bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior Approach for Difficult Major Right Hepatectomy
Authors: Lai Edward C.S. , Fan Sheung‐Tat , Lo Chung‐Mau , Chu Kent‐Man , Liu Chi‐Leung 
Published: August 2002

AbstractIn selected patients with huge right hepatic tumors that had infiltrated the surrounding structures, injudicious mobilization of the liver before transection, as in the conventional manner, may result in excessive bleeding, prolonged ischemia from rotation of the hepatoduodenal ligament, and spillage of cancer cells into the systemic circulation. Alternatively, the “anterior” approach, which involves initial completion of the parenchymal transection before the right hepatic lobe is mobilized, can be adopted for these patients with difficult right hepatic tumors. After hilar control of the inflow vessels, liver parenchyma was transected using an ultrasonic dissector until the anterior surface of the inferior vena cava is exposed. The right hepatic lobe is then mobilized laterally by securing all venous tributaries, including the right hepatic vein. The prospective data of 25 patients who had major right hepatectomy using the “anterior” approach were compared with data from 34 patients who had their operation performed in the conventional manner. Despite the facts that larger tumors (p< 0.004), more extrahepatic structures (p< 0.05), and the caudate lobes (p< 0.03) were resected, the amount of perioperative blood transfusion, fluid replacement, and outcome between the two groups of patients were comparable. There were three hospital deaths, among which one could be attributed to an intraoperative catastrophe during hepatectomy using the conventional approach. The “anterior” approach is a safe, effective option for selected patients undergoing complicated major right hepatectomy.
Prophylactic Surgery for Multiple Endocrine Neoplasia Type IIa after Genetic Diagnosis: Is Parathyroid Transplantation Indicated?
Authors: Decker Ruth A. , Geiger James D. , Cox Charles E. , Mackovjak Marilyn , Sarkar Minakshi , Peacock Michael L. 
Published: August 2002

AbstractIdentification of germline mutations in theRETproto‐oncogene predisposing to multiple endocrine neoplasia type IIa (MEN‐IIa) has allowed a DNA‐based approach to diagnosis and treatment by prophylactic thyroidectomy in children testing genetically positive. Although total thyroidectomy is the accepted operation for C cell disease, the necessity of routine total parathyroidectomy and autotransplantation as previously described in these asymptomatic children is questionable, particularly given the low occurrence of hyperparathyroidism in MEN‐IIa (10–20%). Thirty‐six children (ages 1 month to 12 years) from four MEN‐IIa kindreds at risk for disease underwent genetic testing. Mutational analysis was done using a highly sensitive PCR‐based denaturing gradient gel electrophoresis technique. Parathyroid or serum calcium concentrations were determined preoperatively. Of the 36 children at risk, 18 were found to have a MEN‐IIa mutation; 11 have undergone prophylactic thyroidectomy at ages ranging from 2 to 12 years (mean 7.5 years). In each case, there was no biochemical evidence of hypercalcemia preoperatively, and all parathyroid glands were identified and were found to be grossly normal at exploration. Glands were carefully dissected and left in situ. Postoperatively, 10 of the 11 children maintained normocalcemia, allowing discharge within 24 to 36 hours. Resected thyroid glands contained C cell hyperplasia in nine, medullary carcinoma in one, and normal histology in one. We conclude that an alternative to routine parathyroidectomy may be desirable for prophylactic treatment of MEN‐IIa. In situ parathyroid preservation can be safely achieved without compromising the completeness of the thyroid resection. This conservative approach obviates the potential morbidity associated with total parathyroidectomy and autotransplantation.
Gip‐2Codon 179 Oncogene Mutations: Absent in Adrenal Cortical Tumors
Authors: Demeure Michael J. , Doffek Kara M. , Komorowski Richard A. , Gorski Jack 
Published: August 2002

AbstractThe role of G protein mutations in the pathogenesis of adrenal cortex neoplasms is controversial. Two published studies disagree on the existence of a cysteine or histidine for arginine substitution at position 179 (R179C/H) of the GTP binding region of the α chain of an inhibitory G protein (Gi2α) in these tumors. Prior studies using detection by mutation‐specific oligonucleotide hybridization showed either 3 of 11 or 0 of 56 tumors harbored mutations. To resolve this discrepancy and ascertain the importance of the R179C/H Gi2α mutation in the development of adrenal cortex tumors, we screened tumors from 29 patients (24 with adenoma, 5 with carcinoma) using a more sensitive assay employing polymerase chain reaction (PCR) and examination for restriction fragment length polymorphisms (RFLP). Detection of the potential R179C/H mutation by this technique was possible because the wild‐type coding sequence includes the BSTU‐1 restriction endonuclease recognition site CGCG, whereas the mutated gene does not. Results showed complete digestion of the amplified DNA samples from all 29 patients and the negative control DNA by BSTU‐1, indicating that all tumor samples exhibited only the wild‐type sequence. Direct sequencing of PCR product from four tumor samples confirmed the presence of only the wild‐type sequence. The 0 of 29 rate of R179C/H mutations we found in Gi2α is different than the 3 of 11 positive rate (p< 0.05, Fishers’ exact) previously reported but agrees with the report showing 0 of 56 mutations. We conclude a mutation at position 179 of Gi2α is not important in the pathogenesis of most adrenal cortical tumors.
History of Perforated Duodenal and Gastric Ulcers
Authors: Lau W.Y. , Leow C.K. 
Published: August 2002

AbstractPerforated peptic ulcer as a disease entity has been known since 167 bc. Surgical and nonsurgical treatment strategies for perforated peptic ulcer disease were not developed until the latter half of the nineteenth century. The history of the gradual evolution of the various forms of treatment adopted for the conditions over the last century and a half is described.
Is Percutaneous Cholecystostomy the Optimal Treatment for Acute Cholecystitis in the Very Elderly?
Authors: Sugiyama Masanori , Tokuhara Makoto , Atomi Yutaka 
Published: August 2002

AbstractIn elderly patients emergent cholecystectomy for acute cholecystitis is a high risk procedure. We prospectively assessed the value of percutaneous cholecystostomy for acute cholecystitis in 38 consecutive elderly (≥ 80 years) patients. All 38 underwent percutaneous transhepatic cholecystostomy under ultrasonographic and fluoroscopic guidance for acute cholecystitis (25 calculous, 13 acalculous). Eight (21%) patients had acute severe medical problems, such as shock and respiratory distress. Thirty‐one (82%) patients had chronic severe underlying diseases, including cardiovascular and neurologic diseases. Cholecystostomy was successful in all 38 patients. Prompt clinical improvement was obtained in 36 (95%) patients. Morbidity and mortality rates were 3% and 3%, respectively. After cholecystostomy, 10 patients with cholelithiasis underwent elective cholecystectomy without serious complications. Two patients underwent percutaneous cholecystolithotomy, which produced complete resolution of symptoms. Four of 12 patients with and none of 12 without cholelithiasis had recurrent cholecystitis after catheter removal during a mean follow‐up of 1.8 years. A second cholecystostomy was successful in these four patients. Elderly patients are often poor surgical candidates because of severe cholecystitis or concomitant medical problems. Percutaneous cholecystostomy is a safe, effective treatment for acute cholecystitis even in elderly patients. For calculous cholecystitis, cholecystostomy can be followed by elective surgery, if possible, or by nonsurgical treatment or expectant conservative management in high‐risk patients. Cholecystostomy may be a definitive treatment for acalculous cholecystitis.
Expression of Inducible Nitric Oxide Synthase in Circulating Neutrophils of the Systemic Inflammatory Response Syndrome and Septic Patients
Authors: Tsukahara Yasuhiro , Morisaki Takashi , Horita Yoshiyuki , Torisu Motomichi , Tanaka Masao 
Published: August 2002

AbstractThere is increasing evidence that nitric oxide (NO) is an important factor in the pathogenesis of septic shock. It is known that polymorphonuclear neutrophils (PMNs) are activated during sepsis or after surgical stress, and they then release various toxic mediators including free radicals. It has not been clear whether NO synthesis can be induced in circulating PMNs. Blood samples were obtained from 11 patients with sepsis, 23 patients with systemic inflammatory response syndrome (SIRS), and 16 patients without SIRS (nonSIRS) who underwent operation. We examined mRNA expression of inducible NO synthase (iNOS) in circulating PMNs from those patients pre‐ and postoperatively using the reverse transcriptase polymerase chain reaction (RT‐PCR) method and measured their serum nitrate (NO2\‐) + nitrate (NO3\‐) concentration, peripheral blood white blood cell (WBC) count, and serum C‐reactive protein (CRP) level. The frequency of iNOS expression in PMNs increased in sepsis (100%) and SIRS (70%) patients compared to that in nonSIRS patients (18%) (p < 0.001). The peripheral WBC count and CRP level were significantly higher in iNOS‐positive patients than in iNOS‐negative patients (p < 0.05 andp < 0.01, respectively). Postoperatively, the serum NO2\‐+ NO3\‐ concentration increased in 87% of septic patients and in 56% of patients with SIRS (p < 0.05 for both). Our study indicated that iNOS mRNA expression is induced in human circulating PMNs of patients with postoperative sepsis and SIRS and may be involved in the pathogenesis of the sepsis syndrome.
Current Status of Indications for Surgery in Peptic Ulcer Disease
Authors: Jamieson Glyn G. 
Published: August 2002

AbstractThe eradication of Helicobacter pylori in patients with peptic ulcer disease has greatly diminished the need for antiulcer surgery. However, in societies where such drug therapy is considered too expensive and because occasional patients remain refractory to optimal medical therapy, elective surgery for duodenal ulcer disease is still carried out. If the required expertise is available, it can be undertaken laparoscopically. The advent of endoscopic therapies such as heater probe therapy and injection sclerotherapy has also greatly diminished the need for emergency surgery in bleeding peptic ulcer disease. Once again, however, when such therapy fails surgery is still indicated. Even with perforated peptic ulcer disease the role of surgery has receded somewhat, but here not because of changes in drug therapy. Nonoperative management of perforation is indicated in fit patients if the diagnosis is in doubt, in any patient when surgical facilities are unavailable (e.g., remote geographic areas, on board ship), or when a patient is extremely ill either because of co‐morbidity or late presentation of the disease. Operation should be considered in all patients when the perforation is established to be unsealed, particularly after a trial of conservative management, and in all patients who are otherwise fit.
Wound Healing Associated with Severe Surgical Illness
Authors: Clark Matthew A. , Plank Lindsay D. , Hill Graham L. 
Published: August 2002

Abstract.Severe injury or infection is associated with a hypermetabolic response that, when excessive, results in impaired wound healing and as a consequence increased morbidity and mortality. The objective examination of wound healing in humans is difficult and generally requires the use of models. Evidence is accumulating that nutritional and growth factors play important roles in improving the wound healing response, particularly after thermal injury and uncomplicated major surgery. The septic patient represents the biggest challenge to those seeking to optimize wound healing capacity. Advances in molecular biology have provided promising therapies in experimental studies of wound healing that await clinical investigation.
Current status of the threatened amphibians and reptiles of Japan
Authors: Ota H. 
Published: August 2002

AbstractThis article compares amphibian and reptile components of the original and revised versions of the Red List of Japan, and analyzes geographic patterns of, and major threats to, species and subspecies now assigned to the threatened categories. The numbers of both amphibians and reptiles categorized as threatened in the Red List of Japan have increased greatly through its revision as a result of recent progress in the taxonomy of these groups in Japan, the introduction of new criteria for risk assessment, and unexpectedly rapid declines in the status of several taxa. Threatened taxa of amphibians and reptiles in the revised list tend to be concentrated in the Ryukyu Archipelago, where deforestation seems to be the major ultimate cause of declines. Reduction in the quality and quantity of inland water environments seems to be the major cause of declines in several endemic amphibians from the main islands of Japan. The importance of conservation was emphasized in the revised list by progress in taxonomy, by new insights and data on the estimation of temporal dynamics of population density or habitat size for threatened taxa, and by the impacts of and need to prevent further deforestation in the Ryukyus and of the ongoing destruction of inland water habitats on the main islands of Japan.
Comparison of Skin Staples With Sutures for Anastomosis of the Small Intestine in Dogs
Authors: Coolman Bradley R. , Ehrhart Nicole , Pijanowski Gerald , Ehrhart E.J. , Coolman Shindok L. 
Published: August 2002

Objectives—To develop a technique for approximation of end‐to‐end intestinal anastomoses by using a disposable skin stapler and to compare the stapling technique with an interrupted hand‐sewn approximating end‐to‐end anastomosis of the canine jejunum.Study Design—In vitro evaluation of the stapling technique, followed by an in vivo study of healing and clinical response in dogs.Animal Population—18 mixed‐breed adult dogs.Methods—The anastomotic technique was developed and tested in fresh canine jejunum. Fourteen stapled approximating anastomoses (SAA) and 14 hand‐sewn approximating anastomoses (HAA) were performed in 6 cadavers under simulated surgical conditions. Anastomotic construction times, initial bursting strengths, initial lumen diameters, and gross appearance of the 2 techniques were compared. Healing and clinical response were evaluated in 12 purpose‐bred dogs assigned to 2 groups of 6 animals each. Each dog had 1 SAA and 1 HAA performed in the jejunum, 50 cm apart. Six dogs were killed on postoperative day 4, and 6 dogs were killed on postoperative day 21. Anastomotic construction time, gross and histological healing, bursting strength, lumen diameter, and circumference were compared between techniques.Results—Mean construction time for SAA was significantly faster than for HAA (P= .0001). None of the anastomoses leaked, and there were no major clinical complications in any dog. Bursting strengths were not significantly different at any time for the 2 techniques. Initial bursting strength was 31% to 35% of the normal jejunum. A nonsignificant decrease in bursting strength was observed by postoperative day 4 (26% to 28% of normal), and a significant increase in bursting strength was observed by postoperative day 21 (100% to109% of normal). Neither technique decreased the initial lumen diameter. However, both techniques resulted in a similar degree of luminal stenosis as the anastomoses healed. Anastomotic lumen diameter was significantly decreased from normal in both groups at day 4 (86% to 88% of normal) and day 21 (90% to 91% of normal). There was no significant difference between the circumference of the anastomoses and normal jejunum at any time. Histological analysis showed similar healing for the hand‐sewn and stapled techniques at 4 and 21 days after surgery. For both surgical techniques, day 21 anastomoses had significantly less inflammation and necrosis, significantly more fibrosis, and significantly better continuity of histological layers when compared with day 4 anastomoses.Conclusion—Approximating end‐to‐end intestinal anastomosis with a skin stapler is equivalent in bursting strength, lumen diameter, lumen circumference, and healing characteristics to the traditional hand‐sewn technique, but it can be performed in significantly less time.Clinical Relevance—Skin stapling devices can be used to create technically simple, rapid, and safe end‐to‐end anastomoses in canine jejunum.
Clinical Experiences With Axial Deviation of the Aryepiglottic Folds in 52 Racehorses
Authors: King Dana S. , Tulleners Eric , Martin Benson B. , Parente Eric J. , Boston Ray 
Published: August 2002

Objective—To describe the clinical findings in 52 racehorses with axial deviation of the aryepiglottic folds (ADAF) and to report outcome in 33 of these horses after either rest or transendoscopic laser excision of aryepiglottic fold tissue.Study Design—Retrospective study.Animal or Sample Population—Racehorses admitted for high‐speed treadmill (HST) evaluation of poor performance.Methods—Medical records and videotapes of resting and exercising videoendoscopic examinations were reviewed. Racing performance records and owner or trainer interviews, at least 1 year after HST examination, were used to compare results after either surgical management or rest in 33 horses with ADAF and no other upper‐airway abnormalities.Results—ADAF occurred in 6% of horses evaluated for poor performance. No breed or gender predisposition existed, but horses with ADAF were younger than the overall population evaluated on the HST. Of 52 horses with ADAF, 19 horses had at least one other upper‐airway abnormality. There was no apparent association between ADAF and other causes of dynamic upper‐respiratory obstruction. Surgical correction was successfully performed in standing or anesthetized horses without complications. When ADAF was the only upper‐airway obstruction, 75% of horses that had surgery and 50% of rested horses had objective improvement in performance. Owners and trainers also perceived greater improvement in performance in horses that had surgery.Conclusions—Whereas surgical management of ADAF is recommended, clinical experience indicated that it is not required to resolve ADAF in all horses. However, owners and trainers of horses that had surgery were more satisfied with outcome than those with horses managed conservatively.Clinical Relevance—Diagnosis of ADAF can only be made by videoendoscopic evaluation during high‐speed exercise. Transendoscopic laser excision of the collapsing portion of the aryepiglottic folds can be performed safely in standing horses and results in resolution of airway obstruction and rapid return to training.
Mutational Analysis of the Three Conserved Valine Residues of Insulin and a Proposal of “Isosteric Residue”
Authors: Guo Zhan‐Yun , Tang Yue‐Hua , Zhang Zhou , Feng You‐Min 
Published: August 2002

AbstractTo further understand the role of the three conserved Val residues in insulin, B12Val, B18Val, and A3Val, five insulin mutants‐‐[A3Ser]insulin, [B12Thr]insulin, (desB30)[B12Ser]insulin, [B18Thr] insulin, and [B18Leu]insulin‐‐were obtained by means of site‐directed mutagenesis and their receptor‐binding activities as well as in vivo biological potencies were measured. The two B18 mutants, [B18Thr]insulin and [B18Leu]insulin, both retained relatively high receptor‐binding activities (70% and 30% of native porcine insulin, respectively) as well as relatively high in vivo biological potencies. The receptor‐binding activities of [B12Thr]insulin and (desB30)[B12Ser]insulin were 5.1% and 0.2%, respectively. However the in vivo biological potency of [B12Thr]insulin was still about 50% of native insulin, whereas that of (desB30)[B12Ser]insulin decreased drastically. The [A3Ser]insulin retained 1.4% of the receptor‐binding activity and low in vivo biological potency. These results, together with previous reports showed that when the three conserved Val residues were replaced by residues containing a β‐branched side‐chain, such as Thr or Ile, the insulin mutants retained higher biological activities than those mutants replaced by other residues. Here we propose that Val, Thr, and Ile are “isosteric residues” because they all contain a β‐branched side‐chain. This proposal may have perhaps general significance in protein design and protein engineering.
Polyimide Foams for Aerospace Vehicles
Authors: Weiser Erik S , Johnson Theodore F , St Clair Terry L , Echigo Yoshiaki , Kaneshiro Hisayasu , Grimsley Brian W 
Published: August 2002

Due to a demand by the aerospace industry, NASA has begun developing the next generation of polyimide foams which could be utilized to reduce vehicle weight for the X-33 and Reusable Launch Vehicle (RLV) programmes. The activity at NASA Langley Research Center focuses on developing polyimide foam and foam structures which are made using monomeric solutions or salt solutions formed from the reaction of a dianhydride and diamine dissolved in a mixture of foaming agents and alkyl alcohols. This process can produce polyimide foams with varying properties from a large number of monomers and monomer blends. The specific densities of these foams can range from 0.008 g cc−1 to 0.32 g cc−1. Polyimide foams at densities of 0.032 g cc−1 and 0.08 g cc−1 were tested for a wide range of physical properties. The foams demonstrated excellent thermal stability at 321°C, a good thermal conductivity at 25°C of 0.03 W m−1 K−1, compressive strengths as high as 0.84 MPa at 10% deflection and a limiting oxygen index of 51%. Thermomechanical cyclic testing was also performed on these materials for 50 cycles at temperatures from −253°C to 204°C. The foams survived the cyclic testing without debonding or cracking. Thermal forming of the 0.032 g cc−1 foam was performed and a minimum radius curvature of 0.0711 m was achieved. The foams exhibited excellent properties overall and are shown to be viable for use as cryogenic insulation on the next generation RLV.
Layoffs and violence revisited
Authors: Catalano Ralph , Novaco Raymond W. , McConnell William 
Published: August 2002

AbstractExtension of frustration‐aggression theory suggests both the “provocation hypothesis” (laid‐off workers are at elevated risk of psychogenic violence) and the “inhibition hypothesis” (workers who fear job loss will be at reduced risk of such violence). Previous research found that both hypotheses were supported with data indexing layoffs and the incidence of civil commitment for danger to others in San Francisco County, California, for the 52 weeks beginning August 1, 1993. Whether those results generalize to other times and places has not been determined. We elaborated the theory and replicated the test in San Francisco for the 149 weeks beginning August 1, 1994, and ending June 7, 1997. We also replicated the test using data from Allegheny County, Pennsylvania, for the 111 weeks beginning January 1, 1996, and ending February 28, 1998. The original results from San Francisco County are replicated for men in both communities. The results for women are replicated for the new and more extended period in San Francisco County but not in Allegheny County. Scientific and social policy reasons for continued study of economic conditions on aggressive behavior are discussed.Aggr. Behav. 28:233–247, 2002. © 2002 Wiley‐Liss, Inc.