bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multidetector‐row computed tomography in the management of hepatocellular carcinoma with transcatheter arterial chemoembolization
Authors: Guan Yong‐Song , Hu Ying , Liu Yuan 
Published: May 2006

AbstractWith the introduction of spiral computed tomography and the development of novel imaging technology in recent years, multidetector–row computed tomography (MDCT) has increasingly been used for the diagnosis of various lesions, especially hepatocellular carcinoma (HCC), due to its volume acquisitions, short scanning time, and especially its double‐phase scanning nature, which takes advantage of the dual blood supply of liver. Multidetector–row computed tomography is used to classify HCC into several types based on the blood supply and the histological characteristics of HCC. The evaluation of HCC by MDCT provides crucial clues for the doctors to adopt correct clinical management strategies such as the selection of the appropriate dose of lipiodol before transcatheter arterial chemoembolization (TACE) and the prediction of the prognosis of HCC after TACE. The MDCT scanning allows doctors to choose the region of interest and to evaluate the blood supply according to the lipiodol uptake in order to decide whether there is recrudescence and whether a repeated therapy should be taken. This review describes MDCT, its biphasic scanning, its evaluation of blood supply in HCC and the subsequent classification of HCC, its therapeutic significance before TACE and the prognostic value after TACE.
Comparison of new generation motion‐resistant pulse oximeters
Authors: Townshend Jennifer , Taylor Barry J , Galland Barbara , Williams Sheila 
Published: May 2006

Aim:  To compare the performance of pulse oximeters during movement and brachial artery occlusion.Methods:  Three machines (MasimoSET, using MasimoSET LNOP Pdt paediatric sensor, Mars 2001 using Novametrix paediatric sensor no. 6455 and Nellcor 595 using Nellcor 595 Oximax‐P paediatric sensor and Nellcor 595 MAX‐FAST adhesive forehead reflectance sensor) were used simultaneously on the left hand and forehead. The subjects were 18 healthy children aged 6–10 years. Interventions were 20 sequential 90° body turns from mimicking normal movements while asleep followed by step increases in brachial artery occlusion. Mean heart rate (HR) from the four machines was compared with ECG HR. Haemoglobin O2 saturation was compared with a baseline saturation and the proportion of epochs with false (low) saturation values.Results:  The mean difference from ECG HR was not clinically significantly different for any machine but the limits of agreement were such that the Mars Model 2001 and Nellcor 595 (forehead) could have clinically important differences from ECG‐derived HR (−20.04–15.00 and −14.95–14.04, respectively). Only the Nellcor 595 with finger probe had limits of agreement within the a priori set value of 4%. The prevalence of epochs with an haemoglobin O2 saturation of greater than 4% below baseline values was lowest for the Nellcor 595 finger probe (1.59%) and highest for the Nellcor forehead probe (20.45%). During brachial artery occlusion, all machines performed well up to within 20 mmHg of total occlusion.Conclusion:  Current motion‐resistant pulse oximeters performed well but only the Nellcor 595 with finger probe achieved our a priori set standards.
Initial report on identification and toxicity of Microcystis in King Talal Reservoir, Jordan
Authors: Al‐Jassabi S. , Khalil A. M. 
Published: May 2006

AbstractThe cyanobacteria Microcystis aeruginosa forms extensive summer blooms in the King Talal Reservoir, the largest water body in Jordan. The occurrence of the blooms is a function of the water temperature, light intensity and nutrient concentration, with the nitrogen and phosphorus levels being critical factors. This initial study indicated that the time of the seasonal maximum and intensity of Microcystis blooms in the King Talal Reservoir vary significantly from month to month, with a peak reached in summer. The low nutrient concentrations were observed prior to the summer season. There was a rapid, extensive proliferation of M. aeruginosa during the summer of the same year, especially from 1–30 June to 30 November. The LD50 of microcystin in Balb/c was found to be 50 µL kg−1. Additional studies will provide further information on various aspects of the identification and toxicity of the selected cyanobacterial species.
Application of knowledge management to environmental management projects: A case study for lake management
Authors: Sekino Tatsuki , Nakamura Masahisa 
Published: May 2006

AbstractAlthough environmental management projects typically must collect large quantities of data and information from a variety of related fields, these data and information often are not used effectively. In this study, an experimental version of a knowledge management system (Learning Acceleration and Knowledge Enhancement System) was developed to solve problems related to the acquisition and accumulation of large quantities of information being applied to an international project on lake management. Two functions were incorporated in the system, including (i) a function for previewing retrieved documents so that the information obtained using a specific search word could be easily accessed; and (ii) a thesaurus function to facilitate the sourcing and understanding by decision‐makers and other stakeholders of information in unfamiliar, but related, fields of study. As these functions enable users to search for data and information in fields that might be unfamiliar to them, the application of knowledge management to projects involving environmental issues can be a valuable tool for such projects in the future.
Application of ecological engineering principles in lake management
Authors: Jørgensen S. E. 
Published: May 2006

AbstractThe Ecological Engineering and Ecosystem Restoration previously presented 19 ecological principles that can be used for all ecotechnological projects. This report discusses how all projects that incorporate or involve engineering and management of ecosystems should be guided by these previously noted ecological principles. The principles also can be used as a checklist for ensuring that all relevant ecological considerations are taken into account in the development and implementation of ecotechnology and ecological management projects. This report demonstrates how these 19 principles can be applied in lake management issues. It is shown that the principles also are useful as a checklist for lake management efforts. This report further identifies general and 12 specific recommendations for lake management efforts, which are based on the 19 principles.
Relationship between water flow volume and in‐lake total phosphorus concentrations via dissolved oxygen concentrations and temperature in a warm temperate reservoir: Implications by path analysis
Authors: Tüzün İlhami , İnce Özlem 
Published: May 2006

AbstractThe effects of water inflow–outflow volumes on the in‐lake total phosphorus (TP) concentrations was investigated for the deep, stratified Çubuk II Dam Lake. The fluctuations in the TP concentrations followed a seasonal pattern, with lower values found during the summer, and peak values during wet seasons. Both the seasonal pattern and the horizontal/vertical heterogeneities in the TP concentrations were usually found to be in accordance with those of the water flow parameters. The vertical differences in the TP concentrations provided evidence that an interflow formed at the 5 m and 10 m depths by the water inflow resulted in higher mean TP concentrations at these depths. In contrast, the water outflows had a reducing effect on the TP concentrations, particularly at the 15 m depth, by promoting net TP export. Although the horizontal distribution of the TP concentrations differed slightly between the riverine, transition and lacustrine zones, the differences did not indicate any statistical significance (P > 0.05, multivariate analysis of variance). The path analysis performed on the vertical data proved to be a promising tool in estimating the direct correlations between water flow dynamics and TP concentrations when the decomposition of indirect correlations via dissolved oxygen concentrations and temperature was accounted for in these mutual associations.
Stress barometer at diagnoses in children with school non‐attendance
Authors: KANO KENICHI , ARISAKA OSAMU 
Published: May 2006

AbstractBackground: School non‐attendance is a major social problem in Japan. Many children stop attending school for a variety of reasons. The authors previously reported stress barometer values for healthy Japanese children. In this study, the authors examined the stress barometer values of children with school non‐attendance.Methods: The authors measured stress barometer values, that is, urinary 17‐hydroxycorticosteroids (17‐OHCS) and 17‐ketosteroid sulfates (17‐KS‐S) in 65 children (40 girls and 25 boys; 7–15 years of age) with school non‐attendance, except for pervasive developmental disorder and mental retardation, who attended the outpatient department of Dokkyo University School of Medicine Hospital, Tochigi, Japan, during the past 4 years.Results: A total of 24 (36.9%) of the 65 children had urinary 17‐OHCS values above 2SD, and 14 (21.5%) had urinary 17‐OHCS below 2SD. In total, 10 (15.4%) children had urinary 17‐KS‐S values above 2SD, and four (6.2%) had urinary 17‐KS‐S below 2SD. Five (7.7%) children had urinary 17‐KS‐S/17‐OHCS values above 2SD, and 10 (15.4%) had urinary 17‐KS‐S/17‐OHCS below 2SD.Conclusion: The stress barometer values appear to be clinically useful for evaluating objectively whether children with school non‐attendance have emotional stress.
Risk of obesity enhanced by poor physical activity in high school students
Authors: BABA REIZO , IWAO NOBUKO , KOKETSU MASAAKI , NAGASHIMA MASAMI , INASAKA HIROSHI 
Published: May 2006

AbstractBackground: The aim of this study was to elucidate the interactions between a family history of obesity and poor physical activity.Methods: A case‐control study was performed based on medical check data for all first year high school students admitted to Aichi Prefectural public high schools in the 2004 academic year. Prior to the post‐admission medical check up, all students received an interview sheet containing questions on family history of obesity and extent of physical activity. Experienced nurses measured body mass and height. Valid answers and measurements were obtained from 20 155 boys and 19 682 girls.Results: A family history of obesity, reluctance to exercise, current and recent past sedentary lifestyles each significantly increased risk of obesity (body mass index [BMI] ≥ 25) and severe obesity (BMI ≥ 30) in both boys and girls. Two‐way ANOVA revealed that a family history of obesity, associated with poor exercise, positively affected BMI in both boys and girls. Moreover, significant positive interaction was found between a family history of obesity and each of the unfavorable physical activity conditions. Synergistic effects (synergy indexes > 1) increasing risk of obesity were noted in both boys and girls when a family history of obesity overlapped with reluctance to exercise, current physical inactivity, or recent physical inactivity.Conclusion: Overlapping of family history of obesity and exercise risk factors synergistically increase the BMI and risk of obesity in both boys and girls. Intervention to promote exercise in adolescents who have obese family member(s) should be encouraged.
Surgical closure of patent ductus arteriosus reduces the cerebral tissue oxygenation index in preterm infants: a near‐infrared spectroscopy and Doppler study
Authors: ZARAMELLA PATRIZIA , FREATO FEDERICA , QUARESIMA VALENTINA , FERRARI MARCO , BARTOCCI MARCO , RUBINO MAURIZIO , FALCON ELENA , CHIANDETTI LINO 
Published: May 2006

AbstractBackground: The aim of this study was to investigate the effects of patent ductus arteriosus (PDA) ligature on cerebral oxygen saturation, cerebral blood volume (CBV) and cerebral blood flow velocity by means of near‐infrared spectroscopy (NIRS) and transcranial Doppler simultaneous examinations.Methods: This is an observational study considering 16 babies of gestational age 24–34 weeks diagnosed with PDA who underwent surgical ligation. The cerebral oxygen saturation, CBV and blood gases values were obtained 35 min before ligation, so also around the 14th and 27th min after the clip’s insertion.Results: Cerebral oxygen saturation, measured as tissue oxygenation index (TOI), decreased significantly after PDA ligation from a basal value of 61.1 (3.8) before surgery to 56.6 (3.3) and 55.8 (2.6)%, for the 14th and 27th min, respectively (P < 0.04). CBV before and after clipping was unvaried. A negative correlation was found between ΔpH and ΔCBV after ligation (R = 0.52, P = 0.03), whilst a positive correlation was found between ΔCBV and ΔPaCO2 (R = 0.62, P = 0.009). pH increased at the 27th min post‐ligation.Conclusions: NIRS is a tool for obtaining information on cerebral oxygen saturation and CBV changes during surgical PDA ligation at the bedside. A fall in TOI suggests an increased oxygen extraction during PDA surgery. The lack of increase in ΔCBV or in diastolic flow velocity show that the PDA before the clipping did not limit cerebral blood flow, the drop in TOI suggests increased oxygen consumption over the clip and the need for accurate monitoring of oxygen utilization after the surgical treatment.
Guidelines for the treatment of Crohn’s disease in children
Authors:   WORKING GROUP OF THE JAPANESE SOCIETY FOR PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION, KONNO MUTSUKO , KOBAYASHI AKIO , TOMOMASA TAKESHI , KANEKO HIROAKI , TOYODA SHIGERU , NAKAZATO YUTAKA , NEZU RIICHIRO , MAISAWA SHUN‐ICHI , MIKI KAZUNORI 
Published: May 2006

AbstractThis paper shows guidelines for the treatment of Crohn’s disease in children by the Working Group of the Japanese Society for Pediatric Gastroenterology, Hepatology and Nutrition (Chair: Yuichiro Yamashiro) and the Japanese Society for Pediatric Inflammatory Bowel Disease (Chair: Akio Kobayashi). The points in which these guidelines differ from those for adult patients are as follows. (i) Total enteral nutrition in the form of an elemental formula is indicated as primary therapy for children with Crohn’s disease at onset as well as the active stage. Oral mesalazine is used together. (ii) Total parenteral nutrition (TPN) with oral mesalazine is required for children with serious illness. The use of a corticosteroid should be withheld for at least 1 week after TPN has been started. (iii) When TPN is not considered to be effective, additional corticosteroid is used. Full doses of corticosteroid should be used for at least 2 weeks after clinical improvement has been achieved, and then the dose of the corticosteroid should be tapered carefully. (iv) When surgery is indicated in pediatric patients with stricture or fistula formation and complicated by persistent growth failure despite medical therapy, the optimum time for surgery is thought to be before epiphyseal plates have been closed.
Toxic factors in human urine that injure urothelium
Authors: RAJASEKARAN MAHADEVAN , STEIN PAUL , PARSONS C. LOWELL 
Published: May 2006

Aim:  Loss of the lower urinary permeability barrier and passive potassium cycling into tissue are an initiating event in interstitial cystitis. We tested whether a low molecular weight cytotoxic fraction from normal urine causes sensitivity to intravesical potassium in rats and whether the sulfated anionic polysaccharide pentosan polysulfate can neutralize this fraction's cytotoxic activity.Methods:  A low molecular weight (> 100 < 3500) toxic urinary fraction was prepared from normal human urine by dialysis and the lyophilized, salt free product (toxic factor) further investigated. Anaesthetized adult male Sprague–Dawley rats received intravesical sodium or potassium, and urodynamic parameters, including number of voids and non‐voiding contractions, were recorded. Then protamine sulfate, rehydrated toxic factor, or toxic factor plus pentosan polysulfate was infused, followed by potassium, and urodynamic measurements repeated. The toxic factor was evaluated in a commercial cytotoxicity protocol using cultured rat urothelial cells.Results:  Rat bladder non‐voiding contractions increased markedly over baseline when potassium was infused after toxic factor (1.681 ± 0.1131 non‐voiding contractions/min; P = 0.0004) but not after toxic factor premixed with pentosan polysulfate. Toxic factor had a significant (P < 0.001) cytotoxic effect in cultured rat bladder epithelial cells; toxic factor plus pentosan polysulfate was significantly less cytotoxic than toxic factor alone (P < 0.007).Conclusions:  Normal urine contains a cationic cytotoxic factor that increases urothelial permeability by injuring the mucosa, allowing potassium to penetrate the urothelium and depolarize the underlying nerves and muscles. Pentosan polysulfate neutralizes the toxic factor, attenuates urothelial damage, and suppresses potassium‐mediated bladder hyperactivity.
Outcome of mid‐urethral sling procedures in Korean women with stress urinary incontinence according to body mass index
Authors: KU JA HYEON , OH JIN GYU , SHIN JAE WOOK , KIM SOO WOONG , PAICK JAE‐SEUNG 
Published: May 2006

Background:  The objective of this study was to determine whether the outcome of mid‐urethral sling procedures is influenced by the body mass index of Korean women suffering from stress urinary incontinence (SUI).Methods:  A total of 285 women, ranging in age from 28 to 80 years (mean 55.4), all of whom were followed up for at least 6 months, were ultimately included in this study. The patients were classified as follows: normal weight, 18.5–23 kg/m2; overweight, 23–27.5 kg/m2; obesity, 27.5 kg/m2 or higher.Results:  We noted bladder perforations in 11 cases (4.9%, 3.8% and 2.2% in the normal weight, overweight, and obesity groups, respectively; P = 0.449). We determined there to be no significant differences among the three groups with regard to cure rate (P = 0.173). The rates of postoperative urinary retention were 9.9% in the normal weight group, 10.1% in the overweight group, and 15.6% in the obesity group (P = 0.396). We determined there to be no significant differences among the three groups with regard to the persistence of urgency (P = 0.312). Seventy‐nine patients (27.7%) exhibited symptoms indicative of voiding disorder (hesitancy, poor flow, or sensations of incomplete emptying). The postoperative development of these voiding symptoms was not significantly different among the three groups (P = 0.106).Conclusion:  Our results demonstrate both the feasibility and the safety of mid‐urethral sling procedures for obese Korean women who suffer from SUI. Additional studies, including prospective randomized trials with longer follow‐up periods, will be required in order to confirm these findings.
Follow up of surgical repair of female pelvic floor disorders by a mailed questionnaire
Authors: MATSUYAMA HIDEYASU , HIRATA HIROSHI , TOMIMATSU TAKESHI , YAMAKAWA GEN‐ICHRO , TATSUMURA MASATO , NAITO KATSUSUKE 
Published: May 2006

Background:  This study was conducted to determine whether surgical repair of pelvic prolapse enhances patients’ quality of life (QOL) in the long term.Methods:  A total of 91 patients (median age, 68.0 years) with pelvic prolapse including cystoceles underwent bladder neck suspension with anterior/posterior colporrhaphy between 1997 and 2003. Postoperative QOL was longitudinally assessed by three disease‐specific items (sensation of vaginal bulging, obstructive symptoms, urinary incontinence), and one overall health‐related QOL (HR‐QOL) item.Results:  A longitudinal study demonstrated that a significant improvement in these symptoms was sustained at a median follow up of 65.5 months, although poor HR‐QOL was significantly higher in patients whose age was more than 70 years at surgery (P = 0.0234, Fisher's test). Multivariate analysis revealed update urinary incontinence, update obstructive symptoms, and basic comorbidity to be independent prognostic factors for predicting postoperative moderate‐to‐poor HR‐QOL.Conclusions:  Longer follow up with adequate assessment of patients’ QOL may be crucial for the management of postoperative patients, in particular those having basic comorbidity and aged 70 years or more at surgery.
MAKING A VIRTUE OF NECESSITY: MANAGING THE OPEN ABDOMEN
Authors: De Costa Alan 
Published: May 2006

Background:  The open abdomen, or laparostomy, is becoming increasingly used in the management of critically ill surgical patients.Methods:  The published work on laparostomy is reviewed, in the light of personal experience, with particular attention to the history and pathophysiology associated with laparostomy.Results and Conclusion:  The combination of an inert plastic sheet in contact with the viscera, and the application of subatmospheric pressure on the wound, is an effective combination to maximize the prospects of delayed primary wound closure while minimizing the chance of fistula and ventral hernia.
KEYSTONE ISLAND FLAP: AN ALTERNATIVE RECONSTRUCTIVE OPTION TO FREE FLAPS IN IRRADIATED TISSUE
Authors: Behan Felix , Sizeland Andrew , Porcedu Sandro , Somia Naveen , Wilson Jeremy 
Published: May 2006

Background:  The Keystone Flap is an island flap that is very useful for repairing skin defects of the integument. Described as a keystone, this arc‐shaped flap in fact consists of a schematically designed, perforator‐based reconstructive unit which serendipitously resembles two conjoined VY flaps. This facilitates closure because of the multiple VY points at the extremes, where the surrounding tissue is advanced to close the defect while the flap size remains basically static.Methods:  A consecutive series of nine cases involving the head and neck and inguinal regions were examined to show the use of the Keystone Flap in irradiated tissue for recurrent disease. They are described by using a combination of clinical illustrations and diagrams to explain the surgical technique.Results:  The average age of the patients in the series is 74 years. A low complication rate and rapid wound healing with no significant flap necrosis was shown in this series. Additionally the short operation time is quite beneficial, particularly for the elderly.Conclusion:  There is a low complication rate using Keystone flaps (this double VY is a clinical development from Diffenbach’s original work of 18481) and this technique is particularly useful in achieving wound healing especially after irradiation treatment. This surgical technique once mastered is easy to perform. Another bonus is that there is minimal use of postoperative analgesia. Additional XRT is well tolerated by the patients with minimal evidence of wound complications, while acheiving an acceptable aesthetic appearance.