bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytoprotection of the gastric epithelium
Authors: Moody Frank G. , Zalewsky Charlotte A. , Larsen Kenneth R. 
Published: May 2005

AbstractThe lining of the stomach of man is protected from its unique secretion, hydrochloric acid, by a variety of highly specialized characteristics. Foremost is its relative impermeability to hydrogen ions. The gastric surface epithelial cell which forms a continuous integument from the esophagus to the duodenum plays an important role in this barrier function. Disruption of the barrier by injurious agents, sepsis, or shock may lead to severe erosive gastritis when acid is present within the lumen of the stomach. This process is accelerated during periods of low mucosal blood flow. The relationship of the rate of back‐diffusion of hydrogen ions to mucosal blood flow appears critical. Factors which (a) inhibit acid secretion, (b) strengthen the barrier to H+ diffusion, or (c) increase mucosal blood flow will protect the stomach from injury. Prostaglandins of the A, E, and F series offer a level of protection in experimental erosive gastritis that is out of proportion to their effect on acid secretion and mucosal perfusion. The secretion or filtration of an alkaline secretion may be an important component of the cytoprotection which follows the topical exposure of gastric mucosa to 16,16‐dimethyl (PGE2). The role of mucus release in this situation requires further elucidation.
The pathophysiology of stress ulcer disease
Authors: Silen William , Merhav Aryeh , Simson Jay N. L. 
Published: May 2005

AbstractStress ulcers are superficial mucosal lesions located predominantly in the fundus of the stomach. They occur mainly in the victims of severe trauma and sepsis and are to be clearly distinguished from Cushing's ulcers, ulcers induced by drugs and from activation of a preexistent ulcer. It is generally agreed that mucosal ischemia is the major inciting event in the pathogenesis of acute stress ulceration of the stomach and that the presence of luminal acid and pepsin are required for overt ulceration to develop. Back‐diffusion of acid occurs in the absence of overt disruption of the gastric mucosal barrier, is closely related to the formation of ulcers, and may be enhanced by reflux of duodenal content into the stomach and by diffusion of blood urea into the stomach. Severe acidosis and base deficit together with depression of acid secretion and consequent lowering of alkaline tide are important contributing factors. A differential energy deficit in fundic mucosa as a result of ischemia probably contributes to mucosa damage by interfering with anion exchange (HCO3− for Cl−). The exact role of steroids and prostaglandins is controversial.
Role of gastric mucosal energy metabolism in the etiology of stress ulceration
Authors: Menguy Rene 
Published: May 2005

AbstractIt is generally agreed that mucosal ischemia of the gastrointestinal tract is one of the major consequences of the low‐flow state, be it due to blood loss, fluid loss, or sepsis. In the present paper, arguments are presented in favor of the hypothesis that stress‐induced mucosal injury which tends to occur preferentially in the proximal stomach, duodenum, and terminal ileum results from a mucosal energy deficit severe enough to cause cell death.
Drug‐induced gastric mucosal injury
Authors: Fromm David 
Published: May 2005

AbstractAlthough there is much of anecdotal information about drug injury to the gastric mucosa, only a few agents (e.g., salicylates, nonsteroidal‐nonsalicylate antiinflammatory compounds, and alcohol) have been studied in detail. The presence of acid in the gastric lumen is required for an injurious drug to cause clinically significant injury. Injury occurs as a result of the ability of certain drugs to increase the permeability of the mucosa to its own secreted acid lying within the lumen. As the tissue becomes overwhelmed by the diffusing acid, cell death occurs. Drugs that increase the diffusion of acid also interfere with cellular metabolism, an effect that is independent of the ability of the drug to increase diffusion of acid from the lumen into the tissue. However, when metabolic processes of the mucosa are depressed, the ability of the tissue to buffer diffusing acid is impaired. Thus, the quantity of acid diffusing into the tissue is not as important as the buffering capacity of the mucosa. Most instances of drug‐induced injury are not clinically apparent, yet significant hemorrhage occurs in some patients. Even though the initial episode of hemorrhage may be severe, aggressive nonoperative treatment usually is sufficient, provided the mucosa is no longer exposed to the injurious agent. Only a few patients require operation, the extent of which is still controversial.
Stress ulcer disease in the burned patient
Authors: Pruitt Basil A. , Goodwin Cleon W. 
Published: May 2005

AbstractStress‐induced ulcers of the stomach and duodenum in massively burned patients, otherwise known as Curling's ulcers, result from a defect in the mucosal barrier to secreted acid. The etiology of this defect is related, at least in part, to mucosal ischemia, which is aggravated by hypotension, sepsis, and hypoxia. Early prophylactic administration of antacids and cimetidine, either singly or in combination, has significantly reduced the occurrence of the life‐threatening complications of these lesions. When preventive measures have failed or have not been utilized and massive bleeding or perforation has occurred, these complications of Curling's ulcer appear to be best treated by gastric resection combined with vagotomy.
Methods of prophylaxis in stress ulcer disease
Authors: Priebe Hans ‐Joachim , Skillman John J. 
Published: May 2005

AbstractAlthough infrequent, acute upper gastrointestinal bleeding is potentially life‐threatening for critically ill patients. Gastric erosions can be detected endoscopically in almost all seriously ill patients. Although gastric acid plays a key role in the pathogenesis of acute gastric erosions, mucosal integrity is very much dependent on mucosal permeability, gastric blood flow, the secretory state of the mucosa, and acid‐base balance. Various agents that affect any of these physiological processes such as vitamin A, carbenoxolone, gastrin, vasoactive agents, sodium bicarbonate, and anticholinergic drugs have been used experimentally or clinically in the prevention of stress ulcerations. However, no controlled clinical trials are available. The effectiveness of antacids in the prevention of acute stress ulceration in critically ill patients has been documented in controlled, prospective trials. The effectiveness of the histamine H2‐receptor antagonist cimetidine remains controversial; it is less effective in critically ill patients of the type usually encountered in a respiratory‐surgical intensive care unit but it may be effective in selected groups of patients with head and thermal injury. Prostaglandins have been evaluated increasingly for their cytoprotective effects on the gastric mucosa. Clinical trials are needed to evaluate their effectiveness in the prevention of stress ulcers.
Evaluation of extensive lymph node dissection for carcinoma of the stomach
Authors: Kodama Yoshifumi , Sugimachi Keizo , Soejima Kazuhiko , Matsusaka Toshimitsu , Inokuchi Kiyoshi 
Published: May 2005

AbstractWe compared the results of curative resection for carcinoma of the stomach in 254 patients who underwent simple resection (SR) and 454 patients who underwent extensive regional lymph node dissection (ELD). The 5‐year survival rates of the 2 procedures were significantly different in carcinoma involving the serosa of the stomach; it was 45% in the ELD group and 18% in the SR group (p<0.001). In patients with regional lymph node metastasis we obtained a 5‐year survival rates of 39% and 18% by ELD and SR, respectively (p<0.001). The incidence of metastasis to the secondary lymph nodes, removable only by ELD, was higher in cases with carcinomatous invasion of the deeper layers of the gastric wall, and this may have been the reason why ELD proved to be more effective than SR. ELD is discussed in relation to the site of the primary carcinoma and the extent of lymph node metastasis.
Results of resection of carcinoma of the esophagus and cardia in 196 patients
Authors: Orel Janez J. , Eržen Janez J. , Hrabar Bogomir A. 
Published: May 2005

AbstractDuring the period 1962–1976, 196 patients were operated on for carcinoma of the esophagus (51) and cardia (145). In all patients resection with primary esophagogastrostomy or esophagojejunostomy was performed. Metastases involving the regional lymph nodes were found in 54.2% of patients. The early postoperative mortality rate was 21.9%. The most common cause of death was leakage at the esophagogastric anastomosis (46.5% of deaths). Mean survival period was 16.2 months, overall 5‐year survival rate was 18.7%, and 5‐year survival rate excluding early post‐operative mortality was 21.7%. Mean survival period in patients who had resection of the esophagus with negative lymph nodes was 13.5 months and in those with positive nodes was 8.1 months. Mean survival time in patients after resection of the cardia was 19.7 months if nodes were negative and 8.2 months if nodes were positive.The most frequent cause of late death was advanced cancer and distant metastases. Postoperatively, most patients were able to adopt their previous mode of life. All living patients but 1 are ambulatory, 2/3 perform work that is the same as or easier than that prior to the onset of the illness, they have no difficulty in consuming food, and are physically fit. The most common side effect was heartburn due to reflux esophagitis.
Results of partial and total pancreaticoduodenectomy in 117 patients with chronic pancreatitis
Authors: Gall F. P. , Mühe E. , Gebhardt C. 
Published: May 2005

AbstractThis is a report of 117 pancreaticoduodenectomies performed for chronic pancreatitis, of which 49 were partial and 68 were total. The operative mortality rate of partial pancreaticoduodenectomy was 8.2% and of total pancreatectomy was 20.6%. During a follow‐up period of 6 1/2 years, 76% and 63% of the surgical patients, respectively, continued to drink alcohol as heavily as before. Prior to total pancreatectomy, only 42% of the patients had diabetes. After total extirpation of the organ, all had diabetes and 75% were very difficult to stabilize with insulin, experiencing repeated episodes of hypoglycemic shock. The additional late mortality rate was 20.4% following partial pancreaticoduodenectomy and 19.1% after total resection. After total pancreatectomy, 50% of the late deaths were due to hypoglycemia. After total pancreatectomy, 11% fewer patients were still alive at the end of the follow‐up period than after partial pancreaticoduodenectomy. Total pancreatectomy is justified only in patients who already have diabetes requiring insulin. A new technique is described in which, following resection of the head of the pancreas, the duct system is occluded by injection of a rapidly hardening amino acid solution, leading to atrophy of the excretory pancreas within a few weeks. This procedure has been carried out in 39 patients with a mortality rate of 2.5% and postoperative complications in 7.6%. We believe that the immediate risk of partial pancreaticoduodenectomy in chronic pancreatitis can be decreased markedly and the late results improved by this new technique.
Treatment of bleeding typhoid ulcer of the terminal ileum and cecum
Authors: Eggleston F. C. , Santoshi B. 
Published: May 2005

AbstractOver a 16‐year period, 12 patients were operated upon for bleeding typhoid ulcers of the terminal ileum or cecum with a mortality rate of 17%. Bleeding typhoid ulcer occurred in 0.8% of patients hospitalized for typhoid fever. Males predominated and 1/2 of the patients were in the third decade of life. If bleeding is massive or persistent, early surgery is advocated.
Benign breast disease: The cost of the service and the cost to the patient
Authors: Baum Michael 
Published: May 2005

AbstractThe patients attending a hospital breast clinic during 1 year have been reviewed to assess the impact and cost of benign conditions. Four of 5 patients referred do not have cancer.The cost to the patient lies predominantly in anxiety related to the possibility of cancer and, to a lesser extent, in cosmetic damage due to multiple biopsies.Benign breast disease is a common problem that creates severe anxiety in many women and a heavy burden on an overstretched National Health Service. A policy of reeducating general practitioners when it is safe not to refer may reduce this problem. Cyst aspiration or needle aspiration cytology may reduce the burden to both the patient and the health service, while desensitization of women's groups and women themselves to the needs for breast self‐examination can also reduce this burden.
The endocrine basis of benign breast disorders
Authors: Dogliotti Luigi , Orlandi Fabio , Angeli Alberto 
Published: May 2005

AbstractThere is sound clinical evidence that many benign breast conditions, especially pain, nodularity, and cysts, are likely to have their pathogenesis in hormonal events during reproductive life. Yet the classical theories of persisting hyperestrogenism and luteal progestogen deficiency have not stood up to detailed investigation. Recent work has demonstrated the importance of dynamic hormonal changes and of chronobiological rhythms—daily, menstrual, and seasonal. Recent developments and findings are reviewed to point to the directions in which the basic etiology of these conditions is likely to be discovered.
Sclerosing adenosis
Authors: Preece Paul E. 
Published: May 2005

AbstractThe literature regarding sclerosing adenosis has been reviewed. The pathological and radiological aspects of this benign breast condition have been emphasized since they influence clinical practice.Features of 43 patients diagnosed as having sclerosing adenosis have been reported. Cancer was suspected on mammography in 17, and 25 experienced breast pain. Thus, the lesion is important both as a mimic of malignancy and as a cause of mastalgia. The clinical and radiological features allow the condition to be suspected before biopsy, in which circumstance paraffin histology is greatly preferable to frozen section.
Benign breast disorders in nonwestern populations: Part I—Benign breast disorders in Chinese women
Authors: Alagaratnam Thevakaruna T. , Wong John 
Published: May 2005

AbstractExperience with benign breast disorders has been analyzed in 3 nonwestern populations: Hong Kong, India, and Northern Nigeria. Similarities to and differences from Western experience are found, but of great interest are notable differences between these populations which, as yet, lack explanation. All show “fibroadenosis” and fibroadenoma as common conditions, but the frequency with which phyllodes tumor is diagnosed varies between different centers in India as well as between different racial groups. Tuberculosis is another interesting example—wide differences in the frequency of breast infection are found although tuberculosis itself is common in all 3 countries. The value of prospective studies was shown when mastalgia was studied in this way in India. Often considered a “Western” affliction, these authors have been able to study 112 cases of mastalgia and found it to be twice as common as cancer as a presentation. These differing experiences between populations have been little explored and must hold promise for unravelling some of the enigmas of benign breast disorders in all countries.
Benign breast disorders in nonwestern populations: Part III‐Benign breast disorders in Northern Nigeria
Authors: Onukak Etim E. , Cederquist Robert A. 
Published: May 2005

AbstractExperience with benign breast disorders has been analyzed in 3 nonwestern populations: Hong Kong, India, and Northern Nigeria. Similarities to and differences from Western experience are found, but of great interest are notable differences between these populations which, as yet, lack explanation. All show “fibroadenosis” and fibroadenoma as common conditions, but the frequency with which phylloides tumor is diagnosed varies between different centers in India as well as between different racial groups. Tuberculosis is another interesting example—wide differences in the frequency of breast infection are found although tuberculosis itself is common in all 3 countries. The value of prospective studies was shown when mastalgia was studied in this way in India. Often considered a “Western” affliction, these authors have been able to study 112 cases of mastalgia and found it to be twice as common as cancer as a presentation. These differing experiences between populations have been little explored and must hold promise for unravelling some of the enigmas of benign breast disorders in all countries.
Extracorporeal lithotripsy and combined surgical procedures in the treatment of renoureteral stone disease: Our experience with 2,955 patients
Authors: Rigatti Patrizio , Francesca Francesco , Montorsi Francesco , Consonni Paolo , Guazzoni Giorgio , Di Girolamo Valerio 
Published: May 2005

AbstractFrom May, 1985 to August, 1987, a total of 2,955 patients with renoureteral stone disease presented at our institution and were treated either by extracorporeal lithotripsy alone or combined with percutaneous nephrolithotomy, ureteroscopy, or open surgery. Seventy‐three percent of patients were stone‐free at the 3 month follow‐up date while 22% presented with negative urine culture and small (less than 5 mm) asymptomatic fragments deemed susceptible to spontaneous discharge. The rate of major complications was extremely low (sepsis, 0.03% and major renal bleeding, 1.55%). The application of this multimodal therapeutic strategy allowed successful treatment in almost every case of renoureteral lithiasis with minor iatrogenic damage to the renal parenchyma.
Survival after vagotomy: Results of the Aarhus county vagotomy trial
Authors: Ditlevsen Søren 
Published: May 2005

AbstractIn order to investigate whether the previously found excess mortality in surgically‐treated patients with peptic ulcer might be due partly to the resections employed, a survival analysis was undertaken in 824 patients 8–13 years after different types of vagotomy. These patients had been submitted to selective gastric vagotomy with drainage, selective gastric vagotomy with antrectomy or parietal cell vagotomy with or without drainage for duodenal ulcer, pyloric ulcer, prepyloric ulcer, or combined ulceration during the period from 1972 to 1977.A statistically significant excessive mortality was found for both sexes in the total material compared to the background population. Analysis of the material, subdivided according to the operative methods employed, revealed a significant excess mortality in men treated with selective gastric vagotomy and antrectomy, whereas the mortality rates were slightly and insignificantly raised in the nonantrectomy groups. No significant difference in the mortality could be demonstrated in relation to the site of the ulcers.Analysis of the cause‐specific mortality revealed a significantly raised mortality from gastrointestinal diseases, including a significant excessive mortality in the subgroups of benign peptic ulcer and cirrhosis of the liver. Likewise, the death rate from accidents including the subgroup of suicide was significantly increased. The overall mortality from malignancies was insignificantly raised among patients, whereas cancer in the stomach was significantly increased. An increased mortality from cancer in the lungs and pancreas did not reach statistical significance. These findings are in reasonable accordance with other studies. A significantly increased mortality from gastric cancer has been usual, although not a constant finding after gastric resection. This study has shown, as the first substantial series, that gastric cancer rate is increased after vagotomy as well.
Highly selective vagotomy combined with cholecystectomy: Is there an increased risk of diarrhea?
Authors: Schein Moshe 
Published: May 2005

AbstractThe addition of cholecystectomy to truncal vagotomy and a drainage procedure increases the incidence and severity of postvagotomy diarrhea. This study attempts to establish whether diarrhea is more common after highly selective vagotomy (HSV) and cholecystectomy than after HSV alone. The incidence of diarrhea in 729 patients who underwent HSV without cholecystectomy was found to be 8.8% whereas, in 66 patients in whom HSV was combined with cholecystectomy, the incidence of diarrhea was 9.3%. In most patients, the diarrhea was very mild and in none was it severe. We conclude that the addition of cholecystectomy to HSV does not result in an increased incidence of diarrhea.
Central bisegmentectomy of the liver: Experience in 16 patients
Authors: Hasegawa Hiroshi , Makuuchi Masatoshi , Yamazaki Susumu , Gunvén Peter 
Published: May 2005

AbstractFourteen patients with hepatocellular carcinoma and mild to moderate liver dysfunction and 2 with metachronous liver metastases from rectal cancers underwent central bisegmentectomy of the liver, i.e., en bloc removal of the left medial and right anterior segments. One patient who had undergone preoperative liver artery embolization died in the hospital. Four patients survived without relapse 6–135 months postoperatively. Eleven patients had recurrent tumors, all in the liver remnant, and 2 also had recurrent tumors in the lungs. Six patients who relapsed died 28–93 months postoperatively. Four were alive with disease at 7–89 months, 1 after a second liver resection 54 months after central bisegmentectomy. Six of the 16 patients survived for 5 years or more. The results are favorable for these advanced tumors, often in the presence of liver dysfunction. The indications, technique, and results are discussed.
Perioperative antibiotic prophylaxis in cardiovascular surgery: A prospective randomized comparative trial of cefazolin versus ceftriaxone
Authors: Soteriou M. , Recker F. , Geroulanos S. , Turina M. 
Published: May 2005

AbstractWith a view of possible reduction in antibiotic dosage, several prospective randomized comparative trials performed in our institution showed that a 4‐day prophylactic antimicrobial regimen with cefazolin was equally effective as a 2‐day prophylaxis with cefuroxime and that the best regimen was equally as effective as a double dose of ceftriaxone prophylaxis in major cardiovascular surgery.In this prospective randomized comparative study, 1‐day cefazolin prophylaxis (4×0.5 g intravenously) was compared with a single dose of ceftriaxone prophylaxis (2 g intravenously). Of the 900 patients enrolled in the study, 17 were subsequently excluded. Of the remaining 883 patients, 439 were in the cefazolin group and 444 were in the ceftriaxone group. The overall postoperative infection rate was 5.0% in the cefazolin group and 4.5% in the ceftriaxone group.In view of the almost identical infection rates in both groups, we considered that a single 2 g dose of ceftriaxone offers patients a reliable antimicrobial prophylaxis. The single‐dose prophylaxis has the additional advantage of reducing the dosage administered and the costs of administration.
Tumoral calcinosis
Authors: Prasad V. L. N. , Naresh K. N. , Krishna S. R. Govind , Ananthakrishnan N. , Veliath A. J. 
Published: May 2005

AbstractTumoral calcinosis is an interesting clinical entity. It is not uncommon in certain countries. We report our experience with 22 patients with this condition seen over a 7‐year period and review in detail the modalities of clinical presentation, theories of etiogenesis, histological appearances, and treatment modalities.