bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correction of stromal cell defect after bone marrow transplantation in aplastic anaemia
Authors: Scopes John , Ismail Medhat , Marks Karen J. , Rutherford Timothy R. , Draycott Gwen S. , Pocock Christopher , Gordon‐Smith Edward C. , Gibson Frances M. 
Published: March 2003

Defects in stromal cell function have been demonstrated in a number of aplastic anaemia (AA) patients. Here we have studied a patient with severe AA and abnormal stromal cell function who underwent bone marrow transplantation (BMT). The objective of this study was to investigate the timing and the mechanism of correction of the stromal defect after transplantation. The patient, a 25‐year‐old woman with severe AA, underwent BMT from her brother. BM was obtained from the patient on five occasions: 2 weeks pre BMT, and 3, 8, 16 and 21 months post BMT. Stromal cells were grown to confluence and recharged with purified CD34+ cells from normal donors. The support of such cells, as assessed by weekly colony‐forming assay (CFU) of non‐adherent cells, was compared with that of stromal layers grown from normal BM. A novel technique of combined fluorescence in situ hybridization (FISH) and immunocytochemistry was used to determine the origin of specific stromal cell types on cytospins of stroma post BMT. Stromal function was defective at 2 weeks pre BMT and at 3 months post BMT, but returned to normal at 8 and 16 months post BMT. At 21 months post BMT, stromal fibroblasts and endothelial cells were shown to be of recipient origin, and macrophages and T cells were of donor origin. We present here evidence in a case of severe AA for defective stromal function before BMT and delayed normalization of function after BMT. This correlated with engraftment of donor macrophages and T cells, but not fibroblasts and endothelial cells.
Population-based record linkage study of the incidence of abdominal aortic aneurysm in Western Australia in 1985–1994
Authors: Semmens J B , Norman P E , Lawrence-Brown M M D , Bass A J , Holman C D J 
Published: March 2003

Abstract

Background
The incidence of abdominal aortic aneurysm (AAA) has increased steadily during the past 30 years.

Methods
Trends in the incidence and surgical intervention for AAA in Western Australia were reviewed for the interval 1985–1994. A population-based health database was used to link morbidity and mortality records of all patients aged 55 years or more who died from rupture or were admitted and treated surgically for AAA. Three groups were separated for analysis: patients with a ruptured AAA, those admitted for elective repair and those admitted as an emergency with an acute (non-ruptured) aneurysm.

Results
There was a decline in the incidence of both emergency and elective procedures for AAA after 1992. While the mortality rate from ruptured AAA has also fallen since 1991, the overall case fatality rate for ruptured AAA has fallen by only 1·3 per cent (from 80·7 to 79·3 per cent).

Conclusion
The decline in mortality rate and emergency procedures may result from a fall in the incidence of ruptured AAA, due to an increasing rate of elective surgery before 1992. The decline in elective procedures from 1992 may be due to a fall in the prevalence of AAA owing to high rates of elective surgery, or to a fall in the incidence of the disease itself.
Thermotolerance induces heat shock protein 72 expression and protects against ischaemia–reperfusion-induced lung injury
Authors: Javadpour M , Kelly C J , Chen G , Stokes K , Leahy A , Bouchier-Hayes D J 
Published: March 2003

Abstract

Background
Ischaemia–reperfusion injury is mediated by neutrophil–endothelial interaction. Induction of heat shock proteins attenuates neutrophil–endothelial interactions. The aim of this study was to determine whether thermal preconditioning could have a protective effect on neutrophil-mediated lung injury in an animal model of lower torso ischaemia–reperfusion.

Methods
Sprague-Dawley rats were randomized into: control, ischaemia–reperfusion, and ischaemia–reperfusion preconditioned with hyperthermia groups. Ischaemia–reperfusion injury was induced by infrarenal aortic clamping for 30 min and reperfusion for 120 min. Thermotolerance was induced by raising the core body temperature to 40·5–41·5°C for 15 min, 18 h before ischaemia–reperfusion. Wet:dry lung (W:D) weight ratio, bronchoalveolar lavage protein (BALprot) concentration, tissue myeloperoxidase (MPO) activity and bronchoalveolar lavage polymorphonuclear neutrophil (BAL PMN) count were measured. Heat shock protein 72 (hsp72) expression in lung, intestine and mesentery was measured using Western immunoblotting.

Results
Ischaemia–reperfusion resulted in a significant increase in tissue oedema (W:D weight ratio) and BALprot concentration. In addition there was a marked increase in tissue neutrophil infiltration (MPO activity, BAL PMN concentration). Preconditioning with hyperthemia resulted in increased expression of hsp72 and significantly reduced tissue oedema and neutrophil infiltration.

Conclusion
Thermal preconditioning protects against neutrophil-mediated ischaemia–reperfusion-induced lung injury, possibly by increasing the expression of heat shock proteins.
Experimental study of the effect of adrenaline tolerance on intestinal ischaemia–reperfusion
Authors: Baykal A , Kaynarogˇlu V , Demirpençe E , Kilinç K , Sayek I , Sanaç Y 
Published: March 2003

Abstract

Background
Adrenaline tolerance improves survival in animal models of shock. The purpose of this study was to determine the effects of adrenaline tolerance on intestinal ischaemia–reperfusion in a mouse model.

Methods
Adrenaline tolerance was developed by injecting intravenous adrenaline, gradually increasing the dose to 2 mg/kg over 5 days. In experimental animals the superior mesenteric artery was clamped for 120 min and then released. Evans blue dye was given intravenously to all animals to quantify pulmonary microvascular injury. Some 60 min after clamp release, the animals were killed and the effects of reperfusion assessed on tissue samples.

Results
Evans blue dye concentrations were significantly higher in animals with intestinal ischaemia–reperfusion than in those having sham intestinal ischaemia–reperfusion or in adrenaline-tolerant mice having intestinal ischaemia–reperfusion or sham ischaemia–reperfusion (P&lt;0·01). Malonyldialdehyde levels increased significantly in the lung in the intestinal ischaemia–reperfusion group compared with those in the sham ischaemia–reperfusion group (P&lt;0·001 for liver, lung and small intestine), whereas there was no difference in adrenaline-tolerant animals. There was no significant change induced by adrenaline tolerance in myeloperoxidase levels in any organ.

Conclusion
Adrenaline tolerance reduced the lung permeability caused by intestinal ischaemia–reperfusion. Catecholamines may play a role in free radical generation induced by ischaemia–reperfusion.
Endoluminal abdominal aortic aneurysm surgery
Authors: Woodburn K R , May J , White G H 
Published: March 2003

Abstract

Background
The development of devices designed for the endoluminal repair of abdominal aortic aneurysm has led to the emergence of new endovascular techniques.

Methods
Articles and case reports obtained from a Medline search of the English language literature from 1989 to 1997 are reviewed. This search was carried out using the MeSH heading ‘aortic aneurysm, abdominal’ and the keywords ‘endovascular’ and ‘endoluminal’.

Results
Reported mortality and complication rates for endoluminal aneurysm repair are similar to those following conventional repair, with the exception of continued perfusion of the aneurysm sac which remains a major problem following endoluminal repair.

Conclusion
Successful endoluminal aneurysm exclusion is associated with reduced aneurysm diameter. However, longer term results of endoluminal repair, in particular of sealed endoleaks, are required before randomized controlled trials of endoluminal versus conventional repair can be undertaken.
Active or passive chest drainage after oesophagectomy in 101 patients: a prospective randomized study
Authors: Johansson J , Lindberg C-G , Johnsson F , von Holstein C S , Zilling T , Walther B 
Published: March 2003

Abstract

Background
This study evaluates the efficiency and safety of two methods of chest drainage after uncomplicated oesophagectomy.

Methods
A prospective randomized study between active suction drainage and passive chest drainage was carried out in 101 patients who underwent gastric pull-up oesophagectomy.

Results
No difference in the prevalence of pneumothorax during treatment was noted between the active (nine of 55) and the passive (four of 46) drainage groups (P=0·20). Nor was there any difference in the size (P=0·46) and duration (P=0·53) of the pneumothorax. There was no significant difference in right (P=0·84) and left (P=0·61) basal atelectases and the amounts of right (P=0·10) and left (P=0·24) pleural effusions. There were significantly more basal atelectases (P&lt;0·001) and pleural effusions (P&lt;0·001) in the non-operated left side compared with the operated right side. Postoperative hospital stay was the same in both groups (median 13 days; P=0·86). The hospital mortality rate was two of 101, and was not affected by the type of drainage.

Conclusion
Passive drainage did not reduce hospital stay, but was as safe and effective as the active system in draining the pleural cavity after uncomplicated oesophagectomy.
Evidence that aminoguanidine inhibits endotoxin-induced bacterial translocation
Authors: Kavuklu B , Agalar C , Guc M O , Sayek I 
Published: March 2003

Abstract

Background
The role of inducible nitric oxide synthase (iNOS) in endotoxin-induced bacterial translocation was investigated by using its specific blocker aminoguanidine in 46 albino mice (25–35 g) allocated into four groups.

Methods
The first group received intraperitoneal saline (control; 0·9 per cent w v−1 sodium chloride 1 ml kg−1; n = 6), the second group intraperitoneal endotoxin (Escherichia coli lipopolysaccharide 055:B5 20 mg kg−1; n = 19), the third group intraperitoneal aminoguanidine (20 mg kg−1, 20 min before and 12 h after saline; n = 6) and the fourth group both endotoxin and aminoguanidine intraperitoneally (n = 15). Some 24 h later, the animals were anaesthetized with ether and blood samples were collected by cardiac puncture together with mesenteric lymph node (MLN), spleen and liver specimens under aseptic conditions. Specimens were then cultured to determine the presence of colony-forming units as an index of bacterial translocation.

Results
No bacterial growth was detected in samples from the first and third groups. Colony-forming bacteria were found in ten of 14 MLN samples, eight of 14 spleens, four of 14 livers and three of 14 peripheral blood samples in the second group, with E. coli being the predominant pathogen. In contrast, in the fourth group, colony-forming bacteria were found in only three of 14 MLN samples (P = 0·02 versus the second group), three of 14 spleens and one of 14 liver specimens. None of the values in the fourth group was significantly different from those in the saline control group.

Conclusion
The inhibition of iNOS during endotoxaemia by its specific blocker aminoguanidine attenuates the incidence of bacterial translocation in mice. These results may be exploited clinically for the prophylaxis and treatment of septic states.
Role of octreotide on release of intact 1–84 parathyroid hormone from human parathyroid cells
Authors: Sadler G P , Jones D L , Morgan J M , Neonakis E , Woodhead J S , Wheeler M H 
Published: March 2003

Abstract

Background
Octreotide has been shown to lower urinary calcium in primary hyperparathyroidism although the mechanism remains unclear. This study examined the effect of octreotide on parathyroid hormone (PTH) secretion from human parathyroid cells in culture and as isolated cells. Additionally in situ hybridization was performed for somatostatin receptor messenger RNA (mRNA) and immunocytochemistry for somatostatin in eight parathyroid adenomas.

Methods
Tissue from three hyperplastic glands and three adenomas was studied as dispersed cell suspensions. Incubation was in buffers containing high (2·0 mmol/l) and low (0·5 mmol/l) calcium concentrations, with or without octreotide 200 ng/ml. Cells were also seeded into tissue culture wells for 24 h to allow receptors to regenerate. Supernatant was removed at regular intervals and PTH levels were estimated using a two-site chemiluminescent assay.

Results
Mean(s.e.m.) PTH secretion at 90 min in hyperplastic cells was 445(75) pmol/l in low calcium and 160(42) pmol/l in high calcium (P&lt;0·02), and in adenoma cells was 170(21) pmol/l in low calcium and 137(27) pmol/l in high calcium (P=0·37). There was no significant difference in secretion of PTH from cells incubated with octreotide either in culture or as dispersed cells. In situ hybridization failed to demonstrate any mRNA for the somatostatin receptors and no somatostatin was detected in any cells with immunocytochemistry.

Conclusion
Somatostatin has no direct action on PTH production and release from human parathyroid cells and is unlikely to be of any therapeutic value in the treatment of hyperparathyroidism.
Significance of angiogenesis in cancer therapy
Authors: McNamara D A , Harmey J H , Walsh T N , Redmond H P , Bouchier-Hayes D J 
Published: March 2003

Abstract

Background
For most solid tumours, surgery remains the most effective primary treatment. Despite apparently curative resection, significant numbers of patients develop secondary disease due to growth of undetected micrometastases. The ability of a tumour to metastasize is related to the degree of angiogenesis it induces. In addition, micrometastases rely on new vessel formation to provide the nutrients necessary for growth. A better understanding of how tumours acquire their blood supply may lead to more effective adjuvant therapies and improve survival following surgery.

Methods
A systematic review of the literature on angiogenesis between 1971 and 1997 was performed using the Medline database to ascertain current thinking on angiogenesis and its relevance in oncological surgery.

Results
Angiogenesis is a physiological process subject to autocrine and paracrine regulation which has the potential to become abnormal and play a part in a number of pathological states, including cancer. Increased angiogenic stimuli in the perioperative period, associated with concomitant reduction in tumour-derived antiangiogenic factors following resection of a primary tumour, result in a permissive environment which allows micrometastases to grow.

Conclusion
Recognition of the role of angiogenesis in metastatic tumour growth represents a significant development in our understanding of tumour biology. The development of antiangiogenic agents offers new promise in the treatment of malignancy. Such agents may prevent or control the development and growth of primary and metastatic tumours.
Detection of residual disease following breast-conserving surgery
Authors: Beck N E , Bradburn M J , Vincenti A C , Rainsbury R M 
Published: March 2003

Abstract

Background
Assessment of completeness of tumour excision has become an integral part of breast-conserving surgery, but the accuracy of margin analysis has been questioned. This study compared the results of resection margin analysis with an examination of tumour bed biopsies and of the excised cavity wall.

Methods
One hundred and forty-four patients underwent breast-conserving surgery for T1–2 N0–1 breast cancer. Following wide local excision, four bed biopsies were taken from the cavity wall which was then completely excised. The presence of invasive and in situ disease at the inked resection margin (IRM) and in the adjacent bed biopsies and cavity wall was recorded.

Results
Positive margins and/or residual disease in either the bed biopsies or cavity wall was found in 62 (43 per cent) of 144 cases. Residual disease (invasive or in situ) was present at the IRM in 39 specimens (27 per cent) and was present in 25 bed biopsy (17 per cent) and 39 cavity wall (27 per cent) specimens. These comprised different but overlapping groups of patients.

Conclusion
Margin analysis of wide local excision specimens is a poor predictor of completeness of excision. Routine resection and examination of the entire cavity wall increases the detection of residual disease compared with examination of bed biopsies alone and is a useful adjuvant to conventional margin evaluation.
Experimental study of the effects of deletion variant of hepatocyte growth factor on hepatic ischaemia—reperfusion injury
Authors: Ikegami T , Nishizaki T , Uchiyama H , Hashimoto K , Yanaga K , Sugimachi K 
Published: March 2003

AbstractBackgroundHepatic ischaemia–reperfusion (IR) injury is still a serious complication following liver surgery. The effect of the deletion variant of hepatocyte growth factor (dHGF) on hepatic IR injury was examined in rats.MethodsMale Wistar rats were divided into two groups after 90 min of partial liver ischaemia: the dHGF group which was given dHGF 0·5 mg/kg intravenously immediately after reperfusion, followed by 0·5 mg/kg every 12 h, and the control group, which received vehicle buffer only. Serum chemistry, histopathological findings and liver weights were compared between the groups.ResultsIn the dHGF group, the increase in serum alanine transaminase and hyaluronic acid levels was significantly reduced, and the serum albumin level increased after reperfusion. The extent of hepatic necrosis 24 h after reperfusion was decreased in the dHGF group. Moreover, the proportion of terminal deoxynucleotidyl transferase-mediated 2′-deoxyuridine 5′-triphosphate nick end labelling-positive hepatocytes 6 h after reperfusion was reduced in the dHGF group. The non-ischaemic-, ischaemic- and whole-liver weight: body-weight ratio significantly increased in the dHGF group after reperfusion. The proportion of proliferating cell nuclear antigen-positive hepatocytes in the dHGF group markedly increased after 6 h after reperfusion in the non-ischaemic lobes, while in the ischaemic lobes it increased 24 h after reperfusion.ConclusionThese data suggest that dHGF not only improves recovery from IR injury, but also accelerates recovery from these injuries. dHGF may be an effective pharmacological agent for prevention and treatment of hepatic IR injury.
Influence of gender on outcome from ruptured abdominal aortic aneurysm
Authors: Semmens J B , Norman P E , Lawrence-Brown M M D , Holman C D'A J 
Published: March 2003

Abstract

Background
The aim of the present study was to compare outcomes following ruptured abdominal aortic aneurysm (AAA) in men and women.

Methods
Overall mortality from ruptured AAA was compared in men and women using the Western Australia Health Services Research Database. The linked chains of de-identified hospital morbidity and death records were selected using the ICD-9-CM (International Classification of Diseases—Clinical Modification) diagnostic and procedure codes pertaining to AAA. Cases were divided into three groups for analysis: patients who died without admission to hospital, those admitted to hospital with a ruptured AAA but who did not undergo operation, and patients who underwent operation for ruptured AAA.

Results
Ruptured AAA occurred in 648 men and 225 women over the age of 55 years during the decade 1985–1994. Only 50 per cent of women, compared with 59 per cent of men, were admitted to hospital. Of those admitted to hospital only 37 per cent of women underwent operation, compared with 63 per cent of men. The overall mortality rate from ruptured AAA was 90 per cent in women and 76 per cent in men (χ2 = 50·34, 1 d.f., P &lt; 0·0001). Although women were, on average, 6 years older than men, this unfavourable pattern occurred across all age groups.

Conclusion
Women with a ruptured AAA are more likely to die than men. More research is required to identify the causes of this sex difference.
Surgical management of intra-abdominal desmoid tumours
Authors: Smith A J , Lewis J J , Merchant N B , Leung D H Y , Woodruff J M , Brennan M F 
Published: March 2003

Abstract

Background
Intra-abdominal desmoids are uncommon neoplasms. The aggressive nature of these tumours and the potential for major morbidity secondary to resection can present a difficult surgical dilemma.

Methods
Patients with histologically confirmed intra-abdominal desmoid tumours undergoing laparotomy were identified from a prospective database. Clinical features and outcomes in this group were evaluated.

Results
The study group comprised 24 patients. Sixteen patients underwent complete resection of the tumour while eight had biopsy only, with or without intestinal bypass. Small intestinal resection was performed in 12 patients, including three who had a near-total enterectomy. Median follow-up was 62 months, with an actuarial overall survival rate of 73 per cent at 10 years. There was no difference in survival rate between completely resected and unresected patients (P = 0·73). There were seven deaths in the entire group, of which four were in those undergoing complete resection.

Conclusion
Operation can cure patients with intra-abdominal desmoid tumours, but may result in significant morbidity, especially from loss of small intestine. No other therapy is a predictably good alternative to operation but the natural history of desmoids is often characterized by prolonged periods of stability or even regression. A period of watchful waiting, until significant symptoms develop, may be the most appropriate course in patients who risk mesenteric vascular injury or substantial enterectomy with attempts at resection.
On-line quantitative analysis of surface electromyography of the pelvic floor in patients with faecal incontinence
Authors: Gee A S , Jones R S J , Durdey P 
Published: March 2003

Abstract

Background
Needle electromyography (EMG) remains the ‘gold standard’ for the assessment of external anal sphincter innervation. It is, however, an invasive and poorly tolerated technique. In this study a quantitative form of surface electromyography was compared with needle EMG of the external anal sphincter.

Methods
Invasive needle EMG to assess mean fibre density and neuromuscular jitter was compared directly with quantitative surface EMG in 37 patients with faecal incontinence and 12 age-matched controls.

Results
There was a significant positive correlation between mean fibre density on needle EMG and maximum turns rate on surface EMG (rs = 0·48 (95 per cent confidence interval 0·28–0·76), P = 0·003). Furthermore, surface EMG was able to discriminate between patients with normal neuromuscular jitter and those with increased jitter, a measure of progressive denervation and reinnervation, on the basis of reduced rectified mean surface signal (P = 0·02, Fisher's exact test).

Conclusion
Quantitative surface EMG may potentially replace invasive needle EMG as the investigation of choice in the assessment of anal sphincter electrophysiology.