bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technetium-99m sestamibi parathyroid localization is accurate enough for scan-directed unilateral neck exploration
Authors: Borley N R , Collins R E C , O'Doherty M , Coakley A 
Published: March 2007

Abstract
A retrospective study was conducted into technetium-99m sestamibi imaging of primary hyperparathyroidism to determine the accuracy of identification and localization of parathyroid pathology. Of 56 patients studied, 48 had full preoperative scan data, operative data and pathological results analysed. Overall scan accuracy was 96 per cent. For single gland pathology (adenoma) imaging had a sensitivity of 97 per cent, a specificity of 100 per cent and a positive predictive value of 100 percent. For single gland disease the side was correctly identified in 100 per cent of cases and the site in 94 per cent, but the respective values were only 82 and 79 per cent for multiple gland pathology. Technetium-99m sestamibi imaging is highly sensitive and accurate for primary hyperparathyroidism, with sufficient positive predictive value and accuracy in single gland disease to allow scan-directed unilateral neck exploration.
Breast conservation or mastectomy: Treatment choice of women aged 70 years and older
Authors: Sandison A J P , Gold D M , Wright P , Jones P A 
Published: March 2007

Abstract
Fifty women aged 70 years and older with newly diagnosed carcinoma of the breast were prospectively studied after being offered a choice of four treatment options. Thirty-four of 38 patients who chose their own treatment had breast conservation; four opted for mastectomy. At 12-month follow-up only two women were unhappy with their choice of treatment. It is concluded that elderly women should be involved in deciding the treatment of their breast cancer.
Reduced hepatic acute-phase response after simultaneous resection for gastrointestinal cancer with synchronous liver metastases
Authors: Kimura F , Miyazaki M , Suwa T , Kakizaki S , Itoh H , Kaiho T , Ambiru S , Shimizu H 
Published: March 2007

Abstract
Serum cytokines and hepatic acute-phase responses were studied in seven patients undergoing simultaneous resection of primary gastrointestinal cancer and synchronous metastatic liver tumours and in 12 undergoing partial hepatectomy alone for metachronous hepatic metastases. The incidence of postoperative infectious complications was significantly higher after simultaneous resection than after partial hepatectomy alone (P&lt; 0·05). Although the peak interleukin 6 level was significantly higher after simultaneous resection (P&lt; 0·05), plasma levels of acute-phase proteins were significantly lower (P&lt; 0·05). The results suggest that simultaneous resections further reduce the hepatic acute-phase response and render patients liable to infection compared with partial hepatectomy alone, and result in a higher incidence of postoperative infective complications.
Emergency transhiatal oesophagectomy for instrumental perforation of an obstructed thoracic oesophagus
Authors: Gupta N M 
Published: March 2007

Abstract
Between 1986 and 1994, 14 patients underwent emergency transhiatal oesophagectomy for iatrogenic instrumental perforation of the oesophagus. Continuity of the alimentary tract was restored immediately with cervical anastomosis by oesophagogastroplasty in 13 and oesophagocoloplasty in one. Six patients had oesophageal perforation with a carcinoma, seven had corrosive strictures, and cardiac achalasia was present in one. Only five patients underwent operation within 24 h of initial trauma. There were two postoperative deaths. Resectional surgery, though aggressive, has given good results for perforations with oesophageal strictures. Transhiatal subtotal oesophagectomy has both theoretical and practical advantages over transthoracic resection in the management of instrumental perforation with a distal stricture.
Peritoneal defences and peritoneum-associated lymphoid tissue
Authors: Heel K A , Hall J C 
Published: March 2007

Abstract
The peritoneum is mainly protected by the innate immune system. This consists of mechanical clearance of the peritoneal cavity, activation of complement, and the actions of polymorphonuclear neutrophils and macrophages. The specific immune system, which is mediated by the activity of lymphocytes, provides a secondary amplification system that may be of great importance for patients with intraperitoneal sepsis. This review provides an overview of the relevant innate immune mechanisms and explores the possible role of peritoneum-associated lymphoid tissue.
Endocrine and paracrine hormones in the promotion, progression and recurrence of breast cancer
Authors: Reid S E , Murthy M S , Kaufman M , Scanlon E F 
Published: March 2007

Abstract
Both normal and neoplastic breast tissues are stimulated by endocrine and paracrine hormones. Epidemiological studies have demonstrated the significant role that hormones, growth factors and cytokines have in the promotion, progression and recurrence of breast cancer. Significant variations in the hormonal environment occur based on age, the cyclical changes occurring during the menstrual cycle and (mammographically determined) variations in breast composition. These variations have a significant influence on rates of local recurrence of breast cancer and survival. This review analyses data relevant to these issues and suggests means by which operative results may be improved.
Pulmonary function after laparoscopic cholecystectomy in the elderly
Authors: Milheiro A , Sousa F Castro , Oliveira L , Matos M João 
Published: March 2007

Abstract
The results of laparoscopic cholecystectomy in a group of 52 patients older than 69 years (group 1) were compared with the results of the same operation in a group of 338 younger patients (group 2). In group 1, 23 per cent of patients had acute cholecystitis and 13 per cent were operated on after an episode of acute pancreatitis. In group 2, 8 per cent of patients had acute cholecystitis and 4 per cent were operated on after acute pancreatitis. Pulmonary function was assessed prospectively before operation, 24 h after surgery and on the seventh day after operation, in 20 patients in group 1 and 30 in group 2. In group 1 there was one death (2 per cent); the morbidity rate was 14 per cent and conversion to laparotomy was required in 15 per cent. In group 2 there were no deaths, the morbidity rate was 11 per cent and the conversion rate 4 per cent. No significant differences were found between the two groups in mortality and morbidity rates. Preoperative values of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were significantly lower in group 1 than in group 2 (P &lt; 0·05); the values of FVC, FEV1 and forced expiratory flow at 50 per cent 24 h after surgery were less depressed in group 1 (P &lt; 0·01) and also recovered more quickly in these patients 7 days after operation. Laparoscopic cholecystectomy gives excellent results in geriatric patients and can be recommended as the treatment of choice for symptomatic cholelithiasis in the elderly.
Surgery for left-sided pancreatic cancer
Authors: Fabre J M , Houry S , Manderscheid J C , Huguier M , Baumel H 
Published: March 2007

Abstract
A total of 590 exocrine pancreatic cancers of the body or tail of the pancreas, operated on between January 1982 and December 1988, were analysed. There were 128 pancreatic resections (group 1), 164 palliative bypasses (group 2) and 293 exploratory laparotomies which included 74 splanchnicectomies (group 3). The mortality rate was lower in group 1 (9 per cent) than in group 2 (19 per cent) (P = 0·012). The mortality rate exceeded 40 per cent in groups 1 and 2 for patients aged more than 70 years with pre-existing organ failure. The morbidity rate was 32 per cent in group 1 and 29 per cent in group 2. Patients with metastases had a median survival of 3·4 months, whatever the operative treatment. In the presence of lymph node involvement there was no significant difference in survival between groups 1 and 2. Patients with no metastases and no lymph node involvement had 1- and 3-year survival rates of 38 and 12 per cent respectively after pancreatic resection. Only patients with a small tumour (⩾ 4 cm), no lymph node involvement and no metastases achieved a significantly better survival after resection (P = 0·049). Curative resection should be reserved for a small tumour confined to the pancreas. Fewer than 10 per cent of patients will be suitable for surgery. For the other cases, resection must be considered as a palliative procedure without a significant improvement in survival. It seems justified to limit palliative surgery to candidates for digestive bypass and to use non-surgical palliation for the remainder.
Proinflammatory cytokine release by peripheral blood mononuclear cells from patients with acute pancreatitis
Authors: de Beaux A C , Ross J A , Maingay J P , Fearon K C H , Carter D C 
Published: March 2007

Abstract
Proinflammatory cytokine release was measured from peripheral blood mononuclear cells (PBMCs) isolated from six volunteers and, on admission, from 16 patients with acute pancreatitis. Tumour necrosis factor (TNF) release in patients did not differ significantly from that of volunteers, whereas both interleukin (IL) 6 and IL-8 release in patients was raised when compared with that in the volunteer group (mean(s.e.m.) IL-6 20·7(4·6) versus 9·3(1·7) ng/ml, P = 0·03; IL-8 283(40) versus 128(22) ng/ml, P = 0·04). When variation in white cell count was accounted for, IL-6 and IL-8 release but not that of TNF was significantly greater in patients with severe disease than in those with mild disease. These results point to a complex upregulation of proinflammatory cytokine release from PBMCs in patients with acute pancreatitis, components of which relate to the clinical progress of the disease.
Complete resection of the caudate lobe of the liver: Technique and results
Authors: Bartlett D , Fong Y , Blumgart L H 
Published: March 2007

Abstract
The caudate lobe of the liver is a frequent site of involvement by metastatic or primary liver tumours. This study describes the surgical anatomy and analyses the operative technique, results and postoperative morbidity of complete caudate lobectomy. The data represent a retrospective review of 21 consecutive complete caudate lobe resections performed over a 30-month period. The most common diagnosis was metastatic colorectal cancer (nine patients) and the most common procedure was extended left hepatic lobectomy with en bloc caudate lobectomy. Four patients underwent isolated complete caudate lobe resection. The median operating time was 5 h and the median blood loss was 1160 ml. The major complication rate was 38 per cent (nine major complications in eight patients) with 10 per cent mortality rate (two deaths). The median hospital stay was 11 days. This series demonstrates the feasibility of routine complete caudate lobe resection for tumours with general principles of liver resection. Isolated caudate lobectomy can be performed safely and the addition of caudate lobectomy to major liver resection does not add significantly to the morbidity or mortality of the procedure.
Glyceryl trinitrate prevents neutrophil activation but not thromboxane release following ischaemia-reperfusion injury
Authors: Barry M C , Kelly C J , Stokes K , Abdih H , Sheehan S , Burke P , Hayes D Bouchier 
Published: March 2007

Abstract
The aim of this study was to determine whether glyceryl trinitrate (GTN) has a protective effect on neutrophil- mediated lung injury in a model of aortic occlusion (30 min) and reperfusion (120 min). Sprague-Dawley rats were randomized into control (n = 11), ischaemia-reperfusion (IR) (n = 12), and IR treated with GTN (2 μg kg−1 min−1) during reperfusion (n = 10). Myeloperoxidase (MPO) activity measured pulmonary neutrophil influx. Pulmonary endothelial permeability was measured by wet:dry weight ratio, bronchoalveolar lavage (BAL) protein and neutrophil counts. Neutrophil superoxide release was measured by flow cytometry in a further IR versus GTN experiment (n = 6 in each group). The significant increase in MPO activity produced by IR to a level of 7·99 units g−1 was prevented by GTN which reduced the level to 4·73 units g−1. The increase in pulmonary microvascular leakage after reperfusion was also prevented by GTN: BAL protein without GTN was 992 μg ml−1 and with GTN 579 μg ml−1; BAL neutrophil count without GTN was 3219 cells mm−3 and with GTN 820 cells mm−3; the wet:dry lung weight ratio without GTN was 3·8 and with GTN 3·3. Neutrophil superoxide release increased significantly after 40 min of reperfusion in the untreated IR group (P &lt; 0·05). This increase was prevented in the GTN-treated group. GTN administration had no effect on plasma thromboxane production during revascularization. These data suggest that GTN administration during the reperfusion phase has the potential to decrease pulmonary microvascular injury.
Carotid endarterectomy without angiography
Authors: Shifrin E G , Bornstein N M , Kantarovsky A , Morag B , Zelmanovich L , Portnoi I , Aronovich B 
Published: March 2007

Abstract
Between 1 January 1990 and 1 September 1994 a total of 109 carotid endarterectomies were performed without preoperative angiography. Only two cases were considered by the surgeon to have a poor correlation between the duplex examination results and intraoperative findings; the outcome was good in both. The perioperative mortality rate was 1·8 per cent, one patient dying from sudden haematoma causing asphyxia and the other from unrelated causes following a myocardial revascularization procedure. Two non-disabling strokes also occurred. These results suggest that carotid endarterectomy based on carotid duplex scanning alone without preoperative angiography is safe in selected patients.
Prediction of the risk of death by APACHE II scoring in critically ill trauma patients without head injury
Authors: Muckart D J J , Bhagwanjee S , Neijenhuis P A 
Published: March 2007

Abstract
The ability of the Acute Physiology And Chronic Health Evaluation (APACHE) II scoring system to predict outcome in 199 critically ill patients with trauma but without head injury was assessed prospectively over an 8-month period. Some 178 patients (89·4 per cent) underwent operation and 50 (25·1 per cent) died, 44 after operation and six without undergoing surgery. The mean(s.d.) APACHE II score was 8·0(5·2) for survivors and 14·5(5·5) for non-survivors (P &lt; 0·001). In patients who underwent surgery the mean(s.d.) scores were 7·7(4·6) and 13·4(5·5) (P &lt; 0·001) and for those managed without operation 11·1(7·2) and 14·7(6·3) (P = 0·31) in survivors and non-survivors respectively. The predicted risk of death and observed mortality rate were 5·1 and 25·1 per cent respectively for the entire group, 5 and 25 per cent for patients undergoing surgery, and 7 and 29 per cent for those not operated on. Although the APACHE II system correctly identified all survivors (specificity 100 per cent), it failed to predict death in any patient (sensitivity 0 per cent). The results suggest that this objective prognostic scoring system is not applicable to the patient with trauma who does not have concurrent head injury.
Anatomical basis of intra-arterial chemotherapy for patients with locally advanced breast cancer
Authors: Doughty J C , McCarter D H A , Kane E , Reid A W , Cooke T G , McArdle C S 
Published: March 2007

Abstract
Twenty-eight patients with locally advanced breast cancer received four doses of regional chemotherapy via angiographically placed percutaneous catheters into the internal mammary artery (IMA) and lateral thoracic artery. Patent blue dye was injected to outline the relative contribution to perfusion of each of these vessels. The IMA was found to perfuse 67 (range 20–95) per cent of the breast and the lateral thoracic artery 15 (range 0–35) per cent. In 33 per cent of patients the lateral thoracic artery did not contribute to breast perfusion and a large area of the lateral aspect of the breast was perfused from a further branch of the subclavian or axillary artery. The blood supply to the breast is extremely variable and must be determined in each patient before delivering regional chemotherapy.
Benefits of D2 lymph node dissection for patients with gastric cancer and pN0 and pN1 lymph node metastases
Authors: Siewert J R , Kestlmeier R , Busch R , Böttcher K , Roder J D , Müller J , Fellbaum C , Höfler H 
Published: March 2007

Abstract
A retrospective immunohistological analysis of 100 patients with pT1–3 N0 and pT1–3 N1 gastric adenocarcinoma demonstrated a high frequency of micro-involvement in the removed lymph nodes. The presence of three or more tumour cells in more than 10 per cent of the lymph nodes was of significant prognostic value in the pN0 cases. Multivariate analysis identified micro-involvement as an independent prognostic factor. The results explain why patients benefit from lymphadenectomy even if the removed lymph nodes are not involved by tumour (pN0) in routine histological examination. The frequent occurrence of micro-involvement is a strong argument favouring routine D2 lymph node dissection in gastric cancer surgery in patients with lymph node metastasis.
Prognostic value of monolayer culture patterning in primary cell culture of oesophageal cancer
Authors: Shimada Y , Kanda Y , Shibagaki I , Kato M , Watanabe G , Tanaka H , Kano M , Imamura M 
Published: March 2007

Abstract
The growth of primary cell cultures of oesophageal cancer was compared with the clinical outcome of patients from whom the cancers were taken. Ninety-three patients underwent curative resection, with no operative deaths, and were divided into three groups according to the monolayer culture pattern of the primary cell culture: culture from 43 patients (46 per cent) grew no malignant cells (group 1), 21 (23 per cent) produced monolayer epithelial growth (group 2) and the rest (from 29 patients) established cell lines (group 3). The 5-year survival rate of patients in group 2 (29 per cent) and group 3 (23 per cent) was significantly lower (P &lt; 0·005) than that of those in group 1 (51 per cent). Monolayer epithelial growth potential is a significant prognostic factor in patients with oesophageal cancer.
Otolith fibers and terminals in chick vestibular nuclei
Authors: Popratiloff Anastas , Peusner Kenna D. 
Published: March 2007

AbstractThe distribution of gravity‐sensing, otolith afferent fibers and terminals was studied in the vestibular nuclei of 4–5‐day hatchling chicks by using single and double labeling of fibers and terminals with biocytin conjugated to Alexa Fluor and confocal imaging. The vestibular nuclei are represented in a series of five transverse sections of the brainstem immunolabeled with MAP2. Saccular fibers entered the medulla posterior to and at the level of the posterior tangential vestibular nucleus and coursed through ventral parts, producing ascending and descending branches. Small saccular terminals contacted a few dendrites in the tangential nucleus. In contrast, small saccular terminals contacted many dendrites and a few neuron cell bodies in the ventrolateral vestibular nucleus, vestibulocerebellar nucleus, and descending vestibular nuclei. Utricular fibers coursed through ventral parts of the central tangential nucleus before bifurcating into ascending and descending branches. In the tangential nucleus, utricular fibers formed a few large axosomatic terminals (spoon terminals) and a few small terminals on dendrites. In addition, small utricular terminals contacted numerous dendrites and a few neuron cell bodies in the ventrolateral, vestibulocerebellar, and descending vestibular nuclei. Thus, there was negligible overlap in the distribution of the otolith nerves, although each otolith afferent shared common regions with the canal afferents, previously shown, suggesting that some second‐order vestibular neurons process convergent inputs from otolith and canal afferents. Taken together with previous results, the present findings identify discrete regions of the chick vestibular nuclei where second‐order vestibular neurons likely process directly convergent otolith and canal inputs. J. Comp. Neurol. 502:19–37, 2007. © 2007 Wiley‐Liss, Inc.
Distal splenorenal shunt vs. portal-systemic shunt: Current status of a controlled trial
Authors: Conn H. O. , Resnick R. H. , Grace N. D. , Atterbury C. E. , Horst D. , Groszmann R. J. , Gazmuri P. , Gusberg R. J. , Thayer B. , Berk D. , Wright S. C. , Vollman R. , Tilson D. M. , McDermott W. V. , Cohen J. A. , Kerstein M. , Toole A. L. , Maselli J. P. , Razvi S. , Ishihara A. , Stern H. , Trey C. , O’hara E. T. , Widrich W. , Aisenberg H. , Stansel H. C. , Zinny M. 
Published: March 2007

A prospective controlled comparison of portal-systemic (PSS) and distal splenorenal shunts (DSRS) in cirrhotic patients who had survived hemorrhage from esophagogastric varices was undertaken 5 yr ago at five hospitals by the Boston-New Haven Collaborative Liver Group. The clinical and endoscopic criteria for massive hemorrhage were satisfied in 155 patients. Thirty-four patients were excluded, primarily because of uncontrolled hemorrhage. Thirty-four were rejected because they were poor operative risks and 21 because they did not satisfy criteria. Thirteen patients refused to participate; the remaining 53 were randomized; 29 to receive PSS and 24, DSRS. The two groups were similar in clinical, laboratory, and manometric characteristics. The DSRS group was older and tended to have had more previous hemorrhages. Followup ranged from 1 to 56 months (mean 21). After PSS, which was performed by 10 different surgeons, 6 patients died during the hospital admission (21%) compared to 2 after DSRS (12%). There were 6 late deaths in the PSS group and 4 in the DSRS group. Portal-systemic encephalopathy occurred in 5 of the 23 survivors of PSS (23%), and in 6 of the 19 who survived DSRS (32%). Two patients in the PSS group bled (9%), 1 after thrombosis and 1 after stenosis of the shunt. Three patients in the DSRS group bled (16%) and all had thrombosis of the shunt. PSS was associated with an unexplained but inordinately high operative mortality.
Although the DSRS was accomplished with an acceptably low operative mortality, it was associated with frequent portal-systemic encephalopathy, shunt occlusion, and recurrent hemorrhage. Similar incidences of portal-systemic encephalopathy, shunt occlusion, and recurrent hemorrhage were observed in the PSS group. More patients and longer followup are necessary to determine which of these portal decompressive procedures is superior.
Ligandinemia in primary liver cell cancer in rat and man
Authors: Ohmi Naohito , Arias Irwin M. 
Published: March 2007

Ligandin was quantitated by radioimmunoassay in serum and, when possible, in tumors from patients with primary hepatocellular carcinoma, massive hepatic metastasis or nonhepatic primary neoplasms, and in rats and athymic (nu/nu) mice bearing transplantable ligandin-containing or nonligandin-containing rat hepatocellular carcinomas.
Following transplantation of a ligandin-containing rat hepatocellular carcinoma in rats or athymic (nu/nu) mice, mean serum ligandin concentrations progressively increased and, within 4 months, exceeded normal serum ligandin concentrations by 10-fold.
In 11 of 15 HBsAg negative patients with primary hepatocellular carcinoma, serum ligandin concentrations ranged from 82 to 551 (mean: 298) ng per ml; the mean ligandin concentration in the hepatic neoplasm was 32% of the ligandin concentration in normal liver. In 19 of 22 patients with extensive hepatic metastasis and in each of 20 patients with primary carcinomas without hepatic metastasis, serum ligandin concentrations were normal (7.0 ± 4.0 ng per ml).