bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indications for vascularized free rectus abdominis musculocutaneous flap in oromandibular region in terms of efficiency of anterior rectus sheath
Authors: Yokoo Satoshi , Komori Takahide , Furudoi Syungo , Shibuya Yasuyuki , Umeda Masahiro , Ichinose Akihiro , Nomura Tadashi , Terashi Hiroto , Tahara Shinya , Nibu Ken‐Ichi 
Published: May 2003

AbstractThe anterior rectus sheath, efficacious in reconstructive surgery, is used in oromandibular reconstruction with the free rectus abdominis musculocutaneous flap. This study describes reconstruction with this sheath in 20 patients: to preserve only the swallowing function in 10 patients (formation of the bulge of the reconstructed oral floor and prevention of its sinking); to preserve both swallowing and articulation in 5 patients (formation of the bulge of the reconstructed tongue and prevention of its sinking, concurrent with a money‐pouch‐like reconstruction of the tongue, laryngeal suspension, and neuroanastomosis); and to prevent exposure of the reconstruction plate, replacing the resected mandibular continuity in 5 patients. The purpose of reconstruction was achieved in all patients. The vascularized free rectus abdominis musculocutaneous flap with a firm anterior rectus sheath may be the first choice for these types of reconstruction. © 2003 Wiley‐Liss, Inc. MICROSURGERY 23:96–102 2003
Development and validation of new model for microvascular transplantation of epiphyseal plate allografts with minimal adjoining epiphyseal and metaphyseal bone
Authors: Bray Peter W. , Neligan Peter C. , Bowen C. Vaughan A. , Danska Jayne S. , Boyer Martin I. 
Published: May 2003

AbstractA model for the free allograft microvascular transplantation of rabbit proximal tibial epiphyseal plate allografts was developed, validated, and tested in an in vivo animal model. Transplants contained the minimum amount of adjacent epiphyseal and metaphyseal bone compatible with preservation of the epiphyseal‐plate vascular supply, as determined by corrosion casting. Perfusion to this graft was evaluated quantitatively using radioactive microspheres, and qualitatively using India‐ink injection. Female New Zealand White rabbits at 12 weeks of age were utilized. Vascularized transplantation of epiphyseal plate allografts was performed either into a defect of matched size in the iliac crest or into a soft‐tissue pocket without bone contact. Cyclosporine A immunosuppression (CSA) was administered daily for 6 weeks. Two control groups underwent identical surgical procedures, but had no postoperative immunosuppression. Epiphyseal plates both with and without bone contact, in rabbits immunosuppressed postoperatively with CSA, demonstrated longitudinal growth and preserved viability as determined by positive bromodeoxyuridine uptake. Control epiphyseal plates transferred without postoperative immunosuppression were uniformly nonviable. This new model has value as a basis for further studies into the clinical applicability of isolated epiphyseal‐plate transplants. © 2003 Wiley‐Liss, Inc. MICROSURGERY 23:153–163 2003
Rat model of laryngeal transplantation with normal circulation maintained by combination with the tongue
Authors: Nakai Kunihiro , Hosokawa Ko , Yano Kenji , Sakai Yasuo , Takagi Satoshi , Kubo Tateki , Kakibuchi Masao 
Published: May 2003

AbstractRecent research on laryngeal transplantation used a rat model with physiologically abnormal circulation, because the common carotid artery was used for venous drainage. Since a model with normal circulation is better for accurate assessment, we developed a vascularized laryngeal graft, using the common carotid artery as the arterial supply and the external jugular vein as the venous drainage. The transplant included other tributaries from the tongue and the pharynx by combination with the tongue, because the tributaries from the larynx were very small. Ten transplants were performed. The transplanted organs were examined daily. Seven days after transplantation, the composite grafts were evaluated histologically. The mortality rate was 10%. All composite grafts were fully viable, and their structure was maintained in the remaining nine rats. Our model is appropriate for experiments on laryngeal transplantation. © 2003 Wiley‐Liss, Inc. MICROSURGERY 23:135–140 2003
Free osteocutaneous lateral arm flap: Anatomy and clinical applications
Authors: Haas Franz , Rappl Thomas , Koch Horst , Pittler Petra , Scharnagl Erwin 
Published: May 2003

AbstractFor many surgeons, the potential to reconstruct skin, fascia, tendon, or bone in a single‐stage procedure has made the lateral arm flap the technique of choice for reconstruction of complex defects. The aim of this study was to examine more closely how the humeral bone is supplied by the posterior collateral radial artery. To this end, we dissected 30 cadaver arms to determine the vascular relationship of the lateral arm flap to the humerus. The number of directly supplying vessels, and height to the lateral epicondyle of the humerus, were examined. The reconstructive potential of the osteocutaneous flap in different indications is analyzed in a series of five clinical cases. In all dissected extremities, we found one or two branches of the posterior collateral artery directly and constantly supplying the bone between 2–7 cm proximal to the lateral epicondyle. In five cases, combined defects, including bone, were successfully reconstructed with lateral arm flaps, including vascularized bone. © 2003 Wiley‐Liss, Inc. MICROSURGERY 23:87–95 2003
Clinical application of ipsilateral C7 nerve root transfer for treatment of C5 and C6 avulsion of brachial plexus
Authors: Gu Y.‐D. , Cai P.‐Q. , Xu F. , Peng F. , Chen L. 
Published: May 2003

AbstractWe applied a nerve transfer, using the ipsilateral C7 nerve root to treat the C5 and C6 root avulsion of the brachial plexus. Four patients with C5 and C6 preganglionic injury were operated on with this new technique from 1998–2000. Transfer of the spinal accessory nerve to the suprascapular nerve was simultaneously done in 2 these patients. After a follow‐up of 1–2.5 years, the muscle strength of elbow flexors recovered to M4 (Lovett) in all cases, shoulder abduction of >90° with external rotation of 30–40° was gained in two cases, and that of 15–45° with no external rotation in the other two cases. No remarkable impairment was found in all C7‐innervated muscles except for decrease of muscle power of 1 grade (Lovett) in the short run. This new technique shows promise as an efficacious and safe treatment for C5 and C6 root avulsion of the brachial plexus. However, it should be applied prudently when incomplete injuries of the lower trunk are involved. © 2003 Wiley‐Liss, Inc. MICROSURGERY 23:105–108 2003
Memories of the early years of insulin treatment in the UK
Authors: Gill G , Jones K , Smyth C , Bain S , Barnett A 
Published: May 2003

AbstractThe Diabetes UK Golden Year Study investigated a large cohort of Nabarro Medal winners (with type 1 diabetes of over 50 years duration) for genetic and clinical markers of long‐term survival. During over 400 interviews held, a wealth of stories were collected concerning experiences during the early years of insulin treatment in the UK. Some patients reported difficulties in finding physicians willing to treat them with insulin, and all had to adopt very strict and detailed diet regimens. Prolonged hospital admission at diagnosis was usual, and in those pre‐NHS days, considerable patient expense was common. One woman with type 1 diabetes reported pregnancies in the 1940s that resulted in six miscarriages, one stillbirth and three perinatal deaths. Most patients were surprisingly positive about their experiences, particularly those who came into contact with Dr Robin Lawrence of King's College Hospital. As one participant commented, he had learnt ‘self‐discipline, determination and will‐power’. Copyright © 2003 John Wiley & Sons, Ltd.
Implementing MICRO‐HOPE in primary care with extra nurse support
Authors: Farrell KA , Bowen C , Lovatt S 
Published: May 2003

AbstractAn audit of work to implement the MICRO‐HOPE study findings in a UK rural practice is presented. Seventy‐three out of an eligible group of 142 who fitted the HOPE trial criteria were not taking an ACE inhibitor. Of these, 60 were invited to a special clinic session with a visiting nurse to provide an opportunity to offer ACE inhibitor treatment and follow‐up. The average age of males (n=29) and females (n=31) was 70.7 (SD 9.9) and 70.1 (SD 8.9) respectively. The mean HbA1c of the invited group was 7.64% (CI 7.33–7.95%) and mean blood pressure was 138/75mmHg (CI 134–143/73–77mmHg).Thirty‐five (58%) patients attended and 20 (33%) started taking ramipril as a result of the intervention. In the interim, three had been started on treatment by a hospital. At 12 weeks, 14 (23%) were still on treatment from the practice. Only two (10%) achieved the target dosage of 10mg ramipril daily. Six patients (30%) had side‐effects and stopped ramipril treatment. The total cost of the intervention was £3200.The nurse‐led intervention increased the appropriate ACE inhibitor usage among people with type 2 diabetes from 49% to 59% over three months. The proportion of patients on either an ACE inhibitors or angiotensin II‐receptor antagonists rose from a baseline of 56% to 65% at six months.For a brief intervention, this was a worthwhile effect. This audit shows that increasing ACE inhibitor use is resource intensive but its small scale may exaggerate the effect size. Clarity is needed around the issue of any ‘class effect’ for ACE inhibitors and how patients will cope with the increasing burden of medication. Copyright © 2003 John Wiley & Sons, Ltd.
Continuous quality control in diabetes care – implications
Authors: Baksi AK , Ball R , Bedford S , Hogan D , Thomas Z , Wilson P 
Published: May 2003

AbstractA prospective evaluation of randomly selected consultations was conducted to assess the quality of diabetes care with regard to metabolic control, education of patients, and patient satisfaction. Patients completed an anonymous questionnaire. Health professionals completed a separate questionnaire to record data, and to indicate whether medication was changed and if any education was given.All consultations were conducted by health professionals in secondary care, during six consecutive months. Patients responded to three statements, on a five‐point scale. The statements were: I feel better after this consultation; I was given enough time to discuss my problems; and I have learnt something new about diabetes at this consultation. Biomedical indicators were age, sex, type of therapy for diabetes, BMI, HbA1c, blood pressure and cholesterol.Out of a total of 2213 consultations, 721 (32.6%) were audited; 89% of consultations were conducted by career grade clinicians. There was a high degree of patient satisfaction. The number of patients who had HbA1c of 7% or less was 38 (14%) in the insulin group, and 150 (33%) in the tablet group. Mean (SD) cholesterol was 5.25 (1.03) and 5.4 (1.03) in the insulin and tablet groups respectively. Blood pressure readings were lower in the insulin group.In conclusion, the metabolic standards do not meet those currently recommended although there was a high degree of patient satisfaction. In order to be able to compare quality standards of this evaluation with those provided by other units, it is recommended that there is a national agreement on the cohort of patients in audit, the indicators to be used, and how each indicator is to be expressed. It is also necessary to establish a nationally agreed questionnaire, easy to administer in routine practice, to evaluate patient satisfaction and responses. Copyright © 2003 John Wiley & Sons, Ltd.
A survey of physicians' involvement in the management of diabetic foot ulcers in secondary health care
Authors: Jude EB , Oyibo SO , Millichip MM , Boulton AJM 
Published: May 2003

AbstractA survey was conducted to investigate the management of diabetic foot ulcers by physicians in secondary health care. Questionnaires were sent to 160 consultant diabetologists in the UK. Questions covered a number of important issues regarding the management of diabetic foot ulcers.A 50% response rate was recorded. Reportedly, 67.1% of respondents had a designated foot clinic. The majority (61.1%) of physicians used antibiotics for all clinically infected ulcers. Many (67.1%) used antibiotics until clinical signs of infection had resolved, 25.3% used antibiotics until the ulcer healed completely, while 7.6% used antibiotics for a fixed time period. Most (83.5%) physicians used a variety of techniques for off‐loading foot ulcers, and the majority (81.0%) reviewed patients fortnightly or more frequently. Some physicians (30–50%) admitted all patients with complicated foot ulcers: this number was less in centres that had a designated foot clinic (p=0.01). Two‐thirds of physicians used a combination of intravenous antibiotics for inpatients. The availability of vascular surgery, podiatry and orthotist services in each centre was reported by 91.1%, 92.4% and 77.2% of physicians respectively.In conclusion, there is considerable variation and potential deficiencies in certain aspects of diabetic foot care in the UK. National consensus and guidelines are required to streamline the management of diabetic foot ulcers. Copyright © 2003 John Wiley & Sons, Ltd.
Expert opinion statement on the use of insulin therapy in patients with type 2 diabetes in primary care
Authors: Barnett AH , Capaldi B , Davies‐Lyons M , Farooqi A , Gadsby R , Gilroy J , Hill J , Hughes EJ , Kirby M , Owens D , Tasker PR W , Vora J 
Published: May 2003

AbstractAlthough the United Kingdom Prospective Diabetes Study (UKPDS) demonstrated the undoubted benefits of tight glycaemic control, over time most patients required oral combination therapy or insulin even to get close to glycaemic targets. Despite this, much confusion remains regarding the place of insulin therapy in management of type 2 diabetes.In this article we provide a series of questions and answers relating to the use of insulin therapy in primary care based on the clinical experience of a multidisciplinary group of health professionals working in this area. We overview the undoubted advantage (and pitfalls) of intensive glycaemic control in preventing/delaying vascular complications and provide recommendations on indications for insulin initiation. We go on to discuss the question of who should prescribe insulin and in what clinical setting. Ideally, initiation should be in a clinical setting where the competence and skills exist in a convenient location for the patient. We then consider which insulin regimens should be used in type 2 diabetes with discussion of insulin in combination with oral agents, further intensified insulin treatment (basal bolus regimens) and twice daily premixed insulins. Insulin start doses are also discussed as well as titration regimens. We also consider the role of the rapid‐acting and long‐acting analogues in insulin therapy for type 2 diabetes.We conclude that insulin prescribing in primary care is becoming a reality and probably a necessity in view of the increasing number of patients with type 2 diabetes. This will require appropriate training, funding and support at all levels (particularly from secondary care) if this is to be successful. We hope that this article will help to simplify and demystify insulin prescribing in primary care and allow more patients to be appropriately and optimally treated. Copyright © 2003 John Wiley & Sons, Ltd.
Genetic testing in maturity onset diabetes of the young (MODY) – practical guidelines for professionals
Authors: Shepherd M 
Published: May 2003

AbstractDiagnostic and predictive genetic testing is possible in up to 80% of maturity onset diabetes of the young (MODY) families. Diagnostic genetic testing allows confirmation of MODY and defines the subtype. This allows appropriate advice regarding treatment and likely clinical course to be given. Those undergoing genetic testing should have the opportunity to discuss the implications of the tests and their possible reactions. If HNF‐1α is identified, patients on insulin from diagnosis may benefit from a trial of sulphonylureas. This article provides the first specific guidelines relating to the provision of genetic testing in MODY. Copyright © 2003 John Wiley & Sons, Ltd.
Fragmentation of dihydroxyacetone kinase 1 from Saccharomyces cerevisiae indicates a two‐domain structure
Authors: Molin Mikael , Larsson Thomas , Karlsson Karl‐Anders , Blomberg Anders 
Published: May 2003

AbstractGlobal protein expression in Saccharomyces cerevisiae strains either deleted for both yeast dihydroxyacetone kinases (DAK1 and DAK2) or overexpressing DAK1, was characterized by two‐dimensional polyacrylamide gel electrophoresis (2‐D PAGE). We found protein expression in the double deletion strain to be highly similar to wild‐type. In the strain overexpressing Dak1p, nine spots representing fragments of the Dak1p protein in the size range 40–20 kDa and amounting to approximately 30% of total Dak1p, were discovered (native size Dak1p migrates at roughly 60 kDa). Fragments were characterized by matrix‐assisted laser desorption/ionization mass spectrometry and electrospray mass spectrometry analyses to represent either the N‐ or the C‐terminal part of the DAK1 protein. Cleavage points, predicted from mass spectrometry and 2‐D PAGE data, mapped almost exclusively in the middle region showing low sequence conservation between Dak1p and its closest homologues. We hypothesize that observed Dak1p fragments represent stable structural domains shielded from access by native endoproteases. Furthermore, overexpressing Dak1p with the non‐native N‐terminus (M)A‐, resulted in native size Dak1p and N‐terminal Dak1p fragments appearing in two major 2‐D PAGE forms of approximately equal size and abundance, but with slightly different isoelectric points. However, when overexpressing Dak1p with the native N‐terminus (M)S‐, only the more acidic 2‐D PAGE form appeared. In the N‐terminal acetyltransferase mutant nat1Δ, (M)A‐Dak1p species were converted into the basic form, arguing twin spots to represent forms with acetylated and deacetylated N‐termini. Data thus indicated that (M)A‐N‐termini, in the Dak1p context, were NatA substrates recognized with 50% lower efficiency than (M)S‐N‐termini.
Modulation of gene expression by extracellular pH variations in human fibroblasts: A transcriptomic and proteomic study
Authors: Bumke Maja A. , Neri Dario , Elia Giuliano 
Published: May 2003

AbstractHomeostasis of the intracellular ionic concentration, in particular that of hydrogen ions, is pivotal to the maintenance of cell function and viability. Nonetheless, pH fluctuations in both the intracellular and the extracellular compartments can occurr during development, in physiological processes and in disease. The influence of pH variations on gene expression has been studied in different model systems, but only for a limited number of genes. We have performed a broad range analysis of the patterns of gene expression in normal human dermal fibroblasts at two different pH values (in the presence and in the absence of serum), with the aim of getting a deeper insight into the regulation of the transcriptional program as a response to a pH change. Using the Affymetrix gene chip system, we found that the expression of 2068 genes (out of 12 565) was modulated by more than two‐fold at 24, 48 or 72 h after the shift of the culture medium pH to a more acidic value, stanniocalcin 1 being a remarkable example of a strongly up‐regulated gene. Genes displaying a modulated pattern of expression included, among others, cell cycle regulators (consistent with the observation that acidic pH abolishes the growth of fibroblasts in culture) and relevant extracellular matrix (ECM) components. Extracellular matrix protein 2, a protein with a restricted pattern of expression in adult human tissues, was found to be remarkably overexpressed as a consequence of serum starvation. Since ECM components, whose expression is controlled by pH, have been used as targets for biomolecular intervention, we have complemented the Affymetrix analysis with a two‐dimensional polyacrylamide gel electrophoresis analysis of proteins which are differentially secreted by fibroblasts at acidic or basic pH. Mass spectrometric analysis of more than 650 protein spots allowed the identification of 170 protein isoforms or fragments, belonging to 40 different proteins. Some proteins were only expressed at basic pH (including, for instance, tetranectin), while others (e.g., agrin) were only detectable at acidic pH. Some of the identified proteins may represent promising candidate targets for biomedical applications, e.g., for antibody‐mediated vascular targeting strategies.
Proteomic analysis of the reactive phenotype of astrocytes following endothelin‐1 exposure
Authors: Egnaczyk Gregory F. , Pomonis James D. , Schmidt Julie A. , Rogers Scott D. , Peters Christopher , Ghilardi Joseph R. , Mantyh Patrick W. , Maggio John E. 
Published: May 2003

AbstractReactive gliosis is an invariant feature of the pathology of central nervous system (CNS) injury and a major determinant of neuronal survival and regeneration. To begin to understand the alterations in astrocyte protein expression that drive glial changes that occur following injury, we used an established model system (endothelin‐1 stimulation of hypertrophy) and proteomic analysis to define a discrete set of differentially expressed proteins and post‐translational modifications that occur as the astrocytes change from a quiescent to a reactive state. This orchestrated set of changes included proteins involved in cytoskeletal reorganization (caldesmon, calponin, alpha B‐crystallin, stathmin, collapsing response mediator protein‐2), cell adhesion (vinculin, galectin‐1), signal transduction (RACK‐1) and astrocyte differentiation (glutamine synthetase). Using proteomic analysis to understand what drives astrocyte expression of these functionally divergent molecules may offer insight into the mechanisms by which astrocytes can exhibit both pro‐regenerative and anti‐regenerative activities following CNS injury.