Current use of steroids in management of abnormal raised skin scars.

Scars are a natural part of dermal healing processes and consist of networks of fibrous collagen tissue, laid down in response to injury to the dermis. In some genetically susceptible individuals, the process of scar tissue formation is excessive, and there is an over-secretion of collagen. This causes the formation of benign tumours (raised) scars known as keloid and hypertrophic scars.

Interleukin-4 C-590T polymorphism has no role in coronary artery bypass surgery.

Interleukin-4 exerts anti-inflammatory effects through decreased macrophage production of tumor necrosis factor-alpha and interleukin-1 beta. We investigated genetic predisposition in the interleukin-4 response to coronary revascularization and studied the association between C-590T polymorphism, interleukin-4 levels, and outcome of surgery. DNA was obtained from 96 consecutive patients undergoing elective coronary revascularization.

CD4-regulatory cells in COPD patients.

Background: The numbers of airway CD8 and B lymphocytes are increased in COPD patients, suggesting an autoimmune process. CD4-regulatory T cells control autoimmunity but have not been studied in patients with COPD.

Objective: To compare T-regulatory cell numbers in the BAL from COPD patients, smokers with normal lung function, and healthy nonsmokers (HNS).

Adult weight gain and central obesity in women with and without a family history of breast cancer: a case control study.

Adult weight gain and central obesity can increase breast cancer risk. We determined the prevalence of adult weight gain and central obesity amongst women with a family history (FH) as compared to women with a population risk to determine whether adiposity could contribute to their increased risk. Adult weight gain, waist and waist:hip ratio (WHR) were determined amongst 475 women (aged 20-60 years) attending a regional FH breast cancer risk clinic, compared to 312 age matched women at population risk.

Prevention of venous thromboembolism in surgical patients with breast cancer.

Background: No randomized trial has yet studied venous thromboembolism (VTE) prophylaxis in patients undergoing surgery for breast cancer.

Methods: Relevant articles were identified using Medline searches. Secondary articles were identified from the reference lists of key papers.

Simultaneous determination of androstenedione and testosterone in human serum by liquid chromatography-tandem mass spectrometry.

Background: We aimed to develop a sensitive assay to quantitate serum concentrations of both androstenedione and testosterone within the female range simultaneously, using liquid chromatography-tandem mass spectrometry (LC-MS/MS) for use in the routine clinical laboratory and to compare this method with immunoassay.

Method: Samples (200 microL) were prepared by liquid-liquid extraction using (1 mL) methyl-tert-butyl-ether. Deuterated androstenedione and testosterone were used as internal standards.

Anterior anal sphincter repair can be of long term benefit: a 12-year case cohort from a single surgeon.

Background: Early surgical results of anterior sphincter repair for faecal incontinence can be good, but in the longer term are often disappointing. This study aimed to determine the short and long term outcomes from anterior sphincter repair and identify factors predictive of long term success.

Methods: Patients who underwent anterior sphincter repair between 1989 and 2001 in one institution were identified.

The MDR1/ABCB1 gene, a high-impact risk factor for cardiac transplant rejection.

Background: Variations in the expression and activity levels of the multidrug-resistance MDR1/ABCB1 encoded P- glycoprotein (P-gp) have an impact on the therapeutic efficacy of many drugs. C3435T and G2677 polymorphisms of the MDR1/ABCB1 gene correlate with cellular expression levels of P-gp, a membrane-bound efflux pump which removes a multitude of drugs, including chemotherapy drugs and immunosuppressants, from cells. We aimed to investigate whether the phenomenon of drug resistance, mediated by the MDR1/ABCB1 gene and seen in tumor cells to chemotherapeutic agents, is important in the field of transplantation, predisposing some patients to resistance to immunosuppressants.

Inferior infarction following alcohol septal ablation: a consequence of "collateral damage"?

Alcohol septal ablation is fast becoming the most common method to reduce left ventricular outflow tract gradient in patients with symptomatic hypertrophic obstructive cardiomyopathy. Myocardial contrast echocardiography (MCE) is routinely used as an adjunct to avoid the spread of alcohol to non-target areas of myocardium. We report two cases where despite the careful use of MCE, remote inferior wall myocardial infarctions occurred.

Investigation of stimulus position in the production of the strength duration curve of the external anal sphincter muscle in women with anorectal dysfunction.

Objective: The strength duration test (SDT) is a minimally invasive test of the innervation of a muscle and has been successfully adapted for use on the external anal sphincter (EAS). The SDT has previously been performed on the EAS placing a stimulating probe in the 3 o'clock position. The aim of this study was to determine whether there was any variation in the strength duration curves (SDC) produced at different positions around the EAS.

A technique for accurate and safe injection of steroid in trigger digits using ultrasound guidance.

Steroid injections have long been the main stay of conservative treatment of trigger digits. This procedure gives variable results, which is dependent on a number of factors. The injection of the steroid in the right place improves the success rate and also prevents complications associated with the procedure.

Single dose oral ranitidine improves MRCP image quality: a double-blind study.

Aim: To investigate the possibility of whether a single 300 mg dose of ranitidine given orally 2-3h before magnetic resonance cholangiopancreatography (MRCP) could reduce the signal from the stomach and duodenum, and thus increase the conspicuousness of the biliary tree.

Materials And Methods: Thirty-five volunteers (22 female, 13 male), (age range 21-50) were underwent MRCP in a double-blind, placebo-controlled, randomized, crossover trial on a Philips Intera 1.5 T machine using a phased array surface coil.

Emerging aspects of oesophageal and gastro-oesophageal junction cancer histopathology - an update for the surgical oncologist.

Adenocarcinoma of the oesophagus and gastro-oesophageal junction are rapidly increasing in incidence and have a well described sequence of carcinogenesis: the Barrett's metaplasia-dysplasia-adenocarcinoma sequence. During recent years there have been changes in the knowledge surrounding disease progression, cancer management and histopathology specimen reporting. Tumours around the gastro-oesophageal junction (GOJ) pose several specific challenges.

Mitral valve repair for severe mitral regurgitation: the way forward?

Severe primary mitral regurgitation (MR) has a poor outcome if left uncorrected. Successful mitral valve repair has the unique potential to restore normal life expectancy and is superior to valve replacement. Despite this, mitral repair is performed relatively infrequently and many patients with potentially reparable valves have a replacement instead, subjecting them to unnecessary risk.

Outpatient angioplasty and stenting facilitated by percutaneous arterial suture closure devices.

Aim: To review our practice of outpatient percutaneous vascular interventions facilitated by an arterial suture device.

Materials And Methods: A retrospective review of all patients attending this tertiary centre for iliac or femoral intervention was undertaken between February 2001 and December 2004. All patients who underwent angioplasty or stenting had their puncture sites closed using a Perclose suture.

Aesthetic surgical training in the UK independent sector--the clients' view: Results of a survey on 155 private patients.

As training opportunities in cosmetic surgery become less frequent in teaching hospitals, this survey set out to examine the attitudes of patients towards extending this training into the independent health sector. We questioned 155 private patients, 95% of who were happy for trainees to sit in during their consultations. Of these, 85% were comfortable with the presence of the trainee throughout their appointments and 92% said they saw advantages in having such trainees present.

Quantification of urinary oxalate by liquid chromatography-tandem mass spectrometry with online weak anion exchange chromatography.

Background: Urinary oxalate is commonly measured with an enzymatic assay that is specific but requires a manual clean-up step to reduce ascorbic acid interference. We developed a urinary oxalate assay that uses liquid chromatography-tandem mass spectrometry (LC-MS/MS) with anion exchange chromatography and simple sample preparation.

Methods: We added calibrator or urine sample (10 microL) to 10 microL of (13)C2 oxalate and 400 microL of water and performed separation on a Waters OASIS WAX column, flow rate 0.

Exploring the relationship between severity of dysphonia and voice-related quality of life.

Objectives: To explore whether severity and/or consistency of dysphonia are linked to voice-related quality of life.

Design: Cross-sectional study.

Setting: Specialist voice clinics, University Teaching Hospital.

Troponin T after endoscopic retrograde cholangiopancreatography: no evidence of harm.

Background And Study Aims: It is well recognized that myocardial ischemia can occur during endoscopic retrograde cholangiopancreatography (ERCP). Acute arrhythmias and ST segment changes have been reported by a number of authors, but the longer-term sequelae with regard to permanent myocardial damage are not known. The aim of this study was to determine the presence or absence of significant injury to the heart muscle.

Minimal surgical approach for recurrent hip dislocation using the posterior lip augmentation device for the Charnley hip arthroplasty.

We present the management of recurrent posterior dislocations in cemented Charnley total hip arthroplasties treated with acetabular augmentation. Certain patients are elderly with comorbid conditions and diminished reserves. We have used a minimal surgical approach to implant 21 posterior lip augmentation devices in elderly patients.

Incidence and effect of bare suprarenal stent struts crossing renal ostia following EVAR.

Objectives: The incidence and effect of bare stent struts crossing the renal ostia following endovascular aortic aneurysm repair with the Talent stent-graft is not known. The study aims to establish the incidence in which bare stent struts cross the renal ostia and to assess any associated effects on renal function.

Methods: Fifty-five patients (51 men, mean age 73 years, range 57-90) who had endovascular repair of their abdominal aortic aneurysms with a Talent suprarenal stent-graft were included in the study.