bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intermittent vascular exclusion of the liver (without vena cava clamping) during major hepatectomy
Authors: Elias D , Lasser P , Debaene B , Doidy L , Billard V , Spencer A , Leclercq B 
Published: March 2007

Abstract
Intermittent vascular exclusion of the liver (IVEL) combines clamping of the hepatic pedicle with clamping of the main hepatic veins without interruption of caval flow. In this retrospective study, eight cases of total IVEL and eight of partial IVEL were analysed (involving only the middle and left hepatic veins) during major hepatectomy for malignant tumours. Liver parenchyma was pathological in nine cases. IVEL was feasible in 16 of the 18 attempts and was efficient in reducing bleeding during hepatectomy in 15 cases. Mean duration of IVEL was 60.2 (range 37–140) min, mean blood loss was 1230 (range 300–2800) ml and there were no postoperative complications related to the procedure. The major advantages of this technique of liver vascular exclusion (good tolerance and possibility of long duration) merit its inclusion in the list of different clamping techniques available for use during hepatectomy.
Evaluation of recombinant human erythropoietin to facilitate autologous blood donation before surgery in anaemic patients with cancer of the gastrointestinal tract
Authors: Braga M , Gianotti L , Vignali A , Gentilini O , Servida P , Bordignon C , Di Carlo V 
Published: March 2007

Abstract
The aim of this study was to determine whether the preoperative administration of recombinant human erythropoietin (rHuEPO) could increase the rate of autologous blood donation and reduce the perioperative need for homologous blood in anaemic patients with cancer. Twenty-two anaemic (haematocrit less than 34 per cent), iron-deficient (iron less than 700 µg/I) patients, with gastric or colorectal cancer scheduled for elective surgery, were allocated randomly to two groups. The first (n = 11) received iron saccharate 200 mg/day intravenously for 12 consecutive days. The second (n = 11) received rHuEPO subcutaneously (300 units/kg as first administration, and 100 units/kg 4, 8 and 12 days later) with supplemental iron. On days 4, 8 and 12, if the haematocrit was greater than 34 per cent, patients donated one unit (350 ml) of autologous blood. In the iron group the mean haematocrit did not change from admission (31 per cent) to day 12 of treatment (31 per cent), and no patient could donate autologous blood. In the rHuEPO group, eight patients donated two units of autologous blood and three donated one unit. Four patients in the iron group received perioperative transfusion of homologous blood compared with none in the rHuEPO group. Administration of rHuEPO facilitated the donation of autologous blood and reduced perioperative homologous blood transfusion in anaemic patients with cancer.
‘Squeeze delivery’ excision of subcutaneous lipoma related to anatomic site
Authors: Kenawi M M 
Published: March 2007

Abstract
A small cosmetic incision followed by ‘squeeze delivery’ was attempted for 190 lipomas in 116 patients. This technique was successful without resort to widening of the incision or using scissor dissection in 87 lipomas (46 per cent). Success was not related to size but to the site of the lipoma. The success rate was 100 per cent for excision of lipomas in the forearm and leg.
Role of transoesophageal echocardiography in determining the source of peripheral arterial embolism
Authors: Lagattolla N R F , Burnand K G , Stewart A 
Published: March 2007

Abstract
Thirty patients with peripheral arterial embolism underwent conventional transthoracic echocardiography. Transoesophageal echocardiography was also performed in ten of the same patients. The detection rate of cardiac abnormalities considered responsible for embolism was five of 20 in patients who received only transthoracic echocardiography and eight of ten in those who underwent transoesophageal echocardiography. One abnormality was detected by transthoracic echocardiography in the ten patients who received both tests, while eight cardiac or aortic abnormalities were discovered by transoesophageal echocardiography (P &lt; 0.05). Transoesophageal echocardiography is significantly better than conventional transthoracic echocardiography at detecting cardiac sources of peripheral arterial embolism.
Stapling instruments for intestinal anastomosis in colorectal surgery
Authors: Moran B J 
Published: March 2007

Abstract
The circular stapling instrument has had a major impact in the practice of colorectal surgery. Stapling technology was pioneered in the early part of this century and subsequently modified. Russian initiatives led to development of the original circular stapling instrument and further progress has resulted in instruments that are widely available, reliable and totally disposable. Mechanical failure is now rare and malfunction is generally due to operator error. Complications related to the stapling technique are uncommon, although anastomotic stricture may be more frequent than when handsewn anastomosis is performed. A stapling instrument facilitates and may expedite a surgical procedure but it is an adjunct to, and not a substitute for, meticulous surgical technique.
Elimination of fat emulsion particles from plasma during glucose infusion
Authors: Iriyama K , Tsuchibashi T , Urata H , Miki C , Ilunga K , Li H , Carpentier Y A 
Published: March 2007

Abstract
To determine the optimal rate of infusion of a fat emulsion (long-chain triglycerides; LCTs) for parenteral nutrition, the rate of elimination of triglycerides from plasma was measured on two occasions in three healthy subjects, once while receiving LCTs alone (study I) and once while receiving a combined infusion of glucose and LCTs (study 2). In study 1 a hypertriglyceridaemic clamp was set up by raising the concentration of triglycerides to 2 mmol 1−1 (60-min priming infusion at 0·2 g LCTs per kg body-weight per h) and maintaining this value for 300 min. In study 2 a constant infusion of glucose at a rate of 0·32 g per kg body-weight per h was given throughout the 420-min test, and the hypertriglyceridaemic clamp was set up after 70 min. The infusion of glucose induced a progressive increase in the mean(s.d.) concentration of insulin from 4·3(0·4) μU ml−1to a plateau value of 11·0(0·2) μ ml−1 which was sustained during the last 310 min of the study. During the steady state of the hypertriglyceridaemic clamp, the concentration of triglycerides (2·16(0·17) versus 2·12(0·20) mmol l−1, P = 0·26), as well as the mean(s.d.) rates of infusion of LCTs (0·12(0·08) versus 0·12(0·04) per kg body-weight per h, P = 0·38), did not differ between studies 1 and 2. Thus, an infusion of glucose (and the associated physiological increase in the concentration of insulin) at doses commonly used in parenteral nutrition does not influence the rate of elimination of triglycerides from plasma in normal subjects.
Effect of flow on the resistance of modelled femoral artery stenoses
Authors: Dodds S R , Bourne N K , Chant A D B 
Published: March 2007

Abstract
An accurate model of the pressure-flow relationship of a stenosis is necessary for the correct interpretation of haemodynamic measurements. Modelled femoral artery stenoses were tested in vitro and the pressure drop: flow ratio (resistance) was most accurately represented by a fixed component (Rf) combined with a variable component (Rv) that increased linearly with flow (Q) such that Rv = SvQ. For stenoses of 68–94 per cent area, Rfincreased from 3·2 to 77·7 milliperipheral resistance units (mPRU), while Sv increased from 0·009 to 0·578 mPRU ml−1 min and Rv was dominant for physiological flow rates. It was concluded that the approximation of a significant stenosis to a fixed resistance is incorrect.
Anal transitional zone and columnar cuff in restorative proctocolectomy
Authors: Thompson-Fawcett M W , McC. Mortensen N J 
Published: March 2007

AbstractThe popularity of double stapling the ileal pouch-anal anastomosis probably owes more to the technical ease it brings than to histological considerations or functional results. It is preservation of a ‘columnar cuff’ of mucosa, rather than the restricted site of the anal transitional zone, that should be the focus of research with respect to long-term risk of malignancy and inflammatory complications. If cancer is present in colon that has been removed for ulcerative colitis, there is a 25 per cent incidence of dysplasia in the columnar cuff in the short term. In other circumstances, those who are spared from carcinoma by colectomy are likely to have a similar risk of developing dysplastic change in the columnar cuff with longer follow-up. Double stapling the pouch-anal anastomosis and preserving the anal canal mucosa improves function, but long-term surveillance of the columnar cuff is then required, including biopsies.
Wound metastases following laparoscopic and open surgery for abdominal cancer in a rat model
Authors: Mathew G , Watson D I , Rofe A M , Baigrie C F , Ellis T , Jamieson G G 
Published: March 2007

Abstract
The recent application of laparoscopic resection techniques to malignant disease has raised safety concerns due to metastasis to surgical access wounds. The significance and incidence of this problem are controversial. In the present study a rat model, in which an implanted tumour was lacerated, was used to investigate whether application of laparoscopic techniques for malignant abdominal disease leads to an increased risk of tumour dissemination and implantation within the peritoneal cavity, and abdominal wall wounds. Malignant cells were implanted into the abdominal wall of 42 rats, resulting 7 days later in the growth of a tumour measuring 20–25 mm in diameter. There were three control groups: no surgery (n = 6); blunt manipulation of the tumour laparoscopically (n = 6); and blunt manipulation of the tumour at laparotomy (n = 6). Twenty-four rats underwent surgical laceration of the tumour capsule at either laparoscopy (n = 12) or laparotomy (n = 12). All rats were killed 1 week later, and examined for macroscopic evidence of tumour metastasis. The abdominal surgical wounds were excised for independent microscopic examination by a histopathologist. Growth of the primary tumour was greater in rats that had an operation than in unoperated controls, and was greatest after laparotomy. However, wound metastases were five times more likely after laparoscopic tumour laceration than after the same procedure through an open incision (ten of 12 rats versus two of 12, P = 0·0033). Wound metastases following laparoscopic tumour manipulation are an important and real problem, with significant implications for the application of laparoscopic techniques to excise malignant disease in humans.
Vitamin D3 exacerbates intimal hyperplasia in balloon-injured arteries
Authors: Lamawansa M D , Wysocki S J , House A K , Norman P E 
Published: March 2007

Abstract
Although a high dose of vitamin D3 is known to cause arterial calcification and degeneration, its effect on intimal hyperplasia has never been studied. The aim of this study was to examine the influence of a moderate supplement of vitamin D3 on intimal hyperplasia in the balloon-injured rat carotid artery. Forty-four rats had balloon injury to the carotid artery; 22 were given oral vitamin D3 supplementation (0·25 μg kg−1 day−1). Animals were killed at 4 weeks and the carotid arteries were perfusion fixed and assessed morphometrically by means of computerized image analysis of transverse sections. Mean(s.e.m.) intimal area was significantly greater in the vitamin D3-treated animals than in controls: 0·92(0·05) versus 0·71(0·07) mm2 (P = 0·02). The area of the media of both injured and uninjured arteries was not influenced by vitamin D3 administration. A small dose of vitamin D3 resulted in significant exacerbation of intimal hyperplasia in this rat carotid artery model and raises the question of the role of dietary vitamin D3 in restenosis following vascular intervention.
Prognosis after surgery in patients with incurable rectal cancer: A population-based study
Authors: Mahteme H , Påhlman L , Glimelius B , Graf W 
Published: March 2007

Abstract
In a defined population between 1973 and 1992 151 patients with irresectable metastatic or local rectal cancer were identified. Eighty-one patients underwent resection of the primary tumour (group 1) whereas the primary tumour was left in situ in 70 patients (group 2). During the same time period, 444 patients underwent curative resection. The median survival was 7·5 months in group 1, and 3·5 and 1·9 months for surgically and non-surgically treated patients respectively in group 2. A colostomy for intestinal obstruction became necessary in 12 per cent of the patients with a retained primary tumour. Bilateral hepatic involvement, abnormal liver function test results, peritoneal growth or abdominal lymph node metastases correlated with a short survival (P &lt; 0·01). These results support a selective approach to patients with incurable rectal cancer.
Coagulation and fibrinolytic responses of human peritoneal fluid and plasma to bacterial peritonitis
Authors: van Goor H , Bom V J J , van der Meer J , Sluiter W J , Bleichrodt R P 
Published: March 2007

Abstract
Significantly higher (P &lt; 0·05) thrombin-antithrombin III complex levels were found in the abdominal exudate of patients with peritonitis (median 5500 ng/ml) than in that of controls (median 89 ng/ml). In patients, peritoneal fluid concentrations of tissue and urokinase-type plasminogen activator were increased by factors of 65 and 10 respectively (P &lt; 0·05). The concentration of plasminogen activator inhibitor (PAI) 1 was increased by a factor of about 800 (median 395 versus 0·5 ng/ml, P &lt; 0·05). Despite markedly raised concentrations of PAI, peritoneal fluid displayed fibrinolytic activity as demonstrated by significantly increased (P &lt; 0·05) concentrations of plasmin-α2-antiplasmin complex (median 10 952 versus 57 ng/ml) and fibrin degradation products (median 40 360 versus 126 ng/ml). There was no correlation between plasma and peritoneal fluid concentrations. Intra-abdominal coagulation and fibrinolysis are stimulated in the abdominal cavity of patients with bacterial peritonitis.
Food intake after gastrectomy for gastric carcinoma: The role of a gastric reservoir
Authors: Liedman B , Andersson H , Berglund B , Bosaeus I , Hugosson I , Olbe L , Lundell L 
Published: March 2007

Abstract
Patients with carcinoma of the stomach who underwent curative resection were randomized to total gastrectomy (n = 49), total gastrectomy and an S-shaped gastric substitute (n = 28) or subtotal gastrectomy (n = 12); all had a Roux-en-Y reconstruction. The gastric substitute and gastric remnant allowed a volume of 400–500 ml to be installed without increments in basal pressures. The corresponding volume in the Roux limb was 100 ml. Energy intake was approximately 120 kJ/kg preoperative weight per day 3 months after operation, and then remained constant. Patients who had subtotal gastrectomy ate less (91·7 kJ/kg preoperative weight) 3 months after operation, but thereafter increased their intake. Patients allocated to have a gastric pouch or subtotal gastrectomy complained more frequently of adverse postprandial symptoms (P &lt; 0·03) as a major cause of reduced calorie intake. The construction of a gastric reservoir did not improve nutritional adaptation after surgery for gastric carcinoma.
Alcoholic liver disease: I. Interrelationships among histologic features and the histologic effects of prednisolone therapy
Authors: Boitnott John K. , Maddrey Willis C. 
Published: March 2007

Interrelationships among histologic features of alcoholic liver disease were studied in 24 chronic alcoholics who took part in a double-blind, controlled trial of prednisolone vs. placebo therapy. Each patient underwent liver biopsy at the start and upon completion of the 1-month study. Although all patients had a clinical diagnosis of alcoholic hepatitis and had at least mild alcoholic hepatitis with alcoholic hyalin in their initial liver biopsy specimens, each of the histologic features studied (fat accumulation, bile stasis, alcoholic hyalin, acute inflammation, active intralobular fibrosis, chronic inflammation, bile duct proliferation, established fibrosis, and parenchymal nodularity) covered a wide spectrum of severity.
Relationships of the severities of the individual histologic features were studied within the initial biopsy specimens and between the pre- and posttreatment biopsies. Four major histopathologic categories were evident in the correlation patterns: fat accumulation; cholestasis; alcoholic hepatitis, and cirrhosis. While having common pathogenetic ties and thus often occurring together, the severities of these categories in a given patient at a given time were little related and they are best considered as separate features of alcoholic liver disease. The amount of alcoholic hyalin appeared to be the best single indicator of the severity of alcoholic hepatitis in these patients and was the best predictor in the pretreatment biopsies of the amounts of hepatocellular injury, active fibrosis, acute inflammation, and total inflammation in the posttreatment biopsy specimens. Active fibrosis and hepatocellular injury in turn appeared to be the most immediate precursors of established fibrosis and parenchymal nodularity. Bile duct proliferation was, in part, a reflection of cholestatic disease and, in part, a more nonspecific reflection of chronic alcoholic liver injury, correlating with the amount of established fibrosis. The relationship of chronic inflammation to other histologic features was complex, but probably included an intralobular component related to the severity and stage of alcoholic hepatitis and another, more nonspecific, component related to the amount of established fibrosis or bile duct proliferation.
One month of prednisolone therapy (40 mg per day) significantly decreased the amount of inflammation, but did not have a comparable effect on hepatic fibrosis.
The statistical methods used in this study to investigate the multiple interrelationships among histologic features are useful in evaluating potential pathogenetic relationships and are quite helpful in assessing the effects of treatment.
Serum Bilirubins in Hepatobiliary Disease: Comparison With Other Liver Function Tests and Changes in the Postobstructive Period
Authors: Van Hootegem Philippe , Fevery Johan , Blanckaert Norbert 
Published: March 2007

Unconjugated bilirubin and its mono– and diester conjugates were measured by alkaline methanolysis and normal–phase high–performance liquid chromatography (AMHPLC) in 195 serum specimens obtained from 63 patients with various hepatobiliary disorders and from 47 healthy adult controls. With this assay, esterified bilirubins were undetectable in the controls, and detection of esterified pigment in a sample was interpreted as an abnormal result. Using this criterion, the AMHPLC result in the clinical anicteric patients (n = 39) was more frequently abnormal (87%) than the corresponding value of fasting serum bile acids (48%), SGPT (52%), total bilirubins (55%), alkaline phosphatase (71%) or γ–glutamyl transpeptidase (71%). The cumulative frequency of abnormality of these tests was comparable to that of an abnormal AMHPLC result alone. All icteric patients had detectable esterified bilirubins as well as an increased alkaline phosphatase level, while a normal result was found for serum bile acids in 34%, for SGPT in 29% and for γ–glutamyl transpeptidase in 11%, respectively.
In most hyperbilirubinemic patients, total serum bilirubin levels, as determined by a conventional diazo method, exceeded the value obtained by AMHPLC. This discrepancy, which appears to reflect the presence of bilirubin covalently bound to serum protein, was particularly pronounced following desobstructive intervention in patients with obstructive jaundice, in whom the decline of serum bilirubins showed a fast and a slow disappearance component. The latter portion seemed to correspond with slow plasma clearance of bilirubin covalently linked to serum albumin, disappearing at a rate comparable to that of the albumin moiety.
Long–Term Maintenance of Taurocholate Uptake by Adult Rat Hepatocytes Co–Cultured With A Liver Epithelial Cell Line
Authors: Foliot Armelle , Glaise Denise , Erlinger Serge , Guguen-Guillouzo Christiane 
Published: March 2007

Taurocholate (TC) uptake by adult rat hepatocytes co–cultured with other rat liver epithelial cells (RLEC) was studied comparatively to hepatocytes in primary culture. Cells were cultured on Petri dishes for desired times prior to measuring their ability to transport TC. TC uptake was linear for 150 sec in both culture conditions. In hepatocytes cultured alone, the initial rate of TC uptake at an extracellular concentration of 100 μ M was 0.19 ± 0.02 nmole per min per 106 cells after 48 hr of culture and decreased by 75% after 4 to 6 days. In hepatocytes co–cultured with RLEC, the rate of uptake at 48 hr (0.31 ± 0.01 nmole per min per 106 cells) was significantly higher than in hepatocytes cultured alone (p < 0.01); in addition, TC uptake remained stable at an average rate of 0.17 ± 0.01 nmole per min per 106 cells for up to 56 days. No detectable uptake was found in RLEC cultured alone. TC uptake exhibited both saturable (Vmax = 0.30 ± 0.03 nmole per min per 106 cells and Km = 42.6 ± 4.4 μM) and nonsaturable components. These kinetic parameters were similar to those previously reported in isolated hepatocytes and in short–term cultured hepatocytes. TC uptake exhibited sodium dependence and was significantly reduced when extracellular sodium was replaced by lithium and sucrose, or in the presence of 1 mM ouabain. After 18 days of co–culture, TC uptake had qualitatively the same characteristics as at 48 hr, with a saturable and a nonsaturable component.
These findings strongly support the view that the sodium–dependent bile acid uptake system present in normal hepatocytes was maintained in the co–culture system as previously reported for other liver–specific functions.