bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEVELOPMENT OF A ROBOTIC COLONOSCOPE
Authors: Ng Wan Sing , Phee Soo Jay , Seow Choen , Davies Brian Lawrence 
Published: March 2003

Background: Colonoscopy is a common procedure for the diagnosis of various colon pathologies such as cancer of the colon. Due to the working characteristics of conventional colonoscopes, the present colonoscopy procedure is unpleasant for the patient and is technically demanding for the endoscopist.Methods: A robotic colonoscope named EndoCrawler is proposed for inspection and surgical procedures. Supported by the colonic walls, it can propel itself into the human colon using its rubber bellow actuators to push against the colonic walls. The bellow actuators are distributed circumferentially and longitudinally in order to derive sufficient propelling forces.Results: Promising results from in vitro and in vivo experiments (on pigs) suggested that the EndoCrawler was a viable alternative to the conventional colonoscope. It was observed to be able to move at a speed of 150 mm/min in a live pig colon. It achieved a distance of 30 cm before being stopped by feces.Conclusion: It was demonstrated experimentally on pigs that the plurality of bellow actuators was a viable concept. Efforts are now being dedicated towards reducing the diametral space, improving the ability of the robot to negotiate bends, and improving the crawling speed of the robotic scope.
Macroscopic Classificatrion of Early Colorectal Carcinoma: A Comparison Between Japan and China
Authors: Wang Fang‐yu , Hirata Ichiro , Katsu Ken‐ichi , Zhu Ren‐min , Itoh Masahiro , Mitooka Hideki , Kashida Hiroshi , Shinmizu Seiji , Imamura Akimichi , Tsuruta Osamu , Yu Zhong‐lin , Xiao Shu‐dong , Zhang Zhi‐hong , Xu Zhao‐min 
Published: March 2003

Background: To clarify the similarities and dissimilarities in the macroscopic classification criteria for early colorectal carcinoma (CRC) between Japan and China.Methods: Six early CRC cases were included in this study. Eleven Japanese and Chinese endoscopists were asked to review the colonoscopic pictures of these cases, including before and after indigocarmine spraying. After viewing the pictures, all the endoscopists individually made their classificatory diagnoses of these cases and indicated the findings on which they based each diagnosis.Results: Some lesions diagnosed by Japanese endoscopists as IIa or IIa + IIc, might be classified as Is or Isp by Chinese endoscopists. For superficial lesions consisting of elevation with central depression, IIa + depression, IIa + IIc or IIc + IIa were classified according to the ratio of elevated area/depressed area. However, international as well as interobserver differences still existed in the classification of such lesions. In addition, most Chinese endoscopists overlooked the slightly depressed part on the top of a protruded lesion.Conclusion: Discrepancies on macroscopic classification for early CRC do exist between Japanese and Chinese endoscopists, which were found not only in terminology, but also in recognition of some lesions. In order to develop a universal macroscopic classification, there is a great need for international communication and cooperation.
Cancer Cell Exfoliation by Preoperative Colonoscopic Examination
Authors: Tomiki Yuichi , Kamano Toshiki , Hayashida Yasuo , Okada Tsuyoshi , Kunii Yasuhiro , Ishibiki Yoshiro , Kawase Yoshihiko , Tsurumaru Masahiko 
Published: March 2003

Background: Colonoscopic contact and repeated biopsies have been associated with an increased risk of cancer cell dissemination. We examined whether exfoliated cancer cells were detected during preoperative colonoscopic examination in patients with colorectal cancer.Methods: Twenty‐five patients with colorectal cancer were studied. Samples were collected by four methods: intestinal lavage solution, endoscope tip, forceps channel (n = 22) and biopsy forceps (n = 3). The collected suspensions were centrifuged, fixed in 95% ethanol, stained with Papanicolaou stain and examined microscopically. Viability of the exfoliated cancer cells was studied in five patients. Samples obtained by endoscope tip and forceps channel were suspended in RPMI 1640 medium supplemented with 10% fetal calf serum stained with trypan blue or fluorescent dye and examined.Results: Exfoliated cancer cells were detected in 18 of 25 patients (72%). The detection rate was 45.5% in intestinal lavage solution, 68.2% at the endoscope tip and 81.8% in the forceps channel. The detection rate of exfoliated cancer cells adhering to the colonoscope depended on endoscopic contact (P = 0.009). Trypan blue staining and fluorescent staining confirmed the presence of viable cells among the exfoliated cancer cells.Conclusion: Our findings indicate that cancer cells were exfoliated when the colonoscope passed through a stricture and after biopsy or passage of a colonoscope through a stricture, further manipulation of lesions should be avoided to reduce the risk of implantation metastasis.
NEW MEASURING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY CATHETER FOR STENTING
Authors: Tan Daniel , Yamakawa Tatsuo 
Published: March 2003

Background: The first stent inserted by endoscopic retrograde cholangiopancreatography (ERCP) for a biliary stricture is often either too long or too short, because the length as measured on the ERCP film is a magnified image. To overcome this magnification factor, a new measuring catheter was designed to incorporate radio‐opaque markers at known intervals. This is termed a radio‐opaque ruler for measuring the stricture on the ERCP film.Method: The catheter is inserted until the tip sits at the position where the upper end of a stent should reach. The distance from the tip to the papilla is measured and divided by the distance between the two most distant markers. This ratio is then multiplied by the actual distance between the markers to give the exact length. One cm is added to allow for the lower end to protrude into the duodenum. When the two markers exactly mark the desired distance, the known distance between the markers becomes the exact length because the ratio is one.Results: Six patients with biliary strictures were stented using this measuring catheter. The correct stent was inserted at the first attempt every time. In two patients, the stent was trimmed down to the desired length exactly. The average time taken to complete the procedure was 35 min and no additional sedation was required after the first dose.
German experience with endoscopic transmural drainage for pancreatic pseudocysts
Authors: Dohmoto Matatoshi , Rupp Dietrich K. 
Published: March 2003

Background: Endoscopic drainage provides a good alternative or supplement to a surgical approach for the therapy of pancreatic pseudocysts.Methods: Between 1987 and 2000, 47 patients had been treated for pancreatic pseudocysts by transmural or transductal drainage. In 79% the pseudocysts were due to chronic pancreatitis mainly caused by alcoholism. The main symptoms were abdominal pain in 85% of patients and loss of appetite or weight in 60% of patients. In 17% of patients, signs of septicemia were observed.Results: In 42 patients pancreatic pseudocysts disappeared completely. In the remaining five cases drainage was not successful. Six patients suffered a relapse 7–38 months after drainage. No other recurrences were followed up within 4–10 years. In another six patients the prostheses were renewed because of occlusion or dislocation. Overall six patients had to undergo surgery, three patients because of relapsing cyst, two patients because of insufficient drainage and one patient because of severe bleeding. There was no case of death related to the endoscopic treatment.Conclusions: Since the development of a modified needle type cystotom, the puncture and insertion of the prosthesis for pancreatic cyst drainage is less precarious and quicker. The endoscopic sonography is a valuable supplement to the diagnostic procedure to localize the optimal spot for puncture and to avoid hemorrhage because of damage of intramural or extramural blood vessels. Advantages of endoscopic drainage are minimal invasiveness, short period of hospitalization and low costs. These aspects make endoscopic therapy the first choice of treatment of pancreatic pseudocysts.
Expression of VEGF and its receptors Flt and KDR in gastric cancer
Authors: Liu Dongping , Wang Bingyuan , Jiang Ruolan 
Published: March 2003

OBJECTIVE: The purpose of the present study was to investigate the correlation between the expression of vascular endothelial growth factor (VEGF), the expression of its receptors, Flt and KDR, and the biological behavior of gastric cancer. METHODS: Sixty cases of gastric cancer that had been diagnosed by surgery and pathology were studied with the method of semiquantitative reverse transcriptase–polymerase chain reaction (RT‐PCR), to determine the expression of VEGF, Flt and KDR in gastric cancer tissue. RESULTS: The positive rates of VEGF, Flt and KDR in gastric cancer were 73.3, 86.7 and 80.0%, respectively. In pericancerous tissue, the rates were 43.3, 33.0 and 30.0%, respectively. There were significant differences between the groups with and without lymph node metastasis (P < 0.01). For gastric cancer patients with lymphatic metastasis, the positive rates for VEGF, Flt and KDR were 90.3, 80.6 and 96.8%, respectively; for patients without lymphatic metastasis, the rates were 51.7, 41.3 and 55.1%; there were significant differences between the groups with and without lymph node metastasis (P < 0.01). The positive rates of VEGF and KDR in well‐differentiated gastric cancer were 40.0 and 46.7%, markedly lower than those of the poorly differentiated and undifferentiated gastric cancer groups. The rate of positive expression of Flt in the well‐differentiated gastric cancer group was 73.3%. There was no significant difference between this rate and that of the poorly differentiated and undifferentiated groups (87.5%). The positive expression of VEGF, Flt and KDR was unrelated to the depth of infiltration. CONCLUSIONS: There are some correlations between VEGF, Flt and KDR and the biological behavior of gastric cancer. Knowing where they are expressed at high rates may be of help in evaluating the prognosis of gastric cancer.
Effects of several oral medications on the results of the 14C‐urea breath test
Authors: Mo Jianzhong , Wang Chengdang 
Published: March 2003

OBJECTIVE: To explore the effects of several oral medications on the results of the 14C‐urea breath test (UBT). METHODS: One hundred and twelve patients with chronic gastritis that had tested positive in a rapid urease test were enrolled in the present study and were randomly divided into six groups: 20 patients received 20 mg famotidine b.i.d., 16 patients received 30 mg lansoprazole q.d., 18 patients received 1000 mg sucralfate t.i.d., 20 patients received 50 mg teprenone t.i.d., 20 patients received 220 mg colloidal bismuth subcitrate b.i.d., and 18 patients received four tablets t.i.d. of wei‐de‐an, a traditional Chinese medicine. The 14C‐urea breath test was performed before treatment, 7 days after beginning drug treatment and 7 days after the cessation of drug treatment. RESULTS: All medications, especially colloidal bismuth subcitrate, were influenced by the result of the UBT. Seven days after drug treatment, the negative conversion rate of the UBT was 45.0% (9/20) in the colloidal bismuth subcitrate group, 30.0% (6/20) in the famotidine group, 31.3% (5/16) in the lansoprazole group, 16.7% (3/18) in the sucralfate group, 5.0% (1/20) in the teprenone group and 27.8% (5/18) in the wei‐de‐an group. However, all values returned to positive again 1 week after withdrawal. The influence of famotidine on UBT was similar to that of lansoprazole (P > 0.05). There was no significant difference between the results of the first and the third UBT. CONCLUSIONS: The UBT is a reproducible, non‐invasive method for identifying Helicobacter pylori, but many drugs can influence the result of the UBT, so it is necessary to suspend treatment with these drugs before carrying out the testing procedure.
Expression of DNA‐dependent protein kinase and DNA topoisomerase I in human hepatocellular carcinoma and adjacent normal liver tissues
Authors: LIU Lian Xin , JIANG Hong Chi , ZHU An Long , WANG Xiu Qin , ZHOU Jing , WU Min 
Published: March 2003

OBJECTIVE:  To investigate the gene expression of DNA‐dependent protein kinase (DNA‐PK) and DNA topoisomerase I (DNA TOPO I) in hepatocellular carcinoma (HCC) by use of Atlas Human Cancer cDNA Expression Array membranes, semiquantitative reverse transcription polymerase chain reaction and northern blotting.METHODS:  Hybridization of the cDNA array membrane was performed with α‐32P‐labeled cDNA probes synthesized from RNA isolated from HCC and adjacent non‐cirrhotic normal liver. Reverse trans­cription polymerase chain reaction of 24 pairs of specimens and northern blotting of four pairs of specimens were used to confirm the expression patterns of DNA‐PK and DNA TOPO I identified by Atlas array hybridization.RESULTS:  Among 588 genes spotted on the membrane, 33 genes were related to DNA damage response/ repair/recombination. DNA‐dependent protein kinase and DNA TOPO I were upregulated in HCC. There were no genes downregulated in HCC. Reverse transcription polymerase chain reaction gave results consistent with Atlas Human Cancer cDNA Array findings in DNA‐PK 16/24 and DNA TOPO I 18/24. Northern blot analysis of DNA TOPO I of four paired specimens all showed upregulation in HCC compared with that in normal liver tissues.CONCLUSION:  The result obtained from the Atlas microarray provides for the first time a liver cancer‐specific expression profile, which identifies gene expression comprehensively and systematically. In addition, the finding about genes related to DNA damage response/repair/recombination may lead to clues about the mechanism of multiple drug resistance. The quick method of profiling gene expression by cDNA array provides an overview of key factors that may be involved in HCC. The precise relationship between the altered genes and HCC needs further investigation.
Gender crossover of lung function
Authors: Nakamura Masao , Matsui Toshifumi , Ohrui Takashi , Kida Kozui , Yamaya Mutsuo , Sasaki Hidetada 
Published: March 2003

Background: Although standard values of lung function are used for screening pulmonary diseases, only a few studies have been reported in the elderly.Methods: In this study, lung function in subjects below and above 65 years of age was analysed and the decline in lung function was compared according to age, between those below and those above 65 years.Results: Lung function below 65 years declined more in males than in females in both vital capacity (VC) and forced expiratory volume in 1 s (FEV1). The decline in lung function was greater in females more than 65 years of age, compared with those less than 65 years. In males, the decline in FEV1was less for those more than 65 years than for those below 65 years, although the decline in VC showed a similar tendency to that of females.Conclusions: Selective survival may influence lung function more in men than in women. The gender difference of survival should be considered when estimating standard values, such as lung function, in the elderly.
Feasibility case‐controlled study of day‐case haemorrhoidectomy
Authors: Lam Tzit Yuen David , Lam Steve Ching Wa , Kwok Samuel Po Yin 
Published: March 2003

Introduction:  Haemorrhoidectomy is traditionally an inpatient procedure. With many benefits, the day‐surgery arrangement is an attractive alternative. The feasibility of day‐surgery haemorrhoidectomy was explored and the hospital days were calculated in a case controlled design.Methods:  A single surgeon’s experience of day‐surgery haemorrhoidectomy between 1 July 1999 and 31 March 2000 was compared with inpatient haemorrhoidectomy during the same period. The operations were performed at United Christian Hospital Department of Surgery, Hong Kong (a government‐funded public hospital). Statistical tests were applied where appropriate.Results:  There were 30 day‐surgery and 15 inpatient haemorrhoidectomies. The groups were comparable in terms of age, gender, severity of haemorrhoids, method and duration of haemorrhoidectomy, blood loss, residual haemorrhoids, duration of follow up and unplanned readmission rate. Significantly more day‐patients received general than spinal anaesthesia. Twenty‐six of 30 (87%) patients were successfully discharged after day surgery. Two were admitted for transient fever (< 24 h), one for micturition syncope and one for acute urinary retention. There were four unplanned readmissions after day surgery: one for pain and three for secondary bleeding. All stopped spontaneously. All three unplanned readmissions after inpatient surgery were for secondary bleeding. All stopped spontaneously. Patient stay was significantly shorter for day surgery (1 ± 1 day) than for the inpatient arrangement (4 ± 1.6 days).Conclusion:  Day‐surgery haemorrhoidectomy is feasible. The significantly shorter hospital stay implies savings in public medical expenses.
Breast cancer and pregnancy: a diagnostic and management dilemma
Authors: Puckridge Philip J. , Saunders Christobel M. , Ives Angela D. , Semmens James B. 
Published: March 2003

Background:  The purpose of the present paper was to review the current knowledge of pregnancy concurrent with a diagnosis of breast cancer, and how best to manage this group of women and those breast cancer survivors who may subsequently conceive.Results:  Pregnancy‐associated breast cancer or gestational breast cancer is defined as breast cancer diagnosed during pregnancy or in the 12 months post‐partum. A review of the current literature on breast cancer‐related pregnancy suggests an incidence of between 0.7 and 3.9%. The prognosis is thought not to be significantly different from non‐pregnancy‐associated breast cancer, except in cases where a delay in diagnosis is associated with more advanced disease. The treatment is similar to non‐pregnant cases, with the exception of radiotherapy, which is contraindicated throughout pregnancy; and chemotherapy, which is contraindicated during the first trimester. Few breast cancer survivors go on to conceive, but those who do have no worse breast cancer or pregnancy outcomes.Conclusion:  Most of the research in this field has come from small, specialized institutions and may not reflect what occurs in the wider community. Further population‐based research in this area is needed, and is currently being undertaken in Western Australia.
Vascular surgeon’s experience with intraoperative angioplasty
Authors: McCleary Alistair J. , Gough Michael J. 
Published: March 2003

Background: Intraoperative balloon angioplasty as an adjunct to vascular reconstruction is controversial and radiologists suggest that it may be less effective than preoperative or postoperative percutaneous transluminal angioplasty. The aim of the present study was to explore the role of intraoperative balloon angioplasty as performed by a vascular surgeon. Methods: The notes and angiograms of 63 patients on whom 67 intraoperative angioplasty/stenting procedures were performed were retrieved using a computerized prospective audit system. Results: Although 41 procedures were planned preoperatively, 26 (39%) followed intraoperative angiography. Twenty‐seven were performed to improve inflow for distal reconstructions and 27 were performed to improve outflow for proximal reconstructions. Thirteen (anastomotic stenoses) followed synthetic graft thrombectomy. Twenty‐seven iliac, 15 superficial femoral artery (SFA), 11 popliteal, one anterior tibial and 13 anastomotic lesions were dilated and there were four technical failures. At follow up (median: 24 months; 3‐monthly duplex scan, ankle brachial pressure indices) primary patency rates by lifetable analysis were: iliac, 75%; SFA, 91%; popliteal, 82%; anastomotic, 8%. Conclusions: There are situations in which intraoperative angioplasty would be advantageous and can be performed successfully by a surgeon. Because a significant proportion of procedures was unplanned and a vascular radiologist was not readily available the authors conclude that vascular surgical trainees should be trained in angioplasty techniques. However, balloon angioplasty is ineffective in treating anastomotic stenoses and surgical intervention is required for these lesions.
Post‐discharge surgical wound infection surveillance in a provincial hospital: Follow‐up rates, validity of data and review of the literature
Authors: Kent Paschal , McDonald Malcolm , Harris Owen , Mason Terry , Spelman Denis 
Published: March 2003

Background: Numerous studies suggest that many surgical site infections (SSI) come to light only after discharge from hospital. With increasing trends towards shorter length of stay and ambulatory day surgery, post‐discharge surveillance may become necessary for all infection control programs, but the methodology has yet to be validated and standardized. The overall aim of the present study was to examine the impact of effective post‐discharge SSI follow up on the overall SSI rate. Methods: A prospective targeted surveillance programme of 1291 surgical procedures was conducted at St John of God Health Care Geelong using the standardized National Nosocomial Infections Surveillance (NNIS) method. Questionnaires were sent to surgeons and the results rigorously chased up. Factors giving rise to high follow‐up rates and the relationship between follow up, attrition bias and validity of data were explored using a literature search. Results: A post‐discharge follow‐up rate of 98.7% was achieved. When the post‐discharge data were included, the overall SSI rate (6.0% (95% CI: 4.7–7.4)) was more than double that in hospital (2.7% (95% CI: 1.9–3.8)). Conclusions: An effective post‐discharge follow‐up programme significantly increased the SSI rate. From the authors’ experience and a literature survey, possible ways to achieve high follow‐up rates were suggested. It was also recommended that professional and regulating bodies in Australia be encouraged to standardize methodology and set minimum follow‐up rates for post‐discharge SSI surveillance. Increasing use of computerized hospital database systems for automated data gathering and processing should make this more practicable.
Paradigm shift in surgical approaches to thymectomy
Authors: Yim Anthony P. C. 
Published: March 2003

Background: Thymectomy is an established therapy in the management of myasthenia gravis (MG) used in conjunction with medical treatment. The optimal surgical approach to thymectomy, however, has remained controversial. Method: The present review discusses the author’s experiences of and the literature regarding the management of MG using the video‐assisted thoracic surgery (VATS) approach. Results: This approach was shown to be technically safe in experienced hands and associated with less postoperative pain, better preservation of lung function in the early postoperative period and better cosmetic results than alternative techniques. The intermediate term results of VATS are comparable to those of more radical approaches. It is hoped that this patient‐friendly approach will lead to greater support by patients and their neurologists, for earlier surgery. Conclusion: VATS is an attractive, alternative approach to thymectomy.