bluuebunny/crossref_metadata_2025_split huggingface dataset:
Introduction of a population-based vascular registry: Validity of data and limitations of registration
Authors: Lepäntalo M , Salenius J-P , Luther M , Ylönen K 
Published: March 2007

Abstract
A study was performed to assess the validity of the data in a nationwide vascular registry, Finnvasc, initiated in 1991. Data recorded during the first year were of 3507 procedures (immediate reoperations were excluded); 2436 (69 per cent) were surgical and 1071 (31 per cent) endovascular in nature. The Finnvasc data were compared with 2325 hospital records and re-registration of a random sample of 233 patients treated during October 1991 in nine centres was also carried out. In all, 21 per cent of patients from hospitals participating in Finnvasc were not registered and so it was calculated that about 4500 vascular procedures, 3125 surgical and 1375 endovascular, were performed in Finland in 1991. This represents an average of 900, 625 and 275 procedures per million population per year respectively. The non-registration rate in October was 17 per cent. Apart from operation classification, and function and patency at 1 month, all simple binary and code data at re-registration were in agreement in at least 92 per cent of cases; checklist and numerical data did not show such good conformity. During the first year of the registry many data were either missing or inadequately recorded, emphasizing the need for cross-validation and reregistration of a random sample of cases. Furthermore, the non-uniformity of coding between hospital records and the Finnvasc registry illustrated deficiencies in the current coding system.
Emergency oesophageal transection for uncontrolled variceal haemorrhage
Authors: Willson P D , Kunkler R , Blair S D , Reynolds K W 
Published: March 2007

Abstract
Continued haemorrhage from oesophageal varices despite adequate injection sclerotherapy and tamponade has a high mortality rate. Such patients are usually referred for surgery. Over a 10-year period, 30 patients (21 men and nine women of median age 52 (range 21–70) years) with acute variceal haemorrhage uncontrolled by initial treatment underwent early emergency oesophageal transection. Portal hypertension was caused by alcoholic cirrhosis in 22 patients; other forms of cirrhosis were present in seven and portal vein thrombosis in one. Hepatic function immediately before operation was Pugh grade A in two patients, B in six and C in 22. Deterioration between admission and transection from grade A to B occurred in one patient and from B to C in five. Oesophageal transection stopped variceal haemorrhage in 29 of the 30 patients. Rebleeding from gastric varices within 35 days of surgery occurred in five patients. Postoperative haemorrhage also occurred from perioesophageal vessels (two patients), a gastrotomy (one) and oesophageal ulceration (two). Hepatic failure developed in seven patients, renal failure in five and both hepatic and renal failure in four. Mortality at 30 days occurred in neither of the two patients with liver function of grade A, in one of six of grade B and in 18 of 22 of grade C. The overall 30-day mortality rate was thus 63 per cent. Mortality was related to the preoperative Pugh grade (hazard ratio 3·95 per grade; P = 0·013) and preoperative blood transfusion (hazard ratio 1·37 per unit; P = 0·035). Four of six patients with grade B liver function died within 3 months and 21 of 22 with grade C disease within 1 year. Oesophageal transection is effective at stopping variceal bleeding but does not modify the underlying disease. Caution is urged for patients with grade C hepatocellular impairment proceeding to acute oesophageal transection after initial sclerotherapy. Such patients may benefit more from treatment with somatostatin or an intrahepatic portasystemic stent shunt while awaiting definitive therapy.
Predictors of upper gastrointestinal bleeding in patients with schistosomal periportal fibrosis
Authors: Eltoum I A , Taha T E , Saad A M , Suliman S M , Bennett J L , Nash T E , Homeida M M 
Published: March 2007

Abstract
A case–control study was conducted between 1985 and 1987 in the Gezira-Managil area of central Sudan to assess the major predictors of haematemesis. Eighty-four patients who had suffered at least one attack of oesophageal bleeding and had schistosomal periportal fibrosis demonstrated by ultrasonography were compared with 173 subjects without bleeding but with ultrasonographic evidence of periportal fibrosis. A splenic longitudinal dimension of more than 11 cm, periportal fibrosis worse than grade I and varices more than grade I were independently associated with a significant risk of variceal bleeding. Age, sex, presence of a palpable liver and portal vein diameter were not associated with a significant risk of bleeding after adjustment for potential confounding variables. Factors identified in this study could be helpful in the prophylactic management of patients with complicated schistosomiasis.
Gastrointestinal bezoars
Authors: Robles R , Parrilla P , Escamilla C , Lujan J A , Torralba J A , Liron R , Moreno A 
Published: March 2007

Abstract
Of 99 patients with 117 gastrointestinal bezoars, 69 had undergone previous surgery, the most common operation being bilateral truncal vagotomy with pyloroplasty (55 patients). An excessive intake of vegetable fibre was found in 38 patients and poor mastication in 27. Thirty bezoars presented with gastric symptoms and patients had endoscopy as the diagnostic technique; 87 caused symptoms of intestinal obstruction with the diagnosis made by plain abdominal radiography. Medical treatment by enzymic or endoscopic fragmentation was used for 17 of 30 gastric bezoars; surgery was required in the remainder. Intestinal bezoars causing obstruction can be fragmented and ‘milked’ to the caecum. The stomach should be explored for associated gastric bezoars.
Xanthogranulomatous cholecystitis
Authors: Houston J P , Collins M C , Cameron I , Reed M W R , Parsons M A , Roberts K M 
Published: March 2007

Abstract
Clinical, radiological and pathological findings in 31 patients with xanthogranulomatous cholecystitis have been reviewed. The spectrum of presentation was similar to that of cholelithiasis but fewer patients had biliary colic (17 per cent) and there were more complications (32 per cent). Four patients had a biliary fistula and four a perforated gallbladder with abscess formation. Patients characteristically had gallstones. Appearances often mimicked carcinoma of the gallbladder at ultrasonography and/or laparotomy, with xanthogranulomatous tissue extending to adjacent structures. Xanthogranulomatous cholecystitis and carcinoma of the gallbladder coexisted in three patients. The possibility should be considered that an ‘inoperable tumour’ of the gallbladder may in fact be xanthogranulomatous cholecystitis, a benign condition that frozen-section biopsy may confirm.
Helium pneumoperitoneum for laparoscopic cholecystectomy: Ventilatory and blood gas changes
Authors: McMahon A J , Baxter J N , Murray W , Imrie C W , Kenny G , O'Dwyer P J 
Published: March 2007

Abstract
Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum may result in hypercarbia and acidosis in patients with cardiorespiratory disease. The aim of the present study was to assess helium as an alternative to carbon dioxide for creating the pneumoperitoneum. Ventilation requirements and carbon dioxide levels were assessed at the beginning and end of laparoscopic cholecystectomy using helium (n = 30) and carbon dioxide (n = 30) pneumoperitoneum. Insufflation with helium did not result in an increase in ventilation requirement although, like carbon dioxide pneumoperitoneum, it was associated with a mean rise in peak airway pressure (of 7 cmH2O; P &lt; 0·001). There was also a 3·2-kPa increase in the alveolar-arterial oxygen gradient with helium (P = 0·006). Carbon dioxide pneumoperitoneum was associated with a significant rise in arterial carbon dioxide levels, despite increasing ventilation. Four patients with helium pneumoperitoneum had surgical emphysema for 5 days. Helium may be a suitable alternative to carbon dioxide for creating pneumoperitoneum in patients with severe cardiorespiratory disease. However, because of its low water solubility helium has a lower safety margin than carbon dioxide in the rare event of gas embolism.
Cholelithiasis and bile acid absorption after truncal vagotomy and gastroenterostomy
Authors: Thompson D , Wild R , Merrick M V , Brydon G , MacIntyre I M C , Eastwood M A 
Published: March 2007

Abstract
Gallbladder disease in the form of gallstones demonstrated by ultrasonography or previous cholecystectomy was found in 15 of 26 women of median age 69 (range 52–82) years who had had truncal vagotomy and gastroenterostomy performed a median of 27 (range 11–30) years previously, compared with eight of 31 healthy age-and sex-matched controls drawn from the community (P &lt; 0·02). Bile acid malabsorption identified by retention of 23-selena, 25-homotaurocholate (75SeHCAT) occurred in only two of the 26 patients after vagotomy and there was no relationship between retention and the presence or absence of gallbladder disease. The serum concentration of 7 α-hydroxycholestenone, an indicator of bile acid turnover, was significantly lower in patients with gallbladder disease after vagotomy than in controls (mean(s.e.m.) 19·1(3·7) versus 31·4(4·4) ng/ml, P &lt; 0·05). Bile acid malabsorption does not play a significant role in the pathogenesis of gallstones after vagotomy but decreased bile acid synthesis may be important. There is no correlation between retention of 75SeHCAT and 7 α-hydroxycholestenone levels in patients after vagotomy, indicating that bile acid synthesis and absorption are uncoupled in this situation.
Taurolidine peritoneal lavage as prophylaxis against infection after elective colorectal surgery
Authors: Baker D M , Jones J A , Nguyen-Van-Tam J S , Lloyd J H , Morris D L , Bourke J B , Steele R J C , Hardcastle J D 
Published: March 2007

Abstract
A total of 300 patients undergoing elective colorectal surgery over a 3-year period were randomly assigned to receive intraoperative peritoneal lavage with either taurolidine or saline. Culture swabs were taken from the region of surgery before and after lavage and the development of postoperative infection monitored. Of the positive culture swabs before lavage, a significantly higher proportion were negative after lavage with taurolidine than after that with saline. However, there was no difference in the incidence of postoperative infection between groups, suggesting that taurolidine intraoperative peritoneal lavage confers no clinical benefit over that with saline.
Cancer of the colon and rectum in the West Midlands, 1957–1981
Authors: Allum W H , Slaney G , McConkey C C , Powell J 
Published: March 2007

Abstract
Between 1957 and 1981, 49 904 patients with large bowel cancer were registered at the Birmingham Cancer Registry. The annual incidence was 24·5 per 100 000 population for colonic cancer and 18·4 per 100 000 for that of the rectum. The annual number of patients increased by 41·9 per cent. The age-adjusted 5-year survival rate was 26·4 per cent for colonic carcinoma and 28·2 per cent for rectal cancer. Between 1977 and 1981 these rates increased significantly to 30·3 and 30·0 per cent respectively (P &lt; 0·01). Stage for stage, colonic cancer was associated with longer survival than that of the rectum. Curative and palliative resection rates increased, especially for anterior resection. The operative mortality rate remained constant at 8 per cent. Despite increases in palliative resection rates 50 per cent of these patients required a stoma. Treatment was not undertaken in 37·4 per cent of patients. The end results of treatment are little better than those reported previously from this registry.
Recovery of the internal anal sphincter and continence after restorative proctocolectomy
Authors: Farouk R , Duthie G S , Bartolo D C C 
Published: March 2007

Abstract
The internal anal sphincter (IAS) was assessed prospectively using electromyography and manometry in 66 patients (48 men) undergoing restorative proctocolectomy to determine its role in the gradual return of continence. Twenty-nine patients received a J pouch and 37 a W reservoir. Some 38 pouches (J, ten; W, 28) were hand-sewn (mucosal proctectomy with endoanal anastomosis) and 28 (J, 19; W, nine) stapled (end-to-end pouch-anal anastomosis 1 cm above the dentate line). Twelve patients underwent a one-stage procedure (all J pouches), while the remainder had a covering loop ileostomy. Each patient was reassessed immediately after restorative proctocolectomy and again at 7 days, 1 month, 4 months, 9 months and 18 months after pouch formation. Internal sphincter electromyographic activity was greatly reduced after pouch-anal anastomosis (median preoperative frequency 0·51 Hz versus immediate postoperative frequency 0·21 Hz, P &lt; 0·003) and gradually recovered from 4 months after surgery. At 18 months, measurements of IAS function had not fully recovered to preoperative values (median frequency 0·31 Hz; P &lt; 0·03). Resting anal pressures (median preoperative value 99 cmH2O) decreased by over 50 per cent after surgery (median immediate postoperative resting pressure 44 cmH2O) and recovered gradually but incompletely (median pressure at 18 months 63 cmH2O). Eleven patients reported leakage in the follow-up period. The median (range) resting pressure in these patients (54 (40–71) cmH2O) was not significantly different at 9 months from that of those who were continent either before or after operation (59 (46–68) cmH2O). Prolonged recordings in patients with faecal leakage revealed evidence of high-pressure pouch waves that overwhelmed anal sphincter pressures and coincided with leakage. These episodes were most common during sleep, when anal sphincter activity was reduced.
Investigation and management of subclavian steal syndrome
Authors: Delaney C P , Couse N F , Mehigan D , Keaveny T V 
Published: March 2007

Abstract
Patients with subclavian steal syndrome present with symptoms of vertebrobasilar ischaemia. Although angiography has traditionally been used to confirm the diagnosis of subclavian steal and plan reconstructive surgery in symptomatic patients, duplex ultrasonography now offers rapid diagnosis and also permits examination of the other extracranial vessels. The treatment of subclavian steal syndrome is surgical. Extra-anatomic bypass procedures are used to increase inflow to the subclavian artery, abolishing the steal phenomenon. Carotid–subclavian bypass or transposition and subclavian–subclavian or axilloaxillary bypass are the procedures of choice; selection is governed by the presence of coexistent carotid artery disease. Percutaneous transluminal balloon angioplasty of the subclavian artery is an alternative treatment, although the long-term patency rate is inferior to that of extraanatomic bypass.
Experimental models of acute pancreatitis
Authors: Banerjee A K , Galloway S W , Kingsnorth A N 
Published: March 2007

Abstract
Various models of experimental acute pancreatitis are described. An ideal model would be reproducible, have a similar natural history to that of the human disease and a similar response to treatment. Furthermore, it should be relatively cheap and simple. Few, if any, of the available experimental models completely satisfy these criteria. The appropriate choice of model is discussed, as are possible future developments in this field.
Abdominal aortic aneurysm in Scotland
Authors: Samy A K , Whyte B , MacBain G 
Published: March 2007

Abstract
In the 12-year period to December 1991, 5338 new cases of abdominal aortic aneurysm (AAA) were recorded in the Scottish Morbidity Record (SMR) 1. Data from this source were analysed for accuracy; information from 489 of 500 randomly examined case records matched the SMR 1 data, giving an accuracy of 97·8 per cent. There was a steady yearly increase in the number of reported cases, from 283 in 1980 to 612 in 1991; the male to female ratio was 2·5:1. The mean age was 73·1 years, higher in women (73·4 years for intact and 77·2 years for ruptured aneurysm) than in men (69·8 and 71·8 years respectively). The proportion of patients aged over 75 years increased from 29·0 per cent in 1980 to 38·2 per cent in 1991. Rupture occurred in 36·4 per cent of the aneurysms, and 75·0 per cent of these were in men. The increase in numbers occurred in both intact and ruptured cases, particularly the former. The hospital mortality rate for Scotland was 10·5 per cent for intact AAA (including urgent non-ruptured cases) and 54·7 per cent for ruptured aneurysm (including those not operated on), but these figures varied markedly between health boards.
Compartment syndrome following prolonged pelvic surgery
Authors: Peters P , Baker S R , Leopold P W , Taub N A , Burnand K G 
Published: March 2007

Abstract
Compartment syndrome is a rare but serious complication of prolonged pelvic surgery. Prompted by two recent cases the authors studied the effect of limb angulation and elevation on Doppler ankle artery pressure and compartment pressure in ten normal subjects. Mean ankle pressure when supine was 130·5 (95 per cent confidence interval (c.i.) 124·5–136·5) mmHg and fell to 77·2 (95 per cent c.i. 64·6–89·8) mmHg in the Lloyd-Davies position with 10° of head-down tilt. Reversing table tilt to bring the ankle elevation to 0° in Lloyd-Davies supports restored mean ankle pressure to 114·3 (95 per cent c.i. 105·5–122·9) mmHg (P &lt; 0.001). Placing the lower limb in calf supports was found to increase the mean intracompartmental pressure from 3·0 (95 per cent c.i. 1·2–4·8) mmHg to 11·6 (95 per cent c.i. 9·1–14·1) mmHg. Reversing table tilt significantly restores limb perfusion in patients undergoing prolonged pelvic surgery with the legs elevated and may protect against subsequent compartment syndrome.
Somatostatin and primary hyperparathyroidism
Authors: Lucarotti M E , Hamilton J A , Farndon J R 
Published: March 2007

Abstract
No satisfactory medical therapy exists for the treatment of primary hyperparathyroidism. Calcitonin and diphosphonates do not give good long-term control. This work examines the efficacy of the somatostatin analogue octreotide in the management of hyperparathyroidism. Twenty-one patients were admitted before parathyroid surgery and were treated for 6 days with subcutaneous octreotide 100 μg twice daily. Fasting blood samples were taken for determination of serum levels of calcium and parathyroid hormone, and 24-h urinary calcium excretion was measured before and after treatment. A significant decrease in urinary calcium was demonstrated, but the reduction in serum calcium level was not statistically significant and there was no change in serum parathyroid hormone concentration. Octreotide may provide therapy for patients with hyperparathyroidism and for those who have undergone unsuccessful neck exploration or who are unfit for operation. It may ameliorate hypercalciuria and reduce stone formation. The octapeptide may also have a potential role as a diagnostic test in primary hyperparathyroidism by determining the symptomatic effect of reducing raised levels of serum and urinary calcium.
Clinical efficacy of octreotide scintigraphy in patients with midgut carcinoid tumours and evaluation of intraoperative scintillation detection
Authors: Ahlman H , Wängberg B , Tisell L E , Nilsson O , Fjälling M , Forssell-Aronsson E 
Published: March 2007

Abstract
111In-diethylenetriamine penta-acetate-d-Phe1-octreotide scintigraphy was evaluated in a group of 27 patients with disseminated midgut carcinoid tumour. Additional information gained by the intraoperative use of a scintillation detector was studied in five patients with midgut carcinoid tumours and in two with endocrine pancreatic tumours. In 19 patients tumours not recognized by non-invasive radiological methods were visualized in 27 locations, most commonly in liver and para-aortic lymph nodes. Three false-negative tumour locations were noted (ovarian and peritoneal). With guidance from scintigraphic findings, nine patients underwent surgical tumour reduction, leading to complete remission in three. Clinically suspect tumour lesions were measured by the detector in situ, and ex vivo after excision. After excision the tissue: blood activity concentration ratios were calculated. In situ measurements were helpful in the localization of tumours and in the control of adequate clearance of tumour tissue. High tissue:blood activity concentration ratios at 1, 2 and 5 days in the five patients with midgut carcinoid tumour indicate a potential role for radiation therapy with radiolabelled octreotide in patients with somatostatin receptor-positive tumours.
Reoperation after failed antireflux surgery
Authors: Rieger N A , Jamieson G G , Britten-Jones R , Tew S 
Published: March 2007

Abstract
Between 1978 and 1992, 61 patients were operated on for new or recurrent problems after antireflux surgery. Indications for reoperation were recurrent reflux in 50 patients (associated with dysphagia in 14), dysphagia alone in six and postprandial pain in five. At reoperation the cause of the problem was apparent as anatomical breakdown of the repair in 19 patients, gastric pull-through (slipped Nissen procedure) in 14 and paraoesophageal hernia in six. In 18 patients the cause of the symptoms was not readily apparent. Reoperation consisted of fundo-plication alone in 27 patients, fundoplication with pyloroplasty in eight, fundoplication with proximal gastric vagotomy in four, a Collis–Nissen procedure in 11 (four also had pyloroplasty), a Roux-en-Y procedure in four, total gastrectomy in one and reduction of a paraoesophageal hernia in six. Of the 20 patients with some form of destruction of the gastric outlet six experienced troublesome dumping symptoms and in two this was severe. Two patients died from cardiac causes after surgery. Of the remaining 59 patients, 51 rated the procedure as successful. Repeat antireflux procedures can give results almost as good as those of primary antireflux surgery. However, pyloroplasty and gastric resection should be avoided if at all possible.
Risk of cancer following partial gastrectomy for benign ulcer disease
Authors: Lundegårdh G , Adami H-O , Helmick Ch , Zack M 
Published: March 2007

Abstract
The relative risk of developing cancer after partial gastrectomy for benign ulcer disease, expressed as the standardized incidence ratio, was examined in a population-based cohort comprising 6459 patients operated on between 1950 and 1958. Follow-up to 1983 revealed 1112 patients with cancer versus 1128 expected cases (relative risk 1·0 (95 per cent confidence interval (c.i.) 0·9–1·1)). The overall risk increased over time; it was higher in younger than in older patients but was not related to sex, surgical procedure (Billroth I or II gastrectomy) or diagnosis at operation (duodenal or stomach ulcer). There was an increased risk for lung cancer (relative risk 1·5 (95 per cent c.i. 1·2–1·7)), for oesophageal cancer in patients operated on for stomach ulcer (relative risk 2·2 (95 per cent c.i. 1·0–4·2)) and for cancer of the biliary tract in men (relative risk 1·9 (95 per cent c.i. 1·2–2·9)) and in those operated on for duodenal ulcer (relative risk 1·7 (95 per cent c.i. 1·0–2·8)). The overall risk for genital cancer in women was unchanged but decreased with increasing duration of follow-up and age. Cancers of the nervous system occurred less frequently than expected (relative risk 0·5 (95 per cent c.i. 0·3–0·8)), while the risk for cancer of the buccal cavity, lymphatic and haematopoietic systems, pancreas, breast, prostate, kidney and bladder was unchanged.