bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soil community composition drives aboveground plant–herbivore–parasitoid interactions
Authors: Bezemer T. M. , De Deyn G. B. , Bossinga T. M. , Van Dam N. M. , Harvey J. A. , Van der Putten W. H. 
Published: June 2005

AbstractSoil organisms can influence higher trophic level aboveground organisms, but only very few studies have considered such effects. We manipulated soil community composition of model grassland ecosystems by introducing nematode communities, microorganisms, neither or both groups. Above ground, aphids (Rhopalosiphum padi) and parasitoids (Aphidius colemani) were introduced, and we measured individual performance and population dynamics of plants, aphids and parasitoids. In microcosms with nematode inoculations either with or without microorganism inoculation, aphids offspring production was significantly reduced by 31%. Aphid populations on both host plants Agrostis capillaris and Anthoxanthum odoratum were lowest in microcosms with combined nematode and microorganism inoculations. Opposite results were found for parasitoids. While the number of emerged parasitoids did not differ between treatments, parasitoid mortality and the proportion of males were significantly lower in microcosms with nematode and microorganism inoculations. Parasitized aphids were significantly larger in microcosms with nematodes inoculated. Plant biomass did not differ, but in the preferred host plant A. odoratum, foliar phenolic content was reduced in the presence of nematodes, and also the concentration of amino acids in the phloem. This study shows that the composition of the soil community matters for aboveground multitrophic interactions.
Environmental and geometric constraints on Indo‐Pacific coral reef biodiversity
Authors: Bellwood D. R. , Hughes T. P. , Connolly S. R. , Tanner J. 
Published: June 2005

AbstractThe Indo‐Australian Archipelago supports the world's richest coral reef biodiversity hotspot. Traditional hypotheses that account for such exceptional biodiversity have highlighted the importance of environmental variables such as habitat area and energy input. Recently, however, an additional explanation has been proposed based on geometric constraints in the placement of geographical ranges within a bounded domain, which cause a mid‐domain peak in species richness; the mid‐domain effect (MDE). Here, for the first time, we examine the relative importance of area, energy and MDE jointly on species richness patterns. Model selection indicates that the best model incorporates MDE and reef area, but no energy effect; moreover, this best‐fit model captures all major features of reef fish and coral species richness patterns. Habitat area is the major environmental factor influencing species richness. The prevention of further fragmentation and loss of habitat area is of critical importance for the conservation of coral reef biodiversity.
Complete rectal prolapse in young patients: psychiatric disease a risk factor of poor outcome
Authors: Marceau C. , Parc Y. , Debroux E. , Tiret E. , Parc R. 
Published: June 2005

AbstractObjective  Complete rectal prolapse is rare before the age of 50. The aim of our study was to identify the risk factors of total rectal prolapse before this age and to determine the surgical outcome in this specific group of patients.Patients and methods  The charts of all patients, younger than 50 years old, treated for total rectal prolapse between June 1995 and December 2001 were reviewed. Associated conditions were noted and pre and postoperative functions were compared in regards of constipation and evacuations problems, anal continence (Wexner score), recurrent prolapse and overall satisfaction. All patients underwent an abdominal rectopexy according to the Orr‐Loygue procedure.Results  During the study period, 28 patients (21 females) with a mean age of 34 ± 9 years were treated for a total rectal prolapse in our institution. Five patient (17.8%) had minor complications. After a mean follow up of 25 months, the global continence improved significantly (Wexner score: 4.9 vs 2; P = 0.014): 8 patients suffering from liquid stools incontinence before surgery were continent after rectopexy, while 2 continent patients became incontinent to liquid stools after surgery. Fourteen patients had chronic psychiatric disease requiring permanent treatment. These patients suffered more frequently from constipation (12/14 vs 5/14; P =0.006) and required more often a digital evacuation before surgery (6/14 vs 1/14; P = 0.07) than non psychiatric patients. They also suffered from more severe constipation and required more enemas after surgery (1/14 vs 6/12; P = 0.03) compared to patients without psychiatric disease. The only two patients, who had recurrence also had psychiatric disease.Conclusion  Chronic psychiatric disease requiring long‐term medication is observed in 50% of patients with total rectal prolapse under the age of 50 years. Moreover, the medically induced constipation in these patients could represent a cause of poorer functional outcome. Therefore, we recommand the identification of this preoperative risk factor to assess the results of total rectal prolapse treatment in patients younger than 50 years of age.
Jejunal Crohn's disease is associated with a higher postoperative recurrence rate than ileocaecal Crohn's disease
Authors: Keh C. , Shatari T. , Yamamoto T. , Menon A. , Clark M. A. , Keighley M. R. 
Published: June 2005

AbstractObjective  Crohn's disease is a chronic inflammatory, panintestinal disease of uncertain aetiology. The recurrence rate of Crohn's disease, often taken as the time when further surgical procedure is undertaken, has been reported to be as high as 76% in 10 years. The site of the disease has not yet been associated with the recurrence rate of Crohn's disease. The aim of the study was to compare the outcome of patients who were surgically treated for jejunal Crohn's disease to those whose diseases was confined to the ileocaecal region.Method  The information was tracked from our database of 724 surgically treated Crohn's disease patients between 1943 and 2002. Twenty‐eight patients with jejunal Crohn's disease at their first operation (12 jejunum alone, 16 also involving other sites) were identified. For each of these patients, 3 patients with ileocaecal Crohn's, matched for age, sex, and smoking habits (n = 84) were identified as controls.Results  The median age in both groups was 21 years (range 16–52 years) with a median follow‐up period of 19 years. The 3, 5 and 10 years re‐operation rate for the groups with jejunal disease were 43%, 50% and 61% compared to 22%, 30% and 51% with ileocaecal disease, respectively.Conclusions  The presence of jejunal Crohn's disease is associated with a higher rate of early disease recurrence compared to ileocaecal disease but long‐term recurrences rate do not differ significantly.
Assessment of long‐term quality of life after laparoscopic and open surgery for Crohn's disease
Authors: Thaler K. , Dinnewitzer A. , Oberwalder M. , Weiss E. G. , Nogueras J. J. , Wexner S. D. 
Published: June 2005

AbstractObjective  Surgery for Crohn's disease (CD) is associated with a high recurrence rate and quality of life (QOL) in these patients is controversial. The aim of this study was to assess QOL in patients after laparoscopic and open surgery for CD by two different validated instruments, a generic nonspecific score and a specific gastrointestinal QOL index.Patients and methods  Patients with CD who underwent elective laparoscopic or open ileocaecal resection with primary anastomosis between 1992 and 2000 were followed for recurrence and surgery‐related complications. QOL was assessed by the SF‐36 Health Survey containing a mental (MCS) and a physical (PCS) component summary score and by the Gastrointestinal Quality of Life Index (GIQLI) developed by Eypasch.Results  Thirty‐seven patients with a mean age of 48.8 ± 18.4 years including 23 females and 14 males were evaluated at a mean follow‐up of 42.6 ±25.8 months (minimum of 8 months). Twenty‐one (57%) patients underwent laparoscopic resection and 16 (43%) open surgery. Both groups were well matched for age, gender, ASA class and body mass index. Fourteen (38%) patients developed recurrent disease and 3 (8%) had postoperative incisional hernias. Overall, QOL scores were 103 ± 26.8 for the GIQLI, 47.2 ± 11.8 for the PCS, and 49.2 ± 11.5 for the MCS. The GIQLI correlated well with the SF36, correlation coefficient = 0.68 for GIQLI vs PCS (95% CI, 0.41,0.95) and 0.67 for GIQLI vs MCS (95%CI, 0.39, 0.95), respectively. When compared to the general US population, mean GIQLI scores (−13.8, P = 0.002) and mean PCS scores (−4.7, P = 0.001) were significantly lower in these patients than in healthy individuals. In a multivariate analysis of impact factors on QOL, recurrence within the follow‐up period was the single significant determinant reducing the PCS (−35.1, P = 0.026) and the GIQLI (−36.1, P =0.018).Conclusion  QOL is significantly reduced in patients with CD at long‐term follow‐up after both laparoscopic and open surgery. Recurrence is the only factor adversely affecting QOL of CD patients in remission irrespective of the operative technique applied.
Elevated tumour markers prior to complete tumour removal in patients with pseudomyxoma peritonei predict early recurrence
Authors: Alexander‐Sefre F. , Chandrakumaran K. , Banerjee S. , Sexton R. , Thomas J. M. , Tom Cecil  , Moran B. 
Published: June 2005

AbstractObjective  To assess the potential value of pre‐operative CEA, CA 125 and CA 19–9 in identifying Pseudomyxoma peritonei (PMP) patients at risk of recurrence following complete cytoreductive surgery and intraperitoneal chemotherapy.Method  Between March 1996 and October 2001, 35 patients, with documented pre‐operative tumour marker measurements, underwent complete cytoreduction. Outcome in the 32 survivors was recorded.Results  Median age was 53 years (range: 32–74). There were 17[53%] females. In 9/32[28%] all tumour markers were normal. The most common abnormality was elevated CEA level in 14/32[44%]. Median follow up was 23 months (range: 11–74). Recurrence was detected in 8/32[25%]. The 2‐year recurrence free interval was 53% in those with elevated CEA compared with 94% with normal CEA. The 2‐year disease free intervals were 100% in 9 patients with normal preop markers compared with 66% for the group with at least one abnormal marker.Conclusion  PMP patients with elevated CEA, or more than one abnormal serum tumour maker, are at risk of developing recurrent disease.
Pre‐operative assessment of extramural invasion and sphincteral involvement in rectal cancer by magnetic resonance imaging with phased‐array coil
Authors: Ferri M. , Laghi A. , Mingazzini P. , Iafrate F. , Meli L. , Ricci F. , Passariello R. , Ziparo V. 
Published: June 2005

AbstractObjective  Pre‐operative staging of rectal cancer should identify patients with extrarectal spread, who might benefit from pre‐operative radiotherapy, and patients with minimal sphincteral involvement, who can avoid permanent colostomy. The aim of this study was to assess the accuracy of Magnetic Resonance Imaging (MRI) to predict tumour stage and sphincter status.Patients and methods  Thirty‐three patients with a rectal tumour were pre‐operatively assessed by MRI with a phased‐array coil. Imaging results were correlated with the final pathological findings.Results  The overall accuracy of pre‐operative staging with MRI was 88% (k = 0.75) for extramural tumour invasion and 59% (k = 0.26) for lymph node metastases. MRI correctly evaluated the infiltration of the anal sphincters in 87% of patients (7 of 8 patients with low rectal tumour).Conclusion  MRI provides the surgeon with valuable information regarding extramural tumour spread and sphincteral involvement, enabling appropiate selection of patients for pre‐operative adjuvant therapy or sphincter‐saving surgery.
The prevalence of iron deficiency among patients presenting with colorectal cancer
Authors: L Beale A. , Penney M. D. , Allison M. C. 
Published: June 2005

AbstractObjectives  To examine prospectively the prevalence of iron deficiency among new patients presenting with colorectal cancer and to compare transferrin saturation and serum ferritin as markers of iron deficiency in this group of patients.Patients and methods  Data were gathered on all patients presenting with a new diagnosis of colorectal cancer over a 12‐month period. Iron status was estimated and, when possible, confirmed by measurement of serum ferritin concentration and transferrin saturation. Iron status was further examined in relation to tumour site and Dukes' stage.Results  During the study 157 patients presented with a new colorectal cancer. Of these, 130 could be evaluated and 78[60%] had evidence of iron deficiency. Transferrin saturation was below the reference range in 55 patients, but serum ferritin was below in only 18 patients. Among the 49 patients with right‐sided cancers, 39[80%] were iron deficient. Iron deficiency was significantly more likely in patients with right sided cancers compared with those with cancers at or distal to the splenic flexure (χ2 = 13, P < 0.001).Conclusion  The majority of patients with a new diagnosis of colorectal cancer are iron deficient at presentation. In such patients transferrin saturation measurement is a more sensitive marker of iron deficiency than serum ferritin. The potential role of measuring serum transferrin saturation as an adjunct to faecal occult blood screening should be explored further.
The impact of bone marrow micrometastases on metastatic disease‐free survival in patients with colorectal carcinoma
Authors: O'Connor O. J. , Cahill R. A. , Kirwan W. O. , Redmond H. P. 
Published: June 2005

AbstractAims  The biological relevance of bone marrow micrometastases (BMM) in colorectal cancer remains unknown. Here, we investigate their nature by examining the impact of the presence of BMM on metastatic disease‐free survival in a cohort of patients with this disease.Methods  Sixty‐three consecutive patients undergoing surgery for colorectal cancer of any stage were studied after approval of the study protocol by the local ethics committee and with full individual informed consent. All had bilateral iliac crest bone marrow aspirates prior to operation. Aspirates were then examined for the presence of aberrant cytokeratin‐18‐positive cells by a blinded observer using both flow cytometric and APAAP immunohistochemical techniques.Results  Mean follow‐up after surgery was 4.6 years (range 1.9–6.9) for those without hepatic metastases at diagnosis. Seven of 34 patients with Dukes’ stage A or B developed metastatic disease after a mean interval of 4.7 years (range 3.8–6.8). However, only 2 of these patients demonstrated BMM at the time of surgery. Nine of 15 patients with Dukes’ C carcinoma at the time of surgery subsequently developed metastases after a mean interval of 4.4 years (range 1.9–6.9). Again, only two of these patients had BMM detectable initially. In only three of the 14 patients known to have metastases at the time of operation (i.e. Dukes’‘D’ disease) were BMM found.Conclusion  The presence of BMM as detected by this methodology was not predictive of tumour recurrence or metastasis. This study does not support the consideration of adjuvant therapy based on the presence of BMM at a single pre‐operative time point in patients with colorectal cancer.
Is it possible to predict or prevent third degree tears?
Authors: Byrd L. M. , Hobbiss J. , Tasker M. 
Published: June 2005

AbstractObjectives  This paper reviews the causes anal sphincter injury during vaginal delivery. It emphasises that they are not usually the result of poor obstetric care. The role of the colorectal surgeon in their management is discussed.Methods  Medline was searched using the key words third degree tears, pregnancy, risk factors, prevention and recurrence risk. A hand search of journals and located articles was made. Two hundred and twenty three papers were identified, 84 are referenced.Results  The reported incidence of anal sphincter tears is usually between 0.5% and 2.5% of vaginal deliveries. Maternal factors such as parity and age and obstetric factors such as mode of presentation, the use of forceps and the size of the baby all influence the incidence of sphincter tears. Predicting tears in individual women is inaccurate and midwifery practices can do little to prevent them. Reducing pelvic floor morbidity by increasing the caesarean section rate would require that a large number of caesarean sections be done to prevent a small number of tears. The recognition of perineal trauma is improved by training. Accurate apposition of the sphincters with antibiotic cover and post‐operative laxatives are the important technical aspects of the repair. Colorectal follow up helps to identify those women with symptoms and allows advice about the advisability of subsequent vaginal deliveries. A previous third degree tears increases the risk of a subsequent one, although the overall risk remains low. A second vaginal delivery after a third degree tear that has resulted in a functional deficit predisposes to worsening function. When there is no residual anatomical defect and no functional loss, there is no evidence of increased risk of incontinence following another vaginal delivery.Conclusion  Vaginal delivery will continue to be the main method of delivery and will continue to generate a low incidence of pelvic floor morbidity. The management of injury to the anal sphincter is facilitated by close co‐operation between obstetricians and colorectal surgeons.
Pre‐operative mechanical bowel cleansing or not? an updated meta‐analysis
Authors: Wille‐Jørgensen P. , Guenaga K. F. , Matos D. , Castro A. A. 
Published: June 2005

AbstractObjectives  Pre‐operative mechanical bowel preparation has been considered an efficient regimen against leakage and infectious complications, after colorectal resections. This dogma is based only on observational data and experts' opinions. The aim of this study was to evaluate the efficacy and safety of prophylactic pre‐operative mechanical bowel preparation before elective colorectal surgery.Methods  EMBASE, LILACS, MEDLINE and The Cochrane Library and abstracts from major gastroenterological congresses were searched. No language restrictions were applied. The selection criterion used was randomised clinical trials (RCT) comparing any kind of mechanical bowel preparation with no preparation in patients submitted to elective colorectal surgery and where anastomotic leakage, mortality, and wound infection were outcome measurements. Data were independently extracted by the reviewers and cross‐checked. The methodological quality of each trial was assessed by the same reviewers. For meta‐analysis the Peto‐Odds ratio was used.Results  Of 1592 patients (9 RCTs), 789 were allocated to mechanical bowel preparation (Group A) and 803 to no preparation (Group B) before elective colorectal surgery. Anastomotic leakage developed in 48 (6%) of 772 patients in A compared with 25 (3.2%) of 777 patients in B; Peto OR 2.03, 95% (CI: 1.28–3.26; P = 0.003). Wound infection occurred in 59 (7.4%) of 791 patients in A and in 43 (5.4%) of 803 patients in B; Peto OR 1.46, 95% (CI: 0.97–2.18; P = 0.07);Five (1%) of 509 patients died in group in A compared with 3 (0.61%) of 516 patients in group B; Peto OR 1.72, 95% (CI: 0.43–6.95; nonsignificant).Conclusion  There is no evidence that patients benefit from mechanical bowel preparation. On the contrary taking colorectal surgery as a whole, pre‐operative bowel cleansing leads to a higher rate of anastomotic leakage. The dogma that mechanical bowel preparation is necessary before elective colorectal surgery has to be reconsidered.
Management of pilonidal sinus using fibrin glue: a new concept and preliminary experience
Authors: Seleem M. I. , Al‐Hashemy A. M. 
Published: June 2005

AbstractBackground  There is a multiplicity of treatment techniques described for pilonidal sinus. However none of the methods has emerged as being superior to the others. A ideal treatment should be simple, lead to minimal disability and a rapid return to normal activity. We present the preliminary finding an operative technique using fibrin glue in patents with pilonidal sinus.Patients and methods  The study was carried out in the surgical unit of the Armed Forces Hospital, Khamis Mushayt, Kingdom of Saudi Arabia. From September 2001 to February 2004, 25 consecutive patients with primary pilonidal sinus, were prospectively submitted to tension free excision and fibrin glue injection under local anaesthesia as day surgery cases. There were 23 males and 2 females with a mean age of 26.4 years (range 17–50 years). The data recorded included the duration of the disease symptoms, operative time, duration of hospital stay, postoperative analgesia, and return to work. All excised specimens were sent to histopathology. The postoperative disability and the social disruption were evaluated by indirect questions about the ability to drive a car and the position assumed while at home in the outpatient follow‐up.Results  The mean duration of the symptoms was 15.4 months (range 4–36 months). Mean operative time including local anaesthetic time was 19.3 min (range 15–50 min). The mean hospital stay was 7.5 h (range 6–10 h). All patients were discharged home on the day of surgery. Mean follow‐up was 10.8 months (range 4–36 months). Primary healing was achieved in 24 (96%) patients within two weeks. One (4%) patient had a breakdown of the fibrin glue and the open wound managed with daily betadine dressings.Conclusion  The management of pilonidal sinus with excision under local aaesthesia and application of a fibrin glue is simple and reduces postoperative disability and disruption of patient social life.
Colorectal adenomas with a low frequency of ki‐ras mutations: a sample from a population with a low mortality rate from colorectal cancer
Authors: Kornaros S. , Liloglou T. , Politou M. , Elemenoglou I. 
Published: June 2005

AbstractObjective  To detect and analyse ki‐ras point mutations in colorectal adenomas and carcinomas in patients from Greece, where mortality rate from colorectal cancer is lower than that in other European countries and the USA.Patients and methods  As a method we used PCR‐RFLP technique, to examine ki‐ras codons 12 and 13 mutations in 450 paraffin embedded tissues, consisting of 141 normal mucosas, 165 adenomas and 144 sporadic colorectal cancers taken from 141 patients.Results  Frequency of ki‐ras mutations was 3.2% (3/93) in small adenomas, 5.2% (3/57) in greater than 1 cm adenomas, 20% (3/15) in tissues where adenoma and cancer coexisted and 39.5% (57/144) in colorectal cancer.Conclusion  These data showed that the frequency of ki‐ras mutations was low in all sizes of polyps and high in carcinomas in a sample of a population, characterized by a low mortality rate from colorectal cancer. Ki‐ras mutations were not an early event of colon carcinogenesis in these patients and the low frequency of ki‐ras mutations in adenomas may probably have some relevance to the low mortality rate. Our findings could be explained, not by the dietary habits of this population, but by the presence of other hitherto unknown environmental factors.