bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic Thyroidectomy in 75 Children and Adolescents with Hereditary Medullary Thyroid Carcinoma: German and Austrian Experience
Authors: Dralle Henning , Gimm Oliver , Simon Dietmar , Frank‐Raue Karin , Görtz Günter , Niederle Bruno , Wahl Robert A. , Koch Bernd , Walgenbach Siegfried , Hampel Rainer , Ritter Michael M. , Spelsberg Fritz , Heiss A. , Hinze Raoul , Höppner Wolfgang 
Published: August 2002

AbstractWhen mutations of the RETproto‐oncogene were found in 1993 to account for hereditary medullary thyroid carcinoma (MTC), surgeons obtained the opportunity to operate on patients prophylactically (i.e., at a clinically asymptomatic stage). Whether this approach is justified, and, if so, when and to which extent surgery should be performed remained to be clarified. A questionnaire was sent to all surgical departments in Germany and Austria. All of the patients who fulfilled the following criteria were enrolled: (1) preoperatively proved RET mutation; (2) age ≤ 20 years, (3) clinically asymptomatic thyroid C cell disease; and (4) TNM classification pT0–1/pNX/pN0–1/M0. Seventy‐five patients were identified, and fifteen mutations were detected in six codons. Two adolescents had unilateral pheochromocytomas as part of the multiple endocrine neoplasia II (MEN‐II) syndrome. No hyperparathyroidism was noted. All patients underwent total thyroidectomy, and 57 patients went on to have lymph node dissection. Parathyroid glands were removed in 34 patients and autografted in 11. Histopathology revealed MTC in 46 patients (61%, youngest 4 years); C cell hyperplasia (CCH) only was detected in the other 29 patients. Three patients had lymph node metastases (LNMs) the youngest being age 14 years. Calcitonin levels were not useful for differentiating between CCH and MTC, but in all patients with LNMs at least the stimulated calcitonin levels were assayed. After surgery, five patients (6.7%) sustained permanent hypoparathyroidism, and one patient (1.3%) had a permanent unilateral recurrent nerve palsy. All but three patients (96%) were biochemically cured. In conclusion, prophylactic total thyroidectomy can be performed safely in experienced centers. We recommend prophylactic total thyroidectomy at age 6. Cervicocentral lymph node dissection should be included when calcitonin levels are elevated or if patients are older than 10 years. Bilateral lymph node dissection should be performed if LNMs are suspected or when patients with elevated calcitonin are older than 15 years.
Gastric Bypass Operation for Obesity
Authors: Fobi Mathias A.L. , Lee Hoil , Holness Ronald , Cabinda DeGaulle 
Published: August 2002

AbstractGastric bypass is considered by many to be the gold standard for surgical treatment of obesity. Gastric bypass was a natural evolution from gastric operations that were used for the treatment of peptic ulcer disease. Gastric bypass, first described in 1967, has undergone many modifications. It presently exists as a hybrid operation. Gastric bypass operation has been extensively scrutinized and evaluated against other operations for the treatment of obesity. Co‐morbidities due to severe obesity are usually ameliorated or arrested after the weight loss from gastric bypass. Gastric bypass operation is now being performed with a perioperative morbidity of less than 10%. The average percentage excess weight loss with gastric bypass is 70%. The success rate, defined as 50% excess weight loss after at least 2 years of follow‐up, is 85%. The metabolic deficiencies of gastric bypass are controllable with supplemental intake. This report with special references to the Fobi pouch operation, a modification of gastric bypass done by the author, presents the evolution, modifications, risks, outcome, and future trends of gastric bypass for treatment of obesity.
Evaluation of Retinoblastoma and Ki‐67 Immunostaining as Diagnostic Markers of Benign and Malignant Parathyroid Disease
Authors: Farnebo Filip , Auer Gert , Farnebo Lars‐Ove , Teh Bin Tean , Twigg Stephen , Aspenblad Ulla , Thompson Norman W. , Grimelius Lars , Larsson Catharina , Sandelin Kerstin 
Published: August 2002

AbstractAssessment of the malignant potential of parathyroid tumors in the absence of metastases can be difficult using morphologic criteria alone. In this study we have examined a total of
58 parathyroid tumors (31 benign, 15 malignant, and 12 equivocal) from
54 patients using immunohistochemistry with monoclonal antibodies directed against the retinoblastoma (RB) protein and the cell cycle‐associated antigen Ki‐67 to evaluate their role as diagnostic markers. RB protein immunoreactivity was not useful for distinguishing between benign and malignant parathyroid tumors. Analysis of the proliferation marker Ki‐67 showed that there was a trend toward more intense staining in the malignant cases. The Ki‐67 labeling index was highest in the parathyroid cancers (median 33) and lowest in the sporadic primary adenomas (median 2). An observation that might have clinical implications is that tumors from patients with familial hyperparathyroidism linked to chromosome 1q showed a high Ki‐67 index, indicating strong proliferative activity (median 25). This correlates well with the clinical observation of tumors with malignant potential in this syndrome. Because of the considerable overlap between groups of tumors, Ki‐67 is not suitable for definitive differentiation between benign and malignant tumors. However, Ki‐67 may give valuable information about which patients should be followed more closely.
Anterior Transhepatic Approach for Isolated Resection of the Caudate Lobe of the Liver
Authors: Yamamoto Junji , Kosuge Tomoo , Shimada Kazuaki , Yamasaki Susumu , Takayama Tadatoshi , Makuuchi Masatoshi 
Published: August 2002

AbstractWe have devised a new technique for isolated caudate lobe resection in which we access the caudate lobe by separating the liver parenchyma along the interlobar plane. The safety and radicality of the procedure were evaluated in five patients: four with hepatocellular carcinoma (HCC) and one with metastatic rectal cancer. All of the tumors were located mainly in the paracaval portion of the caudate lobe. The patients with HCC (three of four) underwent an anatomic caudate lobe resection by identification of the right margin of the caudate lobe. Two patients required red blood cell transfusion, and one showed bile leakage after surgery. All of the patients are alive without recurrence more than 4 years after surgery, except one with rectal carcinoma who developed lung metastases. The anterior transhepatic approach is a safe and potentially curative surgical option for a tumor in the paracaval portion of the caudate lobe.
Muscular Performance and Fatigue in Primary Hyperparathyroidism
Authors: Deutch Søren R. , Jensen Martin B. , Christiansen Peer M. , Hessov Ib 
Published: August 2002

AbstractThe purpose of this study was to evaluate changes in muscular strength and endurance, work capacity, and subjective fatigue following surgical treatment of primary hyperparathyroidism (pHPT), and to assess whether changes in muscular function were due to changes in activation of the muscles. A prospective consecutive study design was used, and patients surgically treated for nontoxic goiter served as controls. Nineteen female patients with mild to moderate pHPT and 20 controls were included. Maximal isometric handgrip and quadriceps strength, quadriceps endurance (intermittent stimulation), and quadriceps activation (superimposed twitch technique) were used for evaluation of muscular function. All patients were operated on successfully. Knee extension strength increased by 17 ± 17% (mean ± SD; p= 0.0004) in the patients, whereas no change was observed in the controls. The relative strength increase correlated positively to patient age at operation (r= 0.52, p= 0.02). Handgrip strength, quadriceps endurance, and general work capacity did not change in any group after operation. Subjective fatigue was preoperatively higher in patients than in controls (p= 0.01), and decreased postoperatively to the level of controls. In conclusion, women with pHPT increase knee extension force after parathyroidectomy as a result of increased force generation capacity of the muscle. If change in physical performance is a determinant for change in subjective fatigue in pHPT after operation, then change in strength of the quadriceps muscle seems to be of primary importance, whereas handgrip strength, muscular endurance, and work capacity do not seem to be important. The cause of the increasing strength benefit with increasing age at operation as found in this study needs further investigation.
Parietal Cell Vagotomy versus Vagotomy‐antrectomy: Ulcer Surgery in the Modern Era
Authors: Donahue Philip E. 
Published: August 2002

AbstractPatients with peptic ulcer occasionally develop complications that require surgical intervention, despite the advances in medical treatment and changes in the natural history of disease. The clinical surgeon must make a decision about performing “selective vagotomy antrectomy versus highly selective vagotomy,” based on the information discussed herein. The goals for operative treatment remain safe correction of the presenting problem, avoidance of perioperative morbidity and mortality, and freedom from disabling postoperative side effects. This paper addresses broad aspects of the details of surgical interventions; because most operative procedures are performed in urgent circumstances in patients who often have a variety of conditions, it is not surprising that there is no best operation suited to every complication of ulcer.
Tumors of the Oral Cavity and Pharynx
Authors: Wertheimer‐Hatch Laura , Hatch George F. , Hatch Kathryn F. , Davis Gregory B. , Blanchard D. Kay , Foster Roger S. , Skandalakis John E. 
Published: August 2002

Abstract.We have compiled all the reported cases of smooth muscle (stromal) tumors of the oral cavity and pharynx from 1884 through 1996. Our collective data included 139 leiomyomas (LM) and 68 leiomyosarcomas (LMS); but because we did not have sufficient information for 13 cases of LM, we report on only 126; and we report on only 66 of 68 cases of LMS. The peak age of incidence was 40 to 49 years for benign tumors and 50 to 59 years for malignant lesions, with the incidence in men slightly predominating over that in women. The most common sites of LM of the oral cavity and pharynx were the lips, tongue, and hard and soft palate. The most common sites of LMS included the maxilla and mandible. More than 40% of LMs presented as an intraoral mass, and more than half were known to be present for longer than 1 year. About 10% presented with pain, difficulty chewing or swallowing, swelling, toothache or loose teeth, or a combination of these symptoms. Patients with LMS were much more likely to have obvious symptoms of shorter duration, and one‐third presented with pain or swelling (or both). Other relatively common symptoms of LMS included tenderness, interference with dentures, or an intraoral mass. In this review, there were almost twice as many LMs as LMSs, which was consistent with smooth muscle tumors found in other areas of the gastrointestinal tract.
Limits of Infrapopliteal Bypass Surgery for Critical Leg Ischemia: When Not to Reconstruct
Authors: Biancari Fausto , Kantonen Ilkka , Albäck Anders , Mätzke Sorjo , Luther Michael , Lepäntalo Mauri 
Published: August 2002

Abstract.The aim of this study was to identify the risk factors affecting the immediate 30‐day postoperative outcome of infrapopliteal bypass grafts. A series of 511 revascularization procedures to the infrapopliteal arteries have been performed in 439 patients with critical leg ischemia. There were 306 crural bypasses and 205 pedal bypasses. The 30‐day postoperative primary and secondary patency rates were 77.5% and 83.4%, respectively; the leg salvage rate was 89.8%; the survival rate was 94.7%; and 85.1% of patients were alive with a salvaged leg. A history of myocardial infarction, angina pectoris, or stroke had a great impact on the postoperative cardiac and cerebrovascular fatal and nonfatal complications. C‐reactive protein arose as an important predictor of the length of hospital stay (p= 0.03), postoperative cardiac complications (p= 0.02), leg salvage (p= 0.009), amputation with patent graft (p= 0.009), and patients who survived with a salvaged leg (p= 0.006). Poor results were achieved in patients on long‐term dialysis. Surgical experience had an influence on leg salvage (p= 0.02) and on patients alive with salvaged leg rates (p= 0.009). Infrapopliteal bypass surgery is a demanding procedure requiring high surgical skill and experience. Revascularization may be contraindicated when severe coronary disease, previous stroke, renal failure requiring long‐term dialysis, diabetes, or high serum concentration of C‐reactive protein coexist with critical leg ischemia, as these patients are at high risk for early postoperative leg or life loss.
Evaluation of the Clinical and Histologic Features of Renal Allograft Rejection in Cats
Authors: Kyles Andrew E. , Gregory Clare R. , Griffey Stephen M. , Galvez Jose , Ramsamooj Rajen , Morris Randall E. 
Published: August 2002

Objectives—To describe the clinical signs and histopathologic features of renal allograft rejection in cats, and to provide a historical, untreated control group for use in future studies of feline renal allograft rejection.Animals—Fourteen adult research cats.Methods—Renal transplantation and bilateral nephrectomy were performed in pairs of immunogenically mismatched cats. A physical examination was performed, and packed cell volume, total protein, and plasma creatinine concentrations were measured each day after surgery. The cats were euthanatized when plasma creatinine concentration exceeded 7 mg/dL or when weight loss exceeded 20%. Renal histopathology was scored according to the Banff 97 criteria by 3 pathologists.Results—Nine cats completed the study. Plasma creatinine exceeded 7 mg/dL in 5 cats, weight loss exceeded 20% in 3 cats, and 1 cat was found dead. Clinical signs in cats with rejection were nonspecific or absent. Rectal temperature decreased by 0.8 ± 0.5°C in the 24 hours before euthanasia. The pathologists agreed on the allograft histopathologic category in 6 of 9 cats. The histologic concensus was acute/active rejection in 8 cats and normal in 1 cat. Median survival time of the 8 cats with histologically confirmed allograft rejection was 23 days (range, 8–34 days).Conclusions and Clinical Relevance—Renal allograft rejection is associated with minimal clinical signs. Therefore, plasma creatinine concentration should be measured routinely in patients with a functioning allograft. An increase in plasma creatinine concentration is highly suspicious for allograft rejection, although a biopsy of the renal allograft is needed for definitive diagnosis.
Open Peritoneal Drainage Versus Primary Closure for the Treatment of Septic Peritonitis in Dogs and Cats: 42 Cases (1993–1999)
Authors: Staatz Andrew J. , Monnet Eric , Seim Howard B. 
Published: August 2002

Objective—To determine survival rates in dogs and cats with septic peritonitis treated with open peritoneal drainage (OPD) versus primary closure (PC) after laparotomy.Study design—Retrospective analysis of medical records from Colorado State University Veterinary Teaching Hospital from 1993 to 1999.Sample population—Thirty‐six dogs and 6 cats with septic peritonitis documented by cytological examination or microbiological culture of abdominal fluid.Methods—Medical records of dogs and cats with septic peritonitis treated by OPD or PC were reviewed. Age, weight, species, white blood cell (WBC) count, band neutrophil count, platelet count, serum glucose concentration, heart rate, body temperature, duration of hospitalization, and clinical outcome were recorded for each animal. Differences in treatments administered between the OPD and PC groups as well as the underlying cause of septic peritonitis were determined.Results—There was no significant difference in survival between animals in the OPD versus PC groups (P= .26) with an overall survival rate of 71%. White blood cell count, band neutrophil count, platelet count, serum glucose and total bilirubin concentrations, heart rate, age, and weight were not significantly different between groups (P> .05). A significantly greater number of animals in the OPD group received plasma (P= .009), blood (P= .037), and a jejunostomy tube (P= .02) than animals in the PC group. There was a significant difference in the number of days spent in critical care unit with a mean of 6.0 ± 4.1 days for the OPD group and 3.5 ± 2.3 days for the PC group (P= .02).Conclusions—Open peritoneal drainage for the management of septic peritonitis in dogs and cats is an acceptable alternative to PC.
The Mitochondrial Production of Reactive Oxygen Species: Mechanisms and Implications in Human Pathology
Authors: Lenaz Giorgio 
Published: August 2002

AbstractMitochondria are major sources of reactive oxygen species (ROS); the main sites of superoxide radical production in the respiratory chain are Complexes III and I; however, other mitochondrial enzymes, such as Complex II, glycerol‐1‐phosphate dehydrogenase, and dihydroorotate dehydrogenase, are also involved in production of ROS. ROS appear to be released both in the matrix and in the intermembrane space; however, their appearance outside the mitochondria may not be physiologically relevant. ROS production is increased in State 4 and in all conditions when the respiratory components are substantially in the reduced form. Accordingly, defects inducing decrease of electron transfer in the respiratory chain, as in many pathological conditions, are bound to enhance ROS production.
Complexity of trauma narratives as an index of fragmented memory in PTSD: a critical analysis
Authors: Gray Matt J. , Lombardo Thomas W. 
Published: August 2002

AbstractPTSD researchers and clinicians report observing fragmented and disorganized trauma memories (FDTM) in interviews with PTSD patients and more coherent, organized, and detailed trauma narratives as treatment progresses. Some hypothesize a causal role for FDTM in developing and/or maintaining PTSD symptoms. Operationally defining FDTM is difficult, but a recent study used Flesch reading formulas to gauge narrative complexity and articulation in FDTM. We evaluated the validity of this method by comparing written trauma narratives of 58 undergraduates with and without PTSD on word counts and articulation complexity. Additional narratives on unpleasant and pleasant experiences tested the specificity of group differences. Large initial effect sizes disappeared when writing skill and cognitive ability were controlled suggesting Flesch analyses may not be useful. Furthermore, trauma narrative lengths exceeded those of other memories for both groups, which is inconsistent with FDTM predictions. Most studies supporting FDTM have used oral accounts which we hypothesize may provoke more anxiety than written accounts and thereby produce more fragmented and disorganized narratives. Copyright © 2001 John Wiley & Sons, Ltd.
Semi‐adaptive control of convexly parametrized systems with application to temperature regulation of chemical reactors
Authors: Fradkov Alexander , Ortega Romeo , Bastin George 
Published: August 2002

AbstractIn this paper, we are interested in the problem of adaptive control of non‐linearly parametrized systems. We investigate the viability of defining a stabilizing parameter update law for the case when the plant model is convex on the uncertain parameters. We show that, when the only prior knowledge is convexity, there does not exist an adaptation law—derivable from the standard separable Lyapunov function technique of Parks—applicable for all the state space. Therefore, we propose a semi‐adaptive state feedback controller where adaptation takes place only in the region of the state space where convexity can be used to reduce parameter uncertainty. In the remaining part of the state space we freeze the adaptation and switch to a robust controller. This scheme ensures semi‐global stability for convexly parametrized non‐linear systems with matched uncertainty. The proposed controller is then applied to the problem of temperature regulation of continuous stirred exothermic chemical reactors where reaction heat is convex in the uncertain parameters. Copyright © 2001 John Wiley & Sons, Ltd.
Pharmacodynamics and pharmacokinetics of single doses of subcutaneous pegylated human G‐CSF mutant (Ro 25‐8315) in healthy volunteers: Comparison with single and multiple daily doses of filgrastim
Authors: van der Auwera Phillippe , Platzer Erich , Xu Z.‐X. , Schulz Rainer , Feugeas Olivier , Capdeville Renaud , Edwards David J. 
Published: August 2002

AbstractRo 25‐8315 is produced by conjugation of rhG‐CSF mutant with polyethylene glycol (PEG). The purpose of this study was to examine the pharmacodynamics and pharmacokinetics of Ro 25‐8315 in comparison with Filgrastim (rhG‐CSF). Subjects received single subcutaneous doses of Ro 25‐8315 ranging from 10 to 150 μg/kg using a double‐blind, randomized, placebo‐controlled design. Filgrastim was administered as a single dose (5 or 10 μg/kg) and, following a 14‐day washout period, daily for 7 days. Ro 25‐8315 increased absolute neutrophil count (ANC) by 6‐ to 8‐fold and CD34+ cell count more than 30‐fold at the highest doses tested. Single doses (60–150 μg/kg) of Ro 25‐8315 and multiple doses of Filgrastim had similar effects on ANC and CD34+, although Ro 25‐8315 had a greater effect on CFU‐GM. The pharmacokinetics of Ro 25‐8315 were dose‐dependent, with peak concentrations and area under the serum concentration–time curve (AUC) increasing 100‐fold over the range of doses studied. Time to reach peak concentration (Tmax) and half‐life of Ro 25‐8315 averaged 20–30 hr at all doses, approximately three times longer than with Filgrastim. Adverse events were not serious and occurred with similar frequency with both products. Pegylation of rhG‐CSF mutant results in more desirable pharmacokinetic properties and a longer duration of action with effective increases in ANC and measures of peripheral blood progenitor cell mobilization for at least 1 week. Am. J. Hematol. 66:245–251, 2001. © 2001 Wiley‐Liss, Inc.
Successful treatment with recombinant factor VIIa of therapy‐resistant severe bleeding in a patient with acquired von Willebrand disease
Authors: Friederich Philip W. , Wever Peter C. , Briët Ernest , Doorenbos Cornelis J. , Levi Marcel 
Published: August 2002

AbstractWe describe an elderly man who presented with life‐threatening hematuria and gastrointestinal bleeding caused by acquired von Willebrand disease associated with monoclonal gammopathy of undetermined significance (MGUS). Standard therapy with desmopressin, von Willebrand factor‐containing factor VIII concentrate, tranexamic acid, and immunoglobulin failed to achieve adequate hemostasis. However, treatment with recombinant activated factor VII (rFVIIa) arrested the bleeding completely. Since acquired von Willebrand disease can lead to life‐threatening hemorrhage, clinicians should consider rFVIIa as an effective treatment option if standard therapy fails. Am. J. Hematol. 66:292–294, 2001. © 2001 Wiley‐Liss, Inc.