bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized clinical trial comparing conservative and surgical treatment of neurogenic faecal incontinence
Authors: Österberg A , Edebol Eeg-Olofsson K , Hålldén M , Graf W 
Published: June 2004

Abstract

Background
The treatment of choice in idiopathic (neurogenic) faecal incontinence is controversial. In a randomized study levatorplasty was compared with anal plug electrostimulation of the pelvic floor with respect to functional outcome and physiological variables.

Methods
Thirty-one patients underwent levatorplasty and 28 anal plug electrostimulation of the pelvic floor over 3 years. The results were evaluated at 3, 12 and 24 months after completion of treatment by means of a validated questionnaire and anorectal manometry and manovolumetry.

Results
Incontinence scores were significantly reduced during the entire observation period in both groups (P &lt; 0·001) as was the use of pads (P = 0·003 to P &lt; 0·001). The proportion of patients reporting improvement in physical and social handicap was greater in the levatorplasty group after 3, 12 and 24 months (P = 0·036 to P &lt; 0·001). No significant changes in physiological variables were observed in either group.

Conclusion
Better results were obtained with levatorplasty than with anal plug electrostimulation of the pelvic floor in patients with idiopathic (neurogenic) faecal incontinence. Levatorplasty should be therefore be considered the treatment of choice for this condition.
Prospective survey of factors affecting risk discussion during consent in a surgical specialty
Authors: Pleat J M , Dunkin C S J , Davies C E , Ripley R M , Tyler M P H 
Published: June 2004

AbstractBackgroundThe Department of Health in the UK has developed new consent guidance but without clear recommendations on how the incidence and severity of a given risk should influence its discussion during the process of obtaining informed consent. Plastic surgery is a litigation-prone specialty that offers a paradigm for assessing attitudes to consent.MethodsA questionnaire was sent to all surgeons at six plastic and reconstructive surgery units within the UK. It enquired what incidence of a relatively frequent minor severity risk such as wound infection, or an extremely rare but major risk such as stroke, would merit its discussion when obtaining informed consent for elective surgery.ResultsSixty of 85 questionnaires were returned. For a minor risk, there was a consensus that an incidence threshold of 5 per cent or greater would necessitate its discussion. For a major risk, the modal threshold was 0·1 per cent, but there was a greater variability of response.ConclusionThere was a wide variation of opinion as to how frequently a major risk must occur before it is likely to be conveyed to a patient during the process of consent. The findings suggest that recent change in case law has yet to disseminate fully in one surgical specialty, with the potential for the challenge that consent is not ‘informed’.
Surgical management of primary anorectal melanoma
Authors: Pessaux P , Pocard M , Elias D , Duvillard P , Avril M-F , Zimmerman P , Lasser P 
Published: June 2004

Abstract

Background
This aim of this study was to analyse outcome after surgery for primary anorectal melanoma and to determine factors predictive of survival.

Methods
Records of 40 patients treated between 1977 and 2002 were reviewed.

Results
Twelve men and 28 women of mean age 58·1 (range 37–83) years were included in the analysis. Overall and disease-free survival rates were 17 and 14 per cent at 5 years. Median overall survival was 17 months and disease-free survival was 10 months. The 5-year survival rate was 24 per cent for patients with stage I tumours, and zero for those with stage II or stage III disease. There was no significant difference in overall survival after wide local excision (49 and 16 per cent at 2 and 5 years respectively) and abdominoperineal resection (33 per cent at both time points). In patients with stage I and stage II disease, there was a significant association between poor survival and duration of symptoms (more than 3 months), inguinal lymph node involvement, tumour stage and presence of amelanotic melanoma.

Conclusion
Anorectal melanoma is a rare disease with a poor prognosis. Wide local excision is recommended as primary therapy if negative resection margins can be achieved.
Economic impact of laparoscopic versus open abdominal rectopexy
Authors: Salkeld G , Bagia M , Solomon M 
Published: June 2004

Abstract

Background
The introduction of new laparoscopic techniques has important cost implications. The aim of this study was to compare the cost effectiveness of laparoscopic rectopexy with that of open abdominal rectopexy for full-thickness rectal prolapse.

Methods
A cost effectiveness study was conducted alongside a randomized trial of laparoscopic versus open abdominal rectopexy.

Results
The efficacy trial demonstrated significant subjective and objective differences in favour of the laparoscopic technique. The mean operating time was 51 min longer for laparoscopic rectopexy than for the open procedure. Laparoscopic disposables incurred a mean cost of £291 per patient. The mean duration of hospital stay was significantly shorter for the laparoscopic group (P = 0·001). Laparoscopic rectopexy was associated with an overall mean cost saving of £357 (95 per cent confidence interval £164 to £592; P = 0·042) per patient.

Conclusion
Laparoscopic rectopexy is associated with superior clinical outcomes and is cheaper than the open approach.
Structure and unexpected chiroptical properties of chiral 4‐pyrrolidinyl substituted 2(5H)‐furanones
Authors: Gawroński Jacek , Gawrońska Krystyna , Kwit Marcin , Kacprzak Karol , Rychlewska Urszula 
Published: June 2004

AbstractPlanar 2(5H)‐furanones substituted at C4 with a chiral pyrrolidinyl group show CD spectra which are apparently due to the distortion of the C4‐N1 bond of sp2 character from the plane defined by the 2(5H)‐furanone ring atoms and/or due to the presence of substituents in the pyrrolidine ring. This is a new, previously not encountered structural factor determining the chiroptical properties of 2(5H)‐furanones and emerging from the analysis of X‐ray diffraction data and quantum mechanical DFT computations. In the presence of a C5 pseudoaxial substituent in the furanone ring, the sign of the furanone n–π* and π–π* transition Cotton effects is determined primarily by the previously postulated allylic helicity rule. Chirality 16:405–413, 2004. © 2004 Wiley‐Liss, Inc.
Concomitant versus sequential administration of epirubicin and paclitaxel as first‐line therapy in metastatic breast carcinoma
Authors: Conte Pier Franco , Guarneri Valentina , Bruzzi Paolo , Prochilo Tiziana , Salvadori Barbara , Bolognesi Angelo , Aldrighetti Daniela , Venturini Marco , Rosso Riccardo , Mammoliti Serafina , Carnino Flavio , Giannessi Piergiorgio , Costantini Massimo , Moyano Alfredo , Baldini Editta ,   on behalf of the Gruppo Oncologico Nord Ovest
Published: June 2004

AbstractBACKGROUNDThe authors performed a randomized trial comprising patients with metastatic breast carcinoma (MBC). They used a noninferiority design to evaluate whether the results of sequential administration of epirubicin and paclitaxel were not markedly worse than the concomitant administration in terms of objective response rates (ORRs). Toxicity profile, quality of life (QOL), and pharmacoeconomic evaluations were evaluated as well.METHODSIn the current study, 202 patients with MBC were randomized to receive either the combination of epirubicin at a dose of 90 mg/m2 plus paclitaxel at a dose of 200 mg/m2 for 8 cycles (concomitant arm, n = 108) or epirubicin at a dose of 120 mg/m2 for 4 cycles followed by paclitaxel at a dose of 250 mg/m2 over 3 hours for 4 cycles every 21 days (sequential arm, n = 94).RESULTSThe authors rejected the null hypothesis that the sequential treatment is less active than the standard concomitant regimen (ORRs: concomitant = 58.5%, sequential = 57.6%). The median progression‐free and overall survival periods were 11.0 months (95% confidence interval [95% CI], 9.7–12.3) and 20.0 months (95% CI, 17.2–22.6), respectively, in the concomitant arm and 10.8 months (95% CI, 7.9–13.6) and 26 months (95% CI, 18.1–33.8), respectively, in the sequential arm (P = not significant). Patients who received the sequential regimen experienced a higher incidence of Grade 3/4 (according to the World Health Organization grading system) neutropenia (62.2% of courses vs. 50.62%; P = 0.003) and Grade ≥ 2 neuropathy (45.5% vs. 30.4% of patients; P = 0.03), whereas 6 patients who received the concomitant regimen developed Grade II cardiotoxicity according to New York Heart Association criteria. QOL analyses failed to provide clear differences.CONCLUSIONSThe sequential administration of epirubicin and paclitaxel at full doses was found to be as active as their association. Therefore, both the sequential and the combined administration were acceptable options. Cancer 2004. © 2004 American Cancer Society.
Flow cytometric analysis of isolated liver mitochondria to detect changes relevant to cell death
Authors: Mattiasson Gustav 
Published: June 2004

AbstractBackgroundMitochondria are key players in many forms of cell death, and mitochondrial production of reactive oxygen species (ROS), membrane depolarization, permeability changes, and release of apoptogenic proteins are involved in these processes. Flow cytometric analysis of isolated mitochondria enables parallel analysis of mitochondrial structure and function in individual mitochondria, and small mitochondrial samples are sufficient for analysis. This article describes a well‐characterized protocol for flow cytometric analysis of isolated liver mitochondria that can be used to detect mitochondrial alterations relevant to cell death.MethodsFluorescent probes were used to selectively stain mitochondria (nonyl acridine orange), and to measure membrane potential (tetramethylrhodamine‐methyl‐ester, 1,1′,3,3,3′,3′‐hexamethylindodicarbocyanine‐iodide), as well as production of ROS (2′,7′‐dichlorodihydrofluorescein‐diacetate). Calcium‐induced mitochondrial swelling was detected as a decrease in SSC. To ensure optimal concentrations of all probes, the effect on mitochondrial respiration was evaluated.ResultsThis protocol can be used to determine the purity of the mitochondrial preparation, to detect calcium‐induced morphological changes, small mitochondrial de‐ and hyperpolarizations, as well as physiological changes in ROS generation.ConclusionsFlow cytometry is a very useful tool to simultaneously analyze several mitochondrial parameters that are important in the induction of mitochondria‐mediated cell death. © 2004 Wiley‐Liss, Inc.
Synthesis and Crystal Structure of Cs2(CN3H6)3[(C2H5)2NH2][W7O22(O2)2]·3H2O
Authors: Suzuki Hiroyuki , Hashimoto Masato , Okeya Seichi 
Published: June 2004

AbstractA novel diperoxoheptatungstate was crystallised as a Cs+−CN3H6+−(C2H5)2NH2+ salt and characterised by a single‐crystal X‐ray diffraction method. The anion has a Lindqvist heptametallate structure. The metal atoms are located in a bent 2‐3‐2 arrangement with the central W3 section (W3, W4 and W5) as the hinge. The peroxo groups coordinate the tungsten atoms at both ends of the W3 section (W3 and W5). In the crystal polyanions, caesium and guanidinium cations, and water of crystallisation form tunnel‐like cavities, and the diethylammonium cations are accommodated in the cavities, suggesting a clathrate‐like feature for the compound. (© Wiley‐VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2004)
Use of caesium‐137 data to evaluate SHETRAN simulated long‐term erosion patterns in arable lands
Authors: Norouzi Banis Y. , Bathurst J. C. , Walling D. E. 
Published: June 2004

AbstractThe caesium‐137 method of quantifying soil erosion is used to provide field data for validating the capability of the SHETRAN modelling system for predicting long‐term (30‐year) erosion rates and their spatial variability. Simulations were carried out for two arable farm sites (area 3–5 ha) in central England for which average annual erosion rates of 6·5 and 10·4 t ha−1 year−1 had already been determined using caesium‐137 measurements. These rates were compared with a range of simulated values representing the uncertainty in model output derived from uncertainty in the evaluation of model parameters. A successful validation was achieved in that the simulation range contained the measured rate at both sites, whereas the spatial variability was reproduced excellently at one site and partially at the other. The results indicate that, as the caesium‐137 technique measures the erosion caused by all the processes acting at a site, it is relevant to hydrologically based models such as SHETRAN only if erosion by wind, agricultural activities and other processes not represented in the model are insignificant. The results also indicate a need to reduce the uncertainty in model parameter evaluation. More generally, the caesium‐137 technique is shown to provide field data that improve the severity of the validation procedure (accounting for internal as well as outlet conditions) and that add spatial variability to magnitude as a condition for identifying unrealistic parameter sets when seeking to reduce simulation uncertainty. Copyright © 2004 John Wiley & Sons, Ltd.
An in vivo study of hydrogels based on physiologically clotted fibrin–gelatin composites as wound‐dressing materials
Authors: Noorjahan S.E. , Sastry T.P. 
Published: June 2004

AbstractIn this study we have reported the efficacy of three biomaterials: (a) physiologically clotted fibrin–gelatin composite (PFG), (b) PFG graft copolymerized with 2‐hydroxyethyl methacrylate (PFG–HEMA), and (c) PFG graft copolymerized with 2‐hydroxypropyl methacrylate (PFG–HPMA) as temporary wound‐dressing materials using the rat as an animal model. Full‐thickness excision wounds were made on the back of female rats weighing about 150 ± 10 g. The dressings were applied on the wounds and changed periodically at an interval of 4 days with the respective materials. The wounds treated with PFG–HEMA healed completely on 15th day after wound creation, whereas those treated with PFG and PFG–HPMA resulted in complete healing on the 17th day. The concentrations of collagen, hexosamine, and uronic acid in the granulation tissue were determined. The PFG and its graft copolymers acted as hydrogels, thereby absorbing excess exudates, while still maintaining a moist environment at the wound site. The enhanced wound healing in the experimental animals was reflected in the increased rate of wound contraction. The results of the histological and mechanical studies of the experimental groups revealed that reepithelialization and remodeling of the skin have been achieved by providing a moist environment at the wound site by the biomaterials and thereby hastening the migration of keratinocytes. © 2004 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 71B: 305–312, 2004
Flexural strength of dental composite restoratives: Comparison of biaxial and three‐point bending test
Authors: Chung S. M. , Yap A. U. J. , Chandra S. P. , Lim C. T. 
Published: June 2004

AbstractThis study compared two test methods used to evaluate the flexural strength of resin‐based dental composites. The two test methods evaluated were the three‐point bending test4 and the biaxial flexural test. Materials used in this investigation were from the same manufacturer (3M ESPE) and included microfill (A110), minifill (Z100 and Filtek Z250), polyacid modified (F2000), and flowable [Filtek Flowable (FF)] composites. Flexural strength was determined with the use of both test methods after 1 week of conditioning in water at 37°C. Data were analyzed with the use of an ANOVA/Scheffé test and an independent‐samples t test at significance level 0.05. Mean flexural strength (n = 7) ranged from 66.61 to 147.21 and 67.27 to 182.81 MPa for three‐point bending and ball‐on‐three‐ball biaxial test methods, respectively. In both test methods, Z100 was significantly stronger than all other composites evaluated. In the three‐point bending test, flexural strength of Z250 was significantly higher than A110, F2000 and FF, and FF was significantly stronger than A110 and F2000. The biaxial test method arrived at the same conclusions except that there was no significant difference between Z250 and FF. Pearson's correlation revealed a significantly (p < 0.01) positive and good correlation (R2 = 0.72) in flexural strength between the two test methods. Although the biaxial test has the advantage of utilizing small specimens, the low reproducibility of this test method does not support the proposition that it is a more reliable test method when compared to the ISO three‐point bending test. © 2004 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 71B: 278–283, 2004
Modelling of Cr(VI) removal from polluted groundwaters by ion exchange
Authors: Rivero María J , Primo Oscar , Ortiz M Inmaculada 
Published: June 2004

AbstractThis work reports the viability and modelling of the removal of Cr(VI) from polluted groundwaters by means of ion exchange using the resin Lewatit MP‐64. Feed groundwaters that contained Cr(VI) at an average concentration of 2431 mg dm−3 and 1187 mg dm−3 of chloride and 1735 mg dm−3 of sulfate as main anions were acidified to a pH of 2.0 prior to the removal process. Dynamic experiments were carried out in a fixed bed column with feed waters at flow rates in the range of 2.78 × 10−7 m3 s−1 to 5.55 × 10−7 m3 s−1. Regeneration was achieved with NaOH (2 mol dm−3). From the experimental results, the equilibrium of the ion exchange reaction was successfully modelled, obtaining an equilibrium constant (K′AB) = 44.90. Finally, a mass balance that included mass transfer resistances in the liquid and solid phases was developed and from the comparison between simulated and experimental data the value of the effective intraparticle diffusivity (Ds) was determined as 1.43 × 10−12 m2 s−1. Copyright © 2004 Society of Chemical Industry
Claw‐free 3‐connected P11‐free graphs are hamiltonian
Authors: Łuczak Tomasz , Pfender Florian 
Published: June 2004

AbstractWe show that every 3‐connected claw‐free graph which contains no induced copy of P11 is hamiltonian. Since there exist non‐hamiltonian 3‐connected claw‐free graphs without induced copies of P12 this result is, in a way, best possible. © 2004 Wiley Periodicals, Inc. J Graph Theory 47: 111–121, 2004
Micro Construction of Poly(ε‐caprolactone)/Poly(L‐lactic acid) Blend Film by Solution Casting under Microwave Irradiation
Authors: Jin Wei , Liu Lijian 
Published: June 2004

AbstractSummary: The micro construction of poly(ε‐caprolactone) (PCL) and poly(L‐lactic acid) (PLLA) blend films fabricated by solution casting under microwave irradiation was investigated by selective enzymatic degradation and scanning electron microscopy (SEM).The results were totally different from the blends obtained by conventional methods. The blend was more homogeneous and the PCL continuous phase more compact as no spherulites and tiny zone separation were observed from the film surface and no PCL network was observed inside the film, and the degradation of a PCL plank by Pseudomonas lipase was significantly retarded. The distributed PLLA micro spheres were enlarged and amorphous. The thermal behavior of the blend by microwave heating revealed that PCL and PLLA underwent a melting process, which induced the variations of the PCL phase and PLLA spheres.The weight loss caused by degradation of the PCL/PLLA blend obtained by conventional methods (B50c) is greater than that of the blend obtained by microwave methods (B50m), which reflects the change in morphology from a loose PCL network (B50c) to a dense PCL plank (B50m).magnified imageThe weight loss caused by degradation of the PCL/PLLA blend obtained by conventional methods (B50c) is greater than that of the blend obtained by microwave methods (B50m), which reflects the change in morphology from a loose PCL network (B50c) to a dense PCL plank (B50m).
Hydrogel Networks of Poly(ethylene oxide) Star‐Molecules Supported by Expanded Polytetrafluoroethylene Membranes: Characterization, Biocompatibility Evaluation and Glucose Diffusion Characteristics
Authors: Alexandre Eliane , Schmitt Bertrand , Boudjema Karim , Merrill Edward W. , Lutz Pierre J. 
Published: June 2004

AbstractSummary: The present work discusses the grafting by electron beam irradiation of poly(ethylene oxide) (PEO) star‐shaped polymers onto porous expanded polytetrafluoroethylene (EXPTFE) surfaces. The resulting materials are intended to combine the good biocompatible properties of PEO with the outstanding mechanical properties of PTFE. The star‐shaped PEOs were synthesized via anionic polymerization. 3 Mev electron beam irradiation was applied to graft these PEO stars onto porous EXPTFE surfaces. The hydrophobic EXPTFE surface had to be pre‐modified with N‐vinylpyrrolidone. ESCA was used to quantify the amount of grafted star‐shaped PEO. Unmodified EXPTFE surfaces are well known, when implanted in a body, to be rapidly covered by a layer of cells and fibrin. The EXPTFE coated with PEO were implanted in the peritoneal cavity of rats (or under the back skin). This implantation did not induce any inflammation reactions and SEM analysis had attested the absence of adsorbed cells and fibrin. The glucose diffusion properties of these membranes were studied by a lag time analysis method and compared to those of pure PEO hydrogels. As expected, glucose diffuses through the hydrogel coated membrane and diffusion is not affected by the presence of the EXPTFE membrane.EXPTFE surface before (left) and after (right) PEO hydrogel grafting.magnified imageEXPTFE surface before (left) and after (right) PEO hydrogel grafting.
Cover Picture: Macromol. Mater. Eng. 6/2004
Authors: Bourbigot Serge , Le Bras Michel , Duquesne Sophie , Rochery Maryline 
Published: June 2004

Cover: Intumescent structure obtained after burning poly(propylene) containing an intumescent formulation in the conditions of the limiting oxygen index (LOI) test.Further details can be found in the Feature Article by S. Bourbigot,* M. Le Bras, S. Duquesne, and M. Rochery on page 499.
Carboplatin‐based chemotherapy for refractory and recurrent Ewing's tumours
Authors: Whelan Jeremy S. , McTiernan Anne , Kakouri Eleni , Kilby Anne 
Published: June 2004

AbstractBackgroundFailure of first line therapy for the Ewing's family of tumours (EFT) is associated with a very poor outlook. Studies of second line chemotherapy are therefore necessary to identify active agents and drug combinations. Cisplatin‐based therapy is frequently used in these circumstances but there are few studies to clearly define activity and toxicity. This report details outcome in a cohort of patients with poor risk EFT treated with a carboplatin‐based combination.ProcedureBetween 1990 and 1998, 23 males and 16 females aged between 6 and 48 years (median 23) with relapsed or refractory EFT were treated with carboplatin‐based chemotherapy. Previous chemotherapy had included ifosfamide and doxorubicin in all but two patients. Twenty patients were treated at the time of recurrence, and 19 after a poor response to initial chemotherapy. Treatment comprised of carboplatin to give an area under the plasma carboplatin concentration versus time curve of (AUC) 6 mg/ml, etoposide 120 mg/m2 for 3 days, and cyclophosphamide 500–750 mg/m2 for 2 days, repeated every 21 days.ResultsA total of 105 cycles were given, median 2 per patient (range 1–5). Overall response was 26%, with one complete response and nine partial responses. Median time to progression was 10 weeks (range 2–54). Haematological toxicity was severe requiring dose reductions in 53% of patients. Six patients proceeded to high dose consolidation treatment with bone marrow or peripheral stem cell rescue.ConclusionsThis combination results in a substantial response rate in previously treated patients but with significant toxicity. Responses are, however, relatively short. © 2004 Wiley‐Liss, Inc.