bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ingredients of Organ Dysfunction or Failure
Authors: Gullo A. , Berlot G. 
Published: August 2002

AbstractThe simultaneous dysfunction of several organs (MODS, or multiple organ dysfunction) represents the most challenging task for the intensivist. In recent years more and more patients have been diagnosed as suffering from MODS due to several causes, including better immediate treatment of injuries that only a few years ago would have been considered incompatible with life or with consequent reduced organ reserve. Even if initially MODS has been associated with infections and sepsis, because of its similarity with a generalized inflammatory reaction mediated by a wide array of mediators, it is now clear that noninfectious insults, such as multiple trauma, acute pancreatitis, and retroperitoneal bleeding, can start a chain reaction ultimately leading to the onset of MODS. A specific trigger factor has not yet been identified, but experimental and clinical evidence suggests that the gut, endothelium, and immune system interact to produce the altered metabolic and cardiorespiratory patterns commonly observed in patients with MODS. It is thus possible that a target‐oriented approach, including rapid correction of intestinal underperfusion, supply of specific nutrients, and down‐regulation of the inflammatory cascade, can act as either a preventive measure for subjects at risk or as a main treatment for patients with full‐blown MODS.
Intussusception in Children: International Perspective
Authors: Meier Donald E. , Coln C. Dale , Rescorla Frederick J. , OlaOlorun Akintayo , Tarpley John L. 
Published: August 2002

AbstractFifty consecutive cases of children with intussusception treated at a hospital in a developing country were compared with 50 consecutive cases treated at an American inner city children’s hospital and 50 consecutive cases treated at an American referral children’s hospital. The plan was to recommend ways of improving the treatment of children with intussusception in the developing world. Nonoperative reduction was attempted in the two American hospitals but was not available in the developing world hospital where all children were treated operatively. Children in the developing world hospital had a significantly longer duration of symptoms, an increased incidence of nonviable bowel, and a mortality of 18%. There were no deaths in either American hospital. The poorer outcome for developing world children was related to delay in treatment, the higher incidence of nonviable bowel, and the lack of adequate nursing care for acutely ill children. The use of nonoperative reduction would not have significantly improved the mortality rate among the developing world children. The mortality can best be reduced by: (1) earlier recognition and treatment of the intussusception; and (2) improvement in the postanesthetic care with better monitoring leading to prompt recognition and treatment of postoperative complications.
Combined Gunshot Injuries of the Trachea and Esophagus
Authors: Weiman Darryl S. , Pate James W. , Walker William A. , Brosnan Kathleen M. , Fabian Timothy C. 
Published: August 2002

AbstractDuring an 8‐year period between 1985 and 1993, twelve patients were treated with combined gunshot wounds to the trachea and esophagus. All patients survived, but there were complications, including one tracheoesophageal fistula. Combined injuries of the trachea and esophagus should be repaired primarily, and drains do not necessarily have to be placed. The benefit of a muscle flap placed between the repairs was not confirmed in this series. Complications should be recognized early and treated aggressively to minimize damage to the airway.
Endoscopic Sphincterotomy: 7‐Year Experience
Authors: Lo Chung‐Yau , Lai Edward C.S. , Lo Chung‐Mau , Mok Francis P.T. , Chu Kent‐Man , Liu Chi‐Leung , Fan Sheung‐Tat 
Published: August 2002

AbstractThe present study documents the indications and results of endoscopic sphincterotomy (ES) performed over 7 years in a surgical endoscopy unit. Potential improvement of results over this time period was analyzed. ES was associated with rare but undesirable morbidity and mortality. Specific improvement of results over time has not been reported. ES was attempted in 706 patients (336 men, 370 women) from 1987 to 1994 and was accomplished in 689 patients (97.6%). Complications occurred in 50 patients (7.1%), 13 of whom required emergency operative intervention. The overall 30‐day mortality was 4.7% (n= 33), and procedure‐related mortality was 0.7% (n= 5). There was a significant decrease in hospital mortality (p< 0.01) and operative intervention for procedure‐related complications (p< 0.001) after 1990. Procedure‐related mortality has been reduced from 1.3% to 0.3% since 1990 (p= 0.1). ES in emergency situations or for malignant biliary obstruction did not adversely affect the outcome. It was concluded that ES can be performed safely in most patients. With increasing experience, procedure‐related morbidity and mortality can possibly be reduced.
Clinical Trials and Projected Future of Liver Xenotransplantation
Authors: Fung John , Rao Abdul , Starzl Thomas 
Published: August 2002

AbstractThe trial and error of the pioneering xenotransplant trials over the past three decades has defined the limitation of the species used. Success was tantalizingly close with the chimpanzee, baboon, and other primates. The use of more disparate species has been frustrated by the xenoantibody barrier. Future attempts at clinical xenotransplantation will be hampered by the consideration of the species of animals and the nature of the organs to be transplanted. On one hand, primate donors have the advantage of genetic similarity (and therefore potential compatibility) and less risk of immunologic loss. On the other hand, pig donors are more easily raised, are not sentient animals, and may be less likely to harbor transmissible disease. It is recognized that the success of xenotransplantation may very with different organs. Because it is relatively resistant to antibody‐mediated rejection, the liver is the organ for which there is the greatest chance of long‐term success. Consideration of using xenotransplants on a temporary basis, or as a “bridge” to permanent human transplantation, may allow clinical trials utilizing hearts or kidney xenografts. Issues on metabolic compatibility and infection risks cannot be accurately determined until routine success in clinical xenotransplantation occurs. Based on a limited experience, the conventional approaches to allotransplantation are unlikely to be successful in xenotransplantation. The avoidance of immediate xenograft destruction by hyperacute rejection, achieved using transgenic animals bearing human complement regulatory proteins or modulating the antigenic target on the donor organ, is the first step to successful xenotransplantation. The ability to achieve tolerance by establishing a state of bone marrow chimerism is the key to overcoming the long‐term immunologic insults and avoiding the necessarily high doses of nonspecific immunosuppression that would otherwise be required and associated with a high risk of infectious complications. Xenotransplantation faces criticism that is strongly reminiscent of that leveled against human‐to‐human transplantation during the late 1960s and early 1970s. Yet with persistence, the field of human‐to‐human transplantation has proved highly successful. This success was the result of a stepwise increase in our understanding of the biology of rejection, improvements in drug management, and experience. It is possible that xenotransplantation may not be universally successful until further technologic advances occur; yet cautious exploration of xenotransplantation appears warranted to identify those areas that require further study.
Gene Rearrangement of Immunoglobulin as a Marker of Thyroid Lymphoma
Authors: Matsuzuka Fumio , Fukata Shuji , Kuma Kanji , Miyauchi Akira , Kakudo Kenichi , Sugawara Masahiro 
Published: August 2002

AbstractThyroid lymphoma occurs most commonly in the thyroid gland in association with Hashimoto's thyroiditis. Histologic findings occasionally cannot distinguish lymphoma from Hashimoto's thyroiditis, which creates a serious problem of whether treatment should be initiated. For this study, we examined 33 lymphoma tissues and 10 thyroid tissues from patients with Hashimoto's thyroiditis for the presence of gene rearrangement of immunoglobulin, which represents clonality of B‐cell‐derived tumors. Genomic DNA from thyroid tissues was digested with Bam H1 and Hind III restriction enzymes followed by electrophoresis. A Southern blot was performed with an IgH‐JH probe or IgL‐Jκ probe to detect gene rearrangement. Of the 33 lymphoma tissues, 27 (85%) showed gene rearrangement of immunoglobulin, whereas none of Hashimoto's thyroiditis tissue showed gene rearrangement. Five patients with a positive histologic diagnosis of lymphoma showed a negative gene rearrangement and were treated as having lymphoma. We encountered one case of lymphoma (plasmacytoma) in which gene rearrangement (not histologic findings) was diagnostic. Gene rearrangement of immunoglobulin can be used to detect thyroid lymphoma, particularly when the histologic diagnosis is inconclusive. The sensitivity of detecting thyroid lymphoma by the Southern blot method was about 85% in the present series.
Effects of Surgical Sympathectomy on Skin Blood Flow in a Rat Model of Chronic Limb Ischemia
Authors: van Dielen François M.H. , Kurvers Harrie A.J.M. , Dammers Ruben , oude Egbrink Mirjam G.A. , Slaaf Dick W. , Tordoir Jan H.M. , Kitslaar Peter J.E.H.M. 
Published: August 2002

AbstractThe role of lumbar sympathectomy in the treatment of limb ischemia secondary to arteriosclerosis obliterans has been controversial. Increased temperature and rubor of the skin, which usually follow sympathectomy, have generally been interpreted as indicative of improved nutritive skin blood flow. However, the existence of a (nonnutritive) thermoregulatory level of skin microcirculation makes such an extrapolation questionable. We investigated the total (mainly thermoregulatory) skin blood flow (TSBF) in the hindlimb of 15 male Lewis rats by means of laser Doppler flowmetry and the nutritive skin blood flow (NSBF) by means of capillary microscopy (red blood cell velocity). Transcutaneous oximetry was used to assess skin oxygenation (SO). Measurements were performed before and 2 and 28 days after ligation of the common iliac and iliolumbar artery. Subsequently, either a surgical resection of the sympathetic chain (L2–L6) was performed or a sham operation. Measurements were repeated 2 and 28 days later. For the group of 15 rats as a whole, TSBF (p < 0.05), NSBF (p < 0.05), and SO (p < 0.05) were found to be drastically reduced at day 2 after ligation compared to preligation values. This reduction partially recovered during the following weeks. TSBF (p < 0.05) and NSBF (p < 0.05), however were still reduced at day 28 after ligation compared to preligation values, whereas the SO at this time tended to be lower (p= 0.11). In the sympathectomy group the TSBF was found to be increased at day 2 (p < 0.05) and day 28 (p < 0.05) after sympathectomy, both compared to values obtained at day 28 after ligation. Sympathectomy did not have an effect on NSBF and SO. The sham procedure had no effect on the TSBF, NSBF, or SO. These results indicate that in case of lower limb ischemia, sympathectomy improves skin blood flow at the thermoregulatory but not the nutritive level of skin microcirculation. This may be related to the fact that the thermoregulatory vessels are mainly sympathetically controlled, whereas the nutritive capillaries are mainly controlled by local (nonneural) factors.
Influence of Brain Death and Cardiac Preservation on Systolic and Diastolic Function and Coronary Circulation in the Cross‐circulated Canine Heart RID="" ID="" This International Society of Surgery (ISS)/Soci&eacute;t&eacute; Internationale de Chirurgie (SIC) article was presented at the 37th World Congress of Surgery International Surgical Week (ISW97), Acapulco, Mexico, August 24&ndash;30, 1997.
Authors: Szabó Gábor , Sebening Christian , Hackert Thilo , Hoffmann Lutz , Sonnenberg Karin , Hagl Christian , Tochtermann Ursula , Vahl Christian F. , Hagl Siegfried 
Published: August 2002

AbstractPrevious studies have demonstrated hemodynamic instability and cardiac dysfunction in the brain‐dead organ donor. It remains unclear if primary cardiac dysfunction is responsible for hemodynamic deterioration or decreased cardiac function is secondary to brain death‐associated altered loading conditions. Therefore in the present study the effects of brain death on hemodynamics and cardiac function were analyzed in vivo in an open chest model and ex vivo in a cross‐circulated heart preparation. In a second protocol, the impact of brain death‐associated hemodynamic changes on postischemic graft function was investigated. Brain death was induced injecting saline in a subdural Foley catheter. Induction of brain death led to a hyperdynamic reaction followed by hemodynamic deterioration with a decrease of systemic vascular resistance and myocardial contractility. If the hearts were explanted and assessed ex vivo, no differences were found between control and brain‐dead hearts. Furthermore, both control and brain‐dead hearts showed full functional recovery after 4 hours of hypothermic ischemic storage. Despite hemodynamic deterioration in situ after brain death, there were no differences between the postischemic function of control and brain‐dead hearts. These results indicate that myocardial dysfunction is not irreversible and may be secondary to altered loading conditions, and that the recovery of cardiac function after long‐term hypothermic storage is not impaired by the hemodynamic changes observed in situ after brain death induction. These data may also indicate that potential donor hearts might not be excluded from transplantation on the basis of impaired hemodynamic characteristics, especially if they are evaluated by load‐dependent parameters.
Pylorus‐preserving Pancreaticoduodenectomy versus Conventional Whipple Operation
Authors: Di Carlo Valerio , Zerbi Alessandro , Balzano Gianpaolo , Corso Vittorio 
Published: August 2002

Abstract.During 1990 to 1997 a series of 39 patients underwent a classic pancreaticoduodenectomy and 74 a pylorus‐preserving pancreaticoduodenectomy for pancreatic adenocarcinoma. The two groups had similar tumor characteristics and received comparable adjuvant treatments. No significant differences were found between the two groups in terms of mortality, morbidity, gastric emptying, food intake resumption, and hospital stay. Postoperative survival was not affected by the preservation of the pylorus, determined by both univariate and multivariate analyses. Postoperative nutritional outcome was similar in the two groups, although patients receiving adjuvant chemotherapy had a better nutritional recovery if the whole stomach was preserved. In our opinion pylorus‐preserving pancreatoduodenectomy is the treatment of choice of pancreatic head cancer.
Reduction and Temporary Stabilization of Acetabular Fractures Using ASIF Mandibular Reduction Forceps: Technique and Results Using Plate Fixation in 25 Dogs
Authors: Boswell Kimberly A. , Boone Ernest G. , Boudrieau Randy J. 
Published: August 2002

Objective— To report the results of acetabular fracture fixation in 25 dogs in which a specialized forceps (ASIF mandibular reduction forceps, Synthes USA, Paoli, PA) was used to obtain fracture reduction and stabilization.Study Design— A retrospective clinical study.Animal Population— Twenty‐five client‐owned dogs with traumatic acetabular fractures.Methods— The mandibular reduction forceps (MRF) use a screw on each side of the fracture to attach the clamp directly to the bone and permit direct manipulation of the fragments. Medical records from 25 dogs with acetabular fractures were reviewed to determine the effectiveness of this technique in obtaining, and then maintaining, fracture reduction while a plate was being applied.Results— Clinical results were considered successful in 24 of 25 dogs; the small size of 1 dog prevented application of the MRF. The final reduction and fixation of the fractures was evaluated as anatomic in 17 dogs, near‐anatomic in 6 dogs, and nonanatomic in 1 dog.Conclusions and Clinical Relevance— Application of the MRF is an effective technique for aiding the reduction of acetabular fractures in dogs. It maintains reduction while simultaneously permitting unimpeded access to the dorsal acetabular rim, thus facilitating accurate contouring of a plate. Accurate reduction and rigid fixation of articular fractures is essential to prevent secondary osteoarthritis.
Strangulating Obstruction Caused by Intestinal Herniation Through the Proximal Aspect of the Cecocolic Fold in 9 Horses
Authors: Gayle J'Mai M. , Macharg Margaret A. , Smallwood J. Edgar 
Published: August 2002

Objective—To report the clinical and surgical findings and outcome for horses with strangulating obstruction caused by herniation through the proximal aspect of the cecocolic fold.Study Design—Retrospective study.Animals—Nine horses.Methods—Medical records were reviewed for clinical signs, surgical findings and technique, and outcome. Cadaver ponies and necropsy specimens were also used to study the regional anatomy of the cecocolic fold.Results—The ileum and distal jejunum were strangulated in 8 horses, whereas in 1 horse the small intestine and the left ascending colons were incarcerated in a rent in the cecocolic fold. Two horses were euthanatized at surgery, 6 horses had a small intestinal resection (mean length, 3 m; range, 1.5–6.4 m) and an end‐to‐side jejunocecostomy, and the entrapment was reduced without resection in the horse that had small intestine and ascending colon incarceration; cecocolic fold defects were not closed. One horse was euthanatized 36 hours after surgery because of endotoxemia. Six horses were discharged; 4 were available for long‐term follow‐up, of which 2 were euthanatized, and 2 were euthanatized 12 and 18 months after surgery because of colic signs. Variations in thickness of the cecocolic fold were observed in specimens obtained from necropsy of other horses and ponies.Conclusions—Reasons for this defect are unknown, although observed anatomic differences in cecocolic fold thickness may contribute to the development of defects.Clinical Relevance—Reduction of the entrapped bowel is easiest when traction is placed on the bowel at a 90° to the base of the cecum. Intestinal incarceration through rents within the proximal part of the cecocolic fold should be considered as a differential diagnosis for strangulating obstruction in horses.
Marchuk′s Model of Immune System Dynamics with Application to Tumour Growth
Authors: Foryś Urszula 
Published: August 2002

Marchuk′s model of a general immune reaction is presented in the paper. The results of investigation of the model are summarized. The qualitative behaviour of solutions to the model and its simplification is described. Many illustrations of recovery process, oscillations or lethal outcomes of a disease are shown. The model with time‐dependent immune reactivity is also considered. Periodic dynamics caused by different reasons are compared.In the last section adaptation of the model to tumour–immune interactions is proposed. The role of interleukins in immune processes is taken into account to adapt Marchuk′s model to tumour growth dynamics. Possible immunotherapy is also considered in the proposed model. Some preliminary analysis of the model is presented.
HIF‐1 and AP‐1 Cooperate to Increase Gene Expression in Hypoxia: Role of MAP Kinases
Authors: Michiels Carine , Minet Emmanuel , Michel Gaetan , Mottet Denis , Piret Jean‐Pascal , Raes Martine 
Published: August 2002

AbstractHIF‐1 is the main transcription factor responsible for increased gene expression in hypoxia: VEGF, erythropoietin, GLUT‐1, and glycolytic enzymes are such target genes and all participate in the adaptative response of cells to hypoxia. AP‐1 activation by hypoxia has also been demonstrated in several cell lines and it cooperates with HIF‐1 for increasing VEGF gene transcription in hypoxia. Both HIF‐1 and AP‐1 activation by hypoxia seems to involve members of the MAP kinase family. Here, we summarize the data indicating that ERK and JNK are needed for activation of HIF‐1 and AP‐1, respectively.
Several Features of Tribochemical Synthesis Based on Aromatic Amines
Authors: Krasnov Alexander P , Kireev Vyacheslav V , Mit' Vera A , Kudasheva Dina S , Komarova Lidia I 
Published: August 2002

The present work was devoted to the investigation of aromaticam in ereactions under the conditions of non-traditional tribochemical synthesis at room temperature in different triboreactors. Experimental data indicate the formation of reactive pre-polymer products of interaction, of low-molecular-weight non-melting and non-soluble pyromellitimide with bismaleimide, running the reaction of migratory copolymerization in the solid phase under the conditions in the vibromixer. On the example of paraphenylenediamine and terephthalic aldehyde, the principal possibility of Schiff base synthesis has been demonstrated under the conditions in the shear micromixer, and the optimal regime has been determined. The obtained oligomer products contain thermostable fragments and reactive amino and aldehyde end-groups as well as double bonds of the maleimido cycle still remain. This composition allowed us to use them in polyheteroarylene synthesis of different structures in order to modify their properties.
Scientific literacy for all citizens: different concepts and contents
Authors: Popli Rakesh 
Published: August 2002

In this article, three different descriptions of curricula for scientific literacy (SL) are summarized, compared, and critically reviewed from the point of view of their suitability for all citizens. Science for All Americans, a publication of the American Association for the Advancement of Science, envisages giving every citizen a thorough exposure to the world of science, technology, and mathematics; the report Towards Scientific Literacy, published by the International Institute for Adult Literacy Methods, recommends a phenomenological approach to science designed to make science useful for people in their daily lives; and a similar curriculum, Minimum Science for Everybody, published by a voluntary organization in India, provides a detailed alternative conceptual framework for SL in which community traditions and knowledge systems are interfaced with science. The three reports are seen to differ from one another not only in respect of the contents of the curricula recommended, but also in their approaches, and the world views underlying these different approaches are brought out. It is suggested that SL curricula in both “developed” and “developing” countries be reviewed in the light of the ideas contained in all three reports in accordance with the needs and circumstances of the people. The article argues for the need to review the nature of science from the perspective of the common citizen.