bluuebunny/crossref_metadata_2025_split huggingface dataset:
ENDOSCOPIC SUBMUCOSAL DISSECTION IN THE COLORECTUM: PRESENT STATUS AND FUTURE PROSPECTS
Authors: Uraoka Toshio , Kawahara Yoshiro , Kato Jun , Saito Yutaka , Yamamoto Kazuhide 
Published: June 2009

Endoscopic submucosal dissection (ESD) can successfully resect early stage gastrointestinal tumors, but colorectal ESDs are not widely performed, even by Japanese endoscopists, because of several negative factors. Besides being considerably more difficult in terms of technical demands, colorectal ESDs involve a longer procedure time and have a higher complication rate compared to gastric ESDs. In addition, most colorectal lesions are adenomas or intramucosal cancers that despite their large size that can be curatively treated by endoscopic mucosal resection including piecemeal resection.There is, however, no doubt about ESD having a major therapeutic advantage in being able to achieve a higher en‐bloc resection rate resulting in enhanced curability and more accurate histopathological assessment. Continued improvement in the technical skills of endoscopists, further refinement of such devices as electrical surgical knives and a special colonoscope as well as the development of more effective submucosal injection solutions and new traction systems are expected to facilitate easier, faster and safer colorectal ESD procedures in the relatively near future.
THE NEW RESOURCES OF TREATMENT FOR EARLY STAGE COLORECTAL TUMORS: EMR WITH SMALL INCISION AND SIMPLIFIED ENDOSCOPIC SUBMUCOSAL DISSECTION
Authors: Toyonaga Takashi , Man‐I Mariko , Morita Yoshinori , Sanuki Tsuyoshi , Yoshida Masaru , Kutsumi Hiromu , Inokuchi Hideto , Azuma Takeshi 
Published: June 2009

Introduction:  Early stage colorectal tumors can be removed by endoscopic mucosal resection (EMR) but larger tumors (≧20 mm) may require piecemeal resection. The development of endoscopic submucosal dissection (ESD) has enabled en‐bloc resection of lesions regardless of size and shape. However ESD of colorectal tumor is technically difficult. As the resources, we perform EMR with small incision (EMR with SI) for more reliable EMR, and also ESD with snaring (simplified ESD) for easier and safer ESD.Aim & Methods:  The aim of the study was to retrospectively compare the treatment results of the following 3 methods (EMR with SI/ simplified ESD/ ESD). We treated 24/44/468 colorectal tumors, and examined the tumor size, resected specimen size, procedure time, en‐bloc resection rate, complication rate.Result:  The median tumor size (mm) (EMR with SI/simplified EMR/ESD) was 20/17/30 (EMR with SI vs simplified ESD: P = n.s, simplified ESD vs ESD: P < 0.0001). The median resected specimen size (mm) was 22.5/26/41 (EMR with SI vs simplified ESD: P = 0.0018, simplified ESD vs ESD: P < 0.0001). The procedure time (min.) was 19/27/60 (EMR with SI vs simplified ESD: P = n.s, simplified ESD vs ESD: P < 0.0001) The en‐bloc resection rate (%) was 83.3/90.9/98.9. The complication rate (post‐operative bleeding rate/perforation rate) was 0/0, 2.3/4.5, 1.5/1.5 (simplified ESD vs ESD: P = n.s).Conclusion:  Endoscopic mucosal resection with small incision (EMR with SI) and ESD with snaring (simplified ESD) are a good option to fill the differences between conventional EMR and ESD, and also considered to become nice steps to the introduction of ESD.
Comprehensive geriatric assessment of elderly highlanders in Qinghai, China IV: Comparison of food diversity and its relation to health of Han and Tibetan elderly
Authors: Kimura Yumi , Okumiya Kiyohito , Sakamoto Ryota , Ishine Masayuki , Wada Taizo , Kosaka Yasuyuki , Wada Chizu , Ishimoto Yasuko , Hirosaki Mayumi , Kasahara Yoriko , Konno Akiko , Chen Wingling , Otsuka Kuniaki , Fujisawa Michiko , Nakatsuka Masahiro , Nakashima Michiro , Wang Hongxin , Dai Qingxiang , Yang Airong , Gao Jidong , Li Zhanquan , Qiao Haisheng , Zhang Yongshou , Ge Ri‐Li , Matsubayashi Kozo 
Published: June 2009

Aim:  To examine the association between food diversity and health status of Han and Tibetan elderly highlanders in Qinghai Plateau, China.Methods:  The study population consisted of 240 community‐dwelling elderly subjects aged 60 years or more (176 Han elderly subjects, 64 Tibetan ones). Food diversity was determined using an 11‐item Food Diversity Score Kyoto (FDSK‐11). Subjects were interviewed on health status including activities of daily living (ADL), screening‐based depression and quality of life (QOL). Blood chemical investigation was carried out in association with food diversity.Results:  ADL was significantly lower in both Han and Tibetan elderly with lower food diversity than those with higher diversity. In Han elderly with lower food diversity, QOL was significantly lower in the items of subjective sense of health, relationship with family and subjective happiness, but not significant in Tibetan elderly. A close association was found between lower food diversity and lower financial satisfaction in both Han and Tibetan subjects. No association was found between food diversity and age or body mass index. Higher food diversity was associated with lower blood glucose level in Han elderly subjects, but the opposite association was found in Tibetan ones.Conclusion:  Food diversity was associated with ADL and QOL in highlanders in Qinghai, China. Food assessment is very important as a useful indicator to establish the actual condition of diet and its relation to health status of community‐dwelling elderly as well as the change of economic background in the Qinghai highlands.
Influences of flux‐cored arc welding consumables on dynamic fracture toughness (J1d) of armour grade Q&T steel joints
Authors: MAGUDEESWARAN G. , SATHYANARAYANAN S. , REDDY G. MADHUSUDHAN , BALASUBRAMANIAN V. , MOITRA A. , VENUGOPAL S. , SASIKALA G. 
Published: June 2009

ABSTRACTQuenched and tempered (Q&T) steels are prone to hydrogen‐induced cracking in the HAZ after welding. Austenitic stainless steel (ASS) welding consumables are traditionally used for welding of high hardness Q&T steels as they have higher solubility for hydrogen. The use of stainless steel consumables for a non‐stainless steel base metal is not economical. In recent years, the developments of low hydrogen ferritic steel (LHF) consumables that contain no hygroscopic compounds are utilized for welding of Q&T steels The use of ASS and LHF consumables for armour grade Q&T steel will lead to formation of distinct microstructures in their respective welds. This microstructural heterogeneity will have a drastic influence in the dynamic fracture toughness of the armour grade Q&T steel welds. Hence, an attempt was made in this paper to study the influence of flux‐cored arc welding consumables on dynamic fracture toughness (J1d) of armour grade Q&T steel joints. The flux‐cored arc welding consumables have a significant effect on the dynamic fracture toughness of the armour grade Q&T steel welds. The joints fabricated using ASS flux‐cored wires showed superior J1d values than the joints fabricated using LHF consumables and the base metal.
Ecological limits and diversification rate: alternative paradigms to explain the variation in species richness among clades and regions
Authors: Rabosky Daniel L. 
Published: June 2009

AbstractDiversification rate is one of the most important metrics in macroecological and macroevolutionary studies. Here I demonstrate that diversification analyses can be misleading when researchers assume that diversity increases unbounded through time, as is typical in molecular phylogenetic studies. If clade diversity is regulated by ecological factors, then species richness may be independent of clade age and it may not be possible to infer the rate at which diversity arose. This has substantial consequences for the interpretation of many studies that have contrasted rates of diversification among clades and regions. Often, it is possible to estimate the total diversification experienced by a clade but not diversification rate itself. I show that the evidence for ecological limits on diversity in higher taxa is widespread. Finally, I explore the implications of ecological limits for a variety of ecological and evolutionary questions that involve inferences about speciation and extinction rates from phylogenetic data.
Evaluation of gadolinium‐enhanced T1‐weighted magnetic resonance imaging in the preoperative assessment of local staging in rectal cancer
Authors: Jao S.‐Y. , Yang B.‐Y. , Weng H.‐H. , Yeh C.‐H. , Lee L.‐W. 
Published: June 2009

AbstractAim  The aim of this study was to determine whether gadolinium‐enhanced T1‐weighted magnetic resonance (MR) sequence is beneficial in the preoperative assessment of tumour and nodal staging in patients with primary rectal cancer.Method  Eighty‐eight patients with primary rectal cancer underwent preoperative MR imaging, followed by surgical resection. Two radiologists independently reviewed (i) T2‐weighted MR images (T2WI); (ii) gadolinium‐enhanced T1‐weighted MR images (T1 + Gd); (iii) MR combined with T2WI and T1 + Gd for the prediction of tumour and nodal stage compared with histopathologic findings as the end point. Differences in the diagnostic performance of T2WI only, T1 + Gd image only and combined T2WI and T1 + Gd MR images were analyzed by comparing areas under receiver operating characteristic curves (Az) for each reader. Interobserver agreement was also calculated.Results  There was no significant difference in the Az values of T2WI only, T1 + Gd image only and combined T2WI and T1 + Gd images for the prediction of tumour staging (Az of T2WI, T1 + Gd and combined MR images for reader 1, 0.80, 0.76 and 0.85; reader 2, 0.83, 0.82 and 0.87) and nodal staging (Az for reader 1, 0.73, 0.73 and 0.81; reader 2, 0.79, 0.80 and 0.83). Interobserver agreement for the prediction of tumour staging was moderate to substantial, while only fair agreement was noted for the prediction of nodal staging.Conclusion  Gadolinium‐enhanced T1‐weighted MRI did not increase the diagnostic yield for tumour and nodal staging, and may be omitted in the MR protocol for preoperative assessment of primary rectal cancer.
Does the presence of significant risk factors affect perioperative outcomes after robot‐assisted radical cystectomy?
Authors: Butt Zubair M. , Fazili Anees , Tan Wei , Wilding Gregory E. , Filadora Victor , Kim Hyung L. , Mohler James L. , O’Leary Kathleen A. , Guru Khurshid A. 
Published: June 2009

OBJECTIVETo evaluate the effect of preoperative risk factors on perioperative outcomes up to 3 months after robot‐assisted radical cystectomy (RARC), as RC continues to be associated with a high rate of morbidity and mortality.PATIENTS AND METHODSFrom 2005 to 2007, 66 consecutive patients had RARC at Roswell Park Cancer Institute. Patient demographics, preoperative risk factors and complications up to 3 months after RARC were reviewed from a prospective quality‐assurance database. Patients were stratified into high‐ and low risk groups based on age, previous abdominal surgery, chronic obstructive pulmonary disease (COPD), body mass index (BMI), Revised Cardiac Risk Index (RCRI) and American Society of Anesthesiologists (ASA) score.RESULTSAge, previous abdominal surgery, COPD, BMI, RCRI score and ASA score did not significantly influence complications during or up to 3 months following RARC (P > 0.05). Advanced age was associated with a higher RCRI score (P = 0.014) and an increased likelihood of admission to the Intensive Care Unit (P = 0.007). A higher ASA score was associated with an increased overall hospital stay (P = 0.039). Previous abdominal surgery was associated with more frequent unscheduled postoperative clinic visits (P = 0.014). Operative duration did not significantly influence complication rates (P > 0.05). Fifteen of 62 patients (24%) had a major complication, while 15 (24%) had minor complications within 3 months of surgery. The reoperation rate was 11% and the overall mortality rate was 1.6%.CONCLUSIONSRARC appears to be well tolerated, independent of comorbid risk factors such as age, BMI, RCRI and ASA score.
Prostate‐sparing cystectomy: long‐term oncological results
Authors: De Vries Remco R. , Nieuwenhuijzen Jakko A. , Van Tinteren Harm , Oddens Jorg R. , Visser Otto , Van Der Poel Henk G. , Bex Axel , Meinhardt Willem , Horenblas Simon ,   urological working group of the Amsterdam Comprehensive Cancer Center
Published: June 2009

OBJECTIVETo analyse the oncological outcome of prostate‐sparing cystectomy (PSC).PATIENTS AND METHODSBetween 1994 and 2006, 63 men were treated with PSC after meeting the inclusion criteria (no tumour at the bladder neck, no prostate cancer). The results were compared with patients who had a standard cystoprostatectomy (SC) during the same study period, after matching for clinical and pathological characteristics.RESULTSThe 3‐ and 5‐year disease‐specific survival rates were 77% and 66% in the PSC group, and 68% and 64% in the SC group (log‐rank, P = 0.6). The local recurrence rate was 7.9% and 16% for the PSC and the SC groups, respectively, and the respective distant recurrence rate was 29% and 33%. Subsequent prostate cancer was detected in 3% in the PSC group. None of these patients died from prostate cancer. In the SC group the final pathology showed that 18% had prostate cancer.CONCLUSIONLocal recurrences were not diagnosed more often in the PSC than the SC group. The outcomes of both procedures are comparable with contemporary cystoprostatectomy series. We consider this procedure oncologically safe and offer this to selected patients. However, selection is the key to success, and our results should further be corroborated by the experience of others.
Do nonspecific deep corticomedullary sutures performed during partial nephrectomy adequately control major vascular and collecting system injury?
Authors: L’Esperance James O. , Marguet Charles G. , Walters R. Chanc , Sung Jeffrey C. , Auge Brian K. , Stroup Sean P. , L’Esperance Audry H. , Albala David M. 
Published: June 2009

OBJECTIVETo critically evaluate the effectiveness of placing nonspecific deep corticomedullary sutures in the setting of major vascular and collecting system injury during laparoscopic partial nephrectomy (LPN). We also aimed to evaluate the incidence of ischaemic injury to the remaining renal remnant because of these sutures, as many laparoscopic centres have adopted this practice.MATERIALS AND METHODSWe performed open PN on eight porcine kidneys. Both the artery and vein were clamped. The ureter was transected and tied around an angiocatheter for evaluating collecting system integrity both before and after corticomedullary suturing. The renal artery was cannulated for angiography before and after the corticomedullary suturing. The rate of bleeding was also assessed before and after corticomedullary suturing.RESULTSThere was marked arterial bleeding and large collecting system injury induced in all kidneys. Two of the eight renal units continued to have significant arterial bleeding after the deep corticomedullary sutures were placed. All of the eight units had at least a small urinary leak after suturing, with three having medium‐to‐large leaks. In four of the renal units, there were major segmental vessels occluded by the sutures, as detected by angiography.CONCLUSIONSThe practice of placing nonspecific deep corticomedullary sutures, during PN, may not adequately control major vascular and collecting system injury. In addition, segmental vessels supplying remnant renal tissue are often affected; thereby further compromising function because of devascularization. The search for the best technique for LPN continues.
Analysis of association between the 5‐HTTLPR and STin2 polymorphisms in the serotonin‐transporter gene and clinical response to a selective serotonin reuptake inhibitor (sertraline) in patients with premature ejaculation
Authors: Safarinejad Mohammad Reza 
Published: June 2009

Study Type – Therapy (cohort) Level of Evidence 2bOBJECTIVETo test the hypothesis that polymorphism within the gene‐linked polymorphic region (5‐HTTLPR) and second intron of SLC6A4 gene (STin2) is associated with selective serotonin‐reuptake inhibitors (SSRIs) response in subjects with premature ejaculation (PE).PATIENTS AND METHODSIn all, 246 men with PE were recruited in this study. They were asked to take sertraline 50 mg daily for 2 weeks, and thereafter 100 mg daily, for a 12‐week treatment period. Pretreatment evaluation included history and physical examination, intravaginal ejaculatory latency time (IELT), and International Index of Erectile Function (IIEF). The efficacy of treatment was assessed using responses to IIEF, and geometric mean IELT evaluation. 5‐HTTLPR was genotyped using polymerase chain reaction techniques. A repeated‐measures analysis of variance of geometric mean IELT was done to test a genotype effect on treatment outcome with SSRI (sertraline).RESULTSOf 227 participants who completed the study, 175 (77.1%) responded to sertraline (IELT >1 min). Overall the patients had a 3.7‐fold (95% confidence interval, CI, 1.72–5.46) increase of the geometric mean IELT (P = 0.001). The results showed that responses were significantly better for the LA/LA genotype of the 5‐HTTLPR polymorphism than for S‐allele carriers (P = 0.001). The STin2 12/12 genotype was found more often in those responding to sertraline than in those not responding (P = 0.001). The probability of patients responding sufficiently to sertraline with an LA/LA genotype was highest (odds ratio 4.66, 95% CI, 2.48–6.14).CONCLUSIONSThese findings indicate that the genotype of 5‐HTT contributes in unique ways to the variation in the outcome of PE treatment with SSRIs.
Reliability of screening methods for diabetic retinopathy
Authors: Benbassat Jochanan , Polak Bettine C. P. 
Published: June 2009

AbstractAim  To review studies of the reliability (reproducibility) of the commonly used methods (ophthalmoscopy and inspection of retinal images) of screening for diabetic retinopathy (DR).Research design and methods  Literature search.Results  We found six studies of the intra‐examiner agreement after examining the same retinal images. Three of these found an almost perfect agreement (k > 0.8) after inspecting colour slides and digital images; three other studies reported ‘significant differences’ in microaneurysm counts and only 39–85% agreement rates between two assessments by the same examiner. The inter‐examiner agreement was reported in 24 studies. Using stereoscopic photographs, one study found almost perfect agreement after examining seven fields; another study found a substantial to moderate (k = 0.4–0.8) agreement after examining five fields and a third study found a fair agreement (k = 0.2–0.4) after examining a single field. Studies using single‐ or two‐field monoscopic photographs also have reported agreement rates that have varied between almost perfect, substantial and moderate. In four other studies using biomicroscopy, agreement levels varied between perfect and moderate.Conclusions  Relative to the large number of studies on the validity of the various methods for screening for DR, there are only few studies of their reliability, with a marked variability in their findings. We suggest that future studies of the effectiveness of the various methods for screening for DR should also include data on their reliability.
Pregnancy outcomes in women with gestational diabetes treated with metformin or insulin: a case–control study
Authors: Balani J. , Hyer S. L. , Rodin D. A. , Shehata H. 
Published: June 2009

AbstractAims  To compare maternal and neonatal outcomes in women with gestational diabetes mellitus (GDM) treated with either metformin or insulin.Methods  One hundred and twenty‐seven women with GDM not adequately controlled by dietary measures received metformin 500 mg twice daily initially. The dose was titrated to achieve target blood glucose values. Pregnancy outcomes in the 100 women who remained exclusively on metformin were compared with 100 women with GDM treated with insulin matched for age, weight and ethnicity.Results  There were no significant differences in baseline maternal risk factors. Women treated with insulin had significantly greater mean (sem) weight gain from enrolment to term (2.72 ± 0.4 vs. 0.94 ± 0.3 kg; P < 0.001). There was no difference between the metformin and insulin groups, respectively, comparing gestational hypertension (6 vs. 7%, P = 0.9), pre‐eclampsia (9 vs. 2%, P = 0.06) induction of labour (26 vs. 24%, P = 0.87) or rate of Caesarean section (48 vs. 52%, P = 0.67). No perinatal loss occurred in either group. Neonatal morbidity was improved in the metformin group; prematurity (0 vs. 10%, P < 0.01), neonatal jaundice (8 vs. 30%, P < 0.01) and admission to neonatal unit (6 vs. 19%, P < 0.01). The incidence of macrosomia (birthweight centile > 90) was not significantly different [metformin (14%) vs. insulin (25%); P = 0.07].Conclusions  Women with GDM treated with metformin and with similar baseline risk factors for adverse pregnancy outcomes had less weight gain and improved neonatal outcomes compared with those treated with insulin.
Smoking prevalence in Type 2 diabetes: results of the Study of Health in Pomerania (SHIP) and the German National Health Interview and Examination Survey (GNHIES)
Authors: Schipf S. , Schmidt C. O. , Alte D. , Werner A. , Scheidt‐Nave C. , John U. , Steveling A. , Wallaschofski H. , Völzke H. 
Published: June 2009

AbstractAims  Smoking contributes to the development of diabetes and diabetes‐related complications. Currently, data on smoking prevalence in subjects with diabetes in Germany are lacking. The aim of our analysis was to determine smoking prevalence in adults with Type 2 diabetes mellitus using data from the two population‐based studies in Germany.Methods  From the Study of Health in Pomerania (SHIP) (n = 4283) and the 1998 German National Health Interview and Examination Survey (GNHIES 98) (n = 6663) subjects aged 20–79 years were investigated. Descriptive statistics on smoking prevalence and behaviours were calculated for Type 2 diabetes mellitus and compared with the general population using weightings reflecting the European adult population.Results  Overall, the prevalence of current smokers was lower among persons with than without Type 2 diabetes mellitus in SHIP (17.3% vs. 38.0%) and in GNHIES 98 (24.7% vs. 32.1%). Only in men, there were more former smokers in Type 2 diabetic patients than in subjects without diabetes in both studies. Among current and former smokers, the number of cigarettes smoked was higher among persons with than without Type 2 diabetes mellitus. For men, this finding was consistent in SHIP and GNHIES 98, while in women, this difference was only observed in GNHIES 98.Conclusions  The associations between smoking and Type 2 diabetes mellitus are likely to reflect behavioural changes secondary to illness or medical counselling. The high proportion of current smokers among Type 2 diabetic patients, particularly men, should be monitored in repeated surveys following the introduction of disease management programmes.