bluuebunny/crossref_metadata_2025_split huggingface dataset:
The venous anatomy of the lower oesophagus in normal subjects and in patients with varices: An image analysis study
Authors: Spence R A J 
Published: March 2007

Abstract
The microvasculature of the lower oesophagus has been studied quantitatively using a computer assisted image analysis system. Twenty normal specimens of oesophagus and stomach were studied and seven further specimens from patients with varices were also assessed. Each specimen could be clearly subdivided into three zones. Zone 1 was the stomach where the mean relative area occupied by veins in the lamina propria was 2.6 per cent (s.e.m. ±0.2) in the normal subjects and 3.7 per cent (s.e.m. ±0.8) in the variceal specimens. Zone 2 began at the oesophagogastric junction and extended 2–5 cm into the lower oesophagus. The mean area occupied by veins in the lamina propria increased to 19.8 per cent (s.e.m. ±1.2) in the normal and 32.8 per cent (s.e.m. ±3.9) in the varices specimens. Zone 3 was the remainder of the proximal oesophagus and the mean area occupied by veins in the lamina propria was 4.9 per cent (s.e.m. ±0.3) in the normal and 6.1 per cent (s.e.m. ±0.5) in the varices specimens. Further analysis revealed that this increase in area occupied by veins in the distal oesophagus was due to an increase in both the number and size of vessels in the lamina propria of Zone 2. These findings may explain the propensity for oesophageal varices to bleed mainly from the distal oesophagus.
Surgical treatment of squamous cell carcinoma of the oesophagus
Authors: Hennessy T P J , O'Connell R 
Published: March 2007

Abstract
During the period 1976–1983, a total of 72 patients with squamous cell carcinoma of the oesophagus were seen. Exploration was undertaken in 62 patients and all those explored had their tumours resected. The overall operative mortality rate was 12.9 per cent. Overall survival rates were 49 per cent at 1 year, 31 per cent at 2 years and 11.5 per cent at 5 years.
Dilatation of benign oesophageal strictures in the outpatient department
Authors: Stoddard C J , Simms J M 
Published: March 2007

Abstract
Maloney's mercury weighted dilators have been used to dilate benign oesophageal strictures in 109 patients in the outpatient department. A total of 524 dilatations have been performed. Following dilatation two patients had a small haematemesis but there have been no oesophageal perforations. Maloney's dilators can be used in the outpatient department effectively to dilate benign oesophageal strictures and the risk of complications is low.
Drainage operations in chronic pancreatitis
Authors: Cooper M J , Williamson R C N 
Published: March 2007

Abstract
If pancreatic ductal hypertension explained the pain of chronic pancreatitis, adequate decompression of ectatic ducts should provide lasting relief. We have analysed a personal series of 20 patients (14 men and 6 women) with chronic pancreatitis undergoing one or more drainage procedures. Alcohol was the main aetiological factor, and symptoms had been present for a median of 2.5 years. Pancreatic ductal decompression was achieved by pancreatic sphincteroplasty (n = 4) or longitudinal pancreaticojejunostomy (11). Thirteen patients underwent incidental or additional procedures to decompress the biliary tree: sphincteroplasty (5), choledochal bypass (7) and T-tube drainage (1). Cysts were either drained (7) or resected (3). Two patients required re-operation for subphrenic abscess. Some pancreatic insufficiency was detected pre-operatively in 11 patients (exocrine 10, endocrine 4) and was essentially unchanged in all but one patient who came to total pancreatectomy. Two other patients required a coeliac plexus block, but the remaining 17 patients had good pain relief at a median follow-up of 30 months. Ductal drainage procedures effectively relieve the pain of chronic pancreatitis without further compromising pancreatic function.
Surgery for acute Crohn's colitis: Results and long term follow-up
Authors: Mortensen N J McC , Ritchie Jean K , Hawley P R , Todd I P , Lennard-Jones J E 
Published: March 2007

Abstract
Acute Crohn's disease of the colon requiring emergency surgery is uncommon, but may be increasing in frequency. Between 1954 and 1981, 215 patients had surgery for acute inflammatory bowel disease at St. Mark's Hospital, and of these 18 had acute Crohn's colitis. There was one postoperative death, and the remaining patients were followed up for an average of 8 years. Ten patients had toxic dilatation, two a toxic dilatation with free perforation, three had perforation without dilatation and in three surgery was required for an acute deterioration. Surgical treatment included proctocolectomy (one), colectomy and ileostomy (fourteen), colectomy and ileorectal anastomosis (two) and defunctioning ileostomy alone (one). Subsequent rectal excision was necessary in ten of sixteen patients. Acute colonic Crohn's disease requiring surgery is less likely than ulcerative colitis to be amenable to restorative surgery despite a policy of rectal conservation.
Femoropopliteal bypass with a Goretex prosthesis: A long-term follow-up
Authors: Klimach O , Underwood C J , Charlesworth D 
Published: March 2007

Abstract
This report describes a series of 101 femoropopliteal bypasses performed on 85 patients (16 bilateral procedures), in whom a 6 mm diameter polytetrafluoroethylene prosthesis (Goretex) was used. The indication for operation was severe claudication in 58 cases and pregangrene in 43 cases. After one year there was a statistically significant difference between the cumulative patency rates for these two subgroups at 66 and 29 per cent respectively (P&lt;0·001). In patients with good ‘run-off’, i.e. three patent vessels in the lower leg, there was a tendency for the bypasses to remain patent for longer than in patients in whom there were only one or two vessels present (e.g. 58 and 33 per cent respectively at 2 years), although this trend was not statistically significant. At 3 years the cumulative patency rate for the whole group was 36 per cent and for claudicants alone was 48 per cent.
Acute gastrointestinal complications of infrarenal aortic aneurysm repair
Authors: Crowson M , Fielding J W L , Black J , Ashton F , Slaney G 
Published: March 2007

Abstract
Acute gastrointestinal complications developed in 31 of 472 patients following aortic aneurysmectomy (6·6 per cent). In order of frequency these were: ischaemic intestine in nine patients, mechanical or paralytic ileus in eight patients, peptic ulceration in seven patients, undiagnosed gastrointestinal bleeding in five patients and paraprosthetic fistula in two patients. The risk of developing peptic ulcer complications was not significantly increased in patients with a previous history of peptic ulcer disease. The risk of developing an ischaemic intestine was increased if the distal limb of a prosthesis was anastomosed directly to the external iliac artery. The associated mortality was high and 21 (67·7 per cent) patients died. 33·3 per cent of the mortality occurring with elective aneurysm resection was associated with gastrointestinal complications.
Vascular injury following cardiac catheterization
Authors: McMillan I , Murie J A 
Published: March 2007

Abstract
Fifteen out of 3500 patients undergoing cardiac catheterization sustained arterial injury requiring surgical repair. Seven injuries to the common femoral or profunda femoris arteries presented late as false aneurysms, requiring simple suture repair. Three superficial femoral and four brachial artery injuries presented immediately after catheterization and surgical repair generally required the insertion of a vascular graft. The outcome of surgery was uniformly excellent. Small vessel cannulation is associated with increased likelihood of arterial injury. The common femoral route, with a high puncture site avoiding the superficial femoral or profunda vessels, is to be preferred to the brachial approach.
Benign bile duct stricture following cholecystectomy: Critical factors in management
Authors: Blumgart L H , Kelley C J , Benjamin I S 
Published: March 2007

Abstract
Seventy-eight patients with benign bile duct stricture following cholecystectomy were referred for further management over an 8-year period. The majority (58 per cent) had multiple operations before referral. On presentation 90 per cent of patients had abnormal liver function tests, 19·5 per cent a depressed serum albumin, 49 per cent a history of previous major infection, and 14 per cent associated liver disease and portal hypertension. Seventy-two patients (92 per cent) were operated upon: 63 by stricture repair alone, 4 by stricture repair and portal systemic anastomosis, and one by splenorenal anastomosis alone. Of the patients treated by stricture repair alone and no other procedure 90 per cent have a good result with a mean follow-up of 3.3 years, and an operative (30-day) mortality of 3·2 per cent. There were no postoperative deaths in 61 patients in whom stricture repair alone was performed by direct suture techniques, but in the presence of portal hypertension and liver disease the mortality was 27 per cent. Factors influencing a satisfactory stricture repair were the number of previous operations, site of stricture and type of repair. Factors influencing mortality were the number of previous operations, a history of major infection, the site of stricture, pre-operative serum albumin concentration, and the presence of liver disease and portal hypertension.
Pre-operative localization of parathyroid tumours using static B scan ultrasonography
Authors: Parrott N R , Rose P G , Farndon J R , Johnston I D A 
Published: March 2007

Abstract
Time consuming, inaccurate and often invasive localization procedures before initial surgery in primary hyperparathyroidism are probably not justified. The clinical value of pulsed ultrasound has been appreciated since 1975 and the application of dedicated, high resolution, real time systems is now advocated. This paper examines the efficacy of conventional static B scan equipment in pre-operative localization of parathyroid tumours in 34 patients. When considering all glands, a true positive value (sensitivity) of 55·5 per cent was achieved, with a true negative rate (specificity) of 96·0 per cent. The accuracy for all glands (the true positive plus true negative results as a percentage of all glands scanned) was 85·3 per cent. An accuracy of 93 per cent was achieved when considering glands greater than 5 mm diameter, with false positive and negative rates of 3·6 and 20·0 per cent respectively. The limitations of the technique are discussed in the context of the current literature.
Anorectal profilometry with the microtransducer
Authors: Varma J S , Smith A N 
Published: March 2007

Abstract
The reproducibility of anal sphincter manometry has been evaluated in 17 patients with a continuous pull-through technique using a miniature transducer mounted on a 2mm diameter Dacron catheter. Comparison was made with a conventional station pull-through technique using a 4mm diameter waterfilled microballoon connected to an external transducer. Parameters measured with the microtransducer (maximum resting pressure, squeeze pressure, functional sphincter length, area under high pressure zone, amplitude of rectosphincteric reflex) showed mean coefficients of variation from 3·2 to 5·7 per cent. Pressures measured with the microballoon were uniformly higher than those obtained with the microtransducer. The functional sphincter length was significantly shorter when measured with the microballoon (P &lt; 0·001). The microtransducer provides a highly accurate and reproducible method of anorectal profilometry that avoids many of the drawbacks associated with fluid-filled systems.
Natural killer cells in renal allograft rejection
Authors: Cooksey G , Robins R A , Blamey R W 
Published: March 2007

Abstract
Monoclonal antibody Anti Leu 7 has been used to enumerate peripheral blood NK cells in 20 renal allograft recipients. Blood was taken preoperatively and three times per week for the first month after transplantation; separated mononuclear cells were stained with Anti Leu 7 then analysed on a fluorescence activated cell sorter. Results were related to acute rejection episodes diagnosed clinically and confirmed by Trucut biopsy of grafts. A reduction in the number of Leu 7 positive cells occurred postoperatively. Nineteen out of 20 patients showed a rise in number of circulating NK cells during acute rejection episodes.
Serum carcinoembryonic antigen and acute phase reactant proteins in the pre-operative detection of fixation of colorectal tumours
Authors: Durdey P , Williams N S , Brown D A 
Published: March 2007

Abstract
Fixity of colorectal tumours carries a poor prognosis, but only if it is the consequence of malignant spread. Pre-operative radiotherapy may be beneficial but selection depends on clinical examination which is often inaccurate or impossible. We therefore investigated if serum concentrations of carcinoembryonic antigen and acute phase reactant proteins (APRPS) which may be elevated in patients with colorectal cancer could determine the degree and nature of local spread prior to operation. Carcinoembryonic antigen (CEA), α1 acid glycoprotein (AGP) and C-reactive protein (CRP) were measured pre-operatively in 100 patients with colorectal tumours, 89 of whom had a carcinoma. Thirty-two (36 per cent) were fixed, 18 (56 per cent) by malignancy (FM) and 14 (44 per cent) by inflammation (F1). Levels of CEA, AGP and CRP were all significantly higher in the serum of patients with fixed tumours (P &lt; 0·05). Concentrations of AGP &gt; 1·4 g/l or CRP &gt; 15 mg/l were accurate predictors of tumour fixation (specificity 87 and 90 per cent; sensitivity 78 and 78 per cent. CEA appeared more accurate in determining the nature of fixation. A value of &gt; 50ng/ml predicted 82 per cent of FM tumours (specificity 100 per cent; sensitivity 87 per cent). Thus, pre-operative measurement of serum CEA and APRP appear able to predict fixation of colorectal tumours.
Evidence for sphincter dysfunction in patients with gallstone associated pancreatitis: Effect of ceruletide in patients undergoing cholecystectomy for gallbladder disease and gallstone associated pancreatitis
Authors: Cuschieri A , Cumming J G R , Wood R A B , Baker P R 
Published: March 2007

Abstract
The functional activity of the sphincter of Oddi complex has been examined by ceruletide manometry in patients undergoing cholecystectomy with a normal peroperative cholangiogram. In Group I (n = 14), which included patients with previous acute cholecystitis/biliary colic, the sphincter activity appeared to be normal and responded to intravenous ceruletide by a marked relaxation with a significant fall in both the infusion and postinfusion pressures. In patients undergoing cholecystectomy for gallstone-associated pancreatitis (n = 8), the sphincter exhibited manometric features of hypotonia with low infusion and postinfusion pressures which were not significantly altered by intravenous ceruletide.
Emergency surgery for diverticular disease complicated by generalized and faecal peritonitis: A review
Authors: Krukowski Z H , Matheson N A 
Published: March 2007

Abstract
There is little uniformity in either the indications for operation, the classification of the pathology or the operative management of generalized or faecal peritonitis secondary to perforated diverticular disease. Nevertheless, this review has shown a clear advantage both in terms of immediate mortality and morbidity for primary resection over conservative operations in which the colon is retained in the abdomen. We propose that, when a clinical diagnosis of localized sepsis secondary to diverticular disease is made, the management should be nonoperative with systemic antibiotics and supportive therapy. Operation should be reserved for those patients with obvious generalized peritonitis or failure of conservative treatment. When operation is necessary the affected sigmoid loop should be resected and the operation completed as a Hartmann's procedure in all but the most favourable circumstances when a primary anastomosis may be considered after on-table irrigation of the colon.
An evaluation of pelvic lymphoscintigraphy in the staging of colorectal carcinoma
Authors: Reasbeck P G , Manktelow Anne , McArthur A M , Packer S G K , Berkeley B B 
Published: March 2007

Abstract
Lymphoscintigraphy was used to delineate the lymphatic drainage of the rectum and distal colon in 18 patients with carcinoma of the rectum or sigmoid colon, in four with inflammatory disease of the large bowel and in 20 controls without colorectal pathology. Abdominal imaging was performed after submucosal injection of either 4mCi 99mTc-antimony sulphide colloid or 0·5 mCi 99mTc-dextran into the rectum through a proctoscope. In nine patients with colorectal carcinoma, abdominal imaging was performed immediately pre-operatively and the excised specimen of large bowel was also imaged in vitro immediately postoperatively. The presence or absence of nodal uptake of radionuclide on abdominal scanning did not discriminate between normal and diseased large bowel, and the extent of nodal uptake demonstrated either by abdominal scans or by in vitro scans of excised specimens bore no relationship to the presence or absence of nodal metastases demonstrated histologically in the cancer patients. Pelvic lymphoscintigraphy as performed in this study has no demonstrable value in the diagnosis or staging of colorectal cancer.
Detection of liver metastases. A prospective study comparing liver enzymes, scintigraphy, ultrasonography and computed tomography
Authors: Schreve R H , Terpstra O T , Ausema L , Lameris J S , Van Seijen A J , Jeekel J 
Published: March 2007

Abstract
A prospective comparative study between liver enzymes, scintigraphy, ultrasonography and computed tomography for detection of liver metastases was performed in 113 patients who were eligible for operation for a carcinoma in the gastrointestinal tract. Twenty-three of the 113 patients (20 per cent) had liver metastases. The accuracy of scintigraphy was 79 per cent, of ultrasonography 85 per cent and of computed tomography 88 per cent. The results of these tests showed no statistical differences. Ultrasonography and computed tomography were significantly more accurate than alkaline phosphatase and γ-glutamyl transpeptidase (respectively P&lt;0·01 and P&lt;0·05). Taking into account cost effectiveness, simplicity and patient tolerance, ultrasonography is the test of choice for the detection of liver metastases.
The management of soft tissue sarcomas
Authors: Brennan M F 
Published: March 2007

Abstract
The management of soft tissue sarcomas presents one of the more exciting areas of the application of multimodal therapy for malignancy. Rapid developments have taken place in the understanding of the histogenesis, histopathology, prognostic indicators and treatment approaches. With the combination of local irradiation and adjuvant chemotherapy, limb sparing operations can now be widely advocated with amputation being reserved for proximal difficult lesions. Retroperitoneal sarcomas, however, remain a major challenge with little progress in results of therapy, other than improved operative morbidity in the last 10–15 years. Current prospective, randomized studies of the management policies designed to maximize survival while minimizing morbidity should provide further insights in the near future. Our current and past experience with more than 150 new cases each year allows a brief summary of the understanding and management of these difficult problems.
Benign breast disease in a West Indian population
Authors: Raju G C , Naraynsingh V 
Published: March 2007

Abstract
A review of 1726 breast lesions in West Indian women from Trinidad showed that the pattern of disease is significantly different from that reported in whites but similar to reports from India and Africa. This difference is mainly due to the high frequency of fibro-adenoma in our adolescent women. Fibro-adenoma was the commonest lesion (39.3 per cent), followed by mammary dysplasia (32 per cent) and carcinoma (21 per cent). Although carcinoma comprised only 21 per cent of all breast lesions, nearly 40 per cent of true neoplasms were malignant. We believe all suspicious breast lumps in black women need biopsy and further analysis of morphological components of benign breast lesions is necessary to evaluate precursors to cancer of the breast.
Pain and mobility after inguinal herniorrhaphy: Ineffectiveness of subcutaneous bupivacaine
Authors: Cameron A E P , Cross F W 
Published: March 2007

Abstract
We studied pain and mobility in 101 men undergoing elective unilateral inguinal herniorrhaphy. Subcutaneous infusion of 0.5 per cent bupivacaine via a fine catheter was used as an adjunct to conventional analgesia in half of the patients. This had no effect on the perception of pain measured at 8 and 24 h by visual linear analogue, nor on the analgesics requested by the patients. The walking ability of all patients was significantly impaired 24 h postoperatively, but again bupivacaine conferred no benefit. Organisms were cultured from 12.5 per cent of the catheters.
The diagnosis of aortic graft-enteric fistulae by computed tomography
Authors: Ackroyd Jenny , Williams T G , Thomas M Lea , Burnand K G 
Published: March 2007

Abstract
A number of techniques have been used to diagnose aortic graft-enteric fistulae. These are reviewed and their value assessed. Three patients are described in whom the diagnosis was correctly made from characteristic appearances seen on a computed tomography (CT) scan. Further experience may show that CT scanning has an important role in the detection of this condition.
A 30-year survey of pulmonary embolism verified at autopsy: An analysis of 1274 surgical patients
Authors: Bergqvist D , Lindblad B 
Published: March 2007

Abstract
A retrospective study was undertaken of all surgical patients in Malmö, Sweden, during the period 1951-1980, in whom pulmonary emboli were found at autopsy. The autopsy rate was high throughout the period, ranging from 73 to 100 per cent. Of 5477 patients who died during the period, 1274 had pulmonary emboli (23.6 per cent), 349 of which were considered fatal, 353 contributory to death and 572 incidental. Fifty-one per cent of the patients were not operated upon. The number of contributory and incidental emboli increased over the period, to some extent probably reflecting greater thoroughness in postmortems. The frequency of fatal pulmonary emboli decreased in the last 5 year period. Pulmonary embolism was more rare in patients under 50 years of age. The proportion of females increased. In 24 cases major embolism emanated from thrombi around central venous catheters. This retrospective analysis of a large number of patients shows that pulmonary embolism continues to be a major cause of death in surgical patients, and in Malmö as common a cause of death in operated as in nonoperated patients.
Familial aortic aneurysms: Serum concentrations of triglyceride, cholesterol, HDL-cholesterol and (VLDL + LDL)-cholesterol
Authors: Norrgård Ö , Ängquist K-A , Johnson O 
Published: March 2007

Abstract
Patients with abdominal aortic aneurysms (AAAs) have been compared with healthy controls with respect to the serum concentrations of triglyceride, cholesterol, HDL-cholesterol and (VLDL + LDL)-cholesterol. The concentrations of triglyceride and (VLDL + LDL)-cholesterol in serum were higher in the patients than in the controls, while the concentration of HDL-cholesterol in serum was lower in the patients than in the controls. There was no statistically significant difference in the serum concentration of total cholesterol between the patients and the controls. Twelve patients had first degree relatives (brothers, sisters and/or parents) with AAAs and six patients had second degree relatives (cousins or brothers and sisters of the parents) with AAAs. There was no statistically significant difference between the patients who had first degree relatives with AAAs and the patients without AAAs in the family in the serum concentrations of triglyceride, cholesterol, HDL-cholesterol and (VLDL + LDL)-cholesterol.