bluuebunny/crossref_metadata_2025 huggingface dataset:
Montoneros o la ballena blanca: Malvinas como el cruce de dos obsesiones utópicas
Authors: Svetliza Exequiel
Published: July 2022

La guerra de Malvinas es un episodio histórico atravesado por profundas contradicciones sociales, políticas e ideológicas. Montoneros o la ballena blanca (2012), la novela del historiador Federico Lorenz, ingresa en el convulsionado mundo de la violencia política argentina de las décadas del 70 y 80 para representar dos guerras: la interna, entre la izquierda revolucionaria y la triple A (Alianza Anticomunista Argentina); y la externa, entre Argentina y Gran Bretaña por las islas del Atlántico sur. Historia y ficción se entremezclan en el texto para develar la compartida obsesión de la izquierda y la derecha argentina por Malvinas.
Databases on the history of local population migrations in Russia at the end of the XIX – XX centuries: information capabilities and processing methods. Part I.
Authors: D'yachkov Vladimir L'vovich
Published: July 2022

In the first part of the proposed article, the information capabilities and methods of processing in electronic databases (EBD) of the first two groups of sources on local population migrations in Russia at the end of the XIX – XX centuries are analyzed and illustrated: 1) pre-revolutionary parish registers, Soviet statistics of registry offices for individual rural and urban settlements, materials of All-Russian censuses population and other census documents containing information about the movement of the population at the micro level of individual settlements; 2) replenished "author's" EBDS of student genealogies (48 information parameters; about 150 thousand personalities as of April 2022) and surveys of women who have completed prolific activities (40 information parameters; 11.5 thousand respondents as of April 2022) The scientific novelty of the proposed study of the information capabilities of the first two blocks of representative sources on local migrations of the Russian population of the history of the period under consideration is provided, first of all, by strict adherence to the principle of historicism, obliging to take what is being studied in motion, in the totality of all its aspects and as it was in the real past. The principle of historicism dictates, in turn, the methodology for creating EBDS of traditional and unique mass sources on social history. Records in metric books, materials of registry offices, population censuses, surveys of elderly women and student genealogies with a truly historical method of obtaining and processing data turn out to be necessary, mandatory and often irreplaceable sources of knowledge and tools for uncovering the mobile socio-natural synergy of domestic new and modern history on the longest and continuous rows of complex demographic and sociographic information. Local migrations are the most important, but part of this synergy.
Information System on Digital Humanities: an experiment of describing the Internet resources of Russian archives
Authors: Antopolskii Aleksander Borisovich , Volodin Andrey Urievich
Published: July 2022

The article contains a description of the results of the inventory of the Internet resources of the Russian archives, carried out in order to create a reference and information system on digital humanities (CISG). The objects that together form the infosphere of this discipline are determined. The problem of detailing the level of resources in their accounting and cataloging is considered. The criteria for selecting specific resources that are interesting to the user are discussed. The structure of the database of the projected system is given. The issues of using languages for indexing information objects are discussed. The quantitative characteristics of the inventory are given. The CG system should ensure increased visibility, citation and reuse of digital humanities objects created in Russia. In this study, the resources of federal archives, state archives of the subjects of the Russian Federation presented on the Internet were studied, as well as departmental archives in a small number, if they have socio-humanitarian content. The management bodies of the archives of the subjects of the Russian Federation were included in the database if they have their own website hosting resources of interest. Archives with dominant technical or natural-scientific content were not included in the study. Also, at this stage, the resources of municipal archives were not considered. The study also identified the main methodological problems of accounting and cataloging of Internet resources that need to be solved.
To biofilm or not to biofilm
Authors: Pradeep Shravan , Arratia Paulo E
Published: July 2022

A new model helps to predict under which conditions a species of bacteria will switch to a static lifestyle.
Growth parameters and responses of green algae across a gradient of phototrophic, mixotrophic and heterotrophic conditions
Authors: Young Erica B. , Reed Lindsay , Berges John A.
Published: July 2022

Many studies have shown that algal growth is enhanced by organic carbon and algal mixotrophy is relevant for physiology and commercial cultivation. Most studies have tested only a single organic carbon concentration and report different growth parameters which hampers comparisons and improvements to algal cultivation methodology. This study compared growth of green algae Chlorella vulgaris and Chlamydomonas reinhardtii across a gradient of photoautotrophic-mixotrophic-heterotrophic culture conditions, with five acetate concentrations. Culture growth rates and biomass achieved were compared using different methods of biomass estimation. Both species grew faster and produced the most biomass when supplied with moderate acetate concentrations (1–4 g L−1), but light was required to optimize growth rates, biomass yield, cell size and cell chlorophyll content. Higher acetate concentration (10 g L−1) inhibited algal production. The choice of growth parameter and method to estimate biomass (optical density (OD), chlorophyll a fluorescence, flow cytometry, cell counts) affected apparent responses to organic carbon, but use of OD at 600, 680 or 750 nm was consistent. There were apparent trade-offs among exponential growth rate, maximum biomass, and culture time spent in exponential phase. Different cell responses over 1–10 g L−1 acetate highlight profound physiological acclimation across a gradient of mixotrophy. In both species, cell size vs cell chlorophyll relationships were more constrained in photoautotrophic and heterotrophic cultures, but under mixotrophy, and outside exponential growth phase, these relationships were more variable. This study provides insights into algal physiological responses to mixotrophy but also has practical implications for choosing parameters for monitoring commercial algal cultivation.
FastANI, Mash and Dashing equally differentiate between Klebsiella species
Authors: Hernández-Salmerón Julie E. , Moreno-Hagelsieb Gabriel
Published: July 2022

Bacteria of the genus Klebsiella are among the most important multi-drug resistant human pathogens, though they have been isolated from a variety of environments. The importance and ubiquity of these organisms call for quick and accurate methods for their classification. Average Nucleotide Identity (ANI) is becoming a standard for species delimitation based on whole genome sequence comparison. However, much faster genome comparison tools have been appearing in the literature. In this study we tested the quality of different approaches for genome-based species delineation against ANI. To this end, we compared 1,189 Klebsiella genomes using measures calculated with Mash, Dashing, and DNA compositional signatures, all of which run in a fraction of the time required to obtain ANI. Receiver Operating Characteristic (ROC) curve analyses showed equal quality in species discrimination for ANI, Mash and Dashing, with Area Under the Curve (AUC) values above 0.99, followed by DNA signatures (AUC: 0.96). Accordingly, groups obtained at optimized cutoffs largely agree with species designation, with ANI, Mash and Dashing producing 15 species-level groups. DNA signatures broke the dataset into more than 30 groups. Testing Mash to map species after adding draft genomes to the dataset also showed excellent results (AUC above 0.99), producing a total of 26 Klebsiella species-level groups. The ecological niches of Klebsiella strains were found to neither be related to species delimitation, nor to protein functional content, suggesting that a single Klebsiella species can have a wide repertoire of ecological functions.
Comparison of GUM and Monte Carlo Methods for the Measurement Uncertainty Circular Runout Error of Shafts
Authors: Ounjutturaporn Pornpawit , Kesvarakul Ramil , Poonsawat Pipitanon , Limpadapun Khompee
Published: July 2022

Measurement uncertainty is one of the most important concepts. The ISO IEC 17025:2005 standard: describes harmonized policies and procedures for testing and calibration laboratories. Guide to the expression of uncertainty in measurement (GUM) is a direct uncertainty analysis method, which calculates the combined standard uncertainty and expanded uncertainty by law of propagation of uncertainty. Monte Carlo Method (MCM) as presented by the (GUM S1) involves the propagation of the distributions of the input sources of uncertainty by using a model to provide the distribution of the output. By random sampling, the probability density function of the input quantities. In this paper, present measurement uncertainty to circular runout error. By use shaft standard with a diameter of 32 mm., length 100 mm. From the experiment results, Comparison of GUM and MCM showed no differences. The cases the estimated uncertainty using the GUM approach slightly overestimated the results obtained with the MCM. However, the use of numerical methods such MCM as a valuable alternative to the GUM approach. The practical use of MCM it has proven to be a fundamental tool, being able to address more complex measurement problems that were limited by the GUM approximations.
Role of Statins on Cognition and Section Memory: A Case-control Study
Authors: Shanmugapriya S , Karthika P , Praneetha CS , Rajendiran G
Published: July 2022

Introduction: Statins are a class of lipid lowering medication which can effectively lower cardiovascular mortality and morbidity by the beneficial effects in atherosclerotic cardiovascular disease. Recently, there are increasing concerns over the relationship between statins and cognitive deficits. On the contrary, some studies have indicated an improvement in memory functions with the use of statins. However, the impact of statins on cognition is still unclear. Aim: To analyse the effect of statins on cognition and memory using Mini-Mental Scale Examination (MMSE). Materials and Methods: The case control study was conducted in Department of Cardiology at PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India (tertiary care teaching hospital), from June 2019 to December 2019. Out of total 127 participants, case group included 63 adult patients of both gender, on statin therapy for at least 12 weeks duration and control group included 64 age and gender matched adults who were not on statin therapy. After obtaining a written informed consent, MMSE questionnaire was administered by a trained blinded interviewer to both groups. Pearson’s correlation was done to evaluate any significant correlation between duration of statin therapy with MMSE and individual domain scores. Data was analysed using Statistical Package for Social Sciences (SPSS) version 24.0, and p-value <0.05 was considered significant. Results: The mean age of the cases was 61.1±7.90 years, and that of the control group was 60.6±7.68 years. Using the cut-off score of 23 to diagnose dementia, 21 (33.3%) cases and 24 (37.5%) control participants had cognitive deficits, with no statistically significant difference. The mean score of patients on statin therapy for more than one year (26.45±3.03) was higher compared to those with less than or equal to one year duration of therapy (24.48±4.11), but did not reach statistical significance. But, statistically significant difference between mean scores of cases and controls was evident in cognitive domains like registration (p-value=0.01) and recall (p-value=0.04) in addition to a significant correlation (p-value=0.03) between the duration of statin therapy and orientation score. Conclusion: This study refutes the possibility of an association of statin therapy with cognitive decline in the study population. On the other hand, the results are illustrative of a potential cognitive benefit with the use of statins.
NON-INVASIVE METHOD OF BIOSTIMULANT ADMINISTRATION INTO THE EGG: AN ALTERNATIVE TO IN OVO INJECTIONS
Authors: Lugovaya Inessa S. , Pozyabin Sergey V. , Azarnova Tatyana O. , Naidensky Mark S. , Nikiforova Zoya N.
Published: July 2022

This article discusses practical aspects of a non-invasive method to administer biostimulants inside the egg versus an injection method. Considering literature data and our own long-term studies, benefits and disadvantages were identified for each method of biostimulant administration. Given a large number of small poultry farms, the non-invasive method is technologically simple and cost-effective for the poultry industry. The purpose of this research was to determine the effectiveness of certain biostimulants composition for different types of poultry in a non-invasive way of its administration. The studies were conducted on different poultry farms in the Russian Federation. The experiments used eggs of Hybrid Converter turkeys, Japanese quails, grey-speckled guineafowls, and Ross 308 broilers. Biological control indicators of incubation were recorded against hatched eggs by a method generally accepted on the poultry farms. We received positive results that proved the high efficiency of the non-invasive method of delivering biostimulants into eggs, which contributed to the increased hatchability of young birds. Thus, considering all advantages of the presented method, it can be recommended for use on poultry farms.
PKC α regulates thrombin‐induced PDGF‐B chain gene expression in mesangial cells
Authors: Biswas Purba , Abboud Hanna E. , Kiyomoto Hideyasu , Wenzel Ulrich O. , Grandaliano Giuseppe , Choudhury Goutam Ghosh
Published: July 2002

Thrombin is a potent mitogen for mesangial cells and stimulates PDGF B‐chain gene expression in these cells. It also activates phospholipase C (PLC) resulting in an increase in cytosolic Ca2+ and diacylglycerol (DAG) that are the physiological activators of protein kinase C (PKC). Immunoprecipitation of specific PKC isotypes from thrombin‐stimulated mesangial cells with subsequent measurement of their enzymatic activity shows activation of Ca2+‐dependent PKC α and Ca2+‐independent PKC Σ in a time dependent manner. Optimum activation of both of these isozymes was obtained at 60 minutes. PKC α activity increased 83% over basal while activity of PKC Σ increased 104%. Prolonged exposure of mesangial cells to phorbol myristate acetic acid (PMA) inhibited the enzymatic activity of PKC α but not PKC Σ. This inhibition of PKC α had no effect on thrombin‐induced DNA synthesis but abolished PDGF B‐chain gene expression induced by thrombin. These data provide the first evidence that PKC α activation is necessary for thrombin‐induced PDGF B‐chain gene expression but not for thrombin‐induced DNA synthesis.
Genotype dependent and cigarette specific effects on endothelial nitric oxide synthase gene expression and enzyme activity
Authors: Wang Xing Li , Sim Ah Siew , Wang Min Xia , Murrell George A.C. , Trudinger Brian , Wang Jian
Published: July 2002

We explored the interactive effects of endothelial nitric oxide synthase (eNOS) genotypes and cigarette smoking on protein levels and enzyme activity in 33 postpartum placentas. Whilst the eNOS protein levels were lower in the rare allele (0.48±0.11, n=9 vs. 1.05±0.10, n=24, P<0.01), the eNOS enzyme activity was about 7‐fold higher in the rare allele (4556.2±255.4 vs. 621.8±180.5 cpm/mg/min, P<0.01). Smokers had lower eNOS protein levels (1.07±0.09 vs. 0.50±0.19, P<0.05) in both alleles. It reduced the eNOS activities only in the rare allele (non‐smokers: 6143.8±251.2, n=5, smokers: 2968.5±259.4, n=4, 52% reduction, P<0.01). We conclude that associations between eNOS polymorphism and protein levels and enzyme activities are modifiable by smoking, the effects of smoking are dependent on the eNOS genotypes.
7. Inhalation dose coefficients for members of the public: labelled methane: (Addendum 1 to ICRP Publication 72)
Authors: Valentin D. J.
Published: July 2002

This is an Addendum to ICRP Publication 72 concerning age-dependent doses to members of the public from intakes of radionuclides. It provides inhalation dose coefficients for labelled methane for members of the public, jointly prepared by two Task Groups of ICRP Committee 2.
Embryonic stem‐cell derived neurones express a maturation dependent pattern of voltage‐gated calcium channels and calcium‐binding proteins
Authors: Arnhold Stefan , Andressen Christian , Angelov Doychin N. , Vajna Rolf , Volsen Stephen G. , Hescheler Jürgen , Addicks Klaus
Published: July 2002

There are remarkable changes of calcium binding proteins and voltage dependent Ca2+ channel subtypes during in vitro differentiation of embryonic stem cell derived neurons. To observe these maturation dependent changes neurones were studied using combined immunohistochemical, patch clamp and videomicroscopic time lapse techniques. Embryonic stem cell derived neuronal maturation proceeds from apolar to bi‐ and multipolar neurones, expressing all Ca2+ channel subtypes. There is, however, a clear shift in channel contribution to whole cell current from apolar neurones with mainly N‐ and L‐type channel contribution in favour of P/Q‐ and R‐type participation in bi‐ and multipolar cells. Expression of the calcium binding protein parvalbumin could be detected in bipolar, while calretinin and calbindin was preferentially found in multipolar neurones. Our data provides new insights into fundamental neurodevelopmental mechanisms related to Ca2+ homeostasis, and clarifies contradictory reports on the development of Ca2+ channel expression using primary cultures of neurones already committed to certain brain compartments.
Biodegradation of Hydrogen Sulfide by a Laboratory‐Scale Immobilized Pseudomonas putida CH11 Biofilter
Authors: Chung Ying‐Chien , Huang Chihpin , Tseng Ching‐Ping
Published: July 2002

A heterotrophic Pseudomonas putida CH11 was isolated from livestock farming wastewater and applied for the treatment of H2S‐containing gas. Extensive tests including removal characteristics, metabolic products, and removal efficiencies of H2S by P. putida CH11 were examined in batch and continuous systems. The optimum pH required to remove hydrogen sulfide was found in the range of 6–8. The maximum removal rate and the saturation constant were calculated to be Vm = 1.36 g S/day·kg dry bead and Ks = 45.9 ppm, respectively. The main metabolic product of H2S oxidation was determined to be elemental sulfur. When P. putida CH11 was immobilized within Ca alginate, the cells exhibited high H2S removal efficiency, in excess of 96%, at concentrations of hydrogen sulfide from 10 to 150 ppm (flow rates of 36 and 72 L/h). These results suggest that P. putida CH11 immobilized within Ca alginate has the potential to be used as a H2S removal agent.
γ‐Decalactone Production by Trichoderma harzianumin Stirred Bioreactors
Authors: Serrano‐Carreón Leobardo , Flores Celia , Galindo Enrique
Published: July 2002

Production of γ‐decalactone, a compound having peach‐like aroma characteristics, by a strain of Trichoderma harzianumis reported here for the first time. Cultures were carried out in a 14 L fermentor using castor oil as the sole carbon source. The filamentous‐like growth of the microorganism resulted in highly viscous and non‐Newtonian broths, which caused the formation of stagnant zones in the fermentor. T. harzianum was able to produce 260 mg/L of γ‐decalactone after 7 days of culture in a stirred fermenter operated at 3.3 s−1 and 1 vvm of air flow rate. The production of γ‐decalactone was mainly non‐growth associated. The use of high agitation rates—to improve mixing—resulted in celullar lysis. Cell damage occurred at volumetric power drawn as low as 0.2 W/L. Mycelial morphology (mainly hyphal thickness) changed drastically along the culture and was an important influence on the rheology of the broths. All these characteristics make this system an interesting model of study of hydrodynamically complex fermentations involving up to four phases.
Simultaneous Optimization of Feeding Rate and Operation Parameters for Fed‐Batch Fermentation Processes
Authors: Wang Feng‐Sheng , Cheng Wen‐Ming
Published: July 2002

An efficient method is introduced for simultaneously determining optimal polices of feeding rate and operation parameters for a fermentation process. Such an optimization problem is converted into the finite dimensional optimization problem using the control parametrization technique. The hybrid differential evolution is introduced to solve the converted problem. The optimal production rate obtained by the simultaneous optimization approach could be significantly improved with comparison to a simplified optimization problem, which is considered the optimal feed control only, as observed from the simulation results.
Pivotal role of superoxides generated in the mitochondrial respiratory chain in peroxynitrite-dependent activation of phospholipase A2
Authors: GUIDARELLI Andrea , CANTONI Orazio
Published: July 2002

Exposure of PC12 cells to reagent peroxynitrite promotes the release of arachidonic acid (AA) mediated by activation of phospholipase A2 [Guidarelli, Palomba and Cantoni (2000) Br. J. Pharmacol. 129, 1539–1542]. We now present experimental evidence consistent with the notion that this response is not directly triggered by peroxynitrite but, rather, by reactive oxygen species generated at the level of complex III of the mitochondrial respiratory chain. In particular, superoxide (and not hydrogen peroxide) has a pivotal role in peroxynitrite-dependent activation of phospholipase A2. This observation was confirmed by results showing that superoxide, or peroxynitrite, promotes release of AA in isolated mitochondria. Consistently, the release of AA elicited by either peroxynitrite or A23187 in intact cells was shown to be calcium-dependent and differentially affected by phospholipase A2 inhibitors with different levels of specificity. In particular, the effects of peroxynitrite, unlike those of A23187, were both sensitive to low concentrations of two general phospholipase A2 inhibitors and insensitive to arachidonyltrifluoromethyl ketone, which shows some selectivity towards cytosolic phospholipase A2. In addition, peroxynitrite and A23187 synergistically enhanced the release of AA. Collectively, the above results demonstrate that peroxynitrite causes inhibition of complex III, followed by enforced formation of superoxides that stimulate the activity of a calcium-dependent PLA2 isoform, probably localized in the mitochondria.
Androgen receptor expression is regulated by the phosphoinositide 3-kinase/Akt pathway in normal and tumoral epithelial cells
Authors: MANIN Michèle , BARON Silvère , GOOSSENS Karine , BEAUDOIN Claude , JEAN Claude , VEYSSIERE Georges , VERHOEVEN Guido , MOREL Laurent
Published: July 2002

The androgen receptor (AR) is a ligand-responsive transcription factor known to play a central role in the pathogenesis of prostate cancer. However, the regulation of AR gene expression in the normal and pathological prostate remains poorly understood. This study focuses on the effect of the phosphoinositide 3-kinase (PI 3-kinase)/Akt axis on AR expression in vas deferens epithelial cells (VDEC), a suitable model to study androgen regulation of gene expression, and LNCaP cells (derived from a metastasis at the left supraclavicular lymph node from a 50-year-old patient with a confirmed diagnosis of metastatic prostate carcinoma). Taken together, our data show for the first time that the PI 3-kinase/Akt pathway is required for basal and dihydrotestosterone-induced AR protein expression in both VDEC and LNCaP. Inhibition of the PI 3-kinase/Akt pathway reduced AR expression and the decline in AR protein level correlated with a decrease in AR mRNA in VDEC but not in LNCaP. Since PI 3-kinase/Akt axis is active in prostate cancer, cross-talk between PI 3-kinase/Akt and AR signalling pathways may have implications for endocrine therapy.
Analysis of the tissue factor pathway inhibitor gene and antigen levels in relation to venous thrombosis
Authors: Amini‐Nekoo Ali , Futers T. Simon , Moia Marco , Mannucci Pier M. , Grant Peter J. , Ariëns Robert A. S.
Published: July 2002

Tissue factor pathway inhibitor (TFPI) inhibits tissue factor‐induced coagulation. The major part of TFPI is releasable by heparin. We recently found eight patients with thrombosis and low levels of heparin‐releasable TFPI in whom we investigated the TFPI gene for mutations. A transition of G to A coding for Valine264Methionine in the heparin‐binding domain was found. The Val264Met polymorphism had an allele frequency of 3% in 96 healthy individuals. A silent polymorphism was identified in TFPI exon IV (T→C), which does not alter Tyrosine 56. Apart from Val264Met, which was detected in one out of the eight patients, no other mutations in the TFPI gene were found in patients with low heparin‐releasable TFPI. Analysis of Val264Met in 317 patients with deep vein thrombosis (DVT) and 292 controls showed no association between Val264Met and DVT. However, a study of total TFPI antigen levels in 122 DVT patients and 126 controls demonstrated an association between TFPI levels and venous thrombosis (P = 0·0001). These results provide evidence for a relationship between venous thrombosis and total TFPI level as a possible risk factor, whereas they do not support a link between DVT and mutations in the nine exons of the TFPI gene.
Circulating bile is the main factor responsible for atrial natriuretic peptide release in experimental obstructive jaundice
Authors: Martínez-Ródenas F , Pereira J A , Jiménez W , Gubern J M , Sitges-Serra A
Published: July 2002

Background

Biliary obstruction in the rabbit causes increased release of atrial natriuretic peptide (ANP). Circulating bile, raised biliary pressure or absence of bile in the duodenum may be implicated in this hepatocardiac syndrome.

Methods

An experimental model was developed to elucidate the mechanism linking obstructive jaundice and increased plasma ANP. Hepatic and renal function, biliary tree pressure and ANP plasma concentrations were investigated in conscious rabbits 4 and 24 h after common bile duct ligation, biliovenous shunting or external drainage via a biliary fistula.

Results

Bilirubin concentration increased after bile duct ligation and creation of a biliovenous shunt. Plasma creatinine increased abruptly in rabbits with a biliovenous shunt. At 4 h, the ANP increase in animals with a biliovenous shunt was ninefold that observed after bile duct obstruction while no change was noted after external biliary diversion (mean 350 versus 45 versus 9 fmol/l; P < 0·01). Relief of biliary tree obstruction was associated with a return of ANP levels towards basal normal values.

Conclusion

Raised plasma ANP in obstructive jaundice is not the result of an increased biliary pressure per se or absence of bile in the proximal duodenum but of the passage of bile components to the circulation.
Effect of lithium γ-linolenate on the growth of experimental human pancreatic carcinoma
Authors: Ravichandran D , Cooper A , Johnson C D
Published: July 2002

Background

The lithium salt of γ-linolenic acid (Li-GLA) is growth inhibitory to pancreatic cancer cells in vitro and is reported to prolong the survival of patients with pancreatic cancer. The effect of Li-GLA on the growth of human pancreatic carcinoma in vivo is not known. In this study the effect of parenterally administered Li-GLA on the growth of human pancreatic carcinoma in nude mice was tested.

Methods

Pancreatic tumours were produced in nude mice by subcutaneous implantation of MIA PaCa-2 cells. This cell line is sensitive to Li-GLA in vitro. Mice were randomly treated with intraperitoneal, intravenous or intratumoral Li-GLA. Each group also had controls.

Results

Both intravenous and intraperitoneal administration of Li-GLA had no significant effect on tumour growth or tumour phospholipid fatty acid composition. Intratumoral administration of Li-GLA was, however, associated with a significant antitumour effect.

Conclusion

Within the limitations of this tumour model, the benefit seen with intravenous Li-GLA in patients with pancreatic carcinoma cannot be explained by tumour growth inhibition. Local administration appears to be more effective than intravenous or intraperitoneal therapy.
Smoking may be associated with complications in diverticular disease
Authors: Papagrigoriadis S , Macey L , Bourantas N , Rennie J A
Published: July 2002

Background

The vast majority of people with diverticula remain asymptomatic or develop minor symptoms while a small group develop serious complications that are associated with significant morbidity and mortality rates. The aim was to identify any risk factors predisposing to complications.

Methods

Eighty patients with diverticular disease were studied. Patients in group 1 (n = 45) with complications requiring hospitalization or surgery were compared with those in group 2 (n = 35) with asymptomatic diverticula or minor symptoms. Logistic regression analysis was performed.

Results

No differences in epidemiological factors, concurrent and past medical and surgical conditions or chronic medication were detected between the two groups. Generalized disease was not associated with more complications than sigmoid disease. However, smoking seemed to be an independent factor predisposing to complications; the proportion of smokers in group 1 was significantly greater (24 of 45) than that in group 2 (ten of 35) (odds ratio 2·9, P = 0·028).

Conclusion

In patients with diverticular disease, smoking is associated with an increased risk of complications.
Arterial intervention and reduction in amputation for chronic critical leg ischaemia
Authors:   FINNVASC Study Group, Luther M , Kantonen I , Lepäntalo M , Salenius J-P , Ylönen K
Published: July 2002

Background

Untreated chronic critical leg ischaemia (CLI) usually leads to an amputation or death of a patient. Surgical and endovascular interventions may improve arterial flow. Long infrainguinal reconstruction may be the most useful method for preventing amputations. The value of different reconstruction methods was assessed by their impact on amputation incidence.

Methods

A nationwide 2-year analysis of the incidence of major amputations and reconstructions for CLI was done in Finland (population 5·1 million). Incidences were compared in hospital regions with more than 150 000 inhabitants.

Results

The overall amputation incidence was 216 per million inhabitants per year. The corresponding incidence of arterial reconstructions was 203 per million inhabitants per year. There were large variations in the incidence of amputations and reconstructions; 20-fold differences in infrapopliteal surgical reconstructions and 30-fold differences in endovascular procedures were found. There was a correlation between a high incidence of infrapopliteal surgical reconstructions and a low incidence of amputations. This correlation was found for below-knee amputations only.

Conclusion

These results suggest that long surgical reconstructions improving perfusion directly to the ischaemic tissue can improve leg salvage.
Intraperitoneal polypropylene mesh repair of incisional hernia is not associated with enterocutaneous fistula
Authors: Vrijland W W , Jeekel J , Steyerberg E W , den Hoed P T , Bonjer H J
Published: July 2002

Background

Incisional hernia repair with prosthetic material is followed by fewer recurrences than primary repair. Polypropylene is the most commonly used prosthetic material but may cause enterocutaneous fistulas. The aim of this study was to determine whether enterocutaneous fistulas developed after incisional hernia repair with polypropylene mesh and to evaluate clinical outcome after incisional hernia repair.

Methods

A retrospective analysis of the outcome of incisional hernia repair with polypropylene mesh between 1982 and 1998 was conducted. Follow-up data were obtained from medical records and questionnaires.

Results

Polypropylene incisional hernia repair was performed in 136 patients. Median follow-up was 34 months. No enterocutaneous fistulas developed. Wound infection occurred in 6 per cent. Wound sinus formation occurred in two patients. No mesh was removed because of infection and no persisting infection of the mesh occurred.

Conclusion

Enterocutaneous fistula formation appears to be very rare after incisional hernia repair with polypropylene mesh, regardless of intraperitoneal placement, omental coverage or closing of the peritoneum.
Prospective 5-year audit for day-case laparoscopic cholecystectomy
Authors: Huang A , Stinchcombe C , Phillips D , McWhinnie D L
Published: July 2002

Aims

Laparoscopic cholecystectomy can be performed as a day-case procedure but success depends on adequate recovery time, patient motivation and physical condition. To determine the proportion of patients suitable for a day-case procedure, 23-h stay and inpatient treatment, a prospective audit was introduced in 1994.

Methods

A 5-year (1994–1999) prospective annual audit was performed for all patients undergoing laparoscopic cholecystectomy (537 patients). In the first 3 years patients were either classified as day-case or inpatient stay; the establishment of a 23-h stay ward allowed a third option for these patients.

Results

Day-case laparoscopic cholecystectomy, including 23-h stay in the final 2 years of the audit, increased in each of the 5 years from 16 to 80 per cent. The audit loop was closed when the successful allocation rate for day-case patients was reaudited; this increased from 56 per cent in the first year to 88 per cent in the final year.

Conclusions

This audit has identified the need for extended recovery for patients undergoing more major procedures on an ambulatory basis such as laparoscopic cholecystectomy. Further refinements in selection criteria and improved analgesia control are needed to reduce the unexpected extended stay for day-case and ambulatory patients.
Experience of pancreaticoduodenectomy in a district general hospital
Authors: Akhtar K , Perricone V , Chang D , Watson R J
Published: July 2002

Aims

Long-term survival after surgery for pancreatic cancer remains very low and it is particularly important that minimal surgery-related morbidity and mortality rates are achieved. It has been stated that centres performing small numbers of proximal pancreaticoduodenectomies are likely to have high morbidity and mortality rates. The results of pancreatic surgery in a district general hospital are reported.

Methods

This was a retrospective analysis of all pancreaticoduodenectomies over 4 years.

Results

Twenty-one selected patients underwent proximal pancreaticoduodenectomy and two patients total pancreatectomy over a 4-year period from 1995 to 1999. The operations were performed by two surgeons with a special interest in upper gastrointestinal surgery. The median age was 62 (38–83) years. There were 14 men and nine women. Fifteen patients had adenocarcinoma of the head of the pancreas, five had ampullary carcinoma, one duodenal carcinoma and there was one case of chronic pancreatitis. Six patients had pylorus-preserving pancreaticoduodenectomy (PPPD) and 15 had a standard Whipple procedure. The median stay in hospital was 20 (13–26) days. Two patients had a pancreatic leak, one of whom developed an intra-abdominal abscess which was treated successfully by percutaneous drainage. Six patients experienced delayed gastric emptying, two of whom had PPPD. Both the 30-day and in-hospital mortality rates were zero. The median number of lymph nodes dissected was 12 and in 11 patients no nodal metastasis was found.

Conclusions

It is possible to perform pancreatic surgery in a district general hospital and achieve results that are comparable to those of specialist centres.
Operative versus conservative management of adhesional intestinal obstruction
Authors: Mosley J G , Shoaib A
Published: July 2002

Aims

This prospective controlled trial was undertaken to resolve the controversy over whether intestinal obstruction due to postoperative adhesions should be managed by immediate operation or by conservative care.

Methods

A randomized prospective controlled study was undertaken of all private and public sector patients admitted under the care of one surgeon with intestinal obstruction due to postoperative adhesions over a 15-year period. The patients were randomly allocated either to immediate operation or conservative care with nasogastric aspiration and intravenous fluids. Patients managed conservatively who had not settled after 5 days were operated on. The data were analysed by Student's t test and Fisher's exact test.

Results

There were 127 patients. The two groups were statistically identical regarding age, number of previous operations and time since last operation, and heart rate, blood pressure, haemoglobin concentration, white count and urea level on admission. Sixty-three patients were treated conservatively; 22 failed to settle and were operated on, of whom 11 required a bowel resection. There were two postoperative deaths. In 64 patients treated immediately by operation, the incidence of bowel resection was not significantly reduced (22 per cent; P > 0·05) but there were four postoperative deaths. There was no significant difference in the length of stay.

Conclusions

Conservative management of postoperative adhesional intestinal obstruction is safe and 65 per cent settle. In those who fail to settle there is no significantly increased risk of bowel strangulation. There is no way of identifying those who will not settle from the history or initial investigations on admission.
Telementoring in laparoscopic cholecystectomy: a useful adjunct in training and assessment of higher surgical trainees
Authors: Byrne J P , Mughal M M
Published: July 2002

Aims

This study assessed the feasibility, safety and utility of telementoring as a training tool in laparoscopic cholecystectomy (LC) for higher surgical trainees (HST). Telementoring in LC was developed as a technique for objective assessment of performance and progress in order to help decide when an HST is competent to perform LC unsupervised.

Methods

This was a prospective study of patients attending for LC, with surgery performed by an HST, in which the laparoscopic image was relayed live to an adjoining room where a supervising consultant observed the procedure. The trainee or supervisor sought or proffered advice/assistance as appropriate, and safety, complication rates, operating time, difficulty of procedure, intervention rate and type were recorded.

Results

LC was accomplished in 33 of 34 patients enrolled; there was one conversion to an open procedure. Interaction between the HST and trainer occurred in 11 cases, by way of advice being sought or offered, and in two of these the supervisor scrubbed up and took over the operation. The rate of interaction and duration of the procedure increased with procedure difficulty, with rates of interaction for difficulty grades 1, 2 and 3 of 15 per cent (two of 13), 41 per cent (seven of 17) and 50 per cent (two of four), and overall median operating times of 35 (23–50), 45 (28–75) and 92 (45–110) min respectively.

Conclusions

Telementoring for trainees capable of performing LC is feasible and appears to be safe with a supervising surgeon situated in the immediate vicinity. Telementoring in LC is a promising tool that may provide objective assessment of a trainee's insight, skill and progress in operative performance.
Management of acute pancreatitis: a comparative audit of clinical practice against the recommendations of the British Society of Gastroenterology
Authors: Tunnemann J , Easterbrook J R , Firth J , Wedgwood K R
Published: July 2002

Aims

In 1998 the British Society of Gastroenterology (BSG) published national guidelines for the management of acute pancreatitis (AP) in an attempt to improve diagnosis and reduce mortality rates. A comparative audit was undertaken of the management of AP against the BSG recommendations.

Methods

A retrospective analysis of 53 patients (median age 61 (range 24–95) years) admitted with AP during 1998 was undertaken and a comparison was made with the BSG guidelines.

Results

Some 70 per cent (n = 37) of the patients were admitted with mild AP and 30 per cent (n = 16) with severe AP. The BSG recommendations are shown in parentheses in the following text. The overall mortality rate was 17 per cent (less than 10 per cent), zero in mild AP and 56 per cent in patients with severe AP (less than 30 per cent). A correct diagnosis of AP was made within 48 h of admission in all patients (100 per cent). Severity stratification within 48 h using the Glasgow criteria and C-reactive protein (CRP) level, as suggested by the BSG, was done in approximately 80 per cent of patients.

CRP was measured in 51 per cent of the patients within the first 4 days (100 per cent) and at the end of the first week (100 per cent). Gallstones and alcohol counted for 72 per cent of causes of AP and the aetiology was determined in 77 per cent (75–80 per cent). All patients with severe AP were managed in a high-dependency or intensive therapy unit with central venous pressure monitoring and prophylactic intravenous antibiotics, and underwent dynamic computed tomography within 3–10 days of admission (100 per cent). Some 86 per cent of patients with suspected common bile duct (CBD) stones (jaundice, deranged liver function tests, dilated CBD) underwent endoscopic retrograde cholangiopancreatography with or without duct drainage and clearance.

Conclusions

Management of AP closely mirrors the BSG guidelines, but fails to fully address severity stratification with respect to LDH, CRP and Pao2 at 48 h. A thorough analysis of patients with severe AP (i.e. extent of pancreatic necrosis, onset of infection) has been undertaken to explain the mortality rate and it is proposed to prospectively audit admissions with AP in 1999 in order to close the audit loop.
Symptoms are a poor indication of severity of reflux in Barrett's oesophagus
Authors: Mulligan E D , Purcell T , Lawlor P , Reynolds J V , Byrne P J
Published: July 2002

Aims

Patients with Barrett's oesophagus have increased acid and duodenogastric reflux and impaired motility compared with non-Barrett's patients with reflux disease. Impaired sensitivity to acid infusion and distension have also been described, but the relationship of this visceral response to symptoms is unclear. A symptom index was used to compare Barrett's and non-Barrett's patients with reflux.

Methods

Patients with reflux (DeMeester score above 14) were studied with 24-h pH monitoring and manometry. An event marker recorded symptom events. An event was positive if it corresponded to a period greater than 10 s within 2 min either side of the drop in pH. The symptom index was calculated as the number of symptoms with pH less than 4/total number of symptoms × 100.

Results

Eighteen patients with Barrett's oesophagus were compared with 58 non-Barrett's patients with significant reflux.

Conclusions

Patients with Barrett's oesophagus have a low symptom index compared with non-Barrett's patients with reflux disease. This occurs despite a near 100 per cent increase in acid exposure in the Barrett's group. Symptoms are thus no guide to the severity of reflux in patients with Barrett's oesophagus. Proof of efficacy of therapeutic modalities may need physiological rather than symptom-based confirmation.
Cholecystectomy: does subspecialization alter workload?
Authors: Goodfellow P B , Thomas W E G , Majeed A W , Johnson A G
Published: July 2002

Aims

Cholecystectomy is a common operation. This study reviewed the changes in workload and practice in a teaching hospital over a 4-year period, during which a hepatobiliary subspecialist unit was developed.

Methods

Computerized demographic data, and details of operations and inpatient events were reviewed for all patients undergoing cholecystectomy in a single teaching hospital from 1993 to 1997. For statistical analysis the consultants were grouped into those with a hepatobiliary interest (n = 3) and those with other primary interests (n = 6); and the workload for the first 12 months of the study was compared with that of the last 12-month period.

Results

Between April 1993 and April 1997, 1121 cholecystectomies were performed, of which 75 were excluded because they were performed with other simultaneous procedures. Of the remaining operations, 911 involved cholecystectomy alone (mean patient age 52·9 years), and 135 (12·9 per cent) comprised cholecystectomy with exploration of the common bile duct (ECBD) (mean age 60·1 years). Between the first and last years studied, the rate of ECBD rose significantly from 7·4 to 14·9 per cent (P < 0·01, χ2 test), and the proportion of ECBD procedures being performed by hepatobiliary specialists rose from 31·6 to 52·7 per cent, but this was not statistically significant (P = 0·13). However, for cholecystectomy in the same period the proportion performed by hepatobiliary surgeons rose from 40·4 to 58·5 per cent, representing a highly significant trend (P < 0·001). Following cholecystectomy alone there was a significantly shorter stay associated with patients treated by hepatobiliary surgeons (P = 0·002, F test), although the median postoperative hospital stay was 2 days for both groups of surgeons (interquartile range 1–3 days for hepatobiliary and 1–4 days for non-hepatobiliary surgeons).

Conclusions

Although cholecystectomy is not viewed as a specialist procedure, the trend in this teaching hospital reveals a steady increase in the proportion of cholecystectomies being performed by teams with a biliary interest. The data indicate that this practice is associated with a shorter hospital stay.
Specialized intestinal metaplasia: analysis of prevalence, risk factors and association with gastro-oesophageal reflux disease
Authors: Carton E , Mulligan E D , Keeling P W N , Tanner A , McDonald G , Reynolds J V
Published: July 2002

Aims

There is an increasing awareness that short (less than 3 cm) segments of Barrett's epithelium and macroscopically normal cardia epithelium may harbour specialized intestinal metaplasia (SIM), a premalignant phenotype. This was a prospective study of both the prevalence of SIM in an unselected population of patients attending for endoscopy, and the association of SIM with symptoms, lifestyle, medication, endoscopic oesophagitis and carditis.

Methods

Two hundred consecutive patients underwent endoscopy. Biopsies taken from just below the squamocolumnar junction were stained for SIM, and were analysed for carditis and Helicobacter pylori infection. A detailed questionnaire of symptoms, tobacco consumption and the use of proton pump inhibitors was completed.

Results

Forty-two patients (21 per cent) had SIM, 19 of 126 (15 per cent) in an endoscopically normal oesophagus, 15 of 63 (24 per cent) in a short segment of Barrett's epithelium and eight of 11 in classical Barrett's oesophagus. Comparative analysis between the SIM positive and negative groups with respect to potential risk factors is outlined below.

Conclusions

SIM is prevalent in patients undergoing endoscopy, does not correlate with symptoms or with H. pylori infection, but is significantly associated with endoscopic and pathological markers of gastro-oesophageal reflux.