bluuebunny/crossref_metadata_2025_split huggingface dataset:
Morning glory syndrome associated with posterior pituitary ectopia and hypopituitarism
Authors: Pierre‐Filho Paulo de Tarso P. , Limeira‐Soares Paulo H. , Marcondes Ana Maria 
Published: December 2004

Abstract.Purpose:  To report a patient with morning glory syndrome in combination with posterior pituitary ectopia and to emphasize the need for early recognition of this syndrome as an important step towards the diagnosis and treatment of the systemic anomalies that may be associated with it.Methods:  We present a 7‐year‐old boy who showed short stature, nystagmus, inward deviation and low vision. Ophthalmological and general physical examinations, further endocrine evaluation and magnetic resonance imaging (MRI) of the brain and sella turcica were performed.Results:  Both fundi showed symptoms of morning glory syndrome. The discs were pink and deeply excavated, and were surrounded by a ring of chorioretinal pigmentary disturbance. Magnetic resonance imaging revealed the absence of the infundibulum and posterior pituitary ectopia. Growth hormone studies confirmed the diagnosis of growth hormone deficiency. Therapy with recombinant human growth hormone was initiated.Conclusions:  Although most cases of morning glory syndrome occur as isolated ocular abnormalities, it may occur in association with systemic anomalies, including posterior pituitary ectopia and hypopituitarism. A complete general physical examination and growth evaluation is important for early detection and treatment, resulting in benefit for these patients.
Prevalence of pseudoexfoliation syndrome in Ethiopian patients scheduled for cataract surgery
Authors: Teshome Tiliksew , Regassa Kefyalew 
Published: December 2004

Abstract.Purpose: To evaluate the prevalence of pseudoexfoliation syndrome (PEX) among Ethiopian patients with age‐related cataract scheduled for surgery.Patients and methods: In a prospective study, 229 consecutive eyes with age‐related cataract scheduled for surgery were evaluated for the prevalence of PEX, type of cataract, intraocular pressure (IOP) and glaucoma.Results: The mean age of the 229 patients was 62.1 ± 10.5 years (range 47–91 years). The prevalence of PEX was 39.3% (90 of 229 eyes). Pseudoexfoliation syndrome was bilateral in 62.2% (56/90) of cases. The mean age of those with PEX (63.7 ± 10.7 years) was significantly more than that of those without PEX (60.3 ± 9.2 years) (p = 0.01). The prevalence of PEX significantly increased with age (p = 0.02). Patients with hypermature cataract had significantly more PEX (p < 0.001). Mean IOP was significantly higher in eyes with PEX (18.4 ± 3.2 mmHg) than in those without PEX (15.8 ± 3.6 mmHg) (p < 0.001). Significantly more eyes in the PEX group had IOP > 21 mmHg (p < 0.01) and established glaucoma (p < 0.05). An incidence of PEX was found in all major ethnic groups in Ethiopia. There was no significant difference in the prevalence of PEX between the different ethnic groups (p > 0.5).Conclusions: The prevalence of PEX among Ethiopian patients with cataract is high and occurs at a relatively younger age when compared to previous reports from Europe. Pseudoexfoliation syndrome has been found to be significantly associated with hypermature cataract, higher mean IOP, IOP > 21 mmHg and glaucoma. Population‐based studies are recommended to evaluate the prevalence of PEX in the general population and its association with cataract and glaucoma.
Colour blindness in everyday life and car driving
Authors: Tagarelli Antonio , Piro Anna , Tagarelli Giuseppe , Lantieri Pasquale Bruno , Risso Domenico , Olivieri Rosario Luciano 
Published: December 2004

Abstract.Purpose:  The aim of the present work was to ascertain, through the administration of a psychosocial questionnaire, the difficulties that subjects with defective colour vision experience in carrying out everyday tasks and work, including driving a car with a driver's licence held for no more than 3 years. Methods:  Subjects with defective colour vision (n = 151) and subjects with normal vision (n = 302) completed a psychosocial questionnaire regarding the difficulties associated with congenital colour vision deficiency in daily life, work and driving a car. Subjects were diagnosed as colour‐blind using the Ishihara test. Results:  Statistically significant differences between the two samples were found for daily life activities. Subjects with defective colour vision preferred daytime driving. At night, subjects with defective colour vision had difficulty identifying reflectors on the road and the rear signal lights of cars ahead of them. Conclusion:  Colour‐blind Calabrian subjects admitted to experiencing colour‐related difficulties with a wide range of occupational tasks and leisure pursuits. In particular, colour‐blind Calabrian subjects preferred daytime driving, and fewer drove regularly, compared to orthochromatics, who were indifferent to night or daytime driving.
Comparison of survival of exfoliative glaucoma patients and primary open‐angle glaucoma patients: impact of acetazolamide use
Authors: Ritland J. S. , Egge K. , Lydersen S. , Juul R. , Semb S. O. 
Published: December 2004

Abstract.Purpose: To compare the survival rates of patients with exfoliative glaucoma (XFG) and those with primary open‐angle glaucoma (POAG), and to establish whether the use of acetazolamide has any influence on survival.Methods: The survival data, including date and cause of death, for 1147 patients with XFG or POAG who were ultimately hospitalized at the Eye Department, National Hospital, Oslo, between 1961 and 1970, were analysed retrospectively. The Cox proportional hazard model was used in the survival analyses.Results: No statistically significant differences in survival were found between patients with XFG and those with POAG (p = 0.85). As expected, female gender and younger age at diagnosis were associated with longer survival periods. Surprisingly, we found that patients with more recent birth dates had relatively lower survival rates than patients with earlier birth dates; when this was included in the analyses, the use of acetazolamide was found to be associated with reduced survival (n = 492, p = 0.02).
16S rDNA PCR analysis of infectious keratitis: a case series
Authors: Rudolph Thiemo , Welinder‐Olsson Christina , Lind‐Brandberg Lena , Stenevi Ulf 
Published: December 2004

Abstract.Purpose:  To discuss the value of polymerase chain reaction (PCR) in the management of bacterial infectious keratitis. Methods:  Corneal scrapings of four patients with severe infectious keratitis were analysed by culture and PCR of 16S ribosomal DNA (rDNA), followed by direct sequencing of the resulting amplicon. The medical history of the patients included laser‐assisted in‐situ keratomileusis (LASIK), penetrating keratoplasty (PKP) and trauma. Results:  Using PCR we were able to identify a possible pathogen in all four cases, while bacterial cultures were either negative or did not correspond to the clinical picture. The identified bacteria were a Pseudomonas species, Abiotrophia defectiva, Stenotrophomonas maltophilia and Porphyromonas gingivalis. Conclusions:  Analysis of corneal scrapings by 16S rDNA PCR should be considered as a supplement to standard microbiological procedures. However, the results of this relatively new method have to be interpreted carefully.
An occupational focus on falls with serious injury among older women in Australia
Authors: Mackenzie Lynette , Byles Julie , Mishra Gita 
Published: December 2004

Falls prevention and recovery programs have been developed on a predominantly medical model of understanding falls risk. In this cross‐sectional study, data from 12 900 community‐dwelling women participating in the Australian Longitudinal Study on Women's Health were analysed using multiple stepwise regression to identify if factors related to occupational functioning were independently associated with participants who self‐reported serious falls (n = 655) in the previous year. Four variables were significantly associated with reports of serious falls: poor physical health summary scores (SF‐36); higher scores on a life events scale; higher scores on a ‘feeling dejected’ subscale; and taking medications for ‘nerves’. These variables are directly connected with occupational functioning, and were significantly associated with serious falls despite medical falls risk factors being included in the regression model. Results indicate a need to address the occupational background of participants in the design and delivery of both falls injury prevention and falls recovery programs, especially for community‐dwelling women.
Cloning and characterization of the tomato karyopherin α1 gene promoter
Authors: Mizrachy Liat , Dabush David , Levy Yael , Aloni Roni , Altman Arie , Gafni Yedidya 
Published: December 2004

The karyopherin α1 (LeKAPα 1) gene of tomato (Lycopersicon esculentum) encodes a receptor involved in nuclear import. To analyze the expression pattern of this gene, a genomic clone containing its upstream region was isolated and sequenced. To study the promoter functionality, a 2170 bp fragment (LM1), was fused to glucuronidase (GUS) and introduced into petunia cells by particle bombardment. For further characterization of the promoter, one inverse and three deletion constructs were studied in cell suspension. To follow its expression in tobacco leaves, transgenic plants expressing GUS under the control of the LM1 promoter were made. Expression of LM1–GUS was largely restricted to actively growing leaf regions, suggesting possible involvement of active cell division and plant growth regulators in LeKAPα 1 expression.
Arterial flow induces changes in venous endothelium which are modified by calcium channel blockers
Authors: Golledge Jonathan 
Published: December 2004

Introduction:  Adaptation of saphenous vein to arterial flow may be critical to the results of bypass. The present paper summarizes work recently presented as a Hunterian Lecture. Work includes in vitro investigation of the response of saphenous vein endothelium to arterial flow and assessment of its clinical importance using a cohort of patients undergoing vein bypass surgery.Methods:  Freshly excised human saphenous vein segments were placed in an in vitro flow circuit to simulate arterial and venous flow conditions. Changes in the endothelial expression of proteins were assessed using a combination of immunohistochemistry and Western blotting. The role of ion channels in the changes seen induced by arterial flow in the saphenous vein endothelium was assessed by addition of ion channel blocking medication to the medium perfusing vein segments. A cohort of patients undergoing vein bypass surgery were followed to assess graft patency and the influence of prescribed medication on its outcome.Results:  After arterial flow conditions, the staining area for the endothelial adhesin ICAM‐1 and nitric oxide synthase were increased, while that of the anticoagulant protein thrombomodulin was decreased. The concentration of the important stimulant of the clotting cascade tissue factor was unaffected by arterial flow. These changes were modulated by the addition of ion channel blocking drugs to the vein perfusate. In particular, nifedipine abolished the reduction in thrombomodulin, but increased the amount of tissue factor. In a series of 236 patients undergoing primary infra‐inguinal vein grafts, prescription of calcium channel blocker was associated with improved primary patency.Conclusions:  Important changes in the venous endothelium are induced by arterial flow. Ion channel blocking drugs have the potential to modulate these responses.
Colorectal cancer patterns of care in the Western Sydney and Wentworth Area Health Services
Authors: Barton Michael B. , Gabriel Gabriel Sam , Miles Sharon 
Published: December 2004

Introduction:  Colorectal cancer is a leading cause of morbidity and mortality in Australia. Recent clinical trials show that the recurrence of colorectal cancer decreases with chemotherapy and/or radiotherapy in advanced disease. The present study aimed to document the patterns of care by the type of treatment, document the preoperative investigations and provide results to the Area Health Services.Methods:  A prospective data collection was initiated in May 1994 and ended in May 1996 in the Western Sydney and Wentworth Area Health Services of New South Wales. Deaths and recurrences were followed up until July 2002.Results:  There were 253 colon cancers, 107 rectal cancers and 10 patients with tumours in both the colon and rectum. Forty‐one surgeons performed 299 curative procedures with 78% of them performing one to four procedures annually. One hundred and twenty‐two patients had non‐fatal complications and six (2%) died postoperatively. Twenty‐eight per cent of rectal cancer patients underwent abdomino‐perineal resection and 56% underwent low anterior resection. Forty‐five per cent of rectal cancer patients and 51% of colon cancer patients who were potentially eligible received appropriate adjuvant therapy. Ninety‐one per cent of patients who received chemotherapy had no or mild toxicity. By the end of follow‐up period, 30% of rectal cancer patients and 24% of colon cancer patients had developed recurrence. At last follow up, 197 patients had died. Median overall survival from time of diagnosis was 73 months. Overall 5‐year survival for colonic and rectal cancers was 50% and 57%, respectively. For the 299 patients who had curative procedures, the 5‐year survival was 63% and 62% for colonic and rectal cancers, respectively.Conclusion:  Colorectal cancer patients who were eligible for and received adjuvant therapy had significantly better survival. Rectal cancer patients whose tumours only required low anterior resection had a better survival than those who needed an abdomino‐perineal resection. High‐volume surgeons have less postoperative complications than low‐volume surgeons. The high proportion of late presentations seen in colon cancer patients supports the need for screening to improve early detection.
Complications of intercostal catheter insertion using EMST techniques for chest trauma
Authors: Heng Kenneth , Bystrzycki Adam , Fitzgerald Mark , Gocentas Robert , Bernard Stephen , Niggemeyer Louise , Cooper David James , Kossmann Thomas 
Published: December 2004

Background:  The purpose of the present study was to determine the complication rates associated with intercostal catheter insertion (ICI) performed using Early Management of Severe Trauma (EMST) guidelines on trauma patients admitted through The Alfred Trauma Centre.Methods:  The Alfred Trauma Registry identified demographic and clinical data for patients who underwent ICI in the Alfred hospital following admission for trauma. The medical histories were subsequently reviewed for complications resulting from ICI.Results:  There were 211 ICI performed on 173 trauma patients at The Alfred Trauma Centre between July 2001 and June 2002. The mean injury severity score was 34. Mean age was 38 (range 15−82 years), with 77% of the patients being men. Chest injury was the result of blunt trauma in 90.2% and penetrating trauma in 9.8%. ICI occurred in the Trauma Centre (84%), operating theatre (6%), intensive care unit (9%) and in the general ward (1%). Eighty per cent of patients had a unilateral ICI. The indications for ICI were pneumothorax (45.7%), haemothorax (15.0%), haemopneumothorax (28.3%) and tension pneumothorax (7.5%). There were no insertional and 11 (5.2%) positional complications. The infection rate was 2.4% comprising two superficial and three deep (empyema thoraces) infections. No statistically significant association was found between infective complications and age, injury severity score (ISS), haemothorax, penetrating trauma, prehospital needle thoracostomy and time to ICI. There was no mortality arising from ICI complications.Conclusion:  Intercostal catheter insertion for chest trauma performed in accordance with EMST guidelines has a low complication rate. Prehospital prophylactic chest decompression for ventilated patients with chest trauma, using a lateral rather than an anterior approach, may decrease the incidence of untreated tension pneumothorax.
Laparoscopic adrenalectomy for phaeochromocytoma: with caution
Authors: Thomson Benjamin N. J. , Moulton Carol‐Anne , Davies Michael , Banting Simon W. 
Published: December 2004

Introduction:  Laparoscopic adrenalectomy is well described and many series include patients with phaeochromocytoma. Our aim was to establish whether laparoscopic adrenalectomy for phaeochromocytoma was a safe and feasible technique at our institution.Methods:  Patients requiring adrenalectomy were entered into a prospective database that included patient details, operative data, hormone excretion, tumour size, hospital stay and complications. All operations were performed under the supervision of a single surgeon. Analysis was performed for those patients with a diagnosis of phaeochromocytoma.Results:  Of 60 patients having laparoscopic adrenal surgery, 18 had phaeochromocytoma as the indication. Seventeen (89%) of 19 tumours in these 18 patients were successfully removed laparoscopically. Median operative time was 180 min (range 130−300 min) and this was significantly longer compared with other adrenal pathology. The median tumour size was 6 cm which was significantly larger than other adrenal tumours. Seven (38%) patients developed complications and median postoperative inpatient stay was 5 days (range 3−8 days).Conclusions:  The postoperative stay was equivalent to other laparoscopic series and laparoscopic removal was successful in 89%. The laparoscopic approach to the adrenal gland in phaeochromocytoma is safe and effective treatment.
Effect of total hip arthroplasty on recreational and sporting activity
Authors: Chatterji Urjit , Ashworth Mark J. , Lewis Peter L. , Dobson Peter J. 
Published: December 2004

Background: Common concerns of patients undergoing total hip arthroplasty are whether they can continue with certain recreational and sporting activities or even commence new ones after the procedure. The present paper describes preoperative and postoperative activities, the numbers participating and the time to resume these activities.Methods: Between 1 and 2 years after total hip arthroplasty, 216 patients, who had undergone a total of 235 arthroplasties, were surveyed by postal questionnaire to ascertain how the arthroplasty had affected their recreational and sporting ability. Their preoperative and postoperative activity along with the time to resume was recorded. A general hip score and estimate of physical activity was also collected.Results: The number of patients participating in sport increased from 188 preoperatively to 196 postoperatively. Patients stated that the surgery had a beneficial effect on their performance of sporting activities although the number of sporting events decreased. By multiplying individuals by the number of sports they participated in, there were 434 occurrences of sport preoperatively giving a mean for the group of 1.9 sports per patient. Postoperatively this had reduced to 382, giving a mean of 1.7. Five sports showed a significant change for individual patients from pre to postoperation. Those which showed an increase were exercise walking, where 38 patients (16.8%) who did not walk before surgery took up walking afterwards (P < 0.0001) and aqua aerobics, where 15 took up this activity postoperatively for the first time (P = 0.002). There were three sports which decreased significantly from pre to postoperation. They were, golf where 13 out of 39 (P = 0.005), tennis 13 out of 14 (P = 0.01) and jogging where six out of seven (P = 0.01) patients stopped participating.Conclusion: This study has shown that patients are adopting lower impact activities to participate in after total hip arthroplasty. The total number of patients performing a sport increases postoperatively but the total amount of sport played decreases. These data will help to counsel patients.
Emergency sclerotherapy for control of acute oesophageal variceal bleeding using 3% aqueous phenol: a 15‐year experience
Authors: Desai Chirag S. , Shah Sudeep R. , Mathur S. K. 
Published: December 2004

Background:  The purpose of the present study was to compare the efficacy of emergency endoscopic variceal sclerotherapy (EVS) using 3% aqueous phenol as an initial procedure to control acute oesophageal variceal bleed.Methods:  One hundred and ninety‐five consecutive patients presenting with acute variceal bleed were included in the study. Protocol based endoscopic sclerotherapy and management of bleeding oesophageal varices was done. Immediate cessation of bleeding, re‐bleeding within the first 72 h, success of first injection, final success of EVS, short‐term mortality, influence of aetiology of portal hypertension and severity of liver disease on these results were studied.Results:  Immediate cessation of bleeding was obtained in 191 out of 195 patients (97.9%). Twenty‐seven (13.8%) patients re‐bled within 72 h. On re‐injection final success of EVS was 87.2% (170/195 patients). There was no significant difference between final success rate in cirrhotic versus non‐cirrhotic patients (103/118 (87.3%) vs. 67/77 (87%)). Success of first sclerotherapy session was significantly higher than that of second sclerotherapy session. Surgical rescue was required in 25 (12.8%) patients. Mortality was 3.6%. Failure of EVS and mortality was significantly higher in Child's C group (P = 0.04, Relative risk = 0.5, confidence interval 0.22−1.16).Conclusion:  EVS remains an effective and cost effective modality of treatment to control acute variceal bleeding irrespective of aetiology of portal hypertension provided strict protocol based management is followed. With timely surgical rescue for the failures, the overall mortality can be reduced to less than 5%.
Quantifying symptoms in men with interstitial cystitis/prostatitis, and its correlation with potassium‐sensitivity testing
Authors: Parsons C. Lowell , Rosenberg Matt T. , Sassani Pejvak , Ebrahimi Kamyar , Koziol James A. , Zupkas Paul 
Published: December 2004

OBJECTIVETo determine whether men previously diagnosed with prostatitis also have pathology originating in the bladder.PATIENTS, SUBJECTS AND METHODSWe administered the pelvic pain and urgency/frequency (PUF) questionnaire and the potassium‐sensitivity test (PST) to 50 patients with prostatitis presenting in urological and primary care, and to 14 controls. In a separate control group of 22 men, the urethra was irrigated with KCl or NaCl (11 each) before and after experimental injury of the urethral mucosa.RESULTSAll 50 patients with prostatitis had PUF scores of ≥ 7; 77% were positive for the PST. All 14 controls had PUF scores of 1 or 0 and a negative PST. In the urethral irrigation study in controls, KCl but not NaCl provoked urethral pain after mucosal injury. Before injury, neither KCl nor NaCl caused symptoms.CONCLUSIONThe high rate of positive PST in patients with ‘classic’ prostatitis indicates that pathology originating in the bladder may be an important source of symptoms in most. In patients with prostatitis and female patients with interstitial cystitis, symptoms may arise not from separate disease entities but from a continuum of epithelial dysfunction and potassium cycling that may be present throughout the lower urinary tract.