bluuebunny/crossref_metadata_2025_split huggingface dataset:
The value of ultrasound in the diagnosis and treatment of small hepatocellular carcinoma
Authors: Kanematsu T , Sonoda T , Takenaka K , Matsumata T , Sugimachi K , Inokuchi K 
Published: March 2007

Abstract
Thirty-two patients with a solitary hepatocellular carcinoma of less than 4 cm diameter were treated during the 13 years from 1971 to 1983, two-thirds of them since 1981. Serum α-fetoprotein levels proved to be an excellent diagnostic tool for these early stage carcinomas which are generally asymptomatic. Ultrasonography forms an invaluable test for the detection of occult liver cancer and has enhanced the ability to detect small sized lesions. The accuracy of this method increased from 25 per cent for the period 1971-1980 to 89 per cent for the period 1981–1983. The cumulative survival rates for the 32 patients treated by hepatic resection at 1, 2 and 5 years were 85, 70 and 22.2 per cent (excluded from these figures are four operative deaths giving a 12.5 per cent operative mortality).
Villous adenomas in the duodenum
Authors: Haglund U , Fork F-T , Genell S , Rehnberg O 
Published: March 2007

Abstract
Five patients with villous adenomas in the duodenum are described. In one patient malignant degeneration had occurred at the time of diagnosis. This patient was treated with a pancreaticoduodenal resection and is doing well 2 years postoperatively. The other four patients all had a duodenotomy and a local excision of the tumour. One patient had a recurrence with malignant degeneration within 1 year. The other three patients are doing well without signs of recurrence 1–4 years postoperatively. It is concluded that duodenal villous adenomas are potentially malignant. The strategy of surgical treatment is discussed.
Evaluation of surgical treatment of carcinoma of the oesophagus in the elderly: 20 years' experience
Authors: Sugimachi K , Matsuzaki K , Matsuura H , Kuwano H , Ueo H , Inokuchi K 
Published: March 2007

Abstract
The results of 231 oesophageal resections and reconstruction in 395 patients with thoracic oesophageal carcinoma presenting in the last 20 years are reported. In patients over 70, the incidence of multiple pathology and postoperative complication was high. The most frequent causes of death after surgery were pulmonary complications, and anastomotic leakage. As the mortality rate in the aged group exceeded that of the younger groups, careful pre-operative assessment, the indication for surgery and postoperative care should be carefully considered, even though only surgery offers a hope of cure for patients with oesophageal carcinoma. If the elderly can tolerate the surgical procedures, the 5 year survival rate equals that of the younger patients.
Quality of life after restorative proctocolectomy with pelvic ileal reservoir
Authors: Pezim M E , Nicholls R J 
Published: March 2007

Abstract
Fifty-five patients who had undergone restorative proctocolectomy with a pelvic ileal reservoir between 3 and 82 months previously were sent a detailed questionnaire to assess their quality of life. All patients had experienced an ileostomy at some time. Fifty-one (94 per cent) returned completed questionnaires. The average frequency of evacuation from the reservoir was four times per 24 hours. Antidiarrhoeal medication was required by 14 (27.4 per cent). Continence was normal in 32 (62.7 per cent) and only 3 (5.9 per cent) had troublesome faecal leakage. Twenty-two (43.1 per cent) evacuated stool spontaneously, while 24 (47.1 per cent) needed to catheterize the reservoir for each evacuation. Four patients who had had the reservoir removed were added to the 51 responders to give a total number of 55 whose quality of life was considered in this study. The reservoir was preferred to an ileostomy with regard to confidence (87 per cent), cleanliness (89 per cent), sexual self-image (87 per cent), social (85 per cent) and sport activity (87 per cent), and ease of carrying out work (84 per cent). The overall preference was 87 per cent. Thirty-four (66.7 per cent) felt there was no significant disadvantage associated with the reservoir, while 10 (19.6 per cent) saw the long convalescent period and 9 (17.6 per cent) the requirement for catheterization as drawbacks.
Local recurrence after potentially curative resection for rectal cancer in a series of 1008 patients
Authors: McDermott F T , Hughes E S R , Pihl E , Johnson W R , Price A B 
Published: March 2007

Abstract
Local recurrence and its related mortality after potentially curative resection for rectal cancer have been analysed in a series of 1008 patients managed by one of the authors. Nine hundred and thirty-four were available for analysis of recurrence. One hundred and seven (11 per cent) patients developed local recurrence without evidence of systemic spread and 84 (9 per cent) both local and systemic recurrence. Local recurrence was less common (14 per cent) after resection of tumours of the upper third of the rectum compared with the middle (21 per cent) (P = 0.02) or lower thirds (26 per cent) (P &lt; 0.001). Local recurrence was related to both tumour stage and differentiation (P &lt; 0.001). There was no significant relationship between local recurrence and tumour size or the type of curative resection performed, restorative or non-restorative. The distal margin of clearance after restorative resection did not influence the local recurrence rate. Of patients who developed metastases recurrence was evident within 2 years in 60 per cent. Three hundred and thirty-two patients died from recurrence, 91 (27 per cent) with evidence of local recurrence only, 80 (24 per cent) with combined local and systemic recurrence and 161 (48 per cent) with evidence of systemic spread only. The corresponding median survivals were 35, 34 and 39 months.
The establishment of a microcomputer-based diagnosis and operations index in the Department of Surgery of a district general hospital
Authors: Prout W G , Blood P A 
Published: March 2007

Abstract
The development and running of a microcomputer-based index of diagnoses and operations in the surgical department of a district general hospital is described. Many major problems have occurred, leading to malfunction or failure of the system, but it appears that these difficulties have now been resolved. In one year 4360 records have been fully processed with 4775 diagnoses, and 3968 operation codes have been permanently recorded. A further 560 patient records have been entered and await admission. The day-to-day running of the computer has been achieved by established secretarial staff without increase in number. The advantages and disadvantages of this system are outlined.
A study of rat intestinal wound healing in the presence of radiation injury
Authors: Ormiston M C E 
Published: March 2007

Abstract
Anastomotic dehiscence is a common complication following the resection of intestine with late radiation damage, and can occur even after wide resection of obviously compromised tissue. In this study using male rats, exteriorized segments of terminal ileum and/or the fatty appendages of the testes were exposed to single doses of irradiation (10, 15 and 20 Gy) producing early and late damage of varying severity. Wounds made at intervals from 2-24 weeks after irradiation in normal or irradiated ileum were repaired immediately and wrapped in normal or irradiated appendages. Post mortem examination of the wounds 4-7 days later showed that, in general, control wounds made in unirradiated tissues healed soundly. The incidence of wound breakdown in irradiated tissues was dose-dependent. After irradiation of the ileum alone, the frequency of suture line dehiscence increased with the interval between irradiation and wounding. When the ileum and appendages or appendages alone had been irradiated, the frequency of dehiscence was increased from 2 weeks post-irradiation onwards. This study emphasizes the important role played by adhesions in rat intestinal wound healing and shows that dehiscence may occur if irradiated tissues are positioned next to a suture line made in normal rat intestine. The findings suggest that, in clinical practice, it may be advisable to ensure that anastomoses at risk from radiation damage area wrapped in unirradiated tissue such as omentum.
Influence of pre- and intra- operative factors on the occurrence of postoperative fatigue
Authors: Christensen T , Hougård F , Kehlet H 
Published: March 2007

Abstract
Subjective feeling of fatigue was assessed before and 10, 20 and 30 days after uncomplicated abdominal surgery in 52 patients and after minor otological surgery in 15 patients. In major surgery fatigue increased from 3.0 ± 0.2 (mean±s.e.m.) arbitrary units pre-operatively to 6.1±0.3, 5.3±0.3 and 4.1±0.3 on day 10, 20 and 30, respectively (P &lt; 0.001). In contrast, after minor surgery fatigue did not change from before surgery (2.1±0.3) to day 7 (2.9±0.5) (P&gt;0.05), day 20 (2.3±0.4) (P&lt;0.4), or day 30 after surgery (2.1±0.3) (P&lt;0.9). Differences in fatigue between groups were significant postoperatively (P&lt;0.001), but not pre-operatively (P&lt;0.05). Mean duration of surgery was similar in the two groups. In the abdominal group an increase in postoperative fatigue did not correlate with age, sex, pre-operative degree of fatigue, actual body weight, triceps skinfold thickness (TSF), arm muscle circumference (AMC), anthropometric index (body weight × TSF × AMC) or serum-transferrin, but did slightly with pre-operative body weight related to ideal body weight (r = -0.3, P&lt;0.05). Thus, the magnitude of the trauma and not the duration of anaesthesia may be important for occurrence of postoperative fatigue. Furthermore, fatigue after elective abdominal surgery seems to be unpredictable from the pre-operative status of the patient.
Incisional hernia: A 10 year prospective study of incidence and attitudes
Authors: Mudge Marjorie , Hughes L E 
Published: March 2007

Abstract
Five hundred and sixty-four patients reviewed 1 year after major abdominal surgery have been studied prospectively by a single observer for 10 years to determine the incidence and significance of incisional hernia. Of 337 (60 per cent) patients completing the 10 year follow-up 37 (11 per cent) developed an incisional hernia and 13 (35 per cent) of these first appeared at 5 years or later. One in three hernias caused symptoms. The late appearing hernias were smaller than the early ones, and caused little trouble. Of the 18 patients who consulted their general practitioner, 11 had symptoms and of these six (55 per cent) were referred for surgical opinion. Many hernias were diagnosed at routine outpatient follow-up and were likely to receive treatment from the surgeon. Most symptomatic patients were offered surgery with the remainder usually being offered a corset. In about half our patients (mainly those without symptoms) surgery was refused or advised against although the patients would have accepted it. Recurrence is common after surgical repair (40 per cent) but seems to be related to surgical technique. The possibility of complications occurring from an incisional hernia does not appear to be discussed with patients although obstruction occurred in 14 per cent of our patients with troublesome hernia.
Prediction of outcome following acute variceal haemorrhage
Authors: Garden O J , Motyl H , Gilmour W H , Utley R J , Carter D C 
Published: March 2007

Abstract
In order to identify factors predicting survival following acute variceal haemorrhage, data were collected prospectively from 100 admissions in 70 patients managed by a standard policy employing oesophageal tamponade, injection sclerotherapy and, if necessary, oesophageal transection. Of the ten predictive factors identified by univariate analysis, only prothrombin ratio, serum creatinine and the presence of encephalopathy on admission were shown by stepwise logistic regression to have independent significance. The derived regression equation allowed clearer identification than conventional scoring systems of high and low risk groups and successfully predicted outcome in 90 per cent of admissions.
Oesophageal manometry in patients with varices and following oesophageal transection
Authors: Spence R A J , Johnston G W , Parks T G 
Published: March 2007

Abstract
Thirteen patients who had recently bled from varices underwent oesophageal manometry. A control group of 13 asymptomatic subjects were also studied. Seven of the thirteen variceal patients had manometry before oesophageal transection and repeat manometry at least 1 month following operation. A further group of 17 post-transection patients also underwent manometry at a mean 27.6 months following operation. Comparison between variceal (13) and control subjects (13) showed that the lower oesophageal sphincter pressure, total length and length of the abdominal and proximal portions of the sphincter were similar in the two groups. Pre- and postoperative manometry (7) revealed a significant reduction in lower oesophageal sphincter pressure following transection. The total length of the lower sphincter was shorter postoperatively compared to the pre-operative length. Both the abdominal and the proximal portion of the sphincter were significantly shorter postoperatively. Comparison between post-transection group (24) and control subjects (13) showed that lower oesophageal sphincter pressure was significantly less following transection. Both total length and the length of the abdominal portion of the sphincter were significantly lower in the post-transection group.
Increased efficiency of transfusion practice in routine surgery using pre-operative antibody screening and selective ordering with an abbreviated crossmatch
Authors: Dodsworth Helen , Dudley H A F 
Published: March 2007

Abstract
In an effort to meet the increasing demands for blood to cover routine surgery and in order to reduce the amount of time-expired blood, we have adopted a system of grouping and screening patients' blood pre-operatively but not crossmatching blood unless there is more than a 30 per cent chance that it will be used. This approach is based on schemes developed in the USA over the past three decades. If there is unexpected haemorrhage at operation and the patient's serum is known to be free of irregular antibodies, blood of the same ABO group is provided, with only an abbreviated crossmatch to check ABO compatibility. During the first 6 months in which the new scheme was in operation it is estimated that the laboratory crossmatched at least 3000 units of blood (44 per cent) less than it would otherwise have done. 336 units were transfused after an abbreviated crossmatch and, as expected, there were no haemolytic transfusion reactions.
Abdominal aortic aneurysms in Western Australia: Descriptive epidemiology and patterns of rupture
Authors:   The Members of the West Australian Vascular Service, Castleden W M , Mercer J C 
Published: March 2007

Abstract
All abdominal aortic aneurysms presenting to hospitals and coroners in Western Australia over an 11-year period (January 1971 to December 1981) have been reviewed. A total of 1237 abdominal aortic aneurysms were found. After age and sex standardization it was apparent that the prevalence of diagnosis of abdominal aortic aneurysms had increased from 74.8 per 100 000 to 117.2 per 100 000 for men over 55 years of age (increase of 56.7 per cent) and from 17.5 per 100 000 to 33.9 per 100 000 for women over 55 years of age (increase of 93-7 per cent) during this period. One hundred and twenty-three patients were identified by coroner's autopsy after sudden death from ruptured abdominal aortic aneurysms in whom there had been no previous diagnosis of abdominal aortic aneurysm. Between 1971 to 1981, 478 patients underwent surgery; 225 had elective resection of their aneurysm with a 4.0 per cent fatality rate, and 253 had emergency operations with a 31.2 per cent fatality rate. Seasonal variations contributing to the date of emergency presentation or death from rupture of abdominal aortic aneurysms indicated a possible influence of colder weather upon rupture. It is hoped that the information provided in this paper will be of use to surgeons and physicians involved in health care planning for similar populations.
Vascular occlusion in the pathogenesis of complicated amoebic colitis: Evidence for an hypothesis
Authors: Luvuno F M , Mtshali Z , Baker L W 
Published: March 2007

Abstract
Amoebic perforation of bowel, the final and most serious manifestation of transmural amoebic colitis, is due to thrombotic occlusion of vessels supplying the segment of bowel with subsequent infarction and ischaemic necrosis. The ischaemic nature of the necrosis is confirmed by its shape and the demonstration of vascular thrombosis in the resected specimens of perforated amoebic colitis. Specimen angiography confirms the avascular area confined to the macroscopic lesions. Thrombotic occlusion and amoebic invasion of blood vessels have been demonstrated histologically. This new information suggests that amoebic perforation of the bowel is due to vascular compromise.
Electrophysiological and manometric assessment of the pelvic floor in the solitary rectal ulcer syndrome
Authors: Snooks S J , Nicholls R J , Henry M M , Swash M 
Published: March 2007

Abstract
Fifteen of twenty patients with the solitary rectal ulcer syndrome, eighteen of whom were women, had evidence of reinnervation in the external anal sphincter muscle as demonstrated by single fibre EMG and nine of these patients had an increased pudendal nerve terminal motor latency. In ten patients there was paradoxical puborectalis muscle activity on straining, but damage to the innervation of the external anal sphincter muscle was correlated with a history of straining, and with excessive perineal descent, rather than with paradoxical puborectalis activity. We suggest that this syndrome does not have a single cause.
R2/3 gastrectomy for gastric carcinoma: An audited experience of a consecutive series
Authors: Diggory R T , Cuschieri A 
Published: March 2007

Abstract
A consecutive series of 27 patients with gastric neoplasm (24 carcinoma, 3 lymphoma) have been staged at laparotomy using the Japanese criteria for macroscopic staging. In 20 patients the radical R2/3 resection was considered potentially curative as defined by the Japanese Society for Research in Gastric Cancer. The operative mortality in this subgroup was 1/20 (5 per cent) and 3/27 (11 per cent) in the entire series. Locoregional recurrence was not observed in the potentially curative group. Follow-up has varied from 6 months to 7 years. An overall survival of 12/27 (48 per cent) has been observed to date. Death from cancer dissemination is maximal in the first and second year after resection. The R2/3 resection was considered non-curative in seven patients. In this subgroup there were two postoperative deaths and four have died of metastatic disease within 12 months of the resection. The only 5 year survivor in this group had a gastric lymphoma.
Lesser curve disconnection using a stapling device: Highly selective vagotomy made quicker and easier
Authors: Hooper T L , Macfoy D , Magell J 
Published: March 2007

Abstract
A stapling device has been used to disconnect the lesser curve of the stomach during highly selective vagotomy in a consecutive series of ten patients. This modification renders the operation technically easier and quicker to perform. Postoperative recovery was uneventful in all patients, and in the subsequent follow-up period of 7–15 months, no problems relating to the technique were encountered.
Twenty-five years of injection sclerotherapy for bleeding varices
Authors: Spence R A J , Anderson J R , Johnston G W 
Published: March 2007

Abstract
Acute injection sclerotherapy has been used in Belfast for 25 years and the results are reviewed. During this period 264 patients had injection sclerotherapy for acute bleeding from oesophageal varices during 396 admissions; a rigid oesophagoscope was used and 447 injections were performed. The series includes 19 children who received 69 injections. Thirty-eight had extrahepatic portal venous hypertension and the remainder had intrahepatic disease. Overall, 81 were Child's grade A (including the 38 extrahepatics), 82 were grade B and 101 were grade C. Of the 396 admissions, acute injection sclerotherapy controlled bleeding in 362 instances (control rate 91.4 per cent); control rate in the children's group was 97.1 per cent and in the adults 90.2 per cent. The hospital mortality was 14.9 per cent (57 adults and 2 children). Nineteen deaths were due directly to bleeding oesophageal varices, two from bleeding gastric varices and seven directly or indirectly from oesophageal leaks. Most of the remaining deaths were due to liver failure. We consider that sclerotherapy is valuable in the control of variceal haemorrhage where bleeding is uncontrolled or recurs after vasopressin or tamponade in any admission.
Allergic contact dermatitis to epoxy resin in ostomy bags
Authors: Beck M H , Burrows D , Fregert S , Mendelsohn S 
Published: March 2007

Abstract
Six ostomy patients presenting with peristomal rashes have been shown to be allergic to their ostomy bags and to epoxy resin. Subsequent investigation confirmed the presence in the bags of low molecular weight epoxy resin oligomers, which are known as potent contact sensitizers.
Diagnosis and management of spontaneous transmural rupture of the oesophagus (Boerhaave's syndrome)
Authors: Walker W S , Cameron E W J , Walbaum P R 
Published: March 2007

Abstract
The presentation, diagnosis and management of 14 cases of spontaneous transmural oesophageal rupture have been reviewed. Analysis suggested that the classical triad of vomiting, chest pain and subcutaneous emphysema was rare (1/14) and therefore misleading. Abdominal pain and tenderness obscured the clinical picture; the temporal relationship of pain to vomiting varied and subcutaneous emphysema was uncommon (4/14). Consequently, only two cases were correctly diagnosed on presentation and diagnosis in the others was markedly delayed (average 4 days). Contrast swallow examination, when eventually performed, was diagnostic. Twelve patients underwent repair: four under 24 h, who all survived and eight over 24 h, amongst whom there were one (12·5 per cent) operative and two (25 per cent) late deaths. Conservative management was successful in the remaining two cases. Oesophageal fistula, empyema and incorrect initial surgery were common and serious complications. Management options are reviewed and their relative merits considered.
Reimplantation of the papilla of Vater
Authors: Williamson B W A , McArdle C S , Carter D C 
Published: March 2007

Abstract
Detachment of the papilla of Vater from the duodenum may happen (a) deliberately, during duodenal resection for tumour without concomitant resection of the pancreatic head, and (b) accidentally in the course of gastrectomy for duodenal ulcer, when attempts to exteriorize the ulcer are made. In this report two case histories are cited encompassing both of these circumstances, in which the ampulla was successfully reimplanted into a Roux loop.
111-Indium platelets in monitoring pancreatic allografts in man
Authors: Jurewicz W A , Buckels J A C , Dykes J G A , Chandler S T , Gunson B K , Hawker R J , McCollum C N , McMaster P 
Published: March 2007

Abstract
A technique for monitoring pancreatic allografts in man is presented. The method utilizes 111-indium labelled autologous platelets and provides quantitative and qualitative analysis of uptake of the tracer by the graft. Five patients without any significant accumulation of radiolabelled platelets in their transplants had an uneventful recovery and left hospital with satisfactory graft function. The three patients who suffered graft failure showed abnormal uptake of the tracer. This presented as a diffuse platelet accumulation within the transplanted pancreas in the case of acute rejection, or as a focal accumulation in two cases of venous thrombosis. Minor complications such as perigraft haematoma can also be diagnosed using this technique. We suggest that 111-indium labelled platelets provide a valuable diagnostic aid in the management of pancreatic transplant recipients.