bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sequential systemic platelet-activating factor and interleukin 8 primes neutrophils in patients with trauma at risk of multiple organ failure
Authors: Botha A J , Moore F A , Moore E E , Peterson V M , Silliman C C , Goode A W 
Published: March 2007

Abstract
Plasma from 33 patients at risk of multiple organ failure (MOF) after major trauma was tested for a priming effect on neutrophils, and for the presence of platelet-activating factor (PAF) activity and interleukin (IL) 8. Plasma sampled at 3, 6, 12 and 24 h after injury significantly primed normal neutrophils to release mean(s.e.m.) 1·26(0·19), 1·33(0·26), 1·04(0·14) and 0·86(0·13) nmol superoxide per min per 1·3 × 106 neutrophils respectively (P&lt;0·05). Priming at 3 h after injury was inhibited by mean(s.e.m.) 63·8(7·0) per cent by the PAF antagonist, WEB 2170 (P&lt;0·01). Mean(s.e.m.) plasma IL-8 was raised at 6 and 12 h after injury to 785(183) and 836(175) pg/ml (P&lt;0·01). At 12 h after injury the plasma IL-8 level correlated directly with the number of units of red blood cells transfused (r=0·64, P&lt;0·01), and was significantly higher in the group of six patients who developed MOF (P&lt;0·05). These data suggest that after trauma the mediators PAF and IL-8 appear sequentially in the circulation, are potential mechanisms of circulating neutrophil priming, and that IL-8 may also be an early biochemical marker predicting the onset of MOF.
Use of covered expandable metal stents in the treatment of oesophageal carcinoma and tracheo-oesophageal fistula
Authors: Cook T A , Dehn T C B 
Published: March 2007

Abstract
Palliation for malignant dysphagia has relied on oesophageal dilatation, insertion of rigid prostheses and laser treatment. All three methods have substantial risk of perforation. Displacement of the tube is also well described. Seventeen expandable polyethylene-covered metal stents were inserted in 15 patients with oesophageal carcinoma; there were 11 men and four women, of median age 70 years. Thirteen stents were inserted for dysphagia and four for tracheo-oesophageal fistula (TOF). Stents were inserted endoscopically under fluorosopic control. Seven patients died from their disease a median of 5 (range 1–11) months after stent insertion. Median follow-up in the remainder is 6 (range 1–11) months. Median dysphagia scores before and after insertion were 3 (range 2–4) and 1 (range 1–2) respectively. Stent insertion provided cure of symptoms in patients with TOF. Median hospital stay following insertion was 2 (range 1–20) nights. There were no deaths and no perforations associated with the procedure. Two patients complained of retrosternal chest pain for 2 days after stent insertion. One patient presented with dysphagia related to later stent migration. There has been no deterioration in symptoms of dysphagia in the remainder. Expandable oesophageal stents offer a safe alternative to traditional methods of palliative treatment for oesophageal carcinoma. In the long term they may provide a cost-effective alternative to standard treatments.
Port-site metastases in patients undergoing laparoscopy for gastrointestinal malignancy
Authors: Cook T A , Dehn T C B 
Published: March 2007

Abstract
Laparoscopic colonic resection and laparoscopy for the assessment of malignant disease have been advocated. Metastatic deposits at port sites are recognized but the incidence of these is poorly defined. Forty-six patients, of median age 65 (range 19–90) years, with gastrointestinal malignancy underwent laparoscopy. Eighteen patients died a median of 4 (range 1–28) months after laparoscopy, four following colonic resection and 14 with gastro-oesophageal malignancy; ten had undergone resection. Median follow-up of the 28 survivors is 8 (range 2–39) months. Five of the 46 patients developed port-site recurrence giving an early incidence of port-site recurrence in this cohort of patients of 11 per cent. Five of 20 patients with tumour involving serosal surfaces developed port-site recurrence compared with none of 26 without serosal involvement (P = 0·022, Fisher's exact test). Port-site recurrence may be related to serosal involvement with tumour.
Radical lymphadenectomy in the management of early gastric cancer
Authors: Hayes N , Karat D , Scott D J , Raimes S A , Griffin S M 
Published: March 2007

Abstract
Lymph node metastasis in patients with early gastric cancer was evaluated prospectively to determine whether radical (D2) lymphadenectomy is appropriate in such cases. Twenty-eight (18 per cent) of 156 patients having surgery for gastric cancer had early disease. Lymph node metastasis was found in 12 of the 28 patients. Metastasis was more likely in submucosal than mucosal early gastric cancer (nine of 14 versus three of 14; P = 0·024, Fisher's exact test). In two of three patients with metastasis at the N2 level, the N1 nodes were entirely clear. This study shows a higher incidence of lymph node metastasis than has been reported previously in both the UK and Japan. The high incidence of lymph node metastasis in early gastric cancer supports the continuing use of radical lymphadenectomy in patients who are fit for such major surgery.
Accuracy of laparoscopic ultrasonography in the staging of upper gastrointestinal malignancy
Authors: Anderson D N , Campbell S , Park K G M 
Published: March 2007

Abstract
Laparoscopic ultrasonographic staging was compared prospectively with conventional computed tomography (CT) and ultrasonographic staging of 24 lower-third oesophageal tumours and 20 gastric malignancies. Following laparoscopic ultrasonography, seven patients regarded as being resectable after conventional imaging were excluded from surgical exploration because of ascites with peritoneal deposits (four patients), liver metastases (one), advanced local disease (one) and poor tolerance of general anaesthesia (one). Preoperative T and N stages were compared with the pathological staging following resection in 34 patients. Laparoscopic ultrasonography was significantly more accurate than conventional CT and ultrasonography in assessment of the primary tumour (91 versus 64 per cent, P&lt; 0·01) and nodal status (91 versus 62 per cent, P&lt;0·05). The addition of laparoscopic ultrasonography to conventional procedures for staging upper gastrointestinal malignancy improved the overall accuracy of staging. Although this may have future implications for the selection of patients for multimodality treatment, management decisions are currently based on laparoscopic findings, which in this study resulted in a resection rate of 97 per cent.
Proximal pancreatoduodenectomy for chronic pancreatitis
Authors: Stapleton G N , Williamson R C N 
Published: March 2007

Abstract
A personal series is reported of 52 patients who underwent proximal pancreatoduodenectomy for severe chronic pancreatitis between 1979 and 1994. There were 13 women and 39 men of median age 42·2 (range 12–70) years. Disease predominantly affected the head of pancreas, with calcification present in 37 patients. Indications for operation were chronic pain (47 patients), obstructive jaundice (19) and duodenal stenosis (six); cancer was suspected in 12. In addition, 14 patients had a pseudocyst, two pancreatic endocrine failure and 20 exocrine failure. Aetiology was chronic alcohol abuse in 34, recurrent acute pancreatitis in five and unknown in 13. Pylorus-preserving proximal pancreatoduodenectomy was performed in 45 patients, while the remaining seven had partial gastrectomy. Drainage of a dilated distal pancreatic duct by side-to-side pancreaticojejunal anastomosis was included in 15 patients. Mean operating time was 6·2 (range 4·5–9·5) h and mean blood loss was 2·7 (range 0·2–13·0) litres. There were no hospital deaths, but three patients required a second operation and five had percutaneous drainage of infected collections. During a median follow-up of 54 months, six patients required completion distal pancreatectomy for renewed pain and four others had persistent pain. Four patients required intervention for stricture at the biliary-enteric anastomosis. Ten patients have died from causes not directly related to chronic pancreatitis. Proximal pancreatoduodenectomy is a relatively safe procedure, effectively palliating pain in 80 per cent of patients with chronic pancreatitis.
Brush cytology for the diagnosis of rectal carcinoma
Authors: Farouk R , Edwards J , Thorne M , Young W , MacDonald A W , Monson J R T , Lee P W R 
Published: March 2007

Abstract
The use of brush cytology as an aid in the preoperative diagnosis of rectal cancer was prospectively assessed at 328 examinations in 289 consecutive patients with rectal lesions suspicious of carcinoma. Forty-five patients were reported as having benign polyps. There was 97 per cent agreement between conventional biopsy and cytology brushings for this group. Some 249 patients underwent a subsequent resection allowing comparison with formal histology. Forceps biopsy produced a true-positive diagnosis of cancer in 218 patients (89·7 per cent) and cytology in 222 (91 per cent). The sensitivity for forceps biopsy and cytology was 81 and 83 per cent respectively, with a combined sensitivity of 98 per cent. It is concluded that the addition of cytology to forceps biopsy increases the diagnostic yield in a single examination, and may be a complementary method of establishing the diagnosis of rectal lesions.
Effect of different infusion regimens on colonic motility and efficacy of colostomy irrigation
Authors: Gattuso J M , Kamm M A , Myers C , Saunders B , Roy A 
Published: March 2007

Abstract
The colonic motility response and short-term clinical effectiveness of colonic irrigation was studied in five patients with an end-colostomy, each of whom was studied on up to six occasions, using volumes of 500 and 1500 ml water infused under gravity and over a period of 2·5 and 5 min with a pump. The median baseline colonic luminal pressure was 14 cmH2O and rose to 42 cmH2O with a 500-ml infusion, and to 74 cmH2O with a 1500-ml infusion. Irrigation induced high-pressure (over 200 cmH2O) propagated waves which caused the efflux of colonic contents. These were more numerous after a 1500- than a 500-ml infusion (median 4·5 versus 2·0 respectively). There was no difference between the two volumes infused in the incidence of colostomy breakthrough before subsequent irrigation. Colostomy irrigation with 500–1500 ml water appears to produce intracolonic pressure rises that are safe. These volumes can be infused rapidly under gravity alone.
Strengths and weaknesses of laparoscopic and open mesh inguinal hernia repair: A randomized controlled experimental study
Authors: Morgan L F , Shelton J C , O'Riordan D C , Moore D P , Winslet M C , Davidson B R 
Published: March 2007

Abstract
There are no objective data available on the relative strengths of inguinal hernia repairs. The aim of this randomized controlled study was to measure the force required to disrupt laparoscopic and open mesh repairs in a porcine model. Eleven pigs had inguinal hernia repair following randomization to an open mesh group (n = 5) or a transabdominal preperitoneal laparoscopic group (n = 6). Four weeks after operation the pigs were killed and the pelvic girdles were mounted in a test jig on a mechanical testing machine. The applied disruption forces were measured and recorded. Mean(s.d.) force required to disrupt the normal inguinal canal (n = 11) was 68·6(30·1) N with no difference between groups. The open mesh repair required 110·3(41·4) N and the laparoscopic mesh 220·0(95·2) N. Both open and laparoscopic mesh repairs were stronger than the normal side (P&lt;0·03). The laparoscopic mesh repair was stronger than the open mesh repair (P = 0·04). This model provides a standardized method for mechanically testing inguinal hernia repairs in pigs. It confirms that both open and laparoscopic mesh hernia repairs are stronger than the non-herniated normal side at 4 weeks after operation. Laparoscopic mesh repair is stronger than open mesh repair. The weakest points of the repairs correlate well with those identified in clinical reports.
Effects of vertical-banded gastroplasty on bone and mineral metabolism in obese patients
Authors: Cundy T , Evans M C , Kay R G , Dowman M , Wattie D , Reid I R 
Published: March 2007

Abstract
The surgical treatment of obesity can have adverse effects on bone, but there are few published data on the effects of vertical-banded gastroplasty. Serial measurements of bone mineral density at the lumbar spine and three upper femoral sites, using dual-energy X-ray absorptiometry, and also of biochemical indices of bone and mineral metabolism at intervals up to 2 years after operation were performed in 18 patients with morbid obesity who had vertical-banded gastroplasty. Bone mineral density measurements were also made in age- and sex-matched non-obese controls. Bone density before operation was significantly greater in the obese than in the controls (P&lt;0·02 at all sites). The obese patients lost weight rapidly after vertical-banded gastroplasty (mean weight loss 29 kg at 1 year, P&lt; 0·001). This was accompanied by a measurable loss of bone density from the trochanter and Ward's triangle sites in the upper femur (P&lt;0·05), but not from the lumbar spine. Bone density values remained stable over 14 months in the controls. Hydroxyproline excretion increased significantly (P&lt; 0·005), indicating an increase in bone resorption. Alkaline phosphatase levels decreased significantly (P&lt; 0·001), but this probably represents the reversal of hepatic steatosis. There was no evidence of hyperparathyroidism or vitamin D deficiency. In conclusion, vertical-banded gastroplasty causes modest bone density loss from femoral sites, but not the lumbar spine. The difficulties of assessing bone density changes in the obese are discussed.
Desmoids in familial adenomatous polyposis
Authors: Clark S K , Phillips R K S 
Published: March 2007

Abstract
Clinical desmoid disease affects approximately 10 per cent of patients with familial adenomatous polyposis (FAP); the subclinical rate is unknown. Desmoids are probably neoplastic rather than regenerative in origin and may arise in association with germline or somatic mutations at or beyond codon 1444 of the APC gene. Intra-abdominal desmoids behave unpredictably but are an important cause of death in those with FAP. Signal intensity on magnetic resonance imaging reflects tumour cellularity, which in part determines progression, and this may help management. Surgical treatment of advanced desmoids is hazardous, but medical treatments have limited success. Chemotherapy with doxorubicin and dacarbazine is currently under evaluation.
Encapsulation of Hemoglobin in Mesoporous Silica (FSM)—Enhanced Thermal Stability and Resistance to Denaturants
Authors: Urabe Yoko , Shiomi Toru , Itoh Tetsuji , Kawai Akiko , Tsunoda Tatsuo , Mizukami Fujio , Sakaguchi Kengo 
Published: March 2007

AbstractHemoblogin (Hb), which is a typical oligomeric protein, was introduced into the pores of mesoporous silica (FSM: folded‐sheet mesoporous material) that had a diameter of 7.5 nm. Soret CD spectra of Hb–FSM‐7.5 conjugates showed a peak that was identical to that of free Hb. This suggests that Hb retained its highly ordered structure in the mesoporous silica. In addition, the UV‐visible absorption spectrum showed that Hb had an increased resistance to heat denaturation in the silica. Even after heat treatment at 85 °C, Hb–FSM‐7.5 retained its ligand‐binding activity. The stability of Hb–FSM‐7.5 was examined further by measuring its peroxidase‐like activity. Encapsulation of Hb resulted in the retention of activity in the presence of high NaCl or Gdn‐HCl levels. This suggests that encapsulation prevented dissociation and denaturing. Thus, it seems that the mesopores created a favorable environment for the oligomeric protein to perform its function, even under harsh conditions.
Cardiac catheterization experience in hospitals without cardiovascular surgery programs
Authors: Hansing Charles E. , Hammermeister Karl , Prindle Kirk , Twiss Richard , Schwindt R. Richard , Gowing Burton , Crecelaius Lyle , Robinson Wendell 
Published: March 2007

AbstractIn order to study the cardiac catheterization experience in hospitals without cardiovascular surgery programs, data was collected from all 8 Washington „satellite”︁ laboratories over a 5‐year period. There were 5 deaths (0.13%) during the 3878 coronary arteriography procedures. Of the 5,4 had severe left main coronary artery lesions. Of these patients, 2 died during the 24‐hour follow‐up period after an uncomplicated study. This mortality rate is remarkably good considering that the 5‐year period includes the early experience of 7 laboratories. There were 7 myocardial infarctions (0.18%) and 6 strokes (0.15%).The average number of coronary arteriograms done per angiographer during 1976 was 65.The experience of the Washington State „satellite”︁ cardiac catheterization laboratories proves that the immediate availability of cardiovascular surgery and large case loads per angiographer are not necessary in order to safely perform cardiac catheterization and coronary arteriographic studies. Additional studies should be undertaken to determine the appropriate distribution of cardiac diagnostic facilities.
Hypertrophic cardiomyopathy with midventricular obstruction associated with mitral stenosis: Partial relief of the obstruction by papillary muscle and trabecular resection
Authors: Falicov Raul E. , Karunaratne H. B. , Cahill Noel , Lamberti John J. 
Published: March 2007

AbstractA patient is reported with hypertrophic cardiomyopathy where midventricular obstruction was found in association with mitral stenosis. Partial relief of the intraventricular obstruction was obtained by extensive papillary and trabecular muscle resection in the mid‐left ventricular area, in conjunction with mitral valve replacement with a porcine heterograft.
Clinical and angiographic implications of a depressed echocardiographic ejection fraction in coronary artery disease
Authors: Wharton Thomas P. , Cohn Peter F. , Sloss Laurence J. , Angoff Gerald H. 
Published: March 2007

AbstractTo evaluate the clinical and angiographic implications of a depressed echocardiographic ejection fraction (EF) in coronary artery disease, 45 patients with an echocardiographic EF < 0.50 were studied with complete cardiac catheterizations. Most of the patients had clinical evidence of a prior myocardial infarction, cardiomegaly, and/or congestive heart failure. All had coronary arteriographic evidence of multivessel disease and either reduced cardiac output, elevated left ventricular end‐diastolic pressure, or both. Reduction in percentage of echocardiographic dimensional shortening closely paralleled reduction in echocardiographic EF. Forty of the 45 patients (89%) had an angiographic EF less than 0.50. There was considerable scatter of angiographic EF's with echocardiographic EF's between 0.40 and 0.50, limiting the usefulness of these latter values. However, 23 of the 24 patients (96%) with an echocardiographic EF less than 0.40 had an angiographic EF less than 0.40, and there was a linear relationship between these echocardiographic and angiographic values with a correlation coefficient (r) = 0.54 (SEE = ±0.15, p<0.05). All of the 12 patients with both reduced septal and reduced posterior wall excursion on the echocardiogram had both abnormal echocardiographic and angiographic ejection fractions, and 10 of the 12 had EF < 0.40 by both techniques. Our study suggests that coronary artery disease patients with extensive left ventricular dysfunction can be identified noninvasively, and the echocardiographic EF may be useful in deciding whether such patients may require special cardiac catheterization procedures to evaluate contractile reserve if cardiac surgery is being considered.
Mechanism of electrical alternans in patients with pericardial effusion
Authors: Rinkenberger Robert L. , Polumbo Ralph A. , Bolton Merle R. , Dunn Marvin 
Published: March 2007

AbstractElectrical alternans concomitant with pericardial effusion has been considered a pathognomonic sign suggestive of a large effusion with cardiac tamponade, particularly if there is P wave alternans as well as QRS alternans. However, the mechanism of this phenomenon remains controversial. A patient with pericardial effusion secondary to adenocarcinoma of the lung with metastases, pericardial effusion, electrical alternans, and cardiac tamponade was studied by echocardiography, right and left heart catheterization, and pericardiocentesis. Hemodynamic data were consistent with cardiac tamponade. The echocardiogram demonstrated a large anterior and posterior pericardial effusion. Noncongruous motion of the septum and posterior wall was recorded at a rate equal to the heart rate. In addition, congruous motion of the septum and posterior wall was recorded at a rate that was half the heart rate and corresponded to the electrical alternans. The congruous movement disappeared after pericardiocentesis, as did the electrical alternans. The electrical alternans is synchronous with and due to the pendulous movement of the heart within the pericardial sac, as demonstrated by echocardiogram and cineangiograms.
Relief of coronary artery spasm by nitroglycerin: Time‐dependent variability in drug action
Authors: Fallen Ernest L. , Cairns John A. , Stolberg Harold O. , Tanser Paul H. 
Published: March 2007

AbstractThe arteriographic distinction between a fixed atheromatous obstruction and localized vasospasm in the coronary artery is often decided by the response of the lesion to nitroglycerin. We studied the time course of nitroglycerin in four patients with coronary artery spasm as revealed by selective angiography. Following complete dissolution of a 0.6 mg tablet of nitroglycerin sublingually, a slight increase in heart rate occurred as early as two minutes, variable changes in overall vessel diameter were observed within four minutes, but the localized spasm remained fixed. It was not until six minutes had elasped that reinjection showed disappearance of spasm and uniform patency of the vessel in all cases. These observations stress the importance of waiting an appropriate period of time (at least six minutes) following complete absorption of sublingual nitroglycerin before any conclusion can be rationally drawn regarding the nature of a stenotic lesion as seen angiographically.