bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of oxygen‐derived free radicals in the management of venous (varicose) ulceration: A new approach
Authors: Salim Aws S. 
Published: May 2005

AbstractThis double blind controlled study examined whether oxygen‐derived free radicals interfere with the healing of venous ulceration occurring on the medial side of the leg for the first time. Graduated compression bandages exerting a mean ankle pressure of 42.1±0.3 mmHg and a mean pressure of 17.3±0.2 mmHg just below the knee healed 70% of ulcers within 12 weeks (n=44). Addition of the radical scavengers allopurinol (n=45) or dimethyl sulfoxide (n=44) to the compression bandages (daily application of the powder for 7 days, then once weekly applications to the end of the study at 3 months) significantly (p< 0.01) stimulated the healing of venous ulceration relative to controls when studied 4, 8, and 12 weeks after commencing treatment. After 3 months of treatment, allopurinol healed 93% and dimethyl sulfoxide healed 95% of the venous ulcers. The results suggest that oxygen‐derived free radicals are directly implicated in the mechanism of venous ulceration and are responsible for its persistence. Scavenging such radicals stimulates the healing of ulceration.
Staging for M Disease
Authors: Winton Timothy L. 
Published: May 2005

AbstractThe presence of distant metastatic disease (M disease) in non‐small‐cell cancer patients is associated with a poor prognosis, and surgical resection at the primary site is contraindicated. Careful preoperative evaluation to identify the subset of patients presenting with M disease is essential in order to avoid unnecessary surgery. Current indications for the use of diagnostic techniques and the methods utilized to detect metastatic disease at the commonest sites encountered in patients with non‐small‐cell carcinoma, including the pleura, central nervous system, liver, adrenal glands, and skeletal system, are discussed.
Staging of bronchogenic carcinoma
Authors: Herman Stephen J. 
Published: May 2005

AbstractBoth computed tomography (CT) and magnetic resonance imaging (MRI) can provide important information not obtainable by chest radiography regarding staging of patients with bronchogenic carcinoma. However, while CT and MRI can both detect enlarged mediastinal nodes, this only approximately indicates tumor involvement. For example, enlarged nodes do not necessarily contain tumor, so biopsy is necessary before declaring the patient inoperable. As well, normal‐sized nodes may contain tumor, and whether mediastinoscopy is required in such situations is controversial. Similarly, neither MRI nor CT is highly accurate in detecting mediastinal or chest‐wall involvement, although certain specific features can occasionally be highly predictive of invasion.
Invasive staging of the mediastinum
Authors: Johnston Michael R. 
Published: May 2005

RésuméLes résultats de la résection chirurgicale des cancers du poumon (excepté les cancers à petites cellules) sont bien corrélés avec le stade de la maladie. S'il existe des métastases régionales, il est essentiel de bien évaluer l'état médiastinal avant de proposer une exérèse chirurgicale. Bien qu'il existe plusieurs méthodes d'imagerie moderne, reconnues comme extrêmement efficaces dans l'évaluation de l'extension locorégionale, il persiste des erreurs lorsqu'on prend en compte seulement la taille des ganglions lymphatiques du médiastin pour prédire l'existence de l'envahissement métastatiques ou non. Pour cette raison, la plupart des chirurgiens thoraciques exigent des biopsies réglées et systématiques des ganglions avant d'opérer, surtout lorsque l'imagerie met en évidence des adénopathies médiastinales. Les études de traitement adjuvant conduites actuellement par les groupes d'études multicentriques dans le Continent Nord‐Américain exigent à présent un tel “staging mini‐invasif “. On établit ensuite une carte “métastatique” des différents ganglions lymphatiques du médiastin afin d'y adapter la thérapeutique. Dans le choix interviennent également l'expérience et le savoir du chirurgien, le site de la tumeur primitive et le degré d'extension tumorale locorégionale. L'évaluation du médiastin peut être faite avec un minimum de morbidité et fournit un maximum de renseignements pour le pronostic. Ceci est capital pour bien expliquer aux patients l'attitude thérapeutique qu'on leur propose.
Extended resection for higher‐stage non‐small‐cell lung cancer
Authors: Luketich James D. , Van Raemdonck Dirk E. , Ginsberg Robert J. 
Published: May 2005

AbstractThis report reviews the results of extended surgical resection for advanced lung cancer (stage IIIa, IIIb, IV) reported in the Anglo‐American literature between 1980 and 1993. Complete resection of stage IIIa (T3) tumors with minimal or no nodal involvement resulted in a 5‐year survival approaching 40%. Ipsilateral mediastinal nodal involvement (N2) lowered 5‐year survival to 10–15% and to near 0% if bulky disease was present. Historically, resection of stage IIIb disease has failed to improve survival. Radiation therapy has decreased local recurrence in advanced‐stage disease but has not improved survival.Preliminary results have recently been reported using induction chemotherapy or chemoradiotherapy followed by resection in subsets of patients with stage IIIa and IIIb disease. Induction chemotherapy for bulky N2 (IIIa) disease resulted in major response rates of up to 77% and a 5‐year survival of up to 26% after complete resection. Preliminary results of resection of stage IIIb tumors following induction chemotherapy have achieved 2‐year survivals of 40%. Metastatic lung cancer (stage IV) with disseminated disease remains virtually incurable with poor response rates to chemotherapy. However, resection of isolated brain metastases (M1 disease) resulted in a 5‐year survival near 25%. Resection of other sites of isolated metastatic disease including the adrenal gland is under investigation.The major prognostic factor in these studies has been the ability to completely resect all tumor. To improve resectability rates, induction therapy and radical resections are being combined more frequently. The increased morbidity and mortality of these aggressive approaches requires careful patient selection.
Neoadjuvant and adjuvant therapy in the management of locally advanced non‐small‐cell lung cancer
Authors: Jaklitsch Michael T. , Strauss Gary M. , Sugarbaker David J. 
Published: May 2005

AbstractThe role of adjuvant therapy in non‐small‐cell lung cancer continues to be defined. We review the most recent major reports of adjuvant trials. Three large randomized trials of postoperative chemotherapy and/or radiation therapy for stage I and II patients have noted improvement trends in median and long‐term survival. Two large preoperative phase II trials for stage III A patients have reported high response and surgical resectability rates for preoperative combinations of radiation and chemotherapy, but without significant improvement in survival. In general, most of these protocols require months to complete, and not all patients are able to withstand the associated toxicity. The field of adjuvant therapy is continuing to develop; some of the strategies of ongoing protocols are reviewed.
Postoperative chemotherapy for resected non‐small‐cell lung cancer
Authors: Crump Michael 
Published: May 2005

AbstractSurgical resection is the treatment of choice for patients with stage I and stage II non‐small‐cell lung cancer (NSCLC—squamous cell, adenocarcinoma, and large‐cell carcinoma). Distant recurrence is an important cause of death after complete surgical resection, occurring in 30–60% of patients. Postoperative adjuvant chemotherapy has been studied for over three decades in randomized controlled trials but is not considered standard therapy for this group of patients. The use of multidrug regimens including cisplatin has produced a prolongation of disease‐free survival, but until recently no overall survival benefit has been shown. A new generation of studies is now warranted, employing the more active combinations identified in the 1980s or incorporating one of the many promising new agents being tested in NSCLC. The use of improved supportive care measures, such as the new serotonin receptor antagonist antiemetics, is required to increase compliance with chemotherapy in this group of patients. With this approach, the real goal of adjuvant system chemotherapy—to increase the number of patients actually cured of their cancer—may be attained in early stage NSCLC.
Minicholecystectomy vs conventional cholecystectomy: A prospective randomized trial—Implications in the laparoscopic era
Authors: Assalia Ahmad , Schein Moshe , Kopelman Doron , Hashmonai Moshe 
Published: May 2005

AbstractThe objective of this study was to compare results of elective “open” conventional cholecystectomy (CC) to those of minicholecystectomy (MC). A clinical prospective, randomized trial was designed. The setting was an academic general surgical unit. In the CC group were 26 patients; in the MC group were 24 patients. In the CC group a conventional open cholecystectomy was performed through a subcostal incision; in the MC group operation through an initial 5‐cm subcostal incision was done. Mean length of wound was 14.4 cm and 5.4 cm in the two groups, respectively (p<0.001). Mean operative time was 60 and 59 minutes, respectively. Mean operative difficulty, estimated on a 1–10 scale, was 3.4 and 5.6, respectively (p<0.05). Mean postoperative analgesia requirements (number of doses of 10 mg morphine sulphate) were 5.8 and 4.0, respectively (p=0.002). Mean duration of hospitalization was 4.7 and 3.0 days, respectively (p<0.001). Mean “overall patient satisfaction,” estimated on 1–10 scale, was 6 and 8.3, respectively (p=0.002). We conclude that Minicholecystectomy offers less pain, earlier recovery, and better cosmetic results than the conventional “open” procedure. Published results of MC compare favorably with those of laparoscopic procedures. The implications of these results in the “laparoscopic era” are discussed.
Tumor spread in superficial esophageal cancer: Histopathologic basis for rational surgical treatment
Authors: Nishimaki Tadashi , Tanaka Otsuo , Suzuki Tsutomu , Aizawa Kikuo , Watanabe Hidenobu , Muto Terukazu 
Published: May 2005

AbstractTo formulate a rational approach for the surgical treatment of patients with superficial esophageal cancer (SEC), tumor spread was clinicopathologically studied in 89 patients with SEC. There were 31 mucosal and 58 submucosal tumors. Lymph node metastases were not found in any of those with a mucosal tumor, while one or more lymph nodes were positive for cancer in 41.4% of those with a submucosal tumor. Furthermore, cancer metastasized to extramediastinal nodes, including cervical and abdominal nodes, in 14 patients, accounting for 58.3% of those with nodal metastasis. The 5‐year survival rate was 100% and there were no recurrences after esophagectomy in those with a mucosal tumor, whereas the survival rate of those with a submucosal tumor was 64.3% at 5 years (p<0.01). Based on the different biological behavior of mucosal and submucosal esophageal cancer, we conclude that mucosal tumors may be adequately treated by any type of local resection but submucosal tumors require a subtotal esophagectomy with systematic lymphadenectomy involving the cervical, mediastinal, and abdominal nodes for cure.
Operative procedures of reconstruction after resection of esophageal cancer and the postoperative quality of life
Authors: Kuwano Hiroyuki , Ikebe Masahiko , Baba Kinya , Kitamura Kaoru , Toh Yasushi , Matsuda Hiroyuki , Sugimachi Keizo 
Published: May 2005

AbstractTo investigate the influence of the operative procedures of reconstruction after resection of esophageal cancer on the postoperative quality of life, an interview was conducted and subjective and objective factors related to the quality of life were evaluated in 50 patients without a recurrence of esophageal cancer. Among the 50 cases, reconstruction by the antethoracal route was performed in 9 (group I) and by the retrosternal route in 24 (group II). Intrathoracic anastomosis was done in 17 (group III). A postoperative disturbance of the food passage was seen 22.0, 41.6, and 5.9% in groups I, II, and III, respectively. Dumping symptom was evident 11.1, 12.5, and 11.8%, respectively. Heartburn was seen only in two cases, in group III. A body weight loss of more than 1.0 kg from preoperative weight was seen in 33.3, 41.7, and 41.2% of groups I, II, and III, respectively. There was no difference in the postoperative performance status or laboratory data among the groups. Thus, although intrathoracic anastomosis was favorable for postoperative food passage, there was no significant difference in any other factors in the quality of life among the routes of reconstruction, and the quality of life gradually improved in patients of all groups as postoperative time passed in the cases without postoperative recurrence of esophageal cancer.
T‐lymphocyte transformation in experimental obstructive jaundice: The role of serum‐suppressive factors
Authors: Thompson Ronald L. E. , Ranjbar Shahin , Rowlands Brian J. 
Published: May 2005

AbstractInfective complications are a significant problem in the management of patients with obstructive jaundice, despite the widespread use of prophylactic antibiotics. The cause of this may be suppression of the immune system. This study investigates the effect of serum from an animal model of extrahepatic biliary obstruction (BDL) for 7, 14, and 21 days on the lymphoproliferative response of a single population of T‐lymphocytes to the mitogen phytohemagglutinin (PHA). Mean stimulation counts for lymphocytes cultured with 7 days with BDL serum (938±90p=0.04) and for 21 days with BDL serum (844±253p=0.04) are significantly lower than control serum (2382±1340). The effect of 14 days BDL serum has some suppression of lymphocyte stimulation but this is not significant (1115±429p=0.06). There was no significant correlation with any clinical parameters including bilirubin and the duration of jaundice. We have concluded that serum from animals with obstructive jaundice is immunosuppressive, but further studies are required to identify the factor and its role in vivo.
The role of selective visceral angiography in the management of pancreatic and periampullary cancer
Authors: Murugiah Mahadavan , Windsor John A. , Redhead Doris N. , O'Neill John S. , Suc Bertrand , Garden O. James , Carter David C. 
Published: May 2005

AbstractA prospective study was undertaken to evaluate selective visceral angiography (SVA) in the management of patients with pancreatic and periampullary cancer. Over a 30‐month period 52 patients with potentially resectable pancreatic or periampullary cancer underwent SVA; 4 patients had obvious angiographic evidence of widely disseminated disease and were not subjected to laparotomy while 2 further patients were eventually considered too frail for resection. The remaining 46 patients (median age 58 years, range 37–73 years, males 26, females 20) had no evidence of disseminated disease on ultrasonography and/or CT scanning and had both SVA and surgery and form the basis of this study. Vascular anomalies were detected in 16/46 (35%) patients. Hepatic metastases were wrongly diagnosed by angiography in 7 out of 9 patients (77%). SVA correctly predicted resectability or irresectability in 28/46 patients (overall predictive value 61%). Of the 27 patients who proved to have irresectable disease at operation, 11 were correctly identified by SVA (sensitivity 41%). Of the 13 patients reported to have irresectable disease, 2 underwent resection (false‐positive rate 15%). Of the 33 patients reported to have resectable disease, 16 were irresectable (false‐negative rate 48%). Overall there was a poor relationship between resectability and the angiographic features. On the basis of these data, SVA cannot be considered a sufficiently accurate means of assessing resectability. Its use for this purpose in patients with pancreatic and periampullary cancer is not justified.
Emergency surgical treatment for bleeding duodenal ulcer: Oversewing plus vagotomy versus gastric resection, a controlled randomized trial
Authors: Millat Bertrand , Hay Jean‐Marie , Valleur Patrice , Fingerhut Abe , Fagniez Pierre‐Louis ,   The French Associations for Surgical Research
Published: May 2005

AbstractThe best surgical procedure to treat bleeding bulbar peptic ulcer is unknown. The rates of postoperative bleeding recurrence, duodenal leakage, and mortality were compared in patients undergoing oversewing plus vagotomy (O+V) or gastric resection (GR) with ulcer excision. Of 202 patients undergoing emergency surgery for massive, persistent, or recurrent bleeding from bulbar peptic ulcer, 120 patients were enrolled in a prospective randomized trial. Fiftynine were assigned to O+V and 61 to GR. One patient in each group was excluded after randomization. The two groups were well matched with respect to clinical and prognostic factors. The rate of postoperative bleeding recurrence was 17% after O+V and 3% after GR (p<0.05). The duodenal leak rate was higher after GR than after O+V (13% vs. 3%) (p<0.10) but was not different when the morbidity of reoperations for bleeding recurrence after O+V was considered on an “intention to treat” basis (12% vs. 13%). Overall postoperative mortality was similar: 22% (O+V) versus 23% (GR). Sixteen deaths were unrelated to the surgical procedure itself. Of 82 nonrandomized patients, 10 were not analyzed. In the 72 other nonrandomized patients, bleeding recurrence, duodenal leakage, and postoperative mortality rates were consistent with the results of the controlled trial, as they were 29% (O+V 32%; GR 0.7%), 16% (O+V 0.7%; GR 26%) and 27% (O+V 18%; GR 33.3%), respectively. We conclude that GR with ulcer excision is the procedure of choice for the emergency surgical treatment of bleeding duodenal ulcer because postoperative bleeding recurrence is lower, and the overall rates of mortality and duodenal leakage are the same as with O+V.
Refundoplication for recurrent gastroesophageal reflux
Authors: Luostarinen Markku E. , Isolauri Jouko O. , Koskinen Matti O. , Laitinen Jukka O. , Matikainen Martti J. , Lindholm T. Sam 
Published: May 2005

AbstractReoperation after a failed antireflux procedure is a surgical challenge. Many operative techniques have been proposed, but reports on systematic follow‐up with endoscopy and esophageal function tests are few. The purpose of the present study was to evaluate the results of repeated fundoplication in cases of recurrent reflux, including assessment of esophageal function. Of the 18 cases of repeat fundoplication performed for recurrent reflux during 1970–1991 at Tampere University Hospital, 15 were evaluated a median of 18 (range 5–152) months after reoperation. Follow‐up studies included endoscopy in all and esophageal function tests (esophageal 24‐hour pH recording, manometry, and radionuclide transit) in 14 cases. All the patients had defective fundic wrap before reoperation, whereas at follow‐up 12 of the 15 wraps were intact. Reflux symptoms were diminished in all 15. Six patients (40%), however, had objective recurrence of reflux (esophagitis or pathologic pH recording). Three of the recurrences were due to slipped fundic wrap, but the others were probably caused by impaired esophageal function. By repeat fundoplication the wrap could be repaired as reliably as in primary operation. Symptomatic outcome and objective results were reasonable. The results were, however, not as good as after primary operation, which was due to more impaired esophageal motility caused by prolonged reflux or repeated surgery (or both).
Expression of a potential metastasis suppressor gene (nm23) in thyroid neoplasms
Authors: Farley David R. , Eberhardt Norman L. , Grant Clive S. , Schaid Daniel J. , van Heerden Jonathan A. , Hay Ian D. , Khosla Sundeep 
Published: May 2005

AbstractIdentification of multiple clinical and pathologic prognostic factors in differentiated thyroid cancer has permitted some degree of risk stratification. However, these clinical indices fail to distinguish potential intrinsic differences in tumor virulence. The nm23 gene has been identified as a potential metastasis suppressor gene that is homologous to nucleoside diphosphate kinases. Studies in human breast cancer have shown a significant inverse correlation between nm23 levels and nodal involvement/tumor recurrence. Given the possible clinical utility of a marker of metastatic potential in the management of thyroid carcinoma, we examined 34 thyroid neoplasms and a human medullary thyroid cancer (MTC) cell line (TT) for nm23 expression. Normalized nm23 expression was assessed by Northern analysis of tumor RNA. nm23 Expression (tumor expression/TT cell expression, mean ±SE) was 1.14 ±0.15* in MTCs (n =5), 0.70 ±0.10* in follicular cancers (n=6), 0.51 ±0.11 in papillary cancers (n=19), and 0.31 ±0.03 in follicular adenomas (n=4) (*p< 0.05 when compared to adenomas). Within histologicgroups, we found no correlation between nm23 expression and nodal involvement or distant métastases. Our results indicate that thyroid neoplasms of different histologies express varying levels of the nm23 transcript. Although nm23 expression seems diminished in metastatic breast cancer, it appears not to be the case in metastatic thyroid cancer. The nm23 gene may therefore have different roles in the evolution and metastases of different neoplasms.
Operative ultrasonography during hepatobiliary and pancreatic surgery
Authors: Machi Junji , Sigel Bernard , Zaren Howard A. , Kurohiji Toshihiko , Yamashita Yuichi 
Published: May 2005

AbstractOn the basis of our experience with operative ultrasonography during hepatobiliary and pancreatic surgery, its indications, benefits, and disadvantages are summarized. High‐ resolution operative ultrasound scanning of the liver, biliary tract, and pancreas was performed during 357, 735, and 242 operations, respectively. The benefits of operative ultrasonography were categorized as acquisition of diagnostic information otherwise not available, replacement for or complement to operative radiography, and guidance of surgical procedures. Operative ultrasonography provided beneficial information during 73 of 82 hepatic operations (89.0%), 57 of 69 noncalculous biliary operations (82.6%), and 177 of 242 pancreatic operations (73.1%). Operative ultrasonography was significantly superior (sensitivity 93.3%) to other screening tests for diagnosing liver metastasis from colorectal carcinoma evaluated in 189 patients, and it detected previously unrecognized metastatic tumors in 18 patients (9.5%). For screening common bile duct calculi during 666 operations, operative ultrasonography and operative cholangiography were comparable in all indices of accuracy except for a higher predictability of a positive test of operative ultrasonography (94.8% versus 71.7%). For diagnosing portal vein invasion of pancreatic carcinoma, operative ultrasonography provided better overall accuracy than preoperative studies (89.7% versus 64.1%). On the basis of operative ultrasound findings, previously planned surgical procedures were altered in 32 of 82 hepatic operations (39.0%) and 24 of 145 pancreatic operations for chronic pancreatitis (16.6%). Operative ultrasound guidance of various surgical procedures was performed during 88 hepatic and 84 pancreatic operations, including 40 ultrasound‐ guided hepatectomies and 42 pancreatotomies. Operative ultrasonography has a number of advantages, such as safety and speed in performance, wide application, high diagnostic accuracy, and ability of guiding procedures. Its disadvantages are the limitation of the fields of view in certain applications, the need for special equipment, and a slow learning curve.