bluuebunny/crossref_metadata_2025_split huggingface dataset:
Kinetics and Stability of GM‐CSF Production by Recombinant Yeast Cells Immobilized in a Fibrous‐Bed Bioreactor
Authors: Yang Shang‐Tian , Shu Chin‐Hang 
Published: July 2002

AbstractThe continuous production of murine granulocyte−macrophage colony‐stimulating factor (GM‐CSF) by recombinant yeast cells immobilized in a fibrous‐bed bioreactor was studied. A high cell density of ∼68 g/L and a GM‐CSF productivity of ∼3.5 mg/L·h were attained in the fibrous‐bed bioreactor fed with a rich (nonselective, pH 6.7) medium at a dilution rate of 0.16 h−1. The GM‐CSF production was stable even though the fraction of plasmid‐carrying cells in the reactor effluent gradually dropped below 5% over a period of 2 weeks. At the end of that period, the immobilized cells in the fibrous matrix still had a high fraction, ∼26%, of plasmid‐carrying cells. Similar results were obtained with reactors operated at 0.05 h−1 dilution rate and pH 4.0. Although the GM‐CSF production was lower at pH 4, the reactor was stably operated for over 4 weeks without contamination or significant loss of productivity. The stable long‐term GM‐CSF production from the fibrous‐bed bioreactor was attributed to the effect of cell immobilization on plasmid stability. Because GM‐CSF production was growth‐associated, as was found in batch fermentation with free cells, this stabilization effect cannot be attributed solely to the reduced cell growth in the immobilized cell environment. Plasmid‐carrying cells were preferentially retained in the fibrous matrix, perhaps because their abilities to adhere to the fiber surface and to form cell aggregates were higher than those of plasmid‐free cells.
Stabilization of Active Recombinant Retroviruses in an Amorphous Dry State with Trehalose
Authors: Bieganski Robert M. , Fowler Alex , Morgan Jeffrey R. , Toner Mehmet 
Published: July 2002

AbstractThe disaccharide trehalose is found to be effective for stabilization of active recombinant retroviruses in an amorphous dry state achieved through ambient‐temperature vacuum dehydration of retroviral supernatants. Studies revealed that trehalose is a significantly better desiccation protectant than sucrose, glucose, and dextran: dextran has essentially no protective effect on retroviral survival after drying and rehydration. X‐ray diffractometry of the retroviral supernatant dried with trehalose demonstrated its amorphous nature. The ability to dehydrate retroviral stocks at ambient temperatures into a stable glassy state will have a profound effect for researchers and commercial biotechnology companies which supply retroviral vectors for human gene therapy and basic research.
Infiltrating lobular carcinoma of the breast detected by screening
Authors: Schroën A M A , Wobbes Th , van der Sluis R F 
Published: July 2002

Abstract

Background
This study was a retrospective analysis of all patients with invasive lobular breast cancer who presented to the University Hospital Nijmegen between 1980 and 1990, with follow-up to December 1992. A comparison was made between the invasive lobular carcinomas detected by breast cancer screening and those detected outside the screening project.

Methods
The total number of patients with breast cancer during this interval was 937, of whom 136 (14·5 per cent) had pure infiltrating lobular carcinoma (ILC). Breast cancer screening identified a total of 158 patients with infiltrating breast carcinoma of whom 20 (12·7 per cent) had ILC. Outside the screening programme a total of 116 patients with ILC were diagnosed during the same interval.

Results
The 2- and 5- and 10-year disease-free survival rate in the screen-detected group was 100, 100 and 89 per cent respectively. For the group outside the screening programme this was 88·4, 74·3 and 72·5 per cent respectively (P = 0·04). No patient in the screen-detected group died from breast cancer during follow-up, whereas the 2- and 5- and 10-year breast cancer survival rate for the group detected outside the screening programme was 96·5, 89·1 and 70·6 per cent respectively (P = 0·06).

Conclusion
Between 10 and 15 per cent of patients with invasive lobular breast cancer can be detected by breast screening. These patients have a favourable outcome compared with those who have ILC detected outside the screening programme.
Overexpression of p53 predicts shorter survival in diffuse type gastric cancer
Authors: Lee W-J , Shun C-T , Hong R-L , Wu M-S , Chang K-J , Chen K-M 
Published: July 2002

Abstract

Background
It has been suggested that p53 plays an important part in gastric carcinogenesis but the data remain inconclusive.

Methods
Alteration of the tumour suppressor gene p53 was prospectively investigated by immunohistochemistry in 168 primary gastric cancers.

Results
Positive staining, indicative of gene mutations, was detected in 34 tumours (20·2 per cent). No correlation was observed between expression of p53 and various clinicopathological factors, including age, sex, tumour site, gross type, tumour size, depth of invasion, lymph node metastases, distant metastases, and tumour node metastasis stage. However, p53 overexpression was different between intestinal and diffuse type gastric cancer. Survival analysis revealed a significant survival disadvantage of p53 expression in diffuse type gastric cancer (P = 0·039) but not in the intestinal type. Multivariate analysis of all 168 patients revealed that independent predictors of recurrent disease included age, invasion depth and nodal involvement but not p53 expression.

Conclusion
The presence of p53 overexpression may identify a subset of more aggressive tumours with a poor prognosis in diffuse type gastric cancer.
High prevalence of abdominal aortic aneurysm in a primary care screening programme
Authors: Boll A P M , Verbeek A L M , van de Lisdonk E H , van der Vliet J A 
Published: July 2002

Abstract

Background
The mortality rate associated with ruptured abdominal aortic aneurysm (AAA) remains high. The objective of this study was to assess the feasibility of population screening for AAA.

Methods
In an area with a mixed rural and industrialized population of 60 000 inhabitants, all 23 general practitioners (GPs) participated. The GPs selected from their patient lists men aged 60–80 years. Men whose condition was suitable for aortic surgery were invited for screening by a single postal letter. All men responding had aortic ultrasonography in or close to the GP surgery. Diagnosis of AAA was established when the aortic diameter was 30 mm or greater. Referral for surgery was advised for an aortic diameter of 50 mm or greater.

Results
Of 2914 invitations, 2419 men had ultrasonography, resulting in an attendance rate of 83·0 per cent. A total of 2416 aortic measurements were made; 196 aortic aneurysms were diagnosed (prevalence 8·1 per cent). In 40 men the aortic diameter was over 50 mm.

Conclusion
Ultrasonographic screening for AAA is feasible in a primary care setting.
Impaired healing of extraperitoneal intestinal anastomoses
Authors: Pierie J P E N , de Graaf P W , van Vroonhoven Th J M V , Renooij W , Obertop H 
Published: July 2002

Abstract

Background
The extra-anatomical position of a cervical oesophagogastrostomy might be a reason for impaired anastomotic healing.

Methods
This hypothesis was tested in a rat model. Jejunal resection with an end-to-end jejunojejunostomy was placed intra-abdominally in group 1 (n = 24) and subcutaneously in group 2 (n = 30). Jejunum without anastomosis was placed subcutaneously in group 3 (n = 12). After 3, 7 or 14 days the rats were killed; the bursting pressure of the anastomosis or jejunum was measured and the hydroxyproline level was determined.

Results
Two of 24 rats in group 1 and eight of 30 in group 2 died following anastomotic leakage (P not significant) and were excluded from other measurements. Bursting pressure was decreased after 3 days in group 1 (mean(s.e.) 62(10) mmHg) and group 2 (57(10) mmHg) compared with that in group 3 (204(17) mmHg) (P &lt; 0·001). After 7 days, it was in the normal range in group 1 (200(14) mmHg), but lower in group 2 (104(15) mmHg) compared with that in group 3 (230(8) mmHg) (P &lt; 0·001). Differences in hydroxyproline levels were not statistically significant between the groups after 3, 7 and 14 days.

Conclusion
Healing of jejunojejunostomies is impaired in an extraperitoneal position compared with an intra-abdominal position.
Hepatitis viral status in patients undergoing liver resection for hepatocellular carcinoma
Authors: Wu C-C , Ho W-L , Chen J-T , Tang J-S , Yeh D-C , P'eng F-K 
Published: July 2002

Abstract

Background
Hepatitis B and C viruses are the main causative agents of hepatocellular carcinoma (HCC). The influence of hepatitis viral status on liver resection for HCC remains undetermined.

Methods
Patients who underwent curative resection for HCC were divided into four groups: group 1, seronegative for hepatitis B surface antigen (HBsAg) and antihepatitis C antibody (HCVAb); group 2, seropositive for HBsAg only; group 3, seropositive for HCVAb only; and group 4, seropositive for HBsAg and HCVAb. The clinicopathological characteristics and surgical results of the four groups were compared. Resection of HCC was determined according to liver functional reserve and tumour extent.

Results
There were 40, 131, 70 and 20 patients in groups 1, 2, 3 and 4 respectively. Due to patient selection bias, there were significant differences in some background features, resectional extent and pathological characteristics among the four groups. Postoperative morbidity and mortality, as well as the Union Internacional Contra la Cancrum tumour node metastasis stages, did not differ. Patients in group 1 had a higher disease-free survival rate than those in group 2 (P = 0·02). The actuarial survival rates of patients in groups 2 and 4 were lower than those of groups 1 and 3.

Conclusion
With careful patient selection, the hepatitis viral status does not influence the surgical risks of hepatectomy for HCC. After liver resection for HCC, the long-term survival rate of patients seronegative for HBsAg is greater than that of patients seropositive for HBsAg.
Venous ulcer healing by four-layer compression bandaging is not influenced by the pattern of venous incompetence
Authors: Guest M , Smith J J , Sira M S , Madden P , Greenhalgh R M , Davies A H 
Published: July 2002

Abstract

Background
Previous studies have related deep venous incompetence to reduced venous ulcer healing rates. The aim of this study was to determine the relationship between the pattern of venous incompetence and ulcer healing.

Methods
A total of 198 legs with venous ulceration were investigated with colour venous duplex imaging to determine the presence and site of venous incompetence. All were treated initially with the four-layer bandage technique.

Results
At 6 months, 74 per cent of the venous ulcers had healed using the four-layer bandage technique. There was no significant correlation between the pattern of incompetence and the healing rate of the ulcer. Previous deep vein thrombosis (DVT), increased size of the ulcer and previous episodes of ulceration were associated with a poor healing rate.

Conclusion
The four-layer bandage technique achieved an ulcer healing rate of 74 per cent after 6 months, irrespective of the pattern of venous incompetence. Patients with a large ulcer, previous DVT or previous episodes of ulceration had delayed healing, supporting the previous literature.
Late results of a randomized clinical trial comparing total fundoplication versus calibration of the cardia with posterior gastropexy
Authors: Csendes A , Burdiles P , Korn O , Braghetto I , Huertas C , Rojas J 
Published: July 2002

Abstract

Background
The aim was to perform a prospective randomized study in patients with chronic gastro-oesophageal reflux treated either by total fundoplication or calibration of the cardia with posterior gastropexy. Late follow-up considered subjective and objective parameters, and related outcome to the presence of Barrett's oesophagus.

Methods
A total of 164 patients were randomized to fundoplication (n = 76) or calibration of the cardia (n = 88). They were evaluated by clinical questionnaire, upper gastrointestinal endoscopy with biopsies, oesophageal manometry and gastro-oesophageal reflux studies, including scintigraphy and 24-h oesophageal pH monitoring.

Results
There were no operative deaths. There was 95 per cent follow-up at a mean of 85 months. The mean recurrence rate for both operations was near 40 per cent at 10 years, but patients without Barrett's oesophagus had a recurrence rate after both operations of around 23 per cent compared with 83 per cent after 10 years for those with Barrett's oesophagus (P &lt; 0·0001). Low-grade dysplasia developed in 13 per cent of the patients with Barrett's oesophagus. There were significant differences in all objective parameters in a comparison of patients with Visick I or II and those with Visick III or IV disease at the late assessment.

Conclusion
Both total fundoplication and calibration of the cardia with posterior gastropexy had similar subjective and objective late results. However, results were significantly worse in patients with Barrett's oesophagus.
Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia
Authors:   The Global Lower Extremity Amputation Study Group, Unwin N 
Published: July 2002

Abstract

Background
This study was established to enable a comparison of lower extremity amputation incidence rates between different centres around the world.

Methods
Ten centres, all with populations greater than 200 000, in Japan, Taiwan, Spain, Italy, North America and England collected data on all amputations done between July 1995 and June 1997. Patients were identified from at least two data sources (to allow checks on ascertainment); denominator populations were based on census figures.

Results
The highest amputation rates were in the Navajo population (43·9 per 100 000 population per year for first major amputation in men) and the lowest in Madrid, Spain (2·8 per 100 000 per year). The incidence of amputation rose steeply with age; most amputations occurred in patients over 60 years. In most centres the incidence was higher in men than women and the incidence of major amputations was greater than that of minor amputations. Diabetes was associated with between 25 and 90 per cent of amputations.

Conclusion
Apart from the Navajo centre, differences in the known prevalence of diabetes could not account for the differences in overall incidence of amputation. Differences in the prevalence of peripheral vascular disease are likely to be important, but this and the role of other factors, including availability of health care, are worthy of further investigation.
Diagnostic accuracy of needle-localized open breast biopsy for impalpable breast disease
Authors: Verkooijen H M , Peeters P H M , Pijnappel R M , Koot V C M , Schipper M E I , Rinkes I H M Borel 
Published: July 2002

Abstract

Background
Needle-localized open breast biopsy (NLBB) is considered the gold standard procedure for the diagnosis of impalpable breast disease. In an observational follow-up study the sensitivity and negative predictive value of this procedure was determined in a clinical population with long-term follow-up.

Methods
Some 199 consecutive patients with a benign histological diagnosis on NLBB were followed for the occurrence of breast cancer, using information from the Dutch National Morbid-Anatomical Record Department. Based on a review of mammograms and histological slides, an expert panel decided whether the carcinomas detected during follow-up were newly developed, or were present already at the time of the NLBB.

Results
After a median follow-up of 60·5 months, seven carcinomas were detected. At panel review, six appeared to have been missed by NLBB. The sensitivity of NLBB was 99 per cent after 2 years of follow-up, but dropped to 96 per cent after 5 years. Similarly, the negative predictive value dropped from 99 per cent after 2 years to 94 per cent after 5 years of follow-up.

Conclusion
NLBB is an accurate diagnostic procedure for the evaluation of impalpable breast disease. However, with longer follow-up the accuracy becomes lower than generally reported.
Extending the indications for curative liver resection by portal vein embolization
Authors: Seymour K , Charnley R M , Rose J , Baudouin C J , Manas D M 
Published: July 2002

Abstract

Aims
The aim of ipsilateral portal vein embolization is to induce hypertrophy of normal tissue when resection of a cancerous portion of the liver is contraindicated only by the volume of liver that would remain following surgery. This study reports its use in primary and metastatic liver tumours.

Methods
Eight patients with inoperable liver tumours (three women and five men of median age 68·5 years; three colorectal hepatic metastases, two cholangiocarcinomas and three hepatocellular cancers) were selected for portal vein embolization. Selected portal branches were occluded distally with microbeads and proximally with coils. Liver volumes were determined by magnetic resonance imaging before embolization and again before surgery, 6–8 weeks later.

Results
Embolization was performed successfully in seven patients by the percutaneous–transhepatic route; one further patient required an open cannulation of the inferior mesenteric vein. Management was altered in six patients, who proceeded to ‘curative’ surgery. The projected remaining (predominantly left lobe) liver volumes increased significantly from a median of 350 to 550 ml (P &lt; 0·05, Wilcoxon matched pairs test). Two patients had disease progression such that surgery was no longer indicated. One patient, whose disease progressed, had the left portal branch occluded unintentionally by a misplaced coil that was successfully retrieved, although the left portal branch remained occluded.

Conclusions
Portal vein embolization produced significant hypertrophy of the normal liver and extended the option of ‘curative’ surgery to six of the eight patients in whom it was attempted. It appears to be equally effective for primary and metastatic liver tumours in selected patients.
Laparoscopic splenectomy: a suitable technique for children and adults
Authors: Wheatley T J , Johnstone J M S , Robertson G S M , Hutchinson M , Wood J K , Lloyd D M 
Published: July 2002

Abstract

Aims
Splenectomy retains an important role in the management of certain haematological conditions that fail to respond to conventional medical therapy, and has traditionally been performed through a midline or left subcostal incision with patients requiring 5–7 days in hospital. The well recognized benefits of laparoscopic surgery should also apply to splenectomy. This study aimed to develop a safe and effective technique suitable for all age ranges and without the requirement for expensive stapling devices.

Methods
An operative technique evolved over the 5-year period from 1994, from an initial six-port approach with the patient supine, to a four-port approach in a modified right lateral position, with locking surgical clips applied down a 5-mm port to vessels in the hilum, and removal of the spleen within a retrieval bag through a 4–6-cm Pfannanstiel incision. Data were collected prospectively for all patients undergoing laparoscopic splenectomy at Leicester Royal Infirmary, including demographic details, indication for surgery, duration of surgery, length of inpatient stay, transfusion requirement, postoperative complications and the response of the original condition to surgical intervention.

Results
A total of 40 patients underwent laparoscopic splenectomy (14 children, 26 adults) for a variety of conditions (idiopathic thrombocytopenia (ITP) (n = 24), haemolytic anaemia (n = 9) or malignancy (n = 7)) with a median operating time of 180 min for the first 20 patients and 100 min for the second 20 (P &lt; 0·0001), and median inpatient stay of 3 days for the first 20 patients and 2 days for the second 20 (P &lt; 0·0003). None of the operations was converted to open surgery, five patients required blood and/or platelet transfusion perioperatively, none of the patients had major postoperative complications, 23 of the 24 patients with ITP developed normal platelet counts after operation, and all nine patients with haemolytic anaemia maintained a normal haemoglobin concentration after operation.

Conclusions
Laparoscopic splenectomy can be performed safely and effectively in adults and children without the need for stapling devices.
Morbidity and mortality of inadvertent enterotomy during adhesiotomy
Authors: van der Krabben A A , Dijkstra F R , Nieuwenhuijzen M , Reijnen M M P J , Schaapveld M , van Goor H 
Published: July 2002

Abstract

Background
Inadvertent enterotomy is a feared complication of adhesiotomy during abdominal reoperation. The nature and extent of this adhesion-associated problem are unknown.

Methods
The records of all patients who underwent reoperation between July 1995 and September 1997 were reviewed retrospectively for inadvertent enterotomy, risk factors were analysed using univariate and multivariate parameters, and postoperative morbidity and mortality rates were assessed.

Results
Inadvertent enterotomy occurred in 52 (19 per cent) of 270 reoperations. Dividing adhesions in the lower abdomen and pelvis, in particular, caused bowel injury. In univariate analysis body mass index was significantly higher in patients with inadvertent enterotomy (mean(s.d.) 25·5(4·6) kg/m2) than in those without enterotomy (21·9(4·3) kg/m2) (P &lt; 0·03). Patient age and three or more previous laparotomies appeared to be independent parameters predicting inadvertent enterotomy (odds ratio (95 per cent confidence interval) 1·9 (1·3–2·7) and 10·4 (5·0–21·6) respectively; P &lt; 0·001). Patients with inadvertent enterotomy had significantly more postoperative complications (P &lt; 0·01) and urgent relaparotomies (P &lt; 0·001), a higher rate of admission to the intensive care unit (P &lt; 0·001) and parenteral nutrition usage (P &lt; 0·001), and a longer postoperative hospital stay (P &lt; 0·001).

Conclusion
The incidence of inadvertent enterotomy during reoperation is high. This adhesion-related complication has an impact on postoperative morbidity.
Prognostic significance of oestrogen receptor β in breast cancer
Authors: Speirs V , Kerin M J 
Published: July 2002

Abstract

Background
Endocrine therapy for breast cancer is now well established and with the identification of a second oestrogen receptor, ERβ, 3 years ago it is timely to review the possible significance of this receptor in breast cancer management.

Methods
An up-to-date review of the current literature concerning the role and possible implications of ERβ in human breast cancer was undertaken.

Results
Wild-type and variant ERβ are expressed in human breast tumours. Expression of ERβ correlates with accepted prognostic indicators including lymph node status and tumour grade. Furthermore, levels of ERβ messenger RNA alter during carcinogenesis and are upregulated in breast tumours that develop antioestrogen resistance.

Conclusion
ERβ has potential as a novel clinical prognostic marker in breast cancer, particularly in determining tumours that are resistant to tamoxifen.
Non-operative treatment of abdominal gunshot injuries
Authors: Saadia R , Degiannis E 
Published: July 2002

Abstract

Background
Non-operative treatment is a management option that challenges the traditional mandatory laparotomy for abdominal gunshot injuries.

Methods
All published relevant clinical reports were retrieved by searching through the Medline database and manually. The theoretical arguments in favour of non-operative management as well as the results of the reviewed reports are analysed and evaluated.

Results and conclusion
Patients with proven non-penetration of the abdominal cavity can be offered conservative treatment with a satisfactory outcome. Greater caution should be exercised in the presence of a documented visceral injury until the safety of this option has been established by further clinical trials.