bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conceptual system design evaluation: Rating and ranking versus compliance analysis
Authors: Smith Caroline , Verma Dinesh 
Published: October 2004

AbstractThe conceptual design phase is a critical part of the systems engineering approach, in terms of commitment of both time and money. Structure and discipline at this time are fundamental to the efficient and effective development of competitive products and systems. However, the extent and resolution of information available during this phase, in the form of parameter values and priorities, is typically characterized by imprecision and subjectivity. Such uncertainty can be represented by fuzzy variables and linguistic values. Discrimination between competing product concepts thus necessitates identification of a defuzzification technique to allow comparison of imprecise requirements with imprecise expected values for conceptual alternatives. Since fuzzy numbers do not exhibit complete order, many existing defuzzification techniques are based on the philosophy of rating and ranking fuzzy sets. This paper argues that a defuzzification technique based on the degree of compliance between required and anticipated parameter values is more suited to concept evaluation and selection. The advantage of such an approach is demonstrated and a fuzzy logic based framework for this purpose is proposed. Finally, techniques for accelerating such a compliance analysis are suggested. © 2004 Wiley Periodicals, Inc. Syst Eng 7: 338–351, 2004
The fetal esophagus: anatomical and physiological ultrasonographic characterization using a high‐resolution linear transducer
Authors: Malinger G. , Levine A. , Rotmensch S. 
Published: October 2004

AbstractObjectiveTo study the sonographic anatomy and physiology of the human fetal esophagus during the mid‐trimester of pregnancy using a high‐resolution linear transducer.MethodsThis was a prospective observational study of the fetal esophagus between 19 and 25 weeks' gestation. The study was performed in 60 consecutive fetuses, after a normal anatomy scan, using a 5–13‐MHz matrix array wide‐band transducer. During the examination the collapsed esophagus was first visualized, and followed by a 5‐min video recording in order to demonstrate luminal patency and peristaltic waves.ResultsComplete anatomical visualization of the esophagus was possible in 52 (86.7%) patients and at least partial visualization in 58 (96.7%) patients. Three different patterns of esophageal motility were observed: a simultaneous and short opening of the whole esophagus was found in 35 (58.3%) fetuses; a segmental, peristalsis‐like movement from the pharynx, through the mediastinum, and into the stomach was found in 18 (30%) fetuses; and in one fetus reflux‐like passage of solid contents from the stomach was observed. The mean time required for demonstration of esophageal patency was 96.1 (range, 10–300) s.ConclusionsDemonstration of normal anatomy and physiological activity of the fetal esophagus is feasible using appropriate transducers. The most commonly observed pattern of esophageal motility in the mid‐trimester of pregnancy is the simultaneous relaxation of the upper and lower esophageal sphincters with concurrent opening of the esophageal lumen from the upper thorax to the stomach. Demonstration of a patent esophagus may be helpful in fetuses with suspected esophageal atresia. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.
Sonographic features of decidualized ovarian endometriosis suspicious for malignancy
Authors: Fruscella E. , Testa A. C. , Ferrandina G. , Manfredi R. , Zannoni G. F. , Ludovisi M. , Malaggese M. , Scambia G. 
Published: October 2004

AbstractThe discovery of an ovarian mass during pregnancy is often a difficult issue because of the risk related to surgical intervention during pregnancy. Moreover, ultrasound examination is often unable to provide a definitive diagnosis. A case of decidualized ovarian endometriosis is presented to highlight the challenges in this diagnosis. We report the transvaginal ultrasound findings, including color Doppler examination, magnetic resonance characteristics and tumor marker longitudinal evaluation during the first trimester of pregnancy, as well as the final histological characteristics of the lesion. Decidualization is a rare occurrence in ovarian endometriosis and must be differentiated from malignant transformation. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.
Middle cerebral artery Doppler indices at different sites: prediction of umbilical cord gases in prolonged pregnancies
Authors: Figueras F. , Lanna M. , Palacio M. , Zamora L. , Puerto B. , Coll O. , Cararach V. , Vanrell J. A. 
Published: October 2004

AbstractObjectivesTo assess the value of middle cerebral artery Doppler indices obtained from different sampling sites in predicting umbilical cord gases at delivery in prolonged pregnancies.MethodsThis was a prospective study of consecutive pregnant women referred for prolonged‐pregnancy surveillance. The predictive value of distal and proximal middle cerebral artery Doppler indices for cord blood gases was evaluated in women who delivered within 48 h of their last antenatal test using stepwise multiple regression.ResultsThere was a significant linear correlation between proximal and distal middle cerebral artery pulsatility indices (R = 0.777; P < 0.0001), the mean values being 1.49 (SD, 0.45) and 1.56 (SD, 0.47), respectively. There was also a linear correlation between proximal and distal cerebroplacental ratios (R = 0.68; P < 0.0001), the mean values being 1.85 (SD, 1.96) and 1.92 (SD, 1.89), respectively. The stepwise multiple regression analysis for umbilical artery pH showed that once the distal middle cerebral artery pulsatility index was introduced into the model, the addition of any variable did not result in a significant improvement of the predictive capacity. The model showed a coefficient of determination (R2) of 0.079. There was a significant correlation between umbilical artery pO2 and both proximal middle cerebral artery pulsatility index (positive) and the occurrence of elective Cesarean section (negative). This model accounted for 21% of the variance (R2 = 0.21). No other variables added any significant prediction for pO2.ConclusionsIn post‐term pregnancies the proximal middle cerebral artery pulsatility index significantly predicts umbilical artery pO2 at delivery but does not predict pH. There is a weak association between distal middle cerebral artery pulsatility index and pH but, as this only explains 8% of the variance, it is of little clinical value. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.
Assessment of fetal cerebral arterial and venous blood flow before and after vaginal delivery or Cesarean section
Authors: Baytur Y. B. , Tarhan S. , Uyar Y. , Ozcakir H. T. , Lacin S. , Coban B. , Inceboz U. , Caglar H. 
Published: October 2004

AbstractObjectivesTo compare perinatal intracranial arterial and venous blood velocity changes between healthy term neonates delivered vaginally or by Cesarean section and to correlate these changes with cord blood gases and pH values at birth.MethodsThe study involved 43 healthy term neonates who were delivered vaginally (n = 20) or by Cesarean section (n = 23). All fetuses/neonates were examined by Doppler ultrasound to obtain middle cerebral artery (MCA) and cerebral transverse sinus (Tsin) Doppler waveforms on three occasions (before delivery, and 1 h and 24 h after birth). Pulsatility index (PI) and peak systolic velocity (PSV) for MCA and Tsin were measured and compared between neonates who were delivered vaginally or by Cesarean section. Umbilical cord blood samples were analyzed for umbilical artery and vein pH, pO2 and pCO2 and values were correlated with MCA and Tsin Doppler indices.ResultsMCA‐PI increased and MCA‐PSV decreased at 1 h after birth, and Doppler measurements returned to predelivery values at 24 h after birth. Tsin Doppler measurements remained unchanged at 1 h and 24 h when compared to predelivery values in both the Cesarean and vaginal delivery groups. There was a negative correlation between Tsin‐PI before birth and umbilical venous pH. There was a positive correlation between Tsin‐PSV at 1 h after birth and umbilical vein pCO2.ConclusionsCerebral arterial blood velocity decreases immediately after birth and increases within 24 h, probably as part of neonatal adaptation. Cerebral venous blood velocity remains constant during the perinatal period and is likely to be regulated in a different and more complex manner than that of arterial blood velocity. Mode of delivery does not affect cerebral blood velocity. Copyright © 2004 ISUOG. Published by John Wiley & Sons, Ltd.
On‐line Quality Control of Coated Glass. On‐line Qualitätskontrolle von beschichtetem Glas
Authors: List M. , Melde C. , Krause J. , Köckert C. 
Published: October 2004

AbstractEigenschaften von optischen Schichten, wie z. B. Wärmedämm‐ oder Sonnenschutzschichten, können in der Glasindustrie durch die Messung von Transmission, Reflexion und Flächenwiderstand beschrieben und kontrolliert werden. Verschiedene in situ Transmissionsmessstellen erlauben eine schnelle Rückkopplung zu den einzelnen Beschichtungsprozessen (Schichtdicke und ‐gleichmäßigkeit). Die abschließende Charakterisierung des beschichteten Glases erfolgt durch eine traversierbare ex situ Messung von Transmission, Reflexion und Flächenwiderstand. Präzise und reproduzierbare Messungen erlauben die Anwendung von Reverse Engineering Methoden zur exakten Bestimmung aller Schichtdicken und zur Erkennung von Driften während des Produktionsprozesses.
Experience with Radical esophagogastric devascularization procedures (Sugiura) for variceal bleeding outside Japan
Authors: Dagenais Michel , Langer Bernard , Taylor Bryce R. , Greig Paul D. 
Published: October 2004

AbstractThe Sugiura operation has been reported to have low operative mortality, rebleeding, and encephalopathy rates when carried out in a predominantly nonalcoholic Japanese population with good liver function. A literature review of reports of the Sugiura procedure outside Japan reveals a high complication and mortality rate when it is used as an emergency procedure in patients with advanced liver disease, especially in those with alcoholic cirrhosis. Uncontrolled studies report results that differ little from the Japanese series when the operation is confined to good‐risk patients in the elective situation. Our experience with the Sugiura operation supports its role in these circumstances, especially in patients with portal vein thrombosis and normal liver function. The only good prospective controlled trial has been carried out in patients with schistosomiasis and suggests that the Sugiura operation is far superior to total shunt and may have a slight advantage over the Warren shunt because of its low incidence of postoperative encephalopathy. More controlled trials are required to establish its role in good‐to moderate‐risk patients with alcoholic cirrhosis.
Role of surgical therapy in management of intractable ascites
Authors: Elcheroth Feanny , Vons Corinne , Franco Dominique 
Published: October 2004

AbstractAlmost 10% of patients with cirrhosis and ascites develop intractable ascites. When large‐volume paracentesis fails to relieve aseites, patients may be submitted to one of the three following surgical options: portosystemic shunting, peritoneovenous shunting, or liver transplantations Portosystemic shunting is efficient in clearing ascites, but it is associated with a high rate of encephalopathy and liver failure. The adications for portosystemic shunting are therefore limited for treatment of intractable ascites and should be performed only in patients with good liver function in whom all other treatments failed. Peritoneovenous shunting has been associated with a high rate of early complications and calve obstruction. Improvements in perioperative care and in the material used have greatly reduced the operative risks and increased the patency rate. Mortality remains high in patients with severe liver failure or with history of spontaneous bacterial peritonitis or variceal bleeding. Peritoneovenous shunting should not be done when these risk factors are present. In the absence of such risk factors; peritoneovenous shunting is in good procedure and may provide definitive relief of ascites and long‐term survival in more than 50% of the operated patients. In patients with poor risk factors liver transplantation may be preferable, and the onset of intractable ascites in a patient with a severely compromised liver should trigger the indication of liver replacement.
Molecular biology of gastric cancer
Authors: Tahara Eiichi 
Published: October 2004

AbstractGastric cancer involves changes in multiple oncogenes and multiple suppressor genes, and it causes genetic instability. Aberrant expression and amplification of the c‐met gene, inactivation of the p53 gene, and CD44 abnormal transcripts are common events of both well differentiated and poorly differentiated gastric cancers. Amplification of the cyclin E gene is also observed in gastric cancer regardless of histologic type. Decreased expression of the pic1 (p21) gene occurs independent of the p53 mutations. In addition, K‐ras mutations, c‐erbB‐2 gene amplification, loss of heterozygosity (LOH) and mutations of the APC gene, LOH of the bcl‐2 gene, and LOH at the DCC locus are preferentially associated with well differentiated gastric cancer. Moreover, LOH on chromosome 1q is involved in the progression of well differentiated cancer. Precancerous lesions, including hyperplastic polyp, intestinal metaplasia, and adenoma, share genetic changes found in well differentiated cancers. Conversely, genetic instability may be involved in the first step of stomach carcinogenesis of the poorly differentiated type. Reduction or loss of cadherin and catenins, K‐sam gene amplification, and c‐met gene amplification are necessary for the development and progression of poorly differentiated or scirrhous carcinoma. Interaction between cell‐adhesion molecules in the c‐met expressed tumor cells and hepatocyte growth factor from stromal cells is implicated in the morphogenesis of two types of gastric cancer. Taken together, different genetic pathways of stomach carcinogenesis may exist for well differentiated and poorly differentiated gastric cancers. Some of the former may develop by a cumulative series of gene alterations similar to those of colorectal cancer. Peritoneal dissemination and metastasis may require LOH on chromosome 7q, reduction in nm23 protein, abnormal transcripts of CD44, changes in cadherin and catenins, and overexpression of a 31‐kDa lactoside‐binding lectin.
News of TNM and its use for classification of gastric cancer
Authors: Hermanek P. , Wittekind C. 
Published: October 2004

AbstractTumor classification is associated with two inherent problems: (1) to find a compromise between the simplicity needed for a wide application by the medical community and sufficient differentiation and specification required for the presently high differentiation in treatment options and for detailed analysis of treatment results; and (2) to achieve an agreement between the stability necessary for data collection over long periods and the needed continuous inclusion of new proposals that arise by advances in diagnostic and therapeutic methods and the increasing knowledge of prognostic factors. The aim of this report is to inform on the changes and expansions of the international classification of gastric carcinoma during the last few years, to refer to new developments, to point out the relations between established classifications and molecular biology, and to show the future trend in tumor classification.
Intraoperative radiation therapy for gastric cancer
Authors: Abe Mitsuyuki , Nishimura Yasumasa , Shibamoto Yuta 
Published: October 2004

AbstractFrom among 115 patients who were treated by intraoperative radiation therapy (IORT), 94 patients were classified according to the histologic findings. The control 127 patients who were treated by operation alone during the same period were also histologically classified, and survivals were compared between the two groups. No difference in the survivals of patients with stage I was observed for the two groups. On the other hand, the survivals of patients with stages II through IV who were treated by IORT increased by nearly 10% to 20% at 5 years. A comparative study was also performed on the survivals between patients treated by IORT and those treated by operation alone according to the presence or absence of the serosal invasion and the grade of the lymph node metastasis. The number of patients treated by IORT in whom the serosal invasion and the lymph node metastasis were histologically examined was 57. The 171 control patients who underwent operation alone were examined histologically in the same fashion, and survivals for the two groups were compared. IORT did not afford any benefit if the lymph node metastasis was limited within n1 group or serosal invasion was not found. On the other hand, the 5‐year survival rates for patients who were treated by IORT increased by nearly 10% when the serosal invasion was observed and by nearly 18% when n2 and n3 lymph node metastases were found.
Prophylaxis and treatment of peritoneal carcinomatosis: Intraperitoneal chemotherapy with mitomycin C bound to activated carbon particles
Authors: Takahashi Toshio , Hagiwara Akeo , Shimotsuma Masataka , Sawai Kiyoshi , Yamaguchi Toshiharu 
Published: October 2004

AbstractA novel method of prophylaxis and treatment for peritoneal carcinomatosis—mitomycin C bound to activated carbon particles (MMC‐CH)—was tested in patients with advanced gastric cancer in a prospective randomized study. Activated carbon particles are taken up selectively by lymphatic tissues, which seem to be a primary site of peritoneal carcinomatosis in the peritoneal cavity, and adsorb a large amount of anticancer agent mitomycin C, which is subsequently released slowly and for a protracted period. A group of 113 patients who underwent radical resection for gastric cancer with definite serosal involvement were entered in this trial. Those in the control group received no intraperitoneal anticancer drugs. Patients in the MMC‐CH group were given 50 mg mitomycin C as MMC‐CH, which was dispersed throughout the peritoneal cavity just before surgical closure. No other anticancer drugs were given to these patients after surgery. The 2‐ and 3‐year survival rates for the MMC‐CH group were 42% and 38%, respectively; and the rates for the control group were 28% and 20%, respectively. The difference in survival between the two groups was significant at 2 and 3 years (p<0.05). For the survival of patients with macroscopic peritoneal carcinomatosis, there was no difference between these two groups. For the survival of patients who underwent histologically curative resection, 2‐ and 3‐year survivals for the MMC‐CH group were 66% and 66%, respectively and for the control group 35% and 20%, respectively. The difference between the two groups was statistically significant (p<0.01) at both 2 and 3 years. There was no difference in morbidity after surgery between these two groups, except a bowel (colocutaneous) fistula developed in two patients given MMC‐CH. There were no operative deaths in this series.
Hepatolithiasis associated with cholangiocarcinoma
Authors: Kubo Shoji , Kinoshita Hiroaki , Hirohashi Kazuhiro , Hamda Hiroyuki 
Published: October 2004

AbstractHepatolithiasis is a risk factor for cholangiocarcinoma. It is difficult to make an accurate diagnosis before treatment. In a retrospective study, we identified characteristic clinical features of 103 patients with hepatolithiasis (group H) and 10 patients with hepatolithiasis associated with cholangiocarcinoma (group HC), and examined the methods for diagnosis and treatment. The main symptoms were abdominal pain, fever, and jaundice, although few patients in group HC had jaundice. The incidence of abnormal serum levels of carcinoembryonic antigen (CEA) in group HC was higher than in group H. The incidence of cholangiocarcinoma in cases in which most of the stones were present in the intrahepatic ducts of the left lobe (type I‐L) was higher than the incidence in the other patients. Of the patients who underwent portography in group HC, portal veins in the portion of the liver containing the cholangiocarcinoma were not seen, and this region was atrophic in the operative specimens. The incidence of portal obstruction in portograms in group HC was higher than that in group H. The possibility of carcinoma should be kept in mind if there are high levels of CEA, if the location of the stones is classified as type I‐L, or if portal veins cannot be seen on portograms. In such patients, liver resection should be considered because there may be undiagnosed cholangiocarcinoma.
Early recurrence of hyperthyroidism in patients with Graves' disease treated by subtotal thyroidectomy
Authors: Sugino Kiminori , Mimura Takashi , Ozaki Osamu , Kure Yoshio , Iwasaki Hiroyuki , Wada Nobuyuki , Matsumoto Akihiko , Ito Kunihiko 
Published: October 2004

AbstractPrerequistes for surgical treatment of Graves' disease are that it can be done safely and that it is associated with a low incidence of recurrent hyperthyroidism. Early recurrence is especially undesirable. We studied 728 patients with Graves' disease treated by subtotal thyroidectomy using multivariate analysis in order to determine the factors related to early recurrence. The following factors were analyzed: age, sex, duration of medical treatment, weight of resected thyroid tissue, thyroid remnant size, preoperative level of thyroid‐stimulating hormone (TSH) binding inhibitory immunoglobulin (TBII), and antimicrosomal hemagglutination antibody (MCHA). “Early recurrence” was defined as TSH suppression observed within the first year after surgery and continuing for at least 6 months. A total of 106 patients (14.6%) had early recurrence. Statistical analyses were performed by the chi‐square test for univariate analysis and a logistic model for multivariate analysis. Significant factors were thyroid remnant size, MCHA, and TBII. These results indicated that TBII and MCHA are related to early recurrence of hyperthyroidism, and smaller remnant size is recommended for patients with a high MCHA titer or a high TBII level (or both) in order to avoid early recurrence.
Comparison of cefotaxime plus metronidazole versus cefoxitin for prevention of wound infection after abdominal surgery
Authors: Kow Lilian , Toouli James , Brookman Judith , McDonald Peter James 
Published: October 2004

AbstractIn a randomized prospective stratified trial consisting of 1010 patients undergoing abdominal surgery involving the viscera, the efficacy of cefotaxime plus metronidazole was compared to cefoxitin for preventing wound infection. The efficacy of a single dose of antibiotics versus three doses over 24 hours was also evaluated. This study demonstrated that a single‐dose antibiotic regimen was as effective as a multiple‐dose regimen in the prophylaxis of wound infections following abdominal surgery. In addition it demonstrated that the cefotaxime plus metronidazole regimen is comparable to that of cefoxitin and is more cost‐effective. It is concluded that a single dose of cefotaxime plus metronidazole provides effective prophylaxis against postoperative wound infections following abdominal surgery.