bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of the first year of breast cancer screening in a district hospital
Authors: Bird D L , Fox J N , Ashley S , Imrie M J 
Published: March 2007

Abstract
The Humberside Breast Screening Service completed 1 year of screening by October 1990; 16 534 women were invited of whom 12832 (77.6 per cent) attended. A group of 644 women (5.0 per cent) were called for further assessment and of these 134 underwent 135 primary surgical procedures. After assessment 25 were shown before operation to have cancer. One hundred and nine women had suspicious lesions and proceeded to surgical biopsy; 50 lesions proved malignant (benign: malignant biopsy ratio 1.2:1). The 75 malignant lesions represented a prevalence of 5.8 per 1000 of the screened population. Invasive cancer &gt; 1 cm in diameter formed almost half of the malignant lesions. This service has cost £32 per woman screened or £5533 per cancer detected. The results are comparable to those of previous studies and suggest that a mammographic screening service can be successfully provided in a district hospital setting.
Assessment of non-palpable mammographic abnormalities: Comparison between screening and symptomatic clinics
Authors: Aitken R J , Forrest A P M , Chetty U , Roberts M M , Huggins A , MacDonald H L , Muir B B , Kirkpatrck A E , Anderson T J 
Published: March 2007

Abstract
A retrospective study found that a breast screening clinic generated fewer localization biopsies for non-palpable mammographic abnormalities than a symptomatic clinic (3.36 versus 9.89 per 1000 mammograms, respectively) and that a greater proportion of such biopsies were malignant. This study determined the reason for this difference. There were 108 of 304 (35.5 per cent) and 17 of 130 (13.1 per cent) carcinomas in women attending the screening and breast clinics respectively (relative risk 2.72 (95 per cent confidence interval 1.70–4.34)). This difference was regardless of age. The characteristics of the mammographic abnormality, the Wolfe pattern, a family history of breast carcinoma, parity and age at first pregnancy were similar in both groups. Women attending the screening clinic were referred for localization biopsy after assessment by clinicians and radiologists at a joint clinic; there was no joint assessment for patients attending the breast clinic. The same staff attended both clinics, although the proportion of time spent at each varied. This study suggests that all women with a non-palpable mammographic abnormality should be reviewed at a joint assessment clinic before localization biopsy is recommended.
Isolated hyperthermic liver perfusion with cytostatic-containing perfusate activates the complement cascade
Authors: Arnestad J P , Bengtsson A , Bengtson J-P , Henriksson B-Å , Stenqvist O , Naredi P , Hafström L 
Published: March 2007

Abstract
Eight patients with advanced liver malignancy undergoing isolated hyperthermic liver perfusion with melphalan and cisplatin were studied with regard to complement activation and formation of anaphylatoxins (C3a and C5a) and terminal C5b-9 complement complexes (TCCs). Blood samples for complement variables (C1-INH, C3, C4, C5, C3a, C5a and TCCs) were taken before surgery, 1 min before the start of perfusion, 1, 2 and 3 h after the start of perfusion, and 24 h after operation. Samples were drawn from the perfusate 1 h after the start of perfusion. Activation of complement was observed during perfusion. Raised plasma concentrations of C3a and TCCs were recorded and high levels of C3a and TCCs were found in the perfusate. In vitro tests indicated that melphalan and cisplatin may activate complement. This activation occurred at 37 and 42°C but was more pronounced at 42°C.
Biodistribution of Lipiodol following hepatic arterial injection
Authors: Hind R E , Loizidou M , Perring S , Fleming J , Batty V , Birch S , Taylor I 
Published: March 2007

Abstract
Thirteen patients undergoing selective coeliac angiography before insertion of an indwelling hepatic arterial cannula underwent injection of 3 ml radiolabelled Lipiodol (2 MBq 131I) into the hepatic artery at the end of the procedure. At subsequent laparotomy 1–9 days later, biopsies were taken from normal liver and metastases. The radioactivity of this material was measured to establish the tumour: liver ratios. Two patients with large metastases (&gt; 10 cm in diameter) had low ratios. In the remainder, the median ratio at 24 h was 1.5:1 (range 1.1–2.5:1;n = 5) and 2.6:1 (range 1.5–64.0:1;n = 6) at 3–9 days. Four patients underwent single photon emission computed tomography, which confirmed selective retention of Lipiodol in small metastases, although no activity was detected in a large deposit (&gt; 15 cm) 10 days after injection. The tumour: liver ratio in the other three patients increased from 3.0–5.6:1 on day 1 to 4.5–7.2:1 on day 6. This study suggests that Lipiodol may be a useful therapeutic delivery agent to small colorectal liver metastases.
Non-steroidal anti-inflammatory drugs and appendicitis in patients aged over 50 years
Authors: Campbell K L , De Beaux A C 
Published: March 2007

Abstract
In a retrospective study 84 patients aged ⩾ 50 years undergoing emergency appendicectomy were matched for age and sex with 84 randomly selected emergency admissions as controls. Of the former, 31 (37 per cent) were taking non-steroidal anti-inflammatory drugs (NSAIDs) at admission, compared with nine (11 per cent) of the controls (P &lt; 0.01). In the study group a suppression of the white cell count was identified on admission in those taking NSAIDs (mean 11.9 × 109 l−1) compared with those not (mean 14.8 × 109 l−1) (P = 0.007). This is the first reported association between appendicitis and NSAIDs. The relative risk by odds ratio was substantially increased at 6.5 (95 per cent confidence interval 2.1–8.8). An NSAID-related impairment of host defences leading to failure in the resolution of inflammatory episodes may explain this association. It is further postulated that the suppression of the white cell response may be a marker of such an effect.
Risk of rupture of postangiographic femoral false aneurysm
Authors: Graham A N J , Wilson C M , Hood J M , D'Sa A A B Barros 
Published: March 2007

Abstract
The surgical management of 50 false aneurysms caused by transfemoral arterial catheterization was reviewed to document the incidence and effects of rupture before repair. Twelve false aneurysms ruptured, leading to shock in six patients, distal ischaemia in three and stroke in one. The mean(s.d.) time, from catheterization to rupture was 2.8(1.7) (range 1-6) days. Postoperative complications occurred in seven patients with ruptured and eight with non-ruptured aneurysms (P &lt; 0.04). The mean(s.d.) age of patients with ruptured aneurysms was 67.2(6.3) (95 per cent confidence interval 63.5–70.8) years and those without 58.5(9.1) (95 per cent confidence interval 55.3–61.7) years (P &lt; 0.008). On multiple regression analysis, age, peripheral vascular disease and raised plasma liver enzyme levels on admission were found to be significant independent predictive variables for rupture (all P &lt; 0.05). It is recommended that patients with these risk factors undergo urgent operative correction of femoral false aneurysm.
Physiological and metabolic responses to open and laparoscopic cholecystectomy
Authors: Mealy K , Gallagher H , Barry M , Lennon F , Traynor O , Hyland J 
Published: March 2007

Abstract
This study examined respiratory function and metabolic and subjective responses in patients undergoing laparoscopic (n = 10) and open (n = 11) cholecystectomy for chronic cholecystitis and biliary colic. Patient groups were matched for age, sex, weight and height. The duration of operation was similar in both groups. Respiratory function tests (vital capacity, forced expiratory volume in 1 s, peak flow and arterial blood gases), urinary cortisol, vanillylmandelic acid, metanephrines and nitrogen loss, serum complement component C3 and C-reactive protein (CRP), full blood count, erythrocyte sedimentation rate (ESR) and subjective responses as assessed on a pain analogue scale and by analgesic usage were determined for up to 48 h after surgery. Deterioration in perioperative respiratory function was significantly less for laparoscopic surgery. Arterial blood gas determinations indicated a greater perioperative decrease in arterial pH, with carbon dioxide retention in patients undergoing open cholecystectomy (P &lt; 0.02), reflecting poorer respiratory performance. Hormonal profile changes demonstrated an increase in urinary vanillylmandelic acid in the laparoscopic cholecystectomy group (P &lt; 0.04); no differences were detected in urinary cortisol, metanephrine or nitrogen excretion. Acute-phase responses were greatest in patients undergoing open cholecystectomy as determined by ESR and CRP level (P &lt; 0.02 and P &lt; 0.003, respectively). Pain and analgesic usage were significantly decreased in the laparoscopic cholecystectomy group (P &lt; 0.0009 and P &lt; 0.0001), which led to a decreased hospital stay after operation in these patients (P &lt; 0.0001). These data indicate improved respiratory and subjective responses and diminished acute-phase responses associated with laparoscopic surgery. Catabolic hormone release may, however, be increased.
An improved means of faecal diversion: The trephine stoma
Authors: Anderson I D , Hill J , Vohra R , Schofield P F , Kiff E S 
Published: March 2007

Abstract
Twenty-four patients in whom trephine stoma formation was performed over a 4-syear period are described. This procedure permits the formation of an endileostomy or colostomy without laparotomy. It is simple, rapid, safe and allows speedy recovery. It is widely applicable and previous abdominal surgery is no contraindication. The procedure was impossible in two patients who required laparotomy and in a third in whom a loop colostomy was created. Operation time was shorter and postoperative opiate requirements less than when laparotomy was undertaken for stoma formation. Follow-up (median 1 year) of 17 patients confirmed a low incidence of complications (two prolapses, one parastomal hernia) after trephine stoma formation. This procedure is recommended as the preferred method of ileostomy or colostomy formation when laparotomy is not otherwise indicated.
Encephalopathy in patients with extrahepatic obstruction after lienorenal shunts
Authors: Mohapatra M K , Mohapatra A K , Achary S K , Sahni P , Nundy S 
Published: March 2007

AbstractThirty patients with portal hypertension resulting from extrahepatic portal vein obstruction were studied. Evidence of postshunt encephalopathy was sought using neurological and psychometric tests and visual evoked potentials. Eleven patients were studied before and after lienorenal shunt operations and 19 at varying intervals, from 6 to 123 (median 26) months, after the same procedure. All the shunts were patent and none of the patients developed clinical or subclinical encephalopathy. In patients with extrahepatic portal vein obstruction, a lienorenal shunt does not appear to be associated with postshunt encephalopathy.
Function of the human colon
Authors: Moran B J , Jackson A A 
Published: March 2007

Abstract
Despite the volume of research on human colonic dysfunction, little is known about colonic function in health. This has stemmed partly from the dificulty in obtaining access to the organ. Two approaches have been used: studies on patients with stomas, and intestinal intubation techniques. The colonoscope has also recently been used to gain access. All these methods have limitations and results must be interpreted with caution. The accepted roles of the colon include the conservation of water and electrolytes and the controlled evacuation of faeces. Recent research has demonstrated its importance as a metabolic organ with an influence on overall metabolism, an effect that may in large part be attributed to the activity of colonic microflora. Evidence demonstrating that the defunctioned colon behaves differently from the functioning colon in the same individual has implications for a proper understanding of the organ, as practically all previous in vivo studies have been conducted in cleansed or defunctioned human colon.
Aetiology and treatment of chylous ascites
Authors: Browse N L , Wilson N M , Russo F , Al-Hassan H , Allen D R 
Published: March 2007

Abstract
A series of 45 patients with chylous ascites has been reviewed. The age at presentation ranged from I to 80 (median 12) years; 23 patients were aged ≦15 years. Thirty-five patients had an abnormality of the lymphatics (primary chylous ascites); in the remaining ten, the ascites was secondary to other conditions, principally non-Hodgkin's lymphoma (six patients). Two principal mechanisms of ascites formation were identified using lymphangiography and inspection at laparotomy: leakage from retroperitoneal megalymphatics, usually through a visible lymphoperitoneal fistula (14 patients); and leakage from dilated subserosal lymphatics of the small intestine, invariably associated with leaking lacteals causing protein-losing enteropathy (24 patients). Both sites of leakage were present in a further five patients. In the remaining two patients, chyle was leaking from normal mesenteric lymphatics, in one via a ruptured mesenteric lymph cyst and in the other from the site of a previous lymph node biopsy. Other associated lymphatic abnormalities were present in 36 patients, lymphoedema of the leg being the commonest (26 patients). All patients were initially treated conservatively with dietary manipulation: this as the most satisfactory treatment for those with leaking small bowel lymphatics. Surgery (fistula closure, bowel resection or insertion of a peritoneovenous shunt) was performed in 30 patients. Closure of a retroperitoiieal fistula, when present, was the most successful operation, curing seven of the 12 patients so treated.
In vivo assessment by videomicroscopy of acute renal microvascular responses to cyclosporin
Authors: Abraham J S , Bentley F R , Garrison R N 
Published: March 2007

Abstract
Nephrotoxicity limits the use of cyclosporin A for immunosuppression after organ transplantation and may be caused by glomerular hypoperfusion. Indirect studies have shown that cyclosporin A increases renal vascular resistance and reduces total renal blood flow. This study used direct in vivo videomicroscopy to define the efects of the drug on the renal microcirculation of the rat. An intravenous infusion of cyclosporin A (20 mg per kg body-weight) caused a 13 per cent acute constriction of the proximal interlobular artery and an associated 29 per cent reduction in preglomerular interlobular arterial blood flow. There was a simultaneous increase in mean arterial blood pressure of 34 per cent caused by cyclosporin A and a 23 per cent increase in systemic vascular resistance. Cyclosporin acutely reduces renal microvascular blood flow by vasoconstriction and afects the central circulation, suggesting that a generalized peripheral vasoconstriction is induced.
Metastasectomy
Authors: Barr L C , Skene A I , Meirion Thomas J 
Published: March 2007

Abstract
The literature on metastasectomy abounds in anecdote and retrospective studies of non-randomized patients. In this paper, the published evidence concerning the efficacy of metastasectomy in the lung, liver, brain, gastrointestinal tract and omentum is reviewed to formulate practical recommendations for patient selection and treatment. At some sites metastasectomy can be recommended with little hesitation for more widespread application, but surgery for liver metastases should still be regarded with some reservation.
Management of Gulf War casualties
Authors: Souka H M 
Published: March 2007

Abstract
During the Gulf War 84 patients underwent surgery in the Jubail Armed Forces Hospital, Saudi Arabia. The median time to evacuate casualties to hospital was 8 h 40 min. Fragments caused 88 per cent of injuries; 11 per cent were caused by bullets. Multiple lesions were encountered in 70 per cent of patients. The extremities (76 per cent) were the most frequently injured site, the lower limbs more so than the upper. Soft tissue injuries prevailed (59 per cent).
Indications for primary tamoxifen therapy in elderly women with breast cancer
Authors: Gaskell D J , Hawkins R A , De Carteret S , Chetty U , Sangster K , Forrest A P M 
Published: March 2007

Abstract
A group of 66 elderly women with primary breast cancer were treated with tamoxifen and followed for a minimum of 2 years. Of these, 32 whose disease remained controlled for the 2-year period were considered to have had a ‚worthwhile‚ response, 27 in whom disease progressed were considered to have had an unsatisfactory result and seven opted for alternative treatment. By Union Internacional Contra la Cancrum (UICC) criteria, 14 women had a complete response, 20 a partial response, in five disease remained static and in 20 it progressed without response. Prediction of outcome after assessment according to UICC criteria at 3 and 6 months was unsatisfactory (19 and 34 of 59 correctly predicted respectively). Analysis of multiple tumour measurements over 12 weeks was no better (33 of 59 correctly predicted). Immunocytochemical assay of fine-needle aspirates for oestrogen receptor (ER) provided a better predictor (38 of 47 correct) and the difference in survival between patients with and without ER activity was significant (P &lt; 0.001). Conventional assessments of response at 3 and 6 months are unsatisfactory for judging the long-term benefit to the patient. ER status is the best predictor of response and outcome.
Autotransplantation of splenic tissue in an isolated segment of small intestine
Authors: Shokouh-Amiri M H , Bayat M , Rahimi-Saber S , Lindkaer Jensen S , Kerndrup G 
Published: March 2007

Abstract
The ability of splenic tissue to regenerate when implanted in an isolated segment of small intestine with intact circulation was studied in six pigs. After total splenectomy, 10 per cent of the weight of the spleen was implanted in a 10–15-cm long isolated segment of small intestine with an intact vascular supply. Bowel continuity was established by end-to-end anastomosis. Before implantation, the mucosal layer was completely removed from the isolated segment of the small intestine. The animals were killed 6 months later and the isolated segment of small bowel containing the splenic tissue identified. Most of the implanted splenic tissue was recovered in the isolated segment of small intestine; the weight ranged from 43 to 120 (mean 80) per cent of that of the implanted tissue. An isolated segment of small intestine with an intact circulation produces a higher index of regeneration than other previously reported sites.
Ascaris-induced acute pancreatitis
Authors: Khuroo M S , Zargar S A , Yattoo G N , Koul P , Khan B A , Dar M Y , Alai M S 
Published: March 2007

Abstract
The incidence, clinical disease and outcome of acute pancreatitis caused by ascariasis in an endemic area of Kashmir, India, was studied prospectively. Ascariasis was an aetiological factor in 59 of 256 patients (23.0 per cent) with acute pancreatitis. Worms had invaded the bile duct in 51 patients, the pancreatic duct in four and both ducts in four. Pancreatitis was mild in 46 patients and severe in 13. Associated pyogenic cholangitis was present in eight. Acute complications occurred in 11 patients. Endoscopic retrograde cholangiopancreatography (ERCP) was performed in all cases within 72 h of admission and delineated ascarides in the duodenum invading the ampullary orifice (44 patients), in the bile duct (55) and in the pancreatic duct (eight). At ERCP, worms were extracted from the ampullary orifice and removed via the mouth of 33 patients with intractable epigastric pain, leading to rapid relief of symptoms. The eight patients with pyogenic cholangitis underwent endoscopic nasobiliary drainage to decompress the bile ducts; worms were extracted from the bile duct of three of these patients using a Dormia basket. A total of 56 patients recovered from acute illness with a combination of conservative and endoscopic treatment; the other three required emergency surgery. At a mean(s.d.) follow-up of 19(7) months, ten patients showed symptomatic worm reinvasion of the biliary tree. The overall mortality rate was 3 per cent.
Serum tumour necrosis factor alpha and insulin resistance in gastrointestinal cancer
Authors: McCall J L , Tuckey J A , Parry B R 
Published: March 2007

Abstract
Cancer cachexia may be mediated by endogenous peptides such as tumour necrosis factor alpha (TNF-α). Insulin resistance occurs in these patients, and is also seen experimentally with TNF-α administration. In this study, insulin sensitivity and energy metabolism were measured in 11 patients with gastrointestinal cancer and ten controls, using the euglycaemic glucose clamp and indirect calorimetry. Patients with cancer were significantly more insulin resistant than controls (P &lt; 0.01) and in such patients insulin resistance correlated with serum TNF-α level (rs = 0.74, P &lt; 0.01). Fasting insulin levels also correlated inversely with insulin sensitivity (rs = −0.62, P = 0.003). These results suggest a possible association between endogenous TNF-α production and insulin resistance in patients with gastrointestinal cancer.
Intraoperative colonoscopy in patients with colorectal cancer
Authors: Brullet E , Montané J M , Bombardó J , Bonfill X , Noguè M , Bordas J M 
Published: March 2007

Abstract
Sixty-seven patients underwent intraoperative colonoscopy during elective surgery for colorectal cancer. Complete examination of the colon was achieved in 65 patients (97 per cent), albeit with insertion through a colotomy in three (4 per cent). A synchronous carcinoma was found in six patients (9 per cent), which necessitated a change of planned surgical procedure. Synchronous polyps were detected and removed in 24 patients (36 per cent); two had polyps with carcinoma in situ. The mean age of patients with synchronous carcinoma was significantly higher than that of those without (74.1 versus 61.2 years, P = 0.02). Intraoperative colonoscopy took a mean of 15 min surgical time and only two minor complications (serosal lacerations) were encountered. In patients with colorectal cancer, intraoperative colonoscopy allows complete assessment of the colon and identifies synchronous lesions.
Intraoperative streptokinase: A useful adjunct to balloon-catheter embolectomy
Authors: Beard J D , Nyamekye I , Earnshaw J J , Scott D J A , Thompson J F 
Published: March 2007

Abstract
Intraoperative thrombolysis was attempted in 31 acutely ischaemic legs after operative arteriography had demonstrated residual distal thrombus or occlusion following balloon-catheter thromboembolectomy. There were 30 patients, 16 men and 14 women, aged 43–82 (median 73) years. The indication for operation was severe ischaemia with sensorimotor loss in 25 limbs, failed percutaneous thrombolysis in three and acute graft occlusion in three. A total of 21 perfemoral, 11 perpopliteal and four graft embolectomies were initially performed. Following arteriography, 100 000 units streptokinase was infused down the isolated distal arterial tree over 30 min and arteriography repeated. Complete lysis was achieved in 11 legs (35 per cent) and partial lysis in 12 (39 per cent). Additional procedures required included six operative angioplasties and six bypass grafts. After operation pedal pulses were restored in 14 limbs (45 per cent), with a viable leg in 23 cases (74 per cent) at the time of patient discharge or death. There were five wound haematomas but no evidence of systemic fibrinolysis. Four amputations were required, none in the group undergoing successful lysis, and there were seven deaths, five from cardiac disease. Arteriography after balloon-catheter embolectomy is essential to detect residual thromboembolus and intraoperative streptokinase appears to be a safe and effective way of removing this.