bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological Characteristics and Non-Adhesive Organ Culture of Insulinomas
Authors: Hoem D. , Jensen D. , Steine S. , Thorsen T. E. , Viste A. , Molven A. 
Published: January 2017

Background and Aims: Insulinoma is a very rare type of islet cell tumour, but nevertheless the most common endocrine tumour of the pancreas. We aimed at reviewing our clinical experience with this tumour type and to assess whether organ culture could be obtained from surgically resected insulinoma material. Material and Methods: All patients with insulinomas (6 men and 10 women) referred to Haukeland University Hospital between 1986 and 2006 were included in the study. Median age of onset was 53 years (range 21–74). Biochemical diagnosis was established during a 72 h fast test. Imaging and localization of the tumours were performed with intra-operative ultrasonography, endoscopic ultrasonography, CT-scan and/or transcutaneous ultrasonography. For six patients, organ cultures were set up from tumour tissue fragments. Results: The annual incidence of insulinoma was 0.8 per million. The patients generally presented with non-specific, episodic symptoms, which often were mistaken for cardiovascular, neurological or diabetic disease and in some cases delayed the diagnosis with several years. Two patients had diabetes prior to the diagnosis of insulinoma. Patient weight gain was probably due to increased food intake, compensating for the hypoglycemia. Intra-operative ultrasonography detected all tumours correctly, whereas 73% were detected by endoscopic ultrasonography and 38% by CT scan. Five insulinomas were located in the head, eight in the body and three in the tail of the pancreas. All were removed by open-access surgery, eleven cases by resection and five by enucleation. One tumour was malignant with liver metastases and two patients had tumours defined as borderline. Insulinoma tissue fragments developed into spheroids during the first week of culturing and insulin secretion into the media was demonstrated. Conclusions: Insulinomas are rare and diagnostically challenging tumours. Intra-operative ultrasonography was superior to other imaging modalities to locate the lesion. In organ culture, insulinomas readily form spheroids which may be used to yield insight into beta-cell biology.
Seroma Formation and Method of Mesh Fixation in Laparoscopic Ventral Hernia Repair — Highlights of a Case SERIES
Authors: Sodergren M. H. , Swift I. 
Published: January 2017

Introduction: Laparoscopic ventral hernia repair (LVHR) is gaining popularity amongst minimally invasive surgeons, promising shorter lengths of hospital stay and decreased morbidity compared to conventional open repair. We aim to report our experience of LVHR performed at a single institution and analyse morbidity to improve outcome. Methods: A retrospective analysis using a prospectively collected database and patient records was performed on all patients that underwent LVHR. Patient demographics, morbidity and mortality were recorded. Patients with recurrences underwent further analysis. Results: There were a total of 55 laparoscopic ventral hernia operations performed on 50 patients. 24 (48%) were male, and the median BMI was 31 (range 20–41). The median operating time was 50 mins (range 30–120), the median length of stay (LOS) was one day (range 1–14) and the median follow-up period was 14 months (range 3–31). Operative complications occurred in two (3.6%) patients. Minor morbidity occurred in 12 (21.8%) patients. Eight (14.5%) patients developed seromas within the residual hernia sac post-operatively. There were six recurrences following LVHR in five patients. At re-operation, all recurrences appeared to be due to mesh detachment. Conclusion: LVHR is safe and the results are comparable to published series. We are encouraged by a shorter LOS and operative time compared to most published data. Post-operative seroma formation is common. If there is a suspicion of recurrence, these should all be imaged appropriately to avoid unnecessary operative intervention. A higher BMI is an independent risk factor for recurrence in LVHR. Consideration should be given to using transfascial sutures or other fixation methods to improve recurrence rates in this difficult patient group.
Obesity May Impair the Early Outcome of Total Knee Arthroplasty a Prospective Study of 100 Patients
Authors: Järvenpää J. , Kettunen J. , Kröger H. , Miettinen H. 
Published: January 2017

Background and Aims: Obesity has been linked to the development of osteoarthritis of the knee and increases the probability to fall into total knee arthroplasty. In this study we compared short-term outcome of total knee arthroplasty (TKA) in non-obese and obese patients. Material and Methods: A total of 100 patients underwent TKA between October 2006 and March 2007. They were divided into two groups based on the body mass index: 52 of the patients were obese (BMI ≥ 30 kg/m2) and 48 non-obese (BMI < 30 kg/m2). The short-term outcome was studied using clinical, functional and radiological analysis. The mean of the follow-up period was 3 months. Results: There were five complications (2 wound infections, phlebitis, nerve injury and massive edema) in obese patients group compared with no complications in non-obese (p = 0.028). The obese patients had also worse postoperative range of motion (110o̱ vs.118o̱, p = 0.001) than non-obese and the number of technical errors was 17 in obese and 5 in non-obese group, respectively (p = 0.007). Conclusions: We suggest that obesity may impair the early outcome of total knee arthroplasty and obese patients should be informed about the increased risk of complications related to TKA.
Feasibility of Minilaparotomy versus Laparoscopic Cholecystectomy for Day Surgery: A Prospective Randomised Study
Authors: Harju J. , Kokki H. , Pääkkönen M. , Karjalainen K. , Eskelinen M. 
Published: January 2017

Background and Aims: Minilaparotomy (MC) and laparoscopic cholecystectomy (LC) are commonly applied surgical techniques in the management of symptomatic gallstone disease. Both techniques are used in day surgery patients, but to our knowledge MC and LC have not been compared in randomised trials as day surgery procedures. Material and Methods: In this randomised parallel group clinical trial we compared the success rate of day surgery of MC with that of LC in 60 consecutive patients with non-complicated symptomatic gallstones presented for elective surgery at the Kuusankoski District Hospital (n = 38) and the Kuopio University Hospital (n = 22). Twenty nine patients underwent MC and 31 LC. The patients' outcome was recorded up to four weeks after the operation. Results: The success rate as a day surgery for MC was 66% (19/29) and that for LC 55% (17/31) with no difference between the two groups. Chronic cholecystitis, postoperative nausea and vomiting were significant variables associated with failure in day surgery. There was no difference between the two groups in operation time, perioperative bleeding, conversion to conventional open cholecystectomy (one with MC and three with LC), length of hospital stay or sick leave. Three patients developed superficial infection (two with MC and one with LC). One patient with conversion in the LC-group developed a common bile duct stricture and was readmitted at the 10th postoperative day. Discussion: Both MC and LC are feasible surgical techniques for day surgery. However, appropriate prevention and prompt management of established postoperative nausea and vomiting and careful patient selection are important aspects for success of short-stay approach. If there is a sign of chronic cholecystitis preoperatively, it might be considered as a contraindication for day surgery.
Impact of Early Angiographic Evaluation on the Frequency of Emergency Reoperations after Coronary Bypass Surgery
Authors: Karhunen J. , Raivio P. , Maasilta P. , Sihvo E. , Suojaranta-Ylinen R. , Vento A. , Salminen U. S. 
Published: January 2017

Background and Aims: Early graft failure following coronary bypass surgery results in elevated morbidity and mortality. This study focused on the impact of angiographic graft evaluation. Material and Methods: Of 5251 coronary artery bypass grafting (CABG) patients, 36 with postoperative persistent ischaemia underwent early angiography (23) or emergency resternotomy (13) 2000–2007 (Angiography era). Of the 23 patients, who underwent angiography, five were subsequently reoperated. Of 8807 CABG patients, 76 underwent postoperative emergency resternotomy 1988–1999 (Pre-angiography era) and served as controls. Results: The Angiography era patients were older (64.0 years vs. 58.2 years, P = 0.002) and the proportion of female patients (22% vs. 43%, P = 0.029) was smaller. The rate of emergency reoperations decreased (0.86% vs 0.34%, P < 0.001) during the Angiography era and graft repairs ( P = 0.013) or additional grafts ( P = 0.006) were less frequent, although occluded anastomoses were observed more often ( P = 0.043). In 5 Angiography era patients graft complications were corrected with percutaneous coronary intervention. ICU stay (5.72 ± 0.98 days vs. 5.53 ± 0.68 days) and hospital stay (12.2 ± 1.54 days vs. 13.1 ± 1.63 days) did not differ between the groups, but the rate of myocardial infarction (63.8% vs. 92.1%, P < 0.001) and in-hospital death (22.2% vs. 46.1%, P = 0.015) decreased. Conclusion: After the introduction of early postoperative angiographic evaluation of CABG patients the rate of emergency reoperations and related morbidity and mortality decreased.
Surgical Outcomes and Prognostic Factors for Ampulla of Vater Cancer
Authors: Choi S. B. , Kim W. B. , Song T. J. , Suh S. O. , Kim Y. C. , Choi S. Y. 
Published: January 2017

Background and Aims: The prognosis for patients with ampulla of Vater cancer is better than other periampullary cancers. The aim of the present study is to determine the clinicopathologic factors predictive of survival and recurrence in patients with ampulla of Vater cancer. Material and Methods: From 1991 to 2008, we identified and reviewed 78 patients with ampulla of Vater cancer retrospectively. Clinicopathologic factors possibly influencing survival and recurrence were statistically analyzed. Results: Pancreaticoduodenectomy was performed in 68 patients and 2 patients underwent transduodenal ampullectomy. Hospital mortality was 2.6%. The 5-year survival rates following resection were 59.9%. Univariate analysis for overall survival revealed that total bilirubin greater than 5mg/dl, ulcerative tumors, differentiation, and pancreatic invasion were significant prognostic factors. Recurrence occurred in 31 patients. Univariate analysis for disease-free survival revealed that total bilirubin greater than 5mg/dl, preoperative biliary drainage, tumor differentiation, and stage were statistically significant. Multivariate analysis revealed that tumor differentiation was an independent prognostic factor for recurrence. The presence of lymph node metastasis did not affect overall survival significantly in this study. However, two or more metastatic lymph nodes significantly affect disease-free survival. Conclusions: Pancreaticoduodenectomy is a safe surgical procedure with acceptable long-term survival for ampulla of Vater cancer. Pancreaticoduodenectomy with lymph node dissection might control lymph node spread and enhance survival outcome.
Secondary Healing versus Midline Closure and Modified Bascom Natal Cleft Lift for Pilonidal Sinus Disease
Authors: Dudink R. , Veldkamp J. , Nienhuijs S. , Heemskerk J. 
Published: January 2017

Background and Aims: Pilonidal sinus disease is a common disease in young employed male adults. Ongoing discomfort usually indicates an operative intervention. The main drawback is however the complication of wound healing. Numerous techniques for surgical treatment have been proposed, which underlies the lack of a superior technique. Material and Methods: A retrospective study was performed on the medical notes of 62 patients operated for a pilonidal sinus between May 2005 and December 2006. Used techniques were: ‘modified Bascom procedure’, ‘excision and primary closure’ and ‘excision with secondary wound healing’. Patients' characteristics, operative parameters and data on outcome were included. The primary endpoint was wound healing. Results: Twenty-five patients underwent the modified Bascom procedure, 19 underwent surgical excision with primary midline closure and 18 underwent surgical excision with secondary wound healing. There were no demographical differences between the groups of patients. The modified Bascom technique showed a significantly reduced wound healing time (29 days) compared to primary closure (52 days, p < 0.01) and secondary healing (62 days, p < 0.01). The duration of this modified procedure was significantly longer (49, 33 and 24 minutes respectively, p < 0.01). Conclusions: Wound healing remains an important problem in the surgical treatment of pilonidal disease. Significant faster convalescence can be achieved using the modified Bascom procedure. Wide local excision as primary therapy should not be advocated.
Management of Cement Vertebroplasty in the Treatment of Vertebral Hemangioma
Authors: Boschi V. , Pogorelić Z. , Gulan G. , Perko Z. , Grandić L. , Radonić V. 
Published: January 2017

Background: The vertebral hemangiomas are benign vascular lesions occurring in spine. Although uncommon, symptomatic vertebral hemangiomas can be painful and can limit daily activities. A number of methods have been used in the treatment of symptomatic and aggressive vertebral hemangioma, but none of them is optimal. Treatment with cement vertebroplasty showed very good results. This study aims to illustrate the validity of the treatment with cement vertebroplasty in patients with painful vertebral hemangiomas. Patients and Methods: From January 2000 to January 2007, 24 patients were treated by percutaneous vertebroplasty because of hemangioma: 16 thoracic, 8 lumbar. There were 11 males and 13 females. The average age at the time of surgery was 48 years. All the patients complained of a pain syndrome resistant to continuing medication. All patients underwent X-ray examination, CT-scan and MR of the involved level preoperatively. A unipedicular approach under fluoroscopic guidance has been performed in all patients. All procedures have been carried out under the local anesthesia. The mean follow-up was 5.8 years. Results: In all the patients a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular cement leakage has been observed in 3 patients, without any clinical radicular syndrome onset due to the epidural diffusion. Clinical and radiological follow-up showed stability of the treatment and absence of pain in all patients. Conclusion: Percutaneous treatment with vertebroplasty for symptomatic vertebral hemangiomas is a valuable, less-invasive, and a quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of the vertebral body's fracture.
Role of sexual partner and social networking in fracture penis aetiology
Authors: Majhi Paresh C , Patro Chandra S , Singh Gyan P , Hota Datteswar 
Published: January 2017

Introduction Fractured penis is a well-recognised urological emergency resulting from blunt trauma to the erect penis. The incidence and severity of penile fracture mostly relies on the method of sexual practice adopted by the couple which again depends on their psychosocial behaviour. The aim of this study was to analyse the different circumstances that accompany this injury in relation to severity, such as associated urethral injury, and to address the contribution of the patients’ partners in possible aetiologies and prevalences. Methods A prospective observational study over two years of all patients presenting to our institution with a fractured penis. All patients who were subjected to detailed history and clinical examination, which included educational status, profession and access to internet. The patients’ partners were asked the same questions as well as a sexual behaviour questionnaire to grade their level of sexual appetite. Results Thirteen patients were included; all patients were married with an average age of 37. The coital positions associated with this injury were female on top position (four cases), T position (three cases), knee–elbow coital position (two), male superior coital position (two) and lateral coital position (one); one couple were unable to explain the exact position. Overall, 11/13 (85%) female partners showed moderate to high sexual appetite and only two (15.5%) showed low appetite. Out of the 26 patients and partners, only nine (34.6%) had a profession related to computers, but 16 (61.5%) of them had access to the internet. Conclusions High aggressive sexual behaviour may be a factor for vigorous sexual activity and increase the chance of penile injury. The exact role of social networking though not well established may precipitate more injury through the learning of different coital positions; ‘female on top position’ may be related to a higher incidence of fractured penis.
Relationship between Coping and Depression in Heart Transplant Candidates and Their Spouses
Authors: Burker Eileen J. , Evon Donna M. , Ascari Jill C. , Loiselle Marci M. , Finkel Jerry B. , Mill Michael R. 
Published: January 2017

Context Survival rates for heart transplantation are encouraging, but the pretransplant period can be extremely stressful for patients and their spouses. Although a relationship between patients' depression levels and the coping strategies employed by their spouses has been demonstrated, this association has not been examined in heart transplant candidates and their spouses. Depression in this group of patients is important because heart transplant patients with preoperative depression have been found to have a higher mortality rate after transplantation. Objective To determine if a relationship exists between spousal coping strategies and heart transplant candidates' depression. Methods A descriptive, exploratory pilot study. Participants Twenty-two individuals with end-stage heart disease who were undergoing an inpatient evaluation for heart transplantation, plus their spouses. Design Heart transplant candidates were assessed via the Structured Interview Guide for the Hamilton Depression Scale. Spouses completed the COPE Inventory and the Center for Epidemiological Studies Depression Scale. Results Spousal behavioral disengagement was positively associated with heart transplant candidates' depression. Conclusions Heart transplant candidate depression may follow spousal disengagement, or, conversely, a spouse may disengage in response to the patient becoming depressed. Identification during the pretransplant evaluation of those spouses who cope using behavioral disengagement might be a first step in the process of assessment and intervention. Clinical interventions may need to focus on the spouse as well as on the transplant candidate.
Alternative Therapy Use in Liver Transplant Recipients
Authors: Tickerhoof Lisa , Wagener Marilyn M. , Cacciarelli Thomas V. , Singh Nina 
Published: January 2017

Background The extent of use of alternative therapies and the psychosocial variables predictive of their use have not been well defined in liver transplant recipients. Objective To determine types of alternative therapies used by liver transplant recipients and to assess psychosocial, behavioral, and quality of life variables associated with the use of alternative therapies in these patients. Methods Assessment of types of alternative therapies used, demographic characteristics, satisfaction with social support, coping styles, sense of personal control (mastery), quality of life, and health beliefs in 32 liver transplant recipients. Results Overall, 34.4% of the liver transplant recipients used a form of alternative therapy. Herbal products were used by 45% of the alternative therapy users and included milk thistle (silymarin), eclipta, and green beet leaf—all considered “hepatic tonics.” Alternative therapy users tended to have greater problem-focused coping skills than nonusers ( P = .08). Nineteen percent of the patients incurred annual out-of-pocket expense of at least $100 for alternative therapies. Patients incurring out-of-pocket expenses reported better overall health ( P = .02), were more likely to be employed ( P = .025), and had higher mastery scores ( P = .01). Conclusions Use of alternative therapies is common after liver transplantation. Herbal products used by liver transplant recipients are disease specific; that is, they claim to promote liver health.
Depression in Primary Caregivers of Patients Listed for Liver or Kidney Transplantation
Authors: Bolkhir Ahmed , Loiselle Marci M. , Evon Donna M. , Hayashi Paul H. 
Published: January 2017

Background No studies have examined depression in primary caregivers of adult patients listed for liver or kidney transplantation. Objective To determine the prevalence of depression among primary caregivers of patients listed for liver or kidney transplantation and to compare these 2 groups. Design A cross-sectional survey was conducted. The Center for Epidemiologic Studies Depression Scale and a demographic questionnaire were sent out and returned by mail. Results Of 72 eligible primary caregivers, 42 (58%) participated; the participation rate was similar for caregivers of kidney and liver failure patients (21/32 [66%)] vs 21/40 [53%], P = .3). Mean caregiver age was 54.7 ± 13.6 years. Twenty-three caregivers (54.8%) were spouses, 15 (35.7%) were first-degree relatives, and 26 (62%) were women. Median depression scale score was 5.5 (0–36). Three (7%), 2 (5%), and 3 (7%) participants reported mild, moderate, and severe depression, respectively. Median Center for Epidemiologic Studies Depression Scale score was higher among caregivers of liver versus kidney patients, but the difference was not statistically significant (9 vs 4, P = .2). Depression scale scores did not correlate with age, sex, time listed, or nature or length of relationship with the patient. The prevalence of depression in primary caregivers was 19%; of these caregivers, one third may have had severe depression. Conclusions The prevalence of moderate to severe depression in primary caregivers of liver and kidney transplant candidates is significant. The impact of depression on caregivers as well as patients, both before and after transplantation, deserves study. Screening for depression in caregivers could lead to clinical interventions that benefit caregivers and indirectly improve patient outcomes.