bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluorescent, internally quenched, peptides for exploring the pH‐dependent substrate specificity of cathepsin B
Authors: Ruzza Paolo , Quintieri Luigi , Osler Alessio , Calderan Andrea , Biondi Barbara , Floreani Maura , Guiotto Andrea , Borin Gianfranco
Published: February 2006

Cathepsin B is a cysteine protease that in tumor tissues is localized in both acidic lysosomes and extracellular spaces. It can catalyze the cleavage of peptide bonds by two mechanisms: endoproteolytic attack with a pH optimum around 7.4, and attack from the C‐terminus with a pH optimum at 4.5–5.5. In this work, seven fluorescent, internally quenched, decapeptides have been synthesized using the prototypical cathepsin B selective substrate Z‐Phe‐Arg‐AMC as a lead, and used to identify the structural factors determining the susceptibility of peptides to hydrolysis at acidic and neutral pH values. Each peptide differs from the others in one amino acid (residue 6) and contains a highly fluorescent Nma group linked to the α‐amino function of the N‐terminal Orn residue and a Dnp group linked to the side chain of the Lys8 residue acting as a quencher. Proteolytic cleavage was monitored by measuring the increase of fluorescence at 440 nm upon excitation at 340 nm, and the cleavage sites were determined by HPLC followed by ESI‐MS analysis. Peptides containing Ala or Phe at position 6 are good substrates for the enzyme at both pH 5.0 and 7.4. By contrast, those containing Glu, Asp, Lys or Val are not cleaved at all by cathepsin B at pH 7.4, and are poorly hydrolyzed at pH 5.0. These findings provide new information for the rational design of cathepsin B‐activated peptide‐containing anticancer drugs. Copyright © 2006 European Peptide Society and John Wiley & Sons, Ltd.
Analyses of Stemona alkaloids in Stemona tuberosa by liquid chromatography/tandem mass spectrometry
Authors: Zhou Yan , Jiang Ren‐Wang , Hon Po‐Ming , Xu Yan‐Tong , Chan Yiu‐Man , Chan Tak‐Wah Dominic , Xu Hong‐Xi , Ding Li‐Sheng , But Paul Pui‐Hay , Shaw Pang‐Chui
Published: February 2006

Alkaloid profiles in Stemona tuberosa were found to be highly variable. Six Stemona alkaloids isolated from the plant were subjected to on‐line high‐performance liquid chromatography/electrospray ionization mass spectrometry (HPLC/ESI‐MS) and tandem mass spectrometry (MS/MS) analyses. Their fragmentation patterns and products were useful for their characterization. The LC/MS fingerprints of these alkaloids, though variable among samples, could provide an overall characterization of the authenticity and quality of this species and help to differentiate it from S. japonica and S. sessilifolia, as all three species are recognized as genuine sources of the herb Radix Stemonae in the Pharmacopoeia of the People's Republic of China. Copyright © 2006 John Wiley & Sons, Ltd.
The tension between authoritative and dialogic discourse: A fundamental characteristic of meaning making interactions in high school science lessons
Authors: Scott Philip H. , Mortimer Eduardo F. , Aguiar Orlando G.
Published: February 2006

In this paper, we draw upon a framework for analyzing the discursive interactions of science classrooms (Mortimer & Scott, 2003, Meaning Making in Secondary Science Classrooms, Maidenhead, UK: Open University Press), to probe the movement between authoritative and dialogic discourse in a Brazilian high school science class. More specifically, we argue the point that such shifts between communicative approaches are an inevitable part of teaching whose purpose is to support meaningful learning of scientific knowledge. We suggest that a necessary tension therefore exists between authoritative and dialogic approaches as dialogic exchanges are followed by authoritative interventions (to develop the canonical scientific view), and the authoritative introduction of new ideas is followed by the opportunity for dialogic application and exploration of those ideas. In these ways, one communicative approach follows from the other, authoritativeness acting as a seed for dialogicity and vice versa. We discuss how this analysis, in terms of shifts in communicative approach, offers a new and complementary perspective on supporting “productive disciplinary engagement” (Engle & Conant, 2002, Cognition and Instruction, 20, 399–484) in the classroom. Finally we consider some methodological issues arising from this study. © 2006 Wiley Periodicals, Inc. Sci Ed 90:605–631, 2006
Confidence intervals for multinomial logistic regression in sparse data
Authors: Bull Shelley B. , Lewinger Juan Pablo , Lee Sophia S. F.
Published: February 2006

Logistic regression is one of the most widely used regression models in practice, but alternatives to conventional maximum likelihood estimation methods may be more appropriate for small or sparse samples. Modification of the logistic regression score function to remove first‐order bias is equivalent to penalizing the likelihood by the Jeffreys prior, and yields penalized maximum likelihood estimates (PLEs) that always exist, even in samples in which maximum likelihood estimates (MLEs) are infinite. PLEs are an attractive alternative in small‐to‐moderate‐sized samples, and are preferred to exact conditional MLEs when there are continuous covariates. We present methods to construct confidence intervals (CI) in the penalized multinomial logistic regression model, and compare CI coverage and length for the PLE‐based methods to that of conventional MLE‐based methods in trinomial logistic regressions with both binary and continuous covariates. Based on simulation studies in sparse data sets, we recommend profile CIs over asymptotic Wald‐type intervals for the PLEs in all cases. Furthermore, when finite sample bias and data separation are likely to occur, we prefer PLE profile CIs over MLE methods. Copyright © 2006 John Wiley & Sons, Ltd.
For a fixed Turaev shadow Jones-Vassiliev invariants depend polynomially on the gleams
Authors: Lieberum Jens
Published: February 2006

We use Turaev's technique of shadows and gleams to parametrize the set of all knots in S 3 with the same Hopf projection. We show that the Vassiliev invariants arising from the Jones polynomial Jt (K) are polynomials in the gleams, i.e., for

n \geq 2

, the n-th order Vassiliev invariant un, defined by

J_{e^x}(K) = \sum_{n = 0}^{\infty}u_n(K)x^n

, is a polynomial of degree 2n in the gleams.
Central quotients of biautomatic groups
Authors: Loftin John
Published: February 2006

The quotient of a biautomatic group by a subgroup of the center is shown to be biautomatic. The main tool used is the Neumann-Shapiro triangulation of S n-1, associated to a biautomatic structure on

{\bf Z}^n

. Among other applications, a question of Gersten and Short is settled by showing that direct factors of biautomatic groups are biautomatic.
Unification of Four Versions of Program Semantics
Authors: Rewitzky Ingrid , Brink Chris
Published: February 2006

Computing Science is a new subject, and we have not yet achieved the unification of theories that should support a proper understanding of its structure
. CAR Hoare and He Jifeng, 1998.

In this paper we use
Priestley duality
and
Jónsson/Tarski duality
to translate between four versions of program semantics: the relational model, predicate transformer semantics, information systems, and powerdomains. Our point of entry is the relational model, a kind of Kripke semantics, in which programs are thought of as input-output relations over a structured state space. Specifically, we present the state space as a certain kind of Priestley space, and programs as certain structure-preserving relations over such a space. We then derive, in circular fashion, a predicate transformer semantics from the relational model, an information system from the predicate transformer semantics, a powerdomain from the information system, and the original relational model back again from the powerdomain. The information system is also shown to be related to Hoare logic. To clarify the intuition behind this approach we present a case study, which is a ‘Priestley version’ of the so-called
universal domain
due to Plotkin, and we explicate various ideas about properties of programs and predicates in terms of this case study.
Program Algebra for Component Code
Authors: Bergstra J. A. , Loots M. E.
Published: February 2006

The jump instruction is considered essential for an adequate theoretical understanding of imperative sequential programming. Using atomic actions and tests as a basis we outline an algebra of programs, denoted PGA, which captures the crux of sequential programming. PGA provides an ontology for programs rather than a semantics. Out of a multitude of conceivable semantic views on PGA we single out a behaviour extraction operator which assigns to each program a behaviour. The meaning of the constants of PGA is explained in terms of the extracted behaviour. Using PGA a small hierarchy of program notations is developed. Projection semantics is proposed as a tool for the description of program semantics.
Natural Semantics-Directed Generation of Compilers and Abstract Machines
Authors: Diehl Stephan
Published: February 2006

In this paper we present the motivation, theory and transformations of our semantics-directed compiler generator. The main novelty of our generator is that it generates compilers and abstract machines. The execution times of the abstract machine programs produced by our generated compiler compare well to those of target programs produced by compilers generated by other semantics-directed generators. The generated specifications of compilers and abstract machines are suitable as a starting point for handwriting compilers and abstract machines. Our generator is fully automated and its core transformations are proved correct.
Specifying Cash-Point with DisCo
Authors: Aaltonen Timo , Kellomäki Pertti , Pitkänen Risto
Published: February 2006

We describe how the cash-point service problem of Formal Methods ’99 is specified using DisCo [Dis, JKS91].
Design of an Automatic Teller Machine with Esterel Studio
Authors: Dissoubray Sylvan , Dion Bernard
Published: February 2006

This paper describes how the cash-point service can be specified and simulated using Esterel Studio.
Incorporating physiology into parasitoid behavioral ecology: the allocation of nutritional resources
Authors: Rivero A. , Casas Jerome
Published: February 2006

A critical problem faced by most theoretical studies of parasitoid behavior and population dynamics has been the paucity of empirically obtained information about the pattern of resource allocation to egg production and metabolic maintenance in relation to adult diet in female parasitoids. This review calls for a shift from traditional manipulative feeding studies to studies that quantify the energetic budget of parasitoids and which take into account the dynamic nature of metabolic processes. As guidelines, we highlight the advances made along these lines with other insect groups and some of the simplest tools already available today for fulfilling this goal.
Host‐size‐dependent sex ratio in a parasitoid wasp
Authors: Ueno Takatoshi
Published: February 2006

Charnov's host‐size model explains parasitoid host‐size‐dependent sex ratio as an adaptive consequence when there is a differential effect of host size on the offspring fitness of parasitoid males versus females. This article tests the predictions and the assumptions of the host‐size model. The parasitoid wasp Pimpla nipponica Uchida (Hymenoptera: Ichneumonidae) laid more female eggs in larger or fresher host pupae when choice among hosts of different sizes or ages was allowed. Then, whether an asymmetrical effect of host size and age on the fitness of females versus males existed in P. nipponica was examined. Larger or fresher host pupae yielded larger wasps. Larger females lived longer, whereas male size did not influence male longevity. Large males mated successfully with relatively large females but failed with small females, whereas small males could mate successfully either with small or with large females. Thus, small‐male advantages were found, and this held true even under male–male competition. Ovariole and egg numbers at any one time did not differ among females of different sizes. Larger females attained higher oviposition success and spent less time and energy for oviposition in hosts. Larger females produced more eggs from a single host meal. Taken together, females gained more, and males lost more, by being large. Host size and age thus asymmetrically affected the fitness of offspring males versus females through the relationships between host size or hast age and wasp size, which means the basic assumption of the host‐size model was satisfied. Therefore, sex ratio control by P. nipponica in response to host size and age is adaptive.
Indirect interactions in aphid–parasitoid communities
Authors: Müller C. B. , Godfray H. Charles J.
Published: February 2006

Indirect interactions between populations of different species can be important in structuring natural communities. Indirect effects are either mediated by changes in population densities (trophic or density‐mediated effects) or by changes in the behavior of species that are not trophically connected (behavioral or trait‐mediated effects). We reviewed the literature on aphids and their parasitoids to explore the various possible indirect interactions that can occur in such communities. The review was motivated by our study of a particular aphid–parasitoid community in a natural (i.e., nonagricultural) habitat, and by the wealth of information that exists about aphid–parasitoid systems in agricultural settings. We focused our review on aphid–parasitoid interactions, but considered how these were influenced by the other aphid natural enemies and also by aphid mutualists and host plants. We conclude that indirect effects are likely to have a major effect in structuring aphid–parasitoid communities, and that the latter are a valuable model system for testing ideas about community interactions.
Colony expansion model for describing the spatial distribution of populations
Authors: Yamamura K.
Published: February 2006

Two equations have been used frequently to describe the relation between the sample variance (s2) and sample mean (m) of the number of individuals per quadrat: Taylor's power law, s2 = amb, and Iwao's m*−m regression, s2 = cm + dm2, where a, b, c, and d are constants. We can obtain biological information such as colony size and the degree of aggregation of colonies from parameters c and d of Iwao's m*−m regression. However, we cannot obtain such biological information from parameters a and b of Taylor's power law because these parameters have not been described by simple functions. To mitigate such in‐convenience, I propose a mechanistic model that produces Taylor's power law; this model is called the colony expansion model. This model has the following two assumptions: (1) a population consists of a fixed number of colonies that lie across several quadrats, and (2) the number of individuals per unit occupied area of colony becomes v times larger in an allometric manner when the occupied area of colony becomes h times larger (v≥ 1, h≥ 1). The parameter h indicates the dispersal rate of organisms. We then obtain Taylor's power law with b = {ln[E(h)] + ln[E(v2)]}/{ln[E(h)] + ln[E(v)]}, where E indicates the expectation. We can use the inverse of the exponent, 1/b, as an index of dispersal of individuals because it increases with increasing E(h). This model also yields a relation, known as the Kono–Sugino relation, between the proportion of occupied quadrats and the mean density per quadrat: −ln(1 −p) = fmg, where p is the proportion of occupied quadrats, f is a constant, and g = ln[E(h)]/{ln[E(h)] + ln[E(v)]}. We can use g as an index of dispersal as it increases with increasing E(h). The problem at low densities where Taylor's power law is not applicable is also discussed.
INTRODUCTION
Authors: Liebhold A. , Kamata N.
Published: February 2006

Foliage‐feeding forest insects have served as model systems in the study of animal populations for more than 50 years. Early studies emphasized identification of “key” mortality agents or density‐dependent sources of mortality. However, these efforts became burdened by rhetorical ambiguity, and population ecologists are increasingly focusing on characterizing population behavior and identifying the processes that generate that behavior. Two types of behavior seem to be common in forest insect populations: periodic oscillations (“population cycles”) and spatial synchrony (synchronous fluctuations over large geographic areas). Several population processes (e.g., host–pathogen interactions) have been demonstrated to be capable of producing periodic oscillations, but the precise identity of these processes remains uncertain for most forest insects and presents a challenge to future research. As part of these efforts, a greater emphasis is needed on the use of statistical methods for detecting periodic behavior and for identifying other types of population behavior (e.g., equilibrium dynamics, limit cycles, transient dynamics). Spatial synchrony appears to be even more ubiquitous in forest insect populations. Dispersal and regional stochasticity (”Moran effect”) have been shown to be capable of producing synchrony, but again more research is needed to determine the relative contribution of these processes to synchrony observed in natural populations. In addition, there is a need to search for other types of time–space patterns (e.g., traveling waves, spiral waves) in forest insect populations and to determine their causes.
Modern Morbidity following Pulmonary Resection for Postprimary Tuberculosis
Authors: Rizzi Adriano , Rocco Gaetano , Robustellini Mario , Rossi Gerolamo , Pona Claudio Della , Vertemati Giuseppe
Published: February 2006

Between January 1991 and March 1996, a total of 28 patients with postprimary tuberculosis underwent resection
for disease progression (n= 8), multidrug resistance or noncompliance to the medical treatment (n= 11), parenchymal sequelae (n= 3), suspected cancer
(n= 5), and for the correction of postpneumonectomy
bronchopleural fistula and empyema (n= 1). On
admission, eight patients presented with sputum positivity (28.6%). Similar to previous series, tubercular predilection for upper lobes was
confirmed (21/28, 75%); accordingly, upper lobectomy through an
extrapleural approach was the most common procedure (16/28, 57.1%). Atypical segmental resections or segmentectomies were performed in
seven patients (25%), whereas a bilobectomy was necessary in another
three patients (10.7%) and a completion pneumonectomy in one (3.6%). Additional procedures were an open‐window thoracostomy with
transpericardial closure of the main bronchus and a tailored
thoracoplasty. No operative mortality was reported. Healing was
achieved in 26 patients (93%). Bleeding, either from the chest wall or
hilar dissection, was the only reported intraoperative complication. Median blood loss, inclusive of early postoperative collections from
chest tubes, reached 1330 ml (range 100–3700 ml). Major postoperative
complications included recurrent disease (2/28, 7%) in sputum‐positive
patients and segmental pulmonary embolism (3.5%). Causes of minor
morbidity were air leaks resulting in residual space undergoing
spontaneous resolution (18%), wound breakdown (14%), and, fever
(11%). This limited series confirms the therapeutic value of the
surgical treatment of postprimary tuberculosis, provided that correct
indications, adequate pre‐ and postoperative medical coverage, and
meticulous technique are applied.
Abdominal Tuberculosis
Authors: Aston Niall O.
Published: February 2006

Throughout the world tuberculosis is associated with poverty, deprivation, and human immunodeficiency virus
infection. Abdominal tuberculosis is usually of insidious onset with
diverse symptoms and signs. A few present with acute complications of
perforation, obstruction, or bleeding. The diagnosis is difficult, especially in areas where the disease is less common, as many patients
do not have evidence of pulmonary tuberculosis or a positive skin test. The main differential diagnosis ranges from Crohn's disease in the
young and advanced malignancy in the elderly. Delayed diagnosis is
common, resulting in high mortality. Many investigations provide
findings suggestive but not diagnostic of tuberculosis. With peritoneal
tuberculosis, assay of ascitic fluid adenosine deaminase activity is a
valuable, simple method of diagnosis that may reduce the need for
laparoscopic biopsy. If the clinical suspicion of abdominal
tuberculosis is high, a trial of medical treatment is appropriate. Surgery should be reserved for the complications of the disease. All
patients require treatment with three antituberculous drugs over a
6‐month course.
Surgical Treatment of Bacillus Calmette Guérin Lymphadenitis
Authors: Hengster Paul , Sölder Brigitte , Fille Manfred , Menardi Gesine
Published: February 2006

Although its protective effect is contested and the risk of contracting tuberculosis is rather low
nowadays, BCG vaccination is frequently performed. Changes of strain
repeatedly led to an increased complication rate. In Austria between
1990 and 1991, of 3386 newborn babies (Strain Pasteur) 116 developed
lymphadenitis 3 to 28 weeks after vaccination. The affected children
received four types of treatment: nothing specific, isoniazid, or
surgery with and without isoniazid. Surgical treatment was found to be
necessary in 96 cases. Bacilli were successfully grown in culture in
46% of cases up to week 20 after vaccination; but later than 20 weeks
no culture became positive. All cultured bacteria were
isoniazid‐sensitive. From our data we drew the following conclusions:
Isoniazid therapy did not prove successful when inflamed lymph nodes
exceeded a certain size. Suppurative lymphadenitis in lymph nodes
exceeding 1.0 to 1.5 cm usually led to infiltration or even perforation
of the skin. Surgery prevents these complications and significantly
reduces healing time. Adjuvant isoniazid therapy cannot be recommended, except for generalized BCG tuberculosis.
Prevention of Postoperative Late Kyphosis in Pott's Disease by Anterior Decompression and Intervertebral Grafting
Authors: Korkusuz Feza , İslam Cihangir , Korkusuz Zeki
Published: February 2006

A total of 185 patients with Pott's disease were operated on between 1973 and 1992. Anterior decompression
by preserving the pleura (extrapleural approach) was the preferred
method in the thoracic spine. In the lumbar spine the approach was
retroperitoneal, and interbody fusion was performed in both for the
thoracic and the lumbar regions. Anterior decompression and
intervertebral grafting comprised the treatment. In five patients, internal fixation accompanied anterior decompression and intervertebral
grafting. The aim of instrumentation was to enhance anterior spinal
stability, and Alıcı spinal instrumentation was the preferred
device. Graft destruction and a late increase in kyphosis was prevented
by this means. The mean follow‐up period was 7.5 years. Thirty‐two of
the cases were admitted to the clinic because of Pott's paraplegia: 19 of the cases recovered completely following anterior decompression;
partial recovery was observed in 5 cases; but 8 cases did not recover. Various complications, including seven deaths, were observed in 42 of
the cases.
Risks of the Minimal Access Approach for Laparoscopic Surgery: Multivariate Analysis of Morbidity Related to Umbilical Trocar Insertion
Authors: Mayol Julio , Garcia‐Aguilar Julio , Ortiz‐Oshiro Elena , De‐Diego Carmona Jose A. , Fernandez‐Represa Jesus A.
Published: February 2006

The objective of this study was to determine the morbidity associated with trocar and needle insertion for
laparoscopic surgery and to identify risk factors for complications. Data from a prospectively collected database of all laparoscopic
operations performed at a major teaching hospital over a 4‐year period
were analyzed. In 203 patients closed laparoscopy (Veress needle plus
blind trocar insertion) was used to establish the pneumoperitoneum. Open laparoscopy with a Hasson's trocar was performed in 200 patients. A total of 1206 operative trocars were inserted (mean ± SD
2.99 ± 0.4). Sixty‐nine percutaneous punctures for
cholangiography or liver biopsy were carried out. Of the 403 patients
undergoing laparoscopic surgery, 20 (5%) had developed complications
specifically related to the access to the abdominal cavity after a
minimum follow‐up of 3 months, abdominal wall hematoma being the most
frequent (n= 8, 2.0%), followed by umbilical hernias (n= 6, 1.5%) and umbilical wound infection
(n= 5; 1.2%). The rate of penetrating injuries was
0.2% (n= 1). Of 20 complications, 15 (75%) were
related to the umbilical insertion site. Female sex and closed
laparoscopy were associated with umbilical morbidity by univariate
analysis. In a multivariate analysis, closed laparoscopy was the only
factor associated with these complications (odds ratio = 6.0;p= 0.04). Age, gender, obesity, diabetes mellitus, previous abdominal surgery, and the specific procedure had no
influence. In conclusion, gaining access to the peritoneal cavity for
laparoscopic surgery may cause severe complications, most of which are
related to the umbilical trocar. Although closed laparoscopy can be
safely used, open laparoscopy is associated with a lower morbidity
rate; therefore its utilization is recommended.
Parathyroid Function and Histology in Patients with Parathyroid Adenoma: Correlation of Clinical and Morphologic Findings
Authors: Luts Lena , Bergenfelz Anders , Alumets Jan , Sundler Frank
Published: February 2006

Serum levels of parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium, creatinine, and vitamin D
and the glomerular filtration rate were compared with the histologic
properties and expression of PTH and chromogranin A in excised
parathyroid adenomas from patients with primary hyperparathyroidism
(pHPT). PTH and chromogranin A were detected immunohistochemically, and
their mRNA was demonstrated by in situ hybridization with
quantification of their mRNA levels by image analysis. There was a
positive correlation between the cellular levels of PTH mRNA and the
cellular levels of chromogranin A mRNA (r= 0.4;p < 0.05). However, within certain parts of the adenomas, mostly consisting of chief cells, the expression of PTH mRNA
and chromogranin A mRNA was heterogeneous and the levels did not
correspond to each other. A reduced suppressibility of PTH in patients
with pHPT was confirmed. Although cellular levels of PTH and
chromogranin A and their mRNAs were low in the oxyphilic parts of the
adenomas, there was no correlation between the amount of oxyphilic
cells in the adenomas and the suppressibility of PTH by calcium. There
was also no association between the cellular levels of PTH mRNA or
chromogranin A mRNA as studied by image analysis and “calcium
sensitivity.” Our results thus demonstrate that although PTH and
chromogranin A mRNA levels are in general correlated to each other
there are differences in their expression within and between individual
parathyroid adenomas. It therefore seems likely that the expression of
PTH and chromogranin A are differentially regulated, and that PTH and
chromogranin A may not always be co‐secreted. This point could be of
importance, as chromogranin A and its cleavage products are known to
influence PTH secretion.
Little‐Known Aspect of Theodor Billroth's Work: His Contribution to Musical Theory
Authors: McLaren Neil , Thorbeck Rafael Vara
Published: February 2006

Theodor Billroth's contribution to musical theory is discussed and evaluated. Billroth was a close friend
of the composer Johannes Brahms and was himself extremely musical. At
his death he left the manuscript of a book on musical theory, Wer ist Musikalisch?, which had gone through four editions by 1912. In it he attempted to answer important questions on the nature of sound
perception, the importance of rhythm as a fundamental element in music, the relation of pitch, tone, and volume, and the ways in which to
account for the affective power of music. This article outlines the
main concepts, contributions, and opinions offered by Billroth.
Regeneration of Abdominal Wall Aponeurosis: New Dimension in Marlex Peritoneal Sandwich Repair of Incisional Hernia
Authors: Matapurkar B.G. , Bhargave A. , Dawson Leelawathi , Sonal B.
Published: February 2006

Loss of abdominal wall substance is a major cause of incisional hernia formation. It makes repair of this iatrogenic human ailment a difficult surgical problem. The abdominal wall substance loss has compelled the world's surgical community dealing with this condition to substantiate the repair with extra material such as skin, fascia, wire mesh, and lately biocompatible synthetic mesh. Even though the synthetic mesh is compatible and well tolerated by body tissues, it is not without complications. Regenerative repair in the region of the abdominal wall with substance loss is probably the best repair if it can be achieved. With reasonable success in animal experiments and the positive regenerative capacity of stem cells to transform the peritoneum into an aponeurotic layer, the new technique using a Marlex peritoneal sandwich for repair of large incisional hernias was attempted but was not reported in the article published in the World Journal of Surgery in 1991. The present study is based on experiments on seven mongrel dogs. A suitable embryonal segment of autogenous peritoneum was excised and transfered to the rectus sheath region. The gross appearance of the grafted membrane 3 months after operation revealed tough, thick tissue formation. The histology confirmed the presence of collagen fiber tissue in layers similar to the aponeurosis in the grafted peritoneal membrane. The use of this regeneration in the Marlex peritoneal sandwich technique of repair of large incisional hernias and the scientific rationale of tissue regeneration by desired metaplasia is discussed.
New Minimally Invasive Surgical Technique Using Arterial T‐grafts for Treatment of Double‐vessel Coronary Artery Disease: Experimental Study
Authors: Gulielmos Vassilios , Wagner Florian M. , Behr Friederike , Dangel Markus , Schueler Stephan
Published: February 2006

Minimally invasive surgery has been used successfully in patients with single‐vessel coronary artery disease (CAD), but there are no clinical reports of surgical techniques for the treatment of multivessel disease in this field using both internal mammary arteries (IMAs). Therefore a canine model has been established to demonstrate the feasibility of a minimally invasive surgical treatment of coronary artery double‐vessel disease using both IMAs. Ten mongrel dogs underwent bilateral thoracoscopic preparation of both internal mammary arteries through small left lateral chest ports. Using the Port Access endovascular cardiopulmonary bypass system the right IMA (RIMA) was anastomosed as a free graft end‐to‐side to the left IMA (LIMA) as a T‐graft. After induction of cardioplegic arrest the RIMA was anastomosed to the circumflex artery and the LIMA to the left anterior descending artery. All animals were weaned from cardiopulmonary bypass without inotropic support. The electrocardiogram showed sinus rhythm with no signs of ischemia. Intraoperative coronary angiography demonstrated patency of all anastomoses. The minimally invasive surgical treatment of double‐vessel CAD using arterial T‐grafts of both IMAs is thus feasible. Surgical trauma can be further reduced by harvesting the RIMA transmediastinally through the left lateral chest.
Clinical Experience with Minimally Invasive Coronary Artery and Mitral Valve Surgery with the Advantage of Cardiopulmonary Bypass and Cardioplegic Arrest Using the Port Access Technique
Authors: Gulielmos Vassilios , Wagner Florian M. , Waetzig Beate , Solowjowa Natalja , Tugtekin Sems M. , Schroeder Claudia , Schueler Stephan
Published: February 2006

To minimize surgical trauma, the use of Port Access cardiac surgery was initiated in patients (pts) with coronary artery disease (CAD) (42 pts) or mitral valve disease (MVD) (24 pts) in March 1996 at our institution. Altogether 42 pts (36 men, 6 women; age 31–75 years, median 59.0 years) with isolated lesions of the left anterior descending (LAD) artery underwent Port Access coronary artery surgery (PACAS). A small (5–9 cm) incision was done parasternally on top on the fourth rib. The left internal mammary artery (LIMA) was dissected through the minithoracotomy or by using an additional thoracoscopic approach. A total of 24 pts (12 men, 12 women; age 30–75 years, median 62 years) underwent Port Access mitral valve surgery (PAMVS). In these pts the procedure was performed through a small right thoracotomy (6–8 cm). In all cases, endovascular cardiopulmonary bypass (CPB) was instituted through femoral cannulation, and an additional endoaortic balloon catheter was introduced into the ascending aorta for aortic occlusion. In pts with PACAS the survival was 98% (41/42) and in the PAMVS group 100%. All pts but one survived the PACAS and are well today. There were no deaths in the PAMVS group. The hospital stay was reduced by 1 day on average after PACAS and 3 days after PAMVS. Thus in well selected patients Port Access cardiac surgery represents a safe and feasible minimally invasive surgical approach that avoids the potential complications of a sternotomy while offering the advantages and safety of CPB and cardioplegic arrest. This minimally invasive approach offers a shortened hospital stay and earlier rehabilitation.
Total Esophagectomy versus Proximal Esophagectomy for Esophageal Cancer at the Cervicothoracic Junction
Authors: Fujita Hiromasa , Kakegawa Teruo , Yamana Hideaki , Sueyoshi Susumu , Hikita Shigeki , Mine Takashi , Tanaka Yuichi , Ishikawa Hiroto , Shirouzu Kazuo , Mori Kazunori , Inoue Yojiro , Tanabe Hiroko Yanaga , Kiyokawa Kensuke , Tai Yoshiaki , Inutsuka Hiroki
Published: February 2006

To investigate the adequate extent of esophagectomy and lymphadenectomy for an esophageal cancer localized at the cervicothoracic junction, the mortality and morbidity rates, survival rates, and patterns of recurrence were retrospectively analyzed in two groups—14 patients who underwent total esophagectomy with or without laryngectomy and 15 patients who underwent proximal esophagectomy with or without laryngectomy—at Kurume University Hospital from 1981 to 1996. Proximal esophagectomy with or without laryngectomy resulted in a lower hospital mortality rate and better overall survival for patients who underwent curative esophagectomy compared with total esophagectomy with or without laryngectomy. Multivariate analysis indicated that the extent of esophagectomy (total esophagectomy versus proximal esophagectomy) was not a prognostic factor. The incidence of recurrence was not different between the two groups. Lymph node metastasis or recurrence from such esophageal cancers was localized to the neck and upper mediastinum. For an esophageal cancer localized at the cervicothoracic junction, therefore, proximal esophagectomy with or without laryngectomy and with cervical and upper mediastinal lymphadenectomy could be better indicated for preselected patients.
Clinicopathologic Study of Gastric Cancer Based on Dukes' Classification
Authors: Adachi Yosuke , Suematsu Toshihiro , Yasuda Kazuhiro , Shiromizu Akio , Shiraishi Norio , Kitano Seigo
Published: February 2006

Dukes' classification is a useful staging system in patients with colorectal cancer. The aim of this study was to present clinicopathologic characteristics and survival of patients with gastric cancer based on Dukes' classification. A total of 273 patients with gastric cancer curatively treated by radical gastrectomy and lymph node dissection (D2, D3) were studied. With the modified Dukes' classification, A includes tumors limited to the mucosa, submucosa, or muscularis propria; B includes tumors extending into the subserosa or serosa; Ca includes tumors with one to six positive lymph nodes; and Cb includes tumors with seven or more positive lymph nodes. Dukes' classification modified by the number of positive lymph nodes well correlated with the tumor size (p < 0.01), depth of wall invasion (p < 0.01), level of lymph node metastasis (p < 0.01), and degree of lymphatic permeation (p < 0.01) and venous permeation (p< 0.01). The 5‐year survival rate was significantly different among Dukes' A (98%), Dukes' B (90%), Dukes' Ca (75%), and Dukes' Cb (44%) cases. The results indicate that Dukes' classification modified by the number of positive lymph nodes (Dukes' A, B, Ca, an Cb) significantly correlates with tumor progression and patient survival; and it may be a simple and useful staging system for gastric cancer.
Nutritional Depletion and Dietary Manipulation: Effects on the Immune Response
Authors: Hulsewé Karel W.E. , van Acker Bernadette A.C. , von Meyenfeldt Maarten F. , Soeters Peter B.
Published: February 2006

The association between nutritional depletion and the increased susceptibility for infectious diseases has been recognized for a long time. The complexity of the immune system, however, makes it difficult to unravel the underlying mechanisms. It appears that depletion adversely affects virtually all components of the immune system. This review provides an overview over the specific requirements of substrates by immune cells and the effects of nutritional depletion on various components of the immune response, with special attention to gut‐associated lymphoid tissue. The literature concerning effects of dietary interventions with specific nutrients on the immune response is also discussed. Finally, we offer a hypothesis with regard to the improvement of composition of “trauma” nutrition solutions.
Pancreatic Cancer as a Model: Inflammatory Mediators, Acute‐phase Response, and Cancer Cachexia
Authors: Fearon Kenneth C.H. , Barber Matthew D. , Falconer J.S. , McMillan Donald C. , Ross James A. , Preston Tom
Published: February 2006

Patients with pancreatic cancer frequently develop the syndrome of cancer cachexia. Pro‐inflammatory cytokines have been strongly implicated in the pathogenesis of this syndrome. In patients with pancreatic cancer an acute‐phase response (an index of pro‐inflammatory cytokine activity) is associated with accelerated weight loss, hypermetabolism, anorexia, and a shortened duration of survival. However, little is known about the primary significance of the acute‐phase response in terms of altered hepatic export protein synthesis rates and its potential impact on the body's nitrogen economy. In a recent series of studies on weight‐losing pancreatic cancer patients with hypoalbuminemia we have demonstrated albumin synthesis to be unaltered whereas fibrinogen synthesis is increased two‐ to threefold compared with healthy controls. Because of the mismatch in amino acid composition between the body's main labile amino acid reserve (skeletal muscle) and that of acute‐phase proteins, these results lend support to the concept that in pancreatic cancer the reprioritization of body protein metabolism during an acute‐phase response may well be a significant factor in the loss of lean tissue in these patients.
Effectiveness of Collagen–Gentamicin Implant for Treatment of “Dirty” Abdominal Wounds
Authors: Gomez Gilberto Guzmán Valdivia , Guerrero Teresa Soto , Lluck Manuel Chavelas , Delgado Francisco Juarez
Published: February 2006

p < 0.01) and shortens healing time (p < 0.001) and the period of disability.
Thirty‐six Cases of Obturator Hernia: Does Computed Tomography Contribute to Postoperative Outcome?
Authors: Yokoyama Yukihiro , Yamaguchi Akihiro , Isogai Masatoshi , Hori Akihiro , Kaneoka Yuji
Published: February 2006

p = 0.018). The intraoperative findings, occurrence of postoperative complications, and overall mortality rates were similar between the two groups. There were four postoperative deaths (mortality rate 11%). Three of four patients who died had panperitonitis because of small bowel perforation. The correct preoperative diagnosis of obturator hernia was facilitated by CT of the pelvis, but it has no impact on patient outcome. Early diagnosis and surgical intervention are essential for this rare entity.
Comparison of Outcomes following Transhiatal or Ivor Lewis Esophagectomy for Esophageal Carcinoma
Authors: Gluch Laurence , Smith Ross C. , Bambach Christopher P. , Brown Alastair R.
Published: February 2006

p = 0.05); if two surgeons operated concurrently, THO could be performed 40 minutes quicker than THO or ILO performed by a single surgeon (p= 0.018). The mean initial intensive care unit stay was 2.9 days for ILO versus 1.7 days for THO (p= 0.014). The 30‐day mortality was 5.1%; total in‐hospital mortality was 7.1% with no difference for operation type. There were similar morbidity rates for the procedures. Kaplan‐Meier survival analysis indicated no significant effect of surgical technique; there were no apparent advantages for either operation when patients were compared by tumor type or matched for stage. Hence THO is a valid alternative to ILO, particularly for stage II and III cancer.
Preoperative Transcatheter Arterial Chemoembolization and Prognosis of Patients with Hepatocellular Carcinomas: Retrospective Analysis of 120 Cases
Authors: Lu Cai‐De , Peng Shu‐You , Jiang Xien‐Chuan , Chiba Yukio , Tanigawa Nobuhiko
Published: February 2006

1 (n= 24) and B1 (n= 57), and those with tumors > 8 cm were assigned to groups A2 (n= 20) and B2 (n= 19), respectively. Although no significant differences in survival between groups A1 and B1 were found, group A2 presented superior 1‐, 2‐, and 3‐year tumor‐free survival rates of 80%, 55%, and 32% and 1‐, 3‐, and 5‐year cumulative survival rates of 90%, 53%, and 42%. These figures are in comparison with the tumor‐free survival rates of 50%, 22%, and 11% (p= 0.06), and the cumulative survival rates of 72%, 33%, and 11% (p= 0.01) during the same periods for group B2, respectively. The Cox regression model revealed that for patients with tumors > 8 cm, the relative risk of preoperative TAE for overall survival was 0.38 (p= 0.017), indicating that preoperative TAE might benefit patients with tumors > 8 cm but not those with tumors 2 to 8 cm.
Tribute to a Triad: History of Splenic Anatomy, Physiology, and Surgery—Part 1
Authors: McClusky David A. , Skandalakis Lee J. , Colborn Gene L. , Skandalakis John E.
Published: February 2006

Talmud, the Midrash, and the writings of Hippocrates, Plato, Aristotle, Galen, and several other giants of the past, one can find a lot of Delphian and Byzantine ambiguities. At that time, splenectomy was the art of surgery for many splenic diseases. From antiquity to the Renaissance, efforts were made to study the structure, functions, and anatomy of the spleen. Vesalius questioned Galen; and Malpighi, the founder of microscopic anatomy, gave a sound account of the histology and the physiologic destiny of the spleen. Surgical inquiry gradually became a focal point, yet it was still not clear what purpose the spleen served. It has been within the past 50 years that the most significant advances in the knowledge of the spleen and splenic surgery have been made. The work of Campos Christo in 1962 about the segmental anatomy of the spleen helped surgeons perform a partial splenectomy, thereby avoiding complications of postsplenectomy infection. With the recent successes of laparoscopic splenectomy in selected cases, the future of splenic surgery will undoubtedly bring many more changes.
High-Throughput Protein Crystallography
Authors: Azarani Arezou , Segelke Brent W. , Toppani Dominique , Lekin Timothy
Published: February 2006

An automated platform for low-volume, highthroughput protein crystallization by the sitting drop vapor diffusion has been developed. This platform consists of a novel Society of Biomolecular Screening standard microplate technology, standard automation liquid handling equipment, a software to design customizable, random crystallization buffers, an in-house designed scanner, a crystal recognition software, and Laboratory Information Management Systems. These technologies are designed to eliminate obstacles to the production of protein crystals and to address a number of critical issues faced by crystallography laboratories, namely precision and accuracy, ease of integration and use, speed, and cost.
Automated FTIR Analysis of Free Fatty Acids or Moisture in Edible Oils
Authors: Al-Alawi Ahmed , van de Voort Frederick R. , Sedman Jacqueline , Ghetler Andrew
Published: February 2006

An FTIR spectrometer coupled to an autosampler and attendant methodologies for high-volume automated quantitative analysis of free fatty acids (FFA) or moisture in edible oils are described. Samples are prepared by adding 20 g of oil to a 50 ml screw-capped vial, to which is added either a methanol/NaHNCN solution or dry acetonitrile in a I:I (w/v) ratio for FFA or H2O analysis, respectively. After capping with Mylar-lined septum caps, the vials are loaded into an autosampler tray, which is then agitated vigorously to extract the constituent of interest from the oil into the oil-immiscible solvent, and are then left to stand for ∼ 10 min to allow for phase separation. The upper solvent layer in each vial is aspirated successively into the IR cell, with the Mylar seal allowing facile autosampler needle penetration into the vials. The spectra of the sample extraction solvents serve as spectral backgrounds in addition to being used in monitoring cell path length and verifying cell loading. FFA and H2O analyses are carried out using 100 and 500 μm CaF2 cells, respectively. For FFA analysis, quantification is achieved using the ν (COO) band at 1573 cm−1, while moisture is determined using water absorption bands at 3629 or 1631 cm−1, depending on the moisture range of the samples. Calibration procedures and data are presented. The spectrometer and autosampler are controlled using proprietary Universal Method Platform for InfraRed Evaluation software, which provides a simple user interface and automates the spectral analysis; the output data can also be sent to a Laboratory Information Management System. Validation and performance data obtained with this automated system demonstrate that it is capable of analyzing >60 samples/h, a rate commensurate with the throughput required by commercial contract or high-volume process control laboratories.
Ear protection as a treatment for disruptive snoring: do ear plugs really work?
Authors: Robertson S , Loughran S , MacKenzie K
Published: February 2006

Background: In the absence of surgical treatments with demonstrable long-term efficacy, conservative treatments for snoring remain appropriate. Only limited evidence evaluating the use of ear protection by partners has been published.

Methods: Eligible couples were invited to participate in a two-month trial, with each partner using custom-moulded ear plugs. Five questionnaires were completed by patients and their partners, at baseline and after two months: the snoring outcomes survey (SOS) or the spouse/bed partners survey (SBPS), the Epworth sleepiness scale (ESS), the general health questionnaire-12 (GHQ-12), the Nottingham health profile (NHP) and the Golombok–Rust inventory of marital status (GRIMS).

Results: After two months, there was a significant improvement in the SOS score for patients (p = 0.005), the SBPS score for partners (p = 0.001) and the ESS for partners (p = 0.004).

Conclusions: For selected couples, ear plugs represent an effective short-term treatment for some of the social effects of disruptive snoring, as determined by the SOS, SBPS and ESS questionnaires.