bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional and Morphometric Study of Cryopreserved Human Parathyroid Tissue Transplanted into Nude Mice
Authors: Tanaka Yuji , Funahashi Hiroomi , Imai Tsuneo , Wada Masaki , Tominaga Yoshihiro , Mishra Saroj K. , Takagi Hiroshi 
Published: August 2002

AbstractAs part of an ongoing study of the characteristics of transplanted fresh normal and pathologic parathyroid tissues, we transplanted cryopreserved human parathyroid tissue into nude mice. Hyperplastic glands cryopreserved for various lengths of time (<2 weeks and >1 year) were transplanted into the gluteus muscle of nude mice. Specimens grafted were of two sizes: 10 mg and 30 mg. Serum human parathyroid hormone (hPTH) concentration was estimated by a double‐antibody immunoradiometric assay prior to transplantation and 2, 4, and 8 weeks after transplantation. A low‐calcium diet was given to some mice to evaluate any effects on the grafts of low serum concentrations of calcium. All mice were killed 4 hours after injection of bromodeoxyuridine (Brd U) for assessment of the cell proliferation in grafted parathyroid tissue. Although hPTH secretion of cryopreserved tissue was only half that of fresh tissue, the cryopreserved tissue released hPTH, as did fresh tissue. hPTH secretion was accelerated by stimulation of a low‐calcium diet, and PTH secretion was positively correlated with the volume of transplanted tissue. The number of Brd U‐immunoreactive cells was correlated with the serum concentration of hPTH (r= 0.95), which indicates that cell proliferation is closely related to PTH secretion under the condition of successful transplantation. The experimental transplantation of cryopreserved tissue into nude mice, coupled with a concise immunohistochemical study of the grafts conducted prior to their transplantation into humans, can contribute to the evaluation of PTH secretion and cell proliferation.
Pheochromocytomas: Tendency to Degenerate and Cause Paroxysmal Hypertension
Authors: Ito Yukio , Obara Takao , Yamashita Tomoyuki , Kanbe Masako , Iihara Masatoshi 
Published: August 2002

AbstractEighty‐four patients with pheochromocytoma underwent surgery during the 13‐year period from 1981 to 1994. These patients were divided into three groups according to the degree of parenchymal degeneration, which was estimated by preoperative dynamic computed tomography (CT) scans and resected specimens: solid group, cystic group, and highly cystic group. The relation between the degree of parenchymal degeneration and the clinical variety, size of the tumor, predominant plasma catecholamine, and type of blood pressure disturbance was analyzed. There were 39 cases of solid pheochromocytoma, 37 cases of cystic tumor, and 8 cases of highly cystic pheochromocytoma. The maximal mean diameters for each group were as follows: 5.1 ± 2.3, 6.8 ± 3.0, and 7.9 ± 3.2 cm, respectively. Of the tumors < 3 cm in diameter, 84% were solid; when the tumors were ≥ 6 cm in diameter, approximately 50% were cystic and 20% highly cystic. Of the adrenal pheochromocytomas, 60% were degenerated; 79% of the extraadrenal tumors were solid. Of the epinephrine‐secreting tumors, 70% were degenerated, and 55% of the norepinephrine‐secreting tumors were solid. The clinical pattern of hypertension was related to the degree of degeneration: In the paroxysmal hypertension group 87% of the tumors were degenerated, and in the sustained hypertension group 69% were solid. We therefore believe that parenchymal degeneration of pheochromocytoma is highly correlated with the tumor diameter, location of the tumor, secreted catecholamine, and clinical pattern of hypertension.
Experiences with Percutaneous Endoscopic Gastrostomy
Authors: Gutt Carsten N. , Held Sinikka , Paolucci Vittorio , Encke Albrecht 
Published: August 2002

AbstractToday the procedure of choice for long‐term enteral tube feeding in patients with prolonged swallowing difficulties or inabilities is percutaneous endoscopic gastrostomy (PEG). The primary indications are head and neck cancers, neurologic dysphagia, cancer cachexia, and obstruction of the esophagus and pharynx with enough space for an endoscopic procedure. This technique requires no general anesthesia and is possible in patients with contraindications to surgical gastrostomy. Between September 1994 and April 1995 a total of 115 patients underwent PEG placement attempts. We employed the pull‐technique with 15‐Freka PEG tubes. The average procedure time, including esophagogastroduodenoscopy, was 17 minutes. In nine cases PEG insertion was impossible owing to severe obstruction of the esophagus. In 46 (40%) patients local abdominal pains started on the first or second postoperative day; 7 of these patients required surgical consultation, and no further intervention was needed. In only one patient was there a serious complication that required surgical intervention: a presumed perforation that turned out to have no correlate upon review. All patients received single‐shot antibiotic prophylaxis; and only in those patients with abdominal symptoms do we recommend a prolonged antibiosis. The abdominal symptoms reported were due to a slight leak of gastric fluid causing a topical peritonitis, which required no further treatment. In our experience PEG is a useful alternative to surgical gastrostomy. The simplicity of this procedure leads to low complication rates, short hospitalization, and is possible on an outpatient basis. It is cost‐efficient and has a much better psychological tolerance than nasogastric tubes.
Parathyroid Hormone Content Distinguishes True Normal Parathyroids from Parathyroids of Patients with Primary Hyperparathyroidism
Authors: Weber Collin J. , Russell John , Chryssochoos John T. , Hagler Mary , McGarity William C. 
Published: August 2002

AbstractThe purpose of this study was to clarify the pathophysiology of primary hyperparathyroidism by looking for differences between parathyroids from eucalcemic patients and patients with primary hyperparathyroidism (HPT) with respect to the following parameters: intracellular parathyroid content of parathyroid hormone (PTH) and parathyroid hormone messenger RNA (PTH mRNA); and serum PTH and calcium levels of patients and patient age. Coded samples of human parathyroid biopsies were assayed for PTH content with a C‐terminal‐specific radioimmunoassay. Total cellular RNA was extracted, and PTH mRNA was quantified by dot‐blot analysis. These results were tabulated along with associated data on patient age, preoperative serum PTH, and preoperative calcium levels. The content of PTH was significantly higher in true normal (TN) parathyroids than in parathyroids from patients with hyperparathyroidism. PTH content of adenomas and hyperplasias were similar. PTH content of normal parathyroids biopsied from patients with parathyroid adenomas (NA) was statistically higher than that of adenomas but statistically lower than that of TN parathyroids. PTH mRNA and PTH content were correlated (p< 0.001) for TN parathyroid glands; however, it was not true for glands (grossly normal or otherwise) in patients with HPT. Patient groups were similar with regard to mean patient age and intracellular PTH mRNA levels. Hypercalcemic patients were similar with regard to preoperative serum calcium and PTH levels. NA parathyroids, adenomas, and hyperplasias are different from TN parathyroids with regard to their PTH content. PTH mRNA was similar across all groups. The relation between intracellular PTH mRNA and PTH was significantly absent in patients with HPT compared with TN glands. Furthermore, we have found that PTH content of normal parathyroid in patients with adenoma is similar to that of hyperplastic and adenoma tissues. These data suggest that the PTH content of parathyroid tissues may be of use in differentiating normal from abnormal parathyroids.
Endoscopic Injection Treatment of Gastrointestinal Bleeding in Hemophiliacs
Authors: Ziemski Jan M. , Szczepanik Andrzej B. , Misiak Andrzej , Rudowski Witold J. 
Published: August 2002

AbstractThe aims of this prospective study were to determine the patterns of gastrointestinal (GI) bleeding in hemophiliacs and to assess the hemostatic effect of injection therapy with alcohol. During a 5‐year period (1990–1994) 89 hemophiliacs were admitted to our department with acute GI bleeding. Among these patients duodenal ulcer was found endoscopically to be the most common (42.7%) cause of hemorrhage; gastric ulcer was the source of the bleeding in only three patients (3.4%). A group of 46 patients met the criteria of active or recent bleeding and underwent injection therapy with alcohol. The injected bleeding lesions were duodenal ulcer in 32 patients, duodenal erosion in 2, gastric ulcer in 3, and other gastric lesions (Mallory‐Weiss tear, Dieulafoy lesion, stomal ulcer, erosions) in 9 patients. Initial hemostasis was achieved in 100% and permanent hemostasis in 82.6%. Rebleeding was observed in eight patients (17.4%), with five of them successfully treated by reinjections. Three patients (6.5%) required emergency surgery. The mortality rate in the group of injected patients was 2.2%. One patient died of stroke on day 10 after partial gastrectomy. All injected patients were given replacement therapy with factor VIII or IX for 2 days (29 patients) or 7 to 14 days (17 patients). Analysis of the hemostatic effect achieved in these two subgroups indicate that short‐term replacement therapy (2 days) may be sufficient to ensure adequate hemostasis in hemophiliacs. The results of the present study indicate that injection therapy with alcohol is an effective, safe, proved method to control GI bleeding in hemophiliacs.
Prognostic Significance of Proliferative Cell Nuclear Antigen in Carcinoma of the Extrahepatic Bile Duct
Authors: Nishida Toshirou , Nakao Kazuyasu , Hamaji Masayasu , Nakahara Masa‐Aki , Tsujimoto Masahiko 
Published: August 2002

AbstractBile duct cancers are still difficult to cure, and even if curatively resected locoregional recurrences are frequent. Biologic proliferative activity of the cancer may influence postoperative recurrence and the prognosis. A retrospective study was performed with the medical records of 44 consecutive patients who underwent surgery for histologically extrahepatic bile duct cancer (stage 3 or 4) at Osaka Police Hospital during the period 1980 to 1992. Univariate analysis suggested that the stage according to the UICC classification, curability, DNA ploidy, proliferating cell nuclear antigen (PCNA), S‐phase and G2M‐phase fractions, and histologic differentiation were significant prognostic factors. The Cox's proportional hazard model indicated that PCNA and histologic differentiation were independent prognostic factors for crude and cause‐specific survival. When PCNA was omitted from the analysis, DNA ploidy and histologic differentiation were independent prognostic factors for both crude and cause‐specific survival. These results suggested that proliferative activity influenced the postoperative prognosis of extrahepatic bile duct cancer.
Surgery for Early Gastric Cancer: A European One‐Center Experience
Authors: Jentschura Dirk , Heubner Cornelia , Manegold Bernd Cristoph , Rumstadt Bernhard , Winkler Markus , Trede Michael 
Published: August 2002

AbstractBetween 1972 and 1995 a total of 251 patients with early gastric cancer underwent resection in our department of surgery. At the time of the operation 10.8% of the patients were proved to have lymph node involvement, and two already had distant metastases. A subtotal gastric resection was performed in 59.8% of cases (n= 150), a total gastrectomy in 33.8% (n= 85), and either a proximal or an atypical resection in 6.4% (n= 16). Since 1985 subtotal distal resection and total gastrectomy were accompanied by a systematic lymphadenectomy of compartments I and II. The overall postoperative morbidity was 18.3%, and the hospital mortality, 4.9%; it was only 1.6% within the last decade. Concerning these short‐term results there were no statistically significant differences between the different surgical procedures. The cumulative overall 5‐year‐survival rate was 82.6%. There was no statistically significant influence of either the different surgical procedures or the histologic types according to the Japanese classification of early gastric cancer.
Segment III Cholangiojejunostomy for Carcinoma of the Gallbladder
Authors: Chaudhary Adarsh , Dhar Puneet , Tomey Sudhir , Sachdev Ajay , Agarwal Anil 
Published: August 2002

AbstractJaundice in patients of advanced carcinoma of the gallbladder requires palliation for the distressing symptoms of pruritus and cholangitis. Intrahepatic segment III duct cholangiojejunostomy is a means for alleviating the obstruction with malignant porta block. The authors reviewed their experience with this procedure in 48 patients of carcinoma of the gallbladder. All patients had jaundice; pruritus was present in 44 (92%) and cholangitis in 14 (29%). The level of obstruction was determined preoperatively by percutaneous transhepatic cholangiography. In 32 patients the block was below the level of the bifurcation of the right and left ducts, and 16 patients had a block involving the confluence, isolating the two lobes of the liver. Following segment III cholangiojejunostomy, pruritus was relieved in all and cholangitis in 86% of patients. At the end of 6 weeks a significant fall in serum bilirubin and alkaline phosphatase levels was seen with both types of hilar obstruction. Varying degrees of pain relief was also noted in 75% of patients. Segment III biliary bypass is an effective, one‐time, reliable means of palliation for carcinoma of the gallbladder with hilar obstruction. Its efficacy appears to depend on the duration and depth of the jaundice and on the anatomy of the biliary ductal system in the left hemiliver rather than on the type of hilar obstruction.
Reduced Postoperative Morbidity after Elective Laparoscopic Cholecystectomy: Stratified Matched Case‐Control Study
Authors: Sarli Leopoldo , Pietra Nicola , Sansebastiano Giuliano , Cattaneo Gaetano , Costi Renato , Grattarola Mario , Peracchia Anacleto 
Published: August 2002

AbstractTo answer the question whether laparoscopic cholecystectomy (LC) or open cholecystectomy (OC) is safer in terms of complications and to what extent the “learning curve” influences the frequency of complications after LC, we conducted a matched case–control study. First, 200 patients undergoing LC (LC group A), and two groups of 200 patients undergoing LC at two different periods of the learning curve (LC groups B and C) were matched, taking into account sex, age, anesthesiologic risk, and surgical difficulties. We evaluated the frequency and grade of postoperative complications of these patients and of the last 200 patients undergoing OC before the introduction of LC, retrospectively matched with the LC groups. The total rate of complications in the OC group was 16.0% compared with 5.5% in the LC groups (p < 0.003); the difference was particularly significant for complications classified as grade I, in female patients, those younger than 70, those with low anesthesiologic risk (ASA), and those after cholecystectomy without surgical difficulties. Matched case–control analysis revealed that the complication rate in the LC group significantly decreases with experience (p < 0.01). We conclude that LC is today the treatment of choice for symptomatic cholelithiasis and is replacing OC as the gold standard against which new therapies should be compared.
Immature Host for Xenotransplantation
Authors: Michler Robert E. , Minanov Oktavijan P. , Artrip John H. , Itescu Silviu 
Published: August 2002

AbstractThe overall shortage of appropriate donor organs has prompted transplant physicians and surgeons to consider using organs from other nonhuman species. The shortage of appropriate human donor hearts for newborn recipients is especially severe. Presently, the pig appears to be the most appropriate source for organs. Humans and baboons uniformly develop high titers of complement‐fixing (IgM) anti‐pig xenoantibodies, resulting in complement‐mediated hyperacute rejection (HAR) of pig organs transplanted into mature baboons within minutes to hours. In contrast, newborn humans and baboons do not have high titers of anti‐pig IgM xenoantibody, and consequently pig cardiac xenografts transplanted into newborn baboons do not undergo HAR. Rather, these organs are rejected at days 3 to 4 by a distinctive immunologic process that involves natural killer cells and macrophages. With the addition of cyclosporine‐based triple immunosuppression, this process is reduced and graft life is prolonged to 6 to 7 days. This therapy, however, is not sufficient to prevent the induced humoral response to the graft, and the organs are rejected by antibody‐ and complement‐dependent mechanisms. Future treatment strategies to reduce this humoral response must incorporate immunodepletion columns, soluble complement‐inhibiting agents, and additional anti‐B lymphocyte agents. These strategies, in conjunction with the use of transgenic pig organs that express human membrane‐bound complement regulatory proteins or reduced xenoantigenic epitopes could further prolong graft life. Clinical trials are being formulated that would utilize pig organs as a “bridge,” sustaining a newborn human in need of a heart transplant until an appropriate donor is located.
Survival following Orthotopic Cardiac Xenotransplantation between Juvenile Baboon Recipients and Concordant and Discordant Donor Species: Foundation for Clinical Trials
Authors: Bailey Leonard L. , Gundry Steven R. 
Published: August 2002

AbstractIt has been more than a decade since the last clinical trial of cardiac xenotransplantation in a newborn infant. Since that event, laboratory research at Loma Linda University has focused on survival studies of orthotopically xenografted juvenile baboon recipients. Both concordant and discordant donor species have been used. Transgenic donors have not been explored at Loma Linda. Instead, simplified host immunoregulative protocols, consistent with those used in neonatal cardiac allografting, have been adapted to xenotransplant research. Xenograft bridge to alloengraftment was evaluated in a series of five juvenile baboon recipients. Heterotopically implanted cardiac xenografts stimulated host production of xenoreactive antibody. Orthotopic cardiac allografting was then carried out. Xenoantibody appeared to play little role in immediate or chronic survival of experimental hosts. A clinical protocol of xenobridging to allotransplantation would likely succeed. Two consecutive series of orthotopically xenotransplanted hosts using rhesus monkey cardiac donors demonstrated unprecedented long‐term survival. Splenectomy combined with maintenance therapy consisting of FK‐506 and methotrexate contributed to survival of up to 502 days in one series of xenografted baboon hosts selected for ABO blood grouping, mixed lymphocyte culture, and crossmatch compatibility. Survival beyond a year (maximum 515 days) among three consecutive juvenile baboon recipients of orthotopically implanted rhesus monkey hearts, in which splenectomy was omitted and cyclosporine was substituted for FK‐506, represents a benchmark achievement. Commencing maintenance immunosuppression several weeks prior to transplantation appeared to improve chronic survival significantly. Investigation of discordant (pig‐to‐baboon) host survival has focused on adsorption of naturally occurring xenoreactive antibody at the time of transplantation. This strategy, combined with pretransplant total lymphoid irradiation and both pre‐ and posttransplant immunosuppression, succeeded in preventing hyperacute rejection and resulted in survival of up to 24 days, thereby permitting observation of the delayed xenograft rejection phase. Data support consideration of additional clinical trials of concordant neonatal cardiac xenotransplantation and offer promise for the development of discordant xenotransplantation as an ultimate therapeutic resource.
Diets and Infection: Composition and Consequences
Authors: Alexander J. Wesley , Ogle Cora K. , Nelson Jeffrey L. 
Published: August 2002

AbstractThis brief review focuses on the effects of nutrient composition of enteral diets on the outcome of surgical patients and experimental models of infection. Complete enteral diets containing combinations of immunonutrients (arginine, glutamine, RNA, omega‐3 fatty acids), when given postoperatively or after trauma to surgical patients, can reduce hospital stay, overall costs, and the incidence of wound complications and acquired infections. Immunonutrient diets can also reduce the length of hospital stay when given to patients admitted to the surgical intensive care unit. A high protein diet is usually required for optimal benefit, although administration of high protein immunoenhancing diets may have adverse effects in animals with severe untreated peritonitis because of a sustained overproduction of cytokines.
Historical Development of Surgical Instruments Exemplified by Hemostatic Forceps
Authors: Sachs Michael , Auth Marcus , Encke Albrecht 
Published: August 2002

AbstractWe describe the historical development of surgical instruments exemplified by hemostatic forceps, starting with antique and medieval forceps used for the arrest of bleeding to modern atraumatic hemostatic forceps used for vascular reconstruction. Their development proceeded mainly in three steps: (1) development of ligature forceps directly for hemostasis (Celsus, first century ad; Paré, 1582; L. Heister, 1743; (2) development of atraumatic forceps, which facilitate vascular reconstruction or anastomosis creation by temporarily clamping vessels (Höpfner, 1903; Stich, 1907; Jeger, 1913; (3) construction of tangential forceps, which, by partially clamping vessels with partial maintenance of blood flow, allow the reconstruction or anastomosis of large vessels in a side‐to‐side technique. The first tangential occlusion clamp was developed by Friedrich Trendelenburg (1844–1924) in 1908, when he established the operative treatment for embolism of the pulmonary artery. This clamp was later modified by A.W. Meyer (1927) and V.P. Satinsky (ca. 1950).