bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is There a Role for Palliative Gastrectomy in Patients with Stage IV Gastric Cancer?
Authors: Saidi Reza F. , ReMine Stephen G. , Dudrick Paul S. , Hanna Nader N. 
Published: December 2005

AbstractPatients with metastatic gastric cancer are currently not considered operative candidates and are most often offered systemic therapy. Palliative resection of the primary tumor has been considered irrelevant to the outcome and has been recommended only for palliation of symptoms. We have examined the role of palliative gastrectomy and its impact on survival in patients with stage IV gastric cancer at initial diagnosis between 1990 and 2000. A total of 105 patients with stage IV disease were identified during this period; 81 of them (77.1%) had no resection, and 24 (22.9%) underwent palliative gastric resection. Mean survival in those without resection who received chemotherapy (with or without radiation) treatment was 5.9 months (95% confidence interval 4.2–7.6). For those with resection and adjuvant therapy, mean survival time was 16.3 months (95% confidence interval 4.3–28.8 months). Kaplan‐Meier survival analysis showed significantly better survival in those with resection and adjuvant therapy (log‐rank test, P = 0.01). Mortality and morbidity rates associated with palliative resection were 8.7% and 33.3%, respectively, which did not differ statistically from the 3.7% and 25.3% in patients who underwent curative gastrectomy during same period of time. However, the length of hospitalization (22 versus 16 days) was significantly higher compared with those without stage IV disease. These data suggest that palliative resection combined with adjuvant therapy may improve survival in a selected group of patients with stage IV gastric cancer. Palliative gastrectomy plus systemic therapy should be compared with systemic therapy alone in a randomized trial.
Results of Preoperative Lymphoscintigraphy for Breast Cancer Are Predictive of Identification of Axillary Sentinel Lymph Nodes
Authors: Marchal Frédéric , Rauch Philippe , Morel Olivier , Mayer Jean Claude , Olivier Pierre , Leroux Agnès , Verhaeghe Jean Luc , Guillemin François 
Published: December 2005

AbstractThe aim of this study was to identify the variables associated with successful peroperative sentinel lymph node (SLN) localization. We studied 201 patients with T1, T2, N0 invasive breast cancer who underwent a SLN procedure from 1999 to 2003. Of these 201 patients, 55 underwent peritumoral and 146 underwent periareolar radioisotope injection before the blue dye injection. All patients were operated on by breast conservative surgery and axillary dissection after SLN biopsy. Age, weight, menopausal status, previous biopsy, localization of the tumor, results of lymphoscintigraphy, site of radiotracer injection, tumor size, tumor grade, experience of surgeons, and the number of invaded axillary nodes were analyzed to determine whether they had any significant correlation with successful identification of SLN. Variables found to have a statistically significant influence on the SLN identification rate and on preoperative lymphoscintigraphy identification were introduced into a univariate and multivariate logistic regression model. In multivariate analysis, successful lymphoscintigraphy (P < 0.0001) and the absence of metastatic axillary nodes (P < 0.005) were associated with successful identification of SLNs. The peritumoral injection of radiotracer (P < 0.001), patient age > 60 years (P < 0.003), and localization of the tumor in the upper outer quadrant (P < 0.004) were associated with failure of lymphoscintigraphic visualization of SLN. The technique of SLN detection thus appears to be better for patients with low risk of invaded axillary lymph nodes.
Significance of Extensive Surgery Including Resection of the Pancreas Head for the Treatment of Gallbladder Cancer—From the Perspective of Mode of Lymph Node Involvement and Surgical Outcome
Authors: Sasaki Ryoko , Itabashi Hidenori , Fujita Tomohiro , Takeda Yuichiro , Hoshikawa Koichi , Takahashi Masahiro , Funato Osamu , Nitta Hiroyuki , Kanno Senji , Saito Kazuyoshi 
Published: December 2005

AbstractThe present study aimed to clarify the efficacy of extensive surgery, including pancreas head resection, for more complete lymphadenectomy in the treatment of gallbladder carcinoma. The study involved retrospective analyses of 65 consecutive patients with gallbladder carcinoma who underwent surgical resection between 1982 and 2003. Of these 65 patients, 41.5% displayed node‐positive disease and among them 23.1% had positive para‐aortic nodes. Of six node‐positive 5‐year survivors, five underwent pancreatoduodenectomy combined with S4aS5 hepatic subsegmentectomy. The 5‐year survival rates were 76.2% for pN0, 30.0% for pN1, 45.8% for pN2, and 0% for pM1[lymph], respectively. Significant differences existed in survival rates. Postoperative recurrence was observed in 24.1% (13/54) of patients who underwent R0 resection. Of the four patients who displayed lymph node recurrence, two had pericholedocal and/or posterior pancreatoduodenal lymph node metastasis at the time of surgery and underwent pancreas‐preserving regional lymphadenectomy. These results suggest that extensive resection, including resection of the pancreatic head, is effective in selected patients with up to pN2 lymph node metastasis, as long as complete removal of the cancer can be achieved. Pancreatoduodenectomy combined with S4aS5 hepatic subsegmentectomy should be considered when lymph node metastasis is obvious and the patient is in good condition.
Changing Treatment Strategy for Gastrinoma in Patients with Zollinger‐Ellison Syndrome
Authors: Imamura Masayuki , Komoto Izumi , Ota Shuichi 
Published: December 2005

AbstractWe overviewed the recent development of curative surgery for gastrinoma that has been rapidly improved since the development of new localization techniques, especially the selective arterial secretagogue injection test (SASI test) and somatostatin receptor scintigraphy (SRS). A number of new pathological findings of gastrinomas in patients with Zollinger‐Ellison syndrome have been accumulated in accordance with the increase of curative resection of gastrinomas, and these new findings also have contributed to the progress of the treatment strategy for grastrinomas.
Host defense inNicrophorus quadripunctatusagainst brood parasitism byPtomascopus morio(Coleoptera: Silphidae: Nicrophorinae)
Authors: Suzuki Seizi , Nagano Masahiro 
Published: December 2005

AbstractFew studies have been conducted on the host defenses of insects against brood parasitism. We investigated whether the silphid beetlePtomascopus morio, a brood parasite of related silphid speciesNicrophorus concolor, can also parasitize another silphid speciesNicrophorus quadripunctatusand the manner in whichN. quadripunctatusdefends itself against parasitism. Successful brood parasitism under natural conditions was not observed at the time of year whenP. morioandN. quadripunctatusare both reproductively active. Follow‐up experiments revealed thatP. morioattempts to oviposit nearN. quadripunctatusnests, but is rarely successful if adult hosts are present. WhenP. moriolarvae were experimentally introduced toN. quadripunctatusbroods, someP. moriolarvae survived when the host and parasite larvae were at the same stage. We concluded thatN. quadripunctatusdefends itself against brood parasitism in two ways: (1) potential brood parasites are repelled, thus limiting their access to the resource; and (2) the young of the parasitic species are killed.
Root aerobic respiration and growth characteristics of three Typha species in response to hypoxia
Authors: Matsui Tomomi , Tsuchiya Takayoshi 
Published: December 2005

AbstractThe responses of root aerobic respiration to hypoxia in three common Typha species were examined. Typha latifolia L., T. orientalis Presl, and T. angustifolia L. were hydroponically cultivated under both aerobic and hypoxic growth conditions to measure root oxygen consumption rates. Hypoxia significantly enhanced the root aerobic respiration capacity of the two deep‐water species, T. orientalis and T. angustifolia, while it did not affect that of the shallow‐water species, T. latifolia. T. angustifolia increased its root porosity and root mass ratio, while T. latifolia increased its root diameter under the hypoxic growth conditions. The relative growth rates in biomass of T. orientalis and T. angustifolia were 59 and 39% higher, respectively, under the hypoxic growth conditions than under the aerobic growth conditions. In contrast, that of T. latifolia did not differ between the two conditions. In T. orientalis and T. angustifolia, enhanced root aerobic respiration rates under the hypoxic growth conditions would have increased the nutrient uptake, and thus higher relative growth rates were obtained. For the deep‐water species, T. orientalis and T. angustifolia, the root aerobic respiration capacity was enhanced, probably in order to maintain the generation of respiratory energy under hypoxia.
Self-help with minimal therapist contact for obsessive–compulsive disorder: a review
Authors: Mataix-Cols David , Marks Isaac M. 
Published: December 2005

AbstractThough there are effective psychological and drug treatments for obsessive–compulsive disorder (OCD), many patients remain inadequately treated or untreated. Making effective self-treatment guidance available may increase the number of patients being helped. In this review, database and manual literature searches were performed of case studies, open and randomised controlled trials (RCTs) of bibliotherapy, self-help groups, telecare and computer-aided self-help for OCD. We found no RCTs of bibliotherapy or self-help groups for OCD. Three open studies showed the efficacy of brief exposure and ritual prevention (ERP) instructions delivered by a live therapist by phone. A vicarious ERP computer program was effective in a small open study. Fully interactive computer-aided self-help by ERP for OCD was efficacious in two open studies and a large multicentre RCT, and in a small RCT compliance and outcome with that program was enhanced by brief scheduled support from a clinician. Although more research is needed, self-help approaches have the potential to help many more patients who would otherwise remain inadequately treated or untreated. Their dissemination could save resources used by health care providers. We propose a stepped care model for the treatment of OCD.
Cigarette smoking in long-term schizophrenia
Authors: Salokangas R.K.R. , Honkonen T. , Stengård E. , Koivisto A.-M. , Hietala J. 
Published: December 2005

AbstractPurposeCigarette smoking is a great health problem and prevalent among subjects with schizophrenia. Our aim was to investigate the prevalence and associations of cigarette smoking in patients with long-term schizophrenia.MethodsSeven hundred and sixty schizophrenia patients were interviewed and their cigarette smoking was recorded.ResultsSmoking was more prevalent men than in women patients. In logistic regression analysis, male gender, duration of illness (DUI) from 10 to 19 years, being divorced or separated, lower education and high daily doses of neuroleptics (DDN) associated significantly with regular smoking. Heavy smoking associated, in men, with hospital treatment.ConclusionsIn schizophrenia patients, smoking is associated with long DUI, high DDN and institutional care. Interventions for cessation and/or reduction of cigarette smoking should be a part of the treatment for patients with schizophrenia.
Temperament, character and symptoms of anxiety and depression in the general population
Authors: Jylhä Pekka , Isometsä Erkki 
Published: December 2005

AbstractFew studies have investigated the relationship of temperament and character, as conceptualized in the Temperament and Character Inventory–Revised (TCI-R), to symptoms of depression and anxiety in the general population. In this study a random sample of subjects (20 to 70 years), in two Finnish cities, were surveyed with the TCI-R, Beck Depression and Anxiety Inventories, plus questions related to diagnosed lifetime mental disorders, health care use for psychiatric reasons during the past 12 months, and history of mental disorders in first-degree relatives. Altogether 347 subjects (38.6%) responded. Of the TCI-R dimensions, Harm Avoidance correlated with symptoms of depression (rs
= 0.555, p < 0.001), anxiety (rs= 0.560, p < 0.001), self-reported lifetime mental disorder (rs = 0.272, p< 0.001), health care use for psychiatric reason during the past 12 months (rs = 0.241, p< 0.001) and family history of mental disorder (rs = 0.202, p<0.001). Self-directedness correlated negatively with symptoms of depression (rs = -0.495, p< 0.001), anxiety (rs = -0.458, p < 0.001), lifetime mental disorder (rs = 0.225, p< 0.001) and health care use (rs = -0.135, p = 0.013). Overall, Harm Avoidance and Self-directedness seem to associate moderately with depressive and anxiety symptoms, and somewhat predict self-reported use of health services for psychiatric reasons, and lifetime mental disorder. High harm avoidance may associate with a family history of mental disorder.
Use of Ultra‐High‐Resolution Data for Temporal Bone Dissection Simulation
Authors: Wiet Gregory J. , Schmalbrock Petra , Powell Kimerly , Stredney Don 
Published: December 2005

OBJECTIVESFor the past 5 years, our group has been developing a virtual temporal bone dissection environment for training otologic surgeons. Throughout the course of our development, a recurring challenge is the acquisition of high‐resolution, multimodal, and multi‐scale data sets that are used for the visual as well as haptic (sense of touch) display. This study presents several new techniques in temporal bone imaging and their use as data for surgical simulation.METHODSAt our institution (OSU), we are fortunate to have a high‐field (8 Tesla) magnetic resonance imaging (MRI) research magnet that provides an order of magnitude higher resolution compared to clinical 1.5T MRI scanners. Magnetic resonance imaging has traditionally been superb at delineating soft tissue structure, and certainly, the 8T unit does indeed do this at a resolution of 100‐200 μm3. To delineate the bony structure of the mastoid and middle ear, computed tomography (CT) has traditionally been used because of the high signal‐to‐noise ratio delineating bone signal from air and soft tissue. We have partnered with researchers at other institutions (CCF) to make use of a “microCT” that provides a resolution of 214 × 214 × 390 micrometers of bony structure.RESULTSThis report provides a description of the 2 methodologies and presentation of the striking image data capable of being generated. See images presented.CONCLUSIONSUsing these 2 new and innovative imaging modalities, we provide an order of magnitude greater resolution to the visual and haptic display in our temporal bone dissection simulation environment.
Sialoscopy in Cases of Unclear Swelling of the Major Salivary Glands
Authors: Koch Michael , Zenk Johannes , Bozzato Alessandro , Bumm Klaus , Iro Heinrich 
Published: December 2005

OBJECTIVESialoscopy has developed into an important diagnostic and therapeutic tool for diseases of the major salivary glands.STUDY DESIGN AND SETTINGWe evaluated 103 patients with chronic swelling of the major salivary glands. Routine diagnostic measures revealed no clear diagnosis. The findings of 109 sialoscopies are described. A semi‐rigid endoscope (with a diameter of 1.1 mm and 2 integrated working channels) was used for sialoscopy, 51.5% of the cases in Warthon's duct and 48.5% in Stensen's duct.RESULTSPathologic findings resulted in 83.0% of the submandibular and in 96% of the parotid ducts. Obstruction neither due to sialolithiasis nor stenosis was observed in 56.3%, whereas sialolithiasis was observed in 20.3% of the patients. In 36 (35%) patients, an interventional sialoscopy was performed.CONCLUSIONSIn cases of invisible salivary duct obstruction, especially in those with low mineralized calculi, strictures, stenoses, or postinflammatory changes, sialoscopy gives immediate and direct information about causal pathologies. Moreover, further therapy can be planned within the same procedure.EBM RATINGC
Comparison of the Effectiveness and Safety of Radiofrequency Turbinoplasty and Traditional Surgical Technique in Treatment of Inferior Turbinate Hypertrophy
Authors: Cavaliere Matteo , Mottola Giampiero , Iemma Maurizio 
Published: December 2005

OBJECTIVESInferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvements. In these cases, surgical reduction of inferior turbinates can be proposed. Many different techniques are currently available. We prospectively evaluate the safety and effectiveness of radiofrequency volumetric tissue reduction (RFVTR) compared with the traditional surgical technique.METHODSThe study was conducted on 3 groups of 75 patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy refractory to medical therapy. In group A, the turbinoplasty (TP) was performed using the classical surgical submucosal resection; in group B, the RFVTR was applied to inferior turbinate; and group C patients were not treated and served as control subjects. Nasal endoscopy, visual analogue scale (VAS), anterior active positional rhinomanometry, and saccharin tests were used to assess treatment outcomes at the end of week 1 and months 1 and 3 after surgery.RESULTSTurbinate edema and secretions decreased significantly (P < 0.05) in groups A and B from 1 month after surgery. The secretions in group A increased temporarily on the seventh day after surgery. Concerning the nasal obstruction and related symptoms, significant improvement was observed at 1 month after treatment in all patients (P < 0.05) and continued up to 3 months after surgery (P < 0.0001). Rhinomanometric measurements demonstrated a significant nasal flow increase at 3 months (P < 0.0001). The nasal mucociliary transport time increased in group A at week 1. The difference among the 3 groups at month 1 was observed not significant.CONCLUSIONIn this study, we demonstrated that both RFVTR and TP are effective in improving nasal obstruction and related nasal symptoms. In support of the RFVTR, different factors are important: it can be performed in local anaesthesia; it does not require a nasal package; it does not cause either a change of mucociliary function or an increase of secretions and crusts; and the patient can be discharged immediately after treatment. Therefore, we suggest that the RFVTR offers an efficient, gentle, and function‐maintaining alternative to TP. However, because of the short follow‐up, future investigations are needed for a more exhaustive evaluation of equivalency of the 2 turbinate procedures.EBM RATING: B‐2
Cricoid Palpability as a Selection Criterion for Bedside Tracheostomy
Authors: Husein Omar F. , Massick Douglas D. 
Published: December 2005

OBJECTIVETo prospectively evaluate the significance of cricoid cartilage palpability as a selection criterion for bedside tracheostomy and to prospectively compare a cohort of patients undergoing bedside tracheostomy with another cohort receiving operating room tracheostomy.STUDY DESIGN/SETTINGProspective trial comparing 2 cohorts of patients receiving tracheostomies at a tertiary care center (university hospital). In all, 220 consecutive intubated patients selected for elective tracheostomy were enrolled. Of them, 134 patients had palpable cricoid cartilage and underwent open surgical tracheostomy at the bedside. The remaining 68 patients received open surgical tracheostomies in the operating room. Demographic data, patient anatomic features, and perioperative complications were prospectively recorded. There were no statistically significant differences in age, gender, reason for admission, indication for tracheostomy, Acute Physiology and Chronic Health Evaluation II score, number of days intubated, or time required to perform the procedure for those patients whose tracheostomies were performed in the operating room versus the intensive care unit.RESULTSPatients with a palpable cricoid cartilage had a significantly reduced perioperative complication rate compared with those without a palpable cricoid cartilage (2% vs 22%, P < 0.001). Comparison of cervical girth, mental‐to‐sternum distance, and thyroid‐notch‐to‐sternum distance showed no significant difference between the 2 groups and did not further define selection criteria.CONCLUSIONThis investigation prospectively confirms the safety of bedside tracheostomy placement in properly selected patients. Complication incidences are defined for open surgical tracheostomy at the bedside and in the operating room. Palpability of the cricoid cartilage has significant value as a selection criterion for bedside tracheostomy.SIGNIFICANCEThese findings will aid in the development of protocols and pathways for surgical airway management in critically ill patients to maximize cost‐effective, high‐quality care.EBM RATING: B‐2
Effects of Cytomegalovirus (CMV) Related Deafness on Pediatric Cochlear Implant Outcomes
Authors: Lee Daniel J. , Lustig Lawrence , Sampson Margaret , Chinnici Jill , Niparko John K. 
Published: December 2005

OBJECTIVEHuman cytomegalovirus (CMV) is a commonly recognized viral cause of perinatal sensorineural hearing loss. CMV‐infected infants are also at risk for developmental neurological deficits. This retrospective study assesses the impact of CMV‐induced deafness on pediatric cochlear implant outcomes.STUDY DESIGN AND SETTINGThirteen patients from the Johns Hopkins pediatric cochlear implant database were identified with CMV‐related deafness. A retrospective review of the medical records of the Johns Hopkins Hospital was performed.RESULTSThe mean age at implantation was 5.6 years. Follow‐up audiometric data ranged from 6 to 48 months postoperatively. Mean speech perception scores were 4.5 (out of 6) following implantation.CONCLUSIONWe have shown that cochlear implants can provide useful speech comprehension to patients with CMV‐related deafness. Speech recognition scores were within the range established by our overall pediatric implant population.SIGNIFICANCEThis observation underscores the importance of a multidisciplinary rehabilitation program following implantation in these patients at risk for cognitive delay.EBM RATINGC
Targeted Intra‐Arterial Chemoradiation for Advanced Tonsil Cancer
Authors: Naidu Srikanth I. , Vieira Francisco , Samant Sandeep , Vang Meng C. , Wan Ajim Y. , Robbins Thomas K. 
Published: December 2005

OBJECTIVESTo determine the effects of combined radiation and targeted, intra‐arterial (IA) cisplatin infusions (RADPLAT) in patients with advanced squamous cell carcinoma (SCC) of the tonsil.STUDY DESIGN AND SETTINGProspective study of treatment outcomes and toxicity of patients enrolled on the RADPLAT protocol, with specific analysis of patients with advanced SCC of the tonsil.RESULTSThirty patients with advanced tonsil carcinoma (17 T4, 12 T3, 1 T2) were enrolled, and 24 of 30 patients completed at least 3 IA cisplatin infusions and a minimum of 63 Gy or radiation therapy (minimum therapy). Two‐year estimated overall and disease‐specific survival was 42% and 50%, respectively, for all 30 patients (intent‐to‐treat group) and 49% and 58%, respectively, for the minimum therapy subgroup. The 2‐year estimated local and regional disease control was 87% and 90%, respectively, for the intent‐to‐treat group, and 100% and 90% for the minimum therapy subgroup. Functional organ preservation was achieved in 92% of patients.CONCLUSIONSLocoregional disease control achieved with this regimen appears to be significantly improved over that described in the literature for similarly staged tonsil cancer. Survival, on the other hand, remains comparable.EBM RATINGC