bluuebunny/crossref_metadata_2025_split huggingface dataset:
Success rate and cannulation time between precut sphincterotomy and double‐guidewire technique in truly difficult biliary cannulation
Authors: Angsuwatcharakon Phonthep , Rerknimitr Rungsun , Ridtitid Wiriyaporn , Ponauthai Yuwadee , Kullavanijaya Pinit 
Published: September 2011

AbstractBackground and Aim:  Precut sphincterotomy (PS) is usually indicated in failed standard biliary cannulation (BC). PS requires experienced endoscopists, and contains significant risk. Double‐guidewire (DG) cannulation seems to be easier, and might be useful after failed standard BC. We aimed to compare cannulation time, success rate, and complication rates between the two techniques.Methods:  Patients who failed standard BC within 10 min by the expert were defined as truly difficult BC and randomized into both groups. In the DG group, the first guidewire was left in the pancreatic duct, and then a catheter, pre‐inserted with another guidewire, was used for the BC. In the PS group, a fistulotomy technique was used.Results:  From June 2008 to October 2009, 534 patients underwent endoscopic retrograde cholangiopancreatography. Forty‐four patients (8.2%) who failed standard BC were randomized into the DG group (n = 23) and the PS group (n = 21). Median cannulation times and success rates in the DG and PS groups were 172 versus 394 s (P < 0.001), and 73.9% versus 80.9% (P = 0.724), respectively. The pancreatitis rate and serum amylase at 24 h in the DG and PS groups were 21.7% versus 14.3% (P = 0.701) and 937 versus 195 mg/dL (P = 0.020), respectively. Two from each group developed mild bleeding. No perforation occurred.Conclusion:  In truly difficult BC, the DG technique requires a significant shorter duration for BC, with a comparable success rate to the PS technique. The post‐procedure serum amylase level in the DG group was significantly higher, and there was a trend of more pancreatitis.
Identification of the putative intestinal stem cell marker doublecortin and CaM kinase‐like‐1 in Barrett's esophagus and esophageal adenocarcinoma
Authors: Vega Kenneth J , May Randal , Sureban Sripathi M , Lightfoot Stan A , Qu Dongfeng , Reed Alessandra , Weygant Nathaniel , Ramanujam Rama , Souza Rhonda , Madhoun Mohammad , Whorton Joshua , Anant Shrikant , Meltzer Stephen J , Houchen Courtney W 
Published: September 2011

AbstractBackground and Aim:  In Barrett's esophagus (BE), the normal esophageal squamous epithelium is replaced with a specialized metaplastic columnar epithelium. BE is a premalignant lesion that can progress to esophageal adenocarcinoma (EAC). Currently, there are no early molecular indicators that would predict progression from BE to EAC. As the only permanent residents of the epithelium, stem cells have been implicated in this metaplastic progression. The aim of the present study was to determine the expression of doublecortin and CaM kinase‐like‐1 (DCAMKL‐1) and other putative gastrointestinal stem cell markers in normal esophageal mucosa (NEM), BE, and EAC.Methods:  Human NEM, BE, EAC, and multitissue microarrays were analyzed for DCAMKL‐1, and immunohistochemically scored based on staining intensity and tissue involvement, with epithelia and stroma scored separately. Total RNA isolated from BE and paired NEM was subjected to real‐time reverse‐transcription–polymerase chain reaction analysis for DCAMKL‐1, leucine‐rich repeat‐containing G‐protein‐coupled receptor (LGR5), and Musashi‐1 (Msi‐1) mRNA expression.Results:  DCAMKL‐1 was minimally expressed in squamous NEM, but increased in BE (with and without dysplasia) and EAC tissues. In EAC, we found increased stromal DCAMKL‐1 staining compared to adjacent epithelia. Within the submucosa of dysplastic BE tissues, an increase in the endothelial cell expression of DCAMKL‐1 was observed. Finally, an upregulation of DCAMKL‐1, LGR5, and Msi‐1 mRNA was seen in BE compared to squamous NEM.Conclusions:  In the present study, we report the progressive increase of DCAMKL‐1 expression in BE from dysplasia to EAC. Furthermore, there was an increase in putative stem cell markers DCAMKL‐1, LGR5, and Msi‐1 mRNA. Taken together, these data suggest that the regulation of resident stem cells might play an important role in the progression of BE to EAC.
New opportunity for vaccinating older people: Well‐child clinic visits
Authors: Arslan Ismail , Beyazova Ufuk , Aksakal Nur , Polat Selda , Camurdan Aysu Duyan , Sahin Figen 
Published: September 2011

AbstractBackground:  Streptococcus pneumoniae causes considerable morbidity and mortality in the elderly. As aging of the population is making the health of the elderly a universal priority, preventive measures, such as vaccination, will become increasingly important.Methods:  We designed a prospective interventional study to determine whether recommendations to vaccinate grandparents of children attending well‐child clinics would increase the pneumococcal vaccination rate in the elderly. Children younger than 5 years of age, attending a university well‐child clinic from 1 May to 31 September 2008 who had grandparents over 65 years of age were eligible. A survey including the questions about the demographic characteristics of children, their parents and grandparents over 65 was carried out by face‐to‐face interview with the parents. High‐risk medical conditions and vaccination history of grandparents was also noted and the benefits and necessity of pneumococcal vaccination (23vPPV) for the elderly was emphasized. Four months later these families were contacted to determine whether this intervention had increased the pneumococcal vaccination rates of the elderly.Results:  Information was obtained from 938 grandparents of 545 children. Before the interview, among all grandparents, only 0.9% were vaccinated with 23vPPV. Four months after this intervention, immunization coverage increased to 19.1%. The sex of the grandchild (OR: 1.99) and previous hepatitis B or influenza immunization of the grandparents (OR: 2.73) were the significant parameters accounting for higher immunization rates.Conclusion:  Reminding elderly grandparents about vaccines in well‐child clinics could be an opportunity in this field.
Comparison of the histopathological diagnoses of preoperative dilatation and curettage and hysterectomy specimens
Authors: Barut Aykut , Barut Figen , Arikan Ilker , Harma Muge , Harma Mehmet Ibrahim , Ozmen Bayar Ulku 
Published: September 2011

AbstractAim:  A biopsy is often taken as part of the preoperative workup, regardless of the indication for hysterectomy. Some authors believe that dilatation and curettage is a poor diagnostic procedure for intrauterine pathologies, but dilatation and curettage has been the method of choice for obtaining an endometrial sample. The aim of this study was to investigate the concordance between endometrial histopathological diagnoses from preoperative dilatation and curettage and hysterectomy specimens. The differences between premenopausal and postmenopausal women were also investigated.Methods:  Histopathological results for dilatation and curettage specimens from 645 women (401 premenopausal and 244 postmenopausal) who underwent a hysterectomy between 2003 and 2009 were analyzed retrospectively.Results:  High sensitivity (87.8%), specificity (100%), positive (100%) and negative (98.7%) predictive values, and accuracy (98.8%) were observed for all malignant endometrial pathologies obtained at dilatation and curettage. In postmenopausal women, eight malignancies were missed when the preoperative diagnosis from the dilatation and curettage sample indicated inadequate tissue or premalignant lesions. For premenopausal women, we found only two missed malignancies. The accuracy was 99.5% and 96.8% for malignant pathologies diagnosed from curettage material for pre‐ and postmenopausal women, respectively.Conclusions:  Dilatation and curettage remains the ‘gold standard’ for diagnosing endometrial pathologies, especially malignancies.
Carcinomatous meningitis during systematic chemotherapy in a patient with advanced small‐cell neuroendocrine carcinoma of the uterine cervix
Authors: Watanabe Yoh , Nakai Hidekatsu , Imaoka Izumi , Murakami Takamichi , Hoshiai Hiroshi 
Published: September 2011

AbstractCarcinoma meningitis with uterine cervical cancer is an extremely rare event. We present the clinicopathologic characteristics and diagnostic imaging findings of a patient with advanced small‐cell neuroendocrine carcinoma of the cervix who had developed carcinoma meningitis during systematic chemotherapy.
Urinary pathogens and drug susceptibility patterns of urinary tract infections among antenatal clinic attendees in Ibadan, Nigeria
Authors: Kehinde Aderemi , Adedapo Kayode , Aimakhu Chris , Odukogbe Akin‐Tunde , Olayemi Oladapo , Salako Babatunde 
Published: September 2011

AbstractAim:  To determine the bacterial agents involved in urinary tract infections in pregnant women and their antibiotic susceptibility patterns in Ibadan, Nigeria.Methods:  All consenting subjects who attended antenatal clinics of the University College Hospital and Adeoyo Maternity Hospital, Ibadan, Nigeria, from 1 April 2007 and 30 March 2009 were interviewed to obtain demographic and pregnancy health data. Mid‐stream urine samples obtained were processed by standard methods. Confirmed bacterial isolates were tested against seven antibiotics using the Kirby–Bauer disc diffusion technique.Results:  Of the 473 specimens processed, 136 (28.8%) were positive for microscopy, 118 (25.0%) were culture positive, while 18 (3.8%) were microscopy positive but negative for culture. More than 90% of the bacterial isolates were Gram‐negative bacilli, of which approximately 80% were members of the family Enterobacteriaceae. Klebsiella oxytoca accounted for 45 (38.1%) of the causative agents identified, followed by Escherichia coli (31.3%), Pseudomonas aeruginosa (9.3%) and Proteus mirabilis (6.8%). Candida albicans accounted for three (2.6%) of the isolates. Ten isolates (22.2%) of K. oxytoca were resistant to cefuroxime while three (6.7%) were resistant to ofloxacin. The only Gram‐positive bacterium isolated, Staphylococcus saprophyticus, accounted for four (4.3%) of all pathogens, of which three (75.0%) were susceptible to nitrofurantoin, ofloxacin, cefuroxime and the amoxicillin–clavulanic acid combination.Conclusions:  In conclusion, the incidence of culture‐positive urinary tract infection in pregnancy is common in Ibadan. More studies are needed to evaluate the susceptibility profile of uropathogens to commonly used antibiotics in our environment.
Ultrasound for evaluation of adnexal malignancy: From 2D to 3D ultrasound
Authors: Hata Toshiyuki , Hata Kohkichi , Noguchi Junko , Kanenishi Kenji , Shiota Atsuko 
Published: September 2011

AbstractConventional two‐dimensional (2D) ultrasound has been widely used for the evaluation of adnexal malignancy in gynecologic fields. This 2D ultrasound evaluation includes a morphological assessment, color/power and pulsed Doppler sonographic assessment, scoring system, and contrast agent assessment of adnexal masses. The introduction of three‐dimensional (3D) ultrasound would facilitate the novel assessment of adnexal masses. With the recent advance in 3D power Doppler (3DPD) ultrasound as well as quantitative 3DPD histogram analysis, quantitative and qualitative assessments of the vascularization and blood flow of adnexal masses have become feasible. These novel techniques may assist in the evaluation of adnexal malignancy, and offer potential advantages relative to conventional 2D sonographic assessments. 3D ultrasound may be an important modality in future gynecologic oncology research and in the evaluation of adnexal malignancy in clinical practice, although some limitations regarding the assessment of adnexal malignancy employing 3D ultrasound remain unresolved.
Robot‐assisted extended pelvic lymph node dissection (PLND) at the time of radical prostatectomy (RP): a video‐based illustration of technique, results, and unmet patient selection needs
Authors: Davis John W. , Shah Jay B. , Achim Mary 
Published: September 2011

What's known on the subject? and What does the study add?Extending the pelvic lymph node dissection template for radical prostatectomy to include the hypogastric and sub‐obturator zones increases the number of lymph nodes retrieved and the chance of finding metastases.This study demonstrates how to modify the robot‐assisted technique to accomplish the extended template and demonstrates the short‐term impact of this approach.OBJECTIVE
To describe the differences in technique and results between standard vs extended template pelvic lymph node dissection (PLND) at the time of radical prostatectomy (RP) using a robot‐assisted (RA) technique.
PATIENTS AND METHODS
Using extended templates illustrated for the open surgical technique, a RA technique was developed to solve obstacles related to surgical exposure, identification of key landmarks, proper sequencing of operative steps, and prevention of complicationsshown in the accompanying video.
From May 2006 to October 2007, 261 patients underwent a standard PLND, and from November 2007 to November 2010, 670 underwent an extended PLND (E‐PLND) by one surgeon.
RESULTS
The lymph node (LN) yield increased from a median(interquartile range) of 8 (5–11) to 16 (11–21) with the extended technique (P < 0.001).
The ratio of positive LNs increased from 7% to 18%. Among E‐PLND cases by risk group, positive LNs were found in 39%, 9%, and 3% of high‐, intermediate‐, and low‐risk cases, and the later two groups strongly associated with upgrading and/or upstaging.
Extensive clipping appears necessary to avoid postoperative lymphoceles, and peritoneal fenestration for the extraperitoneal technique.
The median operative duration for E‐PLND was 42 min, roughly double that of a standard PLND.
CONCLUSIONS
E‐PLND is feasible with a RA technique, and increases the LN yield and positive LN ratio;the latter especially in high‐risk disease.
The procedure takes twice as long and requires several updates in technique shown in the video.
Robotic partial nephrectomy: surgical technique
Authors: Sukumar Shyam , Rogers Craig G. 
Published: September 2011

What's known on the subject? and What does the study add?Robotic partial nephrectomy has equivalent oncological outcomes, and possibly better functional outcomes in the short‐to‐intermediate term, when compared to laparoscopic partial nephrectomy. Robotic partial nephrectomy has a less prohibitive learning curve, better ergonomics, and improved vision when compared to laparoscopic partial nephrectomy. We describe our standard transperitoneal technique for robotic partial nephrectomy and also highlight the essential steps in an accompanying video. Novel approaches are discussed, including robotic bulldog clamps for hilar clamping, robotic ultrasound probe for tumour identification, flexible Doppler probe for vessel identification, and barbed suture renorrhaphy. Tips and tricks to avoid common pitfalls and manage complications are discussed.
Kidney sparing approaches have become the ‘gold standard’ for the management of small renal masses and have been shown to be equivalent to radical nephrectomy for oncological outcomes.
Robotic partial nephrectomy (RPN) has emerged as a feasible alternative to other minimally invasive approaches for patients requiring nephron‐sparing surgery.
Several reports have highlighted the benefits of RPN, including a less demanding learning curve and shorter warm ischaemia time.
We describe our operative technique for transperitoneal RPN, discuss contemporary outcomes and suggest tips to avoid complications.
Gestational diabetes and cardiovascular risk factors in the offspring: Results from a cross‐sectional study
Authors: Beyerlein A. , Nehring I. , Rosario A. Schaffrath , von Kries R. 
Published: September 2011

Diabet. Med. 29, 378–384 (2012)AbstractBackground  While the association of gestational diabetes mellitus and abnormal glucose tolerance is beyond doubt, its associations with other cardiovascular disease risk factors in the offspring are less clearly established. Some of these associations, in particular overweight in the offspring, might be confounded by maternal overweight.Methods  Data on 12 542 children in the age of 3–17 years with full information about gestational diabetes mellitus and maternal BMI were available from the German nationwide KiGGS study. We calculated linear and logistic regression models for measurements of body composition, blood pressure, HbA1c and cholesterol values in the offspring with gestational diabetes mellitus as the explanatory variable, with and without adjustment for maternal BMI.Results  The prevalence of gestational diabetes mellitus in the dataset was 2.2%. Unadjusted regression analyses suggested weak positive effects of gestational diabetes mellitus on body composition measurements [e.g. a mean increase in BMI standard deviation scores (SDS) of 0.17 units (95% confidence interval: 0.03, 0.30)]. After adjustment for maternal BMI, the observed associations almost disappeared [e.g. BMI SDS: 0.07 (−0.06, 0.20)]. With respect to blood pressure and cholesterol, no potential effects of gestational diabetes mellitus were observed in both unadjusted and adjusted models.Conclusion  Gestational diabetes mellitus does not appear to have a relevant effect on cardiovascular disease correlates such as blood pressure or cholesterol levels in children, and the potential effect of gestational diabetes mellitus on body composition seems to be widely explainable by maternal BMI.
Association between HbA1c and cardiovascular disease mortality in older Hong Kong Chinese with diabetes
Authors: Xu L. , Chan W. M. , Hui Y. F. , Lam T. H. 
Published: September 2011

Diabet. Med. 29, 393–398 (2012)AbstractObjective  To examine the association between baseline HbA1c level and mortality attributable to all‐cause, cardiovascular disease, coronary heart disease and stroke.Methods  A total of 2137 Chinese aged 65 years or above attending the Elderly Health Service, Department of Health, Hong Kong, with diagnosed diabetes had HbA1c measured during 1998 to 2000 and were followed up to 2009. Information on socio‐economic position, lifestyle factors and disease history was collected. Hazard ratios and 95% confidence intervals with adjustment for potential confounders were calculated using Cox’s proportional hazards models.Results  After an average of 7.9 years of follow‐up, 540 participants had died. After adjusting for potential confounders, higher HbA1c (≥ 69 mmol/mol, 8.5%) increased the risk of cardiovascular disease (hazard ratio 2.11;95% CI 1.37–3.25) and stroke mortality (hazard ratio 2.43; 95% CI 1.06–5.55) compared with HbA1c of 58–68 mmol/mol (7.5–8.4%), and increased the risk of all‐cause (hazard ratio 1.41; 95% CI 1.06–1.86) and coronary heart disease mortality (hazard ratio 2.44; 95% CI 1.11–5.37) compared with HbA1c of 48 mmol/mol (6.5%) or less. Analysis of HbA1c as a continuous variable showed that every XX mmol/mol (1%) increase in HbA1c decreased stroke mortality risk by 51% in those with HbA1c level less than 48 mmol/mol (6.5%) and increased stroke mortality risk by 30% in those with an HbA1c level of 48 mmol/mol (6.5%) or higher, suggesting a U‐shaped association between HbA1c and stroke mortality.Conclusion  High HbA1c predicted excess risk of all‐cause, cardiovascular disease, coronary heart disease and stroke mortality. The question of whether low HbA1c increases mortality in older patients with diabetes needs further investigation.
Sarcasm, Pretense, and The Semantics/Pragmatics Distinction*
Authors: Camp Elisabeth 
Published: September 2011

AbstractTraditional theories of sarcasm treat it as a case of a speaker's meaning the opposite of what she says. Recently, ‘expressivists’ have argued that sarcasm is not a type of speaker meaning at all, but merely the expression of a dissociative attitude toward an evoked thought or perspective. I argue that we should analyze sarcasm in terms of meaning inversion, as the traditional theory does; but that we need to construe ‘meaning’ more broadly, to include illocutionary force and evaluative attitudes as well as propositional content. I distinguish four subclasses of sarcasm, individuated in terms of the target of inversion. Three of these classes raise serious challenges for a standard implicature analysis.
A model of canine leukocyte telomere dynamics
Authors: Benetos Athanase , Kimura Masayuki , Labat Carlos , Buchoff Gerald M. , Huber Shell , Labat Laura , Lu Xiaobin , Aviv Abraham 
Published: September 2011

SummaryRecent studies have found associations of leukocyte telomere length (TL) with diseases of aging and with longevity. However, it is unknown whether birth leukocyte TL or its age‐dependent attrition – the two factors that determine leukocyte TL dynamics – explains these associations because acquiring this information entails monitoring individuals over their entire life course. We tested in dogs a model of leukocyte TL dynamics, based on the following premises: (i) TL is synchronized among somatic tissues; (ii) TL in skeletal muscle, which is largely postmitotic, is a measure of TL in early development; and (iii) the difference between TL in leukocytes and muscle (ΔLMTL) is the extent of leukocyte TL shortening since early development. Using this model, we observed in 83 dogs (ages, 4–42 months) no significant change with age in TLs of skeletal muscle and a shorter TL in leukocytes than in skeletal muscle (P < 0.0001). Age explained 43% of the variation in ΔLMTL (P < 0.00001), but only 6% of the variation in leukocyte TL (P = 0.035) among dogs. Accordingly, muscle TL and ΔLMTL provide the two essential factors of leukocyte TL dynamics in the individual dog. When applied to humans, the partition of the contribution of leukocyte TL during early development vs. telomere shortening afterward might provide information about whether the individual’s longevity is calibrated to either one or both factors that define leukocyte TL dynamics.
Investigating hypercoagulability during treatment for immune‐mediated thrombocytopenia: a pilot study
Authors: O'Marra Shana K. , Shaw Scott P. , deLaforcade Armelle M. 
Published: September 2011

AbstractBackgroundThromboembolism has recently been described as a complication following treatment for idiopathic thrombocytopenic purpura (ITP). This pilot study was undertaken to determine whether dogs suffering from ITP experience hypercoagulability during treatment and recovery.Study designThromboelastograms (TEG) were performed on dogs with ITP within 24 hours of admission to the hospital, the first day the platelet count exceeded 40 × 109/L (Day 1), and on Days 4, 7, and 14.Key findingsAll dogs had hypocoagulable TEG tracings on initial admission to the hospital, but developed TEG tracings suggestive of hypercoagulability during the study period as indicated by increased maximum amplitude.SignificanceDogs with ITP developed changes on TEG consistent with hypercoagulability during the study period. Many factors are likely to contribute to these changes. The clinical risk of thrombosis in these patients is unknown.