bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parathyroid autotransplantation
Authors: Senapati A , Young A E 
Published: March 2007

Abstract
This paper reviews the technique, indications and results of parathyroid autotransplantation. Autotransplantation is most commonly indicated following parathyroidectomy for renal osteodystrophy, but can also be used in primary hyperplastic hyperparathyroidism, re-exploration of the neck and radical neck surgery. The success of the technique ranges from 75 to 100 per cent.
Fine needle aspiration biopsy in the diagnosis and management of fibroadenoma of the breast
Authors: Walters T K , Zuckerman J , Nisbet-Smith A , Hudson E , Chia Y , Burke M 
Published: March 2007

Abstract
Cytological and histological biopsies were obtained on 75 breast lumps clinically diagnosed as flbroadenomas. Of these, 95 per cent of lesions were benign. In 51 (68 per cent) confirmed as flbroadenomas histologically, cytology was benign in 78 per cent, but inadequate for diagnosis in 16 per cent. The remaining 24 lesions included three breast cancers and one lymph node with Hodgkin's disease. In this group cytology was inadequate for diagnosis in 54 per cent, including one breast cancer. No lesion with benign cytology was subsequently shown to be malignant. The study supports the view that clinical diagnosis and cytology are accurate in the diagnosis of benign breast disease of this type. Breast cancer may rarely present with the clinical features of a flbroadenoma and too few lesions have been studied to assess fully the performance of cytological biopsy in detecting these small mobile lesions. A non-excisional policy should therefore include prolonged follow-up and repeat biopsy.
Meakin adjuvant regimen in premenopausal patients with breast cancer
Authors: Smith D , Dewar J A , Horobin J M , Scott J S , Preece P E 
Published: March 2007

Abstract
A 10-year experience using ovarian ablation and prednisolone as adjuvant therapy for premenopausal patients with breast carcinoma, emphasizing tolerability and morbidity is reported. Thirty patients (15 aged &lt;45 years, 15 aged ≥ 45 years; range 28–54 years) underwent mastectomy I lumpectomy with axillary clearance (with or without local irradiation) followed by ovarian irradiation and prednisolone therapy (2.5 mg three times daily for 5 years). Patients were reviewed every 3 months for the first 3 years and every 6 months thereafter. Follow-up was between 1.5 and 10 years (median 5 years). Twenty-four patients are still alive. Three patients stopped therapy because of side-effects. There was a mean(s.e.m.) weight gain of 8.46(1.69) per cent on therapy. Nineteen patients have been weaned off prednisolone over a period of 0.5–7.5 months (median 2 months) and the median length of time off steroids is now 3 years (range 0.5–5 years). This regimen appears to be associated with an acceptable level of patient tolerability and a low chronic morbidity rate and should be considered as an alternative to adjuvant systemic cytotoxic therapy.
Association between extent of colonic mucosal sialomucin change and subsequent local recurrence after curative excision of primary colorectal cancer
Authors: Dawson P M , Habib N A , Fane S , Rees H C , Wood C B , Allen-Mersh T G 
Published: March 2007

Abstract
Two interrelated studies were carried out to determine whether extent of sialomucin change adjacent to a primary colorectal carcinoma predicted local tumour invasiveness and risk of local recurrence. In the first, depth of tumour penetration was correlated with the length of the sialomucin band adjacent to 72 primary colorectal cancers. There was a significant (P &lt; 0.05) increase in sialomucin band length adjacent to tumours invading adjacent structures compared with those which had not (Mann-Whitney U test), although there was no overall correlation between depth of penetration, Dukes' classification or degree of differentiation (Kruskal-Wallis test). A sialomucin band of &gt; 3 cm was associated with a 70 per cent probability of adjacent structure (T4) invasion. These observations were then testedprospectively in a second study involving 256 patients to determine whether the presence of a &gt; 3 cm sialomucin band could predict local recurrence. Presence of a &gt; 3 cm sialomucin band was a significant (χ2 = 7.12, d.f. = 1, P &lt; 0.001) and independent predictor of local but not distant recurrence. In addition both the interval to local recurrence and survival were significantly shorter if a &gt; 3 cm sialomucin band was present. However the accuracy of &gt; 3 cm sialomucin band as a predictive test for local recurrence was only 70 per cent. The extent of sialomucin adjacent to a primary colorectal cancer does provide a crude assessment of tumour invasiveness and risk of local recurrence.
Effect of hydrocele on testis and spermatogenesis
Authors: Dandapat M C , Padhi N C , Patra A P 
Published: March 2007

Abstract
One hundred and twenty cases of big unilateral hydrocele of the tunica vaginalis testis have been studied to ascertain the effect on the structure and function of the testis, taking the normal side as control. There was no pressure effect from the hydrocele on the structure of the testis in 70 per cent, a flattening of testis in 22 per cent, and atrophy of testis in 8 per cent of cases. There was partial arrest of spermatogenesis in JO per cent and total arrest of spermatogenesis in 8 per cent of cases. The remaining 82 per cent showed normal spermatogenesis.
Thallous chloride uptake and DNA profile in parathyroid adenomas
Authors: Carlson G L , Farndon J R , Shenton B K , Clayton C B , Johnston I D A 
Published: March 2007

Abstract
Thallium isotope scintigraphy is used to localize parathyroid adenomas but the mechanism underlying the technique is poorly understood. While larger adenomas are reliably localized the results are less certain for small tumours. This study explores the relationship between cellular DNA profile and thallium uptake (localization accuracy) in 24 parathyroid adenomas. The DNA profile was assessed using flow cytometry and standard subtraction thallium scintigraphy was performed before surgery. Fifteen of the 24 adenomas demonstrated excessive mitotic activity and 13 of these glands were accurately localized. Of the remaining nine glands, only five were localized accurately (P &lt; 0.01, χ2 test including Yates' correction). This difference in thallium uptake could not be accounted for on the basis of gland weight. Thallium localization of parathyroid adenomas is related to mitotic activity. This may explain some of the limitations of this technique.
Duodenogastric reflux and gastric histology after cholecystectomy with or without sphincteroplasty
Authors: Lorusso D , Pezzolla F , Montesani C , Giorgio P , Caruso M L , Cavallini A , Guerra V , Misciagna G 
Published: March 2007

Abstract
Sixteen patients who had undergone cholecystectomy plus sphincteroplasty, 14 cholecystectomized patients and ten control patients were studied to evaluate whether differences existed in duodenogastric reflux and whether these were related to morphological damage of the gastric mucosa. Duodenogastric bile reflux during fasting was evaluated by measuring the concentration of total bile acids (by an enzymatic method) and single bile acids in the gastric juice by high performance liquid chromatography. The damage was evaluated histologically by systematic endoscopic biopsy of the antrum and body of the stomach. There was a statistically significant difference in fasting bile reflux between the three groups (Kruskal-Wallis test, P &lt; 0.001), and the group that underwent cholecystectomy plus sphincteroplasty had a significantly higher median value than the cholecystectomized group (P &lt; 0.05) and the control group (P &lt; 0.01). The distribution of chronic antral atrophic and superficial gastritis was different in the three groups (χ2 test, P &lt; 0.005). Chronic atrophic gastritis was associated with cholecystectomy plus sphincteroplasty (P &lt; 0.01), while chronic superficial gastritis was more frequent in cholecystectomized patients. These results suggest that there may be more duodenogastric reflux after cholecystectomy plus sphincteroplasty than after cholecystectomy alone, and that there may be a correlation between the amount of duodenogastric reflux and the severity of mucosal damage.
Stercoral perforation of the colon
Authors: Serpell J W , Nicholls R J 
Published: March 2007

AbstractStercoral perforation of the colon is rare. The 64 reported cases are reviewed to define the syndrome of Stercoral perforation, and to facilitate accurate diagnosis and treatment. Features of localized or generalized peritonitis were universal; however, only 11 per cent were correctly diagnosed before operation. Recognition that the disease involves a segment of colon rather than only the focal point of perforation is essential to adequate surgical treatment. It is postulated that this is the reason for the higher postoperative mortality following closure of the perforation and proximal colostomy (57 per cent) or exteriorization alone (43 per cent), compared with resection of the diseased segment and exteriorization (32 per cent). Resection and exteriorization is therefore the treatment of choice is most situations.
Surgical strategy for early gastric cancer
Authors: Hioki K , Nakane Y , Yamamoto M 
Published: March 2007

Abstract
The diagnostic and therapeutic options in early gastric cancer are reviewed. In Japan, the rate of detection of early gastric cancers has increased so that minute gastric cancers can now be identified as a result of advances in diagnostic methods. The results of histopathological staging of a large number of resected specimens have led to three surgical options based on size and depth of the primary lesion, namely classical R2 resection, radical resection with limited lymphadenectomy and endoscopic surgery.
Adrenal insufficiency in the cancer patient: Implications for the surgeon
Authors: Ihde J K , Turnbull A D M , Bajorunas D R 
Published: March 2007

Abstract
Aspects of acute and chronic adrenal insufficiency of interest to surgeons who treat cancer patients are reviewed. Clinical features and the management of both primary and secondary types are considered with reference to classification, aetiology, diagnosis and treatment. Specifically considered are the management of patients with Addison's disease and metastases. Prompt recognition and treatment of adrenal insufficiency can avert potentially life-threatening situations.
Disordered colorectal motility in intractable constipation following hysterectomy
Authors: Smith A N , Varma J S , Binnie N R , Papachrysostomou M 
Published: March 2007

Abstract
Colorectal and anal sphincter motility and electrophysiology were investigated in 14 women with profound constipation following hysterectomy and compared with an asymptomatic group of control subjects. Twelve patients complained of significant urinary symptoms. No differences in the motor function of the anal sphincters were detectable. The latency of the pudendoanal reflex was unchanged after hysterectomy. Proctometrograms demonstrated significantly increased rectal volumes and compliance in the hysterectomy group together with deficits of rectal sensory function. In the basal state a significant proximal-to-distal sigmoid colon motility gradient existed only in the control group. Following stimulation with Prostigmin®, this gradient was enhanced in the control group but paradoxically reversed in the hysterectomized patients, thus constituting a functional obstruction. Denervation supersensitivity was demonstrable in two patients tested with carbachol provocation but not in control subjects. These findings suggest dysfunction in the autonomic innervation of the hindgut in some patients who had undergone hysterectomy, resulting in severe constipation.
Intersecting staple lines and blood flow in oesophagojejunal anastomoses
Authors: Zilling T L , Walther B S , Ranstam J 
Published: March 2007

Abstract
Total gastrectomy and oesophagojejunostomy with linear stapling devices were performed on 22 pigs to evaluate whether intersecting staple lines reduce the blood flow with an increased risk of anastomotic leakage. The blood flow at intersecting staple lines and single row staple lines of the anastomosis was studied with the reference organ method 24 h after the first operation. The mean blood flow in intersecting staple lines was 0·305 ml min −1 g −1tissue and 0·307 ml min −1 g −1 tissue for single row staple lines. The confidence interval for the reduction in blood flow for intersecting staple lines compared with non-crossing staple lines was from −16 to +17 per cent. In one animal the reduction in blood flow was 37 per cent; in all other animals there was no reduction in blood flow or a reduction less than 25 per cent. An equivalence test shows that if a reduction in blood flow exists it is most likely to be less than 30per cent (P &lt; 0·001). Our data confirm that intersecting staple lines in oesophagojejunal anastomoses do not reduce mean anastomotic blood flow to a dangerous level.
Surgical results of intrathoracic gastric volvulus complicating hiatal hernia
Authors: Haas O , Rat P , Christophe M , Friedman S , Favre J P 
Published: March 2007

Abstract
From 1981 to 1988, 138 patients with hiatal hernia were treated surgically at our centre. Twenty-one (mean age 76.6 years, 17 women, four men) had an associated intrathoracic gastric volvulus. Eleven patients (mean age 73.2 years), of whom eight were asymptomatic, had an elective procedure. Ten patients (mean age 80.3 years) had emergency surgery, six for acute complications of the volvulus (five cases of strangulation and one of perforated ulcer) and four because of other, unrelated causes of acute abdomen. There were four deaths after operation, all in the emergency surgery group. Four other patients had significant morbidity, all in the emergency group. In the elective cases, all hernias were easily reduced. In one emergency case a gastrotomy was necessary for decompression, and in another gastrectomy was necessary because of gastric gangrene. Our results indicate the need for elective intervention when intrathoracic gastric volvulus is first diagnosed.
Early tracheostomy for primary airway management in the surgical critical care setting
Authors: Rodriguez Jorge L , Steinberg Steven M , Luchetti Frederick A , Gibbons Kevin J , Taheri Paul A , Flint Lewis M 
Published: March 2007

Abstract
During a 12-month period, 264 patients with multiple injuries who required mechanical ventilation were admitted to the surgical intensive care unit. One hundred twenty patients (46%) were disengaged from the ventilator, and 38 patients (14%) died. Of the remaining 106 patients (40%) 51 patients (group I) were to receive tracheostomy within 1 to 7 days, and 55 patients (group II) underwent late (8 or more days after admission) tracheostomy. Multiple variables in four categories (admission, operative, ventilatory, and outcome) were analyzed prospectively to define the impact that early tracheostomy had on duration of mechanical ventilation, intensive care stay, and hospital stay. Morbidity and mortality rates of the procedures were assessed. Early tracheostomy, in a homogeneous group of critically ill patients, is associated with a significant decrease in duration of mechanical ventilation, as well as shorter intensive care unit and hospital stays, compared with translaryngeal endotracheal intubation. There were no deaths attributable to tracheostomy, and overall morbidity of the procedures was 4%. We conclude that early tracheostomy has an overall risk equivalent to that of endotracheal intubation. Furthermore, early tracheostomy shortens days on the ventilator and intensive care unit and hospital days and should be considered for patients in the intensive care unit at risk for more than 7 days of intubation. (Surgery 1990;108:655–9.)
Proximal gastric vagotomy: Follow-up at 10–20 years
Authors: Johnston G W , Spencer E F A , Wilkinson A J , Kennedy T L 
Published: March 2007

Abstract
From August 1969 to December 1989, 600 patients had elective proximal gastric vagotomy for duodenal ulceration with an operative mortality of 0·2 per cent. Of these, 372 patients had surgery over 10 years ago. Three hundred and forty-two patients survived for more than 10 years and, in a prospective study, 305 were reviewed, forming the basis of this 10–20-year follow-up report. Forty-six (15 per cent) have had recurrent ulceration; 80 per cent of these developed symptoms within 5 years and no patient has had recurrence after 13 years. Although 29 patients required reoperation for recurrent ulceration, the current patient satisfaction rate for Visick grades I and II is 92 per cent. Only two patients required reoperation because of gastric stasis. It is concluded that proximal gastric vagotomy is a safe and satisfactory first choice operation for duodenal ulceration.
Gastric adaptive relaxation and symptoms after vagotomy
Authors: Hartley M N , Mackie C R 
Published: March 2007

Abstract
Gastric adaptive relaxation is reported to be impaired after vagotomy. This abnormality has been implicated in the pathogenesis of postvagotomy symptoms, but no association has previously been demonstrated between the two. Gastric adaptive relaxation was measured in 15 healthy volunteers and 33 patients more than 1 year after highly selective vagotomy or truncal vagotomy and drainage. Seventeen patients were asymptomatic. The remainder were symptomatic including seven patients with persistent diarrhoea. Fasted subjects were intubated with a Ryle's tube containing a pressure microtransducer within a flaccid (800 ml) plastic bag. Gastric corpus-fundus pressure was recorded during distension of the bag with air (15 ml/s) over 30 s. Pressure indices were derived from the areas under the pressure curves. Median (range) pressure indices were: healthy volunteers 12·7 (7·5–17·1) cmH2O, highly selective vagotomy 14·0 (9·8–15·9) cmH2O (n.s.), truncal vagotomy and drainage 14·5 (8·6–26·8) cmH2O (P = 0·04). All patients with diarrhoea had abnormally high pressure indices (P &lt; 0·001). Pressure indices in all other patient groups were within the normal range. We conclude that gastric adaptive relaxation remains abnormal in patients with postvagotomy diarrhoea but not in those who are asymptomatic or who have other symptoms.
Peptic ulcer surgery during the H2-receptor antagonist era: A population-based epidemiological study of ulcer surgery in Helsinki from 1972 to 1987
Authors: Paimela H , Tuompo P K , Peräkylä T , Saario I , Höckerstedt K , Kivilaakso E 
Published: March 2007

Abstract
To evaluate the effects of improvements in medical therapy on the incidence of, indications for and operative methods used in peptic ulcer surgery, all cases of primary peptic ulcer surgery among adults in the city of Helsinki in the years 1972, 1977, 1982 and 1987 were analysed. There was a total of 565 such cases in a population which consisted of 5·2 × 105 individuals in 1972 and 4·8 × 105 individuals in 1987. The introduction of H2-receptor antagonists in 1979 was associated with a fall in the annual incidence of elective duodenal ulcer operations, from 15·5 to 6·7 per 105 individuals, and a fall in the annual incidence of elective gastric ulcer operations, from 9·4 to 3·1 per 105 individuals (P &lt; 0·05). The decrease was greatest among males with duodenal ulcer. In contrast, the annual incidence of emergency surgery for ulcer haemorrhage and perforation (all types of ulcers) remained relatively stable, varying from 7·2 to 10·2 per 105 inhabitants over the observation period (n.s.). The mean age of patients undergoing elective surgery remained essentially unchanged. The mean age of patients undergoing emergency surgery increased. The decrease in the annual incidence of elective duodenal ulcer surgery occurred mainly in relation to proximal gastric vagotomy. There was a concomitant relative increase in the incidence of gastric resection. The types of operative procedures used in cases of pyloric, prepyloric and gastric ulcer remained unchanged over the years 1972 to 1987.
Evaluation of the results of oesophagectomy for oesophageal cancer
Authors: Mannell A , Becker P J 
Published: March 2007

Abstract
The long-term results of standard techniques of oesophagectomy were examined in 127 patients with squamous cell carcinoma of the oesophagus. A near-total oesophagectomy with a cervical anastomosis was performed in 93 patients and an oesophagogastrectomy with an intrathoracic anastomosis was carried out in 34 patients. One hundred and eight patients had a curative oesophagectomy and 19 patients had a palliative resection. Eighty patients received radiotherapy to the tumour bed. There were 15 deaths in hospital and the overall 5-year survival rate including perioperative deaths was 13·2 per cent. Survival was adversely affected by incomplete excision of macroscopic tumour (P &lt; 0·001), positive regional lymph nodes (P &lt; 0·05) and distant lymphatic metastases (P &lt; 0·02). The 5-year survival rate of patients with tumour invasion beyond the oesophageal wall (T 3) and negative nodes was 20 per cent. Postoperative irradiation had no effect on the survival of patients with gross residual tumour. Complete clearance of microscopic tumour was achieved in 50 per cent of patients with T 3 tumours and this group did not benefit from adjuvant radiotherapy. Survival in patients undergoing curative oesophagectomy with residual microscopic tumour, however, was significantly improved by irradiation of the tumour bed (P &lt; 0·01). These results suggest that the survival of patients can be increased significantly by the excision of all gross tumour and by identification of those who will benefit from local radiotherapy.
Prolonged intermittent clamping of the portal triad during hepatectomy
Authors: Elias D , Desruennes E , Lasser P 
Published: March 2007

Abstract
From 112 consecutive hepatectomies for malignant tumours performed with intermittent portal triad clamping, we have retrospectively selected the 20 cases in which clamping exceeded 90 min. Intermittent portal clamping of prolonged duration was used because of abnormal liver texture in 13 cases (mainly patients who had received intra-arterial chemotherapy) and/or because of technically difficult hepatectomy. The mean(s.d.) duration of intermittent portal clamping was 109(18) min and in two cases it exceeded 140 min (148 and 150 min). There was no postoperative mortality and the rate of postoperative morbidity was 35 per cent. Postoperative changes in biochemical liver tests were not major and transient hepatic failure occurred in only one patient following subtotal resection of the liver. We conclude that intermittent portal clamping is a useful manoeuvre in partial hepatectomy when resection is difficult or prolonged, or when the liver parenchyma is abnormal. Such clamping may be used for longer than 120 min without major complications.