bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of transpelvic rectus abdominis musculocutaneous flap for anal cancer salvage surgery
Authors: Tei T M , Stolzenburg T , Buntzen S , Laurberg S , Kjeldsen H 
Published: May 2003

Abstract

Background
Perineal wounds following abdominoperineal resection (APR), for persistent or locally recurrent anal cancer, are associated with poor healing secondary to irradiation therapy. The results of APR combined with a vertical rectus abdominis musculocutaneous (VRAM) flap transposed transpelvically to cover the perineal defect are presented.

Methods
Between 1994 and 2000, 105 patients were diagnosed and treated for anal cancer. Twenty-two (21 per cent) underwent a salvage operation owing to persistent or locally recurrent disease. In eight patients, before 1996, the perineum was closed primarily with serious wound complications in five. In the final 14 patients, primary perineal reconstruction with a VRAM flap was performed.

Results
Median age was 65·5 (range 45–78) years. Median follow-up was 14·5 (range 3–41) months. There were no flap-related complications and primary healing was achieved in all patients. Median hospital stay was 17 (range 14–72) days. There were two major complications related to the laparotomy and abdominal closure.

Conclusion
Combining the salvage operation with a VRAM flap facilitates primary healing after surgical treatment for persistent or locally recurrent anal cancer. A single-stage primary reconstructive procedure is feasible, with an acceptable complication rate and high level of patient satisfaction.
Evidence of the effect of ‘specialization’ on the management, surgical outcome and survival from colorectal cancer in Wessex
Authors: Smith J A E , King P M , Lane R H S , Thompson M R 
Published: May 2003

Abstract

Background
A prospective audit of the management of colorectal cancer was established to investigate factors associated with variation in survival observed within the former Wessex region (population three million).

Methods
Some 5173 patients (4562 surgically treated) with colorectal cancer diagnosed between 1991 and 1994 were followed for 5 years. Details of referral, diagnosis, surgical treatment, postoperative complications and outcomes were collected. The association between surgical outcomes and survival and both case volume and specialization (defined to include membership of the Association of Coloproctology of Great Britain and Ireland) was explored, accounting for variables with prognostic significance.

Results
There was a statistically significant association between high-volume operators (more than 50 operations per year) and specialization. The greatest benefit was observed with respect to specialists versus non-specialists, in terms of a lower postoperative mortality rate (odds ratio 0·67 (95 per cent confidence interval (c.i. 0·53 to 0·84)), lower anastomotic leak rates (odds ratio 0·46 (c.i. 0·31 to 0·66)), higher local recurrence-free survival (hazard ratio 0·56 (0·44 to 0·71)) and better long-term survival (hazard ratio 0·76 (c.i. 0·71 to 0·83)).

Conclusion
There is a stronger association between surgical specialization in coloproctology and beneficial outcome than with high-volume caseloads. This is not entirely accounted for by case-mix or patient population, and is seen following colonic and rectal surgery and among patients with advanced disease.
Day-case laparoscopic Nissen fundoplication
Authors: Bailey M E , Garrett W V , Nisar A , Boyle N H , Slater G H 
Published: May 2003

Abstract

Background
The aim was to assess the acceptability and safety of day-case laparoscopic fundoplication for gastro-oesophageal reflux disease (GORD).

Methods
This prospective study commenced in December 1999 and lasted for 18 months. All patients had proven symptomatic GORD. Inclusion criteria were American Society of Anesthesiologists grade I or II with adequate home support. A standard anaesthetic, analgesic and antiemetic protocol was used. Patients were contacted by telephone on the night of discharge and arrangements were made for a nurse to visit the following day. Postoperative pain and nausea were assessed using visual analogue scores (scale 0–10) on a self-completion questionnaire.

Results
Twenty patients were included. There were no postoperative complications. All patients were discharged on the day of surgery. Median time to discharge was 6 h 30 min (range 4·5 to 9 h). One patient reattended casualty the following morning but none required readmission. There was no significant difference in median pain or nausea scores the evening after surgery or the next morning. All patients were satisfied with the information given and aftercare provided. All would recommend it to a friend and 19 of 20 would undergo the procedure as a day case again.

Conclusion
This study suggests that day-case laparoscopic fundoplication is feasible. Patients find it acceptable and it appears safe.
Pathophysiology of intra-abdominal adhesion and abscess formation, and the effect of hyaluronan
Authors: Reijnen M M P J , Bleichrodt R P , van Goor H 
Published: May 2003

AbstractBackgroundIntra-abdominal adhesions and abscesses cause significant morbidity and mortality. The formation of fibrin in the abdominal cavity is a common pathophysiological pathway for both. The aim of this review was to investigate the pathophysiology of intra-abdominal adhesions and abscesses, and to explore the possible sites of action of hyaluronan.MethodsData were reviewed from the literature using the Medline database.ResultsBoth surgery and peritonitis disturb the equilibrium between coagulation and fibrinolysis in the abdominal cavity in favour of the coagulation system. Hyaluronan-based agents reduce adhesion formation after surgery. Moreover, hyaluronan solution reduces abscess formation in experimental peritonitis. Possible mechanisms of action include mechanical separation of wound surfaces, improvement of peritoneal healing, modulation of the inflammatory response and enhanced fibrinolysis.ConclusionDiminished fibrin degradation is a common pathway for the formation of adhesions and abscesses. The potential of hyaluronan-based agents to reduce intra-abdominal adhesions and abscesses in abdominal surgery and sepsis is a promising new concept. Elucidating the mechanisms involved and the clinical application of hyaluronan in peritonitis are challenges for future research.
Ovarian ablation in the adjuvant treatment of premenopausal and perimenopausal breast cancer
Authors: Sainsbury R 
Published: May 2003

Abstract

Background
Ovarian ablation has been employed in the treatment of breast cancer for many decades and, more recently, its value as an adjuvant treatment for premenopausal women with early-stage disease has been clearly demonstrated. This review examines the different methods of achieving ovarian ablation and assesses the relevance of ovarian suppression as a treatment aim.

Methods
Medline searches were used to identify recent key articles relating to the adenoma–carcinoma sequence. Further relevant articles were obtained by manual scanning of the reference lists of selected papers.

Results and conclusion
Ovarian ablation has historically been achieved by surgical or radiological intervention. Although beneficial in premenopausal disease, these methods produce permanent ablation that results in a premature menopause, which may be associated with long-term adverse events. A series of trials have recently demonstrated the benefits of luteinizing hormone releasing hormone (LHRH) agonists, such as goserelin and leuprorelin, as adjuvant treatment for premenopausal hormone-sensitive disease. LHRH agonists produce a reliable suppression of ovarian oestrogen production of equivalent efficacy to adjuvant chemotherapy in hormone-sensitive disease. Effective ovarian suppression is marked by amenorrhoea, but studies have suggested that permanent amenorrhoea is not necessary to confer benefit in the treatment of early breast cancer. LHRH agonists therefore represent a beneficial therapeutic option for premenopausal patients with hormone-sensitive early disease.
Planning eco‐industrial parks: an analysis of Dutch planning methods
Authors: van Leeuwen Marcus G. , Vermeulen Walter J. V. , Glasbergen Pieter 
Published: May 2003

AbstractIn theory, eco‐industrial parks can make significant improvements in the environment. In that light, this article analyses six planning methods currently in use in the Netherlands. The most salient findings are that these methods lack an explicit vision of sustainability, they do not give due consideration to symbiotic or utility‐sharing options, they do not sufficiently engage the companies involved in the development and their policy instruments have a limited environmental impact. The planning methods prove to have many shortcomings: the definition of sustainability is unclear; there are no quantitative standards; information on symbiosis and utility sharing is inadequate; the economic and organizational implications are largely ignored and the environmental impact is insufficiently monitored. However, eco‐industrial parks can only have greater environmental benefits through symbiosis and utility sharing. Therefore, location‐ and company‐specific factors have to be taken into consideration. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment
Dynamic change of corporate environmental strategy: rhetoric and reality
Authors: Rhee Seung‐Kyu , Lee Su‐Yol 
Published: May 2003

AbstractAlthough rhetoric involves political and symbolic posture, and does not always accurately represent reality, it plays an important role in the dynamic change process of environmental strategy. We first elaborate on the related concepts and develop frameworks to analyze corporate environmental strategy and its change. We report two case studies of Korean companies using the framework. Longitudinal case studies also provide additional implications for corporate environmental strategy in developing countries such as Korea.There is a gap between the rhetoric and reality of environmental strategy and it constantly changes over time depending on specific internal and external influences. The strength of external influences is a factor that determines whether the change is real or merely rhetorical. Internal organizational variables most likely affect the reality of environmental strategy. We show that the elaboration of rhetorical and realistic aspects of corporate environmentalism can bring out deeper insights and new theoretical developments. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment
Tracing business and environmental effects of environmental management systems—a study of networking small and medium‐sized enterprises using a joint environmental management system
Authors: Ammenberg Jonas , Hjelm Olof 
Published: May 2003

AbstractIn Hackefors Industrial District in Sweden, 26 small and medium‐sized enterprises (SMEs) have formed an environmental network and implemented a joint environmental management system (EMS) according to ISO 14001. Based on interviews with the environmental co‐ordinators at these enterprises, the effects on business and environmental efforts and impacts are analysed.It can be concluded that the joint EMS has resulted in better relations with important stakeholders, such as existing and potential customers. For example, three‐fifths said that their EMS had made it easier to receive a contract for the sale of products and services. Several environmental improvements have been observed and are presented in the paper, many of which are considered as consequences of the EMSs. Moreover, based on observations during the study, this paper discusses how boundaries and screening affect the connection between EMSs and environmental performance. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment
Environmental and social disclosure and data richness in the mining industry
Authors: Peck Philip , Sinding Knud 
Published: May 2003

AbstractSelf‐regulation by firms and industries in relation to the environmental impact they cause is not a full substitute for more traditional regulation of environmental externalities. However, some self‐regulatory efforts do involve very specific actions that serve to reduce externalities for a specific industry and certainly achieve more than the presentation of a responsible image to the world. An example of such efforts that go beyond common claims about ‘sustainable activities’ is seen in the increasing numbers of mining firms that generate and issue environmental reports. While there is as yet no indisputable proof that reporting has a direct effect on environmental performance, this paper shows that within a single industry there are wide variations in reporting practices and that sincerity is apparent in the process. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment
Compensation systems for green strategy implementation: parametric and non‐parametric approaches
Authors: Lothe Solveig , Myrtveit Ingunn 
Published: May 2003

AbstractThis paper presents a design for compensation systems for green strategy implementation based on parametric and non‐parametric approaches. The purpose of the analysis is to use formal modeling to explain the issues that arise with the multi‐task problem of implementing an environmental strategy in addition to an already existing profit‐oriented strategy. For the first class of compensation systems (parametric), a multi‐task model is used as a basis. For the second class of compensation systems (non‐parametric), data envelopment analysis is applied.Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment
Identity narratives of Muslim foreign workers in Japan
Authors: Onishi Akiko , Murphy‐Shigematsu Stephen 
Published: May 2003

AbstractThis article examines the identity and acculturation experience of Muslim foreign workers in Japan. The psychological impact of prolonged stay in a foreign country was studied by eliciting narratives of experiences of 24 male foreign workers from Bangladesh, Pakistan, and Iran who had been in Japan more than 5 years. By analysing the narratives they produced, three different styles of stories emerged which explained their experiences and their attempts to maintain or construct a sense of identity.Accepting the dominant narrative of Japanese society and describing oneself as ‘almost like Japanese’ was one way. Another strategy stressed the rejection of the dominant narrative as well as attempts to maintain the original narrative of the self as educated and active young men. The third narrative showed how individuals re‐defined themselves as Muslim by incorporating religious identity into a central part of their self‐concepts, and asserting its pervasive effect on all aspects of life.This study provides a perspective for acculturation research focused on social elements of identity, and derived from experiences in a relatively mono‐cultural society recently opening to immigration and in which there is a prevailing ideology of assimilation. Copyright © 2003 John Wiley & Sons, Ltd.
Effect of dexamethasone on neutrophil metabolism
Authors: Garcia Carolina , de Oliveira Marina Costa Xavier , Verlengia Rozangela , Curi Rui , Pithon‐Curi Tania Cristina 
Published: May 2003

AbstractThe effect of dexamethasone on glucose and glutamine metabolism was investigated. The consumption and oxidation of glucose and glutamine, and the production of glutamate and lactate were determined in neutrophils cultured for 3 h in the presence of dexamethasone. The activities and expression of glucose‐6‐phosphate dehydrogenase (G6PDH) and phosphate‐dependent glutaminase were also determined under the same conditions. Addition of dexamethasone to the culture medium caused a significant increase of glucose consumption at 0.5 μm (123.9%) and 1.0 μm (78.3%) concentrations. In spite of this, however, glucose oxidation remained unchanged. The glucocorticoid did not change glutamine consumption but caused a significant increase of glutamate production and did not alter glutamine oxidation. Dexamethasone‐treated neutrophils had a significant decrease of G6PDH activity and expression in particular at 1.0 μm concentration. Phosphate‐ dependent glutaminase activity was also decreased (about 34%) by dexamethasone treatment. A similar effect was observed on glutaminase expression as indicated by RT‐PCR analysis. Thus, the effect of dexamethasone on neutrophil metabolism was particularly noticeable with respect to G6PDH and glutaminase activities where a decrease in the respective mRNA levels was demonstrated. Copyright © 2002 John Wiley & Sons, Ltd.
Chemotactic activity of oligopeptides containing an EWS motif on Tetrahymena pyriformis: the effect of amidation of the C‐terminal residue
Authors: Köhidai László , Bösze Szilvia , Soós Pál , Illyés Eszter , Láng Orsolya , Mák Marianna , Sebestyen Ferenc , Hudecz Ferenc 
Published: May 2003

AbstractChemotactic properties of 3–7‐mer peptides containing an EWS motive and their peptide amides synthesized and characterized by us were investigated in Tetrahymena pyriformis GL model. Analysis of the peptide acids shows that SEWS possesses exceptionally strong (660%±21; 430%±18) chemoattractant ability at 10−12 and 10−11 m respectively. The shorter peptide (EWS) possesses chemorepellent activity, while longer peptides display neutral (WSEWS) or moderate chemoattractant (EWSEWS and GEWSEWS) chemotactic ability. Amidation of the C‐terminus can significantly modify the character of peptides: it points to the conclusion that a free α‐COOH group at this position is required for the high efficiency of SEWS, while in the shorter (EWS) and longer peptides (WSEWS and EWSEWS) amidation can result in chemoattractant ligands. Evaluation of the structure–function relationship of these compounds establishes the significance of Glu (E) with its high surface‐exposed area and negatively‐charged side chain. The high discriminative ability and good chemotactic responsiveness of Tetrahymena support the theory that a chemotactic signalling mechanism working in higher levels of phylogeny is a well conserved and inducible one even in protozoa. Copyright © 2002 John Wiley & Sons, Ltd.
Effects of melatonin on oxidative–antioxidative status of tissues in streptozotocin‐induced diabetic rats
Authors: Aksoy Nurten , Vural Hüseyin , Sabuncu Tevfik , Aksoy Sahin 
Published: May 2003

AbstractIn view of the antioxidant properties of melatonin, the effects of melatonin on the oxidative–antioxidative status of tissues affected by diabetes, e.g. liver, heart and kidneys, were investigated in streptozotocin (STZ)‐induced diabetic rats in the present study. Concentrations of malondialdehyde (MDA) and reduced glutathione (GSH), and activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH‐Px) in the tissues were compared in three groups of 10 rats each (control non‐diabetic rats (group I), untreated diabetic rats (group II) and diabetic rats treated with melatonin (group III)). In the study groups, diabetes developed 3 days after intraperitoneal (i.p.) administration of a single 60 mg kg−1 dose of STZ. Thereafter, while the rats in group II received no treatment, the rats in group III began to receive a 10 mg kg−1 i.p. dose of melatonin per day. After 6 weeks, the rats in groups II and III had significantly lower body weights and higher blood glucose levels than the rats in group I (p < 0.001 and p < 0.001, respectively). MDA levels in the liver, kidney and heart of group II rats were higher than that of the control group (p < 0.01, p < 0.05, p < 0.01, respectively) and diabetic rats treated with melatonin (p < 0.05). The GSH, GSH‐Px and SOD levels increased in diabetic rats. Treatment with melatonin changed them to near control values. Our results confirm that diabetes increases oxidative stress in many organs such as liver, kidney and heart and indicate the role of melatonin in combating the oxidative stress via its free radical‐scavenging and antioxidant properties. Copyright © 2002 John Wiley & Sons, Ltd.
Dantrolene protects erythrocytes against oxidative stress during whole‐body irradiation in rats
Authors: Emin Büyükokuroğlu Mehmet , Taysi Seyithan , Koç Mehmet , Bakan Nuri 
Published: May 2003

AbstractIn our study, we examined the radioprotective effects of dantrolene against γ irradiation‐induced damage of blood cells after total body irradiation of rats. Rats were divided into three groups of eight rats each. The first group was the control group receiving no dantrolene or irradiation, the second group received total body irradiation (RT) with 5 Gy of γ irradiation only, and the third group received dantrolene at a dose of 5 mg kg−1 plus RT. Dantrolene was given intraperitoneally 30 min before RT. All groups were sacrificed 2 h after RT, and blood samples were taken. Leukocyte, and thrombocyte counts and hemoglobin levels were measured. Furthermore, malondialdehyde (MDA) levels in plasma and erythrocytes and superoxide dismutase (SOD) and glutathione peroxidase activities (GSH‐Px) in erythrocytes were determined. It was found that pretreatment with dantrolene at a dose of 5 mg kg−1 significantly reduced the MDA levels and increased the antioxidant SOD and GSH‐Px activities, and prevented the decrease in leukocyte and thrombocyte counts. We conclude that dantrolene has clear antioxidant properties when given prior to radiation exposure and the protective effect of dantrolene against damage inflicted by radiation, depends, at least in part, on the decrease in lipid peroxidation and increase in the activity of antioxidant enzymes SOD and GSH‐Px. Copyright © 2003 John Wiley & Sons, Ltd.
Investigation of antioxidant vitamins (A, E and C) and selenium levels in chickens receiving estrogen or testosterone
Authors: Halifeoglu Ihsan , Karatas Fikret , Canatan Halit , Colak Ramiz , Karadas Erkan 
Published: May 2003

AbstractIn the present study estrogen or testosterone was administered to broiler chickens (6 weeks old) for 5 weeks and levels of antioxidant vitamins (A, E and C) and selenium (Se) were determined. In animals who received estrogen, vitamins A, E, C and Se levels were 0.70 ± 0.19, 11.0 ± 2.45, 20.0 ± 5.17 and 130.0 ± 25.0 μg l−1, respectively. Vitamins A, E, C and Se levels in the testosterone‐administered group were found to be 0.54 ± 0.16, 9.9 ± 1.96, 18.0 ± 5.18 and 100.0 ± 18.0 μg l−1, respectively. Vitamins A, E, C and Se levels were found to be significantly increased in the estrogen‐administered group compared to the controls (p < 0.01, p < 0.01, p < 0.05, p < 0.05, respectively). Although all parameters were increased in testosterone‐treated animals, only increases in vitamins A and E were found to be statistically significant (p < 0.01, p < 0.01, respectively). Based on the present findings, estrogen and testosterone show direct antioxidant effects by increasing the activities of some enzymes and they also cause an increase in antioxidant vitamin levels and hence indirectly also contribute to antioxidant capacity. Copyright © 2002 John Wiley & Sons, Ltd.