bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early and Late Results of Ascending Aorta Surgery: Risk Factors for Early and Late Outcome
Authors: Ergin M. Arisan 
Published: August 2002

AbstractThis study was designed to evaluate risk factors for in‐hospital mortality and midterm survival in patients undergoing ascending aorta surgery at a single institution during an 11‐year period. Between 1984 and 1994 a total of 158 patients underwent an ascending aorta procedure at our institution. Their mean age was 59.6 ± 12.3; 115 (73%) were male, 33 (21%) had a history of congestive heart failure, 61 (39%) had an acute type A dissection, 21 (13%) underwent redo operations, and 55 (35%) were operated on an emergency basis. In‐hospital mortality was 9.7%
(10/103) for elective procedures and 36.4% (20/55) for emergency operations (
p < 0.0001). Multivariable stepwise logistic regression analysis identified the cardiopulmonary bypass time
[odds ratio (OR) = 1.01/min, p= 0.0021], emergency operation (OR = 2.27, p= 0.0022), arch replacement (OR = 2.71, p= 0.0067), and the need of femoral vein cannulation at intervention (OR = 1.89,p= 0.0375) as independent predictors of in‐hospital death. When this kind of analysis was performed, evaluating only the variables known before surgery, acute type A dissection (OR =
2.21, p= 0.0009) and preoperative NYHA class (OR
= 1.88 per class, p= 0.0290) were independent risk factors for in‐hospital death. Follow‐up ranged from 10 to 126 months
(median 42 months), with Kaplan‐Meier survivals of 69 ± 4%, and
60 ± 5% at 5 and 7 years, respectively; survival rates for hospital survivors were 85 ± 4% and 67 ± 7% at 5 and 7 years, respectively. Cox regression analysis has identified arch replacement [relative risk (RR) = 2.48, p <
0.0001], perioperative myocardial infarction (RR = 2.44,p= 0.0003), preoperative NYHA class (RR = 1.97 per class, p= 0.0009), acute type A aortic dissection
(RR = 1.44, p= 0.0238), the need of femoral vein cannulation at intervention (RR = 1.55, p=
0.0332), and redo operation (RR = 1.44, p=
0.0851) as independent predictors of reduced survival at follow‐up. When this kind of analysis was performed on hospital survivors only, postoperative tracheostomy (p= 0.0003, RR =
3.42), reexploration for bleeding (p= 0.0003, RR
= 3.77), and the occurrence of postoperative ventricular arrhythmias
(p= 0.0007, RR = 2.45) emerged as risk factors. Multiple factors affect the early and late outcome after ascending aorta surgery; our data suggest that the preoperative clinical status of the patients and the priority of surgery and aortic dissection are the main determinants of the early results; on the other hand, the early postoperative course is the main determinant of the late outcome of hospital survivors.
Thyroid Cancer in Patients with Familial Adenomatous Polyposis
Authors: Perrier Nancy D. , van Heerden Jon A. , Goellner John R. , Williams E. Dillwyn , Gharib Hossein , Marchesa Pierenico , Church James M. , Fazio Victor W. , Larson Dirk R. 
Published: August 2002

AbstractThe association between thyroid cancer and familial adenomatous polyposis (FAP), albeit rare, is well known. It has been suggested that the thyroid tumors have unique histologic characteristics and may be follicular in origin. Because of their rarity, treatment and long‐term prognosis are uncertain. Twelve such patients (prevalence 399/100,000) seen during 1949–1995 were retrospectively reviewed. Histology was independently re‐reviewed by two pathologists. There were 11 female patients (two sisters) and 1 male patient, with a mean age of 28 years (range 15–61 years). Eight patients (66%) had multicentric tumors and five (42%) bilateral disease. Average tumor diameter was 1.8 cm (range 0.2–5.0 cm). Regional nodal metastases were present in two patients. All 12 thyroid cancers in this series were papillary. The one male patient demonstrated “typical” histology with variable papillary and follicular architecture, whereas the 11 female patients had tumors with unusual histology as described by Harach. Five patients (41%) were treated by total thyroidectomy, five with near‐total thyroidectomy, and two with lobectomy alone. Mean follow‐up was 142 months (range 7 months to 30 years). Regional recurrent disease occurred in two patients, one of whom died of the disease. The 5‐ and 20‐year survivals were 90% and 77%, respectively. The results indicated that all tumors in this study were papillary, although atypical histology was encountered in 91%. The mean age (28 years) is younger than that of patients with sporadic disease. Multicentricity and bilateral disease are common. In view of this finding, total thyroidectomy should be strongly considered. Long‐term prognosis is excellent. The finding of unusual histology in a young patient with papillary thyroid carcinoma should arouse the suspicion of FAP.
Laparoscopy with Laparoscopic Ultrasonography in the TNM Staging of Pancreatic Carcinoma
Authors: John Timothy G. , Wright Andrew , Allan Paul L. , Redhead Doris N. , Paterson‐Brown Simon , Carter David C. , Garden O. James 
Published: August 2002

Abstract.A prospective study was performed comparing laparoscopy with laparoscopic ultrasonography (LapUS), transabdominal ultrasonography (USS), computed tomography (CT), and selective visceral angiography with portal phase venography (SVA) for the assessment of resectability in 50 patients with pancreatic or periampullary cancer. The results were stratified by TNM stages. Tumor unresectability was demonstrated in 36 patients (72%). The sensitivity of LapUS for demonstrating the index lesion was 96%. Laparoscopic ultrasonography failed to predict factors precluding resection by T stage in six patients, and there were no significant differences in the ability of any modality to predict local resectability (predictive value 58–73%). Laparoscopic ultrasonography did not overestimate T stage and was significantly more specific for assessing unresectability compared with USS (100% vs. 64%, p < 0.05) and CT (100% vs. 47%, p < 0.005). No imaging investigation was able to assess the N stage accurately. Metastases were confirmed in 16 patients (32%), with LapUS proving significantly more sensitive than USS (94% vs. 29%, p < 0.001) and CT (94% vs. 33%, p < 0.005). The addition of LapUS to the laparoscopic examination did not change the M stage in any patient, as all metastases were superficially located. Laparoscopy with LapUS was the most reliable method for assessing overall tumour resectability and was significantly more predictive than CT (97% vs. 79%, p < 0.005). These results confirm that laparoscopy is indispensable for detecting occult intraabdominal metastases. LapUS reliably predicts tumor unresectability, offsetting the tendency of USS and CT to overestimate T stage. Methods of accurate N staging remain elusive, and the use of routine SVA is not justified.
Diagnosis and Staging of Pancreatic Cancer by Positron Emission Tomography
Authors: Berberat Pascal , Friess Helmut , Kashiwagi Mikiya , Beger Hans G. , Büchler Markus W. 
Published: August 2002

Abstract.The detection of pancreatic cancer or the discrimination between pancreatic cancer and chronic pancreatitis remains an important diagnostic problem. Several imaging modalities are now used to diagnose pancreatic cancer, including transabdominal ultrasonography (US), contrast‐enhanced computed tomography (CT), magnetic resonance imaging (MRI), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography, and selective angiography. None of these six methods is perfect: Each has advantages and disadvantages, and their sensitivity and specificity are in a high range. In 1990 positron emission tomography (PET) was first applied to diagnose pancreatic cancer. This new diagnostic modality is based on functional changes in the pancreatic cancer cells caused by enhanced glucose metabolism. Increased glucose utilization is one of the characteristics of malignantly transformed cells, independent of their origin. The technical development of PET has allowed this new procedure to be used for clinical evaluation. Using 2‐(18F)‐fluoro‐2‐deoxy‐d‐glucose, PET can identify pancreatic cancer and differentiate pancreatic cancer from chronic pancreatitis with a sensitivity of 85% to 98% and a specificity of 53% to 93%. However, high sensitivity and high specificity are strongly dependent on the tumor stage. At present PET is still experimental and is available only in specialized centers. It may represent a new and noninvasive diagnostic procedure for the detection and the staging of pancreatic cancer. Further clinical studies, especially including patients with early tumor stages (small tumor size), are needed. This review discusses the possibilities and limits of PET and evaluates its importance in the future.
Anaplastic Thyroid Carcinoma Survival
Authors: Voutilainen Petri E. , Multanen Markku , Haapiainen Reijo K. , Leppäniemi Ari K. , Sivula Arto H. 
Published: August 2002

Abstract.Anaplastic thyroid carcinoma is a rare, highly malignant tumor of elderly people. The purpose of this retrospective study was to characterize the patient population and to detect a potential subgroup with better prognosis or any intervention that would be useful. From 1967 through 1994 a total of 33 anaplastic thyroid carcinomas were operated on at the Second Department of Surgery, Helsinki University Central Hospital. There were 26 females and 7 males with mean age of 66.0 years (range 36–89 years). At the time of diagnosis 16 of 33 patients had distant metastases, and 32 of 33 of the tumors had invaded the thyroid capsule. Disease‐specific survival was 9.7% (95% confidence interval from 2.0% to 25.9%) at 1 year using the product limit survival analysis. In the stepwise Cox proportional hazards regression model, local resectability (p= 0.0002), presence of distant metastases at diagnosis (p= 0.0014), radiotherapy (p= 0.014), and radioiodine ablation (p= 0.039) were independent prognostic factors. We concluded that even though statistically significant, independent, prognostic factors can be found the survival of the patients with the best prognostic characteristics is still poor. Only one patient, who had an anaplastic carcinoma focus within an encapsulated follicular thyroid carcinoma, survived in this series. At present there seems to be no surgical treatment that would be efficient for treating symptomatic anaplastic thyroid carcinoma.
Clinical Application of a Blood Pressure Autoregulation System during Hypotensive Anesthesia
Authors: Onodera Hisashi , Maetani Shunzo , Aung Tun , Kan Shugen , Sakamoto Tadahiro , Shiragami Gohtaro , Furutani Eiko , Araki Mituhiko , Imamura Masayuki 
Published: August 2002

Abstract.A blood pressure autoregulation system based on the state‐predictive control method was developed to minimize intraoperative blood loss and hence avoid blood transfusion. In this report, the system is further improved by incorporating fuzzy logic with a fail‐safe function and an individual parameter‐identifying function. The safety and stability of this system had been confirmed by preclinical experiments with dogs. Thereafter clinical application with 17 patients was conducted to maintain their mean arterial pressure at around 60 mmHg during major surgery. The use of this system resulted in decreased blood loss and more speedy and accurate surgery due to a clearer surgical field. Unwanted effects of hypotension were not observed clinically or in laboratory tests. This system is therefore safe, stable, and effective in reducing the blood loss during major surgery that otherwise might cause substantial blood loss.
Anastomotic Diameters and Strictures following Esophagectomy and Total Gastrectomy in 256 Patients
Authors: Johansson Jan , Zilling Thomas , von Holstein Christer Staël , Johnsson Folke , Öberg Stefan , Walther Bruno 
Published: August 2002

AbstractThe prevalence of anastomotic strictures in esophageal anastomoses provides us with limited information about the anastomotic healing process. This prospective study evaluates the exact esophageal anastomotic diameters in 256 patients who underwent esophagectomy and esophagogastrostomy without pyloroplasty (n= 107) or total gastrectomy and Roux reconstruction (n= 149). No perioperative chemoradiotherapy was given. Anastomotic strictures and diameters were assessed during endoscopy by a separately inserted (inflated to the anastomotic width) balloon catheter. The anastomotic diameters increased significantly during the first postoperative year in the esophagectomy (p= 0.001) and gastrectomy (p < 0.001) groups. The anastomoses in the gastrectomy group were significantly wider than those in the esophagectomy group 3 (25.7 versus 19.9 mm), 6 (28.5 versus 22.0 mm), and 12 (30.5 versus 23.3 mm) months after surgery (p < 0.001). Neither the anastomotic site (neck or chest) in the esophagectomy group (p= 0.176) nor that in the gastrectomy group (abdomen or chest) (p= 0.577) influenced the anastomotic diameter. Benign anastomotic strictures were most frequently found after 3 months and after esophagectomy. Esophagojejunostomies performed with 2 linear stapling devices or cartridge size 28 mm showed the widest anastomoses with only 1 stricture. Esophagogastric anastomoses following esophagectomy are narrower and develop more strictures than esophagojejunal anastomoses after total gastrectomy, but both dilate during the first year.
Tumors of the Small Intestine
Authors: Blanchard D. Kay , Budde Jason M. , Hatch George F. , Wertheimer‐Hatch Laura , Hatch Kathryn F. , Davis Gregory B. , Foster Roger S. , Skandalakis John E. 
Published: August 2002

Abstract.This collective review includes all available case reports and series of smooth muscle (stromal) tumors of the small intestine in the world literature from 1881 to 1996. We identified 1074 patients with leiomyoma (LM) and 1689 with leiomyosarcoma (LMS). Our purpose was to update our previous review, which encompassed case reports and series from 1881 to 1959, which included 350 LMs and 257 LMSs. The peak incidence of smooth muscle tumors in the small intestine in both male and female patients was between the ages of 50 and 59. Most commonly, the presenting complaint was gastrointestinal bleeding. Computed tomography was found to detect LM and LMS most successfully and had the additional advantage of locating metastatic disease. The jejunum contained the highest numbers of smooth muscle tumors, followed by the ileum and then the duodenum, with malignant lesions in all locations typically attaining larger diameters than benign tumors. The overall rate of metastatic spread of LMS ranged from 24% to 50%, with the liver being most commonly involved. Unlike other sarcomas, both hematogenous and lymphatic spread were common. The 5‐year survival of 705 patients with LMS from 22 series was 27.8%. For both benign and malignant smooth muscle tumors of the small intestine, surgery remains the treatment of choice, with little efficacy reported for irradiation, chemotherapy, or both.
Intraperitoneal Gossypibomas: The Need to Count Sponges
Authors: Lauwers Patrick R. , Van Hee Robrecht H. 
Published: August 2002

Abstract.Intraperitoneal forgotten foreign bodies are prone to create adhesions and to encapsulate, or to provoke an exudative response, with or without accompanying bacterial infection. Often a process of self‐extrusion is initiated. This is also true for gossypibomas, retained surgical sponges. Presentation is possible as a pseudotumoral, occlusive, or septic syndrome; several cases, however, have remained asymptomatic for as long as several decades. Ultrasonography and radiology (especially computed tomography) contribute significantly to the detection of gossypibomas; magnetic resonance imaging is a less used technique. Detection by plain radiography is difficult. Ultrasonography demonstrates a hyperreflective mass with hypoechoic rim and a strong posterior shadow. Computed tomography shows a well defined mass with internal heterogenous densities. Therapy consists of operative removal of the foreign body in association with resolving its complications. Adding a series of five cases to the existing literature reports, the fate of intraperitoneal forgotten surgical sponges is reviewed.
Persistence of a fig wasp population and evolution of dioecy in figs: a simulation study
Authors: Kameyama Tomoyuki , Harrison Rhett , Yamamura Norio 
Published: August 2002

AbstractThe relationship between fig trees and their pollinator wasps is a well‐known example of species‐specific obligate mutualism. In this article we present a stochastic model of this mutualistic system, referring to data on a dioecious fig (Ficus schwarzii) in Borneo, and examine the conditions for the persistence of a wasp population for a given period. (1) When the average duration of the flowering interval of fig trees is short, even a small fig population can sustain a wasp population successfully. A population whose average period of flowering cycle is half that of another population can sustain a wasp population with a number of trees less than half of the other population. (2) The wasp survival rate (WSR) is higher when (a) the variation of the interval periods of fig flowering is smaller, (b) the fig population size is larger, and (c) figs can prolong their receptivity to wait for a wasp if no wasps are available. (3) WSR is predictable from the average proportion of the fig's receptive phases, in which wasps are available, to their total receptive phases. (4) The persistence period of a wasp population increases exponentially with the number of fig trees. Based on these results we propose a new hypothesis, as a possible scenario, on the evolution of dioecy from monoecy in Ficus.
Hsp27: Novel Regulator of Intracellular Redox State
Authors: Arrigo André‐Patrick 
Published: August 2002

AbstractSmall stress proteins are molecular chaperones that modulate the ability of cells to respond to several types of injuries. In this regard, a protection generated by the expression of mammalian small stress proteins against the cell death induced by oxidative stress has been described. This review summarizes the current knowledge of the protective mechanism generated by the expression of the major mammalian small stress protein Hsp27 in cells exposed to oxidative stress. A possible role of this chaperon protein in the presentation of oxidized proteins to the proteasome degradation machinery is proposed.
Complex I and Parkinson's Disease
Authors: Greenamyre J. Timothy , Sherer Todd B. , Betarbet Ranjita , Panov Alexander V. 
Published: August 2002

AbstractComplex I of the mammalian electron transfer chain is composed of at least 43 protein subunits, of which 7 are encoded by mtDNA. It catalyzes the transfer of electrons from NADH to ubiquinone and translocates protons from the mitochondrial matrix to the intermembrane space. It may also play direct roles in the mitochondrial permeability transition and in cell death pathways. Despite the limitations of current complex I assays, biochemical studies have suggested the presence of a mild, systemic defect of complex I in Parkinson's disease (PD). Recent experimental work has modeled this abnormality using rotenone to systemically inhibit complex I. Chronic rotenone exposure accurately recapitulated the pathological, biochemical, and behavioral features of PD. Thus, relatively subtle complex I abnormalities‐‐either genetic or acquired‐‐may be central to the pathogenesis of PD.
Enhanced MgB2 Superconductivity Under High Pressure
Authors: Liu Zhen-Xing  , Jin Chang-Qing  , You Jiang-Yang  , Li Shao-Chun  , Zhu Jia-Lin  , Yu Ri-Cheng  , Li Feng-Ying,  
Published: August 2002

We report on in situ high-pressure studies up to 1.0 GPa on the
MgB2 superconductor which was high-pressure synthesized. The
as-prepared sample is of high quality in terms of sharp superconducting
transition (T
c) at 39 K from the magnetic measurements. The
in situ high-pressure measurements were carried out using a Be-Cu
piston-cylinder-type instrument with mixed oil as the pressure
transmitting medium which warrants a quasi-hydrostatic pressure
environment at low temperature. The superconducting transitions were
measured using the electrical conductance method. It is found that
T
c increases by more than 1 K with pressure in the low-pressure
range, before the T
c value decreases with the further increase
of the pressure.
A longitudinal examination of the relation between co‐offending with violent accomplices and violent crime
Authors: Conway Kevin P. , McCord Joan 
Published: August 2002

AbstractAlthough the idea that youthful offenders are affected by the company they keep is widely accepted, evidence in support of this idea is based primarily on reports provided by offenders and their peers. As an alternative to relying on reports of criminal behavior, a method that may overestimate the role that peers play in criminal behavior, the current research on co‐offending uses court records to identify and track over time individuals who are known to commit crimes together. The present investigation is the first co‐offending study to track patterns of violent criminal behavior (over an 18‐year period) among a sample of urban offenders and their accomplices. The study tests whether violence “spreads” from violent offenders to those inexperienced in violence. Results indicate that nonviolent offenders who commit their first co‐offense with violent accomplices are at increased risk for subsequent serious violent crime. Findings suggest that lessons of violence can be learned “on the street,” where knowledge is passed along through impromptu social contexts, including those in which offenders commit crimes together. Aggr. Behav. 28:97–108, 2002. © 2002 Wiley‐Liss, Inc.
Radiation therapy and combination of cladribine, cyclophosphamide, and prednisone as treatment of Bing‐Neel syndrome: Case report and review of the literature
Authors: Delgado Julio , Canales Miguel Angel , Garcia Beatriz , Alvarez‐Ferreira Javier , Garcia‐Grande Antonio , Hernandez‐Navarro Fernando 
Published: August 2002

AbstractWaldenström's macroglobulinemia is a low‐grade lymphoma that produces monoclonal IgM. Central nervous system symptoms are frequent in Waldenström's macroglobulinemia, mostly associated with blood hyperviscosity. Nevertheless, central nervous system infiltration by malignant cells (Bing‐Neel syndrome) has rarely been reported. We describe the case of a 72‐year‐old man with Waldenstrom's macroglobulinemia and central nervous system infiltration by malignant cells with tumor formation. All similar cases reported in the literature are reviewed and the different therapeutic approaches discussed. Am. J. Hematol. 69:127–131, 2002. © 2002 Wiley‐Liss, Inc.
Mutation of bcl‐x gene in non‐Hodgkin's lymphoma
Authors: Yamaguchi Hiroki , Inokuchi Koiti , Tarusawa Miki , Dan Kazuo 
Published: August 2002

AbstractThe bcl‐x gene product has two forms, bcl‐xl and bcl‐xs. The bcl‐xl form, similar to bcl‐2, inhibits apoptosis. Reverse transcriptase‐‐polymerase chain reaction‐‐single‐stranded conformation polymorphism (RT‐PCR‐SSCP) gel analysis was used to screen for mutations of the bcl‐xl transcript of 50 non‐Hodgkin’s lymphoma (NHL) cases. One missense mutation in a patient with diffuse large B‐cell lymphoma was found. Sequence analysis of this case showed that AGC (Ser) was mutated to GGC (Gly) in codon 154. An examination of mutation and/or polymorphism in born marrow samples of this case and 50 normal controls by the RT‐PCR‐SSCP method could not detect bandshifts. Mutation of the bcl‐x gene in NHL has not been reported previously. There is a possibility that mutation of the bcl‐x gene play a role in the tumorigenesis of NHL. Am. J. Hematol. 69:74‐76, 2002. © 2002 Wiley‐Liss, Inc.