bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endobronchial Ultrasound‐Guided Transbronchial Needle Aspiration of Undiagnosed Chest Tumors
Authors: Eckardt Jens , Olsen Karen E. , Licht Peter B. 
Published: April 2010

AbstractBackgroundA number of patients with radiologically suspicious chest tumors remain undiagnosed despite bronchoscopy or CT‐guided fine‐needle aspiration (CT‐FNA). Such patients are often referred for mediastinoscopy, which is an invasive surgical procedure that poses a small but significant risk to the patient. Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS) is a well‐established method for mediastinal staging of lung cancer but may also be used as a diagnostic tool in patients with undiagnosed intrathoracic lesions.MethodsDuring a 36‐month period (January 2006 to December 2008), 601 patients underwent EBUS under general anesthesia. Two hundred ninety‐three (293) patients had an established diagnosis of lung cancer and were referred to us for mediastinal staging. The remaining 308 patients had a radiologically suspicious lesion and had been investigated previously by CT and bronchoscopy, including brush cytology, but remained undiagnosed.ResultsOverall, EBUS was able to diagnose 55% of the 308 patients. Diagnostic yield was significantly higher in central parenchymal lesions (72%) compared with enlarged lymph nodes (54%) or peripheral lesions (43%) (P < 0.05). All patients were examined as outpatients and there was not a single complication in any patient.ConclusionsEBUS is a valuable tool to diagnose chest lesions and yield depends on the anatomical location. We believe that EBUS should be the first choice for further workup in patients who remain undiagnosed after conventional CT and bronchoscopy because it is very safe, fast, and minimally invasive.
Effects of Low Central Venous Pressure During Preanhepatic Phase on Blood Loss and Liver and Renal Function in Liver Transplantation
Authors: Feng Zhi‐Ying , Xu Xiao , Zhu Sheng‐Mei , Bein Berthold , Zheng Shu‐Sen 
Published: April 2010

AbstractBackgroundAlthough the low central venous pressure (LCVP) technique is used to decrease blood loss during liver resection, its efficacy and safety during transplant procedures are still debatable. Our study aimed to assess the effects of this technique and its clinical safety for recipients undergoing liver transplantation.MethodsEighty‐six adult patients were randomly divided into a LCVP group and a control group. In the LCVP group, CVP was maintained below 5 mmHg or 40% lower than baseline during the preanhepatic phase by limiting infusion volume, manipulating the patient’s posture, and administration of somatostatin and nitroglycerine. Recipients in the control group received standard care. Hemodynamics, blood loss, liver function, and renal function of the two groups were compared perioperatively.ResultsA lower CVP was maintained in the LCVP group during the preanhepatic phase, resulting in a significant decrease in blood loss (1922 ± 1429 vs. 3111 ± 1833 ml, P < 0.05) and transfusion volume (1200 ± 800 vs. 2400 ± 1200 ml, P < 0.05) intraoperatively. Compared with the control group, the LCVP group had a significantly lower mean arterial pressure at 2 h after the start of the operation (74 ± 11 vs. 84 ± 14 mmHg, P < 0.05), a lower lactate value at the end of the operation (5.9 ± 3.0 vs. 7.2 ± 3.0 mmol/l, P < 0.05), and a better preservation of liver function after the declamping of the portal vein. There were no significant differences in perioperative renal function and postoperative complications between the groups.ConclusionsThe LCVP technique during the preanhepatic phase reduced intraoperative blood loss, protected liver function, and had no detrimental effects on renal function in LT.
Long‐term Career Transition in the Surgical Workforce of Japan: A Retrospective Cohort Study Using the Nationwide Survey of Physicians Data from 1972 to 2006
Authors: Ide Hiroo , Koike Soichi , Yasunaga Hideo , Kodama Tomoko , Ohe Kazuhiko , Imamura Tomoaki 
Published: April 2010

AbstractBackgroundA surgical workforce is essential for providing surgical services to the community. However, little is known about surgeons’ career changes in circumstances where physicians can freely choose their specialty. Differing career transitions among surgical specialties were hypothesized.MethodsLongitudinal data were obtained for all physicians in Japan, giving a total of 4,302,844 items of data (for 390,368 physicians) from 1972 to 2006. Descriptive statistics for all physicians and surgeons were calculated in 1976, 1986, 1996, and 2006. “Active surgeons” (working at hospitals), “primary care surgeons” (working at clinics), and “retired surgeons” were analyzed among physicians licensed in 1972, 1982, and 1992 for the subspecialties of general surgery, orthopedic surgery, neurosurgery, urology, and “other” surgeries. Survival analysis and Cox’s proportional hazard analysis were conducted to examine factors affecting career changes.ResultsDuring the study period, the greatest change was observed in the increased number of surgeons per 100,000 physicians. The percentage of female surgeons and surgeons registered in a surgical subspecialty also increased greatly. Significant differences, by sex, age, and subspecialty, were shown in survival analyses for surgeons’ career changes in the transition from active surgeons to primary care surgeons or retired surgeons. Surgical specialty was still a significant factor for predicting career transition, even after adjustment for the surgeons’ characteristics.ConclusionsThe current study elucidated the differences in career transitions among surgical specialties. Given the observed findings, policy makers should consider more detailed and effective measures for retaining surgeons in active practice.
Radiofrequency Ablation (RFA) of Benign Thyroid Nodules in Patients with Incompletely Resolved Clinical Problems after Ethanol Ablation (EA)
Authors: Lee Jeong Hyun , Kim Yoon Suk , Lee Ducky , Choi Hoon , Yoo Hyunju , Baek Jung Hwan 
Published: April 2010

AbstractBackgroundAlthough ethanol ablation (EA) is effective, refractory cases have been reported in 5–25% of patients, with a marked decline in efficacy on subsequent reattempt. The aim of this study was to evaluate the role of radiofrequency ablation (RFA) after EA of benign thyroid nodules in patients with incompletely resolved initial clinical problems.MethodsAmong 137 patients with 137 benign thyroid nodules who underwent EA, 27 patients (M:F = 5:22; mean age = 38 years, range = 21–60 years) underwent additional RFA if all of the following criteria were fulfilled: (1) complaint of incompletely resolved clinical problems, (2) demonstration of remaining solid component with internal vascularity on 1‐month follow‐up power Doppler US, and (3) patient desire for additional treatment. After RFA, there was improvement of clinical symptoms and characteristics and volume reduction of the treated nodules as seen on US; complications were evaluated at each follow‐up.ResultsThe mean follow‐up duration was 21.2 months (range = 6–38 months) after RFA. The mean symptom grading score of 10‐cm visual analog scale, the mean cosmetic grading score on a 4‐point scale, and the mean volume reduction of thyroid nodules were all significantly decreased from those seen before RFA (2.4–1.1, 3.7–1.5, and 4.2–1.1, respectively) (P < 0.05). There were no major complications.ConclusionsRFA is an effective and safe method for treating benign thyroid nodules in patients with incompletely resolved clinical problems following EA.
Intra‐abdominal Fistulas in Surgically Treated Crohn’s Disease Patients
Authors: Yoon Yong Sik , Yu Chang Sik , Yang Suk‐Kyun , Yoon Sang Nam , Lim Seok‐Byung , Kim Jin Cheon 
Published: April 2010

AbstractBackgroundIntra‐abdominal fistulas occur in one‐third of patients with Crohn’s disease (CD). Although they are common, these fistulas may pose difficult problems for the surgeon. We assessed the clinical presentation of intra‐abdominal fistulas in patients with CD and compared the clinicopathologic characteristics of CD with and without fistulas.MethodsWe analyzed consecutive laparotomy cases for 254 patients with CD between 1991 and 2008. Clinicopathologic data were abstracted from patient charts and a prospectively maintained database. Patient variables with and without fistulas were analyzed using the Fisher’s exact test, chi‐square test, and Student’s t test.ResultsA total of 93 surgical procedures were performed on 83 patients (32.7%) who had at least one intra‐abdominal fistula, revealing a total of 122 fistulas. Enteroenteric fistulas were the most common (30.3%), followed by enterocutaneous (23%), enterosigmoid (19.7%), enterocolonic (9.7%), and enterovesical (9.7%). Most cases (95.7%) underwent intestinal resection, with primary anastomosis in 77 of the cases (82.8%). There was no mortality, although 15 (16.1%) patients experienced postoperative complications. In the comparison of 270 cases with and without fistulas, cases with fistulas tended to have more frequent surgeries for perianal fistulas or abscesses (P = 0.001), more frequent intra‐abdominal abscesses on CT (P = 0.044), and a higher incidence of combined small bowel and colonic disease (P < 0.001).ConclusionsThe incidence and clinical features of fistulas were similar to those reported in previous studies of western patients. We identified that patients with CD and fistulas have more frequent other CD‐related sepsis.
The reality of dietary compliance in the management of phenylketonuria
Authors: MacDonald Anita , Gokmen‐Ozel Hulya , van Rijn Margreet , Burgard Peter 
Published: April 2010

AbstractIn phenylketonuria (PKU), it is common for blood phenylalanine (Phe) concentrations to be outside optimal target ranges, particularly in teenagers and adults, indicating inadequate compliance. It is well known that significant noncompliance exists, and the situation in PKU would appear no different than other chronic conditions. In PKU, compliance is complex, being subject to diverse definitions, and factors influencing compliance include the nature and nurture of the patient, as well as the inconvenience, cost and availability of dietary treatment. It is also a dynamic process, with many patients changing between a state of compliance and partial and noncompliance. In PKU, compliance has received little rigorous study, and there have been few observational reports identifying barriers and behaviors impacting dietary compliance. Compliance assessment measures remain inadequately defined. The direct assessment of blood Phe concentration is perhaps the best overall measure, but there is no universal agreement about the number of Phe concentrations that should be within target range and frequency or timing of measurement. Although no one strategy for improving compliance is universally effective, and an individualized approach to noncompliance is essential, it is important to have clear evidence about the most effective strategies in achieving long‐term dietary adherence in PKU.
Polyurethane Dispersions Based on Interesterification Product of Fish and Linseed Oil
Authors: Nimbalkar Ramakant V. , Athawale Vilas D. 
Published: April 2010

AbstractAlkyd and styrenated alkyd resins based on fish oil and their interesterifications with linseed oil were synthesized. The various properties of fish oil, such as its iodine value, acid value, saponification value and moisture content were determined. The interesterification product of fish oil and linseed oil can be used to partially replace the commercially available linseed oil alkyd resin. Alkyd resin and styrenated alkyd resin were modified with 2,2 dimethylolpropionic acid to introduce acid functionality and then sequentially reacted with isophorone diisocyanate, neutralized with amine, chain extended with ethylenediamine and dispersed in water to form a polyurethane dispersion. The newly synthesized resins and polyurethane dispersions were studied for coating properties such as scratch hardness, adhesion, flexibility, impact, solvent and chemical resistance. The polyurethane dispersions exhibited superior coating properties to those of their respective alkyds and styrenated alkyds.
Monosodium glutamate is not associated with obesity or a greater prevalence of weight gain over 5 years: findings from the Jiangsu Nutrition Study of Chinese adults
Authors: Shi Zumin , Luscombe-Marsh Natalie D. , Wittert Gary A. , Yuan Baojun , Dai Yue , Pan Xiaoqun , Taylor Anne W. 
Published: April 2010

Animal studies and one large cross-sectional study of 752 healthy Chinese men and women suggest that monosodium glutamate (MSG) may be associated with overweight/obesity, and these findings raise public concern over the use of MSG as a flavour enhancer in many commercial foods. The aim of this analysis was to investigate a possible association between MSG intake and obesity, and determine whether a greater MSG intake is associated with a clinically significant weight gain over 5 years. Data from 1282 Chinese men and women who participated in the Jiangsu Nutrition Study were analysed. In the present study, MSG intake and body weight were quantitatively assessed in 2002 and followed up in 2007. MSG intake was not associated with significant weight gain after adjusting for age, sex, multiple lifestyle factors and energy intake. When total glutamate intake was added to the model, an inverse association between MSG intake and 5 % weight gain was found (P = 0·028), but when the model was adjusted for either rice intake or food patterns, this association was abolished. These findings indicate that when other food items or dietary patterns are accounted for, no association exists between MSG intake and weight gain.
Fission-track analysis unravels the denudation history of the Bonar Range in the footwall of the Alpine Fault, South Island, New Zealand
Authors: RING UWE , BERNET MATTHIAS 
Published: April 2010

AbstractWe apply fission-track thermochronology to shed new light on the tectonic history of Zealandia during Late Cretaceous continental extension and the onset of Late Tertiary mountain building in the Southern Alps of New Zealand. The Southern Alps are one of the fastest erosionally exhuming mountain belts on Earth. Exhumation of the Bonar Range in Westland just to the northwest of the Alpine Fault is orders of magnitude slower. We report apatite and zircon fission-track ages from samples that were collected along an ENE–WSW profile across the central Bonar Range, parallel to the tectonic transport direction of a prominent ductile fabric in the basement gneiss. Zircon fission-track (ZFT) ages show a large spread from 121.9 ± 12.1 Ma to 74.9 ± 7.2 Ma (1σ errors). The youngest ZFT ages of 78 to 75 Ma occur at low elevations on either side of the Bonar Range and become older towards the top of the range, thereby showing a symmetric pattern parallel to the ENE-trending profile across the range. Age–elevation relationships suggest an exhumation rate of 50–100 m Ma−1. We relate the ZFT ages to slow erosion of a tectonically inactive spot in the Late Cretaceous magmatic arc of Zealandia. Therefore, the first main significance of the paper is that it demonstrates that not all of 110–90 Ma Zealandia was necessarily participating in extreme core complex-related extension but that there were enclaves of lithosphere that underwent slow erosion. The apatite fission-track (AFT) ages range from 11.1 ± 1.9 Ma to 5.3 ± 1.0 Ma and age–elevation relationships suggest an exhumation rate of c. 200 m Ma−1. We relate the AFT ages to the inception of transpressive motion across the Alpine Fault and modest exhumation in its footwall in Late Miocene times. If so, the second significant point of this paper is that transpressive motion across the Alpine Fault was already under way by c. 11 Ma.
Cutting the chorda tympani: not just a matter of taste
Authors: Guinand N , Just T , Stow N W , Van H Cao , Landis B N 
Published: April 2010

AbstractIntroduction:Chorda tympani injury as a complication of middle-ear surgery has been extensively studied with regard to its effects upon taste. However, the chorda tympani also carries parasympathetic fibres to the salivary glands of the oral cavity. To date, little has been reported about the effect of chorda tympani section upon salivary function.Setting:Tertiary care centre.Material and methods:We report a case series of three patients with bilateral chorda tympani lesions. Chorda tympani function was assessed using ‘taste strips’ and unstimulated sialometry. A careful history of oral symptoms was taken.Results:All patients showed transient or permanent bilateral ageusia of the anterior two-thirds of the tongue, and a decreased resting salivary flow rate. In addition, all patients suffered from transient or persistent, distressing xerostomia.Conclusion:Taste disorders may occur after middle-ear surgery but they are mostly transient, even when the chorda tympani nerves are sectioned bilaterally. In contrast, bilateral chorda tympani lesions may lead to severe, persistent and distressing xerostomia. Based on this neglected aspect of chorda tympani function, we emphasise the importance of preserving the chorda tympani whenever possible.
Protection of tympanomeatal flaps using Visibility Background Material
Authors: Oozeer N B , Iyer A 
Published: April 2010

AbstractBackground:Over the years, various materials have been used by otologists to protect tympanomeatal flaps from damage by suction equipment or drills.Objective:This report aims to describe the use of Mercian's Visibility Background Material®(an inert, silicone-based material licensed for use in the human body, which does not get caught in drill flukes) to protect tympanomeatal flaps.Conclusion:We have used this material for over 12 months, without any complications.
Identification and channel characteristics of cetacean hotspots in waterways of the eastern Sundarbans mangrove forest, Bangladesh
Authors: Smith Brian D. , Diyan M. Abdullah Abu , Mowgli Mansur Rubaiyat , Fahrni Mansur Elisabeth , Ahmed Benazir 
Published: April 2010

AbstractSightings data of two freshwater-dependent cetaceans, the Ganges River dolphin Platanista gangetica gangetica and Irrawaddy dolphin Orcaella brevirostris, were recorded by captains of three nature tourism vessels operating in waterways of the eastern Sundarbans mangrove forest, Bangladesh. These data were used to investigate channel-type preferences and identify cetacean hotspots according to a scoring system based on group, individual and calf encounter rates, the co-occurrence of both species, and encounter rates in neighbouring segments recorded during monsoon, post-monsoon and dry seasons. Six 5-km segments were identified for priority conservation attention from a total of 38 that were surveyed on at least three occasions during each season. An investigation of habitat preferences evaluated 5-km segments that had been surveyed on five or more occasions (n = 69) and assigned them to one of 12 categories defined by channel width, sinuosity and the number of large and small confluences. Significant differences were found between observed and expected frequencies of occurrence in the different segment categories for Ganges River dolphin groups and individuals and for Irrawaddy dolphin individuals. Both Ganges River and Irrawaddy dolphins selected channels with more than two small confluences or at least one large confluence. Understanding the preferred habitat and identifying hotspots of freshwater-dependent cetaceans in the Sundarbans is the first step of a planning process for the potential establishment of a network of protected waterways for these threatened species.
Conservation planning for a widespread, threatened species: WWF and the African elephantLoxodonta africana
Authors: Stephenson Peter J. , Ntiamoa-Baidu Yaa 
Published: April 2010

AbstractIn a case study of conservation planning by a conservation organization working at a continental scale we examine how WWF identified and prioritized its African elephantLoxodonta africanaconservation activities. We (1) review lessons learnt from previous work, (2) identify priority landscapes using biological criteria (e.g. population size and viability) and institutional criteria (e.g. feasibility, sustainability and cost-effectiveness of WWF interventions), and (3) conduct a threat analysis and review of national and subregional action plans. We suggest that species action plans should use priority-setting criteria that focus on conserving the largest and most viable populations at the subspecies level. Clear definition of geographical priorities helps an organization focus its resources and assists monitoring. Species action plans should also take account of plans developed by governments and other stakeholders. Conservation agencies wishing to select which landscapes to invest in for a given species or subspecies could then consider institutional prioritization criteria, such as those used by WWF for the African elephant. This would allow them to invest pragmatically in conservation that has a higher chance of success than work planned solely through scientific analysis. Ultimately, however, no species action plan will succeed unless it has the resources necessary for implementation and the key stakeholders work together in partnership.
Human–wildlife conflict in Mozambique: a national perspective, with emphasis on wildlife attacks on humans
Authors: Dunham Kevin M. , Ghiurghi Andrea , Cumbi Rezia , Urbano Ferdinando 
Published: April 2010

AbstractHuman–wildlife conflicts are common across Africa. In Mozambique, official records show that wildlife killed 265 people during 27 months (July 2006 to September 2008). CrocodileCrocodylus niloticus, lionPanthera leo, elephantLoxodonta africanaand hippopotamusHippopotamus amphibiuscaused most deaths but crocodiles were responsible for 66%. Crocodile attacks occurred across Mozambique but 53% of deaths occurred in districts bordering Lake Cabora Bassa and the Zambezi River. Hippopotamus attacks were also concentrated here. Lion attacks occurred mainly in northern Mozambique and, while people were attacked by elephants across the country, 67% of deaths occurred in northern Mozambique. Attacks by lions, elephants or hippopotamuses were relatively rare but additional data will probably show that attacks by these species are more widespread than the preliminary records suggest. BuffaloSyncerus caffer, hyaenaCrocuta crocutaand leopardPanthera parduswere minor conflict species. Good land-use planning, a long-term solution to many conflicts, is particularly relevant in Mozambique, where the crocodile and hippopotamus populations of protected areas are often in rivers that border these areas, and cause conflicts outside them, and where people commonly live within protected areas. Poverty may prompt fishermen to risk crocodile attack by entering rivers or lakes. The high incidence of conflicts near Limpopo and South Africa’s Kruger National Parks (both within the Great Limpopo Transfrontier Conservation Area) highlights the problems created for people by facilitating the unrestricted movement of wildlife between protected areas across their land.