bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in liver blood flow associated with the growth of hepatic LV10 and MC28 sarcomas in rats
Authors: Hemingway D M , Cooke T G , Grime S J , Jenkins S A 
Published: March 2007

Abstract
Abnormalities in liver blood flow are known to occur in patients and animals with overt hepatic tumour. This study investigated the changes in liver blood flow associated with the development of overt hepatic tumour in two different models. Hepatic tumour was induced by intraportal inoculation of either 300 LV10 sarcoma cells or 105 MC28 sarcoma cells in rats. Liver blood flow and hepatic haemodynamics were measured 3 weeks later when overt liver tumour was present. The hepatic perfusion index (HPI), the ratio of hepatic arterial to total liver blood flow, was raised and portal venous inflow reduced in rats with LV10 tumours, but not in those with MC28 lesions. Hepatic arterial flow was unchanged in LV10 tumours when the HPI was raised and neither model demonstrated arteriosystemic or portosystemic shunting. The changes in portal venous inflow were associated with a significant increase in portal and splanchnic vascular resistance. These studies suggest that liver blood flow changes in the presence of overt hepatic tumour are not related to portal venous obstruction but may be caused by a circulating splanchnic vasoconstrictor.
Oral calcium inhibits rectal epithelial proliferation in familial adenomatous polyposis
Authors: Thomas M G , Thomson J P S , Williamson R C N 
Published: March 2007

Abstract
Calcium reduces colorectal cell turnover and might therefore protect against neoplasia. The inhibitory effects of dietary calcium were tested in a double-blind controlled trial in patients with familial adenomatous polyposis who had undergone previous abdominal colectomy and ileorectal anastomosis. Patients received supplemental calcium carbonate (1500 mg/day) or placebo tablets for 6 months; sigmoidoscopy was performed before and after treatment. Rectal biopsies were maintained in short-term organ culture, and crypt cell production rate (CCPR) was measured stathmokinetically. A total of 25 patients completed the trial; polyp counts were obtained before and after treatment in all and CCPR values in 16. Calcium treatment reduced the mean(s.e.m.) CCPR from 4.72(0.48) to 2.42(0.48) cells per crypt per h (P &lt; 0.05), while values for placebo were unchanged (5.46(1.21) versus 5.08(1.17) cells per crypt per h). Calcium had no demonstrable effect on the number, size or distribution of rectal polyps. The ability of oral calcium supplementation to suppress rectal epithelial proliferation supports its potential to prevent development of colorectal carcinoma in high-risk individuals.
Carcinoid tumours of the appendix in children 1957–1986: Incidence, treatment and outcome
Authors: Parkes S E , Muir K R , Al Sheyyab M , Cameron A H , Pincott J R , Raafat F , Mann J R 
Published: March 2007

Abstract
Forty carcinoid tumours of the appendix were identified in children under 15 years of age between 1957 and 1986 from the records of the West Midlands Regional Children's Tumour Research Group. A significant excess of girls was observed (P = 0.02). All tumours were discovered incidentally and two patients underwent further surgery. Twenty-two of the 29 confirmed locations (76 per cent) were at the tip of the appendix and 34 of the 40 tumours (85 per cent) had invaded beyond the appendiceal submucosa. The reported incidence rate of 1.14 per million children per year remained constant throughout the study period. No recurrences, metastases or deaths from tumour were detected. Appendicectomy alone is confirmed as usually curative, although right hemicolectomy is occasionally necessary. Caution during routine appendicectomy is recommended to avoid possible tumour damage, as is consistent histological examination of all appendices in the paediatric age group. The importance of long-term follow-up is emphasized.
Anal endosonography and correlation with in vitro and in vivo anatomy
Authors: Sultan A H , Nicholls R J , Kammt M A , Hudson C N , Beynon J , Bartram C I 
Published: March 2007

Abstract
The endosonographic anatomy of the anal sphincters was studied by in vivo and in vitro correlation with anatomical dissection. Fourteen fresh anorectal specimens (eight abdominoperineal resection, six post mortem) were scanned in a water-bath with sequential dissection and correlation with the ultrasonographic images. Accurate anatomical identification of the layers during dissection was confirmed histologically. Anal endosonography was performed during operation in 12 patients to validate the in vitro findings. The in vivo study confirmed the in vitro results. Basic endosonographic anatomy has been clarified and inaccuracies in the previous description of the longitudinal muscle and external anal sphincter corrected.
Laparoscopic cholecystectomy
Authors: Macintyre I M C , Wilson R G 
Published: March 2007

Abstract
After laparoscopic cholecystectomy, the patient can expect a hospital stay of &lt; 2 days and a return to work within 2 weeks. The associated operative mortality rate is low at &lt; 0.2 per cent. The increased incidence of bile duct injury with the laparoscopic technique compared with open cholecystectomy is a cause for concern but such injuries should decrease with proper training in laparoscopic surgery. The use of operative cholangiography (whether routine, selective or never) is controversial but there is no evidence that routine cholangiography will prevent major bile duct injury.
Modern management of pancreatic pseudocysts
Authors: Grace P A , Williamson R C N 
Published: March 2007

Abstract
Pseudocysts may develop as a complication of acute pancreatitis, chronic pancreatitis or pancreatic trauma. As new methods of imaging provide fuller information on their incidence and natural history, important differences are emerging between the pseudocysts of acute and chronic pancreatitis. Traditional surgical approaches to the management of pseudocyst are now being challenged by endoscopic techniques and interventional radiology. In the light of these developments the options available are reviewed and strategies for the modern management of pancreatic pseudocysts are suggested.
Peripheral arterial thrombolysis: Intermediate-term results
Authors: Lonsdale R J , Whitaker S C , Berridge D C , Earnshaw J J , Gregson R H S , Wenham P W , Hopkinson B R , Makin G S 
Published: March 2007

Abstract
To determine the intermediate-term results of intra-arterial thrombolysis, 127 consecutive patients receiving 129 courses of treatment were reviewed at a median follow-up of 3 years. At initial review, 30 days after treatment, thrombolysis was successful in 63 cases (49 per cent). Of these patients, 16 were lost to follow-up: 15 died without further vascular symptoms and one moved from the area. Some 35 patients were alive and asymptomatic, of whom 33 had either angiographic or clinical evidence of continued arterial patency. Symptomatic reocclusion occurred in 12 cases; a further two patients remained asymptomatic and reocclusion was detected at follow-up. Two of the 12 symptomatic patients required amputation. Estimated patency rates were 80 per cent at 1 year, 72 per cent at 2 years and 70 per cent at 3 years. The intermediate-term results in the 66 cases in which lysis was unsuccessful were worse, only 16 patients (24 per cent) surviving to follow-up with the treated limb intact. It is concluded that, if thrombolysis is successful at 30 days, the intermediate-term results are good.
Long-term circulatory access via a peripheral implantable port
Authors: Carey P C , Mann D V , Pearce S Z , Windsor A C J , Pullyblank A M , Guillou P J , Monson J R T 
Published: March 2007

Abstract
The use of a novel indwelling central venous catheter system is described which combines the safety of peripheral venous catheter placement with a novel electromagnetic locator device for guidance of the catheter tip into the correct position. This locator system obviates the need for radiological screening or chest radiography for checking catheter placement. Fifty-one patients were studied prospectively and all were successfully cannulated. An infection rate of 0.29 per 1000 catheter-days was seen with a mean system life of 220 (range 15–510) days. The new port has a lower infection rate than other commonly used systems and eliminates complications such as pneumothorax and puncture of major arteries.
Results of a prospective randomized trial of the Angelchik prosthesis and of a consecutive series of 119 patients
Authors: Eyre-Brook I A , Codling B W , Gear M W L 
Published: March 2007

Abstract
The results of a randomized multicentre trial comparing the Angelchik prosthesis with floppy Nissen fundoplication for gastro-oesophageal reflux were assessed 4–6 years after surgery. Of the original 52 patients 48 were traced. A good or excellent result (Visick grade 1 or 2) was obtained in 21 of 25 after insertion of the Angelchik prosthesis compared with 18 of 23 after fundoplication. Poor results were due to recurrent heartburn after fundoplication and to dysphagia after prosthesis insertion. In a separate consecutive series of 119 patients receiving Angelchik prostheses, results were good or excellent in 101 (85 per cent) and poor in 18 (15 per cent). Control of reflux with a correctly positioned prosthesis was good. Troublesome dysphagia (Visick grade 3 or 4) was experienced in eight of the 119 patients. There was no mortality and no incidence of splenectomy or gas-bloat syndrome.
Perineural invasion of carcinoma of the pancreas and biliary tract
Authors: Nagakawa T , Mori K , Nakano T , Kadoya M , Kobayashi H , Akiyama T , Kayahara M , Ohta T , Ueno K , Higashino Y , Konishi I , Miyazaki I 
Published: March 2007

Abstract
Carcinoma of the pancreatobiliary system often produces perineural invasion extending to extrabiliary and extrapancreatic sites. A surgical technique has been developed to manage this invasion and has been used since 1974. Serial sections were prepared from 90 resected specimens and examined for perineural involvement of intramural and extramural biliary plexuses as well as the pancreatic nerve plexus. Perineural invasion was seen in 34 of 40 patients with carcinoma of the common bile duct, in ten of 14 with cancer of the gallbladder and in four of 15 with carcinoma of the papilla of Vater. Invasion extended to the extramural biliary or pancreatic nerve plexuses in 24 of 40 patients with carcinoma of the bile duct. Involvement of the intrapancreatic nerves was seen in all 21 patients with carcinoma of the pancreatic head and that of the pancreatic nerve plexus in 17 of 21. Perineural invasion was often found at the most progressive margin of the tumour. The survival rate of patients with perineural invasion was low compared with that of those without such invasion, although survival of patients with perineural invasion tended to be longer after extensive resection. The perineural space should be regarded as an important route for the spread of pancreatic and biliary carcinoma.
Temporary loop ileostomy for restorative proctocolectomy
Authors: Senapati A , Nicholls R J , Ritchie J K , Tibbs C J , Hawley P R 
Published: March 2007

Abstract
The aim of a defunctioning ileotomy after restorative proctocolectomy is to mitigate the consequences of pelvic sepsis, should it occur. However, there are complications related to the ileostomy itself. Of 310 patients (174 male and 136 female; mean age 33.2 years) who underwent restorative proctocolectomy between 1976 and 1990, 296 had a covering ileostomy and 14 did not. The stoma has been closed in 263 (88.9 per cent) at a median interval from formation of 12.0 weeks. Ileostomy-related complications before closure occurred in 17 patients (5.7 per cent). Laparotomy for obstruction due to the ileostomy was required in seven patients (2.4 per cent). Retraction requiring revision occurred in three patients (1.0 per cent), an abscess behind the stoma in one (0.3 per cent) and miscellaneous appliance problems in seven (2.4 per cent). Following closure, 59 patients overall (22.4 per cent) developed an ileostomy-related complication. There were 30 cases of small bowel obstruction, treated conservatively in 19 (7.2 per cent) and by laparotomy in 11 (4.2 per cent). Peritonitis requiring laparotomy occurred in three patients (1.1 per cent) and two (0.8 per cent) developed an enterocutaneous fistula. There were 14 (5.3 per cent) wound infections and 16 (6.1 per cent) other miscellaneous problems. Significant complications associated with a temporary ileostomy were less frequent in this series than in some other reports. Obstruction was the most common complication and fistula was rare.
Possible role of the autonomic nervous system in sphincter impairment after restorative proctocolectomy
Authors: Hallgren T , Fasth S , Delbro D , Nordgren S , Öresland T , Hultén L 
Published: March 2007

Abstract
Peroperative manometry was performed in 12 patients operated on with endoanal proctectomy and a hand-sewn pouch-anal anastomosis and in 12 in whom proctectomy was performed entirely from above, with the ileal pouch stapled to the top of the anal canal. Results from both groups showed that division of the superior rectal artery reduced the median (95 per cent confidence interval (c.i.)) resting anal pressure from 77.5 (69.9–83.3) mmHg to 64.5 (55.2–70.0) mmHg (P &lt; 0.01). Complete rectal mobilization to the pelvic floor decreased resting pressure by an additional 22 per cent, to a median of 50.0 (95 per cent c.i. 40.1–53.5) mmHg (P &lt; 0.01). After completion of anastomosis, irrespective of the operative technique used, a further decline in median pressure to 35.0 (95 per cent c.i. 26.0–47.7) mmHg could be demonstrated (P &lt; 0.05). This study indicates that anal sphincter pressure is reduced to a similar extent after hand-sewn and stapled anastomoses. Injury to the autonomic nervous supply to the anal sphincter mechanism might be the major cause for this reduction.
Oestrogen and progesterone receptors in colorectal cancer and human colonic cancer cell lines
Authors: Hendrickse C W , Jones C E , Donovan I A , Neoptolemos J P , Baker P R 
Published: March 2007

Abstract
Receptors for oestrogen (ER) and progesterone (PR) were assayed in tissue from 17 patients with colorectal cancer and five colonic cancer cell lines using enzyme immunoassays. ERs and PRs were detected in 15 and 17 cancers respectively, although the levels detected were low: median (range) ER 1.3 (0–11.3) and PR 3.9 (0.3–10.2) fmol per mg protein. These values were not significantly different from median (range) levels of ER (1.1 (0.6–3.0) fmol/mg) and PR (1.9 (0.5–3.2) fmol/mg) detected in normal mucosa. There were significant positive correlations between the levels of ER and PR for cancer tissue (τ = 0.56, P &lt; 0.005; r(log transform) = 0.68, P &lt; 0.003; n = 17) but not for mucosa, and between levels of ER in cancer tissue and mucosa (τ = 0.55, P &lt; 0.05; r(log transform) = 0.70, P &lt; 0.025; n = 10) but not between the corresponding PR values. In maintenance media, which contained phenol red and unstripped fetal calf serum, the median (range) concentration of ER was 1.9 (1.2–10.4) fmol/mg and that for PR 24.3 (9.1–63.2) fmol/mg in the five cell lines studied (HT-29, LS174T, SW620, Lo Vo, COLO 320DM). The addition of oestradiol (10 nmol/l) to phenol red-free medium containing 5 per cent dextran-coated charcoal-treated fetal calf serum had little effect on the concentration of ERs or PRs in SW620, LoVo and COLO 320DM cells after 7 days' culture. It is concluded that ERs and PRs are expressed in malignant and normal colonic mucosa. ERs appear to be a feature of the colonic mucosa rather than the malignant process, but in carcinoma may regulate synthesis of PRs, suggesting a degree of oestrogen responsiveness.
Prophylaxis of postoperative thromboembolism with low molecular weight heparins
Authors: Jørgensen L N , Wille-Jørgensen P , Hauch O 
Published: March 2007

Abstract
To evaluate the thromboprophylactic use of low molecular weight heparins (LMWHs), publications from 27 orthopaedic trials and 35 studies of patients undergoing general or gynaecological surgery were scrutinized and subjected to a partial meta-analysis. In orthopaedic surgery, LMWHs were superior to placebo or dextran and at least as efficient as unfractionated heparin in the prevention of deep vein thrombosis (DVT). Compared with unfractionated heparin, one of the LMWH preparations signficantly reduced the total incidence of DVT. The rate of non-fatal pulmonary embolism was 0.49 per cent in patients receiving LMWH and 1.22 per cent in controls. Seven orthopaedic patients (0.15 per cent) died from pulmonary embolism, none of whom received LMWH. In general surgery, the LMWHs were at least as efficient as unfractionated heparin, with a trend towards a lower risk of pulmonary embolism with the former. Compared with unfractionated heparin, LMWHs did not reduce the postoperative mortality rate, nor did they cause haemorrhage. LMWHs provide safe and efficient prophylaxis by administration once daily.
Proximal gastric vagotomy and anterior seromyotomy with posterior truncal vagotomy assessed by the endoscopic congo red test
Authors: Chisholm E M , Raimes S A , Leong H T , Chung S C S , Li A K C 
Published: March 2007

Abstract
The completeness of vagotomy following proximal gastric vagotomy or anterior seromyotomy with posterior truncal vagotomy was assessed prospectively in 48 patients using the intraoperative congo red test. Pentagastrin (6 μg/kg) was given subcutaneously before the assessment. An endoscope was passed into the stomach and 180 ml congo red solution washed over the gastric mucosa. Continuing acid production was indicated by the appearance of a black colour (pH &lt; 3) 2 min after introduction of the dye. A grading system was adopted where grades I and II showed little black discoloration and grades III and IV showed increasing areas of discoloration indicating that further denervation was required. All 20 patients undergoing anterior seromyotomy with posterior vagotomy were classified as grade I. Fifteen of an initial 23 patients receiving proximal gastric vagotomy were grade III or IV. Following division of either the right gastroepiploic nerve or the posterior vagal trunk, 22 patients improved to grade I (16) or II (six). In the subsequent five proximal vagotomies, modification of the dissection produced grade I results. Anterior seromyotomy with posterior truncal vagotomy gave consistenly complete vagotomy. The congo red test highlighted major differences in the adequacy of vagotomy achieved using various dissection techniques during proximal gastric vagotomy. The test is a useful, reproducible and simple intraoperative method for assessing the completeness of denervation.
Vitamin C status in patients with acute pancreatitis
Authors: Scott P , Bruce C , Schofield D , Shiel N , Braganza J M , McCloy R F 
Published: March 2007

Abstract
Vitamin C is a key antioxidant in human blood plasma and hence could influence the outcome of conditions such as acute pancreatitis in which oxidative stress apparently plays a pivotal role. The concentrations of vitamin C and its immediately bioavailable form, ascorbic acid, in fasting plasma samples from 30 healthy volunteers were compared with those in admission samples from 29 consecutive patients with acute pancreatitis and 27 patients with other acute abdominal crises. Median (range) levels of vitamin C and ascorbic acid, respectively, were 15 (6·3-19) and 12 (4·5-18) μg/ml in the control group, 2·8 (0·3-10) and &lt; 0·5 (&lt; 0·5-6·0) μg/ml in patients with acute pancreatitis, and 3·7 (0·6-15) and 2·3 (&lt; 0·5-15) μg/ml in those with other acute abdominal problems. Admission plasma samples showed equally low vitamin C levels in both groups of patients (P &lt; 0·001 versus controls), but those from patients with acute pancreatitis were further characterized by a disproportionate reduction in ascorbic acid, such that the concentration of ascorbic acid and its ratio to vitamin C were both significantly lower than in samples from patients with an acute abdomen (P &lt; 0·005 and P &lt; 0·001 respectively). It is concluded that the stress of an acute intra-abdominal crisis is accompanied by a non-specific decrease in the plasma level of vitamin C. In acute pancreatitis early and profound oxidative stress compounds this problem by denaturing the available vitamin. There may be a case for the judicious parenteral administration of ascorbic acid to patients with acute pancreatitis to boost plasma antioxidant defence.
Effect of suture material on tumour cell adherence at sites of colonic injury
Authors: Reinbach D , McGregor J R , O'Dwyer P J 
Published: March 2007

Abstract
In an experimental animal model, radiolabelled viable intraperitoneal adenocarcinoma cells adhered in similar numbers to normal rat colon and that injured by a 1-cm colotomy, with median cell counts of 7002 and 8602 respectively (P not significant). Repair of the colotomy with interrupted silk resulted in a significant increase in the median number of cells adhering to the injury site (21888; P = 0.0001 versus normal colon). Repair with Prolene had no effect on tumour cell adherence (a median of 7449 cells adhered; P not significant versus normal colon). Tumour cell adherence at sites of colonic injury is dependent on the suture material used and not on the injury itself in this model. This may be important when choosing suture type for anastomosis in patients undergoing surgery for colorectal cancer.
Increased risk of colorectal cancer associated with congenital anomalies of the urinary tract
Authors: Atwell J D , Taylor I , Cruddas M 
Published: March 2007

Abstract
Two young mothers of children presenting with congenital anomalies of the urinary tract underwent colectomy for carcinoma or adenomatosis of the colon. In another family with urinary anomalies, the maternal grandmother had died from carcinoma of the colon at 36 years of age. This previously unreported association led to two reviews. In the first, of 14 patients with colorectal cancer presenting under 45 years of age, three had known congenital urinary tract anomalies. In the second, which included the first three families, a detailed family history was obtained from children receiving treatment for congenital anomalies of the urinary tract. Seven of 116 grandparents and two mothers among 58 parents had colorectal carcinoma or adenomatosis of the colon; this was significantly greater than the expected incidence. A family history of congenital anomalies of the urinary tract may be a useful marker in screening for colorectal cancer.
Randomized trial comparing three forms of pelvic floor repair for neuropathic faecal incontinence
Authors: Deen K I , Oya M , Ortiz J , Keighley M R B 
Published: March 2007

Abstract
A randomized controlled trial in women with neuropathic faecal incontinence compared total pelvic floor repair (n = 12) with anterior levatorplasty and sphincter plication alone (n = 12) and postanal repair alone (n = 12). Review at 6 and 24 months indicated that results were significantly better for total pelvic floor repair than either of the other procedures. Comlete continence was achieved in eight of the 12 patients 2 years after total pelvic floor repair. Only total repair significantly elongated the anal canal. Both total pelvic floor repair and anterior levatorplasty improved sensation in the upper anal canal.
Total sphincter conservation in high fistula in ano: Results of a new approach
Authors: Matos D , Lunniss P J , Phillips R K S 
Published: March 2007

Abstract
An intersphincteric approach has been developed that allows complete sphincter preservation in some patients with high fistulas. This operation in 13 patients (eight trans-sphincteric, five suprasphincteric tracks) has resulted in complete success in seven, partial success (ultimate sacrifice of the internal anal sphincter) in two and failure in four. When the operation is successful continence is better than after failed procedures.