bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mice lacking the adenosine A1 receptor have normal spatial learning and plasticity in the CA1 region of the hippocampus, but they habituate more slowly
Authors: Giménez‐Llort Lydia , Masino Susan A. , Diao Lihong , Fernández‐Teruel Alberto , Tobeña Adolf , Halldner Linda , Fredholm Bertil B. 
Published: April 2005

AbstractUsing mice with a targeted disruption of the adenosine A1 receptor (A1R), we examined the role of A1Rs in hippocampal long‐term potentiation (LTP), long‐term depression (LTD), and memory formation. Recordings from the Shaffer collateral–CA1 pathway of hippocampal slices from adult mice showed no differences between theta burst and tetanic stimulation‐induced LTP in adenosine A1 receptor knockout (A1R−/−), heterozygote (A1R+/−), and wildtype (A1R+/+) mice. However, paired pulse facilitation was impaired significantly in A1R−/− slices as compared to A1R+/+ slices. LTD in the CA1 region was unaffected by the genetic manipulation. The three genotypes showed similar memory acquisition patterns when assessed for spatial reference and working memory in the Morris water maze tasks at 9 months of age. However, 10 months later A1R−/− mice showed some deficits in the 6‐arm radial tunnel maze test. The latter appeared, however, not due to memory deficits but to decreased habituation to the test environment. Taken together, we observe normal spatial learning and memory and hippocampal CA1 synaptic plasticity in adult adenosine A1R knockout mice, but find modifications in arousal‐related processes, including habituation, in this knockout model. Synapse 57:8–16, 2005. © 2005 Wiley‐Liss, Inc.
A Technique for distal splenocaval shunt in the rat
Authors: Holmin Torsten , Schröder Rolf , Berchtold Rudolf 
Published: April 2005

AbstractDistal splenocaval anastomosis was performed in 58 rats, using a microsurgical technique. Provided that the splenic artery was occluded during construction of the shunt, a patency rate of about 80% could be achieved. The model can be used for studying the effects of shunting blood from the splenic vein into the systemic circulation.
Natural history of cutaneous malignant melanoma
Authors: Briele Henry A. , Das Gupta T. K. 
Published: April 2005

AbstractThe rising incidence of cutaneous malignant melanoma with the consequent increase in mortality from melanoma has intensified efforts to understand the factors that initiate the malignant transformation of melanocytes and to define those tumor‐host interactions that play a relevant role in the clinical course of this disease. Increased exposure to solar radiation has been proposed as an explanation for the rising incidence of melanoma observed in light‐skinned races. Because of the low incidence of melanoma in darkly pigmented races and its tendency in these individuals to develop in relatively nonpigmented areas, such as the sole of the foot, it is postulated that melanin, in addition to its well‐known photoprotective effects, may protect against certain intrinsic carcinogenic agents. Developing cutaneous malignant melanomas progress through several cell types that have varying potentials for invasion and metastasis. This developmental process can be appreciated by examination of the various histologic types of melanomas. Early superficial spreading melanoma and lentigo maligna melanoma are characterized by cells that exhibit a prolonged intraepidermal growth phase, and most of these lesions can be diagnosed while they are still curable by simple surgical therapy. Subpopulations of more aggressive cells eventually develop, however. These cells also may characterize the initial stages of nodular melanoma in which the intraepidermal growth phase is absent and early invasion is common. Prognosis for survival depends on the depth of invasion of the primary tumor. Microstaging of the depth of invasion together with information as to mitotic index, sex, site, age, and histologic type will usually predict the natural history of the disease. With present‐day management, the overall long‐term, disease‐free survival rate of patients with cutaneous melanoma is 60–70% and compares favorably with that of the more common cancers.
Eleven years' experience with hyperthermic perfusion for melanoma of the extremities
Authors: Stehlin John S. , Giovanella Beppino C. , de Ipolyi Peter D. , Anderson Robert F. 
Published: April 2005

AbstractSince 1967, we have used a system of hyperthermic perfusion with melphalan to treat patients with melanoma of the extremities. This report presents additional follow‐up data on 165 patients, first reported on in 1975, who underwent 185 perfusions. The 70 patients classified as stage I (Stehlin classification system) had a 5‐year survival rate of 86.3%. The 5‐year survival rate for the 73 patients with stage II and stage III disease was 52.5%. There was a dramatic increase in the 5‐year survival rate for patients with stage IIIA disease, from 22.2% prior to the use of heat to 74% for 30 patients undergoing hyperthermic perfusion.
Chemotherapy of malignant melanoma
Authors: Benjamin Robert S. 
Published: April 2005

AbstractA number of drugs are being used in chemotherapy treatment programs of advanced melanoma. Of these, DTIC is the most important drug currently in use, producing a response rate of about 20% when used as a single agent. Studies with nitrosoureas report response rates ranging from 6 to 41%, with an average of 24%. Combinations of these 2 agents and other drugs have not yet shown a significant improvement in response over either drug used alone. However, several studies of chemo‐immunotherapy have reported overall response rates in the vicinity of 28%, somewhat higher than that obtained with chemotherapy alone.
The guy's trial of treatments of “early” breast cancer
Authors: Hayward John L. 
Published: April 2005

AbstractBetween 1961 and 1971, 370 patients with stages I and II breast cancer were assigned by random sample to receive either wide local excision or standard radical mastectomy. Patients in both groups received postoperative radiotherapy which, admittedly, would be considered less than optimal nowadays for patients with an intact axilla. Follow‐up has been conducted for 5 years in all patients and for 10 years in about half of them. Wide local excision was followed by a higher incidence of local cancer recurrence. However, there was no significant difference between the 2 operations in 5‐and 10‐year survival. Furthermore, there was no significant difference between the 2 treatment groups in the incidence of distant metastases after 10 years, although patients with stage II cancer had a significantly higher incidence of distant metastases after 5 years (but not after 10 years).
Conservative treatment of breast cancer: A trial in progress at the cancer institute of Milan
Authors: Veronesi Umberto 
Published: April 2005

AbstractIn 1973, a clinical trial was started in patients with stage I breast cancer comparing conservative treatment consisting of partial mastectomy plus axillary dissection plus postoperative radiotherapy to the involved breast with conventional radical mastectomy. Patients with positive lymph nodes in the partial mastectomy group have been further randomized to receive either additional radiotherapy to the supraclavicular and internal mammary node areas or no additional radiotherapy. By June 1976, 302 patients had entered the trial. To date there are no significant differences between the conservative and radical surgical treatment groups in regard to local cancer recurrence, the incidence of distant metastases or the development of cancer in the contralateral breast, but it is too early to have obtained meaningful results.
The residency training program for general surgeons in Groningen, the Netherlands
Authors: Kuijjer Peter J. 
Published: April 2005

AbstractIn 1970, a new residency training program for general surgeons was started at the university hospital in Groningen to meet the new requirements of the national Committee of Specialist Registration and the Central Board. The program consists of 6 years of formal training in general surgery and the surgical specialties, divided into 24 rotation terms of 3 months each. During the 6 years, the residents spend 3‐1/4 years in general surgery (which includes conventional general surgery, pediatric surgery, traumatology, surgical oncology and vascular surgery), 1‐1/4 years distributed among the surgical specialties (orthopedics, anesthesiology, plastic and reconstructive surgery, urology and cardiothoracic surgery), 9 months in the first aid and acute admissions department, 6 months in an elective period of their choice, and 3 months performing consultations. Upon satisfactory completion of the training, the resident is certified as a specialist. No final examinations are given, but the training program is carefully supervised according to strict requirements. Although the program has some problems related to its rigidity, there is general enthusiasm for it among both residents and staff members because it provides a uniformly high standard of surgical education in a stable framework.
Complications of carotid endarterectomy and their prevention
Authors: Thompson Jesse E. 
Published: April 2005

AbstractMortality and morbidity associated with carotid endarterectomy may be minimized by proper selection of patients and proper operative and postoperative management. Complications include cardiac and airway problems related to anesthesia, infection, hematoma, nerve pareses, parotitis, arterial disruption, false aneurysms, and carotid‐cavernous fistula. The most serious complication is the occurrence of neurologic deficits as a result of cerebral emboli or ischemia. Emboli are due to excessive manipulation of the artery, while ischemia results from hypotension, intracerebral thrombosis, or inadequate cerebral protection. Adequacy of collateral blood flow during carotid clamping is determined by temporary occlusion under local anesthesia, measurement of internal carotid artery stump pressure, or EEG monitoring. The most reliable method of cerebral protection is a temporary inlying shunt. Selective shunting is used if the patient is intolerant of temporary clamping, if stump pressure is below 55 mm Hg, or if EEG changes occur. For maximum safety, the author suggests routine shunting and general anesthesia. Operative mortality for patients experiencing transient ischemic attacks should be less than 1% and operation‐related neurologic deficits no more than 2%. Meticulous attention to technical details is obligatory. Hypotension should be avoided during and after operation to avert thrombosis, and excessive hypertension postoperatively must be treated promptly to avoid cerebral hemorrhage and edema. Operation is contraindicated on patients with acute profound and progressing strokes.
Seventeen‐year experience with routine shunting in carotid artery surgery
Authors: Javid Hushang , Julian Ormand C. , Dye William S. , Hunter James A. , Najafi Hassan , Goldin Marshall D. , Serry Cyrus , DeLaria Giacomo A. 
Published: April 2005

AbstractSafety of carotid artery surgery depends on proper case selection, meticulous surgical technique, and appropriate protection of the brain during carotid artery cross‐clamping. Various methods have been devised to determine the adequacy of collateral circulation, none of which has been proven practical and totally reliable. Attempts at increasing cerebral perfusion to the ischemic portion of the brain by induced hypertension, hypercarbia, and hypocarbia have been ineffective.The purpose of this presentation is to report our experience with routine intraluminal shunting in carotid artery surgery during the past 17 years. Advantages of routine shunting include maintenance of regional cerebral blood flow at the preclamping level and the elimination of any need for monitoring and haste during surgery. Insertion of the tube, properly done, does not injure the arterial wall and should not cause embolization. The presence of the tube within the arterial lumen does not interfere with exposure of the atheroma, yet it facilitates repair of the incision and prevents stricture by faulty suturing technique. Results of carotid artery surgery measured by the incidence of stroke are compared between shunted and nonshunted series. A review of the literature confirms our impression that shunting reverses ischemic changes detected by EEG and regional cerebral blood flow determinations. The usefulness of shunting in the surgical management of internal carotid aneurysm, kinked carotid artery, carotid body tumor, and carotid‐subclavian bypass graft is also described.
Fibromuscular dysplasia of the internal carotid artery
Authors: Effeney David J. , Ehrenfeld William K. , Stoney Ronald J. , Wylie Edwin J. 
Published: April 2005

AbstractSixty‐eight patients underwent 104 operations for symptomatic fibromuscular dysplasia between 1965 and 1977. In 8 of the early operations, the artery was resected and primarily anastomosed or replaced with saphenous vein. The remainder of the patients had graduated dilatation of the carotid artery combined, if necessary, with a bifurcation endarterectomy. Four patients had a contralateral endarterectomy for atherosclerosis. There were no operative deaths. Two patients had neurologic deficits after operation, while 7 had 1 transient ischemic attack or amaurosis in the early postoperative period. The follow‐up period extends from 6 months to 12 years. One patient developed a deficit that could be attributed to the carotid artery at the site of the prior dilatation, and 2 patients developed neurologic difficulties secondary to subarachnoid hemorrhage. The exact nature of the disease, its incidence in the community, and the mechanism of symptom production remain unknown. Symptomatic fibromuscular dysplasia is not a benign disorder, and there are no data available to confirm or deny the benefit of medical treatment. Intraluminal dilatation, however, is a safe, durable operation that relieves symptoms and offers prophylaxis against further neurologic sequelae.
Surgical management of atheroma of the aortic dome and origin of supra‐aortic trunks
Authors: Thevenet André 
Published: April 2005

AbstractDuring a 14‐year period, 607 obstructive lesions of supraaortic vessels originating from the aortic arch in 506 patients were submitted to arterial reconstruction. Among these, 28 patients presented multiple proximal aortic arch lesions associated with extensive aortic involvement—an “aortic dome syndrome.” Transsternal revascularization procedures were performed in 28 patients, including 7 in whom endarterectomy of the aortic dome was done under hypothermic circulatory arrest. In addition, in 11 patients, multiple bypass grafts were constructed from the ascending aorta, and in 10 other patients, sequential great vessel endarterectomies were performed, with transposition of the left common carotid artery in 5 patients. Twenty‐four of the 27 survivors are asymptomatic at an average of 6.9 years postoperatively. Progressive atherosclerosis in distal lesions has been observed in 2 patients, and late mortality has occurred in 5 others. Long‐term arterial patency has been demonstrated for follow‐up periods of from 1 to 14 years.
The ophthalmic blood pressure in thyroidectomized patients
Authors: Cardan Emil , Pop Rodica 
Published: April 2005

AbstractA parallel investigation of the blood pressure changes in the brachial and ophthalmic arteries was carried out in a group of 23 patients following subtotal thyroidectomy, and the results were compared with those obtained in a control group of 21 patients operated on for other diseases. A pronounced decrease of the pressure in the ophthalmic artery was found in the thyroidectomized patients. It appeared immediately after surgery, lasted 2 or 3 days, and disappeared spontaneously. The pressure decrease might be correlated with the headache that is frequently encountered in patients after thyroidectomy and that occurred in 17 of the 23 thyroidectomized patients. Changes in carotid blood flow due to the patient's position on the operating table, removal of the thyroid tissue, and liberation of bradykinin are discussed as possible factors that might explain this finding.
Experience with routine postoperative choledochoscopy via the T‐tube sinus tract
Authors: Yamakawa Tatsuo , Komaki Fumio , Shikata Jun‐ichi 
Published: April 2005

AbstractIn the 40‐month period from April, 1974 to July, 1977, postoperative choledochoscopy was performed 566 times in 186 patients at Teikyo University Hospital. Included in this series were 56 patients with retained common bile duct stones and 23 patients with intrahepatic stones; the stones were removed by postoperative choledochoscopy in 52 and 20 of these patients, respectively. In some patients, unsuspected stones were detected endoscopically after a completion T‐tube cholangiogram was reported as negative for stones. Our experience to date indicates that this technique is of substantial diagnostic and therapeutic value in the management of biliary calculi. Therefore, routine use of postoperative choledochoscopy as an adjunct to T‐tube cholangiography is strongly advocated. Failure of attempts to remove retained stones endoscopically and complications in this series were all attributable to inadequate insertion of the T‐tube into the common bile duct at the time of operation. To overcome this problem, a T‐tube of at least No. 18 Fr. caliber, and preferably of No. 20 Fr. caliber, should be inserted at operation into the common bile duct at a right angle, so as to avoid a tortuous sinus tract and produce a tract of sufficient caliber to permit postoperative choledochoscopy.
Nonoperative instrument extraction of retained bile duct stones
Authors: Burhenne H. Joachim 
Published: April 2005

AbstractReoperation for removal of retained bile duct stones after cholecystectomy and common duct exploration can now be avoided by the technique of nonoperative instrument extraction of stones through the sinus tract from the indwelling T tube. In our institution, 380 patients underwent this new procedure of nonoperative percutaneous stone extraction from the biliary tract during the past 7 years. The extraction was accomplished in ambulatory patients under fluoroscopic control. It carried a success rate of 95% and only 5% of the patients required a second operation for stone removal. There was a complication rate of about 5%, and there were no bile duct perforations or mortality. When compared to other therapeutic methods for removing retained stones, such as reoperation, choledochoscopic instrumentation, and attempts at chemical stone dissolution, the nonoperative percutaneous method appears to be the procedure of choice. The nonoperative technique is now practiced in at least 100 institutions in the United States, and successful extractions have also been reported from other countries.
Primary common bile duct stones
Authors: Madden John L. 
Published: April 2005

AbstractPrimary or stasis stones in the common duct are a distinct clinical, anatomical, and pathological entity. In the older patient with chills, fever, and jaundice, it is axiomatic that a primary or stasis stone will be found in a common duct that measures 20 mm or more in diameter. Furthermore, about 20% of such patients will not have stones in the gallbladder. The symptom of chills, having not been observed in patients with cancer of the head of the pancreas, is considered a diagnostic aid in the differentiation of jaundice secondary to common duct stones from jaundice due to malignant obstruction. The primary or stasis stone is the most common type of common duct stone. When present, a definitive operation, preferably choledochoduodenostomy, is advised. A simplified classification of biliary tract stones, preferably that of Aschoff, should be established as the universal standard. Also, based on this standard, worldwide prospective clinical studies should be initiated to obtain data for comparative evaluations to determine the true incidence of primary common duct stones.
Resection for carcinoma of the superior mediastinal segment of the esophagus
Authors: Ong G. B. , Lam K. H. , Lam Peter H. M. , Wong John 
Published: April 2005

AbstractDuring the past 13 years, 86 patients with carcinoma of the esophagus situated at the superior mediastinal segment were admitted and treated at the Queen Mary Hospital, Hong Kong. Only 17 of these patients underwent resection. The resection technique was based on what was described in 1957 by Waddell and Scannell and by Cauchoix and Binet. The whole of the esophagus was removed in each case and the reconstruction, using the stomach, was accomplished by anastomosing the fundus to the cricopharyngeus. In 1 patient an isolated jejunal segment was used in the esophagoplasty, while in another the colon was utilized. There were 3 postoperative deaths, 1 due to a gastrotracheal fistula from erosion by the tracheostomy tube, a second due to hemorrhage, and a third due to bronchopneumonia. Four patients are currently alive and well without evidence of cancer. The longest survivor has lived for 5 years and 3 months. Ten of the patients who were discharged from the hospital lived for from 2 to 15 months, with an average of 8.7 months. This compares favorably with the 6.9 months average survival reported by Procter in patients with carcinoma of the upper third of the esophagus who were treated by radiotherapy. While the mortality rate is still high, the results are encouraging and continued use of surgical treatment is certainly warranted.
Follow‐up results after resection of thoracic esophageal carcinoma
Authors: Kasai Morio , Mori Shozo , Watanabe Toshio 
Published: April 2005

AbstractDuring the past 14.5 years, we have treated 430 patients with carcinoma of the thoracic esophagus. The resection rate was 72% and the overall operative mortality rate was 16%. During the past 5 years, the operative mortality rate has been markedly reduced to 4.5%. The low operative mortality rate in recent years is the result of selection of the operative procedure according to the criteria that we have established for one‐stage radical resection. The overall 5‐year survival rate was 16.5%. Prophylactic postoperative irradiation improved long‐term survival in patients who underwent curative resection; their 5‐year survival rate was 34.6%. Prophylactic irradiation was especially effective in patients who did not have lymph node metastases. The 5‐year survival rate was 87.5% in these patients. The majority of long‐term survivors were leading a normal life for their age.
Fundoplication for the treatment of gastroesophageal reflux in hiatal hernia
Authors: Rossetti M. , Hell K. 
Published: April 2005

AbstractFundoplication, using an abdominal approach, is advocated to create an adequate substitute for the insufficient sphincter in gastroesophageal reflux associated with hiatus hernia. To achieve success, correct indications for surgical treatment are important. Based on experience with approximately 1,400 patients over the past 20 years, these include: (a) a retrosternal burning sensation (in 90% of our cases); (b) objective confirmation of reflux by means of x‐ray and endoscopic examination, together with biopsy examination of the esophageal mucosa and gastric acid evaluation; and (c) evidence of organic complications such as endobrachyesophagus with ulcerostenotic changes at the junction between the esophageal and gastric mucosa. Long‐term follow‐up of 590 patients with simple reflux esophagitis who underwent fundoplication showed that 87.5% were symptom free. In 44 patients with complicated gastroesophageal reflux disease, fundoplication produced clinical healing in 84.1%.