bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duodenoscopic papillotomy and gallstone removal
Authors: Cotton P B , Chapman M , Whiteside C G , Le Quesne L P 
Published: March 2007

Abstract
Using an experimental insulated duodenoscope and a diathermy wire, papillotomy has been performed on 10 patients under diazepam sedation. Seven patients had common bile duct stones (6 following cholecystectomy) and 3 had papillary stenosis. Nine of the patients had severe medical or surgical contraindications to further operative treatment.
Papillotomy was successful in all patients, with no significant bleeding or other complications. Repeat endoscopy 6–14 days after papillotomy demonstrated a healed biliary orifice of 7–10 mm diameter. Stones had already passed in 3 of the 7 patients; in 2 others, stones were extracted using balloon catheters or Dormia type baskets. Two larger stones could not be removed; in one of these patients the stone and basket became impacted at the papilla and had to be removed surgically 2 days later.
Endoscopic papillotomy is an acceptable alternative to surgery in high risk patients, particularly in the treatment of retained common bile duct stones. If long term results prove satisfactory, the technique will have wider application.
Evaluation of biliary tract disease by ultrasonic B-mode scanning
Authors: Addison N V , Follows O J , Weedon M R 
Published: March 2007

Abstract
To establish the value of diagnostic ultrasound (sonar) in the diagnosis of bilitary tract disease, 140 patients were scanned and also had a plain film of the biliary tract. of these, 105 had contrast radiography and 123 were subjected to laparotomy. The results obtained suggest that in the absence of jaundice, sonar compares well with oral cholecystography in demonstrating the gallbladder, but is not as good as intravenous cholangiography in showing the duct system. In the presence of jaundice, however, sonar is considered the imaging investigation of choice.
A prolonged course of cyclophosphamide as an adjunct to mastectomy in the primary treatment of breast carcinoma
Authors: Donovan I A , Powell Jean , Waterhouse J A H , Morrissey D M 
Published: March 2007

Abstract
Cyclophosphamide given after mastectomy for 4–6 months to a consecutive series of patients seen in one surgical practice in the years 1964 and 1965 significantly improved the 10-year survival rate of the treated patients as compared with the patients seen consecutively in the same surgical practice in the years 1957–63. Staging showed that the improvement was due to a significant increase in the survival rate in patients with histologically negative axillary nodes (P &lt; 0·01). There was no significant difference in survival in the node positive or advanced disease groups.
Fibrinolytic activator in the endothelium of the veins of the lower limb
Authors: Nicolaides A N , Clark C T , Thomas R D , Lewis J D 
Published: March 2007

Abstract
The local fibrinolytic activity of the femoral, popliteal and soleal veins has been studied using a histochemical technique. The results suggest that the fibrinolytic activity in the soleal veins may be low when compared with that in the femoral and popliteal veins. This may be an aetiological factor responsible for the high incidence of thrombi occurring in the soleal veins.
Personal experience in the surgical management of carcinoma of the stomach
Authors: Costello C B , Taylor T V , Torrance Bruce 
Published: March 2007

Abstract
A consecutive series of 226 cases of carcinoma of the stomach has been studied. The policy of treatment has been consistent throughout and laparotomy was performed in 96.5 per cent of cases. The follow-up has been studied with regard to duration of symptoms, location and degree of spread of the tumour and different forms of operative treatment. Although Billroth I gastrectomy gave a 32 per cent 5-year survival rate for the less advanced tumours the overall survival remains, as in other series, depressingly low (8.5 per cent). Education of the public to present early would not appear to help the situation as survival was directly proportional to the duration of symptoms.
Protein turnover in patients before and after elective orthopaedic operations
Authors: Crane C W , Picou D , Smith R , Waterlow J C 
Published: March 2007

Abstract
Whole body protein turnover was measured in 11 patients before and after elective orthopaedic operations by giving 15N-glycine orally every 4 hours for 32 hours. The patients were maintained throughout on a constant protein intake. In 2 control subjects a comparison was made between intermittent dosage and continuous infusion of 15N-giycinefor the estimation of total protein turnover. With intermittent dosage the 15N abundance in urinary urea reached a constant level after about 24 hours. Rates of total protein synthesis and breakdown were calculated from the 15N abundance at the plateau level. After surgery there was a moderate increase in urinary N output. The apparent N balance (intake—urinary N) was −0·52 ± 1.31 g/d (mean ± s.d.) before operation and −7·51 ± 4.5 g/d after operation. The rate of protein synthesis fell from 3·83 ± 0·73g kg−1 d−1 before operation to 2·94 ± 0·83 g kg−1 d−1 after operation. This difference is statistically significant (0·05 &gt; P &gt; 0·01). There was no significant change in the rate of protein breakdown. The possibility remains that a block in protein synthesis, probably mainly in muscle, may be partly responsible for the so-called atabolicloss of nitrogen after injury, but this has not been proved.
Platelet function tests during major operation for gastro-intestinal carcinoma
Authors: Kokores J A , Economopoulos T C , Alexopoulos C , Pyrovolakis J , Papayannis A G 
Published: March 2007

Abstract
Platelet function tests were performed on 15 patients undergoing major operation preoperatively, during anaesthesia and 30 minutes and 3 hours after the beginning of operation. It was found that during anaesthesia platelet retention in a glass bead column and platelet aggregation were slightly reduced. During operation the bleeding time and the delay period of the collagen-induced aggregation were progressively prolonged, and the aggregation induced by ADP at a final concentration of 1 and 2 μm and by adrenaline was progressively reduced.
Single dose intra-incisional antibiotic prophylaxis of surgical wound sepsis: A controlled trial of cephaloridine and ampicillin
Authors: Pollock A V , Leaper D J , Evans Mary 
Published: March 2007

Abstract
In a series of 410 consecutive potentially contaminated operations, we have compared the relative efficacy of intra-incisional cephaloridine and ampieillin in single doses of 1 g in 2 ml of water. In high risk operations (ileocolorectal surgery, perforated appendicitis, or when the patient has 2·5 cm or more of subcutaneous fat at the site of the incision) cephaloridine prophylaxis resulted in a primary sepsis rate of 14 per cent compared with 36 per cent for ampicillin. In all other patients the two antibiotics were equally effective. Secondary sepsis, following discharge from the wound of a substance other than pus, was equally common in the two groups.
Intersphincteric excision of the rectum
Authors: Lyttle J A , Parks A G 
Published: March 2007

Abstract
Wide excision of the rectum in inflammatory bowel disease is both unnecessary and undesirable as the healthy pelvic floor is damaged and the pelvic nerves put at risk. An operative technique is described which includes dissection of the anal canal and rectum in the intersphincteric plane, i.e. the plane of fusion between the visceral rectum and anal canal and the somatic pelvic musculature, which minimizes these undesirable elements.
Fifty–three cases are presented. Perineal wound healing rates are comparable with those of other methods of resection and only 1 of 14 men reported partial sexual dysfunction following this operation.
An evaluation of viability tests of human cadaveric kidneys
Authors: Modgill V K , Wiggins P A , Rosenberg I L , Humphrey C S , Giles G R 
Published: March 2007

Abstract
Cadaveric kidneys are sometimes unsuitable for transplantation because of possible ischaemic damage. The advent of perfusion preservation machines has enabled evaluation of perfusion characteristics and perfusate changes of organs prior to transplantation. This study has evaluated the changes in perfusate pH, locate dehydrogenase, lactate and free fatty acid utilization in an attempt to identify those kidneys with ischaemic damage.
In this investigation no single factor was discriminatory and it was not possible to predict with any degree of certainty those kidneys liable to delayed function or to non-function.
Foam elastomer dressing in the management of open granulating wounds: Experience with 250 patients
Authors: Wood R A B , Williams R H P , Hughes L E 
Published: March 2007

Abstract
Our experience in the use of a silicone foam elastomer in the dressing of granulating wounds is described in a series of 250 patients. Among the types of wound treated were a pilonidal sinus, abdominal, perianal and perineal wounds, bed sores and diabetic gangrene of the foot. The technique has marked advantages over conventional packing of wounds in relation to patient comfort and saving of nursing time in hospital, and can eliminate the need for district nursing care in the domiciliary situation. Details of preparation, application and surgical management are given.
Surgical management of hyperhidrosis
Authors: Keaveny T V , Fitzgerald P A M , Donnelly C , Shanik G D 
Published: March 2007

Abstract
Sixty-five patients with severe disabling hyperhidrosis were subjected to operation. Eighty-nine sympathectomies and 42 axillary skin excisions were performed to abolish sweating. Almost 90 per cent of these patients were extremely satisfied with the outcome of surgery, which resulted in a change for the better in their social and working lives. When conservative therapy fails, we recommend these procedures, which often alleviate this most distressing symptom.
Angiographic control of traumatic haemobilia by selective arterial embolization
Authors: Eggink W F , Perlberger R R , van Urk H 
Published: March 2007

Abstract
Traumatic haemobilia was diagnosed and treated successfully by selective arterial catheterization and embolization with Gelfoam particles, thus avoiding the hazards of surgical intervention, in a 16-year-old boy with tuberculous peritonitis. No ill effects to the liver parenchyma were noticed as evidenced by liver function tests and liver scan.
Choledochoscopy in exploration of the common bile duct
Authors: Finnis D , Rowntree T 
Published: March 2007

Abstract
The technique of operative fibreoptic choledochoscopy is described; the results are reported in 88 patients with gallstones requiring exploration of the common bile duct. There were no cases of retained calculi that were endoscopically undetected. Postoperative T-tube cholangiography was carried out in 81 cases and confirmed the findings of operative biliary endoscopy in all cases. Choledochoscopy is an accurate and safe operative procedure which can eliminate the problem of undetected residual calculi.
Local and surgical management of enterocutaneous fistulas
Authors: Irving Miles 
Published: March 2007

Abstract
Intensive nutritional treatment is now recognized as the single most important factor in achieving closure of enterocutaneous fistulas, replacing attempts at early surgical closure. Operation in the early stages of management should be confined to the drainage of abscesses, the defunctioning of diseased or disrupted bowel and the formation of feeding enterostomies. In those few cases where spontaneous closure of the fistula does not occur, definitive surgical operation can be carried out when malnutrition has been corrected. The combination of nutritional treatment, skin protection and judicious surgery can reduce the mortality to below 10 per cent.
The survival of patients with colorectal cancer treated in a regional hospital
Authors: Gill P G , Morris P J 
Published: March 2007

Abstract
The survival rate for 301 patients who had a resection for colorectal cancer in Oxford over a 6-year period between 1966 and 1971 has been reviewed. The crude and age-adjusted 5-year survival rates for those who had a resection for cure were 37·3 per cent and 53·8 per cent respectively. The corresponding survival rates for all patients after resection were 25·8 and 37·2 respectively.
The most important determinant of survival was the pathological stage of the primary tumour, the agecorrected 5-year survival being 100 per cent for stage A lesions, 58 per cent for stage B, 27·1 for stage C and 5·5 per cent for stage D. Patients who presented with either intestinal obstruction or perforation of their carcinoma had a significantly worse prognosis than those who did not. Patients under 35 years of age did not survive as long as older patients. Those patients who had an anterior resection survived longer than those who underwent colectomy or abdominoperineal resection, probably due to the selection of pathologically favourable cases in the former group. The occurrence of infection in the postoperative period did not influence survival.
Thus, in general, patients with colorectal cancer have a poor 5-year survival (with the exception of stage A lesions), and this indicates the need for development of effective adjuvant therapy after surgery for this disease.
Traumatic diaphragmatic hernia
Authors: Bryer J V , Hegarty M M , Howe C , Rubin D , Angorn I B 
Published: March 2007

Abstract
A series of 58 cases of traumatic diaphragmatic hernia following blunt and penetrating injury is reviewed. The problems of radiodiagnosis are outlined and the need for barium contrast studies of the entire gastrointestinal tract to ensure recognition of isolated small bowel herniation is emphasized. Surgical access via laparotomy is recommended in the immediate post-traumatic presentation, whereas thoracotomy is preferable in cases diagnosed after a latent interval. Penetrating injury resulted in smaller diaphragmatic defects, greater morbidity and higher mortality due mainly to infective complications.
Parietal wound drainage in abdominal surgery
Authors: Higson R H , Kettlewell M G W 
Published: March 2007

Abstract
A Prospective randomized study of wound drainage in 250 surgical abdominal wounds was undertaken to determine (a) what effect wound drains had on clean surgical wounds; (b) whether wound drains reduced infection in potentially contaminated wounds; (c) whether wound drainge was an acceptable alternative to the use of topical antibiotics in frankly contaminated wounds.
Ten per cent of clean wounds which had been drained became infected, compared with 2 per cent of control wounds in the same group (p &lt;0.002). Infection was also more common in potentially and frankly contaminated wounds in the presence on a drain. Skin organisms were grown from 8 drained and 2 nondrained wounds in this group (P &lt;0.005), suggesting contamination by the drains. Drains were, however, associated with a lowere infection rate 23 obese patients with frankly contaminated wounds.
Surgical treatment of the severely ischaemic leg: I. Survival rates
Authors: Myers K A , King R B , Scott D F , Johnson N , Morris P J 
Published: March 2007

Abstract
Over a 10-year period, 411 patients with atherosclerotic major artery disease causing severe ischaemia of the legs were treated by surgery. Their survival rate, assessed by the life table method, was 80 per cent at 1 year and 50 per cent at 5 years. Early and late survival rates were significantly worse in elderly patients, and in patients with extensive gangrene. Late survival rates were significantly worse in diabetics, and in patients with clinical myocardial ischaemia.
Patients treated by arterial reconstruction showed a better survival rate than those treated by sympathectomy or amputation, though the latter groups contained more poor risk patients. Survival rates were not influenced by the technique of reconstruction.
A comparison of noxythiolin and povidone-iodine in experimentally induced peritoneal infection in mice
Authors: Browne M K , Leslie G B , Pfirrman R W 
Published: March 2007

Abstract
Noxythiolin (Noxyflex, Geistlich), given intraperitoneally as a 2.5 per cent solution, protected mice from the lethal effects of an intraperitoneal injection of Escherichia coli. Povidone-iodine (Pevidine, Berk), containing 0.075 per cent iodine, gave no protection.
Intravenous isotope calf scanning in the assessment of intermittent claudication
Authors: Hurlow R A , Chandler S T , Hardman J , Strachan C J L 
Published: March 2007

Abstract
A method of hyperaemic calf scanning using a bolus injection of 99Tcm pertechnetate into an arm vein is described and evaluated in 26 patients with intermittent claudication.
From the calf image displayed on a visual display unit after 2.5 minutes' scanning with a gamma camera, an assessment of the patency of the lower popliteal artery and run-off vessels can be made and of the distribution of blood flow to the calf muscles.
The technique enables the measurement of a calf ‘perfusion index’, which was found to be reproducible and to correlate well with the severity of disease in the proximal arteries leading to the calf, as assessed by the resting ankle/brachial pressure index (r = 0.65, P &lt;0.001) and the ankle pressure response to exercise (r = 0.71, P ± 0.001).
The perfusion index correlated with maximum walking time (r = 0.57, P &lt;0.01) but not with claudication time measured on a treadmill (r = 0.30).
Calf scanning is useful in the initial assessment of patients with claudication, and when combined with ankle pressure measurements it can provide objective flow and pressure data for evaluation of the progression of disease in conservatively managed patients with claudication, and for the assessment of the results of operation.
The combination of proximal gastric vagotomy with a rotational posterior gastropexy for duodenal ulcer
Authors: Hancock D M , Sankar M Y , Old J M , Bose A A K , Punnen P C , Mishra S M , Lobo F X , Trinder P 
Published: March 2007

Abstract
Preoperative oesophageal reflux symptoms have been controlled and the emergence of such symptoms de novo prevented in duodenal ulcer patients by combining proximal gastric vagotomy with a rotational posterior gastropexy. Fifty-two patients having such operations are compared with 46 patients treated by proximal gastric vagotomy (PGV) alone. The two groups match for age, sex and weight but there were more grade 3 refluxers in the group having rotational posterior gastropexy (28) than among those having proximal gastric vagotomy alone (5).
Six out of 28 patients in the PGV group who did not have preoperative regurgitation symptoms developed acid brash postoperatively on a 1–6½-year follow-up as against none of 17 patients in the other group. One year follow-up was complete in 94 cases and 57 had a 3·–6½-year follow-up. The 95 per cent confidence limits for cure of grade 3 reflux symptoms by the combined PGV and gastropexy operation were 44·7–88·7 for heartburn and 57·8–97·5 for regurgitation. Postoperative dysphagia can be minimized by attention to a few details during performance of the simple gastropexy procedure.
A pentagastrin-glucose pH monitoring test has been devised for this study. When the mean duration of reflux episodes during the 1 h after pentagastrin and the 1 h after 200 ml of 20 per cent glucose is plotted against the number of such episodes, the differences indicate that PGV impairs whilst PGV and gastropexy improves function at the gastro-oesophageal junction. Faber's peak acid output (PAO1) discriminant (Faber et al., 1975) was first used to define positive insulin tests in males. Such positive cases have been reported as having a 50 per cent chance of developing recurrent ulceration. We found that 9 out of 31 patients in the PGV group were positive at 1 year as against 2 out of 28 patients having the combined operation (P&lt;0·05). We have now applied Maybury's criterion (Maybury et al., 1977) of PAO1 adjusted for height to our results. Significant differences between the two operations were only evident after a curve derived from Maybury's data was increased by 50 per cent and then applied to our results. Nine out of 36 of the PGV group as against 1 out of 36 of the PGV and gastropexy group were positive by this test (P&lt;0·01). Addition of such a procedure to PGV may reduce the ulcer recurrence rate after PGV alone.
Surgical treatment of the severely ischaemic leg: II. Salvage rates
Authors: Myers K A , King R B , Scott D F , Johnson N , Morris P J 
Published: March 2007

Abstract
The salvage rates in 437 severely ischaemic legs (384 patients) treated by arterial reconstuction or by lumbar sympathectomy were studied by the life table method. The results were analysed in the surviving patients.
Following arterial reconstruction, the salvage rate was 70 per cent at 2 years and 60 per cent at 5 years. The results were similar for aortofemoral reconstruction and for femoropopliteal bypass grafting. Following aortofemoral reconstruction the outcome was better for endarterectomy procedures than for Dacron grafts. The salvage rate for femoropopliteal bypass grafts with patent tibial vessels was higher than for grafts to an isolated popliteal segment or for femorotibial grafts. Late occlusion of a reconstruction frequently did not necessitate major amputation, whereas several amputations were required in spite of a functioning reconstruction.
Following sympathectomy the salvage rate was 60 per cent from 1 year onwards. The results were better for tibial artery disease than for femoropopliteal or aortoiliac disease. Failed sympathectomy frequently led to major amputation of the leg or death of the patient.
The salvage rates after either reconstruction or sympathectomy were not influenced by age, sex or a prior history of clinical myocardial ischaemia, but the rates were worse in diabetics. The outcome of either operation was best when the procedure was performed for rest pain or ischaemic ulceration, satisfactory for limited gangrene but very poor for extensive gangrene.
Lumbar radiculopathy contralateral to upper lumbar disc herniation: Report of 3 cases
Authors: Choudhury A R , Taylor J C , Worthington B S , Whitaker R 
Published: March 2007

Abstract
Three cases of lumbar radiculopathy contraluleral to an upper lumbar disc herniation are reported. This clinical syndrome is explained on the basis of prominent spondylotic changes and stenosis contralateral to the side of disc herniation associated with anatomical anomalies of lumber nerve roots. The disc herniation causes displacement and impaction of the dural sac with the emerging nerve roots in a narrowed lateral recess.
Cholecystectomy and a simple technique of operative cholangiography
Authors: Devlin H Brendan , Sahay A K , Tiwari P N , Galvin P B , Peel A L G 
Published: March 2007

Abstract
A simple, easily reproducible technique of operative cholangiography is described. The technique has three advantages: (a) there is no need to divide or ligate the cystic duct; (b) it demonstrates the cystic duct anatomy clearly and is particularly useful in demonstrating stones in that duct thus eliminating the hazard of the retained stone in the cystic duct stump; (c) it is possible to eliminate the problem of false positives due to air bubbles.
A consecutive series of 442 cholecystectomy patients is reviewed. The overall operative mortality was 1·6 per cent; no death could be attributed to operative cholangiography. Thirty-five of 324 patients (10·8 per cent) with gallstones and no history of jaundice were shown to have unexpected abnormalities in the common bile duct.