bluuebunny/crossref_metadata_2025_split huggingface dataset:
Open laparoscopy utilizing either a 5 mm or 10 mm standard intra‐umbilical trocar
Authors: Gordon Simon J. , Maher Peter J. , Seman Elvis I. 
Published: March 2003

To describe a technique for open entry for laparoscopic procedures, utilizing either a standard 5‐ or 10 mm trocar through an 8‐ or 12 mm intra‐umbilical incision, respectively.Two teaching hospitals.A total of 237 patients. The first 186 patients had a 10‐mm trocar inserted, and the latter 51 patients a 5‐mm trocar entry.The average time required to achieve pneumoperitoneum was 3.5 min with no complications encountered. Gas leakage overall occurred in 4.2% of patients, though in no case was remedial fascial suturing required. There were two cases of wound infection (0.8%), including an infected umbilical haemotoma. All minor complications occurred in the first 20 patients undergoing surgery.Open laparoscopy using this technique is safe, quick, and cosmetically excellent with minimal complications and no major disadvantages. It provides an improved safety margin for vascular injury in comparison to closed peritoneal entry, though it is theoretically capable of causing type II visceral injuries.
Fragmentation of a disposable trocar during laparoscopy
Authors: Cosson Michel , Hautefeuille Jerome , Querleu Denis 
Published: March 2003

ObjectiveTo report a case of breakage of the tip of a disposable trocar in the course of laparoscopic surgery, and to seek to establish the causes of the incident, analyse the incident itself, and to attempt to draw conclusions, in order to prevent recurrences.ResultsThis was an generally difficult laparoscopic procedure in an obese patient, but no notable incident occurred. Towards the end of surgery, we noticed the presence of small plastic fragments and saw that the 10‐mm disposable trocar was broken at its tip. Because it would be difficult to locate the small clear fragments, even if the abdomen were incised, and despite the fact that the fragments were sharp, we decided not to convert to laparotomy. We retrieved as many fragments as possible via laparoscopy. The postoperative course was completely normal.ConclusionsThe case illustrates the actual occurrence of a theoretical risk. In order to reduce the risk to a minimum, impacts between plastic trocars and metallic instruments should be avoided. Despite the lack of reaction from the manufacturers, it may be useful to raise the standard of robustness demanded for this product.
Hysteroscopic and immunohistochemical findings in endometrial lesions unresponsive to medroxyprogesterone acetate: a report on four cases
Authors: Maia Hugo , Maltez Amélia , Fahel Paulo , Oliveira Maíta , Athayde Célia , Coutinho Elsimar 
Published: March 2003

ObjectiveThis is a case report showing an association between c‐erbB2 over‐expression in the endometrium and lack of response to progesterone.Patients and methodsDeterminations of oestrogen and progesterone receptors by immunohistochemistry were carried out in four patients with endometrial lesions that did not respond to the administration of progestins, and results were correlated with the presence of c‐erbB2 over‐expression.ResultsThe presence of c‐erbB2 over‐expression in the endometrium was associated with a lack of response to progesterone even in the presence of receptors for this hormone.ConclusionThe presence of c‐erbB2 over‐expression in the endometrium may be an early event in the development of some forms of atypical complex hyperplasia or carcinoma that may not regress with progesterone treatment.
Tensile strengths of extracorporeal slip knots tied with poliglecaprone and polydioxanone
Authors: Ind Thomas , Chou Danny , Lam Alan , Carlton Mark 
Published: March 2003

To compare the tensile strengths of commonly used extracorporeal slipknots when tied with poliglecaprone and polydioxanone.The tensile strength of seven extracorporeal slip knots and the flat square knot were tested using a tensiometer. Knots were tied in random order with 2/0 poliglecaprone and polydioxanone. The study was designed to demonstrate a 5‐newton difference in knot strength with 95% confidence at 80% power. Five knots were studied in each arm of the experiment.A laboratory experiment.Force required to break or cause slippage of knots.Knots tied with polydioxanone had a marginal yet significantly stronger tensile strength of 2.3 N (95% CI 0.1–0.75 N, P = 0.0332). The Tayside, Blood, Hutchon and Western knots had lower tensile strengths than the flat square knot in both poliglecaprone and polydioxanone. The modified Roeder knot was also stronger than the other ligatures when tied in poliglecaprone and more secure than the Western and Tayside knots when tied in polydioxanone.Slip knots tied in poliglecaprone are marginally less strong than those tied in polydioxanone. No extracorporeally tied slip knot is stronger than the modified Roeder knot.
Hysteroscopic uterine septum incision: is endometrial preparation mandatory to reduce operative complications and failure?
Authors: Simsek Tayup , Uner Mine , Trak Bilal 
Published: March 2003

ABSTRACTObjective To evaluate the effect of preoperative endometrial preparation on operative complications and failure rate in hysteroscopic uterine septum incision.Design Prospective study.Setting Department of Obstetrics and Gynaecology, Akdeniz University School of Medicine.Subjects 46 patients with septate uteri were enrolled into the study. In 34 patients incision of the septum was done without endometrial preparation with gonadotrophin‐releasing hormone analogues or progestins, for example, and in 12 patients there was preoperative suppression of the endometrium. Operative complications were recorded and the patients underwent hysterosalpingography after the operation, to evaluate the endometrial cavity. The two groups were compared for operative complications and failure.Results The mean age was 29.2 (range 22–42) and the mean parity was 1.4 (range 0–5). Hysteroscopic incision of the septum was successful (providing an adequate endometrial cavity) in all patients. Operative complications occurred in three patients (6.5%). No statistically significant difference was found between the two groups with regard to operative complications or failure.Conclusion Preoperative endometrial preparation for reduction of operative complications and failure rate is not necessary.
Hysteroscopic resection of submucous fibroids: clinical analysis of 99 cases
Authors: Feng Zuan Chong , Shi Yong Peng , Liu Su Ping 
Published: March 2003

ABSTRACTObjective To evaluate the efficacy of hysteroscopic resection of submucous fibroids.Design A retrospective study of 99 cases.Setting Shanghai Institute of Planned Parenthood Research, Shanghai First Maternity and Infant Health Hospital and the Shanghai Jiading Gynaecological Endoscopy Centre.Subjects The study included 99 patients with submucous fibroids. Out of these, 84 had menorrhagia, 13 had menorrhagia with irregular bleeding and two had postmenopausal bleeding.Interventions Transcervical hysteroscopic resection was used to treat submucous myoma in all patients on one or two occasions. All patients were followed up, for between 6 months and 6 years. Those patients who desired a child underwent hysteroscopic tubal catheterization and hydrotubations to check whether the shape of the uterine cavity recovered after surgery.Results In 94 out of 99 patients, the menstrual pattern became normal; five patients remained hypermenorrhoeic. Two patients were treated with endometrial ablation using a thermal balloon, because of retained myoma within the uterine wall and persistent hypermenorrhoea. Both of these patients experienced hypomenorrhoea for more than 12 months. Only one patient required hysterectomy after 34 months, because of a retained intramural myoma, which had enlarged and caused a recurrence of her menorrhagia. Seven out of the 12 women who desired a child became pregnant.Conclusion Hysteroscopic resection is an effective method for the treatment of submucous fibroids and could replace hysterectomy for some patients. It can shorten the operation time and patients can recover more quickly. For those patients who desire a child, this technique is not only organ‐sparing, but also avoids the intra‐abdominal adhesions induced by laparotomy.
Safety and efficacy of high‐purity concentrates in haemophiliac patients undergoing surgery by continuous infusion
Authors: Tagariello  , Davoli  , Gajo  , De Biasi  , Risato  , Baggio  , Traldi  
Published: March 2003

In this study we explore the feasibility of high‐purity double‐inactivated concentrates by continuous infusion for the treatment of haemophiliacs in a group of patients undergoing different surgical procedures. The patients were enrolled in the study on the basis of their transfusion history, which was well known due to their long‐term follow up at our Haemophilia Center. We did not perform a pre‐operative pharmacokinetic study because one of the aims of this study was to demonstrate that continuous infusion can become a first choice standard treatment in patients with haemophilia. Fourteen haemophilia A and one haemophilia B patients who needed at least 5 days of replacement therapy were monitored for haemostatic efficacy, post‐operative factor VIII and factor IX levels and evaluated for safety and flexibility of the products.The infusion rate of 3 IU kg–1 h–1 was demonstrated to be sufficient to ensure haemostasis and patients did not need additional bolus infusion during the post‐operative period. Our study demonstrates the safety and feasibility of high‐purity concentrates in patients undergoing surgery by continuous infusion, also in the absence of a previous pharmacokinetic study.
Diagnosis of von Willebrand Disease
Authors: Ingerslev J. , Gürsel T. 
Published: March 2003

The haemorrhagic diathesis in von Willebrand disease (vWD) is caused by a quantitative deficiency or a qualitative defect in the von Willebrand factor (vWF) in plasma and/or platelets causing insufficient primary haemostasis. Since vWF binds and protects factor VIII (FVIII) towards random proteolysis, coagulation may also be impaired in patients with a low plasma level of vWF, and in instances where vWF displays insufficient binding capacity to FVIII. The entity of vWD displays a vast heterogeneity. Apart from rarely occurring acquired cases, vWD is an inherited disorder of autosomal linkage. The major clinical hallmark in vWD is an increased tendency to mucocutaneous bleeding that rarely reach life‐threatening proportions, unless vWF is severely reduced or completely absent. Increased bleeding may also occur in sites such as muscles and joints when the level of FVIII is particularly low.Significant progress has recently been achieved through extensive molecular genetic exploration of various forms of vWD. In order to guide treatment and to form a platform for genetic investigation, however, accuracy in diagnosis and phenotypic characterization is important. By means of various laboratory methods, major subclasses of vWD can be differentiated, as presented in another article of this series. Whereas most of the cases of vWD can quite easily be diagnosed and classified using today’s diagnostic methods, the most frequently occurring bleeding disorder of all, vWd type 1 of mild degree, continues to challenge clinicians and diagnostic laboratories. The aim of this paper is to review the laboratory methods most commonly used in diagnostic investigation of the patient suspected of vWD.
The use of haemostatic drugs in haemophilia: desmopressin and antifibrinolytic agents
Authors: Villar A. , Jimenez‐Yuste V. , Quintana M. , Hernandez‐Navarro F. 
Published: March 2003

Summary.  Over the last 4 decades, there have been very significant advances in the treatment of haemophilia. Plasma products first became available in the 1960s, beginning with cryoprecipitate and then intermediate‐purity plasma concentrates, for the treatment of haemophilia A and B. The disasters of viral infections amongst people with haemophilia in the 1980s served to stimulate both the development of techniques of viral inactivation of concentrates and the manufacture of purer products. We therefore now have safe plasma products that are also pure in that they are concentrates of only the deficient protein responsible for the congenital coagulopathy. Preparations of specific coagulation proteins obtained using recombinant biotechnology techniques have been available since 1995. By contrast, pharmacological options for the treatment of the haemophilia remain very limited. The only therapeutic alternatives of real practical value which have been available in the last 30 years for the treatment of haemophilic patients are desmopressin, antifibrinolytic agents, aprotinin, concentrated oestrogens, and local haemostatic agents such as topical thrombin or fibrin glue. This article aims to assess the pharmacological basis and accumulated experience relating to these drugs when used for the prevention and treatment of bleeding in patients with haemorrhagic disorders.
What causes the vegetation types on Mount Bloomfield,a coastal tropical mountain of the western Philippines?
Authors: Proctor J. , Bruijnzeel L. A. , Baker A. J. M. 
Published: March 2003

SummaryMount Bloomfield has been shown to have several vegetation types, including medium stature forest on greywacke, small stature forest on serpentinized peridotite, and scrub and Gymnostoma woodland on dunite. The causes of the large physiognomic and floristic differences among these vegetation types have been investigated by soil chemical analyses, soil physical studies, and by a phytometer experiment involving the crop plant Zea mays. There was no relationship between maximum tree height and the soil chemical factors analysed (P, K, Ca, Mg, Ni) but there was a directly proportional relationship between maximum tree height and soil water retention. The phytometer experiment supported the idea that there is no acute soil toxicity in spite of the high soil Ni and Mg/Ca quotients recorded in this study. It is concluded that soil water retention, perhaps in combination with fire, is the major cause of stature differences among the vegetation types and together with soil chemistry is an important determinant of floristic composition.
Impact of ENSO on East African ecosystems: a multivariate analysis based on climate and remote sensing data
Authors: Plisnier P. D. , Serneels S. , Lambin E. F. 
Published: March 2003

Abstract1 The El Niño‐Southern Oscillation (ENSO) is an important driver of inter‐annual variations in climate and ecosystem productivity in tropical regions. Most previous studies have analysed ENSO‐induced changes in climate based on a single variable, such as rainfall. Also, it is generally assumed that the ENSO impact in East Africa is geographically uniform.2  The objective of this study is to improve understanding of the impact of ENSO on East African ecosystems, by measuring teleconnections between an ENSO index and a number of ecosystem variables in a spatially explicit way and for different time lags. We analysed the spatial patterns of teleconnections in the region by combining time series of climate variables measured for meteorological stations with time series of a vegetation index and surface temperature data measured by remote sensing.3 Our results confirm the ENSO impact on the climatic and ecological variability in East Africa. However, the pattern of teleconnections is much more complex than generally assumed, both in terms of spatial distribution and impact on different ecosystem variables. Not all climate and land surface variables are teleconnected to ENSO in the same way, which leads to a complex impact of ENSO on the ecosystem. Moreover, the ENSO impact is highly differentiated in space, as the direction, magnitude and timing of this impact are controlled by the local climate system, the presence of large lakes, proximity to the coast and, possibly, local topography and land cover.
Functional roles of remnant plant populations in communities and ecosystems
Authors: Eriksson Ove 
Published: March 2003

AbstractA hypothesis is suggested for functional roles of remnant plant populations in communities and ecosystems. A remnant population is capable of persistence during extended time periods, despite a negative population growth rate, due to long‐lived life stages and life‐cycles, including loops that allow population persistence without completion of the whole life cycle. A list of critera is suggested to help identification of remnant plant populations. Several community and ecosystem features may result from the presence of remnant plant populations. Apart from increasing community and ecosystem resilience just by being present, remnant populations may contribute to resilience through enhancing colonization by other plant species, by providing a persistent habitat for assemblages of animals and microorganisms, and by reducing variation in nutrient cycling. It is suggested that the common ability of plants to develop remnant populations is a contributing factor to ecosystem stability. Remnant populations are important for the capacity of ecosystems to cope with the present‐day impact caused by human society, and their occurrence should be recognized in surveys of threatened plant species and communities.
Matrix metalloproteinase‐2 from bronchial epithelial cells induces the proliferation of subepithelial fibroblasts
Authors: Xu J. , Benyon R. C. , Leir S.‐H. , Zhang S. , Holgate S. T. , Lackie P. M. 
Published: March 2003

SummaryBackground In bronchial asthma, subepithelial fibrosis in the conducting airways is associated with increased numbers of subepithelial fibroblasts.Objective This study examined the hypothesis that MMP‐2 from airway epithelial cells induces the proliferation of subepithelial fibroblasts.Methods Using primary bronchial epithelial cells MMP‐2, MT1‐MMP and TIMP‐2 mRNA expression were assessed by Northern blotting and RT‐PCR. Primary bronchial epithelial cells transfected with constructs encoding pro‐MMP‐2 and MT1‐MMP (MMP‐14).Results Transfected cells showed enhanced expression of the appropriate mRNA species by RT‐PCR and enhanced MMP‐2 or MT1‐MMP activity by zymography. Active MMP‐2 levels in epithelial supernatants were increased most by cotransfection with pro‐MMP‐2 and MT1‐MMP encoding constructs. By measuring tritiated thymidine incorporation, supernatants from transfected cells were found to enhance DNA synthesis of primary airway fibroblast cultures compared with controls. There was a strong correlation (r = 0.9, P < 0.01) between MMP‐2 levels in epithelial cell conditioned media and fibroblast proliferation as indicated by DNA synthesis. The MMP inhibitor 1,10‐phenanthroline attenuated the increased proliferation, while the addition of exogenous purified MMP‐2 alone also increased fibroblast proliferation.Conclusions Our results support a role for MMP‐2 in mediating cross‐talk between epithelial cells and myofibroblasts.
Dexamethasone inhibits maturation, cytokine production and FcεRI expression of human cord blood‐derived mast cells
Authors: Smith S. J. , Piliponsky A. M. , Rosenhead F. , Elchalal U. , Nagler A. , Levi‐Schaffer F. 
Published: March 2003

SummaryBackground Mast cells are responsible for eliciting the early phase and for contributing to the development of the late phase of allergic reactions, through the release of cytokines and other inflammatory mediators.Objective To assess whether the glucocorticoid dexamethasone has a direct effect on mast cell progenitor maturation and on mature cord blood‐derived mast cell properties.Methods Mast cells were obtained by culturing human umbilical cord blood mononuclear cells with stem cell factor, IL‐6 and prostaglandin E2. Mast cell numbers were assessed by Toluidine Blue staining and immunocytochemistry of tryptase positive cells. The expression of FcεRI, CD49d and c‐kit was assessed by flow cytometry. Histamine release was determined by a radioenzymatic assay. Cys‐LT, GM‐CSF and TNF‐α production and release were determined by ELISA.Results Dexamethasone (10−6 M−10−9 M) time‐ and dose‐dependently inhibited the maturation of the mast cell progenitors. Dexamethasone did not affect the basal expression of FcεRI, CD49d and c‐kit, but it inhibited the IgE‐dependent enhanced expression of FcεRI. Dexamethasone (10−6 M−10−9 M) had no significant effect on FcεRI‐dependent histamine release or the synthesis and release of Cys‐LT from the mature mast cells. However, pre‐incubation of the mast cell cultures with dexamethasone for 1 h, prior to cross‐linking of FcεRI, dose‐dependently inhibited the production and secretion of both GM‐CSF and TNF‐α.Conclusions From these in vitro data we propose that glucocorticosteroids are effective drugs in the management of allergic inflammation due to their capacity to inhibit mast cell development, IgE‐dependent FcεRI expression and mast cell production of GM‐CSF and TNF‐α.
Effects of fexofenadine and desloratadine on subjective and objective measures of nasal congestion in seasonal allergic rhinitis
Authors: Wilson A. M. , Haggart K. , Sims E. J. , Lipworth B. J. 
Published: March 2003

SummaryBackground In vitro
studies have shown much higher H
1 ‐receptor antagonist potency with desloratadine (DL) compared to fexofenadine (FEX), although it is unclear whether this has any clinical relevance on disease control parameters in seasonal allergic rhinitis (SAR), especially for nasal congestion.Objective To compare the relative efficacy between presently recommended doses of DL and FEX on daily measurements of peak nasal inspiratory flow (PNIF) and nasal symptoms in SAR.Methods Forty‐nine patients with SAR were randomized into a double‐blind, placebo‐controlled cross‐over study during the grass pollen season, comparing 2 weeks of once daily treatment with (a) 180 mg FEX or (b) 5 mg DL, taken in the morning. There was a 7–10 day placebo run‐in and washout prior to each randomized treatment. Measurements were made in the morning (am) and in the evening (pm) for PNIF (the primary outcome variable), nasal and eye symptoms. The average of am/pm values were used for analysis.Results There were significant (P < 0.05) improvements, compared to placebo, with FEX and DL, for PNIF, nasal blockage, nasal irritation, and total nasal symptoms, but not nasal discharge or eye symptoms. There were no significant differences between active treatments. Values for PNIF (L/min) for mean placebo baseline, mean difference from baseline (95% CI for difference) were 126, 10 (4–16) for FEX; and 122, 11 (4–17) for DL. The mean difference (95% CI) between FEX vs. DL was 1 L/min (−7–8). Values for total nasal symptoms (out of 12) were: 3.2, 0.7 (0.2–1.2) for FEX; and 3.4, 0.9 (0.3–1.5) for DL, and for nasal blockage (out of 3) were: 1.1, 0.2 (0.1–0.4) for FEX; and 1.2, 0.3 (0.1–0.5) for DL. The mean difference (95% CI) in total nasal symptoms and nasal blockage between FEX vs. DL was 0.1 (−0.6–0.8) and 0.1 (−0.2–0.3), respectively.Conclusions Recommended once daily doses of fexofenadine and desloratadine were equally effective in improving nasal peak flow and nasal symptoms in SAR.
Past and future of predictions in plant invasions: a field test by time
Authors: Pyšek Petr 
Published: March 2003

AbstractIntensive interest in the alien flora of the Czech Republic stimulated one of the earliest attempts (in the early 1970s) to predict potential invaders of arable land. Another paper published recently by the same research team using the same methodology provides a relatively unique possibility to assess the success of these predictions after a quarter of a century. The predictions were successful for 39.3% of the 28 species included, while 60.7% of invasion cases must be considered as failures. Prediction was rather unsuccessful for the members of Asteraceae (14.3%), and more correct for annuals/biennials (45.5%) than for perennials (16.7%). No pattern was found with respect to the area of origin. The results indicate that past predictions based largely on intuition were less successful than modern prediction systems using the knowledge of a large number of characters and carried out using advanced computation methods. The correct identification of invaders using such systems reaches values between 61% and 91%.