bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolution of surgical treatment for pharyngeal pouch
Authors: Aly A , Devitt P G , Jamieson G G 
Published: May 2004

Abstract

Background
The development of endoscopic techniques, particularly endoscopic stapling, has led to a re-evaluation of the treatment of pharyngeal pouch. The pathophysiology and treatment of the condition is reviewed.

Methods
An electronic literature search was undertaken on the pathophysiology, history and surgery of pharyngeal pouch (Zenker's diverticulum). These last two terms were used to the search the Cochrane, Medline and Embase databases (from 1966 to date) and the bibliographies of extracted articles.

Results and conclusion
With recognition of the central role of the cricopharyngeus muscle in the pathogenesis of pouch formation, the emphasis on treatment has shifted from diverticulectomy to cricopharyngeal myotomy. Minimally invasive techniques have become established since the advent of endoscopic stapling devices. Although randomized controlled data are lacking, the endoscopic approach appears to offer advantages in terms of a shorter duration of anaesthesia, more rapid resumption of oral intake, shorter hospital stay and quicker recovery. It is associated with excellent success rates and minimal morbidity.
Systematic review of safety and effectiveness of an artificial bowel sphincter for faecal incontinence
Authors: Mundy L , Merlin T L , Maddern G J , Hiller J E 
Published: May 2004

Abstract

Background
The aim was to determine the safety and effectiveness of the implantation of an artificial bowel sphincter for the treatment of severe faecal incontinence.

Method
Medical bibliographic databases, the internet and reference lists were searched from January 1966 to January 2003. Only the lowest level of evidence was available for inclusion in this systematic review. Case series and case reports were selected to assess safety, whereas only case series were selected to assess effectiveness.

Results
Fourteen studies met the inclusion criteria. A number of safety issues were reported, including high explantation rates, and rates of adverse events owing to infection, device malfunction, ulceration and pain. Results in published reports were not analysed on an intention-to-treat basis. Continence, quality of life and manometry scores were reported for patients with a functioning device at the end of follow-up. These patients experienced a significant improvement in their level of continence. As no outcome data were presented for those with a non-functioning or explanted device, it is possible that such patients may have a worsened degree of incontinence or decreased quality of life.

Conclusion
Implantation of an artificial bowel sphincter is of uncertain benefit and may possibly harm many patients. Patient selection is therefore critical and should be enhanced by higher-quality research.
Early postoperative small bowel obstruction
Authors: Sajja S B S , Schein M 
Published: May 2004

AbstractBackgroundEarly postoperative small bowel obstruction (EPSBO) is a distinct clinical entity that is often difficult to differentiate from postoperative ileus.MethodsA literature search was performed for articles dealing with early postoperative small bowel obstruction using Medline and Google™.Results and conclusionWhen bowel function does not return within 5 days after surgery, causes of persistent ileus should be excluded and treated. Most instances of mechanical EPSBO can be treated expectantly for at least 10–14 days with almost no risk of bowel strangulation. Some causes of obstruction (for example herniation at a laparoscopic trocar site) require early reintervention, whereas in other cases (such as radiation enteritis, carcinomatosis) reintervention may be deferred indefinitely. Many episodes of EPSBO resolve without the cause being elucidated.
Late follow-up of a randomized trial of surgery plus tamoxifen versus tamoxifen alone in women aged over 70 years with operable breast cancer
Authors: Fennessy M , Bates T , MacRae K , Riley D , Houghton J , Baum M 
Published: May 2004

Abstract

Background
Breast cancer has been considered a more indolent disease in the elderly, who are less tolerant of aggressive therapy. This trial tested the hypothesis that tamoxifen without surgery would provide adequate control of breast cancer for the remainder of life in elderly women, thereby sparing them surgery.

Method
Women aged over 70 years with operable, invasive breast cancer were randomized to receive either tamoxifen alone or surgery plus tamoxifen. Time to treatment failure (TTF), indicating initial primary treatment failure, was the primary endpoint. Overall mortality, and death from breast cancer were also compared between the two groups.

Results
Between 1984 and 1991, 455 patients were included in the trial. The analysis was based on a median follow-up of 12·7 years. The TTF was significantly shorter in the tamoxifen alone group: hazard ratio (HR) 4·41 (95 per cent confidence interval (c.i.) 3·31 to 5·88). Ninety-three (40·4 per cent) of 230 patients randomized to tamoxifen alone underwent surgery for the management of their disease. Both overall mortality and mortality from breast cancer were significantly increased in the tamoxifen alone group, although the survival curves did not diverge for the first 3 three years: HR 1·29 (95 per cent c.i. 1·04 to 1·59) and 1·68 (95 per cent c.i. 1·15 to 2·47) respectively.

Conclusion
Omission of primary surgery in unselected elderly women with operable breast cancer who were fit for the procedure resulted in an increased rate of progression, therapeutic intervention and mortality.
Management of in-transit metastases from cutaneous malignant melanoma
Authors: Hayes A J , Clark M A , Harries M , Thomas J M 
Published: May 2004

Abstract

Background
In-transit metastases from cutaneous malignant melanoma (cutaneous or subcutaneous deposits between the primary melanoma and regional lymph nodes) represent late-stage disease, and their treatment should be tailored accordingly. This article reviews the pathology, clinical significance and treatment options for in-transit disease from melanoma.

Methods
An initial Medline search was undertaken using the keywords ‘melanoma and in-transit’ and ‘melanoma and non-nodal regional recurrence’. Additional original articles were obtained from citations in articles identified by the initial search.

Results and conclusion
In-transit metastases carry a poor prognosis. The method of treatment should be tailored to the extent of cutaneous disease. The first line of treatment remains complete excision with negative histopathological margins. There is no need for wide excision. Carbon dioxide laser therapy is valuable for multiple small cutaneous deposits. Isolated limb perfusion has a role for numerous or bulky advanced in-transit metastases in the limbs that are beyond the scope of simpler techniques. Systemic chemotherapy has response rates of about 25 per cent and is reserved for patients for whom surgery is no longer feasible.
Safety in numbers
Authors: Brennan M F 
Published: May 2004

Abstract
Patient Safety Leading Article Series, 2004. Continuing BJS's 2004 series on patient safety, Murray Brennan of Memorial Sloan-Kettering Cancer Center considers the effects of specialisation and surgical volume, from the viewpoint of both the surgeon and the institution.
The numbers are interesting—and informative—but the whole picture is far from simple and the future is far from clear.
Infection of patients by bloodborne viruses (Br J Surg 2004; 91: 395–399)
Authors: Tansley P 
Published: May 2004

Abstract
The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses can be sent electronically via the BJS website (www.bjs.co.uk) or by post. All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Letters submitted by post should be typed on A4-sized paper in double spacing and should be accompanied by a disk.
On the Importance of Electron Correlation Effects for the π‐π Interactions in Cyclophanes
Authors: Grimme Stefan 
Published: May 2004

AbstractCorrelated ab initio quantum chemical methods based on second‐order perturbation theory and density functional theory (DFT) together with large atomic orbital (AO) basis sets are used to calculate the structures of four cyclophanes with two aromatic rings and one sulphur‐containing phane with one aromatic ring. The calculated geometrical data for [2.2]paracyclophane, cyclophane (superphane), 8,16‐dimethyl[2.2]metacyclophane, 16‐methyl[2.2]metaparacyclophane, and 2,6,15‐trithia[34,10][7]metacyclophane are compared to experimental data from X‐ray crystal structure determinations. In all cases, very accurate theoretical predictions are obtained from the recently developed spin‐component‐scaled MP2 (SCS‐MP2) method, in which the deviations are within the experimental accuracy and expected crystal‐packing or vibrational effects. Especially the inter‐ring distances, which are determined by a detailed balance between attractive van der Waals (dispersive) and repulsive (Pauli) contributions, are very sensitive to the level of theory employed. While standard MP2 theory in general overestimates the dispersive interactions (π–π correlations) between the two aromatic rings leading to too short distances (between 3 and 8 pm), the opposite is observed for DFT methods (errors up to 15 pm). This indicates that an explicit account of dispersive‐type electron correlation effects between the clamped aromatic units is essential for a quantitative description of cyclophane structures. In order to distinguish these effects from “normal” van der Waals interactions, the term “overlap‐dispersive” interaction may be employed. The popular B3 LYP hybrid density functional offers no advantage over the pure PBE functional that at least qualitatively accounts for some of the dispersive effects. The use of properly polarized AO basis sets of at least valence‐triple‐ζ quality is strongly recommended to obtain quantitative predictions with traditional wave function methods.
Direct synaptic connections between rods and OFF cone bipolar cells in the rabbit retina
Authors: Li Wei , Keung Joyce W. , Massey Stephen C. 
Published: May 2004

AbstractMammalian retinal circuits are broadly divided into rod and cone pathways, responsible for dark‐ and light‐adapted vision, respectively. The classic rod pathway employs a single type of rod bipolar cell, which synapses with AII amacrine cells. AII amacrine cells then pass the signal to ON and OFF cone bipolar cells, respectively. Alternatively, rod signals may enter cones via gap junctions between rods and cones, and then pass from cones to cone bipolar cells. Thus, this second rod pathway does not utilize rod bipolar cells. Finally, in rodents, a third rod pathway, involving direct connections between rods and certain OFF cone bipolar cells, has been suggested. In this study, 56 OFF cone bipolar cells in the rabbit retina were dye‐injected with Lucifer Yellow and their photoreceptor connections were examined by confocal microscopy in wholemount. The locations of rod and cone terminals were marked with antibodies to mGluR6 or synaptic proteins. Most OFF cone bipolar dendrites terminated at cone pedicles but some made potential contacts with rod spherules. The synaptic nature of these sites was confirmed by the presence of GluR2 receptors. All three OFF bipolar cell types had dendrites that terminated at rod spherules. However, ∼80% of Ba2 and Ba3, but only 26% of Ba1 OFF cone bipolar cells made rod contacts. This variability suggests differential rod input to certain retinal pathways. In summary, we report anatomical evidence for direct connections between rods and OFF cone bipolar cells in a nonrodent mammal. Our data suggest that this alternative rod pathway may be a common feature of the mammalian retina. J. Comp. Neurol. 474:1–12, 2004. © 2004 Wiley‐Liss, Inc.
Postnatal development of cholinergic synapses on mouse spinal motoneurons
Authors: Wilson Jennifer M. , Rempel Jeremy , Brownstone Robert M. 
Published: May 2004

AbstractFollowing birth, when mammals are relatively immobile, significant development of the motor system facilitates weight bearing and locomotion. Prominent cholinergic C‐terminals develop on somata and proximal dendrites of spinal motoneurons during this time period. It is hypothesized that these terminals are essential in regulating motoneuron excitability and thus their development contributes to motor system maturation. Therefore, the development of pre‐ and postsynaptic components of the C‐terminal synapse on motoneurons in mice during the early postnatal period was investigated. Fluorescence immunohistochemical studies revealed that developmental increases in punctate labeling of presynaptic cholinergic terminals, as visualized by vesicular acetylcholine transporter immunoreactivity (VAChT‐IR) corresponded to the progressive expression and spatial restriction of immunoreactivity for the calcium channel subunit α12.2 (N‐type) located presynaptically and the muscarinic type 2 acetylcholine receptor situated postsynaptically. In addition, clustering of immunoreactivity for the potassium channel subunit KV2.1 occurred within the early postnatal period in concert and colocalized with the maturation of the C‐terminals. The time course of development of these components of the C‐terminal synapse corresponds to the maturation of the motor system that enables the animal to locomote in an adult‐like fashion. J. Comp. Neurol. 474:13–23, 2004. © 2004 Wiley‐Liss, Inc.
Brain mapping of three somatostatin encoding genes in the goldfish
Authors: Canosa Luis Fabián , Cerdá‐Reverter José Miguel , Peter Richard Ector 
Published: May 2004

AbstractIn the present study the brain distribution of three somatostatin (SRIF)‐encoding genes, PSS‐I, PSS‐II, and PSS‐III, was analyzed by in situ hybridization (ISH) in the goldfish. The PSS‐I mRNA showed the widest distribution throughout the brain, whereas PSS‐II transcripts were restricted to some hypothalamic nuclei. On the other hand, PSS‐III presents an intermediate distribution pattern. All SRIF encoding genes are expressed in hypophysiotropic nuclei supporting the idea that, in addition to SRIF‐14, [Pro2] SRIF‐14, and gSRIF‐28 have pituitary‐controlling functions. Moreover, each of the genes is expressed in nuclei directly associated with feeding behavior, suggesting a role for SRIF peptides in the central control of food intake and energy balance. Alternatively, they might have a role in processing sensory information related with feeding behavior, since PSS genes are expressed in the main gustatory, olfactory, and visual centers, which project to the hypothalamic feeding center in teleost fish. J. Comp. Neurol. 474:43–57, 2004. © 2004 Wiley‐Liss, Inc.
Discrete expression of TRPV2 within the hypothalamo‐neurohypophysial system: Implications for regulatory activity within the hypothalamic‐pituitary‐adrenal axis
Authors: Wainwright Anna , Rutter A. Richard , Seabrook Guy R. , Reilly Kathryn , Oliver Kevin R. 
Published: May 2004

AbstractTransient receptor potential channel proteins (TRPs) constitute a steadily growing family of ion channels with a range of purported functions. It has been demonstrated that TRPV2 is activated by moderate thermal stimuli and, in the rat, is expressed in medium to large diameter dorsal root ganglion neurons. In this study, antisera specific for the human TRPV2 homologue were raised and characterized for immunohistochemical use. Subsequently, thorough investigation was made of the localization of this cation channel in the macaque primate brain. TRPV2‐immunoreactive material was highly restrictively localized to hypothalamic paraventricular, suprachiasmatic, and supraoptic nuclei. Confocal double‐ and triple‐labeling studies demonstrated that TRPV2 immunoreactivity is preferentially localized to oxytocinergic and vasopressinergic neurons. Few, if any, cells in these regions expressed TRPV2 immunoreactivity in the absence of oxytocin immunoreactivity or vasopressin immunoreactivity. Expression in the paraventricular and supraoptic nuclei suggests that TRPV2 is likely to play a fundamental role in mediating cation transport in neurohypophysial neurons. TRPV2 has been shown to be translocated upon cell activation and neurons expressing TRPV2 immunoreactivity in vivo are among those known to engage in sporadic, intense activity. Taken together, these data suggest that this channel may play a vital role in mediating physiological activities associated with oxytocin and vasopressin release such as parturition, lactation, and diuresis. These data may also implicate the involvement of TRPV2 in disorders of the hypothalamic‐pituitary‐adrenal axis, including anxiety, depression, hypertension, and preterm labor. J. Comp. Neurol. 474:24–42, 2004. © 2004 Wiley‐Liss, Inc.
Type 1 nitrergic (ND1) cells of the rabbit retina: Comparison with other axon‐bearing amacrine cells
Authors: Vaney David I. 
Published: May 2004

AbstractNADPH diaphorase (NADPHd) histochemistry labels two types of nitrergic amacrine cells in the rabbit retina. Both the large ND1 cells and the small ND2 cells stratify in the middle of the inner plexiform layer, and their overlapping processes produce a dense plexus, which makes it difficult to trace the morphology of single cells. The complete morphology of the ND1 amacrine cells has been revealed by injecting Neurobiotin into large round somata in the inner nuclear layer, which resulted in the labelling of amacrine cells whose proximal morphology and stratification matched those of the ND1 cells stained by NADPHd histochemistry. The Neurobiotin‐injected ND1 cells showed strong homologous tracer coupling to surrounding ND1 cells, and double‐labelling experiments confirmed that these coupled cells showed NADPHd reactivity. The ND1 amacrine cells branch in stratum 3 of the inner plexiform layer, where they produce a sparsely branched dendritic tree of 400–600 μm diameter in ventral peripheral retina. In addition, each cell gives rise to several fine beaded processes, which arise either from a side branch of the dendritic tree or from the tapering of a distal dendrite. These axon‐like processes branch successively within the vicinity of the dendritic field before extending, with little or no further branching, for 3–5 mm from the soma in ventral peripheral retina. Consequently, these cells may span one‐third of the visual field of each eye, and their spatial extent appears to be greater than that of most other types of axon‐bearing amacrine cells injected with Neurobiotin in this study. The morphology and tracer‐coupling pattern of the ND1 cells are compared with those of confirmed type 1 catecholaminergic cells, a presumptive type 2 catecholaminergic cell, the type 1 polyaxonal cells, the long‐range amacrine cells, a novel type of axon‐bearing cell that also branches in stratum 3, and a type of displaced amacrine cell that may correspond to the type 2 polyaxonal cell. J. Comp. Neurol. 474:149–171, 2004. © 2004 Wiley‐Liss, Inc.
Cholinergic elements in the zebrafish central nervous system: Histochemical and immunohistochemical analysis
Authors: Clemente Diego , Porteros Ángel , Weruaga Eduardo , Alonso José Ramón , Arenzana Francisco Javier , Aijón José , Arévalo Rosario 
Published: May 2004

AbstractRecently, the zebrafish has been extensively used for studying the development of the central nervous system (CNS). However, the zebrafish CNS has been poorly analyzed in the adult. The cholinergic/cholinoceptive system of the zebrafish CNS was analyzed by using choline acetyltransferase (ChAT) immunohistochemistry and acetylcholinesterase (AChE) histochemistry in the brain, retina, and spinal cord. AChE labeling was more abundant and more widely distributed than ChAT immunoreactivity. In the telencephalon, ChAT‐immunoreactive (ChAT‐ir) cells were absent, whereas AChE‐positive neurons were observed in both the olfactory bulb and the telencephalic hemispheres. The diencephalon was the region with the lowest density of AChE‐positive cells, mainly located in the pretectum, whereas ChAT‐ir cells were exclusively located in the preoptic region. ChAT‐ir cells were restricted to the periventricular stratum of the optic tectum, but AChE‐positive neurons were observed throughout the whole extension of the lamination except in the marginal stratum. Although ChAT immunoreactivity was restricted to the rostral tegmental, oculomotor, and trochlear nuclei within the mesencephalic tegmentum, a widespread distribution of AChE reactivity was observed in this region. The isthmic region showed abundant AChE‐positive and ChAT‐ir cells in the isthmic, secondary gustatory and superior reticular nucleus and in the nucleus lateralis valvulae. ChAT immunoreactivity was absent in the cerebellum, although AChE staining was observed in Purkinje and granule cells. The medulla oblongata showed a widespread distribution of AChE‐positive cells in all main subdivisions, including the octavolateral area, reticular formation, and motor nuclei of the cranial nerves. ChAT‐ir elements in this area were restricted to the descending octaval nucleus, the octaval efferent nucleus and the motor nuclei of the cranial nerves. Additionally, spinal cord motoneurons appeared positive to both markers. Substantial differences in the ChAT and AChE distribution between zebrafish and other fish species were observed, which could be important because zebrafish is widely used as a genetic or developmental animal model. J. Comp. Neurol. 474:75–107, 2004. © 2004 Wiley‐Liss, Inc.
Postsynaptic localization of γ‐aminobutyric acid transporters and receptors in the outer plexiform layer of the goldfish retina: An ultrastructural study
Authors: Klooster Jan , Nunes Cardozo Bob , Yazulla Stephen , Kamermans Maarten 
Published: May 2004

AbstractThe γ‐aminobutyric acid (GABA)‐ergic system in the outer plexiform layer (OPL) of the goldfish retina was studied via light and electron immunohistochemistry. The subcellular distributions of immunoreactivity (‐IR) of plasma membrane GABA transporters GAT2 and GAT3, the α1 and α3 subunits of the ionotropic GABAA receptor, and the ρ1 subunit of the ionotropic GABAC receptor were determined. The localization of the GAT2‐IR and GAT3‐IR to horizontal cell dendrites at the base of the cone synaptic complex was the main characteristic at the ultrastructural level. Very rarely, GAT2‐IR and GAT3‐IR were found in horizontal cell dendrites innervating rod spherules. α1‐IR and α3‐IR were seen in wide bands in the OPL, whereas ρ1‐IR appeared as a narrow band in the OPL. Most α1‐IR was intracellular in rod and cone terminals. Membrane‐associated α1‐IR was observed in cone pedicles but not in rod spherules; postsynaptic elements were also labeled. α3‐IR was concentrated in the lateral elements of horizontal cell dendrites in cone pedicles. In contrast, ρ1‐IR was found mainly on the spinules of the horizontal cell dendrites in cone pedicles. In addition, in another type of cone pedicle, ρ1‐IR was found at the position of OFF‐bipolar cell dendrites. α3‐IR and ρ1‐IR were rarely found in horizontal cell dendrites innervating rods. We suggest that two GABAergic pathways exist in the outer retina— first, a GABAergic positive loop with GABA receptors mainly on the horizontal cell dendrites and spinules and, second, a GABAergic feedback pathway involving GABA receptors on cone pedicles and GABA transporters on horizontal cells and that this pathway presumably modulates feedback strength from horizontal cells to cones. J. Comp. Neurol. 474:58–74, 2004. © 2004 Wiley‐Liss, Inc.