bluuebunny/crossref_metadata_2025_split huggingface dataset:
SH16 IMPOSTURES, DECEPTIONS AND CREDULITY
Authors: Magee H. R. 
Published: April 2007

In the Cowlishaw Collection of the College Library, there is a little book by an anonymous author entitled “Some Sketches of Impostures, Deceptions and Credulity”. In a series if 26 chapters the author covers a variety of subjects including oracles, false messiahs, vampirism, malingering, medical delusions and many others.Two notable examples of impostures and deceptions that played on the credulity of the public and the medical profession were Mary Tofts who claimed to have given birth to rabbits and Joanna Southcott, a self styled prophetess, who believed she had been impregnated by God and would give birth to a messiah.Other examples of impostures were the report of the miraculous bullet, ruses used in malingering and Dr. Graham’s Celestial Bed.All of these had some temporary popularity but were all recognised as falsehoods.
SH17 PROFESSOR ROBERT GOETZ – INNOVATOR AND PIONEER IN CORONARY ARTERY BYPASS SURGERY
Authors: Harden M. P. 
Published: April 2007

Coronary artery bypass grafting (CABG) is one of the most significant surgical achievements of the 20th century. The contributions of Vineberg, Kolesoz, Favaloro and DeBakey are well known, but the name of Goetz means little to most surgeons. Goetz performed the world’s first successful CABG on May 2, 1960, in Bronx, N.Y.Robert H. Goetz was born in Frankfurt on April 17, 1910 and studied medicine at the University of Frankfurt. In the 1950’s he studied the physiology of the giraffe, whose ability to lift its head from the ground to full height without fainting confounded zoologists, earning him the Vesalius Medal.In 1960 Goetz developed a technique for coronary anastomosis on a beating heart using a tantalum ring on dogs. In an addendum to his article reporting this technique, Goetz announced the successful coronary mammary anastomosis between the right mammary and right coronary on a 38 year old man. The anastomosis was created in just 17 seconds. Before surgery the patient suffered from such debilitating angina that he needed 70 to 90 tablets of GTN a day. He remained pain free for 1 year and died of a posterior wall AMI. Angiogram at autopsy showed the anastomosis to be healed and patent.This was to be the only CABG Goetz completed. Permission to present this case at a meeting of the American Association for Thoracic Surgery was denied, as it was felt that the subject of CABG was unimportant and should be forgotten. In 1982, Goetz retired from surgery and bred prize‐winning Angus bulls as a hobby and died on 15 December, 2000, in Scarsdale, N.Y. He was a remarkable academic surgeon with vision that aided the development of one of the most important surgical advances of the last 50 years.
SH06 WITTGENSTEIN AND THE CONCEPT OF “WOUND SHOCK”
Authors: Stewart G. J. 
Published: April 2007

Ludwig Wittgenstein was one of the most influential and controversial philosophers of the 20th century. His ideas concerning the foundations of mathematics and the role of language remain of essential importance in these fields, while his eccentricities still warrant popular examination. During World War II, having relinquished his chair in philosophy at Cambridge University, he worked as dispensary porter and as laboratory assistant. In these roles and in association with the MRC Research Unit, initially at Guy’s Hospital, London and latter at the Royal Victoria Infirmary, Newcastle‐on Tyne, he was involved in investigations of what was then termed “wound shock”. These studies were carried out on air‐raid and latter industrial accident victims, under the leadership of Grant and Reeves, latter E.G, Bywater.Today, we would recognise the poorly defined clinical syndrome of “wound shock” as manifestations of hypovolaemia. This entity had been recognised since the trench warfare of the First World War, but it is amazing to realise that as recently as the mid decades of the last century, the understanding of the physiology of injury was so rudimentary that this relationship was not recognised.It is instructive to examine Wittgenstein’s role in discussion of the semantics of the term “shock”, which persists in causing confusion in the popular mind, as well as his experimental efforts. The development of understanding concerning hypovolaemic shock and crush injuries following the London Blitz shows how recently some of the most basic concepts on which we manage patients have become evident.
SH09 ANTARCTIC MEDICINE
Authors: Sharp P. A. 
Published: April 2007

From the earliest classical cartographers, belief in the existence of a ‘Terra Australis’ was widespread. There had to be a great southern land to balance the geography of the world. Inexorable plate tectonics may have separated Australia and Antarctica 45 million years ago but it was only within the last few hundred years that Abel Tasman and James Cook isolated and defined them as separate lands for science, politics and strategy.In 1901, the Australian colonies had just federated and formed a nation, the Commonwealth of Australia. The International Geographical Congress had proclaimed 1901 as ‘Antarctica’ year. The heroic age of Antarctic exploration was underway.Antarctic medical practice is unique because there is no indigenous population.This review starts with the primitive medicine practiced by doctors on board with Captain James Cook in 1775. The heroic era of Scott, Shackleton, Amundsen and Mawson was followed by a highly mechanized transition period and ends with modern medicine used in permanent stations and research.In Antarctica, we have Earth’s remaining tenuous links with outer space (the last two great frontiers). NASA scientists have used Antarctica to test lunar survival strategies because ‘this is as close to lunar conditions as we could get here on Earth’.
SO10P A RETROSPECTIVE ANALYSIS OF WOUND INFECTION AFTER PERCUTANEOUS ENDOSCOPIC GASTROSTOMY (PEG) IN CANCER PATIENTS
Authors: Lam T. , Spillane J. B. , Syme D. B. Y. , Wood R. , McPhail T. T. 
Published: April 2007

Purpose  To determine infectious complications following PEG insertion with attention to the effect of chemotherapy, radiotherapy and timing of PEG insertion.Methodology  A review of medical records of patients who underwent PEG insertion at a single institution between 1st July 2003 and 30th June 2005 was performed. PEG infection rate, antibiotic use, and concurrent chemotherapy and/or radiotherapy were recorded. Overall infection rate was calculated and a Quality Control Chart determined no evidence of an infectious outbreak.Results  96 PEG procedures were performed. 92.8% of patients had head and neck cancers, 90.6% had squamous cell carcinoma, 64.6% had distant disease. 71 of 96 patients were male, mean age 61.2 yrs, mean BMI 22.1 kg/m2. Median length of stay was 8 days for infected patients and 5 days for non‐infected patients; median follow‐up 21 days and 19 days respectively. 56 patients had prior chemo‐radiotherapy, 17 radiotherapy alone, 4 chemotherapy alone and 19 had no prior treatment. 14.6% patients had an infection. 21.4% of infected patients did not receive prophylactic antibiotics. Type of cancer, stage of cancer, and co‐morbidities were not predictive of infection. Chemotherapy and/or radiotherapy treatment before, during or after PEG insertion was not statistically significant for PEG infection.Conclusion  An infection rate of 14.6% was found, which falls within the range outlined by other authors. Our study investigated a patient group with tumours, the majority of whom had chemo‐radiotherapy around the time of PEG insertion. There was no statistical difference in infection rate due to timing of PEG insertion and no difference with the use of chemo‐radiotherapy.
SO11P A SYSTEMATIC REVIEW ON THE EFFICACY OF REPEAT HEPATECTOMY FOR RECURRENT LIVER METASTASES FROM COLORECTAL CARCINOMA
Authors: Sim J. , Yan T. D. , Black D. , Morris D. L. 
Published: April 2007

Purpose  The objectives of this systematic review were to critically appraise the quantity and quality of current clinical evidence and demonstrate the efficacy of repeat hepatectomy for CRLM.Methodology  Electronic searches for relevant studies published in peer‐reviewed journals on repeat hepatectomy for recurrent CRLM prior to September 2006 were performed on six databases. All articles identified were assessed with application of selection criteria. The quality of each included study was assessed. Clinical effectiveness was synthesized through a narrative review with full tabulation of results.Results  Seventeen studies with more than 20 patients were included for quality appraisal and data extraction. These 17 studies consisted of two multi‐institutional, one bi‐institutional and 14 single‐center observational studies. The overall perioperative morbidity rate ranged from 7–30% and mortality rate varied from 0–5%. The overall median survival since initial hepatectomy was 26 to 73 months. The overall median survival since the repeat hepatectomy ranged from 23 to 56 months, with 3‐ and 5‐year survival of 24–68% and 21–49%, respectively. The median disease‐free survival ranged from 9 to 52 months, with 3‐ and 5‐year disease‐free survival of 16–68% and 16–48%, respectively. After repeat hepatectomy the rates of recurrence in the liver and at an extra‐hepatic site were 15–67% and 27–64%, respectively.Conclusions  The current literature suggests that repeat hepatectomy is associated with a prolonged survival for recurrent CRLM. Although all studies were observational case series, repeat hepatectomy is justified in selected patients, as there is a lack of evidence for alternative treatment.
SO13P CYTOREDUCTIVE SURGERY COMBINED WITH PERIOPERATIVE INTRAPERITONEAL CHEMOTHERAPY FOR DIFFUSE MALIGNANT PERITONEAL MESOTHELIOMA – ANALYSIS OF 100 CONSECUTIVE PATIENTS FROM A PROSPECTIVE DATABASE
Authors: Yan T. D. , Sim J. , Sugarbaker P. H. 
Published: April 2007

Purpose  Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and invariably fatal neoplasm. Some studies have shown that cytoreductive surgery (CRS) combined with perioperative intraperitoneal chemotherapy (PIC) achieved an improved survival, as compared to historical controls. However, prognostic factors for survival have not been well defined.Methodology  One hundred patients with DMPM underwent CRS and PIC at the Washington Center Institute. The inclusion criteria for surgery consisted of histological diagnosis of DMPM, age < 80 years, good performance status, and signed informed consent. All data were collected prospectively. Eight clinical and eight treatment‐related prognostic factors were analyzed for survival.Results  The overall median survival was 52 months (range 1 to 148 months), with 1‐, 3‐, 5‐ and 7‐year survival of 78%, 55%, 46% and 39%, respectively. Univariate analysis showed that gender (p < 0.001), peritoneal cancer index (p = 0.009), lymph node status (p < 0.001), distant metastasis (p = 0.026), histological type (p < 0.001), intraoperative blood loss (p = 0.035), completeness of cytoreduction (p < 0.001), intraperitoneal chemotherapy regimen (p = 0.041), and redo cytoreductive surgery (p = 0.022) were significant for survival. Multivariate analysis demonstrated that female gender, absence of lymph node involvement, epithelial/multicystic type, and adequate cytoreduction were independently associated with an improved survival.Conclusions  CRS and PIC showed an improved survival for DMPM, as compared to historical controls. Long‐term survival was associated with female gender, absence of lymph node involvement, epithelial or multicystic type and adequate cytoreduction.
SO15P PERCUTANEOUS RADIOFREQUENCY ABLATION OF LUNG TUMOURS: PROGNOSTIC RISK FACTORS FOR LOCAL PROGRESSION
Authors: Ng K. , Yan T. D. , Zhu J. C. , King J. , Glenn D. , Morris D. L. 
Published: April 2007

Purpose  The purpose of this series was to evaluate the prognostic features for local progression in non‐surgical candidates after undergoing percutaneous RFA of lung tumours.Methodology  From Nov 2000, a total of 233 lung neoplasms (9 primary) in 95 patients (56 males, mean age of 66 years) with a mininum follow‐up of 6 months were included in this study. The primary end point was local progression free interval defined from the time of RFA intervention. Local progression was defined as tumour recurrence of previously RFA treated site/s. Univariate and multivariate analysis were performed to identify significant prognostic parameters for post‐ablative tumour recurrence.Results  The mean number of tumours ablated per patient was 2.5 while the mean diametre of tumours was 2.2 cm. After a median follow up period of 24 months (range: 6–54 months), 32% of ablated tumours recurred. The overall median local progression free interval was 20 months (range 3–54 months) with 1, 2 and 3 year local progression free survival of 82%, 74% and 68% respectively. Univariate analysis of lesion characteristics identified size (p = 0.0002), hilar location (p = 0.0141), proximity to bronchus (p = 0.009) and vessel (p = 0.001), number of ablations required per lesion (p = 0.0052) and post‐ablation and tumour volume ratio (p = 0.0002) as statistically significant prognostic factors for tumour recurrence. Multivariate analysis identified size of lung tumours >3 cm (p = 0.07) as an independent risk factor for local progression.Conclusion  Percutaneous lung RFA may play a useful role as a local therapy in non‐surgical candidates with pulmonary neoplasms. However, the efficacy of local control may be restricted to lesions smaller than 3 cm.
SO04 CYTOREDUCTIVE SURGERY AND PERIOPERATIVE INTRAPERITONEAL CHEMOTHERAPY FOR PERITONEAL CARCINOMATOSIS FOR COLORECTAL CARCINOMA
Authors: Sathasivam S. , Yan T. , Chu F. , Morris D. 
Published: April 2007

Cytoreductive surgery (CRS) combined with perioperative intraperitoneal chemotherapy (PIC) has been reported as a treatment option for patients with peritoneal carcinomatosis from colorectal carcinoma.This prospective study was to report survival outcomes and evaluate the significant prognostic factors for overall survival in 30 patients who underwent CRS and PIC.No patients were lost to follow‐up. Univariate analysis was performed to evaluate the significant prognostic factors for overall survival, defined from the time of surgery. Survival analysis was performed by using the Kaplan‐Meier method and compared using the log rank test.The median survival was 29 months (range 2–39 months). No patients died in the post‐operative period. The 1‐ and 2‐year survival rates were 72% and 64%, respectively.Six clinicopathologic factors and one treatment‐related factor for overall survival were analysed by univariant analysis. Clinicopathological factors included gender, age, timing of the surgery, histological grading, liver metastases and Peritoneal Cancer Index (PCI). Treatment‐related factors included operative duration, length of hospital stay, completeness of cytoreduction and peri‐operative morbidity. Three factors were significant for overall survival: non‐mucinous colorectal adenocarcinoma (versus mucinous, p = 0.047), PCI < 13 (versus > 13, p = 0.016), and complete cytoreduction (versus incomplete, p = 0.030).Non‐mucinous colorectal adenocarcinoma and PCI < 13 were associated with an improved survival in the 30 patients who underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis.
SO06 EXTRATHORACIC SOLITARY FIBROUS TUMOURS: OUTCOME OF 33 CASES
Authors: Cranshaw I. M. , Thway K. , Fisher C. , Hargreaves W. , Hayes A. J. , Thomas J. M. 
Published: April 2007

Purpose  Extrathoracic solitary fibrous tumours (SFT) have traditionally been regarded as less aggressive than their intrathoracic counterparts. However there has been some evidence that a subset of more aggressively malignant tumours exist. We examined our experience with these rare tumours in an effort to clarify their clinicopathological behaviour and relate this to their histopathological findings.Methodology  All patients with a histopathological diagnosis of SFT who presented to the Royal Marsden Hospital between 1998 and 2006 were reviewed. Clinicopathological data were recorded for all cases and comparisons made using Fishers exact test and calculating Odds ratios (OR).Results  There were 33 cases included in the study. 18 (55%) cases had malignant features on histological examination and these cases were associated with significantly increased rates of local recurrence (OR 16.21 p 0.021), metastatic disease (OR 8.91 p 0.046) and death (OR 38.29 p < 0.01). Tumours within the abdominal cavity or retroperitoneum were associated with a higher rate of local recurrence compared to those in the limbs (OR 21.67 p < 0.01). One case with benign histopathology developed metastatic disease at 102 months of follow‐up.Conclusion  In our experience extrathoracic SFT have a higher rate of malignant behaviour than that classically described. Those tumours with atypical or malignant features on histological examination should be closely monitored and followed up in the same manner as other high grade soft tissue tumours. Even histologically benign tumours occasionally behave in a malignant fashion.
SO07 LAPAROSCOPIC VERSUS OPEN TOTAL MESORECTAL EXCISION: A CASE‐CONTROL STUDY
Authors: Breukink S. O. , Pierie J. P. E. N. , Grond A. J. , Hoff C. , Wiggers T. , Meijerink W. J. H. J. 
Published: April 2007

Purpose  Because definitive long‐term results are not yet available, the oncological safety of laparoscopic surgery for treatment of rectal cancer remains unproven. The aim of this prospective non‐randomized study was to assess the feasibility and short‐term outcome of laparoscopic total mesorectal excision (LTME) after 25–30 Gy preoperative radiotherapy and to compare the results with a matched‐control group of open TME (OTME).Methodology  A series of 41 patients with primary rectal cancer underwent LTME for rectal cancer and were matched with a historical control group of 41 patients who underwent OTME. Both groups received preoperative short‐term radiotherapy.Results  There was no mortality in the LTME group and 2% mortality in the OTME group. The overall postoperative morbidity was 37% in the LTME group and 51% in the OTME group, including an anastomotic leakage of 9 and 14% in the LTME and OTME groups respectively. A positive circumferential margin was found in 7% of patients in the LTME group and in 12% of the patients in the OTME group.Conclusion  This study shows that LTME is technically feasible and can be performed safely. We show at least a similar surgical completeness using a laparoscopic technique.
SO08 MANAGEMENT OF COMPLEX LARGE VOLUME GROIN TUMOURS WITH RECTUS ABDOMINUS MYOCUTANEOUS FLAPS – A CASE SERIES
Authors: Cranshaw I. M. , Fischer P. , Stainio J. , Thomas J. M. 
Published: April 2007

Purpose  Resection of large volume soft tissue tumours and metastatic disease in the groin commonly involves extensive resection of abdominal wall and overlying skin to achieve adequately wide surgical margins. There are many reconstructive techniques available often requiring specialised plastic surgical input. We have routinely used vertical rectus abdominus myocutaneous flaps (VRAM) to reconstruct these defects and our impression was that these simple flaps provided good cover with few complications.Methodology  A search of our operative database between 1999 and 2005 to identify large volume groin tumours which had been immediately reconstructed with a VRAM. We recorded information on patient demographics, tumour characteristics, reconstruction type, postoperative complications, follow‐up and survival data.Results  18 patients fulfilled our criteria and were included in the study. Tumour pathology was sarcoma 11 (61%), melanoma 4 (22%) and squamous cell carcinoma 3 (17%). Only 6 cases were potientially curative resections for primary tumours with, 5 palliative procedures for recurrent sarcoma and 7 for metastatic. Patients with palliative resections did poorly with and average survival of 17 months (range 6–36 months) but complications were uncommon with partial flap necrosis requiring split skin grafting in one case only. Curative resections had no local recurrences and one death from disease at 44 months.Conclusion  VRAM reconstruction following resection of large volume groin tumours was very successful in our series providing excellent cover in the groin with few complications. The technique is useful in achieving robust surgical palliation and appears equally effective for potentially curative cases.
SO09 PERCUTANEOUS RADIOFREQUENCY ABLATION OF LUNG TUMOURS: RESULTS IN FIRST 100 CONSECUTIVE PATIENTS
Authors: Zhu J. C. , Yan T. D. , Ng K. , King J. , Glenn D. , Morris D. L. 
Published: April 2007

Purpose  The study reported our experience with first 100 consecutive patients who underwent radiofrequency ablation (RFA) of their unresectable malignant lung tumours.Methodology  From Nov 2000 to Dec 2006, the clinical and treatment‐related information regarding the 100 consecutive patients (58 males, mean age of 65 years) with 240 lung tumours treated by RFA were collected prospectively and reviewed retrospectively. RFA was performed under CT guidance with local anaesthetics and conscious sedation. The patients were followed up with chest CT at regular intervals.Results  Five patients had primary lung carcinoma while the remaining patients had pulmonary metastases from extra‐thoracic malignancies, with colorectal cancer being the most common primary site (70%). The mean number of pulmonary lesions ablated was 2.4 per patient; the mean size of lesion was 2.2 cm in diameter. Nineteen patients had repeat RFA for recurrent or residual pulmonary disease. There was no post‐procedural mortality and the overall morbidity rate was 42%. The most common complication was pneumothorax, which occurred in of 31% of procedures (n = 39/127) with only 20 (16%) requiring chest tube placement. After a median follow‐up of 24 months (range 1 to 70 months), 72% of RFA treated lesions did not progress. The overall median disease‐free interval was 13 months, with 1‐, 3‐ and 5‐year disease‐free survival of 55%, 22% and 7% respectively. The overall median survival was 34 months with 1‐, 3‐ and 5‐year‐survival of 85%, 49% and 33% respectively.Conclusion  Percutaneous RFA is an emerging therapy with promising results when surgical resection of pulmonary malignancy cannot be performed.
TN10 MOVING FROM TISSUE TRANSPLANTATION TO TISSUE ENGINEERING – IMMUNOLOGIC SURVEY OF A PROSPECTIVE SCAFFOLD
Authors: Varkey A. , Huang L. H. , Shieh S. J. 
Published: April 2007

Purpose  To highlight the design process for tissue engineered mucosa and evaluate the results of an in – vivo immunologic survey done in an animal model.Methods  21 Sprague Dawley rats were divided into three groups to study the systemic immune response to our developed biomaterial, with two other materials used for comparison. Serial subcutaneous implantation was done to serve as antigenic booster .The animals were sacrificed after a 31 day period and their spleens were harvested, digested to make single cell suspensions and used flow cytometry to quantitate CD4+ and CD8+ cells. The CD8+ cells counts are a reflection of the immuno‐toxicity of the material.Results  CD 4+ and CD8+ counts were expressed as a percentage of total cells. The mean and standard deviation of CD8+ counts of our potential scaffold material was 19.782 ± 4.021 as compared to Duragen which was 21.574 ± 3.837 and the group with porcine skin 19.598 ± 3.678.Conclusions  Striving towards the goal of creating a bioengineered mucosa requires an optimal scaffold with proven immunologic safety. We have attempted to study the systemic immunologic response by comparing our biomaterial with existing materials that are already in clinical use. Though absolute values of CD8+ are comparable and within the same range, larger trials will be needed to establish significant benefits of one over the other.