bluuebunny/crossref_metadata_2025 huggingface dataset:
French Tragic Farce in an Age of Interpellation: Michel Azama'sCroisadesand Hervé Blutsch'sAnatole Felde
Authors: Taylor Scott D.
Published: October 2008

Since its heyday among playwrights like Beckett and Ionesco, the genre of “tragic farce” has continued to interest playwrights, both in France and around the world, as a means of dramatizing such existential concerns as the fragility of identity, the relativity of truth, the plurality of meaning, and the isolated condition of the individual in the modern, technocratic world. Contemporary French dramatists, Michel Azama and Hervé Blutsh, are two such playwrights. They represent voices from what Patrice Pavis has identified as a “new generation” of playwrights who, in recent decades, have moved French theatre beyond a strict adherence to any one particular ideological influence, including Existentialism and Absurdism, and who have instead moved it into a period of “interpellation.” Drawing on Althuser's psychoanalytic understanding of the term, which views “interpellation” as “the central operation by which ideology assigns to the individual human being an identity as a subject/object” (The Columbia Dictionary of Modern Literary and Cultural Criticism 158–59), this article argues that, through their interpellation of ideology, this new generation of playwrights is forcing the contemporary French stage to look into the “Lacanian mirror” in a perpetual process of self-discovery and self-refinement. It argues that this “age of interpellation” reflects a larger trend in French literature in general, known as auto-fiction – a fiction whose creation is based on “facts” and that serves as a conduit into the subconscious. Ultimately, through a close reading of two contemporary tragic farces, Azama's Croisades and Blutsch's Anatole Felde, “interpellative theatre” is seen as being left to grapple with a whole host of simultaneous paradoxes as it attempts to “subject” itself in a contemporary context, caught between the polarities of ambiguity and polyvalence, absolutism and relativity, singularity and pluralism, globalization and cultural identity.
Application of covered stent grafts for intracranial vertebral artery dissecting aneurysms
Authors: He Min , Zhang Heng , Lei Ding , Mao Bo-Yong , You Chao , Xie Xiao-Dong , Sun Hong , Ju Yan , Zhang Jia-Ming
Published: October 2008

Object

Utilization of covered stent grafts in treating neurovascular disorders has been reported, but their efficacy and safety in vertebral artery (VA) dissecting aneurysms needs further investigation.

Methods

Six cases are presented involving VA dissecting aneurysms that were treated by positioning a covered stent graft. Two aneurysms were located distal to the posterior inferior cerebellar artery, and 4 were located proximal to the posterior inferior cerebellar artery. Aspirin as well as ticlopidine or clopidogrel were administered after the procedure to prevent stent-related thrombosis. All patients were followed up both angiographically and clinically.

Results

Five of the 6 patients underwent successful placement of a covered stent graft. The covered stent could not reach the level of the aneurysm in 1 patient with serious vasospasm who died secondary to severe subarachnoid hemorrhage that occurred 3 days later. Patient follow-up ranged from 6 to 14 months (mean 10.4 months), and demonstrated complete stabilization of the obliterated aneurysms, and no obvious intimal hyperplasia. No procedure-related complications such as stenosis or embolization occurred in the 5 patients with successful stent graft placement.

Conclusions

Although long-term follow-up studies using a greater number of patients is required for further validation of this technique, this preliminary assessment shows that covered stent graft placement is an efficient, safe, and microinvasive technique, and is a promising tool in treating intracranial VA dissecting aneurysms.
Glioma surgery using a multimodal navigation system with integrated metabolic images
Authors: Tanaka Yoji , Nariai Tadashi , Momose Toshiya , Aoyagi Masaru , Maehara Taketoshi , Tomori Toshiki , Yoshino Yoshikazu , Nagaoka Tsukasa , Ishiwata Kiichi , Ishii Kenji , Ohno Kikuo
Published: October 2008

Object

A multimodal neuronavigation system using metabolic images with PET and anatomical images from MR images is described here for glioma surgery. The efficacy of the multimodal neuronavigation system was evaluated by comparing the results with that of the conventional navigation system, which routinely uses anatomical images from MR and CT imaging as guides.

Methods

Thirty-three patients with cerebral glioma underwent 36 operations with the aid of either a multimodal or conventional navigation system. All of the patients were preliminarily examined using PET with l-methyl-[11C] methionine (MET) for surgical planning. Seventeen of the operations were performed with the multimodal navigation system by integrating the MET-PET images with anatomical MR images. The other 19 operations were performed using a conventional navigation system based solely on MR imaging.

Results

The multimodal navigation system proved to be more useful than the conventional navigation system in determining the area to be resected by providing a clearer tumor boundary, especially in cases of recurrent tumor that had lost a normal gyral pattern. The multimodal navigation system was therefore more effective than the conventional navigation system in decreasing the mass of the tumor remnant in the resectable portion. A multivariate regression analysis revealed that the multimodal navigation system–guided surgery benefited patient survival significantly more than the conventional navigation–guided surgery (p = 0.016, odds ratio 0.52 [95% confidence interval 0.29–0.88]).

Conclusions

The authors' preliminary intrainstitutional comparison between the 2 navigation systems suggested the possible premise of multimodal navigation. The multimodal navigation system using MET-PET fusion imaging is an interesting technique that may prove to be valuable in the future.
Acute symptomatic cerebellar tonsillar herniation following intraoperative lumbar drainage
Authors: Sugrue Patrick A. , Hsieh Patrick C. , Getch Christopher C. , Batjer H. Hunt
Published: October 2008

Complications of tonsillar herniation associated with lumbar drainage have been reported in the literature. However, acutely symptomatic tonsillar herniation after intraoperative lumbar drainage is rare. The following case illustrates the risk associated with cerebrospinal fluid (CSF) drainage in the setting of tonsillar herniation. The use of lumbar drainage during cranial surgery is a common practice for reducing intracranial pressure and enhancing exposure, but is not without complications. In addition to the complications of the insertion procedure itself, the change in pressure gradient between the intracranial and the suboccipital compartments is of key importance.

The authors present the case of a patient who underwent a subtemporal craniotomy for resection of mesial temporal cavernous malformation with intraoperative lumbar drainage. The patient had a preexisting, asymptomatic 4-mm Chiari malformation and progressive neurological deficits resulting from further cerebellar tonsillar herniation in the early postoperative period developed, which required a lumbar blood patch, decompressive suboccipital craniectomy, and C-1 laminectomy with duroplasty. After placement of the lumbar drain and subsequent CSF drainage, the change in CSF pressure gradient above and below the foramen magnum probably led to the herniation. Unfortunately, the patient has lasting neuropathic pain and cervical cord signal changes on MR images.
Transvenous embolization of a high-flow, posttraumatic fistula between the posterior communicating artery and retroclival venous plexus
Authors: Gandhi Dheeraj , Ansari Sameer A. , Thompson B. Gregory , Maher Cormac
Published: October 2008

Traumatic injuries of the posterior communicating artery are distinctly rare. We report an unusual case of traumatic tear of the posterior communicating artery with fistulous communication to the adjacent, retroclival venous plexus. The fistula, and an accompanying large venous aneurysm, was completely occluded via transvenous embolization. The patency of the posterior communicating artery was preserved.
A mathematical model of idiopathic intracranial hypertension incorporating increased arterial inflow and variable venous outflow collapsibility
Authors: Bateman Grant A. , Stevens Scott A. , Stimpson Jesse
Published: October 2008

Object

A collapsible segment in the venous outflow has been noted in many patients with idiopathic intracranial hypertension (IIH). Mathematical modeling has shown that these collapsible segments can account for the elevated cerebrospinal fluid (CSF) pressures associated with IIH. However, the model required an elevated outflow resistance of up to 10 times normal to predict the CSF pressures actually found clinically. Measurement of blood flow in patients with IIH has shown that inflow rates vary, with higher rates noted in patients with lesser outflow stenoses. The aim of this work was to extend a simple model of cerebral hydrodynamics to accommodate a collapsible sinus and elevations in cerebral blood flow in accordance with in vivo measurements.

Methods

Forty patients with IIH underwent MR imaging in which the degree of stenosis on MR venography was compared with the total blood inflow by using MR flow quantification. The relative outflow resistance in IIH was estimated using the CSF opening pressure. The patients were compared with 14 age-matched control individuals.

Results

Patients were divided into 3 groups based on MR venography appearances (minimal stenosis, stenosis of 40–70% and > 70% stenosis). In vivo measurements suggested a relative resistance elevation of 2.5 times normal, 4.2 times normal, and 4.8 times normal in the 3 groups, respectively. There was an increased inflow of 1.56 times normal, 1.28 times normal, and 1.19 times normal in these groups.

Conclusions

The model correctly predicted the CSF pressures noted in vivo, suggesting that high arterial inflow is required for patients with low-grade stenoses to be symptomatic.
Nimodipine in aneurysmal subarachnoid hemorrhage: a randomized study of intravenous or peroral administration
Authors: Kronvall Erik , Undrén Per , Romner Bertil , Säveland Hans , Cronqvist Mats , Nilsson Ola G.
Published: October 2008

Object

The calcium antagonist nimodipine has been shown to reduce the incidence of ischemic complications following aneurysmal subarachnoid hemorrhage (SAH). Although most randomized studies have been focused on the effect of the peroral administration of nimodipine, intravenous infusion is an alternative and the preferred mode of treatment in many centers. It is unknown whether the route of administration is of any importance for the clinical efficacy of the drug.

Methods

One hundred six patients with acute aneurysmal SAH were randomized to receive either peroral or intravenous nimodipine treatment. The patients were monitored for at least 10 days after bleeding in terms of delayed ischemic neurological deficits (DINDs) and with daily measurements of blood flow velocities in the middle cerebral arteries by using transcranial Doppler ultrasonography. Three months after SAH, clinical outcome and new cerebral infarctions according to MR imaging studies were recorded.

Results

Baseline characteristics (age, sex distribution, clinical status on admission, radiological findings, and aneurysm treatment) did not differ between the treatment groups. There was no significant difference in the incidence of DINDs (28 vs 30% in the peroral and intravenous groups, respectively) or middle cerebral artery blood flow velocities (> 120 cm/second, 50 vs 45%, respectively). Clinical outcome according to the Glasgow Outcome Scale was the same in both groups, and there was no difference in the number of patients with new infarctions on MR imaging.

Conclusions

The results suggest that there is no clinically relevant difference in efficacy between peroral and intravenous administration of nimodipine in preventing DINDs or cerebral vasospasm following SAH.
An Umayyad Fragment of the Qur'an and its Dating
Authors: Dutton Yasin
Published: October 2008

In the absence of clearly dated manuscripts, the problem of dating early Qur'ans has long since exercised the minds of scholars and continues to do so today. In the present paper, we investigate the dating of one early fragment of the Qur'an, which has been dated by radio-carbon dating, and can be dated by art-historical methods, to the middle of the Umayyad period, that is, the latter years of the first century and/or the first years of the second century AH.

In addition to questions of dating, a study of the textual variants and the verse-numbering represented in this fragment and in two further folios from what must be the same manuscript enables us to build up a picture of the reading and the verse-numbering system represented. This leads to the conclusion that this particular manuscript was written according to the Meccan reading tradition represented in the later sources by readers such as Ibn Kathīr, Ibn Muḥayṣin and their associates and/or predecessors.

A further comparison of this manuscript with other, similar manuscripts also allows us more certainty about what were otherwise provisional datings for these other manuscripts, while at the same time allowing us a clearer picture of the characteristics of the so-called ‘Kufic’ script in its earliest stages in the first and early second centuries AH, and a better understanding of its overall development.
Antibody-mediated Prevention of Fusarium Mycotoxins in the Field
Authors: Hu Zu-Quan , Li He-Ping , Zhang Jing-Bo , Glinka Elena , Liao Yu-Cai
Published: October 2008

Fusarium mycotoxins directly accumulated in grains during the infection of wheat and other cereal crops by Fusarium head blight (FHB) pathogens are detrimental to humans and domesticated animals. Prevention of the mycotoxins via the development of FHB-resistant varieties has been a challenge due to the scarcity of natural resistance against FHB pathogens. Various antibodies specific to Fusarium fungi and mycotoxins are widely used in immunoassays and antibody-mediated resistance in planta against Fusarium pathogens has been demonstrated. Antibodies fused to antifungal proteins have been shown to confer a very significantly enhanced Fusarium resistance in transgenic plants. Thus, antibody fusions hold great promise as an effective tool for the prevention of mycotoxin contaminations in cereal grains. This review highlights the utilization of protective antibodies derived from phage display to increase endogenous resistance of wheat to FHB pathogens and consequently to reduce mycotoxins in field. The role played by Fusarium-specific antibody in the resistance is also discussed.
A Tropical Marine Microbial Natural Products Geobibliography as an Example of Desktop Exploration of Current Research Using Web Visualisation Tools
Authors: Mukherjee Joydeep , Llewellyn Lyndon E. , Evans-Illidge Elizabeth A.
Published: October 2008

Microbial marine biodiscovery is a recent scientific endeavour developing at a time when information and other technologies are also undergoing great technical strides. Global visualisation of datasets is now becoming available to the world through powerful and readily available software such as Worldwind ™, ArcGIS Explorer ™ and Google Earth ™. Overlaying custom information upon these tools is within the hands of every scientist and more and more scientific organisations are making data available that can also be integrated into these global visualisation tools. The integrated global view that these tools enable provides a powerful desktop exploration tool. Here we demonstrate the value of this approach to marine microbial biodiscovery by developing a geobibliography that incorporates citations on tropical and near-tropical marine microbial natural products research with Google Earth ™ and additional ancillary global data sets. The tools and software used are all readily available and the reader is able to use and install the material described in this article.
Acetylcholinesterase-Inhibiting Activity of Pyrrole Derivatives from a Novel Marine Gliding Bacterium, Rapidithrix thailandica
Authors: Sangnoi Yutthapong , Sakulkeo Oraphan , Yuenyongsawad Supreeya , Kanjana-opas Akkharawit , Ingkaninan Kornkanok , Plubrukarn Anuchit , Suwanborirux Khanit
Published: October 2008

Acetylcholinesterase-inhibiting activity of marinoquinoline A (1), a new pyrroloquinoline from a novel species of a marine gliding bacterium Rapidithrix thailandica, was assessed (IC50 4.9 μM). Two related pyrrole derivatives, 3-(2'-aminophenyl)-pyrrole (3) and 2,2-dimethyl-pyrrolo-1,2-dihydroquinoline (4), were also isolated from two other strains of R. thailandica. The isolation of 3 from a natural source is reported here for the first time. Compound 4 was proposed to be an isolation artifact derived from 3. The two isolated compounds were virtually inactive in the acetylcholinesterase-inhibitory assay (enzyme inhibition < 30% at 0.1 g L-1).
Norcyperone, a Novel Skeleton Norsesquiterpene from Cyperus rotundus L.
Authors: Xu Yan , Zhang Hong-Wu , Yu Chang-Yuan , Lu Yang , Chang Ying , Zou Zhong-Mei
Published: October 2008

A novel norsesquiterpene, named norcyperone (1), and three known compounds: (-)-clovane-2,9-diol (2), rosenonolactone (3), and 5a,8a-epidioxy-(20S,22E,24R)-ergosta-6,22-dien-3β-ol (4) were isolated from the rhizomes of Cyperus rotundus L. The structure of 1 was elucidated as 8,11,11-trimethylbicyclo[5.3.1]undecane-5a, 8a-epoxy-3-one on the basis of extensive spectroscopic analyses, including 1D- and 2D-NMR, MS experiments, and single-crystal X-ray diffraction. This is the first report of a 8,11,11-trimethyl- bicyclo[5.3.1]undecane-3-one type norsesquiterpene with a tetrahydrofuran ring at C-5 and C-8.
Thin Film on CMOS Active Pixel Sensor for Space Applications
Authors: Schulze Spuentrup Jan Dirk , Burghartz Joachim N. , Graf Heinz-Gerd , Harendt Christine , Hutter Franz , Nicke Markus , Schmidt Uwe , Schubert Markus , Sterzel Juergen
Published: October 2008

A 664 x 664 element Active Pixel image Sensor (APS) with integrated analog signal processing, full frame synchronous shutter and random access for applications in star sensors is presented and discussed. A thick vertical diode array in Thin Film on CMOS (TFC) technology is explored to achieve radiation hardness and maximum fill factor.
At the interface of phylogenetics and population genetics, the phylogeography of Dirca occidentalis (Thymelaeaceae)
Authors: Graves William R. , Schrader James A.
Published: October 2008

Dirca occidentalis is a rare shrub indigenous to only six counties near the San Francisco Bay in California, United States. We used intersimple sequence repeat (ISSR) markers and automated genotyping to probe 29 colonies of D. occidentalis from four geographically disjunct populations (East Bay, North Bay, Salmon Creek, and Peninsula) and used methods of phylogenetics and population genetics to model variation across the species. Results show that the four disjunct populations are genetically isolated and have undergone divergence. Phylogenetic analyses indicate that the East Bay population was the first to diverge, followed by the North Bay, then the Salmon Creek and Peninsula populations. This order of divergence suggests an intriguing natural history for D. occidentalis that is explained by the dynamic geological and climatic history of the Bay Area. Spatial genetic structure detected for the species suggests an interaction of four factors: limited seed dispersal, clonal regeneration, distances traveled by pollinators, and genetic isolation of the four populations. Genetic diversity within the North Bay and Salmon Creek populations is low, indicating poor ecological fitness and risk of decline. ISSRs resolved phylogeographic structure within D. occidentalis, results unattainable with ITS methods, and the integration of tools of phylogenetics and population biology led to an enhanced understanding of this endemic species.
Silica supported single‐walled carbon nanotubes as a modifier in polyethylene composites
Authors: McDaniel Neal D. , McDaniel Max P. , Balzano Leandro , Resasco Daniel E.
Published: October 2008

Composites have been made from single‐wall carbon nanotubes in a polyethylene (PE) matrix, in which different methods of preparation were used to disperse the nanotubes. The study includes using either the refined pure nanotubes (P‐NT) as the source, or the original silica supported nanotubes (SS‐NT). SS‐NT contained nanotubes still incorporated in and around the silica as originally grown. Composites were then made by (1) coprecipitation from a suspension of P‐NT or SS‐NT in a PE solution, or (2) by forming a polymerization catalyst from the SS‐NT, and using it to polymerize ethylene, which ruptures and expands the silica as polymer builds up in the pores. Extrusion was also studied as a method of additional dispersion. Nanotubes were found to have a powerful effect on the melt rheology, increasing the low shear viscosity dramatically. Increasing the nanotube concentration also increased the flexural and tensile moduli, decreased the elongation, and increased the electrical conductivity. Consistent trends were observed from all of these diverse properties: SS‐NT had a stronger effect than P‐NT, and within the SS‐NT group the choice of silica type also had a major effect. Polymerization was generally preferred as the method of dispersing the nanotubes. The conductivity, which in some cases was quite high, was found to be pressure sensitive. Conductive NT/PE composites could be molded into films or extruded into other shapes, or comolded with other PE. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2009
Density Functional Studies on Thromboxane Biosynthesis: Mechanism and Role of the Heme‐Thiolate System
Authors: Yanai Tetsuya K. , Mori Seiji
Published: October 2008

Reaction mechanisms for the isomerization of prostaglandin H2to thromboxane A2, and degradation to 12‐L‐hydroxy‐5,8,10‐heptadecatrienoic acid (HHT) and malondialdehyde (MDA), catalyzed by thromboxane synthase, were investigated using the unrestricted Becke‐three‐parameter plus Lee–Yang–Parr (UB3LYP) density functional level theory. In addition to the reaction pathway through FeIV‐porphyrin intermediates, a new reaction pathway through FeIII‐porphyrin π‐cation radical intermediates was found. Both reactions proceed with the homolytic cleavage of endoperoxide OO to give an alkoxy radical. This intermediate converts into an allyl radical intermediate by a CC homolytic cleavage, followed by the formation of thromboxane A2having a 6‐membered ring through a one electron transfer, or the degradation into HHT and MDA. The proposed mechanism shows that an iron(III)‐containing system having electron acceptor ability is essential for the 6‐membered ring formation leading to thromboxane A2. Our results suggest that the step of the endoperoxide OO homolytic bond cleavage has the highest activation energy following the binding of prostaglandin H2to thromboxane synthase.
Kinetic Evidence for the Influence of Subsurface Oxygen on Palladium Surfaces Towards CO Oxidation at High Temperatures
Authors: Gopinath Chinnakonda S. , Thirunavukkarasu Kandasamy , Nagarajan Sankaranarayanan
Published: October 2008

Transient state kinetics of the catalytic oxidation of CO with O2 on Pd‐surfaces has been measured under isothermal conditions by using a molecular beam approach. Systematic studies were carried out as a function of reaction temperature and CO+O2 composition. With sufficient kinetic evidence, we have demonstrated the positive influence of subsurface oxygen towards CO‐adsorption and oxidation to CO2 at high temperatures (600–900 K) on Pd‐surfaces, and the likely electronic nature of the surface changes with oxygen in the subsurface. These studies also provide a direct proof for CO‐adsorption with a significantly reactive sticking coefficient at high temperatures on Pd‐surfaces exhibiting a significant subsurface O‐coverage.
Randomized clinical trial of botulinum toxin injection for pain relief in patients with thrombosed external haemorrhoids
Authors: Patti R , Arcara M , Bonventre S , Sammartano S , Sparacello M , Vitello G , Di Vita G
Published: October 2008

Background

Thrombosed external haemorrhoids are one of the most frequent anorectal emergencies. They are associated with swelling and intense pain. Internal sphincter hypertonicity plays a role in the aetiology of the pain. This study evaluated the efficacy and safety of an intrasphincteric injection of botulinum toxin for pain relief in patients with thrombosed external haemorrhoids.

Methods

Thirty patients with thrombosed external haemorrhoids who refused surgical operation were randomized into two groups. Patients received an intrasphincteric injection of either 0·6 ml saline or 0·6 ml of a solution containing 30 units botulinum toxin. Anorectal manometry was performed before treatment and 5 days afterwards.

Results

After 5 days of treatment, the maximum resting pressure fell in both groups, but was significantly lower in the botulinum toxin group (P = 0·004). Pain intensity was significantly reduced within 24 h of botulinum toxin treatment (P < 0·001), but only after 1 week in the placebo group (P = 0·019).

Conclusion

A single injection of botulinum toxin into the anal sphincter seems to be effective in rapidly controlling the pain associated with thrombosed external haemorrhoids, and could represent an effective conservative treatment for this condition. Registration number: NCT00717782 (http://www.clinicaltrials.gov).
Case–control comparison of laparoscopic and open washout for peritoneal dialysis-associated peritonitis
Authors: Barlow A D , Yates P J , Hosgood S A , Nicholson M L
Published: October 2008

Background

Peritonitis is the major complication of peritoneal dialysis (PD). Some 25–40 per cent of patients require surgical intervention, traditionally laparotomy, washout and removal of the PD catheter. The aim was to compare this open procedure with laparoscopic washout and catheter removal.

Methods

In a case–control comparison, 20 patients who had laparoscopic washout for PD-associated peritonitis were matched by age and causative organism with 20 patients who had open washout.

Results

The groups were well matched for age, sex, causative organism, preoperative C-reactive protein level, white cell count and presence of bowel wall sclerosis. Laparoscopic surgery was quicker than open operation (mean(s.d.) 49(13) versus 73(30) min; P = 0·006) and postoperative morphine requirements were significantly lower (median 0 versus 27 mg; P < 0·001). Bowel function recovered more quickly in the laparoscopic group, as measured by time to first passage of flatus (mean(s.d.) 2(1) versus 5(4) days; P = 0·004) and resumption of free fluids (median 2 versus 4 days; P = 0·044). Reoperation rates and 30-day mortality were identical in the two groups.

Conclusion

This study suggests that laparoscopic washout for PD peritonitis is as effective as open washout, but is quicker and less painful with earlier return of bowel function.
Fast-track recovery programme after pancreatico- duodenectomy reduces delayed gastric emptying
Authors: Balzano G , Zerbi A , Braga M , Rocchetti S , Beneduce A A , Di Carlo V
Published: October 2008

Background

Data on enhanced recovery programmes after pancreatic surgery are sparse. This retrospective cohort study, using historical controls, aimed to evaluate the impact of a fast-track programme after pancreaticoduodenectomy (PD).

Methods

Between 2004 and 2007, 252 patients undergoing PD were treated by a fast-track programme that included earlier postoperative feeding and mobilization. The patients were compared with an equally sized control group that received a traditional programme from 2000 to 2004. Outcome measures were morbidity, length of stay and readmission rate.

Results

The rates of pancreatic fistula and other intra-abdominal complications were similar in the two groups. Delayed gastric emptying (DGE) was significantly reduced in the fast-track group (13·9 versus 24·6 per cent; P = 0·004). The independent effect of the fast-track protocol in reducing DGE was confirmed by the multiple regression analysis (adjusted odds ratio 0·477, P = 0·005). Length of stay was reduced with the fast-track protocol (median 13 versus 15 days; P < 0·001), without increasing the readmission rate (7·1 versus 6·3 per cent; P = 0·865).

Conclusion

A fast-track programme after PD improves gastric emptying and reduces postoperative stay.
Importance of extrasphincteric mechanisms in the pathophysiology of faecal incontinence in adults with a history of anorectal anomaly
Authors: Athanasakos E P , Ward H C , Williams N S , Scott S M
Published: October 2008

Background

Although surgery for congenital anorectal anomalies (ARAs) aims to preserve anorectal function, faecal incontinence and constipation often result. Apart from the anal sphincters, continence is dependent on multiple anatomical and physiological factors. The aim of this study was to evaluate adults with a history of ARA to determine the role of such factors in functional outcome.

Methods

The study included 20 consecutive adult patients with faecal incontinence who had undergone anorectal surgery as infants. Comprehensive testing included anal manometry, endoanal ultrasonography, tests of pudendal nerve function and rectal sensory function, evacuation proctography and colonic transit studies.

Results

Anal resting tone and squeeze increments were both attenuated in 15 of 19 patients. Integrity of the internal and external anal sphincters was compromised in 16 and 15 of 18 patients respectively. Eleven of 13 had evidence of pudendal neuropathy. Rectal sensation was abnormal in 14 of 18 patients, of whom ten were hypersensitive and four hyposensitive. Rectal evacuation was abnormal in nine of 14. Colonic transit was delayed in five of eight patients with constipation.

Conclusion

Faecal incontinence in adult patients with ARA is related to various pathophysiologies. Structural integrity of the anal sphincters is a major factor, but extrasphincteric mechanisms, notably rectal sensory function, may be as important.
Follow-up schedules after treatment for malignant melanoma
Authors: Francken A B , Accortt N A , Shaw H M , Colman M H , Wiener M , Soong S-J , Hoekstra H J , Thompson J F
Published: October 2008

Background

Existing follow-up guidelines after treatment for melanoma are based largely on dated literature and historical precedent. This study aimed to calculate recurrence rates and establish prognostic factors for recurrence to help redesign a follow-up schedule.

Methods

Data were retrieved from the Sydney Melanoma Unit database for all patients with a single primary melanoma and American Joint Committee on Cancer (AJCC) stage I–II disease, who had received their first treatment between 1959 and 2002. Recurrence rates, timing and survival were recorded by substage, and predictive factors were analysed.

Results

Recurrence occurred in 18·9 per cent (895 of 4748) of patients overall, 5·2 per cent (95 of 1822) of those with stage IA disease, 18·4 per cent (264 of 1436) with IB, 28·7 per cent (215 of 750) with IIA, 40·6 per cent (213 of 524) with IIB and 44·3 per cent (86 of 194) with IIC disease. Overall, the median disease-free survival time was 2·6 years, but there were marked differences between AJCC subgroups. Primary tumour thickness, ulceration and tumour mitotic rate were important predictors of recurrence.

Conclusion

A new follow-up schedule was proposed: stage I annually, stage IIA 6-monthly for 2 years and then annually, stage IIB–IIC 4-monthly for 2 years, 6-monthly in the third year and annually thereafter.
Development and validation of a model predictive of occult nipple involvement in women undergoing mastectomy
Authors: Rusby J E , Brachtel E F , Othus M , Michaelson J S , Koerner F C , Smith B L
Published: October 2008

Background

This prospective study aimed to build a predictive model using preoperative information to aid selection for nipple-sparing mastectomy.

Methods

Two hundred consecutive skin-sparing mastectomy specimens without overt nipple involvement were evaluated. Demographic, preoperative pathology and imaging information was collected. Nipple specimens (2 × 2 × 2 cm) were sectioned at 3-mm intervals. Haematoxylin and eosin-stained slides were examined by a breast pathologist for involvement by tumour. Logistic regression analyses of 65 therapeutic procedures identified factors associated with occult involvement and created a predictive model. This was tested on specimens from a further 65 therapeutic procedures.

Results

Occult nipple involvement was noted in 32 (24·6 per cent) of 130 mastectomy specimens. In the training set, imaging diameter of the lesion and its distance from the nipple predicted nipple involvement on univariable analysis (P = 0·011 and P = 0·014 respectively). The multivariable logistic regression model was validated in the test set. The areas under the receiver–operating characteristic curve were 0·824 and 0·709 for the training and test sets respectively.

Conclusion

Three-quarters of women undergoing mastectomy did not have occult nipple involvement. A clinical tool including tumour size and distance from the nipple has been developed to improve patient selection for nipple-sparing mastectomy.
Risk factors for malnutrition after oesophageal and cardia cancer surgery
Authors: Martin L , Jia C , Rouvelas I , Lagergren P
Published: October 2008

Background

Oesophageal cancer surgery is often followed by malnutrition, but the factors causing weight loss are unknown. The aim of this population-based study was to identify such risk factors.

Methods

Data were collected from a nationwide Swedish organization for research on surgery for oesophageal cancer. A total of 340 patients (75·9 per cent of those eligible) responded to a study-specific questionnaire concerning height and weight, just before and 6 months after surgery. Factors influencing malnutrition, defined as loss of body mass index of at least 15 per cent 6 months after operation, were identified by logistic regression.

Results

Neoadjuvant therapy (received by 10·6 per cent of all patients) and female sex were associated with at least a twofold increased risk of weight loss (odds ratio (OR) 2·41 (95 per cent confidence interval 1·01 to 5·77) and 2·14 (1·07 to 4·28) respectively), whereas preoperative weight loss was associated with a decreased risk (OR 0·13 (0·03 to 0·65)). Age, tumour stage and location, type of oesophageal substitute, suture technique and postoperative complications did not influence the risk.

Conclusion

Neoadjuvant therapy and female sex appear to be associated with an increased risk of malnutrition after oesophageal cancer surgery.
Meta-analysis of intravenous lidocaine and postoperative recovery after abdominal surgery
Authors: Marret E , Rolin M , Beaussier M , Bonnet F
Published: October 2008

Background

Continuous intravenous administration of lidocaine may decrease the duration of ileus and pain after abdominal surgery.

Methods

Three databases (Medline, Embase and the Cochrane Controlled Trials Register) were searched to retrieve randomized controlled trials comparing continuous intravenous lidocaine infusion during and after abdominal surgery with placebo. Study design was scored using the Oxford Quality Score based on randomization, double-blinding and follow-up. Outcome measures were duration of ileus, length of hospital stay, postoperative pain, and incidence of nausea and vomiting.

Results

Eight trials were selected. A total of 161 patients received intravenous lidocaine, with 159 controls. Intravenous lidocaine administration decreased the duration of ileus (weighted mean difference (WMD) − 8·36 h; P < 0·001), length of hospital stay (WMD − 0·84 days; P = 0·002), postoperative pain intensity at 24 h after operation on a 0–100-mm visual analogue scale (WMD − 5·93 mm; P = 0·002), and the incidence of nausea and vomiting (odds ratio 0·39; P = 0·006).

Conclusion

Continuous intravenous administration of lidocaine during and after abdominal surgery improves patient rehabilitation and shortens hospital stay.
Clinical and non-clinical factors influencing postoperative health-related quality of life in patients with colorectal cancer
Authors: Wilson T R , Alexander D J
Published: October 2008

Background

The aim was prospectively to evaluate health-related quality of life (HRQoL) after treatment of potentially curable colorectal cancer.

Methods

HRQoL measurements were acquired by postal questionnaire sent to 210 patients with colorectal cancer for whom there was at least of 1 year of follow-up. Data were collected at seven time points using two validated questionnaires, QLQ-C30/CR38 and Short Form 12. Scores from salient HRQoL domains were compared with population norms. The independent associations between HRQoL and 13 treatment and non-treatment variables were evaluated using linear regression. Recurrences were excluded.

Results

A total of 186 patients (88·6 per cent) were followed up for 1 year, with 136 (64·8 per cent) and 84 (40·0 per cent) reaching the 18-month and 2-year follow-up points respectively. HRQoL improved rapidly after surgery, with most scores equating to population norms by 3–6 months. In addition to baseline performance status, three factors were associated with significantly poorer HRQoL scores: age less than 65 years, low rectal anastomoses and presence of a stoma. The areas predominantly affected were normal daily routines, work and social activities.

Conclusion

HRQoL largely recovered by 6 months in disease-free patients, but some subgroups had poorer scores than others.
Bariatric surgery for metabolic disorders
Authors: Greve J W M , Rubino F
Published: October 2008

Help for diabetics
Improving the outcome of carotid endarterectomy
Authors: Gough M J
Published: October 2008

Little benefit from local anaesthesia
α,β‐Unsaturated and Saturated Derivatives of Be, Mg, and Ca: Are They Carbon or Metal Acids in the Gas Phase?
Authors: Eizaguirre Ane , Mó Otilia , Yáñez Manuel , Guillemin Jean‐Claude
Published: October 2008

The gas‐phase acidity of RXH (R=H, CH3, CH2CH3, CHCH2, CCH; X=Be, Mg, Ca) alkaline‐earth‐metal derivatives has been investigated through the use of high‐level CCSD(T) calculations by using a 6‐311+G(3df,2p) basis set. BeH2is a stronger acid than BH3and CH4for two concomitant reasons: 1) the dissociation energy of the BeH bond is smaller than the dissociation energies of the BH and CH bonds, and 2) the electron affinity of BeH.is larger in absolute value than those of BH2.and CH3.. The acidity also increases on going from BeH2to MgH2due to these two same factors. Quite importantly, despite the fact that the XH bonds in the RXH (X=Mg, Ca) derivatives exhibit the expected Xδ+Hδ−polarity, they behave as metal acids in the gas phase and only Be derivatives behave as carbon acids in the gas phase. The ethylberyllium hydride exhibits an unexpected high acidity compared with the methyl derivative because deprotonation of the system is accompanied by a cyclization that stabilizes the anion. Similarly to that found for derivatives that contain heteroatoms from groups 14, 15, and 16, the unsaturated compounds are stronger acids than the saturated counterparts, with the only exception of the Ca–vinyl derivative. Most importantly, among ethyl, vinyl, and ethynyl derivatives containing a heteroatom of the main group of the Periodic Table, those containing Be, Mg, and Ca are among the strongest gas‐phase acids.
Zur Pyrolyse feuchter Ölpalmschalen im indirekt beheizten Drehrohrreaktor
Authors: Gómez A. , Klose W. , Wiest W.
Published: October 2008

Die Palmölindustrie produziert zurzeit weltweit ca. 53 000 kt/a Restbiomasse, davon sind ca. 7500 kt/a Ölpalmschalen, das Endokarp der Ölpalmfrüchte. Hochkalorische feste, flüssige und gasförmige Brennstoffe sowie die Produktion von Adsorbentien können durch die thermochemische Umwandlung dieser Biomasse bereitgestellt werden. Die Pyrolyse feuchter Ölpalmschalen wird in einem indirekt beheizten Drehrohrreaktor unter besonderer Berücksichtigung der Einflüsse der Aufheizgeschwindigkeit und der Verweilzeit der Schüttung im Reaktor auf die Produktverteilung des Prozesses untersucht.
Progress in Hyperpolarized Ultrafast 2D NMR Spectroscopy
Authors: Mishkovsky Mor , Frydman Lucio
Published: October 2008

An important development in the field of NMR spectroscopy has been the advent of hyperpolarization approaches, capable of yielding nuclear spin states whose value exceeds by orders‐of‐magnitude what even the highest‐field spectrometers can afford under Boltzmann equilibrium. Included among these methods is an ex situ dynamic nuclear polarization (DNP) approach, which yields liquid‐phase samples possessing spin polarizations of up to 50 %. Although capable of providing an NMR sensitivity equivalent to the averaging of about 1 000 000 scans, this methodology is constrained to extract its “superspectrum” within a single—or at most a few—transients. This makes it a poor starting point for conventional 2D NMR acquisition experiments, which require a large number of scans that are identical to one another except for the increment of a certain t1 delay. It has been recently suggested that by merging this ex situ DNP approach with spatially encoded “ultrafast” methods, a suitable starting point could arise for the acquisition of 2D spectra on hyperpolarized liquids. Herein, we describe the experimental principles, potential features, and current limitations of such integration between the two methodologies. For a variety of small molecules, these new hyperpolarized ultrafast experiments can, for equivalent overall durations, provide heteronuclear correlation spectra at significantly lower concentrations than those currently achievable by conventional 2D NMR acquisitions. A variety of challenges still remain to be solved before bringing the full potential of this new integrated 2D NMR approach to fruition; these outstanding issues are discussed.
Comparison of therapeutic action, style and content in cognitive–behavioural and psychodynamic group therapy under clinically representative conditions
Authors: Watzke Birgit , Rueddel Heinz , Koch Uwe , Rudolph Matthias , Schulz Holger
Published: October 2008

It is still an open question whether psychotherapists adhere to their therapeutic conceptions in routine practice (clinician's treatment adherence) and thus to what extent the two most common approaches, cognitive–behavioural (CBT) and psychodynamic therapy (PDT), differ from each other as theoretically expected (treatment differentiation). This holds true especially in case of group therapy.

The study compares essential process components of CBT and PDT group treatments under clinically representative conditions using non‐participating observer ratings. Results demonstrate that CBT group therapists use more cognitive, behavioural and psychoeducational strategies, foster self‐efficacy to a larger extent and are more supporting and empathetic. PDT group therapists use more interpretative and confrontative interventions and focus on interactional and dynamic aspects. The results strongly support that not only in individual psychotherapy—as shown in prior research—but also in the group setting do CBT and PDT reveal very distinct profiles and that therapists primarily abide by their theoretical training also in clinical practice. They allow one to identify differential process components of the group setting and to trace back parameters of outcome to the process of CBT and PDT for clinical routines. Copyright © 2008 John Wiley & Sons, Ltd.
Hydraulic and geomorphic effects on mayfly drift in high‐gradient streams at moderate discharges
Authors: Wilcox Andrew C. , Peckarsky Barbara L. , Taylor Brad W. , Encalada Andrea C.
Published: October 2008

We investigated relationships between geomorphic and hydraulic factors and invertebrate drift in high‐gradient streams. We measured drift density of a highly mobile mayfly (Baetis bicaudatus) into and out of 12 stream reaches in western Colorado, as well as benthic density and abiotic variables within those reaches, during a time of moderate discharge. Multiple regression analysis indicated that drift propensity (drift density/benthic density), a measure of drift standardized by the benthic density of the source population, was significantly related to Reynolds number, a dimensionless ratio of fluid inertial forces to viscous forces, and Shields number, a dimensionless ratio of shear stress to submerged particle weight that quantifies flow competence. Drift propensity was positively correlated with Reynolds number, but counter to our hypothesis that stronger hydraulic forces would be associated with higher drift, mayflies in reaches with greater flow competence (Shields number) showed lower propensities to drift. Further, immigration ratio (drift in/drift out of each reach) increased significantly with Shields number, indicating that more individuals drifted into than out of reaches with higher flow competence. Although we hypothesized that more hydraulically rough stream reaches (i.e. those with greater flow resistance) would be more favourable to benthic invertebrates and would thus have lower drift, neither drift propensity nor immigration ratio were related to flow resistance. In high‐gradient streams at discharges below the range of incipient motion of bed particles, mayfly drift behaviour may be influenced by hydraulic forces, but the relationships we observed are not indicative of passive, abiotically driven drift. Copyright © 2008 John Wiley & Sons, Ltd.
Ligation of Bipyridyl Ligands to Metal 8‐Hydroxyquinolinates – Synthesis, Crystal Structures, and TDDFT Study
Authors: Yue Fan , Zhu Ai‐Xin , Zheng Shao‐Liang , Chen Xiao‐Ming
Published: October 2008

Binding of four bipyridyl ligands, 2,2′‐bipyridine (L1), 1,10‐phenanthroline (L2), 1,4,8,9‐tetraazatriphenylene (L3), and dipyrido[3,2‐a:2′,3′‐c]phenazine (L4) with Cdq2/Znq2 complexes (q = 8‐hydroxyquinoline) gave four neutral, mononuclear CdII/ZnII complexes, namely [Cdq2L1]·H2O·CH3OH (1), [Cdq2L3]·3H2O (2), [Cdq2L4]·2H2O (3), and [Znq2L4]·2CH3OH (4). These mixed‐ligand compounds were taken as models for investigating the interfacial effect at the electron‐transfer layer/light‐emitting layer junction in OLEDs by combination of X‐ray diffraction, fluorophotometric titration, cyclic voltammetry, and time‐dependent density functional theory (TDDFT) calculations. The results shows the formation of these compounds is favorable to energy transition on the contact surface. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2008)