bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arthroscopic subacromial decompression with a holmium:YAG laser: Review of the literature
Authors: Boult Maggi , Wicks Malcolm , Watson David I. , Macdougal Graeme , Shimmin Andrew , Maddern Guy J. 
Published: March 2003

Background: The Australian Safety and Efficacy Register of New Interventional Procedures–Surgical (ASERNIP‐S) undertook to systematically review the literature regarding arthroscopic subacromial decompression (ASD) using a holmium:YAG laser for patients with impingement syndrome, with respect to the safety and efficacy of the procedure. Methods: Studies on ASD with a holmium:YAG laser were identified using MEDLINE (1984 to July 2000), EMBASE (1974 to August 2000) and Current Contents (1993 to week 33 2000). A number of search terms were used: (laser and shoulder) and (surgery or arthroscop* or acromioplasty or orthopaed* or orthoped* or subacromial decompression or impingement syndrome). The Cochrane Library was searched from 1966 to issue 3 2000, using the search terms ‘shoulder and surgery’. Human studies were included for patients with impingement syndrome but without full‐thickness rotator cuff tears or rheumatological disorders, and where shoulder pain had been experienced for more than 3 months. A surgeon and reviewer independently assessed the retrieved articles for their inclusion in the review. Results: Seven papers were identified that related to ASD with a holmium:YAG laser. None of the papers for review offered high‐quality evidence. There were no properly designed randomized controlled studies. The highest level of evidence came from time series studies. No quantitative analysis could be undertaken for this review. Conclusions: Given the extremely low level of evidence available for this procedure it was recommended that further research be conducted to establish the safety and efficacy of the technique. This reinforces the conclusion reached in the Cochrane review of interventions for shoulder pain where insufficient evidence was found to either support or refute the efficacy of other interventions for shoulder pain.
Internal pancreatic fistulas with pancreatic ascites and pancreatic pleural effusions: Recognition and management
Authors: Kaman Lileswar , Behera Arunanshu , Singh Rajinder , Katariya Rabindra Nath 
Published: March 2003

Background: Internal pancreatic fistulas are well recognized complications of chronic pancreatitis. Methods: Six patients with internal pancreatic fistulas were treated over a period of 5 years from 1995 to 1999. Four patients presented with ascites, one patient presented with ascites and bilateral pleural effusion and the sixth patient presented with left‐sided pleural effusion. Five patients were chronic alcoholics and in one patient the cause of pancreatitis was not clear. Although the serum amylase was mildly elevated the levels of amylase in the aspirated fluid were consistently elevated (more than 800 Somogyi units/100 mL), along with the level of proteins (> 3 g/100 mL), and on this basis the diagnosis was made. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated pancreatic ductal disruption in four cases. Initial treatment was conservative, consisting of nasogastric aspiration, nil per oral, antisecretory drugs, repeated paracentesis or thoracocenthesis and total parenteral nutrition (TPN). In two patients nasopancreatic drains (NPD) were placed across the disrupted pancreatic duct. Results: In one patient conservative treatment with NPD was successful, and the remaining five patients required surgical intervention. There was no mortality. Two patients developed surgery‐related complications that were successfully managed, but they required an extended hospital stay. Conclusion: Internal pancreatic fistulas should be treated initially non‐operatively; if this is not effective, operative therapy should be considered without delay.
Determinants of pancreaticoenteric anastomotic leak following pancreaticoduodenectomy
Authors: Srivastava Sanjai , Sikora Sadiq S. , Pandey Chandra M. , Kumar Ashok , Saxena Rajan 
Published: March 2003

Background: The purpose of the present paper was to study the incidence, presentation and management of pancreaticoenteric anastomotic (PEA) leak following pancreaticoduodenectomy (PD) and to identify risk factors associated with PEA leak. Methods: One hundred and twenty patients underwent PD for benign and malignant pancreatic and periampullary lesions from 1989 to 1998. Prospectively collected data were analysed for incidence and outcome of PEA leak. Four clinical, three laboratory parameters, preoperative biliary drainage (PBD), perioperative octreotide use, nine intraoperative parameters, site of tumour and stage of malignant tumours were analysed by univariate and multivariate logistic regression analysis to identify factors influencing PEA leak. Results: Pancreatic leak developed in 15 (12.5%) patients. Nine patients (60%) had a PEA leak that manifested as controlled leak through the drain. All were managed conservatively and the leak stopped after a mean duration of 17 days (range: 6–32 days). Six (40%) patients had associated intra‐abdominal complications, and three (50%) died in the postoperative period. Pancreatic fistula healed in the three remaining patients after a mean duration of 18 days (range: 15–25 days). Diabetes (P = 0.02; odds ratio (OR) = 4.60; 95% confidence interval (CI): 1.23–17.18), PBD (P = 0.03; OR = 4.82; 95% CI: 1.21–19.24), sequence of reconstruction (bilioenteric anastomosis as first anastomosis; P = 0.01; OR = 6.25; 95% CI: 1.45–26.83) and duration of surgery > 8 h (P = 0.01; OR: 5.61; 95% CI: 1.54–20.39) were associated with a significantly higher incidence of PEA leak. Conclusion: Pancreaticoenteric anastomotic leak occurred in 12% of patients undergoing PD for pancreatic and periampullary tumours. The majority of these were uncomplicated and healed with conservative treatment. Complicated leaks were associated with high mortality. Diabetes mellitus, PBD, prolonged surgery and the sequence of reconstruction were risk factors associated with an increased incidence of PEA leak.
Value of magnetic resonance myelography in the diagnosis of disc herniation and spinal stenosis
Authors: Pui Margaret H , Husen Yousuf A 
Published: March 2003

SUMMARYMagnetic resonance imaging provides a good‐quality image over the entire length of the spine and can assess the morphology of the discs and cord. It is the imaging modality of choice in the investigation of spinal diseases. Magnetic resonance myelography (MRM) is non‐invasive, has comparable sensitivity to conventional myelography in visualizing lumbar nerve roots and allows overall assessment of the spinal canal even in the presence of cerebrospinal fluid block. Seventy‐two patients with pre‐surgical diagnosis of disc herniation were prospectively investigated prior to surgery to determine the value of MRM in the diagnosis of disc herniation and spinal stenosis. The difference between the sensitivity and accuracy of MRI (89.0–95.6%, 89.1–95.7%) and MRM (82.4–89.0%, 82.6–89.1%) was not significant for both observers. There was no significant improvement with the addition of MRM to MRI (91.2–97.8%, 91.3–97.8%). Although MRM did not significantly improve the diagnostic accuracy of MRI, it allowed a better overall view of the dural sac and root sleeves, therefore making it easier to diagnose spinal stenosis and disc herniation in a minority of cases.
Acute disseminated encephalomyelitis and multiple sclerosis: Magnetic resonance imaging differentiation
Authors: Singh Surendra , Prabhakar Subhashini , Korah Ipeson P , Warade Sanjay S , Alexander Mathew 
Published: March 2003

SUMMARYThe study was undertaken to compare the MR imaging features of acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) in a country with a high prevalence of ADEM. Magnetic resonance scans from 33 patients diagnosed clinically with MS (14 patients) or ADEM (19 patients) were reviewed concurrently by two radiologists blinded to the clinical diagnosis. The size, site, morphology and pattern of brain and spinal cord involvement were recorded and the MR imaging diagnosis was compared with the clinical diagnosis. The MR imaging findings matched with the clinical diagnosis in 11 of 14 patients with MS (sensitivity = 78.6%), and with the clinical diagnosis in 15 of 18 patients with ADEM (sensitivity = 78.9%). Three patients had non‐specific findings and in a further three patients discordant imaging features were present. One patient with imaging features typical of Balo’s concentric sclerosis was diagnosed clinically as suffering from ADEM. In a country with a high prevalence of ADEM, the majority of patients with ADEM and MS can be differentiated on MR imaging.
Atypical magnetic resonance imaging findings of craniopharyngioma
Authors: Wang Yi‐Xiang J , Jiang Hao , He Guo‐Xiang 
Published: March 2003

SUMMARYThree cases of craniopharyngiomas with atypical MRI findings are reported. The first patient had a nasopharyngeal craniopharyngioma. Its unusual location made diagnosis difficult. The second patient had a massive craniopharyngioma with extensive cystic expansion, involving the anterior, middle and posterior cranial fossae, and extending into the foramen magnum. The tumour of the third patient involved the suprasellar region with a large extension into the third ventricle, and demonstrated a predominantly high signal intensity on all T1‐weighted, proton‐weighted and T2‐weighted images. These patients further stressed the complexity of MRI findings in craniopharyngiomas.
Small ureterocele‐like Gartner’s duct cyst associated with ipsilateral renal aplasia: A case report
Authors: Kalva S P , Rammurti S , Subbarao D , Chittibabu N , Murthy V Subbalakshmi 
Published: March 2003

SUMMARYGartner’s duct cyst associated with ipsilateral renal aplasia is a rare anomaly and fewer than 40 cases have been reported in the literature. A case of Gartner’s duct cyst presenting like an ureterocele on sonography, intravenous pyelography and CT are described.
Preoperative diagnosis of bilateral tuberculous epididymo‐orchitis following intravesical Bacillus Calmette–Guerin therapy for superficial bladder carcinoma
Authors: Muttarak Malai , Lojanapiwat Bannakij , Chaiwun Benjaporn , Wudhikarn Supot 
Published: March 2003

SUMMARYWe report a case of bilateral tuberculous epididymo‐orchitis following intravesical Bacillus Calmette–Guerin (BCG) therapy for superficial bladder carcinoma in which the diagnosis was made by ultrasonography prior to surgery. The US findings include heterogeneous enlargement of the epididymis and testis, associated with scrotal‐skin thickening and scrotal sinus track. Patients with bladder carcinoma treated with intravesical BCG therapy, the presence of scrotal swelling with scrotal‐skin thickening and epididymal involvement suggests tuberculous epididymo‐orchitis rather than testicular tumour. It is important to be aware of this rare complication and to be familiar with the ultrasonographic features so that appropriate treatment can be given.
2002 Australian Radiology Workforce Report
Authors: Jones DN 
Published: March 2003

SUMMARYThis paper describes the current status of radiologist provision in Australia, and explores issues relating to its current adequacy, as well as analysing projections of supply and requirements, and their balancing. Data are drawn from several sources including the results of the Royal Australian and New Zealand College of Radiologists Workforce Survey 2000, and the report of the Australian Medical Workforce Advisory Committee Radiology Working Party 2001. The main conclusions to be drawn are that: (i) there is a current shortfall of radiologist supply in Australia; (ii) future requirements (taking all factors into consideration) are expected to grow at a greater rate than projected supply (based on the status quo); and (iii) supply of radiologists should therefore be increased. These conclusions are roughly in line with those from other countries, such as the UK, Canada and USA. Radiologists practising in Australia also appear to have relatively high productivity, including by some international comparisons. These findings are presented in the context of current issues in Australian medical imaging, including provider consolidation and corporatization, globalization and funding.
Detection of aortoenteric fistula with helical CT
Authors: Puvaneswary M , Cuganesan R 
Published: March 2003

SummaryWe describe a case of a patient with symptoms suggestive of secondary aortoenteric fistula (AEF). Extravasation of contrast medium from the aorta into the lumen of the small bowel was definitive evidence of AEF. The role of abdominal CT performed without oral contrast is discussed.
LIVING IN THE COLD: FREEZE‐INDUCED GENE RESPONSES IN FREEZE‐TOLERANT VERTEBRATES
Authors: Storey Kenneth B 
Published: March 2003

1. Winter survival for numerous cold‐blooded animals includes freeze tolerance: the ability to endure the conversion of as much as 65% of total body water into extracellular ice. Selected molecular adaptations underlying freeze tolerance (e.g. cryoprotectants, ice nucleating proteins) have been widely studied, but the full range of metabolic adjustments needed for freeze endurance remains unknown.2. Recent studies using gene screening techniques are providing a different approach to the search for biochemical responses that support freezing survival by identifying genes and proteins that are up‐regulated by freezing or thawing in freeze‐tolerant amphibians and reptiles.3. Screening of a cDNA library from wood frog liver revealed the freeze‐induced up‐regulation of genes coding for the α‐ and γ‐subunits of fibrinogen (a plasma clotting protein), the mitochondrial ADP/ATP translocase and a novel 10 kDa protein containing a nuclear exporting sequence.4. Northern blotting revealed that these genes were differentially responsive to two of the component stresses of freezing (dehydration and anoxia), indicating that different genes are induced by signals radiating either from cell volume change or oxygen deprivation during freezing.5. Freeze up‐regulation of fibrinogen synthesis in liver and other organs appears to be a damage repair response that anticipates a need for enhanced plasma clotting capacity to deal with ice crystal damage to capillary beds.6. Up‐regulation of ADP/ATP translocase in frog liver is linked with ischaemia resistance and studies with freeze‐ tolerant turtles have shown that other genes encoding proteins involved in mitochondrial energetics (NADH‐ubiquinone oxidoreductase subunit 5, cytochrome C oxidase subunit 1) are also up‐regulated by both anoxia and freezing exposures.7. These studies are making major advances in our understanding of freeze tolerance as a natural phenomenon and also highlight new key areas that can be targeted by applied interventions for the optimization of medical cryopreservation techniques for cells, tissues and organs.
ACUTE EXPOSURE TO A LOW LEVEL OF TESTOSTERONE IMPAIRS RELAXATION IN PORCINE CORONARY ARTERIES
Authors: Quan ADRIAN , Teoh HWEE , Man RICKY YK 
Published: March 2003

SUMMARY1. While the gender bias associated with coronary artery disease has been suggested to be partially accounted for by the protective effects of oestrogens, the role of testosterone remains unclear. The aim of the present study was to determine whether vasorelaxation could be affected by acute administration of testosterone with and without 17β‐oestradiol.2. Precontracted porcine coronary artery rings were relaxed with sodium nitroprusside (SNP), levcromakalim, bradykinin (BK) or A23187. At 1 nmol/L, testosterone impaired relaxations to BK and A23187, while the same concentration of 17β‐oestradiol potentiated levcromakalim‐ and SNP‐induced relaxations. The impairment of relaxation responses by testosterone was reduced in the presence of 17β‐oestradiol, while the enhancement by 17β‐oestradiol was decreased by testosterone.3. We demonstrate that a low level of testosterone can impair agonist‐induced relaxation, an effect that is reduced by 17β‐oestradiol. This further supports evidence indicating a detrimental role for testosterone in coronary artery disease and suggests that circulating levels of testosterone may undermine the beneficial effects of oestrogen in women.
A Short History Of Nitroglycerine And Nitric Oxide In Pharmacology And Physiology
Authors: Marsh Neville , Marsh Alexander 
Published: March 2003

SUMMARY1. Nitroglycerine (NG) was discovered in 1847 by Ascanio Sobrero in Turin, following work with Theophile‐Jules Pelouze. Sobrero first noted the ‘violent headache’ produced by minute quantities of NG on the tongue.2. Constantin Hering, in 1849, tested NG in healthy volunteers, observing that headache was caused with ‘such precision’. Hering pursued NG (‘glonoine’) as a homeopathic remedy for headache, believing that its use fell within the doctrine of ‘like cures like’.3. Alfred Nobel joined Pelouze in 1851 and recognized the potential of NG. He began manufacturing NG in Sweden, overcoming handling problems with his patent detonator. Nobel suffered acutely from angina and was later to refuse NG as a treatment.4. During the mid‐19th century, scientists in Britain took an interest in the newly discovered amyl nitrite, recognized as a powerful vasodilator. Lauder Brunton, the father of modern pharmacology, used the compound to relieve angina in 1867, noting the pharmacological resistance to repeated doses.5. William Murrell first used NG for angina in 1876, although NG entered the British Pharmacopoeia as a remedy for hypertension. William Martindale, the pharmaceutical chemist, prepared ‘. . . a more stable and portable preparation’: 1/100th of a grain in chocolate.6. In the early 20th century, scientists worked on in vitro actions of nitrate‐containing compounds although little progress was made towards understanding the cellular mode of action.7. The NG industry flourished from 1900, exposing workers to high levels of organic nitrites; the phenomena of nitrate tolerance was recognized by the onset of ‘Monday disease’ and of nitrate‐withdrawal/overcompensation by ‘Sunday Heart Attacks’.8. Ferid Murad discovered the release of nitric oxide (NO) from NG and its action on vascular smooth muscle (in 1977). Robert Furchgott and John Zawadski recognized the importance of the endothelium in acetylcholine‐induced vasorelaxation (in 1980) and Louis Ignarro and Salvador Moncada identified endothelial‐derived relaxing factor (EDRF) as NO (in 1987).9. Glycerol trinitrate remains the treatment of choice for relieving angina; other organic esters and inorganic nitrates are also used, but the rapid action of NG and its established efficacy make it the mainstay of angina pectoris relief.
AM424: History Of A Novel Drug Candidate
Authors: Kurek John 
Published: March 2003

SUMMARY1. Leukaemia inhibitory factor (LIF) is a 180 amino acid single‐chain protein, named after its effect on haematopoietic cells. Leukaemia inhibitory factor belongs to a group of cytokines that includes ciliary neurotrophic factor, interleukin (IL)‐6, IL‐11, cardiotrophin‐1 and oncostatin M. All group members use the gp130 signal transducing subunit for intracellular signalling, but show differences in biological effect.2. Research over the past 6–8 years has shown LIF to have potent neuromuscular activity. In vitro and in vivo studies on axotomy and nerve crush models demonstrate a powerful effect of LIF in enhancing the survival of both motor and sensory neurons, while reducing denervation‐induced muscle atrophy. In models of both axotomy induced neuronal death and in the wobbler mouse, LIF is active at doses as low as 1 μg/kg delivered systemically.3. In muscle, LIF will increase the rate of muscle regeneration in vivo when applied exogenously after injury and will stimulate intrinsic muscle repair following its targeted release to dystrophic muscle in the mdx mouse. Leukaemia inhibitory factor may also have a role as an adjunct to myoblast transfer therapy, with studies showing that the transplantation of genetically competent myoblasts into mdx mouse muscle is enhanced when cells are injected with LIF.4. Distribution and pharmacokinetic studies have been conducted in primates with doses of 20 μg/kg recombinant human LIF given subcutaneously over 2 weeks tolerated without major side effects.5. A pharmaceutical form of recombinant human LIF (AM424; AMRAD Operations, Richmond, Victoria, Australia) entered human clinical trials during 1997 and a phase I clinical trial in healthy volunteers has been completed. A phase I repeat dose study has also been completed in cancer patients undergoing chemotherapy. The primary indication for a phase II study is the treatment of chemotherapy induced peripheral neuropathy. Other potential indications include muscle wasting diseases, acute nerve trauma and motor neuron disease.6. The role of LIF in modulating nerve loss should make it an ideal candidate for the treatment of a number of neurological conditions. The phase I study represents the first trial in a programme for the clinical development of AM424.
Effects Of Tachykinin Receptor Agonists And Antagonists On The Guinea‐Pig Isolated Oesophagus
Authors: Kerr Karen P 
Published: March 2003

SUMMARY1. Vagal nerve stimulation of the guinea‐pig isolated oesophagus produced a triphasic tetrodotoxin (TTX)‐sensitive contractile response. The third phase, which was resistant to ganglion blocking drugs, was selectively abolished by capsaicin, suggesting the involvement of one or more neuropeptides released from afferent neurons. Receptors on cholinergic neurons were subsequently activated because the response was atropine sensitive. Contractile responses resulting from exogenous substance P were abolished by atropine and TTX and enhanced by physostigmine. These findings suggest that the third phase may be mediated by the action of a substance P‐like neuropeptide released from sensory nerve endings that subsequently activated cholinergic neurons.2. The tachykinin receptors in the body of the guinea‐pig oesophagus were characterized by determining the relative agonist potencies of natural tachykinins as well as tachykinin receptor‐selective analogues. Antagonist affinities were also determined. The results indicated the presence of both NK2 and NK3 receptors. In addition, the effects of a cocktail of peptidase inhibitors (captopril, thiorphan and amastatin) on responses to various tachykinins and synthetic analogues were determined. The results indicate that one or more peptidases are present in this preparation.3. Experiments using various tachykinin receptor antagonists were performed to determine whether the activation of tachykinin receptors played a role in the mediation of the third phase of the response to vagal nerve stimulation. While this response was unaffected by NK1 and NK2 receptor‐selective antagonists, it was only partially inhibited (23%) by the NK3 receptor antagonist SR 142801. Thus, in the guinea‐pig oesophagus, it appears that NK3 receptors play only a minor role in mediating a contractile response when afferent neurons are excited by vagal nerve stimulation.
Proceedings of the Australian Physiological and Pharmacological Society Symposium: Ion Channels PREDICTING CHANNEL FUNCTION FROM CHANNEL STRUCTURE USING BROWNIAN DYNAMICS SIMULATIONS
Authors: Chung Shin‐Ho , Kuyucak Serdar 
Published: March 2003

SUMMARY1. The transport process of ions across the potassium channel is studied using computer simulations. The shape of the model channel corresponds closely to that deduced from crystallography.2. We first give an intuitive account of how the motion of ions experiencing an applied electric force and interacting with a dielectric boundary and charge residues on the channel wall can be simulated accurately by using a powerful supercomputer.3. We then show how some of the salient features of ion channels can be deduced by following the positions of ions at each discrete step over many millions of time steps.