bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical variable deceleration in the first stage of labor is a characteristic fetal heart‐rate pattern for velamentous cord insertion and hypercoiled cord
Authors: Hasegawa Junichi , Matsuoka Ryu , Ichizuka Kiyotake , Kotani Mihoko , Nakamura Masamitsu , Mikoshiba Takao , Sekizawa Akihiko , Okai Takashi 
Published: August 2008

AbstractAim:  To evaluate whether various umbilical cord abnormalities, including velamentous, marginal cord insertion (VCI, MCI), hypercoiled cord (HCC) and nuchal cord (NC), affect the appearance of atypical variable deceleration (VD) during labor.Methods:  A cohort study was conducted which included cases with cord abnormalities (314 cases) and without them (487 controls), both of which were delivered in our hospital between June 2005 and December 2006. The relationship between cord abnormalities and the intrapartum fetal heart‐rate (FHR) pattern were retrospectively investigated focusing on VD. Analysis of FHR patterns was performed for 30 uterine contractions at the end of the first stage and throughout the whole of the second stage of labor. FHR patterns were analyzed for the presence of VD, atypical and pure VD. The frequencies of each FHR patterns per uterine contraction were assessed. The type of atypical VD was diagnosed in sequence as loss of variability during VD, overshoot, slow return of the FHR to the baseline, VD with no acceleration, and biphasic deceleration. Pure VD was typical VD without signs of atypia.Results:  Frequencies of total VDs were significantly high in cases with VCI, HCC or NC in the first stage. Atypical VDs frequently occurred in cases with VCI, HCC and NC, and pure VDs did in cases with NC. In the second stage, frequencies of total and all types of VDs were not different.Conclusion:  Mainly atypical VD in the first stage was a characteristic FHR pattern for VCI and HCC, and the appearance of such a pattern in cases with antepartum information on these abnormalities could suggest unfavorable fetal status.
Insulin resistance in women with a history of severe pre‐eclampsia
Authors: Soonthornpun Karanrat , Soonthornpun Supamai , Wannaro Prawit , Setasuban Worawong , Thamprasit Atchara 
Published: August 2008

AbstractAim:  This study investigated whether post‐partum insulin resistance existed in women with a history of severe pre‐eclampsia.Methods:  The euglycemic hyperinsulinemic clamp technique was used to assess insulin sensitivity at least 6 months after delivery in 13 women who had had severe pre‐eclampsia and 26 age‐ and body mass index‐matched controls who had had normal pregnancy.Results:  The mean (±SD) durations after delivery were 2.6 ± 1.6 years and 4.5 ± 2.8 years in the pre‐eclampsia and control groups, respectively. The systolic blood pressure was significantly higher in the pre‐eclampsia group (118 ± 11 mmHg vs 109 ± 12 mmHg, P = 0.028). Although the body mass indices were not different among the groups (25.8 ± 3.1 kg/m2 vs 24.6 ± 3.9 kg/m2), the waist and waist‐to‐hip ratio were significantly higher in the women with prior pre‐eclampsia. The pre‐eclampsia group had lower insulin sensitivity index than the controls (5.4 ± 2.5 mg/kg/min/mU/L vs 8.1 ± 4.0 mg/kg/min/mU/L, P = 0.036). Serum triglyceride levels were significantly higher in the pre‐eclampsia group (153 ± 74 mg/dL vs 82 ± 37 mg/dL, P < 0.01). High‐density lipoprotein‐cholesterol levels tended to be lower in the pre‐eclampsia group (42.1 ± 9.7 mg/dL vs 48.2 ± 9.6 mg/dL, P = 0.07).Conclusion:  Women with a history of severe pre‐eclampsia had characteristics of metabolic syndrome and had lower insulin sensitivity compared with those who had had normal pregnancy. These may explain an increased risk of cardiovascular disease in women with pre‐eclampsia.
Periodic size changes in a supernumerary ovary with associated corpus luteal cyst
Authors: Matsubara Yuko , Fujioka Toru , Ikeda Tomoko , Kusanagi Yasuki , Matsubara Keiichi , Ito Masaharu 
Published: August 2008

AbstractSupernumerary ovaries are extremely rare. Herein is reported a case of supernumerary ovary detected in a 31‐year‐old woman who complained of lower abdominal pain on her left side. Ultrasonography indicated a cystic mass in the pelvis, the size of which fluctuated periodically. A laparotomy was performed and indicated two normal ovaries in addition to a cystic mass in the cul‐de‐sac. Histology of the mass confirmed the presence of both normal ovarian tissue and cystic corpus luteal tissue consistent with the presence of a supernumerary ovary. Examination of the patient's medical history suggested that the supernumerary ovary was likely to be of embryonic origin, and not caused by surgical treatment or inflammation. This is the first report of a supernumerary ovary that was associated with periodic episodes of pain and changes in size, and a giant corpus luteal cyst near the rectum.
Quality of life and related factors in women, aged 15–49 in the 12‐month post‐partum period in Turkey
Authors: Akýn Belgin , Ege Emel , Koçoðlu Deniz , Demirören Nesime , Yýlmaz Sema 
Published: August 2008

AbstractAim:  The aim of the present study was to examine the quality of life (QoL) and related factors in women in a 12‐month postpartum period.Methods:  A cross‐sectional study was undertaken to ascertain the factors related to QoL of postpartım women in Konya city, Turkey. Participants of the study consisted of 1749 first‐year postpartum women. Main outcome measures were Quality of Life Scale and factors potentially related to postpartum QoL.Results:  It was found that being over the age of 35 years, having a spouse with a low level of education, having a low income, having a large number of children, not having social support from the spouse or other family members and not having time to rest or sleep were related to QoL.Conclusions:  The QoL of postpartum women is related not only to sociodemographic and fertility characteristics, but also to the degree that social support is available and a woman's ability to find time for herself to rest and sleep.
Transcervical microwave myolysis for uterine myomas assisted by transvaginal ultrasonic guidance
Authors: Kanaoka Yasushi , Yoshida Chika , Fukuda Takeshi , Kajitani Koji , Ishiko Osamu 
Published: August 2008

AbstractAim:  The effects of transcervical microwave myolysis at 2.45 GHz after microwave endometrial ablation for menorrhagia were examined in patients with myomas.Methods:  A transcervical microwave irradiation system assisted by transvaginal ultrasonic guidance was developed. Ten patients waiting for microwave endometrial ablation for menorrhagia caused by myomas entered the study after complete informed consent was obtained. Their outcomes were examined at least 6 months after transcervical microwave myolysis using the system. After completion of microwave endometrial ablation, interstitial microwave irradiation was performed using a guiding needle set in a puncture adaptor attached to a transvaginal ultrasonic probe and a microwave applicator of 1.6 mm in diameter. Shrinkage of the myoma was measured at 3 months and ≥6 months after the operation.Results:  In nine patients with typical myomas, the major part consisting of a submucous or an intramural node 4.0–7.5 cm in size was necrotized. The typical myomas had shrunk by 41–68% at 3 months and 37–69% at ≥6 months after the operation. In one patient with a 6.8‐cm cellular leiomyoma, necrosis was limited to the neighborhood of the applicator tip. Shrinkage was 17% at both 3 and 6 months. This patient required a second microwave endometrial ablation at 6 months to treat recurrent menorrhagia. None of the patients underwent hysterectomy after the treatment. No remarkable complications were encountered.Conclusions:  Typical myomas shrink after microwave myolysis following microwave endometrial ablation. Transcervical microwave myolysis seems to be applicable as a low‐invasive treatment for a typical myoma.
Restoration of bowel continuity after surgery for acute perforated diverticulitis: should Hartmann’s procedure be considered a one‐stage procedure?
Authors: Vermeulen J. , Coene P. P. L. O. , Van Hout N. M. , Van Der Harst E. , Gosselink M. P. , Mannaerts G. H. H. , Weidema W. F. , Lange J. F. 
Published: August 2008

AbstractObjective  Hartmann’s procedure (HP) still remains the most frequently performed procedure in acute perforated diverticulitis, but it results in a end colostomy. Primary anastomosis (PA) with or without defunctioning loop ileostomy (DI) seems a good alternative. The aim of this study was to assess differences in the rate of stomal reversal after HP and PA with DI and to evaluate factors associated with postreversal morbidity in patients operated for acute perforated diverticulitis.Method  All 158 patients who had survived emergency surgery for acute perforated diverticulitis in five teaching hospitals in The Netherlands between 1995 and 2005 and underwent HP or PA with DI were retrospectively studied. Age, gender, ASA‐classification, severity of primary disease, delay of stoma reversal, surgeon’s experience, surgical procedure and type of anastomosis were analysed in relation to outcome after stoma reversal.Results  Of the 158 patients, 139 had undergone HP and 19 PA with DI. The reversal‐rate was higher in patients with DI (14/19; 74%) compared to HP (63/139; 45%) (P = 0.027) Delay between primary surgery and stoma reversal was shorter after PA with DI compared with HP (3.9 vs 9.1 months; P < 0.001). Cumulative postreversal morbidity after HP was 44%. Early surgical complications occurred in 22 of 63 patients. Morbidity after DI reversal was 15% (P < 0.001). Three patients died after HP reversal, none died after DI reversal. Anastomotic leakage was observed in 10 patients after HP reversal. This was less frequently observed when the operation was performed by a specialist colorectal surgeon (10%vs 33%; P = 0.049) and when a stapled anastomosis was performed (4%vs 24%; P = 0.037).Conclusions  Reversal of HP should only be performed by an experienced colorectal surgeon, preferably performing a stapled anastomosis, or probably not be performed at all, as it is accompanied by high postoperative morbidity and even mortality. It is important that these findings are taken in account for when performing primary emergency surgery for acute perforated diverticulitis.
Long‐term surgical load in patients with ileal pouch‐anal anastomosis
Authors: Wasmuth H. H. , Tranø G. , Endreseth B. , Rydning A. , Wibe A. , Myrvold H. E. 
Published: August 2008

AbstractAim  To evaluate surgical workload and complications in patients who had undergone restorative proctocolectomy, through long‐term follow‐up in one single institution.Method  From 1984 to 2006, 304 consecutive patients underwent Ileal Pouch‐Anal Anastomosis (IPAA). There were 182 stapled and 122 hand‐sewn anastomoses. A protective loop ileostomy was established in 256 patients (84%), whereas 48 patients (16%) were without a covering stoma.Results  Twenty‐nine patients (10%) suffered from early anastomotic leakage. A protective stoma did not prevent early anastomotic dehiscence (P = 0.11) or the number of pelvic abscesses (P = 0.09). Early complications required 20 laparotomies with creation of a diverting stoma in nine patients. There were 16 (6%) complications related to closure of the loop ileostomy. Sixty‐six patients needed an additional re‐operation related to the IPAA procedure. There were 20 removals of pouches and three permanent diverting stomas. The estimated removal rate at 20 years of a functioning pouch was 11% (CI ± 6). Altogether 100 (33%) patients had one or more surgical procedures, excluding dilations of anastomotic strictures and closing of a loop ileostomy. These 100 patients underwent 187 surgical procedures. The estimated rate of a first re‐operation due to complications was 52% (CI ± 16) in 20 years. Hand‐sewn anastomoses had similar complications and failure rates as stapled anastomoses.Conclusions  More than half of patients operated with restorative proctocolectomy will need surgical intervention within 20 years and the failure rate is more than 10%. The high risk of complications and failure inherent in the procedure should not be ignored.
Helicobacter species in the human colon
Authors: Keenan J. I. , Beaugie C. R. , Jasmann B. , Potter H. C. , Collett J. A. , Frizelle F. A. 
Published: August 2008

AbstractObjective  To determine the prevalence, frequency and colonization patterns of Helicobacter species throughout the colon.Method  Patients having initial colonoscopy for nonspecific gastrointestinal disturbance had colonic biopsies taken from up to four sites during colonoscopy and examined for evidence of the Helicobacteraceae family using a group‐specific PCR. Serum was also collected and examined for IgG reactivity to Helicobacter pylori.Results  100 patients had colonoscopy of whom 35 were found to have DNA evidence of Helicobacter species throughout the colon, with 22 having H. pylori. Fifteen patients had a demonstrable serum IgG response to H. pylori that was not always associated with molecular evidence of H. pylori DNA in colon biopsies and vice versa. No specific association with colon disease was found in patients with H. pylori infection.Conclusion  We found evidence of Helicobacter infection in a significant number of patients presenting for colonoscopy but no specific association between the presence of these bacteria and colon disease. Our finding of disparity between molecular and serological techniques to detect Helicobacter species suggests that future studies should not rely on serology alone to detect these bacteria in the human colon.
Morbidity and quality of life after continent ileostomy in the Netherlands
Authors: Hoekstra L. T. , De Zwart F. , Guijt M. , Bakx R. , Gerhards M. F. 
Published: August 2008

AbstractBackground  Continent ileostomy (CI) after proctocolectomy is an alternative technique compared to an ileal pouch‐anal anastomosis (IPAA). The question arises as to whether this technique is valuable. The aim of this study was to evaluate the role of the continent ileostomy, by patient follow‐up satisfaction and quality of life assessment.Method  Twenty‐eight patients with a continent ileostomy operated between 1996 and 2007 were compared with patients who received an IPAA or a conventional ileostomy. SF‐36 and EORTC QLC‐CR38 questionnaires and a specific continent ileostomy questionnaire were used to assess differences and patient satisfaction.Results  The quality of life in patients with a CI is not significant better or worse than patients with either a conventional ileostomy or an IPAA. On three scales (sexual enjoyment, gastro‐intestinal tract symptoms and male sexual problems) statistically significant differences were reported. Overall, nearly all patients are very satisfied with the CI. All patients would make the same decision again and would recommend this procedure to other patients.Conclusion  The continent ileostomy remains to be a suitable alternative for the preservation of continence after a proctocolectomy, especially when an ileal pouch‐anal anastomosis is not an option. If a choice has to be made between a CI and conventional ileostomy good preoperative counselling is necessary to make a well founded decision. To minimize complications, these procedures have to be performed in centres with specific expertise. Therefore, knowledge about the CI should be preserved for the future.
Endoscopic transanal resection of rectal adenomas using the urological resectoscope
Authors: Modarai B. , Forshaw M. J. , Sankararajah D. , Murali K. , Stewart M. 
Published: August 2008

AbstractObjective  Large sessile rectal adenomas are often difficult to excise and several different techniques have been described. This study evaluates the results of adenoma excision by endoscopic transanal resection using the urological resectoscope by a single surgeon in a UK district general hospital.Method  Between January 1989 and November 2004, data on all patients treated by endoscopic transanal resection of benign rectal tumours using a urological resectoscope (ETAR) were prospectively collected and analysed.Results  Forty patients (50% male, median age 72 years) underwent a total of 81 endoscopic transanal resections. The tumour characteristics were: size > 2 cm (83%), location in lower 2/3 of rectum (83%) and extensive circumferential carpet‐like appearances (13%). Fifty percent of the patients required only one procedure to achieve clearance. Mean operative time was 26 min (range 10–65 min). Seventy‐eight percent of the patients were discharged home within 24 h. Postoperative morbidity was 8% and in‐hospital mortality was zero. Histology revealed severe dysplasia in 48% of the tumours and five patients were incidentally found to have foci of rectal adenocarcinoma. With a median follow‐up of 47 months (range 2–162 months), local recurrences occurred in 13% (n = 5) of patients. All, except one, were treated successfully with further endoscopic transanal resections.Conclusion  ETAR is simple and safe for managing rectal adenomas.
Self expanding wall stents in malignant colorectal cancer: is complete obstruction a contraindication to stent placement?
Authors: Stenhouse G. J. A. , Page B. , Rowan A. , Giles L. , Macdonald A. 
Published: August 2008

AbstractObjective  Technical failures have previously been associated with complete clinical obstruction and complete block to the retrograde flow of gastrograffin is considered by some to be a contraindication to the procedure. We report on the technical and clinical success rates of self‐expanding metallic stents (SEMS) in both complete and incomplete obstruction in a prospective series of malignant colorectal obstructions.Method  A prospective study of all patients undergoing attempted palliative and bridge to surgery SEMS placement for malignant colorectal obstruction over a 7‐year period (April 1999–October 2006) was undertaken.Results  Seventy‐two patients (49 males) with a mean age of 71 years (range 49–98) were included. Technical success was achieved in 27 of 32 patients (84%) with complete obstruction and 33 of 36 patients (92%) with incomplete obstruction, P < 0.46, Fishers exact test. Clinical success was achieved in 17 of 26 patients (65%) with complete obstruction and 24 of 33 patients (73%) with incomplete obstruction, P < 0.58, Fishers exact test. Although placed correctly in 89% cases, relief of symptoms occurred in only 71%, P = 0.002, matched pairs test. There were two colonic perforations in the series with one procedure related death.Conclusion  Placement of SEMS for obstructing colorectal cancer is technically successful in a high proportion of cases. Complete radiological obstruction is not a contraindication to stent placement. The relief of obstructive symptoms following successful placement of a wall stent is less predictable.
Histopathology reporting in colorectal cancer: a proforma improves quality
Authors: Siriwardana P. N. , Pathmeswaran A. , Hewavisenthi J. , Deen K. I. 
Published: August 2008

AbstractAim  The histopathology report is vital to determine the need for adjuvant therapy and prognosis in colorectal cancer (CRC). Completeness of those in text format is inadequate. This study evaluated the improvement of quality of histopathology reports following the introduction of a template proforma, based on standards set by the Royal College of Pathologists (RCP), UK.Method  Sixty‐eight consecutive histopathology reports based on 19 items for rectal cancer (RC) and 15 items for colon cancer (CC) using the proforma were prospectively analysed and compared with results of a previous audit of 82 consecutive histopathology reports in text format. The percentage of reports containing a statement for each data item for both series was compared using the Normal test for difference between two proportions. Completeness of each report was assessed and a percentage score (percentage completeness) was given. Mean percentage completeness was calculated for each format and compared using the two sample t‐test.Results  Except for comments on the presence of ‘histologically confirmed liver metastases’ in CC and RC, ‘distance from dentate line’ and ‘distance to circumferential margin’ in RC, all other items were commented in more than 90% of reports, where 71% of the items based on the minimum data set were present in all reports. Compared to prose format, the mean percentage completeness (SD) improved from 74% (8) to 91% (4) (P < 0.0001) and from 81% (5) to 99% (1) (P < 0.0001) for RC and CC respectively in template proforma format.Conclusion  A template proforma and surgeon’s contribution in relation to operative findings improves the quality of the histopathology report in CRC.
Prognostic variables to predict cancer‐related death in incidental renal tumours
Authors: Bensalah Karim , Pantuck Allan J. , Crepel Maxime , Verhoest Grégory , Méjean Arnaud , Valéri Antoine , Ficarra Vincenzo , Pfister Christian , Ferrière Jean‐Marie , Soulié Michel , Cindolo Luca , De La Taille Alexandre , Tostain Jacques , Chautard Denis , Schips Luigi , Zigeuner Richard , Abbou Claude C. , Lobel Bernard , Salomon Laurent , Lechevallier Eric , Descotes Jean‐Luc , Guillé Francois , Colombel Marc , Belldegrun Arie S. , Patard Jean‐Jacques 
Published: August 2008

OBJECTIVETo identify, in a large multicentre series of incidental renal tumours, the key factors that could predict cancer‐related deaths, as such tumours have a better outcome than symptomatic tumours and selected patients are increasingly being included in watchful‐waiting protocols.PATIENTS AND METHODSData from 3912 patients were extracted from three international kidney‐cancer databases. Age, gender, Eastern Cooperative Oncology Group (ECOG) performance status (PS), Tumour‐Node‐Metastasis (TNM) stage, tumour size, Fuhrman grade, and final pathology were recorded. Benign tumours and malignant lesions with incomplete information were excluded from final analysis.RESULTSThe mean (sd) age of the patients was 60.6 (12.2) years and the mean tumour size 5.5 (3.5) cm. Most tumours were malignant (90.2%) and of low stage (T1‐T2, 71.7%) and low grade (G1‐G2, 72.4%). There were nodal and distant metastases in 5.7% and 13% of the patients. In all, 525 (14.4%) patients died from cancer; in this group, tumours were >4 cm in 88.2% and had nodal or distant metastases in 20.2% and 49.3%, respectively. Multivariable analysis showed that tumour size >4 cm, ECOG PS ≥1, TNM stage and Fuhrman grade were independent predictors of cancer‐related death.CONCLUSIONA significant proportion of incidental renal tumours can lead to the death of the patient. Standard prognostic variables for renal cell carcinoma appear to remain valid for this subset of patients. A watchful‐waiting strategy should not be recommended if the tumour diameter is >4 cm, if biopsy confirms high‐grade tumours, or if there is an impaired ECOG PS, or computed tomography findings suggest the presence of advanced T stage.