bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surveillance interval of endoscopic examinations for colorectal cancer screening
Authors: NOZAKI RYOICHI , SASAKI TOSHIHARU , MORITA NORIKAZU , YAMADA KAZUTAKA , TAKANO MASAHIRO , HIDAKA HISAMITSU 
Published: March 2003

Background: There have been a few evidence‐based studies concerning the relationship between the length of the surveillance interval of colonoscopic examinations and the risk of colorectal cancer (CRC). The aim of the present study was to assess the appropriate interval between endoscopic examinations for CRC screening in a retrospective cohort study.Methods: The cohort included subjects in whom cancer was not detected at the initial endoscopic examination and in whom endoscopic examination(s) was subsequently performed one or more times. The results of the endoscopic examinations performed in the mass screening for CRC between November 1983 and March 1999 were analyzed. The study end point was the detection of CRC and the detection rates of cancer were assessed among those who underwent examinations at various intervals between successive endoscopic examinations.Results: Among the 117 636 cohort subjects, 63 invasive cancer cases and 112 mucosal cancer cases were found. The odds ratio (OR) for invasive cancer was not significantly elevated even when the interval between successive examinations was over 5 years. The OR for mucosal or invasive cancer was significantly elevated among the subjects in whom the interval between successive examinations was over 5 years (OR, 1.71; 95% confidence interval (CI), 1.07–2.73), than among those in whom the interval was 1 year.Conclusions: Since prolongation of the interval between endoscopic examinations of up to 5 years did not result in any change in the cancer risk among persons who are at average risk for CRC, 5 years may be an adequate interval between endoscopic examinations in the mass screening for CRC.
Endoscopic classification of chronic gastritis based on a pilot study by the research society for gastritis
Authors: Kaminishi Michio , Yamaguchi Hirokazu , Nomura Sachiyo , Oohara Takeshi , Sakai Shigeru , Fukutomi Hisayuki , Nakahara Akira , Kashimura Hiromasa , Oda Masaya , Kitahora Tetsuji , Ichikawa Hideyuki , Yabana Tsuyosi , Yagawa Yuichi , Sugiyama Toshiro , Itabashi Masayuki , Unakami Masamitsu , Oguro Yanao , Sakita Takao 
Published: March 2003

Background: Various types of classification of gastritis have been proposed, but no plausible classification has been available until now. The Research Society for Gastritis performed a pilot study to establish an endoscopic classification, taking into consideration the following: (i) ease of use; (ii) permitting everyone the common image; and (iii) presence of histopathological evidence. Methods: One hundred and fifty‐five patients were enrolled and underwent gastroscopy. Eight basic endoscopic and histological types of gastritis (superficial, hemorrhagic, erosive, verrucous, atrophic, metaplastic, hyperplastic and special types) were defined. Gastritis was endoscopically diagnosed according to the definition of the endoscopic types of gastritis. Four or more biopsy specimens were obtained from the lesser and the greater curvatures of the antrum and the corpus of each patient, and the histological findings of gastritis and Helicobacter pylori infection were assessed. The histological diagnosis of gastritis was made according to the definition of histology types of gastritis. The endoscopic and the histological diagnoses were then compared in a blinded fashion. Results: Endoscopic diagnosis was 62% as sensitive as histological diagnosis for erosive gastritis, 67% for verrucous gastritis and 84% for atrophic gastritis in the antrum. In superficial gastritis, sensitivity was approximately 25% in the corpus, but only 8% in the antrum. Metaplastic and hyperplastic gastritis were correctly diagnosed only in severe cases. Conclusion: Five basic types of gastritis (superficial, erosive, verrucous, atrophic and special types) should be employed for the new endoscopic gastritis classification. Metaplastic and hyperplastic gastritis are considered to be subtypes of atrophic gastritis and they should be excluded from the basic endoscopic classification. A new definition of gastritis in the antrum accompanied by redness still remains to be investigated.
MODIFIED ENDOSCOPIC CONGO RED TEST: A RAPID METHOD TO VISUALIZE GASTRIC ACID SECRETION
Authors: Tóth Ervin , Sjölund Kristina , Thorlacius Henrik 
Published: March 2003

Background:  The conventional endoscopic Congo red test (CRT) permits visualization of acid‐producing mucosa. However, the CRT has not been disseminated into clinical endoscopy, which is partly due to the substantial prolongation of the gastroscopic examination.Methods:  Five healthy volunteers and 551 patients were included in a study designed to develop a more rapid approach based on the CRT. In this modified endoscopic Congo red test (MCRT), 0.2 µg/kg of pentagastrin was given intravenously to stimulate gastric acid production. The technical feasibility, tolerability, reproducibility, and inter‐ and intra‐observer reliability of the MCRT were evaluated.Results:  The MCRT was as effective as the CRT (i.e. 6 µg/kg of pentagastrin was administered intramuscularly) in visualizing the extent of acid‐producing gastric mucosa. Moreover, the MCRT significantly reduced the duration of examination by 63% (almost 8 min), compared to the CRT.Conclusions:  This MCRT is a simple, inexpensive, well‐tolerated and reproducible method with low inter‐ and intra‐observer variability and is well suited for endoscopy units with high workloads.
Mechanisms involved in hydroxycamptothecin‐induced apoptosis of gastric cancer cells
Authors: TU Shui Ping , JIANG Shi Hu , TAN Ji Hong , ZHONG Jie , QIAO Min Min , JIANG Xiao Hua , ZHANG Yong Ping , YUAN Yao Zong , WU Yun Lin , WU Yu Xin 
Published: March 2003

OBJECTIVE: Hydroxycamptothecin (HCPT) is a unique antitumor drug that acts
directly on topoisomerase I and inhibits its activity. However, the mechanism of
HCPT‐induced apoptosis is unclear. In the present study, the mechanism of HCPT‐induced
apoptosis in gastric cancer cells was investigated by detecting the expression of
p53, c‐myc, bcl‐2, bcl‐xl and bcl‐xs genes in gastric cancer cells. METHODS: Apoptosis of gastric cancer cells (SGC‐7901, MKN‐45) was determined
by terminal deoxyribonucleotidyl transferase‐mediated dUTP– digoxigenin nick‐end
labeling (TUNEL) and flow cytometry. The mRNA and protein levels of the p53,
c‐myc, bcl‐2, bcl‐xl and bcl‐xs genes were tested by reverse transcription–polymerase chain reaction analysis and immunocytochemical stain, respectively. RESULTS: Hydroxycamptothecin may induce apoptosis in different differentiated
gastric cancer cells. The effect of HCPT‐induced apoptosis on gastric cancer cells
was dependent on the dose of HCPT used and the time of exposure to HCPT. Both SGC‐7901
and MKN‐45 cells manifested some morphological features of apoptosis after 12 h exposure
to HCPT, including cell shrinkage, nuclear condensation, DNA fragmentation and formation
of apoptotic bodies. Some typical subdiploid peaks before the G0/G1
phase were observed. The apoptotic rates induced by 10 μg/mL HCPT in SGC‐7901
and MKN‐45 cells were 21.88 and 12.34%, respectively. The mRNA and protein
levels of p53 and bcl‐2 were downregulated after treatment with HCPT in SGC‐7901 cells. However, the c‐myc, bcl‐xl and bcl‐xs protein levels were unchanged in SGC‐7901 cells. In MKN‐45 cells, the mRNA and protein levels of p53 increased after treatment with HCPT, whereas the protein levels of bcl‐2, c‐myc, bcl‐xl and bcl‐xs remained unchanged. CONCLUSIONS: Our results indicate that HCPT‐induced apoptosis in gastric
cancer cells may be regulated through modulation of the expression of p53
and bcl‐2 genes.
Autofluorescence imaging analysis of gastric cancer
Authors: XIAO Shu Dong , ZHONG Liang , LUO Hong Yu , CHEN Xiao Yu , SHI Yao 
Published: March 2003

AIMS: To investigate the characteristics of gastric cancer in autofluorescence images.METHODS: A double‐channel laser scanning confocal microscope with an argon ion laser (excitation wavelength 488 nm) and helium−neon laser (excitation wavelength 543 nm) were used to detect autofluorescence from 16 gastric cancer tissue specimens and corresponding normal gastric tissue.RESULTS: Autofluorescence from normal gastric tissue produced a green‐colored image. The intensity of red color increased obviously in all gastric cancer tissues (100%) after illumination and the tissues produced a reddish‐brown‐colored image.CONCLUSIONS: A reddish‐brown image is characteristic of autofluorescence in gastric cancer detected by an argon ion laser and helium−neon laser with a double‐channel laser scanning confocal microscope. Autofluorescence imaging analysis is useful in the diagnosis of gastric cancer.
Head injury‐related road crash mortality in rural Western Australia
Authors: Stella Julian , Sprivulis Peter , Cooke Clive 
Published: March 2003

Background:  The aim of the present paper was to assess the incidence of, and identify factors associated with road crash (RC)‐related fatal head injuries in rural and metropolitan Western Australia.Methods:  Examination of demographics, driving behaviour and RC characteristics for RC fatalities involving a head injury (Abbreviated Injury Scale (AIS) ≥ 2) between 1 January 1998 and 31 December 1999 was carried out using the State Coronial ­Database.Results:  There were 328 deaths. The median age was 28 years and 74.1% of cases were male. Seventy per cent died at the scene. Of scene survivors, 89% were transferred to a metropolitan hospital before dying. Sixty per cent of total RC and 65% of at‐scene deaths occurred in rural areas. Single‐vehicle crashes comprised 45% of total crashes, of which 72.8% occurred in rural locations. Poor driver behaviour was identified in 53% of deaths. Ethanol was implicated in 29.8% of deaths, other intoxicating drugs were implicated in 19.2%, speeding was implicated in 19.5%, and lack of safety restraints/devices was implicated in 22%. Poor driver behaviour was identified in 72% of single‐vehicle deaths, compared with 38% of multivehicle crashes (P < 0.001). Rural people comprised 61% of rural crash victims. Ninety‐one per cent of rural victims died in rural crashes. The incidence of RC death associated with head injury in the rural population is 13.4 deaths/100 000 per year, more than double that for the metropolitan population (6.4 deaths/100 000 per year; P < 0.001).Conclusion:  The rural population of Western Australia is overrepresented in head injury‐related RC deaths. Single‐vehicle crashes where unsafe driving behaviour is implicated comprise a large proportion of these. Strategies to reduce unsafe driving practices aimed at rural drivers are necessary.
Do patients assess rectal bleeding accurately?
Authors: Simpson Richard R. , Kennedy Michael L. , Chew Simon B. , Lubowski David Z. 
Published: March 2003

Background:  The accuracy of a patient’s assessment of the volume of blood passed per rectum is unknown. The aim of the present study was to compare subjective estimations with known amounts of blood.Methods:  Thirty subjects (10 patients, 10 nurses and 10 doctors) made a visual estimation of four volumes of blood (0.25 mL, 10 mL, 50 mL, 200 mL), each placed in a standardized way into a toilet bowl. Subjects gave their estimations in mL, and also by drawing a line on a cup at the level to which they estimated that the amount of blood would fill the cup. Statistical analysis was carried out using Student’s t‐test. Multiple comparisons were analysed by anova.Results:  There was no significant difference between the groups in their estimations of each of the four volumes. Each group made a statistically significant overestimation for the 0.25 mL, 10 mL and 50 mL volumes with cup marking, as well as with estimation in mL (except for patients with the 50 mL volume, where there was a non‐significant overestimation). For the 200 mL volume, patients and doctors made statistically significant underestimations with cup marking, but for nurses the underestimation did not reach sig­nificance. For the 200 mL volume estimations in mL, both nurses and doctors made underestimations that were not significant.Conclusions:  Small to moderate amounts of blood in the toilet bowl are subjectively significantly overestimated, whereas larger volumes tend to be underestimated. This may have implications for the management of patients presenting with rectal bleeding.
Minimally invasive parathyroidectomy using the ‘focused’ lateral approach. II. Surgical technique
Authors: Agarwal Gaurav , Barraclough Bruce H. , Reeve Tom S. , Delbridge Leigh W. 
Published: March 2003

Background: This paper describes the technique of minimally invasive parathyroidectomy. The technique is based on a thorough understanding of the anatomy of the fascial planes in neck, the surgical pathology and embryology of parathyroid glands and precise anatomical interpretation of preoperative localization studies. Methods: Tissue trauma is minimized by using a 2.0 cm incision placed directly over the abnormal parathyroid gland and by removing the adenoma, without compromising the basic endocrine surgical principles of identification and preservation of recurrent laryngeal nerve, avoidance of any capsular breech, and ligation of the vascular pedicle. Results/Conclusions: With proper patient selection, this technique results in a failure rate of less than 4% and ensures that the incidence of complications, such as recurrent laryngeal nerve injury, remains comparable with that of standard open parathyroidectomy.
When exactly can carpal tunnel syndrome be considered work‐related?
Authors: Falkiner Sonja , Myers Stuart 
Published: March 2003

Background: Carpal tunnel syndrome (CTS), compression of the median nerve at the wrist, is the most frequently encountered peripheral entrapment neuropathy. Whilst rates of all other work‐related conditions have declined, the number of work‐related musculoskeletal disorders (which include CTS) has not changed for the past 9 years in the USA. Median days off work are also highest for CTS: 27 compared to 20 for fractures and 18 for amputations. This results in enormous Workers Compensation and other costs to the community. Awareness of CTS as a disorder associated with repeated trauma at work is now so widespread amongst workers that many have diagnosed themselves before being medically assessed, often by means of the Internet. Surprisingly, however, a definite causal relationship has not yet been established for most occupations. Although the quality of research in this area is generally poor, CTS research studies are being used as the basis for acceptance of Workers Compensation claims, substantial expensive ergonomic workplace change and even workplace closures. The fact that the incidence of work‐related musculoskeletal disorders has not changed despite these latter measures would suggest that a causal relationship is not proven and that some resources are being misdirected in CTS prevention and treatment. Method: A literature review of 64 articles on CTS was conducted. This included those articles most frequently cited as demonstrating the relationship between CTS and work. Results: Primary risk factors in the development of CTS are: being a woman of menopausal age, obesity or lack of fitness, diabetes or having a family history of diabetes, osteoarthritis of the carpometacarpal joint of the thumb, smoking, and lifetime alcohol intake. In most cases, work acts as the ‘last straw’ in CTS causation. Conclusion: Except in the case of work that involves very cold temperatures (possibly in conjunction with load and repetition) such as butchery, work is less likely than demographic and disease‐related variables to cause CTS. To label other types of work as having caused CTS, therefore, would result in inappropriate allocation of resources. It would also relieve individuals of the responsibility of addressing correctable lifestyle factors and treatable illnesses such as obesity, diabetes, smoking and increased alcohol intake which may have contributed to their CTS more that their work. This results in both avoidable long‐term health effects and ongoing costs to the community.
Electromagnetic motion analysis in the assessment of surgical skill: Relationship between time and movement
Authors: Mackay Sean , Datta Vivek , Mandalia Mirren , Bassett Paul , Darzi Ara 
Published: March 2003

Introduction:  Electromagnetic motion analysis is a promising method of assessing surgical skill in a skills‐laboratory setting. There is a very strong correlation between movement and time data, and this study was conducted to determine whether this relationship is fixed, or whether it can vary.

Methods
:
After a pilot study, four subjects were recruited. Each performed 30 trials of a simple standardized suturing task, alternating between ‘normal’, ‘precise’, and ‘fast’ strategies. The number of movements, and time to complete each task were recorded.
Results:  Comparing the ‘fast’ to ‘normal’ strategies, there was a significant decrease in total number of movements per trial (P < 0.001), and time taken (P < 0.001). Regression analysis was performed to examine the relationship between the time taken and the number of movements, and revealed significant differences between both the fast (P
= 0.006), and precise (P = 0.002) strategies, when compared to the normal strategy.
Discussion:  This study confirms that the relationship between time and movements is not fixed, but varies with the operative strategy adopted for this simple suturing task.
Relationship between elevated preoperative troponin T and adverse outcomes following cardiac surgery
Authors: Lyon William J. , Baker Robert A. , Andrew Marie J. , Tirimacco Rosy , White Graham H. , Knight John L. 
Published: March 2003

Background:  The prognostic value of troponin T (TnT) has been demonstrated in patients following a myocardial infarction. There are limited data regarding the prognostic utility of preoperative TnT in patients undergoing cardiac surgery. The aim of the present study was to determine if elevated preoperative TnT is a predictor of more complex recovery outcomes in the cardiac surgical setting.Methods:  A single preoperative TnT measurement was assessed in 696 patients undergoing isolated coronary artery bypass graft surgery. Elevated preoperative TnT levels were classified as ≥0.2 ng/mL. Preoperative, intraoperative, intensive care and postoperative events were prospectively recorded for all patients, and retrospectively reviewed for the present study.Results:  Elevated preoperative TnT levels were detected in 10% (71/696) of patients. Compared to patients with normal TnT levels, elevated preoperative TnT increased the risk of mortality at 30 days (7%vs 1%, P = 0.004, odds ratio (OR) = 6.7) and 2 years (14%vs 3%, P < 0.001, OR = 5.0), and resulted in prolonged intensive care unit (ICU) stays (P < 0.001) and longer postoperative hospitalization (P < 0.001). Elevated preoperative TnT was also associated with an increased need for perioperative and postoperative cardiovascular support, early ischaemic change and postoperative congestive cardiac failure. In multivariate analyses preoperative TnT was a significant independent predictor of 30‐day and 2‐year mortality, and duration of ICU stay.Conclusions:  Elevated preoperative TnT highlights a subgroup of cardiac surgical patients who are more likely to have a post­operative course with increased morbidity and mortality.
FATIGUE DESIGN OF SPOT‐WELDED AUSTENITIC AND DUPLEX STAINLESS SHEET STEELS
Authors: Linder J , Melander A , Larsson M , Bergengren Y 
Published: March 2003

The fatigue strength of spot‐welded stainless sheet steels has been investigated. The main part of the fatigue tests was performed on a cold rolled austenitic stainless sheet steel (AISI304) in air at ambient temperature. For comparison, a duplex stainless steel (SAF2304) of similar yield strength as AISI304 was also incorporated into the test programme. Since the fatigue strength of spot‐welded joints depends on the mode of loading, both shear‐loaded and peel‐loaded joints were tested. The fatigue strength of the spot‐welded stainless steels was found to decrease with decreasing sheet thickness. Furthermore, the fatigue strength for peel‐loaded joints is lower than that of shear‐loaded joint for sheets of equal thickness.The local loading conditions at the weld edge have been analysed in terms of finite element calculations and fracture mechanics. A design parameter derived from a fracture mechanics analysis was defined for spot‐welded stainless sheet steels. It was shown to predict the fatigue life of the present steels and joint configurations in a satisfactory way.
EFFECTS OF TEMPERATURE, CYCLIC FREQUENCY AND ENVIRONMENT ON FIBRE DEGRADATION AND FATIGUE CRACK GROWTH RESISTANCE IN A FIBRE‐REINFORCED TITANIUM METAL‐MATRIX COMPOSITE UNDER DISPLACEMENT‐RANGE LOADING
Authors: Shimojo M , Bowen P 
Published: March 2003

The fatigue crack growth resistance of a [0/90°]2s cross‐ply SCS6 fibre‐reinforced Ti–6Al–4V alloy metal‐matrix composite has been assessed under displacement range control (i.e. under load shedding conditions with crack extension) to investigate potential fibre degradation and the process of crack extension at room temperature, and at 450°C, in air and in vacuum. Attention is focused on initial conditions that will promote crack arrest at room temperature. Under the test conditions employed here, regions of crack growth can occur where the applied nominal stress intensity factor range (ΔK) is relatively constant. This ‘constant’ΔK range is the result of a fortuitous balance between the particular test‐piece geometry, loading conditions utilized, matrix crack growth and the rate of fibre fracture. It allows the influence of environment, cyclic frequency and temperature on fatigue crack growth resistance to be analysed more easily than for tests carried out under load control.The crack growth rate remained almost constant but with some steep local retardations in growth rate in the constant ΔK region at a temperature of 450°C, while crack arrest occurred at room temperature for the same initial ΔK. The average crack propagation rate in this ‘constant ΔK region’ at a temperature of 450°C in air was much greater than that at a temperature of 450°C in vacuum. This indicates that environment plays an important role in the process of fibre degradation. The effect of cyclic frequency is saturated at a frequency of less than 1 Hz. The process of crack growth at various frequencies is also discussed.
The significance of fractography for investigations of fatigue crack growth under variable‐amplitude loading
Authors: Schijve  
Published: March 2003

ABSTRACTFatigue crack growth tests were carried out on 2024‐T3 and 7075‐T6 centrally cracked specimens. Variable‐amplitude (VA) load spectra were used with periodic overload (OL) cycles added to constant‐amplitude (CA) cycles. The fatigue fracture surfaces were examined in the SEM to obtain more detailed information on crack growth contributions of different load cycles. The striation patterns could be related to the load histories. SEM observations were related with (i) delayed retardation, (ii) the effect of 10 or a single OL on retardation, (iii) crack growth during the OL cycles, and (iv) crack growth arrest after a high peak load. Fractographs exhibited local scatter of crack growth rates and sometimes a rather tortuous 3D geometry of the crack front. Indications of structurally sensitive crack growth under VA loading were obtained. Fractography appears to be indispensable for the evaluation of fatigue crack growth prediction models in view of similarities and dissimilarities between crack growth under VA and CA loading.