bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regulation of Trophoblast Invasion by IL‐1β and TGF‐ β1
Authors: KARMAKAR SUBHRADIP , DAS CHANDANA 
Published: March 2003

Karmakar S, Das C. Regulation of trophoblast invasion by IL‐1β and TGF‐β1. AJRI 2002; 48:210–219 © Blackwell Munksgaard, 2002 PROBLEM: To investigate the effect of IL‐1β and TGF‐β1 on trophoblast derived proteases and their inhibitors at the mRNA and protein level for elucidation of the mechanism of trophoblast invasion.METHOD OF STUDY: Trophoblast derived proteases and their inhibitors were localized in human placental villi by immunohistochemistry, their regulation at mRNA and protein levels were studied using RT–PCR and zymography, respectively, on trophoblast cells in culture.RESULTS: Trophoblast proteases, matrix metalloproteases (MMP‐2, MMP‐9), membrane type matrix metalloproteases (MT‐MMP1&2) and urokinase type plasminogen activator (uPA) were found to be up regulated by IL‐1β while the protease inhibitors, tissue inhibitor of metalloproteases (TIMP‐1 & 2) and plasminogen activator inhibitors (PAI‐1 & 2) to be up regulated by TGF‐β1.CONCLUSION: Temporo‐spatial regulation of trophoblast invasion is the outcome of a balanced interplay between the proteases and their cognate inhibitors. IL‐1β and TGF‐β1 seem to be critical for regulating the protease network thereby effectively controlling the extent to which the trophoblast may invade the maternal endometrium.
Increased Levels of Macrophage Colony‐Stimulating Factor in the Placenta and Blood in Preeclampsia
Authors: HAYASHI MASATOSHI , HOSHIMOTO KAZUNORI , OHKURA TAKEYOSHI , INABA NORIYUKI 
Published: March 2003

PROBLEM: Macrophage colony‐stimulating factor (M‐CSF) is considered an essential cytokine for placental growth and maintenance. We evaluated whether M‐CSF levels in the placenta and blood in preeclampsia differed from those in normal pregnancies.METHOD OF STUDY: The subjects were 37 pregnant women carrying single fetuses, of whom 19 were women with normal pregnancies and 18 were women with preeclampsia. Their average gestational age at entry was 38 weeks of gestation. Blood was collected before the onset of labor, and separated serum was obtained after centrifugation. A tissue segment of the placenta was cut immediately after delivery. The frozen placental tissue was placed in a plastic tube containing phosphate‐buffered saline. The tissue was fully homogenized and then centrifuged. Separated supernatant was used for subsequent determination. M‐CSF levels in separated serum were measured, and M‐CSF and total protein (TP) levels in separated supernatant were also measured.RESULTS: Both M‐CSF/TP levels in the placenta and M‐CSF levels in blood were significantly higher (P < 0.05–0.01) in preeclampsia than in normal pregnancies.CONCLUSIONS: This is the first report concerning high placenta levels of M‐CSF/TP in preeclampsia. Increased M‐CSF in the placenta supports the hypothesis that immunological abnormalities contribute to the etiology of preeclampsia.
Glomerular Immunoglobulin Deposits Induce Glomerular Inflammation in Pregnant but not in Non‐pregnant Rats
Authors: Faas M.M. , Van Der Schaaf G. , Schipper M. , Moes H. 
Published: March 2003

PROBLEM: Does an inflammatory stimulus evoke a more intense inflammatory response in pregnant rats as compared with non‐pregnant rats?METHOD OF STUDY: Non‐pregnant rats were injected with antibodies against the glomerular basement membrane (GBM), 14 days before pregnancy, to induce a subclinical glomerulonephritis. Part of the rats were rendered pregnant, the others remained non‐pregnant throughout the experiment. Two experiments were performed: in experiment 1, pregnant and non‐pregnant rats were killed at various intervals after the injection with antibody and parameters characteristic of a glomerular inflammation were evaluated using immunohistology on cryostat kidney sections and liver sections. In experiment 2, 24‐hr urinary protein excretion was measured at various days after the injection in pregnant and non‐pregnant rats.RESULTS: Experiment 1 revealed that a significant glomerular inflammation, as characterized by increased numbers of monocytes and LFA‐1 positive cells per glomerulus, was only observed in pregnant rats with glomerulonephritis. Experiment 2 revealed that only pregnant rats with glomerulonephritis showed increased urinary protein excretion.CONCLUSION: The fact that glomerular inflammation coincides with proteinuria only in pregnant rats with glomerulonephritis, may suggest that these phenomena are causally related and promoted by the pregnant condition.
The effect of intracanal Ledermix on root resorption of delayed‐replanted monkey teeth
Authors: Wong Kian Seong , Sae‐Lim Varawan 
Published: March 2003

Abstract
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Progressive root resorption is one of the common sequelae in replanted teeth, which is detrimental to their long‐term prognosis. Ledermix paste, with its composition of triamcinolone acetonide and demethylclortetracycline, has been shown to inhibit inflammation and the associated hard tissue resorption. This study evaluated the effect of immediate intracanal Ledermix on root resorption of delayed‐replanted monkey teeth. A total of 36 roots were root canal treated. For the experimental group, intracanal Ledermix was placed prior to extraction and replantation after 1‐h bench dry. The positive control group was root filled and replanted after 1 h while the negative control group was root filled and replanted immediately. The monkeys were sacrificed after 12 weeks. The H&E histological tissue specimens were prepared and evaluated using a method modified from that of Andreasen's morphometric analysis, as favorable or complete healing and unfavorable healing, comprising inflammatory root resorption and replacement resorption. The results were analyzed using Kruskal–Wallis and Mann–Whitney U‐tests as well as Wilcoxon signed ranks test. The negative control group produced highly significant favorable healing and unfavorable healing as compared to the Ledermix group (P = 0.000). The Ledermix group only showed significantly higher occurrence of complete healing (35.46%) compared to the positive control group (16.58%) (P = 0.037) but there were no significant differences in the inflammatory root resorption and replacement resorption. Nevertheless, when the latter two unfavorable healing patterns were combined, there was a significantly lower overall unfavorable healing in the Ledermix group (64.54%) when compared to the positive control group (83.43%) (P = 0.037). This unfavorable healing outcome in the Ledermix group, however, was not significantly different from the favorable healing outcome with the same treatment modality (P = 0.110).
The effects of subanaesthetic concentrations of xenonin volunteers*
Authors: Bedi A. , McCarroll C. , Murray J. M. , Stevenson M. A. , Fee J. P. H. 
Published: March 2003

SummaryThis study reports the subjective, psychomotor and physiological properties of subanaesthetic concentrations of xenon. Ten healthy male volunteers received either xenon or nitrous oxide in a randomised crossover study design. The subjects breathed either xenon (Xe) or nitrous oxide (N2O) from a closed circuit breathing system, according to a randomised, double‐blind protocol. The concentration of xenon required to produce sedation, ranged between 27 and 45%(median 35%). All subjects completed the xenon protocol. Subjects were tested using the Critical Flicker Fusion test and derived electroencephalogram parameters, however, neither test was found to reliably predict sedation. The respiratory rate decreased markedly during sedation with xenon. The subjects did not experience any airway irritability (coughing, breath‐holding or laryngospasm) during administration of either gas. One subject required anti‐emetic treatment in the N2O group compared to none in the Xe group. Eight subjects reported that they found sedation with xenon pleasant and preferable to nitrous oxide. Xenon sedation was well tolerated and was not associated with any adverse physiological effects, however, it was reported to be subjectively dissimilar to nitrous oxide.
Non‐obstetric surgery during gestation: Risk factors for lower birthweight
Authors: Jenkins Thomas M. , Mackey Suzanne F. , Benzoni Elisa M. , Tolosa Jorge E. , Sciscione Anthony C. 
Published: March 2003

AbstractObjective: To assess the risk for preterm birth and low birthweight for women undergoing non‐obstetric surgery during gestation.Design: Two perinatal tertiary care centres.Population: Women undergoing non‐obstetric surgery during gestation between January 1989 and June 1999.Materials and methods: A chart review was carried out. Cervical cerclages, procedures carried out under local anaesthesia or intravenous sedation, or carried out in combination with Caesarean delivery were excluded.Main outcome measures: Preterm birth (<37 weeks), birthweight.Results: A total of 116 of 69 800 women (0.2%) underwent non‐obstetric surgery, with 96 women delivering under our care. Procedures were more commonly carried out in the second trimester (53%), versus the first (23%) or third trimester (24%). Surgery in the second trimester resulted in the lowest rate of preterm birth (11%). The overall preterm birth rate was 21% (20/96), with 13 out of 20 (65%) occurring between 35 and 37 weeks. The mean interval from surgery to delivery was 18.7 weeks. Rates of preterm birth were similar for either intra‐ versus extra‐abdominal procedures, or general versus regional anaesthetic. Use of a general anaesthetic was associated with a significant decrease in birthweight (3053 vs 3515 g, P = 0.01) despite similar gestational ages at delivery (37.6 vs 38.6 weeks, P = 0.08). Multiple linear regression controlled for gestational age showed that general anaesthesia, longer surgery duration, and intra‐abdominal procedures were all significant independent risk factors for lower birthweight.Conclusion: While non‐obstetric surgery appears to be relatively safe during gestation, general anaesthesia, longer surgery time, and intra‐abdominal procedures are associated with lower birthweights.
Management of labour among women with epidural analgesia
Authors: Roberts Christine L. , Raynes‐Greenow Camille H. , Upton Alexis , Douglas Ian D. , Peat Brian 
Published: March 2003

AbstractTo assess current practices in the labour management of low risk primiparous women with epidural analgesia we surveyed delivery suites in New South Wales (NSW) that annually provide at least 100 epidurals to ‘standard primipara’. Epidural rates among ‘standard primipara’ at these hospitals ranged from 14 to 85% (median 46%). Continuous epidural infusion was the most commonly used technique (63%). For ‘standard primipara’ with an epidural 62% of units usually augmented labour with oxytocin, 89% discontinued the epidural in second stage and 67% had policies of delayed pushing. There is wide variation in epidural availability and in labour management, perhaps reflecting the limited evidence for effective interventions to reduce any unintended effects of epidural analgesia.
Follow-up confirms sustained benefit of circumferential stapled anoplasty in the management of prolapsing haemorrhoids
Authors: Beattie G C , Loudon M A 
Published: March 2003

Abstract

Background
Circumferential stapled anoplasty is gaining popularity as a safe and effective treatment in the surgical management of haemorrhoids and mucosal prolapse. However, little is known about the medium- and long-term durability of this procedure. The aim of this study was to evaluate the medium-term results of stapled anoplasty in maintaining symptom remission and to identify possible procedure-related adverse effects.

Methods
Of a consecutive series of 85 stapled anoplasties in 83 patients, 64 patients were eligible for 6-month review; 50 patients were seen in surgical outpatient clinics and seven were contacted by telephone. All patients attending the outpatient clinic were questioned about current symptoms and overall satisfaction with the procedure. The staple line was palpated digitally and inspected at proctoscopy.

Results
Median (interquartile range) symptom scores were 6 (5–8) before operation compared with 0 (0–1) at 6 months (P &lt; 0·01). There was no deterioration in symptoms between 6-week and 6-month follow-up. No recurrences and no procedure-related adverse effects, in particular impaired continence or persistent anal pain, were identified.

Conclusion
The initial promising results of circumferential stapled anoplasty in effectively treating haemorrhoidal symptoms appear to be sustained at 6-month follow-up.
Endocoil magnetic resonance imaging quantification of external anal sphincter atrophy
Authors: Williams A B , Bartram C I , Modhwadia D , Nicholls T , Halligan S , Kamm M A , Nicholls R J , Kmiot W A 
Published: March 2003

Abstract

Background
Anal function depends on the integrity and quality of the sphincter muscles. The diagnosis of external anal sphincter atrophy on endocoil magnetic resonography has been associated with poor outcome from sphincter repair, although the imaging criteria for atrophy remain unclear.

Methods
Women with intact sphincters on endosonography and either normal (more than 60 cmH2O) (n = 9) or low (n = 16) squeeze pressures had endocoil magnetic resonography and electromyography. The area and fat content of the external anal sphincter and puborectalis were measured on mid-coronal magnetic resonography and images were graded as showing normal, intermediate or advanced atrophy. The definition of the external anal sphincter on endosonography and the thickness of the internal anal sphincter were also assessed.

Results
Women with a normal anal squeeze pressure had a larger external anal sphincter cross-sectional area (mean(s.d.) 240(56) versus 193(62) mm2; P = 0·01) with a lower mean fat content (mean(s.d.) 23(4) versus 30(6) per cent; P &lt; 0·001) than those with low squeeze pressures. There was an overall correlation between squeeze pressure, cross-sectional area (r = 0·32, P = 0·02) and fat content (r = − 0·51, P &lt; 0·001). Patients with a thin (less than 2 mm) internal anal sphincter and/or a poorly defined external sphincter on endosonography were more likely to have atrophy (positive predictive value 74 per cent).

Conclusion
Potential endosonographic markers for external anal sphincter atrophy are suggested, and a visual scale for endocoil magnetic resonographic assessment has been validated.
Prediction of prognosis by echocardiography in patients with midgut carcinoid syndrome
Authors: Westberg G , Wängberg B , Ahlman H , Bergh C H , Beckman-Suurküla M , Caidahl K 
Published: March 2003

Abstract

Background
The association between malignant midgut carcinoid tumours and right-sided cardiac lesions is well known, but the pathogenetic link between tumour secretion and valvular disease is still obscure. The purpose of this investigation was to describe the morphological and functional changes of valvular heart disease in a large patient series and to correlate these findings with hormonal secretion and prognosis.

Methods
Of 64 consecutive patients with the midgut carcinoid syndrome followed between 1985 and 1998, valvular heart disease was evaluated in 52 patients by two-dimensional echocardiography, Doppler estimation of valvular regurgitation and flow profiles. A majority was also evaluated with exercise electrocardiography and spirometry.

Results
Structural and functional abnormalities of the tricuspid valve were found in 65 per cent of patients, while only 19 per cent had pulmonary valve regurgitation. Long-term survival was related to excessive urinary excretion of 5-hydroxyindole acetic acid of over 500 µmol in 24 h, but the main predictor of prognosis was the presence of severe structural and functional abnormalities of the tricuspid valve. Although advanced tricuspid abnormalities were prevalent in this series, only one patient died from right ventricular heart failure.

Conclusion
Tricuspid valvular disease is a common manifestation of the midgut carcinoid syndrome and advanced changes are associated with poor long-term survival. Active surgical and medical therapy of the tumour disease reduced the hormonal secretion and, combined with cardiological surveillance, made right ventricular heart failure a rare cause of death in these patients.
Criteria for extramural perineural invasion as a prognostic factor in rectal cancer
Authors: Ueno H , Hase K , Mochizuki H 
Published: March 2003

Abstract

Background
An abundant extramural autonomic nerve network is an anatomical feature of the rectum. Extramural perineural invasion (PNI) may influence the prognosis after resection of rectal cancer, however, few assessment criteria exist.

Methods
PNI was investigated in 364 patients who underwent curative surgery for rectal cancer penetrating the muscular layer. A grading system was established based on the ‘intensity’ (number of PNI foci in a 20-power field) and ‘depth’ (distance from the muscularis propria) of PNI. PNI-0 was defined as without PNI, PNI-1 as ‘intensity’ of less than five foci and ‘depth’ less than 10 mm, and PNI-2 as five or more foci or 10 mm or greater ‘depth’ of invasion.

Results
PNI was observed in 52 patients (14 per cent) and strongly correlated with pathological tumour node metastasis (pTNM) stage. Five-year survival was related to PNI grade (74 per cent in PNI-0, 50 per cent in PNI-1 and 22 per cent in PNI-2). The rate of local recurrence was also related to PNI stage: 43 per cent in PNI-2 and 9 per cent in both PNI-0 and PNI-1. Multivariate analyses showed that graded PNI was associated both with local recurrence and long-term survival, independent of tumour depth (pTNM T) and nodal involvement (pTNM N).

Conclusion
The PNI grading system may be useful in prognosis and allow case selection for intensive postoperative adjuvant therapy.
Association between plaque instability, angiogenesis and symptomatic carotid occlusive disease
Authors: Mofidi R , Crotty T B , McCarthy P , Sheehan S J , Mehigan D , Keaveny T V 
Published: March 2003

Abstract

Background
Angiogenesis is a recognized feature of the atherosclerotic process and has been described in the context of unstable coronary atherosclerotic lesions. The aim of this study was to assess the association between angiogenesis in atherosclerotic carotid plaques and microscopic features of plaque instability, in particular intraplaque haemorrhage.

Methods
Consecutive patients undergoing carotid endarterectomy were included. Endarterectomy specimens were divided into their constituent atherosclerotic lesions. Histological sections were prepared and stained with haematoxylin and eosin, and immunohistochemically with an endothelial cell marker (CD34). The quantity of intraplaque haemorrhage was measured in transverse histological sections using computerized image analysis. Microvessel counts were performed in CD34-stained sections and were verified through computerized image analysis.

Results
Some 239 atherosclerotic lesions from 73 patients were available for analysis; 73 were early lesions, 74 were raised fibroatheromas and 92 were unstable atherosclerotic plaques. One hundred and fifty lesions were not haemorrhagic; 89 exhibited intraplaque haemorrhage, of which 28 involved less than 50 per cent of the plaque sectional area. There were higher microvessel counts in plaques containing over 50 per cent haemorrhage (P &lt; 0·0001), unstable atherosclerotic lesions (P &lt; 0·0001) and atherosclerotic lesions obtained from symptomatic patients (P &lt; 0·001).

Conclusion
There are strong associations between plaque vascularity, quantity of intraplaque haemorrhage and presence of symptomatic carotid occlusive disease.
Chronic pain and quality of life following open inguinal hernia repair
Authors: Poobalan A S , Bruce J , King P M , Chambers W A , Krukowski Z H , Smith W C S 
Published: March 2003

Abstract

Background
The aim was to determine the frequency and characteristics of chronic pain following open inguinal hernia repair and to identify risk factors for its development.

Methods
This was a questionnaire survey of a historical cohort of patients who underwent inguinal hernia surgery in Aberdeen. The sample comprised all patients (n = 351) who underwent surgery between January 1995 and December 1997, and who were alive and resident in Grampian in October 1999. Outcome measures included self-report of pain persisting for more than 3 months after operation. Pain was characterized by means of the McGill Pain Questionnaire, and quality of life was assessed with the Short Form 36 (SF-36).

Results
A total of 226 patients (64 per cent) completed the questionnaire, 67 (30 per cent) of whom reported chronic pain. Reported pain was predominantly neuropathic in character. Patients at increased risk of chronic pain were under 40 years old (P &lt; 0·001), had day-case surgery (P = 0·004), had subsequent surgery on the same side (P &lt; 0·005) and recalled pain before operation (P = 0·005). The SF-36 scores were significantly different in the social functioning, mental health and pain dimensions in patients with chronic pain.

Conclusion
Chronic pain occurred in 30 per cent of patients after open hernia repair, a higher frequency than has been reported previously. Several risk factors were identified and further prospective research is recommended.
Liver regeneration after major hepatectomy for biliary cancer
Authors: Nagino M , Ando M , Kamiya J , Uesaka K , Sano T , Nimura Y 
Published: March 2003

Abstract

Background
The aim of this study was to evaluate serial changes in liver volume after major hepatectomy for biliary cancer and to elucidate clinical factors influencing liver regeneration.

Methods:
Serial changes in liver volume were determined, using computed tomography, in 81 patients with biliary cancer who underwent right hepatic lobectomy or more extensive liver resection with or without portal vein resection and/or pancreatoduodenectomy. Possible factors influencing liver regeneration were evaluated by univariate and multivariate analyses.

Results
The remnant mean(s.d.) liver volume was 41(8) per cent straight after hepatectomy. This increased rapidly to 59(9) per cent within 2 weeks, then increased more slowly, finally reaching a plateau at 74(12) per cent about 1 year after hepatectomy. The regeneration rate within the first 2 weeks was 16(8) cm3/day and was not related to the extent of posthepatectomy liver dysfunction. On multivariate analysis, the extent of liver resection (P &lt; 0·001), body surface area (P = 0·02), combined portal vein resection (P = 0·024) and preoperative portal vein embolization (P = 0·047) were significantly associated with the liver regeneration rate within the first 2 weeks. In addition, body surface area (P &lt; 0·001) and liver function expressed as plasma clearance rate of indocyanine green (P = 0·01) were significant determinants of final liver volume 1 year after hepatectomy.

Conclusion
The liver regenerates rapidly in the first 2 weeks after major hepatectomy for biliary cancer. This early regeneration is influenced by four clinical factors. Thereafter, liver regeneration progresses slowly and stops when the liver is three-quarters of its original volume, approximately 6 months to 1 year after hepatectomy.