bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomized double-blind placebo-controlled trial of early octreotide in patients with postoperative enterocutaneous fistula
Authors: Sancho J J , di Costanzo J , Nubiola P , Larrad A , Beguiristain A , Roqueta F , Franch G , Oliva A , Gubern J M , Sitges-Serra A 
Published: March 2007

Abstract
Somatostatin and octreotide both enhance closure of gastrointestinal fistulas. The present trial was undertaken to test whether early combined treatment with parenteral nutrition and octreotide 100 μg every 8 h by subcutaneous injection had a beneficial effect compared with parenteral nutrition plus placebo. Thirty-one patients with postoperative gastrointestinal or pancreatic fistula were randomly assigned to receive parenteral nutrition plus octreotide (14 patients) or placebo (17) within 8 days of fistula onset. The percentage reduction in output and rate of spontaneous closure within 20 days were analysed. Mean(s.d.) reduction in output was similar after octreotide and placebo at 24 h (66(43) versus 68(47) per cent, P = 0.9), 48 h (60(46) versus 57(43) per cent, P = 0.8) and 72 h (62(50) versus 66(49) per cent, P = 0.9) after starting the combined treatment. Closure within 20 days was observed in eight of 14 fistulas in patients given octreotide and in six of 17 in those receiving placebo (P = 0.4). Administration of octreotide, within 8 days of fistula onset, associated with parenteral nutrition does not significantly increase the spontaneous fistula closure rate compared with parenteral nutrition plus placebo.
Activated carbon-oriented gastrectomy for early gastric cancer
Authors: Kitamura K , Hagiwara A , Otsuji E , Shimotsuma M , Taniguchi H , Yamaguchi T , Sawai K , Takahashi T 
Published: March 2007

Abstract
Twenty-two patients with early gastric cancer received injections of activated carbon particles (CH-40) to identify during surgery the location of non-palpable tumours present in the upper portion of the stomach. A few days before surgery, 0.2 ml of CH-40 was injected endoscopically into the gastric muscle adjacent to the cancer. In 20 of the 22 patients, the CH-40-stained area was recognized as a blackened patch on the serosal surface of the stomach which indicated the location of the non-palpable cancer tissue. The surgical margin for gastrectomy was defined as the proximal margin of the carbon-stained area and gastrectomies were performed on the 22 patients. CH-40 injection made it possible to choose the extent of lymph node dissection.
Laparoscopic ‘physiological’ antireflux procedure: Preliminary results of a prospective symptomatic and objective study
Authors: Watson A , Spychal R T , Brown M G , Peck N , Callander N 
Published: March 2007

Abstract
The ‘physiological’ antireflux procedure has been shown to be as effective as Nissen fundoplication in reflux control, but with a significant reduction in the incidence of mechanical complications. This technique was attempted laparoscopically in 26 patients in a prospective study involving independent symptomatic, manometric and pH assessment performed before operation and at a mean of 5.5 months after operation. The procedure was successfully completed laparoscopically in 23 (88 per cent) patients. Mean hospital stay was 3.8 days and mean time to return to work 1.8 weeks. There was neither mortality nor reoperation; 91 per cent of patients obtained symptomatic relief (82 per cent Visick grade 1). There was no gas-bloat or inability to belch or vomit. All 14 patients who underwent objective testing had a normal oesophageal pH profile, the mean percentage total time that pH &lt; 4 falling from 11.0 to 1.1 (P &lt; 0.001). Lower oesophageal sphincter characteristics, including relaxation, were similar to control values. These preliminary results suggest symptomatic and objective results comparable to those following open surgery, but with the benefits of a shorter hospital stay and time off work. In addition to a lower incidence of mechanical complications, the relative ease of performance of this procedure confers an additional advantage over Nissen fundoplication when performed laparoscopically.
Laparoscopic exploration of the common bile duct: Lessons learned from 129 consecutive cases
Authors: Rhodes M , Nathanson L , O'Rourke N , Fielding G 
Published: March 2007

Abstract
Since the introduction of laparoscopic cholecystectomy there has been widespread debate about the best way to manage common bile duct (CBD) calculi. Between August 1991 and July 1994, 129 patients underwent laparoscopic exploration of the CBD. Fifteen patients of median age 52 years were managed by glucagon-induced relaxation of the sphincter of Oddi and saline flushing of the bile duct through a cholangiogram catheter. This had a success rate of 73 per cent and took a median of 90min including cholecystectomy. The technique has now been replaced by Dormia basket exploration of the CBD. Transcystic common duct exploration using a Dormia basket was used in 79 patients of median age 47 years. Duct clearance was achieved in 96 per cent of cases with a median operating time of 55 min. Thirty-five patients of median age 52 years were managed by choledochotomy and T tube placement, with a 91 per cent duct clearance rate and a median operating time of 120 min. Overall duct clearance was achieved in 92 per cent of patients with an operative morbidity rate of 5.4 per cent. Duct clearance using either a Dormia basket or choledochotomy and T tube placement was obtained in 95 per cent of patients. Laparoscopic exploration of the CBD is an important alternative in the management of common duct calculi.
Homocysteine and vascular disease
Authors: Berwanger C S , Jeremy J Y , Stansby G 
Published: March 2007

Abstract
There is increasing evidence that a raised blood level of homocysteine (HC) is a risk factor for premature atherosclerosis. With a gene frequency between one in 70 and one in 200 this condition may be more common than previously thought. It should be suspected especially in young patients in whom other risk factors are absent. The diagnosis may be made by demonstrating raised plasma HC levels, either basally or after methionine loading. Studies have shown significantly increased levels of HC in patients with premature coronary artery, peripheral vascular and cerebrovascular disease. The mechanisms by which HC produces vascular damage are, as yet, not completely understood but endothelial injury is probably a central factor. The principle of treatment is to lower HC levels in the blood by administration of vitamin B6, vitamin B12, folate or betaine. How effective this strategy will be in preventing complications is not yet known.
Efficacy of glutamine-enriched enteral nutrition in an experimental model of mucosal ulcerative colitis
Authors: Fujita T , Sakurai K 
Published: March 2007

Abstract
Intact intestinal epithelium and associated lymphatic tissue act as body defences against luminal toxins. This barrier may become threatened or compromised in inflammatory bowel disease, leading to an increase in mucosal permeability and subsequent translocation of endotoxins. The effect of oral glutamine on gut mucosal ornithine decarboxylase activity and on endotoxin levels in portal vein blood was studied in a guinea-pig model of carrageenan-induced colitis. Despite failure to show induction of ornithine decarboxylase activity by glutamine administration, the mean endotoxin level of portal vein blood in guinea-pigs fed a glutamine-enriched elemental diet was 25.3 pg/ml compared with 71.2 pg/ml in animals given a standard elemental diet (P &lt; 0.01). A glutamine-enriched elemental diet may be therapeutically beneficial in patients with inflammatory bowel disease.
Synchronous proctocolectomy and ileoanal pouch formation and the risk of Crohn's disease
Authors: Lucarotti M E , Freeman B J C , Warren B F , Durdey P 
Published: March 2007

Abstract
There is controversy on the advisability of one-stage proctocolectomy and the formation of an ileoanal pouch. Accurate preoperative diagnosis is essential to avoid the error of constructing a pouch in a patient with Crohn's disease. Twenty-four consecutive patients undergoing subtotal colectomy for inflammatory bowel disease were reviewed. All patients had been treated with systemic steroids, 23 were on 5-aminosalicylates and 11 on azathioprine. The preoperative diagnoses, based on a combination of clinical features, colonoscopy, barium enema and biopsy histology, were ulcerative colitis (19), Crohn's disease (four) and inflammatory bowel disease (unclassified) (one). The final diagnosis was made on histological examination of the resected specimen. A discrepancy between initial and final diagnosis occurred in eight patients. In three, the diagnosis was changed from ulcerative colitis to Crohn's disease. Three preoperative diagnoses of Crohn's disease were changed to ulcerative colitis (one), Behcet's disease (one) and diverticulitis (one) on final histology. These data suggest that caution should be exercised in performing synchronous proctocolectomy with the formation of an ileoanal pouch.
Lysis-assisted angioplasty in the treatment of lower-limb arterial thrombosis
Authors: Golledge J , Torrie E P H , Galland R B 
Published: March 2007

Abstract
This study examined the results in 30 patients treated with lysis-assisted angioplasty and compared them with the results of 30 patients with simple stenotic disease treated by angioplasty alone. One patient died on the day of treatment with lysis-assisted angioplasty from arterial perforation and haemorrhage. Of the remaining 29 patients 16 (55 per cent) were symptomatically improved and 13 had early reocclusion. Six patients developed major complications (two deaths, two major haemorrhage, two cerebrovascular accident). The late results were comparable to those for patients undergoing angioplasty alone. The best outcome was obtained in patients with proximal disease (P &lt; 0.01); poor run-off or critical ischaemia did not preclude a good outcome.
Differences in body temperature changes during dressing change in surviving and non-surviving burned patients
Authors: Shiozaki T , Hiraide A , Shimazu T , Ohnishi M , Tasaki O , Yoshioka T , Sugimoto T 
Published: March 2007

Abstract
Change in body temperature (Δ BT) while dressings were being changed was measured in 52 extensively burned adults. The patients were divided into four groups based on outcome and the prognostic burn index (PBI; age + burn index): group I (15 survivors, PBI less than or equal to 80), group II (15 survivors, PBI between 80 and 120), group III (14 non-survivors, PBI between 80 and 120), and group IV (eight non-survivors, PBI greater than 120). The body temperature before the change of dressings was the same in the four groups. The mean(s.d.) Δ BT in all patients was −0.5(0.8)°C. The magnitude of Δ BT was not related to the time required for changing dressings (r = 0.04) or to the non-epithelialized area present at each change of dressings (r = −0.05). All groups showed a similar increase in Δ BT during the early period after the burn, but in group I it began to decrease progressively after the 16th day after the burn (P &lt; 0.05). A reduction in Δ BT was noted in group II from day 25, whereas it was unchanged in groups III and IV (P &lt; 0.05). It also significantly increased 2 days before the diagnosis of sepsis (P &lt; 0.05). These results emphasize that Δ BT may provide useful information about prognosis and the development of sepsis.
Exfoliative cytology in the diagnosis of breast disease
Authors: Dunn J M , Lucarotti M E , Wood S J , Mumford A , Webb A J 
Published: March 2007

Abstract
A total of 393 nipple discharge or scrape smears from 360 women were examined cytologically over a 12-year period. Twenty-nine breast cancers (8 per cent) have been histologically confirmed in this group, of which 16 had malignant smear cytology (sensitivity 55 per cent). Nine patients with breast cancer and positive cytology had impalpable tumours. Two of these cancers were not detected by any other investigation. Thirteen patients with nipple discharge had false-negative cytology, but there were no false-positive results (specificity 100 per cent). All patients with expressible or spontaneous nipple discharges and those with skin changes at the nipple should undergo examination of cytological smears.
Physiological and symptomatic outcome after laparoscopic gastric fundoplication
Authors: McAnena O J , Willson P D , Evans D F , Kadirkamanathan S S , Mannur K R , Wingate D L 
Published: March 2007

Abstract
The complications of open antireflux operations may be reduced by laparoscopic techniques. Fifteen patients of median age 42 (range 16–79) years with gastro-oesophageal reflux underwent laparoscopic fundoplication. Preoperative and postoperative assessment was by clinical scoring, oesophageal pH measurement and manometry. Median (range) operating time was 115 (60–210) min and hospital stay 3 (1–6) days, with no conversions to open operation and only one minor wound infection. Four patients had occasional reflux symptoms on postoperative assessment at a median of 7 weeks and nine had occasional dysphagia. Median DeMeester symptom scores improved from 4 to 1.5 (P = 0.001). There were significant increases in both lower oesophageal sphincter pressure and length. The nocturnal proportion of time at pH &lt; 4 decreased from 9.6 to 0.05 per cent (P = 0.02), although the drop in total proportion of time at pH &lt; 4 (10.4 to 2.2 per cent) was not statistically significant (P = 0.08). Early objective results of laparoscopic fundoplication show improved symptoms, decreased acid reflux and altered lower sphincter function. The procedure combines the benefits of early mobilization and reduced morbidity with the efficacy of the traditional open operation.
Manometric assessment of the effect of the diaphragmatic crural sling in gastro-oesophageal reflux: Implications for surgical management
Authors: Peck N , Callander N , Watson A 
Published: March 2007

Abstract
A manometric method to measure the effect of contraction of the crural sling of the diaphragm on intraoesophageal pressure is described. The manometric crural pressure was measured in 57 patients with gastrooesophageal reflux disease, documented by 24-h ambulatory pH monitoring, and compared between patients with and without hiatal hernia. Repeat measurements were made in 33 patients who underwent antireflux surgery that incorporated a crural repair. Mean crural pressure in 41 patients with hiatal hernia was 5.0 mmHg, compared with 15.0 mmHg in 16 without hiatal hernia (P &lt; 0.01). In the 33 patients undergoing antireflux surgery, mean crural pressure rose from 7.1 mmHg before operation to 11.6 mmHg afterwards (P &lt; 0.02) overall, and from 4.7 to 10.1 mmHg (P &lt; 0.01) in the 26 patients with hiatal hernia. These results confirm a measurable contribution of the diaphragmatic crural sling to resting pressure at the high-pressure zone. The crural pressure is deficient in patients with hiatal hernia compared with that in those with reflux but no hernia. The mean crural pressure is increased in patients by antireflux surgery, particularly in those with hiatal hernia. The results provide objective support for the role of the crural diaphragm in the antireflux mechanism and the rationale of performing crural repair during antireflux surgery, particularly in the presence of hiatal hernia.
Diagnostic laparoscopy combined with laparoscopic ultrasonography in staging of cancer of the pancreatic head region
Authors: Bemelman W A , de Wit L Th , van Delden O M , Smits N J , Obertop H , Rauws E J A , Gouma D J 
Published: March 2007

Abstract
The aim of this study was to assess the additional role of diagnostic laparoscopy combined with laparoscopic ultrasonography in the staging of patients with pancreatic head malignancy. Between January 1993 and June 1994, 73 patients with stage I cancer of the pancreatic head determined by preoperative investigation (endoscopic retrograde cholangiopancreatography and Doppler ultrasonography) were eligible for laparoscopic ultrasonography. The peritoneal cavity was investigated for peritoneal deposits, intrahepatic metastases, malignant infiltration of the portal and superior mesenteric vessels, and N3 lymph node metastases. All patients without histologically proven metastases proceeded to laparotomy. Seventy patients were eligible for evaluation. Sixteen of the 21 patients with distant metastases were diagnosed by laparoscopy with ultrasonography. Forty-nine patients had surgical exploration and trial dissection to assess local resectability. Twenty-nine patients (41 per cent) had resectable pancreatic head tumours. The positive predictive value of local ingrowth as determined by laparoscopic sonography was 93 per cent. Laparotomy was avoided in 19 per cent of patients and the preoperative stage was changed in 41 per cent. Laparoscopy including ultrasonography was effective in staging pancreatic head malignancy.
Clinical improvement after liver transplantation for type I familial amyloid polyneuropathy
Authors: Parrilla P , Ramirez P , Bueno F S , Robles R , Acosta F , Miras M , Pons J A , Andreu F L , Munar-Ques M 
Published: March 2007

Abstract
Long-term results of 13 liver transplantations in patients with a previous diagnosis of type I familial amyloid polyneuropathy (FAP) are presented. The diagnosis of type I FAP was based on the presence of a biochemical marker in the plasma (TTR-Met-30 in 11 patients, TTR-Ala-71 in two). Maximum follow-up is 28 months and the survival rate stands at 11 of 13 patients. Two patients died from sepsis at 2 and 6 months. TTR disappeared from plasma in all cases. Neurological status improved in all eight patients undergoing transplantation more than 6 months previously, although electromyographic studies showed a slight improvement only in the six with follow-up of more than 1 year. All 13 patients showed a hyperdynamic haemodynamic pattern with a high incidence (four patients) of the use of venovenous bypass due to haemodynamic intolerance. Two patients also received transplants by the ‘piggy-back’ technique. In conclusion, liver transplantation may be useful in the treatment of certain patients with FAP to halt and improve the neurological consequences of the disease.
Comparison of continuous versus intermittent ischaemia-reperfusion during liver resection in an experimental model
Authors: Hardy K J , Tancheroen S , Shulkes A 
Published: March 2007

Abstract
It has been proposed that regular restoration of blood flow is beneficial during liver surgery with vascular isolation. The aim of this study was to compare intermittent versus continuous occlusion of blood flow to the resected liver, as measured by survival, liver function tests and histological examination. Male Wistar rats were allocated to have either sham operation, 80 per cent liver resection with 30 min continuous occlusion, or resection with intermittent occlusion (two 15-min periods of ischaemia separated by 5 min reperfusion). There was no significant difference in the survival rate, with 17 of 20 animals surviving in both ischaemia groups. There was a significantly higher serum alanine aminotransferase concentration on day 1 in animals receiving continuous occlusion, and significantly higher concentrations of bilirubin on days 8 and 23 and of serum alkaline phosphatase on day 23 in those having intermittent ischaemia (P &lt; 0.001). There was a significantly greater loss and slower regaining of weight when occlusion was intermittent. Histological changes were significantly more pronounced at day 23 in animals undergoing intermittent ischaemia (P &lt; 0.05), although these were in only one grading. Continuous and intermittent occlusion affected the components of liver function tests differently, with no advantage for one technique. These findings suggest that periodic release of inflow occlusion during liver surgery is not necessary.
Total hepatectomy and liver transplantation: A life-saving procedure in patients with severe hepatic trauma
Authors: Ringe B , Pichlmayr R 
Published: March 2007

Abstract
Management of blunt hepatic trauma has been refined recently and now ranges from non-operative measures to the use of extensive surgical techniques. A consecutive series of eight patients was treated by total hepatectomy, either with a temporary portacaval shunt as a bridging procedure (since no donor liver was available immediately; six patients) or followed by standard liver transplantation (two). Previous operations included perihepatic packing, deep suturing, partial liver resection and hepatic artery ligation, and were attended by severe complications, namely uncontrollable bleeding (four patients) and massive liver necrosis (four). Six of the eight patients died from multiorgan failure or sepsis, and two recipients are alive 49 and 67 months after two-stage hepatectomy and transplantation. This experience demonstrates that total hepatectomy can be a life-saving procedure in exceptional emergencies in patients with potentially lethal hepatic trauma. The prognosis is dependent not only on the severity of liver injury but also on the complications of primary treatment.
Octreotide inhibits the growth and development of three types of experimental liver metastases
Authors: Davies N , Kynaston H , Yates J , Nott D M , Nash J , Taylor B A , Jenkins S A 
Published: March 2007

Abstract
A study was performed to assess the effects of octreotide on the growth and development of liver metastases in rats. Tumour was induced by intraportal injection of three tumorigenic cell lines (the fibrosarcoma HSN and colonic adenocarcinomas K12/Tr and WB2054M) in syngeneic rats. Octreotide treatment (2 μg subcutaneously for 3 or 4 weeks) was started 18 h and 1 week after tumour induction; a delay in treatment of 1 week allowed micrometastases to develop. Treatment with octreotide significantly (P &lt; 0.001) reduced the median hepatic replacement of liver by tumour compared with that of control rats given saline (controls: HSN 76.4 per cent, K12/Tr 17.5 per cent, WB2054M 43.9 per cent; octreotide treatment delayed 18 h: HSN 2.7 per cent, K12/Tr 0.6 per cent, WB2054M 1.3 per cent; octreotide treatment delayed 1 week: HSN 9.3 per cent, K12/Tr 2.5 per cent, WB2054M 2.3 per cent). These results clearly indicate that octreotide significantly inhibits the growth and development of experimental liver metastases. Further studies are required both to delineate the mechanism of action and to investigate these effects in a clinical setting.
Comparison of direct vision and electronic two- and three-dimensional display systems on surgical task efficiency in endoscopic surgery
Authors: Crosthwaite G , Chung T , Dunkley P , Shimi S , Cuschieri A 
Published: March 2007

Abstract
Task efficiency and knot strength was evaluated under standardized conditions using direct vision and electronic imaging with two-dimensional (2-D) and three-dimensional (3-D) systems. Three operators with different endoscopic surgical experience tied a surgeon's knot with standard endoscopic instruments using the three different visual systems in random order. Each operator tied 20 knots with each visual system. Median task efficiency (defined as the time to complete the knot) was 35.0 (interquartile range (i.q.r.) 30.3–43.8) s for direct vision and 53.0 (i.q.r. 45.3–62.8) s and 53.5 (i.q.r. 45.0–64.8) s for 2-D and 3-D imaging respectively (P &lt; 0.05). With respect to direct vision, this represented an overall degradation of task efficiency with the use of electronic imaging of 52 per cent, with no detectable difference between 2-D and 3-D imaging. The knot strength, representing the degree of tightening, was weaker with electronic imaging but the difference was not significant due largely to variation between the three operators.