bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical Relationship of the Medial Pectoral Nerve to the Musculocutaneous Nerve: A Cadaveric Study
Authors: Hansasuta Ake , Tubbs R. Shane , Grabb Paul A. 
Published: September 2004

AbstractOBJECTIVEFor purposes of neurotization of the musculocutaneous nerve (MCN) with the medial pectoral nerve (MPN) after upper trunk brachial plexus injuries, the anatomic relationship between these two nerves was defined in a cadaveric model.METHODSThirty-five brachial plexuses in 18 adult cadavers were dissected. The distance between the origin of the MPN from the medial cord to the origin of the MCN from the lateral cord was measured. The length, diameter, branching, and location of the MPN were recorded. The diameter of the proximal MCN was recorded.RESULTSThirty-seven percent of the MPNs, when detached from the pectoralis muscles, were too short to reach the proximal MCN by a mean distance of 15 mm. The MPN pierced the pectoralis minor muscle in 80% of the dissections. The cross sectional area of the MCN was always larger than the cross sectional area of the MPN by an average factor of 2.5.CONCLUSIONWhen planning to use the MPN for neurotization of the MCN, one should be prepared to harvest an interposition graft, because over one-third of MPNs may not have enough length to reach the MCN in a tension-free manner. Diameter mismatch occurs predictably between the distal MPN and the proximal MCN.
Osteoplastic Lateral Suboccipital Approach for Acoustic Neuroma Surgery: Technical Note
Authors: Sepehrnia Abolghassem , Knopp Ulrich 
Published: September 2004

AbstractOBJECTIVEPersistent headache remains a significant problem in a small group of patients after acoustic neuroma surgery via the lateral suboccipital approach. We describe a modified technique of osteoplastic lateral suboccipital craniotomy for surgery of the cerebellopontine angle. This simple and elegant technique provides a superior cosmetic result and a significant reduction in patients' symptoms.METHODSWe report on our series of 75 patients who underwent surgery for acoustic neuroma. The maximal follow-up period was 4 years.RESULTSNo patients reported headache postoperatively. Cerebrospinal fluid fistulae were not observed.CONCLUSIONThis modified approach minimizes cerebellar retraction, and the neural and vascular structures can be preserved under direct visualization of the tumor. This lateral suboccipital approach is a useful modification of previous approaches in acoustic neuroma surgery. It provides successful tumor resection and excellent functional results.
En Bloc Laminoplasty Performed with Threadwire Saw: Technical Note
Authors: Hara Masahito , Takayasu Masakazu , Takagi Teruhide , Yoshida Jun 
Published: September 2004

Abstract

OBJECTIVE
To introduce a method for a simple, nonexpansive laminoplasty that can be performed with a threadwire saw (T-saw) after en bloc laminotomy has been performed. The method can be applied along the entire spinal region, including the thoracic and lumbar spine.

METHODS
An en bloc laminotomy of trapezoid shape at the cross section is performed bilaterally at the junctional area of the lamina and facet joint with a thin, flexible T-saw, while preserving the supraspinous, interspinous, and interlaminar ligaments. After the intradural procedure has been performed, the laminar flap is replaced in its original site and fixed with 1-0 nylon sutures, resulting in the complete reconstruction of the posterior supporting elements of the spinal column.

RESULTS
En bloc laminoplasty was performed on 16 patients via a T-saw; most of the patients had intradural spinal tumors. The patients did not need their spinal canals to be enlarged after the intradural procedure had been performed. The follow-up period ranged from 2 to 40 months (mean ± standard error, 22.6 ± 3.4 mo). The laminoplasty was performed from the upper cervical to the sacral regions, although the most frequently operated level was the lower thoracic level. Two-level laminoplasty was performed in 12 patients, and three-level laminoplasty was performed in four. The laminoplasty was done safely and without any complications, except in one patient, who experienced thoracic root injury from a T-saw that was accidentally inserted anterior to the roots. No spinal column deformity or sinking of the replaced laminar flap was noted during the follow-up period; patients were assessed at follow-up via radiographs or computed tomographic scans. Computed tomographic scans obtained later indicated that bony fusion occurred at the cutting edges 1.0 to 4.0 months after surgery (mean, 1.90 ± 0.34 mo).

CONCLUSION
Simple en bloc laminoplasty performed with a T-saw is a useful, safe procedure that can be used to reconstruct the posterior spinal elements throughout the whole spinal region after the intradural procedure has been performed.
Vascular Orientation by Intra-arterial Dye Injection during Spinal Arteriovenous Malformation Surgery: Technical Note
Authors: Tani Satoshi , Ikeuchi Satoshi , Hata Yuichi , Abe Toshiaki 
Published: September 2004

Abstract

OBJECTIVE
Rich and complicated vascular structures on the spinal cord often interfere with obliteration of a spinal arteriovenous malformation (AVM). Vascular orientation during spinal AVM surgery is essential. The authors recently performed six consecutive spinal AVM surgeries in five patients (two with perimedullary AVMs, and three with dural arteriovenous fistulae) with the aid of intra-arterial injection of dye (indigo carmine).

METHODS
Two representative cases are described. A microcatheter was placed preoperatively in the artery of interest. Subsequent to the exposure of the vascular complex, a 1-ml injection of indigo carmine (2 mg/ml) clearly demonstrated the feeding arteries and the draining veins around the AVM or dural arteriovenous fistula.

RESULTS
One patient had repeat surgery because of incomplete obliteration of the AVM owing to migration of the catheter. All patients, except one who had temporary postoperative deterioration and persistent neurological deficits, had good surgical outcomes, however. No apparent side effects caused by the dye were reported.

CONCLUSION
The assistance system for spinal AVM surgery is easy and safe and can be applied in other surgical institutions.
Helicobacter pylori and Nonmalignant Diseases
Authors: Kuipers Ernst J. , Malfertheiner Peter 
Published: September 2004

ABSTRACTThis paper reviews the new literature from the past year on the association between colonization with Helicobacter pylori and non‐malignant disease of the upper gastrointestinal tract. This issue has, in the past year, remained a topic of wide research interest yielding many important new data. These data show that H. pylori eradication is the most effective therapy for peptic ulcer disease, but that a considerable proportion of ulcer patients remain to have dyspeptic symptoms. The discussion on the interaction between H. pylori and NSAID use in the etiology of ulcer disease has not yet been settled. Several studies, both from Asia and Europe, now reported that H. pylori eradication has a minimal effect on the primary prevention of ulcer disease in NSAID users, but eradication appears of relevance for the secondary prevention of ulcer disease in addition to proton pump inhibitor maintenance therapy. Various studies brought further support for the hypothesis that H. pylori eradication is of some benefit for patients with non‐ulcer dyspepsia, although the effects are limited. The prevalence of H. pylori is lower among GERD patients than among controls, but H. pylori eradication has not been consistently shown to increase the risk for the newly development of GERD in an individual subject undergoing H. pylori eradication. The discussion on H. pylori and GERD should not preclude us from treating H. pylori‐infected patients for accepted clinical indications. In patients using proton pump inhibitors for GERD, H. pylori eradication leads to a resolution of their corpus‐predominant pangastritis, without impairing the efficacy of PPI therapy.
Epidemiology of Helicobacter pylori Infection
Authors: Perez‐Perez Guillermo I. , Rothenbacher Dietrich , Brenner Hermann 
Published: September 2004

ABSTRACTThis review summarizes key results of epidemiologic studies published in peer‐reviewed journals between April 2003 and March 2004. The prevalence of H. pylori infection continues to vary strongly between developing countries and developed countries, and according to ethnicity, place of birth and socioeconomic factors among people living in the same country. Intrafamilial spread appears to play a central role in transmission of the infection in both developing and developed countries. The role of H. pylori infection in development of noncardia gastric cancer appears to be even much stronger than previously assumed, whereas the lack of an association with cardia cancer and an inverse association with adenocarcinoma of the esophagus could be confirmed. Suggestions for an inverse association of the infection with atopic diseases have recently received further support, whereas evidence concerning the role of the infection (or its eradication) in GERD and a large variety of other extragastric diseases, including cardiovascular disease, remains inconclusive.
Helicobacter pylori Public Health Implications
Authors: Moayyedi Paul , Hunt Richard H. 
Published: September 2004

ABSTRACTPopulation Helicobacter pylori screening and treatment has the potential to dramatically reduce global gastric cancer mortality. There is overwhelming evidence that the infection is a major cause of distal gastric adenocarcinoma. There is also randomized controlled trial evidence that H. pylori eradication reverses or ameliorates histological changes in the gastric mucosa that are important in carcinogenesis. Preliminary randomized controlled trial data suggest that screening and treatment may reduce the risk of gastric cancer although the number of cancer cases was small. Population H. pylori screening and treatment will also reduce mortality from peptic ulcer complications and reduce the burden of dyspepsia in the community. The reduction in health service dyspepsia costs means that this could be the first programme to pay for itself.From a scientific perspective, we still have insufficient evidence to conclude the benefits of population H. pylori screening are greater than the possible harms and we need more randomized controlled trial data. From a public health perspective however, sometimes screening programmes are developed with imperfect information. The medical community should be consistent and if we are instituting other population screening programmes without randomized controlled trial evidence then H. pylori testing and treatment should also be considered.
Helicobacter pylori and Gastric Malignancies
Authors: Asaka Masahiro , Dragosics Brigitte A. 
Published: September 2004

ABSTRACTClinical outcomes of Helicobacter pylori infection are diverse and caused by the variability of H. pylori virulence factors, host susceptibility, environmental factors and their interactions. Prospective epidemiological studies have clearly shown the relationship between H. pylori infection and gastric cancer. In addition, studies in animal models such as Mongolian gerbils with or without the addition of low‐dose chemical carcinogens demonstrated that H. pylori infection can develop gastric carcinoma. Experimental studies have shown that virulence factors of H. pylori interact with gastric epithelial cell signaling related to carcinogenesis.While the effect of H. pylori eradication on prevention of such tumors in chronic H. pylori carriers is still controversial, progress has been made in therapy especially of gastric lymphoma with well tolerated chemotherapeutic regimen.
Helicobacter pylori Infection in Pediatrics
Authors: Crone Julia , Gold Benjamin D. 
Published: September 2004

ABSTRACTThe proposed route of Helicobacter pylori transmission appears to be fecal‐oral, oral‐oral and gastro‐oral, yet, a number of studies challenged these hypotheses in 2003. The use of the stool antigen test and[13]‐C urea breath testing were the tests of choice for diagnosis and ‘test for cure’ of H. pylori in Europe in 2003 but have not yet become accepted standard of care in North America. Pediatric H. pylori consensus guidelines are not yet revised; upper endoscopy and biopsy remain the gold standard for diagnosis of pediatric H. pylori infection. In addition to stronger evidence supporting the role of host influences of H. pylori‐associated gastric cancer risk, compelling evidence was provided for the role of H. pylori in iron deficiency anemia of childhood. Antibiotic resistance remains a problem in conferring treatment failure and 2003 studies indicate that macrolide resistance is higher in children than in adults. Treatment with proton pump inhibitor‐based triple therapy for 10–14 days remains the mainstay for eradication of H. pylori in childhood. Finally, multinational studies are needed to develop screening guidelines for childhood infection to avoid long‐term severe gastroduodenal disease sequelae.
Desloratadine in combination with montelukast in the treatment of chronic urticaria: a randomized, double‐blind, placebo‐controlled study
Authors: Nettis E. , Colanardi M. C. , Paradiso M. T. , Ferrannini A. 
Published: September 2004

SummaryBackground
Chronic urticaria (CU) is a common skin condition. It is frequently a disabling disease due to the persistency of clinical symptoms, the unpredictable course and negative influence on the quality of life.Objective
The aim of this study is to determine whether montelukast, a LTD4 receptor antagonist, plus desloratadine, is more efficacious than desloratadine alone in the treatment of chronic urticaria.Materials
A randomized, double‐blind, placebo‐controlled study was conducted on 81 patients with a diagnosis of CU. A 1‐week single‐blind placebo run‐in period (baseline) was followed by a 6‐weeks double blind active treatment period. The patients were randomized to receive the following treatment once daily: (a) oral desloratadine (5 mg) plus placebo; (b) desloratadine (5 mg) plus montelukast (10 mg); (c) oral placebo alone. The study ended after another 1‐week single‐blind placebo washout period.Results
The evaluable population thus consisted of 76 patients. Both desloratadine alone and desloratadine plus montelukast administered once daily yielded improvements with respect to the baseline assessment as regards pruritus, number of separate episodes, size and number of weals, visual analogue score and patients' quality of life and with respect to the placebo group both in the active treatment period and in the run‐out period. However, desloratadine plus montelukast was shown to improve the symptoms and patients' quality of life significantly more than desloratadine alone, although it did not have a significant effect on the number of urticarial episodes.Conclusion
The combination of desloratadine plus montelukast is effective in the treatment of CU. It may therefore be a valid alternative in patients with relatively mild CU, in view of its efficacy and the lack of adverse events.
Fluticasone propionate aqueous nasal spray does not influence the recurrence rate of chronic rhinosinusitis and nasal polyps 1 year after functional endoscopic sinus surgery
Authors: Dijkstra M. D. , Ebbens F. A. , Poublon R. M. L. , Fokkens W. J. 
Published: September 2004

SummaryBackground
Local corticosteroids are widely used in the treatment of nasal polyps and chronic rhinosinusitis both before and after nasal surgery. Their efficacy after functional endoscopic sinus surgery (FESS) has not been fully established by placebo‐controlled trials.Objective
This double‐blind placebo‐controlled randomized study was performed in order to investigate whether fluticasone propionate aqueous nasal spray (FPANS) reduces the recurrence rate of nasal polyps and chronic rhinosinusitis during the first year after FESS.Patients and methods
The trial looked at 162 patients aged 18 years and older requiring FESS for chronic rhinosinusitis or nasal polyps. After FESS combined with peri‐operative systemic corticosteroids, patients were randomized and given FPANS 400 μg b.i.d., FPANS 800 μg b.i.d. or placebo b.i.d. for the duration of 1 year. Patients were withdrawn from the trial (but still included in the study for statistical purposes) if there were recurrent or persistent diseases, defined as progressive regrowth of nasal polyps, recurrent signs and symptoms of chronic sinusitis combined with abnormalities on computed tomography scan and persistent complaints for at least 2 months after FESS.Results
A significant reduction of symptoms was seen after FESS. After 1 year, 46 patients had been withdrawn from the trial because of recurrent diseases and 32 patients because of persistent symptoms. No differences in the number of patients withdrawn because of recurrent or persistent diseases were found between the patients treated with FPANS and patients treated with placebo. We were also unable to find a positive effect of FPANS compared with placebo in several subgroups such as patients with nasal polyps, high score at FESS or no previous sinus surgery.Conclusion
This placebo‐controlled study does not show that treatment with FPANS up to 1 year after FESS had a positive effect compared with placebo.
Analysis of effector and regulatory immune reactivity to nickel
Authors: Rustemeyer T. , Von Blomberg B. M. E. , Van Hoogstraten I. M. W. , Bruynzeel D. P. , Scheper R. J. 
Published: September 2004

SummaryBackground
Diagnostic patch testing in allergic contact dermatitis faces the risk of boosting existing hypersensitivities or active sensitization. Risk‐free and reliable in vitro assays using peripheral blood are, therefore, wanted.Objectives
Here, we studied new approaches for in vitro monitoring of nickel‐specific effector ad regulatory cell functions in allergic patients and potentially tolerized individuals.Methods
Lymphocyte proliferation assays were carried out with the allergen and additional IL‐12/IL‐7 or IL‐4/IL‐7 cytokine supplements. Release of IFN‐γ and IL‐5 were assessed as measures for type‐1 and type‐2 effector T cell function, respectively, and IL‐10 and TGF‐β1 to monitor possible regulatory T cell function reflecting immunological tolerance. After optimization of in vitro cut‐off values, potency of these parameters was evaluated as compared with conventional nickel patch testing.Results
One hundred and fifty six outpatients were included in this study, 74 of whom presenting with a positive history of nickel allergy. Nickel‐sulphate patch test results showed positive reactions in 43 patients, of whom 40 had a positive history (test sensitivity 54%; specificity 96%; overall accuracy 76%). Proliferation tests without cytokine supplementation showed an accuracy of 68%, which was further improved by supplementing IL‐4/IL‐7 (82%). IFN‐γ and IL‐5 cytokine production, as revealed in IL‐12/IL‐7 and IL‐4/IL‐7 supplemented cultures, respectively, showed accuracies of 70% and 83%. As to the production of putatively immunoregulatory cytokines, IL‐10 was most informative, with highest production rates in nickel‐skin test negative individuals with long‐lasting mucosal metal contact preceding skin piercing.Conclusions
These results indicate that measuring both T cell proliferation and cytokine secretion profiles, in particular IL‐5 release using IL‐4/IL‐7 supplemented medium, offers a promising improvement of the in vitro diagnostic options in monitoring nickel contact sensitization. Since oral nickel contact has been shown earlier to induce active tolerization, nickel‐induced in vitro IL‐10 production may help identify nickel‐tolerized individuals.
Aluminium hydroxide down‐regulates T helper 2 responses by allergen‐stimulated human peripheral blood mononuclear cells
Authors: Wilcock L. K. , Francis J. N. , Durham S. R. 
Published: September 2004

SummaryBackground
Aluminium hydroxide (alum) is a commonly used adjuvant for specific immunotherapy of allergic diseases. While alum is traditionally associated with murine Th2 sensitization, little is known about its effects on secondary allergic responses in humans.Methods
We investigated the in vitro effects of alum on peripheral blood mononuclear cells (PBMC) from atopic donors. PBMC from 18 grass pollen‐sensitive rhinitic subjects were stimulated with Phleum pratense (Phl p) in the presence or absence of alum. After 6 days culture, cytokine production was measured by ELISA and T cell proliferation by radiolabelled thymidine incorporation. The effect of alum on the expression of human leucocyte antigen and CD80/CD86 on cultured antigen‐presenting cells was assessed by flow cytometry.Results
PBMC cultured with Phl p and alum showed a significant decrease in both IL‐5 and IL‐13 production compared with allergen alone (P<0.005 and P<0.001, respectively), but no change in IFN‐γ or IL‐12 production or proliferative responses. These alum‐induced changes in T helper (Th)2 cytokine production were unaffected by the addition of neutralizing antibodies to IL‐4 or IL‐12. Culture of PBMC with alum induced increased expression of CD86 (P=0.004) and HLA (P=0.01) on monocytes while the expression of CD80 was decreased (P=0.02).Summary
Alum down‐regulates allergen‐driven Th2 cytokine responses while Th1 cytokines are unaffected. These data confirm that alum is a useful adjuvant for inclusion in allergen immunotherapy vaccines.
Defective suppression of Th2 cytokines by CD4+CD25+ regulatory T cells in birch allergics during birch pollen season
Authors: Grindebacke H. , Wing K. , Andersson A.‐C. , Suri‐Payer E. , Rak S. , Rudin A. 
Published: September 2004

SummaryBackground
CD4+CD25+ regulatory T cells suppress proliferation and cytokine production by human T cells both to self‐antigens and exogenous antigens. Absence of these cells in human newborns leads to multiple autoimmune and inflammatory disorders together with elevated IgE levels. However, their role in human allergic disease is still unclear.Objective
This study aimed to evaluate the capacity of CD4+CD25+ regulatory T cells to suppress proliferation and cytokine production outside and during birch‐pollen season in birch‐allergic patients relative to non‐allergic controls.Methods
CD4+ cells were obtained from blood of 13 birch‐allergic patients and six non‐allergic controls outside pollen season and from 10 birch‐allergic patients and 10 non‐allergic controls during birch‐pollen season. CD25+ and CD25− fractions were purified with magnetic beads and cell fractions, alone or together in various ratios, were cultured with antigen‐presenting cells and birch‐pollen extract or anti‐CD3 antibody. Proliferation and levels of IFN‐γ, IL‐13, IL‐5 and IL‐10 were measured by thymidin incorporation and ELISA, respectively. Numbers of CD25+ cells were analysed by flow cytometry.Results
CD4+CD25+ regulatory T cells from both allergics and non‐allergics potently suppressed T cell proliferation to birch allergen both outside and during birch‐pollen season. However, during season CD4+CD25+ regulatory T cells from allergic patients but not from non‐allergic controls were defective in down‐regulating birch pollen induced IL‐13 and IL‐5 production, while their capacity to suppress IFN‐γ production was retained. In contrast, outside pollen season the regulatory cells of both allergics and non‐allergic controls were able to inhibit T‐helper 2 cytokine production.Conclusion
This is the first study to show differential suppression of Th1 and Th2 cytokines, with CD4+CD25+ regulatory T cells from birch‐pollen‐allergic patients being unable to down‐regulate Th2, but not Th1 responses during birch‐pollen season.