bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic retrograde cholangiopancreatography in patients with Billroth II gastroenterostomy
Authors: Çiçek Bahattin , Parlak Erkan , Dişibeyaz Selçuk , Koksal Aydın Seref , Şahin Burhan 
Published: November 2006

AbstractBackground and Aim:  Endoscopic retrograde cholangiopancreatography (ERCP) is more complicated in patients with Billroth II gastroenterostomy (B II GE) especially in those associated with Braun anastomosis (BA). The aim of the present study was to review experience of ERCP in patients with B II GE.Methods:  The records of patients with B II GE who had undergone an ERCP within the last 2.5 years were retrospectively evaluated.Results:  Fifty‐two patients with simple B II GE and seven with additional BA underwent ERCP within this period. The probability of common bile duct cannulation and success of endoscopic treatment was 43/52 (83%) and 2/7 (29%) in the respective groups. The reasons for failure were long afferent loop in patients with BA; for the nine patients with B II GE the reasons for failure were tumoral infiltration at the orifice of afferent loop in one patient, peripapillary tumoral invasion in two patients, failure of entrance to the afferent loop due to angulation in two patients, and long afferent loop in the remaining four patients. Overall, perforation developed in 10.2% (6/59 of the patients. Two of these patients died (2/59, 3.4%) and one (1/59, 1.7%) had concomitant pancreatitis.Conclusions:  Although ERCP is successful in a large proportion of patients with B II GE, it carries significant risks such as perforation. ERCP must be performed by experienced endoscopists at institutions that have suitable facilities to manage endoscopy‐related complications.
Endoscopic management of traumatic hepatobiliary injuries
Authors: Singh Virendra , Narasimhan Kannan Laksmi , Verma Ganga Ram , Singh Gurpreet 
Published: November 2006

AbstractBackground:  Non‐surgical treatment has become the therapeutic method of choice in hemodynamically stable patients with liver trauma. There are a few reports of endoscopic management of traumatic hepatobiliary injuries in such patients; however, the optimal intervention is not known.Methods:  Twenty patients with traumatic hepatobiliary injuries from May 1997 to November 2005 were retrospectively evaluated.Results:  There were 18 male and two female patients with a mean age of 21.45 ± 10.17 years (range 7–42 years). Seven patients were children. Patients presented 19.4 ± 17.04 days following trauma. Computed tomography (CT) revealed hepatic laceration in right lobe in 14 (70%) and in left lobe in six (30%) patients. Endoscopic retrograde cholangiopancreatography (ERCP) revealed biliary leak in right duct in 14 (70%) and in left duct in six (30%) patients. Five patients also had bilhemia and one had hemobilia. Thirteen patients (65%) were treated by endoscopic sphincterotomy with nasobiliary drainage and seven (35%) were treated by nasobiliary drainage alone, which enabled fistula closure in 15.76 ± 4.22 days and 12.14 ± 3.93 days, respectively (P > 0.05). One patient in sphincterotomy group died due to multiple bony injuries and fat embolism. Two patients developed fever following ERCP, which responded to antibiotic treatment.Conclusions:  Endoscopic treatment with nasobiliary drainage without sphincterotomy is the optimal method of management of traumatic hepatobiliary injuries in hemodynamically stable patients.
Subjective well‐being as a predictor of all‐cause mortality among middle‐aged and elderly people living in an urban Japanese community: A seven‐year prospective cohort study
Authors: Iwasa Hajime , Kawaai Chieko , Gondo Yasuyuki , Inagaki Hiroki , Suzuki Takao 
Published: November 2006

Background:  Research has reported a close relationship between subjective well‐being and maintenance of physical and psychological health in later life. We explored an intergender difference in subjective well‐being, correlates of subjective well‐being, and a subjective well‐being–mortality association among middle‐aged and elderly people, using a prospective population‐based study.Methods:  The participants were 1034 men and 1413 women aged 52–77 years at the baseline, living in an urban Japanese community. The baseline data on age, number of years of education, hospitalization, chronic conditions, living alone and subjective well‐being (measured by the 17‐item Philadelphia Geriatric Center Morale Scale) collected in 1993.Results:  Analysis of covariance controlling for potential confounders, revealed no intergender difference in subjective well‐being. Multiple regression analysis to explore factors related to subjective well‐being showed that age in men, and the number of years of education in both genders were significantly, independently and positively associated with subjective well‐being, and that hospitalization, chronic conditions and living alone in both genders were significantly, independently and negatively related to subjective well‐being. In the Cox’s multivariate hazard model adjusted for the confounders, there was a significant and independent association between a low level of subjective well‐being and the risk for all‐cause mortality in men (1‐standard‐deviation decrement; risk ratio [RR] = 1.22, 95% confidence interval [CI]: 1.07–1.46) and women (RR = 1.50, 95% CI: 1.15–1.83).Conclusion:  Subjective well‐being is a reliable predictor for all‐cause mortality among middle‐aged and elderly people in both genders.
Comparison of health services use by Chinese urban and rural older adults in Yunnan province
Authors: Li Yawen , Chi Iris , Zhang Kaiti , Guo Ping 
Published: November 2006

Background:  This article examines and compares the pattern of determinants of health services use between Chinese older adults residing in urban and rural areas of Yunnan province, China.Methods:  Data from the Sample Survey on Aged Population in Urban/Rural China (SSAPUR) are used to compare the patterns of determinants for both physician visit and hospitalization between the urban and rural respondents. Andersen’s health service utilization model was adopted as a conceptual framework.Results:  Findings revealed that different patterns of determinants in physician visits and hospitalization existed among the two groups, implying that different barriers in health access are faced. The financial barrier was a prominent factor faced by urban elders in access to both physician visits and hospitalization, while rural elders encountered physical barriers in addition to financial difficulty when accessing health care.Conclusion:  Study of the elderly population in Yunnan province helps to contrast the differences in health service use between urban and rural elders, which would shed light on possible focus in health policy‐making and resource allocation to tackle the different health access barriers.
Identification of cellulolytic bacteria in soil by stable isotope probing
Authors: El Zahar Haichar Feth , Achouak Wafa , Christen Richard , Heulin Thierry , Marol Christine , Marais Marie‐France , Mougel Christophe , Ranjard Lionel , Balesdent Jérôme , Berge Odile 
Published: November 2006

SummaryPlant residues, mainly made up of cellulose, are the largest fraction of organic carbon material in terrestrial ecosystems. Soil microorganisms are mainly responsible for the transfer of this carbon to the atmosphere, but their contribution is not accurately known. The aim of the present study was to identify bacterial populations that are actively involved in cellulose degradation, using the DNA‐stable isotope probing (DNA‐SIP) technique. 13C‐cellulose was produced by Acetobacter xylinus and incubated in soil for 7, 14, 30 and 90 days. Total DNA was extracted from the soil, the 13C‐labelled (heavy) and unlabelled (light) DNA fractions were separated by ultracentrifugation, and the structure of active bacterial communities was analysed by bacterial‐automated ribosomal intergenic spacer analysis (B‐ARISA) and characterized with denaturing gradient gel electrophoresis (DGGE). Cellulose degradation was associated with significant changes in bacterial community structure issued from heavy DNA, leading to the appearance of new bands and increase in relative intensities of other bands until day 30. The majority of bands decreased in relative intensity at day 90. Sequencing and phylogenetic analysis of 10 of these bands in DGGE profiles indicated that most sequences were closely related to sequences from organisms known for their ability to degrade cellulose or to uncultured soil bacteria.
Anammox bacteria disguised as denitrifiers: nitrate reduction to dinitrogen gas via nitrite and ammonium
Authors: Kartal Boran , Kuypers Marcel M. M. , Lavik Gaute , Schalk Jos , Op den Camp Huub J. M. , Jetten Mike S. M. , Strous Marc 
Published: November 2006

SummaryAnaerobic ammonium‐oxidizing (anammox) bacteria oxidize ammonium with nitrite and produce N2. They reside in many natural ecosystems and contribute significantly to the cycling of marine nitrogen. Anammox bacteria generally live under ammonium limitation, and it was assumed that in nature anammox bacteria depend on other biochemical processes for ammonium. In this study we investigated the possibility of dissimilatory nitrate reduction to ammonium by anammox bacteria. Physically purified Kuenenia stuttgartiensis cells reduced 15NO3– to 15NH4+ via 15NO2– as the intermediate. This was followed by the anaerobic oxidation of the produced ammonium and nitrite. The overall end‐product of this metabolism of anammox bacteria was 15N15N dinitrogen gas. The nitrate reduction to nitrite proceeds at a rate of 0.3 ± 0.02 fmol cell−1 day−1 (10% of the ‘normal’ anammox rate). A calcium‐dependent cytochrome c protein with a high (305 μmol min−1 mg protein−1) rate of nitrite reduction to ammonium was partially purified. We present evidence that dissimilatory nitrate reduction to ammonium occurs in Benguela upwelling system at the same site where anammox bacteria were previously detected. This indicates that anammox bacteria could be mediating dissimilatory nitrate reduction to ammonium in natural ecosystems.
Staged anterior resection and TEM to preserve rectal function in synchronous malignant and benign rectal lesions
Authors: Betambeau N. , Simson J. N. L. 
Published: November 2006

AbstractBackground  Traditionally patients with a high rectosigmoid carcinoma and a synchronous large distal rectal adenoma would be treated by low anterior resection with associated loss of rectal function.Method  Four patients with a carcinoma of the upper rectum or distal sigmoid colon and a synchronous distal rectal adenoma were treated by high anterior resection followed by staged Transanal Endoscopic Microsurgery (TEM) thus conserving the distal rectum. Preoperative and postoperative rectal function was assessed using the St. Mark's incontinence score.Results  The proximal carcinomas and distal adenomas were 12–18 cms and 0.5–9 cms respectively from the dentate line. The mean surface area of the distal adenomas was 9.7 cms2. There were no deaths or major complications. There were no recurrences after a mean follow‐up of 31.5 months. Rectal function was unchanged in three patients with a minor increase in the score in one.Conclusion  Staged high anterior resection and ‘rEM offers effective treatment of synchronous rectosigmoid carcinoma and distal rectal adenoma with preservation of rectal function.
Significance of micrometastases in pelvic lymph nodes detected by real‐time reverse transcriptase polymerase chain reaction in patients with clinically localized prostate cancer undergoing radical prostatectomy after neoadjuvant hormonal therapy
Authors: Miyake Hideaki , Kurahashi Toshifumi , Hara Isao , Takenaka Atsushi , Fujisawa Masato 
Published: November 2006

OBJECTIVETo clarify the significance of micrometastases in pelvic lymph nodes in patients treated by radical prostatectomy (RP) for prostate cancer after neoadjuvant hormonal therapy (NHT).PATIENTS AND METHODSThe study included 52 patients with clinically localized prostate cancer who received NHT followed by RP. The expression of prostate‐specific antigen (PSA) and prostate‐specific membrane antigen (PSMA) in 989 lymph nodes isolated from the 52 patients were assessed by a fully quantitative real‐time reverse‐transcriptase polymerase chain reaction (RT‐PCR). We regarded specimens in which either PSA or PSMA mRNA were positive as showing the ‘presence of micrometastasis’. Lymph node specimens were also stained immunohistochemically with an antibody against PSA.RESULTSPathological examinations detected tumour cells in 11 lymph nodes from four patients, and real‐time RT‐PCR further identified micrometastasis in 40 lymph nodes from 19 patients with no pathological evidence of nodal involvement. The presence of micrometastatic cancer cells was confirmed by immunohistochemical staining in 19 lymph nodes from 11 patients with pathologically negative nodes. The presence of micrometastases was significantly associated with other conventional prognostic variables, including the pretreatment serum PSA level, biopsy Gleason score and surgical margin status. The biochemical recurrence‐free survival rate in patients with no micrometastasis was significantly higher than that in those with micrometastasis. Furthermore, multivariate analysis identified the presence of micrometastasis as an independent factor predicting biochemical recurrence.CONCLUSIONSAlthough residual foci of atrophic prostate cancer cells in resected lymph nodes after NHT can be difficult to diagnose by routine pathological examination, the present results show the usefulness of quantitative real‐time RT‐PCR targeting PSA and PSMA genes for detecting micrometastatic tumour foci in pelvic lymph nodes from patients with localized prostate cancer treated by NHT followed by RP. Furthermore, the present findings suggest that micrometastases in pelvic lymph nodes might be, at least partly, important in the development of biochemical recurrence in some patients undergoing RP after NHT.
Prospective evaluation of p53 as a prognostic marker in T1 transitional cell carcinoma of the bladder
Authors: Dalbagni Guido , Parekh Dipen J. , Ben‐Porat Leah , Potenzoni Michele , Herr Harry W. , Reuter Victor E. 
Published: November 2006

There have been several published reports that p53 is a useful prognostic marker for progression and survival in bladder cancer. Authors from the USA used p53 tissue typing by immunohistochemistry in a prospective cohort of patients with T1 bladder cancer, and did not find it to be a clinically useful prognostic marker. In a study from the same institution, investigators found that the concept that a minimal surgical margin in patients undergoing partial nephrectomy for renal cortical tumours should not be allowed in patients with a high malignant potential.OBJECTIVETo prospectively evaluate p53 overexpression as a predictor of survival in patients with a first diagnosis of T1 transitional cell carcinoma (TCC) of the bladder, as several reports implicate p53 as an important prognostic marker for progression and survival, but all previous studies were retrospective, giving conflicting and irreproducible results, rendering inappropriate any attempt at integrating p53 into clinical decision‐making.PATIENTS AND METHODSPatients with a first diagnosis of T1 TCC of the bladder were enrolled; p53 overexpression was assessed by immunohistochemistry (IHC) using both monoclonal antibody 1801 and DO7. The pathological stage and IHC score were assigned by one pathologist, and the markers were scored categorically.RESULTSOf the 89 patients who were evaluable, 53 had p53‐positive tumours. The median follow‐up for the survivors was 52 months. Eighty‐two patients had high‐grade tumours, using the World Health Organisation/International Society of Urological Pathology 1998 grading system. Fifty‐eight patients had unifocal tumours and 34 had associated carcinoma in situ. During the follow‐up, 34 additional patients had a radical cystectomy and nine died from bladder cancer. The association of p53 overexpression with progression or survival was not significant.CONCLUSIONSp53 tissue typing by IHC in a prospective cohort of patients with T1 bladder cancer was not clinically useful as a prognostic marker in a contemporary series of T1 tumours.
Malignancies after renal transplantation in southern Taiwan: experience in one centre
Authors: Feng Wen‐Wei , Wang Tsu‐Nai , Chen Hsiu‐Chao , Ho Ji‐Chen , Ko Ying‐Chin 
Published: November 2006

OBJECTIVETo present data on cancer distribution in renal‐transplant recipients in Chinese people, as in Western studies renal‐transplant recipients are reportedly at greater risk of malignancies, especially skin cancer, but there is limited information in Chinese people.PATIENTS AND METHODSUsing the data of a cancer registry, we compared a hospital‐based cohort of 283 renal‐transplant recipients between 1981 and 2002 with the general population in Taiwan, to identify the incidence and risk factors of cancer.RESULTSThe cumulative period of observation was 22 582.93 person‐months. Twenty‐five patients (8.83%) developed malignancies after renal transplantation; the standardized incidence ratio was 4.6 (95% confidence interval 2.84–6.48). Bladder and renal cancers were commonest, and the cumulative incidence rate (CIR) was 4.59%. The second most frequent type was hepatoma, where the CIR was 1.77%. The third was malignant tumour of the skin, with a CIR of 1.41%; these comprised three Kaposi’s sarcoma and one malignant lymphoma, with no incidence of squamous or basocellular skin cancer.CONCLUSIONCompared with Western countries, the distribution pattern of cancer after kidney transplantation was different, with no squamous or basocellular skin cancers, and a very high incidence of kidney and urinary tract cancer.
Prognostic impact of lymphovascular invasion in radical prostatectomy specimens
Authors: May Matthias , Kaufmann Olaf , Hammermann Fränze , Loy Volker , Siegsmund Michael 
Published: November 2006

OBJECTIVETo estimate the prognostic value of lymphovascular invasion (LVI) in patients with node‐negative prostate cancer treated by radical prostatectomy (RP).PATIENTS AND METHODSIn all, 412 patients with prostatic adenocarcinoma who had RP and pN0 status were analysed for all established standard pathological factors and LVI. The influence of these pathological findings on biochemical failure was evaluated by multivariate analysis with the Cox model. The mean (range) follow‐up was 52.5 (10–116) months.RESULTSLVI was identified in 42 patients (10.2%) and significantly associated with a high preoperative prostate‐specific antigen (PSA) level, a high PSA density, high percentage of positive biopsy cores, high Gleason score, and seminal vesicle invasion. Of the 42 patients with LVI, 33 (79%) had a Gleason score of ≥ 7 and 27 (64%) had pathological stage pT3. The 5‐year biochemical‐free survival was 87.3% for patients with no LVI and 38.3% with LVI on the RP specimen (P < 0.001). By multivariate analysis, LVI and Gleason score were independent predictors of biochemical failure.CONCLUSIONThese results show that in addition to the Gleason score, only LVI is strongly correlated with biochemical failure after RP. These findings support the routine evaluation of LVI status in RP specimens and provide the option for its incorporation into nomograms predictive of oncological outcome.
Routine interval computed tomography to detect new soft‐tissue disease might be unnecessary in patients with androgen‐independent prostate cancer and metastasis only to bone
Authors: Wu Shenhong L. , Jones Elizabeth , Gulley James L. , Arlen Philip M. , Chen Clara C. , Figg William D. , Dahut William L. 
Published: November 2006

OBJECTIVETo identify patients with androgen‐independent prostate cancer (AIPC) with bone metastasis and no soft‐tissue metastases at the time of protocol enrolment, and analyse their disease progression by computed tomography (CT), bone scan, and prostate‐specific antigen (PSA) level to determine the utility of routine interval CT in such patients.PATIENTS AND METHODSBone is the most common metastatic site in patients with AIPC and the only site of metastatic disease for many; because some with initial bone metastasis eventually develop soft‐tissue disease, many clinical trials use routine CT to monitor for the latter as a sign of disease progression, but the actual incidence of new soft‐tissue metastases is unknown and the role of routine interval CT in monitoring for disease progression, especially for asymptomatic patients, is unclear. Thus we reviewed 175 cases of metastatic AIPC from three randomized phase II clinical trials (docetaxel/thalidomide, docetaxel/vaccine, and ketoconazole/alendronate) at the National Cancer Institute between 1995 and 2004. The patients’ PSA levels were assessed every 4 weeks, and CT and bone scans were done every 2–3 months. We retrospectively identified patients with bone metastasis only and examined subsequent CT for the occurrence of soft‐tissue disease. For patients with progressive disease, we also examined bone scan and PSA progression.RESULTSOf 175 patients with metastatic prostate cancer, 105 (60%) had bone metastasis only, 12 (6.9%) had soft‐tissue metastases only, and 58 (33.1%) had both bone and soft‐tissue metastases. The median (range) follow‐up was 8 (1–44) months for the 105 patients with bone metastasis only. During that time, two patients (1.9%) developed new soft‐tissue disease; one developed right iliac fossa lymphadenopathy after 8 months and the other developed a perirectal mass after 12 months. The patient with new lymphadenopathy also had multiple new bone lesions identified by bone scan and PSA progression. The patient with the perirectal mass had PSA progression and a palpable abnormality.CONCLUSIONThis review of patients with AIPC and bone metastasis only, followed for a median of 8 months on clinical trials, shows that the incidence of asymptomatic new soft‐tissue disease as the only sign of disease progression is quite low. Therefore, routine CT to exclude new soft‐tissue disease in this population appears to be unwarranted. We recommend that for these patients CT is done only at the time of disease progression, as shown by bone scan, PSA level, or clinical presentation. We do not exclude the possibility that patients who remain on trial for significantly longer periods might benefit from routine interval CT.
The Gagauz, a Linguistic Enclave, are not a Genetic Isolate
Authors: Nasidze Ivan , Quinque Dominique , Udina Irina , Kunizheva Svetlana , Stoneking Mark 
Published: November 2006

SummaryThe Gagauz are a Turkic‐speaking group that migrated from Turkey to their present location in the southern part of the Republic of Moldova about 150 years ago. Surrounded by Indo‐European‐speaking populations, they thus form a linguistic enclave, which raises the following question: to what extent have they remained in genetic isolation from their geographic neighbours? Analyses of mtDNA and Y chromosome variation indicate that despite their linguistic differences, the Gagauz have admixed extensively with neighbouring groups. Our data suggest that there has been more mtDNA than Y chromosome admixture, in keeping with the patrilocal nature of these groups. Moreover, when compared with another linguistic enclave, the Kalmyks there appears to be a correlation between the amount of genetic admixture and the amount of linguistic influence that these two linguistic enclaves have experienced from neighbouring groups.