bluuebunny/crossref_metadata_2025_split huggingface dataset:
Limited Tumor Involvement Found at Multiple Endocrine Neoplasia Type I Pancreatic Exploration: Can It Be Predicted by Preoperative Tumor Localization?
Authors: Skogseid Britt , Öberg Kjell , Åkerström Göran , Eriksson Barbro , Westlin Jan‐Erik , Janson Eva Tiensuu , Eklöf Hampus , Elvin Anders , Juhlin Claes , Rastad Jonas 
Published: August 2002

AbstractRadiologically demonstrable pancreatic endocrine tumors are a frequent requirement for exploration in patients with multiple endocrine neoplasia type I (MEN‐I). Such delayed intervention is accompanied by a 30% to 50% incidence of pancreatic endocrine metastases. This study explores biochemical tumor markers and operative findings in relation to preoperative pancreatic radiology in 25 MEN‐I patients. They underwent pancreatic surgery with (n= 19) or without (n= 6) radiologic signs of primary tumor and absence of metastases upon conventional examination, including OctreoScan testing (n= 10). Biochemical diagnosis required an increasing elevation of at least two independent pancreatic tumor markers. Tumor diameters averaged 1.1 cm (0–5 cm) and 0.9 cm (0.2–1.5 cm) in the patients with and without positive preoperative radiology, respectively. These investigations never displayed more than one of the consistently multiple tumors, and the results were falsely positive in 26%. Preoperatively unidentified regional or hepatic metastases were found at surgical exploration in 26% of patients with radiologic localization and in none of the others. Limited pancreatic tumor involvement necessitated intraoperative absence of metastases and pancreatic lesions ≤ 1 cm in diameter on palpation, intraoperative ultrasonography, and microscopy. It occurred in 37% and 50% of the patients with and without radiologic tumor localization, respectively. The number of positive tumor markers was similar for patients with limited and major disease (2.3 vs. 2.7), whereas four or more such markers were found in all those with malignancies. The mean marker level was higher in patients with radiologically demonstrable tumors and lower in those with limited disease, but with a substantial overlap. OctreoScan testing was negative in all cases with limited disease and was the single most sensitive method (75%) in the others. Limited pancreatic disease could not be identified preoperatively, and the present means of biochemical pancreatic tumor identification invariably involved the presence of at least one lesion ≥ 7 mm in diameter. Conventional pancreatic imaging is insensitive and nonspecific for recognizing even substantial pancreatic tumors associated with MEN‐I.
Double Parathyroid Adenoma, a Clinically Nondistinct Entity of Primary Hyperparathyroidism
Authors: Szabo Eva , Lundgren Ewa , Juhlin Claes , Ljunghall Sverker , Åkerström Göran , Rastad Jonas 
Published: August 2002

AbstractDouble parathyroid adenoma (DA) has been suggested to be a clinically distinct entity of primary hyperparathyroidism (HPT). Altogether 659 patients with sporadic primary HPT were analyzed retrospectively by evaluating consecutive primary operations for more than three decades. Patients with postoperatively persistent HPT and those with incomplete medical, operative, or histologic records were disregarded. The mean age (± SD) at surgery was 60.9 ± 12.7 years; 78% of the patients were female; and the duration of postoperative follow‐up averaged 7.8 ± 7.2 years. DA, defined as two enlarged parathyroid glands, was found in 77 patients (12%). Enlargement of a single gland (SA) or three or more glands (MA) occurred in 80% and 8%, respectively. DAs were bilateral in 72% of patients, and the weight of the two glands differed by 317 ± 407 mg. The three histologic subgroups of patients exhibited no significant discrepancy with respect to age, classic symptoms of HPT, proportion of overtly asymptomatic individuals, or parathyroid tissue weight. A lower female predominance and extent of hypercalcemia and higher preoperative serum creatinine level occurred with DA and MA compared to SA. SA and DA differed from MA with respect to variably strong trends to lower postoperative incidences of recurrent HPT and hypoparathyroidism. DA seems to comprise an underrated histologic cause of HPT, which is eligible for a conservative operative approach. Clinical characteristics consistent with a distinct entity of sporadic primary HPT were not seen.
Late Results of Heterotopic Autotransplantation of Splenic Tissue into the Greater Omentum
Authors: Weber Thomas , Hanisch Ernst , Baum Richard Paul , Seufert Rainer Maria 
Published: August 2002

AbstractThere is still controversy about the beneficial effects of splenic autotransplantation. As a result, replantation of the spleen has almost been abandoned for surgical treatment of splenic injuries. To learn more about the long‐term effects we have analyzed eight patients 9.2 ± 1.2 years after autotransplantation of the spleen into the greater omentum. Splenic replants could be detected by scintigraphy in seven patients (87.5%). Splenic size, measured by single‐photon emission computed tomography, varied between 19.344 and 471.705 units of volume (UoV). Two patients with the smallest replants had pathologic changes of leukocytes and lymphocyte subsets in 12 of 16 measurements (75%). These changes closely resembled a spleenless state and were similar to those in the patient with no detectable splenic autograft. In contrast, five patients with large splenic replants (49.192–471.705 UoV) revealed pathologic findings in only 2 of 40 measurements (5%). Based on an extensive review of the literature and our own results, it can be concluded that splenic autotransplantation into the greater omentum is superior to splenectomy but undoubtedly less effective than in situ preservation of the spleen. Therefore splenic replantation should still be considered, particularly in pediatric surgery, when in situ preservation of the spleen is not possible by other techniques.
Choledocholithiasis: Percutaneous Treatment
Authors: Navarrete Claudio G. , Castillo Cecilia T. , Castillo Pedro Y. 
Published: August 2002

AbstractThe percutaneous approach to retained biliary duct stones is most reasonable in the presence of a T‐tube because of the low morbidity and mortality as well as its low cost. We report our experience with 353 patients, emphasizing the technique and the solutions to some frequent problems.
Influence of Bile Duct Stones on Patient Features and Effect of Endoscopic Sphincterotomy on Early Outcome of Edematous Gallstone Pancreatitis
Authors: Hammarström Lars‐Erik , Andersson Roland , Stridbeck Hans , Ihse Ingemar 
Published: August 2002

AbstractThe objective of this study was to study the influence on patients’ features and the effect on early outcome of the presence of bile duct stones and endoscopic sphincterotomy (EST), respectively, in the presence of edematous gallstone pancreatitis
(GSP). It was a retrospective review of a patient series from 1981 through 1992 at a university teaching hospital. Altogether 96 patients aged 42 to 93 years (median 74 years) with edematous GSP were investigated by endoscopic retrograde cholangiography (ERC) in our department, 75 of whom underwent ERC at first admission. A total of 49 patients (group 1) had common bile duct (CBD) stones, and in 47 (group
2) no CBD stones were found. All patients in group 1 and 15 in group 2 underwent EST; 57 of the 75 patients had EST at first admission. The main outcome measures were pancreas‐related complications and the length of the hospital stay. The early major complication and stone clearance rates of the EST procedure were 3.2% and 96%, respectively. Duration of symptoms prior to ERC was similar in groups 1 and 2 (median
5 and 8 days, respectively). Serum amylase activity was higher in group
2 patients than in group 1 patients [21–258 (median 75) μkat/L vs.
10–328 (median 48) μkat/L (p= 0.01)], but the length of hospital stay was similar: [4–39 (median 11) days vs. 4–19
(median 9) days (p= 0.05)]. Cholangitis at acute admission was more common in group 1 than in group 2 patients (31% vs.
7%; p= 0.02), whereas a history of pancreatitis was noted more often in group 2 patients (49% vs. 8%; p< 0.001). ERC was done 1 to 18 days (median 2 days) and 1–16 days
(median 5 days) (p= 0.02) after admission in groups 1 and 2 respectively, because of the more frequent cholangitis symptoms in group 1. It was concluded that the history and features at admission differed between patients with and without CBD stones at ERC done during an attack of GSP. Early EST had no influence on outcome or hospitalization. This study does not support routine EST in conjunction with mild GSP.RID="" ID="" <E5>Correspondence to:</E5> L.‐E. Hammarstr&ouml;m, M.D., Ph.D., Department of Surgery, M&auml;larsjukhuset, S‐631 88 Eskilstuna, Sweden
Recombinant Human Erythropoietin and Hemoglobin Concentration at Operation and during the Postoperative Period: Reduced Need for Blood Transfusions in Patients Undergoing Colorectal Surgery—Prospective Double‐blind Placebo‐controlled Study
Authors: Qvist Niels , Boesby Steen , Wolff Birgit , Hansen Carsten P. 
Published: August 2002

AbstractIn a double‐blind placebo‐controlled study we investigated the effect of recombinant human erythropoietin (r‐HuEPO), on the perioperative hemoglobin concentration and the use of blood transfusions in patients undergoing elective colorectal surgery with a preoperative hemoglobin level ≤8.5 mmol/L. Altogether 100 were included, and 81 patients could be evaluated. A total of 38 patients received r‐HuEPO in a dose of 300 IU/kg body weight on day 4 before surgery and 150 IU/kg daily for the following 7 days; 43 patients received placebo. In addition, all patients received daily doses of 200 mg iron orally for 4 days before surgery. There were no differences between the two groups with regard to sex, height, weight, serum electrolytes, and liver function tests at study entry. The preentry hemoglobin concentration was similar in the two groups, with a median value of 7.9 (range 5.3–8.5) mmol/L in the erythropoietin group and 7.6 (5.1–8.5) mmol/L in the placebo group. On the day of surgery the median hemoglobin concentration was 7.8
(5.3–9.2) mmol/L in the erythropoietin group and 7.2 (4.6–8.5) mmol/L in the placebo group (p < 0.05). On postoperative days 3 and 7 the values were 7.2 (5.3–8.2) and 7.5 (5.4–9.4) mmol/L, respectively, in the erythropoietin group compared to 6.7 (5.2–7.8)
and 6.9 (5.1–8.6) mmol/L in the placebo group (p <
0.01). At discharge the hemoglobin concentration was 7.8 (5.9–8.8)
mmol/L in the erythropoietin group and 7.2 (5.4–8.6) mmol/L in the placebo group (p < 0.002). The blood loss during operation was similar in the two groups. In the erythropoietin group the median value was 280 ml (range 25–2000 ml), with the lower and upper quartiles 150 and 500 ml, respectively. In the placebo group the blood loss was median 300 ml (range 50–1800 ml), with the lower and upper quartiles 200 and 750 ml, respectively. The number of blood transfusions given was significantly lower in the erythropoietin group, with a mean of 0.3 (range 0–6) units compared to 1.6 (0–9) units in the control group (p < 0.05). In conclusion, the hemoglobin concentration at the time of surgery and during the week following surgery was significantly higher in the group of patients receiving r‐HuEPO perioperatively compared to the placebo group together with a significant lower use of blood transfusions in the r‐HuEPO group. However, the clinical implications of these findings has yet to be proven.RID="" ID="" <E5>Correspondence to:</E5> N. Qvist, M.D., D.Sci.
Informed Consent in Surgical Trials
Authors: Etchells Edward 
Published: August 2002

Abstract.All participants must provide a valid consent to surgical clinical trials. A valid consent requires patient capacity, adequate disclosure of information, and voluntariness. Capacity is the ability to understand information relevant to making a decision and to appreciate the reasonably foreseeable consequences of a decision or lack of decision. To protect vulnerable persons, an incapable person should not be enrolled in most clinical trials. The only exception is if the study can only be conducted on incapable persons. If the willing research participant is incapable, consent must be obtained from others through a process called substitute (or proxy) consent. Disclosure refers to the provision of relevant information to the patient and its comprehension by the patient. Most surgical trials carry more than minimal risks, so the requirement for careful disclosure of these risks to potential participants is generally stringent. Voluntariness refers to the freedom of a person to make a treatment decision. In specific circumstances related to emergency research, the requirement for consent may be waived. Waiver can be justified only if the delay required to obtain consent would prevent the research from occurring and only after prior consultation with from the “community” of potential research participants.
I. Short Story of Theodor Kocher's Life and Relationship to the International Society of Surgery
Authors: Liebermann‐Meffert Dorothea 
Published: August 2002

AbstractWith the aim of promoting progress in surgery through the friendly exchange of views and experience, the International Society of Surgery was founded in Brussels in 1902, thereby helping to overcome the narrow boundaries of that time's nationalism. At its first congress, the International Society of Surgery (ISS), otherwise known by its French name, Société Internationale de Chirurgie (SIC), already numbered 638 members, among them the most important surgeons from all over the world. Theodor Kocher (1841–1917) was the president of the first congress, held in Brussels in 1905, and was also responsible for the choice of topics. His presidential address clearly reflected the high aims the Society set for itself. Kocher's personal and professional authority, his surgical skill, which he liked so much to communicate to his colleagues, and his international thinking shaped the young Society. He remained on the international committee of the ISS until his death. Renowned surgeons from all over the globe traveled to Bern to see Kocher at work, among whom were many distinguished leaders of U.S. surgery. Thus Kocher's contribution had a great impact on the developing surgery, in particular in the United States. A short curriculum outlines the personality of this outstanding surgeon.
Lidocaine‐metabolizing Activity after Warm Ischemia and Reperfusion of the Rat Liver In Vivo
Authors: Izuishi Kunihiko , Wakabayashi Hisao , Maeba Takashi , Ryu Munemasa , Maeta Hajime 
Published: August 2002

AbstractThe effect of warm ischemia on lidocaine‐metabolizing activity was examined in vivo. Total liver ischemia was produced for 1 hr in Sprague‐Dawley rats by clamping the portal vein and hepatic artery at the hilum. Livers were then reperfused, and liver microsomes were prepared before and 0, 2, 6, and 24 hr, and 3, 6, and 10 days after reperfusion. Microsomal lidocaine‐metabolizing activity and cytochrome P‐450 content were examined. Lidocaine N‐deethylase activity was decreased from 2.25 ± 0.33 to 0.97 ± 0.21 nmol/mg protein/min (mean ± SD) 24 hr after reperfusion. This inhibition was prolonged, and activity gradually recovered after 10 days. The cytochrome P‐450 content showed the same tendency. On the other hand, serum levels of alanine aminotransferase increased significantly 2 hr after reperfusion and returned to control levels 3 days after reperfusion. Liver blood flow recovered rapidly after unclamping and reached baseline levels within 6 hr. Our results suggest that after warm ischemia, prolonged hepatic dysfunction in drug metabolism, which cannot be detected by evaluating serum enzymes or liver blood flow, exists at the microsomal level.
Pathologic Evaluation of Surgical Margins and Local Recurrences after Breast‐conserving Surgery without Irradiation
Authors: Kato Takao , Kimura Tsunehito , Ishii Nobue , Fujii Akiho , Yamamoto Kazuko , Kameoka Shingo , Nishikawa Toshio , Kasajima Takeshi 
Published: August 2002

AbstractThis study was undertaken to evaluate the status of margins of the excised breast tissue using our own method. We also determined the indications for breast‐conserving surgery without irradiation by examining the characteristics of patients with local recurrence and comparing relapse‐free survival (RFS) and overall survival (OS) of patients who underwent wide excision without irradiation with those of 267 patients who underwent total mastectomy. Eighty‐two patients with a 3 cm diameter or less invasive carcinoma were treated with wide excision and axillary dissection between 1987 and 1996. Patients who histologically had four or more axillary lymph node metastases, positive pathologic margins, or a high degree of in situ ductal carcinoma around the main tumor in consecutive step‐sections were excluded from this study. During a median follow‐up of 6 years (range 2–11 years), six patients (7.3%) had local recurrence and five (6.0%) had regional or distant recurrences as their site of first failure. At 11 years the life‐table values for RFS and OS for the wide excision‐treated group were 84.7% and 92.1%, respectively, compared with 85.0% and 90.0%, respectively, for patients treated by total mastectomy. RFS and OS were similar in the two treatment groups. Results in the present study indicate that if the patients treated by breast‐conserving surgery are carefully selected and there are no foci in the pathologic margins, there is a low degree of in situ ductal carcinoma around the tumor, and no multicentricity, it might be unnecessary to administer radiation therapy.
Musculature of the Alimentary Tract
Authors: Skandalakis John E. 
Published: August 2002

Abstract.Leiomyomas and leiomyosarcomas are derived from smooth muscle tissues. Smooth muscle cells also surround the blood vessels that supply the alimentary tract. These cells have at times been said to contribute to the formation of smooth muscle tumors in the alimentary canal. With such an abundance of smooth muscle, there is little reason at present to implicate the smooth muscle elements of blood vessel walls.
Effect of Laparoscopic Cholecystectomy on Platelet Aggregation
Authors: Yol Serdar , Kartal Adil , Çalişkan Ümran , Tavli Şakir , Şahin Mustafa , Bozer Mikdat 
Published: August 2002

Abstract.The purpose of this study was to investigate the effect of laparoscopic cholecystectomy on platelet function. We operated on 40 women with symptomatic gallbladder stone, 20 of whom (study group) underwent laparoscopic cholecystectomy and 20 of whom (control group) open cholecystectomy. Patients with a history of bleeding, abnormal platelet count, or systemic disorders and those who were on salicylates, heparin, or oral anticoagulants were excluded. Blood parameters were checked at the beginning and the end of the operation, including platelet aggregation using adenosine 5′‐diphosphate (ADP), collagen, and ristocetin in a whole‐blood aggregometer. Platelet aggregation was evaluated by percent aggregation. Platelet aggregation due to collagen and ristocetin increased significantly at the end of the operation in the study group (p < 0.001). Aggregation due to ADP did not differ significantly from the start to the end of the operation. Control group results did not show any differences. Although the clinical findings of aggregated platelet are not frequently observed in practice, we suggest that laparoscopy increases platelet aggregation.
Estimation of the probability of insect pest introduction through imported commodities
Authors: Yamamura K. , Katsumata H. 
Published: August 2002

AbstractA quantitative risk assessment is needed for each quarantine pest insect to ensure quarantine security without sacrificing the transparency of international trade. The probability of introduction, which is defined as the probability that one or more reproductive individuals of a pest insect species pass the port, is one of the basic components determining the risk of pest invasion. The probability depends on two biological characteristics of pests: mode of reproduction and spatial distribution of insects per host plant. In this article, the probability of introduction was calculated for each of the following four categories: (1) bisexual, gregarious pests; (2) bisexual, solitary pests; (3) parthenogenetic, gregarious pests; and (4) parthenogenetic, solitary pests. Then, equations were derived to predict the effects of two prevention practices conducted before export: disinfestation treatment and the subsequent export sampling inspection of consignments. These equations also enable estimation of the probability of introduction under natural mortality, which thus can be used in place of the criterion of Maximum Pest Limit (MPL). The method was applied to the Mexican fruit fly Anastrepha ludens (Loew), as an example. The contour graph of the probability of introduction indicated the optimal combination of the intensity of two prevention practices that ensures a given security level. Existence of an antagonistic interaction was also indicated between the disinfestation treatment and the subsequent sampling inspection.
T‐Plate Fixation of Distal Radial Closing Wedge Osteotomies for Treatment of Angular Limb Deformities in 18 Dogs
Authors: Balfour Raviv J. , Boudrieau Randy J. , Gores Barbara R. 
Published: August 2002

Objective— To describe the surgical technique and clinical results of treatment for forelimb angular limb deformities, secondary to premature distal radial or ulnar physeal closure, by using T‐plate fixation of a distal radial closing wedge osteotomy in 18 dogs.Study Design— Retrospective clinical study.Sample Population— 18 client‐owned dogs.Methods— The medical records of 18 dogs that underwent a distal radial closing wedge osteotomy with T‐plate fixation for correction of a forelimb angular limb deformity were reviewed. Small pins (Kirschner wires) were used to obtain the appropriate alignment of the antebrachiocarpal and elbow joints and proper limb orientation. In‐hospital follow‐up evaluation was obtained at the time fracture healing was observed radiographically. Further long‐term follow‐up was obtained by owner interview.Results— Osteotomy sites were radiographically healed within 4 to 12 weeks (mean, 8 weeks) after surgery in the 14 dogs that returned for in‐hospital follow‐up. Limb function was graded as good or excellent in all dogs. Long‐term follow‐up by owner interview rated limb function and cosmetic appearance as good to excellent in all dogs. Plate removal was necessary in one dog 7 months after surgery because of osteopenia in the radius.Conclusion— This surgical technique was considered successful in the treatment of angular limb deformities in all dogs. A good to excellent prognosis is to be expected with this technique, with minimal complications.Clinical Relevance— The use of a T‐plate for the correction of angular limb deformities has not been previously described in the literature. This technique permits accurate correction of the angular limb deformity and minimizes postoperative complications.