bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐steady‐state, non‐uniform transpiration rate and leaf anatomy effects on the progressive stable isotope enrichment of leaf water along monocot leaves
Authors: OGÉE J. , CUNTZ M. , PEYLIN P. , BARIAC T. 
Published: January 2007

ABSTRACTThis study focuses on the spatial patterns of transpiration‐driven water isotope enrichment (Δlw) along monocot leaves. It has been suggested that these spatial patterns are the result of competing effects of advection and (back‐)diffusion of water isotopes along leaf veins and in the mesophyll, but also reflect leaf geometry (e.g. leaf length, interveinal distance) and non‐uniform gas‐exchange parameters. We therefore developed a two‐dimensional model of isotopic leaf water enrichment that incorporates new features, compared with previous models, such as radial diffusion in the xylem, longitudinal diffusion in the mesophyll, non‐uniform gas‐exchange parameters and non‐steady‐state effects. The model reproduces well all published measurements of Δlw along monocot leaf blades, except at the leaf tip and given the uncertainties on measurements and model parameters. We show that the longitudinal diffusion in the mesophyll cannot explain the observed reduction in the isotope gradient at the leaf tip. Our results also suggest that the observed differences in Δlw between C3 and C4 plants reflect more differences in mesophyll tortuosity rather than in leaf length or interveinal distance. Mesophyll tortuosity is by far the most sensitive parameter and different values are required for different experiments on the same plant species. Finally, using new measurements of non‐steady‐state, spatially varying leaf water enrichment we show that spatial patterns are in steady state around midday only, just as observed for bulk leaf water enrichment, but can be easily upscaled to the whole leaf level, regardless of their degree of heterogeneity along the leaf.
The ecophysiology of early angiosperms
Authors: FEILD TAYLOR S. , ARENS NAN CRYSTAL 
Published: January 2007

ABSTRACTAngiosperms first appeared during the Early Cretaceous, and within 30 million years they reigned over many floras worldwide. Associated with this rise to prominence, angiosperms produced a spectrum of reproductive and vegetative innovations, which produced a cascade of ecological consequences that altered the ecology and biogeochemistry of the planet. The pace, pattern and phylogenetic systematics of the Cretaceous angiosperm diversification are broadly sketched out. However, the ecophysiology and environmental interactions that energized the early angiosperm radiation remain unresolved. This constrains our ability to diagnose the selective pressures and habitat contexts responsible for the evolution of fundamental angiosperm features, such as flowers, rapid growth, xylem vessels and net‐veined leaves, which in association with environmental opportunities, drove waves of phylogenetic and ecological diversification. Here, we consider our current understanding of early angiosperm ecophysiology. We focus on comparative patterns of ecophysiological evolution, emphasizing carbon‐ and water‐use traits, by merging recent molecular phylogenetic studies with physiological studies focused on extant basal angiosperms. In doing so, we discuss how early angiosperms established a roothold in pre‐existing Mesozoic plant communities, and how these events canalized subsequent bursts of angiosperm diversification during the Aptian–Albian.
Variegation mutants and mechanisms of chloroplast biogenesis
Authors: YU FEI , FU AIGEN , ALURU MANEESHA , PARK SUNGSOON , XU YANG , LIU HUIYING , LIU XIAYAN , FOUDREE ANDREW , NAMBOGGA MILLY , RODERMEL STEVEN 
Published: January 2007

ABSTRACTVariegated plants typically have green‐ and white‐sectored leaves. Cells in the green sectors contain normal‐appearing chloroplasts, whereas cells in the white sectors lack pigments and appear to be blocked at various stages of chloroplast biogenesis. Variegations can be caused by mutations in nuclear, chloroplast or mitochondrial genes. In some plants, the green and white sectors have different genotypes, but in others they have the same (mutant) genotype. One advantage of variegations is that they provide a means of studying genes for proteins that are important for chloroplast development, but for which mutant analysis is difficult, either because mutations in a gene of interest are lethal or because they do not show a readily distinguishable phenotype. This paper focuses on Arabidopsis variegations, for which the most information is available at the molecular level. Perhaps the most interesting of these are variegations caused by defective nuclear gene products in which the cells of the mutant have a uniform genotype. Two questions are of paramount interest: (1) What is the gene product and how does it function in chloroplast biogenesis? (2) What is the mechanism of variegation and why do green sectors arise in plants with a uniform (mutant) genotype? Two paradigms of variegation mechanism are described: immutans (im) and variegated2 (var2). Both mechanisms emphasize compensating activities and the notion of plastid autonomy, but redundant gene products are proposed to play a role in var2, but not in im. It is hypothesized that threshold levels of certain activities are necessary for normal chloroplast development.
Monitoring of peri‐operative fluid administration by individualized goal‐directed therapy
Authors: Bundgaard‐Nielsen M. , Holte K. , Secher N. H. , Kehlet H. 
Published: January 2007

Background:  In order to avoid peri‐operative hypovolaemia or fluid overload, goal‐directed therapy with individual maximization of flow‐related haemodynamic parameters has been introduced. The objectives of this review are to update research in the area, evaluate the effects on outcome and assess the use of strategies, parameters and monitors for goal‐directed therapy.Methods:  A MEDLINE search (1966 to 2 October 2006) was performed to identify studies in which a goal‐directed therapeutic strategy was used to maximize flow‐related haemodynamic parameters in surgical patients, as well as studies referenced from these papers. Furthermore, methods applied in these studies and other monitors with a potential for goal‐directed therapy are described.Results:  Nine studies were identified pertaining to fluid optimization during the intra‐ and post‐operative period with goal‐directed therapy. Seven studies (n= 725) found a reduced hospital stay. Post‐operative nausea and vomiting (PONV) and ileus were reduced in three studies and complications were reduced in four studies. Of the monitors that may be applied for goal‐directed therapy, only oesophageal Doppler has been tested adequately; however, several other options exist.Conclusion:  Goal‐directed therapy with the maximization of flow‐related haemodynamic variables reduces hospital stay, PONV and complications, and facilitates faster gastrointestinal functional recovery. So far, oesophageal Doppler is recommended, but other monitors are available and call for evaluation.
Comparison of inpatient bed rest and home convalescence following split thickness skin grafting to the lower leg
Authors: Tallon Ben G , Oliver G Fergus 
Published: January 2007

SUMMARYThere has been a substantial move towards care of patients in an outpatient setting. This study was performed to determine if discharge home following split thickness skin grafting to the lower leg compromised graft results or morbidity compared with admission to hospital. Cases were reviewed retrospectively from the dermatology department’s surgical records. All split thickness skin grafts to the lower legs over a 12‐month period were included. All clinical notes were reviewed and phone calls made to patients and relatives. A total of 61 cases were included: 31 admitted as inpatients, 30 discharged home. There was no significant difference between the two groups’ age, sex or comorbidities. A trend was seen in inpatients towards increased infection (P = 0.19) and venous thrombosis (P = 0.34). There is a lack of significant difference between admitted and discharged patients in all outcomes including bleeding, number of dressing clinic follow ups and graft loss. These results suggest that home convalescence after split thickness skin grafting to the lower legs compares favourably with inpatient care.
Retrospective review of primary melanomas excised at Waikato Hospital, New Zealand, 2002–2003
Authors: Barker Scott , Oakley Amanda , Rademaker Marius 
Published: January 2007

SUMMARYThe aim of this study was to review and compare melanomas referred by general practitioners and melanomas identified at specialist clinics. The medical records relating to 113 primary melanomas excised at Waikato Hospital (a specialist regional base hospital) during 2002 and 2003 were reviewed retrospectively. Forty‐seven melanomas (41%) were detected when patients attended specialist clinics (mainly plastic surgery and dermatology), and 66 melanomas (59%) were specifically referred by general practitioners. The melanomas detected at specialist clinics had a lower mean Breslow thickness than those referred by general practitioners (0.57 mm compared with 1.45 mm). Patients referred by general practitioners waited a mean of 26.5 days (range 0–94 days) for first specialist assessment. Following specialist assessment, patients waited a mean of 24.2 days (0–81 days) before excision biopsy.
Diffuse cutaneous leishmaniasis in an HIV‐positive patient in western Africa
Authors: Niamba Pascal , Goumbri‐Lompo Olga , Traoré Adama , Barro‐Traoré Fatou , Soudré Robert T 
Published: January 2007

SUMMARYA 36‐year‐old HIV1‐positive woman presented with a 6‐month history of a progressive papular and nodular eruption of the face and subsequent extensive spread to the rest of the skin. The diagnosis of diffuse cutaneous leishmaniasis was established by direct examination and skin biopsy. This atypical form had a dramatic improvement after a 21‐day treatment with meglumine antimoniate. This clinical form may be confused with other endemic diseases in western Africa, especially leprosy.
A 30‐year history of CD4+ vesiculo‐bullous mycosis fungoides and multiple visceral malignancies
Authors: Pearce Annette , Reid Catherine , Gramp Amanda , Sidhu Shireen 
Published: January 2007

SUMMARYAn 83‐year‐old Caucasian woman presented with a 25‐year history of an itchy, eczematous blistering eruption affecting her trunk and acral sites. She had a past history of adenocarcinoma of the lung, colorectal carcinoma and bladder carcinoma. Several skin biopsies consistently showed features of a spongiotic process. Direct and indirect immunofluorescence studies were repeatedly negative, excluding the possibility of an autoimmune blistering disorder. A skin biopsy several years later, however, showed histological and immunophenotypic features of mycosis fungoides. The literature on this rare phenotype of cutaneous T‐cell lymphoma generally portrays a negative prognosis. Our case illustrates an excellent prognosis with stable disease 30 years after onset.
Assessing the evidence for an association between circumferential tumour clearance and local recurrence after resection of rectal cancer
Authors: Dent O. F. , Haboubi N. , Chapuis P. H. , Chan C. , Lin B. P. C. , Wong S. K C. , Bokey E. L. 
Published: January 2007

AbstractObjective  Circumferential resection margin involvement (CRMI) after resection of rectal cancer is regarded as a risk factor for local recurrence. We have been able to identify only nine peer‐reviewed English‐language publications which focus primarily on this association, and they report widely differing rates of local recurrence. The aims of this study were to review possible reasons for this variability and to assess the evidence for the micrometrically measured threshold defining CRMI.Method  Methodological and statistical evaluation of relevant literature.Results  Several factors which could account for this variability are discussed including the nature of the patient series, surgical technique, curative vs palliative resections, pathology technique, the definition of CRMI, adjuvant therapy, tumour stage, definition and ascertainment of local recurrence, length of follow‐up and method of analysis. The objective evidence for the conventional definition of CRMI as tumour 1 mm or less from a circumferential margin is considered along with the evidence supporting a recent proposal that the margin be extended to 2 mm or less. The evidence is numerically weak in both cases and we believe that neither definition should be set in concrete at this stage.Conclusion  Pending further research, we recommend that routine pathology reports should record frank tumour transection, if present, or otherwise report the histological width of the margin between the tumour and the nearest circumferential line of resection in millimetres. The definition of CRMI should be simply histological evidence of tumour in a line of resection, that is, a margin of 0 mm. The definition of CRMI as a margin of 1 mm should not be adopted as a basis for assessing the quality of surgery.
Risk of second primary colorectal cancer with particular reference to age at diagnosis
Authors: O’Dwyer S. T. , Renehan A. G. , Zwahlen M. , Egger M. 
Published: January 2007

Objective:  Patients with a history of colorectal cancer are considered at increased risk of second metachronous colorectal cancer (SM‐CRC), for which they frequently receive intensive colonoscopic surveillance. In view of the ambiguous nature of the existing evidence and the growing interest in targeted surveillance, we sought to quantify long‐term risk with particular reference to age at diagnosis.Method:  The surveillance epidemiology and end results (SEER) database was used to estimate risk of SM‐CRC after first incident colorectal cancer diagnosed between 1975 and 1999. We calculated time‐dependent rates using Kaplan‐Meier estimates and relative risk compared with the US general population.Results:  From 311, 689 eligible patients, there were 6387 SM‐CRCs. At 15 years following initial diagnosis, the SM‐CRC rate was 6.3% (95% CI: 6.1–6.5). For patients with synchronous primary cancers (n = 9936: 3.2%), the 15‐year SM‐CRC rate increased to 10.5% (95% CI: 9.1–12.2). Younger age predicted for increased relative risks but absolute cumulative rates at 15 years were low (Table).

Age groups (years)
20–29
30–39
40–49
50–59
60–69
70–79
80+

Relative risk–men
60.4
15.1
4.52
1.87
1.34
1.28
1.15

Relative risk–women
18.4
9.63
4.08
2.29
1.72
1.46
1.24

Absolute risk–both sexes
3.53
3.74
4.29
4.70
6.15
7.59
7.26

Conclusion:  The long‐term cumulative risk of SM‐CRCs after first colorectal cancer is low, even among younger age patients. These data do not support the routine use of high‐frequency colonoscopy surveillance in patients with a history of colorectal cancer.
Local recurrence after curative resection for rectal cancer – role of the multi – disciplinary team
Authors: Khera G. , Walsh C. J. , Anderson J. A. , El‐Sayed T. Y. , Haylock B. J. , Myint A. S. , Smith D. B. , Makin C. A. 
Published: January 2007

Objective:  We believe optimal management of rectal cancer should be tailored to the individual patient. This is achieved by close liaison within a well established multidisciplinary team (MDT). Patients also benefit from the unusual alliance between our district general hospital (DGH) and regional oncology centre with expertise in radiotherapy for rectal cancer. To test our beliefs we reviewed the incidence of local recurrence following curative resection for rectal cancer.Method:  A total of 201 consecutive cases of rectal cancer treated from 01/04/1999 to 31/03/2002 were reviewed by one author (GK). 100% case note retrieval was achieved of which 122 curative resections were identified (122/201 = 60.7%). Mean follow up 4½ years.Conclusion:  The incidence of local recurrence was 2.5% (3/122). All occurred in patients having Hartmann's operation. There were no local recurrences following anterior resection or abdomino–perineal resection.

Number (%)
Average distance from anal verge (cm)
Number (%) receiving preoperative radiotherapy

Anterior resection
76/122 (62.3)
11.2
13/76 (17.3)

Hartmanns
9/122 (7.4)
8
4/9 (44.4)

Abdomino–perineal Resection
27/122 (22.1)
4.7
11/27 (40.7)

Discussion:  Data support our belief that, combining modern surgical techniques with radiotherapy +/‐ chemotherapy, high quality outcomes are achievable when care is tailored to individuals by a functional MDT.
Abdominal aortic aneurysm repair and colonic infarction: a risk factor appraisal
Authors: Neary P. , Hurson C. , Briain D. O. , Brabazon A. , Mehigan D. , Keaveny T. V. , Sheehan S. 
Published: January 2007

AbstractObjective  Colonic infarction is a recognized complication of abdominal aortic aneurysm (AAA) surgery. The clinical difficulty in establishing the diagnosis combined with the patient's poor physiological status is usually associated with a fatal outcome. We assessed our experience with this problem to identify a possible risk factor profile for these patients.Method  Patients records were identified from the operative logs, intensive care unit, Hospital Inpatient Enquiry system and vascular unit databases over a 6‐year period.Results  A total of 405 patients underwent AAA repair during this period; 140 as emergency ruptures. Nine patients were identified from the databases with known colonic infarction (2.2%). One was a woman. The mean age was 70 years. Seven patients had emergency ruptures (5%). Twenty independent risk factors were analysed using univariate and multivariate logistic regression models. Significant risk factors identified by using a multivariate analysis included the nature of the presenting patient, preoperative hypotension, prolonged cross‐clamp time, intra‐operative ischaemia and postoperative acidosis. Confirmatory diagnosis was made by colonoscopy in eight patients. One patient survived following the salvage surgery. The mean duration of survival was 10.5 days. The overall mortality was 89% of patients.Conclusion  In our unit infrarenal AAA repair has a 2.2% rate of colonic infarction. A definitive diagnosis is best made by colonoscopy. A risk factor profile for the development of colonic infarction may be constructed on the basis of specific clinical parameters. Earlier intervention on the basis of this profile may ultimately reduce the current excessive mortality.
Management of duodenal involvement in locally advanced colonic carcinoma
Authors: Biyani D. K. , Speake D. , Siriwardena A. , Watson A. J. M. 
Published: January 2007

AbstractRemoval of locally advanced right‐sided colonic carcinoma involving the duodenum can be challenging. There are few data on the optimal surgical approach. Adjacent organ involvement is associated with a poor prognosis and may be classified as inoperable with patients having palliative bypass procedures rather than primary resection. Survival is however improved after en bloc resection of adjoining viscera compared with intestinal bypass. We present a variety of surgical options depending on the extent of local invasion and the debility of the patient.
A novel procedure to assess anismus using three‐dimensional dynamic anal ultrasonography
Authors: Murad‐Regadas S. M. , Regadas F. S. P. , Rodrigues L. V. , Souza M. H. L. P. , Lima D. M. R. , Silva F. R. S. , Filho F. S. P. R. 
Published: January 2007

AbstractObjective  This study aimed to determine the value of three‐dimensional (3D) dynamic endosonography in the assessment of anismus.Method  Sixty‐one women submitted to anorectal manometry were enrolled including 40 healthy women and 21 patients with anismus diagnosed by manometry. Patients were submitted to 3D endosonography. Images were acquired at rest and during straining and analysed in axial and midline longitudinal planes. Sphincter integrity was quantified. The angle between the internal edge of the puborectalis with a vertical line according to the anal canal axis was calculated at rest and during straining.Results  The angle increased in 39 of the 40 normal individuals and decreased in all patients with anismus during straining compared with the angle at rest (88.36°) and straining (98.65°) in normal individuals. In the anismus group, the angle decreased at rest (90.91°) and straining (84.89°). The difference between angle sizes in normal and anismus patients during straining was statistically significant (P < 0.5).Conclusion  Three‐dimensional endosonography is a useful method to assess patients with anismus confirming the anorectal manometric results.
Magnetic resonance imaging in the evaluation of pelvi‐ureteric junction obstruction: an all‐in‐one approach
Authors: El‐Nahas Ahmed R. , Abou El‐Ghar Mohamed E. , Refae Huda F. , Gad Hossam M. , El‐Diasty Tarek A. 
Published: January 2007

Authors from Egypt carried out comprehensive MRI in several patients with PUJ obstruction. This included MR urography, dynamic MRI, and MR angiography. They found this method of analysis to be valuable and accurate as a single‐imaging method for evaluating patients with this condition.OBJECTIVETo study the ability of comprehensive magnetic resonance imaging (MRI) to replace multiple imaging methods in the evaluation of patients with pelvi‐ureteric junction obstruction (PUJO).PATIENTS AND METHODSBetween May 2003 and November 2005, 46 consecutive patients (22 male and 24 females; mean age 31.6 years) with symptomatic primary PUJO were included. All had comprehensive MRI, including MR urography (MRU), dynamic MRI and MR angiography (MRA). Morphological results of MRU were compared with that of renal ultrasonography or intravenous urography, while the anatomical results of MRA were compared with the operative findings. A correlation between MR clearance and radioisotope clearance was done using linear regression analysis.RESULTSMRU showed the morphology of the collecting system in all patients, and the ureter below the PUJ in 31 of 46 (67%), but renal stones were missed in three of 10 patients. MRA showed crossing vessels in 22 patients (48%). There was a strong correlation between MR clearance and radioisotope clearance (r = 0.823, P < 0.001). From the MRI results, 35 patients (19 with crossing vessels and 16 with marked hydronephrosis) had pyeloplasty and 11 had an endopyelotomy. Findings during pyeloplasty showed one false‐negative and one false‐positive result of the preoperative MRI. Therefore, the sensitivity, specificity and accuracy of MRA were 95%, 94% and 94%, respectively. The outcome was successful in 44 (96%) patients. One failure after pyeloplasty was managed with endopyelotomy and the other was treated with pyeloplasty after endopyelotomy.CONCLUSIONComprehensive MRI is a valuable and accurate single‐imaging method for evaluating patients with PUJO.