bluuebunny/crossref_metadata_2025 huggingface dataset:
One hundred and fifty hepatic resections: Evolution of technique towards bloodless surgery
Authors: Rees M , Plant G , Wells J , Bygrave S
Published: February 2007

A technique of hepatic resection is described and the results of 150 resections are reviewed. Hepatic transection was performed, under intermittent portal inflow occlusion, using ultrasonic aspiration to skeletonize portal branches and venous tributaries. Control of venous haemorrhage during resection was optimized by argon beam coagulation and lowering central venous pressure to between 0 and 4 cm H2O by extradural blockade and systemic nitroglycerine infusion. One patient with jaundice died in hospital, giving a mortality rate of 0·7 per cent. There were no deaths in patients without jaundice and cirrhosis. Fifteen patients (10.0 per cent) had significant complications, nine medical and six surgical, including three bile leaks (2.0 per cent). Mean blood loss was 814 ml for the whole study but only 434 ml in the last 4 years. During this latter period mean blood transfusion in hospital was 0·5 units and mean postoperative haemoglobin value fell by 0·7 g per 100 ml. Hepatic resection can be performed with the same degree of confidence and similar low morbidity as any other major surgical procedure.
Successful use of size-mismatched liver allografts in children by delayed primary closure of the abdominal wall
Authors: Soin A S , Friend P J , Noble-Jamieson G , Watson C J E , Jamieson N V , Calne R Y , Barnes N
Published: February 2007

Children who are too ill to await a liver graft of suitable size may be transplanted with a relatively oversized graft by leaving the abdominal wound partially open, the defect being bridged with polypropylene mesh and the mesh reduced in stages until it can be removed and the wound directly closed. This technique has been used in seven children who received nine grafts (five reduced and four full size). Their mean age was 7·3 (range 0·5–11) months and mean weight 5·8 (range 2·3–7·2) kg. Progressive reduction in the size of the transplanted liver made primary closure possible in survivors in up to four stages. Over a follow-up period of 3 to 58 months, five of the nine grafts and five of the seven patients survived. No significant complications attributable to the technique were encountered. The technique of delayed primary abdominal wall closure may be of benefit in children at risk of graft failure because of a size-mismatched graft.
Prospective randomized trial comparing sequential avulsion with stripping of the long saphenous vein
Authors: Khan B , Khan S , Greaney M G , Blair S D
Published: February 2007

Eighty patients with primary varicose veins of the long saphenous system were randomized to have the long saphenous vein removed either by stripping to below the knee or by sequential avulsion. There was no difference between the two methods in the time taken to remove the vein. There was significantly more pain after stripping during the week following operation (P < 0.001). Median pain score after stripping was 5, reducing to 3 at 1 week, compared with 2, reducing to 1, for sequential avulsion. Median area of bruising measured at 1 week was 160 (range 0–1800) cm2 for stripping and 56 (range 0–544) cm2 for sequential avulsion (P < 0.01). Sequential avulsion is less painful, reduces bruising and avoids a significant scar below the knee.
Biomechanical stabilization of the nipple valve in continent ileostomy
Authors: Ecker K W , Hildebrandt U , Haberer M , Feifel G
Published: February 2007

Despite stapler stabilization, sliding complications of nipple valve function occur in 19 per cent of continent ileostomies. Because the tendency of the ileum to desuscept is triggered by traction forces on the mesentery of the nipple during filling of the reservoir, a technique was developed to neutralize this biomechanical strain. In addition, to obtain fibrous healing between the muscular layers, the mucosa of contacting intestinal walls was removed by selective ultrasonic fragmentation. The valves of 18 consecutive patients were operated on with this technique. In six of these, a sliding valve was restabilized in a median time of 1·2 (range 0·4–2·9) years after conventional construction of the pouch. All are functioning well after a median of 4·6 (range 3·0–6·0) years. Between 1·8 and 4·8 years after operation a healed area between the musculature of the nipple and pouch of 4·5–7·2 cm2 was shown by endosonography. This procedure may provide long-term prevention of sliding complications in continent ileostomies.
Prognostic significance of lymph node dissection in gastric cancer
Authors: De Manzoni G , Verlato G , Guglielmi A , Laterza E , Genna M , Cordiano C
Published: February 2007

The results for 162 patients who underwent curative gastrectomy for gastric cancer from January 1988 to June 1994 were analysed statistically with special reference to the effect of lymph node dissection. Median survival was 69·3 months and the overall cumulative 5-year survival rate was 50·2 (95 per cent confidence interval (c.i.) 41·6–58·1) per cent. By univariate analysis age, histology, depth of tumour invasion, node involvement, number of metastatic lymph nodes and type of lymphadenectomy were found to be significant factors related to survival time. Multivariate analysis with the Cox model and stratified for tumour node metastasis stage revealed that only the number of metastatic nodes (P = 0·04) and the extent of lymphadenectomy (P = 0·003) affected survival independently. With respect to D, lymphadenectomy, the relative risk associated with D2 and D4 lymphadenectomy was respectively 0·61 (95 per cent c.i. 0·34–1·10) and 0·26 (95 per cent c.i. 0·12–0·60). The 5-year survival rate was 28 per cent for patients who had a D1 dissection, 63 per cent for those who had D2 and 68 per cent for those who had D4. These results suggest that extended lymphadenectomy (D2) and especially superextended lymphadenectomy (D4) can improve survival in patients with gastric cancer.
Salvage treatment for inoperable neck nodes in head and neck cancer using combined iridium-192 brachytherapy and surgical reconstruction
Authors: Cornes P G S , Cox H J , Rhys-Evans P R , Breach N M , Henk J M
Published: February 2007

The results of debulking surgery and re-irradiation with radioactive implants (brachytherapy) are reported for 39 patients with inoperable metastatic neck nodes from primary head and neck cancers. For 13 patients conventional salvage by partial debulking surgery and brachytherapy proved effective, with 68 per cent control at 1 year, but six patients suffered severe radiation fibrosis, necrosis and contractures. Some 26 patients were treated by combined tumour debulking, skin resurfacing and brachytherapy implant. Initial tumour control and freedom from serious toxicity was achieved in 24 patients. Local control was achieved in 63 per cent of patients at 1 year, with a serious morbidity rate of 12 per cent.
Papillary microcarcinoma of the thyroid gland
Authors: Bramley M D , Harrison B J
Published: February 2007

Papillary microcarcinomas are a specific subgroup of papillary thyroid cancer. They have the same histological features as papillary thyroid cancer but are 1.0 cm or less in diameter. These tumours are a common incidental finding at autopsy and in thyroid glands excised for other pathology. This tumour can metastasize to regional lymph nodes but its ability to cause significant morbidity and mortality has been questioned. As papillary micro-carcinomas can represent up to 30 per cent of all papillary cancers seen in a thyroid surgeon's practice, they are an important group. The aim of this review article is to outline the natural history of papillary microcarcinoma and to offer therapeutic management strategies.
Oesophageal function testing and antireflux surgery
Authors: McLauchlan G
Published: February 2007

Despite the increasing emphasis that is placed on both pH measurement and oesophageal manometry, there is little consensus about their usefulness in the clinical setting. These tests are far from infallible and it is difficult to support their universal application in patients with gastro-oesophageal reflux disease. Nevertheless, these imperfect tests are useful in certain situations and clinicians must strive to use them intelligently for those most likely to benefit.
Influence of cholecystectomy on bile duct width
Authors: Hammarström L-E , Holmin T , Ebbesen A , Stridbeck H
Published: February 2007

The results of published prospective studies on changes in bile duct width after cholecystectomy are contradictory and comprise relatively few patients, often after short or medium-term follow-up. The objectives of this prospective long-term follow-up study were to investigate whether bile duct width increased significantly after cholecystectomy and to seek evidence of biliary obstruction in patients with excessively dilated ducts.
Pneumonia presenting with acute abdominal pain in children
Authors: Ravichandran D , Burge D M
Published: February 2007

Abdominal pain is a common cause of emergency admission in children. Although often due to appendicitis and other intra-abdominal causes, extra-abdominal conditions, especially pneumonia, can simulate an acute abdominal catastrophe. Accurate and prompt diagnosis is essential, not only to avoid general anaesthesia and a negative laparotomy in the presence of pneumonia but also to start antibiotic therapy early so as to prevent the complications of pneumonia.
Quick and simple distal pancreatectomy using the GIA stapler: Report of 35 cases
Authors: Kajiyama Y , Tsurumaru M , Udagawa H , Tsutsumi K , Kinoshita Y , Akiyama H
Published: February 2007

A method for distal pancreatectomy using the multifire GIA-80 stapler (US Surgical, Nonvalk, Connecticut, USA) is reported that is quicker, associated with reduced blood loss and a lower incidence of pancreatic fistula than with other instruments such as the TA-55 stapler (Auto Suture, Ascot, UK). When performing total gastrectomy with distal pancreatectomy and splenectomy to complete a wide lymph node dissection in patients with advanced gastric cancer, this method of pancreatectomy can be useful.
Biliary papillomatosis
Authors: Lam C-M , Yuen S-T , Yuen W-K , Fan S-T
Published: February 2007

Biliary papillomatosis is a rare clinicopathological condition characterized by multiple papillary adenomas involving extensive areas of the biliary tree1. The pathophysiology, clinical features and management of this condition are not well understood. Experience of six patients with biliary papillomatosis is reported.
Colour-coded duplex imaging can safely replace diagnostic arteriography in patients with lower-limb arterial disease
Authors: Pemberton M , Nydahl S , Hartshorne T , Naylor A R , Bell P R F , London N J M
Published: February 2007

The purpose of this study was to review the outcome of adopting colour-coded duplex ultrasonography as the primary imaging modality in patients with symptomatic lower-limb arterial disease. Over a 12-month period 467 consecutive lower-limb duplex scans were performed of which 437 (94 per cent) were technically adequate. Of the 467 limbs, 184 (39 per cent) were managed conservatively, 230 (49 per cent) were referred for percutaneous transluminal angioplasty (PTA), 41 (9 per cent) underwent reconstructive surgery and 12 (3 per cent) required diagnostic arteriography. In patients referred for PTA there were only 22 (10 per cent) unexpected findings; there was agreement about superficial femoral artery occlusion length in 95 (89 per cent) of 107 limbs and about the presence or absence of a superficial femoral artery stump in 91 (85 per cent) of 107 cases. In patients referred for surgery there were no unexpected findings. Colour-coded duplex imaging can safely replace diagnostic arteriography in up to 97 per cent of lower limbs with arterial disease.
A 45-year perspective of congenital diaphragmatic hernia
Authors: Vanamo K
Published: February 2007

The records of 174 consecutive patients with congenital diaphragmatic hernia were reviewed to analyse the changes in the presentation, treatment and outcome during the 45-year interval from 1948 to 1992. For comparison the period was divided into years 1948–1962, 1963–1972, 1973–1982 and years 1983–1992. The proportion of high-risk cases (symptomatic within 6 h of birth) increased from 50 per cent during the first period to 77 per cent during the second, to 86 per cent during the third and to 94 per cent during the fourth. The primary mortality rate (death within 30 days of diaphragmatic repair) increased from 25 per cent during the first period to 35 per cent during the second, 46 per cent during the third and 49 per cent during the fourth. No change occurred in the proportion of infants with diaphragmatic hernia who were stillborn or who died in the maternity unit. Post-mortem lung weight was available in 56 children. Severe pulmonary hypoplasia correlated with early postoperative death and clinical severity. The mean(s.d.) lung weight ratio (combined lung weight divided by the lung weight expected for the body-weight) decreased from 0.70(0.49) during the second period to 0.56(0.36) during the third and 0.40(0.18) during the fourth. The increased proportion of more severe cases with very hypoplastic lungs explains the rise in the mortality rate of patients operated on for congenital diaphragmatic hernia. This may reflect a real change in the disease spectrum rather than improved referral.
Palliation of oesophageal carcinoma using the argon beam coagulator
Authors: Robertson G S M , Thomas M , Jamieson J , Veitch P S , Dennison A R
Published: February 2007

Oesophageal intubation occasionally fails to palliate inoperable carcinoma: some tumours are unsuitable for this procedure and others overgrow the tube. This study reports a series of nine patients (median age 79 (range 55–87) years) in whom the argon beam monopolar coagulator via a flexible endoscopic probe was used to ablate such tumours. Fourteen ablation procedures were performed. The endoscope was passed to the stomach at the end of each procedure. There were no complications; the median hospital stay was 2 (range 1–13) days. Thirteen procedures rendered the patients completely asymptomatic for a median of 6 (range 4–12) weeks. Six patients died a median of 14 (range 4–38) weeks after the first ablation, reflecting their limited life expectancy. The argon beam coagulator provides an effective alternative to laser ablation, being considerably cheaper and safer, while maintaining the minimally invasive nature of the palliation.
Quality of life following resection of oesophageal carcinoma
Authors: Zieren H U , Jacobi C A , Zieren J , Müller J M
Published: February 2007

Quality of life following resection of oesophageal carcinoma was assessed by patients using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and by a psychologist using the Spitzer Index. Quality of life was evaluated in 119 patients on one occasion 12 months after operation and in 30 patients regularly, starting with a preoperative assessment. Self and external evaluation showed a significant correlation (r = 0.61), but quality of life was assessed as being higher by the external observer. Limited physical performance status and somatic complaints were the most important postoperative dysfunctions, whereas emotional, social and economic disorders were found to be less frequent and less severe. Of several factors analysed only tumour recurrence (P<0.01) and anastomotic stricture (P<0.05) lowered quality of life significantly. Compared with the preoperative assessment, quality of life had decreased on discharge from hospital but was restored within 6 months of operation in disease-free patients. Further studies are required to determine the impact of adjuvant therapy for quality of life in patients undergoing surgery for oesophageal cancer.
Preoperative risk assessment in elective general surgery
Authors: Klotz H P , Candinas D , Platz A , Horvàth A , Dindo D , Schlumpf R , Largiadèr F
Published: February 2007

Despite improved surgical techniques there is still a risk of mortality in elective general surgery. In a prospective study preoperative data from 3250 patients were collected and compared with postoperative systemic complications, using univariate χ2 analysis. Highly significant (P< 0.00001) variables were subjected to stepwise logistic regression analysis. The severity of operative procedure, higher American Society of Anesthesiologists (ASA) grade, symptoms of respiratory disease and malignancy were found to be significant risk factors predicting postoperative morbidity (P<0.05). Using these four variables, a simple preoperative risk scoring system has been defined. Class A (up to 5 points) was defined as a low-risk group (systemic complication rate 5.0 per cent), class B (5–7 points) was intermediate risk (systemic complication rate 17.9 per cent) and class C (8–10 points) was high risk (systemic complication rate 33.3 per cent). Patients at high risk for perioperative and postoperative complications are more likely to be identified by this analysis than by using the ASA classification alone.
Chemical composition and potential hazards of electrocautery smoke
Authors: Sagar P M , Meagher A , Sobczak S , Wolff B G
Published: February 2007

Electrocautery is widely used for dissection of tissues and cauterization of blood vessels. A visible plume of smoke is produced, which has an unpleasant odour and can induce acute and chronic inflammatory changes in the respiratory tract'. Airborne particles arc not effectively filtered or evacuated by operating room scavenging systems and facial masks only offer protection from large particles. Little is known about the chemical composition of this smoke and the health risks to the operating room staff have not been identified.

The aim of this study was to determine the chemical composition of electrocautery smoke produced in the course of standard colorectal surgery.
Angiographic Estimation of Relative Coronary Artery Flow Based on Terminal Branching Patterns
Authors: Page Harry L. , Engel H. Jurgen
Published: February 2007

Angiographically “terminal” coronary arterial branches were counted in 100 normal coronary cineangiograms to investigate the possibility that three left ventricular wall regions might be defined by identifying patterns of arterial inflow. An average of 45% of the terminal branches were counted in the anterior region supplied by the anterior descending coronary artery; 25% were counted in the lateral region supplied by diagonal and obtuse marginal arteries, and 30% were counted in the inferior region supplied by the distal circumflex and distal right arteries. Based upon the hypothesis that blood flow through an artery is directly proportional to the number of small branches into which it ramifies, this approach affords an estimate of the relative contribution by individual coronary arteries to total left ventricular perfusion. This concept could prove useful in defining a quantitative grading system of coronary arterial Inflow obstruction.
Exercise Stress Testing in Patients with Chest Pain and Normal Coronary Arteriography: With Review of the Literature
Authors: Goodin Robert R. , Graham Jerry M. , Gwinn James S. , Masden Ronald R. , McMartin Daniel E. , Flowers Nancy C.
Published: February 2007

Eighty of 654 patients studied because of chest pain were found to have normal coronary arteriography. Fifty of these completed submaximal treadmill exercise studies. The purpose of this study was to determine whether treadmill electrocardiography could obviate the need for coronary arteriography in the evalution of patients with undiagnosed chest pain. Of patients studied, 22% had typical angina pectoris, while 78% had atypical chest pain. The resting electrocardiogram was normal in 58% of patients, while 42% showed repolarization abnormalities. Submaximal treadmill testing was normal in 64%, incomplete in 12%, and demonstrated classic ischemic S‐T depression in 24%. Our findings of 24% positive studies in patients with normal vessels and 12% incomplete tests suggest that stress electrocardiography may be of limited value in predicting the morphologic state of the coronary arteries in patients with undiagnosed chest pain.
Evaluation of left ventricular performance in coronary heart disease: Use of isometric handgrip stress test
Authors: Helfant Richard H. , Devilla Maria A. , Banka Vidya S.
Published: February 2007

The usefulness of isometric handgrip exercise in the assessment of left ventricular function was studied in 27 patients, all of whom had angiographically documented coronary artery disease. The effect of extensiveness of coronary disease and presence or absence of collaterals (both delineated by coronary arteriography) on the response to handgrip stress was also evaluated. Of 11 patients with a normal handgrip response, 4 exhibited a normal left ventriculogram and 7 were abnormal. Of these 7, 6 had inferior hypokinesis. Conversely, of 16 patients with an abnormal response, to handgrip, 15 had abnormal ventriculograms. Of these, 9 had anterior akinesis. Of patients with a normal handgrip response 82% had two‐ or three‐vessel coronary disease, and 94% with an abnormal response exhibited two‐ or three‐vessel obstruction. There was no observed correlation between the presence or absence of collaterals and the response to handgrip. This study indicates that (1) handgrip stress, when combined with left ventriculography, often yields important additional information regarding the effect of localized contraction abnormalities on overall left ventricular performance; (2) the extent of coronary obstructive disease or the presence of collaterals per se do not appear to be the primary determinants of left ventricular performance; (3) it is possible that the location as well as severity and extent of left ventricular contraction abnormality may play an important role in determining overall left ventricular performance.
Cineangiographic measurements with the help of a vertebral grid system
Authors: Wagner H. R. , Teske D. W. , Siu T. Oswald
Published: February 2007

Cineangiographic measurements of cardiac structures require knowledge of the magnification factor due to nonparallelity of the X‐ray beams. A new method is presented to determine the magnification factor from cineangiograms based on the patient's height and the height of three vertebral bodies and the adjacent intervertebral distances. The method enables measurement of cardiovascular structures from projected cineangiographic films where the appropriate magnification factor is missing. Furthermore, doubtful magnification factors can be checked out as to their accuracy.
First heart sound: A phono‐echocardiographic correlation with mitral, tricuspid, and aortic valvular events
Authors: Prakash Ravi , Moorthy Krishna , Aronow Wilbert S.
Published: February 2007

We evaluated the relationship of S1 recorded by phonocardiography at the mitral area with motion of the mitral, tricuspid, and aortic valves, recorded by simultaneous echocardiography in 20 cardiac patients with a normal PR interval. The first major component of S1 coincided with mitral valve closure in 20 of 20 patients (100%) and also with tricuspid valve closure in 14 of 20 patients (70%). The second major component of S1 coincided with aortic valve opening in 20 of 20 patients and also with tricuspid valve closure in six of 20 patients (30%). We conclude that the first major component of S1 coincides with mitral valve closure in all patients but may also coincide with tricuspid valve closure in many patients, and the second major component of S1 coincides with aortic valve opening in all patients but may also coincide with tricuspid valve closure in some patients.
Characterization of left ventricular external wall motion in man by video dimension analyzer (Vidian)
Authors: Ludbrook Philip A. , Yin Frank C. P. , Peterson Kirk L.
Published: February 2007

Several investigators have described close relationships between left ventricular wall motion and physiologic cardiac events. Using an improved wall motion tracking devide (Vidian) in studies of 30 patients, we have compared the dynamics of left ventricular wall motion, recorded noninvasively, with high fidelity left ventricular and aortic pressures, intracardiac phonocardiograms, apexcardiograms, and cyclic left ventricular volume curves obtained during cardiac catheterization. Wall motion tracking signals comprised: pre‐ejection outward deflection commencing with the first component of the first heart sound and coincident with the pre‐ejection phase of the left ventricular pressure and apexcardiogram; a sharp descent during ejection, commencing with the „E”︁ point of the apexcardiogram and with the onset of the upstroke of the aortic pressure; end ejection nadir, synchronous with the dicrotic notch of the aortic pressure; a nadir representing cessation of inward displacement, presumably reflecting slight inertial motion of the wall; a brief period of isovolumic relaxation which terminated synchronously with the „O”︁ point of the apexcardiogram; rapid, then slow filling waves, coincident with those of the apexcardiogram, and demarcated by a transitional angulation synchronous with the third heart sound; and „a”︁ wave, occurring simultaneously with that of the apexcardiogram. Ventricular wall motion tracking signals also corresponded to curves representing cyclic changes in left ventricular minor radius, and chamber volume derived from cineventriculograms. In 10 patients with abnormal contraction patterns detected by biplane cineventriculography, anomalous deflections were also recorded during ejection by the Vidian. Left ventricular wall motion tracking with the Vidian: 1) provides a sensitive index for timing of intracardiac events, 2) reflects cyclic changes in ventricular volumes and minor dimensions, 3) provides a convenient noninvasive technique for detection of regional asynergy involving the lateral left ventricular wall, and 4) by correlation with simultaneous ventricular pressure measurements, may provide useful information regarding left ventricular pressure/segment dimension relations.
Left ventricular endomyocardial biopsy I: Description and evaluation of the technique
Authors: Brooksby Iain A. B. , Jenkins B. Stephen , Davies Michael J. , Swanton R. Howard , Coltart D. John , Webb‐Peploe Michael M.
Published: February 2007

The results of left ventricular endomyocardial biopsy by means of a long sheath technique in 154 patients are reported. The risks of left ventricular biopsy are those of left heart catheterisation. In 30 of these patients the results of left and right ventricular biopsy were compared, and in a further 10 patients the right ventricle only was biopsied. Biopsy from the left ventricle carries less risk of cardiac perforation, gives a higher incidence of successful biopsy, and with the exception of hypertrophic obstructive cardiomyopathy yields more diagnostic information.
Left ventricular endomyocardial biopsy III: Ultrastructural characteristics of cardiomyopathy and cardiac hypertrophy with good or poor ventricular function
Authors: Davies Michael J. , Kennedy Sandra , Brooksby Iain A. B. , Darracott Sally Cankovic , Jenkins B. Stephen , Braimbridge Mark V. , Coltart D. John , Webb‐Peploe Michael M.
Published: February 2007

Left ventricular endomyocardial biopsies have been obtained from patients with cardiomyopathy and hypertrophy due to aortic valve disease. These biopsies have been examined by electron microscopy and the ultrastructural abnormalities compared. In congestive cardiomyopathy no specific abnormalities were found although myofibrillary degeneration and membrane‐bound vacuoles were more commonly present. Crossing of whole groups of sarcomeres was found only in asymmetric septal hypertrophy, but was not present in all cases. Amyloid deposits were demonstrated easily by electron microscopy in patients with restrictive cardiomyopathy. In the patients with hypertrophy due to aortic valve disease, no specific features were found and ultrastructural abnormalities did not differentiate between normal and impaired left ventricular functions.
Transbrachial selective arteriography of the neck vessels: Our experience in 258 cases
Authors: Londero Hugo Francisco , de la Fuente Luis M.
Published: February 2007

We have developed a catheter that facilitates the study of the neck vessels via a brachial arteriotomy so that other vascular areas (heart, kidneys, etc) can be studied in the same procedure. The catheter has a preformed curvature with a tapered, closed‐end distal tip. We have successfully utilized this catheter in 258 consecutive patients, 133 (52%) of whom had undergone concurrent studies of other vascular areas, usually cardiac catheterization with coronary arteriography. No major complications occurred with the use of this catheter. We have found that with this catheter we can study the neck vessels via the brachial approach safely and easily and perform studies of other vascular areas using the same arteriotomy.
Integration of a Microreactor in an Existing Production Plant
Authors: Kirschneck D. , Tekautz G.
Published: February 2007

The installation of a StarLam 3000 microreactor in an existing production plant is reported. The aim was to double the capacity of a running two step batch process. This was achieved by installing the microreactor for the first reaction step. A higher reaction rate made it possible to reach overall throughputs of 3.6 tons per hour. Additionally energy savings were achieved. The microreactor is running in production for more than a year now.
Experimentelle Untersuchungen zur Partikelbildung bei der Fällung von Barium‐ und Strontiumsulfat
Authors: Kucher M. , Kind M.
Published: February 2007

An den exemplarischen schwerlöslichen Stoffsystemen Barium‐ und Strontiumsulfat wird der Einfluss der Prozessparameter Übersättigung und freies Gitterionenverhältnis auf das resultierende Fällungsprodukt untersucht. Durch Variation der Übersättigung als thermodynamische Triebkraft für Kristallisationsprozesse kann gezielt Einfluss auf die Partikelgrößenverteilung des gefällten Endproduktes genommen werden.
Flash‐Kristallisation als ein neues Verfahren zur Produktgestaltung kristalliner Güter
Authors: Kaiser R. , Kind M.
Published: February 2007

Zur Herstellung von kristallinen Feststoffen wird der „Flash‐Kristallisations‐Prozess”︁ eingesetzt. Der Vorteil dieses neuen Prozesses liegt darin, dass sowohl die Partikelgröße als auch die Partikelmorphologie durch den Agglomerationsschritt beliebig und unabhängig von der Kristallisation gestaltet werden können. Damit wird ein neuer Weg in der Produktgestaltung kristalliner Güter beschritten.
Partikelbeanspruchung in gerührten Behältern
Authors: Wollny S. , Sperling R.
Published: February 2007

In dieser Übersicht wird die Problematik der Partikelbeanspruchung in turbulenten Strömungen thematisiert. Nach der Darstellung der bisherigen Untersuchungen auf dem Gebiet der Partikelbeanspruchungen in Rührbehältern werden eigene Messergebnisse vorgestellt. Mit Hilfe von Tropfengrößenverteilungen eines Flüssig/Flüssig‐Modellstoffsystems werden die Dispergiereigenschaften eines 3 × 24°‐Schrägblattrührers und eines 6‐Blatt‐Scheibenrührers ermittelt. Die Tropfengrößenverteilungen können mit der Focused Beam Reflectance Measurement‐Sonde zeitlich aufgezeichnet werden. Zudem werden mit der numerischen Fluiddynamik die Geschwindigkeitsgradienten und die Energiedissipationsraten im Rührbehälter bei unterschiedlichen Betriebsbedingungen analysiert. Dabei wird die makroskopische Turbulenz in Schub‐ (Scherung) und Normalspannungen (Dehn‐, Stauchung) unterteilt.
Untersuchungen zur Kristallisation von amorphen lactosehaltigen Pulvern
Authors: Ibach A. , Kind M.
Published: February 2007

Bei der Herstellung von Molkepulver und Molkepulvererzeugnissen durch Sprühtrocknung besteht grundsätzlich die Schwierigkeit, dass die im Ausgangskonzentrat enthaltene gelöste Lactose während der raschen Trocknung amorph erstarrt. Amorphe Lactose ist hygroskopisch und instabil, wodurch ihre weitere Verwendung beeinträchtigt wird. Um technisch sinnvolle Prozessbedingungen für mögliche Verfahren zur Umwandlung der amorphen Phase abschätzen zu können, wird die Kristallisation von amorpher Lactose am Beispiel von Lactose‐, Molkepermeat‐ und Molkepulvern mittels der Differential Scanning Calorimetry untersucht.
Herstellung maßgeschneiderter Nanopartikel durch Fällung in Mikroemulsionen
Authors: Voigt A. , Sundmacher K.
Published: February 2007

Die hier vorgestellte Fällung in Mikroemulsionen ist ein interessantes Konzept, mit dem ein technischer Prozess zur Erzeugung von maßgeschneiderten Partikeln im Nanometerbereich realisiert werden kann. Der grundlegende Prozess der Mikroemulsionsfällung und seine einzelnen Phänomene werden erläutert. Dazu gehören die Untersuchungen des Phasenverhaltens der verwendeten technischen Mikroemulsion aus Cyclohexan, Wasser und Marlipal O13/40 ebenso wie die Variation verschiedener Prozessparameter und die entsprechenden Auswirkungen auf die Partikelgrößenverteilung. Beispielhaft wird die Fällung von Bariumsulfat‐ und Calciumcarbonat‐Nanopartikeln betrachtet. Parallel zu den experimentellen Untersuchungen wird der Prozess modelliert und unter Einsatz einer Monte‐Carlo‐Methode simuliert. Experimente und Simulationen zeigen, dass z. B. Reaktandenkonzentration und Dosierungsrate als Prozessparameter geeignet sind, Partikelgröße und Verteilungsbreite in bestimmten Bereichen gezielt einzustellen. Im engen Zusammenspiel von Experiment und Simulation wird ein umfassendes Prozessverständnis aufgebaut, das die technische Realisierung dieses Verfahrens in weiterer Forschungsarbeit ermöglichen wird.
Temporal regulation of Cre‐recombinase activity in Scl‐positive neurons of the central nervous system
Authors: Bradley Cara K. , Takano Elena A. , Göthert Joachim R. , Göttgens Berthold , Green Anthony R. , Begley C. Glenn , van Eekelen J. Anke M.
Published: February 2007

The Cre/LoxP system provides a powerful tool to investigate gene function in vivo. This system requires Cre‐recombinase expressing mouse lines that permit control of gene recombination in a tissue‐specific and time‐dependent manner. To allow spatio‐temporal gene deletion in specific central nervous system (CNS) neuronal populations, we generated mice with a tamoxifen‐inducible Cre (Cre‐ERT) transgene under control of the Scl/Tal1 neural promoter/enhancer −0.9E3 (−0.9E3CreERT transgenic mice). Using Cre‐reporter mice we have shown that tamoxifen‐mediated Cre‐ERT recombination in −0.9E3CreERT mice recapitulated the anticipated expression pattern of Scl in the caudal thalamus, midbrain, hindbrain, and spinal cord. Cre‐mediated recombination was also effectively induced during embryogenesis and marked the same population of neurons as observed in the adult. Additionally, we identified a tamoxifen‐independent constitutively active −0.9E3CreERT mouse line that will be useful for gene deletion during early neurogenesis. These −0.9E3CreERT mice will provide tools to investigate the role of neuronal genes in the developing and mature CNS. CNS. genesis 45:145–151, 2007.© 2007 Wiley‐Liss, Inc.
Pragmatic abilities in adults with and without dyslexia: a pilot study
Authors: Griffiths Catherine C. B.
Published: February 2007

This study examines well‐compensated adults with dyslexia to see if they experience more problems with pragmatic awareness than the normal population. Social interaction requires an individual to process language at speed by using working memory efficiently, in order to understand the intended, rather than literal, meaning between speaker and hearer. Previous studies have shown evidence amongst the dyslexic population of poor working memory capacity, slower speed of processing and automatization deficit. It is proposed that a dyslexic may not be able to interpret pragmatic content as efficiently as non‐dyslexics, due to the need for fast processing in such circumstances, resulting in resource overload and over‐intensity of memory.

The study compares the score results of 20 dyslexic and 20 non‐dyslexic adults on the Dyslexia Adult Screening Test (DAST), the Right Hemisphere Language Battery and the author's own pragmatic competence questionnaire. The results for all three measures indicate a statistically significant difference in pragmatic competence between the two groups and appear to demonstrate a correlation between dyslexia and pragmatic impairment. Consideration of individual subtest items on the DAST lend support to the argument that this may be due to deficits in working memory, processing and automatization. Copyright © 2007 John Wiley & Sons, Ltd.
Cell‐mediated cytotoxicity against ectromelia virus‐infected target cells. II. Identification of effector cells and analysis of mechanisms
Authors: Gardner I. , Bowern Narelle A. , Blanden R. V.
Published: February 2007

Cell‐mediated cytotoxicity of ectromelia‐immune spleen cells against ectromelia‐infected L929 target cells was abrogated by treatment of the spleen cells with anti‐Θ antibody and complement. Treatment of spleen cells with anti‐immunoglobulin serum and complement, or removal of macrophages had little or no effect on cytotoxicity. Specific or nonspecific soluble cytotoxic factors were not detected, and exogenous interferon did not enhance cytotoxicity. No blocking of cytotoxicity was detected with either hyperimmune or 9‐day immune anti‐ectromelia serum. By varying the spleen cell‐target cell ratio from 3: 1 to 400: 1, it was shown that the efficiency of cytotoxicity was inversely related to spleen cell density. These results were interpreted to mean that thymus‐derived (T) cells, probably acting alone, were responsible for cytotoxicity and that the mechanism involved contact between T cell and target cell.
IgM in bone marrow‐derived lymphocytes. Synthesis, surface deposition, turnover and carbohydrate composition in unstimulated mouse B cells
Authors: Andersson J. , Lafleur L. , Melchers F.
Published: February 2007

Small B lymphocytes can be depleted by velocity sedimentation on serum albumin gradients of a minor fraction (1 %) of large cells contained in spleen cell populations from normal nu/nu mice. Small cells are the mitogen‐sensitive cells. Large cells contain the “background” plaque‐forming cells. The populations of large cells synthesize 10 to 100 times more IgM than the populations of small cells. Large and small cells contain IgM as 7–8 S subunits and as smaller precursors of IgM. Carbohydrate moieties of IgM molecules inside small cells contain the “core” sugars glucosamine and mannose attached to the μ‐chains, but not the penultimate galactose and the terminal fucose residues common to secreted 19 S IgM. Large cells secrete IgM as 19 S pentamers, small cells shed their IgM as 7–8 S subunits. Large cells turn over IgM with a half time around 4 h, small cells turn over IgM with a half time between 20 and 80 h IgM synthesis is actinomycin D‐resistant in large cells and actinomycin‐sensitive in small cells. Surface‐bound IgM molecules can be distinguished within the total cellular pool from IgM molecules situated in intracellular compartments not exposed to the outside by their serological reaction with polyvalent anti‐Ig antibodies on intact cells. With this reaction it can be show that small cells contain over 90 % of their IgM in the surface membrane.
Association between histocompatibility type and the ability to make anti‐Rh antibodies
Authors: Brain P. , Hammond M. G.
Published: February 2007

The HL‐A types of Rh‐negative women with and without anti‐Rh antibodies were examined. In those who made Rh antibodies, there was an excess of HL‐A1, and a deficiency of HL‐A2 and W10, approaching the conventional level of significance. There was, however, a highly significant lack, in the antibody‐making group, of subjects with only one antigen detected at the first (LA) locus. The capacity to make anti‐Rh antibodies and that to make cytotoxic anti‐HL‐A antibodies were strongly correlated.
Phylogeny of the lymphoid system. I. A study of the fate of circulating lymphocytes in plaice
Authors: Ellis A. E. , de Sousa Maria
Published: February 2007

The fate of lymphocytes collected after prolonged drainage of the neural duct of plaice (Pleuronectes platessa), labeled in vitro with [5−3H]uridine and reintroduced intravenously into the same fish was followed by means of scintillation counting and autoradiography.

The characteristics of the lymphoid cell migration observed were very similar to those described in higher vertebrates. No significant numbers of labeled cells penetrated the thymus; the majority was found in the peripheral lymphoid organs, namely, the spleen and kidney. The cells lodging in the lymphoid organs had a capacity to synthesize, RNA, which the labeled cells in nonlymphoid organs lacked.

The autoradiographic study revealed that the population found in the white pulp of the spleen and kidney consisted mainly of small lymphocytes, whereas the labeled large lymphocytes were present in the liver and red pulp of spleen and kidney.

The relevance of the present findings to the understanding of the development of selective lymphoid cell migration is discussed.
The synthesis and assembly of immunoglobulins by malignant human plasmacytes. III. Heterogeneity in IgA polymer assembly
Authors: Buxbaum J. N. , Zolla Susan , Scharff M. D. , Franklin E. C.
Published: February 2007

The pathways of immunoglobulin synthesis and assembly have been studied in bone marrow cells obtained from 9 patients whose serum contained substantial amounts of homogeneous IgA1 myeloma proteins. Eight of the 9 cell samples synthesized light chains in excess of heavy chains. A variety of assembly intermediates, including αL, α2and α2L, were also noted. The major intracellular molecule in most cases was α2L2although larger polymers were noted in the secretions and serum of most of the patients. In only one instance was a large amount of polymer larger than α2L2found inside the cell. As is the case for the assembly for IgM, the sites of IgA polymer assembly and factors responsible for the observed heterogeneity have not yet been established.
The immunological properties of haptens coupled to thymus‐independent carrier molecules. I. The characteristics of the immune response to dinitrophenyllysinesubstituted pneumococcal polysaccharide (SIII) and levan
Authors: Klaus G. G. B. , Humphrey J. H.
Published: February 2007

The antibody response to the hapten 2,4dinitrophenyl (DNP)lysine coupled to two thymus‐independent carrier molecules (pneumococcal polysaccharide SIII and levan) has been studied in mice. The characteristics of the anti‐hapten response are essentially similar to the response to the carrier itself: both conjugates elicit a strongly dose‐dependent IgM response (with little or no IgG antibody), and supraoptimal doses paralyze both anti‐hapten and anti‐carrier antibody responses. The anti‐hapten response to DNPlyslevan is thymus‐independent; it is also carrier‐independent, since levan‐paralyzed mice give a normal antihapten response to the conjugate and, conversely, paralysis of the antihapten reactive lymphocyte population fails to affect the response to the carrier. The results do not support the concept of B cell‐B cell cooperation that has been proposed to explain the immunogenicity of haptenpolysaccharide conjugates. Instead, they indicate that these conjugates immunize separate and noninteracting B cell populations, the one hapten‐specific and the other carrier‐reactive. Both the numbers and the size of anti‐DNP hemolytic plaques were related to the immunizing dose of DNPlyslevan. Preliminary experiments suggest that the reduction in plaque size in partially tolerant mice may be caused by persisting antigen on the surface of immunized lymphoid cells.
Partial amino acid sequences of variable regions of a human IgG1 (κ) myeloma protein with anti‐rubella activity
Authors: Wang A. C. , Fudenberg H. H. , Creyssel R.
Published: February 2007

Amino acid sequences have been determined for the first 26 residues at the amino (N−) terminus of the light chain, the first 27 residues of the heavy chain and the first 23 residues of a large heavy chain fragment of an IgG1 (κ) myeloma protein with anti‐rubella specificity. These data furnish useful information about the primary structure of anti‐rubella antibody.
Surface immunoglobulins of rat immunocytes: Quantitation and fate of cell‐bound peroxidase‐labeled antibody and Fab fragment
Authors: Antoine J.‐C. , Avrameas S.
Published: February 2007

By using antibody‐peroxidase conjugates, quantitative data were obtained concerning events following interactions between anti‐Ig antibodies and surface Ig. About 5 × 105 molecules of peroxidase‐labeled anti‐rat Ig antibodies were bound per positive lymph node cell, at conjugate excess, at 4 °C. Similar quantities of anti‐Fcγ or anti‐Fab were bound per positive cell, suggesting that cell surface IgG antigenic determinants are largely exposed. Experiments performed on thymocytes showed that the number of peroxidase molecules bound per 106 cells was 12 to 16 times higher with lymph node lymphocytes than with thymocytes.

After incubation of cells at 4 °C with peroxidase‐labeled rabbit anti‐rat Ig, the cells were washed and post incubated for various times at 37 °C. The fate of the peroxidase conjugates was followed by measuring enzymatic activity on the cell surface, in the cell, and in the incubation medium. During the first 15 min of incubation at 37 °C, peroxidase activity disappeared rapidly from the cell membrane, while enzymatic activity appeared and rapidly increased in the cell supernatant. After this time, membrane‐bound peroxidase activity was found to be constant, while enzymatic activity of the supernatant increased slightly. After 1 h of incubation at 37 °C, about 20 % of the peroxidase activity had been eluted into the culture medium, 20 % remained on the cell surface, and about 35 % had been pinocytozed.

Similar results were obtained with peroxidase‐labeled sheep‐Fab anti‐rat Ig, except that more peroxidase activity was found in the supernatant and pinocytosis was less pronounced than with whole antibody.

Immunoadsorbents were used to determine if cell‐derived Ig was linked to the peroxidase liberated into the supernatant at 37 °C. Polyacrylamide beads to which were linked anti‐rat Ig antibodies or Fab fragments fixed 40 % of the peroxidase activity. Molecular filtration of the supernatants showed that about 60 % of the peroxidase activity was eluted in the void volume of a Sephadex G‐200 column, the remainder being eluted as free conjugate. Thus, part of the conjugate initially fixed on cells at 4 °C was eluted as cell surface Ig‐anti‐Ig complexes, while another part was apparently released uncomplexed.
An idiotypic cross‐reaction between two streptococcal antibodies from an individual rabbit
Authors: Thunberg A. L. , Kindt T. J.
Published: February 2007

A rabbit immunized with Group C streptococcal vaccine produced two antibodies with specificity for the Group C carbohydrate. Structural, idiotypic, and allotypic comparisons were made between these two antibodies. The use of recombinant molecules prepared from isolated H and L‐chains showed the L‐chains of the antibodies to be idiotypically identical while the H‐chains were extensively cross‐reactive, but distinct. The idiotypically identical L‐chains differed in electrophoretic mobility in alkaline urea gels and in sequence at one position among the first 22 N‐terminal residues. The H‐chains could be differentiated not only idiotypically, but also by the subspecificities of their group a (a3) allotypic determinants.