bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanism of action of injection therapy for bleeding peptic ulcer
Authors: Rajgopal C , Lessels A , Palmer K R 
Published: March 2007

Abstract
The effects of intramucosal injection of 1: 100 000 adrenaline, 5 per cent ethanolamine and normal saline were determined in experimentally created, acutely bleeding gastric mucosal wounds in rabbits. The mean(s.d.) bleeding rate was decreased from 2.3(0.4) to 0.2(0.02) ml/min by adrenaline (P &lt; 0.01), but increased by 1 ml 5 per cent ethanolamine to 4.0(0.6) ml/min (P &lt; 0.05). Normal saline had no haemostatic effect, suggesting that local tamponade is not important. In separate experiments endoscopic injections of 5 per cent ethanolamine, 1: 100 000 adrenaline and normal saline were made in the gastric antrum of rabbits. After 48 h the degree of inflammation was greatest with ethanolamine but, despite tissue necrosis and venous thrombosis, neither endarteritis nor arterial thrombosis occurred. Injections of 5 per cent ethanolamine and 80 per cent ethanol placed next to the ear arteries of rabbits caused local ulceration and necrosis, but endarteritis and arterial thrombosis were again absent.
Management of common bile duct stones using a second-generation extracorporeal shockwave lithotriptor
Authors: Nicholson D A , Martin D F , Tweedle D E F , Rao P N 
Published: March 2007

Abstract
Fifty-four patients with common bile duct stones (8–36 mm in diameter) that could not be removed after endoscopic sphincterotomy, even with the use of mechanical lithotripsy, underwent extracorporeal shockwave lithotripsy (ESWL) using a Siemens Lithostar. Their median age was 75.5 (range 34-89) years. Patients received 4000–6000 shocks per session over approximately 60 min. Seventeen underwent two sessions and two patients three or more. Thirty-seven patients had one stone, ten had two, and seven had three or more. Spontaneous clearance of fragments occurred in only three patients before further endoscopic retrograde cholangiopancreatography was performed to remove fragments. Stones were removed and ducts cleared endoscopically in 35 patients, giving a total of 38 of 54 patients (70 per cent) with complete duct clearance. Fragmentation in response to lithotripsy was dependent on stone size; the number of stones had little efect. ESWL was well tolerated without any haematological or biochemical abnormality. Computed tomography in the first 20 patients showed no hepatic or pancreatic change after treatment. ESWL combined with endoscopic extraction of fragments is an alternative to surgery when preliminary endoscopic extraction and mechanical lithotripsy have failed.
Paediatric intussusception
Authors: Stringer M D , Pablot S M , Brereton R J 
Published: March 2007

Abstract
Intussusception is one of the commonest causes of intestinal obstruction in infants and accounts for about 700 hospital admissions each year in England and Wales. Improved results of treatment have followed recent technological developments, which include ultrasonographic imaging and pneumatic reduction techniques. Most intussusceptions can be reduced successfully without the need for operation but close cooperation between surgeon and radiologist is essential. Mortality and morbidity rates from the condition have progressively declined in recent decades but avoidable deaths still occur.
Editorial Committee of the British Journal of Surgery
Authors: Williamson Robin 
Published: March 2007

Abstract
The overseas membership of the Editorial Board has increased steadily over the past two decades, reflecting the international flavour of The British Journal of Surgery. In 1989, to foster closer links with continental Europe, the Council of the BJS Society appointed the first surgeon from outside Britain to join the Editorial Committee, the body with executive control over the monthly publication of the Journal. There are now three representatives from mainland Europe on the Editorial Committee, and their profiles are given below.
Cytokines in tumour therapy
Authors: Hill A D K , Redmond H P , Croke D T , Grace P A , Bouchier-Hayes D 
Published: March 2007

Abstract
Cytokines are low molecular weight proteins released by cells of the immune system that have therapeutic potential in cancer. They include the interleukins, the interferons, tumour necrosis factor and the colony-stimulating factors. Cytokines are capable of producing significant and sustained responses against a number of tumours. Clinically, the highest response rates to cytokine immunotherapy have been seen in melanoma and renal cell cancer. Current efforts aim to reduce treatment-related toxicity while maintaining the efficacy of cytokines. The therapeutic potential of these agents may be increased with genetic manipulation by introducing genes encoding cytokines into tumour-infiltrating lymphocytes and certain tumour cells. However, immunotherapy remains time consuming and expensive, and further developments are necessary before it can have a definitive role in tumour management.
The electronic information revolution and how to exploit it
Authors: Cox J J , Dawson K J , Hobbs K E F 
Published: March 2007

Abstract
Medical information is increasingly stored in electronic format, enabling faster and more flexible access to the literature. Online, compact disc and floppy disc databases are widely available. The origins and development of these different database media are described. The strengths and weaknesses of each, and the ways in which they complement each other, are examined. Ease of access to medical information can result in data management problems; the role of bibliographic software in ensuring full exploitation of the electronic information revolution is therefore emphasized.
Quality of life following surgery for abdominal aortic aneurysm
Authors: Mageae T R , Scott D J , Dunkley A , St Johnston J , Campbell W B , Baird R N , Horrocks M 
Published: March 2007

Abstract
Repair of abdominal aortic aneurysm (AAA) carries a xconsiderable rate of morbidity and mortality, but little information exists on the quality of life following this procedure. During 1988 and 1989, in two hospitals, 211 patients (186 men and 25 women; median age 74 (range 48--87) years) underwent surgery for AAA. There were 77 ruptured aneurysms and 134 electively repaired. Of these, 38 patients died in hospital (27 ruptured, 11 elective); by the time of review a further eight (one ruptured, seven elective) had died from unrelated causes. Of the 165 survivors, 131 (45 ruptured, 86 elective) were reviewed and questioned as to their physical and mental state before and after surgery. Using the Rosser index, a value for quality of life before and after surgery was calculated (1.0, good; 0, dead). The value for the elective group was 0.94 before operation and 0.96 after, but in the ruptured group fell from 0.98 before surgery to 0.87 afterwards. This study shows that patients undergoing elective surgery for repair of AAA retain good quality of life. By contrast, patients surviving emergency surgery following this procedure seem to suffer a deterioration in life quality, which must be endured for the same expected lifetime as that for the elective group. These results support the need for a national AAA ultrasonographic screening programme.
Role of topical lignocaine during carotid endarterectomy
Authors: Welch M , Tait W F , Durrans D , Carr H M H , Jackson P W , Walker M G 
Published: March 2007

Abstract
Forty carotid endarterectomies were undertaken in 34 patients. Operations were prospectively randomized to periarterial application of either 1 per cent lignocaine (n = 19) or normal saline (n = 21), and detailed measurements taken of intraoperative pulse rate and blood pressure. Patients receiving lignocaine demonstrated a lower pulse rate, and lower systolic and mean blood pressures than those receiving placebo, with significance in relation to clamp application and shunt removal (P &lt; 0.05). It was particulary noticeable that patients receiving lignocaine demonstrated less intraoperative variation in pulse rate and blood pressure. Topical lignocaine stabilizes pulse rate and blood pressure during carotid endarterectomy.
Diagnostic and therapeutic aspects of fine-wire localization biopsy for impalpable breast cancer
Authors: Hastrich D J , Dunn J M , Armstrong J S , Davies J D , Davies Z D , Webb A J , Farndon J R 
Published: March 2007

Abstract
During the first 2 years (July 1989 to July 1991) of the Avon Breast Screening Service, fine-wire localization biopsy was indicated in 213 impalpable breast lesions. A total of 144 lesions were benign and 69 malignant. Only four of 213 lesions (1.9 per cent) were not excised at the first localization. Factors influencing reoperation in the 69 patients with malignant impalpable lesions were examined. There was a significant association (P &lt; 0.001) between parenchymal disturbances on mammography and invasive carcinoma, and between non-invasive carcinoma and microcalcification (P &lt; 0.001). In 31 patients the localization biopsy was the only surgical procedure. Thirty-eight patients required further surgery: 12 underwent further local excision and 26 mastectomy. Reoperation was more frequent in patients with calcification than in those with parenchymal disturbance (P &lt; 0.001). The most frequent indications for mastectomy were inadequate excision of widespread comedo ductal carcinoma in situ or invasive ductal carcinoma combined with extensive ductal carcinoma in situ. Fine-wire localization biopsy was a combined therapeutic and diagnostic procedure in 31 of 69 women with impalpable screen-detected lesions. The majority of patients required further surgery because radiological abnormalities underestimated the extent of disease.
Symptom index as a marker of gastro-oesophageal reflux disease
Authors: Johnston B T , McFarland R J , Collins J S A , Love A H G 
Published: March 2007

Abstract
Forty per cent of patients with heartburn may have no evidence of oesophagitis or of abnormal oesophageal acid exposure. The symptom index correlates symptoms that occur during pH monitoring with episodes of acid reflux, being the number of symptoms during reflux divided by the total number occurring during monitoring. This index was assessed in 61 patients with heartburn. In 39 patients with endoscopic evidence of oesophagitis or abnormal acid exposure times on pH monitoring, the symptom index had a sensitivity of 90 per cent. Of the 22 patients with no objective abnormality, the index was ≥ 50 per cent in five (23 per cent) whose symptoms were presumably due to acid reflux despite results of other investigations being normal, suggesting an acid-sensitive oesophagus. The symptom index is a useful additional measure in the investigation of patients with suspected gastro-oesophageal reflux disease.
Ambulatory measurement of oesophageal function: Clinical use of a new pH and motility recording system
Authors: Barham C P , Gotley D C , Miller R , Mills A , Alderson D 
Published: March 2007

Abstract
Conventional oesophageal manometric studies are open to criticism in that they take place on fasted immobile subjects in the artificial setting of a motility laboratory. A new 24-h pH and motility recording system combined with computerized data analysis was used to study patients with gastro-oesophageal reflux disease and oesophageal motor abnormalities under ambulant conditions. Acid reflux episodes were found to be precipitated by a variety of events with recognizable pressure patterns. Acid clearance abnormalities were demonstrated in patients with erosive oesophagitis but were confined to those with abnormal oesophageal motor function. Improved diagnostic accuracy was demonstrated in the recognition of oesophageal motor disorders.
Inguinal herniotomy in young infants
Authors: Fung A , Barsoum G , Bentley T M , Wild K , Klidjian A M 
Published: March 2007

Abstract
Ninety-two consecutive infants aged up to 12 months underwent primary inguinal herniotomy over a 5-year period. All were treated in a district hospital paediatric surgical unit according to recommendations of the British Association of Paediatric Surgeons. After a mean follow-up of 45.8 months, one patient had a failed repair and four (4 per cent) a hernia recurrence. One infant developed a wound infection. Infantile hernia can be managed safely and efficiently in a district hospital.
Comparative audit: An experimental study of 147882 general surgical admissions during 1990
Authors: Dunn D C , Fowler S 
Published: March 2007

Abstract
In 1991,1025 general surgical Fellows of The Royal College of Surgeons of England were circulated with a pro forma and asked to submit local audit results for admissions during 1990 to a confidential comparative audit service. The individual topics of cholecystectomy and colorectal resection were studied. Data returned by 160 surgeons concerned 147882 admissions including 122620 operations. Overall mortality rates ranged from 0 to 5 per cent and morbidity rates from 0 to 22 per cent. Laparoscopic cholecystectomy was associated with one-quarter of the mortality rate and two-thirds the morbidity rate of open cholecystectomy. Of the 33 surgeons who responded to a survey after the presentation of results, all wished to continue the exercise in future years; 39 per cent had been stimulated to perform further analyses and 15 per cent had changed practice habits as a result. Comparative audit involving large numbers of patients and surgeons is feasible and seems beneficial to participants.
Presentation of abdominal tuberculosis to general surgeons
Authors: Underwood M J , Thompson M M , Sayers R D , Hall A W 
Published: March 2007

Abstract
Abdominal tuberculosis (TB) continues to give rise to diagnostic and therapeutic challenges. A total of 24 patients with abdominal TB who presented to general surgeons over a 9-year period have been reviewed. Most (92 per cent) of these patients were Asian; only one had a past history of pulmonary TB. The most common presenting complaint was abdominal pain in 21 patients (88 per cent) with the associated symptoms of weight loss in 18 (75 per cent), anorexia in 15 (62 per cent) and night sweats in 13 (54 per cent). A tissue diagnosis was obtained in 18 patients (75 per cent) and 17 patients (71 per cent) underwent laparotomy. These results show that the diagnosis of abdominal TB is still difficult to establish, and that many patients undergo laparotomy despite the existence of less invasive diagnostic procedures.
Prevention of cardiovascular effects of endotoxaemia by monoclonal antibodies specific for core endotoxin
Authors: Reidy J , Wright I , Boom S J , Barclay R , DiPadova F , Ramsay G 
Published: March 2007

Abstract
Passive immunization with antibody to the core region of endotoxin (core lipopolysaccharide (LPS)) has been reported to reduce mortality in severe sepsis. A rat model of endotoxaemia that reproduces the hyperdynamic cardiovascular state seen in early sepsis was developed to test monoclonal antibodies specific for core LPS. A thermodilution technique of measuring cardiac output was adapted for use in rats. Twenty-five animals were anaesthetized and mechanically ventilated with monitoring of central venous pressure and mean arterial pressure. Fluid replacement was adjusted to maintain the central venous pressure. Controls (n = 10) and antibody-treated animals (n = 5) showed no significant change in cardiac output. Animals given 0.1 mg kg−1 R2 endotoxin over 1 h (n = 5) showed a significant rise in cardiac output of 65 per cent (P &lt; 0.01). This was abolished in rats given both antibody and endotoxin (n = 5). This study provides evidence that a monoclonal antibody against core LPS abolishes the hyperdynamic state induced by endotoxin infusion.
Prognostic significance of regional lymph node reaction after curative resection of advanced gastric cancer
Authors: Oka M , Yoshino S , Hazama S , Shimoda K , Suzuki M , Suzuki T 
Published: March 2007

Abstract
The prognosis of patients with advanced gastric cancer who undergo curative resection is still unsatisfactory. The relationship between prognosis and various factors such as stage, lymph node metastasis, serosal invasion and regional lymph node reaction (follicular hyperplasia and sinus histiocytosis) was evaluated. Of the factors studied, the only one that correlated well with survival was sinus histiocytosis. Lymph node metastasis was related weakly to prognosis. No correlation between prognosis and stage, serosal invasion or follicular hyperplasia was observed. Sinus histiocytosis may represent the morphological tumour-host immune reaction. Lymph node metastases or histological types were not related to regional lymph node reaction. These results suggest that sinus histiocytosis could be a useful prognostic factor for gastric cancer. Intensive postoperative follow-up for recurrence may be necessary even for patients with low-grade sinus histiocytosis in whom curative surgery is attempted.
Nasogastric intubation and elective abdominal surgery
Authors: Sagar P M , Kruegener G , MacFie J 
Published: March 2007

Abstract
The use of nasogastric tubes after elective abdominal surgery remains standard practice for many surgeons. Such tubes, however, cause much discomfort and are associated with significant morbidity. This paper reviews the arguments for and against nasogastric intubation, and finds little evidence to support its continued routine use.
Prevalence of abdominal aortic aneurysm in the offspring of patients dying from aneurysm rupture
Authors: Bengtsson H , Sonesson B , Länne T , Nilsson P , Solvig J , Loren I , Bergqvist D 
Published: March 2007

Abstract
The prevalence of abdominal aortic aneurysm (AAA) is high in the brothers of patients with aneurysm. A genetic component in the development of AAA has, therefore, been postulated. In this study the offspring of patients who had died from AAA rupture were invited to undergo ultrasonography of the abdominal aorta. The attendance rate was 69per cent. Thirty-nine sons of median age 60 (range 45–75) years and 23 daughters of median age 62 (range 42–80) years were examined. Abdominal aortic dilatation was found in eight men and one woman. The presence of aortic dilatation in these nine cases was not related to age, hypertension, smoking or symptoms of occlusive arterial disease. It is concluded that the sons of those who have died from ruptured AAA constitute a high-risk group for the development of this condition and should be considered for further screening.
Prostacyclin production from seeded prosthetic vascular grafts
Authors: Budd J S , Allen K , Hartley J , Walsh A , James R F L , Bell P R F 
Published: March 2007

Abstract
Endothelial cell seeding has been proposed as a method of improving potency rates in small-calibre prosthetic vascular grafts. In vivo, endothelid cells normally produce prostacyclin (PGI2), a potent antiplatelet agent. The aim of this study was to determine whether seeded grafts show significant PGI2 production after in vivo implantation. Grafts were seeded with either autologous canine venous endothelial cells or autologous microvascular endothelial cells. After 12 weeks, PGI2 production was assessed under basal and stimulated conditions. Seeded grafts were compared with non-seeded controls and the corresponding aorta. The overall patency rate in seeded grafts was 80 per cent compared wiih 10 per cent in non-seeded grafts (P &lt; 0.01). Grafts seeded with cells from either source produced significantly more PGI2 than unseeded grafts in both basal cind stimulated states (P &lt; 0.05). The aorto produced significantly more PGI2 than seeded grafts under both conditions (P &lt; 0.01). Endothelial cell seeding produces a functional graft and leads to an improved patency rate.
Parotidectomy for parotid tumours: 19-year experience from the Netherlands
Authors: Debets J M H , Munting J D K 
Published: March 2007

Abstract
A total of 150 patients were treated for parotid tumours over a period of 19 years. In 94 per cent superficial or total parotidectomy was performed. Histological diagnosis of the resected specimen revealed pleomorphic adenoma in 92 patients (61 per cent), Whartin's tumour in 30 (20 per cent), various benign neoplasms in 11 (7 per cent) and malignant tumour in 17 (11 per cent). After a mean. follow-up of 7.7 years, no recurrence of a benign tumour was seen. Malignant tumours recurred in five patients. Permanent partial facial paralysis was seen in 4 per cent of patients after surgery, for benign lesions. Frey's syndrome was observed in 43 per cent of patients, and was not prevented by resection of the auriculotemporal nerve.
Meal area index: a new technique for quantitative assessment in achalasia by ambulatory manometry during eating
Authors: Stuart R C , Byrne P J , Lawlor P , O'Sullivan G , Hennessy T P J 
Published: March 2007

Abstract
Ambulatory non-perfused oesophageal manometry was used to study oesophageal body function during consumption of a full meal in patients with achalasia. A measure of oesophageal body activity (the meal area index) was developed by calculating the total area under the pressure curve during eating, above the preprandial baseline oesophageal pressure, per meal minute. Untreated patients with achalasia (n = 13) were compared with normal subjects (n = 42) patients with benign stricture (n = 9) and patients with achalasia who had undergone Heller's myotomy (n = 17). The results showed a high meal area index in achalasia, due to a rise in baseline oesophageal pressure and frequent high-amplitude contractions during eating. This was not seen in normal subjects or patients with stricture. The high meal area index was abolished by successful Heller's myotomy but remained in two patients with persisting dysphagia. Sustained high intraoesophageal pressure is generated during consumption of a solid meal in untreated achalasia, resulting in a unique manometric profile. Manometry during eating using the meal area index permits quantitative assessment of oesophageal body function in achalasia and may aid in the assessment of response to treatment.
Evaluation of routine upper digestive tract endoscopy before laparoscopic cholecystectomy
Authors: Ure B M , Troidl H , Spangenberger W , Lefering R , Dietrich A , Sommer H 
Published: March 2007

Abstract
Endoscopy of the upper digestive tract was performed in 376 patients with symptomatic gallstone disease before elective laparoscopic cholecystectomy. Abnormalities were found in 60 patients (16.0 per cent); these included peptic ulcer (n = 14), gastric erosions (n = 15) and oesophagitis (n = 11). Thirty patients were treated medically and two by endoscopic polypectomy. In four patients endoscopy led to cancellation of cholecystectomy; in two the complaints have persisted. Statistical analysis of 28 variables showed few significant differences in symptoms between patients with normal and those with abnormal appearances at endoscopy. It is concluded that routine endoscopy before laparoscopic cholecystectomy is neither clinically useful nor cost effective in patients with symptomatic gallstone disease. This conclusion is related exclusively to patients with typical gallstone symptoms according to the definition used in this department.
Open method versus capsulorrhaphy without drainage in the treatment of children with hepatic hydatid disease
Authors: Wu X , Tan J Z , Yang J H , Shi T H , Zhou S N 
Published: March 2007

Abstract
A recognized major postoperative complication of hepatic hydatid disease is accumulated hydrops leading to secondary infection in the residual cavity of the excised cyst. This study examined two methods of treating cystic hepatic hydatid disease in 43 children. A group of 22 children were treated by a new method of open drainage; 21 underwent capsulorrhaphy without drainage. There was no mortality or morbidity. The open method was associated with more rapid resolution of hydrops and quicker shrinkage of residual cavities, with efficacy over a median follow-up of 42 months.