bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications Analysis with Postoperative Choledochoscopy for Residual Bile Duct Stones
Authors: Kong Jing , Wu Shuo‐Dong , Xian Guo‐Zhe , Yang Su 
Published: January 2010

AbstractBackgroundThis study was designed to review the experience of this department with the treatment of post‐common bile duct exploration residual stones using choledochoscopy and to analyze the complications of choledochoscopy and explore effective methods of prevention.MethodsA choledochoscope (PENTAX fibercholedochoscope and electronic choledochoscope PENTAX ECN‐1530) was used. A total of 2,882 postoperative percutaneous choledochoscopy (POC) sessions were performed on 986 patients with residual bile duct stones from 1980 to 2008 (408 men, 578 women; ages range, 21–82 years). Forty‐five of these had undergone laparoscopic common bile duct exploration (LCBDE); the rest had open bile duct exploration. Seventy‐six participants had choledochoscopy examination (for diagnosis only), and in 910 patients it was performed for both diagnosis and therapy (calculi extraction). In 68 cases, plasma shock wave lithotripsy (PSWL) was performed for larger stones before choledochoscopy extraction.ResultsThe mean duration of choledochoscopy was 25 min (range, 10 min to 2 h), with a mean frequency of 2.85 times (range, 1–11). No mortalities occurred. The procedure was unsuccessful in 28 cases in which stones were not accessible because they were embedded in distal hepatic ducts or because they were in proximal ducts that were severely stenosed. Complications resulted in 13 cases and included perforated sinus, biliary peritonitis, sinus hypoplasia, destruction of the T‐tube system leading to obstruction, basket incarceration, bleeding, and intestinal fistular. Choledochoscopic stone clearance was achieved in 95.5% of the cases.ConclusionsCholedochoscopy is an important treatment option for hepatolithus. It has a high efficiency for stone extraction and fewer complications. However, it should be noted that some of its complications are potentially life‐threatening.
A Systematic Review of Cases Reporting Needle Tract Seeding Following Thyroid Fine Needle Biopsy
Authors: Polyzos Stergios A. , Anastasilakis Athanasios D. 
Published: January 2010

AbstractBackgroundBecause of its accuracy and cost‐effectiveness, thyroid fine needle biopsy (FNB) is the procedure of choice in the preoperative management of thyroid nodules. Needle tract seeding (NTS) has been a concern since the earliest days of FNB, contributing to the delayed acceptance of FNB as a safe procedure. In this review we tried to systematically record all reports of NTS after diagnostic thyroid FNB and provide useful hints to minimize the risk of NTS.MethodsComputerized advanced search for primary evidence was performed in the PubMed (Public/Publisher Medline) electronic database. The search was not limited by publication time or English language.ResultsTen relevant articles were found: eight case reports, one case in a surgical series, and one retrospective observational study.ConclusionsDespite initial concerns about the risk of NTS, FNB is now considered to be a safe procedure. Although proper FNB technique can reduce its risk, NTS is an unavoidable complication of FNB, which clinicians should be aware of. However, the incidence of NTS is low and it doesn’t seem to affect the prognosis because the seedings can be surgically removed without recurrence. The management of the thyroid nodules is to‐date based on FNB, and the benefits from FNB (elimination of needless imaging and surgery) far outweigh the potential risk for NTS.
A Time‐Saving Technique for Specimen Extraction in Sleeve Gastrectomy
Authors: Casella Giovanni , Soricelli Emanuele , Fantini Aldo , Basso Nicola 
Published: January 2010

AbstractBackgroundLaparoscopic sleeve gastrectomy (LSG), first intended as the first step of biliopancreatic diversion with duodenal switch (BPD‐DS), is gaining popularity as a per‐se procedure because of its effectiveness on weight loss and comorbidity resolution. The extraction of the gastrectomy specimen could be challenging and time‐consuming. Different techniques have been described for specimen withdrawal. In this article we report the technique adopted in more than 250 LSGs performed in our department.MethodsIn the first 90 LSGs performed in our department from October 2002, the specimen was extracted in a retrieval bag using an endoloop. In the following 160 cases the technique has been simplified: the grasped specimen is withdrawn through the 15‐mm trocar site without any additional device.ResultsWe registered only two cases of wound infection (1.2%) with the simplified technique, both occurring in the initial cases. There were no cases of trocar site hernia formation.ConclusionThe technique described does not require any special devices and seems to be simpler, saves time, and is cost effective if compared with other techniques previously reported.
T‐tube Duodenocholangiostomy for the Management of Duodenal Fistulae
Authors: Paluszkiewicz Piotr , Dudek Wojciech , Daulatzai Najib , Stanislawek Andrzej , Hart Colin 
Published: January 2010

AbstractBackgroundThe tube decompression of the duodenum through an additional point of access of the duodenal wall or occasionally via the leak site decreases morbidity and mortality in patients with duodenal fistula. The objective of this paper is to present the detailed technique and clinical benefits of simplified duodenal and biliary decompression achieved by transampullary insertion of a T‐tube with one‐step duodenal closure for the prevention and/or treatment of duodenal leak.MethodsThe duodenocholangiostomy using T‐tube with laterally perforated long duodenal limb was performed preventively in 4 patients and as a secondary procedure for septic duodenal leak in another selected 12. The mean output from the fistula, length of hospital stay, incidence of pancreatitis, as well as any postoperative septic events was recorded. The nutritional schedule during the in early postoperative period also was analyzed.ResultsThe outcome was favorable for all patients. The mean length of hospital stay was 19 days. Septic events, such as wound or urinary tract infections, were observed in 30% of patients. Serum amylase and lipase activity was increased in two patients without a clinical picture of pancreatitis. Mean volume of T‐tube duodenocholangiostomy drainage was approximately 500 ml per day during the first postoperative week. Enteral feeding was commenced 10–52 (mean, 21) hours after surgery and was followed by the initiation of normal diet on average 5 days postoperatively.ConclusionsDuodenocholangiostomy performed for duodenal decompression may be a promising alternative to classical tube duodenostomy for selected patients; however, further studies should be made to evaluate fully its practical value.
Fatty acid oxidation disorders: outcome and long‐term prognosis
Authors: Wilcken Bridget 
Published: January 2010

AbstractAssessing the outcome of fatty acid oxidation disorders is difficult, as most are rare. For diagnosis by newborn screening, the situation is compounded: far more cases are diagnosed by screening than by clinical presentation, representing a somewhat different cohort. The literature on outcome was reviewed. For disorders other than medium‐chain acyl‐coenzyme A (CoA) dehydrogenase (MCAD) deficiency there was insufficient evidence to make many firm statements. In MCAD deficiency, risk of death in the first 72 h is around 4%, with a further approximately 5–7% fatality rate in the first 6 years but very low subsequent risk in previously undiagnosed patients. The risk of death after diagnosis is very low at any age, with good management. The long‐term outcome is good nowadays. Very‐long‐chain acyl‐CoA dehydrogenase deficiency poses a risk of death in early infancy, but the condition is generally treatable, with a good outcome after diagnosis. Approximately 10–20% of patients diagnosed by newborn screening and treated nevertheless suffer episodic rhabdomyolysis. Some patients never become symptomatic. Isolated long‐chain 3‐hydroxyacyl‐CoA dehydrogenase deficiency is treatable, but most patients suffer episodic hypoketotic hypoglycaemia and rhabdomyolysis. Generalised mitochondrial tri‐functional protein deficiency has high early mortality rate. A more insidious presentation also occurs, with symptoms sometimes confined to progressive axonal neuropathy. Among carnitine cycle disorders, carnitine transporter deficiency, potentially lethal, is uniformly successfully treated orally with carnitine. Carnitine‐acylcarnitine translocase and early‐onset carnitine palmitoyl transferase type II (CPT II) deficiencies have an extremely high neonatal mortality rate. Late‐onset CPT II is characterised only by episodic rhabdomyolysis on severe exercise. CPT type IA deficiency may often be benign, although early presentation with hypoketotic hypoglycaemia certainly occurs.
Study of inborn errors of metabolism in urine from patients with unexplained mental retardation
Authors: Sempere Angela , Arias Angela , Farré Guillermo , García‐Villoria Judith , Rodríguez‐Pombo Pilar , Desviat Lurdes R. , Merinero Begoña , García‐Cazorla Angels , Vilaseca Maria A. , Ribes Antonia , Artuch Rafael , Campistol Jaume 
Published: January 2010

AbstractMental retardation (MR) is a common disorder frequently of unknown origin. Because there are few studies regarding MR and inborn errors of metabolism (IEM), we aimed to identify patients with IEM from a cohort of 944 patients with unexplained MR. Biochemical examinations such as determination of creatine (Cr) metabolites, acylcarnitines, purine, and pyrimidines in urine were applied. We found seven patients with IEM [three with cerebral Cr deficiency syndromes (CCDS)], one with adenylosuccinate lyase (ADSL) deficiency, and three, born before the neonatal metabolic screening program in Catalonia, with phenylketonuria (PKU). All told, they represent 0.8% of the whole cohort. All of them had additional symptoms such as epilepsy, movement disorders, autism, and other psychiatric disturbances. In conclusion, in patients with MR, it is essential to perform a thorough appraisal of the associated signs and symptoms, and in most disorders, it is necessary to apply specific analyses. In some cases, it is important to achieve an early diagnosis and therapy, which may reduce the morbimortality, and to offer genetic counselling.
Perinatal hypophosphatasia presenting as neonatal epileptic encephalopathy with abnormal neurotransmitter metabolism secondary to reduced co‐factor pyridoxal‐5′‐phosphate availability
Authors: Balasubramaniam Shanti , Bowling Frank , Carpenter Kevin , Earl John , Chaitow Jeffrey , Pitt James , Mornet Etienne , Sillence David , Ellaway Carolyn 
Published: January 2010

AbstractWe describe two neonates presenting with perinatal hypophosphatasia and severe epileptic encephalopathy resulting in death. Both had increased levels of urinary vanillactate, indicating functional deficiency of aromatic amino acid decarboxylase, a pyridoxal‐5‐phosphate (PLP)‐dependent enzyme required for dopamine and serotonin biosynthesis. Clinical findings and results of subsequent metabolic investigations were consistent with secondary pyridoxine‐deficient encephalopathy. These patients highlight the importance of tissue non‐specific alkaline phosphatase in the neuronal PLP‐dependent metabolism of neurotransmitters. In addition, the disturbance of PLP metabolism appears to underlie the predominant neurological presentation in our patients. We recommend the measurement of serum alkaline phosphatase (ALP) during the assessment of perinatal seizures.
Disease severity in sibling pairs with type 1 Gaucher disease
Authors: Elstein Deborah , Gellman Ayelet , Altarescu Gheona , Abrahamov Aya , Hadas‐Halpern Irith , Phillips Mici , Margalit Maya , Lebel Ehud , Itzchaki Menachem , Zimran Ari 
Published: January 2010

AbstractThe only prognostic markers in Gaucher disease, the most common lysosomal storage disorder, are young age at first symptom/sign and the presence of null/severe mutations, both being predictive of more severe phenotypes. Therefore, it would be helpful to know whether siblings with the same genotype can be expected to experience comparable phenotypic expression. All non‐neuronopathic sibling pairs in our referral clinic (1993–2008) with the same genotype were included. For each pair, gender, date of birth, severity score index at presentation, age at diagnosis and first symptom/sign, presence of bone involvement, spleen status, and use of enzyme replacement therapy were tabulated. There were 90 pairs of siblings: two sets of identical twins; 24 pairs of brothers, 24 pairs of sisters, and 42 pairs of mixed gender. For all measures of disease severity used, only in sibling pairs with an older sister and a younger brother were phenotypes significantly different between siblings. Thus, this large cohort of sibling pairs with type 1 Gaucher disease confirmed that, in general, the phenotypic expression in the younger sibling will be similar enough to that of an older affected sibling that genetic counseling may use those findings in a prognostic way.
Explaining Mendelian Inheritance in Genetic Consultations: An IPR Study of Counselor and Counselee Experiences
Authors: Gale Theodora , Pasalodos‐Sanchez Sara , Kerzin‐Storrar Lauren , Hall Georgina , MacLeod Rhona 
Published: January 2010

AbstractThe explanation of Mendelian inheritance is a key component of most genetic counselling consultations, yet no evidence base exists for this area of practice. This qualitative study used Interpersonal Process Recall (IPR) to explore how information about X‐linked inheritance is provided and received in genetic counseling. Twelve consultations involving two senior genetic counselors and 21 counselees were videotaped. Section(s) of videotape featuring the explanation were subsequently played back separately to both counselees and counselors and their responses and reflections recorded. All interviews were fully transcribed and analysed using the constant comparison method. A personalised diagram, drawn “live” by the counselor during the consultation was recalled by counselees as being central to their understanding of the “bottom line”. This helped bridge the gap between scientific information and their family experience and did not appear to require a baseline understanding of genetic concepts such as genes or chromosomes. Counselors reflected on the diagram's positive impact on the way they sequenced, paced and tailored the explanation. A positive counselor‐counselee relationship was vital even during this educative exchange: for counselees to feel at ease discussing complex genetic information and to help gauge counselee understanding.
CLASSICAL NATURAL LAW THEORY, PROPERTY RIGHTS, AND TAXATION
Authors: Feser Edward 
Published: January 2010

AbstractClassical natural law theory derives moral conclusions from the essentialist and teleological understanding of nature enshrined in classical metaphysics. The paper argues that this understanding of nature is as defensible today as it was in the days of Plato, Aristotle, Augustine, and Aquinas. It then shows how a natural law theory of the grounds and content of our moral obligations follows from this understanding of nature, and how a doctrine of natural rights follows in turn from the theory of natural law. With this background in place, the implications of the theory for questions about property rights and taxation are explored. It is argued that classical natural law theory entails the existence of a natural right of private property, and that this right is neither so strong as to supportlaissez fairelibertarianism, nor so weak as to allow for socialism. Though the theory leaves much of the middle ground between these extremes open to empirical rather than moral evaluation, it is argued that there is a strong natural law presumption against social democratic policies and in favor of free enterprise.
THE NATURAL RIGHT OF PROPERTY
Authors: Mack Eric 
Published: January 2010

AbstractThe two main theses of “The Natural Right of Property” are: (i) that persons possess an original, non-acquired right not to be precluded from making extra-personal material their own (or from exercising discretionary control over what they have made their own); and (ii) that this right can and does take the form of a right that others abide by the rules of a (justifiable) practice of property which facilitates persons making extra-personal material their own (and exercising discretionary control over what they have made their own). I articulate some of the good reasons we have to affirm persons' possession of an original, non-acquired right of self-ownership and argue that the same good reasons support the ascription to persons of a natural right of property. I contrast an “inherent feature” conception of the actions through which (initial) rights over extra-personal objects arise with a “practice” conception of (initial) entitlement-generating actions. I argue that the fact that the natural right to property can and does take the form of persons' rights that others abide by the rules of a (justifiable) practice of property explains how there are many instances of (initial) entitlement generation which are not plausibly explained by those wed to the inherent feature conception of entitlement-generating actions and why there is a strong conventional dimension in the procedures through which persons acquire (initial) property rights.
PROPERTY AND RIGHTS
Authors: Narveson Jan 
Published: January 2010

AbstractI present what I take to be the “classical” approach to property rights, in which property is basically a unitary concept: owners are the ones with the right to do, and prohibit others from doing, whatever there is to do with the thing owned, within the limits imposed by the rights of others totheirthings. I expound and defend the idea of “first acquisition” in more or less Lockean mode. I also point to the many difficulties of application of the general idea, leading to the need to negotiate at many points. For example, the vagueness of land ownership as we consider what goes on in the earth below or the sky above; to consideration of not just possible physical damages to others by virtue of ownership, but also aesthetic ones; and to the increasingly important area of intellectual property. I argue that the original idea continues to hold, though it underdetermines any number of specific issues.
REAL-WORLD LUCK EGALITARIANISM
Authors: Sher George 
Published: January 2010

AbstractLuck egalitarians maintain that inequalities are always unjust when they are due to luck, but are not always unjust when they are due to choices for which the parties are responsible. In this paper, I argue that the two halves of this formula do not fit neatly together, and that we arrive at one version of luck egalitarianism if we begin with the notion of luck and interpret responsible choice in terms of its absence, but a very different version if we begin with the notion of responsible choice and interpret luck in terms of its absence. I argue, further, that the difference between the two versions is significant because many real-world inequalities fall precisely in the gap between them, and that attempts to adjudicate between them lead quickly to hard questions about the relation between equality and responsibility.
COERCION, OWNERSHIP, AND THE REDISTRIBUTIVE STATE: JUSTIFICATORY LIBERALISM'S CLASSICAL TILT
Authors: Gaus Gerald 
Published: January 2010

AbstractJustificatory liberalism is liberal in an abstract and foundational sense: it respects each as free and equal, and so insists that coercive laws must be justified to all members of the public. In this essay I consider how this fundamental liberal principle relates to disputes within the liberal tradition on “the extent of the state.” It is widely thought today that this core liberal principle of respect requires that the state regulates the distribution of resources or well-being to conform to principles of fairness, that all citizens be assured of employment and health care, that no one be burdened by mere brute bad luck, and that citizens' economic activities must be regulated to insure that they do not endanger the “fair value” of rights to determine political outcomes. I argue in this essay: (1) a large family of liberal views are consistent with the justificatory liberals project, from classical to egalitarian formulations (but not socialist ones); (2) overall, the justificatory project tilts in the direction of classical formulations.
ADAM SMITH AND THE GREAT MIND FALLACY
Authors: Otteson James R. 
Published: January 2010

AbstractAdam Smith raised a series of obstacles to effective large-scale social planning. In this paper, I draw these Smithian obstacles together to construct what I call the “Great Mind Fallacy,” or the belief that there exists some person or persons who can overcome the obstacles Smith raises. The putative scope of the Great Mind Fallacy is larger than one might initially suppose, which I demonstrate by reviewing several contemporary thinkers who would seem to commit it. I then address two ways the fallacy might be overcome, finding both wanting. I close the paper by suggesting that Smith's Great Mind Fallacy sheds interesting light on his “impartial spectator” standard of morality, including with respect to the specific issues of property and ownership.
Nontraumatic spinal epidural hematomas
Authors: Lövblad K O. , Baumgartner R. W. , Zambaz B. D. , Remonda L. , Ozdoba C. , Schroth G. 
Published: January 2010

Purpose: Spinal epidural hematoma (SEH) is a rare clinical entity with a bleak outcome. The aim of our study was to establish the value of MR findings in the diagnosis of nontraumatic SEH. Material and Methods: Seven patients with nontraumatic SEH were examined by MR at 1.5 T. Two patients were under anticoagulation therapy with heparin, and 2 others were taking salicylic acid. One patient had lupus erythematodes with a marked thrombocytopenia. One patient had a spinal arteriovenous malformation. Results: MR imaging permitted the accurate localization of extradural intraspinal expansive lesions which exhibited the characteristic signal intensities of blood. Five patients underwent laminectomy and evacuation of the hematoma. In the acute phase, the hematomas appeared isointense when compared with the spinal cord on T1-weighted images and hyperintense on T2-weighted images. Later the hematomas were hyperintense on T1-weighted images and showed signals identical to those of cerebrospinal fluid (CSF) on T2-weighted images Conclusion: MR imaging established the exact diagnosis and localization of SEH in all cases. MR also can provide useful information about the age of the hematomas.
Time-dependency in brain lesion enhancement with gadodiamide injection
Authors: Åkeson P. , Nordström C.-H. , Holtås S. 
Published: January 2010

Purpose: To determine the effective time window for MR imaging of tumors with blood-brain barrier (BBB) damage after injection of Gd-containing contrast media. Material and Methods: Eleven patients with 15 brain lesions (metastasis, glioma, abscess) were studied with a T1-weighted spin-echo sequence repeated over periods of up to 43 min after contrast injection. A quotient was calculated between the signals in the lesion and in the gray matter, and plotted against time. Results: All lesions reached 70% of the maximum RATIO within 3.5 min. After 25 min 12 out of 15 lesions showed persistent enhancement within 15% of the maximal RATIO. Conclusion: The peak enhancement of BBB damage occurs around 3.5 min after injection. The effect does not change during the next 25 min. Scanning should not be started until 2–5 min after injection of the contrast medium, and there is no advantage in waiting longer as no major increase (or decline) of contrast can be expected.