bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progression of Metastases and Symptom Improvement from Laparotomy in Midgut Carcinoid Tumors
Authors: Makridis Charlie , Rastad Jonas , Öberg Kjell , Åkerström Göran 
Published: August 2002

AbstractA total of 121 consecutive patients with midgut carcinoid tumors underwent regular clinical control and 158 laparotomies for abdominal symptoms with 1 to 11 years (mean 5.2 years) of follow‐up. Metastases were present in 93% of the patients at study inclusion and developed at initially uninvolved sites with an overall probability of 0.38. Patients without initial tumor spread developed mesenteric or liver metastases with the probability of 0.25 (mean delay 12 years), whereas those with mesenteric metastases exhibited a probability 0.56 to develop liver metastases (mean delay 6.1 years). Spread to extraabdominal sites in patients with mesenteric and liver metastases exhibited a probability of 0.22 (mean delay 4.3 years), and this spread was especially frequent (probability 0.60) in patients with only liver metastases at inclusion. Patients without the carcinoid syndrome (52%) mainly suffered from more or less episodic abdominal pain, nausea, and diarrhea. Marked mesenteric fibrosis detected at surgery (n= 59) generally was accompanied by symptoms of abdominal pain and weight loss, and it often required urgent intervention due to intestinal obstruction or ischemia. Complete or partial symptom alleviation was accomplished in 82% of the operated patients, and generally was most auspicious after primary acute or subacute procedures (n= 54). The complete or partial symptom improvements after surgery lasted for mean 5.3 years and tended to be longer after elective (n= 50) than acute operations. The findings substantiate encouraging results of laparotomy in a compromised cohort of patients with midgut carcinoid tumors. Because the patients also displayed a generally slow progression of metastases, liberal indications for laparotomy should prevail in symptomatic and possibly also asymptomatic individuals with midgut carcinoid tumors.
Teaching Effectiveness of the Advanced Trauma Life Support Program as Demonstrated by an Objective Structured Clinical Examination for Practicing Physicians
Authors: Ali Jameel , Cohen Robert , Adam Rasheed , Gana Theophilus J. , Pierre Ian , Bedaysie Henry , Ali Ernest , West Undine , Winn Jennifer 
Published: August 2002

AbstractAlthough the Advanced Trauma Life Support (ATLS) course is now taught internationally, its teaching effectiveness still requires confirmation. The Objective Structured Clinical Examination (OSCE) reliably assesses clinical performance by utilizing standardized patients. An OSCE of eight 15 minute trauma patient stations and two 40 item MCQ tests were used to test the teaching effectiveness of the ATLS program in 32 practicing physicians who applied for an ATLS program in Trinidad and Tobago. The physicians were randomly assigned to an ATLS group (n= 16) that completed the ATLS course and a non‐ATLS group (n= 16). Before and after the ATLS course, all physicians completed MCQ tests and trauma OSCE. Mean (± SD) OSCE scores (standardized to 20) ranged from 9.8 ± 1.7 to 10.0 ± 1.7 and 9.5 ± 1.8 to 10.8 ± 1.3 in the ATLS and non‐ATLS groups, respectively, prior to the ATLS course (NS). Post‐ATLS OSCE scores ranged from 15.9 ± 1.7 to 17.6 ± 1.7 in the ATLS group (p< 0.05 compared to pre‐ATLS) and 9.5 ± 1.4 to 10.1 ± 1.3 in the non‐ATLS group, which did not improve their OSCE scores. Adherence to priorities was graded 1 to 7 with the pre‐ATLS grades of 1.7 ± 0.6 (ATLS) and 1.8 ± 0.7 (non‐ATLS) and post‐ATLS grades of 6.4 ± 1.1 (ATLS) and 2.1 ± 0.6 (non‐ATLS). Organized approach to trauma was graded 1 to 5 with pre‐ATLS grades of 1.6 ± 0.5 (ATLS) and 1.7 ± 0.6 (non‐ATLS) and post‐ATLS grades of 4.5 ± 0.6 (ATLS) and 1.9 ± 0.6 (non‐ATLS). Pre‐ATLS MCQ scores (%) were similar: 53.1 ± 8.4 (ATLS) and 57.3 ± 5.4 (non‐ATLS), but post‐ATLS scores were greater in the ATLS group: 85.8 ± 7.1 (ATLS) and 64.2 ± 3.6 (non‐ATLS). Our data support the teaching effectiveness of the ATLS program among practicing physicians as measured by improvement in OSCE scores, adherence to trauma priorities, maintenance of an organized approach to trauma care, and cognitive performance in MCQ examinations.
Cost of open versus laparoscopically assisted right hemicolectomy for cancer
Authors: Philipson Bertil M. , Bokey E. Leslie , Moore James W. E. , Chapuis Pierre H. , Bagge Eva 
Published: August 2002

AbstractThe aim of this study was to estimate and compare the costs of open right hemicolectomy (ORHC) versus laparoscopically assisted right hemicolectomy (LARHC) performed for cancer. A retrospective cost analysis of 61 consecutive patients operated on between January 1992 and August 1994 for right‐sided colonic cancer by either LARHC (n = 28) or ORHC (n = 33) was performed. The analysis focused on the cost (in Australian dollars) incurred from the date of operation to the date of discharge. LARHC was significantly more expensive than ORHC (total cost LARHC $9064, ORHC $7881; p < 0.001). LARHC was associated with a significantly longer operating room utilization time (LARHC 261 minutes, ORHC 203 minutes; p < 0.001) and a greater cost of disposables (LARHC $854, ORHC $189; p < 0.001). This study demonstrates no cost benefit for LARHC compared to ORHC when performed for cancer.
Serum Interleukin‐6, Interleukin‐8, Hepatocyte Growth Factor, and Nitric Oxide Changes during Thoracic Surgery
Authors: Yamada Takatsugu , Hisanaga Michiyoshi , Nakajima Yoshiyuki , Kanehiro Hiromichi , Watanabe Akihiko , Ohyama Takao , Nishio Kazushi , Sho Masayuki , Nagao Mitsuo , Harada Akihisa , Matsushima Kouji , Nakano Hiroshige 
Published: August 2002

AbstractThoracic surgery creates a different environment from abdominal surgery in respect to the surgical procedure with pulmonary collapse under unilateral ventilation. Definitive evidence whether surgical trauma during thoracotomy is involved in postoperative pulmonary infections has not been clearly demonstrated. The objectives of this study were to evaluate the influence of surgical trauma during thoracotomy on postoperative infections and to investigate the clinical significance of postoperative humoral mediators in pulmonary infections after surgery. We measured serum interleukin‐6 (IL‐6), IL‐8, hepatocyte growth factor (HGF), and nitric oxide (NO) levels in 27 patients undergoing thoracic surgery; the measurements were before and during thoracotomy, 60 minutes after reinflation, and after surgery. The patients were divided into three groups: lobectomy patients (group A), and esophagectomy patients without (group B) or with (group C) postoperative infections. The serum IL‐6 and IL‐8 levels in group C were markedly elevated 60 minutes after reinflation and were significantly higher than those in group A. The serum IL‐8 levels during that period in group C were significantly higher than those in group B. The postoperative serum IL‐6, IL‐8, HGF, and NO levels were significantly higher in group C than in group B. Taken together, intraoperative hypercytokinemia, especially IL‐8, following the thoracic procedure and subsequent reinflation preceded the clinical onset of postoperative infections. Hence postoperative serum IL‐6, IL‐8, and HGF levels may be useful predictors of infection after esophagectomy.
Obstructive Sleep Apnea in the Obese
Authors: Kyzer Shlomo , Charuzi Ilan 
Published: August 2002

AbstractObstructive sleep apnea (OSA) syndrome occurs in 4% to 9% of middle‐aged men and in 1% to 2% of middle‐aged women. The incidence of OSA among morbidly obese patients is 12‐ to 30‐fold higher. The pathophysiology of OSA is complex and incompletely understood. The important clinical symptoms of OSA include snoring, daytime sleepiness, restless sleep, morning fatigue, and headaches. The diagnosis is made by polysomnography. The possible sequelae of OSA are hypertension, left and right ventricular hypertrophy, sudden cardiovascular death, and increased risk for brain infarction. Nasal continuous positive airway pressure (nCPAP) appears to be the recommended treatment for OSA. Morbidly obese patients may also benefit from weight reduction gastric surgery.
Carcinomatous Infiltration into the Submucosa as a Predictor of Lymph Node Involvement in Early Gastric Cancer
Authors: Ishigami Sumiya , Hokita Shuichi , Natsugoe Shoji , Tokushige Masahiro , Saihara Tetsushi , Iwashige Hirohumi , Aridome Kuniaki , Aikou Takashi 
Published: August 2002

AbstractThe clinicopathologic features of 114 patients with resectable early gastric cancer (EGC) invading the submucosa were examined retrospectively with respect to lymph node involvement and the possibility of performing a minimally invasive operation. Patients were divided into node‐positive (n= 25) and node‐negative (n= 81) groups. Among several pathologic factors, the diameter of the tumor and lymphatic involvement were significantly correlated with nodal involvement. Within the submucosal layer the depth of invasion and the horizontal cancerous expansion also correlated with lymph node disease (p< 0.05). The size of the tumor did not correlate with the length of submucosal infiltration (r= 0.12, p= 0.1). Patients with both slight invasion into the submucosa and less than 5 mm of horizontal expansion were often negative for lymph node involvement and thus may benefit from local surgery as an alternative to gastrectomy.
Pathophysiology of Bile Duct Stones
Authors: Thistle Johnson L. 
Published: August 2002

AbstractSecondary duct stones are usually detected and easily removed at the time of cholecystectomy either during surgery or endoscopically before or after the operation. Primary duct stone diseases, although much less common, are often a greater therapeutic challenge. These stones may be huge, distributed throughout the biliary tree (including areas difficult to access), and unresponsive to pharmacologic measures. Recurrence of primary duct stones is the rule rather than the exception, and reliable methods for prevention remain to be established. Moreover, morbidity and mortality due to biliary obstruction, sepsis, and choliangiocarcinoma make primary bile duct stone disease a formidable adversary. A better understanding of their pathogenesis can facilitate more effective approaches to treatment and, most important, prevention.
Significance of Plasma Thymosin α1 Measurements in Gastric Cancer Patients
Authors: Mitani Masami , Kuwabara Yoshiyuki , Kawamura Hiroyuki , Sato Atsushi , Hattori Kouji , Fujii Yoshitaka 
Published: August 2002

Abstract.Thymosin α1 is a cleavage product of prothymosin α. Expression of prothymosin α increases during cell proliferation. Thymosin α1, measurable in plasma, may be an indicator of cell proliferation especially if a cancer is present. In this report we investigated the relation between the clinical behavior of gastric cancer and the plasma thymosin α1 level. Plasma thymosin α1 was measured in 52 gastric cancer patients using a newly developed radioimmunoassay. Twenty‐one tumors and lymph nodes were examined for thymosin α1 using immunohistochemistry. The plasma thymosin α1 level was higher in gastric cancer patients than in normal volunteers; and it was higher in patients with lymph node involvement than in those with negative nodes. Immunohistochemical study of thymosin α1 showed positivity in 52% of gastric cancers and 100% of lymph node metastasis. We concluded that a high level of plasma thymosin α1 suggests aggressive behavior of a gastric cancer, such as lymph node involvement.
Disordered Metabolic Response with Cancer and Its Management
Authors: Barber Matthew D. , Ross James A. , Fearon Kenneth C.H. 
Published: August 2002

Abstract.The metabolic changes in cancer cachexia appear to be mediated by a complex network of proinflammatory cytokines, neuroendocrine hormones, neurotransmitters, eicosanoids, and tumor‐derived factors produced by the body in response to the tumor and by the tumor itself. The relative importance of these various mediator pathways in relation to either the anorexia or hypermetabolism associated with weight loss in cancer remains to be fully elucidated. Our current understanding suggests that proinflammatory mediators may indeed be a valid target for therapeutic intervention. Trials attempting to modify the inflammatory response to cancer with the hope of improving appetite and reversing catabolism and perhaps thereby improving quality of life and survival are currently underway.
Extinction of populations by inbreeding depression under stochastic environments
Authors: Tanaka Y. 
Published: August 2002

AbstractInbreeding depression may induce rapid extinction due to positive feedbacks between inbreeding depression and reduction of population size, which is often referred to as extinction vortex by inbreeding depression. The present analysis has demonstrated that the extinction vortex is likely to happen with realistic parameter values of genomic mutation rate of lethals or semilethals, equilibrium population size, intrinsic rate of natural increase, and rate of population decline caused by nongenetic extrinsic factors. Simulation models incorporating stochastic fluctuations of population size further indicated that extinction by inbreeding depression is facilitated by environmental fluctuations in population size. The results suggest that there is a positive interaction between genetic stochasticity and environmental stochasticity for extinction of populations by inbreeding depression.
A management policy for sika deer based on sex‐specific hunting
Authors: Matsuda H. , Kaji Koichi , Uno Hiroyuki , Hirakawa Hirofumi , Saitoh T. 
Published: August 2002

AbstractWe consider here a management policy for a sika deer (Cervus nippon) population in the eastern part of Hokkaido. Deer populations are characterized by a large intrinsic rate of population increase, no significant density effects on population growth before population crash, and a relatively simple life history. Our goals of management for the deer population are (1) to avoid irruption with severe damage to agriculture and forestry, (2) to avoid the risk of extinction of the deer population, and (3) to maintain a sustainable yield of deer. To make a robust program on the basis of uncertain information about the deer population, we consider three levels of relative population size and four levels of hunting pressures. We also take into consideration a critical level for extinction, an optimal level, and an irruption level. The hunting pressure for females is set to increase with the population size. We also recommend catching males if the population size is between the critical and optimal levels and catching females and males if the population size is larger than the optimal level. We must avoid cases of irruption or threatened population under various sets of uncertain parameter values. The simulation results suggest that management based on sex‐specific hunting is effective to diminish the annual variation in hunting yield.
Transformation using (x + 0.5) to stabilize the variance of populations
Authors: Yamamura Kohji 
Published: August 2002

AbstractTransformation is required to achieve homo‐scedasticity when we perform ANOVA to test the effect of factors on population abundance. The effectiveness of transformations decreases when the data contain zeros. Especially, the logarithmic transformation or the Box–Cox transformation is not applicable in such a case. For the logarithmic transformation, 1 is traditionally added to avoid such problems. However, there is no concrete foundation as to why 1 is added rather than other constants, such as 0.5 or 2, although the result of ANOVA is much influenced by the added constant. In this paper, I suggest that 0.5 is preferable to 1 as an added constant, because a discrete distribution defined in {0, 1, 2, …} is approximately described by a corresponding continuous distribution defined in (0, ≧) if we add 0.5. Numerical investigation confirms this prediction.
Ultrasonography for the Diagnosis of Diseases of the Tendon and Tendon Sheath of the Biceps Brachii Muscle
Authors: Kramer Martin , Gerwing Martin , Sheppard Claudia , Schimke Ernst 
Published: August 2002

Objective—To describe the ultrasonographic appearance of the normal and diseased biceps brachii tendon and its tendon sheath in dogs.Study Design—A prospective clinical studyAnimals—One hundred twenty client‐owned dogsMethods—In the first part of the study, the ultrasonographic appearance of the normal biceps brachii muscle and the surrounding soft tissue was determined in 27 healthy dogs. Standard views were described and established. In the second part, 120 dogs with suspected pathology of the biceps brachii muscle were examined ultrasonographically. Fifty‐five of these dogs had no sonographic changes, and 65 dogs had sonographically detectable pathologic changes of the tendon or the tendon sheath or both. The mean age of the affected dogs was 3.7 years. The ratio of males to females was 1.95:1. Sedation or anesthesia of the dogs was required because of the extreme movements of the leg necessary for the examination. To achieve a perpendicular view of the tendon and the tendon sheath, the area of the shoulder joint was rotated outward and abducted as far as possible. Examination of the muscle‐tendon apparatus of the biceps brachii muscle was divided into 4 main sections.Results—Linear transducers (7.5–10 MHz) allowed the soft tissue structures to be easily visualized with ultrasonography. Pathologic changes of the tendon and tendon sheath were visualized sonographically by using high‐frequency linear probes. Partial or complete tendon rupture, medial luxation of the tendon, corpora libera in the tendon sheath, and tenosynovitis were clearly shown.Conclusions—High‐frequency ultrasonography using linear transducers allows the examiner to accurately define the pathologic changes in the region of the biceps brachii tendon in dogs.Clinical Relevance—The use of sonography for diagnosis of disease processes of the tendon and tendon sheath of the biceps brachii muscle complements clinical and radiographic examination findings.
Comparison of Two Methods for Presurgical Disinfection of the Equine Hoof
Authors: Hennig Gayle E. , Kraus Bonnie Hay , Fister Richard , King Vickie L. , Steckel Robert R. , Kirker‐head Carl A. 
Published: August 2002

Objectives—To determine for equine hooves the normal resident aerobic bacterial population and the efficacy of 2 methods of disinfection.Study Design—Measurement of total bacterial, gram‐positive bacterial, and gram‐negative bacterial surface populations from the frog, sole, and hoof wall after each step of 2 different preoperative surgical disinfection techniques.Animals—Six adult horses.Methods—Hoof wall, sole, and frog samples were collected for quantitative bacteriology before, during, and after 2 multistep antiseptic preparation techniques: Method A—6‐minute scrub with povidone‐iodine soap, followed by 24‐hour submersion in povidone‐iodine solution‐soaked cotton; and Method B—initial removal of superficial layer of hoof capsule before completing Method A disinfection procedures.Results—Removal of the superficial hoof layer, application of the povidone iodine scrub, and completion of the povidone‐iodine soak all significantly (P< .0008) decreased total bacterial numbers. Method B had significantly lower bacterial counts than method A at each consecutive step. Final total bacterial counts remained greater than 105bacteria per gram of tissue regardless of preparation method.Conclusions—The hoof surface hosts a broad spectrum of aerobic gram‐positive and ‐negative bacteria, many of which are potential pathogens. Bacterial numbers can be significantly reduced by removal of the superficial hoof surface, by application of a povidone‐iodine scrub, and by use of a 24‐hour povidone‐iodine soak. However, bacterial populations >105g per tissue persist after these disinfection procedures.Clinical Relevance—Regardless of the preparation methods used in this study, bacterial populations capable of inducing wound infection remain on the hoof capsule.
Experimental Evaluation of Urinary Bladder Marsupialization in Male Goats
Authors: May Kimberly A. , Moll H. David , Duncan Robert B. , Moon Martha M. , Pleasant R. Scott , Howard Rick D. 
Published: August 2002

Objective— To evaluate the outcome of urinary bladder marsupialization in male goats.Study design— Prospective, experimental study.Animals— Six healthy mixed‐breed male goats.Methods— After experimentally induced urethral obstruction, 6 male goats had urinary bladder marsupialization. Renal ultrasonography, complete blood count, and serum biochemical analysis were evaluated preoperatively (day 0), at 7 postoperative days, and then at 30‐day intervals until 180 days. Stomal diameter was recorded immediately postoperatively and at each postoperative interval. Necropsy examination was performed on day 180 or when stomal stricture or death occurred.Results— Stomal stricture occurred in 1 goat at 120 days. Another goat was found dead at 150 days; severe, suppurative cystitis was identified on necropsy. All goats had mild urine scald dermatitis. Serum biochemical values remained within normal limits, but significant decreases in white blood cell count, serum creatinine concentration, and stomal diameter occurred. At necropsy, all bladders were tubular in shape. Histological evidence of chronic suppurative cystitis and chronic, mild lymphoplasmacytic pyelitis occurred in all goats. Bacterial culture of renal tissue yielded growth in 3 goats, and bladder mucosal swabs yielded bacterial growth in all goats.Conclusions— Although clinical signs of ascending urinary tract infection were not observed in goats with patent stomata, urinary bladder marsupialization may result in ascending urinary tract inflammation or infection.Clinical relevance— Based on our results, urinary bladder marsupialization should be recommended with caution as the primary method for management of urinary tract obstruction in clinical cases.
Intraventricular Tension Pneumocephalus as a Complication of Transfrontal Craniectomy: A Case Report
Authors: Garosi Laurent S. , Penderis Jacques , Brearley Malcom J. , Brearley Jacky C. , Dennis Ruth , Kirkpatrick P. J. 
Published: August 2002

Objective— To report the diagnosis and surgical treatment of a case of intraventricular tension pneumocephalus in a dog after a transfrontal craniectomy for removal of a falx cerebri meningioma.Study design— Case report.Animal— A 12‐year‐old spayed English springer spaniel.Results— Intraventricular air and a fistula between the craniectomy site and ventricular system were identified by magnetic resonance imaging. Prompt repair of the dural defect using prosthetic dura mater resulted in immediate regression of the neurological signs and cerebral spinal fluid rhinorrhea. Magnetic resonance imaging repeated 8 weeks after surgery showed complete resolution of pneumocephalus.Conclusions and clinical relevance— Tension pneumocephalus is an uncommon but life‐threatening complication of craniectomy that requires urgent diagnosis and treatment.