bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninherited sterility in irradiated Phthorimaea operculella females
Authors: Makee H. , Saour G. 
Published: December 2004

Abstract:Newly emerged females of the potato tuber moth, Phthorimaea operculella (Zeller) (Lep., Gelechiidae), were irradiated with various doses of gamma irradiation: 50, 100, 150 and 200 Gy. Inheritance of deleterious effects in the progeny of irradiated female parents was determined. Phthorimaea operculella females became completely sterile when they were exposed to 200 Gy. Therefore, inherited effects were examined in insects exposed to doses lower than 200 Gy. Developmental time and percentage mortality of F1 progeny were higher than the control, regardless of the dose. The sex ratio of F1 progeny was not distorted in favour of either male or female. When F1 individuals were crossed with unirradiated adults, their mating success, number of matings and number of eggs were similar to those of their irradiated female parents, but lower than the control. In contrast, when F1 males and females were mated together, the mating success, number of matings and number of eggs were lower than both their irradiated female parents and the control. The fertility of F1 progeny was higher than that of their irradiated female parents, at all tested crosses. The results showed that the inherited sterility phenomenon did not occur in P. operculella females at the extent known from irradiated males. When the sterile insect technique is used against P. operculella, released females should be completely sterile to prevent any increase in the feral population.
Topographic anatomy of the male perineal structures with special reference to perineal approaches for radical prostatectomy
Authors: Matsubara Akio , Murakami Gen , Arakawa Takashi , Yasumoto Hiroaki , Mutaguchi Kazuaki , Akita Keiichi , Asano Kousuke , Mita Kouji , Usui Tsuguru 
Published: December 2004

AbstractAim: Although perineal approaches for radical prostatectomy have recently gained renewed attention as excellent methods for minimally invasive surgery, the most commonly used techniques, Belt's and Young's approaches, have inadequacies regarding the topographical relationship between the rectourethral and levator ani muscles.Methods: Using macroscopic observations of sagittal slices of 27 male pelvises and smooth muscle immunohistochemical staining of semiserial sections of another eight pelvises, we investigated the topographical anatomy of the perineal structures and their interindividual variations in elderly Japanese men.Results: The inferomedial edge of the levator ani was located 5–15 mm lateral to the midsagittal plane in an area between the urethra and the rectum. The rectourethral smooth muscle had a superoinferior thickness of 5–10 mm and occupied a space between the right and left levator slings. The levator was adjacent to, or continuous with, the striated anal sphincters. A thick connective tissue septum, composed of smooth muscle, was evident between the rectal smooth muscle and the anal sphincter–levator ani complex.Conclusion: Because the connective tissue septum guides the surgeon's finger upwards towards the rectoprostatic space, Belt's approach appears relatively easy; however, rectal injury can sometimes occur if the surgeon loses this guidance. In contrast, if the levator edge is identified as the first step in Young's approach, the rectourethral muscle can be precisely divided, leaving a 3–5‐mm margin from the rectum and sphincter–levator complex. Clinical investigations are now required to modify Young's approach based on the present results.
Malignant transformation of renal angiomyolipoma
Authors: TAKAHASHI NOBUYOSHI , KITAHARA RYUJI , HISHIMOTO YASUYUKI , OHGURO AKIMITSU , HASHIMOTO YASUHIRO , SUZUKI TADASHI 
Published: December 2004

AbstractIn the present paper, two cases of malignant transformation of renal angiomyolipoma without tuberous sclerosis are reported. Pathological examination revealed that, in both cases, in addition to the areas affected by typical angiomyolipoma, there were areas that contained elevated numbers of perivascular epithelioid cells with prominent nuclear pleomorphism. Immunohistochemical examination revealed that both cases were negative for keratin and epithelial membrane antigen, but were positive for the melanogenesis‐related marker HMB‐45. Metastatic diseases appeared 40 months after radical nephrectomy in the first case and 18 months in the second case.
Laparoscopic antegrade continence enema procedure for fecal incontinence in a patient with spina bifida
Authors: AMEDA KANAME , KAKIZAKI HIDEHIRO , MACHINO RINTARO , TANAKA HIROSHI , SHIBATA TAKASHI , KOYANAGI TOMOHIKO 
Published: December 2004

AbstractWe report a laparoscopic procedure for antegrade continence enema (LACE) that was performed successfully in 39‐year‐old man patient with spina bifida suffering from severe fecal incontinence. The patient had been receiving regular follow‐up at our clinic. He desired the antegrade continence enema procedure to improve his intractable fecal incontinence with a less invasive procedure.Following the placement of the first port at the umbilicus using an open access technique, two additional ports were introduced at the upper and lower abdomen in the midline. The appendix was laparoscopically mobilized to the right lower abdomen and brought out through another port. Next, an in situ appendicocutaneostomy was created. The patient began oral intake the day after surgery. Initial irrigation was performed on the second postoperative day. Convalescence was quick and there were no postoperative complications. Although a minor skin incision was required afterward for superficial stoma stenosis, the patient has been in a satisfactory condition with regular enemas.Laparoscopic appendicocutaneostomy can be a reasonable surgical alternative for antegrade continence stoma procedure. LACE has a clear advantage over conventional open procedures in view of its less invasive nature and better cosmetic results.
Retrograde endoscopic laser therapy for transitional cell carcinoma of the upper urinary tract
Authors: MUGIYA SOICHI , MARUYAMA SATOSHI , NAGATA MASAO , HADANO SHINSUKE , NAGAE HIROSHI 
Published: December 2004

AbstractAim: The aim of the present study was to investigate the safety and efficacy of endoscopic laser therapy for transitional cell carcinoma (TCC) of the upper urinary tract.Methods: Tumors of the renal pelvis and ureteropelvic junction were detected by ureteroscopy. The tumors were subjected to biopsy, and after TCC was diagnosed, endoscopic laser therapy (Neodymium‐YAG and Holmium‐YAG) was conducted using a 6.9 Fr. flexible ureterorenoscope.Results: From January 1997 to April 2002, six patients underwent ureteroscopic treatment. Tumor grade was 1 in four patients and 2 in two patients. Average tumor size was 1.45 cm. Endoscopic treatment was chosen for two patients because of the high medical risk associated with open surgery. Another patient underwent diagnostic ureteroscopy, followed immediately by endoscopic treatment. A further three patients elected to undergo ureteroscopic treatment. One patient with large (3 cm), multifocal and incompletely treated tumors died of metastatic disease 22 months after the initial operation. One patient requested nephroureterectomy one month after endoscopic treatment, and pathological examination of the resected specimen revealed no tumor. The other four patients have been followed up for a mean period of 14 months after initial treatment. Recurrence occurred in one patient, and was successfully treated by repeat endoscopic resection. None of the patients required blood transfusion or emergency open surgery.Conclusion: Ureteroscopic treatment of small, localized, low‐grade TCC of the upper urinary tract is now a safe and feasible alternative to nephroureterectomy in selected patients.
Misconduct in medical research: whose responsibility?
Authors: Breen K. J. 
Published: December 2004

Abstract Examples of many types of misconduct in medical research continue to be reported. The true incidence is unknown because there is strong evidence of under‐reporting as well as suggestions of increased detection. Risks to research participants may also be increasing, with contributing factors such as increased pressure on researchers to publish and to produce commercialization of their research. Institutions are perceived to typically respond slowly and inadequately to allegations of research misconduct.More could be done to try to prevent such mis­conduct, such as: (i) educating researchers about research ethics, (ii) assisting and protecting whistleblowers and (iii) instituting processes to adequately and promptly investigate and deal with allegations. In addition, a debate needs to take place as to whether research misconduct allegations should be dealt with at the institutional level or at a national level and whether medical boards should be routinely involved in the more serious breaches of ethical standards by medical practitioners engaged in research. (Intern Med J 2003; 33: 186−191)
Counting the costs of treatment: the reproductive and gynaecological consequences of adjuvant therapy in young women with breast cancer
Authors: Friedlander M. , Thewes B. 
Published: December 2004

Abstract As the mortality rate from breast cancer decreases, the issues facing breast cancer survivors are becoming increasingly important. Survivors of all ages may face physical and psychosocial consequences of their diag­nosis and treatments. However, the long‐term fertility and menopause‐related side‐effects of adjuvant therapy uniquely affect younger premenopausal breast cancer survivors. This article provides an evidence‐based overview of the reproductive and gynaecological impact of breast cancer therapy for premenopausal women diagnosed with breast cancer. The physical and psychosocial implications of premature menopause are presented. Strategies for preserving fertility in selected patients are also discussed. Recent clinical trials strongly indicate that premenopausal women with oestrogen receptor positive tumours should receive endocrine therapy. The increased use of endocrine therapies in younger women raises important questions regarding patient information needs and treatment decision‐making. (Intern Med J 2001; 31: 372−379)
Medication use among older Australian veterans and war widows
Authors: Byles J. E. , Heinze R. , Nair B. (K.) , Parkinson L. 
Published: December 2004

Abstract This study aimed to review the medications used by a group of Australian war veterans and widows, to identify type and number of medications used and potential inappropriate prescribing. Label details of 4304 medications used by 887 participants were recorded and classified according to the Anatomical Therapeutic Chemical code. The median number of regular medications being used was four (interquartile range 2−7), with a median of one other medication (interquartile range 1−2) being taken as needed. Over half (53%) the participants were taking four or more regular medications. There were 26 potential interactions among 25 people. Polypharmacy was a considerable problem for this group of older Australians. (Intern Med J 2003; 33: 388−391)
Respiratory health effects of cannabis: Position Statement of The Thoracic Society of Australia and New Zealand
Authors: Taylor D. R. , Hall W. 
Published: December 2004

Abstract Both the gaseous and the particulate phases of tobacco and cannabis smoke contain a similar range of harmful chemicals. However, differing patterns of inhalation mean that smoking a ‘joint’ of cannabis results in exposure to significantly greater amounts of combusted material than with a tobacco cigarette. The histopathological effects of cannabis smoke exposure include changes consistent with acute and chronic bronchitis. Cellular dysplasia has also been observed, suggesting that, like tobacco smoke, cannabis exposure has the potential to cause malignancy. These features are consistent with the clinical presentation. Symptoms of cough and early morning sputum production are common (20−25%) even in young individuals who smoke cannabis alone. Almost all studies indicate that the effects of cannabis and tobacco smoking are additive and independent. Public health education should dispel the myth that cannabis smoking is relatively safe by highlighting that the adverse respiratory effects of smoking cannabis are similar to those of smoking tobacco, even although it remains to be confirmed that smoking cannabis alone leads to the development of chronic lung disease. (Intern Med J 2003; 33: 310−313)
Concealed Conduction and Dual Pathway Physiology of the Atrioventricular Node
Authors: LIU SHAOWEN , OLSSON S. BERTIL , YANG YANZONG , HERTERVIG EVA , KONGSTAD OLE , YUAN SHIWEN 
Published: December 2004

Introduction: Both concealed conduction and dual pathway physiology are important electrophysiologic characteristics of the AV node. The interaction of AV nodal concealment and duality, however, is not clearly understood. Methods and Results: The properties of AV conduction curves in the presence and absence of a conditioning blocked impulse were prospectively studied during premature atrial stimulation in 20 patients with AV nodal reentrant tachycardia before and after slow pathway ablation and in 14 control patients. AV nodal duality in the control conduction curve in the absence of a conditioning impulse was observed in 19 (95%) of 20 patients with AV nodal reentrant tachycardia. However, AV nodal duality in the modulated conduction curve in the presence of a blocked impulse was only identified in 2 (10%) of 20 patients (2/20 vs 19/20, P < 0.0001). The modulated curve was characterized by a significantly longer AV nodal effective and functional refractory periods compared to the control curve (P < 0.0001) in both patients with and without AV nodal reentry and in AV nodal reentry patients after successful slow pathway ablation. The maximum AH interval (AHmax) of the modulated curve was significantly shorter than the control curve in both patients with (217 ± 74 ms vs 347 ± 55 ms, P < 0.0001) and without AV nodal reentry (178 ± 50 ms vs 214 ± 54 ms, P = 0.02). AHmax of the control curve was significantly longer in AV nodal reentry patients than in controls (P < 0.0001). AHmax of the modulated curve, however, was not significantly different between the two groups. After slow pathway ablation, AHmax of the control curve was significantly reduced (347 ± 55 ms vs 191 ± 40 ms, P < 0.0001). Significant reduction in AHmax of the modulated curve was not observed. Conclusion: An interaction of AV nodal concealed conduction and dual pathway physiology was demonstrated by our data. Slow pathway conduction of the AV node was prevented by the concealed beat in both patients with and without AV nodal reentry. (J Cardiovasc Electrophysiol, Vol. 15, pp. 144‐149, February 2004)
Adaptation of Cardiac Action Potential Durations to Stimulation History with Random Diastolic Intervals
Authors: CHOI BUM‐RAK , LIU TONG , SALAMA GUY 
Published: December 2004

Introduction: The restitution hypothesis proposes that adaptation of cardiac action potential duration (APD) to rate changes is a predictor of ventricular fibrillation (VF). Conventional restitution kinetics plots the APD of a premature beat as a function of the previous diastolic interval (DI), and VF vulnerability is related to how rapidly APD shortens with decreasing DI. However, APD depends not only on the previous DI but also on the history of previous APDs and DIs. For a comprehensive understanding of APD restitution, we developed a random stimulation protocol and curve fitted each APD with the previous DIs and APDs using multiple autoregressive analyses. Methods and Results: Guinea pig hearts (n = 5) were perfused and stained with di‐4 ANEPPS to record optical APs from 252 sites. Activation and repolarization times were detected in real time from one pixel and hearts were stimulated at random DIs (range 0–50 or 0–100 ms). We found that the first, second, and third previous APDs and DIs are required to obtain the best curve fit, which provides the most significant feedback control to APD and up to six previous beats contributed to curve fits (R > 0.8). The coefficients relating the previous DI to APD increased systematically in going from apex to base reflecting the intrinsic gradient of APD across the epicardium. Conclusion: Random restitution is more comprehensive than steady‐state restitution, being based on random and dynamic DIs, and makes possible characterization of restitution in only 32 seconds to track changes in restitution during time‐varying conditions such as ischemia/reperfusion.
Safety and Feasibility of Cryothermal Ablation Within the Mid‐ and Distal Coronary Sinus
Authors: SKANES ALLAN C. , JONES DOUGLAS L. , TEEFY PATRICK , GUIRAUDON COLETTE , YEE RAYMOND , KRAHN ANDREW D. , KLEIN GEORGE J. 
Published: December 2004

Introduction: The aim of this study was to assess the safety and feasibility of catheter‐based cryothermal ablation lesions in the mid‐ and distal coronary sinus. Methods and Results: Cryothermal ablation lesions were delivered using a 7‐French catheter at the mid‐ (n = 13) and distal (n = 12) coronary sinus in 14 swine under general anesthesia. Lesions were delivered for 2 or 4 minutes in a 1:2 randomized ratio such that seven 2‐minute lesions and eighteen 4‐minute lesions were delivered to a maximum negative temperature of −70°C. Integrity of the circumflex artery was assessed by angiography before and after each lesion application. In five animals, arterial Doppler flow velocity was continuously monitored and coronary flow reserve assessed. Histologic assessment of the left AV ring was made after a 48‐hour survival period and lesions graded for depth and transmurality. Eighteen of 25 lesions were >3 mm deep: five of seven 2‐minute lesions and thirteen of eighteen 4‐minute lesions. Lesions were transmural in 18 of 25 cases. Two transmural lesions were limited in depth due to their epicardial position. One 2‐minute mid‐coronary sinus lesion was not found. Adherent thrombus was seen grossly in the coronary sinus at one site and only on microscopic examination in three other lesions. Angiography demonstrated no arterial spasm or thrombosis. Continuous‐flow Doppler remained unchanged throughout lesion production. Coronary flow reserve was unchanged (1.7 ± 0.8 preablation vs 1.7 ± 1.0 postablation, P = 0.6). The media and intima were preserved in all cases. Necrosis of the adventitia was seen in one arterial segment. Conclusion: Catheter‐based cryoablation can produce lesions in the musculature of the adjacent atrium and ventricle when accessed from the coronary sinus without significant injury to the coronary sinus or adjacent artery. This method has potential application as the ablation method of choice when such lesions are required.
Effects of Resynchronization Therapy on Cardiac Function in Pacemaker Patients “Upgraded” to Biventricular Devices
Authors: HORWICH TAMARA , FOSTER ELYSE , DE MARCO TERESA , TSENG ZIAN , SAXON LESLIE 
Published: December 2004

Introduction: Cardiac resynchronization therapy (CRT) improves echocardiographic measures of cardiac function and has a variable effect on QRS duration in patients with left bundle branch block (LBBB). How CRT affects these indices in patients with right ventricular (RV) pacing‐induced LBBB who are “upgraded” with left ventricular (LV) leads for CRT is unknown. We studied the echocardiographic effects of RV pacing and CRT in patients with prior continuous RV pacing after LV lead placement. Methods and Results: Fifteen consecutive patients (age 73 ± 11 years, LV ejection fraction 24 ± 6%, QRS duration 190 ± 27 msec) with New York Heart Association class IIIB–IV symptoms and continuous RV pacing underwent LV lead placement for CRT. Echocardiography and ECG were performed sequentially during RV pacing and CRT. CRT was associated with significantly reduced QRS duration (190 ± 27 msec vs 165 ± 18 msec, P = 0.005) and reduced LV electromechanical delay (180 ± 33 msec vs 161± 43 msec). Baseline QRS duration correlated with CRT response. After CRT, patients had significant improvements in indices of systolic function, including LV ejection fraction, myocardial performance index (MPI), and LV ejection time. Abnormal baseline MPI was associated with greater improvement after CRT. LV end‐diastolic and systolic volumes were similarly decreased with CRT. Mitral valve deceleration time, an index of diastolic function, was not affected by CRT. Conclusion:“Upgrading” RV paced patients with advanced heart failure to CRT improves measures of electrical and LV mechanical synchrony and improves systolic function.
Precariousness in everyday life: homelessness in Japan
Authors: Kennett Patricia , Iwata Masami 
Published: December 2004

The Japanese social structure was established and has been maintained through a mixed economy comprising a balance between the state, the market, the family and the company. Vital elements in maintaining this balance have been the traditional family, full employment and increasing prosperity. More recently, developments have seen a reversal of economic prosperity, rising unemployment, increasing pressure to restructure the employment system and a potential rise in the number of households experiencing housing difficulties. In addition, the predominance of the nuclear family, the increased employment of women and decreased fertility has put the enterprise, family and state dynamic under challenge. This article explores some of the implications of these trends as some of the certainties of the past are giving way to increasing insecurity and risk across a wider section of society. It begins by exploring the institutional and social structure of post‐war Japan, when there was little evidence of poverty and homelessness. It goes on to consider the recent rise in the number of people living on the streets of Japanese cities and the policies put in place. The article then outlines some of the processes of social change that have contributed to the growth in the numbers of homeless people in Japan.La structure sociale japonaise a été créée et préservée grâce à une économie mixte, équilibre complexe entre É tat, marché, famille et entreprise. Les éléments essentiels à cet équilibre étaient la famille traditionnelle, le plein emploi et une prospérité croissante. Or, on a pu constaté dernièrement un revirement économique, une hausse du chômage, une accentuation des forces visant à restructurer l'emploi et une progression latente du nombre de ménages confrontés à des difficultés de logement. De plus, la prédominance de la famille nucléaire, le travail croissant des femmes et la diminution de la fertilité ont remis en question la dynamique entreprise‐famille‐É tat. L'article explore certains effets de ces évolutions, alors que nombre de certitudes passées laissent place à un renforcement de l'insécurité et du risque dans une part plus vaste de la société. L'étude débute par la structure institutionnelle et sociale du Japon de l'après‐guerre, lequel comptait peu de cas de pauvreté et de sans‐abris. Elle aborde ensuite la hausse récente du nombre de personnes vivant dans les rues des grandes villes nippones et les politiques publiques mises en place, tout en décrivant certains des processus de changement social impliqués dans la multiplication des sans‐abris au Japon.