bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone mineral content in patients with primary hyperparathyroidism: a comparison of conservative management with surgical treatment
Authors: Mole P A , Walkinshaw M H , Gunn A , Paterson C R 
Published: March 2007

Abstract
The management of patients with asymptomatic hyperparathyroidism remains controversial. This study examined the extent to which the presence or prospect of bone disease should influence treatment. Bone mineral content (BMC) of the distal forearm was measured by single photon absorptiometry in 67 patients with mild hyperparathyroidism. Twenty-six patients treated surgically and 17 managed conservatively were reviewed regularly for up to 4 years. Eighty per cent of patients had a baseline fat-corrected BMC within the local reference interval for age and sex, but about 75 per cent of values fell below the mean. BMC at the ‘distal’ site of the surgically treated patients improved or stabilized, but a continuing decline was seen in the patients managed conservatively (P &lt; 0.01). Differences were small and concern about future osteoporotic fracture should seldom be a major factor in making decisions about surgical correction of mild hyperparathyroidism.
Recombinant tissue-type plasminogen activator is superior to streptokinase for local intra-arterial thrombolysis
Authors: Lonsdale R J , Berridge D C , Earnshaw J J , Harrison J D , Gregson R H S , Wenham P W , Hopkinson B R , Makin G S 
Published: March 2007

Abstract
The results of local intra-arterial thrombolysis in 98 patients treated with streptokinase and 69 patients treated with recombinant tissue plasminogen activator (rtPA) have been compared. The two groups of patients were well matched and their treatment protocols were identical except with regard to the thrombolytic agent used. Strict criteria for defining successful thrombolysis were used. Successful lysis was achieved in 40 of 98 patients (41 per cent) receiving streptokinase and 40 of 69 patients (58 per cent) receiving rtPA (P &lt; 0·05). The time to lysis was significantly shorter with rtPA, median time 22h, than with streptokinase, median time 40 h (P &lt; 0·002). There was no diference in the incidence of haemorrhagic complications. These results suggest that rtPA is superior to streptokinase for local intra-arterial thrombolysis.
Experimental study of the protective effect of intermittent hepatic pedicle clamping in the rat
Authors: Isozaki H , Adam R , Gigou M , Szekely A M , Shen M , Bismuth H 
Published: March 2007

Abstract
The tolerance of the liver to ischaemia during intermittent clamping of the hepatic pedicle was compared with that during a continuous Pringle manoeuvre. Three groups of rats undergoing total durations of clamping of 60, 90 and 120 min were studied. A temporary peroperative portacaval shunt was used to exclude the efects of splanchnic venous stasis and allow independent study of the efects of hepatic ischaemia. In each group, three methods of portal clamping were evaluated: a continuous Pringle manoeuvre (n = 10), a 30-min intermittent clamping (n = 10) and a 15-min intermittent clamping (n = 10). The clamp release time between the periods of liver ischaemia was 5 min. Survival at day 7 and postoperative changes in liver function (transaminase enzymes, bilirubin, bromsulphthalein elimination, liver adenosine 5′-triphosphate levels) were recorded. Intermittent clamping of the pedicle was tolerated significantly better than continuous clamping. This method optimizes the ability of the liver to tolerate extended periods of ischaemia. For a given duration of ischaemia, no additional improvement could be produced by shortening the intermittent clamping period from 30 to 15 min. These data suggest that, when the Pringle manoeuvre is used, it should be applied intermittently rather than continuously.
Splenic salvage using an absorbable mesh: Feasibility, reliability and safety
Authors: Fingerhut A , Oberlin P , Cotte J-L , Aziz L , Etienne J-C , Vinson-Bonnet B , Aubert J-D , Rea S 
Published: March 2007

Abstract
Forty-nine adults underwent surgery for splenic injury: 17 (group 1) had salvage with a splenic mesh, seven (group 2) underwent other preservation techniques, and 25 (group 3) underwent splenectomy. There were six, zero and 11 hilar lesions in groups 1, 2 and 3, respectively. Seven of 15 associated lesions involved the digestive tract. There was no significant difference in transfusion requirements, length of operation or postoperative complications. One patient died in each of groups 1 and 2, and eight in group 3. Secondary splenectomy was performed once in groups 1 and 2. The duration of hospital stay was shorter in the preservation groups (1 and 2) than in group 3. Splenic preservation was feasible in 24 of 49 adults with splenic injury requiring surgery. The splenic mesh wrap is safe and reliable, and allows splenic salvage even with hilar injury.
Retroperitoneal necrotizing fasciitis
Authors: Woodburn MrK R , Ramsay G , Gillespiet G , Miller D F 
Published: March 2007

Abstract
Necrotizing fasciitis is a mixed infection of the skin and subcutaneous tissues with a characteristic clinical and pathological appearance. Early radical surgical excision of all affected tissue is the treatment of choice. In a series of 19 patients with necrotizing fasciitis, bacteriological assessment in 15 confirmed the mixed nature of the infection, with Bacteroides sp. isolated from ten patients. All 12 patients who underwent radical surgical excision survived. A subgroup of patients was identified in whom the appearance of necrotizing fasciitis in the abdomen or perineum was indicative of more extensive disease in the retroperitoneal tissues. Surgical resection of all affected tissue was not feasible in these cases and the outcome was uniformly fatal, giving an overall mortality rate for the series of 37 per cent.
Improved technique for polytetrafluoroethylene bypass grafting: Long-term results using anastomotic vein patches
Authors: Taylor MrR S , Loh A , McFarland R J , Cox M , Chester J F 
Published: March 2007

Abstract
Results of peripheral arterial bypass using polytetrafluoroethylene grafts have remained poor in comparison with those using saphenous vein grafts, particularly for anastomoses to tibial and peroneal vessels. A simple modification to the conventional operative technique, involving the incorporation of a vein patch into the distal anastomosis, has enabled considerable improvement. Five-year patency rates of 71 per cent for popliteal and 54 per cent for infrapopliteal grafts have been achieved in a series of 256 patients operated on between 1982 and 1989.
Crohn's disease and nutrition
Authors: Stokes M A 
Published: March 2007

Abstract
Malnutrition was included by Crohn as one of the features of the new disease he described. Most patients with Crohn's disease are malnourished even if their disease is not active. Nutritional factors may be implicated in the aetiology of the disease, but this remains unproven. The role of nutritional support and therapy is discussed and it is suggested that improving the patient's nutritional status may have a primary therapeutic as well as a supportive role in the treatment of the disease.
Comparison of Nissen total and Lind partial transabdominal fundoplication in the treatment of gastro-oesophageal reflux
Authors: Walker S J , Holt S , Sanderson C J , Stoddard C J 
Published: March 2007

Abstract
Fifty-two patients with gastro-oesophageal reflux disease refractory to medical treatment were randomized to undergo a Nissen total (360° wrap) or Lind partial(300° wrap) transabdominal fundoplication. Each group was comparable in number (26 patients), mean age (47 and 48 years) and sex distribution (eight women). Preoperative and postoperative assessment involved a modified Visick score, 22-h intraoesophageal pH monitoring, endoscopy and manometry. Follow-up was at 6 weeks and between 3 and 33 (mean 13) months. The prevalence of heartburn and regurgitation and the results of pH monitoring improved significantly after both operations (P &lt; 0.001). At early assessment eight previously asymptomatic patients (31 per cent) from, the Nissen group and six (23 per cent), from the Lind group experienced difficulty swallowing. Ten patients (38 per cent) in each group complained of ‘gas bloat’. Both complications had improved at late assessment in the majority of patients. No statistically significant advantage could be demonstrated, for either operation.
Bioelectrical impedance analysis in the measurement of the body composition of surgical patients
Authors: Fearon K C H , Richardson R A , Hannan J , Cowan S , Watson W , Shenkin A , Garden O J 
Published: March 2007

Abstract
The evaluation of nutritional status in surgical patients remains a difficult problem. Bioelectrical impedance analysis (BIA) is a new method of body composition analysis which is easily performed at the bedside. This study determined the accuracy of BIA in the measurement of total body water (TBW) and potassium (TBK) in a heterogeneous group of surgical patients. The resistance and reactance components of impedance were measured with a whole body impedance analyser. Tritiated water dilution and whole body monitoring were the reference methods for TBW and TBK analysis. With the BIA technique the coefficient of variation for the estimation of TBW was 8.1 per cent and for TBK was 6.4 per cent. Allowing for the errors of the reference methods these results show that BIA is of limited value in the estimation of TBW but may provide a useful index of TBK.
Effect of antibiotics in fibrin sealant on healing colonic anastomoses in the rat
Authors: van der Ham A C , Kort W J , Weijma I M , van den Ingh H F G M , Jeekel H 
Published: March 2007

Abstract
In 90 rats a colonic anastornosis was constructed with 12 interrupted 7/0 polypropylene sutures. Group 1 (n = 30) served as a control group. In group 2 (n = 30) the anastomosis was sealed with, fibrin adhesive and in group 3 (n = 30) a mixture of fibrin, clindamycin and cefotaxime was used. On days 2, 4 and 7, ten animals in each group were killed. Adhesion formation was significantly increased in groups 2 and 3 compared with the control group. On day 2 the anastomosis was significantly stronger after sealing with antibiotic–fibrin mixture. On day 4 the bursting pressure in group 2 was significantly lower than in groups 1 and 3. At the same time the concentration of hydroxyproline was significantly reduced in group 2, but not in group 3. The addition of antibiotics prevents the negative effect of fibrin adhesive on the healing colonic anastomosis and contributes to a stronger anastomosis on day 2 after operation.
Management of empyema thoracis at Lusaka, Zambia
Authors: Desai G A , Mugala D D 
Published: March 2007

Abstract
Of the 39 consecutive patients with empyema thoracis managed by one of the five general surgical units at Lusaka, Zambia, 26 suffered, from human immunodeficiency virus (HIV) infection and 19 were diagnosed as suffering from pulmonary tuberculosis within 3 years of developing empyema thoracis. Thirty patients were between 16 and 40 years of age; of these, 22 suffered from acquired immune deficiency syndrome (AIDS) and all 19 patients with pulmonary tuberculosis belonged to this age group. Of the four patients with empyema thoracis in the age group of 0–5 years, two were suffering from AIDS. The majority of cases of empyema thoracis associated with AIDS present insidiously and, because of late presentation, rib resection is necessary. After surgery these patients were managed at home with the help of a home care team, thus reducing the burden on hospital resources. The morbidity and mortality rates in these patients are higher than in those in whom empyema thoracis is not associated with AIDS.
Body water compartments in patients with obstructive jaundice
Authors: Sitges-Serra A , Carulla X , Piera C , Martínez-Ródenas F , Franch G , Pereira J , Gubern J M 
Published: March 2007

Abstract
To elucidate the pathogenesis of renal dysfunction associated with obstructive jaundice, body water compartments were measured using a multi-isotope dilution technique in ten patients with biliary tract obstruction and in ten control subjects matched for age, sex, weight, height and body surface area. Expressed as a fraction of body-weight, total body water was reduced in jaundiced patients (41.8 versus 44.2 per cent, P &lt; 0.02). Extracellular water volume was also reduced in patients with jaundice (20.3 versus 24.3 per cent, P &lt; 0.003) owing to a reduction of the interstitial space (16.1 versus 19.5 per cent, P &lt; 0.004) and, to a lesser degree, of the plasma volume (4.2 versus 4.8 per cent, P = 0.1). There was a close correlation in jaundiced patients between plasma volume and the creatinine clearance rate (r2 = 0.56, P &lt; 0.02) and between plasma volume and extracellular volume (r2 = 0.77, P &lt; 0.0001). Extracellular volume in such patients also correlated with the percentage weight loss (r2 = 0.42, P = 0.04). Obstructive jaundice is associated with a contracted extracellular water compartment, although extracellular water, as a percentage of body-weight, increased in proportion to the body-weight lost. Reduction of the interstitial volume and a marginally reduced plasma volume may be determinant factors in the pathogenesis of the renal and haemodvnamic disturbances observed in patients with biliary tract obstruction.
Meconium ileus: A review 1972–1990
Authors: Docherty J G , Zaki A , Coutts J A P , Evans T J , Carachi R 
Published: March 2007

Abstract
This article reviews the management and mortality of 53 neonates with meconium ileus and cystic fibrosis treated in one paediatric surgical centre from 1972 to 1990. Forty-four patients (83 per cent) presented with simple meconium ileus and 26 of 40 patients in this group were successfully treated with Gastrografin enemas. Four patients sufered a perforation as a result of the enema (perforation rate 5 per cent). The 1-year survival rate for simple meconium ileus was 81 per cent andfor complicated meconium ileus 75 per cent.
Evaluation of tissue oximetry in perioperative monitoring of colorectal surgery
Authors: van Esbroeck G , Gys T , Hubens A 
Published: March 2007

Abstract
Twenty patients undergoing elective colorectal surgery were studied during and after operation by means of tissue oximetry measuring the subcutaneous partial pressure of oxygen (Psco2) and by gastric intramural pH measurement. Mean(s.d.) Psco2 recorded 24 h after surgery was significantly lower than the peroperative value: 14(10) versus 24(14) mmHg, P &lt; 0.02. The postoperative Psco2 was also significantly lower than that measured in a control group of ten healthy volunteers: 14(10) versus 34(18) mmHg, P &lt; 0.001. The peroperative Psco2 of the patients who developed a postoperative complication was significantly lower than that of those who had an uneventful postoperative clinical outcome: 16(9) versus 32(14) mmHg, P &lt; 0.02. The peroperative Psco2 of the patient group with complications was also significantly lower than that of the control group: 16(9) versus 34(18) mmHg, P &lt; 0.02. The peroperative Psco2 of the group of patients without complications was almost identical to that of the control group. During operation only one patient developed gastric intramural acidosis. Perioperative oxygen debt and the response of subcutaneous tissue oxygen tension to oxygen breathing seemed to correlate better with clinical outcome than gastric wall pH values and the conventional parameters of tissue perfusion.
Use of Teflon stents for lymphovenous anastomosis
Authors: Shaper N J , Rutt D R , Browse N L 
Published: March 2007

Abstract
The treatment of lymphoedema is difficult; conservative and surgical management show variable results. Lymphovenous anastomoses (LVAs) in experimental animals and patients give poor results in the treatment of primary lymphoedema and variable results in that of secondary lymphoedema. Conventional sutured LVAs were compared with anastomoses using polytetrafluoroethylene (Teflon) stents; 32 sutured and 21 stented LVAs were constructed in 16 rabbits with normal lymphatics. Anastomoses were assessed for quality and patency at 1-16 weeks by direct exposure; 27 cases were further assessed using lymphangiography. Patency in stented and sutured LVAs was 71 and 38 per cent at 1 week, and 38 and 8 per cent at 3 weeks, respectively. After 4 weeks all anastomoses were occluded. The quality of stented LVAs seemed to be higher than that of sutured LVAs. Stented LVAs are feasible and probably superior to conventional sutured LVAs. However, the patency of LVAs is of short duration because of the disadvantageous pressure gradient from lymphatics to veins, and this limits their clinical application.
Abdominal aortic aneurysm, glaucoma and deafness: A new familial syndrome
Authors: Adoki I I , Stoodley B J 
Published: March 2007

Abstract
Several reports have suggested a genetic basis for the distribution of abdominal aortic aneurysm (AAA) in some families. The familial clustering of this disease is further demonstrated in this report of ten siblings, five of whom have confirmed AAA. This is the largest cluster so far reported. The majority of patients in this family group also have glaucoma and/or deafness.
Distribution of aortic diameter in a screened male population
Authors: Lucarotti M E , Shaw E , Heather B P 
Published: March 2007

Abstract
Between September 1990 and August 1991, 2291 men aged 65 years were invited for ultrasonographic screening of the aorta in the Gloucestershire aneurysm screening programme; 1748 (76.3 per cent) attended. An aortic diameter ⩽ 2.5 cm was found in 1547 (88.5 per cent); 174 (10.0 per cent) had diameters in the range 2.6-4.0 cm, and 26 (1.5 per cent) had diameters &gt;4.0 cm. The mean(s.d.) aortic diameter was 2.1(0.55) cm and 97.5 per cent of patients had a diameter ⩽3.3 cm. Any man over the age of 65 years with an aortic diameter &gt;3.3 cm has an aortic aneurysm.
Vascular inflow exclusion and hepatic resection
Authors: Taniguchi H , Takahashi T , Shioaki Y , Itoh A , Oguro A 
Published: March 2007

Abstract
Seventy-nine patients undergoing hepatic resection without manipulation of the vena cava were divided into three groups. Group 1 consisted of 32 patients in whom hepatic hilar vascular exclusion was not performed. Group 2 (20 patients) had vascular inflow exclusion performed at the operative site only (right or left unilateral exclusion). Group 3 (27 patients) had total inflow exclusion during hepatic resection. There were no significant differences between the groups in blood loss or blood transfusion requirement. On the third day after operation, the serum glutamic-pyruvic transaminase level in group 3 was significantly higher than that in group 1 (P &lt; 0.01). Vascular inflow exclusion may not be essential for successful hepatic resection.
Mesosigmoplasty as a definitive operation for sigmoid volvulus
Authors: Subrahmanyam M 
Published: March 2007

Abstract
In a prospective study, 126 patients with sigmoid volvulus were treated by mesosigmoplasty during a 12-year period. Patients with sigmoid volvulus with no clinical evidence of gangrene were selected for study, and all were given a trial of non-operative reduction by proctoscopy and passage of a rectal tube. Reduction was achieved in 48 patients (38 per cent), who were subsequently treated by mesosigmoplasty as an elective procedure 1–2 weeks later. For the remaining 78 patients (62 per cent) who were not relieved by the non-operative method, emergency mesosigmoplasty was performed. There was one death in the emergency group, and two patients had a recurrence after 2 and 6 months respectively in the elective group, in whom resection was carried out. In the other 123 patients during a maximum follow-up of 12 (mean 8.2) years no recurrence was detected. Mesosigmoplasty has the advantage of low rates of mortality, morbidity and recurrence; it can be carried out as either an emergency or an elective procedure.
Systemic cytokine response after major surgery
Authors: Baigrie R J , Lamont P M , Kwiatkowski D , Dallman M J , Morris P J 
Published: March 2007

Abstract
The systemic cytokine response to major surgical trauma was studied in 20 patients undergoing elective aortic surgery and five patients after inguinal hernia repair. Tumour necrosis factor alpha and interferon gamma were not detected in these patients. An early and short-lived interleukin 1 beta (IL-1β) response to major surgery was detected only by intensive sampling in the perioperative period. The IL-1β peak preceded a more marked interleukin 6 (IL-6) response that peaked 4–48 h after surgery. IL-6 levels had fallen sharply by 48–72 h in all patients who had an uneventful postoperative course. The IL-6 peaks were significantly lower after hernia surgery than after major aortic operations (P &lt; 0.001); IL-1β was not detected in any samples. Three patients undergoing aortic surgery developed unexpected major postoperative complications. IL-6 levels in this group were significantly higher than those of the other patients undergoing aortic surgery within 6–8 h of skin incision, and remained elevated for longer. These rises in plasma IL-6 levels preceded the clinical onset of major complications by 12–48 h. The systemic IL-1β and IL-6 response to surgical trauma increased with the severity of the surgical insult. An early, exaggerated IL-6 response was associated with the subsequent clinical development of major complications.
Continuing experience with transaxillary excision of the first rib for thoracic outlet syndrome
Authors: Carty N J , Carpenter R , Webster J H H 
Published: March 2007

Abstract
The results of transaxillary excision of the first rib for thoracic outlet syndrome are reported. During a 3-year period, 40 transaxillary rib resections were performed on 32 patients. The symptoms in 33 limbs were completely relieved and in a further four symptoms were improved. These results confirm that transaxillary excision of the first rib is the operation of choice in the management of thoracic outlet syndrome.
Breast cancer in Nigerian women
Authors: Ihekwaba F N 
Published: March 2007

Abstract
A combined retrospective (1971–1980) and prospective (1981–1990) study of the epidemiology, clinical characteristics and pathology of breast cancer in a black African population was carried out. There were 1946 biopsy-proven cases, with a rate frequency of 33.6 per 100 000 patients per year. The age range was 14-96 years but 70 per cent of patients were between 26 and 50 years old. The cumulative frequency of cancer was 0.8 per cent at age &lt;20 years and 3.3 per cent at age &lt;25 years: the peak age range for disease was 36–45 years. Of 1842 evaluable patients, 17.2 per cent presented with stages I or II cancer and 73.8per cent with stage III disease. The dominant histopathological type was infiltrating ductal cancer (49.2 per cent), followed by undiferentiated anaplastic carcinoma (33.3 per cent). Burkitt's lymphoma occurred in five patients and developed concurrently and rapidly during lactation in four. The prospective study did not demonstrate that age at menarche or first full-term pregnancy, duration of breast feeding or parity were risk factors in black women.