bluuebunny/crossref_metadata_2025_split huggingface dataset:
USE OF PORCINE SMALL INTESTINAL SUBMUCOSA IN BLADDER AUGMENTATION IN RABBIT: LONG‐TERM HISTOLOGICAL OUTCOME
Authors: Ayyildiz Ali , Akgül K. Turgay , Huri Emre , NuhoğLu Bariş , Kiliçoğlu Bülent , ÜStün Hüseyin , Gürdal Mesut , Germiyanoğlu Cankon 
Published: August 2010

Aim:  To investigate long‐term histological features of bladder augmentation using porcine small intestine submucosa (SIS) in a rabbit model.Materials and method:  Sixteen New Zealand rabbits were used. Porcine SIS was provided by a manufactured formation derived from the pig. After partial cystectomy was carried out on the bladder, a single layer of SIS (Cook®‐SIS Technology, Cook Biotech Incorporated, West Lafayette, IN, USA) (2 × 5 cm) was sewn to bladder with continuous 5/0 vicryl suture material in a watertight manner. Urinary diversion was not used. The rabbits were killed 12 months later and perivesical fat was removed together with bladder. The 5‐μm preparations taken from the samples were stained with haematoxylin–eosin and Mason’s trichrome dye. S‐100 and F8 stains were also used for immunohistochemical investigations.Results:  The macroscopic view of bladder was normal. SIS was indistinguishable from normal bladder wall, but the region of the graft had a slight white coloration. Microscopic observations showed the continuity of transitional epithelium of host bladder tissue on SIS material. Detrusor and serosal layers were formed and these layers were indistinguishable from host bladder. Fibroblasts were scattered among the collagen fibrils. New vessel formations were present without lymphatic proliferation. Nerve regeneration was excellent. No inflammation was observed in normal and regenerated bladder wall.Conclusion:  At the end of 12 months, the long‐term histological features of bladder augmentation with porcine SIS in a rabbit model, such as presence of new vessel formations, nerve regeneration, collagen and smooth muscle regenerations, which were indistinguishable from original bladder, and the absence of inflammation, showed that SIS seems to be a viable alternative to the use of intestine in bladder augmentation.
INFERIOR VENA CAVA FILTERS AND LOWER LIMB FLAP RECONSTRUCTIONS
Authors: Lo Cheng H. , Leung Michael , Leong James 
Published: August 2010

Background:  This is the first ever study looking at the combination of inferior vena cava (IVC) filters and flap reconstruction in traumatic lower limb injuries. The use of IVC filters is increasing and they are now being used prophylactically in trauma patients who are at a high risk of developing thromboembolism disease. Although it has been postulated that IVC filters, through its positioning in the IVC, results in a higher incidence of venous congestion and possibly failure of lower limb flaps, the effect of IVC filters on lower limb flap reconstructions has not been addressed in the published works. The aim of this study was to determine whether IVC filters affect the outcome of lower limb flap reconstructions in the trauma patient.Methods:  Retrospective case series analysis of consecutive patients at the Alfred Hospital (Melbourne, Australia) who had lower limb flap reconstruction(s) and IVC filter placement from 1 July 2001 to 22 March 2005 (44‐month period).Results:  Seventeen patients (12 men and 5 women) had 23 lower limb flap reconstructions (10 free, 13 local flaps) and IVC filter insertion. All 23 flaps survived with no flap failures. A gracilis muscle free flap developed venous congestion but survived with conservative management.Conclusions:  In our series, IVC filters were not associated with poor outcomes of lower limb flap reconstructions. These findings are encouraging, and based on the evidence to date, the presence of IVC filters should not deter lower limb flap reconstructions in trauma patients. In particular, free flap surgery to traumatized lower limbs is not an issue with patients who have IVC filters.
RISK FACTORS AFFECTING CONVERSION IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Zhang Wei‐Jie , Li Jie‐Ming , Wu Guo‐Zhong , Luo Kun‐Lun , Dong Zhi‐Tao 
Published: August 2010

Background:  Laparoscopic cholecystectomy is the gold standard in the treatment for cholelithiasis, but there are still some patients requiring conversion to open cholecystectomy for several factors. The objective of this study was to evaluate preoperative risk factors for conversion from laparoscopic to open cholecystectomy.Methods:  One thousand two hundred and sixty‐five laparoscopic cholecystectomies were carried out from January 2005 to January 2006 in our hospital. Preoperative clinical, laboratory and radiographic parameters of these patients were kept prospectively and analysed retrospectively.Results:  Conversion to open cholecystectomy was needed in 94 patients (7.4%). The main reason for conversion was inability to safely display and identify anatomical structures of Calot’s triangle correctly secondary to severe inflammation or dense adhesions, Multivariate analysis identified male sex, with Murphy’s sign positive, gall bladder wall thickness > 4 mm and previous upper abdominal surgery as independent predictors of conversion rate to laparotomy.Conclusion:  Preoperative risk factors evaluated by the present study confirm the likelihood of conversion. Recognition of these factors was important for understanding the characteristics of patients at a higher risk of conversion. Identifying risk factors will help the surgeon to plan and counsel the patients and introduce new policies.
ILIOINGUINAL LYMPH NODE DISSECTION FOR PALPABLE METASTATIC MELANOMA TO THE GROIN
Authors: Allan Christopher P. , Hayes Andrew J. , Thomas J. Meirion 
Published: August 2010

Background:  Block dissection of the inguinal lymph nodes is the routine management for palpable metastatic melanoma confined to this node basin. Involvement of the next tier external iliac and obturator lymph nodes in the pelvis is common, and untreated pelvic nodal disease can become advanced before becoming clinically apparent. We have routinely performed combined inguinal and pelvic (ilioinguinal) lymph node block dissection to avoid this morbid outcome.Methods:  A retrospective analysis of all patients undergoing ilioinguinal lymph node dissection for melanoma between January 1998 and January 2006 was carried out.Results:  There were 72 patients with a median age of 52.7 years (19.7–75.2 years) who were followed up for a median of 28.9 months (1.0–115.0 months) after ilioinguinal lymph node dissection. There were 22 (30.6%) of 72 patients with histologically involved pelvic lymph nodes. Preoperative computed tomography (CT) scanning accuracy for pelvic lymph node involvement was as follows: sensitivity 60.0%, specificity 100.0%, positive predictive value 100.0% and negative predictive value 86.2%. Lymphoedema was reported in 32 (44.4%) of 72 patients. Median time to first recurrence was 8.7 months (0.8–69.7 months). Regional recurrence occurred in 6 (8.3%) of 72 patients at a median of 4.9 months (0.9–32.0 months). Extranodal spread was the only factor adversely associated with disease‐free survival. In all patients, 5‐year disease‐free survival was 38% (95% confidence interval (CI) 26–50) and overall survival 47% (95% CI 33–60).Conclusion:  Palpable metastatic melanoma in the groin is commonly associated with pelvic lymph node involvement, is not well predicted by CT scanning and is appropriately managed by ilioinguinal lymph node block dissection.
NEWBORN CIRCUMCISION IN VICTORIA, AUSTRALIA: REASONS AND PARENTAL ATTITUDES
Authors: Xu Bo , Goldman Hershel 
Published: August 2010

Objective:  The objective of this study was to study the reasons why some parents continue to seek professional circumcision service for their newborn boys in Victoria, Australia, their attitudes towards newborn circumcision and their personal characteristics.Subjects and methods:  One hundred thirty‐six parents (62 fathers and 74 mothers) who presented to the Melbourne Circumcision Centre between July and December 2007 were recruited. They represented the parents of 85 newborn boys. A questionnaire designed by the authors was completed by the parents before circumcision. The responses were tabulated and analysed.Results:  The most common reasons for newborn circumcision were hygiene (77.9%), family tradition (57.4%) and medical reasons (36%). The most common perceived benefit was hygiene (95.6%). The most common concern was pain (79.4%). As the number of boys a mother had who were already circumcised increased, the age at circumcision of the newborn boy became earlier (P = 0.024). 41.2% of parents wished for further information to help them better make the decision before or at the time of childbirth in the hospital setting. 76.5% of parents would, 19.1% of parents were unsure and 4.4% would not recommend newborn circumcision by an experienced practitioner to other parents.Conclusion:  Some parents continue to circumcise their newborn boys for hygiene, family tradition and medical reasons in Victoria, Australia. Information about the pros and cons of newborn circumcision needs to be made more readily available to empower parents to make free, informed decisions.
The outcome of patients on the cholecystectomy waiting list in Western Australia 1999–2005
Authors: Epari Krishna P. , Mukhtar Aqif S. , Fletcher David R. , Samarasam Inian , Semmens James B. 
Published: August 2010

AbstractBackground:  Surgeons are noticing increasing numbers of cholecystectomy waiting list patients presenting with complications of their gallstones. In this study, we analysed the outcome of these to ascertain natural history and outcome.Methods:  Data for 5298 waiting list patients in Western Australia, from 1999 to 2006, were analysed. Negative binomial regression was used to analyse waiting times data with Waitlist Year, Urgency Category and Aboriginality, after adjusting for Gender, Location and Age at Cholecystectomy.Results:  The overall median waiting time for surgery was 40 days (interquartile range (IQR) = 15–103). The median waiting times for Urgent, Semi‐Urgent, and Routine categories were 21 (IQR = 8–63), 44 (IQR = 20–97) and 50 (IQR = 17–131) days, respectively. While waiting for surgery, 240 (5%) patients had gallstone‐related admissions. Eighty (33.3%) patients had previous gallstone‐related admissions prior to their enrolment on the waiting list. Analysis of the crude odds ratio showed that the probability of readmission during wait for surgery was three times more, when the surgery was not performed within the recommended time. Aboriginal and Torres Strait Islanders wait 1.77 times longer than non aboriginals (P < 0.001) and waiting time decreased with more recent calendar years. (P= 0.001) Patients in the metropolitan hospitals waited twice as long compared with the regional hospitals (P < 0.001).Conclusion:  Approximately 5% of patients on the waiting list for an elective cholecystectomy were readmitted to the hospital for gallstone‐related problems. Proper categorization of patients and definitive surgical treatment of acute gallbladder disease at index presentation might decrease this readmission rate. More effort needs to be made to ensure equity of access for gallstone patients.
Exploring Australasian Surgical Trainees' Satisfaction with Operating Theatre Learning Using the ‘Surgical Theatre Educational Environment Measure’
Authors: Mahoney Adam , Crowe Philip J. , Harris Peter 
Published: August 2010

AbstractBackground:  Surgical trainees' operating theatre (OT) experiences significantly influence their ability to attain key professional competencies. A measure of trainees' satisfaction with this learning environment would allow recognition of characteristics of highly successful teaching venues and threats to trainee development. Our study aimed to validate the Surgical Theatre Educational Environment Measure (STEEM) and use it to explore Australasian surgical trainees' satisfaction with OT learning.Methods:  In a cross‐sectional study, the STEEM was distributed electronically to all 1500 Royal Australasian College of Surgeons trainees in Australia and New Zealand. Trainee satisfaction was gauged using Likert‐type items, an overall satisfaction measure and content analysis of free‐text comments. The STEEM's psychometric properties were evaluated using exploratory factor analysis.Results:  Three hundred fifty‐six responses were received. The STEEM's original subscales were not supported by the data; empirically grounded subscales were identified for further analysis. Most trainees were satisfied with their OT environment and satisfaction was higher in senior than junior trainees. Trainees' relationship with their supervisor correlated most strongly with overall satisfaction. Less positively, only half of trainees report discussing their operative role with their supervisor prior to surgery.Conclusions:  The a priori STEEM subscales could not be replicated by factor analysis. We developed an empirically grounded instrument capable of identifying areas of trainee concern. The majority of trainees reported high levels of satisfaction. The revised instrument has potential to complement other sources of information to facilitate surgical supervisors' difficult task of optimizing trainees' compatibility with their OT learning environments.
Predicting trauma patient mortality: ICD [or ICD‐10‐AM] versus AIS based approaches
Authors: Willis Cameron D. , Gabbe Belinda J. , Jolley Damien , Harrison James E. , Cameron Peter A. 
Published: August 2010

AbstractBackground:  The International Classification of Diseases Injury Severity Score (ICISS) has been proposed as an International Classification of Diseases (ICD)‐10‐based alternative to mortality prediction tools that use Abbreviated Injury Scale (AIS) data, including the Trauma and Injury Severity Score (TRISS). To date, studies have not examined the performance of ICISS using Australian trauma registry data. This study aimed to compare the performance of ICISS with other mortality prediction tools in an Australian trauma registry.Methods:  This was a retrospective review of prospectively collected data from the Victorian State Trauma Registry. A training dataset was created for model development and a validation dataset for evaluation. The multiplicative ICISS model was compared with a worst injury ICISS approach, Victorian TRISS (V‐TRISS, using local coefficients), maximum AIS severity and a multivariable model including ICD‐10‐AM codes as predictors. Models were investigated for discrimination (C‐statistic) and calibration (Hosmer–Lemeshow statistic).Results:  The multivariable approach had the highest level of discrimination (C‐statistic 0.90) and calibration (H–L 7.65, P= 0.468). Worst injury ICISS, V‐TRISS and maximum AIS had similar performance. The multiplicative ICISS produced the lowest level of discrimination (C‐statistic 0.80) and poorest calibration (H–L 50.23, P < 0.001).Conclusions:  The performance of ICISS may be affected by the data used to develop estimates, the ICD version employed, the methods for deriving estimates and the inclusion of covariates. In this analysis, a multivariable approach using ICD‐10‐AM codes was the best‐performing method. A multivariable ICISS approach may therefore be a useful alternative to AIS‐based methods and may have comparable predictive performance to locally derived TRISS models.
Radiofrequency ablation for hepatocellular carcinoma: a survival analysis of 117 patients
Authors: Li Wing‐Hong , Ma Ka‐Wing , Cheng Mina , Chui King‐Him , Chan Pat‐Tat , Chu Wai‐Ho , Fung Hon‐shing , Kowk Chong‐Hei , Cheung Moon‐Tong 
Published: August 2010

AbstractBackground:  Hepatocellular carcinoma (HCC) is one of the most common malignancies in the world especially in Asia. Radiofrequency ablation is now commonly use as either first line or in combination with other treatment modality for patients with HCC. It is the objective of this article to report our experience in a tertiary referral hospital.Methods:  Patients who diagnosed with HCC and underwent RFA in Queen Elizabeth Hospital during the period from May 2002 to February 2009 were included and analyzed.Results:  During this period, 138 sessions of RFA were performed in 117 consecutive patients with HCC. The calculated rate of primary (single attempt) successful ablation during this entire period was 89.2%. The in‐hospital/30‐day mortality rate was zero, and morbidity was 24.1%. Hospital stays were significantly longer in the open group (4.4 days versus 8.9 days, P = 0.000). Median follow‐up in this study was 21 months. 11 (9.4%), 10 (8.5%) and 49 (41.0%) patients developed local tumor progression (LTP), systemic recurrence and Intrahepatic distant recurrence (IDR), respectively. The mean and median times to recurrence were 15.4 and 11 months, respectively. Most patients (91%) with LTP developed in the first 24 months. Disease‐free survival was 65% at 1 year, 40% at 3 years and 25% at 5 years. Overall survival at 1, 3 and 5 years was 85, 66 and 40%, respectively. Alpha fetoprotein, aFP > 1,000 ng/ml and multiple tumor ablation predicted increased risk of recurrence.Conclusion:  Radiofrequecy ablation is useful tool in treating patients with HCC with high successful rate. However, intrahepatic recurrence is common and a well designed post ablation follow up protocol based on a sound knowledge of recurrence pattern is vital.
CYCLOSERINE IN THE TREATMENT OF URINARY INFECTION
Authors: KUBIK M. M. , DATTA K. 
Published: August 2010

SUMMARYOne hundred and fifty patients, most of them elderly, with urinary infection were treated with cycloserine, 250 mg. twice or three times daily for one week.In 60 per cent, of the cases E. coli was found to be the sole or principal organism isolated in the urine.The result of treatment was classified as good in seventy‐four patients (50 per cent.), fair in thirty‐three patients (22 per cent.), and forty‐three (28 per cent.) were failures.A generous supply of cycloserine for this trial was received from Messrs Eli Lilly and Company Limited.We also wish to thank the staff of the Department of Pathology, Burton Road Hospital, for their help.
NEUROGENIC DISORDERS OF THE BLADDER IN PARKINSONISM1
Authors: MURNAGHAN G. F. 
Published: August 2010

SUMMARY

A high incidence of urinary symptoms is reported in twenty‐nine patients with Parkinsonism.
Urological investigation of these patients by cystometry and cystography revealed a significant incidence of uninhibited neurogenic bladder disorder, though such tonic bladder activity was not apparently directly related to increased tonus of the striated musculature of the external urethral sphincter.
The changes in cystometrogram pattern following stereotaxic surgery show a relationship between lesions in the thalamus or pallidum and tonic bladder activity to suggest participation of the extrapyramidal component of the nervous system in the higher centre control of micturition.
EVALUATION OF THE Hg197CHLQRMERQDRIN KIDNEY SCAN
Authors: Chtsholm G. D. , Aye M. M. , Evans K. 
Published: August 2010

SUMMARYThe radioisotope kidney scan, using Hg197chlormerodrin, has been studied in 120 patients. The properties of the isotope and the technique of the scan are described. Four groups of patients are evaluated: (1) with normal kidney function, (2) with space‐occupying lesions, (3) with unilateral kidney disease, and (4) with uræmia. The findings in each group are discussed.It is concluded that the information obtained from a kidney scan in respect of size, shape, and pathology adds little to that obtained from other urological investigative techniques. However, the kidney scan appears to be of particular value as a measure of functioning renal tissue and this aspect merits further study by more recently developed isotopic methods.We wish to thank Professor Ralph Shackman for permission to study these patients who were under his care. We are indebted to the Department of Medical Physics, Hammersmith Hospital, for their guidance and help and to Mrs J. Stiles, Miss G. Thompson and Miss M. Gallagher for technical assistance. This work was supported in part by a grant from the Medical Research Council.
RENAL ANGIOGRAPHY BY THE PER‐CUTANEOUS NON‐CATHETER LEFT BRACHIAL TECHNIQUE
Authors: Caine Marco , Kedar ShimeonS. , Schwartz Armin 
Published: August 2010

SUMMARYA description is given of the technique of renal angiography by the per‐cutaneous non‐catheter left brachial route.The advantages of this method over the more usual trans‐lumbar and per‐femoral techniques are described, and the possible complications or limitations are discussed.Our experience leads us to recommend this as the method to be preferred for the routine performance of renal angiography.
Providing comprehensive smoking cessation care to surgical patients: The case for computers
Authors: WOLFENDEN LUKE , WIGGERS JOHN , CAMPBELL ELIZABETH , KNIGHT JENNY , KERRIDGE ROSS , SPIGELMAN ALLAN 
Published: August 2010

Abstract
Introduction and Aims. The provision of smoking cessation care to surgical patients before admission can reduce post‐operative complications and encourage long‐term smoking cessation. Our aim was to show how a comprehensive computer‐based smoking cessation intervention, developed to enhance smoking cessation care to surgical patients, addresses barriers to care provision. Design and Methods. Consultations with preoperative clinic staff and reviews of the scientific literature were conducted and identified the following barriers to the provision of effective smoking cessation care: a lack of organisational support, perceived patient objection, a lack of systems to identify smokers, a lack of staff time and skill, perceived inability to change care practices, a perceived lack of efficacy of cessation care and the cost of providing care. Based on positive findings of a pilot trial, a comprehensive computer‐based smoking cessation intervention was implemented in a preoperative clinic. Data from previous evaluations of the intervention were used to assess the extent to which the intervention addressed clinician barriers to care. Results. The computer‐based intervention was found to provide a means to accurately and systematically identify smokers; it required little clinical staff time or skill; it was considered an acceptable form of care by staff and patients; it was effective in encouraging patient cessation and it was inexpensive to deliver relative to other surgical costs. Furthermore, the computer‐based intervention continues to operate in the preoperative clinic in the absence of ongoing research support. Discussion and Conclusions. The implementation of such a model of care should be considered by clinical services interested in reducing the smoking related morbidity and mortality of patients.[Wolfenden L, Wiggers J, Campbell E, Knight J, Kerridge R & Spigelman A. Providing comprehensive smoking cessation care to surgical patients: The case for computers. Drug Alcohol Rev 2009;28:60–65]