bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subcutaneous heparin, plasma heparin levels and postoperative wound haematoma
Authors: Nicolaides A N , Harbourne Tikva , Russell R C G 
Published: March 2007

Abstract
Ninety-five patients, over the age of 40, having general surgical operations, were randomly allocated to a control and test group. The test group received 5000 units of subcutaneous heparin two hours before operation and then 12-hourly for seven days. The patients in the control group received the same regimen of isotonic saline. There was a marked variation in the plasma heparin levels from patient to patient, and from day to day in the same patient. There was a significant increase in the incidence of wound haematoma in patients with a plasma heparin level greater than 0·2 units/ml. The results suggest that the increased incidence of wound haematoma previously reported is due to the increase of incidence in patients who have plasma heparin levels greater than 0·2 units/ml.
Early results of surgery in patients considered cimetidine failures
Authors: Pickard W R , Mackay C 
Published: March 2007

Abstract
Fifty-two consecutive unselected duodenal ulcer patients (Group 1), who had failed to respond to cimetidine and who subsequently underwent elective vagotomy and drainage, were studied. All patients were symptomatic on cimetidine in full recommended dosage. This group has been compared with another group of 634 duodenal ulcer patients (Group 2) undergoing elective vagotomy and drainage in the ‘pre-cimetidine era’. The groups were similar pre-operatively with regard to age, sex, length of history and maximal acid output. Completeness of vagotomy and amount of acid reduction were similar in the two groups. The incidence of recurrent ulceration was 5 per cent in Group 1 and 5·7 per cent in Group 2. Although, of necessity, follow-up is shorter in the cimetidine failures (mean 2·3 years), there is nothing to suggest that failure to respond to cimetidine precludes a satisfactory surgical result.
The management of common bile duct calculi by endoscopic sphincterotomy in patients with gallbladders in situ
Authors: Neoptolemos J P , Carr-Locke D L , Fraser I , Fossard D P 
Published: March 2007

Abstract
Endoscopic sphincterotomy (ES) is widely used in the treatment of patients with common bile duct (CBD) stones following cholecystectomy. The technique has now been extended to patients with gallbladders still present and the results of ES in 100 such patients is reported. Fifty-nine were considered unsuitable for surgery (Group A), in 38 ES was performed as a preliminary to cholecystectomy (Group B) and in 3 ES was performed following emergency cholecystostomy (Group C). ES was achieved in 98 patients and stones completely extracted in 91 patients. In Group A 5 patients required surgery, in 3 because of technical failure and in 2 because of empyema of the gallbladder. One patient who presented in extremis died following failure to extract a large CBD stone. On follow-up (4-50 months), 16 patients have died but in only one from gallbladder sepsis, and one has had a cholecystectomy for pain. In Group B choledochotomy was avoided in 29 of the 37 patients who agreed to cholecystectomy. In Group C no further surgery was required and all patients in Groups B and C remain well. These results indicate that ES is an effective technique for treating patients with CBD stones with the gallbladder in situ, either alone in patients considered unsuitable for surgery or as an adjunct to surgery.
Intrahepatic biliary papillomatosis
Authors: Gouma D J , Mutum S Singh , Benjamin I S , Blumgart L H 
Published: March 2007

Abstract
Intrahepatic bile duct papillomatosis associated with changes of nuclear atypia is described in a young man. Radical excision was performed by left hepatic lobectomy and removal of the common bile duct and left hepatic ducts. Fourteen previous cases of intrahepatic or diffuse intrahepatic and extrahepatic biliary papillomatosis are reviewed. While local recurrence and progression to death from obstructive jaundice and cholangitis is the rule, only two definite cases of malignant change have been reported. Radical surgery may be curative for this rare condition.
Cardiac penetrating injuries: Personal experience of 45 cases
Authors: Demetriades D 
Published: March 2007

Abstract
This study represents the personal experience of the author, in 45 cases of penetrating cardiac wounds. Eleven patients with no signs of life had surgical intervention on the stretcher in the emergency room (ER). One patient survived (mortality 91 per cent). Thirty-four patients were operated on in the operating theatre (OT) with a mortality rate of 12 per cent. The clinical triad of a low blood pressure, high central venous pressure (CVP) and distant cardiac sounds, proved diagnostic in 82 per cent of the patients with cardiac tamponade. Pulsus paradoxus was found in only 7 per cent of tamponade cases. Pericardiocentesis seems to have little value in diagnosing or treating tamponade. The most commonly injured cardiac chamber was the right ventricle (RV) (36 per cent). Coronary artery damage occurred in 4 cases with a mortality of 75 per cent. Aspiration of the ventricles for air embolism was performed in all 16 cases who arrested during operation. A significant volume of air was aspirated in 4 (25 per cent). Early intervention saved three of them.
Correlations between clonogenicity and prognostic factors in human breast cancer
Authors: Smallwood J A , Morgan G R , Cooper A , Kirkham N , Williams C J , Whitehouse J M A , Taylor I 
Published: March 2007

Abstract
The pursuit of more effective systemic treatments in breast cancer has been limited by a failure to maintain or grow tumour cells in vitro. This study reports our experience in obtaining clonogenic growth in 54 primary breast cancers obtained at mastectomy. Of 47 assays free of infection, clonogenic growth was achieved in 22 (41 per cent). Only 5 of 23 oestrogen receptor positive tumours grew compared to 14 of 21 oestrogen receptor negative tumours (χ2 = 9.03; P &lt; 0.01). None of the 5 cytosolic receptor positive tumours contained a nuclear receptor for oestrogen. Growth was not related to tumour stage, menopausal status, age or histological grade. Receptor negative tumours had higher thymidine labelling indices, but these were no different to the tumours grown in the assay.
Carcinoma of the oesophagus
Authors: Ihekwaba F N , Solanke T F 
Published: March 2007

Abstract
A 10-year review of oesophageal cancer in Ibadan, Nigeria, is presented. Seventy-two patients representing a mean annual incidence of 0.31 per 100 000 of the population were found. The age range was 27–96 years, with a mean of 57 years for men and 65 for women. Dysphagia, weight loss and anaemia were the significant features in the majority and 40 per cent of the patients presented between 4 and 12 months (mean 7.5 months). None of the commonly used dietary ingredients could be implicated in the causation of this tumour in which squamous cell cancer accounted for 88.5 per cent of all types. The middle third was the commonest site of tumour formation (45 per cent) while the lower third accounted for 40 per cent. A low operability rate of 32 per cent is recorded and only 21 per cent were suitable for oesophagectomy. Survival among this group was 50 per cent at 1 year, 20 per cent at 3 years and 10 per cent at 4 years.
Adaptation to jejunoileal bypass promotes experimental colorectal carcinogenesis
Authors: Bristol J B , Wells M , Williamson R C N 
Published: March 2007

Abstract
The co-carcinogenic potential of 85 per cent jejunoileal bypass (JIB) was tested in male Sprague-Dawley rats (n = 81) given 6 preliminary injections of the selective intestinal carcinogen azoxymethane (total dose 90 mg/kg). Controls had sham JIB. Colorectal adaptation was studied 30 weeks postoperatively in rats given injections of vehicle alone. JIB caused 17–33 per cent increments in colonic length, weight and crypt depth; crypt cell production rate was more than doubled (P &lt; 0.01). Despite lowering body weight by 27 per cent, JIB increased the median number of colorectal tumours per rat from 3 to 8 (P &lt; 0.01). The findings suggest that evidence of hyperplasia and dysplasia should be sought in patients receiving subtotal jejunoileal bypass for obesity.
Neglected role of torsion and constriction in pathogenesis of simple adhesive bowel obstruction
Authors: Maetani S , Tobe T , Kashiwara S 
Published: March 2007

Abstract
We critically analysed the mechanism of simple adhesive bowel obstruction in 88 re-laparotomies for this condition, paying special attention to obstructing factors beside angulation. Twenty-six obstructions were caused by bowel-to-bowel adhesion, and 42 by adhesion of bowel to other structures, whereas in the remaining 20 these two types were combined. Although angulation was almost always found at the site of obstruction, torsion (twisting of bowel about its axis) was detected in 25 of the 33 in situ observations, usually accompanied by various degrees of organic constriction. In bowel-to-bowel adhesion, the torsion and constriction were produced by a unique relation of the bowel to the adhesion; the latter connected one side of the mesenteric margin to the opposite side, encircling the bowel wall obliquely. This was never seen on non-obstructing adhesions.
We conclude that torsion and constriction are important causes of simple bowel obstruction as well as strangulated obstruction.
Control of major haemorrhage associated with pancreatic pseudocysts by transcatheter arterial embolization
Authors: Huizinga W K J , Kalideen J M , Bryer J V , Bell P S H , Baker L W 
Published: March 2007

Abstract
Massive haemorrhage from a pancreatic pseudocyst is an uncommon cause of upper gastrointestinal bleeding. The condition carries a high mortality and presents a major clinical problem both in terms of timely diagnosis and appropriate surgical therapy. Four patients are presented with pseudocyst-related bleeding arising from the gastroduodenal artery. In all instances the bleeding was successfully controlled by transcatheter embolization with gelfoam. No untoward sequelae were noted and the occlusion remained effective as shown by follow-up angiography 2 months later. The importance of early diagnostic angiography is stressed and it is concluded that interventional angiography may obviate the need for high risk emergency surgery.
Muramyl dipeptide increases tolerance to shock and bacterial challenge in mice
Authors: Ausobsky J R , Cheadle W G , Brosky B G , Polk H C 
Published: March 2007

Abstract
We measured the phagocytic capacity of the reticulo-endothelial system by assay of the clearance of colloidal carbon from the blood stream in both normal mice and mice in which shock had been induced by intraperitoneal injection of hypertonic glucose. The group of shocked mice was further subdivided into those pretreated with the immunoadjuvant, muramyl dipeptide (MDP), and those given placebo. Shock reduced reticulo-endothelial phagocytosis (P &lt; 0.01), whereas pretreatment of shocked mice with MDP led to a hyperphagocytic state (P &lt; 0.01). In a second series of experiments we subjected shocked mice, pretreated with MDP or placebo, to a virulent Klebsiella pneumoniae infection. MDP significantly improved survival (P &lt; 0.01).
Permanent-access hepaticojejunostomy
Authors: Barker E M , Winkler M 
Published: March 2007

Abstract
A new technique of hepaticojejunostomy is described. The technique involves the incorporation of a cutaneous access stoma in the Roux-en-Y loop of jejunum used for the anastomosis. This stoma provides permanent access to the biliary-intestinal anastomosis and to the hepatobiliary tree for non-operative management of chronic and recurrent biliary tract problems.
The septic complications of sigmoid diverticular disease
Authors: Underwood J Weston , Marks C G 
Published: March 2007

AbstractIn 2 years 41 patients were treated surgically for septic complications of diverticular disease of the sigmoid colon. Nine patients had fistulae arising from sigmoid diverticular disease. Resection of the sigmoid was undertaken as the primary procedure in 8 patients with anastomosis in 5. Thirty-two patients had pericolic abscesses or peritonitis. The outcome (morbidity, length of stay) of the 21 patients who underwent primary resection was compared with that of the 11 patients treated by defunctioning colostomy alone. The better results in the larger group of 21 patients indicate that primary resection should be the treatment of choice for the septic complications of diverticular disease.
The treatment of primary hyperparathyroidism during pregnancy
Authors: Nudelmann J , Deutsch A , Sternberg A , Reiss R 
Published: March 2007

Abstract
Data on the management of primary hyperparathyroidism during pregnancy are sparse and relatively few parathyroidectomies have been performed during pregnancy. Provided the diagnosis can be established with reasonable certainty, removal of a parathyroid adenoma should be undertaken during the second or at the beginning of the third trimester. Parathyroidectomy in the hands of a surgeon familiar with this operation carries few risks. The complication rate of untreated cases may reach 80 per cent and include spontaneous abortion, fetal death and neonatal tetany. We present two cases of pregnant women who underwent successful parathyroidectomy during the course of gestation.
Surgical experience of deeply jaundiced patients with bile duct obstruction
Authors: Armstrong C P , Dixon J M , Taylor T V , Davies G C 
Published: March 2007

AbstractOne hundred and twenty consecutive deeply jaundiced patients undergoing surgery for bile duct obstruction were analysed. Diagnosis by either ultrasound or percutaneous transhepatic cholangiography was correct in 84 per cent and 86 per cent of patients respectively. Combination of the two procedures resulted in a diagnostic accuracy of 96.5 per cent. Despite pre-operative antibiotics and intravenous fluids, including Mannitol, infective complications and renal failure were common. Gastrointestinal haemorrhage was a major cause of postoperative morbidity and mortality. The operative mortality in this series was 14.2 per cent and was related to the depth of jaundice in patients with benign disease. The same relationship did not appear to occur in those with malignant disease. The median survival after palliative bypass surgery in patients with malignant obstruction was 6.5 months.
A study of endoscopic sphincterotomy in recurrent pyogenic cholangitis
Authors: Lam S K 
Published: March 2007

Abstract
Recurrent pyogenic cholangitis is a condition prevalent in Asia. Surgery has been the only form of treatment when extrahepatic and/or intrahepatic biliary dilatation, irregularity, debris and calculi are present. Endoscopic sphincterotomy was attempted in 134 such patients, the majority of whom had calculi confined to the common bile duct, and in whom 85.8 per cent were over 60 years old, 61.2 per cent had previous biliary surgery, and 36.6 per cent had an associated major medical illness. Sphincterotomy was successful in 88 per cent of patients, good results were obtained in 81.3 per cent, and stone removal was achieved in 91.7 per cent of those with demonstrable biliary calculi. Major complications occurred in 7.5 per cent, resulting in emergency surgery in 3 per cent and death in 1.5 per cent. The mortality of surgical sphincteroplasty in 143 patients with this condition who were over 60 years old was known to be 7 per cent. Five of 109 patients without residual calculi after endoscopic sphincterotomy developed mild to moderate symptoms after a follow-up period of 6 months to 6 years (median 2.3 years). Endoscopic sphincterotomy is a safe and effective form of treatment in patients with recurrent pyogenic cholangitis whose calculi are confined to the common bile duct.
Wound healing in obstructive jaundice
Authors: Armstrong C P , Dixon J M , Duffy S W , Elton R A , Davies G C 
Published: March 2007

Abstract
Wound healing has been investigated in 373 patients undergoing surgery for obstructive jaundice and 760 anicteric patients undergoing cholecystectomy. Reduced wound healing manifested by a higher frequency of wound dehiscence (3.2 per cent vs. 0.5 per cent) and incisional hernia (10.3 per cent vs. 1.8 per cent) was seen in the jaundiced patients. The factors related to this reduced wound healing have been analysed by univariate and multivariate analysis. The independent factors related to wound dehiscence in the 373 jaundiced patients were: an initial low haematocrit (&lt; 30 per cent), an initial low plasma albumin (&lt; 30 g/l), a history of pancreatitis, a malignant obstructing lesion, and postoperative wound and/or abdominal sepsis. Haematocrit, albumin and postoperative wound and/or abdominal sepsis were also independent factors for incisional hernia. A raised plasma bilirubin was not of independent significance for either wound dehiscence or incisional hernia. It is concluded that reduced wound healing occurs in jaundiced patients and that this is due to the associated features of poor nutritional status (manifested by low haematocrit and low albumin) and malignancy and not to the raised bilirubin per se.
Survival and recurrence after sphincter saving resection and abdominoperineal resection for carcinoma of the middle third of the rectum
Authors: Williams N S , Johnston D 
Published: March 2007

Abstract
Sphincter saving resections (SSR) are being performed with increasing frequency in patients with carcinoma of the lower two-thirds of the rectum. It is not clear, however, whether local and distant recurrence and long term survival after these operations will be comparable with those following abdominoperineal resection (APER). In this retrospective study, we have compared survival and recurrence in patients with carcinoma of the middle third of the rectum (7.5–12 cm from the anal verge) who were treated by APER (n = 83) or low SSR (n = 71). There was a higher proportion of men in the APER group, the mean age was higher and APER patients had tumours with less favourable pathological features. To minimize bias between the two groups, patients with tumours with similar pathological characteristics were compared. The overall cancer specific 5-year survival rate after SSR was 74 per cent and after APER was 62 per cent; the overall recurrence rates were 27 per cent after SSR and 41 per cent after APER; the incidence of local recurrence was 11 per cent after SSR and 8 per cent after APER. In these comparisons and when the patients' tumours were matched for one or two pathological variables, no significant difference was found between the two groups. These results suggest that patients with carcinoma of the middle third of the rectum who are treated by SSR will fare as well as patients who are treated by APER, with respect both to recurrence and to survival. A prospective controlled trial, however, is required to provide final proof of these points.
Hypomagnesaemia after small bowel resection: Treatment with 1 α-hydroxylated vitamin D metabolites
Authors: Selby P L , Peacock M , Bambach C P 
Published: March 2007

Abstract
Seven patients with severe neuromuscular symptoms due to hypomagnesaemia together with hypocalcaemia following extensive resection of the small bowel were treated orally with 1 α-hydroxylated metabolites of vitamin D and magnesium oxide. There was a rapid response in both plasma calcium and magnesium concentrations. The mean plasma magnesium rose from 0·24 to 0·45 mmol/l with the vitamin D metabolites alone and to 0·81 mmol/l when magnesium oxide was added. The plasma calcium rose from 1·78 to 2·21 mmol/l on vitamin D alone and then remained within the normal range. This was accompanied by a rapid resolution of the neuromuscular symptoms. Such oral treatment is both acceptable to the patient and effective both for acute symptoms and in the long term to maintain plasma magnesium concentrations.
The relationship of background mammographic pattern to hormone dependency in breast cancer
Authors: Hinton C P , Williams M R , Roebuck E J , Blamey R W , Glaves J , Nicholson R I , Griffiths K 
Published: March 2007

Abstract
We have studied the relationship between mammographic parenchymal pattern of the breast and oestrogen receptor (ER) status in the primary tumour in 337 patients with operable invasive breast cancer, and the response to endocrine therapy in patients subsequently developing secondary disease. Patients with dysplastic (DY) parenchymal pattern are significantly more likely to develop tumours which are ER-positive. In 92 patients who subsequently developed secondary disease, those whose primary tumour arose in a DY pattern breast were significantly more likely to respond to endocrine therapy irrespective of their ER status.
The pre-operative assessment of advanced gastric cancer by computed tomography
Authors: Dehn T C B , Reznek R H , Nockler I B , White F E 
Published: March 2007

Abstract
Forty-five patients with proven gastric adenocarcinoma underwent pre-operative abdominal computed tomography (CT). The radiological findings of tumour spread were prospectively compared with the surgical findings obtained at laparotomy. CT evidence of involvement of three organs, together with the presence of a large gastric tumour mass, correlated with the inability to resect the tumour in this series.
Transduodenal sphincteroplasty: An analysis of 118 consecutive cases
Authors: Antrum R M , Hall R 
Published: March 2007

Abstract
The results of 118 consecutive common bile duct explorations via transduodenal sphincteroplasty are presented and analysed. The operations were performed for suspected choledocholithiasis by one surgeon over a 10-year period. Choledocholithiasis was proved in 22 per cent of the cholecystectomies carried out during this period and tended to present significantly earlier in females, 14·5 per cent presenting before 35 years of age. One hundred and four survivors were traced and 93·5 per cent had achieved a good result at a mean 5-year follow-up.
Cellulose granulomatous peritonitis
Authors: Brittan R F , Studley J G N , Parkin J V , Rowles P M , Le Quesne L P 
Published: March 2007

Abstract
The case history of a patient developing granulomatous peritonitis due to cellulose is described. At a second laparotomy following an operation for intestinal obstruction due to adhesions, the peritoneum was found to be studded with multiple, yellow nodules, closely resembling tuberculous lesions, but shown on microscopy to be tuberculoid granulomata containing cellulose fibres. The main features of the condition, which is self-limiting, and probably more common than is generally realized, are discussed.
Lymph node imprint cytology for the rapid assessment of axillary node metastases in breast cancer
Authors: Quill D S , Leahy A L , Lawler R G , Finney R D 
Published: March 2007

Abstract
Lymph node imprint cytology was performed on 86 nodes from 13 consecutive patients with breast cancer undergoing simple mastectomy with axillary node sampling, and a prospective comparison with paraffin section was made. The results showed a diagnostic sensitivity and specificity of 0·93 and 0·98 respectively. The predictive value of a positive result was 0·98. This technique can be used to identify patients with Stage I disease rapidly, thereby allowing their exclusion from treatment with peri-operative chemotherapy.