bluuebunny/crossref_metadata_2025 huggingface dataset:
Polemics in the Koran: The Koran’s Negative Argumentation over its Own Origin1
Authors: Boisliveau Anne-Sylvie
Published: May 2013

Abstract

In this article I propose that the polemical passages in the Koran should not be addressed as if they were aiming at narrating a portion of Muḥammad’s life but as parts of the koranic argumentation about its own origin and status. The first part of this paper shows how these polemics convey a religious debate by addressing the question of the sacred origin of the koranic text and the authenticity of Muḥammad’s prophetic role, in parallel. The second part provides an analysis of how the Koran argues about its own religious authority through these polemical passages: by meeting expectations which are described as Jewish and Christian, by refusing any attitude of denial, and by accusing the opponents of forgery. Hypotheses on the type of audiences of these passages are then exposed.
Un cas de dérivation « pivot » en arabe
Authors: Larcher Pierre
Published: May 2013

Résumé

Maʿīn, transcrit en caractères latins Maïn, est une marque d’eau minérale de Tunisie. C’est peut-être un jeu de mots avec l’arabe dialectal mā ʿīn « eau de source » (cl. māʾ ʿayn). Mais c’est aussi une réminiscence coranique. Le mot maʿīn apparaît quatre fois dans le Coran, qualifiant deux fois l’eau, une fois implicitement et une fois explicitement, et deux fois, métaphoriquement, la boisson des élus au Paradis. Les sources arabes anciennes se demandent si maʿīn doit être lu comme un maf ʿūl, lié à la famille lexicale de ʿayn (« source », cf. le verbe ʿāna-yaʿīnu « arriver à une source ») ou un faʿīl, lié à la famille lexicale de maʿn (« couler », en parlant de l’eau). Cette discussion montre que maʿīn est le mot qui a permis le passage d’une famille lexicale à une autre. Il illustre les conditions formelles et sémantiques de ce type de dérivation, qu’on appellera « dérivation pivot ».
One Sky: The Palestinian Writer Liyāna Badr between Two Periods
Authors: Gottesfeld Dorit
Published: May 2013

Abstract

The present article illustrates how the change in the geographic location of Liyāna Badr, one of the prominent Palestinian women writers, influenced her writing in thematic and stylistic terms. It shows how Badr’s writing shifts from descriptions of isolation and loneliness, alienation and yearning for the past, to describing feelings of rage and frustration with the reality of Israeli occupation, and how from an innovative and vague writing style she shifts to a realistic, simple, and direct style that reflects the themes of her stories and the messages she wishes to convey. In this way Badr reinforces the connection of her work with Palestinian existence and the reality of occupation, and does not let the contemporary writing directions adopted by the young women authors influence the degree of Palestinian-ness of her texts.
Among Kings and Sages: Greek and Indian Wisdom in an Arabic Mirror for Princes
Authors: Marlow Louise
Published: May 2013

Abstract

The mirror for princes known as the Naṣīḥat al-mulūk of al-Māwardī, probably a tenth-century text, is replete with references to sources identified by the author as “Indian”. A large number of these texts also appear in the so-called Waṣiyyat Arisṭāṭālīs li-l-Iskandar; some examples find parallels in Kalīla wa-Dimna and Bilawhar wa-Būḏāsaf. These coincidences raise several possibilities: first, that the author’s “Indian” source represents a work of Indic background, translated from Sanskrit or another Indian language into Arabic, probably at the time when the Barmakids were sponsoring such translations in significant numbers; secondly, that it was rendered from an Indian language into Middle Persian in the Sasanian period and from that language into Arabic in the early centuries of the Islamic era; thirdly, that the text was composed in a non-Indian language, probably Middle Persian, and acquired a “forged” Indian genealogy in a parallel to the numerous spurious Greek attributions (a category that would subsequently include the pseudo-Aristotelian testament). The article addresses these three possibilities, and, on the basis of textual and contextual considerations, suggests that at the present stage of research, it is the second that seems most likely.
Ğāḥiẓiana. Addition à l’essai d’inventaire de l’œuvre ǧāḥiẓienne : le Kitāb al-Fityān retrouvé ?1
Authors: Regourd Anne
Published: May 2013

Résumé

Parmi les documents de la Geniza conservés à l’Académie hongroise des Sciences (Budapest), figure un feuillet dont une face porte le titre d’une œuvre attribuée à Ğāḥiẓ, le Kitāb al-Fityān, et dont l’autre comporte le début du texte associé à ce titre. L’objet de cet article est de tenter d’identifier l’œuvre et son sujet, de dater sa composition, de dater et situer la copie, en s’appuyant pour beaucoup sur des arguments philologiques. Une édition complète du texte figure en annexe. Enfin, le feuillet ayant été mis à jour dans la Geniza du Caire, l’article attire l’attention sur son statut de document. L’original a malheureusement disparu de la Bibliothèque de l’Académie des Sciences de Budapest, il n’en demeure qu’une copie argentique, reproduite ici.
Outside the Ghetto: Jews and Christians in the Duchy of Modena
Authors: Aron-Beller Katherine
Published: May 2013

Abstract

Historians have in the past concentrated their studies of early modern Jewish life on the main city-states of Northern Italy where the largest Jewish communities existed. These areas have been categorized as territories which absorbed Jewish immigrants, enclosed them in ghettos, and monitored their actions with the creation of specific agencies. My essay turns to Jewish existence in the smaller towns and rural areas of the duchy of Modena in the seventeenth century, and attempts to question how this alienated minority was able to fare in areas which housed no ghettos. Here the political and religious decentralization, particularly in the early seventeenth century, generated retaliatory hostility as well as intimacy between Jews and Christians. Sources for this study will be Inquisitorial documents that concerned professing Jews. These sources, once decoded, provide extraordinarily rich images of daily life and provide a unique picture of social relations between the two religionists.
Abortion for Foetal Abnormalities in Ireland; The Limited Scope of the Irish Government’s Response to the A, B and C Judgment
Authors: Donoghue Stephen , Smyth Claire-Michelle
Published: May 2013

Abstract

Abortion has been a controversial topic in Irish law and one which the Government has been forced to address following the decision of the European Court of Human Rights in A, B and C v. Ireland. The Working Group established to make recommendations have specifically been instructed to deal only with the issues raised in the A, B and C judgment and legislate on the basic of the ‘X case’. This restricted approach calls for legalisation of abortion only where the life of the mother is at risk, a position unique only to Ireland and Andorra within Europe. The vast majority of member states to the European Convention on Human Rights allow for legal abortion on the basis of foetal abnormality and with this emerging consensus the margin of appreciation hitherto afforded by the European Court to member states is diminishing. The advancement and availability of non-invasive genetic tests that can determine foetal abnormalities together with the ruling in R. R. v. Poland leaves Ireland in a precarious position for omitting any reference to foetal abnormalities in any proposed legislation.
Deliberating or Dithering? Ireland and Human Embryonic Stem Cell Research
Authors: Gough Fionnuala
Published: May 2013

Abstract

Disagreement about matters of public policy concerned with moral issues is inevitable in pluralist democracies. One approach to the resolution of moral conflicts in society is the concept of deliberative democracy, which emphasises the process or procedure which ultimately allows a political decision to be reached. The Republic of Ireland effectively has no legislative framework regulating human embryonic stem cell research (hESC research). This article proposes that Irish policymakers establish a procedural framework, similar to that used in other European democracies, to allow the development of appropriate regulations pertaining to hESC research in Ireland. In particular the article will consider how a three-tier model of procedural regulation has been used to achieve certainty in the area of hESC research in the United Kingdom and Germany and how this model might be applied to Ireland.
The Data Protection and Medical Device Frameworks — Obstacles to the Deployment of mHealth across Europe?
Authors: Quinn Paul , Habbig Ann-Katrin , Mantovani Eugenio , De Hert Paul
Published: May 2013

Abstract

This article examines the receptivity of the current EU legal regime towards innovative mHealth technologies and their deployment on a pan-European basis. At present, a coherent legal strategy towards the development of mHealth technologies does not exist. The deployment of such technologies is influenced in an uncoordinated way by various disparate European legislative initiatives. This article focuses on problems that may be encountered by mHealth platforms through application of the Medical Device and Data Protection Frameworks. Theses frameworks are analysed in this article through the lens of a pan-European deployment of mHealth technologies. The aim throughout is to look for potential problems for the deployment of such technologies posed by these frameworks and, where possible, to suggest improvements.
A New Style of End-of-life Cases: A Patient’s Right to Demand Treatment or a Physician’s Right to Refuse Treatment? The Futility Debate Revisited
Authors: Lemmens Christophe
Published: May 2013

Abstract

A classic end-of-life conflict between a physician and a patient concerns a patient’s refusal of care. New conflicts have begun to emerge. This time the patient wants treatment while the physician refuses treatment based on a futility judgment. Most of the time the predominance of the physician’s view is stressed. In this article this predominance is critically analysed resulting in a re-appraisal of the patient’s will.
Obstacles to the Free Movement of Professionals: Mutual Recognition of Professional Qualifications in the European Union
Authors: van Riemsdijk Micheline
Published: May 2013

Abstract

European states are experiencing a shortage of healthcare workers, and hiring managers are increasingly looking for foreign-trained health professionals to fill care shortages. However, these workers often experience difficulties with the transfer of their professional qualifications across national borders. This article investigates the recognition of Polish nursing qualifications in the EU, studying the directives for mutual recognition of nursing qualifications, negotiations over Poland’s Accession Treaty, and efforts by the Polish Chamber of Nurses and Midwives to reverse its discriminatory conditions. It is argued that the exclusion of the Polish nursing unions from the accession negotiations constitutes a democratic deficit, and that the creation of a single European market is not yet achieved. The findings are placed in a larger discussion about the Europeanization of healthcare delivery, the harmonization of curricula in higher education, and the consequences of these developments for the free movement of skilled workers within the EU.
Free Movement and the Fragmentation of Family Reunification Rights
Authors: Staver Anne
Published: May 2013

Abstract

Family reunification regulations in the EU are increasingly complex, and they vary for different groups of sponsors. This paper documents the existence of four parallel legal regimes for family reunification — national rules for citizens who do not move, EU rules for citizens who move within Europe, the Family Reunification Directive for third-country nationals in the EU, and since 2011, family reunification rights based on EU citizenship status. This paper asks how and why family reunification rules are being thus fragmented, and in particular why so-called ‘reverse discrimination’, where citizens are disadvantaged vis-à-vis non-citizens, is persisting and deepening. It draws on tools from political science, namely historical institutionalism and studies of policy transfer and Europeanization, to showcase the different logics that underlie these puzzling developments.
Direct Numerical Simulations of a Smoke Cloud–Top Mixing Layer as a Model for Stratocumuli
Authors: de Lozar Alberto , Mellado Juan Pedro
Published: May 2013

A radiatively driven cloud-top mixing layer is investigated using direct numerical simulations. This configuration mimics the mixing process across the inversion that bounds the stratocumulus-topped boundary layer. The main focus of this paper is on small-scale turbulence. The finest resolution (7.4 cm) is about two orders of magnitude finer than that in cloud large-eddy simulations (LES). A one-dimensional horizontally averaged model is employed for the radiation. The results show that the definition of the inversion point with the mean buoyancy of 〈b〉(zi) = 0 leads to convective turbulent scalings in the cloud bulk consistent with the Deardorff theory. Three mechanisms contribute to the entrainment by cooling the inversion layer: a molecular flux, a turbulent flux, and the direct radiative cooling by the smoke inside the inversion layer. In the simulations the molecular flux is negligible, but the direct cooling reaches values comparable to the turbulent flux as the inversion layer thickens. The results suggest that the direct cooling might be overestimated in less-resolved models like LES, resulting in an excessive entrainment. The scaled turbulent flux is independent of the stratification for the range of Richardson numbers studied here. As suggested by earlier studies, the turbulent entrainment only occurs at the small scales and eddies larger than approximately four optical lengths (60 m in a typical stratocumulus cloud) perform little or no entrainment. Based on those results, a parameterization is proposed that accounts for a large part (50%–100%) of the entrainment velocities measured in the Second Dynamics and Chemistry of the Marine Stratocumulus (DYCOMS II) campaign.
Acculturation and the acceptance of the Genocide Convention
Authors: Smith Karen E
Published: May 2013

This article contributes to the burgeoning literature on why states ratify human rights treaties. It first analyses why Ireland, the United Kingdom and the United States did not initially ratify or accede to the 1948 Genocide Convention, and then explores why the three countries eventually did accept it, 20–40 years after it was approved by the United Nations General Assembly. The extent to which material costs and benefits, the logic of appropriateness, and acculturation played a role in each of the three cases is assessed. Acculturation is particularly evident in the Irish case, but it also helps to explain the UK and US acceptance of the Convention.
Healthy Trade: The Relationship Between Open Trade and Health
Authors: Stevens Philip , Urbach Jasson , Wills Gabrielle
Published: May 2013

A recurrent theme of the academic literature and wider public discourse is that free trade is bad for health as it promotes economic inequality and insecurity, polluting the environment and making processed foods more widely available. Such views are also widely promulgated by international policymaking organizations such as the World Health Organisation (WHO).

However, there has been little empirical evidence to support these assertions, in particular the relationship between free trade and health. This is an important relationship, as it tells us more about the effect of economic policies on human welfare than bald statistics relating to GDP.

This study aims to build on a nascent literature by examining the relationship between free trade and health, using a range of data relating to trade openness and human development. Our analysis finds that free trade does in fact appear to be associated with better health outcomes, with the relationship particularly pronounced for lower-income countries.

There are two mechanisms that might be responsible for this relationship. On the one hand, trade promotes economic growth, which in turn provides greater sums for individuals to improve their living conditions and for authorities to spend on public health measures such as sanitation and universal vaccination. Another mechanism is ‘knowledge spillover’, wherein international trade increases the global diffusion of both knowledge and products that improve health—ranging from the basics of germ theory to modern pharmaceuticals and medical devices.
A Foreign Field No Longer: India, the IPL, and the Global Business of Cricket
Authors: Agur Colin
Published: May 2013

In the past decade India has become the financing hub for cricket, a broadcaster in its own right, and an agenda-setter in the management of all forms of the game. What some commentators have called the ‘Indianization’ of cricket extends beyond business: it is a social, political, and cultural phenomenon. For five seasons, the Indian Premier League (IPL) has offered a glimpse of this phenomenon, prompting enthusiasm from young fans and those who stand to profit from the new league, and resistance from traditionalists. This paper discusses the material and symbolic roles the IPL has come to play in global cricket. It begins with an overview of the IPL’s history, discusses how the IPL is changing the global business of cricket, and explores how the IPL is challenging the traditional culture of the sport. The paper concludes with arguments about the IPL as a grand spectacle, and a cultural phenomenon that, despite its problems, might prove its critics wrong. Throughout, the paper treats the IPL as a useful case study not only in the business of sports, but also more widely in our theoretical and empirical studies of globalization.
Mixed-mode I/III fatigue delamination growth in woven glass/epoxy composite laminates at cryogenic temperatures
Authors: Miura Masaya , Shindo Yasuhide , Takeda Tomo , Narita Fumio
Published: May 2013

This work deals with the delamination growth behavior in woven glass fiber reinforced polymer (GFRP) composite laminates under mixed-mode I/III fatigue loading at cryogenic temperatures. Fatigue delamination tests were carried out with eight-point bending plate (8PBP) specimens at room temperature, liquid nitrogen temperature (77 K), and liquid helium temperature (4 K), and the delamination growth rate data were expressed in terms of the energy release rate range during fatigue loading. The energy release rate was calculated using the three-dimensional finite element method. Moreover, the fracture surface characteristics of the woven GFRP laminates under mixed-mode I/III fatigue loading were examined by scanning electron microscopy (SEM).
Effect of montmorillonite on moisture resistance of the rubber-modified phenolic on fiberglass
Authors: Shen Ming-Xia , Duan Peng-Peng , Han Yong-Qin
Published: May 2013

Sodium montmorillonite was organized by a series of alkyl quaternary ammonium to make an organic modified montmorillonite (OMMT). The organic montmorillonite-resorcinol-formaldehyde-latex (OMMT/RFL) film was prepared by introducing OMMT into RFL, and aging and curing later. The OMMT was valued by X-ray diffraction and Fourier Transform Infrared Spectroscopy (FTIR). The adhesion of the OMMT/RFL-coated fiberglass was evaluated using an H-adhesion technique. The mass-gain of OMMT/RFL and the tensile properties of the coated fiberglass were studied under different humidities. The results show that the best moisture resistance could be gained while 16MMT at 1.5 wt%. Compared with the tensile properties of RFL, the tensile strength of OMMT/RFL increases by 21.2%, the tensile modulus by 23.1% under humidity of 98%; the OMMT/RFL displays a better dynamic storage modulus at elevated temperature.
New Evidence on Gibrat’s Law for Cities
Authors: González-Val Rafael , Lanaspa Luis , Sanz-Gracia Fernando
Published: May 2013

The aim of this work is to test empirically the validity of Gibrat’s law on the growth of cities, using data on the complete distribution of cities (without size restrictions) from three countries (the US, Spain and Italy) for the entire 20th century. In order to achieve this, different techniques are used. First, panel data unit root tests tend to confirm the validity of Gibrat’s law in the upper-tail distribution. Secondly, when the entire distribution is considered using non-parametric methods, it is found that Gibrat’s law does not hold exactly in the long term (in general, size affects the variance of the growth process but not its mean). Moreover, the log-normal distribution works well as a description of city size distributions across the whole century when no truncation point is considered.
Video-Assisted Modified Left Sympathectomy for Long-QT Syndrome
Authors: Weng Guo Xing , Ding Hang , Qi Juan , Xu Chun Xuan
Published: May 2013

A 22-year-old female suffering from idiopathic long-QT syndrome complicated by frequent syncope, torsade-de-pointes-type ventricular tachycardia, and asthma, was successfully treated by video-assisted extensive left second and third thoracic sympathetic ganglionectomy, instead of left stellate and first thoracic ganglio-nectomy, to avoid postoperative Horner's syndrome. The QT interval was significantly shortened from 0.6 to 0.43 seconds four days after the surgery. It remained at 0.43 seconds during a 3-month follow-up with no recurrence of tachycardia or syncope.
Spontaneous Pneumopericardium and Pneumomediastinum
Authors: Arda Kemal , Eldem Olcay , Siğirci Ahmet , Özkan Fikri Özgür
Published: May 2013

A 20-year-old man with a 5-year history of ulcerative colitis presented with sudden chest pain and diarrhea. Chest radiography, echocardiography, and computed tomography demonstrated pneumomediastinum and pneumopericardium. The condition resolved completely after one week.
Endoscopic Vein Surgery in Lower Extremities with VasoView System
Authors: Hirokawa Masayuki , Oda Katsushi , Yamamoto Akira , Nishimori Hideaki , Hata Atsushi , Fukutomi Takashi , Hirose Kunihiko , Sasaguri Shiro
Published: May 2013

The VasoView system was used for endoscopic saphenous vein harvesting in 10 coronary artery bypass patients and for endoscopic subfascial division of perforating veins in 8 patients with varicose veins. In both procedures, the surface of the saphenous vein and the subfascial plane were dissected using the VasoView dissection cannula. An operative tunnel was subsequently created by inflating and deflating the balloon and maintained by carbon dioxide insufflation. The branches of the saphenous vein and the perforating veins were divided with bipolar scissors under endoscopic vision. In endoscopic saphenous vein harvesting, the mean graft length was 31.5 ± 7.5 cm and the mean number of skin incisions was 3 ± 1.2. In endoscopic subfascial division of perforating veins, 3.4 ± 1.7 veins were divided. The VasoView system is attributed with a decrease in complications after vein surgery in the lower extremities.
Transhiatal versus Transthoracic Esophagectomy for Distal Esophageal Cancer
Authors: Gupta Narendar Mohan
Published: May 2013

From 1982 to 1986, 27 of 34 consecutive patients with squamous cell carcinoma of the distal esophagus had resection by the transthoracic approach. From 1987 to 1990, 39 of 48 consecutive patients underwent transhiatal esophagectomy. The two groups were comparable in terms of demographics, preoperative risk factors, and tumor stage. All patients had received one cycle of anterior chemotherapy. The incidence of pneumonia and wound infection was significantly higher following transthoracic compared to transhiatal resection (44% versus 18%). Transhiatal esophagectomy required markedly less operating time (137 versus 327 min) but had a higher incidence of recurrent laryngeal nerve palsy (20% versus 0%). Anastomotic leaks occurred with similar frequency in both groups (23% versus 19%) and intrathoracic disruption carried a very high mortality (80%). Transhiatal resection had lower mortality (10% versus 26%) and both groups had similar survival. These results suggest that compared to transthoracic esophagectomy, the transhiatal approach had fewer complications, a lower mortality rate, and comparable survival, and thus remains an acceptable procedure for resection of squamous cell carcinoma of the distal esophagus.
Carotid Artery-to-Jugular Vein Fistula: Repair Using Cardiopulmonary Bypass
Authors: Talwar Sachin , Bhan Anil , Sharma Rajesh , Choudhary Shiv Kumar , Venugopal Panangipalli
Published: May 2013

An internal carotid artery-to-internal jugular vein fistula was observed at angiography in a 35-year-old man who had sustained a gunshot injury 6 months earlier. Successful repair required institution of cardiopulmonary bypass.
Prevalence of Rheumatic Fever and Rheumatic Heart Disease in Yemen
Authors: Al-Munibari Abdul Nasser , Nasher Thabet Mohsen , Ismail Siddig Ahmed , Mukhtar El-Daw Ahmed
Published: May 2013

The major aim of this study was to determine the prevalence of rheumatic heart disease in Yemen. Between October 1997 and March 1998, a prospective cluster-sampling screening study was carried out on 5000 schoolchildren (2504 female and 2496 male), aged 5 to 18 years. Suspected cases were subjected to electrocardiography, chest radiography, and Doppler echocardiography. Although no case of active rheumatic fever was found, 12 girls and 6 boys were affected by the disease, giving a prevalence of 3.6 per 1000, which is higher than that reported from neighboring countries. All confirmed and suspected cases were given penicillin G benzathine every 3 weeks, according to body weight, after a test dose. Prevention programs for rheumatic fever, together with prevention of streptococcal throat infections, are goals for the near future.
Hemostatic Markers and Renal Function after Cardiopulmonary Bypass
Authors: Yilmaz Mustafa , Haznedaroğlu İbrahim , Ateş M Şanser , Kirazli Şerafettin , Paşaoğlu İlhan
Published: May 2013

To evaluate coagulation status after cardiopulmonary bypass and its relation to renal function, thrombin-antithrombin III complex and prothrombin fragment 1+2 were measured as thrombotic markers in 46 patients undergoing coronary artery bypass grafting. Postoperative serum creatinine values exceeded 20 mg·L−1 in 12 patients, indicating compromised renal function; there was a statistically significant increase in the postoperative levels of thrombotic markers in these patients. These data indicate that patients with renal dysfunction after cardiopulmonary bypass have a thrombotic tendency. Anticoagulant treatment is recommended in such patients.
Intrathoracic Extrapulmonary Hydatid Cyst
Authors: Beşirli Kazim , Burhani Mohamad Said , Arslan Caner , Tüzün Hasan , Kaynak Kamil
Published: May 2013

A 30-year-old man with a history of hepatic hydatid cyst was admitted with a mass lesion in the posterior mediastinum. Surgical intervention and subsequent pathological and microbiologic investigations revealed the mass to be a hydatid cyst located on the descending aorta in the posterior mediastinum and not invading the lung parenchyma. Albendazole treatment was added. No recurrence was seen in 15 months of follow-up.
Ventricular Outflow Tract Reconstruction with Polystan Valved Conduit
Authors: Kim Yong Jin , Choi Yong Soo , Lee Jeong Ryul , Rho Joon Ryang
Published: May 2013

Experience with Polystan valved conduits in children with congenital heart disease was reviewed. From May 1997 to October 2000, 52 Polystan valved conduits were used for reconstruction of the pulmonary ventricular outflow tract in 50 patients. The median age was 24 months (range, 7 days to 19 years), body weight was 11 kg (range, 2.8 to 52 kg), and conduit size at operation was 19 mm (range, 12 to 24 mm). Early mortality was 12% (6/50). Late mortality was 6% (3/50). The median follow-up of survivors was 25 months (range, 2 to 43 months). Three patients underwent conduit replacement; 2 received larger conduits in a second-stage operation for ventricular septal defect closure. There was no death at reoperation. Polystan valved conduits can be used for reconstruction of the pulmonary ventricular outflow tract in congenital heart disease, with no significant conduit-related problems.
Cardiac Malformation in Thoracopagus Twins
Authors: Tansel Türkan , Yazicioğlu Fehmi , Çankaya Atilla , Yaşar Levent
Published: May 2013

A case of thoracopagus twins with conjoined hearts and livers is described. The female twins were delivered in the 19th week of gestation. There was a common pericardial sac and the hearts were joined at the atrial and ventricular levels. Prenatally, surgical separation was considered impossible due to the fused heart, which was confirmed by the autopsy findings.
Emergency Operation for Spontaneous Coronary Artery Dissection in Young Female
Authors: Shirakawa Yukitoshi , Matsumiya Goro , Ohtake Shigeaki , Sawa Yoshiki , Kagisaki Koji , Matsuda Hikaru
Published: May 2013

Emergency coronary artery bypass grafting using a composite graft of the right internal thoracic artery and the radial artery was successfully performed for impending myocardial infarction secondary to spontaneous dissection of the right coronary artery in a 46-year-old woman. As spontaneous coronary artery dissection frequently presents as myocardial infarction or sudden death, timely diagnosis and intervention are required.
Thoracofemoral Bypass for Treatment of Juxtarenal Aortic Occlusion
Authors: Köksal Cengiz , Sarikaya Sabit , Zengin Mustafa
Published: May 2013

Descending thoracic aorta-to-femoral artery bypass grafting is considered a good alternative procedure for revascularization in cases of aortic graft failure, graft infection, and other intraabdominal pathologies not amenable to standard aortofemoral revascularization. Its use as the primary mode of treatment in selected cases is still under investigation. From January 1998 to June 2001, 5 patients underwent descending thoracic aorta-to-femoral artery bypass grafting as primary treatment for juxtarenal aortic occlusion. There was no operative mortality nor major morbidity; a groin incision infection occurred in one case. The mean hospital stay was 8.2 days and intensive care unit stay was 2.6 days. Graft failure was not encountered in the short-term follow-up. In spite of the small number of patients, it was concluded that thoracic aortofemoral bypass offers excellent inflow and reliable patency and may be considered for primary revascularization in cases of juxtarenal aortic occlusion.
Off-Pump Coronary Artery Surgery in the Elderly
Authors: Meharwal Zile S , Trehan Naresh
Published: May 2013

We compared the results of off-pump (n = 186) and on-pump (n = 389) coronary artery bypass grafting in elderly patients over 70 years old. Patients undergoing single-vessel revascularization were excluded from the study. The 2 groups matched in preoperative risk factors. Operative mortality was comparable (off-pump 2.2% versus on-pump 4.6%). The off-pump group fared better in intubation time (16 ± 4 hours versus 25 ± 5 hours), blood loss (365 ± 58 mL versus 584 ± 72 mL), the need for blood transfusion (31.7% versus 44%), reoperation for bleeding (0.5% versus 3.6%), atrial fibrillation (10.2% versus 18.5%), intensive care unit stay (21 ± 8 hours versus 34 ± 10 hours), and total hospital stay (5 ± 2 days versus 8 ± 3 days). Off-pump bypass surgery is thus safe for elderly patients and is associated with reduced morbidity and shorter hospitalization than on-pump surgery.
Reappraisal of Fascia Lata Grafts for Reconstruction of Chest Wall Defects
Authors: Murakawa Tomohiro , Nakajima Jun , Maeda Katsuhide , Tanaka Makoto , Takamoto Shinichi
Published: May 2013

Large chest wall defects require surgical reconstruction to ensure structural stability and to prevent flail chest. We used autologous fascia lata grafts to reconstruct skeletal chest wall defects in 8 consecutive patients. Sufficient chest wall stability was obtained; and no complications, such as flail chest, infection, or seroma, have been observed in any of the cases to date.
Ellis-Van Creveld Syndrome Associated with Thymic Hypoplasia
Authors: Akar Haci , Konuralp Cüneyt , Baysal Kemal , Kolbakir Ferşat
Published: May 2013

A 16-month-old girl presented with the classic signs of Ellis-van Creveld syndrome. Mitral clefts were repaired by direct suturing. The single atrium was repaired by creating a new septum with a pericardial patch, leaving the coronary sinus in the left atrium. During perioperative exploration, thymic hypoplasia was recognized.
Heartport Endoclamp for Complex Cardiac Repairs with Total Circulatory Arrest
Authors: Stoica Serban C , Craig Stewart R , Sinclair Colin J , Campanella Ciro
Published: May 2013

A method of performing redo cardiac operations using port-access technology and total circulatory arrest is described. The technique was useful in 2 cases requiring re-intervention within 4 months of the primary procedure. The indications were repair of an infected ventricular aneurysm and recurrence of a postinfarction ventricular septal defect. Dense mediastinal adhesions were avoided by approaching the site of pathology directly via a left anterior thoracotomy.
Transcatheter Embolization Treatment of Coronary Arteriovenous Fistulas
Authors: Aydogan Ümrah
Published: May 2013

Transcatheter coronary arteriovenous fistula occlusion was performed in 5 children with a median age of 5.3 years (range, 0.7 to 11 years). Surgical ligation had been carried out previously in one case, but recanalization occurred during follow-up. Dilation of the feeding artery was observed in 4 patients, with an additional aneurysm of the coronary artery in one of these. Occlusion was attempted three times in 1 patient, twice in 2, and once in the other 2. Detachable balloons were used in 2 procedures, and controlled-release coils in 3. Complete occlusion of the fistula was achieved in 4 patients. In the 5th patient, occlusion of one of two fistulas was unsuccessful, and mild to moderate aortic valve insufficiency developed due to catheter manipulation. Our experience indicates that transcatheter occlusion of congenital coronary arteriovenous fistula is at least as successful as surgical intervention. Multiple occlusion procedures can be avoided by selecting the optimal technique in each case.
Age and Left Ventricular Impairment Predict Reopening for Bleeding
Authors: Deng Yongzhi , Byth Karen , Paterson Hugh S
Published: May 2013

Statistical analysis of data collected prospectively from all patients undergoing surgery under cardiopulmonary bypass from September 1994 to November 1998 (group 1) was performed to identify preoperative risk factors for reopening for bleeding. Multiple logistic regression analysis of 19 preoperative variables was carried out with reoperation for bleeding as the endpoint. The protocol for intraoperative use of aprotinin was then changed to include high-risk patients. Data collected from all subsequent patients from May 1999 to March 2002 (group 2) were analyzed. Subgroup analyses on primary isolated coronary artery surgery were also performed. Data were obtained from 1,946 patients aged 22 to 88 years (mean, 62.5 years). Older age, severe left ventricular impairment, redo surgery, and chronic renal failure were the independent predictors of reopening for bleeding in group 1. There were no independent predictors of reopening in group 2. Older age and chronic renal failure were the predictors of reexploration for bleeding in patients undergoing primary isolated coronary artery grafting. Prophylactic measures to prevent excessive bleeding should be used in elderly patients and those with severe left ventricular impairment, redo surgery, and chronic renal failure.
Starfish Heart Positioner and Harmonic Scalpel for Redo Off-Pump Coronary Bypass
Authors: Niinami Hiroshi , Suda Yuji , Takeuchi Yasuo
Published: May 2013

In a redo off-pump coronary artery bypass operation through a repeat median sternotomy, use of the Starfish Heart Positioner in combination with the Harmonic Scalpel may facilitate dissection of adhesions without hemodynamic impairment.
Left Ventricular Fibroma Causing Atypical Chest Pain
Authors: Goel Mukesh , Malhotra Rajneesh , Kohli Vijay , Mishra Manisha , Jain Sudhir , Mehta Yatin , Trehan Naresh
Published: May 2013

A 29-year-old man with atypical chest pain for 3 years and exertional angina for 3 months was found to have a large homogenous mass in the apicolateral area of the left ventricle. The mass, weighing 78 g, was excised successfully and identified as a fibroma.
Thrombectomy with Disc Rotation of Medtronic Valves
Authors: Kale Suresh B , Saksena Devendra S , Agnihotri Yeshwant C , Ayyer Kalyan H
Published: May 2013

Thrombotic obstruction of prosthetic valves is a serious problem. Early diagnosis and prompt treatment are life-saving in these cases. Three patients presented with subacute and chronic symptoms of prosthetic valve thrombosis of varying duration (7 days to 2 years). All 3 had a Medtronic Hall tilting disc valve implanted in a previous operation in the aortic or mitral position. Diagnosis was established by 2-dimensional echocardiography. Under cardiopulmonary or femorofemoral bypass, thrombectomy and rotation of the disc within the valve housing were performed through a median sternotomy. All the patients had an uncomplicated postoperative course. Pressure gradients fell markedly at discharge 8 to 10 days after surgery. The patients were followed up for between 3 and 11 months, during which they showed excellent prosthetic valve function and reduced gradients. The ability to rotate the valve within the housing allows adequate thrombectomy and pannus excision. Even several years after implantation (more than 10 years in 2 cases), the valve could still be rotated readily to obtain optimum flow and low pressure gradients.
Predictors of Outcome for Myasthenia Gravis after Thymectomy
Authors: El-Medany Yasser , Hajjar Waseem , Essa Mohamed , Al-Kattan Khaled , Hariri Zohair , Ashour Mahmoud
Published: May 2013

The aim of this study was to assess the clinical outcome of patients with myasthenia gravis treated with maximal thymectomy and to identify prognostic variables that predict the outcome. Over 15 years, from 1986 to 2001, we collected data on 100 patients with myasthenia gravis who underwent maximal thymectomy and retrospectively reviewed their outcome. Women comprised 63% and the median age was 25 years (range, 4 to 61). The median duration of the disease was 26 months (range, 1 to 240). According to the Osserman classification, there were seven patients in class I, 31 in class II, 47 in class III, and 15 in class IV. In non thymomatous patients (93 patients), complete remission rate progressively increased from 37.4% to 58.2% and 75% at 3, 10 and 15 years of follow-up respectively. These findings suggest that the complete remission rate is prone to increase with time after maximal thymectomy. The total benefit rate achieved was estimated to be 86% while 14% did not improve at a mean follow-up period of 7.6 years (range, 8 to 180 months). Univariate analysis ( p < 0.05) showed that age, thymic histology and ectopic thymic tissue are significant prognostic factors for outcome.
Semi-Skeletonized Internal Mammary Artery Grafts and Sternal Wound Complications
Authors: Deng Yongzhi , Byth Karen , Paterson Hugh S
Published: May 2013

This study aimed to evaluate the risk factors for sternal wound complications in patients undergoing myocardial revascularization using bilateral semi-skeletonized internal mammary arteries. Prospectively collected data on 751 patients undergoing coronary artery surgery from September 1994 to August 2002 were analyzed. The mean age of the patients was 56 years, 633 (84%) were male, 44 (6%) were over 66 years of age, and 170 (23%) were diabetic. Forty-four (5.9%) patients developed sternal wound complications. Among these cases, sternal infection occurred in 22 (2.9%) patients, of which 15 (2.0%) had sternal infection with mediastinitis and 7 (0.9%) had sternal infection alone. Independent risk factors for any sternal wound complications were peripheral vascular disease, diet-controlled diabetes, and delayed sternal closure. The risk factors for sternal infection were diabetes, postoperative pulmonary complications, and postoperative stroke. The perioperative mortality rate was 1.5% (11 patients), including 2 patients who had sternal wound complications. The use of bilateral semi-skeletonized internal mammary artery conduits carries a comparable sternal wound complication rate as conduits harvested by other techniques.
Anticoagulation in Patients with Mechanical Valves during Pregnancy
Authors: Geelani Muhammad A , Singh Sandeep , Verma Amitabh , Nagesh Ayalasomayajula , Betigeri Vithal , Nigam Madhuri
Published: May 2013

Mechanical valve thrombosis is a life-threatening event, while pregnancy is associated with a hypercoagulable state. Thus, in pregnant women with mechanical valves, adequate anticoagulation becomes even more critical. This prospective study was conducted to establish a uniform anticoagulation regimen for these women. A total of 250 pregnancies in 245 women with mechanical heart valves were evaluated. The patients were divided into 2 groups: group 1 ( n = 150) took oral warfarin throughout pregnancy and group 2 ( n = 100) received subcutaneous heparin in the 1st trimester and oral warfarin for the other trimesters. Both groups received heparin at the time of delivery. There were no coumarin-induced fetal malformations. Minor thromboembolic episodes took place in 5 women in group 1 and 3 in group 2. Valve thrombosis occurred in 1 woman in group 2 and led to 1 maternal death in this series. The incidence of spontaneous abortion was similar between the groups. We conclude that warfarin is safe and convenient to use during pregnancy. The teratogenic effects of warfarin during the 1st trimester are overstated, and switching to heparin is not mandatory.
Diltiazem versus Amiodarone to Prevent Atrial Fibrillation in Coronary Surgery
Authors: Mikroulis Dimitrios , Didilis Vassilios , Konstantinou Fotios , Tsakiridis Kosmas , Vretzakis Georgios , Bougioukas Georgios
Published: May 2013

The prophylactic effect of amiodarone on atrial fibrillation after coronary bypass grafting with extracorporeal circulation was compared with that of diltiazem in two groups of 60 patients each. Patients were monitored continuously for 8 days. The incidence of atrial fibrillation was recorded retrospectively in a control group of 60 patients who received our standard prophylactic regimen of an oral beta blocker. The incidence of postoperative atrial fibrillation was not significantly different in the two test groups: 11.7% for the amiodarone group and 10% for the diltiazem group. The incidence of atrial fibrillation in the control group was 23.3% and the differences were marginally significant when compared to the amiodarone ( p = 0.093) and diltiazem groups ( p = 0.050). The prophylactic use of diltiazem or amiodarone is feasible and safe for patients undergoing coronary bypass, with similar rates of atrial fibrillation.
Congenital Giant Diverticulum of the Left Ventricle in an Adult
Authors: Oruganti Sai S , Ayapati Dharma R , James Milton A , Jinna Jagan MR , Damera Seshagiri R , Challa Sundaram
Published: May 2013

Congenital diverticulum of the left ventricle is a rare anomaly. Echocardiography, cardiac catheterization, and magnetic resonance imaging of the heart diagnosed a giant left ventricular diverticulum in a 20-year-old male with a history of dyspnea and palpitations. He underwent successful surgical correction of the left ventricular diverticulum.
Analysis of Recurrent Mitral Regurgitation after Mitral Valve Repair
Authors: Shin Hong Ju , Lee Yong Jik , Choo Suk Jung , Song Hyun , Chung Cheol Hyun , Lee Jae Won
Published: May 2013

Mitral valve repair was performed in 437 patients with mitral regurgitation from January 1994 to January 2002. The causes of mitral regurgitation were degenerative in 238 (54%), rheumatic in 134 (31%), and others in 65 (15%). The most frequently employed surgical techniques were ring annuloplasty in 417 (95%) cases, new chordae formation in 216 (50%), and quadrangular resection in 117 (27%). The mean follow-up was 29.04 ± 22.81 months. There were 5 (1.2%) early and 5 (1.2%) late deaths. The reoperation rate was 1.6% with 41 (9%) cases of recurrent mitral regurgitation. Of these 22 were procedure-related: incomplete repair in 13, discordant new chordal length in 7, suture dehiscence and leaflet perforation in 1 case each. There were 19 cases of valve related failures: progression of rheumatic disease in 18 and subacute infective endocarditis in 1. Valve-related failure strongly correlated with progression of rheumatic disease. As initial operative success was the prime determinant of repair durability, intraoperative repair assessment with transesophageal echocardiography was essential.
Stent Implantation to Maintain Patency of a Stenosed Blalock Taussig Shunt
Authors: Kouatli Amjad , Al-Ata Jameel , Galal M Omar , Amin Muhammed A , Hussain Arif
Published: May 2013

A 14-year-old female with complex congenital heart disease underwent a left-sided classical Blalock Taussig (BT) shunt 15 days after birth. Ten years after the operation her oxygen saturation had decreased significantly. An angiography revealed a severely stenosed BT shunt. Balloon dilation including implantation of a 6 × 13 mm stent was performed successfully. Immediately after intervention, oxygen saturation rose from 55% to 80 84% in room air. Follow-up at a year and a half later showed the classical BT shunt was still patent.
Associated Coronary Anomalies in 135 Iranian Patients with Tetralogy of Fallot
Authors: Hekmat Manouchehr , Rafieyian Sima , Foroughi Mahnoush , Tehrani Majidi Mohammad M , Monfared Beheshti Mahmoud , Hassantash Seyed A
Published: May 2013

Coronary artery anomalies are common among patients with tetralogy of Fallot. One hundred and thirty-five patients (80 males and 55 females) with tetralogy of Fallot who underwent repair between 1995 and 2002 were studied to determine the incidence of coronary anomalies in Iranian patients. Eight (5.9%) patients (4 males and 4 females) had a surgically relevant coronary artery anomaly: single coronary ostium in 5, origin of the left anterior descending artery from the right coronary artery in 2, and origin of the right coronary artery from the left coronary artery in 1. The surgical technique in 3 of these patients was repair of the ventricular septal defect with a transverse incision on the right ventricle, without damage to the coronary arteries. In another patient, an allograft aortic valve cylinder was inserted. In the other 4 patients with a single coronary ostium, placement of a limited transannular patch was adequate. Consideration of these anomalies during primary repair could decrease the risk of operation in such patients. However, it seems that the presence of anomalous coronary arteries does not affect incremental risk after surgical repair.
Relationship of Tumor Size to Survival in Patients with pT2N0 Lung Cancer
Authors: Suemitsu Ryuichi , Ueda Hitoshi , Shikada Yasunori , Ondo Kaoru , Yoshino Ichiro , Maehara Yoshihiko
Published: May 2013

Lung cancer extending beyond 3 cm in diameter without lymph node or distant metastasis is defined as T2. The purpose of this study was to analyze the prognosis based on tumor size for patients with resected T2N0M0 non-small cell lung cancer. The 268 patients who underwent complete resection of a lung tumor > 3 cm in diameter were reviewed retrospectively. They were divided into 3 groups based on tumor size: 3–5 cm, > 5–7 cm, and > 7 cm. There were significant differences in the 5-year survival rates of 61.4%, 47.9%, and 21.9% in each group, respectively. In the two subgroups with tumor sizes 3–4 cm and > 4 cm, the 5-year survival was 63.8% and 48.1%, respectively. Tumors > 4 cm in diameter indicate a poor long-term prognosis.