bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathologic manifestations of early‐onset endometrial cancer in Japanese women with a familial predisposition to cancer
Authors: Yamagami Wataru , Susumu Nobuyuki , Banno Kouji , Hirao Takeshi , Kataoka Fumio , Hirasawa Akira , Suzuki Nao , Aoki Daisuke , Nozawa Shiro 
Published: September 2005

AbstractAim: The number of patients under 40 years of age with early‐onset endometrial cancer is on the rise in Japan. Preservation of fertility in younger patients is a critical issue. In order to examine the clinical and pathological characteristics of these patients, cases of early‐onset endometrial cancer at a single hospital were analyzed.Methods: Seventy‐four patients were diagnosed with endometrial cancer before age 40 and included in this study after obtaining informed consent.Results: The clinical characteristics included a significantly higher prevalence of complications such as nulligravidity and nulliparity (P < 0.001). Pathologically, well‐differentiated endometrial carcinoma was significantly more frequent (P = 0.011). The 5‐year survival rate was high (98.7%). In regards to the relationship between clinicopathological features and grade of differentiation, the prevalence of G2 and G3 carcinoma was not significantly lower (P = 0.24) in patients with obesity. Although the frequency of G2 and G3 carcinoma was significantly higher in patients with a family history of cancer (P = 0.02), their 5‐year survival rate was not significantly lower (100%).Conclusion: This study found that these two types of early‐onset endometrial cancer are clinicopathologically different. In patients with a family history of cancer, their body mass index was lower, and the frequency of G2 and G3 carcinoma was significantly higher, but their 5‐year disease‐free survival rate was not significantly lower.
Diagnostic evaluation of Karman endometrial aspiration in patients with abnormal uterine bleeding
Authors: Tansathit Thitinan , Chichareon Saibua , Tocharoenvanich Sathana , Dechsukhum Chavaboon 
Published: September 2005

AbstractAim: To assess sensitivity and specificity of Karman aspiration in the diagnosis of abnormal endometrium compared with the final diagnosis and evaluate tissue adequacy obtained by Karman aspiration.Methods: The study group were women who presented with abnormal uterine bleeding to Songklanagarind Hospital between August 2003 and July 2004 and who underwent Karman aspiration prior to conventional curettage. The final diagnosis was defined as the most severe histopathology from either Karman aspiration or conventional curettage. Abnormal endometrium included inflammation, polyp, hyperplasia and malignant changes.Results: Two hundred and twenty‐six women were assessed. Endometrial aspiration showed a sensitivity of 89.6% and specificity 100.0% in diagnosis of abnormal endometrium. Abnormal endometrium was detected in 58 women. Of 11 women diagnosed with endometrial cancer, only one case was undetected by Karman aspiration due to a failure to create negative pressure in the uterus. Endometrial aspiration yielded adequate tissue in 86.7%.Conclusion: Karman endometrial aspiration is an accurate and easy procedure, and should be considered in the initial evaluation of abnormal uterine bleeding.
Cohesive‐zone modelling of the deformation and fracture of spot‐welded joints
Authors: CAVALLI M. N. , THOULESS M. D. , YANG Q. D. 
Published: September 2005

ABSTRACTThe deformation and failure of spot‐welded joints have been successfully modelled using a cohesive‐zone model for fracture. This has been accomplished by implementing a user‐defined, three‐dimensional, cohesive‐zone element within a commercial finite‐element package. The model requires two material parameters for each mode of deformation. Results show that the material parameters from this type of approach are transferable for identical spot welds in different geometries where a single parameter (such as maximum stress) is not. The approach has been demonstrated using a model system consisting of spot‐welded joints made from 5754 aluminium sheets. The techniques for determining the cohesive fracture parameters for both nugget fracture and nugget pullout are described in this paper. It has been demonstrated that once the appropriate cohesive parameters for a weld are determined, quantitative predictions can be developed for the strengths, deformations and failure mechanisms of different geometries with nominally identical welds.
Neonatal pneumothorax – an unexpected perioperative complication
Authors: GLAISYER HILARY , WAY CAROLYN 
Published: September 2005

SummaryWe report our experience of three cases of intraoperative pneumothorax in neonatal surgical patients. Following a review of the literature, we discuss possible causes for each case and methods of treatment. We emphasize the need for inclusion of pneumothorax as a cause for cardiorespiratory instability even when no predisposition is identifiable and highlight the need for prompt treatment to prevent serious morbidity and mortality.
Perioperative care of a patient with Beare–Stevenson syndrome
Authors: UPMEYER SARA , BOTHWELL MARCELLA , TOBIAS JOSEPH D. 
Published: September 2005

SummaryBeare–Stevenson syndrome is a craniofacial syndrome consisting of a specific pattern of craniosynostosis resulting in a cloverleaf skull deformity and hydrocephalus, down‐slanting palpebral fissures, proptosis, hypertelorism, strabismus, dysmorphic ears, choanal atresia, cleft palate, cutis gyratum, acanthosis nigricans, and abnormal genitalia. Its primary cause has been identified as a single amino acid substitution in fibroblast growth factor receptor 2. Of primary importance to the anesthesiologist are issues related to airway management resulting from midface hypoplasia, choanal atresia, and airway abnormalities (tracheal stenosis). Additional issues affecting airway management include associated cervical spine and foramen magnum abnormalities. The authors present their experience caring for a patient with Beare–Stevenson syndrome and discuss the anesthesia care of these patients.
Onset and duration of mivacurium‐induced neuromuscular blockade in children with Charcot–Marie–Tooth disease. A case series with five children
Authors: SCHMITT HUBERT J. , WICK STEFANIE , MÜNSTER TINO 
Published: September 2005

SummaryBackground:  The Charcot–Marie–Tooth (CMT) disorders are a group of hereditary motor and sensory neuropathies characterized clinically by peripheral muscle wasting and weakness. We hypothesized that unknown involvement of the muscle used for monitoring neuromuscular block may account for the conflicting reports about the effect of nondepolarizing neuromuscular agents in these patients. The aim of this study was to compare onset and recovery from mivacurium‐induced neuromuscular block on the adductor pollicis and orbicularis oculi muscles.Methods:  We used mivacurium 0.2 mg·kg−1 in five children (aged 7–12 years) with CMT type I undergoing propofol–fentanyl–oxygen–air anesthesia for orthopedic surgery. Using acceleromyography, neuromuscular transmission was monitored in parallel in the eye and thumb muscles, and onset and duration times were recorded.Results:  Following bolus administration of 0.2 mg·kg−1 of mivacurium the onset time ranged between 135 and 240 s and 75 and 165 s in the eye and in the thumb, respectively. The recovery time varied between 5.3 and 16 min and 6 and 31.3 min in the eye and in the thumb, respectively.Conclusions:  In our small series of patients with CMT the clinical duration of mivacurium‐induced neuromuscular block was similar to data known from children without neuromuscular disease.
Postoperative shivering in children and causative factors
Authors: AKIN AYNUR , ESMAOGLU ALIYE , BOYACI ADEM 
Published: September 2005

SummaryBackground:  The aim of this study is to investigate the incidence of shivering in children and to reveal the causative factors as well as any possible clinical implications.Methods:  This study was conducted on 1507 children who underwent surgery under general anesthesia. The patients were admitted to the postanesthesia care unit after the operation and their body temperatures measured from the tympanic membrane. The type of operation, operative time, method of anesthesia induction, age, and number of cases in which caudal block had been used were recorded.Results:  Of the 1507 children, 53 (3.5%) experienced shivering. The use of intravenous induction agents, age older than 6 years, and prolonged duration of surgery were associated with shivering. The type of the operation and gender had no effect. The frequency of shivering was lower in children who underwent caudal block with a statistical significance (P < 0.05).Conclusions:  The overall incidence of shivering in children is low (3.5%). Use of intravenous induction agents, age older than 6 years, and prolonged duration of surgery were associated with shivering; prophylaxis is not necessary in children, treatment is given only when shivering occurs.
Lifespan and stress resistance of Caenorhabditis elegans are increased by expression of glutathione transferases capable of metabolizing the lipid peroxidation product 4‐hydroxynonenal
Authors: Ayyadevara Srinivas , Engle Mark R. , Singh Sharda P. , Dandapat Abhijit , Lichti Cheryl F. , Beneš Helen , Shmookler Reis Robert J. , Liebau Eva , Zimniak Piotr 
Published: September 2005

Summary Caenorhabditis elegans expresses a glutathione transferase (GST) belonging to the Pi class, for which we propose the name CeGSTP2‐2. CeGSTP2‐2 (the product of the gst‐10 gene) has the ability to conjugate the lipid peroxidation product 4‐hydroxynonenal (4‐HNE). Transgenic C. elegans strains were generated in which the 5′‐flanking region and promoter of gst‐10 were placed upstream of gst‐10 and mGsta4 cDNAs, respectively. mGsta4 encodes the murine mGSTA4‐4, an enzyme with particularly high catalytic efficiency for 4‐HNE. The localization of both transgenes was similar to that of native CeGSTP2‐2. The 4‐HNE‐conjugating activity in worm lysates increased in the order: control < mGsta4 transgenic < gst‐10 transgenic; and the amount of 4‐HNE‐protein adducts decreased in the same order, indicating that the transgenic enzymes were active and effective in limiting electrophilic damage by 4‐HNE. Stress resistance and lifespan were measured in transgenic animals (five independent lines each) and were compared with two independent control lines. Resistance to paraquat, heat shock, ultraviolet irradiation and hydrogen peroxide was greater in transgenic strains. Median lifespan of mGsta4 and gst‐10 transgenic strains vs. control strains was increased by 13% and 22%, respectively. In addition to the cause–effect relationship between GST expression and lifespan observed in the transgenic lines, correlative evidence was also obtained in a series of congenic lines of C. elegans in which lifespan paralleled the 4‐HNE‐conjugating activity in whole‐animal lysates. We conclude that electrophilic damage by 4‐HNE may contribute to organismal aging.
Valdecoxib for Treatment of a Single, Acute, Moderate to Severe Migraine Headache
Authors: Kudrow David , Thomas H. Mikel , Ruoff Gary , Ishkanian Gary , Sands George , Le Vu H. , Brown Mark T. 
Published: September 2005

Objective.—To evaluate the analgesic efficacy and safety of a single 20‐ or 40‐mg dose of valdecoxib compared with placebo in treatment of a single, acute, moderate or severe migraine headache, with or without aura.Background.—Valdecoxib, an oral COX‐2 specific inhibitor, is indicated for relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis and treatment of primary dysmenorrhea. This study assessed the optimal dose of valdecoxib for treatment of a single, acute, moderate to severe migraine headache.Methods.—This was a double‐blind, randomized, placebo‐ and active‐controlled, multicenter, single‐dose (primary end point) and multiple‐dose (secondary end point), 56‐day study of valdecoxib in the treatment of a single, acute, moderate or severe migraine headache, with or without aura. Migraine headaches were diagnosed according to International Headache Society (IHS) criteria. The primary efficacy end point was headache response (defined as reduction of headache pain intensity from moderate or severe to mild or none) at 2 hours postdose. Patients assessed their headache pain intensity and presence or absence of migraine‐associated nausea, vomiting, phonophobia, and photophobia at intervals from 0 to 24 hours postdose. Sumatriptan 50 mg (encapsulated, in standard method, to maintain blinding) was included as a positive control for assay sensitivity. No statistical comparisons were performed between active treatment arms (valdecoxib 20 mg, valdecoxib 40 mg, and sumatriptan 50 mg). Adverse events and safety parameters were monitored throughout the study.Results.—In the intent‐to‐treat population of 570 patients (135 valdecoxib 20 mg, 151 valdecoxib 40 mg, 143 sumatriptan, and 141 placebo), no significant differences in baseline demographics among treatment groups were observed. The headache response rate with valdecoxib 40 mg and sumatriptan 50 mg was significantly greater than that with placebo at all time points from 2 to 24 hours postdose. With valdecoxib 20 mg, headache response rate was significantly greater than placebo from 2 to 4 hours. Significantly fewer patients treated with valdecoxib 40 mg, compared with placebo, experienced nausea, vomiting, and phonophobia at 2 hours postdose.Conclusions.—A single 40‐mg dose of valdecoxib is effective and well tolerated in treatment of migraine headache pain and associated symptoms.
Patterns and Predictors of Prescription Medication Use in the Management of Headache: Findings From the 2000 Medical Expenditure Panel Survey
Authors: Devine Joshua W. , Farley Joel F. , Hadsall Ronald S. 
Published: September 2005

Objective.—The primary objectives were to examine national trends of prescription medication use for headache and explore patterns of variation in the use of these medications across social and demographic levels.Background.—Despite widespread use of prescription medication for management of headache, little is known about utilization patterns or patient characteristics associated with receiving this type of treatment.Methods.—This study conducted a secondary analysis of data obtained during the 2000 Medical Expenditure Panel Survey, a representative survey of the U.S. noninstitutionalized population. Weighted descriptive statistics and logistic regression models were used to evaluate patterns and rates of overall prescription medication use in patients reporting headache as a household condition.Results.—An estimated 9.7 million people 18 years or older reported suffering from headache in 2000. Of these, 46% reported using at least one medication for the treatment of headache. Migraine‐specific abortive medication (ie, selective serotonin receptor agonists and ergotamine derivatives) was the most frequently reported medication class, used by 36% of participants. Opiate analgesics and butalbital‐containing products also experienced extensive prescribing reported by 22% and 17% of survey respondents, respectively. After adjustment for covariates, wide variation in the use of prescription medication was observed across sociodemographic characteristics including age, ethnicity, and insurance status.Conclusion.—The observed variation in prescription medication use by drug class and sociodemographic characteristics suggests strategies are needed for improving current prescribing patterns in this patient population.
Assessing Cortical Excitability in Migraine: Reliability of Magnetic Suppression of Perceptual Accuracy Technique Over Time
Authors: Custers Anouk , Mulleners Wim M. , Chronicle Edward P. 
Published: September 2005

Objectives.—To examine test–retest reliability of magnetic suppression of perceptual accuracy (MSPA) prior to its use as a marker of cortical excitability in a trial of migraine prophylactic agents.Background.—MSPA is a relatively novel avenue of research in headache, providing an opportunity to study cortical responsiveness objectively and noninvasively. However, little is known about the reliability of magnetic stimulation protocols such as MSPA in longitudinal research designs.Methods.—We tested 10 healthy headache‐free volunteers who had no family history of migraine. In 54 trials, they were briefly presented different three‐letter combinations, flashed on a computer screen for 24 ms (target). After a brief interval, each target was followed by a single magnetic pulse through a 90‐mm circular coil centered 7 cm above inion in the midline. The interval between target and magnetic pulse was systematically varied. Volunteers were requested to report as many letters as they had possibly identified. After 2 weeks, all volunteers were retested using identical methods.Results.—MSPA performance is expressed as a profile of response accuracy (ie, percentage of correctly identified letters) across target‐pulse intervals. Profiles were characteristic of normal headache‐free subjects at the first test. Analysis of variance revealed no significant difference in profiles between test and retest (F= 2.05; P= .136): the retest profiles are almost coincidental with the test profiles.Conclusions.—MSPA is a safe and objective measure of cortical excitability, which is reliable over time. MSPA, therefore, shows excellent promise as a biological marker of cortical response in trials of migraine prophylactics.
Changes in Cortical Processing of Pain in Chronic Migraine
Authors: De Tommaso Marina , Losito Luciana , Difruscolo Olimpia , Libro Giuseppe , Guido Marco , Livrea Paolo 
Published: September 2005

Objective.—The aim of this study was to perform a topographic and dipolar analysis of nociceptive‐evoked responses obtained by laser stimulus under basal conditions in a cohort of chronic migraine (CM) patients, compared with migraine without aura (MWA) patients and noncraniofacial pain controls.Background.—An increased activation of cortical areas devoted to the emotional and attentive components of pain was previously found during the course of the migraine attack; it was more pronounced in patients reporting higher frequency of migraine.Methods.—Twenty‐six outpatients were enrolled in the study; 16 fulfilled the criteria of CM, and 10 were affected by MWA. Fifteen noncraniofacial pain subjects were also selected. The pain stimulus was a CO2 laser pulses. The right‐supraorbital zone was stimulated. Source localization analysis was performed on the most prominent laser‐evoked potentials (LEPs) peak (P2) for each data set. The anatomical locations of the P2 sources were projected onto a standard normalized 3D MRI model.Results.—The CM group differed significantly from both MWA patients and controls for the x coordinate and from controls for the z coordinates. The P2 dipole localized in the rostral cingulate cortex in CM patients, lying in a more posterior location within the anterior cingulate cortex (ACC) in both controls and MWA patients. The x coordinate of the P2 dipole, expressing the postero‐anterior location, was significantly correlated with frequency of headache.Conclusions.—CM seems to be characterized by a distinctive pattern of cortical elaboration of pain, with a prevalent activation of the rostral portion of the ACC: our results suggest that this may be a predisposing factor to migraine chronicity.
Nursing Home Practitioner Survey of Diagnostic Criteria for Urinary Tract Infections
Authors: Juthani‐Mehta Manisha , Drickamer Margaret A. , Towle Virginia , Zhang Ying , Tinetti Mary E. , Quagliarello Vincent J. 
Published: September 2005

Objectives: To identify clinical and laboratory criteria used by nursing home practitioners for diagnosis and treatment of urinary tract infections (UTIs) in nursing home residents. To determine practitioner knowledge of the most commonly used consensus criteria (i.e., McGeer criteria) for UTIs.Design: Self‐administered survey.Setting: Three New Haven–area nursing homes.Participants: Physicians (n=25), physician assistants (PAs, n=3), directors/assistant directors of nursing (n=8), charge nurses (n=37), and infection control practitioners (n=3).Measurements: Open‐ and closed‐ended questions.Results: Nineteen physicians, three PAs, and 41 nurses completed 63 of 76 (83%) surveys. The five most commonly reported triggers for suspecting UTI in noncatheterized residents were change in mental status (57/63, 90%), fever (48/63, 76%), change in voiding pattern (44/63, 70%), dysuria (41/63, 65%), and change in character of urine (37/63, 59%). Asked to identify their first diagnostic step in the evaluation of UTIs, 48% (30/63) said urinary dipstick analysis, and 40% (25/63) said urinalysis and urine culture. Fourteen of 22 (64%) physicians and PAs versus 40 of 40 (100%) nurses were aware of the McGeer criteria for noncatheterized patients (P<.001); 12 of 22 (55%) physicians and PAs versus 38 of 39 (97%) nurses used them in clinical practice (P<.001).Conclusion: Although surveillance and treatment consensus criteria have been developed, there are no universally accepted diagnostic criteria. This survey demonstrated a distinction between surveillance criteria and criteria practitioners used in clinical practice. Prospective data are needed to develop evidence‐based clinical and laboratory criteria of UTIs in nursing home residents that can be used to identify prospectively tested treatment and prevention strategies.
Tilt Testing: Is It Necessary in All Patients with Suspected Vaso‐Vagal Syncope?
Authors: KULAKOWSKI PIOTR , PIOTROWSKA DOROTA , KONOFOLSKA AGNIESZKA 
Published: September 2005

Background: Head‐up tilt testing (HUTT) is a well‐established diagnostic tool in patients with suspected vaso‐vagal syncope (VVS). However, it is time‐consuming and requires special equipment. Thus, identification of simple parameters which could predict the outcome of HUTT could simplify diagnostic steps by obviating the need for HUTT.
Aim: To assess which symptoms associated with spontaneous syncope or other details from medical history can predict HUTT results.
Methods: The study group consisted of 202 unselected patients (69 males, mean age 43 ± 20 years) who were admitted to our syncope unit for HUTT due to suspected VVS. They filled in a detailed questionnaire including 34 standard questions concerning medical history as well as circumstances and symptoms associated with syncopal episodes. Patients were tilted to 70° for 45 minutes or the test was stopped earlier if syncope occurred. A stepwise multiple logistic regression was performed in order to assess which parameters independently predicted the results of HUTT. A point‐score was developed by assigning ±1, ±2, or ±3 points to each of the factors based on the relative magnitude of the estimated regression coefficient. The points were then summed and a diagnostic threshold chosen using plots of sensitivity and specificity curves.
Results: Syncope was induced by HUTT in 67 (33%) patients. In the whole study group, a point‐score identified patients with positive HUTT with a sensitivity of 87.9%, and specificity of 36.3%. When the analysis was confined to the subgroup with >4 syncopal episodes in the past, the sensitivity of a point‐score was 94.4%, and specificity—60%, and in the subgroup with >2 syncopal episodes occurring within 1 month preceding HUTT, sensitivity values reached 88.2% at the specificity level of 90.9%.
Conclusions: In patients with frequent syncopal episodes, especially clustered shortly before performing HUTT, in whom symptoms are very suggestive of VVS, a simple point‐score system based on medical history accurately predicts HUTT results. Thus, HUTT may not be necessary for establishing diagnosis in this group of patients.