bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptomatic duodenal diverticulum
Authors: Jang Lee Chan , Kim Sun Whe , Park Yong Hyun , Kim Jin‐Pok 
Published: October 2004

AbstractTo determine management guidelines for symptomatic duodenal diverticulum, we reviewed medical records of 26 patients. Complicated duodenal diverticulum was the only possible cause of symptoms‐abdominal pain, fever and chills, melena, vomiting‐in 18 patients. Ten patients improved with conservative management, and eight patients underwent diverticulectomy with or without various other procedures. Among the eight patients, one patient who had duodenal fistula died of respiratory complications on the second postoperative day. Symptoms recurred in two patients: One had a distal common bile duct (CBD) stricture and underwent choledochojejunostomy. In the other patient a CBD stone developed 3 years later, and choledocholithotomy and choledochojejunostomy were performed. Eight patients had associated gallstone disease as well as the diverticulum. Five of the eight had a history of operation for gallstone disease; four improved with conservative treatment, and one underwent choledochojejunostomy. Two patients were thought to have an innocent diverticulum and underwent cholecystectomy and choledocholithotomy only. One patient underwent diverticulectomy and sphincteroplasty for a CBD stone and pervaterian diverticulum. In conclusion, operations for duodenal diverticulum should be reserved for seriously complicated diverticula, and the surgeon should be aware that pervaterian diverticulum can be a cause of choledocholithiasis.
Meckel's diverticulum in Amsterdam: Experience in 136 patients
Authors: Bemelman Willem A. , Hugenholtz Elise , Heij Hugo A. , Wiersma Piet H. , Obertop Hugh 
Published: October 2004

AbstractThe object of this study was to establish the relation of symptomatic diverticula to the age and gender of the patients and to the presence of ectopic tissue. A total of 136 patients with surgically treated diverticula were collected from the medical charts of five Amsterdam hospitals; 51 had undergone resection because of diverticulum‐related symptoms and 85 during laparotomy for other causes. Obstruction was the predominant symptom (39%) in the 51 symptomatic patients. Hemorrhage, perforation, diverticulitis, and intussusception were the other symptoms (12–14% each). Obstruction occurred mainly in patients under age 10 years and perforation in patients 10 to 30 years old. All symptoms, hemorrhage excepted, occurred two to four times more in men. Hemorrhage and perforation were associated with the presence of ectopic gastric tissue. We concluded that symptoms caused by Meckel's diverticula are mainly due to the presence of bands or ectopic gastric tissue. The symptoms manifest at an early age (77% in those under age 30) and predominantly in males. Diverticula found incidentally in patients younger than 30 years should be resected. In the older patients, resection is indicated if ectopic gastric tissue is suspected. Diverticular bands can simply be cut.
Antioxidative vitamin treatment: Effect on lipid peroxidation and limb swelling after revascularization operations
Authors: Rabl H. , Khoschsorur G. , Petek W. 
Published: October 2004

AbstractThe objective of this study was to evaluate the antioxidative properties of the multivitamin cocktail Omnibionta® (α‐tocopherol, ascorbic acid, retinol, vitamin B complex) in terms of diminishing lipid peroxidation with improvement of leg edema performance after limb revascularization operations in humans. Fifty‐one subjects were selected; the control group contained 27 patients and the treatment group 24 patients, who received the vitamin cocktail intravenously before the start of reperfusion. All patients suffered from acute or chronic arterial occlusive disease, except two subjects with arterial trauma. MDA‐TBARS in plasma, quantified by HPLC, taken as a measure of lipid peroxidation was significantly increased (p<0.001) in the control group 1 hour after reperfusion onset and decreased to its baseline value within the following 2 hours (0.73±0.26, 1.21±0.48, 0.99±0.48, 0.73±0.33 nmol/ml). In contrast, in the treatment group MDA‐TBARS did not exceed the baseline value during the reperfusion period (0.93±0.30, 0.70±0.29, 0.65±0.23, 0.70±0.37 nmol/ml). Leg edema, expressed by extremity circumference, was significantly (p<0.008) elevated in the control group (30.7±4.04 cm versus 35.35±4.12 cm) compared to a lack of increase in the treatment group (29.25±5.13 cm versus 29.76±5.70 cm). These results suggest that antioxidative vitamin treatment might be valuable in preventing lipid peroxidation and decreasing extremity edema.
Coelioscopic cholecystectomy: Experience with 2006 cases
Authors: Dubois François , Berthelot Gérard , Levard Hughes 
Published: October 2004

Abstract2006 laparoscopic cholecystectomies (LC) were performed from April 1988 to December 1992 by three senior surgeons using the French technique and selective intraoperative cholangiography (IOC). Obesity was present in 318 patients (15.8%), respiratory insufficiency in 75 (3.7%), inflammation in 251 (12.5%), and common bile duct (CBD) stones in 83 (4.1%). The presence of these additional ailments is a good indication for L.C. Conversion to laparotomy occurred in 43 cases (2.1%). The rate of complications was 2%; 25 (1.25%) were nonbiliary complications and 15 (0.7%) were biliary‐related; there was one death. IOC is not effective in preventing biliary complications, as those observed in this study would not have been recognized or avoided by it. IOC is carried out only selectively to locate unsuspected stones in patients with risk factors of CBD lithiasis. Laparoscopic treatment of CBD stones is still controversial.
Outcome of 49 repairs of bile duct injuries after laparoscopic cholecystectomy
Authors: Schol Francois P. G. , Go Peter M. N. Y. H. , Gouma Dirk J. 
Published: October 2004

AbstractTreatment of bile duct injuries after laparoscopic cholecystectomy is still under discussion. The aim of this study was to evaluate the results of end‐to‐end or biliodigestive anastomosis for various types of bile duct injury. Patient charts of 49 (0.81%) classified bile duct injuries from a national survey of 6076 laparoscopic cholecystectomies in The Netherlands were analyzed. The median follow‐up after repair was 183 days (range 14–570 days). Statistical analysis showed that an end‐to‐end anastomosis was preferred by the surgeons for less severe bile duct injuries and a biliodigestive repair for more severe injuries. Three patients died owing to a delayed detected bile duct injury. Twelve bile duct strictures occurred after repair, leading to a stricture rate of 25%. The time elapsed between repair and occurrence of a stricture was 134 days (range 13–270 days). The type of repair or the severity of the bile duct injury did not determine the outcome of the repair. Histologically proved cholecystitis predisposed a stricture at the repair site. It was concluded that treatment of bile duct injuries is associated with a high stricture rate at the repair site of the anastomosis. End‐to‐end anastomosis is mostly successful for the less severe injury detected during laparoscopic cholecystectomy. For all other cases this repair can at least be considered a temporary internal drainage procedure. The biliodigestive anastomosis can best be considered a delayed repair after a drainage procedure has resolved the local inflammatory status.
Extended cholecystectomy for carcinoma of the gallbladder
Authors: Onoyama Hirohiko , Yamamoto Masahiro , Tseng Anthony , Ajiki Tetsuo , Saitoh Yoich 
Published: October 2004

AbstractWe evaluated extended cholecystectomy, wedge resection of the gallbladder bed, and regional lymphadenectomy for carcinoma of the gallbladder. Between 1971 and 1993 we treated 227 patients, 59 of whom were treated with simple cholecystectomy and 66 with extended cholecystectomy. The tumors were classified according to the stages proposed by the Japanese Society of Biliary Surgery. For Stage I and II discase extended cholecystectomy had a better result than simple cholecystectomy. For the extended cholecystectomy cases the cumulative 5‐year survival rate was 78.9% for Stage I, 63.6% for Stage II, 44.4% for Stage III, and 8.3% for Stage IV. The survival of Stage I patients was excellent. For cases more advanced than Stage II (S3, N2, Hinf1, and Binf1), the prognosis was significantly worse. In these cases more aggressive surgery may be needed.
Clinical experience with the intrahepatic posterior approach to the portal triad for right hepatectomy and right segmental resection
Authors: Maddern Guy J. , Manganas Dimitrios , Launois Bernard 
Published: October 2004

AbstractAn intrahepatic posterior approach to the portal triad has been used over a 2‐year period to perform right hepatectomies and right segmental resections in 29 patients (20 men, 9 women; median age 63 years, range 22–82 years). Two resections were palliative for cholangiocarcinomas; the remainder included 9 hepatocellular carcinomas, 12 colorectal metastases, 2 adenomas, 3 cancers of the gallbladder, and one case of chronic hepatic fibrosis. The median operative time was 3 hours 40 minutes (3:40; range 2:20–7:00) with a median period of hepatic ischemia of 87 minutes (range 27–152 minutes). Median blood transfused was 0 unit (range 0–12 units) with only three patients requiring intensive care admission. There was one hospital death. All but one patient was followed up after surgery (median period 24 months; range 1–36 months) at which time there had been three deaths from metastatic disease; the remaining patients were free of clinical recurrence. This operative approach allows minimally resective surgery to be performed safely with excellent shortand medium‐term results.
Electrorectography in chronic constipation
Authors: Shafik Ahmed 
Published: October 2004

AbstractThe rectal electrical activity recorded by electrorectogram (ERG) was studied in 22 chronically constipated subjects and 16 healthy colunteers. The latter had a mean (±SD) age of 42.6±8.5 years; 10 were men and 6 women. Of the 22 constipated patients, 14 had inertia‐type age 38.4±12.2 years. The rectal electrical activity was recorded by a silver‐silver chloride electrode situated 1 cm from the tip of a 6 F catheter, which was applied to the rectal mucosa by suction. At least four recording sessions of 120 minutes each were performed for each individual. In normal volunteers, regular and reproducible pacesetter potentials (PPs) were recorded with a mean frequency of 2.8±0.8 cycles/min (cpm), amplitude 2.1±0.8 mV, and velocity 4.6±0.8 cm/sec. They were followed randomly by action potentials (APs). In IC patients the PPs were so infrequent that in most cases half an hour would have elapsed without recording a PP; the mean frequency was 2.4±0.2 cycle/60 min, amplitude 0.92±0.02 mV, and velocity 4.1±0.6 cm/sec. APs were not recorded in 10 patients during the recording time; in two patients they were occasional. In OC subjects regular and reproducible PPs were recorded with a higher frequency (p<0.01) and velocity (p<0.05) than normal. Two ERG patterns were identified in those with chronic constipation: bradyrectia and tachyrectia. The former was recorded in the IC subjects and the latter in OC subjects. It is concluded that ERG is a technique by which electromechanical activity is recorded. It is noninvasive and nonradiologic, and it can be included as an investigative tool for rectal detrusor disorders.
Current melanoma epidemic: A nonmetastasizing form of melanoma?
Authors: Burton Robert C. , Armstrong Bruce K. 
Published: October 2004

AbstractDuring the mid to late 1980s in white populations in Australia, New Zealand, and Scotland, melanoma incidence increased sharply above preceding long‐term trends. Most of this increase was in thin melanomas (<1.50 mm thick), and men were more affected than women. Thick melanomas also generally increased in incidence, particularly in men 65 years or older. Although advancement of the time of diagnosis was a likely factor in the increase in melanoma incidence, the maintenance of new higher incidence levels and the increase in the incidence of thick lesions indicated that earlier diagnosis did not explain most of the increase. Real increases in incidence due to continuation of long‐term trends and the increasing diagnosis of a preexisting, nonmetastasizing form of thin melanoma probably explain most of the recent increases in melanoma incidence.
Megestrol melanoma study
Authors: Nathanson Larry , Garrison Michael 
Published: October 2004

AbstractThe progestogen megestrol acetate (160 mg/day PO continuously starting 2 days before chemotherapy) plus chemotherapy with dacarbazine (220 mg/m2/day IV for 3 days), cisplatin (25–30 mg/m2/day IV for 3 days) every 3 weeks, and carmustine (150 mg/m2 IV single dose every 6 weeks) were administered to 22 patients, 18 of whom were evaluable. Toxicity was tolerable, and more than 80% of ideal dosing was achieved during the first two cycles of treatment. A net weight gain of 0.95 kg was observed during this program of treatment. A 56% objective response rate, including visceral responding sites, with a median duration of response of 37.5+weeks was achieved. A median survival of 15 months for all evaluable study patients was seen, which is somewhat longer than that achieved by most prior studies, including those employing the same chemotherapy regimen plus tamoxifen. Megestrol acetate may contribute to a high objective response rate and prolonged median survival in viscerally dominant mètastatic melanoma when used with a chemotherapy regimen of dacarbazine, carmustine, and cisplatin.
Local melanoma recurrences in the scar after limited surgery for primary tumor
Authors: Drzewiecki Krzysztof T. , Andersson Anders P. 
Published: October 2004

AbstractThe clinical and histologic records of 46 consecutive patients were reviewed who during the period 1980–1993 had recurrence from melanoma in the scar after limited surgery for a skin tumor. They constituted about 50% of all patients admitted with local recurrence from melanoma during this period. At reexamination of the primary tumors, 16 were found to be malignant melanomas and 9 were nevi (four atypical and five benign). Twenty‐one specimens were missing, 11 of which had never been sent for histologic examination. The median thickness of nine measurable melanomas was 0.66 mm. The recurrences in scar consisted of 34 primary melanomas: 18 superficial spreading, 4 nodular, 3 lentigo malignant, and 9 unclassified. Twelve tumors were dermal melanoma metastases. The median thickness of the 25 measurable melanomas was 0.78 mm. The 5‐year overall survival was 69%. At the closing date of the study 15 patients had died, 13 of them because of disseminated melanoma. A comparison of the survival curves from this study with those from other series of melanomas with comparable tumor thickness indicates a considerably worse prognosis than is expected with such thin tumors. We believe that the considerable number of local recurrences in the form of a new primary in a scar following limited surgery supports the theory of limited field change around a primary melanoma. Furthermore, limited procedures for primary melanoma, if followed by a recurrence in the scar, worsen the prognosis.
Involvement of the 4q21 region in human malignant melanomas: Cytogenetic and immunocytochemical characterization of three primary cell cultures
Authors: Grammatico P. , Roccella M. , Catricalà C. , Roccella F. , Bucher S. , Mordenti C. , Amantea A. , Di Rosa C. , Del Porto G. 
Published: October 2004

AbstractThe GRO1 oncogene (melanoma growth‐stimulating activity alpha)_has been localized in region 4q21. The involvement of this chromosomal region in clonal aberrations found in primary melanoma cell cultures could have an important role in the etiology and pathogenesis of this tumor. We characterized three primary cell cultures obtained from different patients, each of which showed clonal chromosomal aberrations involving the 4q21 region.
Spontaneous regression of human melanoma/nonmelanoma skin cancer: Association with infiltrating CD4+ T cells
Authors: Halliday Gary M. , Patel Anita , Hunt Michelle J. , Tefany Frances J. , Barnetson Ross St. C. 
Published: October 2004

AbstractSpontaneous regression occurs in some human malignant melanomas and basal cell carcinomas (BCCs). We have compared the cellular infiltrate in regressing and nonregressing tumors in order to analyze the mechanism by which regression occurs. Regressing primary melanomas and BCCs were infiltrated with a larger number of CD4+, but not CD8+, T lymphocytes than were seen in nonregressing tumors. The number of interleukin 2 receptor‐positive (early activation marker) but not transferrin receptor‐positive (intermediate activation marker) T cells was increased, indicating that the infiltrating T cells were activated. Large numbers of Langerhans cells, macrophages, and other class II major histocompatibility complex (MHC)‐expressing cells were present but were not increased in the regressing tumors. There were no detectable B lymphocytes, and the regressing tumor cells displayed levels of HLA‐DR expression similar to those of the nonregressing tumors. Comparison of squamous cell carcinoma (SCCs) with keratoacanthomas (KAs), which are likely to be a spontaneously regressing form of SCC, also showed increased infiltration of activated CD4+, but not CD8+, T cells within the KA. A murine ultraviolet (UV)‐induced squamous tumor that spontaneously regresses when transplanted into immunocompetent syngeneic mice was also infiltrated with increased numbers of activated CD4+, but not CD8+, T cells prior to and during rejection. These results indicate that spontaneous regression of human skin tumors is likely to be immunologically mediated, and that CD4+ T lymphocytes seem to mediate this regression.
Laparoscopy for management of nontraumatic acute abdomen
Authors: Navez B. , d'Udekem Y. , Cambier E. , Richir C. , de Pierpont B. , Guiot P. 
Published: October 2004

AbstractThe diagnostic and therapeutic influence of laparoscopy has been studied in 255 patients presenting with nontraumatic acute abdominal pain. Laparoscopy provided a correct diagnosis in 93% (236 of 255) of the cases, the others requiring a laparotomy. An erroneous preoperative diagnosis was corrected by laparoscopy in 50 patients (20%), which called for a change of treatment in 25 patients (10%). Seventy‐three percent (186 of 255) of acute abdominal conditions were treated exclusively by laparoscopy, 23% (58 of 255) by conventional surgery, and 4% (11 of 255) by laparoscopically assisted surgery. Mortality was 2% (5 of 247) and morbidity 11% (28 of 247). We conclude that laparoscopy is a valuable tool for the general surgeon facing a patient with an acute abdomen.
Laparoscopic cholecystectomy: An original three‐trocar technique
Authors: Slim Karem , Pezet Denis , Stencl Jan , Lechner Christian , Le Roux Stéphane , Lointier Patrice , Chipponi Jacques 
Published: October 2004

AbstractAt present, laparoscopic cholecystectomy is the treatment of choice for gallbladder stones. The operating technique reported by most authors includes the use of four trocars. We report a group of 710 consecutive patients treated by an original three‐trocar technique. The use of the fourth trocar was necessary in only 55 cases (8%). However, among 56 cases of acute cholecystitis the use of the fourth trocar was necessary in 14 cases (25%) (p<0.01). Twenty‐six laparoscopies were converted to open procedures (3.6%). Four common bile duct injuries were observed (0.5%): two of them among the 655 operations with three trocars (0.3%) and two after application of the fourth trocar at the beginning of the procedure because of dissection difficulties. Our results are similar to those using the “classic” four‐trocar technique. Moreover, this technique is less expensive and allows one less scar.
Surgery for chronic pancreatitis: What quality of life ahead?
Authors: Petrin Pietro , Andreoli Amelia , Antoniutti Michel , Zaramella Dellina , Da Lio Corrado , Bonadimani Bruno , Garbin Luigi , Pedrazzoli Sergio 
Published: October 2004

AbstractWe attempted to evaluate the quality of life of patients with proved long‐lasting chronic pancreatitis. We measured the clinical and psychological status of 60 patients who had undergone various surgical treatments for their disease. The presence and severity of depression and other symptoms of distress were assessed, as were disease‐specific functional and physical problems. Few patients had serious conditions, such as pain, malnutrition, or psychoneurotic complaints. The relation between depression and the time of onset of symptoms and of surgery appeared doubtful, and no statistically significant correlations were found between severity of emotional disturbance and other functional characteristics. Insulin‐dependent diabetes and correlated diseases had the most negative influence on everyday well‐being. Postoperative follow‐up and the need for recurrent medical control and care did not lead to negative feelings.
Resection of the pancreatic head with or without gastrectomy
Authors: Watanapa Prasit , Williamson Robin C. N. 
Published: October 2004

AbstractEarly and late results of proximal pancreatoduodenectomy were determined in a personal and consecutive series of 100 patients (64 men, 36 women, mean age 51.9 years). Final diagnoses were chronic pancreatitis in 35, idiopathic bile duct stricture in 1, carcinoma of the head of pancreas in 27, and other periampullary tumors in 37 (duodenal carcinoma 11, ampullary carcinoma 11, neuroendocrine tumor 10, cholangiocarcinoma 5). Mean follow‐up period was 30.5 months (range 3.5–132.0 months). Resection was conventional (including distal gastrectomy) in 39 patients and conservative (retaining the stomach, pylorus, and duodenal cap) in 61 patients. Resection for inflammatory disease caused greater operative blood loss (mean 2.29 versus 1.75 L;p=0.054) and a longer operative time (6.2 versus 5.2 hours;p=0.040) than resection for neoplastic disease. There were four operative deaths, two from leakage of the pancreatic anastomosis; another two patients survived pancreatojejunostomy leaks. Twenty patients developed postoperative complications, seven of whom required reoperation. Good pain relief was obtained in 76% of patients with chronic pancreatitis, but five required completion distal pancreatectomy at a mean 22.8 months after the first resection. Mean survival of patients with pancreatic cancer was 13.2 months. Sixteen patients with other periampullary cancers are still alive 41.6 months after the operation.
Effect of low‐dose subcutaneous heparin on postoperative wound hematomas: Randomized clinical trial on hospitalized inguinal hernia patients in Germany
Authors: Schmitz Rainer , Kansy Marion , Moser Karl‐Heinz , Treckmann Jürgen 
Published: October 2004

AbstractA randomized prospective study of low‐dose heparin was performed in 89 surgical patients during and after Bassini‐Lotheissen repair. The patients were divided into two groups: (1) Low‐dose heparin: 5000 units 2 hours before operation and 5000 units every 8 hours for 5 days after the operation. (2) Dextran 40 (Rheomacrodex); administered during the operation, with an additional infusion of dextran (500 ml/day) for the next 3 days. The frequency of wound complications in 45 the heparin‐treated patients was 22.0% (comprising 10 hematomas), compared to only 4.5% in the dextran‐treated patients (n=44 patients). These findings are significant (p<0.05). Low‐dose heparin should therefore be administered routinely only to patients with increased risk of thromboembolism.