bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful use of size-mismatched liver allografts in children by delayed primary closure of the abdominal wall
Authors: Soin A S , Friend P J , Noble-Jamieson G , Watson C J E , Jamieson N V , Calne R Y , Barnes N 
Published: February 2007

Abstract
Children who are too ill to await a liver graft of suitable size may be transplanted with a relatively oversized graft by leaving the abdominal wound partially open, the defect being bridged with polypropylene mesh and the mesh reduced in stages until it can be removed and the wound directly closed. This technique has been used in seven children who received nine grafts (five reduced and four full size). Their mean age was 7·3 (range 0·5–11) months and mean weight 5·8 (range 2·3–7·2) kg. Progressive reduction in the size of the transplanted liver made primary closure possible in survivors in up to four stages. Over a follow-up period of 3 to 58 months, five of the nine grafts and five of the seven patients survived. No significant complications attributable to the technique were encountered. The technique of delayed primary abdominal wall closure may be of benefit in children at risk of graft failure because of a size-mismatched graft.
Prospective randomized trial comparing sequential avulsion with stripping of the long saphenous vein
Authors: Khan B , Khan S , Greaney M G , Blair S D 
Published: February 2007

Abstract
Eighty patients with primary varicose veins of the long saphenous system were randomized to have the long saphenous vein removed either by stripping to below the knee or by sequential avulsion. There was no difference between the two methods in the time taken to remove the vein. There was significantly more pain after stripping during the week following operation (P &lt; 0.001). Median pain score after stripping was 5, reducing to 3 at 1 week, compared with 2, reducing to 1, for sequential avulsion. Median area of bruising measured at 1 week was 160 (range 0–1800) cm2 for stripping and 56 (range 0–544) cm2 for sequential avulsion (P &lt; 0.01). Sequential avulsion is less painful, reduces bruising and avoids a significant scar below the knee.
Biomechanical stabilization of the nipple valve in continent ileostomy
Authors: Ecker K W , Hildebrandt U , Haberer M , Feifel G 
Published: February 2007

Abstract
Despite stapler stabilization, sliding complications of nipple valve function occur in 19 per cent of continent ileostomies. Because the tendency of the ileum to desuscept is triggered by traction forces on the mesentery of the nipple during filling of the reservoir, a technique was developed to neutralize this biomechanical strain. In addition, to obtain fibrous healing between the muscular layers, the mucosa of contacting intestinal walls was removed by selective ultrasonic fragmentation. The valves of 18 consecutive patients were operated on with this technique. In six of these, a sliding valve was restabilized in a median time of 1·2 (range 0·4–2·9) years after conventional construction of the pouch. All are functioning well after a median of 4·6 (range 3·0–6·0) years. Between 1·8 and 4·8 years after operation a healed area between the musculature of the nipple and pouch of 4·5–7·2 cm2 was shown by endosonography. This procedure may provide long-term prevention of sliding complications in continent ileostomies.
Prognostic significance of lymph node dissection in gastric cancer
Authors: De Manzoni G , Verlato G , Guglielmi A , Laterza E , Genna M , Cordiano C 
Published: February 2007

Abstract
The results for 162 patients who underwent curative gastrectomy for gastric cancer from January 1988 to June 1994 were analysed statistically with special reference to the effect of lymph node dissection. Median survival was 69·3 months and the overall cumulative 5-year survival rate was 50·2 (95 per cent confidence interval (c.i.) 41·6–58·1) per cent. By univariate analysis age, histology, depth of tumour invasion, node involvement, number of metastatic lymph nodes and type of lymphadenectomy were found to be significant factors related to survival time. Multivariate analysis with the Cox model and stratified for tumour node metastasis stage revealed that only the number of metastatic nodes (P = 0·04) and the extent of lymphadenectomy (P = 0·003) affected survival independently. With respect to D, lymphadenectomy, the relative risk associated with D2 and D4 lymphadenectomy was respectively 0·61 (95 per cent c.i. 0·34–1·10) and 0·26 (95 per cent c.i. 0·12–0·60). The 5-year survival rate was 28 per cent for patients who had a D1 dissection, 63 per cent for those who had D2 and 68 per cent for those who had D4. These results suggest that extended lymphadenectomy (D2) and especially superextended lymphadenectomy (D4) can improve survival in patients with gastric cancer.
Salvage treatment for inoperable neck nodes in head and neck cancer using combined iridium-192 brachytherapy and surgical reconstruction
Authors: Cornes P G S , Cox H J , Rhys-Evans P R , Breach N M , Henk J M 
Published: February 2007

Abstract
The results of debulking surgery and re-irradiation with radioactive implants (brachytherapy) are reported for 39 patients with inoperable metastatic neck nodes from primary head and neck cancers. For 13 patients conventional salvage by partial debulking surgery and brachytherapy proved effective, with 68 per cent control at 1 year, but six patients suffered severe radiation fibrosis, necrosis and contractures. Some 26 patients were treated by combined tumour debulking, skin resurfacing and brachytherapy implant. Initial tumour control and freedom from serious toxicity was achieved in 24 patients. Local control was achieved in 63 per cent of patients at 1 year, with a serious morbidity rate of 12 per cent.
Papillary microcarcinoma of the thyroid gland
Authors: Bramley M D , Harrison B J 
Published: February 2007

Abstract
Papillary microcarcinomas are a specific subgroup of papillary thyroid cancer. They have the same histological features as papillary thyroid cancer but are 1.0 cm or less in diameter. These tumours are a common incidental finding at autopsy and in thyroid glands excised for other pathology. This tumour can metastasize to regional lymph nodes but its ability to cause significant morbidity and mortality has been questioned. As papillary micro-carcinomas can represent up to 30 per cent of all papillary cancers seen in a thyroid surgeon's practice, they are an important group. The aim of this review article is to outline the natural history of papillary microcarcinoma and to offer therapeutic management strategies.
Oesophageal function testing and antireflux surgery
Authors: McLauchlan G 
Published: February 2007

Abstract
Despite the increasing emphasis that is placed on both pH measurement and oesophageal manometry, there is little consensus about their usefulness in the clinical setting. These tests are far from infallible and it is difficult to support their universal application in patients with gastro-oesophageal reflux disease. Nevertheless, these imperfect tests are useful in certain situations and clinicians must strive to use them intelligently for those most likely to benefit.
Influence of cholecystectomy on bile duct width
Authors: Hammarström L-E , Holmin T , Ebbesen A , Stridbeck H 
Published: February 2007

Abstract
The results of published prospective studies on changes in bile duct width after cholecystectomy are contradictory and comprise relatively few patients, often after short or medium-term follow-up. The objectives of this prospective long-term follow-up study were to investigate whether bile duct width increased significantly after cholecystectomy and to seek evidence of biliary obstruction in patients with excessively dilated ducts.
Pneumonia presenting with acute abdominal pain in children
Authors: Ravichandran D , Burge D M 
Published: February 2007

Abstract
Abdominal pain is a common cause of emergency admission in children. Although often due to appendicitis and other intra-abdominal causes, extra-abdominal conditions, especially pneumonia, can simulate an acute abdominal catastrophe. Accurate and prompt diagnosis is essential, not only to avoid general anaesthesia and a negative laparotomy in the presence of pneumonia but also to start antibiotic therapy early so as to prevent the complications of pneumonia.
Quick and simple distal pancreatectomy using the GIA stapler: Report of 35 cases
Authors: Kajiyama Y , Tsurumaru M , Udagawa H , Tsutsumi K , Kinoshita Y , Akiyama H 
Published: February 2007

Abstract
A method for distal pancreatectomy using the multifire GIA-80 stapler (US Surgical, Nonvalk, Connecticut, USA) is reported that is quicker, associated with reduced blood loss and a lower incidence of pancreatic fistula than with other instruments such as the TA-55 stapler (Auto Suture, Ascot, UK). When performing total gastrectomy with distal pancreatectomy and splenectomy to complete a wide lymph node dissection in patients with advanced gastric cancer, this method of pancreatectomy can be useful.
Biliary papillomatosis
Authors: Lam C-M , Yuen S-T , Yuen W-K , Fan S-T 
Published: February 2007

Abstract
Biliary papillomatosis is a rare clinicopathological condition characterized by multiple papillary adenomas involving extensive areas of the biliary tree1. The pathophysiology, clinical features and management of this condition are not well understood. Experience of six patients with biliary papillomatosis is reported.
Colour-coded duplex imaging can safely replace diagnostic arteriography in patients with lower-limb arterial disease
Authors: Pemberton M , Nydahl S , Hartshorne T , Naylor A R , Bell P R F , London N J M 
Published: February 2007

Abstract
The purpose of this study was to review the outcome of adopting colour-coded duplex ultrasonography as the primary imaging modality in patients with symptomatic lower-limb arterial disease. Over a 12-month period 467 consecutive lower-limb duplex scans were performed of which 437 (94 per cent) were technically adequate. Of the 467 limbs, 184 (39 per cent) were managed conservatively, 230 (49 per cent) were referred for percutaneous transluminal angioplasty (PTA), 41 (9 per cent) underwent reconstructive surgery and 12 (3 per cent) required diagnostic arteriography. In patients referred for PTA there were only 22 (10 per cent) unexpected findings; there was agreement about superficial femoral artery occlusion length in 95 (89 per cent) of 107 limbs and about the presence or absence of a superficial femoral artery stump in 91 (85 per cent) of 107 cases. In patients referred for surgery there were no unexpected findings. Colour-coded duplex imaging can safely replace diagnostic arteriography in up to 97 per cent of lower limbs with arterial disease.
A 45-year perspective of congenital diaphragmatic hernia
Authors: Vanamo K 
Published: February 2007

Abstract
The records of 174 consecutive patients with congenital diaphragmatic hernia were reviewed to analyse the changes in the presentation, treatment and outcome during the 45-year interval from 1948 to 1992. For comparison the period was divided into years 1948–1962, 1963–1972, 1973–1982 and years 1983–1992. The proportion of high-risk cases (symptomatic within 6 h of birth) increased from 50 per cent during the first period to 77 per cent during the second, to 86 per cent during the third and to 94 per cent during the fourth. The primary mortality rate (death within 30 days of diaphragmatic repair) increased from 25 per cent during the first period to 35 per cent during the second, 46 per cent during the third and 49 per cent during the fourth. No change occurred in the proportion of infants with diaphragmatic hernia who were stillborn or who died in the maternity unit. Post-mortem lung weight was available in 56 children. Severe pulmonary hypoplasia correlated with early postoperative death and clinical severity. The mean(s.d.) lung weight ratio (combined lung weight divided by the lung weight expected for the body-weight) decreased from 0.70(0.49) during the second period to 0.56(0.36) during the third and 0.40(0.18) during the fourth. The increased proportion of more severe cases with very hypoplastic lungs explains the rise in the mortality rate of patients operated on for congenital diaphragmatic hernia. This may reflect a real change in the disease spectrum rather than improved referral.
Palliation of oesophageal carcinoma using the argon beam coagulator
Authors: Robertson G S M , Thomas M , Jamieson J , Veitch P S , Dennison A R 
Published: February 2007

Abstract
Oesophageal intubation occasionally fails to palliate inoperable carcinoma: some tumours are unsuitable for this procedure and others overgrow the tube. This study reports a series of nine patients (median age 79 (range 55–87) years) in whom the argon beam monopolar coagulator via a flexible endoscopic probe was used to ablate such tumours. Fourteen ablation procedures were performed. The endoscope was passed to the stomach at the end of each procedure. There were no complications; the median hospital stay was 2 (range 1–13) days. Thirteen procedures rendered the patients completely asymptomatic for a median of 6 (range 4–12) weeks. Six patients died a median of 14 (range 4–38) weeks after the first ablation, reflecting their limited life expectancy. The argon beam coagulator provides an effective alternative to laser ablation, being considerably cheaper and safer, while maintaining the minimally invasive nature of the palliation.
Quality of life following resection of oesophageal carcinoma
Authors: Zieren H U , Jacobi C A , Zieren J , Müller J M 
Published: February 2007

Abstract
Quality of life following resection of oesophageal carcinoma was assessed by patients using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and by a psychologist using the Spitzer Index. Quality of life was evaluated in 119 patients on one occasion 12 months after operation and in 30 patients regularly, starting with a preoperative assessment. Self and external evaluation showed a significant correlation (r = 0.61), but quality of life was assessed as being higher by the external observer. Limited physical performance status and somatic complaints were the most important postoperative dysfunctions, whereas emotional, social and economic disorders were found to be less frequent and less severe. Of several factors analysed only tumour recurrence (P&lt;0.01) and anastomotic stricture (P&lt;0.05) lowered quality of life significantly. Compared with the preoperative assessment, quality of life had decreased on discharge from hospital but was restored within 6 months of operation in disease-free patients. Further studies are required to determine the impact of adjuvant therapy for quality of life in patients undergoing surgery for oesophageal cancer.
Preoperative risk assessment in elective general surgery
Authors: Klotz H P , Candinas D , Platz A , Horvàth A , Dindo D , Schlumpf R , Largiadèr F 
Published: February 2007

Abstract
Despite improved surgical techniques there is still a risk of mortality in elective general surgery. In a prospective study preoperative data from 3250 patients were collected and compared with postoperative systemic complications, using univariate χ2 analysis. Highly significant (P&lt; 0.00001) variables were subjected to stepwise logistic regression analysis. The severity of operative procedure, higher American Society of Anesthesiologists (ASA) grade, symptoms of respiratory disease and malignancy were found to be significant risk factors predicting postoperative morbidity (P&lt;0.05). Using these four variables, a simple preoperative risk scoring system has been defined. Class A (up to 5 points) was defined as a low-risk group (systemic complication rate 5.0 per cent), class B (5–7 points) was intermediate risk (systemic complication rate 17.9 per cent) and class C (8–10 points) was high risk (systemic complication rate 33.3 per cent). Patients at high risk for perioperative and postoperative complications are more likely to be identified by this analysis than by using the ASA classification alone.
Chemical composition and potential hazards of electrocautery smoke
Authors: Sagar P M , Meagher A , Sobczak S , Wolff B G 
Published: February 2007

Abstract
Electrocautery is widely used for dissection of tissues and cauterization of blood vessels. A visible plume of smoke is produced, which has an unpleasant odour and can induce acute and chronic inflammatory changes in the respiratory tract'. Airborne particles arc not effectively filtered or evacuated by operating room scavenging systems and facial masks only offer protection from large particles. Little is known about the chemical composition of this smoke and the health risks to the operating room staff have not been identified.
The aim of this study was to determine the chemical composition of electrocautery smoke produced in the course of standard colorectal surgery.
Angiographic Estimation of Relative Coronary Artery Flow Based on Terminal Branching Patterns
Authors: Page Harry L. , Engel H. Jurgen 
Published: February 2007

AbstractAngiographically “terminal” coronary arterial branches were counted in 100 normal coronary cineangiograms to investigate the possibility that three left ventricular wall regions might be defined by identifying patterns of arterial inflow. An average of 45% of the terminal branches were counted in the anterior region supplied by the anterior descending coronary artery; 25% were counted in the lateral region supplied by diagonal and obtuse marginal arteries, and 30% were counted in the inferior region supplied by the distal circumflex and distal right arteries. Based upon the hypothesis that blood flow through an artery is directly proportional to the number of small branches into which it ramifies, this approach affords an estimate of the relative contribution by individual coronary arteries to total left ventricular perfusion. This concept could prove useful in defining a quantitative grading system of coronary arterial Inflow obstruction.
Exercise Stress Testing in Patients with Chest Pain and Normal Coronary Arteriography: With Review of the Literature
Authors: Goodin Robert R. , Graham Jerry M. , Gwinn James S. , Masden Ronald R. , McMartin Daniel E. , Flowers Nancy C. 
Published: February 2007

AbstractEighty of 654 patients studied because of chest pain were found to have normal coronary arteriography. Fifty of these completed submaximal treadmill exercise studies. The purpose of this study was to determine whether treadmill electrocardiography could obviate the need for coronary arteriography in the evalution of patients with undiagnosed chest pain. Of patients studied, 22% had typical angina pectoris, while 78% had atypical chest pain. The resting electrocardiogram was normal in 58% of patients, while 42% showed repolarization abnormalities. Submaximal treadmill testing was normal in 64%, incomplete in 12%, and demonstrated classic ischemic S‐T depression in 24%. Our findings of 24% positive studies in patients with normal vessels and 12% incomplete tests suggest that stress electrocardiography may be of limited value in predicting the morphologic state of the coronary arteries in patients with undiagnosed chest pain.
Evaluation of left ventricular performance in coronary heart disease: Use of isometric handgrip stress test
Authors: Helfant Richard H. , Devilla Maria A. , Banka Vidya S. 
Published: February 2007

AbstractThe usefulness of isometric handgrip exercise in the assessment of left ventricular function was studied in 27 patients, all of whom had angiographically documented coronary artery disease. The effect of extensiveness of coronary disease and presence or absence of collaterals (both delineated by coronary arteriography) on the response to handgrip stress was also evaluated. Of 11 patients with a normal handgrip response, 4 exhibited a normal left ventriculogram and 7 were abnormal. Of these 7, 6 had inferior hypokinesis. Conversely, of 16 patients with an abnormal response, to handgrip, 15 had abnormal ventriculograms. Of these, 9 had anterior akinesis. Of patients with a normal handgrip response 82% had two‐ or three‐vessel coronary disease, and 94% with an abnormal response exhibited two‐ or three‐vessel obstruction. There was no observed correlation between the presence or absence of collaterals and the response to handgrip. This study indicates that (1) handgrip stress, when combined with left ventriculography, often yields important additional information regarding the effect of localized contraction abnormalities on overall left ventricular performance; (2) the extent of coronary obstructive disease or the presence of collaterals per se do not appear to be the primary determinants of left ventricular performance; (3) it is possible that the location as well as severity and extent of left ventricular contraction abnormality may play an important role in determining overall left ventricular performance.
Cineangiographic measurements with the help of a vertebral grid system
Authors: Wagner H. R. , Teske D. W. , Siu T. Oswald 
Published: February 2007

AbstractCineangiographic measurements of cardiac structures require knowledge of the magnification factor due to nonparallelity of the X‐ray beams. A new method is presented to determine the magnification factor from cineangiograms based on the patient's height and the height of three vertebral bodies and the adjacent intervertebral distances. The method enables measurement of cardiovascular structures from projected cineangiographic films where the appropriate magnification factor is missing. Furthermore, doubtful magnification factors can be checked out as to their accuracy.
First heart sound: A phono‐echocardiographic correlation with mitral, tricuspid, and aortic valvular events
Authors: Prakash Ravi , Moorthy Krishna , Aronow Wilbert S. 
Published: February 2007

AbstractWe evaluated the relationship of S1 recorded by phonocardiography at the mitral area with motion of the mitral, tricuspid, and aortic valves, recorded by simultaneous echocardiography in 20 cardiac patients with a normal PR interval. The first major component of S1 coincided with mitral valve closure in 20 of 20 patients (100%) and also with tricuspid valve closure in 14 of 20 patients (70%). The second major component of S1 coincided with aortic valve opening in 20 of 20 patients and also with tricuspid valve closure in six of 20 patients (30%). We conclude that the first major component of S1 coincides with mitral valve closure in all patients but may also coincide with tricuspid valve closure in many patients, and the second major component of S1 coincides with aortic valve opening in all patients but may also coincide with tricuspid valve closure in some patients.