bluuebunny/crossref_metadata_2025_split huggingface dataset:
Needle Tract Implantation of Hepatocellular Carcinoma and Pancreatic Carcinoma after Ultrasound‐guided Percutaneous Puncture: Clinical and Pathologic Characteristics and the Treatment of Needle Tract Implantation
Authors: Kosugi Chihiro , Furuse Junji , Ishii Hiroshi , Maru Yasushi , Yoshino Masahiro , Kinoshita Taira , Konishi Masaru , Nakagohri Toshio , Inoue Kazuto , Oda Tatsuya 
Published: July 2004

AbstractTumor implantation along the needle tract following percutaneous procedures under ultrasonographic guidance for hepatocellular carcinoma (HCC) and pancreatic carcinoma (PC) has been well documented. The purpose of the present study was to investigate the correlation between the procedure, the pathologic differentiation of the primary tumor, and the treatment after implantation. Between July 1992 and March 2000, HCC patients (n = 372) who underwent biopsy, percutaneous ethanol injection (PEI) therapy and percutaneous microwave coagulation therapy (PMCT) and PC (n = 73) patients who underwent biopsy were retrospectively studied. Needle tract implantation was found in six of the HCC patients (1.6%) and one of the PC patients (1.4%). The interval to diagnosis ranged from 5 to 25 months (mean ± SD 11.2 ± 7.6 months) in the HCC patients. The needle tract implantation was evident for all procedure types in these patients (two after PEI alone, two after both biopsy and PEI, and one after PMCT) and for each degree of pathologic differentiation of the primary tumors (well differentiated in one, moderately differentiated in two, and poorly differentiated in one). Each implanted tumor was surgically resected, with no recurrence at the focal lesion. These results suggest that needle tract implantation develops regardless of the procedure or the pathologic differentiation of the primary tumor, and that surgical resection might be effective for controlling these implanted lesions.
Management of Retrohepatic Inferior Vena Cava Injury during Hepatectomy for Neoplasms
Authors: Ai‐jun Li , Meng‐chao Wu , Guang‐shun Yang , Han Chen , Fen Shen 
Published: July 2004

AbstractThe aim of this article is to discuss the management of retrohepatic inferior vena cava injury during hepatectomy for neoplasms. Step‐by‐step hepatic vascular exclusion, digital compression, finger pinching, and surface‐to‐surface suturing were used in the management of retrohepatic inferior vena cava injury during hepatic resection in 16 cases: 12 patients underwent exclusion of the hepatic artery and portal vein by portal triad clamping (PTC) only; 3 underwent PTC and exclusion of the infrahepatic inferior vena cava (IVC); and 1 underwent PTC together with exclusion of the suprahepatic and infrahepatic IVC. In all cases, bleeding stopped immediately after the management described, with no intraoperative deaths and no postoperative bleeding. The median follow‐up was 42.5 months (range 19–60 months) for all patients, and the 5‐year survival rate of all patients with malignant tumors was 28.57%. One died of lung metastasis 19 months after operation, one with spontaneous rupture of a hepatocellular carcinoma 19 months after operation, and eight others from recurrence or metastasis 21, 23, 24, 27, 30, 35, 50, or 54 months after operation, respectively. Two patients had a recurrence 4 years and 4 years 6 months after the initial operation, respectively. The recurrent tumors of the liver were resected. The other patients are currently alive without recurrence or metastasis. The techniques described are safe, simple, practical, time‐saving, and effective for controlling massive bleeding arising from injury to the retrohepatic inferior vena cava during hepatic resection.
Anastomotic Healing in a Small Bowel Transplantation Model in the Rat
Authors: Wasserberg Nir , Tzakis Andreas G. , Santiago Sergio F. , Ruiz Phillip , Salgar Shashikumar K. 
Published: July 2004

AbstractAnastomotic healing is impaired after intestinal surgery because of ischemia and reperfusion injury (IRI), which can result in intestinal leaks leading to increased mortality. The objective of this study was to determine the effects of transplant IRI and immune mechanisms on intestinal graft anastomotic healing. Orthotopic intestinal transplantations (OIT) were performed in rats. The experimental design consisted of six groups A–F (n = 5/group): A, allogeneic OIT treated with tacrolimus (1mg/kg/day); B, syngeneic OIT treated with tacrolimus; C, syngeneic OIT; D, allogeneic OIT; E, proximal and distal anastomoses performed in nontransplanted animals; F, same as in group E but treated with tacrolimus. Anastomotic bursting pressure (ABP), hydroxyproline content (HPC), and mucosal inflammatory infiltrate (MII) were determined at the anastomotic sites (proximal and distal) and compared between groups. ABP was significantly (p < 0.001) reduced in OIT groups A, B, C, and D compared to control groups E and F at both the proximal and distal anastomotic sites. HPC was ∼1 μg/mg of tissue in groups A, B, C, and D, and ∼5μg/mg of tissue in groups E and F. This demonstrates a significant (p < 0.001) reduction in HPC after OIT. MII was significantly (p < 0.001) increased in OIT groups when compared to nontransplanted control groups. MII was also significantly (p < 0.05) increased in allogeneic OIT groups A and D compared to syngeneic OIT groups B and C. Generally, ABP and HPC were inversely proportional to MII in both nontransplanted control and OIT groups. Reduced anastomotic strength was demonstrated in both syngeneic and allogeneic OIT anastomotic sites irrespective of immunosuppressive therapy, and is probably related to IRI.
Relation between Hepatic and Portal Veins in the Right Paramedian Sector: Proposal for Anatomical Reclassification of the Liver
Authors: Cho Akihiro , Okazumi Shinichi , Makino Harufumi , Miura Fumihiko , Ohira Gaku , Yoshinaga Yushin , Toma Takayuki , Kudo Hidehiro , Matsubara Katsuhiko , Ryu Munemasa , Ochiai Takenori 
Published: July 2004

AbstractAlthough a right liver graft without a middle hepatic vein resulted in potential venous congestion in the right paramedian sector, the details of the hepatic venous distribution in the right paramedian sector have not been established. In this study, the ramification patterns of the hepatic veins draining the right anterosuperior segment (S8) and the relation between the hepatic and portal veins were assessed using multislice computed tomography in 44 patients without lesions in the liver. All 52 drainage veins of the ventral area of S8 joined the middle hepatic vein, and all 48 drainage veins of the dorsal area joined the right hepatic vein. The hepatic vein crossing between the ventral and dorsal areas was observed in each patient examined. Therefore, we propose a reclassification wherein the right paramedian sector is divided into ventral and dorsal segments. This new classification may contribute to the development of new and safer surgical procedures, including more limited resection and right lobe adult living donor liver transplantation to avoid graft congestion.
Practice Patterns in Breast Cancer Surgery: Canadian Perspective
Authors: Porter Geoffrey A. , McMulkin‐Tait Heather 
Published: July 2004

AbstractBreast cancer is a common disease, and the surgical management is continually evolving. The objective of this study was to describe the current breast cancer practice patterns among Canadian surgeons. All active General Surgeons (n = 1172), as accredited by the Royal College of Physicians and Surgeons of Canada, were sent a 31‐item questionnaire. Anonymous responses were collected and analyzed regarding surgeon demographics, practice, and perceptions regarding surgical care of breast cancer patients. Overall 640 active surgeons responded; of these, 519 (81%) treated breast cancer and formed the study cohort. Practice settings included community (55%), community with university affiliation (28%), and academic (17%). The majority of surgeons (76%) stated that < 25% of their practice was devoted to breast disease, and 42% performed ≤ 2 breast cancer operations/month. Immediate breast reconstruction (IBR) was used by 57% of surgeons. On multivariate analysis, higher surgeon volume of breast cancer cases (p = 0.0008), fellowship training in Surgical Oncology (p = 0.009), community population (p = 0.001), and academic practice setting (p < 0.0001) were independently associated with the use of IBR. Of the 640 surgeons who responded, 79% stated that breast cancer surgery should be performed by “most general surgeons.” In Canada, most breast cancer surgery was performed by general surgeons who did not appear to have an interest, as defined by training or clinical volume, in breast cancer. Although variability regarding specific surgical issues was found among subgroups of surgeons, the majority of respondents felt that most general surgeons should treat breast cancer.
Effect of Spontaneous Portosystemic Shunts on Hemorrhage from Esophagogastric Varices
Authors: Hsieh Jan‐Sing , Wang Jaw‐Yuan , Huang Che‐Jen , Chen Fang‐Ming , Huang Tsung‐Jen 
Published: July 2004

AbstractThe role of a massive spontaneous portosystemic shunt (MSPSS) in cirrhotic patients with portal hypertension remains unclear. The aim of this study was to investigate clinical outcomes and portal hemodynamic changes following ligation of the MSPSS during devascularization surgery. Portography and gastroendoscopy were performed before and after surgery for hemodynamic and follow‐up studies. Three types of MSPSS were demonstrated portographically: 22 portoumbilical shunts, 18 splenorenal shunts, and 2 inferior mesenteric‐caval shunts. A total of 40 MSPSS patients with esophagogastric variceal (EGV) bleeding underwent surgery: 26 had ligation of the MSPSS, and the remaining 14 served as the nonligation group. Neither the preoperative mean portal pressure (MPP) nor the postoperative MPP were significantly different between the ligation and nonligation groups (p > 0.1), and there was no significant difference regarding surgical mortality, recurrent varices, or cumulative survival rate for the two groups in the follow‐up study. However, postoperative portography demonstrated persistent drainage of portal flow and decreased intrahepatic portal perfusion in the nonligation patients. Clinical signs of hepatic encephalopathy subsided after ligation of the MSPSS in three patients. Therefore ligation of the MSPSS, which may be responsible for the development of encephalopathy, is recommended during devascularization surgery for EGV in cirrhotic patients.
Identification of Sentinel Lymph Nodes in Colon Cancer Depends on the Amount of Dye Injected Relative to Tumor Size
Authors: Viehl Carsten T. , Hamel Christian T. , Marti Walter R. , Guller Ulrich , Eisner Lukas , Stammberger Uz , Terracciano Luigi , Spichtin Hans P. , Harder Felix , Zuber Markus 
Published: July 2004

AbstractRecent studies have shown that the sentinel lymph node (SLN) procedure might improve staging in colon cancer. However, low SLN identification and high false negative rates have also been reported. In a two‐institution study, the SLN procedure with isosulfan blue 1% was performed according to a standardized protocol in 31 patients with open resections for colon cancer. Data were collected prospectively. The database was analyzed retrospectively to determine factors contributing to a low identification rate. The SLN identification rate was 87% and the false negative rate was 50%. Successful SLN identification was significantly associated with application of higher volumes of dye relative to the tumor diameter (p = 0.04) and more frequent tumor localization in the sigmoid colon (p = 0.04) as compared to missing SLN identification. The tumor diameter was not significantly different in the two groups. Sentinel lymph node identification in colon cancer depends on the amount of dye injected relative to the tumor size. Application of only 1 ml of dye—the amount generally recommended in the literature—is not sufficient in large tumors.
Predictors of Surgical Outcome for Complicated Pneumonia in Children: Impact of Bacterial Virulence
Authors: Margenthaler Julie A. , Weber Thomas R. , Keller Martin S. 
Published: July 2004

AbstractThe charts of 110 children with community acquired bacterial pneumonia were reviewed. A subset of children who required surgical intervention for empyema or parapneumonic effusion was identified. Patients were divided into two treatment groups: antibiotics/tube thoracostomy alone (group 1) versus operative intervention (group 2). Overall, 33 (30%) of the children required surgical intervention for complications. Seventeen (15%, group 1) were successfully treated with antibiotics/tube thoracostomy alone, while 16 (15%) in group 2 were treatment crossovers, failing this initial therapy. Of group 2 children, 4 (25%) underwent thoracotomy and lobectomy, while 12 (75%) underwent video‐assisted thoracoscopic surgery (VATS). Although group 2 children were younger than those in group 1 (4.4 ± 3.6 versus 6.3 ± 4.1 years, p < 0.05) and had longer hospitalizations (20.1 ± 10.1 versus 8.2 ± 3.9 days, p < 0.05), symptom duration, preoperative antibiotics, fibrinolytic use, and leukocytosis were similar (p > 0.05). Group 1 children had 13 (76%) positive cultures, 92% with pan‐sensitivities, in contrast to group 2, which had 12 (75%) positive cultures, but only 33% were sensitive to first‐line antibiotics (p < 0.01). Group 2 patients were also more likely to have complex multi‐loculated empyemas, pneumatoceles, or pulmonary necrosis identified on imaging studies (100% versus 24%, p < 0.01). These data suggest that the natural history of pneumonia in children is heavily influenced by bacterial virulence. Tube thoracostomy and appropriate antibiotics remain effective for pan‐sensitive, simple parapneumonic effusions and empyema. Complex parapneumonic effusions and empyema, however, which occur more frequently in the setting of first‐line antibiotic resistance, often fail more conservative managements and may be best treated by earlier operative debridement.
The comet assay differentiates efficiently and rapidly between genotoxins and cytotoxins in quiescent cells
Authors: Daza P. , Torreblanca J. , Moreno F.J. 
Published: July 2004

AbstractOur main aim was to establish the efficiency of the single cell electrophoresis technique for differentiating between drugs that bind DNA and those that do not. The alkaline comet assay was used to test the responses of human leukocytes (quiescent cells) to damage induced by reportedly genotoxic and reportedly cytotoxic agents. Incubation of G0 leukocytes for 1 h with the genotoxic agents camptothecin and actinomycin C provoked DNA migration, observed as comet figures. On the other hand, when cells were treated with the cytotoxic agents cordycepin, fluorodeoxyuridine and puromycin, the leukocyte nuclei were indistinguishable from those of untreated cells. In addition, we have developed a rapid method using non‐proliferating cells that requires neither culture nor lymphocyte isolation. This method promises to be useful as a rapid in vitro screening assay.
America and the world: (still) a work in progress?
Authors: Miller Linda B. 
Published: July 2004

Andrew J. Bacevich, American Empire (Cambridge, MA: Harvard University Press, 2002).Charles Kupchan, The End of the American Era (New York: Alfred Knopf, 2002).Ivo H. Daadler and James M. Lindsay, America Unbound (Washington, DC: Brookings
Institution, 2003).Did 11 September 2001 change everything about the United States including its foreign policy? Have the subsequent US-led wars in Afghanistan and Iraq altered the scholarly calculus of what should be studied and how? Must authors determined to assert the continuing importance of history, geopolitics or domestic factors as explanatory variables recast or abandon their existing conclusions to highlight the newer realities after the terrorist attacks and their aftermath? If so, how? These questions lead to others. Is there a usable American past that helps illuminate the dilemmas of the present? If so, where is it found? Is there a sustainable future role for the US in the world, beyond ideology or improvisation? If so, what are its contours? Is the Bush administration truly ‘radical’ or even ‘revolutionary’ in its imperial thrusts? After Afghanistan and Iraq, is American foreign policy still largely a success story? Or is the United States en route to becoming an ordinary country, albeit one with extraordinary resources in both hard and soft power?
Exploring the Public Understanding of Basic Genetic Concepts
Authors: Lanie Angela D. , Jayaratne Toby Epstein , Sheldon Jane P. , Kardia Sharon L. R. , Anderson Elizabeth S. , Feldbaum Merle , Petty Elizabeth M. 
Published: July 2004

AbstractIt is predicted that the rapid acquisition of new genetic knowledge and related applications during the next decade will have significant implications for virtually all members of society. Currently, most people get exposed to information about genes and genetics only through stories publicized in the media. We sought to understand how individuals in the general population used and understood the concepts of “genetics” and “genes.” During in‐depth one‐on‐one telephone interviews with adults in the United States, we asked questions exploring their basic understanding of these terms, as well as their belief as to the location of genes in the human body. A wide range of responses was received. Despite conversational familiarity with genetic terminology, many noted frustration or were hesitant when trying to answer these questions. In addition, some responses reflected a lack of understanding about basic genetic science that may have significant implications for broader public education measures in genetic literacy, genetic counseling, public health practices, and even routine health care.
Translating Genetics Leaflets into Languages Other Than English: Lessons from an Assessment of Urdu Materials
Authors: Shaw Alison , Ahmed Mushtaq 
Published: July 2004

AbstractGenetic counselors frequently counsel clients whose first language is not English, relying on interpreters and on supplementary translated written material. This paper highlights factors that counselors need to consider before using or commissioning translated leaflets. It is based on an assessment of leaflets translated into Urdu, the national language of Pakistan, which are available through U.K. genetics clinics for use with Pakistani‐origin clients. The 2 authors, who know Urdu as their 2nd and 1st languages respectively, independently read each leaflet, checking for accuracy of information, ease of reading and understanding, cultural sensitivity, and contact details for Urdu‐speaking professionals. There were factual errors and confusing or very difficult text in all leaflets; some leaflets also contained culturally insensitive messages that could alienate users of genetics services. The paper discusses the reasons for these pitfalls and makes recommendations to guide the future production of translated genetics leaflets.
Structure Investigations of Molecular Crystals Containing the Ring System Cyclo-tris(2,6-pyridylformamidine) by Means of X-ray Powder Diffraction and Force-Field-Constrained Rietveld Refinement
Authors: Friedel P. , Tobisch J. , Jehnichen D. , Bergmann J. , Taut T. , Rillich M. , Kunert C. , Böhme F. 
Published: July 2004

A new heterocyclic compound, cyclo-tris(2,6-pyridylformamidine), was synthesized as a highly crystalline powder-like substance from which very small whiskers were produced by a sublimation technique. By rotating-crystal and powder diffraction measurements, a set of structural data were obtained which were fitted mathematically to a structural model. The fitting procedure included geometry optimization byab initiocalculations, crystal structure and X-ray diffraction pattern simulation as well as structure refinement based on the newly developed Rietveld algorithmBGMN®under force-field constraints. A single-crystal structure refinement could not be carried out because of the small size of the whiskers. In order to obtain the atomic coordinates a new procedure incorporating a powder diffraction pattern refinement was used. Cyclo-tris(2,6-pyridylformamidine) crystallizes in a monoclinic unit cell witha = 28.18 (1),b = 14.67 (1),c = 4.428 (1) Å, β = 90.10 (2)°. The symmetry was determined asP21/a. The expected threefold symmetry of the cyclic compound was disturbed in the crystallized state, in agreement with solid-state NMR investigations. The best approximation was obtained when water molecules were additionally packed into the unit cell.
Variability in nomenclature used for nevi with architectural disorder and cytologic atypia (microscopically dysplastic nevi) by dermatologists and dermatopathologists
Authors: Shapiro Michael , Chren Mary‐Margaret , Levy Ross M. , Elder David E. , LeBoit Philip E. , Mihm Martin C. , Margolis David J. , Gimotty Phyllis A. , Ming Michael E. 
Published: July 2004

Background:  Although a nevus with the microscopic features of a ‘dysplastic nevus’ is commonly seen, the nomenclature used to describe such a lesion has been thought to be inconsistent. A 1992 National Institutes of Health (NIH) Consensus Conference sought to unify nomenclature and suggested that the term ‘nevus with architectural disorder’ be used along with a comment on melanocytic atypia.Methods:  We performed a cross‐sectional mail survey to determine preferred terminology as well as the level of adherence to the NIH‐recommended nomenclature. All 856 active members of the American Society of Dermatopathology (ASDP) and 1100 (13.0%) of the 8471 active members of the American Academy of Dermatology (AAD) were surveyed.Results:  Five hundred and thirty‐three ASDP members and 483 AAD members who fulfilled eligibility criteria completed the questionnaire. The term ‘dysplastic nevus’ was favored by the largest number of responders (favored by 39.1% of ASDP members and 62.3% of AAD members), while the 1992 NIH Consensus Conference‐recommended terminology was the second most popular term (25.3% of ASDP and 15.1% of AAD members). Dermatopathologists (OR = 1.9, p = 0.0001) and those who had dual training in dermatology and dermatopathology (OR = 1.6, p = 0.02 for ASDP members; OR = 2.3, p = 0.02 for AAD members) were more likely to adhere to the 1992 NIH Consensus Conference nomenclature.Conclusions:  Despite attempts to unify nomenclature for microscopically dysplastic nevi through the NIH Consensus Conference, wide variation in terminology persists.
Pilomatricoma with a bullous appearance
Authors: Yiqun Jiang , Jianfang Sun 
Published: July 2004

Background:  Pilomatricoma is a benign, cutaneous neoplasm with differentiation toward hair matrix. The tumor is usually a deep‐seated, solitary, firm nodule with overlying normal epidermis. Pilomatricoma with a bullous appearance is very rare.Methods:  A 16‐year‐old Chinese girl with a soft, purplish, translucent bulla on the left shoulder for 6 months and a nodule underlying the bulla is described.Results:  The histopathologic findings were consistent with pilomatricoma. There was extraordinary dilation of lymphatic vessels in the overlying dermis, which explains the clinical bullous appearance. The surrounding dermis had an edematous appearance. A Verhoeff–van Gieson stain disclosed the marked reduction of the elastic fibers, and an alcian blue stain was negative.Conclusions:  The patient is diagnosed as bullous variant of pilomatricoma.