bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operative results in 143 patients with hepatocellular carcinoma
Authors: Segawa Tohru , Tsuchiya Ryoichi , Furui Junichiro , Izawa Kunihide , Tsunoda Tsukasa , Kanematsu Takashi 
Published: May 2005

AbstractA total of 143 patients who underwent hepatic resection for hepatocellular carcinoma in our department were reviewed. The review was conducted for two periods: 1970–1982 (early period) and 1983–1990 (late period), that is, the periods before and after introduction of the hepatic surgical technique involving the use of a microwave tissue coagulator and ultrasonic dissector. One patient underwent extended lobectomy, 12 lobectomy, 9 segmentectomy, and 26 partial hepatectomy during the early period. Two patients underwent extended lobectomy, 7 lobectomy, 9 segmentectomy, 36 subsegmentectomy, and 41 partial hepatectomy during the late period. Operative mortality and hospital mortality were 16.7% and 22.9% during the early period and 1.1% and 8.4% during the late period, respectively. The overall mortality rate was significantly lower during the late period than during the early period. Postoperative complications developed in 62.5% of the patients with hepatic resection during the early period and in 48.4% of the patients during the late period. The size of tumors during the early period was significantly greater than that during the late period. Intraoperative blood loss during the late period was significantly lower than that during the early period. The survival curve was better among patients who underwent hepatic resection during the late period than among those during the early period. The satisfactory results during the late period are due to the introduction of intraoperative ultrasonography, microwave tissue coagulation, and ultrasonic dissection for hepatic surgery.
Recent advances in medical imaging: Surgery planning and simulation
Authors: McEwan Christopher Neill , Fukuta Keizo 
Published: May 2005

AbstractThree‐dimensional display of medical image data has under gone rapid development since its introduction. This article explores the current state‐of‐the‐art of 3‐dimensional imaging applied to surgery planning and discusses the various image acquisition sources: computed tomography (CT), cine CT, magnetic resonance imaging, and ultrasound. Since increased physician involvement is the goal of the surgery planning software described, the future directions discussed emphasize the inclusion of “expert“ knowledge and ways to facilitate realistic interaction for surgery simulation.
Cephaloceles: Classification, pathology, and management
Authors: David David J. , Proudman Timothy W. 
Published: May 2005

AbstractA cephalocele is defined as a herniation of cranial contents through a defect in the skull. Cephaloceles are classified according to their contents and location. We have reviewed a total of 112 patients with cephaloceles, 51 of whom had sincipital meningoencephaloceles (fronto‐ethmoidal meningoencephaloceles). This group is distinctive in its demographic distribution, in the effect on growth of other facial structures, and in the combined craniofacial approach needed to treat them. This review is based on the sincipital encephaloceles with the other cephaloceles included for completeness. Despite many theories, the cause of congenital cephalocele is not known. Preoperative work‐up includes 3‐dimensional computed tomography scan of the facial skeleton, and surgical management is multidisciplinary in nature. The aim is to remove the lesion before the deformity has time to greatly distort facial growth, which appears to realign itself after surgery. The 50 patients who underwent surgery for fronto‐ethmoidal encephalocele all survived with minimal complications.
Early operation in craniofacial dysostosis
Authors: Mühlbauer Wolfgang , Anderl Hans , Heeckt Peter , Schmidt Andreas , Zenker Jörg , Höpner Frank , Schaarschmidt Bernd 
Published: May 2005

AbstractCraniofacial dysostosis is encountered in different congenital malformations such as Kleeblattschädel deformity, Crouzon's disease, and Apert's, Chotzen's, Pfeiffer's, and Carpenter's syndromes. Premature closure of cranial and facial sutures leads to characteristic disfigurement of the skull with orbital and maxillary hypoplasia. Operative treatment should be performed as early in life as possible to prevent further functional and esthetic deficiencies, and psychosocial problems. Correction is done by an intracranial approach with mobilization, remodeling, and advancement of the deformed skull. Thirty‐two children have been operated during the first year of life with a maximum follow‐up of 8 years. Most favorable results were obtained in 28 cases. The rate of complications were lower than in a series of children operated on later in life. We advocate that complex 1‐stage corrections of craniofacial syndromes may be safely carried out during infancy utilizing modern techniques, expert pediatric anesthesia, and postoperative intensive care.
Facial clefts
Authors: van der Meulen Jacques C. H. , Vaandrager J. Michiel 
Published: May 2005

AbstractFacial clefts, including those of the lip and palate, are extremely rare. Some arise at the junction of facial processes preventing fusion, others have their origin in or between ossification centers. Virtually all are associated with osseous deficiencies.This article reviews the pathogenesis and morphology of these clefts. The principles of skeletal and soft tissue reconstruction are discussed and the experience of the authors with various new techniques is reported.
Correction of orbital hypertelorism in Asian patients
Authors: Ohmori Kitaro 
Published: May 2005

AbstractIn this article, correction of orbital hypertelorism in Oriental patients is summarized. An orbital osteotomy is currently used to correct an abnormally wide interorbital distance. At present, associated deformities such as a short nose and a depression deformity in the temporal region following orbital osteotomy can be partially corrected. In Oriental patients, the Mongolian fold can be enhanced after correction of orbital hypertelorism. This fold can be easily corrected by epicantoplasty.
Hemifacial microsomia
Authors: Poole Michael D. 
Published: May 2005

AbstractHemifacial microsomia is variable with respect to the degree of the deformity it presents, thus, treatment varies. Mild degrees of the condition are usually treated adequately by waiting until adolescence, when definitive surgical correction of any skeletal or soft tissue asymmetry can be dealt with. Some mild and moderate cases may benefit from orthodontic functional appliance therapy during growth, but orthodontic opinion is divided on the value of such therapy. Children with severe forms of hemifacial microsomia are improved in appearance during their school years by early surgery performed in the preschool period. A number of surgical approaches have been used at this stage. The technique currently being used by the author involves composite transfer of vascularized soft tissue for contouring, together with a vascularized costochondral strut to lengthen the affected side of the mandible. Early results using this method are satisfactory, but further work is required to assess the advantages of this over other techniques.
Midface retrusion
Authors: Ortiz‐Monasterio Fernando , Musolas Alberto 
Published: May 2005

AbstractExperience with 162 patients for whom a midface advancement was performed over the last 10 years is reported. The series includes cases of primary maxillary hypoplasia, post‐cleft deformities, and major craniofacial anomalies. The indications and techniques applicable to each particular deformity are discussed and final results are analyzed. The overall facial esthetic concept is emphasized to ensure achievement of not only a good functional result, but also a pleasant appearance.
Craniofacial trauma
Authors: Merville L. C. , Diner P. A. , Blomgren I. 
Published: May 2005

AbstractThe treatment of combined major dislocations of the face and skull requires a craniofacial team consisting of a plastic maxillofacial surgeon, a neurosurgeon, an anesthesiologist, and radiologists. The best results can only be achieved at the primary intervention both from a functional and an esthetic standpoint. Careful preoperative clinical and radiologic examinations are mandatory to reach these high goals.In primary repair, the cranial approach aims at constructing “a monobloc bone flap“ to suture meningeal tears and to reinforce them with a pericranial graft, to close the cranial base completely using cancellous bone grafts, and to exclude the frontal sinuses. The facial skeleton is repaired by constructing a rigid external facial frame and thereafter progressing centrally finishing with the “internal“ orbitonasal dislocations. The reconstruction aims at a self‐stabilizing bone puzzle fixed with interosseous wires, making external fixation unnecessary. Secondary repair requires osteotomies at fracture sites to reposition malunited fractures and the use of autogenous bone grafts for stabilization.
Advances in craniofacial tumor surgery
Authors: Jackson Ian T. 
Published: May 2005

AbstractThe use of craniofacial surgical techniques has stimulated the development of new approaches to the excision of skull base tumors. Experience gained from operating on 200 skull base tumors (45 nonmalignant and 155 malignant) is presented. The cranial base area is subdivided into specific areas, and surgical approaches have been devised. In addition, the use of vascularized tissue such as the galea, temporalis fascia, temporalis muscle, or free vascularized tissue transfer has prevented the complication of infection so frequently seen as a cause for morbidity and mortality in the past.In this series, there were no major infections. The variety of pathology seen in this area is considerable. Therefore, in a series such as this operated on by a single surgeon, only trends can be observed. We suggest that with experience, surgery in this area is safe, and the long‐term survival of this mixture of tumors (primary, recurrent, carcinomas, and sarcomas) is between 40% and 50%, and, therefore, makes excisional procedures worthwhile.
The contribution of microsurgical reconstruction to craniofacial surgery
Authors: Jones Neil Ford 
Published: May 2005

AbstractCraniofacial surgery has revolutionized the surgical treatment of congenital anomalies affecting the facial and cranial skeleton. Similar techniques have since been used in the reconstruction of patients with extensive craniofacial injuries and following craniofacial resection of tumors involving the midface. The application of microsurgical free flaps to some of these craniofacial problems is another significant advance.Microsurgical transfer of deepithelialized skin flaps or omentum will allow the augmentation of soft tissue contour defects of the face in patients with hemifacial microsomia and Romberg's progressive facial hemiatrophy. Following craniofacial resection of extensive tumors of the midface, microsurgical free flaps and vascularized bone grafts will provide soft tissue coverage and, occasionally, both bone and soft tissue composite reconstruction of the resultant defect. Finally, intracranial infection, following Craniofacial Surgery and neurosurgical excision of tumors involving the skull base, may be effectively prevented by separation of the dura from the nasopharynx by microsurgical transfer of free muscle flaps and omentum.
Posttraumatic skeletal muscle proteolysis: The role of the hormonal environment
Authors: Bessey Palmer Q. , Jiang Zhu‐ming , Johnson Daniel J. , Smith Robert J. , Wilmore Douglas W. 
Published: May 2005

AbstractTo investigate the role of hormones as mediators of net skeletal muscle proteolysis following injury, healthy normal male volunteers received a continuous 76‐hour infusion of the 3 “stress“ hormones: hydrocortisone, glucagon, and epinephrine. As a control, each subject received a saline infusion during another 4‐day period. Ten paired studies were conducted. Diets were constant and matched on both occasions. Triple hormone infusion achieved hormone concentrations similar to those seen following mild‐moderate injury. After 72 hours of infusion, skeletal muscle intracellular glutamine concentrations were lower in the hormone studies than in the control group (N=4). Free amino acid concentrations in arterial whole blood and forearm amino acid efflux were little affected by hormonal infusion. Thus, alteration of the hormonal environment by the triple hormone infusion was not a sufficient stimulus to induce all of the changes in skeletal muscle proteolysis observed in critical illness. Since studies utilizing neurohormonal blockade have shown diminished net muscle proteolysis, the stress hormones appear to be necessary but not sufficient for the protein catabolic response to injury.
Modulation of inflammatory reactions by surgical trauma: Lack of relationship with corticosteroid secretion
Authors: Kinnaert Paul , Van Geertruyden Nancy , DePauw Luc , Van Gansbeke Bernard , Bournonville Bernadette , DeCoster‐Gervy Christine 
Published: May 2005

AbstractThe effect of surgery on inflammation was studied in male Wistar R/A rats using the carrageenin‐induced edema model. Swelling of the paw was measured in standardized arbitrary units 2, 4, and 6 hr after a subcutaneous injection of carrageenin iota in the subplantar region of the right hind limb. It was significantly depressed in rats submitted to laparotomy (5.0±0.4, 8.0±1.0, 13.7±1.9) when compared with controls simply anesthetized with ether (6.2±0.5, 15.5±1.2, 23.7±0.6) (p<0.001 at 4 and 6 hr). This inhibition lasted for at least 24 hr and was also observed after amputation, although in these experiments, the difference between operated animals and controls was not significant. Alterations of the inflammatory cellular infiltrate were studied using polyurethane sponges soaked with carrageenin lambda implanted subcutaneously in control animals and rats undergoing laparotomy or amputation. The total number of cells recovered from these sponges 5 hr after implantation was smaller in operated rats (2.9±0.4×106cells after laparotomy, 3.1±1.0 ×106cells after amputation) when compared with controls (11.1±1.9× 106cells and 10.3±1.3×106cells) (p<0.001 for laparotomy andp< 0.005 for amputation). The inhibitory effect of operative trauma was not abolished by bilateral adrenalectomy performed 12 days before laparotomy. In rats, surgical trauma induces a depression of remote inflammatory reactions. This phenomenon is not related to increased corticosterone levels.
Prognosis of patients over 75 years of age with a ruptured abdominal aortic aneurysm
Authors: Salo Jarmo A. , Perhoniemi Vesa J. , Lepäntalo Mauri J. A. , Mattila Petri S. 
Published: May 2005

AbstractForty‐seven patients (34 males and 13 females) over 75 years of age (mean: 79.7±3.8 SD) suffering from a ruptured abdominal aortic aneurysm were operated on between 1977 and 1986. In 16 patients (34%), the aneurysm had been diagnosed previously. Seventeen patients (36%) had a delay of 6 hours or more in the beginning of the treatment and 26 (55%) were in shock preoperatively. The mean diameter of the aneurysms was 8.9±2.6 cm (SD) and the mean operative bleeding was 8.5±7.8 (SD) liters. The mean operating time was 220±96 (SD) minutes. The 1‐month mortality was 60% (28 patients) and 63% (12 patients) of survivors had postoperative complications, mostly pneumonia. The 5‐year survival rate was 26%. In the analysis of risk factors associated with death, preoperative shock, old age, and a previously diagnosed but untreated abdominal aortic aneurysm were associated with a significantly worse prognosis.
Pancreas and islet transplantation
Authors: Sutherland David E. R. , Matas Arthur J. , Najarian John S. 
Published: May 2005

AbstractConsiderable evidence supports the hypothesis that the microangiopathic lesions of diabetes are secondary to disordered metabolism. This hypothesis underlies the rationale for whole pancreas and islet transplantation. Whole pancreas transplantation has had limited clinical success—only 1 of 47 recipients reported to the ACS/NIH Transplant Registry is currently alive. Major problems have been allograft rejection and complications related to either the exocrine pancreas or concomitant transplantation of the duodenum. Experimental approaches to whole pancreas transplantation include use of duct‐ligated organs or extraperitoneal transplantation of segmental grafts, with exocrine duct drainage established to either host ureter or a retroperitoneal Roux‐en‐y loop of bowel. The difficulties with whole pancreas transplantation have stimulated the development of techniques allowing transplantation of islet tissue as a free graft. Transplantation of purified adult islets, of dispersed neonatal pancreas, or of adult pancreatic fragments with exocrine enzymes inactivated can effectively ameliorate experimental diabetes when transplanted to either the intraperitoneal or portal vein sites. In dogs, adult pancreatic fragments containing both islet and exocrine tissue components can effectively ameliorate diabetes when transplanted to the spleen. The first clinical trials of islet transplantation used only small quantities of purified islets. Although insulin requirements of some recipients were reduced, a completely successful islet transplantation in humans has not been accomplished. Procurement of a sufficient quantity of islet tissue and prevention of allograft rejection are major problems, but solutions appear to be forthcoming from the laboratory. The ability of both whole pancreas and islet transplantation to prevent the development or halt the progression of secondary lesions in experimental diabetes provides an impetus to pursue such an approach in humans.
Comparison of postoperative complications following radical and modified radical mastectomy
Authors: Feigenberg Zvi , Zer Michael , Dintsman Moshe 
Published: May 2005

AbstractA retrospective study was carried out by reviewing the files of 100 patients who had undergone radical mastectomy and 100 patients who had undergone modified radical mastectomy from 1966 to 1975 for the purpose of comparing early and late complications. In each group, 80 patients were involved in long‐term follow‐up. Immediate postoperative complications—notably seromas, wound infection, and flap necrosis—were found to be considerably fewer following modified radical mastectomy. There was also a significantly lower incidence of late complications, such as limb edema and recurrent infection, after modified radical mastectomy. Since the cure rates achieved by the two radical mastectomy procedures appear to be similar, it is concluded that modified radical mastectomy is the procedure of choice in stages I and II cancer of the breast.
The effect of selective proximal vagotomy with and without pyloroplasty on serum gastrin levels and acid secretion after feeding and sham feeding in dogs
Authors: Bauer H. , Holle F. , Okukubo F. , Andersson S. , Arnold R. , Creutzfeldt W. 
Published: May 2005

AbstractIn a first operative stage, 4 dogs were prepared with Heidenhain pouches (HP) and 3 with Pavlov pouches (PP), 2 of the latter with an additional esophageal cannula. In a second stage all dogs had a selective proximal vagotomy (SPV), and in a third stage a submucosal pyloroplasty (P). Sham feeding experiments were carried out on the 2 dogs with PP and an esophageal fistula before and after SPV. Feeding tests were performed in all animals after the three operative procedures. Gastrin release after sham feeding increased significantly after SPV, whereas PP acid secretion was abolished. Gastrin release after feeding increased significantly after SPV in both HP and PP dogs. Acid secretion from HP was correlated with the changes in postprandial serum gastrin levels. PP acid secretion was diminished after SPV, in spite of the elevated gastrin levels. Subsequent pyloroplasty induced a significant decrease in the postprandial gastrin levels in both HP and PP dogs. However, acid secretion decreased significantly only in HP dogs.
Ureterocystostomy in renal transplantation: Comparison of endo‐ and extravesical anastomoses
Authors: Hooghe L. , Kinnaert P. , Schulman C. C. , Toussaint C. , Van Geertruyden J. , Vereerstraeten P. 
Published: May 2005

AbstractAmong 241 renal transplants with implantation of the ureter into the urinary bladder, the endovesical technique of Politano and Leadbetter (PL) was used in 108 cases and the extravesical technique of Grégoir and Lieh (GrL) was used in 133. Urinary fistulas occurred in 10 patients (9.3%) with the PL technique and in only 1 patient (0.8%) with the GrL technique. The difference was highly significant (p<0.01). Stenosis of the ureter developed in 3 patients (2.8%) following the PL technique and in 9 patients (6.8%) after the GrL technique, an insignificant difference (p>0.10). None of the complications resulted in death or failure of transplantation. It is concluded that the extravesical technique of Grégoir and Lich is the best method of avoiding urinary leakage, which is the most dangerous urologic complication of kidney transplantation.
A 44‐year experience with tuberculous enterocolitis
Authors: Homan William P. , Grafe William R. , Dineen Peter 
Published: May 2005

AbstractThirty‐one eases of intestinal tuberculosis, diagnosed from 1932 through 1975 at The New York Hospital‐Cornell Medical Center, were reviewed with particular reference to the impact of antituberculous chemotherapy on the outcome of the disease and to the role of surgery in diagnosis and treatment. The chest X‐ray was 90% effective in demonstrating evidence of tuberculosis in this series. However, since even on gross examination differentiation of intestinal tuberculosis from Crohn's disease or neoplasia may be impossible, surgical exploration is indicated when diagnosis is in doubt and biopsy and culture of intra‐abdominal tissue should be performed for diagnostic purposes. The importance of instituting immediate therapy is emphasized by a 67% mortality rate in the prestreptomycin era and a 21% mortality rate in patients receiving appropriate drug therapy. Because of the success of chemotherapy, intestinal resection is seldom indicated, except in those cases in which scarring and stricture formation demand surgical relief of intestinal obstruction, or in which the complications of fistula, hemorrhage, or perforation may occur.
Experience with the use of propranolol in the surgical management of thyrotoxicosis
Authors: Starling James R. , Thomas Colin G. 
Published: May 2005

AbstractA review of the preoperative preparation of 47 patients undergoing subtotal thyroidectomy for thyrotoxicosis was carried out to evaluate the role of propranolol hydrochloride. Based on the premise that subtotal thyroidectomy is performed at least risk in the patient who is euthyroid, propranolol has its primary role as an adjunct to preparation with thioamide drugs. The most common indications for its use are inadequate control with thioamides and drug toxicity. Less frequent indications are its use in pregnant patients and patients who cannot be relied on to comply with a medical regimen outside the hospital environment. Patients can safely be treated preoperatively in the hospital in a reasonable period of time. When propranolol is used without thioamide drugs, the addition of Lugol's solution is of value in control of the thyrotoxicosis.