bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of venous thromboembolism in a Chinese population
Authors: Cheuk B L Y , Cheung G C Y , Cheng S W K 
Published: March 2004

Abstract

Background
Deep vein thrombosis (DVT) is uncommon in Asians and routine thromboprophylaxis for surgery is controversial. Despite recent reports of higher incidences in some Asian countries, population-based data are lacking.

Methods
Information from 2000 to 2001 was retrieved from a centralized computer public healthcare database serving an ethnic Chinese population of 6·7 million. The incidence, demographics and hospital mortality rates of DVT and pulmonary embolism (PE) were obtained, and analysed for different surgical categories.

Results
The overall annual incidences of DVT and PE were 17·1 and 3·9 per 100 000 population respectively. Venous thromboembolic disease was more common with increasing age in both sexes. The annual age-specific incidences of DVT and PE were 81·1 and 18·6 per 100 000 for those aged 65 years and over. Hospital mortality rates associated with DVT and PE were 7·3 and 23·8 per cent respectively. Among 120 940 surgical operations a year, the mean incidence of postoperative DVT and PE was only 0·13 and 0·04 per cent respectively. No high-risk surgical group was identified.

Conclusion
Venous thromboembolism is not as common in Chinese as in Caucasians, but it is certainly not rare. The majority of DVTs and PEs, however, were not associated with surgery, so routine thromboprophylaxis may not be required.
Long-term outcome following loose-seton technique for external sphincter preservation in complex anal fistula
Authors: Buchanan G N , Owen H A , Torkington J , Lunniss P J , Nicholls R J , Cohen C R G 
Published: March 2004

Abstract

Background
This study determined the long-term outcome after use of the loose-seton technique (LST) to eradicate complex fistula in ano.

Methods
Twenty patients whose complex fistula in ano was treated by the LST a minimum of 10 years previously were assessed by case-note review, supplemented where necessary by mailed and telephone interview.

Results
Eighteen patients had a trans-sphincteric and two a suprasphincteric fistula. There were seven supralevator and 12 ischiorectal secondary extensions. At short-term follow-up, a median of 6 months following seton removal, perianal sepsis had been eradicated in 13 of 20 patients. However, the long-term success rate of the LST was lower than that noted in the short term (four versus 13 of 20). Sixteen patients had persisting or recurrent sepsis, necessitating further surgery in 13. In the long term, external sphincter division was necessary to control sepsis in seven of the 20 patients compared with three of 20 patients at short-term follow-up. The rate of relapse in those with Crohn's disease and cryptoglandular fistula in ano was similar (five of six versus 11 of 14; P = 1·000). The fistula recurred in seven, 11 and 15 patients at 6, 15 and 60 months respectively after seton removal.

Conclusion
The success rate of the LST for complex fistula in ano falls over time. Counselling before seton removal should emphasize that, although most patients do not require sphincter division and some are cured by this technique, many patients develop further sepsis that usually requires surgery.
Randomized clinical trial of the costs of open and laparoscopic surgery for colonic cancer
Authors: Janson M , Björholt I , Carlsson P , Haglind E , Henriksson M , Lindholm E , Anderberg B 
Published: March 2004

AbstractBackgroundThere has been no randomized clinical trial of the costs of laparoscopic colonic resection (LCR) compared with those of open colonic resection (OCR) in the treatment of colonic cancer.MethodsA subset of Swedish patients included in the Colon Cancer Open Or Laparoscopic Resection (COLOR) trial was included in a prospective cost analysis; costs were calculated up to 12 weeks after surgery. All relevant costs to society were included. No effects of the procedures, such as quality of life or survival, were taken into account.ResultsTwo hundred and ten patients were included in the primary analysis, 98 of whom had LCR and 112 OCR. Total costs to society did not differ significantly between groups (difference in means for LCR versus OCR €1846; P = 0·104). The cost of operation was significantly higher for LCR than for OCR (difference in means €1171; P &lt; 0·001), as was the cost of the first admission (difference in means €1556; P = 0·015) and the total cost to the healthcare system (difference in means €2244; P = 0·018).ConclusionWithin 12 weeks of surgery for colonic cancer, there was no difference in total costs to society incurred by LCR and OCR. The LCR procedure, however, was more costly to the healthcare system.
Sexual health in women following pelvic surgery for rectal cancer
Authors: Platell C F E , Thompson P J , Makin G B 
Published: March 2004

Abstract

Background
Sexual dysfunction is a recognized complication in men undergoing pelvic surgery for rectal cancer. There is, however, little information on the influence of such surgery on sexual health in women. The aim of this study was to evaluate sexual health in women undergoing pelvic surgery for rectal cancer.

Methods
The study group included women who underwent pelvic surgery for rectal cancer at the Colorectal Surgical Unit, Fremantle Hospital between 1996 and 2002. The patients were contacted by telephone and invited to complete an anonymized questionnaire on sexual health. A control group comprised women who had undergone surgery for colonic cancer during the same interval.

Results
Fifty women in the study group were contacted, of whom 22 completed questionnaires. Sixty-two women in the control group were contacted and 19 completed questionnaires. Women in the study group were significantly younger than those in the control group. Compared with those in the control group, women who had undergone pelvic surgery were significantly more likely to feel less attractive, feel that the vagina was either too short or less elastic during intercourse, experience superficial pain during intercourse, and complain of faecal soiling during intercourse. Women in the study group were concerned that these limitations would persist for the rest of their lives. There were no differences between the two groups in relationship to sexual arousal or libido.

Conclusion
Pelvic surgery for rectal cancer has a significant influence on sexual health in women.
Infection of patients by bloodborne viruses
Authors: Tansley P D T , Beresford N , Ladas G , Goldstraw P , Dusmet M 
Published: March 2004

Abstract

Background
Despite taking precautions, healthcare workers performing invasive procedures run a small risk of infection by bloodborne viruses. When injury occurs, the viral status of the patient is often unknown and testing requires informed consent, which may be refused. On the other hand, although the chance of transmission of infection from a healthcare worker to a patient is extremely small, such personnel have an obligation of disclosure and, if seropositive, are barred from performing invasive procedures.

Methods
The medical literature on bloodborne virus transmission between carers and patients was reviewed, and the UK Department of Health, General Medical Council and Royal College of Surgeons of England guidelines on the risk management of these infections were read, along with secondary references from all sources.

Results and conclusion
Patients have complete protection of confidentiality and the right to refuse testing, but these rights do not apply to the healthcare worker. When injured in circumstances in which the patient cannot or will not permit testing, carers can only submit to the risks of prophylactic treatment or go into denial. Infection may have devastating professional, personal and financial implications to carers and their dependants. Ways to re-establish a just balance between the legitimate rights of patients and healthcare workers are discussed.
The broad ligament: A review of its anatomy and development in different species and hormonal environments
Authors: Miller Anne , Hong Matthew K.‐H. , Hutson John M. 
Published: March 2004

AbstractThe broad ligament is a double fold of peritoneum forming a mesentery for the human female genital tract. We investigated the anatomy of the broad ligament in different species and its hormonal regulation to determine if it had a role in gonadal positioning. The medical and veterinary literature was reviewed for descriptions of broad ligament anatomy and development. In addition, four adult female rats were dissected to compare the macroscopic anatomy of the broad ligament with any homologous structures in the male (n = 2). Detailed review was made of human males with persistent Müllerian duct syndrome (PMDS) and of bovine freemartin calves to determine the effect of abnormal hormonal environments on broad ligament development. Human and veterinary texts show variable broad ligament development between species, most being consistent with the size and shape of the uterus and uterine tubes. The broad ligament in adult female rats is a simple peritoneal fold and is homologous with the mesentery of the testis and vas deferens in males. Patients with PMDS and bovine freemartins have a broad ligament with intermediate anatomy. In PMDS the broad ligament is elongated and narrow, and not attached to the pelvic wall. The broad ligament is the mesentery of the genital ducts, and its anatomy varies with the degree of Müllerian duct fusion. The absence of a human male homologue is unusual, as the genital mesentery persists in male rodents. Apparent lack of a male homologue in the human may relate to obliteration of the processus vaginalis. The variable development of the broad ligament in pathological conditions is consistent with a role for steroid hormones in its development. Clin. Anat. 17:244–251, 2004. © 2004 Wiley‐Liss, Inc.
Femoral head of the rectus femoris muscle
Authors: Tubbs R. Shane , Salter George , Oakes W. Jerry 
Published: March 2004

AbstractVariability of the muscles of the anterior thigh is minimal. After review of the extant medical literature, we believe this to be the first reported case of a femoral head of the left and right rectus femoris muscles. In addition to this anomaly, our anatomic specimen demonstrated an accessory head of the right brachialis muscle and the quadratus plantae muscles inserted into the tendons of both the flexor hallucis longus and flexor digitorum longus. In clinical practice, knowledge of the possibility of an anomalous accessory femoral head of the rectus femoris muscle in clinical practice would be useful for those who might palpate this unusual muscle or encounter it surgically. Clin. Anat. 17:276–278, 2004. © 2004 Wiley‐Liss, Inc.
Restoration of motor function of the deep fibular (peroneal) nerve by direct nerve transfer of branches from the tibial nerve: An anatomical study
Authors: Bodily Kale D. , Spinner Robert J. , Bishop Allen T. 
Published: March 2004

AbstractTraction injuries of the common fibular (peroneal) nerve frequently result in significant morbidity due to tibialis anterior muscle paralysis and the associated loss of ankle dorsiflexion. Because current treatment options are often unsuccessful or unsatisfactory, other treatment approaches need to be explored. In this investigation, the anatomical feasibility of an alternative option, consisting of nerve transfer of motor branches from the tibial nerve to the deep fibular nerve, was studied. In ten cadaveric limbs, the branching pattern, length, and diameter of motor branches of the tibial nerve in the proximal leg were characterized; nerve transfer of each of these motor branches was then simulated to the proximal deep fibular nerve. A consistent, reproducible pattern of tibial nerve innervation was seen with minor variability. Branches to the flexor hallucis longus and flexor digitorum longus muscles were determined to be adequate, based on their branch point, branch pattern, and length, for direct nerve transfer in all specimens. Other branches, including those to the tibialis posterior, popliteus, gastrocnemius, and soleus muscles were not consistently adequate for direct nerve transfer for injuries extending to the bifurcation of the common fibular nerve or distal to it. For neuromas of the common fibular nerve that do not extend as far distally, branches to the soleus and lateral head of the gastrocnemius may be adequate for direct transfer if the intramuscular portions of these nerves are dissected. This study confirms the anatomical feasibility of direct nerve transfer using nerves to toe‐flexor muscles as a treatment option to restore ankle dorsiflexion in cases of common fibular nerve injury. Clin. Anat. 17:201–205, 2004. © 2004 Wiley‐Liss, Inc.
Study on the anatomical dimensions of the human sigmoid colon
Authors: Bhatnagar B.N.S. , Sharma C.L.N. , Gupta S.N. , Mathur M.M. , Reddy D.C.S. 
Published: March 2004

AbstractAlthough the sigmoid colon is commonly afflicted with disease, studies on its anatomical dimensions are scarce. It is suspected that dimensions of the sigmoid colon change with age. This study documents data on the anatomical measurements of the sigmoid colon in 70 Indian subjects (51 live and 19 cadavers). Seven parameters of sigmoid colon anatomy measured included length and width of the sigmoid colon and mesocolon at specific points. Three mesocolic indices (width to length ratios) were calculated. Comparisons of measurements in the live and cadaver subjects and in the two sexes were made. The relationship of change in parameters with age was assessed. Appropriate statistical methods were used and the differences were considered significant at P ⩽ 0.05. The study showed wide ranging variations in the values of various measured parameters of the sigmoid colon. Seven patterns of the shape of the sigmoid loop were identified. In the commonest pattern the sigmoid mesocolon was vertically longer than wide (dolichomesocolic), the sigmoid loop having its maximum convexity located just a little proximal to the apex. Patterns where the width of the mesocolon was greater than the vertical length (brachymesocolic) were also observed. The gender analysis showed that the sigmoid mesocolon of the female was brachymesocolic (wider than long), whereas that of the male was dolichomesocolic (longer than wide). This might explain the higher incidence of sigmoid volvulus in the male. This study also showed that the measurements of the sigmoid colon and its mesocolon do not change significantly within the age range of 16–60 years in the two sexes. Also noteworthy is the observation that in the cadaver the sigmoid colon shows considerable shrinkage, particularly of its mesocolon; consequently the data from cadaver subjects, though valuable for anthropometric use, have limitations when used for clinical applications. Clin. Anat. 17:236–243, 2004. © 2004 Wiley‐Liss, Inc.
Lateral costal artery: Accessory thoracic vessel of clinical interest
Authors: Barberini F. , Cavallini A. , Carpino G. , Correr S. , Brunone F. 
Published: March 2004

AbstractThe lateral costal artery (LCA), a supernumerary branch of the internal thoracic artery (ITA), occurs in several ethnic groups on one side of the thorax or on both, in 15–30% of cases. It has been considered responsible for the “steal‐syndrome” of the coronary blood after coronary artery bypass grafting and it used occasionally for myocardial revascularization. To clarify its functional significance, an interpretation based on our findings and human and comparative anatomy and embryology has been attempted. We report on a case where a right LCA of about 2 mm in caliber, rising from the ITA 2.5 cm below the subclavian, coursed as far as the 4th intercostal space for a distance of 13 cm after the anterior axillary line. Anastomosing with the intercostal arteries, it can act as a blood derivative circuit of the thoracic wall. Embryologically, this artery, like the normal parietal arteries of the trunk, might form a longitudinal channel connecting the intersegmental arteries. In mammals having a thoracic cage transversely restricted (quadrupeds), the ITA is more lateral than in primates having a circular thorax, and gives off a ventral branch toward the sternum. It might be hypothesized that the sternal branch occurring in quadrupeds, undergoing adaptation to the thoracic shape of primates, may become the main trunk of the ITA, whereas the LCA may be the remnant of the ITA of quadrupeds. Because the LCA ran partly along the “milk line” of humans, it might be regarded as a supernumerary mammary artery. Clin. Anat. 17:218–226, 2004. © 2004 Wiley‐Liss, Inc.
The use of complementary and alternative medical providers by insured cancer patients in Washington state
Authors: Lafferty William E. , Bellas Allen , Corage Baden Andrea , Tyree Patrick Timothy , Standish Leanna J. , Patterson Ruth 
Published: March 2004

AbstractBACKGROUNDInsurance coverage of complementary and alternative medicine (CAM) is expanding. However, to the authors' knowledge, little is know concerning CAM utilization among cancer patients under the insurance model of financing. In this study, the authors evaluated CAM provider utilization by cancer patients in a state that requires the inclusion of alternative practitioners in private, commercial insurance products.METHODSAn analysis was carried out of year 2000 claims data from two large Washington State insurance companies.RESULTSOf 357,709 claimants, 7915 claimants (2.3%) had a cancer diagnosis. Among cancer patients, 7.1% had a claim for naturopathy, acupuncture, or massage; and 11.6% had a claim for chiropractic during the study year. The use of naturopathy (odds ratio [OR], 2.0; P < 0.001) and acupuncture (OR, 1.4; P < 0.001) were more common, and the use of chiropractic was less common (OR, 0.9; P < 0.001) for cancer patients compared with those without cancer. No significant differences were noted in the use of massage between the two groups. Except in 2 individuals (0.03%), cancer patients also had at least 1 conventional provider claim during the year. Factors associated with nonchiropractic alternative provider use were female gender, the presence of metastatic cancer, hematologic malignancy, and the use of chemotherapy. Increased use of naturopathic physicians accounted for much of this trend. Musculoskeletal pain was the most common diagnosis at the CAM provider visit. Billed amounts for alternative services were < 2% of the overall medical bills for cancer patients.CONCLUSIONSA substantial number of insured cancer patients will use alternative providers if they are given the choice. The cost of this treatment is modest compared with conventional care charges. For individuals with cancer, CAM providers do not appear to be replacing conventional providers but instead are integrated into overall care. Cancer 2004;100:1522–30. © 2004 American Cancer Society.
Metastatic trophoblastic disease after an initial diagnosis of partial hydatidiform mole
Authors: Cheung Annie N. Y. , Khoo Ui Soon , Lai Caroline Y. L. , Chan Kelvin Y. K. , Xue Wei‐Cheng , Cheng Danny K. L. , Chiu Pui‐Man , Tsao Sai‐Wah , Ngan Hextan Y. S. 
Published: March 2004

AbstractBACKGROUNDHydatidiform mole (HM) is classified into partial (PHM) and complete (CHM) subtypes according to histopathologic and genetic criteria. Traditionally, it is believed that PHM carries a better prognosis and rarely develops metastasis. However, making a distinction between PHM and CHM using histologic criteria alone may be difficult.METHODSThe authors used fluorescent microsatellite genotyping following laser‐capture microdissection and chromosome in situ hybridization (CISH) to perform a genetic analysis of six patients with histologically diagnosed PHM who subsequently developed metastatic gestational trophoblastic neoplasia.RESULTSPatients ranged in age from 25 years to 44 years (mean, 33.2 years). The gestational age of the molar pregnancies varied from 6 weeks to 20 weeks. All six patients had pulmonary metastases, with additional liver metastasis in two patients. Among the six patients with histologically diagnosed PHM, it was found that four patients had a diploid karyotype and no maternal alleles; thus, their neoplasms actually were CHM. Maternal genome was detected in the remaining two patients consistent with a biparental origin, and these patients had a triploid karyotype. CISH findings in all patients correlated with the genotyping findings. Triploid HM had maternally derived alleles, whereas diploid HMs were purely androgenetic.CONCLUSIONSIn the current study, which may be the largest series of genetically analyzed metastatic PHMs to date, the difficulty of histologic distinction between PHM and CHM was confirmed. Molecular analysis may help to refine the classification of HM. Although the current findings support the belief that most aggressive trophoblastic diseases are derived from CHM, a small number of PHMs do progress to metastatic disease. Thus, the current study reaffirmed that all patients with HM should be followed closely irrespective of histologic subclassification. Cancer 2004;100:1411–7. © 2004 American Cancer Society.
Intracranial meningeal hemangiopericytoma: The role of radiotherapy
Authors: Soyuer Serdar , Chang Eric L. , Selek Ugur , McCutcheon Ian E. , Maor Moshe H. 
Published: March 2004

AbstractBACKGROUNDThe current retrospective study was undertaken to evaluate the treatment outcomes of patients with meningeal hemangiopericytoma (M‐HPC), to define the role of radiotherapy in the management of the disease, and to report on the patterns of failure.METHODSThe medical records of 29 patients with nonmetastatic M‐HPC treated at The University of Texas M. D. Anderson Cancer Center (Houston, TX) between August 1979 and March 1999 were reviewed. Fifteen patients (52%) underwent macroscopic total resection (‘gross total resection’ [GTR]), 10 (34%) underwent subtotal resection (STR), and 4 (14%) had unknown extent of surgery. Ten of 24 patients received adjuvant radiotherapy.RESULTSThe 5, 10, and 15‐year overall survival rates were 85%, 68%, and 43%, respectively. The local control rates at 5 and 10 years were 68% and 22%, respectively. Two patients experienced disease recurrence at another intracranial site. Sixteen patients (55%) developed extraneural metastases. Four patients (14%) developed spinal metastases. The 5‐, 10‐, and 15‐year distant metastasis–free survival rates were 80%, 46%, and 21%, respectively. The 5‐year local control rates for patients treated with GTR and STR were 84% and 38%, respectively (P = 0.003). Of the 15 patients treated with GTR, 3 received adjuvant radiotherapy as part of their initial treatment. Malignant disease did not recur locally in these three patients. However, the effect of the adjuvant radiotherapy on local control was not statistically significant.CONCLUSIONSM‐HPCs can recur locally or distantly in the neural axis or as extraneural distant metastases. Based on literature review and the patterns of failure in the current series, attempting to perform GTR followed by limited‐field radiotherapy appeared to represent a reasonable approach for the initial management of M‐HPC. Cancer 2004;100:1491–7. © 2004 American Cancer Society.