bluuebunny/crossref_metadata_2025_split huggingface dataset:
Empfehlungen zur Mindestbewehrung von schubbeanspruchten Fugen. Ein mechanisches Modell und Ableitungen für die Bemessung
Authors: Lindig Volker 
Published: March 2007

AbstractSowohl Verbundkonstruktionen aus Stahlbetonfertigteilen und Ortbeton als auch nachträglich durch Ortbetonschichten ergänzte Stahlbetontragwerke charakterisieren sich durch das kraftschlüssige Zusammenwirken von Betongrenzflächen unterschiedlichen Alters und unterschiedlicher Festigkeit. Um ein plötzliches Abscheren oder ein Öffnen dieser Grenzflächen in Fugen unter Gebrauchslast zu vermeiden, ist eine Mindestbewehrung erforderlich. In den internationalen Regelwerken sind zur Mindestbewehrung von Verbundfugen sehr unterschiedliche oder keine spezifischen Festlegungen enthalten. Im Beitrag wird ein mechanisches Modell zur Bestimmung der Mindestbewehrungsrate von schubbeanspruchten Fugen abgeleitet. Mit diesem plastischen Ansatz wird die empfohlene Mindestbewehrungsrate für Verbundfugen in Abhängigkeit von der Fugenrauigkeit und den Baustoffkennwerten ermittelt und tabellarisch für in der Baupraxis häufig vorkommende Stahlsorten und Betonfestigkeitsklassen zusammengefasst. Oft genügt diese Mindestbewehrung. Sodann folgen Empfehlungen zur Vereinfachung der Fugenbemessung.
Some aspects of adenocarcinoma of the appendix
Authors: Slack W W 
Published: March 2007

Summary
Five new cases of adenocarcinoma of the appendix are reported. Adenocarcinoma of the appendix must be carefully differentiated from carcinoma of the cæcum and histologically from a carcinoid tumour. In a proportion, some cases present as acute appendicitis; in these only microscopy will reveal the presence of carcinoma. Right hemicolectomy, it is suggested, is the correct treatment, even if this has to be done as a second operation after routine histological examination of the appendix associated with acute appendicitis seems to be relatively poor owing to the diffculties in early diagnosis and the ease with which the tumour can reach the peritoneum. On the other hand, when no overlying acute inflammatory lesion is present, the prognosis is much better.
Spontaneous rupture of the oesophagus
Authors: Hugh T B 
Published: March 2007

AbstractSince the first report by Barrett, in 1947, of successful suture of a spontaneous rupture of the oesophagus, many survivals from this disaster have been reported. Unfortunately the condition is still frequently not diagnosed at an early stage. The history is usually characteristic, with sudden severe retrosternal or interscapular pain following vomiting. When this story is accompanied by rapid respiration and surgical emphysema in the supraclavicular areas, or mediastinal emphysema on radiographs, the diagnosis is certain, although there are pitfalls as the following case illustrates.
Total pelvic exenteration for locally advanced colorectal carcinoma
Authors: Shtrouzu K , Isomoto H , Kakegawa T 
Published: March 2007

Abstract
Twenty-six patients who underwent total pelvic exenteration for locally advanced colorectal cancer were studied retrospectively. The operative mortality rate was 8 per cent (two deaths). In patients with stage II primary disease the recurrence rate after curative surgery was three of seven, although the mean survival time was 58 months and the 5-year survival rate 71 per cent. Patients with stage III primary disease had a shorter mean survival time regardless of supposed curability (curative 14 months versus non-curative 9 months). Patients with stage IV disease had a mean survival time of 5 months. In patients who underwent curative surgery for recurrent disease the mean survival time was 33 months and 5-year survival rate 25 per cent, although in those receiving non-curative surgery the survival time was significantly shorter at 10 months (P &lt; 0.05). Total pelvic exenteration is warranted for patients with stage II locally advanced colorectal carcinoma and is an option for those with recurrent carcinoma when performed with curvative intent.
Importance of human immunodeficiency virus-associated lymphadenopathy and tuberculous lymphadenitis in patients undergoing lymph node biopsy in Zambia
Authors: Bem C , Patil P S , Bharucha H , Namaambo K , Luo N 
Published: March 2007

Abstract
The relative importance of human immunodeficiency virus (HIV)-associated lymphadenopathy amongst patients presenting for lymph node biopsy in Central Africa is unknown. HIV-1 serology and histology of patients undergoing superficial lymph node biopsy during 1989–1990 in Lusaka, Zambia, were examined in a prospective cohort study of HIV serology and by retrospective review of laboratory records. Of 727 lymph nodes biopsied in Lusaka in 1989–1990, 380 (52 per cent) showed tuberculous lymphadenitis, 160 (22 per cent) histology suggestive of primary HIV lymphadenopathy and 66 (9 per cent) nodal Kaposi's disease. HIV serology was tested in 280 adults and was positive in 91 per cent (255 patients), including 89 per cent (153 of 171) of those with tuberculous lymphadenitis, 98 per cent (63 of 64) of those with histology suspicious of primary HIV lymphadenopathy and all (24 of 24) with nodal Kaposi's disease. Other HIV-associated lymphadenopathy included nodal lymphomas and lymphoepithelial cysts. HIV serology was tested in 22 children and was positive in eight, including four of 14 with tuberculous lymphadenitis. It is concluded that HIV-associated lymphadenopathy, especially tuberculous lymphadenitis, is very common amongst patients presenting for lymph node biopsy in Central Africa.
Audit of outcome of major surgery in the elderly
Authors: Walsh T H 
Published: March 2007

Abstract
The clinical outcome of 152 patients aged 65 years or over who were referred to the author's institute between August 1990 and August 1991 with certain specified gastrointestinal malignancies and acute, life-threatening abdominal conditions, were audited concurrently. Two groups were considered: patients aged 65–79 years and those over 80 years. The mortality rate within 30 days of surgery was 14 per cent in both age groups, although significantly fewer patients aged over 80 years (35 of 54) were considered suitable for surgery than in the 65–79 years age group (84 of 98) (0.01 &gt;P&gt;0.001). Morbidity after operation and cost of treatment were not significantly different between the two groups. Two years after surgery 40 per cent of the patients aged over 80 years and 58 per cent of those aged 65–79 years were alive. Quality of life in these survivors was good with 85 per cent of those aged over 80 years living at home and 72 per cent fit enough to undertake light work.
Cell kinetics in vivo of human breast cancer
Authors: Stanton P D , Cooke T G , Forster G , Smith D , Going J J 
Published: March 2007

Abstract
Rates of cell proliferation within tumours may provide prognostic information and help in the rational administration of chemotherapy and radiotherapy. in vivo labelling with 5-bromo-2′-deoxyuridine (BrdU) was used in 89 women with breast cancer to determine the labelling index for BrdU (BLI), the length of S phase (Tg) and the potential doubling time of the tumour (Tpot). Kinetic data were obtained in 84 patients. The median BLI was 3.2 per cent, Ts 12 h, and Tpot 12.5 days. There was no systematic difference in the labelling index determined by flow cytometry and by manual counting on sections. Labelling indices were significantly higher in aneuploid tumours, and in tumours not expressing oestrogen receptors, but were not correlated with tumour size, nodal status, or expression of c-erbB2. In vivo measurement of tumour cell kinetics can be made rapidly and reliably in the majority of human breast cancers, and may have a role to play in planning therapy.
Pattern of recurrence after oesophageal resection for cancer: Clinical implications
Authors: Law S Y K , Fok M , Wong J 
Published: March 2007

Abstract
Patterns of disease recurrence were reviewed in 108 patients who had curative resection for squamous cell cancer of the thoracic oesophagus. At a median follow-up of 20 months, 56 patients (52 per cent) had recurrence. Most presented within 2 years. Extrathoracic recurrence was found in 41 per cent of patients and intrathoracic recurrence in 25 per cent. Systemic organ metastases (26 per cent) were as frequent as intrathoracic recurrences. Twelve patients (11 per cent) developed cervical lymph node (CLN) recurrence; their mean time to recurrencewas 12.6 months, compared with 13.1 months for recurrence at locations other than the neck (P = 0.8). Median survival was 23 and 13 months respectively (P = 0.27). Preoperative chemotherapy lowered the recurrence rate from 60 per cent to 30 per cent, (P = 0.01) but did not affect survival. The addition of cervical lymphadenectomy would benefit few patients and must be counterbalanced with increased morbidity and cost. The frequency of systemic organ metastases calls for further investigation of the possible benefits of chemotherapy.
Management of intestinal obstruction after gastrectomy for carcinoma
Authors: Nakane Y , Okumura S , Akehira K , Okamura S , Boku T , Okusa T 
Published: March 2007

Abstract
Intestinal obstruction after operation for gastrointestinal cancer may be due to postoperative adhesions, a focal, potentially resectable, malignant deposit or diffuse carcinomatosis1,2. It is commonly assumed that the obstruction is due to advanced malignancy and that death is inevitable.
Effects and limitations of prolonged intermittent ischaemia for hepatic resection of the cirrhotic liver
Authors: Wu C-C , Hwang C-R , Liu T-J , P'eng F-K 
Published: March 2007

Abstract
Intermittent clamping of the hepatic pedicle during hepatectomy may reduce operative bleeding, but its limitations and long-term effects on the cirrhotic liver are unknown. Eighty-three patients with cirrhosis undergoing hepatectomy with repeated clamping for 15 min and declamping for 5 min were divided into three groups based on total clamping duration: group 1 less than 40 min (39 patients); group 2 40–80 min (28); group 3 more than 80 min (16). Larger tumours were associated with longer ischaemia times (P = 0.002), longer operating times, greater operative blood loss and increased blood transfusion requirements (P&lt; 0.001), and resulted in higher postoperative levels of serum transaminases and lactic dehydrogenase (P&lt; 0.001). Operative morbidity and mortality rates, and the late hepatic failure rate, were not affected. The longest total ischaemia time was 204 min but the uppermost time limit for hepatic ischaemia remains to be determined.
Intestinal barrier dysfunction in clinical and experimental obstructive jaundice and its reversal by internal biliary drainage
Authors: Parks R W , Clements W D B , Smye M G , Pope C , Rowlands B J , Diamond T 
Published: March 2007

Abstract
Intestinal mucosal barrier function in obstructive jaundice was assessed in an animal model and in patients. The effect of internal biliary drainage in patients was also examined. Bile duct ligation for 1 week in the rat resulted in significant bacterial translocation (in seven of 12 animals following ligation versus none of the sham-operated controls, P&lt;0·01). Intestinal permeability, measured by the urinary recovery of orally administered polyethylene glycol, was also significantly increased (+ 66·2 per cent for ligation versus −11·6 per cent for sham, P&lt;0·01). A prospective study was performed on 33 patients with obstructive jaundice undergoing internal biliary drainage, and results were compared with those in six non-jaundiced patients undergoing laparotomy or endoscopic retrograde cholangiopancreatography and in 11 healthy volunteers. The lactulose: mannitol ratio was used as an intestinal permeability index. Mean(s.e.m.) intestinal permeability assessed before operation was significantly increased in jaundiced patients compared with control patients (0·050(0·010) versus 0·016(0·003), P&lt;0·005). The mean(s.e.m.) lactulose: mannitol ratio in the healthy volunteers was 0·020(0·003), which was similar to that in control patients. In the jaundiced group of patients the intestinal permeability index fell to within normal levels after 28 days of internal biliary drainage (0·050 before operation versus 0·021 at 28 days, P&lt;0·02). These data indicate that intestinal barrier function is impaired in obstructive jaundice and that this impairment is reversed by return of bile to the gastrointestinal tract.
A 4-year prospective audit of the cause of death after infrarenal aortic aneurysm surgery
Authors: Sandison A J P , Panayiotopoulos Y , Edmondson R C , Tyrrell M R , Taylor P R 
Published: March 2007

Abstract
This study was a 4-year prospective audit of abdominal aortic aneurysm surgery including 222 aneurysm repairs: 106 elective, 76 urgent and 40 emergency. Twenty-five patients died: four who underwent elective surgery, seven urgent and 14 emergency. The two major causes of death, multiple organ failure and colonic ischaemia, were responsible for 11 of the 25 deaths. The three deaths from myocardial infarction all occurred in patients with a leaking aneurysm. Blood loss was significantly higher in patients with multiple organ failure and in those with colonic ischaemia. Methods to identify patients at high risk of massive blood loss and colonic ischaemia may be a way to reduce mortality.
Disconnection, pouch revision and reconnection of the ileal pouch-anal anastomosis
Authors: Sagar P M , Dozois R R , Wolff B G , Kelly K A 
Published: March 2007

AbstractThe aim of this retrospective study was to determine the outcome of patients with a dysfunctional pelvic ileal reservoir in whom disconnection of an ileal pouch-anal anastomosis (IPAA), pouch revision and reanastomosis had been carried out. There were 23 patients (15 women). At the revision operation functional problems were found to be due to a long efferent spout (nine patients), sepsis and/or fistula (four), a redundant blind limb (three), a twisted pouch (three), anastomotic problems (three) or no reservoir (one). The pouch was salvaged in 16 patients and a new pouch was constructed in seven. The pouch-anal anastomosis was resutured in 22 patients and stapled in one. Postoperative complications (all minor) occurred in six patients. Two patients underwent two revisions of IPAA. At a median follow-up of 5 (range 1–10) years, 11 patients reported good to excellent function, five reported fair function and one reported recurrent pouchitis. Revision surgery was unsuccessful in six of 23 patients (three had gross incontinence, two excessive bowel movements and one Crohn's disease), and they subsequently underwent pouch excision. It is concluded that revision of an ileal reservoir and IPAA can be undertaken safely with good results in carefully selected patients.
Conservative management of infective mastitis and breast abscesses after ultrasonographic assessment
Authors: O'Hara R J , Dexter S P L , Fox J N 
Published: March 2007

Abstract
Current practice in this unit for a suspected breast abscess is preliminary ultrasonographic scan, aspiration of any pus, antibiotic therapy and repeat aspiration in the outpatient clinic if necessary. Inflammatory masses are treated with antibiotics alone. A retrospective review of this strategy has been made. Over a 2-year interval 53 patients were admitted to hospital with a suspected breast abscess. Twenty-two abscesses were aspirated, of which 19 resolved and three required subsequent incision and drainage. Eight patients underwent primary incision and drainage, one of whom required a second drainage procedure. In five patients the abscess discharged spontaneously before intervention. The remaining 18 patients were found on ultrasonography to have inflammation without evidence of focal pus which settled with antibiotic therapy in all but two patients. One of these was found to have an inflammatory cancer and the other developed an abscess, which was drained. Aspiration combined with ultrasonographic imaging is an effective alternative to incision and drainage.
Hepatobiliary anatomy in patients with transposition of the gallbladder: Implications for safe laparoscopic cholecystectomy
Authors: Idu M , Jakimowicz J , Iuppa A , Cuschieri A 
Published: March 2007

Abstract
The surgical anatomy of six patients with sinistroposition of the gallbladder is described. Five of these were encountered in a consecutive series of 1764 patients undergoing laparoscopic cholecystectomy for symptomatic gallstone disease in two hospitals between 1989 and 1994, a prevalence of 0·3 per cent in patients undergoing this operation. Despite the left-sided transposition of the gallbladder, the biliary pain experienced by these patients was always on the right side. Preoperative diagnosis of this anomaly was made in only one of six patients despite routine preoperative external ultrasonography and selective preoperative cholangiography. In sinistroposition the cystic artery always crosses in front of the common bile duct from right to left. The cystic duct may open on the left or right side of the common hepatic duct. The anomaly does not preclude safe laparoscopic cholecystectomy but modifications of the port sites and use of the falciform lift facilitate the procedure in these cases. The anatomical features of the sixth case encountered in a patient undergoing resection of hilar cholangiocarcinoma indicate that sinistroposition of the gallbladder may be due to failure of development of segment IV of the liver.
Abdominal wounds in war
Authors: Coupland R 
Published: March 2007

Abstract
The reported mortality rate associated with abdominal wounds sustained in war varies considerably because of the heterogeneity of wounds and the different circumstances under which figures have been collected rather than different treatment strategies. This review draws together a personal experience, reports from ten wars, and information from a database for war wounded into an analysis of abdominal wounds. The analysis attempts to bring understanding to why people die with abdominal wounds in war and so clarifies logistic and treatment issues.
Surgery for biliary obstruction by tumour thrombus in primary liver cancer
Authors: Tantawi B , Cherqui D , van Nhieu J Tran , Kracht M , Fagniez P L 
Published: March 2007

Abstract
Five patients with primary liver cancer presented with obstructive jaundice due to extension of tumour thrombus into the biliary ducts. Three patients had hepatocellular carcinoma, two of whom had alcoholic cirrhosis, and the other two had a peripheral cholangiocarcinoma. Preoperative diagnosis of biliary thrombus was best achieved by ultrasonography and computed tomography which showed peripheral hepatic tumour with dilated bile ducts containing dense material. All patients underwent liver resection associated with biliary exploration, clearance and T-tube drainage. Major hepatectomy was required in four cases. There were no postoperative deaths; one patient developed a subphrenic collection of bile which was drained percutaneously. All patients survived more than a year; median survival was 29 months. There are two long-term survivors without recurrence at 29 and 80 months. Patients with primary liver cancer and jaundice due to migrated tumour fragments in the common bile duct may benefit from surgical resection which can result in long-term resolution of symptoms and occasional cure.
Clinical anatomy of the C1 dorsal root, ganglion, and ramus: A review and anatomical study
Authors: Tubbs R. Shane , Loukas Marios , Slappey John B. , Shoja Mohammadali M. , Oakes W. Jerry , Salter E. George 
Published: March 2007

AbstractDiscrepancies abound in the literature regarding the anatomy and incidence of the C1 dorsal roots, ganglia, and rami. The present study was performed to elucidate further the detailed anatomy of these structures and to review their clinical relevance. Thirty‐adult cadavers were used for this study. The mean age for this group was 72 years. C1 and C2 spinal nerves were identified in 100% of the specimens examined. In 46.6% of specimens, C1 dorsal rootlets were identified and of these, 28.5% had an associated dorsal root ganglion. In 50% of specimens, the spinal accessory nerve joined with dorsal rootlets of C1. C1 in these cases did not possess a dorsal root ganglion. There were no significant differences between left sides, gender, and age (P > 0.05). Additional knowledge regarding the C1 dorsal roots, ganglia, and rami may be of use to the clinician who treats various pain syndromes including medically and surgically intractable occipital neuralgia. Clin. Anat. 20:624–627, 2007. © 2007 Wiley‐Liss, Inc.
A geometric basis for calculation of right ventricular volume in man
Authors: Boak J. Gordon , Bove Alfred A. , Kreulen Thomas , Spann James F. 
Published: March 2007

AbstractA clinically applicable method for determining right ventricular volume was developed using a new hemielliptical model. The model was derived from a detailed study of right ventricular geometry. Silicone rubber casts were made from 7 adult human right ventricles at autopsy. Cast volumes measured by water displacement ranged from 30 to 144 ml. Serial sections were made of each cast, and the product of the long and short axis of all sections was found to be directly related to the cross‐sectional area and independent of the region or the volume of the ventricle from which the slice originated. Further, using a hemielliptical model, the volume V of each ventricle could be calculated from the equation: V = (π/4) Σ dwh where, d is the depth, w is the width parallel to the septum, and h is the thickness of the cross section. Calculated volume agreed closely with displacement volume throughout (r equals; 0.99, slope equals; 1.05 ± 0.04, intercept equals; −3.6 ± 4., SEE equals; 4.27 ml). Using the same model, calculation of right ventricular surface area was found to agree closely with measured surface area (r equals; 0.99, slope equals; 0.94, intercept equals; −.6, SEE equals; 3.9).This model can be used to calculate right ventricular volumes from biplane radiographs in man using the equation V equals; (π/4)(ARAO·ALAO)/HsbL where ARAO equals; the area of the 30° right anterior oblique image, A, HL equals; the area and height respectively of the 60° left anterior oblique image. For all 7 casts, radiographic volume agreed closely with directly measured volume (slope equals; 0.97, intercept equals; −5.5, r equals; 0.99, SEE equals; 4.7). Evaluation of positional effects showed that radiographic volume was most accurate when the 30° RAO/60° LAO projections were used. This study provides a method of calculating right ventricular volume, based upon right ventricular geometry, that may be applied to evaluating the volume of the right ventricle in man.
Coronary artery fistula: Estimation of shunt using 99m Tc‐Albumin particles
Authors: Blau Nathan , Adatepe Mustafa H. , Begg Frank R. 
Published: March 2007

AbstractA 60‐year‐old man presented with complaints of angina pectoris and was found to have a coronary artery fistula between his left main trunk and main pulmonary artery. Particles of 99m Tc‐Albumin were injected in the ostium of the left coronary artery, and differential radioactive counts were obtained over both lung fields and myocardium. The degree of left to right shunt was calculated at 56% of total left coronary artery flow. The patient underwent ligation of the fistula without any complications. This case report represents a new application of myocardial radioisotopic scanning.
Plain film identification of failure of interior vena caval‐right atrial continuity
Authors: Folger Gordon M. 
Published: March 2007

AbstractThe identification of absence of continuity of the inferior vena cava (IVC) with the right atrium assumes major importance at the time of right heart catheterization. The appearance of the IVC in the lateral chest radiogram is diagnostically different from the normal when discontinuity is present and 2 radiographic patterns have been recognized: 1) total absence of the IVC shadow; 2) straightened and posteriorly directed IVC shadow contrasting sharply with the anteriorly directed normally continuous IVC. This latter sign is considered reproducibly accurate in the identification of the IVC which fails to have continuity with the right atrium.