bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXTRAHEPATIC BILIARY ANATOMY AT LAPAROSCOPIC CHOLECYSTECTOMY: IS ABERRANT ANATOMY IMPORTANT?
Authors: Larobina Marco , Nottle Peter D. 
Published: June 2005

Background:  The prevention of major duct injury at cholecystectomy relies on the accurate dissection of the cystic duct and artery, and avoidance of major adjacent biliary and vascular structures. Innumerable variations in the anatomy of the extrahepatic biliary tree and associated vasculature have been reported from radiographical and anatomical studies, and are cited as a potential cause of bile duct injury at cholecystectomy.Methods:  A photographic study of the dissected anatomy of 186 consecutive cholecystectomies was undertaken and each photo analysed to assess the position of the cystic duct and artery, the common bile duct and any anomalous structures.Results:  The anatomy in the region of the gallbladder neck was relatively constant. Anatomical variations were uncommon and anomalous ducts were not seen. Vascular variations were the only significant abnormalities found in the present series.Conclusion:  Anatomy in the region of the gallbladder neck varies mostly in vascular patterns. Aberrant ducts or duct abnormalities are rarely seen during cholecystectomy hightlighting the principle that careful dissection and identification is the key to safe cholecystectomy.
OPTIMUM DURATION OF PROPHYLACTIC ANTIBIOTICS IN ACUTE NON‐PERFORATED APPENDICITIS
Authors: Mui Lik Man , Ng Calvin S. H. , Wong Simon K. H. , Lam Yuk‐Hoi , Fung Terence M. K. , Fok Kar‐Lung , Chung Sydney S. C. , Ng Enders K. W. 
Published: June 2005

Background:  The effect of extended prophylactic antibiotic therapy on postoperative infective complications such as wound infection and intra‐abdominal abscess for non‐perforated appendicitis is poorly defined.Methods:  In a randomized controlled trial of 269 patients aged 15–70 years with non‐perforated appendicitis undergoing open appendicectomy; 92 received single dose preoperative (group A), 94 received three‐dose (group B) and 83 received 5‐day perioperative (group C) regimens of cefuroxime and metronidazole. Postoperative infective complication was the primary endpoint. Secondary outcomes included length of hospital stay and complications related to antibiotic therapy.Results:  The rate of postoperative infective complication was not significantly different among the groups (6.5% group A, 6.4% group B, 3.6% group C). The duration of antibiotic therapy had no significant effect on the length of hospital stay. Complications related to antibiotic treatment were significantly more common for 5‐day perioperative antibiotic group (C) compared with single dose preoperative antibiotic group (A) (P = 0.048).Conclusion:  Single dose of preoperative antibiotics is adequate for prevention of postoperative infective complications in patients with non‐perforated appendicitis undergoing open appendicectomy. Prolonging the use of antibiotics can lead to unnecessary antibiotic related complications.
REPAIR OF INJURIES TO THE THORACIC AORTA AND GREAT VESSELS: AUCKLAND, NEW ZEALAND 1995–2004
Authors: Baguley Campbell J. , Sibal Amul K. , Alison Peter M. 
Published: June 2005

Background:  Traumatic injury to the aorta and great vessels is a surgical emergency with survivors who reach hospital typically having suffered multiple injuries. There are several diagnostic and treatment options available, with new modalities emerging to challenge the gold standards. A review of recent trends in management of these injuries in Auckland, New Zealand was carried out and patient outcomes assessed.Methods:  The charts of patients admitted to Auckland and Green Lane Hospital's cardiothoracic intensive care unit, with a diagnosis of injury to the thoracic aorta or great vessels since 1995 were retrospectively reviewed. Imaging techniques, injury types and treatment methods were analysed along with survival and neurological morbidity.Results:  In the study period our unit operated on 29 cases of traumatic rupture of the thoracic aorta or great vessels. Digital subtraction angiography and more recently, multidetector computed tomography scanning have been used to diagnose the injury. Twenty‐seven injuries were to the aorta and two to the innominate artery. The 30‐day survival rate of those reaching the operating theatre was 90%. There was one case of postoperative hemiparesis and five cases of recurrent laryngeal nerve injury, but none of spinal cord ischaemic injury. Endoluminal stent grafting was carried out for one patient, without complication.Conclusions:  Good survival rates exist for those who reach surgery for traumatic rupture of the aorta or great vessels. Multidetector computed tomography scanning is an alternative to digital subtraction angiography, potentially reducing treatment delay. In addition endoluminal grafting as opposed to open repair has been reported as a safe technique. The injury remains a surgical emergency requiring urgent diagnosis and transfer to an equipped cardiothoracic unit for definitive treatment.
IS TEMPORAL ARTERY BIOPSY A WORTHWHILE PROCEDURE?
Authors: Chong Elaine W. T. , Robertson Amanda J. 
Published: June 2005

Background: Temporal artery biopsy (TAB) has been accepted as the gold standard for the diagnosis of giant cell arteritis (GCA) or temporal arteritis (TA) even though it is of low sensitivity and specificity. Current medical practice recommends commencing high dose steroids before performing a biopsy, and the continued use of long‐term steroids even if biopsy is negative but clinical suspicion of the diagnosis is high. The aim of the present study is to determine if TAB results actually changes the management of patients suspected of GCA or TA.Methods: Retrospective case note analysis of 70 consecutive patients with TAB over 5 years (1999–2003) from Royal Melbourne Hospital (RMH), Melbourne, Australia.Results: Histology revealed five (7%) positive biopsies, five (7%) of ‘healed arteritis’, and 60 (86%) negative biopsies. After excluding 15 patients who were lost to follow up, management of 13 (23.6%) patients was influenced by the biopsy results: seven with negative biopsies had steroids discontinued while six patients with biopsies showing positive and healed arteritis continued on steroids. Management of 42 (76.4%) patients was not altered following biopsy results: 11 with negative biopsy continued on steroids, 19 never started because of low clinical suspicion and 12 ceased steroids some time after biopsy as there was no symptomatic improvement.Conclusion: With the management of 76.4% of patients unchanged following biopsy, some may argue that these patients underwent unnecessary surgery. However, TAB is a minor procedure that can yield important results for the management of GCA, which if untreated can lead to serious complications. We believe TAB should be performed where there is clinical suspicion of GCA.
THE LEARNING CURVE IN LEARNING THE CURVE: A REVIEW OF NUSS PROCEDURE IN TEENAGERS
Authors: Ong Caroline C. P. , Choo Kelvin , Morreau Philip , Auldist Alex 
Published: June 2005

Background:  The Nuss procedure is a new minimally invasive repair for pectus excavatum that was first published in 1998. Modifications in technique are constantly evolving to minimize complications, especially bar displacement, which are higher in adolescents and adults. The present study reviews our early experience with this procedure in a much older group of children than previously reported and suggests an alternative method of avoiding bar displacement.Methods:  Retrospective chart review was carried out on 78 consecutive patients who underwent the Nuss procedure between December 1999 and January 2004. All patients underwent a uniform technique using bilateral lateral stabilisers and thoracoscopy was not used. Operative details, subjective cosmetic results and complication rates were assessed.Results:  The mean age was 15.4 ± 3.2 years. Single bars were used in 95%, double bars in 5%. The defect was asymmetrical in 26%. The defect was mild in 7%, moderate in 59% and severe in 34%. The median length of stay was 6.0 days (range 4–11). Total operating time was 58 min (range 35–95). Patient controlled analgesia (morphine) for pain relief was used for 105 h (range 61–169) or 4.4 days; the epidural infusion was stopped 1 day earlier. Cosmetic results were excellent in 80.3%. There was residual asymmetry in 75% of the asymmetrical defects although all were improved. Complications included eight (10%) reoperations for bar displacement. This was related to the learning curve as seven of these occurred in the first 2 years of the series. Removal of the bar has been accomplished in 31 (40%) patients. This was elective in all but four patients (three early removals for pain and one for infection).Conclusions:  The Nuss procedure gives good results even in teenagers. Modification of technique and increased experience has reduced complications. The use of bilateral lateral stabilisers without additional wire fixation is an alternative method to avoid bar displacement.
PHRENOLOGY AND THE NEUROSCIENCES: CONTRIBUTIONS OF F. J. GALL AND J. G. SPURZHEIM
Authors: Simpson Donald 
Published: June 2005

The pseudoscience of phrenology arose from the observations and intuitions of Franz Joseph Gall (1758–1828) and his disciple Johann Gaspar Spurzheim (1776–1832). Gall believed that mental functions are localized in discrete parts of the brain, which he called organs. He located the organs subserving intellectual functions chiefly in the cerebral cortex. To support this doctrine, Gall and Spurzheim carried out extensive neuro‐anatomical studies, and made some important discoveries. The Gordon Craig Library contains a book by Spurzheim on the anatomy of the brain, published in London in 1826, which summarizes these discoveries. Gall also believed that the functional strength of the cerebral and cerebellar organs was expressed by their bulk: a well‐developed organ caused a bulge in the overlying cranial bone. Hence, feeling the bumps of the skull was a means of assessing the individual's personality. This very fallacious component of Gall's doctrine had great influence in the nineteenth century, affecting psychiatry, criminology and educational theory. Further research demolished Gall's doctrine, and phrenology sank into disrepute. Nevertheless, phrenological thinking played an important part in the growth of clinical neurology in the second half of the nineteenth century.
Carboplatin and piroxicam therapy in 31 dogs with transitional cell carcinoma of the urinary bladder
Authors: Boria P. A. , Glickman N. W. , Schmidt B. R. , Widmer W. R. , Mutsaers A. J. , Adams L. G. , Snyder P. W. , DiBernardi L. , De Gortari A. E. , Bonney P. L. , Knapp D. W. 
Published: June 2005

AbstractInvasive transitional cell carcinoma (TCC) of the urinary bladder responds poorly to medical therapy. Combining platinum chemotherapy with a cyclooxygenase (cox) inhibitor has shown promise against canine TCC, where the disease closely mimics the human condition. A phase II clinical trial of carboplatin combined with the cox inhibitor, piroxicam, was performed in 31 dogs with naturally occurring, histopathologically confirmed, measurable TCC. Complete tumour staging was performed before and at 6‐week intervals during therapy. Tumour responses in 29 dogs included 11 partial remissions, 13 stable disease and five progressive disease. Two of the 31 dogs were withdrawn prior to the re‐staging of the tumour. Gastrointestinal toxicity was observed in 23 dogs. Hematologic toxicity was noted in 11 dogs. The median survival was 161 days from first carboplatin treatment to death. In conclusion, carboplatin/piroxicam induced remission in 40% of dogs providing evidence that a cox inhibitor enhances the antitumour activity of carboplatin. The frequent toxicity and limited survival, however, do not support the use of this specific protocol against TCC.
Survival analysis of one versus two treatments of local delivery cisplatin in a biodegradable polymer for canine osteosarcoma
Authors: Mehl M. L. , Seguin B. , Dernell W. S. , Lafferty M. , Kass P. H. , Withrow S. J. 
Published: June 2005

AbstractThe purpose of this study was to evaluate one versus two doses of local delivery cisplatin in a biodegradable polymer (OPLA‐Pt) for the treatment of osteosarcoma (OSA) after amputation in dogs. Medical records were reviewed retrospectively, and 105 dogs were included in the study; 39% of dogs received one treatment (surgical implantation) of OPLA‐Pt and 61% of dogs received two treatments of OPLA‐Pt after amputation. Administration of two doses of OPLA‐Pt did not have a significant effect on disease‐free interval or survival time compared to one dose. The anatomic site of the tumour was identified as a prognostic factor, and dogs with proximal humeral OSA had the shortest disease‐free interval and survival times. There was no advantage to giving a second dose of local delivery cisplatin following amputation for the treatment of OSA in dogs.
Intraocular lens power prediction for triple procedures in Fuchs' dystrophy using multiple regression analysis
Authors: Viestenz Anja , Seitz Berthold , Langenbucher Achim 
Published: June 2005

Abstract.Purpose:  To develop a correcting term for intraocular power (IOLP) prediction for penetrating keratoplasty combined with simultaneous extracapsular cataract extraction and posterior chamber lens implantation (triple procedure). Methods:  As part of a prospective clinical study, triple procedures were performed in 42 eyes with Fuchs' dystrophy. Only eyes with readable preoperative K‐values were included in this study. Differences (DEV) between achieved and target refraction (TR) depending on the values of the theoretical‐optical formula according to HAIGIS were investigated using multiple regression analysis in a linear anova model: DEV = a + b CP + c AL + d IOLP + e TR. CP represents central corneal power, AL represents axial length. Results:  Spherical equivalent after suture removal was − 1.39 ± 2.86 D (TR: − 1.64 ± 1.72 D). A multiple regression formula was developed for correction of conventionally calculated IOL power. CP (b = − 1.391, p = 0.028), AL (c = − 4.733, p = 0.007), IOLP (d = − 1.301, p = 0.009) and TR (e = − 1.804, p = 0.005) correlated significantly with DEV (a = 198.684). Conclusion:  Proposed correcting multiple regression formula for IOL power prediction may help to improve the postoperative refractive outcome in patients undergoing triple procedures.
Clinical evaluation of the arched blade for cataract surgery
Authors: Kojima Takashi , Kaga Tatsushi , Watanabe Mitsunori , Uda Keiko , Naito Naohisa , Saito Yutaka , Ichikawa Kazuo 
Published: June 2005

Abstract.Purpose:  To evaluate the efficacy of the arched blade for making clear corneal incisions in cataract surgery. Methods:  This prospective study comprised 112 eyes of 74 patients scheduled for cataract surgery. Temporal clear corneal incisions were made with either a 3.2‐mm conventional flat blade or the arched blade. The choice of knife was randomly assigned. Two surgeons, one with substantial cataract surgery experience and the other with less experience, performed the surgery. Corneal topography and aberration were examined pre‐ and postoperatively. The degree of surgically induced astigmatism (SIA) and high order aberration was analysed. The self‐sealing ability of the wound was also compared between both blades. Results:  For the less experienced surgeon, the degree of SIA was significantly higher with the 3.2‐mm flat blade than with the 3.2‐mm arched blade as measured at any time during postoperative follow‐up. For the more experienced surgeon, the degree of high order aberration increased significantly with the 3.2‐mm flat blade. The incision's self‐sealing ability was significantly better when the wound was made with the arched blade rather than with the flat blade. Conclusion:  The arched blade proved to be effective in reducing surgically induced astigmatism and high order aberration in cataract surgery, particularly when used by the less experienced surgeon. Using the arched blade should lead to better wound self‐sealing and, therefore, safer surgical results.
Increased CD40 ligand in patients with acute anterior uveitis
Authors: Øgard Carsten , Sørensen Torben L. , Krogh Erik 
Published: June 2005

Abstract.Purpose:  The inflammatory response in acute anterior uveitis (AU) is believed to be primarily mediated by autoreactive T‐cells. We wanted to evaluate whether the T‐cell activation marker CD40 ligand is involved in the AU immunopathogenesis. Methods:  We evaluated the expression of the CD40 ligand on CD4+ T‐cells, CD8+ T‐cells and CD19+ B‐cells on peripheral blood mononuclear cells using flow cytometry in six patients with unilateral AU, six patients with monosymptomatic optic neuritis (ON) as inflammatory controls, and in six healthy controls. The ex vivo induction of the CD40 ligand on T‐cells in patients and controls was also studied. Results:  A significantly higher expression of the CD40 ligand on both CD4+ (p < 0.05) and CD8+ (p < 0.05) T‐cells in patients with AU compared to ON patients and healthy controls was found. There was a significantly higher induction of the CD40 ligand on CD8+ T‐cells in AU patients compared to ON patients and healthy controls (p < 0.01). No differences in the B‐cell population were observed between the three groups. Conclusion:  Patients with AU had increased expression of the CD40 ligand on T‐cells in the blood and expressed higher levels of the CD40 ligand when stimulated, compared to ophthalmological inflammatory controls and healthy controls. The data suggest that the CD40 ligand is involved in the development of AU.
The effects of sildenafil on ocular blood flow
Authors: Koksal Murat , Ozdemir Huseyin , Kargi Sebnem , Yesilli Cetin , Tomaç Sühan , Mahmutyazicioglu Kamran , Mungan Aydin 
Published: June 2005

Abstract.Purpose:  To investigate the effects of sildenafil, a popular new drug in the treatment of erectile dysfunction, on ocular blood flow. Methods:  This study was designed as a prospective, double‐blind, placebo‐controlled study. Twenty participants with erectile dysfunction were given a single oral dose of 100 mg sildenafil, while 10 participants with erectile dysfunction were given placebo. All the participants underwent routine systemic and ophthalmological examinations. Intraocular pressure, systolic and diastolic blood pressure and ocular blood flow (ophthalmic, central retinal, short posterior ciliary arteries) were measured in both eyes before and 1 hour after the dose of sildenafil or placebo. Ocular blood flow measurements were performed using colour Doppler ultrasonography. Results:  None of the parameters were significantly different between the groups before study drug intake. Although central retinal artery velocities were not changed, ophthalmic artery and short posterior ciliary artery peak systolic velocity, end‐diastolic velocity, and mean velocity values were significantly increased 1 hour after drug intake in the sildenafil group compared to the placebo group (p < 0.05). Conclusion:  Sildenafil causes a significant increase in blood flow in these arteries. A possible role of inhibition of phosphodiesterase‐5 in vascular smooth muscles by sildenafil is implicated. Further studies are needed to investigate the effects of sildenafil on ocular blood flow in patients with senile macular degeneration, diabetic retinopathy and glaucoma.
Echographic examination with new generation contrast agent of choroidal malignant melanomas
Authors: Forte R. , Cennamo G. , Staibano S. , De Rosa G. 
Published: June 2005

Abstract.Purpose:  To determine the efficacy of echography with new generation contrast agents in visualizing vascularization of choroidal malignant melanomas. Methods:  An echographic contrast medium consisting of phospholipidic microbubbles filled with sulphur hexafluoride (Sonovue®) was used to visualize microcirculation in 25 cases of choroidal lesions already diagnosed with standardized echography (21 choroidal malignant melanomas, four disciform lesions). Results:  In untreated malignant melanomas contrast agent echography revealed the presence of a dense microcirculation inside the mass. In one case vitreal seeding of the contrast agent was detectable before enucleation and histological examination revealed the presence of tumoral cells. In 12 cases treated with transpupillary thermotherapy, contrast agent echographic evaluation showed heavy regression of microcirculation after 1 week, confirmed in one case by histology, and a reduction of 70–80% in dimensions after 6 months (which appeared to have stabilized at subsequent examinations). In four cases treated with proton beam brachytherapy 2 years prior to our examination, contrast agent echography showed the absence of a microvascular network and the presence of large vessels and blood lakes. In four cases of disciform lesion, deep and superficial retina‐associated vascularization was observed, with a weak spread of contrast agent inside the lesion. Conclusion:  Live representation with good resolution of choroidal malignant melanoma microcirculation was obtained.
The presence of Propionibacterium spp. in the vitreous fluid of uveitis patients with sarcoidosis
Authors: Yasuhara Toru , Tada Rei , Nakano Yukiko , Tei Mamoru , Mochida Chikako , Kamei Motohiro , Kinoshita Shigeru 
Published: June 2005

Abstract.Purpose:  An immunological reaction to a bacterial antigen, such as Mycobacterium tuberculosis or Propionibacterium spp., is suspected to be an initial mechanism in the disorder known as sarcoidosis. We investigated whether or not P. acnes, P. granulosum or M. tuberculosis are present in the vitreous fluid of eyes suffering from uveitis with sarcoidosis. Methods:  Using polymerase chain reaction, we analysed the presence of P. acnes, P. granulosum and/or M. tuberculosis DNA in vitreous samples taken from six eyes with sarcoidosis and six control eyes. Results:  Among the six uveitis eyes with sarcoidosis, we detected P. acnes DNA in two eyes, P. granulosum DNA in four eyes, and both P. acnes and P. granulosum DNA in one eye, but no Propionibacterium spp. in the control eyes. M. tuberculosis DNA was not present in any of the patient or control eyes. Conclusions:  This is the first report indicating the presence of Propionibacterium spp. and/or its DNA in the vitreous fluid of sarcoidic eyes with uveitis. This, therefore, supports the idea that Propionibacterium spp. are involved in the aetiology of uveitis in sarcoidosis.
The time pattern of bilateral exudative age‐related macular degeneration
Authors: Gudnadottir G S. , Magnusson K P. , Stefansson E. , Jonasson F. , Helgadottir G. , Sigurdsson H. 
Published: June 2005

Abstract.Purpose:  To study time patterns in bilateral exudative age‐related macular degeneration (AMD) and the pattern of drusen before and after the onset of exudative AMD. Material and Methods:  Out of 2220 individuals in the Icelandic genetic study of AMD, 151 had bilateral exudative AMD. We searched for previous records in the Icelandic University Retina Unit. For the 65 patients with a fluorescein angiography record of both eyes, we established the time between the onset of disease in each eye. For the 53 patients with colour fundus photographs of the latter eye taken prior to the occurrence of exudative disease, we graded the drusen before and after the onset of exudative AMD in the second eye. Results:  The time interval between the onset of exudative AMD in the first and second eyes was 2.5 years (95% CI: 1.8–3.2; n = 65) and the median was 1.8 years. In 82% of cases the second eye was affected within 4 years. Soft drusen in the macula were found in 95% of eyes that later developed exudative disease (n = 53). Soft and hard drusen decreased in number in the central macula following the development of exudative disease. Conclusions:  Bilateral exudative AMD develops within a few years in both eyes. Drusen are less visible following the onset of exudative AMD in the second eye.