bluuebunny/crossref_metadata_2025_split huggingface dataset:
Small bowel tumours in emergency surgery: specificity of clinical presentation
Authors: Catena Fausto , Ansaloni Luca , Gazzotti Filippo , Gagliardi Stefano , Di Saverio Salomone , De Cataldis Angelo , Taffurelli Mario 
Published: November 2005

Background:  Despite advances in diagnostic modalities, small bowel tumours are notoriously difficult to diagnose and are often advanced at the time of definitive treatment. These malignancies can cause insidious abdominal pain and weight loss, or create surgical emergencies including haemorrhage, obstruction or perforation. The aim of the present study was to describe the clinical presentation, diagnostic work‐up, surgical therapy and short‐term outcome of 34 patients with primary and secondary small bowel tumours submitted for surgical procedures in an emergency setting and to look for a correlation between clinical presentation and the type of tumours.Methods:  From 1995 to 2005, 34 consecutive surgical cases of small bowel tumours were treated at the Department of Emergency Surgery of St Orsola‐Malpighi University Hospital, Bologna, Italy. Clinical and radiological charts of these patients were reviewed retrospectively from the department database.Results:  All patients presented as surgical emergencies: intestinal obstruction was the most common clinical presentation (15 cases), followed by perforation (11 cases) and gastrointestinal bleeding (eight cases). Lymphoma was the most frequent histologic type (nine patients), followed by stromal tumours (eight patients), carcinoids (seven patients), adenocarcinoma (seven patients) and metastasis (three patients). Of the nine patients with lymphoma, eight were perforated, all patients with stromal tumours had bleeding, and all carcinoids patients had bowel obstruction. There were two patients with melanoma metastasis, both had bowel intussusception. Resection of the neoplasm was carried out in 32 patients and two patients were deemed unresectable and received a palliative procedure.Conclusions:  The present study shows that there is a correlation between small bowel tumours and clinical emergency presentation: gastrointestinal stromal tumours (GIST) mostly bleed; carcinoids make an obstruction; lymphomas cause a perforation; and melanoma metastasis causes intussusception.
Methods of surgical therapy in pulmonary hydatid disease: is capitonnage advantageous?
Authors: Erdogan Abdullah , Ayten Arife , Demircan Abid 
Published: November 2005

Background:  Hydatid disease of the lungs is still a serious health problem for some Mediterranean countries. The best surgical therapy for the treatment of this disease is still unclear. In this clinical retrospective study, we aimed to investigate whether capitonnage is an effective therapy method for a pulmonary hydatid cyst or not.Methods:  Between 1990 and 2004, 89 patients (49 male and 40 female) each with a pulmonary hydatid cyst were treated surgically. The patients were divided into two groups based on whether capitonnage was carried out (group 1, n = 44) or not (group 2, n = 45). Cystotomy and the closure of the bronchial openings were carried out in both groups. The results were assessed in two groups during a 1 year follow‐up period. The groups were comparable with regards to their clinical, operative and demographic characteristics.Results:  There was no mortality, and no significant difference in hospitalisation time between the two groups. It was 8.2 ± 3.2 days for group 1 and 8 ± 3.1 days for group 2 (P = 0.89). The most serious complications were restricted bronchopleural fistula (only one patient in group 2), empyema (only one patient in group 1 and two patients in group 2), and prolonged air leak (five patients in group 1 and six patients in group 2). These results were not valuable statistically (P = 1.00, P = 1.00 and P = 0.78, respectively).Conclusions:  We conclude that it is not an advantage to carry out capitonnage when treating pulmonary hydatid cysts.
Aggressive surgical resection for hilar cholangiocarcinoma
Authors: Lai Eric C. H. , Lau Wan Yee 
Published: November 2005

Background:  Surgical treatment of hilar cholangiocarcinoma remains a great challenge to surgeons because of its low resectability, poor survival, and high operative mortality and morbidity.Methods:  The medical and pathological records of 36 patients with a preoperative diagnosis of ‘resectable’ hilar cholangiocarcinoma operated on by us between January 1998 and December 2002 were studied. The clinical presentations, operative records, and pathology results were retrospectively reviewed.Results:  Twenty‐six patients (72%) underwent resection with curative intent. Apart from resection of the extrahepatic biliary tree and porta hepatis lymph node dissection, 85% received concomitant en‐bloc liver resection and 4% received ex situ liver resection and auto‐transplantation. The margin of resection was negative (R0 resection) in 73% of patients, and microscopically positive (R1 resection) in the remaining 27%. The 30‐day hospital mortality was 7.6%. Of the patients, 42% had major postoperative complications. The median survival was 20 months, with the longest survival 75 months. The 1‐, 3‐ and 5‐year actuarial overall survival rate after resection with curative intent was 77%, 31%, and 12%, respectively. The 1‐, 3‐, and 5‐year actuarial overall survival after R0 resection was 84%, 42%, and 16%, respectively. Tumour recurrence occurred in 58% of patients.Conclusions:  Aggressive surgery increases the resectability of hilar cholangiocarcinoma. R0 resection provides the only chance of long‐term survival of these patients.
Aspirin induces apoptosis in oesophageal cancer cells by inhibiting the pathway of NF‐kappaB downstream regulation of cyclooxygenase‐2
Authors: Liu Jun‐Feng , Jamieson Glyn G. , Drew Paul A. , Zhu Gui‐Jun , Zhang Shao‐Wei , Zhu Tie‐Nian , Shan Bao‐En , Wang Qi‐Zhang 
Published: November 2005

Background:  Aspirin has potential in the prevention or treatment of oesophageal cancer, the seventh most common cancer in the world, but its mechanism of action is still not certain.Methods:  The oesophageal squamous cell carcinoma cell line TE‐13 was cultured with aspirin at different concentrations or for different times. Proliferation and apoptosis were measured by MTT reduction and flow cytometry. Expression of COX‐2 mRNA was measured by RT‐PCR and COX‐2 protein levels with Western blot analysis. Nuclear NF‐kappaB and cytoplasmic IkappaB protein levels were determined by electrophoretic mobility shift assay and Western blot, respectively.Results:  Aspirin significantly inhibited cell proliferation and induced apoptosis at concentrations of 1, 4, 8 mmol/L. Aspirin dose‐dependently decreased the levels of COX‐2 mRNA, COX‐2 protein and nuclear NF‐kappaB protein and increased the cytoplasmic IkappaB protein.Conclusion:  We conclude that aspirin inhibits the proliferation of, and induced apoptosis in, the cultured TE‐13 SCC cell line. These changes correlate with a reduction in COX‐2 mRNA and protein expression, prostaglandin synthesis, an inhibition of NF‐kappaB nuclear translocation, and an increase in cytoplasmic IkappaB. These results support the further investigation of the cyclooxygenase pathway in investigating the potential of aspirin and similar drugs in cancer prevention and therapy.
WHO GAINS FROM WHOM? SPILLOVERS, COMPETITION AND TECHNOLOGY SOURCING IN THE FOREIGN‐OWNED SECTOR OF UK MANUFACTURING
Authors: Driffield Nigel , Love James H. 
Published: November 2005

AbstractThere is a growing literature explaining foreign direct investment flows in terms of ‘technology sourcing’, whereby multinational firms invest in certain locations not to exploit their firm‐specific assets in the host environment, but to access technology that is generated by host country firms. However, it is far from clear whether the literature has found significant evidence of such activity beyond a few isolated examples. This paper extends this work by allowing for the possibility of multinational enterprises (MNEs) sourcing technology not only from host country firms but also from each other within a host economy. The paper demonstrates that MNEs in the UK do indeed appropriate spillovers both from indigenous firms and from other foreign investors, but that there are also significant competition effects that act to reduce productivity in certain industries. The paper also explores which countries' affiliates gain most from technology sourcing in the UK, and which generate the greatest spillovers within the foreign‐owned sector.
THE IMPACT OF FOREIGN OWNERSHIP AND EFFICIENCY ON POLLUTION ABATEMENT EXPENDITURE BY CHEMICAL PLANTS: SOME UK EVIDENCE
Authors: Collins Alan , Harris Richard I. D. 
Published: November 2005

AbstractThis paper examines the impact of foreign ownership and efficiency on chemical plants' pollution abatement expenditure. The model estimates presented reveal not only which factors are the key determinants of whether any abatement expenditure occurs but also explain how much was spent on the principal categories of pollution control. These chemical plant results present a conspicuous contrast with earlier results based on other industrial sectors. This would suggest that the efficiency–pollution spending relationship is also characterised by industry specific effects.
The promotion of private health insurance and its implications for the social organisation of healthcare: a case study of private sector obstetric practice in Chile
Authors: Murray Susan F. , Elston Mary Ann 
Published: November 2005

AbstractThis paper examines some of the implications of the process of privatisation of a national healthcare system for the delivery, organisation and, ultimately, the outcome of services. Through a case study of obstetric care in Chile, we illuminate the relationships between the macro‐level of political decisions, the meso‐level of the organisations through which government reforms were enacted, and the micro‐level of clinical practice. We show that, for a significant proportion of Chilean women seeking maternity care, privatisation has led to expanded access and to ostensibly highly‐personalised relationships with specialists. However, because of the fragmentation of maternity services, the altered work patterns for obstetricians occasioned by changes in healthcare financing and the relatively weak market position of most obstetricians, this personalised care is dependent on highly technologised obstetric practices. By examining the specific organisational arrangements under which private maternity care is conducted in Chile we shed light on the connection between privately‐funded maternity care and high caesarean section rates in this setting.
Managerialism in the Australian public health sector: towards the hyper‐rationalisation of professional bureaucracies
Authors: Germov John 
Published: November 2005

AbstractThis paper draws on qualitative case‐study research to discuss the impact of managerialism on the work organisation of public sector health professionals in Australia. The case studies included 71 semi‐structured interviews with a broad range of public sector health professionals (predominantly nursing and allied health professionals, with some doctors and managers). The data are used to examine the implications of managerialism for the organisation of professional (public) bureaucracies. The findings show that while health professionals were able to exert their agency to influence managerial processes, the incorporation of managerial strategies into professional practice placed constraints upon professional autonomy. The impact of managerialism on professional bureaucracies is examined using the neo‐Weberian framework of hyper‐rationality, an ideal type derived from a combination of four forms of rationality identified in Weber's work: practical, formal, substantive and theoretical rationality. Applied to the social organisation of health‐care work, this paper critically examines the utility of the hyper‐rationality ideal type, noting its limitations and the insights it provides in conceptualising the impact of managerialism on professional (public) bureaucracies.
Arguing about the evidence: readers, writers and inscription devices in coronary heart disease risk assessment
Authors: Will Catherine M. 
Published: November 2005

AbstractThis paper examines the history of tools developed to assess an individual's risk of coronary heart disease. A close reading of the tools themselves is combined with an analysis of debates published in medical journals such as the British Medical Journal (BMJ) and The Lancet. These literary conversations between scientists and doctors reveal complex negotiations about the form and meaning of medical technologies that have yet to become fully ‘stable’. Early tools were promoted as a response to the high cost of cholesterol‐lowering drugs (statins), but came to embody broader attempts to shape medical practice. These include the promotion of what has been understood as evidence‐based medicine and regulation by political and professional actors, as well as the spread of ‘risk thinking’ more generally. Despite having a central place in recent British guidelines and policy, there is a surprising variety of tools in circulation, and ongoing uncertainty about their use and value.
Finding dignity in dirty work: the constraints and rewards of low‐wage home care labour
Authors: Stacey Clare L. 
Published: November 2005

AbstractThe ageing of the population in the US and elsewhere raises important questions about who will provide long‐term care for elderly and disabled people. Current projections indicate that home care workers – most of whom are unskilled, untrained and underpaid – will increasingly absorb responsibility for care. While research to date confirms the demanding aspects of the work and the need for improved working conditions, little is known about how home care workers themselves experience and negotiate their labour on a daily basis. This paper attempts to address this gap by examining how home care workers assign meaning to their ‘dirty work’. Qualitative interviews suggest that home care workers have a conflicted, often contradictory, relationship to their labour. Workers identify constraints that compromise their ability to do a good job or to experience their work as meaningful, but they also report several rewards that come from caring for dependent adults. I suggest workers draw dignity from these rewards, especially workers who enter home care after fleeing an alienating service job, within or outside the healthcare industry.
Access, boundaries and their effects: legitimate participation in anaesthesia
Authors: Goodwin Dawn , Pope Catherine , Mort Maggie , Smith Andrew 
Published: November 2005

AbstractThe distribution of work, knowledge and responsibilities in the delivery of anaesthesia has attained particular significance recently as attempts to meet the demands of the European Working Times Directive intensify existing pressures to reorganise anaesthetic services. Using Lave and Wenger's (1991) notions of ‘legitimate peripheral participation’ in ‘communities of practice’ (and Wenger 1998) to analyse ethnographic data of anaesthetic practice we illustrate how work and knowledge are currently configured, and when knowledge may legitimately be taken as the basis for action. The ability to initiate action, to prescribe healthcare interventions, we suggest, is a critical element in the organisation of anaesthetic practices and therefore central to any attempts to reshape the delivery of anaesthetic services.
Liver allograft radiotherapy to treat rejection in children: efficacy in orthotopic liver transplantation and long‐term safety
Authors: Stephenne Xavier , Najimi Mustapha , Janssen Magda , Reding Raymond , De Ville de Goyet Jean , Sokal Etienne M. 
Published: November 2005

Abstract: Background: We studied, retrospectively, the efficacy to control rejection and long‐term safety of liver allograft radiotherapy (RT) performed in 14 children. Long‐term safety data were collected with the prospect of possible use of RT in liver cell transplantation (LCT).Methods: Immune suppression included cyclosporine, azathioprine and prednisone. In case of intractable rejection, low‐dose allograft RT was administered daily for 3 days, and short‐term efficacy was evaluated by liver enzyme assays and histology. The long‐term outcome was compared with that of 122 patients undergone transplantation and who had similar treatment, but no RT.Results: Survival at 15 years was 71.4% vs 69.7% in the comparison group. In the RT group, rejection control was complete in six of 14 children and partial in two, all being alive and well 14–18 years later. Ten of 14 children had follow‐up biopsy. Six children had normal histology and four had mild unspecific fibrosis. The long‐term follow‐up biopsy in the comparison group showed fibrosis in 42 of 85 children. The incidence of complications was similar in both groups.Conclusions: This series shows that, such a RT regimen appeared to be efficient and safe as a rescue treatment for acute rejection. Provided that further investigations in animal models show a certain benefit of low‐dose irradiation around LCT, such a regimen could be proposed in human liver cell transplant programmes.
Advances in digital quantification technique enhance discrimination between mild and advanced liver fibrosis in chronic hepatitis C
Authors: Lazzarini Amy L. , Levine Robert A. , Ploutz‐Snyder Robert J. , Sanderson Schuyler O. 
Published: November 2005

Abstract:
Background and Aims: The necessity of liver biopsy for staging fibrosis and its quantification in patients with chronic hepatitis C (CHC) remains controversial. Semiquantitative scoring of fibrosis is considered more subjective and less objective than digital quantification by image analysis. However, measurement of fibrosis using digital image analysis is thought to be less reliable in determining early stage fibrosis as compared with advanced fibrosis or cirrhosis. Our aims were to correlate all Ishak stages of fibrosis (0–6) with fibrosis percentage (%) using computerized digital image analysis, and thereby seek to improve discrimination between varying levels of liver fibrosis.Methods: Fibrosis % data were obtained by image analysis on 164 trichrome‐stained liver biopsies from untreated patients with CHC, representing all Ishak stages of fibrosis.Results: Digital analysis of fibrosis % was highly correlated with Ishak scores of fibrosis (Kendall's τ–β=0.86, P<0.001). Receiver–operator characteristic curves showed reliable discriminative capability of our digital image measurement of fibrosis when compared with semiquantitative assessments of fibrosis. Excellent interobserver reliability was found.Conclusions: Recent advances in digital quantification of fibrosis have resulted in improved discrimination between the varying stages of liver fibrosis, including mild fibrosis. This method is reproducible, can detect early as well as advanced fibrosis or cirrhosis, may prove to be the best assessment of mild fibrosis, and may be more precise than semiquantitative estimation of changes for monitoring fibrosis progression or regression during clinical therapeutic trials.
Oligonucleotide microarray analysis of differential transporter regulation in the regenerating rat liver
Authors: Dransfeld Olaf , Gehrmann Thor , Köhrer Karl , Kircheis Gerald , Holneicher Claudia , Häussinger Dieter , Wettstein Matthias 
Published: November 2005

Abstract: Aims: The aim of this study was to investigate the regulation of hepatic transport systems during liver regeneration.Methods: A DNA oligonucleotide microarray was developed with probes for 400 transcripts. Data were confirmed using real‐time PCR and on a functional level in the perfused rat liver. Liver homogenates were taken 3–48 h following 2/3‐hepatectomy in rats and compared with sham‐operated and non‐operated controls.Results: A more than two‐fold increase or decrease of expression was obtained in 183 genes following partial hepatectomy and in 16 genes in sham‐operated rats. A strong induction during liver regeneration was detected for the amino acid transporters LAT4, SN2 and sodium‐dependent neutral amino acid transporter (ASCT)2, whereas amino acid transport system (ATA)2 and ATA3 expressions remained unchanged. The upregulation of ASCT2 may be responsible for the increase in sodium‐dependent neutral amino acid influx important for liver cell proliferation. Expression of the osmolyte transporters Smit, TauT and Bgt1 was almost unchanged indicating that osmolytes are not involved in the cell volume increase during liver regeneration. The basolateral bile salt transporter Ntcp messenger RNA (mRNA) was significantly downregulated, whereas bile salt export pump (Bsep) and multidrug resistance protein (Mrp)2 expressions remained almost unchanged. An increased mRNA expression following partial hepatectomy was detected for organic anion transporting polypeptide (Oatp)5, Octn1, Octn2 and SGLT2. In contrast, Mrp6, Oatp 2, Oatp 3, Oatp 4 and Oatp 7 were downregulated. A five‐fold upregulation at the protein level was shown for the Na+–K+–2Cl− cotransporter sodium‐potassium‐2‐chloride cotransporter (NKCC1).Conclusions: The data show a differential regulation of hepatic transport systems during liver regeneration.
Hepatitis C‐associated autoimmunity in patients coinfected with HIV
Authors: Woitas Rainer P. , Stoschus Bodo , Terjung Birgit , Vogel Martin , Kupfer Bernd , Brackmann Hans H. , Rockstroh Jürgen K. , Sauerbruch Tilman , Spengler Ulrich 
Published: November 2005

Abstract: Background: Hepatitis C virus (HCV) infection is associated with multiple extrahepatic manifestations. It is unclear to what extent extrahepatic manifestations occur in HIV/HCV coinfection.Methods: We prospectively assessed cross‐sectional frequencies of autoimmune manifestations in HIV/HCV‐coinfected patients (n=98), HIV‐mono‐infected (n=45) and HCV‐mono‐infected patients (n=78). Diagnostic vasculitis scores, HCV and HIV loads, CD4 cell counts, thyroid‐, cardiolipin‐, non‐organ‐specific tissue antibodies (nuclear, smooth muscle, anti‐liver–kidney–microsome, neutrophil–cytoplasmic) and cryoglobulins were determined.Results: Synergistic effects of HCV and HIV infection were observed with respect to the prevalence of antibodies against thyroglobulin (HCV infection 15.4%, HIV infection 8.8%, HIV/HCV coinfection 30.6%; P<0.001) and cardiolipin antibodies (HCV infection 9.0%, HIV infection 31%, HIV/HCV coinfection 46%; P<0.001). Cryoglobulinemia type III, was significantly associated with HCV infection (HCV, 25.6%; HIV/HCV, 20.4%) but not with HIV infection (4.4%, P<0.05). Rheumatoid factor was commonly detected in patients with HCV infection (48%), but occurred considerably less frequently in patients with HIV infection (4.4%) or HIV/HCV coinfection (9.5%, P<0.01).Conclusion: HIV coinfection appears to differentially modulate the frequency of HCV‐related autoimmunity. However, autoimmunity is rarely accompanied by clinical manifestations.