bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management options in vertebral artery injuries
Authors: Demetriades D , Theodorou D , Asensio J , Golshani S , Belzberg H , Yellin A , Weaver F , Berne T V 
Published: March 2007

Abstract
The treatment of 22 patients with vertebral artery injuries was reviewed. Only four patients required an emergency operation. Most of the injuries (13 of 22) were successfully managed by observation. Five patients were managed by angiographic embolization which was successful in three. In three patients with an aneurysm and arteriovenous fistula, proximal embolization of the vascular lesion was not adequate and a suboccipital craniectomy was required for distal ligation. Most vertebral artery injuries can safely be managed without an operation, or by angiographic embolization. Surgical intervention should be reserved for patients with severe bleeding or where embolization has failed.
Open diagnostic peritoneal lavage
Authors: Potter M A , Paterson-Brown S 
Published: March 2007

Abstract
Diagnostic peritoneal lavage (DPL) plays an important part in the assessment of patients with blunt abdominal trauma. For reasons of safety the open technique is recommended by the Advanced Trauma Life Support (ATLS) Course for Physicians1. In the absence of good lighting and with limited assistance in the trauma suite this method can be time-consuming and often contaminated with blood especially in the obese patient. For similar reasons of safety open techniques for insertion of laparoscopic ports have been developed. The open technique for port insertion2 provides a quick, virtually blood-free access to the peritoneum whatever the ambient conditions and equipment available. This technique is described below.
Prolonged peripheral parenteral nutrition with an ultrafine cannula and low-osmolality feed
Authors: Williams N , Wales S , Irving M H 
Published: March 2007

Abstract
Peripheral parenteral nutrition is an attractive alternative to centrally delivered parenteral nutrition because it obviates the need for central venous cannulation and its attendant complications. Some 45 consecutive patients were fed peripherally using a 22-G polyurethane catheter and a fat-based, low-osmolality feed. Of these patients, 36 were fed for a median of 8.5 (range 3–31) days without peripheral vein thrombophlebitis (PVT). Seven patients developed PVT after a median of 6 (range 5–7) days. The cumulative daily risk of PVT was 0.016 episodes per day. These results suggest that prolonged (more than 7 days) problem-free peripheral parenteral nutrition is possible.
Hepatectomy with an ultrasonic dissector for hepatocellular carcinoma
Authors: Fan S-T , Lai E C S , Lo C-M , Chu K-M , Liu C-L , Wong J 
Published: March 2007

Abstract
This study compared the results of hepatectomy for hepatocellular carcinoma (HCC) using an ultrasonic dissector with those of a combination of the crushing clamp and finger fracture techniques. The crushing clamp and finger fracture method was used from 1989 to 1992 in 96 patients (group 1) and the ultrasonic dissector from 1993 to 1994 in 69 patients (group 2). Data from these two sets of patients were collected prospectively. The groups were comparable in terms of preoperative liver function, tumour size and stage, and the incidence of cirrhosis. Major hepatectomy was performed in 69 patients (72 per cent) of group 1 and in 52 (75 per cent) of those in group 2. Use of the ultrasonic dissector resulted in lower mean(s.e.m.) blood loss (group 1 3.4(0.4) litres versus group 2 2.4(0.2) litres, P = 0.02), lower mean(s.e.m.) blood transfusion requirement (2.2(0.2) versus 1.2(0.2) litres, P =0.001) and more patients not requiring blood transfusion (8 per cent of group 1 versus 32 per cent of group 2, P = 0.0001). Postoperative complications occurred in 45 patients (47 per cent) of group 1 and 19 (28 per cent) of those in group 2 (P = 0.012). There were no deaths in group 2 whereas the hospital mortality rate in group 1 was 16 of 96 (17 per cent) (P = 0.0004). A wider tumour-free resection margin (mean(s.e.m.) 1.2(0.1) versus 0.9(0.1) cm, P&lt;0.05) and lower serum bilirubin level throughout the postoperative period were also observed in group 2 patients. The ultrasonic dissector is better than the crushing clamp and finger fracture technique in hepatectomy for HCC.
Invited comment
Authors: Chant A D B 
Published: March 2007

Abstract
The author's leg ulcer unit has been involved in compression methods for 45 years1. During this time views expressed by its clinicians on compression and its relevance to the aetiology of ulceration have developed in parallel. This differs from the situation in other centres, where the cause of such lesions has so far been examined in detail only in the ulcerated leg itself. The situation found in such limbs includes ‘venostasis’, leg oedema, arteriovenous shunts, free radicals, pericapillary fibrin cuffs, micro-oedema, and vessel plugging by leucocytes and microthrombi. By contrast the author's unit has approached the problem from the perspective of the normal limb. The physiological vulnerability of any limb has been used as a model for the vulnerability of the varicose limb. A compression treatment regimen counteracts two simple gross determinants of ulceration; first, the pressure amplitude changes during exercise and, second, the pressure gradient. This broad conceptual approach has allowed the identification of important relationships which have long since been buried beneath the wealth of what the author believes to be a secondary phenomenon recorded in the literature.
Thirty-five years of isolated limb perfusion for melanoma: Indications and results
Authors: Vrouenraets B C , Nieweg O E , Kroon B B R 
Published: March 2007

Abstract
Isolated limb perfusion (ILP) for limb melanoma remains controversial despite its frequent use for over 35 years. To determine whether it has proven benefits, reported results have been reviewed. The value of adjuvant ILP cannot be determined from the multitude of retrospective studies on this subject. Preliminary results of the large European Organization for Research and Treatment of Cancer–World Health Organization–North American Perfusion Group trial suggest that patients with melanomas of 1·5–3·0 mm in thickness who do not undergo elective lymph node dissection may have a locoregional control benefit from ILP. However, as long as a definite survival advantage for ILP has not been demonstrated, such treatment does not seem justified for these patients. The value of prophylactic ILP after resection of recurrent limb melanoma is also scientifically unproven. The potential prevention of further limb recurrence for only a limited period of time, as demonstrated in a rather small Swedish trial, probably does not justify routine use of ILP in these patients; a large international trial will be needed to assess whether ILP provides a survival advantage. For those with locally inoperable limb melanoma, ILP appears to be the treatment of choice since it results in complete disappearance of all macroscopic disease in a substantial proportion of patients, removing the need for amputation and providing palliation of symptoms. However, high limb recurrence rates and short duration of response need improvement. Results of alternative treatments should be compared prospectively with those of ILP in this clinical situation.
Vascular complications of injecting drug misuse
Authors: Woodburn K R , Murie J A 
Published: March 2007

Abstract
Drug misuse is now a significant problem in western society; many different Pharmaceuticals are administered by drug abusers as intravenous preparations. This has resulted in an increasing number of complications associated with prolonged intravascular and perivascular injection of abused substances. These complications of intravenous drug abuse may lead to limb-threatening arterial injuries that present a considerable management problem in patients who often have significant co-morbidity. This article provides a comprehensive review of the vascular complications that result from drug misuse by injection. It discusses the aetiology and clinical features of these complications and highlights the limited role of both the general surgeon and specialist vascular surgeon in the management of these patients.
Vein morphology and bypass graft stenosis
Authors: Varty K , Porter K , Bell P R F , London N J M 
Published: March 2007

Abstract
Vein wall morphology (intimal and medial thickness) was studied in a consecutive series of 100 veins before organ culture. The development of a proliferative neointima after 14 days in culture was quantified by measuring neointimal thickness, and the relationship between this and the original vein wall morphology was investigated. The correlation between the intimal or medial thickness before culture and neointimal thickness following culture was poor (rS intima/neointima = 0·21, rS media/neointima = 0·09). Long saphenous vein biopsies were obtained from 53 patients at the time of infrainguinal bypass surgery and their morphology was studied as above. Median intimal and medial thickness before grafting was 21 (range 2–208) and 245 (range 108–557) μm respectively. After 12 months in a colour duplex graft surveillance programme, 46 grafts were patent and 17 of these had developed a stenosis. There was no difference in intimal (28 versus 19 μm, P = 0·1) or medial (247 versus 245 μm, P = 0·47) thickness between stenosed and non-stenosed grafts respectively. Both the laboratory and clinical evidence from this study fail to support the hypothesis that pre-existing vein wall thickening is a key factor in the aetiology of vein graft stenosis.
Image-guided core biopsy in patients with breast disease
Authors: Chare M J B , Flowers C I , O'Brien C J , Dawson A 
Published: March 2007

Abstract
Ultrasonographically-guided core biopsy has been used as an adjunct to triple assessment when fine-needle aspiration cytology was inadequate or equivocal, if the overall assessment of the patient was uncertain, or if it was deemed the preferred diagnostic option. Some 143 of 2603 patients had a guided core biopsy, 125 to establish the diagnosis and 18 to obtain histology in cytologically proven malignancy. A diagnosis of malignancy was established in 43 of the 125 patients who had a diagnostic core biopsy. Some 45 patients with benign disease were either discharged or returned to follow-up on the basis of the core biopsy. The remaining 37 patients required surgical biopsy, of whom 13 had malignant and 24 benign disease. The overall positive predictive value for malignancy was 98 per cent. Experience with ultrasonographically-guided core biopsy shows that it can reduce the need for surgical biopsy in both benign and malignant conditions of the breast.
Angiogenesis inhibitor TNP-470 prevents implanted liver metastases after partial hepatectomy in an experimental model without impairing wound healing
Authors: Tanaka H , Taniguchi H , Mugitani T , Koishi Y , Masuyama M , Koyama H , Hoshima M , Takahashi T 
Published: March 2007

Abstract
The ability of the angiogenesis inhibitor TNP-470 to prevent liver metastasis after partial hepatectomy, and whether TNP-470 impairs liver regeneration or skin wound healing, was evaluated. Following the injection of VX2 carcinoma cells into the portal vein of rabbits, half of the animals underwent resection of the middle hepatic lobe (hepatectomized group) and half did not (non-hepatectomized group). TNP-470 (50 mg) was infused continuously into the portal vein in both groups for 7 days, while controls received only water. The hepatectomized TNP-470-treated group had significantly fewer tumours (mean(s.e.m.) 23·3(12·3)) than the hepatectomized control group (123·7(24·4)). There was no significant difference in the 5-bromo-2′-deoxyuridine labelling index of regenerated hepatocytes between the TNP-470-treated and control groups. Wound healing in TNP-470-treated animals was not impaired. Intraportal infusion of TNP-470 prevents the recurrence of liver metastasis after partial hepatectomy without impairing healing or liver regeneration.
Clinicopathological features and prognosis of gastric cancer in young European adults
Authors: Santoro R , Carboni F , Lepiane P , Ettorre G M , Santoro E 
Published: March 2007

AbstractBackgroundThe aims of this study were to define the clinicopathological features and prognosis of gastric cancer in young European adults.MethodsBetween 1990 and 2004, 603 patients with gastric cancer were enrolled in a prospective database. The findings for 51 (8·5 per cent) patients aged 45 years or less were compared with those of 457 aged between 46 and 75 years.ResultsIn the younger group there were significantly more women (57 versus 36·3 per cent; P = 0·004), Laurén diffuse-type carcinomas (73 versus 42·7 per cent; P &lt; 0·001), N2–3 lymph node metastases (59 versus 38·9 per cent; P = 0·005), stage IV disease (49 versus 35·7 per cent; P = 0·085) and resections that were non-curative (36 versus 18·5 per cent; P = 0·007) than in the older patients. Actuarial survival rates in younger patients at 5 and 10 years after resection were 40 and 32 per cent respectively, similar to those in older patients (P = 0·540). Unfavourable prognostic factors associated with poor 5-year survival were the degree of gastric wall invasion (T3–4 versus T1–2; P &lt; 0·001), lymph node invasion (positive versus negative; P &lt; 0·001), disease stage (III–IV versus I–II; P &lt; 0·001) and curability of resection (non-curative versus curative; P &lt; 0·001).ConclusionGastric cancer in young adults tends to be more advanced; however, when matched for stage, the prognosis does not differ from that of older patients.
Compared to whom? The impact of status on third person effects in advertising persuasion in a South African context
Authors: Grier Sonya A. , Brumbaugh Anne M. 
Published: February 2007

Abstract

In an experiment conducted in South Africa, we show that perceptual differences between the self and other that underlie third person effects have not only magnitude (e.g., third person effects increase as perceived self‐other differences increase), but also valence. Specifically, individuals contrast themselves against lower status others, resulting in greater third person effects, but compare themselves favorably with higher status others, resulting in smaller third person effects. High status others serve as a norm against which people gauge their own and others' responsiveness to persuasion attempts like advertising. Implications for third person effects, status and the construal of the ‘other,’ and the socio‐cultural context of advertising are discussed. Additionally, we describe managerial considerations regarding branding and target marketing that diverge from Western assumptions about persuasion knowledge and receptivity toward advertising.

Copyright © 2007 John Wiley & Sons, Ltd.
In Vivo Characterization of Tandem C‐Terminal Thioesterase Domains in Arthrofactin Synthetase
Authors: Roongsawang Niran , Washio Kenji , Morikawa Masaaki 
Published: February 2007

AbstractMacrocyclization of a peptide or a lipopeptide occurs at the last step of synthesis and is usually catalyzed by a single C‐terminal thioesterase (Te) domain. Arthrofactin synthetase (Arf) from Pseudomonas sp. MIS38 represents a novel type of nonribosomal peptide synthetase that contains unique tandem C‐terminal Te domains, ArfC_Te1 and ArfC_Te2. In order to analyze their function in vivo, site‐directed mutagenesis was introduced at the putative active‐site residues in ArfC_Te1 and ArfC_Te2. It was found that both Te domains were functional. Peaks corresponding to arthrofactin and its derivatives were absent in ArfC_Te1:S89A, ArfC_Te1:S89T, and ArfC_Te1:E26G/F27A mutants, and the production of arthrofactin by ArfC_Te2:S92A, ArfC_Te2:S92A/D118A, and ArfCΔTe2 was reduced by 95 % without an alteration of the cyclic lipoundecapeptide structure. These results suggest that Ser89 in ArfC_Te1 is essential for the completion of macrocyclization and the release of product. Glu26 and Phe27 residues are also part of the active site of ArfC_Te1. ArfC_Te2 might have been added during the evolution of Arf in order to improve macrocyclization efficiency.
Snare retrieval of a catheter fragment with inaccessible ends from the pulmonary artery
Authors: Greenfield Douglas H. , McMullan George K. , Parisi Alfred F. , Askenazi Joseph 
Published: March 2007

AbstractFrequent use of central venous lines has led to an increasing problem with embolized catheter fragments which have become lodged in the right heart and pulmonary vasculature. Removal of catheter fragments is justified because of a high complication rate when they are left in situ. Using a snare retrieval apparatus catheter fragments may be quickly and easily removed. In the past year we have seen 3 patients with embolized catheter fragments. One case was unusual in that its transverse position in the pulmonary vasculature required initial dislodgement with a pigtail catheter before it could be successfully snared. The literature and our experience suggest that most, if not all, catheter fragments in the right heart and pulmonary circulation can be successfully retrieved without resorting to thoracotomy.
Neovascularity related to a mural thrombus
Authors: Calick Arthur , Dorsey Thomas J. 
Published: March 2007

AbstractThis is a case report on an unusual angiographic finding related to a left ventricular mural thrombus. An abnormal vascular blush of contrast was noted on performing coronary arteriography. This was attributed to neovascularity in a left ventricular mural thrombus. This abnormality must be distinguished from vascular fistulas, intracardiac communications, and tumors in making appropriate therapeutic decisions.
Profiles of radionuclide left ventricular ejection fraction changes induced by supine bicycle exercise in normals and patients with coronary heart disease
Authors: Pfisterer Matthias E. , Slutsky Robert A. , Schuler Gerhard , Ricci Donald R. , Swanson Sue S. , Gordon Donald G. , Battler Alexander , Froelicher Victor F. , Peterson Kirk E. , Ashburn William L. 
Published: March 2007

AbstractThis paper presents the profiles of left ventricular ejection fraction (EF) during and following supine bicycle exercise in normal subjects and in patients with coronary heart disease, as well as the relationship of the described patterns to clinical parameters. Twenty normal men and 40 patients with coronary artery disease were studied using gated equilibrium radionuclide angiography (EQ‐EF). In the normals, during exercise, EF increased by a mean of 25% of the resting value, with an increase of no less than 11%. The exercise‐limiting symptom in patients with coronary artery disease was angina pectoris in 20 and fatigue in the other 20 patients. In the angina patients, there was a mean decrease in EF of 20%, and in the other coronary artery disease patients ejection fraction changed little. Only two patients with coronary artery disease increased ejection fraction from a normal resting value to peak exercise by more than 11%, and they had isolated right coronary lesions. An “overshoot” elevation of ejection fraction above resting levels was demonstrated following termination of exercise in most patients. The patients with a significant fall in exercise ejection fraction more frequently had abnormal exercise‐induced ECG changes as well as abnormal left ventriculograms and more severe coronary artery disease at cardiac catheterization than the patients with little change in ejection fraction. We conclude that 1) normals could be separated from most patients with significant coronary artery disease in this study population; 2) ejection fraction must be measured at maximal exercise for it to have diagnostic value, since there could be a normal rise before and after peak exercise and an abnormal response missed; and 3) the ejection fraction response to exercise reflects the severity of the underlying coronary artery disease. The described patterns of exerciseinduced changes in left ventricular ejection fraction are important to consider when using this new technique to diagnose and evaluate patients with coronary artery disease.
Left atrial volume estimation by two‐dimensional echocardiography
Authors: Schabelman Sergio , Schiller Nelson B. , Silverman Norman H. , Ports Thomas A. 
Published: March 2007

AbstractWe examined 12 patients aged six months to 76 years by echocardiography to determine left atrial volume. The results were compared with angiographic left atrial volumes calculated by the biplane Simpson's rule method. Three two‐dimensional planes were used: precordial long axis, apical two‐chamber, and four‐chamber. Area outlines were traced using a light pen computational system providing single plane area length estimates of left atrial volume. The two apical left atrial outlines were combined, and Simpson's rule method was used to calculate left atrial volume. M‐mode echocardio‐grams performed on these patients were used to estimate left atrial volume. As the resuits of covariance analysis showed that there was no significant difference in the line of regression in systole and diastole, these data were pooled for subsequent comparison with angiography.The closest correlation with angiography was the biplane Simpson rule method with the echocardiographic left atrial volume (Y) = 1.0, angiographic volume (X) + 6.3 ml, r = 0.86. The single plane area length estimates also correlated well with angiography, but correction factors were required. M‐mode estimates of left atrial volume could only correlate to angiography using a power function y = 3.7 X1.80, r = 0.69.We conclude that left atrial volume can be determined by two‐dimensional echocardiography and that this technique is superior to M‐mode echocardiography.
Percutaneous central venous catheterization performed by medical house officers: A prospective study
Authors: Bo‐Linn George W. , Anderson David J. , Anderson Kenneth C. , McGoon Michael D. 
Published: March 2007

AbstractWe prospectively determined the complications of percutaneous central venous catheterizations performed by medical house officers in 302 patients. We also analyzed the factors affecting the success and complication rates of such invasive procedures. The central vein was successfully catheterized in 363 (77% ) of 470 attempts. The internal jugular and subclavian vein approaches were significantly more successful (86% ) than the external jugular vein approach (61%, P < 0.001 by X2). The success rate improved significantly when catheterization was attempted under elective circumstances (P < 0.003) and also after the vein was initially located with a small‐gauge needle (P < 0.001). Our results suggest that efforts should be abandoned after the third unsuccessful pass with a large‐gauge needle in the same site. Complications of catheter insertion included bleeding (ten patients), hematoma (15 patients), inadvertent arterial punctures (14 patients), iatrogenic pleural effusions (four patients), and pneumothoraces (eight patients). No complications appeared to have a major adverse effect on a patient's clinical course. The inexperienced operator (fewer than 25 prior catheterizations) has a success rate equal to that of the more experienced operator (more than 25 prior catheterizations), but he may be more likely to produce a complication. Medical house officers can perform percutaneous central venous catheterizations with a high rate of success and at low risk to the patient.