bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of sequential leucocyte counts and C-reactive protein measurements in acute appendicitis
Authors: Thompson M M , Underwood M J , Dookeran K A , Lloyd D M , Bell P R F 
Published: March 2007

AbstractThe accurate clinical diagnosis of acute appendicitis is dificult, and many techniques have been suggested to improve diagnostic accuracy such as laparoscopy, ultrasonography and barium enema examination. In this study serial total leucocyte counts and serial C-reactive protein (CRP) concentrations in acute appendicitis were measured. The sensitivity and specificity of serial leucocyte counts in acute appendicitis were 92 and 100 per cent, and for CRP concentrations 69 and 75 per cent, respectively. The sensitivity and specificity of serial total leucocyte counts fulfilled the criteria for a diagnostic test. It is suggested that in patients with equivocal clinical findings, clinical observation combined with serial leucocyte counts may improve decision making.
Fat-wrapping in Crohn's disease: Pathological basis and relevance to surgical practice
Authors: Sheehan A L , Warren B F , Gear M W L , Shepherd N A 
Published: March 2007

Abstract
The connective tissue changes that accompany intestinal Crohn's disease have received little attention from pathologists. This is particularly so with fat hypertrophy, and yet surgeons have long recognized the phenomenon of fat-wrapping in the intestines and used it to delineate the extent of active disease. A consecutive, unselected series of 27 intestinal resections performed on 25 patients for histologically confirmed Crohn's disease was studied to correlate fat-wrapping with other clinicopathological features. Fat-wrapping was identified in 12 of 16 ieal resections and in seven of 11 large bowel resections. It correlated closely with transmural inflammation and there was a relationship between fat-wrapping and other connective tissue changes including fibrosis, muscularization and stricture formation. Morphometry demonstrated that there was true hypertrophy and that fat-wrapping does not relate solely to bowel wall shrinkage. There was correlation with ulceration but in 11 cases macroscopic ulceration extended beyond the fat-wrapping and in six to surgical resection margins. The pathological features of 225 small intestinal resections were reviewed and fat-wrapping was seen only in Crohn's disease. Fat-wrapping correlates best with transmural inflammation and represents part of the connective tissue changes that accompany intestinal Crohn's disease. Findings also suggest that fat-wrapping alone should not be used as an accurate marker of disease extent at the time of surgery.
Prospective randomized comparison of in situ and reversed infrapopliteal vein grafts
Authors: Harris P L , Veith F J , Shanik G P , Nott D , Wengerter K R , Moore D J 
Published: March 2007

Abstract
A three-centre prospective randomized trial was undertaken to compare the efficacy of in situ and reversed saphenous vein grafts for long bypasses to tibial and peroneal arteries. Of 162 patients entered into the study, 82 received an in situgraft and 80 a reversed vein graft. All operations were for limb salvage and the two groups of patients were well matched for age, sex, incidence of diabetes, smoking habits and coronary artery disease. At a maximum follow-up of 3 years there were 48 primary graft failures: 19 in the in situ group and 29 in the reversed vein group. Of these, three in situ grafts and seven reversed grafts were salvaged by secondary intervention. Secondary cumulative patency rates calculated at 3 years after operation were 68 and 66 per cent respectively for in situ and reversed grafts (P not significant). Cumulative limb salvage rates were 78 per cent for in situ grafts and 87 per cent for reversed grafts (P not significant). Separate analysis of a subgroup with small veins (≦ 3·5 mm minimum diameter) showed cumulative patency rates at 2 years of 74 per cent for in situ grafts and 60 per cent for reversed grafts (P not significant). These results indicate that for veins &gt;3·5 mm in diameter the in situ and reversed techniques for operation are equally effective. Some doubt remains about the best way of using smaller veins; a large number of such veins need to be studied to resolve this question.
Function of ileal J pouch-anal anastomosis in patients with familial adenomatous polyposis
Authors: Penna C , Tiret E , Kartheuser A , Hannoun L , Nordlinger B , Parc R 
Published: March 2007

AbstractPouch function after proctocolectomy and ileal J pouch-anal anastomosis was assessed at 1 and 5 years in 41 patients with familial adenomatous polyposis. The mean(s.d.) stool frequency per 24 h decreased from 4·4(1·7) to 3·9(1·8) (P &lt; 0·05), the mean(s.d.) nocturnal stool frequency fell from 0·6(1·0) to 0·3(0·6) (P &lt; 0·05), and the number of patients having nocturnal bowel movements decreased from 16 to seven (P &lt; 0·05). At 5 years, only one patient still followed a strict diet (versus ten at 1 year, P &lt; 0·05) and only two needed antidiarrhoeal medication (versus ten at 1 year, P &lt; 0·05). There were no episodes of pouchitis or late reservoir-related complications. The function of ileal pouch-anal anastomosis improves over time in patients with familial adenomatous polyposis.
Intraoperative measurement of vascular graft resistance as a predictor of early outcome
Authors: Davies A H , Magee T R , Baird R N , Horrocks M 
Published: March 2007

AbstractThe quality of distal run-off is one of the most important factors influencing the early outcome of femorodistal vein grafting. During femoropopliteal and infrapopliteal bypass, assessment of graft resistance and flow were made using a combination of Doppler flowmeter recordings and measurements of arterial pressure. In a series of 100 reconstructions there were 12 early failures. The mean (95 per cent confidence interval (c.i.)) maximal flow measurement in the group of grafts that failed when anastomosed to the popliteal artery or tibioperoneal trunk was 125 (74–176) ml/min compared with 256 (223–289) ml/min in successful grafts (P = 0.006). The corresponding figures for grafts inserted into a single crural vessel were 99 (72–126) and 165 (137–193) ml/min (P &lt; 0.02). In the group that failed the mean (95 per cent c.i.) resistance after papaverine injection was 1.02 (0.82–1.22) peripheral resistance units (p.r.u.) compared with 0.47 (0.44–0.51) p.r.u. in the successful group (P &lt; 0.001). Using a combination of resistance &gt; 0.9 p.r.u. and capacity loss ratio after papaverine injection &lt; 10 per cent to identify grafts that subsequently failed, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 92, 97, 85, 99 and 97 per cent respectively. These results confirm that haemodynamic measurements can be used at operation to identify a group of patients in whom bypass is likely to fail.
Faecal occult blood screening for colorectal neoplasia in a targeted high-risk population
Authors: Caffarey S M , Broughton C I M , Marks C G 
Published: March 2007

AbstractA general practice-based programme was initiated in 1987 to identify individuals at high risk of developing large bowel cancer and offer them screening of faecal occult blood. In all, 5298 people from 21 general practices in the Guildford area were offered 7510 screening tests. In total, 5934 tests were completed (compliance rate 79.0 per cent) with 287 positive results (4.8 per cent). Of the patients with positive results, 44 had cancer and 38 polyps. The sensitivity of the test for cancer was 63 per cent, the specificity 96 per cent and the positive predictive value for all neoplasia 29 per cent. The detection rate of 44 cancers per 5934 people screened compares favourably with data from the Nottinghambased screening of an unselected population (0.74 versus 0.23 per cent).
Conservative treatment for low rectal carcinoma by local excision with or without radiotherapy
Authors: Rouanet P , Aubert B Saint , Fabre J M , Astre C , Liu J Z , Dubois J B , Joyeux H , Solassol C , Pujol H 
Published: March 2007

AbstractThirty-seven patients with low rectal carcinoma were treated by transanal resection between January 1979 and December 1988. Adjuvant radiotherapy was used in eight patients before operation, in 13 after operation and six patients had both preoperative and postoperative radiotherapy. The selection criteria for transanal resection were low, superficial tumours treated conservatively with curative intent (group 1, 18 patients) or patients medically unfit for (12) or refusing (seven) abdominoperineal resection (APR) (group 2, 19 patients). In group 1, the local recurrence rate was 11 per cent with an overall 5-year survival rate of 100 per cent. In group 2, the local recurrence rate was 53 per cent with an overall 5-year survival rate of 35 per cent. There was no postoperative mortality and minimal morbidity. Salvage of local failure was by APR in six patients. The survival rate after local recurrence was 70 per cent at 1 year and 30 per cent at 5 years. Transanal resection can be proposed as a curative procedure for selected low, small, minimally infiltrating and well differentiated adenocarcinomas. Local control might be improved by postoperative radiotherapy for Astler—Coller stage B1 tumours or those above 3 cm in diameter. Further trials should examine the results of high-dose (60 Gy) preoperative radiotherapy so that transanal resection might be employed for favourable postirradiation stage (0 or A) lesions. This new strategy will benefit from a better evaluation of tumour response after primary radiotherapy and an improved assessment of histological excision margins.
Intersphincteric resection for low rectal tumours
Authors: Schiessel R , Karner-Hanusch J , Herbst F , Teleky B , Wunderlich M 
Published: March 2007

Abstract
An abdominoperineal operation is described that extends rectal resection for low tumours into the intersphincteric plane with removal of the internal sphincter. Bowel continuity is restored by coloanal anastomosis. Of 38 patients who underwent surgery since 1984, 34 had low rectal cancer and four carcinoid or large villous adenoma. There was no mortality. Four patients developed local recurrence during a median observation period of 3 years. Continence was satisfactory in all patients. The median daily number of bowel movements during the first months after colostomy closure was 9 but decreased to 3 after 1 year and 1 after 2 years. Anal manometry demonstrated a significant reduction of mean resting pressure from 91·8 to 35·1 cmH2O with no recovery after 2 years (P&lt;0·0001). Squeeze pressure showed only a transient decrease.
Segment III cholangiojejunostomy for palliation of malignant hilar obstruction
Authors: Guthrie C M , Banting S W , Garden O J , Carter D C 
Published: March 2007

Abstract
Between 1984 and 1992, 26 patients with obstructive jaundice due to malignancy at the liver hilum were treated by segment III Roux-en-Y cholangiojejunostomy. Twenty-two patients had hilar cholangiocarcinoma, one carcinoma of the gallbladder, one pancreatic carcinoma, one recurrent gastric carcinoma and one lymphoma. Seventeen patients had no complications in the postoperative period and six had complications; there were three postoperative deaths. Eighteen of the 23 surviving patients experienced complete resolution of jaundice for at least 3 months. Four developed recurrent jaundice and three had episodes of cholangitis before death. Segment III cholangiojejunostomy offers effective palliation for most patients with irresectable hilar malignancy.
Influence of screening on the incidence of ruptured abdominal aortic aneurysm: 5-year results of a randomized controlled study
Authors: Scott R A P , Wilson N M , Ashton H A , Kay D N 
Published: March 2007

Abstract
From family medical practices 15775 men and women aged 65-80 years were identified and randomized into two groups: one group was invited for ultrasonographic screening for abdominal aortic aneurysm (AAA), and the other acted as age- and sex-matched controls. Of the 7887 invited for screening 5394 (68·4 per cent) accepted. AAA was detected in 218 (4·0 per cent overall and 7·6 per cent of men). Aortic surgery was offered to the screened group if certain criteria were met and no patient died from rupture who was fit for operation and accepted elective treatment. The incidence of rupture was reduced by 55 per cent in men in the group invited for screening, compared with controls. The incidence of rupture in women was low in both groups.
Percutaneous cholecystostomy: A valuable technique in high-risk patients with presumed acute cholecystitis
Authors: Melin M M , Sarr M G , Bender C E , van Heerden J A 
Published: March 2007

Abstract
Percutaneous cholecystostomy offers a potentially important therapeutic modality for critically ill patients with acute cholecystitis who represent a high risk for general anaesthesia. The aim of the study was to assess experience with percutaneous cholecystostomy in resolving the acute episode of cholecystitis without operative intervention. Twenty-two consecutive patients with a clinical diagnosis of acute cholecystitis underwent the procedure. All were at high risk for general anaesthesia, and all but one developed cholecystitis while hospitalized for another co-morbid condition; 14 were in an intensive care unit. Twenty-one of the 22 patients proved to have acute cholecystitis (11 acalculous, ten cholelithiasis). There were no acute technical complications. Toxaemia resolved in 17 of the 21 patients with acute cholecystitis. Acute cholecystitis failed to resolve in three patients; all died within 48 h from overwhelming generalized sepsis. One patient required emergency cholecystectomy for bile peritonitis when the cholecystostomy catheter became dislodged 24 h after placement. The 60-day mortality rate for the acalculous and calculous patient groups was 55 and 20 per cent, respectively. Only three interval cholecystectomies have been performed at a mean follow-up of 19 months. In conclusion, percutaneous cholecystostomy may be the procedure of choice for the management of acute cholecystitis in the very high-risk critically ill patient. If symptoms fail to resolve quickly, ongoing sepsis, cholangitis or gallbladder necrosis should be suspected.
Effect of transcutaneous electrical muscle stimulation on postoperative muscle mass and protein synthesis
Authors: Vinge O , Edvardsen L , Jensen F , Jensen F G , Wernerman J , Kehlet H 
Published: March 2007

Abstract
In an experimental study, 13 patients undergoing major elective abdominal surgery were given postoperative transcutaneous electrical muscle stimulation (TEMS) to the quadriceps femoris muscle on one leg; the opposite leg served as control. Changes in cross-sectional area (CSA) and muscle protein synthesis were assessed by computed tomography and ribosome analysis of percutaneous muscle biopsies before surgery and on the sixth postoperative day. The percentage of polyribosomes in the ribosome suspension decreased significantly (P &lt; 0·03) after operation in control legs, but not in stimulated legs (P &gt; 0·16). The total concentration of ribosomes decreased significantly in legs treated with TEMS (P &lt; 0·03) but not in control legs (P &gt; 0·16). CSA decreased significantly in both legs. The decrease in polyribosomes and CSA after operation was significantly less in stimulated legs than in controls (P &lt; 0·05). TEMS may be a simple and effective method for improving muscle protein synthesis and muscle mass after abdominal surgery and should be evaluated in other catabolic states with muscle wasting.
Augusta Déjerine‐Klumpke: The first female neuroanatomist
Authors: Shoja Mohammadali M. , Tubbs R. Shane 
Published: March 2007

AbstractAugusta Déjerine‐Klumpke, the wife of Joseph Jules Dejerine, an eminent French neurologist, was an American and the first woman to intern in a Parisian hospital. She is known for Klumpke's radicular palsy, which is a neuropathy involving the lower nerve roots of the brachial plexus. The neuroanatomical treatise that she wrote together with her husband is considered a masterpiece. Klumpke won several awards in medical science, the first of which was in the field of anatomy when she was a student. She was a pioneer of rehabilitation therapy after spinal cord injuries and contributed much to our current knowledge of spinal cord diseases. We review the current English and French literature regarding this neuroanatomist who was the first woman to directly contribute to the writing of a neuroanatomy textbook. Clin. Anat. 20:585–587, 2007. © 2007 Wiley‐Liss, Inc.
Coronary and left ventricular pacing as standby in invasive cardiology
Authors: De La Serna Fernando , Meier Bernhard , Pande Abhay K. , Urban Philip , Adatte Jean‐Jacques , Moles Victor P. , Killisch Jean‐Pierre , Bodenmann Jean‐Jacques , Barcellona Gaetano , Dorsaz Pierre‐André , Favre Josiane 
Published: March 2007

AbstractCoronary pacing using as unipolar negative electrode a guidewire placed in a coronary branch was tested in 349 sites of 300 consecutive patients undergoing coronary angio‐plasty. It was possible for 339 sites (97%). The threshold currents ranged from 1 to 15 (mean ± standard deviation 3.4 ± 2.4) mA. Side effects were seen in 13 patients (4%): 6 (2%) had transient coronary spasm, 4 (1%) had diaphragmatic stimulation, and 3 (1%) had stinging pain at the skin electrode. Of the 10 cases with pacing failure, left ventricular pacing was successfully tested in 5 by introducing the coronary wire or another wire into the left ventricle. It yielded a threshold of 2–8 (3.2 ± 2.7) mA. Therapeutic pacing for significant bradycardia was required in 7 patients (2%). It was successful in all. Coronary or left ventricular pacing appears to be a simple and reliable temporary measure. When there is no wire in the coronary artery or for diagnostic catheterization, left ventricular pacing can be done using the same setup and any type of guidewire.
Percutaneous closure of a secundum atrial septal defect and double balloon valvotomies of a severe mitral and aortic valve stenosis in a patient with lutembacher's syndrome and severe pulmonary hypertension
Authors: Ruiz Carlos E. , Gamra Habib , Mahrer Peter , Allen John W. , O'Laughlin Martin P. , Lau Francis Y. K. 
Published: March 2007

AbstractThis is a 43‐yr‐old female presenting with recurrent atrial septal defect, closed surgically, 10 years prior, severe aortic and mitral stenosis, and severe tricuspid regurgitation. She was considered inoperable because of the severe pulmonary hypertension and the complexity of the disease. A percutaneous umbrella closure of the atrial septal defect in conjunction with mitral and aortic balloon valvotomies could be safely and successfully performed. After significant clinical and hemodynamic improvement, surgery was judged feasible, but was refused by the patient who suddenly expired 8 weeks later.The usefulness of percutaneous therapy as a rescue procedure and the management of patients with Eisenmenger's physiology are discussed.
Coronary arteriovenous fistula presenting as congestive heart failure
Authors: Kugelmass Aaron D. , Manning Warren J. , Piana Robert N. , Weintraub Ronald M. , Baim Donald S. , Grossman William 
Published: March 2007

AbstractCoronary arteriovenous fistulae are rare, but can be of hemodynamic significance. We report a circumflex‐coronary sinus fistula in an elderly man which was associated with a loud continuous murmur and congestive heart failure. Noninvasive evaluation, including transesophageal echocardiography and magnetic resonance imaging, suggested the diagnosis. Angiographic diagnosis of concomitant atherosclerotic coronary disease may be difficult, and can require postoperative study. © 1992 Wiley‐Liss, Inc.
Origin of all three coronary arteries from separate ostia in the right sinus of valsalva: A rarely reported coronary artery anomaly
Authors: Pollack Brian D. , Belkin Robert N. , Lazar Steven , Pucillo Anthony , Cohen Martin B. , Weiss Melvin B. , Herman Michael V. 
Published: March 2007

AbstractAnomalous origin of the circumflex and left anterior descending coronary arteries from separate ostia in the right sinus of Valsalva is a rarely reported phenomenon. Few clinical details concerning patients with this anomaly are available in the literature. Angiographic and clinical data in an adult patient with this finding are reported here. © 1992 Wiley‐Liss, Inc.
Coronary rotational ablation for unsuccessful angioplasty due to failure to cross the stenosis with a dilation catheter
Authors: Brown Robert I.G. , Penn Ian M. 
Published: March 2007

AbstractAttempted coronary angioplasty of a right coronary artery sub‐total occlusion was unsuccessful due to failure to cross the lesion with the dilatation catheter. Both fixed‐wire and over‐the‐wire systems were tried. Coronary rotational ablation was successful in reducing the stenosis and allowing successful angioplasty. © 1992 Wiley‐Liss, Inc.
Prolapsing large aneurysm of the atrial septum simulating a right atrial mass
Authors: Angelini Paolo , Wilansky Susan , Gaos Carlos , Montazavi Ali , Boncompagni Enzo , Cooley Denton A. 
Published: March 2007

AbstractAn unusual case of a large, prolapsing atrial septal aneurysm in a patient with an otherwise normal heart is described. The aneurysm caused right atrial obstruction and resuited in a “tumor effect.” The patient experienced debilitating symptoms for years before receiving an appropriate diagnosis and curative surgical treatment. © 1992 Wiley‐Liss, Inc.
Right atrial myxoma associated with vascular malformation and atypical chest pain
Authors: Fox James J. , Bonavita Gregory J. , Sethi Virender 
Published: March 2007

AbstractA 58‐yr‐old woman with a right atrial myxoma associated with a vascular malformation supplied by the right coronary artery is described. She presented with atypical chest pain that was reproduced during angiography of the malformation. Findings were confirmed during surgery. © 1992 Wiley‐Liss, Inc.
Instantaneous recruitment of reversed coronary collaterals that had been dormant for six years
Authors: Moles Victor P. , Meier Bernhard , Urban Philip , Pande Abhay K. 
Published: March 2007

AbstractWe report a case of instantaneous recruitment of reversed coronary collaterals 6 years after their disappearance with recanalization of the recipient vessel. Coronary collaterals can provide flow in both directions and remain immediately recruitable for years in case of occlusion of either vessel involved. © 1992 Wiley‐Liss, Inc.
Intracoronary thrombus: Chronic urokinase infusion and evaluation with intravascular ultrasound
Authors: Jain Ashit , Ramee Stephen R. , Mesa Juan , Collins Tyrone J. , White Christopher J. 
Published: March 2007

AbstractPercutaneous revascularization of coronary arteries with intraluminal thrombi is a clinical problem. We report a patient in whom we administered prolonged infusion of intracoronary urokinase and then assessed the stenosis with intravascular ultrasound before and after atherectomy. We found both angiography and intravascular ultrasound to be misleading in determining the presence of residual thrombus after thrombolysis. © 1992 Wiley‐Liss, Inc.
Percutaneous transfemoral spring coil embolization of a pseudoaneurysm of the femoral artery
Authors: Saito Shigeru , Arai Hidekazu , Kim Kunikane , Aoki Naoto , Tsurugida Masanobu 
Published: March 2007

AbstractPseudoaneurysm of the femoral artery is a possible complication of percutaneous trans‐femoral catheterization. Its typical treatment has been open surgical repair. This article describes a new technique for the treatment of femoral artery pseudoaneurysm by spring coil embolization. © 1992 Wiley‐Liss, Inc.