bluuebunny/crossref_metadata_2025_split huggingface dataset:
Filarial lymphoedema and elephantiasis of lower limb: A review of 44 cases
Authors: Dandapat M C , Mohapatro S K , Mohanty S S 
Published: March 2007

Abstract
Twenty patients with early lymphoedema due to filariasis and twenty-four patients with elephantiasis of the lower limb were subjected to lymph nodovenous shunt (LNVS) and Charles' operation respectively. In 62 per cent of cases subjected to LNVS operation, there was a rapid relief of lymphoedema followed by slow reduction, 24 per cent had slow and gradual reduction and 14 per cent had very slight reduction in volume and circumference. Patients subjected to Charles' operation had immediate volume and circumference reduction and skin graft ‘take’ was 88 per cent. There were no operative and a few minor postoperative complications in both the procedures, infection being most notable in those who had undergone Charles' operation. The hospital stay was 7–10 days in LNVS and 21–36 days in Charles' operation. There was no mortality. The long-term results of the present study in terms of volume and circumference reduction, skin condition and freeness of joint movement were encouraging. It is concluded that, while excisional surgery such as Charles' operation becomes necessary for late states of lymphoedema which have progressed to elephantiasis, nodovenous shunt alone is sufficient to relieve early stages of lymphoedema due to filariasis.
Fine needle aspiration biopsy cytology in the diagnosis of thyroid cancer: Comparative study of 213 operated patients
Authors: Harsoulis P , Leontsinit Maria , Economout A , Gerasimidis T , Smbarounis C 
Published: March 2007

Abstract
Between 1982 and 1984, fine needle aspiration biopsy cytology (ABC) was performed in 1100 patients (aged 14–80, 993 women), with nodular goitre, who had either a solitary cold nodule or dominant hypofunctioning nodule(s) within a multinodular or diffusely enlarged gland. Surgery was performed in 213 patients based on clinical and cytological criteria, and the histology of the surgical specimens was correlated with the cytological findings. ABC specimens were sufficient for cytological diagnosis in 190 patients and were classified as malignant (positive), suspicious or benign. In 37 patients who had a final histological diagnosis of malignancy, cytology was positive or suspicious in 33 and benign in 4. In the remaining 153 patients with benign histology there were 7 positive or suspicious aspirates, and 146 benign. The 37 malignancies included papillary carcinomas in 26 patients (24 positive or suspicious and 2 benign on cytology), Hürthle-cell tumours in 6 (6 positive), follicular carcinoma in 1 (negative), anaplastic carcinoma in 1 (suspicious), medullary carcinoma in 2 (1 positive, 1 negative), and lymphoma in 1 (positive). Our results indicate that the overall sensitivity rate of the ABC method for cancer was 89·2 per cent, the diagnostic specificity 95·4 per cent, the false-positive rate 17·5 per cent and the false negative rate 2·6 per cent. The overall accuracy of the method was 94·2 per cent. It is concluded that papillary and Hürthle-cell carcinomas can be diagnosed accurately with ABC but we recommend that the method be used in conjunction with clinical information and other conventional diagnostic procedures.
The clearance of 125I-labelled fibrin from the subcutaneous tissue of limbs with lipodermatosclerosis
Authors: Leach R D , Browse N L 
Published: March 2007

Abstract
The clearance of radioactive fibrin from the subcutaneous tissues has been measured in the rat and in the limbs of normal subjects, patients with varicose veins, and patients with lipodermatosclerosis. The animal experiments showed that the most effective way of producing a subcutaneous deposit of fibrin was by the simultaneous injection of labelled fibrinogen and thrombin. The clearance of these clots was delayed when fibrinolysis was depressed with ε-aminocaproic acid. Clearance of subcutaneous fibrin in man was significantly slower in the arms of patients with varicose veins and lipodermatosclerosis. Similarly clearance in the legs of patients with lipodermatosclerosis was significantly slower than that of the normal subjects and those with uncomplicated varicose veins. The clearance of fibrin from the legs of patients with lipodermatosclerosis was significantly slower than the clearance from their arms but there was no difference between arm and leg clearance in the normal subjects and those with uncomplicated varicose veins. The patients with lipodermatosclerosis had a significantly longer dilute blood clot lysis time. The inability to clear subcutaneous fibrin may be an aetological factor of lipodermatosclerosis.
Differential effects of sacral anterior root stimulation on anal sphincter and colorectal motility in spinally injured man
Authors: Varma J S , Binnie N , Smith A N , Creasey G H , Edmond P 
Published: March 2007

Abstract
The motility responses of the sigmoid colon, rectum and external anal sphincter to sequential electrical stimulation of the anterior sacral roots (S2, S3 and S4) were studied in five patients with traumatic spinal cord injury. Identical and reproducible results were obtained. S2 stimulation provoked isolated low-pressure colorectal contractions. S3 stimulation initiated high-pressure colorectal motor activity which appeared peristaltic and was enhanced with repetitive stimuli. This response appeared to be frequency-dependent. S4 stimulation increased colonic and rectal tone. External sphincter activity was stimulated in increasing order from S2 to S4. These observations directly elucidate the central control of colorectal motility and may have implications in the treatment of severe constipation following spinal injury.
Decreased interleukin−2 production in patients with gastrointestinal cancer
Authors: Monson J R T , Ramsden Carol , Guillou P J 
Published: March 2007

Abstract
Mitogen-stimulated basal and maximal interleukin-2 production has been measured in 60 control subjects and 45 patients with gastrointestinal cancer (14 localized and 31 advanced). Peripheral blood T cell subsets in these subjects were also measured. In patients with advanced gastrointestinal cancer interleukin-2 production (mean ± s.e.m. units/ml) is impaired when compared with that of control subjects (26·5 ± 7 versus 61·1 ± 9, P &lt; 0·0001) or patients with localized cancer (26·5 ± 7 versus 59·4 ± 13, P &lt; 0·02). This cannot be restored to normal by in vitro irradiation of the lymphocytes, suggesting that the impaired function is not due to IL-2 suppressor cells. Using monoclonal antibodies the percentages of T cell subsets were similar in all groups and we therefore conclude that the reduced production of IL-2 in these patients is due to deficient helper T cell function. These results provide a rational basis for the administration of exogenous IL-2 in the future management of patients with advanced gastrointestinal cancer.
Subtotal versus total gastrectomy for cancer of the lower two-thirds of the stomach: A new approach to an old problem
Authors: Gennari L , Bozzetti F , Bonfanti G , Morabito A , Bufalino Rosaria , Doci R , Andreola S 
Published: March 2007

Abstract
Many surgeons favour total gastrectomy (TG) ‘de principe’ in the treatment of gastric cancer, but final demonstration of its advantage over subtotal gastrectomy (SG) is still lacking. We analysed survival after curative TG or SG within groups of patients stratified according to the main prognostic variables as found in multivariate analysis, i.e., nodal status, degree of invasion of the gastric wall, patient age and sex. Our series consisted of 361 patients treated by curative SG and 41 by curative TG, admitted to the Istituto Nazionale Tumori of Milan between 1965 and 1979. In patients with lymph node involvement survival appeared to be significantly better (P = 0.0005) after SG. However, stratifying for age it was found that the benefit was limited to patients over 60 years old. No significant difference in survival was found in the group without nodal involvement (N —) and invasion of the wall to the serosa or beyond. No statistical comparison was possible in N — groups with invasion confined to mucosa, submucosa or muscularis propria because of the small number of such patients who underwent TG. We conclude that SG still represents the standard reference operation for gastric carcinoma provided that a safe proximal margin of resection is guaranteed.
Clinical and immunological results of segmental splenectomy in schistosomiasis
Authors: Kamel R , Dunn M A , Skelly R R , Kamel I A , Zayed M G , Ramadan M , Cahill R A , el Maharakawy S , Ismail A , Ahmed A 
Published: March 2007

Abstract
We evaluated segmental splenectomy in 51 patients who required splenectomy to relieve the symptoms of schistosomal splenomegaly, and compared their course with that of 44 patients who underwent total splenectomy in an unrandomized study. We describe a minor modification of our initial technique. Patients having segmental splenectomy had a similar postoperative course to those having total splenectomy. Conversion of a segmental to a total splenectomy was required in two cases due to technical faults. No regrowth of the spleen has occurred in up to 4 years of observation. We noted an increased percentage of T lymphocytes with an increased ratio of T helper to T suppressor cells in patients having segmental splenectomy. Our cumulative experience supports adoption and wider evaluation of segmental splenectomy in schistosomiasis.
Synchronous abdominotrans-sphincteric resection of low rectal cancer: New technique for direct colo-anal anastomosis
Authors: Lazorthes F , Fages P , Chiotasso P , Bugat R 
Published: March 2007

Abstract
Sixty-five patients with low rectal cancer 4–9 cm from the anal margin were treated by rectal resection and direct colo-anal anastomosis. The procedure simultaneously combined abdominal dissection with the patient in the lateral position with a trans-sphincteric approach. In 57 cases a temporary defunctioning colostomy was performed. There were no postoperative deaths. Six patients (9 per cent) developed pelvic sepsis or anastomotic leakage. Faecal continence was normal in 46 of 51 patients (91 per cent) who were operated on at least 1 year previously. The remaining 5 complained of occasional minor soiling. No patients require a permanent colostomy for incontinence. Of 29 patients treated for potential cure &gt; 3 years previously, 24 (82 per cent) were alive without recurrence. Local recurrence occurred in four patients (6 per cent). Direct colo-anal anastomosis using a combined abdominotrans-sphincteric approach has produced good functional results without impairing the patient's life expectancy.
Conservative management of breast cancer
Authors: Sarrazin Danièle , Dewar J A , Arriagada R , Benhamou Simone , Benhamou Ellen , Lasser P , Fontaine Franc̨oise , Travagli J P , Spielmann M , le Chevalier T , Contesso Geneviève 
Published: March 2007

Abstract
Between 1970 and 1982, 592 patients with T1 and small T2 breast cancers were treated at the Institut Gustave-Roussy by a combination of conservative surgery and radiotherapy. Mean follow-up was 78 months. The actuarial survival rate at 5 and 10 years was 92 per cent and 80 per cent respectively. There were 36 locoregional relapses of which 26 were within the treated breast. The actuarial relapse rate within the breast was 5 per cent at 5 years. If operable, a relapse within the breast did not significantly affect overall survival. The efficacy of conservative management of small breast tumours is confirmed.
Effect of the method of biopsy on the prognosis of and reliability of receptor assays in patients with operable breast cancer
Authors: Fentiman I S , Millis R R , Chaudary M A , King R J B , Miller K J , Hayward J L 
Published: March 2007

Abstract
A comparison has been made of the survival of contemporary patients treated by mastectomy in whom the original diagnosis was made by either Tru-cut biopsy or by excision biopsy. After a minimum of 5 years of follow-up there was no difference in survival between those biopsied by either method. When subdivided by tumour size again no differences emerged. Among those patients in whom the original Tru-cut biopsy was false negative there was no difference in survival compared with those treated by excision biopsy. This suggests that Tru-cut biopsy is a safe method for obtaining a histological diagnosis in operable breast cancer. Furthermore, when the receptor status of the tumours from the two groups was determined, there was no difference in the percentage of oestrogen receptor positive tumours, nor in the mean receptor value. However, there were more progesterone receptor positive tumours among the Tru-cut group, suggesting that a better tumour sample could have been submitted for analysis. This may be yet another advantage for the use of Tru-cut biopsy for the diagnosis of breast cancer.
Breast scintigraphy with 99mTc-diethylene triamine penta-acetic acid for the detection of malignant disease
Authors: den Outer A J , Pauwels E K J , Zwaveling A , Puylaert J B , Hermans J , de Lange E E 
Published: March 2007

Abstract
A single-blind prospective study of 99mTc-diethylene triamine penta-acetic acid (DTPA) breast scintigraphy was performed on 160 women who presented at the outpatient clinic with suspected breast tumour. The sensitivity of scintigraphy in establishing the diagnosis of breast cancer was 75 per cent. The specificity of scintigraphy in excluding the presence of breast cancer was 91 per cent. The diagnostic value of DTPA breast scintigraphy is at present too low in comparison with mammography to be clinically useful.
Effect of surgical experience on the results of resection for oesophageal carcinoma
Authors: Matthews H R , Powell D J , McConkey C C 
Published: March 2007

Abstract
From 1957 to 1976 oesophageal resection for carcinoma was performed in 1119 patients reported to the West Midlands Cancer Registry. The operations were performed on 581 patients by 127 surgeons who averaged three or less resections per annum the ‘occasional' group’. These were compared with 538 patients (the ‘frequent’ group) whose resections were performed by four surgeons who averaged six or more resections per annum. Operative mortality was 39·4 per cent in the ‘occasional’ group and 21·6 per cent in the ‘frequent’ group (P &lt; 0·001). The age adjusted 5-year survival was 11·1 and 15·2 per cent respectively (P &lt; 0·05) but when the operative deaths were excluded there was no significant difference. We suggest that oesophageal resection for carcinoma should be performed only where there is an acceptably low operative mortality rate.
Adenolymphoma of the parotid: Aetiology, diagnosis and treatment
Authors: Ebbs S R , Webb A J 
Published: March 2007

AbstractIn order to study the changing clinical pattern, diagnosis and surgical treatment of adenolymphoma, the records of all 57 patients with a confirmed histological diagnosis, made at Bristol Royal Infirmary between 1951 and 1984, were reviewed; in 3 patients (5 per cent) bilateral lesions had been found. No characteristics emerged in a review of the history and clinical examination which would have enabled a correct pre-operative diagnosis to be made. During the period of study the incidence of adenolymphoma increased 24-fold. (Parotid pleomorphic salivary adenomas increased in incidence by only 42 per cent over the same period). Before 1965 all patients were men; between 1965 and 1975 the male to female ratio was 3:1; between 1975 and 1985, 1·6:1. Of the 48 patients who had a relevant history taken 45 were smokers (93·8 per cent). It is postulated that tobacco consumption is important in the development of adenolymphoma, and has produced the changes in incidence and sex ratio. Fine needle aspiration biopsy cytology (FNAB) afforded the only method of achieving a pre-operative diagnosis. This was successful in 64·7 per cent. Superficial parotidectomy induced a 43 per cent incidence of facial nerve neurapraxia. Controlled enucleation reduced this to 8 per cent. Enucleation is the procedure of choice for adenolymphoma but can only be employed with confidence if an exact pre-operative diagnosis is made.
Failure to improve survival by improved diagnostic techniques in patients with malignant jaundice
Authors: Gillen P , Peel A L G 
Published: March 2007

Abstract
In a consecutive series of 118 patients with malignant obstructive jaundice at North Tees General Hospital only 70 patients were adjudged fit to undergo surgery. Tumour resection was possible in only four patients. Palliative bypass was performed in 45 patients while 21 patients had no procedure other than an exploratory laparotomy. In contrast to the accuracy of investigation the results of surgery have been poor with considerable mortality (42·8 per cent) and lack of long-term survivors. The results emphasize the role of non-surgical methods for relieving jaundice of malignant aetiology, especially in frail elderly patients and those who have metastases at the time of presentation.
Bile peritonitis after removal of T-tubes from the common bile duct
Authors: Corbett C R R , Fyfe N C M , Nicholls R J , Jackson B T 
Published: March 2007

Abstract
Bile peritonitis can occur when a T-tube is electively removed from the common bile duct, but this is regarded as a rare complication. Plastic T-tubes are known to increase the risk and should not be used. Latex rubber T-tubes are preferred but the complication can still occur. We present three patients with this complication despite the use of a latex T-tube. A questionnaire was sent to 107 surgeons in the South East Thames Region. The replies showed that the complication is far more common than generally realized. Based on these replies the risk of bile peritonitis each time a latex T-tube is electively removed from the common bile duct is calculated to be 0·84 per cent or 1 in every 119 explorations.
Effects of hepatic metastases on resting energy expenditure in patients with colorectal cancer
Authors: Hansell D T , Davies J W L , Burns H J G 
Published: March 2007

Abstract
There are frequent reports that cancer causes an increase in resting energy expenditure (REE), and the presence of hepatic metastases is said to increase REE further. The effect of tumour burden on REE has been measured in 24 patients before and following surgery for colorectal cancer. Fifteen patients had a ‘curative’ resection whereas nine patients were found to have hepatic metastases at the time of surgery. No significant differences in REE were found between the groups either before surgery or at follow-up, by which time all 15 curative resection patients were tumour free and the remaining nine had progression of their hepatic disease. It is concluded that neither surgical removal of the primary tumour nor progression of metastatic hepatic disease significantly alters REE in patients with colorectal cancer.
Influence of tumour site on presentation, management and subsequent outcome in large bowel cancer
Authors: Aldridge M C , Phillips R K S , Hittinger Rosemary , Fry J S , Fielding L P 
Published: March 2007

Abstract
To demonstrate any difference in outcome between patients with carcinoma at various sites within the large bowel, analysis of a large number of patients is necessary. From the Large Bowel Cancer Project, 4292 patients have been evaluated to compare mode of presentation, surgical management, pathological findings and outcome. Carcinoma at the splenic flexure was associated with the highest risk of obstruction (49 per cent); postoperative cardiopulmonary complications (36 per cent); in-hospital mortality (18 per cent); and the lowest age-adjusted 5-year survival (28 per cent), even after curative resection (38 per cent). This survival disadvantage was seen even in those without obstruction. Further, it was not accounted for by differences in age, sex, Dukes' stage or tumour differentiation between the various sites as stratification by these variables failed to alter significance (log rank χ2 = 11·1; d.f. = 4; P &lt; 0·05). Compared with carcinoma of the left colon and rectum, tumours in the right colon were more likely to be poorly differentiated and locally advanced (in terms of fixation and penetration of the bowel wall) but were not associated with a higher risk of either distant spread at presentation or local recurrence. Age-adjusted 5-year survival following curative surgery was higher for the right colon (65 per cent) than the left (59 per cent).
Influence of anticoagulant treatment in preventing graft occlusion following saphenous vein bypass for femoropopliteal occlusive disease
Authors: Kretschmer G , Wenzl E , Wagner O , Polterauer P , Ehringer H , Minar E , Schemper M 
Published: March 2007

Abstract
Seventy-one patients underwent a classical reversed saphenous vein graft for femoropopliteal occlusive disease and were enrolled in a controlled clinical trial. During the second postoperative week the patients were allocated randomly into one of two groups; group 1 consisted of 34 patients who received coumarine, group 2 (37 patients) served as a control group without any anticoagulant treatment. The mean follow-up was 18 months. After 12 months the cumulative patency rate was 81 per cent and after 18 months 75 per cent; for patients receiving coumarine treatment, the respective figures were 90 and 82 per cent and for those with no anticoagulant treatment 72 and 67 per cent, the decrease being significant. When the bypass operation was performed for limb salvage (clinical stages III and IV) the overall results were worse (12 months, 72 per cent; 18 months, 68 per cent) than in stage II and stage II–III (12 months, 90 per cent; 18 months, 85 per cent). In limb salvage surgery the positive effects of anticoagulant treatment were significant (with treatment: 12 months, 87 per cent; 18 months, 87 per cent; without treatment: 12 months, 60 per cent; 18 months, 53 per cent). The site of the distal anastomosis (above knee: 12 months, 81 per cent; 18 months, 73 per cent versus below knee: 12 months, 80 per cent; 18 months, 75 per cent) did not have any demonstrable influence on the patency rate.
Early postoperative course following elective splenectomy in haematological diseases: A high complication rate in patients with myeloproliferative disorders
Authors: Malmaeus J , Akre T , Adami H-O , Hagberg H 
Published: March 2007

Abstract
One hundred and sixty-seven patients subjected to splenectomy on haematological indications were studied. They were grouped into five diagnostic categories: auto-immune disorders (52 patients), Hodgkin's disease (32) lymphoproliferative malignancies (60), myeloproliferative malignancies (18) and miscellaneous (5). The total number of complications and deaths were 42 (25 per cent) and nine (5 per cent), respectively. Infections were the most common complication, occurring in 30 cases and accounting for 59 per cent of all sequelae. Patients with auto-immune disorders had a high frequency of subphrenic left-sided abscesses (5/52). Splenectomy for Hodgkin's disease was associated with a very low frequency of complications. In the 60 patients with lymphoproliferative malignancies left-sided pneumonia was common (9/60). Complications occurred in 56 per cent of the patients with myeloproliferative disorders, the associated mortality rate being 28 per cent. It is concluded that elective splenectomy in haematological diseases seems to be a safe procedure in most patients with the exception of individuals with myeloproliferative malignancies. The high operative risk in this group makes the benefit questionable. In patients with auto-immune disorders the high frequency of subphrenic abscesses indicates that prophylactic antibiotic treatment should be considered.