bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential distribution of cubilin and megalin expression in the mouse embryo
Authors: Drake Christopher J. , Fleming Paul A. , Larue Amanda C. , Barth Jeremy L. , Chintalapudi Mastan R. , Argraves W. Scott 
Published: February 2004

AbstractCubilin and megalin are cell surface proteins that work cooperatively in many absorptive epithelia to mediate endocytosis of lipoproteins, vitamin carriers, and other proteins. Here we have investigated the coordinate expression of these receptors during mouse development. Our findings indicate that while there are sites where the receptors are co‐expressed, there are other tissues where expression is not overlapping. Apical cubilin expression is pronounced in the extraembryonic visceral endoderm (VE) of 6–9.5 days postcoitum (dpc) embryos. By contrast, little megalin expression is evident in the VE at 6 dpc. However, megalin expression in the VE increases as development progresses (7.5–9.5 dpc), although it is not as uniformly distributed as cubilin. Punctate expression of megalin is also apparent in the region of the ectoplacental cone associated with decidual cells, whereas cubilin expression is not seen in association with the ectoplacenta. Strong expression of megalin is observed in the neural ectoderm, neural plate and neural tube (6–8.5 dpc), but cubilin expression is not apparent in any of these tissues. At 8.5 dpc, megalin is expressed in the developing endothelial cells of blood islands, whereas cubilin is absent from these cells. Finally, cubilin, but not megalin, is expressed by a subpopulation of cells dispersed within the 7.5 dpc embryonic endoderm and having a migratory morphology. In summary, the co‐expression of cubilin and megalin in the VE is consistent with the two proteins functioning jointly in this tissue. However, the differential distribution pattern indicates that the proteins also function independent of one another. Furthermore, the finding of megalin expression in blood island endothelial cells and cubilin expression in embryonic endoderm highlight potential new developmental roles for these proteins. Anat Rec Part A 277A:163–170, 2004. © 2004 Wiley‐Liss, Inc.
Clonogenic analysis reveals reserve stem cells in postnatal mammals. II. Pluripotent epiblastic‐like stem cells
Authors: Young Henry E. , Duplaa Cecile , Yost Michael J. , Henson Nicholas L. , Floyd Julie A. , Detmer Kristina , Thompson Angela J. , Powell Steven W. , Gamblin T. Clark , Kizziah Kirk , Holland Benjamin J. , Boev Angel , Van De Water J.M. , Godbee Dan C. , Jackson Stephanie , Rimando Marylen , Edwards Chad R. , Wu Eveline , Cawley Chris , Edwards Pamela D. , Macgregor Anna , Bozof Ryan , Thompson T. Michele , Petro George J. , Shelton Heather M. , McCampbell Beth L. , Mills Jared C. , Flynt Frederick L. , Steele Timothy A. , Kearney Marianne , Kirincich‐Greathead Amy , Hardy Wade , Young Paul R. , Amin Aman V. , Williams R. Steve , Horton Miranda M. , Mcguinn Shaun , Hawkins Kristina C. , Ericson Kurt , Terracio Louis , Moreau Catherine , Hixson Douglas , Tobin Brian W. , Hudson John , Bowyer Frank P. , Black Asa C. 
Published: February 2004

AbstractUndifferentiated cells have been identified in the prenatal blastocyst, inner cell mass, and gonadal ridges of rodents and primates, including humans. After isolation these cells express molecular and immunological markers for embryonic cells, capabilities for extended self‐renewal, and telomerase activity. When allowed to differentiate, embryonic stem cells express phenotypic markers for tissues of ectodermal, mesodermal, and endodermal origin. When implanted in vivo, undifferentiated noninduced embryonic stem cells formed teratomas. In this report we describe a cell clone isolated from postnatal rat skeletal muscle and derived by repetitive single‐cell clonogenic analysis. In the undifferentiated state it consists of very small cells having a high ratio of nucleus to cytoplasm. The clone expresses molecular and immunological markers for embryonic stem cells. It exhibits telomerase activity, which is consistent with its extended capability for self‐renewal. When induced to differentiate, it expressed phenotypic markers for tissues of ectodermal, mesodermal, and endodermal origin. The clone was designated as a postnatal pluripotent epiblastic‐like stem cell (PPELSC). The undifferentiated clone was transfected with a genomic marker and assayed for alterations in stem cell characteristics. No alterations were noted. The labeled clone, when implanted into heart after injury, incorporated into myocardial tissues undergoing repair. The labeled clone was subjected to directed lineage induction in vitro, resulting in the formation of islet‐like structures (ILSs) that secreted insulin in response to a glucose challenge. This study suggests that embryonic‐like stem cells are retained within postnatal mammals and have the potential for use in gene therapy and tissue engineering. Anat Rec Part A 277A:178–203, 2004. © 2004 Wiley‐Liss, Inc.
Granule types and their morphological changes in terminal cluster and acinar cells in the late pre‐ and early postnatal rat sublingual gland
Authors: Kikuchi Ken‐Ichiro , Aiyama Shigeo , Ikeda Rie , Matsuoka Takanori , Takada Kiyomi 
Published: February 2004

AbstractThe developmental characteristics of serous cells appearing in the rat sublingual gland from the late prenatal to the early postnatal period were investigated in this study. Particular attention was paid to the morphological changes observed in the secretory granules at the histochemical and ultrastructural level. On prenatal day 18, granules with homogeneous high electron density (Type I granules), and mottled granules (Type II granules) with heterogeneous electron density appeared in the narrow luminar cytoplasm of cells constituting the terminal clusters. On prenatal day 19, these granules decreased in number and were replaced by bipartite granules (Type III granules) composed of a highly electron‐dense core and a more electron‐lucent rim. Pronase treatment almost completely digested the Type I and II granules and the electron‐dense core of the Type III granules, although some of the Type I and II granules in serous demilunes at a later stage were insufficiently digested. On prenatal day 19.5, homogeneous granules of low electron density (Type IV granules) appeared in the terminal clusters and acini, and increased in number daily, making up 92.8% of the total granules on postnatal day 28. The granule morphology on electron microscopy, Alcian blue, and periodic acid‐Schiff staining strongly suggested that Type I and II granules were serous granules, Type IV granules were mucous granules, and Type III granules were transforming‐type granules. None of the secretory cells showed chromatin condensation, which is a characteristic of apoptosis. These findings suggest that the developing rat sublingual gland from the late prenatal to early postnatal period has numerous serous granules in the terminal clusters and acini, and that the majority of granules are replaced by mucous granules through transforming‐type granules. In addition, because apoptotic figures of secretory cells could not be detected, it appears that most of the serous cells in the developing rat sublingual gland might have changed to mucous cells. Anat Rec Part A 277A:209–215, 2004. © 2004 Wiley‐Liss, Inc.
Total number and mean size of alveoli in mammalian lung estimated using fractionator sampling and unbiased estimates of the Euler characteristic of alveolar openings
Authors: Hyde D.M. , Tyler N.K. , Putney L.F. , Singh P. , Gundersen H.J.G. 
Published: February 2004

AbstractEstimation of alveolar number in the lung has traditionally been done by assuming a geometric shape and counting alveolar profiles in single, independent sections. In this study, we used the unbiased disector principle to estimate the Euler characteristic (and thereby the number) of alveolar openings in rat lungs and rhesus monkey lung lobes and to obtain robust estimates of average alveolar volume. The estimator of total alveolar number was based on systematic, uniformly random sampling using the fractionator sampling design. The number of alveoli in the rat lung ranged from 17.3 · 106 to 24.6 · 106, with a mean of 20.1 · 106. The average number of alveoli in the two left lung lobes in the monkey ranged from 48.8 · 106 to 67.1 · 106 with a mean of 57.7 · 106. The coefficient of error due to stereological sampling was of the order of 0.06 in both rats and monkeys and the biological variation (coefficient of variance between individuals) was 0.15 in rat and 0.13 in monkey (left lobe, only). Between subdivisions (left/right in rat and cranial/caudal in monkey) there was an increase in variation, most markedly in the rat. With age (2−13 years) the alveolar volume increased 3‐fold (as did parenchymal volume) in monkeys, but the alveolar number was unchanged. This study illustrates that use of the Euler characteristic and fractionator sampling is a robust and efficient, unbiased principle for the estimation of total alveolar number in the lung or in well‐defined parts of it. Anat Rec Part A 274A:216–226, 2004. © 2004 Wiley‐Liss, Inc.
Adverse histopathological findings as a guide to patient management after curative resection of node-positive colonic cancer
Authors: Chapuis P H , Dent O F , Bokey E L , Newland R C , Sinclair G 
Published: February 2004

Abstract

Background
The aim of this study was to identify patient and tumour characteristics that might assist in developing an improved approach to patient selection for chemotherapy after resection of clinicopathological stage C colonic cancer.

Methods
Clinical, pathological and follow-up data have been collected prospectively for all patients undergoing resection for colorectal cancer at Concord Hospital since 1971. From an initial 2980 patients, after exclusions 378 remained who had a potentially curative operation for colonic cancer with nodal metastases and did not receive adjuvant chemotherapy. Associations between several pathological features and survival were examined by proportional hazards regression.

Results
In a multivariate model, both overall and colonic cancer-specific survival rates were negatively associated with serosal surface involvement, apical node metastasis, high histological grade and venous invasion. The survival of patients with stage C disease who had none of these adverse features was not significantly different from that of patients with stage B lesions. However, survival diminished significantly when one or more of the adverse features were present.

Conclusion
Patients with a stage C tumour but with none of the identified adverse features experience relatively good survival and are unlikely to benefit from adjuvant chemotherapy. In this series such patients accounted for 40·5 per cent of patients with stage C disease.
Right hemicolectomy does not confer a survival advantage in patients with mucinous carcinoma of the appendix and peritoneal seeding
Authors: González-Moreno S , Sugarbaker P H 
Published: February 2004

Abstract

Background
Traditionally epithelial malignancies of the appendix with or without carcinomatosis have been treated by right hemicolectomy. Recent accumulation of a large number of patients with this disease has enabled a re-evaluation of this surgical judgement.

Methods
Clinical data on 501 patients with epithelial malignancy of the appendix were collected prospectively. All patients had peritoneal seeding at the time of referral and were treated by cytoreductive surgery and perioperative intraperitoneal chemotherapy. The main independent variable for statistical analysis was the surgical procedure used to resect the primary cancer (appendicectomy alone versus right hemicolectomy). Nineteen other clinical and pathological variables were considered as control variables. The endpoint for all analyses was survival.

Results
Median follow-up after the initial diagnosis was 4 years. The rate of regional lymph node positivity was 5·0 per cent. When the incidence of lymph node metastasis was determined by histological type, it was statistically significantly higher in intestinal (66·7 per cent) than in mucinous (4·2 per cent) tumours (P &lt; 0·001). The presence of lymph node metastases had no influence on prognosis (P = 0·155). The surgical procedure (appendicectomy alone versus right hemicolectomy) had an influence on patient survival by univariate analysis (P &lt; 0·001), but not by multivariate analysis (P = 0·258).

Conclusion
Right hemicolectomy does not confer a survival advantage in patients with mucinous appendiceal tumours with peritoneal seeding. These data suggest that right hemicolectomy should be avoided unless metastatic involvement of the appendiceal or distal ileocolic lymph nodes is documented by biopsy, or the resection margin is inadequate.
Routine day-case laparoscopic cholecystectomy
Authors: Leeder P C , Matthews T , Krzeminska K , Dehn T C B 
Published: February 2004

Abstract

Background
A prospective study was carried out to assess the feasibility of performing true day-case laparoscopic surgery in a district general hospital.

Methods
All patients admitted consecutively under the care of one surgeon for laparoscopic cholecystectomy were included in the study. Selection criteria for a day-case procedure included an American Society of Anesthesiologists grade of I or II and the availability of a responsible carer at home. Patients were discharged 4–6 h after surgery with a standard analgesia pack and a contact number for advice. All patients were contacted by telephone on the day after discharge. A postal questionnaire was sent to the first 100 patients to assess satisfaction with the day-case process.

Results
Of 357 patients admitted for laparoscopic cholecystectomy over a 24-month period, 154 (43·1 per cent) were operated on as day cases on a morning theatre list. Twenty-two patients required an overnight stay (14·3 per cent), three because of conversion to an open procedure. One patient was readmitted for neck pain. Eighty-two (92·1 per cent) of 89 patients were either satisfied or very satisfied with the day-case procedure.

Conclusion
This study has demonstrated a low rate of overnight stay (14·3 per cent) and readmission (1·9 per cent), and a high degree of patient satisfaction for day-case laparoscopic cholecystectomy.
Management of blunt liver trauma in a tertiary referral centre
Authors: Coughlin P A , Stringer M D , Lodge J P A , Pollard S G , Prasad K R , Toogood G J 
Published: February 2004

Abstract

Background
In recent years, several reports from North America have highlighted the success of conservative treatment in patients with blunt liver trauma. The aim of this study was to identify trends in the management of blunt liver trauma in a UK tertiary referral centre dealing with both adults and children over a 10-year period.

Methods
A retrospective case note review was performed on 71 consecutive patients (58 male patients) of median age 25 years admitted to the hepatobiliary unit over the 10-year period from 1992 to 2001 with blunt liver trauma. Data relating to referring source, severity of liver injury, initial and subsequent management and outcome were collected using a standard pro forma.

Results
Sixty-two of the 71 patients were referred from other surgical units. Of these, 14 had undergone laparotomy at the referring hospital, with ten having perihepatic packing; the other 48 were managed conservatively. Of the 62 patients transferred to the authors' unit, 12 required surgical intervention for the liver injury. The mean number of patients with blunt liver trauma increased between the first second 5-year periods, from 3·2 to 11·0 patients per year. There was a significant reduction in the proportion of patients requiring surgery for the liver injury in both the authors' unit (from seven of 16 patients in 1992–1996 to seven of 55 in 1997–2001; P = 0·017, χ2 test) and referring hospitals (from six of 12 to eight of 50; P = 0·014, χ2 test). The reduction in the mortality rate, from two (12·5 per cent) of 16 in the first period to four (7·3 per cent) of 55 in the second, was not significant (P = 0·880, χ2 test).

Conclusion
This study demonstrated a marked increase in the number of patients with blunt liver trauma referred to a regional hepatobiliary centre in recent years. It has confirmed that the majority of such patients can be treated successfully without surgery.
Chinese experience with hepatectomy for huge hepatocellular carcinoma
Authors: Chen X P , Qiu F Z , Wu Z D , Zhang B X 
Published: February 2004

Abstract

Background
The risks and outcome of hepatic resection for huge hepatocellular carcinoma (HCC) are controversial.

Methods
The clinical records of 525 patients who underwent resection of HCC greater than 10 cm in diameter were studied retrospectively. Prognostic factors for long-term survival were evaluated by univariate and multivariate analyses.

Results
Postoperative complications were common (26·8 per cent) and five patients (0·9 per cent) required relaparotomy. The 30-day mortality rate was 2·7 per cent. The main causes of postoperative death were liver failure (nine patients) and bleeding (four). The 3-, 5- and 10-year crude survival rates after liver resection were 34·3, 16·8 and 2·9 per cent respectively.

Conclusion
Prognostic factors for long-term survival mainly reflected the biological behaviour of the tumour. They can be used only as a guide in balancing the risks of operation against the potential benefits of resection in a patient in poor general condition or with poor liver function. They cannot be used alone to exclude patients from liver resection with curative intent. Liver resection for huge HCC was safe and efficacious. It should be used to treat patients with acceptable surgical risks and resectable tumours.
Risk-adjusted prediction of operative mortality in oesophagogastric surgery with O-POSSUM
Authors: Tekkis P P , McCulloch P , Poloniecki J D , Prytherch D R , Kessaris N , Steger A C 
Published: February 2004

Abstract

Introduction
The present study was designed to develop a dedicated oesophagogastric model for the prediction of risk-adjusted postoperative mortality in upper gastrointestinal surgery (O-POSSUM).

Methods
Using 1042 patients undergoing oesophageal (n = 538) or gastric (n = 504) surgery between 1994 and 2000 the Portsmouth predictor equation for mortality (P-POSSUM) scoring system was compared with a standard logistic regression O-POSSUM model and a multilevel O-POSSUM model using the following independent factors: age, physiological status, mode of surgery, type of surgery and histological stage.

Results
The overall mortality rate was 12·0 per cent (elective mortality rate 9·4 per cent and emergency mortality rate 26·9 per cent). P-POSSUM overpredicted mortality (14·5 per cent), particularly in the elective group of patients. The multilevel model offered higher discrimination than the single-level O-POSSUM and P-POSSUM models (area under receiver–operator characteristic curve 79·7 versus 74·6 and 74·3 per cent). When observed to expected outcomes were evaluated, the multilevel O-POSSUM model was found to offer better calibration (Hosmer–Lemeshow χ2 statistic 10·15 versus 10·52 and 28·80).

Conclusion
The multilevel O-POSSUM model provided an accurate risk-adjusted prediction of death from oesophageal and gastric surgery for individual patients. In conjunction with a multidisciplinary approach to patient management, the model may be used in everyday practice for perioperative counselling of patients and their carers.
Randomized clinical trial of the use of a prosthetic mesh to prevent parastomal hernia
Authors: Jänes A , Cengiz Y , Israelsson L A 
Published: February 2004

Abstract

Background
Parastomal hernia is a common complication following colostomy, and repair with a prosthetic mesh is associated with the lowest recurrence rate. The aim of this study was to determine the effect on stoma complications of using a mesh at the primary operation.

Methods
Patients undergoing permanent colostomy were randomized to have either a conventional stoma or the addition of a mesh placed in a sublay position. A large-pore lightweight mesh with a reduced polypropylene content and a high proportion of absorbable material was used.

Results
Twenty-seven patients were randomized to have a conventional stoma and 27 to have the mesh. No infection, fistula formation or pain occurred (observation time 2–28 months). At the 12-month follow-up, parastomal hernia was present in eight of 18 patients without a mesh and in none of 16 patients in whom the mesh was used.

Conclusion
A lightweight prosthetic mesh in a sublay position at the stoma site was not associated with infection or other early complications. Preliminary results indicate that the mesh prevented the development of parastomal hernia.
Predictors of extrahepatic recurrence after resection of colorectal liver metastases
Authors: Ueno H , Mochizuki H , Hashiguchi Y , Hatsuse K , Fujimoto H , Hase K 
Published: February 2004

Abstract

Background
It is important to identify patients at high risk of extrahepatic recurrence after surgery for liver metastases, in order to maximize the survival benefit obtained by prophylactic regional chemotherapy.

Methods
Data from 68 patients who underwent resection of colorectal liver metastases but who did not receive hepatic arterial chemotherapy or intravenous systemic chemotherapy were collected. Twenty-two variables were examined by univariate and multivariate analyses to determine which factors were relevant to extrahepatic recurrence. A scoring system was developed that included the most relevant factors.

Results
The extrahepatic recurrence rate at 3 years after hepatectomy was 57·8 per cent. Three variables were independently associated with extrahepatic recurrence including raised serum level of carcinoembryonic antigen after hepatectomy (relative risk (RR) 5·4, P &lt; 0·001), venous invasion of the primary tumour (RR 4·0, P = 0·001) and high-grade budding of the primary tumour (RR 3·1, P = 0·006). Patients with none of these risk factors had a 3-year extrahepatic recurrence rate of 7·1 per cent, compared with 61·6 per cent for those with one risk factor and 100 per cent for those with two or three risk factors.

Conclusion
It was possible to identify patients at high risk of disease relapse at extrahepatic sites. This system might be used on an individual basis to select patients with colorectal liver metastases for regional chemotherapy or systemic chemotherapy after surgical intervention.