bluuebunny/crossref_metadata_2025_split huggingface dataset:
VEIN‐TO‐ARTERY GRAFTS: THE LONG‐TERM DEVELOPMENT OF NEO‐INTIMAL HYPERPLASIA AND ITS RELATIONSHIP TO VASA VASORUM AND SYMPATHETIC INNERVATION
Authors: Mcgeachie JohnK. , Meagher Stephen , Prendergast FrancisJ. 
Published: January 2008

A series of 14 vein‐to‐artery grafts, 1 mm in diameter and 5 mm long, were inserted microsurgically into iliac arteries of rats. They were analysed histologically 8–18 months later and compared with control iliac arteries in the same rats.Neo‐intimal hyperplasia developed and was measured in all grafts but the values did not significantly exceed the equivalent intimal plus medial thicknesses of control arteries. Vasa vasorum developed and were quantitated as the number of vessels per mm2 of neo‐intima, but also did not differ significantly from control values. The density of sympathetic innervation was quantitated using fluorescent catecholamines. There was an overall significant increase in the long‐term graft innervation compared with control arteries.These results show that such small vein grafts adapt and function very effectively, in a manner remarkably similar to the artery they replace, for long periods of time.
D‐DIMER LEVELS IN BLOOD SALVAGE FOR AUTOTRANSFUSION
Authors: Lawrence‐brown M. M. D. , Couch C. , Halliday M. , Hellings M. , Barr A. , Marshall L. 
Published: January 2008

Autotransfusion of operatively salvaged blood is an increasingly attractive and used practice. The fear of precipitating a coagulopathy, however, has retarded the acceptance of autotransfusions and the efficiency and convenience of banked homologous blood has proved too competitive in recent years. The risk of transmitting diseases with bank homologous blood has seen a resurgence in the development of autotransfusion. The current alternatives to pre‐operative autologous banking or dilution are the reinfusing of filtered salvaged blood, and of blood which has been further processed by washing which involves the extra cost of time, personnel and equipment. Washing removes possible harmful products, but also removes coagulation factors.D‐dimer levels were estimated by monoclonal antibody techniques in salvaged blood before and after washing in 10 patients undergoing aortic surgery and in 10u of homologous banked blood. The d‐dimer levels in the unwashed blood were increased 85 times, but were normal in the washed blood. D‐dimers are an indication of activation of the coagulation and fibrinolytic systems and the presence of fibrin degradation products.
PROGNOSTIC INDICATORS FOR FAILURE OF SURVEILLANCE MANAGEMENT OF STAGE I NON‐SEMINOMATOUS GERM CELL TUMOURS
Authors: Costello AnthonyJ. , Mortensen PeterH. , Stillwell RossG. 
Published: January 2008

Fifty‐three patients presenting with non‐seminomatous germ cell tumours (nsgct) of the testis were examined. Particular interest was directed towards the association of several morphological features of the primary tumour with metastatic disease, either at presentation or later in the course of the tumour.It is apparent from this study that the presence of vascular invasion in the primary tumour, high t stage (advanced local disease) and the presence of choriocarcinoma are poor prognostic signs in nsgct. In such tumours presenting as clinical stage i, surveillance management may not be appropriate because of the high rate of relapse.
RADIONUCLIDE BONE SCAN IN FRONTAL SINUS OSTEOMA
Authors: Noyek ArnoldM. , Chapnik JerryS. , Kirsh JoelC. 
Published: January 2008

Frontal sinus osteomas, whether cortical or cancellous by morphologic radiologic appearance, appear to represent metaplasia rather than neoplasia occurring at the frontal‐ethmoid suture line. These osleomas are not infrequently found completely or partially within the frontal sinus or adjacent ethmoid complex. Regardless of specific anatomic site, they occur at the embryologic junction of enchondral and membranous frontal bone. Those osteomas which produce mechanical complications (ostial obstruction or facial deformity or proplosis) give clear indication for surgical intervention. A much larger group of osteomas, however, is detected on routine plain radiographic examinations carried out for other reasons. Unfortunately, the singular conventional radiographic finding of an osteoma has, in the past, frequently been the sole and primary indication for surgical intervention.The purpose of the present paper was to review the experience with 10 frontal sinus osteomas managed expectantly over the past 11 years. All were imaged serially with morphologic studies, including conventional x‐rays and computerized tomography scans. A radionuclide bone scan was carried out in all patients at the time of initial presentation. Those identified as producing mechanical complications clinically, or a ‘hot’ bone scan by radionuclide study, were regarded as appropriate for osteoplaslic frontal sinusectomy for removal of the osteoma; three cases were approached in this way. On the other hand, utilizing this physiologic imaging parameter, a ‘cold’ bone scan indicated the presence of a relatively inert osteoma, in terms of biologic growth activity. Thus, adopting a non‐operative approach, and following these patients over the 4–11 year period appears to have been validated. The imaging findings and the results of this clinical study in these patients with a physiologically inert osteoma by 99mtc‐methylene diphosphonate bone scan have been reviewed.
INTESTINAL ATRESIA: FACTORS AFFECTING SURVIVAL
Authors: Smith GrahameH. H. , Glasson Martin 
Published: January 2008

Eighty‐four patients with congenital jejuno‐ileal or colonic atresia treated at this hospital during the years 1961–86 were studied. There were 42 cases of jejunal atresia, seven cases of jejuno‐ileal atresia, 33 cases of ileal atresia and two cases of colonic atresia. Multiple atresias occurred in 19 patients. During the first 15 years of the study the mortality rate was 56%. In the last 10 years it was 22%.Multivariate linear modelling techniques were used to determine the factors associated with a fatal outcome. In order of magnitude associations were found between death and year of treatment (p < 0.01), the type of anastomosis performed to correct the atresis (p < 0.05), the presence of other congenital abnormalities (p < 0.01) and presence of a malrotation (p < 0.02). The anastomoses associated with the highest mortality were those with a stoma.The mean length of bowel resected proximal to the anastomosis was 15cm and the mean length resected distally 5 cm. Eleven patients had 60cm or less of small bowel remaining after surgery and only three of these survived.The highest mortality rate can be expected in patients with other congenital abnormalities and those with a malrotation. A primary anastomosis without a stoma is recommended.
A NEW TECHNIQUE FOR CHRONIC VENOUS ULCERS OF THE LOWER LIMB: MODIFIED FELDER‐ROB PROCEDURE
Authors: Ananthakrishnan N. , Parkash Satya , Banerjee S. N. 
Published: January 2008

Subfascial ligation of perforating veins is a commonly performed operative procedure for chronic venous ulcers of the leg. The most widely adopted incision currently used is the posterior midline approach described by felder. This, however, is associated with significant morbidity due to necrosis of skin overlying the tendo achillis with consequent exposure‐induced necrosis and contracture of the tendon.A new incision based on anatomical studies is described. The procedure was adopted in 45 limbs with chronic venous ulcers. The incision is associated with very minimal morbidity and has given excellent results in the form of a major necrosis rate of only 4.4% (none of which involved the skin over the tendo achillis or the tendon itself) and an ulcer recurrence rate of 4.4% during the period of follow‐up of 2–8 years.
A 2 YEAR EXPERIENCE OF A NUTRITIONAL SUPPORT SERVICE: PROSPECTIVE STUDY OF 229 NON‐INTENSIVE CARE PATIENTS RECEIVING PARENTERAL NUTRITION
Authors: Fletcher J. P. , Muodie J. M. 
Published: January 2008

During a 2 year period, 229 non‐intensive care patients received total parenteral nutrition (tpn) for a mean of 23.2 days.Nutritional parameters of weight, triceps skin‐fold thickness (tsf), mid‐arm muscle circumference (mamc), total lymphocyte count (tlc), serum albumin and serum transferrin were measured prior to commencement of tpn and then at weekly intervals.All parameters showed an upward trend during the period of tpn. This was small and not statistically significant for weight, tsf, mamc and albumin; the trends were greater and statistically significant for transferrin (p= 0.001) and tlc (p= 0.002).In contrast, in the 14.4% of patients who died, albumin, transferrin and tlc all fell. Patients who died had a significantly lower initial albumin (p= 0.05), transferrin (p= 0.04) and tlc (p= 0.04). The last values obtained in patients who died were very significantly lower for albumin (p < 0.001), transferrin (p < 0.001) and tlc (p= 0.003).Single‐lumen tunnelled subclavian catheters had a significantly lower incidence of catheter sepsis (4.8%) compared with double‐lumen (17.4%) and triple‐lumen (13.7%) catheters (p= 0.01).There was also a greater incidence of mechanical and thrombotic complications with multiple‐lumen catheters compared with single‐lumen catheters (p= 0.02).This study shows that the nutritional indices albumin, transferrin and tlc have prognostic significance. Single‐lumen rather than multiple‐lumen catheters should be used for administration of tpn whenever possible.
CARCINOID TUMOURS IN AUCKLAND, NEW ZEALAND
Authors: Shaw JamesH. F. , Canal Alasandra 
Published: January 2008

Carcinoid tumours in auckland diagnosed during 1976–87 have been reviewed retrospectively. Eighty‐three patients with carcinoid tumours were seen during this time (56 appendiceal, 11 small bowel, two colorectal, 10 pulmonary and four other). Three patients had carcinoid syndrome.The most common presentation for appendiceal carcinoid was acute appendicitis. The most common presentations for pulmonary lesions were incidental findings on chest x‐ray, recurrent chest infection or haemoptysis, while bowel lesions presented with abdominal pain or rectal bleeding.Following resection, 53 of 56 appendiceal patients were alive and well (two died from other causes) and 10 of 10 pulmonary carcinoids were alive and well. In contrast, both patients with colorectal carcinoid died from their disease within 1 year, and, of the patients with small bowel carcinoid, one died of the disease and more than half of the remainder are alive with metaslatic spread and symptoms at the time of study. The most important prognostic variables governing outcome were anatomical site of the primary lesion and the state of the histological margins following resection.
CAROTID ARTERY ATHEROMA: ULTRASOUND APPEARANCE IN SYMPTOMATIC AND ASYMPTOMATIC VESSELS
Authors: Steffen C. M. , Gray‐wealed A. C. , Byrne K. E. , Lusby R. J. 
Published: January 2008

The distribution of carotid plaque ultrasound appearance has been evaluated using duplex ultrasound in symptomatic and asymptomatic patients. There were 134 patients with unilateral carotid territory symptoms who subsequently underwent endarterectomy of the symptomatic carotid bifurcation, and 92 asymptomatic patients. Both carotid bifurcations in all patients were examined, thus providing three groups of vessels for study: (i) asymptomatic vessels in asymptomatic patients (n= 184); (ii) asymptomatic vessels in symptomatic patients (n= 134); and (iii) asymptomatic contralateral vessels in symptomatic patients (n= 134).Ultrasound appearances were classified as types 1–4. This classification has previously been compared prospectively with endarterectomy specimen pathology where the more echolucent type 1 and 2 lesions correlated well with the presence of intraplaque haemorrhage or ulceration.In the symptomatic arteries, type 1 and 2 lesions were predominant, whereas in the asymptomatic patients the most common lesions were types 3 and 4. This difference was statistically significant (p < 0.01). Evaluation of the asymptomatic contralateral vessel in the symptomatic patients showed a pattern of plaque type distribution between the other two groups.
PHARMACOLOGICAL MANIPULATION OF POSTOPERATIVE INTESTINAL ADHESIONS
Authors: Sparnon AnthonyL. , Spitz Lewis 
Published: January 2008

Paralytic ileus and intestinal adhesions are common events following infra‐abdominal surgery. The theoretical hypothesis ‘that stimulation of the postoperative bowel will reduce intestinal adhesions’ was studied in a rat model for intestinal adhesions in which postoperative bowel motility was pharmacologically manipulated.Immediate postoperative stimulation of gastrointestinal motility by the prokinetic agent, cisapride, resulted in a significant reduction in both the number and extent of adhesions.Inhibition of postoperative intestinal motility with the anticholinergic agent, atropine, resulted in a greater number of more dense adhesions involving an increased length of bowel.
MORBIDITY, MORTALITY AND SURVIVAL FOLLOWING RESECTION FOR CARCINOMA OF THE RECTUM AT CONCORD HOSPITAL
Authors: Bokey E. L. , Chapuis P. H. , Hughes W. J. , Koorey S. G. , Hinder J. M. , Edwards R. 
Published: January 2008

Colorectal cancer is the most common internal malignancy in Australia, and the rectum is the most commonsite. The morbidity, mortality and survival of 561 consecutive patients with rectal cancer who had a resection at Concord Hospital during the 16‐year period 1971–86 were evaluated.More than half of the operations performed were low anterior resections (LAR), with total abdominoperinal excisions (APE) of the rectum comprising another third. There was a 5.1% mortality rate in LAR patients and a 3.1% mortality rate in the APE group. Respiratory complications, urinary tract infections and wound infections were the most common causes of morbidity in both LAR and APE.The median survival for patients treated by LAR and APE standardized for clinicopathological staging was 111.5 and 47.1 months (A), 79.0 and 65.5 months (B), 41.3 and 28.5 (C), and 14.7 and 12.4 (D) respecticvely.
CARCINOMA OF THE STOMACH: A REVIEW WITH SPECIAL REFERENCE TO TOTAL GASTRECTOMY
Authors: Carmalt H. L. , Gillett D. J. , Hollinshead J. W. 
Published: January 2008

Five hundred and eleven patients with adenocarcinoma of the stomach were reviewed. Weight loss and abdominal pain were the most common symptoms. One‐third of patients were found to have proximal gastric lesions with dysphagia being a major symptom in 23% of all patients. Laparotomy was performed on 88% of patients with 56% of the entire series undergoing gastric resection.The overall 5‐year survival rate was 12.3% and for curative resection 43%. The 5‐year survival rate of patients undergoing total gastrectomy was 53% and for patients undergoing subtotal or partial gastrectomy the 5‐year survival rate was 42%. The operative mortality. similar in both groups. was 8.1% versus 5.6%.Palliation was better achieved by resection than bypass. Total gastrectomy for palliation was undertaken in 48 patients. This group of patients has achieved a good quality of life and a mean survival rate of 12.5 months.
SURGICAL ANALYSIS AND BIOLOGICAL BEHAVIOUR OF 2277 BASAL CELL CARCINOMAS
Authors: Emmett A. J. J. 
Published: January 2008

A total of 2277 basal cell carcinomas (BCC) treated by surgical excision over a twenty‐year period has been followed and analysed into clinical and histopathological type. This paper documents the incidence of different BCC types and points to the importance of the infiltrating, morphoeic and multifocal types.Many BCC are of one homogeneous histopathological type, although others have important secondary characteristics which may not be obvious clinically.We reserve the use of the word ‘infiltrating’for BCC types which show microscopically the following characteristics: areas with lack of palisading; small cell clumps; and spiky thin cords of cells projecting out with loose stroma. These may penetrate far and wide along tissue planes and nerves, producing recurrence and spread, despite apparently adequate excision. The infiltrating BCC may also occur secondarily with other primary BCC types, accounting for their — at times — unexpectedly severe effects.
SESSILE ADENOMAS OF THE RECTUM: A PERSONAL SERIES 1974‐1984
Authors: Tjandra Joe J. , Cuthbertson Alan M. , Penfold Campbell 
Published: January 2008

Sessile (villous) tumours of the rectum are uncommon and individual surgeons are unlikely to have wide experience in their management. A study was made of a unique personal series (AMC) of 104 cases encountered from 1974 to 1984; minimum duration of follow‐up was 5 years. Clinically obvious rectal cancers were excluded from the study. Ages ranged from 42 to 89 years (mean 64.9 years) with a male : female ratio of 1.5:1. The commonest clinical presentations of sessile tumours of the rectum were rectal bleeding (45%) and altered bowel habit (38%). Hypokalaemia was a very uncomnion presenting symptom (1%). These tumours ranged in longitudinal diameter from 1 to 9 cm, with 66% of cases > 3 cm and 33% of cases > 5 cm. The incidence of malignancy in sessile adenomas > 3 cm (27%) was more than triple that of adenomas < 3 cm (8%) and the presence of induration on rectal examination was the most reliable clinical indicator of the presence of malignancy.Local transanal diathermy excision was a satisfactory form of treatment for most sessile tumours of the rectum (benign and malignant), especially if they were < 3cm (0% recurrence rate). It had the added advantage of preserving the anal sphincter and was possible in a higher proportion of sessile tumours in the lower half of the rectum (89%) than those in the upper half of the rectum (42%). The overall recurrence rate after local transanal excision was 8% for benign sessile adenomas and 33% for those containing invasive carcinoma. Recurrent tumours were treated by resection (6 of 9 tumours) or further local excision (3 of 9 tumours) depending on the general condition of the patients and the histology. This approach produced results which compared favourably with cases treated by resection as the initial procedure, either because of its site in the upper half of the rectum or because of its extremely large size (> 5 cm). In addition, a 5‐year follow‐up appears to be adequate for patients with sessile tumours of the rectum as all recurrences occurred within this period.
PREVENTING BREAST CANCER: IS IT POSSIBLE?
Authors: Ingram David 
Published: January 2008

Breast cancer is a common cause of suffering and death in Australia. Improvements in detection and therapy will make only small inroads into mortality, and will not reduce suffering. Reducing the incidence of breast cancer by preventive measures is a logical step, and this paper reviews how it might be achieved.Reducing the population's exposure to known risk factors for breast cancer is logical; however, the potential for improvement is limited. Reduction in age at first pregnancy is impractical and measures such as weight reduction and reducing consumption of fat and alcohol are likely to be only partially successful. Increasing activity in youth is a concept that requires further investigation, but is a possible area of promise. Exogenous hormone use probably contributes little to the incidence of breast cancer, but prescribing patterns for post‐menopausal oestrogens are changing and require monitoring.The use of hormone manipulation to prevent breast cancer has considerable potential benefit. Two approaches have been proposed. The first involves reversible suppression of ovarian function by luteinizing hormone‐releasing hormone (LHRH) agonists after child‐bearing has finished, combined with low‐dose conjugated equine oestrogen to compensate for oestrogen loss. The other involves the use of the anti‐oestrogen, tamoxifen. Both measures have the potential to halve breast cancer incidence. There is some evidence that non‐hormonal chemoprevention is possible, but clinical trial data are lacking.
LASER TREATMENT OF PHARYNGEAL POUCH
Authors: Benjamin Bruce , Innocenti Marzio 
Published: January 2008

The symptoms of pharyngeal pouch become more troublesome, eventually requiring surgical treatment. Excision of the pouch and cricopharyngeal myotomy through a neck incision was the operation of choice until Dohlman described endoscopic diathermy operative treatment 30 years ago.' The diathermy technique has been largely superseded by endoscopic microsurgical division of the cricopharyngeus muscle in the party wall using carbon dioxide laser. This operation is now established as a precise, accurate and safe procedure providing reliable relief of symptoms with minimal risk to the patient.Fifteen patients treated by the microsurgical laser procedure in the past 5 years am reported.
PERI‐OPERATIVE COLONOSCOPY DETECTS SYNCHRONOUS TUMOURS IN PATIENTS WITH COLORECTAL CANCERS
Authors: Sugrue M. , Black R. , Watts J. , Rich C. , Toouli J. 
Published: January 2008

The aim of this study was to assess the value of colonoscopy as a pen‐operative investigation in patients treated for colorectal cancer by surgical excision. Patients (134 male, 83 female) undergoing curative resection for colorectal carcinoma between August 1984 and January 1989 had colonoscopy within 3 months of surgery. Eleven patients (5%) had a synchronous cancer, which was diagnosed by colonoscopy in eight. In six of these eight, the diagnosis was made after surgery and 3 patients needed a second colectomy. However, in 3 patients the synchronous cancer was removed endoscopically without the need for further surgical resection. Most synchronous cancers had an earlier pathological stage than the index tumour. The rate of synchronous cancers was higher in patients with synchronous benign polyps (16%) than in those without polyps (3%).Colonoscopy is clearly justified as a peri‐operative investigation in all patients undergoing potentially curative resection of colorectal cancer. If possible, the examination should be carried out prior to surgery, to guide the extent of resection.
POSTOPERATIVE FATIGUE: A PROSPECTIVE PHYSIOLOGICAL STUDY OF PATIENTS UNDERGOING MAJOR ABDOMINAL SURGERY
Authors: Schroeder David , Hill GrahamL. 
Published: January 2008

We attempted to define the site of muscle action accounting for the apparent muscle weakness occurring with postoperative fatigue. A model of the normal pathway of muscle contraction is presented. A series of studies, designed to separate the elements of the pathway, was performed on 38 patients undergoing major abdominal surgery. Central fatigue was measured with christensen's analogue, voluntary strength by grip strength, perceived effort by grading the difficulty of a set work load, involuntary muscle function by ulnar nerve stimulation, and muscle bulk represented by total body nitrogen, measured by in vivo neuron activation analysis.Fatigue increased for the first 2 weeks after operation, was back to pre‐operative levels within 1 month, and improved further at 3 months. Grip strength fell after operation and returned to pre‐operative levels within 3 months. Perceived effort rose after operation and returned to pre‐operative levels by 3 months. Involuntary muscle function was unaffected by operation. Similarly, total body nitrogen fell in the first 2 weeks after operation but was improved on baseline levels at 3 months. However, there was no consistent correlation between the movement patterns of any of the muscle parameters and fatigue.The results suggest that fatigue after surgery is not accompanied by any muscular defect, and that the apparent muscular weakness is probably a secondary phenomenon to the central fatigue.