bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome and number of cataract surgeries in India: policy issues for blindness control
Authors: Dandona Lalit , Dandona Rakhi , Anand Raj , Srinivas Marmamula , Rajashekar Varda 
Published: March 2003

Abstract Purpose: To assess what impact attention to quality of cataract surgery and postoperative follow up can have on cataract blindness in India, and to estimate the number of surgeries needed to eliminate cataract blindness in India. Methods: In a population‐based sample of 5268 persons in two rural areas in the state of Andhra Pradesh, India, data on the visual outcome of cataract surgery were obtained on 129 eyes of 106 persons operated previously. These were compared with the visual outcome of cataract surgery performed during 1999 in 2394 eyes of 2213 persons at two new rural eye centres set up in these areas that pay particular attention to the quality of eye care. Blindness in an eye was defined as presenting distance visual acuity less than 6/60, and in a person as this acuity level in the better eye. These data were extrapolated to India. Results: In the population‐based sample, of the 129 operated eyes, 51 (39.5%) were blind after surgery, which included 41 (31.8%) from cataract surgery‐related causes. Of the 106 persons in the population sample who had had cataract surgery in one or both eyes, 26 (24.5%) were still blind. In contrast, for the cataract surgery at the two rural eye centres paying attention to quality, 3.1% of the eyes and 1.8% of the persons were blind soon after surgery, but these figures could increase 2.6 times over the lifetime of these persons. The 3.5 million cataract surgeries in India in 2000 are estimated to result in 0.32 million persons having blindness averted over their lifetime. To eliminate cataract blindness in India, an estimated 9 million good‐quality cataract surgeries are needed every year during 2001−2005, increasing to over 14 million surgeries needed every year during 2016−2020 on persons most likely to go blind from cataract. Conclusions: The number of persons in whom blindness is being averted due to cataract surgery in India is currently a very small fraction of the number blind from cataract. If adequate attention is given to the quality of eye care, for the current number of cataract surgeries in India it should be possible to increase by threefold the number in whom blindness can be averted with cataract surgery. In addition to improving quality, the annual number of cataract surgeries has to be at least threefold the current number during 2006−2010 if cataract blindness in India is to be eliminated.
Hemodynamic evaluation of rectal varices by endoscopic color Doppler ultrasonography
Authors: Sato Takahiro , Yamazaki Katsu , Toyota Jouji , Karino Yoshiyasu , Ohmura Takumi , Suga Toshihiro 
Published: March 2003

Background: Rectal varices are an infrequent but potentially serious cause of hematochezia. In this paper, the hemodynamics of rectal varices using endoscopic color Doppler ultrasonography (ECDUS) are evaluated.Method: This study consisted of six rectal variceal patients who had F2 type of the rectum, and four of the six had a positive red color sign. We monitored the color flow images of rectal varices.Results: Color flow images of rectal varices were obtained in all six patients. Color flow images of inflow and outflow vessels of rectal varices were obtained in all six patients. We performed endoscopic injection sclerotherapy (EIS) on three of the six patients. After EIS, ECDUS revealed the disappearance of the variceal blood flow in one case, and the decrease of blood flow in two cases.Conclusion: The technique of ECDUS is a useful modality for detecting rectal varices on color flow images and for evaluating the therapeutic effects of EIS.
Efficacy of Argon Plasma Coagulation for Bleeding Gastroduodenal Ulcers
Authors: Asakura Yasushi , Imai Yukinori , Arai Shin , Kinoshita Manabu , Kakinuma Toru , Kakoi Kotaro , Rai Fumie , Eguchi Yuichiro , Fujiwara Kenji , Ota Shinichi 
Published: March 2003

Background:  Argon plasma coagulation (APC) can achieve an effective coagulation of large areas with a relatively shallow but well‐controlled and uniform coagulation depth. There are only a few reports of APC therapy applied to bleeding peptic ulcers, especially ulcers with exposed vessels.Methods:  The aim of this study is to evaluate the usefulness of APC as a means of achieving endoscopic hemostasis for bleeding gastroduodenal ulcers. Thirty‐nine patients having these ulcers were treated with APC.Results:  The success rates for initial hemostasis and complete hemostasis with APC are 87% and 97.4%, respectively. These results are almost equal to those of injection therapy and hemoclip. Six cases that re‐bled after other hemostatic procedures obtained complete hemostasis finally with APC. In one ineffective case of APC, complete endoscopic hemostasis was achieved with hemoclip.Conclusion:  Argon plasma coagulation therapy is an effective therapeutic alternative in endoscopic hemostasis for bleeding peptic ulcers.
Anorectal manometric abnormalities and effect of cisapride in patients with chronic idiopathic constipation
Authors: Duowu Zou , Guoming Xu , Zhaoshen Li , Ning Yin 
Published: March 2003

OBJECTIVES: To investigate abnormalities in anorectal motility, changes in rectal visceral perception of balloon distention and the effect of cisapride on patients with chronic idiopathic constipation (CIC). METHODS: Anorectal manometry was carried out in 30 CIC patients using the Synectics Visceral Stimulator combined with PcPolygraf before and after treatment with cisapride (10 mg three times daily for 4 weeks). Twenty age‐matched controls were also studied before cisapride therapy. RESULTS: Patients with CIC had lower anorectal sphincter squeeze pressures (P < 0.05), larger minimum relaxation volumes necessary to elicit the anorectal inhibitory reflux (P < 0.05), higher rectal defecation volume thresholds and higher rectal maximum tolerable volume thresholds (P < 0.01) compared with the controls. All of the abnormalities significantly improved and defecation frequency greatly increased after 4 weeks of cisapride therapy (P < 0.01). Cisapride was effective in 46.67% of patients with CIC. CONCLUSIONS: Patients with CIC have abnormalities of both anorectal motility and rectal visceral perception of balloon distention. Cisapride can improve these abnormalities and is effective in approximately one‐half of CIC cases.
Effect of release‐controlled nifedipine on portal hemodynamics in cirrhotic patients
Authors: Chengyong Qin , Dongxing Liu , Juren Zhu , Lina Fu , Zhaohai Wan , Guoquan Zhang , Tao Jia 
Published: March 2003

OBJECTIVE: To evaluate the therapeutic effect of release‐controlled nifedipine on portal hypertension. METHODS: Thirty‐two cirrhotic patients were enrolled to investigate, by using duplex Doppler ultrasonography, differences in portal hemodynamics before and after treatment with release‐controlled nifedipine (30 mg once per day). RESULTS: After taking nifedipine, the diameter, blood velocity and blood flow of the portal vein decreased, but only the change in velocity was statistically significant. After treatment, the congestion index increased, and the blood velocity and blood flow of the splenic vein significantly decreased. The resistance and pulsatile indices of the right hepatic and splenic arteries also decreased markedly. The total hepatic blood flow was elevated slightly and there were no significant changes in mean arterial pressure and heart rate. CONCLUSIONS: The resistance and pulsatile indices of the hepatic and splenic arteries are representative indices of portal resistance. Release‐controlled nifedipine may decrease portal pressure by the following mechanisms: (i) decrease of systemic blood pressure triggers the sympathetic reflex, leading to splanchnic artery constriction and portal blood flow reduction; (ii) dilatation of the portal vein and sinusoids leads to decrease portal resistance; and (iii) dilatation of the collateral veins. Nifedipine has no significant effect on systemic circulation in normotensive cirrhotic patients, therefore it has good prospects as a drug for clinical use in portal hypertension.
Preliminary assessment of miniprobe sonography in the diagnosis of gastric varices and evaluation of treatment with Histoacryl
Authors: Qi Zhu , Yunlin Wu , Jiayu Xu 
Published: March 2003

OBJECTIVE: In comparison with conventional endoscopy, the clinical value of miniprobe sonography (MPS) was assessed both in the diagnosis of gastric varices (GV) and in the evaluation of its treatment with the tissue adhesive agent Histoacryl. METHODS: Twelve patients with liver cirrhosis and portal hypertension caused by hepatitis B in nine cases and hepatitis C in three cases were examined by MPS to verify the presence of gastric fundic varices before and after endoscopic treatment with Histoacryl. Curative efficacy of Histoacryl treatment was defined by the finding of variceal lumen obliteration characteristics in the ultrasonic image. RESULTS: Gastric fundic varices were detected in 10 patients by using MPS, however, only seven cases were detected by using conventional macroscopic examination. For gastric fundic varices, the diagnostic accuracies of standard endoscopy and MPS were 75% (9/12) and 100% (12/12), respectively. Furthermore, MPS was able to produce a practical ultrasonic image of complete or incomplete variceal vessel lumen obliteration for use in the assessment of the efficacy of endoscopic treatment with Histoacryl. CONCLUSIONS: Miniprobe sonography was found to be significantly superior to conventional macroscopic diagnosis in both the detection of fundic varices and the evaluation of the efficacy of endoscopic therapy. Moreover, MPS could play an important role in follow up and in evaluation of the need for further treatment. Therefore, MPS appears to be a safe and very useful clinical technique in evaluating patients with portal hypertension with respect to the detection of fundic varices and may help in selecting patients for appropriate therapy.
Beneficial effects of growth hormone on bacterial translocation during the course of acute necrotizing pancreatitis in rats
Authors: Xingpeng Wang , Bingxian Wang , Jianxin Wu , Guoliang Wang 
Published: March 2003

OBJECTIVE: Because bacterial translocation from the gut is one of the important sources of bacterial infection in acute necrotizing pancreatitis (ANP), and growth hormone (GH) has the ability to promote intestinal epithelial proliferation, we investigated the effects of GH on bacterial translocation in a rat ANP model. METHODS: Acute necrotizing pancreatitis was induced in rats via injection of 5% sodium taurocholate into the biliopancreatic duct. The rats with ANP were treated with either human recombinant GH or a placebo. Laparotomized animals without ANP induction (sham operation) served as controls. Twenty‐four hours after the operation, blood was drawn for bacterial culture and determinations of amylase, lipase and endotoxin. Peritoneal fluid and specimens of mesenteric lymph nodes (MLN), liver, pancreas and spleen were taken for bacterial culture by standard techniques. Intestinal mucosal permeability was assessed by measuring the movement of [125I]‐labeled albumin from blood to the intestinal lumen. Insulin‐like growth factor‐1 (IGF‐1) mRNA was detected in the liver and ileum by reverse transcription–polymerase chain reaction (RT‐PCR). Morphological changes in the pancreas and ileum were also analyzed. RESULTS: Administration of GH significantly decreased the activity of serum amylase and lipase, decreased the plasma endotoxin level and reduced the incidence of bacterial translocation. Moreover, the survival rate of ANP rats was improved. The severity of inflammation in the pancreas and ileum was reduced by GH treatment. Ileal mucosal thickness, villus height and crypt depth in GH‐treated rats were obviously increased as compared with those of ANP rats. The intestinal permeability was markedly decreased in the GH group as compared with the ANP group. GH treatment resulted in upregulation of IGF‐1 mRNA expression in ileum, but not in liver. CONCLUSIONS: These results suggest that exogenous GH has beneficial effects in maintaining the integrity of the intestinal mucosal barrier and reducing the incidence of bacterial translocation in rats with ANP. One of the mechanisms might be the upregulation of IGF‐1 mRNA in the intestine by GH.
Screening of gastric cancer cell sublines using the adhesion method
Authors: Chen Xiangrong , Ren Weiping , Dong Jufang , Xiao Shudong , Sloane Bonnie F. 
Published: March 2003

OBJECTIVE: To screen subpopulations of gastric cancer cell lines with different malignant phenotypes. METHODS: Two subpopulations from the human gastric cancer cell line MKN‐45 were separated by using the laminin adhesion method. One subpopulation was less invasive and non‐metastatic, whereas the other was more invasive and metastatic. The relative invasiveness and migratory capacities of the two subgroups were observed by using the Boyden chamber and by inoculating the cells into nude mice. RESULTS: The two subgroups, the laminin‐adherent cells (Lm+) and the laminin non‐adherent cells (Lm–), were separated. During in vitro experiments, the Lm+ cells were more invasive and their migratory ability was greater relative to the Lm– cells. The rates of tumor formation after subcutaneous inoculation in nude mice and of lung tumor foci formation after tail vein inoculation were higher in Lm+ cells than those in Lm– cells. In vivo, Lm+ cells were found to have higher metastatic potential and to be more invasive. CONCLUSIONS: In vitro, the adhesion method is a simple and time‐saving way to screen a particular phenotypic cell subpopulation with a high success rate. There are discrepancies in invasiveness and migratory ability between in vitro Lm+ and Lm– cells, which suggests that these properties of gastric cancer cells are closely related to their adhesiveness to the basement membrane and extracellular matrix.
Effect of vitamin E and selenium on the tissue inhibitor of metalloproteinase‐1 mRNA expression in hepatic stellate cells
Authors: Li Xuanhai , Wang Yuqin , Cheng Wufeng , Wang Danyi , Li Feng 
Published: March 2003

OBJECTIVE: To investigate the effects of vitamin E and different doses of selenium on the expression of the tissue inhibitor of metalloproteinase‐1 (TIMP‐1) mRNA in the hepatic stellate cells (HSC) of CCl4‐induced hepato‐fibrotic rats. The mechanism of these therapeutic actions is investigated at a molecular level. METHODS: Hepatic fibroses were induced by intraperitoneal injection of 40% CCl4 in olive oil and treated by dietary supplementation with vitamin E and different doses of selenium. Liver tissue sections were stained with routine hematoxylin and eosin staining and Masson trichrome staining for collagen. With β‐actin as an internal control, the reverse transcriptase–polymerase chain reaction (RT‐PCR) method was applied to quantify the change of TIMP‐1 mRNA in HSC. RESULTS: The expression level of TIMP‐1 mRNA in HSC was significantly downregulated and collagenous fiber proliferation in the liver was also significantly reduced in the groups of rats treated with vitamin E (250 mg/kg) and low dosages of selenium (0.2 mg/kg). However, the expression of TIMP‐1 mRNA was upregulated, but not significantly, in the group treated with high dosages of selenium (1.0 mg/kg). CONCLUSIONS: The expression level of TIMP‐1 mRNA in HSC was significantly downregulated and collagenous fiber proliferation in the liver was significantly reduced in the groups of rats treated with vitamin E and appropriate dosages of selenium. This did not occur in groups with high dosages of selenium.
Establishment of a trinitrobenzene sulfonic acid‐induced rat colitis model
Authors: WANG Hao , OUYANG Qin , HU Ren Wei 
Published: March 2003

OBJECTIVE: To set up a trinitrobenzene sulfonic acid (TNBS)‐induced colitis model in the rat and to assess its value in research studies of inflammatory bowel disease (IBD). METHODS: A 0.85‐mL enema containing 30 mg TNBS dissolved in 50% ethanol was instilled into the rat colon to induce distal colitis. Control rats were instilled with 50% ethanol or TNBS/saline alone. Macroscopic histological changes of the colon and myeloperoxidase (MPO) activity of the mucosa were evaluated. RESULTS: One week after the TNBS/ethanol enema, hyperemia, edema and ulceration of the colonic mucosa appeared with predominant infiltration of polymorphonuclear leukocytes in the distal colon. Four weeks after TNBS/ethanol enema, ulcers had healed macroscopically and lymphocytes and plasma cells became predominant. The tissue MPO activity increased on the first day after the TNBS/ethanol enema and this increase in MPO activity lasted for 3 weeks, but declined 4 weeks after the TNBS/ethanol enema. In contrast, macroscopic, histological changes and MPO activity returned to normal levels in control rats within the first week. CONCLUSIONS: Trinitrobenzene sulfonic acid/ ethanol‐induced rat distal colitis is an ideal model of IBD and may serve as a tool for the investigation of the pathogenesis of and effects of pharmaceuticals on IBD.
Transcription of interleukin‐8 in gastric epithelial cells by Helicobacter pylori isolated from Chinese patients
Authors: LI Shu De , XU Guo Ming , LI Zhao Shen , JI Xu Huai , CRABTREE JE 
Published: March 2003

OBJECTIVE:  To observe the effect of the vacA genotype and the cag pathogenicity island (cag PAI) of Helicobacter pylori isolated from Chinese patients on the transcription of interleukin‐8 (IL‐8) in gastric epithelial cells.METHODS:  The vacA genotype and the existence of the cag PAI in strains of H. pylori were determined by gene sequencing and Southern blotting, respectively. L5F11 gastric epithelial cells carrying the IL‐8 report gene were cocultured with the bacteria; transcription of IL‐8 was indicated by luciferase activity and cytotoxin activity was detected by using a HeLa cell vacuolating assay.RESULTS:  Strains with a complete cag PAI (n
= 15) were able to induce luciferase transcription to a greater extent than the wild‐type cag‐negative strain G50[(0.47 ± 0.09) × 106 c.p.m. vs (0.13 ± 0.02) × 106 c.p.m.; P < 0.01]. There was no difference in the luciferase activity induced by strains with partial cag (n
= 4) and by G50[(0.23 ± 0.08) × 106 c.p.m. vs (0.13 ± 0.02) × 106 c.p.m.; P > 0.05)]. No difference was found in the luciferase activity induced by the strains with vacA s1/m1 (n
= 5) and the strains with s1/m2 (n
= 14) [(0.29 ± 0.12) × 106 c..p.m. vs (0.53 ± 0.41) × 106 c.p.m.; P > 0.05] although the former had much higher vacuolating cytotoxin activity than the latter (P < 0.001).CONCLUSION:  The transcription of IL‐8 in gastric epithelial cells induced by H. pylori isolated from Chinese patients is associated with the existence of cag PAI and not with the vacA genotype.
Inhibitory effects of aspirin and indometacin on the growth of Helicobacter pylori in vitro
Authors: WANG Wei Hong , HU Fu Lian , CY WONG Benjamin , BERG Douglas E , LAM Shiu‐Kum 
Published: March 2003

OBJECTIVE:  The interactions between non‐steroidal anti‐inflammatory drugs and Helicobacter pylori have not been sufficiently documented to date. The aim of this study was to investigate the possible effects of aspirin and indometacin on the growth of H. pylori and to determine the effects of aspirin on the susceptibility of H. pylori to some antimicrobials.METHODS:  Kinetic studies were performed by inoculating strains of H. pylori in brucella broth with different concentrations of aspirin and indometacin. Growth of bacteria in the broth was assessed spectrophotometrically and by viable colony counts after incubation for 24 and 48 h. Bacterial morphology was determined by Gram stain under light microscopy. The minimal inhibitory concentration (MIC) of aspirin and indometacin was determined by the standard agar dilution method. The MIC of amoxicillin, clarithromycin and metronidazole was measured in the presence and absence of aspirin by the E‐test method.RESULTS:  Kinetic studies revealed that aspirin and indometacin inhibited the growth of H. pylori in a dose‐dependent manner. The bactericidal activity of these agents was expressed by cell lysis. Aspirin at 400 µg/mL produced an almost 2‐log decrease in the number of CFU/mL at 48 h. Similar inhibitory effects were obtained when 100 µg/mL indometacin was tested. The MIC at which 90% of H. pylori was inhibited was 512 µg/mL and 128 µg/mL for aspirin and indometacin, respectively. Increased susceptibility of H. pylori to amoxicillin, clarithromycin and metro­nidazole was found in the presence of aspirin.CONCLUSIONS:  Aspirin and indometacin could significantly inhibit the growth of H. pylori when incubated in brucella broth in vitro. A subinhibitory concentration of aspirin enhanced the susceptibility of H. pylori to some antimicrobial agents.
Pyogenic liver abscess complicated by endogenous endophthalmitis
Authors: Tan Yu‐Meng , Chong Chee K. , Chow Pierce K. H. 
Published: March 2003

Background:  Endogenous endophthalmitis is an inflammation of ocular tissues that can lead to deterioration of and loss of vision. Rarely, this can complicate the course of a patient with pyogenic liver abscess.Methods:  Over an 18‐month period, 68 patients were treated for pyogenic liver abscesses. Three patients, all of whom were male and with diabetes, were diagnosed with a Klebsiella pneumoniae liver abscess complicated by endogenous endophthalmitis. Open surgical or percutaneous drainage of the liver abscess was undertaken and the symptomology and outcome of the endophthalmitis reviewed.Results:  There was no mortality in our series. Two patients presented with simultaneous abdominal and ocular symptoms and one patient had ocular symptoms 3 days after surgical drainage of the liver abscess. Despite aggressive treatment, all patients had permanent deterioration of visual function with one patient becoming blind and requiring evisceration of the infected eye.Conclusion:  Ocular symptoms in patients treated for pyogenic abscesses must be dealt with urgently with an ophthalmologic consultation. Increased awareness of this complication and a high index of suspicion are paramount for salvage of visual function.
Training general practitioners in flexible sigmoidoscopy to screen for colorectal cancer
Authors: Martin Jenepher A. , Crotty Brendan , Barbaro Dominic , Higlett Tracey , Zalcberg John 
Published: March 2003

Background:  A screening programme to detect polyps or early carcinoma would significantly reduce the mortality and morbidity of colorectal cancer (CRC). The aims of the present study were to evaluate: (i) the feasibility of training general practitioners in flexible sigmoidoscopy (FS) for CRC screening; (ii) the acceptability of screening by faecal occult blood testing (FOBT) and FS in asymptomatic standard risk Australians aged over 50 years; and (iii) the yield of such screening.Methods:  Subjects were recruited by general practitioner (GP) referral, newspaper advertisement or by a direct approach to retirement villages. Participants were mailed a FOBT kit and a prescreening questionnaire. Flexible sigmoidoscopy was performed by a GP supervised by an experienced endoscopist. Subjects then completed a second questionnaire. General practitioners were assessed after 50 unassisted procedures.Results:  A total of 264 individuals contacted the study coordinator; 169 were screened. Screening was accepted well by the participants. Fifteen per cent of subjects had polyps and 4% had a positive FOBT. Training in FS was adversely affected by the availability of resources. Three GPs completed 50 unassisted procedures over a 15‐month period, but none were able to reliably assess the distal bowel.Conclusions:  Although the three trainees and their supervisors did not consider that the GPs were adequately trained after 50 unassisted procedures, training was adversely affected by limited resources within the Victorian public hospital system. Screening by FOBT and FS was considered to be acceptable by the patients undergoing these procedures. Existing facilities are not adequate if GPs are to be trained in FS as part of a national CRC screening program.