bluuebunny/crossref_metadata_2025_split huggingface dataset:
Conservative Surgery for Treatment of Hydatid Cysts in Children
Authors: Türkyılmaz Zafer , Sönmez Kaan , Karabulut Ramazan , Demirogulları Billur , Göl Hakkı , Basaklar A. Can , Kale Nuri 
Published: May 2004

AbstractHuman echinococcosis is endemic in Turkey and many other areas of the world. Fifteen years of surgical assessment related to involved structures, operative procedures, complications, and the recurrence rate is analyzed in pediatric patients with pulmonary and abdominal hydatid cysts. Between 1986 and 2001, the records of 42 pediatric patients (15 girls, 27 boys; ages 2–15 years) with pulmonary and abdominal hydatid cysts operated on in our clinic were analyzed retrospectively. The features of the disease, involved structures, operative procedures, complications, and recurrences were noted. A total of 26 patients presented with solitary cysts in the lung (9) and liver (17). Another 11 had multiple cysts in both lung and liver, and 5 had disseminated abdominal disease. Conservative surgical procedures were used for all lung and liver cysts: cystotomy (7) or cystotomy plus capitonnage (13) for lung cysts; partial pericystectomy with capitonnage (25), omentoplasty (28), tube drainage in the presence of bile leakage (5), or a combination of these procedures for liver cysts. Cyst excision was used for omental and peritoneal localizations when feasible. Radical procedures were never used (wedge or major liver and lung resections). Operative mortality was zero, and the morbidity rate was 14%. Three patients with disseminated disease (7%) showed recurrence. We suggest that no partial organ resections are necessary for hydatid disease, and highly successful results can be achieved using conservative surgical approaches, such as cystotomy plus capitonnage for lung cysts and partial pericystectomy with capitonnage, omentoplasty, or both for liver cysts.
Long‐term Follow‐up of Patients with Elevated PTH Levels following Successful Exploration for Primary Hyperparathyroidism
Authors: Nordenström E. , Westerdahl Johan , Bergenfelz A. 
Published: May 2004

AbstractSeveral studies have documented elevated parathyroid hormone (PTH) levels after seemingly successful exploration for primary hyperparathyroidism (pHPT). It is not known if this is a transient phenomenon after pHPT surgery or if it predisposes to recurrent disease. A series of 99 consecutive patients with pHPT who had solitary parathyroid adenomas were followed for 5 years. Serum levels of PTH and biochemical variables reflecting PTH activity were measured before operation, at 8 weeks postoperatively, and then yearly for 5 years. All patients were normocalcemic after exploration. At 8 weeks after operation 28% of the patients had elevated serum PTH levels; at 5 years this figure decreased to 16%. During the 5‐year follow‐up one group of patients normalized their PTH levels, another group’s PTH levels fluctuated, and still another group had consistently normal PTH levels. Patients with fluctuating PTH levels had increased levels of serum calcium and phosphate. Some of these patients (15%) showed signs of impaired renal function. Two patients with consistently elevated PTH levels showed signs of mild renal dysfunction, and one of them developed recurrent HPT. Elevated PTH levels after successful parathyroid surgery is not a transient phenomenon. An increased risk for recurrent disease is postulated for some of the patients who do not normalize their PTH levels postoperatively, and long‐term surveillance of these patients is suggested.
Pheochromocytoma Surgery: Epidemiologic Peculiarities in Children
Authors: Beltsevich Dmitry G. , Kuznetsov Nikolay S. , Kazaryan Airazat M. , Lysenko Maryana A. 
Published: May 2004

AbstractManifestations of pheochromocytoma have some specific features in children. The aim of this study was to explore epidemiologic differences of the disease course in children and adults, the principal causes of pheochromocytoma recurrence, and the optimal extent of an operative intervention in a group of patients with initial manifestation of their tumor during childhood. A total of 520 patients with pheochromocytoma underwent surgery from 1957 to 2001. The mean age of the patients was 39.3 ± 9.2 years; 50 patients (9.6%) were 16 years or under (children’s group). There were 213 males (41%) in the general group and 32 males (62%) in the children’s group. Bilateral adrenal lesions were present in 68 patients (13.1%), including 16 of the 50 children (32%). The tumors were extraadrenal in 36 patients (6.9%), including 9 of the 50 children (18%). The combination of pheochromocytoma and a hereditary syndrome was present in 36 cases (6.9%). Follow‐up was obtained in 260 patients, including 46 children. Length of follow‐up varied from 4 to 25 years (average 8.4 ± 1.9 years). The pheochromocytoma recurred in 49 patients (18.8% of surveyed patients), with a true recurrence (a tumor in the region of the primary operation or metastases) in 16 patients (6.15%). A true pheochromocytoma recurrence was noted in 6 of the 50 children (12.0%). Organ‐sparing tactics for multicentric adrenal lesions was a principal cause of the true recurrence. Therefore we believe it is necessary to perform a radical operation, which includes adrenalectomy and removal of the tumor, in patients with a high risk of recurrence.
Liver Transplantation Techniques with Preservation of the Natural Venovenous Bypass: Effect on Surgical Resection of Renal Cell Carcinoma Invading the Inferior Vena Cava
Authors: Delis Spiros , Dervenis Christos , Lytras Dimitrios , Avgerinos Costas , Soloway Mark , Ciancio Gaetano 
Published: May 2004

AbstractAlthough renal tumors invading the inferior vena cava (IVC) are unusual, they represent a challenge to the surgical team because their accessibility is difficult. Liver transplantation techniques have been developed that preserve the venous collaterals, enhance the exposure, increase the safety of the resection, and avoid cardiopulmonary bypass. We describe our technique for dealing with renal tumors that have invaded the IVC, a combined experience of two centers, and the safety of the procedure and subsequent low morbidity. Between May 1997 and February 2003, a total of 45 patients (mean age 60.7 years) underwent surgical resection of a renal tumor extending into the IVC by techniques developed from liver transplantation, with the intention to avoid sternotomy and cardiopulmonary bypass. In 42 patients (93.3%) surgical resection of the tumor and thrombus was successful using the transabdominal approach while preserving the venous collaterals; 3 patients with a level IV tumor thrombus required cardiopulmonary bypass. The mean operating time was 342 minutes, and the mean estimated blood loss was 1442 cc. Postoperative ileus in one patient required laparoscopic lysis of the adhesions, and 2 patients (4.4%) died owing to multiple system organ failure and massive pulmonary embolism. The median follow‐up was 36 months, during which time 6 patients developed metastatic disease and 37 were disease‐free. We concluded that liver transplantation techniques enhance the surgical management of complicated urologic tumors. Patients with tumor thrombus extending to the IVC can be treated while avoiding thoracotomy and cardiopulmonary bypass.
Pancreaticoduodenectomy with En Bloc Portal Vein Resection for Pancreatic Carcinoma with Suspected Portal Vein Involvement
Authors: Poon Ronnie T. , Fan Sheung Tat , Lo Chung Mau , Liu Chi Leung , Lam Chi Ming , Yuen Wai Key , Yeung Chun , Wong John 
Published: May 2004

AbstractPancreaticoduodenectomy combined with portal vein resection is increasingly accepted as a viable treatment option for pancreatic carcinoma with suspected involvement of the portal vein.However, its clinical benefit remains controversial. This study evaluated the outcomes of pancreaticoduodenectomy with portal vein resection for pancreatic carcinoma in a group of Chinese patients operated on by a specialized team in a center with a low case volume of pancreatic cancer. The perioperative and long‐term outcomes of 12 patients with portal vein resection for suspected involvement of the portal vein and 38 patients who underwent pancreaticoduodenectomy without portal vein resection during the same period were compared. In the former group, eight patients underwent segmental resection, and four patients underwent wedge resection of the portal vein. There were no significant differences in operative blood loss (median 0.8 vs. 0.8 liter, p = 0.313), hospital mortality (0% vs. 2.6%, p = 1.000), or operative morbidity (41.7% vs. 42.1%, p = 0.979) between the two groups. Patients who required portal vein resection had higher frequencies of microscopic lymphatic permeation (58.3% vs. 18.4%, p = 0.023) and vascular invasion (50.0% vs. 15.8%, p = 0.025). Long‐term survival was comparable between patients with portal vein resection and those without it (median 19.5 vs. 20.7 months, p = 0.769). These findings suggest that pancreaticoduodenectomy combined with portal vein resection can be performed safely by a specialized team in a center with a low case volume of pancreatic carcinoma and that it may offer survival benefit in patients with suspected portal vein involvement.
Microsurgical Techniques for Lymphedema Treatment: Derivative Lymphatic‐Venous Microsurgery
Authors: Campisi Corradino , Boccardo Francesco 
Published: May 2004

AbstractWe analyzed clinicopathologic and imaging features of chronic peripheral lymphedema to identify imaging findings indicative of its exact etiopathogenesis and to establish the optimal treatment strategy. One of the main problems of microsurgery for lymphedema is the discrepancy between the excellent technical possibilities and the subsequently insufficient reduction of the lymphedematous tissue fibrosis and sclerosis. Appropriate treatment based on pathologic studies and surgical outcome have not been adequately documented. Over the past 25 years, 676 patients with peripheral lymphedema have been treated with microsurgical lymphatic‐venous anastomoses. Of these patients, 447 (66%) were available for long‐term follow‐up study. Objective assessment was undertaken by water volumetry and lymphoscintigraphy. Objectively, volume changes showed a significant improvement in 561 patients (83%), with an average reduction of 67% of the excess volume. Of the 447 patients followed, 380 (85%) have been able to discontinue the use of conservative measures, with an average follow‐up of more than 7 years and average reduction in excess volume of 69%. There was an 87% reduction in the incidence of cellulitis after microsurgery. Microsurgical lymphatic‐venous anastomoses have a place in the treatment of peripheral lymphedema and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment. Improved results can be expected with operations performed early, during the first stages of lymphedema.
Cost‐effectiveness of Two Follow‐up Strategies for Curative Resection of Colorectal Cancer: Comparative Study Using a Markov Model
Authors: Borie Frédéric , Combescure Christophe , Daurès Jean‐Pierre , Trétarre Brigitte , Millat Bertrand 
Published: May 2004

AbstractThe follow‐up of patients with curative resection of colorectal cancer is still controversial. The means mobilized for postoperative monitoring come at a high cost. However, the modalities are neither formalized nor validated with regard to an improved 5‐year survival rate. To compare the cost‐effectiveness of both strategies for patient follow‐up during the 7 years following curative resection of colorectal cancer, we performed a cost‐effectiveness analysis adjusted for quality of life. Using data from the literature and a population study, a simulation of follow‐up on patients who had undergone curative resection of colorectal cancer was carried out over a 7‐year period using a Markov model. Two Markov processes were modeled to compare the cost‐effectiveness ratio adjusted for quality of life in patients with a follow‐up in accordance with the recommendations of the 1998 French Consensus Conference (standard follow‐up) with the carcinoembryonic antigen (CEA) assay and a simplified follow‐up. The influence of standard follow‐up on the quality‐adjusted life expectancy of patients who had Duke’s stage A and B colorectal cancer appears to be modest, with increases of 2.5 monthsand 1.3 months, respectively; it is more acceptable for patients who had had Duke’s stage C, with an increase of 11 months. The high variability of cost‐effectiveness ratios (> 7 years) of ± 44,830 and 180,195 € per quality‐adjusted life‐years (QALY), respectively) did not favor the standard follow‐up. The cost‐effectiveness ratio (> 7 years) of patients having had Duke’s stage C colorectal cancer was 1,058 (sd: 2746) € per QALY and could favor the standard follow‐up. This study showed that standard follow‐up with CEA assay tended to preferentially improve the survival of Duke’s stage C patients. The type of examination needed and the frequency with which it has to be carried out should take account of the stage, treatment for the initial illness, and the patient’s age.
Improved Prognosis of Resected Esophageal Cancer
Authors: Stein Hubert J. , Siewert Jörg‐Rüdiger 
Published: May 2004

AbstractBecause of the perceived high risk of esophagectomy and the assumed poor long‐term results, the role of surgical resection as the mainstay of treatment for localized esophageal cancer is currently being challenged. Early tumors are increasingly approached by endoscopic mucosectomy or mucosal ablation techniques, whereas combined radiochemotherapy without surgery has become the treatment of choice for locally advanced tumors at many institutions. Several recent reports and our experience, however, indicate that surgical resection of esophageal cancer has become a safe procedure and long‐term survival rates after surgical resection have improved markedly during the past two decades. A number of factors have been associated with the marked reduction in postoperative mortality and improved long‐term survival after surgical resection. They include changes in the epidemiology with an increased rate of adenocarcinoma mostly located distally, patient selection for surgery, improvements in surgical technique and perioperative management, and the use of neoadjuvant treatment protocols. The treatment strategy and extent of the surgical procedure can now be tailored based on histologic tumor type, tumor location, tumor stage, and the general condition of the patient. With an individualized approach, surgical resection of esophageal cancer can predictably offer cure. Surgical resection thus remains the major pillar in the successful treatment of esophageal cancer.
Effect of a landfill on the home range and group size of coyotes (Canis latrans) in a tropical deciduous forest
Authors: Hidalgo‐Mihart Mircea G. , Cantú‐Salazar Lisette , López‐González Carlos A. , Fernandez Erin C. , González‐Romero Alberto 
Published: April 2004

AbstractThe effect of an open landfill and the seasonality of a tropical deciduous forest in Jalisco, Mexico, was tested on the home range and group size of coyotesCanis latransunder the Resource Dispersion Hypothesis (RDH), which proposes that in social carnivores dispersion of patches of limited resources determines home‐range size, whereas independently, abundance of resources affects group size. The predictions in this study were that coyotes using the landfill, where food is available all year due to the continuous arrival of food wastes that are concentrated in a single patch, would have smaller, seasonally constant home ranges than coyotes living outside, where food is distributed in several patches. In this area, coyotes would increase their home ranges during the dry season due to seasonal changes in resource availability. Also, a larger coyote group size should exist in the landfill, where food abundance is greater. Home‐range size and group size of coyotes living in and outside the landfill were estimated by radio‐tracking. Home ranges of coyotes in the landfill varied from 0.9 to 9.5 km2, whereas home‐range sizes of coyotes outside the landfill varied from 10.9 to 43.7 km2. Seasonality had no effect on the home‐range sizes. We identified a group of four adult coyotes in the landfill and no group formation in coyotes outside. These results support the predictions about home‐range and group size of coyotes in relation to landfill presence, and indicate that under the circumstances of our study, coyotes follow the postulates proposed by the RDH.
Prevalence and correlates of stunting among children in rural Pakistan
Authors: SHAH SYED M , SELWYN BEATRICE J , LUBY STEPHEN , MERCHANT ANWAR , BANO RASHIDA 
Published: May 2004

Abstract

Background
: Protein‐energy malnutrition remains an important underlying cause of death among preschool children in Pakistan. The present study aimed to estimate the prevalence of stunting and its correlates and to explore the role of sex bias in remote rural villages of south Pakistan.
Methods
: We selected 1878 children less than 3 years of age through stratified random sampling from 64 villages having the number of children enrolled proportionate to the size of each village, in rural Sindh, Pakistan. Trained investigators completed child physical measurements and a maternal interview. The Z‐scores for the distribution of height‐for‐age (stunting) and weight‐for‐height (wasting) were estimated relative to those of the National Center for Health Statistics/Center for Disease Control (NCHS/CDC) reference population.
Results
: A total of 483 (26%) of the 1878 children were wasted, 977 (55%) were stunted and 259 (15%) were both wasted and stunted. Mothers who were illiterate were more likely to have children who were stunted (odds ratio (OR) = 1.27, 95% confidence interval (CI) 1.11–1.61). Fathers who earn less than Rs. 1000 (US $20) per month (OR = 1.35, 95% CI 1.12–1.66) were more likely to have children who were stunted. Children living in an overcrowded house were more likely to be stunted (OR = 1.44, 95% CI 1.18–1.75). Male children compared to females were equally likely to be stunted (57 vs 55%, OR 1.03, 95% CI 0.86–1.25).
Conclusions
: In this region of lower Sindh, stunting is more common than wasting. Female illiteracy, poor household income and overcrowding are important risk factors for stunting. The prevalent belief that in rural Pakistan, parents pay attention to feeding male children at the cost of female children is not proven by these data.
Endothelin‐1 in children with acute poststreptococcal glomerulonephritis and hypertension
Authors: NICOLAIDOU POLYXENI , GEORGOULI HELEN , MATSINOS YIANNIS , PSYCHOU FOTINI , MESSARITAKI ANNA , GOURGIOTIS DIMITRIS , ZEIS PETROS 
Published: May 2004

Abstract

Background
: Endothelin‐1 (ET‐1), the most potent vasoconstrictor peptide, is known to play a role in arterial hypertension. In patients with acute poststreptococcal glomerulonephritis (APSGN) an increase in the production of ET‐1 is suspected due to damaged endothelium, platelet activation and increased thrombin production in the glomeruli. The aim of the present study was to investigate whether the levels of plasma ET‐1 are elevated in children with APSGN. Furthermore, we examined the association between plasma ET‐1 levels and blood pressure levels in the same children.
Methods
: We studied 18 children (14 boys) with APSGN (mean age 7.44~2.82 years). Fourteen healthy children served as controls. The following parameters were evaluated: plasma ET‐1, plasma atrial natriuretic peptide (ANP), plasma renin (Rn), serum aldosterone (Aldo), creatinine clearance (Ccr) and fractional excretion of sodium (FENa).
Results
: The mean plasma ET‐1 concentrations were higher in patients with APSGN (3.39~1.86 pg/mL) compared to controls (1.40~0.15 pg/mL; P=0.0001). Patients with APSGN also had higher plasma ANP concentrations (41.67~27.99 pg/mL) than the controls (22.80~4.24 pg/mL; P=0.011). Plasma Rn concentrations were lower in patients (24.54~16.34 μU/mL) compared to controls (56.76~32.36 μU/mL; P=0.027). A positive correlation was found between ET‐1 plasma concentrations and the height of systolic or diastolic blood pressure (r=0.57, P=0.013 and r=0.53, P=0.023, respectively).
Conclusions
: Our results suggest that increased plasma ET‐1 concentrations may play an important role in the pathogenesis of hypertension in children with acute poststreptococcal glomerulonephritis.
Transcatheter occlusion of patent ductus arteriosus using tornado platinum coils
Authors: SUDA KENJI , MATSUMURA MASAHIKO 
Published: May 2004

Abstract

Background
: The purpose of the present study was to develop a method to occlude a patent ductus arteriosus (PDA) using a tornado platinum coil, which is compatible with magnetic fields.
Methods
: Twelve patients with a PDA (5 boys and 7 girls; 0.6 to 7 yrs; 6.5 to 22.1 kg) were enrolled. The minimum size of the PDA ranged from 0.2 mm to 3.6 mm. Either the anterograde or retrograde method was applied using a retrievable system that consisted of a 5‐Fr multipurpose catheter and a 3‐Fr bioptome. Three to 3.5 loops of the larger end of a tornado platinum coil were placed in the aortic ampulla and the remaining 0.5–1.0 loop of the smaller end of the coil was placed in the main pulmonary artery.
Results
: In 11 patients with minimum size of PDA ≤ 2.8 mm, the PDA was successfully occluded using one to five tornado platinum coils and, in 10 of 11 patients, an echocardiogram confirmed complete occlusion up to 6 months after the procedures. In the remaining patient with a relatively large PDA (3.6 mm), the PDA could not be occluded because of instability of the coils.
Conclusions
: It is feasible to occlude a relatively small PDA (≤ 2.8 mm) using tornado platinum coils, but further study is warranted to evaluate the safety and efficacy of this method.
Hypophosphatemia in juvenile patients with systemic lupus erythematosus
Authors: FUJIWARA IKUMA , OGAWA EISHIN , KONDO YOSHIAKI , OHURA TOSHIHIRO , IINUMA KAZUIE 
Published: May 2004

Abstract

Background
: Hypophosphatemia is observed in both genetic diseases and acquired disorders, although it has never been described in systemic lupus erythematosus (SLE). The present study reports hypophosphatemia observed in patients with SLE, and investigates whether serum phosphorus (P) concentration is associated with disease activity and some cytokines.
Methods
: Six girls with SLE (age 10 to 16 years) and seven age‐matched controls were studied. Relationships between serum P and parameters that represented disease activity were evaluated. Interleukin (IL) 6 and tumor necrosis factor α (TNF‐α) levels were measured by enzyme‐linked immunosorbent assay (ELISA).
Results
: Two of the patients with SLE developed marked hypophosphatemia during active disease. Their serum P significantly correlated positively with serum complements, red blood cell (RBC) and platelet counts, and negatively with anti‐double‐stranded DNA antibody (dsDNAab). Three of the remaining four patients showed the same trend, in which their serum P significantly correlated with RBC, platelets, dsDNAab and/or serum complement concentrations. Serum and urinary IL‐6 and serum TNF‐α were higher in active SLE patients than those with inactive disease or in the control group. In addition, the concentrations of these cytokines significantly correlated inversely with serum P. Renal tubular reabsorption of P was significantly lower in patients with active disease both with and without lupus nephritis.
Conclusions
: Hypophosphatemia may be another sign of juvenile SLE, and serum P may represent disease activity. Both TNF‐α and IL‐6 may be related to hypophosphatemia in patients with SLE. Waste of P from renal tubules may be a possible mechanism of hypophosphatemia in SLE.