1,720,956 research outputs found
Long-term efficacy and safety of a nitinol closure clip system for anal fistula treatment
No full textIntroduction: Treatment failure of anal fistula results in high re-occurrence rate. Material and methods: Efficacy and safety of a nitinol closure clip system (bear-claw clip) were evaluated for anal fistulae treatment in a 36-month long-term follow-up study. Results: Twenty-two patients were included. No patient had been treated with a bear-claw clip system before. All patients were fully continent before treatment. Follow-up time was 36 months (range 19-48 months). We observed a re-occurrence rate of 41% (nine patients) with presence of an active fistula. Time to recurrence was on average 6.9 months (range 3-11 months). Thirteen patients (59%) showed a complete healing of the fistula. Placed clip was removed in all patients on average after almost 5.8 months (3-12 months), in three cases the clip was left in situ. We did not observe any incontinence; one patient reported recurrent burning after defecation once the clip system was removed. Discussions: Clip placement is a minimally invasive sphincter-preserving procedure with minimal complications and with an acceptable recurrence rate in the long term. However, bear-claw clip placement should probably be offered patients as a treatment option before more invasive procedures with higher perioperative morbidity are taken into consideration
Challenging dedifferentiated liposarcoma identified by MDM2-amplification, a report of two cases
No full textBackground Liposarcoma is the most frequent soft tissue sarcoma. Well differentiated liposarcoma may progress into dedifferentiated liposarcoma with pleomorphic histology. A minority additionally features myogenic, osteo- or chondrosarcomatous heterologous differentiation. Genomic amplification of the Mouse double minute 2 homolog (MDM2) locus is characteristic for well differentiated and dedifferentiated liposarcomas. Detection of MDM2 amplification may supplement histopathology and aid to distinguish liposarcoma from other soft tissue neoplasia. Case presentation Here we present two cases of dedifferentiated liposarcoma with challenging presentation. Case 1 features a myogenic component. As the tumour infiltrated the abdominal muscles and showed immunohistochemical expression of myogenic proteins, rhabdomyosarcoma had to be ruled out. Case 2 has an osteosarcomatous component resembling extraosseous osteosarcoma. The MDM2 status was determined in both cases and helped making the correct diagnosis. Overexpression of MDM2 and co-overexpression of Cyclin-dependent kinase 4 is demonstrated by immunohistochemistry. The underlying MDM2 amplification is shown by fluorescence in situ hybridisation. Since low grade osteosarcoma may also harbour MDM2 amplification it is emphasised that the amplification has to be present in the lipomatous parts of the tumour to distinguish liposarcoma from extraosseous osteosarcoma. Conclusions The two cases exemplify challenges in the diagnoses of dedifferentiated liposarcoma. Liposarcoma often has pleomorphic histology and additionally may feature heterologous components that mimic other soft tissue neoplasms. Amplification of MDM2 is characteristic for well differentiated and dedifferentiated liposarcomas. Determination of the MDM2 status by in situ hybridisation may assist histopathology and help to rule out differential diagnoses
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Long-term results of transanal haemorrhoidal dearterialization (THD) in the stage II and III of haemorrhoids combined with mucopexy.
No full textDie THD (transanale Hämorrhoidendearterilisation) kombiniert mit Mukopexie hat sich in der Praxis der proktologisch tätigen Chirurgen neben der Staplerhämorrhoidopexie nach Longo und konventionellen resezierenden Eingriffen fest etabliert. Allerdings liegen zurzeit nur wenige Studien mit Langzeitergebnissen vor.
In der Zeit vom dem 01.01.2009 bis zum 31.12.2012 wurden in der Klinik für Allgemein- und Viszeralchirurgie des Roten Kreuz Krankenhaus Kassel 129 Patienten mittels transanalen Hämorrhoidendearterilisation (THD) mit Rekto-Anal-Repair (RAR) behandelt. Davon waren 79 Männer (61%) und 50 Frauen (39%). Allen Patienten wurde im Rahmen einer Nachsorgestudie ein standardisierter Fragebogen übersandt. Es wurde nach Auftreten von einem Rezidiv, den Rezidivbeschwerden, der Auswirkung auf Stuhl- und Miktionsverhalten und Kontinenz, sowie nach der allgemeinen Patientenzufriedenheit gefragt.
Wir konnten nach Erfüllen aller Voraussetzungen der Ethikkommission bei der Landesärztekammer Hessen die Daten von 85 Patienten auswerten. Die Nachbeobachtungszeit betrug im Durchschnitt 54 Monate (28-76). 52 Patienten blieben beschwerdefrei, 33 Patienten (39%) berichteten über Rezidivbeschwerden, 11 Patienten (13%) wurden deswegen erneut operiert. Im Langzeitverlauf ergab sich keine Änderung des Miktionsverhaltens, bzw. der Urininkontinenz. 24 Patienten klagten vor der Operation über Verstopfungsneigung und 16 Patienten über Inkontinenz, 12 Patienten davon klagten sowohl über Stuhlentleerungs- als auch Inkontinenzstörungen. Der CCC-Score betrug im Mittel vor der Operation 6 und nach der Operation 5. Für Patienten mit Stuhlkontinenz betrug der CCI-Score im Mittel 3 vor und 3 danach. Eine Änderung des Stuhlverhaltens wurde in 15 (20%) Fällen beobachtet, 8 Patienten berichteten über eine positive Änderung von Obstipationsbeschwerden. 2 Patienten haben eine Verschlechterung der Obstipation bei unveränderter Inkontinenz und 3 Patienten eine Verschlechterung der Obstipation und Inkontinenz angegeben. Bei 3 Patienten trat eine leichte Inkontinenz auf. Die Zufriedenheit der Patienten, gemessen anhand der Analogscala von 1 bis 10 wurde in der Gesamtgruppe 7,7 und in der Patientengruppe mit Rezidivbeschwerden von 6,9 angegeben.
Das THD-Verfahren zeigt sich in der Langzeitbeobachtung als eine sichere und komplikationsarme Methode der Hämorrhoidenbehandlung. Ein Wiederholungseingriff war nur in 13% erforderlich, was sich in der großen Zufriedenheit der Patienten widerspiegelte. Ein Einfluss auf das Stuhlverhalten wurde in 20% der Fälle beobachtet. Dabei überwog eine Verbesserung der Obstipationsbeschwerden in 11% der Fälle. Die Anderen zeigten in den meisten Fällen eine leichte Zunahme von Obstipationsbeschwerden oder leichte Inkontinenzbeschwerden. Keiner der Patienten entwickelte eine schwere Stuhlinkontinenz.Purpose
The THD (transanal haemorrhoidal dearterialization) combined with mucopexy has firmly established itself in the practice. However, there are only few trials with long term results available.
Methods
Between January 2009 and December 2012 were treated 129 consecutive patients in the Red Cross Hospital in Kassel using transanal haemorrhoidal dearterialization (THD) with rekto-anal repair (RAR). The sex distribution was 61% (n=79) males and 39% (n=50) females. The median age was 52 years. The long-term follow-up was performed using a standardized questionnaire mailed. This questionnaire has assessed effects of THD with RAR on recurrent, relapse symptoms, stool and micturition and continence, as well as the general patient satisfaction.
Results
After approval by the ethics committee, we were able to analyze the data of 85 patients. The mean follow-up was 54 months (ranging 28-76 months). 52 patients remained free of symptoms, 33 (39%) reported a recurrence of symptoms, 11 (13%) patients had to be operated again. There were no micturition behavior and urinary incontinence reported. 24 patients complained before the operation about the tendency to constipation and 16 on the incontinence, 12 of them complained about both defecation disorders. The CCCS (Cleveland clinic constipation-score) averaged 6 scores before the operation and 5 scores after the operation. The CCIS (Cleveland clinic incontinence score) amounted in average 3 scores before and 3 scores after the operation. A change of stool behavior was observed in 15 (20%) cases, 8 (11%) of them reported on positive changes of constipation symptoms. 2 reported on deterioration of constipation without deterioration of incontinence and 3 had a deterioration of both constipation and incontinence. In 3 cases a slight incontinence occurred. A visual analog scale was used to assess patient satisfaction, ranging from 0 (least satisfied) to 10 (most satisfied). The mean postoperative score was 7,7 in the total group of patients and 6,9 in the group of patients with recurrent symptoms.
Conclusions
The THD (transanal haemorrhoidal dearterialization) combined with mucopexy is a safe and effective treatment for haemorrhoidal disease. A further surgery was required in only 13% of cases, which proves a high level of patient satisfaction. A change of stool behavior was observed in 15 cases (20%), out of which eight (11%) showed improvement. In other cases the slight increase of constipation and incontinence was observed. No one has developed sever incontinence
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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