bluuebunny/crossref_metadata_2025 huggingface dataset:
Liquid chromatography/electrospray ionization mass spectrometry for the characterization of twenty‐three flavonoids in the extract of Dalbergia odorifera
Authors: Liu Rongxia , Ye Min , Guo Hongzhu , Bi Kaishun , Guo De‐an
Published: May 2005

A method incorporating high‐performance liquid chromatography (HPLC) with electrospray ionization and tandem mass spectrometry, with parallel analysis by HPLC with UV detection using a diode‐array detector, was developed for the qualitative characterization of flavonoids in D. odorifera. Twenty‐three flavonoids, including six isoflavones, six neoflavones, four isoflavanones, three flavanones, two chalcones, one isoflavanonol and one pterocarpan, were unambiguously identified by comparing their retention times, UV and MS spectra with those of authentic compounds. Furthermore, the collision‐induced dissociations of the [MH]− ions were studied to clarify the MS behavior of the different types of flavonoids. In negative ion ESI‐MS all the flavonoids yielded prominent [MH]− ions in the first order mass spectra. Fragments involving losses of CH, H2O, CO, C2H2O, and CO2 were observed in the MS/MS spectra. Each of the seven types of flavonoid showed characteristic MS/MS fragmentation patterns. The isoflavanones, flavanones and chalcones were observed to undergo retro‐Diels‐Alder fragmentations. The spectra of almost all the neoflavonoids unexpectedly exhibited only [MHCH3]−. radical anions as base peaks without any further fragmentation. Substitution positions also remarkably influenced the fragmentation behavior, which could assist in distinction among the flavonoid isomers. The fragmentation rules deduced here could aid in the characterization of other flavonoids of these types. Copyright © 2005 John Wiley & Sons, Ltd.
Three sources of CO2 efflux from soil partitioned by 13C natural abundance in an incubation study
Authors: Kuzyakov Yakov , Bol Roland
Published: May 2005

This study describes a novel approach to separate three soil carbon (C) sources by one tracer method (here 13C natural abundance). The approach is based on the combination of C3 and C4 sources in different treatments, identical decomposition of C3 and C4 substances in soil, and subsequent calculation of their contribution to the total CO2 efflux. We used the temporal dynamics of the CO2 efflux from a C3 grassland soil amended with added C3 or C4 slurry and/or C3 or C4 sugar to estimate contributions of three separate C sources: native soil organic matter (SOM), slurry and sugar, to CO2 efflux. Soil with slurry and/or sugar was incubated under controlled conditions, and concentration and δ13C values of evolved CO2 were measured over a 2‐week period. The main assumption needed for separation of three C sources in CO2 efflux, i.e. identical decomposition of applied C3 and C4 sugars in soil, was investigated and proven. The relative contribution to the CO2 efflux increased, but its duration decreased with an increased microbial availability of the C source, i.e. sugar > slurry > SOM. The microorganisms used the C sources according to their availability. The contribution of sugar to the CO2 efflux was finished after 2–4 days. Separation of three CO2 sources and comparison of CO2 from different treatments tracing the changes of SOM and slurry decomposition induced by addition of sugar were investigated. During the sugar decomposition (the first 2–4 days), the SOM decomposition strongly decreased. At the same time the contribution of slurry‐C to CO2 increased. The shortcomings and limitations as well as possible future applications of the suggested method including FACE (Free Air Carbon dioxide Enrichments) and continuous labelling experiments are discussed. Copyright © 2005 John Wiley & Sons, Ltd.
Denaturant sensitive regions in creatine kinase identified by hydrogen/deuterium exchange
Authors: Mazon Hortense , Marcillat Olivier , Forest Eric , Vial Christian
Published: May 2005

The GdmHCl‐induced unfolding of creatine kinase (CK) has been studied by hydrogen/deuterium (H/D) exchange combined with mass spectrometry. MM‐CK unfolded for various periods in different denaturant concentrations was pulsed‐labeled with deuterium to identify different conformational intermediate states. For all denaturation times or GdmHCl concentrations, we observed variable proportions of only two species. The low‐mass envelope of isotope peaks corresponds to a species that has gained about 10 deuteriums more than native CK, and the high‐mass envelope to a completely deuterated species. To localize precisely the unfolded regions in the states highly populated during denaturation, the protein was digested with two proteases (pepsin and type XIII protease) after H/D exchange and rapid quenching of the reaction. The two sets of fragments obtained were analyzed by liquid chromatography coupled to mass spectrometry to determine the deuterium level in each fragment. Bimodal distributions of deuterium were found for most peptides, indicating that these regions were either folded or unfolded. This behavior is consistent with cooperative, localized unfolding. However, we observed a monomodal distribution of deuterium in two regions (1–12 and 162–186). We conclude that the increment of mass observed in the low‐mass species of the intact protein (+10 Da) has its origin in these two segments. These regions, which are very sensitive to low GdmHCl concentrations, are involved in the monomer–monomer interface of CK and their perturbation is likely to weaken the dimeric structure. At higher denaturant concentration, this would induce dissociation of the dimer. Copyright © 2005 John Wiley & Sons, Ltd.
Rapid screening of drugs of abuse and their metabolites by gas chromatography/mass spectrometry: application to urinalysis
Authors: Strano‐Rossi Sabina , Molaioni Francesco , Rossi Francesca , Botrè Francesco
Published: May 2005

This paper describes a rapid gas chromatographic/mass spectrometric (GC/MS) screening method for the detection of drugs of abuse and/or their metabolites in urine. Synthetic stimulants, opiates, cocaine metabolites, cannabinoids—and specifically the acid metabolite of tetrahydrocannabinol (THC‐COOH)—can be simultaneously extracted by a single liquid/liquid separation step, at alkaline pH, and assayed as trimethylsilyl derivatives by GC/MS in SIM (selected ion monitoring) mode. All the analytes show a good linearity (R2 > 0.99 for most of the considered substances) in the range 25–1000 ng/mL, with a good reproducibility of both the retention times (CV% <0.7) and the relative abundances of the characteristic diagnostic ions (CV% <13). The limit of detection (LOD) of the method is 25 ng/mL of target compound in human urine for most of the substances investigated, 3 ng/mL for THC‐COOH, and 10 ng/mL for norbuprenorphine. Validation of the method allows its application to different fields of forensic analytical toxicology, including antidoping analysis. Copyright © 2005 John Wiley & Sons, Ltd.
Characterization of phenolic compounds in the Chinese herbal drug Tu‐Si‐Zi by liquid chromatography coupled to electrospray ionization mass spectrometry
Authors: Ye Min , Yan Yuning , Guo De‐an
Published: May 2005

Phenolic compounds are the major bioactive constituents of the Chinese herbal drug Tu‐Si‐Zi, which is prepared from the seeds of Cuscuta chinensis. However, seeds of C. australis also are offered under the name of this drug in the herb market. In order to make a comparison of their chemical constituents, the phenolic compounds of these two Cuscuta species were analyzed by high‐performance liquid chromatography/diode‐array detection/electrospray ion trap tandem mass spectrometry (HPLC/DAD/ESI‐MSn). A total of 50 compounds were observed in the methanol extracts, including 23 flavonoids, 20 lignans and 7 quinic acid derivatives. These compounds were separated on a C18 column and identified or tentatively characterized based on UV spectra and MS fragmentation behavior. In contrast to previous reports, the phenolic patterns of these two Cuscuta species were found to be very different. Kaempferol and astragalin were the predominant constituents of C. australis, while hyperoside was the major compound in C. chinensis. Most of the identified compounds, especially the acylated flavonoid glycosides, have not previously been reported from Cuscuta species. In addition, a 30 Da neutral loss observed for flavonols was investigated and could be used to differentiate flavonoid isomers such as kaempferol and luteolin. The ESI‐MS fragmentation behavior of furofuran lignans was also investigated, and a characteristic pathway is proposed. The large differences observed between the phenolic constituents of C. chinensis and C. australis strongly encouraged further comparison of the bioactivities of these two species. Copyright © 2005 John Wiley & Sons, Ltd.
Dual linear ion trap/orthogonal acceleration time‐of‐flight mass spectrometer with improved precursor ion selectivity
Authors: Hashimoto Yuichiro , Hasegawa Hideki , Waki Izumi
Published: May 2005

A new hybrid mass spectrometer based on dual linear ion traps (LITs) and an orthogonal acceleration time‐of‐flight mass spectrometer (oaTOF), that can achieve MSn analysis and high‐mass‐accuracy detection with high sensitivity, has been developed. Dual‐LIT was necessary because, in a single LIT plus oaTOF combination, the LIT pressure favorable for high precursor selectivity in MSn analysis (less than 1 mTorr) was far different from an optimum damping pressure (50–100 mTorr) for efficient connection to the TOF mass spectrometer. A dual‐LIT solved this problem of inconsistency of the optimum pressures by using the first LIT for MSn analysis and the second LIT for collisional damping. This dual‐LIT/TOF instrument achieved high‐sensitivity MSn analysis with high precursor‐ion selectivity. Copyright © 2005 John Wiley & Sons, Ltd.
An application of electrospray ionization tandem mass spectrometry to probe the interaction of Ca2+/Mg2+/Zn2+ and Cl− with gramicidin A
Authors: Sudhir Putty‐Reddy , Wu Hui‐Fen , Zhou Zi‐Cong
Published: May 2005

The peptide, gramicidin A (GrA), has been demonstrated to interact with divalent salts (CaCl2, MgCl2, and ZnCl2) using electrospray ionization mass spectrometry (ESI‐MS). The ESI‐MS analysis revealed different complexes formed due to the interaction of Val‐GrA and Ile‐GrA with divalent salts: [Val or Ile‐GrA‐H+M]+, [Val or Ile‐GrA+MCl]+ and [Val or Ile‐GrA+M]2+, where M is Ca or Mg or Zn. All these complexes have been subjected to collisionally activated dissociation (CAD). CAD of singly and doubly charged GrA and metal complexes exhibited the losses of water molecules, indicating the ligand preference of GrA. MS/MS and MS3 of [Val or Ile‐GrA+MCl]+ resulted in the elimination of chloride ion and water, respectively. The tandem mass spectrometry data of the complex [Val‐GrA+MCl]+ suggest that chloride interaction is stronger in the presence of Ca than of Mg and Zn. This study reveals that GrA could interact with Ca, Mg, and Zn in metal ion form as well as in ion pair (MCl) form. The interactions of GrA with Ca support the proposal of a physical basis for the messenger role of Ca (Urry et al., J. Biol. Chem. 1982, 257: 6659–6661). Copyright © 2005 John Wiley & Sons, Ltd.
Rapid determination of urinary globotriaosylceramide isoform profiles by electrospray ionization mass spectrometry using stearoyl‐d35‐globotriaosylceramide as internal standard
Authors: Fauler Guenter , Rechberger Gerald N. , Devrnja Danijela , Erwa Wolfgang , Plecko Barbara , Kotanko Peter , Breunig Frank , Paschke Eduard
Published: May 2005

Globotriaosylceramide is a neutral glycolipid containing the trihexoside Gal(α1‐4)Gal(ß1‐4)Glc(ß1‐1′) covalently bound to N‐acylsphingosine. It was identified as the main storage substance in the kidney of patients with Fabry disease, an X‐linked deficiency of lysosomal α‐galactosidase A which can significantly be ameliorated by enzyme replacement therapy. Unlike hemizygote males, affected heterozygote females cannot be identified by enzyme assays and therefore may remain untreated. A quantitation of urinary globotriaosylceramides was proposed as an alternative method for their diagnosis. However, the required studies on physiological and pathological variations in the excretion of trihexosides so far have been prevented by a lack of suitable methods. A validated, robust and quick high‐throughput method for the quantitative analysis of globotriaosylceramide isoforms using stable‐isotope‐dilution/internal standardization and electrospray ionization mass spectrometry (ESI‐MS) was developed. An internal standard, stearoyl‐d35‐globotriaosylceramide, was synthesized by enzymatic coupling of d35‐stearic acid to the corresponding lyso‐ceramidetrihexoside. Glycolipid isoforms of high purity were obtained from a 5‐mL urine portion by extraction on C18 solid‐phase columns and a novel washing protocol. ESI‐MS analysis was performed in full and neutral loss scan modes. Urinary trihexosyl‐ and some of the di‐ and monohexosylceramide isoforms can be quantified within a single experiment. All glycolipid isoforms were above detection limit in healthy male and female subjects (n = 63). Prominent elevations of tetracosanoyl‐(C24:0 plus C24:1)‐globotriaosylceramides were found in urines from female (>2.5‐fold above normals) or male Fabry patients (>5.8‐fold above normals), but not among controls. Globotriaosylceramide isoforms shall now be analyzed in Fabry patients, non‐genetic kidney disease and healthy subjects to define the conditions for a safe diagnosis of heterozygotes. Copyright © 2005 John Wiley & Sons, Ltd.
Photoionization of CH3I mediated by the C state in the visible and ultraviolet regions
Authors: Sharma P. , Vatsa R. K. , Rajasekhar B. N. , Das N. C. , Ghanty T. K. , Kulshreshtha S. K.
Published: May 2005

Three/two‐photon resonant multiphoton ionization (MPI) of the CH3I monomer has been studied in the gas phase at 532 and 355 nm using time‐of‐flight mass spectrometry. Under low laser intensity (∼109 W/cm2) the mass spectra showed peaks at m/z 15, 127 and 142, corresponding to [CH3]+, [I]+ and [CH3I]+ species, at both these wavelengths. The laser power dependence for [CH3I]+, [I]+ and [CH3]+ ions showed a three‐photon dependence at 532 nm. For the same three ions, photoionization studies at 355 nm gave a power dependence of 2. Both these results suggest that a vibronic energy level at ∼7 eV, lying in the Rydberg C state, acts as a resonant intermediate level in ionization of CH3I. In the case of 355 nm, with increasing intensity additional peaks at m/z 139 and 141 were observed which could be assigned to [CI]+ and [CH2I]+ fragments. In contrast, for high intensity radiation at 532 nm (∼2 × 1010 W/cm2), only the [CI]+ fragment was observed. At these wavelengths, fragment ions observed in mass spectra mainly arise from photodissociation of the parent ion. Experiments at another wavelength in the visible region (564.2 nm) confirmed the results obtained at 532 nm. In order to assess the role of the Ã state in these MPI experiments, additional experiments were performed at 266 and 282.1 nm, which access the Ã state directly via a one‐photon transition, and showed absence of a surviving precursor ion. Reaction energies for various possible dissociation channels of CH3I/[CH3I]+/[CH2I]+ were calculated theoretically at the MP2 level using the GAMESS electronic structure program. Copyright © 2005 John Wiley & Sons, Ltd.
Electrospray ionization studies of transition‐metal complexes of 2‐acetylbenzimidazolethiosemicarbazone using collision‐induced dissociation and ion‐molecule reactions
Authors: Bhaskar G. , Chary M. Adharvana , Kumar M. Kiran , Syamasundar K. , Vairamani M. , Prabhakar S.
Published: May 2005

The complexes of transition‐metal ions (M2+, where M = Fe, Co, Ni, Cu, Zn, Cd, and Hg) with 2‐acetylbenzimidazolethiosemicarbazone (L) are studied under electrospray ionization (ESI) conditions. The ESI mass spectra of Fe and Co complexes showed the complex ions corresponding to [M+2L–2H]+, and those of Ni and Zn complexes showed [M+2L–H]+ ions, wherein the metal/ligand ratio is 1:2 and the oxidation state of the central metal ion is +3 in the case of Fe and Co and +2 in the case of Ni and Zn. The Cd and Cu complexes showed preferentially 1:1 complex ions, i.e., [M+L–H]+ or [M+L+Cl]+, whereas Hg formed both 1:1 and 1:2 complex ions. During formation of the above complex ions one or two ligands are deprotonated after keto‐enol tautomerism, depending on the nature and oxidation state of central metal ion. The structures and coordination numbers of the metal ions in the complex ions were studied by their collision‐induced dissociation spectra and ion‐molecule reactions with acetonitrile or propylamine in the collision cell. Based on these results it is concluded that Fe, Co, Ni and Zn form stable octahedral complexes, whereas tetrahedral or square planar complexes are formed preferentially for other metals. In addition, the Cu complex showed a [2L+2Cu–3H]+ ion with a CuCu bond. Copyright © 2005 John Wiley & Sons, Ltd.
Comparison of inductively coupled plasma mass spectrometry techniques in the determination of platinum in urine: quadrupole vs. sector field
Authors: Spezia Sandro , Bocca Beatrice , Forte Giovanni , Gatti Anna , Mincione Giovanna , Ronchi Anna , Bavazzano Paolo , Alimonti Alessandro , Minoia Claudio
Published: May 2005

In recent years the increasing use of platinum (Pt) both in medical and in industrial applications has caused its growing anthropogenic emission and spread in the environment. Pt is released into the atmosphere by exhaust catalytic converters, and Pt compounds are often used in antitumour therapies. As a consequence, significant amounts of Pt can be detected in hospital wastewaters. This can lead to an increase in the exposure levels to Pt, especially in urban areas. It is therefore necessary to determine Pt reference values in the general population, by using suitable procedures able to achieve adequate analytical performances. Several measurements of Pt in biological fluids have been reported, but the analytical methods used for the determination of Pt often lack information about the uncertainty of the results, especially for low concentrations of urinary Pt in non‐occupationally exposed subjects. The present paper considers the measurement of urinary Pt levels in a general population group from central Italy, by both quadrupole (Q) and sector field (SF) inductively coupled plasma mass spectrometry (ICP‐MS). The two procedures were validated and their expanded uncertainties were evaluated. The limits of detection (LODs), calculated taking into account dilution factors, were 0.18 and 0.05 ng L−1 of Pt for the Q and SF procedures, respectively. The median value observed was 4.13 ng L−1 of Pt in urine, while the relative combined uncertainty at 5 ng L−1 was below 20% with both ICP‐MS techniques. These data are in good agreement with those reported in the literature for similar studies. Copyright © 2005 John Wiley & Sons, Ltd.
Factors influencing success in introductory college chemistry
Authors: Tai Robert H. , Sadler Philip M. , Loehr John F.
Published: May 2005

Previous research has found a wide range of predictors of student performance in introductory college chemistry. These predictors are associated with both the students' backgrounds and their high school learning experiences. The purpose of this research study was to examine the link between high school chemistry pedagogical experiences and performance in introductory college chemistry while accounting for individual educational and demographic differences. The researchers surveyed 1531 students enrolled in first‐semester introductory college chemistry courses for science and engineering majors at 12 different U.S. colleges and universities. Using multiple regression analysis, the researchers uncovered several interesting high school pedagogical experiences that appeared to be linked with varying levels of performance in college chemistry. Most notably, the researchers found that repeating chemistry labs for understanding was associated with higher student grades, whereas overemphasis on lab procedure in high school chemistry was associated with lower grades in college. These results suggest that high school teachers' pedagogical choices may have a link to future student performance. © 2005 Wiley Periodicals, Inc. J Res Sci Teach 42: 987–1012, 2005
Gestational sac volume measured by three‐dimensional ultrasound at 11 to 13 + 6 weeks of gestation: relation to chromosomal defects
Authors: Falcon O. , Wegrzyn P. , Faro C. , Peralta C. F. A. , Nicolaides K. H.
Published: May 2005

Objective

To determine the potential value of measuring the gestational sac volume (GSV) at 11 to 13 + 6 weeks of gestation in screening for chromosomal defects.

Methods

The GSV was measured using three‐dimensional (3D) ultrasound in 500 consecutive singleton pregnancies immediately before chorionic villus sampling (CVS) for fetal karyotyping at 11 to 13 + 6 (median 12) weeks of gestation.

Results

The fetal karyotype was normal in 417 pregnancies and abnormal in 83. In the chromosomally normal group, the mean GSV increased significantly with gestational age from a mean of 69 mL at 11 weeks to 144 mL at 13 + 6 weeks (the standard deviation was 27 mL). In the chromosomally abnormal group, the mean GSV for gestational age was not significantly different from normal in fetuses with trisomy 21, trisomy 18 and Turner syndrome, but it was smaller in those with triploidy and trisomy 13. However, the mean GSV for crown–rump length (CRL) was significantly larger in trisomy 18, smaller in triploidy and trisomy 13, and not different from normal in trisomy 21 and Turner syndrome. The mean CRL for gestational age was significantly smaller than normal in trisomy 18, triploidy and trisomy 13.

Conclusions

The measurement of the GSV at 11 to 13 + 6 weeks of gestation is unlikely to provide useful prediction of the major chromosomal defects. In trisomy 13 and triploidy, the small GSV may be due to early onset fetal growth restriction and reduced amniotic fluid volume. In trisomy 18, the increase in GSV is probably due to the presence of associated fetal abnormalities that interfere with fetal swallowing. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.
Application of PIXE and PIGE under variable ion beam incident angle to several fields of archaeometry
Authors: Weber G. , Martinot L. , Strivay D. , Garnir H. P. , George P.
Published: May 2005

For several years, the specific features of PIXE and PIGE have made them very attractive in the field of archaeometry. Among them, non‐destructivity is one of the most important. The possibility of working under atmospheric pressure is also important because of the very different shapes and sizes of the artefacts concerned. However, these ion beam techniques suffer from the same disadvantage: the information coming from x‐rays or γ‐rays produced at different places along the charged particle path is integrated. That prevents one from taking into account the possible element concentration gradients due to multi‐layered systems or diffusion processes. This paper presents several applications of PIXE and PIGE applied under variable ion beam incident angle. PIGE has been mainly used for studying ancient glass items or glass windows in order to detect or evaluate the glass corrosion process. The examples given for PIGE deal with Roman and Merovingian glass objects and cathedral glass windows and PIXE applications concern studies for resolving the multilayered structure of easel paintings. The set‐up allowing one to perform the measurements should be very stable, the rotation axis should pass through the beam axis and the detector should follow the sample movement. Copyright © 2005 John Wiley & Sons, Ltd.
Contribution of atomic bremsstrahlung in PIXE spectra and screening effect in atomic bremsstrahlung
Authors: Ishii K. , Yamazaki H. , Matsuyama S. , Galster W. , Satoh T. , Budnar M.
Published: May 2005

The continuous background appearing in PIXE spectra has been studied in detail and is understood to comprise three main components: secondary electron bremsstrahlung (SEB), atomic bremsstrahlung (AB) and nuclear bremsstrahlung (NB). Here, studies on continuous x‐rays in PIXE are reviewed and a new phenomenon is discussed, the screening effect of the projectile by target electrons in AB. Copyright © 2005 John Wiley & Sons, Ltd.
The effect of stored blood on mesenteric oxygen extraction during endotoxin shock
Authors: Garg Dinesh K. , Kaldis Louise G. , Miller Warren C. , Jacobson Eugene D. , Bowen John C.
Published: May 2005

Storage of blood in acid‐citrate‐dextrose (ACD) solution gradually depletes red cell 2,3‐diphosphoglycerate (DPG) and increases the affinity of hemoglobin for oxygen. We examined the effect of exchange transfusion of DPG‐depleted blood on mesenteric blood flow and oxygen consumption in dogs subjected to endotoxin shock. Two groups of 6 dogs each were anesthetized and subjected to exchange transfusion with either fresh ACD blood or 21‐day‐old ACD blood prior to administration ofEscherichia coli endotoxin (2 mg/kg). Mesenteric blood flow, arteriovenous oxygen content difference and systemic arterial blood pressure were monitored continuously before and for 60 min after endotoxin. Mesenteric blood flow was reduced from 250±21 ml/min before endotoxin to 114±15 ml/min at 5 min, 157±29 ml/min at 30 min, and 112±17 ml/min at 60 min after endotoxin in the dogs exchanged with fresh blood. Corresponding values for intestinal oxygen consumption were 10.4±1.0, 7.5±0.8, 8.4±1.0, and 6.8±0.7 ml/min. In dogs transfused with 21‐day‐old blood, pre‐endotoxin blood flow was 208±2 ml/min and declined to 115±12, 93±5, and 80±8 ml/min at 5, 30, and 60 min post‐endotoxin. Corresponding values for intestinal oxygen consumption were 8.1±0.9, 6.6±0.7, 6.2±0.5, and 5.5±0.7 ml/min. There was no significant difference (p>0.1) in responses of blood flow or oxygen consumption to endotoxin shock between the two groups of dogs. These findings indicate that exchange transfusion with DPG‐depleted blood does not impair oxygen extraction by the ischemic intestine.
The effect of glucagon on pancreatic secretion and plasma secretin in dogs
Authors: Miller Thomas A. , Watson Larry C. , Rayford Phillip L. , Thompson James C.
Published: May 2005

The inhibitory effect of glucagon on pancreatic exocrine secretion induced by endogenously released secretin was studied in 4 dogs with chronic pancreatic fistulas and open gastric fistulas. After a constant level of pancreatic secretion was established by intraduodenal hydrochloric acid perfusion (9 mEq/hr), glucagon (30Μg/kg‐hr) was administered intravenously for 1 hr. Compared to a separate control study in which dogs received intraduodenal HCl alone, glucagon caused a significant decrease in both pancreatic volume flow and bicarbonate output. Glucagon had no effect on pancreatic protein secretion, and circulating levels of endogenously released secretin remained unchanged. It is concluded that the inhibitory effect of glucagon on pancreatic secretion is not mediated through inhibition of secretin release. The chemical homology between glucagon and secretin suggests that glucagon may mediate its inhibitory action by competing with secretin at the level of the pancreatic receptor site.
Epidemiology of cancer of the stomach
Authors: Yamagata Shoichi , Hisamichi Shigeru
Published: May 2005

The epidemiologic study of cancer is based primarily on mortality, morbidity, clinical, and autopsy statistics. The analysis of the results of a mass survey examination of the stomach has contributed considerably to the epidemiologic study of gastric cancer. We present a survey of the literature on stomach cancer mortality and incidence in relation to geography, age, sex, race, and environment. Thereupon, we offer the results and evaluate the effects of a mass survey examination of the stomach which was begun in 1960 in Miyagi Prefecture, Japan. It is to be noted that the mortality rate from stomach cancer per 10,000 persons per year in the nonexamined group was approximately 2.4 times higher than that of the examined group.
Precancerous lesions of the stomach
Authors: Yamagata Shoichi , Hisamichi Shigeru
Published: May 2005

The etiology of stomach cancer in relation to preexisting mucosal alterations is described and discussed from a review of the literature and our own previously reported experience. The incidence of “cancerization” or malignant change of gastric polyp, chronic gastric ulcer, and chronic gastritis varies considerably from researcher to researcher. Clinical follow‐up studies in many cases of gastric polyp and chronic ulcer discovered in the mass survey examination of the stomach revealed incidences of malignant degeneration of 2.3% of the gastric polyp cases and 2.06% of the gastric ulcer cases.
Diagnosis of advanced gastric cancer
Authors: Nagao Fusahiro , Takahashi Nobuhiro
Published: May 2005

A series of 536 patients who underwent gastric resections for advanced gastric cancer has been reviewed with regard to the diagnostic procedures for detecting gastric cancer. There were no characteristic symptoms of gastric cancer, but weight loss was a frequent complaint. Variation in the type and frequency of symptoms did not appear to depend on the presence or absence of metastases. Patients whose operations were delayed more than one year after the onset of symptoms accounted for 33% of the series, and 38% of these had visited their physicians within 6 months after the onset of symptoms but were misdiagnosed as having chronic gastritis or benign ulcer. The results of various laboratory examinations were not specific. Gastric acidity was found to be distinctly lower than in patients with benign gastric disease. Techniques of radiology, endoscopy, and endoscopic biopsy of the stomach have greatly improved, and the overall rates of correct diagnosis of gastric cancer were 96% by x‐ray, 98% by endoscopy, and 90% by biopsy. These rates were slightly lowered when only Borrmann type IV lesions were considered. Celiac angiography was useful to determine the extent or depth of cancerous invasion and to detect liver metastases. The frequency of positive PPD or DNCB skin tests appeared to decrease as the stage of cancer advanced, indicating immunologic impairment in advanced gastric cancer.
Stump cancer following gastric surgery
Authors: Nicholls John C.
Published: May 2005

This paper reviews the literature regarding the development of gastric cancer in the stomach remnant following gastric resection. Although there is as yet little supporting experimental evidence, clinical studies suggest that the risk of developing gastric cancer is increased, perhaps as much as 6‐fold, following partial gastrectomy for benign lesions. It also appears that the risk of developing cancer is greatest if the lesion for which the gastrectomy was originally performed was a gastric ulcer rather than a duodenal ulcer. The type of gastrectomy does not seem to influence this increased risk. Hypotheses are reviewed concerning the role of changes in gastric morphology following partial gastrectomy in the development of cancer.
Cimetidine and the gastric surgeon
Authors: Clark Charles G. , Boulos Paul B.
Published: May 2005

A study of the effects of cimetidine has been made in patients referred to a surgical clinic. Cimetidine is undoubtedly useful in aiding the healing of acute duodenal ulcers, but once treatment is stopped, the majority recur. After healing, maintenance treatment is useful in preventing ulcer recurrence, but once the drug is stopped, recurrence soon follows. At present the evidence suggests that treatment with cimetidine may have to be life‐long. Most surgeons would not accept this as an alternative to surgery in the treatment of chronic duodenal ulcer. However, in the treatment of recurrent ulceration after surgery, and where symptoms are relieved by cimetidine, the patient may prefer drugs to further operation.
Radiotherapy for esophageal carcinoma
Authors: Pearson James G.
Published: May 2005

During the last 30 years, there have been improvements in radiotherapy not matched by improvements in earlier diagnosis. The screening program in the People's Republic of China is an exception. For lower incidence areas, greater patient and physician awareness and the addition of brushings, washings, and cytology to improved barium studies and endoscopy for the earlier investigation of dysphagia may contribute to earlier diagnosis and thus more effective radiotherapy.

There are no experimental data to prove that either surgery or radiotherapy is preferable in the management of the various categories of esophageal cancer; however, close teamwork between the disciplines is fruitful. Neither radio‐therapy nor surgery for esophageal cancer is optimal in the hands of the occasional practitioner. In communities where radiotherapy and surgery are both highly developed and closely associated, optimal benefit is likely to be achieved if patients with squamous carcinoma of the middle and upper thirds of the esophagus are treated initially by radiotherapy with surgery held in reserve for local recurrences, and patients with squamous carcinoma of the lower third and all adenocarcinomas are treated surgically unless medically unfit. For the patients treated primarily by surgery, preoperative radiotherapy may help.

Patients with more advanced disease can usually be helped by palliative radiotherapy, with intubation held in reserve until an adequate fluid diet can no longer be swallowed.

Prevention is conceivable and would be unquestionably preferable.
Parenchymal cell mass determination in parathyroid glands and its application in a material of hyperparathyroidism
Authors: åkerström G. , Grimelius L. , Johansson H. , Pertoft H. , Lundqvist J.
Published: May 2005

Parencbymal cell mass determination with a density gradient technique was used as a supplement to the histological examination of parathyroid glands in a series of patients operated on for hyperparathyroidism. The parenchymal cell mass was easily determined intraoperatively and constituted an objective parameter in the differentiation between normal and abnormal parathyroid glands. It is suggested that such objective determinations of the parenchymal cell mass should be considered in parathyroid histological diagnosis.
Clinical characteristics and surgical results in hyperparathyroidism caused by water‐clear cell hyperplasia
Authors: Tisell Lars ‐Eric , Hedman Ingmar , Hansson Göran
Published: May 2005

Twenty‐nine patients were treated for water‐clear cell hyperplasia (WCCH) of the parathyroid glands and 531 for single adenoma during a 26‐year period ending in 1978. The annual incidence of WCCH did not change during the period, whereas the number of adenoma cases markedly increased. Patients with WCCH had higher serium calcium levels and more severe disease than did those with adenoma. Mental symptoms and impaired renal function were especially common, and 4 patients later died of renal failure. The reversed sex ratio, with more men than women among the WCCH patients, can explain their higher prevalence of renal calculi. Operative treatment resulted in a cure of hyperparathyroidism (HPT) in 24 WCCH patients, 7 of whom developed hypocalcemia. Five patients remained hypercalcémie. Because of the morbidity of WCCH, persistent HPT should be avoided and more radical surgery performed than is currently recommended.
Trauma severity scoring to predict mortality
Authors: Champion Howard R. , Sacco William J. , Hunt Thomas K.
Published: May 2005

The evaluation of the care of the multiple trauma patient requires indices that predict survival or death and that reveal the presence or absence of complications. This article reviews briefly the different scales that have been developed. It is concluded that both anatomic and physiologic injury scores are required. A methodology of patient care evaluation is then developed based upon preliminary method (PRE), a state transition screen (STS), and a definitive method (DEF). The preliminary method is illustrated by use of the Trauma Score and the Injury Severity Score to predict patient outcome. This is then compared with the actual patient outcome. The STS methodology reveals patients who are better or worse than expected in their course in the hospital. The DEF method is used for comparison between institutions or for different time periods at a given institution.
The injury severity score
Authors: Goris R. J. A.
Published: May 2005

The assets and drawbacks of ISS are documented, utilising 2 groups of patients with blunt multiple trauma. Group I consisted of 80 patients with 417 fractures and 163 major associated injuries. Group A had early fracture stabilization and prophylactic ventilation, Group B had early fracture stabilization without prophylactic ventilation, Group C had delayed fracture stabilization and prophylactic ventilatory support. Utilising the ISS, subgroups of A and C were constructed that had injury severity scores ≥ 50 (means 57 and 58.7) containing 19 and 11 patients. Group A had a 10% mortality rate, a late sepsis mortality rate of 6%, and ARDS incidence of 26%, and a mean duration of ventilation of 6 days, while group C had a late sepsis mortality rate of 55%, and ARDS incidence of 82%, and a mean duration of ventilation of 26 days. It is concluded, that early operative stabilization of fractures is safe, and in significant part is associated with a reduced number of late sepsis deaths while reducing the duration of ventilator support required, and that prophylactic ventilator support (i.e., continued support after surgery significantly reduces the incidence of ARDS).

Group II consisted of all blunt trauma patients with an ISS greater than 20, admitted during 1981. Sixty‐eight patients were admitted and the correlation was sought between ISS and mortality. It was concluded, that death exclusively from central nervous system injury should be analyzed separately from death from other causes in multiply injured patients. Reference is made to other applications of ISS than the documentation of mortality and suggestions are made for improving ISS by including the Glasgow‐coma scale and including patients related risk data. A plea is made to devise a standard method for ISS calculation.
The pulmonary response to trauma and mechanical ventilation: Its consequences on hemodynamic function
Authors: Laver Myron B.
Published: May 2005

The lung and heart, including the right ventricle (RV) and left ventricle (LV), must be regarded as an integrated system. A change in function of any one, including the addition of mechanical ventilation, will induce a change in function of the other. Interaction between RV and LV primarily via the septum and initially independent of pericardial constraints, is now a fact of life that complicates the evaluation of either left or right ventricular function as an isolated system. In this setting, an increase in LV filling pressure at constant stroke volume need not reflect straightforward myocardial depression. A change in motion of the interventricular septum represents an important variable that modifies the usual evaluation of function based on the Frank‐Starling relationship.

The RV is susceptible to large changes in volumes with small changes in filling pressure. These variations can have a significant effect on LV end‐diastolic compliance and may result in RV ischemia due to an excessive elevation of RV free wall stress when right coronary artery disease or an inadequate systemic perfusion pressure is present.
Brain injuries in polytrauma
Authors: Bakay Louis
Published: May 2005

The magnitude of the cerebral injury is the ultimate determining factor in survival versus death and ability versus disability in most multiple trauma patients. The acute failures of oxygen transport that occur in these patients can clearly increase the magnitude of the brain injury. This occurs either via cardiopulmonary failure or prolonged epileptic seizures. Both sources must be quickly reversed. The magnitude of the brain injury may also be increased by delayed diagnosis of expanding intracranial lesions. The rapid availability of computed tomography (CT) scans of the head is of great importance in the early diagnosis of intracranial lesions. In the absence of CT scans, skull x‐rays and cerebral angiography in association with sequential evaluations of consciousness and neurological function are useful. Medications that change the state of consciousness interfere with such follow‐up and should be avoided if at all possible.

Acute extradural hematomas are generally not associated with much initial brain damage and produce rapidly progressive brain damage. Therefore, their treatment constitutes an absolute neurosurgical emergency. If these coexist with intra‐abdominal bleeding, then 2 operating teams should proceed simultaneously. In contrast, both intracerebral and subdural hematomas reflect relatively severe initial brain damage which cannot be changed and produce a slower rise in pressure and thus a slower rate of destruction of additional brain tissue. The time scale for treatment of these lesions is, therefore, longer than that for extradural hemorrhages.

Additional brain damage may also be produced by cerebral edema. The intracranial pressure is best monitored in trauma cases by pressure monitoring bolt. The preferred agents for therapy are clearly mannitol acutely (0.5 to 1.5 g/kg body weight as a single dose) followed by a continuous infusion with an osmolality maintained at 315 to 320 mOsm. Lasix® may also be used. In the absence of control of intracranial pressure, then barbiturate coma may be utilized (3 to 5 mg/kg as an initial dose followed by maintenance of plasma levels at 2.5 to 3.5 mg/100 ml).
Intra‐abdominal injuries in polytrauma
Authors: Polk Hiram C. , Flint Lewis M.
Published: May 2005

The most important preoperative objective in the management of the patient with abdominal trauma is to ascertain whether or not a laparotomy is needed and not the diagnosis of a specific organ injury. This objective is complicated in multiple trauma patients by the extra‐abdominal injuries which change the abdominal findings. Peritoneal lavage is of great help in making this decision. The second important decision relates to whether or not the control of abdominal blood loss is to be achieved as a part of or after cardiopulmonary resuscitation. Clearly, the blood bank must be alerted and sufficient personnel must be available to pump the blood. Such surgery must always be conducted under full physiologic monitoring of cardiopulmonary function, with a warming blanket to prevent hypothermia, and with x‐ray facilities. The third decision concerns the role of the laparotomy in the treatment of the other injuries the patient has received. It is usually wise to have 2 operating teams at work.

Given the nature of blunt trauma it is wise to prepare the patient from the sternal notch to mid‐thighs so that any surgical eventuality may be managed. This is associated with a long midline incision. The first operative objective is control of hemorrhage; the second, prevention of further contamination; and the third, a precise diagnosis of the anatomy of each injury. The subsequent objectives for liver, pancreaticoduodenal, gastrointestinal, and splenic injuries are discussed in detail. In the severely contaminated abdomen, delayed primary closure of the wound above the fascia is utilized.
Vascular injuries in polytrauma
Authors: Heberer G. , Becker H. M. , Dittmer H. , Stelter W. J.
Published: May 2005

In our surgical clinic, from January 1, 1978, to May 15, 1982, a total of 41 patients with polytrauma exhibited 45 concomitant vascular injuries requiring operation. This group of patients represents 10% of the 407 multiple trauma patients treated during this period. The incidence of vascular lesions of shoulder, neck, and upper extremities was 2.7% (n=11); lower extremities, 4.7% (n=19); within the abdominal cavity, 1% (n=4); and of acute thoracic aortic rupture, 2.7% (n=11). Seven patients (17%) died: 4 from additional brain trauma, 3 from hemorrhage by aortic ruptures. There were 6 major amputations (2 primary, 4 secondary) and 2 borderline amputations. In the remaining 26 patients, a good result following vascular repair was achieved. Angiologic examination, including computed tomography and angiography, is of great importance. Vascular repair deserves high priority since bleeding and/or ischemia threatens the patient's limbs, organs, or even life. This is especially true for the acute thoracic aortic rupture as a typical vascular injury in polytrauma. The incidence of peripheral vascular injuries in polytrauma is twice as high (7.3%) as in isolated extremity fractures (3.6%).
Osteosynthesis of major fractures in polytrauma
Authors: Tscherne H. , Oestern H. J. , Sturm J.
Published: May 2005

The treatment of multiple trauma patients is subdivided into pre‐hospital and hospital periods. The hospital period is divided according to diagnostic and therapeutic measures into acute, primary, secondary, and tertiary periods. In the acute period, all life‐threatening injuries, e.g., severe abdominal bleeding, are treated. In the primary period, visceral injuries such as bowel rupture and fractures with vessel injuries, open fractures, open joints, severe compartment syndromes, and closed femoral fractures require surgery. In the secondary period, prolonged joint reconstructions, closed fractures of the forearm, and partially reconstructive surgery are performed. In the tertiary period, reconstructive surgery is done (e.g., cancellous bone grafts). Using this regimen in multiple trauma patients, we not only obtain restoration of vital function, but also good restoration of the extremities is achieved.
Maxillofacial injuries in polytrauma
Authors: Spiessl B.
Published: May 2005

Maxillofacial surgery can make a substantial contribution to the optimal care of the multiple trauma patient when it is integrated into a coordinated, interdisciplinary overall treatment scheme. With regard to the priority of indication (i.e., reanimation, first surgical phase, stabilization phase), we seldom (1% of cases) have to perform emergency surgery (priority 1) to stop bleeding from the maxillary artery. Clinical and radiographic diagnostic measures can be kept to a minimum, since treatment of the facial skeleton is generally indicated at the end of the stabilization phase (priority 3). As a basic rule, the treatment should be definitive and should be aimed at early mobilization. This requires the uncompromising application of rigid internal fixation.
The neuroendocrine response to multiple trauma
Authors: Gann Donald S. , Lilly Michael P.
Published: May 2005

The neuroendocrine response to multiple trauma is a coordinated, complex, changing response which has as its objective maintenance of life by preserving oxygen delivery and the mobilization and utilization of the synthetic and energetic substrates required by the body.

The afferent system is composed of neural input from the various chemoceptors, nociceptors, and baroceptors which monitor normal bodily function, in addition to the effects of plasma factors directly on the brain (e.g., glucose and amino acids). The efferent system is composed of the autonomic nervous system and the output of the anterior and posterior pituitary and other hormones. The efferent response is shown by measurements of ACTH, arginine vasopressin, growth hormone, prolactin, norepinephrineepinephrine, and opiate peptides. This efferent output then modulates the response of the pancreatic islets with the observed changes in glucagon and insulin and of the adrenal glands with additional changes in the catechol‐amines and cortisol. The renin‐angiotensin‐aldosterone system involving the kidney and adrenal gland is another responding system.

The preceding relationships are discussed in some detail. Restoration of normal neuroendocrine function is best achieved by prompt restoration of blood volume, relief of pain and anxiety, restoration of normal food intake, excision of damaged tissue, and prevention of subsequent organ failure (e.g., pulmonary).