bluuebunny/crossref_metadata_2025_split huggingface dataset:
Review of treatment of pterygium in Queensland: 10 years after a primary survey
Authors: Troutbeck Robyn , Hirst Lawrence 
Published: March 2003

ABSTRACT Purpose: To assess the practices in pterygium removal as a follow‐up study to a similar project 10 years ago, in order to compare the current trends with those noted a decade ago. Methods: A survey was sent to all practising ophthalmologists in Queensland (100). Results: Eighty‐seven of the 100 ophthalmologists undertook pterygium surgery with no change in indications for removal, grading or anaesthesia compared to 10 years ago. Nearly half of the ophthalmologists varied their surgical technique from eight commonly used methods according to the individual patient. More than half the respondents used a swinging conjunctival flap and 29% used simple excision leaving the area bare for primary pterygia, although nearly one‐quarter of the ophthalmologists added adjunctive therapies such as beta irradiation or mitomycin. For recurrent pterygia, one‐third of ophthalmologists preferred adjunctive therapies, and 57% used an autoconjunctival transplant. Conclusion: There has been no consistent trend in surgical removal of pterygia with a significant number of primary pterygia still removed using bare scleral closure.
Trends in health service delivery for cataract surgery at a large Australian ophthalmic hospital
Authors: Yi Qing , Flanagan Sandra J , McCarty Daniel J 
Published: March 2003

ABSTRACT Purpose: To evaluate trends in health service delivery for cataract surgery at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Methods: A retrospective study was conducted of computerized hospital admissions for cataract surgery from July 1994 through June 1999. Main outcome measures included the annual number of cataract surgeries, waiting time, percentage of patients hospitalized overnight, length of overnight hospitalization, type of cataract surgery, surgery duration and total time in the operating theatre. Results: Although the annual number of patients undergoing cataract surgery increased from 3395 to 4796 over the 5‐year study interval, there was a 13‐day reduction in mean waiting time for public patients, a 30% reduction in overnight hospitalizations and a half‐day reduction in length of hospitalization for all patients. There was also an increasing trend in use of phacoemulsification cataract extraction. Conclusions: The health‐care delivery for cataract surgery appears to have improved during the past 5 years at the Royal Victorian Eye and Ear Hospital.
Corticosteroid‐induced glaucoma in a child after a scleral reinforcement procedure
Authors: Park Joseph J , Gole Glen A 
Published: March 2003

AbstractCorticoteroid‐induced glaucoma can result from either topical or systemic corticosteroid use. Compared with adults, the corticosteroid response in children is less well known. The case is reported of a child who developed glaucoma after receiving topical corticosteroids following a scleral re­inforcement procedure. The raised intraocular pressure was controlled after cessation of the corticosteroids and with the use of antiglaucoma therapy. As many forms of cortico­steroids are widely used, children on corticosteroids should have regular intraocular pressure measurements as part of their management.
Questioning the need for routine bone marrow aspiration and lumbar puncture in patients with retinoblastoma
Authors: Azar Domit , Donaldson Craig , Dalla‐Pozza Luciano 
Published: March 2003

Abstract Purpose: This study assesses the value of routinely investigating children with retinoblastoma with bone marrow aspiration and lumbar puncture, staging investigations not without risk and trauma to the patient, emotional stress on parents and financial cost to the community. Methods: Medical files and specimens were obtained and examined for patients with retinoblastoma presenting to the Royal Alexandra Hospital for Children, Camperdown and the Children's Hospital at Westmead, Sydney, from 1975 to 2001. Results: In total, 123 patients presented; 62 (50.4%) were boys and 61 (49.6%) were girls. Of these 123 patients, 74 (60.2%) had unilateral disease, 46 (37.4%) involving the left eye and 28 (22.8%) involving the right eye. There were 47 (38.2%) patients with bilateral disease, and two (1.6%) with trilateral disease. Mean age of presentation was 17.9 months (23.1 months for unilateral subjects; 10.3 months for bi­lateral subjects; 3.5 months for trilateral subjects). There were 13 (10.6%) with a positive family history. Of 74 unilateral subjects, 70 (94.6%) required enucleation and four (5.4%) were salvaged. Of 47 bilateral subjects, 13 (27.7%) did not require enucleation, 27 (57.4%) required unilateral enucleation and seven (14.9%) required bilateral enucleation. Both trilateral subjects died. Of all 123 subjects, 112 (91.1%) had bone marrow aspiration and lumbar puncture performed during initial assessment, and none showed evidence of malignancy. Conclusions: Given the small but significant risks associated with these procedures, the results of this study cannot support bone marrow aspiration and lumbar puncture as routine investigations in all patients presenting with retinoblastoma, suggesting a more limited usage of these investigations is warranted.
A prospective study of endoscopic treatment for early gastric cancer in Japan: An interim report
Authors: Ida Kazunori , Nakazawa Saburo , Hiki Yoshiki , Kurihara Minoru , Yoshino Junji , Tada Masahiro , Shimao Hitoshi , Katoh Takahiro , Niwa Hirofumi , Sakita Takao 
Published: March 2003

Background: This prospective study was designed to clarify the present status and problems inherent in endoscopic treatment of early gastric cancer by endoscopic mucosal resection and other modalities in Japan and to investigate the possibility of extending the indications for endoscopic treatment. Methods: A total of 409 patients with early gastric cancer lesions were enrolled in this study. Of these, 219 lesions (182 in group I and 37 in group II) were evaluated. Results: Histological evaluation in group I showed that complete resection, relatively incomplete resection, and absolutely incomplete resection were carried out for 103 (56.6%), 20 (11.0%), and 59 (32.4%) lesions, respectively. Surgery was performed for two lesions of the absolutely incomplete resection group. The remaining 180 lesions were followed up with endoscopy after endoscopic treatment. Recurrence occurred in 14 of 57 lesions with absolutely incomplete resection receiving additional endoscopic treatment, while no recurrence was noted in the lesions of the complete resection or relatively incomplete resection group. At present, 175 lesions of group I have been followed up with endoscopy. Histological evaluation of 30 lesions with differentiated carcinoma in group II revealed that complete resection was successful in only six (20%) lesions. Thirty lesions, including 24 receiving additional endoscopic treatment for absolutely incomplete resection, were followed up endoscopically. None of the lesions showed recurrence. Conclusion: An interim report of this study is presented herein. Both groups have been followed up over the past 5 years, and in the final report of this study the authors aim to discuss the effectiveness of various kinds of therapeutic modalities and extend the indication of endoscopic treatment for early gastric cancer.
ARGON PLASMA COAGULATION FOR THE ENDOSCOPIC TREATMENT OF A NON‐RESECTABLE KLATSKIN TUMOR: IN VITRO AND IN VIVO STUDY
Authors: Shim Chan Sup , Moon Jong Ho , Cho Young Deok , Hong Su Jin , Kim Jin Oh , Cho Joo Young , Lee Moon Sung , Jeon Hoon Bae , Hur Kyung Yul , Jin So Young 
Published: March 2003

Background: Palliative treatment including stenting is limited in patients with Klatskin tumor. Argon plasma coagulation (APC) is a new local treatment modality for the devitalization and debulking of tumors. Argon plasma coagulation could be a candidate method for relief of biliary strictures in patients with non‐resectable Klatskin tumor in whom biliary stenting has failed. This study provides an evaluation of the technical feasibility, safety, and effect of APC as a palliative strategy in patients with non‐resectable Klatskin tumor.Methods: In vitro studies were performed in order to investigate the dimension of coagulation necrosis in 11 human gallbladders. The currents were applied in normal air conditions and a bowl filled with normal saline in five and six specimens, respectively. Argon plasma coagulation was also performed on three patients with Klatskin tumor who showed no effective drainage via percutaneous transhepatic approach with a cholangioscope.Results: A coagulation current was delivered to the specimen even if in normal saline. The maximum depth and diameter of necrosis was 3 and 6.5 mm under normal air conditions, compared with 2 and 5 mm in water conditions. No perforation of the gallbladder wall occurred in any of the lesions. The dimension of the necrosis increased with increasing impact time and energy settings. Argon plasma coagulation application was possible on tumors of patients without severe complication.Conclusion: Argon plasma coagulation seems to be applicable, effective and relatively safe in palliative treatment for advanced non‐resectable Klatskin tumor via cholangioscopy. Longer follow ups and comparative trials with other treatment modalities are, however, required.
Visualization of gastric cardial varices by balloon‐sheathed ultrasonic microprobe
Authors: Sato Takahiro , Yamazaki Katsu , Toyota Jouji , Karino Yoshiyasu , Ohmura Takumi , Suga Toshihiro 
Published: March 2003

Background:There is little information in the literature on the diagnosis of esophagogastric varices via ultrasonic microprobe (UMP).Methods:Twenty‐one patients with esophageal varices (five cases F3; 16 cases F2) were studied. First, ultrasonographic observation of the cardiac area using deaerated water through the biopsy channel (the water repletion method) was performed followed by the balloon sheath method using MH‐246R (3.2 mm in diameter; Olympus, Tokyo, Japan).Results:The vessel images of intramural gastric varices were delineated in all 21 patients with both the water repletion method and the balloon sheath method. The overall features of perigastric collateral veins were obtained in 14 of 21 patients (66.7%) using the water repletion method and in 18 of 21 patients (85.7%) with the balloon sheath method. Vessel images of communicating veins were obtained in 10 of 21 patients (47.6%) with the water repletion method and in 17 of 21 patients (81.0%) with the balloon sheath method.Conclusion:We conclude that detailed evaluation of esophageal varix hemodynamics in the cardia is most successfully accomplished by using the balloon sheath method of UMP in conjunction with the water repletion method.
Liver abscess that developed after a long interval of transcatheter arterial embolization followed by formation of hepatoduodenal fistula
Authors: NAKAMURA HIROSHI , MIZOKAMI YUJI , SHIRAISHI TAKAHISA , OTSUBO TOSHIYA , SHIRAI KENJI , KARIYA YOSHIYUKI , OMATA TAKAYUKI , TAKEYAMA HIROKI , MATSUOKA TAKESHI , NISHIGAMI TAKESHI 
Published: March 2003

ABSTRACTA 55‐year‐old male patient with hepatocellular carcinoma underwent transcatheter arterial embolization (TAE). He became febrile and experienced pain at the right hypochondrial region 323 days later, which led to the discovery of a liver abscess that fistulated into the duodenal bulb. There have been no reports on the fistulation of liver abscesses into the digestive system following TAE. Rhodococcus equi was isolated as a causative agent, which distinguished the case further.
CLINICOPATHOLOGICAL STUDY OF UNSUSPECTED GALLBLADDER CANCER DIAGNOSED AFTER LAPAROSCOPIC CHOLECYSTECTOMY
Authors: SAKAMOTO KAZUHIRO , KITAJIMA MASAYUKI , SHIROTA SHIGERU , WATABE SUGURU , OKUZAWA ATSUSHI , MATSUDA MITSUHIRO , ONO KEN , KOBAYASHI SHIGERU , KAMANO TOSHIKI , TSURUMARU MASAHIKO , HIRAI SHU 
Published: March 2003

Background:  Laparoscopic cholecystectomy (LC) has become a common treatment for benign gallbladder diseases. However, this method has not been established for gallbladder cancer.Methods:  In the present study, we examined the clinicopathlogical features of gallbladder cancer that was diagnosed after LC.Results:  The presence of unsuspected gallbladder cancer was found in five out of 498 patients (1.00%). Preoperative diagnoses were gallstone in two, gallstone with adenomyomatosis in one, adenomyomatosis in one and gallbladder polyp in one. During LC, there was no evidence of cancer, but bile leakage occurred in two patients. Histologically, the carcinoma had invaded into the subserosa in four patients and into the mucosa in one patient. An additional operation was performed in three patients. Histological examination revealed no cancer cells in the resected liver and lymph nodes. During the average follow‐up period of 47.5 months, no recurrences were observed. Although one patient died of liver metastasis 33 months later, the other three patients who underwent an additional radical operation, showed no recurrence.Conclusions:  It is important to prevent port site recurrence or dissemination during LC, so a careful maneuver is required to avoid perforation of the gallbladder. At the time of bile leakage, it is best to wash around the liver bed fully to prevent recurrences of unsuspected gallbladder cancers. If gallbladder cancer has invaded the subserosa or deeper level histologically, a radical second operation should be performed as soon as possible.
Miniprobe sonography in the evaluation of 169 patients with gastrointestinal disease
Authors: Qi Zhu , Yaozong Yuan , Jiayu Xu , Fengzhao Wang , Shihu Jiang , Yunlin Wu , Peiqing Zhao 
Published: March 2003

OBJECTIVE: It is still difficult to precisely differentiate elevated lesions of the gastrointestinal mucosa or estimate the depth of malignant lesions by using conventional endoscopy and biopsy. The aim of the present study was to assess the clinical value of miniprobe sonography (MPS). METHODS: A total of 169 patients (including 83 patients who underwent endoscopic treatment or surgery) with gastrointestinal disease were examined by using MPS in conjunction with endoscopic examination. The diagnosis according to MPS was compared with macroscopic findings, endoscopic biopsy and surgical results. RESULTS: In the case of elevated lesions of the gastrointestinal mucosa with negative biopsies, compared with surgical findings, the diagnostic accuracy of MPS was 98.3% (115/117). In the case of malignant lesions, MPS findings with regard to the lesion depth were 100% in agreement with those from surgical biopsy (31/31). CONCLUSION: The MPS technique is significantly superior to conventional endoscopy with pathological biopsy in the differentiation of elevated lesions of the gastrointestinal mucosa and thus has important clinical value. But in the case of malignant lesions, only the depth of infiltration into the gastrointestinal wall can be correctly assessed by MPS, so its value is limited in the identification of lymph nodes and distal metastases.
Parkinsonism in patients with subcortical arteriosclerotic encephalopathy: A magnetic resonance imaging study
Authors: Hanyu Haruo , Tanaka Yuriko , Asano Tetsuichi , Sakurai Hirofumi , Iwamoto Toshihiko , Takasaki Masaru 
Published: March 2003

Background: The aim of the present paper was to determine anatomical brain damage causing parkinsonism in patients with subcortical arteriosclerotic encephalopathy.Methods: Using magnetic resonance imaging, the findings in 16 subcortical arterio‐sclerotic encephalopathy patients with parkinsonism were compared with those of 16 subcortical arteriosclerotic encephalopathy patients without parkinsonism. In addition to conventional magnetic resonance imaging, the magnetization transfer technique was also employed, and the magnetization transfer ratios of white matter hyperintensity lesions in the frontal lobe were measured to detect structural changes.Results: The extent of infarcted lesions in the lentiform nucleus of patients with parkinsonism was significantly greater than in patients without parkinsonism. Although white matter hyperintensity areas did not differ significantly between the two patient groups, magnetization transfer ratios in the white matter hyperintensity lesions of patients with parkinsonism were significantly lower than those of patients without parkinsonism. The lower magnetization transfer ratios suggest that tissue damage of white matter lesions in patients with parkinsonism is more severe than in patients without it.Conclusion: Both severe tissue damage in the frontal white matter and extensive infarcted lesions in the lentiform nucleus might be responsible for the development of parkinsonism in patients with subcortical arteriosclerotic encephalopathy.
Prevalence and characteristics of older community residents with mild cognitive decline
Authors: Fujiwara Yoshinori , Watanabe Shuichiro , Kumagai Shu , Yoshida Yuko , Takabayashi Koji , Morita Masahiro , Hasegawa Akihiro , Hoshi Tanji , Yokode Masayuki , Kita Toru , Shinkai Shoji 
Published: March 2003

Background: Cognitive impairment is a major health issue, but epidemiological data on mild cognitive decline have been almost absent in Japan.Methods: Of all residents aged 65 years and over living in Yoita town, Niigata Prefecture, Japan in the year 2000 (n = 1673), 1544 participated in the interview survey held at community halls or at home (92.3% response). They underwent the Mini‐Mental State Examination (MMSE) for assessment of cognitive function and answered questionnaires comprising socio‐demographic, psychological, physical and medical, and social activity items. Higher‐level functional capacities were evaluated with the Tokyo Metropolitan Index of Competence (TMIG‐Index of Competence). According to subject’s age and MMSE score, all subjects were classified into 3 groups: control (MMSE > 1 SD below age‐specific means), mild cognitive decline (MMSE ≥ 21 and ≤ 1 SD below age‐specific means), and severe cognitive decline (MMSE ≤ 20), and compared various characteristics among these groups.Results: Mean MMSE score of the subjects showed a linear decline with advancing age. Among the participants, 232 (15.2%) were classified as mild cognitive decline. Compared with the controls, the subjects with mild cognitive decline reported poorer subjective health, more depressive moods, more history of stroke, more prevalence of basic activity of daily living (BADL) disability, and lower higher‐level functional capacity, even after controlling for possible confounding factors. They also reported a low level of social activities: both participating in group activities and enjoying hobbies were less frequent. Their food intake pattern tended to be monotonous.Conclusions: Older persons with mild cognitive decline comprised a substantial proportion (15.2%) of the community‐dwelling older population. In addition to lower cognitive function, they had lower levels of functional capacity and social activity.
Association between a promoter polymorphism of the paraoxonase PON1 gene and pathologically verified idiopathic Parkinson’s disease
Authors: Kazama Hirohito , Hosoi Takayuki , Nakahara Ken‐ichi , Murayama Shigeo , Saito Yuko , Kanemaru Kazutomi , Nagura Hiroshi , Arai Tomio , Sawabe Motoji , Toba Kenji , Yamanouchi Hiroshi , Orimo Hajime 
Published: March 2003

Background:  Exposure to pesticide is associated with an elevated risk of Parkinson’s disease (PD). Oxidative stress is also implicated in the etiology of PD. Paraoxonase (PON1) detoxifies organophosphates and exhibits antioxidant properties. It was postulated that polymorphisms of the PON1 gene lead to increased risk of PD.Methods:  The seven polymorphisms of the PON1 gene were typed and neuropathologic examination performed in 360 Japanese people (191 men and 169 women) consecutively autopsied at a general hospital.Results:  Thirty‐three patients (18 men and 15 women) were diagnosed with pathologically verified idiopathic PD (pviPD). The proportion of male patients with pviPD was highest in the AA genotype (29.4%) of the G(−824)A polymorphism, followed by the GA genotype (9.3%), and least in the GG genotype (6.0%). These genotypic distributions and allele frequency were significantly different between male patients with and without pviPD (P = 0.021 and P = 0.012, respectively). The odds ratio for the −824 A allele versus the −824G allele was 2.47 (95% CI 1.23–4.96). No association between pviPD and the PON1 polymorphisms was found in the female patients.Conclusion:  Possession of the −824A allele may increase the risk of PD in Japanese men.
Management of the acute scrotum in children
Authors: Corbett Harriet J. , Simpson Erroll T. 
Published: March 2003

Background: The study investigates the hypothesis that testicular torsion is over‐diagnosed by emergency department (ED) doctors. Diagnoses made by ED doctors are compared with those made by a surgical registrar or specialist and the review outcome by a surgical registrar or specialist on diagnosis and management is evaluated. Methods: Medical records of all boys up to the age of 14 years who presented with an acute scrotum to the ED at The Canberra Hospital between October 1995 and October 2000 were retrospectively reviewed. Results: A total of 182 boys presented to the ED on 190 occasions; mean age of presentation was 10.1 years and mean time from onset of pain to presentation was 27.6 h. Ninety (47.4%) patients had a torted testicular appendage, 23 (12.1%) had testicular torsion and 12 (6.3%) had epididymitis or orchitis. Eighty‐one patients underwent surgery, in whom 61 were excluded from having testicular torsion. Testicular torsion was suspected by ED doctors in 57.5% of patients, by registrars in 35.4% and by specialists in 17.7%. Overall, the correct diagnosis was made by ED doctors in 39% of patients, by registrars in 53% and by specialists in 76%. Conclusions: Less experienced examiners suspect testicular torsion more frequently than surgical registrars or specialists. Review of the patient by an experienced examiner should allow for more accurate initial diagnoses and spare some children unnecessary surgical procedures.