bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving Outcomes for Diabetic Patients Undergoing Vascular Surgery
Authors: Najarian Joyce , Swavely Deborah , Wilson Eric , Merkle Larry , Wasser Thomas , Quinn Angela Hesener , Urffer Sallie , Young Mark
Published: March 2007

Improving management of inpatients with diabetes undergoing vascular surgery requires collaboration among many health care practitioners. This article describes a performance improvement project that implemented two evidence-based algorithmic order sets to guide perioperative glucose management for diabetic patients undergoing vascular procedures and utilized a certified diabetes educator (CDE) to educate health care practitioners. Results showed statistically and clinically significant reductions in infection and differences in mean blood glucose between pre- and postintervention groups, including a direct relationship between glucose control and the level of involvement of a CDE in patient care.
Stress and Diabetes: A Review of the Links
Authors: Lloyd Cathy , Smith Julie , Weinger Katie
Published: March 2007

Evidence suggests that stressful experiences might affect diabetes, in terms of both its onset and its exacerbation. In this article, the authors review some of this evidence and consider ways in which stress might affect diabetes, both through physiological mechanisms and via behavior. They also discuss the implications of this for clinical practice and care.
Diabetes Management in Correctional Institutions
Authors:   American Diabetes Association
Published: March 2007

In Brief This is a reprint of an American Diabetes Association position statement on diabetes management in correctional facilities. Originally approved in 1989, it was most recently revised in 2004. Reprinted with permission from Diabetes Care 28 (Suppl. 1):S53–S60,2005.
Managing the Care of Patients With Diabetes in the Home Care Setting
Authors: O'Reilly Caryl Ann
Published: March 2007

In Brief Patients are released from hospitals and rehabilitation centers earlier in the continuum of care than ever before. Individuals with diabetes, either as a primary diagnosis or a comorbid condition, are no exception to this trend. This, combined with an end to the fee-for-service payment structure, has challenged home care clinicians to find effective ways of transitioning these patients from an acute episode of illness to a return to the community. Recognizing the impact of diabetes as an independent risk factor is key to achieving favorable health outcomes.
Diabetes Care in an Urban Specialty Clinic
Authors: Ernst Kris
Published: March 2007

In Brief Interpersonal health communication can affect individuals'awareness, knowledge, attitudes, self-efficacy, skills, and commitment to behavior change. Personalizing and involving people in their own care facilitates sustained behavior change. Health communication cannot compensate for inadequate health care or inadequate access to health care services nor produce sustained change in complex health behaviors without some type of support network. Health care providers working with people who have limited resources and education sometimes make the erroneous assumption that these individuals cannot adequately comprehend self-care practice recommendations.
Gaseous Signaling: Nitric Oxide and Carbon Monoxide as Messenger Molecules
Authors: Chung Kenny K. K. , Dawson Valina L. , Dawson Ted M.
Published: March 2007

The concept of a gaseous molecule as a signaling messenger was unthinkable before 1980s. However, it is now well‐recognized that nitric oxide (NO) is an important signaling molecule in different organisms. Carbon monoxide coordinates together with NO to modulate signal transduction. First described as endothelium‐derived relaxing factor, NO controls a wide range of biological processes. The action of NO is mainly through its reaction with metal or cysteine residues on proteins. For example, the vessel dilation effect of NO is mediated through the activation of guanylate cyclase by the formation of iron nitroysl within the active site of the enzyme. Another more common signaling mechanism is
S
‐nitrosylation through the reaction of NO on cysteine residues of proteins. A number of proteins are modified by
S
‐nitrosylation and it is an important redox signaling mechanism for the control of a broad range of physiologic and cellular functions. The pathophysiological importance of this modification is demonstrated by recent studies showing that the imbalance o nitrosylation is correlated to various human diseases. Thus, the in‐depth understanding of how
S
‐nitrosylation can control different physiological and cellular processes will provide valuable information in the development of new therapeutic targets for different diseases in the future.
Psychopharmacology of Autism Spectrum Disorders
Authors: Martino Adriana Di , Dickstein Steven G. , Zuddas Alessandro , Castellanos F. Xavier
Published: March 2007

Pervasive developmental disorders (PDDs) and autistic disorder in particular are neurodevelopmental diseases characterized by qualitative impairments in social interaction and communication skills and by the presence of restricted and stereotyped behaviors, interests, and activities. The pathophysiological mechanisms underlying these three core symptom clusters are not yet fully understood, and currently there are no treatments which cure these core features of PDD. Psychosocial treatment modalities for individuals with PDD include special education, language therapy, and family support, each of which aims to improve global functioning and increase adaptability. Pharmacotherapy may play an essential role in augmenting an individual's ability to participate fully in these treatments, especially in individuals who have maladaptive behaviors and those with comorbid psychiatric disorders. Pharmacological strategies intend to reduce either the intensity of core symptoms of PDD or the interference of comorbid psychiatric disorders. Clinicians must judiciously use medications that treat the symptoms of comorbid disorders or the symptoms associated with the core triad of PDD. Most recently, in placebo‐controlled trials, risperidone and serotonim selective reuptake inhibitors (SSRIs) have been shown to reduce the restricted behaviors, interests, and activities of some individuals with PDD. In this chapter, we review current pharmacological studies on PDD. Specifically, we will highlight published studies of typical and atypical antipsychotics, serotonergic agents, mood stabilizers, stimulants, α‐2‐adrenergic medications, and others. General pharmacotherapy strategies to target symptom domains in PDD are then discussed.
Antiobesity Pharmacotherapy: Current Treatment Options and Future Perspectives
Authors: Shi Yuguang
Published: March 2007

This chapter provides a summary of historic perspectives and currently available pharmaceutical therapies for the treatment of obesity. An overview is provided on the pipeline of anti‐obesity drugs currently in development; with emphasis on the central mechanisms of these drug candidates. The obesity drug market has encountered frequent problems in the past with limited efficacy, toxicity, and strong resistance of the system to perturbation. These hurdles can be overcome in the future with progress in our understanding of the complicated and often redundant pathways that safeguards the energy metabolism for survival under both feast and famine conditions. To be ultimately successful, obesity treatments may require combination therapies that target both central and peripheral mechanisms as well as behavior modifications to achieve sustained weight loss effect.
A Route to Self‐Organized Honeycomb Microstructured Polystyrene Films and Their Chemical Characterization by ToF‐SIMS Imaging
Authors: Yunus S. , Delcorte A. , Poleunis C. , Bertrand P. , Bolognesi A. , Botta C.
Published: March 2007

A new type of polymer compound that allows the formation of highly ordered microstructured films by casting from a volatile solvent in the presence of humidity, and its characterization by ToF‐SIMS (time‐of‐flight secondary‐ion mass spectrometry) are presented. A honeycomb structure is obtained by activation of 2,2,6,6‐tetramethyl‐1‐piperidinyloxyl (TEMPO)‐terminated polystyrene (PS) with p‐toluenesulfonic acid (PTSA). The mechanism of this activation reaction, leading to a more polar PS termination, is deduced from simple experiments and supported by ToF‐SIMS characterization. Positive and negative ToF‐SIMS imaging allows different chemical regions correlating to the film morphology to be distinguished. This new, straightforward activation process, together with ToF‐SIMS chemical imaging, provides a better understanding of the phenomena underlying the formation of these films by directly linking the role of polar terminations to the microscale self‐organization. This new method, transposable to other organic acids, suggests interesting new perspectives in the field of self‐organized chemical and topographical patterning.
Topological analysis of citation networks to discover the future core articles
Authors: Shibata Naoki , Kajikawa Yuya , Matsushima Katsumori
Published: March 2007

In this article, we investigated the factors determining the capability of academic articles to be cited in the future using a topological analysis of citation networks. The basic idea is that articles that will have many citations were in a “similar” position topologically in the past. To validate this hypothesis, we investigated the correlation between future times cited and three measures of centrality: clustering centrality, closeness centrality, and betweenness centrality. We also analyzed the effect of aging as well as of self‐correlation of times cited. Case studies were performed in the two following recent representative innovations: Gallium Nitride and Complex Networks. The results suggest that times cited is the main factor in explaining the near future times cited, and betweenness centrality is correlated with the distant future times cited. The effect of topological position on the capability to be cited is influenced by the migrating phenomenon in which the activated center of research shifts from an existing domain to a new emerging domain.
Steric and electrostatic interactions govern nanofiltration of amino acids
Authors: Shim Yongki , Chellam Shankararaman
Published: March 2007

Crossflow nanofiltration experiments were performed to investigate the factors influencing the removal of amino acids by a commercially available polymeric thin‐film composite membrane. The removals of five monoprotic (Ala, Val, Leu, Gly, and Thr), one diprotic (Asp), and one dibasic (Arg) amino acids in a range of permeate fluxes, feed pH values, and ionic strengths were analyzed using a phenomenological model of membrane transport. At any given pH and ionic strength, reflection coefficients (rejection at asymptotically infinite flux) of monoprotic amino acids increased with molar radius demonstrating the role of steric interactions on their removal. Additionally, consistent with Donnan exclusion, higher reflection coefficients were obtained when the membrane and the amino acids both carried the same nature of charge (positive or negative). In other words, both co‐ion repulsion and molecular size determined amino acids removal. Importantly, the removal of effectively neutral amino acids were significantly higher than neutral sugars and alcohols of similar size demonstrating that even near their isoelectric point, zwitterionic characteristics preclude them from being considered as strictly neutral. Biotechnol. Bioeng. 2007;98; 451–461. © 2007 Wiley Periodicals, Inc.
Specific volume and adiabatic compressibility measurements of native and aggregated recombinant human interleukin‐1 receptor antagonist: Density differences enable pressure‐modulated refolding
Authors: Seefeldt Matthew B. , Crouch Chris , Kendrick Brent , Randolph Theodore W.
Published: March 2007

High hydrostatic pressures have been used to dissociate non‐native protein aggregates and foster refolding to the native conformation. In this study, partial specific volume and adiabatic compressibility measurements were used to examine the volumetric contributions to pressure‐modulated refolding. The thermodynamics of pressure‐modulated refolding from non‐native aggregates of recombinant human interleukin‐1 receptor antagonist (IL‐1ra) were determined by partial specific volume and adiabatic compressibility measurements. Aggregates of IL‐1ra formed at elevated temperatures (55°C) were found to be less dense than native IL‐1ra and refolded at 31°C under 1,500 bar pressure with a yield of 57%. Partial specific adiabatic compressibility measurements suggest that the formation of solvent‐free cavities within the interior of IL‐1ra aggregates cause the apparent increase in specific volume. Dense, pressure‐stable aggregates could be formed at 2,000 bar which could not be refolded with additional high pressure treatment, demonstrating that aggregate formation conditions and structure dictate pressure‐modulated refolding yields. Biotechnol. Bioeng. 2007;98; 476–485. © 2007 Wiley Periodicals, Inc.
High‐throughput screening of packed‐bed chromatography coupled with SELDI‐TOF MS analysis: monoclonal antibodies versus host cell protein
Authors: Wierling Pierre Schulze , Bogumil Ralf , Knieps‐Grünhagen Esther , Hubbuch Jürgen
Published: March 2007

A feasibility study to couple high throughput screening of packed bed chromatography with mass spectrometric detection by SELDI‐TOF MS is presented. As model system monoclonal antibodies (mAb) versus host cell protein (HCP) from an industrial cultivation was chosen. Packed bed chromatography was screened on a TECAN Evo Freedom 200 station using miniaturized chromatographic columns placed on a specially designed array carrier linked to a commercially available T‐Stack module. Gradient elution of the bound proteins was performed by applying a multiple step strategy. When analyzing selected HCP peaks as well as the detected antibody peaks throughout the chromatographic runs a direct correlation between applied and detected components was established. The sensitivity of conventional protein A chromatography was found to be lower than SELDI‐TOF MS analysis. During initial screening a shift in the elution pattern for one of the monoclonal antibodies detected with all four resins was identified to be a heterogeneity in the mAb glycosylation pattern. In addition, a detailed differentiation between various HCP fractions through out the chromatographic process using SELDI‐TOF analysis let to the detection of HCP components possibly adhering to the mAbs during chromatographic separations. Biotechnol. Bioeng. 2007;98; 440–450. © 2007 Wiley Periodicals, Inc.
The reversibility of postgastrectomy alkaline reflux gastritis by a Roux-en-Y loop
Authors: Lawson H H
Published: March 2007

Partial gastrectomies were carried out in 6 dogs. All developed stomal gastritis. Prevention of reflux by a Roux-en-Y loop allowed the mucosa to return to histological normality. These findings support the use of this procedure for the condition of postgastrectomy reflux gastritis in human subjects, and explain the need for a vagotomy at the same operation.
Tumoral calcinosis
Authors: Berg Derek
Published: March 2007

An extreme case of tumoral calcinosis is presented. This condition is common in the highland natives of New Guinea and is commonly referred to as “hip stones”. The pathogenesis, clinical findings, and treatment are discussed and the relevant literature is reviewed.
Depression of immune responsiveness in breast and large-bowel tumours as measured by heterophile antibody activity
Authors: Thomas Gareth G , Fox Miles
Published: March 2007

Decrease in heterophile antibody activity to cow, pig, and sheep red blood-cells was found in groups of patients with large-bowel and breast tumours irrespective of the extent and spread of the tumour or the length of known history. The significance of these observations is discussed in the light of known cancer-surveillance mechanisms. The findings may reflect decreased host immunological resistance to these tumours even in the early stage of their development, and the measurement of heterophile antibody activity may provide a useful and uncomplicated screening test.
Mucous extravasation theory as a cause of plunging ranulas
Authors: Roediger W E W , Lloyd P , Lawson H H
Published: March 2007

The theory that plunging ranulas arise as a result of mucous extravasation from the sublingual salivary gland is investigated.

Biochemical, histochemical, and histological results support the view that plunging ranulas are salivary gland extravasations, which most probably arise from the sublingual gland.

Two cases of plunging ranula were treated by primary excision of the sublingual gland through the mouth.

The successful results support the view that the extravasating source is the sublingual gland.
Inactivation of pentagastrin by the liver
Authors: Wyllie J H , Stagg B H , Temperley J M
Published: March 2007

Pentagastrin is deamidated to pentagastrin acid by high-speed supernatant preparations obtained from rat, dog and human liver. The product, which contains all the amino acids in the parent substance, is biologically inactive. Experiments with pentagastrin labelled with carbon 14 indicate that this reaction also occurs in intact dogs.
Stress—a significant factor in venous thrombosis?
Authors: Britton B J , Hawkey Christine , Wood W G , Peele Muriel
Published: March 2007

The changes in blood coagulation, fibrinolysis and sympatho–adrenal activity have been studied in 30 patients before, during and after elective surgery. The significance of adrenaline in the causation of the changes in coagulation and fibrinolysis has been investigated in three experimental models, using in man the adrenergic stimulus produced by exercise and in sheep the adrenergic stimulus produced by haemorrhage.

During exercise in man the coagulation change closely correlated with the adrenaline response but fibrinolysis did not. Furthermore, the coagulation response was modified by beta adrenergic blockade with propranolol, oxprenolol, pindolol and butoxamine but not practolol, suggesting that this response was mediated by the beta−2 adrenergic receptor. Fibrinolysis was not inhibited by these drugs.

Substantiation and development of these findings could lead to a new approach to the problem of venous thrombosis by inhibiting the coagulation changes that occur with surgery, without altering the fibrinolytic response.
Long term review of the results of rubber band ligation of haemorrhoids
Authors: Steinberg David M , Liegois H , Alexander-Williams J
Published: March 2007

A long term assessment (mean 4.8 years) of the value of rubber band ligation treatment for haemorrhoids has been obtained by a questionnaire answered by 125 of 147 patients. Eighty-nine per cent of patients were cured or satisfied with the results of treatment, although complete absence of symptoms was only obtained in 44 per cent. Further conservative treatment (rubber band ligation or manual dilatation) was required in 12 per cent and only 3 (2 per cent) have had a haemor-rhoidectomy. Similar results were obtained for patients with the additional symptoms of pain and irritation, the presence of large skin tags and for the majority of third degree piles.
Gynaecomastia
Authors: Hamer D B
Published: March 2007

There are two different types of male breast enlargement—gynaecomastia and mammaplasia. A series of 53 consecutive patients with one of these conditions is presented. In the younger age group treatment has usually been conservative, surgery only being advocated when the diagnosis was in doubt or for cosmetic reasons. In the older age group the diagnosis must be confirmed histologically. The incidence of underlying conditions is much higher in this series than in any previously reported.
The construction of a skin-lined hemithorax in pigs
Authors: Wosornu Lade
Published: March 2007

The feasibility of creating a skin-lined hemithorax was tested in 6 pigs. All the pigs survived intrapleural skin grafting, and within 3 weeks they doubled their mean initial weight from 16·0 ± 1·6 kg to 32·4 ± 2s·6 kg. In 4 (out of 4) pigs the skin-lined cavity was opened successfully to the exterior; it had reproduced closely the contour of the hemithorax. It is concluded that it is feasible to construct a skin-lined hemithorax with a mean volume of 276·0 ± 19·6 ml in pigs, whose mean body weight was 37·5 ± 2·5 kg. This confirms earlier work in the rat.
Caecal rupture due to colonic ileus
Authors: Gierson Eugene D , Storm F Kristian , Shaw William , Coyne Susan K
Published: March 2007

Caecal rupture due to colonic ileus is rare and has a mortality rate of 43 per cent. Three new cases are presented and the 18 previously reported cases are reviewed. The disease has always occurred in association with another illness, has usually afflicted patients over the age of 55 and has only resulted when the caecum was at least 9 cm in diameter. The technique of ‘blowhole’ caecostomy, a method for decompressing the distended caecum, is described.
Bilateral extradural haematomas
Authors: Subrahmanian M V , Rajendraprasad G B , Rao B Dibbala
Published: March 2007

Eleven cases of bilateral extradural haematomas were encountered in a total of 49 cases of extradural haematoma during a period of 4 years among 1000 consecutive cases of acute head injury. Assault was held responsible for 60 per cent of the total head injuries. Most of the patients were seen late; 8 were already unconscious and 5 had dilated fixed pupils. All 11 patients died, 4 soon after admission. Nine cases were found to have associated brain damage at autopsy. In 2 cases bilateral extradural haematomas with compression of the brain were the only intracranial abnormalities. In 4 cases a clot was missed on conventional exploration.
The surgical management of ingrowing toenail
Authors: Murray W R , Bedi B S
Published: March 2007

A retrospective review has been carried out on 200 randomly selected patients with ingrowing toenail in order to assess the surgical management and its results. There was a predominance of males between the ages of 11 and 30 with an ingrowing toenail. Despite the high recurrence rate following simple avulsion of the toenail, its place in the initial management of the condition is justified. As regards more-definitive surgery, total proximal nail bed ablation was found to give the best results. Sepsis at the time of operation neither increased the recurrence rate nor caused severe postoperative sepsis.

A surgical management policy for the treatment of ingrowing toenail is outlined and discussed.
The effect of raising the concentration of potassium in the blood or intestinal lumen on the transport of potassium in the dog intestine
Authors: Hardy-Smith Anne , Shields R
Published: March 2007

The rates of transport of potassium, sodium and water across the intestinal mucosa of Thiry-Vella fistulas of colon and ileum, were studied in dogs in two experimental situations; (1) following intravenous infusion of potassium (15 mEq) over 30 minutes and (2) during variations in the intraluminal concentration of potassium in the range 0·8–16·0 mEq/l.

Following intravenous infusion of potassium the rates of potassium secretion into the colon were usually increased; the rates of sodium and water absorption were either unchanged or decreased. The unidirectional rate of movement of potassium into the lumen increased as the concentration difference across the mucosa increased; the movement of potassium in the opposite direction remained relatively constant. The unidirectional movement of sodium and water into the lumen of the colon also increased but to a lesser extent. The effect on potassium transport in the ileum was not so marked.

With increase in the intraluminal concentration of potassium there was a decrease in the rate of net potassium secretion in both colon and ileum. The rates of net absorption of sodium and water were not significantly altered. Unidirectional potassium movement into the body increased in all the ileal fistulas.
Orthotopic liver transplantation: An experimental study on the prevention of infections with Gram-negative organisms
Authors: Schalm S W , Popescu D T , Van Der Waay D , Krom R A F , Hendriks W D H , Terpstra J L , Jerusalem C
Published: March 2007

Infection with Gram-negative bacteria is frequently the cause of death in human liver transplantation. In experimental liver transplantation in mongrel dogs we detected Gram-negative septicaemia in 73 per cent of our first 15 cases; maximal survival was 26 days.

In a second series of 27 orthotopic liver transplantations in tissue-typed littermate dogs and littermate pigs the standard surgical technique and aftercare were changed with regard to four factors: an end-to-end common bile duct anastomosis was made instead of a gallbladder to duodenum anastomosis; the continuous postoperative bacteriostatic antibiotic therapy was changed to a single 2-day course of bactericidal antibiotics; preoperative selective bowel decontamination combined with postoperative protective isolation was introduced; the dosage of azathioprine used for immuno-suppression was reduced.

Infectious complications decreased markedly to 8 per cent, with survival beyond 1 year in 37 per cent of the animals. Therefore under experimental conditions Gram-negative septicaemia can be prevented in liver transplantation; whether all the factors cited above are important in this regard remains to be determined.
Surgical treatment of thyrotoxicosis: Results of 272 operations with special reference to preoperative treatment with anti-thyroid drugs and L-thyroxine
Authors: Heimann Peter , Martinson Jan
Published: March 2007

From 1959 to 1970, 272 operations for thyrotoxicosis were performed. Most of the patients received antithyroid drugs and thyroid hormones preoperatively. The patients were continuously followed up. The primary results with low morbidity and no mortality as well as the long term results with a low rate of recurrence and a relatively high incidence of thyroid substitution are discussed. A safe and effective programme for surgical treatment of thyrotoxicosis is described. Anti-thyroid drugs and thyroid hormones should be administered as the method of choice in preparing these patients for surgery.
Gastric acid secretion following renal transplantation
Authors: Canavan J S F , Briggs J D , Bell P R F
Published: March 2007

Gastric acid secretion studies were performed in 10 patients on regular dialysis and again following transplantation. While on dialysis, the acid output was high, with mean peak values after pentagastrin of 37·2 mEq/h in males and 26·3 mEq/h in females. These compared with values in normal subjects of 21·6 mEq/h in males and 12·3 mEq/h in females.

Following transplantation continuous steroid therapy was given. Repeat gastric acid secretion studies showed no significant change, with values of 37·1 mEq/h in males and 24·6 mEq/h in females. The high incidence of gastro-intestinal haemorrhage and perforation following transplantation is probably due mainly to steroid therapy, but the ulcerogenic effect of steroids would not seem to be mediated by increased gastric acid secretion.
Symptomatic hypoglycaemia, liver glycogen depletion and cirrhosis following jejuno-ileal bypass for gross obesity
Authors: Wilcox R G
Published: March 2007

A new complication following jejuno-ileal bypass for gross obesity is described. The patient suffered from hypoglycaemic attacks which were associated with total depletion of liver glycogen together with a progressive micronodular cirrhosis. Increased dietary protein and calorie content relieved her symptoms, restored liver glycogen but had no effect on the development of the cirrhosis over the next 12 months.
Splenectomy in childhood: A review in England and Wales, 1960–4
Authors: Walker William
Published: March 2007

An investigation was carried out of' 821 children under the age of 16 years who were subjected to splenectomy in England and Wales during the 5 years 1 960-4. A postal follow-up study provided satisfactory information concerning 96 per cent of these. Excluding early postoperative deaths, practically all the cases were followed up for 2 years or more and 70 per cent for more than 5 years.

Forty-nine children had died since operation. 32, from underlying disease and 17 from infection.

Fifty children (6 per cent of the survivors) had major infections considered to be due to the primary condition aggravated by splenectomy. Seven died, all from the primary disease.

Sixteen children (2 per cent) developed septicaemic illnesses and 10 died. In these the effect of' splenectomy was considered to be the primary factor. Fourteen of the 16 had been operated on in the first 4 years of life.

Practically all the serious infections occurred within 3 years of operation and pneumococcus was the organism most frequently implicated.

Ninety per cent of the splenectomies in childhood were performed, for accidental injury, congenital haemolytic anaemia or idiopathic thrombocytopenic purpura. Accidental injury to the spleen rarely occurs in very young children, and in the other two conditions splenectomy can usually be safely delayed until over the age of 3 years. If this is achieved it is estimated that the unavoidable risk of dangerous infection is less than I per cent.

One in 10 splenectomies will be curried out for severe und potentially fatal illnesses and in this situation the risk from operation is of secondary importance. Many such conditions carry increased susceptibility to infection per se or because corticosteroids or other immune suppressants are used in their management.

It is recommended that splenectomy be avoided if at all possible during the early years of life. It is further recommended that prophylactic penicillin be administered for 3 years following operation whatever its indication and whatever the age of the patient. If the underlying condition itself curries risk of infection more active and more prolonged prophylaxis may he indicated.
Long survival after renal transplantation in man
Authors: Woodruff M F A , Nolan B , Anderton J L , Abouna G M , Morton J B , Jenkins A McL
Published: March 2007

The indications for transplantation, complications, management and results in 127 consecutive patients who had received renal transplants between October 1960 and December 1974 are presented, In 2 cases the donor was an identical twin, in 22 a living relative other than a twin, in 2 an unrelated individual in whom nephrectomy was performed for therapeutic reasons and in 101 a cadaver. At the end of the period under review there were 37 patients alive with grafts which had functioned for 6 months or more; of these, 28 had survived for more than 2 years, 13 for more than 5 years, 6 for more than 8 years and 2 for more than 12 years. Thirty-four patients were employed or doing routine housework or receiving full-time education. One patient fathered a child 4 years after transplantation; another gave birth to a healthy infant 3 years afrer transplantation.
Temporal lobe swelling: A common treatable complication of head injury
Authors: Maurice-Williams R S
Published: March 2007

Four cases are described of focal contusion and swelling of the temporal lobe after head injury, giving rise to acute cerebral compression. The clinical features, pathology and treatment of this condition are discussed. It is suggested that this occurrence may be a common treatable complication of closed head injuries which may easily be overlooked, with fatal results, if exploratory cranial surgery is undertaken without preliminary cerebral angiography.
Paraganglionomas in the neck
Authors: Sundaram M , Cope V
Published: March 2007

Three paraganglionomas in the neck investigated by angiography are presented. The value of angiogrphy in these tumours is stressed, and one case showed distinctive radiological features hitherto undescribed which probably constitute a basis for the definitive preoperative diagnosis of malignant lesions.
Grafting of the major veins: The value of anti-thrombotic drugs to maintain patency
Authors: Thomas J M Price , Glynn M F X , Rickwood A M K , Cough M H
Published: March 2007

The value of anti-thrombotic drugs to maintain the patency of grafts into the central venous system is described. The infrarenal portion of the inferior vena cava in mongrel dogs was used as the test bed. Two autologous graft materials were used: first, the tissue reaction to implanted silicone rubber, and, secondly, free peritoneum. Phenylbutazone was the drug administered to inhibit the aggregation of platelets at the blood-graft interface. The low patency rate of the control group of animals conformed with previous experimental studies. The high patency of grafts in the phenylbutazone-treated animals (up to 92 per cent) was predictable after studying the in vitro behaviour of their platelets pre-operatively.
Fistula formation complicating pancreatic abscess
Authors: Henderson J M , Macdonald J A E
Published: March 2007

Internal fistula formation is a rare Complication of pancreatic abscess of pseudocyst; a fairly extensive search of the literature has produced only 47 cases. Common factors in the aetiology, presentation and management are discussed, and a further case is reported which demonstrates many features of this unusual condition.
Treatment of thyroid cancer in 293 patients
Authors: Staunton M D , Greening W P
Published: March 2007

Two hundred and ninety-three patients with thyroid cancer were treated at The Royal Marsden Hospital, London, between 1931 and 1963. Thirty-six per cent of the tumours were papillary, 21 per cent follicular, 1 per cent medullary and 42 per cent anaplastic. Surgery combined with radiotherapy formed the commonest treatment régime. Thirty-six per cent of the patients with papillary carcinoma survived for 20 years, 20 per cent with follicular tumour and 4 per cent with anaplastic carcinoma. The present series indicates that treatment influences the survival time, confirms the prognostic value of histology and age and shows that papillary node metastases do not prejudice survival.
Typhoid ileal perforations: Why such mortalities?
Authors: Archampong E Q
Published: March 2007

The average mortality of 25 per cent in typhoid perforations of the ileum treated operatively could be reduced, because only half of the cases die of the lethal complications of myocarditis and toxaemia. The results of the present study show important differences between the preoperative fluid and electrolyte therapy of survivors nnd non-survivors as well as differences in the urinary output per hour. The perforation-operation interval as well as duration of the illness also have prognostic significance. The problem of enteric fever must ultimately be solved by preventive measures, but the results of this review indicate that attention to these factors could halve the present mortality.
Intermittent non-sterile self-catheterization
Authors: Whitfield H N , Mayo M E
Published: March 2007

Fourteen patients suffering from voiding disorders of various aetiologies were taught the art of intermittent self-catheterization. The rationale of this form of treatment is discussed and it is suggested that this régime may play a useful role in the management of patients who are not amenable to surgery or other forms of treatment.
The treatment of mixed parotid tumours by enucleation and radiotherapy
Authors: McEvedy Brian V , Ross W M
Published: March 2007

A series of mixed parotid tumours treated by simple enucleation and radiotherapy between 1962 and 1968 is discussed. There were 73 primary and 8 recurrent cases. Only 2 small recurrences occurred in the 73 primary cases, although 4 other patients were lost to follow-up after 7 years or more. In the 8 recurrent cases, 7 had been treated elsewhere by enucleation alone, thus confirming the opinion that this operation is frequently unsuccessful. Treatment was by further local excision and radiotherapy and no recurrences have occurred.

The view is therefore expressed that simple enucleation and radiotherapy is the treatment of choice in all primary mixed parotid tumours.
Thyroidectomy for non-familial medullary carcinoma
Authors: Roediger W E W
Published: March 2007

Two cases of non-familial medullary carcinoma of the thyroid which had thyroid tissue remaining after initial thyroidectomy were shown to contain residual, intra-glandular carcinoma at reoperation. This observation, the distribution of C cells in the normal thyroid gland and the lymph node spread of this carcinoma have led to the proposal of a bilateral 90 per cent upper pole thyroidectomy including the superior parathyroids for cases of non-familial medullary carcinoma. This operation removes all the C-cell-bearing area and leaves a small thyroid remnant at the lower pole for preservation of the inferior parathyroid glands. The operation is discussed with reference to these factors.
The clinical significance of venous thrombosis of the calf
Authors: Doouss T W
Published: March 2007

A total of 379 general surgical and hip replacement patients were studied with the radioactive fibrinogen uptake test and the Doppler ultrasound flow detector to determine the incidence and natural history of postoperative deep vein thrombosis (DVT) in their lower limbs. The overall incidence of D VT was 33 per cent, but clinical follow-up indicated that the great majority of these patients suffered no ill effects. It is concluded that thrombosis diagnosed by the radioactive fibrinogen uptake test is of very limited clinical significance and that the technique cannot be recommended as a screening test for DVT.
A controlled trial of intraperitoneal noxytiolin in perforated appendicitis
Authors: Gurry J F , King D W , Rutter K P , Brooke B N
Published: March 2007

A controlled trial of intraperitoneal noxytiolin (Noxiflex) solution in patients with peritonitis due to perforafed appendicitis is reported. No significant difference was found in the incidence of complications between the treated and a control group, raising doubts as to whether this substance is of value when used intraperitoneally in peritonitis.
Impedance plethysmography: Evaluation of a simplified system of electrodes for the measurement of blood flow in the lower limb
Authors: Schraibman I G , Mott D , Naylor G P , Charlesworth D
Published: March 2007

Venous occlusion plethysmography was used to measure the flow of blood into the lower limbs of 30 normal volunteers. An impedance plethysmograph, using disposable point electrodes, was compared with a mercury in Silastic strain gauge plethysmograph in 20 subjects. The effect of changes in the configuration of the point electrodes was studied in 10 subjects. Impedance plethysmography was shown to be reproducible, and one particular configuration of point electrodes was shown to be superior to the others.
An experimental evaluation of the types of material used for bile duct drainage tubes
Authors: Apalakis Achilles
Published: March 2007

A comparison has been carried out of the properties of latex, silicone, red rubber and polyvinyl chloride (PVC) T tubes draining the common bile duct in dogs. The tubes remained in the animals for 15–98 days. Bile cultures, liver function tests, cholangiograms and the histology of the common bile ducts were studied, and the changes in the physical properties of tubes implanted in the experimental animals, and of those after 1 month's incubation in human bile, were assessed. The elasticity of the tubes was also measured and the tissue reaction around them observed. Finally, the tissue reaction following implantation in mice of tubes which had been incubated in human bile for 1 month was investigated, and compared with that when new tubes were used.

Polyvinyl chloride tubes caused the least reaction in both the common bile duct and the peritoneal cavity. However, the lack of tissue tract formation around them, owing to their inertness, and their rapid development of rigidity make them unsuitable for use in biliary surgery. Red rubber tubes were found to be the most irritant. While silicone tubes proved to have desirable physical properties compared with latex tubes, they did, however, disintegrate easily with improper handling on suturing and were slow to produce a satisfactory tract, the latter fact suggesting that they would be unsuitable for short ferm biliary drainage. It appears that the latex tube is the tube of choice for drainage periods of up to 3 months, while silicone tubes are preferable when intubation for longer periods is necessary. Red rubber tubes may be the alternative for routine short term drainage if a latex tube is not available.
Double intussusception of the small bowel through a patent vitello-intestinal duct
Authors: Mustafa R
Published: March 2007

A case of double intussusception through n patent vitello-intestinal duct is reported. The rarity of this condition is the reason for this short report.
An instrumental method of performing Lord's procedure for haemorrhoids
Authors: Taylor T V
Published: March 2007

An instrument has been designed for carrying out Lord's procedure in the treatment of haemorrhoids. This permits standardization of the procedure with less likelihood of mucosal trauma. The inflatable dilator is covered by a disposable plastic cover. The efficacy of the instrument has been established.
A report on missile injuries in Cyprus 1974
Authors: Malpass C P , Winter J S
Published: March 2007

This paper details the experiences of the Princess Mary's Royal Air Force Hospital, Akrotiri (TPMH), during the last 6 months of 1974. TPMH was at that time a small hospital (120 beds) with a clinical staff of 17 situated in the south of Cyprus (Fig. 1).

The series comprises 71 patients injured by bullets, shrapnel, bomb-blasts or mines, drawn from British personnel, United Nations Forces and the local Cypriot military and civilian population, resulting from the coup d'état of 15 July 1974 and the subsequent Turkish invasion and air attacks.

The casualties were often severely wounded beyond the capabilities of the local hospitals. They were mostly admitted during a 2-week period, but many required multiple operations extending over the next 3 or 4 months, and altogether 119 operations were carried out on 41 patients at TPMH.

The organization of the limited resources of the medical, nursing and supporting staff is outlined.

The correct treatment of missile wounds is emphasized. Resuscitation, wound excision, splintage and delayed suture or grafting are essential. Minimal morbidity and mortality are gained by a practised approach to the compounded results of violence.
Perfusion in the experimental preservation of the rat heart
Authors: Agrawal L S , Rosenberg I L , Giles G R
Published: March 2007

Rat hearts have been preserved for 24 hours using four different preservation solutions. The results suggest that the best preservation fluid is Tyrode's solution with Ficoll 5 per cent. A comparison of simple cooling of the heart and perfusion, either continuous or intermittent, has shown that intermittent perfusion of the heart for 2 minutes every 6 hours gives the highest rate of 24-how preservation.
A technique for rapid harvesting of cadaveric renal and pancreatic grafts after circulatory arrest
Authors: Björkén C , Lundgren G , Ringdén O , Groth C G
Published: March 2007

In several countries, organs for transplantation cannot be removed from cadaver donors until cardiac arrest has occurred. A technique is described for removal of the kidneys and pancreas in which the whole abdominal contents are freed and reflected so that the retroperi-toneal organs lie uppermost. The aorta is opened longitudinally and the relevant arteries are cannulated via their orifices. Cold per fusion of the three organs can usually be initiated 5–15 minutes after cardiac arrest and significant ischaemia is avoided. The full length of the vascular pedicles can be preserved and the dissection of the retroperitoneal organs is greatly facilitated.
A controlled trial of glucagon in experimental pancreatitis
Authors: Waterworth M W , Barbezat G O , Hickman Rosemary , Terblanche John
Published: March 2007

This study was designed to assess the value of glucagon infusion in pigs with experimental pancreatitis. The condition was induced by injection of bile into the pancreatic duct directly after intravenous injection of secref in. Macroscopic haemorrhagic panereatitis ensued immediately, and was accompanied by a rise in the serum amylase of five to ten times.

An experimental group of 15 pigs was given glucagon by continuous infusion for 18 hours beginning 18 hours after induction of pancreatitis. A control group was given intravenous saline.

Fourteen of the 15 treated animals survived for 1 week and 3 died within 2 weeks, after which the remaining animals were sacrificed. Ten of the 15 controls died within the first week, Serum amylase levels in both groups began to decline when infusion was commenced, but levels in the treated group were significantly lower than in the controls.

Autopsy showed prominent peripancreatic granulation tissue in the treated animals, a significant incidence of pericarditis in both groups and pancreatic pseudo-cysts in 3 controls and 1 treated animal.

These results suggest that glucagon effectively reduced the mortality in pigs with experimental pancreatitis and that a controlled clinical trial of treatment is justified.
Antibiotics in biliary surgery
Authors: Gunn A A
Published: March 2007

Infection is the major cause of morbidity following biliary surgery and it has been shown that the patients with infected bile can be detected preoperatively. This paper presents the results of a controlled trial comparing patients expected to have infected bile who received surgical treatment with and without antibiotic therapy. The results showed a reduction in the incidence and severity of complications in the treated group.
The results of surgical treatment for carcinoma of the rectum at St Mark's Hospital from 1948 to 1972
Authors: Lockhart-Mummery H E , Ritchie Jean K , Hawley P R
Published: March 2007

The surgical treatment of 3163 patients seen at St Mark's Hospital with a single adenocarcinoma of the rectum in the years 1948–72 is described and the results analysed.

In 2948 patients (93·2 per cent) the primary tumour was removed. The operative mortality fell from 7·0 per cent in the years 1948–52 to 2·1 per cent in 1968–72. The proportion of restorative operations has risen steadily over the years to a level of 41·1 per cent in the years 1968–72.

There were 2410 operation survivors in the years 1948–67, The crude 5-year survival rate in the whole group was 47·1 per cent (corrected figure 56·7 per cent), and 56·6 per cent (corrected figure 68·4 per cent) for the 1931 survivors of radical operations.

Comparison of results for patients surviving radical synchronous combined excision and radical anterior resection shows a significant difference in the two groups: in the former the crude 5-year survival rate was 52·7 per cent (corrected figure 63·8 per cent), and in the latter group the respective figures were 66·7 and 79·4 per cent. A higher proportion of Dukes' A and B cases and of low grade tumours are shown as the pathological background to the more favourable prognosis for patients surviving radical anterior resection.
Duodenoscopic papillotomy and gallstone removal
Authors: Cotton P B , Chapman M , Whiteside C G , Le Quesne L P
Published: March 2007

Using an experimental insulated duodenoscope and a diathermy wire, papillotomy has been performed on 10 patients under diazepam sedation. Seven patients had common bile duct stones (6 following cholecystectomy) and 3 had papillary stenosis. Nine of the patients had severe medical or surgical contraindications to further operative treatment.

Papillotomy was successful in all patients, with no significant bleeding or other complications. Repeat endoscopy 6–14 days after papillotomy demonstrated a healed biliary orifice of 7–10 mm diameter. Stones had already passed in 3 of the 7 patients; in 2 others, stones were extracted using balloon catheters or Dormia type baskets. Two larger stones could not be removed; in one of these patients the stone and basket became impacted at the papilla and had to be removed surgically 2 days later.

Endoscopic papillotomy is an acceptable alternative to surgery in high risk patients, particularly in the treatment of retained common bile duct stones. If long term results prove satisfactory, the technique will have wider application.