bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enzymatic activities of Ura2 and Ura1 proteins (aspartate carbamoyltransferase and dihydro‐orotate dehydrogenase) are present in both isolated membranes and cytoplasm of Saccharomyces cerevisiae
Authors: Voříšek J. , Techniková Z. , Schwippel J. , Benoist P. 
Published: August 2002

AbstractComputational analysis predicted three potential hydrophobic transmembrane α‐helices within the Ura2 multidomain protein of Saccharomyces cerevisiae, the C‐terminal subdomain of which catalyses the second step of uridine‐monophosphate biosynthesis by its L‐aspartate carbamoyltransferase activity (EC 2.1.3.2). The fourth step of pyrimidine biosynthesis is catalysed by dihydro‐orotate dehydrogenase (Ura1 protein; EC 1.3.99.11), which was similarly characterized as a peripheral membrane protein. Ex situ, the activities of the investigated enzymes were associated both with isolated yeast membranes, fractionated by differential centrifugation to remove intact nuclei, and with soluble cytoplasmic proteins. Copyright © 2002 John Wiley & Sons, Ltd.
Posterolateral aspect and stability of the knee joint. II. Posterolateral instability and effect of isolated and combined posterolateral reconstruction on knee stability: a biomechanical study
Authors: Krudwig Wilfried K. , Witzel Ulrich , Ullrich Karin 
Published: August 2002

AbstractThis study evaluated the correlation between the number of transected posterolateral structures (PLS) and the grade of posterolateral rotational instability, determined the effect of the popliteus muscle‐tendon unit on the tibial rotation, and examined the effect of an isolated posterior cruciate ligament (PCL) and combined PCL‐PLS reconstruction on knee stability. Sectioning the popliteofibular and lateral collateral ligaments both caused an increase in tibial external rotation. Cutting the PT resulted in a statistically highly significant excessive external rotation and externally shifted neutral position of the tibia over the full range of motion. Tensioning the popliteus muscle‐tendon unit led to a statistically highly significant internally shifted neutral tibial rotation and a decreased internal and an increased external rotation without affecting the total rotational arcs. The isolated PCL reconstruction did not affect the external rotation, whereas the combined PCL‐PLS reconstruction reset the knee to nearly physiological laxity patterns.
Pancreatic Function after Acute Biliary Pancreatitis: Does It Change?
Authors: Ibars Eugenia Pareja , Sánchez de Rojas Enrique Artigues , Quereda Luis Aparisi , Ramis Ricardo Fabra , Sanjuan Vicente Martínez , Peris Ramón Trullenque 
Published: August 2002

According to the Cambridge and Marseilles symposia, morphologic and functional recovery from acute biliary pancreatitis (ABP) occurs if the initial cause and complications are eradicated. Nevertheless, in recent years there has been controversy over this topic, and varying results have been reported. These differing results may be due to different diagnostic methods, number of patients studied with regard to etiologic factors, severity of the disease, and differences in the tests used. A total of 63 ABP patients
[17 male (27%), 46 female (73%); 45 mild, 18 severe] were prospectively studied. All patients underwent cholecystectomy. No patient in this series underwent necrosectomy or pancreatectomy. During the acute phase the severity of the disease was assessed following the Atlanta criteria, and the occurrence and rate of necrosis were determined by dynamic computed tomography. Exocrine and endocrine pancreatic functions were assessed at 1 month, 6 months, and 1 year after the ABP episode by means of various pancreatic function tests. We evaluated the occurrence of pancreatic failure following ABP and if this deficiency was associated with the severity of the episode.
According to the classic symposia criteria, the study showed no deficit in exocrine or endocrine pancreatic function. No statistically significant differences were found when the pancreatic function and severity of the process were assessed.
Natural History of Early Colorectal Cancer
Authors: Matsui Toshiyuki , Yao Tsuneyoshi , Iwashita Akinori 
Published: August 2002

AbstractSince superficial tumors have been found, their peculiar pathologic features have evoked questions concerning their biologic behavior, their natural history. The aim of the present study was to elucidate the natural history of colorectal cancers (CRCs) including superficial cancers, using a retrospective radiologic method. Forty nine cancers that had had initial configurations of early cancer seen by previous radiography and that were examined pathologically were the subject of the present study. Growth speeds [doubling time (DT) calculation] and configurational changes at the various stages (invasion depth) were compared between polypoid growth (PG) and nonpolypoid growth (NPG). Growth speeds of mucosal cancer and submucosal cancer were also compared. The results showed that early CRC grows slowly (DT 31.2 months) when the cancer is limited to the mucosa. However, as tumors grow down to the submucosa, their growth speed accelerates (DT 25.8 months). The DT of these early cancers were longer than that of advanced cancers. The pathologic growth pattern (NPG or PG) of the CRCs did not affect the tumor growth speed. In respect to tumor configuration, when the tumor is limited to the submucosa the antecedent growth pattern may be easily deduced. It seems difficult, however, to know the initial growth patterns in advanced cancers because cancers with polyloid growth frequently change to a nonpolypoid growth pattern when in advanced stages. Among 32 advanced cancers, only 6 (19%) derived from IIc/IIc+IIa cancer. The most common (more than 70%) origin of advanced cancer seems to be IIa, Is, and Isp lesions. These results suggest that NPG cancers or superficial depressed cancers are not the main origins of advanced cancers, and that these cancer do not show extraordinarily rapid growth.
Thyroid Gland and Surgery of the Thyroglossal Duct: Exercise in Applied Embryology
Authors: Organ Gregory M. , Organ Claude H. 
Published: August 2002

AbstractThyroglossal duct cysts (TDCs), the most common congenital cervical abnormality, originates from the medial anlage of the thyroid gland and presents as a painless asymptomatic midline suprahyoid mass. It does not represent a diagnostic challenge. The tract may persist as a fibrous cord or leave nests of cells anywhere along its embryonic path, and it gives rise to the development of TDC. The Sistrunk operation described in 1920 consists of en bloc cystectomy and central hyoidectomy, with tract excision up to the foramen cecum. This procedure remains an effective treatment for TDC. Malignant degeneration of TDC is rare (0.7%).
Surgeon's Approach to the Thyroid Gland: Surgical Anatomy and the Importance of Technique
Authors: Bliss Richard D. , Gauger Paul G. , Delbridge Leigh W. 
Published: August 2002

AbstractThe cornerstone of safe and effective thyroid surgery is thorough training in and understanding of thyroid anatomy and pathology. With appropriate techniques, total thyroid lobectomy and total thyroidectomy (which should be considered simply as a bilateral total thyroid lobectomy performed during the same operation) can be undertaken with minimal risk of damage to the recurrent laryngeal nerves, the external branches of the superior laryngeal nerves, and the parathyroid glands. Safe surgery requires a specific operative plan, progressing in a series of logical, orderly, anatomically based steps. Exposure of the thyroid gland is followed by careful dissection of the superior pole, utilizing the avascular plane between the superior pole and the cricothyroid muscle to identify and preserve the external branch of the superior laryngeal nerve. Medial retraction of the gland then allows dissection of the lateral aspect of the thyroid lobe. Protection of the recurrent laryngeal nerves and preservation of the blood supply to the parathyroid glands is best achieved by “capsular dissection,” ligating the tertiary branches of the inferior thyroid artery on the gland surface. If a parathyroid gland cannot be preserved or becomes ischemic after dissection of its vascular pedicle, it should be immediately minced and autotransplanted into the ipsilateral sternocleidomastoid muscle. The current evolution of outpatient or short‐stay thyroidectomy emphasizes the need to avoid complications by utilizing meticulous surgical technique. Minimally invasive thyroidectomy utilizing endoscopic techniques may also affect the practice of thyroid surgery. Even so, understanding the surgical anatomy of the thyroid gland and its possible variations is paramount to safe and effective surgery.
Total Thyroidectomy or Thyroid Lobectomy in Patients with Low‐risk Differentiated Thyroid Cancer: Surgical Decision Analysis of a Controversy Using a Mathematical Model
Authors: Kebebew Electron , Duh Quan‐Yang , Clark Orlo H. 
Published: August 2002

AbstractThere is a general consensus that total or near‐total thyroidectomy is the optimal treatment for patients with high risk differentiated thyroid cancer (DTC), but the optimal extent of thyroidectomy in patients with low risk DTC continues to be controversial. To determine the optimal extent of thyroidectomy in patients with low risk DTC, we used decision analysis to compare the trade‐offs of total thyroidectomy (TT) to thyroid lobectomy (TL). The decision analysis model included the probabilities of thyroidectomy complications, risk of DTC recurrence, and death from DTC. This information was obtained from the literature and from outcome data for patients with low risk DTC from our institution. In addition, the concept of utilities was used in the analysis. To determine the utility of each health outcome state (thyroidectomy complication, DTC recurrence, and DTC mortality for low risk patients) a survey was conducted. Overall, prospective patients viewed DTC recurrence as less desirable than thyroidectomy complication. The utilities assigned by the survey participants varied over a wide range, with 61.5% of the individuals viewing the occurrence of a thyroidectomy complication as better than DTC recurrence. At baseline utilities and probabilities, TT had a higher expected utility than TL. One‐way sensitivity analysis varying the rates of (1) thyroidectomy complication, (2) DTC recurrence, and (3) DTC mortality over the possible range showed that complication from initial thyroidectomy was the most important factor that determined the preferred extent of thyroidectomy. TL was the preferred surgical approach only if a complication rate of > 33:1, TT/TL complication rate ratio, was assumed. When no differences in DTC recurrence between the two approaches was assumed in the model, TL had a higher expected utility using the baseline utilities of thyroidectomy complication and DTC mortality. The analysis indicates that TT in patients with low risk DTC is preferable to TL. However, TL is preferred if (1) no difference in the DTC recurrence rate between the two approaches is assumed, (2) a higher complication rate for TT is used (> 33 times higher), or (3) the utility ratio of thyroidectomy complication to DTC recurrence is < 0.8 TL. We believe this decision analysis model provides an objective approach that others can use to select the optimal extent of thyroidectomy based on patient preference of health outcome states, institution‐specific outcome data for DTC recurrence or mortality, and the surgeon‐specific complication rate.
Modern Anesthetic Techniques for Thoracic Operations
Authors: Brodsky Jay B. , Fitzmaurice Brett 
Published: August 2002

AbstractContinuing advances in anesthesiology enable surgeons to perform more and more complex operations. Nowhere is this relation more important than for the patient undergoing thoracic surgery. Specialized anesthetic techniques including safe lung separation, the maintenance of oxygenation during selective one‐lung ventilation, and effective postoperative analgesia allow procedures such as lung volume reduction surgery and lung transplantation to be performed routinely. This paper reviews modern clinical practices in the field of thoracic anesthesia.
Vagus
Authors: Gunn S.W.A. 
Published: August 2002

World Journal of Surgeryhas been studying the etymologic genealogy of some common terms in surgical usage. Thus the bile duct strangely leads us to symphony orchestras, dukes, coins, and dictators; and a bacteriologic culture is found to be related to such unexpected cousins as religion, agronomy, war, and civilization. If these connections appear somewhat vague, they could not be more so than with the vagus.—The Editor
Gut Ischemia, Oxidative Stress, and Bacterial Translocation in Elevated Abdominal Pressure in Rats
Authors: Eleftheriadis E. , Kotzampassi K. , Papanotas K. , Heliadis N. , Sarris K. 
Published: August 2002

AbstractThe purpose of this experimental study was to investigate whether the increased intraabdominal pressure due to gas insufflation creates intestinal ischemia leading to oxygen free radical production and bacterial translocation. A group of 88 rats were studied, 40 of which were subjected to a 15 mmHg pressure pneumoperitoneum for 60 minutes, with the following parameters being studied: mean arterial pressure after carotid catheterization; intestinal microcirculation by means of the laser‐Doppler technique; gut metabolic activity (O2 extraction) by blood sampling from portal vein and carotid artery; intestinal, hepatic, splenic, and lung free radical production (malondialdehyde); and bacterial translocation toward the mesenteric lymph nodes, liver, and spleen at 3 and 18 hours after pneumoperitoneum deflation. The mean arterial pressure exhibited no alterations, whereas the jejunal mucosa microcirculation was significantly decreased (p= 0.0001), as was the gut metabolic activity (p= 0.025). Malondialdehyde was increased in gut mucosa (p= 0.0002), liver (p= 0.02), spleen (p= 0.03), and lung (p= 0.017). Bacterial translocation toward the mesenteric lymph nodes (p= 0.002), spleen (p= 0.002), and liver (p= 0.05) was increased in the 3‐hour group; in the 18‐hour group bacteria were not found in mesenteric lymph nodes but were in liver (p= 0.008) and spleen (p= 0.035). It is concluded that elevated intraabdominal pressure in the rat leads to intestinal ischemia, oxygen free radical production, and bacterial translocation. These results must be reproduced in humans and their clinical significance clarified.
Treatment of Liver Metastases of Carcinoid Tumors
Authors: Ahlman Håkan , Westberg Gunnel , Wängberg Bo , Nilsson Ola , Tylén Ulf , Scherstén Tore , Tisell Lars‐Erik 
Published: August 2002

AbstractLiver metastases imply a major problem in patients with carcinoid tumors. Patients with localized disease should always undergo resection for cure. Patients with distant metastatic disease can also undergo resection for potential cure or symptom palliation because of the slow growth rate of many carcinoid tumors. In patients with the midgut carcinoid syndrome and bilobar hepatic disease we have performed primary surgery to relieve such symptoms as intestinal obstruction and ischemia, followed by successive embolizations of the hepatic arteries to reduce functional tumor burden in the liver. For optimal palliation, all patients with residual tumor were treated by octreotide. In a consecutive series of 64 patients with the midgut carcinoid syndrome we thus attained a 5‐year survival rate of 70%. Fourteen of the patients underwent intentionally curative surgery (e.g., primary surgery followed by liver surgery). Of these patients, none died from their tumor disease during the period of study. The value of adjunctive interferon therapy is currently under evaluation.
Options for Treatment of Persistent Aneurysm Perfusion after Endovascular Repair
Authors: Ivancev K. , Chuter T. , Lindh M. , Lindbladt B. , Brunkwall J. , Risberg B. 
Published: August 2002

AbstractPersistent aneurysm perfusion represents failure of endovascular repair. The leak may occur around either end of the prosthesis or through a collateral route. Most cases can be treated by endovascular means. Stents can be rotated, the prosthesis can be lengthened at either end, and collateral pathways can be occluded, all without recourse to open repair. This report describes the management of persistent aneurysm perfusion in five patients from a total experience of 32 cases of endovascular aneurysm repair.
Posterior Retroperitoneoscopy as a New Minimally Invasive Approach for Adrenalectomy: Results of 30 Adrenalectomies in 27 Patients
Authors: Walz Martin K. , Peitgen Klaus , Hoermann Rudolf , Giebler Reiner M. , Mann Klaus , Eigler Friedrich W. 
Published: August 2002

AbstractPosterior retroperitoneoscopic adrenalectomy is a new minimally invasive method. It represents an alternative to conventional open procedures and laparoscopic techniques. Between July 1994 and November 1995 a total of 30 retroperitoneoscopic adrenalectomies were performed on 27 patients. In 24 patients, unilateral tumors were seen (size 1–7 cm): seven Cushing adenomas, five Conn adenomas, seven pheochromocytomas, four hormonally inactive tumors, one cyst. Three patients suffered from Cushing syndrome with bilateral adrenal gland hyperplasias (two inoperable pituitary gland tumors, one bronchial carcinoid with ACTH secretion). The operations were carried out in prone position. After balloon dilatation of the retroperitoneum and creation of a pneumoperitoneum the preparation of the adrenal gland was performed via three trocar sites positioned below the 12th rib. Twenty‐five adrenalectomies were completed endoscopically, and five times (among four patients) conversion to the conventional posterior technique was necessary. The average operating time of complete endoscopic adrenalectomies was 124 minutes (45–225 minutes); blood loss was 10 to 120 ml. With minimal need for postoperative analgesia (average dosage 7.9 mg of piritramide), mobilization and adequate food uptake were possible on the day of operation. The posterior retroperitoneoscopic adrenalectomy is a relatively fast, safe method, with the advantages of the posterior open approach and minimally invasive surgery. It therefore represents an important addition to adrenal gland surgery.
Tall‐Cell Variant of Papillary Thyroid Cancer: Disregarded Entity?
Authors: Rüter A. , Nishiyama R. , Lennquist S. 
Published: August 2002

AbstractThe tall‐cell variant of papillary thyroid carcinoma (TCV) has been described as an aggressive tumor with a significantly higher incidence of recurrence and mortality than other forms of papillary carcinoma. In some series it has accounted for up to 10%, whereas in other series it has not been reported at all, indicating that there are difficulties identifying it. In a series of 162 consecutively treated patients with papillary thyroid carcinoma treated by total thyroidectomy according to a highly standardized procedure, all specimens were specifically examined by an international group of pathologists to establish the occurrence of TCV. All patients with TCV were studied with regard to local aggressiveness, the presence of metastases, iodine uptake, DNA pattern, thyroglobulin production, treatment (surgical and adjuvant), and outcome (follow‐up 3–17 years, median 10 years). At primary histopathologic evaluation by the local pathologist, three patients were recorded as having TCV. At special evaluation by the expert group, eight more cases were found, giving a total of 11 patients in this series (7%). Five of them had extracapsular growth, and four were multifocal. Three had metastases at the time of admission. Seven tumors were diploid, one tetraploid, and three aneuploid. Of the three patients with primary distant metastases two died (8 and 24 months after operation), and one is still alive after 10 years. Four other patients developed recurrences, one of whom died from cardiac failure, but the others have so far been treated successfully. Two of these recurrences had no radioiodine uptake, and one had no rise in thyroglobulin concentrations; the other two had rising values that correlated with recurrence. The other four patients are alive without recurrence. It was concluded that identification of the TCV requires examination by an experienced pathologist. Moreover, it may have a higher incidence than is generally recognized. No reliable criteria for prognostic classification were identified. The results suggest that early identification and active treatment can lead to an outcome more favorable than has previously been described.
Interventional and surgical treatment of pancreatic abscess
Authors: Mithöfer Kai , Mueller Peter R. , Warshaw Andrew L. 
Published: August 2002

AbstractPancreatic abscess is one of the infectious complications of acute pancreatitis. It is a collection principally containing pus, but it may also contain variable amounts of semisolid necrotic debris. Most of these abscesses evolve from the progressive liquefaction of necrotic pancreatic and peripancreatic tissues, but some arise from infection of peripancreatic fluid or collections elsewhere in the peritoneal cavity. Included also are abscesses found after surgical débridement and drainage of pancreatic necrosis. Although open surgical treatment of infected necrosis is the established treatment of choice, percutaneous drainage of abscesses is successful in some circumstances. We used percutaneous catheter drainage in 39 patients during 1987–1995. Only 9 of 29 (31%) attempts at primary therapy were successful; 2 patients died, and 18 required subsequent surgical drainage. On the other hand, 14 of 14 patients with recurrent or residual abscesses after surgical drainage were successfully drained percutaneously. Percutaneous catheter drainage of pancreatic abscesses may be useful for initial stabilization of septic patients, drainage of further abscesses after surgical intervention (especially when access for reoperation will be difficult), associated abscesses remote from the pancreas, and selected unilocular collections at a sufficient interval after necrotizing pancreatitis to have allowed essentially complete liquefaction.
Hepatic Surgery and Hepatic Surgical Anatomy: Historical Partners in Progress
Authors: McClusky David A. , Skandalakis Lee J. , Colborn Gene L. , Skandalakis John E. 
Published: August 2002

AbstractWhether for hepatic trauma or transplantation, a surgeon's knowledge of hepatic anatomy commonly determines a patient's outcome. The first medically relevant anatomic studies of the liver emerged with the endeavors of Herophilus and Erasistratus between 310 and 280 bc. Yet it was not until after the development of anesthesia and antisepsis that the first formal resections were performed during the late 1800s. After vascular occlusion principles had been developed as a means of successful hemorrhage control, several deliberate attempts were made to repair the liver surgically. Such efforts culminated in the work of Wendel in 1910 when he followed avascular planes during hepatectomy. The functional anatomy of surgery and surgical technique had suddenly joined in an effort to advance the practice, and eventually the efficacy of hepatic surgeons in facilitating the modern era of segmental anatomy extended hepatectomies and transplantation surgery.