bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost analysis of microsurgical reconstruction in the head and neck
Authors: Miller Michael J. , Swartz William M. , Miller Robert H. , Harvey Joseph M. 
Published: February 2007

AbstractIn a cost‐conscious environment, pressure exists to justify the use of expensive techniques such as reconstructive microsurgery in head and neck patients. Therefore, the costs and effectiveness of 39 consecutive free tissue transfers in patients with head and neck defects due to neoplasia (77%), trauma (13%), or congenital causes (10%) were assessed by reviewing clinical and billing records. The technical success rate was 95% with a 29% rate of complications. Most patients returned to preoperative levels of social activities, and none admitted dissatisfaction with their results. Average cost was $27,000 per case with 16 days of hospitalization. Average cost for aerodigestive tract tumors was $37,400 with 21 days of hospitalization. Costs were directly related to the etiology of the defect and incidence of complications. Applying cost‐effectiveness principles we believe that these costs are justified by the high level of patient satisfaction and enhanced quality of life.
Effects of a three‐drug antineoplastic protocol of wound healing in rats: A biomechanical and histologic study on gastrointestinal anastomoses and laparotomy wounds
Authors: Salm Richard , Wullich Bernd , Kiefer Günter , Fiebig Heinz‐Herbert , Farthmann Eduard Heinrich 
Published: February 2007

AbstractUsing biomechanical and histologic approaches, the effect of perioperative administration of a drug protocol containing 5‐fluoruracil, Adriamycin, and mitomycin C (FAM) on the healing of gastrointestinal anastomoses and laparotomy wounds in rats was examined. Application of FAM immediately before operation resulted in significant impairment of wound healing in the early postoperative period. Once the proliferation of fibroblasts and collagen synthesis had led to an increase of mechanical strength, no negative effect on wound healing could be detected applying the same chemotherapeutic agents. These findings indicate the early inflammatory phase of the wound healing process to be most vulnerable to the chemotherapeutic effects. This has significant implications if the theoretical advantages of starting adjuvant chemotherapeutic treatment in the immediate postoperative period are implemented.
Perioperative chemotherapy in oral cancer
Authors: Rao Raja S. , Parikh Deepak M. , Parikh Hemen K. , Bhansali Mehul B. , Fakih Abdul R. 
Published: February 2007

AbstractThis is an interim report of a study of perioperative adjuvant chemotherapy following radical surgery for oral cancer, based on the hypothesis of Goldie and Coleman. 135 patients of alveolobuccal carcinoma, clinically stage III and IV, were entered on the protocol. After a curative resection, they were randomized. The test arm received methotrexate 50 mg/m2 on the 3rd, 10th, and 17th postoperative days. The control arm was only observed. This analysis at 12 months showed a disease free survival of 71% in the test arm vs. 45% in the control arm, which is statistically highly significant (P <0.01). Analysis of recurrence pattern showed that recurrence at the primary site was dramatically reduced during the first 6 postoperative months (P<0.01). Our study provided further clinical evidence in support of the concepts of Goldie and Coleman that the timing of chemotherapeutic drugs is very critical for a successful end result.
Latissimus dorsi musculocutaneous flap for elbow extension
Authors: Pruzansky Mark , Kelly Mark , Weinberg Hubert 
Published: February 2007

AbstractThe latissimus dorsi mycocutaneous flap has developed a reputation for its versatility in both skin and soft tissue coverage and for restoration of elbow function in both flexion and extension. In a case presented, a large extra‐abdominal desmoid was removed along with the entire deltoid and three‐quarters of the triceps. The latissimus dorsi was elevated with a large overlying skin island and rotated on its neurovascular pedicle into the defect in the posterior shoulder and upper arm to replace the resected triceps and deltoid muscle, and to provide coverage in this region.
Ten‐year survivors after surgical treatment and perioperative irradiation for esophageal carcinoma
Authors: Mori Masaki , Ohno Shinji , Shimono Reishi , Kuwano Hiroyuki , Sugimachi Keizo 
Published: February 2007

AbstractTen of 150 patients with primary squamous cell carcinoma of the esophagus and surgically treated, survived for more than 10 years. All 10 underwent a complete resection of the primary tumor and extensive lymph node dissection plus perioperative irradiation. The clinicopathologic findings in these 10 patients were reviewed. Five were female. Seven of the tumors exceeded 6 cm in length; seven were early stage, and the remaining three were advanced stage tumors. Lymph node metastases were evident in three, lymph vessel permeation was recognized in four, and no vascular vessel permeation was seen in any tumor. Two tumors had a characteristic appearance of carcinoma with lymphoid stroma, suggesting a good prognosis. In six for which cytophotometric DNA analysis could be done, four were type II, two were type III, and none was type IV. Thus, a complete resection of the primary tumor and extensive lymph node dissection can lead to a long survival time even for those with an advanced primary esophageal carcinoma.
Upper abdominal cancer surgery in the very elderly
Authors: Alexander H. Richard , Turnbull Alan D. , Salamone Joseph , Keefe Deborah , Melendez Jose 
Published: February 2007

AbstractFrom January 1981 to December 1987, 59 major upper abdominal operations were performed on 57 patients aged 80 to 90 years at Memorial Sloan‐Kettering Cancer Center. Procedures for primary adenocarcinoma of the stomach, distal esophagus, pancreas, or hepatobiliary system were performed with curative intent or for palliation in 34 of 59 patients (58%) and bypass with limited or no resection in 13 of 59 patients (22%) patients. Emergency operations were performed in six (10%) patients for gastric bleeding, perforation, or outlet obstruction. Six (10%) patients underwent laparotomy for benign biliary obstruction (1), splenectomy for secondary thrombocytopenia (2), or gastrectomy for sarcoma (2) or lymphoma (1). Hospital mortality was 15% overall and 9% for major resections, 15% for bypass, and 67% for emergency procedures. Major complications occurred in 10 (20%) elective procedures. Mortality was associated with respiratory or cardiac failure while complications most commonly included arrhythmias and wound infection. Mean postoperative hospitalization was 18 days overall and 45 patients (76%) were discharged home. Median survival following major resection was 17.5 months but less than 2 months after bypass procedures. A protocol of pre‐operative evaluation, intra‐operative hemodynamic monitoring and postoperative intensive care has been formalized for use in elderly or poor‐risk patients.
Adenosquamous carcinoma of the pancreas: A clinicopathologic study
Authors: Yamaguchi Koji , Enjoji Munetomo 
Published: February 2007

AbstractA total of eight patients with adenosquamous carcinoma of the pancreas were studied clinicopathologically. Histochemical and immunohistochemical studies were also done. The 8 patients were composed of 4 men and 4 women with a mean age of 56 years, which was 9 years younger than for other pancreatic carcinoma. The site of origin and size of the tumors were similar to those of usual pancreatic carcinoma. Histopathologically, all eight tumors showed an abrupt transition between adenocarcinoma and squamous cell carcinoma. Squamous cell carcinoma was located at the periphery of the tumors. Histochemistry and immunohistochemistry disclosed a different nature for both components. The cumulative 1‐year survival rate of the 8 patients was 21.4%, compared to 42.1% of 72 with adenocarcinoma of the pancreas. The survival curve of the 8 patients with adenosquamous carcinoma was significantly less favorable than that of 36 patients with well‐differentiated adenocarcinoma of the pancreas. These facts support the view that squamous cell carcinoma in adenosquamous carcinoma of the pancreas is squamous cell metaplasia of the pre‐existing adenocarcinoma. The clinical course of adenosquamous carcinoma of the pancreas was unfavorable.
Radical hysterectomy with lymphadenectomy for treatment of early stage cervical cancer: Clinical experience of 278 cases
Authors: Ayhan Ali , Sel Tuncer Z. Çuk 
Published: February 2007

AbstractThis study includes 278 cases of stage I and II cervical cancer subjected to radical hysterectomy and lymphadenectomy. The clinical experience of 278 cases is reviewed. Of these cases, 215 were in stage I, and 63 were in stage II. Intraoperative complications occurred at a rate of 9.7% and involved injuries to the great vessels, lower urinary tract, nerves, and rectum. Operative mortality was found to be 0.3%. Postoperative complications were observed in 20.1% of patients. Fistulae were observed in 8 (2.8%) patients. The overall survival rate was 83.8%. The 5‐year survival rates for stages IA, IB, IIA, and IIB were 100.0%, 87.9%, 71.0%, and 64.0%, respectively. Pelvic lymph node metastases varied from 0% for stage IA to 40.0% for stage IIB and paraaortic involvement varied from 0% for stage IA to 50.0% for stage IIB. Radical surgery seems to be the treatment of choice for patients with early invasive cervical cancer.
Histiocytic neoplasias: Immunohistochemical evaluation of their frequencies among malignant lymphoma and related conditions in Japan
Authors: Aozasa Katsuyuki , Ohsawa Masahiko , Saeki Kazunori , Horiuchi Keisuke , Tamai Masamitsu , Kohro Takashi , Kurata Akihiko 
Published: February 2007

AbstractThrough histologic review of 1,766 cases with malignant lymphoma and related conditions, 35 cases (2%) were selected as probable histiocytic neoplasias. Proliferating cells in these cases had voluminous, granulated cytoplasm, and round to irregularly shaped nuclei often with bi‐ or multinucleated forms showing monomorphous or polymorphous proliferation accompanying small lymphocytes, plasma cells, and, less frequently, eosinophils. Cases showing proliferation of convoluted cells with numerous benign‐appearing histiocytes or large cells with clear cytoplasm were excluded under a diagnosis of T‐cell lymphoma. To evaluate the immunologic character of proliferating cells, immunohistochemistry using antibodies Mx‐Pan B, MB‐1, MT‐1, UCHL‐1, lysozyme, α1‐arantitrypsin, α1‐antichymotrypsin, S‐100α, S‐100α, Leu M1, epithelial membrane antigen, and Ki‐1 were carried out in 23 cases. Naphthol‐ASD‐chloroacetate reaction and toluidine blue stain were also performed. These procedures revealed that 12 cases (52%) were B‐cell type, three cases (13%) T‐cell type, six cases (26%) true histiocytic type, and two cases null type. Therefore, the frequency of cases with true histiocytic neoplasias among cases with malignant lymphoma and related conditions in Japan may be 0.5%.
Thyroid cancer and multiple primary malignancies in Israel
Authors: Stein Moshe , Lachter Jesse , Bartal Arieh , Rennert Gad , Kuten Avraham 
Published: February 2007

AbstractThe exact risk of multiple primary neoplasms in patients with thyroid cancer is difficult to ascertain from the data available in the literature. Three thousand seventy‐two patients with thyroid cancer, listed in the Israel Cancer Registry during a 16‐year time span, were studied to determine the true incidence of another primary cancer. Ninety‐two cases were reported as having an additional primary cancer. The prevalence of multiple primary malignancies was 3%. The frequency was higher among patients of European rather than of Asian or African origin. The second primary cancers in order of decreasing frequency were of the breast, lung, colorectum, head and neck, and lymphoma/myeloma. Most of the deaths were due to the additional cancer. The 5‐year survival rate was highest for head and neck and lowest for lung cancer patients. These results emphasize the need for greater awareness of the possibility of developing additional cancers, and indicate the need to incorporate strategies for the prevention, early detection, and treatment of multiple primary neoplasms.
A feasibility study of the SDI test for the evaluation of gastrointestinal cancer sensitivity to anticancer drugs
Authors: Yamauchi Masaji , Satta Tetsuya , Ito Akihiro , Kongo Tatsuhei , Takagi Hiroshi 
Published: February 2007

AbstractThe succinic dehydrogenase inhibition (SDI) test has been widely used to evaluate the sensitivity of cancer cells to anticancer agents. Recently, the techniques for tissue culture have progressed; the ability to make formazan has improved with the use of methylthiazol tetrazolium bromide (MTT) instead of triphenyl tetrazolium chloride (TTC) in this assay. Therefore, we modified the SDI test in order to evaluate the drug response to gastrointestinal cancer and applied it in a clinical study. In this assay, the optimal concentration levels of mytomycin‐C and Adriamycin for the clinical materials are 10 μg/ml, that is, 10 times higher than for the cancer cell line, and that of Cisplatin is 30 μg/ml, for Cisplatin is unstable in the culture medium. To evaluate its antitumor effect, it was found necessary to expose the cancer cells to 5‐fluorouracil (5‐FU) for 3 days. We applied this assay for the clinical materials; the evaluable rate of this assay is 83.3%. The peculiarity of this assay is its high evaluable rate. These results suggest that this test may be useful for clinical application.
The risky shift
Authors: Spratt John S. 
Published: February 2007

AbstractCurrently, there seems to be a great hurry to develop guidelines for the clinical management of everything. Many evolving guidelines are proffered to be consensus decisions, which means, in most cases, that the guidelines were agreed on by multidisciplinary groups or committees. There is an unfortunate tendency to assume that consensus decisions are, a priori, correct and constitute the best and only way to address different problems.
Patterns of DNA‐ploidy in operable colorectal carcinoma: A prospective study of 100 cases
Authors: Russo Antonio , Bazan Viviana , Plaja Sergio , Leonardi Patricia , Bazan Pietro 
Published: February 2007

AbstractA prospective study of cellular DNA content was made by means of flow cytometry in a nonconsecutive series of 100 patients undergoing surgery for primary colorectal adenocarcinoma. DNA‐aneuploidy was present in 80% of cases (80/100); 39% of these were multiclonal (31/80). There was no significant correlation between DNA‐ploidy and the clinical and pathological features examined, except for the primary tumor site (right colon vs. left colon vs. rectum: P <0.001). After a minimum follow‐up of 30 months, out of 40 patients with no local invasion and/or distant metastases, 100% (9/9) of those with DNA‐diploid neoplasias showed no signs of disease relapse, vs. 55% (17/31) of the DNA‐aneuploid cases (P <0.05). Furthermore, in 45 cases with a minimum follow‐up of 30 months, overall survival was 90% in patients with DNA‐diploid carcinomas and 43% in the DNA‐aneuploid cases (P <0.05).
Results of multimodal therapy in Ewing's sarcoma: A retrospective analysis of 20 patients
Authors: Ben‐Arush Myriam , Kuten Abraham , Perez‐Nahum Monique , Cohen Yoram , Bialik Victor 
Published: February 2007

AbstractA retrospective analysis was performed of 20 patients with Ewing's sarcoma treated by combined modality therapy, consisting of surgery, radiotherapy, and chemotherapy. Fourteen patients (70%) achieved complete remission and 5 patients (25%) were in partial remission at the end of treatment. One patient (5%) failed to respond to combined modality therapy. The overall 5 year actuarial survival was 64% and the disease free survival, 55%. Persistent or recurrent disease occurred in 8 patients (40%); one of them was salvaged by surgery and chemotherapy. Site and extent of primary lesion were prognosticators of patients' outcome. One patient developed radiation‐related‐sequelae. The efficacy of aggressive management consisting of wide surgery, radiotherapy and intermittent high dose chemotherapy is discussed.
Benign cartilaginous tumors of the upper airway
Authors: Frank James L. , Schwartz Beth R. , Price Linda M. , Neifeld James P. 
Published: February 2007

AbstractBenign cartilaginous neoplasms of the laryngotracheal apparatus are uncommon clinical entities. Two cases of cartilaginous lesions of the upper airway are reported. Resection with maintenance of upper airway structural integrity is the preferred treatment. Temporary tracheostomy is often necessary and can provide access for stenting of the tracheal repair.
Thoracoscopy in the diagnosis of pleural effusion of ambiguous etiology
Authors: Sharma Sanjay , D'cruz Anil 
Published: February 2007

AbstractBetween 1985 and 1989, 27 patients underwent thoracoscopy for an undiagnosed pleural effusion. Prior thoracocentesis (in all patients) and a needle pleural biopsy (in 15 patients) had been nondiagnostic. The rigid thoracoscope was used in 21 patients, the cystoscope in 4 patients, and the flexible bronchoscope in 2 patients. We had one mortality, and there was no operative morbidity. Thoracoscopy was diagnostic in 24 of the 27 patients (4 benign, 20 malignant). The average duration of stay in the hospital was 48 hr. We conclude that thoracoscopy is an important diagnostic aid in the management of a pleural effusion of ambiguous origin and that it is a relatively safe procedure that can be performed with an acceptable morbidity and mortality.
Comparison of R1 and R2 gastrectomy for gastric cancer in patients over 80 years of age
Authors: Korenaga Daisuke , Baba Hideo , Kakeji Yoshihiro , Orita Hiroyuki , Haraguchi Masaru , Maehara Yoshihiko , Saku Motonori , Sugimachi Keizo 
Published: February 2007

AbstractTo evaluate the benefit of R2 gastrectomy for gastric cancer in Japanese patients over 80 years of age, data on 93 patients who underwent gastrectomy between 1967 and 1989 were collected retrospectively from charts filed in the Kyushu University Hospital and two affiliated national hospitals. Of 93 patients, 62 had a localized tumor without evidence of metastatic spread. These 62 patients were classified into two groups according to the procedures performed: 35 underwent R1 gastrectomy and 27, R2 gastrectomy. The clinical and pathological characteristics of the patients in the two groups were comparable at the time of surgery, except that the group who underwent R1 gastrectomy was older. R2 gastrectomy involved a significantly longer operation time (P < 0.01) and greater intraoperative blood loss (P < 0.05) when compared to R1 gastrectomy, but no patient undergoing this extensive surgery died. The difference in the morbidity rate between the two groups was not statistically significant. The 5‐year survival rate was 55.8% in the R1 group and 65.4% in the R2 group. When gastric cancer invaded the serosa and/or secondary nodes, a substantial increase in survival time was gained with R2 gastrectomy when compared to an R1 operation. These findings suggest that an R2 gastrectomy is feasible, even for patients over 80 years, but is indicated mainly when the carcinoma has invaded the serosa and/or secondary nodes and the patients are at good risk for major surgery.
Mammogram‐directed fine‐needle aspiration of nonpalpable breast lesions
Authors: Arishita Gary I. , Cruz Bradley K. , Harding Clark T. , Arbutina David R. 
Published: February 2007

AbstractA prospective study was undertaken to evaluate the effectiveness of mammogram directed fine‐needle aspiration cytology in women with nonpalpable abnormalities detected on mammogram. Seventy patients were entered into the research protocol, with 61 patients undergoing mammogram directed fine‐needle aspiration. Forty‐three of the aspirates were adequate for diagnosis. Fine‐needle aspiration yielded an accurate diagnosis in 12 of the 14 carcinomas in which the sample was considered adequate, for a sensitivity of 87%. No patients were falsely diagnosed with malignant disease, a specificity of 100%. The predictive value of a positive test was 100%, and that of a negative test was 93%. We conclude that fine‐needle aspiration cytology can aid in making a diagnosis when nonpalpable breast abnormalities are detected on mammogram.
Survival of patients with metastatic breast cancer diagnosed between 1955 and 1980
Authors: Debonis Daniel , Terz Jose J. , Eldar Samuel , Hill L. Robert 
Published: February 2007

AbstractIn order to determine whether current programs for the management of metastatic breast cancer have led to improved patient survival, we determined the median survival times for five‐year intervals of 849 patients admitted to the City of Hope National Medical Center with metastatic breast cancer from 1955 to 1980. Survival curves were constructed from the dates of first diagnosis of breast cancer and to the first metastasis for all population subsets and clinical subsets: menopausal status, presence or absence of visceral metastases, length of disease‐free interval, and pattern of palliative therapy. In this analysis, the median survival in each successive interval of five years from diagnosis of the primary tumor was 52.1, 45.0, 49.9, 41.1, and 36.0 months, and the survival times from the first metastasis were 31.9, 23.0, 24.2, 23.9, and 18.7 months. Survival times in each of the clinical subsets remained unchanged during the period of observation, regardless of the therapeutic modalities included in the treatment regimens. This study indicates that changes in palliative therapy for metastatic breast cancer during the 25 years of observation have not influenced overall survival. Therefore, it seems appropriate that the therapeutic risk/benefit ratio and impact on quality of life should be reassessed when asymptomatic patients are treated, or when aggressive palliative therapy is used outside a clinical research setting.
Frequency and experience with carcinoma of the thyroid at a private, a veterans administration, and a university hospital
Authors: Flynn Michael B. , Tarter Jeremy , Lyons Kela , Ragsdale Terry 
Published: February 2007

AbstractWe evaluated the treatment experiences with thyroid carcinoma at a private, a Veterans Administration, and a University hospital to determine the frequency, treatment, and outcome of patients with this uncommon malignant tumor. All 120 patients with thyroid carcinoma were identified through hospital tumor registries between 1953 and 1988, representing 0.3% of the total cancer registry cases during this period. Well‐differentiated carcinoma of the thyroid represented 73%, medullary carcinoma 7%, poorly differentiated carcinoma 18%, and Hürthle cell carcinoma 2% of histologic varieties. Seventy‐eight percent of patients were treated initially by surgery or by surgery plus postoperative irradiation. The remaining patients received other treatment. At 10 years after treatment, 90% of patients with well‐differentiated carcinoma survived, while only 20% of patients with medullary and poorly differentiated carcinoma survived. Sixty percent of recurrences for all histologic types appeared within the first 12 months after treatment. Patients with well‐differentiated carcinoma had sporadic recurrences over a 21‐year period. Recognition of these time intervals allows for better follow‐up management.