bluuebunny/crossref_metadata_2025_split huggingface dataset:
Large abdominal incisional hernias: Repair by fascial approximation reinforced with a stainless steel mesh
Authors: Validire J , Imbaud P , Dutet D , Duron J J 
Published: March 2007

Abstract
One hundred and fifty large abdominal incisional hernias were treated following a standardized operating technique using metallic mesh (Toilinox®) and approximation of the anterior sheath of the rectus abdominis. The average follow-up was four years. Good clinical results without pain were found in more than 95 per cent of the patients. Recurrence occurred in 9.5 per cent of the patients. The complications, wound infection or parietal necrosis, never necessitated removal of the prosthesis. These results justify the use of this technique even when intra-abdominal septic procedure is associated.
Controlled environment unit in the care of the below-knee amputation stump
Authors: Ruckley C V , Rae A , Prescott R J 
Published: March 2007

Abstract
A controlled environment unit has been compared with plaster dressings in the management of the below knee stump in 60 patients undergoing amputation for advanced vascular disease. The main criteria were stump healing and the speed of rehabilitation. There were 30 patients in each group. Three patients died within 10 days of operation. Primary healing was obtained in 65 per cent, secondary healing in 22 per cent and revision to above knee was required in 13 per cent. There were no statistically significant differences between the two groups. Neither did they differ in the times taken to reach the various stages of rehabilitation from bed excercises to independent walking with final prosthesis. While the controlled environment unit was as effective as the plaster dressing it tended to impede the patients' early mobility and to hinder nursing care. In particular it is not recommended for patients who may be confused or restless in the early postoperative period.
Deep vein reflux: An assessment by descending phlebography
Authors: Ackroyd J S , Thomas M Lea , Browse N L 
Published: March 2007

Abstract
This study of 51 patients aims to define the ‘normal’ range of reflux in the deep veins and the incidence of pathological reflux in patients with the post-thrombotic syndrome (PTS). ‘Normal’ limbs, limbs with simple varicose veins and limbs with post-thrombotic syndrome have been studied using a standardized technique for descending phlebography, supine and with a controlled Valsalva. The ‘normal’ range of reflux has been found to be grade 0–2. The incidence of pathological reflux in patients with proven post-thrombotic damage to the deep veins is 31 per cent.
Increased glomerular filtration rate in patients after reconstructive surgery on the abdominal aorta
Authors: Nielsen O M , Engell H C 
Published: March 2007

Abstract
Fifty-three patients undergoing elective reconstructive surgery on the abdominal aorta were included in a prospective study to obtain information on postoperative glomerular filtration rate (GFR) in relation to increased fluid and sodium intake and decreased plasma colloid osmotic pressure (COP). GFR, extracellular fluid volume (ECV) and COP were measured before operation and on the first and fourth day after surgery. GFR and ECV were measured by means of the single injection residue detection method using the inulin analogue polyfructosan-S as marker. The compiled GFR values increased from 92.3 to 103.7 ml min−1 1.73m−2 (P &lt; 0.002) on the first day, and to 105.3 ml min−1 1.73m−2 (P &lt; 0.001) on the fourth day after surgery. Concomitantly, ECV increased from 8.9 litres 1.73m−2 before operation to 9.5 litres 1.73m−2 (P &lt; 0.05) and 9.6 litres 1.73m−2 (P &lt; 0.025) respectively. Positive linear correlation was found on the first postoperative day between GFR per 1.73m2 and ECV per 1.73m2 (r = 0.33, P &lt; 0.05) and between GFR per 1.73m2 and extracellular sodium content per 1.73m2 (r = 0.38, P &lt; 0.01). COP was not correlated to GFR per 1.73m2. The postoperative increase in GFR found in this study is most likely to be the result of increased ECV and renal plasma flow. Whether other factors are also involved remains unknown.
Radioimmunolocalization and selection for surgery in recurrent colorectal cancer
Authors: Begent R H J , Keep Patricia A , Searle Frances , Green A J , Mitchell H D C , Jones Barbara E , Dent Joan , Pendower J E H , Parkins R A , Reynolds K W , Cooke T G , Mersh T Allen , Bagshawe K D 
Published: March 2007

Abstract
The value of radioimmunolocalization (RIL) of cancer depends on its performance in situations where the result determines the choice of management. A rise in serum carcinoembryonic antigen (CEA) values after apparently curative resection of colorectal cancer implies localized, resectable recurrence in some patients and widespread unresectable tumour in others. This study investigated the ability of RIL with radiolabelled antibody to CEA and a novel numerical method for analysis of results to determine the extent of disease in 31 patients with raised serum CEA but no physical signs of recurrence. Surgical exploration or conventional radiology later confirmed the presence of tumour in 94 per cent of sites which were positive by RIL. Negative RIL predicted the absence of disease in 53 per cent of patients. The investigation could discriminate between localized and disseminated disease and often performed better than conventional radiology. RIL appears useful in selection of patients for second look laparotomy.
The incidence of Filaria as an aetiological factor for testicular hydrocele
Authors: Dandapat M C , Mohapatro S K , Mohanty S S 
Published: March 2007

Abstract
Five hundred cases of hydrocele of the tunica vaginalis testis (TVT) have been studied in detail in order to ascertain their aetiology. In 43 per cent of cases hydrocele was found to be definitely due to filariasis, in 14 per cent it was highly likely that filariasis was responsible and in 16 per cent filariasis was suspected to be the aetiological factor. The remaining 27 per cent of cases were found to be non-filarial.
Ruptured abdominal aortic aneurysms: A study of incidence and mortality
Authors: Johansson G , Swedenborg J 
Published: March 2007

Abstract
The incidence of ruptured abdominal aortic aneurysms (AAA) during 1980 in the Stockholm county and the clinical fate of the patients were evaluated. Eighty-eight patients with ruptured AAA were found, an incidence of 0.06 per thousand. The overall mortality was 94 per cent. Sixty-four patients reached hospital, twenty-three received a correct diagnosis; thirteen were operated upon and five survived. Autopsy or operation revealed that most ruptures were retroperitoneal (88 per cent) and that only two aneurysms (2 per cent) extended above the renal arteries. It is concluded that the high mortality rate following rupture is more dependent upon failure to operate than on operative mortality.
Randomized study of Corynebacterium parvum adjuvant therapy following surgery for (Stage II) malignant melanoma
Authors: Thatcher N , Mene Aruna , Banerjee S S , Craig P , Gleave N , Orton C 
Published: March 2007

Abstract
One hundred and fifteen patients with histologically proven primary cutaneous melanoma were entered into a randomized prospective study following surgical removal of clinically obvious regional metastases. The study started in 1977 and was completed in June 1982. Fifty-eight patients (10 with regional skin metastases and 48 with regional node metastases) were in the control group and 57 (15 regional skin, and 42 regional node metastases) received adjuvant C. parvum. Other clinical features were well balanced for each group. C. parvum, 2 mg/m2 IV was repeated eight times at three weekly intervals. The schedule was based on previous work which indicated significant increase in killer cell activity. There was no serious toxicity and 22 patients exhibited tachyphylaxis. Seventeen patients in the control group (11 tumour free) are alive at 24–80 months, and 20 patients in the C. parvum group (12 tumour free) are alive 24–76 months from randomization. No statistically significant difference (P &gt; 0.05) was observed between the two patient groups for overall survival (median 26 months) or relapse free survival (median 8 months) from the date of randomization. Nor was the overall survival from the date of primary surgery (median 52 months, range 4–237) or the relapse free survival, median 28 months, range 2–225, significantly different between the two groups of patients. The relapse pattern in the two groups, and survival after relapse were no different though the response rate to actinomycin D and DTIC chemotherapy was significantly higher in the control (48 per cent) than in the C. parvum (23 per cent) group. Toxicity to chemotherapy was not significantly affected by previous C. parvum treatment. Although there were trends for better survival, in the C. parvum patient group, statistically significant activity has not been noted in this study.
Monoclonal immunoscintigraphy for the detection of primary colorectal cancers: A prospective study
Authors: Finan P J , Ritson Anne , Ware Fiona , Parkin A , Robinson P J , Sikora K , Giles G R 
Published: March 2007

Abstract
A prospective study to investigate the value of monoclonal antibody (McAb) immunoscintigraphy for the detection of primary tumours of the colon and rectum has been undertaken. Twelve patients received 1 mg 131I-labelled McAb YPC 2/12·1, an antibody raised to a human colonic carcinoma membrane preparation. Imaging of the blood pool was achieved using 99mTc-labelled red cells. After surgery specimens were scanned and samples of normal and malignant tissue excised to obtain antibody binding ratios. In only one patient was the primary tumour visualized pre-operatively. Images of the resected specimens revealed the primary tumour in ten cases but this appeared to be a function of increased blood pool within the tumour rather than specific antibody localization. The mean tumour/normal tissue count ratio was 1·27:1 (range 0·63:1–1·93:1). It is concluded that the McAb YPC 2/12·1 is unlikely to be of use clinically. Furthermore when selecting McAbs for the purposes of immunoscintigraphy the results of in vitro binding to malignant cell lines, immunohistological studies and xenograft experiments may be misleading and careful clinical evaluation is necessary.
Strategy for lymph node biopsy in homosexual men suspected of having LAV/HTLV-III related disease
Authors: Scott H J , Glynn M J , Lane I F , Anderson M G , Theodorou N A , Murray-Lyon I M , Reynolds K W 
Published: March 2007

Abstract
Since January 1985 we have changed our policy regarding lymph node biopsy in male homosexuals presenting with lymphadenopathy. Before that date-all such patients underwent biopsy if there was no apparent cause. We no longer perform biopsy in male homosexuals presenting with uncomplicated persistent generalized lymphadenopathy (enlargement to more than 1 cm of lymph nodes in more than one extra-inguinal site for more than 3 months with no apparent cause) provided that the patient is positive for the antibody to lymphadenopathy associated virus/human T-lymphotropic virus type III. Such a policy should reduce the need for open biopsy procedures in this group of patients.
Low molecular weight heparin once daily compared with conventional low-dose heparin twice daily. A prospective double-blind multicentre trial on prevention of postoperative thrombosis
Authors: Bergqvist D , Burmark Ulla Stina , Frisell J , Hallböök T , Lindblad B , Risberg B , Törngren S , Wallin G 
Published: March 2007

Abstract
In a randomized, prospective, double-blind multicentre trial, the effect of conventional low-dose heparin 5000 units twice daily, was compared with that of a low molecular weight heparin fragment (4000–5000) 5000 anti-factor Xa units once daily. Four hundred and thirty-two patients fulfilled the inclusion criteria and were analysed for development of deep vein thrombosis (125I-labelled fibrinogen test) and haemorrhagic complications. Thrombosis occurred in a 4·3 per cent of patients in the low-dose heparin group and in 6·4 per cent of patients in the heparin fragment group, a difference which is not significant. There was a significant delay in the onset of thrombosis in the heparin fragment group. Mortality did not differ between the groups, nor did peroperative blood loss or transfusion requirements or infectious complications. Haemorrhagic complications occurred significantly more often in the fragment group (11·6 per cent) than in the conventional heparin group (4·6 per cent). Patients in the heparin fragment group experienced local pain following the subcutaneous injection significantly less often.
Anteroposterior rectopexy in the treatment of solitary rectal ulcer syndrome without overt rectal prolapse
Authors: Nicholls R J , Simson J N L 
Published: March 2007

Abstract
There is evidence that the solitary rectal ulcer syndrome is associated with rectal prolapse either overt or internal. The anterior rectal wall is affected in most cases and a modified abdominal rectopexy has been used with the aim of supporting both the anterior and posterior aspects of the rectum. Fourteen patients aged 19–70 years (mean 34·2 years) in whom conservative treatment has failed, have been treated by anteroposterior rectopexy. Tenesmus, bleeding and the passage of mucus have been abolished or greatly improved in 12, 14 and 13 patients respectively. The number of attempts to defaecate per 24 h has fallen from 8·7 ± 1·4(s.e.m.) pre-operatively to 3·4 ± 1·0(s.e.m.) postoperatively (P &lt; 0·05) and the time spent in the lavatory has been reduced from 146 ± 18(s.e.m.) min to 15 ± 3(s.e.m.) min. Two patients have developed severe constipation postoperatively and two others have had persistent or recurrent tenesmus. Combined anteroposterior rectopexy has improved 12 out of 14 patients with the solitary ulcer syndrome without external rectal prolapse when assessed at 2–48 months postoperatively.
‘Laparostomy’: A technique for the management of intractable intra-abdominal sepsis
Authors: Mughal M M , Bancewicz J , Irving M H 
Published: March 2007

Abstract
Following laparotomy for severe intra-abdominal sepsis, the abdominal cavity was left open to heal by granulation in 18 patients. In 14 patients, operation was required because of recurrent gastrointestinal perforation or anastomotic dehiscence. In three, the indication for this procedure was recurrent pancreatic abscess. Of the 17, 13 had previously undergone multiple operations which had failed to control sepsis. Laparostomy was performed as a primary procedure in only one case, a patient with fulminating pancreatitis requiring pancreatic necrosectomy. All patients received parenteral nutrition. The overall mortality was 28 per cent. However, there was only one death among the last 9 patients treated compared with 4 in the previous 9. The median sepsis score in the first 9 (19, range 10–26) was not significantly different (P &gt; 0·05)from that in the subsequent 9 patients (17, range 8–21). Three of the four who had initially presented with severe acute pancreatitis died. No patient eviscerated and only 9 (50 per cent) required mechanical ventilation for a median duration of 5 days. The median time for wound healing was 10 weeks and 6 patients have subsequently undergone definitive surgery with satisfactory results. Laparostomy is a valuable technique in the management of severe, intractable intra-abdominal sepsis.
Adjuvant radiotherapy and chemotherapy in breast cancer
Authors: McArdle C S , Crawford D , Dykes E H , Calman K C , Hole D , Russell A R , Smith D C 
Published: March 2007

Abstract
Three hundred and twenty-two women with involvement of axillary lymph nodes following surgery for operable breast cancer were randomized to receive either postoperative radiotherapy, chemotherapy (CMF) or radiotherapy followed by chemotherapy. There was an increase in disease free interval in pre- and postmenopausal patients receiving radiotherapy and chemotherapy regardless of the number of nodes involved. However, there was a trend towards an improvement in disease related survival only in those patients with more than three nodes involved.
Anorectal function following coloanal sleeve anastomosis for chronic radiation injury to the rectum
Authors: Varma J S , Smith A N 
Published: March 2007

Abstract
Anorectal manometry and electrophysiological studies of the pelvic floor were performed in eight patients who had undergone anterior resection of the rectum with mucosal proctectomy and colo-anal sleeve anastomosis for radiation rectal injury. There is a severe reduction in the compliance of the neorectum and in the maximal tolerable volume. Maximum basal anal canal pressure and physiological sphincter length are also significantly reduced although the ‘squeeze’ pressure of the external anal sphincter and the latency of the pudendo-anal reflex were unaffected. Four patients had an absent rectosphincteric reflex, four patients involuntarily expelled the test balloon at the maximal tolerable volume during a proctometrogram and four patients demonstrated increased EMG activity of the pelvic floor on straining and on rectal distension. These abnormalities help to explain many of the patients' symptoms. Histological abnormalities of the myenteric plexus were a prominent feature in all the excised specimens and may be responsible for some of the functional abnormalities.
Negative effect of Metoclopramide in postoperative adynamic ileus. A prospective, randomized, double blind study
Authors: Jepsen S , Klærke Anette , Nielsen P H , Simonsen O 
Published: March 2007

Abstract
In a double blind controlled study including 60 patients it was found that Metoclopramide has a negative effect upon the resolution of postoperative adynamic ileus. Metoclopramide causes a delay in the time from operation to the first passage of flatus.
Intragastric bile acids and scintigraphy in the assessment of duodenogastric reflux
Authors: Houghton P W J , McC. Mortensen N J , Thomas W E G , Cooper M J , Morgan A P , Davies E R 
Published: March 2007

Abstract
Following endoscopic gastric juice aspiration, intragastric bile acids were measured in 105 patients undergoing routine or review gastroscopy. Subsequently, duodenogastric reflux was assessed using 99mTc butyliminodiacetic acid (BIDA) scintigraphy and intragastric bile acid levels compared with the grades of reflux assessed scintigraphically. There was a significant correlation between both free and total intragastric bile acid levels and the degree of radiological bile reflux, especially when reflux was severe. Both endoscopic measurements of bile acids and BIDA scintigraphy appear to be useful methods for determining duodenogastric reflux, but neither may be accurate enough to quantify minor degrees of reflux.
Proximal gastric vagotomy or truncal vagotomy and drainage for chronic duodenal ulcer?
Authors: Clark C G , Fresini A , Araujo J G C , Boulos P B 
Published: March 2007

Abstract
A comparison has been made between truncal vagotomy and drainage (TVD) and proximal gastric vagotomy (PGV) performed electively for chronic duodenal ulceration from 1968 to 1981 in 209 and 272 patients respectively. The morbidity was 23 per cent after TVD and 19·8 per cent after PGV, with a mortality of 0·5 per cent and 0·4 per cent respectively. Of 163 patients in the former group and 253 patients in the latter group the follow-up was an average of 5·7 and 6·2 years respectively; 128 patients (78·5 per cent) and 198 (78·3 per cent) respectively had a good functional result, graded as Visick I and II, but 35 (21·7 per cent) and 55 (21·7 per cent), respectively, had a poor result owing to recurrent ulceration in 23 (14·1 per cent) after TVD and 44 (17·4 per cent) after PGV. These results were not statistically different. The frequency of diarrhoea was 23 per cent and dumping 6·8 per cent after TVD which was significantly reduced to 2·0per cent (P &lt;0·005) and 1·2per cent (P &lt;0·025), respectively, after PGV. However, only five patients (3·0 per cent) had severe symptoms from diarrhoea and two (1·2 per cent) from dumping after TVD. Both operations seem to carry an equal incidence of unsatisfactory results, though for slightly different reasons it might be concluded that both procedures have an equal degree of acceptability.
Renal parenchymal carcinoma in children
Authors: Booth C M 
Published: March 2007

Abstract
A series of 14 cases of renal parenchymal carcinoma in patients under 20 years of age is presented and reviewed with the best documented case reports from the literature. Unlike its adult counterpart the tumour has an equal sex ratio and minor trauma frequently precipitates presentation, otherwise its behaviour is similar. The treatment of choice is nephrectomy but, unlike adults, there is evidence to support the value of adjunctive radiotherapy and chemotherapy in the treatment of local spread. Prognosis is particularly worsened by cellular granularity, and vascular or direct extrarenal spread. The 5 year survival rate is 52 per cent.
Local recurrence of colorectal cancer: Effect of early detection and aggressive surgery
Authors: Schiessel R , Wunderlich M , Herbst F 
Published: March 2007

Abstract
A prospective study was undertaken of the incidence, symptoms, diagnostic measures and therapy of local recurrences of colorectal carcinoma following radical surgical management. Out of 715 patients, 156 (22 per cent) developed recurrence of the tumour, which was local in 90 patients. In addition, 36 patients with local recurrence from other hospitals were treated. Half of the patients were symptom-free at the time of diagnosis. Out of the 126 patients, 109 were treated by surgery, a radical operation being feasible in 53 cases. Fifty per cent of these have survived for at least 17 months. The operative mortality was very low (4.6 per cent), although extensive surgery was necessary in most of the cases. The preliminary results of this study support the hypothesis that a postoperative follow-up programme for patients with colorectal cancer leads to early detection of local recurrence and improves the chance of cure by surgical treatment.
Comparison of the function of triplicated and duplicated pelvic ileal reservoirs after mucosal proctectomy and ileo-anal anastomosis for ulcerative colitis and adenomatous polyposis
Authors: Nasmyth D G , Williams N S , Johnston D 
Published: March 2007

Abstract
Among 39 consecutive patients who underwent colectomy, mucosal proctectomy and ileo-anal anastomosis, a triplicated pelvic ileal pouch was constructed in 17, and a duplicated pouch in 22 patients. There was no mortality, but complications such as anastomotic dehiscence and pelvic sepsis led to removal of the pouch in seven patients (18 per cent). The functioning of the pouch and anal sphincter was assessed in 31 patients 6 months, and in 22 patients 12 months after closure of the diverting ileostomy. By 6 months, all patients were either completely continent or experienced only minor leakage and defaecation could be deferred for more than 15 min by 81 per cent of patients and flatus distinguished from faeces by 90 per cent of patients. No significant differences between triplicated and duplicated pouches were discernible at 6 months. At 12 months defaecation was significantly less frequent (P &lt; 0.05) in patients with triplicated pouches (median, 5 times in 24 h) than in patients with duplicated pouches (7 times in 24 h). All patients with triplicated pouches and all except one with duplicated pouches were able to defaecate spontaneously, without needing to intubate the reservoir. Thus, provided the early postoperative problems can be overcome, most patients achieve good anal function after mucosal proctectomy combined with a pelvic ileal reservoir. No evidence was found in this study that the functional results of duplicated pouches were superior to those of triplicated pouches; in fact, the triplicated pouches proved to be slightly superior.