bluuebunny/crossref_metadata_2025_split huggingface dataset:
The management of suspected tumours of the colon: The role of colonoscopy in general surgery
Authors: McKelvey S T D 
Published: March 2007

Summary
The role of colornoscopy in the management of 100 cases of suspected large bowel tumuour is described. Forty out of 47 patients with an equivocal barium enema examination were satisfactorily examined and the possibility of a tumour being present was either confirmed or refuted. Examination of 30 patients with otherwise unexplained blood loss from the bowel revealed the cause in 50 per cent of them. Twenty-nine patients had pedunculated polyps which were snared and removed, thus avoiding laparotomy and colotomy.
The problem of distinguishing tumours from other lesions or retained faeces by radiology arises most often in the sigmoid colon. This segment is easily examined using a short flexible endoscope. General surgeons taking up colonoscopy will find a 1-m single-channel instrument convenient to use and capable of renching approximately 90 per cent of colonic tumours that require further investigation or endoscopic resection. Facilities for the examination of the whole colon should be available in established endoscopy units.
Cancer of the large bowel in a defined population: Canterbury, New Zealand, 1970–4
Authors: Stewart R J , Robson R A , Stewart A W , Stewart Joanna M , MacBeth W A A G 
Published: March 2007

Summary
A total of 1024 new cases of cancer of the large bowel occurred in Canterbury, New Zealand (population 400 796), in the 5 years 1970–4. Of these, 992 were diagnosed before death and are reviewed in this paper.
The high incidence of this disease in New Zealanders of European origin is illustrated. A significant difference in site distribution of primary tumours between the sexes was found, with a female preponderance of cancer of the proximal colon gradually changing to a male preponderance of cancer of the rectum. In all, 61.5 per cent of the patients had lymph node metastases or advanced disease at the time of diagnosis or tretment. Largely as a consequence of this, only 65 per cent were able to have potentially curative treatment.
The estimated crude 5-year survial rate of the whole group was 32.7 per cent (relative rate 42.8 per cent) and the crude 5-year survival rate after otentially curative surgery was 48.4 per cent (relative rate 62.4 per cent).
The results are compared with those of other outhors. They emphasize the generally unsatisfactory outcome of treatemtn.
Axillary vein entrapment
Authors: Boontje A H 
Published: March 2007

Summary
This paper describes a patient with right axillary vein obstruction resulting from compression of the vein due to anomalous muscle tissue extending from the latissimus dorsi muscle across the neurovascular bundle to the pectoralis major muscle. This ‘axillopectoral muscle’ causing entrapment of the axillary vein has been described in only a few cases. These previous reports are discussed, with special reference to the symptoms and phlebographic findings. The obstruction and the symptoms caused by it are intermittent; the phlebographic features are characteristic.
Partial and complete atrophy affecting hepatic segments and lobes
Authors: Ham J M 
Published: March 2007

Summary
Thirty-four patients with atrophic lesions of liver segments or lobes are described. The primary diagnoses included alcoholic liver disease, various forms of cirrhosis, hydatid disease, tumours and sclerosing cholangitis. Seventeen patients had complete atrophy of the segment or lobe and the other 17 patients had partial atrophy (i.e. a reduction of at least 50 per cent in the size of the affected area). Complete atrophy affected the left lobe more frequently than the right. The condition is important, first, because it is more common than is generally recognized, and second, because it may create considerable diagnostic and therapeutic problems.
Acute pancreatitis in Hong Kong
Authors: Ong G B , Lam K H , Lam S K , Lim T K , Wong John 
Published: March 2007

Summary
A series of 311 Chinese patients with acute pancreatitis admitted to Queen Mary Hospital, Hong Kong, over a 10-year period is reviewed. Biliary tract disease was associated with pancreatitis in 52.4 per cent of patients and 77.9 per cent of them had stones, mud or parasites in the common bile duct. Fever and jaundice were present in 55 per cent and 41.2 per cent of patients respectively. Because of the prevalence of recurrent pyogenic cholangitis among the indigenous population, emergency operation, with the aim of common duct decompression, was conducted in 54.3 per cent of patients during the acute episode, with a mortality rate of 14.8 per cent. Five of 142 patients (3.5 per cent) died whilst on conservative treatment and all 5 had haemorrhagic pancreatitis. The overall mortality rate was 9.6 per cent. Exploration of the common bile duct, which was carried out in 57.4 per cent of patients in the acute phase, was not associated with a higher mortality than when laparotomy alone was performed, and 19 patients had sphincteroplasty without any death. Subtotal pancreatectomy was performed in 2 patients with haemorrhagic pancreatitis with 1 death.
The Celestin tube in the palliation of carcinoma of the oesophagus and cardia
Authors: Saunders N R 
Published: March 2007

Summary
A series of 105 patients with dysphagia due to inoperable carcinoma of the oesophagus or cardia of the stomach, and 11 patients with dysphagia secondary to malignant mediastinal nodes, was treated by intubation with a Celestin tube. The hospital mortality was high but 81 patients left hospital and 29 were still alive at 6 months. The prognosis for those with dysphagia due to malignant posterior mediastinal nodes was very poor, with no survivors at 6 months. Oesophageal perforation was a serious operative complication, with a hospital mortality of 83 per cent. Chest and wound infections were the most common postoperative complications occurring in 28 and 20 per cent of the patients, respectively.
The restoration of swallowing was satisfactory in the majority of survivors although readmission with a blocked or displaced tube was not uncommon.
Intrarectal metronidazole in the prevention of anaerobic infections after emergency appendicectomy: A controlled clinical trial
Authors: Rodgers J , Ross D , McNaught W , Gillespie G 
Published: March 2007

Summary
A series of 102 patients with presumptive acute appendicitis entered a prospective, randomized, clinical trial of intrarectal metronidazole given over a 48-h period commencing before surgery. Adequate levels of circulating metronidazole were achieved. A significant reduction in the incidence of anaerobic wound infection was observed in the treated group (P &lt; 0.02). The convenience and short duration of the prophylactic regimen allowed early discharge from hospital. No untoward effects were observed.
A double-blind trial of a single intravenous dose of metronidazole as prophylaxis against wound infection following appendicectomy
Authors: Greenall M J , Bakran A , Pickford I R , Bradley J A , Halsall A , MacFie J , Odell M , Cooke E Mary , Lincoln Christine , McMahon M J 
Published: March 2007

Summary
One hundred patients undergoing appendicectomy through a right iliac fossa incision were randomized to receive normal saline or 500 mg metronidazole as an intravenous infusion during the operation. One patient in the saline group developed an erythcmatous rash. There were 13 wound infections (as defined by the discharge of pus), 12 (out of 51) in the saline group and 1 (out of 49) in the metronidazole group. Bacteroides spp. were frequently cultured from the lumen of removed appendices and from pus obtained from infected wounds. This work supports the value of metronidazole but suggests that a single-dose regimen is adequate for prophylaxis.
The morbidity of carotid endarterectomy
Authors: Bouchier-Hayes D , De Costa A , MacGowan W A L 
Published: March 2007

Summary
The results of 72 carotid endarterectomy operations carried out by three consultant surgeons were analysed. Thirty-eight operations (32.8 per cent) were performed in patients with mild or resolving stroke and 33 operations (45.9 per cent) in patients with transient ischaemic attacks and/or amaurosis fugax. Five patients (7 per cent) died in the early postoperative period, 2 as a result of strokes and the others from cardiac causes. Seventy-six per cent of patients had a satisfactory long term result, remaining free from stroke, blindness or recurrent transient ischaemic attacks over the follow-up period of 1–7 years.
There were 10 patients (13.8 per cent), including 2 who died, who developed early postoperative neurological deficits; 4 (5.5 per cent) had transient defects and 6 (8.3 per cent) had permanent deficits. Of these patients, 4 had proved occlusions of the reconstructed artery. In 3 patients, cerebral embolization during operation was suspected as the cause. There were, in addition, 2 asymptomatic patients whose reconstruction was shown to be occluded on follow-up postoperative angiography. The continued absence of symptoms, therefore, is no guarantee that the reconstruction is patent and some more objective method of assessment is necessary if the results of carotid endarterectomy are to be critically analysed. The incidence of neurological deficits could, it is believed, be reduced by greater experience with the operation, the routine use of per-operative intra-arterial shunting and peroperative angiography to confirm the patency of the reconstruction.
The clinical relevance of radiologically revealed Paget's disease of bone (osteitis deformans)
Authors: Guyer P B 
Published: March 2007

Summary
Radiological and hospital records of 400 patients with Paget's disease that was shown radiologically have been examined in an effort to establish the clinical significance of the disease. Twenty-eight per cent of the patients were considered to have symptoms related to their disease, the most frequent symptom being bone pain, deformity and fracture. It appears that Paget's disease may predispose to the formation of urinary calculi. Malignant change and neurological and cardiovascular complications are rare, and osteitis deformans does not appear to predispose to osteoarthrosis.
Distribution of plasma-bound hydroxyproline in breast cancer, benign breast disease and healthy females
Authors: Nehlawi M F , Cuschieri A , Clark J , Wood R A B 
Published: March 2007

Summary
In normal adult females, patients with benign breast disease and patients with breast cancer, hydroxyproline (OHPro) was found in the plasma attached to the protein fractions which were separated by Sephadex gel filtration. In addition, a distinct moiety, probably a protein sub-unit, containing substantial amounts of this imino acid, occurred in between gel filtration fractions III and IV. Quantitative differences in the OHPro content of these various fractions were observed in the groups of patients studied. Significant elevations in the peptide-bound OHPro (fraction IV) were found only in patients with breast cancer and the level appeared to correlate with the degree of advancement of the disease. Similar findings relate to the OHPro content of the sub-protein moiety which is found between gel filtration fractions III and IV. A reduced level of high molecular weight hyproprotein (fraction I) was found in the breast cancer group.
Does obstructive jaundice adversely affect wound healing?
Authors: Greaney M G , Van Noort R , Smythe A , Irvin T T 
Published: March 2007

Summary
The effect of obstructive jaundice on wound healing has been investigated in an experimental study of abdominal wounds in rats following ligation and division of the common bile duct. Animals were jaundiced for 2 weeks before a second operation at which the abdominal wounds were made. The wounds in jaundiced and control animals showed no significant differences in mechanical strength during a 21-day period of study but there was a significant delay in the accumulation of collagen in the wounds of jaundiced animals. The findings suggest that the biochemical changes in the wounds of jaundiced animals did not interfere with wound repair and cast doubt on the thesis that jaundice has an adverse effect on wound healing.
The surgical treatment of axillary hyperhidrosis
Authors: Bergkvist Leif , Engevik Lennart 
Published: March 2007

Summary
Axillary hyperhidrosis is a common condition and young people often suffer unnecessarily for many years in spite of the availability of good surgical methods for cure. We describe our own modification of Pettersson and Strömbäck's (1970) method of excision of the sweat glands. During the years 1972-6 218 axillary operations have been performed on 109 patients at the surgical clinic in Västerås for axillary hyperhidrosis. We reviewed 104 of these and found that 71 patients were completely satisfied and only 7 unsatisfied. Twelve patients wanted to be reoperated either because they still sweated or because they were unhappy with their scars. Thus, we found that overall the surgical methods are safe, simple and give good results.
The effect of levamisole on postoperative immunosuppression
Authors: Windle R , Wood R F M , Bell P R F 
Published: March 2007

Summary
Cell mediated immunity was studied before and after surgery in patients with colorectal cancer. Thymus-derived (T) lymphocytes were enumerated and their non-specific activity was measured by assessing phytohaemagglutinin (PHA)-induced blastogenesis. Specific T lymphocyte activity was measured by leucocyte migration inhibition in response to purified protein derivative of tuberculin (PPD) and autochthonous tumour extract. One group of patients received levamisole postoperatively and the other group consisted of controls. There was a more rapid return to preoperative levels of leucocyte migration inhibition to both antigens by the levamisole group. However, levamisole administration had only a marginal efect on the postoperative depression of cell counts and did not restore depressed lymphoblast transformation.
Effect of epidural analgesia on metabolic profiles during and after surgery
Authors: Kehlet H , Brandt M R , Hansen A Prange , Alberti K G M M 
Published: March 2007

Abstract
Blood concentrations of glucose, lactate, alanine, free fatty acids, glycerol and 3-hydroxybutyrate were measured during 24 h in 12 females undergoing elective hysterectomy under either general anaesthesia or epidural analgesia extending from T4 to S5. The results showed that the peroperative and immediate postoperative metabolic profiles in the group receiving general anaesthesia reflected substrate mobilization (increased glucose, lactate, 3-hydroxybutyrate), and that epidural analgesia blocked these changes, probably mediated through an inhibited adrenaline response to surgery. Peroperative values of free fatty acids and glycerol were significantly lowered by epidural analgesia, indicating inhibition of lipolysis. Alanine decreased similarly in both groups. In the later postoperative period metabolic profiles were similar in the two groups, indicating that the influence of fasting may override the effect of the relatively minor trauma.
Experiences with head injuries in a regional neurosurgical unit
Authors: Jeffreys R V , Azzam N I 
Published: March 2007

Abstract
A review of all patients with major head injuries transferred to a regional neurosurgical unit for the years 1975 and 1976 has been carried out for comparison with the total number of patients with head injury admitted to district general hospitals of the region. Fifty-four per cent of patients admitted to the neurosurgical unit have resumed their old occupation and 20 per cent died. The significance of these figures is discussed, particularly in the light of the need for a more comprehensive policy for treating head injuries within the United Kingdom.
Leg haemodynamics during reconstructive vascular surgery
Authors: Sonnenfeld T , Cronestrand R , Nowak J 
Published: March 2007

Abstract
The aim of this study was to find the best haemodynamic variables for a correct assessment of the function of a femoropopliteal bypass graft. The results are based on intraoperative measurements performed on 11 patients undergoing surgical reconstruction of the femoral artery with a femoropopliteal reversed saphenous vein bypass graft.
Both blood transfusion and local intra-arterial injection of 40 mg of papaverine resulted in a significant increase in common femoral arterial and graft blood flows as well as in femoropopliteal pressure difference. At the same time there was a significant decrease in total leg and lower leg resistance, whereas the resistance over the graft was not significantly altered by changes in blood volume or by pharmacological vasodilatation.
It was shown that, for a complete assessment of the bypass function, both the resistance in the graft and in the lower leg must be evaluated. This can be effected by simultaneously measuring both the blood pressure and the blood flow. It was also shown that the femoropopliteal pressure difference per se does not indicate the true capacity of the graft. It is concluded that, during reconstructive vascular surgery, leg haemodynamic variables are influenced by variations in blood volume and vasomotor tone. This is of importance for the correct interpretation of a single haemodynamic variable and for the correct quantitative evaluation of the results of vascular surgery.
Bleeding duodenal ulcer: Reduction in mortality with a planned approach
Authors: Hunt P S , Korman M G , Hansky J , Marshall R D , Peck G S , McCann W J 
Published: March 2007

Summary
In a 6-year prospective study from 1972 to 1978 266 patients were admitted to a haematemesis and melaena unit with bleeding duodenal ulcer. There were 13 deaths, a mortality of 5 per cent. A comparison between the three consecutive 2-year periods of study showed an intial mortality of 6 per cent for the first 4 years falling to 2 per cent for the 93 admissions during the final 2 years of experience. Of the 120 patients treated surgically, 10 died in hospital, giving an operative mortality of 8 per cent. The trend in operative mortality was from 13 per cent for the initial 2-year period to 8 per cent for the second period and to 3 per cent for the final 2 years. The operative rate was consecutively 45, 50 and 34 per cent. There was 1 death in conservatively treated patients during each 2-year period of study. Three types of operation were performed: vagotomy, pyloroplasty and oversewing of the ulcer; Polya gastrectomy; and vagotomy and antrectomy. There was no difference in morbidity and mortality between these operations. At a mean follow-up of 3·1 years, 90 per cent of the patients had a good result from their operation. It is concluded that a prospective system of management with an active policy of early endoscopy, surgery and regular audit reduces the mortality from bleeding duodenal ulcer.
Anti-Xa factor as a predictor of postoperative deep vein thrombosis in general surgery
Authors: Gunn Iain G 
Published: March 2007

Summary
This study was stimulated by a recent report linking a low preoperative level of an endogenous coagulation inhibitor (anti-Xa factor) with an increased incidence of postoperative deep venous thrombosis (DVT) (Stamatakis et al., 1977).
Preoperative and postoperative levels of anti-Xa were measured and correlated with the postoperative incidence of deep venous thrombosis assessed by the 125I fibrinogen uptake test to determine whether a high risk group could be isolated and a suitable regimen of prophylaxis introduced.
In this study of 22 surgical patients the postoperative DVT rate was 41 per cent. However, preoperative measurements of anti-Xa activity failed to show any statistically significant difference between those patients with DVT and the non-DVT group. The findings do not support the use of anti-Xa levels as a preoperative predictor of postoperative DVT in the individual.
Small bowel strictures after blunt abdominal trauma
Authors: Marks C G , Nolan D J , Piris J , Webster C U 
Published: March 2007

Summary
Two patients with strictures of the small intestine after blunt abdominal trauma are reported. In the first there were multiple severe injuries and the ileal stricture due to a mesenteric tear was not diagnosed until 6 weeks later. In the second an apparently minor injury was responsible for direct damage to the wall of the jejunum and a subsequent stricture.
A lung colony clonogenic cell assay for human malignant melanoma in immune-suppressed mice and its use to determine chemosensitivity, radiosensitivity and the relationship between tumour size and response to therapy
Authors: Thomas J Meirion 
Published: March 2007

Summary
A lung colony assay for clonogenic cells of human tumours in immune-suppressed mice is presented. The assay was used to determine the chemosensitivity of two malignant melanomas. One tumour reproduced the spectrum of chemosensitivity associated clinically with three cytotoxic agents. The other melanoma reproduced the chemosensitivity demonstrated in the patient from whom the tumour was biopsied.
The importance of tumour size as a determinant of response to melphalan was investigated and the clonogenic cell survival in smaller tumours was found to be slightly but significantly lower than in larger tumours.
An investigation of the importance of size as a determinant of response to radiotherapy demonstrated that 0·5-mm diameter tumour nodules were significantly more sensitive to irradiation than 2-cm diameter nodules. The hypoxic fraction of the larger tumours was 65 per cent, which is higher than that reported for experimental animal tumours or a human pancreatic tumour. This could be a factor in the clincical radioresistance of malignant melanoma.
The interpretation of mammographic ductal enlargement in cancerous breasts
Authors: Mansel R E , Gravelle I H , Hughes L E 
Published: March 2007

Summary
The xeromammograms of 128 women with breast cancer were coded radiologically according to Wolfe's gradings. The mastectomy specimens were then histologically examined for the presence of ductal abnormality.
The ducts were found to be normal in the cases coded as normal radiologically but they were not always abnormal histologically when considered to be abnormal radiologically. ‘Ductal prominence’ may be due to duct ectasia, intraduct hyperplasia or periductal collagenosis.
Plasma exchange and Raynaud's phenomenon—Its assessment by Doppler ultrasound velocimetry
Authors: O'Reilly M J G , Dodds A J , Roberts V C , Cotton L T 
Published: March 2007

Summary
In a group of 47 patients with Raynaud's phenomenon, Doppler ultrasound velocimetry was used to establish the severity of the disease by detecting the patency of the digital arteries. In conjunction with small digital occlusion cuffs, digital artery systolic pressure was measured on either side of the finger. A significant variation in systolic pressure was detected in each finger, and on each side of individual fingers. A more sensitive index of the severity of the disease was noted when the digital systolic pressure was compared to the brachial systolic pressure.
Plasma exchange, a potent method of lowering whole blood viscosity and plasma fibrinogen, was used to treat 18 of these patients. There was a significant improvement in digital vessel patency at both 21 °C and 13 °C after plasma exchange. Both the digital artery systolic pressure and the pressure index improved significantly after treatment.