bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radical resection for cancer of the hypopharynx and cervical oesophagus with repair by stomach transposition
Authors: Harrison D F N , Thompson A E , Buchanan G 
Published: March 2007

Summary
The results of 58 consecutive cases of pharyngolaryngooesophagectomy and pharyngogastric anastomosis are presented. The Grey Turner technique is used, but modified by adding bilateral chest drainage established by guidance from below the diaphragm and a jejunostomy. The immediate postoperative therapy management of hypocalcaemia with calcium gluconate and long term control with calciferol is described.
An overall 3-year survival rate of 29 per cent has been obtained. Seven patients survived longer than 7 years, the longest living over 10 years. The authors conclude that, with careful management this technique is within the compass of competent surgeons with good facilities and should be the surgical treatment of choice for these difficult tumours.
Prognosis in relation to symptom duration in colon cancer
Authors: McDermott F T , Hughes E S R , Pihl E , Milne B J , Price A B 
Published: March 2007

Summary
Between 1950 and 1978 754 patients underwent operation by one of the authors for carcinoma of the colon. Follow-up data were available on 99 per cent. Tumour stage distribution did not differ significantly with increasing duration of symptoms. The proportion of curative to palliative operative procedures was unrelated to symptom duration. Cancer specific survival for the entire patient series was worse when symptoms had been present for less than 3 months compared with 3–6 months, 6–12 months or 12 months or more (P&lt;0·001, P&lt;0·02 and P&lt;0·04, respectively). Cancer specific survival after curative resection was also worse in patients with a symptom duration of less than 3 months compared with 3–6 months or 12 months or more (P&lt;0·02 and P&lt;0·03, respectively). These results show that colon cancer patients in whom the diagnosis is made and operation performed after a short symptomatic period do not have less advanced tumours nor better survival prospects.
Comparative results of surgical management of single carcinomas of the colon and rectum: A series of 1939 patients managed by one surgeon
Authors: McDermott F T , Hughes E S R , Pihl E , Milne B J , Price A B 
Published: March 2007

Summary
A comparative analysis has been made of the results of surgical management of single carcinomas of the colon and rectum in a series of 1939 patients treated by one surgeon. The data were prospectively collected, with 99 per cent follow-up. Cancer specific survival did not differ significantly between patients with colonic or rectal cancer. Survival prospects were better for women (P = 0·02) and for patients less than 40 years of age (P = 0·03). Survival was significantly related to tumour staging (P&lt;0·001). Cancer specific survival was better after curative resection for colonic than rectal carcinoma (P = 0·003). Five-year survival for patients with colonic tumours was 76 per cent and for rectal tumours 69 per cent. The 10-year survival figures were 73 per cent and 61 per cent respectively. This difference was accounted for by a higher proportion of Dukes' stage C tumours in the rectum (P&lt;0·001) and better survival prospects for colonic compared to rectal stage C1 tumours (P = 0·02). Sphincter-saving resections were performed in 64 per cent of rectal cancer patients managed by curative resection. Survival tended to be better than after sphincter-sacrificing operations. After palliative resection, median survival for colonic and rectal cancer was 14 and 13 months respectively. After palliative bypass operations the corresponding figures were 4 and 8 months.
Structural deterioration of prosthetic oesophageal tubes: An in vitro comparison of latex rubber and silicone rubber tubes
Authors: Branicki F J , Ogilvie A L , Willis M R , Atkinson Michael 
Published: March 2007

Summary
In a series of 100 patients with carcinoma of the oesophagus or cardia undergoing palliative intubation at endoscopy using a latex rubber or a silicone rubber tube 2 cases of tube fragmentation were encountered and are described.
The effects of hydrochloric acid, bile and irradiation on the tubes have been studied in vitro. After incubation in hydrochloric acid (0·1 mol/l), the breaking force of latex rubber tubes fell by 31 per cent (48 N) but did not change significantly for silicone rubber tubes. The addition of bile to the hydrochloric acid (0·1 mol/l) did not further influence the breaking force of either type of tube. Megavoltage irradiation with 7500 rad did not affect the breaking strength of silicone rubber tubes but caused a reduction of breaking strength of latex rubber tubes. These findings suggest that silicone rubber has advantages over latex rubber as a material for prosthetic oesophageal tubes.
Pulmonary function and fibrinogen metabolism in acute pancreatitis
Authors: Berry A R , Taylor T V , Davies G C 
Published: March 2007

Summary
Respiratory complications were studied in 50 patients with acute pancreatitis, and the relationship of these complications to parameters of fibrinogen metabolism was investigated. The mean arterial Po2 of the patients was 9·85±3·8 kPa (s.d.). Forty-three per cent of patients on admission were hypoxaemic. The mean Po2 was lower in patients who subsequently developed complications of acute pancreatitis (mean Po2 7·85±1·42 kPa (s.d.), P&lt;0·01). Vital capacity on admission was decreased by 50 per cent in 41 per cent of patients and by 20 per cent in 77 per cent of patients with pancreatitis. At discharge, 38 per cent of patients still had a 20 per cent decrease in their vital capacity.
Fibrinogen levels were elevated in 80 per cent of patients on admission and there was a negative correlation between these levels and the arterial Po2 (r = −0·6, P&lt;0·001). Fibrinogen degradation products were elevated in 45 per cent of patients.
The results confirm that marked lung damage occurs in acute pancreatitis and suggest that the effects are prolonged. The possibility that this damage may be related to pulmonary fibrin deposition is discussed.
The effect of altered luminal nutrition on cellular proliferation and plasma concentrations of enteroglucagon and gastrin after small bowel resection in the rat
Authors: Sagor G R , Al-Mukhtar M Y T , Ghatei M A , Wright N A , Bloom S R 
Published: March 2007

Abstract
Luminal nutrition is known to have a trophic effect on small bowel mucosa after intestinal resection. Humoral agents, however, may also contribute to this process. Two of the proposed humoral agents, enteroglucagon and gastrin, were therefore investigated after intestinal resection and transection in the rat, and changes in their concentration in the plasma were related to cellular proliferation.
Forty-eight male Wistar rats had either 75 per cent proximal small bowel resection or jejunal transection. The animals were further divided into three groups, each with a different nutritional intake. The first group were allowed food ad libitum. The second group were kept under hypothermic conditions which resulted in hyperphagia, while the last group were nourished intravenously. A further 8 animals had a laparotomy only (sham operation). All animals were killed 12 days after operation, plasma enteroglucagon and gastrin were measured, while determination of the crypt cell production rate (CCPR) was used to denote cellular proliferation.
In each group resected rats had significantly higher crypt cell production rates and greater enteroglucagon levels compared with transected animals. However, only in the normally fed group was plasma gastrin increased in resected animals, there being no significant difference in the plasma concentration of this peptide in transected compared with resected rats, in both the intravenously fed and hyperphagic groups.
In the models studied enteroglucagon appears to be a more likely candidate for a humoral trophic agent than gastrin in intestinal adaptation.
The amylase-to-creatinine clearance ratio—a non-specific response to acute illness?
Authors: McMahon M J , Playforth M J , Rashid S A , Cooper E H 
Published: March 2007

Abstract
It was felt that the apparent specificity of the amylase-to-creatinine clearance ratio (ACCR) in several previous studies of pancreatitis might reflect a failure to utilize adequately ill control subjects. The ACCR and the renal clearances of beta 2-microglobulin (B2-m), similarly related to creatinine (BCCR) as well as the urinary concentration of albumin, were compared in 27 patients with acute pancreatitis, 8 with a perforated peptic ulcer and 7 with mild biliary colic, during the first 5 days in hospital. Acute pancreatitis was graded as mild (6), moderate (14) or severe (7), using a combination of clinical data, diagnostic peritoneal lavage and multiple criteria. Further assessment of the severity of the acute illness was obtained from measurement of C-reactive protein (C-RP). Lowest C-RP levels were found in the patients with mild pancreatitis and biliary colic, and highest levels in the patients with severe pancreatitis and perforated ulcer (P &lt; 0.002). Similarly, ACCR and BCCR levels were significantly lower in the two mild groups than in the two severe ones (P &lt; 0.01 and &lt; 0.002 respectively), although plasma amylase was raised only in patients with pancreatitis and plasma B2-m was similar in all groups. Electrophoresis of urine showed dense bands of tubuloprotein in patients from both severe groups. Urine albumin was higher in severe pancreatitis than in perforated ulcer (P &lt; 0.1), perhaps indicating a more specific glomerular lesion in pancreatitis. Thus a rise in amylase clearance appeared to be related to the severity of the acute illness, and may be a component of a non-specific tubuloproteinuria. In this study patients with a perforated peptic ulcer had increases in ACCR similar to those seen in patients with severe pancreatitis, and we are therefore doubtful whether ACCR has any role in the clinical diagnosis of pancreatic disease.
Malignant oesophageal strictures: A review of techniques for palliative intubation
Authors: Earlam Richard , Cunha-Melo J R 
Published: March 2007

AbstractA review of the different designs for palliative oesophageal intubation tubes confirms Souttar's original suggestion that they should be flexible, incompressible, non-traumatic, compact, have an adequate lumen and stay in place. The internal diameter should be at least 10 mm. The thickness of the wall should be about 1 mm. The length will vary according to the stricture and should be as short as possible, provided that the proximal rim prevents future longitudinal growth occluding the lumen. Various methods of achieving the ability to stay in place are described, which comprise either a large proximal rim or a roughened barrel. No details about results are given because the original patient populations vary so much. Success probably depends more on the technical expertise and experience of the surgeon than specific variations in design.
Radiotherapy for dysphagia due to gastric carcinoma
Authors: Mantell B S 
Published: March 2007

Abstract
Palliative treatment by radiotherapy was attempted in 17 cases of dysphagia, due to inoperable gastric carcinoma. Thirteen experienced a useful improvement in swallowing. Radiotherapy, using a moderate dose of radiation, is suggested as an alternative to intubation in such patients.
Tamponade and injection sclerotherapy in the management of bleeding oesophageal varices
Authors: Barsoum Maged Sami , Bolous Fathi Iskander , El-Rooby Abushady Ahmed , Rizk-Allah Mounir Azmy , Ibrahim Amal Sami 
Published: March 2007

Abstract
One hundred patients with bleeding oesophageal varices were randomized into two treatment groups after resuscitation. One group was managed by tamponade only (group 1); the other group (group 2) was treated by endoscopic injection of oesophageal varices. The patients in group 2 were further subdivided into 25 patients (group 2a), who had tamponade applied immediately after sclerotherapy, and 25 patients (group 2b), who had sclerotherapy without subsequent tamponade.
Injection of varices controlled the acute bleeding episode more effectively than tamponade (74 per cent in group 2 v. 42 per cent in group 1). There was no significant difference in the overall mortality rate of the two groups, but group 2 had a significantly higher proportion of Child's grade C patients (38/50 v. 29/50 = 76 v. 58 per cent). If only Child's grade C patients are considered, 16 out of 29 (55 per cent) died in group 1, whereas only 12 out of 38 (32 per cent) died in group 2 (P &lt; 0·05).
Tamponade applied after sclerotherapy had no demonstrable effect on the outcome of sclerotherapy. The long term follow-up of patients (maximum 4 years) showed that recurrence of bleeding was less in the sclerotherapy group (8·1 per cent) than in the tamponade only group (27·6 per cent; P &lt; 0·05).
Dacron patch for closure of experimental stomach defects
Authors: Smyrnis Sotiris A 
Published: March 2007

Abstract
A Dacron patch was used to close acute defects of the stomach in rabbits. No deaths were directly attributed to the procedure. The patch was completely covered by new growth of tissue within 6 weeks. In the sixth postoperative month some evidence of rejection of the prosthetic material was present and 1½ years after the operation the patch was found in granulation tissue near the stomach. From this study it was concluded that this new technique is simple, can be performed safely and offers satisfactory results. Moreover, these experiments seem to indicate that this method may have clinical applications in the treatment of gastrointestinal fistulas in carefully selected cases.
Prophylactic lymph node dissection in clinical stage I cutaneous malignant melanoma: Results of surgical treatment in 1319 patients
Authors: Milton G W , Shaw H M , McCarthy W H , Pearson L , Balch C M , Soong S J 
Published: March 2007

Abstract
A retrospective study was made of 1319 patients with cutaneous primary malignant melanoma and regional lymph nodes clinically free of disease, whose first definitive surgical treatment was either (a) wide excision of the primary lesion (WE) or (b) wide excision of the primary lesion plus a prophylactic lymph node dissection (PLND). Patients were stratified according to three dominant prognostic factors, as revealed by multifactorial analyses: sex of patient, the anatomical site and thickness of the primary lesion.
Of 380 patients who underwent PLND for lymph nodes clinically free of disease, there was microscopic evidence of nodal metastases in 5 per cent. Despite this, prognosis in these patients was nearly twice as good as in those patients undergoing lymph node dissection for clinically involved nodes. Five-year survival rates for all those clinical stage I patients with lesions less than 0·8 mm thick were high irrespective of initial surgical treatment. In men with lesions of intermediate thickness (particularly 1·6–3·0 mm), survival rates for those undergoing PLND were considerably higher than for those undergoing WE. There were no survival benefits of PLND in men with lesions thicker than 3·0 mm. This was in contrast to the situation in women, where PLND was indicated for patients with the thickest lesions.
This study has defined three parameters which can serve as useful practical guides for selecting alternative surgical procedures in the management of clinical stage I cutaneous malignant melanoma.
Management of postoperative enterocutaneous fistulas: The roles of parenteral nutrition and surgery
Authors: Sitges-Serra A , Jaurrieta E , Sitges-Creus A 
Published: March 2007

Abstract
A series of 75 patients with 87 postoperative enterocutaneous fistulas (PEF) is reported. All received parenteral nutrition after the diagnosis of PEF was made. There were 16 deaths (21·3 per cent) and 62 fistulas (71·2 per cent) closed spontaneously. A classification of PEF is proposed according to the results obtained. The therapeutic approach cannot be uniform in all types of PEF. We feel that parenteral nutrition has substantially improved the prognosis of fistulous patients by increasing the rate of spontaneous closure and improving the nutritional status of patients needing repeated operations. Comparison between series of patients to establish the usefulness of parenteral nutrition is bound to yield inconclusive data due to marked differences in patient populations. We suggest that proper information be obtained by studying series of homogeneous patients, namely those who develop oesophageal, gastric or intestinal fistulas after surgery.
Pilonidal fistulas mimicking fistulas-in-ano
Authors: Vallance S 
Published: March 2007

Abstract
Four pilonidal fistulas which were initially diagnosed as fistulas-in-ano are reported. Only one perianal pilonidal fistula and four perineal pilonidal sinuses have previously been reported. It is suggested that they are more common than the literature suggests and should be excluded when patients present with symptoms of fistula-in-ano.
The aetiology of perirectal sepsis
Authors: Whitehead S M , Leach R D , Eykyn S J , Phillips I 
Published: March 2007

Abstract
Organisms that are present in the normal faecal flora, especially Bacteroides fragilis, were isolated significantly more often from perirectal abscesses associated with a fistula. Other organisms similar to those associated with infection of obstructed apocrine glands at other sites were isolated from abscesses without fistulas. These findings suggest that perirectal abscesses with and without fistulas may have a different aetiology and that appropriate bacteriological investigation may give an indication of the presence of an unsuspected fistula and thus provide useful guidance to the correct surgical management of the patient. Staphylococcus aureus and other skin organisms were found less frequently than in previous studies on perirectal sepsis and were equally common in cases with or without a fistula-in-ano.
The changing role of staging laparotomy in Hodgkin's disease: A personal series of 310 patients
Authors: Glees J P , Barr L C , McElwain T J , Peckham M J , Gazet J-C 
Published: March 2007

Abstract
A series of 310 patients with Hodgkin's disease having a staging laparotomy under the care of one surgeon (J-C. G.) between October 1969 and June 1980 is presented. A total of 51 per cent had positive laparotomy findings, and 30 per cent had their staging altered, but there was a low incidence of positive laparotomy findings when performed within 2 months of initial treatment by chemotherapy. None of the investigations used to determine possible splenic or hepatic involvement preoperatively was found to be of any value, and their routine use is not recommended. Bipedal lymphography was found to give an accurate assessment of iliac and lower para-aortic nodal involvement, and so the laparotomy protocol since 1975 has not included biopsy of these nodes. The incidence of minor complications was 31 per cent and of major complications 4 per cent. One patient died.
Staging laparotomy has played an important part in the management of Hodgkin's disease over the past decade, but it is likely to assume a less prominent role in the 1980s as the role of chemotherapy in early Hodgkin's disease expands. In non-bulky clinical stage I and II Hodgkin's disease, when radiotherapy alone is curative, then a staging laparotomy is justifiable because it will detect occult abdominal disease, especially in the lymphogram-negative patient, which may require the addition of chemotherapy or more extensive radiotherapy. Laparotomy is essentially an operation to remove the spleen and to obtain adequate liver biopsy specimens in order to ascertain possible involvement of these two organs. Non-opacified nodes at the porta hepatis and coeliac axis should also be sampled, as should a node from the poorly opacified upper paraaortic area. Routine oophoropexy is not recommended.
Electrically induced short-lasting tetanus of the calf muscles for prevention of deep vein thrombosis
Authors: Lindström Björn , Korsan-Bengtsen Kristoffer , Jonsson Olof , Petruson Björn , Pettersson Silas , Wikstrand John 
Published: March 2007

Abstract
Electrical calf muscle stimulation during surgery has been used for the prevention of deep vein thrombosis (DVT) with varied results in several studies. This effect is mainly achieved by the reduction of venous stasis in the legs. Another possible beneficial effect might be an increased fibrinolytic activity of the blood secondary to the muscle contractions. Previously, single electrical impulses have been used for stimulation, giving rise to ‘single twitches’ in the muscles. In the present study the effect on calf volume of muscle stimulation with groups of impulses giving a short-lasting tetanus was investigated. Changes in calf volume were recorded by strain gauge plethysmography. Optimal values for duration, number and frequency of the impulses within the groups were determined. Stimulation with groups of impulses reduced calf venous volume approximately three times more efficiently than stimulation with single impulses. Calf muscle stimulation did not enhance the increase in fibrinolytic activity of venous blood observed after oesophago- or laryngoscopies under general anaesthesia.
Choice of injection site for low dose heparin in inguinal herniorrhaphy
Authors: De Lange Samuel 
Published: March 2007

Abstract
A prospective controlled randomized clinical trial of 125 patients undergoing elective inguinal hernia repair demonstrates that the arm is preferable to the abdominal wall as injection site for low dose heparin with regard to wound haematoma formation. Two patients in the ‘arm’ group developed a wound haematoma compared with 18 patients in the ‘abdomen’ group (P &lt; 0·005). 99Tcm-labelled heparin was used to study the pharmacokinetics of heparin in an attempt to explain the results.
Bromocriptine in severe cyclical breast pain
Authors: Durning Patricia , Sellwood R A 
Published: March 2007

Abstract
The use of bromocriptine has been evaluated in a double-blind crossover trial of placebo against 5 mg bromocriptine over six menstrual cycles in 38 women with severe cyclical breast pain. Assessment using both the linear analogue system and clinical examination showed a statistically significant reduction in pain, tenderness and nodularity.
Biliary and pancreatoduodenal diversion by means of an isolated jejunal loop
Authors: González E Moreno , Blanch G García , García I García , Kempin J Calleja , Pascual M Hidalgo 
Published: March 2007

Abstract
Seven patients suffering from chronic pancreatitis, with dilatation of the duct of Wirsung and obstruction of the intrapancreatic segment of the choledochus, underwent a pancreatic and biliary jejunoduodenal diversion. An isolated jejunal loop was used as a conduit between the bile and pancreatic ducts and duodenum in 3 patients, while in 4 patients separate isolated loops between the duct and duodenum were fashioned. The postoperative period passed without incident. All the patients were symptom free 3 months after operation.
Polya gastrectomy for recurrent ulceration following vagotomy
Authors: Clark C G , Ward M W N 
Published: March 2007

AbstractThirty-seven patients with recurrent ulceration after vagotomy were treated by Polya gastrectomy and have been followed up for a minimum of 3 years (median 5 years). The diagnosis of recurrent ulcer was made by endoscopy or at operation. Nine patients were initially treated with cimetidine and either failed to respond or relapsed on maintenance dosage. There were 2 operative deaths and 2 patients were lost to follow-up. The results of Polya gastrectomy were Visick grade I: 61 per cent, Visick grade II: 15 per cent, Visick grade III: 9 per cent and Visick grade IV: 15 per cent. Two patients had further recurrent ulceration.