bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of the new interpretation of the insulin test in predicting duodenal ulcer relapse after treatment with cimetidine
Authors: Maybury N Keith , Carr-Locke David L 
Published: March 2007

Abstract
Twenty-one patients with duodenal ulcer were treated with cimetidine. After 2 weeks they were submitted to an insulin test and the results were compared with a range of secretion previously established in untreated duodenal ulcer patients (1). The secretion of 13 patients fell within this range and so they were predicted to have a high risk of relapse. The patients whose secretion was below the range had a predicted low risk of relapse. After 4 weeks treatment repeat endoscopy showed that 4 ulcers had failed to heal. The secretion of 3 of the patients was within the range of the high risk group. The remaining 17 patients were followed up (range 20–23 months): 9 relapsed and 8 remained symptom-free. Eight of the 9 were in the high risk group and 6 of the 8 symptom-free patients were in the low risk group. In all, 11 out of 13 were correctly predicted in the high risk group and 6 out of 8 in the low risk group.
The performance of the insulin test in predicting liability to relapse following cimetidine treatment was significant (P = 0·0225).
The influence of ischaemia on the biliary tract
Authors: McMaster Paul , Walton Robert M , White Derek G D , Medd Richard K , Syrakos Theodore P 
Published: March 2007

Abstract
Damage of the biliary tract at the end of a period of hepatic preservation prior to liver transplantation has been observed in man. This damage may be important in the development of early biliary complications.
A model of hepatic biliary ischaemia in the pig has been developed which permits comparison between the influences of warm and cold ischaemic damage on the biliary tract. The major damage to the biliary tract in the pig in this model appears to occur after prolonged cold preservation.
A controlled trial of naftidrofuryl (Praxilene) in the treatment of intermittent claudication
Authors: Clyne C A C , Galland R B , Fox M J , Gustave R , Jantet G H , Jamieson C W 
Published: March 2007

Abstract
We present the results of a double-blind trial of naftidrofuryl (Praxilene) in the treatment of intermittent claudication. One hundred and twenty-eight patients were subjected to a standard walking test 3 and 6 months after treatment. There was no significant objective improvement attributable to the drug. Although both groups significantly increased their walking time to the onset of pain, those patients over 60 years old taking naftidrofuryl showed a significant improvement over their pretreatment walking times to onset of pain, whereas their controls did not.
Retardation of wound healing by procaine
Authors: Morris Tom , Appleby Rachel 
Published: March 2007

Summary
Lignocaine has previously been shown to retard wound healing; the retardation is directly related to the concentration of the drug used and is enhanced by the addition of adrenaline. The study described in this paper aimed to determine whether procaine has a similar effect and, if so, whether the effect is enhanced by adrenaline. We measured the effect of sterile water alone and of procaine in various concentrations on the tensile strength of skin wounds in rats, 5 and 7 days after operation. At 5 days sterile water had produced a significant retardation of wound healing. All concentrations of procaine produced significant retardation of healing at 5 days and adrenaline enhanced this effect. By 7 days the effect was greatly diminished and only those rats injected with 2 per cent procaine with adrenaline had significantly weaker wounds. The study suggests that 2 per cent procaine with adrenaline is better avoided and even when lower concentrations are used sutures should be retained for 7 days.
Percutaneous catheter drainage of liver abscess: An alternative to open drainage?
Authors: Kraulis J E , Bird B L , Colapinto N D 
Published: March 2007

Summary
Percutaneous catheter drainage is still a new concept. Only 4 cases have been reported thus far and this paper reports 2 further cases. The technique of percutaneous catheterization of a liver abscess under CAT scan control is described, and the management of the catheter by a closed irrigation system is set out. Unless there is another compelling reason to do a laparotomy, we feel that this procedure is well worth a trial in view of the high mortality still associated with open drainage. Further experience may well prove percutaneous catheter drainage to be the procedure of choice for liver abscess.
Diagnosis of intestinal duplication by 99Tcm-pertechnetate scanning
Authors: Waterston Tony , Lyall M H , Longrigg Neil , Wisbey M L 
Published: March 2007

Summary
A case is described of a 19-month-old boy who presented with melaena. Intestinal duplication was diagnosed by 99Tcm-pertechnetate scanning and was confirmed at operation 2 years later, when the child was admitted with intestinal perforation.
The technique is a reliable, non-invasive method for diagnosing ectopic gastric mucosa and is recommended in all cases of unexplained rectal bleeding in children.
The appearance of endotoxin following urethral instrumentation
Authors: Sim A J W , McCartney A Christine 
Published: March 2007

Summary
The Limulus amoebocyte lysate test was used to detect the presence of endotoxin in the venous blood of 10 patients following urethral instrumentation. The test was negative in all patients before instrumentation, became positive in 9 immediately after instrumentation and in 1 30 min after instrumentation. In 6 patients endotoxin reappeared between 1.5 h and 4.5 h after instrumentation. All blood samples, cultured aerobically and anaerobically, were sterile. Escherichia coli were cultured from one midstream specimen of urine and from one urethral swab in the same patient taken before instrumentation. There were no significant changes in either pulse rate or axillary temperature following instrumentation.
The natural history of malignant thyroid lymphomas
Authors: Grimley R P , Oates G D 
Published: March 2007

Summary
Twelve patients with malignant thyroid lymphomas seen over a 12-year period were reviewed. Two of these patients developed intra-abdominal lymphoma and a third, adult coeliac disease. Treatment by radiotherapy and thyroxine was effective, with thyroid excision mainly reserved for obstructing lesions. Prognosis was not affected by local metastases. A plea is made for open thyroid biopsy and accurate clinical staging of patients with this disease.
Serum lipids and high density lipoprotein cholesterol in peripheral vascular disease
Authors: Trayner M , Mannarino E , Clyne C A C , Thompson G R 
Published: March 2007

Summary
Serum lipids and high density lipoprotein (HDL) cholesterol concentrations were measured in 32 patients with peripheral vascular disease (PVD) and 38 control subjects. Hypertriglyceridaemia (&gt;1·8 mmol/l) was significantly more common in PVD patients of both sexes than among controls but mean serum triglyceride levels were significantly higher only among males. Hypercholesterolaemia (&gt;7 mmol/l) was not more common in PVD patients nor did mean serum total cholesterol or HDL cholesterol levels differ significantly from control subjects. The HDL ratio, however, was significantly reduced in both males and females with PVD. These results suggest that expressing the amount of cholesterol carried in HDL in relative terms is a better index of vascular risk than is its absolute concentration. The HDL cholesterol level and the HDL ratio were both significantly lower in controls who smoked than in non-smokers; this may explain the reduced HDL ratio in PVD patients, most of whom were smokers.
The Celestin tube in the treatment of benign oesophageal strictures
Authors: Wilson Michael G , Bristol James B , Mortensen Neil J , John Howell T 
Published: March 2007

Summary
Celestin tubes have been used in two groups of patients with advanced benign oesophageal strictures. Group 1 consisted of 22 elderly, poor risk patients in whom intubation alone, via a gastrotomy, has provided good symptomatic relief of dysphagia. In 11 younger, better risk patients (group 2), it has been used as a temporary indwelling dilator in combination with repair of the hiatus hernia and has been removed at a mean of 5 months postoperatively. Seventy-three per cent of patients have remained free of recurrence when followed up for 2 years.
The importance of personality measurement in the assessment of response to treatment for ischaemic rest pain
Authors: Wong Andrew L , McBain Gordon C 
Published: March 2007

Summary
The purpose of the study was to investigate the relationship between personality and ischaemic rest pain. Twenty-four patients with peripheral vascular disease unsuitable for surgery and suffering from ischaemic rest pain were treated equally with 14 days of bed rest and intravenous naftidrofuryl and their pain analogue scores and personality structures were analysed.
There was a general trend of improvement in their analogue pain scores and patients with high neuroticism (N) and extroversion (E) levels had a better response to treatment, but which only became significant on one occasion when both N and E levels were high.
Levels of N and E were compared with those of the normal population both before and after treatment and were found to be similar even after amputation.
Bilateral carcinoma of the breast
Authors: Bailey M J , Royce C , Sloane J P , Ford H T , Powles T J , Gazet J-C 
Published: March 2007

Summary
Among the 911 cases of carcinoma of the breast treated between 1969 and 1978 there were 39 cases of bilateral primary cancer. Of these, 17 were synchronous tumours defined as cancers diagnosed and treated during the same primary hospital admission. The remaining 22 patients had tumours that were diagnosed separately (metachronous tumours), with a mean time interval of 5 years and 8 months between presentation of first and second primaries (range 6 months to 20 years). Of the metachronous tumours, 20 had presented within 7 years of the diagnosis of the first primary (2·2 per cent of all patients). The patients with synchronous disease fared badly, but patients in the metachronous group had a good prognosis. This is due, at least in part, to the inherent selection of patients in the metachronous group who have to survive the first primary tumour in order to develop the second. However, careful follow-up after the first primary may also account for the relatively good prognosis of this group. We therefore recommend continuing regular out-patient follow-up, with careful examination of the second breast, for all patients having undergone treatment for cancer of the breast.
The complications of arteriovenous grafts for vascular access
Authors: Guillou Pierre J , Leveson Stephen H , Kester Ralph C 
Published: March 2007

Summary
An analysis has been made of the complications occurring in 86 arteriovenous grafts performed for vascular access over a 5-year period ending in July 1979. Synthetic grafts provide significantly more complication-free dialyses than do biological grafts. They are less susceptible to sepsis and aneurysm formation and, when thrombosis does supervene, synthetic grafts can more readily be retrieved than biological grafts. Dacron velour in particular appears to have a low primary and secondary failure rate compared with other types of graft. Grafts implanted in the straight configuration have lower thrombosis rates than looped grafts. While the forearm remains the site of choice for the insertion of an arteriovenous graft, equally good results may be obtained with a graft interposed between the femoral artery and vein.
Proctocolectomy with ileal reservoir and anal anastomosis
Authors: Parks A G , Nicholls R J , Belliveau P 
Published: March 2007

Summary
A technique of proctocolectomy avoiding an ileostomy has been developed for patients with ulcerative colitis or polyposis coli. After excision of all diseased tissue a reservoir of terminal ileum is constructed which is brought through the rectal stump denuded of mucosa; an ileo-anal anastomosis is then carried out.
Twenty-one patients (17 ulcerative colitis, 4 polyposis) have been treated and 20 followed for from 2 to 34 months (mean 13·5 months). There was no mortality but early complications occurred in 9 patients. All are currently well, with no disturbance of urinary or sexual function. Continence of faeces is complete in all during the day, but 1 patient evacuates unconsciously at night. The average frequency of evacuation is 3·8 times in 24 h. Ten patients void spontaneously. All patients tolerate a full diet and only 2 use medicaments to reduce frequency.
This operation appears to be a satisfactory alternative to proctocolectomy with a permanent ileostomy.
A physiological study of elastic compression stockings in venous disorders of the leg
Authors: Jones N A G , Webb P J , Rees R I , Kakkar V V 
Published: March 2007

Summary
The physiological effects of elastic compression stockings on venous disorders of the leg have been studied in three groups of 10 patients. These patients were divided by examination and ascending venography into those with: (a) a normal venous system in the leg, (b) superficial varicose veins and (c) a post-phlebitic limb.
In a randomized cross-over trial each group wore Eesiness NHS two-way stretch or Sigvaris medium compression below-knee stockings for three weeks. In the post-phlebitic limb group a further comparison was made with Sigvaris strong compression below-knee stockings after a 6-week rest period. The effects were objectively compared using foot volumetry and sodium (24Na) subcutaneous tissue clearance.
The physiological benefits of Sigvaris medium and strong compression stockings were comprehensively demonstrated by both methods of assessment in patients with the post-phlebitic limb. Benefit from Sigvaris medium compression stockings was also demonstrated in the patients with varicose veins. In the group with normal veins there were negligible physiological benefits from compression stockings. Eesiness stockings failed to produce a significant physiological effect in each group.
Management of the amputated thumb
Authors: Leonard A G , Colville J 
Published: March 2007

Summary
Two cases are described, one of replantation of an amputated thumb, the other of late reconstruction by toe transfer. A possible reason for the good results in thumb replantation is mentioned, and the advantages of toe transfer in thumb reconstruction are discussed. Suggestions are made as to the course of action to take when confronted with a patient with an amputated thumb.
Spontaneous perforation of the extra-hepatic bile ducts in neonates and infants
Authors: Lloyd D A , Mickel R E 
Published: March 2007

Summary
Biliary ascites due to ‘spontaneous’ perforation of the extra-hepatic bile ducts is uncommon, and should be suspected in an infant who, after a period of good health, develops jaundice and progressive abdominal distension. When the presentation is acute without jaundice the diagnosis is unlikely to be considered unless paracentesis is performed. The perforation is typically located in the common bile duct near its junction with the cystic duct and simple peritoneal drainage without suture is recommended unless the bile duct is obstructed, in which case T tube drainage or a bypass procedure is required. The prognosis is good.
Four patients are presented who illustrate the spectrum of clinical presentation and the different methods of management. Two patients in whom the perforation was in the cystic duct were successfully treated by cholecystectomy.
In most cases the aetiology is not apparent, but important factors may be weakening of the common bile duct wall due to ischaemia or pancreatic juice reflux, associated with a rise in choledochal pressure. In older children the onset of biliary ascites may be preceded by an acute gastrointestinal illness, which, may be a predisposing factor.
Excision of mid-rectal lesions by the Kraske sacral approach
Authors: Christiansen John 
Published: March 2007

Summary
Thirteen patients had a benign and 4 patients a malignant growth of the mid-rectum excised by the Kraske sacral procedure. Two patients developed a faecal fistula, one of which closed spontaneously. Recurrence of a villous adenoma occurred in 2 patients. There was no operative mortality and no thromboembolic or cardiovascular complications.
The place of isolated rectal excision in the treatment of ulcerative colitis
Authors: Clark C G , Ward M W N 
Published: March 2007

Summary
Four patients with ulcerative procrocolitis apparently confined to the rectum had incapacitating diarrhoea which was treated by rectosigmoid resection and a left iliac colostomy. In 3 patients disease recurred within a year, but responded well to conservative management. One of the patients required colectomy and ileostomy 5 years after the initial operation.
Anorectal pressure and rectal compliance after low anterior resection
Authors: Suzuki Hiroshi , Matsumoto Ko'Ichi , Amano Shin'Ichi , Fujioka Masaki , Honzumi Makoto 
Published: March 2007

Summary
Measurements of the resting pressure profile of the anorectum, recto-anal reflex and of rectal compliance (reservoir function of the rectum) were made in 24 normal subjects and 16 patients who had undergone low anterior resection for cancer of the sigmoid colon or upper half of the rectum.
In the early postoperative period (&lt;6 month) frequent bowel movements and occasional soiling were experienced by most patients. Fifteen of 16 such patients had regular bowel movements and no soiling after six months.
The present studies disclosed that there was a close correlation between control of bowel movements and rectal compliance, but not between the resting pressure profile of the anorectum or the recto-anal reflex and control of bowel movements after low anterior resection.
Peritoneovenous shunting for ascites in cancer patients
Authors: Oosterlee J 
Published: March 2007

Summary
Twenty patients with malignant ascites were treated by insertion of a peritoneovenous shunt. Twelve had a Le Veen shunt, 7 a Denver shunt and 1 patient had a Le Veen shunt subsequently replaced by a Denver shunt. Overall survival was poor, which reflects the advanced stage of the patients' disease. Function of the Denver shunt seemed to be better than that of the Le Veen shunt, None of the 8 Denver shunts inserted was a complete failure, while 4 out of 13 Le Veen shunts were of no benefit. With a satisfactorily functioning shunt, good palliation was always achieved. A Denver shunt has become our first choice.
Reliability of axillary lymph node scintiphotography in suspected carcinoma of the breast
Authors: Christensen B , Blichert-Toft M , Siemssen O J , Nielsen S L 
Published: March 2007

Summary
The ability of axillary lymph nodes to take up 99Tcm-labelled antimony sulphide colloid in suspected carcinoma of the breast was investigated in 111 consecutive patients. Eight out of 17 patients with histologically confirmed carcinoma of the breast had a low colloid uptake on the affected side, i.e. a positive scintiphoto. Eighty-two out of 94 patients with benign breast disease had an equal colloid uptake on the two sides or increased uptake on the symptomatic side, i.e. a negative scintiphoto. The reliability of the test is low and the test can neither be recommended for screening to select patients for further investigations nor as a routine examination.
Postoperative deep vein thrombosis caused by intravenous fluids during surgery
Authors: Janvrin S B , Davies G , Greenhalgh R M 
Published: March 2007

Summary
Using a new method of measuring whole blood clotting time, we have confirmed the findings of others, that blood clots faster when diluted with saline. A prospective trial was designed to test the hypothesis that intravenous saline peroperatively causes hypercoagulation and increases the risk of venous thrombosis. Sixty patients admitted for routine laparotomy were randomly allocated to either a group receiving intravenous fluids during or after operation (Wet), or a group receiving no intravenous fluids (Dry). The Wet patients became significantly more haemodilute and hypercoagulable than the Dry (P &lt; 0·001), and these changes correlated. A postoperative deep vein thrombosis occurred in 30 per cent of the Wet patients, but in only 7 per cent of the Dry (P &lt; 0·05). The need for intravenous fluids during uncomplicated surgery is probably unproved, and their greater use may have contributed to the increasing prevalence of venous thromboembolism.
The human tumour xenograft—a valid model in experimental chemotherapy?
Authors: Shorthouse A J , Smyth J F , Steel G G , Ellison M , Mills J , Peckham M J 
Published: March 2007

Summary
The chemotherapeutic response of a series of patients with bronchial carcinoma has been compared with the response of their xenografts established in immune-suppressed mice.
The in situ endpoint of growth delay in subcutaneous tumours was the main parameter used to assess xenograft response, but clonogenic cell survival studies were also performed to assess the extent of cell kill associated with in vivo responses.
Histology, chromosome analysis and demonstration of ectopic hormone production indicated that the xenografts retained human morphology and functional behaviour. Clinical response was assessed by serial measurement of metastases. The chemotherapeutic validity of xenografts is supported by this study in which 21 separate responses in 16 patients and their respective xenografts were similar. Metastases regressed completely in 5 out of 7 patients with oat cell carcinoma. Xenografts derived from these were also highly responsive to similar chemotherapy. In contrast, minimal responses were observed in xenografts established from two chemoresistant patients.
One large cell anaplastic, 3 squamous and 4 adenocarcinomas were universally chemoresistant in patients and their xenografts.
It is concluded that the bronchial carcinoma xenografts broadly retained human morphology and functional behaviour, and reproduced the pattern of chemotherapeutic response of their source tumours. The present work suggests that the incorporation of human tumour xenografts into drug development programmes is justified, although their usefulness in a predictive capacity to select appropriate chemotherapy for individual patients remains limited.
Assessment of the secretin provocation test in the diagnosis of gastrinoma
Authors: Primrose John N , Ratcliffe John G , Joffe Stephen N 
Published: March 2007

Summary
The effect of intravenous secretin on plasma immunoreactive gastrin is presumed to improve diagnostic accuracy in patients with a gastrinoma. To investigate this further, the secretin provocation test was performed in control patients (n = 10), patients with a primary duodenal ulcer (n = 10), patients who had previously had surgery for a duodenal ulcer (n = 20), patients with symptomatic recurrent peptic ulceration (n = 50) and 2 patients with a histologically proved gastrinoma. It was found that the secretin test gave a false positive result in 3 out of 10 symptomatic duodenal ulcer patients, 2 out of 20 patients who had had previous duodenal ulcer surgery and were now asymptomatic and 15 out of 50 patients with recurrent peptic ulceration. Both gastrinoma patients had positive secretin tests but there were no obvious criteria that separated the gastrin response of a gastrinoma patient from those with primary or recurrent peptic ulceration. It is concluded that the secretin test is probably of little value in both the screening and the diagnosis of a gastrinoma.