bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parenchymal transforming growth factor beta‐1: Its type II receptor and Smad signaling pathway correlate with inflammation and fibrosis in chronic liver disease of viral etiology
Authors: CALABRESE FIORELLA , VALENTE MARIALUISA , GIACOMETTI CINZIA , PETTENAZZO ELENA , BENVEGNU LUISA , ALBERTI ALFREDO , GATTA ANGELO , PONTISSO PATRIZIA 
Published: October 2003

AbstractBackground and Aims:  Transforming growth factor‐beta (TGF‐beta) system is involved in the control of cell growth and extracellular matrix formation. Previous studies in patients with chronic liver disease have shown that increased TGF‐beta expression significantly correlates with the degree of hepatic fibrosis. The aim of our study was to define TGF‐beta system expression in hepatic parenchymal cells and its significance in patients with differing extents of chronic liver disease of viral etiology.Methods:  Expression of  TGF‐beta 1, TGF‐beta 1 type II receptor (TGF‐beta RII) and the Smad signaling pathway was evaluated in consecutive liver sections of 77 patients with chronic liver disease (65 HCV positive and 12 HBV positive). Results were correlated with histological scores and apoptotic activity.Results:  TGF‐beta 1 was demonstrated in the liver of 30/56 (53.6%) patients with chronic hepatitis and 20/21 (95%) patients with cirrhosis, but in none of the 20 normal livers. Positive cytokine reaction was seen both in stromal cells and hepatocytes. Expression of TGF‐beta RII and Smad proteins showed a distribution pattern similar to that of  TGF‐beta, with a direct correlation in terms of immunoreactivity extent. A significant correlation was found between parenchymal expression of  TGF‐beta system and inflammatory and fibrosis scores. No correlation was found with apoptotic index and other morphological, clinical or virological parameters.Conclusions:  The TGF‐beta system is up‐regulated at the ligand, receptor and signaling level in the liver of patients with more active disease. The strong expression of  TGF‐beta and the Smad pathway in parenchymal cells suggests that hepatocytes, in addition to mesenchymal cells, may play an important role in the progression of liver disease.
Analysis of CYP2E1 polymorphism for the determination of genetic susceptibility to gastric cancer in Koreans
Authors: PARK GEUN TAE , LEE OH YOUNG , KWON SUNG JOON , LEE CHUN GEUN , YOON BYUNG CHUL , HAHM JOON SOO , LEE MIN HO , HOO LEE DONG , KEE CHOON SUHK , SUN HEE SIK 
Published: October 2003

AbstractBackground:  Interindividual genetic differences in susceptibility to chemical carcinogens are among the most important host factors in human cancer. The present study was undertaken to reveal the association between the polymorphism of CYP2E1 (CYP2E1/PstI and CYP2E1/DraI) with genetic susceptibility to gastric cancer development in Koreans.Methods:  In the present study, 120 gastric cancer patients and 145 controls with no history of tumors were analyzed. CYP2E1 was determined by polymerase chain reaction‐restriction fragment length polymorphisms (PCR‐RFLP), or PCR and direct gel electrophoresis.Results:  The overall genotype distribution of CYP2E1 was not significantly different from that of controls. However, the genotype distribution of the patient subgroups with a history of heavy cigarette smoking (>30 pack/year) in the CYP2E1/PstI and CYP2E1/DraI polymorphisms were significantly different from those of non‐smoking patients (P = 0.0122 and P = 0.0029, respectively). The difference was also noticeable in the younger patient subgroup (aged ≤50 years) compared with normal controls (P = 0.0414) in the CYP2E1/PstI. The relative risk estimation for the combination of the CYP2E1/PstI and CYP2E1/DraI polymorphisms revealed that the odds ratio for individuals with homozygotes of rare alleles (c2/c2, C/C) was 5.6 (95% confidence interval = 0.9–39.1).Conclusions:  : These results suggest the possible involvement of the CYP2E1 polymorphism in smoking‐induced gastric cancer development in Koreans as one of the risk factors which increases genetic susceptibility.
Obstetric cholestasis with elevated gamma glutamyl transpeptidase: Incidence, presentation and treatment
Authors: MILKIEWICZ PIOTR , GALLAGHER RUTH , CHAMBERS JENNY , EGGINGTON ENID , WEAVER JUDITH , ELIAS ELWYN 
Published: October 2003

AbstractBackground:  Obstetric cholestasis (OC) may cause severe pruritus in the mother and lead to fetal distress and stillbirth. The etiology of OC is multifactorial, but includes inherited dysfunction of bile canalicular transporters. One of these, multidrug resistant protein 3 (MDR3), a phospholipid transporter, when dysfunctional is associated with elevated levels of gamma glutamyl transpeptidase (GGT). The aim of the present study was to assess the incidence of OC associated with elevated GGT. We compared the natural history of a cholestatic pregnancy and the efficacy of ursodeoxycholic acid (URSO) in OC patients grouped according to a normal or raised GGT level.Methods:  Eighty‐one patients with OC were analyzed. OC was diagnosed in patients with pruritus and elevated serum bile acids (SBA). Fifty‐seven consenting volunteer patients (70%) were treated with URSO.Results:  Elevated GGT at presentation was found in 21 patients (30%) and was associated with significantly higher serum levels of aspartate transaminase (AST), bilirubin (BIL) and SBA. OC presented at approximately the same gestation week in both groups of patients. In patients not treated with URSO, liver function tests (LFT) showed no significant change from the time of diagnosis to delivery. Patients from both groups responded to URSO with significant improvement in their AST and alanine aminotransferase (ALT) levels, but SBA fell significantly only in the normal GGT group.Conclusions:  An elevated GGT occurs in less than one‐third of patients with OC in the UK and, when present, is associated with greater impairment of LFT, but no difference in gestational age at onset. Treatment with URSO appears to be safe and significantly improves LFT in patients with OC, with the exception of SBA in the high GGT group.
Expression of hepatoma‐derived growth factor in hepatocarcinogenesis
Authors: YOSHIDA KENYA , NAKAMURA HIDEJI , OKUDA YORIHIDE , ENOMOTO HIRAYUKI , KISHIMA YOSHIHIKO , UYAMA HIROKAZU , ITO HIROAKI , HIRASAWA TSUTOMU , INAGAKI SHUICHIRO , KAWASE ICHIRO 
Published: October 2003

AbstractBackground and Aim:  The present study investigated the expression of hepatoma‐derived growth factor (HDGF) in human hepatocellular carcinoma (HCC) and in the liver during hepatocarcinogenesis in two rodent models.Methods:  Expression of HDGF was analyzed using northern blotting and immunohistochemistry in the human and rodent models.Results:  Hepatoma‐derived growth factor was more highly expressed in HCC than in the adjacent liver in humans with hepatitis, as shown by northern blotting. Using immunohistochemistry with the specific anti‐HDGF antibody, HDGF was more strongly and frequently expressed in the nucleus and cytoplasm of HCC cells than in the adjacent normal hepatocytes. Hepatoma‐derived growth factor was also more strongly expressed in the tumors than in the adjacent fatty liver of fatty liver Shionogi (FLS) mice, than in the cirrhotic liver of choline‐deficient amino acid feeding rats, as shown by northern blotting and immunohistochemistry. In the liver of FLS mice, HDGF expression increased gradually from the age of 24 weeks through to 52 weeks after birth, showing that HDGF expression was already increased at an early stage before tumor development. In the non‐tumorous liver with fatty change, the foci expressing HDGF appeared at 24 weeks of age, which were the activated macrophage clusters with enhanced DNA synthesis and fat droplets. It is suggested that HDGF was secreted or released from these foci and stimulated hepatocyte proliferation in a paracrine manner in FLS mice, and stimulated the proliferation of hepatic tumor cells in an autocrine manner.Conclusions:  The present findings suggest that HDGF plays an important role in the development or progression of HCC in humans and rodents.
Genetic risk factors for cerebral infarction using data from a large‐scale genetic epidemiological study: the Ohasama Study
Authors: Katsuya Tomohiro , Sugimoto Ken , Hozawa Atsushi , Ohkubo Takayoshi , Yamamoto Koichi , Matsuo Akiko , Ishikawa Kazuhiko , Matsubara Mitsunobu , Rakugi Hiromi , Tsuji Ichiro , Imai Yutaka , Ogihara Toshio 
Published: October 2003

Background:  With the imminent advent of an extremely aged society, there will be an increasing requirement for the prediction, early detection and treatment of cerebral infarction. Involved in the etiological mechanisms of cerebral infarction are a number of complex genetic and environmental factors related to the onset and progression of hypertension and arteriosclerosis. Elucidation of the significance of the various risk factors will require definite identification of phenotypes using large numbers of subjects.Methods:  The present study was conducted as part of a cohort study with subjects from the general population of a rural community (the Ohasama Study). Blood pressure (BP) patterns were assessed through random home‐based and clinical measurements, as well as 24 h ambulatory BP monitoring. Magnetic resonance imaging of the brain was carried out in some subjects in order to detect asymptomatic cerebral infarcts, the maximum intima–media thickness was determined by carotid high‐resolution ultrasonography, and cognitive function was assessed using the mini mental state examination. Correlation analysis of these parameters and the candidate hypertensive genotypes was then performed.Results:  Significant associations were seen between (i) gene polymorphisms in the renin–angiotensin system and asymptomatic cerebral infarction and the non‐dipper pattern of circadian blood pressure variation; and (ii) endothelial nitric oxide synthase (eNOS) gene polymorphism and arterial pressure, lacunar score and cognitive function. An association was seen between the endothelin‐1 polymorphism and hypertension, but only in obese subjects.Conclusion:  There are interactions between genes and the environment in the etiology of cerebral infarction.
Influence of sex and estrogen on vitamin D‐induced arterial calcification in rats
Authors: Nakamura Tetsuro , Akishita Masahiro , Kozaki Koichi , Toba Kenji , Orimo Hajime , Ouchi Yasuyoshi 
Published: October 2003

Background:  It is known that the process of arteriosclerosis is affected by sex and estrogen. The present study was thus undertaken to examine the effects of these factors on arterial calcification, a form of arteriosclerosis, using a rat model of vitamin D toxicity.Methods and results:  Vehicle or 5 µg/kg per day 1α(OH)D3 was given to male and female 30‐week‐old Fisher rats for 2 weeks. Arterial calcification, evaluated by calcium content in the aorta, was 70% more marked in male rats compared to that in female rats, whereas calcium content in the aorta was similar in vehicle‐treated male and female rats. Next, the effects of ovariectomy and estrogen replacement (estradiol dipropionate 20 µg/kg per week) were examined in female rats given 5 µg/kg per day 1α(OH)D3 for 2 weeks. Calcium content in the aorta was significantly higher in ovariectomized rats than in sham‐operated rats and in ovariectomized and estrogen‐replaced rats. No difference between the groups was seen when vehicle was given to the animals.Conclusions:  These results suggest that sex and estrogen can modify the process of arterial calcification. The mechanisms remain to be determined, although the effects were independent of serum calcium level.
Initial experience of abdominal aortic aneurysm repairs in Borneo
Authors: Yii Ming Kon 
Published: October 2003

Background:  Abdominal aortic aneurysms (AAA) repairs are routineoperations with low mortality in the developed world. There arefew studies on the operative management of AAA in the Asian population.This study reports the initial results from a unit with no previousexperience in this surgery by a single surgeon on completion oftraining.Methods:  All patients with AAA repair from a prospective databasebetween 1996 and 1999 in the south‐east Asian state of Sarawak inBorneo Island were analyzed. Three groups were identified on presentationaccording to clinical urgency of surgery. Elective surgery was offeredto all good risk patients with AAA of ≥ 5 cm.All symptomatic patients were offered surgery unless contraindicatedmedically.Results:  AAA repairs were performed in 69 patients: 32 (46%)had elective repairs of asymptomatic AAA; 20 (29%) hadurgent surgery for symptomatic non‐ruptured AAA; and 17 (25%)had surgery for ruptured AAA. The mortality rate for elective surgery was6%; the two deaths occurred early in the series with thesubsequent 25 repairs recorded no further mortality. The mortalityrates for the urgent, symptomatic non‐ruptured AAA repair and rupturedAAA repair were 20% and 35%, respectively. Cardiacand res­piratory complications were the main morbidities.Sixty‐three patients seen during this period had no surgery; threepresented and died of ruptured AAA, 34 had AAA of ≤ 5 cmin diameter, and 26 with AAA of ≥ 5 cmdiameter had either no consent for surgery or serious medical contraindications.Conclusion:  This study showed that AAA can be repaired safely byhighly motivated and adequately trained surgeons in a hospital withlittle previous experience.
Analysis of the outcomes of a visiting surgical service to small rural communities
Authors: Hughes‐Anderson Wayne , House Jill , Aitken Robert J. , Rankin Sarah L. , House Anthony K. 
Published: October 2003

Background:  A team of visiting surgeons has provided regular clinics and day surgery to rural locations in country towns away from resident surgical centres. This format has provided continuity of care for 7 years despite a constantly changing medical workforce. The aim of the present study was to review the results of the group and to compare them against national standards and to provide a model for future outreach programmes.Methods:  All patient diagnoses, procedures and clinical outcomes were recorded prospectively. This record of activity was then collated. District hospital records and clinical notes have been rechecked for complications over a discrete 4 year period.Results:  There have been 7419 items of service provided, including 2676 procedures. The diagnostic grouping and subsequent day‐surgery activity are consistent with the top 30 surgical separations from all Australian hospitals. These patients have been found suitable to remain in their own home environment for treatment.Conclusion:  Experienced surgeons operating on selected patients with careful nursing care, in small country hospitals have outcomes similar to urban hospitals.
Role of community diagnostic ultrasound examination in the diagnosis of full‐thickness rotator cuff tears
Authors: Goldberg Jerome A. , Bruce Warwick J. M. , Walsh William , Sonnabend David H. 
Published: October 2003

Background:  Diagnostic ultrasound examination has become the most commonly used investigation in Australia for diagnosing rotator cuff tears. The authors felt that the results of such investigations were often inaccurate in their clinical practices.Methods:  The diagnostic ultrasound findings in 336 cases were compared to arthrography, and in 225 cases findings at surgery.Results:  A very poor accuracy rate of 0.38 was found for diagnostic ultrasound examination. The sensitivity was 0.24 and specificity was 0.61.Conclusions:  Extreme caution is recommended in the use of diagnostic ultrasound, as currently practised in a general community setting, in diagnosing full‐thickness rotator cuff tears.
Effect of transdermal glyceryl trinitrate and anti‐inflammatory gel in infusion phlebitis
Authors: Çökmez Atilla , Gür Serhat , Genç Hüdai , Deniz Sümer , Tarcan Ercüment 
Published: October 2003

Background:  Phlebitis is the commonest complication of intravenous infusion. It has been suggested that it is initiated by venoconstriction at the infusion site, hence treatment with a vasodilator may reduce its incidence.Methods:  A prospective controlled study was carried out on the effect of transdermal glyceryl trinitrate (GTN) and topical anti‐inflammatory gel (non‐steroidal anti‐inflammatory drug; NSAID) on the survival of peripheral intravenous infusion in 386 patients.Results:  A total of 34.9% (43 out of 123) of the infusions failed in the control group compared with 14.1% (18 out of 127) in the NSAID group (P < 0.05) and 30.8% (43 out of 136) in the GTN group (P < 0.05). In the control group 31 positive cultures were obtained. Twenty‐one positive cultures were obtained in the GTN group and four cases of bacterial proliferation were observed in the NSAID group.Conclusions:  Infusion phlebitis is a common problem in hospitalized patients and its incidence can be effectively reduced by NSAI gel and GTN but NSAI gel is more effective than GTN.
Bereavement in paediatric intensive care
Authors: Stack Charles G. 
Published: October 2003

SummaryThe death of a child is a very sad event in anyone's life. It also affects all staff in paediatric intensive care units in different ways at different times. The publication of standards of bereavement care in paediatric intensive care hopes to be able to assist medical and nursing staff to understand and feel more confident in this emotionally difficult area of medicine. The aim of this article is to summarize some of the major points made in the document.
A rare cause of upper airway obstruction in a 5‐year‐old girl: a laryngeal web
Authors: Siggers B.R.C. , Ross O. , Randall C. , Connett G. 
Published: October 2003

SummaryA case is described of a 5‐year‐old girl with respiratory distress. She was intubated without difficulty, but developed respiratory distress on extubation. Laryngoscopy/bronchoscopy via a laryngeal mask airwayTM revealed an extensive layngeal web which was removed with laser therapy. The causes and differential diagnosis of laryngeal web are discussed.
Investigation of the radiological relationship between iliac crests, conus medullaris and vertebral level in children
Authors: Tame Simon J. , Burstal Richard 
Published: October 2003

SummaryBackground: The inability of anaesthetists to accurately identify vertebral spaces has been documented. The aim of our magnetic resonance imaging (MRI) study was to find the relationship of vertebral body level with Tuffier's line and the conus medullaris in children.Methods: Forty‐nine children aged 10 years or less who had MRI scanning in the region of the lumbar spine were identified. If either the conus medullaris or iliac crests were visible, the corresponding vertebral body level was recorded.Results: The level of the conus could be identified in 43 patients. The median conus level was at L1 with an interquartile range (IQR) of 0.5 vertebral levels. The level of the crests could be identified in 35 patients. The median crest height was L5 with an IQR of 0.5 vertebral levels. The difference between conus and crest levels could only be calculated in 29 patients. In the remainder of the children one of the two pieces of the data was not available. The median difference was 4 vertebral levels with an interquartile range (IQR) of 1. Two of 49 children, both of whom had tethered cords, had differences of <2 vertebral levels.Conclusions: Our data confirmed that the iliac crests and conus medullaris were consistently related to the predicted vertebral levels in children. In the absence of a tethered spinal cord, subarachnoid puncture at L4–5 or below should present little risk of conus damage. Tuffier's line corresponded with a radiological level of L4–L5 in our study population.
A long‐term continuous infusion via a sciatic catheter in a 3‐year‐old boy
Authors: Ivani Giorgio , Codipietro Luigi , Gagliardi Ferdinando , Rosso Franca , Mossetti Valeria , Vitale Pasquale 
Published: October 2003

SummaryWe describe the case of a 3‐year‐old boy with a subtotal amputation of the right foot who received treatment for pain via a peripheral catheter positioned at the level of the sciatic nerve (lateral approach).We administered a continuous infusion of 0.2% ropivacaine, 0.4 mg·kg−1·h−1 plus clonidine 0.12 μg·kg−1·h−1 for 21 days.Pain relief was complete and the patient did not require any further rescue analgesia throughout the period even during medications and surgical treatment in our intensive care unit.We discuss the safety and efficacy of the use of a peripheral continuous infusion in children compared with other techniques of analgesia.
Validation of a six‐graded faces scale for evaluation of postoperative pain in children
Authors: Bosenberg A. , Thomas J. , Lopez T. , Kokinsky E. , Larsson L.E. 
Published: October 2003

SummaryBackground: The faces pain scales are often used for self‐report assessment of paediatric pain. The aim of this study was to evaluate the validity of a six‐graded faces pain scale after surgery by comparing the level of agreement between the children's report of faces pain scores and experienced nurses’ assessment of pain by observation of behaviour. The faces pain scores before, at and after administration of analgesics were analysed. The study was performed in two South African hospitals, one with a mainly rural population and the other with an urban population.Methods: A total of 110 children aged 4–12 years, scheduled for inguinal surgery in the two South African hospitals, were included in the study. The anaesthetic technique was standardized. All patients received a caudal block preoperatively. Postoperative pain assessments were made every hour for 8 h after the caudal block was performed. A designated nurse assessed pain by using a four‐graded descriptive scale (no, mild, moderate or severe pain) and thereafter the child reported pain by using the six‐graded faces pain scale.Results: A high correlation was found between the two methods of assessment (τ = 0.76, P < 0.0001). The correlation between methods was high in both hospital populations and in all age groups. The weakest correlation was found in children aged 8–12 years (τ = 0.56, P < 0.01). Significantly lower faces pain scores were found after administration of analgesics compared with pain rating before analgesics (P < 0.0001). The proportion of patients with pain scores above 2 decreased from 86% to 31% (P < 0.001).Conclusions: The findings support this six‐graded faces pain scale as a useful and valid instrument for measuring pain in the postoperative period in children aged 4–12 years.
Detection of epidural catheters with ultrasound in children
Authors: Chawathe M.S. , Jones R.M. , Gildersleve C.D. , Harrison S.K. , Morris S.J. , Eickmann C. 
Published: October 2003

SummaryBackground:  The aim of this study was to assess whether a noninvasive imaging technique such as ultrasound could visualize an epidural catheter in the epidural space in children.Methods:  Following local ethics committee approval and informed parental consent a pilot study of 12 cases was performed. Children undergoing major surgery requiring epidural analgesia were recruited. All catheters were introduced via the lumbar region. All children were scanned within 24 h of epidural insertion by consultant paediatric radiologists. If the catheter was identified in the epidural space then an attempt was made to visualize the entire length of the catheter.Results:  The epidural catheter was detected in nine of 12 patients. All of these were less than 6 months old. The entire length of the catheter was visualized in five of the nine patients. It was possible to estimate the most cephalad level of the catheter in seven of the nine patients. This was in the thoracic region in all cases and an appropriate level for the intended surgical procedure. It was not possible to precisely identify the tip of the catheter as a distinct entity using ultrasound.Conclusion:  This study shows that it is possible to visualize an epidural catheter in the epidural space in children under 6 months of age using ultrasound.