bluuebunny/crossref_metadata_2025 huggingface dataset:
The stepwise supramolecular organisation of guanosine derivatives
Authors: Gottarelli Giovanni , Spada Gian Piero
Published: March 2004

Several supramolecular architectures generated by guanosine derivatives are described. The research
started from the fortuitous observation of a lyotropic behavior exhibited by a guanylic nucleotide in water.
This observation stimulated extensive research on several natural and lipophilic guanosine derivatives which
self‐assemble in different architectures (discs, ribbons, helices . . .),
according to their structure and environment. These ordered structures can be used as scaffolds for photo‐
or electro‐active moieties and for the fabrication of molecular electronic devices. © 2004 The
Japan Chemical Journal Forum and John Wiley & Sons, Inc. Chem Rec 4: 39–49; 2004: Published online in
Wiley InterScience (www.interscience.wiley.com) DOI 10.1002/tcr.20005
Superposition: composition vs refinement of non-deterministic, action-based systems
Authors: Lopes Antónia , Fiadeiro José Luiz
Published: March 2004

The traditional notion of superposition has been used for supporting two distinct aspects of parallel program design: composition and refinement. This is because, when trace-based semantics of concurrency are considered, which is typical of most formal methods, these two relationships are modelled as inclusion between sets of behaviours. However, when forms of non-deterministic behaviour have to be considered, which is the case for component and service-based development, these two aspects do not coincide. In this paper, we show how the two roles of superposition can be separated and supported at the language and semantic levels. For this purpose, we use a categorical formalisation of program design in the language CommUnity that we are also using for addressing architectural concerns, another area in which the distinction between composition and refinement is particularly important.
ERC – An object-oriented refinement calculus for Eiffel
Authors: Paige Richard F. , Ostroff Jonathan S.
Published: March 2004

We present a refinement calculus for transforming object-oriented (OO) specifications (or ‘contracts’) of classes into executable Eiffel programs. The calculus includes the usual collection of algorithmic refinement rules for assignments, if-statements, and loops. However, the calculus also deals with some of the specific challenges of OO, namely rules for introducing
feature calls
and reference types (involving aliasing). The refinement process is compositional in the sense that a class specification is refined to code based only on the specifications (not the implementations) of the classes that the specification depends upon. We discuss how automated support for such a process can be developed based on existing tools. This work is done in the context of a larger project involving methods for the seamless design of OO software in the graphical design notation BON (akin to UML). The goal is to maintain model and source code integrity, i.e., the software developer can work on either the model or the code, where (ideally) changes in one view are reflected instantaneously and automatically in all views.
Integration of UML and VHDL-AMS for analogue system modelling
Authors: Carr C. T. , McGinnity T. M. , McDaid L. J.
Published: March 2004

This paper details a new object-oriented methodology that permits a unified modelling language (UML) behavioural representation of analogue circuits at system level. The proposed method demonstrates a novel approach to the problem of behavioural representation of an analogue topology, by constructing a consistent set of rules for automated mapping of the UML model to a VHDL-AMS specification. The VHDL-AMS specification enables behavioural simulation of the UML model and the methodology is validated using an analogue subsystem level application.
Barrier synchronisation: Axiomatisation and relaxation
Authors: Stewart A. , Clint M. , Gabarró J.
Published: March 2004

The bulk synchronous parallel (BSP) model is underpinned by a global synchronisation operation. This operation both synchronises processes and updates local stores using asynchronous communications. In this paper a generalised, nondeterministic, substitution axiom (over functions) is identified with BSP barrier synchronisation. Correctness proofs of BSP programs based on the axiom are structurally similar to proofs of correctness of sequential programs. Global synchronisation is often considered to be relatively expensive to implement on distributed architectures for applications having low levels of communications. In an extreme situation a process having no external interactions may have to wait unnecessarily at a barrier. In this paper a form of barrier operation is introduced which is straightforward to reason about and, with a view to increasing the potential for efficient implementation, permits barrier operations to be relaxed through partial uncoupling thereby allowing processes which do not need to synchronise to proceed.
Complications of Thyroid Surgery: Analysis of a Multicentric Study on 14,934 Patients Operated on in Italy over 5 Years
Authors: Rosato Lodovico , Avenia Nicola , Bernante Paolo , De Palma Maurizio , Gulino Giuseppe , Nasi Pier Giorgio , Pelizzo Maria Rosa , Pezzullo Luciano
Published: March 2004

Complication rates associated with thyroid surgery can be evaluated only through analysis of case studies and follow‐up data. This study covers postoperative data from 14,934 patients subjected to a follow‐up of 5 years. Among them, 3130 (20.9%) underwent total lobectomy (TL), 9599 (64.3%) total thyroidectomy (TT), 1448 (9.7%) subtotal thyroidectomy with a monolateral remnant (MRST), and 757 (5.1%) subtotal thyroidectomy with bilateral remnants (BRST). A total of 6% of the patients had already been operated on. Persistent hypoparathyroidism occurred after 1.7% of all the operations, and temporary hypoparathyroidism was noted in 8.3%. Permanent palsy of the laryngeal recurrent nerve (LRN) occurred in 1.0% of patients, transient palsy in 2.0%, and diplegia in 0.4%. The superior laryngeal nerve was damaged in 3.7%; dysphagia occurred in 1.4% of cases, hemorrhage in 1.2%, and wound infection in 0.3%. No deaths were reported. A significant rate of LRN damage was noted, which has an important impact on the patient’s social life. Hypoparathyroidism after total thyroidectomy is an important complication that can be successfully treated by therapy, although it is not always easily managed in special circumstances such as in young persons or pregnant women. The complications associated with thyroid surgery must be kept in mind so the surgeon can carefully evaluate the surgical and medical therapeutic options, have more precise surgical indications, and be able to give the patient adequate information.
Changes in Extrathymic T Cells in the Liver and Intestinal Intraepithelium in Mice with Obstructive Jaundice
Authors: Ueno Kimihiko , Ajiki Tetsuo , Watanabe Hisami , Abo Toru , Takeyama Yoshifumi , Onoyama Hirohiko , Kuroda Yoshikazu
Published: March 2004

Recently, T cells were classified into two categories: intrathymic T cells (ITCs; thymus‐derived T cells) and extrathymic T cells (ETCs). ETC, localized in the liver and intestinal intraepithelium (IE), play an important immunologic role in the suppressed condition of T‐cell development in the thymus. Given the fact that complications of surgery in patients with obstructive jaundice are often related to immunosuppression in the gut–liver circulation, we attempted to investigate the changes in the proportion of ETCs in mice with obstructive jaundice. Three mice models were prepared (n = 10 per group): sham group with simple laparotomy; ligation group with common bile duct ligation; deoxycholic acid (DCA) group with an oral intake of DCA as a model of the presence of bile salts in the gut lumen. In each model, total mononuclear cells (MNCs), ITCs in the thymus, and ETCs in the liver and IE were counted using monoclonal antibodies in conjunction with a two‐color immunofluorescence test by flow cytometry. In the ligation group the number of MNCs was reduced in the thymus and IE, and only those in the IE recovered after oral intake of DCA. A decrease of ITCs in the thymus and the increase in ETCs in the liver and IE occurred simultaneously during the early phase of biliary obstruction. At day 7 after biliary obstruction, ETCs in the livers of the DCA and ligation groups decreased to nearly the level in the sham group. However, on day 7 the ETCs in the IE remained significantly higher in the DCA group than in the ligation group. These results suggested that ETCs can act in place of ITCs at an early phase of obstructive jaundice, and the presence of bile in the gut lumen may be associated with the consumption of ETCs in the IE, a reaction that may bring about improved immunoreactivity.
Dedicated Screening Mammography for Diagnosis of Small Breast Cancer
Authors: Kirshtein Boris , Crystal Pavel , Koretz Michael , Strano Selwyn
Published: March 2004

Breast cancer is the most common malignancy in women, and early diagnosis is a cornerstone of successful treatment. Mammography is the sole acceptable method for breast cancer screening, but its efficacy is still disputable. The aim of this study was to determine whether the influence of dedicated mammographic team skills could improve the diagnostic accuracy of screening mammography and detection of small breast cancers. From June 1992 to September 1996 a total of 17,393 screening mammograms and 335 mammographically guided needle‐localization breast biopsies were performed. From August 1994, a dedicated mammographer commenced work in our hospital. Screening mammography and biopsy results were compared for the nondedicated period (NDP) and the dedicated period (DP). The biopsy rate decreased from 2.9% to 1.3% (p < 0.0001), and the positive biopsy rate increased from 26.3% to 48.2% (p < 0.0001) during the respective periods. The cancer detection rate not changed significantly (p = 0.27) through the whole study period, but the subgroup of small carcinomas (T0, T1a, T1b) increased significantly (p < 0.04), from 25 cases in the NDP to 40 cases in the DP. We concluded that dedicated mammography team skills can significantly improve the detection of small breast cancers and permit more effective diagnosis of breast cancer by reducing the number of breast biopsies ultimately found to be benign.
Metastatic Tumor Doubling Time: Most Important Prehepatectomy Predictor of Survival and Nonrecurrence of Hepatic Colorectal Cancer Metastasis
Authors: Tanaka Kuniya , Shimada Hiroshi , Miura Masaru , Fujii Yoshiro , Yamaguchi Shigeki , Endo Itaru , Sekido Hitoshi , Togo Shinji , Ike Hideyuki
Published: March 2004

We determined the relative value of the metastatic colorectal cancer doubling time as a predictor of recurrence and survival after hepatectomy in comparison with other established predictors. Consecutive patients who underwent hepatic resection (n = 144) for colorectal cancer liver metastases were studied retrospectively to identify factors that influence overall survival and recurrence in the remnant liver. Overall 5‐year survival and nonrecurrence rates were 49.8% and 50.8%, respectively. By multivariate analysis, large liver tumors (p = 0.038), p53 expression by the liver tumor (p = 0.011), and a short liver metastasis doubling time (≤ 45 days, p = 0.013) negatively affected survival; doubling times > 45 days (adjusted relative risk 0.06; p < 0.001) positively influenced disease‐free survival. In patients with remnant liver recurrence, a short doubling time was associated with short disease‐free intervals (7.3 ± 6.2 months), multiple metastases (63.6%), and fewer attempts at repeat hepatectomy (22.7%). The doubling time determines tumor size and reflects the patient’s immune and nutritional status. A short doubling time is the most reliable risk factor for multiple metastases, early recurrence, and poor prognosis. Further studies with a larger number of patients are needed to confirm this conclusion.
Xanthogranulomatous Cholecystitis: 15 Years’ Experience
Authors: Guzmán‐Valdivia Gilberto
Published: March 2004

The demographic and clinical aspects of xanthogranulomatous cholecystitis (XGC) over a period of 15 years are reviewed. The review entailed examining 12,426 clinical files of patients who had undergone cholecystectomy, including 182 patients with a histopathologic diagnosis of XGC. Altogether, 1.46% of the cholecystectomies performed were done on patients with a diagnosis of XGC. XGC presented in patients over the age of 32, with a male/female ratio of 2:1. Thickening of the gallbladder wall, seen on ultrasonography and computed tomography scans, was demonstrated in 100% of the cases. A total of 17% of the cases presented in acute form. Obstructive jaundice was observed in 23% of the patients, 11 of which cases were associated with choledocholithiasis (30% of these patients had jaundice) and the rest with extrinsic obstruction of the bile tract (Mirizzi syndrome). XGC was associated with lithiasis in 85% of the cases. A malignant lesion was suspected during operation in 30% of the cases, requiring histopathologic examination during surgery. Carcinomatous lesions were found in 3% of the cases. Surgical difficulty was reported in 65% of the cases, resulting in the performance of partial cholecystectomy in 35%. XGC is an infrequent form of chronic inflammation of the gallbladder, the clinical presentation of which is similar to that of cholecystitis; given the thickening of the gallbladder wall, it makes cholecystectomy difficult. As XGC may resemble adenocarcinoma, differentiation is essential by means of intraoperative histologic examination to ensure optimal surgical treatment.
Deterioration of Hepatic Functional Reserve in Patients with Hepatocellular Carcinoma after Resection: Incidence, Risk Factors, and Association with Intrahepatic Tumor Recurrence
Authors: Huo Teh‐Ia , Lui Wing‐Yu , Wu Jaw‐Ching , Huang Yi‐Hsiang , King Kuang‐Liang , Loong Che‐Chuan , Lee Pui‐Ching , Chang Full‐Young , Lee Shou‐Dong
Published: March 2004

Hepatocellular carcinoma (HCC) is frequently associated with liver cirrhosis. Patients with HCCs undergoing surgical resection may have declining hepatic functional reserve over time. However, the incidence and risk factors of hepatic decompensation, and its relation to postoperative tumor recurrence are unknown. This study investigated 241 HCC patients (208 male; age 61 ± 13 years) undergoing resection with a long‐term follow‐up. The Child‐Pugh scoring system was used to evaluate the postoperative deterioration of liver reserve, defined as a sustained increment in the Child‐Pugh score by 2 or more. The 1‐, 3‐, and 5‐year cumulative probabilities of postoperative decompensation were 14%, 32%, and 56%, respectively, during a follow‐up period of 27 ± 18 months (range 3‐75 months). The average increment in Child‐Pugh score was 1.4 ± 1.1 in 2.3 ± 1.5 years, or 0.6 point per year. Altogether, 74 (31%) patients developed postoperative hepatic decompensation during the follow‐up period, 43 (58%) of whom had decompensation within 2 years of resection. Large (> 3 cm) tumor size was the only independent predictor associated with hepatic decompensation (relative risk 1.7, 95% confidence interval 1.1–2.8, p = 0.041) and was a significant risk factor for intrahepatic tumor recurrence (p = 0.018). Patients with tumor recurrence more frequently (40% of 109 patients vs. 23% of 132 patients, p = 0.005) and more rapidly (0.8 vs. 0.4 point per year) developed hepatic decompensation than those without recurrence. In conclusion, large HCCs are closely associated with hepatic decompensation in patients after resection. Tumor recurrence may predispose to the development of hepatic decompensation in these patients.
Evaluation of 18F‐2‐deoxy‐2‐fluoro‐d‐glucose Positron Emission Tomography for Gastric Cancer
Authors: Mochiki Erito , Kuwano Hiroyuki , Katoh Hiroyuki , Asao Takayuki , Oriuchi Noboru , Endo Keigo
Published: March 2004

Positron emission tomography (PET) with 18F‐2‐deoxy‐2‐fluoro‐d‐glucose (FDG) has been investigated as a means of detecting certain primary tumors and their metastatic disease in recent years. The aim of this study was to compare the performance of FDG‐PET and operative assessment with formal pathologic staging. Altogether, 85 patients had undergone surgical treatment for gastric cancer with curative intent, with FDG‐PET preoperatively. The results using FDG‐PET were compared with those using computed tomography (CT); they were also correlated with the pathologic findings. For quantitative analysis, the regional tumor uptake was measured by the standard uptake value (SUV) using a region of interest technique. Using FDG‐PET, the primary tumor was visualized in 75.2% of patients. A comparison of the FDG uptake and the clinicopathologic findings showed that there was a significant association between FDG uptake and the depth of invasion, the size of the tumor, and lymph node metastasis. FDG‐PET scans had less accuracy for diagnosing locoregional lymph nodes than CT because of a significant lack of sensitivity (23.3% vs. 65.0%). The survival rate for patients with high FDG uptake (SUV > 4) was significantly lower than that for those with low FDG uptake (SUV < 4) (p < 0.05). FDG‐PET was successful in detecting the primary gastric cancer lesion but not for finding early‐stage gastric cancers. Detection of nodal metastasis also was not possible by FDG‐PET. However, FDG‐PET appears to provide important additional information concerning the aggressiveness of the tumor and the prognosis in patients with gastric cancer.
Surgical Site Infections in Breast Surgery: Case‐control Study
Authors: Vilar‐Compte Diana , Jacquemin Benedicte , Robles‐Vidal Carlos , Volkow Patricia
Published: March 2004

The purpose of this study was to estimate the frequency of surgical site infections (SSIs) and identify associated risk factors for each type of breast surgery at a cancer hospital. We used a nested case‐control design. Between February 1, 2000 and July 31, 2000, all breast surgeries performed were recorded on a daily basis. After hospital discharge, we evaluated patients simultaneously with surgeons three times a week for 30 days or longer. The odds ratio (OR) was estimated using logistic regression analysis. The study followed 280 patients (298 wounds). Altogether, 77 SSIs were detected, for an overall SSI rate of 25.8% (77/298). For excisions, conservative surgery, and radical mastectomies the SSI rates were 1.4%, 18.0%, and 38.3%, respectively. Excisions were excluded (n = 68) for risk factor analysis. After multivariate analysis, risk factors associated with SSIs were obesity [OR 2.5, 95% confidence interval (CI) 1.2–4.3], concomitant chemotherapy and radiation (OR 2.3, 95% CI 1.2–4.3), radical surgery (OR 3.1, 95% CI 1.1–8.6), insertion of a second drain during the late postoperative period (OR 3.7, 95% CI 1.8–7.8), and drainage duration ≥ 19 days (OR 2.9, 95% CI 1.5–5.6). The bacteria most frequently isolated were Pseudomonas aeruginosa (n = 18), Serratia sp. (n = 18), Staphylococcus aureus (n = 10), and Staphylococcus epidermidis (n = 10). Poor compliance with infection control practices and wound management was detected throughout the study period. The overall frequency of SSIs for mastectomies was higher than the reported rates, which was principally related to the more radical surgery required for advanced‐stage disease, preoperative irradiation, and inadequate wound and drain care.
Obstructive Jaundice in Rats: Cause of Spatial Memory Deficits with Recovery after Biliary Decompression
Authors: Huang Li‐Tung , Hsieh Chih‐Sung , Chou Ming‐Huei , Chuang Jiin‐Haur , Liou Chia‐Wei , Tiao Mao‐Meng , Lai Ming‐Chi
Published: March 2004

Children with end‐stage liver disease have been found to have cognitive deficits. The aim of this study was to examine whether cholestatic jaundice causes spatial deficits in rats and if these cognitive deficits are reversed by biliary drainage. Rats were randomly divided into three groups. In the first group, the bile duct was ligated for 3 weeks (BDL group); in the second group, the proximal bile duct was ligated with a Broviac CV catheter for 2 weeks followed by a tube bilioduodenostomy (TBD group); in the third group, a sham operation was performed (SHAM group). All the surviving rats were assessed for spatial learning and memory (a major cognitive function in rats) by the Morris water maze task about 3 weeks after the first operation. Blood was aspirated by cardiocentesis and assayed for total bilirubin, albumin, ammonia, and hemoglobin levels on the day following the water maze task. During the four consecutive acquisition trial days of the Morris water maze, jaundiced rats (BDL group) had a significant longer latency to escape than the SHAM group (p < 0.05). Rats that underwent biliary decompression for 1 week (TBD group) showed improved status of the spatial deficit, as they required less time to reach the escape platform, approaching the performance of the SHAM group. The BDL group had a significantly higher serum ammonia level, higher bilirubin level, and lower hemoglobin level than the other two groups. After biliary decompression for 1 week, the serum albumin concentration in the TBD group still did not return to the level of the SHAM group. The results of this study suggest that long‐term cholestasis results in spatial memory deficits in rats that correlate with anemia and hyperbilirubinemia encephalopathy. Early biliary decompression of obstructive jaundice improves spatial memory deficits, possibly related to the recovery of the serum ammonia and hemoglobin levels.
Prognostic Significance of Apex Axillary Invasion for Locoregional Recurrence and Effect of Postmastectomy Radiotherapy on Overall Survival in Node‐Positive Breast Cancer Patients
Authors: Kuru Bekir , Camlibel Mithat , Dinc Soykan , Gulcelik Mehmet A. , Alagol Haluk
Published: March 2004

Postmastectomy irradiation substantially reduces the risk of locoregional recurrences (LRR) of breast carcinoma. However, debates continue on the prognostic factors for radiotherapy and the effect of radiotherapy on overall survival. The present study was undertaken to investigate the prognostic significance of level III positive nodes, along with the other factors for LRR, and to evaluate the effect of postmastectomy radiotherapy on overall survival among node‐positive breast carcinoma treated systemically. Data from 549 consecutive node‐positive breast cancer patients who underwent modified radical mastectomy and received adjuvant systemic therapy were studied retrospectively. Prognostic factors for LRR and the effect of postmastectomy radiotherapy on overall survival were analyzed. Survival curves were generated by the Kaplan‐Meier method, and multivariate analysis was performed by the Cox proportional hazard model. The 5‐year locoregional recurrence rate is 7%. Apical invasion was found to be an independent prognostic factor for LRR (HR 2.6, CI 1.29–5.35) along with a finding of 4 or more positive nodes and T3 tumor. Adjuvant radiotherapy decreased LRR and improved survival significantly. Apical invasion, 4 or more positive axillary lymph nodes, and T3 tumor are the predictors of LRR, and patients with these adverse factors are candidates for adjuvant radiotherapy. Postmastectomy radiotherapy improves overall survival.
Nitric Oxide and Wound Healing
Authors: Rizk Majida , Witte Maria B. , Barbul Adrian
Published: March 2004

Nitric oxide is a short‐lived free radical that acts at the molecular, cellular, and physiologic level. Since its discovery almost 20 years ago it has proven itself as an important element in wound healing. This review highlights many of the important aspects of nitric oxide in wound healing, including a review of the basic biology of nitric oxide, its role as part of the cytokine cascade and as a promoter of angiogenesis, as well as its more recently elucidated role in apoptosis.
Oxygen in Wound Healing and Infection
Authors: Gottrup Finn
Published: March 2004

It is a fundamental clinical observation that wounds do not heal in tissue that does not bleed, and they almost always heal in tissue that bleeds extensively. Continuous supply of oxygen to the tissue through microcirculation is vital for the healing process and for resistance to infection. Evaluation of tissue perfusion and oxygenation is important in all types of wound patients. Monitoring systems should measure the hemodynamic situation and the ability of the cardiovascular system to deliver an adequate volume of oxygen to meet the metabolic demands of the peripheral tissue. Oxygen therapy is important in relation to both healing and resistance to infections. External factors have been shown to significantly decrease the peripheral oxygen supply, and supplementary perioperative oxygen to reduce the surgical wound infection rate by one‐ half in patients undergoing colorectal resection. Hyperbaric oxygen therapy may be beneficial in situations where the nutritive flow and oxygen supply to the healing tissue are compromised by local injury, and particularly if anaerobic infection is present. However, the definitive proof for the effect and indications of this therapy in wound healing still has to be established. It can be concluded that adequate delivery of oxygen to the wound tissue is vital for optimal healing and resistance to infection. Assessment of perfusion and oxygenation is essential for the wound patient, as well as the treating personnel. The indication for hyperbaric oxygen treatment still needs to be defined. During wound healing the continuity and function of the damaged tissue are re‐established. This is only possible through a restoration of the microcirculation and thereby the nutrition to the tissue. The main component of the nutrition is oxygen, which is critically important for healing a wound by production of granulation tissue and for ensuring resistance against infection. This has been shown experimentally, but recently a short period of supplementary oxygen has been shown to decrease wound complications in clinical practice as well.
Oxygen in Wound Healing—More than a Nutrient
Authors: Tandara Andrea A. , Mustoe Thomas A.
Published: March 2004

This article provides an overview of the role of oxygen in wound healing. The understanding of this role has undergone a major evolution from its long‐recognized importance as an essential factor for oxidative metabolism, to its recognition as an important cell signal interacting with growth factors and other signals to regulate signal transduction pathways. Our laboratory has been engaged in thestudy of animal models of skin ischemia to explore in vivo the impact of hypoxia as well as the use of oxygen as a therapeutic agent either alone or in combination with other agents such as growth factors. We have demonstrated a synergistic effect of systemic hyperbaric oxygen and growth factors that has been substantiated by Hunt’s group. Within the past 10 years research in the field of wound healing has given new insight into the mechanism of action of hypoxia and hyperoxia as modifiers of the normal time‐course of wound healing. The article concludes with a discussion of why hypoxia and hyperoxia intercurrently play an important role in wound healing. Hypoxia‐inducible factor 1 is crucial in that interplay.
Clinical Hyperbaric Oxygen Therapy, Wound Perfusion, and Transcutaneous Oximetry
Authors: Niinikoski Juha H.A.
Published: March 2004

Hyperbaric oxygen therapy (HBOT) is an important adjunct in the management of problem wounds which exist in chronic oxygen deficiency and in which the local oxygen tension is below optimal for healing. In the treatment of hypoxic and ischemic wounds, the most important effects of hyperbaric oxygenation are the stimulation of fibroblast proliferation and differentiation, increased collagen formation and cross‐linking, augmented neovascularization, and the stimulation of leukocyte microbial killing. Ischemic soft tissues also benefit from hyperoxygenation through improved preservation of energy metabolism and reduction of edema. Hyperbaric oxygen is administered in either a multiplace or a monoplace hyperbaric chamber. Normally, pressures of 2 to 2.5 ATA are used for a period of 90 minutes once or twice daily. For an objective assessment of wound perfusion and oxygenation, transcutaneous oximetry provides a simple, reliable, noninvasive, diagnostic technique. It can be used for assessment of tissue perfusion in the vicinity of the problem wound. Transcutaneous oximetry may be used in the assessment of wound healing potential, selection of amputation level, and patient selection for HBOT. In diabetic patients with chronic foot ulcers peri‐wound transcutaneous oxygen tensions (TcPo2) over 400 mmHg in 2.5 ATA hyperbaric oxygen or over 50 mmHg in normobaric pure oxygen predict healing success with adjuncted HBOT with high accuracy.
Development of a Wound Dressing Targeting Neutrophil Function
Authors: Nygren Håkan , Malmberg Per , Sahlin Herman
Published: March 2004

Earlier studies show that neutrophils are virtually unable to kill Staphylococcus aureus in vitro. However, upon addition of 10 mM N‐acetylcysteine (NAC) or reduced glutathione (GSH) the neutrophil bacterial killing ability becomes excellent. We want to exploit this phenomenon to develop a wound dressing material that will improve neutrophil function. To study the mechanisms behind the downregulation of neutrophil elimination of bacteria, we used different markers for neutrophil function on surface‐adhering neutrophils in contact with S. aureus with or without addition of the antioxidants NAC or GSH. Analysis by scanning electron microscopy showed cell shrinkage and numerous cytoplasmic processes on surface‐adhering neutrophils exposed to S. aureus. In cells exposed to S. aureus and GSH, the cells were of normal size and the cytoplasm was spread as in normal attachment. Staining for intracellular GSH, a hallmark of oxidative stress, showed little difference between the experimental groups, indicating that the cells were not damaged by traditional oxidative stress. The H2O2 production of neutrophils, measured by Amplex red, was correlated to bacterial exposure and was not affected by the addition of scavengers. The intracellular and extracellular production of ROS was measured by luminol‐amplified chemiluminescence. The apparent ROS‐production was mostly intracellular and decreased in the presence of scavengers. However, extracellular production of ROS was not affected by the addition of NAC. The production of nitric oxide (NO) was measured spectrophotometrically as the production of nitrate apparently decreased in the presence of scavengers, probably as a result of interference with the reagents in the test system. In conclusion, differences between leukocytes that were able to eliminate S. aureus and those that were not were mainly seen in the morphology of the cells and in cell viability. The morphological findings point to a difference in NO signaling in the absence and presence of ROS scavengers.
Reactive Oxygen Species and EGR‐1 Gene Expression in Surgical Postoperative Peritoneal Adhesions
Authors: Roy Sashwati , Clark Clancy J. , Mohebali Khashayar , Bhatt Udayan , Wallace William A. , Nahman N. Stanley , Ellison E. Christopher , Melvin W. Scott , Sen Chandan K.
Published: March 2004

Postoperative peritoneal adhesions are common and serious complications of general abdominal and gynecological surgery that can lead to chronic abdominal pain, small‐bowel obstruction and infertility. The specific pathophysiology of peritoneal adhesions remains elusive and current treatment is relegated to prevention through meticulous surgical technique and protective physical barriers, gels and solutions. We have reported that reactive oxygen species (ROS), generated by phagocytic cells at the site of tissue injury, serve as major signaling molecules regulating the expression of vascular endothelial growth factor (VEGF) and subsequent wound repair. We hypothesized that peritoneal adhesions are a product of over‐healing surgical wounds and that, like in wound healing, ROS are implicated in their pathogenesis. We examined the presence of footprints of ROS and the ROS‐inducible angiogenic factor VEGF in human adhesion tissue. An experimental model of peritoneal adhesion was established in rodents to study of the dynamics of ROS‐induced gene expression during de novo adhesion tissue formation. Immunohistochemical analysis demonstrated presence of ROS/oxidant and macrophages in human peritoneal tissue. The presence of ROS and ROS‐sensitive transcription factor EGR‐1 was also evident in an experimental rodent peritoneal adhesion model. Along with ROS, VEGF, and a large number of mature and immature CD31/vWF positive blood vessels were present in the adhesion tissue. These observations are not consistent with the contention that adhesions are non‐functional scar tissue. The newly developed rodent model of adhesion may present a useful approach to reproducibly and objectively study molecular mechanisms underlying the dynamic process of de novo adhesion tissue formation.
Experimental Models of Stress and Wound Healing
Authors: Sheridan John F. , Padgett David A. , Avitsur Ronit , Marucha Phillip T.
Published: March 2004

Experimental animal models have been used to examine stress‐induced interactions among the nervous, endocrine, and immune systems. Generally, the response to stress results in a body‐wide set of physiologic adaptations, mediated through the activation of neuroendocrine pathways that intersect and modulate inflammatory and immune responses. These interacting responses modulate diverse physiological processes including the initiation of tissue repair and wound healing. Two different stressors were used to activate neuroendocrine responses to study their impact on wound healing: restraint (RST) and social disruption (SDR). Previous studies showed that both stressors activate the hypothalamic‐pituitary‐adrenal (HPA) axis, resulting in elevated plasma levels of the corticosterone (cort) response and modulation of pro‐inflammatory cytokine response. To test the effects of stress‐induced HPA activation on inflammatory responses and wound healing, a 3.5‐mm cutaneous punch biopsy wound was placed on the dorsal surface of control and stressed (RST or SDR) C57BL/6 male mice and the kinetics of wound healing were studied over 10 days. RST slowed wound healing in inbred C57BL/6 mice, whereas the wounds on SDR mice healed in a fashion similar to the non‐stressed, home cage controls.
Oxygen: At the Foundation of Wound Healing—Introduction
Authors: Hunt Thomas K. , Ellison E. Christopher , Sen Chandan K.
Published: March 2004

“Wound Healing: Oxygen & Emerging Therapeutics” Columbus, Ohio, September 12–15, 2002. Sponsored by the National Institutes of Health (R13AR049171), International Union of Biochemistry & Molecular Biology and UNESCO‐Global Network of Molecular & Cell Biology. Conference co‐chairs: Chandan K. Sen, the Ohio State University Medical Center and Thomas K. Hunt, University of California‐ San Francisco. This congress was conceived for two reasons: to consolidate what is known about oxygen in the repair process and to stimulate discussion about new developments of control of healing by redox regulated signaling processes. A historical and evolutionary perspective on the role of oxygen in wound healing—from the classical physiology of oxygen in the wound to the refined concept of redox signaling— is presented.
What caused the decline of the Lake IJsselmeer eel stock after 1960?
Authors: Dekker Willem
Published: March 2004

The European eel (Anguilla anguilla L.) is in severe decline: landings from and recruitment to the stock have fallen off since the mid-1960s and the early 1980s, respectively. Several hypotheses on the causes of the decline in recruitment have been advanced, some predicting an earlier decline of the adult stock. In order to narrow the range of potential hypotheses, this paper contrasts current ones with trends in abundance and length distribution of the local stock in Lake IJsselmeer (the Netherlands) over the period of the decline. The data set consists of research surveys, market sampling, gear development experiments, etc., since 1904, and is uninterrupted since 1950. A statistical analysis is designed in which sampling characteristics (length selectivity of gears and of mesh sizes, and sample selection procedures) are separated out of trends in the local stock over the years (abundance, length composition). The decline of the Lake IJsselmeer stock started in 1960, affected exploited and undersized eels, and was steeper for larger eels. The abundance of the smallest size class in the lake matches the independently recorded recruitment strength, which did not decline before 1980. Excessive exploitation, habitat loss, barriers to migration, introduced parasites, and changes in ocean climate cannot explain the observed trends when taken individually. Therefore, the cause of the decline of the local stock in Lake IJsselmeer is still a mystery and, because the historical information is limited and cannot be added to, is likely to remain so.
Comparing the modelled and measured target-strength variability of walleye pollock, Theragra chalcogramma
Authors: Hazen Elliott L. , Horne John K.
Published: March 2004

Many biological and physical factors potentially affect target strength. While these sources have been identified, few studies have compared the relative effects of individual factors. Modelled and measured target strengths in non-dimensional metrics were used to compare and rank the effects of fish length, tilt, depth, and acoustic frequency on backscatter intensity. Ex situ measurements of target strength were used to examine the effects of tilt and depth and then compared to backscatter model predictions. Swimbladder volume reduction due to increasing pressure at depth was modelled using Boyle's law and by varying the ratio of dorsal to lateral compression. We found that length has the largest effect on the modelled and measured backscatter intensity, followed by tilt, frequency, and depth. Including tilt distributions in backscatter estimates improved the match between empirical target-strength measures and model predictions. Non-dimensional influence ratios provide insight into the sources and magnitudes of the backscatter variability.
A Long Financial March: Pension Reform in China
Authors: BÉLAND DANIEL , YU KA MAN
Published: March 2004

In the context of rapid economic and demographic change, the People's Republic of China has attempted to reshape its public pension system. Although China's current pension system has drawn the attention of many policy analysts, no theoretically informed account on the politics of Chinese pension reform has yet been published. Grounded in a broad institutionalist perspective, this contribution analyses contemporary pension politics in China through the interplay of four main factors: (1) decentralisation and limited administrative capacity, which make it difficult to rationalise and transform the existing pension system; (2) feedback effects from previously enacted pension schemes that further complicate policy change; (3) liberalisation and economic reforms, which have created ‘vested interests’ in the newly established private sector, but which have lacked the strength to generate a mature financial system; (4) finally, the apparent dominance of the neo-liberal financial paradigm commonly associated with the World Bank. While this financial paradigm favours the adoption of new reform proposals, the economic and institutional factors mentioned above complicate their implementation.
Family Policy and Civil Registration in England and Wales: An Analysis of the White Paper Civil Registration: Vital Change
Authors: FINCH JANET
Published: March 2004

The article considers the implications for family policy of the proposed new changes to the registration of births, marriages and deaths, contained in the British government White Paper Civil Registration: Vital Change (2002). It asks whether, and to what extent, the changes proposed are ‘facilitative’ or ‘persuasive’. It is argued that, whilst the changes are in part designed to facilitate more diverse patterns of partnering and parenting now evident in the population there are limitations, for example in respect of same sex partnerships. There are also clearly ‘persuasive’ elements. These are consistent with changes in family policy which focus more on the individuals than on the nuclear family as the focus of policy, which are tolerant of different forms of partnering, but which place supporting parenthood as the highest priority. Changes in civil registration are seen as an essential condition for implementing other types of changes in the family policy arena.
The Unknown Titmuss
Authors: WELSHMAN JOHN
Published: March 2004

Recent writing in social policy on the role of agency has made important assumptions about social administration in the post-war period. In particular it is suggested that interpretations of the causes of poverty, and the thinking of Richard Titmuss, were characterised by a ‘denial’ of agency and almost total emphasis on structural factors. The implications were that this left the Titmuss paradigm vulnerable to more individualistic interpretations in the 1980s. In this article we look more closely at Titmuss's work and thought in the three decades of the 1940s, the 1950s, and the 1960s, aiming to produce a fuller and more nuanced analysis. We argue that the distinctive position adopted by Titmuss was in large part his response to earlier and on-going debates about social pathology. What he was trying to do was to make others aware of the broader context in which behaviour had to be analysed. But Titmuss himself became constrained by the paradigm that he did more than anyone else to create. Thus debates about behaviour, structure, and poverty have been marked as much by continuity as by change.
Public Participation and Collaborative Governance
Authors: NEWMAN JANET , BARNES MARIAN , SULLIVAN HELEN , KNOPS ANDREW
Published: March 2004

This paper draws on the findings of a study within the ESRC's Democracy and Participation Programme. It explores the processes of participation within deliberative forums – such as user panels, youth forums, area based committees – developed as a means of encouraging a more active, participating mode of citizenship and of improving welfare services by making them more responsive to users. Our findings open up a number of issues about constraints on the development of ‘collaborative governance’. To understand these constraints, we suggest, there is need to locate participation initiatives in the context of government policy, to explore ways in which such policy is interpreted and enacted by strategic actors in local organisations and to examine the perceptions of members of deliberative forums themselves. Our findings highlight the constraints on the ‘political opportunity structures’ created by the enhanced policy focus on public participation, and the consequent limits to ‘collaborative governance’. We discuss how governance theory and social movement theory can each contribute to the analysis, but also suggest productive points of engagement through which each of these bodies of theory might enrich the other.
A kind of symbiosis
Authors: McArthur Tom
Published: March 2004

Not only do copies of ET go round the world, but our contributors are based in a multitude of places. In recent editions, we have been using map motifs on the front cover to demonstrate the worldwideness (internationality? globality?) of the journal and its topics, and it seems appropriate, at least this once, to pinpoint the kind of places from which contributions come or to which they relate (or both). On this cover we see at a glance that ET78 has four source-cum-topic areas in Europe, three in East Asia, two in North America, and two in Australasia/Oceania.
Invented languages and new worlds
Authors: LO BIANCO JOSEPH
Published: March 2004

THE LIFE of a language involves relationships between linguistic elements and extra-linguistic contexts. The linguistic elements are varied and multiple, involving both written and spoken symbols and grammars, while the extra-linguistic contexts are the innumerable societies, cultures, and sub-cultures of humankind, including its worlds of reality, imagination, and ideology. This article discusses invented languages, partly in order to explore the motivations and schemes of their inventors and partly to compare languages created for international use (often called international auxiliary languages or IALs) with English, which itself functions as an IAL but is very much an uninvented language.
Why China English should stand alongside British, American, and the other ‘world Englishes’
Authors: QIONG HU XIAO
Published: March 2004

ENGLISH as the world's lingua franca has become a focus of attention for many scholars. Since China joined the World Trade Organization (WTO), the motivation to learn English has dramatically increased. This paper questions the need for English in China to conform to any of the existing standard varieties, arguing that this objective is both undesirable and virtually unattainable, especially in respect to pronunciation, and that Chinese learners should therefore be learning ‘China English’. In an investigation with over 1,200 Chinese students at her university, the writer discovered that the vast majority had never heard of either World English or China English, believing instead that proficiency in standard American or British English should be their goal. She proposes both a reorientation of English language learning in China and a radical revision of the materials used there for both practical and cultural reasons.
Adapting English into Chinese
Authors: HU PETER
Published: March 2004

WHY IS English a global language? Although the reasons are manifold – historical, geographical, economic, political, social, cultural – the key reason, it seems to me, is linguistic: its morphology is simple, many of its words are short and pithy, and among the key world languages it has the largest vocabulary. These features have helped it become the most widely used language in the world: a situation that makes Uncle French and Grandpa German envious. English has been open-minded since childhood. In the long process of exchange, English words lost most of their inflections and words of different origins were mixed together (Burchfield 1984:13). Unlike traditional German and French, English has been open to foreign penetration and never drives new words out. It is this openness that continually enriches the language. Chinese also likes to borrow from other languages. Old Chinese borrowed 35,000 words from Buddhism, and Modern Chinese has absorbed countless words from Western civilizations. This paper inquires into the mutual borrowing between English and Chinese, summarizes the techniques of borrowing words from English into Chinese, and asserts that semantic transliteration is the best approach to adopting foreign words.
A chapter of English teaching in Korea
Authors: JEONG YOUNG-KUK
Published: March 2004

THIS ACCOUNT of the growth of English language teaching in South Korea moves from the grammar-fixated traditions of the late 19th and earlier 20th centuries through more recent politically and educationally lively times to an English – and especially American English – ‘fever’. This urge towards English involves much of the nation and many kinds of schools and universities. In particular it constrasts school English with a massive parallel realm of private tuition, and, more recently, the widespread individual use of audio-materials. More recently still it has led to the emergence of a novel private university, the International Graduate School of English, founded and financed by a publisher who has himself been closely involved with the issue of how young Koreans can most effectively learn a language which much of the nation considers vital to the nation's future.