bluuebunny/crossref_metadata_2025_split huggingface dataset:
Study on minute surface structures of the depressed‐type early gastric cancer with magnifying endoscopy
Authors: Tobita Kouji 
Published: March 2003

Background: Gastric surface patterns and morphology of minute surface vessels in depressed lesions were analyzed using a magnifying endoscope with high resolving power to contribute to qualitative diagnosis of gastric cancer.Methods: Subjects were diagnosed with depressed‐type early gastric cancer (pT1), there were 63 lesions, 38 differentiated‐type lesions, and 25 undifferentiated‐type lesions. There were also 40 benign depressed lesions found. After routine observations with an endoscope, amplifying observations of lesions were made by EG‐410CR (Fuji Photo Optical; Saitama, Japan) (CR). The images were compared with macroscopic patterns and histopathological patterns of the surgical specimens and endoscopic mucosal resection specimens.Results: Surface patterns of gastric depressed lesions were classified as irregular protrusion, normal papilla, pseudopapilla and amorphia. Irregular protrusion was found only in cancerous lesions. Characteristic minute vessels were observed in amorphia. Their patterns were classified into the following six types: sand, fence, round net, flat net, branch and coil. Irregular protrusion and minute vessels in amorphia (round net, flat net, branch and coil) were specific to cancers. There was a tendency for round net and flat net patterns to be found often in differentiated cancers and for branch and coil patterns to be found often in undifferentiated cancers.Conclusion: This magnifying endoscopic classification is considered useful for the qualitative diagnosis of depressed‐type early gastric cancer.
JGES consensus meeting report in DDW‐Japan 2000, Kobe: interpretation of the layered structure of gastrointestinal wall with endoscopic ultrasonography
Authors: YAMANAKA TAKEO 
Published: March 2003

Background: The layered structure of the hollow organ visualized during endoscopic ultrasonography (EUS) has been interpreted in various ways and any consensus of opinion about how to interpret a layered structure is not yet established. This has caused confusion among physicians during discussions at academic forums or meetings. Therefore, it is necessary to establish a standard of interpretation as a basis for research and for such discussions.Purpose: To clarify a relationship between the layered structure in EUS and the histologic structure of the gastrointestinal wall.Method: To hold a meeting with participation from members eligible to pursue the purpose described.
Dietary preferences in Japanese centenarians favoring dairy foods
Authors: Shimizu Kenichiro , Noji Hiroyasu , Takeda Sumie , Hirose Nobuyoshi , Gondo Yasuyuki , Konishi Kanoko 
Published: March 2003

Background:  Relatively few studies have considered the dietary preferences of the oldest elderly individuals. As persons aged over 100 years have survived for a particularly long period of time, the dietary habits of centenarians might be significant factors influencing late‐life health.Methods:  We compared the dietary practices of 94 centenarians living in Tokyo metropolitan with those of 30 other healthy elderly people (older controls) and 98 healthy middle‐aged subjects (younger controls). Dietary intake was recorded for 3 successive days and was classified in terms of 18 food groups: cereals, potatoes, sugars, sweets, fats, nuts, legumes, fishes, meats, eggs, dairy products, vegetables, fruits, mushrooms, algae, beverages, seasonings, and processed foods. Dietary patterns were classified by a k‐means cluster analysis based on the proportional intake of each food group. Each pattern identified was evaluated nutritionally.Results:  While the daily intake of protein, fat, carbohydrate, and total calories was highest in younger controls and lowest in centenarians, no significant differences were evident when intake was evaluated relative to body weight. Four clusters of subjects preferred beverages, vegetables, dairy products, and cereals, respectively. Preference for beverages was most frequent in younger controls while preference for vegetables was relatively frequent in older controls. A pattern preferring dairy products was particularly characteristic of centenarians. Dairy products were advantageous for calcium intake while a preference for vegetables was of great advantage – assisting in the intake of vitamins and iron.Conclusions:  Japanese centenarians showed a preference for dairy products which, therefore, means that their calcium intake is high.
Initial experience of vocal cord evaluation using grey‐scale, real‐time, B‐mode ultrasound
Authors: Sidhu Stan , Stanton Raymond , Shahidi Sharam , Chu John , Chew Simon , Campbell Peter 
Published: March 2003

Background:   To evaluate whether grey‐scale, real‐time, B‐mode ultrasound (US) is a reliable alternative to nasopharyngoscopy for assessing vocal cord function post‐thyroid and post‐parathyroid surgery.Methods:   A prospective validation study was undertaken comparing grey‐scale, real‐time, B‐mode vocal cord US with the standard of nasopharyngoscopy in 100 consecutive patients undergoing thyroid and parathyroid surgery between 1 February 1999 and 31 August 1999, with seven patients with known cord palsy. The sensitivity and specificity of grey‐scale, real‐time vocal cord US for the detection of vocal cord palsy when compared to the standard of nasopharyngoscopy was analysed.Results:   In the postsurgical group, there were six nerves (3.2% of the nerves at risk) transient and no permanent vocal cord palsies. US identified four of six transient palsies and reported two false negatives and three false positives. US identified four of seven cord palsies in the non‐surgical group with known cord palsy. Analysis of the 107 combined patients showed US had sensitivity of 62% (8/13), specificity of 97% (91/94), a positive predictive value of 73% (8/11) and a negative predictive value of 95% (91/96) for detecting cord paralysis compared to the standard of nasopharyngoscopy.Conclusion:   Despite the enthusiasm of earlier reports, our initial experience with grey‐scale, real‐time, B‐mode US suggests it is not a reliable alternative to nasopharyngoscopy for assessing vocal cord function post‐thyroid and post‐parathyroid surgery. Further recruitment of patients with known vocal cord palsy is required to confirm or refute these initial impressions.
Conservative approach is feasible in the management of acute diverticulitis of the right colon
Authors: Chiu Philip W. Y. , Lam Clement Y. W. , Chow Tam‐Lin , Kwok Samuel P. Y. 
Published: March 2003

Background:  Acute diverticulitis of the caecum and ascending colon is uncommon. Controversies abound as regards the optimal surgical treatment, ranging from appendectomy, diverticulectomy to right hemicolectomy. The aim of the present paper was to review treatment strategy followed by a critical appraisal.Methods:  The case notes of 30 patients with acute diverticulitis of the right colon who were treated at the United Christian Hos­pital, Hong Kong from 1992 to 1998 were systematically reviewed. The data were subjected to statistical analysis.Results:  The median age was 34 years, with a male:female ratio of 1:1.15. All patients presented with acute right lower abdominal pain and localized rebound tenderness. All were diagnosed preoperatively as having appendicitis. The mean duration of symptoms was 2 days (range: 1–6 days). Two treatment groups were identified. Group A (n = 16; 53%) received appendicectomy alone, while group B (n = 14; 47%) underwent diverticulectomy in addition to appendicectomy, including one patient with perforated diverticulitis. Overall, there was no procedure‐related morbidity or mortality. Both groups received a similar duration of broad‐spectrum anti­biotics. All the patients were interviewed by phone after operation to detect any recurrence of symptoms, with a median follow‐up interval of 34 months (range: 11–78 months). There was no recurrence of symptoms in group A, which received appendicectomy and antibiotics. The only difference was operative time.Conclusion:  For non‐perforated diverticulitis of the right colon, appendicectomy and intravenous antibiotics without diverticulectomy is the preferred treatment strategy.
Total colectomy and J‐pouch ileorectal anastomosis for obstructed tumours of the rectosigmoid junction
Authors: Chrysos Emmanuel , Athanasakis Elias , Vassilakis John Sophocles , Zoras Odysseas , Xynos Evaghelos 
Published: March 2003

Background: Subtotal colectomy with ileosigmoid or ileorectal anastomosis is one of the standard procedures for obstructed tumours of the left colon. The lower the level of the anastomosis, the greater the number of bowel motions per day. The aim of the present study was to assess whether an ileal pouch–rectal anastomosis is associated with fewer bowel motions per day. Methods: In four patients with obstructed carcinoma of the rectosigmoid junction and upper rectum, a total colectomy with removal of the upper rectum for adequate tumour clearance was used, followed by construction of a 10 cm ileal J‐pouch that was subsequently anastomosed to the distal rectal stump. Results: Postoperative recovery was uneventful in all patients. At 3 months postoperatively, anorectal manometry showed anal resting and squeeze pressures at lower normal limits and a neorectal capacity ranging from 160 to 310 mL. One year postoperatively, all patients experienced one to three normal bowel motions daily and no episodes of incontinence. Conclusions: Total colectomy with ileal J‐pouch–rectal anastomosis is a reasonable operative alternative in cases with obstructed tumours of the rectosigmoid junction, which necessitate removal of the upper rectum.
Influence of preoperative medical status and delay to surgery on death following a hip fracture
Authors: Stoddart Julian , Horne Geoffrey , Devane Peter 
Published: March 2003

Background:  A retrospective study of 138 patients with fractured hips was undertaken to determine if a delay to surgery beyond 24 h influenced 1‐year mortality. In particular, the results of the subgroup of patients who were in the American Society of Anes­thesiologists (ASA) Class 3 or 4 were considered.Methods:  Patients were found using ICD‐9 database information. One‐year mortality data was collected from Births, Deaths and Marriages − the New Zealand government agency that collects and stores statistics on these events.Results:  The 1‐year mortality rate was 17.4%. Age, operation type and time to surgery did not significantly affect 1‐year mortality. American Society of Anesthesiologists’ Class 1 and 2 patients had a significantly lower 1‐year mortality (5.3%) than ASA Class 3 and 4 patients (22.4%) (P = 0.02).Conclusion:  Time to surgery did not significantly affect 1‐year mortality within each ASA Class.
Effect of cervical hard collar on intracranial pressure after head injury
Authors: Mobbs Ralph J. , Stoodley Marcus A. , Fuller John 
Published: March 2003

Background:  Patients suffering head trauma are at high risk of having a concomitant cervical spine injury. A rigid cervical collar is usually applied to each patient until spinal stability is confirmed. Hard collars potentially cause venous outflow obstruction and are a nociceptive stimulus, which might elevate intracranial pressure (ICP). This study tested the hypothesis that application of a hard collar is associated with an increase in ICP.Methods:  A prospective series of 10 head‐injured patients with a postresuscitation Glasgow coma scale score of nine or less had ICP measurements before and after cervical hard collar application.Results:  Nine out of 10 patients had a rise in ICP following application of the collar. The difference in pre‐ and postapplication ICP was statistically significant (P < 0.05).Conclusions:  Early assessment of the cervical spine in head‐injured patients is recommended to minimize the risk of intracranial hypertension related to prolonged cervical spine immobilization with a hard collar.
Clinicopathological features of patients with Borrmann type IV gastric carcinoma
Authors: Kim Dong Yi , Kim Hyeong Rok , Kim Young Jin , Kim Shin Kon 
Published: March 2003

Background:  To determine whether there is a specific pattern of clinicopathological features that could be used to distinguish ­Borrmanntype IV gastric carcinoma from other types of gastric carcinoma.Methods:  We retrospectively analysed the clinicopathological features of patients with Borrmann type IV carcinoma of the stomach.The results were compared with the features of patients who had other types of gastric carcinoma.Results:  The incidence of Borrmann type IV gastric carcinomawas 11.0% (199 patients). A poorly differentiated tumour was found in 120 out of 199 patients (60.3%) with Borrmanntype IV gastric carcinoma. The positive lymph node metastasis was found in 150 out of 199 patients (75.4%) with Borrmanntype IV gastric carcinoma (P < 0.0001).The incidence of serosal invasion (91.5%) and peritoneal dissemination (37.7%) was significantly higher in these patients. Of the patients with Borrmann type IV gastric carcinoma,161 patients (80.9%) were classified as either stage IIIor IV at initial diagnosis. The curative resection rate of patientswith Borrmann type IV gastric carcinoma was lower than that of patients with other types of gastric carcinoma (P < 0.001).The survival rate was higher in patients with a curative resection(P < 0.001). The 5‐year survival rate of patients with Borrmann type IV tumour was lower than that of patients with other types of gastric carcinoma (P < 0.001).The 5‐year survival rates were 90.9% for stage I patients with Borrmann type IV gastric carcinoma and 39.5%, 18.6% and8.7% for stages II, III and IV, respectively (P < 0.001).Conclusion:  Improving the prognosis for patients with Borrmanntype IV gastric carcinoma requires early detection and a curative resection.
Primary megaureter: Results of surgical treatment
Authors: Aksnes Gunnar , Imaji Reisuke , Dewan Paddy A. 
Published: March 2003

Background:  The aim of this study was to assess the clinical and radiological outcome after surgical treatment for primary ­megaureter.Methods:  A retrospective analysis of 16 patients who had reimplantation of 17 primary megaureters between January 1997 and April 2001 was performed. Patients who had additional urinary tract pathology were not included in this study. The intent of the study was to focus on the complex range of data points that were used to reach the decision to operate.Results:  Six of eight patients with febrile urinary tract infections prior to surgery have been without infections postoperatively. One patient who presented with daytime wetting has less wetting postoperatively, and one baby who presented with failure to thrive and postfeed vomiting, is feeding well postoperatively. On ultrasound investigation, the median diameter of the megaureter prior to operation was 11 mm (range 6−24 mm). One month after the operation, dilatation of the ureter could no longer be demonstrated in 10, was reduced in six, and increased in one of 17 ureters. Three months postoperatively, hydroureter was no longer detected in 14 and was reduced in three. In comparison, the hydronephrosis 1 month postoperatively was reduced in six, unchanged in seven and worse in four out of 17 kidneys, and 3 months after the operation, hydronephrosis was reduced in 13 and was unchanged in four compared with preoperative findings. Renograms at 3 months postoperatively showed free drainage in the 11 kidneys with impaired drainage preoperatively, and drainage continued to be normal in all six kidneys with normal drainage preoperatively. Median pre­operative renographic split function was 47% (range 39−54%), and was not significantly changed 3 months after the operation.Conclusions:  When the decision to surgically intervene was made on a multifactorial basis, reimplantation of a primary mega­ureter resulted in improved clinical status, reduced dilation of the ureter and renal pelvis, and free drainage of the upper urinary tract.
Hand‐assisted laparoscopic adrenalectomy: An alternative minimal invasive surgical technique for the adrenal gland
Authors: Bennett Ian C. , Ray Mark 
Published: March 2003

Background:  Presently the surgical approach to the adrenal gland is in a state of flux. While the traditional approach to the adrenal gland has been the open transabdominal technique, more recently laparoscopic approaches, particularly via the transabdominal route, have increasingly been utilized. However, laparoscopic intervention for the adrenal gland can be problematic in certain circumstances, particularly for large adrenal masses and in instances of adrenal malignancies.Methods:  In this report we describe the use of hand‐assisted laparoscopic adrenalectomy as an alternative minimal invasive surgical approach to the adrenal gland. Hand‐assisted laparoscopic adrenalectomy using the HandPort system (Smith & Nephew, Sydney, Australia) was undertaken in three patients requiring adrenalectomy for mass lesions including one patient with Conn's syndrome.Results:  In all three cases, surgery proceeded promptly and uneventfully. In the present paper, the details of the technique of hand‐assisted adrenalectomy are described. This is the first report in the world literature of this new technique for the adrenal gland.Conclusions:  Hand‐assisted laparoscopic adrenalectomy is an easily performed technique, which can be completed within a short operative time span and which has the advantage of providing intraoperative tactile localization for the adrenal gland. It may be particularly applicable for large adrenal tumours, yet only involves the performance of a small abdominal incision. Postoperative recovery is comparable with that reported for the laparoscopic‐only technique. Hand‐assisted adrenalectomy is a new technique which has great potential and which warrants further evaluation.
Colonoscopic surveillance after surgery for colorectal cancer
Authors: Yusoff Ian F. , Hoffman Neville E. , Ee Hooi C. 
Published: March 2003

Background:  Intensive colonoscopic surveillance after resection of colorectal cancer (CRC) has been shown not to improve outcome. The National Health and Medical Research Council of Australia (NHMRC) has recently published guidelines recommending appropriate surveillance intervals after CRC resection. The aims of the present study were to assess current and past patterns of postoperative CRC surveillance and to determine the yield of neoplasia from such surveillance.Methods:  An audit was performed of all patients who underwent colonoscopy following surgical resection of CRC from 1989 to 2001. Two groups were assessed: (i) all patients undergoing surveillance colonoscopies; and (ii) all patients diagnosed with CRC at Sir Charles Gairdner Hospital (SCGH) who subsequently had postoperative colonoscopies. Patients who had their index colonoscopy at the study centre and who subsequently underwent surveillance colonoscopies were studied in detail. Yield for neoplasia, patterns of surveillance and concordance with NHMRC recommendations were determined.Results:  There were 990 surveillance examinations performed and colorectal adenomas were identified in 184. However, only one case of recurrent cancer was detected. There were a total of 161 patients who had CRC diagnosed and underwent surveillance at SCGH. Of these patients, 75% underwent colonoscopy at 12 months after resection and 48% of these cases underwent a further examination within 12 months. Only 23% of examinations concurred with NHMRC recommendations and practice has not changed with release of these guidelines.Conclusions:  Resectable CRC recurrences are rarely detected at colonoscopic surveillance. Surveillance colonoscopies are ­performed too frequently and release of NHMRC guidelines has failed to change practice.
Surgical rotations in provincial South Australia: The traineess’ perspective
Authors: Bruening Martin H. , Anthony Adrian A. , Maddern Guy J. 
Published: March 2003

Background:  Rural general surgery is faced with a shortage of resident surgeons in many parts of Australia. Although it is accepted that an undergraduate rural exposure favourably influences graduates to undertake rural practice, it is not known whether postgraduate terms exert a similar effect.Method:  Advanced general surgical trainees in 2000 were rotated for 1‐month terms to Whyalla, a major provincial centre in South Australia. The trainees were asked to complete a questionnaire before and after the rotation.Results:  A total of nine trainees completed a rural term in Whyalla. Eight questionnaires were returned prior to the rotation and seven following the time in Whyalla. The overall experience, and the teaching standards and pathology experienced were rated highly but the term had little effect in changing trainee’s attitudes towards eventual practice location.Conclusion:  Postgraduate surgical terms in South Australia are a relatively new phenomenon compared to other states in Australia. Without a foundation in rural surgery at an undergraduate level, surgical terms for trainees, despite being of high quality, might not be very successful in influencing graduates to practise surgery in rural locations.
DEVELOPMENT OF FATIGUE CRACKING IN AIRCRAFT ENGINE COMPRESSOR DISKS OF TITANIUM ALLOY Ti–6Al–3Mo–2Cr
Authors: Shaniavski AA , Losey AI , Banov MD 
Published: March 2003

Fractographic features related to fatigue growth in a titanium alloy Ti–6Al–3Mo–2Cr were examined in compressor disks that had failed in service. In‐flight block cyclic loading that included hold‐time loading and variable amplitudes of vibrational loading produced fracture characteristics which mainly reflected the two‐phase (α + β) lamellar structure of the titanium alloy and contained localized areas of fatigue striations.Blocks of cyclic loads which included cycles of hold‐time loading during the testing of disks resulted mainly in the formation of fatigue striations with no evidence of the lamellar microstructure of the titanium alloy. An analytical equation Vi = [(1 − ν2 )/(16  π  E  σ0.2 )][Ke ]2i is suggested to describe the relationship between the crack propagation rate, V, and the equivalent stress intensity factor, Ke , as applied to the semi‐ and then to the quarter‐elliptical‐shaped cracks. Fractographic features are discussed and the disks’ fatigue crack growth behaviour over 50 flights is demonstrated.
Intersonic mode II crack acceleration
Authors: Broberg K.B. 
Published: March 2003

ABSTRACTAn analytic solution is given for intersonic mode II crack acceleration. The solution is obtained by first considering a self‐similar problem, motion of a semi‐infinite crack at constant velocity, under the action of a constant crack face load, appearing behind the crack edge. This solution is then repeatedly used in a superposition scheme, which finally yields the solution for an accelerating crack.
Numerical investigation of creep crack growth in cross‐weld CT specimens. Part I: influence of mismatch in creep deformation properties and notch tip location
Authors: Segle P. , Andersson P. , Samuelson L. Å. 
Published: March 2003

Creep crack growth (CCG) in cross‐weld CT specimens is investigated using two‐dimensional finite element simulations. A creep ductility‐based damage model describes the accumulation of creep damage ahead of the crack tip where a constraint parameter and the creep strain rate perpendicular to the crack plane are used as characterizing parameters.The numerical results reveal that, not only the material properties of the region in which the crack is propagating, but also the deformation properties of the surrounding material influence the CCG behaviour. For the specimen configurations investigated, the location of the starter notch in the HAZ of the cross‐weld CT specimen has, however, a minor influence on the CCG rate and the value of C *. This applies as long as the crack is propagating within a sufficiently narrow region that has material properties which can be regarded as homogeneous.