bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prediction of the outcome of portacavel shunt using bromsulphthalein (BSP): A retrospective aspect
Authors: Turner Jean , Cuschieri A , Shields R 
Published: March 2007

Abstract
A series of 17 patients is presented in whom compartmental BSP kinetics were determined before portacaval shunt operations. The results suggest that calculation of the equivalent liver volume is a valuable aid in the safer selection of patients, by providing a more accurate prediction of outcome than do conventional preoperative criteria.
Choledochal cyst: A review of 18 cases
Authors: Yue Paul C K 
Published: March 2007

Abstract
Eighteen cases of choledochal cyst affecting Chinese patients are reported. The clinical picture may be one of four types. In infancy, jaundice may be the only feature. In children and adults there may be the classic triad of features or an abdominal mass without jaundice. Terminally, there may be bleeding from oesophageal varices due to biliary cirrhosis. Barium meal examination is the most useful radiological investigation. Intravenous cholangiography is sometimes helpful. The various methods of operative treatment are discussed. Ten cases of cyst excision were performed without mortality.
Disseminated intravascular coagulation with peripheral gangrene complicating acute appendicitis
Authors: Fredlund P E , Göransson G 
Published: March 2007

Abstract
A case is reported of acute appendicitis complicated by disseminated intravascular coagulation and spasm of the peripheral arteries, which led to bilateral amputation of the feet. The cause of the complication is supposed to be endotoxaemia. The possibility of inhibited function of the patient's reticirlo-endotheliai system is suggested.
Deep vein thrombosis: Preclinical diagnosis by thermography
Authors: Cooke E D , Pilcher M F 
Published: March 2007

Abstract
A raised temperature and delayed cooling on exposure of the thrombosed limb is an early sign of deep vein thrombosis (DVT). This sign can be detected by using thermography when not apparent clinically.
The grey tone thermograph has a characteristic appearance in DVT.
Of 53 cases of DVT demonstrated by phlebography, 51 were previously suspected on thermographic examination.
The method is non-invasive and can be repeated at will.
Relationship between changes in plasma gastrin and lower oesophageal sphincter pressure after meals
Authors: McCall I W , Harvey R F , Owens Caroline J , Clendinnen B G 
Published: March 2007

Abstract
Changes in plasma gastrin and lower oesophageal sphincter pressure were measured in 20 subjects after a standard protein meal. Significant increases in both gastrin and sphincter pressure were seen. Peak gastrin response occurred an average of 19.5 minutes and peak lower oesophageal sphincter response 43.0 minutes after the meal. Both gastrin and sphincter pressure showed a wide spectrum of response. In 5 subjects there was no appreciable rise (&lt; 5 pg/ml) in plasma gastrin after the meal, and 3 of these had symptoms of oesophageal reflux. In this group there was only a small but nevertheless significant rise in lower oesophageal sphincter pressure (mean pressure rise 18.0 per cent of fasting value, P &lt; 0.05). Greater increases in sphincter pressure (mean rise 54.2 per cent, P &lt; 0.005) were seen in subjects with a moderate (up to 50 pg/ml) rise in plasma gastrin, and those with the most marked gastrin response (&gt; 50 pg/ml) showed the greatest rise in pressure (mean rise 80.3 per cent, P &lt; 0.0025).
These results suggest that endogenous plasma gastrin is the main stimulus to the rise in lower oesophageal sphincter pressure after food. Subjects with a poor gastrin response to the meal have only a small increase in sphincter pressure and as a result may be more liable to develop gastro-oesophageal reflux.
A clinicopathological review of 68 carcinomas of the gallbladder
Authors: Donaldson L A , Busuttil A 
Published: March 2007

Abstract
A clinical and pathological review of 68 patients with a primary carcinoma of the gallbladder was undertaken. A prolonged preceding history of biliary disease was noted. Preoperative radiological and biochemical investigations were not helpful, but an isolated elevation in serum alkaline phosphatase level in the absence of any biliary obstruction or hepatic dysfunction was noticed in some patients. The significance of stones in relation to pathogenesis is discussed. A more radical surgical approach involving a partial hepatectomy appears to be the only possible treatment in view of the mode of spread of this tumour and the bad overall prognosis.
The continent ileostomy of Kock (ileal intra-abdominal reservoir)
Authors: Halvorsen Jan F , Heimann Peter 
Published: March 2007

Abstract
A series of 9 patients with ulcerative colitis undergoing proctocolectomy and ileal intra-abdominal reservoir is reported. Eight patients are continent and 1 is incontinent. Early and late postoperative complications, work capacity and social and sexual functions are described.
Trans-sphenoidal hypophysectomy in disseminated carcinoma of the breast
Authors: Robin P E , Powell D Jean , Waterhouse J A H , Dalton G A 
Published: March 2007

Abstract
One hundred and eight patients with advanced carcinoma of the breast were treated by trans-sphenoidal hypophysectomy and followed up for at least 1 year. The results were assessed both by clinical response and objectively by survival following hypophysectomy, as expressed by the survival ratio. The two methods showed close correlation.
The results show that there is a variation in response relating to menopausal status and age at diagnosis, subsequent hormonal manipulation and physical condition at hypophysectomy. Younger patients whose carcinoma is diagnosed after menopause carry a good prognosis, yet the older premenopausal patients, especially if their clinical condition is poor, do not benefit. Easily available clinical information can be a guide to prognosis.
Plasma catecholamines in severely injured patients: A prospective study on 45 patients with multiple injuries
Authors: Jäättelä A , Alho A , Avikainen V , Karaharju E , Kataja J , Lahdensuu M , Lepistö P , Rokkanen P , Tervo T 
Published: March 2007

Abstract
Plasma catecholamine levels were studied in 45 severely injured patients for 8 days after the trauma. Sixteen of the patients were classified as critically injured and 29 as seriously injured.
The total plasma catecholamine values of the whole group immediately after the injury were almost twice as high as the eighth day reference values and remained significantly higher than these values for 6 hours after the trauma. On admission both the plasma adrenaline and noradrenaline levels were elevated. The plasma adrenaline levels on admission correlated with the blood volume replacement which was required within the first 6 hours.
The plasma noradrenaline levels in the critically injured group were significantly higher throughout the observation period than in the seriously injured group. A corresponding difference was observed in the plasma adrenaline concentrations only during the first 12 hours.
The results showed that strong stimulation of the sympathetic nervous system occurs in severely injured patients. Factors stimulating the sympathetic nervous system apparently included hypovolaemia, tissue hypoxia, acidosis and the pain produced by the truama and therapeutic measures.
Postoperative problems and management after hepatic resection for blunt injury to the liver
Authors: Vajrabukka T , Bloom A L , Sussman M , Wood C B , Blumgart L H 
Published: March 2007

Abstract
The postoperative problems and management of 8 patients following right hepatic lobectomy for blunt liver injury are discussed. Multiple injury and in particular chest injury are of importance. Respiratory distress may be insidious in onset and must be anticipated. Most patients require at least temporary positive pressure ventilation.
Liver regeneration is rapid and histological evidence of regenerative hyperplasia is present within 3 days of injury.
Hypoglycaemia of a degree sufficient to threaten life may occur postoperatively, particularly in the first 48 hours. Jaundice may be a worrying postoperative feature, but the use of T-tube drainage after hepatic lobectomy will enable any possible extrahepatic obstruction to be excluded. Hypoproteinaemia and hypo-albuminaemia occur in the immediate postoperative period, and recovery rapidly follows the peak period of regenerative activity of the liver. Normal levels are regained by the fourth to sixth postoperative weeks.
Prophylactic antibiotics have no place in the postoperative management of blunt liver injury.
Haemorrhagic diathesis is common after hepatic resection and is of a complex nature. Intravascular coagulation may occur and factor V deficiency is common. The mainstay of treatment is transfusion of fresh blood.
Report of a family with inherited medullary carcinoma of the thyroid and phaeochromocytoma
Authors: Beaugie J M , Belchetz P E , Brown C L , Frankel R J , Lloyd Margaret H 
Published: March 2007

Abstract
A family in which several members have medullary carcinoma and phaeochromocytoma is described. Four of the 5 patients in this family who had a phaeochromocytoma have died; in one of these the medullary carcinoma may have contributed to death but in general the thyroid cancers were slow growing. In our experience successful diagnosis and treatment of the phaeochromocytomas have presented the greatest challenge. The welfare of future generations with this syndrome would seem to depend upon regular clinical and biochemical surveillance of the individuals and expeditious diagnosis and treatment of their tumours, particularly the phaeochromocytomas.
Tuberculous peripheral lymphadenitis in the Igbos of Nigeria
Authors: Onuigbo Wilson I B 
Published: March 2007

Abstract
Peripheral lymphadenitis is a leading manifestation of tuberculosis. Among the Igbos, who constitute one of the largest ethnic groups in Nigeria, it presents most commonly in the neck, as in other parts of the world. An inguinal presentation, however, is also common. The nodes are often of considerable size. The maximal incidence occurs in the 10-29-year age group, males outnumbering females slightly. It is only in the 40-59-year range that tuberculosis is less common than lymphoma or carcinoma of the peripheral lymph nodes.
Small doses of subcutaneous sodium heparin in the prevention of deep vein thrombosis after elective hip operations
Authors: Thrombosis Clinical Study Group Venous 
Published: March 2007

Abstract
The efficacy of small perioperative doses of subcutaneous heparin in preventing deep vein thrombosis has been studied in a controlled clinical trial on 64 patients undergoing elective hip surgery. The results indicate that the regimen of sodium heparin used was safe provided that the correct dose is given. It reduced the frequency of postoperative deep vein thrombosis from 37 to 7 per cent.
Injury of the facial nerve during surgery of the parotid gland
Authors: Ward C M 
Published: March 2007

AbstractThe notes of 158 patients who had undergone surgery of the parotid gland for benign and malignant disease were studied to discover the circumstances in which the facial nerve might be injured.Limited surgery carried as great a risk of injury to the facial nerve as during extended surgery. Extended surgery provided greater risk of injury to the facial nerve on secondary exploration (71 per cent) than on primary exploration (6.5 per cent).It is concluded that every primary exploratory procedure of the parotid gland should be a formal conservative parotidectomy unless the tumour is obviously malignant.
Effect of surgical trauma on plasma concentrations of cyclic AMP and cortisol
Authors: Gill G V , Prudhoe K , Cook D B , Latner A L 
Published: March 2007

Abstract
The response of plasma cortisol and cyclic AMP concentrations to surgical trauma was examined in 7 general surgical patients. Five patients made uncomplicated recoveries and showed peak cortisol levels at 6 hours postoperatively, returning to normal by 24 hours. One patient developed postoperative pneumonia and the plasma cortisol remained elevated up to 48 hours, and the final patient showed no cortisol response at all. The plasma cyclic AMP concentrations showed a consistent rise during the operation itself, which was statistically significant when compared with preoperative levels (P &lt; 0.0125). Concentrations had fallen to normal by 6 hours in all the cases, except in the patient who developed pneumonia, where the plasma cyclic AMP also showed a prolonged elevation. The significance of these findings requires further elucidation, but the temporal relationship of the cyclic AMP and cortisol peaks would support the hypothesis that cyclic AMP may play a part in the mediation of ACTH release following surgical trauma.
Incidental appendicectomy with laparotomy for trauma
Authors: Norton Lawrence W , Sweeney Marna , Eiseman Ben 
Published: March 2007

Abstract
Incidental appendicectomy was performed in 83 of 206 patients undergoing laparotomy for abdominal trauma. No organs were injured in 42 per cent of the appendicectomy patients and in 17 per cent of the non-appendicectomy patients, thus making comparison between the groups unreliable. While the incidence of intestinal perforation was 21 per cent in the appendicectomy patients, the rate of wound infection was only 7 per cent. One complication (pelvic abscess) was possibly attributable to incidental appendicectomy.
Since males below the age of 50 face a significant risk of future appendicitis and represent the majority of patients with abdominal trauma, it may be advisable to perform incidental appendicectomy with laparotomy for trauma in such patients. Specific indications for incidental appendicectomy during laparotomy for trauma are suggested.
Undetected aorto-iliac insufficiency: A reason for early failure of saphenous vein bypass grafts for obstruction of the superficial femoral artery
Authors: Charlesworth D , Harris P L , Cave F D , Taylor Linda 
Published: March 2007

Abstract
A series of 29 femoropopliteal bypass operations is described. The patients were selected carefully to exclude those with clinical and aortographic evidence of aorto-iliac disease. A pulsatility index was calculated from the velocity waveforms recorded over the common femoral and popliteal arteries. The pulsatility index is the ratio of the amplitude of the waveform to its mean height over one cardiac cycle. There was a highly significant difference in the result of the operation between patients with a pulsatility index of 4 or more in the common femoral artery and patients with a pulsatility index of less than 4. We concluded that calculation of this pulsatility index provides useful additional evidence when selecting patients suitable for a femoropopliteal bypass.
Abdominoscrotal hydrocele
Authors: Parekh B R , Reinboth G , Mishra O P 
Published: March 2007

Abstract
The number of cases of abdominoscrotal hydrocele reported in the literature has been brought up to date, which, including the 3 cases reported here, is 83 of which 21 are from India.
The pathogenesis of this lesion is discussed. It is concluded that all cases of abdominoscrotal hydrocele are due to progressive involvement and distension of the patent processus vaginalis which is cut off from the general peritoneal cavity.
A new classification of abdominoscrotal hydrocele is suggested on the basis of experience gained from the 3 cases reported here.
Carcinoma arising in thyroglossal duct remnant: Case reports and review of the literature
Authors: Saharia Prakash C 
Published: March 2007

Abstract
Two cases of thyroglossal duct cyst carcinoma are presented and the world literature is reviewed. There are only 74 cases reported to date. In nearly all the cases the clinical diagnosis was thyroglossal cyst. Although the great majority of the tumours were papillary adenocarcinomas, 13·15 per cent were of other histological types. The treatment has been quite variable, but the most common initial treatment was Sistrunk's (1928) operation. Following the establishment of the diagnosis of malignancy, thyroidectomy was done in several cases, but it failed to show any evidence of malignancy in most of the thyroids removed, which establishes firmly the de novo origin of these tumours from the thyroglossal duct remnant. In only one case had tumour disseminated to distant organs, the lung, liver, etc. The scepticism as to whether some of the carcinomas associated with thyroglossal duct remnants may not in fact represent metastases from a small primary tumour of thyroid gland is examined. It appears that, though a possibility of primary or metastatic tumour in the thyroid does exist, the probability does not appear to be high. From our own experience it is suggested that local excision followed by radiotherapy, irrespective of recurrence, may be worth considering for the treatment of such carcinomas.
False abdominal aortic and iliac aneurysms
Authors: Chavatzas Demetrios , Jamieson Crawford 
Published: March 2007

Abstract
A case of late postoperative false abdominal aortic and iliac aneurysms complicated by malposition of the inferior vena cava is presented and attention is drawn to its presentation, diagnosis and management. Several factors assumed to be responsible for the formation of the false aneurysms 7 years after the previous grafting operation are discussed.
Serum α-1-acid glycoprotein as an index of dissemination in breast cancer
Authors: Roberts J G , Keyser J W , Baum M 
Published: March 2007

Abstract
Assay of the serum α-1-acid glycoprotein (SAGP) produced by the liver in response to many disease states is shown to reflect prognosis and monitor progress in patients with early, recurrent and disseminated breast cancer. Eighteen of 26 patients with localized breast cancer and positive bone scans had elevated SAGP when first seen, but within 5 months of treatment 5 further patients with positive bone scans developed an elevated SAGP. Furthermore, an initally abnormal SAGP. evel became normal within 5 months in 5 of 6 patients with negative bone scans. While elevated SAGP in breast cancer correlates with positive bone scans, a series of normal values may indicate patients without early haematogenous dissemination of their disease.
The place of frozen section in the practical management of melanoma
Authors: Hughes L E 
Published: March 2007

Abstract
A selective policy is proposed for the use of frozen section in suspected melanoma which provides maximal help while minimizing false frozen section diagnosis. It is based on the fact that suspected melanomas fall into two broad groups which present different problems in diagnosis and management.
A raised lesion is likely to be a highly malignant melanoma or a lesion of non-naevoid cells. Differentiation is readily made on frozen section and allows immediate radical excision. A flat pigmented lesion is usually of obvious naevoid origin, and the problem is whether early malignant change has occurred. It is better managed by urgent paraffin section to avoid sampling error.
Frozen section has a place in the management of a single doubtful node in a patient being managed by a “watch” policy.
The surgical cure of primary varicose veins
Authors: Rivlin Stanley 
Published: March 2007

Abstract
A prime requisite of successful varicose vein surgery is a detailed clinical examination. This reveals a new test for short saphenous incompetence and shows that 14 per cent of varices stem from a saphenopopliteal reflux. The intimate details of juxtafemoral and juxtapopliteal ligation are emphasized and the common causes of failure pointed out. The technique of “scarless” varicose vein surgery is described. A 6–10-year follow-up of some 2000 patients reveals an overall recurrence rate of 7 per cent.
Surgical complications of implanting pacemakers
Authors: Siddons Harold , Nowak K 
Published: March 2007

Abstract
An analysis of the complications of implanting pacemakers at St George's Hospital between 1967 and 1973 highlights the difficulties of implanting foreign bodies. During this 7 years 1543 pacemakers were implanted in 779 adults. In 91 patients there were 118 implants with surgical complications, most of them due to a pressure necrosis or local infection; 3 septicaemias occurred. The various complications are classified and related to technique of implantation. Methods of management of the complications are presented.
As an Appendix the operative techniques of first and subsequent implantations are outlined.
The effect of posture on the emptying of the intrathoracic vagotomized stomach
Authors: Hinder R A 
Published: March 2007

Abstract
Ten patients were studied at periods ranging from 4 months to 25 years after oesophagogastrostomy and gastric drainage. Gastric emptying studies and overnight gastric aspirates in both the supine and erect positions were carried out, Evidence was found in these patients of increased duodenogastric refrux and poor gastric emptying in the supine posture. All of the patients had gastritis, and some had gastric mucosal ulceration. These findings have led to the conclusion that in the supine posture the combination of duodenogastric reflux and poor gastric emptying leads to gastric mucosal damage.
Changes in the blood fibrinolytic activity after surgery (the effect of deep vein thrombosis and malignant disease)
Authors: Browse N L , Gray L , Morland M 
Published: March 2007

Abstract
The changes in blood fibrinolytic activity before and after operation have been investigated in 56 patients. The results have been analysed to assess the effect of the presence of malignant disease and the development of deep vein thombosis.
The results show that patients with malignant disease and those with thrombosis have a fibrinolytic shut-down. This shut-down appears to be secondary to these two conditions and not the cause of the thrombosis. Patients without carcinoma and without thrombosis do not have a significant shut-down. The fibrinolytic shut-down results from a reduced release of activator from the peripheral store, not a reduction in the size of the store itself.
Resection of an unusually large goitre
Authors: Manoppo Adrie E 
Published: March 2007

Summary
This paper reports the resection of a benign non-toxic goitre measuring 75 × 60 × 45 cm in a patient aged 48 who was unable to walk or sit because of the size of the goitre. The tumour proved to arise from the right half of the thyroid. A right-sided hemistrumectomy was performed under local anaesthesia with the patient prone. A temporary tracheostomy was established. The postoperative course was uneventful apart from slight necrosis of the wound edge. The patient was discharged in good health on the twentieth postoperative day.
The mechanisms of traumatic rupture of the thoracic aorta
Authors: Sevitt Simon 
Published: March 2007

Summary
This paper reviews evidence and ideas on closed accidental rupture of the aorta, and refers to an analysis of 37 subjects in whom traumatic aortic ruptures were found at necropsy. The mechanisms of rupture of the ascending aorta and the proximal and distal parts of the descending aorta are discussed.
Aortic rupture is one of the major causes of rapid death after traffic accidents, especially in occupants of motor vehicles. However, about 20 per cent of subjects survive for hours, days or longer after the accident, allowing time for surgical repair in some cases.