bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arterial healing in the dog after intraluminal delivery of pulsed Nd–YAG laser energy
Authors: Cross F W , Bowker T J , Bown S G 
Published: March 2007

Abstract
The application of laser energy to percutaneous recanalization of diseased blood vessels is of interest to vascular surgeons and radiologists. We have examined the effect of pulsed infrared light from a 100 μs pulsed Nd-YAG laser on the dog aorta in order to determine the dose response, perforation thresholds and healing properties in vascular tissue. We used 100 μs pulses of 0·5 J energy at 10 Hz repetition rate via a 400 μm optical fibre to make 205 craters in 10 dogs at total energies of 5–25 J. The perforation threshold was 15 J in six animals and 20 J in four. The dose response was linear at 10 μm tissue vaporized per Joule delivered. Animals were killed immediately and at intervals of 24 h, 4, 7, and 10 days, 2, 3 and 6 weeks, and 3 and 6 months. Material was retrieved for histology and examined by light and scanning electron microscopy. The tissue exhibited features of laser damage that were less marked than those seen with continuous wave lasers; there was less heat damage surrounding the craters which healed well, even after perforation. This laser is likely to be suitable for human laser angioplasty provided the energy is given in increments of 15 J or less.
The future of external beam irradiation as initial treatment of rectal cancer
Authors: Papillon J 
Published: March 2007

Abstract
Several trials have demonstrated that pre-operative irradiation for rectal cancer decreases significantly the incidence of pelvic recurrence. However, this method is far from being generally accepted. It is now possible to enhance the effectiveness of external beam irradiation and to use it to extend the field of sphincter-saving and conservative procedures. Our protocol consists of a split-course regimen with a short course of cobalt-60 arc rotation (3000 cGy in 12 days). After 2 months rest, the second stage of treatment depends upon the pressure of residual disease and the site of the tumour. It consists of either radical surgery (82 cases) or conservative treatment by intracavitary irradiation in the event of a favourable initial response or in the case of poor risk patients (73 cases). In the radiotherapy-surgical group, the subsequent operative specimens were tumour free in 17 per cent of cases and assigned to Dukes' A category in 32 per cent of cases. Of 91 patients with T2 or T3 tumour involving the lower third of the rectum (followed up for more than 3 years) 72 (84 per cent) had no recurrence. Thirty-three of these patients (46 per cent) underwent a colostomy while 39 (54 per cent) had normal anal function. These results demonstrate the major place that a properly planned external beam irradiation can have in the curative management of cancers of the low rectum.
Mammillary fistula
Authors: Bundred N J , Dixon J M , Chetty U , Forrest A P M 
Published: March 2007

Abstract
Forty women presenting with mammillary fistulas over a 6 year period have been reviewed. The events preceding the fistula were incision of a periareolar breast abscess (n = 24), breast biopsy (n = 13) and spontaneous discharge of an inflammatory mass (n = 3). Only two of the women with abscesses were lactating. Two patients had granulomatous mastitis. The remaining 36 patients were all considered to have periductal mastitis/mammary duct ectasia as the cause of their fistulas. The two mammillary fistulas associated with lactation healed spontaneously. Nine patients had the fistula excised and the wound packed; this resulted in satisfactory healing in all but one patient. Twenty-one patients had excision of the fistula and primary closure, without antibiotic cover, but only ten healed without complications and six patients required further surgical procedures for a recurrent fistula. Six patients had primary excision and closure under antibiotic cover with a penicillin and metronidazole; all healed. Mammillary fistulas are complications of the periductal mastitis/duct ectasia syndrome. They should be treated by excision and primary closure under appropriate antibiotic cover or alternatively excised and left open to granulate.
Evaluation of hepatic resection for hepatocellular carcinoma in the elderly
Authors: Ezaki T , Yukaya H , Ogawa Y 
Published: March 2007

Abstract
The results of 139 hepatic resections in 154 patients with hepatocellular carcinoma (HCC) operated upon in the last 6 years are reported. These 139 Japanese patients were classified into three groups according to age. Group I included 58 patients under 55 years of age, group II 44 aged from 56 to 65 years and group III 37 aged over 66 years. Fewer cases in group III had histological evidence of cirrhosis than in the other two groups. There was a statistically significant marked decline in the pre-operative cardiac and pulmonary function in group III patients. However, there was no statistical difference in postoperative complications, mortality and survival rate among the three groups. The results after hepatic resection seemed to depend on pre-operative liver function and histology, and on control of the haemorrhage at operation. The results indicate that liver surgery for elderly patients with hepatocellular carcinoma is justifiable given careful patient selection.
Nissen fundoplication and pyloroplasty in the management of gastro-oesophageal reflux in children
Authors: Davidson B R , Hurd Diana M , Johnstone M S 
Published: March 2007

Abstract
A retrospective study was carried out of children undergoing Nissen fundoplication and pyloroplasty for the correction of gastro-oesophageal reflux. Twenty children (thirteen males, seven females) aged 8 months to 12 years underwent surgery over a 10 year period. Forty per cent were mentally retarded. Presentation was failure to thrive in 19 (95 per cent), recurrent vomiting in 18 (90 per cent) and haematemesis in 14 (70 per cent). Four children had Barrett's oesophagus. There were no operative or perioperative mortalities. Follow-up (mean period 3 years, 9 months) revealed no further symptoms of reflux. The ‘normal’ children gained weight postoperatively whereas the ‘retarded’ group did not. Adhesion obstruction (10 per cent) was the major late postoperative complication. Regression of Barrett's epithelium was noted endoscopically. ‘Gas-bloat’ syndrome, a major complication following fundoplication, was not encountered.
Treatment of mesenteric infarction
Authors: Clavien P A , Muller C , Harder F 
Published: March 2007

Abstract
Eighty-one cases of mesenteric infarction documented by angiography, laparotomy or autopsy were reviewed to assess the cause of the persistently high mortality. Thirty-seven patients (46 per cent) were felt to have inoperable lesions and were treated by supportive care only, while forty-four (54 per cent) underwent bowel resection and/or revascularization. Of these 44 patients 20 (45 per cent) survived, 14 (32 per cent) died of an early recurrence of infarction and 10 (23 per cent) died of an unrelated cause. In view of the high recurrence rate in the early postoperative period, treatment must prevent the causes of persistent or recurrent ischaemia such as vasoconstriction and reperfusion tissue damage. On the basis of recent clinical and experimental research we suggest that treatment should include routine angiography with selective perfusion of vasodilators through the superior mesenteric artery, pharmacological prevention of ischaemic and reperfusion tissue damage before surgery, and postoperative anticoagulation.
A reliable and readily available method of measuring limb blood flow in intermittent claudication
Authors: Wilkinson D , Vowden P , Parkin A , Wiggins P A , Robinson P J , Kester R C 
Published: March 2007

Abstract
To evaluate isotope limb blood flow measurement in intermittent claudication we have assessed 58 non-diabetic patients comparing our new method with treadmill testing and Doppler assessment. Limb blood flow was applicable to all 58 patients; 25 patients were unable to walk on a treadmill and of the 33 who could 12 failed to walk for one minute, making a standard one minute exercise test inappropriate. In those patients who could perform exercise tests there was a significant correlation between maximum walking distance and limb blood flow (r = 0.35, P = 0.02). Resting, post-exercise and post-hyperaemic ankle-brachial systolic pressure indices bore no relationship to the maximum walking distance. Isotope limb blood flow measurement is reproducible (r = 0.97), can be applied to those patients who cannot walk on a treadmill and provides information about both legs. It correlated significantly with all the other tests and can be recommended for the minimally invasive assessment of intermittent claudication.
Mathematical prediction of ileal pouch capacity
Authors: Thomson W H F , Simpson A H R W , Wheeler J L 
Published: March 2007

Abstract
Restorative proctocolectomy is an operation still in the stage of development. Three main types of ileal pouch construction are used, but the advocacy of each probably arises more from familiarity and convenience than from scientific considerations. Since, other things being equal, pouch capacity can be expected to affect stool frequency, it seemed reasonable to examine calculable pouch capacity geometrically for different methods of construction. A mathematical model was therefore used to compare the double loop (‘J’) type with the quadruple loop (‘W’) construction. The W was estimated to have a capacity more than half as great again as the J. Similarly anastomotic methods which encroach on the ileal circumference by creating an inverted edge can be expected to reduce resultant capacity by 10 per cent or more.
Activated oestrogen receptor in human breast cancer: Clinical and biochemical correlates
Authors: White J O , Herschman M J , Parmar G , Philipson K A , Elder M G , Habib N A , Wood C B 
Published: March 2007

Abstract
The oestrogen receptor (ER) contains a DNA-binding site, the activity of which can be determined by its binding to oligo(dT)-cellulose. In premenopausal women with breast cancer, 53 per cent of ER-positive tumours were capable of binding to oligo(dT)-cellulose (activated ER); the corresponding proportion in postmenopausal patients was 70 per cent (P&lt;0·005). Disease recurrence was significantly increased in patients whose tumours contained non-activated rather than activated ER. The presence of activated ER was associated with a significant increase in the median activity of creatine kinase in premenopausal and postmenopausal patients. In postmenopausal patients the incidence of progesterone receptor was higher in tumours that contained activated ER than in tumours that contained ER not capable of binding to oligo(dT)-cellulose (non-activated). The incidence of activated ER was not related to disease stage or nodal involvement at the time of sampling. The data suggest that ER-positive tumours can be divided, according to the activity of the DNA-binding site, into subgroups with differing biological properties.
Injection sclerotherapy in adult patients with extrahepatic portal venous obstruction
Authors: Kahn D , Terblanche J , Kitano S , Bornman P 
Published: March 2007

Abstract
Thirty-nine adult and teenage patients with extrahepatic portal venous obstruction (EHPVO) were treated with injection sclerotherapy. There were 22 males and 17 females with a mean age of 27 years (range 12–69). Oesophageal varices were eradicated in 33 patients after seven injections (range 1–17) over a mean of 14·5 months (range 1–48). Fewer injections were needed to eradicate varices in older patients. Variceal bleeding occurred on 13 occasions in 9 patients before eradication of varices and on 4 occasions in 4 of the 33 patients in whom varices had been eradicated, with a mean follow-up of 44 months (range 3–105). There were no deaths during the study period. Complications, mostly of a minor nature, occurred in 25 patients and included injection site leak in 5, stenosis in 7 and mucosal ulceration in 23. We conclude that injection sclerotherapy is the treatment of choice in patients with EHPVO.
Controlled trial of occlusive dressings in healing chronic venous ulcers
Authors: Backhouse C M , Blair S D , Savage A P , Walton Jackie , McCollum C N 
Published: March 2007

Abstract
Fifty-six patients with chronic venous ulcers present for a mean of 2.4 years were randomized to either a new occlusive hydrocolloid dressing (Granuflex, Squibb Surgicare) or a porous non-adherent dressing (N A, Johnson and Johnson). In all patients, dressings were applied beneath a standard graduated compression bandage. There was no difference between the two groups, with complete healing in 21 out of 28 (75 per cent) of occlusive dressing patients and 22 out of 28 (78 per cent) with N A dressings by 12 weeks. Careful graduated compression bandaging achieves healing even in the majority of so-called resistant chronic venous ulcers; there was no additional benefit from applying occlusive dressings which tend to be expensive.
Late ischaemic sequelae after umbilical artery catheterization
Authors: Bergqvist D , Bergentz S E , Hermansson G , Lundberg H O , Troeng T 
Published: March 2007

Abstract
Late ischaemic complications of umbilical artery catheterization are well recognized but very little is known about long-term consequences. Two cases are presented which indicate that umbilical artery catheterization during the neonatal period may give rise to late ischaemic complications.
Duplex scanning of the internal carotid artery: An assessment of cerebral blood flow
Authors: Leopold P W , Shandall A A , Feustel P , Corson J D , Shah D M , Popp A J , Fortune J B , Leather R P , Karmody A M 
Published: March 2007

Abstract
Duplex ultrasound scanning (B-mode imaging and pulsed Doppler shift analysis) was used to measure internal carotid artery blood flow (ICBF) in 20 volunteers. The effect of changes in end tidal CO2 on cerebral blood flow was measured. When corrected to a Pco, of 40 torr (5.32 kPa) internal carotid artery blood flow was 286 ± 16 ml min−1 (mean ± s.e.m.). Specific CO2 reactivity (the change in flow per torr change in CO2) was 8·16±0·69 ml min−1 torr−1 which was equivalent to 2·0 ± 0·1 per cent of the flow at 40 torr per torr change in CO2 (percentage CO2 reactivity). The mean value and the CO2 reactivity compare favourably with previously reported measurements by other techniques. These data suggest that the non-invasive measurement of internal carotid artery blood flow by Doppler ultrasound scanning is an assessment of cerebral blood flow that can be used to study both normal and pathological changes within the cerebral circulation.
Orchidopexy: The effect of changing patterns of referral and treatment on outcome
Authors: London N J M , Joseph H T , Johnstone J M S 
Published: March 2007

Abstract
One-hundred and twenty-eight orchidopexies performed between 1979 and 1981 were reviewed in 1985, and the results compared with the results of operations performed in 1972. The age of referral has been determined for 1972, 1979–1981 and 1985. The number of unsatisfactory results has decreased from 35 per cent in 1972 to 9.4 per cent between 1979 and 1981. Five cases of the ‘ascending testicle’ were discovered, confirming the importance of this phenomenon. We suggest that the optimum age for orchidopexy is during the second year of life; however, during 1985, only 20 per cent of boys referred for orchidopexy were under 3 years of age. Doctors performing neonatal examinations should consider the possibility of cryptorchidism and ensure that affected neonates are reviewed at 1 year. The potential theoretical advantages of orchidopexy at an early age will only be converted into clinical benefit if the operation is performed by an experienced surgeon who has developed an expertise in this area of surgery.
Implantation of a pressure cuff around the subphrenic oesophagus
Authors: Miskowiak J , Burcharth F , Olesen H P , Baden H , Hald T , Aggestrup S 
Published: March 2007

Abstract
The possibility of implanting a pressure cuff around the subphrenic oesophagus as a barrier to reflux was tested in six pigs. The oesophagus tolerated cuff pressures from 48 to 95 cm H2O, corresponding to intra-oesophageal pressures from 27 to 75 cm H2O. The pigs with the perioesophageal cuff swallowed a solid diet without difficulty. However, dysphagia occurred in pigs kept alive for more than a month and the main reason was malfunction of the device because of surrounding fibrosis. This problem should be solved before implantation of the device in humans is attempted.
Edrophonium provocation test in the diagnosis of diffuse oesophageal spasm
Authors: Linsell Jane , Owen W J , Mason R C , Anggiansah Angela 
Published: March 2007

Abstract
Criteria for diffuse oesophageal spasm(DOS) are dysphagia and chest pain with oesophageal manometry showing retention of peristalsis with the presence of synchronous contractions in response to wet swallows. Because of the intermittent nature of the symptoms, edrophonium was used as a provocative agent to increase diagnostic yield. Three hundred and ninety-six patients underwent transnasal manometry using a Gaeltec system of six internal transducers arranged at 5 cm intervals from the catheter tip; the majority of these patients received 10 mg edrophonium as an intravenous bolus. Reproduction of symptoms with typical manometry of DOS indicated a positive provocation test. There were no significant side effects. DOS was diagnosed in 34 patients who had either the typical manometry or a positive provocation test. Thirty of these patients received edrophonium. Twenty patients had baseline manometry which was diagnostic and ten of this group had a positive provocation test. The remaining 10 patients, who had normal baseline manometry, had positive provocation tests following the injection of edrophonium. Without edrophonium provocation testing, about a third of patients would not have been diagnosed as having DOS.
Intracystic injection of OK-432: A new sclerosing therapy for cystic hygroma in children
Authors: Ogita S , Tsuto T , Tokiwa K , Takahashi T 
Published: March 2007

Abstract
Nine patients with cystic hygroma were treated with a new sclerosing therapy consisting of intracystic injection of OK-432 (group A Streptococcus pyogenes of human origin). Favourable results including complete regression in eight patients and marked regression in one were observed within 2–3 months without serious side-effects except for fever of 2–3 days' duration and local inflammatory reaction lasting for 3–4 days. Local inflammatory reaction did not cause any damage to the overlying skin and did not lead to scar formation.
Intussusception in children 5–15 years of age
Authors: Reijnen J A M , Joosten H J M , Festen C 
Published: March 2007

Abstract
Twenty cases of intussusception in children between the ages of 5 and 15 years were compared with intussusception in infancy and early childhood. They accounted for 18·5 percent of all 108 children treated for intussusception in two large hospitals from 1964 to 1984. Diagnosis of intussusception was delayed, probably due to an unusual presentation. Fifty-five per cent had a definite predisposing factor precipitating the intussusception and 45 per cent had a small bowel intussusception, which warranted early surgical intervention. In the absence of contraindications no child should be disqualified from an attempt at hydrostatic reduction. After hydrostatic reduction careful follow-up is required to exclude an organic lesion, possibly by a small bowel follow-through meal. Surgery is indicated after hydrostatic reduction in case of chronically recurrent abdominal complaints.
The ischaemic leg as a source of complement activation
Authors: Bengtson A , Holmberg Pia , Heideman M 
Published: March 2007

Abstract
Complement activation before and after surgical resection was studied in 40 patients with ischaemic legs (17 with acute and 23 with chronic ischaemia). Plasma anaphylatoxin concentrations (C3a and C5a) and anaphylatoxin inhibitor (AI) activity were studied pre-operatively, and 1h, 24 h and 1 week postoperatively. Increased plasma anaphylatoxin concentrations were found pre-operatively. Anaphylatoxin levels in plasma had returned to normal one week postoperatively. Patients with acute ischaemia had higher plasma C3a and C5a pre-operatively and during the first 24 h postoperatively than patients with chronic ischaemia. Anaphylatoxins increase vascular permeability, smooth muscle contraction and histamine release from mast cells. Their enhanced activity might be one of the explanations for respiratory, hepatic and renal insufficiency before surgical resection in patients with extensive ischaemia.
Evaluation of the prognostic factors in gastric cancer: The effect of chemotherapy on survival
Authors: Cunningham D , Hole D , Taggart D J , Soukop M , Carter D C , McArdle C S 
Published: March 2007

Abstract
This is a retrospective review of 328 consecutive patients with histologically confirmed gastric adenocarcinoma diagnosed in one centre between 1974 and 1984. Of these patients, 128 (39 per cent) had a curative resection, 32 (9·8 per cent) had a palliative resection, 33 (10·0 per cent) had a gastro-enterostomy, 26 (7·9 per cent) had a Celestin tube inserted, 58 (17·7 per cent) had a laparotomy alone, and 51 (15·5 per cent) had no surgical procedure. The 5 year survival was 11 per cent but all long term survivors were patients who had a curative resection. Using multivariate analysis the best predictor of survival after curative resection was the presence or absence of serosal involvement (P = 0·0004). Patients with a long history of presenting symptoms (&gt; 6 months) survived longer than those with a short history (P = 0·001). The impact of chemotherapy on the survival of 202 patients with advanced gastric cancer was analysed by multivariate analysis. The median survival of the 50 patients receiving combination chemotherapy was better than that of the 152 who did not (median survivals 160 versus 71 days; P&lt;0·001). When deaths occurring within 14 days of diagnosis were excluded, the significance value dropped to P = 0·02. Comparison of the groups treated between 1974 and 1979, when 8 per cent of 92 patients received chemotherapy, with 1980–1984, when 45 per cent of 110 patients received chemotherapy, showed no significant difference in survival.
Gastrointestinal haemorrhage from a second source in patients with colonic angiodysplasia
Authors: Steger A C , Galland R B , Hemingway Anne , Wood C B , Spencer J 
Published: March 2007

Abstract
Angiodysplasia of the colon is increasingly recognized as a cause of obscure gastrointestinal haemorrhage. On review of 71 patients with angiodysplasia, 40 came to surgery. Of these, nine (22·5 per cent) were also found to have small bowel lesions, either at the original laparotomy (7) or later when further investigations were performed for recurrent bleeding. Angiodysplasia can only be confidently diagnosed as the source of blood loss if seen to be actively bleeding. If a synchronous small bowel lesion is seen, we recommend that it should be removed at the same time as the colectomy.
Percutaneous transhepatic cholangioscopy
Authors: Chen M F , Jan Y Y , Lee T Y 
Published: March 2007

Abstract
Since 1983, percutaneous transhepatic cholangioscopy has been performed in 50 patients for both therapeutic and diagnostic purposes. Percutaneous transhepatic cholangioscopy was used to evaluate the nature of obstructive jaundice in 15 patients and bile duct stones were removed in 35 patients, 27 of whom also had intrahepatic duct stones. The overall success rate for stone removal was 80 per cent. Complications were few with no mortality. Emergency surgery was necessary in two patients, one for subphrenic haematoma, the other for a bile leak. Percutaneous transhepatic cholangioscopy is an effective and safe method for management of biliary stones and is a useful procedure for establishing the diagnosis of obstructive jaundice.