bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACCURACY OF ENDOSCOPIC DIAGNOSIS OF HELICOBACTER PYLORI IN PATIENTS WITH HEMORRHAGIC PEPTIC ULCERS
Authors: WONG REI MING , OTA SHINICHI , BAMBA HIROMI , ITOYAMA SHINJI , SEKINE SUSUMU , KAWAMOTO CHIAKI , YOSHIDA YUKIO 
Published: March 2003

Background:  Recent progress in Helicobacter pylori eradication has resulted in dramatic improvements in the incidence of peptic ulcers and decreased rates of ulcer relapse. Because bleeding is an important complication of ulcer diseases, accurate diagnosis of H. pylori infection is necessary.Methods:  We studied the efficacy of diagnostic methods to detect H. pylori in hemorrhagic peptic ulcer patients. A total of 59 patients who had received emergency endoscopy because of symptoms such as hematemesis, melena or tarry stool, were examined. Endoscopic methods of H. pylori diagnosis (culture, histological assessment and rapid urease test) and serum anti‐H. pylori assays were used in the hemorrhagic peptic ulcer group and the control group.Results:  The percentage of endoscopically determined H. pylori‐negative patients was significantly higher in the hemorrhagic ulcer group than the control group (P < 0.05). Out of the endoscopically determined H. pylori‐negative patients in the hemorrhagic ulcer group, 78.9% were serologically H. pylori‐positive.Conclusion:  Endoscopic methods are not sufficient for the diagnosis of H. pylori infection in hemorrhagic ulcer patients. Therefore, serum anti‐H. pylori assessment should also be performed for such patients.
Epidemiological study of symptomatic gastroesophageal reflux disease in China: Beijing and Shanghai
Authors: Guozong Pan , Guoming Xu , Meiyun Ke , Shaomei Han , Huiping Guo , Zhaoshen Li , Xiucai Fang , Duowu Zou , Sucai Lu , Jing Liu 
Published: March 2003

OBJECTIVE: To explore the 1‐year point prevalences (July–September 1996) of symptomatic gastroesophageal reflux (GER), gastroesophageal reflux disease (GERD) and reflux esophagitis (RE) in the adult population of two Chinese city‐regions (Beijing and Shanghai) and to identify the conditions that predispose patients to GERD. METHODS: Phase I: 5000 residents of the two regions aged between 18 and 70 years were studied via a questionnaire. The study was carried out by cluster sampling from city, suburban and rural areas by using simple random sampling. Symptom scores (Sc) of the intensity and frequency of heartburn, acid reflux and regurgitation within 1 year of the time of study were taken as indices of acid reflux (highest score, Sc = 18) and Sc ≥ 6 indicated the presence of symptomatic GER. Phase II: a small number of patients who were identified as having symptomatic GER in the survey were enrolled in a case– control study using gastroscopy and 24‐h pH monitoring to obtain correct diagnostic rates of GERD and RE. Estimates of the prevalence of GERD and RE were then adjusted according to the rates of correct diagnosis. RESULTS: A total of 4992 subjects completed the survey, 2.5% had heartburn once daily, 8.97% had symptomatic GER (Sc ≥ 6) and the male to female ratio was 1:1.11. Point prevalences for the year for GERD and RE were 5.77 and 1.92%, respectively. Stratified analysis indicated that the prevalence of symptomatic GER in Beijing (10.19%) was higher than that in Shanghai (7.76%) and there was also a higher prevalence of GER in males, manual laborers, people from rural areas and people older than 40 years of age in Beijing as compared with Shanghai. Stepwise logistic analysis indicated that GER had a close relationship with dental, pharyngolaryngeal disorders and respiratory diseases. The conditions that predispose patients to GERD are (OR, odds ratio): age > 40 (OR = 1.01), eating greasy/oily food (OR = 6.56), overeating (OR = 1.99), tiredness (OR = 2.35), emotional stress (OR = 2.22), pregnancy (OR = 6.80) and constipation (OR = 1.65). CONCLUSIONS: Gastroesophageal reflux disease is a common disease in the adult Chinese population and it is more common in Beijing than in Shanghai.
Experimental study on pancreatic cancer gene therapy using the HSV‐TK gene mediated by a retroviral vector
Authors: Suqing Xie , Guoming Xu , Zhaoshen Li , Guangwen Cao 
Published: March 2003

OBJECTIVE: To study the value of the herpes simplex virus type I thymidine kinase (HSV‐TK) gene mediated by a retroviral vector in the treatment of human pancreatic cancer cell line 8988. METHODS: The HSV‐TK gene was directionally cloned into a site following the SV40 promoter that was adjacent to the 5′ LTR (long terminal repeats) and the neomycin phosphotransferase gene in the retroviral vector pMNSM. This enabled the TK gene to integrate into the chromatin of the host cell. The recombinant plasmid pMNS‐TK‐M was then transfected into the retrovirus‐packaging cell Pa317. Finally, the HSV‐TK gene was transfected into pancreatic cancer cell line 8988 by the recombinant retrovirus after selection with G418. RESULTS: The HSV‐TK gene was stably integrated into the host cell and its expression confirmed by Southern blotting and drug‐sensitivity tests. In vitro studies showed that the acyclovir (ACV) sensitivity level in the 8988/TK+ cells was higher than that of the parent cells. The cells that were transfected with the TK gene were significantly susceptible to ACV. In vivo studies in nude mice showed that intraperitoneal injection of ACV might postpone the formation of implanted tumors and produce a treatment effect on the tumors. CONCLUSIONS: This study demonstrated that the HSV‐TK/ACV retroviral system could be used in vivo to treat pancreatic cancer.
Pathological development of the gastric mucosa in Helicobacter pylori‐related diseases
Authors: Liu Tianshu , Wang Jiyao , Chen Shiyao , Yue Fan 
Published: March 2003

OBJECTIVE: To study the relationship between Helicobacter pylori eradication and the pathological development of the gastric mucosa in H. pylori‐related diseases. METHODS: One hundred and ninety‐one H. pylori‐infected patients were randomly given anti‐H. pylori or non‐anti‐H. pylori medications. Endoscopic examination was carried out 1 year after treatment. Pathological classifications followed the Sydney System. RESULTS: Of the 191 patients, those with chronic inflammation of the gastric mucosa improved (P < 0.05), as did those with atrophy and intestinal metaplasia (P < 0.05). Helicobacter pylori was eradicated in 107 patients, but not in 84 patients. Compared with those patients in whom H. pylori was not eradicated, those with H. pylori eradicated had ameliorated chronic inflammation of the gastric mucosa (P < 0.05) and active inflammation reduced in some cases (P < 0.05). Notwithstanding a stratification of different gastric diseases and different treatments, patients with H. pylori eradicated showed a more marked improvement in mucosal chronic inflammation than did patients in whom H. pylori was not eradicated (P < 0.05). CONCLUSIONS: These results suggest that H. pylori infection is closely related to active inflammation of the gastric mucosa. Helicobacter pylori eradication is beneficial in improving chronic inflammation of the gastric mucosa.
Prevalences of metronidazole‐ and clarithromycin‐resistant Helicobacter pylori isolates in Shanghai and molecular mechanism of resistance to clarithromycin
Authors: Shi Tong , Liu Wenzhong , Xiao Shudong , Xu Weiwen 
Published: March 2003

OBJECTIVE: To investigate the prevalences of metronidazole‐ and clarithromycin‐resistant Helicobacter pylori over the period from 1995 to 1999 in Shanghai, and the molecular mechanism of resistance to clarithromycin. METHODS: A total of 150 H. pylori strains were randomly selected from the isolates collected in 1995, 1997 and 1999, and tested for sensitivity against metronidazole and clarithromycin by using the E‐test. The mechanism of resistance was studied by polymerase chain reaction (PCR)–restriction fragment length polymorphism (RFLP). RESULTS: It was found that 42% (21/50), 57% (27/50) and 70% (35/50) of the tested strains were resistant to metronidazole among the isolates collected in 1995, 1997 and 1999, respectively. In 1995, there was no strain (0/50) resistant to clarithromycin, of which the prevalence rose to 2% (1/50) in 1997, and to 10% (5/50) in 1999. The prevalences of metronidazole‐ and clarithromycin‐resistant H. pylori in 1999 were significantly higher than those in 1995 (P < 0.05). Of nine clarithromycin‐resistant H. pylori strains, eight were found to have an A→G mutation at position 2144 of domain V of the 23S rRNA. CONCLUSIONS: These results suggest a significant increase in the prevalences of metronidazole‐ and clarithromycin‐resistant H. pylori in Shanghai during the 1995–1999 period. The majority (88.8%) of clarithromycin‐resistant H. pylori isolates have an A2144G mutation in domain V of the 23S rRNA.
Characteristic features of folate‐deficient neurological diseases in the elderly
Authors: Yukawa Motoko , Miyachi Takafumi , Ochi Hidekazu , Katayama Sadao , Kohriyama Tatsuo , Mimori Yasuyo , Nakamura Shigenobu 
Published: March 2003

Background:  Folic acid (folate) deficiency causes neurological disorders in aged people, the characteristic features of which were examined.Methods:  Serum folate levels were determined in 343 neurological patients by chemiluminescence. We found 36 folate‐deficient patients (10.5%) who were divided into elderly ≥ 65 years old (12 cases) and younger group, < 65 years old (24 cases), and were administered folate (15 mg/day) for 60 days.Results:  Serum folate levels were not different between the elderly and younger group, while folate levels were lower in elderly females than elderly males. Neuropathy was more frequent in elderly male than elderly female patients. Elderly neurological patients with neuropathy more readily responded to folate supplementation than those without neuropathy. Folate‐deficient patients with dementia were older than those without dementia, although nine younger patients had dementia and four of nine cases showed frontal dementia. Anemia or female sex was more frequent and neuropathy was less frequent among elderly patients with central nervous system involvement. Serum folate levels were lower in elderly anemic than nonanemic patients. Tube feeding was more frequent in elderly folate‐deficient neurological patients than in younger ones. Folate therapy was less effective in elderly patients with dementia, although three cases improved. Elderly folate‐deficient patients treated with tube feeding did not respond to the folate supplement.Conclusion:  Folate deficiency was not rare among aged neurological patients, and its features were different from younger patients. Since folate‐deficient neuroencephalopathies are responsive to folate supplementation in the elderly, the examination of elderly patients’ serum folate level is valuable.
Rising incidence of breast cancer in Papua New Guinea
Authors: Halder Anirudh , Morewya Jacob , Watters David A. K. 
Published: March 2003

Background: Three previous reports have shown the incidence of breast cancer in Papua New Guinea (PNG) to have risen in the 30 years between 1958 and 1987. In the present report the incidence and pathology of breast cancer in the decade 1989–1998 are described. Methods: This was a retrospective review of all histopathology specimens in PNG from 1989 to 1998. During this period the female population grew from 1 640 000 to more than 2 000 000. Results: There were 790 cases of breast cancer. The age of the patient was not known in 221 cases (26%). The age‐standardized incidence was 6.9 per 100 000. The incidence of breast cancer has been steadily rising in the 40 years since cancers were recorded in PNG. The incidence has risen in all four regions, most notably in the islands. The peak incidence was in the 45–54‐year‐old age group (18.4/100 000); 83.9% of women with breast cancer were aged 54 or less. Fifteen per cent were under 35 years old and 55.7% were under 45. The incidence fell in the elderly. The tumours tended to be advanced. The actual size was recorded in only 163 cases (20.7%) but there were only three T1 tumours in this group. Clinical signs of advanced breast cancer were recorded in 206 cases: ulceration of skin (91 cases), peau d’ orange (69 cases), nipple retraction (43 cases) and lymphoedema of the upper extremity (three cases). Axillary nodes were positive in 185 of 247 patients (75%) in whom they were sampled. Conclusions: The incidence of breast cancer in PNG women has steadily risen over the past 40 years and the highest age‐specific incidence occurs in the 35–54 age group. Tumours present late at an advanced stage. Clinical information on pathology request forms is poor and a prospective clinical audit is needed. Strategies need to be developed to detect breast cancer earlier in this population of women.
Colon trauma: Royal Melbourne Hospital experience
Authors: Steel Malcolm , Danne Peter , Jones Ian 
Published: March 2003

Background: Recent studies from the USA and South Africa suggest that primary repair or resection and primary anastomosis have become the recommended treatment for most traumatic colon injuries. The aim of the present review is to determine the applicability of these studies to the urban Australian setting.Methods: All patients with colon injuries operated on at the Royal Melbourne Hospital from March 1989 to March 1999 were identified. Data were collected by a retrospective chart review.Results:  A total of 20 patients sustained 26 injuries to the colon. Blunt

injuries were more common than penetrating injuries (14 vs 6). Significant other injuries occurred in 15 patients. Colostomies were performed in four patients. The overall mortality rate was 10%. There were no anastomotic leaks. Primary repair or resection and primary anastomosis were not associated with any increase in intra‐abdominal complications.Conclusion:  Evidence from large trauma centres supporting primary repair or resection and primary anastomosis is also applicable to regions that have a low rate of traumatic colon injury.
Synovial ablation in a rabbit rheumatoid arthritis model using photodynamic therapy
Authors: Beischer Andrew D. , Bhathal Prithi , De Steiger Richard , Penn David , Stylli Stan 
Published: March 2003

Background:  At present there is no ideal minimally invasive method for ablating inflamed synovium in joints that has been unres­ponsive to optimal medical management in patients with rheumatoid arthritis. The aim of this study was to determine whether photo­dynamic therapy could be used for this purpose.Methods: In a rabbit knee model of rheumatoid arthritis the pharmacokinetics of the photosensitizer Haematoporphyrin Derivative (HpD) into periarticular tissues and blood was measured following intravenous injection of HpD. The second phase of the study was to determine the histological effect of HpD activation by 63 nm light delivered via an intra‐articular optic fibre using a dye pumped KTP‐YAG laser. The light dose was varied from 0−200 joule/cm2.Results:  Pharmacokinetic studies determined that inflamed synovium rapidly accumulated HpD, with peak levels being reached 12 h following intravenous injection. The ratio of HpD uptake into inflamed synovium versus peri‐articular quadriceps muscle was found to be 22.8. Histological examination of the treated knees indicated that selective destruction of inflamed synovium was achieved at light doses 100 joules/cm2 and above. No significant effect was observed on normal intra‐articular tissues.Conclusion:  We have demonstrated that the first generation photosensitizer HpD selectively accumulates within inflamed ­synovium. Activation of HpD by intra‐articular light administration resulted in selective ablation of the inflamed synovium. These findings indicate that PDT offers potential as a new selective, minimally invasive synovectomy technique.
A compliant tip reduces the peak pressure of laparoscopic graspers
Authors: Marucci Damian D. , Cartmill John A. , Martin Christopher J. , Walsh William R. 
Published: March 2003

Background:  Previous studies have demonstrated that high pressures are generated at the tips of laparoscopic graspers, which can cause tissue injury. This study examines the effect of a compliant edge on tip pressure.Methods:  One of a pair of identical laparoscopic graspers was modified by refashioning the tip out of silicone. A thin film pressure transducer (I‐scan 6900 sensor) was deployed between the jaws of the grasper and a simulated tissue (leather strap). Load and handle pressures were kept constant. Peak tip pressure readings were taken as the load orientation was increased from the perpendicular to 135° (n = 10). The data was analysed using anova and a post‐hoc Duncan's multiple range test.Results:  Peak tip pressures generated by the compliant tipped grasper were significantly less than those developed by the unmodified grasper, particularly at high‐load orientations.Conclusion:  High pressures generated at the tip of laparoscopic graspers can be reduced by altering the mechanical properties (compliance) of the tip.
Does frozen section have a role in the intraoperative management of thyroid nodules?
Authors: Cheng Michael S. P. , Morgan Joanna L. , Serpell Jonathan W. 
Published: March 2003

Background: Frozen section in thyroid surgery is used to make an intraoperative pathological diagnosis of malignancy in a thyroid nodule at the time of hemithyroidectomy. A positive diagnosis allows completion of thyroidectomy, thus avoiding reoperation. However, the use of fine needle aspiration cytology in making a preoperative diagnosis of cancer has resulted in the lack of a defined role for frozen section. We examined the role of frozen section as an adjunct to fine needle aspiration cytology in determining which cytological subset will benefit from frozen section.Methods: All patients who underwent thyroidectomy between 1992 and 2000 by a single endocrine surgeon were reviewed.Results: Two hundred and nine frozen sections were performed, of which 144 underwent preoperative fine needle aspiration cytology. Frozen sections reported 135 benign nodules, 59 follicular neoplasms, five specimens with suspicious histology and 10 cancers. Ten out of 20 thyroid cancers were correctly identified by frozen section (sensitivity: 50%; specificity: 100%), eight cancers were reported on frozen section as indeterminate and two benign. Of 144 fine needle aspiration cytological procedures, frozen section on seven suspicious aspirates identified two cancers, and frozen section on 70 follicular aspirates identified four cancers, allowing intraoperative conversions to total thyroidectomy. Frozen section on seven malignant aspirates confirmed four cancers but resulted in reoperation for three because of the indeterminate frozen section reports. There were no cancers found on 135 benign aspirates.Conclusions: Frozen section on benign aspirates is unhelpful in the management of thyroid nodules. It need not be performed for cytologically proven malignant thyroid nodules. Selective use of frozen section complements fine needle aspiration cytology findings of suspicious or follicular lesions, especially in the subset with papillary cancer, allowing one‐stage total thyroidectomy.
Open access endoscopy in rural and remote Western Australia: Does it work?
Authors: Hughes‐Anderson Wayne , Rankin Sarah L. , House Jill , Aitken James , Heath Dugal , House Anthony K. 
Published: March 2003

Background:  Access to diagnostic endoscopy is limited in rural and remote Western Australia. Published reports suggest open access referrals may result in over‐servicing, this is reduced by adherence to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines.The aim was to assess whether an out reach surgical service offering open access endoscopy to rural areas was being over utilized.Methods:  Prospective data collection from all patients undergoing upper and lower endoscopy procedures between January 1996 and June 2000 were included in the present study. Indications for referral between the general practitioners and the visiting surgeons were reviewed in patient records and assessed for compliance with the ASGE guidelines. The groups were analysed for appropriateness of referrals and frequency of positive pathology investigations. Records for all patients undergoing colonoscopy were reviewed to determine the reason and number of cancelled procedures.Results:   A total of 772 endoscopies were performed and 75% were booked as open access services. The referral rate for procedures was greater for general practitioners (583) compared to the visiting surgeons (189), the overall compliance rate for approved indications using the ASGE guidelines for both groups was 92%. There was no significant difference in pathology found between groups.Conclusion:  The present study shows that an outreach rural surgical service programme in Western Australia offering open access endoscopy conforms to international guidelines and does not induce unnecessary procedures. Rural patients benefit from a personal cost savings andconvenience. There is an associated reduction in government‐assisted travel costs to larger centres as well as decreased waiting lists.
DUCTILE TEARING SIMULATION BASED ON A LOCAL ENERGETIC CRITERION
Authors: Marie S , Chapuliot S 
Published: March 2003

It is well known that the tearing resistance curve J–Δa is not a material property and that probably the energy dissipation rate is preferable to the integral J to characterize crack growth. The G parameter represents the energy dissipated in plasticity and fracture and, under certain conditions, this parameter could be used directly as a critical value for a criterion based on an energy release rate calculated near the crack tip to simulate propagation. Indeed, we see that a local energy release rate could be calculated near the crack tip to take account only of that portion of energy which participates in the fracture.We applied this approach to simulate the crack growth for CT specimens with and without side grooves in a 20 MnMoNi 55 ferritic steel, and compared the results with Rousselier’s model.
SMALL FATIGUE CRACKS IN AN AUSTENITIC STAINLESS STEEL
Authors: Lindstedt U , Karlsson B , Nystr M 
Published: March 2003

The present study concerns nucleation and growth of small surface cracks during the low‐cycle fatigue of a nitrogen‐containing austenitic stainless steel. Metallographic replicas as well as longitudinal sectioning were used to record the developing crack pattern on the specimen surface. The influence of grain size and nitrogen content is considered. Small surface cracks are observed after about 10% of the fatigue life. The nucleation of cracks continues until about half of the lifetime, when the crack density saturates. This saturation phenomenon is related to the local unloading effect of growing cracks.The mean crack length increases continuously as a power‐law until specimen failure. However, small grains and a low nitrogen content amplify the effect of crack–grain boundary interactions resulting in an intermediate retardation in growth.At high nitrogen contents, the crack growth characteristics are very much related to the slip bands formed. This results in a more simultaneous growth of cracks, a more jagged feature of the cracks introducing a higher roughness‐induced crack closure effect, and, consequently, better fatigue properties.