bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidental Parathyroidectomy during Thyroid Surgery: An Underappreciated Complication of Thyroidectomy
Authors: Sakorafas George H. , Stafyla Vania , Bramis Constantinos , Kotsifopoulos Nikolaos , Kolettis Theophilos , Kassaras George 
Published: November 2005

AbstractThe aim of this study was to investigate the incidence, risk factors, and clinical relevance of incidental parathyroidectomy during thyroid surgery. Prospective analysis of data in patients following thyroidectomy, specifically regarding the presence of parathyroid parenchyma in the thyroidectomy specimens, the underlying thyroid pathology, and the presence of postoperative hypocalcemia (biochemical/clinical). The clinical records of 158 patients who underwent thyroid surgery during a 2‐year period were reviewed. Pathology reports were carefully reviewed for the nature of the underlying thyroid disease, the presence, number, and size of incidentally resected parathyroid gland(s), their location, and possible parathyroid pathology. Serum calcium levels were measured preoperatively, on the day of surgery, and on postoperative days 1, 2, and 7 or even later as needed. Two groups of patients were studied: a group with incidental parathyroidectomy following thyroidectomy (group A) and a group without incidental parathyroidectomy after thyroidectomy (group B). Total/near‐total thyroidectomy was the procedure of choice and was performed in 154 patients; total lobectomy and contralateral subtotal lobectomy was performed in the other 4 patients. Elective central neck lymph node dissection was performed in four patients with neck lymphadenopathy. Inadvertently removed parathyroid tissue was found in 28 cases (17.7 %); in 6 of these patients (21%) the parathyroid tissue was intrathyroidal. The percentage of women in group A was significantly higher than in group B (93% vs. 58.5%, P = 0.0002). There was no statistically significant difference between the two groups (A and B) regarding the preoperative (presumed) diagnosis, the histologic diagnosis of thyroid disease (benign versus malignant), the type/extent of surgery, or the presence of thyroiditis. Biochemical and clinical hypocalcemia was observed in 6 (21%) and 2 (7%) patients in group A, respectively, and in 30 (23%) and 8 (6%) patients of group B, respectively. There was no statistically significant difference regarding the occurrence of postoperative hypocalcemia (clinical/biochemical) between the two groups (P = 0.33). Incidental parathyroidectomy is not uncommon following thyroidectomy and in a significant percentage of cases it may be due to the intrathyroidal location of the parathyroid glands. Incidental parathyroidectomy was not found to be associated with postoperative hypocalcemia (biochemical/clinical). Incidental parathyroidectomy may be considered as a potentially preventable but clinically minor complication of thyroid surgery.
Comparison of Resected and Non‐resected Intraductal Papillary Mucinous Neoplasms of the Pancreas
Authors: Wang Shin‐E , Shyr Yi‐Ming , Chen Tien‐Hua , Su Cheng‐Hsi , Hwang Tsann‐Long , Jeng Kuo‐Shyang , Chen Jui‐Hao , Wu Chew‐Wun , Lui Wing‐Yiu 
Published: November 2005

AbstractBy comparing the clinicopathological features and survivals between the resected and non‐resected intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, this study tried to clarify the natural history of IPMNs, to provide a strategy for treatment, and to determine the justification of not performing resection for some patients. A total of 57 patients with IPMN, including 39 resected and 18 non‐resected IPMNs, were recruited for study. Data on demographics, clinical presentations, diagnostic work‐up, treatment modality, clinical course, and outcomes were evaluated and compared between the resected and non‐resected IPMNs. The most common clinical presentation was abdominal pain (57% in total IPMNs, 67% in resected, 33% in non‐resected), followed by body weight loss (32% in total IPMNs, 33% in resected, 28% in non‐resected). The sensitivity in the diagnosis of IPMN was highest by magnetic resonance cholangiopancreatography (MRCP) (88%), followed by endoscopic retrograde cholangiopancreatography (ERCP) (68%), and computed tomography scan (CT scan) (42%) and sonography (10%). The median survival was 21.5 months for patients with resected IPMNs, ranging from 2 to 124 months, and 14 months in non‐resected IPMN patients, ranging from 5.5 to 70 months. There is no significant survival difference between the resected and non‐resected groups, with a 5‐year survival of 69.8% in resected IPMNs and 59.8% in non‐resected IPMNs, P = 0.347. The survival outcome of the unresectable non‐resected IPMNs was much inferior to the resected IPMNs, P = 0.002 and resectable non‐resected IPMNs, P = 0.001. Thus, the prime prognostic factor in predicting the survival outcome of IPMNs is resectability, instead of resection itself. Long‐term survival could also be expected in resectable IPMNs without resection. No resection for the IPMN may be justified for patients with high surgical risks, especially for those who are asymptomatic and very aged.
Outcome in Right Living Related Liver Transplantation with Branch‐Patch Arterial Reconstruction
Authors: Di Benedetto F. , Lauro A. , Masetti M. , Cautero N. , Quintini C. , De Ruvo N. , Romano A. , Guerrini G. , Dazzi A. , Molteni G. , Siniscalchi A. , Bertani H. , Miller C.M. , Pinna A.D. 
Published: November 2005

AbstractcRight lobe living liver transplantation is being performed worldwide with increased frequency. Difficult arterial reconstructions are often encountered because of small diameter or discrepancy between arterial stumps. The risk of arterial thrombosis is reported as high as 26%: microsurgical techniques have reduced this rate below 2%, increasing warm ischemia time. We have developed a new branch patch technique in living related liver transplantation using the donor cystic artery to create an enlarged patch anastomosis that enables increase in the vessel’s diameter and therefore greater inflow to the liver. We have followed 8 patients treated with this technique. After more than 1 year (mean follow‐up: 636 days) we did not observe any arterial thrombosis by Doppler ultrasound performed every 3 months. The mean resistance index was 0.68 (0.57–0.83–). Three patients died with functional graft without signs of thrombosis. We believe that the cystic artery branch patch technique is feasible in all cases. It is fast (mean time: 6.2 min), it allows a shorter warm ischemia time, and there is no increased risk of thrombosis.
Results of Surgical, Laparoscopic, and Percutaneous Treatment for Hydatid Disease of the Liver: 10 Years Experience with 355 Patients
Authors: Yagci Gokhan , Ustunsoz Bahri , Kaymakcioglu Nihat , Bozlar Ugur , Gorgulu Semih , Simsek Abdurrahman , Akdeniz Ali , Cetiner Sadettin , Tufan Turgut 
Published: November 2005

AbstractSelection of the most appropriate treatment to obtain the best results with the lowest rate of recurrence and minimal morbidity and mortality is mandatory for the management of hepatic hydatid disease. The surgical approach is the mainstay of treatment, and there has been a tendency toward laparoscopic surgery and, more recently, percutaneous treatment (PT), which has become increasingly popular with revolutions in techniques. We aimed to evaluate the results of current therapeutic methods in the context of a 10‐year single‐institution experience. Between 1992 and 2003, 355 patients with 510 hydatid cysts of the liver were treated by open operation, laparoscopic surgery, or PT. The series included 128 females and 227 males ranging in age from 10 years to 73 years. Preferred treatment modalities, perioperative complications, interventions, recurrences, and length of hospital stay were retrospectively analyzed. There were two postoperative deaths (1.08%) in the open surgery group. Biliary leakage was observed in 28 patients treated with open surgery, in 10 patients after PT, and in 2 after laparoscopic treatment. Recurrence rates were 16.2%, 3.3%, and 3.5% after open surgery, laparoscopic surgery, and percutaneous treatment, respectively. Characteristics of the cyst, presence of cystobiliary communications, and the availability of a multidisciplinary team are the factors that we believe directly affect the results. Radical surgery can be done safely for suitable cases; conventional procedures are associated with greater morbidity. Laparoscopic surgery seems effective and safe, with low morbidity and recurrence rates for type I–III cysts in accessible localizations. Our experience with PAIR (puncture, aspiration, injection, and reaspiration) and catheterization provides evidence that the procedure is an effective and safe option.
Antibody Response of Autogenous Splenic Tissue Implanted in the Abdominal Cavity of Mice
Authors: Nunes Sérgio I. , Rezende Alice B. , Teixeira Francisco M. , Ferreira Ana Paula , Alves Márcio M.J. , Jamel Nelson , Assis Raimunda V.C. , Teixeira Henrique C. 
Published: November 2005

AbstractThere is still controversy about the immunologic function of autotransplanted splenic tissue. In this study, splenic autotransplantation was performed in the abdominal cavity of mice, and the plaque‐forming cell (PFC) assay was used to investigate the frequency of antibody‐forming cells in response to sheep red blood cell (SRBC) immunization. BALB/c mice were divided into four groups according to the location of the autogenous graft: intraomental (IO), free peritoneal splenosis (FPS), retroperitoneal (RP), and nongrafted control (CT). Thirty days after surgery the mice were immunized intraperitoneally with SRBCs, and 4 days later splenic immunoglobulin M anti‐SRBC‐secreting cells were determined by counting the number of PFCs. All the immunized mice showed increased numbers of PFCs that were about 2 logs higher than those in the the nonimmunized controls (P < 0.005). The frequencies of anti‐SRBC‐producing cells in the tissues grafted in various sites of the abdominal cavity (IO, FPS, RP), in the normal spleen from nonoperated controls (CT), or in the sham‐operated control group (SCT) were not notably different (5582 ± 2475 PFC/107 cells for IO; 4849 ± 1856 for FPS; 6604 ± 2903 for RP; 5940 ± 5029 for CT; and 6172 ± 2203 for SCT). Similar histology with small architectural variations was observed in all implants; less white pulp was involved, and there was more congestion in the red pulp, with extensive sinusoids and reticular fiber proliferation. This study shows that the T cell‐dependent antibody response in implanted splenic tissues is as efficient as in the intact spleen, with no difference between the graft sites studied. This immune response does not depend on the slight architectural variations observed in the splenic implants.
Gender Differences in Quality of Life of Patients with Rectal Cancer. A Five‐Year Prospective Study
Authors: Schmidt Christian E. , Bestmann Beate , Küchler Thomas , Longo Walter E. , Rohde Volker , Kremer Bernd 
Published: November 2005

AbstractTo determine how quality of life changes over time and to assess gender‐related differences in quality of life of rectal cancer patients we conducted a 5‐year study. Little is known about how quality of life (QoL) changes over time in patients after surgery for rectal cancer, and whether gender of the patients is associated with a different perception of QoL. The aim of this study was to assess prospectively, changes in quality of life after surgery for rectal cancer, with a focus on gender related differences. Over a 5‐year period, the EORTC‐QLQ‐C‐30 and a tumor‐specific module were prospectively administered to patients before surgery, at discharge, 3, 6, 12, and 24 months postoperatively. Comparisons were made between female and male patients. A total of 519 patients participated in the study, 264 men and 255 women. The two groups were comparable in terms of surgical procedures, adjuvant treatment, tumor stage, and histology. Most QoL scores dropped significantly below baseline in the early postoperative period. From the third month onward, global health, emotional and physical functioning, improved. Female gender was associated with significantly worse global health and physical functioning and with higher scores on treatment strain and fatigue. Men reported difficulties with sexual enjoyment; furthermore, over time, sexual problems created high levels of strain in men, worse than baseline levels in the early postoperative period. These problems tended to continue over the course of time. The findings in this study confirm that QoL changes after surgery and differs between men and women. Women appear to be affected by impaired physical functioning and global health. Female gender is associated with significantly higher fatigue levels and increased strain values after surgery. Through impaired sexual enjoyment, men are put more under strain than woman.
Prognostic Significance of Vascular Endothelial Growth Factor D in Gastric Carcinoma
Authors: Shida Atsuo , Fujioka Shuichi , Ishibashi Yoshio , Kobayashi Katsutoshi , Nimura Hiroshi , Mitsumori Norio , Suzuki Yutaka , Kawakami Makio , Urashima Mitsuyoshi , Yanaga Katsuhiko 
Published: November 2005

AbstractThe angiogenic factor called vascular endothelial growth factor (VEGF)‐D is a ligand for VEGF receptor‐2 (VEGFR‐2/KDR) and receptor‐3 (VEGFR‐3/Flt‐4). It is implicated in the development of lymphatic vessels and promotion of lymphatic metastasis. The purpose of this study was to investigate the prognostic significance of VEGF‐D expression in patients with gastric carcinoma. We assessed the expression of VEGF‐D in gastric carcinoma by immunohistochemistry on 143 consecutive patients’ stored sections and evaluated the lymphatic vessel count (LVC) in tumors using the novel selective lymphatic endothelium marker D2‐40. VEGF‐D expression was observed in 55 (39%) tumor sections. The expression of VEGF‐D correlated significantly with tumor size, T of the TNM classification, lymphatic and venous system invasion, LVC, lymph node metastasis, M of TNM, and pTNM stage. Multivariate analysis indicated that VEGF‐D expression was an independent prognostic factor for both relapse‐free survival (RFS) and overall survival (OS). Our data indicate the involvement of VEGF‐D in tumor progression via lymphoangiogenic pathways. Practically, VEGF‐D expression can be useful for predicting RFS and OS in patients with gastric carcinoma.
Needle Tract Implantation of Papillary Thyroid Carcinoma after Fine‐needle Aspiration Biopsy
Authors: Ito Yasuhiro , Tomoda Chisato , Uruno Takashi , Takamura Yuuki , Miya Akihiro , Kobayashi Kaoru , Matsuzuka Fumio , Kuma Kanji , Miyauchi Akira 
Published: November 2005

AbstractAlthough fine‐needle aspiration biopsy (FNAB) is a useful tool for diagnosing thyroid carcinoma, there are some risks of complications. In this study, we investigated tumor implantation by FNAB of papillary carcinoma. We compared the characteristics of the main tumors and implanted tumors of patients showing FNAB implantations. Between 1990 and 2002, 4912 patients underwent FNAB and were diagnosed as having papillary carcinoma. We encountered 7 cases of needle tract implantation, which account only for 0.14%. We reviewed these 7 cases as well as 3 other patients who underwent FNAB in other hospitals. The intervals between FNAB and detection of the implanted tumor ranged from 2 to 131 months. For these 10 patients, the main tumors in 6 were diagnosed as poorly differentiated carcinoma, and 7 showed extrathyroid extension. Five showed the development of implanted tumor after comparatively shorter intervals (2–68 months), and we classified these as the short interval group. The remaining 5 were classified as the long interval group, because tumor development occurred after 87–131 months. All 5 cases in the short interval group involved preoperatively detectable lymph node metastasis; those in the long interval group did not. The MIB‐1 labeling index of the implanted tumor was high in 4 cases in the short interval group, but it was low in all cases in the long interval group. The implanted tumors could be surgically removed without recurrence at the focal sites. These findings indicate that, although high growth activity in the metastatic lesions may be a risk factor of FNAB, inducing the growth of implanted tumors along the needle tract within a short interval after the procedure, FNAB remains the most useful technique for diagnosing thyroid carcinoma. The incidence of implantation was low, and when it did occur, the tumors could be surgically removed without recurrence.
Navigational Maxillofacial Surgery Using Virtual Models
Authors: Hohlweg‐Majert B. , Schön Ralf , Schmelzeisen Rainer , Gellrich Nils‐Claudius , Schramm Alexander 
Published: November 2005

AbstractAblative tumor surgery and orbital and midface reconstruction, as much as orthognathic surgery, requires detailed planning using computed tomography (CT) or magnetic resonance imaging (MRI). These techniques also allow simulation of complex surgeries preoperatively. Proper reconstruction depends on reliable information to choose the correct type of grafts and to predict the outcome. This study evaluates the benefit and indications of computer‐assisted surgery in the treatment of 107 patients who underwent craniomaxillofacial surgery. Based on a CT or MRI data set, an optical navigation system was used for preoperative planning, intraoperative navigation, and postoperative control. Surgery could be preoperatively planned and intraoperatively navigated. Preoperatively, it required that soft and hard tissues were measured using the mirrored data set of the unaffected side; the size and location of the graft were chosen virtually. Intraoperatively contours of transplanted tissues were navigated to the preoperatively simulated reconstructive result. Computer‐assisted treatment was successfully completed in all 107 cases. Preoperatively outlined safety margins could be exactly controlled during tumor resection. Reconstruction was designed and performed precisely as virtually planned. Image‐guided treatment improves preoperative planning by visualizing the individual anatomy, outlining the intended reconstructive outcome, and by objectifying the effect of adjuvant therapy. Intraoperative navigation makes tumor and reconstructive surgery more reliable by showing the safety margins, saving vital structures, and leading the reconstruction to preoperatively planned objectives.
Mirizzi Syndrome: Ten Years Experience from a Teaching Hospital in Riyadh
Authors: Al‐Akeely Mohammed H.A. , Alam Mohammed K. , Bismar Hayan Abdulrahman , Khalid Kamran , Al‐Teimi Ibrahim , Al‐Dossary Nasser Faleh 
Published: November 2005

AbstractObjectiveMirizzi syndrome (MS) is an uncommon presentation of cholelithiasis. This study aims to find the incidence and analyze the outcome of management of this condition at Riyadh Medical Complex (RMC) with particular reference to diagnostic methods and outcome of surgical treatment.MethodsRetrospective study on 17 consecutive patients of MS diagnosed and managed at RMC over ten year period. The records were reviewed for demography, clinical presentation, diagnostic methods, operative procedures, postoperative complication and follow up.ResultsThe incidence of MS syndrome was 0.7% of 2415 cholecystectomies. There was preponderance of Type I variety (58.8%). Ultrasonography was able to diagnose 82% cases. ERCP suggested the diagnosis in all cases and helped further in classifying and management of these patients. All Type I cases were managed with partial cholecystectomy, two underwent laparoscopic surgery. Three Type II patients were managed by partial cholecystectomy alone. Three patients with Type III variety had choledochoplasty whereas one remaining patient with Type IV variety underwent hepatico‐jejunostomy. All patients had complete recovery with 17.6% procedure‐related morbidity and no hospital mortality. All patients are doing well over a mean follow up 6.5 years.ConclusionPreoperative diagnosis of Mirizzi syndrome by ultrasound and ERCP is essential to prevent serious complications during surgery. Partial cholecystectomy is an adequate procedure for Types I & II MS. Choledochoplasty provides an effective surgical repair in Type III cases. Although laparoscopic cholecystectomy in MS may be hazardous, it may still be tried in preoperatively diagnosed type I cases, provided the surgeon is experienced and keeps a low threshold for conversion open surgery.
Liver Regeneration and Splenic Enlargement in Donors after Living‐Donor Liver Transplantation
Authors: Ibrahim Salleh , Chen Chao‐Long , Wang Chih‐Chi , Wang Shih‐Ho , Lin Chih‐Che , Liu Yeuh‐Wei , Yang Chin‐Hsiang , Yong Chee‐Chien , Concejero Allan , Cheng Yu‐Fan 
Published: November 2005

AbstractLiver regeneration after donor hepactectomy offers a unique insight into the process of liver regeneration in normal livers. As the liver restores itself, concurrent splenic enlargement occurs. There are many theories about why this phenomenon takes place: some investigators have proposed a relative portal hypertension that leads to splenic congestion or, perhaps, the presence of a common growth factor that induces both the liver and spleen to enlarge. Between the months of June 2001 and May 2004, 112 live donor liver transplants (LDLTs) were performed in Chang Gung Memorial Hospital, Kaohsiung, Taiwan. The total number of donor hepatectomies performed during this period was 113, however, because one of the cases required dual donors. Of our 113 donors, we eventually analyzed the data of 109; 4 patients were lost to follow‐up 6 months later and were excluded from our study. The average age of our donor population was 32.32 ± 8.48 years. The mean liver volume at donation was noted to be 1207.72 ± 219.95 cm3, and 6 months later, it was 1027.18 ± 202.41 cm3. Expressed as a percentage of the original volume, the mean liver volume 6 months after hepatectomy was 90.70% ± 12.47% in this series. For right graft donors, mean liver volume after 6 months was 89.68% ± 12.37% of the original liver volume, whereas that for left graft donors was 91.99% ± 12.6%. Only 26 of the 109 (23.85%) donors were able to achieve full regeneration 6 months post‐donation. Notably, liver function profiles of all donors were normal when measured 6 months after operation. The average splenic volume at donation as measured by computed tomography (CT) volumetry was 159 ± 58 cm3, and the splenic volume 6 months post‐donation was 213 ± 85 cm3. There was a mean increment in splenic volume of 35% ± 28% 6 months after donation. The blood profiles of the donors were monitored; particular attention was given to platelet levels and liver function tests, and these were found to be within normal limits 6 months after operation. Of note, splenic enlargement was significantly greater among right‐sided donors than their left‐sided counterparts. Greater splenic enlargement was also observed in those donors who achieved full liver regeneration at their evaluation 6 months postoperatively than in those who did not. Although original liver volume was not re‐established in most patients 6 months after liver donation, there seemed to have been no untoward effects to the donor. The factors that affect liver regeneration are complex and myriad. Although there is splenic enlargement at 6 months post‐donation in donors of LDLT, there are no untoward effects of this enlargement.