bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness in cleaning oval‐shaped root canals using Anatomic Endodontic Technology, ProFile and manual instrumentation: a scanning electron microscopic study
Authors: Zmener O. , Pameijer C. H. , Banegas G. 
Published: May 2005

AbstractAim  To compare in vitro the cleanliness of root canal walls in oval‐shaped root canals following automated or manual instrumentation.Methodology  Forty‐five oval‐shaped single‐rooted maxillary and mandibular premolars with straight canals were divided into three groups of 15. Automated canal preparation was performed using Anatomic Endodontic Technology (AET, group 1) and the ProFile system (group 2). Manual instrumentation (group 3) was performed with K‐Flexofiles. Irrigation was performed using alternately 5.25% NaOCl and 17% EDTA, followed by rinsing with saline. The roots were split longitudinally into halves and the canals examined at ×200 and ×400 in a scanning electron microscope. The presence of debris and smear layer was recorded at distances of 1, 5 and 10 mm from the working length using a three‐step scoring scale and a 300 μm square grid. Mean scores for debris and smear layer were calculated and statistically analysed for significance (P < 0.05) between and within groups, using the Kruskal–Wallis nonparametric anova and Dunn's tests.Results  At 1, 5 and 10‐mm levels the root canals prepared with AET had significantly less surface debris and smear layer on the canal walls compared with canals prepared with ProFile or manual instrumentation. For all three groups significantly lower mean smear layer scores (P < 0.05) were recorded at 5 and 10‐mm levels compared with the 1 mm level. Significantly lower mean debris scores (P < 0.05) were also recorded at 5 and 10‐mm levels for the AET group whereas no significant differences were found between the three levels for the ProFile and manual instrumentation groups.Conclusions  Although better instrumentation scores were obtained in canals prepared with AET, complete cleanliness was not achieved by any of the techniques and instruments investigated.
The environmental control of plant species density on a Himalayan elevation gradient
Authors: Carpenter Chris 
Published: May 2005

AbstractAim In eastern Nepal, forests occupy an elevation gradient of 4000 m with bioclimatic zones from near tropical to alpine. Understorey plants and trees were censused to measure species density and identify patterns of ecological change. By sampling in a manner robust against spurious mid‐domain effects, I aim to identify biologically valid controls on species density.Location The study area consists of land below 4250 m elevation between 27.1 and 27.8° N latitude, 86.5 and 88.0° E longitude on the southern slopes of the Himalaya Range in eastern Nepal. Sampling sites are limited to intact, natural forest with relatively little human impact.Methods Team members counted species of understorey plants and trees ≥ 10 cm d.b.h. in 0.04 ha plots throughout the study area. In addition, basal area, leafing phenology and species composition were determined for the trees in each plot. Estimates of regional species density were compiled for successive 250 m elevation bands from 250 to 4250 m elevation. Species density trends were identified and compared with the expectations of O'Brien's [Journal of Biogeography25(1998) 379–398] climate‐based water–energy dynamics model.Results Stand basal area, tree leafing phenology and taxonomic composition (angiosperm vs. gymnosperm) show non‐random change with elevation. Understorey plant and tree species density both have a humped, unimodal trend with more species near the bottom of the gradient and fewest at the top. These trends are consistent with expected effects of the climatically active water and energy variables. After curve‐fitting, significant spatial structure in the residuals suggests that tree communities within the 1750–2250 m elevation range do not realize their climatic potential species richness.Main conclusions Neither mid‐domain effects nor biologically valid boundary effects like dispersal limitation explain the plant species density trends observed. Trends do fit a model in which species density is controlled by the same ‘active’ climatic variables that predict species richness on continental scales. Patterns of leafing phenology on the elevation gradient provide further support for the hypothesis of environmental control of species density. The productivity–diversity linkage that exists on continental scales may also apply on the smaller scale of a Himalayan elevation gradient. Human activity and possible competitive exclusion byCastanopsis tribuloidesare the two best explanations for the observed decline in tree species density at 1750–2250 m elevation. Burning, lopping for fodder and livestock grazing might account for the decline, but this study does not assess the relative importance of these activities. The elevation richest for understorey plant and tree species (500–1500 m) also has the most severe reduction in forest cover. Local farmers deserve credit for sustaining plant biodiversity in forest enclaves, but further loss of forest at these elevations should be discouraged.
GSK‐3 activity in neocortical cells is inhibited by lithium but not carbamazepine or valproic acid
Authors: Jonathan Ryves W , Dalton Emma C , Harwood Adrian J , Williams Robin SB 
Published: May 2005

Objectives:  Lithium (Li+) has been suggested to target the enzyme glycogen synthase kinase 3 (GSK‐3) as a mechanism of mood stabilization. Inhibition of GSK‐3 by a second mood‐stabilizer, valproic acid (VPA), has also been reported, but this effect is dependent on cell type. It is currently unknown if carbamazepine (CBZ) inhibits GSK‐3 activity. We have sought to compare the inhibitory effect of Li+, VPA and CBZ on GSK‐3 activity.Methods:  We treated rat primary cultured neurones at three times therapeutic drug concentration with CBZ, VPA and Li+ and examined changes in GSK‐3 protein levels, activity and phosphorylation of downstream targets. To eliminate a possible direct effect of these drugs at higher concentrations, we also looked for direct inhibition of both GSK‐3 isoforms at a range of concentrations.Results:  CBZ, VPA and Li+ did not change the levels of the GSK‐3 or produce an irreversible in vivo effect on GSK‐3 activity. Only Li+ inhibited the phosphorylation of a cytoskeletal target of GSK‐3, tau, whereas CBZ and VPA did not. Surprisingly, none of these drugs altered β‐catenin levels in these cells, a process attenuated by GSK‐3 activity. Finally, only Li+ directly inhibits GSK‐3 activity (both α and β isoforms) at therapeutic levels in direct biochemical assays.Conclusion:  Thus we show that neither GSK‐3 nor the altered GSK‐3 signalling pathway can provide a common mechanism of action of mood‐stabilizing drugs in the mammalian brain.
Hashimoto's encephalopathy presenting with bipolar affective disorder
Authors: Müssig Karsten , Bartels Mathias , Gallwitz Baptist , Leube Dirk , Häring Hans‐Ulrich , Kircher Tilo 
Published: May 2005

Objective:  We report on a rare case of Hashimoto's encephalopathy associated with a bipolar affective disorder.Case report:  A 32‐year‐old woman presented with a bipolar affective disorder and Hashimoto's thyroiditis. Neurological investigations (magnetic resonance imaging of the brain and cerebrospinal fluid) did not reveal any pathological findings except for a pathological electroencephalogram (EEG). Despite consequent antidepressant treatment, the patient remitted only in conjunction with normalization of the EEG after short‐term treatment with high doses of prednisolone.Conclusion:  In treatment resistant courses of disorders, the thorough clinical and laboratory investigation of our patient revealed a very efficient treatment strategy. Cases of Hashimoto's encephalopathy associated with the occurrence of a manic episode and hence with bipolar disorder are rare; this is the first reported case. However, clinicians should be alert to this possibility.
Drug‐drug interactions as a determinant of elevated lithium serum levels in daily clinical practice
Authors: Wilting Ingeborg , Movig Kristian LL , Moolenaar Marieke , Hekster Yechiel A , Brouwers Jacobus RBJ , Heerdink Eibert R , Nolen Willem A , Egberts Antoine CG 
Published: May 2005

Objective:  Lithium is a drug with a narrow therapeutic window. Concomitantly used medication is a potentially influencing factor of lithium serum concentrations. We conducted a multicentre retrospective case‐control study with the aim of investigating lithium‐related drug interactions as determinants of elevated lithium serum levels in daily clinical practice.Methods:  Cases were patients with an increase of at least 50% in lithium serum concentrations resulting in an elevated lithium serum level of at least 1.3 mmol/L, and who were not suspected of a suicide attempt. Controls were patients who showed stable lithium serum levels within the therapeutic range. Use and start of non‐steroidal anti‐inflammatory drugs, diuretics, renin–angiotensin inhibitors, theophyllin and antibiotics were investigated as potential determinants of the elevated lithium serum levels. Irregularity in lithium dispensing pattern, change in lithium dosing regimen, age, gender, prescribing physician and laboratory parameters were investigated as potential confounders.Results:  We included 51 cases and 51 controls in our study. Five (9.8%) controls and 15 (29.4%) cases used potentially interacting co‐medication [OR of 3.83 (95%CI 1.28–11.48)]. Start of potentially interacting co‐medication was observed in eight (15.7%) cases and in zero (0%) controls resulting in an OR of 20.13 (95% CI 1.13–359). After adjustment for co‐medication, irregularity in lithium dispensing pattern, change in lithium dosing regimen, and age, the statistically significant association was lost. We report an OR of 2.70 (95% CI 0.78–9.31) for use of concomitant medication, with a large contribution of antibiotic agents, and an OR of 3.14 (95% CI 1.15–8.61) for irregularity in lithium dispensing pattern.Conclusion:  Use of co‐medication, especially antibiotics, tends to be associated with elevated lithium serum levels.
Seasonal water level fluctuations: Implications for reservoir limnology and management
Authors: Geraldes Ana Maria , Boavida Maria‐José 
Published: May 2005

AbstractWith the purpose of finding out whether seasonal water level fluctuations could affect water quality in a reservoir subjected to those changes, trends in environmental variables and in phytoplankton and zooplankton assemblages were analysed. The reservoir's hydrological cycle was characterized by three regimes. The maximum level phase lasted from January to the beginning of June, the emptying phase existed between mid‐June to the beginning of September and the minimum level phase lasted from mid‐September to the beginning of the first autumn/winter rain events. The highest values of total phosphorus, soluble reactive phosphorus, nitrate, water colour and chlorophyll a were found during the minimum level phase. The phytoplankton assemblage was dominated by taxa typical of meso‐eutrophic environments during the emptying and minimum level phases. However, during the maximum level phase, taxa generally found in more oligotrophic systems were observed here also. Similar to other disturbed systems, the zooplankton assemblage was dominated by Rotifera, except in summer and autumn when the cladoceran Ceriodaphnia quadrangula and/or the copepod Tropocyclops prasinus became dominant. Although those shifts seem to be related to water level variations, further research is needed to evaluate to what extent they might also be induced by other seasonal factors acting independently of water fluctuations. Based upon the obtained data, suggestions for reservoir management are proposed.
Neutrophilic involvement in the damage to coronary arteries in acute stage of Kawasaki disease
Authors: Takahashi Kei , Oharaseki Toshiaki , Naoe Shiro , Wakayama Megumi , Yokouchi Yuki 
Published: May 2005

Abstract
Background
: There has been no morphological evidence that polymorphonuclear leukocytes (PMNL) infiltrate the coronary arterial lesions of acute Kawasaki disease (KD) patients, although clinical data indicate the activation of PMNL.
Methods
: The experimental materials consisted of eight autopsy patients who died during the acute phase of KD. Duration of the illness ranged from 6 to 32 days. The tissues were fixed and embedded in paraffin. Hematoxylin and eosin, elastica van Gieson and azan–Mallory stainings were performed for routine histological examination. In addition, antibodies to CD3, CD20, CD68 and neutrophil elastase were used for immunohistochemistry to identify infiltrating cells in arterial lesions.
Results
: The inflammatory cells that appeared in the coronary arterial lesions were mainly composed of macrophages in all patients. In addition, numerous neutrophils were also identified in the coronary arterial lesions of the patients who died 10 days after the onset of KD. Neutrophilic infiltration reached a peak earlier than the peaks of CD68+ macrophages, CD3+ T lymphocytes and CD20+ B lymphocytes.
Conclusions
: These results suggest that neutrophils are involved in the damage occurring to coronary arteries in the early stage of KD. Vasodilation might occur as a result of injury to vascular walls caused by neutrophils, as well as macrophages.
Poor correlation between hemolysis and jaundice in glucose 6‐phosphate dehydrogenase‐deficient babies
Authors: Jalloh Salamatu , Van Rostenberghe Hans , Yusoff Narazah M , Ghazali Selamah , Nik Ismail Nik Zainal , Matsuo Masafumi , Wahab Nor Akmal , Nishio Hisahide 
Published: May 2005

Abstract
Background
: The role of hemolysis in the pathophysiology of neonatal jaundice (NNJ) in patients with glucose 6‐phosphate dehydrogenase (G6PD) deficiency has been questioned recently. The aim of the present study was to determine the contribution of hemolysis to the pathophysiology of jaundice in Malay neonates with G6PD deficiency and NNJ.
Methods
: Four groups of babies were included in the study: (i) G6PD deficient with NNJ; (ii) G6PD deficient without NNJ; (iii) G6PD normal with NNJ; and (iv) normal controls. Babies with other known causes of jaundice were excluded from the study. All subjects underwent the following investigations on day 3–5 after birth: hemoglobin level (Hb), serum bilirubin level, carboxyhemoglobin (CO‐Hb) concentration, reticulocyte count and full blood picture. The results of the investigations were compared between the groups using SPSS version 11.
Results
: Babies with G6PD and jaundice had a similar percentage of CO‐Hb to babies with G6PD without NNJ or babies with normal G6PD and NNJ (1.76 ± 0.40% vs 1.66 ± 0.31% and 1.67 ± 0.28%, respectively; P: 0.23 and 0.41, respectively). Total Hb levels and reticulocyte counts were not significantly different between the groups. The blood film showed more (even though not reaching significance) hemolysis in the G6PD patients but results of the blood film were very similar for G6PD patients with and those without NNJ.
Conclusion
: Hemolysis is not a main determinant of neonatal jaundice in G6PD‐deficient babies.
Airway lavage with exogenous surfactant in an animal model of meconium aspiration syndrome
Authors: Zhang Erquan , Hiroma Takehiko , Sahashi Takeshi , Taki Atsuko , Yoda Tatsuya , Nakamura Tomohiko 
Published: May 2005

Abstract
Background
: Meconium aspiration syndrome (MAS) is a major cause of respiratory morbidity and mortality in term infants, and occasionally causes serious respiratory disturbance. Viscous meconium debris in the trachea interferes with ventilation, and chest physiotherapy (CPT) is effective for removing secretions from the trachea. The effects of conventional exogenous diluted surfactant lavage combined with CPT were evaluated in a MAS animal model in a randomized controlled study.
Methods
: Twenty‐three MAS model adult Japanese rabbits were randomized into three groups and artificially ventilated for 3 h with the following treatments: group 1, suction only (n = 7); group 2, surfactant lavage (n = 7); group 3, surfactant lavage with CPT (n = 7). Surfactant lavage was performed by infusing 2 mL/kg of diluted Surfactant TA (Surfacten; 6 mg/mL) into the trachea over approximately5 s, then performing gentle manual bagging six times, and aspirating the tracheal contents using a suction catheter. This procedure was performed four times in four different positions (total, 8 mL/kg). In group 3, CPT (squeezing) was performed during expiration of manual bagging in surfactant lavage.
Results
: In group 3, PaO2 improved significantly (P < 0.05) at all time points compared with those in the other groups. Oxygenation index (OI) in group 3 improved significantly (P < 0.05) at all time points except after 0.5 h compared with that in group 1, and at 2, 2.5, and 3 h compared with that in group 2.
Conclusions
: A combination of exogenous surfactant lavage and CPT (squeezing) improves respiratory disturbance in MAS.
Infected cephalohematoma of newborns: Experience in a medical center in Taiwan
Authors: Chang Hung‐Yang , Chiu Nan‐Chang , Huang Fu‐Yuan , Kao Hsin‐An , Hsu Chyong‐Hsin , Hung Han‐Yang 
Published: May 2005

Abstract
Background
: The objective of the present retrospective study was to clarify the clinical course, major pathogens, and other infections associated with infected cephalohematoma.
Methods
: From January 1978 to December 2003, records of all newborns were reviewed for evidence of an infected cephalohematoma, based either on local signs of infection or a diagnostic tap that yielded pus. Patients were divided into two groups: those seen in the early period (1978–1990) and in the late period (1991–2003).
Results
: Twenty‐eight newborns with infected cephalohematoma were identified, 14 each in the early and late periods. The mean age at onset was 17.8 ± 13.9 days. The most common local findings were erythema (79%), increasing size of the hematoma (68%), and a fluctuant mass (46%), while fever (64%), poor appetite (39%) and irritability (18%) were the common systemic signs. Common laboratory findings included leukocytosis (82%) and an elevated C‐reactive protein (61%). Escherichia coli was the most common pathogen (16 patients, 57%) and was isolated significantly more frequently in the late period (early period: 36%, late period: 79%, P < 0.05). Staphylococcus aureus was the second common pathogen (five patients, 18%). Ten patients (36%) had other associated infection: eight had sepsis, three had meningitis, and one had osteomyelitis. In the early period three patients (11%) died.
Conclusions
: Clinicians should be aware that cephalohematoma is a potential site of infection. The incidence of associated system infection is high and may result in mortality. Appropriate diagnostic and therapeutic measures should be undertaken promptly if there are infectious signs.
COMPLICATIONS OF INTESTINAL MILKING: EXPERIMENTAL MODEL
Authors: Aysan Erhan , Demir Mete , Kinaci Erdem , Basak Fatih 
Published: May 2005

Background:  Intestinal milking is a frequently used method in abdominal surgery for various purposes; although it is frequently used for eliminating distension, moving faeces, bezoar or other foreign objects proximal or distal, there are no experimental or prospective studies in the surgical literature with respect to complications of the method. The purpose of the present study was to investigate complications of the milking process in an experimental model.Methods:  Forty‐four outbred, 8‐month old Wistar albino male rats with weights ranging between 195 and 225 g were used. Four rats were used for preliminary study. The other 40 rats were divided into two equal groups. In the study group (n = 20), a plastic sphere, 3 mm in diameter was sent to the stomach via oro‐gastric tubes. This sphere was then moved into the cecum by milking. In the control group rats (n = 20) the small intestines were manipulated at 1‐cm intervals but milking was not performed.Results:  In the study group six rats (30%) developed grade 1, 11 rats (55%) developed grade 2, and three rats (15%) developed grade 3 peritoneal adhesion. In the control group, 18 rats (90%) had no adhesions and only two rats (10%) developed grade 1 adhesion (χ2 = 34, P < 0.0001). In the study group, four rats (20%) had small bowel obstruction, whereas no rats in the control group developed small bowel obstruction (Fisher's P > 0.05). Peritoneal smear culture was positive in 11 rats (55%) in the study group, whereas it was positive in two rats (10%) in the control group (Fisher's P < 0.01).Conclusions:  Intestinal milking is a process that can cause severe peritoneal adhesions and peritoneal contamination, which may lead to small bowel obstruction. Avoiding milking to the extent possible in eliminating distension intraluminal material that may cause obstruction, and preferring alternative methods is important for reducing postoperative morbidity.
MANAGEMENT OF SUPERFICIAL BLADDER CANCER IN VICTORIA: 1990 AND 1995
Authors: Frydenberg Mark , Millar Jeremy L. , Toner Guy , Bolton Damien , Syme Rodney , Thursfield Vicky J. , Giles Graham G. ,   and Urology Study Committee of the Victorian Co‐operative Oncology Group, Cancer Council of Victoria
Published: May 2005

Background:  A retrospective survey of medical practitioners was undertaken to describe the tumour characteristics, management and outcomes of all superficial bladder cancers newly diagnosed in 1990 and in 1995 in Victoria.Methods:  Cases were identified from the population cancer registry. The survey was conducted in 1999 and the cohort followed up until 2000 to obtain at least 5 years of follow‐up data on all patients, in particular to identify recurrence of tumour as assessed at surveillance cystoscopy and progression to muscle invasive cancer.Results:  Tumour recurrence was observed in 390/610 patients (63.9%), of whom 56.9% had their recurrence noted at the first check cystoscopy. Ultimately 43 (6.3%) of patients progressed to invasive disease, with this subgroup demonstrating 5‐year overall survival of 35% (95% confidence interval (CI) 21–49%). Ultimately survival was proportional to the extent of tumour invasion, being greater in low‐risk patients (76%, 95% CI 72–80%, mucosal disease only) than in high‐risk patients (46%, 95% CI 36–56%, lamina propria invasion noted at diagnosis).Conclusions:  In low‐risk subgroups of patients with superficial transitional cell carcinoma, the frequency of surveillance cystoscopy may be able to be reduced to levels in accordance with established European guidelines without a likely impact on patient survival. Where progression to muscle invasive disease does ensue, more aggressive management may be warranted in order to try to improve survival.
BIOGLUE: A REVIEW OF THE USE OF THIS NEW SURGICAL ADHESIVE IN THORACIC SURGERY
Authors: Passage Jurgen , Tam Robert , Windsor Morgan , O'Brien Mark 
Published: May 2005

Background:  Alveolar air leaks and broncho‐pleural fistulae after thoracic surgical procedures contribute significantly to hospital morbidity and mortality. BioGlue has offered the thoracic surgeon an alternative to the products presently used to reduce the incidence of these complications. This retrospective study reviews our experience with this new adhesive.Methods:  Forty patients upon whom BioGlue was used were identified through operation records. Pre‐, intra‐ and postoperative data were collected to establish use, indications and outcome.Results:  The predominant underlying pathology was malignancy. In 32 patients BioGlue was used during the primary procedure while in the remaining eight, persistent air‐ or lymph‐leak led to a further procedure requiring the use of glue. The indications for BioGlue use were alveolar air leak (36), broncho‐pleural fistula (2) and lymph leak (2). There was one death. In 35 out of 36 patients with alveolar air leak, BioGlue controlled the leak at the site of application.Conclusions:  Our results in this particular patient group indicate that BioGlue is a reliable adjunct in the reduction of alveolar air leaks. Although further studies are necessary to establish the role of BioGlue in thoracic surgery in comparison to other sealants, these initial results are promising.