bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study of the motile activity of the colon in rectal inertia constipation
Authors: SHAFIK AHMED , AHMED ISMAIL 
Published: March 2003

AbstractBackground: We have recently demonstrated that rectal distension effected left colonic contraction, which probably acts to feed the rectum with fecal matter each time the rectum distends and evacuates its contents. This effect was postulated to occur through the recto‐colic reflex. As the colonic status in rectal inertia constipation was scarcely addressed in the literature, we investigated this point.Methods: The response of the colonic pressure to rectal balloon distension in increments of 10 mL of water was studied in 38 patients with rectal inertia constipation (IC) (age 42.6 ± 14.3 years, 29 women) and 12 healthy volunteers (40.9 ± 12.2 years, nine women). The rectal and colonic pressures were measured by saline‐perfused tubes connected to a pneumohydraulic infusion system. The rectum was distended by a condom applied to the end of a 10‐F catheter.Results: The rectal and left colonic resting pressures were significantly
lower in the patients than in the controls (P < 0.5, P < 0.05,
respectively). In the healthy volunteers, rectal distension up to first rectal sensation
produced no significant rectal or colonic pressure changes (P > 0.05, P
> 0.05). At urge, rectal and left colonic pressures increased significantly (P
< 0.001, P < 0.001, respectively), but there were no changes in the
right colonic pressure (P > 0.05). The colonic response lasted as long
as the rectum was distended. In IC, patients did not perceive the first rectal or
urge sensation up to a rectal balloon filling of 300 mL; there was no rectal or colonic
pressure response (P > 0.05, P > 0.05).Conclusion: In normal subjects, left colonic contraction on rectal distension probably acts to feed the rectum with fecal material. In IC, the low left colonic resting pressure assumedly points to left colonic hypotonia which appears to aggravate the constipation produced by the inertic rectum. Furthermore, non‐response of the left colon to rectal distension probably impedes rectal feeding with fecal matter and enhances constipation.© 2002 Blackwell Science Asia Pty Ltd
Long‐term quality of life of postoperative rectal cancer patients
Authors: HAMASHIMA CHISATO 
Published: March 2003

Abstract

Background:
The long‐term quality of life (QOL) of postoperative rectal cancer patients has not been previously investigated in Japan and may vary depending on the surgical technique used (i.e. with or without a stoma).
Methods:
The Kanagawa Cancer Registry was used to select 348 rectal cancer patients who underwent surgery at the St Marianna University Hospital between 1978 and 1997. Of these, 164 surviving patients were sent a postal survey consisting of the Japanese EuroQol instrument with an additional questionnaire on present symptoms and lifestyle.
Results and conclusions:
One hundred and ten responses were received, including 38 from stoma patients. The presence of a stoma did not affect the QOL of the male patients, while it did affect that of the female patients. The QOL of the long‐term survival group was associated with several items concerning lifestyle, symptoms and usual activity, and the association did not depend on the presence of a stoma. The long‐term QOL could be recognized according to the characteristics of rectal cancer patients, independent of the presence of a stoma.© 2002 Blackwell Publishing Asia Pty Ltd
Management of bleeding in the cirrhotic patient
Authors: Chung Sydney 
Published: March 2003

Abstract  Important advances have been made in the management of variceal bleeding. Despite these advances, bleeding in the patient with cirrhosis remains one of the most demanding clinical challenges that a gastroenterologist or gastrointestinal surgeon may face. The aim is to identify the source of bleeding, control active bleeding and prevent rebleeding. This requires a multidisciplinary team, and the optimal management algorithm depends on the clinical circumstance of the patient and the local availability of endoscopic, radiological and surgical expertise. Injection sclerotherapy is effective in stopping acute variceal bleeding, but has the drawback of a high incidence of complications. Endoscopic variceal ligation is just as effective, and is associated with fewer complications. An overtube allows repeated introductions of the endoscope to be more tolerable for the patient and protects the airway against aspiration of blood; its use should be encouraged in patients with massive bleeding. Newer ligators can deliver multiple bands without removal of the scope but the high cost of these disposable devices limits their widespread use. Bleeding from gastric varices is even more challenging; the treatment of choice is injection with cyanoacrylate glue. To prevent rebleeding, beta‐blockers are recommended for all patients with large varices (including those which have never bled). Injection sclerotherapy or band ligation, conducted at weekly intervals after the initial control of bleeding, is equally effective at obliterating varices and decreasing the risk of further hemorrhage; band ligation results in fewer complications. Other newer treatment modalities for variceal bleeding, such as somatostatin analogs, transjugular intrahepatic portasystemic shunt and liver transplantation, offer more optimal approaches to control bleeding and prevent rebleeding, but may be prohibitively expensive. Even for the most affluent communities, affordability, cost‐effectiveness, and resource rationing are important considerations in management of patients with cirrhosis complicated by gastrointestinal bleeding.© 2002 Blackwell Publishing Asia Pty Ltd
Serum ferritin and Helicobacter pylori infection in children: A sero‐epidemiologic study in Korea
Authors: SEO JEONG KEE , KO JAE SUNG , CHOI KYUNG DAN 
Published: March 2003

Abstract
Background
: Helicobacter pylori
infection is known to affect iron metabolism and serum ferritin levels, which are reduced in adults with
H. pylori
infection. The aim of the present study was to investigate the association between
H. pylori infection and iron status in healthy Korean children.
Methods
: The H. pylori seropositivity in 753 schoolchildren aged 6–12 years was screened for using an ELISA and confirmed by western blot analyses. Serum ferritin levels were measured using an immunoradiometric assay in 36 H. pylori‐seropositive children and in 72 age‐ and gender‐matched seronegative controls.
Results
: The median serum ferritin levels were significantly lower in H. pylori‐seropositive children than in seronegative controls (24 vs 39 ng/mL; P < 0.001). The prevalence of iron deficiency (ferritin < 15 ng/mL) in H. pylori‐seropositive children was significantly higher (13.9%) than in seronegative children (2.8%). This association persisted after adjusting for age and their socioeconomic status (odds ratio, 5.6; 95% confidence interval, 1.0–30.6).
Conclusion
: Serum ferritin levels are reduced in children with H. pylori infection. The H. pylori infection may lead to iron deficiency in children.© 2002 Blackwell Publishing Asia Pty Ltd
Aldehydic products of lipid peroxidation do not directly activate rat hepatic stellate cells
Authors: OLYNYK JOHN K , KHAN NADEEM A , RAMM GRANT A , BROWN KYLE E , O'NEILL ROSEMARY , BRITTON ROBERT S , BACON BRUCE R 
Published: March 2003

Abstract
Background and Aim
: Activation of hepatic stellate cells (HSC) results in the transdifferentiation of the resting (quiescent) phenotype to one characterized by loss of vitamin A droplets, increased α‐smooth muscle actin (SMA) expression and increased collagen production. Aldehydic products of lipid peroxidation have been shown to increase collagen production by cultured fibroblasts and by passaged HSC, but it is unclear whether these products of lipid peroxidation can initiate the activation of HSC. In the present study the effects were examined of two aldehydic products of lipid peroxidation, malondialdehyde (MDA) and 4‐hydroxynonenal (HNE), on activation of rat HSC in early culture as measured by SMA and desmin expression, and collagen production.
Methods
: The HSC from normal rat liver were plated in plastic wells and exposed to either MDA (5–200 µmol/L), HNE (0.1–20 µmol/L) or vehicle for either 3 or 7 days. The cells were then harvested; SMA and desmin levels were measured by western blotting. Collagen production was measured by radiolabeled proline incorporation after 6 h of aldehyde exposure.
Results:
Malondialdehyde (100 and 200 µmol/L) decreased SMA expression during the 3‐day and 7‐day exposures compared with controls. 4‐Hydroxynonenal (20 µmol/L) decreased SMA expression significantly while no effects were observed with lower concentrations compared with controls during the 3‐day exposure. Seven‐day exposure to HNE (0.1–20 µmol/L) failed to alter SMA expression compared with controls. Exposure to MDA or HNE did not influence desmin expression or collagen production.
Conclusions
: Aldehydic products of lipid peroxidation do not directly activate HSC in early culture and alternative pathways may be responsible for HSC activation during oxidative stress.© 2002 Blackwell Publishing Asia Pty Ltd
Factors affecting complete resection of gastric tumors by the endoscopic mucosal resection procedure
Authors: Ohyama Takanori , Kobayashi Yasuki , Mori Katsumi , Kano Katsumi , Sakurai Yukihiro , Sato Yuzuru 
Published: March 2003

Abstract Background: In Japan, endoscopic mucosal resection (EMR) has been widely used as a treatment option for small early gastric cancer (EGC). The present study reviewed 178 cases for the 10‐year period 1987–1997 in order to clarify the factors affecting the successful outcome of EMR.Methods: Logistic regression analysis was used to examine whether complete resection of EGC correlated with the patient's age, gender, the characteristics of the tumor (location, macroscopic form, and size), the duration of the procedure and the experience of the doctor.Results: The location of the tumor and the duration of the procedure correlated with the completeness of the resection (P < 0.01 and P < 0.05, respectively). Endoscopic mucosal resection was more difficult to perform for tumors in the gastric body than in the antrum or incisura region, and the longer the procedure the less complete the resection.Conclusion: The outcome of EMR is affected significantly by the location of the EGC.
Evaluation of two stool antigen tests for the detection of Helicobacter pylori infection in the Chinese population
Authors: WONG BENJAMIN CHUN YU , XIA HARRY HUA XIANG , CHEUNG HESS KWAN LOK , NG FOOK HONG , WONG SIU YIN , CHOW KAI CHIU , LIN SHAO KAI , YIN YAN , WONG WAI MAN , YUEN MAN FUNG , LAM SHIU KUM 
Published: March 2003

AbstractBackground and Aim: The stool antigen test, the HpSA test, has been validated mainly in Western countries, but not properly in the Chinese population. Recently, another stool antigen test, the Apollo test, was developed, but its accuracy has rarely been validated. The aim of this study is to compare the accuracy of these two tests in the diagnosis of Helicobacter pylori infection in the Chinese population.Methods: Consecutive dyspeptic patients referred for upper endoscopy were recruited. During endoscopy, biopsies were taken for the rapid urease test and histological examination as the gold standard. Stool specimens were collected and used for the HpSA and Apollo tests.Results: Overall, 86 patients (39 males and 47 females, with a mean age of 55.8 years) were recruited. Helicobacter pylori infection was present in 44 (51%) patients as determined by the gold standard. The sensitivity, specificity and accuracy were 86.4, 100, and 93.0%, respectively, for the HpSA, and 90.9, 97.6, and 94.2%, respectively, for the Apollo test when cases with equivocal results were considered as positive. In addition, agreement was achieved in 81 (94.2%) cases between the two tests, with a Kappa value of 0.887.Conclusion: Both the HpSA and Apollo tests achieve acceptable sensitivity and excellent specificity, with accuracies of over 90% for the detection of H. pylori infection in the Chinese population.© 2003 Blackwell Publishing Asia Pty Ltd
The evolution of diagnostic trends in congenital heart disease: A population‐based study
Authors: Grech V 
Published: March 2003

Objective: To analyse historical trends in diagnosis of congenital heart disease (CHD) in all diagnosed cardiac malformations born between 1945 and 1994 in a population‐based study, the first of its type. Methodology: Retrospective analysis of age and mode of diagnosis was carried out in 953 patients with CHD, in the setting of a regional hospital providing diagnostic and follow up services for all of Malta. Main outcome measures were age at diagnosis, cumulative percentage diagnosis by age and mode of diagnosis. Results: A significant negative correlation of age at diagnosis with time was found for both lesions not requiring intervention, and requiring intervention (P < 0.0001). Cumulative percentage diagnosis by age increased progressively with time. Echocardiography increased the birth prevalence of definitively diagnosed defects, particularly of lesions not requiring intervention. The annual number of cardiac catheters for these conditions has decreased with an increased number and proportion of interventional catheters. The current catheterization rate for CHD is 6.1/100 000 population. Conclusion: Echocardiography has led to an increase in the diagnosis in the birth prevalence of CHD, and provided early diagnosis, supplanting cardiac catheterization as a primary diagnostic tool.
Evaluating the potential for opportunistic vaccination in a Northern Territory hospital
Authors: Skull SA , Krause V , Roberts LA , Dalton CB 
Published: March 2003

Objective: To evaluate the potential for opportunistic vaccination and a simple intervention aimed at improving vaccination coverage for children in hospital. Methods: Hospital records were reviewed for children under 7 years, discharged from paediatric wards (PW) and the emergency department (ED) for 4 weeks before and after an intervention (423 and 446 children, respectively). This comprised the education of staff and the introduction of prompts to record vaccination status. Results: Documentation of vaccination status increased in the PW (63–90%) and the ED (24–46%), as did the adequacy of detail recorded (51–77% and 8–36%, respectively). Opportunistic vaccination increased from zero of 84 opportunities during the first audit to six of 139 following the intervention. All but one vaccine was given in the PW. Opportunistic vaccination improved when documentation identified a need for vaccination (P = 0.02). Conclusion: There were numerous missed opportunities to vaccinate children in hospital, especially in the ED. Simple prompts improved documentation of vaccination status and the detail of information recorded. Despite improved documentation, opportunistic vaccination failed to improve in the ED. Improving documentation of vaccination status is not sufficient in itself to improve opportunistic vaccination.
Reference ranges for blood pressure in preschool Australians, obtained by oscillometry
Authors: Blake KV , Gurrin LC , Evans SF , Newnham JP , Landau LI , Stanley FJ , Beilin LJ 
Published: March 2003

Objective: To derive reference centiles for blood pressure in children aged 1–6 years which seek to address shortcomings in available reference ranges. Methods: Prospective cohort study of 2876 children in Perth, Western Australia, commenced in 1989 with serial blood pressure measurements through early childhood obtained by oscillometry under standardized conditions. Results: Gender‐specific reference centile charts for systolic and diastolic blood pressure, (i) across ages 1–6 years and (ii) across the range of corrected Body Mass Index values at ages 1, 3 and 6 years, were generated by fitting linear models with both fixed and random effects. Conclusions: Reference values for blood pressure for young children are of clinical use and may be of long‐term predictive value.
Critical influenza virus infection
Authors: Kappagoda C , Isaacs D , Mellis C , Peat J , De Silva L , O’Connell A 
Published: March 2003

Objective: To determine the risk of death from influenza infection in children with chronic underlying disease. Methodology: An 18‐year retrospective study of children with ‘critical’ influenza A or B virus infection, defined as requiring admission to intensive care or resulting in death, but excluding laryngotracheobronchitis (LTB). Influenza infection was diagnosed by viral culture and/or immunofluorescence of respiratory secretions. Patients with LTB were analysed separately. Results: There were 27 cases of critical influenza virus infection over the study period, comprising 26 admissions to the intensive care unit (excluding LTB) and one death on the general wards. Thirteen (48%) of the 27 children had chronic underlying disease. In addition, 12 children with LTB were admitted to the intensive care unit. The LTB children were older and less likely to have chronic underlying disease. Nosocomial infection caused seven (26%) of the 27 critical infections. Nine (33%) of the 27 children with critical influenza died. Six (46%) of 13 children with chronic underlying disease and influenza admitted to intensive care died, compared with three of 14 (21%) without any underlying disease (odds ratio = 3.1, 95% confidence interval 0.6–14.0). Conclusions: Critical life‐threatening influenza virus infection was uncommon, but the mortality was high (33%), particularly in children with chronic underlying disease. Nosocomial infection with influenza was an important cause of admission to intensive care.
X‐Linked agammaglobulinaemia and the underlying genetics in two kindreds
Authors: Pienaar S , Eley B , Beatty Dw , Henderson He 
Published: March 2003

Objective: Molecular analysis of the Bruton’s tyrosine kinase (Btk) gene in two unrelated families, with a combined total of seven boys, affected by X‐linked agammaglobulinaemia (XLA). Methods: Protein electrophoresis and western blotting were used for the examination of Btk protein synthesis in blood leucocytes. Isolation of the coding sequence of the Btk gene was performed by amplification using the reverse transcription–polymerase chain reaction (RT‐PCR) technique. Sequence alterations were screened for by the single‐stranded conformation polymorphism (SSCP) method and characterized by standard sequencing protocols. Results: Western blotting revealed Btk protein to be absent in leucocytes of affected males from both families. A novel 3 b.p. deletion in exon 3 of the Btk gene was found to be responsible for the XLA phenotype in the affected proband in one family (kindred I). A diagnostic PCR assay was established to detect this mutation in other affected male siblings and carrier females. For the second family (kindred II), the coding sequence of the Btk gene and the promoter region were found to be normal. Conclusions: The present study has demonstrated genetic heterogeneity in the Btk gene in South African XLA patients and has identified a novel mutation in this gene in the largest of the affected kindreds. The gene mutation in the second kindred was undetermined and may be indicative of a defect in some other gene associated with Btk function or stability. Western blotting was found to be informative in establishing a deficiency of Btk protein in both probands and is recommended as a frontline procedure in the molecular diagnosis and work‐up of XLA.
A review of annual growth screening in Aboriginal schoolchildren in Australia
Authors: Paterson BA , McKinnon CP , Edmond KM 
Published: March 2003

Objectives: To determine if growth screening in school‐age Aboriginal children detects new, treatable growth problems.Methodology: A retrospective review of health centre records of children identified as stunted or wasted from school screening from 11 remote Aboriginal communities in the Top End of the Northern Territory. The age of onset of growth faltering, the occurrence of new growth problems in school‐age children and initiation of treatment in response to the school screening results were determined.Results: Weight faltering had occurred in all children by 18 months. The average age of onset of weight faltering was 6.6 months (range 3.5–12 months) for stunted children and 8.9 months (range 7.5–18 months) for wasted children. Height faltering in stunted children commenced in all children with documented height measurements by 3 years. Staff did not report anynewinterventions for poor growth as a result of screening school‐age children in 1993 although many children had previously been assessed by the local doctor or visiting paediatrician and were being monitored.Conclusions: All children that were found to be stunted or wasted were already known to have poor growth prior to school entry. A change in focus is needed from repeatedly weighing and measuring school‐age children to developing community‐ based interventions to improve the nutritional status of all children. Annual measurement of weight and height beyond 5 years of age is not recommended unless it is used to help evaluate interventions aimed at improving nutritional status and educational achievement.
The epidemiology of invasive pneumococcal disease in children in Far North Queensland
Authors: Fagan RL , Hanna JN , Messer RD , Brookes DL , Murphy DM 
Published: March 2003

Objectives: To describe the epidemiology of invasive pneumococcal disease in children under 5 years of age in Far North Queensland and to examine the potential impact of a seven‐ and 11‐valent conjugate pneumococcal vaccine. Methods: A review of all cases of invasive pneumococcal disease in children under 5 years of age in Far North Queensland over a 9 year period (1992–2000). The distribution of the serotypes of isolates causing invasive pneumococcal disease was compared with the serotypes contained in the two vaccines. Results: The annual incidence in indigenous and non‐indigenous children under 5 years of age was 163 (95% confidence interval (CI) 122–213) and 42 (95% CI 31–55) cases per 100 000 children, respectively. For children under 2 years of age, these figures were 297 (95% CI 208–411) and 71 (95% CI 49–100), respectively. There was a greater variety of serotypes isolated from indigenous children (n = 17) than from non‐indigenous children (n = 9; P < 0.01). The serotypes within the seven‐valent vaccine accounted for 62% (95% CI 46–75%) and 88% (95% CI 76–95%) of the isolates from indigenous and non‐indigenous children, respectively (P < 0.01). Serotypes within the 11‐valent vaccine accounted for 72% (95% CI 57–84%) of the isolates from indigenous children under 5 years of age, but did not account for any extra isolates from non‐indigenous children. Conclusion: Although the seven‐ and 11‐valent conjugate pneumococcal vaccines cover only approximately 60 and 70%, respectively, of the isolates that cause invasive disease in indigenous children in Far North Queensland, they nevertheless have the potential to prevent much morbidity in and hospitalization of these children. It will be essential to maintain surveillance following the introduction of conjugate pneumococcal vaccines so as to monitor changes in the incidence of invasive pneumococcal disease, particularly in high‐risk children.