bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of immunotherapy in the management of patients with malignant melanoma
Authors: Goodnight James E. , Morton Donald L. 
Published: April 2005

AbstractImmunotherapy using a variety of agents may be beneficial in controlling accessible cutaneous melanoma metastases and may have potential for limiting the growth of systemic disease when used in the adjuvant setting. Approximately 20% of patients with metastases limited to the skin can be brought into complete remission with local, intralesional BCG immunotherapy. Dinitrochlorobenzene (DNCB), vaccinia virus,C. parvum,and transfer factor have also been tested for activity in local immunotherapy. BCG, DNCB, and vaccinia virus appear to be the most effective. Adjuvant immunotherapy has shown some promise, particularly with regard to improvement in survival. In a study of adjuvant immunotherapy with BCG in patients with stage II disease, recurrence rates were similar, but of those patients who developed recurrences, those who received BCG lived significantly longer. Immunotherapy, used either alone or in combination with chemotherapeutic agents, has shown little or no activity in the treatment of metastatic malignant melanoma.
Combined modality therapy of malignant melanoma
Authors: Hersh Evan M. , Gutterman Jordan U. , McBride Charles M. 
Published: April 2005

AbstractThe major modalities of therapy, namely, surgery, radiotherapy, chemotherapy, and immunotherapy, are each of value in selected cases of malignant melanoma. However, because none of these therapies, alone, is capable of curing or controlling some subgroups of melanoma patients, combined modality therapy needs to be used more extensively. Surgery is of particular value in the treatment of primary tumors and in recurrent or regional metastatic disease. Chemotherapy for malignant melanoma has been disappointing. The most active single agent, DTIC, induces only about a 20% response rate, and little or no significant improvement is seen when DTIC is combined with other agents. However, chemotherapeutic agents when utilized by isolation perfusion in the treatment of primary or recurrent melanoma of the extremities, in conjunction with surgical excision of the primary tumor, produce cure rates of approximately 85% in patients with stage I disease and 50% in those with stage II disease. Immunotherapy appears to be of significant value in primary melanoma, and intra‐lesional BCG immunotherapy of cutaneous or subcutaneous metastatic lesions has yielded a 50% response rate.Successful combined modality therapy would take into account the natural history and course of the disease. Conventional therapy consists of surgery as primary therapy, followed by chemo‐ or immunotherapy. Further research is needed to determine if better results can be achieved by altering the sequence of utilization of the various treatment modalities.
Diagnostic methods in breast cancer
Authors: Johnsén Christer , Bjurstam Nils 
Published: April 2005

AbstractThe curability of breast cancer can be increased by efforts at early diagnosis using mammography, self‐examination of the breast and periodic examinations in a cancer screening program. We have studied a triple diagnostic approach that combines clinical examination, mammography and fine needle aspiration biopsy in women with breast symptoms and have found that diagnostic accuracy is increased, breast cancer is diagnosed earlier, treatment is better planned, radical surgery is usually possible without preliminary open biopsy, precancerous lesions are detected, high risk groups of patients are identified, and surgical biopsy of benign lesions can be avoided in many patients.
The role of skeletal scintigraphy in detection of metastatic breast cancer
Authors: Galasko C. S. B. 
Published: April 2005

AbstractThe most common site of metastases from breast cancer is the skeleton. Conventional methods of detecting skeletal metastases are not very sensitive. Substantial evidence indicates that skeletal scintigraphy is the most accurate method of demonstrating metastases to bone, particularly in patients with “early” breast cancer who have no manifestations of metastatic disease. In a study of 50 patients with advanced mammary carcinoma, skeletal metastases were demonstrated by scintigram (and later confirmed) in 84%, but by conventional x‐rays in only 50%. More important, in 50 patients with “early” breast cancer who had negative skeletal x‐rays, lesions were found by scintigraphy in 24%. All of these patients developed disseminated carcinoma and 83% of them died within 5 years. In contrast, only 34% of patients with a negative scintigram developed disseminated carcinoma within 5 years.
“Superstaging” in breast cancer—A correlation of lymph node histology and investigations designed to detect occult metastatic disease
Authors: Cant E. L. , Smith A. F. , Sumerling M. D. , Forrest A. P. M. 
Published: April 2005

AbstractIn an effort to detect occult metastases in women with “early” breast cancer and no evidence of metastatic disease by conventional criteria, 50 women with “early” breast cancer were subjected to a battery of tests that included skeletal scintiscanning, liver scintiscanning, and measurements of urinary hydroxyproline, serum alkaline phosphatase of bone origin, serum alkaline phosphatase of liver origin and serum gamma glutamyl transpeptidase. One or more abnormalities suggestive of occult metastatic disease in the skeleton and/or the liver were found in 44% of patients. There was no correlation between positive test results and the finding of positive pectoral lymph nodes (found in 42% of patients). Short‐term follow‐up suggests a correlation between positive test results and development of recurrent disease. It appears that the performance of these tests preoperatively and the histological evaluation of pectoral and axillary lymph nodes are complementary approaches to the staging of breast cancer.
United States trials of conservative surgery
Authors: Fisher Bernard 
Published: April 2005

AbstractFrom August 1971 to August 1974, almost 1700 patients with clinically curable breast cancer in 34 institutions in the United States and Canada were entered into the National Surgical Adjuvant Breast Project (NSABP) trial comparing the results of total (simple) mastectomy with those of radical mastectomy. Patients with clinically negative axillary nodes in the total mastectomy group were further randomized to receive postoperative regional radiotherapy or no radiotherapy, but the latter patients underwent an axillary dissection if clinically positive axillary nodes developed after operation. Patients with clinically positive axillary nodes in the total mastectomy group automatically received postoperative regional radiotherapy. After a follow‐up period of 2 to 5 years, there are no significant differences in the results of the various types of treatment in either the groups of patients with clinically negative axillary nodes or those with clinically positive axillary nodes.In June 1976 the NSABP initiated a new study comparing total mastectomy plus axillary dissection, segmental mastectomy plus axillary dissection, and segmental mastectomy plus axillary dissection plus postoperative radiation of the involved breast. All patients with histologically positive axillary nodes receive adjuvant chemotherapy. In the two segmental mastectomy groups, subsequent appearance of cancer in the involved breast is treated by total mastectomy.
The role of topically applied dexamethasone in preventing peritoneal adhesions: Experimental and clinical studies
Authors: Shikata Jun‐ichi , Yamaoka Ikuo 
Published: April 2005

AbstractIn an experimental study, the serosa of the ileum of rats was injured with silver nitrate, and the effect of topical application of a dexamethasone solution on subsequent formation of intraperitoneal adhesions was compared to the effect of saline irrigation (controls). There was a highly significant difference (p<0.01) in the incidence and grade of adhesions observed 1 and 4 weeks postoperatively between the control and dexamethasone‐treated rats. Furthermore, adhesive intestinal strictures were observed in the control rats, but not in the animals that received dexamethasone. Administration of dexamethasone at the time of laparotomy and again 1 week postoperatively was most effective in preventing adhesions.In a clinical trial, topical application of dexamethasone at the time of laparotomy for recurrent adhesive intestinal obstruction in 34 patients was associated with a 9% incidence of further recurrence of adhesive obstruction over a 1–6 year follow‐up period, compared to a 31% incidence of recurrent obstruction in 13 similar patients who received only saline irrigation. Intraperitoneal administration of dexamethasone at the time of laparotomy and for the first 2 days postoperatively in 5 patients was followed by no recurrence of obstruction.
Selection of patients with ischemic cerebrovascular disease for arterial surgery
Authors: Fields William S. 
Published: April 2005

AbstractThe selection of patients with transient ischemic symptoms or stroke for arterial surgery should be based on an understanding of the mechanisms that underlie the clinical manifestations. A thorough clinical evaluation of the neurologic and vascular status by history and physical examination is essential. Noninvasive methods for detecting alterations in cerebral or ophthalmic arterial blood pressure and flow are useful in screening patients for arteriography. However, complete and detailed angiography is an absolute requisite prior to surgery to delineate the exact location, extent, and morphologic characteristics of any lesions that may be present. The aim of extracranial vascular surgery is the prevention of irreversible neurologic deficit or, in some patients, the extension of an already existing deficit. Extracranial vascular surgery should be done only by surgeons who have demonstrated that they can achieve an acceptably low level of mortality and severe morbidity (overall less than 1%). This is particularly imperative since the most suitable candidates are individuals who are neurologically intact or neurologically stable at the time of surgery.
Role of gastric mucosal pepsin in the pathogenesis of acute stress ulceration
Authors: Nagamachi Yukio , Nakamura Takuji 
Published: April 2005

AbstractMeasurements of acid and pepsin in gastric juice and the pepsin concentration in the fundic mucosa were performed in 4 patients who underwent partial gastrectomy for bleeding from acute gastric mucosal erosions (“stress ulcers”) and in 30 patients who underwent partial gastrectomy for chronic gastric or duodenal ulcers. The most striking finding was a significantly higher level of fundic mucosal pepsin in the patients with acute gastric erosions than the chronic ulcer patients. This finding was associated with a significantly lower concentration of pepsin in gastric juice, a low level of acid secretion, and the expected high plasma level of corticosteroids associated with stress. As a result, the ratio of gastric mucosal pepsin to gastric juice pepsin was significantly higher in patients with acute gastric erosions than in those with chronic ulcers. It is possible that a rapid increase in endogenous corticosteroid levels induces an increase in intracellular pepsin in the fundic mucosa, and that this sequence of events plays a role in the pathogenesis of stress ulcer.
The treatment of hyperthyroidism
Authors: Crile George 
Published: April 2005

AbstractWhenever there are alternative methods of treatment, one surgical and the other nonsurgical, and when each method is equally effective, the nonsurgical method invariably prevails. Patients dislike surgery and so do the internists whom they first consult. There seems to be no question that thyroidectomy for Graves' disease and its complications of vocal cord paralysis, tetany, hypothyroidism, recurrent hyperthyroidism, unsightly scar, and accidental death will soon be things of the past.131I involves no risk, and the only side effect or complication is preventable hypothyroidism. If the facts of the case were explained to the patients, none of them would choose thyroidectomy over treatment with131I. It is the responsibility of the physician to tell the patient the facts.
Influence of the abdominal vagi and gastric antrum on humoral control of gastric acid secretion
Authors: Watanabe Hideo , Kinoshita Mahito , Kondo Toshihiko , Konishi Masatoshi , Miyamoto Hideyuki , Kano Yoshiaki , Kushida Toshiaki , Komi Nobuhiko 
Published: April 2005

AbstractThe influence of the abdominal vagi (especially the gastric antral branch), the antrum, and the duodenum on humoral control of gastric acid secretion was studied in 9 dogs with Heidenhain pouches (HP). The dogs were divided into 2 groups and subjected to the following sequential operations:Group I: (6 dogs) The first operation was section of the antral branch of the vagus nerve. The second operation was antrectomy with Billroth I gastroduodenostomy. The third operation was transthoracic truncal vagotomy.Group II: (3 dogs) The first operation was antrectomy and Billroth II gastrojejunostomy and the second operation was transthoracic truncal vagotomy. During the control period when the dogs had only an HP, pouch acid secretion and serum gastrin level increased after feeding. After antral vagotomy, both pouch secretion and the serum gastrin level after feeding were significantly lower. The second operation of antrectomy with Billroth I gastroduodenostomy in Group I resulted in a further significant decrease in both pouch acid secretion and serum gastrin level. Similar decreases occurred after the first operation of antrectomy with Billroth II gastrojejunostomy in Group II. In both groups, after the final operation of transthoracic truncal vagotomy, pouch acid secretion tended to increase, while the serum gastrin level increased slightly in Group I but not in Group II. It is concluded that vagal innervation of the antrum plays a role in gastrin release and gastric acid secretion.
Plasma glucagon in acute and chronic pancreatitis
Authors: Buch Annette , Holst Jens , Schmidt Arne , Buch Jan 
Published: April 2005

AbstractThe increased use of glucagon in the treatment of acute pancreatitis led us to study plasma glucagon in 26 patients with acute pancreatitis and 33 patients with chronic pancreatitis. In all patients simultaneous measurements of plasma glucagon, serum amylase, and serum calcium were performed. In acute pancreatitis there was a tendency toward elevated plasma glucagon and low serum calcium levels, but there was no significant correlation between the concentrations of plasma glucagon, serum calcium, and serum amylase. The plasma glucagon concentrations were found to be low in only 2% of the measurements during the first week of the acute attack. These findings do not support the use of glucagon in the treatment of pancreatitis.
Prevention and treatment of recurrent bile duct stones by choledochoduodenostomy
Authors: Johnson Alan G. , Rains Anthony J. Harding 
Published: April 2005

AbstractCholedochoduodenostomy is a procedure to be used as an option in certain circumstances and the decision often has to be made at the time of operation. The 2 essential criteria are a dilated common bile duct and an obstruction at its lower end. It may be used at a first operation to prevent recurrent stones if there is clear evidence of a primary duct problem, or at a second operation for recurrent stones when the existence of a duct problem is usually more certain. There are some situations in which choledochoduodenostomy is a genuine alternative to sphincteroplasty. We favor choledochoduodenostomy in obese patients, if there is difficult access to the sphincter, if there is a long stricture as in chronic pancreatitis, when there is suppurative cholangitis, or when the duct is already being explored from above. There is a variety of operative techniques using continuous or interrupted sutures, but it is inadvisable to put nonabsorbable sutures into the lumen of the bile duct. The incision in the duodenum can be longitudinal or transverse, but the duodenum must be rolled up on to the bile duct without tension. The only diet restriction after operation involves avoidance of indigestible particles such as tomato and apple skins and grape pips which may become lodged in the distal bile duct. In the worldwide experience with follow‐up periods of up to 20 years, “ascending” cholangitis has been very rare (about 1%) when the operation was performed correctly with an initial stoma size of at least 2.5 cm.
Extremity replantation
Authors: Chung‐Wei Chen , Yun‐Qing Qian , Zhong‐Jia Yu. ,   The Research Laboratory for Replantation of Severed Limbs
Published: April 2005

AbstractFrom January, 1963 to June, 1976, replantation of severed limbs and digits was performed in 438 patients at the Shanghai Sixth People's Hospital. The survival rate of replanted limbs was 83.2%, and 57.5% for replanted digits. Since 1973, the survival rate of replanted digits using microsurgery has been 92.3%. There were no postoperative deaths and few systemic complications. Local complications were responsible for failure of the replantation in 122 patients. Follow‐up for more than 1 year of 214 patients showed only 3.9% with little or no functional recovery, despite survival of the replanted limb, while 34.1% were able to resume their original work with complete or nearly complete recovery of sensation. Replantation has been used successfully in severed extremities that experienced up to 36 hours of ischemia, in transpositional replantation of multiple severed digits, and with resection of the tumorbearing segment of a malignant upper extremity. In order to improve the rate of success, we believe that popularization of the replantation technique is most important.
Effect of fat on meal‐stimulated gastric and pancreatic secretion
Authors: Llanos Osvaldo L. , Swierczek Janusz S. , Miller Thomas A. , Said Sami I. , Rayford Phillip L. , Thompson James C. 
Published: April 2005

AbstractIn 5 dogs with chronic gastric and pancreatic fistulas, gastric secretion was continuously stimulated with a 10% liver extract meal, kept at a constant pH 7 by intragastric titration. After the first hour of stimulation, intraduodenal sodium oleate was infused in graded doses. Gastric acid and pancreatic secretion (volume, bicarbonate and protein) were measured. Plasma gastrin, secretin, VIP, and GIP were determined by radioimmunoassay. The liver extract meal evoked a gastric acid output of 12±1.4 mEq/30 min and a rise in plasma gastrin from 90 ± 20 to 250±50 pg/ml. Sodium oleate produced inhibition of acid secretion by 40% and 70% at doses of 8 and 16 mmol/hr, respectively. Sodium oleate produced a dose‐dependent increase in volume of pancreatic juice, bicarbonate and protein output. Meal‐stimulated plasma gastrin levels were not affected by sodium oleate. Plasma secretin and VIP levels remained unchanged during the infusion of sodium oleate. GIP was released by liver extract meal and, in addition, in a dose‐related fashion by graded doses of sodium oleate. It is concluded that VIP and secretin are not released by fat and they are not involved in the inhibition of gastric secretion. GIP may be one of the mediators in the inhibition of gastric acid secretion by fat. The inhibition of acid secretion by fat is not mediated by suppression of gastrin release.
Arterial epigastricocavernous anastomosis for the treatment of sexual impotence
Authors: Michal Václav , Kramář Rudolf , Pospíchal Jan , Hejhal Libor 
Published: April 2005

AbstractPrevious histologic and phalloarteriographic studies that we have performed suggest that stenoses and occlusions of the arteries supplying the penis play a very important role in the etiology of sexual impotence in many patients. This report describes the results of direct arterial anastomosis to the cavernous bodies of the penis, using the inferior epigastric artery and microsurgical technique, in 21 impotent males ranging in age from 40 to 63 years. The objective of the operation was to increase basal penile blood flow to a level, determined by preoperative studies, just below that necessary to maintain an effective erection. A limited capacity to increase blood flow in response to an erotic stimulus could then suffice to produce an erection. The anastomosis became occluded in 6 patients, and the complication of priapism developed in 3. The bypass remained patent in 13 patients, 11 of whom experienced improved erection. Nine patients resumed normal sexual activity that, prior to operation, was impossible.
Exceptional performance in heart preservation with an amino acid—Containing perfusion fluid
Authors: Păuşescu Exacustodian , Mendler Nikolaus , Gebhardt Klaus , Sebening Fritz 
Published: April 2005

AbstractThis is a report of a study aimed at putting into practice a new theory for hypothermic preservation of viable organs. A perfusion fluid elaborated according to this theory was applied in preservation of the heart, and resulted in storage of the heart for up to 72 hours with preservation of its functions (rhythm, presystolic ventricular pressure, systolic ventricular pressure, cardiac work, coronary blood pressure, sensitivity to drugs) and its morphology. An important finding was that repeated heart storage for 24 hours alternating with functional testing for 5–7 hours could be performed without irreversible alterations of cardiac function and fine structure. Furthermore, during functional testing following storage the hearts consistently demonstrated improvement of function in time, suggesting that the preserved myocardial tissues were able to rapidly achieve metabolic reequilibration. The results of this study provide the possibility of developing a system for efficient ex vivo heart conditioning before transplantation.
Magnetic resonance techniques in the assessment of myelin and myelination
Authors: Barkovich A. J. 
Published: April 2005

SummaryLeukodystrophy is a common central nervous system manifestation of inborn errors of metabolism. Until magnetic resonance imaging (MRI) emerged as a clinical tool, the diagnosis of leukodystrophy was difficult and imprecise; MRI has allowed new understandings and classifications of leukodystrophies that have greatly enhanced both our diagnostic ability and our understanding of these complex disorders. However, optimal use of MRI in this setting requires a fundamental understanding of myelin structure, myelin development, and the changes seen on MRI with myelination and demyelination. The purpose of this review is to provide the reader with the necessary tools for the use of MRI to diagnose and follow patients with leukodystrophies.
Sorabji Piano Music
Authors: Rapoport Paul 
Published: April 2005

SORABJI: Two Piano Pieces; Fantaisie espagnole; Valse-Fantaisie: Hommage à Johann Strauss; Three Pastiches; Le jardin parfumé; Nocturne Jami; Gulistan; Introito and Preludio corale from Opus clavicembalisticum; Prelude, Interlude, and Fugue; Fragment for Harold Rutland; Fantasiettina sul nome illustre dell'egregio poeta Christopher Grieve ossia Hugh M'Diarmid; Quære reliqua hujus materiei inter secretiora; St. Bertrand de Comminges: ‘He was Laughing in the Tower’. HABERMANN: À la manière de Sorabji: ‘Au clair de la lune’. Michael Habermann (pno). BMS 427CD–429CD (3-CD set).SORABJI: Piano Sonata No. 4. Jonathan Powell (pno). Altarus AIR-CD-9069(1)–9069(3) (3-CD set priced as 2).