bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selective gelfoam embolization of primary racemose haemangioma of the bronchial artery
Authors: SANNO Ken , HATANAKA Nobuyuki , YAMAGISHI Toru , NAKAZAWA Ichiro , HIRANO Yusuke , HOSAKA Kimio , KAMEMURA Hirotaka 
Published: April 2009

ABSTRACTA 54‐year‐old male presented with haemoptysis. Bronchial arteriography revealed a bent, meandering and dilated bronchial artery with vascular hyperplasia in multiple locations. The patient was diagnosed as having primary racemose haemangioma of the bronchial artery. Using a microcatheter, TorconNB (5 Fr) and Progreat (2.7 Fr), selective gelfoam embolization of the descending branch of the right bronchial artery was performed using the double catheter method. This approach would allow effective treatment of the haemorrhage and avoid spinal cord injury.
The efficacy and safety of tiotropium in Chinese patients with stable chronic obstructive pulmonary disease: A meta‐analysis
Authors: WU Qibiao , LI Guochun , LEI Wun I. , ZHOU Xiqiao 
Published: April 2009

ABSTRACTBackground and objective:  Tiotropium is the only long‐acting inhaled anticholinergic bronchodilator currently available in China, but information about its clinical effect in this population is limited. This meta‐analysis assessed the efficacy and safety of tiotropium in Chinese patients with stable COPD.Methods:  An electronic search of the literature was undertaken to identify randomized controlled trials (RCTs) of tiotropium in Chinese patients, which were then assessed for inclusion in a meta‐analysis. The efficacy and safety of tiotropium was compared with placebo and ipratropium, using the outcomes of FEV1, FEV1%, symptoms, frequency of exacerbations, adverse events and safety.Results:  Eleven RCTs recruiting 1006 patients were included in the meta‐analysis. Compared with both placebo and ipratropium, tiotropium significantly improved FEV1[weighted mean difference (WMD) = 304 mL, 95% CI 271–337], FEV1% (WMD = 8.35%, 95% CI 5.40–11.31) and symptoms [relative risk (RR) = 2.00, 95% CI 1.61–2.49]. Tiotropium significantly reduced the risk of exacerbations (RR = 0.07, 95% CI 0.01–0.54) compared with placebo, and there was a non‐significant reduction in the risk of exacerbations compared with ipratropium (RR = 0.70, 95% CI 0.13–3.75). Tiotropium was well tolerated with a similar safety profile to placebo and ipratropium (RR = 1.16, 95% CI 0.76–1.77, P = 0.49).Conclusions:  Tiotropium improved pulmonary function and symptoms, reduced exacerbations and was well tolerated and safe. On the basis of its efficacy and safety profile, tiotropium appears to be a reasonable first‐line choice for the management of Chinese patients with stable COPD. Additional long‐term RCTs are required to further evaluate the efficacy and safety of tiotropium.
Identification of a calcium‐controlled negative regulatory system affecting Vibrio cholerae biofilm formation
Authors: Bilecen Kivanc , Yildiz Fitnat H. 
Published: April 2009

Summary Vibrio cholerae's capacity to cause outbreaks of cholera is linked to its survival and adaptability to changes in aquatic environments. One of the environmental conditions that can vary in V. cholerae's natural aquatic habitats is calcium (Ca+2). In this study, we investigated the response of V. cholerae to changes in extracellular Ca2+ levels. Whole‐genome expression profiling revealed that Ca2+ decreased the expression of genes required for biofilm matrix production. Luria–Bertani (LB) medium supplemented with Ca2+ (LBCa2+) caused V. cholerae to form biofilms with decreased thickness and increased roughness, as compared with biofilms formed in LB. Furthermore, addition of Ca2+ led to dissolution in biofilms. Transcription of two genes encoding a two‐component regulatory system pair, now termed calcium‐regulated sensor (carS) and regulator (carR), was decreased in cells grown in LBCa2+. Analysis of null and overexpression alleles of carS and carR revealed that expression of vps (Vibriopolysaccharide) genes and biofilm formation are negatively regulated by the CarRS two‐component regulatory system. Through epistasis analysis we determined that CarR acts in parallel with HapR, the negative regulator of vps gene expression.
Resection of the primary tumour or other palliative procedures in incurable stage IV colorectal cancer patients?
Authors: Mik M. , Dziki L. , Galbfach P. , Trzcinski R. , Sygut A. , Dziki A. 
Published: April 2009

AbstractObjective  The aims of the study were to analyse the early and late results of surgical treatment in patients with stage IV colorectal cancer (CRC) and to evaluate the effect of primary tumour resection and other clinical factors on survival.Method  A group of 134 patients with stage IV CRC was electively operated on between 1996 and 2000. The first group underwent resection of the primary tumour (52 patients; mean age 63.4 ± 10.3) and the second group of patients underwent procedures without resection (82 patients; mean age 62.6 ± 10.6).Results  Postoperative morbidity occurred significantly more often (P = 0.041) in the first group – in 26 patients (50%) than in the second group – 19 patients (23.1%). The resection of the primary tumour increased the survival probability; hazard ratio (HR): 1.78; 95% confidence interval (CI): 1.21–2.78%; P = 0.004. Bi‐lobar metastases increased mortality risk compared with uni‐lobar; HR 2.32; 95% CI: 1.47–3.68; P = 0.0003. The 2‐year survival rate in patients with uni‐lobar metastases in the first group was 44.2%, in the second group: 30.7%; P = 0.023.Conclusion  Primary tumour resection in stage IV CRC increases the risk of postoperative complications. In the given setting, however, it results in an increased 2‐year survival rate but it may not influence the 5‐year survival rate. In patients with bi‐lobar liver metastases resection of the primary tumour does not prolong survival time.
Surgery of recurrent parastomal hernia: direct repair or relocation?
Authors: Riansuwan W. , Hull T. L. , Millan M. M. , Hammel J. P. 
Published: April 2009

AbstractPurpose  Parastomal hernia is a common late complication after stoma creation. The management options are many; unfortunately, most literature suggests unsatisfactory results. There are few studies comparing the outcomes after repair of parastomal hernias especially in recurrent cases, and the results are controversial. The aim of this study was to compare outcomes after repair of recurrent parastomal hernias between direct repair (DR) and relocation (RL).Method  We performed a retrospective chart review of patients who underwent direct repair or RL for recurrent parastomal hernia during the period between 1990 and 2005. Perioperative data and re‐recurrence rates were obtained and analysed with appropriate statistical methods.Results  With mean follow‐up time of 2 years, 50 operations were available for evaluation; 27 (54%) DR and 23 (46%) RL [five same‐side RL (SSRL) and 18 opposite‐side RL (OSRL)]. There were no deaths and there were similar complication rates between groups. Four of five (80%) SSRL had a re‐recurrent parastomal hernia. Considering only DR with OSRL, although OSRL had longer operative time and hospital stay than DR, the re‐recurrence rate was lower (38%vs 74%; P = 0.02). However, with Kaplan–Meier calculated and longer predicted follow‐up time, re‐recurrence rates were similar (Log rank P = 0.09).Conclusion  Recurrent parastomal hernia repair is associated with high re‐recurrence rates.OSRL seems to have promising short‐term outcomes; however, whether these results hold up long‐term remains unclear. Therefore, larger cohorts of patients with longer follow‐up or prospective randomized trials are needed.
Do guidelines improve clinical practice? – a national survey on surveillance colonoscopies
Authors: John B. J. , Irukulla S. , Mendall M. A. , Abulafi A. M. 
Published: April 2009

AbstractBackground  Colonoscopic services are increasingly being utilized in surveillance of conditions predisposing to colorectal cancers (CRC). The ACPGBI/BSG guidelines are the most commonly followed recommendations. Numerous retrospective studies have shown poor compliance with them. We conducted a national survey of colonoscopic practitioners investigating attitudes, awareness and implementation of surveillance guidelines.Method  A postal questionnaire was sent to a random population of 250 ACPGBI and 200 BSG members. Questions assessed practice as regards colorectal polyp surveillance, family screening and surveillance for past history of CRC.Results  The ACPGBI/BSG guidelines were the most commonly followed recommendations. Only 17.2% of practitioners used the criteria that would ensure accurate implementation of guidelines for colorectal adenoma surveillance. With regards to familial surveillance for CRC, 53.5% respondents assessed familial risk accurately, while 69.3% recommended surveillance incorrectly. A total of 48.8% of ACPGBI members recommended five yearly colonoscopies following curative treatment for CRC.Conclusion  This study has revealed the widespread ignorance of guidelines, which will potentially translate into the gross over utilization of colonoscopic resources. Strategies to improve and audit guideline implementation must be integral to guideline formation. Methods to improve accurate guideline implementation need to be explored.
Incontinence following sphincter division for treatment of anal fistula
Authors: Bokhari S. , Lindsey I. 
Published: April 2009

AbstractObjective  Management of anal fistula poses problems because of competing goals of cure and maintenance of continence. There is increasing recognition of significant rates of incontinence after sphincter‐dividing anal surgery. We aimed to determine cure and continence status in a cohort of anal fistula patients managed by both sphincter‐dividing and conserving approaches.Method  Data on fistula, healing and continence status were gathered by patient questionnaire (Cleveland Clinic incontinence questionnaire), telephone interview and chart review. Fistulae were defined as simple (low risk of incontinence) or complex (high risk). Surgery was defined as sphincter conservation and sphincter division. Incontinence was graded by traditional severity scale (minor/major). Fistula healing was defined as absence of acute or chronic sepsis symptoms from surgery to date of last follow‐up.Results  One hundred and twenty‐eight patients were evaluated  (out of whom 71% were male subjects, age range 17–82, median age 45 years).Fifty‐two percent of the fistulae were complex and 48% were simple, of which 51% and 85% underwent sphincter division respectively. Healing rates were higher for sphincter division than conservation (87%vs 73%, P = 0.06). Complex fistulae undergoing sphincter division led to a higher rate of major incontinence (13%) than sphincter conservation (0%) (P = 0.03). For simple fistulae treated by sphincter division, major (5%) and minor incontinence (11%) was not inconsiderable.Conclusion  Though cure rates are excellent, incontinence rates remain unacceptably high following sphincter division for complex fistulae and are not insignificant even for simple fistulae. More sphincter conservation should be undertaken.
Positron‐emission tomography/computed tomography (PET/CT) in the initial staging of primary rectal cancer
Authors: Eglinton T. , Luck A. , Bartholomeusz D. , Varghese R. , Lawrence M. 
Published: April 2009

AbstractObjective  The aim of this study was to assess the role of 18flourodeoxyglucose positron‐emission tomography/computed tomography (PET/CT) in the initial staging of primary rectal adenocarcinoma.Method  A total of 20 patients with adenocarcinoma of the rectum were assessed with both PET/CT and conventional staging (CT chest/abdomen/pelvis, MRI rectum). Discordance with conventional imaging and incidental findings on PET were recorded and the patients presented to a colorectal cancer multidisciplinary team to assess management changes. Patients were followed up so that discordant or incidental findings could be verified by intra‐operative examination, imaging or histology where possible.Results  Positron‐emission tomography/computed tomography correctly identified the primary tumour in all 20 patients. Comparing PET/CT with conventional staging modalities, there were 11 discordant or incidental findings in nine patients (45%). This resulted in a potential change in stage in 30% (four patients downstaged and two upstaged). PET/CT suggested additional neoplastic pathology in three patients and excluded the same in two patients. The incidental neoplastic findings were of minor clinical significance and one was eventually deemed false positive. While PET/CT resulted in potential management changes in five patients (25%), no changes in surgical management occurred. When tumours were grouped according to conventional stage, PET/CT resulted in fewer changes in stage in stage I (0%), compared with stages II to IV (43%) (P = 0.08).Conclusion  Positron‐emission tomography/computed tomography provides additional information to conventional staging in primary rectal cancer. This information produced minor management changes in this study and did not effect surgical management. PET/CT may be most appropriately used selectively in more advanced stages and where indeterminate findings exist with conventional staging.
Quality assurance in colonoscopy: role of endomucosal clips
Authors: Maslekar S. , Avery G. , Duthie G. S. 
Published: April 2009

AbstractObjective  Quality assurance in colonoscopy is important, and subjective assessment of completion based on endoscopic signs can be inaccurate leading to missed lesions. We aimed to determine the technique of endomucosal clips with follow‐up X‐rays in objectively documenting completion and correlation with pathology miss rates.Method  A total of 82 patients undergoing colonoscopy by trained colonoscopists had an endomucosal clip applied to the most proximal bowel reached. A plain abdominal X‐ray was performed while there was still a pneumocolon, and the clip position was assessed by a blinded radiologist to determine objective completion rates. Repeat colonoscopies were performed in patients with incomplete procedures. Pathology and endoscopy database were also reviewed to identify missed lesions at a median follow‐up of 6 years. These were correlated with colonoscopy completions.Results  The clip was found in caecum of 76 (93%), ascending‐colon in three (3.6%), hepatic flexure in one (1.2%) and splenic flexure in two (2.4%) patients. The endoscopist opinion was incorrect in six incomplete colonoscopies. A total of 33 patients underwent repeat colonoscopies over the median 6‐year follow‐up. Three adenomas and one carcinoma were missed in the incomplete group and were subsequently picked up in repeat endoscopies. Only one adenoma was truly missed in complete colonoscopies, providing an overall miss rate of 1.3%.Conclusion  Use of endomucosal clips with follow‐on abdominal X‐ray is a safe and effective method of determining completion of colonoscopy. This technique is also an excellent objective measure of quality assurance of completion and miss rates in colonoscopy, especially when combined with an audit to determine the missed lesions at two years postprocedure.
Changes in fatigability of the striated anal canal after childbirth
Authors: Cattle K. R. , Telford K. , Kiff E. S. 
Published: April 2009

AbstractAim  Anal manometry is an established assessment tool for patients with faecal incontinence. Fatigue rate index (FRI) has been shown to discriminate between symptomatic patients and controls. The aim of this study was to compare manometry and fatigability of the anal canal in nulliparous women before and after childbirth.Method  An air‐filled manometry device was used to record maximum resting and squeeze pressures, fatigue rate (recorded over 20 s) and FRI. Recordings were made before and after vaginal delivery.Results  Nineteen women were studied. Resting anal canal pressure was not significantly different before and after delivery (57.1 ± 13.6 vs 51.1 ± 11.9 cmH2O, P = 0.1). Squeeze pressure was significantly lower postpartum (106.5 ± 43.6 vs 75.5 ± 45.6 cmH2O, P < 0.001). Fatigue rate was significantly reduced postpartum (−129.5 ± 74.7 vs−76.1 ± 54.8 cmH2O/min, P = 0.001), but FRI was not significantly altered (1.23 ± 1.49 vs 1.41 ± 1.27 min, P = 0.09).Conclusion  Maximal squeeze pressure and fatigue rate of the anal canal are significantly reduced after childbirth. Resting anal canal pressure and FRI are not significantly different.
Hempel's Paradox, Law‐likeness and Causal Relations
Authors: Schroeder Severin 
Published: April 2009

AbstractIt is widely thought that Bayesian confirmation theory has provided a solution to Hempel's Paradox (the Ravens Paradox). I discuss one well‐known example of this approach, by John Mackie, and argue that it is unconvincing. I then suggest an alternative solution, which shows that the Bayesian approach is altogether mistaken. Nicod's Condition should be rejected because a generalisation is not confirmed by any of its instances if it is not law‐like. And even law‐like non‐basic empirical generalisations, which are expressions of assumed underlying causal regularities, are not so confirmed if they are absurd in the light of our causal background knowledge or if their instances are not also possible instances of the relevant causal claim.
Ethics Beyond Moral Theory
Authors: Chappell Timothy 
Published: April 2009

AbstractI develop an anti‐theory view of ethics. Moral theory (Kantian, utilitarian, virtue ethical, etc.) is the dominant approach to ethics among academic philosophers. But moral theory's hunt for a single Master Factor (utility, universalisability, virtue . . .) is implausibly systematising and reductionist. Perhaps scientism drives the approach? But good science always insists on respect for the data, even messy data: I criticise Singer's remarks on infanticide as a clear instance of moral theory failing to respect the data of moral perceptions and moral intuitions.Moral theory also fails to provide a coherent basis for real‐world motivation, justification, explanation, and prediction of good and bad, right and wrong. Consider for instance the marginal place of love in moral theory, compared with its central place in people's actual ethical outlooks and decision making. Hence, moral theory typically fails to ground any adequate ethical outlook. I propose that it is the notion of an ethical outlook that philosophical ethicists should pursue, not the unfruitful and distorting notion of a moral theory.
A tour not so grand: mobile Muslims in northern Pakistan
Authors: Marsden Magnus 
Published: April 2009

This paper explores the ways in which village Muslims living in the Chitral region of northern Pakistan seek to nurture and sustain their region as a socially heterogeneous space by actively embarking on local forms of travel. The heterogeneity of places in the region offers potentials for Chitrali Muslims to enact diverse ways of being Muslim, forge complex structures of attachment to Chitral, and cultivate an attitude of curiosity as to the heterogeneity of life in their region. The expanding body of anthropological work on sacred landscapes is brought into conversation with ethnographic studies in urban settings of the role played by everyday practices in the formation of Muslim ethical selfhood. In doing so, I suggest the wider insights into understanding the complexity and diversity of Muslim experiences of and responses to modernity that are afforded by a consideration of rural societies.RésuméL’auteur étudie la façon dont les villageois musulmans de la région de Chitral, dans le nord du Pakistan, s’efforcent d’entretenir et de soutenir leur région en tant qu’espace socialement hétérogène, en entreprenant diverses formes de voyages locaux. L’hétérogénéité des lieux au sein même de la région donne aux Chitralis la possibilité de vivre différentes manières d’être musulmans, de forger des structures complexes d’attachement au Chitral et de cultiver une attitude de curiosité envers les multiples visages de la vie dans leur région. Le corpus grandissant de travaux anthropologiques sur les paysages sacrés sont confrontés ici aux études ethnographiques en milieu urbain consacrées au rôle des pratiques quotidiennes dans la formation du Moi éthique musulman. Par ce biais, l’article suggère que l’examen des sociétés rurales élargit l’approche de la complexité et de la diversité des façons dont les musulmans appréhendent la modernité et y répondent.
The Continuing Muddles of Monetary Theory: A Steadfast Refusal to Face Facts
Authors: GOODHART C. A. E. 
Published: April 2009

Lionel Robbins was concerned about the methodology of economic science. When he discussed the relationship between theory and ‘reality’, two of the examples of inappropriate relationships were taken from monetary economics. Such shortcomings continue. Among the worst are:(1) IS/LM: whereby the monetary authorities set the monetary base, and the interest rate is market determined;(2) the monetary base multiplier of bank deposits, and the role of reserve ratios;(3) the current three‐equation neoclassical consensus, assuming perfect creditworthiness, and hence no need for banks;(4) the analysis of the evolution of money.
An electrophysiological assessment of distractor suppression in visual search tasks
Authors: Mazza Veronica , Turatto Massimo , Caramazza Alfonso 
Published: April 2009

AbstractWe investigated whether the N2pc is unequivocally linked to distractor‐suppression mechanisms, as is commonly assumed. According to the distractor‐suppression account of the N2pc, no suppression, and thus no N2pc, should occur when homogeneous distractors help in selecting the target, such as when the target feature is unpredictable. Participants performed a simple detection or a finer discrimination on a singleton target, which had either a variable or a constant color. Contrary to the distractor‐suppression account, an N2pc was present for both the variable and the constant conditions, and for both tasks. Additionally, target feature consistency correlated with earlier N2pc onsets relative to variable blocks. Both results indicate that the N2pc is not unequivocally linked to distractor‐suppression mechanisms, but may index mechanisms involved in identifying and localizing relevant stimuli through enhancement of their features.
Neural inhibition and interhemispheric connections in two‐choice reaction time: A Laplacian ERP study
Authors: Meynier Chloe , Burle Boris , Possamaï Camille‐Aime , Vidal Franck , Hasbroucq Thierry 
Published: April 2009

AbstractIn between‐hand choice reaction time tasks, the motor cortex involved in the required response is activated while the motor cortex involved in the non‐required response is inhibited. Such an inhibition could be implemented actively between the responses defined as possible alternatives by the task instructions or, alternatively, could passively result from some kind of “reciprocal inhibition” between the two motor cortices. The present study addressed this issue. To this end, we compared the surface Laplacian transforms of electroencephalographic (EEG) waves recorded over the contralateral and ipsilateral motor cortices in between‐hand and within‐hand choice conditions. The dynamics of the recorded EEG activities suggest that inhibition is implemented in a feed‐forward manner between the cortical zones controlling the different response alternatives rather than between homologous motor cortical structures.