bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of adding ketorolac to intravenous morphine patient‐controlled analgesia on bowel function in colorectal surgery patients – a prospective, randomized, double‐blind study
Authors: Chen J‐Y. , Wu G‐J. , Mok M. S. , Chou Y‐H. , Sun W‐Z. , Chen P‐L. , Chan W‐S. , Yien H‐W. , Wen Y‐R. 
Published: March 2005

Background:  Postoperative ileus (PI) is the transient impairment of bowel motility due to surgical trauma and the associated physiological responses. Postoperative ileus results in patient discomfort, increases gastrointestinal risks, prolongs hospital stay and increases medical expenses. In this study, we investigated the effect of patient‐controlled analgesia (PCA) morphine with or without ketorolac on bowel functions in patients after colorectal surgeries.Methods:  A total of 79 patients who received elective colorectal resection were randomly allocated into two groups receiving either intravenous PCA morphine (M group) or intravenous PCA morphine plus ketorolac (K group). Recovery of bowel functions (bowel movement, passage of flatus, and soft diet intake), pain scores, morphine consumption, time for first ambulation, and opioid‐related side‐effects were recorded.Results:  Patients in the K group received 29% less morphine than patients in the M group with comparable pain scores. The first bowel movement (1.5 [0.7–1.9] vs. 1.7 [1.0–2.8] days, P < 0.05) and the first ambulation (2.2 ± 1.0 vs. 2.8 ± 1.2 days, P < 0.05) were significantly earlier in the K group than in the M group. The time of the first flatus passing, the first intake of soft diet, and duration of hospital stay were not significantly different between the two groups.Conclusions:  The results of this study suggest that addition of ketorolac to intravenous morphine PCA provides an opioid‐sparing effect but has limited benefit in shortening the duration of bowel immobility and time to first ambulation. These findings imply that postoperative ileus is attributable to multiple factors in addition to morphine consumption.
Effects of inoculum density of pinewood nematode on the development of pine wilt disease in Japanese black pine seedlings pretreated with simulated acid rain
Authors: Asai E. , Futai K. 
Published: March 2005

SummarySix‐month‐old Japanese black pine seedlings (Pinus thunbergii) were exposed to simulated acid rain (SAR) at pH 3 and 2 three times a week. After treatment for 2 months, the seedlings were inoculated with a virulent isolate (S10) of the pinewood nematode (Bursaphelenchusxylophilus), at three inoculum levels (Pi = 50, 160 or 500 nematodes per seedling). In seedlings inoculated with 500 nematodes, both population growth of nematodes and disease development were accelerated by pretreatment with SAR at pH 3 or 2. In seedlings inoculated with 50 nematodes, population growth of the nematodes was suppressed and more time was needed for seedlings to die when pretreated with pH 3 SAR. This suggests that exposure to pH 3 SAR increased not only the progress of mortality, but also simultaneously enhanced the tolerance limit of the seedlings to the pinewood nematode – the critical value of physiological burden (represented as a product of time and initial nematode population) necessary to kill a seedling. Exposure to pH 2 SAR accelerated nematode reproduction in seedlings and increased seedling mortality irrespective of the number of nematodes inoculated.
Rheumatic fever: The relationship between clinical manifestations and laboratory tests
Authors: Roodpeyma S , Kamali Z , Zare R 
Published: March 2005

Objectives: To determine the relationship between the severity of clinical features of rheumatic fever (RF), and antistreptolysin O titre (ASOT) and/or erythrocyte sedimentation rate (ESR). Methods: Clinical and laboratory data from 102 children with RF who had been admitted at a university hospital in Tehran between 1992 and 2002 were reviewed retrospectively. In order to categorize the severity of clinical manifestations of disease, patients were divided into three groups. Those with arthritis alone were defined as group A, carditis with or without arthritis as group B and carditis (with or without arthritis) with congestive heart failure as group C. Results: Thirty‐one cases were enrolled in group A, 39 in group B, and 32 in group C. We didn't find a significant relationship between the severity of clinical presentation of disease and ASOT (P = 0.89) and ESR (P = 0.24). Seventy‐two patients presented with first attack and 30 had recurrences. The frequency of congestive heart failure (CHF) in first attacks was 31.2%vs 68.8% in recurrences (P < 0.0001). No Significant relationship was found between the number of involved valves and ASOT (P = 0.4) or ESR (P = 0.8). Conclusion: Variable clinical presentation of disease and increasing intensity of cardiac involvement is not related to the ASOT or ESR levels.
Serum elastase in the diagnosis of acute pancreatitis: a prospective study
Authors: Wilson Robert B. , Warusavitarne Janindra , Crameri Donna M. , Alvaro Frank , Davies David J. , Merrett Neil 
Published: March 2005

Background:  The aim of the present study was to evaluate the usefulness of the elastase 1 (E1) enzyme‐linked immunosorbent assay (ELISA) in the diagnosis of acute pancreatitis. This is the first Australian evaluation of the E1 ELISA.Methods:  Three groups of patients were prospectively assessed: control patients, patients with acute pancreatitis, and patients with acute non‐pancreatitic abdominal pain. Serum was collected on all patients on admission and the sensitivity, specificity and diagnostic accuracy of serum elastase, amylase and lipase was determined.Results:  Twenty‐nine patients with 30 episodes of pancreatitis, 38 patients with acute non‐pancreatitic abdominal pain and 121 control patients were studied. For all patient episodes E1 ELISA at a cut‐off of 3.5 ng/mL had a sensitivity of 80%, specificity of 96% and an efficiency of 94% in the diagnosis of acute pancreatitis. For episodes more than 48 h after onset of symptoms, sensitivity was 100%, specificity was 96% and diagnostic efficiency was 96%. This performance was equivalent to amylase but inferior to lipase.Conclusion:  Of the biochemical markers for pancreatitis currently available, lipase is the most useful. The relatively inferior sensitivity and problematic reference range for the ELISA E1, together with its limitations in measuring total elastase, currently prevent its widespread use.
Thyroid cancer in the renal transplant population: epidemiological study
Authors: Pond Franklin , Serpell Jonathan W. , Webster Angela 
Published: March 2005

Background:  The epidemiology of thyroid neoplasms in the renal transplant population has not been widely published. The present study compares the behaviour of thyroid cancer in the transplant cohort with that of the general population. It also documents the transplantation outcomes of patients with thyroid and non‐thyroid cancers.Methods:  All recipients of renal grafts are registered with the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Data were obtained from this institution and analysed using Microsoft Excel and stata statistical software. Risk ratio, attributable risk, Mann−Whitney test, and the Kaplan−Meier survival probability were calculated.Results:  Between 1963 and 31 March 2002, 23 (0.22%) patients were diagnosed with thyroid cancer from a cohort of 10 689 renal transplant recipients. The median age in the renal‐transplant thyroid cancer group was 48.2 years (range: 23−67 years), and there were 11 (48%) male patients, compared to 26% of thyroid cancer patients in the general population (P = 0.02). The median time to thyroid cancer diagnosis after transplantation was 68 months (range: 3−253 months) compared to 102 months (range: 3−363 months; P = 0.004) in non‐thyroid cancers. Ten patients (43%) were found to have lymphatic metastasis, eight of whom presented at the time of primary diagnosis. The risk ratio (RR) was 5.2 (95% confidence interval: 2.0−16.6), with an attributable risk of 17.4 cases per 10 000. There were two cancer‐related deaths resulting in a survival probability of 89% at 5, 10 and 15 years.Conclusions:  There is a higher incidence of thyroid cancer and an altered sex distribution in the renal transplant population. A significant proportion presents with lymphatic metastasis requiring lymph node dissection and radioactive iodine treatment.
Nerve injuries in orthopaedics: is there anything more we need to tell our patients?
Authors: Ek Eugene T. , Yu Emma P. , Chan Jason T. , Love Bruce R. 
Published: March 2005

Background:  Perioperative nerve injuries are uncommon in most elective orthopaedic operations. However, despite the low incidence, patients tend to be most unforgiving when this complication occurs. The present study aims to determine the adequacy of the consent process, and seeks to identify deficiencies.Methods:  All elective patients who experienced a perioperative nerve palsy between 1996 and 2003 were retrospectively identified. A telephone questionnaire assessed recall of the consent and risks discussed. Patients were asked what they would have liked to have been advised, and whether this would affect their decision for operation.Results:  Twenty‐four of the 32 patients were contacted. From the questionnaire, 66.7% recalled discussing the risks of the operation. 66.7% would have liked to have discussed, in particular, risk of nerve palsy at time of consent. However, 83.3% of patients, knowing fully the risk of nerve injury, would still have proceeded with the operation. Of the 24 cases, only three had documentation of the risks discussed during consent.Conclusion:  The need to adequately provide informed consent for nerve dysfunction is present. The present study demonstrates a dilemma between the provision of information and the creation of fear in the minds of recipients of surgery.
Modified saphenous−peritoneal shunt in refractory ascites: new technique
Authors: Chen Jia‐Hui , Liu Hsiao‐Dung , Yu Jyh‐Cherng , Chen Chung‐Jueng , Shih Ming‐Lang , Liu Yao‐Chi , Hsieh Chung‐Bao 
Published: March 2005

Background:  Refractory ascites is a serious complication for patients with decompensated liver cirrhosis. Saphenous−peritoneal shunting is a possible surgical treatment for its relief, but tends to lead to higher groin infections. The purpose of the present paper was to determine whether a modified procedure could resolve the problem and offer potential advantages over a peritoneo‐venous shunt.Methods:  Sixteen patients with refractory ascites who received modified saphenous−peritoneal shunts were studied. Clinical data such as bodyweight, abdominal girth, indocyanine green 15‐min retention rate (ICG‐15), serum bilirubin concentrations, Child−Pugh Score, creatinine clearance (CCr), daily urinary output, urine sodium (UNa) and operative complications were recorded before, and 3 months after, surgery.Results:  Three months after the operation, the urinary output, nutritional status and Child−Pugh scores had improved, but ICG‐15 and total bilirubin output had not changed significantly. The CCr, UNa bodyweight and abdominal girth tended to decrease, but not significantly. No groin infections were noted following this procedure.Conclusions:  This modified procedure not only improved the nutritional status of cirrhotic patients with refractory ascites but also improved their quality of life. Infections and obstructions decreased in the short term. However, long‐term follow up is mandatory. This new technique requires more practice and experience.
Support adapter for radiofrequency ablation probe: experimental study
Authors: Ishikawa Susumu , Oki Shigeru , Muraoka Masato , Kashiwabara Kenji , Morishita Yasuo 
Published: March 2005

Background:  The purpose of the present study was to experimentally evaluate a new support adapter, which was created in order to insure a more complete contact between the ablation probe and a beating heart.Methods:  Support sleeve adapters for the Cobra Cooled probe were fashioned using a semi‐rigid plastic. Forty epicardial radiofrequency ablation (RFA) lesions were created on both atria under the condition of a beating heart in six pigs weighing 26−30 kg. A Cobra Cooled surgical probe was used with continuous internal irrigation of a saline solution (500 mL/h). The ablation temperature was fixed at 80°C and the duration of the RFA in each case was 20, 30 and 60 s.Results:  A support adapter ensured a more complete epicardial contact between the probe and a beating heart. An RFA probe supported by the adapter delivered greater power to the tissue. The histopathological transmural coagulation was obtained in 82% and 72% in RFA lesions with and without the adaptor, respectively.Conclusion:  A new adapter was effective in the epicardial RFA under the condition of a beating heart.
Fine‐needle aspiration cytology in parotid masses: our experience in Canterbury, New Zealand
Authors: Riley Neil , Allison Robert , Stevenson Scott 
Published: March 2005

Background:  The purpose of the present study was to assess the value of fine‐needle aspiration cytology (FNAC) in parotid masses.Methods:  A retrospective review was carried out of FNAC results in parotid masses and the findings compared to histology on subsequent parotidectomy.Results:  One hundred parotid masses were investigated. Eighty‐six had the cytological diagnosis confirmed by histology, 14 had a different diagnosis at histology. In two of these 14, a malignancy was found where a non‐neoplastic condition had been detected. In the other 12, various non‐malignant lesions were wrongly identified by FNAC. Squamous cell carcinoma was the commonest parotid malignancy in the present study.Conclusion:  Fine‐needle aspiration cytology was found to be an effective diagnostic tool in the hands of experienced pathologists at Christchurch Hospital, NZ.
Single‐breath vital capacity rapid inhalation induction with sevoflurane: feasibility in children
Authors: FERNANDEZ MODESTO , LEJUS CORINNE , RIVAULT OLIVIER , BAZIN VÉRONIQUE , LE ROUX CORINNE , BIZOUARN PHILIPPE , PINAUD MICHEL 
Published: March 2005

SummaryBackground:  Single‐breath vital capacity technique is currently administered for inhalation induction of anesthesia with sevoflurane in adults. Because sevoflurane is used in children, the aim of this open nonrandomized trial was to explore the feasibility and acceptance of this technique in midazolam premedicated patients aged from 4 to 15 years old.Methods:  A pediatric population (n = 118) was instructed in the vital capacity technique after their arrival in the induction room in a standardized and playful manner. Induction was performed with a circle‐absorber breathing circuit, primed with sevoflurane 7% in 100% O2. Success of the single‐breath vital capacity, delay of induction, hemodynamic and airway tolerance, acceptance by the children and side effects were analyzed. A multivariate logistic regression model was used to identify independent risk factors associated with the failure of the vital capacity technique.Results:  Single‐breath vital capacity technique was achieved by 57% of the children. The success rate highly correlated with age and ranged from 10% in 4–5 years old to 75% at 11 years and 95% by 14 years. Other factors for success were cooperation and understanding. The need for more than two explanations of the technique was predictive of failure. Delays in the loss of the eyelash reflex and central pupil myosis were obtained in 34 s (18–50) and 242 s (145–278), respectively [median (interquartile ranges)]. Hemodynamic tolerance was good with few airway complications.Conclusion:  Rapid anesthesia induction using a single‐breath technique with 7% sevoflurane is effective and well tolerated in children, particularly in those above 9 years of age, and in fact, success rate was markedly lower in the young age groups.
Hepatobiliary transporter expression in human hepatocellular carcinoma
Authors: Zollner Gernot , Wagner Martin , Fickert Peter , Silbert Dagmar , Fuchsbichler Andrea , Zatloukal Kurt , Denk Helmut , Trauner Michael 
Published: March 2005

Abstract: Background/Aims: Treatment of hepatocellular carcinoma (HCC) is hampered by resistance to chemotherapy, which might be mediated by multidrug resistance P‐glycoproteins (MDR P‐gps) and MDR‐associated proteins (MRPs). The effectiveness of cytostatics could be further impeded by reduced hepatocellular drug uptake into HCCs. Therefore, we aimed to determine P‐gp, MRP and organic anion transporting protein OATP2 (SLC21A6) expression in HCC. Furthermore, we investigated expression of the major bile salt uptake system Na+/taurocholate cotransporter NTCP (SLC10A1), since bile salt‐coupled chemotherapeutics were proposed to increase therapeutic drug enrichment in HCC.Material/Methods: mRNA and protein expression and tissue distribution of P‐gps, MRPs, OATP2 and NTCP were assessed in HCC and peritumorous non‐neoplastic tissue by reverse transcription polymerase chain reaction, Western blotting and immunohistochemistry, respectively.Results: Expression of P‐gps (multidrug export pump MDR1 (ABCB1), phospholipid flippase MDR3 (ABCB4), sister of P‐glycoprotein SPGP (ABCB11)) and basolateral MRP homologue MRP3 (ABCC3) showed a trend for decreased levels in HCC but was highly variable among individual tumors. In contrast, canalicular conjugate export pump MRP2 (ABCC2) expression was generally maintained or even showed a trend towards increased levels. NTCP and OATP2 expression was markedly reduced in most HCCs (P<0.05). Expression of the genuine drug transporter, the concentrative nucleoside transporter (CNT1), was highly variable and showed a trend for reduced levels in HCC.Summary/Conclusions: MRP2 seems to be the major candidate transporter involved in chemoresistance and reduced expression of OATP2 may further contribute to low drug accumulation in HCCs. Overexpression of drug exporters is not a general feature of HCC but could account for chemoresistance of individual cases. Since expression of uptake systems is generally reduced in HCC, bile salt‐coupled therapeutics may not represent a suitable strategy to overcome insufficient drug enrichment.
Cyclic AMP‐phosphodiesterases inhibitor improves sodium excretion in rats with cirrhosis and ascites
Authors: Ahloulay Mina , Bankir Lise , Lugnier Claire , Le Bec Alain , Poirel Odile , Moreau Richard , Lebrec Didier 
Published: March 2005

Abstract:Background: The mechanisms responsible for renal dysfunction and sodium retention in cirrhosis remain unclear. Cyclic AMP (cAMP) regulates sodium reabsorption in the proximal nephron. This study investigates the role of cAMP metabolism in renal dysfunction in cirrhosis.Methods: Renal function was studied by the clearance technique in anesthetized control and cirrhotic rats with or without ascites. cAMP phosphodiesterase (PDE) activity was measured in the renal cortex in vitro. Moroever, the effects on renal function of the intravenous administration of cAMP and rolipram, a powerful and specific cAMP‐PDE4 inhibitor, were evaluated.Results: In control and in non‐ascitic cirrhotic rats, cAMP administration significantly increased sodium and phosphate excretions, but did not change these excretions in cirrhotic rats with ascites. cAMP‐PDE activity was higher in ascitic than in control rats (P<0.05). Rolipram infusion significantly increased sodium and phosphate excretion only in cirrhotic rats with ascites.Conclusion: These results suggest that increased renal cAMP‐PDE activity is responsible for resistance to the natriuretic effects of cAMP in cirrhosis and plays a role in the development of ascites.
Severity of liver disease does not predict osteopenia or low bone mineral density in primary sclerosing cholangitis
Authors: Campbell Mical S. , Lichtenstein Gary R. , Rhim Andrew D. , Pazianas Michael , Faust Thomas 
Published: March 2005

Abstract:Background: The association between metabolic bone disease and cholestatic liver disease has been poorly characterized. To date a single institution has published data suggesting that in primary sclerosing cholangitis (PSC), advanced liver disease predicts advanced bone disease.Aim: To determine the association between the severity of liver disease and bone mineral density (BMD) in PSC patients.Methods: We identified 30 PSC patients who had undergone dual energy X‐ray absorptiometry (DXA) scan. We compared lumbar spine DXA scores between patients with more and less advanced liver disease.Results: Nine patients were osteopenic (30%), and one patient was osteoporotic. Five patients were female (17%), and none was postmenopausal. BMD was not different between patients listed and not listed for liver transplantation (P=0.49) or between patients with and without hepatic decompensation (P=0.63). Model for end‐stage liver disease (MELD) score (P=0.99) and the modified Mayo risk score (P=0.25) did not predict BMD.Conclusions: Our study is the first to suggest that low bone density cannot be predicted by the severity of liver disease in PSC. Perhaps other known risk factors for osteoporosis will be important predictors of abnormal bone density in this patient population.
Comparison of recurrence after hepatic resection in patients with hepatitis B vs. hepatitis C‐related small hepatocellular carcinoma in hepatitis B virus endemic area
Authors: Huang Yi‐Hsiang , Wu Jaw‐Ching , Chen Chien‐Hung , Chang Ting‐Tsung , Lee Pui‐Ching , Chau Gar‐Yang , Lui Wing‐Yiu , Chang Full‐Young , Lee Shou‐Dong 
Published: March 2005

Abstract: Purpose:Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are two important factors in the development of hepatocellular carcinoma (HCC). The carcinogenic mechanism of HBV and HCV is considered to be different. It is interesting to compare the recurrence after hepatic resection in patients with small HCC who were infected with HBV or HCV.Methods:From 1991 to 1995, 145 patients who were positive for hepatitis B surface antigen (HBsAg) or antibody to HCV (anti‐HCV) and diagnosed as small HCC (≤3 cm) in three medical centers in Taiwan were evaluated in this study. All patients underwent hepatic resection. Among them, 83 (57.2%) were infected by HBV, 51 (35.2%) were infected by HCV, and 11 (7.6%) had dual HBV and HCV infection.Results:Anti‐HCV+ HCCs were associated with older age, lower serum albumin, higher alanine transaminase (ALT) level and multi‐nodular tumors during diagnosis. During the follow‐up, 92 (63.4%) patients developed tumor recurrence. Anti‐HCV+ HCC had a higher cumulated recurrence rate than HBsAg+ HCC (72.4% vs 53.6 % at 5 year,P=0.032). In multivariate analysis, the presence of vascular invasion and lower serum albumin levels (<3.9 g/dl) were the determinants for tumor recurrence.Conclusions:HCV infection, as compared with HBV infection, had a higher cumulated recurrence after hepatic resection in patients with small HCC. Low serum albumin level was significantly associated with recurrence among these patients.