bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunohistochemical Studies on Oestrogen Receptor Alpha (ERα) and the Proliferative Marker Ki‐67 in the Sow Uterus at Different Stages of the Oestrous Cycle
Authors: Sukjumlong S , Kaeoket K , Dalin A‐M , Persson E 
Published: March 2003

ContentsIn order to better understand physiological changes during the different stages of the oestrous cycle, immunohistochemistry was used in the present study to investigate the distribution of oestrogen receptor alpha (ERα) as well as the proliferative marker Ki‐67, in the sow uterus during the oestrous cycle. Uterine samples were collected from multiparous sows with normal reproductive performance at selected stages of the oestrous cycle: at late dioestrus (d 17), prooestrus (d 19), oestrous (d 1), early dioestrus (d 4) and dioestrus (d 11–12), respectively. The tissue samples were fixed in 10% formaldehyde, embedded in paraffin and subjected to immunohistochemistry using monoclonal antibodies against ERα (C‐311) and Ki‐67 (MM‐1).In general, the immunostaining of both ERα and Ki‐67 was confined to nuclei of the target cells. Variations were seen, not only at the different stages of the oestrous cycle, but also in the different tissue compartments of the uterus. In the epithelia, the strongest ERα staining and highest amount of positive Ki‐67 cells were found at early dioestrus. In the myometrium, the highest levels of staining of both ERα and Ki‐67 positive cells were found at pro‐oestrus and oestrus. For the proliferative marker, Ki‐67, no positive cells were found at dioestrus and late dioestrus in the epithelium and myometrium. In the connective tissue stroma (subepithelial layer), the highest number of ERα positive cells were found at oestrus, which was significantly different compared with other stages (p≤0.05), whereas the levels of Ki‐67 positive cells were relatively low and did not differ between the stages examined. Significant correlations between the number of ERα positive cells in the stroma and Ki‐67 positive cells in the epithelia were observed. This suggests indirect regulatory mechanisms on epithelial proliferation via ERα in the stroma.In conclusion, these findings in the sow uterus show that the presence of ERα as well as Ki‐67 protein varies not only between different stages of the oestrous cycle but also between different tissue compartments of the uterus. These findings indicate various regulatory mechanisms and stress the importance of localising ERα and proliferating cells in different uterine tissues.
Psychiatric and social outcomes of a rural district general hospital in the 1990s
Authors: Habibis Daphne , Schneider Rosemary , Hazelton Michael , Bowling Alison , Davidson John 
Published: March 2003

ABSTRACT: This study investigates the psychiatric and social outcomes of treatment by the psychiatric unit of a district general hospital in a semirural region of Australia. The study is a naturalistic investigation of a routine clinical service, and utilizes a longitudinal panel design. Repeat interviews at admission, 1 month and 1 year later were conducted with all consenting respondents (n = 57) with a diagnosis of schizophrenia, bipolar disorder or related condition, as well as with their nominated relatives. Patients showed significant improvements on clinical measures (P < 0.001) and a high rate of continuation of medication. Most measures of social functioning showed improvement although few were statistically significant. Patient and relative satisfaction was high. Relative worry showed significant improvement in the first month (P < 0.05). There was a high rate of readmission (31 patients) and mean days in hospital were also high at 43 days. These results suggest that basic district general hospital care, operating under both budgetary restrictions and the difficulties associated with recruiting staff can nonetheless provide a credible service. However, the results fall short of what research tells us can be achieved when services are adequately funded and more specifically targeted to meet patient needs.
Ethical practice guidelines: an evaluation
Authors: Cleary Michelle , Jordan Raighne , Horsfall Jan 
Published: March 2003

ABSTRACT: Ethical practice guidelines (EPGs) were developed for use in Central Sydney Area Mental Health Service to guide contemporary mental health nursing practice and serve as a resource for clinical mental health nurses in relation to their professional conduct and practice. This survey of mental health nurses aimed to ascertain feedback on the application of the EPGs in the clinical arena. Nurses from the Central Sydney Area Mental Health Service (n = 350) were asked to complete a 15‐item survey developed by the authors. A total of 121 nurses completed the survey. Findings from the survey reveal that the information provided in the EPGs is useful (91%) and the EPGs provide sufficient guidance for practice (94%). Most respondents (96%) reported feeling confident dealing with ethical practice situations and 75% indicated interest in further education and training in this domain. Findings from this survey support the need to explore avenues to facilitate education, discussion and reflective practice in relation to ethical mental health nursing practice.
The role of the community mental health nurse in the administration of depot neuroleptic medication: ‘Not just the needle nurse!’
Authors: Muir‐Cochrane Eimear Caitlin 
Published: March 2003

The role of the community mental health nurse in the administration of depot neuroleptic medication: ‘Not just the needle nurse!’ An ethnographic study explored the nature of community mental health nurses’ involvement with clients during appointments for the administration of depot neuroleptic medication. Little has been written about this aspect of community mental health nursing practice. Findings illustrate how community mental health nurses attempt to engage clients in meaningful interactions when they attend appointments for their injections. Promoting an atmosphere of normalcy and minimising the distress of having neuroleptic medication by injection were key elements in approaches employed by nurses in this study. Results support current discussions in nursing literature concerned with the need for community mental health nurses to have well‐developed interpersonal skills to enable them to capitalise therapeutically from the depot injection encounter.
Caring as the ontological and epistemological foundations of nursing: A view of caring from the perspectives of Australian nurses
Authors: Cheung Jenny 
Published: March 2003

Caring as the ontological and epistemological foundations of nursing: A view of caring from the perspectives of Australian nurses In a study using unstructured interviews to explore nurses’ understanding and interpretations of caring in nursing, one of the major themes emerging from the data is that through caring for patients, nurses discover the meaning and nature of nursing and what it means for them to be nurses. In the process of caring for patients, nurses further develop and understand the knowledge and skill of caring which constitutes the knowledge base of nursing. The data also show that nurses, in their practice, continue to define, develop and shape the meaning and knowledge of caring in nursing. From the evidence of this study, this paper argues that caring can be considered as the ontological and epistemological foundations of nursing.
Epidemiology and prophylaxis of viral hepatitis:A global perspective
Authors: POOVORAWAN YONG , CHATCHATEE PANTIPA , CHONGSRISAWAT VORANUSH 
Published: March 2003

AbstractBackgroundViral hepatitis with various forms of acute and chronic liver disease as potential and ultimately fatal sequelae presents a public health problem worldwide.MethodsRecent published reports on the global epidemiology and prophylaxis of viral hepatitis were reviewed.ResultsWith the advances in novel technologies, eight distinct types of hepatitis virus have been described: Hepatitis A, B, C, D, E, G, TT and SEN viruses. Hepatitis A and E viruses are transmitted by the fecal‐oral route and do not induce a chronic carrier state. Due to major changes in epidemiology of hepatitis A virus their significance is more pronounced in areas of intermediate endemicity. Since the available hepatitis A vaccine is rather expensive, cost‐benefit studies should be performed with emphasis on the area under consideration or specialized vulnerable groups. Parenterally transmitted hepatitis B and C viruses are major causes of chronic liver disease, including cirrhosis, hepatocellular carcinoma and end‐stage liver failure. Hepatitis D virus is unable to replicate on its own, it requires an established hepatitis B virus infection to be able to replicate. Since its introduction, hepatitis B vaccine has been widely used leading to a significant decrease in HBV infection in countries with universal vaccination. Hepatitis G and TT viruses have been characterized within the latter part of the past decade but their significance as to the causation of human liver disease has yet to be elucidated. Likewise, the precise impact of the most recently described SEN virus isolated from patients with post‐transfusion hepatitis awaits further studies.ConclusionsIn the course of this review, we present the situation and focus on research activities emphasizing epidemiology and prevention of the various forms of viral hepatitis.
Management of YMDD mutations during lamivudine therapy in patients with chronic hepatitis B
Authors: LIAW YUN‐FAN 
Published: March 2003

Abstract  Lamivudine is a nuleoside analog with potent inhibitory effects on hepatitis B virus (HBV) replication. Prolonged therapy is required for sustained suppression. However, HBV species with mutations in the tyrosine‐methionine‐aspartate‐aspartate (YMDD) locus of the HBV‐RNA‐dependent DNA polymerase confering resistance to lamivudine may emerge after 6–9 months therapy with an incidence of 38% and 67% after 2 and 4 years of lamivudine therapy, respectively. During continued lamivudine therapy, patients with YMDD mutant HBV usually show serum alanine aminotransferase (ALT) and HBV‐DNA elevations at lower median levels than their baseline. Marked flare of serum ALT or acute exacerbation may occurred as the results of cytotoxic T lymphocyte mediated immune response directed against YMDD mutant. Although viral clearance with or without emergence of distinct lamivudine resistant mutants may occur after such exacerbations, 20% of the exacerbations are complicated with decompensation or even fatality. The exacerbations appear to be more severe than those occur during the natural course of wild type HBV chronic infection. The current practice of continuing lamivudine therapy, therefore, requires careful evaluation. Alternatives include interferon therapy but this seems ineffective. Adefovir dipivoxil and entecavir may effectively suppress the YMDD mutant but these treatments have not yet been available for use. Recent studies have shown no benefit to continuing lamivudine therapy in patients with YMDD mutantions. Before a rescue drug becomes available, the most cost‐effective strategy is to select patients with stronger endogenous anti‐HBV immunity to increase efficacy and to shorten the duration of lamivudine therapy to avoid the emergence of YMDD mutations.© 2002 Blackwell Publishing Asia Pty Ltd
Evidence‐based medicine in the treatment of hepatocellular carcinoma
Authors: LLOVET JOSEP M 
Published: March 2003

Abstract The incidence of hepatocellular carcinoma is increasing worldwide. Diagnosis at early stage is crucial to allow the application of curative treatments, that are the sole hope to increase their life expectancy. Surgical resection and liver transplantation are considered the first line options for early tumors, although there is no agreement on which is the best treatment approach. Resection achieves excellent results in patients with single tumors, absence of portal hypertension and normal bilirubin, but is limited by the high recurrence rate. Liver transplantation also achieves excellent results in patients with single tumors smaller than 5 cm or even three nodules smaller than 3 cm. However, this procedure is hampered by the shortage of donors and the increasing waiting times that have reduced their intention‐to‐treat outcomes. Treatment while waiting for a donor is controversial, but radical antitumoral therapies seem cost‐effective in long waiting times. Percutaneous therapies are reserved for patients with single non‐surgical tumors. More than 60 randomized clinical trials have been published to assess treatments for patients with advanced tumors, but there is no definitive evidence of survival benefits. A recent randomized trial reported that chemoembolization may benefit HCC patients in terms of survival, but additional studies to confirm this data are recommended.© 2002 Blackwell Publishing Asia Pty Ltd
Molecular characterization of hepatitis B virus surface antigen mutants in Singapore patients with hepatocellular carcinoma and hepatitis B virus carriers negative for HBsAg but positive for anti‐HBs and anti‐HBc
Authors: OON *CHONG JIN , CHEN WEI NING , GOH KEE TAI , MESENAS STEVEN , NG HAN SEONG , CHIANG GILBERT , TAN CLARENCE , KOH SHIUAN , TENG SIAW WEI , TOH IVY , MOH MEI CHUNG , GOO KIAN SIM , TAN KAELING , LEONG AI LIN , TAN GEK SAN 
Published: March 2003

Abstract
Background

and Aims
: Mutations on the a‐determinant of hepatitis B virus surface antigen (HBsAg), capable of escaping detection and vaccination, are identified in HBsAg‐positive/anti‐HBs‐positive vaccinated infants. We studied the prevalence of these mutants in HBsAg‐negative/anti‐HBc‐positive chronic HBV carriers and patients with hepatocellular carcinoma (HCC).
Methods
: DNA sequence coding for the antigenic a‐determinant of HBsAg was amplified from either HCC genomic DNA or serum samples of the selected patients and sequenced. The replicative mutant genomes were reconstituted in vitro and their reactivity to commercial kits measured.
Results
: Mutations within and/or outside the a‐determinant were identified in patients seronegative for HBsAg. They were then reconstituted in vitro and transiently transfected into HepG2 cells. Culture medium containing secreted HBV viral particles was collected and assayed for their binding to commercial kits. Drastic decrease of reactivity to these kits was seen with most of the identified mutations, including those located outside the a‐determinant.
Conclusion
: The existence of a more complex antigenic structure of HBsAg is indicated by the decreased reactivity to detection of mutations, some of which are outside the a‐determinant, escape vaccination and may persist in seronegative patients. The high proportion of HBsAg mutants that are integrated in HCC genomes suggests a role of these mutants in hepatocarcinogenesis, possibly leading to mutant HBV‐related HCC.© 2002 Blackwell Publishing Asia Pty Ltd
CASE REPORT: Reactive lymphoid hyperplasia of liver coexisting with chronic thyroiditis: Radiographical characteristics of the disorder
Authors: Nagano Kenichi , Fukuda Yoshihide , Nakano Isao , Katano Yoshiaki , Toyoda Hidenori , Nonami Toshiaki , Nagasaka Tetsurou , Hayakawa Tetsuo 
Published: March 2003

Background: Reactive lymphoid hyperplasia of the liver is an extremely rare entity, with six cases reported so far. Methods: We encountered a 47‐year‐old Japanese female with reactive lymphoid hyperplasia of the liver, which coexisted with chronic thyroiditis. The lesion was discovered incidentally as a hypo‐echoic mass with a hyper‐echoic rim at a routine ultrasonography examination. It increased from 12 to 17 mm diameter in 6 months. Radiological studies, such as contrast‐enhanced computerized tomography (CT) and angiography demonstrated a hypervascular lesion. Results: It was consequently diagnosed as a neoplasm with malignant potentiality and she underwent partial hepatectomy. The lesion was composed of small mature lymphocytes which formed prominent lymphoid follicles with germinal centres, scattered plasma cells and stromal fibrosis. Immunohistochemical study revealed polyclonal origins of the involved lymphocytes. DNA analysis for the immunoglobulin heavy gene and the T cell receptor beta gene using Southern blot hybridization showed no monoclonality. The following features have characterized the images in past cases, as well as ours: hypo‐echoic mass, occasionally with a rim, in ultrasonography and hypervascularity, shown by angiography and enhanced CT.
Differential Helicobacter pylori infection rates in two contrasting gastric cancer risk regions of South China
Authors: Wong BCY , Lam SK , Ching CK , Hu WHC , Kwok E , Ho J , Yuen ST , Gao Z , Chen JS , Lai KC , Ong LY , Chen BW , Wang WH , Jiang XW , Hou XH , Lu JY ,   THE CHINA GASTRIC CANCER STUDY GROUP
Published: March 2003

Background: Carriers of Helicobacter pylori are believed to have a three‐ to six‐fold increased risk of developing gastric cancer. We have recently conducted a simultaneous cross‐sectional population study on the prevalence of H. pylori infection in a cohort of asymptomatic adult volunteers in two contrasting gastric cancer risk regions of South China, Hong Kong and Changle of Fujian. Their mean annual gastric cancer mortality has been approximately 7.5 and 75/100 000 population, respectively, since the beginning of the last decade. The aim of this study was to evaluate if H. pylori prevalence bears any relationship to gastric cancer mortality rates in these two southern regions of China. Methods: Sera were obtained from 397 volunteers in Hong Kong. They were tested for anti‐H.pylori immunoglobulin (Ig) G antibody by using a commercial enzyme‐linked immunosorbent assay (ELISA) kit. Volunteers of Changle (1456) had upper endoscopy examination and were also tested for anti‐H. pylori IgG antibody by the same ELISA method. Results: The overall H. pylori infection prevalence was significantly higher in Changle (80.4%) than in Hong Kong (58.4%; P < 0.01). The high prevalence is associated with more atrophic gastritis. The overall risk of gastric cancer in people of Changle is approximately five‐fold that of Hong Kong (adjusted odds ratio 4.9, 95% CI 2.5–9.8). Conclusions: It is concluded that the prevalence of H. pylori infection rates bear a direct relationship to gastric cancer mortality rates in these two southern regions of China. Thus, H. pylori most likely plays a significant aetiopathogenetic role in gastric carcinogenesis in subjects living in Changle.
Analysis of adhesion molecules in patients with idiopathic portal hypertension
Authors: Yamaguchi Naoko , Tokushige Katsutoshi , Haruta Ikuko , Yamauchi Katsumi , Hayashi Naoaki 
Published: March 2003

Background: The aetiology of idiopathic portal hypertension (IPH) is unknown. However, some evidence of immunological abnormalities in IPH patients has been reported. Methods: As adhesion molecules are important in the interaction between lymphocytes and accessory and target cells, the expression and release of the soluble form of vascular cell adhesion molecule‐1 (VCAM‐1) and intercellular adhesion molecule (ICAM‐1) were examined in this study. Results: In IPH patients, the serum level of soluble VCAM‐1 was found to be increased, compared with that of healthy subjects, fatty liver patients and chronic hepatitis patients. The level of soluble ICAM‐1 of IPH patients was found to be slightly increased, compared with that of healthy subjects; however, it was not different from the level in patients with other diseases. The expression of VCAM‐1 was observed in the sinusoidal lining cells and endothelial cells around the liver vessels of several IPH patients. In contrast, ICAM‐1 was weakly expressed in sinusoidal lining cells and hepatocytes in the liver tissue of only one of four IPH patients. Conclusions: This differential pattern of VCAM‐1 and ICAM‐1 was found in IPH patients and it was suggested that VCAM‐1 might be an important molecule in the occurrence of IPH.
A sclerosant with astringent properties developed in China for oesophageal varices: Comparison with ethanolamine oleate and polidocanol
Authors: Nishida Ryuichi , Inoue Ryoichi , Takimoto Yukinobu , Kita Toru 
Published: March 2003

Background: Xiao zhi ling (XZL), which consists of Chinese nutgalls and aluminium potassium sulphate, is used as a local injection for the treatment of internal haemorrhoids in China. It is also used for endoscopic sclerotherapy of oesophageal varices. To date, however, it has not been compared with other sclerosants with regard to its safety and efficacy. Methods: In the present study, the effect on the endothelium and the haemolytic and thrombosing effects of XZL were compared with those of 5% ethanolamine oleate and 1% polidocanol, using an endothelial cell line and red blood cells taken from rats and the dorsal marginal ear vein of rabbits. In addition, XZL was injected into the area surrounding varices in rats and its efficacy was studied endoscopically and histologically. Results: Xiao zhi ling reduced the size of varices in rats after causing severe damage in the injected region. Compared with the other two sclerosants, however, XZL had little effect on the endothelium and was the least haemolytic compound. Furthermore, XZL did not cause thrombosis in the injected vein of a rabbit. Conclusions: These results suggest that XZL is another type of sclerosant with astringent rather than detergent properties. This compound should be used to treat oesophageal varices by paravariceal injection in smaller doses than 5% ethanolamine oleate and 1% polidocanol.
Relationship between asthma and gastro‐oesophageal reflux: Significance of endoscopic grade of reflux oesophagitis in adult asthmatics
Authors: Nakase Hiroshi , Itani Toshinao , Mimura Jun , Kawasaki Toshihiko , Komori Hideshi , Tomioka Hiromi , Chiba Tsutomu 
Published: March 2003

Background: The association between asthma and gastro‐oesophageal reflux disease (GERD) is well known. The aim of this study was to elucidate the causal relationship between reflux oesophagitis (RE) and asthma. Methods: Seventy‐two adult asthmatics were examined regarding their GERD symptoms, and each underwent an endoscopic examination. According to the Los Angeles classification, we divided the patients into three groups: group 1 (n = 52), no mucosal break; group 2 (n = 15), RE corresponding to grades A or B; group 3 (n = 5), RE corresponding to grades C or D. The asthmatics in groups 2 and 3 received anti‐reflux treatment for their GERD for 8 weeks. Their morning and evening peak expiratory flow rates (PEFR), daily variability of the PEFR and daily use of an inhalation bronchodilator were compared before and after this treatment. Results: The percentage of severe asthma and postprandial exacerbation of asthma in group 3 were significantly higher than those in the other two groups. In contrast, the number of eosinophiles and the serum level of immunoglobulin E in group 3 were significantly lower than those in the other two groups. After the antireflux treatment, significant improvements of both PEFR and daily use of the inhalation bronchodilator were observed only in group 3. Conclusions: The endoscopic severity of RE is associated with the characteristics of adult asthmatics and the treatment of severe RE improved the asthmatics’ condition.