bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Significance of the Chinese People's Liberation Army White Paper
Authors: Noumoff S.J. 
Published: December 2005

In December 2004 the People's Liberation Army issued its status report, the White Paper, summarising its view of the global configuration of forces and projecting its response. The operating assumptions are: (1) while the international situation is stable, there are factors present of instability, uncertainty and insecurity, which are increasing, at the same time that hegemonism and unilateralism are gaining; (2) the tendency towards multi-polarisation is deepening; (3) new changes are altering the existing balance of power; (4) while the developing world is increasing global democratisation with a more vocal say, the gap between the North and the South is ever widening; (5) the world wide revolution in Military Affairs requires both new technology and new doctrines; (6) localised wars of a geopolitical, ethnic and religious nature are a constant threat; (7) any attempt by Taiwan to separate will be crushed; and (8) non-traditional threats are on the increase. To properly position the White Paper in perspective, it is essential to examine the 1999 study by two senior PLA Colonels, Unrestricted Warfare, which was characterised by the US as the doctrine of a technologically weaker China as it confronts the superior US power. A careful examination of this study reveals a thoroughly thought-out evaluation of both US and Chinese strengths and weaknesses in technology, strategy and doctrine. There is little doubt that the wake-up call for the PLA was triggered by the Gulf War—Operation Desert Storm. China's response, it is argued, is multiple—ranging from altering force levels to increasing its educational/technical levels; developing a seamless strategy for a transition from a peacetime to a wartime economy; seeking a leapfrog strategy in military technology; not falling into the trap of seeking superiority in all areas of military technology; and constructing and reinforcing an alliance structure of both multilateral institutional nature as well as on the bilateral level.
Bone Loss after Initiation of Androgen Deprivation Therapy in Patients with Prostate Cancer
Authors: Greenspan Susan L. , Coates Penelope , Sereika Susan M. , Nelson Joel B. , Trump Donald L. , Resnick Neil M. 
Published: December 2005

Context: Although androgen deprivation therapy (ADT) for prostate cancer is associated with bone loss, little is known about when this bone loss occurs.
Objective: We postulated that men on ADT would experience the greatest bone loss acutely after initiation of ADT.
Design and Setting: We conducted a 12-month prospective study at an academic medical center.
Patients or Other Participants: We studied 152 men with prostate cancer (30 with acute ADT, &lt;6 months; 50 with chronic ADT, ≥6 months; and 72 with no ADT) and 43 healthy age-matched controls.
Main Outcome Measures: We assessed bone mineral density (BMD) of the hip, wrist, total body, and spine; body composition; and markers of bone turnover.
Results: After 12 months, men receiving acute ADT had a significant reduction in BMD of 2.5 ± 0.6% at the total hip, 2.4 ± 1.0% at the trochanter, 2.6 ± 0.5% at the total radius, 3.3 ± 0.5% at the total body, and 4.0 ± 1.5% at the posteroanterior spine (all P &lt; 0.05). Men with chronic ADT had a 2.0 ± 0.6% reduction in BMD at the total radius (P &lt; 0.05). Healthy controls and men with prostate cancer not receiving ADT had no significant reduction in BMD. Both use and duration of ADT were associated with change in bone mass at the hip (P &lt; 0.05). Men receiving acute ADT had a 10.4 ± 1.7% increase in total body fat and a 3.5 ± 0.5% reduction in total body lean mass at 12 months, whereas body composition did not change in men with prostate cancer on chronic ADT or in healthy controls (P &lt; 0.05). Markers of bone formation and resorption were elevated in men receiving acute ADT after 6 and 12 months compared with the other men with prostate cancer and controls (P &lt; 0.05). Men in the highest tertile of bone turnover markers at 6 months had the greatest loss of bone density at 12 months.
Conclusions: Men with prostate cancer who are initiating ADT have a 5- to 10-fold increased loss of bone density at multiple skeletal sites compared with either healthy controls or men with prostate cancer who are not on ADT, placing them at increased risk of fracture. Bone loss is maximal in the first year after initiation of ADT, suggesting initiation of early preventive therapy.
The Valine Allele of the V89L Polymorphism in the 5-α-Reductase Gene Confers a Reduced Risk for Hypospadias
Authors: Thai Hanh T. T. , Kalbasi Mina , Lagerstedt Kristina , Frisén Louise , Kockum Ingrid , Nordenskjöld Agneta 
Published: December 2005

Context: Hypospadias is one of the most common malformations in man, with an incidence of 1:300 in newborn boys. No gene has been identified that causes isolated hypospadias, but the androgenic influence is important during male genital development.
Objective: A key enzyme for the androgenic function is steroid 5-α-reductase (SRD5A2). The V89L polymorphism in the SRD5A2 gene has been studied and found to be of functional importance. The leucine version of the enzyme is 30% less efficient than the valine variant.
Design, Setting, Patients, and Results: We have genotyped 158 hypospadias cases and 96 unaffected controls for this polymorphism and found a significant negative association for the V89 allele in hypospadias (odds ratio, 0.24; 95% confidence interval, 0.14–0.41 for homozygous individuals). This indicates that a fully functional 5-α-reductase enzyme (homozygous for V89) protects the male urethral development. This association is shown regardless of heredity, ethnicity, and severity of phenotype. We have also sequenced a selected material of 37 sporadic cases of more severe hypospadias for mutations in the androgen receptor AR, SRD5A2, and 17β-hydroxysteroid dehydrogenase HSD17B3 genes and found only two previously described mutations, one in the AR and one in the SRD5A2 gene.
Conclusion: This finding is in accordance with the assumption that functional polymorphisms may play an important role in complex disorders such as hypospadias when several genes as well as environmental factors contribute to the etiology.
Synthesis of Thyroid Hormone Binding Proteins Transthyretin and Albumin by Human Trophoblast
Authors: McKinnon Brett , Li Huika , Richard Kerry , Mortimer Robin 
Published: December 2005

Context: Mechanisms regulating materno-fetal transfer of thyroid hormone are not well understood. Modulation of trophoblast type 3 iodothyronine deiodinase (D3) may play an important role.Objective: The objective of this study was to investigate trophoblast thyroid hormone binding proteins that may modulate interactions between D3 and T4.Design: Placentas were obtained by informed consent from women delivering normal infants by repeat cesarean section at 38–40 wk gestation. T4 and T3 binding was examined in human placenta. Serum thyroid hormone binding proteins were identified by Western blotting, and their mRNA was examined by RT-PCR. Presence of these proteins in trophoblast was determined by immunocytochemistry and immunofluorescence. Cytosol was progressively purified to reveal additional thyroid hormone binding proteins that were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry. Effects of mefenamic acid on placental deiodination were examined by HPLC.Results: We detected high-affinity T4 and T3 binding in human placental cytosol. All three major serum-binding proteins, T4 binding globulin (TBG), transthyretin (TTR), and albumin, were present in cytosol. TTR mRNA and albumin mRNA were detected in human placenta, and TTR and albumin were identified histochemically in syncytiotrophoblasts. Neither TBG mRNA nor TBG was detected, suggesting that plasma TBG had contaminated the cytosol preparation. Low-affinity thyroid hormone binding proteins α-1-antitrypsin and α-1-acid glycoprotein were also identified. Addition of mefenamic acid, a potent inhibitor of thyroid hormone binding, to placental cytosol significantly enhanced deiodination of T4 by D3.Conclusions: Placenta produces a series of thyroid hormone binding proteins that may modify thyroid hormone deiodination and materno-fetal thyroid hormone transport.
Hypothalamic-Pituitary Dysfunction after Irradiation of Nonpituitary Brain Tumors in Adults
Authors: Agha Amar , Sherlock Mark , Brennan Sinead , O’Connor Stephen A. , O’Sullivan Eoin , Rogers Bairbre , Faul Clare , Rawluk Daniel , Tormey William , Thompson Christopher J. 
Published: December 2005

Context: Hypothalamic-pituitary (HP) dysfunction is common in children treated with cranial radiotherapy (RT) for brain tumors, but there is little known about the risk of HP dysfunction in adults treated with RT for primary nonpituitary brain tumors.
Objective: The objective was to study the frequency of HP dysfunction in adults after RT for nonpituitary brain tumors.
Method: We studied 56 adult patients who received external beam RT for primary nonpituitary brain tumors at time intervals of 12–150 months after RT. The control group consisted of 20 RT-naive patients with primary brain tumors. GH and adrenal axes were assessed using the insulin tolerance test or the glucagon stimulation test. Gonadotroph, thyrotroph, and lactotroph function were assessed using baseline blood measurements. The biological effective dose (BED) to the HP axis was calculated in the RT patients.
Results: Hypopituitarism was present in 41% of patients. The frequency of GH, ACTH, gonadotropin, and TSH deficiencies, and hyperprolactinemia was 32, 21, 27, 9, and 32%, respectively. Any degree of hypopituitarism and GH deficiency was significantly associated with longer time interval from RT and greater BED. However, gonadotropin deficiency and hyperprolactinemia were only related to BED, whereas ACTH deficiency was only significantly associated with the time interval from RT. One RT-naive patient was GH deficient.
Conclusion: Adult patients treated with cranial irradiation for primary nonpituitary brain tumors are at high risk of hypopituitarism, which is time and dose dependent. Long-term surveillance and periodic evaluation are needed. We recommend that adult late effect clinics, similar to those for children, should be established.
Aneurysmal Rupture During Coiling: Low Incidence and Good Outcomes at a Single Large Volume Center
Authors: Brisman Jonathan L. , Niimi Yasunari , Song Joon K. , Berenstein Alejandro 
Published: December 2005

Abstract

OBJECTIVE:
To study the incidence and clinical outcomes of intraoperative aneurysm rupture (IOR) during endovascular coil embolization at a single large volume center and to review the literature on this subject to determine whether IOR rupture rate and mortality correlate with volume of aneurysms treated at a given center and years since the institution of Guglielmi detachable coils as a treatment modality.

METHODS:
We reviewed the aneurysm database at the Center for Endovascular Surgery since its inception (1997–2003) and reviewed 600 consecutively treated intracranial aneurysms in which coiling was attempted. All patients who sustained an IOR were studied. Procedural and follow-up angiograms as well as clinical outcomes were retrospectively reviewed. A literature review was conducted.

RESULTS:
Six patients (1.0%) experienced IOR (1.4% in acutely ruptured lesions, 0% in unruptured). All six had presented with diffuse subarachnoid hemorrhage (Fisher Grade 3) and in good clinical grade (Hunt & Hess Grades 1–3). One patient was rendered permanently disabled secondary to delay in controlling the IOR. All others were neurologically unchanged. A review of the literature revealed a trend in correlation between volume of aneurysms treated and IOR rate; no statistically significant correlation was found between volume of aneurysms treated or years since the introduction of GDC technology and IOR rates or mortality.

CONCLUSION:
IOR remains a serious risk of endosaccular coiling of intracranial aneurysms, with aneurysms presenting with subarachnoid hemorrhage at greater risk for this complication. This risk can be minimized with very low associated morbidity and mortality (incidence 1%, 17% morbidity, 0% mortality at our institution).
Spontaneous Spinal Subarachnoid Hemorrhage Secondary to Spinal Aneurysms: Diagnosis and Treatment Paradigm
Authors: Gonzalez L Fernando , Zabramski Joseph M. , Tabrizi Peyman , Wallace Robert C. , Massand Manoj G. , Spetzler Robert F. 
Published: December 2005

Abstract

INTRODUCTION:
Isolated spinal aneurysms are rare; only a few have been reported. To the best of our knowledge, this series represents the largest experience with four ruptured spinal aneurysms, all of which were treated surgically.

METHODS:
Clinical information from the hospital charts and diagnostic images of four patients with the diagnosis of spinal aneurysms were reviewed from the senior authors' (RFS, JMZ) office database, surgical reports, and radiological imaging database. Follow-up examinations were performed by phone interview, when possible, and by chart review.

RESULTS:
Between 1997 and 2004, four patients with ruptured spinal aneurysms underwent surgical treatment. All aneurysms were located within the spinal canal and manifested with spinal subarachnoid hemorrhage. No collagen disease, aortic coartaction, arteriovenous fistula, or arteriovenous malformations were identified in these patients.

CONCLUSION:
Subarachnoid hemorrhage within the spinal cord can be caused by ruptured aneurysms. Spinal aneurysms are rare, but should be considered within the differential diagnosis of patients with intracranial subarachnoid hemorrhage when cranial angiography is negative. Magnetic resonance imaging and selective spinal angiography are useful for workup, but definitive diagnosis may require surgical exploration.
Stereotactic Aspiration and Antibiotic Treatment Combined with Hyperbaric Oxygen Therapy in the Management of Bacterial Brain Abscesses
Authors: Kutlay Murat , Çolak Ahmet , Yıldız Şenol , Demircan Nusret , Akın Osman Niyazi 
Published: December 2005

AbstractOBJECTIVE:Despite advances in surgical techniques in the management of the brain abscess, long-term antibiotics are as crucial to cure as the initial surgical procedure itself. This study was designed to evaluate the effect of adjuvant hyperbaric oxygen (HBO) therapy on the duration of antibiotic treatment.METHODS:Between 1999 and 2004, 13 patients with bacterial brain abscesses treated with stereotactic aspiration combined with HBO and systemic antibiotic therapy. Patients younger than 18 years of age were excluded from this study. Postoperatively, all patients were given a 4-week course of intravenous antibiotics. Additionally, patients received hyperbaric oxygen (HBO, 100% O2 at 2.5 ATA for 60 min) twice daily for five consecutive days, and an additional treatment (100% O2 at 2.5 ATA for 60 min daily) was given for 25 days.RESULTS:There were eight male and five female patients. Their ages ranged between 18 and 71 years, with a mean of 43.9 years. The average duration of follow-up was 9.5 months (range, 8–13 mo). This treatment modality allowed infection control and healing for all 13 patients with 0% recurrence rate. HBO treatment was tolerated well, and there were no adverse effects of pressurization. At the end of the follow-up period, 12 patients had a good outcome: nine are without sequelae, and three have a mild hemiparesis but are capable of self-care. One patient has a moderate hemiparesis.CONCLUSION:Although the number of patients is small, this series represents the largest reported group of brain abscess patients treated with stereotactic aspiration combined with antibiotic and HBO therapy. Our preliminary results indicate that the length of time on antibiotics can be shortened with the use of HBO as an adjunctive treatment.
Linear Accelerator Radiosurgery for Trigeminal Neuralgia
Authors: Richards Gregory M. , Bradley Kristin A. , Tomé Wolfgang A. , Bentzen Søren M. , Resnick Daniel K. , Mehta Minesh P. 
Published: December 2005

Abstract

OBJECTIVE:
To report the clinical outcomes following treatment of trigeminal neuralgia with linear accelerator-based radiosurgery.

METHODS:
Twenty-eight patients with medication refractory idiopathic trigeminal neuralgia were treated with a single fraction of 80 Gy to the trigeminal nerve root. For treatment delivery, a 4-mm collimator and a 7-arc technique were delivered using a stereotactic floor stand system with an isocenter stability of 0.2 ± 0.1 mm to minimize dose to the brainstem. Treatment delivery time was approximately 55 minutes.

RESULTS:
With a median follow-up of 12 months (range, 1–40 mo), 57% of patients achieved complete pain relief and 75% (exact 95% confidence interval, 55 to 89%) had their pain reduced to 3 or less on a 10-point pain scale. Median time to pain relief was 1 month. Four patients did not respond to treatment. The actuarial mean time to pain recurrence in responders was 14 months, and the actuarial mean response duration in major to complete responders was 16 months. Women had significantly longer mean time to pain recurrence than men (16 versus 7 months; P = 0.05). Three patients reported new mild facial numbness after radiosurgery and one patient developed neurotrophic keratopathy.

CONCLUSION:
Linear accelerator-based radiosurgery for medication refractory trigeminal neuralgia provides effective pain relief with a low complication rate.
Missile-Caused Complete Lesions of the Peroneal Nerve and Peroneal Division of the Sciatic Nerve: Results of 157 Repairs
Authors: Roganovic Zoran 
Published: December 2005

AbstractOBJECTIVE:There are few large-volume studies of the repair of complete missile-caused peroneal nerve and peroneal division lesions. In this prospective study, the outcomes of such repairs are studied and the factors influencing the outcomes are analyzed.METHODS:During a 3-year period, 157 patients with complete missile-caused lesions of the peroneal nerve or peroneal division were treated surgically in the Belgrade Military Medical Academy: 37 patients with high-level (above the middle of the thigh), 90 patients with intermediate-level (above the popliteal crease), and 30 patients with low-level repairs. After at least 4 years of follow-up, outcome was defined on the basis of motor recovery, neurophysiological recovery, and patient judgment of the quality of outcome (poor, insufficient, good, or excellent). Good and excellent outcomes were considered successful. The factors of repair level, defect length, manner of repair, preoperative interval, severity of tissue damage in the repair region, and patient age were studied for their effect on outcome.RESULTS:A successful outcome was obtained in 10.8% of high-level repairs, 31.1% of intermediate-level repairs, and 56.7% of low-level repairs (P &lt; 0.001). Nerve defect and preoperative interval were significantly shorter for patients with a successful outcome compared with those with an unsuccessful outcome (P&lt; 0.001). Worsening of the outcome began with the nerve defect larger than 4 cm and preoperative interval greater than 3 months (P&lt; 0.001). Severity of local tissue damage significantly influenced the outcome (P= 0.008). Repair level (P&lt; 0.001), preoperative interval (P= 0.001), severity of local tissue damage (P= 0.011), and length of nerve defect (P= 0.011) were independent predictors for a successful outcome.CONCLUSION:After peroneal nerve or peroneal division repairs, a successful outcome is most probable with low-level lesions repaired in the first 3 months after injury using grafts smaller than 4 cm. Conversely, high-level repairs delayed for more than 7 months after injury and using grafts larger than 8 cm are probably not worthwhile.
Pulsatile Tinnitus and the Intrameatal Vascular Loop: Why Do We Not Hear Our Carotids?
Authors: De Ridder Dirk , De Ridder Leo , Nowé Vicky , Thierens Hubert , Van de Heyning Paul , Møller Aage 
Published: December 2005

Abstract

OBJECTIVE:
Pulsatile tinnitus is characterized by hearing the heart beat or respiration in one or both ears. In 15% of patients with pulsatile tinnitus, no cause can be found. Other investigators have suggested that a vascular loop entering the internal auditory meatus can be another cause of arterial, pulse synchronous tinnitus. If so, we should constantly hear the arterial pulsations of the carotid arteries passing through the petrous bone.

METHODS:
Using magnetic resonance imaging, 17 patients with unilateral pulsatile tinnitus and 46 with non-pulsatile tinnitus were analyzed for the presence of a vascular loop entering into the internal acoustic meatus. Four temporal bones were sectioned to find structural differences between the internal acoustic meatus and the pericarotid area. Four patients with intrameatal vascular loops and ipsilateral pulsatile tinnitus underwent surgery by Teflon interpositioning between the loop and the cochlea.

RESULTS:
In unilateral pulsatile tinnitus, a statistically highly significant amount of intrameatal vascular loops was noted in comparison to non-pulsatile tinnitus. A well-developed pericarotid venous plexus was found histologically. Three of the four patients who underwent surgery were initially tinnitus free, but pulsations recurred after 3 months in one patient.

CONCLUSION:
Vascular loops in the internal auditory canal may generate pulsatile tinnitus. It may be treated by placing Teflon between the cochlea and the intrameatal vascular loop. One then does not hear the pulsation of the carotids due to a dampening effect of a pericarotid venous plexus.