bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of carotid artery stenosis using pulse wave transit time
Authors: Horrocks M , Roberts V C , Cotton L T 
Published: March 2007

Summary
A prospective study has been undertaken on 24 patients to establish the relationship between the degree of internal carotid artery stenosis, as estimated by arteriography, and the pulse wave transit time in the carotid artery. The technique involves the simultaneous use of two continuous wave Doppler velocimeters, one on the carotid and one on the supraorbital artery, to measure the flow waves and hence deduce the pulse wave transit times. The measured transit times varied from 17 to 124 ms with a beat-to-beat variation of 11 per cent.
The absolute transit time in any segment correlated moderately well with the estimated degree of stenosis (r = 0.68, P &lt; 0.001). However, normalization of the transit times, to correct for the effects of blood pressure and age, produced an improved correlation between the variables (r = 0.8, P &lt; 0.001). Normalization was achieved by dividing the common carotid to supraorbital transit time by the shortest transit time found between the common carotid and either the superficial temporal or brachial arteries.
Significant differences in the normalized transit times were found between arteries that were diametrically stenosed by more than 50 per cent, by between 21 and 50 per cent and by 20 per cent or below. It is concluded that pulse wave transit time measurement can provide a simple and reproducible non-invasive technique for the diagnosis of varying degrees of carotid artery stenosis.
Radiological assessment of nipple–valve insufficiency in Kock's continent reservoir ileostomy
Authors: Standertskjöld-Nordenstam C-G , Palmu A , Sivula A 
Published: March 2007

Summary
In a series of 51 continent reservoir ileostomies nipple–valve insufficiency developed in 15 patients who were examined radiographically to find the cause for the loss of continency. The radiological diagnosis was confirmed at reoperation. The causes for nipple–valve insufficiency were a total or partial disappearance of the nipple–valve by sliding of the invaginate (7 cases) and dislocation of an undamaged nipple out of the reservoir (8 cases). In these groups the radiological diagnosis was compatible with the operative findings in all but one case. At reoperation a fistula in the nipple–valve was found in 3 cases, but in no instance had this been diagnosed radiologically. A correct preoperative diagnosis is valuable, especially in cases of dislocation, where a danger exists that the real mechanism of valve insufficiency may remain obscure at operation.
Closure of colostomy in infants and children
Authors: Rickwood A M K , Hemalatha V , Brooman P 
Published: March 2007

Summary
A retrospective survey of 100 consecutive colostomy closures in infants and children is presented: the operative technique consisted of bowel resection and anastomosis, usually as a single layer, with intraperitoneal closure. Faecal fistula occurred in 5 cases and there were other major complications in 8 instances. Wound infection occurred in 43 patients. The subsequent use of a more aggressive bowel preparation reduced the incidence of this complication.
The ingrowing toenail: A modified segmental matrix excision operation
Authors: Gabriel S S , Dallos V , Stevenson D Lang 
Published: March 2007

Summary
A series of 528 patients with ingrowing toenails has been operated on under local anaesthetic by one surgeon using a simple technique in which a segment of germinal matrix is completely excised without cutting skin and with minimal interference with the nail wall. Normal footwear was worn by the fifth day in 79 per cent of patients. The recurrence rate was 1.7 per cent.
Melanoma of the nipple and areola
Authors: Papachristou D N , Kinne D , Ashikari R , Fortner J G 
Published: March 2007

Summary
Fourteen primary melanomas arising in the nipple and areola of the breast were treated by mastectomy and axillary dissection. Four patients had axillary lymph node metastases and all were dead within 3 years of their operation, while the 10 patients with no axillary node involvement were free from recurrent disease 5 years after their operation. On the basis of clinical and anatomical studies, it is suggested that a wide local excision without mastectomy is adequate for the treatment of nipple and areola melanomas.
Sclerotherapy for hydrocoele and epididymal cysts
Authors: Nash J R 
Published: March 2007

Summary
A prospective study was carried out on the efficacy of sclerotherapy for the treatment of hydrocoeles and epididymal cysts. Thirty-six hydrocoeles and 13 epididymal cysts were treated and followed up for between 1 and 2 years. Thirty-four hydrocoeles were cured, 1 failed to respond to treatment and 1 recurred after treatment. All 13 epididymal cysts were cured.
The effect of aspirin on the fibrinolytic activity of gastric juice
Authors: O'Brien T E , Hadley Helen , Irving M H 
Published: March 2007

Summary
Fibrinolytic activity in the gastric juice of normal subjects has been studied by a double-blind cross-over technique comparing the effect of placebo and pentagastrin against aspirin and pentagastrin. Aspirin effectively produced a gastritis and pure fibrinolytic activity was detected in the gastric juice, but the number of samples showing pure fibrinolytic activity did not differ between the two groups. In both the placebo and the aspirin groups the presence of a protease active at neutral pH and capable of dissolving fibrin is confirmed. Aspirin is unlikely to cause gastric bleeding by increasing local fibrinolytic activity within the stomach. The model, so constructed, is not sensitive enough to be of value in investigating further the role of gastric fibrinolytic activity in gastric haemorrhage.
Chronic abdominal pain: A surgical or psychiatric symptom?
Authors: Woodhouse C R J , Bockner S 
Published: March 2007

Summary
A prospective investigation of chronic, non-specific abdominal pain in 20 patients is reported. The cause was found to be psychiatric in 8 (40 per cent), while a surgical cause was found in only 3 (15 per cent). Four had irritable colon (20 per cent) and no diagnosis was made in 5 (25 per cent). It is suggested that such pain is more often a psychiatric than a surgical symptom and therefore a psychiatric consultation should be a routine part of the investigation.
The management of insulin tumours of the pancreas
Authors: Le Quesne L P , Nabarro J D N , Kurtz A , Zweig S 
Published: March 2007

Summary
A series of 26 patients diagnosed as having an insulin-secreting, islet-cell tumour of the pancreas is described. Three patients were treated medically, but in the remaining 23 the tumour was found at operation; 1 patient had a carcinoma with hepatic metastases, but in the other 22 the tumour was apparently benign and the subsequent course of these patients has confirmed this conclusion.
The tumour was found at the initial operation in 19 of the 22 patients with a benign tumour treated surgically. Of the other 3, the tumour was removed at a second operation in 2 and at a third operation in 1. Two of the 22 patients died following the operation.
Diazoxide was administered to 21 patients, before and/or after operation. It was given preoperatively to 17 patients, in all of whom it prevented the development of hypoglycaemic symptoms, but in 2 it caused serious fluid retention and had to be discontinued. Seven patients have been successfully treated with long term diazoxide, either as an alternative to surgery or following an unsuccessful operation, 1 of these being the patient with an islet-cell carcinoma. In these patients diazoxide has been given for up to 12 years without apparent side effects.
Selective coeliac angiography was performed in 13 patients. In no patient did it provide critical information that significantly influenced the treatment of the patient.
Percutaneous, transhepatic portal venous catheterization was performed in 4 patients and indicated the site of the tumour in 3, 2 of whom had had 1 previous operation and 1 had had 2 previous operations, at none of which was a tumour found: in all 3 patients the tumour was removed at a subsequent operation.
The application of these findings to the management of patients with an insulinoma is discussed and a scheme of management is proposed.
A comparison of xenon-133 clearance with electromagnetic flowmeters and an indicator dilution method for the measurement of liver blood flow
Authors: Thorne Joanna , Bennett R , Shields R , Johnson J , Taylor I 
Published: March 2007

Summary
Measurement of liver blood flow has been carried out by three different methods in 14 dogs to assess the accuracy of xenon-133 clearance following portal vein injection.
Electromagnetic flowmetry with flow probes on the hepatic artery and portal vein resulted in a mean value of 121.9 ± 39.3 ml min−1 100 g−1. An indicator dilution study utilizing chromium-51-labelled red cells gave a mean value of 119.4 ± 31.4 ml min−1 100 g−1 and the xenon-133 clearance following portal vein injection, 120.3 ± 33.8 ml min−1 100 g−1. One-way analysis of variance showed no statistically significant variation between these three groups. There was a close correlation between xenon-133 clearance and electromagnetic flowmetry and between xenon-133 clearance and the indicator dilution technique.
These data suggest that xenon-133 clearance following portal vein injection gives an accurate assessment of liver blood flow and this technique (as well as direct parenchymal injection) can be adapted for clinical use.
Exploration of the common bile duct: A comparative study
Authors: Vellacott K D , Powell P H 
Published: March 2007

Summary
The results of a retrospective comparative study of 122 patients who underwent explorations of the common bile duct in a district general hospital over a 5-year period are presented. Seventy-eight patients had a supraduodenal choledochotomy, 32 had a transduodenal sphincterotomy and 12 had a combination of both procedures.
Particular attention was paid to postoperative complications in relation to the grade of the surgeon performing the operation and also to the age of the patient.
A total of 78 (64 per cent) patients had definite stones in the common bile duct. Of these patients, 7 (9 per cent) were subsequently shown to have retained stones, all having been operated on by registrars. Registrars also did more negative explorations than consultants.
Nine patients (7.4 per cent) died, all but 1 of them being over the age of 70 and 4 of them having had a combined procedure.
We conclude that transduodenal exploration should be avoided in patients over 70, particularly when added to a supraduodenal exploration.
Haemorrhagic cholecystitis
Authors: Shah V R , Clegg J F 
Published: March 2007

Summary
Two cases of haemobilia due to haemorrhagic cholecystitis are presented; only 28 other cases have been described. As there are so many more dramatic causes and treatment for haemobilia it is important for the surgeon to recognize that a common operation will suffice for this rare condition. In both cases bacteria were grown from the bile and it is to be hoped that bile culture will be recorded more commonly in future in cases of this interesting condition.
The excretion of alkaline ribonuclease by children undergoing surgery
Authors: Barlow G B , Whitear Susan H , Wilkinson A W 
Published: March 2007

Summary
The excretion of alkaline ribonuclease has been measured in the urine of two groups of children after major operations. The excretion was significantly increased in all patients after open operations on the heart and in many of those who were operated on soon after birth for anomalies in the intestine. It is suggested that these elevations may indicate a disturbance of pancreatic function.
Phaeochromocytomas in 72 patients: Clinical and diagnostic features, treatment and long term results
Authors: Modlin I M , Farndon J R , Shepherd A , Johnston I D A , Kennedy T L , Montgomery D A D , Welbourn R B 
Published: March 2007

Summary
Phaeochromocytomas were diagnosed in 72 patients in Hammersmith, Belfast and Newcastle between 1955 and 1976. Fourteen were found unexpectedly at autopsy while 58 were diagnosed in life. Associated lesions included neurofibromatosis (7 patients), medullary carcinoma of the thyroid (3), renal artery stenosis (2) and cerebellar haemangioblastoma (1). The clinical features were similar to those reported by others. Hypertension was found in all but one of the patients and was sustained only in 17 per cent, paroxysmal only in 48 per cent and sustained with superadded paroxysms in 33 per cent. Hypertension was significantly greater in the women than in the men.
Diagnosis was confirmed chemically in all patients and urinary vanylmandelic acid (VMA) was elevated in all but one. Tumours were localized correctly by various radiographic techniques and by selective venous sampling in over 80 per cent of patients. The tumours were in adrenals in 59 patients (bilateral in 6) and at extra-adrenal, intra-abdominal sites in 13.
The tumours were removed surgically from those in whom they were diagnosed in life. Before 1967 3 of 17 patients died after operation (18 per cent). Since then patients have been prepared with alpha blockade and have received infusions of plasma, blood or dextran after removal of the tumours. One of 41 patients so treated has died after operation (2 per cent). Phaeochromocytomas were diagnosed and treated in pregnancy in 4 patients, all of whom survived. Two of the fetuses died.
Five tumours diagnosed in life were malignant and 2 recurred (40 per cent). Fifty-three were benign and 2 of these recurred locally (4 per cent).
All but 2 patients (who could not be traced) were followed completely from 1 to 20 years after operation and 3 died during this period. Two-thirds of the patients were alive after 10 years.
Paroxysmal hypertension was abolished by operation, but sustained hypertension often persisted and required drug therapy.
It is concluded that at least one-third of phaeochromocytomas are not diagnosed in life and that a high index of suspicion is required to bring them to light. If they are diagnosed and treated by present methods, the prognosis is good.
Pancreatogram changes in patients with calculous biliary disease
Authors: Axon A T R , Ashton M G , Lintott D J 
Published: March 2007

Summary
A successful pancreatogram was obtained at endoscopic retrograde cholangiopancreatography (ERCP) in 53 patients with calculous biliary disease. Twenty-eight patients presented with jaundice and 25 with pain. In both groups there was a high incidence of pancreatogram abnormalities (47 and 48 per cent respectively). These findings demonstrate that the pancreas is often abnormal in the presence of complicated calculous biliary disease even though there may be no recent clinical evidence of pancreatitis and suggest that asymptomatic chronic pancreatitis may be common. The clinical significance of the abnormalities is discussed.
Cimetidine in the treatment of peptic ulceration following renal transplantation
Authors: Williams G , Castro J E 
Published: March 2007

Summary
Seven patients who developed peptic ulceration following renal transplantation have been treated by cirnetidine. One died before its value could be assessed. The remaining 6 were symptom-free within 48 h. In 3 patients the ulcer appeared healed on gastroscopy, in one there was no change, another required operation for gastrointestinal bleeding 1 month afrer beginning cimetidine and the other patient has been lost to follow-up after 5 months' treatment. Two patients had a significant rise of serum creatinine whilst on the drug, but there is no evidence of increased immunological reactivity towards the graft and no agranulocytosis.
Does rectal examination affect serum acid phosphatase levels?
Authors: Bannerjee S K , Barker I F , Waterworth T A 
Published: March 2007

Summary
Formol-stable serum acid phosphatase (SAP) was measured in 200 patients with symptoms of prostatism, before and at varying time intervals after digital rectal examination. In three separate groups of 50 patients SAP levels were measured before and at 5,15 and 30 min following rectal examination and in a fourth group of 50 patients it was measured before and at 6, 24 and 48 h after examination. No significant change occurred in SAP levels following this examination in any of the groups sfudied. We conclude that rectal examination does not raise the SAP and that, contrary to popular belief, blood levels recorded at any time within this 48-h period are reliable.
Sparks mandril, velour Dacron and autogenous saphenous vein grafts in femoropopliteal bypass
Authors: Christenson J T , Eklöf B 
Published: March 2007

Summary
Ninety-nine consecutive vascular reconstructions with femoropopliteal bypass performed during 1973-6 have been reviewed. A Sparks mandril was used in 11 patients, reversed autogenous saphenous vein in 30 and velour Dacron prostheses in 58. The indication for operation was severe ischaemia in 79 per cent. The overall patency rate at 12 months was 70 per cent for autogenous vein, 46 per cent for velour Dacron prosthesis and 18 per cent for Sparks mandril. When the distal anastomosis was located above the knee the patency rate was 100 per cent and 87 per cent for autogenous vein and velour Dacron graft sespectively, while the corresponding figures for distal anastomosis below the knee were 58 per cent and 11 per cent. At follow-up 60 per cent of the patients showed improvement owing to the vascular reconstruction.
A study of basal cell carcinoma of the inner canthus, 1967–72
Authors: McGregor John C 
Published: March 2007

Summary
Basal cell carcinoma was the commonest malignant lesion at the inner canthus. Reconstruction following excision was most commonly achieved with a post-auricular full thickness graft. Provided excision is adequate, a local flap is a good alternative. There is no evidence that the use of a graft increased recurrence, but it may have allowed earlier detection. The primary recurrence rate after primary surgical excision was 3.6 per cent. Recurrence occurred in several cases when histology indicated incomplete excision. Follow-up under these circumstances should be continued for up to 10 years. When adequate primary surgical excision was performed, there was no evidence that rodent ulcer of the inner canthus behaves diferently or has a worse prognosis than at other sites. There has probably been undue concern in the past about epiphora following resection of the lacrimal drainage system.
Muscle and serum adenosine triphosphatase in patients suffering from tetanus
Authors: Singh K M , Sawheny D , Kapoor N K 
Published: March 2007

Abstract
Serial estimation of muscle and serum adenosine triphosphatase (ATPase) activity was performed in 16 healthy control patients and 32 cases with tetanus. There was no significant difference due to age and sex in muscle and serum ATPase activity between the normal and tetanus cases. Tetanus patients showed a marked increase in muscle and serum ATPase activity as compared to normal. The ATPase activity increased with the severity of convulsion and disease. There was increased mortality in tetanus patients having higher values of muscle and serum ATPase.
Lingual thyroid: A review of 12 cases
Authors: Kamat M R , Kulkarni J N , Desai P B , Jussawalla D J 
Published: March 2007

Abstract
Twelve patients with lingual thyroid are reviewed. Two of these patients had a follicular carcinoma in the ectopic gland and both are well 5 and 16 years after treatment.
The diagnosis is essentially clinical but confirmation may be made with a thyroid scan.
Six patients were treated conservatively with thyroxine with good results. Six patients were treated by surgical excision, 2 undergoing autotransplantation of the excised gland into the anterior abdominal wall.
Post-surgical hyponatraemia: The role of intravenous fluids and arginine vasopressin
Authors: Thomas T H , Morgan D B 
Published: March 2007

Abstract
In 14 patients having undergone abdominal surgery, plasma sodium, urine volume and osmolality and the urinary excretion of arginine vasopressin (AVP), the antidiuretic hormone in man, were measured daily for 7 days. Each patient was given 31 of intravenous fluids daily. In 8 patients the fluid was saline and in the other 6 it was dextrose-saline.
The plasma sodium did not change in the saline group whereas it fell in the dextrose-saline group during the day of operation and then remained low. On the day of operation the urinary AVP increased to very high levels in both groups of patients. On that day and during the postoperative period the AVP level and urine osmolality were much higher in the saline group than in the dextrose-saline group, which suggests that a loss or redistribution of extracellular fluid was not the cause of the high AVP. These results taken together suggest that it was the higher AVP level in the saline group that was required to keep the plasma sodium normal. On the other hand, the results suggest that in the dextrosesaline group, although the AVP was lower than in the saline group, it produced a urine osmolality greater than that necessary for balance so that the patients retained water and became hyponatraemic.
The fall in plasma sodium was small compared with that seen in patients with symptoms of water intoxication, but it may nevertheless have clinical effects and is best avoided. The results suggest that in these patients hyponatraemia can be avoided if saline rather than dextrose-saline is given on the day of operation.
Postprandial serum gastrin levels in patients with combined hypergastrinaemia and hyperchlorhydria
Authors: Lamers C B H , Van Tongeren J H M 
Published: March 2007

Abstract
We have determined the serum gastrin response to a standard test meal in 13 unoperated patients with combined fasting hypergastrinaemia (more than 150 ng/l) and basal hypersecretion of gastric acid (BAO more than 10 mmol/h). In 10 of 11 patients with proved or presumptive Zollinger–Ellison syndrome the peak postprandial rise in serum gastrin concentration was less than 50 per cent of basal value. The integrated gastrin response to feeding ranged from − 71.9 to 211.8 μg/l × 150 min. In 2 patients with proved hypergastrinaemia of antral origin, however, serum gastrin rose to 223 per cent and 225 per cent respectively of basal value after ingestion of the meal. The integrated postprandial serum gastrin responses in these patients were 66.8 and 22.0 μ/l × 150 min. Two patients with Zollinger–Ellison syndrome and total gastrectomy showed peak serum gastrin levels after feeding of 174 and 225 per cent of basal concentration. The integrated postprandial gastrin secretions were 365 and 366 μg/l × 150 min respectively.
It is concluded that the serum gastrin response to feeding, when expressed as percentage change, may be helpful in the differential diagnosis of unoperated patients with fasting hypergastrinaemia and basal gastric acid hypersecretion.
Autoparathyroidectomy: A case report
Authors: McLatchie G R , Morris E W , Forrester A , Fogelman I 
Published: March 2007

Abstract
This report describes a patient with primary hyperparathyroidism who became spontaneously normocalcaemic preoperatively. This was due to infarction in a parathyroid adenoma. Plasma parathormone (PTH) levels were monitored pre-and postoperatively.
Tracheal collapse after thyroidectomy
Authors: Green W E R , Shepperd H W H , Stevenson H M , Wilson W 
Published: March 2007

Abstract
Tracheal collapse after thyroidectomy is uncommon; when it occurs, complete airway obstruction is often sudden, unexpected and fatal.
In this paper a patient treated for tracheal collapse by tracheostomy and followed up for 1 year is described and, from a review of the literature, a further 9 cases are presented. The aetiology of the condition, the patient at risk and the technique of management are discussed.