt M. , Wallace W. H. , Shankar A. 
Published: August 2007

AbstractThis report describes the clinical outcomes and follow‐up records of 42 children with nodular lymphocyte predominant Hodgkin lymphoma (LPHL) treated on United Kingdom Children's Cancer Study Group (UKCCSG) HD1 (1982–1992) and HD2 protocols (1992–2000). The clinical records of 42 children with LPHL treated between 1982 and 2000 were reviewed retrospectively. All 42 had histology reviewed centrally and confirmed as LPHL by an expert panel. In both trials, only patients with stage IA disease had the option of being treated with either involved field radiation alone or combination chemotherapy consisting of chlorambucil, vinblastine, procarbazine and prednisolone (ChlVPP). Patients with all other stages were treated with ChlVPP chemotherapy. Thirty‐five patients (83%) presented with early stage disease (Stages I & II). All 42 patients achieved a complete remission (CR). Six children relapsed after primary therapy. The 5‐ and 10‐year relapse‐free survival rates were 87% and 82% respectively. Forty‐one are currently alive in CR. In conclusion, children with low‐stage LPHL treated between 1982 and 2000 according to the UK strategy for classical Hodgkin lymphoma (HL) had an excellent prognosis. There have been no second malignancies or transformations to B‐cell non‐Hodgkin lymphoma.
General surgical patients’ perspectives of the adequacy and appropriateness of discharge planning to facilitate health decision‐making at home
Authors: McMurray Anne , Johnson Patricia , Wallis Marianne , Patterson Elizabeth , Griffiths Susan 
Published: August 2007

Aim.  To investigate general surgical patients’ perspectives of the adequacy and appropriateness of their discharge planning.Objectives.  To identify any aspects of discharge planning that could be strengthened to assist people in managing their posthospital care and maintaining continuity of care.Background.  Appropriate discharge planning is a priority in today's healthcare environment in which patients are discharged ‘quicker and sicker’, sometimes without home support. Adequate and appropriate discharge planning helps promote health literacy, which has benefits for both patients and their caregivers in helping them manage postsurgical recovery at home.Design.  A qualitative, interpretive study was designed in which patients were interviewed at least one week after they returned home from hospital.Methods.  Purposeful sampling was used to interview 13 general surgical patients from one of three hospitals (two public and one private) in New South Wales and Queensland, Australia. Data were collected in unstructured interviews and analysed using thematic analysis. Reflective analysis by individual research team members generated preliminary themes, which were then analysed collectively by all members of the research team to achieve consensus on patients’ perspectives.Results.  Themes included a ‘one‐size‐fits‐all’ approach to providing discharge information; inconsistent or variable advice from different health professionals; a lack of predischarge assessment of their home and/or work conditions and the need for follow‐up assessment of patient and carer needs.Conclusions.  The findings of this study illuminate the need for a more individualized approach to discharge planning, taking into account the patient's age, gender, surgical procedure and family and community support for immediate and longer‐term nursing follow‐up.Relevance to clinical practice.  Patients would be more adequately prepared for their recovery period at home, by encouraging client‐centred, interdisciplinary communication between health practitioners; adopting a flexible, approach to discharge planning which is tailored to individual needs of postsurgical patients, particularly in relation to advice and information related to recovery; and encouraging and supporting adequate health literacy for self‐management.
Newly qualified Irish nurses’ interpretation of their preparation and experiences of registration
Authors: Mooney Mary 
Published: August 2007

Aims and objectives.  The aim of this paper is to report on the insights of newly qualified Irish nurses into their preparation for registration as general nurses and to develop insights into the postregistration experience.Background.  Nurse education in Ireland has undergone much reform over the past decade. These changes include the introduction of supernumerary status for nursing students and the formation of links with institutes of higher education. No Irish literature was found on this subject.Method.  Individual semi‐structured, in‐depth interviews were held with 12 newly registered nurses, from two cohorts, within 10 months of qualification. A grounded theory approach was adopted and content analysis employed to analyse the data.Results.  Two categories, entitled Learning the Ropes and The Metamorphosis emerged from the analysis of data. Within each of these categories there were two subcategories. All respondents reported that since qualification, they had become increasingly conscious of their isolation and unmet needs as nursing students. Postregistration, they enjoyed their increased status and widespread recognition by others.Conclusions.  This study details how improvements can be made at clinical level to assist the preparation of nursing students for registration. The positive aspects of registration are revealed through descriptions of comparisons of pre‐ and postregistration experiences, while the shortcomings of the journey to registration are described.Relevance to clinical practice.  Pre‐registration nurses have unmet clinical needs which, if fulfilled, would benefit them post‐registration. Good ward morale is elementary for student learning and enhances the post‐registration experience. Registered nurses are highly conscious of their altered status. These findings are pertinent to clinicians and educationalists as they prepare nursing students for practice.
Care for emergency department patients who have experienced domestic violence: a review of the evidence base
Authors: Olive Philippa 
Published: August 2007

Aims.  A literature review was conducted to identify and evaluate the research base underpinning care for emergency department patients who have experienced domestic violence.Background.  The extent of domestic violence in the general population has placed it high on health and social policy agendas. The Department of Health has recognized the role of health care professionals to identify and provide interventions for patients who have experienced domestic violence.Method.  Systematic review.Results.  At least 6% of emergency department patients have experienced domestic violence in the previous 12 months although actual prevalence rates are probably higher. Simple direct questioning in a supportive environment is effective in facilitating disclosure and hence detecting cases of abuse. Although routine screening is most effective, index of suspicion screening is the current mode of practice in the UK. Index of suspicion screening is likely to contribute to under‐detection and result in inequitable health care. Patients with supportive networks have reduced adverse mental health outcomes. Women will have negative perceptions of emergency care if their abuse is minimalized or not identified. Women want their needs and the needs of their children to be explored and addressed. Access to community resources is increased if patients receive education and information.Conclusion.  Domestic violence is an indisputable health issue for many emergency department patients. Practitioners face challenges from ambiguity in practice guidelines and the paucity of research to support interventions. Recommendations for practice based on the current evidence base are presented.Relevance to clinical practice.  The nursing care for patients in emergency and acute health care settings who have experienced domestic violence should focus on three domains of: (1) Providing physical, psychological and emotional support; (2) Enhancing safety of the patient and their family; (3) Promoting self‐efficacy.
Malaria‐specific antibody responses and parasite persistence after infection of mice with Plasmodium chabaudi chabaudi
Authors: ACHTMAN A. H. , STEPHENS R. , CADMAN E. T. , HARRISON V. , LANGHORNE J. 
Published: August 2007

SUMMARY While it is known that antibodies are critical for clearance of malaria infections, it is not clear whether adequate antibody responses are maintained and what effect chronic infection has on this response. Here we show that mice with low‐grade chronic primary infections of Plasmodium chabaudi or infections very recently eliminated have reduced second infections when compared with the second infection of parasite‐free mice. We also show that parasite‐specific antibody responses induced by infection of mice with Plasmodium chabaudi contain both short‐ and long‐lived components as well as memory B cells responsible for a faster antibody response during re‐infection. Furthermore, parasite‐specific antibodies to the C‐terminal fragment of merozoite surface protein‐1 (MSP‐1) undergo avidity maturation. However, antibodies with both low and high avidity persist throughout infection and after re‐infection, suggesting repeated rounds of activation and maturation of memory B cells. Neither the avidity profile of the antibody response, nor its maintenance is affected by persisting live parasites. Therefore, differences in parasitemia in re‐infection cannot be explained solely by higher levels of antibody or greater affinity maturation of malaria‐specific antibodies. These data suggest that there may be an antibody‐independent component to the early control of secondary infections in mice that are chronically infected.
A Colonoscopic Study of Aphthoid Ulcers of the Large Intestine
Authors: SATO Shuichi , NAGASAKO Kou , YASHIRO Kurato , IIZUKA Bun‐ei , OBATA Hiroshi 
Published: August 2007

Abstract:Colonoscopic characteristics of aphthoid ulcers in amebiasis, Crohn's disease, and tuberculosis were evaluated. Multiple aphthoid ulcers were featured in 14 out of 15 cases of amebiasis, 7 out of 74 cases of Crohn's disease, and 5 out of 24 cases of tuberculosis. Aphthoid ulcers of amebiasis were often confined to the rectum and lower sigmoid colon, being characterized by marginal elevation and erythema. Crohn's aphthoid ulcers lacked the red halo in all but one case. No verrucous elevations were observed. The intervening mucosa appeared intact in all cases. Aphthoid ulcers of intestinal tuberculosis were oval or lozenge‐shaped. They were surrounded by a marginal red halo in 4 cases (80%), however, the red halos found in tuberculosis patients were milder than those of patients with amebiasis. Aphthoid ulcers of Crohn's disease and tuberculosis showed a tendency to be arranged in a specific direction. Crohn's ulcers were arranged in a longitudinal fashion, whereas tuberculous ulcers were arranged in a circular fashion. Ulcers of amebiasis were arranged entirely at random. Biopsy from aphthoid ulcers of amebiasis showed parasites in 64%, whereas cytological studies were positive in 93% of cases.
Evaluation of Esophago‐gastric Varices with Endoscopic Ultrasonography
Authors: URABE Takeshi , YONESHIMA Manabu , OIKO Yoshiyasu , INAGAKI Yutaka , KANEKO Shuichi , UNOURA Masashi , KOBAYASHI Ken‐ichi 
Published: August 2007

Abstract:Esophago‐gastric varices of 22 patients were studied using a newly developed method of endoscopic ultrasonography (EUS). During the observation, the esophagus was filled with de‐aerated water, and reflux of the water was prevented using a balloon placed 7 cm proximal to the tip of the endoscope. Thirteen of 22 patients received endoscopic sclerotherapy (EIS) for their esophago‐gastric varices, and sequential changes of the varices were observed mith EUS.The EUS method demonstrated esophago‐gastric varices as singular, or a bundle of low‐echoic luminal structures, and extramural collateral vessels were also observed. Therefore, it was possible to evaluate the residual blood flow after EIS by the EUS findings. Sequential changes of the treated varices were observed as follows: (1) formation of a thrombus in the varices, (2) thickening of variceal wall, and (3) disappearance of luminal structures. Small luminal structures in the extramural space of the lower esophagus, dilated paraesophageal veins, were detected in 6 of 13 patients with EIS. The recurrence rate was smaller and the remission period was longer in these 6 patients than those in patients without these luminal structures. Our new EUS method has been shown to be useful not only for the morphological evaluation of varices, but also for the assessment of the effect of EIS.
Pancreatic Sphincterotomy and Pure Pancreatic Juice Collection for Treatment of Chronic Pancreatitis
Authors: FUJI Tadasu , OHMURA Ryosuke , SASAKI Toshiyuki , PUA Shirley , AMANO Hideo , OKITA Kiwamu , TAKEMOTO Tadayoshi 
Published: August 2007

Abstract: After our introduction of endoscopic pancreatic sphincterotomy for treatment of chronic pancreatitis in 1985, our interest has been focused to the value of pure pancreatic juice collection with or without pancreatic sphincterotomy for management of chronic pancreatitis.Through pancreatic sphincterotomy, pain relief was obtained in 13 out of 16 cases with moderate and marked chronic pancreatitis. After pancreatic sphincterotomy extraction of pancreatic calculi using basket forceps was done successfully in 2 of these cases, Spontaneous stone passage occured in the other 2. In pure pancreatic juice collection without pancreatic sphincterotomy, pain relief was seen in 6 out of 13 cases with mild and moderate chronic pancreatitis. The protein plug was simultaneously aspirated during the procedure in 3 cases.Recently, we have indicated in these patients both pancreatic sphincterotomy and pure pancreatic juice collection and noted pain relief was obtained in all of the 8 cases with this approach. With an improvement in the technology of pancreatic drainage, these endoscopic treatment modalities may be possibly useful to stop the progression of chronic pancreatitis.
Clinicopathological Study on Flat and Depressed Minute Colorecta Carcinomas
Authors: HIRATA Ichiro , TANAKA Masaya , SUGIMOTO Kenji , YOSHIZUMI Munenori , UMEGAKI Eiji , MASAKI Hirohide , OHSHIBA Saburo 
Published: August 2007

Abstract: Over the last two years, a total colonoscopy was performed on 3,006 patients and 232 colorectal carcinomas were detected in these patients. Seventy one (30.6%) of the carcinomas were found to be early cancers. Eighteen (25.4%) of these 71 early cancers were minute (>5 mm) colorectal carcinomas of the flat or depressed type and they were resected endoscopically. More than half of them were accompanied by colonic polyps.Among the characteristic endoscopic features of flat and depressed early colorectal carcinomas are redness, fine granularity and defects of the innominate groove on the lesional surface.Another important finding is whitish annular mucosa surrounding the lesion. The gross appearance of these lesions was depression (3 lesions), depression with a marginal elevation (11 lesions), or flat (4 lesions).On histological examination, all the lesions were found to be well–differentiated intramucosal adenocarcinoma. It appears that depressed lesions with or without marginal elevation have a tendency to horizontal and vertical invasion, respectively. Moreover, it is thought that flat lesions are very early cancers that might later develop into depressed lesions with or without marginal elevation, or flat elevated lesions.
Electronic Endoscopy and Biopsy Findings During the Course of Reflux Esophagitis
Authors: TOKI Munetoshi , OHWADA Tsuneo , SEKIGUCHI Toshikazu 
Published: August 2007

Abstract: We observed the esophageal mucosa in 90 patients with reflux, esophagitis using a zoom‐type electronic endoscope and clarified the endoscopic characteristics of each stage of the disease as well as the response to treatment. It was possible to differentiate between white slough, erosions and regenerating epithelium from observations of the magnified mucosa.The white slough appeared uniform and featureless, the erosions appeared irregular and had featureless reddish areas, and regenerating epithelium were noted in the reddish areas in addition to various types of mucosal surface structure.Biopsies obtained after the disappearance of the white sloughs of reflux esophagitis from the mucosal membrane of the discolored esophagitis generally showed the “accessory findings” of the diagnostic criteria of the Japanese Society of Esophageal Diseases. Even in the early scarring stage (S1), the inflammation persisted under the regenerating mucosa, and it was necessary to continue treatment until the late scarring stage (S2) to prevent recurrence.Regarding treatment, H2 receptor antagonists were effective, but 19.4% of the patients showed resistance to them. Intractable esophagitis was often seen in stage III and IV of the Savary & Miller classification and in the elderly patients. Intractable esophagitis was associated with a high incidence of hiatus hernia, a reduced lower esophageal sphincter pressure, and a reduction in primary peristalsis in the lower esophagus.
Comparison of Injection Materials for the Elevation of Gastric Mucosa Prior to Endoscopic Mucosal Resection
Authors: UENO Akihiko , KATOH Yoshihisa , HARADA Takashi 
Published: August 2007

Abstract:Endoscopic mucosal resection (EMR), namely strip biopsy, to eradicate gastric mucosal lesions requires certain special techniques, including submucosal injection of appropriate agents. This experimental study using dogs was conducted to compare, with regard to the degree of duration of mucosal elevation and subsequent histologic changes of the gastric wall, three injection materials; physiological saline, hypertonic saline with epinephrine (HSE) and 10% soybean oil. The duration of mucosal elevation which should be sufficient for the EMR procedure did not differ between the three agents. The post‐injection histologic changes included vessel dilatation in the peri‐muscularis mucosae, dilatation of the lymphatic channels and vessel congestion. These changes appeared in all injection material groups, and the vessel congestion was found to be more conspicuous in the HSE group.All EMRs in this series were performed by single snare cutting, which was also evaluated. The margin of the stripped material was well limited to the submucosal layer in all cases, but the depth of the ulcers formed varied. The healing process of the ulcer for the first 4 weeks was delayed in the soybean oil group. Although there were few cases of perforation in this experiment and some subjects had adhesion between the gastric serosa and adjacent organs, the single snare method could be applicable for clinical use by skilled hands.
An Endoscopically Resected Case of Early Carcinoma of the Duodenal Bulb
Authors: TAKESHITA Kimiya , WATANUKI Shigeo , GOSEKI Narihide , OKABE Satoshi , SAITO Naoya , ENDO Mitsuo , NAKAJIMA Takatoshi , MIYATA Tatsuya 
Published: August 2007

Abstract:We report here on a case of early carcinoma originating in the duodenal bulb. The patient was a 70‐year‐old woman who complained of nausea. A gastrointestinal endoscopy disclosed a lesion protruding from the duodenal bulb and a biopsy revealed adenocarcinoma. According to the results of the endoscopy, the tumor was subpedunculated and probably confined in the mucosal layer.Based on these findings, we performed an endoscopic tumor resection. A histological examination of the resected specimen revealed a papillotubular adenocarcinoma (1.7 × 1.2 × 0.8 cm) localized in the mucosal layer. No carcinomatous lesion was left in the resected margin. No symptoms of recurrence have been noted during the last 6 months.When considering clinical pathology of the present case, we assessed 39 cases of primary early carcinoma in the duodenal bulb previously reported in the Japanese literature. We considered that our patient was the 14th in Japan with an early carcinoma of the duodenum which was completely excised via endoscopic resection. We expect that endoscopic resection of early duodenal carcinoma will be widely used in the future.