bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transpelvic Gunshot Wounds: Routine Laparotomy or Selective Management?
Authors: Velmahos George C. , Demetriades Demetrios , Cornwell Edward E. 
Published: August 2002

AbstractMandatory exploration is the standard method for managing patients with gunshot wounds to the abdomen and back. This policy is associated with a high incidence of unnecessary laparotomies and significant morbidity. Reports from our center have shown that a policy of selective management, based on clinical findings, is safe in such patients. Patients with bullet trajectories that carry a high likelihood for intraabdominal organ injury may constitute a subgroup at particular risk. The need for routine or selective exploration in similar patients must be assessed. Therefore we decided to analyze patients with transpelvic gunshot wounds. The objective of the study was to examine if a policy of selective management of patients with transpelvic gunshot wounds is safe. This prospective study was conducted at an academic level I trauma center. We admitted 37 patients with transpelvic gunshot wounds over a 12‐month period. All patients were managed according to a protocol that dictated laparotomy in the presence of significant clinical findings (peritoneal signs, hemodynamic instability, gross hematuria, rectal bleeding) and observation in the absence of the above. Additional diagnostic workup was performed only in appropriate cases rather than routinely. Nineteen (51.3%) patients were immediately operated on the basis of clinical findings. Sixteen of these laparotomies were therapeutic. Eighteen (48.6%) patients were initially observed. Subsequently, three of them underwent exploration for development of abdominal tenderness. All three laparotomies were nontherapeutic. The remaining 15 (40.5%) patients were successfully managed nonoperatively. There were no delays in diagnosis or missed injuries. Clinical examination had a sensitivity of 100% and specificity of 71.4% in detecting the need for laparotomy. A policy of selective management is thus safe, even for patients who suffer gunshot wounds with a high likelihood for intraabdominal organ injury. Clinical examination, supported by additional studies in appropriate cases, is the main method of selecting patients for operation or nonoperative treatment.
Parathyroid Carcinoma: Sixteen New Cases and Suggestions for Correct Management
Authors: Favia Gennaro , Lumachi Franco , Polistina Francesco , D’Amico Davide F. 
Published: August 2002

AbstractWe undertook a retrospective study in 16 patients with parathyroid carcinoma, with the aim of conveying experience from management of this rare cause of hyperparathyroidism (HPT). From 1980 to 1996 we operated on 309 patients with HPT, 290 of whom had primary HPT, and parathyroid carcinoma was diagnosed in 16 (5.2%) cases. In none was the malignancy diagnosed preoperatively. The average serum calcium and parathyroid hormone levels were significantly higher (
p < 0.05) than in patients with parathyroid adenoma, and the mean tumor size was 2.9 cm (median 2.5 cm, range 1.5–4.5 cm). Twenty‐eight operations were performed with resulting normalization of serum calcium levels for more than 6 months in 11 patients. Six patients presented prolonged postoperative hypocalcemia (2–10 months), and five patients had persistent HPT. Ten patients experienced recurrent disease; the median disease‐free period was 24 months (range 4–72 months). None of the patients was treated with chemotherapy, one patient underwent radiation therapy (50 Gy in 25 sessions) but required reoperation for local recurrence 4 months later. Three patients are still alive (two with recurrence). Average survival was 40 months (median 31 months, range 11–131 months).
Recognizing, Scoring, and Predicting Blast Injuries RID="" ID="" This International Association for the Surgery of Trauma and Surgical Intensive Care (IATSIC) article was presented at the 37th World Congress of Surgery International Surgical Week (ISW97), Acapulco, Mexico, August 24&ndash;30, 1997.
Authors: Cernak Ibolja , Savic Jovan , Zunic Gordana , Pejnovic Nada , Jovanikic Olivera , Stepic Vladislav 
Published: August 2002

AbstractThe aim of this study was to find relevant signs and readily available parameters for the recognition of blast injuries and estimation of their severity. The injury severity, estimated by the Injury Severity Score (ISS), Red Cross Wound Classification (RCWC), and experimentally defined Pathology Scoring System for Blast Injuries (PSS/IS) according to Yelverton and modified for use in humans, was compared with a great number of subjective sensations, clinical signs, parameters of hemodynamic, metabolic, neuroendocrine and immune conditions. On the basis of these data, the confidence of the above‐mentioned methods was analyzed in the evaluation of blast injuries. This study included 1303 casualties, wounded by explosive devices and with suspected blast injuries, treated at the Military Medical Academy in Belgrade (MMA) from 1991 to 1994. The patients were examined on admission at the MMA (<18 hours) and during hospitalization (1, 2, 5, and 7 days after wounding). The casualties with confirmed blast injury (n= 665, 51%)
had an ISS ranging from 0 to 34 (mean 13) had wounds ranging from G1ST
(soft tissue wounds caused by low energy transfer) to G3VF (massive wounds with fractures and injury of vital structures) according to the RCWC, with PSS/IS scores from 2 to 105 (mean 60). Statistically significant correlation was found between ISS and PSS/IS as well as RCWC and PSS/IS. Cytokines (IL‐1, TNFalpha) and amino acids responded to a blast injury in similar manner as to gunshot wounds with a greater ISS or more severe RCWC injury type. The subjective sensations in blasted patients (deafness, thoracic pain, vertigo) and mediators, confirmed in previous experimental investigations as important factors in the pathogenesis of blast injuries
(TxA2, sulfidopeptide leukotrienes) were relationed only to the PSS/IS.RID="" ID="" <E5>Correspondence to:</E5> I. Cernak, M.D., Ph.D.
Palliative Chemotherapy and Radiotherapy for Pancreatic Cancer: Is It Worthwhile?
Authors: van der Schelling George P. , Jeekel Johannes 
Published: August 2002

Abstract.The role of palliative chemotherapy or radiotherapy (or both) in pancreatic cancer is discussed. In patients with disseminated pancreatic cancer chemoradiotherapy has so far not been effective in prolonging survival. Recent trials with gemcitabine has shown a modest improvement in clinical benefit and survival. Patients with locally advanced disease should be offered 5‐fluorouracil and radiation therapy, as valid data have repeatedly shown better median survival compared to no therapy. The option of a second‐look laparotomy to evaluate resectability after palliative chemoradiotherapy in patients with locally advanced disease should be applied liberally because currently available imaging techniques sometimes do not accurately reflect tumor size and tumor progression. New treatment strategies, such as regional perfusion, are being investigated.
Adrenal Gland and Renal Sonography
Authors: Little Andrew F. 
Published: August 2002

AbstractUltrasound (US) is an established imaging modality for the assessment of the kidneys and adrenal glands. The advantages include its lack of ionizing radiation, speed, multiplanar real time evaluation, and cost compared with more expensive modalities. The addition of color Doppler also permits accurate evaluation of blood flow, which is especially useful in renal assessment. As with all sonography, both renal and adrenal US are highly dependent on the operator's skill and experience and require meticulous scanning techniques. In particular, adrenal sonography can be difficult due to the lack of a satisfactory acoustic window through which the incident US beam passes. This review summarizes the various morphologic appearances seen in common renal and adrenal pathologies, many of which have characteristic US appearances enabling accurate diagnosis.
Hepatic Adenoma and Focal Nodular Hyperplasia: Differential Diagnosis and Treatment
Authors: Herman Paulo , Pugliese Vincenzo , Machado Marcel A.C. , Montagnini Andre L. , Salem Marcelo Z. , Bacchella Telesforo , D'Albuquerque Luis A.C. , Saad William A. , Machado Marcel C.C. , Pinotti Henrique W. 
Published: August 2002

AbstractThe diagnosis of benign hepatic tumors as hepatic adenoma (HA) and focal nodular hyperplasia (FNH) remains a challenge for clinicians and surgeons. The importance of differentiating between these lesions is based on the fact that HA must be surgically resected and FNH can be only observed. A series of 23 female patients with benign liver tumors (13 FNH, 10 HA) were evaluated, and a radiologic diagnostic algorithm was employed with the aim of establishing preoperative criteria for the differential diagnosis. All patients were submitted to surgical biopsy or hepatic resection to confirm the diagnosis. Based only on clinical and laboratory data, distinction was not possible. According to the investigative algorithm, the diagnosis was correct in 82.6% of the cases; but even with the development of imaging methods, which were used in combination, the differentiation was not possible in four patients. For FNH cases scintigraphy presented a sensitivity of 38.4% and specificity of 100%, whereas for HA the sensitivity reached 60% and specificity 85.7%. Magnetic resonance imaging, employed when scintigraphic findings were not typical, presented sensitivities of 71.4% and 80% and specificities of 100% and 100% for FNH and HA, respectively. Preoperative diagnosis of FNH was possible in 10 of 13 (76.9%) patients and was confirmed by histology in all of them. In one case, FNH was misdiagnosed as HA. The diagnosis of HA was possible in 9 of 10 (90%) adenoma cases. Surgical biopsy remains the best method for the differential diagnosis between HA and FNH and must be performed in all doubtful cases. Surgical resection is the treatment of choice for all patients with adenoma and can be performed safely. With the evolution of imaging methods it seems that the preoperative diagnosis of FNH may be considered reliable, thereby avoiding unnecessary surgical resection.
Changes in Intermediary Metabolism in Severe Surgical Illness
Authors: Wolfe Robert R. , Martini Wenjun Z. 
Published: August 2002

Abstract.Under normal circumstances there is a reciprocal relation between the availability of free fatty acids (FFAs) and glucose in plasma. In the fasted state, FFAs predominate in both availability and the relative contribution to energy production, whereas the same is true for glucose in the fed state. The extent of glucose oxidation is directly determined by its availability, whereas FFAs are normally available well in excess of their rate of oxidation. The rate of FFA oxidation is determined by the rate of transfer into the mitochondria via the carnitine palmitoyltransferase (CPT) enzyme system, which in turn is regulated by the metabolism of glucose. With critical illness the stress response involves mobilization of both plasma glucose and FFAs simultaneously in both the fed and fasted states. In the situation of excess availability of substrates, the metabolism of glucose limits the oxidation of FFAs, thereby channeling those fatty acids into triglyceride (TG) stores in the muscle and the liver. The high FFA concentrations and increased tissue TG stores can limit glucose clearance from the blood, thereby contributing to the development of hyperglycemia. Also, the excessive metabolism of glucose can result in lacticacidemia and can contribute to the depletion of muscle glutamine. The nutritional treatment of such patients must account for these underlying metabolic responses to avoid amplifying potentially detrimental responses to the excess availability of substrates already present in the fasting state.
Prepubic Urethrostomy: A Long‐Term Study in 16 Cats
Authors: Baines S. J. , Rennie S. , White R. S. A. 
Published: August 2002

Objective— To investigate the indications for and long‐term outcome of prepubic urethrostomy (PPU) in the cat.Study Design— Retrospective survey.Animals— Sixteen cats that had undergone PPU.Methods— Data were recovered from the medical records of the cats. Follow‐up information was obtained from the owners and referring veterinarians.Results— Indications for PPU were: failed perineal urethrostomy for the management of idiopathic lower urinary tract disease (ILUTD) (8 cats) or urethral trauma (1 cat); unresolved pelvic urethral obstruction after recurrent ILUTD (5 cats); and stenosis of the pelvic urethra as a result of trauma (2 cats). A patent urethral stoma was created in all cases. Signs of lower urinary tract disease were present in 8 cats postoperatively. With appropriate dietary management, these signs resolved in 2 cats and improved in another 4 cats. Eleven cats experienced postoperative complications that consisted of peristomal skin irritation or necrosis (7 cats) and urinary incontinence (6 cats). Complications developed in the immediate postoperative period in 6 cats, and resolved in 2 of these. Six cats developed late complications, at 6 to 84 months postoperatively. Six cats were euthanatized between 1 and 26 months' postoperatively. The mean survival time in these cats was 13 months. Reasons for euthanasia included urinary incontinence (3 cats), skin necrosis (2 cats), and unresolvable ILUTD (1 cat).Conclusions— PPU is a salvage procedure that is successful in relieving the signs of urinary tract obstruction and preventing further obstruction. However, potential complications should limit its use to cases in which standard techniques for perineal urethrostomy cannot be performed.Clinical Relevance— PPU is a comparatively simple procedure that should be considered as a salvage technique for obstructive disease of the pelvic urethra.
Evaluation of a Vessel‐Sealing Device for use in Laparoscopic Ovariectomy in Mares
Authors: Hand Reese , Rakestraw Peter , Taylor Tex 
Published: August 2002

Objective—To evaluate a vessel‐sealing instrument (LigaSure™) as a method for hemostasis of the ovarian vasculature.Study design—Prospective study.Animals or sample population—Thirteen mares (8 experimental, 5 patients), aged 2 to 20 years and weighing 405 to 500 kg.Methods—Thirteen mares had standing bilateral laparoscopic ovariectomy using a vessel‐sealing device (LigaSure) to provide hemostasis. Eight reproductively normal experimental mares were divided into 2 groups: 1 group was re‐examined laparoscopically 72 hours and the other group 10 days after the initial standing laparoscopic ovariectomy. The vessel‐sealing device uses high current and low voltage, along with pressure, to reorganize the collagen into a translucent seal to achieve hemostasis of the ovarian vasculature.Results—No major operative or postoperative complications were encountered. Complete hemostasis of the ovarian pedicle was accomplished. One mare had a fever for 24 hours' postoperatively; this responded to a single dose of flunixin meglumine.Conclusions—The LigaSure appears to be a safe method for hemostasis of the ovarian vasculature.Clinical relevance—Benefits of the LigaSure include no foreign material remaining in the abdomen and minimal to no need for surgical dissection before application. The LigaSure eliminates complications with potential ligature slippage and bleeding during dissection.
Transendoscopic Electrosurgery of an Equine Pulmonary Granular Cell Tumor
Authors: Ohnesorge Bernhard , Gehlen Heidrun , Wohlsein Peter 
Published: August 2002

Objective— Description of transendoscopic electrosurgical treatment of a pulmonary granular cell tumor in a horse.Study design— Case report.Animals— A 12‐year‐old Standardbred mare.Methods— After endoscopic examination and transendoscopic biopsy, a granular cell tumor nodule was removed transendoscopically from the right principal bronchus of the sedated horse (0.02 mg/kg detomide intravenous) with a monopolar electrosurgical wire snare. Two days later, the surgical area was irradiated transendoscopically using a Nd‐YAG laser.Results— After surgery, the horse had no further signs of respiratory disease. Clinical and endoscopic examination and radiography performed 4 times during the following 2 years showed no evidence of recurrence.Conclusions— Transendoscopic electrosurgical removal of nodular masses located intraluminally in the principal bronchi is possible on the sedated standing horse.Clinical relevance— Granular tumors are rare lung neoplasms that lead to unspecific signs of a low airway disease. Diagnosis requires endoscopic examination of the large bronchi. Early intraluminal stages can be treated transendoscopically.
Cell Compartmentalization in Redox Signaling
Authors: Pani Giovambattista , Bedogni Barbara , Colavitti Renata , Anzevino Rosanna , Borrello Silvia , Galeotti Tommaso 
Published: August 2002

AbstractFrom a growing body of evidence on the role of Reactive Oxygen Species as intracellular signaling molecules, the concept starts to emerge that cell responses to redox changes are function of the intracellular site where oxidants are produced and/or meet their molecular targets. In particular,a major distinction between oxidative events in the cytosolic versus the mitochondrial compartment appears to exist in terms of physiological stimuli, signaling mechanisms and functional consequences. Experimental data supporting this view are reviewed here, and the potential implications of this new perspective in redox signaling are discussed.
Aggression and bullying
Authors: Roland Erling , Idsøe Thormod 
Published: August 2002

AbstractModels are presented describing how bullying others and being bullied are related to proactive and reactive aggressiveness. This was investigated among 1801 pupils in Norwegian schools at the end of grade five and among 2083 pupils at the end of grade eight. Pupils in the two samples were approximately 11 and 14 years old, respectively. The procedure of structural equation modeling with latent variables was followed using LISREL 8.30 to estimate the parameters. Analyses were conducted for boys and girls separately at fifth and eighth grades. Support for the assumptions of factor solution and factorial invariance of the concepts across gender and age was obtained independently from estimating structural parameters. Both proactive and reactive aggressiveness were related to bullying others and to being bullied at Level 5. Among the older pupils, there was a strong relationship between proactive aggressiveness and bullying others, while reactive aggressiveness was much more weakly related to bullying others. Being bullied, on the other hand, was only weakly related to proactive and reactive aggressiveness among the older pupils. Age was therefore an important factor in determining how proactive and reactive aggressiveness were related to bullying. When pupil gender is concerned, power‐related proactive aggressiveness in predicting bullying was a more important factor for boys, while affiliation‐related proactive aggressiveness was a more powerful factor for girls. Aggr. Behav. 27:446–462, 2001. © 2001 Wiley‐Liss, Inc.
Agonistic behavior and growth in newly emerged brown trout (Salmo trutta L) of sea‐ranched and wild origin
Authors: Hedenskog Mikael , Petersson Erik , Järvi Torbjörn 
Published: August 2002

AbstractSelection experiments and game theory models have revealed that the changes in agonistic behavior following selection for rapid growth rate of fish depend on the access of food. If food is spatially restricted and in excess of demand, the intensity of agonistic behaviors will decrease. This prediction was tested in an experiment on wild and sea‐ranched brown trout (Salmo trutta L.) fry originating from a common stock. Agonistic behavior, activity, and specific growth rate were studied in tanks (56 × 56 cm) at high (159.4 fry/m2) and low (9.6 fry/m2) stocking densities given either a large or small food ration (3.0% and 1.5%, respectively, food per total body weight and day). Observations were done during 4 days in each trial. Generally, fry of sea‐ranched origin had a higher growth rate. No differences in activity were found. Intensity of agonistic behavior was higher among wild groups. There was a tendency for interaction between density and strain, e.g., wild fish were relatively more aggressive at higher densities. Food ration had no effect on level of agonistic behavior. These results indicate that the selection for rapid growth in hatcheries may indirectly select for reduced aggressiveness. Genetic integrity and diversity of wild populations may be threatened when interbreeding occurs between wild and hatchery fish. Aggr. Behav. 28:145–153, 2002. © 2002 Wiley‐Liss, Inc.
On the design of adaptive notch filters
Authors: Clarke D. W. 
Published: August 2002

AbstractIn instrumentation and other applications, the on‐line estimation of the frequency and amplitude of a noise‐corrupted sinewave is of great practical interest. Recently an adaptive notch filter (ANF) with global convergence properties has been developed, and is a candidate approach to our problem. This paper analyses the transient and noise properties of this ANF and equips the method with design equations. Using frequency ranges greater than (up to 2 decades) and signal/noise ratios less than (down to −16 dB) those commonly found in the ANF literature, it is verified by extensive simulations that the new frequency estimator has excellent tracking and noise‐rejection properties, provided that the signal/noise ratio is not too small. A comparison is made of its behaviour with that of a phase‐locked loop, a method commonly used in practice. Copyright © 2001 John Wiley & Sons, Ltd.
CD56 expression in myeloperoxidase‐negative FAB M5 acute myeloid leukemia
Authors: Delgado Julio , Morado Marta , Jimenez Mª Carmen , Garcia‐Grande Arancha , Hernandez‐Navarro Fernando 
Published: August 2002

AbstractCD56 is a natural killer (NK) cell marker that has been identified in approximately 15–20% of acute myeloid leukemia (AML) cases, where it has been associated with monocytic morphology and chromosomal abnormalities such as trisomy 8, t(8;21), t(15;17), and 11q23 rearrangements. The clinical presentation, chromosomal abnormalities as detected by fluorescent in‐situ hybridization (FISH), and clinical outcomes of 7 patients with AML are presented. These cases were characterized by French‐American‐British (FAB) M5 morphology, myeloperoxidase (MPO) negativity, and co‐expression of myelomonocytic and NK cell‐associated antigens (CD11c+, CD13+, CD15+, CD33+, HLA‐DR+, and CD56+). All patients presented lymph node, hepatic, or splenic involvement at diagnosis. Despite the homogeneous morphologic and immunophenotypic characteristics the outcomes varied considerably. Two patients died during induction therapy, but the other five patients attained complete remission (CR). Of these five patients, 4 have received a bone marrow transplantation (autologous or allogeneic) and 3 of them are in CR (median follow‐up: 45 months). The three patients with 11q23 rearrangements had a poor outcome and died of their disease within 1 year of diagnosis. Further studies with a larger group of patients would help establish the actual prognostic value of these morphologic, immunophenotypic and cytogenetic features. Am. J. Hematol. 69:28–30, 2002. © 2002 Wiley‐Liss, Inc.