bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of endogenous secretin on plasma glucagon after total pancreatectomy
Authors: Sudo Takaaki , Suzuki Takashi , Tobe Takayoshi , Umemura Hiroya , Shiraha Sei , Kuyama Takeshi 
Published: May 2005

AbstractNormal dogs and totally pancreatectomized dogs with intact stomach and duodenum were given 0.1 N hydrochloric acid directly into the duodenum in a study of the effect of endogenous secretin on glucagon secretion. The glucagon responsive to 30K antibody first decreased after total pancreatectomy, but increased with time if no insulin was administered. Total pancreatectomy was followed by a gradual, statistically significant increase in the basal secretion of blood secretin. The endogenous secretin secreted in response to the infusion of 0.1 N hydrochloric acid into the duodenum in no way varied the blood glucagon level in normal dogs, but slightly decreased blood gut glucagon in totally pancreatectomized dogs. The secretion of blood secretin in response to the infusion of 0.1 N hydrochloric acid into the duodenum was maintained even after total pancreatectomy.
Prophylaxis of recurrent goiter by high‐dose L‐thyroxine
Authors: Goretzki P. , Roeher H. D. , Horeyseck G. 
Published: May 2005

AbstractIn a prospective, randomized, controlled study of 64 patients after bilateral subtotal thyroidectomy, a high dosage of 1.0 mg L‐thyroxine taken once a week was compared to the usual intake of 0.1 mg L‐thyroxine daily for prevention of recurrent goiter. During a follow‐up study for 52 weeks, the effectiveness and acceptability of an intermittent high dosage was assessed clinically and also by measuring basal TSH, stimulated TSH, iT4, and iT3. In both groups, postoperative elevated TSH levels could be reduced to subnormal levels by L‐thyroxine intake. iT3 and iT4 levels remained in the normal range after either daily or intermittent therapy. The weekly high dosage of 1.0 mg L‐thyroxine has proved to be at least as effective as the usual therapy with no apparent disadvantage.
Results of surgery in fibrodysplastic renal artery stenosis
Authors: Jakubowski Hans D. , Eigler Friedrich W. , Montag Heinrich 
Published: May 2005

AbstractAt the University of Essen Hospital, 202 patients underwent operations for renovascular hypertension between September, 1971, and August, 1979. In 75 (37.2%) of the patients (64 female and 11 male, ages 8–55 years), a fibrodysplastic stenosis of one or both renal arteries was found. These patients were treated after angiographic demonstration of a renal artery stenosis, with no further functional testing, e.g., renal vein renin ratio or Saralasin test. Operative procedures included resection of the stenosis and reanastomosis in 45, vein patch angioplasty in 13, vein graft reconstruction in 11, and reimplantation of the renal artery into the aorta in 6 patients. In 5 patients (6.7%) a nephrectomy was necessary because of artery thrombosis. There were no operative deaths. Ninety‐six percent of the patients showed a normal or improved blood pressure in the immediate postoperative course. In more than 85% of the patients, reinvestigated 2, 4, and 6 years after the operation, hypertension was cured or improved. We conclude that surgical treatment of renal artery stenosis of flbrodysplastic origin is indicated without further functional tests.
Surgical closure of patent ductus arteriosus outside the operating theater
Authors: Pate James W. , Korones Shelton , Sarasohn Charles 
Published: May 2005

AbstractThe widespread availability of newborn centers and competent management of respiratory problems in the newborn have allowed survival of many infants with patent ductus arteriosus (PDA) who previously would have died.Most deaths after surgical correction of PDA in the newborn have been due to problems in management of ventilation and nursing care. Since most patients are intubated and on respirators prior to election of operative closure, we decided to close the ductus in the newborn center, without moving the patient or disturbing the equipment. The same nurses and pediatric fellows would manage the infant after surgery.The first 9 consecutive premature infants with near‐fatal respiratory problems associated with patent ductus arteriosus and operated upon in the newborn center all survived, improved, and were discharged home. There were no infections or other major surgical complications. We conclude that, in properly selected patients, surgical closure of the patent ductus arteriosus is best done in the newborn center under local anesthesia.
Surgical and metabolic management of patients with external fistulas of the small intestine associated with Crohn's disease
Authors: Hill Graham L. , Bourchier Russell G. , Witney Graham B. 
Published: May 2005

AbstractIn order to define more clearly the principles of surgical and metabolic management of patients with external small bowel fistulas in association with Crohn's disease, a consecutive series of 85 patients (26 with Crohn's disease) was studied. The patients were all managed by one surgeon and, in the last 60 patients, management was according to a standard protocol. In 19 cases, detailed metabolic studies (body composition, plasma proteins, and total energy expenditure) were conducted at intervals during the period of treatment.In 69 (82%) of the 85 patients, successful closure of the fistula was achieved (36 spontaneously, and 33 surgically), and the mortality rate was 16%. The overall results were similar for the Crohn's patients, except that spontaneous closure occurred significantly less often (in 4 of 26 patients). Two distinct types of Crohn's fistula were observed. In 10 patients, the fistula arose in the early postoperative period and was not associated with residual Crohn's disease. The pattern of behavior and overall results of treatment of these patients were the same as for non‐Crohn's patients. In 16 patients whose fistula arose from an area of Crohn's disease (6 postoperatively, 10 spontaneously after discharge of an abscess), spontaneous closure was not observed. Surgery was undertaken in 15 of these patients, and was successful in 14; one patient died.Studies of body stores of protein showed that massive losses (2% per day) occurred in patients in whom sepsis was uncontrolled, in spite of intravenous nutrition (IVN). Although the total energy expenditure of Crohn's patients was no different from that of non‐Crohn's patients (45 kcal/kg per day), studies of total body protein while the patients were being given IVN showed that, when active Crohn's disease remained in situ, the expected increase in body protein stores of about 1 kg did not occur.It is concluded that fistulas unassociated with residual Crohn's disease should be managed along conventional lines. Those fistulas arising from diseased small intestine all require surgery. This is performed after sepsis has been drained, metabolic deficits (but not necessarily deficits of body protein) have been corrected, and the anatomy of the fistula has been defined. The surgical procedure is a radical one involving complete dissection of the entire small intestine, resection of the bowel involved, and performance of a primary anastomosis.
Carcinoma of the gastric cardia: Surgical management and long‐term survival
Authors: Moreaux Jean , Msika Simon 
Published: May 2005

AbstractFrom 1964 to 1985, a total of 114 patients (94 men and 20 women) were operated on. The resectability rate was 71%, and 53% of the patients were thought potentially curable. Either abdominal or combined abdominal and thoracic approaches were preferred. Proximal esophagogastrectomy (54 cases) was performed in cases with wide esophageal extension and total gastrectomy (27 cases) was performed for tumors localized in the gastric cardia. There was intraoperative examination of the esophageal margin. There was lymph node involvement in 57% of cases and esophageal extension in 59%. Three patients died in the postoperative course, none after curative resection. There was 1 (1.2%) clinical anastomotic leak. The overall 5‐year survival rate was 18.5%. The actuarial 5‐year survival rate was 29±8% after resection and 40±7% after curative resection, and the 10‐year survival rate was 20±7 and 28±7, respectively. Symptom duration, age, or sex had no significant influence on prognosis. Lymph node involvement, tumor depth penetration, and esophageal extension were the main prognostic factors.
Long‐term survival in Japanese patients with far advanced carcinoma of the stomach
Authors: Korenaga Daisuke , Tsujitani Shunichi , Haraguchi Masaru , Okamura Takeshi , Tamada Ryuichiro , Sugimachi Keizo , Akazawa Kohei , Nose Yoshiaki 
Published: May 2005

AbstractAmong 1,220 Japanese patients with gastric carcinoma who had undergone resection in the Department of Surgery II, Kyushu University Hospital, Fukuoka, Japan from 1965 to 1980, there were 432 (35.4%) with far advanced carcinoma, designated as a lesion with factors such as peritoneal dissemination, hepatic metastasis, widespread nodal involvement extending to tertiary (hepatoduodenal, retropancreatic, and mesenteric) or quaternary (middle colic and paraaortic) nodes, or direct invasion to adjacent organs. The overall 5‐year survival rate in these 432 patients was 10.2%. The 5‐year survival rate in patients with a single factor was 16.3%, being significantly higher than the 2.8% or less in cases with more than 2 factors (p<0.01). Patients with tertiary nodal involvement or directly invaded organs alone survived at a rate of 26.1% and 21.8% in the 5‐year follow‐up, respectively. Radical procedures such as extensive lymphadenectomy and combined resection of the invaded organs further lengthened the survival time. The 5‐year survival rates were less than 10% in patients with other factors, singly or more than 2 factors in combination. There appear to be 2 subgroups in whom the rates of survival differ: potentially curable and noncurable patients. More intensive therapeutic regimens corresponding to both groups need to be considered.
Effect of oral branched chain amino acids on behavior and brain serotonin metabolism in portacaval shunted rats
Authors: Bengtsson Finn , Nobin Anders , Falck Bengt , Gage Fred H. , Jeppsson Bengt 
Published: May 2005

AbstractIt has been suggested that administration of branched chain amino acids (BCAA) can reverse some of the alterations in metabolism and behavior seen in patients with portal‐systemic encephalopathy (PSE). We investigated the effects of a diet enriched in BCAA on serotonin metabolism in the central nervous system (CNS) and on behavior in rats with a chronic portacaval shunt (PCS).In a first trial (trial 1), an increased CNS serotonin synthesis rate and impaired behavior were observed in PCS rats given a standard laboratory diet. Thereafter, the rats in the trial were given an equicaloric and equinitrogenous diet with (36% BCAA) or without (21% BCAA) BCAA enrichment for an additional 2 weeks. Intake of the BCAA‐enriched diet resulted in normalization of CNS serotonin metabolism, similar to shamoperated rats (with unaltered CNS serotonin metabolism given BCAA enrichment or not), in comparison with PCS rats without BCAA enrichment in their food. The behavioral alterations following PCS were, however, not reversed by BCAA feeding.In a second trial (trial 2), we investigated the behavioral effects of 4 weeks of oral BCAA. From the results, we could state only minor effects of this treatment on impaired behavior following PCS, when compared with PCS without BCAA‐enriched diet.In both trial 1 and 2, the high plasma ammonia levels of the PCS rats were unaffected by the oral treatment of BCAA. The overall nitrogen balance remained comparable between all groups.The present study demonstrates that a BCAA‐enriched diet normalizes CNS serotonin metabolism in the PCS rat. The impaired behavioral performances could not, however, be completely reversed, suggesting that factors other than brain serotonin may also be involved in the development of PSE.
Necrosectomy and postoperative local lavage in patients with necrotizing pancreatitis: Results of a prospective clinical trial
Authors: Beger Hans G. , Büchler Markus , Bittner Reinhard , Oettinger Wolfgang , Block Silvia , Nevalainen Timo 
Published: May 2005

AbstractSeventy‐four patients with necrotizing pancreatitis were included in a prospective clinical trial of a surgical management protocol comprising necrosectomy and postoperative local lavage of the lesser sac and of the necrosis cavity. Fifty‐eight patients showed preoperative organ failures such as pulmonary dysfunctions (57%), renal dysfunctions (37%), shock (12%), and sepsis (26%) in spite of intensive care treatment. The median value of the early prognostic signs was 4.5 points. Intraoperatively, 62% of the patients revealed extensive intrapancreatic parenchymal necrosis, 69% had extrapancreatic necrosis, and 39% showed bacterial contamination of the necrotic material. Following the necrosectomy, postoperative local lavage was performed for an average period of 25 days with 7 liters (median) of lavage fluid per 24 hours. In each of 18 studied patients, a considerable release of immunoreactive trypsin was demonstrated and, in each of 20 studied patients, a high concentration of immunoreactive phospholipase A2 was demonstrated in the lavage fluid up to the 12th/14th postoperative day. The intensive care period averaged 6 1/2 days, the hospital stay averaged 54 days. The hospital mortality rate was 8.1%. It is concluded that restricted necrosectomy and postoperative local lavage treatment correspond in particular to the pathomorphologic conditions and to the local release of biologically active compounds such as bacteria, endotoxin, trypsin, and phospholipase A2 in patients with necrotizing pancreatitis.
Quality of life and patterns of recurrence following transhiatal esophagectomy for cancer: Results of a prospective follow‐up in 50 patients
Authors: Barbier Peter A. , Luder Peter J. , Schüpfer Guido , Becker Christoph D. , Wagner Hans E. 
Published: May 2005

AbstractA prospective follow‐up was performed in 50 consecutive patients who had previously undergone transhiatal esophagectomy without thoracotomy (THE) for esophageal carcinoma. The follow‐up period ranged from 1 to 5 years (mean, 18.4 months). At each control, a clinical, laboratory, and radiologic examination including barium esophagography and computed tomographic (CT) scan was obtained in order to assess quality of life and to detect tumor recurrence.Twenty‐three patients (46%) developed recurrent carcinoma, all but one within 12 months of surgery. The survival rates were 57% at 1 year, 34% at 2 years, and 23% at 3 years. The median survival time was 15.7 months. Recurrence was initially confined to the mediastinum in 50% of patients, whereas 50% already had systemic metastases when recurrence was first detected.Radiologic examinations, especially CT, were far more sensitive in detecting tumor recurrence than was the clinical evaluation, thus, offering the chance to initiate an appropriate adjuvant therapy at the earliest possible time. Stage I and stage II tumors as well as differentiated tumors showed a significantly lower recurrence rate than tumors of stages III and IV and low‐grade tumors. THE offers good quality of life in virtually all patients and is able to restore a normal food intake in all but a few patients. Due to the high rate of local tumor recurrence, it is suggested that THE should probably be reserved for poor‐risk patients whereas good‐risk patients with limited disease would profit from a thoracoabdominal esophagectomy with lymph node dissection.
Caroli's disease
Authors: Mercadier M. , Chigot J. P. , Clot J. P. , Langlois P. , Lansiaux P. 
Published: May 2005

AbstractIn 1958, Caroli [1, 2] was the first to describe congenital dilatations of intrahepatic bile ducts concerning a segment, a sector, a lobe, or both halves of the liver. Sometimes the dilatations are associated with congenital hepatic fibrosis as described in 1954 by Grumbach [3], dilatations of biliary ductules (biliary angiomatosis), and parenchymal sclerosis. This hereditary autosomal recessive disease is associated in many cases with nephrospongiosis or Cacchi‐Ricci's disease [4].Caroli's disease is quite rare. By 1982, a total of 99 cases had been reported in the world literature. Aside from these cases we have seen and operated on 10 patients [5, 6].In Caroli's disease, stenosis and dilatations give rise initially to biliary stasis and, secondly, to intrahepatic biliary lithiasis and biliary infection. The normal course in Caroli's disease consists of suppurative cholangitis, septicemia with gram‐negative organisms, and intrahepatic and subphrenic abscesses. The disease must be recognized before these serious complications arise. The new hepatobiliary imaging procedures should now allow an early diagnosis and, therefore, a better therapeutic approach.
Choice of treatment for hepatolithiasis based on pathological findings
Authors: Koga Akitoshi , Miyazaki Kohji , Ichimiya Hitoshi , Nakayama Fumio 
Published: May 2005

AbstractThe results of surgical treatment in 56 patients with hepatolithiasis are reported including a follow‐up study on 53 patients who survived more than 1 year (median, 5 years and 8 months). Patients were treated by 4 different procedures, i.e., common duct exploration in 32 patients, hepatic resection in 13 patients, hepatic resection with intrahepatic cholangiojejunostomy in 6 patients, and endoscopic stone removal in 5 patients. These procedures were combined with additional procedures, i.e., sphincteroplasty and bilioenteric anastomosis when necessary. There were no operative deaths. The stones were completely removed in 51.8% of the patients. Follow‐up study for 1 to 10 years showed good results in 70.8% of the patients. Residual stones were often observed in the cases with stricture at the liver hilum and this led to poor results at follow‐up. The results of various procedures were evaluated in relation to the prevailing pathology such as bile duct stricture and the location of stones.
Multimodal therapy in anaplastic giant cell thyroid carcinoma
Authors: Werner B. , Abele J. , Alveryd A. , Björklund A. , Franzén S. , Granberg P. ‐O. , Landberg T. , Lundell G. , Löwhagen T. , Sundblad R. , Tennvall J. 
Published: May 2005

AbstractA therapy aiming at pre‐ and postoperative radiotherapy with concomitant chemotherapy has been used in 19 patients with anaplastic giant cell carcinoma of the thyroid gland. Radiotherapy was administered twice daily, 5 days a week; the cytostatic drugs employed were bleomycin, cyclophosphamide, and 5‐fluorouracil. Patients with advanced disease (distant metastases and/or vocal cord paralysis,n= 9) had a median survival time from diagnosis of 7 months, while patients with less advanced disease survived on average 12 months. In the latter group there were 3 survivors. The patients who died succumbed to metastatic disease rather than to local growth. No patient required tracheostomy and the side effects due to treatment were usually well tolerated.
Complications of the Swan‐Ganz catheter
Authors: Slung Hilton B. , Scher Kenneth S. 
Published: May 2005

AbstractTwo hundred thirty Swan‐Ganz catheters were inserted into 225 patients. Meticulous attention was paid to techniques of insertion and post‐insertion catheter care. The preferred route of insertion was via the right internal jugular vein.Minor problems included neck hematomas in 5 attempts (2.2%), catheter migration after insertion in 13 cases (5.6%), and 1 balloon rupture. Only 9 of 230 catheter insertions (3.9%) were associated with major complications. Six of 9 problems, classed as major, were transient arrhythmias which occurred during catheter insertion but were rapidly corrected. In one patient the catheter knotted and had to be removed in the cardiac catheterization laboratory. Two patients (0.9%) suffered non‐fatal pulmonary artery injuries. There were no episodes of catheterrelated sepsis nor were there any deaths attributed to the use of the catheter.We conclude that the flow‐directed pulmonary artery catheter is a relatively low‐risk monitoring device.
Chronic acalculous gallbladder disease: A clinical enigma
Authors: Nora Paul F. , Davis Robert P. , Fernandez Michael J. 
Published: May 2005

AbstractPatients with classic symptoms of gallbladder disease who have negative oral cholecystograms (OCG) or ultrasonography present perplexing management problems. The surgical literature attests to the fact that there is a marked difference of opinion as to the role of surgery in these patients. The high recurrence rate of symptoms in patients following surgery reported in some series has been a source of major concern.We have attempted to define the appropriate approach to this problem for the past decade. Initially, the findings of prolonged visualization of the gallbladder on OCG in association with a fatty meal was considered an indication for surgery. This initial group of patients followed over a decade showed about 75% to be symptom free. Subsequently, additional patients were subjected to cholecystokinin oral cholecystography (CCK‐OCG). With follow‐up for over 6 years, the results have shown about 80% relief of biliary tract symptoms in these patients (CCK‐OCG category) following surgery.Continued attempts to further define those patients who will benefit from surgery has resulted in the utilization of radionuclide imaging in association with cholecystokinin injection (CCK‐RNI). One hundred patients were subjected to CCK quantitative biliary imaging. Seventy‐six patients were considered to have inadequate gallbladder emptying; 30 patients with no gallbladder emptying on CCK‐RNI were subjected to cholecystectomy. All patients subjected to cholecystectomy showed abnormal histological findings in the gallbladder. These 30 patients have been followed from 1 to 3 1/2 years and there has been no recurrence of symptoms in any following surgery.
Segmental versus total colectomy for large bowel Crohn's disease
Authors: Stern H. S. , Goldberg S. M. , Rothenberger D. A. , Nivatvongs S. , Schottler J. , Christenson C. , Nemer F. , Balcos E. 
Published: May 2005

AbstractReports of the long‐term results of excisional surgery for Crohn's disease restricted to the large intestine have revealed apparently conflicting data. Recurrent enteritis after colectomy and ileotomy varies from 3% to 46%. Variations in patient selection, differences in pathologic criteria and criteria for defining recurrences, and length, completeness, and accuracy of the follow‐up may well explain such differences in the literature. Certainly, the extent of the operative procedure could influence recurrence rates. A retrospective review was undertaken to determine whether segmental colon resection was ever justified in patients with Crohn's disease clinically confined to the colon.
Excessive bleeding at hepatic resection after experimental liver denervation
Authors: Kullendorff C. ‐M. , Zoucas E. , Lindfeldt J. , Holmin T. 
Published: May 2005

AbstractThe effects of microsurgical denervation of the liver on blood loss, bleeding time, platelet count, and partial thromboplastin time (APT‐time) after standardized liver resection were studied in the rat. The hepatic nerves in the hepatoduodenal ligament were dyed, identified, and resected with the aid of a microsurgical technique. During the same anesthesia and also one week after denervation, a 3‐ to 4‐fold increase in blood loss and bleeding time was demonstrated when compared to sham‐operated and control rats. As a result of the increased blood loss, hemoglobin and hematocrit values fell, whereas platelet count and APT‐time were essentially unchanged. The denervation procedure had no influence on platelet aggregation. In all probability, the increased bleeding after hepatic resection in the denervated rats is a reflection of an interrupted nerve supply to the liver. The results may have interesting implications for human liver surgery.