bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of laboratory ware related changes in conformational and mechanical properties of collagen
Authors: Sripriya R. , Ahmed Md. Rafiuddin , Sehgal P. K. , Jayakumar R. 
Published: January 2003

AbstractEnzyme‐treated acid‐solubilized bovine collagen (ESBC Type I) prepared in laboratory‐grade glass and polypropylene ware under identical conditions have shown different conformational and mechanical properties. Circular dichroism (CD) studies on ESBC have shown higher triple‐helical contents in polypropylene laboratory‐grade ware compared to laboratory ware of glass. Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetric (DSC) studies have supported the conformational changes performed on both preparations. Both preparations, in membrane form, were evaluated for their mechanical properties—viz., shrinkage temperature (St), dissolution temperature (Dt), and tensile strength (Ts). The collagen membrane of ESBC prepared in polypropylene showed significantly higher values compared to glass ones. No difference was seen in shrinkage temperature data of the two membranes. Reduced viscosity of ESBC was also measured for both preparations, and it had a significantly higher value in polypropylene ware compared to ESBC prepared in glassware. We postulate that the presence of silicate ions (SiO3−2) in glassware has a role in all these changes. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 87: 2186–2192, 2003
Stereologic characterization and spatial distribution patterns of Betz cells in the human primary motor cortex
Authors: Rivara Claire‐Bénédicte , Sherwood Chet C. , Bouras Constantin , Hof Patrick R. 
Published: January 2003

AbstractBetz cells are giant motoneurons located in layer Vb of the primate primary motor cortex. We conducted stereological analyses of Betz cells and neighboring pyramidal cells from the brains of six neurologically normal elderly humans to determine their volume, total number, and spatial distribution, and to relate these data to functional localization. The distribution of cellular volumes exhibits a bimodal pattern, delineating two different subpopulations. Betz cell volumes follow a mediolateral gradient, the largest Betz cells being located on the most medial part of the motor cortex. Additionally, the shape of Betz cells varies between the rostral and caudal parts of the primary motor cortex, supporting the notion that there are anatomically distinct zones in primary motor cortex. The total number of Betz cells per hemisphere accounts for about one‐tenth of the total number of pyramidal cells in layer Vb. Analysis of spatial distribution using Voronoi tessellation revealed maximal clustering of Betz cells in a zone situated two‐thirds from the midline along the mediolateral axis of the primary motor cortex. These data suggest that Betz cells have a discrete subregional distribution that may correspond to certain aspects of the functional parcellation of area 4. These results may offer a histological correlate of functional imaging studies and are relevant in the context of neurodegenerative diseases such as amyotrophic lateral sclerosis, progressive supranuclear palsy, and Guamanian amyotrophic lateral sclerosis/Parkinsonism‐dementia, and in studies of normal brain aging. Anat Rec Part A 270A:137–151, 2003. © 2003 Wiley‐Liss, Inc.
The human vomeronasal organ. V. An interpretation of its discovery by Ruysch, Jacobson, or Kölliker, with an English translation of Kölliker (1877)
Authors: Bhatnagar Kunwar P. , Smith Timothy D. 
Published: January 2003

AbstractThe vomeronasal organs (VNOs) of mammals are highly variable epithelial structures found bilaterally in the mucosa of the nasal septum. Whereas the discovery of the human VNO is traditionally ascribed to Frederick Ruysch (1703, 1724), the organ is named after Ludwig Levin Jacobson (1811, 1813) who described it in nonhuman mammals. We recently have pointed out controversies surrounding the incidence and structure of the enigmatic human VNO, and herein, we provide a historical analysis of its discovery. We present evidence that the honor of discovering the human VNO truly belongs to Kölliker (1877), and not to Ruysch. Ruysch illustrated the lateral view of a 2‐year‐old infant's nasal septum, and it is unclear whether the right nasal passage, the tubular VNO or its opening, or an unrelated duct is being indicated. Jacobson reported the VNO to be missing in humans. Its discovery in the human embryo can be related in part to later authors, such as Dursy (1869). Our reappraisal of the literature confirms that Kölliker was actually the first among these 18th–689th century investigators to provide evidence of the human VNO as a histologically identifiable structure in the fetus and the adult. Anat Rec (Part B: New Anat) 270B:4–15, 2003. © 2003 Wiley‐Liss, Inc.
Integration of advanced technologies to enhance problem‐based learning over distance: Project TOUCH
Authors: Jacobs Joshua , Caudell Thomas , Wilks David , Keep Marcus F. , Mitchell Steven , Buchanan Holly , Saland Linda , Rosenheimer Julie , Lozanoff Beth K. , Lozanoff Scott , Saiki Stanley , Alverson Dale 
Published: January 2003

AbstractDistance education delivery has increased dramatically in recent years as a result of the rapid advancement of communication technology. The National Computational Science Alliance's Access Grid represents a significant advancement in communication technology with potential for distance medical education. The purpose of this study is to provide an overview of the TOUCH project (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) with special emphasis on the process of problem‐based learning case development for distribution over the Access Grid. The objective of the TOUCH project is to use emerging Internet‐based technology to overcome geographic barriers for delivery of tutorial sessions to medical students pursuing rotations at remote sites. The TOUCH project also is aimed at developing a patient simulation engine and an immersive virtual reality environment to achieve a realistic health care scenario enhancing the learning experience. A traumatic head injury case is developed and distributed over the Access Grid as a demonstration of the TOUCH system. Project TOUCH serves as an example of a computer‐based learning system for developing and implementing problem‐based learning cases within the medical curriculum, but this system should be easily applied to other educational environments and disciplines involving functional and clinical anatomy. Future phases will explore PC versions of the TOUCH cases for increased distribution. Anat Rec (Part B: New Anat) 270B:16–22, 2003. © 2003 Wiley‐Liss, Inc.
Anatomy and the Access Grid: Exploiting plastinated brain sections for use in distributed medical education
Authors: Lozanoff Scott , Lozanoff Beth K. , Sora Mircea‐Constantin , Rosenheimer Julie , Keep Marcus F. , Tregear Jonathon , Saland Linda , Jacobs Joshua , Saiki Stanley , Alverson Dale 
Published: January 2003

AbstractComputerized animation is becoming an increasingly popular method to provide dynamic presentation of anatomical concepts. However, most animations use artistic renderings as the base illustrations that are subsequently altered to depict movement. In most cases, the artistic rendering is a schematic that lacks realism. Plastinated sections provide a useful alternative to artistic renderings to serve as a base image for animation. The purpose of this study is to describe a method for developing animations by using plastinated sections. This application is used in Project TOUCH as a supplemental learning tool for a problem‐based learning case distributed over the National Computational Science Alliance's Access Grid. The case involves traumatic head injury that results in an epidural hematoma with transtentorial uncal herniation. In addition, a subdural hematoma is animated permitting the student to contrast the two processes for a better understanding of dural hematomas, in general. The method outlined uses P40 plastinated coronal brain sections that are digitized and to which contiguous anatomical structures are rendered. The base illustration is rendered, interpolated, and viewed while audio narration describes the event. This method demonstrates how realistic anatomical animations can be generated quickly and inexpensively for medical education purposes by using plastinated brain sections. Anat Rec (Part B: New Anat) 270B:30–37, 2003. © 2003 Wiley‐Liss, Inc.
Virtual patient simulator for distributed collaborative medical education
Authors: Caudell Thomas P. , Summers Kenneth L. , Holten Jim , Hakamata Takeshi , Mowafi Moad , Jacobs Joshua , Lozanoff Beth K. , Lozanoff Scott , Wilks David , Keep Marcus F. , Saiki Stanley , Alverson Dale 
Published: January 2003

AbstractProject TOUCH (Telehealth Outreach for Unified Community Health; http://hsc.unm.edu/touch) investigates the feasibility of using advanced technologies to enhance education in an innovative problem‐based learning format currently being used in medical school curricula, applying specific clinical case models, and deploying to remote sites/workstations. The University of New Mexico's School of Medicine and the John A. Burns School of Medicine at the University of Hawai'i face similar health care challenges in providing and delivering services and training to remote and rural areas. Recognizing that health care needs are local and require local solutions, both states are committed to improving health care delivery to their unique populations by sharing information and experiences through emerging telehealth technologies by using high‐performance computing and communications resources. The purpose of this study is to describe the deployment of a problem‐based learning case distributed over the National Computational Science Alliance's Access Grid. Emphasis is placed on the underlying technical components of the TOUCH project, including the virtual reality development tool Flatland, the artificial intelligence–based simulation engine, the Access Grid, high‐performance computing platforms, and the software that connects them all. In addition, educational and technical challenges for Project TOUCH are identified. Anat Rec (Part B: New Anat) 270B:23–29, 2003. © 2003 Wiley‐Liss, Inc.
Observed increases in positive affect during behavioral treatment
Authors: Toole Lisa M. , Bowman Lynn G. , Thomason Jessica L. , Hagopian Louis P. , Rush Karena S. 
Published: January 2003

AbstractA 15‐year‐old female diagnosed with mental retardation was admitted to an inpatient facility for the assessment and treatment of a severe behavior disorder. A behavioral treatment to reduce destructive behavior consisting of enriched environment, differential reinforcement, and time‐out was evaluated in a reversal design. Data on affect were collected during baseline and treatment phases. In addition to achieving clinically significant reductions in problem behavior, collateral improvements in positive affect were observed during treatment phases. Copyright © 2003 John Wiley & Sons, Ltd.
Major amputation for soft-tissue sarcoma
Authors: Clark M A , Thomas J M 
Published: January 2003

Abstract

Background
Advances in oncological practice have reduced the number of major amputations performed for soft-tissue sarcoma, but this remains a valuable, if infrequent, option for both curative and palliative indications.

Methods
A review of patients and case-notes was carried out from the prospective sarcoma database at the Royal Marsden Hospital.

Results
Over a 10-year interval, 40 major amputations (18 forequarter, 17 hindquarter and five through hip) were performed, predominantly for disease recurring after previous limb-conserving surgery (31 of 40). A wide variety of soft-tissue sarcoma subtypes was seen; they were often large (more than 10 cm; 18 of 40) or multifocal (six), usually high grade (25), and frequently proximal or involving neurovascular structures such that limb salvage was precluded. Median range age of the patients was 59 (17–87) years. The operative 30-day mortality rate was zero. Hospital stay was a median of 10·5 days for forequarter amputation, and 19 days for hindquarter and through-hip amputation. Local recurrence occurred in ten patients, six of whom had concurrent distant metastases. Twenty-seven patients were alive (20 disease free) at a median follow-up of 12 months, nine of whom were alive without evidence of disease beyond 2 years. Ten patients died after a median of 7·5 months; three survived more than 2 years.

Conclusion
Major amputation is a useful procedure in carefully selected patients with soft-tissue sarcoma.
Mortality, morbidity and functional outcome after ileorectal anastomosis
Authors: Elton C , Makin G , Hitos K , Cohen C R G 
Published: January 2003

Abstract

Background
Total colectomy with an ileorectal anastomosis (IRA) is a commonly performed operation. Postoperative mortality and morbidity are reported to be low and functional outcome is generally rated as good to excellent. The aim of this study was to review postoperative mortality, morbidity and functional results in an effort to identify risk factors predictive of a poor outcome.

Methods
Some 215 patients (118 women and 97 men) with a median age of 33 (interquartile range (i.q.r.) 25–47) years underwent an IRA between November 1990 and December 1999. Median follow-up was 2 years 9 months (i.q.r. 1–5 years). The clinical notes of these patients were reviewed retrospectively to analyse the postoperative course, bowel function and long-term clinical outcome.

Results
The indications for surgery included familial adenomatous polyposis (52·1 per cent), Crohn's disease (14·4 per cent), functional bowel disorder (14·4 per cent), ulcerative colitis (8·4 per cent) and colonic carcinoma (4·7 per cent). The overall 30-day mortality and morbidity rates were 0·9 and 26·0 per cent respectively. This included anastomotic leak (6·5 per cent), small bowel obstruction (14·4 per cent), fistula (2·8 per cent) and anastomotic stricture (1·4 per cent). The incidence of fistula and anastomotic stricture was significantly higher in Crohn's disease (P &lt; 0·001 and P = 0·005 respectively). Only 16 of 31 patients with Crohn's disease had a functioning IRA at long-term follow-up. Median stool frequency was 3 (i.q.r. 3–5) per day one year following surgery and did not change with longer follow-up.

Conclusion
Mortality and morbidity rates following IRA are low. Postoperative fistula and anastomotic stricture are more common in patients with Crohn's disease, approximately half of whom will eventually need a permanent ileostomy. Long-term bowel function for all groups is satisfactory.
Risk of dysplasia in the columnar cuff after stapled restorative proctocolectomy
Authors: Coull D B , Lee F D , Henderson A P , Anderson J H , McKee R F , Finlay I G 
Published: January 2003

Abstract

Background
Stapled restorative proctocolectomy (SRP) for ulcerative colitis retains a ‘cuff’ of columnar epithelium, which carries a risk of undergoing malignant change. The risk of neoplastic transformation was studied in a series of patients who underwent SRP for ulcerative colitis.

Methods
One hundred and thirty-five patients who underwent SRP for ulcerative colitis between 1988 and 1998 were followed up by cuff surveillance biopsy. The median follow-up was 56 (range 12–145) months and the median time since diagnosis of ulcerative colitis was 8·8 (range 2–32) years.

Results
The cuff biopsies showed no dysplasia or carcinoma. The accuracy of obtaining cuff mucosa in the biopsy was 65 per cent. Chronic inflammation was present in 94 per cent of cuff biopsies.

Conclusion
This study shows no evidence of either dysplasia or carcinoma in the columnar cuff mucosa, up to 12 years after pouch formation. This suggests that cuff surveillance in the first decade after SRP, in the absence of dysplasia or carcinoma in the original colectomy specimen, may be unnecessary. Regular cuff surveillance biopsies after SRP should continue for patients with high-grade dysplasia or carcinoma in the original resection specimen.
Effect on diagnostic efficiency of analgesia for undifferentiated abdominal pain
Authors: Thomas S H , Silen W 
Published: January 2003

Abstract

Background
The question of whether it is safe to provide analgesia for patients with undifferentiated acute abdominal pain is marked by longstanding controversy over the possible masking of physical findings. The goal of this review is to assess the pertinent studies.

Method
A Medline search was performed in April 2002, using the terms ‘analgesia’, ‘abdominal pain’, ‘acute abdomen’ and ‘morphine’. Other articles were identified using the bibliographies of papers found through Medline. All articles reporting clinical trials of analgesia and its effects on diagnosis or physical examination were reviewed.

Results
A total of eight trials (one reported only as an abstract) were identified. Because of significant disparity in trial design, no formal analysis such as meta-analysis was performed. However, detailed review of the trials revealed a striking consistency in results. In no study was there an association between analgesia and diagnostic impairment or dangerous masking of the findings of physical examination.

Conclusion
The literature addressing early pain relief for abdominal pain is characterized by weaknesses, but there is a common theme suggesting that analgesia is safe. Pending further research, which should address some of the shortcomings of extant studies, a practice of judicious provision of analgesia appears safe, reasonable and in the best interests of patients in pain.
Impact of surgical procedure for gastric cancer on quality of life
Authors: Díaz de Liaño A , Oteiza Martínez F , Ciga M A , Aizcorbe M , Cobo F , Trujillo R 
Published: January 2003

Abstract

Background
The aim was to assess quality of life in a group of patients who had a curative resection for gastric cancer.

Methods
The European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire with a gastric cancer-specific module was used in patients who had undergone R0 gastrectomy between 1992 and 1999, and who had no disease at the last check-up. A response was obtained from 54 patients, 36 men and 18 women, of mean age 67 years. Of these, 24 patients had total gastrectomy and 26 D2 lymphadenectomy.

Results
Significant differences were found only in the social domain of quality of life in patients aged over 70 years (P = 0·036); there was no impact of operation type on overall quality of life.

Conclusion
The quality of life of patients undergoing curative surgery for gastric cancer, regardless of age, was not significantly influenced by the type of gastrectomy, or whether lymphadenectomy was performed.
Autologous blood storage before hepatectomy for hepatocellular carcinoma with underlying liver disease
Authors: Itamoto T , Katayama K , Nakahara H , Tashiro H , Asahara T 
Published: January 2003

AbstractBackgroundPreoperative autologous blood donation has been suggested for patients with liver disease who are to undergo liver resection. The aim of this retrospective study was to clarify the risk factors for increased blood loss and the need for blood transfusion during hepatectomy for hepatocellular carcinoma (HCC).MethodsFrom January 1996 to December 2000, 206 consecutive patients, 98·5 per cent of whom had underlying liver disease, underwent elective hepatectomy for HCC.ResultsMajor hepatectomy was performed in 34 patients (16·5 per cent) and minor hepatectomy in 172 patients (83·5 per cent). The mean blood loss was 410 (median 260) ml. Eleven (5·3 per cent) of the 206 patients received blood transfusion during or after the operation. Operation time (P = 0·004) and central venous pressure (CVP) (P = 0·041) were independently correlated with blood loss of more than 1000 ml. Only preoperative haemoglobin level (P = 0·001) was independently correlated with the need for blood transfusion.ConclusionIn patients with underlying liver disease, maintaining CVP at a level below 5 cmH2O during parenchymal transection to reduce blood loss is more important than reserving autologous blood before the operation.
The National Health Service Breast Screening Programme and British Association of Surgical Oncology audit of quality assurance in breast screening 1996–2001
Authors: Sauven P , Bishop H , Patnick J , Walton J , Wheeler E , Lawrence G 
Published: January 2003

Abstract

Background
The National Health Service Breast Screening Programme (NHSBSP) is an example of a nationally coordinated quality assurance programme in which all the professional groups involved participate.

Methods
Surgeons, radiologists and pathologists defined the clinical outcome measures against which they would subsequently be audited. The NHSBSP and the Association of Breast Surgery at BASO are jointly responsible for coordinating an annual audit of all surgical activities undertaken within the NHSBSP.

Results
The trends for key outcome measures between 1996 and 2001 are provided. The preoperative diagnosis rate (minimum standard 70 per cent or more) improved from 63 to 87 per cent. This rise was mirrored by an increase in the use of core biopsy in preference to fine-needle cytology. The proportion of patients in whom lymph node status was recorded improved from 81 to 93 per cent. There was no significant change in the number of women treated by low case-load surgeons and waiting times for surgery increased through the study interval.

Conclusion
The BASO–NHSBSP Breast Audit has recorded major changes in clinical practice over 5 years. A key feature has been the dissemination of good practice through feedback of the results at local and national level.
Organ-preserving pancreatic head resection in chronic pancreatitis
Authors: Farkas G , Leindler L , Daróczi M , Farkas G 
Published: January 2003

AbstractBackgroundTwenty to thirty per cent of patients with chronic pancreatitis develop inflammatory enlargement of the head of the pancreas. A safe procedure has been developed for duodenum-preserving pancreatic head resection; this report describes the preliminary results achieved.MethodsThirty patients, 27 men and three women of mean age 44 years, underwent surgical resection following the development of an inflammatory mass in the pancreatic head. All patients had weight loss and frequent abdominal pain. Jaundice was present in three and diabetes mellitus in ten patients. The diagnosis of chronic pancreatitis was made by a combination of endoscopic retrograde cholangiopancreatography, sonography and computed tomography. Pancreatic function was assessed by amylum tolerance test (ATT), oral glucose tolerance test and stool elastase measurement. The surgical procedure involved wide local resection of the inflammatory tumour in the pancreatic head, without division of the pancreas over the portal vein. Reconstruction involved drainage via a jejunal Roux-en-Y loop. In three icteric cases, prepapillary bile duct anastomosis was also performed using the same jejunal loop.ResultsThere were no hospital deaths or major complications. After a median follow-up of 10 (range 6–14) months, all patients were symptom free. The mean increase in body-weight was 8·9 (range 4–20) kg. The ATT and stool elastase level demonstrated improved exocrine function but there was no change in endocrine function.ConclusionThis type of pancreatic head resection is a safe procedure that provides good short-term relief of symptoms associated with inflammatory changes in the head of the pancreas in chronic pancreatitis.