bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Value of Flow Cytometric DNA Analysis in Non‐Small‐Cell Lung Cancer: Rationale of Sequential Processing of Frozen and Paraffin‐Embedded Tissue
Authors: Mugüerza José M. , Díez Manuel , Torres Antonio J. , López‐Asenjo José A. , Picardo Antonio L. , Gómez Ana , Hernando Florentino , Cayón Roberto , Granell Javier , Balibrea José L. 
Published: August 2002

AbstractThe objective of this study was to determine the prognostic information provided by flow cytometric DNA analysis in non‐small‐cell lung cancer. Lung samples of 132 consecutive patients submitted to surgery were prospectively processed. When no aneuploid populations were detected in fresh frozen samples, the process continued as a second step in paraffin‐embedded tissue, consuming all the tumor available. The influence of ploidy on the postoperative outcome was studied by both a univariate and a multivariate analysis. Aneuploidy was found in 81 patients (61.4%). Fourteen patients showed no aneuploidy in fresh frozen samples; and only after further analysis in paraffin‐embedded tissue was abnormal DNA detected. Overall, the 36‐month survival was 69% for the diploid group and 24% for the aneuploid group (p= 0.0006). Including subjects submitted to complete tumor removal (stages I, II, and IIIA) in a multivariate analysis adjusted for TNM stage and histologic type, bearers of aneuploid tumors exhibited a higher risk of relapse (hazard ratio 2.65; CI 95% 1.5–4.66;p= 0.004) or death (hazard ratio 2.17; CI 95% 1.08–4.39;p= 0.032) than patients with diploid tumors. DNA ploidy resulted an independent prognostic factor of survival and tumor relapse in completely resected non‐small‐cell lung cancer. Sequential analysis of fresh and paraffin‐embedded samples can help avoid the bias due to intratumoral DNA content heterogeneity. DNA ploidy could be an useful parameter in any future multifactorial analysis of outcome in such tumors.
Treatment of Primary Multiple Early Gastric Cancer: From the Viewpoint of Clinicopathologic Features
Authors: Takeshita Kimiya , Tani Masao , Honda Tooru , Saeki Ichiro , Kando Fumio , Saito Naoya , Endo Mitsuo 
Published: August 2002

AbstractThe treatment of multiple early gastric cancer was investigated through the clinicopathologic assessment of 61 cases of primary multiple early gastric cancer (82 accessory lesions) treated by surgical resection over a 15‐year period. These cases accounted for 11.7% of all cases of early gastric cancer resected during the same period. The 61 patients included 48 men (mean age 64 years) and 13 women (61 years). Of the 82 accessory lesions, 41 (50%) were located in the same region as the main lesion. The most frequent combination of macroscopic types of the main lesion and the accessory lesion was depressed type/depressed type (28 cases). The main lesion was of the well differentiated type in 39 (64%) of the 61 cases; the accessory lesion was also well differentiated in 37 of the 39 cases. Of the 82 accessory lesions, 29 (35%) had been overlooked preoperatively; most of them were located in the middle third of the stomach and included 17 depressed and 10 flat lesions, most of which measured no more than 1 cm. Cases of multiple early gastric cancer are characterized by the predominance of male patients of advanced age (>60 years), a combination of the same macroscopic type of the main and accessory lesions, and well differentiated carcinoma. Lymph node metastasis and vascular invasion are equally or less frequent than in cases of solitary early gastric cancer. The postoperative crude survival rate in patients with multiple gastric cancer is similar to that in those with solitary gastric cancer. Therefore we believe that multiple early gastric cancer does not require extended operative procedures. Endoscopic treatment may be indicated if each lesion fits the criteria for treatment and careful follow‐up is ensured.
Complement Activation, Its Consequences, and Blockade by Gene Transfer
Authors: Carrington Christine A. , Richards Andrew C. , van den Bogaerde Johan , Tucker Alexander W. , White David J.G. 
Published: August 2002

AbstractThe success of xenotransplanting vascularized pig organs into humans is limited owing to the immediate immune reaction, termed hyperacute rejection (HAR). This reaction is primarily mediated by naturally occurring xenoreactive antibodies binding to the graft and activating the complement system, resulting in organ dysfunction. Pig membrane‐bound complement regulatory proteins efficiently control autologous complement only and are unable to protect against human complement‐mediated damage. One line of current research to overcome HAR of pig organs involves the expression of human complement regulatory proteins by pig cells. In vitro data have demonstrated that pig endothelial cells expressing human regulators of complement activation (RCAs) are resistant to human complement‐mediated attack, which has led to the successful production of pigs transgenic for human RCAs. Ex vivo perfusion studies using fresh human blood with organs from these animals has shown an improvement in graft function and survival through expression of human RCAs compared to that of nontransgenic pig organs. Similar results have been observed in primate models, where expression of human RCA proteins on the pig donor organ has resulted in protection against HAR and prolongation of graft survival. The initial complement‐mediated immunologic barrier of HAR has been overcome through this genetic incorporation of human RCAs into pigs, and it is now possible to study the subsequent mechanisms of xenograft rejection in the pig‐to‐human combination.
Baboon Bone Marrow Transplantation in Humans: Application of Cross‐Species Disease Resistance
Authors: Exner Beate G. , Neipp Michael , Ildstad Suzanne T. 
Published: August 2002

AbstractXenotransplantation is a newly evolving field. A renewed interest has emerged coincidentally with the shortage of donor organs for transplantation. Bone marrow (BM) chimerism has been suggested as a potential strategy to induce tolerance to xenografts and control the immune response across a species barrier. Bone marrow transplantation (BMTx) displays unique features compared to solid‐organ transplantation or transplantation of other cellular grafts. To achieve engraftment of the pluripotent hematopoietic stem cell, which generates all lineages of the hematolymphopoietic system, conditioning of the recipient (usually a combination of irradiation and cytoablative chemotherapy) is required. Once engraftment is achieved, graft function is stable and rejection does not occur, even without immunosuppression. On the other hand, the graft itself is able to generate an immune response against the host, resulting in graft‐versus‐host disease (GVHD). A newly recognized advantage to xenotransplantation is species‐specific disease resistance. In terms of BMTx, important questions arise: Can xenogeneic BM generate a competent immune response across species barriers? Will cross‐species GVHD occur? What are the possible applications to humans? This review addresses these questions. Problems emerging from xenogeneic BMTx are summarized and strategies for their solution discussed.
Surgery for Nonalcoholic Chronic Pancreatitis
Authors: Sharma Atul K. , Pande Girish K. , Sahni Peush , Nundy Samiran 
Published: August 2002

AbstractThere are few reports on operations in patients with nonalcoholic pancreatitis. Between 1985 and 1995 we operated on 58 such patients, 38 of whom were male and 20 female with a mean age of 35 years (range 5–72 years). The indications for operation were pain (n= 49), biliary obstruction (n= 12), duodenal obstruction (n= 10), portal hypertension (n= 11), cysts (n= 14), and pancreatic ascites (n= 3). Thirty‐four patients with a dilated pancreatic duct underwent pancreaticojejunostomy; cysts were drained internally in eight, and biliary and duodenal obstruction was bypassed. Ten patients also underwent surgery for portal hypertension. Four (7%) patients died during the postoperative period. Of the remaining 54 patients, 48 (89%) were followed up for a median period of 63 months (range 6 months to 10 years). Six died: four of pancreatic cancer, one of cerebrovascular accident, and one of malnutrition. Of the 34 surviving patients operated for pain, 30 (88%) felt better, of whom 24 (71%) had complete relief of pain; 14 (41%) recorded a weight gain. Pancreatic decompression results in immediate and lasting pain relief in most patients with nonalcoholic chronic pancreatitis.
Assessment of Risk Factors for Pancreatic Resection for Cancer
Authors: Crucitti Francesco , Doglietto Giovanni Battista , Viola Gabriele , Frontera Domenico , De Cosmo Germano , Sgadari Antonio , Vicari Donatella , Rizzi Alfredo 
Published: August 2002

AbstractA series of 101 consecutive patients undergoing pancreatic resection for cancer was retrospectively analyzed to define factors that may affect the immediate postoperative outcome. Overall morbidity and mortality were 28.7% and 10.9%, respectively, although these figures were greatly reduced during the last years; the complication rate dropped from 55.6% (1981–1987) to 20.0% (1993–1995) and the mortality from 16.7% to 6.7%. At univariate statistical analysis the patient characteristics (sex, age, American Society of Anesthesiologists [ASA] class, nutritional status, jaundice), tumor characteristics (site, size, TNM stage, and grading), and type of surgery were found not to affect postoperative morbidity and mortality. In contrast, a significantly lower rate of complications was observed in patients not undergoing gastric resection, in those who received 3 units or less of blood intraoperatively, and in subjects operated more recently (after 1990). At multivariate analysis the period when the operation was performed was the only independent variable that affected the immediate postoperative outcome. Among the examined factors, only the experience acquired over time regarding the intra‐ and perioperative treatment of these patients seems able to lower the rate of postoperative complications.
Use of the Scalp as a Donor Site for Large Burn Wound Coverage: Review of 150 Patients
Authors: Chang Li‐Yen , Yang Jui‐Yung , Chuang Shiow‐Shuh , Hsiao Cheng‐Wei 
Published: August 2002

AbstractThe characteristics of rapid wound healing and multiple harvest capacity make the scalp an important donor site when dealing with large and deep burn wounds. This paper reports the results of a retrospective analysis of 150 patients treated for large burn wounds. The findings indicated that bleeding during graft skin harvest could be limited to 50 ml by intradermal injection of epinephrine (1:2,000,000), high‐concentration epinephrine‐soaked gauze compression (1:20,000), and temporary porcine skin coverage. Use of a scalp graft also carried a low risk of complications, with only four (2.7%) major complications including three cases (2.0%) of visible alopecia and one case (0.7%) of hair transplantation. There were no hypertrophic scars, even in the patient who had the largest number (11) of repeat harvests.
Transcylindrical Cholecystectomy: New Technique for Minimally Invasive Cholecystectomy
Authors: Grau‐Talens Enrique Javier , García‐Olives Francisco , Rupérez‐Arribas María Pilar 
Published: August 2002

AbstractMinilaparotomy cholecystectomy presents exposition difficulties, and laparoscopy requires expensive equipment and additional training. Laparotomy is more painful, causes trauma to the abdominal wall, and requires a longer convalescence; it is also less aesthetic. We present a new technique for minilaparotomy cholecystectomy, transcylindrical cholecystectomy (TC), based on the introduction of a 3.8‐ or 5.0‐cm diameter cylinder (10.0 cm long). The cylinder serves the purpose of separating and isolating the hepatocystic triangle from the surrounding structures, thereby providing a stable surgical field and adequate vision of the hepatocystic triangle so the technique can be performed safely. Patients who have been diagnosed with symptomatic cholelithiasis, who are convalescent from biliary pancreatitis, or who have acute cholecystitis have been treated consecutively by TC. We have carried out the procedure on 116 occasions, 94 using the 3.8‐cm cylinder and 28 with the 5.0‐cm cylinder; both cylinders were used in 6 cases. The indications for using the 5.0‐cm cylinder were mainly cholecystitis, pancreatitis, choledocholithiasis, and difficulty with the 3.8‐cm cylinder. The result is a 4.5‐ or 7.0‐cm incision. We had difficulty recognizing the anatomy in 11 dissections so we had to enlarge the incision. We have not had accidents related to placement of the cylinder, hemorrhage, or bile duct injuries. The median operating time was 43 minutes, and the mean postoperative stay was 1.8 days. Postoperative FVC and FEV1 reductions were 21.7% and 27.4%, respectively. The technique has proved fast, safe, and practicable using conventional material. The cost of TC is $701 (US).
Induction of Heat Shock Response: Effect on the Rat Liver with Carbon Tetrachloride‐induced Fibrosis from Ischemia‐reperfusion Injury
Authors: Shimabukuro Takashi , Yamamoto Yuzo , Kume Makoto , Kimoto Syuji , Okamoto Ryoji , Morimoto Taisuke , Yamaoka Yoshio 
Published: August 2002

AbstractThe role of heat shock pretreatment in the induction of tolerance for ischemia‐reperfusion injury was investigated in rat livers with fibrosis produced by carbon tetrachloride (CCl4) injected subcutaneously. The control group (group C,
n= 56) received no pretreatment except anesthesia, and the heat shock group (group HS,n= 56) were exposed to heat shock (42°C) for 15 minutes. After a 48‐hour recovery all rats were subjected to 30 minutes of warm ischemia. Western blotting analysis was employed for heat shock protein (HSP) 72 detection. The adenine nucleotide levels in liver tissue and the liver enzyme levels in serum were measured before and after ischemic intervention (seven animals were used at each of six time point measurements in both groups). HSP72 was induced in group HS at greater intensity than in group C. The survival rate on postoperative day 7 in group C (3/14) was significantly poorer than that in group HS (14/14) (p < 0.01). The higher survival rate in group HS was accompanied by more rapid recovery of the adenosine triphosphate level and lower serum levels of liver enzymes after reperfusion (p < 0.01 vs. group C). Heat shock preconditioning induces HSP72 in the rat liver with fibrosis and provides significantly increased tolerance of warm‐ischemia reperfusion injury.
Overexpression of nm23 Protein Assessed by Color Video Image Analysis in Metastatic Colorectal Cancer: Correlation with Reduced Patient Survival
Authors: Berney Christophe R. , Yang Jia‐Lin , Fisher Richard J. , Russell Pamela J. , Crowe Philip J. 
Published: August 2002

AbstractThe function and prognostic significance of the nm23 gene is controversial in colorectal cancer (CRC). The aim of this study was to determine if nm23 protein expression correlated with the subsequent development of liver metastasis. Paraffin‐embedded sections of 30 metastasizing CRC primaries and their subsequently resected liver secondaries were compared with those of 28 nonmetastasizing CRCs, 20 adenomas, and 20 cases of normal colonic mucosa. Expression of nm23 protein, assayed by immunohistochemistry, was measured using a standard semiquantitative scaling system and compared with a microcomputer‐based color video image analysis (VIA). There was good correlation between color VIA and semiquantitative evaluation of nm23 immunoreactivity, confirming the validity of quantitative analysis (Pearson's r= 0.88; p < 0.001). Metastasizing CRC primaries and secondaries overexpressed nm23 protein when compared with the other clinical groups, particularly nonmetastasizing CRC (Student'st‐test, p < 0.001). Furthermore, more nm23 immunoreactivity was associated with a higher risk of death from CRC (log‐rank test, p= 0.002). These results suggest that overexpression of nm23 is highly associated with liver metastases from CRC and reduced survival.
Preoperative and Intraoperative Topographic Diagnosis of Insulinomas
Authors: Kuzin Nikolay M. , Egorov Aleksey V. , Kondrashin Sergey A. , Lotov Aleksey N. , Kuznetzov Nikolay S. , Majorova Julia B. 
Published: August 2002

AbstractAltogether 120 patients with organic hyperinsulinism underwent clinical examination and treatment (38 male, 82 female, mean age 44.2 ± 4.6 years). The cause of hyperinsulinism was benign insulinomas in 96 (80.0%), malignant tumors in 9 (7.5%), and hyperplasia of beta cells in 6 (5.0%). In 9 (7.5%) patients the origin of hyperinsulinism was not diagnosed. The tumor was localized in the head, body, and tail of the pancreas in 31.8%, 36.4%, and 31.8% of cases, respectively. Intraoperative ultrasonography (IOUS) was undertaken in 37 patients, and in 83 cases only intraoperative palpation was done. Arterial stimulated venous sampling (ASVS) was performed in 17 patients (blood was sampled from the right hepatic vein for determination of the insulin level after arterial stimulation by calcium gluconate in different parts of the pancreas). The sensitivity of ultrasonography (US) was 29.5%, computed tomography (CT) 24.2%, angiography 55.9%, superselective angiography (branches of the celiac trunk) 72.2%, and intraoperative palpation 90.0%. ASVS showed an accuracy of 90.0%. Combining angiography with ASVS gave an exact diagnosis of hyperinsulinism in 100% of cases, and IOUS revealed tumors in 100% of cases. Hyperplasia of beta‐cells was diagnosed only by means of ASVS. A total of 117 patients underwent surgery, including distal resection of pancreas (n= 39), enucleation of tumor (n= 70), and laparotomy (n= 8). The postoperative mortality associated with insulinomas was 7.7%. The frequency of postoperative complications was 43.6%. Benign insulinomas recurred at a rate of 5.4%. Patients with malignant insulinomas had a 5‐year survival of 66.0%. The diagnosis of insulinomas was achieved by a combination of selective angiography, ASVS, and IOUS.
Anaplastic Giant Cell Carcinoma of the Thyroid Gland: Treatment and Survival Over a 25‐Year Period
Authors: Nilsson Ola , Lindeberg Johan , Zedenius Jan , Ekman Eva , Tennvall Jan , Blomgren Henric , Grimelius Lars , Lundell Göran , Wallin Göran 
Published: August 2002

AbstractAnaplastic giant cell carcinoma of the thyroid is a rare but highly malignant tumor. At the Karolinska Hospital in Stockholm, surgery, chemotherapy, and radiotherapy have been used separately or in various combinations in 81 patients admitted with this diagnosis during 1971–1997. In this study, we present the various multimodality treatment regimens and their changes over the years and the subsequent differences in survival and local tumor control. Overall, eight patients (10%) survived more than 2 years. All survivors were treated with combinations of chemotherapy, radiotherapy, and surgery. Among the patients who died, local tumor control was achieved by the therapy given in many cases. The results suggest that our current strategy with a combination of preoperative hyperfractionated accelerated radiotherapy, doxorubicin pre‐ and postoperatively, and debulking surgery whenever possible results in better local tumor control and an increased chance of survival.
Liposuction: Procedure for Focal Volume Reduction and Body Contour Remodeling
Authors: del Campo Antonio Fuente , Allegretti Eustacio Rojas , Filho Jose Amandio Fernandes , Gordon Christopher Burnside 
Published: August 2002

AbstractLiposuction is the most commonly used procedure for focal reduction of body fat deposits and remodeling the body contour. The procedure consists in aspirating fat from lamellar deposits using a vacuum source connected to a cannula that is passed bluntly through fatty tissue. Adjuncts to the procedure include infiltration of solutions to aid in fat removal or to limit blood loss and the application of ultrasonic energy to lyse fat cells before suction aspiration. Surgical history, theory, procedures, indications, potential complications, and guidelines are discussed herein.
Second Step: Testing—Outcome Measurements
Authors: Lorenz Wilfried , Troidl Hans , Solomkin Joseph S. , Nies Christoph , Sitter Helmut , Koller Michael , Krack Walter , Roizen Michael F. 
Published: August 2002

AbstractDespite worldwide enthusiasm for endoscopic surgery, this new technology is now on the top of McKinlay's “product life circle curve.” Critical questions are being asked about its benefits and burdens, but the concepts applied and the methodologies used for technology assessment are in a similar position as endoscopic surgery and need a critical evaluation. (1) There are incorrect and outdated concepts for the scientific basis of surgery (surgical theory) including the basic sciences involved; biomedicine still dominates, but assessment of outcome after operations is no longer possible without clinical epidemiology and social psychology. (2) Based on an outdated scientific theory for surgery, an outdated concept of disease is still propagated. It is denoted as mechanical and is based solely on biomedicine. Human subjects are reduced to biologic machines, and outcomes measurement excludes most dimensions of functioning and well‐being. To achieve a valid result for outcome measures, a hermeneutic approach must be combined with the mechanical approach. (3) Based on an outdated model of disease, the outcomes used in endoscopic surgery rely too much on traditional measures, such as mortality rate, complication rate, hospital stay, and especially an endless list of biochemical mediators. Their alterations during the perioperative period have not yet been shown to be related to clinical or hermeneutic outcomes. A new method of assessment for clinical trials in endoscopic surgery and for other surgical problems is outlined, such as for surgical infections and for surgical oncology. It includes an index of recovery and objective health status assessed by the doctor, a quality‐of‐life self‐report by the patient, and the true endpoint concept as a critical weighting of both types of outcome by patients and doctors.