bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhibition of calcium oxalate precipitation by bile salts
Authors: Saso Luciano , Grippa Eleonora , Gatto Maria Teresa , Silvestrini Bruno 
Published: March 2003

Abstract Background: Both urinary and biliary stones can contain calcium. Bile salts (BA), which are known to bind Ca2+, are commonly used to dissolve the latter but not the former.Methods: The effect of physiologic BA on calcium oxalate (CaOx) precipitation was evaluated by a recently developed method.Results: The Ca2+ binding properties of BA were confirmed by small but significant decreases in pH observed following addition of CaCl2 to bile acids solutions. More importantly, BA inhibited CaOx precipitation with effective concentrations of approximately 10−3 mol/L. The clinical relevance of the latter observation is presently unknown but it is of note that in the same in vitro assay, the activity of BA appeared comparable to that of citric acid, the most common drug for urolithiasis. Although BA do not reach mmol/L levels in urine, they are known to change the physicochemical properties of this fluid, possibly slowing down the crystal growth process. However, the hypothetical therapeutic use of BA in former stone patients would present at least two major problems: (i) hepatotoxicity and (ii) lithogenic activity, due to hyperoxaluria subsequent to increased intestinal absorption of oxalate.ConclusionThe ability of BA in effectively binding calcium ions and in inhibiting the precipitation of CaOx appears of interest from both a physiopathologic and a pharmacologic point of view, even if it does not currently seem exploitable for prophylactic or therapeutic purposes.
Extraperitoneal bladder rupture secondary to rectal impalement
Authors: Tanuma Yasushi , Horita Hiroki , Kadono Masao 
Published: March 2003

AbstractImpalement injury to both the urinary bladder and the rectum is a rare occurrence. A 45‐year‐old man was referred to our hospital because he had been stabbed through the internal femoral skin by a steel bar. Retrograde cystography and computed tomography failed to demonstrate bladder rupture. We carried out cystoscopy (CS) because of the existence of gross hematuria and found a penetrating wound in the posterior wall. Colon fiberscopy revealed two wounds in the rectum, one of which communicated with the bladder. A diagnostic laparoscopy revealed no associated injuries in the peritoneal cavity. Vesicorectal injury was diagnosed and treatment included transanal closure of fistulas and indwelling ureteral and urethral catheters. Postoperative CS revealed complete closure of the injury.
Need for sling surgery in patients with large cystoceles and masked stress urinary incontinence
Authors: Yamada Takumi , Ichiyanagi Nobutaka , Kamata Shigeyoshi , Sakai Yasuyuki , Nagahama Katsushi , Tanizawa Akiko , Watanabe Toru , Horiuchi Susumu , Saitoh Hiroshi 
Published: March 2003

AbstractBackground:We studied the need for sling surgery in patients who suffered from large cystoceles and masked stress urinary incontinence.Methods:Twenty patients who had large cystoceles but neither evidence nor history of stress incontinence were enrolled in this study. The cystocele was reduced using a reducing device. Masked urinary incontinence was identified by a 60 m pad weighing test and a stress test. The cystocele was reduced using a pessary ring in 14 patients, or a vaginal pack formed of two rolls of ordinary 28 × 28 cm gauze in six patients. Ten of 20 patients were diagnosed with masked stress urinary incontinence and were treated with anterior colporrhaphy and a suburethral sling procedure. The other 10 patients were continent after use of a cystocele reducing device and were treated with anterior colporrhaphy alone. Average follow‐up periods of the patients with or without masked stress urinary incontinence were 51.2 months (range, 24.0–72.0 months) or 57.6 months (range, 27.0–70.0 months), respectively.Results:One of the 10 patients diagnosed with masked stress incontinence had mild stress urinary incontinence postoperatively. None of the 10 continent patients had stress incontinence after anterior colporrhaphy alone.Conclusions:Reducing devices of protruding cystocele were clinically useful in the detection of masked stress incontinence. Sling surgery was effective to prevent emerging stress urinary incontinence for patients who suffered from cystocele and masked stress incontinence.
Lymphangioma of the kidney
Authors: HONMA ICHIYA , TAKAGI YOSHIO , SHIGYO MASANORI , SUNAOSHI KENICHI , WAKABAYASHI JUNICHI , HARADA OI , MIYAO NORIOMI 
Published: March 2003

AbstractLymphangiomas are rare benign tumors that are congenital malformations of the lymphatic system. Most cases present in children as a soft, cystic mass in the neck and the axilla. Primary renal lymphangioma is exceedingly rare, with only 35 cases reported so far. We report a case of primary lymphangioma arising from the kidney. A 59‐year‐old man was referred for evaluation of a right renal mass found in an abdominal ultrasonography during a health checkup. Abdominal ultrasonography and computed tomography (CT) revealed a 3.2 × 2.9 cm multiloculated cystic mass in the upper pole of the right kidney. We could not deny malignant disease such as cystic renal cell carcinoma with any diagnostic modalities. The patient was brought to surgery. During the surgical procedure, the tumor was suspected to be lymphangioma of the kidney as a result of a frozen‐ section histopathological evaluation. Therefore enucleation of the tumor was performed. Pathological evaluation of the specimen revealed lymphangioma arising from the kidney. The patient is free of disease after a 3‐month follow‐up period.
Adrenal metastasis from renal cell carcinoma: Significance of adrenalectomy
Authors: ITO AKIHIRO , SATOH MAKOTO , OHYAMA CHIKARA , SAITO SEIICHI , SHINTAKU ICHIRO , NAKANO OSAMU , AOKI HIROSHI , HOSHI SENJI , ORIKASA SEIICHI 
Published: March 2003

Abstract
Background
: The present study examined adrenal metastasis resulting from renal cell carcinoma (RCC), with the aim of assessing the need for routine ipsilateral adrenalectomy during radical nephrectomy.
Methods
:Ipsilateral and contralateral adrenal metastases were investigated in 256 patients with RCC who had undergone radical nephrectomy from 1977 to 1996 at the Tohoku University School of Medicine.
Results
:Twelve of the 256 patients (4.7%) had adrenal metastasis. Ten of these 12 patients had progressed to disseminated disease with very poor prognosis. Two patients who had solitary adrenal metastases remained disease‐free for 21 and 7 years. Four patients showed metastases to the contralateral adrenal gland. Adrenal metastases in seven of 12 patients were identified by pre‐ or postoperative computed tomography (CT), and in another five macroscopically during surgery.
Conclusions
:Adrenalectomy was regarded as a possible curative treatment for patients with solitary adrenal metastasis. However, the incidence of this kind of metastasis was minimal and contralateral adrenal metastases may occur in RCC cases. We therefore believe that adrenalectomy should only be performed if radiographic evidence reveals metastases in the adrenal gland or if gross disease is present at the time of nephrectomy.
Failure to maintain the suppressed level of serum testosterone during luteinizing hormone‐releasing hormone agonist therapy in a patient with prostate cancer
Authors: Kinouchi Toshiaki , Maeda Osamu , Ono Yutaka , Meguro Norio , Kuroda Masao , Usami Michiyuki 
Published: March 2003

AbstractA 75‐year‐old man with metastatic prostate cancer had been treated with goserelin acetate, and prostate specific antigen (PSA) had decreased, but 11/2 years after beginning the treatment of goserelin acetate, PSA was markedly elevated and serum testosterone was at normal level. After castration the serum testosterone was at castrate level and PSA decreased. In the present case, leuprorelin acetate 1‐month depot suppressed the luteinizing hormone level in 1 month, even after the patient underwent castration.
Survey of incidence of urological cancer in South Korea: A 15‐year summary
Authors: Cheon Jun , Kim Choung‐Soo , Lee Eun Sik , Hong Sung Joon , Cho Yong‐Hyun , Shin Eui Chul , Lee Won Chul , Yoon Moon Soo 
Published: March 2003

AbstractBackground: Although the pattern of cancer incidence in South Korea is not the same as that of western countries, urological cancer will become one of the major cancers in South Korea in the near future. The pattern of cancer in South Korea is becoming steadily similar to that in western countries. It is, therefore, important to understand the epidemiological features of cancer. Surveillance of cancer incidence and mortality trends provides clues to etiology and helps to assess the effects of improved diagnostic, screening and intervention measures.Methods: The subjects of the study were 13 208 patients living in South Korea, newly diagnosed with urological cancer during the period of 1985–1999. The data were analyzed by age, sex, geography and period of diagnosis (1985–1989; 1990–1994; 1995–1999).Results: Bladder cancer was the most common urological cancer in South Korea (6867 cases, 52.0%). The incidence of prostate cancer and renal cell carcinoma was similar. Male patients outnumbered female patients by a ratio of 5.4 : 1. In both sexes, the peak incidence of urological cancer in South Korea was noted in the 70+ age group. The geographic distribution of urological cancer across seven residential areas was similar. The incidence rate of all urological cancer (except urethral and penile cancer) had increased remarkably, especially in the last several years. The crude incidence rate of urological cancer among Koreans in South Korea was estimated to be 46.55 per 100 000 males, 8.64per 100 000 females and 27.67 per 100 000 across both sexes.Conclusion: Although this survey is not definitive, these data should be useful in showing general patterns or changes of incidence of urological cancer in South Korea. The elevated incidence of urological cancer noted in our survey also indicates the need for continued promotion of urological cancer screening programs. Moreover, these results may be useful in indicating directions for future research of urological cancer.
Randomized trial of trigger point injection for renal colic
Authors: IGUCHI MASANORI , KATOH YOSHINARI , KOIKE HIROYUKI , HAYASHI TAIJI , NAKAMURA MASATO 
Published: March 2003

Abstract Background: Many drugs have been utilized for the treatment of renal colic, but to date no drugs that relieve pain quickly and completely have been developed. Thus, we conducted a prospective trial to evaluate the effects of trigger point injection on renal colic. In this study, we used a local injection of lidocaine to the trigger point of patients experiencing renal colic, and evaluated the efficacy in patients using the visual analog scale.Methods: Sixty patients with renal colic were enrolled in this study and divided into two groups by a simple randomization: (i) the butylscopolamine group (n = 30, intravenous injection of butylscopolamine bromide and sulpyrine); and (ii) the lidocaine group (n = 30, local anesthesia to the trigger point with lidocaine).Results: Renal colic had disappeared completely at the end of the trigger point injection in 15/30 patients and the average time required to produce a 50% improvement in symptoms was 9 min in all patients in the group. In the lidocaine group, only one patient needed an additional anodyne treatment after 60 min and none of the 29 patients whose pain disappeared within 60 min needed further anodyne treatment within 24 h. These results were all significantly superior to those of the conventional treatment. No side‐effects and complications were observed.Conclusion: Trigger point injection, in our experience, is an easy, safe and effective method for the amelioration of renal colic. It was significantly superior to the combination of intravenous butylscopolamine and sulpyrine.
Surface‐active phospholipid: a Pandora’s box of clinical applications. Part I. The lung and air spaces
Authors: Hills B. A. 
Published: March 2003

AbstractAlmost everywhere in the body there are phospholipids, not only comprising the lipid bilayer of membranes, but also in the free state. What is seldom appreciated, except in respirology, is that these ‘free’ phospholipids are unusual in that many are highly surface active. Surface activity is a property of certain substances (surfactants), conferred by their molecular constitution and configuration, which predisposes them to locate at interfaces because, in doing so, they reduce interfacial energy. When adsorbed (reversibly bound) to solid surfaces, surfactants can impart many highly desirable properties that have been widely studied and long accepted in the physical sciences, while their commercial applications have withstood the test of time. These desirable properties include lubricity (boundary lubrication), release (antistick) and ­dewatering, while providing a barrier to corrosion, abrasion, solute transmission and to biological ­microorganisms. Many of these offer obvious roles for surface‐active phospholipid (SAPL), ranging from a corrosion inhibitor in the stomach to a load‐bearing lubricant in the joints. This opens a veritable ‘Pandora’s box’ of potential clinical applications.Part I of this review challenges traditional beliefs in respirology that ‘surfactant’ is unique to the lung and, moreover, that its actions are confined to the ­liquid−air interface. Evidence is discussed that, by binding to alveolar epithelium, SAPL imparts semipermeability needed before channels pumping ions can also pump water vital for maintaining fluid ­balance. Evidence is also reviewed for a lining to upper airways, sinuses and Eustachian tube where it can act like a standard release agent. (Intern Med J 2002; 32: 170−178)
Scleroderma in South Australia: epidemiological observations of possible pathogenic significance
Authors: Roberts‐Thomson P. J. , Jones M. , Hakendorf P. , Kencana Dharmapatni A. A. S. S. , Walker J. G. , Macfarlane J. G. , Smith M. D. , Ahern M. J. 
Published: March 2003

Abstract Background: Scleroderma is an autoimmune disorder of unknown cause. Previous epidemiological studies have suggested some regional clustering and associations with occupations involving exposure to silica dusts and hydrocarbons. Aims: To determine: (i) prevalence and incidence of scleroderma in South Australia (SA), a state with a stable population living in well‐defined urban, rural and industrial regions, (ii) hospital separation rates, (iii) cumulative survival rates, (iv) gender and disease subclassification, (v) geographical residency and occupations, (vi) familial associations and (vii) age at onset versus age‐specific incidence rate. Methods: Creation of the South Australian Scleroderma Register (SASR) to identify demographics and clinical and serological features of all scleroderma patients resident in SA. Results: Scleroderma occurs in South Australia with a point prevalence of 23 per 105 and an incidence of approximately 1/15th of this. However, this prevalence is high compared with other regional world studies. Scleroderma is predominantly a female disease, with most patients having the limited form of scleroderma characterized by the presence of the anticentromere antibody and a mean survival of 27.6 years. In contrast, diffuse scleroderma is a less benign disease occurring at an early age of onset and has a mean survival of 9.6 years. Scleroderma occurs throughout SA without regional localization. Weak associations are seen in males, but not females, with occupations involving possible environmental exposure to silica or hydrocarbons. Scleroderma rarely occurs in families. Conclusion: No strong genetic or environmental influences were found to account for the relatively common occurrence of scleroderma in SA. The age at onset versus age‐specific incidence curve suggests that scleroderma can be considered as a stochastic illness involving a number of random events occurring in a predisposed population. These random events may involve mutations of pivotal somatic genes. (Intern Med J 2001; 31: 220–229)
Hepatocellular carcinoma: current approaches to diagnosis and management
Authors: McCaughan G. W. , Koorey D. J. , Strasser S. I. 
Published: March 2003

Abstract Hepatocellular carcinoma, frequently associated with chronic viral hepatitis, is the fourth most common cancer worldwide. The incidence in Western countries is rising rapidly. Recent developments in diagnostic imaging allow for identification of small lesions amenable to curative therapy. Effective therapy of advanced hepatocellular carcinoma remains a major clinical problem. (Intern Med J 2002; 32: 394−400)
Recent trends in lipid management: raising the bar and shifting the goalposts?
Authors: Sullivan D. R. 
Published: March 2003

Abstract The National Heart Foundation of Australia, in conjunction with the Cardiac Society of Australia and New Zealand, updated its Lipid Guidelines at the end of 2001, but on‐going modification is anticipated to stay abreast of the rapid progress in this field. Research at all levels re‐affirms the fundamental importance of lipid metabolism in many physiological and pathological processes. In addition, clinical trials such as the recent Heart Protection Study broaden the indications for intervention. The present review summarizes recent advances and analyzes emerging attitudes towards diagnosis and management that will influence future recommendations and practice. (Intern Med J 2003; 33: 95−102)
Anaesthesia for scoliosis surgery in a patient on anticoagulant therapy
Authors: Leitao  , Isaac  
Published: March 2003

Kyphoscoliosis surgery is frequently associated with major blood loss and coagulation disorders. A patient with juvenile rheumatoid arthritis, heart valve prosthesis and respiratory restrictive syndrome, was submitted to surgical correction of kyphoscoliosis. Current drug therapy included digitalis, oral anticoagulant and nonsteroidal anti‐inflammatory drugs. After careful preoperative evaluation, oral anticoagulant and nonsteroidal anti‐inflammatory drugs were discontinued (five and ten days before surgery, respectively), and intravenous heparin was introduced and maintained until two h before surgery. Bacterial endocarditis prophylaxis was obtained with ampicillin (50 mg·kg−1) and gentamicin (1.5 mg·kg−1). Anaesthetic management followed a general, balanced technique and the use of invasive monitoring devices. Clotting times were kept within the normal range—prothrombin time between 13 s and 14 s; partial thromboplastin time between 28 s and 30 sSurgery was straightforward. The patient remained ventilated for 24 h and intravenous morphine (6 μg·kg−1·h−1) was used for nurse controlled analgesia. Afterwards, this was changed for patient controlled analgesia. Intravenous heparin was restarted 12 h after surgery and there were no complications postoperativelyKeeping the patient without anticoagulant therapy during this kind of surgery, was the less harmful option, taking into consideration that haemorrhage is inevitable and thromboembolism is a potential, though serious risk.
Laryngeal mask airway use in children with acute burns: intraoperative airway management
Authors: McCall John E. , Fischer Carl G. , Schomaker Elizabeth , Young Jacqueline M. 
Published: March 2003

SummaryPaediatric patients with acute burns often require many operative procedures in short succession; yet due to inhalation injury or recent extubation their airways may be susceptible to tracheal tube induced damage. We proposed the laryngeal mask airway (LMA) as a useful airway management tool in this setting. In this prospective study, 80 eight (88) patients with mean age (±SD) of 7.8±4.7 years and average percentage total body surface area burned (%TBSA) of 21±18% had their airways managed with an LMA while in the operating room for 141 procedures. Twenty‐five patients (28.4%) had been previously intubated for burn management and 19 (21.6%) had evidence of inhalation injury. During each procedure, the patient was evaluated for airway obstruction, laryngospasm, inability to ventilate, hypoxaemia, evidence of aspiration/regurgitation or any situation which required intraoperative manipulation/removal of the LMA. Of the 141 procedures, 122 were without airway problems. Of the remaining 19, nine required only a simple reseating of the LMA for correction. The other 10 events include arterial desaturation (n=3), partial laryngospasm (5), airway obstruction (1) and regurgitation without aspiration (1). In each case, corrective action led to resolution of the problem with no patient morbidity. This series demonstrates the LMA is a safe and efficacious airway management device in the paediatric burn population.
Anaesthesia for manipulation of forearm fractures in children: a survey of current practice
Authors: Marcus R.J. , Thompson J.P. 
Published: March 2003

SummaryDespite recent recommendations that all children presenting for urgent or emergency surgery should be treated as though they have a full stomach, a local audit had shown a wide variation in technique used for anaesthesia in children after trauma. Therefore, a postal questionnaire was sent to 500 anaesthetists regarding their preferred anaesthetic technique for a 6‐year‐old child requiring manipulation of a forearm fracture. Four clinical situations were presented differing in the timing of surgery in relation to the injury, starvation times before injury and the administration of opioid analgesia. Rapid sequence induction and tracheal intubation was preferred by 83% of all anaesthetists for surgery on the day of injury if the child had eaten 2 h prior to injury and had received opioid analgesia, but the percentage was significantly lower in experienced anaesthetists (P < 0.05) compared with trainees, and was 34.5% overall if surgery was delayed until the following day. Only 19.3% would perform a rapid sequence induction for surgery on the day of injury if the child had not eaten for 6 h before the injury. We conclude that not all anaesthetists believe that rapid sequence induction is necessary for anaesthesia after forearm fractures, despite recent recommendations.
Anaesthetic management of liver haemorrhage during laparotomy in a premature infant with necrotizing enterocolitis
Authors: Breschan Christian , Kraschl Raimund , Krenn Roland , Krumpholz Ruth , Jost Robert , Likar Rudolf 
Published: March 2003

SummaryThe case of a 680 g premature baby who developed massive spontaneous liver haemorrhage during laparotomy for necrotizing enterocolitis is reported. The infant survived due to rapid and massive fluid administration, including transfusion of large volumes of blood and blood products, in combination with high dose inotropic support and the surgical use of packing with thrombostatic sponges. Good venous access, including two central venous lines, turned out to be very useful.
Intramucosal gastric pH during liver transplantation
Authors: Concha Mario , Dagnino Jorge , Altermatt Fernando 
Published: March 2003

SummaryIntramucosal gastric pH (pHi) was measured during liver transplantation in a 3‐year‐old girl. The basal value was below that reported as normal for paediatric patients under stable normal ventilatory and haemodynamic conditions. Additional reductions of the pHi were observed during the hepatectomy and anhepatic phase, in the absence of haemodynamic or ventilatory alterations. The reperfusion phase was characterized by a progressive return toward normal values. Because we did not measure oxygen delivery and consumption, we cannot determine whether the reduction of the pHi was due to insufficient oxygen delivery or a result of the vascular anatomical alterations due to the surgical procedure.