bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous transhepatic occlusion for bleeding oesophageal varices
Authors: Henderson J M , Buist T A S , MacPherson A I S 
Published: March 2007

Abstract
Using the technique described by Lunderquist et al. (1977), transhepatic injection of oesophageal varices has been performed under local anaesthesia in 9 patients with portal hypertension (11 procedures). On 2 occasions it was not possible to enter the left gastric vein. Bleeding resumed within 2 days of radiologically satisfactory occlusion in 2 patients and at 1, 3, 4 and 10 months after 4 procedures in 3 patients. Other complications included portal vein thrombosis, gross ascites and right pleural effusion. There were 2 hospital deaths, both in alcoholic patients with poor hepatic function. In spite of the apparently high morbidity we consider that there is a place for this technique in tiding over patients who are bleeding from oesophageal varices and are medically unsuitable for any surgical procedure.
Ingrowing toenails: The results of treatment
Authors: Palmer Bernard V , Jones Angela 
Published: March 2007

Abstract
Completed questionnaires were received from 208 patients on whom 245 operations for ingrowing toenails had been performed at King's College Hospital. Avulsion of a strip of nail had an 83 per cent recurrence rate, total nail avulsion 70 per cent, Zadik operations 28 per cent and wedge resections 29 per cent.
It is recommended that immediate avulsion of ingrown toenails should not be a routine practice.
Wound sepsis following gastrointestinal surgery: A comparison of topical and two-dose systemic cephradine
Authors: Finch D R A , Taylor Lorraine , Morris P J 
Published: March 2007

Abstract
A prospective study of the effect of the route of administration of prophylactic antibiotic on the wound infection rate following gastrointestinal surgery was performed. Patients were randomly allocated to one of three groups: group 1 received no form of antibiotic prophylaxis; group 2 received 1 g of cephradine applied topically to the wound at closure; group 3 received 1 g of cephradine intravenously at induction of anaesthesia and a further intravenous dose of 500 mg 4 h later. Wound infections occurred in 12 of 83 patients in the control group (14.5 per cent), in 6 of the 83 patients in the group who received topical antibiotic (7.2 per cent) and in 3 of the 82 patients who received systemic antibiotics (3.6 per cent). Only the group who received systemic antibiotic showed a statistically significant reduction in the incidence of wound infections compared with the control group (P = 0.03).
A case of craniocleidal dysostosis presenting with vascular complications
Authors: Short D W 
Published: March 2007

Abstract
A case of craniocleidal dysostosis was presented. In spite of the skeletal abnormalities present, the disease was not diagnosed until the patient, a married woman of 63, developed ischaemia of her right upper limb, followed by cerebral symptoms. An arch aortogram demonstrated an occlusion of the first part of the right subclavian artery involving the origin of the vertebral artery and a post-stenotic dilatation of the left subclavian artery due to costoclavicular compression. Such vascular abnormalities have not been previously described in this condition.
A 10-year survey of large bowel carcinoma at Groote Schuur Hospital with particular reference to patients under 30 years of age
Authors: Elloit M S , Louw J H 
Published: March 2007

Summary
In a 10-years survey of large bowel carcinoma at Groote Schuur Hospital 926 cases were studied retrospectively. A marked difference was seen in both the age of presentation and histological differentiation in two different racial groups. All patients who were 29 years of age or less at the time of presentation have been studied in detail. Predisposing factors, symptomatology, treatment, pathology and prgnosis are discussed. It is apparent that large bowel carcinoma in the young has a very poor prognosis.
Total excision or restorative resection for carcinoma of the middle third of the rectum
Authors: Nicholls R J , Ritchie Jean K , Wadsworth Jane , Parks A G 
Published: March 2007

Summary
Restorative resection is being used increasingly for carcinoma of the mid rectum but it is not yet certain whether this operation is as curative as total excision. Between 1963 and 1972, 209 patients left St Mark's Hospital after a radical operation for a single rectal carcinoma situated between 8 and 12 cm from the anal verge. A total of 199 patients was followed up for 5 years. Of these, 112 had been treated by total excision of the rectum and 87 by restorative operation. Survival was correlated with the Dukes' stage, histological grade and extent of local spread in the two groups.
There was no significant difference in 5-year survival after either total excision or restorative resection for Dukes' B (74 per cent, 71 per cent respectively) or average grade (61 per cent, 73 per cent respectively) tumours. Patients with Dukes' C tumours fared better when treated by restorative resection (36 per cent, 63 per cent), probably due to fewer high grade tumours in the restorative group (38 per cent, 18 per cent). Combining two variables, survival was not significantly different for patients with Dukes' B tumours of average grade (69 per cent, 62 per cent) or for Dukes' C tumours of average grade (48 per cent, 76 per cent). When the three pathological variables were combined, there was an improved survival after restorative resection for some pathological combinations.
It is concluded that restorative resection for carcinoma of the mid rectum is as curative as total excision in terms of 5-year survival.
The fibrinolytic activity of the vein following venous stasis
Authors: Wu Andrew V O , Mansfield Averil 
Published: March 2007

Summary
This animal study investigated the fibrinolytic activity in the vein wall of the pig following venous stasis, which was induced artificially using an intermittently inflated pneumatic cuff. The method used to measure the fibrinolytic activity was modified from Todd's original technique. The area of lysis and the area of the vein wall were measured and expressed as a ratio, called the fibrinolytic index. After 3 h of intermittent venous stasis the fibrinolytic index was reduced by 68 per cent, significantly lower than the control group.
The reduction of the fibrinolytic index by venous stasis could play an important part in the development of deep vein thrombosis.
The incidence of deep vein thrombosis in Hong Kong Chinese after hip surgery for fracture of the proximal femur
Authors: Mok C K , Hoaglund F T , Rogoff S M , Chow S P , Ma A , Yau A C M C 
Published: March 2007

Summary
Fifty-three Hong Kong Chinese patients with fractures of the proximal femur have been studied after hip surgery using functional ascending phlebrograms for evaluating deep vein thrombosis. There was an incidence of deep vein thrombosis of 53·1 per cent in the fractured limbs and 14·3 per cent in the uninjured limbs. The majority of thrombi (84·6 per cent) were located in the calf. No clinical of fatal pulmonary embolism was observed.
Noxythiolin (Noxyflex), aprotinin (Trasylol) and peritoneal adhesion formation: An experimental study in the rat
Authors: Raftery A T 
Published: March 2007

Summary
Clinical and experimental studies have suggested that noxythiolin and aprotinin may prevent intraperitoneal adhesion formation. A comparison was therefore made of their efficacy in preventing the reformation of adhesions following surgical lysis in a controlled trial using rats. Neither noxythiolon nor aprotinin had any significant benefit over surgical lysis alone. The mortality rate was high in the noxythiolin-treated group.
A safe and effective disposable low pressure suction drain
Authors: Seely M F , Hyde W A , Irving Miles 
Published: March 2007

Summary
The physical and microbiological properties of a new disposable suction drainage system have been investigated under clinical and laboratory conditions. The system appears to have overcome the disadvantages associated with previous disposable and reusable low pressure suction drainage systems for use after surgical operation in that this system effectively prevents reflux and retrograde contamination.
Total small bowel strangulation: A case report
Authors: Pettersson Gösta , Svensson Jan-Olov , Darle Nils 
Published: March 2007

Summary
A case of strangulation of the entire small intestine caused by an internal incarcerated hernia is presented. At laparotomy the small intestine was severely discoloured, paralytic and the viability of the bowel was questionable. No resection was performed. At a second laparotomy 10 h later the intestine was hyperaemic and exhibited lively motor activity. Recovery was complete. The importance of prolonged conservative management in avoiding extensive resection is stressed.
Blood transfusion and renal transplantation
Authors: Proud G , Shenton B K , Smith B M 
Published: March 2007

Summary
Blood transfusions given to potential renal transplant recipients are beneficial to subsequent graft survival. This study has shown an association between the inhibitory activity of patients' plasma on their own non-specific lymphocyte responses to antigen and the administration of blood transfusions. Most of the inhibitory activity was related to alpha-2 macroglobulin. Alpha-2 macroglobulin was able to prolong the survival of rat cardiac allografts. Immunoregulatory activity related to the alpha globulins of plasma has been described in a wide variety of conditions (i.e. cancer, pregnancy, diabetes) and this study has shown similar activity following blood transfusions.
Radionuclide venography for the demonstration of the proximal deep venous system
Authors: Bentley P G , Kakkar V V 
Published: March 2007

Summary
The majority of pulmonary emboli originate in the deep veins of the lower limb. Fatal emboli usually arise from thrombi that have extended into the femoral or iliac veins or lower inferior vena cava. It is often impossible to demonstrate this area, the proximal venous segment, using conventional ascending venography when there is deep venous occlusion.
The alternative methods available—retrograde, pertrochanteric and transfemoral venography—are invasive. Radionuclide venography (RNV) has been developed as a less invasive alternative. It has been found to be accurate in the proximal deep venous system when compared with conventional ascending venography, and in the presence of proximal occlusion it gives images unobtainable by other means. The radiation dose is extremely low and a perfusion lung scan is obtained without further injection of isotope. RNV appears to be the best method for monitoring the progress of thrombolytic therapy for major venous occlusion.
Nature of the disturbance in the body fluid compartments during and after surgical operations
Authors: Robarts W M 
Published: March 2007

Summary
Haematocrit and plasma protein concentrations have been measured in patients undergoing surgical operations in order to estimate relative changes in the volumes of the extracellular and plasma compartments. That these provide valid estimates of volume changes has been shown by applying them to patients known to have lost extracellular fluid. Further confirmation that changes in haematocrit, as indices of falls in plasma volume, are valid even after surgery is provided by measurements of red cell mass, using red cells labelled with 99Tcm.
When these methods were applied to patients undergoing abdominal and non-abdominal operations, only the abdominal group showed a significant fall in plasma volume. This fall was caused not by a loss of crystalloid from the extracellular space as a whole, but by a loss of plasma; the magnitude of this loss correlated significantly with the duration of operation. These changes were also demonstrated using the radioisotope dilution indicators 125I (RISA) and 131I (RISA).
The value of measuring intravascular platelet aggregates in the prediction of postoperative pulmonary dysfunction
Authors: McCollum C N , Campbell I T 
Published: March 2007

Summary
A modified Swank screen filter technique was used to investigate, first, whether intravascular platelet aggregates (IPA) could be detected in patients immediately after surgery and then, the relationship between IPA levels and postoperative pulmonary function. The test, as modified, achieved an excellent reproducibility (r = 0·95) and a close correlation with the number of aggregates identified in samples of femoral vein blood by subsequent scanning electron microscopy (r = 0·93).
In 20 patients IPA levels were measured 30 min and 3 h after surgery and pulmonary function (arterial Po2, physiological dead space and alveolar/arterial Po2 gradient) was evaluated preoperatively and on days 1 and 7 postoperatively. Patients with elevated IPA levels suffered a greater mean fall in arterial Po2 at 7 days (1·8 kPa) than did patients with normal IPA levels (0·6 kPa) (P &lt; 0·05). This was explained by a marked increase in the pulmonary arteriovenous shunt as indicated by the alveolar/arterial Po2 gradient (2·3 kPa v. 0·4 kPa, P &lt; 0·01). Those patients with increased pulmonary shunting and arterial hypoxia 1 week after surgery also had a greater fall in the platelet count on the first postoperative day.
The screen filtration technique is a reproducible test which measures IPA accurately and may be used to predict pulmonary function 1 week later. This suggests that treatment to inhibit IPA may reduce postoperative pulmonary dysfunction.
Regulation of enterokinase synthesis in animal and human small intestine by luminal signals: Its implication in upper gastrointestinal surgery
Authors: Bett N J 
Published: March 2007

Summary
Enterokinase is an enzyme produced by the mucosa of the small intestine. Its sole function is to activate trypsinogen to trypsin. In animals and man the duodenum and proximal jejunum have high levels of activity whereas the remaining small bowel has minimal levels.
A reproducible assay was developed for measuring mucosal enterokinase activity applicable to operative and endoscopic biopsies. Anaesthetic and operative techniques were developed for small intestinal resections in guinea-pigs to ensure their long term survival.
Transposition of high-enterokinase-secreting segments of guinea-pig small intestine to low-enterokinase regions and vice versa showed no alteration of entero-Kinase activity in the transposed segments. Similarly, resection of the enterokinase region in five proximal pancreaticoduodenectomy operations in man revealed no induction of enterokinase in the remaining jejunum at endoscopy 6 months later.
Isolation of high-enterokinase-secreting segments of small bowel from their luminal continuity by fashioning of Thiry—Vella fistulas led to a decay of enterokinase activity to minimal levels within 12–16 h. Perfusion of these fistulas with trypsin and sodium, or chymotrypsin and sodium, prevented this decay. If the enterokinase was allowed to decay over 24 h its activity could be restored to 80 per cent of its normal level by perfusion for 24 h with trypsin and sodium.
Trypsin and sodium act in combination on an enterocyte membrane receptor to stimulate enterokinase synthesis.
Simple enucleation and radiotherapy in the treatment of the pleomorphic salivary adenoma of the parotid gland
Authors: Armitstead P R , Smiddy F G , Frank H G 
Published: March 2007

Summary
A series of 76 patients with a primary pleomorphic salivary adenoma treated by simple extracapsular enucleation and high energy radiation between 1963 and 1976 is presented. Analysis of the results has shown a very low incidence of complications with only minimal cosmetic deformity. Of the 76 patients, only 5 have been lost to follow-up, 3 patients have died of causes unrelated to the tumour and only 1 patient has developed a recurrence. Further local excision in this patient showed the histological appearances of adenocarcinoma.
Segmental air plethysmography during arterial reconstruction
Authors: Baird R N , Davies P W , Bird D R 
Published: March 2007

Summary
Sixty-one patients undergoing 83 lower limb reconstructions for chronic arterial ischaemia or aortic aneurysm from April 1977 to March 1979 were monitored intraoperatively using the pulse volume recorder (PVR), Doppler auscultation and palpation of pedal pulses. Nine technical defects (11 per cent) were recognized 5 min after declamping and corrected before the operative wound was closed. In 31 grafts to the popliteal artery median ankle PVR amplitude increased from 4·5 mm (95 per cent confidence limits, 2–6 mm) at the start of the operation to 18 mm (14–21 mm, P &lt; 0·0001 Wilcoxon). Four poor PVR wave forms were successfully improved by operative revision. Initial median calf PVR amplitude with isolated aortic or iliac artery occlusions in 30 limbs was 41 mm (29–56 mm), similar to that in 22 control limbs (38 mm, 28–53 mm), and did not alter following successful reconstruction. In this group there were 2 operative revisions and all grafts were patent postoperatively.
In successful proximal reconstructions of 22 severely ischaemic limbs with combined proximal and distal disease, median PVR amplitude fell from 10·5 mm (6·5–14 mm) to 8 mm (6·5–15 mm, not significant). There were 3 operative revisions and all grafts remained patent postoperatively. In this group with combined proximal and distal disease pulse wave transit time (R wave of ECG to peak calf PVR wave form) became shortened from 577 ms (542–633 ms) to 481 ms (467–495 ms, P &lt; 0·05). Where operative correction was required, transit time on initial declamping became prolonged but fell to less than the pre-reconstruction transit time following successful revision. These results suggest that the information provided by intraoperative monitoring with the PVR will contribute towards a reduction in early graft occlusions and re-explorations in the postoperative period.
Anorectal Crohn's disease
Authors: Williams N S , Macfie J , Celestin L R 
Published: March 2007

Summary
Four hundred and twenty-three patients with Crohn's disease have been reviewed, 48 of whom had isolated anorectal involvement—an incidence of 11·4 per cent. These patients were compared with 48 randomly selected and sex-matched cases who presented with isolated ileocolic disease.
The age of the anorectal patients (53·6 ± 18 years) was greater than that of the controls (34·2 ± 12 years). The duration of follow-up was 6·0 ± 4 years and 12·6 ± 8 years respectively. Rectal bleeding, diarrhoea and perianal disease were more common in the anorectal group. Twenty-two patients (46 per cent) with anorectal disease and 40 (83 per cent) in the ileocolic group underwent definitive surgery. There were 4 (18 per cent) postoperative deaths in the anorectal group and none among the controls.
The incidence of recurrence was lower among the anorectal patients (21 per cent) compared with the ileocolic group (40 per cent). However, the estimated probability of recurrence, based on the duration of follow-up, the number of deaths during follow-up and the actual incidence of recurrence, is similar in both groups.
In vitro dissolution of human gallstones: The efficacy of heparinized solutions
Authors: Toouli J , Williamson B W A , Gooszen H , Blumgart L H 
Published: March 2007

Abstract
The use of heparinized solutions to dissolve or fragment stones retained in the biliary tree after surgery is still controversial. In this in vitro study heparin in concentrations of up to 100 000 u/l did not dissolve or fragment the stones examined, nor did it enhance the dissolution properties of the bile salt, sodium cholate.
Intestinal bacterial metabolism of protein and bile acids: Role in pathogenesis of hepatic disease after jejuno-ileal bypass surgery
Authors: Powell-Jackson P R , Maudgal D P , Sharp Dorothy , Goldie Alison , Maxwell J D 
Published: March 2007

Abstract
Jejunal bacterial colonization and intestinal metabolism of bile acids and protein by bacteria have been investigated in 12 patients with abnormal liver histology following jeujno-ileal bypass surgery for obesity.
Aerobic and/or anaerobic coionic flora was present in jejunal aspirates from 8 of 12 bypass patients, but in none of the controls. Intestinal protein metabolism and bile acid deconjugation (measured by urinary indican excretion and 14C-glycocholic acid breath test) was significantly enhanced in bypass patients.
Intestinal bacterial overgrowth, with abnormal intestinal metabolism by bacteria of ingested nutrients and bile acids, could contribute to hepatic disease after bypass surgery via the production of endogenous hepatotoxins.
Chylous ascites and obstructive lymphoedema of the small bowel following abdominal radiotherapy
Authors: Hurst P A , Edwards J M 
Published: March 2007

Abstract
The case history of a patient who developed chylous ascites following abdominal irradiation for recurrent carcinoma of the colon is presented. Laparotomy revealed generalized radiation damage of the small bowel with a particularly severely affected segment of jejunum, from the serosal surface of which chyle was seen to be leaking. Mesenteric. lymphangiography revealed an obstruction to lymphatic drainage in the mesentery. Resection of the worst affected segment of bowel prevented further development of chylous ascites.
Leucocyte counts in the diagnosis and prognosis of acute appendicitis in children
Authors: Doraiswamy N V 
Published: March 2007

Abstract
Preoperative total and differential leucocyte counts were made in 225 children with acute appendicitis, 50 children with a normal appendix and 100 children with acute abdominal pain which resolved without any therapy. When adjusted to age, neutrophilia in 96 per cent, 30 per cent and 32 per cent and leucocytosis in 41·8 per cent, 4 per cent and 3 per cent was noted in the respective groups, the levels being significantly higher in the acute appendicitis group than in the other two groups. Among children with appendicitis, infections were observed in 62·8 per cent of the group with leucocytosis and in 13·7 per cent of the group with a normal leucocyte count; the difference is statistically significant. It is suggested that in acute appendicitis neutrophilia supports the diagnosis and leucocytosis indicates the prognosis. The rate of infection increases as the total leucocyte count rises above the upper normal limit. The difference of opinions on the significance of leucocyte counts in acute appendicitis is discussed.
The presentation of gastrointestinal lymphoma: Study of a population
Authors: Green John A , Dawson Audrey A , Jones Peter F , Brunt Peter W 
Published: March 2007

Abstract
The clinical presentation and findings in 45 patients with lymphoma of the gastrointestinal tract occurring in an unselected population are described. Nineteen patients presented as emergencies with haemorrhage, perforation, pyloric stenosis or intestinal obstruction. Systemic symptoms, peripheral lymph node enlargement and hepatosplenomegaly were rare, and a preoperative diagnosis of lymphoma was seldom made. Endoscopy was superior to radiology in defining lesions in the stomach and duodenum. Lesions which were multicentric, or of unusual macroscopic appearance, were common in the small bowel, and these should raise the suspicion of lymphoma.
Local and systemic recurrence was common, but was not always fatal. Patients with gastric lymphomas survived longer than those with intestinal disease.
Pneumatosis coli and sigmoid volvulus: A report of 4 cases
Authors: Gillon J , Holt S , Sircus W 
Published: March 2007

Abstract
Pneumatosis coli is an uncommon disease which is frequently misdiagnosed and inapproapriately treated. The condition can usually be managed conservatively but complications requiring surgical treatment are occasionally encountered. We describe 4 patients with pneumatosis coli and associated volvulus of the sigmoid colon. Some of the factors that may have contributed to pneumocyst formation in these 4 patients are discussed with reference to recent advances in our understanding of the pathogenesis of pneumatosis coli.