bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of RANTES mRNA in skin lesions of feline eosinophilic plaque
Authors: Kimura Tomoe , Kano Rui , Maeda Sadatoshi , Tsujimoto Hajime , Nagata Masahiko , Hasegawa Atsuhiko 
Published: November 2003

Abstract One of the mechanisms of eosinophil infiltration is its induction by chemoattractants such as regulated upon activation, normal T‐expressed and secreted (RANTES) which is a cysteine–cysteine chemokine that mediates chemotaxis and activation of eosinophils in humans and mice. Skin lesions of feline eosinophilic plaque are characterized by a predominant infiltration of eosinophils. The mechanism(s) of eosinophilic infiltration in the skin and/or mucosa of cats is unknown. It is possible that RANTES is involved. To investigate the presence of RANTES in the skin of cats with eosinophilic plaques and nonaffected skin, we cloned and sequenced the full‐length feline RANTES cDNA gene, in order to determine whether it is present in the skin of cats with eosinophilic plaques and/or if it is present in normal adjacent skin. We were able to document the the expression of RANTES mRNAs in skin with feline eosinophilic plaque as well as in normal cat skin. The full‐length cDNA sequence of the RANTES gene (742 bp) contained a single open reading frame of 276 bp encoding a protein of 92 amino acids. The amino acid sequence of feline RANTES shared 67 and 74% sequence identity with that of bovine and mouse RANTES genes, respectively. RT–PCR analysis on RANTES mRNA in the skin of cats with eosinophilic plaque revealed that its expression was higher in the eosinophilic plaque skin lesions than in the normal skin. The result suggested that RANTES might play a role to induce eosinophil infiltration in feline eosinophilic plaque lesions.
SUBOPTIMAL PREVENTIVE PRACTICES IN PATIENTS WITH CAROTID AND PERIPHERAL VASCULAR OCCLUSIVE DISEASE IN A TERTIARY REFERRAL SETTING
Authors: Teh Lip Gen , Sieunarine Kishore , Eikelboom John , Prendergast Frank J. , Goodman Marcel A. , Joesbury Karen , Watt Eilidth 
Published: November 2003

Background:  Effective strategies for the prevention of adverse vascular events in patients with atherosclerotic vascular disease include smoking cessation, platelet inhibition, antihypertensives, hypoglycaemic and cholesterol lowering agents. The current literature suggests that these practices are suboptimal in patients with peripheral vascular disease (PVD). This study aims to examine and compare the use of preventive therapy in patients admitted for interventions related to peripheral and carotid atherosclerotic occlusive disease.Methods:  All inpatients undergoing diagnostic or therapeutic procedures for occlusive disease of the lower limb and carotid artery at Royal Perth Hospital, Western Australia, between January 2000 and December 2000 were included in the study. Their medical charts were reviewed to measure the prevalence of the use of antithrombotic, antihypertensive and cholesterol‐lowering therapies.Results:  Medical charts of 256 patients (97%) were reviewed during the study period. Carotid related procedures accounted for 26% of the sample. Overall, 80% were prescribed antithrombotic (antiplatelet or anticoagulation) therapy at the time of discharge. In the carotid group, 97% were on some form of antithrombotic therapy as opposed to 75% in the PVD group. Antihypertensive and cholesterol lowering therapies were used in 82% and 63%, respectively, of the carotid group vs 68% and 36% in the PVD group. Rates of preventive practices were lowest in the subgroup of PVD patients without a history of coronary or cerebrovascular disease.Conclusions:  Preventive therapies are under utilized in patients with PVD. Effective strategies need to be developed to encourage the use of these adjunctive therapies in the long‐term management of vascular patients.
TRAINING OUTSIDE OF THE BOX
Authors: Hill Andrew G. , Woodfield John C. 
Published: November 2003

Background:  Developments in surgical training in Australasia allow for individualization of training to suit individual requirements. One uncommon career track is medical aid or missionary surgery in the developing world. It is difficult to receive appropriate training for this type of surgical practice in Australasia. The present paper describes a novel approach to preparing for this kind of work by spending a 6 month rotation in a mission hospital in rural East Africa.Methods:  The surgical trainee spent 5 months working at Kijabe Hospital in Kenya. This is a large mission hospital with a busy general surgical workload and adequate staffing for training.Results:  The trainee performed 214 major cases, in a broad range of general surgery, under appropriate supervision. He also took part in regular educational sessions, surgical audit, and helped to develop one of East Africa's pioneering laparoscopic surgical ­programmes.Conclusions:  The present paper demonstrates that it is possible for Australasian trainees to gain useful experience in the rural African environment, in hospitals where appropriate surgical supervision is available.
EFFECT OF CAROTID BIFURCATION LOCATION ON THE LENGTH OF INTERNAL CAROTID DISEASE
Authors: Beiles C. Barry 
Published: November 2003

Background:  A relationship between the height of the carotid bifurcation and the extent of disease in the internal carotid artery has not been reported. The aim of the present study was to determine if such a correlation exists.Methods:  Fifty‐one patients undergoing carotid endarterectomy had measurements made of the height of the carotid bifurcation from the sternoclavicular joint. The length of disease removed distal to the bifurcation after carotid endarterectomy was also measured. Correlation analysis was performed.Results:  There is a statistically significant negative correlation between the extent of disease in the internal carotid artery and the height of the bifurcation.Conclusions:  A low carotid bifurcation correlates with a longer extent of disease in the internal carotid artery.
SERUM INSULIN‐LIKE GROWTH FACTOR‐I AND INSULIN‐LIKE GROWTH FACTOR BINDING PROTEIN‐3 FOLLOWING CHEMOTHERAPY FOR ADVANCED BREAST CANCER
Authors: Holdaway Ian M. , Mason Barbara H. , Lethaby Anne E. , Singh Vijay , Harvey Vernon J. , Thompson Paul I. , Evans Barrie D. 
Published: November 2003

Background:  Insulin‐like growth factor‐I (IGF‐I) and IGF binding protein‐3 (IGFBP‐3) appear to influence the growth of breast cancer cells in vitro, and epidemiological studies suggest higher serum IGF‐I levels increase the risk of breast cancer. IGF‐I and IGFBP‐3 have therefore been measured in women with advanced breast cancer to determine if changes in serum levels predict the response to treatment by chemotherapy.Methods:  Serum IGF‐I and IGFBP‐3 levels were measured in 14 patients before and after 1 week of chemotherapy. Changes in serum levels were compared with duration of survival.Results:  Mean basal serum levels of IGF‐I and IGFBP‐3 were not significantly different between patients with advanced breast cancer and controls or women with early breast cancer. Serum IGFBP‐3 fell significantly 1 week after initiation of chemotherapy. Patient survival was not significantly related to baseline IGF‐I or IGFBP‐3 levels, but when the fall in serum levels 1 week after starting treatment was expressed either as absolute change or as a percentage of baseline, those individuals with a decrease in IGFBP‐3 greater than the median had significantly poorer survival (median survival 5.5 months vs 18 months). These results were independent of other prognostic variables such as previous disease‐free survival, and were also unaffected by the change in serum albumin with treatment. The fall in IGF‐I and IGFBP‐3 with chemotherapy mainly occurred in those with hepatic metastases, but prediction of survival was explained solely by the extent of the fall in IGFBP‐3.Conclusions:  This preliminary study has shown that serum IGFBP‐3 falls significantly following initiation of chemotherapy and the extent of reduction significantly predicts the response to treatment.
ANTERIOR TONGUE CANCER: AGE IS NOT A PREDICTOR OF OUTCOME AND SHOULD NOT ALTER TREATMENT
Authors: Veness Michael J. , Morgan Gary J. , Sathiyaseelan Yasoda , Gebski Val 
Published: November 2003

Background:  Mucosal head and neck cancers usually occur in older males after years of smoking and alcohol abuse. Despite this, approximately 5% of cases occur in young adults. The aetiology remains unclear and the anterior tongue is a prevalent site. Prognosis has been reported as worse in young patients and some have proposed a more aggressive treatment approach.Methods:  Patients diagnosed with previously untreated anterior tongue squamous cell carcinoma and treated with curative intent were identified. Retrospective and prospective data were collected. Univariate and multivariate analyses were undertaken using Cox regression analysis. The outcome of patients treated with anterior tongue cancer using a cut‐off age of 40 years was compared.Results:  Between 1980 and 2000, 106 males and 58 females with anterior tongue squamous cell carcinoma were treated at Westmead Hospital. Median follow up was 47 months (6−210 months). Twenty‐two patients (13.4%) were aged ≤40 years. Other than age, patient demographics, TNM stage and treatment approach were similar between the two groups. Eighty‐one per cent had either a T1 or T2 primary. In total, 139 patients (84.8%) had surgery or surgery and radiotherapy. A total of 56 (34%) patients experienced a recurrent event, with nodal recurrence occurring most often as the first site (n = 33, 59%). Young patients had a higher recurrence rate (45.5% vs 32.4%; P = 0.23). Relapse‐free survival at 5 years was 62% versus 81% (P = 0.27). Overall survival at 5 years was 65% versus 67% (P = 0.74).Conclusions:  In keeping with recently published evidence, young age at diagnosis with anterior tongue cancer did not portend worse outcome. There is therefore currently no strong evidence to support a different treatment approach in young patients.
DECREASED PHAGOCYTIC CAPACITY OF AUTOTRANSPLANTED SPLENIC TISSUE
Authors: Smith Eric , J. De Young Neville , Drew Paul A. 
Published: November 2003

Background:  Asplenic patients have an increased risk of infections. Operations such as autotransplantation have been proposed to restore functional splenic tissue after splenectomy, but the protective value of this tissue is unclear. Immune responses such as production of antibody remain impaired in humans and animals even when such tissue is present, and clearance of particles from the blood is reported to be less efficient than by normal spleen tissue. The present study investigated the phagocytic capacity of cells in the regenerated tissue in vitro, free of the confounding effects of hepatic clearance.Methods:  Single cell suspensions were prepared from splenic tissue from rats 6 months after splenic autotransplantation or sham operation. Phagocytosis of killed, fluorescein‐labelled bacteria was measured by flow cytometry.Results:  Autotransplanted tissue contained fewer phagocytic cells than normal tissue, and these cells phagocytosed less per cell. Phagocytosis by spleen cells was dependent on heat‐labile opsonic factors.Conclusions:  Autotransplanted splenic tissue does not restore the phagocytic capacity lost following splenectomy.
ASSOCIATION OF PERIPAPILLARY FISTULA WITH COMMON BILE DUCT STONES AND CHOLANGITIS
Authors: Karincaoglu Melih , Yildirim Bulent , Kantarceken Bulent , Aladag Murat , Hilmioglu Fatih 
Published: November 2003

Background:  Peripapillary choledochoduodenal fistula (PCDF) is occasionally detected during endoscopic retrograde cholangiopancreatography. Cholelithiasis and biliary bougienage are two suspected causes of PCDF.Methods:  The medical records for 841 patients who underwent endoscopic retrograde cholangiopancreatography between 1993 and 2002 were reviewed for evaluation of PCDF.Results:  A total of 327 patients had common bile duct stones, and 16 of these had a PCDF at the papilla of Vater. None of the 16 patients had a history of pancreatitis, duodenal ulcer, or had undergone endoscopic retrograde cholangiopancreatography previously. Seven of the 16 had not undergone biliary surgery.Conclusions:  This study indicates that PCDF is a relatively common complication of common bile duct stones and cholangitis. According to the present results, PCDF is more frequently associated with common bile duct stones than with biliary surgery and bougienage.
DISTAL PANCREATECTOMY: IS STAPLE CLOSURE BENEFICIAL?
Authors: Takeuchi Kunio , Tsuzuki Yasushi , Ando Tetsu , Sekihara Masao , Hara Takashi , Kori Takayuki , Nakajima Hiroki , Kuwano Hiroyuki 
Published: November 2003

Background:  Appropriate closure of the pancreatic remnant after distal pancreatectomy remains controversial. Data on distal pancreatectomy were reviewed to evaluate the effectiveness of staple closure compared with suture closure.Methods:  Thirty‐three patients underwent distal pancreatectomy between January 1994 and December 2001. They were subdivided according to the method of closure of the distal pancreatic stump: the staple group comprised 10 patients and the suture group comprised 23 patients. Charts were reviewed for the method of closure of the distal stump as well as for the serum and urinary amylase level, mortality and morbidity.Results:  In the staple group, no patient developed a pancreatic fistula, whereas in the suture group, eight patients (33.3%) developed a pancreatic fistula (P = 0.0353). The serum amylase level (mean ± SD) on the first postoperative day was 185 ± 71 IU/L in the staple group and 499 ± 461 IU/L in the suture group (P = 0.0413).Conclusion:  Staple closure by means of a Powered Multifire Endo GIA 60 is a simple, quick and safe alternative to the standard suture closure technique, as it reduces the incidence of pancreatic fistula.
PROXIMAL GASTRIC EXCLUSION FOR UNRESECTABLE GASTRIC CANCER
Authors: Dolan Kevin , Sue‐Ling Henry 
Published: November 2003

Background:  Patients with unresectable distal gastric cancer causing obstruction have classically undergone palliative gastrojejunostomy, but high mortality rates and delayed return of gastric emptying have been reported. The aim of the present study was to compare gastrojejunostomy and proximal gastric exclusion in patients with unresectable distal gastric cancer.Methods:  Until 1996, patients with unresectable obstructing distal gastric cancer underwent antecolic gastrojejunostomy, but since 1997 we have performed proximal gastric exclusion for these patients. Mortality, morbidity, time taken to resume oral fluids and normal diet, length of palliation and survival were compared.Results:  There was no mortality in either the gastrojejunostomy group (n = 4) or the exclusion group (n = 6). A single patient in the gastrojejunostomy group developed a sacral sore and another patient had recurrent vomiting following gastrojejunostomy. Exclusion resulted in a quicker return to diet and a slightly longer survival, although these were not statistically significant.Conclusion:  Proximal gastric exclusion offers a safe, quick and life‐enduring palliation for unresectable malignant gastric outlet obstruction.
Controlled failure design of drillstring threaded connections
Authors: KNIGHT M. J. , BRENNAN F. P. , DOVER W. D. 
Published: November 2003

ABSTRACTThe threaded connection of the type used in hydrocarbon exploration is a critical component of the drillstring that is highly susceptible to fatigue damage. Fatigue crack growth can either lead to a catastrophic failure of the connection, known as a twist‐off, or can be a non‐critical failure, known as a wash‐out. The design philosophy of Controlled Failure Design has been used in order to promote a ‘friendly’ non‐critical failure in the connection, by the controlled application of compressive residual stresses. The influence of compressive residual stress and its effect on controlling fatigue crack shape has been experimentally investigated with the development of thread root cold rolling equipment. Through the control of the cold rolling process, it has been demonstrated that fatigue crack growth can be controlled to produce a localized, non‐critical failure in the connection.
Genitourinary tract injuries in girls
Authors: Okur H. , Küçükaydin M. , Kazez A. , Turan C. , Bozkurt A. 
Published: November 2003

Objective To evaluate lower genitourinary tract injuries in girls and to propose guidelines for the investigation and initial management of this unusual injury. Patients and methods  The hospital records of 38 girls (aged 2–13 years) treated in our institution because of lower genitourinary (LG) tract injury between 1988 and 1995 were reviewed retrospectively. Urethral ruptures were detected in six patients, but the most frequent injuries were to the vulva (63%) and vagina (53%). There were pelvic fractures in eight patients and femoral fractures in a further five. Eight patients had concomitant anorectal lacerations. Vaginal and perineal lacerations were repaired primarily and a temporary urethral catheter was placed for a mean of 3 days. Partial urethral disruptions were repaired primarily over a stenting catheter in three patients. In one case, vaginal laceration and proximal complete rupture of the urethra was managed through a transvaginal approach with end‐to‐end urethral anastomosis over a stenting catheter. There was a complete rupture of the distal urethra and avulsion of the external meatus in two cases and these patients were managed by urethral advancement and meatoplasty. Results Perineal physical signs did not reflect the severity of the lesions and cystovaginoscopy allowed localization of lacerations in some cases. Primary repair was possible in all cases. Three patients (8%) had wound infection after surgery. One patient had temporary urinary incontinence which was managed conservatively and one patient had faecal incontinence which needed secondary surgery. Conclusion All female paediatric patients with suspected LG tract injury should undergo examination under anaesthesia to determine the degree of injury or possible concomitant injury to the urethra, bladder or rectum. Primary repair of these injuries is recommended.
Clinical, radiological and histological features of adrenal myelolipoma: review and experience with a further eight cases
Authors: El‐Mekresh M.M. , Abdel‐Gawad M. , El‐Diasty T. , El‐Baz M. , Ghoneim M.A. 
Published: November 2003

Objective To review published reports of surgically treated adrenal myelolipomas and report experience with a further eight cases. Patients and methods Eight patients (three men and five women, mean age 50.7 years) with adrenal myelolipoma were treated surgically because of the tumour size, symptomatology and/or associated renal pathology. Associated medical problems included hypertension in three patients and diabetes mellitus in one but none of the tumours was endocrinologically active. Results Five patients were diagnosed definitively by abdominal ultrasonography, computed tomography and angiography while the other three were incidentally diagnosed during surgical intervention for ipsilateral renal cell carcinoma in one patient, hydronephrotic kidney in another and multiple renal stones in the third. On pathological examination, the masses removed were surrounded by a thin fibrous capsule and compressed cortical tissue. A cut section was bright yellow with foci of red‐brown discoloration. Microscopically, the tumour consisted mainly of mature adipose tissue with scattered islands of haemopoietic cells. There was no operative mortality and no gross morbidity. Conclusion The management of adrenal myelolipoma should be appropriate to each individual case. Operative intervention should be reserved for symptomatic patients or those with large ‘silent’ tumours that may produce life‐threatening shock secondary to spontaneous haemorrhage. Small asymptomatic tumours with definite radiological findings can be followed expectantly.
The safety of finasteride used in benign prostatic hypertrophy: a non‐interventional observational cohort study in 14 772 patients
Authors: Wilton L. , Pearce G. , Edet E. , Freemantle S. , Stephens M.D.B. , Mann R.D. 
Published: November 2003

Objective To examine the safety of finasteride as used in general medical practice to treat benign prostatic hypertrophy (BPH). Patients and methods Information was collected on 14 772 patients who were included in an observational cohort study conducted using Prescription‐Event Monitoring. Results Finasteride was reported to have been effective in 60% of the patients in whom an opinion on efficacy was recorded. Impotence or ejaculatory failure was reported in 2.1% of the patients, decreased libido in 1% and gynaecomastia and related conditions in 0.4%. Impotence was the most frequent reason for stopping treatment with finasteride and was the most commonly reported adverse reaction to the drug. Of the patients included in the elderly cohort involved in this study, 819 (5.5%) died; none of these deaths was attributed to finasteride. Conclusion Impotence or ejaculatory failure, decreased libido and gynaecomastia in a small proportion of patients were associated with the use of finasteride. The results of this study strongly suggest that this drug is acceptably safe when used in accordance with the current prescribing information.
Free‐to‐total prostate‐specific antigen serum concentrations in patients with prostate cancer and benign prostatic hyperplasia
Authors: Wolff J.M. , Borchers H. , Effert P.J. , Habib F.K. , Jakse G. 
Published: November 2003

Objective To determine whether the proportion of total serum prostate‐specific antigen (tPSA) which is unbound or free (free PSA) offers a better discriminant for the detection of patients with prostate cancer (CaP) and those with benign prostatic hyperplasia (BPH) than does serum tPSA alone. Patients and methods In a retrospective analysis, the proportion of free PSA was determined in the sera of 60 patients with histologically confirmed localized (n=39; pT1–3NoMo) and metastatic (n=21; T2–4NxM+) CaP and 45 patients with BPH. Forty patients with urolithiasis served as a control group. Serum levels of free and total PSA were determined using a chemiluminescent enzyme immunoassay. Results Patients with CaP had a lower percentage of free PSA (localized CaP median 8.8%; metastatic CaP median 7.1%) than patients with BPH (median 19.5%) and those with urolithiasis (median 18.8%; P<0.001). The percentage of free PSA did not differ significantly between patients with clinically localized and metastatic disease. Conclusion The determination of the proportion of free PSA enhanced the discrimination between BPH and CaP and may reduce the number of unnecessary biopsies in patients with an elevated PSA. The results warrant further investigations in a broader population to improve the clinical use of serum PSA as a tumour marker for discriminating patients with an early, potentially curable CaP from men with BPH.