bluuebunny/crossref_metadata_2025_split huggingface dataset:
5‐Aza‐2′‐deoxycytidine‐induced cytotoxicity and limb reduction defects in the mouse
Authors: Rosen Mitchell B. , Chernoff Neil 
Published: August 2002

AbstractBackground5‐Aza‐2′‐deoxycytidine (dAZA), causes hindlimb phocomelia in CD‐1 mice. Studies in our laboratory have examined the hypothesis that compound‐ induced changes in gene expression may uniquely affect hindlimb pattern formation. The present study tests the hypothesis that dAZA causes limb dysplasia by inducing cytotoxicity among rapidly proliferating cells in the limb bud mesenchyme.MethodsPregnant CD‐1 mice were given a teratogenic dose of dAZA (i.p.) at different times on GD 10 and fetuses evaluated for skeletal development in both sets of limbs by standard methods. Using general histology and BrdU immunohistochemistry, limb mesenchymal cell death and cell proliferation were then assessed in embryos at various times post dosing, shortly after initial limb bud outgrowth. The effect of dAZA on early limb chondrogenesis was also studied using Northern analysis of scleraxis and Alcian blue staining of whole mount limb buds.ResultsCompound related hindlimb defects were not restricted to a specific set of skeletal elements but consisted of a range of temporally related limb anomalies. Modest defects of the radius were observed as well. These results are consistent with a general insult to the limb mesenchyme. Mesenchymal cell death and reduced cell proliferation were also observed in both sets of limbs. The timing and location of these effects indicate a role for cytotoxicity in the etiology of dAZA induced limb defects. These effects also agree with the greater teratogenicity of dAZA in the hindlimb because they were more pronounced in that limb. The expression of scleraxis, a marker of early chondrogenesis, was reduced 12 hr after dAZA exposure, a time coincident with maximal cell death, as was the subsequent emergence of Alcian blue stained long bone anlagen.ConclusionsThese findings support the hypothesis that cytotoxic changes in the limb bud mesenchyme during early limb outgrowth can induce the proximal limb truncations characteristic of phocomelia after dAZA administration. Teratology 65:180–190, 2002. © 2002 Wiley‐Liss, Inc.
Epidemiology of Down syndrome (Trisomy 21), Hawaii, 1986–97
Authors: Forrester Mathias B. , Merz Ruth D. 
Published: August 2002

AbstractBackgroundThe live birth prevalence of Down syndrome is approximately 10 per 10,000 live births in the United States. Down syndrome prevalence has been reported to change over time and to vary by selected demographic factors.MethodsData from a population‐based birth defects registry in Hawaii involving 363 Down syndrome cases delivered during 1986–97 were used to calculate overall prevalence and to investigate secular trends and differences by selected demographic factors.ResultsThe total (live birth, fetal death, and elective termination) prevalence was 14.74 per 10,000 live births and fetal deaths. The unadjusted live birth prevalence was 8.67 per 10,000 live births. The adjusted live birth (live births and proportion of elective terminations expected to have resulted in live births) prevalence was 12.59 per 10,000 live births. No significant secular trends were observed for either total prevalence (P = 0.688) or adjusted live birth prevalence (P = 0.604). The total Down syndrome prevalence per 10,000 live births was highest for Far East Asians (22.01), followed by whites (17.06), Filipinos (15.94), and Pacific Islanders (9.21). Prevalence per 10,000 births was higher in metropolitan Honolulu (18.57) than in the rest of Hawaii (14.15). After adjusting for maternal age, however, the differences within the demographic groups were not statistically significant.ConclusionsThe live birth prevalence of Down syndrome in Hawaii during 1986–97 was lower than reported in the literature. Prevalence did not change significantly over time. Any differences in prevalence by maternal race/ethnicity and place of residence appeared to result from differences in maternal age distribution. Teratology 65:207–212, 2002. © 2002 Wiley‐Liss, Inc.
Continued occurrence of Accutane®‐exposed pregnancies
Authors: Honein M.A. , Paulozzi L.J. , Erickson J.D. 
Published: August 2002

AbstractBackgroundAccutane® a teratogenic prescription drug licensed to treat severe, recalcitrant nodular acne. First‐trimester pregnancy exposure can cause major birth defects. The manufacturer began a Pregnancy Prevention Program (PPP) in 1988; however, exposed pregnancies continue to occur. In 1996, the manufacturer began a direct‐to‐consumer advertising campaign, raising concerns of more exposed pregnancies.MethodsWe examined trends in Accutane use by reproductive‐aged women. We also interviewed a series of 14 women in California who had recent Accutane‐exposed pregnancies to identify opportunities for prevention.ResultsThe estimated number of Accutane prescriptions for reproductive‐aged women has more than doubled in the past 10 years; it is the most widely used teratogenic drug in the United States, with approximately 2.5 per 1,000 reproductive‐aged women exposed to Accutane in 1999. One‐half of the women interviewed reported seeing an advertisement for prescription acne treatment before taking Accutane. Eight of the 14 women used no contraception at the time of the exposed pregnancy; 13 of the 14 women did not use two forms of contraception. Four of the 14 women did not have pregnancy tests before starting Accutane. None reported seeing all PPP components, and four saw only the information on the pill packet. These 14 pregnancies resulted in four live infants who had no apparent birth defects, one live‐born infant with multiple defects, four spontaneous abortions, and five induced abortions.ConclusionsThe increase in Accutane use observed among females may be exacerbated by advertising. Physicians and patients must use more caution with teratogenic prescription drugs. Teratology 64:142–147, 2001. Published 2001 Wiley‐Liss, Inc.
Occurrence of 20S RNA and 23S RNA replicons in industrial yeast strains and their variation under nutritional stress conditions
Authors: López Victoria , Gil Rosario , Vicente Carbonell José , Navarro Alfonso 
Published: August 2002

AbstractWe have characterized industrial yeast strains used in the brewing, baking, and winemaking industries for the presence or absence of cytoplasmic single‐stranded 20S and 23S RNAs. Furthermore, the variation of intracellular concentrations of these replicons in brewing and laboratory strains under nutritional stress conditions was determined. Our results show a correlation between the relative abundance of these replicons and exposure of yeast to nutritionally stressful conditions, indicating that these RNAs could be employed as molecular probes to evaluate the exposure of 20S+ and/or 23S+ yeast strains to stress situations during industrial manipulation. During this study, several 20S−23S+ Saccharomyces cerevisiae strains were isolated and identified. This is the first time that a yeast strain containing only 23S RNA has been reported, demonstrating that 20S RNA is not required for 23S RNA replication. Copyright © 2002 John Wiley & Sons, Ltd.
A versatile enzyme immunoassay for the determination of progestogens in feces and serum
Authors: Graham Laura , Schwarzenberger Franz , Möstl Erich , Galama Wieke , Savage Anne 
Published: August 2002

AbstractThe ability of zoos to monitor the reproductive status of their animals can vastly improve the effectiveness of husbandry/management practices, and noninvasive methods such as fecal steroid analysis are the easiest to apply in a zoo setting. Furthermore, enzyme immunoassay (EIA) is preferred to radioimmunoassay (RIA) as the method of quantifying hormones because EIAs do not involve the use, storage, and disposal of radioactive materials. However, progesterone is excreted in the feces as predominantly unconjugated metabolites (progestogens) and, until recently, antibodies able to cross‐react with a variety of progestogens were used primarily in RIAs. An EIA using a broad‐spectrum progestogen antibody is described and applied to serum and/or fecal samples from female African elephants, black rhinoceros, white rhinoceros, okapi, and hippopotami. The clear progestogen profiles generated in these species suggest that the described EIA would be as versatile as the RIA using the same antibody and could be a practical and economical alternative to RIAs for monitoring gonadal function via progestogen analysis in zoo species. Zoo Biol 20:227–236, 2001. © 2001 Wiley‐Liss, Inc.
Intraoperative Transfusion: Is It a Real Prognostic Factor of Periampullary Cancer Following Pancreatoduodenectomy?
Authors: Park Sang‐Jae , Kim Sun‐Whe , Jang Jin‐Young , Lee Kuhn‐Uk , Park Yong‐Hyun 
Published: August 2002

The purpose of this study was to clarify the prognostic significance of transfusion following pancreatoduodenectomy for periampullary cancers. We analyzed 357
periampullary cancers from 1985 to 1997 (ampullary cancer 130 cases,
distal bile duct cancer 141 cases, pancreatic head cancer 86 cases). A total of 215 (60%) of the 357 patients have received intraoperative transfusion. The 5‐year survival rate of 130 ampullary cancer patients was 59%; altogether, 76 patients (58%) underwent intraoperative transfusion. The 5‐year survival rate of patients without intraoperative transfusion was 79%, whereas that of patients with a transfusion was 47% (p = 0.029). Following multivariate analysis, intraoperative transfusion was found to be an independent poor prognostic factor for those with ampullary cancer
(relative risk 2.174). Among those with common bile duct cancer, the overall 5‐year survival rate was 33%, and the 5‐year survival rates for patients with (n = 87) or without
(n = 54) transfusion were 25% and 38%, respectively,
which did not reach statistical significance (p =
0.0717). For those with pancreatic head cancer, the overall 5‐year survival rate was 16%, and there was no survival difference between transfused (n = 52) and untransfused
(n = 34) patients. In the present study the reason was not clear, although intraoperative transfusion was an independent significant prognostic factor for ampullary cancer. Careful dissection to minimize intraoperative bleeding is mandatory during pancreatoduodenectomy for ampullary cancer.
Future of Thyroid Surgery and Training Surgeons to Meet the Expectations of 2000 and Beyond
Authors: Harness Jay K. , van Heerden Jon A. , Lennquist Sten , Rothmund Matthias , Barraclough Bruce H. , Goode A.W. , Rosen Irving B. , Fujimoto Yoshihide , Proye Charles 
Published: August 2002

AbstractWhat is the future of thyroid surgery in the new millennium? How can surgeons keep abreast of advances in thyroid endocrinology, genetics, surgical therapy, and other aspects of thyroid disease management? How should surgeons be trained to become highly competent in thyroid disease and to perform safe, effective thyroid operative procedures? Nine internationally recognized endocrine surgeons were asked to express their views on these and related subjects. They noted that advances in molecular biology, pathology, and genetics of thyroid disease should allow more tailored surgical approaches during the twenty‐first century. Current training of general surgical residents in thyroid and other types of endocrine surgery is highly variable, which may contribute to increased complication rates and number of second operations. The leadership for addressing these deficiencies and promoting a more organized approach to thyroid disease management should come from national endocrine surgery associations and their leaders. It is incumbent upon endocrine surgeons to maintain their central role in the management of many aspects of thyroid disease. Organizing teams of specialists into thyroid centers (centers of excellence) can (1) increase efficiency; (2) increase quality of care; (3) decrease costs; (4) encourage a more individualized approach to surgery; (5) lower complication rates; and (6) foster innovation in technology and disease management. Two years of additional fellowship training in thyroid and endocrine surgery is now being advocated by increasing numbers of national endocrine surgical associations as the best way to prepare surgeons for society's needs for highly skilled, competent thyroid surgeons of the future.
Curative Resection of Microgastrinomas Based on the Intraoperative Secretin Test
Authors: Kato Masayuki , Imamura Masayuki , Hosotani Ryo , Shimada Yutaka , Doi Ryuichiro , Itami Atsushi , Komoto Izumi , Kosaka Tadako , Konishi Junji 
Published: August 2002

AbstractThe intravenous secretin injection test (secretin test) has been used for the differential diagnosis of gastrinoma. In this study we report that the intraoperative secretin test (IOS test) is also useful for determining the extent of curability in patients with Zollinger‐Ellison syndrome (ZES). Twelve patients with ZES underwent surgical exploration and the IOS test. The results of the IOS test were obtained by rapid radioimmunoassay of the serum gastrin level (IRG) within 60 minutes. The test was diagnosed as negative when the maximum increase of serum IRG was less than 80 pg/ml and also less than 20% of the basal serum IRG level. Three of the twelve patients underwent pancreatoduodenectomy (PD), and two patients underwent distal pancreatectomy. Extirpation of duodenal tumors with dissection of regional lymph nodes was performed in seven patients. In two of the seven patients the IOS test remained positive after extirpation of the duodenal tumors and the dissection of regional lymph nodes. In one patient PD was performed on the basis of the positive results, and the IOS test became negative after PD. In the other patient, two tiny metastatic liver tumors were identified and were resected, but the IOS test did not become negative. We closed the abdomen in 11 patients when we obtained negative results from the IOS test. The results of the IOS test were almost identical to the data obtained by the standard assay postoperatively. The serum IRG levels of all but one patient fell to the normal level, and the secretin test became negative postoperatively. The IOS test is thus useful and indispensable for curative resection of microgastrinomas in patients with ZES.
Acute biliary pancreatitis: Diagnosis and management
Authors: Liu Chi‐Leung , Lo Chung‐Mau , Fan Sheung‐Tat 
Published: August 2002

AbstractAcute biliary pancreatitis is a serious complication of biliary calculous disease and is associated with significant morbidity and mortality. The role of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute biliary pancreatitis has been the focus of discussion in recent years. In addition, the exact role of laparoscopic cholecystectomy (LC) in the management of acute biliary pancreatitis has not yet been fully defined. In this report, we evaluated a protocol of emergency ERCP (within 24 hours) for predicted severe attacks, early ERCP (within 72 hours) for predicted mild attacks, and interval LC for management of acute biliary pancreatitis. Between January 1992 and June 1995 a total of 75 patients with acute biliary pancreatitis were managed according to the protocol. Bedside ultrasonography at admission diagnosed 94% of all 64 patients with gallbladder stones, but the sensitivity of visualizing choledocholithiasis was low (19%). Forty‐five (60%) of them were predicted to have a severe attack by either Ranson or glucose/urea criteria. Emergency ERCP and endoscopic sphincterotomy (ES) for identifiable common bile duct (CBD) or ampullary stones were performed on all patients predicted to have a severe attack within 24 hours from presentation. An early endoscopic procedure was performed on all patients predicted to have a mild attack within 72 hours from presentation. ERCP was successful in 95% of all patients, and CBD stones were detected in 52 (69%) of them. ES and stone clearance were successful in all of these 52 patients. The morbidity associated with the endoscopic procedure was 3%, and there were no deaths. All except one patient survived the attack of acute pancreatitis, resulting in an overall mortality of 1%. Interval LC was performed on 46 patients with a conversion rate of 4%. The median postoperative hospital stay after LC was 2 days, and there was no major intraoperative or postoperative morbidity or mortality. Our experience suggests that the policy of emergency ERCP for patients with predicted severe disease, early ERCP for patients with predicted mild disease, and interval LC are associated with favorable outcomes in patients with acute biliary pancreatitis. Acute biliary pancreatitis can be managed safely and effectively by a combined endoscopic and laparoscopic approach.
Effect of Subtotal Thyroidectomy on Natural History of Ophthalmopathy in Graves’ Disease
Authors: Abe Yoshifumi , Sato Haruhiro , Noguchi Masako , Mimura Takashi , Sugino Kiminori , Ozaki Osamu , Yoshimura Horoshi , Ito Kunihiko 
Published: August 2002

AbstractGraves’ ophthalmopathy is a complex disease whose pathogenesis is thought to be autoimmune. The treatment of Graves’ disease is considered to be related to the progression of Graves’ ophthalmopathy. There have been no long‐term prospective studies on the natural course of Graves’ ophthalmopathy. In this study we assessed the influence of subtotal thyroidectomy on the outcome of Graves’ ophthalmopathy, comparing it with that of radioactive iodine treatment. Altogether 287 untreated patients with Graves’ disease referred to Ito hospital in 1989 were followed prospectively for 5 years. A group of 67 patients were treated with radioactive iodine, and 18 patients underwent surgery. Proptosis of the eyes was measured in all patients using Hertel's exophthalmometer. The mean value of proptosis in patients with untreated Graves’ disease was 14.8 ± 0.2 mm (mean ± SEM), and after 5 years it increased slightly to 15.0 ± 0.2 mm. The mean changes of proptosis in patients treated surgically and patients given radioactive iodine were −0.01 ± 0.22 and 0.93 ± 0.28 mm, respectively (p < 0.05). In patients treated by subtotal thyroidectomy, ophthalmopathy did not change in 77.8%; it progressed in 5.6% and was alleviated in 16.7%. In patients treated with radioactive iodine, the ophthalmopathy did not change in 86.6%, progressed in 10.4%, and was alleviated in 3.0%. These findings indicate that surgery can be a better treatment than radioactive iodine for Graves’ patients with ophthalmopathy.
Surgical Treatment of Spontaneous Pneumothorax: Ten‐year Experience
Authors: Athanassiadi Kalliopi , Kalavrouziotis G. , Loutsidis A. , Hatzimichalis A. , Bellenis I. , Exarchos N. 
Published: August 2002

AbstractSpontaneous pneumothorax (SP) is commonly observed in young, tall, thin subjects without apparent underlying lung disease and in the elderly with chronic emphysematous lung disease. We present our experience in treating SP during the last decade. From December 1986 to November 1996 a total of 417 consecutive patients with SP were admitted to our department. There were 349 males (83.7%) and 68 females, ranging in age from 14 to 93 years. A right‐side SP was detected in 234 cases (56.1%), a left‐side SP in 175 (42.0%), and a bilateral SP in 8 (1.9%). Treatment included observation/aspiration (n= 16, 3.8%), tube thoracostomy (n= 372, 89.2%), multiple tubes (n= 29, 7.0%), blood pleurodesis (n= 13, 3.1%), midsternotomy (n= 3, 0.7%), and minithoracotomy (n= 92, 22.1%). Primary indications for operation were recurrent SP (n= 49) and persistent air leak (n= 46). Blebs or bullae were found in all patients and were ablated by stapling. Pleural abrasion was also performed. All showed good lung expansion postoperatively. Perioperative mortality was zero. The mean hospital stay was 6.5 days. Follow‐up of 89 patients who had undergone surgical treatment (93.7%) at 1 to 100 months revealed only one recurrence. Tube thoracostomy is still the treatment of choice for SP. Surgical intervention is recommended only in cases of recurrent SP or persistent air leak. Minithoracotomy is a safe surgical approach with satisfactory cosmetic results.
Short‐term Outcome and Predictors of Adverse Events following Pulmonary Thromboendarterectomy
Authors: Gilbert Timothy B. , Gaine Sean P. , Rubin Lewis J. , Sequeira Alejandro J. 
Published: August 2002

AbstractPulmonary complications including hypoxemia, right heart failure, and prolonged ventilation may follow pulmonary thromboendarterectomy (PTE) performed via cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest. Seventeen adult patients have undergone PTE at the University of Maryland Medical System during the preceding 3 years. From these patients, clinical and hemodynamic parameters were tabulated pre‐CPB, post‐CPB, at admission to the intensive care unit (ICU), and prior to discontinuation of invasive monitoring in the ICU. Data on anthropometric variables, survival, and times of extracorporeal circulation, mechanical ventilation, and hospital stay were also collected. The mean values for pulmonary arterial systolic and diastolic pressures and pulmonary vascular resistance (PVR) decreased significantly from pre‐CPB values after PTE (all p < 0.05). Mild mixed acidosis present at ICU admission resolved prior to discharge (p= 0.002). The length of mechanical ventilation time was positively correlated with the absolute post‐CPB PVR and negatively correlated with the relative change in central venous pressure (CVP) from pre‐CPB to post‐CPB values (r= 0.75, p= 0.037). Of the pre‐CPB anthropometric variables, only body mass index was significantly higher in nonsurvivors (p= 0.037). Pulmonary artery pressures and vascular resistance fall significantly after PTE. A lower post‐CPB PVR and a relatively decreased (i.e., from pre‐CPB values) CVP predict reduced length of postoperative ventilation but not of the hospital stay. Mortality appears increased in patients with a large body habitus.
Primary Biliary Stones: Diagnosis and Management
Authors: Liu Chi‐Leung , Fan Sheung‐Tat , Wong John 
Published: August 2002

AbstractTo review the results of treatment of primary biliary stones, 96 consecutive patients managed from 1991 to 1996 were studied retrospectively. Acute cholangitis and abdominal pain were the presenting symptoms in 57 patients (59%) and 29 patients (30%), respectively. Fifty‐four patients (56%) had a history of biliary surgery. Endoscopic retrograde cholangiopancreatography, ultrasonography, and computed tomography were frequently employed for diagnosis of primary biliary stones and were performed on 84 patients (88%), 90 patients (94%), and 89 patients (93%), respectively. Intrahepatic stones were identified in 91 patients (95%) and biliary strictures in 34 patients (35%). Concomitant cholangiocarcinoma occurred in 15 patients (16%). Hepatic resection was required in 55 patients (57%) for removal of an atrophic liver lobe or a segment related to repeated infection, biliary strictures, liver abscesses, or cholangiocarcinoma. Intraoperative choledochoscopy was routinely performed in all patients to detect, remove, or confirm clearance of biliary stones. A hepaticocutaneous jejunostomy (HCJ) was constructed in 70 patients (73%) to facilitate postoperative choledochoscopic examination or biliary stone extraction. Twenty‐two patients (23%) had residual stones and required postoperative choledochoscopic extraction. Complete eradication of residual stones was achieved in all patients. Postoperative morbidity occurred in 28 patients (29%), and there was one hospital death (a patient with cholangiocarcinoma). With a median follow‐up of 26 months (range 2–62 months), stones recurred in three patients. In conclusion, the early results of treatment of primary biliary stones were satisfactory owing to a systematic, aggressive approach that consisted of hepatic resection, frequent construction of an HCJ, and postoperative choledochoscopy.