bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histomorphometric features of hydatidiform moles in early pregnancy: relationship to detectability by ultrasound examination
Authors: Fowler D. J. , Lindsay I. , Seckl M. J. , Sebire N. J. 
Published: December 2006

AbstractObjectiveThe majority of partial (PHM) and complete (CHM) hydatidiform moles are diagnosed in early pregnancy. About half are identified as molar on ultrasonographic examination prior to evacuation. It is uncertain whether unsuspected cases represent an intrinsically different molar phenotype or are simply dependant on sonographer expertise. We measured a microscopic parameter, average villus diameter, of evacuated PHMs and CHMs to ascertain the cause of non‐detection on ultrasound.MethodsFifty‐four molar pregnancies were examined from the files of the Trophoblastic Disease Unit, in which results of an ultrasound examination prior to evacuation were known. In each, the average cross‐sectional diameter of the largest 10 villi was recorded. Maximum villus diameters were compared between gestational age groups (<14 weeks and ≥14 weeks), and ultrasound detection groups (detected (d) and not detected (nd)).ResultsThe average maximum villus diameter of the largest hydropic villi was significantly less in the first trimester for both PHMs and CHMs that were undetected by ultrasound examination compared to those identified as molar sonographically (P < 0.001 and P < 0.001, respectively). There was no significant difference in the maximum villus diameter between PHMs and CHMs that were not detected sonographically in the first trimester (P = 0.44). Beyond 14 weeks of gestation, there was no significant difference between PHMs detected and undetected sonographically (P = 0.88).ConclusionThe average diameter of the largest, most hydropic villi, is significantly greater in cases of PHMs and CHMs detected by ultrasound examination in the first trimester compared to that of those not detected sonographically, but beyond 14 weeks such differences are minimal. These findings suggest that, although sonographer expertise could potentially increase ultrasound detection rates somewhat for PHMs and CHMs, a significant proportion of cases demonstrate minimal hydropic change in the first trimester and are therefore likely to remain unidentifiable by ultrasound examination prior to evacuation, even with improved sonographer expertise. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
Frontomaxillary facial angle at 11 + 0 to 13 + 6 weeks' gestation—reproducibility of measurements
Authors: Plasencia W. , Dagklis T. , Sotiriadis A. , Borenstein M. , Nicolaides K. H. 
Published: December 2006

AbstractObjectiveTo assess the intra‐ and interobserver reproducibility in the measurement of the frontomaxillary facial (FMF) angle at 11 + 0 to 13 + 6 weeks' gestation and to investigate the effect of deviations from the exact mid‐sagittal view on these measurements.MethodsThree‐dimensional (3D) volumes of the fetal face were used by two operators to measure the FMF angle in 50 chromosomally normal and 50 trisomy 21 fetuses. The measurements were taken in the exact mid‐sagittal view and repeated after lateral rotation of the head by 5°, 10° and 15° away from the vertical position of the occipitofrontal diameter axis. Mean difference and 95% limits of agreement between paired measurements of FMF angle by the same and by two different sonographers were determined.ResultsIn the mid‐sagittal plane the maxillary bone was rectangularly shaped. Rotation away from this plane became easily recognizable because at a mean of 7° (range, 4–10°) the shape of the maxilla changed with the appearance of the zygomatic process of the maxilla and at a mean of 8° (range, 4–12°) the tip of the nose became invisible. In both the normal and trisomy 21 fetuses the FMF angle measured at 5–15° was not significantly different from the one measured in the mid‐sagittal plane. In 95% of the cases, the difference between paired measurements of the FMF angle by the same sonographer at the mid‐sagittal plane was between − 2.3° and 3.0° and at 15° it was − 1.0° to 6.8°. At the mid‐sagittal plane, the difference in measurements between two sonographers was − 3.1 to 3.0°.ConclusionThe landmarks that define the mid‐sagittal plane of the fetal face are the tip of the nose and the rectangularly shaped maxilla. Measurement of the FMF angle is highly reproducible. Copyright © 2006 ISUOG. Published by John Wiley & Sons, Ltd.
Postoperative Glycemic Control after Central Pancreatectomy for Mid‐gland Lesions
Authors: Allendorf John D. , Schrope Beth A. , Lauerman Margaret H. , Inabnet William B. , Chabot John A. 
Published: December 2006

AbstractIntroductionPatients undergoing partial pancreatectomy are at risk for developing surgically induced diabetes. Patients with lesions in the neck and body of the pancreas are at increased risk because traditional resectional approaches (pancreaticoduodenectomy or distal pancreatectomy) must be extended to remove the tumor with adequate margins. Increasingly, we have been performing pancreatic parenchyma‐sparing resections (central pancreatectomy with pancreaticogastrostomy) in an effort to reduce the risk of postpancreatectomy endocrine insufficiency.MethodsThe operative records of patients who underwent pancreatectomy at our institution from 1999 to 2005 were reviewed. We identified 26 patients who underwent central pancreatectomy with pancreaticogastrostomy reconstruction for cystic lesions (n = 23), neuroendocrine tumors (n = 2), and Frantz’s tumor (n = 1). Charts were reviewed for patient demographics, volume of resection, complications, and evaluation of postoperative glycemic control.ResultsThe mean follow‐up was 33 months (range 3–72 months). The average volume of pancreas resected was 49.6 ± 38.6 cm3, and the mean diameter of the lesions was 2.6 ± 1.5 cm. Nine complications occurred in eight patients (overall morbidity 31%), and the average length of stay was 6.9 ± 2.7 days. Pancreatic leaks (n = 2; 7.7%) were successfully managed nonoperatively. There was no operative mortality, and there has been no tumor recurrence. None of the patients were diabetic preoperatively. Postoperatively, two (7.7%) developed endocrine insufficiency with a mean postoperative hemoglobin A1c (HbA1c) value of 7.65%. Neither patient has required exogenous insulin. HbA1c in the remaining patients was 5.9% ± 0.5%.ConclusionsPancreatic parenchyma‐sparing surgery for lesions in the midportion of the gland can be performed with acceptable morbidity. Postoperative glycemic control after pancreatic parenchyma‐sparing surgery compares favorably with that reported for patients with traditional resections.
Prognostic Implication of Para‐aortic Lymph Node Metastasis in Resectable Pancreatic Cancer
Authors: Doi Ryuichiro , Kami Kazuhiro , Ito Daisuke , Fujimoto Koji , Kawaguchi Yoshiya , Wada Michihiko , Kogire Masafumi , Hosotani Ryo , Imamura Masayuki , Uemoto Shinji 
Published: December 2006

AbstractBackgroundThe survival curve of patients who undergo surgical resection of pancreatic cancer displays a steep decline within 1 year and a relatively slow decline thereafter. The patients with a short survival time may have identifiable clinicopathologic factors that lead to rapid relapse.Study DesignWe analyzed clinicopathologic factors in 133 patients who underwent margin‐negative pancreatoduodenectomy with extended radical lymphadenectomy for invasive ductal carcinoma of the pancreas to detect factors that could be responsible for the short survival.ResultsTumor size, invasion of the anterior pancreatic capsule, retroperitoneal invasion, portal venous invasion, major arterial invasion, and metastasis to the para‐aortic lymph nodes were variables associated with survival time in univariate analysis. Metastasis to the para‐aortic lymph nodes was the single independent factor with a significant association with mortality in multivariate analysis. Some 84% of the patients who had positive para‐aortic lymph nodes died within 1 year, versus 46% of the patients with negative nodes.ConclusionsAlthough tumors that involve the para‐aortic lymph nodes may technically be resectable, the expected postoperative survival time for most patients is less than 1 year. If para‐aortic nodal metastasis is detected, alternative treatment strategies should be considered.
Impact of Methicillin‐resistant Staphylococcus aureus Infection on Outcome after Esophagectomy
Authors: Bowrey David J. , Evans Martyn D. , Clark Geoffrey W. B. 
Published: December 2006

AbstractBackgroundInfection with methicillin‐resistant Staphylococcus aureus (MRSA) has reached endemic proportions in the United Kingdom. The aim of the present study was to determine the frequency of MRSA infection in patients undergoing esophagectomy and to report its impact on patient outcome.Patients and MethodsThe study population was 98 patients undergoing esophagectomy for carcinoma during the years 1998–2004. Patient information was collected prospectively and entered into a computerized database and analyzed retrospectively by univariate and multivariate analysis.ResultsOverall, 20 of the 98 patients (20%) developed infection with MRSA after esophagectomy. Patients who developed MRSA infection had greater levels of postoperative morbidity, longer intensive care unit (ICU) stays (median 2 days versus 1 day, P = 0.005) and hospital stays (21 days versus 16 days, P < 0.001) compared to those who did not develop infection. Multivariate analysis identified preoperative chemotherapy (P = 0.006) and readmission to the ICU (P = 0.007) as significant risk factors with MRSA infection. Overall, 17 of 46 patients (37%) who received neoadjuvant chemotherapy developed MRSA infection, compared to 3 of 52 (6%) who did not receive this treatment (P = 0.0001).ConclusionsOverall, one in five patients undergoing esophagectomy developed MRSA infection, with those patients who received neoadjuvant chemotherapy identified as being at greatest risk of this complication. This is an alarming finding, as neoadjuvant chemotherapy is the standard of care for patients with esophageal carcinoma in the United Kingdom.
Effect of 5‐Fluorouracil plus Interferon on the Integrity of Colonic Anastomoses Covering with Fibrin Glue
Authors: Kanellos D. , Blouhos K. , Pramateftakis M. G. , Kanellos I. , Demetriades H. , Sakkas L. , Betsis D. 
Published: December 2006

AbstractBackgroundIt has been well established that the immediate postoperative intraperitoneal administration of chemotherapeutic agents such as 5‐fluorouracil (5‐FU) after curative colon resection for colon cancer destroys disseminated cancer cells and inhibits micrometastases but also inhibits anastomotic healing. On the other hand, the application of fibrin glue constitutes a physical barrier around the anastomosis and may prevent anastomotic leakage. The purpose of this experimental study was to determine the effect of 5‐FU plus interferon (IFN)‐α‐2a on the integrity of colonic anastomoses covered with fibrin glue when injected intraperitoneally immediately after colon resection.Materials and MethodsSixty rats were randomized to one of four groups. After resection of a 1‐cm segment of the transverse colon, an end‐to‐end sutured anastomosis was performed. Rats of the control and the fibrin glue groups were injected with 6 ml of 0.9% sodium chloride (NaCl) solution intraperitoneally. Rats in the 5‐FU + IFN and the 5‐FU + IFN + fibrin glue groups received 5‐FU plus IFN intraperitoneally. The colonic anastomoses of the rats in the fibrin glue and in the 5‐FU + IFN + fibrin glue groups were covered with fibrin glue. All rats were sacrificed on the 8th postoperative day, and the anastomoses were examined macroscopically. The bursting pressure measurements were recorded, and the anastomoses were graded histologically.ResultsOnly the 5‐FU + IFN group had anastomoses rupture, and the rupture rate (33%) in this group was significantly greater than in the other groups, where there were no ruptures (P= 0.015). The adhesion formations score was, on average, significantly higher in rats of the 5‐FU + IFN group compared with the control group (P= 0.006) and the 5‐FU + IFN + fibrin glue group (P= 0.010). Bursting pressures were significantly lower in the control group when compared to the fibrin glue and 5‐FU + IFN + fibrin glue group (P< 0.001). Rats in the 5‐FU + IFN + fibrin glue group developed significantly more marked neoangiogenesis than rats in the other groups. Inflammatory cell infiltration, collagen deposition, and fibroblast activity did not differ significantly among the four groups (P= 0.856,P= 0.192 andP= 0.243, respectively).ConclusionThe immediate postoperative intraperitoneal administration of 5‐FU plus IFN impairs colonic healing. However, when the colonic anastomoses were covered with fibrin glue, the injection of 5‐FU plus IFN had no adverse effects on the integrity of the anastomoses.
Carcinoma of the Ampulla of Vater: Factors Influencing Long‐term Survival of 127 Patients with Resection
Authors: Qiao Qi‐lu , Zhao Yi‐guo , Ye Mu‐lin , Yang Yin‐mo , Zhao Jian‐xun , Huang Yan‐ting , Wan Yuan‐lian 
Published: December 2006

AbstractIntroductionThe prognosis for patients with carcinoma of the ampulla of Vater is improved relative to other periampullary neoplasms. Identification of independent prognostic factors in ampullary carcinomas has been limited by the small number of tumors resected. The aim of the present study was to determine the clinicopathologic factors that influence long‐term survival in patients with resected ampullary carcinoma.MethodsClinicopathologic data were retrospectively reviewed for patients with ampullary carcinomas radically resected between March 1987 and September 2002. The correlation between clinicopathologic variables and survival of patients after resection was examined by the Kaplan‐Meier method, the log‐rank test, and Cox proportional hazards regression. Ampullary carcinomas were radically resected in 127 patients either by pancreaticoduodenectomy (n = 124) or local resection (n = 3).ResultsHospital mortality was 9.7%. The overall actuarial survival rates (including hospital deaths) at 1, 3, 5, and 10 years were 76.2%, 46.8%, 43.3%, and 35.7%, respectively. Factors that significantly influenced survival were lymph node status (P < 0.001), depth of tumor infiltration (P = 0.029), and TNM stage (P < 0.001) on univariate analysis. On multivariate analysis, both depth of infiltration and lymph node status were the independent determinants of survival after resection (P = 0.003, P = 0.005, respectively).ConclusionsCarcinoma of the ampulla of Vater has a higher resectability rate and a much better survival rate than pancreatic cancer. Pancreaticoduodenectomy is the treatment of choice for this tumor. Long‐term survival was independently influenced by the depth of tumor infiltration and lymph node metastasis.
Blood Perfusion of the Free Anterolateral Thigh Perforator Flap: Its Beneficial Effect in the Reconstruction of Infected Wounds in the Lower Extremity
Authors: Gravvanis Andreas , Tsoutsos Dimosthenis , Karakitsos Dimitrios , Iconomou Thomais , Papadopoulos Othon 
Published: December 2006

AbstractBackgroundIn a prospective study, we evaluated the blood perfusion and the blood flow of anterolateral thigh (ALT) flap by both near‐infrared spectroscopy and color Doppler ultrasonography. Moreover, we assessed the ability of the perforator flap to reconstruct infected wounds of the lower extremity in 11 patients.MethodsNear‐infrared spectroscopy showed excellent oxygen saturation, and Doppler ultrasonography documented excellent blood flow and decreased vascular resistance in the ALT flap postoperatively.ResultsAll flaps were successful and all wounds healed uneventfully within 2 weeks without any signs of recurrences or persistent infection. All patients achieved acceptable gait function after rehabilitation.ConclusionsApart from the mandatory role of thorough debridement, our results indicate that the ALT flap offers rich blood supply to the recipient area, thus contributing to the sterilization and healing of an infected wound within a short time period.
Early Video‐Assisted Thoracic Surgery for Primary Spontaneous Hemopneumothorax
Authors: Chang Yu‐Tang , Dai Zen‐Kong , Kao Eing‐Long , Chuang Hung‐Yi , Cheng Yu‐Jen , Chou Shah‐Hwa , Huang Meei‐Feng 
Published: December 2006

AbstractIntroductionPrimary spontaneous hemopneumothorax (PSHP) is a rare surgical emergency. The aim of this study was to compare the previous strategy of tube thoracostomy followed by thoracotomy when complications developed with early video‐assisted thoracic surgery (VATS) for PSHP.MethodsBetween November 1989 and May 2005, a total of 24 consecutive patients with PSHP were retrospectively reviewed. Before January 2000, there were 13 patients who were subjected to the treatment strategy of initial tube thoracostomy and underwent operation if the condition deteriorated or later complications occurred (group T). Under this strategy, all of these patients later required operations. After January 2000, another 11 patients were treated with VATS as soon as their condition stabilized after tube thoracostomy and resuscitation (group V). The data for the two groups were compared: sex, age, involved side, initial heart rate (HR) and mean blood pressure (BP), initial hemoglobin (Hb), preoperative blood loss, operating time, amount of blood transfusion, period of chest tube drainage (POD), length of hospital stay (LOS), complications, and length of follow‐up.ResultsThe sex, age, involved side, and the initial HR, BP, and Hb of the two groups were similar. The patients of group V had a significantly longer operating time [group V, 111 minutes (mean); group T, 85 minutes, P = 0.002]; less preoperative blood loss (group V, 946 ml; group T, 1687 ml, P = 0.003); less blood transfusion (group V, 465 ml; group T, 1044 ml, P = 0.002); shorter POD (group V, 4 days; group T, 7 days, P = 0.011); and shorter LOS (group V, 5 days; group T, 10 days, P = 0.002). No mortality or recurrence was noted in the entire series.ConclusionsOur study suggests that surgery should be undertaken for PSHP as soon as possible after the clinical condition has stabilized. Under this strategy, VATS is an acceptable approach. It allows a shorter hospital stay and is exempt from unnecessary blood transfusion. Later complications, such as empyema and impaired lung reexpansion, can also be avoided.
Selected Patients with Metastatic Melanoma May Benefit from Liver Resection
Authors: Herman Paulo , Machado Marcel Autran C. , Montagnini André Luis , D’Albuquerque Luiz A. C. , Saad William A. , Machado Marcel C. C. 
Published: December 2006

AbstractBackgroundIn the last few years there has been expanding use of hepatic resection for non‐colorectal metastases. The purpose of this study is to evaluate the experience of liver resection for patients with metastatic melanoma.MethodsEighteen patients with metastatic melanoma were explored for possible surgical resection. All patients fitted the following criteria: absence of extra‐hepatic disease after evaluation with CT/MRI and FDG‐PET scans; disease‐free interval longer than 24 months after the resection of the primary melanoma; presumed completely resectable lesions; absence of clinical co‐morbidities.ResultsLiver resection was performed in 10 patients; 8 out of 18 presented with irresectable tumors and/or peritoneal metastases and were not operated. One patient presented with postoperative biliary fistula and was conservatively managed. No other complications or postoperative mortality were observed. After a mean follow‐up of 25.4 months, 5 patients are alive and without evidence of recurrence. Overall median survival was 22 months; overall survival and disease‐free survival were 70% and 50% respectively.ConclusionsResection of liver metastases from melanoma in a selected group of patients may increase survival. Exploratory laparoscopy should be included in the preoperative armamentarium of diagnostic tools.
Spleen‐preserving Distal Pancreatectomy with Excision of Splenic Artery and Vein: A Case‐matched Comparison with Conventional Distal Pancreatectomy with Splenectomy
Authors: Carrère Nicolas , Abid Skander , Julio Charles Henri , Bloom Eric , Pradère Bernard 
Published: December 2006

AbstractBackgroundThe value of spleen preservation during distal pancreatectomy (DP) still remains controversial. Spleen‐preserving DP with excision of the splenic artery and vein is a simplified technique for spleen preservation. The aim of this study was to compare the postoperative course of DP with or without splenectomy.Patients and MethodsFrom 1990 to 2005, 38 consecutive patients with benign or low‐grade malignant disease underwent a spleen‐preserving DP operation with excision of the splenic artery and vein (Conservative Group). They were compared with 38 patients who underwent conventional DP with splenectomy over the same time period (Splenectomy Group) and who had been matched for age, American Society of Anesthesiologists (ASA) score, and pathological diagnosis. Postoperative courses were analyzed and compared between the Conservative Group and Splenectomy Group.ResultsSpleen preservation was effective in 36 of the 38 attempts (95%). Postoperative complications – in particular, infectious intra‐abdominal complications – were significantly higher in the Splenectomy Group (34 and 18%, respectively) than in the Conservative Group (13 and 3%, respectively) (P = 0.03 and P = 0.02, respectively). The length of the surgery, perioperative blood loss or transfusions, perioperative mortality and length of hospital stay did not differ between the two groups. Univariate analysis showed that splenectomy was the only risk factor for postoperative complication.ConclusionsSpleen‐preserving DP with excision of the splenic artery and vein is a fast, safe and effective procedure associated, in this series, with a reduction of postoperative complications relative to conventional DP with splenectomy. This technique should be considered in patients with benign or low‐grade malignant disease of the pancreas.
Electrically tunable solid-state silicon nanopore ion filter
Authors: Vidal Julien , Gracheva Maria E. , Leburton Jean-Pierre 
Published: December 2006

Abstract
We show that a nanopore in a silicon membrane connected to a voltage source can be used as an electrically tunable ion filter. By applying a voltage between the heavily doped semiconductor and the electrolyte, it is possible to invert the ion population inside the nanopore and vary the conductance for both cations and anions in order to achieve selective conduction of ions even in the presence of significant surface charges in the membrane. Our model based on the solution of the Poisson equation and linear transport theory indicates that in narrow nanopores substantial gain can be achieved by controlling electrically the width of the charge double layer.
Application of enzymes to the synthesis of amino acid‐based bola and gemini surfactants
Authors: Valivety Rao , Gill Iqbal S. , Vulfson Evgeny N. 
Published: December 2006

AbstractA facile and flexible chemoenzymatic route for the preparation of a variety of amino acid‐based surfactants ranging from simple monoesters to more complex bola‐ and gemini‐amphiphiles is described. The methodology is based on the observation that some lipases, notably immobilized Candida antarctica and Rhizomucor miehei, readily accept N‐Cbzamino acids as substrates and catalyze their esterification/amidation with long‐chain alcohols and α,ω‐diols/α,ω‐diamines in excellent yield. The resulting alkanediyl‐α,ω‐bis‐(N‐Cbz‐amino acid) can be either deprotected using conventional procedures to attain a number of multifunctional bola‐amphiphiles or further modified to obtain a range of amino acid‐based gemini surfactants.