bluuebunny/crossref_metadata_2025_split huggingface dataset:
Individual particle characterization of Siberian aerosols by micro‐PIXE and backscattering spectrometry
Authors: Van Malderen H. , Hoornaert S. , Injuk J. , Przybylowicz W. J. , Pineda C. A. , Prozesky V. M. , Van Grieken R. 
Published: August 2002

AbstractIndividual particle analysis using micro‐PIXE and proton backscattering was performed for selected aerosol samples collected over Siberia. Point analyses were complemented by x‐ray mapping for complex particles. Hierarchical cluster analysis of 124 particles identified in general the same particle groups, as found by automated electron microprobe analyses of approximately 25 000 particles from the same locations. However, owing to the superior sensitivity of micro‐PIXE, a number of heavy metals were identified, suggesting an anthropogenic origin of particles. These metals remained undetected by EPXMA owing to its inferior sensitivity. Elemental mapping of single aerosol particles yielded important information on the chemical heterogeneities. Copyright © 2001 John Wiley & Sons, Ltd.
Additional Hepatocellular Carcinomas Undetectable before Surgery
Authors: Shuto Taichi , Hirohashi Kazuhiro , Ikebe Takashi , Mikami Shinichi , Yamamoto Takatsugu , Kubo Shoji , Wakasa Kenichi , Kinoshita Hiroaki 
Published: August 2002

AbstractThe presence of small additional hepatocellular carcinomas (HCCs) undetectable before hepatic resection is a crucial topic for hepatic surgeons. We assessed the incidence of pathologically diagnosed multiple HCCs in 267 patients who underwent hepatic resection for HCC. Ninety‐five additional HCC nodules were detected in 72 of the patients (27%). The survival rate of these 72 patients was significant worse than for the 195 with single nodular HCC (p= 0.0013). Twenty‐one (22%) were detected before surgery, 29 (31%) during surgery, and 45 (47%) on pathologic examination after surgery. The mean nodule diameters for each group were 2.1, 1.0, and 0.9 cm, respectively (p < 0.0001). None of the 21 nodules detected before surgery was well differentiated, whereas 30 of the 74 nodules in the other two groups were well‐differentiated. Although the mean nodule diameter of the well‐differentiated HCC group was the smallest, there was no significant difference among the three groups assigned according to tumor differentiation (p= 0.2355). Altogether, 9 of 16 patients with additional nodules detected before surgery (56%) and 49 of 59 with additional nodules detected during or after surgery (88%) had cirrhosis of the liver. The odds ratio for detecting a new HCC nodule during or after surgery in the presence of cirrhosis was 5.444 (p= 0.0087). Improvement in the detection of small additional HCC nodules before and during surgery and meticulous follow‐up after surgery are necessary for patients with cirrhosis. For patients without cirrhosis, surgical treatment may be performed according to the results of preoperative imaging studies.
Low‐Molecular‐Weight Heparins and Daflon for Prevention of Postoperative Thromboembolism
Authors: Tsimoyiannis Evangelos C. , Floras Grigorios , Antoniou Nikolaos , Papanikolaou Nikolaos , Siakas Philipos , Tassis Andreas 
Published: August 2002

AbstractThe efficacy of low‐molecular‐weight heparins (LMWH) alone versus a combination of Daflon 500 mg with LMWH in preventing postoperative symptomatic thromboembolism was investigated. A total of 1372 patients aged 40 years or older undergoing major abdominal, pelvic, or abdominal wall surgery were randomized into four groups. Group A (n= 591) received enoxoparin 20 mg or fraxiparin 0.3 ml. Group B (n= 595) received the regimens of group A plus Daflon 500 mg. Group C (n= 93) received enoxoparin 40 mg or fraxiparin 0.6 ml. Group D (n= 93) received the regimens of group C plus Daflon 500 mg. Each LMWH was given subcutaneously once a day during the hospitalization and continued in groups C and D for 15 days after discharge (high risk patients). Daflon 500 mg was given as two tablets every 8 hours during the day before surgery, two tablets 6 hours before surgery, and two tablets once a day on postoperative days 4 to 15. Daily clinical examination was performed; and phlebography or perfusion lung scanning (or both) were used in symptomatic patients to confirm deep vein thrombosis (DVT) or pulmonary embolism (PE). The wound was examined on a daily basis for hematomas. The diagnosis of PE was established in two patients of group A and in three patients of group C; symptomatic DVT was established in one patient in group A and three patients of group C. Neither DVT nor PE were established in Daflon 500 mg groups. These data suggest that the combination of Daflon 500 mg and LMWH is more effective than LMWH alone for preventing symptomatic thromboembolism.
Benefits and Risks of Blood Transfusion in Surgical Patients
Authors: Greenburg A.G. 
Published: August 2002

AbstractThis article attempts to put into a risk‐related perspective modern red blood cell (RBC) transfusion therapy. When making the decision to transfuse, RBCs or blood products, it is important to weigh the risks and benefits of the proposed therapy. It is equally important to evaluate the risk of not transfusing and the morbidity and mortality associated with that decision. After nearly a century of use, RBC transfusions continue to be associated with a variety of risks. Although the initial risks of mismatch and infectious disease transmission are ever decreasing, new risk considerations, particularly immunosuppression, are being uncovered. Because of the nearly universal worldwide fear of transfusion‐related transmission of infectious disease a more conservative transfusion policy has generally taken hold. Transfusion avoidance philosophies and then increased use of autologous RBCs have become commonplace. This article puts a decision‐oriented slant on the risk and benefit of transfusion therapy. The issues behind the inability to discern a defined benefit as well as a commentary on the newly perceived risks is provided. Overall, when increased oxygen delivery is required, the addition of RBCs has an apparent survival benefit in some specific patients. In these patients the risk of transfusion‐related complication is minimized compared to the mortality outcome. For cancer and trauma patients, if transfusion is immunosuppressive and therefore detrimental, alternatives must be considered. The newest question is whether the act of transfusion, independent of the form, allogeneic or autologous, is of itself immunosuppressive.
Uncommon Sites of Hydatid Disease
Authors: Prousalidis J. , Tzardinoglou K. , Sgouradis L. , Katsohis C. , Aletras H. 
Published: August 2002

AbstractEchinococcosis remains an endemic surgical problem in many Mediterranean countries. We report our experience with such cases when the disease is located in uncommon sites, outside the liver and lungs. This study was an effort similar to a previous one but with more cases and additional information. Between 1967 and 1994 a total of 49 patients suffering from hydatid cysts located in various organs other than the liver and lungs presented to our clinic. There were 28 men and 21 women, with their ages ranging from 10 to 66 years and 22 to 80 years, respectively. Among these patients, 25 had the parasitic cyst in the peritoneal cavity, 10 in the spleen, 5 in the kidney, 3 in the spinal column, 2 in the retroperitoneal space, 1 in the abdominal wall, 1 in the myocardium, 1 in the thoracic wall, and 1 in the thigh. Their hospital stay was 9 to 88 days (average 27 days). Only two patients—one with cardiac hydatidosis and one with spinal hydatidosis—died postoperatively. Three patients with multiple cysts in the peritoneum and one with cysts in the thigh had recurrences of the disease and were reoperated successfully.
Effect of Duodenal Distension on the Pyloric Sphincter and Antrum and the Gastric Corpus: Duodenopyloric Reflex
Authors: Shafik Ahmed 
Published: August 2002

AbstractThe mechanical effect of balloon distension of the duodenum on the stomach was studied in 10 mongrel dogs with a mean weight of 14.8 ± 3.2 kg. The response of the pyloric sphincter and antrum as well as of the corpus of the stomach to duodenal distension by a balloon filled with water in increments of 2 ml, up to 6 ml, was determined. The test was repeated after anesthetizing the pyloric sphincter and antrum and the duodenum, each at a separate time. In 5 of 10 dogs the effect of duodenal distension on the vagotomized stomach was studied. Duodenal distension with 2 ml of water produced an increase in the pyloric sphincter pressure (p < 0.05) and a decrease in the antral pressure (p < 0.05); it had no effect on corporeal pressure (p > 0.05). Distension with 4 ml and 6 ml produced the same effect as 2 ml (p > 0.05). The anesthetized pyloric sphincter and antrum did not respond to duodenal distension. Likewise, the pyloric sphincter and antrum showed no response to distension of the anesthetized duodenum or of the duodenum after vagotomy. Pyloric sphincter contraction and antral dilatation upon duodenal distension suggest a reflex relation we call the duodenopyloric reflex. This reflex appears to prevent duodenopyloric reflux. Moreover, the antrum dilates probably to accommodate more gastric contents.
Intraoperative Insulin Measurement during Surgical Management of Insulinomas
Authors: Proye Charles , Pattou François , Carnaille Bruno , Lefebvre Jean , Decoulx Marc , d’Herbomez Michèle 
Published: August 2002

AbstractIntraoperative hormonal measurements have been used successfully to guide the surgical treatment of various endocrine diseases. In this study, we report the results of intraoperative insulin measurement (IIM) in patients with organic hypoglycemia. IIMs were performed during 52 operations in 51 patients. Hyperinsulinism was secondary to a sporadic insulinoma (M= 40), a type I multiple endocrine neoplasia (MEN‐I) (M= 8), an insulin‐secreting carcinoma (M= 1), or pancreatic nesidioblastosis (M= 2). The insulin was measured with a radioimmunologic assay in blood samples simultaneously drawn from a peripheral vein and the portal vein at the beginning of the operation (T1) and 20 minutes after tumor removal (T2). Normoglycemia was achieved after surgery in 50 cases (96%). Systemic and portal insulin levels were normal at T1 in eight patients, precluding any further interpretation of the test. Completeness of surgery was confirmed by normalization of both systemic and portal insulin levels at T2 in 36 patients. In seven cases the systemic or portal insulin levels (or both) remained elevated at T2 despite a favorable outcome after surgery. Failure of the surgical procedure was predicted in two patients by the persistence of high levels of insulin at T2. In patients with initially elevated serum insulin levels, the positive predictive value and the specificity of intraoperative insulin measurement for completeness of surgery were both 100%. The sensitivity was 84%, the negative predictive value 22%, and the accuracy of the test 84%. We concluded that IIM is a simple, highly reliable tool for predicting the completeness of surgery in patients with organic hypoglycemia. IIM appears to be a valuable addendum to the surgical armamentarium against insulinoma especially for patients with atypical causes, such as MEN, insulin‐secreting carcinoma, or pancreatic nesidioblastosis.
Are There Indications for Palliative Resection in Pancreatic Cancer?
Authors: Gouma D.J. , van Dijkum E.J.M. Nieveen , van Geenen R.C.I. , van Gulik T.M. , Obertop H. 
Published: August 2002

Abstract.Controversy exists about the indication for a palliative pancreatoduodenectomy. A palliative resection for patients with a pancreatic carcinoma can be performed safely nowadays with low mortality and acceptable morbidity in centers with experience. The early results in terms of mortality and morbidity are not different from resections with curative intent or even after bypass surgery. The procedure seems effective for controlling symptoms of the disease, and the quality of life after a palliative resection is acceptable and not worse than after bypass surgery. It is, however, still doubtful whether the incidence of symptom recurrence, such as jaundice, obstruction, and pain, is lower after resection than after bypass surgery. The longer survival after palliative resection could also be due to patient selection and postoperative treatment. There are no randomized trials to prove the superiority of palliative resection over bypass surgery. The safety of pancreatic resection for cancer has already changed the policy in centers with experience, and surgeons are more willing to perform a resection because the results are better or at least the same as after bypass surgery. There are, however, no results to confirm that a palliative resection should be performed routinely or to justify resection as a debulking procedure.
Clinical Trials
Authors: Kestle John R. W. 
Published: August 2002

Abstract.The randomized clinical trial (RCT) is often referred to as the gold standard for the assessment of treatment efficacy. RCTs are receiving greater attention in the literature and higher priority by funding agencies than they have in the past. In this paper, the basic principles of clinical trial design are reviewed using examples from the neurosurgical literature. The importance of designing the trial to answer one question well is emphasized.
Prospective Study of Gastric Outlet Obstruction in Unresectable Periampullary Adenocarcinoma
Authors: Shyr Yi‐Ming , Su Cheng‐Hsi , Wu Chew‐Wun , Lui Wing‐Yiu 
Published: August 2002

AbstractControversy persists regarding the role of prophylactic gastrojejunostomy in patients with unresectable periampullary adenocarcinoma. In review of the retrospective series, presence of gastric outlet obstruction (GOO) has been claimed to be a bad prognostic sign. This prospective study aimed to clarify the necessity of routine prophylactic gastrojejunostomy in patients with unresectable periampullary adenocarcinoma. The incidence and prognostic significance of GOO were also evaluated. Sixty‐six patients with unresectable periampullary adenocarcinoma were enrolled. They were divided into 2 groups to receive either a single biliary bypass or a double bypass (concomitant gastric and biliary bypasses) if they had GOO. The single bypass group was followed up to assess the incidence of GOO and subsequent need of a gastric bypass. Prognostic factors were evaluated by univariate and multivariate analyses. Forty‐four (67%) of the overall 66 patients presented with GOO at the time of diagnosis. There was no statistical difference regarding the morbidity and mortality between the 2 groups, except longer (7 days) hospital stay in the double bypass group. Seven (31.8%) of the 22 patients in the single bypass group subsequently developed GOO an average of 6.2 ± 1.0 months after their initial biliary bypass. By univariate analysis, significant prognostic factors for unresectable periampullary adenocarcinoma were: GOO (p= 0.0379), pancreatic head origin (p= 0.0146 by univariate analysis), and distant metastasis (p < 0.0001). After multivariate analysis, only pancreatic head origin and distant metastasis remained significant independent factors of poor prognosis. In conclusion, gastrojejunostomy should be performed prophylactically in addition to a biliary bypass in patients with unresectable periampullary adenocarcinoma. The presence of GOO is not an independent factor of poor prognosis, but a reflection of the aggressive biologic behavior of pancreatic head adenocarcinoma.
Asynchronization of local population dynamics and persistence of a metapopulation: a lesson from an endangered composite plant, Aster kantoensis
Authors: Shimada M. , Ishihama F. 
Published: August 2002

AbstractFragmentation of a large habitat makes local populations less linked to others, and a whole population structure changes to a metapopulation. The smaller a local population is, the more strengthened extinction factors become. Then, frequent extinctions of local populations threaten persistence of the metapopulation unless recolonizations occur rapidly enough after local extinctions. Spatially structured models have been more widely used for predicting future population dynamics and for assessing the extinction risk of a metapopulation. In this article, we first review such spatially structured models that have been applied to conservation biology, focusing on effects of asynchronization among local population dynamics on persistence of the whole metapopulation. Second, we introduce our ongoing project on extinction risk assessment of an endangered composite biennial plant, Aster kantoensis, in the riverside habitat, based on a lattice model for describing its spatiotemporal population dynamics. The model predicted that the extinction risk of A. kantoensis depends on both the frequency of flood occurrence and the time to coverage of a local habitat by other competitively stronger perennials. Finally, we present a measure (Hassell and Pacala's CV2) for quantifying the effect of asynchronization among local population dynamics on the persistence of a whole metapopulation in conservation ecology.
Hepatic lobe torsion in 3 dogs and a cat
Authors: Swann Heather M. , Brown Dorothy Cimino 
Published: August 2002

Objective—To describe the clinical features of hepatic lobe torsions in 3 dogs and 1 cat.Study Design—Retrospective clinical study.Animals—Three client‐owned dogs and 1 client‐owned cat.Methods—Medical records were reviewed, and information regarding signalment, clinical signs, physical‐exam findings, diagnostic tests performed, treatment, outcome, and follow‐up was retrieved.Results—Clinical signs existed for 4 hours to 1 week before examination. Signs were nonspecific in 2 animals that did not have an obvious cause for the hepatic torsion. These signs consisted of lethargy (2), polyuria/polydypsia (2), and anorexia (1). In the other 2 animals, signs were suggestive of the underlying cause of the hepatic lobe torsion. In 1 dog, the torsion was associated with a traumatic diaphragmatic hernia. The cat had a concurrent hemoabdomen secondary to a ruptured hepatocellular carcinoma. Bloodwork abnormalities were nonspecific. Twisted liver lobes included the left lateral lobe (2), the caudate lobe (1), and the right medial lobe (1). Surgical resection (2) or repositioning (1) of the affected liver lobe was attempted in the 3 dogs, and was successful in 2.Conclusions—Hepatic lobe torsion is a rare problem but has been reported in humans, rabbits, dogs, pigs, a cat, and a horse. The left lateral liver lobe is most frequently affected. This condition may be idiopathic or associated with neoplasia or absence of ligamentous support (congenital or traumatic) to the liver.Clinical Relevance—Prompt surgical resection or repositioning of the involved liver lobe can lead to a successful outcome, avoiding the deleterious effects of venous obstruction such as thrombosis and subsequent necrosis.
Analysis of Factors Affecting Survival in Dogs With Aortic Body Tumors
Authors: Ehrhart Nicole , Ehrhart E. J. , Willis Jennifer , Sisson David , Constable Peter , Greenfield Cathy , Manfra‐Maretta Sandra , Hintermeister John 
Published: August 2002

Objective—To evaluate the effect of perioperative and operative variables on survival time in dogs with aortic body tumors.Study Design—Retrospective study.Sample Population—Twenty‐four client‐owned dogs with histologically confirmed aortic body tumor.Methods—Seventy‐eight patient records of dogs seen at the University of Illinois Veterinary Teaching Hospital between 1989 and 1999 with a diagnosis of a heart‐base mass were reviewed. Dogs without histologic conformation of an aortic body tumor were excluded. Age; sex; breed; the presence of pleural effusion, pericardial effusion, or abdominal effusion; evidence of cardiac arrhythmias; evidence of distant metastasis; treatment with pericardectomy; treatment with chemotherapy; and time from diagnosis until euthanasia or death were recorded on a spreadsheet. Cox proportional‐hazard ratios were used to calculate the relationship of risk variables to survival time. Median survival time was determined using life‐table analysis.Results—Twenty‐four dogs met the criteria for inclusion in the study. The median age of dogs with aortic body tumors was 9 years. All dogs had a surgical biopsy performed. Fourteen dogs had a pericardectomy at the time of the biopsy procedure. Of all factors analyzed, only treatment with pericardectomy had a significant influence on survival (P= .0029). Dogs that had pericardectomy survived longer (median survival, 730 days; range, 1–1,621 days) compared with dogs that did not have pericardectomy (median survival, 42 days; range, 1–180 days). This finding was independent of the presence or absence of pericardial effusion at the time of surgery.Clinical Relevance—Dogs that are diagnosed with aortic body tumors may benefit from a pericardectomy at the time of surgical biopsy.
Innovation in the food industry
Authors: Traill W. Bruce , Meulenberg Matthew 
Published: August 2002

AbstractTwelve food‐manufacturing companies in six European countries have been studied with respect to the way in which they innovate, their motivations, and their emphasis on product or process innovation. It is suggested that the traditional “demand‐pull” versus “technology‐push” versus “a mixture of both” debate is too simplistic. Firms behave differently depending on their dominant “orientations” towards the product, the process, or the market, the types of market they supply (particularly whether they supply branded or private‐label products), the nature of their ownership (public, private, co‐operative), market size and scope, and company size. The suggestions of the case studies are, in general, supported by quantitative results from a survey of food manufacturers, though the survey was not designed specifically for this purpose and further quantitative model development is proposed. The findings reported in this article and the proposed refinements are important to firms and policy‐makers concerned with the efficiency and effectiveness of food industry innovation [JEL Classification Codes: L100, L200, L660] © 2002 Wiley Periodicals, Inc.
Treatment of sinus histiocytosis with massive lymphadenopathy (rosai‐dorfman disease): Report of a case and literature review
Authors: Pulsoni Alessandro , Anghel Gabriel , Falcucci Paolo , Matera Roberta , Pescarmona Edoardo , Ribersani Michela , Villiva' Nicoletta , Mandelli Franco 
Published: August 2002

AbstractSinus histiocytosis with massive lymphadenopathy (SHML) is a rare disorder of unknown etiology, usually associated with lymph node enlargement in various superficial or deep sites. It usually shows a prolonged clinical course with occasional exacerbation and remission phases. We describe the long‐term follow‐up of a case of SHML that showed typical clinical features and in which various therapeutic strategies were attempted. Chemotherapy and α‐interferon (IFN) were ineffective; surgery was ultimately required with satisfactory results. From an extensive literature review we found different treatment strategies in SHML in the 80 cases published between 1969 and 2000. Spontaneous resolution of adenopathies is frequently observed: 32 out of 40 cases which did not receive chemotherapy, radiotherapy, or surgery were healthy at the time of publication. Radiotherapy alone showed conflicting results: 3 complete remissions (CR) were obtained in the 9 patients treated. Surgical debulking when required was effective—8/9 CR—while chemotherapy showed generally negative results. IFN has been previously employed in only one case. In conclusion, clinical observation without treatment is advisable when possible. In the presence of vital organ compression and/or extranodal localization with important clinical signs, surgical debulking may be necessary. Radiotherapy has shown limited efficacy, while chemotherapy is in general ineffective. More experience is needed to evaluate the role of IFN. Am. J. Hematol. 69:67‐71, 2002. © 2002 Wiley‐Liss, Inc.