bluuebunny/crossref_metadata_2025_split huggingface dataset:
Androgen and oestrogen receptors in hepatocellular carcinoma and surrounding liver parenchyma: Impact on intrahepatic recurrence after hepatic resection
Authors: Nagasue N , Yu L , Yukaya H , Kohno H , Nakamura T 
Published: March 2007

Abstract
Seventy-eight patients in whom androgen or oestrogen receptors, or both, were assayed in hepatocellular carcinoma (HCC) and the surrounding liver were discharged from hospital after curative resection of the tumour. Intrahepatic recurrence was evaluated retrospectively after 28–128 months follow-up to determine the association with receptor status. Androgen and oestrogen receptors in HCC significantly influenced the intrahepatic recurrence rate. The recurrence-free 5-year survival rate was 55 per cent for patients who had androgen receptor-negative tumours, 24 per cent for oestrogen receptor-negative, 10 per cent for oestrogen receptor-positive and 0 for androgen receptor-positive (P = 0.0322). Recurrence-free 5-year survival in 57 patients who had both receptor assays was 75 per cent for patients who had androgen receptor-negative, oestrogen receptor-negative tumours, 50 per cent for androgen receptor-negative, oestrogen receptor-positive, but 0 for androgen receptor-positive, oestrogen receptor-positive and androgen receptor-positive, oestrogen receptor-negative (P = 0.0104). The presence or absence of androgen or oestrogen receptor in the liver, however, was not associated with intrahepatic recurrence (P = 0.7534). Thus, androgen receptors are strongly associated with intrahepatic recurrence of HCC, while oestrogen receptors are weakly associated. Receptor status in the normal liver was not related to intrahepatic recurrence.
Detrimental effects of perioperative blood transfusion
Authors: Nielsen H J 
Published: March 2007

Abstract
Evidence suggests that perioperative allogeneic blood transfusion increases the risk of infectious complications after major surgery and of cancer recurrence after curative operation. This has been attributed to immuno-suppression. Several authors have suggested that filtered whole blood and/or red cell concentrate, or leucocyte-and buffy coat-reduced red cells in artificial medium or their own plasma, may reduce postoperative immuno-suppression. It was also anticipated that the use of autologous blood might minimize the risk of perioperative transfusion, but studies have unexpectedly shown similar postoperative infectious complications and cancer recurrence and/or survival rates in patients receiving autologous blood donated before operation and those receiving allogeneic blood. Future studies should identify common risk factors associated with blood storage.
Indium-111 platelet scintigraphy in vascular disease
Authors: Smyth J V , Dodd P D F , Walker M G 
Published: March 2007

Abstract
Indium-111 labelled platelet scintigraphy permits simple, accurate evaluation of platelet kinetics and sites of deposition. The most meaningful results are obtained from serial scans, although these are clinically useful in only a few of the many applications that have been suggested, principally in studies of acute thrombosis, prosthetic graft thrombogenicity and antiplatelet medication. Key pitfalls are associated with selection of regions and patient variation.
New grade-related prognostic variable for rectal cancer
Authors: Gagliardi G , Stepniewska K A , Hershman M J , Hawley P R , Talbot I C 
Published: March 2007

Abstract
The effect of microacinar growth patterns on survival after radical surgery for rectal cancer was assessed in 138 consecutive patients. All had Dukes and Jass staging and a median follow-up of 95 (range 11–180) months. Tumour acini were classified according to size (microacinar, 28; macroacinar, 110). Patients with microacinar tumours had a significantly reduced 5-year survival rate compared with those with macroacinar lesions (43 and 68 per cent respectively, P = 0.004). When examined in the presence of other histological factors, acinar size had independent prognostic value (relative risk 2.37, P = 0.006). This was true even when the Dukes and Jass classifications were included in the model (relative risk 2.08, P = 0.02 and 1.95, P = 0.03 respectively). Histological classification of rectal tumours into microacinar and macroacinar types adds prognostic value to the Dukes and Jass classifications and may be a more objective criterion than conventional histological grading.
Prospective randomized trial comparing J colonic pouch-anal anastomosis and straight coloanal reconstruction
Authors: Seow-Choen F , Goh H S 
Published: March 2007

Abstract
Twenty patients (13 men) with low rectal cancer, median (range) age 64.5 (38–83) years were prospectively randomized to undergo ultra-low anterior resection with a J colonic pouch-anal anastomosis (median (range) distance of anastomosis from the anal verge 3 (1–4) cm). Another 20 patients (15 men), median (range) age 62.5 (44–86) years) with low rectal cancer were randomized to a straight coloanal anastomosis (median (range) distance of anastomosis from the anal verge 3.25 (2–5) cm). There were no significant differences in operative time or complications between the two groups. There was significantly better postoperative anal function in patients who underwent pouch-anal anastomosis at 1, 6 and 12 months after ileostomy closure. At 12 months all patients (19 of 19) with a pouch reconstruction had regained normal continence compared with 14 of 20 of those who had a straight coloanal anastomosis. No patient complained of severe constipation requiring enema or intubation to evacuate.
Colonic J pouch-anal anastomosis after rectal excision for carcinoma: Functional outcome
Authors: Mortensen N J M , Ramirez J M , Takeuchi N , Humphreys M M Smilgin 
Published: March 2007

Abstract
A consecutive series of 23 patients with colonic J pouch-anal anastomosis for low rectal cancer (17 men; mean age 64.4 (range 44–76) years) was studied prospectively. The mean distance from the pouch-anal anastomosis to the anal verge was 3.5 (range 2.0–4.5) cm. During follow-up one patient died from an unrelated cause and four developed metastases, two local and two hepatic. In 19 surviving patients a mean of 7 months after ileostomy closure mean bowel frequency was 2.1 (range 1–4) per day, five patients had urgency and four had mild faecal seepage up to three times per week, and seven patients had some degree of incomplete evacuation. In 13 patients there were no manometric differences before and after surgery with respect to maximum tolerated volume or maximum resting pressure, but maximum squeeze pressure was significantly lower after surgery (mean 189 versus 132 cmH2O before and after surgery respectively, P &lt; 0.05). Colonic pouch reconstruction should be considered as an alternative to straight coloanal anastomosis in patients undergoing very low anterior resection.
Bile acid absorption from ileoanal pouches using enema scintigraphy
Authors: Bain I M , Mostafa A B , Harding L K , Neoptolemos J P , Keighley M R B 
Published: March 2007

Abstract
It is unclear whether bile acid absorption is affected by ileoanal pouch construction. Bile acid absorption was measured in the abdomen of 16 patients with pouches (nine with good and seven with poor pouch function based on a clinical score) and in six patients with an end ileostomy using a radiolabelled synthetic bile acid (75SeHCAT) enema and dynamic scintigraphy. The median (interquartile range) 75SeHCAT absorption was 81 (79–87) per cent in patients with ileostomy, 46 (43–53) per cent in patients having well functioning pouches, and 24 (18–38) per cent in the group with poor pouch function (P &lt; 0.01). Log transformation of the absorption curves revealed a two-component uptake (fast component t1/2 = 1.4–7.2 min; slow component t1/2 = 16–144 min) in all patients with ileostomy, in eight of nine patients with pouches with good function, and in one of seven patients with a poorly functioning pouch (P &lt; 0.05); in the other six patients with poorly functioning pouches, only the slow component of absorption was present. This test showed significantly reduced bile acid absorption in patients with an ileoanal pouch and gave an objective discrimination between well and poorly functioning pouches.
Laparoscopic groin hernia repair: Results of 200 consecutive herniorraphies
Authors: Kald A , Smedh K , Anderberg B 
Published: March 2007

Abstract
Laparoscopic hernia surgery was introduced in this unit in May 1992. Up to September 1993, 175 patients with 200 inguinal and femoral hernias were treated using this approach. This prospective study deals with intraoperative and postoperative complications, patient recovery and early operative results. The median (range) age was 58 (21–87) years and the median (range) follow–up was 12 (5–24) months. A laparoscopic transabdominal preperitoneal technique was used. The median (range) operation time was 67 (23–160) min for unilateral hernias and the median (range) hospital stay was 1 (0–27) day.
Major complications were two postoperative bowel obstructions and seven recurrences, six of these in the first 31 patients. Overall, 17 minor complications were recorded; 52 per cent of the patients were back at work within 1 week, and 94 per cent within 1 month. The value of laparoscopic hernia repair remains to be determined and randomized controlled trials will be necessary.
Malignant epithelial parotid tumours: A rational treatment policy
Authors: Ball A B S , Fish S , Thomas J Meirion 
Published: March 2007

Abstract
Formal parotidectomy was undertaken in 271 patients by one surgeon over 11 years. Forty patients were treated for malignant salivary tumours (nine were recurrent). Low grade tumours (45 per cent) were treated by surgery alone, untreated high-grade tumours (55 per cent) by surgery and radiotherapy, before or after operation, depending on clinical findings. The aims of surgery were to obtain tumour clearance, to preserve the facial nerve if possible, and to perform radical neck dissection for palpable malignant lymphadenopathy proven cytologically and for high-grade tumours when intraoperative jugulodigastric lymph node biopsy confirmed metastasis. Four patients sustained facial weakness as a result of surgery. At a median of 46 months follow-up two patients had developed local recurrence. Eleven patients with high-grade but none with low-grade tumours died from metastases. Patients with high-grade lesions with facial weakness from malignant infiltration and those with lymphatic metastasis have a significantly worse prognosis than those without. Locoregional control of parotid cancers can be achieved by formal parotidectomy and selective irradiation without routine sacrifice of the facial nerve.
Computed tomographic portography in preoperative imaging of hepatic neoplasms
Authors: Moran B J , O'Rourke N , Plant G R , Rees M 
Published: March 2007

Abstract
Preoperative selection of suitable patients for liver resection is dependent on the quality of radiological imaging. Computed tomography (CT) identifies approximately 70 per cent of lesions. Computed tomographic arterial portography (CTAP) during contrast enhancement of the liver via the portal vein may be superior to conventional CT. Preoperative CTAP was evaluated in 60 patients with hepatic neoplasm (48 having colorectal metastases) who subsequently underwent laparotomy. The preoperative images were compared with intraoperative palpation, intraoperative ultrasonography and histology of the resected liver. Fifty-six patients (93 per cent) underwent partial hepatectomy. The detection rate sensitivity for CTAP was 110 of 116 lesions in the 56 patients (95 per cent) and for intraoperative ultrasonography was 114 of 116 (98 per cent). CTAP correctly identified all lesions found at histology in 50 of 56 (89 per cent) resected specimens. At laparotomy four of 60 patients (7 per cent) were inoperable; two of these had been predicted to be so by this technique. CTAP correctly identifies and locates the majority of hepatic tumours, particularly metastases, and is the procedure of choice for selection of suitable candidates for partial hepatectomy.
Influence of laparoscopic and conventional cholecystectomy upon cell-mediated immunity
Authors: Griffith J P , Everitt N J , Lancaster F , Boylston A , Richards S J , Scott C S , Benson E A , Sue-Ling H M , McMahon M J 
Published: March 2007

Abstract
Surgery, trauma and anaesthesia induce a state of transient immunosuppression. Laparoscopic cholecystectomy has several well documented clinical advantages over traditional cholecystectomy and provokes a lower acute phase response, thought to be a result of the smaller wound size. The influence of laparoscopic cholecystectomy (21 patients) and conventional open cholecystectomy (13 patients) upon components of the cell-mediated immune system was investigated. Cell-mediated immunity was studied by in vitro assays of T lymphocyte proliferation to different mitogens, and by natural killer cell cytotoxicity using a standard 51Cr release assay. Blood samples were taken before and 24 h after the start of the operation. In the sample taken after operation there was significant depression of T lymphocyte proliferation to phytohaemagglutinin (stimulation index 149.4 versus 33.3, P &lt; 0.002), staphy-lococcal enterotoxin B (85.2 versus 52.6, P = 0.01) and toxic shock syndrome toxin (48.4 versus 14.8, P = 0.08) in the group of patients who underwent open surgery, but not in the group treated by laparoscopic surgery. There was a small but statistically insignificant decrease of natural killer cell cytotoxicity in both groups of patients. These findings suggest that laparoscopic cholecystectomy causes less depression of cell-mediated immunity than open cholecystectomy.
Klippel-Trenaunay syndrome: Clinical features, complications and management in children
Authors: Samuel M , Spitz L 
Published: March 2007

Abstract
Clinical features and management of 47 children with Klippel-Trenaunay syndrome treated since 1970 were reviewed. Haemangiomas and soft tissue and/or skeletal hypertrophy were present in all 47 patients; venous varicosities developed in 37 (79 per cent). There was no clinical evidence of macrofistulous arteriovenous communications in any patient. Thromboembolic episodes occurred in five children (11 per cent) and 25 (53 per cent) experienced thrombophlebitis. The Kasabach-Merritt syndrome was observed in 21 (45 per cent) and six (13 per cent) presented with high-output cardiac failure. Other manifestations included haematuria in five (11 per cent), rectal or colonic haemorrhage in six (13 per cent), and vaginal, vulval or penile bleeding in six (13 per cent) children with visceral and pelvic haemangiomas. In 26 patients (55 per cent) symptomatic treatment only was required. Surgery was undertaken in selected cases for complications of the haemangioma, for cosmetic reasons and for chronic venous insufficiency. Only one of four children who underwent resection of varicose veins improved. There was no death, but significant morbidity was associated with the treatment of Kasabach-Merritt syndrome and high-output cardiac failure.
Blood flow in breast cancer and fibroadenoma estimated by colour Doppler ultrasonography
Authors: Holcombe C , Pugh N , Lyons K , Douglas-Jones A , Mansel R E , Horgan K 
Published: March 2007

Abstract
Blood flow was measured by colour Doppler ultrasonography in 33 fibroadenomas of size 5–31 mm and 28 malignant breast masses of 8–37 mm visible on ultrasonography. There was detectable blood flow in 11 fibroadenomas and 21 cancers (P &lt; 0.01). The median peak systolic frequency was 1.0 (range 0.25–2.0) kHz in malignant tumours and 0.5 (range 0.2–1.25) kHz in fibroadenomas. Blood flow was not detected in the eight fibroadenomas of less than 13 mm but was present in five of seven cancers smaller than this. Five of six carcinomas with three or more detectable vessels were classified as grade III on histological examination, compared with two of 11 carcinomas with one or two vessels. Similarly, five of seven cancers with three or more detectable vessels had axillary lymph node metastases compared with two of 13 with only one or two vessels. Detectable blood flow in breast masses is more common in cancer than in fibroadenoma and is highly suggestive of malignancy if the mass is less than 13 mm in size. Malignant tumours with a larger number of vessels are more likely to be of high grade and to have associated axillary node metastases.
Non-operative management of breast masses diagnosed as fibroadenoma
Authors: Cant P J , Madden M V , Coleman M G , Dent D M 
Published: March 2007

Abstract
A 7–9-year study was undertaken in 99 female patients (median age 20 years), 56 of whom had single and 43 multiple fibroadenomas (total 279). Thirty-four women with 58 masses (21 per cent) were lost to follow-up. Twenty-eight women with 73 masses (26 per cent) subsequently underwent excision at a median of 10 (range 3–59) months for single and 38 (1–110) months for multiple fibroadenomas (P = 0.03), with histological confirmation in 71 and other benign disease in two cases. There was resolution of 107 masses (38 per cent of those entered into the study, 72 per cent of those not lost or excised), leaving 41 persisting masses (15 per cent of those entered into the study, 28 per cent of those not lost or excised). The actuarial probability of disappearance was 0.46 at 5 years and 0.69 at 9 years (Kaplan-Meier analysis). There was no difference in the rate of resolution when 56 single lesions were compared with 223 multiple lesions, or when 192 lesions measuring 2 cm or less in diameter were compared with 87 greater than 2 cm. Resolution was significantly more frequent in women aged 20 years or less than in those who were older (P &lt; 0.01). Non-operative management remains a safe approach in selected women and should be followed by resolution of half of fibroadenomas at 5 years.
Regression and progression of Barrett's oesophagus after antireflux surgery
Authors: Sagar P M , Ackroyd R , Hosie K B , Patterson J E , Stoddard C J , Kingsnorth A N 
Published: March 2007

Abstract
The effects of antireflux surgery on Barrett's oesophagus were studied. Fifty-six patients (45 men and 11 women of median age 48.5 (range 20–78) years) with histologically confirmed Barrett's oesophagus (greater than 3 cm in length) and gastro-oesophageal reflux underwent antireflux surgery. Symptoms were noted and patients underwent manometry and pH recording before and after operation, and annual flexible endoscopy. Fundoplication resulted in a significant improvement in lower oesophageal sphincter pressure (median (interquartile range (i.q.r.) 8 (5–14) mmHg before operation versus 17 (11–22) mmHg after operation, P &lt; 0.001). Twenty-four of the 56 patients had partial or complete regression of Barrett's oesophagus (median (i.q.r.) length 8 (3–18) cm before versus 4 (0–10) cm after operation, P &lt; 0.001) but nine showed progression (median (i.q.r.) length 6 (3–11) cm before versus 10 (6–15) cm after operation, P &lt; 0.01) (median follow-up 5.5 (range 2.0–10.5) years). Carcinoma developed in one patient. The length of Barrett's oesophagus was unchanged in 23 patients. Regression was more likely to occur in patients who underwent fundoplication with previous or concomitant vagotomy (x2 = 7.21, 1 d.f., P &lt; 0.01) and in those with a good symptomatic result (x2 = 23.52, 1 d.f., P &lt; 0.001).
Use of a feeding jejunostomy after oesophagogastric surgery
Authors: Wakefield S E , Mansell N J , Baigrie R J , Dowling B L 
Published: March 2007

Abstract
Over a 5-year period, 58 patients with oesophageal or gastric malignancy underwent surgical resection with oesophagogastric or oesophagojejunal anastomosis. All were fed temporarily with a catheter feeding jejunostomy placed at the time of surgery. All patients tolerated the feeding well. There were no catheter-related deaths and only one serious complication, formation of an abscess following catheter dislodgement. Experience with this technique suggests that it is a safe and cheap method of feeding patients after oesophagogastric surgery. Such patients are particularly suitable for a feeding jejunostomy as they are frequently malnourished, rarely have prolonged postoperative ileus and may develop complications that delay the onset of oral intake.
Laparoscopic repair of perforated peptic ulcer
Authors: Lau W Y , Leung K L , Zhu X L , Lam Y H , Chung S C S , Li A K C 
Published: March 2007

Abstract
A total of 100 consecutive patients with perforated duodenal or juxtapyloric ulcers were treated by: laparotomy and omental patch repair (group 1, n = 44); laparoscopic suture patch repair (group 2, n = 35); and laparoscopic fibrin glue repair (group 3, n = 21). The three groups were comparable in Acute Physiology And Chronic Health Evaluation II score and in other known operative risk factors such as shock on admission, delayed presentation and associated underlying medical illness. Operative mortality and morbidity data were identical in all groups. The mean operating time was 52.1, 101.3 and 61.1 min respectively in the three groups (group 1 versus group 2, group 2 versus group 3, and group 1 versus groups 2 and 3 combined, P &lt; 0.001). The median number of doses of analgesia required after operation was 4, 3 and 1 respectively (group 1 versus groups 2 and 3, P &lt; 0.05). Conversion to laparotomy was necessary in six patients in group 2 and in one in group 3 (P not significant). The median hospital stay was 5 days in all three groups. Patients who underwent laparoscopic repair of perforated peptic ulcer required fewer postoperative doses of analgesia than those who had open repair. Laparoscopic glue repair has the additional advantage over laparoscopic suture of being technically simpler; it also takes less time to perform.
Pancreatitis associated with choledochal cyst and other anomalies in childhood
Authors: Okada A , Higaki J , Nakamura T , Fukui Y , Kamata S 
Published: March 2007

Abstract
Fifty-one children with anatomical anomalies of the pancreatic duct developed pancreatitis associated with either congenital dilatation of the bile duct (choledochal cyst; n = 48) or other rare causes (n = 3). Among those with choledochal cyst, 41 underwent primary surgical resection of the dilated bile duct, while five of the remaining seven patients receiving cystenterostomy underwent secondary resection of the cyst.
New concepts in the pathophysiology of oxygen metabolism during sepsis
Authors: Vlessis A A , Goldman R K , Trunkey D D 
Published: March 2007

Abstract
Sepsis is an intriguing pathological condition associated with many complex metabolic and physiological alterations. In this review a novel hypothesis in the pathophysiology of oxygen metabolism during sepsis is explored. It is proposed that the hypermetabolic response to sepsis results from enhanced reactive oxygen generation by phagocytes. Reactive oxygen detoxification by host enzyme systems subsequently leads to alterations in oxidative metabolism. The similarities between the metabolic consequences of reactive oxygen metabolism and the metabolic changes observed during sepsis are outlined. A unified concept is presented to help explain the pathophysiological changes in oxygen metabolism during sepsis.