bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental vascularized segmentai pancreatic and islet transplantation in the baboon
Authors: du Toit Don F. , Heydenrych Jacobus J. , Smit Ben , Louw Gabriel , Zuurmond Theuns , Laker Lida , Els Daniel , Weideman André , Wolfe‐Coote Sonja , van der Merwe Emanuel A. , Groenewald Wilhelm A. 
Published: May 2005

AbstractThe present study was undertaken to evaluate the effectiveness of cyclosporine (CYA) and total body irradiation (TBI) or total lymphoid irradiation (TLI) in suppressing segmental pancreatic allograft rejection in totally pancreatectomized outbred Chacma baboons. In addition, the study includes our preliminary results with subcapsular renal autotransplantation of dispersed autologous pancreas in the primate.CYA in doses of 25–50 mg/kg per day produced a slight but significant prolongation of graft survival. There was a wide variation of daily CYA serum trough levels exhibited between primates on the same daily oral dose, and there was no clear correlation between absolute CYA serum trough levels and rejection. Although heterotopic auto‐ or allotransplantation of the tail of the pancreas in the baboon was capable of maintaining normoglycemia in pancreatectomized baboons until rejection of the graft, glucose intolerance, reduced K‐values, and hypoinsulinemia were consistent findings during glucose tolerance tests, suggesting transplantation of an insufficient islet cell mass.Animals that received 76 rad (TBI) remained normoglycemic between 14 and 36 days with a median of 22 days, which indicated a modest but significant prolongation of graft survival. Animals treated with TLI (600 rad) sustained graft function between 7 and 31 days with a median of 17 days. The optimal regimen of irradiation in terms of cumulative dose, dose per fraction, number of fractions, and frequency of irradiation still requires refinement in this model.Primates receiving subcapsular autologous dispersed pancreas failed to become normoglycemic and plasma glucose levels never dropped below 12 mmol/L. Postmortem examination revealed diffuse chemical peritonitis associated with surrounding fat necrosis and autodigestion of the retroperitoneal tissues, suggesting that this technique has no clinical application at present.
Experience in human segmental pancreas transplantation
Authors: McMaster P. , Michael J. , Adu D. , Gibby O. M. , Vlassis T. 
Published: May 2005

AbstractPancreas transplantation in the United Kingdom was initiated just over a decade ago and interest further developed with the introduction of ductal injection techniques and cyclosporin. However, graft losses associated with technical problems remain a significant problem, and experiences over the last year with other units initiating programs suggest progress continues to be slow.
The revolution in breast cancer surgery: Science or anecdotalism?
Authors: Fisher Bernard 
Published: May 2005

AbstractDuring the past 15 to 20 years, there have resulted revolutionary changes in the local/regional management of primary breast cancer. Why have those changes come about? Has science played a role or have they been entirely related to the experiences of a few who have “tampered with tradition” for some nebulous reason? This report traces the pathway of change from Halsted's time to the present and attempts to point out wherever possible the relation of these changes to science and/or to “anecdotalism.” It traces the origins of the Halstedian hypothesis of cancer management, the reasons for its perpetuation, and the clinical challenges to it which were really not challenges at all. A description of laboratory and clinical research in the 1960's which led to an alternative hypothesis is presented, as is a description of how clinical trials tested the alternative hypothesis. The results of those trials, recently reported, lend support to a concept of surgery for cancer which embodies biological principles rather than the mechanistic and anatomical principles of the past. A brief discussion is provided relative to how cancer surgery interrelates with other modalities and the article concludes with the author's concept of a surgical oncologist.
Adjuvant chemotherapy in stage II breast cancer: A brief overview of the NSABP clinical trials
Authors: Wolmark Norman , Fisher Bernard 
Published: May 2005

AbstractSince 1972 the National Surgical Adjuvant Breast and Bowel Project (NSABP) has completed 5 adjuvant chemotherapy protocols into which over 3,500 histologically nodepositive patients have been entered; data for this review are derived predominantly from the first 3 studies. Each study was performed sequentially with the intent of identifying patient subsets responding to 1, 2, or 3 chemotherapeutic agents. Comparison of disease‐free survival in patients receiving l‐phenylalanine mustard (L‐PAM) or placebo after 10 years of follow‐up disclosed that L‐PAM was beneficial in patients up to 49 years of age, but not in women ⩾50 years. Further analysis indicated that the subset of patients ⩽49 years with 1–3 positive nodes sustained the greatest increment in disease‐free survival with single‐agent L‐PAM. The addition of 5‐fluorouracil (5‐FU) to L‐PAM was superior to L‐PAM alone in patients ⩾50 years of age, particularly those with ⩾4 positive nodes. This effect became attenuated after 6 years of follow‐up. The 3‐drug regimen of L‐PAM, 5‐FU, and methotrexate failed to provide a benefit over and above that achieved by the L‐PAM‐5‐FU combination in all subsets examined. Two further NSABP protocols are described in which the addition of Adriamycin® to L‐PAM and 5‐FU is addressed. The rationale for the current generation of NSABP adjuvant chemotherapy trials using short intensive Adriamycin® and cyclophosphamide regimens is discussed. The results continue to underscore the heterogeneous response to chemotherapy demonstrated by patient subsets characterized on the basis of age and nodal status.
Adjuvant CMF chemotherapy in operable breast cancer: Ten years later
Authors: Bonadonna Gianni , Rossi Anna , Valagussa Pinuccia 
Published: May 2005

AbstractThis article reports the 10‐year results of a trial testing radical mastectomy with or without adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) in 386 women with breast cancer and positive axillary lymph nodes. The long‐term analysis confirmed that adjuvant chemotherapy was able to produce a significant relapse‐free survival improvement (43.4%) versus control (31.4%,p<0.001) and a trend in total survival (55.2% versus 47.3%,p=0.10). Both relapse‐free survival and total survival benefit were significant in premenopausal women. Relapsefree survival was not influenced by drug‐induced amenorrhea. In both treatment groups, the results were inversely related to the number of histologically involved axillary nodes. On relapse, salvage treatment applied in the control group failed to produce superior results compared to those achieved in the CMF group and yielded a similar median survival from first relapse between control (37 months) and CMF (32 months) patients. The incidence of severe myelosuppression and hair loss was low (less than 10%) and reversible. Prolonged chemotherapy was not associated with an increased incidence of second neoplasms. We conclude that CMF, as given in this study, was able to improve the course of premenopausal women with high‐risk breast cancer during the first decade following radical mastectomy.
A randomized trial of CMF versus CMFVP as adjuvant chemotherapy in women with node‐positive stage II breast cancer: A CALGB study
Authors: Wood William C. , Weiss Raymond B. , Tormey Douglass C. , Holland James F. , Henry Patrick H. , Leone Louis A. , Rafla Sameer , Silver Richard T. , Carey Robert W. , Lesnick Gerson J. , Weinberg Vivian E. , Korzun Ann H. ,   Cancer and Leukemia Group B
Published: May 2005

AbstractWomen treated by mastectomy for node‐positive breast carcinoma were randomly assigned to receive an induction course and 2 years of maintenance chemotherapy with cyclophosphamide, methotrexate, and 5‐fluorouracil (CMF) or CMF plus vincristine and prednisone (CMFVP). Five‐hundred twenty‐five evaluable patients were entered between 1975 and 1980. CMVFP was superior to CMF for patients with more than 3 positive nodes(p=0.01) with disease‐free survival of 50% at 5 years with CMFVP compared with 36% with CMF. The advantage of CMFVP was not seen in patients with 1–3 positive nodes and was most marked in patients with 10 or more nodes. This suggests benefit from increased treatment with increasing disease burden. The superiority of CMFVP was more marked in postmenopausal patients(p=0.04) than in premenopausal(p=0.12). The advantage of CMFVP in disease‐free survival is not yet apparent in overall survival.
Adjuvant therapy for breast cancer with positive axillary nodes designed according to estrogen receptor status
Authors: Rivkin Saul E. , Knight William A. , McDivitt Robert , Cruz Tony , Foulkes Mary , Osborne C. Kent , Fabian Carol J. , Costanzi John J. 
Published: May 2005

AbstractThis is a preliminary report of the Southwest Oncology Group in which therapy is randomized by estrogen receptor (ER) data. Estrogen receptor‐negative patients receive either 1 or 2 years of cyclophosphamide, methotrexate, 5‐fluorouracil, vincristine, and prednisone (CMFVP). The ER‐positive group receive CMFVP for 1 year and/or hormonal therapy. The findings to date include: (a) Estrogen receptor‐positive patients have a significantly longer disease‐free interval compared to ER‐negative patients (p =0.004); (b) there is no significant difference in diseasefree interval for ER‐negative patients who receive either 1 or 2 years of CMFVP; (c) the data for ER‐positive patients is too preliminary to report for disease‐free or total survival; and (d) toxicity is acceptable because of frequent monitoring and examinations which result in the low percentage of life‐threatening toxicity.
Adjuvant chemotherapy in postmenopausal women: Results of sequential noncross‐resistant regimens
Authors: Brambilla Cristina , Rossi Anna , Valagussa Pinuccia , Bonadonna Gianni 
Published: May 2005

AbstractThis article reports the 6‐year results of a controlled adjuvant trial carried out in 140 postmenopausal women aged 65 years or less having resectable breast cancer and positive axillary nodes. Within 4 weeks after surgery, patients were started on cyclophosphamide, methotrexate, and fluorouracil and prednisone (CMFP) for 6 cycles followed by Adriamycin® plus vincristine (AV) for 4 cycles. Chemotherapy was delivered with minimal dose reduction schedule. Patients were randomized to receive standard dose regimen for both combinations (treatment A) or progressive dose intensification (treatment B). There was no significant difference in the relapse‐free (RFS) and overall survival (OS) rates between the 2 treatment groups. Treatment results were inversely related to the number of involved axillary nodes. In the subset with 1 to 3 positive nodes, present findings are superior (RFS 75.2%, OS 84.2%) when retrospectively compared to the 6‐year results achieved with adjuvant CMF in the same postmenopausal subset (12 cycles: RFS 55.4%, OS 67.3%; 6 cycles: RFS 47.5%, OS 65.5%). Acute toxicity was moderate and reversible, and no patient showed signs of cardiomyopathy. The results of this trial indicate that sequential noncross‐resistant combinations administered with minimal dose reductions can favorably affect the postoperative course of postmenopausal women with limited nodal involvement. The study design does not allow for quantitating the relative contribution of CMFP versus AV chemotherapy.
Six‐year results of a controlled trial of tamoxifen as single adjuvant agent in management of early breast cancer
Authors: Wilson A. J. , Baum M. , Brinkley D. M. , Dossett J. A. , McPherson K. , Patterson J. S. , Rubens R. D. , Smiddy F. G. , Stoll B. A. , Richards D. , Ellis S. H. 
Published: May 2005

AbstractA randomized controlled trial of tamoxifen as a single adjuvant agent after mastectomy for early breast cancer, reported on at an average follow‐up of almost 2 years in 1983, has now been followed up to a maximum of 6 years. One thousand two hundred eighty five patients aged 75 or less were entered into the trial. Premenopausal women with positive axillary nodes and postmenopausal women with both positive and negative axillary nodes were randomized to receive either tamoxifen 10 mg twice daily for 2 years or to the untreated control group with systemic therapy reserved until the time of relapse. Forty‐six percent of the trial population had primary tumor specimens assayed for estrogen receptor (ER) content. There has been a highly significant reduction in death rate, with 45 (34%) fewer deaths observed in the treated group than in the control group. This benefit appeared to be independent of menopausal, nodal, or ER status.
Synchronous multiple early gastric carcinoma: A study of 178 cases
Authors: Noguchi Yoshikazu , Ohta Hirotoshi , Takagi Kunio , Ike Hideyuki , Takahashi Tomoyuki , Ohashi Ichiro , Kuno Keijiro , Kajitani Tamaki , Kato Yo 
Published: May 2005

AbstractOver the past 3 decades, ending in 1979, resection has been performed in 7,220 patients with gastric carcinoma. Synchronous multiple gastric carcinoma, according to the diagnostic criteria of Moertel, was found in 468, of which 178 (38%) were “early.” There were 135 double, 33 triple, and 10 quadruple early carcinomas. Fewer than one‐third of the smaller tumors were diagnosed preoperatively, and 61.5% of the smaller lesions were less than 10 mm in diameter. In 53% of the patients, the smaller lesions were in the lower one‐third of the stomach with the main lesion in the upper one‐third, whereas in 13% the smaller neoplasms were located in the upper one‐third of the stomach with the main lesion in the lower one‐third. The clinical significance of the smaller lesions was their location relative to the resection line. When planning treatment of gastric carcinoma, it is important to evaluate the whole stomach before and during the operation and after examining the resected specimen. The 5‐year survival rate for patients with multiple early gastric carcinoma was 85.8%.
A comparison of the prophylactic value of cefotetan and metronidazole in appendectomy
Authors: Buckels John A. C. , Brookstein Roger , Bonser Robert , Bullen Barry , Alexander‐Williams John 
Published: May 2005

AbstractIn a prospective randomized trial of 97 patients undergoing appendectomy, the prophylactic value of cefotetan, a new semi‐synthetic cephamycin with activity against a wide range of aerobic and anaerobic bacteria, has been compared with that of metronidazole. A significantly lower wound sepsis rate was found with cefotetan (4.2%) than with metronidazole (19.1%). The superior results of cefotetan appear to be due to its anti‐aerobic as well as anti‐anaerobic activity.
Lasers in gynecology
Authors: Bellina Joseph H. 
Published: May 2005

AbstractThe CO2 laser is widely used in gynecology. It has been most effective in the treatment of intraepithelial cervical neoplasia. Tissue healing is superior to that observed with other destructive modalities. The laser is also useful in the treatment of vaginal lesions because relatively inaccessible sites can be treated by allowing reflection of the beam through the use of mirrors. The laser has also been used intra‐abdominally primarily for adhesiolysis, fimbrioplasty, tubal reanastomosis and cornual reimplantation. The laser has also been useful for the treatment of ovarian endometriosis. The scarring resulting from laser destruction is minimal and patients generally have a much shorter course of convalescence than when the scalpel or electrocoagulation techniques are used.
Phototherapy of tumors
Authors: Bown S. G. 
Published: May 2005

AbstractLasers provide a means of delivering high intensity light to small well‐defined areas under precise control. The biological response depends on the light wavelength and intensity and the absorption characteristics of the target organ. The most important effects are thermal and include tissue vaporization, necrosis with later sloughing, and necrosis stimulating an inflammatory response which may lead to local fibrosis. The Carbon Dioxide Laser can cut or vaporize neoplastic tissue in areas accessible to rigid endoscopy, but the more penetrating Nd YAG and Argon laser beams can be transmitted via flexible fibers and have greater potential for destroying larger tumors without unacceptable damage to surrounding areas. More selective tumor phototherapy is possible in some organs by sensitization with HpD (hematoporphyrin derivative) and subsequent treatment with a dye laser. This effect is non‐thermal and depends on the production of singlet oxygen by activated HpD. The precision possible for local treatment of solid tumors with lasers is greater than for almost any other techniques, but careful quantitative studies are needed to establish the appropriate treatment parameters in any particular situation.
The role of lasers in otolaryngology
Authors: Carruth J. A. S. 
Published: May 2005

AbstractThe role of the carbon dioxide laser in Otolaryngology is becoming clearly defined and its advantages well recognized. It enables the surgeon to remove tissue, by cell vaporization, immediately with high precision, minimal bleeding, and minimal damage to residual normal tissues. Healing is not complicated by edema and is rapid and remarkably pain free. All these advantages make the CO2 laser of the greatest value in surgery to the airway. Benign, premalignant, and malignant lesions in the food and air passages may be treated by the CO2 laser but in the treatment of some malignancies, further controlled series are needed to establish its role.The Argon laser, coupled to an operating microscope, may be used to perform delicate surgical procedures in the middle ear with no mechanical trauma to the ossicular chain and inner ear. This use of the Argon laser is currently under assessment.The dye laser may be used to activate a hematoporphyrin derivative, which is selectively retained by malignant tissues. This causes destruction of the malignant cells with no damage to surrounding normal tissues. Some remarkable results have been reported for this new treatment for malignant disease.
Intraperitoneal approach to regional hyperthermia—possible anticancer applications
Authors: Smith George V. , MacMillan Richard , Stribling Joseph 
Published: May 2005

AbstractInduction of hyperthermia in dogs by irrigation of the peritoneal cavity via a closed circuit system was evaluated for possible use in the management of cancer patients. Dogs were subjected to lavage of the peritoneal cavity with crystalloid solution at 41°–43°C in a closed circuit system. Temperatures of the liver and hollow viscera were maintained at 40°–42°C for 4 hours. The animals tolerated the procedure, and the parietal incisions and intestinal anastomoses healed without difficulty. Evidence of toxicity was minimal. Plans for studies of this modality in patients with cancer are underway.
Upper gastrointestinal bleeding in renal transplant recipients: The role of prophylactic gastric surgery
Authors: Haffner Jon F. W. , Jakobsen Arnt , Flatmark Audun L. 
Published: May 2005

AbstractA study of 535 recipients of a first renal graft has been done to analyze whether pretransplant proximal gastric vagotomy (PGV) influenced the frequency of upper gastrointestinal bleeding. The 11‐year period of the study (1969–1979) was divided into two periods: from 1969 to mid‐1973, there were 125 patients, and from 1974 through 1979, there were 410 patients to be studied. Pretransplant gastric resection was performed on 39 recipients with known peptic ulcer disease and, during the 1974–1979 period, pretransplant PGV was performed on 38 patients with demonstrated hyperchlorhydria. Gastroduodenal bleeding developed in 8 of 125 patients (6.4%) during the first period and 19 of 410 patients (4.6%) during the second period, but when resected patients are eliminated, the rates are similar for the two periods (5.1% versus 5%). The overall rate of death from gastroduodenal bleeding was reduced from 4% in the first period to 1.7% in the second, due to a reduction of the bleeding mortality rate from 62% in the first period to 37% in the second. In spite of prophylactic gastric surgery in patients with a previous history of peptic ulcer, some 5–15% of non‐ulcer transplant recipients develop gastroduodenal bleeding after transplantation.
Dextran prophylaxis of fatal pulmonary embolism
Authors: Ljungström Karl‐Gösta 
Published: May 2005

AbstractThromboembolic prophylaxis with dextran 70 was given routinely to patients undergoing major surgery from 1970 to 1972 and from 1975 to 1977, using slightly different dosages. During 1968 to 1970 and 1972 to 1974, no routine prophylaxis was given. During the 4 respective 2‐year periods studied, the following number of postoperative fatal pulmonary emboli (FPE) were verified at autopsy: 16 (no prophylaxis); 6 (dextran); 19 (no prophylaxis); and 4 (dextran). The incidence of FPE in relation to major operations was 35/5,094 (0.69%) without prophylaxis, and 10/4,881 (0.20%) with prophylaxis,p < 0.001. The autopsy rate was 93.4% in postoperative deaths. Adherence to prophylaxis was 88 ± 5%. Routine prophylaxis with dextran 70 during surgery is, therefore, effective against fatal pulmonary embolism. Furthermore, it is easy to perform, lacking many of the practical disadvantages of oral anticoagulants and heparin.
Open treatment of abdominal septic catastrophies
Authors: Broomé Albert , Hansson Lars , Lundgren Fredrik , Smedberg Sam 
Published: May 2005

AbstractFrom 1973 to 1981, a total of 30 patients undergoing reoperative surgery for serious septic complications were treated without closure of the abdominal cavity. The open wound was covered with gauze soaked in saline. Intraabdominal abscesses could then be evacuated directly, if necessary, under slight general anesthesia in the patient's own bed. Reperitonealization and excess growth of granulation tissue was seen within 2 weeks. Sixteen patients survived. In 10 of these, the wound healed secondarily without any other treatment. In the remaining 6, split‐skin grafts or a pedicled flap was necessary. In 4 patients the abdominal wall almost reestablished itself. The remaining 12 patients showed larger or smaller defects with negligible problems. Patients with severe abdominal sepsis, associated with necrotic wound edges, multiple laparotomies, and multiple organ failures should have the abdominal cavity left completely open.
Colohepatic fistula due to hydatid disease
Authors: Morris D. L. , Smith W. D. F. , Alexander‐Williams J. 
Published: May 2005

AbstractCommunication of a hepatic hydatid cyst to the colon appears to be extremely rare. We report a 54‐year‐old male who underwent surgery for a huge hydatid cyst. Four days after the cyst was aspirated and many daughter cysts were removed, gross fecal contamination occurred as a result of a 0.5‐cm defect in the right transverse colon. The defect was repaired and the colon temporarily exteriorized. Recovery was uneventful.