bluuebunny/crossref_metadata_2025_split huggingface dataset:
Data, Model, Conclusion, Doing it Again
Authors: Molenaar Ivo W. 
Published: February 2006

This paper explores the robustness of conclusions from a statistical model against variations in model choice (rather than variations in random sampling and random assignment to treatments, which are the usual variations covered by inferential statistics). After the problem formulation in section 1, section 2 presents an example from Box and Tiao in which variation in parent distribution is modeled for a one sample location problem. An adaptive Bayesian procedure permits to use a weighted mixture of parent distributions rather than choosing just one, such as a normal or a uniform distribution.In section 3 similar considerations are applied to an event history model for the influence of education and gender on age at first marriage, but here the conclusions are hardly influenced by the choice of the duration distribution. In section 4 a brief discussion of model choice in factor analysis and structural equation models is followed by a more elaborate treatment of the choice of integer valued slopes for item response functions in the OPLM model which is an extension of the Rasch model. A modest simulation study suggests that Adaptive Bayesian Modeling with a mixture of sets of slopes works better than fixing one set of postulated slopes.The paper concludes with some remarks on the roles and sources of prior distributions followed by a short epilogue which argues that simultaneous consideration of a class of models for the same data is sometimes superior to exclusively analyzing the data under one specific model chosen from such a class.
Logistic Positive Exponent Family of Models: Virtue of Asymmetric Item Characteristic Curves
Authors: Samejima Fumiko 
Published: February 2006

The paper addresses and discusses whether the tradition of accepting point-symmetric item characteristic curves is justified by uncovering the inconsistent relationship between the difficulties of items and the order of maximum likelihood estimates of ability. This inconsistency is intrinsic in models that provide point-symmetric item characteristic curves, and in this paper focus is put on the normal ogive model for observation. It is also questioned if in the logistic model the sufficient statistic has forfeited the rationale that is appropriate to the psychological reality. It is observed that the logistic model can be interpreted as the case in which the inconsistency in ordering the maximum likelihood estimates is degenerated.The paper proposes a family of models, called the logistic positive exponent family, which provides asymmetric item chacteristic curves. A model in this family has a consistent principle in ordering the maximum likelihood estimates of ability. The family is divided into two subsets each of which has its own principle, and includes the logistic model as a transition from one principle to the other. Rationale and some illustrative examples are given.
Isotonic Ordinal Probabilistic Models (ISOP)
Authors: Scheiblechner Hartmann 
Published: February 2006

The concept of an ordinal instrumental probabilistic comparison is introduced. It relies on an ordinal scale given a priori and on the concept of stochastic dominance. It is used to define a weakly independently ordered system, or isotonic ordinal probabilistic (ISOP) model, which allows the construction of separate “sample-free” ordinal scales on a set of “subjects” and a set of “items”. The ISOP-model is a common nonparametric theoretical structure for unidimensional models for quantitative, ordinal and dichotomous variables.Fundamental theorems on dichotomous and polytomous weakly independently ordered systems are derived. It is shown that the raw score system has the same formal properties as the latent system, and therefore the latter can be tested at the observed empirical level.
Video‐Assisted Thoracoscopic Surgery for Recurrent Spontaneous Pneumothorax: The Long‐term Benefit
Authors: Ben‐Nun A. , Soudack M. , Best L. A. 
Published: February 2006

AbstractBackgroundManagement of recurrent primary spontaneous pneumothorax by open surgery was considered the treatment of choice until recently. The major drawbacks of this management are the prolonged postoperative pain and cosmetic results. In the last decade, video‐assisted thoracoscopic surgery (VATS) has replaced the routine use of open surgery. Most papers that compared limited open surgery to VATS addressed the early postoperative results, and studies that assessed the long‐term results focused primarily on the rate of recurrence and pulmonary function tests. The aim of this study was to compare the outcome of minithoracotomy and VATS with emphasis on patients’ long‐term, subjective perspective and satisfaction.MethodsMedical records of patients with recurrent primary spontaneous pneumothorax were retrospectively reviewed. Patients who underwent surgical treatment by limited thoracotomy (63 patients) or VATS (58 patients) more than 3 years ago were enrolled. Hospital medical charts were used to compare the early postoperative results. Outpatient clinic records and a telephone questionnaire were employed to evaluate long‐term results.ResultsThere was no mortality or major morbidity in either group, and hospitalization time was similar. Patients in the thoracotomy group needed significantly higher doses of narcotic analgesia for a longer period. There were two cases of recurrence in the VATS group (3%). Seventy‐eight percent of patients in the VATS and 21% in the thoracotomy group classified their pain as insignificant a month following the operation (P < 0.05). Three years following surgery, 97% of the VATS group patients considered themselves completely recovered from the operation compared with only 79% in the thoracotomy group (P < 0.05). Nineteen percent of the thoracotomy group and 3% of the VATS group suffered from chronic or intermittent pain necessitating use of analgesics more than once a month. Thirteen percent of patients from the open procedure group required services from the pain clinic. Patients in the VATS group were, in general, much more satisfied with their operation and with the surgical scars compared with patients from the thoracotomy group.ConclusionWe recommend video‐assisted surgery as the first‐line surgical treatment for patients with recurrent primary spontaneous pneumothorax. This recommendation is based on its somewhat favorable early postoperative course, the superior long‐term outcome, and patient satisfaction.
Treatment of Bladder Tumors and Benign Prostatic Hyperplasia with a New TUR System Using Physiological Saline as Perfusate
Authors: Yoshimura Rikio , Adachi Takahisa , Funao Kiyoaki , Kobayakawa Hitoshi , Matsuyama Masahide , Tsuchida Kennji , Takemoto Yoshiaki , Nakatani Tatsuya 
Published: February 2006

AbstractThis article presents a new transurethral resection (TUR) system for use in endoscopic surgery. By using an electroconductive solution (physiological saline) as the perfusate in lieu of conventional non‐electroconductive solution (Uromatic), additional anesthesia (e.g., obturator nerve blocking) is not required. The new TUR is carried out in an electroconductive solution such as saline, and because radiofrequency current flows from the resecting electrode through the perfusate to the outer sheath, no counter‐electrode is needed. We have treated both bladder tumor and benign prostatic hyperplasia cases with this new system. Surgery was safely performed in all TUR‐bt cases without requiring obturator nerve blocking. During both TUR‐bt and transurethral resection of the prostate (TUR‐P) using this system, tissue resection and coagulation equivalents were similar to the conventional TUR system. In previous TUR, preoperative obturator nerve blocking was necessary, and in some cases, incomplete blocking or complications occurred. When physiological saline is used as the perfusate, blood electrolyte levels are not greatly changed, even after extensive resection of the bladder wall; as a result, this new system is also cost effective because physiological saline is less expensive than non‐electroconductive solutions and requires no counter‐electrode. Thus, in comparison with conventional TUR, this new system is both significantly safer and more cost effective.
New Prognostic Scales LAST‐1 and LAST‐2: Supporting Prediction and Staging of Thyroid Cancer
Authors: Lachinski Andrzej J. , Stefaniak Tomasz , Kobiela Jarek , Connor Saxon , Gruca Zbigniew , Sledzinski Zbigniew 
Published: February 2006

AbstractIntroductionEpidemiologically, thyroid gland tumors are lesions of the highest importance among endocrine tumors in humans. Although the results of surgical treatment of the highly differentiated (follicular and papillary) tumors seem to be satisfactory, treatment of the poorly differentiated (medullary and anaplastic) tumor still demands clinical and basic investigations. In this study the authors sought to evaluate clinical and molecular factors that could contribute to preoperative detection of more advanced thyroid cancers (i.e., those that exhibit extrathyroid spread and lymph node invasion).MethodsA total of 27 patients operated on for thyroid cancer were evaluated according to age, sex, time from the onset of the disease, cytogenetic changes, and loss of heterozygosity (LOH) in 14 microsatellite markers. The output variables were defined according to postoperative findings and the TNM 2002 score. The T1‐2 N0 M0 cases were defined as local malignancy (LM); and T3‐4 any N any M, any T N1 any M, or any T any N M1 were considered advanced malignancy (AM). The control groups consisted of 25 patients with multinodular goiter (MNG) and 32 patients with follicular adenoma (FA). In all cases, clinical and molecular data similar to those listed above were collected, excluding staging and follow‐up information.ResultsThere was no predominant specific type of chromosomal aberration observed and no marker lost in more than five patients (18%). The logistic regression identified three input variables as contributing significantly to the dichotomized outcome measure (LM vs. AM): LOH in any of the examined loci, age of the patient at the presentation, and the sex of the patient. Furthermore, discriminant analysis revealed four input variables differentiating among TC, FA, and MNG patients. Based on the multivariate analysis results, two numeric prognostic scales were fashioned: LAST‐1, a scale applicable to differentiation of thyroid cancers at different degrees of clinical advancement; and LAST‐2, a scale applicable to differentiation of any thyroid lumps.ConclusionsIt was concluded that LOH and the age and sex of the patients can provide sufficient data to predict thyroid cancer with a high degree of clinical advancement. LAST‐1 scale is a reliable tool for identifying these patients. The LAST‐2 scale gives supportive information about the character of thyroid lumps, distinguishing TC from MNG and FA.
Incidence of Vascular Injuries after Use of the Angio‐Seal Closure Device following Endovascular Procedures in a Single Center
Authors: Castelli Patrizio , Caronno Roberto , Piffaretti Gabriele , Tozzi Matteo , Lomazzi Chiara 
Published: February 2006

AbstractIntroductionPercutaneous closure devices have been used to obtain rapid hemostasis and early mobilization of the patient after arterial catheterization. However, we observed challenging problems with the sealing procedure that require further surgical intervention. The present report is a retrospective analysis of the patterns of injury and the final outcome of four cases of femoral artery injury following the use of Angio‐Seal.MethodsDuring the last 24 months, in a group of 175 patients (131 men, 44 women; median age 68.4 years, range 47–81 years) underwent percutaneous closure after diagnostic (n = 53) or therapeutic (n = 122) endovascular procedures. Among them we observed four patients (three men, one woman; median age 65.2 ± 10.8 years, range 47–75 years) who developed severe limiting claudication and required vascular repair of an iatrogenic vascular injury following deployment of the Angio‐Seal. They had a femoral thrombosis due to narrowing/severe intimal dissection.ResultsAll patients required operative intervention with removal of the device. We performed femoropopliteal thrombectomy and common femoral endarterectomy with patch angioplasty (n = 2), resection of the femoral bifurcation and reimplantation of the deep femoral artery (n = 1), and femoral bifurcation endarterectomy with direct arterial suture (n = 1). The median hospital stay was 6.5 ± 3.8 days (range 4–12 days). Limb salvage was achieved in all of the surviving patients at a mean follow‐up of 7 months (range 1–12 months).ConclusionsVascular injuries are uncommon after use of the hemostasis closure device. When they occur, however, they are likely to require challenging surgical correction.
A Prophylactic Infusion of Calcium Solution Reduces the Risk of Symptomatic Hypocalcemia in Patients after Total Thyroidectomy
Authors: Uruno Takashi , Miyauchi Akira , Shimizu Kazuo , Tomoda Chisato , Takamura Yuuki , Ito Yasuhiro , Miya Akihiro , Kobayashi Kaoru , Matsuzuka Fumio , Amino Nobuyuki , Kuma Kanji 
Published: February 2006

AbstractBackgroundSeveral risk factors have been associated with post‐operative transient hypocalcemia after thyroid surgery. However, there are no studies evaluating preventive measures to avoid symptomatic postoperative hypocalcemia. Although intravenous infusion of calcium improves hypocalcemic symptoms, it is unknown whether prophylactic infusion prevents symptoms of postoperative hypocalcemia.Patients and MethodsFive hundred and forty‐seven patients underwent total thyroidectomy. Two groups were identified: group A (n = 243) received prophylactic intravenous drip infusion of 78–156 mg of calcium solution at 3–8hours after operation, and group B (n = 304) received no prophylactic treatment. Prophylactic infusion was used only once if the patients did not have symptoms of hypocalcemia. Serum calcium (Ca) levels, intact parathyroid hormone (i‐PTH) levels on the first postoperative day (1st POD), and the prevalence of symptoms of hypocalcemia were prospectively analyzed.ResultsThe serum Ca levels at the 1st POD in group A patients (7.91 ± 0.49 mg/dl, mean ± SD) was significantly higher than group B patients (7.65 ± 0.54, P < 0.0001), while the serum i‐PTH levels were not significantly different between the two groups. The prevalence of numbness and / or tetany before noon on the 1st POD was significantly lower in group A patients. Prophylactic infusion of calcium solution reduced the prevalence of tetany from 8.6% to 2.1%.ConclusionA prophylactic infusion of calcium solution after total thyroidectomy may be useful in reducing the development of symptomatic hypocalcemia and reduces the patients’ risk of having discomfort and anxiety due to hypocalcemia.
Comparison of Kugel and Lichtenstein Operations for Inguinal Hernia Repair: Results of a Prospective Randomized Study
Authors: Dogru Osman , Girgin Mustafa , Bulbuller Nurullah , Cetinkaya Ziya , Aygen Erhan , Camci Cemalettin 
Published: February 2006

AbstractIntroductionThe aim of this prospective randomized clinical study was to compare the Lichtenstein hernia repair with Kugel’s patch hernia repair.MethodsFrom September 1999 to August 2002, adult patients with inguinal hernia were randomized into two groups. Group I included patients with the Lichtenstein hernioplasty, and group II included patients with the Kugel hernioplasty. The duration of the operation, surgical findings, and postoperative complications were recorded for the patients in both groups.ResultsA total of 139 patients (134 men, 5 women) were randomized to either group I or group II. No significant differences were observed for the duration of the operation or the complication rates between the groups during the same follow‐up time (53.06 ± 5.6 months vs. 53.41 ± 7.11 months in groups I and II, respectively).ConclusionsKugel herniorraphy is a minimally invasive method and as safe as the Lichtenstein hernia repair technique, with similar complication rates.
Perforation of the Gastrointestinal Tract Secondary to Ingestion of Foreign Bodies
Authors: Goh Brian K.P. , Chow Pierce K.H. , Quah Hak‐Mien , Ong Hock‐Soo , Eu Kong‐Weng , Ooi London L.P.J. , Wong Wai‐Keong 
Published: February 2006

AbstractIntroductionIngesting a foreign body (FB) is not an uncommon occurrence. Most pass through the gastrointestinal (GI) tract uneventfully, and perforation is rare. The aim of this study was to report our experience with ingested FB perforations of the GI tract treated surgically at our institution.MethodsA total of 62 consecutive patients who underwent surgery for an ingested FB perforation of the GI tract between 1990 and 2005 were retrospectively reviewed. Three patients with no definite FB demonstrated intraoperatively were included.ResultsThe patients had a median age of 58 years, and 37 (60%) were male. Of the 59 FBs recovered, 55 (93%) were toothpicks and dietary FBs such as fish bones or bone fragments. A definitive preoperative history of FB ingestion was obtained for only two patients, and 36 of 52 patients (69%) wore dentures. Altogether, 18 (29%) perforations occurred in the anus or distal rectum, and 44 perforations were intraabdominal, with the most common abdominal site being the distal ileum (39%). Patients with FB perforations in the stomach, duodenum, and large intestine were significantly more likely to be afebrile (P= 0.043), to have chronic symptoms (> 3 days) (P< 0.001), to have a normal total white blood cell count (P< 0.001), and to be asymptomatic or present with an abdominal mass or abscess (P< 0.001) compared to those with FB perforations in the jejunum and ileum.ConclusionsIngested FB perforation in the adult population is most commonly secondary to unconscious accidental ingestion and is frequently caused by dietary FBs especially fish bones. A preoperative history of FB ingestion is thus rarely obtained, although wearing dentures is a common risk factor. FB perforations of the stomach, duodenum, and large intestine tend to present with a longer, more innocuous clinical picture than perforations in the jejunum or ileum.
Prospective Comparison of Laparoscopic Left Hemicolectomy for Colon Cancer with Laparoscopic Left Hemicolectomy for Benign Colorectal Disease
Authors: Sarli Leopoldo , Pavlidis Clara , Cinieri Francesco Giovanni , Regina Gabriele , Sansebastiano Giuliano , Veronesi Licia , Ferro Michelina , Morari Silvia , Violi Vincenzo , Roncoroni Luigi 
Published: February 2006

AbstractBackgroundShort‐term outcome and anorectal function results after laparoscopic hemicolectomy for colon cancer were compared with results after laparoscopic hemicolectomy for benign diseases.MethodsA total of 108 patients who underwent laparoscopic left colectomy (60 for colon cancer, 48 for diverticulitis or polyposis) were enrolled in the study. Left hemicolectomy in patients affected by cancer was performed by high ligation of the inferior mesenteric artery. A questionnaire concerning anorectal function was mailed to patients 6 months after surgery.ResultsComplications were more frequent in the cancer group than in the benign disease group: overall morbidity rate (29.6% versus 8.7%; P = 0.009), diarrhea during the first 6 postoperative months (58.7% versus 34.1%; P = 0.022), and anorectal function problems (fecal incontinence and/or the inability to discriminate between gas and stool, and/or urgency, and/or tenesmus) (65.2% versus 31.7%; P = 0.002).DiscussionThe level of ligation of the lower mesenteric artery and damage at the lower mesenteric ganglion could explain the poorer anorectal function outcome in the colon cancer group.
Prognostic Factors of Primary Small Bowel Adenocarcinoma: Univariate and Multivariate Analysis
Authors: Wu Ting‐Jung , Yeh Chun‐Nan , Chao Tzu‐Chieh , Jan Yi‐Yin , Chen Miin‐Fu 
Published: February 2006

AbstractBackgroundAdenocarcinoma of the small bowel is relatively less common than malignancies of the esophagus, stomach, and colorectum. In small bowel adenocarcinoma, various prognostic factors influence the disease‐free status and overall survival rates.Materials and MethodsEighty patients who were diagnosed with small bowel adenocarcinoma and treated at our institute between 1983 and 2003 were retrospectively reviewed.ResultsThe patients included 40 men and 40 women with an age range of 15 to 93 years (median: 62 years). Only 51.3% of patients were accurately proved preoperatively to have a malignancy by endoscopic biopsy. Sixty patients underwent surgical treatment, and 45 of those patients had curative resection. The follow‐up period ranged from 2.5 to 229.7 months, with a median of 9.1 months. The cumulative 1‐, 3‐, and 5‐year survival rates for all patients (excluding 3 patients who died in the immediate postoperative period) were 43.6%, 22.8%, and 17.5%, respectively. The cumulative 1‐, 3‐, and 5‐year disease‐free survival rate for all 43 patients with curative resection (excluding 2 patients who died in the immediate postoperative period) was 54.9%, 30.5%, and 27.4%, respectively. Meanwhile, multivariate analysis with Cox proportional hazards analysis demonstrated that earlier tumor stages (stages I and II) and curative resection were two independent factors influencing favorable overall survival. Lymph node metastasis was the only independent factor predicting poor disease‐free survival in patients undergoing curative resection.ConclusionsPoor prognosis of small bowel adenocarcinoma may be related to a delay in the diagnosis and treatment of the disease. Curative resection is the aim of surgical treatment for small bowel adenocarcinoma. Lymph node metastasis at presentation of the disease predicts tumor recurrence and distant metastasis after curative surgical treatment.
Popliteal Venous Aneurysm—A Systematic Review
Authors: Bergqvist David , Björck Martin , Ljungman Christer 
Published: February 2006

AbstractBackgroundPopliteal vein aneurysm is a rare but potentially problematic disease with a risk of pulmonary embolism.MethodA systematic literature search was performed.ResultsA total of 105 popliteal vein aneurysms were identified, with a slight female and left‐sided preponderance. Dominating symptoms are caused by pulmonary embolism, followed by local symptoms with a palpable mass. In four patients arterial symptoms were reported. The most frequently used diagnostic test was phlebography, increasingly replaced by duplex ultrasonography in recent years. Because pulmonary embolism is a potential, it motivates surgical removal. In most cases excision and lateral suture is possible. Four fatal cases were reported. Unfortunately follow‐up time and results are poorly documented.ConclusionPopliteal venous aneurysm is rare but should be considered as a local source of pulmonary embolism when no other explanation is found.