bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intestinal antisepsis: Rationale and results
Authors: Condon Robert E. 
Published: May 2005

AbstractThe intensive, short‐term, low‐dose neomycin‐erythromycin preparation regimen we have reported is effective in both microbiologic and clinical terms. The evidence establishing the efficacy of neomycin and erythromycin base in elective resections of the colon and rectum is reviewed. The concentration of bacteria in the lumen of the bowel is reliably decreased at the time of operation; emergence of resistant organisms has not been noted. Clinically, the incidence of all forms of septic complications is significantly reduced.In comparison with other effective regimens of oral antimicrobial bowel preparation, we continue to prefer neomycin‐erythromycin because it is less expensive, the drugs administered are less toxic, and emergence of resistant organisms has not been noted. Neomycin‐erythromycin remains the “gold standard” regimen against which other regimens of both oral and systemic bowel preparation should be compared directly in future clinical trials.
Plasma clearance of bromsulphalein® (BSP) in children with biliary atresia and other hepatobiliary disorders
Authors: Bianchi Adrian , Baker Peter R. 
Published: May 2005

AbstractBromsulphalein® (BSP) plasma clearance has been studied in 17 infants with hepatobiliary disorders, including 9 with biliary atresia. A total of 26 clearance studies were made, 24 of which were analyzed by means of a modified 2‐compartmental model to provide quantitative data on hepatocellular function.The initial BSP plasma clearance curve indicated an absence of biliary excretion in 13 patients, including all 9 patients with biliary atresia. The presence of an excretory phase appears, therefore, to exclude a diagnosis of biliary atresia. Of the 4 other patients, 3 had biliary tract disorders and 1, severe neonatal hepatitis.The “atretic” type curves were analyzed by a modification of the usual technique, which enabled quantitation of hepatocellular function in the absence of biliary excretion. The equivalent liver volume (ELV), which is an estimate of the functional liver cell mass, was less than 400 ml/kg in 5 of the 6 patients with biliary atresia who are now dead or not thriving and icteric, whereas all 3 patients currently thriving and anicteric, and who had undergone hepatic portoenterostomy, had ELV values greater than 500 ml/kg.Transhepatic cholangiography and bile drainage in a patient with inspissated bile syndrome with an “atretic” type BSP clearance curve prior to operation resulted in restoration of biliary excretion and a marked and progressive improvement in all aspects of liver function.Quantitative analysis of BSP plasma clearance is a simple technique which may be of value in the differential diagnosis of biliary disorders, and as a means of evaluating the progression of hepatic disease and the success of surgical management of biliary atresia.
Free perforation of the small bowel in Crohn's disease
Authors: Abascal Javier , Diaz‐Rojas Fernando , Jorge José , Sanchez‐Vegazo Inmaculada , Escartin Pedro , Abreu Luis , Chantar César 
Published: May 2005

AbstractThree patients with an uncommon complication of Crohn's disease are presented. A free perforation of the diseased terminal ileum was found at laparotomy in all patients. Pneumoperitoneum was not seen on x‐ray. They all under‐went emergency surgery with a tentative diagnosis of acute appendicitis and/or generalized peritonitis. The surgical management is described.The literature was reviewed regarding free perforation of the small bowel in Crohn's disease. The clinical and radiological findings of this condition are described. Simple suture of the perforation should be avoided because of the high mortality (33%) and complications rates (44%) recorded in the literature with this surgical procedure. According to the limited world experience, resection of the diseased bowel is the treatment of choice in these patients.
The value of revisional surgery for the treatment of postoperative alkaline reflux gastritis
Authors: Lygidakis N. J. 
Published: May 2005

AbstractTwenty‐eight patients with postoperative alkaline reflux gastritis from a series of 2,437 operations carried out for gastroduodenal ulcer are presented. The incidence of this complication was significantly higher after Polya gastrectomy (2.1%). In all 28 cases, the diagnosis was endoscopically and histologically documented. Revisional surgery proved to be safe and efficacious. There were no deaths, no serious complications, and the results obtained proved to be impressive in both the short and long term. None of our patients required reoperation. The follow‐up was 100% and from 6 months to 10 years.
Motor and electrical activity of the gastroduodenal junction before and after submucosal pyloroplasty
Authors: Reiser S. B. , Holle G. E. 
Published: May 2005

AbstractIn 5 mongrel dogs, motor and electrical activity of the gastroduodenal wall was measured before and after submucosal pyloroplasty using 5 transducers and 5 bipolar serosal electrodes. The significant increase in the motility index (MI) by 105% (p<0.05), as well as the contractile activity by 231% (p<0.01), in the antrum preoperatively after feeding was not demonstrated postoperatively. In spite of this, gastric emptying was accelerated postoperatively by 15 minutes, to a total time of about 2 hours by radiological check with solid meal. Disturbances of motor and electrical patterns in the distal antrum and the duodenal cap that are seen after Finney and Heinike‐Mikulicz pyloroplasty were not observed in the present study in which submucosal pyloroplasty was performed. Since the submucosal pyloroplasty protects the hypomuscular zone of the gastroduodenal junction, the reflex inhibition of the duodenal cap during large antrat contractions is not disturbed postoperatively.
Follow‐up evaluation of thyroid function after thyroidectomy for thyrotoxicosis
Authors: Harada Tanekazu , Shimaoka Katsutaro , Arita Seizaburo , Nakanishi Yuri 
Published: May 2005

AbstractOne hundred fifty‐seven patients with hyperthyroidism treated by subtotal thyroidectomy 2–8 years previously were followed up with serum T3, T4, and TSH determinations. There was some difficulty in distinguishing the various groups of patients by thyroid function tests. However, it was determined that the percentages of patients with hyperthyroidism, euthyroidism, and hypothyroidism, based on T3 values, were 3.2%, 89.7%, and 7.1%, respectively, whereas 5.8%, 41.6%, and 53.1% were hyperthyroid, euthyroid, and hypothyroid by TSH criteria. Subclinical hypothyroidism, that is, increased TSH levels but normal T3 and T4 levels, accounted for the major discrepancy in these results. Subclinical hypothyroidism is more sensitive to disclosure by the TRH stimulation test. However, the incidence and severity of hypothyroidism after thyroidectomy are lower and milder than after131I treatment. The recurrence rate is less than that after the administration of antithyroid drugs, and postoperative complications are rare. Surgical treatment, therefore, plays an important role in the treatment of patients with hyperthyroidism. Those patients with sustained subclinical hypothyroidism after subtotal thyroidectomy should receive supplemental thyroid hormone.
Biological characteristics of adenomatous nodules, adenomas, and hyperfunctioning nodules as defined by adenylate cyclase activity and TSH receptors
Authors: Thomas C. G. , Combest W. , McQuade R. , Jordan H. , Reddick R. , Nayfeh S. N. 
Published: May 2005

AbstractThis study was designed to examine the functional characteristics of thyroid adenomas, adenomatous (colloid) nodules, hyperfunctioning nodules, and normal thyroid parenchyma with respect to the presence of TSH receptors, levels of adenylate cyclase, and the responsiveness of adenylate cyclase to specific stimuli, e.g., NaF (sodium fluoride), GTPγS [guanosine 5′‐0‐(3‐thiotriphosphatate)], PGE1, and TSH. Aliquots of specimens from patients undergoing thyroidectomy [11 normal thyroids, 7 adenomas, 8 adenomatous (colloid) nodules, 5 hyperfunctioning nodules] were immersed in liquid nitrogen and stored at 90°C. Studies were performed on partially purified plasma membranes. Receptor binding of125I‐TSH was quantitated and analyzed according to Scatchard. Adenylate cyclase activity was assayed in the same tissue fraction by conversion of (α‐32P) ATP to cAMP.High‐ and low‐affinity TSH receptors were present in adenomatous (colloid) nodules, hyperfunctioning nodules, and normal thyroid parenchyma. The thyroid adenomas had high‐affinity receptors in normal quantities; low‐affinity receptors were present at normal or decreased levels. The basal adenylate cyclase activity was slightly increased in thyroid adenomas. All groups had adenylate cyclase response to NaF with the thyroid adenomas being 60% more responsive than normal thyroid parenchyma (p <0.005). All tissues responded to PGE1, with normal thyroid parenchyma being twice as responsive as thyroid adenomas. The adenylate cyclase response of adenomatous (colloid) nodules and hyperfunctioning nodules was distinct from that of adenomas and comparable to that of normal thyroid parenchyma. The adenylate cyclase response to TSH was fourfold in thyroid adenomas and twofold in adenomatous (colloid) nodules compared to normal thyroid parenchyma.
Evaluation of various types of needle biopsies of the thyroid
Authors: Esselstyn Caldwell B. , Crile George 
Published: May 2005

AbstractThyroid needle biopsy has been used at the Cleveland Clinic since 1948 in more than 2,000 instances without serious complications. In the years 1979 and 1980, there were 481 needle biopsies performed, and the patients have been followed from 1 to 3 years. One hundred fourteen needle biopsies were with the 18‐gauge needle, 119 were with the fine needle, and 248 were Tru‐cut® biopsies. One hundred fourteen of the patients had 2 kinds of biopsies at the same time, usually Tru‐cut® and fine needle. The Trucut® needle biopsy gave the highest percentage of success in obtaining diagnostic material with only a 4% failure in the hands of the surgeon using it most often. Aspiration with an 18‐gauge needle and fixing the aspirate to form a cell block was found to be a safe and satisfactory way of obtaining material from cysts or nodules too small to be safely and easily sampled by a Tru‐cut® technique. The fine‐needle (ABC) biopsy is safe, simple, and economical and provides material sufficient to diagnose all types of thyroid cancer except the low‐grade follicular type. This limits to some extent the usefulness of the ABC biopsy. Even with Tru‐cut® core biopsies, it is often impossible to distinguish between cellular adenomas and low‐grade adenocarcinomas. Since approximately one‐third will prove to be malignant, surgery is adviced for these patients.The most significant accomplishment of the routine use of needle biopsy in the diagnosis of thyroid nodules has been the diagnosis of malignancy in more than 5% of the patients with nodules. This has permitted us to avoid surgery in 87% of all patients with thyroid nodules. As a result, in the time period reviewed, 21 of the 46 patients (47%) who had thyroid surgery had malignant tumors.
A prospective controlled study of fine‐needle aspiration and Tru‐cut® needle biopsy of dominant thyroid nodules
Authors: Boey John , Hsu C. , Collins Robert J. , Wong John 
Published: May 2005

AbstractIn order to evaluate the relative merits of fine‐needle aspiration (FNA) and Tru‐cut® needle biopsy (TNB), we conducted a prospective controlled trial in 384 patients who had dominant thyroid nodules. FNA had a slightly higher diagnostic yield and fewer complications than TNB. Definitive confirmation of the biopsy diagnoses was obtained in 41.1% of the patients. Both techniques achieved a very high degree of overall accuracy, and false‐positive errors among non‐follicular lesions occurred only in cases labeled as possibly malignant. However, neither method could reliably distinguish between a benign and malignant follicular neoplasm. Including follicular neoplasms as suspicious for malignancy, the individual sensitivity rates for cancer were 86.5% and 91.9% for FNA and TNB, respectively. The combined use of FNA and TNB, however, detected 97.3% of the 37 malignancies.Rather than demonstrating any overwhelming relative advantage, this study would support the use of both FNA and TNB to investigate dominant nodules. When combined with clinical information and imaging studies, needle biopsy can reduce the number of unnecessary operations without seriously compromising the removal of thyroid cancers.
Prognostic value of nuclear DNA content in papillary thyroid carcinoma
Authors: Cohn Kenneth , Bäckdahl Martin , Forsslund Gun , Auer Gert , Lundell Göran , Löwhagen Torsten , Tallroth Eva , Willems Jan ‐Silvester , Zetterberg Anders , Granberg Per ‐Ola 
Published: May 2005

AbstractThe prognostic value of nuclear DNA content in papillary thyroid carcinoma was studied retrospectively in 90 patients. Eighty survived for at least 10 years, and 10 died, of papillary thyroid carcinoma, between 6 months and 12 years after diagnosis. Clinical data as well as morphological tumor characteristics were examined. DNA measurements in morphologically identified single tumor cells were performed either on fine‐needle aspiration material or on histologic sections. The tumors of the survivors were composed of cells with a DNA content comparable to that of normal cells, whereas the tumors of the non‐survivors had significantly higher DNA values. The data suggest that DNA measurements in papillary thyroid carcinoma offer a valuable adjunct to standard clinical and microscopic analysis.
Measurement of nuclear DNA content in thyroid diagnosis
Authors: Bengtsson Allan , Malmaeus Jan , Grimelius Lars , Johansson Henry , Pontén Jan , Rastad Jonas , Åkerström Göran 
Published: May 2005

AbstractThe nuclear DNA content in thyroid cell imprints was determined in 94 patients with different thyroid diseases by single‐cell cytophotometry. Sixty‐three of the patients had benign thyroid lesions and 31 had different thyroid malignancies. The WHO tumor classification was used. The DNA values are presented in frequency histograms according to the ploidy and degree of proliferation. The histograms were classified into 6 groups: I, II, II +, III, IV, and IV +. The patients have been followed up for up to 6 years.With the exception of 1 case of thyrotoxicosis, the DNA values in benign thyroid lesions fell into group I–II or II +. Apart from 4 patients with small nodules of medullary carcinoma, the values in all patients with differentiated or anaplastic carcinomas were classified as group III, IV, or IV+.Determination of the DNA content may be a valuable adjunct in the differentiation between benign and malignant thyroid lesions. The presence of aneuploid cells seems to indicate a malignancy and in our material there was a clear difference in DNA content between follicular adenomas and follicular carcinomas.
Prevalence of C‐cell hyperplasia and medullary thyroid carcinoma in a consecutive series of pheochromocytoma patients
Authors: Jansson Svante , Hansson Göran , Salander Håkan , Stenström Gunnar , Tisell Lars ‐Erik 
Published: May 2005

AbstractDuring a 27‐year period (1956–1982), 64 patients were treated surgically for pheochromocytoma. There was no kinship among any of these subjects. The true prevalence of C‐cell disease of the thyroid in this series was searched for by performing serum calcitonin determinations after provocation with pentagastrin. Postoperative follow‐up of the pheochromocytoma disease was performed by blood pressure measurement and determination of urinary excretion of catecholamines and metabolites. Ten individuals (15.6%) were found to have C‐cell disease indicating that they had multiple endocrine neoplasia type II (MEN II) syndromes. Seven of these patients had been diagnosed before the time of follow‐up evaluation, 4 because of symptoms and 3 because of the screening procedure. At the systematic follow‐up, 3 “new” cases of C‐cell disease were diagnosed. As a result of the screening procedure, we found 4 “new” MEN II kindreds. After unilateral adrenalectomy, 7 of the 10 MEN II patients have been followed for more than 7.7 years without signs of recurrent adrenal disease.Our results suggest that the prevalence of MEN II syndromes among pheochromocytoma patients is higher than previously reported. Removal of only grossly evident pheochromocytomas and careful follow‐up is a good alternative to routine bilateral adrenalectomy in MEN II patients with pheochromocytoma.
Ultrasonic localization and cytologic identification of parathyroid tumors
Authors: Rastad Jonas , Johansson Henry , Lindgren Per G. , Ljunghall Sverker , Stenkvist Björn , Åkerström Göran 
Published: May 2005

AbstractUltrasonic examination of the parathyroid glands was performed in 55 consecutive patients with subsequent surgically verified hyperparathyroidism. Ultrasound located 26 of 37 parathyroid adenomas in the neck. Eleven of 48 hyperplastic glands in the neck were visualized by ultrasound in 16 patients with primary or uremic hyperplasia. A parathyroid adenoma was revealed in all 3 patients with hypercalcemic crisis and in all 5 patients with an adenoma and a previously unsuccessful exploration of the neck. Two of 3 glands were visualized by ultrasound prior to secondary explorations in 3 patients with primary hyperplasia associated with the multiple endocrine neoplasia syndrome type I. Undetected parathyroid glands were generally small and located in regions of the neck difficult to detect by ultrasound. It was often difficult to unequivocally establish that identified lesions represented a parathyroid gland. Nodules and cysts of the thyroid and lymph nodes were misinterpreted for parathyroid lesions. Ultrasonically guided fine‐needle biopsies were obtained from 8 parathyroid lesions, 7 thyroid tumors, and 2 lymph nodes. By cytologic examination these tissues could be discriminated after a differential staining of the aspirates.
Assessment of parathyroid graft function after autotransplantation of fresh and cryopreserved tissue
Authors: Rothmund Matthias , Wagner Peter K. 
Published: May 2005

AbstractExperience in autotransplantation of fresh and cryopreserved parathyroid tissue is reported. In 100 patients autografting of fresh tissue was combined with total parathyroidectomy (TPX + AT). Cryopreserved parathyroid glands were grafted after reoperation for primary (p) and secondary (s) hyperparathyroidism (HPT) in 4 patients (3p and 1s), and in 3 with TPX + AT for sHPT after the fresh tissue grafted during initial surgery failed to function.One to seven years after TPX + AT, nearly 90% of 65 patients presented with normal graft function, 7.7% were hypocalcemic, and 3% exhibited graft‐dependent hypercalcemia. In only 31% of all patients could a PTH‐gradient—grafted versus non‐grafted arm—be demonstrated. All 3 patients with pHPT who received cryopreserved autologous tissue showed normal function 6–34 months later. In 2 of 4 patients with sHPT the autografted cryopreserved tissue secretes enough PTH to maintain a normal calcium level. The results of autotransplantation of cryopreserved tissue do not depend on the length of cryopreservation but on accurate freezing and thawing technique.
Successful resection of intrathoracic metastases from two patients with parathyroid carcinoma
Authors: Dubost C. , Jehanno C. , Lavergne A. , Le Charpentier Y. 
Published: May 2005

AbstractPatients with functioning parathyroid carcinoma (PTC) may develop local or distant metastases many years after primary surgical resection. Such lesions are sometimes very difficult to localize, even with current investigative methods (including computed tomographic scanning, scintiscan, angiography, and selective venous catheterization with PTH radioimmunoassay). Unfortunately, radiation therapy, antineoplastic chemotherapy, and medical therapy aimed at reducing the hypercalcemia are generally unsuccessful. Surgical excision is, in fact, the only hope of controlling the disease, as illustrated by our 2 cases of successful resection of intrathoracic metastases. The first patient had a single intrapulmonary metastatic nodule 12 years after resection of a primary tumor. Two years after the thoracic operation, the serum calcium was normal. Following resection of a primary parathyroid carcinoma, the second patient had resection of a local recurrence (3 years later) and subsequently an intramediastinal metastasis (5 years later). He is hypocalcemic 1 year after the last surgery.
MEN I pancreas: A histological and immunohistochemical study
Authors: Thompson Norman W. , Lloyd Ricardo V. , Nishiyama Ronald H. , Vinik Aaron I. , Strodel William E. , Allo Maria D. , Eckhauser Frederic E. , Talpos Gary , Mervak Tim 
Published: May 2005

AbstractThe spectrum and extent of islet cell histopathological findings in patients with multiple endocrine neoplasia, type I (MEN I) syndrome has never been clearly defined. Although some patients have discreet tumors causing clinically evident syndromes, others may have no symptoms until metastatic islet cell carcinoma is apparent. Whether diffuse islet cell disease occurs in all patients with grossly apparent tumors is not known. This study is an attempt to define both the functional and anatomical extent of islet cell disease and its relationship with the clinical course of patients with MEN I syndrome.The resected specimens of pancreas from 14 patients with MEN I syndrome were evaluated for hyperplasia, nesidioblastosis, multiple tumors, and evidence of malignancy. In 12 cases, specimens consisted of distal pancreas and, in 2 cases, the entire pancreas was available. Multiple sections were taken from each specimen. Immunoperoxidase staining was done for gastrin, pancreatic polypeptide, glucagon, serotonin, VIP, somatostatin, and neuron‐specific enolase in sections of 24 tumors from 10 patients. Five of the 10 patients with Zollinger‐Ellison syndrome underwent total gastrectomy and 3 others underwent only pancreatic procedures to control their acid hypersecretion.The following is concluded. All MEN I patients with pancreatic neoplasms have diffuse islet cell involvement consisting of nesidioblastosis, micro‐ and macronodular hyperplasia. Some tumors produce multiple hormones and these patients are at risk to develop new tumors, but complete excision of grossly apparent tumors may result in long‐term control of the endocrinopathy present. This is particularly true for patients with insulinoma and hypoglycemia. Selected patients with gastrinoma may also be considered for excision of their islet cell tumor(s) without concomitant gastrectomy, especially if transhepatic venous sampling demonstrates a single site of excess gastrin production. However, if transhepatic venous sampling demonstrates diffuse sources of hypergastrinemia, a local pancreatic procedure will invariably be unsuccessful. Total pancreatectomy in MEN I patients with disease localized to the pancreas is the only curative surgical procedure but is rarely indicated.
Prevalence of diffuse pancreatic beta islet cell disease with hyperinsulinism: Problems in recognition and management
Authors: Harrison Timothy S. , Fajans Stefan S. , Floyd John C. , Thompson Norman W. , Rasbach Dennis A. , Santen Richard J. , Cohen Cynthia 
Published: May 2005

AbstractAmong 77 patients with endogenous hyperinsulinism seen in 2 medical centers, diffuse islet cell disease accounted for 17 (22%) patients. Since diffuse islet cell disease poses special problems in management, its prevalence is emphasized in this report.Among these patients with diffuse islet cell disease, there were 11 patients with adenomatosis, 4 with nesidioblastosis, and 2 with islet cell hyperplasia. Six of the 77 patients were found in multiple endocrine neoplasia, type I kindreds; diffuse islet cell disease was documented in 4 of these patients.We outline principles of management in patients with diffuse islet cell disease. Frozen section microscopy failed to identify nesidioblastosis or islet cell hyperplasia.