bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic sclerotherapy in nonalcoholic liver cirrhosis: Preliminary results of a prospective controlled randomized trial
Authors: Russo Antonio , Giannone Giorgio , Magnano Antonio , Passanisi Guido , Longo Carmen 
Published: May 2005

AbstractBetween June, 1984 and December, 1985, a total of 41 patients were enrolled in a prospective controlled randomized trial comparing prophylactic sclerotherapy and medical treatment for the prevention of the first esophageal variceal bleeding. All patients had nonalcoholic liver cirrhosis, fourth degree varices, and no past history of gastrointestinal bleeding. The patients were randomly assigned to the control group (20 patients) or to the sclerotherapy group (21 patients); most of the patients belonged to Child's classes A and B.After a mean follow‐up of 16.8 months, there were 3 variceal bleeding episodes and a 10% mortality rate in the control group whereas neither hemorrhage nor death was observed in the sclerotherapy group. In the latter group, severe complications occurred in 9.5% of the patients; the rate of recurrence after eradication of esophageal varices was 40%.Although there were no statistically significant results, the favorable trend toward a lower bleeding risk and better survival observed in the treated patients suggests that a longer trial in a larger population of cirrhotic patients with a longer follow‐up should be considered.
Endoscopic treatment of bleeding peptic ulcers
Authors: Nakagawa Kunitoshi , Asaki Shigeru , Sato Toshio 
Published: May 2005

AbstractSince June, 1979, patients with upper gastrointestinal bleeding, other than of the varices, have been subjected to the procedure of endoscopic hemostasis with injection of absolute ethanol. This method is based on the principle of tissue dehydration and fixation with absolute ethanol. In this procedure, the bleeding vessels are dehydrated and fixed with consequent vasoconstriction and necrosis of the vascular wall, including its endothelial lining, thereby facilitating thrombogenesis and hemostasis. We have applied this method in 147 cases of upper gastrointestinal bleeding, obtaining a successful temporary hemostasis in all cases. Rebleeding from the same site occurred in 5 cases and new bleeding from another site occurred in 6 cases; however, in these cases, hemostasis was successfully obtained by reinjecting ethanol. After hemostasis, 6 patients received elective surgery and another 2 were operated on due to perforation of the stomach. Of the patients treated by this method, 11 died due to causes unrelated to gastrointestinal bleeding. After the hemostatic procedure, cure of the ulcer by conservative treatment was attained in the remaining 136 cases. Therefore, the local injection of absolute ethanol is an effective hemostatic method for upper gastrointestinal bleeding.
Endoscopic laser therapy in the curative and palliative treatment of upper gastrointestinal cancer
Authors: Suzuki Hiroaki , Miho Otomi , Watanabe Yutaka , Kohyama Masayuki , Nagao Fusahiro 
Published: May 2005

AbstractEndoscopic laser treatment was initially applied for gastrointestinal bleeding, but has been actively extended, especially in Japan, to the curative treatment of early upper gastrointestinal cancers.We have treated 10 cases of early gastric cancer and 1 case of early esophageal cancer by Nd‐YAG laser radiation, and 2 cases of early gastric cancer by photochemical therapy (PCT) with argon laser + hematoporphyrin derivative. Also, 62 cases of advanced cancer were treated, 10 of the esophagus and 52 of the stomach, for bleeding (18 cases) or stenosis (34 cases). The cases were nonresectable or they were patients who refused surgery. Satisfactory results were obtained by treatment with YAG laser, but have not yet been obtained with PCT.In order to find indications for the possible extension of endoscopic laser therapy to operable cases of early gastric cancer, we studied lymph node metastases in 200 cases of early gastric cancer surgically treated by us. It was found that early gastric cancers (both mucosal and submucosal) measuring less than 2 cm in diameter, of type I, IIa, and IIc (without ulcer scar), had no lymph node metastases and such cases can be treated by local therapy—such as endoscopic laser therapy.In palliative endoscopic laser therapy for complications of advanced gastrointestinal cancers, there are no major problems with active performance. We obtained a high (90%) hemostatic rate in bleeding cases of upper gastrointestinal cancer and a satisfactory (65%) rate of dilating effect in cases of cancerous stenosis at the esophagus and cardia. A national survey in this field is also discussed in this report to show the present status of endoscopic laser therapy in the curative and palliative treatment of upper gastrointestinal cancer in Japan.
Percutaneous endoscopic gastrostomy: Indications, limitations, techniques, and results
Authors: Ponsky Jeffrey L. , Gauderer Michael W. L. 
Published: May 2005

AbstractPercutaneous endoscopic gastrostomy was introduced in 1980 as an alternative to traditional operative methods for the creation of a feeding gastrostomy. The indications for the procedure are essentially the same as those for traditional gastrostomy and include the inability to swallow secondary to neurological impairment, oropharyngeal neoplasms, and facial trauma. The method is contraindicated in the presence of massive ascites, total esophageal obstruction, coagulation disorders, and sepsis. Several variations on the original technique have been developed, and results with each are comparable. The morbidity and mortality with percutaneous methods has been at least as good as those reported for operative techniques while the cost has been lower and patient acceptance high. In spite of the ease with which gastrostomy may be performed by the percutaneous method, patient selection must be appropriate and details of technique closely followed if results are to remain acceptable.
Intraoperative endoscopy of the gastrointestinal tract: Clinical necessity or lack of preoperative preparation?
Authors: Bowden Talmadge A. 
Published: May 2005

AbstractIntraoperative gastrointestinal endoscopy is an evolving technique that has received limited attention in the literature through case and small series reports. This literature does contain some papers in which the method was employed instead of conventional endoscopy, but, in general, intraoperative endoscopy has been effectively used as an aid to the surgeon to locate pathology not otherwise detectable and to enhance diagnosis and therapy at laparotomy. The procedure will not be required often, but when used, has the potential to be of as much service to the surgeon as a scalpel or retractor. As more surgeons are being trained in gastrointestinal endoscopy, the indications and uses will surely expand.
Complications and hazards of gastrointestinal endoscopy
Authors: Habr‐Gama Angelita , Waye Jerome D. 
Published: May 2005

AbstractThe diagnostic and therapeutic contribution of fiberoptic endoscopy to the advancement of the knowledge of gastrointestinal disease and to its proper management is already established. Technical refinements in the new instruments and extensive acceptance of the advantages of the method makes fiberendoscopy a procedure widely used throughout the world. Therefore, the appreciation of its potential risk of complications and hazards is justified. This review summarizes the complications and hazards of fiberoptic gastrointestinal endoscopy gleaned from reports of endoscopic surveys and individual experiences. Causes and means whereby complications related to upper intestinal and colonic endoscopy can be prevented or treated are discussed.
Renal autotransplantation
Authors: Flatmark Audun , Albrechtsen Dagfinn , Sødal Gunnar , Bondevik Helge , Jakobsen Arnt , Brekke Inge B. 
Published: May 2005

AbstractIn the period, 1973–1985, a total of 305 renal autotransplantations (often with extracorporeal repair) were performed in 274 patients for fibromuscular (56) or atherosclerotic (98) renovascular disease, nephrolithiasis (97), renal tumor (15), or ureteral injury (8). One‐third of the patients had reduced renal function, and approximately half of the patients with renovascular lesions presented with severe or malignant hypertension. The postoperative mortality rate of 4% was related to age over 60 years and reduced renal function. Postoperatively, 3.6% of the autografted kidneys were lost due to vascular thrombosis (7) or other causes (4). Twenty‐five percent (69) of the patients had a solitary kidney. Two patients died postoperatively with functioning autografts. Long‐term renal function remained stable in 60 patients, and deteriorated in 7.We conclude that autotransplantation and extracorporeal repair provide safe and efficient treatment for selected difficult renal lesions.
Results of treatment of patients with hepatocellular carcinoma with severe cirrhosis of the liver
Authors: Fujio Nagahisa , Sakai Katsuji , Kinoshita Hiroaki , Hirohashi Kazuhiro , Kubo Shoji , Iwasa Ryutaro , Choon Lee Kwang 
Published: May 2005

AbstractWe retrospectively classified patients with hepatocellular carcinoma by the results of tests of 15‐minute indocyanine green retention (ICGR15). Of the 201 patients with hepatocellular carcinoma admitted to our department in the past 6 years, 36 patients were assigned to group 1 (ICGR15 <10.0%), 81 patients to group 2 (ICGR15=10.1–20.0%), and 84 patients to group 3 (ICGR15≥20.1%). Of the total 201 patients, 72% underwent liver resection (78% of group 1 patients, 80% of group 2 patients, and 62% of group 3 patients).We regarded the cirrhosis of the patients in group 3 as severe and studied their survival rate classified by the treatment used. Of these 84 patients, 52 patients were treated by liver resection, about half of whom were treated preoperatively by transcatheter arterial embolization (TAE). Another 9 patients were treated preoperatively by both TAE and portal vein embolization (PVE). At 2 years, and again at 3 years, the survival rate was significantly higher when TAE was used preoperatively than with resection alone. We think that the possibility of performing needed liver resection will be enlarged by preoperative PVE and that liver resection can be done more safely after use of PVE in some patients.
Differential diagnosis between secondary hyperparathyroidism and aluminum intoxication in uremic patients: Usefulness of99mTc‐pyrophosphate bone scintigraphy
Authors: Kinnaert Paul , Van Hooff Ingrid , Schoutens André , Bergmann Pierre , Fuss Michel , Dratwa Max , Vienne Anne , Pasteels Jean‐Lambert , van Geertruyden Jean , Vanherweghem Jean‐Louis 
Published: May 2005

AbstractForty‐one patients in chronic end‐stage renal failure and 4 patients with a functioning kidney transplant presented with spontaneous hypercalcemia or intolerance to vitamin D3 sterols and/or oral calcium supplements. Bone iliac crest biopsy with aluminum staining and Tc‐pyrophosphate bone scintigraphy with determination of Fogelman score were performed in all cases. Two patients had aluminum‐induced osteomalacia (AL O). Thirty‐eight biopsies showed renal osteodystrophy (secondary hyperparathyroidism or various combinations of osteitis fibrosa and osteomalacia): 19 with positive staining for aluminum (RO + AL) and 19 without aluminum deposits (RO). The series also comprised 2 cases of pure osteomalacia (OM), 2 cases of osteoporosis (OP), and 1 case of osteoporosis with aluminum accumulation (OP + AL). Mean Fogelman score in RO patients (9.1±0.3) was significantly higher than in all other categories (5.9±0.5 for RO + AL, and scores ranging from 0 to 8 in the last 7 patients,p<0.01). Patients with massive aluminum accumulation in bone (>75% of the total trabecular surface) showed no or very low uptake of the isotope by the skeleton. Fogelman scores of 9 or higher were always associated with histological secondary hyperparathyroidism.99mTc‐pyrophosphate bone scintigraphy is helpful to distinguish aluminum intoxication from secondary hyperparathyroidism in uremic patients.
Choledochal cyst resection and reconstruction by biliary‐jejuno‐duodenal diversion
Authors: González E. Moreno , García I. García , Pascual M. Hidalgo , Kempin J. Calleja , Blanch G. García , Gutiérrez M. Gomez , Díaz J. Arias , Santiuste A. Calle 
Published: May 2005

AbstractFrom January, 1983 to December, 1986, a total of 9 patients, ranging in age from 2 years and 4 months to 36 years, with choledochal cysts were treated. Symptoms were right upper quadrant pain (n=9), ascending cholangitis (n=7), and jaundice (n=6). A right upper quadrant mass was palpable in 7 patients and gallstones were present in 5 patients. Diagnosis was established by intravenous cholangiogram and ultrasound.The operation was performed through a right subcostal laparotomy. The choledochal cyst diameter ranged from 4.5 to 7 cm. The cyst and the common duct were dissected from the hepatic artery and portal vein. The choledochus was sectioned above the duodenum and the distal end was closed by interrupted sutures. The common duct was divided below the hepatic confluence and the diameter enlarged by longitudinal section of the left hepatic duct. A 30‐cm‐long segment of isolated jejunum was passed through the transverse mesocolon to the right of the middle colic vessels and behind the duodenum and then interposed between the hepatic confluence and the second portion of the duodenum. Biliary‐jejunal anastomosis was performed in 1 layer with interrupted absorbable stitches. No mortality or serious complications occurred during follow‐up (1–4 years). No cholangitis, fever, or pain have developed. All patients were studied postoperatively by biochemical test, ultrasonography, Tc 99m DISIDA, and barium meal swallow. Good liver function and biliary excretion, and absence of duodeno‐jejuno biliary reflux were demonstrated.
The use of blood components in the treatment of congenital coagulation disorders
Authors: Nilsson Inga Marie , Larsson S. Anders , Bergentz Sven ‐Erik 
Published: May 2005

AbstractHemophilia and von Willebrand's disease are the most common congenital coagulation and bleeding disorders. The situation for patients suffering from these conditions has changed drastically during the last 2 to 3 decades. It is the purpose of this article, first, to give data on demography and mortality in hemophilia and, then, to review basic problems of therapy, especially in connection with surgery in hemophilia and von Willebrand's disease with emphasis on the use of blood components.
The use of blood components in patients with malignancy
Authors: Murphy Scott 
Published: May 2005

AbstractMany recent improvements in the management of patients with malignancy would have been impossible without parallel improvements in our ability to support patients through periods of severe bone marrow aplasia produced by the disease or aggressive therapy of the disease. The purpose of this article is to review the use of transfusion of platelets, erythrocytes, and granulocytes in the treatment of these patients.
Immune hemolytic transfusion reactions
Authors: Seyfried Halina , Walewska Irena 
Published: May 2005

AbstractHemolytic reactions such as immune complications of incompatible blood transfusion are described. Characteristics of the immediate intravascular and extravascular antibody mediated red cell destruction are presented with particular attention to delayed hemolytic transfusion reactions. Moreover, the most frequent causes of incompatible blood transfusion are summarized. A general strategy to assure the immunologic safety in blood transfusion is suggested.
Transmission of diseases by blood transfusion
Authors: Seidl Siegfried , Kühnl Peter 
Published: May 2005

AbstractA major risk of blood transfusion is transmission of infectious diseases. The pattern of these diseases varies in different parts of the world. This article reviews the viral, bacterial, and parasitic infections that can be transmitted by transfusion of blood or blood products. A major part of the article deals with posttransfusion hepatitis, the most frequent complication.
Transfusion‐associated acquired immunodeficiency syndrome
Authors: Peterman Thomas A. 
Published: May 2005

AbstractThe acquired immunodeficiency syndrome (AIDS) is the most severe manifestation of infection with a newly recognized retrovirus known as HTLV‐III/LAV (human T‐lymphotropic virus type III/lymphadenopathy‐associated virus). Persons with AIDS have a severe disorder of the immune system that renders them susceptible to a number of opportunistic infections and cancers. Over 80% die within 2 years of diagnosis. Thousands of people have developed AIDS. Most are homosexual/bisexual men or intravenous drug users in the United States or highly sexually active heterosexuals in central Africa or Haiti. Many countries, however, are reporting rapid increases in the number of cases. A small proportion of AIDS patients have been infected by contaminated clotting‐factor concentrates or by blood transfusions. Although AIDS is a rare complication of blood transfusions, it has evoked more fear of transfusions than other more common infectious agents.Strategies for preventing transfusion‐associated AIDS have been suggested by investigations of recipients who have developed disease, donors who have transmitted infection, and components that served as vehicles of transmission. HTLV‐III/LAV antibody tests are now available for screening blood before transfusion. The effectiveness of the prevention strategies and the properties of the HTLV‐III/LAV antibody tests are reviewed.
Acceptable hematocrit levels in surgical patients
Authors: Messmer K. F. W. 
Published: May 2005

AbstractThe ready availability of blood and blood components has resulted in a liberal use of blood transfusions; however, the transfusion of blood is still associated with significant risks for the recipient. The appearance of the acquired immunodeficiency syndrome and the evidence that homologous blood can induce immunosuppression and thereby impair the host resistance of surgical patients has led to a reconsideration of the indications for blood transfusions. It has also fostered application of alternative methods with the aim of reducing the number of homologous blood transfusions. Based on the data available from studies on intentional perioperative hemodilution in patients undergoing elective surgery, and data from patients in intensive care, a hematocrit level of about 30% is acceptable for surgical patients, provided oxygen transport is not impaired by the reduced saturation of arterial blood or inadequate perfusion. The basic mechanism that compensates for the reduced oxygen capacity of the blood is a rise in cardiac output and stroke volume, both depending on adequate venous return and myocardial function. The hematocrit setpoint has to be determined for the individual patient with regard to the history of the underlying disease, circulating blood volume, and actual oxygen needs. By accepting a perioperative hematocrit level of 30% for patients without respiratory and cardiac disease or increased oxygen demand, respectively, the number of transfusions of homologous blood can be reduced and dangerous side effects can be avoided.
Autologous blood predeposit for elective surgery: An Italian experience
Authors: Rebulla P. , Giovanetti A. M. , Mercuriali F. , Sirchia G. ,   “Autotransfusion Team”
Published: May 2005

AbstractA program of predeposit autotransfusion in elective surgery was implemented with the main purpose of decreasing the incidence of posttransfusion hepatitis and of conserving homologous blood. Specific procedures and computer programs were designed to monitor the transfusion practice by key indicators, and the incidence of posttransfusion hepatitis and HTLV‐III infections. Arrangements were devised to ensure the proper management of autologous and homologous units. In 1985, autologous units accounted for 13.5% of all units transfused in elective surgery. While encouraging, our results indicate that efforts have to be made to improve organization and increase awareness of the benefits of autotransfusion in the medical and lay communities.
Worldwide supply of blood and blood products
Authors: Britten Anthony F. H. 
Published: May 2005

AbstractBlood services have achieved a high degree of sophistication, but there remain serious logistic problems which interfere with the adequacy of blood supplies. Many countries have not been able to implement modern component therapy. Supplies of certain specialized products, such as factor VIII, are insufficient almost everywhere. There is a lively international trade in blood products, and corresponding evidence of disease transmission when the rate of infection is relatively high in the exporting region. The answer to these problems lies in the development everywhere of effective blood programs, based on the organization of nonremunerated blood donors.
Fecal peritonitis: Microbial adherence to serosal mesothelium and resistance to peritoneal lavage
Authors: Edmiston Charles E. , Goheen Michael P. , Kornhall Sven , Jones Frank E. , Condon Robert E. 
Published: May 2005

AbstractFecal contamination of the peritoneal cavity is a serious and potentially life‐threatening event. While numerous models have been developed to study the pathogenesis of intraabdominal infection, to date, most investigations have failed to focus on the adherence of the contaminants to the serosal mesothelium. In the present investigation, the cecal ligation and puncture technique (CLP) was performed in Sprague‐Dawley rats to study the following: (a) the kinetics of microbial adherence to the serosal mesothelium, (b) the stability of the aerobic and anaerobic intraperitoneal/mesothelial populations, following extended saline lavage, and (c) the impact of antimicrobial lavage on the stability of the mesothelial microbial populations. The Enterobacteriaceae rapidly colonized the serosal mesothelium and were the predominant flora up to 4 hours post‐CLP. After 8 hours, theBacteroides fragilisgroup represented the predominant peritoneal wash and mesothelial‐associated microorganisms. Extended saline lavage failed to significantly reduce the mesothelial microbial populations. While antimicrobial lavage produced an immediate decrease in mesothelial microbial recovery, the results were transitory and the microbial populations achieved or exceeded prelavage levels at 24 hours postlavage. Microbial colonization of the peritoneal mesothelial surface is a rapid and stable phenomena following penetrating injury to the distal bowel. The results further suggest that the mesothelial populations are resistant to intraperitoneal lavage.
Principles and limitations of operative management of intraabdominal infections
Authors: Farthmann Eduard H. , Schöffel Ulrich 
Published: May 2005

AbstractOperative management of intraabdominal infections still rests on the principles of elimination of focus, reduction of contamination of the peritoneal cavity, and treatment of residual infection. To control the source of contamination from a perforated viscus primary closure, exclusion or resection may be considered with respect to the severity of peritonitis and to the underlying disease. The principle of “peritoneal toilet” with complementary use of systemic and/or local antibiotics is generally accepted even if the value of aggressive debridement is still debated controversely. For the treatment of residual and the prevention of recurrent infection, closed and open lavage techniques, the left‐open abdomen, and planned relaparotomy represent the major approaches in severe generalized peritonitis when the infectious focus might not be securely controlled. The values and disadvantages of different regimens are discussed, additional measures are briefly described, and an outlook on areas of further research is given.