bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of peroxisome‐proliferator activated receptor‐gamma (PPARγ) and the PPARγ co‐activator, PGC‐1, in human breast cancer correlates with clinical outcomes
Authors: Jiang Wen G. , Douglas‐Jones Anthony , Mansel Robert E. 
Published: July 2003

AbstractPeroxisome‐proliferator activated receptor‐gamma (PPARγ) belongs to a family of nuclear receptors and acts as receptor for peroxisome‐proliferators, steroids, retinoic acids, and polyunsaturated fatty acids. Our study examined the transcript levels of peroxisome‐proliferator activated receptor‐gamma (PPARγ) and its co‐activator (PGC‐1) in a cohort of patients with breast cancer. An invasive breast cancer cell, MDA MB 231 exhibited lower level of expression of PPARγ, compared to non‐invasive MCF‐7. Breast cancer tissues (n= 120) exhibited a lower level of PPARγ mRNA compared to normal tissues (n= 25,p= 0.05). No difference, however, was seen with PGC‐1. Although the levels of PPARγ and PGC‐1 did not correlate with nodal involvement and grade, significantly lower levels of PPARγ were seen in TNM3 and TNM4 tumors and from patients with local recurrence and those who died of breast cancer. Lowest level of PGC‐1 was also seen in TNM3 and TNM4 tumors and patients who died of breast cancer. We conclude that there is aberrant expression of PPARγ and its co‐activator, PGC‐1, in human breast cancer and low levels of these molecules in cancer tissues are associated with poor clinical outcomes. © 2003 Wiley‐Liss, Inc.
A warm welcome for destination quality brands: the example of the Pays Cathare region
Authors: Woods Megan , Deegan Jim 
Published: July 2003

AbstractIn this paper, the salient complexities characterising quality management at the tourism destination are outlined, and in light of these, a number of quality principles are deemed particularly appropriate for the further investigation of destination quality management (DQM). The complexities include the significant number of services provided at the destination, the highly fragmented nature of the tourism destination product and the large number of small businesses that go to comprise this product. General principles are drawn from the SERVQUAL, Kano and EFQM Business Excellence models in order to provide a tentative framework for investigating how one destination has striven to overcome these challenges. The example of the Pays Cathare Region in southern France, which has been recognised by the European Commission as an example of best practice in integrated quality management (IQM), shows how these quality tenets can be translated from the theoretical framework into actual practice by means of its destination quality brand. Copyright © 2003 John Wiley &Sons, Ltd.
Transitional economy tourism: German travel consumers' perceptions of Lithuania
Authors: Clottey Birute , Lennon Ron 
Published: July 2003

AbstractThis paper examines the current status of tourism in Lithuania as well as potential German tourists' perceptions of Lithuania as a tourist destination. As tourism is an important source of foreign exchange and provides jobs for a large number of people, the Lithuanian Government is quite interested in increasing the number of tourists visiting the country. Data gathered at the International Tourism Exchange in Berlin was analysed and recommendations made concerning marketing techniques that could be used to increase tourism from the European Union and other western countries. Copyright © 2003 John Wiley &Sons, Ltd.
In vivo autofluorescence spectroscopy of oral premalignant and malignant lesions: Distortion of fluorescence intensity by submucous fibrosis
Authors: Tsai Tsuimin , Chen Hsin‐Ming , Wang Chih‐Yu , Tsai Jui‐Chang , Chen Chin‐Tin , Chiang Chun‐Pin 
Published: July 2003

AbstractBackground and ObjectivesTo test whether autofluorescence spectroscopy can be used for the diagnosis of oral neoplasia in a high‐risk population, we characterized the in vivo autofluorescence spectra from oral submucous fibrosis (OSF) lesions and oral premalignant and malignant lesions in both OSF and non‐OSF patients.Study Design/Materials and MethodsAutofluore scence emission spectra were measured under the excitation wavelength of 330 nm, using a Xenon lamp‐based fluorospectrometer coupled to a handheld optical fiber probe. Autofluorescence spectroscopies were analyzed among patients with OSF lesions, and oral lesions of epithelial hyperkeratosis (EH), epithelial dysplasia (ED), and squamous cell carcinomas (SCC) and normal oral mucosa (NOM) of healthy volunteers.ResultsWe found that the most intensely autofluorescence emission peaks occurred at 380 nm and 460 nm. For comparing the spectral patterns among different groups of oral lesions and NOM, ratios of the area under the spectrum of 460±10 nm to that under the spectrum of 380±10 nm (denoted as A460±10nm/A380±10nm) were calculated. The mean ratio values increased gradually from OSF to NOM, to EH and ED, and to SCC. The ANOVA test showed significant differences in the ratio value among all categories of samples (P<0.01). On the other hand, we found that EH, ED, and SCC lesions on OSF patients had distorted autofluorescence intensity. The mean ratio values of EH, ED, and SCC between non‐OSF and OSF patients show significant differences. Furthermore, an ANOVA test showed NOM is not distinguishable from EH and ED lesions on oral fibrotic mucosa (P>0.05).ConclusionsAutofluorescence spectroscopy can be used to diagnose EH, ED, and SCC lesions in non‐OSF patients but not in OSF patients. Lasers Surg. Med. 33:40–47, 2003. © 2003 Wiley‐Liss, Inc.
Thermal response of human skin epidermis to 595‐nm laser irradiation at high incident dosages and long pulse durations in conjunction with cryogen spray cooling: An ex‐vivo study
Authors: Dai Tianhong , Pikkula Brian M. , Tunnell James W. , Chang David W. , Anvari Bahman 
Published: July 2003

AbstractBackground and ObjectivesImproved laser treatment of cutaneous hypervascular lesions is expected by utilizing higher incident dosages, longer pulse durations and longer wavelengths than those currently used in clinical settings. However, simply increasing the incident dosage will also increase the risk of nonspecific thermal injury to the epidermis due to light absorption by melanin. In this study, we investigated the thermal response of human skin epidermis to 595‐nm wavelength laser irradiation at high incident dosages (up to 20 J/cm2) and long pulse durations (up to 40 milliseconds) in conjunction with cryogen spray cooling (CSC) using ex‐vivo human skin samples.Study Design/Materials and MethodsThe Candela V‐beam™ laser (595‐nm wavelength) was used in the experiments. Ex‐vivo human skin samples (Fitzpatrick types I–VI) were irradiated at the incident dosages D0 = 4, 6, 10, 15, and 20 J/cm2, laser pulse durations τlaser = 1.5, 10, and 40 milliseconds, without and with CSC (refrigerant‐134A, spurt duration τCSC = 100 milliseconds). Thermal injury to the epidermis was evaluated by histological observations.ResultsUnder the same incident dosage, longer pulse durations led to reduced thermal injury to the epidermis. Without CSC, no demonstrable thermal injury to the epidermis was observed in skin types I–II irradiated at the incident dosage as high as 15 J/cm2, and in skin types III–IV at 10 J/cm2. When CSC was applied, no evidence of thermal injury to the epidermis was present in skin types I–II even when irradiated at the maximum available incident dosage of the laser system (20 J/cm2). In skin types III–IV, no demonstrable thermal injury to the epidermis was observed when using incident dosage as high as 15 J/cm2 in conjunction with CSC. In skin type VI, thermal injury to the epidermis could not be avoided even at the setting D0 = 4 J/cm2, τlaser = 40 milliseconds in conjunction with CSC.ConclusionsFor a given incident dosage, longer pulse durations help reduce thermal injury to the epidermis. When a 100‐millisecond cryogen spurt is applied, thermal injury to the epidermis can be prevented in ex‐vivo skin types I–IV when irradiated at higher incident dosages (15–20 J/cm2) than those currently used in clinical settings. Further studies on optimizing the CSC parameters in conjunction with the laser irradiation parameters are needed to protect skin types V–VI from thermal injury to the epidermis. Lasers Surg. Med. 33:16–24, 2003. © 2003 Wiley‐Liss, Inc.
Arterial wall strength after endovascular photodynamic therapy
Authors: Gabeler Edward E.E. , van Hillegersberg Richard , Sluiter Wim , Kliffen Mike , Statius van Eps Randolph G. , Honkoop Jan , Carlier Stephane G. , van Urk Hero 
Published: July 2003

AbstractBackground and ObjectivesVascular photodynamic therapy (PDT) inhibits intimal hyperplasia (IH) induced by angioplasty in rat iliac arteries by eradicating the proliferating smooth muscle cells. This process may jeopardise the structure and strength of the arterial wall, reflected by a decreased bursting pressure.Study design/Materials and MethodsThirty male Wistar rats of 250–300 g were subdivided into 3 groups (n = 10). In all groups, IH was induced by balloon injury (BI). One experimental group received PDT at 50 J/cm diffuser length, the other group at 100 J/cm diffuser length. The third group served as control group and received no PDT. In half of each group the bursting pressure was analyzed after 2 hours (n = 5), in the other half after 1 year.ResultsTwo hours after the procedure the bursting pressure was 3.37 ± 0.58 (±SEM) bar in the BI + PDT 50 and 3.96 ± 0.43 bar in the BI + PDT 100 group, compared to 2.20 ± 0.27 bar in the BI group (P < 0.05). After 1 year these values were 3.18 ± 0.87 bar in the BI + PDT 50 (P < 0.05) and 2.02 ± 0.31 bar in the BI + PDT 100 group, compared to 2.10 ± 0.30 bar in the BI group (NS). In the BI + PDT 100 group, 3 out of 5 rats appeared to have aneurysmal dilatation after 1 year.ConclusionsEndovascular PDT increases the arterial wall strength as measured by the bursting pressure at short‐term. After 1 year, wall strength is not diminished as measured by bursting pressure, but aneurysmal dilatation nevertheless developed with 100 J/cm · dl. This may limit the use of high energy PDT. Lasers Surg. Med. 33:8–15, 2003. © 2003 Wiley‐Liss, Inc.
Improved quality of life after XeCl excimer transmyocardial laser revascularization: Results of a randomized trial
Authors: Huikeshoven Menno , van der Sloot Jos A.P. , Tukkie Raymond , van Gemert Martin J.C. , Tijssen Jan G.P. , Beek Johan F. 
Published: July 2003

AbstractBackground and ObjectivesWe assessed quality of life (QOL) after XeCl transmyocardial laser revascularization (TMLR).Study Design/Materials and MethodsThirty patients were randomized to receive XeCl excimer TMLR or optimal cardiac medication (controls). QOL was assessed at baseline, 1, 3, 6, and 12 months using three different questionnaires: The Medical Outcomes Study Short Form‐24 (MOS SF‐24), the EuroQol Standardized Questionnaire, and the Seattle Angina Questionnaire (SAQ). The primary outcome measure was the change in score between baseline and 12 months.ResultsTMLR patients scored significantly better compared to controls in the MOS SF‐24 social functioning, energy, general health, and bodily pain domains, in the EuroQol usual activity domain and the EuroQol Visual Analogue Scale, and in the SAQ physical limitation, angina frequency and disease perception domains.ConclusionsQOL significantly improved after XeCl excimer TMLR compared to medication. These results are similar to reported improvements in QOL after CO2 and Ho:YAG TMLR. Lasers Surg. Med. 33:1–7, 2003. © 2003 Wiley‐Liss, Inc.
Nonablative laser and light treatments: Histology and tissue effects—A Review
Authors: Alam Murad , Hsu Te‐Shao , Dover Jeffrey S. , Wrone David A. , Arndt Kenneth A. 
Published: July 2003

AbstractBackground and ObjectivesNonablative laser and light treatments have largely replaced ablative laser therapy in clinical use for the improvement of the visible signs of cutaneous photoaging, including rhytides, vascular lesions, and pigmentation. However, the mechanisms underlying the reported clinical efficacy of nonablative treatments are not well‐understood. The purpose of this analysis is to critically evaluate what is known about histologic and tissue effects of nonablative laser therapy and suggest future directions for research.Study Design/Materials and MethodsThis is a review of the English language literature pertaining to nonablative laser and light treatments available through MEDline (1995–2002), and unpublished reports presented at major national meetings. Only studies that included harvesting and analysis of tissue samples are included.Results and Conclusions(a) Thermal injury to the dermis in association with epidermal cooling most likely affects the dermal vasculature, which initiates a cascade of inflammatory events that includes fibroblastic proliferation and apparent up‐regulation of collagen expression; (b) There is no indication that nonablative treatments are harmful or able to induce skin cancer; (c) It is possible that the horizontally distributed collagen reported after nonablative treatments is a “microscar,” an enlarged Grenz sone associated with repetitive photo‐induced trauma; (d) Further research is needed to elucidate the biophysical mechanisms underlying nonablative treatment, as well as to distinguish the utility of different wavelengths on epidermal and dermal improvement. Lasers Surg. Med. 33:30–39, 2003. © 2003 Wiley‐Liss, Inc.
Quality of GPs' referral letters to diabetes secondary care
Authors: Syed AA , Large DM 
Published: July 2003

AbstractGood quality referral information enables appropriate triage and the best use of scarce secondary care resources. We evaluated the quality of GPs' referral letters to our district general hospital diabetes centre to identify types of information that receive the highest and the least priority with the objective of developing constructive feedback.Eighty‐one letters from 51 GPs, excluding requests for reassessment, emergency inpatient care or non‐diabetic concerns, were evaluated on 24 parameters of varying clinical importance and categorised as ‘low’(0.0–9.9), ‘mid’(10.0–19.9) or ‘high’ (20.0–30.0) scoring (total 30.0 points).Total scores ranged from 4.5 to 30 (mean 13.3). Mean per cent scores (95% confidence intervals), for selected parameters were: home glucose monitoring 29.6 (19.9 to 39.3); HbA1c 47.8 (38.3 to 57.4); retinal surveillance 32.1 (21.9 to 42.3) and complications 30.9 (20.9 to 40.8); microalbuminuria 28.4 (18.4 to 38.3) and renal complications 23.5 (14.3 to 32.6); foot care 19.8 (11.0 to 28.5) and complications 24.1 (14.9 to 33.2); blood pressure 41.4 (30.9 to 51.8); bodyweight 30.3 (20.9 to 39.6). Low‐scoring letters (32.1%) regularly provided five items of information, mid‐scoring (51.9%) 10 items and high‐scoring (16.1%) 20 items.Overall, letters were lacking in information regarding surveillance, recognition and management of microangiopathy, blood pressure, body weight, home glucose monitoring and biochemistry. High‐scoring letters reflected good insight into the care of people with diabetes. Copyright © 2003 John Wiley & Sons, Ltd.
Ensuring the quality of diabetes care: Use of the QUAD‐CAT model and Alphabet Strategy in clinical practice
Authors: Goenka N , Panja S , James D , Shaikh S , Morrissey J , Patel V 
Published: July 2003

AbstractThere are wide regional variations in the quality and provision of diabetes care. The pressure is on health care providers to deliver care of the highest quality. The Quality of Care Diabetes Assessment Tool (QUAD‐CAT) was developed to benchmark the care provided in primary and secondary care, based on the American Diabetes Association (ADA) model.We studied data from a random selection of 25 diabetic patients from 10 primary care centres and 100 diabetic patients from George Eliot Hospital diabetes clinic. Data were collected based on the template of the Alphabet Strategy for managing diabetes, for various parameters, including HbA1c, blood pressure, eye and foot examination, nephropathy assessment, lipid profile and aspirin use. A patient questionnaire was included to assess the subjective quality of service.Points were allocated based on the ADA scoring system. In order for a centre to be accredited, 80 out of 110 points were required. The overall points range was 40–95, with three practices accredited. There was a wide variation in performance in the key measures assessed between the practices.In conclusion, QUAD‐CAT provides an easily conducted and well‐accepted tool to evaluate the quality of clinical care and patient's perception of diabetes services Copyright © 2003 John Wiley & Sons, Ltd.
Spontaneous and long‐term resolution of diabetes following diabetic ketoacidosis: a rare entity?
Authors: Baynes KCR , Chan NN , Feher MD 
Published: July 2003

AbstractDiabetic ketoacidosis is usually characterised by absolute insulin deficiency with an essential requirement for life‐long insulin therapy. We report a case of a 40‐year‐old Ghanaian man, who presented with classical diabetic ketoacidosis, in the absence of any previous history of diabetes or intercurrent illness. After conventional treatment with insulin for one year, he submitted himself to a course of treatment with Chinese herbal medicines and accupressure. Over the following year he became normoglycaemic without the need for exogenous insulin therapy demonstrating the unusual feature of resolution of type 1 diabetes. Spontaneous resolution of hyperglycaemia following diabetic ketoacidosis challenges the traditional understanding of the pathogenesis of this condition, which is usually attributed to non‐reversible insulin deficiency. Newly diagnosed patients presenting with diabetic ketoacidosis may have ‘atypical’ diabetes, rather than life‐long insulin deficiency due to autoimmune type 1 diabetes. Literature review suggests that atypical (idiopathic or J‐type), diabetes is probably more common than is appreciated. Copyright © 2002 John Wiley & Sons, Ltd.
Medication and fitness to drive
Authors: Del Río M. C. , Alvarez F. J. 
Published: July 2003

AbstractPurposeThe aim of this study is to analyze the consumption patterns of medicaments among motor vehicle drivers who attend ‘Medical Driving Test Centres’ and the relation between habitual consumption of medicaments and fitness to drive.MethodsThe study was carried out on 8043 drivers who attended 25 Medical Driving Test Centres.Results24.7% of drivers chronically consume medicaments while 6.8% consume medicaments along with alcohol every day. Of those who chronically consume medicaments with a warning about the medications on driving, 65.8% were considered ‘fit’ to drive, 27.3% ‘fit with restrictions’, 5.1% ‘suspended’ and 0.4% ‘unfit’.ConclusionsThe results show how frequent the consumption of medicaments along with alcohol is and that the great majority of drivers who take medicaments are considered fit to drive. Copyright © 2003 John Wiley & Sons, Ltd.
Prescribing patterns of tricyclic and selective serotonin reuptake inhibitor antidepressants among a sample of adolescents and young adults
Authors: Kairuz Therèse , Truter Ilse , Hugo Johan , Foxcroft Cheryl 
Published: July 2003

AbstractPurposeThere are few studies that document antidepressant prescribing in young patients. Although tricyclic antidepressants (TCAs) are considered equal in efficacy to selective serotonin reuptake inhibitors (SSRIs), the latter have an improved side effect profile. The aim of this study was to investigate the prescribing patterns of TCAs and SSRIs among adolescents and young adults, with reference to prescribing frequency, cost and dose.MethodA retrospective drug utilization study was conducted over a 14‐month period, from January 2000 to February 2001.ResultsThere were 166 antidepressants prescribed to 98 adolescents and young adults. TCAs were prescribed more frequently than SSRIs, with amitryptiline and fluoxetine being the two most frequently prescribed antidepressants. Fluoxetine accounted for a higher ratio of cost to prescribing frequency than amitryptiline. Amitryptiline was issued in small quantities of tablets, resulting in a low average calculated prescribed daily dose (PDD). Duration of treatment was not considered optimal for SSRIs or TCAs.ConclusionThis study elicits prescribing patterns that contribute to the relative scarcity of data on antidepressant drugs for young patients. Copyright © 2003 John Wiley & Sons, Ltd.
Use of the New Zealand Intensive Medicines Monitoring Programme to study the levonorgestrel‐releasing intrauterine device (Mirena)
Authors: Zhou Lifeng , Harrison‐Woolrych Mira , Coulter David M. 
Published: July 2003

AbstractPurposeTo demonstrate how the Intensive Medicines Monitoring Programme (IMMP) can be used to monitor adverse events associated with an intrauterine device, using the levonorgestrel‐releasing intrauterine device (Mirena) as an example.MethodsA long‐term prospective observational cohort study using Prescription Event Monitoring (PEM) is currently being undertaken in women using Mirena in New Zealand. This report describes the method used and reports the early results for those women who used the device between March 1998 and March 2001. Adverse events were recorded by inserting doctors and general practitioners on registration forms and systematic follow‐up questionnaires.ResultsBetween March 1998 and March 2001, the IMMP received 3519 registration forms for insertions in 3452 women. ‘Difficult insertion’ was the most frequently reported event (3.6% of all insertions). Approximately, 2% of the Mirena insertions were carried out under GA and there were three uterine perforations (0.9 per 1000 insertions) in the total cohort. To date, follow‐up questionnaires have been processed for 495 patients. The response rate for these was 83%.ConclusionAs adapted in the IMMP, PEM is an effective tool for the early post‐marketing surveillance of an intrauterine device in real life clinical practice. Copyright © 2003 John Wiley & Sons, Ltd.
A consensus‐binding structure for adenine at the atomic level permits searching for the ligand site in a wide spectrum of adenine‐containing complexes
Authors: Kuttner Yosef Y. , Sobolev Vladimir , Raskind Alexander , Edelman Marvin 
Published: July 2003

AbstractAttempts to derive structural features of ligand‐binding sites have traditionally involved seeking commonalities at the residue level. Recently, structural studies have turned to atomic interactions of small molecular fragments to extract common binding‐site properties. Here, we explore the use of larger ligand elements to derive a consensus binding structure for the ligand as a whole. We superimposed multiple molecular structures from a nonredundant set of adenosine‐5′‐triphosphate (ATP) protein complexes, using the adenine moiety as template. Clustered binding‐site atoms of compatible atomic classes forming attractive contacts with the adenine probe were extracted. A set of atomic clusters characterizing the adenine binding pocket was then derived. Among the clusters are three vertices representing the interactions of adenine atom N6 with its protein‐binding niche. These vertices, together with atom C6 of the purine ring system, complete the set of four vertices for the pyramid‐like structure of the N6 anchor atom. Also, the sequence relationship for the adenine‐binding loop interacting with the C2–N6 end of the conjugated ring system is expanded to include a third hydrophilic cluster interacting with atom N1. A search procedure involving interatomic distances between cluster centers was formulated and applied to seek putative binding sites in test cases. The results show that a consensus network of clusters, based on an adenine probe and an ATP‐complexed training set of proteins, is sufficient to recognize the experimental cavity for adenine in a wide spectrum of ligand–protein complexes. Proteins 2003;52:400–411. © 2003 Wiley‐Liss, Inc.