bluuebunny/crossref_metadata_2025_split huggingface dataset:
How tight should tension sutures be tied? A controlled clinical trial
Authors: Rosenberg I L , Brennan T G , Giles G R 
Published: March 2007

Abstract
In a prospective randomized trial there was no advantage in tying tension sutures flush with the wound; by tying them loosely (over three fingers of the assistant's hand) there was less wound pain and less cutting in of the tension suture into the ridge of the wound and along the suture tracks.
The survival rate of men with carcinoma of the breast
Authors: Slack Robert W T 
Published: March 2007

Abstract
The Cancer Register for the South-West Region of England has been used to examine the survival rate of men with carcinoma of the breast, and a comparison has been made with carcinoma of the breast in women. For all men with carcinoma of the breast the prognosis is worse than for all women, but comparing the prognosis by clinical stage, the difference between men and women is small. However, the survival rate in men under 65 years of age is appreciably better than for men over 65, and for older men the survival rate is considerably less than for women over 65.
Pressure measurements beneath below-knee amputation stump bandages: Elastic bandaging, the Puddifoot dressing and a pneumatic bandaging technique compared
Authors: Isherwood P A , Robertson J C , Rossi D A 
Published: March 2007

Abstract
Elastic wrap bandaging is unreliable and dangerous in terms of pressure and pressure distribution (tourniquet effect). The Puddifoot dressing is safe and is less likely to produce a tourniquet effect. The range of pressures it produces is low-possibly too low to achieve ideal moulding or oedema control. A pneumatic bandage achieved a relatively narrow range of pressures between capillary and arteriolar blood pressures. It minimized tourniquet effects and differences between skilled and unskilled bandagers. It is sufficiently promising to merit development.
Severe pseudomembranous colitis after lincomycin and clindamycin
Authors: Smart R F , Ramsden D A , Gear M W L , Nicol A , Lennox W M 
Published: March 2007

Abstract
Four cases of severe pseudomembranous colitis following the use of lincomycin and clindamycin are described; 2 required emergency total colectomy and 2 died. Cases of such gravity after the use of these drugs have not been previously reported.
One hundred and fifty-six orthopaedic cases where clindamycin and lincomycin were used postoperatively are reviewed; 34 had diarrhoea (22 per cent), and 3 of the severe cases occurred in this group.
The diagnosis of pseudomembranous colitis may be difficult as the latent period from initiation of drug therapy to commencement of diarrhoea may be as much as 18 days, and that from cessation of drug therapy may be as much as 11 days. The value of early sigmoidoscopy in cases of diarrhoea of obscure aetiology is emphasized, and the characteristic sigmoidoscopic and histological appearances of pseudomembranous colitis are described.
As these drugs may produce a lethal condition it is suggested that they should be used with appropriate discretion, especially in the elderly female who appears to be most at risk.
Some observations on gallstones and bile composition
Authors: Sutor D June , Cowie A G A , Clark C G 
Published: March 2007

Abstract
A series of 31 consecutive patients undergoing surgery for gallstone disease has been studied and the composition of the gallstones and bile from the gallbladder und common duct determined. As a result of the stone analysis by the X-ray powder diffraction method, the patients were classified according to whether their stones consisted of cholesterol, calcium salts or a mixture of the two. The mean composition of the common duct bile for the groups with cholesterol and mixed stones was just outside the micellar region of cholesterol solubility. The gallbladder bile from the cholesterol group of stone-formers was also supersaturated, but the gallblader bile from the group of mixed stone-formers was undersaturated with respect to cholesterol. None of the patients forming gallstones of calcium salts showed any abnormality in the cholesterol content of their bile.
Pancreatic pseudocysts
Authors: Karatzas G M 
Published: March 2007

Abstract
Twenty-seven patients with 32 pancreatic pseudocysts have been seen during the past 10 years at St George's Hospital, London. Two of the pseudocysts were found in unusual positions-one in the right inguinal canal and the other one in the porta hepatis. Approximately half of the pseudocysts in this series followed biliaryinduced pancreatitis. The various clinical presentations are reported and the surgical treatment is discussed. Internal drainage is the most effective treatment and in the majority of cases transgastric cystogastrostomy via a tube is the procedure of choice. One death occurred, an overall mortality rate of 3.1 per cent.
Curling's ulcer: A rare condition
Authors: Muir Ian F K , Jones Peter F 
Published: March 2007

Abstract
A case of Curling's ulceration of the duodenum in a child with 50 per cent burns, requiring operative arrest of the bleeding, is reported, and this condition is reviewed. Inquiry among the surgical units treating burns in Great Britain showed that only 18 cases of alimentary bleeding had been seen in the course of treating some 32 500 patients. The incidence in Europe and Australia appears to be of the same order, bur there is a much higher incidence in some burns units in North America. Possible reasons for these differences are examined. The occurrence and treatment of Curling's ulcer in childhood are considered.
A comparison between suction and corrugated drainage after simple mastectomy: A report of a controlled trial
Authors: Bourke J B , Balfour T W , Hardcastle J D , Wilkins J L 
Published: March 2007

Abstract
A randomized prospective trial of closed suction wound drainage compared with corrugated wound drainage after simple mastectomy for early breast cancer (lesion confined to the breast and without skin ulceration)is reported. Fifty-one patients were admitted to the study anti there was no difference between the two groups with respect to local complications such as infection, skin necrosis and collection under flaps and wound healing. Dressings require to be performed significantly less frequently with suction as opposed to corrugated drainage and suction drains were removed significantly sooner than corrugated drains. It is concluded that closed suction wound drainage should be used after simple mastectomy.
Pleural empyema in association with renal sepsis
Authors: Irving A D , Turner M A 
Published: March 2007

Abstract
Five cases of pleural empyema in association with perinephric abscess or renal infection are presented. This represents 4 per cent of a series of 122 pleural empyemas, or 30 per cent of' empyemas with subdiaphragmatic aetiology.
It is suggested that the renal tract should be investigated in all cases of recurrent or non-resolving pleural empyema of uncertain aetiology.
Testicular involvement in the retroperitoneal fibrosis syndrome
Authors: Fraser Ian 
Published: March 2007

Abstract
A case of retroperitoneal fibrosis involving the testicle is presented. The widespread extent of the retroperitoneal fibrosis syndrome is reviewed briefly. The literature contains little information concerning the aetiology of testicular involvement in the disease process, which generally affects the para-aortic tissues. The physical signs mimic testicular neoplasm. A common embryological derivation of the tissues affected is postulated.
The value of the leucocyte count in the diagnosis of acute appendicitis
Authors: Raftery A T 
Published: March 2007

Abstract
Total and differential leucocyte counts were performed on 175 patients with a provisional diagnosis of acute appendicitis. Ninety-six per cent of patients with acute appendicitis had either an abnormal total or differential leucocyte count. Four of 24 patients operated on with a normal leucocyte count had acute appendicitis. It is concluded that leucocytosis of above 10 000/mm3 or a differential in excess of 75 per cent neutrophils supports the clinical diagnosis of acute appendicitis and that routine estimation of the leucocyte count is a useful investigation. While a normal leucocyte count does not exclude even a perforated appendicitis, such a count should prompt further review of the diagnosis, especially in the presence of an atypical history or minimal physical signs.
Syndromes in amoebic liver abscess
Authors: Ramachandran S , Goonatillake H D , Induruwa P A C 
Published: March 2007

Abstract
A series of 137 patients with amoebic liver abscess has been studied. Recognition of clearly defined but diverse clinical syndromes was found to be necessary not only in diagnosis but also in planned surgical management. The majority of patients had the classic syndrome of fever, sight abdominal or chest pain, hepatomegaly, hepatic tenderness and radiological abnormalities. Other syndromes of presentation included the silent abscess, acute amoebic colitis, the acute abdomen, the intra-abdominal lump, the external sinus, pyrexia of obscure origin, obstructice, jaundice and renal, pleuro-pulmonary and cardiac symptoms. The syndromes due to an abscess in different parts of the right lobe and in the left lobe of the liver are to some extent distinct. In spite of the varied modes of presentation of amoebic liver abscess, the key to diagnosis is an understanding of the chronological sequence of the disease and its progression from one syndrome to another. Diagnostic methods of value and the mortality are discussed.
Carcinoids of the first part of the duodenum
Authors: Orttz Hector , Ortega José S , Bernat Ramón , Sitges Antonio 
Published: March 2007

Abstract
Three cases of duodenal carcinoid tumour are described and the histology of this type of tumour is discussed. Two of the patients have been followed up for 8 years. No further complications related to the tumours have been observed.
Primary suture of the perineal wound following rectal excision for adenocarcinoma
Authors: Marks C G , Leighton Monica , Ritchie Jean K , Hawley P R 
Published: March 2007

Abstract
A statistical analysis of the correlations between a number of factors, including age, tumour pathology and surgical management, and the results of primary suture of the perineum after excision of the rectum for adenocarcinoma in 63 males is presented.
An unsuccessful outcome was related to the extent of the dissection either necessitated by advanced tumour or resulting from excision of the coccyx. A successful result was associated with small tumours and preoperative antibacterial treatment.
Topical antibacterial treatments, topical mercuric perchloride and the drainage route did not appear to affect the outcome.
Surgical research in the United Kingdom: Past, present and future
Authors: Dudley H A F 
Published: March 2007

Abstract
The history of Surgical research in the United Kingdom leading to the foundation of the Surgical Research Society (SRS) is briefly reviewed. The tendency of the SRS has been to become increasingly rigorous, reductionist and a forum for work which is not only of a high standard but also largely completed. This has had both good and potentially bad effects. Susgeons should realize that their major involvements in research will lie in the relatively untidy field of clinical science, and it is hoped that this view will continue to influence the activities of the SRS.
Salvage of the lower limb
Authors: Yogasundram Y N 
Published: March 2007

Abstract
This is a retrospective study of 80 patients with 94 severely ischaemic lower limbs treated over a period of' 6 years. Arterial reconstruction was possible in 47 patients (54 limbs) and 76 per cent of' these limbs were salvaged. There was no operative mortality. An attempt has been made to analyse the reasons for the failure. The fate of the patients who underwent major amputation is described. The selection of patients for direct arterial surgery is discussed, together with some of the technical problems involved.
Rectal sphincter reconstruction in perineal colostomies after abdominoperineal resection for cancer
Authors: Simonsen Oscar S , Stolf Noedir A G , Aun Frederico , Raia Arrigo , Habr-Gama Angelita 
Published: March 2007

Abstract
A surgical technique is proposed for the reconstruction of the anal sphincter in perineal colostomies after abdominoperineal resection for cancer. The procedure, which employs the gracilis muscle for the sphincteric reconstruction, is described and the operative results and complications are analysed in 24 patients submitted to this type of surgery. Of the 22 patients who were followed up, 17 had excellent or good results with retention of solid or soft stools. Three patients had poor results with no voluntary retention, while 2 others were partly incontinent of solid faeces. In this group of 5 patients, 3 had stenosis of the colostomy and I had no sensibility of impending defaecation.
Cancer prognosis predicted by preoperative lymphocyte responsiveness in vitro
Authors: Watkins Sylvia M 
Published: March 2007

Abstract
The prognosis in cancer patients was studied in relation to their preoperative cell-mediated immune status. Thirty patients with various types of operable cancer were studied. Transformation of the lymphocytes in response to phytohaemagglutinin (PHA) in vitro was measured preoperatively. All the patients were followed up for 3 years. Those with normal preoperative lymphocyte responsiveness had a far better prognosis than those in whom this test was subnormal.
Gastric lesions in generalized neurofibromatosis
Authors: Hoare A M , Elkington S G 
Published: March 2007

Abstract
A patient with dyspepsia and multiple gastric polyps associated with generalized neurofibromatosis is described, and the English literature on generalized neurofibromatosis with gastric involvement is reviewed. Nine patients with gastric neurofibromas have been reported and 2 with one and two gastric polyps respectively, but none with multiple gastric polyps. The commonest presentation has been dyspepsia suggestive of a peptic ulcer.
Fournier's gangrene: A report of 5 cases
Authors: Pande S K , Mewara P C 
Published: March 2007

Abstract
A report of 5 cases of infective gangrene of the genitalia and adjacent tissues occurring within a If-1/4year period is presented. Of these, 4 cases occurred within 5 months. All the patients were adult males. During the same period no similar pathology was observed in any female or child. Such a large number of cases occurring in so short a time is intriguing but we are unable to explain it. The treatment in all cases was with general supportive drugs, blood transfusion when needed and specific antibiotics. Local excision of the dead tissues and dressing with hydrogen peroxide and eusol gave satisfactory results.
Sternoclavicular joint enlargement following block dissection
Authors: Lamb C E M 
Published: March 2007

Abstract
The sternoclavicular joint may become enlarged subsequent to block dissection of' the neck. It should be managed conservatively and does not require removal, although both clinical and X-ray appearances may give rise to suspicion of' metastasis in the head of the clavicle. A hypothesis of the pathology of' this unfamiliar condition is proposed.
The treatment of acute abscesses by incision, curettage and primary suture under antibiotic cover
Authors: Jones N A G , Wilson D H 
Published: March 2007

Abstract
One hundred and fifty consecutive acute abscesses have been treated by incision, curettage and primary suture under antibiotic cover. The antibiotic used in this series was lincomycin 600 mg i.m. with premedication and clindamycin 150 mg 4-hourlyfor 4 days postoperatively (children and infants received smaller doses). Similar results for the rate of healing were achieved in all groups of abscesses. A case is made for the use of the technique of incision, curettage and primary suture with antibiotic cover for acute abscesses as an alternative to conventional methods of treatment.
Bronchopleural fistula: A review of 86 cases
Authors: Williams N S , Lewis C T 
Published: March 2007

Abstract
A review of all the bronchopleural fistulas which developed following pulmonary resection in the Department of Cardio-Vascular and Thoracic Surgery of The London Hospital between 1953 and 1973 is presented. During this period 3150 pulmonary resections were performed for various conditions and 86 fistulas occurred, an incidence of 2·7per cent.
The aetiology, diagnosis and treatment of thesefistulas are discussed.
Exomphalos and gastroschisis: A 10-year review
Authors: Venugopal S , Zachary R B , Spitz L 
Published: March 2007

Abstract
Ninety-six cases of exomphalos or gastroschisis managed at The Children's Hospital, Shefield, during the period 1964–74 are analysed. There were 36 cases with minor lesions, 30 with major lesions, 27 with a ruptured exomphalos and only 3 with gastroschisis. The overall mortality rate was 46·9 per cent. Survival could be closely correlated with the birth weight, the nature of the primary lesion, the presence or absence of liver within the sac and the presence and severity of associated congenital anomalies. A ‘scoring system’ based on these criteria is proposed to predict the prognosis of an infant with an exomphalos.
Prophylaxis against anaerobic sepsis in bowel surgery
Authors: Keighley M R B , Crapp A R , Burdon D W , Cooke W T , Alexander-Williams J 
Published: March 2007

Abstract
Sixty-two patients were admitted to a prospective randomized controlled trial 10 investigate the influence of a prophylactic antibiotic, lincomycin, on anaerobic sepsis following bowel surgery. The incidence of postoperative sepsis was reduced from 45 to 18 per cent (P &lt; 0·025). Wound infections were reduced from 38 to 12 per cent (P &lt; 0·05). Intra-abdominal or pelvic abscess occurred in 1 of the treated group compared with 3 controls. Septicaemia occurred after operation in 1 patient receiving lincomycin and in 3 of the controls; in 2 of the latter, pure growths of bacteroides were isolated from the blood cultures and 1 of these patients died. Although Iincomycin had no influence on the number of patients who developed aerobic postoperative infections, there was a significant reduction in the incidence of sepsis due to bacteroides, which occurred in 10 of the control group compared with 1 in the lincomycin group (P &lt; 0·005). No patients developed complications attributable to lincomycin, such as pseudomembranous colitis.
These data indicate that the genus Bacteroides are important pathogenic organisms and are responsible for postoperative morbidity. Furthermore, anaerobic sepsis can be reduced by appropriate prophylactic antibiotics.
Colonic lymphoma complicating ulcerative colitis
Authors: Renton P , Blackshaw A J 
Published: March 2007

Abstract
Colonic lymphoma is a rare complication of ulcerative colitis. Two cases are described in patients who had had ulcerative colitis for 12 and 22 years respectively. Both patients presented with a recent change in their symptoms, which had become increasingly severe and which had not remitted with customary treatment for ulcerative colitis. Physical and haematological examinations revealed no evidence of generalized lymphoma, though barium enema studies indicated the sites of the lymphomatous lesions superimposed on chronic ulcerative colitis which were confirmed at operation and biopsy.
A study of perineal wound healing after abdominoperineal resection
Authors: Saha S K , Robinson A F 
Published: March 2007

Abstract
A comparative study of 53 cases has revealed that a technique of complete primary closure of the perineal wound after abdominoperineal resection of the rectum and anal canal appears to be a superior, more rational approach than other orthodox techniques, (It is unsuitable for any case contaminated with pus or faeces during operation.) Redivac apparatus used through a separate route for continuous drainage from the sacral cavity has made the postoperative care easier for nurses and surgeons and this period more comfortable for the patient. It provides a simple method compared with other suction apparatus used for the same purpose.
Of the 53 cases, 12 were operated on using a traditional technique involving the closure of the perineal wound around a tube drain connected to an underwater seal, while in the remaining 41 the approach described here was used. Primary healing of the perineal wound with the latter approach was obtained in about 88 percent, With the other technique the figures were 34 and 66 per cent respectively for early healing within 3 weeks and delayed healing between 3–8 weeks. Primary healing of the perineal wound reduces the total stay in hospital and the morbidity.
The distribution and early morphology of the chronic gastric mucosal reaction
Authors: Lawson H H 
Published: March 2007

Abstract
The distribution of the chronic gastric mucosal reaction (CGMR) that resulted from the exposure of the mucosa to refluxing duodenal contents did not suggest that one area of the stomach was more susceptible than another. The earliest histological appearances of established CGMR as seen 3 months after surgery were epithelial proliferation and pseudo-pyloric metaplasia.
The role of the pyloric antrum and Hofmeister valve in the development of the chronic gastric mucosal reaction
Authors: Lawson H H 
Published: March 2007

Abstract
A limited chronic gastric mucosal reuction (CGMR) develops when duodenal contents enter the stomach with an intact pyloric antrum. However, after antrectomy the same stimulus leads to a widespread CGMR. The pyloric antrum, therefore, seems to influence the development of the CGMR. A Hofmeister valve included in a Polya gastrectomy does not prevent the development of the CGMR, presumably because reflux is not prevented.
The relationship of plasma glucagon to the hyperglycaemia and hyperinsulinaemia of surgical operation
Authors: Giddings A E B , O'Connor K J , Rowlands B J , Mangnall D , Clark R G 
Published: March 2007

Abstract
In a controlled metabolic study of 42patients undergoing abdominal surgery a significant increase in basal values of immunoreactive glucagon (IRG) was found 24 hours postoperatively. No correlation between the onset and duration of hyperglycaemia and the increase of IRG was observed. No increase in immunoreactive insulin (IRZ) was seen during operation, but there was a rise 24 hours postoperatively.
The infusion of arginine was accompanied by a rise in IRG both pre- and postoperatively, but despite the high values obtained there was no accompanying further increase in basal plasma glucose in the postoperative situation. The pre- and postoperative IRI responses were similar. Our evidence suggests that glucagon is not a primary mediator of the stress response, or of the hyperglycaemia of surgical operation in these patients.
Amputation for vascular disease
Authors: Jamieson C W , Hill D 
Published: March 2007

Abstract
Amputation for peripheral ischaemia still has a depressingly high early and late mortality, and morbidity and the end result are usually less than satisfactory. Individual surgeons probably see too few amputees to treat them with maximal efficiency, and these patients create a large burden on beds and resources.
There is room for improvement in all aspects of our management of amputees. Primary healing rates might be better with less heroic attempts to obtain a distal amputation. Sepsis is lessened by the use of prophylactic antibiotics. Tight bandaging and the intra-operative fitting of prostheses are undesirable. Simple tests of skin blood pressure may aid prediction of the degree of ischaemia at the proposed level of limb section and the chances of healing. The late mortality is high and merits study of methods designed to reduce it such as long term anticoagulation.