bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventive effect of preoperative portal vein ligation on endotoxin-induced hepatic failure in hepatectomized rats is associated with reduced tumour necrosis factor α production
Authors: Yachida S , Ikeda K , Kaneda K , Goda F , Maeba T , Maeta H 
Published: July 2002

Abstract

Background
Preoperative portal vein embolization successfully reduces the incidence of postoperative hepatic failure in which endotoxin is postulated to be involved. To identify the mechanism of this preventive effect, the relationship of endotoxin-induced liver injury with tumour necrosis factor (TNF) α and nitric oxide production in the peripheral blood, liver and spleen of rats subjected to preoperative portal vein branch ligation (PVL) was compared with that in rats undergoing sham operation.

Methods
Rats with PVL and those that underwent sham operation were subjected to resection of ligated liver lobes (PVL-Hx rats) and two-thirds hepatectomy (noPVL-Hx rats) respectively at day 5, followed by intravenous administration of endotoxin 200 μg/kg body-weight at day 7. At various time intervals after endotoxin injection, the peripheral blood, liver and spleen tissues were harvested and analysed for TNF-α and nitric oxide production.

Results
The survival rates of noPVL-Hx and PVL-Hx rats at 48 h after endotoxin administration were 40 and 100 per cent respectively. The former rats showed more extensive liver injury as represented by higher serum aminotransferase and hyaluronate levels than the latter. Plasma concentrations of TNF-α at 1·5 h after endotoxin treatment were significantly higher in noPVL-Hx rats (mean(s.e.m.) 22 125(2175) pg/ml; n = 6) than PVL-Hx rats (8344(4076) pg/ml; n = 6) (P &lt; 0·01). Consistent with this, expression of TNF-α messenger RNA in the liver and spleen was suppressed in PVL-Hx rats. In two-thirds hepatectomized rats, plasma TNF-α concentrations after endotoxin administration at 1, 2 and 3 days (14 350(2186), 26 375(2478) and 23 000(3745) pg/ml respectively; n = 6 each) were significantly higher than that before operation (9067(1559) pg/ml; n = 6) (P &lt; 0·05), whereas those at 5 and 7 days (10 102(3616) and 8580(1427) pg/ml respectively; n = 6 each) showed no significant increase. Furthermore, nitric oxide production in peripheral blood and liver was suppressed by preoperative PVL.

Conclusion
Prevention of endotoxin-induced liver failure by preoperative PVL is associated with reduced production of TNF-α in the later phase of liver regeneration.
Factors predictive of outcome after surgery for faecal incontinence
Authors: Baig M K , Wexner S D 
Published: July 2002

Abstract

Background
Surgical treatment of faecal incontinence may be categorized into procedures that either repair or augment the native sphincter mechanism or, alternatively, require construction of a neosphincter using either autologous tissue or an artificial device.

Methods
This article reviews the currently available surgical options for the treatment of faecal incontinence, discusses factors predictive of outcome, and includes an algorithm for treatment.

Results and conclusion
Procedures such as postanal repair, direct sphincter repair and reefing are seldom used. Overlapping repair has become the operation of choice in incontinent patients with isolated anterior defects in the external anal sphincter muscle, particularly in postobstetric trauma. Pudendal neuropathy seems to be a predictive factor of success, although this is not universally accepted. Total pelvic floor repair has been offered as a recent alternative. Neosphincter procedures include a gluteoplasty, non-stimulated and stimulated unilateral or bilateral graciloplasty and artificial bowel sphincter. The success and morbidity rates with the stimulated graciloplasty and artificial bowel sphincter appear similar. The newest alternative, sacral nerve stimulation, seems promising. In the final analysis, case selection and surgical judgement are probably the most important factors influencing the success of surgery for faecal incontinence.
Activation of human neutrophils by mycobacterial phenolic glycolipids
Authors: Fäldt J , Dahlgren C , Karlsson A , Ahmed A M S , Minnikin D E , Ridell M 
Published: July 2002

SUMMARYThe interaction between mycobacterial phenolic glycolipids (PGLs) and phagocytes was studied. Human neutrophils were allowed to interact with each of four purified mycobacterial PGLs and the neutrophil production of reactive oxygen metabolites was followed kinetically by luminol-/isoluminol-amplified chemiluminescence. The PGLs from Mycobacterium tuberculosis and Mycobacterium kansasii, respectively, were shown to stimulate the production of oxygen metabolites, while PGLs from Mycobacterium marinum and Mycobacterium bovis BCG, respectively, were unable to induce an oxidative response. Periodate treatment of the M. tuberculosis PGL decreased the production of oxygen radicals, showing the importance of the PGL carbohydrate moiety for the interaction. The activation, however, could not be inhibited by rhamnose or fucose, indicating a complex interaction which probably involves more than one saccharide unit. This is in line with the fact that the activating PGLs from M. tuberculosis and M. kansasii contain tri- and tetrasaccharides, respectively, while the nonactivating PGLs from M. marinum and M. bovis BCG each contain a monosaccharide. The complement receptor 3 (CR3) has earlier been shown to be of importance for the phagocyte binding of mycobacteria, but did not appear to be involved in the activation of neutrophils by PGLs. The subcellular localization of the reactive oxygen metabolites formed was related to the way in which the glycolipids were presented to the cells.
Comparison of serum thyrotrophin concentrations determined by a third generation assay in patients with various types of overt and subclinical thyrotoxicosis
Authors: Kasagi Kanji , Kousaka Tadako , Misaki Takashi , Iwata Masahiro , Alam Mohammad Sayeedul , Konishi Junji 
Published: July 2002

OBJECTIVERecent increases in the sensitivity of methods used to measure TSH, especially third generation assays, have enabled separation of partial from complete pituitary suppression in patients with thyrotoxicosis. We have investigated the use of a sensitive chemiluminescent enzymeimmunoassay in the differential diagnosis of thyrotoxicosis.DESIGN AND PATIENTSSerum TSH concentrations were determined by chemiluminescent enzymeimmunoassay in patients with various types of overt and subclinical thyrotoxicosis.RESULTSThe assay was highly sensitive with an analytical sensitivity of 0.0016 mU/l. Among 45 hyperthyroid patients with untreated Graves' disease, 37 (82.2%) showed undetectably low levels (<0.002 mU/l). Serum TSH in the remaining 8 patients (17.8%) was 0.003–0.005 mU/l. In contrast, TSH was undetectably low in only 5 (20.0%) of 20 patients with painless thyroiditis and in 2 (12.5%) of 16 patients with subacute thyroiditis. Eleven (55.0%) with painless thyroiditis and 12 (75.0%) with subacute thyroiditis had TSH values greater than 0.005 mU/l (0.006–0.032 and 0.006–0.228 mU/l, respectively; normal range 0.5–5.0 mU/l). Serum TSH levels were subnormal in 10 of 12 patients with euthyroid ophthalmic Graves' disease, including 4 with undetectably low levels. Among 11 patients with an autonomously functioning thyroid nodule 6, including 1 with normal free T4 and free T3 and 2 with normal free T3, showed TSH values less than 0.002 mU/l. No significant correlation was observed between serum free T4 or free T3 and TSH concentrations in thyrotoxic patients. Together with the incomplete suppression of TSH observed in those with destructive thyroiditis, this suggests that the grade of TSH suppression was influenced by the duration of illness at the time of blood sampling.CONCLUSIONThe third‐generation TSH assay is useful for the differential diagnosis of various types of thyrotoxicosis, especially between Graves' disease and destructive thyroiditis.
An audit of root canal treatment performed by undergraduate students
Authors: Hayes S. J. , Gibson M. , Hammond M. , Bryant S. T. , Dummer P. M. H. 
Published: July 2002

AbstractAimThe objective of this study was to audit the quality of root canal treatment performed by undergraduate students on adult patients.MethodologyAll root canal treatment completed by first and second clinical year undergraduates over a 12‐month period were included in the study. The availability and readability of pretreatment, diagnostic length, try‐in point and postoperative radiographs were noted for each case. All readable postoperative radiographs of primary treatments were examined for quality of the root filling, categorized as complete, incomplete apical, incomplete apical and lateral or not assessable. The distance from the radiographic apex of the root to the apical extent of each root filling was measured to 0.1 mm precision.ResultsUndergraduates performed primary treatment on 157 teeth. A postoperative radiograph was available in 97% of cases. A try‐in point radiograph was unavailable in one‐fifth of cases. Twenty‐seven teeth (13%) were categorized as satisfactory in terms of both radiographic quality and distance of the root filling from the radiographic apex.ConclusionsOverall, the technical quality of root canal treatment completed by undergraduate students was poor.
Morphological and molecular evidence for hybridization and introgression in a willow (Salix) hybrid zone
Authors: Hardig T. M. , Brunsfeld S. J. , Fritz R. S. , Morgan M. , Orians C. M. 
Published: July 2002

AbstractHybrid zones provide biologists with the opportunity to examine genetic and ecological interactions between differentiated populations. Accurate identification of hybrid genealogies is considered a necessary prerequisite to understanding observed patterns of hybridization–related phenomena. We analysed molecular and morphological data from individuals in a hybrid zone between two species of willows (Salix sericeaMarshall andS. eriocephalaMichaux) and report the use of randomly amplified polymorphic DNA (RAPD), chloroplast DNA (cpDNA), and ribosomal DNA (rDNA) markers, as well as vegetative morphology and foliar chemistry data to identify individuals in terms of hybrid genealogy and to infer the direction and extent of backcrossing and introgression within the hybrid zone. A novel version of a maximum likelihood estimate approach (developed for this study) was used to calculate hybrid index scores from RAPD marker data; this method produced results similar to those obtained using traditional arithmetic methods. Distribution of rDNA, cpDNA, and chemistry data were examined within the graphical context of RAPD–based hybrid index score histograms and principal component analyses (PCA) on RAPD and morphology data. Seven of the 21 plants classified asS. eriocephalain the field were possible introgressants. Another plant presented an unequivocal example of backcrossedS. sericeachemistry and RAPD markers. Inter– and intraspecific chloroplast diversity found within the hybrid zone suggests both historic introgression (perhaps in a glacial refugium), and contemporary hybridization. Patterns of inheritance and expression within the hybrid zone suggest that morphological characters are often not expressed in a simple additive fashion, and problems associated with both morphological and molecular data are considered.
Awareness of eye donation in an urban population in India
Authors: Dandona Rakhi , Dandona Lalit , Naduvilath Thomas J , McCarty Catherine A , Rao Gullapalli N 
Published: July 2002

Purpose: Awareness of eye donation and willingness to pledge eyes for donation was assessed in the urban population of Hyderabad, India, where corneal blindness is a significant problem. Methods: A total of 2522 subjects of all ages, representative of the Hyderabad population, participated in the Andhra Pradesh Eye Disease Study. Subjects >15 years old were interviewed regarding awareness of eye donation and willingness to pledge eyes for donation. Results: Age–gender‐adjusted prevalence of awareness of eye donation was 73.8% (95% CI: 66.5–81.0%) but only 1.9% (95% CI: 0.16–3.66%) had pledged eyes. With multivariate analysis, significantly less awareness of eye donation was found in illiterate subjects (OR 0.1; 95% CI: 0.1–0.14), subjects ≥70 years old (OR 0.3; 95% CI: 0.2–0.6), subjects of lower socio‐economic status (OR 0.4; 95% CI: 0.3–0.6), females (OR 0.6; 95% CI: 0.5–0.8) and Muslims (OR 0.7; 95% CI: 0.6–0.9). Media was the major source of information about eye donation. Of those aware of eye donation, 44.9% were willing to pledge eyes. Willingness to pledge eyes for donation was significantly lower in Muslims (OR 0.18; 95% CI: 0.13–0.24) than in Hindus and in subjects ≥60 years old (OR 0.3; 95% CI: 0.2–0.5). Conclusions: These data show that although only a few had pledged eyes there is enough potential in this population for obtaining many more corneas for transplantation. The information about distribution and demographic associations of awareness and willingness for eye donation could help in developing strategies to increase procurement of corneas for dealing with corneal blindness.
A New Conceptual Paradigm from Genetics and Psychobiology for the Science of Mental Health
Authors: Cloninger C. Robert 
Published: July 2002

Objective: The assumptions and goals underlying current systems of classification are critically examined. Method: Current systems of classification are based on assumptions that health can be adequately defined as the absence of disorders and that psychiatric disorders are discrete disease entities that can be categorically defined. These assumptions appear to be inconsistent with available knowledge of the psychobiology, genetics, development and evolution of thoughts, emotions, and behaviour. Results: An alternative psychobiologically based paradigm is described based on the model that mental health and its disorders are emergent properties of complex interactions among multidimensional neuroadaptive systems. Conclusions: This permits an explicit definition of optimum mental health and a descriptive system that is more effective for professionals, individuals, and society in understanding and achieving increased adaptive fitness.
Premixed insulin aspart 30 vs. premixed human insulin 30/70 twice daily: a randomized trial in Type 1 and Type 2 diabetic patients
Authors: Boehm B. O. , Home P. D. , Behrend C. , Kamp N. M. , Lindholm A. 
Published: July 2002

AbstractAim To compare the efficacy and safety of premixed insulin aspart (30% free and 70% protamine‐bound, BIAsp 30) with human insulin premix (BHI 30) used in a twice‐daily injection regimen in people with Type 1 and Type 2 diabetes.Methods People with Type 1 and Type 2 diabetes (n = 294) using twice‐daily insulin were randomized to a 12‐week open‐label comparison of BIAsp 30 and BHI 30. Efficacy was assessed by analysis of variance of 12‐week data, adjusted for baseline level.Results BIAsp 30 was as effective as BHI 30 based on the primary efficacy measure, HbA1c, mean difference –0.01 (90% confidence interval (CI) –0.14; 0.12) %Hb. Meal‐time self‐measured blood glucose increment averaged over the three main meals was significantly lower in the BIAsp 30 group than in the BHI 30 group (–0.68 (–1.20; –0.16) mmol/l; P < 0.02). Significant improvements were observed after breakfast, before lunch, after dinner and at bedtime (P < 0.02–0.05), with blood glucose around 1.0 mmol/l lower in the BIAsp 30 group. The number of major hypoglycaemic episodes with BIAsp 30 was half that with BHI 30. However, the overall risk of both minor and major hypoglycaemia did not differ significantly between treatments.Conclusion Post‐prandial glycaemic control was significantly improved, without increasing the risk of hypoglycaemia, and overall control was similar when people with Type 1 and Type 2 diabetes were treated on a twice‐daily regimen with immediate premeal injections of BIAsp 30 compared with BHI 30.Diabet. Med. 19, 393–399 (2002)
Rate of Reading Test®: its reliability, and its validity in the assessment of the effects of coloured overlays
Authors: Wilkins A. J. , Jeanes R. J. , Pumfrey P. D. , Laskier M. 
Published: July 2002

SummaryA simple reading test that can be undertaken by disabled readers is described. The test is suitable for use in the optometric clinic, taking less than 2 minutes to administer per passage. Test‐retest scores are acceptably reliable. The test reveals increases in the speed of reading when coloured overlays are used both (1) in children who have made long‐term use of coloured overlays for reading, and (2) in children who will subsequently do so.
Refusing Artificial Nutrition and Hydration: Does Statutory Law Send the Wrong Message?
Authors: Sieger Carol E. , Arnold Jason F. , Ahronheim Judith C. 
Published: July 2002

Ethical consensus and appellate court decisions view artificial nutrition and hydration (ANH) as medical treatment that can be refused like other treatments. However, advance directive statutes may produce obstacles for refusal of ANH, as distinct from other life‐sustaining treatments, in patients who lack capacity.This paper reviews state statutes and appellate case law regarding medical decision making for patients who lack decisional capacity. Twenty states (39%) have one or more explicit statutory provisions delineating a separate and more stringent standard for ANH refusal. These standards include higher evidentiary standard; requirement for specific preauthorization, qualifying medical conditions, second medical opinion, or judicial review; refusal not permitted; refusal not permitted if death would result from “starvation” or “dehydration”; and previous law with higher standard applies to old documents. In 11 of these states and in eight others, statutory law contains language that could be misinterpreted, implying, but not rising to, an explicitly higher standard. Four appellate decisions departed from the judicial consensus that ANH can be refused like other treatments, but subsequent court decisions or legislative enactments reduced or eliminated their impact.Legislators and the courts should ask whether higher standards for ANH refusal are appropriate in light of case law authority that ANH should not be treated differently and in light of statutory language that preserves those common law rights. These higher standards may make it more difficult in certain states to refuse ANH for patients who lack capacity or place a burden on good practice by making providers fearful of the law.
Nursing Home Residents Covered by Medicare Risk Contracts: Early Findings from the EverCare Evaluation Project
Authors: Kane Robert L. , Flood Shannon , Keckhafer Gail , Bershadsky Boris , Lum Yat‐Sang 
Published: July 2002

OBJECTIVES: To compare the characteristics of a sample of EverCare nursing home residents with two control groups: one composed of other residents in the same homes and another made up of residents in matched nursing homes. To compare levels of unmet need, satisfaction with medical care, and the use of advance directives.DESIGN: Quasi‐experimental design using two control groups to minimize selection effects. Information collected by in‐person surveys of nursing home residents and telephone surveys of proxies and family members.SETTING: Nursing homes affiliated with EverCare and matched control homes.PARTICIPANTS: Nursing home residents and their family members.MEASUREMENTS: Questionnaire addressing function (activities of daily living (ADLs)), unmet care needs, pain, use of advance directives, satisfaction, and caregiver burden.RESULTS: In general, the experimental and control groups were similar, but the EverCare sample had more dementia and less ADL disability. Family members in the EverCare sample expressed greater satisfaction with several aspects of the medical care they received than did controls. Satisfaction of residents in the EverCare sample was more comparable with that of controls. There was no difference in experience with advance directives between EverCare and control groups.CONCLUSIONS: EverCare appears to be a model of managed care worth tracking. It is producing care that is at least comparable with what is available in the fee‐for‐service environment, with evidence that families seem to appreciate the added attention. There is some suggestion that it has enrolled a less disabled but more demented population. Pending results on the effects of this care on hospitalization and emergency care should shed useful light.
Measurements of neutral beam species, impurities, spatial divergence, energy dispersion, pressure, and reionization using the TFTR U.S. Common Long Pulse Ion Source
Authors: Kugel H. W. , Gammel G. M. , Grisham L. R. , Kaita R. , Kamperschroer J. H. , Langley R. A. , Magee C. W. , Medley S. S. , Murphy T. J. , Roquemore A. L. , Williams M. D. 
Published: July 2002

Results are given from the first comprehensive and complementary measurements using the final production U.S. Common Long Pulse Ion Sources mounted on both the TFTR neutral beam test beamline and the TFTR neutral beam injection system, with actual tokamak experimental conditions, power systems, controls, and operating methods. The set of diagnostics included water calorimetry, thermocouples, vacuum ionization gauges, photodiodes, neutron, gamma-ray, and charged particle spectroscopy, optical multichannel analysis, charge exchange spectroscopy, Rutherford backscatter spectroscopy, and implantation/secondary ion mass spectroscopy. These systems were used to perform complementary measurements of neutral beam species, impurities, spatial divergence, energy dispersion, pressure, and reionization. The measurements were performed either in the neutralizer region, where the beam contained both ions and neutrals, or in the region of the output neutral beam. The average of the neutral particle ratios in the range from 80 to 114 keV is D0[E]:D0[E/2]:D0[E/3]=53(5):27(4):20(4), where the quantities in parentheses are the average experimental uncertainties.
The corresponding neutral power ratio is P0[E]:P0[E/2]:P0[E/3]=72(9):19(3):9(2). The half widths (1/e) in the horizontal plane for the full-, half-, and third-energy components were 0.26°, 0.34°, and 0.42°, respectively. The dispersions of the full-, half-, and third-energy components were 1.20 keV, 2.35 keV, and 2.26 keV, respectively. The carbon impurity concentration in a 80 keV D0 beam was not greater than 2×10−4 per D0 beam particle, and exhibited an apparent acceleration state of C+. The oxygen impurity concentration was less than 5×10−4 per D0 beam particle, and exhibited an apparent acceleration state of O+. A variety of vacuum conditions were observed depending on the operating conditions. Typically, pressures in the transition ducts were in the range from 0.3 to 0.7×10−5 Torr at the beginning of injection pulses, and reionized power losses were in the range from 0.75% to 1.5% of incident power. At the end of injection pulses, pressures in the transition ducts were in the range from 0.6 to 2×10−5 Torr and reionized power losses were in the range from 2% to 6% of incident power. This work describes generic results, new apparatus, and advances in measurement techniques for the optimization of tokamak neutral beam heating operations and the analysis of neutral beam heated plasmas.