bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glove powder promotes adhesion formation and facilitates tumour cell adhesion and growth
Authors: van den Tol M P , Haverlag R , van Rossen M E E , Bonthuis F , Marquet R L , Jeekel J 
Published: March 2003

Abstract

Background
The presence of foreign material in the abdominal cavity irritates the peritoneal surface, leading to an inflammatory response. This defensive mechanism can provoke adhesion formation. The same peritoneal defence cascade is thought to play a role in the process of intra-abdominal tumour recurrence. The aim of this study was to evaluate whether glove powder produced peritoneal adhesions in a rat adhesion model and whether it promoted intra-abdominal tumour recurrence in a rat tumour cell adhesion and growth model.

Methods
A reproducible model that allowed semiquantitative scoring of adhesion formation or tumour load was used in three different groups of rats. One group was treated by intra-abdominal application of powder obtained from starch-powdered gloves, one by application of pure starch and in one group no powder was used.

Results
Application of glove powder or pure starch on minimally and severely traumatized peritoneum gave rise to significantly greater adhesion formation and intra-abdominal tumour load than peritoneal trauma alone (both P &lt; 0·001).

Conclusion
Starch-induced peritoneal trauma leads not only to more adhesion formation but also to increased adhesion and growth of tumour cells. Since good powder-free alternatives are available there is no longer any justification for the use of powdered gloves during intra-abdominal surgery.
Quality of life after low anterior resection with total mesorectal excision and temporary loop ileostomy for rectal carcinoma
Authors: O'Leary D P , Fide C J , Foy C , Lucarotti M E 
Published: March 2003

Abstract

Background
Low anterior resection (LAR) with total mesorectal excision (TME) may be the optimal operation for carcinoma of the mid or lower rectum. Routine formation of a temporary defunctioning stoma has been recommended with TME. The impact of this strategy on health-related quality of life (HRQOL) has not been addressed.

Methods
A prospective longitudinal study was conducted among 24 patients undergoing LAR with TME and loop ileostomy for rectal cancer. Clinical outcomes were documented. HRQOL was assessed using Short Form 36 (SF-36). Twenty-three patients undergoing high anterior resection (HAR) for rectosigmoid cancer were studied concurrently to determine the effects of major colorectal resection without a stoma.

Results
Time to resume normal diet, length of stay in hospital and time to return to non-work activities were similar after HAR or LAR with TME and loop ileostomy. Twelve weeks after HAR SF-36 scores were stable or improved compared with preoperative levels. In contrast, 12 weeks after LAR + TME patients had a reduction in physical functioning scores on SF-36. SF-36 scores improved after ileostomy closure. Ileostomy closure increased total hospital stay and time off non-work activities.

Conclusion
LAR with TME and temporary loop ileostomy for rectal cancer results in a long total hospital stay and impairs aspects of HRQOL. Prompt stoma closure should be a priority in these patients.
Effects of adenosine on ischaemia–reperfusion injury associated with rat pancreas transplantation
Authors: Pi F , Badosa F , Sola A , Roselló Catafau J , Xaus C , Prats N , Gelpí E , Hotter G 
Published: March 2003

Abstract

Background
During cold preservation, cellular consumption of adenosine triphosphate leads to the accumulation of nucleotides and nucleosides. The precise role of adenosine in modulating the inflammatory response of cold-preserved pancreas after reperfusion remains to be elucidated. The aim of this study was to assess the influence of adenosine on the inflammatory response associated with the process of ischaemia–reperfusion in rat pancreas transplantation.

Methods
The effect of adenosine from preservation solution on the levels of high-energy nucleotides and their breakdown products after cold ischaemic preservation was determined. In addition, the inflammatory response associated with the process of ischaemia–reperfusion in pancreas transplantation was quantified with and without pretreatment with the adenosine antagonist theophylline, and during preservation of the organ in University of Wisconsin solution with and without adenosine.

Results
Adenosine from preservation solution is able to modify the nucleotide and nucleoside content of preserved pancreas, indicating that adenosine is incorporated and metabolized in tissue. Administration of the adenosine antagonist to transplanted rats moderated the increases in nitrite and nitrate, myeloperoxidase activity and lipoperoxidation levels in the pancreas.

Conclusion
Adenosine in the preservation solution may enhance the inflammatory response in rat pancreas transplantation.
Influence of the number of lymph nodes examined on staging of gastric cancer
Authors: Lee H K , Yang H-K , Kim W H , Lee K U , Choe K J , Kim J-P 
Published: March 2003

Abstract

Background
Nodal staging for gastric cancer according to the 1997 Union Internacional Contra la Cancrum tumour node metastasis classification is based on the number of metastatic lymph nodes. The aim of this study was to evaluate whether the number of lymph nodes examined affected staging of gastric cancer.

Methods
A retrospective study was performed in 4789 consecutive patients with gastric cancer, who had undergone curative resection (R0) from 1986 to 1995. Patients were classified according to the number of nodes examined. The number of metastatic lymph nodes and stage-stratified survival were compared.

Results
There were significant differences in the number of metastatic lymph nodes and survival in stage IIIA between patients with 15 or more lymph nodes and those with fewer than 15 nodes. In analysis restricted to patients with 15 or more nodes, stage-stratified survival did not vary significantly with lymph node yields for any stage except IIIB, in which there was a significant difference between the subgroup with fewer than 20 examined lymph nodes and patients with 35 or more nodes.

Conclusion
The number of lymph nodes examined did not significantly affect node staging of gastric cancer as long as at least 15 nodes were examined. For stage IIIB, more than 15 lymph nodes may be required for optimal staging.
Conservative management of appendix mass in children
Authors: Gillick J , Velayudham M , Puri P 
Published: March 2003

Abstract

Background
The management of an appendix mass in children is controversial. An experience of conservative management of appendix masses in a paediatric population over the last 19 years is reviewed.

Methods
The medical records of all children who presented with an appendix mass to one of three children's hospitals between 1982 and 2000 were reviewed. In that interval 427 children with a mean age of 7·3 years (range from 2 months to 18 years) presented with an appendix mass. Sixteen children had an immediate appendicectomy. The remaining 411 children were treated conservatively by close observation and antibiotics, with intravenous fluids and nasogastric suction if required. Once the child was well enough for discharge home, elective appendicectomy was booked for 4–6 weeks later.

Results
Three hundred and forty-six (84·2 per cent) of the children responded to initial conservative management and were discharged after a median stay of 6 (range 3–24) days. The children returned 4–6 weeks later for elective appendicectomy. The complication rate for elective appendicectomy was 2·3 per cent (eight patients). Those who had an uncomplicated elective appendicectomy had a median hospital stay of 3 (range 1–6) days. Histological examination demonstrated acute or subacute inflammation in 50·8 per cent of appendices removed at elective appendicectomy.

Conclusion
Non-operative management of an appendix mass followed by elective appendicectomy is a safe and effective method of management.
Non-operative management of the primary tumour in patients with incurable stage IV colorectal cancer
Authors: Sarela A I , Guthrie J A , Seymour M T , Ride E , Guillou P J , O'Riordain D S 
Published: March 2003

Abstract

Background
Excision of primary colorectal cancer associated with irresectable synchronous metastases confers high morbidity and mortality with uncertain benefit.

Methods
For patients with incurable stage IV colorectal cancer, minimally symptomatic primary tumours were left in situ and 5-fluorouracil-based chemotherapy was administered systemically. Primary tumour-specific complications and survival were monitored.

Results
There were 13 men and 11 women with primary tumours in the right colon (eight), transverse colon (one), sigmoid colon (eight) or rectum (seven). Eleven patients had metastases limited to the liver (liver replacement less than 25 per cent in one, 25–50 per cent in four and more than 50 per cent in six) and 13 patients had extrahepatic disease (lung or peritoneum). Four patients with sigmoid colon tumours developed bowel obstruction, which required an uncomplicated operation in two and deployment of colonic stents in two patients, at 1, 3, 12 and 20 months from diagnosis. Three further patients underwent right hemicolectomy for abdominal pain of uncertain aetiology, with poor symptomatic relief, and another had a potentially curative operation following disease downstaging. The overall median survival was 10·3 months with a 1-year actuarial survival rate of 44 per cent.

Conclusion
A policy to defer resection of minimally symptomatic primary colorectal cancer is associated with a low risk of complications before death from progressive systemic disease.
Role of the neutrophil in the development of systemic inflammatory response syndrome and sepsis following abdominal aortic surgery
Authors: Spark J I , Scott D J A 
Published: March 2003

Abstract

Introduction
There is evidence to suggest that the polymorphonuclear neutrophil (PMN) plays a critical early step in the development of the ischaemia–reperfusion syndrome, the systemic inflammatory response syndrome (SIRS) and sepsis. The PMN receptor CD16 plays an important role in phagocytosis, cell-mediated cytotoxicity and the release of free radicals and proteolytic enzymes. The aim of this study was to determine whether there is any relationship between PMN CD16 expression, phagocytosis and the development of sepsis.

Methods
Fifty patients who underwent elective infrarenal abdominal aortic aneurysm repair were studied. Venous blood was taken before operation, throughout surgery and for 7 days after operation. CD16 expression was measured, unstimulated and following further stimulation, by means of flow cytometry. Phagocytosis was determined using flow cytometry.

Results
Some 36 patients had an uncomplicated recovery; 14 developed SIRS or sepsis. There was no difference between the two groups with respect to nutritional, co-morbid or technical factors. In the group that developed septic complications after operation, the level of PMN CD16 expression was significantly higher before surgery (mean channel fluorescence (MCF) 30·2 versus 10·4; P &lt; 0·05, Mann–Whitney U test) and throughout the postoperative period. Surgery produced no change in CD16 expression. After operation, stimulation of PMNs in the septic group resulted in a fall in CD16 expression (40·8 versus 20·4 MCF; P &lt; 0·05, Mann–Whitney U test); surgery produced no change in the level of expression in the uncomplicated group.

Conclusion
This study provides evidence of phenotypic and functional differences in neutrophil behaviour in patients who develop sepsis following aneursym surgery.
Anti-human epidermal growth factor receptor 2 monoclonal antibody therapy for breast cancer
Authors: Leonard D S , Hill A D K , Kelly L , Dijkstra B , McDermott E , O'Higgins N J 
Published: March 2003

Abstract

Background
Advances in molecular biology and improved understanding of tumour biology have led to the development of novel treatments for cancer. Trastuzumab (Herceptin; Genentech, San Francisco, California, USA) is a monoclonal antibody directed against human epidermal growth factor receptor (HER) 2 protein, which is overexpressed in a wide variety of human cancers, including 20–30 per cent of human breast cancers. HER-2 plays an important role in oncogenic transformation, tumorigenesis and metastatic spread. Overexpression is associated with a poor prognosis and predicts a poor response to several treatment modalities.

Method
Literature relating to the monoclonal antibody was identified by a Medline literature search and by cross-referencing from the references of seminal articles on the subject. Four major clinical trials were identified and reviewed.

Results and conclusion
In clinical trials approximately 15–20 per cent of patients with HER-2-overexpressing tumours benefited from treatment with trastuzumab. In sensitive patients the antibody appeared to have intrinsic anticancer activity when given as a single agent. In combination chemotherapy it appeared to act synergistically with other agents. Ongoing research is evaluating trastuzumab in combination with numerous standard chemotherapy regimens and with other novel chemotherapeutic agents. Clinical trials have also revealed several serious side-effects of monoclonal antibody therapy. Most notable is an unpredictable cardiotoxicity, especially when used in combination with anthracycline-based chemotherapy regimens.
Randomized clinical trial of no wound drains and early discharge in the treatment of women with breast cancer
Authors: Purushotham A D , McLatchie E , Young D , George W D , Stallard S , Doughty J , Brown D C , Farish C , Walker A , Millar K , Murray G 
Published: March 2003

Abstract

Background
Women undergoing surgery for primary breast cancer routinely have suction drains inserted deep to the wounds, which are removed approximately 6–8 days after operation, requiring a period of stay of that duration in hospital. The aim of this study was to perform a prospective randomized clinical trial to evaluate a new surgical technique of suturing flaps without wound drainage, combined with early discharge, in women undergoing surgery for breast cancer.

Methods
A total of 375 patients undergoing surgery for breast cancer were randomized to conventional surgery or suturing of flaps with no drain. The main outcome measures were length of hospital stay, surgical morbidity, psychological morbidity and health economics.

Results
Suturing of flaps and avoiding wound drainage in women undergoing surgery for breast cancer resulted in a significantly shorter hospital stay. Adopting this surgical technique with early discharge did not lead to any difference in surgical or psychological morbidity. Health economic benefits to the National Health Service resulted from saved bed days with no impact on community costs.

Conclusion
Wound drainage following surgery for breast cancer can be avoided, thereby facilitating early discharge with no associated increase in surgical or psychological morbidity.
Randomized clinical trial of Ligasure™versus conventional diathermy for day-case haemorrhoidectomy
Authors: Jayne D G , Botterill I , Ambrose N S , Brennan T G , Guillou P J , O'Riordain D S 
Published: March 2003

Abstract

Background
Haemorrhoidectomy is frequently associated with postoperative pain and prolonged hospital stay. A new technique of haemorrhoidectomy using the Ligasure™ device suited to day-case surgery is described. This technique was compared with conventional open diathermy haemorrhoidectomy.

Methods
Forty patients with grade III or IV haemorrhoids were randomized to Ligasure™ (group 1) or conventional diathermy (group 2) haemorrhoidectomy. Operative details were recorded and patients recorded daily pain scores on a linear analogue scale. Follow-up was at 1, 3, 6 and 12 weeks to evaluate complications, return to normal activity, ongoing symptoms and patient satisfaction.

Results
Reduced intraoperative blood loss (median (range) 0 (0–5) ml versus 20 (12–22) ml; P &lt; 0·001) and a shorter operating time (10 (8–11) versus 20 (18–25) min; P &lt; 0·001) was observed in group 1 compared with group 2. More patients in group 1 were discharged on the day of operation (18 of 20 versus 11 of 20; P &lt; 0·05) and there was a trend towards lower postoperative pain scores on day 1 (group 1 median 5 (95 per cent confidence interval (c.i.) 2·6 to 6·8) versus group 2 7 (95 per cent c.i. 4·2 to 7·7); P = 0·36). There was no difference between the two groups in the degree of patient satisfaction or number of postoperative complications.

Conclusion
Ligasure™ diathermy may be used safely in the treatment of patients with grade III or IV haemorrhoids. It reduces intraoperative blood loss and operating time, and facilitates same-day discharge.
Purification and characterization of three galactose specific lectins from Mulberry seeds (Morus sp.)
Authors: Yeasmin Tanzima , Tang Md Abul Kashem , Razzaque Abdur , Absar Nurul 
Published: March 2003

Three lectins were extracted and purified from mulberry seeds by gel filtration of 100% ammonium sulfate saturated crude protein extract followed by ion‐exchange chromatography on DEAE and CM‐cellulose. The lectins were found to be homogeneous as judged by polyacrylamide disc gel electrophoresis. The molecular masses of the lectins as determined by gel filtration were 175 000 for MSL‐1, 120 000 for MSL‐2 and 89 500 for MSL‐3. MSL‐1 is dimer in nature, with the two monomers held together by disulfide bond(s), while MSL‐2 and MSL‐3 contain four nonidentical subunits that are held together by nonionic hydrophobic interactions.The lectins agglutinated rat red blood cells and this agglutination was inhibited specifically by galactose, methyl‐α‐d‐galactopyranoside, methyl‐β‐d‐galactopyranoside, lactose and raffinose. The lectins MSL‐1, MSL‐2 and MSL‐3 contained 5.7, 5.4 and 4.5% neutral sugars, respectively, and the sugar composition of the lectins was glucose and mannose for MSL‐1 and galactose for both MSL‐2 and MSL‐3. The lectins exhibited strong cytotoxic effect in brine shrimp lethality bioassay.
Natural course of sensitization to cow's milk and hen's egg in childhood atopic dermatitis: ETACTM Study Group
Authors: Wolkerstorfer A. , Wahn U. , Kjellman N. I. M. , Diepgen T. L. , De Longueville M. , Oranje A. P. 
Published: March 2003

Background Sensitization to food allergens has been implicated in the pathogenesis of atopic diseases, in particular atopic dermatitis (AD). The aim of the present paper is to investigate the natural course of sensitization to egg and to cow's milk and its relationship with the severity of AD.Methods The placebo intention‐to‐treat population of the ETACTM (Early Treatment of the Atopic Child) study consisted of 397 children with AD aged 12–24 months (mean± SD: 17.2 ± 4.1 months) who were followed for 18 months. All children were examined for objective SCORing Atopic Dermatitis (SCORAD) and specific IgE amongst other, to egg and to cow's milk at inclusion and after 3, 12 and 18 months. Fifteen patients were excluded from this analysis due to major protocol violations thus leaving 382 patients in the analysed population.Results Sensitization to egg and to cow's milk was more common in atopic children with severe AD at all time‐points. At inclusion, children sensitized to both egg and to cow's milk had the most severe AD (Kruskall‐Wallis test P = 0.007). The degree of sensitization expressed in RAST classes was significantly related to the severity of AD. Furthermore, children sensitized to egg or to cow's milk at inclusion had a higher risk of persistence of AD (84% and 67%, respectively, vs. 57% in those not sensitized) and a higher objective SCORAD after 18 months follow‐up.Conclusion We found an association between severity of AD and sensitization to egg or to cow's milk. Moreover, sensitization to egg, and to a lesser extent cow's milk, indicates a worse outcome of AD in terms of persistence and severity of the disease.
The association between persistent eosinophilia and asthma in childhood is independent of atopic status
Authors: Karakoc F. , Remes S. T. , Martinez F. D. , Wright A. L. 
Published: March 2003

Background Although peripheral blood eosinophilia is associated with risk of asthma, the relation with atopy has not been established.Objective To assess the relationship between eosinophils and chronic asthma in childhood, and to determine the factors associated with eosinophil levels over time.Methods Percent eosinophils/300 white blood cell (WBC) count (‘eos’) was measured at 9 months, 6 years and 11 years in subjects participating in the prospective Tucson Children's Respiratory Study. Children were classified based on the number of measurements in which they had low (≤ 2%) or high (> 5%) eosinophils, as follows: (1) Persistently low eos (n = 130); (2) Low eos (intermittently low or consistently moderate, but never high, n = 317); (3) Intermittently high eos (n = 192); and (4) Persistently high eos (n = 17). Only children with ≥ 2 eos measurements were included in the analysis. Chronic asthma was defined as medical doctor (MD)‐diagnosed asthma with reports of wheezing during the previous year, on ≥ 3 questionnaires completed between 2 and 13 years of age. Children with at least one positive skin prick test (SPT; ≥ 3 mm) at age 6 or 11 were considered ‘atopic’.Results Chronic asthma was linearly related to longitudinally ascertained eosinophils (trend χ2P < 0.001) with prevalence ranging from 5.8% among children with persistently low eos to 37.5% among children with persistently high eos. This relation was independent of atopy. Parental history of asthma was associated with both chronic asthma (P < 0.001) and with longitudinal eosinophil status (P < 0.001). After adjusting for atopy and gender, there was a 70% increase in asthma risk with each increase in longitudinal eosinophil level. This stepwise increase was reduced to 48% when parental asthma was added to the model.Conclusion Longitudinal eosinophil levels are linearly associated with chronic asthma in childhood, independent of atopy. The strong association between parental asthma and eosinophil status suggests that genetic background may be an important determinant of eosinophilic response.
Distribution of the common warthog (Phacochoerus africanus) and the desert warthog (Phacochoerus aethiopicus) in the Horn of Africa
Authors: D'Huart Jean‐Pierre , Grubb Peter 
Published: March 2003

AbstractThe Somali warthog, Phacochoerus aethiopicus delamerei, is the surviving relative of the Cape warthog, P. a. aethiopicus, which formerly inhabited Cape Province but became extinct in the last century. It is only recently that these two subspecies of Phacochoerus aethiopicus have been restored to the status of a species – the ‘desert warthog’– distinct from the common warthog, P. africanus (Grubb, 1985; Grubb & Oliver, 1991; Grubb, 1993). Mitochondrial DNA analysis has recently confirmed that the common and desert warthogs are two different and widely divergent species (Randi et al., unpublished). This preliminary study maps their distribution in the Horn of Africa, and discusses the significance of ecological barriers that limit these distributions. One hundred and thirty‐three skulls from 64 different localities in five countries – mostly from museum collections – were identified. New material was obtained from the field and reliable literature data were also recorded. Locality records suggest that the optimal habitats of desert warthog are low altitude arid lands. The two species may overlap locally in northern Somalia, northern and eastern Kenya and southern and south‐eastern Ethiopia, but the desert warthog's precise range is still not accurately established and basic data about its conservation status, ecology and behaviour are still very poor.