bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifactorial analysis of septic bile and septic complications in biliary surgery
Authors: Landau Ofer , Kott Itamar , Deutsch Alexander A. , Stelman Eldad , Reiss Rafael 
Published: August 2005

AbstractA unifactorial analysis for possible risk factors was applied to 2,700 consecutive operations for benign disease of the biliary tract. A series of high risk factors in relation to positive bacteriology and septic complication could be identified. These risk factors were patients who were elderly (>70 years;p<0.001), those who were diabetic, those who had a serum bilirubin >1.1 mg% (p<0.001), those who had acute cholecystitis (p<0.001), and those in whom choledochal stones were found (p<0.001). Using a multivariate analysis, we concluded that in patients with no risk factors (56.9%) the incidence of a positive bacteriology was low (10.9%) and they should receive no antibiotic prophylaxis. Patients with one risk factor (24%), had a 36% incidence of positive bacteriology and minimal pre‐operative prophylaxis is recommended. Patients with two or more risk factors (19.1%) had a 77.6% incidence of positive bacteriology and full peri‐operative prophylaxis is recommended, starting pre‐operatively and continuing for 3 to 5 days postoperatively. The aim of this study was to identify patients at risk for septic complication in biliary surgery and to create new guidelines for the antibiotic treatment of selected groups.
Small bowel anastomosis with the biofragmentable anastomosis ring and manual suture: A prospective, randomized study
Authors: Gullichsen Risto , Ovaska Jari , Rantala Arto , Havia Tapani 
Published: August 2005

AbstractA total of 170 patients undergoing upper gastrointestinal surgery requiring a jejuno‐jejunal enteroanastomosis were randomized into two groups according to the method to be employed at the enteroanastomosis. The most common procedures were partial gastrectomy for benign disease (84 patients), partial or total gastrectomy for malignant disease (35 patients), and bilioenteral bypass (31 patients, 25 for malignant disease). The enteroanastomosis was created by manual suture (3‐0 Dexon®, two layers) in 89 patients and with the Biofragmentable Anastomosis Ring (Valtrac‐BAR®) in 81 patients. Both end‐to‐side (101 patients) and side‐to‐side (69 patients) reconstructions were done. No ruptures or obstructions of the jejuno‐jejunal anastomosis occurred. The postoperative recovery of the gastrointestinal tract was similar in the two groups in duration of nasogastric drainage, intravenous fluid therapy, and intestinal paralysis. Nor was there any difference between the groups in the duration of the postoperative hospital stay. Ten patients, 7 in suture‐group and 3 in BAR‐group, died postoperatively of causes unrelated to the enteroanastomosis. Thus the mortality rate was 7.9% in the suture group and 3.7% in the BAR group. The biofragmentable ring offers a safe alternative to manual sutures for small bowel anastomoses.
Chondrosarcomas of the head and neck
Authors: Ruark Deborah S. , Schlehaider Uwe K. , Shah Jatin P. 
Published: August 2005

AbstractChondrosarcomas of the head and neck are uncommon. Over a 35‐year period (1950–1985) at our institution, 557 patients had an established diagnosis of chondrosarcoma. In 28 (5%) of these patients, the tumor was located in the head and neck region. A retrospective analysis was performed in an attempt to accurately define clinical characteristics, management, and outcome in these 28 patients. The patient population consisted of 15 males and 13 females whose ages ranged from 10 to 72 years, with a median of 38 years. Ten (36%) patients were untreated and 18 (64%) previously treated patients were referred for further management. The primary sites were maxilla (11), cervical vertebrae (7), mandible (3), skull (2), sphenoid and ethmoid sinuses (2), frontal sinus (1), nasal septum (1), and orbit (1). Lesions arising in the larynx were excluded from this study. The most common presenting symptom was a painless mass. Surgery was the definitive treatment in all patients. However, adjuvant radiation therapy or chemotherapy was utilized for residual disease in almost half of the cases (13 patients). Follow‐up ranged from 5 to 35 years. Twelve (43%) of the 28 patients were known to be alive and free of disease more than 5 years after surgery. The most common cause of death was uncontrollable local disease (88%). However, only 3 of the 10 previously untreated patients developed local recurrence. For all patients, the median interval from time of first recurrence until death was 25 months (range 6 to 70 months). Positive margins in 8 of 12 patients resulted in local recurrence and eventual death. Distant metastases were documented in 18% of patients, most often involving the lungs. Analysis of a subgroup of patients treated more recently (1975–1985) reveals 7 (78%) of 9 patients to be alive and free of disease at 5 years postoperatively.
Burn depth: A review
Authors: Heimbach David , Engrav Loren , Grube Baiba , Marvin Janet 
Published: August 2005

AbstractDespite the plethora of technologic advances, the most common technique for diagnosing burn depth remains the clinical assessment of an experienced burn surgeon. It is clear that this assessment is accurate for very deep and very shallow burns. But since clinical judgment is not precise in telling whether a dermal burn will heal in 3 weeks, efforts to develop a burn depth indicator are certainly warranted to accurately determine which dermal burns to excise and graft. This review summarizes the considerable literature in which a variety of techniques to determine burn depth have been used.
Burn shock resuscitation
Authors: Warden Glenn D. 
Published: August 2005

AbstractThe goal of fluid resuscitation in the burn patient is maintenance of vital organ function at the least immediate or delayed physiological cost. To optimize fluid resuscitation in severely burned patients, the amount of fluid should be just enough to maintain vital organ function without producing iatrogenic pathological changes. The composition of the resuscitation fluid in the first 24 hours postburn probably makes very little difference; however, it should be individualized to the particular patient. The utilization of the advantages of hypertonic, crystalloid, and colloid solutions at various times postburn will minimize the amount of edema formation. The rate of administration of resuscitation fluids should be that necessary to maintain satisfactory organ function, with maintenance of hourly urine outputs of 30 cc to 50 cc in adults and 1–2 cc/kg/% burn in children. When a child reaches 30 kg to 50 kg in weight, the urine output should be maintained at the adult level. With our current knowledge of the massive fluid shifts and vascular changes that occur, mortality related to burn‐induced hypovolemia has decreased considerably. The failure rate for adequate initial volume restoration is less than 5% even for patients with burns of more than 85% of the total body surface area. These improved statistics, however, are derived from experience in burn centers, where there is substantial knowledge of the pathophysiology of burn injury. Inadequate volume replacement in major burns is, unfortunately, common when clinicians lack sufficient knowledge in this area.
Benefits and limitations of burn wound excision
Authors: Monafo William W. , Bessey Palmer Q. 
Published: August 2005

AbstractThis review is intended to provide a balanced view of the role of surgical burn wound excision and closure within the larger context of the total care and rehabilitation of patients with burn injury. The historical background leading to present practice is outlined. The salient technical and logistical problems associated with the performance of wound excision are discussed, with emphasis on the necessity for expeditiously completing these procedures which are associated with major blood loss. A realistic analysis of the results of excisional therapy in patients with burns of varying severity is presented. Benefits attributable to the surgical phase of therapy become progressively more difficult to identify as the size of deep burns increases beyond 20% of total body surface area.
Burn wound closure using permanent skin replacement materials
Authors: Tompkins Ronald G. , Burke John F. 
Published: August 2005

AbstractOver the past decade, very significant advances in the development of clinically useful, permanent skin replacement materials have taken place. The most prominent and successful approaches to the physiological closure of an open wound have been either by creating a totally artificial dermal matrix material, by using culture techniques to expand cell populations for autologous transplantation, or by using a combination of these methods. As a result of substantial early progress in this field, permanent skin replacement materials as a treatment modality promise significant contributions to improved wound management and increased survival rates for patients with devastating soft tissue destruction such as massive burn injuries.
Evaluation of the laparoscopic cholecystectomy on patients with simple and complicated cholecystolithiasis
Authors: Fabre Jean M. , Pyda Przemyslaw , de Charles Seguin des Hons , Lepage Bernard , Balmes Michel , Baumel Hughes , Domergue Jacques 
Published: August 2005

AbstractLaparoscopic cholecystectomy is now a well described method for the treatment of cholelithiasis. The purpose of this paper is to define its implementation, limits, risks and indications. Following a prospective method, the results of this treatment were compared in 187 patients with simple cholelithiasis and 75 patients with complicated cholelithiasis. Cholecystectomy was performed with a straight optic introduced through the paraumbilical region, and coupled with video camera. Two, 3, or 4 other trocars were inserted and placed as required by anatomic conditions. In the group with simple cholelithiasis, laparoscopic cholecystectomy was performed in 99% of the patients while in the group with complicated cholelithiasis the procedure was achieved in 75% of the patients. Immediate laparotomy was done in 1% and 25% of cases respectively in both groups. No interventional mortality occurred. Post‐operative complications have been acceptable (1.6% and 2.7%), with no late complications reported. Our study shows that laparoscopic cholecystectomy is feasible in the majority of cases of complicated cholelithiasis and that the main advantages of this method were retained.
The surgical management of benign and malignant thyroid neoplasms in marshall islanders exposed to hydrogen bomb fallout
Authors: Dobyns Brown M. , Hyrmer Barbara A. 
Published: August 2005

AbstractOn March 1, 1954, a serious fallout accident occurred during the United States atomic testing program at Bikini in the Trust Territory of the Pacific Islands. Following the detonation of a large thermonuclear device (known as Bravo) an unexpected shift in winds resulted in deposition of radioactive debris on several inhabited atolls in the Marshall Islands. During the early post‐detonation period military, sea, and air surveys traced the hottest portion of the parabolic cloud as it drifted in an ever widening pattern of diminishing concentration eastward and southeast of Bikini. The center of the cloud passed North of the Rongelap Atoll, which was the nearest inhabited atoll. This report concerns the development of thyroid lesions, the special circumstances encountered during thyroid surgery, and the results of the surgical management of benign and malignant lesions that were subsequently encountered in this population.
Omental Flap in Pancreaticoduodenectomy for Protection of Splanchnic Vessels
Authors: Maeda Atsuyuki , Ebata Tomoki , Kanemoto Hideyuki , Matsunaga Kazuya , Bando Etsuro , Yamaguchi Shigeki , Uesaka Katsuhiko 
Published: August 2005

AbstractIntraabdominal bleeding, the most life‐threatening complication following pancreaticoduodenectomy (PD), most often is associated with failure of a pancreaticojejunostomy anastomosis or with intraabdominal infection. We investigated whether placement of an omental flap around the splanchnic vessels in PD could reduce the occurrence of intraabdominal bleeding and other postoperative complications. One hundred consecutive patients who underwent PD at the authors’ institution between January 2000 and October 2004 were enrolled in this prospective study. After dissection of the hepatoduodenal ligament, the major splanchnic arteries and the portal vein were covered by the omental flap. Preoperative condition, incidence of pancreatic fistula, intra‐abdominal bleeding, other complications, treatment mortality, and hospital stay were analyzed for interrelationships. The frequency of pancreatic fistula (20%) differed little from those in previous reports. However, intraabdominal bleeding was observed in only 1 (1.0%) patient, who was considered to have too thin a flap. No intraabdominal abscess was encountered. No mortality or complications occurred in relation to the omental flap. Thus, wrapping an omental flap around dissected splanchnic vessels in PD reduced postoperative intraabdominal bleeding and infection, but failed to prevent pancreatic fistulas.
Emergency obstetric care in Pakistan: Potential for reduced maternal mortality through improved basic EmOC facilities, services, and access
Authors: Ali M. , Hotta M. , Kuroiwa C. , Ushijima H. 
Published: August 2005

AbstractObjective: To ascertain and compare compliance with UN emergency obstetric care (EmOC) recommendations by public health care centers in Pakistan's Punjab and Northwest Frontier Province (NWFP) provinces. Method: Cross‐sectional data were collected from July through September 2003 using UN process indicators. From each province, 30% of districts (n = 19); were randomly selected; all public health facilities providing EmOC services (n = 170) were included. Results: The study found that out of 170 facilities only 22 were providing basic and 37 comprehensive EmOC services in the areas studied. Only 5.7% of births occurred in EmOC health facilities. Met need was 9% and 0.5% of women gave birth by cesarean section. The case fatality rate was a low 0.7%, probably due to poor record keeping. Access and several indicators were better in NWFP than in Punjab. Conclusion: Almost all indicators were below UN recommendations. Health policy makers and planners must take immediate, appropriate measures at district and hospital levels to reduce maternal mortality.
Loss of TSLC1 expression in lung adenocarcinoma: Relationships with histological subtypes, sex and prognostic significance
Authors: Goto Akiteru , Niki Toshiro , Chi‐pin Li , Matsubara Daisuke , Murakami Yoshinori , Funata Nobuaki , Fukayama Masashi 
Published: August 2005

The TSLC1 (tumor suppressor in lung cancer 1) gene is a tumor suppressor recently identified through functional complementation in a lung adenocarcinoma cell line A549. In this study we immunohistochemically examined the loss of TSLC1 expression in 93 cases of surgically resected lung adenocarcinoma, and investigated its correlation with clinicopathological parameters, including histological subtypes of tumors. The prognostic significance of loss of TSLC1 expression was analyzed by univariate and multivariate analyses, in parallel with other prognostic markers such as p53, p27, and Ki‐67. In non‐cancerous lung tissue, TSLC1 was weakly positive in bronchial and bronchiolar epithelial cells, type II pneumocytes and bronchial glands. Overall, TSLC1 was negative in 60 of 93 lung adenocarcinomas. TSLC1 was mainly localized in the cytoplasm of the cells, but cell membrane staining was also observed, especially at sites of cell–cell adhesion. TSLC1‐negative tumors were more frequently observed in male cases (41/54 cases, 70.0%) than in female cases (19/39 cases, 48.7%) (P < 0.01). Notably, TSLC1 expression was preserved in a non‐invasive, bronchiolo‐alveolar histological pattern of tumor cells (P < 0.0001). Survival analyses showed that loss of TSLC1 expression was associated with lower patient survival in univariate and multivariate analyses (P < 0.05 and P = 0.059, respectively). Subset analyses further showed that the prognostic impact of loss of TSLC1 was significant for male patients (P = 0.0089), but not for female patients. We conclude that TSLC1 is expressed in a subset of lung adenocarcinomas, especially in those with bronchiolo‐alveolar spread pattern. Loss of TSLC1 is associated with lower patient survival, supporting its role as a tumor suppressor. (Cancer Sci 2005; 96: 480 –486)
Clinical usefulness of total hepatitis C virus core antigen quantification to monitor the response to treatment with peginterferon alpha‐2a plus ribavirin*
Authors: González V. , Padilla E. , Diago M. , Giménez M. D. , Solà R. , Matas L. , Montoliu S. , Morillas R. M. , Pérez C. , Planas R. 
Published: August 2005

Summary.  Early virological response may predict outcome following treatment with peginterferon alpha‐2a and ribavirin in patients chronically infected with hepatitis C virus (HCV). As total HCV core antigen may constitute an alternative direct marker to HCV RNA for assessing the levels of viraemia in such patients, we evaluated the correlation between HCV core antigen and HCV RNA, and whether HCV core antigen at baseline, 4 and 12 weeks after treatment could predict sustained virological response (SVR) to combined therapy, in comparison with HCV RNA.A total of 290 serum samples from 58 previously treatment naïve chronic HCV patients were examined for HCV core antigen and HCV‐RNA by means of quantitative HCV RNA when receiving combination therapy for the first time.SVR was significantly associated with basal HCV core antigen but not with HCV RNA. There was a good correlation between HCV core antigen and HCV RNA (r2 = 0.781). The negative predictive value of HCV core antigen testing in predicting nonresponse at weeks 4 and 12 were 75 and 100%, and for undetectable or a 2‐log drop in HCV RNA were 69.6 and 75% respectively.HCV core antigen detection is quick, and easy to perform alternative to HCV RNA, and could be used as a marker of HCV viraemia for monitoring the progress of therapy.
Polymorphisms of the renin–angiotensin system and the severity of fibrosis in chronic hepatitis C virus infection
Authors: Forrest E. H. , Thorburn D. , Spence E. , Oien K. A. , Inglis G. , Smith C.‐A. , McCruden E. A. B. , Fox R. , Mills P. R. 
Published: August 2005

Summary.  Patients with chronic hepatitis C virus (HCV) infection vary in their rates of fibrosis progression. The renin–angiotensin system (RAS) regulates fibrosis. Polymorphisms in the genes of the RAS may contribute to the outcome of renal and cardiovascular disease.We studied four RAS gene polymorphisms in 195 patients with chronic HCV infection. Patients were grouped by Ishak stage of fibrosis on liver biopsy: group 1 (fibrosis score 0 or 1; n = 97), group 2 (fibrosis score 2 or 3; n = 73) and group 3 (fibrosis score 4–6; n = 25). Polymorphisms of the angiotensinogen (AGT) gene (M235T and AT‐6), the angiotensin I converting enzyme gene and the type 1 angiotensin II receptor gene were assayed.There was no difference in the distribution of these polymorphisms of the RAS between the fibrosis groups. There did not appear to be any increased prevalence of fibrosis if two or even three of the polymorphisms associated with increased RAS effect were present. On multivariate analysis factors significantly associated with fibrosis were necroinflammatory activity (P < 0.001) and age (P < 0.001).No association was identified between these four RAS polymorphisms and fibrosis in chronic HCV infection.
Perceptions of social stigma and its effect on interpersonal relationships of young males who experience a psychotic disorder
Authors: Lloyd Chris , Sullivan Dan , Williams Philip Lee 
Published: August 2005

Background:  People with psychotic disorders experience high levels of disability and impairment as a result of their illness. Difficulty in the area of social relationships poses a substantial problem with the majority of people with psychosis being socially isolated. Many of them experience an unmet need for services. Methods:  A focus group was conducted with the aim of investigating the perceived experience of six young men who had a psychotic disorder to gain an understanding of the impact this had on interpersonal relationships. Results:  The major themes identified were: (i) a significant decrease in the internal and external control of one's life at the onset of illness; (ii) the effects of labelling and stigma on interpersonal relationships; and (iii) the change in self perception that these effects bring. Conclusion:  The implications of the findings for rehabilitation interventions are presented, specifically psychosocial group interventions addressing interpersonal relationships.
Exploration of Australian and New Zealand indigenous people's spirituality and mental health
Authors: Tse Samson , Lloyd Chris , Petchkovsky Leon , Manaia Wiremu 
Published: August 2005

Background: Spirituality has been defined as an overarching construct that involves personal beliefs or values that provide a sense of meaning and unity with self, people, nature and universe. Spirituality may be experienced within or outside formal religion. At least in English‐speaking countries, therapists reported discussing spiritual issues with service users more frequently than before. In the literature, there continues to be debate regarding definitions of spirituality and how spirituality fits with occupational therapy practice models.Methods and Results: To advance the discussion, we explore the concept of spirituality among indigenous people of Australia and New Zealand, and use mental health as a practice setting to suggest how occupational therapists can address the spiritual needs of individuals recovering from mental health problems.Conclusion: The implications for assessment and interventions to improve coping skills, social support, self‐esteem and instil hope of recovery from mental illness are considered.
Role of impaired peritubular capillary and hypoxia in progressive interstitial fibrosis after 56 subtotal nephrectomy of rats
Authors: ZHANG BIN , LIANG XINLING , SHI WEI , YE ZHIMING , HE CHAOSHENG , HU XIANGMING , LIU SHUANGXIN 
Published: August 2005

SUMMARY:Aim:  To investigate the potential role of peritubular capillary (PTC) loss and subsequent hypoxia as a pathogenic factor in interstitial fibrosis after renal ablation in rats.Methods:  PTC loss and tubulointerstitial hypoxia in remnant kidney rats (SNTx group), sham‐operated rats (sham group) and normal animals (normal group) were assessed by peritubular CD141‐positive staining lumina and tubulointerstitial hypoxia‐inducible factor α subunit 1 (HIF‐1α) expression, respectively, at the time points of week 3, week 6 and week 12. The related cardinal factors contributing to interstitial fibrosis, such as transforming growth factor‐β1 (TGF‐β1), α‐smooth muscle actin (α‐SMA) were also evaluated and analysed in the context of progressive PTC loss. Expression of TGF‐β1 mRNA in cultured renal tubular epithelial cells (MDCK cells) exposed to hypoxia was also investigated.Results:  PTC loss and tubulointerstitial hypoxia were noted even in the early stage (week 3) when the interstitial fibrosis was mild, and were persistent in the process of developing interstitial fibrosis. An in vitro study showed that hypoxia enhanced TGF‐β1 mRNA expression in the MDCK cells.Conclusion:  PTC loss or hypoxic milieu in the tubulointerstitium is a pathological event, which may contribute to the developing interstitial fibrosis mediated by direct hypoxic effects and via hypoxia‐induced TGF‐β1 expression.