bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro comparison studies of truncated rhodopsin promoter fragments from various species in human cell lines
Authors: May Leigh A , Lai Chooi‐May , Rakoczy P Elizabeth 
Published: September 2003

Abstract Background: The aim of the present study was to define the rhodopsin promoter elements of various mammalian species by evaluating the effect of these promoters on transgene specificity and expression in human cell lines. Additional characterization of these promoters was performed in the presence or absence of a human inter­photoreceptor retinoid‐binding protein (IRBP) enhancer element. Methods: Truncated murine, bovine and human rhodopsin promoter fragments containing 1.4 kb of the 5′ upstream regulatory sequence were subcloned into pEGFP‐N1 expression vector to drive the expression of the green fluorescence protein (GFP). Fluorescence‐activated cell sorter analysis was used to determine the strength and specificity of GFP expression in three human cell lines, in the presence or absence of an IRBP enhancer element at the 5′ end of the promoters. Results: It was found that the truncated murine rhodopsin promoter was the strongest in Y‐79 retinoblastoma cells but it was less specific than the truncated human rhodopsin promoter. It is surmised that transcription factors located at the 5′ proximal region of the rhodopsin promoter fragments were responsible for the expression patterns seen in the present study. Conclusions: These results indicate that the rhodopsin promoter of choice for in vivo work should be from the same species if specificity is to be maximal and the addition of the IRBP enhancer element could increase transgene expression in photoreceptor cells without deleterious effects on specificity.
Helicobacter pylori‐eradication therapy decreases the level of neutrophil‐derived oxidants in the ulcerous mucosa of the human stomach: Relationship between ulcer stage and mucosal oxidant level
Authors: Suzuki Masayuki , Suzuki Hidekazu , Kitahora Tetsuji , Nagahashi Shoichi , Masaoka Tatsuhiro , Tanaka Shin , Suzuki Kouichi , Ishii Hiromasa 
Published: September 2003

Background:  The purpose of the present study was to determine the effect of Helicobacter pylori eradication on the intensity of inflammation in the ulcerous mucosa by measuring the level of neutrophil‐associated oxidants and to understand the role of mucosal inflammation in ulcer relapse from the viewpoints of the scarring stage and the H. pylori‐infection status. The level of inflammation in the gastric mucosa after the eradication of H. pylori was examined using biopsy samples obtained from patients with gastric ulcers.Methods:  Gastric mucosal specimens were endoscopically obtained before and after H. pylori‐eradication therapy from 39 patients with gastric ulcers and a positive H. pylori‐infection status. The level of neutrophil‐derived oxidants was then measured in each sample using a luminol‐dependent chemiluminescence (ChL) assay.Results:  Chemiluminescence activity in the ulcer portion and the background gastric mucosa (antrum and corpus) was significantly reduced 3 months after successful therapy (n = 32). The ChL activity was further decreased 9 months after successful therapy, but the activity in the ulcer portion remained unchanged. In patients who did not respond to the H. pylori‐eradication therapy (n = 7), the ChL activities were not altered in any mucosal portion after the therapy. Before the H. pylori‐eradication therapy, a higher ChL activity was observed in open ulcer tissue than in scarred tissue. The ChL activity in the scarred tissue was reduced 3 months after the successful eradication of H. pylori; however, the ChL activity in the red scars was significantly higher than that in the white scars. The ChL level in the white scars was almost equivalent to that in the background mucosa 9 months after the completion of the H. pylori‐eradication therapy.Conclusion:  The eradication of H. pylori may reduce the level of oxidant production in gastric ulcers, promoting the prevention of ulcer recurrence. Furthermore, the presence of a red scar may indicate unstable healing, even after the successful eradication of H. pylori.
Use of non‐powder surgical glove for extraction of gallbladder in laparoscopic cholecystectomy
Authors: Yano Hiroshi , Okada Kazuyuki , Kinuta Masakatsu , Iwazawa Takashi , Kanoh Toshiyuki , Monden Takushi 
Published: September 2003

Background:  The present study was conducted to evaluate the usefulness and safety of the non‐powder surgical glove for extraction of the gallbladder in laparoscopic cholecystectomy.Methods:  A total of 830 patients who underwent laparoscopic cholecystectomy using the surgical glove for extraction of the gallbladder in our hospital were analyzed. The operative times, blood loss during the operation, intra‐ and postoperative complications, length of hospital stay and the rate of morbidity were evaluated.Results:  The mean operative time, mean intraoperative blood loss and mean length of hospital stay were 98.9 min, 12.1 g, and 7.93 days, respectively. The most frequent complication in this study was postoperative bleeding from the liver bed or port sites. Postoperative wound infection was found in six (0.72%) of 830 cases. Umbilical port infection was found in five of six cases. Seven cases with gallbladder cancer were incidentally detected by intra‐ or postoperative pathology. Five cases underwent reoperation by open laparotomy to resect the regional lymph nodes. Two cases have been followed up, because the depth of cancer invasion was limited to the mucosa of the gallbladder. There was no intra‐abdominal abscess formation and no port site metastasis in this study.Conclusion:  The use of the surgical glove for extraction of the gallbladder is safe, cheap, simple and potentially reduces significant morbidity. Its routine use at laparoscopic cholecystectomy is strongly advocated where bile leak occurs or tumor is suspected.
Endoscopic ultrasound‐guided drainage of pancreatic pseudocysts using a large‐channel echoendoscope and a conventional polypectomy snare
Authors: Enya Masamichi , Yasuda Ichiro , Tomita Eiichi , Shirakami Youhei , Otsuji Kentaro , Shinoda Tohru , Moriwaki Hisataka 
Published: September 2003

Background:  Endoscopic drainage of pancreatic pseudocysts is becoming common. Recent techniques using endoscopic ultrasound (EUS) have made the procedure safer and easier. However, bleeding related to the procedure is sometimes still experienced and placement of the tube is also sometimes difficult in cases where the cystic wall is thick and hard. We describe a new technique of EUS‐guided drainage using a large‐channel echoendoscope, a conventional polypectomy snare and a high‐frequency current generator with automatic controls. We also evaluate this technique's utility.Methods:  Between May 2001 and December 2002, EUS‐guided drainage was attempted in consecutive patients with symptomatic pancreatic pseudocysts that had resisted conservative treatments. The EUS device was a recently introduced large‐channel linear scanning echoendoscope. A puncture was made with a 19 G needle under EUS guidance and a 0.035 inch guidewire was passed through the puncture and into the pseudocyst. Then, a conventional polypectomy snare was used to enlarge the puncture tract with the new current generator, and a 7 Fr pigtail‐type nasocystic drain was placed.Results:  The drainage was successful and insertion of the drain was easy in all 13 patients included in the study. No complications related to the procedure, such as bleeding and perforation, were observed. The clinical symptoms resolved after the procedure in all patients. In nine patients, the cyst completely disappeared and the discharge also stopped, allowing the tube to be removed after a mean of 15 days. The median follow‐up period for these nine patients was 4 months and no recurrence has been observed. In two other patients, the cysts shrank but did not disappear completely 4 weeks or more after the procedure. Since both of these patients had had previous cystic infections, they were given surgical operations. In the remaining two cases, the cystic lumen completely disappeared but the discharge continued for 4 weeks, so we replaced the 7 Fr nasobiliary tube with a 10 Fr internal drainage tube.Conclusion:  This method is an easy and effective treatment for pancreatic pseudocysts. It may also reduce the risk of bleeding related to the procedure.
Modification of endoscopic mucosal resection to collect plural polypectomied specimens with clip connected with string using a one‐channel colonoscope
Authors: Hashimoto Yoshinari , Toyota Jyo , Fujii Toshihito , Kasahara Hiroshi , Yoshizumi Kazuo , Kim Yong‐Sik , Nakamura Yoichiro , Maekawa Syuji , Urakawa Tomoaki 
Published: September 2003

Background:  Multiple colon polyps and early cancers are often detected at colonoscopy, but we could not collect all polypectomied specimens in one insertion of a colonoscope. Endoscopic mucosal resection (EMR) may often be very difficult for the collection of the size, type, form, or location of the polyps.Methods:  We performed EMR to collect plural polypectomied specimens by a modified new technique using a clip connected with a string in 40 patients (25 male, 15 female) who visited Saiseikai Nakatsu Hospital and Mitsubishi Kobe Hospital  for  colonoscopic  treatment.  The  method  was  as  follows:  (i)  insert  a  colonoscope;  (ii)  check  polyps  by  indigocarmine pigmentation and endoscopic ultrasonography (EUS); (iii) check the lift‐up sign by submucosal injection of 2.5% hypersaline‐epinephrine containing indigocarmine; (iv) make a clip connected with string (Tegusu‐3 go) and insert the clip kit through the channel of the colonoscope; (v) clip the polyp; (vi) insert snare in the channel of an endoscope, passing the string through the center of the snare; (vii) snare the polyp with counter traction of string and cutting by bipolar electric power; (viii) check for bleeding. If there is bleeding from the polypectomied site, another clip is necessary; and (ix) collect polyp. If there are many polyps, flags connecting the string are required.Results and Conclusion:  All polyps were treated and collected in all patients by one insertion of the colonoscope without complications. Our modified EMR method was useful in the collection of multiple polypectomied polyps.
Enhancing the fertility of poor responders by treatment with estrogen rebound combined with a short protocol
Authors: Yokota Yoshimasa , Yokota Mikako , Yokota Hidemi , Makita Masami , Sato Setsuko , Araki Yasuhisa 
Published: September 2003

Aim:  To assess the efficacy of estrogen rebound (ER) plus flare‐up by gonadotropin releasing hormone agonist (GnRH‐a) in poor responders who failed to become pregnant prior to a long protocol treatment.Methods:  The patients comprised of thirty‐one infertile patients with oocyte retrieval levels of less than five, who had undergone several long protocol treatment cycles. The efficacy of treatment with the ER plus flare‐up from GnRH‐a was compared with the prior long protocol treatment. The main outcome measures are: confirmation of ER, maximal serum E2 levels prior to human chorionic gonadotropin (hCG) administration, follicular development, dose, and duration of gonadotrophins in a clinical setting.Results:  The ER was confirmed by estrogen levels; FSH increased with ER plus flare‐up from GnRH‐a. Although the 31 patients included in the study had undergone frequent prior treatment cycles, including the long protocol, the pregnancy rate per embryo transfer following ER plus flare‐up by GnRH‐a was 37.5% (nine of 24). The number of follicles, number of oocytes retrieved, and the E2 level was higher than those found in prior treatment cycles.Conclusion:  Exogenous estrogen administration with PremarinR plus flare‐up by GnRH‐a may represent an alternative and effective protocol for poor responder patients who had previously undergone several prior long protocol treatments. (Reprod Med Biol 2003; 2: 127–131)
Cellular adhesion molecules and cardiovascular disease. Part II. Their association with conventional and emerging risk factors, acute coronary events and cardiovascular risk prediction
Authors: Hope S. A. , Meredith I. T. 
Published: September 2003

Abstract The role of cellular adhesion molecules in the patho­genesis of atherosclerosis has now been clearly demonstrated. Plasma levels of adhesion molecules, which have been shed from the cell surface, have also been associated with the presence of clinical atherosclerotic disease, cardiovascular risk factors and acute coronary syndromes. However, there is little consensus in the literature, including between the large well‐designed population studies. This may be explained either by unrecognized confounding factors or, alternatively, by the unpredictable relationship between cell surface expression and activity of cellular adhesion molecules and their shedding into the plasma under different circumstances. Probably for the latter reasons, there is at present little evidence that the measurement of circulating adhesion molecules is likely to offer any additional benefit for individual patients above the assessment of conventional cardiovascular risk factors in the assessment of either the extent of, or future risk from, cardiovascular disease. (Intern Med J 2003; 33: 450−462)
Recovery of pure red‐cell aplasia secondary to antierythropoietin antibodies after cessation of recombinant human erythropoietin
Authors: Panchapakesan U. , Austin S. K. , Shafransky A. , Lawrence J. A. , Savdie E. 
Published: September 2003

Abstract We describe a patient with end‐stage renal failure (ESRF) who developed anti‐erythropoietin (anti‐EPO) antibodies and pure red‐cell aplasia (PRCA) after using Eprex (Janssen‐Cilag, Sydney). Anti‐EPO antibodies were detected with an immunoprecipitation technique and were shown to inhibit erythropoiesis in vitro. Antibody levels waned upon ceasing Eprex. The patient required transfusions for 21 months then recovered after immunosuppression. (Intern Med J 2003; 33: 468−471)
Glycometabolic status and acute myocardial infarction: has the time come for glucose‐insulin‐(potassium) therapy?
Authors: Wong V. , Cheung N. W. , Boyages S. C. 
Published: September 2003

Abstract Glucose‐insulin‐potassium infusion as a metabolic therapy was first advocated for the management of acute myocardial infarction (AMI) in 1960s. Over the subsequent decades, enthusiasm for its use has been patchy, especially with the availability of other effective treatments such as reperfusion therapy for AMI. Several clinical studies in the mid‐1990s revived the interest in the glycometabolic aspects of patients with AMI. The somewhat conflicting results of these recent studies have generated debate over the significance of the glycometabolic state following acute coronary occlusion and the role of insulin‐based infusion therapy. Although most of the available evidence is in favour of an insulin‐based therapy, there are still many aspects of this therapy that require clarification. More evidence will be required from further clinical trials before it is adopted in routine clinical practice. (Intern Med J 2003; 33: 443−449)
Evaluation of a warfarin initiation protocol for older people
Authors: Wilkinson T. J. , Sainsbury R. 
Published: September 2003

Abstract A protocol for initiation of warfarin therapy, targeted specifically for older people and based on individual responses to initial warfarin doses, was evaluated in a case‐control study. People within the protocol group: (i) received higher initial doses of warfarin, (ii) reached an international normalized ratio (INR) of 2 more quickly, (iii) spent more time with INR of 2−3 in the first week and (iv) were less likely to be over‐anticoagulated. However, the proportion of people who reached an INR of 2 too quickly (in <4 days) was no greater. The protocol correctly predicted the maintenance dose range of warfarin in over 70% of cases. (Intern Med J 2003; 33: 465−467)
Collective danger and individual risk: cultural perspectives on the hazards of medical research
Authors: Parker D. B. , Barrett R. J. 
Published: September 2003

Abstract Changes in medical research ethics in the past two decades have made the communication of risk to potential participants a legal imperative. Using ethnographic data from two different cultures, we examine the hazards associated with medical research in relation to the respective societal contexts that imbue them with meaning. The Iban, a Dayak people indigenous to Borneo, perceive the hazards of participating in research in terms of danger to the collective. In Australia they are construed in terms of risk to individuals. Risk in medical research is one manifestation of a broader notion of ‘risk’ that is constitutive of the research enterprise itself and, we argue, fundamental to post‐industrial society. (Intern Med J 2003; 33: 463−464)
Heterogeneity of amiodarone‐induced thyrotoxicosis: evaluation of colour‐flow Doppler sonography in predicting therapeutic response
Authors: Wong R. , Cheung W. , Stockigt J. R. , Topliss D. J. 
Published: September 2003

Abstract Background:  Amiodarone‐induced thyrotoxicosis (AIT) presents a therapeutic challenge because of its resistance to standard antithyroid therapy. In iodine‐deplete environments, colour‐flow Doppler sonography (CFDS) has allowed distinction between two types of AIT: (i) Type I AIT, associated with increased vascularity (CFDS I−III) and response to thionamide antithyroid drug and (ii) type II AIT, with no/little thyroid vascularity (CFDS 0) and prednisolone responsiveness.Aim:  To clarify if CFDS patterns correlated with treatment outcomes in a retrospective study of 24 patients with AIT in an iodine‐replete environment.Methods:  Medical records of patients who presented to a teaching hospital between January 1998 to December 2000 were reviewed. Results of CFDS, ultrasound measurement of thyroid size and technetium scanning of the thyroid were correlated with treatment responses, especially prednisolone responsiveness.Results:  Thirteen of 24 patients showed CFDS 0. Twelve of these 13 were evaluable for prednisolone responsiveness, of whom seven (58%) were prednisolone‐responsive. Of 11 patients with CFDS I−III, four (36%) responded to antithyroid medication alone and only one of seven (14%) was prednisolone‐responsive. Euthyroidism was achieved twice as rapidly in patients with CFDS 0 than those with CFDS I‐III. Because of medical treatment failure, seven patients, from both CFDS groups, required urgent near‐total thyroidectomy which was successful and uncomplicated in all cases.Conclusions:  CFDS is useful in the management of AIT because CFDS 0 correlates better with prednisolone response (58%) than CFDS I−III (14%). However, unlike experience in iodine‐deficient regions, the results of the present study revealed that treatment responses to thionamide or prednisolone were heterogeneous within uniform CFDS patterns. Thus, prednisolone‐­responsiveness was not consistently predicted by CFDS 0, but the presence of flow appeared to correlate with non‐response to prednisolone. (Intern Med J 2003; 33: 420−426)
Decreased prostatic arachidonic acid in human prostatic carcinoma
Authors: Faas F.H. , Dang A.Q. , White J. , Schaefer R.F. , Johnson D.E. 
Published: September 2003

OBJECTIVETo measure prostatic and blood fatty acid composition in a large group of patients undergoing prostatectomy for benign or malignant prostate disease, as there is evidence linking arachidonic acid metabolism and prostate cancer through its role as an eicosanoid precursor, and earlier studies showed lower prostatic arachidonic acid content in a few patients.PATIENTS AND METHODSProstatic phospholipid fatty acid composition was determined in prostate tissue from 173 patients undergoing prostate surgery, i.e. radical prostatectomy, cystoprostatectomy or transurethral resection (TURP). Blood fatty acid composition was determined in 99 of these patients and in 85 undergoing prostatic needle biopsy.RESULTSThere was a significantly lower percentage of arachidonic acid in malignant than in benign portions of the prostate (15.2% vs 17%) in all patients assessed. The changes were greatest in those undergoing TURP for known prostate cancer (13.4% vs 17.2%), these patients having the greatest proportion of malignancy in the specimens. There were no consistent changes in blood fatty acid composition.CONCLUSIONThis is the first prospective study of arachidonic acids levels involving many consecutive patients undergoing prostate surgery for either benign or malignant disease. The lower prostatic arachidonic acid level is probably a result of the increased use of arachidonic acid for producing prostaglandins and/or leukotrienes. Further understanding of the cause and/or consequence of this finding might lead to a better understanding of prostate cancer.
Long‐term results of nephron‐sparing surgery for renal cell carcinoma in 114 patients: risk factors for progressive disease
Authors: Zigeuner R. , Quehenberger F. , Pummer K. , Petritsch P. , Hubmer G. 
Published: September 2003

OBJECTIVESTo evaluate risk factors for metastatic disease after nephron‐sparing surgery (NSS) for renal cell carcinoma (RCC).PATIENTS AND METHODSNSS for RCC was used 117 times in 114 patients at our institution; 61 had a normal contralateral kidney and were selected for elective NSS, and in 56 cases (53 patients) the indication for NSS was imperative. Univariate and multiple regression analysis was used to evaluate the risk factors for metastatic disease.RESULTSAfter a mean follow‐up of 80 months, there was tumour progression in 17 of the 114 patients (15%). In the univariate analysis, the tumour diameter (P = 0.03) and imperative indication (P = 0.009), and in multiple regression analysis only imperative indication, were significant risk factors for metastatic disease (P = 0.016).CONCLUSIONSElective NSS for RCC provides excellent long‐term results in selected patients, whereas those undergoing NSS imperatively are at a significantly higher risk of metastatic disease and require a close follow‐up.
Long‐term outcome of bladder papillary urothelial neoplasms of low malignant potential
Authors: Fujii Y. , Kawakami S. , Koga F. , Nemoto T. , Kihara K. 
Published: September 2003

OBJECTIVETo evaluate the long‐term outcome of bladder papillary urothelial neoplasms of low malignant potential (PUNLMP).PATIENTS AND METHODSOf 475 consecutive patients with newly diagnosed bladder tumours between 1976 and 1993, 330 (69%) had superficial (Ta and T1) tumours and 53 (11%) were diagnosed as having PUNLMP. Fifty patients (mean age at presentation 57.2 years, range 26–83; male‐to‐female ratio 6 : 1) who were followed for> 5 years or until they died, were included in the present study. All histological slides were reviewed, and fulfilled the diagnostic criteria of the 1998 World Health Organization/International Society of Urological Pathology classification system.RESULTSThe mean (median, range) follow‐up was 11.7 (10.8, 1.3–24.4) years. During the follow‐up, 30 patients (60%) had local recurrences. The 2, 5 and 10‐year recurrence‐free rates were 66%, 51% and 36%, respectively. No patients developed high‐grade or muscle‐invasive (≥ T2) carcinomas, or upper urinary tract tumours, or died from the disease. At the last follow‐up, 34 patients (68%) had been disease‐free for> 5 years.CONCLUSIONSDespite a high recurrence rate, PUNLMP carries a very low malignant potential. We agree with the use of the term ‘papillary urothelial neoplasms of low malignant potential’ instead of ‘superficial bladder carcinoma (cancer)’ for these tumours.