bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of prorating risk in the development of life‐tables
Authors: Odum R. Andrew , Smith Brandie R. 
Published: August 2002

AbstractThis study used computer models to investigate two different strategies for assessing risk in the development of age‐based life‐tables from studbook data sets. One methodology is similar to that currently employed in American Zoo and Aquarium Association population management, which prorates animals at risk within age‐classes. The other follows the method used in human life‐tables that assumes animals are at risk for the entire age‐class. This study concludes that prorating risk may invalidate population growth projections by significantly and unequally over‐estimating fecundity and mortality rates. This effect is most pronounced in species that have distinct breeding seasons (birth pulse populations), seasonal mortality, and small data sets. Recommendations include using a non‐prorated methodology, tabulating life‐tables using only completely known age‐class data, and combining population parameters for emigrations, releases, and deaths for population growth projections. Zoo Biol 20:279–291, 2001. © 2001 Wiley‐Liss, Inc.
Landmarks in the Development of Hematopoietic Cell Transplantation
Authors: Thomas E. Donnall 
Published: August 2002

Abstract.The field of bone marrow transplantation has evolved over a period of 50 years. Reports of beneficial treatment of murine leukemia by irradiation and injection of marrow cells from another mouse stimulated interest in attempting to use these techniques to treat patients with leukemia. The first few bold attempts at human application were generally met with a total lack of success except for a few transplants involving identical twins. Understanding the HLA system led to the ability to select compatible sibling donors. The first successful long‐term survivors were reported at the end of the 1960s. During the 1970's patients were given transplants for leukemia after failure of all other treatment. Survivals were poor, but some patients were cured. Transplantation early in the course of the disease resulted in greatly improved survival. During the 1980s improved control of infections, the use of peripheral blood as the source of stem cells, and the ability to select donors other than family members resulted in wide application of hematopoietic cell grafting.
Screening for Early Colorectal Cancer
Authors: Kronborg Ole 
Published: August 2002

AbstractThere is now solid evidence from randomized trials suggesting that it is possible to reduce mortality from colorectal cancer by 15% to 25% by screening with fecal occult blood tests (FOBTs). The major benefit results from detection of early cancer in average‐risk persons above 50 years of age who have a positive test followed by colonoscopy. However, it has to be demonstrated that the same acceptability can be reached in the general population as that obtained in trials. Many countries must establish a screening organization in a limited area to learn how satisfactory quality assurance can be obtained before a country‐wide screening program is set up. So far, screening has not resulted in a reduced incidence of colorectal cancer in true population studies despite removal of two to three times as many possible precursors compared to controls. Cost‐effectiveness will probably be as good as that known from screening for breast cancer with mammography and better than that for cervical cancer. However, the calculations are based on the unhydrated Hemoccult‐II test in randomized trials. More sensitive methods would be attractive, but none has yet been evaluated properly in average‐risk persons. There is no general agreement how to screen high risk groups such as patients with previous colorectal adenomas and carcinomas, one or two first‐degree relatives with colorectal neoplasia, or ulcerative colitis. Families with familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer, however, are presented with firm guidelines. Genetic screening has been helpful in no more than these two small groups in the colorectal carcinoma universe.
Contribution to the History of Plastic and Reconstructive Surgery from Dubrovnik and Split during the Fourteenth to Sixteenth Centuries
Authors: Bacic Jurica , Skrobolja Ante , Kojic Niksa , Polanda‐Bacic Gordana 
Published: August 2002

AbstractMedieval contracts for medical treatment are, without doubt, evidence of proper and adequate insight into the quality of operations performed centuries ago. Historical archives in Dalmatian cities have preserved a certain number of such contracts. Their contents assist in better understanding our historical heritage. This paper submits contracts, kept in Dubrovnik and Split, for the operation of inguinal hernia. A case depicting a defective palate treated by Amatus Lusitanus, who lived in Dubrovnik from 1555 to 1558, is also presented.
Study of Three Patients with Congenital Adrenal Hyperplasia Treated by Bilateral Adrenalectomy
Authors: Warinner Sonja A. , Zimmerman Donald , Thompson Geoffrey B. , Grant Clive S. 
Published: August 2002

AbstractMedical management of congenital adrenal hyperplasia (CAH) patients has led to suboptimal results in most cases. High glucocorticoid doses, often needed to suppress adrenal androgen production, may lead to signs of Cushing syndrome. Incompletely suppressed androgen levels commonly lead to premature closure of growth centers, acne, virilization, precocious puberty, irregular or absent menses, and decreased fertility in female CAH patients. A newly proposed therapy for CAH patients is bilateral adrenalectomy. Three Caucasian female patients with 21‐hydroxylase deficiency were treated with bilateral adrenalectomy. Two of the three procedures were accomplished laparoscopically. In each patient, medical management alone was unsuccessful. Two patients had salt‐losing 21‐hydroxylase deficiency. The third patient had uncontrolled hyperandrogenism complicated by obesity and glucose intolerance. All patients had low height percentiles with respect to their normalized percentiles for weight. Bone age was advanced in one patient. Androgen and renin levels were well controlled in two patients, whereas the third patient had persistent hyperandrogenism. Bilateral adrenalectomy was performed at the ages of 14, 19, and 30 years with follow‐up, to date, of 25 months, 10 months, and 26 months, respectively. Postoperatively, all patients were free from hyperandrogenism. One patient experienced one episode of urosepsis precipitating an addisonian crisis. Bilateral adrenalectomy may successfully address the problems of increasing steroid requirements and hyperandrogenism in patients with severe CAH. The ability to perform this operation laparoscopically coupled with the overall metabolic benefits make bilateral adrenalectomy a reasonable alternative to lifelong androgen suppression in select patients.
Advances in the Staging of Intrathoracic Malignancies
Authors: Whyte Richard I. 
Published: August 2002

HeadingConventional staging of lung and esophageal tumors has consisted of a thorough history and physical examination, screening laboratory studies, computed tomography, and radionuclide imaging. Newer modalities including positron emission scanning, endoscopic ultrasonography, minimally invasive surgery (laparoscopy and thoracoscopy), and immunohistochemical staining of lymph node tissue. The roles of these techniques are subject to much current debate, and they may ultimately add information that is valuable for staging and optimally treating patients with intrathoracic malignancies.
Temporary Pancreatic Duct Occlusion by Ethibloc: Cause of Microcirculatory Shutdown, Acute Inflammation, and Pancreas Necrosis
Authors: Plusczyk Thorsten , Westermann Simone , Bersal Björn , Menger Michael , Feifel Gernot 
Published: August 2002

AbstractTemporary obliteration of the pancreatic duct has been suggested to be beneficial in chronic pancreatitis, segmental pancreatic transplantation, and following Roux‐Y pancreaticojejunostomy. Little is known, however, as to whether obliteration of the duct alters exocrine pancreatic physiology. Therefore we studied in male inbred Lewis rats the immediate effects of Ethibloc‐induced duct obliteration (Ethibloc: Ethicon, Norderstedt, Germany) on pancreatic microcirculation, inflammation, and tissue injury (n= 8), and compared these effects with those caused by experimental pancreatitis (4% sodium taurocholate; n= 8). Animals receiving an intraductal infusion of saline served as controls (n= 8). Duct occlusion with Ethibloc resulted in a marked decrease (p < 0.05) in capillary red blood cell (RBC) velocity and functional capillary density (FCD) to 88 ± 39 μm/s (baseline 716 ± 40 μm/s) and 72 ± 33 cm−1 (baseline 493 ± 21 cm−1), respectively, which was even more pronounced when compared with that observed in experimental pancreatitis (333 ± 62 μm/s and 195 ± 44 cm−1, respectively). In parallel, the manifestation of tissue damage was found to be more severe after Ethibloc; and chloracetate esterase staining showed a larger number of infiltrating leukocytes [555 ± 86/high power field (HPF) versus pancreatitis: 160 ± 12/HPF; p < 0.05). We conclude that intraductal application of Ethibloc induces significant microcirculatory failure and a marked inflammatory response, which are even more pronounced when compared with the changes observed with experimental pancreatitis. Based on these results and the fact that there is no direct proof for a benefit of temporary duct occlusion by Ethibloc, it is proposed that the procedure be reevaluated for its use in pancreatic surgery.
Liver Metastatic Model for Human Gastric Cancer Established by Orthotopic Tumor Cell Implantation
Authors: Yamaguchi Koji , Ura Hideki , Yasoshima Takahiro , Shishido Takayuki , Denno Ryuichi , Hirata Koichi 
Published: August 2002

Abstract.We have established an orthotopic implantation model that is highly metastatic to the liver. A human gastric carcinoma cell line, AZ521, with low capacity for liver metastasis was implanted as a single‐cell suspension in the stomach of nude mice. The tumor cells derived from a few liver metastatic foci were subsequently implanted orthotopically, and we established a cell line, AZH5G, by repeating the in vivo stepwise selection method. This metastasizing line (AZH5G) developed liver metastasis in seven of eight (87.5%) cases, whereas parental AZ521 developed in 3 of 20 (15.0%). The in vitro growth activities of AZH5G were lower than that of AZ521, although the in vivo tumorigenicity of AZH5G was clearly higher than that of AZ521. Motility assays demonstrated higher motility of AZH5G than of AZ521. Flow cytometric analysis demonstrated that the expression of α6‐integrin significantly decreased in AZH5G (4.9% ± 4.1%) compared to in AZ521 (17.7% ± 8.1%) (p < 0.05). The adhesive activity of AZH5G cells to laminin was lower than that of AZ521 cells. In contrast, the adhesive activity of AZH5G cells to fibronectin was clearly higher than that of AZ521 cells. These findings suggested that changes in the expression of integrins on the cell surface might play an important role in metastatic ability. This well characterized line and its in vivo experimental model should be useful to investigate the mechanisms of liver metastasis and to develop a new therapeutic approach for human gastric cancer.
Inguinal Hernia Repair in the New Millennium: Plug and Patch Repair with Local Anesthesia
Authors: Zieren Jürgen , Hoksch Beatrix , Wenger Frank A. , Opitz Isabell , Müller Jochen M. 
Published: August 2002

Abstract.Plug and patch repair is a safe, economic method for repairing inguinal hernias, with patient comfort comparable to that with laparoscopic hernia repair. The technique is simple to perform under local anesthesia and easily learned without a learning curve. Complications are rare, and recovery and return to work are rapid. After performing plug and patch repair on 400 patients with a follow‐up examination rate of 93% and a median postoperative observation time of 42 months, we have recorded a recurrence rate of only 0.25%.
Can the Use of Growth Hormone Reduce the Postoperative Fatigue Syndrome?
Authors: Vara‐Thorbeck R. , Guerrero J. A. , Ruiz‐Requena E. , García‐Carriazo M. 
Published: August 2002

AbstractConvalescence after surgery is characterized by a period of fatigue (POF). If we assume that the POF syndrome has a multifactorial etiology, it is clear that the aim of therapeutic measures should be to reduce the response to surgical stress. The purpose of the present study was to determine if administering exogenous human growth hormone (hGH) can prevent the development or reduce the duration of the POF. We carried out a placebo‐controlled randomized double‐blind trial with 48 patients after elective cholecystectomy (placebo, or control group,n= 26; hGH‐treated group,n= 22). Eligibility criteria were strict so as to introduce as few variables as possible. The results obtained in the study show that for moderate surgical injury (cholecystectomy in metabolically healthy subjects) the administering of low doses of hGH (8 IU/day) minimized the POF syndrome (Christensen score). Furthermore, a positive nitrogen balance was achieved in the hGH‐treated group during the postoperative period from the first 24 hours onward. This finding correlates with the significant increase in serum levels of hGH (p< 0.05) and insulin‐like growth factor 1 (IGF‐1) (p< 0.001). On the other hand, anthropometric measurements in the hGH‐treated group revealed a slight but continuous decrease in body weight and thickness of the triceps skinfold; however, arm muscle circumference did not significantly change during the postoperative period. These findings are related to the effects of the application of exogenous growth hormone, which preserves or increases lean body mass and reduces adipose tissue mass. The serum transferrin level proved to be a reliable biochemical indicator of POF.
Stromal Fibroblasts Adjacent to Invasive Thyroid Tumors: Expression of Gelatinase A But Not Stromelysin 3 mRNA
Authors: Zedenius Jan , Ståhle‐Bäckdahl Mona , Enberg Ulla , Grimelius Lars , Larsson Catharina , Wallin Göran , Bäckdahl Martin 
Published: August 2002

AbstractThyroid tumors vary widely in biologic behavior; they range from benign adenomas to rapidly growing anaplastic carcinomas. Among thyroid neoplasms, the follicular tumor is especially suited as a model for studies of tumor cell invasion; the distinction between adenomas and carcinomas relies mainly on the presence of capsular and vascular invasion. Matrix metalloproteinases play an important role in tumor cell invasion, as they are able to degrade basement membrane and extracellular matrix components. Twenty‐nine thyroid tumors of varying type and aggressiveness were selected for analysis of relative molecular weight 72,000‐dalton type IV collagenase (gelatinase A) expression by mRNA in situ hybridization. Strong gelatinase A mRNA expression was seen in 10 of 14 follicular carcinomas, in none of six follicular adenomas, in all four anaplastic carcinomas, and in four of five papillary carcinomas. The expression was restricted to fibroblasts in the stroma adjacent or close to invading tumor cells. Twelve of the tumors were also investigated for expression of stromelysin 3 mRNA, no expression of which was detected in any tumor. The findings suggest that gelatinase A contributes to the invasive process and spread of aggressive thyroid tumors.
Management of Carcinoid Tumors of the Stomach, Duodenum, and Pancreas
Authors: Åkerström Göran 
Published: August 2002

AbstractCarcinoids of the stomach, duodenum, and pancreas are represented by a variety of tumors with variable histologic and clinical features. Multicentric gastric carcinoids and concomitant nonantral argyrophilic hyperplasia are common in chronic atrophic gastritis, more rarely due to a multiple endocrine neoplasia (MEN)‐related Zollinger‐Ellison syndrome (ZES). These tumors are infrequently associated with metastases and may generally be dealt with by repeated endoscopic fulguration. Sporadic carcinoids tend to be larger, invasive, and more often metastatic, especially in the presence of atypical histology. Small tumors may be removed by endoscopy, but larger lesions need to be surgically excised. In association with metastases a histamine‐related atypical carcinoid syndrome may evolve and require treatment with a somatostatin analog. Poorly differentiated neuroendocrine carcinomas of the stomach constitute markedly aggressive tumors that rarely are suitable for radical surgery. Gastrinomas are the most prevalent duodenal carcinoids and a common cause of ZES especially in MEN‐I. Despite a marked tendency for regional lymph node dissemination, liver metastases occur late and duodenal gastrinomas are often excisable, thereby offering favorable odds for cure in ZES. Unusual somatostatin‐rich carcinoids in the ampulla of Vater relate to von Recklinghausen’s disease and may be the cause of obstructive jaundice; depending on their size, these tumors may be removed by local excision or pancreaticoduodenectomy. Gangliocytic paragangliomas are unusual, generally benign lesions of the duodenum. Rare pancreatic tumors with serotonin immunoreactivity may be classified as carcinoids and constitute an unusual cause of the carcinoid syndrome.
Acute Surgical Treatment of Complicated Peptic Ulcers with Special Reference to the Elderly
Authors: Bulut Orhan , Rasmussen Christian , Fischer Anders 
Published: August 2002

AbstractThe results of 136 consecutive patients treated surgically for the acute complications of peptic ulcers between 1990 and 1993 are reviewed. All patients required emergency operation. Among 136 patients, 91 had perforations, 42 hemorrhage, and 3 a penetrated peptic ulcer. The median age was 77 years; 65% were women; and 83% were more than 60 years old. Concurrent disease requiring medical treatment were present in 92 patients; 79 patients (58%) were currently or recently taking antiinflammatory drugs at the time of admission; 66% of the patients had duodenal ulcer. Only 46 patients (34%) had no postoperative complications; pneumonia, arrhythmia, bleeding, and septic complications were the most frequent. The overall mortality was 30%. Sepsis and multiple organ failure was the leading cause of death in most of the patients. It was concluded that elderly individuals using two or more antiinflammatory drugs should be considered potential peptic ulcer patients and should be treated prophylactically with ulcer‐healing drugs.
Endovascular Repair of Abdominal Aortic Aneurysms Using the EGS Tube and Bifurcated Graft Systems
Authors: Colburn Michael D. , Moore Wesley S. 
Published: August 2002

AbstractLeft untreated, aneurysmal disease of the abdominal aorta is a highly lethal condition. Standard transabdominal repair of aortic aneurysm, although successful and durable, continues to be plagued by significant morbidity, mortality, and cost. Placement of an endovascular graft through a femoral arteriotomy is a new technique that could potentially reduced this morbidity and cost without sacrificing efficacy. This report details the development of a U.S. Food and Drug Administration (FDA)‐approved endovascular grafting device. In addition, we describe our experience screening patients and summarize our clinical experience with the placement of both tube and bifurcated endovascular graft systems. To date, 16 patients have undergone endovascular repair with a tube graft at UCLA, and three bifurcated grafts have been placed. Two patients required conversion to conventional open aneurysm repair. All the remaining procedures were successful, and there were no perioperative deaths or major complications. We conclude that endovascular grafting of aortic aneurysms is both feasible and safe. Long‐term patency and the ability of this technique to prevent the known complications of aortic aneurysmal disease remain unanswered questions at this time.
Retroperitoneal Nephrectomy: Comparison of Laparoscopy with Open Surgery
Authors: Doublet Jean D. , Barreto Helio S. , Degremont Anne C. , Gattegno Bernard , Thibault Philippe 
Published: August 2002

AbstractRetroperitoneal laparoscopic nephrectomy (RLN) is a relatively recent technique whose performance needs to be firmly established. The aim of this study was to compare the results of RLNs in 19 patients with retrospective results for 10 cases of open surgery. Ten of the RLN patients had transplanted kidneys. We used a slightly modified, already published technique with only three trocars that did not require balloon dilatation of the retroperitoneal space. It was successful in patients with and without transplants. The average operative times of RLN and open surgery were 115 and 110 minutes, respectively. In no instance did the laparoscopic procedure need to be converted to open surgery. There were no peri‐ or postoperative complications that could be related to the RLN technique. The average length of hospitalization after RLN was considerably shorter (3.8 days) than after open surgery (7.9 days). In conclusion, our experience shows that RLN is a safe, reproducible technique that reduces recovery time. It has become our first‐line approach for simple nephrectomy, nephroureterectomy for ureteral tumors, and removal of the native kidney in transplant recipients.
Intraoperative Manometry during Laparoscopic Operation for Esophageal Achalasia: Does Pneumoperitoneum Affect Manometry?
Authors: Kamiike Wataru , Taniguchi Eiji , Iwase Kazuhiro , Ito Toshinori , Nezu Riichirou , Nishida Toshirou , Inoue Masahiro , Ohashi Shuichi , Matsuda Hikaru 
Published: August 2002

AbstractThe effects of pneumoperitoneum on the lower esophageal sphincter (LES) were evaluated during laparoscopic operation for esophageal achalasia. Intraoperative manometry was performed in three patients who underwent laparoscopic cardiomyectomy with Dor’s fundoplication and five patients who underwent laparoscopic cholecystectomy (LC). The LES pressure and the length of the high‐pressure zone (HPZ) did not change during pneumoperitoneum in either the achalasia and the LC group. In the achalasia group the LES pressure was sufficiently decreased following completion of cardiomyectomy, and the length of the HPZ was found to be sufficiently long after completion of fundoplication. The postoperative courses of the achalasia patients were uneventful, and they have had no symptoms of achalasia or gastroesophageal reflux since the operation. Accordingly, intraoperative manometry during 12 mmHg pneumoperitoneum was considered to be available for laparoscopic surgery for esophageal achalasia.