bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resection of malignant brain tumors in eloquent cortical areas: a new multimodal approach combining 5-aminolevulinic acid and intraoperative monitoring
Authors: Feigl Guenther C. , Ritz Rainer , Moraes Mario , Klein Jan , Ramina Kristofer , Gharabaghi Alireza , Krischek Boris , Danz Soeren , Bornemann Antje , Liebsch Marina , Tatagiba Marcos S. 
Published: November 2009

Object
Several studies have revealed that the gross-total resection (GTR) of malignant brain tumors has a significant influence on patient survival. Frequently, however, GTR cannot be achieved because the borders between healthy brain and diseased tissue are blurred in the infiltration zones of malignant brain tumors. Especially in eloquent cortical areas, resection is frequently stopped before total removal is achieved to avoid causing neurological deficits. Interestingly, 5-aminolevulinic acid (5-ALA) has been shown to help visualize tumor tissue intraoperatively and, thus, can significantly improve the possibility of achieving GTR of primary malignant brain tumors. The aim of this study was to go one step further and evaluate the utility and limitations of fluorescence-guided resections of primary malignant brain tumors in eloquent cortical areas in combination with intraoperative monitoring based on multimodal functional imaging data.

Methods
Eighteen patients with primary malignant brain tumors in eloquent areas were included in this prospective study. Preoperative neuroradiological examinations included MR imaging with magnetization-prepared rapid gradient echo (MPRAGE), functional MR, and diffusion tensor imaging sequences to visualize functional areas and fiber tracts. Imaging data were analyzed offline, loaded into a neuronavigational system, and used intraoperatively during resections. All patients received 5-ALA 6 hours before surgery. Fluorescence-guided tumor resections were combined with intraoperative monitoring and cortical as well as subcortical stimulation to localize functional areas and fiber tracts during surgery.

Results
Twenty-five procedures were performed in 18 consecutive patients. In 24% of all surgeries, resection was stopped because a functional area or cortical tract was identified in the resection area or because motor evoked potential amplitudes were reduced in an area where fluorescent tumor cells were still seen intraoperatively. Grosstotal resection could be achieved in 16 (64%) of the surgeries with preservation of all functional areas and fiber tracts. In 2 patients presurgical hemiparesis became accentuated postoperatively, and 1 of these patients also suffered from a new homonymous hemianopia following a second resection.

Conclusions
The authors' first results show that tumor resections with 5-ALA in combination with intraoperative cortical stimulation have the advantages of both methods and, thus, provide additional safety for the neurosurgeon during resections of primary malignant brain tumors in eloquent areas. Nonetheless, more cases and additional studies are necessary to further prove the advantages of this multimodal strategy.
Nationwide study of decompressive surgery for malignant supratentorial infarction in the Czech Republic: utilization and outcome predictors
Authors: Bar Michal , Mikulik Robert , Školoudík David , Czerny Daniel , Lipina Radim , Klecka Lukas , Juran Vilem , Mraček Jan , Vondráčková Denisa , Hrabalek Lumir , Brzezny Richard , Dienelt Jan 
Published: November 2009

Object
Decompressive surgery within 48 hours in patients younger than 60 years of age reduces mortality and morbidity from malignant supratentorial infarction. The goal of this study was to characterize the utilization of decompressive surgery in the Czech Republic in 2006.

Methods
This nationwide study was undertaken from September to December 2007 using a questionnaire sent to all neurosurgery departments in the Czech Republic. Diagnosis of brain infarction and decompressive surgery was based on discharge codes. Patient data were retrieved from hospital charts. Favorable outcome was defined as a modified Rankin scale score ≤4 on the day of discharge from the hospital.

Results
Data were obtained from 15 of the 16 neurosurgery departments in the Czech Republic (94%) and from 39 patients (11 female [28%]). The average patient age was 52 ± 14 years (11 patients > 60), median time to surgery was 48 hours (interquartile range [IQR] 26–67 hours; 15 patients > 48 hours), median National Institutes of Health Stroke Scale score was 22 (IQR 16–30), median infarct volume was 341 cm3 (IQR 243–375 cm3), mean shift from the midline was 9.9 ± 4.1 mm, median duration of hospitalization was 19 days (IQR 13–30 days), and mean bone flap surface area was 75 cm2 (IQR 70–97 cm2). A favorable outcome was achieved in 19 patients (49%). The median number of procedures per site in 2006 was 1.5 (range 0–13 procedures). Five sites (31%) serving one-third of the entire population did not perform any decompressive surgery. No variable was a significant predictor of outcome in a multiple regression model.

Conclusions
In 2006 decompressive surgery was underutilized and occurred late in the clinical course in the Czech Republic. Revision of national guidelines is necessary to incorporate the latest data and ensure that the patients who can benefit most receive treatment.
Microstructural Engineering of Hydroxyapatite Membranes to Enhance Proton Conductivity
Authors: Liu Dongxia , Savino Keith , Yates Matthew Z. 
Published: November 2009

AbstractA new approach to enhancing proton conductivity of ceramics is demonstrated by aligning proton conductive pathways and eliminating resistive grain boundaries. Hydroxyapatite (HAP) membranes are synthesized by multistage crystallization onto palladium. The synthesis involves three steps: electrochemical deposition of HAP seeds, secondary hydrothermal crystallization onto the seed layer to promote c‐axis growth normal to the substrate, and tertiary hydrothermal crystallization to promote a‐axis growth to fill the gaps between the aligned crystals. The c‐axis alignment with crystal domains spanning the membrane thickness significantly enhances proton conduction since protons are primarily transported along the c‐axes of HAP crystals. The novel HAP membranes display proton conductivity almost four orders of magnitude higher than traditional sintered HAP ceramics. The HAP membranes on palladium hydrogen membrane substrates hold promise for use in intermediate‐temperature fuel cells, chemical sensors, and other devices. The synthesis approach presented may also be applied to other ion‐conducting membrane materials to enhance transport properties.
Iridium‐Catalyzed Selective Synthesis of 4‐Substituted Benzofurans and Indoles via Directed Cyclodehydration
Authors: Tsuchikama Kyoji , Hashimoto Yu‐ki , Endo Kohei , Shibata Takanori 
Published: November 2009

AbstractA directed cyclization‐dehydration cascade of α‐aryloxy ketones and α‐arylamino ketones was efficiently catalyzed by a cationic iridium‐BINAP complex, which afforded various types of 4‐substituted benzofurans and indoles in high yields with complete regioselectivity. The newly developed protocol also enabled the enantioselective preparation of chiral 4‐acetyloxindole using a chiral iridium catalyst.
A Coherent Mechanistic Rationale for Additive Effects and Autoinductive Behaviour in Proline‐Mediated Reactions
Authors: Zotova Natalia , Moran Antonio , Armstrong Alan , Blackmond Donna G. 
Published: November 2009

AbstractDifferences in the kinetic behaviour of aldol reactions compared to aminoxylation and amination reactions are rationalized by consideration of the rate‐determining step in each case. Both autoinductive behaviour and the rate‐enhancing effect of additives are attributed to an effect on the enamine formation step.
The effect of organo‐montmorillonite on the compatibility and properties of nylon 66/polypropylene blend
Authors: Yang Qing‐Quan , Guo Zhao‐Xia , Yu Jian 
Published: November 2009

AbstractNylon 66/polypropylene (PP) blends containing maleated polypropylene and organo‐montmorillonite (OMMT) have been prepared by melt compounding using a well‐dispersed master‐batch of nylon 6/OMMT nanocomposite as the source of OMMT. The effects of OMMT platelets on the compatibility and properties of the blends have been investigated. The blend morphology has been observed by the use of field emission scanning electron microscopy, showing a sharp decrease in domain size. The dispersion and location of OMMT have been investigated by X‐ray diffraction and transmission electron microscopy. A high‐density occupation of OMMT at the interface (i.e. Nylon‐g‐PP interphase region) is revealed by Fourier transform infrared spectroscopy and thermogravimetric analysis of the extraction residue after the removal of nylon phase by formic acid. A significant gain in stiffness is realized with the use of OMMT while the toughness of the material is maintained. The possible mechanism of compatibilization also is discussed. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2010
Chemical modification of rigid poly(vinyl chloride) by the substitution with nucleophiles
Authors: Kameda Tomohito , Fukuda Yuuzou , Grause Guido , Yoshioka Toshiaki 
Published: November 2009

AbstractThe reaction of rigid poly(vinyl chloride) (PVC) with iodide, hydroxide, azide, and thiocyanate as nucleophiles (Nu) in ethylene glycol (EG) resulted in the substitution of Cl by Nu additional to the elimination of HCl, leading to the dehydrochlorination of the rigid PVC. High substitution rates were observed for hydroxide, azide and thiocyanate, while the addition of iodide accelerated predominately the elimination of HCl. The substitution by thiocyanate resulted at 150°C in both thiocyanate and isothiocyanate structures, whereas at 190°C, only isothiocyanate was observed in the polymer. The dehydrochlorination yield increased with an increasing molar SCN/Cl ratio, resulting in a maximum substitution at high molar SCN/Cl ratios. When EG was replaced by diethylene glycol (DEG) as solvent, the dehydrochlorination was found to be accelerated. It was assumed that DEG has a higher compatibility with PVC, making it easier to penetrate the rigid PVC particle. For triethylene glycol (TEG), the rapid dehydrochlorination resulted probably in the coverage of the surface of the PVC particle by methyl methacrylate/butadiene/styrene (MBS), preventing the penetration by the solution. The substitution/dehydrochlorination ratio decreased in the order of EG > DEG > TEG because of the declining polarity of the solvent, stabilizing the activated SN2 complex. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2010
Synthesis and characterization of new unsaturated polyesters containing cyclopentapyrazoline moiety in the main chain
Authors: Alkskas Ismail A. , El‐gnidi Bashir A. , Azam Faizul 
Published: November 2009

Abstract3‐p‐Hydroxyphenyl‐6‐p‐hydroxybenzylidene cyclopentapyrazoline (III) and 3‐vanillyl‐7‐vanillylidene cyclopentapyrazoline (IV) were used as new starting materials for preparing new unsaturated polyesters. The polyesters were prepared by reacting (III) or (IV) with adipoyl, sebacoyl, isophthaloyl, and terephthaloyl dichlorides utilizing the interfacial polycondensation technique. The polyester samples have been characterized by elemental and spectral analyses. The polyesters have inherent viscosities of 0.55–0.97 dL/g. All the polyesters are semicrystalline and most of them are partially soluble in most common organic solvents but freely soluble in concentrated sulfuric acid. Their glass transition temperatures (Tg) range from 103.34 to 208.81°C, and the temperatures of 10% weight loss as high as 190 to 260°C in air, indicating that these aromatic polyesters have high Tg and excellent thermal stability. Doping with iodine dramatically raised the conductivity and produced dark brown colored semiconductive polymers with a maximum conductivity in the order of 3.1 × 10−7 Ω−1 cm−1. © 2009 Wiley Periodicals, Inc. J Appl Polym Sci, 2010
Prevention of postoperative adhesion formation by individual and combined administration of 4 per cent icodextrin and dimetindene maleate
Authors: Tepetes K , Asprodini E K , Christodoulidis G , Spyridakis M , Kouvaras E , Hatzitheofilou K 
Published: November 2009

Abstract

Background
To date, no single method has been successful in eliminating peritoneal adhesion formation after major abdominal surgery. This study evaluated the individual and possible synergistic effect of a local intraperitoneal barrier, 4 per cent icodextrin, and an intravenously administered antihistamine drug, dimetindene maleate, in the prevention of adhesion development following surgical trauma.

Methods
De novo experimental adhesions were induced by standardized trauma of the peritoneum and large bowel in 120 New Zealand White rabbits. The animals were randomized into four groups receiving intraperitoneal saline, intraperitoneal 4 per cent icodextrin (60 ml), intravenous dimetindene maleate (0·1 mg/kg) and 4 per cent icodextrin–dimetindene in combination (n = 30 per group). Ten days later, adhesion scores and incidence were assessed by two independent surgeons. and surface area by computer-aided planimetry.

Results
Treatment with either icodextrin or dimetindene maleate significantly reduced adhesion scores and increased the incidence of adhesion-free animals in an equipotent manner. The effect of combined treatment on severity, incidence and surface area of adhesions was more pronounced than that of each drug administered separately.

Conclusion
Combined administration of 4 per cent icodextrin and dimetindene maleate may be used safely and efficaciously to prevent surgically induced adhesions.
Blinded randomized clinical trial of botulinum toxin versus isosorbide dinitrate ointment for treatment of anal fissure
Authors: Festen S , Gisbertz S S , van Schaagen F , Gerhards M F 
Published: November 2009

Abstract

Background
Nitric oxide donors such as isosorbide dinitrate (ISDN) are considered the first choice of treatment for anal fissure. After reports of the successful treatment of such fissures with botulinum toxin, this randomized blinded trial compared botulinum toxin with ISDN in the treatment of chronic anal fissure.

Methods
Patients were randomized to receive an injection of botulinum in the internal anal sphincter and a placebo ointment, or a placebo injection and ISDN ointment. The primary endpoint was macroscopic fissure healing after 4 months.

Results
After 4 months macroscopic healing of the fissures was noted in 14 of 37 patients in the botulinum group and 21 of 36 in the ISDN group. Pain scores were lower among patients who received ISDN, although the difference was not significant. Side-effects were similar in the two groups.

Conclusion
In contrast with previous reports on botulinum toxin as a therapeutic agent for anal fissure, this study found no advantage over treatment with a nitric oxide donor as regards fissure healing and fissure-related pain.
Economic evaluation of a randomized clinical trial of hospitalversustelephone follow-up after treatment for breast cancer
Authors: Beaver K , Hollingworth W , McDonald R , Dunn G , Tysver-Robinson D , Thomson L , Hindley A C , Susnerwala S S , Luker K 
Published: November 2009

AbstractBackgroundThis was an economic evaluation of hospital versus telephone follow-up by specialist nurses after treatment for breast cancer.MethodsA cost minimization analysis was carried out from a National Health Service (NHS) perspective using data from a trial in which 374 women were randomized to telephone or hospital follow-up. Primary analysis compared NHS resource use for routine follow-up over a mean of 24 months. Secondary analyses included patient and carer travel and productivity costs, and NHS and personal social services costs of care in patients with recurrent breast cancer.ResultsPatients who had telephone follow-up had approximately 20 per cent more consultations (634 versus 524). The longer duration of telephone consultations and the frequent use of junior medical staff in hospital clinics resulted in higher routine costs for telephone follow-up (mean difference £55 (bias-corrected 95 per cent confidence interval (b.c.i.) £29 to £77)). There were no significant differences in the costs of treating recurrence, but patients who had hospital-based follow-up had significantly higher travel and productivity costs (mean difference £47 (95 per cent b.c.i. £40 to £55)).ConclusionTelephone follow-up for breast cancer may reduce the burden on busy hospital clinics but will not necessarily lead to cost or salary savings.
High preoperative serum vascular endothelial growth factor levels predict poor clinical outcome after curative resection of gastric cancer
Authors: Vidal Ó , Metges J-P , Elizalde I , Valentíni M , Volant A , Molina R , Castells A , Pera M 
Published: November 2009

Abstract

Background
Tumour vascular endothelial growth factor (VEGF) and tumour urokinase-type plasminogen activator (uPA) are prognostic factors in gastric cancer but surgical specimens are required for testing. The prognostic value of preoperative serum VEGF (s-VEGF) and serum uPA (s-uPA) levels was evaluated in patients undergoing potentially curative (R0) gastric cancer resection.

Methods
Concentrations of s-VEGF and s-uPA were measured 97 patients with gastric cancer and 20 controls. Angiogenesis was measured in vitro based on human endothelial cell tube formation.

Results
Levels of s-VEGF were higher in patients with gastric cancer than controls (median 288 versus 189 pg/ml respectively; P = 0·002). They were associated with pathological tumour node metastasis (pTNM) stage, pT, pN, lymph node ratio and perineural invasion, and correlated with platelet counts. In multivariable analysis, s-VEGF over 320 pg/ml was the only preoperative predictor of both recurrence and disease-specific survival. Serum from patients with raised s-VEGF levels enhanced angiogenesis in vitro significantly more than serum from those with a s-VEGF level of 320 pg/ml or less.

Conclusion
High preoperative s-VEGF level is an independent prognostic factor for recurrence and survival after R0 resection of gastric cancer. This may provide a useful guide to decision making regarding neoadjuvant and adjuvant therapies.
Short-term outcomes from a prospective randomized trial comparing laparoscopic and open surgery for colorectal cancer
Authors: Neudecker J , Klein F , Bittner R , Carus T , Stroux A , Schwenk W 
Published: November 2009

Abstract

Background
Randomized trials in low-risk populations have failed to show any benefit for laparoscopic compared with open colorectal resection in terms of morbidity. Furthermore, it is not known whether laparoscopic colorectal resection would yield advantages if randomization were revealed during surgery after a diagnostic laparoscopy.

Methods
Patients with cancer of the colon or upper rectum were randomly assigned to laparoscopic or open resection. All patients underwent diagnostic laparoscopy to assess whether laparoscopic resection was feasible and the result of randomization was then revealed to the surgeon. Main endpoints were overall, general and surgical morbidity, and mortality.

Results
Some 679 patients underwent diagnostic laparoscopy which led to the exclusion of 207; 250 patients were allocated to laparoscopic and 222 to open resection. Conversion to laparotomy occurred in 28 patients (11·2 per cent). There were no differences in morbidity (overall 25·2 versus 23·9 per cent) or mortality (1·2 versus 0·9 per cent) between laparoscopic and open groups. Postoperative hospital stay was shorter after laparoscopic resection (median (range) 10 (1–123) versus 12 (4–109) days; P = 0·032).

Conclusion
Laparoscopic resection of colorectal cancer is associated with increased operating time but does not decrease morbidity even in a moderate-risk population.
Advantage of a one-stop referral and management service for ruptured abdominal aortic aneurysms
Authors: Hafez H , Owen L W , Lorimer C F K , Bajwa A 
Published: November 2009

Abstract

Background
In 2005, 4003 deaths in England and Wales were attributed to ruptured abdominal aortic aneurysm (RAAA). This study examined the referral and management patterns of this condition within one English county.

Methods
West Sussex has a population of 811 000 and is served by five hospitals with two main vascular networks. Between January 2005 and December 2007, data for community and in-hospital RAAA interventions and deaths were obtained. Probability of intervention and outcome for each network were calculated.

Results
Of 341 RAAA, 228 (66·9 per cent) presented to hospital. The mean distance travelled to hospitals with a full on-site vascular service was 17·6 (95 per cent confidence interval 15·5 to 19·7) km (124 patients) compared with 11·0 (9·5 to 12·7) km (104 patients) to hospitals with a partial or no vascular service (P &lt; 0·001). Patients managed by the network with a one-stop RAAA management policy had an odds ratio of 2·4 for undergoing surgery and 2·5 for surviving the operation (P = 0·001 and P = 0·017 respectively).

Conclusion
Patients with RAAA should be offered a one-stop emergency vascular service even if this involves further travel. Such a strategy offers significantly higher chance of intervention and survival from ruptured AAA.
Amyloid fibrils as a nanoscaffold for enzyme immobilization
Authors: Pilkington Sarah M. , Roberts Sarah J. , Meade Susie J. , Gerrard Juliet A. 
Published: November 2009

AbstractAmyloid fibrils are a misfolded state, formed by many proteins when subjected to denaturing conditions. Their constituent amino acids make them ideally suited as a readily functionalized nanoscaffold for enzyme immobilization and their strength, stability, and nanometer size are attractive features for exploitation in the creation of new bionanomaterials. We report successful functionalization of amyloid fibrils by conjugation to glucose oxidase (GOD) using glutaraldehyde. GOD retained activity upon attachment and successful cross‐linking was determined using electrophoresis, centrifugation, sucrose gradient centrifugation, and TEM. The resulting functionalized enzyme scaffold was then incorporated into a model poly(vinyl alcohol) (PVOH) film, to create a new bionanomaterial. The antibacterial effect of the functionalized film was then tested on E. coli, the growth of which was inhibited, demonstrating the incorporation of GOD antibacterial activity into the PVOH film. The incorporation of the GOD‐functionalized amyloid fibrils into PVOH provides an excellent ‘proof of concept’ model for the creation of a new bionanomaterial using a functionalized amyloid fibril scaffold. © 2009 American Institute of Chemical Engineers Biotechnol. Prog., 2010