bluuebunny/crossref_metadata_2025_split huggingface dataset:
Choledochal cyst
Authors: Cheney M. , Rustad D. G. , Lilly J. R. 
Published: May 2005

AbstractCholedochal cyst is a congenital malformation of the pancreatobiliary system. Its pathogenesis is not completely understood. The pathologic features are cystic dilatation of the common bile duct, normal liver parenchyma, a normal intrahepatic biliary system (except when associated with Caroli's disease), and partial obstruction of the terminal common bile duct.The presenting symptom in most children is mild intermittent jaundice. Ultrasound is the best initial investigation. Transhepatic cholangiography and endoscopic retrograde cholangiopancreatography define the extent of intrahepatic and extrahepatic disease but are not necessary studies in all patients.Traditionally, cyst enterostomy (i.e., drainage of the cyst into interposed intestine) was the standard operative procedure. More recently, cyst excision has become the procedure of choice. We employ a technique in which excision is confined to the inside of the cyst which eliminates many of the technical hazards of resection. The procedure was performed in 11 infants and children with no mortality and minor morbidity.
Esophageal atresia: Embryogenesis and management
Authors: de Lorimier Alfred A. , Harrison Michael R. 
Published: May 2005

AbstractThe embryogenesis of esophageal atresia is reviewed. Esophageal atresia is frequently associated with other predictable anomalies and prematurity. The management of esophageal atresia will vary according to the size and vigor of the baby, the severity of complicating anomalies, and the distance between the 2 esophageal ends. Surgical repair is not urgent, since the infant can be maintained by sump suction of the proximal esophagus to prevent aspiration of mucus and by gastrostomy or jejunal feedings. When associated anomalies or pulmonary complications have been resolved, the definitive repair is performed. If there is a long distance between the esophageal ends, it is usually possible over a period of time to bring the 2 ends close together by bougie stretching and by performing a series of esophageal myotomies. Complications that should be anticipated following repair include anastomotic stricture, recurrent tracheoesophageal fistula, esophageal dysmotility, tracheomalacia, and gastroesophageal reflux with aspiration, impaired caloric intake, and esophagitis.
Shunt surgery for treatment of portal hypertension in children
Authors: Valayer J. , Hay J. ‐M. , Gauthier F. , Broto J. 
Published: May 2005

AbstractShunt surgery in children suffering from portal hypertension (PH) is considered as an immediate and definite mode of prevention of recurrent gastrointestinal hemorrhage. Certain conditions must be met: (a) normal liver; (b) normal veins available within the portal system; (c) a sufficient portosystemic gradient of pressure; and (d) a surgical team with experience in portal venous surgery. In patients in whom PH is an epiphenomenon of severe liver disease, other means of hemostasis for bleeding esophageal varices should be sought. The difficult decision is in the child with specific liver alterations without major hepatocellular dysfunction but in whom the prognosis cannot be precisely foreseen. A few more years will be needed before one can tell if shunt surgery is the best choice for this category of patient.
Surgery of gastroesophageal reflux
Authors: Carcassonne M. , Guys J. M. , Delarue A. , Sarles J. 
Published: May 2005

AbstractDuring the last 20 years, 262 patients were diagnosed with gastroesophageal reflux (GER) at La Timone Children's Hospital, Marseille, France. Seventy‐eight patients (60 infants and 18 children) were treated operatively. Both newer investigations such as scintiscan and Ph measurements, as well as standard ones, such as barium esophagogram and esophagoscopy, failed to demonstrate a precise relationship between reflux and symptoms. Selection of patients for surgery depends on clinical symptoms linked to GER, for example, failure of a 3‐week medical trial, association with anatomic disorders such as hiatal hernia, and respiratory complications proven to originate from GER. Numerous surgical procedures have been described. The best appears to be the Nissen fundoplication associated with gastropexy.
Surgery of necrotizing enterocolitis
Authors: Kosloske Ann M. 
Published: May 2005

AbstractNecrotizing enterocolitis (NEC) has become a frequent neonatal surgical emergency. This disease, characterized by crepitant intestinal necrosis, occurs primarily in premature infants. Operation is necessary if intestinal perforation or gangrene occurs. Of the many proposed indications for operation in NEC, those of proven validity are: pneumoperitoneum, a fixed dilated loop on serial x‐rays, erythema of the abdominal wall, an abdominal mass, or a positive paracentesis (consisting of brown fluid and/or bacteria on Gram's stain). Paracentesis has aided the early identification of infants with intestinal gangrene prior to perforation. Early recognition of gangrene is important because the mortality rate following operation after perforation (64%) is double that of operation for gangrene (30%). The cardinal principles of operation for acute NEC are excision of all the gangrenous bowel, exteriorization of the marginally viable ends, and preservation of as much intestine as possible. Our preferred method of exteriorization is by the Mikulicz enterostomy, because its subsequent closure appears to be safer than closure of a double enterostomy with separated stomas. The survival of infants operated on for NEC at the University of New Mexico Hospital was 34 of 63 (54%). Six late deaths occurred, for an overall survival of 28 of 63 (44%). Nine survivors (32%) required treatment for late intestinal strictures. Recent follow‐up studies on infants surviving NEC show an encouraging prognosis for normal growth and development.
Enteral and parenteral nutrition in the short bowel syndrome in children
Authors: Ricour C. , Duhamel J. F. , Arnaud‐Battandier F. , Couard Y. , Revillon Y. , Nihoul‐Fekete C. 
Published: May 2005

AbstractThirteen children, aged 2 to 16 years, had a subtotal resection of small bowel, following a mid‐gut volvulus in 10 cases. All children are alive, and their growth is normal; 36 cumulative patient‐years of parenteral nutrition and 11 years of constant‐rate enteral nutrition were performed. In 7 cases, in which residual small bowel varied between 30 to 120 cm, termination of all artificial nutritional support was possible 30 months in mean after intestinal resection. In contrast, if resection was near total with less than 20 cm remaining, life‐long dependence on parenteral nutrition is unavoidable unless intestinal transplantation becomes feasible. With cyclic parenteral nutrition at home, the patients' quality of life is near normal.
The cost‐effectiveness of early or delayed surgery in acute cholecystitis
Authors: Alinder Gunnar , Herlin Per , Lindgren Björn , Holmin Torsten 
Published: May 2005

AbstractEarly surgery has been recommended as the treatment of choice for acute cholecystitis in several clinical studies during the last 15 years. This was the outcome of a recent study from 4 Swedish hospitals, on which the present study on the economic aspects is based. Fifty‐three patients with acute cholecystitis treated at the University Hospital of Lund were analyzed. Acute cholecystectomy (early surgery =ES) was performed in 33 cases and 20 were subjected to delayed surgery (DS). Conservative treatment was found to be on an average 65% more expensive than early cholecystectomy. The average hospital cost for delayed surgery amounted to Swedish kronor (SEK) 22,755 ($3,034 U.S.). The corresponding sum for early surgery was SEK 13,755 ($1,834 U.S.). These findings support the opinion that early surgery is to be recommended in the management of acute cholecystitis.
Reinnervation of the endocrine pancreas after autotransplantation of pancreatic fragments in the spleen of the dog: A morphofunctional study
Authors: Madureira Mário L. C. , Adolfo A. , Dias J. , Sebe M. , Carvalhais H. A. , von Hafe P. 
Published: May 2005

AbstractSecondary diabetes following pancreatectomy in the dog was prevented by autotransplantation of pancreatic fragments in the spleen. The function and composition of the endocrine elements were analyzed by functional studies and by light and electron microscopy at 4, 8, and 24 weeks. During these different periods, splenectomy proved that all the animals were dependent on the transplanted tissue for normoglycemia. The morphologic study of the spleen showed the survival of the intrinsic pancreatic ganglia as well as the presence of an amyelinic, terminal nervous network, with adrenergic varicosities, exclusively related to the endocrine elements.Nerve endings were identified in close contact with beta, alpha‐2, and alpha‐1 cells, either isolated in the splenic pulp or forming insular structures with a variable size and composition. No cholinergic varicosities could be identified nor was there any innervation in the ductal and acinar tissue.From 4 weeks on, Schwann cells could be seen coating large surfaces of the endocrine cells at the same time as they sheathed nervous elements, thus creating true “neuroinsular complexes” with beta and alpha‐2 cells. The few ganglia that could only be identified under light microscopy, as well as the ultrastructural characteristics of the innervation, suggest that the sympathetic fibers of the perivascular, trabecular and capsular plexus of the spleen had grown and invaded the inoculated endocrine tissue in the splenic pulp.
Neuroendocrine tumors of the gut
Authors: Durning Patricia , Galland Robert B. , Nagorney David M. , Welbourn Richard B. 
Published: May 2005

AbstractOf 75 patients with neuroendocrine tumors of the gut, 50 had functioning lesions, causing endocrine syndromes. These included 16 insulinomas, 13 gastrinomas, 5 vipomas (4 pancreatic, 1 adrenal), 4 corticotrophinomas, and 1 renal enteroglucagonoma. Three patients had mixed endocrine syndromes. Eight or 9 patients with pancreatic lesions had multiple endocrine adenopathy (MEA I), including 3 of 4 patients with multiple insulinomas and all 3 patients with malignant gastrinomas. Localization of the pancreatic insulinomas, vipomas, and mixed tumors by arteriography was excellent, but few gastrinomas were detected before operation. Eight patients developed the malignant carcinoid syndrome with metastases from primary tumors in the ileum (6 patients), bronchus, and stomach. Hepatic artery embolization provided palliative relief for several with this and some other syndromes. Twenty‐five patients had tumors that caused nonspecific features only. These included 18 appendicular carcinoids, 5 islet cell carcinomas, and 2 other apudomas (1 hepatic and 1 whose primary site is unknown). The importance of the latter is that they are more responsive to therapy and have a better prognosis than the more common acinar tumors. Over 40% of the patients had lesions that were cured surgically and over 80% obtained some benefit from treatment.
Václav Treitz (1819–1872): Czechoslovakian pathoanatomist and patriot
Authors: Fox Richard S. , Fox Claire G. , Graham William P. 
Published: May 2005

RésuméVáclav Treitz (1819–1872) qui fut un grand anatomiste et pathologiste d'origine tchèque s'est opposé à la domination autrichienne de son pays et à la germanisation de l'enseignement de l'Université Charles Ferdinand siège de l'une des plus anciennes des Ecoles de Médecine européennes. Il a lutté toute sa vie en faveur de la Bohême sa patrie et pour que l'enseignement médical à Prague soit dispensé en langue tchèque bien qu'il ait fait ses études médicales en pays germanique, à Vienne, capitale du monde médical au milieu du dix‐neuvième siècle.Au cours de ses périgrinations entre Vienne où il étudia, Prague et Cracovie où il enseigna il suivit toujours la même conduite, s'interessant à 1'anatomie, à l'anatomie‐pathologique et à la chirurgie. En 1853, alors qu'il exerçait à Cracovie il publia en allemand pour diffuser ses idées la description du ligament suspenseur de l'angle duodéno‐jéjunal qui porte son nom depuis lors. Il décrivait aussi d'autre formations constituées de fibres lisses au niveau du pharynx, de la troisième couche de l'estomac, du sphincter anal, de la vessie et de la “tunica dartos” du sacrum. En 1857, il publia un autre article important intitulé: hernie rétro‐péritonéale, contribution à l'histoire des hernies. En 1859, son dernier travail important consacré aux “lésions intestinales de l'urémie” décrivait non seulement les lesions mais le mécanisme de leur constitution. Esprit ouvert il fut l'un des premiers à soutenir la thèse de Semmelweis affirmant que la fièvre puerpérale était d'origine infectieuse, l'infection étant transmise par le corps saignant, et aussi à prouver le traitement de la tuberculose par le repos.Esprit contestataire et frondeur mais avisé et rigoureux, Václav Treitz fut un grand anatomiste innovateur, un pathologiste rigoureux et aussi un grand patriote dont la Tchécoslavaquie peut être fière.
Rare late complication after operation of traumatic aneurysm of the thoracic aorta
Authors: Heberer G. , Stelter W. J. , Jauch K. ‐W. 
Published: May 2005

AbstractIn a 60‐year‐old patient, an anastomotic aneurysm developed 22 years after interposition of a Dacron® prosthesis for repair of a traumatic aneurysm of the descending aorta. Computed tomography and transfemoral aortography suggested a complete suture dehiscence with a free‐floating graft. Operation confirmed that the silk sutures had completely disappeared. A new 20‐mm woven Dacron® prosthesis was inserted with nonresorbable suture material.We recommend long‐term follow‐up with chest x‐ray in all patients after prosthetic aortic reconstruction. Noninvasive computed tomography and contrast‐enhanced computed tomography have proven a very useful and sensitive method for detection of suture dehiscence, false aneurysm, and other complications.
Resection and embolization in the management of secondary hepatic tumors
Authors: Blumgart Leslie H. , Allison David J. 
Published: May 2005

AbstractThe management of hepatic metastases either by means of hepatic resection or by hepatic artery embolization is reviewed. Hepatic resection is of value either as a palliative or potentially curative measure, especially in secondary deposits arising from primary sites in the colorectum. Approximately 26% of patients with primary colorectal cancer will have hepatic metastases at diagnosis and, of these, some 5–10% will be amenable to resection. Untreated, all patients die within 5 years, but resection of solitary metastases would appear to offer a 20% chance of 5‐year survival. Better results have been obtained with resection carried out for smaller lesions. Major resections carried out for large lesions are not as successful.Hepatic artery embolization is useful in a wide variety of secondary hepatic deposits, not only to treat local symptoms but also to ameliorate the systemic effects produced by secondary deposits arising from primary endocrine tumors. Controlled clinical studies allowing comparison of the results of tumor embolization with those of other forms of palliative therapy or of symptomatic treatment are now necessary.
Primary carcinoma of the liver: Improvement in sight?
Authors: Bengmark S. , Hafström L. , Jeppsson B. , Sundqvist K. 
Published: May 2005

AbstractA retrospective analysis of 99 histologically verified primary liver carcinomas seen at the Department of Surgery, University of Lund, from 1965 to 1978 has been performed. The material is comparable to other studies with regard to age and sex distribution and occurrence of cirrhosis. The common presenting symptoms were abdominal discomfort and weight loss. During 1965–1970, most diagnoses were made at laparotomy or at autopsy. There was a low incidence of resectability and a short mean survival rate. In the latter half of the study, 1971–1978, wider use of thin needle biopsy, angiography and liver scan has contributed to more accurate preoperative diagnoses in this group. Diagnoses seemed also to be made at an earlier stage of the disease in this group, which led to a higher resectability. This, in combination with postoperative adjuvant chemotherapy, may have contributed to the favorable results, with more than half of the patients alive 24 months after resection.
Metastatic disease in the liver from colorectal cancer: An appraisal of liver surgery
Authors: Bengmark Stig , Hafström Larsolof , Jeppsson Bengt , Jönsson Per‐Ebbe , Rydén Stefan , Sundqvist Kaj 
Published: May 2005

AbstractThis study supports the opinion that liver resection or metastasis enucleation with a margin of normal tissue around the tumor for liver metastases from colorectal cancer can be recommended. The 3‐year survival rate of 20–25% is far better than the 3‐year survival rates reported after resection of the primary organ for cancers such as, for example, the pancreas and esophagus and is almost as good as that of surgery of primary rectal cancer Dukes' C. Liver resection has an acceptably low postoperative mortality (less than 10%), morbidity, and complication rate.
The Aarhus County Vagotomy Trial: Trends in the problem of recurrent ulcer after parietal cell vagotomy and selective gastric vagotomy with drainage
Authors: Andersen Daniel , Amdrup Erik , HØstrup Hans , SØrensen Finn Hanberg 
Published: May 2005

AbstractIn a prospective, randomized study, 691 patients with duodenal (DU), pyloric (PU), or prepyloric (PPU) ulcers have been followed for 2–5 years after operation with parietal cell vagotomy (PCV) or selective gastric vagotomy with drainage (SGV+D). About half the patients have been followed for 5 years. Cumulative 5‐year recurrence rates, calculated by a life table method, suggest a higher recurrence rate for patients with DU when operated with PCV (15%) than when operated with SGV + D (9%), but the difference was not statistically significant (p>0.05). Patients with PU/PPU had higher recurrence rates following either procedure than patients with DU (PCV: 33%; SGV+D: 14%).A study of the change in recurrence risk as a function of time after operation suggests that the recurrence rate following SGV+D when used for DU will continue to rise after 5 years, but probably very slowly. The recurrence rate after 5 years is unpredictable, however, for PCV when used for DU, and unpredictable for both methods when used for PU/PPU.The recurrence rate was found to be independent of the level of preoperative gastric acid secretion, and this was true for both PCV and SGV+D, An increased recurrence rate was, on the other hand, found to be associated with <50% postoperative reduction in pentagastrin‐stimulated acid secretion.
Measurement of duodenogastric reflux with99mTc‐HIDA in duodenal ulcer patients
Authors: Schmidt Gerd F. , Schneider Johann A. , Bauer Hartwig , Frey Kurt W. , Holle Fritz 
Published: May 2005

AbstractThere are contradictory reports as to whether the pylorus plays an important role in preventing duodenogastric reflux. In the present study we measured bile reflux under fasting conditions, employing a new radionuclide method which was modified for easy and standardized use. Intravenously administered99mTc‐HIDA (0.1 mCi) is detected in gastric juice aspirated during routine gastric secretion analysis. In order to prove that the radioactivity in the aspirate comes from reflux, in preliminary intraoperative experiments we clamped the antrum and measured the intraluminal activity. Only a very low amount of free activity was found. We found the same result in 3 Heidenhain pouch dogs. We then studied the bile regurgitation in 60 patients with duodenal ulcer disease and in 30 patients operated on for duodenal ulcers (selective proximal vagotomy with pyloroplasty). Preoperatively, we found bile reflux in 66% of the patients. There was a distinct difference between active and chronic ulcers. In the florid state, 76% of our patients had bile reflux as compared to 58% in the chronic state. After pyloric surgery, with a pyloroplasty appropriate to form and function, bile reflux was not increased. Our conclusion is that the pylorus seems to have no important reflux‐preventing properties.
Biliary scintiscanning in suspected acute cholecystitis
Authors: Ram M. D. , Mattingly Sally S. , Kim E. Ed , Coupal J. , Griffen Ward O. 
Published: May 2005

AbstractThe value of biliary scintiscanning in the early diagnosis of suspected acute cholecystitis was studied in 50 patients. All the patients had clinical features and laboratory data suggestive of acute cholecystitis. Scintigraphy was performed using99mTc HIDA and BIDA and the results were compared to oral cholecystography (OCG) and ultrasonography (US). Nineteen patients were proven at operation and at subsequent histologic examination to have had acute cholecystitis, while the other 31 had different conditions. The scan was 100% sensitive and 96% accurate, while OCG was sensitive in 93% and accurate in 86% in this group. US was not very useful in our experience. Scintiscanning could be performed in the acute stage even in the presence of vomiting and jaundice and was not associated with any adverse reactions. It is very valuable in the diagnosis of patients with suspected acute cholecystitis.
Operative procedures in the management of liver hydatidoses
Authors: Dugalić D. , Djukić V. , Milićević M. , Stevović D. , KneŽević J. , Pantić J. 
Published: May 2005

AbstractScintiscanning and laboratory and clinical examinations in most cases lead to accurate preoperative hydatid cyst diagnosis and reveal the localization of the cyst in the liver. Selecting the adequate operative procedure and taking all precautions to prevent contamination during surgery, ensure good results and minimize the incidence of postoperative complications. Experience with 204 patients is presented.
Simultaneous colostomy and ileostomy—ileostomy with an autonomically continent sphincter
Authors: Palma Eduardo Carlos 
Published: May 2005

AbstractA technique is described for performance of a simultaneous colostomy and ileostomy by detaching and exteriorizing the cecal fundus and the distal end of the last ileal loop, and by making an ample opening of the fundus. The ileocecal sphincter remains intact and serves as an autonomically functioning sphincter for the ileostomy.Forty‐one patients were operated on; there were good results in 40 patients (97.6%) and one death (2.4%). Through the ileostomy, total diversion of feces was obtained. The ileocecal sphincter functioned autonomically with intermittent and widely spaced evacuation of feces. A double enterostomy was used with good results:
As an associated complementary operation in 19 patients, with no operative death; 17 were left colectomies for cancer, and 2 for complicated sigmoiditis (late mortality, 15.8%);
As a complementary operation in 20 cases of occlusion, with one operative death; 15 were severe intestinal occlusion (late mortality, 20%) and 5, occlusive peritonitis (late mortality, 40%);
In 2 cases of severe intractable hemorrhagic ulcerative colitis (with no deaths). Total proctocolectomy was performed subsequently, preserving the ileostomy with a sphincter.The last ileal loop became enlarged and functioned as a colon voiding feces autonomically during 3 or 4 short periods daily, after meals.From the above results, the author concludes that this technique is a valuable procedure: (a) to be used instead of transverse colostomy in colectomies; (b) for retrograde decompressive aspiration of the small gut in severe intestinal occlusion; and (c) to perform as ileostomy with an autonomically functioning sphincter.