bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Relationship among Fungicide‐resistant Phenotypes of Botrytis cinerea Based on RAPD Analysis
Authors: Paplomatas E. J. , Pappas A. C. , Antoniadis D. 
Published: September 2004

AbstractOn the basis of the mode of spore germination and mycelial growth on fungicide‐amended media, 200 Botrytis cinerea Pers.:Fr. single spore isolates were classified into six representative groups of resistant phenotypes. Sixty eight isolates were phenylcarbamate highly resistant (PcmHR, wild type), eight were dicarboximide moderately and phenylcarbamate highly resistant (DicMRPCMHR), four were benzimidazole and phenylcarbamate highly resistant (BenHRPcmHR), five were dicarboximide and benzimidazole moderately resistant and phenylcarbamate highly resistant (DicMRBenMRPcmHR), twenty were dicarboximide moderately and benzimidazole highly resistant (DicMRBenHR) and ninety five isolates were benzimidazole highly resistant (BENHR). Two representative isolates of each phenotype were examined by random amplified polymorphic DNA (RAPD) fingerprint analysis. Relationships among the isolates were determined using the unweighted pair‐group method with arithmetic average (UPGMA) and dendrograms were constructed. Regardless of host, geographical origin and year of the isolation, phylogenetic analysis revealed the clear differentiation of the six phenotypic‐resistant groups classified into three clusters. The first cluster included isolates of the PcmHR phenotype with subdivisions included the wild type, the DicMR and the BenHR phenotypes. The latter two phenotypes maintained their wild type insensitivity to diethofencarb. This first cluster was branching with a second cluster that included the double resistance phenotypes DicMRBenMR and DicMRBenHR. A third cluster, which was most distantly related to the above two included isolates of BenHR only. The presented data show a positive correlation between conventional and molecular techniques in definition of fungicide‐resistant phenotypes and support earlier findings of the genetically based diversity of fungicide resistance.
Delay in surgery for acute appendicitis
Authors: Maroju Nanda K. , Robinson Smile S. , Sistla Sarath C. , Narasimhan Raghavan , Sahai Ajit 
Published: September 2004

Background:  The present study investigates the effect of delay in appendicectomy on the outcome of surgery and also examines the contribution of patient and physician related delay to the stage of appendicitis.Methods:  During a 12‐month period, 114 consecutive adult patients undergoing appendicectomy for acute appendicitis were monitored prospectively. Time of onset of symptoms, presentation to the hospital, surgery consultation, decision to operate and starting of surgery were all noted. The stage of the appendicitis was identified based on operative findings and pathology reports. Postoperative events were recorded. The stage of appendicitis and outcome were related to the prehospital and in‐hospital delay of each patient.Results:  There were three (2.6%) normal, 62 (54.4%) early inflamed and 49 (43%) cases of advanced appendicitis. The total delay from onset of symptoms to performance of appendicectomy was 2.4 times longer in the advanced appendicitis group than in the early inflamed appendicitis group. There was no significant difference in the in‐hospital delay between the two groups. Delay in the resumption of oral feed and total hospital stay were significantly higher in the advanced appendicitis group.Conclusions:  The present prospective study concludes that morbidity caused by acute appendicitis correlates directly with delay in treatment. In the majority of cases the delay in treatment is predominantly caused by patient related factors. The negative appendicectomy rate can be reduced by close observation of cases with clinical uncertainty without increasing the morbidity.
Local recurrence following surgical treatment for carcinoma of the lower rectum
Authors: Polglase Adrian L. , Grodski Simon F. , Tremayne Ann B. , Chee Justin B. L. , Bhathal Prithi S. 
Published: September 2004

Background:  The present paper examines the local recurrence rate following surgical treatment for carcinoma of the lower rectum with principally blunt dissection directed at tumour‐specific mesorectal excision (including total mesorectal excision when appropriate).Methods:  During the period April 1987−December 1999, 123 consecutive resections for carcinoma of the middle and distal thirds of the rectum were performed. The patients had low anterior resection, ultra low anterior resection or abdomino‐perineal resection. Ninety‐six eligible patients underwent curative resection. The mean follow‐up period was 66.8 months ±44.3 (range 3−176 months). Data were available on all patients having been prospectively registered and retrospectively collated and computer coded.Results:  The overall rate of local recurrence was 5.2% (four recurrences following ultra low anterior resection and one following abdomino‐perineal resection. No local recurrence occurred after low anterior resections.). Local recurrences occurred between 16 and 52 months from the time of resection, and the cumulative risk of developing local recurrence at 5 years for all patients was 7.6%. The overall 5‐year cancer specific survival of the 96 patients was 80.8%, and the overall probability of being disease free at 5 years, including both local and distal recurrence, was 71.8%.Conclusion:  The results of the present series confirm the safety of careful blunt techniques combined with sharp dissection for rectal mobilization along fascial planes resulting in extraction of an oncologic package with tumour‐specific mesorectal excision (or total mesorectal excision when appropriate).
Resources for managing trauma in rural New South Wales, Australia
Authors: Wong Kenneth , Petchell Jeffrey 
Published: September 2004

Background:  Trauma bypass is not always appropriate in the management of rural trauma because of the large distances and travel times. Rural hospitals in New South Wales, Australia are an essential component of the statewide integrated trauma system. The present study profiles the trauma resources of base hospitals in rural New South Wales.Methods:  A structured questionnaire, addressed to the ‘Director, Emergency Department’ was distributed to all rural base hospitals in New South Wales. Follow‐up telephone interviews were administered to complete data collection.Results:  Fourteen hospitals were identified. General and orthopaedic surgeons provided trauma care in all hospitals. Forty‐three per cent of hospitals had resident subspecialty surgeons. Fifty per cent of hospitals had a formal hospital trauma team. In the remaining hospitals, the most common reason (86%) stated for the absence of a formal trauma team was a lack of personnel to provide 24 h immediate response to all trauma presentations. Seventy‐one per cent of hospitals are staffed by a single doctor after hours. All hospitals had 24 h access to plain radiography and blood products. 86% had 24 h access to ultrasound and computed tomography, although always on an ‘on‐call’ basis after hours. All hospitals had the capability to maintain ventilated patients, averaging two ventilated beds per hospital. An average of two trauma patients per hospital per month is transferred to a larger institution. Sixty‐four per cent of hospitals participated in a trauma retrievals for their surrounding areas. Seventy‐one per cent of hospitals engaged in quality assurance activities regarding trauma outcomes.Conclusions:  Formal responses to major trauma in rural base hospitals in New South Wales are often restricted by a lack of specialist medical personnel. Nevertheless, the majority of hospitals have the resources to manage major trauma.
A 23‐hour care centre model for the management of surgical patients
Authors: Ryan Richard , Davoren Judith , Grant Helen , Delbridge Leigh 
Published: September 2004

Background:  Much of the emphasis on gaining efficiencies in surgical care have, to date, focused on increasing day only (DO) facilities and increasing the utilization of day of surgery admissions (DOSA) for longer stay cases. However, for the majority of cases requiring surgery, both elective and acute, the episode of care can generally be delivered within an envelope of 23 h during which time patients require only pain relief and monitoring in a supervised setting until fit for discharge. The aim of the present study was to evaluate a pilot of a 23‐h care centre at a principal referral hospital.Methods:  A 23‐h care centre was established at a principal referral hospital in January 2003 in association with an existing DO and DOSA facility. All patients, both emergency and elective as well as surgical and medical, who fitted the following criteria were admitted as ‘23‐h patients’ to the centre: absolute expectation of discharge within 24 h; preadmission screening by a nurse screener (if elective); agreed clinical guidelines in place; agreement to protocol‐based, nurse‐initiated discharge. Outcomes were evaluated after 3 months. Existing admission criteria for DO and DOSA patients were maintained.Results:  Over 3 months, 1601 patients utilized the 23‐h care centre as follows: 593 DO patients, 410 DOSA patients and 598 23‐h patients. Transfers from the emergency department constituted 47% of all 23‐h patients. Utilization varied with the departments of hand surgery, ear, nose and throat/head and neck surgery, and gastrointestinal surgery all managing more than 55% of their operative workload as 23‐h patients (excluding DO and DOSA patients). Excluding inappropriate admissions, overall discharge compliance was 83%. Three departments achieved the compliance benchmark of 90% of admitted patients discharged within 23 h. Only 1% of patients discharged required referral back to the emergency department, with a further 2% being reviewed by their general practitioner.Conclusion:  The 23‐h care centre model, incorporating DO, DOSA and 23‐h patients, offers a workable system of healthcare delivery for patients who do not require a prolonged stay in hospital including, potentially, the majority of surgical patients.
Re‐operation for hyperparathyroidism
Authors: Liew Victor , Gough Ian R. , Nolan Gregory , Fryar Barry 
Published: September 2004

Introduction:  Re‐operation for hyperparathyroidism (HPT) represents a challenge for experienced endocrine surgeons. The present study reviews the technical and pathological factors for failure of initial surgery and identifies strategies to approach re‐operative parathyroidectomy.Methods:  Clinical details, operation notes, pathology, localization studies and complications for re‐operative cases performed by three surgeons were reviewed.Results:   Over a 10‐year period there were 40 re‐operative cases with a 98% success rate. There were 31 patients with primary HPT, 21 with persistent primary (PP) and 10 with recurrent primary (RP). Multigland disease (MGD) was present in 19 of the 31 (61%) primary HPT cases. The culprit gland was ectopic in 14 cases, at a normal location in 10 and there was regrowth at previously excised sites or remnant disease in 10.There were nine patients with secondary HPT, four with persistent secondary (PS) and five with recurrent secondary (RS). The culprit gland was ectopic in five, at a normal location in four and regrowth at a previously excised site in two.Pre‐operative investigations were employed in all cases and the most helpful were sestamibi scan (S) and selective venous sampling (SVS) for parathyroid hormone (PTH) concentration. True positive localizations for S was in 20 of 34 cases (59%), SVS in seven of nine (78%), computed tomography (CT) in seven of 17 (41%) and ultrasound scan (USS) in 10 of 28 (36%).Conclusions:  Re‐operative parathyroidectomy can be performed by experienced surgeons with a very high success rate and minimal complications.
Endovascular treatment of epistaxis
Authors: Vokes David E. , McIvor Nicholas P. , Wattie W. John , Chaplin John M. , Morton Randall P. 
Published: September 2004

Aim:  Embolization of external carotid vessels in the treatment of intractable epistaxis is not well documented in Australasia. The aim of the present retrospective study was to audit our experience with the technique, and to compare it with other centres.Methods:  Retrospective review.Results:  Twenty‐nine embolizations were performed in 28 patients. Embolization was successful in 24 out of 28 patients (86%). Three patients required ligation of the anterior ethmoidal arteries, one of whom subsequently underwent successful repeat embolization. There were minor complications in 6/29 procedures (21%), and no major complications.Conclusion:  Our outcomes compare favourably with those of larger centres. Embolization is an effective tool in the management of patients with intractable epistaxis.
Antiproliferative effects of low molecular weight heparin
Authors: Fletcher John P. , Ao Peng Y. , Hawthorne Wayne J. 
Published: September 2004

Aim:  To investigate the effect of low molecular weight heparins (LMWH) on the inhibition of intimal hyperplasia (IH) developing in prosthetic vascular patch graft implanted into sheep carotid artery.Methods:  A gelatin sealed Dacron patch graft was implanted into the common carotid artery of sheep, which were then allocated to a control group (n = 10) or to one of four treatment groups (each group n = 10) receiving either a low dose (LD) or high dose (HD) of one of two LMWH (enoxaparin 1 or 2 mg/kg/day, dalteparin 100 or 200 units/kg/day) administered subcutaneously for 4 weeks. Anti‐activated factor X and activated partial thromboplastin time were assayed from blood collected prior to and at 1 and 2 h after LMWH administration on days 3, 7, 14, 21 and 28. Animals were killed on day 28 after taking blood samples prior to, then at 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 h following the last injection. Grafts were collected for analysis and measurements of intimal thickness obtained under light microscopy from eight transverse sections of each grafted artery aided by computer image analysis. An IH index was calculated by dividing the area of IH (mm2) by the width of the graft (mm).Results:  Intimal hyperplasia index measurements (mean ± SD) were: controls 0.574 ± 0.077, LD enoxaparin 0.471 ± 0.056, LD dalteparin 0.404 ± 0.025, HD enoxaparin 0.398 ± 0.068, HD dalteparin 0.332 ± 0.048. The reductions in IH index compared to controls were significant (P < 0.05) for both LD and HD dalteparin and for HD enoxaparin.Conclusion:  Both LMWH dalteparin and enoxaparin reduced the amount of IH formation with dalteparin showing a greater effect in the present animal study. The possibility that different LMWH might exert differing antiproliferative effects requires further investigation.
Evidence‐based update of chemotherapy options for metastatic colorectal cancer
Authors: Damjanovic Dragan , Thompson Paul , Findlay Michael P. N. 
Published: September 2004

Colorectal carcinoma is one of the most common malignancies in the Western world. Although fluorouracil (5‐FU) has been used for over 40 years, only in the last decade has its value been recognized in the treatment of advanced colorectal cancer. Early randomized studies explored the best possible doses and schedules of 5‐FU and its modulators such as folinic acid or leucovorin (LV) in combination with respect to efficacy and side‐effects. The development of oral fluoropyrimidines, in particular capecitabine, has made chemotherapy further accessible and acceptable.The introduction of newer cytotoxics irinotecan and oxaliplatin has achieved a significant improvement in survival rates with manageable toxicity. With appropriate selection of patients and proper sequencing of currently most efficient regimens, median survival durations of around 20 months can now be reached. Novel targeted therapies (bevacizumab, cetuximab and cyclooxygenase‐2 (COX‐2) inhibitors) in combination with most efficient chemotherapy regimens will probably push the median survival beyond the 2‐year mark.The present article is an overview of most important studies that have substantially changed the approach to metastatic colorectal cancer and have given the patients and clinicians a wider range of options for treating this illness.
Small bowel tumours: a 10 year experience in four sydney teaching hospitals
Authors: Rangiah David S. , Cox Michael , Richardson Mark , Tompsett Elizabeth , Crawford Michael 
Published: September 2004

Background:  Small bowel tumours are uncommon and can have a long delay prior to diagnosis. The present study aims to compare the use of computed tomography (CT) and contrast small bowel series (SBS) in their diagnosis and to outline the clinical features of small bowel tumours.Methods:  A retrospective, case note study was conducted between 1990 and 2000 in four Sydney teaching hospitals. The data collected included clinical features, investigations and tumour characteristics.Results:  One hundred and sixty‐six people with small bowel tumours were identified (91 malignant; 75 benign). Malignant tumours consisted of adenocarcinomas (31%), carcinoid tumours (12%), lymphomas (7%) and leiomyosarcomas (5%). Benign tumours consisted of adenomas (22%), hamartomas (13%), leiomyomas (4%), inflammatory polyps (4%) and hyperplastic polyps (2%) and a benign schwannoma (1%). Adenocarcinomas were mainly located in the duodenum (P < 0.001) and carcinoid tumours in the ileum (P < 0.001). Malignant tumours were associated with a higher proportion of symptoms (P < 0.01), signs (P < 0.001) and episodes of small bowel obstruction (P < 0.01). Abdominal CT scans demonstrated a greater sensitivity (87.7%) than SBS (72.9%) with a slightly improved sensitivity when both investigations were used (89.3%). Abdominal ultrasound had a lower sensitivity than both of the above investigations of 65%. Gastroduodenoscopy had a sensitivity of 90% for diagnosing duodenal tumours.Operative procedures were performed on 92 patients with a preoperative diagnosis made in 77%. Metastatic spread of malignant tumours was evident in 46%. The sites of spread were to lymph nodes (23%), liver (21%) and distant locations (2%) at diagnosis.Conclusions:  Malignant small bowel tumours are more likely to produce symptoms and signs than benign tumours, particularly caused by small bowel obstruction. Abdominal CT is the best radiological investigation for small bowel tumours and has a slight complimentary effect with SBS in improving the chances of detection. Gastroduodenoscopy remains the best investigation of duodenal tumours.
Presynaptic source of quantal size variability at GABAergic synapses in rat hippocampal neurons in culture
Authors: Barberis Andrea , Petrini Enrica Maria , Cherubini Enrico 
Published: September 2004

AbstractThe variability of quantal size depends on both presynaptic (profile of the neurotransmitter concentration in the cleft) and postsynaptic (number and gating properties of postsynaptic receptors) factors. Here we have examined the possibility that at nonsaturated synapses in cultured hippocampal neurons, changes in both the transmitter concentration peak and its clearance from the synaptic cleft may influence the variability of spontaneous miniature synaptic GABAergic currents (mIPSCs). We found that, in contrast to the slow‐off GABAA receptor antagonist bicuculline, fast‐off competitive antagonists such as SR‐95103 and TPMPA differentially blocked small and large mIPSCs. In the presence of flurazepam, a drug believed to increase the affinity of GABA for GABAAR, small mIPSCs were enhanced more efficiently than large events. Moreover, the addition of dextran, which increases the viscosity of the extracellular fluid, preferentially increased small mIPSCs with respect to large ones. These observations suggest that changes in the concentration peak and the speed of GABA clearance in the cleft may be an important source of synaptic variability. The study of the correlation between peak amplitude and kinetics of mIPSCs allowed determination of the relative contribution of transmitter peak concentration vs. time of GABA clearance. Small synaptic responses were associated with fast onset and decay kinetics while large amplitude currents were asociated with slow kinetics, indicating a crucial role for GABA synaptic clearance in variability of mIPSCs. By using model simulations we were able to estimate the range of variability of both the concentration and the speed of clearance of the GABA transient in the synaptic cleft.
Topographic distribution of direct and hippocampus‐ mediated entorhinal cortex activity evoked by olfactory tract stimulation
Authors: Gnatkovsky Vadym , Uva Laura , De Curtis Marco 
Published: September 2004

AbstractOlfactory information is central for memory‐related functions, such as recognition and spatial orientation. To understand the role of olfaction in learning and memory, the distribution and propagation of olfactory tract‐driven activity in the parahippocampal region needs to be characterized. We recently demonstrated that repetitive stimulation of the olfactory tract in the isolated guinea pig brain preparation induces an early direct activation of the rostrolateral entorhinal region followed by a delayed response in the medial entorhinal cortex (EC), preceded by the interposed activation of the hippocampus. In the present study we performed a detailed topographic analysis of both the early and the delayed entorhinal responses induced by patterned stimulation of the lateral olfactory tract in the isolated guinea pig brain. Bi‐dimensional maps of EC activity recorded at 128 recording sites with 4 × 4 matrix electrodes (410 µm interlead separation) sequentially placed in eight different positions, showed (i) an early (onset at 16.09 ± 1.2 ms) low amplitude potential mediated by the monosynaptic LOT input, followed by (ii) an associative potential in the rostral EC which originates from the piriform cortex (onset at 33.2 ± 2.3 ms), and (iii) a delayed potential dependent on the previous activation of the hippocampus. The sharp component of the delayed response had an onset latency between 52 and 63 ms and was followed by a slow wave. Laminar profile analysis demonstrated that in the caudomedial EC the delayed response was associated with two distinct current sinks located in deep and in superficial layers, whereas in the rostrolateral EC a small‐amplitude sink could be detected in the superficial layers exclusively. The present report demonstrates that the output generated by the hippocampal activation is unevenly distributed across different EC subregions and indicates that exclusively the medial and caudal divisions receive a deep‐layer input from the hippocampus. In the rostrolateral EC, specific network interactions may be generated by the convergence of the direct olfactory input and the olfaction‐driven hippocampal output.