bluuebunny/crossref_metadata_2025_split huggingface dataset:
HRCT findings in the lungs of primary care patients with lower respiratory tract infection
Authors: Lähde S. , Jartti A. , Broas M. , Koivisto M. , Syrjälä H. 
Published: July 2004

Purpose: To survey the prevalence and type of lung patterns detectable at high-resolution CT (HRCT) in a primary care population seeking help for cough and fever. Material and Methods: The HRCT patterns of 103 patients obtained at the primary visit to a municipal health centre for cough and fever were evaluated. Forced expiratory examinations were obtained in 93 patients. Results: Lower respiratory tract infection (LRTI)-related findings (present at inclusion, healed at follow-up, not explained by any other factor) were seen in 19 patients (18.7%), of whom 11 also showed opacities, even though of lesser extent, at conventional chest radiography. The following patterns were found: ground-glass opacity (58%), discrete consolidations (52%), confluent consolidations (16%; 1 case with an air bronchogram), air space nodules (10%), peribronchovascular thickening (37%), tree-in-bud pattern (26%), free pleural fluid (5%), and septal thickening (5%). An expiratory mosaic pattern was seen in 19 (20%) out of 93 patients. In addition, lymph node enlargement (&gt;1 cm) was recorded in 7 patients out of 103. Conclusion: HRCT is more sensitive than chest radiography in detecting LRTI-related lung lesions in a primary care population. The pattern typically comprises subtle scattered polymorphous opacities with varying attenuation affecting several lung segments. LRTI-related HRCT pattern deserves consideration as a differential diagnostic alternative in patients examined due to any lower respiratory tract symptoms.
MR characteristics of acute cholangitis
Authors: Håkansson K. , Ekberg O. , Håkansson H.-O. , Leander P. 
Published: July 2004

Purpose: To describe the MR appearance of acute cholangitis and discuss the role of MR imaging as a diagnostic method in this disease. Material and Methods: Of 60 patients with clinical acute cholangitis, 12 were examined with MR before endoscopic retrograde pancreatography (ERCP). A retrospective review was performed of MR and ERCP findings. The MR findings registered were presence of biliary duct dilatation, intraluminal filling defects due to stones or sludge, bands of mucosal oedema of the biliary ducts, intra- and retroperitoneal oedema/fluid, and definition of the cause of obstruction, e.g. stones, stenosis or tumour was made. Results: Acute cholangitis was related to obstruction from choledocholithiasis (n=8), pancreatic cancer (n=1), benign biliary duct stricture (n=1), papillary stenosis (n=1) and without evidence of an obstructing cause (n=1). One patient had an acute obstructive suppurative (toxic) cholangitis. Conclusion: MR imaging has a role in the non-invasive radiographic arsenal of techniques to confirm or exclude the diagnosis of acute cholangitis, especially in older patients where the clinical symptoms may be vague.
Gray-scale and doppler ultrasound imaging features of vascular canals in human femoral condylar epiphysis
Authors: Oshima H. , Mizutani H. , Ohba S. 
Published: July 2004

Purpose: To describe the gray-scale and color Doppler ultrasound imaging features of vascular canals in human femoral condylar epiphysis. Material and Methods: Vascular canals in the femoral condylar epiphysis were examined using gray-scale and Doppler US. The study was performed in 45 volunteers (aged &lt;1 month-72 years) who comprised 1 subject with short stature, 1 subject with Klippel-Trenaunay-Weber syndrome and 43 subjects with normal growth. Results: In the 8-year-old and younger group (n=34), vascular canals were observed in 32 subjects (94%), whereas vascular canals were not observed in the 9-year-old and older group (n=11). Vascular canals were visualized as hyperechoic lines and dots. With Doppler US, blood flow in the vascular canals was observed in 20 of the 32 subjects (62.5%). Spectral Doppler analysis was possible in 15 subjects, in all of whom only arterial waveforms were observed. Conclusion: US was helpful to delineate the vascular canals and flow therein. The detection and evaluation of vascular canals and blood flow therein may prove useful in understanding growth.
Acetabular inclination and anteversion in infants using 3D MR imaging
Authors: Falliner A. , Muhle C. , Brossmann J. 
Published: July 2004

Purpose: To establish if 3D MR imaging could be used for measurements of acetabular inclination and anteversion in infants specimens. Material and Methods: 3D MR data of 3 pelvic preparations of 6-week- to 10-month-old infant specimens was gathered. MR imaging in transaxial and frontal planes was carried out to measure the acetabular inclination and anteversion: a method to determine the MR planes for measurements is described. It was oriented on anatomical landmarks of the pelvis and therefore allowed adjustment of the frontal and transaxial planes, independent of the pelvis position. Results: The mean acetabular inclination angle was 48°, and the mean acetabular anteversion was 23°. Because of the low number of cases the results can only be assessed as a tendency, but MR imaging seems to be suitable for measurements of acetabular inclination and anteversion.
Image-guided fine-needle aspiration cytology of deep-seated enlarged lymph nodes
Authors: Saikia U. Nahar , Khirdwadkar N. , Saikia B. , Sood B. , Goldsmith R. , Dey P. , Gupta S.K. 
Published: July 2004

Purpose: To evaluate the role of image-guided fine-needle aspiration cytology (FNAC) of deep-seated lymph nodes. Material and Methods: Image-guided FNACs were performed on 242 patients of deep-seated lymph nodes which included thoracic, retroperitoneal and abdominal nodes. A sterile 3.5/5-MHz micro convex sector probe was used for localisation of the node. The FNAC was performed using a 0.7- to 0.9-mm needle with the stylet removed and attached to a 20-ml syringe and FNAC handle after the needle was visualised in the lesion. For each case a minimum of 4-5 smears were made, and two observers without bias interpreted the smears. Results: A total of 242 patients were aspirated, of which 216 (90%) aspirations were US-guided and the remaining 26 (10%) were CT-guided. Adequate material for cytologic diagnosis was obtained in 208 (86%) patients with a similar diagnostic accuracy. The aspirate material was non-representative or scanty in 34 (14%) patients. The most common cytological diagnosis was tuberculosis/consistent with tuberculosis seen in 108 (45%) patients followed by metastasis (17%) and reactive hyperplasia (10%). Non-Hodgkin lymphoma was diagnosed in 22 (9%) patients. All patients were briefly followed for a period of 1 1/2 to 2 years (mean 1 year). Conclusion: Image-guided FNAC has a pivotal role, and is a cost-effective tool for establishing tissue diagnosis as a primary investigative modality. It is also helpful and accurate in follow-up of patients with a known malignant disease, thereby avoiding surgical intervention.
Book Reviews
Authors: Pech Peter , Hietala Sven-Ola , Lönnemark Maria , Raininko Raili , Jonsson Kjell 
Published: July 2004

Paediatric Ultrasound. Edited by H. M. L. Carty. Greenwich Medical Media Ltd., London 2001. The Pathophysiologic Basis of Nuclear Medicine. Edited by A. H. Elgazzar. Springer-Verlag 2001. ISBN 3-540-65914-5. Price: DEM 349. Imaging for Students, 2nd edn. By D. A. Lisle & A. Russell. Arnold, London 2001. ISBN 0-340-76231-4. The Encyclopaedia of Medical Imaging, vols. VI:1 Neuroradiology, and VI:2 Head and Neck Imaging. Edited by H. Pettersson, D. Allison, G. Scotti & R. Hermans. The NICER Institute, Oslo, Norway 2000. ISBN 82-91942-07-2. Fundamentals of Hand and Wrist Imaging. Edited by G. Guglielmi et al. Springer-Verlag 2001. ISBN 3-540-67854-9. Price: hardcover DEM 399.
MR imaging of pituitary adenomas treated with the prolactin inhibitor quinagolide
Authors: Ilkko E. , Tikkakoski T. , Salmela P. , Pyhtinen J. , Kurunlahti M. 
Published: July 2004

Purpose: To evaluate the volume of micro- and macroadenomas in quinagolide-treated patients with resistance to or intolerance of bromocriptine. Material and Methods: The effect of the prolactin inhibitor quinagolide on the volume of pituitary adenoma was evaluated retrospectively in 11 female patients. Prolactin levels before and after the treatment were also recorded. The indications for quinagolide therapy were side-effects of bromocriptine in 5 cases, a poor response to bromocriptine in 5 cases and both in 1 case. MR imaging with a 1.0-T magnet was performed to determine the volume reduction of the adenomas. Results: The average volume reduction of macroadenomas was 324 mm3 (46%) and that of microadenomas 73 mm3 (57%). The level of prolactin secreted by macroadenomas was reduced by an average of 163 μg/l (65%) and that by microadenomas of 113 μg (73%). In 2 microadenomas and in 1 macroadenoma, signal intensity changed during the treatment in T1-weighted images. In follow-up no changes in signal intensity were seen in 8 adenomas in non-contrast T1-weighted images. A haemorrhagic lesion was seen in 1 macroadenoma before treatment, but it disappeared during treatment. Conclusion: Quinagolide was found to be an effective alternative to bromocriptine in cases with drug intolerance or resistance, and MR imaging a suitable method for the follow-up of macro- and microadenomas.
US-guided fine-needle aspiration biopsy of thyroid nodules
Authors: Court-Payen M. , Nygaard B. , Horn T. , Jacobsen G. Krag , Brændstrup O. , Narvestad E. , Pedersen L. Mark , Hancke S. , Holm H.H. 
Published: July 2004

Purpose: To determine which nodular areas provide most adequate and accurate material for cytology during US-guided fine-needle aspiration biopsy (FNAB) of thyroid nodules. Material and Methods: In a prospective multicentre study, US-guided FNAB (0.8 mm) was performed in 342 thyroid nodules (338 patients, 285 women, 18-83 years, 285 palpable). Histology was obtained in 169 nodules, revealing 75 neoplasms (44.4%) including 18 cancers (10.7%). In 206 solid nodules, 2 passes (central and peripheral) were compared. In 82 complex nodules, 2 passes (solid area and cystic area) were compared. Results: The inadequacy rate was 16.4% and the false-negative rates were 2.2% and 28.1% for the diagnosis of cancer and neoplasm, respectively. In solid nodules, material was more adequate with peripheral passes compared to central passes, but the difference was not significant. In complex nodules, the inadequacy rate was much higher for passes in cystic areas (80.5%) compared to passes in solid areas (46.3%). Conclusion: Cystic areas due to degeneration seldom provided adequate material when aspirated. Aspiration should always be obtained from solid areas, at best using US-guidance. Adenomas and non-neoplastic nodules were difficult to distinguish.
Ectopic thymic tissue in the paediatric age group
Authors: Chu W.C.W. , Metreweli C. 
Published: July 2004

Purpose: The presence of ectopic thymic tissue is well known along the embryological descent track in the neck. The aim of this study was to detect the frequency of cervical thymic rests in children. Material and Methods: Eighteen consecutive children had neck US performed using an ATL 5000 unit with a 12.5 MHz liner probe. The presence of small rests of thymic tissue was sought. Results: 61% of the children had thymic tissue detected in the neck. Out of those with positive findings, 82% had a thymic rest on the right side, 9% on the left side and 9% had thymic rests bilaterally. Conclusion: Small rests of ectopic thymic tissue in the cervical region are commonly seen in the paediatric age group. It is important to identify the thymic rests for what they are and avoid unnecessary anxiety or intervention.
A Political economy of land reform in South Africa*
Authors: Hall Ruth 
Published: July 2004

Land reform is one way in which the ‘new’ South Africa set out to redress the injustices of apartheid and, by redistributing land to black South Africans, to transform the structural basis of racial inequality. During the first decade of democracy, land reform has fallen far short of both public expectations and official targets. This article describes the progress of the programme and its changing nature. It is argued that a recent shift in land policy, from a focus on the rural poor to ‘emerging’ black commercial farmers, is consistent with changes in macro-economic policy and reflects shifting class alliances. The programme now appears to pursue a limited deracialisation of the commercial farming areas rather than a process of agrarian restructuring. Most fundamentally, land reform has not yet provided a strategy to overcome agrarian dualism.
This paper draws on research by the author under the aegis of the ‘Evaluating Land and Agrarian Reform in South Africa’ research programme at the Programme for Land and Agrarian Studies (PLAAS), University of Western Cape, and in particular the final report of that research, co-authored with Peter Jacobs and Edward Lahiff (Hall, Jacobs and Lahiff, 2003).
Hemofiltration but Not Steroids Results in Earlier Tracheal Extubation following Cardiopulmonary Bypass
Authors: Oliver William C. , Nuttall Gregory A. , Orszulak Thomas A. , Bamlet William R. , Abel Martin D. , Ereth Mark H. , Schaff Hartzell V. 
Published: July 2004

Background
Activation of the inflammatory cascade is thought to account for some of the respiratory dysfunction and prolonged mechanical ventilation associated with cardiopulmonary bypass. The objective of this investigation was to identify whether perioperative steroids or hemofiltration during cardiopulmonary bypass, by their attenuation of inflammation, would reduce duration of mechanical ventilation after cardiac surgery.

Methods
After Institutional Review Board approval and informed consent, 192 patients scheduled to undergo elective primary coronary artery bypass grafting or valvular replacement or repair were randomized in a double-blind prospective study into three groups. One group (Control) received saline at induction and at 6-h intervals for four doses. Another group (Hemofil) received saline and hemofiltration to obtain 27 ml/kg of hemofiltrate. The final group (Steroid) received 1 g methylprednisolone before anesthesia induction and then 4 mg of dexamethasone at 6-h intervals for four doses. All patients underwent normothermic cardiopulmonary bypass and received propofol for postoperative sedation. Separate two-sample comparisons were performed to compare each experimental group versus the control group using the Wilcoxon rank sum test for continuous variables and Fisher exact test for categorical variables. In all cases, two-tailed P values </= 0.05 were considered statistically significant.

Results
The median time until the patient reached an intermittent mandatory ventilation of 4/min (258.5 versus 385.0 min, respectively; P = 0.02) and tracheal extubation (352.0 versus 518.0 min; P = 0.03) was significantly reduced for group Hemofil but no different for Steroid compared to Control.

Conclusions
Hemofiltration and steroids are both previously reported to attenuate the inflammatory response but only hemofiltration reduced time to tracheal extubation for adults after cardiopulmonary bypass in this study.
Effects of Anesthetic Agents on Focal Adhesion Kinase (pp125FAK) Tyrosine Phosphorylation in Rat Hippocampal Slices
Authors: Dahmani Souhayl , Tesnière Antoine , Rouelle Danielle , Toutant Madeleine , Desmonts Jean-Marie , Mantz Jean 
Published: July 2004

Background
Tyrosine protein kinase proteins exert a prominent control on signaling pathways and may couple rapid events, such as action potential and neurotransmitter release, to long-lasting changes in synaptic strength and survival. Whether anesthetics modulate tyrosine kinase activity remains unknown. The aim of the current study was therefore to examine the effects of intravenous and volatile anesthetics on the phosphorylation of focal adhesion kinase (ppFAK), a functionally important nonreceptor tyrosine kinase, in the rat hippocampus.

Methods
Phosphorylation of ppFAK was examined in hippocampal slices by immunoblotting with both antiphosphotyrosine and specific anti-ppFAK antibodies. Experiments were performed in the absence (control) or presence of various concentrations of pharmacologic or anesthetic agents or both.

Results
Clinically relevant concentrations of thiopental, propofol, etomidate, isoflurane, sevoflurane, and desflurane induced a concentration-related increase in tyrosine phosphorylation. In contrast, ketamine (up to 100 microm) and the nonimmobilizer F6 (1,2-dichlorohexafluorocyclobutane, 25 microm) did not significantly affect ppFAK phosphorylation. The anesthetic-induced increase in ppFAK phosphorylation was blocked by GF 109203X, RO 318220, and chelerythrin (100 microm), three structurally distinct inhibitors of protein kinase C and U 73122 (50 microm), an inhibitor of phospholipase C. The propofol- and isoflurane-induced increase in ppFAK phosphorylation was reversible and showed nonadditivity of effects with phorbol 12-myristate 13-acetate (an activator of protein kinase C, 0.1 microm). In contrast, ketamine (up to 100 microm), MK801 (10 microm, an N-methyl-d-aspartate receptor antagonist), bicuculline (10 microm, a gamma-aminobutyric acid type A receptor antagonist), and dantrolene (30 microm, an inhibitor of the ryanodine receptor) were ineffective in blocking anesthetic-induced activation of tyrosine phosphorylation.

Conclusion
Except for ketamine, anesthetic agents markedly increase tyrosine phosphorylation of ppFAK in the rat hippocampus, most likely via the phospholipase C-protein kinase C pathway, whereas the nonimmobilizer F6 does not. These results suggest that ppFAK represents a target for anesthetic action in the brain.
Direct Cardiac Effects of Coronary Site-directed Thiopental and Its Enantiomers
Authors: Mather Laurence E. , Duke Colin C. , Ladd Leigh A. , Copeland Susan E. , Gallagher Gabrielle , Chang Dennis H.T. 
Published: July 2004

Background
Previous evidence from laboratory animal studies indicates that R-thiopental has a greater margin of safety than either the more potent S-thiopental or the clinically used rac-thiopental. Although thiopental can cause cardiovascular depression from direct myocardial effects as well as indirect central nervous system and peripheral effects, no studies have yet determined whether its myocardial effects are enantioselective. A lesser direct effect would provide further evidence supporting R-thiopental as a preferred single enantiomer replacement for rac-thiopental.

Methods
The direct myocardial effects of the thiopental enantiomers were compared to those of rac-thiopental and propofol, using a crossover design with small incremental doses infused over 3 min, on separate days, into the left coronary arteries of conscious sheep. Hemodynamic and electrocardiographic measurements were acquired, and serial blood samples were collected during the studies for drug analyses.

Results
All three forms of thiopental and propofol produced significant hemodynamic effects consisting of dose-related and rapid-onset decreases in left ventricular dP/dtmax and stroke volume, and increases in left coronary blood flow and heart rate. Cardiac output, mean arterial blood pressure, and central venous pressure remained unaltered. The effects did not differ significantly among rac-thiopental, enantiopure R- or S-thiopental, or propofol. Arterial blood drug concentrations were consistently less than those associated with systemic effects.

Conclusions
Although previous evidence indicates that R-thiopental could make a suitable single-enantiomer replacement for rac-thiopental, the current study did not find a significant difference in direct cardiac effects among the thiopental enantiomers, racemate, or propofol.
Relative Amnesic Potency of Five Inhalational Anesthetics Follows the Meyer-Overton Rule
Authors: Alkire Michael T. , Gorski Lukasz A. 
Published: July 2004

Background
Doses of volatile anesthetics around 0.3 minimum alveolar concentration (MAC) inhibit learning. However, threshold amnesic doses and relative potencies between agents are not well established. The authors determined amnesic potency in rats for four common volatiles and nitrous oxide.

Methods
After institutional review board approval, adult Sprague-Dawley rats received inhibitory avoidance training during exposure to either air or various subanesthetic doses of desflurane, sevoflurane, isoflurane, halothane, or nitrous oxide (4-21 rats/dose). Animals were trained to remain in a starting "safe" compartment for 100 consecutive seconds by administering a foot shock (0.3 mA) each time they entered an adjacent "shock" compartment. Memory was assessed at 24 h. Anesthetic effects on pain thresholds were separately determined.

Results
Learning: Only relatively higher doses of sevoflurane, halothane, and desflurane increased the number of shocks required for task acquisition. Memory: Significantly decreased retention performance (P < 0.05) was found at relatively low inspired concentrations of 0.2% isoflurane, 0.3% sevoflurane and halothane, 0.44% desflurane, and 20% nitrous oxide. Amnesic potency was nitrous oxide >/= desflurane > sevoflurane >/= isoflurane > halothane, (rank-ordered ED50 values as %MAC). Amnesic potency correlated with oil:gas partition coefficients (r = -0.956, P < 0.007). Halothane, only at 0.08%, enhanced retention (P < 0.01). All agents were analgesic at higher doses.

Conclusions
Amnesic potency differs between agents; nitrous oxide is most potent and halothane is least potent relative to MAC. The amnesic threshold ranges from 0.06 to 0.3 MAC. The correlation between potency and oil:gas partition coefficients suggests a fundamental role for hydrophobicity in mediating amnesia, similar to its association with MAC. Some agents (e.g., halothane) may enhance aversive memory retention at doses typically encountered during emergence.
Epidural Neostigmine Combined with Sufentanil Provides Balanced and Selective Analgesia in Early Labor
Authors: Roelants Fabienne , Lavand’homme Patricia M. 
Published: July 2004

Background
This study evaluated the efficacy of an epidural single dose of neostigmine combined with sufentanil to provide selective and balanced analgesia at the beginning of labor.

Methods
After informed consent, 125 healthy parturients were randomly allocated to receive, after a test dose, a single injection of either epidural sufentanil 20 micrograms (minimal analgesic dose) or 10 micrograms or a combination of sufentanil 10 micrograms with neostigmine 250, 500, or 750 micrograms in a total volume of 12 ml. Pain scores were recorded at regular intervals to determine onset and duration of analgesia. Maternal and fetal vital parameters as well as side effects were closely monitored.

Results
Parturients did not differ concerning demographic data. Epidural neostigmine 500 micrograms with sufentanil 10 micrograms produced effective analgesia (visual analog scale <30 mm within 10 min in 72% parturients and within 15 min in 85% parturients; average duration of 119 min, confidence interval 96-142 min) that was as effective as epidural sufentanil 20 micrograms. Epidural combination with neostigmine 250 micrograms was ineffective, whereas 750 micrograms did not produce higher effect than 500 micrograms. No motor block was recorded. Maternal and fetal vital parameters remained stable during labor.

Conclusions
Epidural combination of neostigmine 500 micrograms (e.g., 6-7 micrograms/kg) with sufentanil 10 micrograms provides similar duration of analgesia as epidural sufentanil 20 micrograms and allows effective and selective analgesia devoid of side effects in the first stage of labor.