bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional Dermolipectomy as Treatment for Sequelae of Massive Weight Loss
Authors: del Campo Antonio Fuente , Allegretti Eustacio Rojas , Filho Jose Amandio Fernandes , Gordon Christopher Burnside 
Published: August 2002

AbstractDermolipectomy is the most important procedure for treatment of the deformities engendered by massive weight loss. It remains the only treatment for excising redundant skin. Although liposuction is useful for removing fatty deposits without traditional surgical incisions, its application is limited by the ability of the skin to contract and conform to the newly sculpted figure. Thus liposuction may serve as an adjunct when treating the sequelae of weight loss but not as a primary procedure. In response to changing expectations, reconstructive surgeons have developed increasingly ingenious and specific dermolipectomy procedures to minimize or hide scars, lessen morbidity, and enhance function. Liposuction in combination with dermolipectomy has expanded the applicability of traditional procedures to a wider variety of patients. Surgical history, patient selection, surgical planning, a spectrum of regional dermolipectomy procedures, and potential complications are discussed herein.
Perforation Due to Metastatic Tumors of the Ileocecal Region
Authors: Shiraishi Masayuki , Hiroyasu Shungo , Nosato Eiji , Shimoji Hideaki , Kusano Toshiomi , Muto Yoshihiro 
Published: August 2002

AbstractWe reviewed our department's medical records between April 1986 and April 1994 to identify patients who showed acute abdominal symptoms requiring surgical treatment due to metastatic tumors of the small intestine. In group A, seven patients (30%) were treated for acute peritonitis, and all were found to have an intestinal perforation due to hematogenous metastases (group A). In group B, 16 patients (70%) were treated for an intestinal obstruction, and all were found to have disseminated tumors of the small intestine (group B). In group A all tumors were isolated and located exclusively in the ileocecal region, whereas all tumors in group B showed peritoneal dissemination, with no predominant anatomic localization. In general, the intestinal tumors in group A originated from cancers of the upper aerodigestive tract, whereas those in group B originated from advanced cancers in the abdominal cavity. The tumors were significantly smaller and the period between the onset of symptoms from the original malignancy and the onset of abdominal symptoms (perforation or obstruction) was significantly shorter in group A. In conclusion, intestinal metastases located in the ileocecal region have unique clinicopathologic features and so should be recognized as a distinct disease entity. Therefore when patients with a known upper aerodigestive malignancy exhibit acute abdominal symptoms, intestinal metastasis to the ileocecal region, necrotic changes, and perforation should be considered in the differential diagnosis.
Wound Healing of Intestinal Anastomosis after Digestive Surgery under Septic Conditions: Participation of Local Interleukin‐6 Expression
Authors: Ishimura Ken , Tsubouchi Taijiro , Okano Keiichi , Maeba Takashi , Maeta Hajime 
Published: August 2002

AbstractThis study aimed to evaluate the integrity of anastomotic wound healing after digestive surgery under septic conditions and to observe local interleukin‐6 (IL‐6) expression around the anastomotic segment. Experimental animals were separated into lipopolysaccharide (LPS) and control groups. Each was injected with LPS or normal saline solution into the peritoneal cavity 24 hours before transection and anastomosis of the colon. The anastomotic bursting pressure (ABP) and tissue hydroxyproline concentration (HP) were measured as indicators of wound healing. Immunohistochemical staining for IL‐6 was performed on tissue samples obtained from the anastomotic segment, lung, liver, and kidney. The reactive cells were counted by light microscopy. The ABP and HP were significantly lower in the LPS group than the control group 7 days after the surgery. In the LPS group, IL‐6 expression around the anastomotic segment was enhanced 1 and 6 hours after surgery but suppressed 24 hours afterward. In contrast, IL‐6 expression in lung, liver, and kidney was enhanced in the LPS group 24 hours after surgery but not in the control group. It is suggested that anastomotic wound healing is impaired after digestive tract surgery under septic conditions, and local IL‐6 expression participates in wound healing.
Genetic and Biochemical Screening for Endocrine Disease: III. Costs and Logistics
Authors: Delbridge Leigh , Robinson Bruce 
Published: August 2002

AbstractThe cost of screening tests in endocrine disease can be determined in a number of ways, including the charge or billed cost, the production cost, or most appropriately the cost to achieve the intended aim of the test (cost‐effectiveness). Cost‐effectiveness analysis allows clinicians to determine whether an added benefit of a test comes at an acceptable cost. For example, analysis of the cost‐effectiveness of routine thyroid function tests prior to surgery in elderly patients with nodular thyroid disease shows that the cost per life saved is only US $405, making the tests clearly cost‐effective. Cost‐effectiveness does not always equate with affordability, however, especially in developing countries. Thyroid function testing prior to surgery represents only 0.8% of the average household income in Australia and is therefore both cost‐effective and affordable, whereas in Sri Lanka the same screening test represents up to 50% of the average monthly income. A survey of membership of the International Association of Endocrine Surgeons worldwide showed that molecular genetic screening for endocrine disease is readily available in 67% of institutions, with all of those having facilities for the rearrangement during transfection (
RET) proto‐oncogene testing, and lesser numbers having access to the Meningene, the von Hippel‐Lindau syndrome (VHL) gene, or linkage analysis for familial pheochromocytoma. The median cost of screening for the RET proto‐oncogene was $290 (range $100–3000). Cost‐effectiveness analysis of molecular genetic screening for MEN‐II syndrome demonstrates that the cost per life saved is only $5175. This compares favorably with reliance on screening based on annual pentagastrin testing, where the cost per life saved is as high as $76,315. Molecular genetic screening for endocrine disease (e.g., the MEN‐II syndrome) is not only cost‐effective but the therapy required (total thyroidectomy) is both acceptable and well tolerated.
Significance of Biologic Aggressiveness and Proliferating Activity in Papillary Thyroid Carcinoma
Authors: Kurozumi Kazushi , Nakao Kazuyasu , Nishida Toshirou , Nakahara Masaaki , Ogino Nobuo , Tsujimoto Masahiko 
Published: August 2002

AbstractPapillary thyroid carcinoma is a frequent thyroid cancer. Many factors have been reported to be of prognostic importance, but the significance of biologic factors suggesting aggressiveness and proliferating activity has not been sufficiently documented. Conventional prognostic factors such as age, extrathyroidal invasion, lymph node and distant metastasis, and biologic factors including histologic differentiation, DNA ploidy, S‐phase and G2M‐phase fractions, and expression of CD44 variant 6 (CD44‐v6) obtained from 131 patients who underwent surgery for papillary thyroid carcinoma at Osaka Police Hospital were analyzed retrospectively. Age was closely related to extrathyroidal invasion, G2M‐phase fraction, and CD44‐v6 expression. Extrathyroidal invasion was independently related to age, gender, and lymph node metastasis. The grade of lymph node metastasis was related to extrathyroidal invasion, gender, distant metastasis, and CD44‐v6 expression. Distant metastasis was associated with aneuploid tumors. Cause‐specific survival was independently related to biologic factors including extrathyroidal invasion, distant metastasis, DNA ploidy and S‐phase fraction. These results suggest that biologic factors indicating aggressiveness and proliferating activity are important for papillary thyroid carcinoma.
Surgical Repair of Postinfarction Ventricular Septal Defect: 10‐Year Experience
Authors: Athanassiadi Kalliopi , Apostolakis Efstratios , Kalavrouziotis Georgios , Charitos Christos , Karamichali Evangelia , Kakavos Dimitrios , Lolas Christos 
Published: August 2002

AbstractPostinfarction ventricular septal defect
(PIVSD) remains a surgical challenge resulting in devastating mortality rates. We present our 10‐year experience in surgical management of this catastrophic complication of acute myocardial infarction. During a decade (1987–1996) 14 patients with PIVSD were treated surgically in our department. There were 10 men and 4 women, ranging in age from 51 to 78 years. The rupture occurred within the first 4 days after the infarction in most cases (n= 10). Eight patients were supported perioperatively by intraaortic balloon counterpulsation
(IABP). In all cases the surgical technique included infarctectomy and ventricular septum reconstruction with synthetic patches. Coronary artery bypass grafting was synchronously performed in four patients. Seven patients died perioperatively (mortality rate 50%) due to heart failure and to multiple organ failure. The most frequent complications were low cardiac output syndrome, hemorrhage, and respiratory and renal insufficiency. The PIVSD needs urgent surgical intervention with the patient hemodynamically stable after cardiac catheterization. Long‐term results are favorable for survivors.RID="" ID="" <E5>Correspondence to:</E5> K. Athanassiadi, M.D., Ph.D., 34A Konstantinoupoleos Str., 15562 Holargos, Athens, Greece
The Luminati of Leiden: From Bontius to Boerhaave
Authors: Kidd Mark , Modlin Irvin M. 
Published: August 2002

Abstract.In the glittering canopy of the history of great medical centers of Europe, none was more viviscent than Leiden. Although wealthy nations nurtured great medical establishments in Padua, Salerno, Montpellier, and Paris, it was from a diminutive market town in The Netherlands that a group of medical cognoscenti arose whose intellectual prowess blazed across the intellectual firmament of seventeenth and eighteenth century Europe. The tradition of medical excellence established by Bontius was amplified by the surgeon Peter Paaw, whose stewardship of the Anatomical Theater guided it to heights comparable to those achieved at Padua. At the same time, Clusius established a botanical garden that would have no rival for two centuries. The multitalented Sylvius educated some of the greatest minds of the generation, accepted the Harveian theories of circulation, and succeeded in fostering an intellectual environment characterized by novel ideas and tolerance of thought. van Horne defined and chartered the existence of lymphatic circulation, and Bartholin destroyed the myth of the liver as a source of blood. Exalting in the freedom of thought, the cabal of Ruysch, Steensen, de Graaf, and Swammerdam banded together under Sylvius and van Horne and made significant advances in pancreatic, lymphatic, reproductive, and respiratory physiology. There is little doubt, however, that of all the great names linked with Leiden, it is Boerhaave's that is universally held to be synonymous with that of the city. As a clinician, scientist, and teacher, the aura of his knowledge and fame spread to the farthest corners of Europe. Without doubt, the great medical schools of Edinburgh, Vienna, and Gottingen owe their subsequent potency to him. Thus the legacy of Leiden provides the richest of all earthly concepts—an appreciation of the unique spiritual power and intellectual wealth that devolves from the pursuit of the life of the mind.
Ultrasound of the Prostate and Testicles
Authors: Lavoipierre Alain M. 
Published: August 2002

AbstractConsiderable advances have occurred in the sonographic imaging of small parts over recent years, including improved transducer technology and Doppler imaging. After reviewing briefly prostatic anatomy, including McNeal's concept of zonal anatomy, the techniques used for examining the prostate gland sonographically and for performing biopsy are discussed. Ultrasound (US) findings in the normal gland, in benign prostatic hyperplasia, and in prostatic cancer are described, with an emphasis on cancer. The role of targeted and random biopsy is assessed, as is the role of color Doppler in detecting prostatic cancer. An overview of the findings in inflammation and infertility also is provided. The technique used for examining the scrotum and testicles is discussed after a short review of scrotal anatomy. The sonographic appearances of the normal scrotal contents are described, followed by a discussion of findings in tumors, inflammatory conditions, and testicular torsion. A synopsis of the appearances of cysts and microlithiasis also is provided. Both the increased use and expectations by surgeons of US in the assessment of the prostate and testicles make it imperative to understand the techniques, range of findings, new developments, and limitations involved in using this modality.
Endosonography of the Anal Canal and Rectum
Authors: Kumar Adarsh , Scholefield John Howard 
Published: August 2002

AbstractEndosonography has evolved into an effective tool for the accurate preoperative assessment of anorectal pathology, from idiopathic anal pain to malignancy. The published data suggest that endosonography is currently the best method for assessing the structural integrity of the anal sphincter and for staging rectal cancer. The development of new treatment modalities for rectal cancer, including local excision, preoperative radiotherapy, and total mesorectal excision, has increased the importance of accurate preoperative staging to allow the optimum treatment planning. However, there is little information about the impact of endosonographic findings on clinical decision making. Education, training, and quality control in the use of endosonography also require further work. This article aims to evaluate the usefulness and limitations of this technique in clinical practice.
Trends in Peptic Ulcer Bleeding and Surgical Treatment
Authors: Ohmann Christian , Imhof Michael , Röher Hans‐Dietrich 
Published: August 2002

AbstractAn evidence‐based approach is followed, with grading of evidence by study design, to evaluate surgical treatment of a bleeding peptic ulcer. In contrast to endoscopic treatment, reports of surgical treatment are rare, with only five randomized trials having been identified. Epidemiologic studies have demonstrated that the incidence of emergency surgery has not changed despite major improvements with endoscopic treatment. There are no proven alternatives to emergency operation for massive bleeding uncontrollable by endoscopic procedures. There is some debate about surgery for rebleeding, but no randomized trial has assessed whether a second endoscopic treatment alone is preferable to surgery with or without repeated endoscopic treatment. Concerning the type of operative procedure, the existing body of evidence, including two randomized studies, indicates that patients are best served by a relatively aggressive surgical approach. Today the value of these studies is limited owing to prevention of ulcer recurrence by eradication and technical improvements of local procedures (e.g., arterial ligation). Early elective surgery was tested in two randomized studies and several uncontrolled series, which demonstrated that it may be beneficial in high risk groups and harmful in others. Indications for early elective surgery should be refined taking into account updated prognostic information and more effective endoscopic treatment. Because of a new understanding of ulcer disease the role of surgery has changed markedly within the last years, no longer aiming to cure the disease but primarily to stop the hemorrhage. Evidence, however, is not derived from properly randomized controlled trials but is based on theoretic arguments and knowledge from studies not primarily dealing with operative treatment.
Ultrastructural Alterations of Polytetrafluoroethylene Prostheses Implanted in Abdominal Wall Provoked by Infection: Clinical and Experimental Study
Authors: Bellón Juan M. , Contreras Luis A. , Buján Julia 
Published: August 2002

Abstract.Infection of an expanded polytetrafluoroethylene (ePTFE) prosthesis after implant is a major drawback of its use in current clinical practice. The aim of the present study was to compare the behavior of such prostheses implanted into New Zealand rabbits with that of prostheses infected after clinical implant. Experimental implants of ePTFE Soft Tissue Patch were performed to repair defects (7 × 5 cm) created in the abdominal wall of 10 rabbits. Prior to implant the prostheses were contaminated with Staphylococcus aureus. Five animals implanted with noncontaminated ePTFE prostheses served as controls. All the animals were sacrificed at 30 days after implant. For the clinical study, specimens were taken from three ePTFE implants that had been found to be infected after intervention. The clinical and experimental implant specimens were processed for light microscopy and scanning electron microscopy. Macroscopic and microscopic examination of experimental and clinical implants revealed alterations to the ePTFE structure, such as areas of fragmentation, fracture lines, and detachment of fine layers of ePTFE that harbored numerous Staphylococcus colonies. Neoformed tissue around contaminated implants was arranged more loosely, and on occasion large spaces between fibers gave rise to an “unknitted” appearance with respect to the control implants. It may be concluded that microporous ePTFE prostheses show similar behavior following experimental or clinical implant in the presence of infection. Irreversible changes to the structure of the prosthesis are produced owing to colonization of the biomaterial by microorganisms, which in most cases necessitates total replacement of the prosthesis.
Palpatory Method Used to Identify the Recurrent Laryngeal Nerve during Thyroidectomy
Authors: Procacciante Fabio , Picozzi Pietro , Pacifici Massimo , Picconi Stefania , Ruggeri Sandro , Fantini Aldo , Basso Nicola 
Published: August 2002

Abstract.The major complication of thyroid surgery, occurring in 1% to 6% of cases, is injury to the recurrent laryngeal nerve (RLN). A simple method to identify the RLN during thyroid surgery is described by the authors. It consists in palpation of the nerve caudally to the inferior pole of the thyroid, after the nerve has been made taut by the upward and medial traction of the thyroid gland. This method was used on 47 human cadavers and 45 patients with benign thyroid diseases. It made it possible to identify the RLN in all of the cadavers and 52 of the 55 identifications during 45 thyroidectomies (in 10 total thyroidectomies the identification was bilateral). Laryngeal motility was normal in all patients at postoperative laryngoscopy. Using the palpation before dissection in the region of the inferior thyroid artery, the traditional viewing method became easier and safer, reducing the risk of injury where it is most likely to occur to the nerve.
Behavioral processes and egg‐laying decisions of the bean weevil, Callosobruchus maculatus
Authors: Horng S. ‐B. , Lin H. ‐C. , Wu W. ‐J. , Godfray H. C. J. 
Published: August 2002

AbstractEmpirical studies of behavioral processes were designed in a seed beetle, Callosobruchus maculatus, to distinguish between two alternative tactical models, namely, comparison tactics and threshold tactics of seed choice, and also to deduce the behavioral rule of its oviposition decisions. Search sequences and the oviposition process of the female bruchid beetle were observed and recorded. Analyzing data of the search sequence showed that the female bruchid beetle repeatedly encountered seeds randomly and tended to oviposit on a newly encountered seed in an ovposition bout. These results contradict the usual comparison models, which predict that the female will return to choose any one of the previously encountered seeds after sampling. In addition, the oviposition decision (rejection or acceptance of an encountered seed to oviposit) was analyzed with a generalized linear modeling (GLIM) technique. Modeling showed that the probability of accepting a seed with different numbers of eggs on it changed during her egg‐laying process. This evidence supports the idea that the female is using a threshold tactic and that her acceptance threshold is being adjusted by experience gained during the egg‐laying process. The analysis of statistical modeling also showed that both the time since the last oviposition and the number of eggs which had been laid by the female had a significant effect on the probability of accepting seeds with different numbers of eggs. Therefore, a time measuring system and the physiological state variable, e.g., eggload of the female, should be included in the behavioral rule to explore how the female makes her decision in the egg‐laying process and to examine the importance of choice behavior as a component of selection and adaptation.
Search for Signature Inversion in the πi13/2⊗νi13/2Band in Odd-Odd178Ir
Authors: Zhang Yu-Hu  , T. Hayakawa  , M. Oshima  , Y. Toh  , J. Katakura  , Y. Hatsukawa  , M. Matsuda  , N. Shinohara  , T. Ishii  , H. Kusakari  , M. Sugawara  , T. Komatsubara  , K. Furuno  
Published: August 2002

The search for the πi13/2⊗νi13/2band in178Ir has been conducted through the152Sm(31P,5nγ) 178Ir reaction and the excitation functions,x-γ and γ-γ-tcoincidence measurements. Five rotational bands have been newly identified. The low-spin signature inversion in the πi13/2⊗νi13/2band has been confirmed by the observations of linking transitions and signature crossing atI= 25.5 ℏ. The inversion phenomenon in πh11/2⊗νi13/2, πh9/2⊗νi13/2and πi13/2⊗νi13/2structures in178Ir provides a unique testing ground for different theoretical interpretations.
Triple differential cross section measurements in H2and D2
Authors: N Scherer  , H Lörch  , V Schmidt  
Published: August 2002

Triple differential cross sections (TDCS) for double photoionization in H2and D2(for comparison also in helium) have been measured for equal energy sharing,E1 = E2 = 10 eV. In agreement with previous observations by the Reddish group and in comparison to the equivalent helium case, our D2data confirm a `narrowing' effect in the correlation factor which influences the observed TDCS lobes, as well as a `filling-in' effect at relative angles θ1,2 = 180°. However, we do not confirm the previous differences in the magnitude of D2and H2TDCS values. Instead, we get equal TDCS strengths and, in comparison to helium, reasonable agreement with the corresponding total cross section ratio for double photoionization in He and D2.
Neutron powder diffraction study ( T = 4.2-300 K) and polarization analysis of YBaCuFeO5+δ
Authors: Mombrú A W , Prassides K , Christides C , Erwin R , Pissas M , Mitros C , Niarchos D 
Published: August 2002

Abstract
The crystal and magnetic structures of the perovskite YBaCuFeO5+δ have been studied in the temperature range T = 4.2-300 K by powder neutron diffraction. In addition to the antiferromagnetic ordering transition at TN
= 442 K, a commensurate–incommensurate magnetic transition is detected at TN
′ = 190 K. Below this temperature, two sets of satellite peaks surround the (1/2,1/2,1/2) magnetic peak at d ∼ Å, collapsing into a single set of satellites below 155 K. Polarization analysis has been performed to confirm the magnetic nature of the (1/2,1/2,1/2)± satellites.