bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing pattern of histological type, location, stage and outcome of surgical treatment of gastric carcinoma
Authors: Borch K , Jönsson B , Tarpila E , Franzén T , Berglund J , Kullman E , Franzén L 
Published: March 2003

Abstract

Background
There are indications that some features of gastric carcinoma are changing, with a possible impact on prognosis. The aim of this study was to examine any changes in type, location, stage, resection rate, postoperative mortality rate or prognosis for patients with gastric carcinoma in a well defined population.

Methods
During 1974–1991, 1161 new cases of gastric adenocarcinoma were diagnosed in Östergötland County, Sweden. Tumour location, Laurén histological type, tumour node metastasis (TNM) stage, radicality of tumour resection and postoperative complications were recorded after histological re-evaluation of tissue specimens and examination of all patient records. Dates of death were obtained from the Swedish Central Bureau of Statistics. Time trends were studied by comparing the intervals 1974–1982 (period 1) and 1983–1991 (period 2).

Results
The proportion of diffuse type of adenocarcinoma increased (from 27 to 35 per cent), while that of mixed type decreased (from 16 to 9 per cent) and that of intestinal type was unchanged. The proportion of tumours located in the proximal two-thirds of the stomach increased (from 32 to 42 per cent) and the proportion of patients with tumours in TNM stage IV decreased (from 32 to 25 per cent). Overall tumour resection rates were unchanged, although the proportion of radical total gastrectomies increased (from 36 to 50 per cent). Excluding tumours of the cardia or gastric remnant after previous ulcer surgery, the 5-year relative survival rate after radical resection increased from 25 to 36 per cent and the postoperative mortality rate decreased for both radical (from 11 to 4 per cent) and palliative (from 18 to 6 per cent) resection.

Conclusion
The patterns of tumour histology, location and stage of gastric carcinoma have changed in the authors' region. These changes were paralleled by a significant improvement in survival and postoperative mortality rates.
Experimental study of a novel fibrin sealant for achieving haemostasis following partial hepatectomy
Authors: Davidson B R , Burnett S , Javed M S , Seifalian A , Moore D , Doctor N 
Published: March 2003

Abstract

Background
Ensuring adequate haemostasis is a major difficulty in the field of liver surgery. This study aimed to evaluate a novel fibrin sealant (Vivostat), designed for autologous preparation, in a porcine model of partial hepatectomy.

Methods
Thirty-six Large White Landrace pigs underwent partial left hepatectomy by finger fracture under portal vascular inflow occlusion. Animals were randomized to treatment of the resected surface with either fibrin sealant (Vivostat, n = 12) or regenerated oxidized cellulose gauze (Surgicel, n = 12), or were left untreated (controls, n = 12). Blood loss from the resection margin was measured at 2-min intervals for 10 min, and the time to haemostasis was recorded. Following complete haemostasis the animals recovered for 7 days.

Results
Median (range) blood loss in the control group was 94·3 (17·3–467·0) g, and was significantly reduced with Vivostat (13·8 (5·5–150·9) g) and Surgicel (22·8 (5·8–67·3) g). Median (range) time to haemostasis in controls (31 (12–52) min) was also significantly reduced by Vivostat (8 (0–32) min) and Surgicel (10 (0–19) min) (both P &lt; 0·001 versus controls, Kruskal–Wallis test).

Conclusion
The novel fibrin sealant, Vivostat, is as effective as Surgicel cellulose gauze in achieving haemostasis after porcine partial hepatic lobectomy.
Impact of timing on completion thyroidectomy for thyroid cancer
Authors: Tan M P , Agarwal G , Reeve T S , Barraclough B H , Delbridge L W 
Published: March 2003

Abstract

Background
It has been stated that completion thyroidectomy for thyroid malignancy should be performed either within 10 days of the primary operation or after 3 months, to reduce the incidence of complications. The aim of this study was to review the impact of timing on the rate of complications following completion thyroidectomy.

Methods
Data were obtained retrospectively from the Endocrine Surgery Thyroid Data Base, to which the records of all patients have been entered since 1957. The patients who had the last 100 consecutive completion thyroidectomies for thyroid cancer comprised the study group.

Results
Sixty-three patients had the second operation performed within 10 days or more than 90 days after the initial operation (group 1). Thirty-seven patients had reoperation between 10 and 90 days after the first procedure (group 2). One patient (2 per cent) in group 1 and one patient (3 per cent) in group 2 suffered a permanent complication (P not significant).

Conclusion
There was no definite impact of the timing of surgery on the rate of complications after completion thyroidectomy.
Role of fine-needle aspiration biopsy and frozen-section evaluation in the surgical management of thyroid nodules
Authors: Caraci P , Aversa S , Mussa A , Pancani G , Ondolo C , Conticello S 
Published: March 2003

Abstract

Background
The role of routine frozen section (FS) in the surgical management of thyroid nodules remains uncertain. This study reviewed the role of FS in the presence of an adequate fine-needle aspiration biopsy (FNAB).

Methods
FNAB and FS were evaluated in 206 patients who had surgery for a thyroid nodule. Cytological specimens were classified as benign, malignant or suspicious. The FS diagnoses were benign, malignant or deferred.

Results
A cytological diagnosis was obtained in 93 nodules; the remaining 113 were classified as suspicious, of which 21 were malignant on definitive examination. The overall accuracy of FNAB was 53 per cent. FS evaluation identified 165 lesions as benign; the diagnosis was deferred until definitive histological evaluation in only eight. The overall accuracy, therefore, was 96 per cent. Routine use of FS was cost-effective; lowering the number of reoperations led to an estimated saving of about 40 per cent.

Conclusion
These data suggest that FS remains an important tool in the surgical management of thyroid nodules and can reduce the number of patients requiring reoperation.
Impact of socioeconomic deprivation on outcome after surgery for colorectal cancer
Authors: Hole D J , McArdle C S 
Published: March 2003

AbstractBackgroundPrevious studies have demonstrated that socioeconomic deprivation is associated with poorer survival in patients with colorectal cancer. These differences have been attributed to more advanced disease at presentation.MethodsA total of 2269 patients undergoing resection for colorectal cancer in hospitals in central Scotland between 1991 and 1994 were studied. Socioeconomic status was defined using the Carstairs deprivation index. The impact of deprivation on case mix, treatment and outcome was analysed.ResultsThere were no significant differences in mode of presentation, extent of disease at presentation, type of resection and postoperative mortality rate among the socioeconomic groups. Following curative resection, the overall survival rate at 5 years was 47·0 per cent in deprived patients, compared with 55·4 per cent in affluent patients (P = 0·05); the cancer-specific survival rate was 62·6 per cent in the deprived and 68·1 per cent in the affluent (P = 0·05). Compared with the affluent, the adjusted hazard ratios for the deprived were 1·36 (95 per cent confidence interval (c.i.) 1·09 to 1·69) for overall mortality and 1·26 (95 per cent c.i. 0·95 to 1·67) for cancer-specific mortality. Following palliative resection, there was no difference in survival between the affluent and deprived for either overall (P = 0·27) or cancer-specific (P = 0·89) mortality.ConclusionThese findings confirm that the cancer-specific survival rate following surgery for colorectal cancer is lower in deprived patients. Stage of disease at presentation and type of operation did not account for this difference. The excess mortality was confined to patients undergoing apparently curative resection.
Surgical anatomy of segmental liver transplantation
Authors: Deshpande R R , Heaton N D , Rela M 
Published: March 2003

Abstract

Background
The emergence of split and living donor liver transplantation has necessitated re-evaluation of liver anatomy in greater depth and from a different perspective than before. Early attempts at split liver transplantation were met with significant numbers of vascular and biliary complications. Technical innovations in this field have evolved largely by recognizing anatomical anomalies and variations at operation, and devising novel ways of dealing with them. This has led to increasing acceptance of these procedures and decreased morbidity and mortality rates, similar to those observed with whole liver transplantation.

Methods and results
The following review is based on clinical experience of more than 180 split and living related liver transplantations in adults and children, performed over a 7-year period from 1994 to 2001.

Conclusion
A comprehensive understanding and application of surgical anatomy of the liver is essential to improve and maintain the excellent results of segmental liver transplantation.
Experimental study of large-volume microwave ablation in the liver
Authors: Strickland A D , Clegg P J , Cronin N J , Swift B , Festing M , West K P , Robertson G S M , Lloyd D M 
Published: March 2003

Abstract

Background
Microwave coagulation therapy is useful in the destruction of small, irresectable liver tumours of primary and secondary origin. Unfortunately, the small lesion size produced by currently available equipment makes it difficult and time consuming completely to ablate lesions larger than 3 cm in diameter. A microwave system capable of producing large-volume ablations in very short periods of time has been developed. Using a large-animal model the ability of the equipment to produce large-volume lesions in a safe, predictable and dose-dependent manner was tested.

Methods
Fourteen large white pigs were anaesthetized and underwent multiple microwave treatments. The animals were killed at different timepoints to investigate lesion size and evolution.

Results
The microwave system was able to generate large-volume ablations of up to 6·5 cm in diameter in a controlled and dose-dependent manner.

Conclusion
This novel microwave system allows the ablation of large volumes of liver tissue in a short period of time. The ability to produce lesions reproducibly and safely highlights the potential of this system in the future treatment of irresectable liver tumours.
A study of death by anoikis in cultured epithelial cells
Authors: Bretland A. J. , Lawry J. , Sharrard R. M. 
Published: March 2003

Abstract. Background: Epithelial cells are critically dependent upon cell‐matrix and cell‐cell adhesion for growth and survival. Anoikis is programmed cell death caused by disruption of cell‐substrate adhesion in normal epithelial cells. Methods: We studied the induction of anoikis in vitro in two cell lines; HaCaT and SW742. PI3K, JAK2 and PKC are key elements in signalling pathways regulating cell survival, and using specific inhibitors we also examined their potential role in the induction of anoikis. Results: When prevented from adhesion by culture on polyHEMA, HaCaT cells underwent apoptosis selectively from the proliferating population; surviving cells underwent cell cycle arrest. In SW742 cells anoikis also occurred, but was balanced by increased cycling. The effects of specific kinase inhibitors indicated that both Janus kinase 2 and protein kinase C partially protect HaCaT cells from anoikis through inducing cell cycle arrest of surviving nonadherent cells; inhibition of Phosphatidylinositol 3‐kinase did not induce cycling in HaCaTs prevented from adhesion but did stimulate anoikis. SW742 cells showed markedly different responses: Janus kinase 2 inhibition activated apoptosis directly, Phosphatidylinositol 3‐kinase inhibition stimulated both cell cycling and apoptosis, while protein kinase C inhibition stimulated cycling but inhibited apoptosis. Conclusions: Susceptibility to cell death in adhesion‐prevented epithelial cells may thus be regulated by signalling pathways involving Phosphatidylinositol 3‐kinase, Janus kinase 2 and protein kinase C. The ability of epithelial tumour cells to invade and metastasize may therefore result from disruption of these pathways.
Nitric oxide induces apoptosis in NALM‐6, a leukaemia cell line with low cyclin E protein levels
Authors: Mozart M. , Scuderi R. , Celsing F. , Aguilar‐Santelises M. 
Published: March 2003

Abstract.Intracellular nitric oxide levels may differ in resting and stimulated cells and contribute to the regulation of cell survival and proliferation through a variety of mechanisms and effects. We exposed two B‐cell lines to a range of S‐nitroso‐N‐acetyl‐d,l‐penicillamine (SNAP) concentrations in order to examine their susceptibility to exogenous nitric oxide and the participation of nitric oxide as modulator of cell proliferation. Although both FLEB and NALM‐6 decreased their levels of thymidine incorporation, only NALM‐6 cells were induced to undergo G1 arrest, phosphatidyl serine exposure and DNA fragmentation when cultured in the presence of 250 µm SNAP. This higher sensitivity of NALM‐6 coincided with initially low cyclin E protein levels which were increased 7.8‐fold after culture for 24 h with 250 µm SNAP. In contrast, there was no difference in cyclins A and D3, Bcl‐2 and actin levels, neither at the beginning nor at the end of the 24 h culture. Our study reveals that FLEB and NALM‐6 exhibit different response to the same concentration of nitric oxide, that nitric oxide can simultaneously induce cell cycle alterations and apoptosis, and further suggests an association between these two processes, with the involvement of cell cycle regulatory molecules.
Inhibition of human neuroblastoma cell proliferation and EGF receptor phosphorylation by gangliosides GM1, GM3, GD1Aand GT1B
Authors: Mirkin B. L. , Clark S. H. , Zhang C. 
Published: March 2003

Abstract. The inhibitory action of gangliosides GT1B, GD1A, GM3and GM1on cell proliferation and epidermal growth factor receptor (EGFR) phosphorylation was determined in the N‐myc amplified human neuroblastoma cell line NBL‐W. The IC50of each ganglioside was estimated from concentration‐response regressions generated by incubating NBL‐W cells with incremental concentrations (5–1000 µm) of GT1B, GD1A, GM3or GM1for 4 days. Cell proliferation was quantitatively determined by a colourimetric assay using tetrazolium dye and spectrophotometric analysis, and EGFR phosphorylation by densitometry of Western blots. All gangliosides assayed, with the exception of GM1, inhibited NBL‐W cell proliferation in a concentration‐dependent manner. The IC50s for gangliosides GT1B[molecular weight (MW) 2129], GM3(MW 1236), and GD1A(MW 1838) were (mean ± SEM) 117 ± 26, 255 ± 29, and 425 ± 44 m, respectively. In contrast, the IC50for GM1(MW 1547) could not be determined. Incubation of NBL‐W cells with epidermal growth factor (EGF) concentrations ranging from 0.1 to 1000 ng/ml progressively increased cell proliferation rate, but it plateaued at concentrations above 10 ng/ml. EGFR tyrosine phosphorylation, however, was incrementally stimulated by EGF concentrations from 1 to 100 ng/ml. The suppression of EGF‐induced EGFR phosphorylation differed for each ganglioside, and their respective inhibitory potencies were as follows: EGFR phosphorylation [area under curve (+ EGF)/area under curve (– EGF)]: control (no ganglioside added) = 8.2; GM1 = 8.3; GD1A = 6.7; GM3 = 4.87, and GT1B = 4.09. The lower the ratio, the greater the inhibitory activity of the ganglioside. Gangliosides GD1Aand GT1B, which have terminal N‐acetyl neuraminic acid moieties, as well as one and two N‐acetyl neuraminic acid residues linked to the internal galactose, respectively, both inhibited cell proliferation and EGFR phosphorylation. However, GD1Awas a more potent suppressor of cell proliferation and GT1Bmost effective against EGFR phosphorylation. GM3, which only has a terminal N‐acetyl neuraminic acid, inhibited cell proliferation and EGFR phosphorylation almost equivalently. These data suggest that gangliosides differ in their potency as inhibitors of NBL‐W neuroblastoma cell proliferation and EGFR tyrosine phosphorylation, and that perturbations in the differential expression of membrane glycosphingolipids may play a role in modulating neuroblastoma growth.
G2‐phase radiation response in lymphoblastoid cell lines from Nijmegen breakage syndrome
Authors: Antoccia A. , Di Masi A. , Maraschio P. , Stumm M. , Ricordy R. , Tanzarella C. 
Published: March 2003

Abstract.The relationship between G2‐phase checkpoint activation, cytoplasmic cyclin‐B1 accumulation and nuclear phosphorylation of p34CDC2was studied in Nijmegen breakage syndrome cells treated with DNA damaging agents. Experiments were performed on lymphoblastoid cell lines from four Nijmegen breakage syndrome patients with different mutations, as well as on cells from an ataxia telangiectasia patient. Lymphoblastoid cell lines were irradiated with 0.50–2 Gy X‐rays and the percentage of G2‐phase accumulated cells was evaluated by means of flow cytometry in samples that were harvested 24 h later. The G2‐checkpoint activation was analysed by scoring the mitotic index at 2 and 4 h after treatment with 0.5 and 1 Gy X‐rays and treatment with the DNA double‐strand break inducer calicheamicin‐γ1. Cytoplasmic accumulation of cyclin‐B1 was evaluated by means of fluorescence immunostaining or Western blotting, in cells harvested shortly after irradiation with 1 and 2 Gy. The extent of tyrosine 15‐phosphorylated p34CDC2was assessed in the nuclear fractions. Nijmegen breakage syndrome cells showed suboptimal G2‐phase checkpoint activation respect to normal cells and were greatly different from ataxia telangiectasia cells. Increased cytoplasmic cyclin‐B1 accumulation was detected by both immunofluorescence and immunoblot in normal as well as in Nijmegen breakage syndrome cells. Furthermore, nuclear p34CDC2. phosphorylation was detected at a higher level in Nijmegen breakage syndrome than in ataxia telangiectasia cells. In conclusion, our data do not suggest that failure to activate checkpoints plays a major role in the radiosensitivity of Nijmegen breakage syndrome cells.
Establishment of a triploid V79 cell line from tetraploid cells obtained through polyploidization using K‐252a
Authors: Fujikawa‐Yamamoto Kohzaburo , Yamagishi Hiroko , Miyagoshi Minoru 
Published: March 2003

Abstract. Triploid V79 cells were established from tetraploid cells. Diploid V79 cells were polyploidized by K‐252a, an inhibitor of protein kinases, and then released from the drug for 10 days. At that time, the cell population was a mixture of diploid and tetraploid cells. Triploid cells were obtained through the cloning of tetraploid cells. They had 33 chromosomes (1.5 times the diploid number) and showed a karyotype of three homologueous chromosomes. The duration of the G1, S and G2/M phases was almost the same as for diploid cells. The cell volume of triploid V79 cells was about two times that of the diploid cells. An explanation for the diploid‐tetraploid‐triploid transition is proposed.
Epithelial cell proliferative activity and oral cancer progression
Authors: Thomson P. J. , Soames J. V. , Booth C. , O'Shea J. A. 
Published: March 2003

Abstract. Accurate, predictive assessment of the behaviour and progression of oral cancers and precancers remains elusive in clinical practice. Archival tissue specimens from 10 previously treated patients with oral lesions of known clinical outcome (3 years post‐treatment) were re‐examined histopathologically, and proliferative cell labelling indices (LIs) determined for Ki67, cyclin A and histone mRNA cell cycle markers. While histone mRNA labelling ultimately proved unreliable, both Ki67 and cyclin A LIs demonstrated a clear trend for enhanced labelling to occur in increasingly dysplastic and neoplastic tissue, with particular emphasis on suprabasal labelling in abnormal tissue. Perhaps of greatest significance was the observation of increased LIs and suprabasal labelling in lesions with poor clinical outcome, such as patients developing recurrent disease or cervical lymph node metastasis. Measurement of cell proliferative activity in individual oral epithelial dysplastic lesions or invasive squamous cell carcinomas may thus provide unique, predictive information on clinical outcome.
Helping parents by working with their children in individual child therapy
Authors: Wilson Kate , Ryan Virginia 
Published: March 2003

ABSTRACTThe paper describes a small scale pilot process and outcome study that was undertaken at the University of York. The study is based on accounts of treatment interventions with children conducted by trainee play therapists studying on the University's programme in non‐directive play therapy. These are being used to develop a methodology for evaluating the effectiveness of non‐directive play therapy as an intervention for distressed and maltreated children. The focus of this paper is on one finding of the study, namely that play therapy undertaken with individual children, in addition to bringing about improvements in the children's problems, may improve their parents’ parenting behaviour if they are appropriately involved in the therapy. The paper describes the cases and their outcomes at a 6‐month follow‐up. It illustrates the finding of changes in parenting behaviour through three case studies, and discusses the kinds of changes, possible reasons for them, and necessary practice requirements if these changes are to take place. The paper concludes that engaging parents in a broadly collaborative effort may be facilitated by a primary initial focus on their children.
Family budgets and public money: spending fostering payments
Authors: Kirton Derek 
Published: March 2003

ABSTRACTIn this second of two papers based on a study of payment issues within foster care, the focus is on expenditure. It is argued that the hybrid public/private nature of fostering gives rise to contradictory pressures for carers, including the status of maintenance payments as both part of family budgets and a form of delegated public expenditure. For example, carers are required in principle both to spend fixed amounts upon foster children and to treat them in like fashion to their own children. In this paper, the issue of ‘like treatment’ is explored, along with the significance of payment for ‘children who foster’ and for relationships between carers and foster children. Also examined are the challenges presented by differences between carers’ material circumstances and those of birth families, especially when reunification is planned. Overall, the paper seeks to show how the handling of expenditure becomes closely entwined with inter‐personal dynamics within foster care.
Play therapy: the children's views
Authors: Carroll Jo 
Published: March 2003

ABSTRACTThis paper describes my efforts, as a practising play therapist, to listen to children’s opinions about the play therapy experience. There has been ongoing interaction between this project and my clinical work. Previous research has attended to adult agendas, and I have tried to give children a voice. There have been methodological challenges. However, data from the children confirm the overriding importance of the relationship, providing the context for the therapeutic experience. Within the playroom, children distinguish between talking and playing, and both have a role. However, while therapists ascribe meaning to play, most children see it as ‘just fun’. For some children having fun, in the context of a thoughtful and sustaining relationship, was the most significant aspect of the therapeutic process. Others were able to reflect more deeply and recognize the value of having difficult feelings thought about and understood.