bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential Diagnosis of Stenosing Lesions at the Hepatic Hilus
Authors: Koea Jonathan , Holden Andrew , Chau Kai , McCall John 
Published: April 2004

ABSTRACTA significant number of stenosing lesions at the hepatic hilus represent benign disease rather than hilar cholangiocarcinoma. It is unclear, however, which perioperative investigations are useful for defining benign lesions in this location. A series of 49 consecutive patients who presented with obstructive jaundice due to a stenosing lesion at the hepatic hilus were investigated by documenting elevated plasma bilirubin levels, the presence of weight loss, and elevated carcinoembryonic antigen (CEA) and Ca 19‐9 concentrations. Radiologic investigations included direct cholangiography, transabdominal ultrasonography, computed tomographic (CT) scans and magnetic resonance imaging (MRI). A tissue diagnosis was obtained in all patients, and the preoperative investigations were reviewed to assess their accuracy for predicting malignancy. The final tissue diagnosis was a benign lesion in 12 patients (benign idiopathic strictures 10, choledocholithiasis 2). Among the 37 patients who presented with a malignant lesion, 2 had metastatic colorectal cancer, 7 had gallbladder cancer, and 28 had hilar cholangiocarcinoma. Of the 12 patients with benign lesions, 4 (33%) had elevated tumor markers (CEA and CA 19‐9), 12 (100%) had cholangiograms suspicious for malignancy, and 9 (75%) had CT and MRI features consistent with a malignant diagnosis. Thus among patients presenting with hilar strictures approximately one‐fifth are due to nonmalignant causes, but the preoperative diagnosis is difficult and resection remains the most reliable way to rule out malignancy in this site.
Preoperative Ultrasonographic Examination for Lymph Node Metastasis: Usefulness when Designing Lymph Node Dissection for Papillary Microcarcinoma of the Thyroid
Authors: Ito Yasuhiro , Tomoda Chisato , Uruno Takashi , Takamura Yuuki , Miya Akihiro , Kobayashi Kaoru , Matsuzuka Fumio , Kuma Kanji , Miyauchi Akira 
Published: April 2004

ABSTRACTPapillary microcarcinoma has an excellent prognosis after surgical treatment, but how to dissect the lymph nodes remains an open question. In this study, we investigated whether modified radical neck dissection (MND) affected the lymph node recurrence‐free survival (LN‐RFS) rate for 590 patients with papillary microcarcinoma and recurrence in the lateral compartment who underwent surgery in our hospital between 1993 and 2001. MND was performed in 316 patients, and metastasis in lateral compartment was preoperatively detected on ultrasonography in 67. These 67 patients showed significantly worse LN‐RFS (p = 0.0038) than the remaining 249 patients without preoperatively detectable lateral node metastasis. Of the 523 patients (590 minus the 67 patients) whose lateral node metastasis was not detected preoperatively, 249 underwent MND; the remaining 274 patients did not. There was no significant difference in LN‐RFS between these two groups. Our preliminary data suggest that with papillary microcarcinoma: (1) MND is not necessary in patients without lateral node metastasis detected on ultrasonography preoperatively, and (2) patients with preoperatively detected lateral node metastasis are more likely to develop recurrence in the lymph nodes so careful MND should be performed.
Methods Used by the Hippocratic Physicians for Weight Reduction
Authors: Christopoulou‐Aletra Helen , Papavramidou Niki 
Published: April 2004

AbstractIn classical antiquity, particularly in the Hippocratic Corpus, obesity was considered the cause of disease and, in the extreme, death. This attitude mirrors the general ideology of the times where any deviation from the norm and from logic was unacceptable. The image of balance and of the ideal body weight was clearly depicted in ancient Greek art. The same attitude is reflected in the Hippocratic texts where obesity is again condemned as a deviation from the norm. The cause of obesity refers to the surplus of one of the liquids circulating in the body. Thus treatment points mainly to restoring the balance of liquids. This is accomplished by diet, drugs, and most importantly exercise. Walking, running, wrestling, and other practices are advised together with baths, massage, rest, and the “appropriate” life style.
Impaired postural control in patients affected by tension‐type headache
Authors: Giacomini P.G. , Alessandrini M. , Evangelista M. , Napolitano B. , Lanciani R. , Camaioni D. 
Published: April 2004

AbstractSixteen subjects, affected by chronic tension‐type headache (TTH) accordingly to the International Headache Society Classification (1988) criteria, in presence of tenderness in pericranial muscles, with a mean age of 37 ± 11.8 years, and ten healthy volunteer subjects, age and sex matched, were submitted to postural analysis by Static Posturography (S.Ve.P. Amplaid). Aim of the study was to evaluate whether patients with TTH have disturbed postural control, as compared to normal subjects. Postural analysis considered all posturographic variables but focused on spectral frequency analysis of body sway. In both open (OE) and closed eyes (CE) condition, spectral frequency analysis showed a significantly increased body sway at low (OE=p≤0.01; CE=p≤0.01) and middle (OE=p≤0.01; CE=p≤0.01) frequencies on the antero‐posterior (y) plane and at low frequencies (OE=p≤0.05; CE=p≤0.05) on the lateral (x) plane. Statistical analysis was performed using the Student's t test for unpaired data, p value ≤0.05 defined significant.The proprioceptive input seems to be predominant at middle and high frequencies in maintaining posture, our results seem then to suggest a proprioceptive disturbance in TTH patients. The disturbance is likely related to chronic pericranial muscle contraction and tenderness. Posturography and spectral analysis may help not only in the diagnosis of a postural disturbance but even more in the follow‐up of TTH patients, during and after a medical and/or a rehabilitative treatment.
Stress relaxation of bone significantly affects the pull‐out behavior of pedicle screws
Authors: Inceoglu Serkan , McLain Robert F. , Cayli Suleyman , Kilincer Cumhur , Ferrara Lisa 
Published: April 2004

AbstractThe initial fixation strength of pedicle screws is commonly tested using a standard pull‐out test with load applied at a constant rate. This method overlooks the cyclic nature of in situ loading responsible for clinical failure. This study was undertaken to determine the effects of stress relaxation properties at the bone–screw interface on screw fixation strength. Pedicle screws were inserted into calf lumbar vertebrae using a paired testing array. After embedding and mounting in a custom fixture, axial pull‐out tests were performed at the rates of 1, 5, and 25 mm/min. For each vertebra, one screw was pulled at a continuous rate. The other screw was pulled at increments of 0.5 mm, at the same rate, with 1000 s pause between increments. Peak load, energy‐to‐failure, displacement‐to‐failure, and stiffness were calculated for each screw pull‐out test. Two‐way ANOVA showed that the standard pull‐out method yielded significantly higher peak loads (p < 0.05) at faster pull‐out rates and higher stiffnesses (p < 0.05) at all rates compared to the stress relaxation pull‐out protocol. These results suggest that the stress relaxation properties of bone significantly affect the pull‐out behavior of pedicle screws, reducing the peak load and stiffness values observed during testing. This mode of testing may provide a better biomechanical model of screw pull‐out failure and a more accurate estimate of initial fixation strength. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved.
Prophylactic Effect of Pentoxifylline on Radiotherapy Complications: A Clinical Study
Authors: Aygenc Erdinc , Celikkanat Serdar , Kaymakci Mustafa , Aksaray Ferdi , Ozdem Cafer 
Published: April 2004

OBJECTIVEThe purpose of this study was to assess the prophylactic effect of pentoxifylline (Ptx) on complications related to radiation.STUDY DESIGN AND SETTINGSeventy‐eight patients who had postoperative radiotherapy for squamous cell carcinoma of the head and neck were enrolled into a prospective study. Patients were randomly assigned to the Ptx group (40 patients) and the control group (38 patients). Ptx was given to the patients at a dose of 400 mg 3 times a day orally to a total of 1200 mg. We noted radiotherapy complications in each group.RESULTSFour patients were not able to tolerate this drug due to the development of gastrointestinal symptoms and dizziness. Late skin changes, fibrosis, and soft tissue necrosis were more severely in the control group than in the Ptx group (P < 0.05). We could find no positive effects on acute skin reactions and pain (P > 0.05).CONCLUSIONOur study suggests that Ptx has a prophylactic effect on the radiation complications. This can be explained by protective effect of Ptx against vascular pathology. (Otolaryngol Head Neck Surg 2004;130:351–6.)
Radiofrequency Ablation versus Electrocautery in Tonsillectomy
Authors: Hall Daniel J. , Littlefield Philip D. , Birkmire‐Peters Deborah P. , Holtel Capt Michael R. 
Published: April 2004

OBJECTIVESThe objective of this study was to compare the safety, difficulty of removal, and postoperative pain profile of radiofrequency ablation versus standard electrocautery removal of tonsils.STUDY DESIGN AND SETTINGA prospective, blinded study was designed to remove 1 tonsil with each of the 2 methods. Time of operation, estimated blood loss, difficulty of operation, postoperative pain, rate of postoperative hemorrhage, and the patient's preferred technique were evaluated.RESULTSThe operating time was significantly longer (P < 0.007) and the patients reported significantly less pain (P < 0.001) with radiofrequency ablation. There were no differences in blood loss, difficulty of operation, or postoperative hemorrhage rates. The patients preferred the radiofrequency ablation technique (P < 0.001).CONCLUSIONRadiofrequency ablation is a viable method to remove tonsillar tissue. Operating time for this procedure will likely decrease with experience. There was significantly less pain reported with radiofrequency ablation compared with standard electrocautery. (Otolaryngol Head Neck Surg 2004;130:300–5.)
Minimizing Complications in the Use of Titanium Condylar Head Reconstruction Prostheses
Authors: Daniel Elena , Browne J. Dale 
Published: April 2004

OBJECTIVEThe study goals were to evaluate the use of titanium condylar prostheses in the setting of tumor resection and to discuss the techniques used to minimize complications.STUDY DESIGN AND SETTINGWe conducted a retrospective review of a case series in a tertiary care hospital. Six patients underwent mandibulectomy, including the condyle, with primary reconstruction using titanium condylar prostheses. Charts were reviewed for operative technique, pathology, and complications.RESULTSPathology included squamous cell carcinoma, Ewing's sarcoma, embryonic rhabdomyo‐sarcoma, giant cell granuloma, and adenocarcinoma. Three patients are alive without disease. Follow‐up spanned 6.4 years with premorbid occlusion established in all cases, and there were no prosthesis extrusions or erosions. The condylar head was wrapped in preserved joint capsule or adjacent temporalis muscle/fascia and secured with permanent purse‐string sutures; careful duplication of the length, and angulation of the native mandible from the angle to the superior extent of the condylar head.CONCLUSIONTitanium condylar prostheses are a viable choice in the setting of tumor resection and reconstruction, with appropriate technical precautions. (Otolaryngol Head Neck Surg 2004;130: 344–50.)
Outcomes after Nasal Septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) Study
Authors: Stewart Michael G. , Smith Timothy L. , Weaver Edward M. , Witsell David L. , Yueh Bevan , Hannley Maureen T. , Johnson Jonas T. ,   The Nose Study Investigators
Published: April 2004

OBJECTIVEOur goal was to assess disease‐specific quality of life outcomes after nasal septoplasty in adults with nasal obstruction.DESIGN, SETTINGS, AND PATIENTSWe conducted a prospective observational outcomes multicenter study with 14 sites and 16 investigators, including private practice and academic settings. Patients had had septal deviation and symptomatic nasal obstruction for at least 3 months, and medical management had failed.METHODSPatients with septal deviation completed a validated outcomes instrument (the Nasal Obstruction Septoplasty Effectiveness (NOSE) scale) before and 3 and 6 months after septoplasty, with or without partial turbinectomy.RESULTSFifty‐nine patients underwent surgery; there was a significant improvement in mean NOSE score at 3 months after septoplasty (67.5 versus 23.1, P < 0.0001), and this improvement was unchanged at 6 months. Patient satisfaction was very high, and patients used significantly fewer nasal medications.CONCLUSIONSIn patients with septal deformity, nasal septoplasty results in significant improvement in disease‐specific quality of life, high patient satisfaction, and decreased medication use. (Otolaryngol Head Neck Surg 2004;130:283–90.)
Venous Drainage of the Platysma Myocutaneous Flap
Authors: Agarwal Anurag , Schneck Carson D. , Kelley Daniel J. 
Published: April 2004

OBJECTIVESThe platysma myocutaneous flap offers a regional reconstruction option for relatively small soft tissue defects in the head and neck area. However, epidermolysis of its skin paddle with resultant fibrosis and tongue tethering has been documented. This has been attributed to arterial and/or venous vascular compromise. We investigated the venous drainage patterns of this flap in a cadaveric study.STUDY DESIGN AND SETTINGWe made selective Microfil dye injections into the external and internal jugular veins of 5 cadavers. A wide cervical flap was then raised, and anatomic dissection of the superficial and deep venous systems was performed to identify the dominant draining veins of the platysma flap.RESULTSUniversally, small communicating veins from the internal jugular venous system were noted to drain the platysma flap anteriorly. The external jugular vein was noted to drain the flap posteriorly.CONCLUSIONSAlthough it is difficult to preserve the anterior communicating veins with 180° flap rotation, the results of this study suggest a possible benefit of external jugular vein harvest in continuity with the platysma flap. Further clinical studies are needed to assess whether flap venous congestion, epidermolysis, and resultant fibrosis can be minimized with this technique. (Otolaryngol Head Neck Surg 2004;130:357–9.)
Cancer control in women. Update 2003
Authors: Boyle P. , Leon M.E. , Maisonneuve P. , Autier P. 
Published: April 2004

AbstractThe global cancer burden in women appeared to be increasing quickly at the end of the twentieth century with notable increases in the absolute numbers of cases of breast, cervix, lung and colorectal cancer of concern. However, prospects for cancer control in women appear to be good within our current knowledge and deserve close attention. Rates of lung cancer in women are increasing substantially in many countries and seem set to overtake breast cancer as the commonest form of cancer death in women in many parts of the world. These changes are due to the effects of cigarette smoking, a habit which women widely embraced during the second half of the last century. The high levels of smoking current in young women, which have yet to have their full impact on death rates, constitute an important hazard not only for future cancer risks but for several other important causes of death.Although the breast is the commonest form of cancer in women in most western countries, the etiology of this disease remains elusive and preventable causes remain to be identified. Endogenous hormones also appear to have a role in cancer risk in women: oral contraceptives seem to increase slightly the risk of breast cancer in users in the use, and in the immediate post‐use, period, but ten years after cessation the risk returns to that of never users. Oral contraceptive usage also appears to be protective against ovarian and endometrial cancer. The use of Hormonal Replacement Therapy (HRT) appears to increase the risk of endometrial cancer and a positive association with breast cancer risk appears to exist.Within our current knowledge of the epidemiology of cancer in women, the most important Cancer Control strategy is the prevention of cigarette smoking and the increase in the prevalence of adult women quitting smoking. Screening has also shown to be effective in reducing incidence and mortality of cervix cancer and mortality from breast and colorectal cancer. Although more work is needed, it is becoming clear that there could be an important role of HPV testing to further enhance cervix cancer screening.
Promising directions for the diagnosis and management of gynecological cancers
Authors: Kohn E.C. , Mills G.B. , Liotta L. 
Published: April 2004

AbstractDiagnosis and management of cancer requires tools with both high sensitivity and specificity. The minimally invasive cervical smear has demonstrated how a test, even one with low specificity, can change the public health profile of a cancer from a late stage deadly disease to early diagnosis with rare tumor‐related deaths. The benefit of such a test is best demonstrated by the low frequency of cervix cancer and its good outcome in countries where this test is readily available and used with appropriate secondary follow up. Early and specific symptoms, and identification and prevention for high risk groups has had similar impact for endometrial cancer. Neither a robust test, nor reliable or specific early symptoms are available for ovarian cancer, making clinical and scientific advances in this area a critical world‐wide need. Current approaches testing one protein or gene marker at a time will not address this crisis expeditiously. New sensitive, specific, accurate, and reliable technologies that can be implemented using high throughput mechanisms are needed at as low a cost as possible. Ideally, these technologies should be focused on readily available patient resources, such as blood or urine, or as in the case of cervix cancer, minimally invasive informative approaches such as cervical smears. Techniques that allow data mining from a large input database overcome the slow advances of one protein‐one gene investigation, and further address the multi‐faceted carcinogenesis process occurring even in germ line mutation‐associated malignancy. Proteomics, the study of the cellular proteins and their activation states, has led the progress in biomarker development for ovarian and other cancers and is being applied to management assessment. Amenable to high throughput, internet interface, and representative of the proteome spectrum, proteomic technology is the newest and most promising direction for translational developments in gynecologic cancers.
Introduction to the Special Section: Geology and Geophysics of Io
Authors: McEwen Alfred S. 
Published: April 2004

Io is about the size and density of Earth's Moon, but it has a dramatically different thermal state and geologic history. Tidal heating leads to intense volcanic and tectonic activity, so Io is an accelerated experiment in planetary geology and geophysics. Here we can witness volcanic activity on very large scales and at very high temperatures, perhaps providing insights into the early histories of the terrestrial planets.Io has always been a high‐priority objective of Galileo, but her proximity to Jupiter's intense radiation belt has meant saving the best for last. An Io flyby occurred during Jupiter orbit insertion in December 1995, but a tape recorder anomaly led to cancellation of remote‐sensing observations. No further close flybys of Io were planned until the final two orbits (I24 and I25) of the Galileo Europa Mission (GEM) late in 1999 in order to minimize radiation damage to spacecraft and instrument electronics. I24 was an exciting encounter, with a spacecraft safing event and recovery just hours before Io closest approach. Most of the Io data were acquired, but not without problems. The majority of images from the Solid State Imager (SSI) were acquired in a mode that failed due to the cumulative radiation damage, producing garbled images, although reconstruction has produced some useful pictures [Keszthelyi et al., this issue]. Also, the grating of the Near‐Infrared Mapping Spectrometer (NIMS) became stuck leading to loss of spectral sampling [Lopes et al., this issue]. These instrument problems were mitigated by the use of different observation modes or strategies in subsequent orbits. The 125 polar pass included another safing event, this time eliminating the recording of the highest‐resolution observations. However, the medium‐resolution observations were of excellent quality and provided a surprise look at a new fissure eruption at Tvashtar Catena. GEM was followed by the Galileo Millennium Mission (GMM) including another close Io flyby in orbit I27, a fully successful encounter. Three additional Io flybys are anticipated in August 2001 (I31), October 2001 (I32), and January 2002 (I33). The groundtracks for all six Io encounters are shown in Plate 1.
Linking shore with the ocean floor in real time in archeological oceanography
Authors: Ballard Robert D. 
Published: April 2004

In ocean exploration, physically transporting human beings in small numbers to remote regions of the world, and then taking them to the bottom of the ocean in very smaller numbers for short periods of time to explore short stretches of the sea floor, is clearly a costly and inefficient way to explore these vast regions of our planet.Recently, however, during an expedition to the Black Sea, lnternet2 and a high‐bandwidth satellite link made it possible for scientists to work on the ocean floor without ever having to leave the comfort of their university laboratory Internet2 is a consortium of 206 universities working with industry and the government to develop and deploy an advanced Internet network that operates at 10 gigabits per second. Its future goal is to offer 100 megabits per second via its Abilene backbone to its user base (see www.internet2.edu/about).
Recent surface faulting investigated in Kamchatka volcanic arc
Authors: Tibaldi Alessandro 
Published: April 2004

Large tectonic earthquakes may trigger other phenomena such as volcanic eruptions and edifice collapse, and such events in coastal areas can generate tsunamis. When closely spaced in time, these events can combine their effects to cause more serious and variable consequences than anticipated from volcanic or seismic hazards forecasts separately. The Kamchatka volcanic arc, because it has been affected recently by such events, provides an invaluable natural laboratory for understanding these phenomena.An international team recently studied the strong events (Mw >5.5) that have occurred in Kamchatka over the last 10 k.y. The work was organized within the framework of a new NATO‐Russia collaborative project studying major events occurring in volcanic arcs. It follows a joint US‐Russian investigation carried out during 2000–2002 under the umbrella of the National Geographic Society, the U.S. National Science Foundation, and the Russian Foundation for Basic Research, which combined volcanic, geochemical, and geophysical evidence of catastrophic geological events. This work is now being built on by providing the field data necessary to understand the age, magnitude, and recurrence intervals of paleoearthquakes; and the location, geometry, and kinematics of the main active crustal faults. Improvements in the understanding of the age and size of Holocene eruptions and refinement of their ash dispersal patterns are also being made. A multidisciplinary team is involved in this work, as well as similar studies in the Aeolian volcanic arc in Italy thus allowing the results to be combined and compared to arrive at more general perspectives.