bluuebunny/crossref_metadata_2025_split huggingface dataset:
A codon 31ser–arg polymorphism of the WAF‐1/CIP‐1/p21/tumour suppressor gene in Chinese primary open‐angle glaucoma
Authors: Tsai Fuu‐Jen , Lin Hui‐Ju , Chen Wen‐Chi , Tsai Chang‐Hai , Tsai Shih‐Wei 
Published: December 2004

Abstract.Purpose:  Glaucomatous neuropathy is a type of cell death by apoptosis. Apoptosis is a genetically controlled form of cell death, and one of its primary regulatory steps is the activation of the tumour suppressor protein p53, of which p21 is an effector protein. The association between p21 codon 31 polymorphism and primary open‐angle glaucoma (POAG) patients was evaluated in this study.Methods:  The study included 58 POAG patients and a control group of 59 healthy volunteers. Polymerase chain reaction‐based analysis was used to resolve the p21 codon 31 polymorphism.Results:  The genotype frequencies of p21 codon 31 polymorphism were statistically different (p < 0.05) between the two groups. The Arg allele of the p21 codon 31 polymorphism was more frequently found in POAG patients than in healthy individuals (odds ratio: 2.389, 95% confidence interval: 1.14–5.01).Conclusion:  This study suggests that an association exists between the Arg allele of the p21 codon 31 polymorphism and POAG in the Chinese population.
Venous thromboembolism prophylaxis for surgical patients in an Asian hospital
Authors: Tan Li Hoon , Tan Shwu Chuin 
Published: December 2004

Background:  Venous thromboembolism (VTE) is increasingly recognized as a significant postoperative complication in Asian hospitals. Recommendations have been published for VTE prophylaxis. We conducted a prospective survey of the risk profile and measures used for VTE prophylaxis in elective surgical patients in our hospital.Methods:  All patients who underwent elective general or orthopaedic surgery over a 4‐week period were included. Information collected included demographic data, presence of risk factors, type and duration of surgery, perioperative use of VTE prophylaxis and any diagnosis of deep vein thrombosis or pulmonary embolism during the current admission as well as in any readmissions in the 6 weeks after discharge. The patients were classified based on their age, risk factors and type of surgery into low, moderate, high or highest risk and the prophylactic measures they received compared with published recommendations.Results:  Two hundred and twenty‐six patients underwent 227 elective surgeries over the 4‐week period. There were 7 low, 16 moderate, 45 high and 55 highest risk patients. One hundred and three patients could not be classified. Postoperative prophylactic measures were omitted in 93.8%, 81.8% and 31.5% of patients in moderate, high and highest risk groups, respectively. One patient developed clinical deep vein thrombosis preoperatively and one postoperatively. There were no cases of pulmonary embolism.Conclusions:  VTE prophylaxis is underutilized in our survey. Further studies are required to identify the reasons for omission and to develop hospital specific protocols to increase appropriate use of prophylaxis.
Horner's syndrome in association with thyroid and parathyroid disease
Authors: Harding Jane L. , Sywak Mark S. , Sidhu Stan , Delbridge Leigh W. 
Published: December 2004

Background:  Injury to the cervical sympathetic chain and its consequence, Horner's syndrome, as a result of thyroid pathology or surgical intervention is an uncommon complication. The purpose of the present study was to examine the experience of one endocrine surgical unit with pre and postoperative Horner's syndrome.Methods:  This is a retrospective case series. The study group comprised all patients undergoing thyroid and parathyroid surgery at Royal North Shore Hospital from January 2000 to October 2003 who were identified as having either pre or postoperative Horner's syndrome. Patient demographics, operation performed, underlying pathology and outcomes were evaluated.Results:  There were nine cases of Horner's syndrome recorded from a total of 2208 thyroid and parathyroid operations undertaken: three with preoperative Horner’s, an incidence of 0.14%, six with postoperative Horner’s, an incidence of 0.27%. Patients ranged in age from 22 to 87 years. Two of the three preoperative cases were related to benign pathology, the remaining case having anaplastic carcinoma. Five of the six postoperative cases were related to thyroid malignancy with lymph node dissection; one case was associated with benign parathyroid pathology.Conclusions:  Cervical sympathetic chain injury is a rare complication of surgery for thyroid and parathyroid conditions. The presence of preoperative Horner's does not necessarily indicate an underlying malignancy.
Antireflux anastomosis following oesophagectomy
Authors: Aly A. , Jamieson G. G. , Pyragius M. , Devitt P. G. 
Published: December 2004

Background:  Reflux of duodeno‐gastric fluid is a significant problem after oesophagectomy with gastric conduit reconstruction. It can impact considerably upon the patient's quality of life and can induce oesophagitis and Barrett's metaplasia in the remnant oesophagus.Aim:  The aim of the present study was to describe the use of a modified fundoplication in controlling reflux after oesophagectomy.Methods:  Patients undergoing subtotal oesophagectomy at the Royal Adelaide Hospital were identified. Clinical and operative details were obtained from hospital records. All patients had an end oesophagus to side stomach anastomosis. Two cohorts were identified – one with a standard anastomosis only and the other in whom a modified fundoplication had been added. A structured phone interview was used to assess reflux in the two groups with a minimum of 6 months follow up. The interviewer was blinded to the operative details.Results:  The operative technique is described. A total of 44 patients were assessed, 33 having the fundoplication type anastomosis and 11 the standard anastomosis. Operative morbidity was not different between the groups. Symptoms of reflux were better controlled in patients with the fundoplication anastomosis than in patients with a standard anastomosis. Of those with a fundoplication, 14 of 33 patients (42%) were asymptomatic with respect to reflux compared to only one of 11 patients (9%) in the standard anastomosis group. Only four of the 33 patients (12%) with a fundoplication anastomosis had symptoms of severe reflux while seven of the 11 patients (63%) with a standard anastomosis had severe reflux symptoms.Conclusions:  This initial evaluation of a modified fundoplication as an antireflux manoeuvre after oesophagectomy suggests that the technique is effective in controlling post‐oesophagectomy reflux in the majority of patients. It is simple to perform and may have benefits in improving quality of life and preventing oesophagitis and metaplastic changes in the remnant oesophagus. A more detailed prospective study of the technique is warranted.
Dorsal lumbotomy incision in paediatric pyeloplasty
Authors: Bajpai Minu , Kumar Arbinder , Tripathi Madhavi , Bal Chandrashekhar S. 
Published: December 2004

Background:  The purpose of the present study was to comprehensively assess the results of surgical management of pelvi‐ureteric junction (PUJ) obstruction using lumbotomy as the surgical approach.Methods:  Records of 36 consecutive patients with unilateral PUJ obstruction who underwent pyeloplasty in the last 5 years were reviewed retrospectively. The investigations included renal function tests, ultrasound and serial renal diuretic scans. A micturating cystourethrogram was also done whenever indicated. A dismembered pyeloplasty via lumbotomy was the only surgical approach considered. Thirteen patients had a right pyeloplasty while 23 had a left pyeloplasty. Mean age at diagnosis was 57 months in 31 patients while five were antenatally diagnosed (range 1 month−12 years). Age at surgery ranged from 1 month to 12 years with a mean of 59.9 months. Nine children underwent surgery in infancy. Six patients had a preoperative percutaneous nephrostomy (PCN) placement, five for poorly functioning kidneys (less than 10% split renal function) and one for oliguria. Records were reviewed for age at diagnosis, age at surgery, duration of surgery, preoperative and postoperative split renal function.Results:  The follow‐up period in the present study ranged from 9 months to 68 months with a mean of 44.9 months. Mean duration of surgery was 78 min of the group as a whole but in PCN patients it was significantly more (100 min vs 71.3 min). Fourteen patients had an improvement in split renal function noticed at 3 and 6 months postoperatively, 17 patients had no change while one patient had a deterioration of split renal function. Four patients had a solitary functioning kidney and in all of these glomerular filtration rate improved postoperatively. Hospital stay was on the average 7.45 days with a range of 6−10 days. However, when a double‐J (D‐J) stent was used across the anastomosis and the uretero‐vesical junction (transrenal D‐J stenting), the mean stay was reduced to 3 days. All patients returned to full oral feeds by postoperative day 1. No incidences of wound related problems were encountered.Conclusions:  Pyeloplasty results in predictably good outcome in paediatric PUJ obstruction whenever indicated. The lumbotomy approach avoids muscle cutting, thereby minimizing complications related to wound and assisting with faster recovery. Keeping a double‐J (D‐J) stent across the anastomosis and the uretero‐vesical junction (transrenal D‐J stenting) reduces hospital stay.
Novel in‐line multielectrode radiofrequency ablation considerably reduces blood loss during liver resection in an animal model
Authors: Gananadha Sivakumar , Morris David L. 
Published: December 2004

Introduction:  Liver resection is widely used in the treatment of primary and secondary liver tumours. One of several important factors associated with mortality both in cirrhotic and non‐cirrhotic patients after liver resection is operative blood loss. We evaluated the use of a prototype radiofrequency ablation probe to treat the transection plane prior to liver resection in the sheep model.Methods:  In‐line radiofrequency ablation (RFA) was performed on the liver using a prototype device consisting of 11 electrodes mounted on a 8‐cm base. The RITA 1500 generator was used for power delivery. Ultrasonic aspirator (UA) and clamp resection were performed on the liver of sheep with and without in‐line RFA. The blood loss was measured by weighing swabs.Results:  A total of 26 liver resections were performed. The mean (SD) blood loss with UA resection was 0.032 g (0.011) versus 0.005 (0.005) g without and with prior in‐line RFA, respectively (P = 0.001). The mean (SD) blood loss with clamp resection was 0.087 (0.10) g versus 0.01 (0.008) without and with in‐line RFA, respectively (P = 0.155).Conclusion:  In‐line RFA makes liver resection easier with minimal blood loss and may make cirrhotic liver resection easier with minimal blood loss. This is likely to improve the operative safety of liver resection.
Surgical management of thoracic outlet syndrome: a 10‐year experience
Authors: Samarasam Inian , Sadhu David , Agarwal Sunil , Nayak Sukria 
Published: December 2004

Background:  Thoracic Outlet Syndrome (TOS) refers to compression of the neurovascular structures in the region between the scalene muscles and the first rib, or by anatomical abnormalities such as cervical rib, fibrous bands and other variations in the scalene musculature.Methods:  Our experience with 63 consecutive operations for TOS, over a period of 10 years, has been reviewed. Preoperative symptoms and signs, investigations, surgery done, complications and the outcome of surgery are analysed.Results:  A total of 60 patients underwent 63 operations for decompression of TOS. All the 63 first ribs, were excised by the transaxillary approach. In seven patients (16%), a combined transaxillary and supraclavicular approach was used. There was no operative mortality in this series. The operative complications included pneumothorax in four patients (6.3%), which was treated by insertion of chest drain, and lower brachial plexus neuropraxia in two patients (3%), which improved with conservative management. The mean duration of postoperative hospital stay was 3.6 days. At 12 months following surgery, 56 patients (93%) had complete or partial relief of symptoms and only four patients (6.6%) had no relief of symptoms.Conclusion:  The results of the present study confirm that transaxillary excision of the first rib is a surgical procedure associated with very low morbidity and excellent relief of symptoms. It can therefore be offered as an early option for patients with thoracic outlet syndrome. It may be combined with the supraclavicular approach if exposure of the subclavian artery is required for vascular reconstruction.
Patient preference for bra or binder after breast surgery
Authors: Laura Sharon , Clark David , Harvey Fiona 
Published: December 2004

Background:  No data are currently available to assess the relative merits of breast binder or bra following breast surgery.Methods:  A randomized controlled study was undertaken to compare a breast binder with a bra postoperatively for patients undergoing lumpectomies, partial mastectomies and total mastectomies.Results:  Fifty‐eight patients were included in the study. Six different parameters were compared and the bra was found better on all criteria; a small group of patients who initially used a binder and then, for a second procedure, used a bra, found the bra more comfortable.Conclusion:  Postoperative discomfort can be decreased by using a well‐fitting bra rather than a breast binder.
New method of abdominoplasty for morbidly obese patients
Authors: Ollapallil Jacob , Koong David , Panchacharavel Gowrinanthanan , Butcher Charles , Yapo Benjamin 
Published: December 2004

Introduction:  We report two cases of morbidly obese patients with huge infected abdominal aprons who underwent apronectomies at Alice Springs Hospital, Northern Territory, Australia. We describe a novel technique which to date has not been described in the available literature. Patients afflicted by morbid obesity with large aprons can be incapacitated by immobility as well as suffer from recurrent infections. Apronectomy in this situation can be difficult because of the heavy weight of the apron.Method:  This technique involves the use of a small crane and large orthopaedic K‐nails. Two K‐nails were inserted into the apron and attached to a small crane. This facilitated the elevation and manipulation of the apron during surgical dissection. The abdominal tissue removed from the female and male weighed 30 kg and 64 kg, respectively. The wounds were closed primarily and drained by three large bore suction drains.Results:  The female patient had a largely uneventful postoperative course with a minor wound infection that resolved with conservative treatment. The other patient required a more protracted course of antibiotics for his more severe infection. Mobility was markedly improved in both individuals.Conclusion:  This novel technique can be used successfully for severely morbidly obese individuals and can significantly reduce the surgeon's and assistants’ difficulty in manipulating and handling a heavy apron during dissection.
Establishment of Banking System for Allogeneic Cultured Dermal Substitute
Authors: Kuroyanagi Yoshimitsu , Kubo Kentaro , Matsui Hiromich , Kim Hyun Jung , Numari Shinichiro , Mabuchi Yho , Kagawa Shizuko 
Published: December 2004

Abstract:   Allogeneic cultured dermal substitute (CDS) was prepared by culturing fibroblasts on a two‐layered spongy matrix of hyaluronic acid (HA) and atelo‐collagen (Col). Allogeneic CDS can be cryopreserved and transported to other hospitals in a frozen state. Vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), hepatocyte growth factor (HGF), platelet derived growth factor (PDGF)‐AA, transforming growth factor (TGF)‐β1, keratinocytes growth factor (KGF), interleukin (IL)‐6 and IL‐8 were contained in the culture medium which was used in preparing CDS over a cultivation period of one week (fresh CDS culture medium sample). After thawing a cryopreserved CDS, the CDS was recultured in a culture medium for one week. VEGF, bFGF, HGF, TGF‐β1 and IL‐8 were contained in the culture medium which was used in reculturing CDS for one week (cryopreserved CDS culture medium sample), although some cytokines were detected at a lower level than those before freezing. This finding suggests that the cryopreserved CDS retains its ability to release these cytokines.Clinical research on allogeneic CDS, which was newly developed at the R & D Center for Artificial Skin of Kitasato University, has been carried out in medical centers across Japan with the support of the Millennium Project of the Ministry of Health, Labor and Welfare. It was demonstrated that the allogeneic CDS functions as an excellent cell therapy for intractable skin ulcers as well as burn injuries. The spongy matrix itself, as well as the cytokines released from the allogeneic CDS, seemed to be beneficial for the treatment of intractable skin defect.
The safety and efficacy of unoprostone 0.15% versus brimonidine 0.2%
Authors: Stewart William C. , Stewart Jeanette A. , Day Douglas G. , Jenkins Jessica 
Published: December 2004

Abstract.Purpose:  To compare the efficacy and safety of unoprostone versus brimonidine both given twice daily in ocular hypertensive or primary open‐angle glaucoma subjects.Methods:  After a 1‐month washout period a baseline diurnal curve was measured every 2 hours from 08 : 00 hours (trough) to 20 : 00 hours in subjects with a trough intraocular pressure (IOP) and the pressure 24 mmHg. Qualified subjects were randomized to either brimonidine or unoprostone. After 6 weeks of treatment the period 1 diurnal curve was performed. Subjects were then switched to the opposite treatment for 6 weeks and the period 2 diurnal curve was performed.Results:  A total of 33 subjects were included in this study. In the brimonidine‐treated group the trough IOP 20.1 ± 2.8 mmHg was reduced from baseline up to 8 hours after dosing. In the unoprostone‐treated group the trough IOP was 19.5 ± 3.0 mmHg, which was statistically equal to that of brimonidine (p = 0.21), was reduced from baseline for 12 hours after dosing. Brimonidine decreased the IOP statistically more than unoprostone at 10 : 00 and 12 : 00 hours (p < 0.0001 and p = 0.02, respectively), while unoprostone reduced the IOP more than brimonidine at 18 : 00 and 20 : 00 hours (p = 0.002 and p = 0.05, respectively). Safety levels were similar between groups, but unoprostone caused more ocular stinging than brimonidine (p = 0.008).Conclusion:  This study suggests that twice daily brimonidine demonstrates a statistically greater peak reduction in IOP than unoprostone. However, unoprostone, but not brimonidine, decreased IOP over the complete 12‐hour daytime dosing cycle.
Phototherapeutic keratectomy in Salzmann's nodular degeneration
Authors: Germundsson Johan , Fagerholm Per 
Published: December 2004

Abstract.Purpose:  To describe the outcome in vision and refraction of phototherapeutic keratectomy (PTK) in Salzmann's nodular degeneration (SND).Methods:  Five eyes of four patients underwent PTK with the objective of restoring an acceptable refractive status and improving visual acuity. This surgical technique aims to make the nodules level with the corneal surface using an excimer laser.Results:  Best corrected visual acuity (BCVA) improved in all five eyes. Astigmatism was reduced in four eyes and increased somewhat in one. During the observation period one eye suffered a late recurrence that required a penetrating graft.Conclusion:  Salzmann's nodular degeneration is a rare disease that is sometimes difficult to diagnose as it has some resemblance to other diseases. The aetiology of the disease is unknown. Phototherapeutic keratectomy is a safe and effective mode of treatment. Recurrences occur with time.
Ocular anisometropia and laterality
Authors: Goldschmidt Ernst , Lyhne Niels , Lam Carly S. Y. 
Published: December 2004

Abstract.Purpose:  To study the difference in refraction between right and left eyes (anisometropia) in different age groups, look for evidence of eye laterality (more refractive error in one eye) and compare the size of anisometropia in the myopic and emmetropic ranges.Methods:  The study was based on children in Hong Kong (examined at the age of 6 years and again at the age of 8.5 years) and their parents (aged 26–60 years).Results:  In all age groups the difference between right and left eyes in sphere and cylinder was modest, in most cases ≤ 0.25 D. In both children and their parents a tendency towards spherical right eye laterality was found in the myopic individuals (p < 0.05). This was not the case with the cylinder. In the 8.5‐year‐old children and in their parents, the numerical size of spherical anisometropia increased with myopia (p < 0.05 and p < 0.01, respectively). Cylindrical anisometropia did not exhibit such an increase.Conclusion:  In Hong Kong children and their parents we found a tendency towards more spherical myopia in right eyes (laterality) in myopic cases. The numerical size of spherical anisometropia also increased in myopia in these groups. Cylindrical anisometropia appeared to be independent of spherical ametropia. In most cases right/left differences in both sphere and cylinder were small and our findings justify the use of data from one eye only in publications on refraction.
Fungal endophthalmitis caused by Paecilomyces variotii following cataract surgery: a presumed operating room air‐conditioning system contamination
Authors: Tarkkanen Ahti , Raivio Virpi , Anttila Veli‐Jukka , Tommila Petri , Ralli Reijo , Merenmies Lauri , Immonen Ilkka 
Published: December 2004

Abstract.Purpose:  To report a case of delayed fungal endophthalmitis by Paecilomyces variotii following uncomplicated cataract surgery. To our knowledge this is the first reported case of postoperative endophthalmitis by this species.Methods:  We report the longterm clinical follow‐up of an 83‐year‐old female who underwent uncomplicated sutureless, small‐incision cataract surgery. She developed recurring uveitis 4 months after surgery. Vitreous tap and finally complete vitrectomy with removal of the capsular bag including the intraocular lens were performed. Fungi were studied by histopathology and culture.Results:  At histopathological examination, the fungi were found to be closely related with the capsular bag. A few mononuclear inflammatory cells were encountered. At culture, Paecilomyces variotii, a common ubiquitous non‐pathogenic saprophyte, was identified. Despite systemic, intravitreal and topical antifungal therapy after vitrectomy the uveitis recurred several times, but no fungal organisms were isolated from the repeat intraocular specimen. At 18 months postoperatively the subject's visual acuity was finger counting at 2 metres. At the time of surgery the operating room air‐conditioning system was undergoing repairs. Cases of fungal endophthalmitis after contamination from air‐conditioning ventilation systems have been reported before, but none of the cases reported have been caused by P. variotii.Conclusion:  P. variotii, a non‐pathogenic environmental saprophyte, may be disastrous if introduced into the eye. International recommendations on the environmental control of the operating room air‐conditioning ventilation system should be strictly followed. No intraoperative surgery should be undertaken while the air‐conditioning system is undergoing repairs or service.