bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum Hyaluronate Level for Predicting Subclinical Liver Dysfunction after Hepatectomy
Authors: Mizuguchi Toru , Katsuramaki Tadashi , Nobuoka Takayuki , Kawamoto Masaki , Oshima Hideki , Kawasaki Hiroyuki , Kikuchi Hitoshi , Shibata Chihiro , Hirata Koichi 
Published: October 2004

AbstractThe serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 15 minutes (ICGR15), lectin‐cholesterol (LCAT), hepatocyte growth factor (HGF), liver uptake ratio of technetium‐99m galactosyl human serum albumin (99mTc‐GSA) at 15 minutes (HH15), prealbumin, and hepatic uptake ratio of 99mTc‐GSA at 15 minutes (LHL15). In addition, the model for end‐stage liver disease (MELD) score at 7 days after operation was well correlated with serum HA, ICGR15, HH15, and LHL15. In patients who showed serum an HA level of = 100 ng/ml before hepatectomy, the MELD score had significantly deteriorated by 7 days after hepatectomy. Of the 20 patients who showed a serum HA level < 100 ng/ml before hepatectomy, 11 had high serum HA after hepatectomy. The bilirubin level 7 days after operation in this group was much higher than that for patients who maintained a serum HA level < 100 ng/ml after hepatectomy. In addition, the serum HGF level before hepatectomy in this group was significantly lower. We concluded that the serum HA level is a reliable indicator when evaluating liver function and predicting liver dysfunction after hepatectomy. Furthermore, patients with a significantly low HGF level who have a normal HA level are susceptible to liver dysfunction after hepatectomy.
Changes in Splenic Volume during Liver Regeneration
Authors: Ando Hideya , Nagino Masato , Arai Toshiyuki , Nishio Hideki , Nimura Yuji 
Published: October 2004

AbstractLittle is known about the relation between liver regeneration and splenic size. We monitored serial changes in liver and spleen volumes using computed tomography in 24 patients with biliary cancer who underwent right hepatectomy or more extensive liver resection following portal vein embolization (PVE). Nonembolized hepatic segments increased in volume from 316 ± 97 cm3 (34% ± 8% of total liver volume) before PVE to 410 ± 115 cm3 (44% ± 8%) after PVE. The volume of nonembolized hepatic segments (i.e., remnant liver) increased to 617 ± 111 cm3 (59% ± 10% of total liver volume before PVE) 14 days after hepatectomy and then increased slowly to reach 795 ± 231 cm3 (76% ± 16%) 1 year after hepatectomy. Splenic volume increased from 87 ± 29 cm3 before PVE to 104 ± 38 cm3 (119% ± 17% of original volume) after PVE. Splenic volume increased to 137 ± 65 cm3 (155% ± 40%) by 14 days after hepatectomy and to 155 ± 67 cm3 (179% ± 41%) by 28 days after hepatectomy, with no further change at 1 year after hepatectomy (153 ± 92 cm3; 174% ± 79%). The rate of increase in splenic volume within the first 14 days after hepatectomy was 2.7 ± 3.6 cm3/day, correlating well with increases in remnant liver volume (r = 0.64, p = 0.0006). These data indicate that the spleen is enlarged during liver regeneration, suggesting that the liver and spleen share certain common growth regulatory mechanisms.
Resection of the Colon Simultaneously with Pancreaticoduodenectomy for Tumors of the Pancreas and Periampullary Region: Short‐term and Long‐term Results
Authors: Suzuki Yasuyuki , Fujino Yasuhiro , Tanioka Yasuki , Sakai Tetsuya , Ajiki Tetsuo , Ueda Takashi , Tominaga Masahiro , Kuroda Yoshikazu 
Published: October 2004

AbstractSimultaneous resection of the colon with pancreaticoduodenectomy (PD) is occasionally inevitable to accomplish curative resection in instances when a periampullary tumor involves the mesentery of the colon. However, there is little information regarding short‐ and long‐term outcomes of this aggressive surgery. Among 95 consecutive patients who underwent PD for periampullary malignant tumors, 12 had simultaneous resection of the right colon (group 1) and 83 underwent PD alone (group 2). Intraoperative variables, postoperative morbidity and mortality, and the length of the hospital stay were comparatively analyzed. Survival was also compared between the groups in a subset of 36 pancreatic adenocarcinoma patients. Group 1 included more patients with pancreatic cancer, and portal vein resection was more frequently performed, which seemed to be associated with a significantly longer operating time (640 vs. 510 minutes) and increased total blood loss (1965 vs. 1220 ml). However, morbidity and mortality rates did not differ between the groups (50,0% and 0%, respectively, in group 1; 44.6% and 1.2%, respectively, in group 2). The median hospital stays were 67 and 48 days in groups 1 and 2, respectively. In a subset of 36 pancreatic adenocarcinoma patients, the median progression‐free survivals were 6 months in both groups 1 and 2; the median overall survivals were 14 months in group 1 and 12 months in group 2. There was no statistically significant difference in survival between the groups. Simultaneous right hemicolectomy with curative intent at the time of PD could thus be performed safely and may offer a survival benefit even for individuals who have advanced pancreatic cancers with involvement of the transverse mesocolon.
Immunohistochemical Study of DPC4 and p53 Proteins in Gallbladder and Bile Duct Cancers
Authors: Chuang Shih‐Chang , Lee King‐Teh , Tsai Kun‐Bow , Sheen Pai‐Ching , Nagai Eishi , Mizumoto Kazuhiro , Tanaka Masao 
Published: October 2004

AbstractGallbladder and bile duct carcinomas belong to the family of biliary tract tumors, but they demonstrate different clinical behavior. We evaluated a series of biliary tract carcinomas to determine whether they also had genotypic differences by analysis of the tumor suppressor genes DPC4 and p53. Twenty‐one gallbladder cancers, 20 intrahepatic bile duct carcinomas, and 10 extrahepatic bile duct carcinomas were retrieved from the surgical pathology files of Kaohsiung Medical University Hospital. Sections were immunostained with monoclonal antibodies to the DPC4 and P53 proteins. Statistical differences between gallbladder cancer and bile duct carcinomas were determined using ?2 analysis or the Fisher’s exact test, when appropriate. Two of the 21 gallbladder cancers (9.5%), 7 of the 20 intrahepatic bile duct carcinomas (35%), and five of the 10 extrahepatic bile duct carcinomas (50%) were negatively labeled for DPC4. The differences were significant between gallbladder carcinoma and both intrahepatic bile duct carcinomas (p = 0.023) and extrahepatic bile duct carcinomas (p = 0.012). A higher frequency of P53 overexpression was found in gallbladder cancers (61.9%) than in intrahepatic bile duct carcinomas (26.3%) (p = 0.024). This study suggests that the DPC4 gene may play a limited role in gallbladder carcinoma; however, p53 gene mutation is more frequently found in gallbladder cancers. In contrast, DPC4 deletion may be more common in bile duct carcinomas, especially in those arising from the extrahepatic bile duct. These findings support the concept that gallbladder and bile duct carcinomas are different tumors with differing etiologies and tumorigenesis.
Selective Venous Sampling in Recurrent and Persistent Hyperparathyroidism: Indication, Technique, and Results
Authors: Chaffanjon Philippe C.J. , Voirin David , Vasdev Ashok , Chabre Olivier , Kenyon Norman M. , Brichon Pierre Yves 
Published: October 2004

AbstractBetween 1992 and 2002, 542 patients underwent a surgical treatment for hyperparathyroidism in our department. Twenty‐three selective venous sampling procedures (SVS) were performed because of the failure of the other methods of diagnosis. These patients have recurrent or persistent hyperparathyroidism. Noninvasive methods of topographical diagnosis have failed or they have given contradictory results. In our experience, the surgeon needs a precise localization of the pathological glands in these difficult cases. In our series of SVS, specificity was 85.7% and sensitivity was 94.7%. Our results show that a high postoperative gradient of parathyroid hormone in the internal thoracic veins indicates an ectopic pathological gland in the thymus. A high gradient in a vertebral vein indicates a pathological superior parathyroid gland, usually in a retro‐esophageal position.
Cytoreductive Surgery and Intraperitoneal Chemohyperthermia for Recurrent Peritoneal Carcinomatosis from Ovarian Cancer
Authors: Zanon Claudio , Clara Renzo , Chiappino Isabella , Bortolini Massimiliano , Cornaglia Silvia , Simone Paolo , Bruno Francesco , De Riu Leonarda , Airoldi Mario , Pedani Fulvia 
Published: October 2004

AbstractAggressive surgical cytoreduction has been shown to have a positive impact on survival of patients with ovarian cancer. After first‐line chemotherapy, 47% of patients relapse within 5 years, and median survival after second line chemotherapy is 10—15 months. Adding intraperitoneal chemohyperthermia (IPCH) to surgical cytoreduction could further control ceolomic spread of disease. The aim of this study was to determine morbidity and mortality, regional relapse‐free survival and, preliminarily, overall survival after combining cytoreductive surgery with IPCH for the treatment of peritoneal carcinomatosis from ovarian epithelial cancer relapsed after prior chemotherapy. Thirty women affected with such a relapse were included. Patients underwent extensive cytoreductive surgery including tumor resections and peritonectomy, followed by intraoperative IPCH with cisplatin. Complete surgical cytoreduction down to nodules less than 2.5 mm (CC0—CC1) was obtained in 23 patients (77%). One patient died postoperatively from a pulmonary embolism. Major postoperative morbidity was 5/30 (16.7%). We registered one case of anastomotic leakage, a spontaneous ileum perforation, a postoperative cholecystitis, a hydrothorax, and one patient with bone marrow toxicity. Kaplan‐Meier estimates of median locoregional relapse‐free survival and median overall survival were 17.1 months and 28.1 months, respectively. Patients with CC0—CC1 had locoregional relapse‐free and overall survival rates of 24.4 and 37.8 months, whereas the remainder had survival rates of 4.1 and 11.0 months. We concluded that cytoreductive surgery combined with IPCH is feasible with acceptable morbidity and mortality and seems to promise good results in selected patients affected with peritoneal carcinomatosis from ovarian cancer.
Edoardo Bassini and the Wound That Inspires
Authors: Thomas Andrew D. , Rogers Ann 
Published: October 2004

AbstractEdoardo Bassini, an Italian surgeon active at the turn of the 19th century, made a lasting contribution to surgery with his elucidation of the cure for inguinal hernia. The magnitude of this contribution in contrast to centuries of frustration in attempting surgical repair of hernia is described, as are Bassini’s personal experiences, which may have played a role in his successful search for a cure.
Coronary Bypass before Simultaneous Pancreas‐Kidney Transplants for Type 1 Diabetics in Renal Failure
Authors: Molina J. Ernesto , Sutherland David E.R. , Wang Yang , Gruessner Angelika C. , Bland Barbara J. 
Published: October 2004

AbstractOur study examined the results of coronary artery bypass (CAB) before simultaneous pancreas‐kidney (SPK) transplant in type 1 diabetics in renal failure. Of 588 pancreas transplant patients from 1992 to 2002, 77 (24 females, 53 males) were candidates for SPK transplant. All 77 had coronary evaluation and were referred for pretransplant CAB. Among the 77 CAB patients, the mean age was 42 years (range: 30– 63 years), and the duration of diabetes was 28.52 years (range: 9–51 years). All had neuropathy, retinopathy, and nephropathy; 12.9% (n = 10) had angina; and 76% (n = 59) were on dialysis at the time of CAB. The creatinine level of the 18 nondialysis patients was 3.7 mg%; 42.8% (n = 33) had suffered myocardial infarction. The left ventricular ejection fraction (LVEF) was 49% (30‐65%). At CAB surgery, 88% (n = 68) triple, 9% (n = 7) double, and 2.5% (n = 2) single arterial grafts were implanted. All 77 CAB patients had severe coronary artery disease (CAD); some vessels could not be bypassed in 9.8%. At surgery, 3.4 grafts/patient were implanted (range: 1–6 grafts). All 59 dialysis patients continued dialysis after CAB; 6 nondialysis patients required dialysis after CAB. The intensive care stay averaged 1.86 days (range: 1–10 days); the hospital stay averaged 10.5 days (range 6–28 days). There was no operative mortality. Eventually, 68 patients underwent SPK transplant; 9 await organs. The waiting period for 68 CAB patients who had SPK was 2 years, 5 months (range: 2 months to 10 years). The SPK operative mortality was 3.9% (n = 3). Significant CAD exists in patients > 30 years of age with type 1 diabetes and renal failure. Pretransplant CAB can be done safely and may reduce posttransplant mortality associated with cardiac events.
Efficacy of Pre‐incisional Bupivacaine Infiltration on Postoperative Pain Relief after Appendectomy: Prospective Double‐blind Randomized Trial
Authors: Lohsiriwat Varut , Lert‐akyamanee Narong , Rushatamukayanunt Winchai 
Published: October 2004

AbstractPain is the most undesirable and threatening experience for surgical patients. This study aims to determine the efficacy of pre‐incisional analgesic bupivacaine infiltration (preemptive analgesia) on postoperative pain relief after appendectomy. A prospective randomized double‐blinded study was conducted on 123 patients aged 13–45 years with a preoperative and‐postoperative diagnosis of acute appendicitis admitted to Siriraj Hospital, Bangkok, from January to May 2002. They were randomly set into two groups: the control (61 patients) and the preemptive (62 patients). In the preemptive group, bupivacaine (Marcaine) was infiltrated into the skin and subcutaneous tissue along the proposed wound line before gridiron incision, and also into the muscle layer after incision. The control group received no injection. Routine appendectomy was done. Pain score was assessed by the patients in the first 48 hr while they were lying supine and as they moved to a sitting position at 24 and 48 hr after operation. Morphine injection was given on patients’ request with pain score = 5 every 4 hr in the first 48 hr or until analgesic paracetamol could be taken orally. The pain score during the first 6, 12, 24, and 48 hr, including the score while sitting up, were all significantly lower (p < 0.001) in the preemptive group. So were the total number of morphine injections and the amount of morphine used postoperatively. The pain reduction could be due to interruption of inflammatory or pain mediator cascades that normally occur during an operation. This study showed that pre‐incisional bupivacaine infiltration is an effective and simple method of reducing postoperative pain for patients undergoing appendectomy.
Extended Thymectomy in Patients with Myasthenia Gravis with High Thoracic Epidural Anesthesia Alone
Authors: Tsunezuka Yoshio , Oda Makoto , Matsumoto Isao , Tamura Masaya , Watanabe Go 
Published: October 2004

AbstractSuccessful extended thymectomy was performed in three patients with myasthenia gravis under only high thoracic epidural anesthesia with voluntary breathing. It was not necessary to intubate a tracheal tube during operation for any of the patients. Neither muscle relaxants nor volatile anesthetic agents were required. The mean operating time was 2.0 ± 0.5 hours. The drainage tubes were removed the day after operation in all patients. In two patients the arterial oxygen saturation (SaO2) and the arterial partial pressure of carbon dioxide (PaCO2) and oxygen (PaO2) were stable; in the third patient the SaO2 was temporarily decreased to 92 mmHg when bilateral mediastinal pleura were opened. The right pleural defect was then covered with a large wet towel, which was pressed on the defect, and thoracic drainage was performed. The left pleural defect was repaired with 3‐0 Vicryl after suctioning the air in the pleural space, after which the SaO2 recovered. All patients were able to drink water and walk within 1 hour after the operation. This procedure is advantageous in that the use of muscle relaxants and volatile anesthetic agents prevented the laryngeal injury that results from translaryngeal intubation; in turn we avoided causing postoperative respiratory insufficiency. This may be suitable for the operation of some patients with MG, but further studies are required to define the indication.
Spiegel’s Lobe Bile Ducts Often Drain into the Right Hepatic Duct or Its Branches: Study Using Drip‐Infusion Cholangiography‐Computed Tomography in 179 Consecutive Patients
Authors: Kitami Masahiro , Murakami Gen , Ko Saiho , Takase Kei , Tuboi Masahiro , Saito Haruo , Nakajima Yoshiyuki , Takahashi Shoki 
Published: October 2004

AbstractUsing drip‐infusion cholangiography‐computed tomography (DIC‐CT), we successfully identified the bile ducts draining the caudate lobe in 138 of 179 consecutive patients with extrahepatic cholelithiasis (179 ducts from Spiegel’s lobe and 154 from the paracaval portion; 1–5 ducts per patient). The dorsal subsegmental duct of S8 (B8c) was often identified and could be discriminated from the paracaval caudate ducts, thus acting as a landmark for the right margin of the caudate lobe. Notably, in more than one‐third of the 138 patients, at least one of the Spiegel’s lobe ducts drained into the right hepatic duct or its branches (30.2% of the 179 ducts overall; all ducts joined branches of the right lobe in 25 patients). Similarly, 34.4% of the 154 paracaval caudate lobe ducts drained into the left hepatic duct or its branches. These “anatomical left/right dissociations” between the drainage territory and route were much more frequent than previously reported. Our results confirm the effectiveness of DIC‐CT as a classical, noninvasive method for presurgical evaluation of the biliary system, but they also suggest that anatomical partial resection of the dorsal liver in patients with hilar cholangioma is often impossible because of contralateral biliary drainage.
Improved Health‐related Quality of Life after Coronary Artery Bypass Grafting Is Unrelated to Use of Cardiopulmonary Bypass
Authors: Järvinen Otso , Saarinen Timo , Julkunen Juhani , Laurikka Jari , Huhtala Heini , Tarkka Matti R. 
Published: October 2004

AbstractThis prospective study was instituted to assess whether the use of the on‐pump method or the off‐pump method affects changes in health‐related quality of life (QOL) as evaluated a year after coronary artery bypass graft (CABG) surgery. Data including preoperative risk factors and postoperative morbidity up to discharge were collected from 508 CABG patients operated in the Heart Center of a university hospital and further treated in secondary referral hospitals. Four hundred and fifty‐two (89.0%) patients underwent operation with the on‐pump method and 56 (11.0%) with the off‐pump method, i.e., without cardiopulmonary bypass (CPB). The RAND‐36 Health Survey (RAND‐36) was used as indicator of QOL. The primary outcome measure was a change in the physical component summary (PCS) and mental component summary (MCS) from the RAND‐36. Symptomatic status was estimated according to New York Heart Association (NYHA) class. Assessments were made preoperatively and repeated 12 months later. The majority of patients operated on‐pump (85.6%) and off‐pump (92.9%) had a favorable outcome without major complications (p = 0.136). The present data showed significant improvement (p < 0.001) in all eight domains of QOL following on‐pump CABG. Likewise, off‐pump patients improved in all eight aspects, and the change was statistically significant in six dimensions. A highly significant (p < 0.001) pattern of change was seen in the RAND‐36 MCS and PCS scores in both operative groups. Differences between the groups were nonsignificant. We conclude that most patients experience significant improvement in health‐related QOL during the first year after CABG, and that cardiopulmonary bypass has no effect on patients’ subsequent health‐related QOL, but its use depends on specific indications.
Penetrating Cardiac Wounds: Principles for Surgical Management
Authors: Gao Jin‐mou , Gao Yun‐han , Wei Gong‐bin , Liu Guo‐long , Tian Xian‐yang , Hu Ping , Li Chang‐hua 
Published: October 2004

AbstractStab wounds are the main type of penetrating cardiac injury in China and they have a fairly good prognosis when the patient receives expeditious and appropriate management. The objective of this study is to present the experience of managing the patients with penetrating cardiac injuries. A retrospective study involving 82 cases with penetrating wounds of the heart in the past 16 years was carried out. Stab wounds accounted for 86.58% of this series (71 of 82 patients). All 82 cases were treated operatively. The amount of preoperative infusion as fluid resuscitation for shock was less than 1,000 ml in 65.85% of the present study. Only in three patients was preoperative pericardiocentesis performed, yielding a false‐negative result in one. Six patients sustaining cardiac arrest soon after arrival were subjected to emergency room thoracotomy (ERT), and five of them surviced. The overall survival rate was 96.34%. One patient died of exsanguination due to injury of multiple chambers; of the remaining 2 deaths after operation 1 was associated with abdominal injuries and the other with failure of cerebral resuscitation. From the experience reported in this study, early establishment of diagnosis and prompt thoracotomy against time are the fundamental factors affecting the outcome of penetrating cardiac injuries. Preoperative massive transfusion and pericardiocentesis are not advocated.
Laparoscopic Cholecystectomy: Is It a Conscious Preference among Turkish Patients with Symptomatic Gallstones? — Prospective Study
Authors: Cingi Asım , Düşünceli Fikret , Güllüoğlu Bahadır M. , Yeğen Cumhur , Aktan A. ızdemir , Yalın Rıfat 
Published: October 2004

AbstractLaparoscopic cholecystectomy (LC) has the advantages of early return to full daily activity, early return to work, and better cosmetic result, as well as quickly resolving pain. Yet how this information about the procedure influences a patient’s attitude toward laparocopy is not known. In this study we analyzed the factors that play role in the decision‐making process of patients who choose laparoscopic surgery, and we also evaluated patients’ knowledge of laparoscopy and their expectations. A questionnaire was used in evaluating 98 patients suffering from symptomatic cholelithiasis scheduled for elective laparoscopic cholecystectomy between January 2001 and January 2002. Females constituted 81% of the study population. Most of the patients (56%) were housewives. While 45% of the patients had an educational status of primary school degree only, 14% had graduated from a university. Forty‐three patients described their level of knowledge about laparoscopy as “low” (had only heard about laparoscopy). In 61% of the patients the surgeon was the sole decision maker about the type of the operation. Almost none of the patients had a preference for the time of discharge from the hospital after surgery, and only three of the actively working patients offered a time interval for return to work. From this study we concluded that most patients have inadequate information about laparoscopic surgery, that the type of operation is dictated mostly by the surgeon, and that early discharge and early return to work are not important for many patients.