bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and treatment of autoimmune hepatitis at age 65 and older
Authors: Verslype C. , George C. , Buchel E. , Nevens F. , Van Steenbergen W. , Fevery J. 
Published: March 2005

SummaryAim:  To study features in older patients with autoimmune hepatitis, as this was considered mainly a disease of young females.Methods:  Analysis of 28 patients diagnosed at age ≥65 years compared with 84 younger patients.Results:  The incidence was similar at all age decades. The ratio M:F was 1 : 3 (≥65 years) vs. 1 : 2 (<65 years). Presenting symptoms were not different when compared with younger patients and consisted of general malaise and fatigue (36%), jaundice ± other symptoms (50%), or ascites (11%). Antinuclear antibodies (ANA) ≥ 1/80 were positive in 93%, smooth muscle antibodies (SMA) > 1/40 in 50%, anti‐liver kidney microsomes (anti‐LKM) proved always negative. Histology showed acute necrotizing hepatitis in 19%, severe interphase hepatitis in 15%, chronic hepatitis with plasmo‐lymphocytic infiltrate in 30%, cirrhosis in 29% (with active inflammation in one‐third); biopsy was refused in 11%. The elderly responded very well to low doses of methylprednisolone (≤8 mg) and azathioprine (1 mg/kg). This schedule obviates side‐effects such as infections seen with higher dosages.Conclusion:  Autoimmune hepatitis has to be also looked for in the elderly with acute and chronic hepatitis. The steroid therapy should be individualized but kept at a low dose.
A refined radiation hybrid map of the telomeric region of bovine chromosome 18q25–q26 compared with human chromosome 19q13
Authors: Mömke S. , Kuiper H. , Spötter A. , Drögemüller C. , Distl O. 
Published: March 2005

SummaryGenome‐wide scans have mapped economically important quantitative trait loci (QTL) for mastitis susceptibility in dairy cattle at the telomeric end of bovine chromosome 18 (BTA18). In order to increase the density of markers in this chromosomal region and to improve breakpoint resolution in the human–bovine comparative map, this study describes the chromosomal assignment of seven newly developed gene‐associated markers and five microsatellites and eight previously mapped sequence tagged site markers near these QTL. The orientation of KCNJ14, BAX, CD37, NKG7, LIM2, PRKCG, TNNT1, MGC2705, RPL28, EPN1, ZNF582, ZIM2, STK13, ZNF132 and SLC27A5 on the 3000‐rad radiation hybrid (RH) map of BTA18 is homologous to the organization found on the corresponding 10 Mbp of human chromosome 19q (HSA19q). The resulting bovine RH map with a length of 20.9 cR spans over about 11 cM on the bovine linkage map. The location of KCNJ14 and SLC27A5 flanking the RH map on BTA18q25–26 has been confirmed by fluorescence in situ hybridization. The data of this refined human–bovine comparative map should improve selection of candidate genes for mastitis susceptibility in dairy cattle.
Epidural ropivacaine 1% with and without sufentanil addition for Caesarean section
Authors: Bachmann‐Mennenga B. , Veit G. , Biscoping J. , Steinicke B. , Heesen M. 
Published: March 2005

Background:  So far only ropivacaine concentrations of 0.5 and 0.75% have been used for Caesarean section. This prospective double‐blind trial evaluated the anaesthetic quality of ropivacaine 1% with and without sufentanil addition.Methods:  Three groups of patients (n = 20 each) scheduled for an elective Caesarean section were studied. The patients received initially 120 mg ropivacaine, or 120 mg ropivacaine plus 10 µg or 20 µg sufentanil. Additional epidural ropivacaine was injected if necessary. Primary outcome parameter was time to achieve sensory block at T4. Moreover, pain intensity at delivery (visual analogue scale, VAS), incidence of maternal side‐effects (hypotension, bradycardia, nausea, vomiting, shivering, pruritus), and neonatal outcome (Apgar score, neurologic and adaptive capacity score, umbilical cord blood‐gas values) were recorded.Results:  The onset time for the sensory block was not significantly different among the groups. Also, VAS scores at delivery did not differ significantly between the plain ropivacaine 1% group (18 ± 29 mm), the 10‐µg sufentanil group (1 ± 5 mm), and the 20‐µg sufentanil group (6 ± 18 mm). The total dose of ropivacaine was significantly higher in the plain ropivacaine 1% group (145 ± 19 mg) compared to the patients receiving additional 10 µg sufentanil (130 ± 15 mg, P = 0.02) or 20 µg sufentanil (129 ± 16 mg, P = 0.01). The incidence of maternal side‐effects and neonatal outcome were similar in all groups.Conclusion:  Ropivacaine 1% alone provided sufficient analgesia. Sufentanil addition did not significantly improve the quality of epidural anaesthesia with ropivacaine 1.0% for Caesarean section.
Prevalence of IgE antibodies to morphine. Relation to the high and low incidences of NMBA anaphylaxis in Norway and Sweden, respectively
Authors: Florvaag E. , Johansson S. G. O. , Öman H. , Venemalm L. , Degerbeck F. , Dybendal T. , Lundberg M. 
Published: March 2005

Background:  Anaphylactic reactions to a neuromuscular blocking agent (NMBA) is more than six times as common in Norway as in Sweden, probably due to differences in preoperative sensitization. The prevalence of IgE‐sensitization to morphine (MOR) and suxamethonium (SUX) in comparable populations in Bergen, Norway, and Stockholm, Sweden, was studied and related to possible sensitizing agents.Methods:  Three hundred sera of ‘allergics’ and 500 blood donors in Bergen and Stockholm were tested for IgE antibodies to MOR and SUX using Pharmacia Diagnostics ImmunoCAP®(Uppsala, Sweden) assay and the results compared to those of 65 patients from Bergen with documented anaphylaxis to NMBA. In addition, 84 different household chemicals were tested, by IgE antibody inhibition, for SUX and MOR.Results:  In Norway 0.4% of blood donors, 3.7% of allergics and 38.5% of anaphylactics were IgE‐sensitized to SUX, and 5.0, 10.0 and 66.7%, respectively, to MOR. No serum from Sweden was positive. The majority of those sensitized (69%) were women. Several household chemicals contained SUX and/or MOR activity, but the only difference between Norway and Sweden was cough mixtures containing pholcodine (PHO). IgE antibodies to PHO were present in 6.0% of blood donors from Norway and in no serum from Sweden. Of the anaphylactics, 65–68% were sensitized to MOR or PHO but only 39% to SUX.Conclusions:  IgE‐sensitization to SUX, MOR and PHO was detected in Norway but not in Sweden. One possible explanation is the unrestricted use of cough mixtures containing MOR derivatives in Norway.
Effect of additives in lidocaine spray on postoperative sore throat, hoarseness and dysphagia after total intravenous anaesthesia
Authors: Hara K. , Maruyama K. 
Published: March 2005

Background:  Laryngo‐tracheal lidocaine spray before intubation is associated with an increased risk of postoperative throat problems. Our study investigated the effect of additives contained in lidocaine spray on postoperative sore throat, hoarseness and dysphagia.Methods:  We compared the incidence and severity of postoperative throat complications after laryngo‐tracheal application of lidocaine spray (40 mg), lidocaine (40 mg) or normal saline as placebo during laryngoscopy with total intravenous anaesthesia in 122 ASA I–III patients aged 15–87 years in a double‐blinded, placebo‐controlled study. The incidence and severity of postoperative sore throat, hoarseness and dysphagia were evaluated on the day of and the day after surgery.Results:  Sore throat and dysphagia were significantly more severe after lidocaine spray was used than after lidocaine or placebo was used. However, there was no significant difference in the incidence or severity of postoperative sore throat, hoarseness or dysphagia between the lidocaine group and the placebo group throughout the study.Conclusion:  These results suggest that additives in lidocaine spray, not lidocaine itself, contribute to the increase in postoperative throat problems. Therefore, lidocaine spray should be avoided to prevent these unnecessary complications. Our findings also confirm that laryngo‐tracheal lidocaine application does not prevent sore throat, hoarseness or dysphagia after total intravenous anaesthesia.
Participation in the RACS Sentinel Node Biopsy versus Axillary Clearance Trial
Authors: Wetzig Neil R. , Gill P. Grantley , Ung Owen , Collins John , Kollias James , Gillett David , Gebski Val , Greig Caroline , Ray Adam , Stockler Martin ,   for the RACS SNAC Group
Published: March 2005

Background:  The Royal Australasian College of Surgeons (RACS) SNAC trial is a randomized controlled trial of sentinel node biopsy (SNB) versus axillary clearance (AC). It opened in May 2001 and is recruiting rapidly with good acceptance by consumers.Methods:  A study of eligibility and treatment choices was conducted between November 2001 and September 2002 for women presenting with early breast cancer to 10 centres participating in the trial.Results:  More than half of the 622 women (54%) were ineligible for trial entry because they had large (> 3 cm) or multicentric cancers. Participation was offered to 92% of eligible women and was taken up by 63%. The commonest reason for not participating was the desire to choose treatment rather than have it randomly allocated. Despite this there is a great acceptance of clinical trials because very few women (4% of those eligible) gave ‘lack of interest in clinical trials’ as the reason for non‐participation. Few women who declined trial participation chose to have SNB alone (4.5% of those eligible).Conclusion:  Sentinel node biopsy may become the standard of care for managing small breast cancers, but a significant number of patients will still require or choose axillary dissection. Results from large randomized trials are needed to determine the relative benefits and harms of SNB compared with AC. Surgeons must carefully discuss options for management with their patients.
Spectral doppler characterization of endoleaks following endoluminal abdominal aortic aneurysm repair
Authors: Wright Isabel A. , Gordon Malcolm K. , Buckenham Tim M. 
Published: March 2005

Background:  Colour Doppler ultrasound of endoluminal abdominal aortic aneurysm repair is becoming an established imaging technique in identifying endoleak. Management and treatment of endoleak is determined in part by the exact nature of the endoleak, namely its type and whether it has single or multiple vessel inflow and outflow. To date, spectral Doppler waveform analysis has provided some information about the propensity for spontaneous seal of isolated type II endoleaks, rather than assisting in their classification.Methods:  We present a collection of three case reports outlining the directionality/phasicity of the Doppler waveform profile associated with endoleaks whose type and subtype (uni‐ /or multi‐conduital) were angiographically determined.Results:  In all three cases uniconduital type II endoleak demonstrated a to‐and‐fro waveform on Doppler ultrasound imaging.Conclusions:  To‐and‐fro Doppler waveforms may be associated with uniconduital type II endoleaks. If upon investigation of further cases this is found to be the case, this waveform classification may facilitate determination of the subtype (uni‐ or multi‐conduital) of endoleak, thus identifying those cases which may be more amenable to percutaneous repair.
CT‐guided lung biopsies in children: anesthesia management and complications
Authors: BENDON ANJU ANNE , KRISHNAN B.S. , KORULA GRACE 
Published: March 2005

SummaryWe describe the anesthetic management of three children who underwent CT‐guided lung biopsies and the complications associated with the procedure. We discuss the likely causes and recommend steps that would help decrease the risk of these complications during such a procedure.
Ultrasound‐guided central venous cannulation in a very small preterm neonate
Authors: MACHOTTA ANDREAS , KERNER SABINE , HÖHNE CLAUDIA , KERNER THORALF 
Published: March 2005

SummaryPercutaneous central venous cannulation of small infants is a challenging procedure. The use of ultrasound guidance has been shown to increase the success rate generally in children and to decrease the incidence of associated complications. To demonstrate that this technique is also suitable in very small infants we describe the case of a preterm neonate of 850 g body weight (BW), in which percutaneous central venous cannulation was performed successfully using ultrasound imaging for guidance.
A case of supercarbia following pneumoperitoneum in an infant
Authors: LEW Y.S. , THAMBI DORAI C.R. , PHYU P.T. 
Published: March 2005

SummaryA 4‐month‐old healthy male infant underwent left herniotomy under general anesthesia with caudal block. Carbon dioxide (CO2) pneumoperitoneum was created through the left hernial sac for inspection of the right processus vaginalis. Episodes of desaturation associated with significant reduction in chest compliance were noted intraoperatively. This was overcome by increasing the inspired oxygen concentration (FiO2). The infant failed to regain consciousness and spontaneous respiration at the end of surgery. The chest compliance deteriorated further and clinically a CO2 pneumothorax (capnothorax) was suspected. The endtidal carbon dioxide (PEco2) was initially low in the immediate postoperative period. Subsequent to the readministration of sevoflurane and manual ventilation with a Jackson Rees circuit, a sudden surge in PEco2 with improvement of chest compliance was observed. At that time arterial blood gas (ABG) analysis revealed a PCO2 of 17.5 kPa (134 mmHg) and pH of 6.9. The causes of severe hypercarbia and the physiological changes observed in this infant are discussed.
Reduced prevalence of ischemic events and abnormal supraortic flow patterns in patients with liver cirrhosis
Authors: Berzigotti Annalisa , Bonfiglioli Andrea , Muscari Antonio , Bianchi Giampaolo , LiBassi Silvia , Bernardi Mauro , Zoli Marco 
Published: March 2005

Abstract:Background: A reduced prevalence of cardiovascular diseases has been reported in liver cirrhosis. However, studies focusing on supraortic district of cirrhotic patients are lacking.Methods: By ultrasound duplex scanning, the presence and severity of atherosclerotic plaques and flow pattern abnormalities were assessed in carotid and vertebral arteries of 118 cirrhotics aged 60.7±12.8 (1 standard deviation) years, and in 236 controls matched with cirrhotic patients according to age, sex and cigarette smoking.Results: Previous ischemic strokes were significantly less numerous in cirrhotic patients than in controls (0.8% vs. 10.5%; P=0.0009); also the prevalence of myocardial infarction was significantly reduced (1.7% vs. 6.4%; P=0.0532). Moreover, cirrhotic patients differed from controls for a lower prevalence of hypertension and hypercholesterolemia, and for a greater proportion of diabetics. Although the presence and severity of atherosclerotic plaques was similar in the two groups, liver cirrhosis was associated with a lower prevalence of abnormal flow patterns (13.6% vs. 29.2%; P=0.0011). The inverse association of hemodynamic changes with liver cirrhosis persisted after all main risk factors were simultaneously taken into account by multiple logistic regression. However, in the presence of hypertension, hypercholesterolemia and cigarette smoking, the ‘protective’ effect of cirrhosis on the occurrence of abnormal flow patterns was no longer detectable.Conclusions: Advanced liver disease is associated with a reduced prevalence of ischemic stroke, which seems to be related to a decreased prevalence of abnormal flow patterns in the supraortic vessels, especially among non‐smokers.
Physical hemodynamic interaction between portal venous and hepatic arterial blood flow in humans
Authors: Sugimoto Hiroyuki , Kaneko Tetsuya , Hirota Masashi , Inoue Soichiro , Takeda Shin , Nakao Akimasa 
Published: March 2005

Abstract:Objective: The hepatic arterial end‐diastolic velocity (HAEDV) is normally equal to portal vein peak velocity (PVPV). However, there is no report of quantitative measurement that HAEDV was equal to PVPV. We investigated the interaction in PVPV and HAEDV in both chronic and acute hepatic hemodynamic changes.Methods: One hundred and nineteen patients (54 with cirrhosis, 23 with chronic hepatitis, and 42 with no diffuse liver disorder) were enrolled. We investigated the differences in PVPV and HAEDV among the patients with and without liver disorder. In addition, we measured the intraindividual changes in HAEDV when PVPV was mechanically changed by percutaneous isolated hepatic perfusion in six patients and by percutaneous transhepatic portal embolization (PTPE) in six more.Results: HAEDV was nearly equal to PVPV not only in patients with both normal and hepatitis but also in those with cirrhosis (PVPV−HAEDV=3.0±5.2, 2.2±5.4, 2.3±6.5 cm/s, respectively). In the intraindividual study, both PVPV and HAEDV decreased during hepatic mechanical perfusion and HAEDV was equal to PVPV (8.2±2.8, 10.5±1.5 cm/s, respectively). After PTPE, PVPV was increased and hepatic arterial peak systolic velocity was reciprocally decreased. However, HAEDV was nearly equal to PVPV 7 days after PTPE (PVPV−HAEDV=5.9±5.1 cm/s).Conclusions: Since arterial end‐diastolic velocity depends on the downstream vascular resistance, lower HAEDV in patients with cirrhosis was considered to reflect a high outflow resistance. If there is no collateral pathway, we consider that HAEDV may actually reflect sinusoidal resistance to the same degree as PVPV.
SEN virus infection influences the pathological findings in liver but does not affect the incidence of hepatocellular carcinoma in patients with chronic hepatitis C and liver cirrhosis
Authors: Moriyama Mitsuhiko , Mikuni Morio , Matsumura Hiroshi , Nakamura Hitomi , Oshiro Shyu , Aoki Hiroshi , Shimizu Toshihiro , Yamagami Hiroaki , Shioda Atsuo , Kaneko Miki , Tanaka Naohide , Arakawa Yasuyuki 
Published: March 2005

Abstract:Background/Aims: This investigation compared the histological findings in the livers of chronic hepatitis C patients who were or were not co‐infected with SEN virus (SEN‐V) to determine the histological and clinical characteristics of SEN‐V infection in Japan.Methods: Three hundred and ninety‐two patients with hepatitis C virus‐associated chronic hepatitis (CH) or liver cirrhosis (LC) were included in the study. Serum samples were tested for the presence of SEN‐V DNA by nested polymerase chain reaction. The liver biopsy specimen of each patient was examined and scores were assigned to indicate the severity of each of the following features: inflammatory cell infiltration in the periportal, parenchymal, and portal areas; F stage; portal sclerotic change; perivenular fibrosis; pericellular fibrosis; damage to the bile ducts; steatosis and irregular regeneration of hepatocytes (IR).Results: Of the 473 patients, 194 (41.0%) were positive for SEN‐V DNA. The rate of progression of F stage correlated with SEN‐V DNA positivity. The blood biochemical parameters did not differ significantly between the SEN‐V DNA‐positive and ‐negative patients. The histological features of the livers of SEN‐V DNA‐positive patients included more severe parenchymal inflammatory cell infiltration and more IR. In particular, among those at the F2, F3 and F4 stages, the degree of IR of the SEN‐V DNA‐positive patients was significantly greater than that of the SEN‐V DNA‐negative patients. The cumulative probability of hepatocellular carcinoma (HCC) incidence and survival rate did not differ between the SEN‐V DNA‐positive and‐negative patients.Conclusions: SEN‐V co‐infection may influence the histopathological features of the livers of patients with type C CH and LC but does not affect the outcome of patients with type C chronic liver disease.
Instant diagnosis of spontaneous bacterial peritonitis using leukocyte esterase reagent strips: Nephur‐Test® vs. MultistixSG®
Authors: Sapey Thierry , Kabissa Denis , Fort Eric , Laurin Christine , Mendler Michel Henry 
Published: March 2005

Abstract:Background/Aim: Spontaneous bacterial peritonitis (SBP), defined by an ascites neutrophil count >250/μl, is a severe complication of cirrhosis and demands prompt diagnosis. Leukocyte esterase reagent strips can rapidly detect leukocytes in physiological fluids. We compared the performance of two leukocyte esterase reagent strips in the diagnosis of SBP.Methods: Non‐selected patients with cirrhosis and ascites were prospectively included in a Community Hospital. Manual ascites cytology, culture and biochemistry were compared with the Nephur‐Test® (read at 60 s: negative+1 to+3) and MultistixSG® (read at 120 s: negative, trace, +1 to +3). Multiple investigators performed the tests with repeat readings by one nurse.Results: Two hundred and forty five ascites fluid samples were obtained in 51 patients: 44% in conditions of SBP antibiotic prophylaxis, 64% in an ambulatory setting. Seventeen samples had an ascites polymorphonuclear count of ≥250/μl, associated with a positive ascites culture in seven, obtained in 12 patients (24%), 53% in an ambulatory setting. Sensitivity, specificity, and positive and negative predictive values were: Nephur‐Test® (88.2%, 99.6%, 93.8%, 99.1%); MultistixSG® (64.7%, 99.6%, 91.7%, 97.4%). There was excellent agreement between the investigators and the nurse.Conclusions: Leukocyte esterase reagent strips may provide a rapid bedside diagnosis of SBP and thereby shorten time to appropriate management. The Nephur‐Test® appeared to out‐perform MultistixSG®. These tests might be particularly useful in ambulatory settings or whenever ascites fluid analysis is not rapidly available.
Effects of ammonium hydroxide treatment on the in vitro dry matter digestibility and gas production of wheat straw, sugarcane bagasse medium and konara oak rotted by edible basidiomycetes
Authors: OKANO Kanji , BOONLUE Surachai , SUZUKI Yuichi 
Published: March 2005

ABSTRACTWheat straw, sugarcane bagasse medium and konara oak logs used to cultivate edible basidiomycetes were treated with ammonium hydroxide to investigate the relationship between the degree of rotting and the effect of ammonium hydroxide treatment on digestibility. Wheat straw was sampled before inoculation and on days 67 and 97 after inoculation with Pleurotus salmoneostramineus. Similarly, bagasse media were sampled before inoculation and on days 47 and 96 after inoculation with Pleurotus abalonus. Konara oak logs were sampled before inoculation and at 2 and 4 years after inoculation with Lentinula edodes. Aliquots of the samples were treated with ammonium hydroxide (NH4‐N, 3% dry matter) at 45°C for 10 days. Ammonium hydroxide treatment increased the in vitro dry matter digestibility (IVDMD) and gas production (IVGP) of all the samples, except the konara oak samples collected before inoculation. The degree of increased digestibility was largest for the samples collected after short cultivation periods, followed by those collected after long cultivation periods and those collected before inoculation. However, the IVDMD and IVGP values after short cultivation periods were lower than those after long cultivation periods. Ammonium hydroxide treatment is effective at improving the digestibility of white‐rotted materials, although the effect is lessened as rotting proceeds.