bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory Cecal Masses in Patients Presenting with Appendicitis
Authors: Poon Ronnie Tung‐Ping , Chu Kin‐Wah 
Published: April 2006

Abstract.An unexpected inflammatory cecal mass of uncertain etiology encountered during surgery for presumed appendicitis poses a dilemma to the surgeon when deciding the appropriate operative management. A retrospective study was performed to review the pathology and surgical management of this condition. Among 3224 patients who had emergency surgery for a diagnosis of acute appendicitis between January 1990 and December 1997, a group of 52 patients (1.6%) underwent either ileocecal resection or right hemicolectomy for an inflammatory cecal mass of uncertain etiology. The final pathologic diagnosis was cecal diverticulitis in 26 patients (50%), appendiceal phlegmon or abscess in 21 patients (40%), cecal carcinoma in 3 patients (6%), tuberculosis in 1 patient (2%) and schistosomiasis in another patient (2%). Altogether 34 patients underwent ileocecal resection, and 18 patients underwent right hemicolectomy, including the 3 patients with cecal carcinoma. Ileocecal resection was associated with a shorter mean operative time (144 vs. 201 minutes; p < 0.001), a lower morbidity rate (3% vs. 22%; p= 0.043), and a shortened mean postoperative hospital stay (6.8 vs. 11.2 days; p= 0.011) than right hemicolectomy. There was no mortality in either group. In conclusion, most inflammatory cecal masses are due to benign pathologies and could be managed safely and sufficiently with ileocecal resection. Careful intraoperative assessment including examination of the resected specimen is essential to exclude malignancy, which would require right hemicolectomy.
Prognostic Factors in 2230 Korean Colorectal Cancer Patients: Analysis of Consecutively Operated Cases
Authors: Park Young Jin , Park Kyu Joo , Park Jae‐Gahb , Lee Kuhn Uk , Choe Kuk Jin , Kim Jin‐Pok 
Published: April 2006

Abstract.To define the prognostic factors in Korean colorectal cancer patients, univariate and multivariate analysis were performed on data from 2230 consecutive patients who underwent resection for colorectal cancer at the Seoul National University Hospital. The prognostic variables used for the analysis included patient's age, gender, bowel obstruction, bleeding, symptom duration, preoperative leukocyte count, preoperative serum carcinoembryonic antigen (CEA) level, Dukes' stage, tumor location, tumor size, depth of bowel wall invasion, number of lymph node metastases, histologic differentiation, and gross morphology of tumor. The overall 5‐year survival rate was 62%. In the univariate analysis, all the factors except sex, symptom duration, and tumor size were associated with prognosis. Among the factors significant in the univariate analysis, Dukes' stage (p < 0.001), number of lymph node metastasis (p < 0.001), CEA level (p < 0.001), tumor location (p= 0.003), gross morphology of tumor (p= 0.017), and depth of bowel wall invasion (p= 0.031) were significant in the multivariate analysis. Several differences in prognostic factors between colon cancer and rectal cancer were observed. In the multivariate analysis, gross tumor morphology was significant only for colon cancer, and histologic differentiation was significant only for rectal cancer. Lymph node metastasis was an independent prognostic variable for both colon and rectal cancer, but its significance was more prominent for rectal cancer. Although Dukes' stage is the most reliable prognostic predictor, this study shows that other factors (preoperative CEA level, gross morphology of tumor, location of tumor, nodal status) also provide important information for the outcome of the patient.
Incidence of Malignant Melanoma in Auckland, New Zealand: Highest Rates in the World
Authors: Jones Wayne O. , Harman C. Richard , Ng Alexander K.T. , Shaw James H.F. 
Published: April 2006

Abstract.The calculation of incidence rates of melanoma in New Zealand has been hampered in the past by incomplete registration of cases. The aim of this study was to document the incidence of melanoma in the Auckland Caucasian population and to define the pathologic characteristics of these lesions. Data were collected for the Auckland region from the New Zealand Cancer Registry and the Auckland Melanoma Unit database for 1995 and combined with census statistics to give the crude and age‐standardized rates for invasive melanoma. The results were analyzed by gender, morphology, body site, and thickness. The crude annual incidence for invasive cutaneous malignant melanoma was 77.7/100,000. The age‐standardized annual rate was 56.2/100,000 with no statistically significant differences in the rates for males and females. The cumulative risk of developing melanoma over a lifetime, from age 0 to 74, was 5.7% overall. The age‐specific rates steadily increase with advancing age. The lesions were generally thin; 64% were less than 0.76 mm, and only 7% were thicker than 3.00 mm. In conclusion, the Caucasian population in the Auckland region has the highest incidence of melanoma in the world.
From Billroth to PCV: A Century of Gastric Surgery
Authors: Weil Peter H. , Buchberger Robert 
Published: April 2006

Abstract.The development of gastric surgery is one of the most fascinating chapters in surgical history. The first operations on the stomach were done during the second half of the nineteenth century; at first they were minor procedures but then gradually became more daring, major procedures—albeit with considerable mortality. The work of Theodor Billroth and his pupils ushered in the era of major resectional therapy, first for cancer and later also for ulcer disease. Complications due to the lack of understanding gastric physiology plagued the early days of ulcer surgery, and a variety of modifications tried to remedy these problems. Although the role of the vagus was known through Pavlov's studies, its practical application had to wait until well into the twentieth century. For several decades, resection and vagotomy, separately or combined, were practiced until more sophisticated types of vagotomy began to dominate and replace resection in the surgical treatment of ulcer disease. Resection remained the treatment for cancer. We thus see over a period of 100 years, owing to the increased understanding of physiologic factors, a gradual shift from major resections toward smaller, better directed procedures. The pioneering work of Billroth and his generation, however, must not be forgotten.
Symbolic Approaches to Probability Distributions in Process Algebra
Authors: Tofts C. 
Published: April 2006

Abstract.
One of the major problems in modelling with process algebras is that of state explosion. With the addition of information describing duration, models become more exposed to growth in the size of the description of their behaviour. We describe a symbolic approach to the description of duration information within a probabilistic calculus that has two benefits: firstly we can describe behaviour without instantiating distributions; secondly we can control the growth in our system representation as a trade against model accuracy. We can compute upper bounds on performance without the inclusion of additional state information in our systems. A large example, from the discrete event simulation literature, is presented to demonstrate the effectiveness of the approach.
GW627368X ((N‐{2‐[4‐(4,9‐diethoxy‐1‐oxo‐1,3‐dihydro‐2H‐benzo[f]isoindol‐2‐yl)phenyl]acetyl} benzene sulphonamide): a novel, potent and selective prostanoid EP4 receptor antagonist
Authors: Wilson Richard J , Giblin Gerard M P , Roomans Susan , Rhodes Sharron A , Cartwright Kerri‐Ann , Shield Vanessa J , Brown Jason , Wise Alan , Chowdhury Jannatara , Pritchard Sara , Coote Jim , Noel Lloyd S , Kenakin Terry , Burns‐Kurtis Cynthia L , Morrison Valerie , Gray David W , Giles Heather 
Published: April 2006

N‐{2‐[4‐(4,9‐diethoxy‐1‐oxo‐1,3‐dihydro‐2H‐benzo[f]isoindol‐2‐yl)phenyl]acetyl}benzene sulphonamide (GW627368X) is a novel, potent and selective competitive antagonist of prostanoid EP4 receptors with additional human TP receptor affinity.
At recombinant human prostanoid EP4 receptors expressed in HEK293 cells, GW627368X produced parallel rightward shifts of PGE2 concentration–effect (E/[A]) curves resulting in an affinity (pKb) estimate of 7.9±0.4 and a Schild slpoe not significantly different from unity. The affinity was independent of the agonist used.
In rings of phenylephrine precontracted piglet saphenous vein, GW627368X (30–300 nM) produced parallel rightward displacement of PGE2 E/[A] curves (pKb=9.2±0.2; slope=1).
GW627368X appears to bind to human prostanoid TP receptors but not the TP receptors of other species. In human washed platelets, GW627368X (10 μM) produced 100% inhibition of U‐46619 (EC100)‐induced aggregation (approximate pA2 ∼7.0). However, in rings of rabbit and piglet saphenous vein and of guinea‐pig aorta GW627368X (10 μM) did not displace U‐46619 E/[A] curves indicating an affinity of <5.0 for rabbit and guinea‐pig prostanoid TP receptors.
In functional assays GW627368X is devoid of both agonism and antagonist affinity for prostanoid CRTH2, EP2, EP3, IP and FP receptors. At prostanoid EP1 receptors, GW627368X was an antagonist with a pA2 of 6.0, and at prostanoid IP receptors the compound increased the maximum effect of iloprost by 55%. At rabbit prostanoid EP2 receptors the pA2 of GW627368X was <5.0.
In competition radioligand bioassays, GW627368X had affinity for human prostanoid EP4 and TP receptors (pKi=7.0±0.2 (n=10) and 6.8 (n=2), respectively). Affinity for all other human prostanoid receptors was <5.3.
GW627368X will be a valuable tool to explore the role of the prostanoid EP4 receptor in many physiological and pathological settings.

British Journal of Pharmacology (2006) 148, 326–339. doi:10.1038/sj.bjp.0706726
Magnetic resonance imaging-guided diskography and diagnostic lumbar 0.23t MRI: an assessment study
Authors: Sequeiros Blanco R. , Niinimäki J. , Ojala R. , Haapea M. , Vaara T. , Klemola R. , Tervonen O. 
Published: April 2006

Purpose: To describe the in vivo appearance of magnetic resonance imaging (MRI) diskograms of normal and degenerated lumbar intervertebral disks, and to evaluate the differences in imaging findings between sequential diagnostic MRI and MRI diskography. Material and Methods: Nine consecutive patients underwent MRI-guided diskography in order to determine possible pain provocation during puncture and contrast medium injection. All patients had preceding clinical suspicion of lumbar diskogenic pain and findings of lumbar disk degeneration in diagnostic (MRI, computed tomography (CT), plain radiography). A 0.23T open MRI scanner with interventional tools was used for imaging and instrument guidance. On all patients, a complementary diagnostic MRI study of the lumbar spine before and after the MRI-guided disk injection was performed, and subsequent axial MRI diskograms were obtained. Results: A total of 25 disk punctures were initialized, and 25 MRI diskograms were obtained and their expression described. There was a correlation between the degenerative disk findings visualized by diagnostic MRI and MRI diskograms. Conclusion: The use of gadolinium contrast media in MRI-guided diskography enables the evaluation of MRI diskograms. Our results suggest that MRI-guided diskography can be used to substitute conventional diskography or CT-diskography and as an augmenting method to assess diagnostic information upon degenerative processes of the lumbar spine.
Availability, indications, and technical performance of computed tomographic colonography: a national survey
Authors: Fisichella V. , Hellström M. 
Published: April 2006

Purpose: To determine the availability, indications, and technique of computed tomographic colonography (CTC) in Sweden and to investigate opinions on its future role in colon imaging. Material and Methods: In May 2004, a questionnaire on CTC was mailed to all Departments of Radiology in Sweden, and one year later a telephone interview was conducted with the departments that intended to start a CTC service. Results: Ninety-nine departments (83%) answered the questionnaire, indicating that 23/99 (23.2%) offered a CTC service. Reasons for non-implementation of CTC were lack of CTC training in 34/73 (46.6%) and non-availability of multi-detector row CT scanners in 33/73 (45.2%), while 26% were awaiting further scientific documentation on CTC. Incomplete colonoscopy was the main indication for CTC in 21/23 (91.3%) departments performing CTC. Dual positioning, room air insufflation, and thin-slice collimation were used in all the responding departments. The number of CTC studies performed varied from 1–5 (26.1%) to more than 200 (17.4%). Intravenous contrast material was routinely administered by 9/23 (39.1%) departments. Out of 30 (39.5%) departments that in 2004 intended to start CTC, 9 (30%) had done so by June 2005. A total of 32/99 (32.3%) departments had therefore started CTC by June 2005. Half of the departments that replied believed that CTC would absolutely or probably replace barium enema in the future. Conclusion: The survey shows relatively limited diffusion of CTC practice in Sweden, with approximately one-third of radiology departments offering a CTC service, mostly on a small scale. A wider dissemination of CTC requires further scientific documentation of its capability, intensified educational efforts, and additional funding.
Macrophage uptake of ultra-small iron oxide particles for magnetic resonance imaging in experimental acute cardiac transplant rejection
Authors: Penno E. , Johnsson C. , Johansson L. , Ahlström H. 
Published: April 2006

Purpose: To discriminate between acutely rejecting and non-rejecting transplanted hearts using a blood pool contrast agent and T2* magnetic resonance imaging (MRI) in a clinical 1.5T scanner. Material and Methods: Allogeneic and syngeneic heterotopic heart transplantations were performed in rats. One allogeneic and one syngeneic group each received either the ultra-small iron oxide particle (USPIO), at two different doses, or no contrast agent at all. MRI was performed on postoperative day 6. Immediately after the MR scanning, contrast agent was injected and a further MRI was done 24 h later. Change in T2* was calculated. Results: No significant difference in change in T2* could be seen between rejecting and non-rejecting grafts in either of the doses, or in the control groups. There was a difference between the allogeneic group that received the higher contrast agent dose and the allogeneic group that did not receive any contrast agent at all. Conclusion: In our rat model, measurements of T2* after myocardial macrophage uptake of AMI-227 in a clinical 1.5T scanner were not useful for the diagnosis of acute rejection.
Co-Carriage Rates of Vancomycin-ResistantEnterococcusand Extended-Spectrum Beta-Lactamase-Producing Bacteria Among a Cohort of Intensive Care Unit Patients: Implications for an Active Surveillance Program
Authors: Harris Anthony D. , Nemoy Lucia , Johnson Judith A. , Martin-Carnahan Amy , Smith David L. , Standiford Hal , Perencevich Eli N. 
Published: April 2006

AbstractObjective:To assess the co-colonization rates of extended-spectrum beta-lactamase (ESBL)-producing bacteria and vancomycin-resistantEnterococcus(VRE) obtained on active surveillance cultures.Design:Prospective cohort study.Setting:Medical and surgical intensive care units (ICUs) of a tertiary-care hospital.Patients:Patients admitted between September 2001 and November 2002 to the medical and surgical ICUs at the University of Maryland Medical System had active surveillance perirectal cultures performed. Samples were concurrently processed for VRE and ESBL-producing bacteria.Results:Of 1,362 patients who had active surveillance cultures on admission, 136 (10%) were colonized with VRE. Among these, 15 (positive predictive value, 11%) were co-colonized with ESBL. Among the 1,226 who were VRE negative, 1,209 were also ESBL negative (negative predictive value, 99%). Among the 1,362 who had active surveillance cultures on admission, 32 (2%) were colonized with ESBL. Among these, 15 (47%) were co-colonized with VRE. Of the 32 patients colonized with ESBL, 10 (31%) had positive clinical cultures for ESBL on the same hospital admission. For these 10 patients, the surveillance cultures were positive an average of 2.7 days earlier than the clinical cultures.Conclusions:Patients who are colonized with VRE can also be co-colonized with other antibiotic-resistant bacteria such as ESBL-producing bacteria. Our study is the first to measure co-colonization rates of VRE and ESBL-producing bacteria. Isolating VRE-colonized patients would isolate 47% of the ESBL-colonized patients without the need for further testing. Hence, active surveillance for VRE should also theoretically diminish the amount of patient-to-patient transmission of ESBL-producing bacteria.
Use of a Novel Selective Medium to Detect Methicillin-ResistantStaphylococcus aureusin Colonized Patients of an Intensive Care Unit
Authors: Dias Cícero Gomes , Röpke Marcos Vinícius Rosa , Superti Silvana , Berquó Laura , d'Azevedo Pedro 
Published: April 2006

AbstractBackground:Detection of colonized patients is important for implementing control measures for methicillin-resistantStaphylococcus aureus(MRSA). Laboratory detection of MRSA carriers is increased by the use of selective screening media, helping control dissemination of such organisms.Objective:To evaluate three different media, including selective and nonselective media, in the detection of MRSA from clinical specimens of patients of an intensive care unit (ICU).Patients:Adult patients in the ICU of the Hospital Mae de Deus, Porto Alegre, Brazil.Methods:A total of 224 specimens were obtained from the nares of patients and plated on blood agar, mannitol sait agar containing 2 μg/mL of oxacillin (MSAO), and oxacillin resistance screening agar base (ORSAB). The presence of MRSA was investigated in typical colonies growing on the three types of media. Discrepant results were resolved by detection of themecA gene by polymerase chain reaction and the modified penicillin binding protein known as PBP2'.Results:MRSA was detected in 32 (14.3%) of 224 specimens. Blood agar, MSAO, and ORSAB detected MRSA in 17, 31, and 28 specimens, respectively. After the coagulase test, no false resistance was observed.Conclusion:MSAO and ORSAB performed equivalently in the detection of MRSA of colonized patients and require a single supplementary test (coagulase) to confirm MRSA.
Carriage ofStaphylococcus aureusAmong Injection Drug Users: Lower Prevalence in an Injection Heroin Maintenance Program Than in an Oral Methadone Program
Authors: Bassetti Stefano , Wolfisberg Lea , Jaussi Barbara , Frei Reno , Kuntze Marcus F. , Battegay Manuel , Widmer Andreas F. 
Published: April 2006

AbstractObjectives:To compare the prevalence ofStaphylococcus aureusand methicillin-resistantS. aureus(MRSA) carriage among injection drug users (IDUs) treated in an injection heroin maintenance program with that among IDUs treated in an oral methadone program, and to determine predictors ofS. aureuscarriage.Design:Survey.Setting:Two opiate maintenance programs at a psychiatrie university clinic.Participants:A volunteer sample consisting of 94 (74%) of 127 IDUs treated in an injection opiate maintenance program with at least twice daily injections of heroin, and 70 (56%) of 125 IDUs treated in an oral methadone program.Results:Addicts treated in the intravenous heroin substitution program had a significantly lower overall rate ofS. aureuscarriage (37 of 94 [39.4%] vs 42 of 70 [60%];P= .009) and a significantly lower rate of nasal carriage (21 of 94 [22.3%] vs 30 of 70 [42.9%];P= .005) than did addicts treated in the oral methadone program. Being treated in the oral methadone program was the only independent predictor ofS. aureuscarriage (odds ratio, 2.27; 95% confidence interval, 1.19-4.31;P=.012). AllS. aureusisolates were susceptible to oxacillin.Conclusions:The regular use of needles under aseptic conditions did not increase the rate ofS. aureuscarriage among IDUs. Further studies are necessary to investigate whether the lower rate ofS. aureuscarriage among IDUs treated with intravenous heroin leads to a lower incidence ofS. aureusinfections in these patients.
Chloramphenicol Resistance in Vancomycin-Resistant Enterococcal Bacteremia: Impact of Prior Fluoroquinolone Use?
Authors: Gould Carolyn V. , Fishman Neil O. , Nachamkin Irving , Lautenbach Ebbing 
Published: April 2006

AbstractObjective:The prevalence of vancomycin-resistant enterococci (VRE) has increased markedly during the past decade. Few data exist regarding the epidemiology of resistance of VRE to chloramphenicol, one of the few therapeutic options.Design:Survey and case-control study.Setting:A 725-bed, tertiary-care academie medical center and a 344-bed urban community hospital.Patients:Hospitalized patients with blood cultures demonstrating VRE.Methods:We examined the trends in the prevalence of chloramphenicol resistance in VRE blood isolates at our institution from 1991 through 2002 and conducted a case-control study to identify risk factors for chloramphenicol resistance among these isolates.Results:From 1991 through 2002, the annual prevalence of chloramphenicol-resistant VRE increased from 0% to 12% (P < .001, chi-square test for trend). Twenty-two case-patients with chloramphenicol-resistant VRE bloodstream isolates were compared with 79 randomly selected control-patients with chloramphenicol-susceptible VRE. Independent risk factors for chloramphenicol-resistant VRE were prior chloramphenicol use (odds ratio [OR], 10.9; 95% confidence interval [CI95], 1.72-68.91; P = .01) and prior fluoroquinolone use (OR, 4.74; CI95, 1.15-19.42; P = .03). Chloramphenicol-resistant VRE isolates were more likely to be susceptible to beta-lactams and resistant to tetracycline than were chloramphenicol-susceptible VRE isolates.Conclusions:Significant increases in the prevalence of chloramphenicol-resistant VRE may limit the future utility of chloramphenicol in the treatment of VRE infections, and close monitoring of susceptibility trends should continue. The association between fluoroquinolone use and chloramphenicol-resistant VRE, reflecting possible co-selection of resistance, suggests that recent dramatic increases in fluoroquinolone use may have broader implications than previously recognized.
Which Strategies Follow From the Surveillance of Multidrug-Resistant Bacteria to Strengthen the Control of Their Spread? A French Experience
Authors: Lepelletier Didier , Perron Stéphanie , Huguenin Hélène , Picard Monique , Bemer Pascale , Caillon Jocelyne , Juvin Marie-Emmanuelle , Drugeon Henri Bernard 
Published: April 2006

AbstractEfforts to enhance standard precautions and to isolate patients with positive routine clinical cultures during 3 years were insufficient to decrease multidrug-resistant bacteria infection rates. Routine screening for carriage in high-risk patients may be necessary to hait transmission and control the hospital reservoir.
Aggressive Control Measures for ResistantAcinetobacter baumanniiand the Impact on Acquisition of Methicillin-ResistantStaphylococcus aureusand Vancomycin-ResistantEnterococcusin a Medical Intensive Care Unit
Authors: Wright Marc-Oliver , Hebden Joan N. , Harris Anthony D. , Shanholtz Cari B. , Standiford Harold C. , Furuno Jon P. , Perencevich Eli N. 
Published: April 2006

AbstractThe medical ICU implemented aggressive control measures following an outbreak of multidrug-resistant, clonalAcinetobacter baumannii.Multivariable regression analyses comparing acquisition (6 months preceding to 6 months during or following the outbreak) revealed decreased VRE and MRSA acquisition. Aggressive control measures can reduce VRE, and perhaps MRSA, transmission.