bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of prostate specific antigen α1‐antichymotrypsin complex for the detection of prostate cancer in patients with a PSA level of 4.1–10.0ng/mL: Comparison with PSA‐related parameters
Authors: Miyake Hideaki , Hara Shoji , Nomi Masashi , Arakawa Soichi , Kamidono Sadao , Hara Isao 
Published: March 2003

AbstractBackground:The aim of the present study was to evaluate the usefulness of prostate specific antigen α1‐antichymotrypsin complex (PSA‐ACT) in the differential diagnosis of prostate cancer in patients with a PSA level of 4.1–10.0 ng/mL compared to several PSA‐ and PSA‐ACT‐related parameters.Methods:Serum samples were obtained from 103 patients with no evidence of malignancy on biopsy and 29 with histologically confirmed prostate cancer. All patients had pretreatment serum PSA levels between 4.0 and 10.0 ng/mL. The different forms of serum PSA, including total PSA (tPSA), free PSA (fPSA) and PSA‐ACT were measured using immunofluorometric techniques with different monoclonal antibodies against PSA and ACT. Furthermore, tPSA and PSA‐ACT densities of the whole prostate (PSAD and ACTD, respectively) and the f‐to‐tPSA and the f‐to‐PSA‐ACT ratios (F/T ratio and F/ACT ratio, respectively) were calculated.Results:The differences between patients with prostate cancer and benign prostatic disease were significant with respect to all six parameters examined in this study. Analysis of receiver operating characteristics revealed that the areas under the curve for PSA‐ACT, ACTD and the F/ACT ratio were larger than those for tPSA, PSAD and the F/T ratio, respectively. However, there were no significant differences in discrimination between benign and malignant diseases among these six parameters.Conclusions:In patients who have an intermediate serum PSA level, PSA‐ACT and its associated parameters may not be significantly superior in the differential diagnosis between prostate cancer and benign prostatic diseases compared to tPSA and its traditional relatives.
Mycobacterium tuberculosis infection of bilateral cervical lymph nodes after renal transplantation
Authors: Ishikawa Kiyohito , Hoshinaga Kiyotaka , Maruyama Takahiro , Izumitani Masanobu , Shiroki Ryoichi 
Published: March 2003

AbstractWe report the case of a 52‐year‐old man who underwent a renal transplantation and subsequently developed extrapulmonary tuberculosis. The immunosuppressive agent was intravenously administered continuously together with antituberculosis drugs. The tuberculosis improved and renal function has been well preserved for more than 3 years post transplantation.
Adult‐onset idiopathic hypogonadotropic hypogonadism presented with erectile and ejaculatory disorder
Authors: KOBAYASHI TAKASHI , OKUNO HIROSHI , NISHIYAMA HIROYUKI , NAKAMURA EIJIRO , OGAWA OSAMU , KAWAHARA MASAHIRO , SHIMATSU AKIRA 
Published: March 2003

AbstractA 37‐year‐old man who had fathered a child five years previously presented with erectile and ejaculatory disorder. Endocrinological examinations revealed isolated luteinizing hormone‐releasing hormone (LHRH) deficiency of hypothalamus, resulting in hypogonadotropic hypogonadism, and no causative abnormality was detected in imaging studies, including magnetic resonance imaging (MRI). Having a diagnosis of adult‐onset hypogonadotropic hypogonadism, the patient received pulsatile subcutaneous administration of gonadotropin‐releasing hormone (GnRH). Sperm analysis and serum level of testosterone improved to normal in a few months. His wife became pregnant using artificial insemination with her husband's semen 15 months after the beginning of the treatment.
Ultrasonographic changes of the female bladder neck during development
Authors: SUGAYA KIMIO , NISHIJIMA SAORI , ODA MASAMI , OWAN TOMOKO , ASHITOMI KATSUHIRO , MIYAZATO MINORU , MOROZUMI MAKOTO , HATANO TADASHI , OGAWA YOSHIHIDE 
Published: March 2003

AbstractBackground: Our previous study showed that the anteroposterior vesical wall angle (APVA) at the bladder neck on transabdominal ultrasonography varied widely between women. The present study examines whether the APVA changes during development in girls with a normal bladder.Methods: Seventy‐four females aged 0–29 years with normal bladders were examined by transabdominal ultrasonography. They were divided into six age groups and their APVA was measured in the supine position by sagittal ultrasonography. Intravenous urography was conducted to examine bladder neck descent and bladder neck opening.Results: The APVA ranged from 85 to 200°. The mean APVA in girls aged 0–4 years was 129 ± 30° (±SD) and the mean APVA in girls aged 5–9 years was 135 ± 25°. The mean APVA at ages 10–14 years was 161 ± 26°; at 15–19 years, 164 ± 33°; at 20–24 years, 164 ± 18°; and at 25–29 years, 163 ± 16°. The APVA values of these four groups were significantly larger (P < 0.05) than those of the two younger groups. No bladder abnormalities were found on intravenous urography.Conclusion: The APVA was small in some girls under 10 years of age, but the APVA of girls aged over 10 years was similar to that in young adults. The APVA may reflect bladder base plate tone and be partially related to hormonal changes in females during development.
Benchmarking ambulance call‐to‐needle times for thrombolysis after acute myocardial infarction in Australia:  a pilot study
Authors: Kelly A‐M. , Kerr D. , Patrick I. , Walker T. 
Published: March 2003

Abstract Background: Thrombolysis for patients with acute myocardial infarction (AMI) is of greatest benefit when treatment is commenced as soon as possible after symptom onset. The British Heart Foundation (BHF) recently set a benchmark recommending that eligible patients with AMI receive thrombolytic therapy less than 90 min after calling for medical assistance. Aims: The purpose of this study was to compare the performance of an urban emergency service to this benchmark. A secondary objective was to determine whether patients treated outside this time were at a greater risk of mortality. Methods: This study consisted of an explicit retrospective analysis of medical records for all patients who presented by ambulance to the Emergency Department (ED) of Western Hospital and received thrombolysis for AMI within 12 h of symptom onset. The study was conducted for the 18‐month period between 1 January 1999 and 30 June 2000. Information collected included times of: (i) symptom onset, (ii) call for ambulance, (iii) ambulance response, (iv) transport to hospital and (v) thrombolysis, as well as final diagnosis and in‐hospital mortality. For the purposes of this study, call‐to‐needle time (CTN) was defined as the time between calling the ambulance and commencement of thrombolytic therapy. Results: One hundred and twenty‐seven patients met the inclusion criteria. Median CTN was 81 min (range 42−279 min). Sixty‐four per cent of patients were treated within the 90‐min benchmark. The relative risk of mortality for patients treated outside the 90‐min benchmark was 2.6 (95% CI 0.98−6.72). Conclusion: This study showed that the BHF benchmark for CTN was not being met for over one‐third of patients in the study region, with potential impact on mortality after AMI. Further research is needed to establish: (i) whether there is relationship bet‐ween longer transportation times and mortality, (ii) whether the findings of this study may be applied to other regions and (iii) what strategies might be employed to reduce CTN. (Intern Med J 2002; 32: 138−142)
Haemochromatosis: iron still matters
Authors: Bassett M. L. 
Published: March 2003

AbstractOur ability to detect those predisposed to haemochromatosis is greatly enhanced by testing for HFE mutations. Ironically, this diagnostic advance has led to some confusion regarding the criteria for diagnosis of haemochromatosis, with overreliance on genetic testing instead of investigations for iron overload. Because many people who are homozygous for the C282Y mutation, or compound heterozygous for the C282Y and H63D mutations, either do not express or only partially express the disease, it is essential to confirm a diagnosis of haemochromatosis on the basis of increased body iron stores. Liver biopsy remains the best method of confirming this and has an important role in the patient with either borderline iron overload or advanced disease. Persistent elevation of serum ferritin concentration in the absence of overt liver damage, inflammation or neoplasia, and estimation of mobilized body iron by repeated phlebotomy, are reasonable alternatives to liver biopsy. Although the precise definition of iron overload is debated, a diagnosis of haemochromatosis cannot be made without demonstrating increased body iron stores. (Intern Med J 2001; 31: 237–242)
Spondyloarthropathies: an overview
Authors: Stafford L. , Youssef P. P. 
Published: March 2003

Abstract Spondyloarthropathies are important and common inflammatory arthropathies that occur in approximately 2% of the population. They are often underrecognized. The diagnosis features the presence of asymmetrical, predominately lower limb arthritis and/or inflammatory back pain. The spondyloarthropathies can be subdivided into several disease subcategories, including ankylosing spondylitis, Reiter’s/reactive arthritis, psoriatic arthritis, inflammatory bowel disease‐associated arthritis and a large group of undifferentiated spondyloarthritis. The interactions between infectious agents and the individual’s genetic background are important aetiological factors. Therapies for these conditions include physical therapy, non‐steroidal anti‐inflammatories and disease‐modifying drugs. (Intern Med J 2002; 32: 40–46)
Control of nausea and vomiting after chemotherapy: what is the evidence?
Authors: Bartlett N. , Koczwara B. 
Published: March 2003

Abstract The control of nausea and vomiting is an important problem for patients undergoing chemotherapy. With the introduction of newer agents, including 5‐HT3 antagonists, nausea and vomiting control after chemotherapy has much improved but is not always optimal. While there is an intrinsic limitation to the efficacy of anti‐emetic drugs, their efficacy can be further reduced if the drugs are not used approp­riately. In some circumstances newer anti‐emetics may be unnecessary and better nausea and vomiting control may be established by use of older agents. This paper summarizes current evidence regarding the optimal approach to management of nausea and vomiting in patients undergoing chemotherapy. (Intern Med J 2002; 32: 401−407)
Tunnelling of caudal epidural catheters in infants
Authors: Vas Lakshmi , Naik Veena , Patil Bharati , Sanzgiri Savitha 
Published: March 2003

SummaryThe working conditions in the developing world necessitate the development of many adaptations and improvizations of accepted anaesthetic techniques to improve patient care. Subcutaneous tunnelling of caudally placed epidural catheters is one such improvization to prevent the soiling of the catheter by urine and faeces. This study compares the duration of retention of catheter in a group with tunnelled catheters with an untunnelled group. The absence of a catheter emerging through skin at the site of catheter insertion hastens healing thus prolonging the retention of catheter in the tunnelled group and soiling ceases to be a major problem.
Superior vena cava obstruction and liver transplantation in a child
Authors: Stewart Penelope C.H. , Baines David B. , Harrison Victor L. 
Published: March 2003

SummaryWe report a case of superior vena cava obstruction in a child, which was probably secondary to long‐term central venous cannulation. The obstruction was asymptomatic preoperatively, but became evident during liver transplantation, and complicated the intraoperative management. There is one other case report of this occurring in an adult in similar circumstances, and we believe that ours is the first report of such a presentation in the paediatric age group.
Traumatic pharyngo–oesophageal perforation in the newborn: a condition mimicking oesophageal atresia
Authors: Pumberger W. , Bader T. , Golej J. , Pokieser P. , Semsroth M. 
Published: March 2003

SummaryTwo newborn infants with traumatic perforation of the pharyngo–oesophageal region are presented. This injury was induced by pharyngeal suction catheters and/or vigorous attempts at nasogastric or tracheal intubation during resuscitation of the newborn. The true nature of this condition remained unrecognized and the babies were thus referred with a tentative diagnosis of oesophageal atresia. The perforation itself could be treated successfully without surgery, despite a severe complication in one infant resulting from inadvertent use of barium sulphate contrast medium. Raising awareness of the possibility of this injury should help in avoiding this complication by gentle and skilful action during newborn resuscitation, particularly in the premature infant.
Anaesthetic management of a 6‐week‐old child with unilateral pulmonary interstitial emphysema
Authors: Mccartney C.J.L. , Johnston G. 
Published: March 2003

SummaryWe report the case of a 6‐week‐old female infant suffering from respiratory distress related to cystic changes affecting the entire left lung. Anaesthesia was induced with sevoflurane in oxygen and spontaneous ventilation was maintained until intubation of the right main bronchus was secured. A left pneumonectomy was performed and the postoperative course was uneventful. The pathological diagnosis was pulmonary interstitial emphysema. This has not been previously reported in an otherwise normal child delivered uneventfully at term. The anaesthetic management of a child with a cystic lung lesion is discussed.
Transoesophageal echocardiographic monitoring during paediatric cardiac surgery: obtainable information and feasibility in 532 children
Authors: Sloth Erik , Pedersen Jens , Olsen Kirsten Hjortholm , Wanscher Michael , Hansen Ole Kromann , Sørensen KELD E. 
Published: March 2003

Background: We hypothesized that transoesophageal echocardiography (TOE) performed by the anaesthesiologists would be beneficial for monitoring purposes during paediatric cardiac surgery. We present the results for the first 5 years in 532 consecutive children. Methods: The probe was successfully inserted in 99% of cases and remained in the oesophagus for 211 min on average (range 10–555 min). Results: Insignificant valve leak, single‐ or biventricular failure and volume depletion were the most common new findings due to TOE. Changes in inotropic strategy and volume replacement were the most frequent interventions. In 45% of the cases, new information was disclosed and, in a total of 8% of cases, decisive information was provided. Except for tracheal extubation in one child who was uneventfully reintubated, no severe complications were identified. Conclusions: These data stress the safety and ease of performing TOE in children undergoing cardiac surgery. There is evidence for benefit from TOE findings to potentially enhance the therapeutic basis.
Severe epiglottic prolapse and the obscured larynx at intubation
Authors: Vaz F.M. , Neumann A.M. , Albert D. 
Published: March 2003

SummaryLaryngomalacia is the most common congenital anomaly of the larynx and usually involves prolapse of the arytenoids, so‐called `posterior laryngomalacia'. Most cases resolve with growth of the child and maturation of the larynx, although, rarely, significant airway obstruction can be present. Severe laryngomalacia preventing intubation is rarely encountered. We report a case of a difficult emergency intubation secondary to `anterior laryngomalacia' in a 4‐month‐old boy in whom the epiglottis prolapsed posteriorly and became trapped in the laryngeal introitus. The child was referred with a diagnosis of laryngeal atresia on the basis of the intubating laryngoscopic view of no apparent epiglottis or laryngeal inlet. The child was transferred with a tube in the oesophagus that kept the child oxygenated. At the time, oxygenation was felt to be due to a coexisting tracheo‐oesophageal fistula, although this was eventually found not to be the case.
An Audit of Preoperative Behaviour and Premedication Practise at Great Ormond Street Hospital
Authors: Meyer T.E. , Lakheeram I. 
Published: March 2003

Introduction  Despite advances in anaesthesia many children are distressed at induction of anaesthesia (1). The use of paediatric premedication has declined considerably over the last ten years (2). The aim of our audit was to look at preoperative behaviour and premedication practice at our institute.Method  One hundred and seventy seven patients undergoing elective procedures in the main theatre suite at the hospital were audited. This therefore excluded cardiac and neuroanaesthesia. Behaviour scores in the anaesthetic room prior to and at induction were assessed by the operating department assistants. We looked at frequency, type, dose and timing of premedication. The induction method, age and previous anaesthesia were noted. Parents routinely accompany children at induction of anaesthesia.Results  Overall 75% of children had satisfactory behaviour scores in the anaesthetic room dropping to 47% at induction. The graph shows the age distribution and associated behaviour scores. Of the patients with satisfactory behaviour scores all received their premedication between 20 and 60 min prior to induction. Three patients in the unsatisfactory behaviour group received their premedication outside this optimal time. Children who had had previous anaesthetics (76%) had worse behaviour scores than those with none both in the anaesthetic room and at induction with satisfactory scores of 71% vs. 84% and 44% vs. 51 % respectively. Those having gas inductions (63%) had worse behaviour scores at induction compared with children having intravenous induction with satisfactory scores of 42% vs. 52% respectively. 12% of all children audited received a sedative premedication. 16 received Midazolam 0.5 mg/kg, 3 Temazepam 10 or 20 mg and 1 Triclofos 50 mg·kg−1 all given orally. The premedication rate for children with previous anaesthetic experience was 14% vs. 5% in those with none.Only 5% of children received an atropine premedication 20–40 mcg·kg−1 orally. Only 1 of the 14 children age 6 months and 2 of the 14 children age 6 months−1 year were premedicated with atropine.Discussion  As a paediatric tertiary referral centre, many of the patients have previous experience of anaesthetics and have ongoing medical problems Our audit found that many of these children, especially age 1–3, are distressed at induction of anaesthesia despite methods shown to reduce peri‐operative anxiety, including play specialists. It also confirms the perceived trend for decreasing use of sedative and anticholinergic premedication. However several papers report decrease in distress at induction (1) especially in high‐risk groups (2) without undue delays in awakening and discharge using midazolain premedication.Conclusion  It was decided that a more child friendly anaesthetic room with pictures, toys and other distractions would be helpful. There may also be a need to increase the use of sedative premedication in high‐risk groups especially preschool children.
Parents' perceptions and use of analgesics at home after children's day surgery
Authors: Kankkunen Päivi , Vehviläinen‐Julkunen Katri , Pietilä Anna‐Maija , Kokki Hannu , Halonen Pirjo 
Published: March 2003

SummaryBackground: Children are found to suffer from unnecessarily severe postoperative pain following day surgery. Reasons for parents' insufficient use of analgesics may be based on misleading perceptions of children's analgesics. The purpose of this study was to describe parents' perceptions and use of analgesics for children after discharge at home.Methods: In this survey, 840 questionnaires were given to parents, and answers from 201 mothers and 114 fathers whose children, aged 1–6 years, had undergone day surgery in 10 Finnish hospitals are presented.Results: One‐third (36%) of the children were assessed as having moderate or severe postoperative pain after discharge. More than three‐quarters of the parents had given analgesics to the child. Analgesics were given mostly to children who were assessed to have pain and found to have several types of pain behaviour. Most of the parents had accurate perceptions of children's analgesics, but some of them had misleading perceptions of the nature and adverse effects of children's analgesics, which were related to giving analgesics to the child. Fathers, more often than mothers, seem to have such misleading perceptions.Conclusions: Parents tended to give analgesics to children who actually needed pain alleviation. Parents' perceptions of children's analgesics were mostly accurate. However, misleading perceptions of children's analgesics also exist among the parents. These misleading perceptions appear to decrease parents' use of children's postoperative pain medication.
Periocular neurofibrosarcoma in a horse
Authors: Strubbe D. Todd 
Published: March 2003

AbstractA periocular neurofibrosarcoma was debulked and treated with intralesional cisplatin in a 5‐year‐old Thoroughbred mare. The horse presented with a 1‐year history of a large slowly progressing subcutaneous mass over the right supraorbital process. The mass was surgically debulked, and intralesional cisplatin (1.0 mg/cm3) was injected in 3 doses at 2 weeks, 5 weeks, and 8 weeks postoperatively. No recurrence was noted over a 15‐month follow‐up period. Histopathology of the mass indicated neurofibrosarcoma.
Congenital ocular abnormalities of Rocky Mountain Horses
Authors: Ramsey  , Ewart  , Render  , Cook  , Latimer  
Published: March 2003

Objective:To determine the incidence and describe ocular abnormalities in a cross‐section of the population of Rocky Mountain Horses.Design:Prospective study.Animals:Five‐hundred and fourteen Rocky Mountain Horses.Procedure:Ophthalmic examinations were performed using a slit‐lamp biomicroscope and an indirect ophthalmoscope. Intraocular pressures were measured by applanation tonometry. Eyes from six horses were obtained for histologic examination.Results:Cysts of the posterior iris, ciliary body, and peripheral retina were detected most frequently (249 horses), and were always located temporally. Curvilinear streaks of retinal pigmented epithelium extending from the peripheral temporal retina marked the boundary of previous retinal detachment in 189 horses. Retinal dysplasia was detected in 125 horses. Multiple ocular anomalies were evident in 71 horses and were always bilateral and symmetrical. Affected eyes had a large, clear cornea that protruded excessively and had an apparent short radius of curvature, a deep anterior chamber, miotic and dyscoric pupil, and iris hypoplasia. Pupillary light responses were decreased or absent and pupils failed to dilate after repeated instillation of mydriatic drugs in horses with multiple ocular anomalies. Less frequently encountered abnormalities included peripheral iridocorneal adhesions and goniosynechiae. Congenital cataract was always present in eyes with multiple abnormalities. Intraocular pressures did not differ among horses with normal eyes and horses with multiple ocular abnormalities. Histologic examination of eyes corroborated the clinical appearance.