bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nerve-root injections for the relief of pain in patients with osteoporotic vertebral fractures
Authors: Kim D-J. , Yun Y-H. , Wang J-M. 
Published: March 2003

We have studied 58 patients with pain from osteoporotic vertebral fractures which did not respond to conservative treatment. These were 53 women and five men with a mean age of 72.5 years. They received a nerve-root injection with lidocaine, bupivicaine and DepoMedrol. The mean follow-up period was 13.5 months. The mean pain scores before treatment, at one and six months after treatment and at the final follow-up were 85, 24.9, 14.1, and 17.4, respectively. According to our modified criteria for grading results, six patients were considered to have an excellent result, 42 good and ten fair. A newly developed compression fracture was noted in three patients. There were no complications related to the injection. Our study suggests that nerve-root injections are effective in reducing pain in patients with osteoporotic vertebral fractures and that these patients should be considered for this treatment before percutaneous vertebroplasty or operative intervention is attempted.
Reduction of blood loss using high-dose aprotinin in major orthopaedic surgery
Authors: Jeserschek R. , Clar H. , Aigner C. , Rehak P. , Primus B. , Windhager R. 
Published: March 2003

We have investigated in a prospective, randomised placebo-controlled study the effect of high-dose aprotinin on blood loss in patients admitted for major surgery (revision arthroplasty of the hip or knee, or for resection of a soft-tissue sarcoma). The mean intraoperative blood loss was reduced from 1957 ml in the control group to 736 ml in the aprotinin group (p = 0.002). The mean requirement for intraoperative homologous blood transfusion in the aprotinin group was 1.4 units (95% CI 0.2 to 2.7) and 3.1 units (95% CI 1.7 to 4.6) in the control group (p = 0.033). The mean length of hospital stay was reduced from 27.8 days in the control group to 17.6 days in the aprotinin group which was not statistically significant. The intraoperative use of aprotinin in major orthopaedic operations significantly reduced blood loss and the required amount of packed cells. It may result in a decrease in the length of hospital stay and costs.
Trochanteric reduction osteotomy as a treatment for refractory trochanteric bursitis
Authors: Govaert L. H. M. , van der Vis H. M. , Marti R. K. , Albers G. H. R. 
Published: March 2003

We describe a new operative procedure for patients with chronic trochanteric bursitis. Between March 1994 and May 2000, a trochanteric reduction osteotomy was performed on ten patients (12 hips). All had received conservative treatment for at least one year. Previous surgical treatment with a longitudinal release of the iliotibial band combined with excision of the trochanteric bursa had been performed on five hips. None had responded to these treatments. The mean follow-up was 23.5 months (6 to 77). The mean Merle d’Aubigné and Postel score improved from 15.8 (8 to 20) before to 27.5 (18 to 30) after operation, six patients showing very great improvement, five great improvement and one fair improvement. We conclude that trochanteric reduction osteotomy is a safe and effective procedure for patients with refractory trochanteric bursitis who do not respond to conservative treatment.
A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee
Authors: Bentley G. , Biant L. C. , Carrington R. W. J. , Akmal M. , Goldberg A. , Williams A. M. , Skinner J. A. , Pringle J. 
Published: March 2003

Autologous chondrocyte implantation (ACI) and mosaicplasty are both claimed to be successful for the repair of defects of the articular cartilage of the knee but there has been no comparative study of the two methods. A total of 100 patients with a mean age of 31.3 years (16 to 49) and with a symptomatic lesion of the articular cartilage in the knee which was suitable for cartilage repair was randomised to undergo either ACI or mosaicplasty; 58 patients had ACI and 42 mosaicplasty. Most lesions were post-traumatic and the mean size of the defect was 4.66 cm2. The mean duration of symptoms was 7.2 years and the mean number of previous operations, excluding arthroscopy, was 1.5. The mean follow-up was 19 months (12 to 26). Functional assessment using the modified Cincinatti and Stanmore scores and objective clinical assessment showed that 88% had excellent or good results after ACI compared with 69% after mosaicplasty. Arthroscopy at one year demonstrated excellent or good repairs in 82% after ACI and in 34% after mosaicplasty. All five patellar mosaicplasties failed. Our prospective, randomised, clinical trial has shown significant superiority of ACI over mosaicplasty for the repair of articular defects in the knee. The results for ACI are comparable with those in other studies, but those for mosaicplasty suggest that its continued use is of dubious value.
Enhancing Treatment of Bipolar Disorder Using the Patient's Belief System
Authors: Makela Eugene H , Griffith Robert K 
Published: March 2003

OBJECTIVE: To report a patient with bipolar disorder in whom elements of the patient's belief system were used to foster acceptance of medication treatment. CASE SUMMARY: A 21-year-old white man with bipolar disorder began refusing prescribed divalproex sodium treatment. On consultation, the psychiatric pharmacist identified key elements of the patient's belief system and used this information in developing a plan to foster patient acceptance of lithium carbonate treatment. DISCUSSION: Noncompliance with treatment for bipolar disorder is common, and reluctance to accept initial pharmacotherapeutic intervention often occurs. There are many possible reasons for this phenomenon. Patients may not believe in pharmacotherapy and/or in its benefit, fear adverse reactions, or deny that they are ill. We report a patient in denial of his illness and believing that divalproex sodium was causing adverse effects. A psychiatric pharmacist consultant identified certain patient beliefs that were ultimately important in developing a treatment plan that was acceptable to the patient. The consultant, accompanied by a colleague, used persuasive technique in proposing treatment with the natural product lithium. The patient was discharged within 1 week of accepting the lithium therapy. CONCLUSIONS: When a patient refuses to accept needed treatment, it is important to carefully examine the reasons for this refusal, focusing on the patient's beliefs about the illness and the therapy. Intervention strategies can be developed, using this information, to foster treatment adherence and produce positive outcomes.
Meperidine Misuse in a Patient with Sphincter of Oddi Dysfunction
Authors: Hubbard Garrick P , Wolfe Kelly R 
Published: March 2003

OBJECTIVE: To report a seizure occurring secondary to meperidine treatment despite normal renal and central nervous system (CNS) function, and to provide a review of meperidine's role in pain management, including its use in pancreatitis and sphincter of Oddi dysfunction. CASE SUMMARY: A 55-year-old white woman with a history of sphincter of Oddi dysfunction presented to the emergency department with severe abdominal pain. On admission to the hospital, the serum creatinine level was 0.6 mg/dL with slightly elevated aspartate aminotransferase of 56 U/L (normal range 0–31) and alanine aminotransferase of 34 U/L (0–31). The patient received repeated and escalating doses of intravenous meperidine, resulting in a generalized seizure on day 4 of hospitalization. The accumulated meperidine dose was 2125 mg. Buprenorphine was substituted in place of meperidine, and the patient had no further reported complications. She was then transferred to a tertiary-care facility for sphincter of Oddi reevaluation. An objective causality assessment revealed the adverse drug event as probable. DISCUSSION: Despite alternative opioids, meperidine continues to be used in pain management. Meperidine is different from other opioids because its active metabolite, normeperidine, is neurotoxic. Patients with renal insufficiency, liver failure, or CNS dysfunction are at increased risk for adverse drug reactions related to normeperidine accumulation. Due to normeperidine's extended half-life, however, accumulation of normeperidine can occur in any patient receiving repeated doses of meperidine. CONCLUSIONS: This case demonstrates the potential hazards that exist when using meperidine in any patient. Meperidine's inherent risks of both undertreating pain and causing adverse drug reactions should prompt clinicians and health organizations to restrict its use in pain management. This restriction should not make exceptions to meperidine's traditional use in pancreatitis or sphincter of Oddi dysfunction.
Rhabdomyolysis and Acute Renal Failure following an Ethanol and Diphenhydramine Overdose
Authors: Haas Curtis E , Magram Yanina , Mishra Archana 
Published: March 2003

OBJECTIVE: To report a case of nontraumatic rhabdomyolysis complicated by oliguric, acute renal failure following an intentional overdose of ethanol and diphenhydramine. CASE SUMMARY: A 21-year-old white man was admitted through the emergency department following an intentional overdose of ethanol and diphenhydramine. The patient subsequently developed acute renal failure, and a diagnosis of nontraumatic rhabdomyolysis was made. With the absence of other common causes in this case, the rhabdomyolysis was believed to be due to the combined ethanol and diphenhydramine overdose. DISCUSSION: Rhabdomyolysis is a severe and life-threatening syndrome caused by various insults to skeletal muscle, including drug-induced injury. Early detection and institution of effective treatments are essential to minimizing the complications of this syndrome. A delay in establishing the diagnosis in this case likely contributed to the severity of the renal failure. CONCLUSIONS: Nontraumatic rhabdomyolysis is an uncommon adverse outcome of drug and toxin ingestion. Due to the potential severity of the complications of this syndrome and the importance of early recognition and treatment to prevent renal failure, clinicians should have a high index of suspicion for rhabdomyolysis following overdoses that involve alcohol or antihistamines.
Testosterone Replacement Therapy for Bone Loss Prevention in HIV-Infected Males
Authors: Clay Patrick G , Lam Amy I 
Published: March 2003

OBJECTIVE: To review the use of testosterone for the prevention of bone loss in men with HIV infection. DATA SOURCES: A MEDLINE search (1966–May 2002) on the use of testosterone in osteoporosis/HIV infection was performed. A reference bibliography search was also completed. DATA SYNTHESIS: Osteopenia/osteoporosis is reported in HIV-infected men due to a myriad of factors. Sex hormone deficiency is a frequent endocrine abnormality in this population. CONCLUSIONS: In HIV-negative men, testosterone may be beneficial for preventing bone loss and hastening the resolution of fractures. Testosterone's role in preventing bone loss in HIV-infected men remains to be defined.
Lecture versus Web Tutorial for Pharmacy Students' Learning of MDI Technique
Authors: Erickson Steven R , Chang Amy , Johnson Cary E , Gruppen Larry D 
Published: March 2003

OBJECTIVE: To compare pharmacy students' acquired knowledge and ability to assess metered-dose inhaler (MDI) technique after a traditional lecture versus a Web-based MDI technique tutorial. METHODS: All 42 third-year PharmD students completed a baseline MDI technique knowledge test and were then randomized into 1 of 3 groups. The Web group completed the tutorial on the college dispensing laboratory computers; the lecture group participated in the MDI technique excerpt of the asthma therapeutics lecture; and the control group participated in a 15-minute discussion of participants' hobbies. Afterward, participants in each group completed an identical MDI technique knowledge posttest. Students then observed a standardized mock patient perform MDI technique, documenting steps that were conducted incorrectly. MDI technique knowledge test and MDI technique evaluation test scores were compared between groups using repeated measures ANOVA. RESULTS: There was no significant difference in the baseline MDI technique knowledge test scores between groups. The post-MDI technique knowledge test scores for the Web and lecture groups did not differ significantly (p = 0.38), and both were significantly different from the control group (p < 0.001). MDI technique knowledge scores increased significantly for the Web and lecture groups from pre- to post-assessment, but did not change for the control group. A 2-way repeated measures ANOVA analysis demonstrated no significant interaction of subject and group characteristics. The MDI technique evaluation scores for the Web and lecture groups were not significantly different (p = 0.50), and both were significantly different from the control group (p ≤ 0.001). CONCLUSIONS: The Web-based MDI technique tutorial was as effective as the standard lecture format in pharmacy students acquiring knowledge of MDI technique and in evaluating a mock-patient exhibiting incorrect MDI technique. Further testing is required to assess the longitudinal effect of the program.
Cover Picture: A Powerful Combinatorial Screen to Identify High‐Affinity Terbium(III)‐Binding Peptides (ChemBioChem 4/2003)
Authors: Nitz Mark , Franz Katherine J. , Maglathlin Rebecca L. , Imperiali Barbara 
Published: March 2003

AbstractThe cover picture shows the chemistry and biology used to develop a new protein labeling strategy based on lanthanide‐binding peptides. Focused peptide libraries are screened to identify oligopeptide motifs of dual function: the peptides bind TbIII with remarkably high affinity and promote intense TbIII luminescence. The peptide sequences are then genetically encoded to create recombinant fusion proteins that possess a site‐specific and minimally invasive fluorophore. Further information can be found in the two articles by Imperiali and co‐workers on pp. 265–271 and pp. 272–276.
Lanthanide‐Binding Tags as Versatile Protein Coexpression Probes
Authors: Franz Katherine J. , Nitz Mark , Imperiali Barbara 
Published: March 2003

AbstractComprehensive proteomic analyses require new methodologies to accelerate the correlation of gene sequence with protein function. Key tools for such efforts include biophysical probes that integrate into the covalent architecture of proteins. Lanthanide‐binding tags (LBTs) are expressible, multitasking fusion partners that are optimized to bind lanthanide ions and have several desirable attributes, which include long‐lived luminescence, excellent X‐ray scattering power for phase determination, and magnetic properties to facilitate NMR spectroscopic structure elucidation. Herein, we present peptide sequences with a 40‐fold higher affinity for Tb3+ ions and significantly brighter luminescence intensity compared with existing peptides. Incorporation of an LBT onto ubiquitin as a prototype fusion protein allows the use of powerful protein‐visualization techniques, which include rapid luminescence detection of LBT‐tagged proteins in SDS‐PAGE gels, as well as determination of protein concentrations in complex mixtures. The LBT strategy is a new alternative for expressing fluorescent fusion proteins by routine molecular biological techniques.
On the Generation of Catalytic Antibodies by Transition State Analogues
Authors: Barbany Montserrat , Gutiérrez‐de‐Terán Hugo , Sanz Ferran , Villà‐Freixa Jordi , Warshel Arieh 
Published: March 2003

AbstractThe effective design of catalytic antibodies represents a major conceptual and practical challenge. It is implicitly assumed that a proper transition state analogue (TSA) can elicit a catalytic antibody (CA) that will catalyze the given reaction in a similar way to an enzyme that would evolve (or was evolved) to catalyze this reaction. However, in most cases it was found that the TSA used produced CAs with relatively low rate enhancement as compared to the corresponding enzymes, when these exist. The present work explores the origin of this problem, by developing two approaches that examine the similarity of the TSA and the corresponding transition state (TS). These analyses are used to assess the proficiency of the CA generated by the given TSA. Both approaches focus on electrostatic effects that have been found to play a major role in enzymatic reactions. The first method uses molecular interaction potentials to look for the similarity between the TSA and the TS and, in principle, to help in designing new haptens by using 3D quantitative struture–activity relationships. The second and more quantitative approach generates a grid of Langevin dipoles, which are polarized by the TSA, and then uses the grid to bind the TS. Comparison of the resulting binding energy with the binding energy of the TS to the grid that was polarized by the TS provides an estimate of the proficiency of the given CA. Our methods are used in examining the origin of the difference between the catalytic power of the 1F7 CA and chorismate mutase. It is demonstrated that the relatively small changes in charge and structure between the TS and TSA are sufficient to account for the difference in proficiency between the CA and the enzyme. Apparently the environment that was preorganized to stabilize the TSA charge distribution does not provide a sufficient stabilization to the TS. The general implications of our findings and the difficulties in designing a perfect TSA are discussed. Finally, the possible use of our approach in screening for an optimal TSA is pointed out.
Nuclear Localisation Sequence Templated Nonviral Gene Delivery Vectors: Investigation of Intracellular Trafficking Events of LMD and LD Vector Systems
Authors: Keller Michael , Harbottle Richard P. , Perouzel Eric , Colin Morvane , Shah Imran , Rahim Ahad , Vaysse Laurence , Bergau Anna , Moritz Sylviane , Brahimi‐Horn Christiane , Coutelle Charles , Miller Andrew D. 
Published: March 2003

AbstractThe impact of a peptide that contains a nuclear localisation sequence (NLS) on intracellular DNA trafficking was studied. We used the adenoviral core peptide mu and an SV40 NLS peptide to condense plasmid DNA (pDNA) prior to formulation with 3β‐[N‐(N′, N′‐dimethylaminoethane)carbamoyl]cholesterol/dioleoyl‐L‐α‐phosphatidyl ethanolamine (DC‐Chol/DOPE) liposomes to give LMD and LND vectors, respectively. Fluorescent‐labelled lipid and peptides plus dye‐labelled pDNA components were used to investigate gene delivery in dividing and S‐phase growth‐arrested cells. Confocal microscopic analyses reveal little difference in intracellular trafficking events. Strikingly, mu peptide associates with nuclei and nucleoli of cells within less than 15 mins incubation of LMD with cells, which suggests that mu peptide has an NLS function. These NLS properties were confirmed by cloning of a mu‐β‐galactosidase fusion protein that localises in the nuclei of cells after cytosolic translation. In dividing cells both LMD and LND deliver pDNA(Cy3) to nuclei within 30–45 min incubation with cells. By contrast, pDNA is detected only in the cytoplasm in growth‐arrested cells over the period of time investigated, and not in the nuclei. LD systems prepared from DC‐Chol/DOPE cationic liposomes and pDNA(Cy3) behave similarly to LMD systems, which suggests that mu peptide is unable to influence trafficking events in this current LMD formulation, in spite of its strong NLS capacity. We further describe the effect of polyethyleneglycol (PEG) on cellular uptake. “Stealth” systems obtained by post‐coating LMD particles with fluorescent‐labelled PEG molecules (0.5, 5 and 10 mol % fluorescein‐PEG5000‐N‐hydroxysuccinimide) were prepared and shown to be internalised rapidly (mins) by cells, without detectable transgene expression. This result indicates that PEG blocks intracellular trafficking of pDNA.
Solitary fibrous tumor of the thyroid: Cytopathologic findings and differential diagnosis
Authors: Parwani Anil V. , Galindo Rene , Steinberg David M. , Zeiger Martha A. , Westra William H. , Ali Syed Z. 
Published: March 2003

AbstractSolitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm that arises primarily from the pleura. Extrapleural occurrences are rare. To our knowledge, there is no published account of this entity in the thyroid in the cytopathology literature. We report the case of a 61‐yr‐old man who was evaluated at The Johns Hopkins Hospital for a slow‐growing thyroid mass that was present for 2 yr despite thyroid hormone suppression. Thyroid‐stimulating hormone (TSH) was within normal limits. The patient underwent ultrasound‐guided fine‐needle aspiration (FNA), which showed predominantly discohesive slender spindle‐shaped cells and fragments of collagenized stromal tissue. After the FNA diagnosis of “thyroid neoplasm” was made, the patient underwent a near‐total thyroidectomy, which revealed a SFT. Differential diagnosis of spindle cell lesions in thyroid is also presented. Diagn. Cytopathol. 2003;28:213–216. © 2003 Wiley‐Liss, Inc.
Endoscopic bile duct brushing of malignant pancreatic biliary strictures: Retrospective study with comparison of conventional smear and ThinPrep® techniques
Authors: Ylagan Lourdes R. , Liu Lucy H. , Maluf Horacio M. 
Published: March 2003

AbstractEndoscopic bile duct brushing (EBDB) is carried out to differentiate benign from malignant biliary strictures in patients who have pancreaticobiliary disease. The sensitivity of this method for the diagnosis of malignancy is relatively low. The aim of this study is to analyze the cytomorphologic features that are helpful in increasing the sensitivity of detecting these lesions on cytologic samples. These features are compared with slides prepared with the ThinPrep® technique. The study included 142 patients with bile duct obstruction or pancreatic mass who underwent EBDB and follow‐up surgery or biopsy between 1997 to 2000. Twenty‐five (18%) of these cases were positive for malignancy in both EBDB and follow‐up surgical biopsy; 20 of these cases were used as positive controls (PC). Sixty‐one (43%) were negative in both EBDB and follow‐up surgical biopsy specimens, and 21 of those cases were used as negative controls (NC). Fifty‐six (39%) cases were negative/atypical in EBDB cytology but were suspicious or positive in the surgical or biopsy specimens (false‐negative). We identified the cytologic criteria that were helpful in differentiating our positive and negative control groups and applied these criteria to our false‐negative group to see whether our sensitivity could be increased, using well‐defined cytologic criteria alone. Of the 56 false‐negative cases, 9 (16%) were upgraded to suspicious/positive based on the presence of the following features: three‐dimensional (3D) micropapillae (95% PC vs 19% NC, P < 0.0001), anisonucleosis (90% PC vs 5% NC, P < 0.0001), high nuclear‐to‐cytoplasmic (N/C) ratio (95% PC vs 9% NC, P < 0.0001), nuclear contour irregularity (65% PC vs 24% NC, P = 0.0079), and prominent nucleoli (70% PC vs 38% NC, P = 0.0406). Cytomorphologic features which were not helpful in distinguishing positive and negative cases were: single naked nuclei (50% PC vs 28% NC, P = 0.1597), chromatin granularity (50% PC vs 62% NC, P = 0.54), and necrosis (10% PC vs 5% NC, P = 0.5197). Improvement in diagnostic sensitivity for carcinoma of pancreaticobiliary tract in EBDB samples may be achieved by identifying the key malignant cytomorphologic features: 3D micropapillae, anisonucleosis, nuclear contour irregularity, prominent nucleoli, and high N/C ratio. The sensitivity in detecting malignant biliary strictures increased from 31% to 42% based on these criteria in our current study. Diagn. Cytopathol. 2003;28:196–204. © 2003 Wiley‐Liss, Inc.