bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salvage abdominoperineal resection after failed Nigro protocol: modest success, major morbidity
Authors: Papaconstantinou H. T. , Bullard K. M. , Rothenberger D. A. , Madoff R. D. 
Published: January 2006

AbstractObjective  Chemotherapy and radiation (C‐XRT) is the first‐line therapy for epidermoid carcinomas of the anal canal (ECAC). Treatment failure occurs in up to 33% of patients. Salvage‐abdominoperineal resection (APR) is the treatment of choice for locoregional failure but pre‐operative radiation may increase wound complications. The purpose of this study was to evaluate patient survival and wound complications after salvage‐APR for C‐XRT failure.Methods  We reviewed the clinical records of all patients who failed initial C‐XRT for ECAC diagnosed between 1992 and 2002. We evaluated patient demographics, treatment, tumour characteristics, survival and postoperative complications.Results  Nineteen patients were identified. The mean age at diagnosis was 55 years. Eight (42%) patients had persistent disease; 11 (58%) had tumour recurrence. APR was performed in 15 patients. Perineal wound complications occurred in 12 (80%) patients; half were major complications. Primary flap reconstruction at time of APR was performed in 5 (33%) patients; 2 experienced major wound complications. Overall‐survival after salvage APR was 40% (6/15) and disease‐free survival was 47% (7/15) at a median follow‐up of 14 months (range 2–95 months). Recurrence after salvage‐APR occurred in 7 (47%) patients at a median follow‐up of 5 months (range 3–19 months). Kaplan‐Meier survival analysis showed an advantage for recurrent over persistent disease with 2‐year and 5‐year survival rates of 75%vs 34% and 28%vs 0%, respectively.Conclusions  Failure of C‐XRT for ECAC is associated with a poor prognosis. Although salvage APR may be curative in some patients, perineal wound complications are frequent and primary flap reconstruction is not reliable.
Stapled haemorrhoidopexy in fourth degree haemorrhoidal prolapse: is it worthwhile?
Authors: Finco C. , Sarzo G. , Savastano S. , Degregori S. , Merigliano S. 
Published: January 2006

AbstractIntroduction  Ten years after the introduction of stapled haemorrhoidopexy few studies have stratified patients by degree of haemorrhoidal disease when analysing results.Objective  The aim of this study was prospectively to evaluate 116 patients who underwent stapled anopexy conducted by the same surgeon for III or IV degree haemorrhoidal prolapse.Materials and methods  One hundred and sixteen consecutive patients affected by symptomatic haemorrhoids of III or IV degree underwent stapled anopexy using the technique described by Longo in the period January 2001 to October 2003. Mean follow‐up was 28.1 months. Fischer's exact test was used for statistical analysis. Results, in terms of morbidity and recurrence rates, were stratified according to degree of haemorrhoidal disease.Results  There was no statistically significant difference between the results for third degree compared with fourth degree prolapse although there was a trend towards increased incidence of postoperative bleeding and recurrence.Conclusion  Third degree haemorrhoidal prolapse remains the best indication for stapled haemorrhoidopexy. This procedure may also be indicated in fourth degree haemorrhoidal prolapse. Patients with fourth degree haemorrhoids may be subjected to this procedure following adequate discussion of the outcome.
Characteristics of technical visionaries as perceived by American and British industrial physicists
Authors: Vojak Bruce A. , Griffin Abbie , Price Raymond L. , Perlov Konstantin 
Published: January 2006

This research explores which characteristics most frequently appear in industrial technical visionaries and which are perceived as being the most important contributors to their success. Industrial technical visionaries are defined as ‘technical individuals who effectively synthesize multiple technologies and business strategy to identify new and innovative breakthrough products and processes’. The perceptions of a total of 418 American and British industrial physicists were evaluated for this study to produce the first descriptive analysis of these key individuals based on a large‐scale investigation. The research provides a profile of technical visionary characteristics that can be employed in identifying those with the potential for contributing in this role.In addition to their recognized depth and breadth of technical expertise, technical visionaries are, first and foremost, emotionally involved, energetic, stubborn in pursuing objectives and interpersonally capable. They are a self‐motivated driving force in a firm, not just the source of technical insight. These individuals' knowledge of, and ability to navigate, the business world is perceived as more important to their success than most of their technical skills, other than technical depth. Finally, the traits associated with technical visionaries' ‘idealist’ nature are perceived as important, indicating that this characteristic should not be overlooked as defining who these individuals are.
Rat liver fibrosis regresses better with pegylated interferon α2b and ursodeoxycholic acid treatments than spontaneous recovery
Authors: Tasci IIker , Mas Mehmet R. , Vural Sevil A. , Comert Bilgin , Alcigir Gunay , Serdar Muhittin , Mas Nuket , Isik Ahmet T. , Ates Yuksel 
Published: January 2006

Abstract: Background/aims: Fibrosis and cirrhosis are common complications of chronic liver diseases. An imbalance between fibrogenesis and fibrolysis results in scarring of the liver parenchyma. We aimed to investigate the possible antifibrotic effectiveness of a newly modified interferon molecule peginterferon α2b (PEG‐IFNα2b) which has better antiviral activity, and ursodeoxycholic acid (UDCA).Methodology: Liver fibrosis was established on 60 male Sprague Dawley rats with CCl4 in 12 weeks. After cessation of CCl4 Group I was left for spontaneous recovery. Group II was treated with PEG‐IFN 1.5 μg/kg/week, Group III with UDCA 25 mg/kg/day and Group IV with combination of both drugs. All rats were killed at week 16. Histopathologic fibrosis scores, tissue hydroxyproline, TIMP‐1 and MMP‐13 levels were determined. Hepatic stellate cell apoptosis was detected by dual staining with TUNEL technique and anti‐α smooth muscle actin.Results: Fibrosis scores were lower in Group II, III and IV than Group I (p<0.05 for group I vs. II and III; p<0.01 for group I vs. IV). Tissue hydroxyproline levels were significantly decreased in Group II, III and IV when compared to Group I (p<0.05 for group I vs. II, p<0.01 for group I vs. III and IV). Lower liver TIMP‐1 and higher MMP‐13 levels were measured in Group II, III, and Group IV than Group I (p<0.01 for TIMP‐1 and p<0.01, for MMP). Activated HSC apoptosis was significantly increased in Group II, III and IV when compared to Group I (p<0.01, for all). There was significantly higher apoptosis in Group II than Group III and IV (p<0.01).Conclusion: Treatment with both PEG‐IFNα2b and UDCA improved CCl4 induced rat liver fibrosis. Significantly higher effects were obtained using these agents in combination.
Salivary Levels of CGRP and VIP in Rhinosinusitis and Migraine Patients
Authors: Bellamy Jaime L. , Cady Roger K. , Durham Paul L. 
Published: January 2006

Background.—Secretion of calcitonin gene‐related peptide (CGRP) from trigeminal nerves and vasoactive intestinal peptide (VIP) from parasympathetic nerves is involved in the pathophysiology of migraine and rhinosinusitis. Analysis of these neuropeptides in human saliva samples can be used as markers of trigeminal and parasympathetic nerve activity in patients between and during attacks as well as in response to specific treatments.Objective.—To compare the amount of trigeminal sensory and parasympathetic nerve activation by measuring CGRP and VIP levels in the saliva of subjects experiencing noninfectious allergic rhinosinusitis, migraine with sinus symptoms, and no symptoms.Methods.—Subjects were enrolled in three groups. Group A: subjects without a history of migraine, “sinus” headache, or allergic rhinosinusitis within the previous 6 months. Group B: subjects with chronic recurrent noninfectious rhinosinusitis and no history of migraine or “sinus” headache. Group C: subjects with self‐described “sinus” headaches whose symptoms met International Headache Society diagnostic criteria (1.1 or 1.2) for migraine. The total amount of CGRP and VIP present in saliva collected under normal, pathological, and therapeutic conditions was determined by radioimmunoassay. Neuropeptide levels were normalized to total volume and amount of protein, and levels were correlated to onset and change in clinical symptoms.Results.—Total volume, total protein, and CGRP and VIP levels did not significantly change in saliva collected on consecutive days in the clinic and at the subject's home, respectively. No appreciable change in baseline salivary levels of CGRP and VIP was detected in control subjects. However, baseline salivary levels of CGRP and VIP were significantly elevated between attacks in allergic rhinosinusitis and migraine subjects compared to control values. For rhinosinusitis subjects, the amount of CGRP and VIP during attacks returned to baseline values following treatment with pseudoephedrine and relief of symptoms. Similarly, CGRP and VIP levels during a migraine headache were significantly reduced within 2 hours after sumatriptan treatment and reported symptom relief.Conclusion.—Correlation of CGRP and VIP saliva levels observed in our study supports physiologically coordinated regulation of trigeminal and parasympathetic nerve activation in allergic rhinosinusitis and migraine patients between and during attacks as well as following treatment. Furthermore, our findings demonstrate that analysis of human saliva neuropeptides may provide a semiquantitative index of pathological and therapeutic states and, therefore, function as a clinical model for studying neuronal mechanisms involved in migraine and rhinosinusitis.
Is Low Blood Magnesium Level Associated With Hemodialysis Headache?
Authors: Goksel Basak Karakurum , Torun Dilek , Karaca Sibel , Karatas Mehmet , Tan Meliha , Sezgin Nurzen , Benli Sibel , Sezer Siren , Ozdemir Nurhan 
Published: January 2006

Objective.—The aim of this study was to evaluate the prevalence, demographic, clinical features, and possible risk factors for hemodialysis headache (HDH).Background.—HDH has been recognized for many years, but the pathophysiology of this condition is not known. High arterial blood pressure, decreased serum osmolality, sodium washout, and high blood urea nitrogen level are reported risk factors for HDH. Low serum magnesium (Mg) level is known to cause some types of headache, including migraine (menstrual migraine in particular), tension‐type headaches, and cluster and posttraumatic headaches. Low Mg has also been reported in HDH patients.Methods.—A total of 250 hemodialysis (HD) patients were questioned about problems with headache. Of these, 75 were diagnosed with HDH according to the revised International Headache Society criteria for 2003. Eighty age‐ and sex‐matched HD patients without HDH were selected as a control group. For each HDH and control subject, arterial diastolic and systolic blood pressure, body weight, and serum levels of sodium, blood urea nitrogen, creatinine, and Mg were measured before and after one HD session. Urea reduction rate and ultrafiltration were determined. Serum levels of phosphorus, calcium, albumin, and parathormone were measured only before the session. Findings in the HDH and control group were statistically compared.Results.—As noted, 75 (30%) of the total 250 HD patients surveyed were diagnosed with HDH. The mean headache duration in this group was 5.17 ± 5 hours. Vertex location, bilateral headache, dull nature, and moderate severity were the most prevalent features of HDH. There were no statistically significant differences between the HDH and control groups with respect to causes of end‐stage renal disease. There were no significant differences between the HDH and control groups with respect to predialysis values for blood urea nitrogen, body weight, and arterial blood pressure (P > .05), and the same was true for comparisons of the postdialysis values for these parameters. The mean predialysis sodium level in the HDH group was higher than in the control group (P= .003). Both the mean predialysis and mean postdialysis Mg levels in the HDH group were significantly lower than the corresponding levels in the control group (P= .05 and P= .02, respectively).Conclusions.—The results suggest that low blood Mg level and high blood sodium level may be risk factors for HDH. Magnesium supplementation may help patients with HDH whose serum Mg levels are found to be low.
Subclinical Left Ventricular Dysfunction in Migraine Attacks
Authors: Vidalón Manuel 
Published: January 2006

Objective.—The aim of the present study was to evaluate cardiac performance of patients with migraine attacks during the overload produced by phenylephrine infusion.Background.—It is known that circulatory changes occur during migraine. However, the relationship between this finding and transient cardiac dysfunction is still unknown.Methods.—By means of two‐dimensional direct M‐mode echocardiography, we measured fractional shortening, ejection fraction, and mean velocity of circumferential fibers shortening in 18 patients with migraine and in 10 normal subjects as a control group. These measures were performed in two different periods: during attack‐free intervals and during attacks. Pain intensity of typical migraine attack was evaluated on a 0 to 10 scale.Results.—Cardiac size and function were normal at rest in both groups. However, during migraine attacks, phenylephrine infusion provoked significant decrease in fractional shortening, EF, and mean velocity of circumferential fibers shortening, followed by concomitant increase of headache severity. On the other hand, during the attack‐free interval and in the control group phenylephrine infusion did not show significant changes in cardiac function parameters.Conclusions.—Our data suggest that left ventricular dysfunction during the phenylephrine test could participate in the complex pathophysiological mechanism of migraine attacks.
Translating Instruments for Cross‐Cultural Studies in Headache Research
Authors: Peters Michele , Passchier Jan 
Published: January 2006

Objective.—To describe translation methods, to outline current recommendations for translation and to give an overview of translation procedures used in headache.Background.—In health‐care research, particularly in the domain of health‐related quality of life, an increasing number of questionnaires are translated for cross‐ cultural comparison. A number of headache‐related questionnaires have also been translated. To ensure true cross‐cultural comparison, it is important to use rigorous translation methods to ensure a high quality translated version of the instruments.Methods.—Literature relevant to cross‐cultural translations was reviewed, as well as literature concerning translation of headache‐related instruments.Conclusion.—More information on the translation process for headache‐related instruments is essential to carry out high quality cross‐cultural research. Recommendation are given to encourage good translation practices.
Cusums to Measure Chronic Daily Headache
Authors: Freidank‐Mueschenborn Edda , Fox Anthony W. 
Published: January 2006

Objective.—To investigate whether cumulated summed differences (cusums) can be used as a method for detecting effective interventions in chronic daily headache (CDH). If so, then can such interventions be detected sooner than 28 days?Background.—CDH probably represents the greatest current challenge in the field of headache treatment. Clinical trial methodologies for its study are not standardized but usually use fixed 28‐day observation periods. Similarly, 28‐day observation periods are common review intervals for stepped‐care patient management strategies.Methods.—A theoretical patient was modeled, with daily headache scores that had maximal variation for 28 consecutive daily measures. The cusums for this “norm” or control data set were plotted and correlated with time using a simple spreadsheet. Departure of a postintervention cusum from the 95% confidence interval of the control data set was chosen as an indicator of sensitivity to various model perturbations that had clinical correlates.Results.—When 1 to 17 randomly distributed headache‐free days were used to perturb the 28‐day model, cusums consistently diverged from the norm. If at least 3 headache‐free days occurred, then the cusum detected the intervention in less than 28 days of observation. Reanalysis of a previously published study of magnesium oxide suggests that its negative conclusions should be reconsidered.Conclusion.—Cusums can be useful tools for detecting change in CDH, whether at the level of the clinical trial or when managing patients using stepped‐care treatment algorithms.
Jugular Compression and Radionuclide Cisternographic Patterns in Patients With Chronic Headache
Authors: Horikoshi Toru , Uchida Mikito , Watanabe Arata , Ikegawa Hiroaki , Umeda Takako 
Published: January 2006

Objective.—We investigated the value of the jugular compression test (JCT) in screening patients with chronic headache attributable to persistent cerebrospinal fluid (CSF) leakage.Methods.—Clinical records of 35 consecutive patients who underwent both 111In‐diethylenetriamine pentaacetic acid radioisotope (RI) cisternography and JCT were retrospectively analyzed.Results.—A strong correlation was seen between JCT and RI cisternographic findings. Most patients who reported a feeling of fullness in the ear, hearing loss or headache during JCT had positive findings on RI cisternograms indicative of CSF leakage. In contrast, no RI study abnormalities were seen in patients reporting no symptoms in JCT.Conclusions.—Among patients complaining of refractory headache and other miscellaneous symptoms, JCT may represent a simple, economic, and reliable technique in the screening of candidates for RI cisternography to evaluate CSF leakage. A subgroup of patients with chronic headache may have persistent CSF leakage.
Gastric Stasis in Migraine: More Than Just a Paroxysmal Abnormality During a Migraine Attack
Authors: Aurora Sheena K. , Kori Shashidhar H. , Barrodale Pat , McDonald Susan A. , Haseley David 
Published: January 2006

Objective.—The aim of this article is to evaluate gastric motility and emptying in the ictal and interictal period in migraine.Background.—Nausea is a predominant symptom of migraine and the basis of it is thought to be gastric stasis. Objective methods to establish this are however lacking. We utilized gastric scintigraphy studies to determine gastric motility in the ictal and interictal period of migraine.Methods.—Ten migraine subjects were compared to equal number of age and sex matched controls. Gastric scintigraphy using a standard meal was performed in all control subjects once and in all 10 migraine subjects in the interictal period and nine studies were performed in the ictal period migraine.Results.—The time to half emptying was delayed in migraine ictally (78%) and interictal period (80%) using normative data at this institution. Gastric stasis was less pronounced ictally (149.9 minutes) compared to interictal period (188.8 minutes). There was a significant delay compared to nonmigrainous controls (migraine 188.8 minutes vs normal controls 111.8 minutes; P < .05). These data were replicated in percentage of radioactive material remaining in the stomach at 2 hours.Conclusions.—Contrary to previous belief, this study has demonstrated that migraineurs suffer from gastric stasis both during and outside an acute migraine attack. This may suggest that migraineurs may have an abnormal autonomic function compared to nonmigrainous controls. The potential role of this in pathophysiology of migraine is discussed and avenues for further investigations are explored.
Chronic Bilateral Stimulation of the Anterior Thalamus of Kainate‐treated Rats Increases Seizure Frequency
Authors: Lado Fred A. 
Published: January 2006

Summary:  Purpose: Electrical stimulation of the anterior nucleus of the thalamus (ANT) is receiving increased attention as a novel means of controlling intractable epilepsy, and has entered human clinical trial. Animal data supporting the anticonvulsant benefit of ANT stimulation, however, has been obtained from acute chemoconvulsant models of epilepsy rather than models of chronic epilepsy with spontaneous seizures. It is unknown whether ANT stimulation is effective in models of chronic epilepsy. Methods: Bilateral ANT stimulation was evaluated in rats with chronic epilepsy following acute status epilepticus (SE) produced by systemic kainic acid (KA) administration. The evolution of epilepsy following KA SE and the effects of ANT stimulation were monitored by continuous video‐EEG. Results: Following KA SE, most rats have 2–8 seizures per day, and the average seizure rate increases over time, doubling over the course of 14 weeks. Behavioral seizure severity, after the initial development of epilepsy, remains stable. Seizure frequency during ANT stimulation was 2.5 times the baseline seizure frequency. In some cases stimulation triggered seizures were observed. The effects of stimulation were specific to the ANT. Stimulation applied to electrodes placed outside the ANT did not significantly worsen seizure frequency. Conclusions: ANT stimulation exacerbated seizure frequency in rats with chronic epilepsy following kainate status epilepticus.
Hippocampal T2 Signal Change during Amygdala Kindling Epileptogenesis
Authors: Jupp Bianca , Williams John P. , Tesiram Yasvir A. , Vosmansky Milosh , O'Brien Terence J. 
Published: January 2006

Summary:  Purpose: The rat electrical amygdala kindling model is one of the most widely studied animal models of temporal lobe epilepsy (TLE); however, the processes underlying epileptogenesis in this model remain incompletely understood. Magnetic resonance imaging (MRI) is a powerful method to investigate epileptogenesis, allowing serial imaging of associated structural and functional changes in vivo. Here we report on the results of serial MRI acquisitions during epileptogenesis in this model. Methods: Serial T2‐weighted MR images were acquired before, during, and after the induction of kindling, to investigate the development and progression of imaging abnormalities. Results: T2‐weighted acquisitions demonstrated the development of regions of increased signal in the rostral ipsilateral regions of CA1 and dentate gyrus in kindled (five of seven) but not in control rats (p < 0.05). Quantification of the T2 signal demonstrated a significant increase in kindled animals when compared with controls, 2 weeks after kindling ceased, in the ipsilateral hippocampus and the hippocampal sub regions of CA1 and the dentate gyrus (p < 0.05). No significant difference was observed in hippocampal volumes between kindled or control animals at any of the times. Conclusions: The results of this study validate a method for acquiring serial MRI during amygdala kindling and demonstrate the induction of T2 signal abnormalities in focal regions of the hippocampus. These regions may be important sites for the neurobiologic changes that contribute to epileptogenesis in this model.