bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical lidocaine effectively reduced the increase of systolic blood pressure after side‐clamping of the aorta in off‐pump cardiac surgery
Authors: Kweon T. D. , Kim S. H. , Oh Y. J. , Shim J. K. , Hong Y. W. , Kwak Y.‐L. 
Published: August 2006

Background:  Side‐clamping of the ascending aorta during off‐pump coronary artery bypass surgery (OPCAB) may be associated with a significant increase in systemic blood pressure which may rarely result in aortic dissection. We evaluated whether topical application of lidocaine on the ascending aorta could reduce the rise in systemic blood pressure during side‐clamping of the aorta in OPCAB.Methods:  Forty‐four patients scheduled for OPCAB were randomly allocated to receive gauze soaked with 10 ml of 4% lidocaine (n= 22) or normal saline (n= 22) on the side‐clamping site of the aorta. Sodium nitroprusside (SNP) was infused as necessary to maintain the systolic blood pressure at around 100 mmHg immediately prior to and during side‐clamp of the aorta. The requirement and frequency of use of SNP, as well as haemodynamic variables, were recorded serially.Results:  The number of patients requiring an SNP infusion and the average amount of infused SNP were significantly less in the lidocaine group. Systolic blood pressure increased significantly during side‐clamping in the control group, but not in the lidocaine group.Conclusion:  Topical application of lidocaine on the surface of the aorta is a simple and effective method to reduce the risk of a sudden increase in systemic blood pressure during side‐clamping of the aorta.
Reconciling differences in trophic control in mid‐latitude marine ecosystems
Authors: Frank Kenneth T. , Petrie Brian , Shackell Nancy L. , Choi Jae S. 
Published: August 2006

AbstractThe dependence of long‐term fishery yields on primary productivity, largely based on cross‐system comparisons and without reference to the potential dynamic character of this relationship, has long been considered strong evidence for bottom‐up control in marine systems. We examined time series of intensive empirical observations from nine heavily exploited regions in the western North Atlantic and find evidence of spatial variance of trophic control. Top‐down control dominated in northern areas, the dynamics evolved from bottom‐up to top‐down in an intermediate region, and bottom‐up control governed the southern areas. A simplified, trophic control diagram was developed accounting for top‐down and bottom‐up forcing within a larger region whose base state dynamics are bottom‐up and can accommodate time‐varying dynamics. Species diversity and ocean temperature co‐varied, being relatively high in southern areas and lower in the north, mirroring the shifting pattern of trophic control. A combination of compensatory population dynamics and accelerated demographic rates in southern areas seems to account for the greater stability of the predator species complex in this region.
B001 Multicentre Randomized Trial of Sphincter Preserving Surgery for Ultra‐Low Rectal Carcinoma
Authors: Rullier E. , Rivoire M. , Lelong B. , Vanseymortier L. , Mineur L. , Pocard M. , Lasser P. , Faucheron J.l. , Dravet F. , Pezet D. , Saint‐Aubert B. , Rouanet P 
Published: August 2006

Objective  This randomized study compared two neoadjuvant treatments in patients with a low rectal cancer less than 2 cm from the anal verge that would have required APR before radiotherapy.Method  A total of 207 patients (71% uT3) with a rectal carcinoma at 0.5 cm from the anal verge were randomized in two groups. The group HDR received a high dose of radiotherapy (45 Gy + boost 18 Gy). The group RCT received 45 Gy with concomitant chemotherapy (5FU). Surgery was performed 6 weeks after treatment, surgeons were trained with TME, APR and intersphincteric resection.Results  The rate of sphincter preserving surgery was 83% after HDR and 86% after RCT (P = 0.69). There was no difference in morbidity, clinical tumour regression (80% vs. 87%) and complete pathological response (8% vs. 15%) between HDR and RCT. Overall, the rate of R0 resection was 78%. After a follow‐up of 23 months, the rates of local and distant recurrence were 6% and 19% respectively and the disease‐free survival was 77%. Survival was better after sphincter preservation than after APR.Conclusion  Sphincter preservation was achieved in 85% of ultra‐low rectal carcinomas without compromising oncological prinicples. No difference was observed between HDR and RCT. Further follow‐up is necessary to confirm this conservative approach.
B002 Sacral Nerve Modulation for Faecal Incontinence: Repaired Anal Sphincter Complex Versus Anal Sphincter Defect
Authors: Melenhorst J. , Koch S.M. , Uludag Ö. , Van Gemert W.G. , Baeten C.G. 
Published: August 2006

Objective  Sacral nerve modulation (SNM) for the treatment of faecal incontinence (FI) was originally performed with an intact anal sphincter. Two groups of patients were analysed to investigate whether SNM is as effective in patients with FI associated with an anal sphincter defect as in patients with FI after an anal repair (AR).Method  Group A was initially treated with an AR resulting in an anatomically intact anal sphincter. They were treated with SNM because of persisting or recurring FI. Group B consisted of patients with a defect in the sphincter primarily treated with SNM. The follow‐up visits were scheduled at 1, 3, 6, and 12 months and annually thereafter.Results  Group A consisted of 20 patients. The mean number of incontinence episodes decreased significantly with SNM (P = 0.018). There was no significant difference in resting and squeeze pressures during SNM. Group B consisted of 20 women. The size of the defect in the anal sphincter varied between 17% and 33%. The mean number of incontinence episodes decreased significantly with SNM (P = 0.012). Again there was no significant change in the resting and squeeze pressures. Comparison between group A and B revealed no statistical difference.Conclusion  Faecal incontinence associated with an anal sphincter defect of <33% of the circumference can be treated primarily with SNM.
B004 Small, Flat and Depressed Colorectal Carcinomas: Natural History and Survival
Authors: Tweedle E.M. , Azadeh B. , Rooney P.S. 
Published: August 2006

Objective  The natural history of flat and depressed colorectal carcinomas is poorly understood in Western countries. We compared small, polypoid and flat or depressed tumours surgically resected in our teaching hospital over a nine‐year period. Analysis of TNM staging and survival is presented.Method  A total of 1763 colorectal cancers were identified. Small tumours <20 mm across were included, M:F 1:1, age 69, (42–90 years). Slides were reviewed by a histopathologist and classified using Japanese Research Society Classification, JRSC.Results  There were 61 small cancers, 64% (39/61) were flat or depressed and 33% (20/61) polypoid. Two tumours were unclassifiable. T3 tumours at presentation were more likely to be flat or depressed than polypoid, (P = 0.016). Significantly more T1 tumours at presentation were polypoid (P = 0.033). Rates of nodal metastases were high in both groups, (30% in polypoid vs. 39% flat/depressed; non‐significant P = 0.361). Five‐year disease‐specific survival for small tumours was 54% and for node positive tumours was 19%, (P = 0.003). Flat/depressed morphology predicted a non‐significant reduction in three‐year survival of 63% (92%–167%, P = 0.197).Conclusion  Small and flat cancers should be staged and treated radically because of high rates of systemic disease. Further work is aimed at elucidating the pathway of development of flat cancers.
B005 Tumour Cells in Peri‐Tumoural Fibrosis after Neoadjuvant Treatment in Locally Advanced Rectal Cancer
Authors: Tanaka S. , Palmer G. , Martling A. , Lindholm J. , Holm T. 
Published: August 2006

Objective  In patients with locally advanced (T4) rectal cancer extended resections are usually performed to achieve R0 resection. A significant downsizing and downstaging is often seen after neoadjuvant treatment and histopathological assessment may reveal a T0–T3 tumour with fibrosis between the tumour and the adjacent resected structure. Provided this fibrosis does not contain tumour cells, a less extensive, organ preserving, resection would be preferable in such patients. The aim of this study was to assess the presence of tumour cells within the peri‐tumoural fibrosisMethod  A total of 53 patients with locally advanced (T4) rectal cancer according to clinical and/or radiological evaluation were treated with preoperative radiotherapy or radio‐chemotherapy. Extensive surgery, including resection of another structure or organ was performed based on the pretreatment assessment. Histopathological examination was performed using routine staining supplemented by immunohistochemistry (CK 20).Results  Scattered tumour cells within the fibrosis, at or outside the mesorectal fascia, were found in 26 patients and in the remaining patients no tumour cells were found.Conclusion  Although neoadjuvant treatment often induces fibrosis and downsizes locally advanced rectal cancer, less extensive resections (i.e. TME alone) cannot be advocated since the peri‐tumoural fibrosis contains tumour cells in 50% of the patients.
An overview of findings from a six‐country European survey on consumer attitudes to the metabolic syndrome, genetics in nutrition, and potential agro‐food technologies
Authors: De Almeida M. D. V. , Pinhão S. , Stewart‐Knox B. , Parr H. J. , Gibney M. J. 
Published: August 2006

Summary  Metabolic syndrome, a cluster of cardiovascular risk factors that can lead to type 2 diabetes and/or heart disease, is at the centre of LIPGENE. This European Union (EU)‐funded project integrates human nutrition, genomics, agro‐food, social and economic analysis. In the social science module of the project, a six‐country survey was carried out to provide data on consumers’ attitudes towards the metabolic syndrome, potential agro‐food technologies and nutrigenomics. A total of 5967 participants aged 15 years plus from six European countries were interviewed.Heart disease, obesity, bulimia, anorexia and type 2 diabetes were the most frequently identified diet‐related diseases. Nearly 30% of participants self‐reported suffering from stress, and one in five reported having central obesity. High blood pressure was identified as an extremely high/high‐risk condition for almost half of the sample, followed by high cholesterol. Respondents reported the three most important ways of reducing personal risk of type 2 diabetes or heart disease to be increasing physical activity, eating more fruit and vegetables, and decreasing intake of fatty foods. However, lack of motivation, lack of information and lack of knowledge were identified as barriers to healthy actions. Participants associated the concept of ‘functional foods’ with fruit and vegetables, which were consumed at least once a week by most of them, but they also reported consuming high‐fibre products, probiotic yogurt drinks, foods with added vitamins and/or minerals, and cholesterol‐lowering spreads/drinks. However, the most commonly desired health benefits from foods to reduce the risk of type 2 diabetes and heart disease were a cholesterol‐lowering effect, blood sugar control and weight reduction. The preferred foods to decrease metabolic syndrome were fish, cheese and yogurt ‘with healthy fat’, but these foods were less acceptable to respondents if developed through genetic modification (GM) technology, and more than 30% of the sample would not eat GM foods at all. However, participants said that they would be more willing to consume GM foods if these foods provided health benefits. The survey also showed that many people would be willing to undergo a genetic test for general interest or in order for a diet to be tailored to their needs.
Love as a Contested Concept
Authors: HAMILTON RICHARD PAUL 
Published: August 2006

Theorists about love typically downplay the scale of persistent and possibly intractable disagreement about love. Where they have considered such disagreements at all, they have tended to treat them as an example of the lack of clarity surrounding the concept of love, a problem which can be resolved by philosophical analysis. In doing so, they invariably slip into prescriptive mode and offer moral injunctions in the guise of conceptual analyses.This article argues for philosophical modesty. I propose that the starting point of any coherent philosophical investigation of love must be a willingness to take our disagreements seriously. These disagreements stem from profound moral differences: we disagree about love inasmuch as we disagree about how we should properly treat one another.With a series of examples drawn from philosophy, literature and real life I attempt to illustrate some of the disagreements that arise in relation to erotic love. Drawing upon the work of Wittgenstein, Friedrich Waissman and W.B. Gallie, I suggest that any robust theory of love needs to take account of its contestable nature and the integral role it plays in our moral life.
Differential integration efforts of mandatory and optional sentence constituents
Authors: Prior Anat , Bentin Shlomo 
Published: August 2006

AbstractWe investigated the online sensitivity of the semantic integration system to the different roles played by sentence constituents that are necessary (verbs and nouns) or optional (adjectives) for argument completion. We compared the effect of semantic incongruities introduced in both types of words on the N400 ERP component. Participants read sentences for meaning, half of which were rendered anomalous by an incongruent verb, noun, or an early/late adjective. Incongruent adjectives led to smaller N400 effects than did incongruent nouns and verbs, and the congruity effect for sentence‐final adjectives was not significant. All incongruities are therefore not created equal: Incongruent optional sentence constituents create less of an integrative burden than incongruent mandatory sentence constituents, suggesting that online sentence integration processes are sensitive to the distinct roles played by different words in shaping sentence meaning.
Psychological wellbeing after laparoscopic and abdominal hysterectomy—a randomised controlled multicentre study
Authors: Persson P , Wijma K , Hammar M , Kjølhede P 
Published: August 2006

Objective  To compare laparoscopic hysterectomy and abdominal total hysterectomy regarding influence on postoperative psychological wellbeing and surgical measures.Design  A prospective, open, randomised multicentre trial.Setting  Five hospitals in the South East of Sweden.Population  Hundred and twenty‐five women scheduled for hysterectomy for benign conditions were enrolled in the study, and 119 women completed the study. Fifty‐six women were randomised to abdominal hysterectomy and 63 to laparoscopic hysterectomy.Methods  Psychometric tests measuring general wellbeing, depression and anxiety preoperatively and 5 weeks and 6 months postoperatively.Main outcome measures  Effects of operating method on the psychological wellbeing postoperatively. Analysis of data regarding operating time, peroperative and postoperative complications, blood loss, hospital stay and recovery time.Results  No significant differences in the scores were observed between the two groups in any of the four psychometric tests. Both the surgical methods were associated with a significantly higher degree of psychological wellbeing 5 weeks postoperatively compared with preoperatively. The operating time was significantly longer for the laparoscopic hysterectomy group, but the duration of the stay in hospital and sick‐leave were significantly shorter for laparoscopic hysterectomy group compared with the abdominal hysterectomy group.Conclusions  General psychological wellbeing is equal after laparoscopic and abdominal hysterectomy within 6 months after the operation. The advantages of the laparoscopic hysterectomy are the shorter stay in hospital and shorter sick‐leave, but these issues must be balanced by a longer duration of the operation.
Fasting capillary glucose as a screening test for gestational diabetes mellitus
Authors: Fadl H , Östlund I , Nilsson K , Hanson U 
Published: August 2006

Objective  To evaluate fasting capillary glucose as a screening test for gestational diabetes mellitus (GDM) compared with traditional risk factors and repeated random capillary glucose measurements.Design  Cross‐sectional, population‐based study.Setting  Maternal Health Care Clinics in Örebro County, Sweden.Population  An unselected population of women without diabetes.Methods  Fasting capillary glucose levels were measured at gestational weeks 28–32. Random capillary glucose levels were measured four to six times during pregnancy. Traditional risk factors for GDM were registered. GDM was diagnosed using a 75‐g oral glucose tolerance test.Main outcome measures  Sensitivity, specificity, likelihood ratios.Results  In 55 of 3616 women participating in the study, GDM was diagnosed before 34 weeks of gestation. For fasting capillary glucose cutoff values between 4.0 and 5.0 mmol/l, sensitivity was in the range between 87 and 47% and specificity between 51 and 96%. Using a combined screening model of traditional risk factors with fasting capillary glucose at various cutoff values increased the sensitivity only slightly compared with using fasting capillary glucose alone.Conclusion  In this Swedish, unselected, low‐risk population, fasting capillary glucose measurements were found to be an acceptable and useful screening test for GDM.
Electrocorticographic Discharge Patterns in Glioneuronal Tumors and Focal Cortical Dysplasia
Authors: Ferrier Cyrille H. , Aronica Eleanora , Leijten Frans S.S. , Spliet Wim G.M. , Van Huffelen Alexander C. , Van Rijen Peter C. , Binnie Colin D. 
Published: August 2006

Summary:  Purpose: To determine whether highly epileptiform electrocorticographical discharge patterns occur in patients with glioneuronal tumors (GNTs) and focal cortical dysplasia (FCD) and whether specific histopathological features are related to such patterns. Methods: The series consists of operated patients with pharmacoresistant epilepsy because of FCD or GNT between 1992 and 2003. Electrocorticography was reviewed for presence of continuous spiking, bursts, recruiting discharges, or sporadic spikes. Surgical specimens were reviewed for the presence of balloon cells, (coexisting) cortical dysplasia, and relative frequencies of neurons, glia, and microglia. Results: Continuous spiking was seen in 55% versus 12% of patients with FCD and GNT, respectively (p = 0.005). Bursts and recruiting discharges were seen in a similar proportion of patients with FCD or GNT. Ninety‐one percent of patients with continuous spiking showed (coexisting) cortical dysplasia in contrast to 42% of patients without this pattern (p = 0.004). The presence of balloon cells and glia or microglia content were not associated with discharge patterns. Conclusion: Continuous spiking, bursts, and recruiting discharges occur in patients with FCD and GNT. Continuous spiking was seen significantly more often in patients with FCD. When continuous spiking is found with GNT, it is likely to be associated with dysplastic regions with a high neuronal density.
FDG‐PET/MRI Coregistration and Diffusion‐Tensor Imaging Distinguish Epileptogenic Tubers and Cortex in Patients with Tuberous Sclerosis Complex: A Preliminary Report
Authors: Chandra Poodipedi S. , Salamon Noriko , Huang Jimmy , Wu Joyce Y. , Koh Susan , Vinters Harry V. , Mathern Gary W. 
Published: August 2006

Summary: Purpose:Patients with tuberous sclerosis complex (TSC) are potential surgical candidates if the epileptogenic region(s) can be accurately identified. This retrospective study determined whether FDG‐PET/MRI coregistration and diffusion‐tensor imaging (DTI) showed better accuracy in the localization of epileptogenic cortex than structural MRI in TSC patients.Methods:FDG‐PET/MRI coregistration and/or DTI for apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were utilized in 15 TSC patients. Presurgery scalp EEG and postsurgery seizure control identified epileptogenic tubers (n = 27) and these were compared with nonepileptogenic tubers (n = 204) for MRI tuber volume, volume of FDG‐PET hypometabolism on MRI coregistration, DTI, ADC, and FA values.Results:Compared with nonepileptogenic tubers, epileptogenic regions had increased volume of FDG‐PET hypometabolism (p < 0.0001), and increased ADC values in subtuber white matter (p < 0.0001). In contrast, the largest MRI identified tuber (p = 0.046) and decreased FA values (p = 0.58) were less accurate in identifying epileptogenic regions. Larger volumes of FDG‐PET hypometabolism correlated positively with increased ADC values (p = 0.029), and localized to areas of cortical dysplasia adjacent to the tuber in four cases.Conclusions:Larger volumes of FDG‐PET hypometabolism relative to MRI tuber size and higher ADC values identified epileptogenic tubers and adjoining cortex containing cortical dysplasia in TSC patients with improved accuracy compared with largest tuber by MRI or lowest FA values. Used in conjunction with ictal scalp EEG and interictal magnetoencephalography, these newer neuroimaging techniques should improve the noninvasive evaluation of TSC patients with intractable epilepsy in distinguishing epileptogenic sites for surgical resection.
Increased Apparent Oral Clearance of Valproic Acid during Intake of Combined Contraceptive Steroids in Women with Epilepsy
Authors: Galimberti Carlo Andrea , Mazzucchelli Iolanda , Arbasino Carla , Canevini Maria Paola , Fattore Cinzia , Perucca Emilio 
Published: August 2006

Summary:  Purpose: To determine potential changes in total and unbound serum valproic acid (VPA) concentrations at steady‐state during a cycle of intake of combined hormonal contraceptive (HC) steroids. Methods: Blood samples were collected from nine women stabilized on VPA monotherapy on two separate randomized occasions: (i) at the end of the 4‐ to 7‐day HC‐free interval, and (ii) on the last day of the HC intake period. Trough concentrations of VPA in serum and serum ultrafiltrates were determined by fluorescence polarization immunoassay. Results: In all women, total and unbound VPA concentrations were higher during the HC‐free interval than during HC intake (means ± SD: 425 ± 184 vs. 350 ± 145 μmol/L, respectively, for total VPA, p = 0.002, and 55 ± 37 vs. 39 ± 25 μmol/L, respectively, for unbound VPA, p = 0.005). Compared with the HC‐free interval, HC intake was associated with a mean 21.5% increase in VPA total apparent oral clearance (from 8.0 ± 5.2 to 9.7 ± 6.4 ml/h/kg, p = 0.01) and a 45.2 % increase in VPA unbound apparent oral clearance (from 79 ± 81 to 115 ± 121 ml/h/kg, p = 0.029). Conclusions: The apparent oral clearance of total and unbound VPA increases during the HC intake period compared with the HC‐free interval, probably due to induction of glucuronosyltransferase by ethinylestradiol. The magnitude of the change varies across individuals, being potentially clinically relevant in some cases. Serum VPA concentrations should be monitored when adding or discontinuing HC steroids, and possibly during the on–off intervals of a HC cycle.