bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of extracorporeal shock wave lithotripsy in hepato‐biliary‐pancreatic surgery
Authors: van der Hul René L. , Plaisier Peter W. , Terpstra Onno T. , Braining Hajo A. 
Published: May 2005

AbstractSince the early 1980s extracorporeal shock wave lithotripsy (ESWL) has partially replaced major operative procedures in various fields of surgery. In the interest of the patient, it is important to determine the exact role of ESWL in surgery. Comparing our own prospectively followed patients with other patient series, we have tried to assess this role. We treated 133 patients with cholecystolithiasis, 80 patients with choledocholithiasis, and 17 patients with pancreatic stones using a second‐ generation lithotriptor, the Siemens Lithostar (Siemens, Erlangen, Germany). The results suggest a limited role of ESWL for cholecystolithiasis, in which it is reserved for patients with high operative risk and patients who reject an operation. For choledocholithiasis ESWL seems to become an integral part of the treatment in the elderly patient in whom endoscopic stone removal proved impossible. Finally, ESWL could become a first option for the treatment of intractable pain in patients with chronic calcifying pancreatitis.
Clinicopathologic factors influencing survival of patients with bile duct carcinoma: Multivariate statistical analysis
Authors: Bhuiya Md. Mukhlesur Rahman , Nimura Yuji , Kamiya Junichi , Kondo Satoshi , Nagino Masato , Hayakawa Naokazu 
Published: May 2005

AbstractTo evaluate the influence of various clinicopathologic factors on survival, a computer analysis was performed on 70 patients who underwent resection for bile duct carcinoma. Univariate analysis of overall survival involving all the patients identified 10 factors that were associated with a significant outcome: location of primary lesion (p=0.01), pancreatic invasion (p=0.004), duodenal invasion (p=0.005), macroscopic and microscopic vascular involvement (tp=0.009 andp=0.04), perineural invasion (p=0.02), lymphatic vessel involvement (p=0.04), lymph node metastasis (p=0.02), histologictype (p=0.02), and depth of cancer invasion (p=0.04). However, when the interactive effects of these factors were taken into account, the pancreatic invasion and perineural invasion were selected as the two most significant prognostic factors in a multivariate analysis using the Cox stepwise proportional hazards model. The age, sex, size of the tumor, macroscopic type of lesions, hepatic infiltration, serosal invasion, resected surgical margin at the proximal and distal ends, exposed surgical margin, peritoneal dissemination, and hepatic metastasis were not significantly associated with prognosis.
Redo hepatic resection for metastatic colorectal carcinoma
Authors: Fowler Wyatt C. , Hoffman John P. , Eisenberg Burton L. 
Published: May 2005

AbstractRedo hepatic resection for recurrent colorectal metastasis was performed in eight patients. There was no operative mortality; major morbidity occurred in 25% and minor morbidity in 13% of patients. Four patients are alive and disease‐free at 9, 23, 39, and 49 months, respectively, after their repeat hepatic resection. Four patients have died of recurrent disease, with a median time to recurrence of 6 months and median survival of 15 months. Patterns of failure include hepatic failure alone in two patients and pulmonary and hepatic failure in two. Repeat liver resection can be performed safely and may be beneficial in some patients with recurrent metastases confined to the liver after previous hepatic metastasectomy.
Orthotopic liver transplantation in the presence of partial or total portal vein thrombosis: Problems in diagnosis and management
Authors: Cherqui D. , Duvoux C. , Rahmouni A. , Rotman N. , Dhumeaux D. , Julien M. , Fagniez P. L. 
Published: May 2005

AbstractFrom January 1989 to May 1992, 70 orthotopic liver transplantations (OLT) were performed in 69 patients, 53 of whom had cirrhosis (77%). Eleven patients (16%) had preoperative partial or total portal vein thrombosis (PVT). Ten of these patients had cirrhosis of various causes. PVT was total in three cases and partial in eight. Total PVT was detected preoperatively in all three cases. By contrast, partial PVT was diagnosed preoperatively in only three of the eight cases. In the five other cases of partial PVT, the obstruction was discovered intraoperatively during dissection of the portal vein. Surgical management of PVT consisted of phlebothrombectomy in ten cases followed by usual end‐to‐end portal anastomosis in nine cases and anastomosis of the graft's portal vein to the splenomesenteric confluence in one case. Atypical anastomosis of the graft's portal vein to a dilated choledocal vein was performed in one case of total PVT. There were no deaths or complications related to the presence of preoperative PVT or to its management. One patient died postoperatively of primary graft nonfunction at day 5. One patient had arterial thrombosis 3 months after OLT and was successfully retransplanted. Two patients died of recurrent carcinoma 3 and 7 months after OLT. Eight patients are alive 4 to 39 months after OLT. We conclude from this series that (1) the prevalence of preoperative PVT among patients transplanted for advanced cirrhosis may be high (19% of the cirrhotics in this series); (2) PVT is often partial and so difficult to diagnose preoperatively; (3) PVT, even when total, can be managed successfully during surgery and does not seem to affect survival.
Electrorectography in chronic proctitis
Authors: Shafik Ahmed 
Published: May 2005

AbstractRectal electrical activity, measured by electrorectography (ERG), was studied in 18 patients with chronic proctitis (11 ulcerative and 7 bilharzial proctitis). Mean age was 36.6±9.4 (SD) years. Eight healthy volunteers were included as controls. Monopolar recordings were made from silver‐silver chloride electrodes situated 1 cm from the tip of the catheter, which was applied to the rectal mucosa. Signals from the electrode were displayed on a U‐V recorder. Rectal neck and rectal pressures were recorded simultaneously. Pacesetter potentials (PP) were also recorded from all subjects. The healthy volunteers had a mean frequency of 2.6±0.6 cycles per minute (cpm), an amplitude of 2.4±0.5 mV, and a velocity of 4.3 ± 0.5 cm/sec. The potentials had the same frequency and regular rhythm when the test was repeated and were followed randomly by bursts of action potentials (AP). The rectal pressure increased simultaneously with the AP. In the proctitis patients the PP frequency was higher than normal (mean 8.2 ±1.6 cpm in patients with bilharziasis and 8.9 ± 2.1 cpm in those with ulcerative proctitis) (p<0.001), whereas the amplitude and velocity were lower than normal (p<0.05 andp<0.01, respectively). APs had higher frequency and amplitude and were accompanied by higher rectal pressure than in the normal volunteers. The increased PP, or tachyrectia, may be due to rectal wall or rectosigmoid pacemaker irritation caused by proctitis, whereas the diminished amplitude and velocity may be caused by a diseased rectal wall. The increased AP frequency and amplitude seem to cause increased rectal contractile activity with a resulting tenesmus. ERG is safe, noninvasive, nonradiologic, and it may prove helpful for diagnosing proctitis.
Paracolostomal hernia: Repair with use of a Dacron prosthesis
Authors: Alexandre J. H. , Bouillot J. L. 
Published: May 2005

AbstractSeveral surgical procedures have been described for the repair of paracolostomal hernia. We describe a local technique approach using stoma relocation with insertion of a Dacron prosthesis. Among 14 patients operated on for paracolostomal hernia, this technique was used in 10 patients. There was no mortality or morbidity (no prosthesis infection). During follow‐up there was one recurrence, which was reoperated with a good final result. This technique can be recommended for the few patients in whom a surgical repair is mandated.
Three‐dimensional imaging in craniofacial surgery
Authors: Zonneveld Frans W. , Lobregt Steven , van der Meulen Jacques C. H. , Vaandrager J. Michiel 
Published: May 2005

AbstractOver the past decade, three‐dimensional (3‐D) imaging has been developed to such a stage of perfection and to such a level of interactive selective imaging of specific anatomic and pathologic structures that craniofacial surgeons can now use this technique effectively in the planning of complicated reconstructive surgery. In addition, modeling techniques have been devised that can be used in surgical simulation and in the manufacture of implants and prosthetic devices.The technical aspects of 3‐D imaging are discussed in relation to their applications in Craniofacial Surgery, and reference is made to the literature describing these techniques in full detail.The results are illustrated with cases that the authors have processed by means of: (a) a clinical research program that was developed on a general purpose computer which provided full flexibility in changing and improving the reconstruction algorithms (Lobregt algorithms and DEC VAX 750 computer), (b) a system under development (Pixar PICS 2000), and (c) a commercial system (Cemax 1500X).Finally, a number of emerging techniques are discussed such as surgical simulation (electronic sculpting), and trends such as multimodality imaging.
Craniosynostosis
Authors: Marchac Daniel , Renier Dominique 
Published: May 2005

AbstractCraniosynostosis affects approximately one infant out of one thousand. Increase of intracranial pressure and risks of functional problems are more frequent than previously thought, especially in single‐suture synostosis. Frontocranial remodeling will correct both functional and esthetic consequences of craniosynostosis. The best time for surgery is the first year of life, 2–3 months of age for the brachycephalies, and 6–9 months of age for the other craniosynostoses. Not only does growth not deteriorate after forehead remodeling, but the adjacent orbitonasal areas improve with time. In Crouzon's disease and Apert's syndrome, early frontal advancement does not prevent the midface retrusion, and a radical frontofacial advancement may be occasionally indicated in very severe cases. Frontocranial remodeling is also indicated in children presenting with sequelae of classical neurosurgical treatment or those who have had no treatment.
Treacher Collins Syndrome: Present concepts of the disorder and their surgical correction
Authors: Argenta Louis C. , Iacobucci John J. 
Published: May 2005

AbstractTreacher Collins Syndrome is a rare bilateral congenital deformity occurring in 1 in 10,000 births. It is also known, in the European literature, as Franceschetti Syndrome, and is additionally known as mandibulofacial dysostosis. It is a syndrome with a very wide spectrum of manifestations characterized by distortions of the orbit secondary to hypoplasia of the maxilla, mandible, and, most markedly, of the zygoma. Soft tissue deformities include lower lid colobomas, laxity and dystopia of the lateral canthus, microtia, and a paucity of the muscular aponeurosis of the midface. The syndrome is frequently accompanied by significant hearing loss, early failure to thrive, chronic respiratory insufficiency, and sleep apnea. Intelligence is usually within normal limits although learning disabilities are common in early life. These major anatomical and physiological abnormalities, as well as the psychological and social stigma associated with severe facial deformity, make this syndrome one of the most challenging reconstructive problems presented to the craniofacial surgeon.
Anastomotic leakage after resection and bypass for esophageal cancer: Lessons learned from the past
Authors: Lorentz Theo , Fok Manson , Wong John 
Published: May 2005

AbstractA retrospective study of anastomotic leakage has been undertaken in 730 patients who had resection or bypass for carcinoma of the esophagus during the period 1964–1982 at the Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong. Partial or complete gangrene of the substitute loop also resulting in anastomotic disruptions were excluded from this series. Anastomotic leakage due to suture line failure occurred in 182 patients (24.9%).Two factors were found by multivariate analysis to influence leakage: the type of operation and the choice of organ used as substitute. Leakage occurred more than twice as often in bypass (42.7%) than in resection (18.3%). When the substitute used for reconstruction was viable, jejunum was associated with the lowest incidence of leakage followed by whole stomach, distal stomach, and colon in that order. The risk of leakage for any combination of the type of operation (resection or bypass) and substitute loop used was calculated. The probability of leakage was lowest when a resection was performed and jejunum was used as substitute. In view of the simplicity and relative safety of using the whole stomach, esophagectomy followed by gastric reconstruction is still the procedure of choice for the majority of patients. A bypass procedure using colon as substitute has the highest leakage rate. A low leakage rate should now be obtained, otherwise nonoperative therapy has a legitimate claim as the preferred alternative treatment modality.
Proposed definitions for diagnosis, severity scoring, stratification, and outcome for trials on intraabdominal infection
Authors: Nyström Per ‐Olof , Bax Richard , Dellinger E. Patchen , Dominioni Lorenzo , Knaus William A. , Meakins Jonathan L. , Ohmann Christian , Solomkin Joseph S. , Wacha Hannes , Wittmann Dietmar H. ,   Joint Working Party of SIS North America and Europe
Published: May 2005

AbstractAnalysis of the experience with scientific studies on patients with secondary intraabdominal infection has revealed that problems of interpretation and comparability between studies exist as they relate to variable diagnostic criteria, unmeasured severity of disease, and unclear outcome measures. A consistent system of definitions has been developed to address these deficiencies. Intraabdominal infection is defined as clinical peritonitis requiring both operative and microbiological confirmation for proof of infection. The APACHE II system is proposed for grading the severity of the infection and for stratification of patient risk of mortality. Mortality and time until death, on one hand, and recovery and time until recovery, on the other, are proposed as the main outcome measures, both being independently and positively defined. It is anticipated that this system of minimum rules will produce studies that can be compared, hence, accelerating knowledge and understanding about intraabdominal infection and its best treatment.
A 14‐year experience with kidney transplantation
Authors: Weil Richard , Schröter Gerhard P. J. , West John C. , Starzl Thomas E. 
Published: May 2005

AbstractBetween November, 1962 and August, 1975, 668 kidney transplants were done in 556 consecutive patients at Denver, Colorado. The Denver experience has been divided into 7 periods of time, according to the conditions of care during each period. The results in related transplantation have changed little during the decade beginning in 1966. The results in unrelated transplantation have not materially changed since 1968. The long‐term patient survival after related transplantation has been better than after cadaver transplantation. The results of transplantation in 57 children ages 3 to 18 years have been slightly better than the results of adult transplantation.The outcome of kidney transplantation and the feasibility of improving this therapy with present techniques are limited by our inability to accurately match each patient with the immunologically best donor and by our inability to precisely control the immune system of the recipient. Rejection is still the main reason for graft loss, and sepsis remains the main cause of patient mortality. More specific and less toxic means of achieving graft acceptance are needed before a higher level of patient service can be realized. However, even with the tools now available, thousands of recipients throughout the world have been returned to useful lives.
Current results of human heart transplantation
Authors: Dong Eugene , Shumway Norman E. 
Published: May 2005

AbstractAt Stanford University Medical Center 109 patients have received 114 heart transplants since 1968. The major indication for transplantation has been cardiac failure due to myopathy secondary to coronary arteriosclerosis. Idiopathic cardiomyopathy has been the second greatest indication. The immunosuppressive regimen has consisted of azathioprine, prednisone, and antithymocyte globulin. Overall, 1‐year survival is 52% and recent results indicate a 1‐year survival rate of 66%. Currently, 44 patients are alive and the longest surviving patient has enjoyed 6.5 post‐transplant years.
Progress in liver transplantation
Authors: Putnam Charles W. , Halgrimson Charles G. , Koep Lawrence , Starzl Thomas E. 
Published: May 2005

AbstractSince the first clinical orthotopic liver transplant was performed 13 years ago, approximately 275 patients have undergone this procedure. The Denver series constitutes about 40% of this total experience. In our series, the overall 1‐year survival has been 29%; the longest survivor is now 6 2/3 years posttransplantation. Most of the early deaths have been caused by technical complications, frequently related to difficulties in establishing and maintaining adequate biliary drainage. The late deaths have been from a variety of causes, including recurrent tumor, hepatitis, bile duct obstruction, and chronic rejection.Favorable indications for liver transplantation include biliary atresia, chronic aggressive hepatitis, inborn errors of metabolism, and certain other benign hepatic diseases. Alcoholic cirrhosis is a less favorable indication and primary hepatic malignancy is a relative contraindication. The immunologic criteria for donor‐recipient selection are much less rigid than for renal transplantation.Biliary reconstruction is the principal technical problem encountered with orthotopic liver transplantation. Guidelines for the establishment of biliary drainage, its evaluation, and the management of postoperative biliary complications are discussed.
Lung transplantation 1977
Authors: Veith Frank J. , Koerner Spencer K. 
Published: May 2005

AbstractMany problems in the areas of donor lung procurement, bronchial anastomotic complications, and allograft rejection must be solved before widespread success in therapeutic lung transplantation becomes a reality. However, none of these problems is insurmountable. Considerable progress has already been made toward solving many of them, and the existence of promising new avenues of investigation appears to bode well for the solution of others. Thus, despite the disappointing human experience to date and despite the large number of complex problems that must be overcome, the prospects are good that increasing success with human lung transplantation will be achieved in the future.
Marrow transplantation for aplastic anemia and acute leukemia
Authors: Thomas E. Donnall , Weiden Paul L. ,   Seattle Marrow Transplant Group
Published: May 2005

AbstractPatients with severe aplastic anemia or refractory acute leukemia with HLA identical sibling donors were considered for marrow transplantation in Seattle. Patients with aplastic anemia were generally conditioned for grafting by high‐dose cyclophosphamide (CY); those with acute leukemia by CY and total body irradiation. All patients received methotrexate post‐grafting to ameliorate anticipated graft‐versus‐host disease (GVHD) and were supported with blood products, antibiotics, and intensive care as necessary.Of 73 patients with aplastic anemia, 31 are alive 1 to 5 1/2 years following transplantation; 25 are well, 6 have chronic GVHD. Major causes of death were GVHD (16 patients), graft rejection (17 patients), and infection (6 patients). Of 110 patients with acute leukemia, 17 are alive 1 to 6 years after transplantation. There has been no evidence of recurrent leukemia in 14, although leukemia has relapsed and a subsequent remission has been induced in 3 patients. Respiratory failure secondary to interstitial pneumonia led to the death of 34 patients, other infections led to the death of 16 patients, and 27 patients died as a result of recurrent leukemia.These studies in man, and laboratory studies in the dog, contribute information about many aspects of transplantation biology. Discussed in this report are graft rejection, GVHD, graft‐versus‐leukemia, the nature of stable graft‐host tolerance, and the genetics of transplantation.Despite the many problems that remain, the results described in man establish marrow transplantation as an important form of therapy for selected patients with an otherwise fatal illness.
Results of surgery for gastric cancer and effect of adjuvant mitomycin C on cancer recurrence
Authors: Imanaga Hajime , Nakazato Hiroaki 
Published: May 2005

AbstractThis study involved 1628 patients who underwent surgery for gastric cancer between 1964 and 1973. No gastric resection was performed in 330 patients because of extensive cancer, and all died within 2.5 years. A noncurative resection was performed in 286 patients and most of these died within 3 years, although 12.2% survived for 5 years and 9.7% survived for 8 years. Of the 995 patients who underwent a curative resection in which all macroscopic cancer was removed, 63.7% survived for 5 years and 58.3% survived for 8 years. Survival was directly related to the stage of cancer at the time of operation; in the 9th postoperative year it was 80% in stage 1,48% in stage II, and 19% in stage III. Evaluation of the influence on survival of the two major staging criteria showed that serosal invasion by cancer had a substantially greater negative effect on survival than regional lymph node metastases. In the absence of serosal invasion (even when there were regional lymph node metastases), recurrence usually took the form of hematogenous metastases to the liver rather than peritoneal disease, indicating that it was possible to eradicate all local disease by surgery, but not to eliminate disease in the blood vessels or bloodstream.In the hope of improving the survival rate obtained by curative resection of gastric cancer, investigators in 19 cooperating hospitals have conducted 4 separate studies of surgical adjuvant chemotherapy with mitomycin C (MMC), involving 2636 patients. Administration of MMC twice weekly for 5 weeks after curative resection increased the overall 5‐year survival rate by 13.5% and produced a highly significant 36.6% increase in 5‐year survival in patients with stage II cancer. MMC was particularly effective in preventing hematogenous metastases to the liver in patients who did not have serosal invasion, but it was not effective when the cancer invaded the serosa.
Adenine nucleotide levels in preserved and ischemically injured canine kidneys
Authors: Collins Geoffrey M. , Taft Peter , Green Richard D. , Ruprecht Roswitha , Halasz Nicholas A. 
Published: May 2005

AbstractThis study explored the relationship between adenine nucleotide levels in canine renal cortex and renal function following: (a) graded periods of warm ischemia; (b) 48 hours' flush cooling with electrolyte solutions and ice storage; and (c) continuous hypothermic perfusion. Exposure to normothermic ischemia resulted in a rapid (within 15 minutes) degradation of ATP to ADP and AMP as well as a slow decline in total adenine nucleotide (TAN) to levels which were proportional to the duration of the ischemic injury. No functional impairment was evident after 15 minutes' ischemia, but with longer times, both the extent of decline in TAN and the degree of recovery following restoration of blood flow could be used to predict the quality of renal function.The relationship between TAN levels and function was of less predictive value following cold storage or continuous perfusion. The efficacy of intracellular flush solutions could not be attributed solely to conservation of TAN, nor did the well‐maintained TAN levels during continuous perfusion necessarily lead to significantly better 48‐hour storage than flush cooling with C2 solution.