bluuebunny/crossref_metadata_2025_split huggingface dataset:
A measure of subjective burden for dementia care: the Caregiving Difficulty Scale – Intellectual Disability
Authors: McCallion P. , McCarron M. , Force L. T. 
Published: April 2005

AbstractBackground  It has been suggested in the literature on family caregiving for persons with Alzheimer's dementia (AD) that levels of objective and subjective burden among carers often predict institutionalization of the persons with AD. There is a paucity of measures to assess whether perceived burden among formal caregivers may also predict movement to more restrictive settings for persons with intellectual disabilities (ID) and AD. This study focused upon the development of a measure of subjective burden, The Caregiving Difficulty Scale – Intellectual Disability (CDS‐ID) as a first step in addressing this measurement deficit.Methods  An existing caregiver subjective burden scale, the Caregiving Hassles Scale (CHS) was adapted for use with 203 staff caregivers of persons with ID and AD. Preliminary testing of existing CHS items and proposed new items was carried out in two countries, Ireland and the USA. Confirmatory factor analysis with the existing items and exploratory factor analysis with existing and proposed new items for the scale was used to establish the content and test the psychometric properties of a revised scale, the CDS‐IDResults  On the existing CHS items, staff carers appeared to experience greater subjective burden than has been reported for family caregivers. However, the psychometric properties of the CHS found with this population were poor. Factor analysis produced a revised scale, the CDS‐ID with three subscales with Cronbach alphas ranging from 0.75 to 0.93 and 38 items overall.Conclusions  This new scale when used with objective burden and other scales offers an opportunity to more systematically measure the difficulties staff experience when caring for persons with ID who present with symptoms of AD.
Theory of mind deficits in children with fragile X syndrome
Authors: Cornish K. , Burack J. A. , Rahman A. , Munir F. , Russo N. , Grant C. 
Published: April 2005

AbstractBackground  Given the consistent findings of theory of mind deficits in children with autism, it would be extremely beneficial to examine the profile of theory of mind abilities in other clinical groups such as fragile X syndrome (FXS) and Down syndrome (DS).Aim  The aim of the present study was to assess whether boys with FXS are impaired in simple social situations that require them to understand their own and others’ mental states – in essence: do they have a ‘theory of mind’?Method  Well‐standardized tasks of theory of mind, the location change false belief task and the appearance–reality tasks were employed to examine whether any impairment might be specific to the FXS or part of a more generalized developmental deficit.Results  The results suggest that children with FXS do have impairment in theory of mind that is comparable to the deficit reported in other groups with learning disabilities such as DS. However, closer inspection of the impairment between these groups revealed qualitative differences in error types (realist vs. phenomenist), suggestive of atypical development that goes beyond general cognitive delay.Conclusion  The findings are discussed in terms of the teasing apart of different components of social cognition in order to identify syndrome‐specific deficiencies and proficiencies.
Reflection on SARS precautions in a severe intellectual disabilities hospital in Hong Kong
Authors: Wong S. Y. , Lim W. W. C. , Que T. L. , Au D. M. Y. 
Published: April 2005

AbstractBackground  Hong Kong went through a battle with a new respiratory disease, severe acute respiratory syndrome (SARS), from March to June 2003. All clinical settings, including rehabilitative and infirmary setting, have actively involved in fighting against the infection. The intent of this paper was to reflect on the SARS precautionary measures that had been taken in a severe intellectual disabilities hospital in Hong Kong.Methods  A review on six SARS precautionary measures were conducted. They were assessment of risk, formulation of operational guidelines, implementation of infection control measures, education and training of staff, conducting audits and carrying out environmental improvement work.Results  Patients were at risk of getting infected from carers, visitors, volunteers, and staff and patients of general hospitals. A SARS Quarantine Unit, isolation ward, was opened to isolate patients who might have had close contact with SARS patients during a stay in a general hospital or when they returned from home leave. Undoubtedly, both staff and relatives participated in preventing the patients from being infected. No day leave and home leave was reported and the number of hospitalization in general hospital was decreased during the critical period. Three infection control audits were conducted and improvement work was carried out subsequently.Conclusion  The practice of grouping within a standard isolation room is recommended to continue in the future. Moreover, intensive infection control training for all staff is of highest importance to safeguard the health of both staff and patient.
Resistance index in benign prostatic hyperplasia using power doppler imaging and clinical outcomes after transurethral vaporization of the prostate
Authors: TSURU NOBUO , KURITA YUTAKA , SUZUKI KAZUO , FUJITA KIMIO 
Published: April 2005

Abstract  Background:  Using power Doppler ultrasonography (PDUS), we investigate the change of resistance index (RI) before and after transurethral vaporization of the prostate (TUVP) in benign prostatic hyperplasia (BPH) patients.Methods:  In all, 49 patients underwent transrectal PDUS before receiving TUVP, three were excluded because of cancer and three could not be followed up. The remaining 43 were enrolled in the present study. Patients were assessed before and 1, 3 and 6 months after surgery, giving a mean duration of follow‐up of 9.1 months. International prostate symptom scores (IPSS), quality of life (QOL) scores, postvoiding residual urine volumes (PVR) and maximum urinary flow rates (Qmax) were evaluated and total prostatic volume (TPV) and RI were measured using PDUS.Results:  Resistance index ranged from 0.64 to 0.91. The postoperative parameters except for RI, such as TPV, PVR, IPSS and QOL scores improved significantly at the follow‐up assessment after surgery. The elevated RI decreased significantly 1, 3 and 6 months after the treatment. Resistance index significantly decreased after TUVP and IPSS and other urodymamics parameters improved.Conclusions:  The present study suggested that RI could evaluate the severity of BPH and the degree of intraprostatic pressure or bladder outlet obstruction.
The long‐term voiding function and sexual function after pelvic nerve‐sparing radical surgery for rectal cancer
Authors: AMEDA KANAME , KAKIZAKI HIDEHIRO , KOYANAGI TOMOHIKO , HIRAKAWA KAZUSHI , KUSUMI TAKAYA , HOSOKAWA MASAO 
Published: April 2005

Abstract  Background:  The aim of the present study is to symptomatically analyze the extent to which pelvic nerve‐sparing radical surgery for rectal cancer impacts on long‐term voiding and male sexual function.Methods:  A self‐administered questionnaire was mailed to 68 patients who underwent pelvic nerve‐sparing radical surgery for invasive rectal cancer with 52 responses (28 men and 24 women; 27 complete and 25 incomplete preservation; response rate 76.5%). Each patient was asked to record if there had been any changes in lower urinary tract symptoms after surgery. Sexual function was also investigated in men.Results:  Of the 52 patients, 48 (92%) maintained voluntary voiding without catheterization in the long term. Clean intermittent self‐catheterization was performed in only four patients with incomplete preservation because of persistent voiding dysfunction. Subjectively, approximately 60% of the patients remained unchanged in lower urinary tract symptoms after surgery. The satisfaction rate regarding the current voiding status was significantly higher in women than in men (83% versus 61%, P = 0.0294), but was not significantly different between those with complete (76%) and incomplete preservation (64%). Despite the acceptable urinary status, 88% of men had some deterioration in the erectile function, regardless of the types of surgical procedures. Overall, 64% of men were unsatisfied with the current sexual function.Conclusions:  Pelvic nerve‐sparing radical surgery for rectal cancer preserved the long‐term voiding function in the majority of patients. In completely preserved patients and in women, symptomatic outcomes were more satisfactory. Postoperative erectile dysfunction was found to be a serious problem, even in complete nerve‐sparing procedure.
Lectin‐reactive alpha‐fetoprotein as a marker for testicular tumor activity
Authors: KAWAI KOJI , KOJIMA TAKAHIRO , MIYANAGA NAOTO , HATTORI KAZUNORI , HINOTSU SHIRO , SHIMAZUI TORU , AKAZA HIDEYUKI 
Published: April 2005

Abstract  Background:  Lens culinaris agglutin (LCA)‐affinity electrophoresis resolves serum α‐fetoprotein (AFP) into three isoforms, AFP‐L1, ‐L2 and ‐L3. The ratio of AFP‐L3 to total AFP (AFP‐L3%) is frequently high in hepatocellular carcinoma (HCC) patients, and thus, it is widely used for early diagnosis of HCC. In the present study, we used the subfraction profile of LCA‐binding AFP to diagnose and monitor testicular tumor activity.Methods:  Serum samples were collected from 21 testicular tumor patients, and the LCA‐reactive fractions were determined by LCA‐affinity electrophoresis coupled with antibody‐affinity blotting. The histological diagnosis was non‐seminomatous germ cell tumor (NSGCT) in 15 patients and pure seminoma in six patients.Results:  Serum AFP levels were abnormally elevated (>20 ng/mL) in 10 of 15 NSGCT patients. One NSGCT patient and two seminoma patients showed borderline AFP levels between 10 and 20 ng/mL. LCA‐reactive AFP was detected in all 11 NSGCT patients with serum AFP levels above 10 ng/mL, but not in the two seminoma patients with serum AFP levels above 10 ng/mL. In testicular tumor patients, the broad band of AFP‐L2 could not be completely separated from AFP‐L3. The mean ratio of AFP‐L3 plus AFP‐L2 (AFP‐L2 + 3%) was as high as 94% (range 80–99%) in these patients. Serial determinations of LCA‐reactive fractions were performed in eight of the 11 LCA‐reactive AFP‐positive patients. They included five patients who received chemotherapy, and three patients who underwent orchiectomy for stage I NSGCT. In three of eight patients, LCA‐reactive AFP was detected even after normalization of total AFP levels. All three patients relapsed, with elevation of serum AFP within several months.Conclusion:  Determination of LCA‐reactive AFP might be a useful marker for testicular tumor activity in patients with lower AFP levels.
Presentation and therapy of myelolipoma
Authors: MEYER ANDREAS , BEHREND MATTHIAS 
Published: April 2005

Abstract  Background:  Adrenal myelolipoma is a rare and benign, hormonally inactive tumor frequently discovered incidentally. Because of the increasing rate of detection of adrenal myelolipoma, use of the correct diagnostic examination and treatment, with respect to surgical excision or regular controls, is continually gaining importance. We report herein on the largest series of surgically treated patients with adrenal myelolipoma from a single institute.Methods:  The clinical charts of 12 patients who underwent adrenal surgery for myelolipoma were reviewed. Follow up was carried out by means of re‐examination or by personal contact with the primary physician. It was possible to perform a re‐examination on eight of the 12 patients 6.9 years after the operation: one patient had died 5.2 years after surgery.Results:  Diagnosis of adrenal myelolipoma was made incidentally in seven patients, and during examination for reasons of unspecific abdominal or flank pain in five patients. A transabdominal approach was taken in five patients, a subcostal approach was taken in three patients and a translumbal approach was taken in four patients. At the follow up, all formerly symptomatic patients were free of symptoms. No recurrence could be seen; however, in one patient a contralateral adrenal myelolipoma had developed.Conclusions:  Symptomatic tumors, growing tumors or tumors larger than 10 cm should be excised surgically by means of an endoscopic or conventional approach, depending on the size. Surgical indication should not be liberalized by the introduction of more gentle operative techniques such as the translumbal or the endoscopic approach. A close follow up should be maintained in the case of patients free of symptoms, and for those with a definite diagnosis from imaging procedures.
Prognostic significance of vascular invasion in patients with bladder cancer who underwent radical cystectomy
Authors: HARADA KEN‐ICHI , SAKAI IORI , HARA ISAO , ETO HIROSHI , MIYAKE HIDEAKI 
Published: April 2005

Abstract  Background:  The objective of this study was to determine whether vascular invasion (i.e. lymphatic and blood vessel invasion) could be a useful prognostic predictor in patients with locally invasive transitional cell carcinoma (TCC) of the bladder who underwent radical cystectomy.Methods:  This series included 114 consecutive patients undergoing radical cystectomy for primary TCC of the bladder between November 1989 and July 2003. Several clinicopathological characteristics of these patients were analyzed, focusing on the association between vascular invasion and disease recurrence after radical cystectomy.Results:  Lymphatic and blood vessel invasions were detected in 55 (48.2%) and 33 (29.8%) specimens, respectively. Lymphatic invasion was significantly associated with pathological stage, tumor grade, lymph node metastasis, blood vessel invasion and disease recurrence, whereas blood vessel invasion was significantly related to pathological stage, lymph node metastasis, lymphatic invasion and disease recurrence. Recurrence‐free survival in patients with lymphatic invasion was significantly lower than that in those without lymphatic invasion, and a similar significant difference in recurrence‐free survival was observed between patients with and without blood vessel invasion. However, multivariate analysis using the Cox proportional hazards model showed that only pathological stage and lymph node metastasis could be used as independent predictors for disease recurrence after radical cystectomy.Conclusions:  Despite a significant association between several prognostic parameters, vascular invasion was not an independent predictor of disease recurrence; therefore, if there are other conventional parameters available, there might not be any additional advantage to considering the presence of vascular invasion when predicting the prognosis of patients undergoing radical cystectomy for TCC of the bladder.
Study of a rat model for calcium oxalate crystal formation without severe renal damage in selected conditions
Authors: YAMAGUCHI SATOSHI , WIESSNER JOHN H , HASEGAWA ANDREW T , HUNG LINDA Y , MANDEL GRETCHEN S , MANDEL NEIL S 
Published: April 2005

Abstract  Background:  Although nephrotoxic in high doses, ethylene glycol (EG) has been used with ammonium chloride (NH4Cl) or vitamin D3 to study calcium oxalate stone formation in rat models. In the present study we used EG alone or with NH4Cl to study hyperoxaluria, crystaluria, and crystal attachment to renal epithelial cells in rats with minimal renal damage.Methods:  Six‐week‐old male Sprague–Dawley (SD) rats were given food and special drinking water. In experiment 1 the drinking water contained 1.0% NH4Cl plus four different concentrations of EG (0.8%, 0.4%, 0.2%, 0.1%). In experiment 2 the drinking water contained EG alone (0.8%, 0.4%, 0.2%, 0.1%). Urine was collected for 24 h before the rats were sacrificed. In experiment 1 the rats were sacrificed 5–13 days after starting the special water. In experiment 2 the rats were sacrificed 7–21 days after starting the special water. Bladder urine was also obtained. Blood and urine were tested for calcium, phosphorus, and creatinine. In addition, urine was tested for pH, oxalate and N‐acetyl‐β‐D glucosaminidase (NAG). Kidney sections were stained with hematoxylin‐eosin, von Kossa and Pizzolato stain. Crystal morphology was determined using polarizing microscopy, and composition was determined using high‐resolution X‐ray powder diffraction.Results:  Experiment 1: Aggravation of renal function, an increase in urinary oxalate and NAG excretion, and crystals observed in the kidneys all correlated with EG concentration and length of drinking time. In bladder urine, calcium oxalate monohydrate (COM) crystals exceeded calcium oxalate dihydrate (COD) crystals. Experiment 2: Renal function remained unchanged. Oxalate excretion increased and NAG increased slightly. Crystals occurred only in the papillary tip region. Crystals in bladder urine were mostly COD.Conclusion:  In the current rat model, calcium oxalate crystaluria could be induced without severe renal damage in selected cases. Either and/or both COM and COD might form and interact with kidney epithelium. We propose different experimental conditions to study the various phases of calcium oxalate stone formation in young male SD rats.
The relationship of magnesium intake to serum and urinary calcium and magnesium levels in Trinidadian stone formers
Authors: ANATOL TREVOR I , PEREIRA LEXLEY PINTO , MATTHEW JASON , SAWH LALL 
Published: April 2005

Abstract  Background:  The present study was undertaken to investigate the relationship between the dietary intake of magnesium and the serum and urinary levels of calcium and magnesium in a group of Trinidadian stone formers.Methods:  A group of 102 confirmed stone formers presenting to urological clinics were interviewed using a questionnaire designed to obtain a semi‐quantitative estimate of their oral magnesium intake. Patients were invited to give blood samples for serum calcium and magnesium levels and to provide 24‐h urine specimens for the measurement of urinary levels of these minerals, as well as total urinary volumes. A group of 102 controls was subjected to a similar interview and blood and urinary testing. Chi‐square tests and Student's t‐tests were used to examine group demographic differences. The Mann–Whitney test investigated differences in biochemical indices. Binary logistic regression was used to identify predictors of stone formation.Results:  Blood samples were obtained from 60 patients and 98 controls. Urine samples were returned by 34 patients and 97 controls. Only 10 stones were retrieved from patients. Patients had a significantly lower magnesium intake, but higher median serum and urinary calcium levels, and higher serum calcium to magnesium ratios than controls. Independent variables capable of predicting stone formation included total magnesium intake and serum and urinary calcium levels.Conclusions:  Increased serum and urinary calcium levels, calcium to magnesium ratios, and a low magnesium intake were predictive of stone formation in this Trinidadian population.
Intussusception of the bladder neck does not promote early restoration to urinary continence after non‐nerve‐sparing radical retropubic prostatectomy
Authors: SAKAI IORI , HARADA KEN‐ICHI , HARA ISAO , ETO HIROSHI , MIYAKE HIDEAKI 
Published: April 2005

Abstract  Background:  The objectives of the present study were to investigate whether buttressing sutures, which prevent the bladder neck from pulling open as the bladder fills, can promote earlier recovery from urinary incontinence after radical retropubic prostatectomy (RRP) and to identify possible risk factors associated with urinary incontinence after RRP.Methods:  The present study included 72 patients who underwent non‐nerve‐sparing RRP without neoadjuvant therapy between January and December 2003. Among these 72 patients, intussusception of the bladder neck was performed in 24 who consented to this procedure. In the present series, continence was defined as the absence of any need to use sanitary pads or diapers. Continence was evaluated by a patient interview 1, 3 and 6 months after RRP.Results:  There were no significant differences in clinicopathological characteristics between patients with and without intussusception of the bladder neck. The percentage of continent patients 1, 3 and 6 months after RRP was 34.7%, 63.9% and 95.8%, respectively, and there were no significant differences in continence between the two groups at any time point. Among several factors examined, only bladder neck preservation was an independent predictor of recovery from urinary incontinence 1 and 3 months after RRP.Conclusions:  These findings suggest that it would be important to preserve the bladder neck for early return to continence after non‐nerve‐sparing RRP; however, intussusception of the bladder neck may not offer significant improvement in earlier return of urinary control.
Sebaceous gland carcinoma of the eyelid presenting as a conjunctival papilloma
Authors: Khong Jwu Jin , Leibovitch Igal , Selva Dinesh , Dodd Thomas , Muecke James 
Published: April 2005

AbstractAn unusual presentation of sebaceous carcinoma of the eyelid is described in a 96‐year‐old man who presented with a large papillomatous palpebral conjunctival lesion in the left upper eyelid. The patient underwent a shave excision of the lesion, followed by a full thickness excision with paraffin section margin control. Histopathology revealed a sebaceous gland carcinoma with no evidence of pagetoid spread. Although rare, sebaceous gland carcinoma should be considered in the differential diagnosis of a conjunctival papilloma.
Periorbital ecchymosis as a sign of perforating injury of the globe
Authors: Ghazi‐Nouri Seyed M , Vote Brendan J , Sullivan Paul M 
Published: April 2005

AbstractThe distinction between penetrating eye injury with retained intraocular foreign body and perforating globe injuries is not always easy clinically. The case is presented of a 25‐year‐old man who sustained a perforating eye injury that was through a clear self‐sealing corneal entry site and had no conjunctival or periorbital injury. He had periorbital ecchymosis on presentation suggesting that the globe had been perforated with resulting retro‐orbital blood tracking to the periorbital region. This sign would not be expected had the foreign body remained intraocular. The management options of these cases are discussed.
Clinical Case Notes
Authors: Wakely Laura A , Small Keith M , Long Helen M , Maslin Keith F , Wells Anthony P 
Published: April 2005

AbstractThe case is presented of a highly aggressive congenital epithelial cyst of the anterior chamber. The patient underwent four primary procedures to remove the cyst and its three recurrences, and one procedure for secondary glaucoma. The primary cyst and first recurrence occurred in the anterior chamber, whereas the second and third recurrences occurred in the pars plana region. Attempts at optical correction of the eye were weighed against complications arising from further procedures, and a conservative approach favouring preservation of the eye became the management strategy in this case.