bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intermittent Pringle Maneuver and Hepatic Function: Perioperative Monitoring by Noninvasive ICG‐Clearance
Authors: Tralhão José Guilherme , Hoti Emir , Oliveiros Bárbara , Abrantes Ana M. , Botelho M. Filomena , Castro‐Sousa F. 
Published: September 2009

AbstractBackgroundIntermittent Pringle maneuver or selective portal clamping often are used to control inflow during parenchymal liver transection. This study was designed to determinate whether these maneuvers are associated with adverse hepatic function.MethodsResection was performed without portal clamping in 17 patients (group 1). Selective continuous portal clamping was performed in 11 patients (group 2) and the remaining 33 patients (group 3) had intermittent nonselective portal clamping (occlusion of the main portal trunk). The centers’ protocol for total portal occlusion is 15‐min occlusion alternated with 5‐min reperfusion in patients with normal liver parenchyma or 10 min alternated with 5 min in patients with abnormal parenchyma. ICG elimination tests were conducted concurrently using a noninvasive monitor that tracks the plasma disappearance rate (PDR‐ICG‐%/min) and 15‐min retention rate after administration (ICG‐R15‐%).ResultsThere was no statistically difference between the three studied groups in terms of sequential changes of ICG‐PDR (p < 0.625) or ICG‐R15 (p < 0.398).ConclusionsOur study indicates that 15 min of intermittent Pringle maneuver or selective hemihepatic continuous portal clamping are safe methods of vascular control during liver resection, with no adverse effects on hepatocellular function.
A Critical Evaluation of Risk Factors for Complications After Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Colorectal Peritoneal Carcinomatosis
Authors: Saxena Akshat , Yan Tristan D. , Morris David L. 
Published: September 2009

AbstractBackgroundCytoreductive surgery (CRS) combined with perioperative intraperitoneal chemotherapy (PIC) has demonstrated improved survival in selected patients with colorectal peritoneal carcinomatosis (CRPC). This treatment modality is associated with relatively high rates of perioperative morbidity and mortality. This study evaluated the clinical and treatment‐related risk factors for perioperative morbidity and mortality in patients with CRPC who underwent CRS and PIC.MethodsSixty‐three consecutive patients who underwent CRS and PIC for CRPC were evaluated. Adverse events were rated from grades I to V with increasing severity. Clinical and treatment‐related risk factors for grades III and IV/V morbidity were determined.ResultsThere were no perioperative deaths (0%). The grades III and IV morbidity rates were 14 and 17%, respectively. A peritoneal cancer index >12 (p = 0.019), transfusion >4 units (p = 0.028), number of peritonectomy procedures >3 (p = 0.013), left upper quadrant peritonectomy procedure (p < 0.001), and number of primary colonic anastomosis >1 (p = 0.004) were associated with grade IV morbidity on univariate analysis. Only left upper quadrant procedure was associated with grade IV morbidity on multivariate analysis (p = 0.002). Only number of primary colonic anastomosis >1 (p = 0.037) was associated with grade III morbidity on univariate analysis. This also was associated with grade III morbidity on multivariate analysis (p = 0.028).ConclusionsCRS and PIC has an acceptable risk of perioperative morbidity in carefully selected patients with CRPC. Patients who require extensive surgery have the highest risk for a severe adverse event. Preoperative evaluation of patients is essential to improve perioperative outcome.
The Lymph Node Ratio Is a Powerful Prognostic Factor of Node‐Positive Colon Cancers Undergoing Potentially Curative Surgery
Authors: Galizia Gennaro , Orditura Michele , Ferraraccio Francesca , Castellano Paolo , Pinto Margherita , Zamboli Anna , Cecere Sabrina , De Vita Ferdinando , Pignatelli Carlo , Lieto Eva 
Published: September 2009

AbstractBackgroundThe number of harvested (LNs) and metastatic nodes (LNs+) represents the most significant factor to define postoperative treatment and prognosis in colon cancer. However, its assessment may be inadequate causing an incorrect cancer staging. The lymph node ratio (LNR: the ratio between metastatic and resected nodes) has shown prognostic significance in many tumors; however, its role in colon cancer is not clearly elucidated. This study investigated LNR as a prognostic factor in node‐positive colon cancers.MethodsA total of 145 consecutive patients with node‐positive colon cancer who underwent curative surgery and adjuvant chemotherapy in a single oncologic unit entered this study.ResultsLNR ranged from 0.0416 to 0.9; it was clearly lower in pN1 than pN2 patients, and increased as tumor stage worsened. ROC analysis selected 0.1818 as the best LNR cutoff value. Low LNR patients did significantly better than high LNR patients; this difference was not dependent on the number of LNs and stronger than differences observed by grouping patients according to LNs or LNs+. When stratified by low and high LNR value, pN1 and pN2 patients, as well as stage III subgroups were shown to display substantially different outcomes. LNR was an independent prognostic factor for disease‐specific survival, and the only covariate related to disease‐free survival.ConclusionsLNR was a robust prognostic indicator for node‐positive colon cancers undergoing curative surgery. Because this ratio‐based staging was demonstrated to reduce stage migration and to aid in identifying high‐risk patients, it should be proposed as a standard tool for colon cancer staging.
Comparison of Invasiveness Between Laparoscopy‐Assisted Total Gastrectomy and Open Total Gastrectomy
Authors: Kawamura Hideki , Yokota Ryoichi , Homma Shigenori , Kondo Yukifumi 
Published: September 2009

AbstractBackgroundBecause only a few studies have been performed to date on the invasiveness of laparoscopy‐assisted total gastrectomy (LATG) compared with open total gastrectomy (OTG), the minimal invasiveness of LATG has been unclear.MethodsThe OTG cohort contained 35 cases, which were performed from April 2003 to October 2005. The LATG cohort contained 46 cases, which were performed from November 2005 to November 2008. Postoperative changes over time in various parameters relating to minimal invasiveness were evaluated. We used the Wong‐Baker FACES Pain Rating Scale to evaluate pain. Vital signs and a face scale were analyzed using daily maximum values on postoperative days (POD) 1–7. A hematological examination was performed on the preoperative day and POD 1, 4, 7, and 10. The number of days until oxygen saturation level (SaO2) was 95% or more in room air was used to evaluate respiratory function.ResultsSignificantly lower pain scores were obtained in the LATG group on POD 1, 4, 5, and 7. There was a significantly lower body temperature in the LATG group on POD 7. A significantly lower white blood cell count was revealed for LATG patients on POD 10, and for C‐reactive protein on POD 1. Significantly higher serum total protein values were observed in the LATG group on POD 1, 4, and 7. Significantly lower blood sugar level was found in the LATG group on POD 4 and 7. The number of days until SaO2 was 95% or more in room air was significantly fewer in the LATG group.ConclusionsLATG seems to be a less invasive procedure than OTG.
Comparison of Four Staging Systems of Lymph Node Metastasis in Gastric Cancer
Authors: Zhang Ming , Zhu Guanyu , Ma Yan , Xue Yingwei 
Published: September 2009

AbstractBackgroundThe classification of lymph node metastasis in patients with gastric cancer is still controversial. Our aim was to evaluate the relative merits of four staging systems of lymph node metastasis.MethodsIn our study, the nodal status was classified according to the 5th edition of the tumor node metastasis (TNM) system, the Japanese Classification of Gastric Carcinoma (JCGC), the ratio of metastatic lymph nodes, and the size of the largest metastatic lymph node. Each staging system was scored as good (+2), fair (+1), or poor (0) with respect to the theoretical value (extent of the anatomical lymphatic tumor spread), convenience (simplicity), surgical applicability (extent of lymph node dissection), and prognostic value (ability to predict survival rate).ResultsIn the multivariate analysis including the four staging systems and other potential prognostic factors, stepwise Cox regression revealed that the ratio of metastatic lymph nodes was the most independent prognostic factor. The TNM, ratio, and size systems were convenient because they had no consideration for the location of the tumor and lymph node. Although the JCGC system had advantages in theoretical value and surgical application, it was most optional due to the complexity of the system.ConclusionsAlthough all different staging systems are comparable, the metastatic lymph node ratio system is convenient, reproducible, and has the highest ability to predict survival.
Incidental Gallbladder Carcinoma Diagnosed During or After Laparoscopic Cholecystectomy
Authors: Zhang Wei‐Jie , Xu Gui‐Fang , Zou Xiao‐Ping , Wang Wei‐Bing , Yu Jun‐Chi , Wu Guo‐Zhong , Lu Chun‐Lei 
Published: September 2009

AbstractBackgroundGallbladder carcinoma (GC) is a highly lethal neoplasm. With the increase of cholecystectomies since the wide acceptance of laparoscopic cholecystectomy (LC), the incidental diagnosis of gallbladder carcinoma is more frequent. The aim of the present study was to report our experience with GC diagnosed during or after the performance of LC.MethodsA total of 10,466 LCs were carried out from January 1999 to December 2007 in our hospital. Records of patients with incidental carcinoma were collected and analyzed retrospectively.ResultsOf all the patients, 20 (0.19%) were histopathologically diagnosed as having a GC. There were 4 men and 16 women; the median age in this group was 65.7 years (range: 37–81 years).The depth of cancer invasion was: pTis (4 cases), pT1a (2 cases), pT1b (2 cases), pT2 (6 cases), pT3 (4 cases), and pT4 (2 cases). The sensitivity and specificity of intraoperatively frozen section examination were 83.3 and 100%, respectively. Patients with in situ, pT1a and pT1b tumors underwent LC only, and there were no recurrences. The survival rate between patients with GC diagnosed during or after LC showed no difference; it was dependent on the depth of cancer invasion.ConclusionsThe survival with incidental GC is related to stage, and it validates that a carefully performed LC is adequate treatment for carcinoma in situ, and stage 1a and b cancer. A frozen section examination was helpful but did not provide a definitive diagnosis. Meticulous techniques during LC, including retrieval of the gallbladder in a retrieval bag, may prevent port‐site recurrence and intraperitoneal dissemination.
Nanoscale Visualization of Elastic Inhomogeneities at TiN Coatings Using Ultrasonic Force Microscopy
Authors: Hidalgo JA , Montero-Ocampo C , Cuberes MT 
Published: September 2009

Abstract
Ultrasonic force microscopy has been applied to the characterization of titanium nitride coatings deposited by physical vapor deposition dc magnetron sputtering on stainless steel substrates. The titanium nitride layers exhibit a rich variety of elastic contrast in the ultrasonic force microscopy images. Nanoscale inhomogeneities in stiffness on the titanium nitride films have been attributed to softer substoichiometric titanium nitride species and/or trapped subsurface gas. The results show that increasing the sputtering power at the Ti cathode increases the elastic homogeneity of the titanium nitride layers on the nanometer scale. Ultrasonic force microscopy elastic mapping on titanium nitride layers demonstrates the capability of the technique to provide information of high value for the engineering of improved coatings.
Kinetic Study of the Prooxidant Effect of α‐Tocopherol. Hydrogen Abstraction from Lipids by α‐Tocopheroxyl Radical
Authors: Ouchi Aya , Ishikura Masaharu , Konishi Kensuke , Nagaoka Shin‐ichi , Mukai Kazuo 
Published: September 2009

AbstractA kinetic study of the prooxidant effect of α‐tocopherol was performed. The rates of allylic hydrogen abstraction from various unsaturated fatty acid esters (ethyl stearate 1, ethyl oleate 2, ethyl linoleate 3, ethyl linolenate 4, and ethyl arachidonate 5) by α‐tocopheroxyl radical in toluene were determined, using a double‐mixing stopped‐flow spectrophotometer. The second‐order rate constants (kp) obtained are <1 × 10−2 M−1s−1 for 1, 1.90 × 10−2 M−1s−1 for 2, 8.33 × 10−2M−1s−1 for 3, 1.92 × 10−1 M−1s−1 for 4, and 2.43 × 10−1M−1s−1 for 5 at 25.0 °C. Fatty acid esters 3, 4, and 5 contain two, four, and six –CH2– hydrogen atoms activated by two π‐electron systems (–C=C–CH2–C=C–). On the other hand, fatty acid ester 2 has four –CH2– hydrogen atoms activated by a single π‐electron system (–CH2–C=C–CH2–). Thus, the rate constants, kabstr/H, given on an available hydrogen basis are kp/4 = 4.75 × 10−3M−1s−1 for 2, kp/2 = 4.16 × 10−2 M−1s−1 for 3, kp/4 = 4.79 × 10−2M−1s−1 for 4, and kp/6 = 4.05 × 10−2M−1s−1 for 5. The kabstr/H values obtained for 3, 4, and 5 are similar to each other, and are by about one order of magnitude higher than that for 2. From these results, it is suggested that the prooxidant effect of α‐tocopherol in edible oils, fats, and low‐density lipoproteins may be induced by the above hydrogen abstraction reaction.
Variation of grain nitrogen content in relation with grain yield in old and modern Spanish wheats grown under a wide range of agronomic conditions in a Mediterranean region
Authors: ACRECHE M. M. , SLAFER G. A. 
Published: September 2009

SUMMARYWheat yield and grain nitrogen concentration (GNC; mg N/g grain) are frequently negatively correlated. In most growing conditions, this is mainly due to a feedback process between GNC and the number of grains/m2. In Mediterranean conditions, breeders may have produced cultivars with conservative grain set. The present study aimed at clarifying the main physiological determinants of grain nitrogen accumulation (GNA) in Mediterranean wheat and to analyse how breeding has affected them. Five field experiments were carried out in north-eastern Spain in the 2005/06 and 2006/07 growing seasons with three cultivars released at different times and an advanced line. Depending on the experiment, source-sink ratios during grain filling were altered by reducing grain number/m2 either through pre-anthesis shading (unshaded control or 0·75 shading only between jointing and anthesis) or by directly trimming the spikes after anthesis and before the onset of the effective grain filling period (un-trimmed control or spikes halved 7–10 days after anthesis). Grain nitrogen content (GN content; mg N/grain) decreased with the year of release of the genotypes. As the number of grains/m2 was also increased by breeding there was a clear dilution effect on the amount of nitrogen allocated to each grain. However, the increase in GN content in old genotypes did not compensate for the loss in grain nitrogen yield (GNY) due to the lower number of grains/m2. GN content of all genotypes increased (increases ranged from 0·13 to 0·40 mg N/grain, depending on experiment and genotype) in response to the post-anthesis spike trimming or pre-anthesis shading. The degree of source-limitation for GNA increased with the year of release of the genotypes (and thus with increases in grain number/m2) from 0·22 (mean of the four manipulative experiments) in the oldest cultivar to 0·51 (mean of the four manipulative experiments) in the most modern line. It was found that final GN content depended strongly on the source-sink ratio established at anthesis between the number of grains set and the amount of nitrogen absorbed at this stage. Thus, Mediterranean wheat breeding that improved yield through increases in grain number/m2 reduced the GN content by diluting a rather limited source of nitrogen into more grains. This dilution effect produced by breeding was further confirmed by the reversal effect produced by grain number/m2 reductions due to either pre-anthesis shading or post-anthesis spike trimming.
Early response to antidepressant treatment in bulimia nervosa
Authors: Sysko R. , Sha N. , Wang Y. , Duan N. , Walsh B. T. 
Published: September 2009

BackgroundBulimia nervosa (BN) is a serious psychiatric disorder characterized by frequent episodes of binge eating and inappropriate compensatory behavior. Numerous trials have found that antidepressant medications are efficacious for the treatment of BN. Early response to antidepressant treatment, in the first few weeks after medication is initiated, may provide clinically useful information about an individual's likelihood of ultimately benefitting or not responding to such treatment. The purpose of this study was to examine the relationship between initial and later response to fluoxetine, the only antidepressant medication approved by the US Food and Drug Administration (FDA) for the treatment of BN, with the goal of developing guidelines to aid clinicians in deciding when to alter the course of treatment.MethodData from the two largest medication trials conducted in BN (n=785) were used. Receiver operating characteristic (ROC) curves were constructed to assess whether symptom change during the first several weeks of treatment was associated with eventual non-response to fluoxetine at the end of the trial.ResultsEventual non-responders to fluoxetine could be reliably identified by the third week of treatment.ConclusionsPatients with BN who fail to report a ⩾60% decrease in the frequency of binge eating or vomiting at week 3 are unlikely to respond to fluoxetine. As no reliable relationships between pretreatment characteristics and eventual response to pharmacotherapy have been identified for BN, early response is one of the only available indicators to guide clinical management.
Prognostic value of cognitive functioning for global functional recovery in first-episode schizophrenia
Authors: González-Blanch C. , Perez-Iglesias R. , Pardo-García G. , Rodríguez-Sánchez J. M. , Martínez-García O. , Vázquez-Barquero J. L. , Crespo-Facorro B. 
Published: September 2009

BackgroundIt has become widely accepted that cognitive deficits in schizophrenia are related to functional outcome. However, it remains to be seen whether these associations are relevant for predicting which cases will have a global functional recovery. In this study, we attempt to determine whether global functional recovery (integrating social and occupational outcomes) after first-episode schizophrenia (FES) can be predicted by cognitive variables.MethodA total of 131 FES patients with functional deficits (n=97) and functional recovery (n=34) as determined at 1-year follow-up were examined. Neuropsychological, sociodemographic, pre-morbid and clinical data at baseline were analysed using independent groups comparisons and a logistic regression method.ResultsSustained attention and negative symptoms emerged as significant predictors of good global functional outcome. Although the model revealed a high accuracy (91%) in the classification of patients with functional deficits, it was unacceptably low (26%) in the classification of patients with global functional recovery.ConclusionsThe limitations found in the prediction of a favourable global functional outcome may well be an indication for a need to address the role of other factors not commonly included in longitudinal studies of long-term outcomes in schizophrenia.
Meta‐analysis in evidence‐based orthodontics
Authors: Papadopoulos MA 
Published: September 2009

Structured AbstractAuthor – Papadopoulos MAObjective – In the last 10 years, health sciences literature has seen a significant increase in papers that report findings of meta‐analyses. Meta‐analysis overcomes the weakness of conventional narrative literature review. Moreover, it has established itself as a significant tool in clinical research and evidence‐based medicine. But despite its station in the field, it is not without controversy. The aim of this paper is to present the main controversies that surround meta‐analyses and to discuss the most important issues of conduct and reporting of results derived from these studies.Results – Controversial issues include the ability of the investigators to combine studies that differ in important aspects; such as study populations, experimental designs and quality controls, and the like. It has been argued that selection bias could exist. Thus, it is common for the results of meta‐analyses to be contradictory. As any other statistical procedure or analytical approach, meta‐analyses too can be misused or abused. Misleading results could be avoided if certain basic principles are followed in the conduct of a meta‐analysis. In particular, attention should be given to: (a) the methods of literature search for the studies to be included in the analysis, (b) the measures taken to reduce or eliminate bias, (c) the inclusion and exclusion criteria of the individual studies from the analysis, (d) how the data will be extracted from the literature, and (e) how the data will be analyzed statistically.Conclusion – Reports of meta‐analytical studies carried out with the above parameters in mind yield a more objective appraisal of the evidence, and a more precise estimate of the treatment effect.
Effects of the headgear‐activator Teuscher appliance in the treatment of class II division 1 malocclusion: a geometric morphometric study
Authors: Singh GD , Thind BS 
Published: September 2009

Structured AbstractAuthors – Singh GD, Thind BSObjectives – To test the hypothesis that there are no gender differences in the outcomes of patients with class II malocclusion treated with the headgear‐activator Teuscher appliance (HATA).Design – Retrospective, longitudinalSetting and Sample Population – Puerto Rico and Scotland, UK. Thirty‐one patients requiring correction of class II division 1 malocclusions.Experimental Variable – Male and female patients treated using HATA.Outcome Measures – Mean pre‐ and post‐treatment parameters derived from cephalometry subjected to t‐tests, and finite‐element scaling analysis (FESA), which localizes and quantifies differences between mean pre‐ and post‐treatment configurations.Results – Post‐treatment, cephalometry showed that for both males and females, angle SNA decreased, SNB increased, and lower facial heights increased significantly (p < 0.01). For the female post‐treatment configuration, FESA revealed large size increases (≈20%) located in the inter‐maxillary region, the ramus and mandibular body, and around the nasal and mental regions. Conversely, the lip region was diminished (≈20%). Similarly, male post‐treatment showed size increases located in the inter‐maxillary region that extended into the nasal region and the mandibular body (≈10–15%), and around the chin (15%). The lip region was diminished (≈5%).Conclusion – In the attainment of a normal occlusion, both male and female patients treated for class II malocclusions using HATA exhibit antero‐posterior restraint of the maxilla, improvements in the mandible maintaining facial height, and lip changes commensurate with improvements in the soft tissue profile.