bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insertional mutagenesis in yeasts using T‐DNA from Agrobacterium tumefaciens
Authors: Bundock Paul , van Attikum Haico , den Dulk‐Ras Amke , Hooykaas Paul J. J. 
Published: August 2002

AbstractInsertional mutagenesis is a powerful tool for the isolation of novel mutations. The gene delivery system of the bacterium Agrobacterium tumefaciens, which mediates transfer not only to plants but also to yeasts and fungi, could be exploited to generate collections of yeasts containing insertional mutations if there were no bias towards particular integration sites, as is the case in plants. To test this, we have analysed a small collection of Saccharomyces cerevisiae strains with T‐DNA copies integrated in the S. cerevisiae genome. The position of 54 of these T‐DNAs was determined. The T‐DNA showed no clear preference for certain DNA sequences or genomic regions. We have isolated insertions in the coding regions of the genes YGR125w, YDR250c, YGR141w, YGR045c, YPL017c, YGR040w, YDL052c, YJL148w, YCL033c, YFL061w, YJR033c, YDR175c and YLR309c confirming that these genes are non‐essential for S. cerevisiae haploid growth on minimal medium. Given the advantages of T‐DNA, we propose its use as an ideal mobile DNA element for insertional mutagenesis in yeasts. Copyright © 2002 John Wiley & Sons, Ltd.
Towards a Formal Treatment of Implicit Invocation Using Rely/Guarantee Reasoning
Authors: Dingel J. , Garlan D. , Jha S. , Notkin D. 
Published: August 2002

Abstract.
Implicit invocation [SuN92, GaN91] has become an important architectural style for large-scale system design and evolution. This paper addresses the lack of specification and verification formalisms for such systems. A formal computational model for implicit invocation is presented. We develop a verification framework for implicit invocation that is based on Jones' rely/guarantee reasoning for concurrent systems [Jon83, Stø91]. The application of the framework is illustrated with several examples. The merits and limitations of the rely/guarantee paradigm in the context of implicit invocation systems are also discussed.
Management of Hyperthyroidism Due to Graves' and Nodular Diseases
Authors: Okamoto Takahiro , Iihara Masatoshi , Obara Takao 
Published: August 2002

AbstractEndocrine surgeons have had an important role in the management of hyperthyroidism due to either Graves' disease or toxic nodule(s). Since alternative treatments such as antithyroid drugs or radioiodine are also available, the decision‐making for management should be based on clear assessment of advantages and limitations of each of the treatment options. Surgery provides rapid resolution of these conditions, and cure rates are high, although it may be associated with perioperative complications and postoperative thyroid dysfunction. The authors' experience in the surgical treatment of hyperthyroidism and a review of the recent literature are outlined in this report.
Management of Nonfunctioning Islet Cell Carcinomas
Authors: Bartsch Detlef K. , Schilling Thomas , Ramaswamy Annette , Gerdes Berthold , Celik Ilhan , Wagner Hans‐Joachim , Simon Babette , Rothmund Matthias 
Published: August 2002

AbstractTumors arising from the pancreatic islet cells are rare and represent a heterogeneous group of benign or malignant lesions. Most tumors present with well characterized syndromes, whereas others appear to be nonfunctioning. The clinical features of 11 men and 7 women with nonfunctioning islet cell carcinomas operated on between 1983 and 1998 were reviewed. The median patient age was 53.5 years (range 26–74 years). The most frequent presenting symptoms were abdominal pain (13 patients), weight loss (7 patients), and obstructive jaundice (4 patients). Gut hormone profiles were normal in all patients. Abdominal sonography and computed tomography localized the tumor in 17 patients, and correct prediction of an endocrine tumor was achieved in 12 patients. Six of seven patients showed a hypervascular tumor upon angiograpy, and seven of eight patients preoperatively had positive somatostatin receptor scintigraphy. At operation, regional or distant metastases were present in 15 (83%) and 6 (33%) patients, respectively. Eleven patients underwent potentially curative resections, and the remaining seven patients were managed palliatively by resection (four patients) or bypass procedures (three patients). Three patients had up to three more resection for metastases. Eight patients received postoperative octreotide, interferon α therapy, or both. The overall cumulative 5‐ and 10‐year survival rates were 65.4% and 49.1%, respectively. Of the 11 patients who underwent curative resection, 10 were alive after a median follow‐up of 63 months (range 7–180 months), but only 5 are free from disease. Although surgical cure is rare in nonfunctioning islet cell carcinomas, significant long‐term palliation can be achieved in a large proportion of patients with an aggressive surgical approach and, when indicated, additional medical therapy.
Effect of Fecal Diversion Alone on Perianal Crohn's Disease
Authors: Yamamoto Takayuki , Allan Robert N. , Keighley Michael R.B. 
Published: August 2002

Abstract.The role of fecal diversion alone for perianal Crohn's disease remains unclear. This study was undertaken to assess its role in perianal Crohn's disease and to examine predictive factors for outcome. Thirty‐one patients who underwent fecal diversion alone for perianal Crohn's disease between 1970 and 1997 were reviewed. The principal indications for fecal diversion were severe perianal sepsis in 13 patients, recurrent deep anal ulcer in 3, complex anorectal fistula in 9, and rectovaginal fistula in 6. Twenty‐five patients (81%) went into early remission, and six (19%) failed to respond. Of the 25 early responders, 17 relapsed at a median duration of 23 months after fecal diversion. By contrast, 8 patients (26%) went into complete remission and required no further surgery at a median duration of 81 months after the diversion. Altogether, 22 patients required surgery at a median duration of 20 months after fecal diversion: proctectomy in 21 and repeated drainage of anal sepsis in 1. At present, intestinal continuity has been restored in only three patients (10%). The following parameters were compared in patients with and without complete remission after fecal diversion: age, gender, duration of disease, steroid use, smoking, coexisting Crohn's disease, preoperative blood indices, and Crohn's disease activity index. None of these parameters affected the outcome. In conclusion, fecal diversion alone is effective in selected patients with perianal disease, but the prospect of restoring intestinal continuity is low. There were no parameters to identify those in whom a successful outcome is likely.
Effect of Sucrose on Collagen Metabolism in Keloid, Hypertrophic Scar, and Granulation Tissue Fibroblast Cultures
Authors: Kössi Jyrki , Vähä‐Kreula Marko , Peltonen Juha , Risteli Juha , Laato Matti 
Published: August 2002

Abstract.Sucrose has been used to treat wounds with excellent results and with minimal abnormal scarring. In this study the effects of sucrose on collagen metabolism in fibroblast culture was evaluated. Sucrose (5.5, 15, or 25 mM) was added to granulation tissue, hypertrophic scar, and keloid fibroblast cultures. mRNA levels and procollagen aminopropeptides for type I and III collagens in cell culture medium were studied. Sucrose decreased mRNA levels for proα1(I) and proα1(III) collagens in fibroblast cultures derived from hypertrophic scar and keloid. In normal granulation tissue fibroblast cultures, 5.5 mM sucrose increased mRNA levels for proα1(I) and proα1(III) collagen, and higher concentrations decreased them. The synthesis of type I collagen decreased dose‐dependently in all cell strains, whereas the synthesis of type III collagen decreased only in granulation tissue fibroblasts. To conclude, in vitro high concentrations of sucrose down‐regulate both collagen gene expression and synthesis in normal granulation tissue fibroblasts, whereas in fibroblasts derived from abnormal scar sucrose down‐regulates only type I collagen gene expression and synthesis, changing the pattern of collagen metabolism toward normal.
Prospective Randomized Comparison of Two Preoperative Skin Preparation Techniques in a Developing World Country
Authors: Meier Donald E. , Nkor Sunday K. , Aasa David , OlaOlorun David A. , Tarpley John L. 
Published: August 2002

AbstractPovidone‐iodine (PI) is a scarce and expensive item for some hospitals in developing countries. This prospective, randomized study was performed at Baptist Medical Centre (BMCO) in Ogbomoso, Nigeria to determine if the use of PI for preoperative skin preparation would result in a lower postoperative wound infection rate and to identify other factors influencing the infection rate. Two hundred patients undergoing inguinal hernia repair were randomized to receive skin preparation with either: (1) locally available, inexpensive market soap and methylated spirit or (2) imported PI. The two groups were equally stratified. The overall postoperative wound infection rate was 5.5%, and there was no significant difference between the groups (5.1% vs. 5.9%). Factors that did not affect the infection rate included gender, age, type of anesthesia, type or duration of the operative procedure, and number of breaks in optimal technique. There were eight abscesses and three cases of cellulitis without suppuration diagnosed an average of 10 days postoperatively. Staphylococcus was the only bacterium identified on Gram stain or culture. The expense of procuring PI is not justified at BMCO. Available funds may better be used for preoperative antibiotics or for improvement in hospital infrastructure, which should result in fewer breaks in optimal operating room technique.
New Therapy Complementary to Transcatheter Arterial Embolization for Hepatocellular Carcinoma
Authors: Yamada Ryusaku , Nakamura Kenji , Nishida Norifumi , Matsuoka Toshiyuki , Yamada Katsuyuki , Tanaka Kayo , Terada Masaki , Sato Morio 
Published: August 2002

Abstract.A new therapy complementary to transcatheter arterial embolization (TAE) in which anticancer agents are percutaneously injected into the tumor under ultrasound guidance (percutaneous injection chemotherapy combined with TAE; TAE‐PICT) has been developed and found to be effective. A total of 68 hepatocellular carcinoma (HCC) nodules in 50 patients were treated with TAE‐PICT, and the complications were evaluated. Among those with solitary HCC nodules 5 cm in diameter, 17 were treated with TAE‐PICT and 24 with only TAE in a prospective comparative study. No major complications were seen, and the anticancer drugs could still be found in the tumor 3 months after injection. A significantly higher cumulative survival rate (p = 0.03961) and significantly higher cumulative recurrence‐free survival rate (p = 0.00647) were achieved in patients treated with TAE‐PICT than in those treated with TAE alone.
Familial Hyperparathyroidism without Multiple Endocrine Neoplasia
Authors: Huang Shih‐Ming , Duh Quan‐Yang , Shaver John , Siperstein Allan E. , Kraimps Jean‐Louis , Clark Orlo H. 
Published: August 2002

AbstractHyperparathyroidism occurs sporadically, in association with multiple endocrine neoplasia (MEN) types I and II, or rarely as familial hyperparathyroidism (FHPT) without other manifestations. We analyzed our experience in 16 FHPT patients from 14 families treated between 1934 and 1991 and reviewed 51 other FHPT patients reported in the literature to determine the clinical course of these patients. Among our 16 patients, 7 (44%) had a serum calcium level ≥ 3.75 mmol/L, 5 (31%) presented with hypercalcemic crisis, 3 (19%) had osteitis fibrosa cystica, 5 (31%) had nephrolithiasis, 1 had pancreatitis, 12 (75%) had multiple abnormal parathyroid glands, 3 (19%) had supernumerary glands, and 7 (44%) required reoperation for persistent (n= 4) or recurrent (n= 3) hyperparathyroidism. Three patients (19%) also had papillary thyroid cancer, and 7 (44%) had other coexistent thyroid disorders. Among 51 patients with FHPT reported in the literature, 23 (45%) had serum calcium ≥ 3.75 mmol/L, and 23 (45%) had multiple abnormal parathyroid glands; 10 (20%) had recurrent hyperparathyroidism. FHPT without other endocrinopathies is a distinct entity. Patients with FHPT have multiple abnormal parathyroid glands and are prone to both recurrent and persistent hyperparathyroidism. They frequently present with profound hypercalcemia or hypercalcemic crisis, in contrast to patients with MEN‐associated hyperparathyroidism or sporadic hyperparathyroidism.
Myomammary Flap of Pectoralis Major Muscle for Breast Reconstruction: New Technique
Authors: Denewer Adel Taha 
Published: August 2002

AbstractSimple mastectomy and modified radical mastectomy is still the preferred surgical technique for management of breast cancer, as it is always in the second stage (II). Breast reconstruction in Egypt is always accompanied by reduction mammoplasty of the other breast. The new method utilizes a myomammary flap from the other side. This flap depends on the other breast being of moderate or large size. The flap being transferred depends on the pedicle of the pectoralis major tunneled under the skin. The new technique utilizes the nipple on the healthy side to reconstruct the nipple of the new breast at the same time. A reduction mammoplasty was achieved in healthy contralateral huge breasts. A total of 23 female patients were submitted for breast reconstruction using a pectoralis major myomammary flap from the other relatively large breast. The flap depended on a blood supply from the pectoral branch of the thoracoacromial artery. Good cosmetic results were achieved in 60% of cases, fair results in 25%, and unsatisfactory results in 15%. In conclusion, this new technique of breast reconstruction is suitable especially for patients with large, healthy breasts and for relatively poor patients.
Lack of Survival Benefit of Extended Lymph Node Dissection for Ductal Adenocarcinoma of the Head of the Pancreas: Retrospective Multi‐institutional Analysis in Japan
Authors: Mukaiya Mitsuhiro , Hirata Koichi , Satoh Takashi , Kimura Masami , Yamashiro Kazuhiro , Ura Hideki , Oikawa Ikuo , Denno Ryuichi 
Published: August 2002

AbstractIt has not been established that extended lymph node resection is necessary for ductal adenocarcinoma of the head of the pancreas. According to the general rules for the study of pancreatic cancer, a multiinstitutional, retrospective clinical study was undertaken to investigate the efficiency of extended lymph node dissection for this malignancy. Altogether 501 patients underwent resection of the pancreas between 1991 and 1994 at 77 medical facilities; the surgical procedures, staging, lymph node dissection, curability, and survival rate were analyzed retrospectively. Eighteen of the patients died within 30 postoperative days, leaving 483 patients to be studied. The resection was curative microscopically in 94 patients, resulting in a 3‐year survival of 29%. Macroscopically curative resection resulted in a 3‐year survival of 14%; noncurative resection produced a 3‐year survival of 6%. Although extended lymph node dissection was performed on 38 patients in stage I, 42 patients in stage II, 206 patients in stage III, and 1 patient in stage IV, there was no improvement in survival when the results were compared to those seen after standard or palliative lymph node dissection. The extent of lymph node dissection has not affected the prognosis for ductal adenocarcinoma of the head of the pancreas at any stage of the course of the disease. Excessive lymph node dissection in advanced cases does not necessarily lead to a favorable prognosis. The patients who undergo a radical operation with an adequate lymph node dissection have longer survivals.
Stage‐dependent Therapy of Rectal Carcinoid Tumors
Authors: Schindl Martin , Niederle Bruno , Häfner Michael , Teleky Bela , Längle Friedrich , Kaserer Klaus , Schöfl Rainer 
Published: August 2002

AbstractAlthough malignant behavior of rectal carcinoid tumors is rare, the risk of metastases and death does exist. Adaptation of therapy according to the estimated malignancy seems necessary. To develop a stage‐dependent therapy, 31 patients with rectal carcinoid tumors measuring 5 to 50 mm in diameter were analyzed retrospectively. Malignancy was estimated according to tumor size, infiltration depth, and histopathology. There were 18 tumors within the mucosa and submucosa (T1), 7 tumors with muscularis propria invasion (T2), and carcinoid tumor penetrating the full rectal wall (T3) or spreading to surrounding tissue (T4) in 6 patients. Altogether 20 patients (65%) were treated with a minimally invasive intervention: endoscopic polypectomy (EP) in 12 and transanal excision (TE) in 8 patients. In 11 patients (35%) aggressive surgical procedures—anterior resection (AR) in 4 and abdominoperineal resection (APR) in 7—were performed. After a mean ± SD follow‐up of 86.0 ± 61.3 months, tumor recurrence was not seen in any of the 20 patients with minimally invasive treatment, and all were still alive. No severe complications associated with surgical procedures were detected. In contrast, 5 of the 10 patients with advanced tumor stage died from their disease despite aggressive surgery (AR, APR). In conclusion, depending on tumor stage, treatment of rectal carcinoids includes EP, TE, or extended resection. Minimally invasive techniques are safe treatments for small to medium‐size T1/T2 rectal carcinoids. Extended surgery cannot improve the overall survival of those with advanced tumors (T3/T4, N1, M1) but can be beneficial for preventing local complications.
Intraoperative Gastrin Measurements during Surgical Management of Patients with Gastrinomas: Experience with 20 Cases
Authors: Proye Charles , Pattou François , Carnaille Bruno , Paris Jean‐Claude , d’Herbomez Michèle , Marchandise Xavier 
Published: August 2002

AbstractDespite recent advances in imaging techniques for endocrine tumors of the duodenum and the pancreas, preoperative localization of gastrinomas is inconsistent. Successful surgical management of patients with Zollinger‐Ellison syndrome (ZES) and removal of all gastrin‐secreting tumors remains a difficult task. The aim of the study was to evaluate the predictive value of intraoperative gastrin measurements for successful surgical treatment in patients with gastrinomas. Intraoperative gastrin measurements were performed in 20 patients with ZES who underwent resection of gastrin‐secreting tumors. Gastrin was measured with a radioimmunologic assay in blood samples obtained from a peripheral vein and from the portal vein at the beginning of the operation (T0) and 20 minutes after removal of the lesion(s) (T1). In 16 patients gastrin was also measured 4 minutes after injection of secretin 3 U/kg (T2). Thirteen patients (65%) were cured by surgery. In two of them, peripheral and portal gastrin levels were normal at T0, precluding any further interpretation of the test. Completeness of surgery was confirmed by normalization of gastrin levels at T1 or the absence of stimulation at T2 (or both) in 10 patients. In only one case did the gastrin levels remain elevated at T1 despite a favorable outcome after surgery. In each of the seven patients (35%) who had persisting disease at 1 year, failure of the surgical procedure was predicted by persistence of high levels of gastrin at T1. In patients with hypergastrinemia, the positive predictive value of intraoperative gastrin measurement for completeness of surgery and the specificity were 100%. The negative predictive value was 88% and the sensitivity 91%. The overall accuracy of the test was 94%. In patients with ZES the normalization of systemic hypergastrinemia during surgery affirms the successful removal of all gastrin‐secreting tumors. We conclude that intraoperative gastrin measurement is a valuable addendum for optimizing the surgical management of gastrinoma.
Somatostatin Receptor Subtypes, Octreotide Scintigraphy, and Clinical Response to Octreotide Treatment in Patients with Neuroendocrine Tumors
Authors: Kölby Lars , Wängberg Bo , Ahlman Håkan , Tisell Lars‐Erik , Fjälling Martha , Forssell‐Aronsson Eva , Nilsson Ola 
Published: August 2002

AbstractSeveral types of neuroendocrine tumor express high numbers of somatostatin receptors (sstr). We have compared the expression of sstr subtypes with the outcome of octreotide scintigraphy in patients with carcinoids and medullary thyroid carcinoma (MTC) in comparison with Hürthle cell tumors. The effect of sstr activation (octreotide treatment) on tumor markers was also studied in patients with disseminated carcinoid tumors. Six patients with carcinoid tumors (four midgut and two foregut), and three patients with thyroid tumors (one MTC, one Hürthle cell carcinoma, and one Hürthle cell adenoma) were studied. Octreotide scintigraphy visualized tumor sites in all nine patients. Macroscopic tumor was verified at these sites at subsequent surgical exploration. Using Northern blotting and subtype‐specific riboprobes, sstr could be detected in all tumors examined. All five sstr subtypes were detected in most of the carcinoid tumors. All six carcinoids expressed sstr2. This was in contrast to the findings for the thyroid tumors analyzed, which also expressed several sstr subtypes but in some cases lacked expression of sstr2. This was also the case for normal thyroid tissue. Clinically, octreotide treatment of the patients with midgut carcinoid tumors resulted in palliation of hormonal symptoms accompanied by a significant reduction of urinary 5‐HIAA levels (28–71%). These results indicate that carcinoid tumors frequently express all five sstr subtypes. The thyroid tumors also expressed multiple sstr but could lack expression of sstr2. Nevertheless, these tumors were visualized by octreotide scintigraphy, indicating that sstr2 expression is not a prerequisite for tumor imaging.