bluuebunny/crossref_metadata_2025 huggingface dataset:
Barry Commoner's Day
Authors: Testa Chicco
Published: July 2017

“Barry Commoner's Day” represents for me a great opportunity to settle up my debt of gratitude to Barry Commoner. I thank Barry for the personal friendship he has honored me with for many years, allowing me to take advantage of his experience, his good advice, and his scientific and political teaching. He used to be an incorrigible optimist. And I hope he has not changed with the passing of the years because God knows how much environmentalists need people like him since they have a tendency to complain and foretell misfortunes. But Barry's contribution is not just optimism. His great contribution lies in his ability in matching economic and social rationality, technological progress, and the minimization of environmental impacts. That is to say, the finding that at the basis of the processes involving the destruction of natural resources, there is often an irrational behavior, which is technologically and economically disadvantageous.
Program Development for Disadvantaged High-Ability Students
Authors: Kim Mihyeon , Cross Jennifer , Cross Tracy
Published: July 2017

Examining lessons learned through 4 years of experience of hosting Camp Launch, a university-based residential science, technology, engineering, and mathematics (STEM) enrichment program for low-income, high-ability, middle school students, this article explores components of the program and offers suggestions for implementing programs that serve this population. The camp exposes students to a variety of learning activities, including academic classes in STEM area and writing, personal development class, evening classes beyond STEM areas such as art and drama, diverse physical activities, career conference, and field trips. For such a program to be successful, it is critical to find and develop good human resources, including teachers experienced with the population and counselors who are mature and effective communicators. Curriculum must be appropriate for high-ability students, and all staff members should be prepared to work with this special population. A network of collaborators, from university professors to museums, helps to make the program successful.
The Rise of England's First Daily Newspaper
Authors: Rosenberg Marvin
Published: July 2017

During the 12 years of its publication under Sam Buckley, the London Daily Courant held closely to the statement of its aims published in the first issue of March 11, 1702. Dr. Rosenberg, an assistant professor of journalism at the University of California, has done extensive research on the files of the Courant.
Staff and Doctoral Research in Progress, 1952-53
Authors: Swanson Charles E.
Published: July 2017

This report includes current research projects by staff members and doctoral candidates in American schools and departments of journalism, unless otherwise noted. It omits confidential work or work scheduled for publication before April 1, 1953. “S” indicates staff member, “D” doctoral candidate, “C” completed.
Research in Brief
Authors: Darrow Ralph C.
Published: July 2017

This department is devoted to shorter articles and notes on research in the communications field, either completed or in progress. Readers are invited to submit reports on investigative studies which might prove useful to other students because of content, method, or implications for further research.
Articles on Mass Communications in American Magazines
Authors: Higbie Charles E. ,   Assisted, Baker Dean C. , Duncan Charles T. , Pride Armistead S. , Brown Donald E.
Published: July 2017

Adjustment of press and radio relations with the new administration was the subject of a great number of the articles in American magazines during 1953's first quarter. With the details gradually falling in place, it appeared that the relationships at most levels in Washington were starting out along the same lines of custom that prevailed during recent years. A tentative indication from the White House hinted that the previous administration's order on classification of governmental information, which drew heated criticism last year, would be continued.

In New York several newspapers appealed the judge's ruling in the Jelke case barring newsmen from the courtroom during a large part of the trial. The appeal was lost in the highest New York appeal court. Also attracting great interest was the outcome of the New Orleans Times-Picayune advertising case still before the Supreme Court when the quarter ended. In preparation for trial was a Kansas City Star advertising suit. Both cases involved the right of newspapers to fix “forced combination” advertising regulations which the government contended restricted trade.
The Smith-Mundt Act: A Legislative History
Authors: Paulu Burton
Published: July 2017

The issues encountered when Congress passed the Smith-Mundt Act have their parallels in current Washington debates. Dr. Paulu, manager of Radio Station KUOM in Minneapolis, was an overseas OWI employee during the war. He will go to London this fall as a Fulbright scholar to study the BBC.
Surveys of Reader Attitudes toward Newspaper Combinations
Authors: Stewart Raymond F.
Published: July 2017

Although audiences differ, the views held by readers about local newspaper combinations in four cities show marked similarities. The author, a former research associate and assistant professor of journalism at Emory University, now heads his own research organization in Atlanta.
The Sacramento Union: Voice of California, 1851-75
Authors: Firebaugh Dorothy Gile
Published: July 2017

Journalistic historians usually have overlooked the fact that this newspaper held a dominant position in the state during the first two decades after the gold rush. It achieved national as well as local stature and helped materially to preserve the nation's integrity during the Civil War crisis.
Research in Brief
Authors: Braman Edwin C. , Jones Robert L.
Published: July 2017

This department is devoted to shorter articles and notes on research in the communications field, either completed or in progress. Readers are invited to submit reports on investigative studies which might prove useful to other students because of content, method, or implications for further research.
A Selected Bibliography from Foreign Journals
Authors:   Assisted, Alisky Marvin
Published: July 2017

Among the events that attracted the attention of the European professional journals the most important are:

The difficulties between the editor and the directors of the Gazette de Lausanne, ending with the editor retaining his independence. A similar case arose in Turin with the Gazette del Popolo.

The pros and cons of commercial TV as discussed in Great Britain; the first session of the Press Council also led to many articles in the British journals.

Unusual news also was the announcement of a new London daily to start in October—this time originating from a weekly.

This quarter was characterized further by the richness of international congresses, both of journalists and scientists.
Articles on Mass Communications in American Magazines
Authors: Higbie Charles E. ,   Assisted, Baker Dean C. , Brown Donald E. , Duncan Charles T. , Pride Armistead S. , Valleau John F.
Published: July 2017

Suspension of publication of the major New York City dailies for a period of 11 days in early December because of an engravers strike resulted in controversy in several categories of journalism literature. Besides obvious interest in the results of the strike in the areas of labor relations and economics, debate developed over the action of related unions in making the strike mandatory by honoring the picket lines of the engravers union and the decision of the New York Herald Tribune in refraining from publishing although not a direct party to the strike action.

Relations between the working press and the Eisenhower administration developed enough friction on at least two points to produce noteworthy articles of comment and criticism. Information “leaks” to favored correspondents were charged at a presidential press conference and defended as justified under some circumstances by the President. Even more partisan bickering developed as a result of Attorney-General Herbert Brownell's revelation about the handling of suspected security risks in the Truman administration. After a stormy presidential press conference at which some reporters failed to obtain all requested information on the affair, a New York Times poll of correspondents showed that a majority felt the administration, but not the President, was succumbing to “McCarthyism.” Direct radio transcriptions of some presidential conferences were sanctioned and an “unofficial transcription” for newsmen was instituted during this quarter.
The Press and Public School Superintendents in California
Authors: Carter Roy E.
Published: July 2017

The image of the press held by the school administrator—a major news source in most communities—is pointed up by this study. While conducting the research the author has been an acting associate professor of journalism at Stanford. Next fall he will join the faculty at the University of North Carolina.
A Predictive and Comparative Study of Journalism Personnel
Authors: Jones Robert L.
Published: July 2017

Certain ability tests are useful in selecting students likely to succeed scholastically in journalism, while comparative studies reveal that those who do well in journalism courses have high competence in areas where top-level newspapermen excel. Dr. Jones is director of Minnesota's Journalism Research Division.
The Licensed Press in the U. S. Occupation Zone of Germany
Authors: Meier Ernst
Published: July 2017

The development of an entirely new press in Germany between 1945 and 1949 was a great victory for the licensing system, but in reorienting the people toward democracy it was less successful. Dr. Meier is director of the Journalism Institute, College of Social Sciences, Nuernberg, and recently visited this country.
Research in Brief
Authors: Ingelhart Louis E. , Zook Ellrose D.
Published: July 2017

This department is devoted to shorter articles and notes on research in the communications field, either completed or in progress. Readers are invited to submit reports on investigative studies which might prove useful to other students because of content, method, or implications for further research.
A Selected Bibliography from Foreign Journals
Authors:   Assisted, Haiderer F. , Fenkart E. , Alisky Marvin
Published: July 2017

The International Press Institute organized a meeting of French and German editors in Strasbourg. The following communique was approved unanimously: The press in both Germany and France is called on to achieve a great task in eliminating misunderstandings and prejudices and furthering mutual understanding between the two peoples. In pursuit of these aims the press must bring to its work objectivity, dignity and an awareness of the responsibilities involved. Journalists taking part in the meeting at Strasbourg pledge themselves in a “gentleman's agreement” to observe these principles in their newspapers.
Research in Brief
Authors: Sennett T. B.
Published: July 2017

This department is devoted to shorter articles and notes on research in the communications field, either completed or in progress. Readers are invited to submit reports on investigative studies which might prove useful to other students because of content, method, or implications for further research.
Articles on Mass Communications in American Magazines: A Selected Annotated Bibliography
Authors: Higbie Charles E. ,   Assisted, Baker Dean C. , Brown Donald E. , Duncan Charles T. , Pride Armistead S.
Published: July 2017

Journalism ethics were debated sharply in relationship to several widely varying incidents which erupted at various points in the nation during April, May and June. General Motors Corporation withdrew advertising from the Wall Street Journal in apparent retribution for an article which revealed coming automobile styling on GM automobiles. This method of retaliation for an alleged breach of confidence was attacked by many editors. This incident followed alleged pressure by big automobile companies to induce newspapers to turn-down classified advertisements for new cars from all but company-authorized dealers.

In New England, a score of news men were revealed to have accepted extra pay from race track corporations and from state governmental units. While at least two wire service employees were separated from their news jobs as a result, some newspapers defended the right of their employees to such outside remuneration.

A New York appeals court reversed a lower court decision in the Jelke case because newspapermen were kept from the courtroom during a portion of the trial. A sensational libel suit brought by writer Quentin Reynolds against columnist Westbrook Pegler was notable because most newspapers ignored or played-down this seeming newspaper “natural.”

In simple communication activity, the second quarter will be remembered for the McCarthy-Army hearings in Washington. Issues arising from this hearing may arise for years but the immediate effect in periodical articles was not especially noteworthy.
A New Dimension in Journalism
Authors: Wiebe Gerhart D.
Published: July 2017

How far can journalists go in increasing audience perception of important events by presenting them in an intimate frame of reference? Dr. Wiebe, research psychologist for CBS-Radio, points to viewer reaction to the Army-McCarthy hearing telecasts as evidence that new concepts of news presentation may be needed.
College Backgrounds of Staffs of American Daily Newspapers
Authors: Rafferty Keen , Jermain Leonard L.
Published: July 2017

More than half of American daily newspapermen are college graduates, and a fourth hold degrees from schools and departments of journalism, this survey based on a representative sample of papers indicates. Professors Rafferty and Jermain are members of the journalism faculty at the University of New Mexico.
Chronic Myelogenous Leukemia Presenting as a Secondary Malignancy After BCR-ABL1-negative B-lymphoblastic Leukemia/Lymphoma in a Pediatric Patient
Authors: Popa Gheorghe , Blag Cristina , Olteanu Horatiu
Published: July 2017

Chronic myelogenous leukemia, BCR-ABL1 positive (CML) is a rare myeloproliferative neoplasm in children and presents even less often as a secondary malignancy in the pediatric population. Below, we report a patient with Philadelphia-negative B-lymphoblastic leukemia/lymphoma, who developed CML several years after achieving complete remission, and summarize the existing literature on the clinical and pathologic features of CML as a secondary pediatric malignancy.
Placenta Increta Presenting as Exaggerated Placental Site Reaction
Authors: Cramer Stewart F , Heller Debra S
Published: July 2017

Exaggerated placental site (EPS) is usually an incidental finding seen in curettings after an abortion. Placenta increta is, by definition, a disease that damages and destroys myometrium; however, prior literature has not paid sufficient attention to the role of myometrium in its pathogenesis and diagnosis. We present an unusual case of placenta increta in a hysterectomy performed for uterine perforation after curettage for the termination of pregnancy at 18 weeks. The initial histologic section of the implantation site suggested EPS. Actin stains showed degenerated inflamed muscle at the EPS-like site, keratin stains showed interstitial trophoblast in the zone of myometrial damage, and the wall of the corpus was grossly thinned under the placenta. The myometrial damage may have softened the wall, predisposing to uterine perforation by the curettage procedure.
Hematogones Detected by Flow Cytometry in a Child with Vitamin B12 Deficiency
Authors: Sutton Lisa , Mba Nkechi
Published: July 2017

Vitamin B12 deficiency is a known cause of megaloblastic anemia and bone marrow failure. Bone marrow biopsies are not frequently performed as part of the diagnostic workup and can demonstrate morphologic features that overlap with myelodysplastic syndrome (MDS) and acute leukemia. We describe a case of a dysplastic bone marrow with increased bone marrow hematogones detected by flow cytometry in a child with vitamin B12 deficiency. Hematogones are normal B cell precursors, and hyperplasia has been described in a variety of often reactive conditions and also disease. Hematogones are not typically seen in MDS. The presence of hematogones may help differentiate the dysplastic changes seen in vitamin B12 deficiency from MDS.
The Stillbirth Classification System for the Safe Passage Study
Authors: Boyd Theonia K , Wright Colleen A , Odendaal Hein J , Elliott Amy J , Sens Mary Ann , Folkerth Rebecca D , Roberts Drucilla J , Kinney Hannah C ,   for the PASS Network
Published: July 2017

Objective

Describe the classification system for assigning the cause of stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD-funded Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network. The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads.

Methods

The PASS Network classification system is based upon 5 “sites of origin” for cause of stillbirth, further subdivided into mechanism subcategories; both are employed to assign an ultimate cause of death. Each PASS stillbirth was assigned a cause of death and status of sporadic versus recurrent. Adjudication involved review of maternal and obstetrical records; fetal autopsy and placental findings; and required complete consensus in each case. Two published classification systems, ie, INCODE and ReCoDe, were used for comparison.

Results

Causes of stillbirth classified were fetal (26%), placental (53%), external (5%), and undetermined (16%). Nine cases (47%) had placental causes of death due to maternal disorders that carry recurrence risks. There was full agreement for cause of death across the 3 classification systems in 26% of cases and partial agreement among them in 42% of cases.

Conclusions

The proposed PASS schema employs a user-friendly classification that provides comparable information to previously published systems. Advantages include its simplicity, mechanistic formulations, tight clinicopathologic integration, provision for an undetermined category, and its wide applicability to perinatal mortality review boards with access to information routinely collected during clinicopathologic evaluations.
Abnormal Muscularization of Intra-acinar Pulmonary Arteries in Two Cases Presenting as Sudden Infant Death
Authors: Zainun Khairul , Hope Kirsten , Nicholson Andrew G , Cohen Marta C
Published: July 2017

Abnormal muscularization of acinar arteries is the hallmark of persistent pulmonary hypertension of newborn (PPHN), an uncommon disease with high rate of morbidity and mortality. PPHN presents with signs of respiratory distress immediately following birth. We herein report 2 cases presenting as a witnessed sudden unexpected death in the late neonatal period, preceded by respiratory deterioration and in whom the presence of abnormal muscularization of the acinar pulmonary arteries was reminiscent of PPHN. The significance of this report is twofold: to increase the awareness among pediatricians and pathologists of this feature that can present in some cases of Sudden Unexpected Death in Infancy/Sudden Infant Death Syndrome, and to highlight the importance of performing a thorough autopsy in order to identify the abnormality.
An assessment of the introduction of healthcare assistants into primary healthcare
Authors: Asher Gillian
Published: July 2017

Although healthcare assistants have been deployed in secondary healthcare for a number of years, their use in primary healthcare is quite recent. A nurse practitioner reviews the practical difficulties encountered and suggests strategies for ensuring patient safety is maintained.
Negligent failure to prescribe prophylaxis against steroid-induced osteoporosis
Authors: Davies Andrew , Horne Michael
Published: July 2017

General damages: £18,000; September 2005;

Total Award: £38,000

Development of generalised osteoporosis and three wedge fractures of the spine (T8, 9 and 11) following negligent failure to prescribe prophylaxis against steroid-induced osteoporosis.
The need for cost-effectiveness studies in telemedicine
Authors: Hailey David
Published: July 2017

summary

Telemedicine has the potential substantially to improve the delivery of health care. However, cost-effectiveness studies are needed to help define the appropriate scope and application of telemedicine in different settings. Reports on the evaluation of telemedicine are dominated by technical and feasibility studies. Such studies may be very helpful for initial decision making. However, any cost information at this level tends to be very preliminary and often concerned with making a case to proceed further. Decision makers will wish for further information as the telemedicine application is introduced, to consider its effectiveness – its performance under routine conditions. Without information on the costs and effectiveness of telemedicine services, decision makers run the risk of supporting telemedicine systems that are not responsive to health-care needs or which do not provide cost-effective services. The most immediate needs seem to be improvements in the conduct and reporting of studies, and additional information on the performance of telemedicine in routine practice. Investigators need to provide transparent accounts of their studies, describing in detail the approaches taken, sources of data and assumptions made, and indicating the reliability of their results. Decisions may have to be made on the basis of limited studies, but sufficient detail must be made available to decision makers.
Delivery of rural and remote health care via a broadband Internet Protocol network – views of potential users
Authors: Jennett P , Yeo M , Scott R , Hebert M , Teo W
Published: July 2017

summary

We asked the views of potential users of a proposed Canadian broadband Internet Protocol (IP) network for health, the Alberta SuperNet. The three user groups were drawn from the public, provider and private sectors. In all, 35 health-sector participants were selected (17 government, nine health-care organizations, five providers/ practitioners and four private sector). The questionnaire was Web-based, semistructured and self-administered. It consisted of four major areas: value, readiness, effect on usual care and limitations. A total of 28 (80%) individuals responded to the questionnaire: 21 (81%) were from the public sector (three provincial, nine regional and nine organizational), three (60%) were from the provider sector and four (100%) were from the private sector. Overall, the items related to health services and health human resources were considered to be the most valuable to rural communities. Respondents identified the expansion of telehealth services as the most important, except those from the private sector, who ranked this a close second. The health system's move to the use of electronic health records was ranked second in importance by all respondents. The private-sector respondents viewed all user groups to be generally less ready (mean score 2.5 on a seven-point scale from 1 = not ready to 7 = ready), while the public-sector respondents were the most optimistic (mean score 4.0). Specific socioeconomic impact data were limited. The top-ranked disadvantage of the 10 suggested was that ‘Changes in health-service delivery practices and/or processes will be required’.
Contending Indian Art Worlds
Authors: Bundgaard Helle
Published: July 2017

This article argues that the notion of a singular art world will have to give way to that of ‘art worlds’, the point being, as Myers has suggested, ‘to imagine conditions of cultural heterogeneity, rather than those of consensus, as the common situation of cultural interpretation’ (1994: 13). The argument is based on a detailed analysis of the contending practice and discourse of two - of the several - groups involved with a traditional craft in coastal Orissa. More specifically the article explores the relation between the pragmatic concerns of patta chitra painters regarding their work on the one hand and the Indian art elite's priorities on the other. A central issue is the way the painters, as agents, seek to influence the reality in which they live. The specific case of a painter, who contextually has reframed Sanskrit extracts in order to secure his position as an acknowledged artist, illustrates the creative aspect of agency.
Surgical Treatment of Hepatic and Pulmonary Metastases from Non-Colorectal and Non-Neuroendocrine Carcinoma
Authors: Büchler P. , Pfannschmidt J. , Rudek B. , Dienemann H. , Lehnert T.
Published: July 2017

Background:

Surgical resection is standard treatment for colorectal and neuroendocrine liver metases provided the tumor can be removed completely. The same is true for isolated pulmonary metastases. To date, only few reports have addressed the value of surgical resection of organ metastases from other solid tumors.

Methods:

The literature was searched by Medline, conference proceedings and cross-referencing of published articles for information pertaining to the long-term results of surgical treatment of non-colorectal and non-neuroendocrine (NCNN) liver or lung metastases.

Results:

Resection of hepatic and pulmonary metastases is increasingly performed in non-colorectal and non-neuroendocrine malignancies. Mortality and morbidity of hepatic and pulmonary resection are low and 5 year survival can be expected to reach some 20–30 percent, irrespective of the histological type of the primary tumor.

Conclusion:

Resection of hepatic or pulmonary metastasis should be considered in all patients with low operative risk provided that complete resection is possible.
T-Lymphocyte Subsets in Patients with AJCC Stage III Gastric Cancer during Postoperative Adjuvant Chemotherapy
Authors: Cho M. Y. , Joh Y. G. , Kim N. R. , Jung S. I. , Bae J. W. , Kim Y. C. , Koo B.H. , Whang C. W. , Suh S. O.
Published: July 2017

Background and Aims:

Advanced neoplastic diseases alter the immune response in cancer patients. The aim of this study was to evaluate the changes of T-lymphocyte subsets during postoperative adjuvant chemotherapy, and the relationship between T-lymphocyte subsets and tumor recurrence in AJCC stage III gastric cancers.

Material and Methods:

Analysis of T-lymphocyte subsets was performed in 39 patients with stage III gastric adenocarcinoma who had undergone a curative gastric resection and postoperative chemotherapy. Circulating T-lymphocyte subsets were measured on venous blood by using flow cytometry and monoclonal antibodies on preoperative day 1, and postoperative months 1, 3, and 6.

Results:

The 5-year disease-free survival rates of patients with stage 3a and 3b gastric cancer were 57.1 % and 33.3 %, respectively (p = 0.06). Values of CD3+ and CD4+ T-cells, and CD4+/CD8+ ratios were consistently lower in the recurrence group throughout the observation period. CD4+ T-cell counts were significantly lower in the recurrence group on preoperative day 1, and postoperative months 1 and 6. However, most values of the T-lymphocyte subsets showed no statistically significant difference when comparing the stage 3a and 3b disease patient groups.

Conclusions:

The results of this study suggest that immunosuppression associated with CD3+ and CD4+ T-cell depression is a risk factor for postoperative recurrence in patients with stage III gastric cancer.
Bipolar Hemiartroplasty in the Treatment of Hip Fracture: Are Special Centres Necessary for the Optimal Outcome?
Authors: Sarvilinna R. , Pajamäki J. , Sovelius R. , Puolakka T. , Huhtala H. , Järvinen M.
Published: July 2017

Background and Aims:

This study compares retrospectively clinical follow-up of 72 bipolar arthroplasties made either by specialist surgeons or residents.

Material and Methods:

72 patients with a life-expectancy of more than three years were selected to have bipolar arthroplasty for the treatment of femoral collum fracture at Tampere University Hospital district during 1993–1995. The average age of the patients was 70 (47–92) years. All patients were followed at least 4 years for mortality as well as primary and late complications. A group of 49 (68 %) patients could be followed more carefully by clinical examination, by questionaire or by phone.

Results:

20 (28 %) patients died during the first three years after surgery and four (6 %) patients were re-operated. The bare preoperative clinical estimation made by the senior consultant surgeon did not predict good enough the life expectancy of the patients. Four patients had been revised, all operated by a senior surgeon. There were no revisions among the patients operated by junior doctors. No statistical differences were found between the patients operated by junior or senior surgeons or between cemented and cementless prostheses in pain, walking distances, limping, getting in to a car, need of support or sitting in high or normal chair.

Conclusions:

The bipolar arthroplasty was found to give reproducible results also when residents take the responsibility of hip fracture treatment.
Composite Implant of Native Bovine Bone Morphogenetic Protein (BMP) and Biocoral in the Treatment of Scaphoid Nonunions — A Preliminary Study
Authors: Kujala S. , Raatikainen T. , Ryhänen J. , Kaarela O. , Jalovaara P.
Published: July 2017

Background and Aims:

Bone morphogenetic protein (BMP) has been shown to induce bone formation and union in long bone defects and nonunions. We report a preliminary study of a composite implant consisting of a biocoral frame, carrier collagen and bovine BMP in the treatment of scaphoid nonunions.

Material and Methods:

Two proximal and eight waist area scaphoid nonunions were treated using BMP/coral implant combined with either the Matti-Russe procedure (2 cases) or an interpositional bone graft fixed with screws or compression fixation pins (8 cases). In two cases only a one piece BMP/coral implant was used as an interpositional graft and in other cases interpositional autograft was used with granular BMP/coral implant placed between the fragments and the graft.

Results and Conclusions:

Only two wrists resulted in complete union. These preliminary results suggest that composite implant of BMP, as used in the present study, may not solve the problems encountered in the treatment of scaphoid nonunions. Poor vascular conditions in scaphoid may not provide enough mandatory osteogenic cells for BMP to function properly. In avascular conditions coral does not resorb edequately and implants may also work as a sequester between the bone graft and the scaphoid bone and therefore actually inhibit the healing process.
Failures and Successes in Total HIP Replacement-Why Good Ideas May Not Work
Authors: Morscher E. W.
Published: July 2017

The course of development of total hip replacement (THR) is neither harmonious nor linear. Progress and set-backs alternate. Progress in THR manifests itself through reductions in the number and the severity of complications (infection, aseptic loosening, prematurely worn components, etc.).

Innovation is the motor of progress. However, today's innovation may well be tomorrow's revision!

Progress has been achieved in part through new implant materials and designs that provide improvements in such things as stress distribution in surrounding bone, tissue compatibility and osseointegration, and resistance to both wear and cyclic fatigue. Of at least equal importance, however, are improvements achieved in operative procedures (e.g., cementing technique) and finally, in clinical quality control: more complete documentation of implant and patient variables, establishment of implant registers, and utilization of outcome studies to guide the course of further development.

Causes of failure in THR are numerous. However, unexpected side effects of innovations are the most frequent cause. An innovation may solve one problem, but also creates new ones. Problems in innovation which can lead to failures include: over-generalization of expected patient responses, ignoring past experience or assigning wrong causes to encountered problems, and finally, ignoring the dynamic nature of the living system (which can be described as using “necro-” instead of biomechanical thinking).

Quality control in both manufacturing and clinical practice has to be improved. The pioneer times have come to an end. Today's patients should have the right to be operated on by a well trained surgeon and to be provided with well tested, well-understood implant materials and devices.

Progress in endoprosthetics has led to the present high level of clinical success. Paradoxically, however, success is the greatest obstacle to further progress. This is because the curve of progress as a result of effort expended has turned asymptotic in endoprosthetics, as it does in many endeavors. In such situations the more a product (e.g., surgical implant and procedure, automobile design, computer program) becomes successful, the more efforts (and finances) are needed for further progress. On the other hand, the “scissors” — Created by crossing what might be feasible with what resources are available — Open widely and can cut sharply. In fact, financial restrictions may force orthopaedic surgeons and the medical device and technology industry to turn to lower technologies in the future. However, whatever new developments in endoprosthetics may bring (be they sophistications or simplifications), we must remain open-minded and not assume things to be facts until there is evidence to support them.
Tissue Engineering — Body Parts from the Petri Dish
Authors: Kratz G. , Huss F.
Published: July 2017

The development of methods to regenerate human tissues and organs by tissue engineering (TE), will have a dramatic influence on many medical specialities in the future. The essence of plastic surgery is to reconstruct disrupted and damaged tissues by the use of a plethora of techniques spanning from small local skin flaps to highly advanced microsurgery and free composite grafts. However, these methods only focus on moving tissue from one part of the patient to another without actual regeneration. To be able to take the next step in development of the speciality it is of necessity to address this issue. Hence it follows naturally that plastic surgeons lead and represent the driving force of the development within the research of tissue engineering. In this paper we would like to present active research and also give an overview of areas in tissue engineering that are of special interest to the plastic surgeon.
Soft Tissue Sarcoma of the Trunk and Extremities
Authors: Tukiainen E. , Böhling T. , Huuhtanen R.
Published: July 2017

The diagnostic methods and treatment modalities of soft tissue sarcomas have evolved with the multidisciplinary approach. The soft tissue sarcoma team must have specialists capable of using and combining modern methods of radiology and pathology, cytogenetics, tumour surgery, tissue transfer techniques, radiotherapy and chemotherapy for optimal local and systemic treatment. Limb sparing surgery combined with radiotherapy has lowered the amputation rate and maintained low rates of local recurrence. Reconstructive surgery facilitates treatment of patients with soft tissue sarcoma by permitting tumour resection with adequate margins, protects vital structures, enables early postoperative radiation therapy, maintains extremity length, and if necessary assists in palliative procedures. The ability to maintain function and aesthetics after tumour resection, and effective palliation improves the quality of life for these patients. Early recognition and appropriate referral to a tumour centre improve the outcome.
The Potential Use of Recombinant Activated Factor VII in Trauma and Surgery
Authors: Sapsford W.
Published: July 2017

It is possible that recombinant activated factor VII (rFVIIa) could revolutionise the medical and surgical management of haemorrhage following trauma and surgery due to its ease of administration and mechanism of action. This article reviews the evidence for the use of rFVIIa as a pro-coagulant, its mechanism of action, safety and recent research into its use in blunt and penetrating trauma and haemorrhage. The potential role of rFVIIa, both in the pre-hospital environment and in the emergency room or operating theatre, is discussed. Administration of rFVIIa at the roadside, on the battlefield or in trauma centre may have significant potential implications, especially for the paramedical and surgical teams and even for strategic planners. Finally, the areas where further research is needed to provide objective evidence of its efficacy are elaborated. The potential thromboembolic complications of systemic administration of rFVIIa need to be carefully monitored but the high cost of this drug is likely to be the limiting factor in its widespread use.
Endovascular vs Open AAA Repair: Similar Effects on Renal Proximal Tubular Function
Authors: Aho P.-S. , Niemi T. , Lindgren L. , Lepäntalo M.
Published: July 2017

Aim:

To compare the effect of open and endovascular repair on renal function.

Materials and methods:

In a prospective, non-randomized study twenty-four abdominal aortic aneurysms (AAA) treatable with either method were repaired, 15 using endovascular device (ENDO group) and nine with open surgery with infrarenal aortic cross-clamping (OPEN group). All the patients had standardised general anaesthesia, intravascular fluid therapy and monitoring. Renal function tests and cardiovascular measurements were performed at predetermined intervals.

Results:

N-acetyl-β-D-glucosaminidase indexed to urinary creatinine (U-NAG/crea), sensitive marker of renal proximal tubular damage, increased similarly in both groups at the end of surgery (two-way ANOVA, p < 0.05). No patient developed clinical renal impairment, on the contrary, creatinine clearance was increased, serum cystatin C (a sensitive marker of renal glomerular filtration) and serum creatinine concentration decreased at 24 hours postoperatively (Wilcoxon paired test, p < 0.05). Intraoperative blood loss and the amount of administered crystalloids were higher in the OPEN than in the ENDO group (Mann-Whitney U-test, p < 0.05). The cardiovascular measurements were comparable between the groups. The mean (SD) amount of radio-contrast media given was 3.1 (1.1) ml/kg in the ENDO group.

Conclusions:

Our results indicate that endovascular AAA repair does not protect renal proximal tubular function. A temporary renal tubular dysfunction was found both in open and in endovascular AAA repair which did not lead to permanent changes in renal function.
The Effect of Fibrin Sealant Combined with Fibrinolysis Inhibitor on Reducing the Amount of Lymphatic Leakage after Axillary Evacuation in Breast Cancer
Authors: Mustonen P. K. , Härmä M. A. , Eskelinen M. J.
Published: July 2017

Background and Aims:

One third of women undergoing mastectomy with axillary evacuation for primary breast cancer suffer from postoperative seromas leading to unnecessary costs and complications such as infections and new operations. Different methods to prevent seroma formation have been tried without permanent success. The aim of this prospective randomised study was to examine the effect of fibrin sealant with fibrinolysis inhibitor firstly on the reduction of the amount of lymphatic leakage after axillary evacuation and secondly on the reduction of days with drains and postoperative seroma punctures.

Methods:

40 patients with primary breast cancer were prospectively randomised to the treatment group (n = 19) getting fibrin clue combined with fibrinolysis inhibitor (aprotinin) sprayed into the axillary fossa and to the control group (n = 21).

Results:

There were no differences in the incidence of postoperative seromas between the groups. However, the seromas were easier to treat if fibrin clue was used. Total quantity (mean ± SD) of lymphorrhea and total number of aspirations (mean ± SD) were almost twice as high in the patients of the control group compared to those having fibrin sealant. In the treatment group seromas resolved after one or occasionally after two aspirations in 71 % of patients, while in the control group 90 % of patients needed three or more aspirations.

Conclusion:

Potentially, fibrin sealant combined with fibrinolysis inhibitor might be used for the treatment of post-axillary evacuation lymphorrhea and seroma.
Hip Fractures in Finland — A Comparison of Patient Characteristics and Outcomes in Six Hospitals
Authors: Heikkinen T. , Willig R. , Hänninen A. , Koskinen K. , Mannismäki P. , Alavaikko A. , von und zu Fraunberg M. , Jalovaara P.
Published: July 2017

Background and Aims:

To compare six Finnish hospitals for the quality of treatment of hip fractures and to obtain information for the development of care.

Material and Methods:

Data of 1179 consecutive hip fracture patients (about 200 patients per hospital) was collected prospectively, using similar standardized forms and focusing on background factors and the four-month functional outcome.

Results:

There were significant differences between the hospitals in patient characteristics (age, place of residence, walking ability, use of walking aids, morbidity and type of fracture) and in the unadjusted outcome variables at four months' follow-up (place of residence, mobility, use of walking aids and pain in injured hip). After adjustment for baseline characteristics, there was a significant difference in the post-fracture walking ability between the centres but no significant differences in post-fracture place of residence. Unadjusted mortality did not vary between the centres, but adjustment resulted in significant differences. The most marked difference in surgical methods between the hospitals was seen in the use of either sliding hip screw or Gamma Nail for trochanteric fractures, but this difference was not reflected in the results of multivariate analysis.

Conclusions:

We found minor differences in mobility and mortality between the participating hospitals, and these might serve them as a stimulus for improving their standard of good practice. Continuous quality improvement by repeating the audit cycle is recommended in order to reach and then improve the prevalent standards in the care of hip fracture patients. Confounding factors should be adjusted when comparing the medical centres treating hip fractures, and the evaluation of the results should be multidimensional.
Inflammatory Response on the Pancreatic Acinar Cell Injury
Authors: Bhatia M.
Published: July 2017

Acute pancreatitis is an inflammatory disorder, and inflammation not only affects the pathogenesis but also the course of the disease. Acinar cell injury early in acute pancreatitis leads to a local inflammatory reaction; if marked this leads to a systemic inflammatory response syndrome (SIRS). An excessive SIRS leads to distant organ damage and multiple organ dysfunction syndrome (MODS). MODS associated with acute pancreatitis is the primary cause of morbidity and mortality in this condition. Recent studies by us and other investigators have established the critical role played by inflammatory mediators such as TNF-α, IL-1β, IL-6, IL-8, CINC/GRO-α, MCP-1, PAF, IL-10, CD40L, C5a, ICAM-1, MIP1-α, RANTES, substance P, and hydrogen sulfide in acute pancreatitis and the resultant MODS. This review intends to present an overview of the inflammatory response that takes place following pancreatic acinar cell injury.
Fibrogenesis in the Pancreas after Acinar Cell Injury
Authors: Patel M. , Fine D. R.
Published: July 2017

Fibrosis within the pancreas is a key feature of chronic pancreatitis and pancreatic cancer. It has now been well demonstrated that following injury to acinar cells, pancreatic stellate cell activation, migration and proliferation is the key mediator of this process. Many cytokines and growth factors have been studied, particularly TGF-β, which appears to be the major stimulus to fibrinogenesis. There is current interest in the mechanisms of phenotypic change between the active and quiescent forms, apoptosis and the signalling pathways that may be involved. The pancreatic stellate cell is likely to play an important role in maintaining the normal extracellular matrix; we speculate that the dysregulation of this process is an important factor in chronic pancreatitis.
Clinical Value of Severity Markers in Acute Pancreatitis
Authors: Lempinen M. , Puolakkainen P. , Kemppainen E.
Published: July 2017

Acute pancreatitis is a common digestive disease of which the severity may vary from mild, edematous to severe, necrotizing disease. An improved outcome in the severe form of the disease is based on early identification of disease severity and subsequent focused management of these high-risk patients. However, the ability of clinicians to predict, upon presentation, which patient will have mild or severe acute pancreatitis is not accurate. Prospective systems using clinical criteria have been used to determine severity in patients with acute pancreatitis, such as the Ranson's prognostic signs, Glasgow score, and the acute physiology and chronic health evaluation II score (APACHE II). Their application in clinical practise has been limited by the time delay of at least 48 h to judge all parameters in the former two and by being cumbersome and time-consuming in the latter. Contrast-enhanced computed tomography is presently the most accurate non-invasive single method to evaluate the severity of acute pancreatitis. It cannot, however, be performed to all patients with acute pancreatitis. Therefore, considerable interest has grown in the development of reliable biochemical markers that reflect the severity of acute pancreatitis. In this article we critically appraise current and new severity markers of acute pancreatitis in their ability to distinguish between mild and severe disease and their clinical utility.
Treatment of Pancreatic Pseudocysts
Authors: Andrén-Sandberg Å. , Ansorge C. , Eiriksson K. , Glomsaker T. , Maleckas A.
Published: July 2017

According to the Atlanta classification an acute pseudocyst is a collection of pancreatic juice enclosed by a wall of fibrous or granulation tissue, which arises as a consequence of acute pancreatitis or pancreatic trauma, whereas a chronic pseudocyst is a collection of pancreatic juice enclosed by a wall of fibrous or granulation tissue, which arises as a consequence of chronic pancreatitis and lack an antecedent episode of acute pancreatitis.

It is generally agreed that acute and chronic pseudocysts have a different natural history, though many reports do not differentiate between pseudocysts that complicate acute pancreatitis and those that complicate chronic disease. Observation — “conservative treatment” — of a patient with a pseudocyst is preponderantly based on the knowledge that spontaneous resolution can occur. It must, however, be admitted that there is substantial risk of complications or even death; first of all due to bleeding.

There are no randomized studies for the management protocols for pancreatic pseudocysts. Therefore, today we have to rely on best clinical practice, but still certain advice may be given. First of all it is important to differentiate acute from chronic pseudocysts for management, but at the same time not miss cystic neoplasias. Conservative treatment should always be considered the first option (pseudocysts should not be treated just because they are there). However, if intervention is needed, a procedure that is well known should always be considered first. The results of percutaneous or endoscopic drainage are probably more dependent on the experience of the interventionist than the choice of procedure and if surgery is needed, an intern anastomosis can hold sutures not until several weeks (if possible 6 weeks).