bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public versus private patient priorities and satisfaction in cataract surgery
Authors: Pager Chet K , McCluskey Peter J 
Published: November 2004

Abstract Background: Despite strong stereotypes of differences, few studies have compared private and public patient priorities and satisfaction, and none in the context of cataract surgery. The objective of this study was to compare samples of private and public patients undergoing day‐stay cataract surgery. Methods: Forty‐two public patients and 39 private patients were asked to rate the importance of 13 domains that prior research has shown to influence patient satisfaction. Patients were also asked about their waiting time, amount of information they received, and current and expected VF‐14 functional ability. One month after surgery, patients recorded their satisfaction with each of the 13 domains. Results: Public patients waited ninefold longer for surgery and had lower preoperative visual function. Nonetheless both groups expected, and achieved, the same level of postoperative outcome. Although 90% of private patients were satisfied with the information they received regarding the surgery, 45% of public patients wanted more. There were significant differences in priorities between private and public patients. After surgery, public patients were less satisfied than private patients, although when accounting for the importance as well as satisfaction of each factor, the level of satisfaction between groups was not different. Conclusions: The dearth of information received by public patients raises important questions whether their surgery decision was sufficiently individualized or adequately consented. Patient satisfaction is an important health outcome, and understanding both the domains of satisfaction, as well as their relative importance to patients, is necessary to improve the overall quality of patient care.
Calcification of intraocular hydrogel lens: evidence of dystrophic calcification
Authors: Yong Jim LC , Lertsumitkul Somsak , Killingsworth Murray C , Filipic Marijan 
Published: November 2004

Abstract Purpose: To report and describe the surface calcification of three cases of implanted intraocular hydrogel lens. Methods: Three surgically extracted hydrogel intraocular lenses were studied by light and transmission electron microscopy as well as by energy dispersion X‐ray microanalysis. Results: The lens surfaces were covered by granular deposits of calcium phosphate, clearly delineated by von Kossa and alizarin stains for calcium. Transmission electron microscopy showed the deposits to be located within the superficial lens material to a depth of 7 µm and to be associated with what appear to be traces of cellular material including basement membrane and plasmalemma. To the authors’ knowledge there has been only one other transmission electron microscopic study. Energy dispersion X‐ray microanalysis showed the deposits to contain calcium and phosphorous in all cases. Conclusions: This study confirms and extends the previous reports of five cases of calcification of hydrogel intraocular lenses. The exact mechanism of calcification remains obscure but evidence suggesting cell‐mediated dystrophic calcification of the lens surface is presented. Further study is required to monitor the incidence and development of this phenomenon.
Clinical Case Notes
Authors: Garrott Helen , O'Day Justin 
Published: November 2004

AbstractSnowflake degeneration of intraocular lenses is a recently recognized late postoperative complication of cataract surgery. All known cases reported to date in the literature have involved polymethyl metha­crylate (PMMA) lens optic material. Reported herein is an atypical variant of snowflake degeneration of a PMMA posterior chamber intraocular lens in an 81‐year‐old woman, 7 years post implantation. The aetiology of the atypical late opacification of the intraocular lens is this case is unclear, and no clinical risk factors appear to have been identified.
Clinical Case Notes
Authors: Ooi Kenneth G‐J , Nabili Shahriar , Thompson Kirsteen J , Gavin Michael P 
Published: November 2004

AbstractAnterior and posterior visual pathway disturbances have been reported post‐coronary artery bypass graft surgery. Acute angle‐closure glaucoma after general anaesthesia has also been well described in the literature. To date, however, there are only two cases of angle closure caused by tonic pupils. The case is reported herein of bilateral subacute angle‐closure glaucoma that occurred following coronary artery bypass graft surgery in association with tonic pupils.
Clinical Case Notes
Authors: Patel Dipika V , Phang Kian Liun , Grupcheva Christina N , Best Stephen J , McGhee Charles NJ 
Published: November 2004

AbstractA 90‐year‐old woman developed a large circular capsulorhexis‐like defect in Descemet's membrane as a complication of small incision cataract surgery. Nine months post‐surgery, in vivo confocal microscopic examination of the temporal mid‐peripheral cornea revealed an endothelial cell density of 934 ± 69 cells/mm2 (normal range 1566–3088 cells/mm2). Endothelial pigmented deposits were visible as scattered hyper‐reflective areas on the posterior endothelial surface. Descemet's folds were also noted. In vivo confocal microscopy performed 3 years later showed the temporal mid‐peripheral corneal endothelial density (in the region of the break) was 948 ± 66 cells/mm2. A reduction of endothelial polymegathism and pleomorphism was observed. Imaging in the region of the temporal portion of the original Descemet's defect showed well‐defined linear structures with hyper‐reflective edges. Compared to 3 years previously, the cornea at the level of Descemet's membrane appeared to have greater reflectivity. This case demonstrates how microstructural changes in the cornea can be described and analysed over time with the assistance of in vivo confocal microscopy.
Clinical Case Notes
Authors: Thiagalingam Sureka , Fernando Glen T , Tan Kimberley , O'Donnell Brett A , Weeks Kerry , Branley Michael 
Published: November 2004

AbstractOrbital apex syndrome secondary to mucormycosis in immuno­compromised patients is well described; however, few reports exist of a paranasal sinus mycetoma resulting in this presentation in the immuno­competent patient. The case is reported of a 92‐year‐old man who developed orbital apex syndrome secondary to a sphen­oidal sinus mycetoma of Pseudallescheria boydii.
Amniotic membrane grafting in the surgical management of primary pterygium
Authors: Essex Rohan W , Snibson Grant R , Daniell Mark , Tole Derek M 
Published: November 2004

Abstract Background: To evaluate the efficacy of amniotic membrane transplantation in primary pterygium surgery. Methods: Patients presenting to the outpatient clinic of the Royal Victorian Eye and Ear Hospital with primary pterygium requiring surgical management were included in this study. The pterygia were excised to bare sclera and the conjunctival defects were closed with amniotic membrane grafts. The primary outcome was pterygium recurrence. Results: Twenty‐eight pterygia of 26 patients were included. Twenty‐three patients (88%, 25 eyes) completed 12 months follow up. By 12 months postoperatively 16 of these eyes (64%) had developed corneal recurrence and a further two had developed a limbal recurrence (9%). Five required repeat surgery during the 12 month follow‐up period. No association was found between pterygium recurrence and pterygium size (P = 0.33), amniotic membrane graft dimension (P = 0.12), patient age (P = 0.53) or patient sex (P = 0.63). Conclusion: Amniotic membrane grafting for primary pterygium was associated with an unacceptably high recurrence rate in this population.
Quantification of amino acid neurochemistry secondary to NMDA or betaxolol application
Authors: Sun Daniel , Kalloniatis Michael 
Published: November 2004

Abstract Background: Alterations in retinal amino acid neurochemistry are an indicator of metabolic function. Glutamate is the primary excitatory amino acid neurotransmitter within the retina, and excessive levels of glutamate can potentially cause excitotoxicity, in particular, through the N‐methyl‐D‐aspartate (NMDA) subtype of glutamate receptor. Anomalies in NMDA receptor function have been implicated as causing many neurodegenerative disorders, and overactivation leads to neuronal death secondary to metabolic insult. Several pharmaceutical agents have been proposed as potential neuroprotective agents against excitotoxicity (e.g. betaxolol), yet any effects such drugs have on retinal neurochemistry have not been determined. Therefore, the aim of this study was to quantify the changes in retinal amino acid neurochemistry secondary to the application of NMDA with and without betaxolol. Methods: Functional NMDA channel activation was confirmed in both amacrine and ganglion cells by quantifying the entry into these neurones of a channel permeable probe (agmatine: 1‐amino‐4‐guanidobutane [AGB]). By probing serial thin sections with immunoglobulins targeting AGB, glutamate, γ‐aminobutyric acid (GABA) and glycine, it was possible to simultaneously study the neurochemical characteristic as well as the NMDA‐evoked AGB responses of different neurochemical populations of inner retinal neurones. Results: The authors have previously shown no accumulation of glutamate or GABA within Müller cells following NMDA application. Herein they report altered GABA and glycine immunoreactivity, but not glutamate immunoreactivity within neurones of the amacrine and ganglion cell layers following NMDA application. Finally, the addition of betaxolol did not significantly alter the normal neurochemistry of the retina. Conclusion: The retina possesses intrinsic mechanisms that allow it to maintain metabolic integrity during short periods of high NMDA application.
A tribute to Charles David Kelman MD: ophthalmologist, inventor and pioneer of phacoemulsification surgery
Authors: Pandey Suresh K , Milverton E John , Maloof Anthony J 
Published: November 2004

AbstractCharles David Kelman was born in Brooklyn, New York, USA, on 23 May 1930 and passed away in Boca Raton, Florida, USA, on 1 June 2004 at the age of 74 years after a long battle with cancer. He received a Bachelor of Science degree from Tufts University in 1950 and completed medical studies at the University of Geneva, Switzerland, in 1956. He was Clinical Professor of Ophthalmology at New York Medical College and an Attending Surgeon at New York Eye and Ear Infirmary and Manhattan Eye, Ear and Throat Hospital. Although a prolific inventor, he will be best remembered for developing phacoemulsification, following his realization while sitting in a dentist's chair, that ultrasonic vibrations could be used to emulsify the aged crystalline lens through a very small incision. His pioneering work revolutionized cataract surgery. He also pioneered cryo‐extraction of cataracts, the use of freezing for the repair of retinal detachments and designed numerous ophthalmic instruments and intraocular lenses. Dr Kelman received numerous awards, including the American Academy of Ophthalmology Achievement Award (1970), the Ridley Medal from the International Congress of Ophthalmology (1990), and the Inventor of the Year Award from The New York Patent, Trademark and Copyright Law Association (1992). Most recently (2003), Dr Kelman was honoured by the American Academy of Ophthalmology with the Laureate Recognition award. Dr Kelman was also an accomplished Broadway producer, composer and jazz saxophonist. With his demise, the ophthalmic and medical community lost a famed inventor with multifaceted talents and one of the great ophthalmologists of the twentieth century.
HIV and tuberculosis co‐infection in south‐western Sydney: experience from a case series
Authors: Limaye S , Quin J , Steele R. H 
Published: November 2004

Abstract A case series of six patients with HIV and Mycobacterium tuberculosis co‐infection is presented. All patients were overseas‐born and in all but one there was profound immunodeficiency. We recommend HIV screening of all cases of M. tuberculosis and a high degree of suspicion of tuberculosis in immigrants with HIV infection from endemic areas. Management problems included delayed diagnosis, rapid progression, paradoxical reactions and requirement for surgical intervention in three patients. Therapeutic complications included possible drug malabsorption, adverse events and drug interactions. M. tuberculosis was fully drug sensitive in all cases. (Intern Med J 2004; 34: 203−206)
Nonalcoholic fatty liver disease: is all the fat bad?
Authors: Clouston A. D. , Powell E. E. 
Published: November 2004

AbstractNonalcoholic fatty liver disease is now a major cause of liver disease in developed countries, largely as a result of an epidemic of obesity, diabetes and sedentary lifestyles. This has resulted in raised clinical awareness and diagnostic refinement. The entity encompasses several histologic patterns from benign steatosis to nonalcoholic steatohepatitis, the latter having a significant risk of progressive fibrosis and the development of cirrhosis. Labor­atory tests and imaging are not able to distinguish steatosis from steatohepatitis, which requires liver biopsy. However following an assessment of several risk factors, patients can be stratified for the potential risk of fibrosis, allowing the rational use of liver biopsy. This review will describe the various patterns of nonalcoholic fatty liver disease and relate this to disease pathogenesis and progression. Strategies for management, including experimental interventions, will be discussed. (Intern Med J 2004; 34: 187−191)
A chronic disease management programme can reduce days in hospital for patients with chronic obstructive pulmonary disease
Authors: Rea H. , McAuley S. , Stewart A. , Lamont C. , Roseman P. , Didsbury P. 
Published: November 2004

AbstractBackground:  A steady increase in chronic obstructive pulmonary disease (COPD) admissions was addressed by enhancing primary care to provide intensive chronic disease management.Aim:  To compare the effect of a disease management programme, including a COPD management guideline, a patient‐specific care plan and collaboration between patients, general practitioners, practice nurses, hospital physicians and nurse specialists with conventional care, on hospital admissions and quality of life.Methods:  One hundred and thirty‐five patients with a clinical diagnosis of moderate to severe COPD were identified from hospital admission data and general practice records. General practices were randomized to either conventional care (CON), or the intervention (INT). Pre‐ and post‐study assessment included spirometry, Shuttle Walk Test, Short Form‐36, and the Chronic Respiratory Questionnaire (CRQ). Admission data were compared for 12 months prior to and during the trial.Results: For respiratory conditions, mean hospital bed days per patient per year for the INT group were reduced from 2.8 to 1.1, whereas those for the CON group increased from 3.5 to 4.0 (group difference, P = 0.030) The INT group also showed an improvement for two dimensions of the CRQ, fatigue (P = 0.010) and mastery (P = 0.007).Conclusions: A chronic disease management programme for COPD patients that incorporated a variety of interventions, including pulmonary rehabilitation and implemented by primary care, reduced admissions and hospital bed days. Key elements were patient participation and information sharing among healthcare providers. (Intern Med J 2004; 34: 608−614)
Dynamic regulation of spine–dendrite coupling in cultured hippocampal neurons
Authors: Korkotian Eduard , Holcman David , Segal Menahem 
Published: November 2004

AbstractWe investigated the role of dendritic spine morphology in spine–dendrite calcium communication using novel experimental and theoretical approaches. A transient rise in [Ca2+]i was produced in individual spine heads of Fluo‐4‐loaded cultured hippocampal neurons by flash photolysis of caged calcium. Following flash photolysis in the spine head, a delayed [Ca2+]i transient was detected in the parent dendrites of only short, but not long, spines. Delayed elevated fluorescence in the dendrite of the short spines was also seen with a membrane‐bound fluorophore and fluorescence recovery from bleaching of a calcium‐bound fluorophore had a much slower kinetics, indicating that the dendritic fluorescence change reflects a genuine diffusion of free [Ca2+]i from the spine head to the parent dendrite. Calcium diffusion between spine head and the parent dendrite was regulated by calcium stores as well as by a Na–Ca exchanger. Spine length varied with the recent history of the [Ca2+]i variations in the spine, such that small numbers of calcium transients resulted in elongation of spines whereas large numbers of calcium transients caused shrinkage of the spines. Consequently, spine elongation resulted in a complete isolation of the spine from the dendrite, while shrinkage caused an enhanced coupling with the parent dendrite. These studies highlight a dynamically regulated coupling between a dendritic spine head and its parent dendrite.
A single high dose of cocaine induces behavioural sensitization and modifies mRNA encoding GluR1 and GAP‐43 in rats
Authors: Grignaschi Giuliano , Burbassi Silvia , Zennaro Eleonora , Bendotti Caterina , Cervo Luigi 
Published: November 2004

AbstractNeuroadaptive changes underlying repeated exposure to cocaine‐induced behavioural sensitization have been related to modification in the pattern of synaptic connectivity and excitatory transmission. Remarkably, even a single exposure to abused drugs is sufficient to elicit lasting behavioural sensitization. The present study investigated whether in Sprague–Dawley rats a single, behavioural sensitizing dose of cocaine is sufficient to induce changes in the mRNA levels of growth‐associated protein 43 (GAP‐43), an important protein in mediating experience‐dependent plasticity and synaptic reorganization, and of glutamate receptor 1 (GluR1), a subunit of AMPA glutamate receptors, a protein that is up‐regulated with repeated cocaine. Single exposure to 20, but not 10 mg/kg cocaine induced locomotor sensitization to a second injection of 10 mg/kg cocaine, observed at 24 h, 48 h and 7 days. Single dose of 20 but not 10 mg/kg cocaine 48 h before scheduled death significantly enhanced GluR1 and GAP‐43 mRNA expression in the nucleus accumbens (NAc), both shell and core subregions, and ventral tegmental area (VTA). No changes were found in the levels of mRNA for GluR1 and GAP‐43 in the frontal cortex, caudate putamen, dentate gyrus of hippocampus and basolateral nucleus of the amygdala after the single dose of 20 mg/kg cocaine. These results further strengthen the involvement of NAc and VTA in the behavioural sensitization and suggest a role of GAP‐43 in the synaptic reorganization associated to drug abuse.
Δ9‐tetrahydrocannabinol decreases somatic and motivational manifestations of nicotine withdrawal in mice
Authors: Balerio Graciela N. , Aso Ester , Berrendero Fernando , Murtra Patricia , Maldonado Rafael 
Published: November 2004

AbstractThe possible interactions between Δ9‐tetrahydrocannabinol (Δ9‐THC) and nicotine remain unclear in spite of the current association of cannabis and tobacco in humans. The aim of the present study was to explore the interactions between these two drugs of abuse by evaluating the consequences of Δ9‐THC administration on the somatic manifestations and the aversive motivational state associated with nicotine withdrawal in mice. Acute Δ9‐THC administration significantly decreased the incidence of several nicotine withdrawal signs precipitated by mecamylamine or naloxone, such as wet‐dog‐shakes, paw tremor and scratches. In both experimental conditions, the global withdrawal score was also significantly attenuated by acute Δ9‐THC administration. This effect of Δ9‐THC was not due to possible adaptive changes induced by chronic nicotine on CB1 cannabinoid receptors, as the density and functional activity of these receptors were not modified by chronic nicotine administration in the different brain structures investigated. We also evaluated the consequences of Δ9‐THC administration on c‐Fos expression in several brain structures after chronic nicotine administration and withdrawal. c‐Fos was decreased in the caudate putamen and the dentate gyrus after mecamylamine precipitated nicotine withdrawal. However, acute Δ9‐THC administration did not modify c‐Fos expression under these experimental conditions. Finally, Δ9‐THC also reversed conditioned place aversion associated to naloxone precipitated nicotine withdrawal. Taken together, these results indicate that Δ9‐THC administration attenuated somatic signs of nicotine withdrawal and this effect was not associated with compensatory changes on CB1 cannabinoid receptors during chronic nicotine administration. In addition, Δ9‐THC also ameliorated the aversive motivational consequences of nicotine withdrawal.
A soluble Nogo receptor differentially affects plasticity of spinally projecting axons
Authors: MacDermid V. E. , McPhail L. T. , Tsang B. , Rosenthal A. , Davies A. , Ramer M. S. 
Published: November 2004

AbstractIn the central nervous system, regeneration of injured axons and sprouting of intact axons are suppressed by myelin‐derived molecules that bind to the Nogo receptor (NgR). We used a soluble form of the NgR (sNgR), constructed as an IgG of the human NgR extracellular domain, to manipulate plasticity of uninjured primary afferent and descending monoaminergic projections to the rat spinal cord following dorsal rhizotomy. Rats with quadruple dorsal rhizotomies were treated with intrathecal sNgR or saline, or were left untreated for 2 weeks. Rhizotomy alone resulted in sprouting of serotonergic axons and to a lesser extent, tyrosine‐hydroxylase (TH)‐expressing axons, while axons expressing dopamine‐β‐hydroxylase (DβH) were unaffected. Human IgG immunohistochemistry revealed that sNgR infused into the intrathecal space penetrated approximately 300 µm into spinal white and grey matter. Separate axonal populations differed in their responses to intrathecal sNgR: TH‐expressing and DβH‐expressing axons responded most and least vigorously, respectively. Serotonergic axons were identified by serotonin (5‐HT) or serotonin transporter (SERT) immunohistochemistry. Interestingly, a large increase in 5‐HT compared to SERT‐positive axons density in both saline and sNgR‐treated rats indicated that serotonergic axons both sprouted and increased their transmitter content in response to rhizotomy and sNgR treatment. Calcitonin gene‐related peptide‐positive axons were largely depleted ipsilaterally by rhizotomy, and sNgR increased axon density only in deeper contralateral laminae (III–V). GAP‐43 immunohistochemistry revealed a small increase in axon density following dorsal rhizotomy that was further augmented by sNgR treatment. These results reveal a differential effect of myelin antagonism on distinct populations of spinally projecting axons.