bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of histologically node‐negative esophageal squamous cell carcinoma
Authors: Tabira Yoichi , Yasunaga Masahiro , Sakaguchi Tomonori , Yamaguchi Yuji , Okuma Toshiyuki , Kawasuji Michio 
Published: December 2002

AbstractThe outcome of node‐negative esophageal carcinoma and the prognostic significance of lymph node micrometastasis remain unknown. The aim of this retrospective study was to clarify these two points. A series of 98 patients who underwent curative operation for histologically node‐negative (pNO in TNM classification) esophageal carcinoma were enrolled in the study. We reviewed the cause of death of these patients. The survival curves were calculated and compared after stratifications according to clinicopathologic parameters. Lymph node micrometastasis in the patients with recurrences was examined using immunohistochemical staining of cytokeratin. Their ages ranged from 45 to 83 years (mean 64.3 years). There were 83 men and 15 women. Altogether, 54 patients were still alive, and 44 had died. A total of 9 patients died from recurrence of their esophageal carcinoma, 33 died from other causes (pneumonia 11, extraesophageal carcinoma 7, and so on), and 2 died from unknown causes. Eight patients had locoregionai recurrences, and two patients had distant recurrences. The overall survival rate for the 98 patients was 58.2%. The survival for patients with pT2 or pT3 tumors was significantly worse than for those with pTis or pTl tumors (p=0.02, log‐rank test). Other clinicopathologic factors did not affect the prognosis. Immunohistochemical study found no lymph node micrometastasis in 365 lymph nodes resected from the patients with recurrences. Only the depth of tumor invasion affected the outcome of patients with node‐negative esophageal carcinoma. Altogether, 75% of patients died of other causes without recurrence, with the two main causes of death being pulmonary complications and extraesophageal carcinoma in these patients. Lymph node micrometastasis was not associated with recurrence in this series.
Total thyroidectomy for management of benign thyroid disease: Review of 526 cases
Authors: Bellantone Rocco , Lombardi Celestino Pio , Bossola Maurizio , Boscherini Mauro , De Crea Carmela , Alesina Pierfrancesco , Traini Emanuela , Princi Pietro , Raffaelli Marco 
Published: December 2002

AbstractTotal thyroidectomy is not frequently performed in cases of benign disease because of the associated risk of postoperative hypoparathyroidism and recurrent laryngeal nerve (RLN) damage. We chose a series of patients who had undergone total thyroidectomy (TT) for benign thyroid tumors to evaluate the safety of this approach and its role in the treatment of nonmalignant lesions of the thyroid. We considered only patients with a minimum follow‐up of 24 months. Records of 526 patients who underwent TT were carefully reviewed, assessing for perioperative complications and late sequelae. The mean age was 44 ± 15.7 years; 109 patients (20.7%) were male and 417 (79.3%) were female. Altogether, 65 patients (12.3%) were operated on for toxic goiter, 429 (81.6%) for bilateral nodular goiter, and 32 (6.1%) for thyroiditis. Postoperative hemorrhage requiring reoperation occurred in 8 cases (1.5%). The incidences of permanent RLN palsy (considered as a percentage of the nerves at risk) and permanent hypocalcemia were 0.4% and 3.4%, respectively. A trend toward a decrease in the complication rate was observed during the last 5 years. There were no disease recurrences during a mean follow‐up of 44 months. The results of our series show that TT can be performed safely in patients, with a low incidence of lifetime disabilities. TT has the advantage of reducing/avoiding the risk of disease recurrence and reoperation and should therefore be considered a valuable option for treating benign thyroid diseases.
Multifactorial risk profile for bone fractures in primary hyperparathyroidism
Authors: Nordenström Erik , Westerdahl Johan , Lindergård Birger , Lindblom Pia , Bergenfelz Anders 
Published: December 2002

AbstractPrimary hyperparathyroidism (pHPT) is associated with an increased fracture risk, and decreased bone density thus has been considered an indication for surgery. However, many pHPT patients have a multifactorial risk profile for osteoporosis and bone fractures. The aim of the present study was to evaluate variables associated with fracture risk within the group of pHPT patients. A series of 203 consecutive patients operated for pHPT were investigated with bone mineral content and biochemical and clinical risk factors for bone fracture. Seventeen patients (8%) had a history of at least one bone fracture up to 5 years before pHPT surgery. Twenty‐six patients (13%) had a history of at least one fracture during the 10‐year period prior to surgery. In the univariate analyses corticosteroid treatment, serum levels of alkaline phosphatase, 25‐hydroxyvitamin D3, type I collagen telopeptide, and bone mineral content were found to be associated with a history of bone fractures up to 10 years before surgery. Additionally, age and menopausal status were of importance for fractures during the 10‐year‐period, whereas a history of cardiovascular disease was important for fractures during the 5‐year‐period prior to surgery. Multivariate analyses showed that serum level of PTH was independently associated with bone fractures during the 5‐year period prior to pHPT surgery and further that serum level of 25‐hydroxyvitamin D3 was associated with fractures up to 10 years before surgery. In conclusion, serum levels of 25‐hydroxyvitamin D3 and PTH were independently associated with a history of bone fractures in pHPT. These variables should be considered when evaluating patients for parathyroid surgery.
Retrospective evaluation of carcinoid tumors of the appendix in children
Authors: Prommegger Rupert , Obrist Peter , Ensinger Christian , Profanter Christoph , Mittermair Reinhard , Hager Josef 
Published: December 2002

AbstractCarcinoids of the appendix are rare in children and are usually diagnosed incidentally on histologic investigation following appendectomy for appendicitis. To investigate the significance of the diagnosis of appendiceal carcinoid in children, we conducted a retrospective study of the treatment and follow‐up of 36 children with histologically confirmed carcinoid tumors of the appendix. Between 1970 and 2000 a total of 36 patients (25 girls, 11 boys) were diagnosed with appendiceal carcinoid. The median age of the patients at diagnosis was 12.3 years (range 6–16 years). The indication for appendectomy was acute lower right quadrant pain in 27 cases and chronic right lower quadrant pain in 9 patients. In 27 specimens the tumor was localized at the apex, in 7 at the midportion, and in 2 at the base of the appendix. The median tumor diameter was 6 mm (range 3–17 mm). Concomitant severe appendicitis was diagnosed in 14 patients 2 with a perforated appendicitis. In only one tumor were mucin‐producing cells detectable. After a median follow‐up of 10 years (range 2 months to 30 years) all patients were tumor‐free. None of the patients had a synchronous or metachronous noncarcinoid malignant tumor. Appendiceal carcinoids are usually asymptomatic, and the indication for surgical Intervention is acute or chronic abdominal pains in the right lower quadrant. For most patients the prognosis is excellent after appendectomy. As in adults, appendectomy is the appropriate treatment.
Long‐term outcome of surgical revascularization of supraaortic vessels
Authors: Uurto Ilkka T. , Lautamatti Visa , Zeitlin Rainer , Salenius Juha P. 
Published: December 2002

AbstractThe aim of this study was to evaluate long‐term results of different surgical reconstructions of supraaortic vessels, particularly the subclavian and innominate arteries. It is a retrospective review of 33 years experience in a teaching hospital; 80 surgical revascularizations were performed in 76 patients who suffered occlusive disease of subclavian or innominate artery from 1965 to 1998. These included 38 bypass (BP) Operations (28 carotid‐subclavian, 4 aorto‐subclavian, 3 aorto‐innominate, and 3 subclavian transpositions) and 42 endarterectomies (EA). All available patients (34) were reassessed clinically, and by triplex scanning. The mean clinical follow‐up was 9 months (range 1 to 116 months) for all patients and for control‐examined patients 158 months (range 6 to 346 months). Four patients were lost to follow‐up. The perioperative mortality was 2.5% (BP, 0%; EA, 5%). The overall patency rate for both the BP and the EA procedures was 95% at 1 and 5 years; 91% at 10 years (BP, 89%; EA, 93%) and 89% (BP, 87%; EA, 90%) at 15 years. Most of the patients (84%) were satisfied with the clinical result in the long term. We conclude that surgical revascularization of supraaortic vessels is an infrequent procedure, and all surgical techniques give good and durable long‐term outcome.
Functional and morphologic properties of a modified mesh for inguinal hernia repair
Authors: Junge Karsten , Klinge Uwe , Rosch Raphael , Klosterhalfen Bernd , Schumpelick Volker 
Published: December 2002

AbstractInguinal hernia repair is one of the most frequently performed operations. Next to conventional techniques, open and laparoscopic tension‐free methods using mesh implants to reinforce the abdominal wall are increasingly carried out, even becoming the standard procedure in many countries. Because of the benefits of material‐reduced meshes for incisional hernia repair, a new mesh modification for tension‐free inguinal hernia repair has been developed. In the present study this new low‐weight mesh (Vypro II) made of polypropylene and polyglactin multifilaments was compared to a common heavy‐weight polypropylene mesh (Prolene) regarding their functional consequences and the morphologic tissue response. After implantation in rats as an inlay, abdominal wall mobility was recorded by three‐dimensional photogrammetry and the tensile strength of the suture zone and the mesh itself was measured at 3, 21, and 90 days. Explanted tissue samples have been investigated for their histologic reaction in regard to the inflammatory infiltrate, vascularization, and connective and fat tissue ingrowth. Numbers of granulocytes, macrophages, fibroblasts, lymphocytes, and foreign giant body cells have been evaluated to reflect the quality of the tissue response. The cellular response was assessed by measuring DNA strand breaks and apoptosis (TUNEL), proliferation (Ki67), and cell stress (HSP70). The results indicated that restriction of abdominal wall mobility was significantly reduced with Vypro II compared to that seen with heavy‐weight mesh modification, and the inflammatory reaction and connective tissue formation were markedly diminished. Apoptosis and cell proliferation showed considerably lowered levels, and expression of cytoprotective HSP70 was significantly increased. The present study thus confirms the benefits of material‐reduced mesh modifications. The new low‐weight mesh (Vypro II) could be advantageous in inguinal hernia repair.
Modulation of renal sympathetic nerve activity during pneumoperitoneum in rats
Authors: Tanaka Kunihiko , Tsuchiya Yo , Ree Ken , Morita Hironobu 
Published: December 2002

AbstractTo examine neural control of renal function during pneumoperitoneum, renal sympathetic nerve activity (RSNA) was measured in pentobarbital‐anesthetized rats that had their entire nervous system intact or that had undergone lower thoracic dorsal rhizotomy or abdominal vagotomy. During pneumoperitoneum with intraabdominal pressure (IAP) of 10 mmHg, the mean arterial pressure did not change, but central venous pressure increased by 10 mmHg in all groups. In intact rats, the RSNA increased to 285 ± 22% during pneumoperitoneum and gradually recovered after release of the insufflation. The RSNA responses decreased during pneumoperitoneum in rats with dorsal rhizotomy or vagotomy compared to responses in intact rats. In intact rats the urine volume and Na+ excretion decreased during pneumoperitoneum and increased just after insufflation release. Dorsal rhizotomy, vagotomy, or renal denervation did not alter the antidiuretic and antinatriuretic responses during pneumoperitoneum; however, diuretic and natriuretic responses were completely abolished by either of these denervations following insufflation release. These results suggest that oliguria during pneumoperitoneum was not due to neural control of renal function but probably to a mechanical influence induced by the elevated LAP. On the other hand, diuretic and natriuretic responses after insufflation release were thought to be a neurally mediated response.
Laparoscopic appendectomy for perforated appendicitis
Authors: So Jimmy B. Y. , Chiong Ee‐Cherk , Chiong Edmond , Cheah Wei‐Keat , Lomanto David , Goh Peter , Kum Cheng‐Kiong 
Published: December 2002

AbstractAlthough laparoscopic appendectomy for uncomplicated appendicitis is feasible and safe, its application to perforated appendicitis is uncertain. A retrospective study of all patients with perforated appendicitis from 1992 to 1999 in a university hospital was performed. A series of 231 patients were diagnosed as having perforated appendicitis. Of these patients, 85 underwent laparoscopy (LA), among whom 40 (47%) required conversion to an open procedure. An open appendectomy (OA) was performed in 146 patients. The operating time was similar for the two groups. Return of fluid and solid diet intake were faster in LA than OA patients (p<0.01). Postoperative infections including wound infections and abdominal abscesses occurred in 14% of patients in the laparoscopy group and in 26% of those with OA (p<0.05). The surgeon’s experience correlated with the conversion rate. Laparoscopic appendectomy is associated with a high conversion rate for perforated appendicitis. If successful, it offers patients faster recovery and less risk of infectious complications.
Pharmacotherapy for chronic hemorrhagic radiation proctitis
Authors: Gul Yunus A. , Prasannan Subhita , Jabar Faisal M. , Shaker Abdul R. H. , Moissinac Kevin 
Published: December 2002

AbstractEndoscopic thermal therapy and formalin are being increasingly recommended for the treatment of chronic hemorrhagic radiation proctitis. It may be too early, however, to discard pharmacologic agents from the management process, especially in medical institutions where specialized equipment is unavailable. We prospectively assessed the effectiveness of medical therapy in 14 consecutive patients with chronic hemorrhagic radiation proctitis from July 1999 to June 2001. All 14 subjects were women (mean age 56 years), 13 of whom had had radio‐therapy for Cancer of the cervix. The median time to onset of Symptoms following irradiation was 16 months. Six patients had a hemoglobin level of<8 g/dl, and blood transfusion was required in 11 patients. In five patients (36%) initially treated with hydrocortisone enemas prior to referral, this treatment continued; and the remaining nine patients were commenced on sucralfate enemas. Two patients given rectal hydrocortisone continued to bleed and were treated with sucralfate enemas and topical formalin, respectively. Rectal sucralfate Suspension effectively procured symptomatic alleviation in all 11 patients. Rectal bleeding recurred in two patients who had been managed exclusively with hydrocortisone and sucralfate enemas, respectively, over a mean follow‐up of 6 months. Both patients were managed with topical formalin, which con‐trolled their Symptoms. Even though the number of subjects in this study is small, sucralfate enema can be recommended as an effective first‐line agent for managing patients with chronic hemorrhagic radiation proctitis. The use of more specialized therapy can therefore be reserved for cases where primary treatment failure occurs with sucralfate therapy.
Clinicoanatomical study on the infraportal bile ducts of segment 3
Authors: Ozden Ilgin , Kamiya Junichi , Nagino Masato , Uesaka Katsuhiko , Sano Tsuyoshi , Nimura Yuji 
Published: December 2002

AbstractIn some patients, bile ducts of segments 2 and 3 (B2 and B3) run caudally to the umbilical portion of the left portal vein (UP)—an infra‐portal course. We aimed to evaluate the frequency and clinical implications of this variation. Between January 1992 and October 2000, 108 patients underwent resection for hilar cholangiocarcinoma. The records of the 6 patients with infraportal left hepatic ducts were evaluated. An infraportal B3 was diagnosed in 6 patients (6%). No patient had an infraportal B2. An infraportal B3 could be demonstrated by computed tomography (CT) before biliary drainage, percutaneous transhepatic or endoscopic cholangiography, portography after percutaneous transhepatic biliary drainage (PTBD) via B3 and CT after PTBD via B3. Four patients (4/6) had a liver bridge covering Rex’s recess (B3 not in the bridge). The incidence of the bridge in 75 comparable patients was 9/75. In conclusion, common radiologic methods are sufficient for diagnosis of abnormal biliary anatomy. The presence of a liver bridge over Rex’s recess is suggestive of this variation. Separate biliary reconstruction for an infraportal branch is mandatory in an extended right hepatectomy for biliary tract cancer and may be necessary in liver transplantation with segments 2+3 grafting.
Danazol and plasma lipoprotein metabolism
Authors: Shepherd J. 
Published: December 2002

AbstractThe potential long‐term impact of danazol on coronary risk hinges on its effect on lipoprotein metabolism rather than its influence on total plasma lipids. Danazol may exert a regulatory influence on three key processes in lipoprotein metabolism: hepatic lipase activity; low‐density lipoprotein receptor function; and lecithin:cholesterol acyl‐transferase activity. Danazol decreases plasma fibrinogen and lipoprotein (a) levels, promotes fibrinolysis and causes a rise in plasminogen. Such changes are beneficial as they inhibit the process of thrombosis. Androgenic properties of danazol produce effects on plasma lipids and lipoproteins which oppose estrogen‐induced changes. The usual recipients of danazol therapy are premenopausal females, in whom the absolute risk of ischemic heart disease is low. If the drug were shown to increase ischemic heart disease risk, detrimental factors must be weighed against its considerable and proven clinical benefits.
Continuous Separation of Multicomponent Protein Mixtures by Annular Displacement Chromatography
Authors: Giovannini Roberto , Freitag Ruth 
Published: December 2002

AbstractDisplacement chromatography is a predominantly nonlinear mode of chromatography, which has certain advantages over the elution mode for preparative bioseparations. Whereas continuous production (and separation) processes have their theoretical benefits in this context, protein displacement chromatography has up to now only been performed in the batch mode. In this contribution, we demonstrate that the principle of continuous annular chromatography can be adapted to displacement chromatography. Separations of up to three standard proteins (two whey proteins, soybean trypsin inhibitor) were developed and optimized using a small (4 × 250 mm) batch column. These separations were subsequently transferred directly to the continuous system (500‐mL column). Separations of similar quality in terms of final product purity and recovery yield were obtained using the continuous system.
Genetic Programming Assisted Stochastic Optimization Strategies for Optimization of Glucose to Gluconic Acid Fermentation
Authors: Cheema Jitender Jit Singh , Sankpal Narendra V. , Tambe Sanjeev S. , Kulkarni Bhaskar D. 
Published: December 2002

AbstractThis article presents two hybrid strategies for the modeling and optimization of the glucose to gluconic acid batch bioprocess. In the hybrid approaches, first a novel artificial intelligence formalism, namely, genetic programming (GP), is used to develop a process model solely from the historic process input‐output data. In the next step, the input space of the GP‐based model, representing process operating conditions, is optimized using two stochastic optimization (SO) formalisms, viz., genetic algorithms (GAs) and simultaneous perturbation stochastic approximation (SPSA). These SO formalisms possess certain unique advantages over the commonly used gradient‐based optimization techniques. The principal advantage of the GP‐GA and GP‐SPSA hybrid techniques is that process modeling and optimization can be performed exclusively from the process input‐output data without invoking the detailed knowledge of the process phenomenology. The GP‐GA and GP‐SPSA techniques have been employed for modeling and optimization of the glucose to gluconic acid bioprocess, and the optimized process operating conditions obtained thereby have been compared with those obtained using two other hybrid modeling‐optimization paradigms integrating artificial neural networks (ANNs) and GA/SPSA formalisms. Finally, the overall optimized operating conditions given by the GP‐GA method, when verified experimentally resulted in a significant improvement in the gluconic acid yield. The hybrid strategies presented here are generic in nature and can be employed for modeling and optimization of a wide variety of batch and continuous bioprocesses.
A Lab‐Built Respirometer for Plant and Animal Cell Culture
Authors: Lamboursain Laurence , St‐Onge Frédéric , Jolicoeur Mario 
Published: December 2002

AbstractA very simple off‐line respirometer was developed to measure oxygen consumption rates of low respiring and shear‐sensitive cell suspensions. The respirometer is composed of a 10 mL glass syringe in which the plunger was substituted with a polarographic dissolved oxygen probe. Mechanical agitation is provided by means of a magnetic stirring bar inside the measuring chamber and a stir plate placed bellow the respirometer. Abiotic oxygen fluxes occurring in the measurement chamber such as oxygen diffusion and probe oxygen consumption were investigated. The apparent oxygen uptake rate was then corrected for abiotic oxygen fluxes, leading to accurate measurements of respiration rates ranging from 0.5 to 25.0 mM·h−1. Additionally, the effect of the stirring bar shape and of the test length on the integrity of plant ( Eschschzoltzia californica) and animal (NS0) cells was evaluated. Animal cells showed a higher resistance to mechanical stirring inside the respirometer compared to plant cells (0% of broken cells and 78.1% respectively for a polygonal stirring bar and a 15 min test). For plant cells, cell damage inside the measurement chamber was reduced by optimizing the stirring bar shape and reducing the test length to 5 min or less. This very simple design was shown to provide reliable and low‐cost quantification of the oxygen uptake rate of plant and animal cells and can be use even for more demanding measurements such as oxygen affinity studies.
Application of Fungi as Biocatalysts for the Reduction of Diethyl 1‐Oxoalkylphosphonates in Anhydrous Hexane
Authors: Brzezińska‐Rodak Małorzata , Żymańczyk‐Duda Ewa , Kafarski Paweał , Lejczak Barbara 
Published: December 2002

AbstractFive different species of microorganisms, namely, Rhodotorula rubra, Rhodotorula glutinis, Cladosporium sp., Verticillium sp., and baker's yeast, turned out to be useful biocatalysts for enantioselective reduction of a variety of diethyl 1‐oxoalkylphosphonates. To suppress substrate decomposition, bioreductions were carried out under anhydrous conditions, using lyophilized cells immobilized on Celite R 630. The influence of reaction conditions such as biotransformation time and chemical additives on the yield of the reaction is discussed.