bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute right iliac fossa pain in acquired immunodeficiency: A comparison between patients with and without acquired immune deficiency syndrome
Authors: Savioz D , Lironi A , Zurbuchen P , Leissing C , Kaiser L , Morel P 
Published: March 2007

Abstract
A retrospective review was performed of the clinical features present in 17 patients who were human immunodeficiency virus (HIV) positive requiring a diagnostic or therapeutic procedure for suspected appendicitis. Patients who were acquired immune deficiency syndrome (AIDS) free (n = 11) and those with AIDS (n = 6) were compared. Ten of the 11 patients who were AIDS-free had appendicitis. The morbidity rate was 9 per cent, similar to that expected in seronegative patients, but the appendix perforation rate was 50 per cent. Only two of the six patients with AIDS had appendicitis. Three suffered from an HIV-related disease process. Computed tomography (CT) was performed in four of the six patients with AIDS, and was considered of diagnostic help in three. In patients with AIDS, the morbidity rate rose to 50 per cent. Surgical decision-making with regard to HIV-positive patients who were AIDS-free with suspected appendicitis should be similar to that for seronegative patients. For patients with AIDS, alternative diagnostic strategies, including pre- operative CT, or possibly laparoscopy, should be considered.
Response to regional chemotherapy in patients with variant hepatic arterial anatomy
Authors: Doughty J C , Warren H , Anderson J H , Stewart I S , Reid A W , Cooke T G , McArdle C S 
Published: March 2007

Abstract
Regional chemotherapy for colorectal liver metastases is conventionally delivered by a catheter inserted into the gastroduodenal artery. However, up to 40 per cent of patients have ‘unconventional’ hepatic arterial anatomy. The response rate to regional chemotherapy was examined in 28 patients with normal and in 17 with variant hepatic arterial anatomy. There was no significant difference in response rates between the two groups.
Aortic prosthetic infection: 50 Patients treated by radical or local surgery
Authors: Hannon R J , Wolfe J H N , Mansfield A O 
Published: March 2007

Abstract
Fifty patients with aortic prosthetic infection were managed in a period of 10 years from 1983 to 1993. Twenty-five patients had recurrent sepsis after local surgery (group 1) and 22 of these eventually required radical surgery. Twenty-five patients had radical graft excision as the first procedure (group 2). Group 1 contained an excess of patients with local groin symptoms (11 in group 1 versus five in group 2, P = 0·03) and in this group fewer radiological techniques were used to document the extent of graft infection. The perioperative mortality rate was similar in both groups (seven in group 1 versus five in group 2). The number of amputations was also similar (five in group 1 versus four in group 2). The triad of occlusive disease, aortobifemoral bypass and groin symptoms was associated with eight of nine amputations. While the authors would consider using local techniques if the anastomosis was intact, the graft remained patent and infection appeared to be confined to the groin, this combination is uncommon and radical graft excision remains the preferred treatment.
Inhibition of neutrophil respiratory burst and cytokine priming by γ-linolenic acid
Authors: Jiang W G , Puntis M C A , Horrobin D F , Scott C , Hallett M B 
Published: March 2007

Abstract
The effect of n-6 fatty acids, particularly y-linolenic acid (GLA), on the oxidase response and neutrophil priming by tumour necrosis factor a and interleukin 8 was studied in both normal volunteers and patients with obstructive jaundice. GLA inhibited the neutrophil respiratory burst at concentrations higher than 50 μmol/l, but abolished cytokine priming at concentrations as low as 1 μmmol/1. Inhibition was not the result of either cytotoxicity to the neutrophils or alteration in cytosolic free calcium homoeostasis. It is concluded that GLA is a potential inhibitor of neutrophil priming by cytokines and of the oxidative response.
Use of a laparoscopic trocar for percutaneous introduction of drains into intra-abdominal abscesses
Authors: Singh K , Lamparelli M , Foley R J E 
Published: March 2007

Abstract
Drainage of an intra-abdominal abscess is a difficult problem. Laparotomy with open drainage, although effective, carries a certain morbidity and mortality rate. Percutaneous drainage using one of the various pigtail catheters is often ineffective, especially when there is debris within the abscess. These catheters tend to become blocked unless they are flushed regularly owing to a smaller lumen1. A method is described for introducing a wide-bore Robinson drain under ultrasonographic guidance using local anaesthesia.
Routine preoperative infusion cholangiography at elective cholecystectomy: A prospective study in 694 patients
Authors: Hammarström L-E , Holmin T , Stridbeck H , Ihse I 
Published: March 2007

Abstract
The role of preoperative infusion cholangiography (PIC) before elective cholecystectomy has yet to be defined. Between 1985 and 1991 PIC was performed routinely in 694 patients with median (range) age of 52 (17–85) years with biliary calculus disease 1 or 4 days before elective cholecystectomy. Satisfactory opacification of the biliary system was achieved in 90·1 per cent and mild to moderate adverse reactions to the infusion of contrast medium occurred in 0·9 per cent of patients. Peroperative cholangiography (POC) in 43 of 499 patients with a normal PIC was normal. The presence of common bile duct stones was confirmed in 34 of 36 patients with prominent stones at bile duct exploration and in 8 of 26 with suspected stones at PIC. Bile duct dilatation (median diameter 10 mm) without concomitant stones was seen at PIC and confirmed at POC in 20 patients. Bile duct anomalies were found or suspected in 35 patients at PIC and were confirmed in six by POC (n = 5), or during the cholecystectomy making the anomaly incidence 0·9 per cent. Information provided by the PIC was not of crucial importance for safe execution of cholecystectomy in any patient, while a single (minor) bile duct lesion (1 of 694; 0·1 per cent) could be ascribed to severe pericholecystitis. The results of this study suggest that routine PIC is not warranted. However, PIC is an alternative to selective preoperative endoscopic retrograde cholangiography or selective POC. PIC needs to be supported by POC in approximately 20 per cent of patients (in case of absent or poor opacification of the bile ducts or suspicion of stones or anomalies at PIC).
Intravenous infusion cholangiography for investigation of the bile duct: A direct comparison with endoscopic retrograde cholangiopancreatography
Authors: Bloom I T M , Gibbs S L , Keeling-Roberts C S , Brough W A 
Published: March 2007

Abstract
Laparoscopic cholecystectomy has led to an increase in preoperative endoscopic retrograde cholangiopancreatography (ERCP) for the investigation of bile duct stones. ERCP and intravenous infusion cholangiography (IIC) were compared in 111 consecutive patients without jaundice considered to be at high risk for bile duct stones. Both investigations were successfully completed in 100 patients. IIC and ERCP demonstrated a normal bile duct in 81 patients and bile duct stones in 16 patients. IIC failed to identify bile duct stones in two patients (1·8 per cent). IIC was 89 per cent sensitive and 99 per cent specific for detecting bile duct stones in patients without jaundice. It is suggested that IIC is a cost-effective preoperative investigation for bile duct calculi.
Long-term results of endoscopic stenting and surgical drainage for biliary stricture due to chronic pancreatitis
Authors: Smits M E , Rauws E A J , van Gulik T M , Gouma D J , Tytgat G N J , Huibregtse K 
Published: March 2007

Abstract
A retrospective evaluation was made of the long-term results of endoscopic stenting in 58 patients with benign biliary stricture due to chronic pancreatitis. Immediate relief of jaundice and cholestasis was achieved in all patients after endoscopic stent insertion. Median follow-up was 49 months. Five (9 per cent) of the 58 patients had complications following therapeutic endoscopic retrograde cholangiopancreatography. Late stent-related complications occurred in 37 (64 per cent) of 58 patients. There were no deaths. Sixteen (28 per cent) of the 58 patients had regression of the biliary stricture and permanent removal of the stent. Forty-two patients had persistent biliary stricture: 26 had continued stenting and 16 underwent surgical procedures. Early morbidity after surgery was found in six of 16 patients, with no deaths. Postoperative relief of jaundice was achieved in 15 of the 16 patients. In conclusion, endoscopic stenting and surgery are both effective treatments for biliary stricture in patients with chronic pancreatitis. Endoscopic stenting is associated with fewer early complications. However, late stent-related complications remain a major limitation. Endoscopic stenting offers definitive treatment in more than one-quarter of patients (28 per cent).
Topical glyceryl trinitrate in the treatment of chronic anal fissure
Authors: Watson S J , Kamm M A , Nicholls R J , Phillips R K S 
Published: March 2007

Abstract
The aetiology of anal fissure is unclear, but there is an association with high maximum resting pressure (MRP). Internal sphincterotomy reduces MRP and heals fissure through an increase in local blood supply. Glyceryl trinitrate (GTN) is a nitric oxide donor which contributes to internal anal sphincter relaxation via a non-adrenergic non-cholinergic pathway. GTN ointment was applied topically in different concentrations to the anal margin in patients with chronic anal fissure to monitor its effect primarily on MRP and secondarily on fissure healing. Nineteen patients with chronic anal fissure were treated with ointment containing increasing concentrations of GTN (0·2–0·8 per cent) to produce a reduction in MRP of greater than 25 per cent. The actual dose of GTN varied as no standard delivery system has been developed, but a ‘typical amount’ of GTN ointment weighed about 200 mg. In 15 of 19 patients, a concentration greater than 0·2 per cent was required to lower the MRP by at least 25 per cent. The minimum concentration of GTN that reduced the resting pressure by at least 25 per cent was prescribed and local application was carried out by the patient twice daily for 6 weeks. At 6 weeks, nine patients had healed, six required sphincterotomy and four were lost to follow-up. Eight of the nine patients with healed fistula required a GTN concentration of 0·3 per cent or more. Sixteen patients were resistant to the usually effective dose of 0·2 per cent GTN. In three there was tachyphylaxis and the duration of action of GTN was less than the 12 h described previously in control patients. Two patients did not fulfil the study because of headache.
Prognostic significance of radial margins of clearance in rectal cancer
Authors: de Haas-Kock D F M , Baeten C G M I , Jager J J , Langendijk J A , Schouten L J , Volovics A , Arends J W 
Published: March 2007

Abstract
A retrospective review of 325 patients was undertaken to analyse whether involvement of the radial resection margin (RRM) could predict locally recurrent disease or distant metastases in patients who had curative surgery for rectal or rectosigmoid cancer. Information on the RRM was available in 253 patients. The RRM was involved in 31 (12 per cent). Nine of these 31 patients developed local recurrence (29 per cent), while only 17 local recurrences were diagnosed in 217 patients (8 per cent) without involvement of the RRM (P&lt;0·01). At 2 years the overall local recurrence rate was 10 per cent. Distant metastases were diagnosed in 46 patients (18 per cent) and RRM involvement was identified as a prognostic factor depending on lymph node involvement (N stage) (P = 0·02). Local recurrence and some distant metastases result from microscopically incomplete resection. Assessment of the radial depth of tumour invasion by careful histological examination of the specimen may be used for selection of patients for adjuvant radiotherapy and/or chemotherapy.
Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery
Authors: Andersen J , Hjort-Jakobsen D , Christiansen P S , Kehlet H 
Published: March 2007

Abstract

Background
Initial programmes of fast-track open colonic surgery with a planned 2-day postoperative hospital stay have had a high readmission rate (about 20 per cent). The aim of this large, consecutive series was to compare readmission rates after a fast-track open colonic surgery programme with a planned hospital stay of 2 versus 3 days.

Methods
The study included 541 consecutive colonic resections from one surgical department with a structured care programme, including well defined discharge criteria, between April 1997 and December 2005. The planned hospital stay was increased from 2 to 3 days from August 2004. All patients were examined 8 and 30 days after surgery.

Results
Readmission rates fell from 20·1 per cent in 408 patients with a planned 2-day hospital stay (period 1) to 11·3 per cent in 133 patients with a planned 3-day hospital stay (period 2) (P &lt; 0·020). Median length of primary hospital stay was 2 and 3 days, median stay after readmission was 5 and 5·5 days, and median (mean) total stay was 3 (5·6) and 3 (5·7) days in periods 1 and 2 respectively. The readmission rate in period 2 was lower because there were fewer readmissions for short-term observation or social reasons. There was no difference in type and incidence of morbidity between the two periods.

Conclusion
Readmission after fast-track open colonic resection was reduced by planning discharge 3 instead of 2 days after surgery, with the same discharge criteria.
Methodological problems related to the quantitative assessment of stretch, elastic recoil, and balloon‐artery ratio
Authors: Hermans Walter R. M. , Rensing Benno J. , Strauss Bradley H. , Serruys Patrick W. 
Published: March 2007

AbstractThe (inflated) balloon is important to determine the extent of stretch (theoretical maximal gain in diameter or area during PTCA), elastic recoil (the loss in diameter or area immediately after PTCA), and whether under‐ or over‐sizing (balloon‐artery ratio) of the dilated lesion occurred. In these assessments, the inflated balloon is used as scaling device with assumed uniformity along its entire length. In order to assess more accurately stretch, elastic recoil, and the balloon‐artery ratio, the balloon diameter was measured over its entire length with edge detection and videodensitometry in 505 lesions (453 patients). With an average inflation pressure of 8.3 ± 2.6 atm a difference between the minimal and the maximal balloon diameter of 0.59 ± 0.23 mm was measured using edge detection and 1.70 ± 0.90 mm2 difference in area using videodensitometry. This results in large variations in the calculated stretch, elastic recoil, and balloon‐artery ratio depending on the site of the balloon chosen for assessment. The mean difference ± SD between stretch and elastic recoil assessed by edge detection and videodensitometry (using the minimal luminal diameter or area of the balloon) are respectively 0.00 ± 0.19 and 0.00 ± 0.24, suggesting that both methods are appropriate.
Relationship of anticoagulation and radiographic contrast agents to thrombosis during coronary angiography and angioplasty: Are there real concerns?
Authors: Hill James A. , Grabowski Eric F. 
Published: March 2007

AbstractRadiographic contrast agents are essential for the performance of coronary angiography and angioplasty. Historical data show that thrombosis‐related events have occurred since coronary angiography has been performed. Newer non‐ionic agents have been shown to be safer than conventional high osmolar ionic agents especially in high risk patients, but concern has been raised about a potentially increased risk of thrombosis with the use of these agents. A review of basic and clinical evidence for this perception does not support the view that an increase in thrombosis‐related events has occurred as a result of non‐ionic contrast media use in coronary angiographic procedures.
The vineberg procedure revisited: Angiographic evaluation and coronary artery bypass surgery in a patient 21 years following bilateral internal mammary artery implantation
Authors: Topaz On , Pavlos Stephan , Mackall Judith A. , Nair Ravi , Hsu Jack 
Published: March 2007

AbstractA patient receiving bilateral internal mammary implantation (Vineberg's operation) in 1969 was symptom free for a period of 21 years. In 1990 he developed acute myocardial infarction followed by post‐infarction angina. Cardiac catheterization revealed severe left main and three vessel disease and patency of both mammary implants which filled the left anterior descending and circumflex coronary arteries via collaterals. Coronary artery bypass surgery was indicated due to the native coronary artery disease and inability of the internal mammary grafts' blood flow to alleviate symptoms. The patient underwent direct coronary artery bypass grafting utilizing femoral vessels for cannulation and saphenous veins for grafting, while preserving the mammary implants. This unique case attests to the longevity of the internal mammary artery grafts. These grafts, even if directly implanted, can serve as a crucial source of blood to an otherwise severely under‐perfused myocardium. Strategy and technical aspects of surgical redo in patients who underwent Vineberg's operation are discussed.
Ischemia‐Induced depressed systolic thickening is transiently augmented by remote coronary occlusion
Authors: Gascho Joseph A. , Copenhaver Gary L. , Davidson William R. 
Published: March 2007

AbstractTo determine if ischemia‐induced depressed myocardial thickening can be augmented by remote coronary occlusion, posterior wall function (pulsed Doppler crystal) was measured before and after left anterior descending coronary artery occlusion in the presence of reduced circumflex coronary artery flow (of sufficient severity to reduce resting function) in an anesthetized open‐chest canine preparation in which the circumflex was pump‐perfused with carotid arterial blood.Left anterior descending coronary occlusion elicited an immediate significant increase in posterior bed thickening fraction (TF%) (3.7 ± 1.5 to 5.9 ± 1.3%), but by 135 sec TF% had again deteriorated. The transient increase in thickening was not caused by increased flow to the posterior bed (microspheres, n = 3), nor was it related to a Frank‐Starling mechanism (echocardiography, n = 3).Despite an ischemic‐induced reduction in systolic shortening, systolic thickening can be transiently augmented by remote coronary occlusion. The etiology may be related to systolic unloading.
Balloon angioplasty for complete obstruction of inferior vena cava: Needle puncture followed by balloon dilatation
Authors: Dev Vishva , Kaul Upendra , Sahni Peush , Sharma Sanjiv 
Published: March 2007

AbstractWe report herein 2 cases with complete obstruction of the suprahepatic portion of the inferior vena cava successfully treated by balloon angioplasty after crossing the obstructing segment with the stiff end of the guidewire in 1 case and the Brockenbrough's trans‐septal needle in the other. The gradients across the obstruction fell from 13 and 20 mm Hg to 3 and 4 mm Hg, respectively. Angioplasty resulted in dramatic clinical hemo‐dynamic and angiographic improvement.
Use of balloon occlusion to improve visualization of anomalous pulmonary venous return in an adult with cor triatriatum
Authors: Papagiannis John , Harrison J. Kevin , Hermiller James B. , Harding Michael B. , Armstrong Brenda E. , Ungerleider Ross M. , Bashore Thomas M. 
Published: March 2007

AbstractCor triatriatum, although rare in adults, is often associated with anomalous pulmonary venous return. Accurate diagnosis of the pulmonary venous return and its anatomic connections is essential in planning proper surgical correction. This case illustrates the advantage of selective pulmonary artery angiography in obtaining accurate detail of the pulmonary venous anatomy from digital subtraction levophase images. Selective right and left pulmonary angiography was performed using a balloon catheter to simultaneously occlude the opposite pulmonary artery. This technique was well tolerated and greatly enhanced visualization of the anomalous pulmonary venous connections, allowing proper planning for corrective surgery.
Systemic embolism as a complication of percutaneous mitral valvuloplasty
Authors: Drobinski G. , Montalescot G. , Evans J. , Nivet M. , Thomas D. , Grosgogeat Y. 
Published: March 2007

AbstractSystemic embolism is a potential and severe complication of percutaneous mitral valve dilatation. In our series of 80 cases, the incidence of systemic embolism was 3.75% (3 cases). Two cases occurred during the procedure itself. The cause of embolism was different in each case: cruoric thrombus formation occurred in 2 cases during or after dilatation, and was attributable to inappropriate heparinization, and catheter and guidewire thrombogenicity. In both cases heparin administration was delayed or given at a lower dosage. In the third case, calcific embolism occurred several days after valve dilatation. We think that the embolic calcified fragment was detached from the mitral leaflet at the time of or after balloon inflation. In these 3 cases, intraatrial thrombus mobilization was not the mechanism of systemic embolism. In 2 cases, transeosophageal echocardiography had been performed before dilatation and excluded the presence of an atrial thrombus the day before the procedure. It is concluded that, together with mobilisation of left atrial thrombi, which can be adequately detected by transeosophageal echocardiography, catheter‐induced thrombi represent a significant cause of embolic complications and must be prevented by giving full‐dose heparin during the total duration of the procedure. Calcific embolism may also occur, and may become more frequent if mitral valve balloon dilatation is proposed to a larger number of patients with valvular and subvalvular calcifications.
Left ventricular diverticulum: Case report and review of the literature
Authors: Walton‐Shirley Melissa , Smith Steven M. , Talley J. David 
Published: March 2007

AbstractWe describe two patients with left ventricular diverticula which were seen during routine left ventriculography. The diverticula were probably incidental findings and asymptomatic. A review of the literature to determine associated cardiac and extra‐cardiac abnormalities and related morbidity and mortality with emphasis of potential treatment strategies is presented. © 1992 Wiley‐Liss, Inc.