bluuebunny/crossref_metadata_2025 huggingface dataset:
Anterior lesser curve seromyotomy with posterior truncal vagotomy versus proximal gastric vagotomy: Results of a prospective randomized trial 3–8 years after surgery
Authors: Walia H. S. , El‐Karim Hassan Abd
Published: October 2004

In a prospective randomized trial, anterior lesser curve seromytomy with posterior truncal vagotomy (ASPTV,n=50) was compared with proximal gastric vagotomy (PGV,n=50). Most of our patients were young men with ASA grade I risk, and 80% were expatriates. They were followed up for 3 to 8 years after surgery. The mean reductions of basal acid output (BAO) and insulin‐stimulated peak acid output (IPAO) were 85% and 88%, respectively, soon after surgery for both ASPTV and PGV groups. These values remained at 70% and 60% of their preoperative level for 1 year. Good to excellent results (Visick I and II) were recorded in 76% of cases in both groups. The recurrent ulcer rate was 14% for PGV and 12% for ASPTV. This trial suggests that for the treatment of duodenal ulcer ASPTV is as good an operation as PGV.
Endoscopic injection sclerotherapy for esophageal varices in the elderly
Authors: Ohta Masayuki , Hashizume Makoto , Kamakura Tatsuro , Ueno Kiichiro , Tomikawa Morimasa , Tanoue Kazuo , Kitano Seigo , Sugimachi Keizo
Published: October 2004

A group of 1127 patients who underwent sclerotherapy for esophageal varices were compared for outcome in terms of age: over and ander age 70 years. Esophageal varices were completely eradicated in 81 of 110 patients >70 years (73.6%) and in 791 of 1017 patients <70 years (77.8%). Gastrointestinal bleeding after sclerotherapy occurred in 9 patients >70 years (8.2%) and in 84 of those <70 years (8.3%). Complications occurred in 16 patients >70 years (14.5%) and in 141 <70 years (13.9%). Liver failure and hepatoma accounted for more than 80% of the causes of death in both groups (80.3% versus 83.8%). The 5‐year cumulative survival rates in patients with bleeding esophageal varices (bleeders) without hepatoma were 21.8% in those >70 years and 58.7% in those <70 years (p<0.01), the relative survivals being 25.3% versus 66.6%. Patients without hepatoma and treated by prophylactic sclerotherapy accounted for 66.2% of patients >70 years and 61.7% of those <70 years, the relative survivals being 75.9% versus 71.9%. As analyzed by the Cox proportional‐hazards model, age >70 years was a prognostic factor in the bleeders (p<0.01) but not in the nonbleeders. We recommend that elderly patients with esophageal varices be given prophylactic sclerotherapy, as the outcome for these patients is poor once bleeding has occurred.
Clinicopathological study on carcinoma of the extrahepatic bile duct with special focus on cancer invasion on the surgical margins
Authors: Ogura Yoshifumi , Takahashi Koji , Tabata Masami , Mizumoto Ryuji
Published: October 2004

To clarify the clinical significance of the status of surgical margins, especially the dissected margin in the transverse direction, a clinicopathologic study was performed on 60 patients with carcinoma of the bile duct who underwent radical resection. The patients in group A (n=28) had no cancer invasion within 5 mm of the dissected margiu in the transverse direction. They had a higher incidence of the well differentiated type of carcinoma and a lower incidence of lymph node metastasis and microscopic tumor extension than the patients in group B. Group B (n=32) included patients with cancer involvement within 5 mm of the dissected margin in the transverse direction. Some group A patients were found to have advanced carcinoma of the lower bile duct, but they were the only ones whose lesions were at an early stage (e.g., lesion restricted to subserosal involvement or less) among those with carcinoma of the hepatic duct and the upper and middle bile ducts. Local recurrence was found to occur more frequently as the tumor approached the liver, and the incidence of local recurrence was significantly higher in patients in group B than in group A (75.0% versus 28.5%). These results indicate that patients with cancer invasion within 5 mm of the surgical margin develop early recurrence of tumor even after conventional radical resection and that further radical dissection of the hepatoduodenal ligament with hepatectomy or pancreatoduodenectomy may be required to improve survival for these cases.
Current status and future possibilities of transjugular intrahepatic portosystemic shunts in the management of portal hypertension
Authors: Radosevich Paul M. , LaBerge Jeanne M. , Gordon Roy L.
Published: October 2004

Transjugular intrahepatic portosystemic shunt (TIPS) is an exciting new method for treating complications of cirrhosis. Technical advances have allowed TIPS to be widely applied in the treatment of variceal bleeding. This article presents and discusses the results of recent experiences in TIPS placement. TIPS can be successfully placed in almost all patients. The complication rate of the procedure is low. TIPS is an effective means of controlling variceal bleeding and is especially useful for controlling bleeding in patients awaiting liver transplantation. It may also have a role in the treatment of ascites and other conditions related to portal hypertension. The most important issue facing TIPS is the long‐term patency of the shunt. Potential solutions to the problem of long‐term shunt patency are discussed.
Squamous cell carcinoma of the esophagus: Therapeutic dilemma
Authors: Altorki Nasser K. , Girardi Leonard , Skinner David B.
Published: October 2004

Seventy‐five patients with squamous cell carcinoma of the esophagus were evaluated over a 5‐year period. Most of the patients had advanced‐stage cancer when first seen. Only 50% were surgically explored, and 33% underwent resection. Operative mortality was 8%. Despite the immediate and durable palliation provided by surgical resection, survival rates were poor. Early diagnosis and aggressive surgical resection are the main hopes for improved long‐term results.
Esophageal squamous cell carcinoma: Pathology and prognosis
Authors: Ide Hiroko , Nakamura Tsutomu , Hayashi Kazuhiko , Endo Takeshi , Kobayashi Ataru , Eguchi Reiki , Hanyu Fujio
Published: October 2004

Between 1985 and 1992 a total of 403 patients with resected thoracic esophageal squamous cell carcinoma were evaluated histopathologically, and various pathologic findings related to survival were examined. Concerning depth of tumor invasion, 8 (2%) cases were pTis, 110 (27%) were pT1, 48 (12%) were pT2, 202 (50%) were pT3, and 35 (9%) were pT4. Lymphatic invasion was detected in 299 cases (74%), blood vessel invasion in 200 cases (49%), intramural metastasis in 45 (11%), and lymph node metastasis in 232 (58%). In pT1 carcinoma cases, 4% of mucosal carcinomas and 30% of submucosal carcinomas had lymph node metastasis. Tumors with deeper invasion had a higher incidence of lymph node metastasis: 74% of pT3 carcinomas and 83% of pT4 carcinomas. The sites of lymph node metastasis were divided into mediastinal, cervical, and abdominal fields; and rates of lymph node metastasis were 49%, 14%, and 41%, respectively. In all resected cases, the operative mortality rate was 3.2%, and the overall 5‐year survival rate was 44.8%. The 5‐year survival rate of patients with curative resection (R0and R1) was 49.5%, whereas patients with palliative resection (R2) did not survive more than 3 years. There was no significant difference in survival relative to tumor location. In curatively resected cases, the significant prognostic factors by multivariate analysis were pT category, vascular invasion, lymph node metastasis, and intramural metastasis. Prognosis of lymph node‐positive cases did not depend on the positive node site. Patients with only one positive node had a better prognosis, and those with six or more positive nodes had a poor prognosis. Concerning lymph node metastasis, other factors that worsened prognosis were a positive node larger than 1 cm, two‐ to three‐field metastasis, and positive cervical nodes in cases of lower‐third esophageal carcinoma.
Risk analysis in resection of squamous cell carcinoma of the esophagus
Authors: Law Simon Y. K. , Fok Manson , Wong John
Published: October 2004

A study of risk factors that affect morbidity and mortality in 523 patients with squamous cell cancer of the esophagus who had one‐stage resection was undertaken. The 30‐day and hospital mortality rates were 5.0% and 15.5%, respectively. Pulmonary complications, malignant cachexia, and surgical complications accounted for 42%, 25%, and 21% of hospital deaths, respectively. Major pulmonary complications occurred in 23% of patients. Multivariate analysis identified six factors that predicted major pulmonary complications: age, mid‐arm circumference, percent of predicted FEV1, abnormal chest radiograph, amount of blood loss, and palliative resection. Three risk groups of pulmonary complications were identified: low, median, and high risk group with complications in 3%, 17%, and 43% of patients, respectively. Significantly, patients with curative resection had a lower hospital mortality rate (9%) than those with palliative resection (20%), p=0.001. Patients with stage I, IIa, or IIb disease had a lower hospital mortality rate (9%) than those with stage III or IV disease (18%), p=0.026. Multivariate analysis identified six factors that predicted hospital death: age, mid‐arm circumference, history of smoking, incentive spirometry, number of stairs climbed, and amount of blood loss. Three risk groups of hospital death were identified: low, median, and high risk groups with death in 7%, 30%, and 38%, respectively. Anastomotic leakage rate was 4%. Technical faults were identified in 53% of patients with leakage. Together with other surgical complications, a presumed or apparent technical error was noted in 63% of patients. The identification of high‐risk patients and prevention of technical faults can help improve surgical outcome.
Operable esophageal carcinoma: Current results from Hong Kong
Authors: Fok Manson , Law Simon Y. K. , Wong John
Published: October 2004

Over an 11‐year period 1158 patients with esophageal cancers were managed by the Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 857 (74.0%) of whom had confirmed squamous cell carcinoma. Operation was carried out in 76.5% of patients: 25.4% underwent curative resection, 36.2% underwent palliative resection, 13.8% had bypass operations, and 1.2% had a simple exploration. In the resection group, the mean age was 62.6 years with a strong male predominance of 6.4:1.0. Most patients were heavy smokers and heavy drinkers; 27.9% had increased pulmonary risks, and 8.3% had increased cardiac risks for resection. Most (56%) of the tumors were located in the middle third of the esophagus; 70.4% of patients had operative stage III disease, and 7.2% had stage IV disease. The 30‐day mortality and hospital mortality after resection were 4.9% and 15.9%, respectively. The primary cause of 30‐day mortality was cardiopulmonary‐related complications (65.2%), and the commonest causes for hospital deaths were from pulmonary complications (40.0%) and advancing malignancy (23.6%). The median survivals for stages I, IIA, IIB, III, and IV were 83.5, 24.3, 37.8, 8.6, and 5.0 months, respectively. Of the survivors, at 1, 6, and 12 postoperative months, respectively, 63%, 76%, and 83% of patients were able to take a full solid meal similar to the normal diet consumed before their disease.
Anastomosis
Authors: Bardini Romeo , Asolati Massimo , Ruol Alberto , Bonavina Luigi , Baseggio Serena , Peracchia Alberto
Published: October 2004

Esophageal anastomosis is still associated with a high rate of complications even though they have decreased considerably in recent years. Anastomotic leaks are more frequent in the neck than in the chest, and related mortality rate is not different. The leakage incidence does not depend on suture materials or on technical modalities used to perform the anastomosis. In fact, there is no difference between the leakage rate when comparing manual and mechanical anastomoses. The leak incidence after both mechanical and manual anastomoses is much higher in collective reviews than in reports coming from leading centers. “Frequent” esophageal surgeons can learn from their previous experience and therefore avoid technical errors, whereas “casual” esophageal surgeons do not have this opportunity. Performing an esophageal anastomosis is a technical matter, and suture healing is independent of the patient's biologic situation. Anastomotic fibrotic stricutures are frequent after both manual and mechanical anastomoses, and most can be avoided by meticulous suturing technique.
Adjuvant therapies for cancer of the thoracic esophagus
Authors: Nishihira Tetsuro , Nakano Tatsuya , Mori Shozo
Published: October 2004

During the past four decades, especially in recent years, various active adjuvant therapies combined with surgery have improved the outcome in cases of cancer of the esophagus. However, no optimum adjuvant therapy has been determined. From 1981 to 1992, 341 patients with regional and distant node metastasis who underwent curative surgery were treated with postoperative radiotherapy (RT), postoperative radiochemotherapy (RC), and postoperative aggressive chemotherapy (AGC) in a controlled study in our department of surgery. Five‐year survival rates, including operative deaths and unrelated diseases of the former group, were 0% for RT, 19.9% for surgery alone, 39.8% for RC, and 48.2% for AGC. Such rates for the latter group were 6.8% for AGC, 13.3% for surgery alone, and 33.3% for RC. In addition, results of a group study on the effectiveness of three‐field node dissection in 715 cases of thoracic esophageal carcinoma by 10 institutions were analyzed. This analysis showed that there were no differences in the 5‐year survival rate of curative surgery in cases with positive nodes among the groups treated with surgery alone (SA), with postoperative radiotherapy (PR), and with postoperative chemotherapy (PC). As to the 91 cases with positive cervical nodes, the 3‐year survival rates in cases treated with SA (n=22), PR(n=20), and PC (n=49) were 25.3%, 48.1%, and 53.6%, respectively; a significant improvement of survival in these patients. Summaries of studies of preoperative or postoperative radiotherapy, and both multimodal therapies are introduced.
Outcome of peptic ulcer hemorrhage treated according to a defined approach
Authors: Mueller Xavier , Rothenbuehler Jean‐Marc , Amery Anthony , Meyer Beat , Harder Felix
Published: October 2004

The short‐ and long‐term bleeding recurrence and mortality of 157 consecutive patients admitted emergently over a period of 2 years with in actively bleeding peptic ulcer were analyzed. They were treated uniformly according to a defined approach where suitable candidates for surgery were operated on early. The data of the 5‐year follow‐up were analyzed by constructing life tables. There were 94 men and 63 women with a median age of 72.3 years; 83 ulcers were gastric and 74 duodenal. Thirty‐one patients underwent an operation. Eleven patients (7%) died within the first month, one in the surgical group. During the follow‐up 13 patients rebled and 54 died, two of the deaths related to peptic ulcer disease. The life table for rebleeding and ulcer‐related deaths showed a cumulative risk of 11.8% at 5 years, and the cumulative risk was not statistically different between patients according to their age (60 years and older versus younger), sex, the site of their ulcer (gastric versus duodenal), or the type of treatment (conservative versus surgical). With a well defined approach and early selective surgery, the short‐term mortality compares favorably with the usual 10% or more reported. The high mortality rate during the follow‐up reflects the advanced age of patients with coexisting disease. This long‐term follow‐up study could be used as a comparison against future studies evaluating new therapies.
Prospective nonrandomized study of conventional versus laparoscopic appendectomy
Authors: Reiertsen Ola , Trondsen Erik , Bakka Arne , Andersen Ove K. , Larsen Stig , Rosseland Arne R.
Published: October 2004

With the introduction of laparsocopic appendectomy a prospective study was started. Patients with suspected appendicitis were selected for conventional appendectomy or laparoscopy according to the preference of the surgeon on call. During a 1‐year period 233 patients were included, of whom 97 underwent conventional appendectomy and 136 laparoscopy. Among the patients selected to lasparoscopy, laparoscopic appendectomy was carried out in 72 cases, conventional appendectomy in 32, and only diagnostic laparoscopy in the remaining 32. Removal of a normal appendix was significantly more common in the group of patients directly selected for conventional appendectomy compared to laparoscopy (p<0.01). The duration of the operation was shorter (p<0.05) and the postoperative hospital stay and the convalescence longer (p<0.05) with conventional than with laparoscopic appendectomy. Peroperative problems and minor postoperative complications were more common (p<0.01) with laparoscopic than conventional appendectomy. However, the clinical impact of these problems were limited. The difference between the procedures regarding major complications was not significant. Laparoscopic appendectomy seems to be at least as good as conventional appendectomy. However, randomized controlled trials are needed to decide which of the procedures to recommend.
DNA ploidy and biologic aggressiveness of gastric adenocarcinoma in Chinese
Authors: Shen Kuo‐Liang , Chu Chi‐Hong
Published: October 2004

The mortality rate of gastric cancer in the Chinese population has reached a plateau. The main prognostic factor for gastric adenocarcinoma is recognized as tumor stage. Recently, abnormalities in DNA content have been considered as a new prognostic factor. Whether abnormal DNA content can be used as a prognostic tool for Chinese patients with gastric cancer is unknown. To investigate this relation DNA ploidy and prognosis of gastric cancer patients were studied using paraffin‐embedded specimens. A group of 104 newly diagnosed and surgically resected gastric cancer specimens obtained from January 1984 to December 1986 were examined for DNA content by flow cytometry. The quality of flow cytometry was acceptable with a mean coefficient of variance of 5.45. The results showed that 38 cases (36.5%) had DNA aneuploidy; 42 cases had metastatic lymph nodes with enough tumor cells, and 31.0% of these cases had DNA aneuploidy. DNA aneuploidy of primary tumors was correlated to lymph node metastasis and patient's age, whereas DNA aneuploidy of metastatic lymph nodes was significantly correlated to the serosal invasion of the gastric wall at the primary site. The important parameters for prognosis were curability of surgical resection, serosal invasion, tumor size, and distant metastasis. DNA aneuploidy of both primary tumors or metastatic lymph nodes appeared to be unrelated to the prognosis of gastric adenocarcinoma in Chinese patients. We therefore propose that DNA aneuploidy of gastric cancer is associated with tumor growth but not biologic aggressiveness.
Symmetry properties for the extremals of the Sobolev trace embedding
Authors: Fernández Bonder Julian , Lami Dozo Enrique , Rossi Julio D.
Published: October 2004

In this article we study symmetry properties of the extremals for the Sobolev trace embedding

H^1(B(0,μ))↪L^q(∂B(0,μ))

with

1⩽q⩽2(N−1)/(N−2)

for different values of

μ

. These extremals

u

are solutions of the problem

\begin{cases}
\Delta u = u & \text{in } B(0,\mu ), \\
\frac{\partial u}{\partial \eta } = \lambda \left|u\right|^{q - 2_{u}} & \text{on }\partial B(0,\mu ).
\end{cases}

We find that, for

1⩽q<2(N−1)/(N−2)

, there exists a unique normalized extremal

u

, which is positive and has to be radial, for

μ

small enough. For the critical case,

q=2(N−1)/(N−2)

, as a consequence of the symmetry properties for small balls, we conclude the existence of radial extremals. Finally, for

1<q⩽2

, we show that a radial extremal exists for every ball.

Dans cet article nous étudions des propriétés de symétrie des extrémales de l’immersion de Sobolev

H^1(B(0,μ))↪L^q(∂B(0,μ))

, où

1⩽q⩽2(N−1)/(N−2)

en fonction du rayon

μ

. Ces extrémales sont solutions du problème

\begin{cases}
\Delta u = u & \text{dans } B(0,\mu ), \\
\frac{\partial u}{\partial \eta } = \lambda \left|u\right|^{q - 2_{u}} & \text{sur }\partial B(0,\mu ).
\end{cases}

Nous trouvons que, pour

1⩽q<2(N−1)/(N−2)

, il existe une extrémale normalisée unique

u

, qui est positive et radiale, pour

μ

suffisamment petite. Dans le cas critique

q=2(N−1)/(N−2)

, comme conséquence des propriétés de symétrie pour des petits rayons, nous déduisons l’existence d’extrémales. Finalement, pour

1<q⩽2

, nous montrons qu’une extrémale radiale existe pour toute boule.
Hydrostatic Stokes equations with non-smooth data for mixed boundary conditions
Authors: Guillén-González F. , Rodrı́guez-Bellido M.A. , Rojas-Medar M.A.
Published: October 2004

The main subject of this work is to study the concept of very weak solution for the hydrostatic Stokes system with mixed boundary conditions (non-smooth Neumann conditions on the rigid surface and homogeneous Dirichlet conditions elsewhere on the boundary). In the Stokes framework, this concept has been studied by Conca [Rev. Mat. Apl. 10 (1989)] imposing non-smooth Dirichlet boundary conditions.

In this paper, we introduce the dual problem that turns out to be a hydrostatic Stokes system with non-free divergence condition. First, we obtain strong regularity for this dual problem (which can be viewed as a generalisation of the regularity results for the hydrostatic Stokes system with free divergence condition obtained by Ziane [Appl. Anal. 58 (1995)]). Afterwards, we prove existence and uniqueness of very weak solution for the (primal) problem.

As a consequence of this result, the existence of strong solution for the non-stationary hydrostatic Navier-Stokes equations is proved, weakening the hypothesis over the time derivative of the wind stress tensor imposed by Guillén-González, Masmoudi and Rodrı́guez-Bellido [Differential Integral Equations 50 (2001)].

Le but principal de ce travail est d’étudier le concept de solution très faible pour le système de Stokes hydrostatique avec conditions aux limites mixtes (condition de Neumann non régulière sur la surface rigide et condition de Dirichlet homogène dans le reste). Dans le cas du problème de Stokes, ce sujet a été étudié par Conca [Rev. Mat. Apl. 10 (1989)] en imposant une condition aux limites de Dirichlet non homogène et peu régulière.

Dans ce papier, on introduit le problème dual qui est aussi un système de Stokes hydrostatique mais avec une condition de divergence non nulle. D’abord, on obtient la régularité forte pour le problème dual (ce résultat peut être consideré comme une généralisation des résultats de régularité pour le système de Stokes hydrostatique avec la condition de divergence nulle, obtenus par Ziane [Appl. Anal. 58 (1995)]). On montre ensuite l’existence et unicité de solution très faible pour le problème primal.

Comme conséquence de ce résultat, on montre l’existence de solution forte pour le problème de Navier-Stokes hydrostatique non-stationnaire, avec une hypothèse sur la dérivée par rapport au temps du tenseur du vent plus faible que celle qui était imposée par Guillén-González, Masmoudi et Rodrı́guez-Bellido [Differential Integral Equations 50 (2001)].
Characterization and representation of the lower semicontinuous envelope of the elastica functional
Authors: Bellettini G. , Mugnai L.
Published: October 2004

We characterize the lower semicontinuous envelope

\overline{\mathcal F}

of the functional

{\mathcal F}(E):=\int_{\partial E}[1+|κ_{∂E}|^p] d{\mathcal H}^1

, defined on boundaries of sets

E\subset ℝ^2

, where

κ_{∂E}

denotes the curvature of

∂E

and

p>1

. Through a desingularization procedure, we find the domain of

\overline{\mathcal F}

and its expression, by means of different representation formulas.

On caractérise l’enveloppe semi-continue inférieure

\overline{\mathcal F}

de la fonctionnelle

\mathcal F(E):=\int_{∂E}[1+|κ_{∂E}|^p] d\mathcal H^1

, définie sur la classe des frontières des domaines

E\subset ℝ^2

, où

κ_{∂E}

dénote la courbure de

∂E

et

p>1

. Grâce à une méthode de désingularisation, on trouve le domaine de

\overline{\mathcal F}

et son expression, à l’aide de différentes formules de représentation.
Cloning and functional expression of invertebrate connexins from Halocynthia pyriformis
Authors: White Thomas W. , Wang Huan , Mui Rickie , Litteral Jennifer , Brink Peter R.
Published: October 2004

Unlike many other ion channels, unrelated gene families encode gap junctions in different animal phyla. Connexin and pannexin genes are found in deuterostomes, while protostomal species use innexin genes. Connexins are often described as vertebrate genes, despite the existence of invertebrate deuterostomes. We have cloned connexin sequences from an invertebrate chordate, Halocynthia pyriformis. Invertebrate connexins shared 25–40% sequence identity with human connexins, had extracellular domains containing six invariant cysteine residues, coding regions that were interrupted by introns, and formed functional channels in vitro. These data show that gap junction channels based on connexins are present in animals that predate vertebrate evolution.
Amyloid aggregates of the prion peptide PrP106–126 are destabilised by oxidation and by the action of dendrimers
Authors: Heegaard Peter M.H. , Pedersen Heidi Gertz , Flink James , Boas Ulrik
Published: October 2004

The prion protein (PrP) peptide 106–126 forms amyloid aggregates in vitro and this sequence is speculated to be involved in the formation of amyloid fibrils by the abnormally folded PrP protein (PrPSc) found in spongiform encephalopathies. It is shown here by incubation experiments in water using Thioflavin T (ThT) as a fluorescent probe for amyloid formation that changes in C‐terminal charge, oxidation state and conformational stabilisation lead to large changes in amyloid forming behaviour (amyloidogenicity) of this peptide. Amyloid formation is favoured by a charged C‐terminus and is strongly inhibited by oxidation. Furthermore, cationic dendrimers are shown to perturb peptide fibrillation in a process dependent on the nature of the charged groups on the dendrimer surface.
What do doctors think their caseload should be to maintain their skills for delivery care?
Authors: Scotland G.S. , Bullough C.H.W.
Published: October 2004

Objectives: To seek the opinions of doctors on what they thought the minimum, maximum and optimum annual caseload should be for the maintenance of skills and competence in a variety of obstetric procedures. Methods: An expert panel of respondents from Africa and Asia was asked to give their opinions on what they believed the minimum, maximum and optimum caseload should be for 11 obstetric procedures via a series of structured questionnaires (Delphi exercise). In subsequent questionnaires, participants were asked if they wished to reconsider their opinions in light of the group response. Results: The median values of responses given for the minimum, maximum and optimum caseloads for the 11 obstetric procedures did not change substantially over time, though greater consensus was developed as indicated by reductions in the size of inter‐quartile ranges in later rounds. Conclusions: We encountered several problems associated with using the Delphi technique in this context, which throws doubt on the validity and usefulness of our results. Caseload is just one of many factors, as indicated by our expert panel that need to be considered when planning the delivery of obstetric services in remote areas. High quality training, continued medical education, appropriate quality assurance procedures, and provision of a supportive enabling environment are also important requirements. In addition, the views of clinicians need to be balanced against more objective evidence of quality of care and patient outcome in relation to procedural volume. Such evidence is lacking in the field of obstetrics and requires further investigation.
Self-Administered Hand Symptom Diagram for Carpal Tunnel Syndrome Diagnosis
Authors: SHARMA V. , WILDER-SMITH E. P.
Published: October 2004

In a prospective case series in Singapore we studied whether a hand symptom diagram can be used to predict carpal tunnel syndrome as defined by standardized clinical and neurophysiological protocol. Forty patients (mean age, 48 years, range 18–76) with carpal tunnel syndrome found it difficult to complete the hand diagram, and only four patients were able to mark it helpfully. There was no relation between drawings, clinical and neurophysiological parameters. A self-administered hand symptoms diagram is not useful for supporting a diagnosis of carpal tunnel syndrome amongst Singaporeans. Cultural factors may significantly influence subjective assessment scales such as the self-administered hand symptom diagram, which has been found effective in North American populations.
THE CURIOUS HISTORICAL DETERMINISM OF RANDALL COLLINS
Authors: MISZTAL BARBARA , FREUNDLIEB DIETER
Published: October 2004

Randall Collins' The Sociology of Philosophies: A Global Theory of Intellectual Change (1998) examines and compares communities of intellectuals linked as networks in ancient and medieval China and India, medieval and modern Japan, ancient Greece, medieval Islam and Judaism, medieval Christendom and modern Europe. The book has been the subject of many interesting and often positive reflections (for example, European Journal of Social Theory 3 (I), 2000; Review Symposium or reviews in Sociological Theory 19 (I), March 2001). However, it has also attracted a number of critical reviews (for example, reviews in Philosophy of the Social Sciences 30 (2), June 2000). Since not many books achieve such notoriety, it is worthwhile to rethink Collins' controversial approach. The aim of this paper is to encourage further debates of notions and issues presented in Collins' book. We would like, by joining two voices—sociologist and philosopher—to reopen discussion of Collins' attempt to discover a universality of patterns of intellectual change, as we think that more interpretative rather than explanatory versions of our respective disciplines can enrich our understanding of blueprints of intellectual creativity.
TAXES AND JUSTICE
Authors: KOLM SERGE-CHRISTOPHE
Published: October 2004

A RATHER dim recollection of Thomas Nagel's books over the decades leaves the impression of an extraordinarily perceptive and deep thought, straightforwardly revealing the essentials of the topic, yet remaining at a high level of abstraction and generality. We now have, on this latter aspect, exactly the opposite, since the topic is the taxes you pay, while keeping the former virtue in focussing on the basic divide of normative politics. Here, indeed, two outstanding philosophical minds stoop over one of the most mundane of issues, the rightfulness of taxation. Economists, politicians, lawyers and laymen will all be delighted about this new dimension of the debate. This issue—let us recall—is of some importance since the public sector commonly consumes about half of national products.
TOCQUEVILLE IN THE POLITICAL ARENA ACTOR OR ANALYST?
Authors: BURRAGE MICHAEL
Published: October 2004

The blurbs on the jacket of this book are unusually misleading. A U.S. senator avers that it ‘conveys a sweep of historical analysis that gives us deep insight… into the American character’, and ‘sheds light on America's present and possible future as well as its past’. Since it contains virtually no historical or sociological evidence about the United States, it is hard to see how it might do this. One Harvard professor calls it ‘a major work of political theory’, and another ‘an enduring work of political theory in its own right’. But while the author conveys his disaffection with contemporary American democracy, he nowhere clearly and succinctly formulates anything that might reasonably be called a theory. A Johns Hopkins professor thinks that it ‘shows us how pertinent Tocqueville remains for democrats today’. Incidentally, it may perhaps do this, though this is hardly the author's intent, since he emphasizes the archaic and feudal quality of Tocqueville's final account of democracy.
REVOLUTIONARY MOVEMENTS IN COMPARATIVE PERSPECTIVE
Authors: DUNN JOHN
Published: October 2004

REVOLUTION entered modern politics in the form of a bold and ambitious political judgment, aimed both at grasping something momentous, which was unmistakably happening, and at gauging its limited susceptibility to intentional control. From the outset that judgment, and the term in which it was precariously embodied, picked out one key image: the necessitated and ineluctably hazardous resolution of a profound crisis within a particular society, which must and would transform through intense political and social struggle its forms of government and social organization, and very possibly also of economic life. Over time every element in that judgment has proved as vulnerable as it was always bound to be contentious. But for all its manifest exposure and inevitable provocation, for almost two centuries, it went a long way towards setting the agenda for modern politics the world over. The two most inflammatory elements in the judgment were clear from quite early on in the French Revolution. One was the sense of crisis as the working through of a clearly intelligible fatality. The other was the fond hope that, once compelled to begin, that crisis must in due course issue in a resolution of the acute strains which had occasioned it in the first place. Jeff Goodwin's title does not explicitly affirm either element; but it contrives to evoke both, and do so in their most politically insinuating form.
Spectral Secularism: Religion, Politics and Democracy in India
Authors: ASSAYAG JACKIE
Published: October 2004

Everyone invokes secularism in India. So the spectrum of secularism is very large. However, it is rather the spectral ideas of “majority” (hindus) and “minorities” (Muslims, Christians) conceived in demographic (rather than political) terms which characterizes the discussion of this question. The insistence of Hindu nationalists on emphasizing that they are the majority tend to blur the difference between Hindu identity and Indian identity, coextensive with the territory of India. This concept, moreover, serves them in their legitimating of the democratic system insofar as the arithmetical rule is a first principle of this political regime. In the name of a secularism founded on the idea of the greater number (and also the supposed ideal of immemorial Hindu tolerance) India must be governed in accordance with demographic fact defined in religious terms. One of the paradoxical consequence of this “majoritarianism” is the development of “majority minority complex” of the Hindus and the increasing hate and violence (against Muslims and Christians). Today, the Hindu nationalism programme effectively dominates public debate. Its partisans has succeeded in discriminating between “friends” and “foes”, those inside and those outside, those whom one holds dear and those whom one pillories on the basis of a real or imaginary menace weighing upon autochthony, culture, religion and race, and the national (state) sovereignty.
Party Activists, Campaign Resources and Candidate Position Taking: Theory, Tests and Applications
Authors: MOON WOOJIN
Published: October 2004

Electoral competition is here specified as revolving around both candidate policy positions and non-policy issues.Two candidates spend their resources on non-policy issues to sway citizens' ideological voting decisions but they are constrained by their party activists who provide them with electoral resources. In this setting, a candidate with a resource advantage converges more towards the centre, but a candidate with a resource disadvantage diverges more from the centre. This asymmetry in two candidates' incentives to converge generates the result that the two candidates do not converge towards each other. To test these theoretical results, two-stage estimation is used in this article to solve the reciprocal relationship between policy moderation and campaign resources. This analysis produces strong empirical support for the model in the context of US Senate elections between 1974 and 2000.
Standard Voting Power Indexes Do Not Work: An Empirical Analysis
Authors: GELMAN ANDREW , KATZ JONATHAN N. , BAFUMI JOSEPH
Published: October 2004

Voting power indexes such as that of Banzhaf are derived, explicitly or implicitly, from the assumption that all votes are equally likely (i.e., random voting). That assumption implies that the probability of a vote being decisive in a jurisdiction with n voters is proportional to 1/√n. In this article the authors show how this hypothesis has been empirically tested and rejected using data from various US and European elections. They find that the probability of a decisive vote is approximately proportional to 1/n. The random voting model (and, more generally, the square-root rule) overestimates the probability of close elections in larger jurisdictions. As a result, classical voting power indexes make voters in large jurisdictions appear more powerful than they really are. The most important political implication of their result is that proportionally weighted voting systems (that is, each jurisdiction gets a number of votes proportional to n) are basically fair. This contradicts the claim in the voting power literature that weights should be approximately proportional to √n.
Analytic Conservatism
Authors: BRENNAN GEOFFREY , HAMLIN ALAN
Published: October 2004

We propose an analytic account of dispositional conservatism that attempts to uncover a foundation of what is often taken to be an anti-foundationalist position. We identify a bias in favour of the status quo as a key component of the conservative disposition and address the question of the justification of such a conservative disposition, and the circumstances in which the widespread adoption of such a disposition might be normatively desirable. Our analysis builds on a structural link between the economist's traditional emphasis on questions of feasibility and the conservative's attachment to the status quo.
Review Article: Dismantling the Health Care State? Political Institutions, Public Policies and the Comparative Politics of Health Reform
Authors: HACKER JACOB S.
Published: October 2004

This article examines the recent pattern and progress of health care reform in affluent democracies, focusing in particular on Britain, Canada, Germany, the Netherlands and the United States. Its main contention is that efforts to reform health care in advanced industrial states have been marked by a paradoxical pattern of ‘reform without change and change without reform’, in which large-scale structural reforms have had surprisingly modest effects yet major ground-level shifts have, nonetheless, frequently occurred as a result of decentralized adjustments to cost control. The main task of the article is to investigate the reasons for and effects of this puzzling pattern by plumbing the largely unexplored theoretical territory between comparative health policy analysis and cross-national research on the welfare state. Along the way, the article develops a simple model of the politics of reform that helps explain cross-national variation in legislative and policy outcomes – particularly outcomes that occur through decentralized processes of internal policy ‘conversion’ and policy ‘drift’, rather than through formal legislative reform. It also takes up a number of other intriguing issues raised by recent trends: why, for example, market reforms are clustered in centralized political and medical frameworks; why these reforms have generally enhanced state authority rather than market autonomy; why, despite fragmentation, decentralized political and medical systems shifted towards an expanded government role; and why significant retrenchment of the public-private structure of health benefits occurred in the United States.
The Impact of Issue Preferences on Voting Choices in the Swiss Federal Elections, 1999
Authors: KRIESI HANSPETER , SCIARINI PASCAL
Published: October 2004

This Note presents a study of the impact of issue positions of political parties on electoral choice. Together with economic performance and the popularity of leaders and candidates, issue-specific considerations are the main ‘short-term’ forces influencing the voting choices of individual voters. Issue voting has been shown to matter in a large number of studies. Most recently, Alvarez et al. have demonstrated the power of issues in British general elections, which have long been known as an important case of class voting. They argue that one should no longer debate whether issues (and the economy) matter in British elections: ‘Instead, the focus should shift from whether to how much and to how their influence in particular elections compares to their influence on other British elections, and to elections in other nations.’
The first fossil ribbonfish (Teleostei, Lampridiformes, Trachipteridae)
Authors: CARNEVALE GIORGIO
Published: October 2004

The first fossil ribbonfish, Trachipterus mauritanicus sp. nov., based on a single specimen, is described from Sidi-Brahim, an Upper Miocene (Messinian) locality situated in the central sector of the Chelif Basin, northwestern Algeria. Trachipterus mauritanicus sp. nov. is characterized by a flattened neurocranium and an advanced insertion of the dorsal fin. Based on skeletal morphology, T. mauritanicus sp. nov. appears to be related to T. arawatae and T. trachypterus. Trachipterus mauritanicus sp. nov. represents the eighth taxon described up to now from Sidi-Brahim. The occurrence of the first fossil member of the family Trachipteridae from the Upper Miocene sediments of northwestern Algeria emphasizes the crucial importance of the Messinian ichthyofaunas from Algeria to our knowledge of the fossil record of the Teleostei.
Cenozoic volcanism in the Middle East: petrogenesis of alkali basalts from northern Lebanon
Authors: ABDEL-RAHMAN ABDEL-FATTAH M. , NASSAR PHILIP E.
Published: October 2004

The Cenozoic volcanic field of the Akkar region in northern Lebanon consists of a thick succession (200 m) of basaltic lava flows, erupted at the junction between a restraining bend (the Yammouneh transform fault) and its northern extension (the Ghab transform) in Syria. Both faults are part of the Dead Sea transform fault system, which represents the boundary between the Arabian and African plates and the Levantine subplate. The lavas are made up of about 15–25 vol. % olivine (Fo79–84), 30–40 % clinopyroxene (salite), 40–50 % plagioclase (An58–67), and opaque Fe–Ti oxides (∼ 5 %). Geochemically, they exhibit a narrow range of SiO2 (44.6 to 47.0 wt %), and MgO (2.9 to 7.5 wt %), are relatively enriched in TiO2 (2.0 to 2.9 wt %), and are classified as alkali basalts. Mg-numbers range from 0.32 to 0.59, with an average of 0.47. The rocks are enriched in incompatible trace elements such as Zr (98–184 ppm), Nb (16–39 ppm) and Y (25–34 ppm). The REE patterns are fractionated ((La/Yb)N=8.2), and are generally parallel to subparallel. Such compositions are typical of those of HIMU-OIB and plume-related magmas. Elemental ratios such as K/P (2.9), La/Ta (21.8), La/Nb (0.80), Nb/Y (0.92) and Th/Nb (0.35), and the low average SiO2 content (46.1 wt %) suggest that the magma was subjected to minimal crustal contamination. This may be related to a rapid ascent of the parental magma, in agreement with the nature (mafic, oceanic crust-like) and the thickness (only about 12 km) of the crust of the Eastern Mediterranean region. Cenozoic volcanism in this region is interpreted to have occurred in association with an episode of localized extension, particularly at the junction between the Yammouneh restraining bend and the Dead Sea–Ghab Transform (that is, in a transtensional tectonic regime). The 143Nd/144Nd isotopic composition of the basaltic rocks of northern Lebanon ranges from 0.512842 to 0.512934 (εNd=4.0 to 5.8), and 87Sr/86Sr from 0.703317 to 0.703579, suggesting a HIMU-like mantle source. Modelling indicates that the magma was produced by a small degree of partial melting (F=2 %) of a primitive, garnet lherzolitic mantle source, possibly containing a minor spinel component.
Late Pleistocene extension and strike-slip in the Dead Sea Basin
Authors: BARTOV YUVAL , SAGY AMIR
Published: October 2004

A newly discovered active small-scale pull-apart (Mor structure), located in the western part of the Dead Sea Basin, shows recent basin-parallel extension and strike-slip faulting, and offers a rare view of pull-apart internal structure. The Mor structure is bounded by N–S-trending strike-slip faults, and cross-cut by low-angle, E–W-trending normal faults. The geometry of this pull-apart suggests that displacement between the two stepped N–S strike-slip faults of the Mor structure is transferred by the extension associated with the normal faults. The continuing deformation in this structure is evident by the observation of at least three deformation episodes between 50 ka and present. The calculated sinistral slip-rate is 3.5 mm/yr over the last 30 000 years. This slip rate indicates that the Mor structure overlies the currently most active strike-slip fault within the western border of the Dead Sea pull-apart. The Mor structure is an example of a small pull-apart basin developed within a larger pull-apart. This type of hierarchy in pull-apart structures is an indication for their ongoing evolution.
Ordovician and Silurian protolith ages of metamorphosed clastic sedimentary rocks from the southern Schwarzwald, SW Germany: a palynological study and its bearing on the Early Palaeozoic geotectonic evolution
Authors: VAIDA M. , HANN H. P. , SAWATZKI G. , FRISCH W.
Published: October 2004

Sedimentation ages of metamorphosed clastic sedimentary rocks in the southern Schwarzwald were determined by associations of palynomorphs. In the northern subunit of the Badenweiler–Lenzkirch Zone, two lithostratigraphic assemblages could be discerned in low-grade metamorphic units by their facies and age, thus revealing a more complex internal structure of this zone than previously assumed. Lower Ordovician metagreywackes and metapelites were discerned from Silurian metasiltstones. In the cataclastically overprinted metasiltstones and phyllites of the southern subunit of the Badenweiler–Lenzkirch Zone, only poorly preserved microfossil remains could be detected. These show that the sedimentation ages must be Ordovician or younger, but still probably Early Palaeozoic. High-grade metapelitic rocks of the South Schwarzwald Gneiss Complex contain chitinozoans in lenses and layers of schists, that are rich in biotite and graphite. They yielded mid-Silurian ages and show that this crystalline complex does not represent an older basement unit but was the result of marine sedimentation at that time. The new age determinations have a bearing on geodynamic reconstructions of the internal Variscides in Early Palaeozoic time. They show that sedimentation in the oceanic realm of the Badenweiler–Lenzkirch Zone or its margins did not occur before the Ordovician. After transformation of the northern passive into an active continental margin, younger greywackes not older than Middle Devonian received detritus from a volcanic arc, forming above the subduction zone.