bluuebunny/crossref_metadata_2025_split huggingface dataset:
Latent Subclinical Medullary Thyroid Carcinoma: Diagnosis and Treatment
Authors: Henry Jean‐François , Denizot Anne , Puccini Marco , Gramatica Luis , Kvachenyuk Andrey , Conte Devolx Bernard , De Micco Cathérine 
Published: August 2002

AbstractSporadic medullary thyroid carcinoma (SMTC) is usually diagnosed at a clinical stage often associated with lymph node involvement. Hence surgical treatment does not result in definitive cure in many patients. Studies have demonstrated that routine measurement of serum basal calcitonin (CT) in patients with nodular thyroid disease allows preoperative, early diagnosis of unsuspected SMTC. The aim of this work was to assess the results of surgery in patients operated on for subclinical SMTC detected preoperatively by measurement of serum CT. Results were compared with those obtained in patients with SMTCs diagnosed at a clinical stage and operated on during the same period. During a 4‐year period (1993–1996) 24 SMTCs were diagnosed and treated in our department. They were diagnosed at a clinical stage in 13 patients (group 1): palpable thyroid tumor (n= 11), palpable metastatic lymph node (n= 6), distant metastases (n= 4). In nine cases the diagnosis was made by both fine‐needle aspiration cytology and serum CT measurement. In the four other cases the initial cytology was incorrect, but the diagnosis was revised on the basis of elevated basal CT values. In 11 patients (group 2) presenting with nodular thyroid disease, SMTC was not clinically detectable. SMTC was preoperatively suspected by elevated CT levels: basal CT > 10 pg/ml and pentagastrin‐stimulated CT peak > 100 pg/ml. One patient in group 1 with distant metastases was not operated on. All of the other 12 patients underwent total thyroidectomy and extensive lymph node dissection. The mean size of the tumors was 27 mm. Lymph node involvement was found in nine patients. After surgery, CT levels returned to normal in five patients but remained elevated in five others; the two remaining patients died of distant metastases. All 11 patients in group 2 underwent total thyroidectomy and central neck dissection. None of the 11 patients had nodal extension. All 11 patients are biochemically cured. It was concluded that routine measurement of basal serum CT in those with nodular thyroid disease allows early, preoperative diagnosis of subclinical SMTC and improves the results of surgery.
Efficacy of PdB in Preventing Intraoperative Risk of Infectious Diseases
Authors: Botet Xavier , Serra Javier , Padrós Rafael , López Santos , Boldó Enric , Llauradó Josep M. , Trias Ramon , Rius Xavier 
Published: August 2002

AbstractThe objectives of this study were to (1) determine the number of punctures surgeons and assistants suffer during operations involving a laparotomy during the intraabdominal and closure phases; and (2) determine if the number of puncture injuries during wound closure can be reduced using a new surgical instrument (PdB) that protects the surgeon's hands and the patient's viscera against needlesticks. For the first objective, all laparotomies performed during 1 month (n= 52) were controlled, collecting the gloves used and determining the number of perforations. For the second objective, a randomized prospective controlled study, involving two series of 100 medial laparotomies, was carried out. The incidence of perforations was 29% during the intraabdominal phase and 16% during the wound closure phase. The glove perforation rate while closing medial laparotomies was 31.5% if the PdB was not used and 3% if the PdB was used (p < 0.0001). The glove perforation rate during laparotomy is significant, but with the use of the PdB this incidence can be significantly reduced.
Effect of Basic Prehospital Trauma Life Support Program on Cognitive and Trauma Management Skills
Authors: Ali Jameel , Adam Rasheed , Josa David , Pierre Ian , Bedsaysie Henry , West Undine , Winn Jennifer , Ali Ernest , Haynes Beresford 
Published: August 2002

AbstractWe tested the effectiveness of a basic prehospital trauma life support (PHTLS) program by assessing cognitive performance and trauma management skills among prehospital trauma personnel. Fourteen subjects who completed a standard PHTLS course (group I) were compared to a matched group not completing a PHTLS program (group II). Cognitive performance was assessed on 50‐item multiple choice examinations, and trauma skills management was assessed with four simulated trauma patients. Pre‐PHTLS multiple choice questionnaire scores were similar (45.8 ± 9.4% vs. 48.8 ± 8.9% for groups I and II, respectively), but the post‐PHTLS scores were higher in group I (80.4 ± 5.9%) than in group II (52.6 ± 4.9%). Pre‐PHTLS simulated trauma patient performance scores (standardized to a maximum total of 20 for each station) were similar at all four stations for both groups, ranging from 7.9 to 10.4. The post‐PHTLS scores were statistically significantly higher at all four stations for group I (range 16.0–19.0) compared to those for group II (range 8.0–11.1). The overall mean pre‐PHTLS score for all four stations was 8.3 ± 2.1 for group I and 8.8 ± 2.0 (NS) for group II; the group I post‐PHTLS mean score for the four stations was 17.1 ± 2.7 (
p < 0.05) compared to 9.1 ± 2.3 for group II. Pre‐PHTLS Adherence to Priority scores on a scale of 1 to 7 were similar (1.1 ± 0.9 for group I and 1.2 ± 1.0 for group II). Post‐PHTLS group I Priority scores increased to 5.9 ± 1.1. Group II (1.1 ± 1.0) did not improve their post‐PHTLS scores. The pre‐PHTLS Organized Approach scores in the simulated trauma patients on a scale of 1 to 5 were 2.1 ± 1.0 for group I and 1.9 ± 1.2 for group II (NS) compared to 4.2 ± 0.9 (p < 0.05) in group I and 2.0 ± 0.8 in group II after PHTLS. This study demonstrates improved cognitive and trauma management skills performance among prehospital paramedical personnel who complete the basic PHTLS program.
Adjuvant Therapy for Pancreatic Cancer
Authors: Ghaneh Paula , Kawesha Anthony , Howes Nathan , Jones Lucie , Neoptolemos John P. 
Published: August 2002

Abstract.Pancreatic cancer is a major cause of cancer death; and despite advances in the standards of surgery and supportive care, the median and long‐term survival rates have not shown similar dramatic improvements. Techniques such as radical surgery alone cannot guarantee a cure. Previous work with conventional chemotherapy and radiotherapy in patients with advanced pancreatic cancer has indicated a role for adjuvant therapy for patients with resectable tumors. The main modalities that have been assessed are based on the Gastrointestinal Tumour Study Group (GITSG) results using 5‐fluorouracil chemotherapy, external beam radiation therapy (EBRT), or both. Alternative approaches such as neoadjuvant therapy have been used, which may increase the number of patients suitable for resection; and regional therapy techniques have been used to increase the therapeutic potential by concentrating agents to the tumor bed. The results of single or combination therapy do show some improvement in survival but have been limited in most cases to retrospective nonrandomized series of patients. Therefore the results must be assessed as such. There are several large randomized trials that will deliver definitive answers in the near future as to whether conventional adjuvant therapy is effective. New approaches using novel agents for advanced disease are currently being assessed, and they may eventually identify the most appropriate and effective agents to use for pancreatic cancer in the adjuvant setting.
Surgical Treatment of Postpneumonic Empyema
Authors: Angelillo‐Mackinlay Tomas , Lyons Gustavo A. , Piedras Miguel Barboza , Angelillo‐Mackinlay Diego 
Published: August 2002

Abstract.Postpneumonic empyema complicates 5% of all pneumonia cases. The loculated fibrinopurulent stage cannot be resolved by drainage tube insertion alone; it requires a débriding limited thoracotomy. Recent reports of series seem to indicate that video‐assisted thoracic surgery (VATS) can replace thoracotomy advantageously. Eighty‐six cases of postpneumonic empyema were operated on in our institution during the last 12 years: 33 cases (group I) using limited thoracotomy (1985–1991) and 53 by VATS (1992–1996). Data were collected prospectively for group II and retrospectively for the first group. The two populations were comparable in age, gender, stage of disease, and co‐morbid status. There were no significant differences between the groups. VATS débridement for loculated fibrinopurulent postpneumonic empyema offers better results than thoracotomy in terms of resolution of the disease and length of stay in hospital. It also seems to be more advantageous, resulting in fewer surgical sequelae, lower cost, less labor impediment, and better cosmesis.
Current Status of Thoracoscopic Lung Volume Reduction
Authors: Krucylak Peter E. , Keller Cesar A. , Naunheim Keith S. 
Published: August 2002

Abstract.Surgical therapy has recently been reintroduced for the treatment of emphysema, and a number of investigators have used video‐assisted thoracic surgical (VATS) techniques to accomplish lung volume reduction. The published reports differ with regard to patient selection, preoperative preparation, operative approach, and surgical technique. The results of these reports are reviewed and compared. Thoracoscopic lung volume reduction appears to be a useful part of the surgeon's armamentarium in managing patients with severe pulmonary emphysema.
Intraoperative Ultrasonography versus Helical Computed Tomography and Computed Tomography with Arterioportography in Diagnosing Colorectal Liver Metastases: Lesion‐by‐lesion Analysis
Authors: Schmidt Johannes , Strotzer Markus , Fraunhofer Stefan , Boedeker Herman , Zirngibl Hubert 
Published: August 2002

AbstractHelical computed tomography with arterioportography (CTAP) and intraoperative sonography (IOUS) are both recognized to be extremely sensitive in the detection of liver metastases measuring <2 cm in diameter. As sensitivity and specificity values for both techniques differ significantly in the literature and in default of sufficient published data regarding this subject, a lesion‐by‐lesion analysis was considered necessary. Accuracy of IOUS was compared with helical computed tomography (CT) and portal‐phase contrast enhancement (CTAP) in the preoperative detection of liver metastases from colorectal carcinoma projected as a prospective blinded study. Cost efficiency should be determined. Liver CTAP and IOUS were evaluated in 33 patients with colorectal carcinoma. Metastases were resected in 10 cases, and the remaining 23 patients were observed for follow‐up with CT investigations every 3 months for a period of 1 year. CTAP and IOUS detected all 13 lesions measuring 5–10 mm (13/13). One metastasis measuring >10 mm was missed by IOUS. CTAP presented an ideal sensitivity of 100%, but specificity was as low as 68%. IOUS sensitivity was 98% and specificity was 95%. IOUS and CTAP are of comparable value regarding the detection of liver metastases <10 mm. Both techniques may be used if resections of synchronous or metachronous metastases are planned in order not to miss limiting small lesions and to prevent superfluous liver surgery. Helical CT scan with dynamic intravenous contrast enhancement is considered the most cost‐effective preoperative staging method, although local staging may not be achieved because of insufficient intraabdominal survey.
Repeated Clinical and Laboratory Examinations in Patients with an Equivocal Diagnosis of Appendicitis
Authors: Andersson Roland E. , Hugander Anders , Ravn Hans , Offenbartl Karsten , Ghazi Sam H. , Nyström Per Olof , Olaison Gunnar 
Published: August 2002

Abstract.In‐hospital observation with repeated clinical examinations is commonly used in patients with an equivocal diagnosis of appendicitis. It is not known if repeated measurements of temperature and laboratory examinations have any diagnostic importance in this situation. The importance of repeated measurements of the body temperature, white blood cell (WBC) and differential cell counts, C‐reactive protein concentration (CRP) and of the surgeon's repeated assessments was prospectively analyzed in 420 patients with an equivocal diagnosis of appendicitis at admission who were reexamined after a median of 6 hours of observation. The final diagnosis was appendicitis in 137 patients. After observation the inflammatory response was increasing among patients with appendicitis and decreasing among patients without appendicitis. The variables discriminating power for appendicitis consequently increased, from an area under the receiver operating characteristic (ROC) curve of 0.56 to 0.77 at admission, to 0.75 to 0.85 after observation. The ROC area of the surgeons' clinical assessment increased from 0.69 to 0.89. The WBC and differential cell counts were the best discriminators at the repeat examination. The change in the variables between the observations had weak discriminating power and had no additional importance in addition to the actual level at the repeat examination. To conclude, the diagnostic information of the temperature and laboratory examinations increased after observation. Repeated controls of the body temperature and laboratory examinations are therefore useful in the management of patients with equivocal signs of appendicitis, but the result of the examinations must be integrated with the clinical assessment.
Femoral Medullary Infarction Secondary to Canine Total Hip Arthroplasty
Authors: Sebestyen Peter , Marcellin‐Little DENIS J. , Deyoung Bonnie A. 
Published: August 2002

Objective—To evaluate the prevalence of femoral intramedullary infarction after total hip arthroplasty (THA) and to determine whether any specific femoral morphology predisposes to bone infarction.Study Design—Retrospective clinical study.Sample Population—All dogs from our hospital population undergoing THA between 1984 and 1997 with radiographic follow‐up available at 1 year or more postoperatively.Methods—A case control study was conducted within the THA group to determine risk factors predisposing to femoral infarction after THA. Medical records and radiographs were reviewed. Data were collected on clinical parameters, femoral morphology, prosthesis, and bone changes. Radiographic diagnosis was confirmed using histopathology in 11 femora. Radiographs of 50 age‐matched control dogs weighing more than 20 kg with coxofemoral degenerative joint disease were randomly chosen to determine the prevalence of bone infarction in nonoperated dogs.Results—Ninety‐one dogs with 110 THA were included in the study. Fifteen of the 110 femora with THA had radiographic evidence of infarction (14%). Infarction was not present in any femora in the control group. There was no significant difference in the prevalence of infarction between dogs that received cemented or uncemented prostheses. Clinical signs were not reported in any patient that developed femoral infarction. Young age (P = .03) and a distance between the greater trochanter and nutrient foramen greater than 79 mm (P = .008) predisposed dogs to femoral infarction. Over time, three infarcts decreased in size radiographically, five remained unchanged, and three expanded. An osteosarcoma developed at the site of a bone infarct in one dog.Conclusion—Femoral intramedullary infarction occurred in 15 of 110 THA. Young age at the time of THA and a greater distance between the greater trochanter and the nutrient foramen predisposed to infarction.Clinical Relevance—Intramedullary infarction occurs after canine THA. These bone infarcts do not appear to cause clinical signs; however, they may present a diagnostic challenge. Malignant transformation could potentially result from medullary infarction.
Effects of Superior Check Desmotomy on Flexor Tendon and Suspensory Ligament Strain in Equine Cadaver Limbs
Authors: Alexander Guy R. , Gibson Katherine T. , Day Robert E. , Robertson Ian D. 
Published: August 2002

Objective—To measure the effects of transection of the accessory ligament of the superficial digital flexor (SDF) muscle (superior check desmotomy) on flexor tendon and suspensory ligament (SL) strain in vitro.Study Design—In vitro experimental biomechanical investigation.Animals Used—Ten equine cadaver forelimbs.Methods—The effects of superior check desmotomy were determined using equine cadaver forelimbs secured in a servocontrolled hydraulic testing machine. Strain sensors were used to measure strain on the superficial and deep digital flexor tendons and SL, and a goniometer was used to measure joint angles when the limb was loaded at 890 N and 3,115 N before desmotomy, and at 3,115 N after desmotomy.Results—Superior check desmotomy was associated with significantly increased strains on the SDF tendon and SL, and significant alterations in the angles of the metacarpophalangeal and carpal joints.Conclusions—The superior check ligament has an important role in maintaining joint angles and load distribution in the forelimb. Lengthening of the SDF musculotendinous unit after superior check desmotomy may be associated with increased strain on the SL.Clinical Relevance—Transection of the accessory ligament of the SDF muscle may predispose horses to SL desmitis postoperatively.
Laparoscopic Ovariectomy Using Sequential Electrocoagulation and Sharp Transection of the Equine Mesovarium
Authors: Rodgerson Dwayne H. , Belknap James K. , Wilson David A. 
Published: August 2002

Objective—To describe in horses and ponies a laparoscopic ovariectomy technique facilitated by electrosurgical instrumentation.Study Design—Elective ovariectomy was performed in 23 mares using laparoscopic electrosurgical instrumentation.Animals or Sample Population—Twenty‐three mares (13 horses, 10 ponies), aged from 2 to 21 years and weighing 90 to 545 kg.Methods—Food was withheld for a minimum of 12 hours. Mares were sedated with detomidine hydrochloride (0.02 to 0.03 mg/kg) or xylazine hydrochloride (0.5 to 1.0 mg/kg). Excluding the pony mares, all other mares were restrained in stocks. Portal sites in the paralumbar fossa region were desensitized with 2% mepivacaine. Abdominal insufflation was achieved through a teat cannula positioned in the ventral abdomen or a Verres‐type needle placed through the paralumbar fossa. After trocar and laparoscope insertion, the ipsilateral ovary and mesovarium were identified, and the mesovarium, tubal membrane, and proper ligament were infiltrated with 2% mepivacaine. The mesovarium was coagulated using bipolar or monopolar electrosurgical forceps and transected sequentially from cranial to caudal until the ovary was completely freed and then removed. The contralateral ovary was removed in a similar fashion through the opposite paralumbar fossa.Results—Bipolar and monopolar electrosurgical forceps were easy to use and provided adequate coagulation of vessels within the mesovarium. Two mares were euthanatized after the procedure for unrelated reasons. One mare had mild signs of colic 24 hours after ovariectomy. In 1 pony mare, the incision used to remove one ovary dehisced on the 5th postoperative day and was allowed to heal by second‐intention. No long‐term complications had occurred in 11 horses and 10 ponies, 6 to 24 months after surgery.Conclusion—Laparoscopic ovariectomy and hemostasis of the mesovarium can be easily accomplished using electrosurgical instrumentation.Clinical Relevance—Standing laparoscopic ovariectomy, using electrosurgical instrumentation, is an effective and safe technique to provide hemostasis of the mesovarium in mares.
Circuit Synthesis from Fibonacci Decision Diagrams
Authors: Stanković Radomir S. , Astola Jaakko , Stanković Milena , Egiazarian Karen 
Published: August 2002

In decision diagrams (DDs) methods for circuit synthesis, it is possible to directly transfer a DD for a given function f into a network realizing f by the replacement of non‐terminal nodes in the DD with the corresponding circuit modules.The chief bottleneck of mapping a DD into a network is the inherent feature that the depth of the network produced, is equal to the number of variables in f . For this reason, it is proposed a method for small depth circuit synthesis through reachability matrices describing connections among the nodes in the DD for f.In this paper, we first generalized DD methods for circuit design to Fibonacci interconnection topologies through the Fibonacci decision diagrams (FibDDs). Then, we extended the small depth circuit synthesis method to FibDDs. In this way, design methods through DDs are completely transferred from Boolean to Fibonacci topologies.
Foundations for Applications of Gibbs Derivatives in Logic Design and VLSI
Authors: Stanković Radomir S. , Stanković Milena , Creutzburg Reiner 
Published: August 2002

New technologies and increased requirements for performances of digital systems require new mathematical theories and tools as a basis for future VLSI CAD systems. New or alternative mathematical approaches and concepts must be suitable to solve some concrete problems in VLSI and efficient algorithms for their efficient application should be provided. This paper is an attempt in this direction and relates with the recently renewed interest in arithmetic expressions for switching functions, instead representations in Boolean structures, and spectral techniques and differential operators in switching theory and applications.Logic derivatives are efficiently used in solving different tasks in logic design, as for example, fault detection, functional decomposition, detection of symmetries and co‐symmetries of logic functions, etc. Their application is based on the property that by differential operators, we can measure the rate of change of a logic function. However, by logic derivatives, we can hardly distinguish the direction of the change of the function, since they are defined in finite algebraic structures.Gibbs derivatives are a class of differential operators on groups, which applied to logic functions, permit to overcome this disadvantage of logic derivatives. Therefore, they may be useful in logic design in the same areas where the logic derivatives have been already using. For such applications, it is important to provide fast algorithms for calculation of Gibbs derivatives on finite groups efficiently in terms of space and time.In this paper, we discuss the methods for efficient calculation of Gibbs derivatives. These methods should represent a basis for further applications of these and related operators in VLSI CAD systems.
Multidimensional NMR Methods for Protein Structure Determination
Authors: Kanelis Voula , Forman‐Kay Julie D. , Kay Lewis E. 
Published: August 2002

AbstractStructural studies of proteins are critical for understanding biological processes at the molecular level. Nuclear magnetic resonance (NMR) spectroscopy is a powerful technique for obtaining structural and dynamic information on proteins and protein‐ligand complexes. In the present review, methodologies for NMR structure determination of proteins and macromolecular complexes are described. In addition, a number of recent advances that reduce the molecular weight limitations previously imposed on NMR studies of biomolecules are discussed, highlighting applications of these technologies to protein systems studied in our laboratories.