bluuebunny/crossref_metadata_2025_split huggingface dataset:
EUS/IDUS AND ENDOSCOPIC PAPILLECTOMY
Authors: Hirooka Yoshiki , Itoh Akihiro , Goto Hidemi 
Published: October 2004

In our institute, the indication of endoscopic papillectomy is set for adenoma or early cancer without tumor growth in the bile duct or the pancreatic duct. The substantial complete excision rate was 78.8%. One out of 11 incomplete excision cases was removed surgically for tumor persistence, and, as for remaining the 10 cases without persistence had been under serial observations. One case out of the serial observations had local recurrence in 5 years 5 months after papillectomy and surgical resection was performed. Further cases and long‐term serial observations may be required to get evidence of an appropriate indication.In addition, for 60 cases experienced in our institute, the safety of this therapy was reviewed. We experienced bleeding (13.3%), pancreatitis (10%), and cholangitis (3.3%) as early complications, but all cases were successfully treated conservatively. There were no serious conditions as late complications, and endoscopic papillectomy was evaluated as a safe therapy.
ENDOSCOPIC ULTRASOUND STAGING OF PANCREATIC CANCER
Authors: Van Dam Jacques 
Published: October 2004

The pancreatic cancer tumor remains difficult to cure in its advanced form making early diagnosis and accurate staging essential. There is debate regarding the single best diagnostic or staging modality as well as the best approach in imaging patients with pancreatic cancer.Methods:  The recent literature regarding the staging of patients with pancreatic cancer was reviewed. Special attention was directed to comparative trials of imaging modalities that included endoscopic ultrasonography (EUS).Results:  EUS accuracy ranges from 78–94% for pancreatic tumor staging and from 64–82% for nodal staging. EUS remains the most sensitive imaging modality for small pancreatic tumors.Conclusion:  EUS remains the preferred imaging modality in many patients with pancreatic cancer by virtue of its ability to detect even the smallest lesions, determine the presence of vascular involvement, and acquire tissue of primary tumors, lymph nodes and distant metastases. Continued advances in ultrasound imaging and fine needle aspiration techniques will improve the yield of EUS. Interventional applications of EUS in patients with pancreatic tumors will provide an expanding role for EUS in the future.
POSSIBILITY OF THE DEVELOPMENT AND CLINICAL USE OF A CAPSULE ULTRASOUND ENDOSCOPE
Authors: Yasuda Kenjiro 
Published: October 2004

Development of technology has made it possible to produce the micromachine. In the field of endoscopy, wireless capsule endoscopy (CE) has been developed and opened up a new field in endoscopic study. The common indication in clinical cases is limited to the diagnosis of lesions in the deeper small intestine. Clinical application of this system is increasing at a remarkable rate, though target organs and endoscopic performance are limited.On the other hand, endoscopic ultrasound (EUS) technology has advanced rapidly during the last 20 years. The improvement of ultrasound scanners, including the size of the scanner, quality of image and plural changeable frequency has been successfully developed. On the basis of these technological advances, we can discuss the potential ability of developing a capsule ultrasound endoscopy.
Single‐blind follow‐up study on the effectiveness of a symbiotic preparation in irritable bowel syndrome
Authors: TSUCHIYA J , BARRETO R , OKURA R , KAWAKITA S , FESCE E , MAROTTA F 
Published: October 2004

OBJECTIVE:  Experimental and clinical studies have shown that a novel symbiotic (known as SCM‐III) exerts a beneficial effect on gut translocation and local and systemic inflammatory and microbial metabolic parameters. The present investigation was a preliminary trial on the effectiveness of SCM‐III for irritable bowel syndrome (IBS).METHODS:  Sixty‐eight consecutive adult patients with IBS who were free from lactose malabsorption, abdominal surgery, overt psychiatric disorders and ongoing psychotropic drug therapy or ethanol abuse were studied prospectively and divided into 2 groups that were comparable for age, gender, body size, education and pattern of presenting symptoms. The 2 groups were blindly given for 12 weeks either SCM‐III 10 mL t.i.d or the same dosage of heat‐inactivated symbiotic.RESULTS:  Treatment with SCM‐III was ‘effective’ or ‘very effective’ in more than 80% of the patients (P < 0.01 vs baseline values and control). Less than 5% reported ‘not effective’ as the final evaluation compared with over 40% of patients in the control group. After 6 weeks of treatment, a significant improvement of pain and bloating was reported in the treatment group compared with control and baseline values. There was also a benefit for bowel habits, mostly for patients with constipation or alternating bowel habits. No overt clinical or biochemical adverse side‐effects were recorded.CONCLUSION:  Compared with baseline values and the control group, SCM‐III resulted in a significant increase in lactobacilla, eubacteria and bifidobacteria, which suggests that some selected IBS patients could benefit substantially from symbiotics, but the treatment may need to be given on a cyclic schedule because of the temporary modification of the fecal flora.
Clinical significance of functional constipation categorized by colonic transit time and pelvic floor electromyography
Authors: XIONG Guan Ying , ZHAO Zhi Quan 
Published: October 2004

OBJECTIVE:  Functional constipation (FC) is a common gastrointestinal disorder, the incidence of which is increasing each year with the changes in life style and diet, and the age of patients is becoming younger. Correct categorization will guide the treatment of FC and in the present study colonic transit time (CTT) and pelvic floor electromyography (PFE) were evaluated for their clinical significance in categorizing FC.METHODS:  Thirty‐two cases of FC diagnosed by Rome II criteria with a duration of 6 months to 30 years were enrolled. Radio‐opaque markers were used to detect CTT, the transit index (TI) and colonic evacuation rate; PFE was used to observe whether there was any paradoxical movement between the pelvic floor and abdominal muscles.RESULTS:  Colonic transit time was recorded in 32 patients: 20 had outlet obstruction constipation and 12 had slow transit type. In the outlet obstruction type, PFE showed varying degrees of paradoxical movement between the muscles, whereas in the slow transit type, only 4 cases showed it.CONCLUSION:  Functional constipation can be categorized by CTT and PFE, which are simple, painless and feasible to perform.
Mechanism of hepatocytes apoptosis induced by the proapoptosis protein Bid
Authors: BAI Li , CAO Chuan Ping , MAO Gao Ping 
Published: October 2004

OBJECTIVE:  To investigate the mechanism of hepatocyte apoptosis induced by the proapoptosis protein Bid.METHODS:  Mouse primary hepatocytes were isolated from wild‐type and Bid‐deficient mice and treated with tumor necrosis factor‐alpha (TNF‐α) or anti‐Fas antibody to induce cell apoptosis. Immunofluorescence staining of Bax was performed to recognize Bax translocation and its conformational change. The wild‐type mice or wild‐type mice transfected with the adenovirus carried DN‐FADD (Dominant Negative–Fas Associated Death Domain) and the Bid‐deficient mice were injected with anti‐Fas antibody 2 h before being killed. Caspase 3 and 8 activities were measured. Bands of Bid cleavage and Bax conformational change were detected by Western blot.RESULTS:  Death receptors, including TNF‐α and anti‐Fas antibody, induced hepatocytes apoptosis, Bax translocation and conformational change through activation of Bid, which caused Bax to be inserted into the mitochondrial membrane of hepatocytes. The translocation and insertion of Bax were blocked when Bid was knocked out or blocked, and hepatocyte apoptosis was delayed or inhibited.CONCLUSION:  Hepatocyte apoptosis induced by death receptors is regulated by Bid and the translocation and insertion of Bax are also dependent on Bid.
Peutz–Jeghers syndrome: case reports and update on diagnosis and treatment
Authors: DONG Ke , LI Bo 
Published: October 2004

OBJECTIVE:  To analyze the etiology and diagnostic methods of Peutz–Jeghers syndrome (PJS) and thus establish a treatment strategy.METHODS:  Clinical data from six patients with PJS were evaluated from the aspect of familial history, carcinogenesis and recurrence of polyps.RESULTS:  The fathers of four and the mother of one of the six patients had PJS. The grandfather of three of the six patients had PJS. There was a history of cancer in three of the five families. Case 4 underwent two laparotomies for intussusceptions caused by recurrent polyps of the small intestine. Case 5 also had recurrent small intestinal polyps and required a laparotomy after 1 year of initial treatment. Polyps in cases 1 and 4 showed adenomatous changes and those in case 2 were associated with gastric cancer.CONCLUSIONS:  Patients with PJS have a strong family history of cancer and a high incidence of recurrence of small intestinal polyps. Malignant changes of polyps may follow the hamartoma–adenoma–carcinoma sequence. Careful follow‐up is mandatory for gastrointestinal tract symptoms, and other solid organs that are susceptible to malignant change.
Studies on the use of chhana and paneer whey in the preparation of puras (pancakes)
Authors: JINDAL A R , SHOREE M , SHUKLA F C , SINGH B 
Published: October 2004

Puras (pancakes) are widely accepted traditional Indian foods. Studies were conducted on the use of chhana and paneer whey in the preparation of sweet and salty puras. Six samples of chhana and paneer whey were substituted in sweet and salty puras at different whey to water ratios (0 : 100, 20 : 80, 40 : 60, 60 : 40, 80 : 20, 100 : 0). The effects of chhana and paneer whey on sensory evaluation showed that sweet puras containing mixed milk chhana whey and salty puras containing cow's milk chhana whey scored highest with respect to appearance, body and texture, flavour and taste, and overall acceptability. In general, commercial samples scored less, which may be due to poor handling and maintenance of whey by commercial manufacturers. Whey substitutions also improved fat, total solids, protein and ash of both sweet and salty puras. It is interesting to note that none of sweet and salty pura samples was below the limits acceptable to the panellists. It can be thus concluded that chhana and paneer whey can be used successfully in the preparation of puras for value addition.
Biobehavioral Correlates of Relocation in the Frail Elderly: Salivary Cortisol, Affect, and Cognitive Function
Authors: Hodgson Nancy , Freedman Vicki A. , Granger Douglas A. , Erno Amy 
Published: October 2004

Objectives: To examine affect and physiological stress in frail older adults in response to a voluntary nursing home relocation.Design: Randomized, controlled trial.Setting: Long‐term care facility located within the greater Philadelphia, Pennsylvania, community.Participants: Seventy‐seven nursing home residents, aged 65 and over.Intervention: Experimental group residents were relocated to a newly built nursing home facility with a cluster design in the fall of 2001; control group residents were moved after study completion in the spring of 2002.Measurements: Mini‐Mental State Examination scores, Observed Affect Rating Scale scores, salivary cortisol, blood pressure, and pulse obtained 1 week before moving and 1 week and 4 weeks after moving.Results: Relocated nursing home residents demonstrated significant differences in salivary cortisol and mood from a randomly selected group of residents that had not yet moved. Relocation resulted in significantly higher cortisol levels 1 week after the move (P=.005), followed by a significant decline in afternoon cortisol at 4 weeks after the move (P=.03). Moreover, relocated residents had significantly lower depression and anxiety symptoms and pulse rates than residents who had not yet moved.Conclusion: These findings have important implications for planning medical and social services for relocated elderly. Efforts should be made to prepare individuals for the initial stressors associated with relocation, but it also appears that the stress imposed by relocation is time limited and may begin to ease as early as 4 weeks postmove.
Urinary Incontinence and Psychological Distress in Community‐Dwelling Older African Americans and Whites
Authors: Bogner Hillary R. 
Published: October 2004

Objectives: To compare the association between urinary incontinence (UI) and psychological distress in older African Americans and whites.Design: A population‐based longitudinal survey.Setting: Continuing participants in a study of community‐dwelling adults who were initially living in East Baltimore in 1981.Participants: African Americans and whites aged 50 and older at follow‐up interviews performed between 1993 and 1996 for whom complete data were available (n=747).Measurements: Participants were classified as incontinent if any uncontrolled urine loss within the 12 months before the interview was reported. Psychological distress was assessed using the General Health Questionnaire (GHQ).Results: African Americans with UI were more likely to experience psychological distress as measured using the GHQ than were African Americans without UI (unadjusted odds ratio=4.22, 95% confidence interval=1.72–10.39). In multivariate models that controlled for age, sex, education, functional status, cognitive status, and chronic medical conditions, this association remained statistically significant. The association between UI and psychological distress did not achieve statistical significance in whites.Conclusion: The effect of UI on emotional well‐being may be greater for African Americans than for whites.
Patient Relocation in the 6 Months After Hip Fracture: Risk Factors for Fragmented Care
Authors: Boockvar Kenneth S. , Litke Ann , Penrod Joan D. , Halm Ethan A. , Morrison R. Sean , Silberzweig Stacey B. , Magaziner Jay , Koval Kenneth , Siu Albert L. 
Published: October 2004

Objectives: To describe the incidence and patterns of patient relocation after hip fracture, identify factors associated with relocation, and examine effect of relocation on outcomes.Design: Prospective cohort study.Setting: Four hospitals in the New York metropolitan area.Participants: A total of 562 patients hospitalized for hip fracture discharged alive in 1997 to 1998.Measurements: Patient characteristics and hospital course were ascertained using patient or surrogate interview, research nurse assessment, and medical record review. Patient location was ascertained at five time points using patient or surrogate interview, and hospital readmissions were identified using New York state and hospital admission databases. Mobility was measured using patient or surrogate report using the Functional Independence Measure.Results: During 6 months of follow‐up, the mean number of relocations per patient±standard deviation was 3.5±1.5 (range 2–10). Forty‐one percent of relocations were between home and hospital, 36% between rehabilitation or nursing facility and hospital, 17% between rehabilitation or nursing facility and home, and 4% between two rehabilitation/nursing facilities. In a Poisson regression model that controlled for patient characteristics, hospital course, and length of follow‐up, factors associated with relocation (P<.05) were absence of dementia, in‐hospital delirium, one or more new impairments at hospital discharge, hospital discharge other than to home, and not living at home alone prefracture. Relocation was not significantly associated with immobility or mortality at 6 months (odds ratio=1.14, 95% confidence interval=0.97–1.35).Conclusion: Subgroups of patients with elevated risk of relocation after hip fracture may be target groups for intensive care coordination and care planning interventions.
Inflammatory and Thrombotic Blood Markers and Walking‐Related Disability in Men and Women with and Without Peripheral Arterial Disease
Authors: McDermott Mary M. , Guralnik Jack M. , Greenland Philip , Green David , Liu Kiang , Ridker Paul M. , Chan Cheeling , Criqui Michael H. , Ferrucci Luigi , Taylor Lloyd M. , Pearce William H. , Schneider Joseph R. , Oskin Sarah I. 
Published: October 2004

Objectives: To determine whether higher circulating levels of thrombotic and inflammatory markers are associated with greater disability.Design: Cross‐sectional.Setting: Academic medical center.Participants: A total of 346 men and women with peripheral arterial disease (PAD) and 203 without PAD.Measurements: Disability measures were the Walking Impairment Questionnaire (WIQ) distance, speed, and stair‐climbing scores and the 36‐item Short‐Form (SF‐36) physical functioning score. The SF‐36 and WIQ are scored on a 0 to 100 scale (100=best).Results: In persons with PAD, higher D‐dimer levels were associated with lower WIQ speed scores (P<.001), lower stair‐climbing scores (P<.04), and poorer SF‐36 physical functioning scores (P<.01), adjusting for known and potential confounders. In participants without PAD, higher D‐dimer levels were associated with lower WIQ distance scores (P<.03), lower speed scores (P<.05), and poorer SF‐36 physical functioning scores (P<.02). Higher high‐sensitivity C‐reactive protein (hsCRP) levels were associated with lower WIQ distance (P<.02) and speed scores (P<.001) in persons without PAD. Most of these associations were attenuated after additional adjustment for objectively measured functional limitations.Conclusion: Higher circulating D‐dimer and hsCRP levels are associated with greater disability in walking and physical functioning in individuals with and without PAD. Physiological changes that result in walking disability may mediate these associations.
The Coming Epidemic of Obesity in Elderly Americans
Authors: Arterburn David E. , Crane Paul K. , Sullivan Sean D. 
Published: October 2004

Objectives: To estimate the prevalence of obesity in elderly Americans in 2010 and to discuss the health and economic implications of these estimates.Design: Three methods of generating future point‐prevalence estimates using data from consecutive cross‐sectional studies.Setting: All regions of the United States.Participants: Estimates were based on five nationally representative surveys of the adult population of the United States, conducted from 1960 to 2000, and population estimates from the U.S. Census Bureau.Measurements: Changes in obesity (body mass index (BMI) ≥30 kg/m2) and normal weight (BMI <25 kg/m2) prevalence for men and women by 10‐year U.S. birth cohorts were examined. The prevalence of obesity and normal weight in the elderly in 2010 was estimated under three different scenarios of obesity prevalence change.Results: It was estimated that the prevalence of obesity in adults aged 60 and older will increase from 32.0% in 2000 to 37.4% in 2010 (range 33.6–39.6%). The number of obese adults aged 60 and older will increase from 14.6 to 20.9 million (range 18.8–22.2 million). Similarly, it was estimated that the prevalence of normal weight among adults aged 60 and older will decrease from 30.6% in 2000 to 26.7% in 2010 (range 31.0–24.7%).Conclusion: The prevalence of obesity in elderly Americans will likely continue to increase, challenging healthcare delivery and financing systems in the United States.
Inappropriate Medication Use and Health Outcomes in the Elderly
Authors: Fu Alex Z. , Liu Gordon G. , Christensen Dale B. 
Published: October 2004

Inappropriate medication use is a major problem for the elderly. Although increasing attention has been paid to inappropriate prescription medication use, most previous research has been limited to the investigation of prevalence and trends. Few studies provide the empirical evidence for the adverse effect of inappropriate medication use on health outcomes at the national level. This study is the first attempt to assess the relationship between inappropriate prescription use and health status for the elderly in the United States.Based on the 1996 Medical Expenditure Panel Survey, inappropriate medication use in a national representative elderly population was first identified using Beers criteria. A survey type of ordered probit model was then estimated to quantify the effect of inappropriate drug use on patient self‐perceived health status measured using a five‐point scale (poor, fair, good, very good, and excellent). After controlling for a set of possible confounding factors, it was found that individuals using inappropriate medications in Round 1 were more likely than those not using inappropriate medications to report poorer health status in Round 2. Other risk factors for poor health status include a higher number of prescriptions, being black, having low education, and having one or more chronic diseases.This study provides strong evidence of a significant adverse effect of inappropriate medication use on patient health status. These findings lend partial support to the use of Beers criteria in assessing the quality of prescribing and the appropriateness of medication use in the elderly population.
Construction of a Herpes Simplex Virus Type 1 Mutant with Only a Three-Nucleotide Change in the Branchpoint Region of the Latency-Associated Transcript (LAT) and the Stability of Its Two-Kilobase LAT Intron
Authors: Ng Alan K. , Block Timothy M. , Aiamkitsumrit Benjamas , Wang Mengjun , Clementi Emily , Wu Ting-Ting , Taylor John M. , Su Ying-Hsiu 
Published: October 2004

ABSTRACT
Previous studies using a eukaryotic expression system indicated that the unusual stability of the latency-associated transcript (LAT) intron was due to its nonconsensus branchpoint sequence (T.-T Wu, Y.-H. Su, T. M. Block, and J. M. Taylor, Virology, 243:140-149, 1998). The present study investigated the role of the branchpoint sequence in the stability of the intron expressed from the herpes simplex virus type 1 (HSV-1) genome and the role of LAT intron stability in the HSV-1 life cycle. A branchpoint mutant called Sy2 and the corresponding rescued viruses, SyRA and SyRB, were constructed. To preserve the coding sequence of the immediate early gene icp0, which overlaps with the branchpoint region of the 2-kb LAT, a 3-nucleotide mutation into the branchpoint region of the 2-kb LAT was introduced, resulting in a branchpoint that is 85% identical to the consensus intron branchpoint sequence of eukaryotic cells. As anticipated, there was a 90- to 96-fold reduction in 2-kb LAT accumulation following productive infection in tissue culture and latent infection in mice with Sy2, as determined by Northern blot analysis. These results clearly suggest that the accumulation of the 2-kb intron in tissue culture and in vivo is, at least in part, due to the nonconsensus branchpoint sequence of the LAT intron. Interestingly, a failure to accumulate LAT was associated with greater progeny production of Sy2 at a low multiplicity of infection (0.01) in tissue culture, but not in mice. However, the ability of mutant Sy2 to reactivate from trigeminal ganglia (TG) derived from latently infected mice was indistinguishable from that of wild-type virus, as assayed in the mouse TG explant reactivation system.