bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human Macrophage-Induced Vascular Smooth Muscle Cell Apoptosis Requires NO Enhancement of Fas/Fas-L Interactions
Authors: Boyle Joseph J. , Weissberg Peter L. , Bennett Martin R. 
Published: October 2002

Objective—We have previously shown that macrophages induce vascular smooth muscle cell (VSMC) apoptosis in vitro by cell-cell proximity and Fas-L/Fas interactions. Because NO is a short-range mediator, we tested whether NO mediates macrophage-induced VSMC apoptosis.Methods and Results—NO synthase (NOS) inhibitors markedly inhibited macrophage-induced apoptosis of carotid plaque VSMCs (apoptotic indices, 81±2.9% for control and 28.2±3.9% forNG-nitro-l-arginine methyl ester [L-NAME] treatment) and coronary medial VSMCs (apoptotic indices, 76±5.5% for control and 3.5±0.8% for L-NAME treatment). Inactive enantiomers were without effect (P>0.05). Cultured macrophages, but not VSMCs, expressed inducible NOS (but not neuronal NOS or endothelial NOS) concomitant with activation and secreted 1.51±0.3 fmol nitrite per cell, which was blocked by L-NAME (100 μmol/L). Diethylene triamine nitric oxide (DETA/NO) and sodium nitroprusside (NO donors) induced VSMC cell-surface Fas and enhanced plaque VSMC apoptosis induced by agonistic anti-Fas antibody (apoptotic indices, 6.6±1.8% for control, 6.3±1.5% for DETA/NO, 26±1.8% for Fas, and 44±6.9% for Fas+DETA/NO). In isolated macrophages, NOS inhibitors reduced and NO donors increased surface Fas-L, indicating an NO-dependent autocrine enhancement of macrophage surface Fas-L.Conclusions—Together, these data indicate that macrophage-derived NO is required for macrophage-induced VSMC apoptosis and that it acts by enhancing Fas-L/Fas interactions.
Lysophosphatidylcholine Stimulates Monocyte Chemoattractant Protein-1 Gene Expression in Rat Aortic Smooth Muscle Cells
Authors: Rong James X. , Berman Joan W. , Taubman Mark B. , Fisher Edward A. 
Published: October 2002

Objective—Monocyte chemoattractant protein (MCP)-1 is a proatherogenic factor that is responsible for ≈60% of plaque macrophages in mouse models of atherosclerosis. We investigated whether lysophosphatidylcholine (LPC), enriched in oxidized low density lipoprotein, can modulate the expression of MCP-1 in arterial wall cells.Methods and Results—LPC induced a 3-fold increase in MCP-1 mRNA in rat vascular smooth muscle cells (VSMCs) in a time- and dose-dependent manner. Nuclear runon analysis showed that this increase was attributable to increased MCP-1 gene transcription. There was a 2-fold increase in MCP-1 protein in the conditioned media of cells treated with LPC. LPC-associated increases of MCP-1 mRNA and protein were similar to those produced by platelet-derived growth factor-BB, a known inducer of MCP-1. Analyses of the MCP-1 promoter in transiently transfected VSMCs indicated an LPC-responsive element(s) between base pairs −146 and −261 (relative to transcription initiation). Further studies suggested that LPC-induced MCP-1 expression partially involves mitogen-activated protein kinase/extracellular signal–regulated kinase, a tyrosine kinase(s), and (to a lesser extent) protein kinase C but not the activation of the platelet-derived growth factor receptor.Conclusions—LPC stimulates MCP-1 expression at the transcriptional level in VSMCs, suggesting a molecular mechanism by which LPC contributes to the atherogenicity of oxidized low density lipoprotein.
Donor-lymphocyte infusion induces transplantation tolerance by activating systemic and graft-infiltrating double-negative regulatory T cells
Authors: Young Kevin J. , Yang Liming , Phillips M. James , Zhang Li 
Published: October 2002

AbstractDonor-lymphocyte infusion (DLI) before transplantation can lead to specific tolerance to allografts in mice, nonhuman primates, and humans. We and others have demonstrated a role for regulatory T cells in DLI-induced, donor-specific transplantation tolerance, but it is not known how regulatory T cells are activated and where they execute their function. In this study, we observed, in both transgenic and normal mice, that DLI before transplantation is required for activation of αβ-T-cell-receptor–positive, CD3+CD4−CD8− double-negative (DN) regulatory T cells in the periphery of recipient mice. More interestingly, DLI induced DN regulatory T cells to migrate preferentially to donor-specific allogeneic skin grafts and to form a majority of graft-infiltrating T cells in accepted skin allografts. Furthermore, both recipient-derived peripheral and graft-infiltrating DN T cells were able to suppress and kill antidonor CD8+ T cells in an antigen-specific manner. These data indicate that DLI may induce donor-specific transplantation tolerance by activating recipient DN regulatory T cells in the periphery and by promoting migration of regulatory T cells to donor-specific allogeneic skin grafts. Our results also show that DN regulatory T cells can eliminate antidonor T cells both systemically and locally, a finding suggesting that graft-infiltrating T cells can be beneficial to graft survival.
A national survey of disinfection techniques for flexible nasendoscopes in UK ENT out-patient departments
Authors: Banfield G. K. , Hinton A. E. 
Published: October 2002

Flexible fibre-optic nasendoscopes have become a ubiquitous ENT out-patient tool for the inspection of the nasopharynx, larynx and hypopharynx. Disinfection of the instrument between patient use is important to prevent potential spread of infection but the methods used vary considerably. We designed a questionnaire which was piloted and then sent to 115 UK ENT out-patient departments to establish current UK practice. Most units (67 per cent) use a chemical soak system but the type of chemical disinfectant, the method of delivery and the duration of soak varied considerably. A few hospitals use a disposable plastic sheath system and others simply wipe the instrument with an alcohol swab in between patient use. The protocols for disinfection after high risk patients e.g. human immunodeficiency virus (HIV), hepatitis B varied from hospital to hospital.The results demonstrate a lack of standard practice that is wasteful of financial resources and may expose patients to unnecessary risk. There is a need for an authoritative ENT body to publish national guidelines as may be found in other specialities and other countries.
De novo laryngeal carcinoma in childhood
Authors: McDermott Annlouise , Raj Prabhakaran , Glaholm John , Pearman Kenneth , Macnamara Marcelle 
Published: October 2002

Numerous factors contribute towards a late diagnosis of laryngeal malignancy in childhood. These include its rarity, the similarity of its early symptoms to those of other benign, common childhood conditions as well as the relative difficulty encountered during paediatric laryngeal examination.We believe that these cases are of sufficient interest when they occur to warrant reporting since the consequences of late diagnosis in these young patients can be serious.We present a case of an 11-year-old boy with advanced squamous cell carcinoma of the larynx (T3N0M0), who was successfully treated with primary total laryngectomy and bilateral selective neck dissections to avoid the potential additional morbidity of radical radiotherapy.
Arcuate eminence in Caucasian populations
Authors: Tsunoda Atsunobu 
Published: October 2002

The arcuate eminence (AE) was studied in 21 Caucasian cadavers (42 temporal bones), with particular reference to its relationship to the superior semicircular canal (SSC) and the temporal lobe. An arc-like eminence was observed in over 80 per cent of specimens, however, they did not exactly correspond to the SSC and such eminences corresponded to the sulci of the temporal lobe. The round and domed eminence corresponded to each SSC in seven temporal bones. The distances between the SSC and the middle cranial fossa were varied (0–2.5 mm, mean: 1.2 mm+± 0.6 mm) whereas distances between the lateral semicircular canal and tympanic cavity were relatively consistent (0.6–1.4 mm, mean: 1.0 mm ± 0.2 mm).These data indicate that the AE is trace of the temporal lobe and the SSC gave little effect to the surface of the middle cranial fossa. These findings could well be applicable to all humans.
Waiting times during the management of head and neck tumours
Authors: Jones T. M. , Hargrove O. , Lancaster J. , Fenton J. , Shenoy A. , Roland N. J. 
Published: October 2002

The waiting times incurred during the management of 75 consecutive head and neck oncology patients attending for post-treatment follow-up were reviewed. Data were gleaned from general practitioner (GP) referral letters, patient case-notes as well as radiology and histology reports. The mean time for GP referral to ENT was 5.1 weeks. From ENT to endoscopy was 3.1 weeks, to histology 3.5 weeks, to computed tomography (CT) scan 5.6 weeks, to magnetic resonance scan (MR) 4.1 weeks, to primary radiotherapy 10.3 weeks and to surgery 5.5 weeks. The mean symptom duration prior to referral was 4.9 months.Our results compare unfavourably with the standards recommended by the BAO-HNS. Local modifiations may improve matters, but significant increases in funding, manpower and equipment are required to achieve the stipulated standards. Moreover, criteria for referral have to be re-emphasized and patient education has to be addressed as these appear to contribute the longest delay in the diagnosis of head and neck tumours.
Patient satisfaction with bilateral bone-anchored hearing aids: the Birmingham experience
Authors: Dutt Sunil N. , McDermott Ann-Louise , Burrell Stuart P. , Cooper Huw R. , Reid Andrew P. , Proops David W. 
Published: October 2002

The Birmingham bone-anchored hearing aid (BAHA) programme has fitted more than 300 patients with unilateral bone-anchored hearing aids since 1988. Some of the patients who benefited well with unilateral aids and who had used bilateral conventional aids previously applied for bilateral amplification. To date, 15 patients have been fitted with bilateral BAHAs. The benefits of bilateral amplification have been compared to unilateral amplification in 11 of these patients. Subjective analysis in the form of validated comprehensive questionnaires was undertaken.The Glasgow benefit inventory (GBI), which is a subjective patient orientated post-interventional questionnaire developed to evaluate any otorhinolaryngological surgery and therapy was administered. The results revealed that the use of bilateral bone-anchored hearing aids significantly enhanced general well being (patient benefit) and improved the patient’s state of health (quality of life). The Chung and Stephens questionnaire which addresses specific issues related to binaural hearing was used. Our preliminary results are encouraging and are comparable to the experience of the Nijmegen BAHA group.
Evaluation of individually ventilated cage systems for laboratory rodents: cage environment and animal health aspects
Authors: Höglund A. U. , Renström A. 
Published: October 2002

The use of individually ventilated cage (IVC) systems has become an attractive housing regime of laboratory rodents. The benefits of IVC systems are, reportedly, a high degree of containment combined with relative ease of handling, and a high degree of protection from allergenes. In the present study we tested whether two IVC systems (BioZone VentiRack, IVC1 and Techniplast SealSafe, IVC2S), in which we held mature male NMRI mice, were constructed to maintain a constant differential pressure, positive or negative, during a prolonged period of time. We also measured ammonia (NH3) concentrations after about 2 weeks of use, and CO2 build-up during a 60 min simulated power failure situation. In addition, animal weight development and bite-wound frequency were recorded (Renström et al. 2000). From the present study it is concluded that the IVC1 air handling system provides a more uniform and balanced differential pressure than the IVC2S. Both systems effectively scavenge NH3 when bedding material is not soaked by urine. Although the IVCs are dependent on the continual function of the fans to work properly, it seems unlikely that CO2 concentrations increase to hazardous levels, as a result of a one hour power failure, with the type of cages used in this study. Differences in weight development and bite-wound occurrence were noted between the two IVC systems. Causes for these differences could not be established and need more investigation.
Implementation of evidence-based medicine: evaluation of the Promoting Action on Clinical Effectiveness programme
Authors: Dopson Sue , Locock Louise , Chambers David , Gabbay John 
Published: October 2002

Objectives: To evaluate the Promoting Action on Clinical Effectiveness (PACE) programme, which sought to implement clinically effective practice in 16 local sites. Methods: 182 semi-structured interviews, usually by telephone, with project team members, clinicians, and senior managers and representatives from the Department of Health and the King's Fund. Results: The most influential factors were strong evidence, supportive opinion leaders and integration within a committed organization; without these factors, projects had little chance of success. Other factors (context analysis, professional involvement and good project management) emerged as important, supporting processes; their presence might be an additional help, but on their own they would not be enough to initiate change. A serious problem with any of them could have a strong adverse impact. Conclusions: Although there is no simple formula for the factors that ensure successful implementation of research-based improvements to clinical practice, certain principles do seem to help. Time and resource need to be devoted to a period of local negotiation and adaptation of good research evidence based on a careful understanding of the local context, in which opinion leader influence is an important component of a well managed and preferably well integrated process of change.
Does waiting for total hip replacement matter? Prospective cohort study
Authors: Hajat Shakoor , Fitzpatrick Ray , Morris Richard , Reeves Barnaby , Rigge Marianne , Williams Olwen , Murray David , Gregg Paul 
Published: October 2002

Objectives: To assess the impact on the outcome of total hip replacement of the length of timing spent waiting for surgery. Methods: One hundred and forty-three orthopaedic and general hospitals provided information about aspects of surgical practice for each total hip replacement conducted between September 1996 and October 1997 for publicly and privately funded operations in five English health regions. These data were linked to patient information about hip-related pain and disability status (measured using the Oxford Hip Score) before operation and at 3 and 12 months after. Data were analysed using multiple regression analysis. Results: Questionnaires were completed by surgeons for 10 410 (78%) patients treated during the recruitment period and by 7151 (54%) patients. Twelve months after total hip replacement, the majority of patients experienced substantial improvements in hip-related pain and disability (as measured by the Oxford Hip Score). Those patients who started with a worse Oxford Hip Score before the operation tended to remain worse after the operation. Worse pre-operative score was associated with an increased length of either outpatient or inpatient wait, and this trend remained after the operation. The relationship between waiting time and outcome remained after adjustment for possible confounding variables. A consistently worse score was observed in public compared with private patients at all three time-points. In addition, in both sectors, those patients who were socially disadvantaged had a worse score than more socially advantaged patients both before and after the operation. Conclusions: Waiting for surgery is associated with worse outcomes 12 months later. Longer-term outcome needs to be considered to see if this association persists.
Salaried contracts in UK general practice: a study of job satisfaction and stress
Authors: Gosden Toby , Williams Jacky , Petchey Roland , Leese Brenda , Sibbald Bonnie 
Published: October 2002

Objectives: To compare job satisfaction and stress levels of general practitioners (GPs) employed on salaried contracts with GPs on a 'standard' performance-related contract paid by fee-for-service and capitation. Methods: Job satisfaction and stress levels were assessed using data from two postal surveys of GPs: a national survey of 'standard' contract GPs carried out in 1998; and a survey of salaried GPs and their non-salaried GP employers in 1999. Differences in satisfaction and stress scores were assessed by t-tests; regression analysis was used to control for confounding factors and possible selection bias. Results: We achieved a response rate of 77% in the 1999 survey of salaried and non-salaried GPs; 48% of 'standard' contract GPs responded in the 1998 survey. We found that salaried GPs were as satisfied overall as both non-salaried GP employers and GPs on the 'standard' contract, even after controlling for confounding factors and selection bias. Salaried GPs were more satisfied with their remuneration, working hours and the recognition they got for their work. They experienced more stress with two factors but less stress with 19 factors compared with the 'standard' contract GPs. Conclusions: Overall job satisfaction levels among salaried doctors were similar to those of doctors on contracts paid by mixed fee-for-service and capitation. Future studies of job satisfaction levels under different doctor payment systems need to take account of the extent to which doctors have preferences for different types of contract if they are to derive unbiased results.
Strategies to contain the emergence of antimicrobial resistance: a systematic review of effectiveness and cost-effectiveness
Authors: Wilton Paula , Smith Richard , Coast Joanna , Millar Michael 
Published: October 2002

Objectives: To conduct a systematic review of the literature to describe and critically appraise studies reporting on the cost and/or effectiveness of interventions proposed to control the emergence of antimicrobial resistance (AMR). Methods: The search for relevant studies encompassed consultation with world experts in AMR, and electronic bibliographic database search of: Medline (1960-2000); ISI (1981-2000); EMBASE (1988-2000); Grey Literature (1999-2000); Database of Reviews of Effectiveness (DARE) and the NHS Health Economic Evaluation Database (HEED) at York University's Centre for Reviews and Dissemination (CRD) (numerous years); OPAC (1975-2000); and the Cochrane Library Online (1990-2000). Only studies that concerned the effectiveness or cost-effectiveness of measures specifically designed to contain the emergence of AMR were reviewed. Standardised data extraction sheets, based on existing checklists for effectiveness and cost-effectiveness, were used to assess the validity of each study using the 'risk of bias criteria' suggested in the Cochrane Handbook. Only studies categorised as being at low or moderate risk of bias were reported fully. The reliability of the data review process was monitored by comparison of several, random, independent assessments by all authors. The mix of study methods (i.e. including studies based on non-randomised controlled trials) meant that formal meta-analysis was not possible, and thus a qualitative review was performed. Results: In total, 43 studies were reviewed, with 21 classed as being at moderate or low risk of bias and therefore reported in the paper. These studies covered policies on: restricting the use of antimicrobials (five studies, suggesting that restriction policies can alter prescriber behaviour, although with limited evidence of subsequent effect on AMR); prescriber education, feedback and use of guidelines (six studies, with no clear conclusion); combination therapies (seven studies, showing the potential to lower drug-specific resistance, although for an indeterminate time period); vaccination (three studies showing cost/effectiveness). Most of these studies were: from the developed world, principally the USA; hospital-based, with few community level interventions; and concerned with effectiveness, not cost-effectiveness. Conclusions: Overall, there is an absence of good evidence concerning what is effective, and especially cost-effective, in reducing the emergence of AMR. However, in addition to more research concerning these forms of intervention, the paper highlights four specific areas for further investigation: validating intermediate or surrogate outcome measures to enable better use to be made of the literature on intermediate measures; development and evaluation of 'macro' strategies; research into specific aspects of AMR in developing countries; and empirical and methodological research concerning the economic evaluation of interventions.
Diagnosis and prognosis of Australia&s health information for evidence-based policy
Authors: Gool Kees Van , Lancsar Emily , Viney Rosalie , Hall Jane , Haywood Philip 
Published: October 2002

Without adequate information it is difficult to determine the success or failure of health policies. This paper assesses the adequacy of Australia&s health information for evidence-based policy. Three policy areas are analysed: the impact of changing the public and private health financing mix; waiting lists and waiting times; and pooling of funds. In each, the issue is analysed to identify the key policy questions, the available data and existing analyses are examined, and gaps in data availability and analysis are assessed. There is variability in the extent and usefulness of current health information. In terms of the impact of changing the financing mix, there is good information on the distribution of finance, but much less available on comparative use or efficiency of public and private hospitals. There is comprehensive information available on waiting lists and waiting times but little analysis of the implications of this for equity of access or the costs and benefits of reducing waiting times. There is insufficient information for the development of the capitation based formulae required for the introduction of the pooling of funds, nor enough information to assess the extent and impact of current cost-shifting which might be addressed by pooling funds. While the concept of evidence-based medicine has been embraced with regard to specific treatment decisions, there has not been a parallel investment in the use of evidence to drive policy decisions.