bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of three methods to obtain percutaneous needle core biopsies of a renal allograft
Authors: Beckingham I J , Nicholson M L , Kirk G , Veitch P S , Bell P R F 
Published: March 2007

Abstract
During 280 renal transplant biopsy procedures, 440 biopsy cores were obtained using three techniques: blind vertical pass, ultrasonographic guidance and ultrasonographic guidance with immediate specimen examination by stereoscopic microscopy. The success rates per procedure in obtaining renal cortex by blind vertical pass, ultrasonographic guidance and ultrasonographic guidance with microscopy were 75, 91 and 100 per cent respectively. Ultrasonographic guidance improves the success rate of percutaneous renal allograft biopsy. The additional use of immediate examination by stereoscopic microscopy yields a 100 per cent success rate for individual biopsy procedures.
Prospective randomized trial of Ivalon sponge versus sutured rectopexy for full-thickness rectal prolapse
Authors: Novell J R , Osborne M J , Winslet M C , Lewis A A M 
Published: March 2007

Abstract
Ivalon sponge rectopexy is a safe reliable procedure in the management of rectal prolapse. Sutured rectopexy is simpler and avoids the use of foreign material. Sutured rectopexy is mandatory if synchronous resection is to be considered. Sixty-three patients (62 women) with fullthickness rectal prolapse were entered into a prospective randomized trial of Ivalon sponge rectopexy (31 patients) versus sutured rectopexy (32). Twenty patients (32 per cent) had coexistent incontinence (ten in each group). The operation was performed in the standard manner with a sutured rectangle of sponge or sutures alone placed along the length of the sacrum. Postoperative morbidity occurred in nine patients (14 per cent) of whom three underwent a sutured procedure and six Ivalon rectopexy: wound infection in three, chest infection in two, urinary tract infection in two and thromboembolism in two. There were no deaths within 30 days. At a median follow-up of 47 months prolapse had recurred in two patients (3 per cent), one in each group, 14 (22 per cent) suffered from incontinence (of whom five had undergone a sutured procedure), while 25 (40 per cent) had developed constipation (of whom 15 had received Ivalon rectopexy). The medium-term results of rectopexy by suture alone are equivalent to those obtained following the conventional Ivalon procedure. These data suggest that Ivalon rectopexy could now be abandoned.
Haemorrhoids: Pathology, pathophysiology and aetiology
Authors: Loder P B , Kamm M A , Nicholls R J , Phillips R K S 
Published: March 2007

Abstract
Haemorrhoidal disease is the consequence of distal displacement of the anal cushions, which are normal structures with an important role in continence. The causes of haemorrhoidal disease are unknown; constipation and abnormal bowel habit are commonly blamed despite largely contrary evidence. The most consistently demonstrated physiological abnormality is an increased maximum resting anal pressure. Most evidence points to this being a secondary phenomenon rather than the cause of haemorrhoidal disease. Among the many unexplored areas are the function of the longitudinal muscle in relation to haemorrhoidal disease, the description and pharmacological responsiveness of the anal subepithelial muscle, and the clinical role of specific pharmacological agents that might reverse some of the observed physiological changes.
Cerebral oxygen saturation, transcranial Doppler ultrasonography and stump pressure in carotid surgery
Authors: Williams I M , Vohra R , Farrell A , Picton A J , Mortimer A J , McCollum C N 
Published: March 2007

Abstract
Transcranial Doppler ultrasonography (TCD) of the middle cerebral artery (MCA), light-reflective cerebral oximetry and measurement of internal carotid artery stump pressure were compared as methods of monitoring cerebral perfusion during carotid surgery in 33 patients. Median cerebral oxygen saturation was 70 (range 62–85) per cent and TCD-measured mean blood velocity 42 (range 19–91) cm/s before carotid cross-clamping, falling to 68 (53–83) per cent and 16 (0–50) cm/s respectively on application of the clamps (P &lt; 0·001). Stump pressure correlated closely with MCA blood velocity 30 s after the start of cross-clamping (rs = 0·58, P &lt; 0·001), but not with cerebral oxygen saturation. A fall of 5 per cent or more in cerebral oxygen saturation following cross-clamp application was predicted by a decrease in mean MCA blood velocity of at least 60 per cent. Changes in cerebral oxygen saturation correlated significantly with systolic blood pressure throughout the perioperative period (rs = 0·41, P &lt; 0·001). Significant falls in cerebral oxygenation were not predicted by low stump pressure but were associated with large reductions in the mean MCA blood velocity measured by TCD.
Minimal antibiotic therapy after emergency abdominal surgery: A prospective study
Authors: Schein M , Assalia A , Bachus H 
Published: March 2007

Abstract
The optimal duration for courses of antibiotic therapy following emergency abdominal surgery was examined. The length of postoperative administration was based on the operative findings of contamination versus infection and the degree of the latter. A total of 163 patients (mean APACHE II score 7) were stratified into four groups: group 1 (60 patients), no postoperative antibiotics; group 2 (32), antibiotic therapy for 24 h; group 3 (48), administration for 48 h; and group 4 (23), antibiotic therapy for 72 h to 5 days. Three patients (2 per cent) died. Wound infection developed in 12 patients (7 per cent) and postoperative intra-abdominal infection in two (1 per cent). Antibiotics were stopped according to the protocol in 28 patients in spite of continued fever; one developed a subhepatic abscess and three had wound infections. Distinguishing contamination from infection and operative stratification of the latter allowed a successful ‘minimal’ postoperative antibiotic policy to be employed.
Role of acid secretory response to sham feeding in predicting recurrent ulceration after proximal gastric vagotomy
Authors: Stenquist B , Forssell H , Olbe L , Lundell L 
Published: March 2007

Abstract
The completeness of vagal denervation in determining the long–term outcome of patients with duodenal ulcer disease after proximal gastric vagotomy (PGV) was studied by examining the relationship between the postoperative acid secretory response to sham feeding (‘chew and spit’ technique) and the subsequent ulcer recurrence rate during a mean follow-up of 7·5 (range 5–15) years. The cumulative recurrence rate of 98 patients analysed prospectively was 11 per cent Of 22 patients who had incomplete vagotomy as suggested by the sham feeding response, five had a later relapse. This compares with only an 8 per cent relapse rate among those with a secretory response suggesting complete vagotomy. Four patients suffered from a relapse more than 5 years after operation but none had undergone incomplete vagotomy. However, in seven patients with an early postoperative relapse (within 5 years) five had had incomplete vagal denervation (P &lt; 0·05). In this latter group the median time elapsed from surgery until the first recurrence was only 1 year. It is concluded that the early postoperative acid secretory response to a sham feeding stimulus is clinically useful as it allows prediction of the risk of early relapse after PGV. This test may be helpful for the validation of new techniques of vagotomy.
Relationship between weight loss, reduction of body cell mass and inflammatory response in patients with cancer
Authors: McMillan D C , Preston T , Watson W S , Simpson J M , Fearon K C H , Shenkin A , Burns H J G , McArdle C S 
Published: March 2007

Abstract
Reduced food intake is a major cause of continuing weight loss in patients with cancer. Previous work has suggested that an ongoing inflammatory response may also contribute to weight loss and alter the nature of body tissue loss. To examine this, body cell mass was estimated using measurements of total body potassium (TBK) in 31 patients with gastrointestinal cancer and weight loss with or without an inflammatory response (C-reactive protein level above 5 mg/1). Albumin levels, total body water and 24-h urinary creatinine clearance were also measured. When measured TBK was expressed as a percentage of predicted normal values there was a significant reduction in TBK for patients with an inflammatory response compared with that of those without (P = 0·04). However, when a different prediction equation for TBK was used this difference was not significant (P = 0·29). Therefore, it remains uncertain whether an ongoing inflammatory response in patients with cancer and weight loss contributes to loss of body cell mass.
Localization and surgical management of insulinoma
Authors: Geoghegan J G , Jackson J E , Lewis M P N , Owen E R T C , Bloom S R , Lynn J A , Williamson R C N 
Published: March 2007

Abstract
Over a 14-year period 34 patients were referred for surgical treatment of insulinoma. The diagnosis was confirmed by demonstrating hypoglycaemia with inappropriate hyperinsulinaemia during prolonged fasting. Selective visceral angiography localized 30 solitary benign insulinomas and two carcinomas. In two patients with islet cell hyperplasia, angiography demonstrated a single lesion only. Ultrasonography had a sensitivity of 15 per cent and computed tomography a sensitivity of 24 per cent in the localization of tumours. All patients but one were treated by operation. Eighteen tumours were enucleated and 13 (including both patients with islet cell hyperplasia) were treated by distal pancreatectomy. Two patients underwent negative primary exploration; both had single adenomas removed at reexploration. There were no operative deaths but nine patients (predominantly those undergoing pancreatic resection) had complications. Thirty-one patients were symptom-free following operation at a mean follow-up of 16 months.
Diabetes impairs the development of early strength, but not the accumulation of collagen, during intestinal anastomotic healing in the rat
Authors: Verhofstad M H J , Hendriks Th 
Published: March 2007

Abstract
The evidence that diabetes mellitus adversely affects healing is derived from data on skin, where diminished wound strength is accompanied by a reduced collagen content. As no such data are available on intestinal anastomotic repair, and it has been reported that collagen metabolism in skin and intestine is affected differently by the diabetic state, anastomotic healing in the rat intestine during uncontrolled diabetes was examined. Wistar rats underwent resection and anastomosis of both ileum and colon 1 week after a single injection of streptozotocin (diabetic group) or citrate (control group). After 3 days the mean bursting pressure of ileal anastomoses was 4·1 kPa in controls and 1·0 kPa in diabetic animals (P &lt; 0·05). For colon, these values were 12·0 and 4·9 kPa respectively (P &lt; 0·05). This negative effect of diabetes persisted after 7 days in ileum but not in colon. Diabetic animals had more anastomotic abscesses, especially in the ileum: nine of 16 animals at 3 days after operation versus one of 15 in the control group (P &lt; 0·01). Anastomotic hydroxyproline concentration and content in diabetic animals were not reduced. The postoperative collagen synthetic capacity, as measured in tissue explants, was strongly stimulated in the wound area and appeared essentially unchanged in the diabetic animals. Uncontrolled streptozotocin-induced diabetes severely impairs the development of anastomotic strength in the rat intestine but, unlike impaired wound healing in skin, this phenomenon is not caused by deficient accumulation of collagen.
Fibrinolytic activity in the abdominal cavity of rats with faecal peritonitis
Authors: van Goor H , de Graaf J S , Grond J , Sluiter W J , van der Meer J , Bom V J J , Bleichrodt R P 
Published: March 2007

Abstract
Generalized peritonitis causes a reduction in abdominal fibrinolytic activity, resulting in persistence of intraabdominal fibrin with subsequent adhesion and abscess formation. The activities of tissue plasminogen activator (tPA) and plasminogen activator inhibitor (PAI) were measured in the peritoneal fluid of rats with faecal peritonitis and correlated with the extent of peritoneal damage to determine the cause of decreased fibrinolysis. Activity of tPA was low during the study period of 8 days, but higher in rats with peritonitis than in controls. The activity of PAI in rats with peritonitis was significantly increased compared with that of controls during the whole study period (P &lt; 0·001). Histological signs of damage to the peritoneum were similar in rats with peritonitis and controls. There was no correlation between the extent of peritoneal damage and tPA or PAI activity. The increased activity of PAI in the peritoneal fluid of rats with faecal peritonitis may be the main cause of reduced fibrinolysis in the abdominal cavity. Activities of tPA and PAI may originate not only from the mesothelium but from other sources.
Results of anal or low rectal anastomosis and pouch construction for megarectum and megacolon
Authors: Stewart J , Kumar D , Keighley M R B 
Published: March 2007

Abstract
Over a 16-year period 34 patients underwent surgery for idiopathic megarectum or megacolon; 18 had megarectum with or without megasigmoid, one megacolon only and 15 megarectum and total megacolon (nine with a previous colectomy). Ten patients underwent low rectal or anal anastomosis without pouch formation (colodistal proctostomy, eight; coloanal anastomosis, two), eight had colonic pouch-anal anastomosis (J pouch) and 14 had an ileal J pouch after restorative proctocolectomy; one underwent subtotal colectomy with ileorectal anastomosis and one loop ileostomy alone. There was one death, from intestinal obstruction 24 months after operation. Twenty-seven of 32 evaluable patients without a stoma became fully continent following resection and sphincter-saving procedures. Three of 18 had a poor result after resection for megarectum because of recurrent constipation. One of 14 patients became incontinent after restorative proctocolectomy for megacolon and megarectum and in a further four persistent abdominal distension and pain was treated by pouch excision.
Oxygen free radical activity in experimental colonic carcinoma
Authors: Qureshi A , Gorey T F , Byrne P , Kay E , McKeever J , Hennessy T P J 
Published: March 2007

Abstract
Oxygen free radical activity has been implicated in carcinogenesis through DNA lysis. This study measured chemiluminescence and superoxide dismutase (SOD) inhibition as an index of oxygen free radical activity in azoxymethane-induced colonic carcinoma. After 3 weeks of acclimatization, ten Fisher 344 rats were injected with azoxymethane (7 mg kg−1 week−1) over 10 weeks. All animals were killed at 37 weeks and colonic mucosa (5–25 mg wet weight) was sampled from sites of histologically confirmed gross tumour and sites 3–5 cm distant from tumour as well as from ten paired normal controls. The samples were processed in buffered luminol and chemiluminescence was measured in a luminometer. Each sample was then placed in a solution of SOD for 3 min before a second chemiluminescence estimation. Mean(s.e.m.) chemiluminescence from control mucosal samples decreased from 8·1(1·0) to 3·9(1·1) mV per 100 mg tissue (P &lt; 0·05) after incubation in SOD, suggesting that oxygen free radical activity was being measured. There was an increase to 20·2(0·9) mV per 100 mg in azoxymethane-treated colon remote from tumour and to 53·9(2·1) mV per 100 mg at tumour sites; both were reduced significantly after incubation with SOD to 6·7(0·7) and 11·0(0·8) mV per 100 mg respectively (P &lt; 0·001). Chemiluminescence was significantly increased in azoxymethane-induced colonic carcinoma, both remote from and maximally at the tumour site, suggesting a field change in carcinogenesis associated with oxygen free radical activity.
Reducing the risk of viral transmission at operation by electronic monitoring of the surgeon—patient barrier
Authors: MacIntyre I M C , Currie J S , Smith D N , Anderson I D , Cadossi R 
Published: March 2007

Abstract
A new electronic device designed to detect glove holes, wet gowns and glove permeability was assessed during 50 general surgical operations. The cause of each alarm was recorded and the surgeon's awareness of any breach noted. Some 266 alarms were recorded of which 45 were ascribed to glove holes, 86 to wet gowns, 115 to glove porosity and 20 to other causes. Glove holes occurred in 29 of the 50 procedures; the surgeon was unaware of the hole in almost 70 per cent of cases. Holes were more common in laparotomy than in laparoscopic procedures (P = 0·006). In 20 per cent of instances surgeons did not respond immediately to the alarm (median delay 16 min). Six of eight surgeons who used the device indicated that they would do so regularly for major abdominal surgery. The electronic system accurately detects breaches in the surgeon–patient barrier. Its use should improve surgical discipline in acting to restore the barrier, protecting patient and surgeon alike.
Dental infection in vascular surgical patients
Authors: Stansby G , Byrne M T L , Hamilton G 
Published: March 2007

Abstract
Seventy patients, 18 women and 52 men of mean age 68 (range 52–81) years, with vascular disease were studied using the Community Periodontal Index of Treatment Needs (CPITN). Twenty-six were edentulous and 44 dentate; 32 dentate patients were wearing partial dentures. All had occlusive peripheral arterial disease (ankle:brachial pressure index less than 0.9) or aortic aneurysm. No significant periodontal pathology was found in edentulous patients. Of the dentate patients, 28 were in the significant pathology range (CPITN 4) and 12 were in the moderate pathology group (CPITN 3); only four had no significant pathology (CPITN 0–2). As a proportion of prosthetic vascular graft infections may be due to dental sepsis, surgeons should consider referral for dental assessment before elective bypass grafting and patients should be warned about the importance of dental care after operation.
Comparison between preoperative cytology and intraoperative frozensection biopsy in the diagnosis of thyroid nodules
Authors: Rodríguez J M , Parrilla P , Sola J , Bas A , Aguilar J , Moreno A , Soria T 
Published: March 2007

Abstract
The value of intraoperative frozen-section biopsy of thyroid nodules (solitary or dominant in a multinodular goitre) was examined in patients who underwent fine-needle aspiration cytology (FNAC) for diagnosis before operation. A total of 170 consecutive patients were evaluated and classified according to whether the cytological diagnosis was benign, suspicious or malignant. In the benign group, diagnostic accuracy was 98 per cent for FNAC and 97 per cent for intraoperative biopsy. In those with suspicious cytology, diagnostic accuracy was 12 per cent for FNAC and 96 per cent for intraoperative biopsy. In those with malignant cytology there was 100 per cent accuracy for FNAC and 76 per cent for biopsy. Intraoperative biopsy by frozen section is useful in patients undergoing surgery for a thyroid nodule with a ‘suspicious’ cytology. It adds no information in patients with a diagnosis of malignancy following cytological assessment and is of limited use in those in whom a benign lesion is diagnosed.
Immunocytochemical staining of pS2 protein in fine-needle aspirate from breast cancer is an accurate guide to response to tamoxifen in patients aged over 70 years
Authors: Wilson Y G , Rhodes M , Ibrahim N B N , Padfield C J H , Cawthorn S J 
Published: March 2007

Abstract
Fine-needle aspirates from 52 breast cancers in 50 patients over 70 years of age were immunocytochemically stained for pS2 protein. All patients were treated with tamoxifen 40 mg/day and followed up at intervals of 2 months. The size of the tumour was serially assessed with calipers and portable ultrasonography. Change in tumour size was confirmed mammographically. Clinical monitoring was performed blind of the pS2 status. Twenty-five tumours were pS2 positive, of which 23 showed a significant response; ten went into complete remission (mean time to complete remission 6·8 (range 2–14) months) and 13 demonstrated partial remission (mean follow-up 8·9 (range 6–19) months). Two tumours remained static. Twenty-seven tumours were pS2 negative and none of these responded to tamoxifen; six remained static (mean follow-up 11·5 (range 6–14) months) and 21 progressed (mean time to progression 7·0 (range 3·14) months) (P &lt; 0·001). Immunocytochemical assessment of fine-needle aspirates from elderly women with breast cancer accurately predicts a worthwhile response to tamoxifen.
Liver regeneration is enhanced by omeprazole in rats following partial hepatectomy
Authors: Ohtake M , Aono T , Sakaguchi T , Tsukada K , Hatakeyama K 
Published: March 2007

Abstract
The effect of omeprazole on liver regeneration was studied in rats following partial (65 per cent) hepatectomy. Omeprazole 0.2 mg/kg increased the relative liver weight (weight of liver as a proportion of body-weight) and mitotic index (P &lt; 0.05). There was no difference in food and water intake. The serum gastrin concentration was significantly higher in animals receiving omeprazole 0.2 mg/kg than in controls (P &lt; 0.05). Omeprazole administration induced an increase in the level of serum alkaline phosphatase (P &lt; 0.05) but had no effect on serum albumin, glutamic-pyruvic transaminase and total bilirubin levels. Omeprazole stimulates liver regeneration after partial hepatectomy and this regeneration may be mediated by gastrin.
Liver resection with total vascular exclusion for malignant tumours
Authors: Habib N , Zografos G , Dalla Serra G , Greco L , Bean A 
Published: March 2007

Abstract
The records of 47 patients with no cirrhosis who underwent 56 liver resections under total vascular exclusion (TVE) for malignant tumours, both primary and secondary, were reviewed to study the effects of TVE. The mean(s.e.m.) blood loss was 1651(233) (median 1200 (range 200–8500)) ml and the mean(s.e.m.) intraoperative blood transfusion 930(100) (median 700 (range 0–2800)) ml. In 18 liver resections (32 per cent) no blood transfusion was administered. The mean(s.e.m.) postoperative hospital stay was 19·7(14·2) days. The 30-day operative mortality rate was nil but the hospital mortality rate was 4 per cent. Postoperative prothrombin time was influenced by the amount of liver resected and the duration of TVE but not by the amount of blood transfused. Postoperative serum levels of aspartate aminotransferase and bilirubin were not influenced by either the amount of liver resected or the duration of TVE.
Effect of extent of anterior resection and sex on disease-free survival and local recurrence in patients with rectal cancer
Authors: Buhre L M D , Mulder N H , de Ruiter A J , van Loon A J , Verschueren R C J 
Published: March 2007

Abstract
Results are presented following 119 curative resections for rectal cancer performed on 47 women and 72 men. Throughout the study it was policy to remove part of the female genital tract when the rectal tumour impinged on the uterus and/or the posterior vaginal wall. After a median follow-up of 7·5 years, local recurrence occurred in three of 46 women and 15 of 71 men (P = 0·03). The survival rates at 5 years were 71 per cent for women (95 per cent confidence interval 56–83 per cent) and 60 per cent for men (95 per cent confidence interval 50–71 per cent) (P &lt; 0·05). The risk for distant metastasis was comparable, suggesting an influence of local recurrence on survival. Reduction of the local recurrence rate coincides with the higher proportion of anterior extensions of surgery in women (19 of 47) than in men (two of 72).