bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examination of the reliability of the portable calorimeter
Authors: Igawa Shoji , Sakamaki Mikako , Miyazaki Masami 
Published: March 2003

Summary1. The present study was performed in order to determine the reliablility of the portable calorimeter.2. Resting energy expenditure (REE) was measured by two different apparatuses: one was the typical gas analyser, the other was the portable calorimeter.3. Although there are differences among individuals, unless the subject has been exposed to severe physical activity prior to the measurement, a suitable resting time prior to the measurement of resting metabolic rate is 10 min.4. For the measurement of resting metabolic rate, fluctuations in respiratory quotient (RQ) are extremely small; there is greater fluctuation due to variations in respiration. Therefore, for the screening of energy consumption, the use of a fixed value for RQ is sufficient when measuring only oxygen uptake.5. Respiratory fluctuations vary from person to person and it is not possible to make stable measurements in 1 or 2 min. Therefore, a suitable measurement time for resting metabolic rate is from 3 to approximately 6 min.6. The results indicate that this portable calorimeter is a useful apparatus for measuring REE in the field.
Foot formation in Hydra: Commitment of the basal disk cells in the lower peduncle
Authors: Kobayakawa Yoshitaka , Kodama Rie 
Published: March 2003

Foot regeneration in the freshwater hydra Pelmatohydra robusta was examined using a monoclonal antibody AE03 as a marker. This antibody specifically recognizes mucous‐producing ectodermal epithelial cells in the basal disk, but not cells in the peduncle region located just above the basal disk in the foot. When the basal disk was removed by amputation at the upper or lower part of the peduncle, AE03‐positive (basal disk) cells always appeared at the regenerating tip of the footless polyp approximately 12–16 h later. When a small piece of tissue was cut out from the upper or lower peduncle region, the tissue invariably turned into a smooth spherical or oblong shape within a few hours. AE03 signal appeared in these spheres variably depending on their origin: when tissue pieces were derived from the lower peduncle, the signal appeared in nearly all pieces and often covered the entire surface of the pieces within 24 h. In contrast, the signal appeared in less than 10% of pieces derived from the upper peduncle. Furthermore, the signal seldom covered more than half of the surface of these pieces. When maintained for many days, pieces derived from the upper peduncle often regenerated tentacles, whereas those from the lower peduncle seldom did. These and other observations suggest that epithelial cells in the peduncle can rapidly differentiate into basal disk cells when the basal tissue is removed. However, cells in the upper peduncle are not irreversibly committed to differentiate into basal disk cells because, when cut out as small tissue pieces, they could remain AE03 negative and become tentacle cells. In contrast, the cells in the lower peduncle apparently are irreversibly committed to differentiate into basal disk cells, as they always turned rapidly into AE03‐positive cells once they were physically separated from (and freed from the influence of) the basal disk itself, regardless of the separation methods used.
Bidder's organ in the toad Bufo marinus: Effects of orchidectomy on the morphology and expression of lamina‐associated polypeptide 2
Authors: Brown Federico D. , Del Pino Eugenia M. , Krohne Georg 
Published: March 2003

The Bidder's organ is an undeveloped ovary located anterior to the testis in male true toads (Bufonidae). The presence of sperm and oocytes, derived from the primordial germ cells of the male toad, provides an exceptional condition for the study of germ cell differentiation in vertebrates. In this study, the effects of orchidectomy on morphology and on lamina‐associated polypeptide 2 (LAP2) expression were investigated in the Bidder's organ of Bufo marinus. To characterize bidderian oocytes, oogenesis in the ovary was divided into six stages. It was found that ovarian and bidderian oocytes were morphologically identical. To determine the expression of LAP2 isoforms, oocytes from the ovary and the Bidder's organ were examined by sodium dodecylsulfate–polyacrylamide gel electrophoresis and immunoblotting. In amphibians, LAP2β is expressed in somatic cells, whereas LAP2ω is expressed in oocytes. The Bidder's organ normally contained previtellogenic oocytes of less than 150 µm in diameter that expressed LAP2β. However, the organ in some male toads contained a few larger oocytes, resulting in the faint detection of LAP2ω. After orchidectomy, bidderian oocytes grew and strongly expressed LAP2ω. Moreover, as in the ovary, LAP2ω was upregulated in bidderian oocytes of 240 µm in diameter. This work represents the first demonstration of the molecular similarity between ovarian and bidderian oocytes.
In vitro Cre/loxP system in cells from developing gonads: Investigation of the Sry promoter
Authors: Ito Masanori , Yokouchi Kou , Naito Kunihiko , Endo Hitoshi , Hakamata Yoji , Miyazaki Jun‐ichi , Tojo Hideaki 
Published: March 2003

There have been few studies on the regulatory elements of the Sry gene, mainly because no Sry‐expressing cell lines have yet been established. This paper describes a useful tool for investigating the regulation and upstream region of Sry by means of the in vitro Cre/loxP system. Using plasmids containing the 9.9 kb mouse genomic Sry previously shown to induce testis development in XX transgenic mice, we constructed a Sry/Cre fusion gene plasmid in which Cre expression is controlled by the 5′ and 3′ untranslated regions of mouse Sry. To distinguish between male and female gonads of 11.5 days post‐coitus (d.p.c.) fetuses, double transgenic fetuses carrying both the CAG (cytomegalovirus enhancer and β‐actin promoter)/loxP/lacZ transgene on the autosome and the green fluorescent protein transgene ubiquitously expressed on the Y chromosome were produced by crossing between two transgenic mouse lines. When Sry/Cre plasmids were transfected into the cells that had been prepared from the gonads, brains and livers of double transgenic fetuses, only a small number of X‐gal‐stained cells were detected among the primary cultured cells from male and female gonads, and none were detected among the cells from the other tissues. The X‐gal‐positive cells were negative for alkaline phosphatase, indicating that these cells were somatic cells expressing Sry. The Sry/Cre plasmids with a 0.4 kb upstream region of Sry yielded a large number of X‐gal‐positive cells in the cells from gonads, including various tissues of 11.5 d.p.c. fetuses, indicating the loss of the tissue‐specific expression of Sry. The Sry/Cre with a 1.4 kb upstream region maintained tissue‐specific activity of Sry. The results indicate that the present in vitro Cre/loxP system using transgenic mice is a simple and useful system for investigating the regulatory element of sex determination‐related genes, including Sry.
Rapid assessment team reduces waiting time
Authors: Grant Steven , Spain David , Green David 
Published: March 2003

Abstract Objective: In an effort to reduce waiting times and improve the performance of the clinical indicator waiting time relative to triage category, a rapid assessment team was implemented. Methods: The rapid assessment team consists of the rapid assessment team doctor and triage nurse. The rapid assessment team ensured, wherever possible, that patients were medically assessed prior to expiration of the waiting time appropriate to their National Triage Scale. Waiting time performance indicators, median waiting time and length of stay during the 3 months the rapid assessment team was operative were compared with the same period 1 year before. Results: During the 3 month period where the rapid assessment team was operative, 59.0% of patients (n = 5877) were seen within accepted time standards and the median waiting time was 32 min. This compared with 39.1% (n = 3901) and 50 min, respectively, in the same period 1 year before (P < 0.001). There was no significant difference in median length of stay (3.2 h for both, P = 0.18). Improvements in waiting times occurred in all triage categories except category 1. Due to a lack of resources and funds, the rapid assessment team was discontinued on 4 October 1997. Conclusions: The rapid assessment team reduces doctor waiting times. Departments considering implementing a rapid assessment team should ensure it is funded as a separate resource.
Safety of a nurse‐managed, titrated analgesia protocol for the management of severe pain in the emergency department
Authors: Coman Michael , Kelly Anne‐Maree 
Published: March 2003

Objectives: The objectives of this study were: (i) to determine the adverse‐effects profile of a nurse‐managed, titrated intravenous analgesia protocol; and (ii) to characterize the use of opioid analgesics for acute pain in a setting where an intravenous analgesia protocol was in place. Method: Retrospective chart audit of 401 consecutive cases (May–July 1996) of opioid analgesic administration for the management of pain in an adult metropolitan emergency department was performed. Results: Of the 401 cases, 345 (86%) received opioid analgesia using the nurse‐managed, titrated analgesia protocol. Nineteen adverse events were documented in this group (5.5% of patients; 95% CI = 3.3–8.5%). There were 17 episodes of hypotension (blood pressure below 100 mmHg), one hypersensitivity reaction and one vagal reaction. There were no documented cases of respiratory depression and no patient was administered naloxone. Of the patients suffering hypotension, seven required no intervention and the remaining 10 responded well to an infusion of fluids. Conclusion: The nurse‐managed, titrated intravenous analgesia protocol is a well‐used and safe method of providing analgesia.
Marine envenomation: An update — A presentation on the current status of marine envenomation first aid and medical treatments
Authors: Fenner Peter 
Published: March 2003

AbstractMarine envenomation is common worldwide. The current first aid and medical treatments of envenomation discussed include stingray, stonefish, sea snakes and cone shells, as well as treatments for Chironex box jellyfish, Irukandji and other stinging jellyfish. Not all current recommended first‐aid treatments have been proven but most have a sound basis and appear effective. Further research is current.
Management of the first‐time transient ischaemic attack
Authors: Hankey Graeme J 
Published: March 2003

AbstractThe assessment and management of patients with a suspected transient ischaemic attack of the brain or eye is a daily task in busy emergency departments. They are common, affecting about 50 per 100 000 population each year. Conditions which mimic a transient ischaemic attack are even more common (e.g. migraine aura, partial seizures, benign paroxysmal positional vertigo, hysteria). This comprehensive review outlines an approach to the management of this complex and challenging problem.
Training for the role of triage in Australasia
Authors: Kelly Anne‐Maree , Richardson Drew 
Published: March 2003

AbstractObjective:To characterize the prerequisite experience and training undertaken by nurses for the role of triage in emergency departments in Australasia.Methods:Postal survey of charge nurses/unit nurse managers of all Australasian emergency departments accredited for specialist emergency physician training by the Australasian College for Emergency Medicine.Results:The response rate was 89%. The most common duration of prerequisite experience was 12–18 months. Most programmes use a combination of educational activities, with self‐directed learning packages, lectures and mentored experience being the most common. Three hospitals reported no preparation for triage.Conclusion:In Australasia, there is wide variability in required training and experience before triage duties are performed. Strategies to set suggested minimum standards in these areas and to make training activities more accessible are recommended.
Options in Prehospital analgesia
Authors: Borland Meredith L , Jacobs Ian , Rogers Ian R 
Published: March 2003

AbstractBackground: Prehospital analgesia options for paramedics have been limited due to the difficulty in achieving safe and effective pain relief without compromising transportation to hospital. The present paper identifies the analgesia methods currently available in the prehospital setting so as to evaluate the various options and highlight areas for future research.Methods: A literature review of Medline and Embase databases from 1966 until the present was undertaken. Further hand searching of all the references identified in these papers was also performed. All current literature was analysed and categorized according to one of four levels of evidence using National Health and Medical Research Council of Australia guidelines (1999).Results: There is a paucity of randomized control trials relating to prehospital analgesia. All published literature was level III or IV prospective or retrospective studies. Drug options used included nitrous oxide/oxygen mixtures, intravenous/intramuscular nalbuphine, intravenous tramadol and intravenous pure opiate agonists.Conclusions: The evidence supporting analgesic options in the prehospital setting is limited. There are few published data in this area despite the inadequacy of pain relief being recognized as a weakness in prehospital care. Prehospital analgesia is an area worthy of innovative methods for the administration of safe and effective analgesics without significant impact on transport times. Such methods should be prospectively evaluated in well‐constructed trials.
Intranasal fentanyl reduces acute pain in children in the emergency department: A safety and efficacy study
Authors: Borland Meredith L , Jacobs Ian , Geelhoed Gary 
Published: March 2003

AbstractIntroduction: Provision of rapid, painless and effective analgesia to children remains problematic in the prehospital and emergency setting. Intranasal fentanyl has the potential to eliminate many of the problems of narcotic administration in children. The aim of this study, conducted in a tertiary paediatric emergency department was to evaluate the safety and efficacy of intranasal fentanyl in children.Methods: Children in acute pain aged between three and 12 years inclusive were enrolled on presentation to the emergency department. Routine observations and pain scoring by the child and caregiver was undertaken prior to the child receiving fentanyl (20 µg for 3–7 year olds and 40 µg for 8–12 year olds) and at intervals of 5 min for 30 min Additional fentanyl at the dose of 20 µg was given 5 minutely as required. Caregivers and older children used a visual analogue scale (VAS) and the younger children used the Wong‐Baker faces scale (WBS).Results: Forty five children were enrolled with a mean age of 8.0 years. The median dose of fentanyl administered was 1.5 µg/kg. Mean pain score in 32 children using the VAS was 62.3 mm (95% confidence interval 53.2–69.4 mm) at presentation and reduced at 10 min to 44.6 mm (95% confidence interval 36.2–53.1 mm). In 16 children using WBS the initial mean reading was 4.0 (95% confidence interval 3.3–4.7) and reduced to 2.2 (95% confidence interval 1.3–3.1) at 10 min. Caregiver pain scores showed a mean preintervention pain score of 64.9 mm (95% confidence interval 57.7–72.2 mm) with a significant reduction at 10 min to 41.7 mm (95% confidence interval 34.7–48.6 mm). There was no significant alteration in pulse rate, respiratory rate, and blood pressure or oxygen saturations. There were no negative side‐effects.Conclusions: Early and significant reduction in pain (compared to baseline assessments) was achieved in children using intranasal fentanyl by 10 min and sustained throughout the 30 min of observations. This raises the possibility of using intranasal fentanyl in children in the prehospital setting as well as a role for this form of analgesia as triage nurse‐initiated administration in the emergency department.
Validation of a tool to safely triage selected patients with chest pain to unmonitored beds
Authors: Sultana Ronald V , Kerr Debra , Kelly Anne‐Maree , Cameron Peter 
Published: March 2003

AbstractObjective: To externally validate a chest pain protocol that triages low risk patients with chest pain to an unmonitored bed.Methods: Retrospective study of all patients admitted from the emergency department of a tertiary referral public teaching hospital with an admission diagnosis of ‘unstable angina’ or suspected ischemic chest pain. Data was collected on adverse outcomes and analysed on the basis of intention‐to‐treat according to the chest pain protocol.Results: There were no life‐threatening arrhythmias, cardiac arrests or deaths within the first 72 h of admission in the group assigned to an unmonitored bed by the chest pain protocol ([0/244]; 0.0%: 95% confidence interval 0.0–1.5%). Four patients had an uncomplicated myocardial infarction, two patients had recurrent ischemic chest pain and one patient developed acute pulmonary oedema ([7/244]; 2.9%: 95% confidence interval 1.2–5.8%).Conclusion: This retrospective study externally validated the chest pain protocol. Care in a monitored bed would not have altered outcomes for patients triaged to an unmonitored bed by the chest pain protocol. Compared to current guidelines, application of the chest pain protocol could increase the availability of monitored beds.
Presentation of near‐hanging to an emergency department in the Northern Territory
Authors: Davidson Jennifer A 
Published: March 2003

AbstractObjective: To describe the epidemiology and outcomes of patients presenting after near‐hanging to an emergency department in the Northern Territory of Australia.Methods: A descriptive retrospective review of hospital and retrieval records was made of all patients presenting to the Royal Darwin Hospital between January 1995 and August 2000 as a result of near‐hanging.Results: There were 72 patients who presented after near‐hanging in the study period. The majority of patients were young adult males of Aboriginal descent living in the Tiwi Islands. Psychiatric and drug abuse histories were a prominent feature. No cervical spine injuries were detected and there were no neurological deficits in the survivors.Conclusion: Near‐hanging appears to be a significant problem among young indigenous males, especially those from the Tiwi Islands. Strategies to identify risk factors linked to suicide and to help empower families to reduce the incidence of self‐harm are integral to addressing this problem.
Early experience of sentinel lymph node biopsy in breast cancer with blue dye technique
Authors: Chung Chi‐Kin , Hung Wai‐Ka , Chan Miranda Chi‐Mui , Lau Yvonne , Mak Kong‐Ling , Yip Andrew Wai‐Chun 
Published: March 2003

Objective: Sentinel lymph node biopsy (SLNB) is a minimally invasive staging procedure for breast cancer. Results of the first 30 cases of SLNB performed at Kwong Wah Hospital, Hong Kong, were reviewed.Design: This feasibility study applied and assessed a new procedure in Chinese patients. The study was carried out at the Breast Centre, Kwong Wah Hospital, Hong Kong. Sentinel lymph node biopsy was performed with a blue dye technique alone. All patients had full axillary dissection after SLNB.Patients: Female patients with invasive carcinoma of breast and no clinical palpable axillary lymph node were included.Main outcome measures: Pathological results of both the SLN and the remaining axillary content were compared.Results and Conclusion: Sentinel lymph nodes were successfully biopsied in 83% of cases. Sensitivity was 75% and accuracy was 88%. With experience, sentinel lymph node biopsy is feasible in Chinese patients.
The use of intraoperative angiography in the management of neurovascular disorders
Authors: Lui Wai‐Man , Fan Yiu‐Wah , Cheng Pui‐Wai , Wong Wai‐Cheong 
Published: March 2003

Objective: To review our experience of intraoperative angiography in dealing with neurovascular disorders and to substantiate the usefulness of this investigation.Method: From April 1999 to November 2000, 32 cases of intraoperative angiogram were studied.Results: Two out of 30 intraoperative angiograms were unsuccessful. The angiographic machine broke down during one of the attempts. In one patient, intimal dissection of the femoral artery was noted during the procedure and the study was abandoned; the patient recovered uneventfully. Among the 30 completed angiograms, 19 were for cerebral aneurysm, 10 for arteriovenous malformation (AVM) and one for extracranial–intracranial (EC‐IC) bypass. There was no procedure‐related complication. Among the 19 angiograms performed for cerebral aneurysms, total occlusion was confirmed in 14 patients (74%), residual aneurysms were detected in two patients (10%) and branch occlusions were detected in three patients (16%). Of the 10 angiograms performed for AVM, total removal was confirmed in nine (90%), whereas residual AVM was detected in one patient (10%). One intraoperative angiogram for EC‐IC bypass confirmed the patency of the graft.Conclusions: The study showed that cerebral intraoperative angiography is safe and frequently reveals unclipped aneurysm necks, unexpected major vessel occlusion and residual AVM. Intraoperative cerebral angiography should be recommended as a standard practice for treating neurovascular disorders. Chinese Abstract imageimage
Clinical outcome of conservative therapy for stage T1, grade 3 transitional cell carcinoma of the bladder
Authors: HARA ISAO , MIYAKE HIDEAKI , TAKECHI YOSHIZUMI , ETO HIROSHI , GOTOH AKINOBU , FUJISAWA MASATO , OKADA HIROSHI , ARAKAWA SOICHI , KAMIDONO SADAO ,   KOBE UROGENITAL TUMOR STUDY GROUP
Published: March 2003

AbstractBackground: The objective of this study was to retrospectively investigate the effectiveness of transurethral resection of bladder tumor (TURBT) and intravesical instillation therapy for stage T1, grade 3 (T1G3) transitional cell carcinoma (TCC) of the urinary bladder.Methods: Between January 1995 and December 1997, 97 patients with T1G3 TCC of the urinary bladder were treated by TURBT and adjuvant intravesical instillation with bacillus Calmette‐Guérin (BCG) or other anticancer agents. The recurrence‐free survival rates were evaluated according to several clinicopathological factors. The cases that progressed to muscle invasive disease were also analysed.Results: In this series, the median follow‐up period was 25 months (range, 5– 41) after the initial TURBT. Intravesical recurrence was noted in 44 patients (45%), and the 1, 2, and 3 year recurrence‐free survival rates were 72%, 58%, and 42%, respectively. Multivariate analyses revealed that the risk of intravesical recurrence was significantly higher for patients who did not receive BCG therapy, irrespective of age, gender, tumor size, multiplicity, pathological stage, concomitant carcinoma in situ, and lymphovascular involvement. Moreover, after a median of 10 months, disease progression occurred in seven patients (7%), of which only one patient was treated by BCG therapy after initial TURBT.Conclusion: These findings suggest that intravesical instillation with BCG combined with TURBT is an effective conservative treatment for T1G3 TCC of the bladder. Patients with negative prognostic factors should be treated by BCG rather than other anticancer agents after TURBT.