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PubMed1996

The intranuclear site of excision of each intron in Balbiani ring 3 pre-mRNA is influenced by the time remaining to transcription termination and different excision efficiencies for the various introns.

The 10.9-kb Balbiani ring 3 (BR3) gene contains 38 constitutively excised introns. Both nascent and nucleoplasmic, released BR3 gene pre-mRNA can be isolated by microdissection of the polytene salivary gland nuclei in which the gene is transcribed. Here we analyze the order of intron excision in relation to transcription and to intranuclear transport. We demonstrate that the introns are excised with an overall 5' to 3' polarity that is established during transcription and maintained during transport. In contrast, we also show that individual introns are excised at very different rates and that neighboring introns are removed in a preferred order that is not necessarily 5' to 3'. Splicing factors are, in addition, shown to associate with the nascent BR3 pre-mRNA. Our data argue that functional spliceosomes assemble rapidly as introns appear in the pre-mRNA, but that intron-specific properties influence the kinetics of spliceosome assembly and/or function, resulting in cotranscriptional excision of some introns, preferentially those located in the 5' part of the pre-mRNA, and posttranscriptional excision of other introns, preferentially those located in the 3' part of the pre-mRNA.

Animals↗

PubMed1990

Isolated limb perfusion for localized melanoma of the extremity. A matched comparison of wide local excision with isolated limb perfusion and wide local excision alone.

The therapeutic efficacy of isolated limb perfusion in patients with localized melanoma of the extremity remains controversial. We compared patients treated at the University of Texas M.D. Anderson Cancer Center, Houston, with wide local excision and isolated limb perfusion using either melphalan or imidazole carboxamide with a group matched for prognostic factors from the University of Alabama at Birmingham and the University of Sydney (Australia) who were treated with wide local excision alone. No significant difference in disease-free or overall survival rates was found between patients treated with wide local excision with adjuvant isolated limb perfusion or wide local excision alone. However, a subset of patients with thicker lesions (greater than 2.0 mm) treated with wide local excision and isolated limb perfusion using melphalan had a significant improvement in both disease-free and overall survival rates. These data suggest that isolated limb perfusion using melphalan may improve survival rates in selected patients with localized melanoma of the extremity who are at increased risk for local and regional micrometastases, and justifies the continued study of this treatment approach in prospective clinical trials.

Aminoimidazole Carboxamide↗

PubMed2006

The influence of histopathologic criteria on the long-term prognosis of locally excised pT1 rectal carcinomas: results of local excision (transanal endoscopic microsurgery) and immediate reoperation.

PURPOSE: Local excision of early rectal cancer is a controversial issue, which is in part because of differences in the evaluation of histopathologic criteria. This prospective study was designed to determine prognostic factors for recurrences and the need for reoperation. METHODS: In 105 of 118 patients with pT1 carcinomas and local excision, results of recurrence rates and ten-year cancer-free survival were studied separately according to different histologic criteria (R0, R1, Rx, R < or = 1 mm, high-/low-risk situation), tumor localization (anterior, posterior, lateral wall and third of rectum), size, and degree of resection (full-thickness/partial wall). Patients were grouped into local excision (n = 89) and local excision followed by reoperation (n = 21). Risk classification was performed by division into "low-risk" carcinomas after local R0-resection (Group A) and unfavorable histologic results after local resection (R1, Rx, R < or = 1 mm, high-risk situation; Group B). RESULTS: Local recurrence rates after local R0-resection of low-risk carcinomas were 6 percent, whereas patients in Group B with local resection were 39 percent. The recurrence risk in those patients was significantly reduced to 6 percent by reoperation (P = 0.015). In addition, ten-year, cancer-free survival was 93 percent in Group B after reoperation compared with 89 percent in patients of Group A after local excision alone. CONCLUSIONS: Local R0-resection in cases with low-risk pT1 carcinomas represents an oncologically adequate therapy, which results in similar survival rates compared with primary radical surgery of pT1N0M0 rectal carcinomas. High recurrence rates are observed in tumors with unfavorable histologic result (Group B) requiring further treatment. In these cases immediate reoperation reduces the recurrence rate to 6 percent.

Adult↗

PubMed2003

Marginally excised parotid pleomorphic salivary adenomas: risk factors for recurrence and management. A 12.5-year mean follow-up study of histologically marginal excisions.

The aim of the study was to identify recurrence risk factors in surgically excised parotid pleomorphic salivary adenomas. We reviewed the case histories and histological findings for all cases of marginal or inadequate excision of pleomorphic salivary adenomas at the Royal Hallamshire Hospital, Sheffield, UK, between 1980 and 1995. A total of 83 cases with complete records were identified, with a mean follow-up period of 12.5 years. The histological slides were reviewed in each case. The overall recurrence rate was 6.0%. Where tumour was present at the margin, recurrence occurred in 17.6% of cases. However, cases conventionally regarded as marginally excised and likely to recur (tissue margin < 1 mm) showed recurrence in only 1.8% of cases. Intraoperative capsular rupture, microscopic capsular invasion by tumour and several other surgical factors were not predictive of recurrence. Adequate excision of pleomorphic salivary adenomas, in the sense of minimal recurrence risk, does not require more than a fraction of a millimetre of surrounding tissue. Only pleomorphic salivary adenomas with tumour actually at the excision margin require prolonged follow-up or consideration of radiotherapy. Provided that the tumour can be removed intact, the surgical approach for pleomorphic salivary adenomas should be guided by the need to preserve vital structures rather than by an attempt to remove a cuff of normal tissue with the tumour.

Adenoma, Pleomorphic↗

PubMed1999

Scaphotrapezoid arthritis: prevalence in thumbs undergoing trapezium excision arthroplasty and efficacy of proximal trapezoid excision.

Between June 1995 and May 1998, 37 patients underwent trapezium excision arthroplasty. Preoperative radiographic assessment for scaphotrapezoid arthritis was performed. At the time of surgery intraoperative inspection of the scaphotrapezoid joint allowed calculation of the true prevalence of arthritis as well as sensitivity and specificity of the radiographic diagnosis. The true prevalence of scaphotrapezoid arthritis was 62%. The sensitivity of the radiographic diagnosis was 44% and the specificity was 86%. Comparison of surgical results in 23 patients who underwent both trapezium excision arthroplasty and proximal trapezoid excision, with 14 patients who underwent the former procedure, only showed that there was no morbidity associated with the latter. Because of the potential that scaphotrapezoid arthritis may cause residual symptoms following trapezium excision arthroplasty, and in light of the low sensitivity of radiographs, routine intraoperative assessment of the joint is recommended so that proximal trapezoid excision can be performed if degenerative change is present.

Adult↗

PubMed1996

A 32-year follow-up of lunate excision for Kienbock's disease: a case report and a review of results from excision and other treatment methods.

Lunate excision alone is seldom utilized in the management of Kienbock's disease due to concerns about progressive carpal collapse following removal of this central carpal bone. We report a 32-year follow-up of a patient who underwent lunate excision only for treatment of Kienbock's disease with a successful outcome. Although lunate excision is thought to be associated with a high failure rate, a review of the literature suggests that success rates following lunate excision are comparable to those reported for other more conventional techniques such as radial shortening, ulnar lengthening, limited carpal fusions, and proximal row carpectomy. The current perception that lunate excision is associated with a high failure rate is not supported in the literature. As such, it may not be appropriate to assign this operation to the category of "historical interest only."

Carpal Bones↗

PubMedDate not supplied

A comparison of standard femoral head and neck excision and femoral head and neck excision using a biceps femoris muscle flap in the dog.

Sixteen normal 20 to 30 kg dogs had standard femoral head and neck excision (8 dogs) or femoral head and neck excision with interposition of a biceps muscle flap (8 dogs). Lameness lessened at week 6, and did not differ between groups; neither group returned to a completely normal gait. Weightbearing decreased on the operated pelvic limb compared to controls (forceplate analysis). Weightbearing force of the muscle flap dogs was significantly less at weeks 6 and 16 than that of the standard femoral head and neck excision dogs. The operated limb of both groups was shortened; shortening was significantly greater for the muscle flap group. Hip extension was limited in both groups. Both groups had decreased (more acute) hip, stifle, and hock angles measured in standing position. Thigh muscle atrophy was more pronounced in the muscle flap group at week 6. More soft tissue was interposed in the muscle flap group at necropsy compared to the group with standard femoral head and neck excision, but the difference was not statistically significant. Skeletal muscle fibers were present in the interposed fibrous connective tissue of the muscle flap group, and the healed surfaces were smoother than those of the standard femoral head and neck excision group.

Animals↗

PubMed1996

The influence of hormonal status on excision margins after large loop excision of the transformation zone (LLETZ).

To evaluate the influence of the type of contraception used and post-menopausal status on the involvement of excision margins with CIN after Large Loop Excision of the Transformation Zone (LLETZ), the authors reviewed a computerised database and the clinical files of 451 sequential women treated by LLETZ, for CIN diagnosed on cytology and colposcopy. There was a statistically significant association between both the use of Long Acting Injectable Progesterone (LAIP) and post menopausal status with histological report of incomplete excision of CIN on the endocervical excision margin. Therefore, the authors conclude that both progesterone-only containing contraception and menopause induced atrophy of the endocervical epithelium significantly increase the risk of involvement of the endocervical excision margin with CIN in the treatment by LLETZ. This parameter is of particular importance, as it is one of the known factors for recurrence.

Contraception↗

PubMed1997

Conservative management of patients with histological incomplete excision of cervical intraepithelial neoplasia after large loop excision of transformation zone.

OBJECTIVE: To evaluate conservative management of patients with histological incomplete excision of CIN after large loop excision of transformation zone (LLETZ). METHODS: Two hundred and seventeen patients with high grade CIN were treated with LLETZ from October 1, 1992 to December 31, 1994. Fifty-three patients (24.4%) had incomplete excision on histology. All patients were followed up cytologically every 3 to 6 months during the first 18 months and then yearly till December 1996. Those patients with positive endocervical margins were followed up with both cervical smear and endocervical smear. RESULTS: The mean follow-up duration was 30.4 months. Ten patients were found to have persistent or recurrent disease. Five patients had second LLETZ and complete excision was achieved in 4 of them, one patient had cone biopsy and two had hysterectomy. One patient was found to have stage I a cervical cancer. CONCLUSION: A report of incomplete excision of CIN after LLETZ calls for follow-up with cytology and colposcopy and not aggressive retreatment.

Adult↗

PubMed1988

Wide excision of primary breast cancer: the incidence of residual carcinoma at the site of excision.

Fifty-one consecutive women with early breast cancer underwent wide excision and axillary clearance. After wide excision five biopsies were taken from the walls of the cavity. On histological examination tumour was present in the cavity biopsies in 13 cases (25%). The presence of ductal carcinoma in situ in the primary tumour was not associated with an increased number of positive cavity biopsies. In nine cases incomplete excision was due to separate foci of invasive or in situ carcinoma, in two cases tumour was contiguous with the primary carcinoma and in two, separate foci and contiguous disease both occurred. The high incidence of residual local tumour after wide excision of breast cancer demands the need for postoperative irradiation to the breast and frequent review.

Adult↗

PubMed1985

Brown recluse spider bites. A comparison of early surgical excision versus dapsone and delayed surgical excision.

In a prospective study, 31 patients with brown recluse spider bites were treated by either immediate surgical excision or with the leukocyte inhibitor, dapsone, followed by delayed surgical excision. Patients were matched for age, gender, and lesion size and were excluded if the typical history and physical findings were not present. In patients treated with immediate surgical excision (N = 14), delayed wound healing (N = 5) and objectional scarring (N = 7) were common complications. However, pretreatment treatment with dapsone reduced the incidence of wound complications (N = 1) and objectional scarring (N = 1) (p less than 0.05), while reducing the need for surgical excision (N = 1). There were no severe drug reactions due to dapsone, although one patient had persistent G.I. upset. Pretreatment with dapsone not only reduced surgical complications but also improved the outcome of patients bitten by the brown recluse spider.

Adolescent↗

PubMed1983

Isolation and properties of strains of Micrococcus (Deinococcus) radiodurans unable to excise ultraviolet light-induced pyrimidine dimers from DNA: evidence for two excision pathways.

A mutant of Deinococcus (formerly Micrococcus) radiodurans (strain 302, mutant in mtcA) sensitive to both the lethal effect of mitomycin C and the mutagenic effect of simple alkylating agents, but having wild-type resistance to UV light, was treated with the mutagen N-methyl-N'-nitro-N-nitrosoguanidine in an attempt to isolate strains deficient in the ability to excise UV-induced pyrimidine dimers. Three strains were isolated that were UV-sensitive, but had wild-type resistance to the lethal effect of methyl methanesulphonate and all were shown to be unable to excise pyrimidine dimers. The three strains UVS9, UVS25 and UVS78 had, in addition to the mutation in mtcA, mutations in loci designated uvsC, uvsD and uvsE, respectively. When the mutant mtcA gene was replaced by its wild-type allele in all three strains they became UV- and mitomycin C-resistant. On incubating the double mutants UVS9, UVS25 and UVS78 with wild-type DNA about 50% of the transformants selected for UV resistance were mitomycin C-sensitive and about 50% resistant depending on whether the mutant mtcA or the uvsC, D or E genes had been replaced by their wild-type alleles. Although strains mutant singly in uvsC, D or E were UV-resistant the rates of excision of pyrimidine dimers differed between them and was slower in all of them than in the wild-type and strain 302. The results indicate that wild-type D. radiodurans possesses two pathways for the excision of pyrimidine dimers and that mutational blocks in both must exist for the excisionless phenotype to be expressed.

DNA Repair↗

PubMed2002

[Experimental study on viscoelasticity of spinal lumbar vertebrae (T12-S1) by simulating the operation of excising intervertebral disc and planting bone on back route and the operation of excising intervertebral disc and inserting fusion cage].

According to the physiological characteristics of lumbar vertebrae in Chinese, we designed and made a lumbar vertebral fusion cage of titanium and then engaged in its biomechanical test. T12-S1 of lumbar vertebrae from 18 fresh dead bodies were used. We measured the stress relaxation and the creep effects of the normal group (T12-S1 of intact lumbar vertebrae), the control group 1(simulating operation of excising intervertebral disc and planting bone on the back route) and the control group 2(simulating operation of excising intervertebral disc and inserting fusion cage). The data and stress, strain-time curves under the condition of constant stress and strain were obtained. Regression analysis yielded the reduced stress relaxation and creep functions. Finally, we analyzed and discussed the effects of the operation of excising intervertebral disc and planting bone on the back route and the operation of excising intervertebral disc and inserting fusion cage on the stability of spine.

Elasticity↗

PubMedDate not supplied

Clinicopathologic predictors of incomplete excision after loop electrosurgical excision for cervical preneoplasia.

The aim of this study was to identify the factors affecting incomplete excision after the loop electrosurgical excision procedure (LEEP) for evaluation and treatment of cervical neoplasia. Patients with abnormal cervical cytology who underwent colposcopy and LEEP at Chiang Mai University Hospital between October 2004 and July 2005, were retrospectively evaluated. During the study period, 201 patients were eligible for analysis. All cone margin involvement was observed in 44% of the patients (95% CI, 37.3-51.4). Multivariate analysis revealed that invasive cancer on cytology (adjusted odds ratio [aOR] =3.05, 95% confidence interval [CI] =1.03 to 9.00; P=0.02), invasive cancer on LEEP histopathology (aOR=9.73, 95%CI =3.95 to 23.9; P<0.001), and a cone length of less than 10 mm (aOR =1.95, 95%CI =1.04 to 3.66; P =0.03) were significant predictors for any cone margin involvement. For endocervical margin involvement, postmenopausal status and a cone length of less than 10 mm were significant predictors of incomplete excision. In contrast to endocervical margin involvement, postmenopausal status was significantly associated with a decreased risk of ectocervical margin involvement. Invasive cancer on histopathology was a significant predictor of both ecto- and endocervical margin involvement. In conclusion, invasive cancer either on cytology or LEEP specimens and a cone length of less than 10 mm are significant predictors of incomplete excision.

Adult↗

PubMed1988

Wound healing strength: a comparative study of stainless steel blade excisions and contact Nd:YAG laser excisions.

A contact Nd:YAG laser with a sapphire tip was used to perform excisions in the eyelids of rabbits in order to compare the healing process and the wound strength to similar excisions made using a stainless steel blade. There was no bleeding from the excision made with the Nd:YAG laser; both groups showed similar wound strength and scars at the end of the experimental study.

Animals↗

PubMed2005

Modified lay-open (incision, curettage, partial lateral wall excision and marsupialization) versus total excision with primary closure in the treatment of chronic sacrococcygeal pilonidal sinus: a prospective, randomized clinical trial with a complete two-year follow-up.

BACKGROUND AND AIMS: The best surgical technique for treating pilonidal sinus disease is controversial. The aim of this study is to compare the modified lay-open technique with primary closure following excision with respect to operating time, healing time, time before return to work, morbidity rate, and recurrence rate. PATIENTS AND METHODS: After a pre-study power analysis, 142 patients with chronic sacrococcygeal pilonidal sinus were prospectively and randomly allocated, either to the modified lay-open group (Group A, n=73) or the primary closure group (Group B, n=69). In the former, incision, curettage, partial lateral wall excision, and marsupialization were performed. Single doses of cefazoline (1 g) and metronidazole (500 mg) were given intravenously 15 min before surgery to all patients. RESULTS: There were no differences with respect to gender, age, body mass index, and mean operating time between the groups. In Group A, healing failure and early bridging occurred in one patient each. In Group B, wound infection occurred in four patients, wound breakdown in three, one healing failure and hematoma in one patient each. Morbidity and recurrence rates were significantly lower in Group A (2.7 vs. 13%, P=0.028 and 1.4 vs. 17.4%, P<0.001 respectively). The median time before return to work in Group A was significantly shorter than in Group B (3 [range 2--8] vs. 21 [range 14--63] days, P<0.001). The median healing time in Group A was significantly longer than in Group B (7 [range 3--16] weeks vs. 2 [range 2--9] weeks; P<0.001). CONCLUSION: The results of the present study suggest that modified lay-open is superior to excision with primary closure for the surgical treatment of chronic sacrococcygeal pilonidal sinus with regard to morbidity and recurrence rates, and time before return to work, although healing time is longer.

Adolescent↗

PubMed1986

Lack of excision of 4HAQO adducts from DNA by cell extracts that excise pyrimidine dimers.

A substrate of DNA containing 4HAQO adducts, suitable for studies of excision repair, was prepared by reacting calf thymus DNA with [3H]monoacetyl-4HAQO. A crude HeLa cell extract was prepared by the method of Mortelmans et al (Proc. Natl. Acad. Sci. U.S.A. 73, 2757, 1976). The cell extract would specifically excise pyrimidine dimers from UV-irradiated DNA but would not release 4HAQO adducts in an acid soluble form. This result points to different initial steps in the excision repair process for these two forms of damage even though much of the repair mechanism is common to both.

4-Hydroxyaminoquinoline-1-oxide↗

PubMed1987

Excision-amplification of mitochondrial DNA during senescence in Podospora anserina. A potential role for an 11 base-pair consensus sequence in the excision process.

Three novel mitochondrial excision-amplification plasmids of Podospora anserina were identified and the excision-junction sites on the mitochondrial genome determined. All three plasmids were at least partially derived from a common region of the mitochondrial genome termed EcoRI-7 (E7). The entire 5651 base-pair sequence of E7 is presented. Included within this sequence are the E7-specific excision-junction sites of these novel plasmids, the localizations of nine tRNA genes, and the localization of a class I intron of the large rRNA mitochondrial gene. The E7 region contains the 3' portion of this large rRNA gene. Formation of these three novel plasmids as well as other previously described mitochondrial plasmids was found to be associated with the presence of an 11 base-pair consensus sequence, GGCGCAAGCTC, or its complementary sequence. A possible role for this consensus sequence and its complement in plasmid formation and the senescence process of Podospora is discussed. A possible role for the tRNA genes in plasmid formation is considered.

Ascomycota↗