bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic resonance imaging findings and outcome in severe tick‐borne encephalitis. report of four cases and review of the literature
Authors: Marjelund S. , Tikkakoski T. , Tuisku S. , Räisänen S. 
Published: April 2004

Purpose: To describe the magnetic resonance imaging (MRI) findings of four patients with proven tick‐borne encephalitis (TBE). These are the most northern cases reported from Scandinavia. Experience of turbo fluid‐attenuated inversion recovery (FLAIR) and diffusion‐weighted imaging (DWI) has not previously been published in this context. Material and Methods: The MRI findings of four consecutive patients with TBE treated in our hospital during the year 2002 were evaluated. MRI was done during the first week of illness, and follow‐up scans were available in three cases. Results: In T2‐weighted and turbo FLAIR images, thalamic hyperintensity was equally evident in three of the four patients. One of them also showed hyperintensity in the left putamen and the internal capsule and another patient in the peduncles and the hypothalamus. T1‐weighted images without contrast were normal in all patients, and leptomeningeal enhancement was detected in only one patient. The two patients who underwent DW images did not show any restricted diffusion. Follow‐up MR images showed no atrophy or necrotic foci, and the signal abnormalities disappeared during 16–34 weeks of follow‐up. Conclusion: T2‐weighted and turbo FLAIR sequences proved equally effective in detecting and delineating the thalamic, brainstem, and basal ganglia pathologies. According to our results, mechanisms other than cytotoxic edema contribute to the signal pathology. Radiologists should be familiar with the MR findings of TBE even in non‐endemic areas.
Intermittent hepatic artery antibiotic infusion therapy for pyogenic hepatic abscess
Authors: Matoba M. , Tonami H. , Kuginuki M. , Yamamoto I. , Takashima S. 
Published: April 2004

Purpose: To study the efficacy and problems associated with intermittent hepatic artery antibiotic infusion therapy for pyogenic hepatic abscess. Material and Methods: The material comprised eight patients with pyogenic hepatic abscess in whom percutaneous drainage could not be performed and intravenous administration of antibiotics was ineffective. An injection catheter was introduced into the common hepatic artery. Almost the same dose of antibiotics as with intravenous administration was infused intra‐arterially 2–4 times per day. Results: A therapeutic effect was achieved in six of the eight cases. In these 6 cases, the mean period of intra‐arterial infusion was 10.8 days, while the mean period of catheter placement was 14.7 days. Using broad spectrum antibiotics, the therapeutic effect was obtained regardless of the numbers, morphologic characteristics, and differences in location of the abscesses. No significant complications were noted except in one case of splenic infarction. Conclusion: Intermittent hepatic artery antibiotic infusion therapy is useful as an alternative therapeutic procedure for pyogenic hepatic abscess in which percutaneous drainage cannot be performed and intravenous administration of antibiotics is ineffective.
T helper cell polarisation as a measure of the maturation of the immune response
Authors: Cameron Scott B. , Stolte Ellen H. , Chow Anthony W. , Savelkoul Huub F. J. 
Published: April 2004

Background: T helper cell polarisation is important under chronic immune stimulatory conditions and drives the type of the evolving immune response. Mice treated with superantigens in vivo display strong effects on Th subset differentiation. The aim of the study was to detect the intrinsic capacity of T cells to polarise under various ex vivo conditions.Methods: Purified CD4+ T cells obtained from superantigen‐treated mice were cultured under Th polarising conditions in vitro. By combining intracellular cytokine staining and subsequent flow cytometric analysis with quantitative cytokine measurements in culture supernatants by enzyme‐linked immunosorbent assay (ELISA), the differential Th polarising capacity of the treatment can be detected in a qualitative and quantitative manner.Results and conclusions: BALB/c mice were shown to be biased to develop strong Th2 polarised immune responses using Th0 stimulation of purified CD4+ T cells from phosphate‐buffered saline‐treated mice. Nevertheless, our analysis methodology convincingly showed that even in these mice, Toxic Shock Syndrome Toxin‐1 treatment in vivo resulted in a significantly stronger Th1 polarising effect than control treatment. Our results indicate that populations of Th cells can be assessed individually for their differential Th1 or Th2 maturation capacity in vivo by analysing robust in vitro polarisation cultures combined with intracellular cytokine staining and ELISA.
Tumour necrosis factor‐α polymorphism as one of the complex inherited factors in pemphigus
Authors: Torzecka Jolanta Dorota , Narbutt Joanna , Sysa-jedrzejowska Anna , Borowiec Maciej , Ptasinska Anetta , Woszczek Grzegorz , Kowalski Marek L. 
Published: April 2004

The aim of our study was to analyse a significance of tumour necrosis factor (TNF)‐α promoter gene polymorphisms in relation to the HLA‐DR locus in genetic predisposition to pemphigus. TNF‐α gene polymorphisms in position ‐238 and ‐308 were identified using a modified polymerase chain reaction‐restriction fragment length polymorphism method in 53 patients with pemphigus (38 with pemphigus vulgaris, 15 with pemphigus foliaceus) and 87 healthy controls. The HLA‐DRB1 locus was typed using the polymerase chain reaction SSO method in all the patients and 152 population controls.Carriers of the TNF‐α polymorphic ‐308 A allele were found to be more frequent in the pemphigus foliaceus group in comparison with the control group (odds ratio (OR)=8.12; P = 0.0005). A significant association between HLA‐DRB1*04 (OR=3.86; Pcor = 0.0001) and DRB1*14 (OR=8.4; Pcor = 0.0001) and pemphigus vulgaris was found. In this group of patients a decreased frequency of HLA‐DRB1*07 (OR=0.08; Pcor = 0.006) was also identified.We have shown for the first time a positive association of TNF‐α polymorphism in position ‐308 with pemphigus foliaceus.
Simultaneous measurement of multiple Th1 and Th2 serum cytokines in psoriasis and correlation with disease severity
Authors: Jacob Sharon E. , Nassiri Mehdi , Kerdel Francisco A. , Vincek Vladimir 
Published: April 2004

Background: Psoriatic plaques have been shown to contain increased levels of proinflammatory cytokines. Serum levels of interleukin (IL)‐6, IL‐7, IL‐8, and interferon (IFN)‐γ have been reported elevated in psoriatic patients.Aim: To evaluate serum cytokine profiles in psoriasis patients by improved enzyme‐linked immunosorbent assay (ELISA) technique and to correlate these levels with disease severity.Methods: We analyzed single serum samples from 10 patients with active untreated psoriasis, two patients with active treated psoriasis, and five healthy volunteers for major T helper type 1 and T helper type 2 cytokines using the LINCOplex ELISA multi‐analyte detection system that permits simultaneous detection of multiple cytokines from a single sample. The disease severity, including erythema, induration, scale, and surface area, was assessed.Results: IFN‐γ was markedly elevated in all sera from psoriasis patients, 33.8±1.3 pg/ml (mean±standard error) versus 8±1.5 pg/ml for normal controls (P < 0.01), and positively correlated with all indices of disease severity (Spearman r > 0.6). IL‐8 was also increased in psoriasis patients (24.4±1.8 pg/ml) versus normal controls (3.6±1.2 pg/ml) (p < 0.05) and positively correlated with the degree of erythema (Spearman r > 0.6). Mean IL‐12 levels were decreased in sera from psoriasis patients (8.5±1.2 pg/ml) compared with normal controls (42.2±5.3 pg/ml) (P < 0.01). Also, serum IL‐10 levels were below detection levels in psoriatics compared with controls (6.4±1.3 pg/ml).Conclusions: This new ELISA system allowed rapid and reliable detection of numerous cytokines in single serum samples from patients with psoriasis. We observed that IFN‐γ and IL‐8 cytokines were elevated in psoriatics and correlated with parameters of disease severity while IL‐10 and IL‐12 were decreased.
Ramsey's theory of National Saving: A Mathematician in Cambridge
Authors: Gaspard Marion 
Published: April 2004

In the December 1928 issue of the Economic Journal, Frank Ramsey asked the question “how much of its income should a nation save?” Few of the Cambridge economists of the 1930s were convinced by his highly formalized answer. His contribution sank quickly into oblivion, remaining there for about thirty-five years. In the 1960s, the success of the Hamiltonian formalism and the increasing interest for optimal growth led on the contrary to a quasi “natural” use of Ramsey's former intuitions. These mathematical tools became so widespread that, a few years later, new classical macroeconomics uses a new interpretation of the “à la Ramsey” models, within the setting of representative agent models, in order to bypass the Arrow and Sonnenschein-Mantel-Debreu “impossibility results.” The “à la Ramsey” model is the backbone of modern new classical macroeconomics. It is thus not surprising that these successive moves in macro-economic theory came to foster a slanted interpretation of Ramsey's 1928 article. In this respect, Roger E. A. Farmer's point of view is representative of the retrospective tribute sometimes paid to Ramsey's article:F. Ramsey was one of the first economists to study how an infinitely lived agent should allocate his resources over time. His work was at the forefront of mathematical economics at the time it was written but his approach has now become a standard part of graduate macroeconomic courses. Many applications of Ramsey's work assume that there is only one agent in the economy and that this representative agent can be thought of as a stand-in for the workings of the market mechanism (Farmer 1993, p. 77).
Living in the Moment: Lags, Leads, and the Link Between Legislative Agendas and Interest Advocacy*
Authors: Lowery David , Gray Virginia , Fellowes Matthew , Anderson Jennifer 
Published: April 2004

Objectives. Based on sharply divergent interpretations about the nature of the politics of organized interests, three competing perspectives imply that organized interests variously lead, lag, or are contemporaneous with legislative agendas.Methods. We contribute to this debate by presenting data using a short‐term timeframe to assess the sequence of the relationship between legislative agendas and lobbying activity; we examine the lags and leads in the relationship between legislative agendas in 1995, 1997, and 1999 and the density of state lobbying communities in 1997 using Gray and Lowery's (1996) energy, stability, area (ESA) model of interest system density.Results. The analysis provides little support for the lagging and leading hypotheses and strong support for the contemporaneous hypothesis.Conclusions. Although this analysis will not end all debates over the sequential relationship between legislative agendas and lobbying activity, it suggests that legislative agenda and interest system density are largely governed by within‐session dynamics.
A controlled trial comparing emergency hemorrhoidectomy versus conservative treatment for acutely thrombosed hemorrhoid
Authors: LAM C.Y.W. , LAM D.T.Y. , CHOI C.Y. , CHIU P.W.Y. , LAM S.C.W. , KWOK S.P.Y. 
Published: April 2004

Aim: Acutely thrombosed hemorrhoid is either treated conservatively or with emergency hemorrhoidectomy. The treatments have not been compared in a randomized controlled trial. We aim to investigate the relative effectiveness and safety of the two modes of treatment.Methods: We performed a randomized controlled trial at the United Christian Hospital. Patients with acutely thrombosed hemorrhoids were randomized to either conservative management or emergency hemorrhoidectomy. The primary outcome was the number of days to halve the visual analog pain score (VAS). Secondary outcomes included VAS on follow‐up, early and late functional status, total analgesic requirment, days off work and complication rate.Results: Forty‐six patients entered the trial between June 2000 and October 2001. Twenty‐three were randomized to each group. Demographic variables were similar for both groups, so was VAS on admission. The number of days taken to halve the VAS was significantly shorter after emergency hemorrhoidectomy (2.5 vs 4.2 days, P=0.001). VAS at days 14, 21, 28 were similar between the groups. The functional status (mobilization and sitting, defecatory pain) at days 3, 6, 14, 21 and 28 were also similar. Analgesic requirements and days off work were similar. There was no complication after emergency hemorrhoidectomy. After resolution, nine patients (45%) of the conservative group required hemorrhoidectomy for persistent symptoms.Conclusion: Emergency hemorrhoidectomy relieves pain faster than conservative management. It is safe and has similar functional results as conservative management. Emergency hemorrhoidectomy is therefore the treatment of choice.
A Prospective Comparative Study Between Targeted Parathyroidectomy Under Local Anaesthesia And Conventional Parathyroidectomy In Primary Hyperparathyroidism
Authors: FUNG T.M.K. , AHUJA A.T. , LAM Y.H. , YUEN H.Y. , WONG K.T. , LAU J.Y.W. 
Published: April 2004

Introduction: Minimal invasive parathyroidectomy (MIP) has evolved as a popular method in the treatment of primary hyperparathyroidism. Our study aimed to examine how effective is MIP compared to conventional parathyroidectomy.Methods: All patients with primary hyperparathyroidism received a triage ultrasound scan. In patients who had their parathyroid glands localized by the ultrasound, parathyroidectomy was performed under local anaesthesia (LA‐MIP) via a 3‐cm incision using the lateral approach. In patients with negative imaging, they underwent conventional parathyroidectomy under general anaesthesia (GA). Cure is defined as remaining normocalcemic on follow up. The cure rate, complication rate, hospital stay and number of frozen sections utilized were compared.Results: Forty‐four patients were treated by LA‐MIP and 37 patients were treated by GA since 1999–2003. The positive predictive value of USG localization was 97%. After a median follow up of 24 months, there were no difference in the cure rate (41/44 in LA‐MIP versus 35/37 in GA, P > 0.05) and complication rate (2/44 in LA‐MIP vs 2/37 in GA, P > 0.05). However, the LA group was found to have shorter hosptial stay (median = 1 vs 2 in GA, P < 0.05) and utilized less frozen‐sections (median = 1 vs 2 in GA, P < 0.05).Conclusions: Ultrasound‐guided minimal invasive parathyroidectomy under local anaesthesia is as effective as conventional parathyroidectomy in the treatment of primary hyperparathyroidism. An estimated cost‐reduction of HK $14 432 was found in each case treated by LA‐MIP through utilizing less frozen‐sections, less general anaesthesia and shorter hosiptal stay.
Retrospective review on laparoscopic cholecystectomy in patients with acute cholecystitis in a community hospital
Authors: HUI S.K. , CHEUNG K.F. , FAN N. , NG W.T. 
Published: April 2004

Aim: Since the first audit of laparoscopic cholecystectomy (LC) in patients suffering from acute cholecystitis in 1999–2000, the policy of early laparoscopic cholecystectomy was launched in Yan Chai Hospital. The present study aims to look at the conversion rate, complication and hospital stay.Methods: Retrospective review of laparoscopic cholecystectomies was done for patients presented with acute cholecystitis from January 2001 to June 2003. Only patients with both clinical and histopathological diagnosis of acute cholecystitis were included. Patients presented with acute cholangitis and pancreatitis were excluded. Predictive factors including age, sex, fever, WBC, duration of symptoms, timing of surgery were analysed. Chi‐Square test and Mann–Whitney test were used for statistical analysis with significance level set at 5%.Results: Total 141 patients with acute cholecystitis were operated with initial laparoscopic approach. Mean age was 60.1 years old. 70.9% of operation performed within 48 h after admission. The overall conversion rate was 33%. Significant predictive factors for conversion were: older patient (mean age for LC group was 58.2 years old [95%CI 54.5–61.8] and for conversion group was 64.5 years old [95% CI 60.1–68.9], P=0.046), delayed presentation (P=0.001), fever before operation (P=0.039), operation performed after 72 h after admission (P=0.026). Conversion rate for operation performed within first 24 h after admission was 26.2%. Conversion rate increased to 68% for operation performed 74 h after admission. For patients with body temperature ≥38°C before operation, conversion rate was significant higher (i.e. 50 vs 26%) (P=0.012). Conversion rates for patients with 1 day symptom and for patients with 3 days or longer symptom were 18.8% and 51%, respectively. Sex, ASA and WBC count were not significant predictive factors. The mean operation time for successful laparoscopic group was 101 min and 102 min for conversion group. Complications occurred in 14.8% of cases including chest infection (3), AMI (2), wound infection (6), CBD injury (1). Mean hospital stay was 6.6 day for successful LC group and was longer for conversion group (10.7 day).Conclusion: Older patient, delayed presentation and fever on presentation were associated with higher conversion rate. Earlier operation was associated with successful LC. Conversion rate was similar to previous study done in 1999–2000. In coming future, efforts should be made (i.e. 24 h liver function test, radiological support) to achieve an earlier diagnosis of acute cholecystitis and hence better operative outcome.**Multiple regression analysis in progress, data will be submitted as soon as possible.
Laparoscopic repair for perforated duodenal ulcer: graham patch technique
Authors: LAM P.W.F. , LAM C.S. , HUI E.K.L. , SUN Y.W. , MOK F.P.T. 
Published: April 2004

Aim: This article described the technique to avoid suture entanglement during laparoscopic Graham patch repair (LGPR) and the feasibility of the technique.Methods: Twenty‐four patients with perforated duodenal ulcer from January 2000 to February 2004 were subjected to LGPR. The same principle of open Graham patch repair was exercised.Result: LGPR was performed successfully in 23 males and one female, median age of 44.5. No conversion to open surgery. Median perforation size was 5 mm, range 3–10 mm. Median operative time was 80 min Median for ambulation was postoperative day 2, and postoperative stay was 4 days. Median analgesic requirement was: one dose of pethidine (50 mg imi injection) and zero tablet of dologesic. Complications included one pelvic collection treated by antibiotics, one urinary retention and one pyloric stenosis. No leakage and no wound infection.Conclusion: LGPR was a feasible alternative for laparoscopic repair of perforated duodenal ulcer, and might be particularly suitable for larger perforation.
Management of postoperative urinary retention: a randomized trial of in‐out versus overnight catheterization
Authors: LAU H. , LAM B. , PATIL N.G. 
Published: April 2004

Background: There has been no consensus on the best catheterization strategy for the management of postoperative urinary retention. A prospective randomized trial was undertaken to establish the best practice guidelines for the management of postoperative urinary retention. We also evaluated the contemporary incidence of urinary retention following different categories of general surgery and examined risk factors associated with its occurrence.Methods: All patients who underwent elective inpatient surgery between January 2002 and June 2003 were recruited in the study. Patients who developed postoperative urinary retention were randomized to either having in‐out catheterization or placement of an indwelling catheter for 24 h after surgery.Results: A total of 1448 patients were recruited. The overall incidence of urinary retention was 4.1% (n=60). Significant risk factors associated with postoperative urinary retention included old age, anorectal procedures and use of spinal anaesthesia. Comparison of re‐catheterization and urinary tract infection rates between patients who were treated with in‐out versus overnight catheterization showed no significant differences.Conclusions: Postoperative urinary retention should be managed by in‐out catheterization. Indwelling catheterization for 24 h appeared to bestow no additional benefits. The incidence of urinary retention increased with age, anorectal procedures and the use of spinal anaesthesia.
Sedation with oral midazolam in adults undergoing upper gastrointestinal endoscopy: a double‐blind placebo‐controlled randomized trial
Authors: MUI L.M. , TEOH A.Y.B. , NG E.K.W. , YEUNG A.C.M. AU , CHUNG S.C.S. , LAU J.Y.W. 
Published: April 2004

Aim: To investigate the effectiveness of oral midazolam as premedication in undergoing upper endoscopy (OGD).Methods: One hundred and thirty patients were randomized to receive either 7.5 mg oral midazolam (n=65) or placebo (n=65) as premedication. Outcomes measures included anxiety score in visual analogue scale during OGD, overall tolerance, extent of amnesia, overall satisfaction, patient's willingness to repeat procedure, recovery time and haemodynamic changes after medication.Results: The median (interquartile range [IQR]) anxiety score in midazolam group was significantly lower than in control group (2.0 IQR [0–4.9] vs 3.8 IQR [2.1–7.95]; P < 0.001). A significant greater number of patients in midazolam group graded overall tolerance as ‘excellent or good’ (P=0.002) and reported a partial or complete amnesia response (P=0.03) when compared to control group. Although there were no statistically significant differences in satisfaction score between groups, more patients in midazolam group were willing to repeat procedure if necessary (89.2 vs 69.2%; P=0.005). The median recovery time was significantly longer in midazolam group than in control group (5minutes IQR [5–15] vs 5 min IQR [5–10]; P=0.014). There were no statistically significant differences in haemodynamic changes between groups after medication.Conclusion: Premedication with oral midazolam is a safe and effective sedation method that significantly reduces anxiety and improves overall tolerance during OGD.