bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of norepinephrine and acetylcholine on portal–systemic collaterals of common bile duct‐ligated cirrhotic rat
Authors: CHAN CHE‐CHANG , CHANG CHING‐CHIH , HUANG HUI‐CHUN , WANG SUN‐SANG , LEE FA‐YAUH , CHANG FULL‐YOUNG , LIN HAN‐CHIEH , TAI CHUN‐CHING , LEE SHOU‐DONG 
Published: November 2005

AbstractBackground:  Catecholamine exerts profound vascular effects on vascular smooth muscle, and serum norepinephrine (Nepi) and sympathetic nervous activity are increased in cirrhosis. The vascular response of Nepi and acetylcholine (Ach) in portal–systemic collaterals of cirrhotic rats is unknown. The purpose of the present study was to investigate the effects of Nepi and Ach on portal–systemic collaterals of common bile duct‐ligated (BDL) cirrhotic rats.Methods:  Perfusion studies were performed 6 weeks after BDL when hepatic cirrhosis was induced. Three series of experiments were performed in BDL rats: (i) the Nepi (10−10 mol/L−10−5 mol/L) vasoconstrictory responses with (n = 6) and without (n = 5) α1‐ (phentolamine, 5 × 10−6 mol/L) or β‐  (propranolol,  10−5 mol/L)  receptor  antagonist  (n = 6  and  5,  respectively);  (ii)  the  Ach  (10−8 mol/L−10−5 mol/L) vasodilatory responses in Nepi‐ preconstricted portal–systemic collaterals in the absence (n = 7) or presence (n = 8) of Nϖ‐ l‐nitro‐arginine (NNA, 10−4 mol/L); and (iii) the effect of indomethacin (10−5 mol/L; n = 6) on Nepi responses. The collateral vascular responses were evaluated by the in situ collateral perfusion.Results:  Norepinephrine significantly increased the perfusion pressure and was inhibited by phentolamine (P < 0.05). The constrictive responses of Nepi were not significantly modified in the presence of propranolol (P > 0.05). Acetylcholine produced >50% relaxation of the Nepi‐preconstricted collateral vessels and was inhibited by NNA (P < 0.05). In addition, indomethacin significantly enhanced the constrictive response of Nepi (P < 0.05).Conclusion:  Norepinephrine has a vasoconstrictive effect on the portal–systemic collaterals of cirrhotic rats and this effect was mediated by α1‐receptor. Both nitric oxide and prostaglandin are endogenous modulators in the collateral circulation of cirrhotic rats.© 2005 Blackwell Publishing Asia Pty Ltd
Clinical implications of the extent of invasion of T3 esophageal cancer by endoscopic ultrasound
Authors: YUSUF TONY E , HAREWOOD GAVIN C , CLAIN JONATHAN E , LEVY MICHAEL J , TOPAZIAN MARK D , RAJAN ELIZABETH 
Published: November 2005

AbstractBackground: Endoscopic ultrasound (EUS) is an accurate imaging modality for local staging of esophageal cancer. We aimed to determine if depth of tumor invasion beyond muscularis propria (MP), as determined by preoperative EUS, is predictive of tumor recurrence or survival (a positive change in mortality) in patients with T3 esophageal cancer.Methods: Records and images of all patients with T3 N1 M0 esophageal cancer staged with EUS at our institution between January 1999 and October 2003 were reviewed. EUS images were independently reviewed by five blinded endosonographers and tumors were classified as minimally invasive (invasion < 3 mm beyond MP) or advanced (invasion ≥ 3 mm beyond MP) T3 disease.Results: One hundred and sixty‐five patients with esophageal cancer underwent EUS for staging and 39 patients with T3 N1 esophageal cancer were identified; 17 patients had minimally invasive T3 disease and 22 had advanced disease. All patients underwent neoadjuvant chemoradiation therapy followed by esophagectomy. Median follow up was 13 months. Adjusting for age and sex, minimally invasive disease was not associated with a statistically significant improvement in recurrence‐free survival (hazard ratio, 1.45; 95% CI, 0.88–2.41,P = 0.14) or mortality (hazard ratio, 0.96; 95% CI: 0.49–1.78,P = 0.91).Conclusions: The extent of invasion of T3 esophageal cancer beyond MP, as determined by EUS, is not a significant predictor of tumor recurrence or mortality.
Effect of topical esophageal acidification on salivary secretion: Identification of the mechanism of action
Authors: SHAFIK AHMED , EL‐SIBAI OLFAT , SHAFIK ALI A , MOSTAFA RANDA 
Published: November 2005

AbstractBackground:  In past studies, investigators have reported that the salivary glands respond to esophageal acidification by increased salivary secretion and termed this response the ‘esophago–salivary response’. The existence, however, of such a reflex was but a speculation because the verification of its mechanism could not be traced in the literature. In the current study, the hypothesis that the salivary glands’ response to esophageal acidification is a reflex was investigated.Methods:  In 15 healthy volunteers (nine men, six women, age 32.3 ± 4.2 years) the saliva of the four salivary glands was collected by intubation after individual esophageal perfusion with normal saline and 100 mmol HCl. The test was repeated after each of the lower esophagus and the salivary glands had been separately anesthetized. The latency was calculated.Results:  The mean basal volume of saliva was 62.7 ± 6.4 mL/60 min. This volume did not show a significant change (P > 0.05) on esophageal saline instillation, whereas acid perfusion effected a significant increase (P < 0.01). The mean latency was 12.4 ± 2.7 s. Esophageal acid perfusion after lower esophageal anesthetization did not produce a significant change in salivary volume; similar results were obtained on repetition of the test after anesthetization of salivary glands. When saline was used instead of lidocaine in the lower esophagus or salivary glands, the salivary glands’ response was similar to that without saline perfusion.Conclusion:  Esophageal acidification effected an increase of secreted saliva which clears the esophagus of the refluxed acid. Increased salivation on esophageal acidification is suggested to be a reflex and is mediated through the ‘esophago–salivary’ reflex. This reflex might be of diagnostic significance in the investigation of reflux esophagitis, a point that requires further study.
Psychological impact and cosmetic outcome of surgical breast cancer strategies
Authors: Nano Maria Teresa , Gill Peter Grantley , Kollias James , Bochner Melissa Anne , Malycha Peter , Winefield Helen R. 
Published: November 2005

Background:  Current surgical treatment modalities for breast cancer include breast conserving surgery, mastectomy alone and mastectomy with breast reconstruction. There are recognized benefits of breast conservation and breast reconstruction over mastectomy but there are few studies assessing this area in Australia. The aim of the present study was to compare the various surgical strategies for breast cancer treatment in terms of quality of life, cosmesis and patient satisfaction.Methods:  A chart analysis was conducted of all patients who underwent Breast Cancer Reconstruction at the Royal Adelaide Hospital Breast Unit between 1990 and 2002. Patients were then traced and asked to take part in an interview. Mastectomy and breast conservation patients who attended outpatient clinic for follow up were also approached. All three groups were interviewed and self‐assessment quality of life questionnaires (Functional Assessment of Cancer Therapy−Breast, body image) were administered. The breast conservation and reconstruction groups also underwent assessment of satisfaction and cosmesis.Results:  A total of 78 mastectomy, 109 breast conservation and 123 breast reconstruction patients were interviewed. Quality of life assessment was similar between the three groups but the breast conservation and reconstruction patients’ body image scores were superior to the mastectomy group. Patient satisfaction was higher in the reconstruction group than the breast conservation group of patients, while cosmesis was similar.Conclusion:  While little difference was seen on quality of life assessment, body image is improved with the use of breast conservation and reconstruction. The high satisfaction and cosmesis scores in the breast reconstruction group are an indication of the superior results that can be achieved with breast reconstruction.
Surgical treatment of femoral artery infected false aneurysms in drug abusers
Authors: Georgiadis George S. , Lazarides Miltos K. , Polychronidis Alexandros , Simopoulos Constantinos 
Published: November 2005

Background:  Post‐traumatic femoral artery infected false aneurysms (pfa‐IFA) in drug abusers are very common in modern societies, but their surgical management remains controversial.Methods:  A review was undertaken of the English‐language literature between 1967 and 2004 for relevant articles describing at least four cases of pfa‐IFA in drug‐addict populations. The available surgical treatment options are discussed.Results:  Recent surgical therapeutic reports favour aneurysm ligation and excision (Lig‐Exc) and local debridement (Ld) with observation‐selective (delayed) revascularization in cases where limb viability is threatened, or Lig‐Exc and Ld alone without vascular reconstruction. The former method carries the risk of delayed decision on attempted extremity salvage (12.1% amputation rate), accepting early (13.5%) and late (7.5%) claudication rate, and although the latter method has much lower early and late amputation rates (5.7 and 6.3%, respectively), it results in a high percentage of claudication and disability (early, 54.4%; late, 44.3%). Immediate (routine) revascularization using either in situ or extra‐anatomic bypass has also been associated with high complication rates. Even when it occurs through non‐infected tissue planes, the risk of graft infection (early, 21.1%; late, 32.4%) is of great concern, and the possibility of sepsis (together with anastomotic dehiscence (14%) and even amputation) is high (early, 9.8%; late, 11.3%). Reversing the order of revascularization produces zero early complication rates, but long‐term follow up reveals that 5.5% of patients have graft infection and 5.5% have had amputation. The follow up rates reported in the literature are poor (only 31.7% completed), and are also sometimes inaccurate.Conclusions:  No surgical treatment for pfa‐IFA has been proved to be safe in terms of the overall surgical complications. Longer follow‐up periods are needed to provide accurate results.
Outcome of surgery for parotid tumours: 5‐year experience of a general surgical unit in a teaching hospital
Authors: Al Salamah Saleh M. , Khalid Kamran , Khan Iftikhar A. R. , Gul Rahman 
Published: November 2005

Background:  Most of the recent reports on the surgical management of parotid gland disorders come from specialist divisions of otolaryngology, head and neck, or faciomaxillary surgery. The aim of the present study was to evaluate the outcome of surgery for parotid tumours in a general surgical unit of a teaching hospital.Method:  A prospective clinicopathological study was undertaken over a 5‐year period for consecutive patients operated on for parotid gland tumours in the King Saud University Unit of Riyadh Medical Complex. Parameters analyzed were demographic details, clinical presentation, diagnostic work‐up, type of surgery, and outcome in terms of early and late morbidity.Results:  Thirty seven parotid operations were performed on 36 consecutive patients. All patients presented with parotid gland swelling. Mean age was 51.6 years with a male preponderance. Fine‐needle aspiration diagnosed the pathology in 33 out of 37 lesions. Pleomorphic adenoma was the commonest pathology observed in 24 patients (64.9%). Warthin's tumour was more common among male patients and was the only pathology with bilateral involvement. Malignant tumour was found in five patients (13.5%). Superficial conservative parotidectomy was the most frequently performed operation (84%). Overall postoperative morbidity was 13.5%. Transient facial nerve palsy was observed in seven cases (19%). There was no recurrence identified in patients with benign diseases during the mean follow up of 38.5 months.Conclusion:  Parotid gland surgery can still be performed in a general surgery unit with comparable outcome. However, the operation should be performed in units with special interest and experience in surgery for parotid gland disorders.
Clinical variables associated with positive angiographic localization of lower gastrointestinal bleeding
Authors: Abbas Saleh M. , Bissett Ian P. , Holden Andrew , Woodfield J. C. , Parry Bryan R. , Duncan David 
Published: November 2005

Background:  Localizing the source of severe lower gastrointestinal (GI) bleeding is often difficult but is important to plan the extent of colonic resection. The purpose of the present paper was to audit the Auckland Hospital experience of selective angiography, in localizing lower GI bleeding.Methods:  Patients admitted to Auckland Hospital with rectal bleeding and who subsequently had angiography were evaluated by reviewing their clinical notes and radiological results during a 7‐year period (1997−2003). Data collected included demographic details, haemodynamic parameters, change in haemoglobin level, requirement of blood transfusion within 24 h before the procedure, site of the bleeding and pathology.Results:  The notes of 88 patients (male, n = 51; median age 69 years, range 8−99 years) were available for review and analysis. The site of bleeding was localized in 38 (51%); 30 of them had bleeding in the right colon or small bowel and eight in the left colon. Positive localization correlated with: haemodynamic instability P < 0.0001; drop in haemoglobin level of ≥50 from previous admission (P = 0.02); transfusion requirement of ≥5 units of blood within 24 h (P < 0.0001). Logistic regression analysis showed transfusion requirement of ≥5 units to achieve haemodynamic stability to be the most powerful predictor of accurate localization (odds ratio, 40).Conclusion:  Catheter angiography for acute lower GI bleeding will successfully localize a point of bleeding in approximately 50% of patients. The most useful clinical indicator for positive angiography was haemodynamic instability particularly in those who require transfusion of ≥5 units of blood to achieve haemodynamic stability.
Rates for mastectomy are lower in women attending a breast‐screening programme
Authors: Samnakay Naeem , Tinning Jill , Ives Angela , Willsher Peter , Archer Steve , Wylie Elizabeth , Saunders Christobel 
Published: November 2005

Background:  Mammographic screening for breast cancer facilitates earlier recognition of lesions, thus potentially allowing for breast‐conserving surgery. Few studies have compared the final surgical outcomes of women presenting through breast screening programmes with those presenting via other sources. Are breast cancer patients presenting through BreastScreen more likely to undergo breast‐conserving surgery than those presenting from other sources?Methods:  Using the Royal Perth Hospital (RPH) Multidisciplinary Breast Service Database, the final surgical outcomes were reviewed for 723 women treated for breast cancer at RPH between January 2000 and August 2002. During this period, 397 patients were referred to the RPH Multidisciplinary Breast Clinic from BreastScreen WA, and 326 were referred from other sources.Results:  Of all patients undergoing surgery for breast cancer, 58% in the screen group and 36% in the non‐screen group had breast‐conserving surgery (P < 0.0001). When surgical outcomes for women in the BreastScreen target age range of 50−69 years were analysed, 59.5% in the screen group and 42.3% in the non‐screen group had breast‐conserving surgery (P < 0.001). Patient choice was second only to disease extent as a factor determining the outcome of mastectomy. In both cohorts, more than 40% of patients who underwent re‐excisional surgery for positive margins, after initial breast‐conserving surgery, had residual invasive or in situ disease present.Conclusions:  At RPH, BreastScreen patients were more likely to undergo breast‐conserving surgery than those who presented from other sources. A significant proportion of women with positive margins after initial breast‐conserving surgery had residual in situ or invasive disease. Re‐excision for positive margins was thus warranted.
Complete resection of non‐small‐cell lung cancer and oligo‐metastatic brain disease
Authors: Daniels Marissa , Wright Gavin M. 
Published: November 2005

Background:  Non‐small‐cell lung cancer is a leading cause of cancer morbidity and mortality in Australia. Brain metastases are common, and rapidly fatal if untreated. Optimal management consists of resection and whole brain irradiation. However, there is a paucity of local data documenting survival after such treatment.Methods:  Medical records for all patients who underwent complete resection of non‐small‐cell lung cancer at one institution between January 1999 and December 2003 were reviewed in order to determine survival after initial surgery. The survival of all patients was compared with patients who underwent resection of synchronous or metachronous brain metastases and whole brain irradiation as part of their lung cancer management.Results:  Between 1 January 1999 and 31 December 2003, 170 patients underwent complete resection of non‐small‐cell lung cancer by a thoracic surgeon. Resection of synchronous or metachronous brain metastases followed by whole brain irradiation was also carried out on 15 of these patients. Complete cerebral resection was achieved in 12 cases. The overall 5‐year survival after attempted curative resection of brain metastases and successful complete resection was 60% and 70%, respectively. The survival of patients with both cerebral metastasectomy and lung cancer resection approximated that of the cohort of patients that only required complete resection of their lung cancer.Conclusions:  Control of local disease at each site and long‐term survival after lung resection and resection of either synchronous or metachronous brain metastasis and whole brain irradiation is readily achievable. We believe this should continue as the standard of care for this presentation.
Repair of mandible defect with tissue engineering bone in rabbits
Authors: Li Zhi , Li Zu‐Bing 
Published: November 2005

Background:  The aim of the present study was to investigate the effect of tissue engineering bone composed of bone marrow‐derived osteoblasts and demineralized bone in repairing mandible defect.Methods:  Bone marrow‐derived osteoblasts of 20 rabbits were cultured and seeded into scaffold of allogeneic demineralized bone to construct tissue engineering bone graft in vitro, which was used to repair the 10 × 5‐mm bone defect made in the same rabbit mandible edge. Implant of demineralized bone alone was as the control. Rabbits were killed according to the schedule: five after 2 weeks, five after 4 weeks, five after 8 weeks, five after 12 weeks, and the implants were harvested for gross, radiographic, and histological observation.Results:  New bone formation at the margin region of defect and osteogenesis at the centre were observed in the implant of tissue engineering bone, and the bone formation pattern included osteogenesis, osteoconduction, and osteoinduction. In the implant of demineralized bone alone, the major bone formation pattern was ‘creeping substitute’.Conclusions:  The tissue engineering bone graft constructed by autogenous bone marrow‐derived osteoblasts and allogeneic demineralized bone was better than demineralized bone alone in bone formation capability, which might be an ideal graft for bone defect repair.
Rare localizations of echinococcosis: personal experience
Authors: Versaci Antonino , Scuderi Giuseppe , Rosato Alessio , Angiò Luigi Giuseppe , Oliva Grazia , Sfuncia Giuseppe , Saladino Edoardo , Macrì Antonio 
Published: November 2005

Background:  The rare localizations of hydatidosis represent an interesting topic, especially with reference to epidemiological and diagnostic problems. Hydatid disease, common in Mediterranean countries, still remains endemic in some regions of Italy.Methods:  In the period April 1983−October 2003 73 patients with hydatid disease were observed.Results:  Seven patients (9.5%) presented a primary rare localization (thyroid, kidney, sacrospinal muscle, peritoneum and spleen). The main peculiarity of primary rare hydatidosis localizations concerns diffusion of the infecting embryo; the most reliable hypothesis is that liver and lung can be bypassed through precapillary anastomosis between pre‐ and post‐parenchymal circulation. The new imaging techniques allow a correct topographic evaluation and so a radical surgical treatment. The chemotherapy, complementary to surgery, produced degenerative modifications of parasite in 75.8% of the present cases and reduction of recurrence from 23.3% to 6.7%. At follow up of 1−5 years no patients had recurrence.Conclusion:  It is important to be aware, especially in countries where echinococcosis is endemic, that it is possible to find an echinococcosis cyst in a rare localization.
Infra‐inguinal revascularization surgical site infections: Australasian benchmark
Authors: Hassen Tiffany A. , Fitridge Robert A. 
Published: November 2005

Background:  Infra‐inguinal revascularization surgery remains one of the most commonly performed major vascular procedures in contemporary practice. Surgical site infections (SSI) are a common cause of morbidity in this patient cohort and generate high rates of limb loss and mortality when vascular graft involvement occurs. An overall reduction in North American SSI has been attributed to the establishment of national benchmarks. A comparable Australasian benchmark does not exist. The purpose of the present study was to assess the methods used by Australasian vascular units to determine SSI rates and to instigate the development of an acceptable benchmark.Methods:  A structured questionnaire pertaining to SSI after infra‐inguinal revascularization surgery was sent to 26 Australasian vascular units. Data requested included the number and type of lower extremity revascularization procedures performed. Units were also asked to report the methods employed for defining and detecting wound infections and to document their SSI rate. The incidence of SSI causation by methicillin‐resistant Staphylococcus aureus (MRSA) was also sought.Results:  The total number of revascularizations performed annually varied from 28 to 179 between units. The SSI rates ranged from 0 to 38%. The incidence of MRSA involvement varied from <1% to 56%. The SSI surveillance methodology varied considerably between units.Conclusions:  The present study confirms the significant incidence of SSI after infra‐inguinal revascularization surgery in contemporary vascular practice. Standardized definitions and surveillance protocols are required to facilitate inter‐ and intrahospital comparisons. A possible benchmark infection rate may be 10−20%.