bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum fatty acid analysis and digestibility study in the Vancouver Island marmot (Marmota vancouverensis) fed a captive diet supplemented with α‐linolenic acid
Authors: Legaarden Thea K. , Walton J‐P , Plaizier Jan C. , McBride Brian W. , Valdes Eduardo V. 
Published: August 2002

AbstractMammals that hibernate must rely on endogenous lipid reserves to survive over winter. This study was conducted to compare the difference in serum fatty acid composition, dietary intake, and apparent digestibility in the Vancouver Island marmot (N = 6) fed the Metro Zoo lagomorph diet supplemented with α‐linolenic acid [C(18:3) n‐3 (α‐LA)]. The experiment was designed as a 3 × 3 Latin square with three 17‐day collection periods. The test diets contained 12.16, 14.85, and 17.05% α‐LA as a percentage of fatty acids in the diet supplied through the addition of flaxseed oil (∼53% α‐LA). Across treatments, dry matter intake (g/d), dry matter digestibility, apparent fat digestibility, and apparent neutral detergent fiber digestibility did not differ significantly (P > 0.05). There were no significant differences in serum α‐LA concentration between the three levels of α‐LA supplementation. However, this supplementation did elevate serum α‐LA, eicosapentaenoic acid [C20:5 (n‐3)], and docosahexaenoic acid [C22:6 (n‐3)] levels compared with feeding the basal zoo lagomorph diet (P < 0.05). Thus, supplementation of the basal zoo lagomorph diet with α‐LA elevated the serum levels of essential fatty acids in the Vancouver Island marmot. Zoo Biol 20:251–259, 2001. © 2001 Wiley‐Liss, Inc.
Histoclinical Analysis of Early Colorectal Cancer
Authors: Park Young Jin , Kim Woo‐Ho , Paeng Sung Suk , Park Jae‐Gahb 
Published: August 2002

AbstractTo evaluate the clinicopathologic characteristics of early colorectal cancer (ECC), histopathologic and clinical features of 90 ECC patients who underwent surgical resection (not including the endoscopic polypectomized cases) and 1704 patients with advanced colorectal cancer were analyzed. Smaller size, better histologic differentiation, less lymph node (LN) metastasis, and better clinical outcome were observed in those with ECC than in patients with more advanced lesions. LN metastasis was found in 5 patients with ECC among the 56 patients who underwent bowel resection (8.9%). Tumors with LN metastasis were more frequently associated with deep submucosal invasion, absence of an adenomatous component within the tumor, sessile configuration, and lymphovascular invasion. Tumors showing deep submucosal layer invasion were associated with a more unfavorable histologic grade, lymphovascular invasion, LN metastasis, sessile morphology, and absence of an adenomatous component within the tumor. Recurrence was observed in two patients who underwent local excision for their submucosal cancer. One of the patients was salvaged after bowel resection, but one patient died of distant metastasis. From our data analysis and literature review, extensive submucosal invasion, lymphovascular invasion, sessile configuration, and tumors with no adenomatous component should be considered high risk factors for LN metastasis and recurrence after limited therapy.
Prostate Cancer: Where We Have Been, Where We Are, Where We Are Going
Authors: Brawer Michael K. 
Published: August 2002

AbstractProstate cancer has generated more debate over the last decade than perhaps any other malignancy. This stems from many factors, not the least of which is the fact that the histologic incidence far exceeds clinically manifested disease. Despite this fact, prostate cancer remains the most common male malignancy and the second most common cause of cancer‐related mortality in most Western societies. Significant advances have occurred in virtually all domains surrounding prostate cancer, including increased understanding of the molecular and genetic basis of the disease, improved methods of early detection and screening, refinement of biopsy techniques, and advances in staging and therapeutic approaches. Even with these advances, the sobering mortality statistics clearly underscore the need for further insight and progress.
Parathyroid Xenotransplantation without Immunosuppression in Experimental Hypoparathyroidism: Long‐term In Vivo Function following Microencapsulation with a Clinically Suitable Alginate
Authors: Hasse Christian , Bohrer Thomas , Barth Peter , Stinner Benno , Cohen Richard , Cramer Hubert , Zimmermann Ulrich , Rothmund Matthias 
Published: August 2002

AbstractPermanent hypoparthyroidism is one of the most difficult of all endocrine disorders to treat medically. Because this deficiency syndrome rarely is a life‐threatening condition, systemic immunosuppression for recipients of transgenic transplants is not justified. An alternative would be protecting the tissue to be transplanted from the immunologic response (immunoisolation) by coating it with a semipermeable membrane‐ microencapsulation. Unfortunately, prior to the first clinical use, further analysis of the coating substance (alginate) demonstrated that it has potential cancerogenic properties. Using a purified amitogenic alginate suitable for clinical use, we accomplished allotransplantation in a long‐term animal model and reported the first clinical cases without postoperative immunosuppression recently. In view of the potential clinical use, we investigated the ability of the microencapsulation technology with the novel amitogenic alginate in experimental hypoparathyroidism (80 parathyroidectomized rats) to enable transgenic transplantation across the highest immunologic barrier (xenotransplantation: human to rat) to ensure intact transplant function without immunosuppression. In a controlled, long‐term animal study, the effect of microencapsulation on xenotransplanted human parathyroid tissue was evaluated over a period of 30 weeks (microencapsulated and naked hyperplastic parathyroid tissue, respectively). Functionally, human parathyroid tissue was able to replace that of rats. More than 6 months after xenotransplantation 32 of 40 animals that had received microencapsulated transplants were normocalcemic. In contrast, serum calcium concentrations dropped to postparathyroidectomy levels within 3 weeks in the animals that had received naked tissue only. Correspondingly, normocalcemic animals showed vital parathyroid tissue inside the microcapsules, which were surrounded by a small rim of fibroblasts. When combining microencapsulation with an improved tissue culture method, xenotransplantation of human parathyroid tissue and maintenance of its physiologic function is reproducibly achieved over the highest transplantation barrier. Using the amitogenic alginate may be a crucial step toward the first clinical use of this technique for parathyroid xenotransplantation without immunosuppression.
Distribution and Functional Significance of Somatostatin Receptors in Malignant Melanoma
Authors: Lum Sharon S. , Fletcher William S. , O'Dorisio M. Sue , Nance Robert W. , Pommier Rodney F. , Caprara Moonkung 
Published: August 2002

AbstractMalignant melanoma is a neuroendocrine tumor that contains somatostatin receptors (SSTRs). Adjuvant therapy for melanoma is limited. Because melanomas arise from neural crest cells, we sought to evaluate the distribution of SSTR subtypes found in these tumors and their functional significance by imaging with 111In‐pentetreotide scintigraphy (OctreoScan). Octreotide binds with greatest affinity to SSTR2 and SSTR5. Studying the expression of SSTRs in melanoma may demonstrate a potential role for octreotide in the treatment of melanoma. A series of 23 melanomas from 17 patients who underwent resection of regional or distant metastases were evaluated for the presence of SSTRs by the reverse transcriptase‐polymerase chain reaction (RT‐PCR) using primers specific for SSTR1 through SSTR5. Identity of RT‐PCR products was confirmed by Southern blot analysis. Sixteen patients underwent preoperative OctreoScan. SSTR1 was expressed in 96% of tumors, SSTR2 in 83%, SSTR3 in 61%, SSTR4 in 57%, and SSTR5 in 9%. OctreoScan imaged 63% of tumors. There was no correlation between SSTR subtype expression and OctreoScan result. Most of the melanomas expressed mRNA for SSTR1 and SSTR2, with approximately half expressing SSTR3 and SSTR4. The SSTR mRNA for SSTR2 appears to be transcribed into functional protein that binds 111In‐pentetreotide in more than half of these patients. Although OctreoScan has limited sensitivity for localizing melanomas, tumors that can be imaged by OctreoScan may be amenable to adjuvant therapy with octreotide or targeted therapy with high‐energy radioisotope‐labeled octreotide. These studies clearly define melanoma as a neuroendocrine tumor, which may open new avenues for tumor control.
Diagnosis and Therapy for Ampullary Tumors: 63 Cases
Authors: Chareton B. , Coiffic J. , Landen S. , Bardaxoglou E. , Campion J.P. , Launois B. 
Published: August 2002

AbstractFrom 1970 to 1992 a total of 63 patients underwent operation for ampullary tumor: 40 pancreatoduodenectomies (PDs), 3 total PDs, 8 ampullectomies, and 12 bypass or exploratory laparotomies. The resectability rate was 68%. There were 9 benign tumors, 1 anaplastic tumor, and 53 adenocarcinomas. According to Martin’s classification, there were 7 stage I, 11 stage II, 14 stage III, and 21 stage IV tumors. All patients with stage I, II, and III tumors underwent resection. Patients with stage IV tumors had either resection (n= 11) or bypass (n= 10). The mean duration of hospital stay was 20.6 days. Operative mortality was 12.7% for the whole series and 7.5% after PD (2.5% for the last 10 years). Overall survival was 40% at 5 years (85% for stage I, 65% for stage II, 44% for stage III, and 8% for stage IV). Survival was better for stages I, II, and III after PD than after ampullectomy. For stage IV patients survival was 70% after PD versus 20% after bypass at 1 year and 25% versus 0% after 2 years. In our opinion, PD should be proposed even for benign lesions because two of our patients had to undergo repeat operation (PD) 4 and 22 years later, respectively, for stage IV disease. PD is our choice for all tumors of the ampulla.
Selective Nonoperative Management of Abdominal Stab Wounds: Prospective, Randomized Study
Authors: Leppäniemi Ari K. , Haapiainen Reijo K. 
Published: August 2002

AbstractIn a prospective, randomized trial the safety and cost‐effectiveness of selective nonoperative management was compared to mandatory laparotomy in patients with abdominal stab wounds not requiring immediate laparotomy for hemodynamic instability, generalized peritonitis, or evisceration of abdominal contents. Fifty‐one patients were randomly assigned to mandatory laparotomy or expectant nonoperative management and compared for early (<90 days) mortality and morbidity, length of hospital stay, and hospital costs. There was no early mortality. The morbidity rate was 19% following mandatory laparotomy and 8% after observation (p= 0.26). Four patients (17%) managed nonoperatively required delayed laparotomy. The hospital stay was shorter in the observation group (median 2 days versus 5 days;p= 0.002). About $2800 (US) was saved for every patient who underwent successful nonoperative management. It is concluded that selective nonoperative management of abdominal stab wounds, although resulting in delayed laparotomy in some patients, is safe and the preferred strategy for minimizing the days in hospital with concomitant savings in hospital costs. Mandatory laparotomy detects some unexpected organ injuries earlier and more accurately but results in a high nontherapeutic laparotomy rate and surgical management of minor injuries that in many cases could be managed nonoperatively.
Efficacy and Safety of a Low‐Molecular‐Weight Heparin and Standard Unfractionated Heparin for Prophylaxis of Postoperative Venous Thromboembolism: European Multicenter Trial
Authors: Kakkar V.V. , Boeckl O. , Boneu B. , Bordenave L. , Brehm O.A. , Brücke Peter , Coccheri S. , Cohen A.T. , Galland F. , Haas S. , Jarrige J. , Koppenhagen K. , LeQuerrec A. , Parraguette E. , Prandoni P. , Roder J.D. , Roos M. , Rüschemeyer C. , Siewert J.R. , Vinazzer H. , Wenzel E. 
Published: August 2002

AbstractA randomized, double‐blind multicenter trial was performed to compare the safety and efficacy of a new low‐molecular‐weight heparin (LMWH) (LU 47311, Clivarine) and standard unfractionated heparin for the prophylaxis of postoperative venous thromboembolism. Altogether 1351 patients scheduled to undergo abdominal surgery were included. Main outcome measures included the incidence of thromboembolic events (deep vein thrombosis, pulmonary embolism, or both) and bleeding complications, including wound hematoma. A total of 655 patients received 1750 anti‐Xa IU of LMWH plus a placebo injection daily; 677 patients received 5000 IU of unfractionated heparin (UFH) twice a day. Both drugs were found to be equally effective, as 4.7% of patients in the LMWH group and 4.3% in the UFH group developed postoperative thromboembolic complications. However, the incidence of bleeding complications was significantly reduced in the LMWH group: 55 (8.3%) patients in the LMWH group and 80 (11.8%) in the UFH group developed bleeding complications, a relative risk (RR) of 0.70 (95% CI 0.51–0.97;p= 0.03); wound hematoma occurred in 29 (4.4%) of the LMWH group compared with 55 (7.7%) in those in the UFH group for an RR of 0.57 (95% CI 0.37–0.88;p= 0.01). This study confirmed that a very low dose of 1750 anti‐Xa IU daily of this new LMWH is as effective as 10,000 IU of UFH for preventing postoperative deep vein thrombosis. At this dose its administration is associated with a significant reduction in the risk of bleeding including wound hematoma.
Local Excision of Rectal Cancer
Authors: Bleday Ronald 
Published: August 2002

AbstractThe prospect of treating a rectal cancer often leads to significant fear among patients because of the possibility of a permanent colostomy. Although radical resection, in particular abdominoperineal resection, has been used effectively for rectal cancer treatment, other techniques such as local excision with or without adjuvant therapy have been used with significantly less morbidity than that of the abdominoperineal resection, with excellent cure rates. There are essentially three local excision techniques that can be used to remove a small rectal cancer completely. Selection criteria are critical for choosing the appropriate patient for these techniques. Tumors must be less than 4 cm in diameter and take up less than 40% of the rectal wall circumference. They also need to be relatively close to the dentate line and have no evidence of any invasion into the mesorectum or perirectal nodes. Preoperative staging with endorectal ultrasonography, computed tomography, and digital examination helps select appropriate patients. Retrospective series have shown significant success using local excision techniques, with local recurrence rates ranging from 0% to 11% for early‐stage lesions. Prospective series have shown similar recurrence rates. Postoperative function with or without adjuvant therapy has not been adequately documented along with quality of life and must be part of any future reports on local excision techniques as well as all rectal cancer treatment studies. Local excision does, however, seem to provide adequate treatment in well selected patients and provides a less morbid alternative to the treatment of rectal cancer than radical resection, particularly abdominoperineal resection, which obligates the patient to a permanent colostomy.
Soft Tissue Infections
Authors: Lewis Ronald T. 
Published: August 2002

AbstractSoft tissue infections vary widely in their nature and severity, and their nomenclature is confusing. A clear approach to management must allow rapid identification and treatment of the diffuse necrotizing infections because they are life‐threatening. This review classifies soft tissue infections by their degree of localization and the presence of tissue necrosis. Most focal nonnecrotizing infections start in the skin or adnexae and are easily recognized and readily treated by local measures. Patients with cellulitis, the commonest diffuse nonnecrotizing infection, should be stratified from mild to severe and complicated and then treated with oral or systemic antibiotics. Focal necrotizing infections are relatively uncommon, but they are readily diagnosed on sight and effectively managed by local débridement and systemic antibiotics. In contrast, diffuse necrotizing infections may masquerade in many forms, delaying diagnosis and treatment. Edema out of proportion to erythema, subcutaneous gas, and skin vesicles are important markers. Aggressive sequential débridement and broad‐spectrum intravenous antibiotics revised after 48 hours provide the best strategy for management.
Systematic Lymph Node Dissection for Clinically Diagnosed Peripheral Non‐Small‐Cell Lung Cancer Less Than 2 cm in Diameter
Authors: Sugi Kazuro , Nawata Kouichi , Fujita Nobuhiro , Ueda Kazuhiro , Tanaka Toshiki , Matsuoka Takahisa , Kaneda Yoshikazu , Esato Kensuke 
Published: August 2002

AbstractThe value of radical systematic lymphadenectomy for treatment of early‐stage bronchial carcinoma is controversial. We performed a prospective randomized study to address this question. Altogether 115 patients with peripheral non‐small‐cell lung cancers smaller than 2 cm in diameter were enrolled in this study. They were randomly assigned into a lobectomy with lymph node sampling group (sampling group, n= 56) or a lobectomy with radical systematic lymph node dissection group (dissection group,n= 59). Inclusion criteria were based only on preoperative clinical studies. Four tumors were larger than 2 cm postoperatively. One patient had disseminated disease, and two had intrapulmonary metastases discovered at surgery. Two patients had small‐cell carcinoma. There were four with pathologic N1 disease and seven with N2 disease in the dissection group and three with N1 and eight with N2 disease in the sampling group. The numbers of local and distant recurrences were two and six, respectively, in the dissection group and two and five in the sampling group. The overall 5‐year survival was 81% in the dissection group and 84% in the sampling group. No significant differences in the recurrence rate or survival was seen between the groups. Our results demonstrate that clinically evaluated peripheral non‐small‐cell carcinomas smaller than 2 cm in diameter do not require radical systematic mediastinal and hilar lymph node dissection.
Penetrating Chest Injuries: Unusually High Incidence of High‐velocity Gunshot Wounds in Civilian Practice
Authors: Inci Ilhan , Özçelik Cemal , Taçyildiz Ibrahim , Nizam Özgür , Eren Nesimi , Özgen Gökalp 
Published: August 2002

AbstractPenetrating chest injuries are a challenge to the thoracic or trauma surgeon. Penetrating thoracic trauma, especially that due to high‐velocity gunshot wounds, is increasing at an alarming rate in our region. We report our experience with penetrating chest injuries mainly due to high‐velocity gunshot wounds. During a period of 6 years we retrospectively reviewed the hospital records of 755 patients admitted to the Department of Thoracic and Cardiovascular Surgery, Dicle University School of Medicine, with the diagnosis of penetrating thoracic trauma. The mean age was 27.48 years, and 89.8% were male. The causes of penetrating injury were stab wounds in 45.3% and gunshot wounds in 54.7%. About 30% of the wounds were due to high‐velocity gunshots; and among the gunshot wounds 56.2% were due to high‐velocity shots. The most common thoracic injury was hemothorax
(n= 190) followed by hemopneumothorax (n= 184). Isolated thoracic injuries were found in 53% of the patients. Nonoperative management was sufficient in 92% of the patients. Thoracotomy was performed in 8.1%. The mean duration of hospitalization was 11.2 days. The mean injury severity score (ISS) was 20.17 ± 13.87. The morbidity was 23.3% and the mortality 5.6%. Fifty percent of all deaths were due to adult respiratory distress syndrome. Altogether 17% of patients with an ISS >25 died, whereas only 0.9% of those with a score <16 died. The mortality due to firearms was 8.95%. We concluded that in civilian practice chest tube thoracostomy remains by far the most common method of treating penetrating injury to the chest. The easy availability of high‐velocity guns will continue to increase the number of civilians injured by these weapons.
Long‐term Results of Polyglactin Mesh for the Prevention of Incisional Hernias in Obese Patients
Authors: Pans Alain , Elen Philippe , Dewé Walthère , Desaive Claude 
Published: August 2002

AbstractThe aim of this study was to compare prospectively the incidence of incisional hernia in two groups of patients operated on for morbid obesity, with or without intraperitoneal polyglactin mesh. From October 1990 to September 1993, a total of 288 patients were randomly assigned to the two groups. There were 144 patients in the mesh group and 144 in the no‐mesh group. Altogether 240 patients (83%) were reviewed personally, 45 (16%) were interviewed by phone (n= 39) or mail (n= 6), and 3 (1%) were inaccessible for follow‐up since discharge from the hospital. The mean follow‐up period was 29.8 months (range 0–67 months). A total of 33 incisional hernias were observed in the mesh group and 41 in the no‐mesh group. There was no significant difference in the distribution of herniation time between the two groups (p= 0.43). The two main predictive factors of herniation were age and weight. In conclusion, the use of an intraperitoneal polyglactin mesh does not prevent postoperative incisional hernias in obese patients.
Redifferentiation Therapy with Retinoids: Therapeutic Option for Advanced Follicular and Papillary Thyroid Carcinoma
Authors: Simon Dietmar , Koehrle Josef , Reiners Christoph , Boerner Anne R. , Schmutzler Cornelia , Mainz K. , Goretzki Peter E. , Roeher Hans D. 
Published: August 2002

AbstractDuring the course of tumor progression the differentiated morphologic and functional characteristics of differentiated thyroid carcinomas (DTC) disappear. This corresponds to more aggressive growth, metastatic spread, and loss of iodine uptake. Experimental data give strong evidence that differentiated functions of iodine metabolism can be reinduced by retinoic acids. Results of a study performed in patients with advanced DTC are presented. Twenty patients with DTC (eight follicular, seven papillary, five oxyphilic) were selected for treatment with retinoic acid 1.5 mg/kg body weight/day over 5 weeks. All patients had advanced tumor stages with prior operative and radioiodine treatment. Extensive tumor invasion, distant metastatic spread, or insufficient or no radioiodine uptake precluded any conventional therapeutic option. The aim was to assess the changes under retinoid treatment. Iodine uptake increased in eight patients (three follicular, three papillary, two oxyphilic). Thyroglobulin (TG) as parameter for tumor mass and differentiation increased in 12 (63%) patients, decreased in 6 (32%), and did not change in 1 (5%). Retinoids do have an effect on differentiation status of DTC, reinducing iodine uptake in 50% of patients. TG levels do not always parallel a response in iodine uptake.