bluuebunny/crossref_metadata_2025_split huggingface dataset:
The place of hepatobiliary isotope scanning in the diagnosis of gallbladder disease
Authors: Hall Andrew W , Wisbey M L , Hutchinson F , Wood Robert A B , Cuschieri Alfred 
Published: March 2007

Abstract
The present trend towards a more aggressive operative policy in acute cholecystitis has led to a search for more accurate methods of diagnosis. A possible contender in this field is hepatobiliary isotope scanning.
Ninety-nine patients with right-sided upper abdominal pain were studied after the intravenous injection of 99Tcm-pyridoxylideneglutamate. In addition, contrast radiology was performed in 87 of these. Subsequently 23 were shown to have acute cholecystitis, 45 to have other gallbladder disease and 31 to have no evidence of cholecystic pathology.
Isotope scanning was found to be reliable when negative at excluding acute cholecystitis (predictive value 100 per cent) and when positive at confirming gallbladder disease (predictive value 100 per cent). In these respects it compared favourably with contrast radiology (corresponding predictive values 80 per cent and 94 per cent) but was greatly inferior for the exclusion of cholelithiasis.
A practical method of scanning for routine clinical use is outlined and it is suggested that the method may be clinically useful as a first investigation in those patients presenting with acute right-sided upper abdominal pain. It may also be helpful in confirming pathology in a nonfunctioning gallbladder on oral cholecystography. When the isotope scan is negative (normal) contrast radiology is still required to exclude cholelithiasis. By a combination of the two techniques the correct diagnosis was arrived at in each of the 99 patients studied, suggesting that the methods may have complementary roles.
Studies with bombesin in the Zollinger—Ellison syndrome
Authors: Basso Nicola , Lezoche Emanuele , Materia Alberto , Jun Edward Passaro , Speranza Vincenzo 
Published: March 2007

Abstract
Preliminary data showed that bombesin stimulated serum gastrin levels in patients with the Zollinger—Ellison syndrome (ZES). In this study, the total immunoreactive gastrin and the different molecular forms of gastrin were measured in 16 patients with ZES (11 with proved pancreatic gastrinoma, 2 with proved duodenal gastrinoma and 3 with uncertain tumour localization) following bombesin infusion and following calcium infusion in 13 patients.
In all patients with gastrinoma (both pancreatic and duodenal) bombesin augmented serum gastrin levels. In patients with pancreatic gastrinoma calcium infusion was a more potent stimulator of gastrin secretion than bombesin. In the 2 patients with duodenal gastrinoma bombesin was more potent than calcium in stimulating serum gastrin levels with a basal/stimulated gastrin level ratio similar to the ratio found in patients with incomplete antrectomy. These data suggest that gastrin-producing cells from duodenal gastrinomas may be more closely related to the normal antral G cells than to the gastrin-producing cells from pancreatic gastrinomas. Furthermore, the comparison between the basal/calcium and the basal/bombesin stimulated gastrin levels may help in differentiating preoperatively patients with pancreatic gastrinoma from patients with retained antral mucosa.
In all the patients studied, bombesin augmented the concentration of all of the gastrin components considered.
These data support the hypothesis that G 34, G 17 and the N-terminal G 17 fragment are all present in gastrinomas.
Viscid faecal masses and acute appendicitis
Authors: McLellan Douglas R 
Published: March 2007

Abstract
The luminal contents of 200 consecutive appendicectomy specimens were examined prospectively to see if there was any association between viscid faecal matter and acute appendicitis. Faecaliths were found in 13·5 per cent of appendices and were associated with acute inflammation. Viscid faecal masses were present in 28·5 per cent of appendices, but were found more frequently in normal appendices. It is concluded that there is no relationship between acute appendicitis and viscid faecal matter in the lumen.
Volvulus of the transverse colon
Authors: Anderson J R , Lee D , Taylor T V , McLean Ross A H 
Published: March 2007

Abstract
Volvulus of the transverse colon is rare. Seven cases, 6 acute, are presented. Early diagnosis and prompt surgical management prevented complications. At laparotomy, extended right hemicolectomy or end colostomy and distal mucous fistula are the procedures of choice. Nonresection was associated with recurrence in three cases.
Endoscopic insertion of palliative oesophageal tubes in oesophagogastric neoplasms
Authors: Jones D Brian , Davies Phillip S , Smith Paul M 
Published: March 2007

Abstract
Fifty-five patients have undergone fibreoptic endoscopy under diazepam sedation with attempted insertion of a Celestin tube by the Nottingham introducer for an unresectable oesophagogastric malignant stricture.
There were 4 perforations in 48 successful intubations (8·3 per cent), 3 patients subsequently dying and the fourth healing spontaneously. There were 4 proximal tube displacements; 3 patients later returned with bolus obstruction.
Thirty-five (73 per cent) of the 48 patients who were successfully intubated left hospital with relief of dysphagia for periods ranging from 10 days to 18 months antil death (mean 5·5 months). Of the 13 deaths in hospital, 6 occurred as a result of the procedure (mortality rate 12·5 per cent).
We conclude that endoscopic insertion of palliative oesophagogastric tubes is relatively safe, simple to perform and could replace surgical introduction. It is technically more difficult in cases of gastric neoplasm involving the cardia.
Arginine vasopressin release following surgical operations
Authors: Cochrane John P S , Forsling Mary L , Gow Neil Menzies , Le Quesne Leslie P 
Published: March 2007

Abstract
A study of plasma arginine vasopressin (AVP) concentrations in 16 patients undergoing uncomplicated cholecystectomy was carried out to determine the relative importance of the various stimuli to AVP secretion during and after an operation. Eight of the 16 patients were given a high epidural blockade from T4 to T12 and blood samples were taken before, at frequent intervals during and for two days after operation for determination of plasma AVP and osmolality; systolic blood pressure was measured each time a blood sample was taken.
In the 16 patients there was a 1·8-fold rise of plasma AVP after induction of anaesthesia (from 1·7 pmol/l median basal value to 3·1 pmol/l) and an 8·8-fold rise after skin incision, the highest concentration during operation being 102 pmol/l. There was no significant difference in AVP concentrations, urine volumes or plasma osmolality in the control and epidural groups. Systolic blood pressure fell in all patients during operation bybetween 14 and 54 per cent, the fall being significantly greater in the epidural group.
Notwithstanding the evidence that certain nervous impulses do cause an increased secretion of AVP during operation, these results clearly show that in the absence of such stimuli there is still an increased secretion, almost certainly caused by a fall in the blood pressure.
A low volume burn resuscitation regimen: Assessment of performance by probit analysis
Authors: Griffiths R W , Cross N L , Laing J E 
Published: March 2007

Summary
The findings are presented of a 10-year retrospective review of burn admissions to the Wessex Regional Burn Centre, where a low volume colloid resuscitation regimen is employed. An analysis of mortality probability has been conducted using probit analysis, and the areas of burn injury associated with a 50 per cent mortality probability (LA50) were determined for four different age groups. LA50 values obtained were 0–14 years 59 per cent body surface area (BSA) burn, 15–44 years 70 per cent BSA burn, 45–64 years 38 per cent burn, 65 years and over 17 per cent BSA burn. The figures obtained parallel closely those reported from another large burn centre in the United Kingdom where a widely different fluid regimen is used. The results of this analysis suggest that wide variations in fluid resuscitation regimens, particularly with regard to volume, do little to affect the mortality associated with burn injury as assessed by probit analysis.
Pancreatic fistula complicating pancreatectomy for malignant disease
Authors: Papachristou Dimitrios N , Fortner Joseph G 
Published: March 2007

Summary
The incidence of pancreatic fistula in a series of 178 pancreatic resections was 25 per cent and was influenced by thetype of pancreatectomy, the management of the remaining pancreas and the size of the pancreatic duct. Thus, fistulas appeared in 52 per cent of patients undergoing pancreatoduodenectomy as compared to only 7 per cent of those undergoing distal pancreatectomy (P&lt;0·001). Ligation of the pancreatic duct in pancreatoduodenectomy led to a 70 per cent incidence; the incidence was 33 per cent if the pancreas was anastomosed to the jejunum instead (P&lt;0·001). Fistulas were rare in patients who had dilated pancreatic ducts. Fistulas, once they were established, were rarely influenced bytreatment. One out of 5 patients developing pancreatic fistula died, while fistulas were responsible for half of the operative deaths. The study indicated that pancreatojejunostomy is safe in the presence of ductal dilatation; it does not, however, protect from fistula if the pancreatic duct is normal. It also indicated that radiation of the pancreatic remnant in selected patients with persistent fistulas might be a useful therapeutic alternative.
The importance of pain, pruritus and soiling as symptoms of haemorrhoids and their response to haemorrhoidectomy or rubber band ligation
Authors: Murie John A , Sim Andrew J W , Mackenzie Iain 
Published: March 2007

Summary
Bowel habit, anal pain or discomfort, pruritus ani and faecal soiling have been assessed in 82 patients with uncomplicated, prolapsing haemorrhoids before and after successful treatment (improvement in rectal bleeding and haemorrhoidal prolapse) by haemorrhoidectomy or rubber band ligation. An age and sex-matched control group of patients without haemorrhoids was similarly assessed. The bowel habit of the haemorrhoid group was not different from that of the control population. Pain or discomfort, pruritus and faecal soiling were much commoner in the pretreatment haemorrhoid group, compared to controls. Treatments designed to abolish rectal bleeding and prolapse (the cardinal symptoms of haemorrhoids) also reduced the incidence of these three symptoms. Only anal pain or discomfort, however, was reduced to the incidence found in the control group. Haemorrhoidectomy and rubber band ligation appeared equally effective in controlling all three symptoms. It is concluded that anal pain or discomfort, pruritus ani and faecal soiling are common symptoms of uncomplicated haemorrhoids and that they are abolished in the majority of patients by successful treatment for rectal bleeding and haemorrhoidal prolapse.
The effect of dihydroergotamine and heparin on the incidence of thromboembolic complications following total hip replacement: A randomized controlled clinical trial
Authors: Morris W T , Hardy A E 
Published: March 2007

Summary
A randomized blind clinical trial was carried out to assess the effect of dihydroergotamine (DHE) alone and in combination with heparin on the incidence of thromboembolic complications of total hip replacement. It was found that a combination of DHE 0·5 mg and heparin 5000 units subcutaneously, given 8-hourly in separate injection sites, reduced the incidence of thromboembolic complications from 63 per cent in the untreated controls to 7·4 per cent in the treated group. This difference was highly significant. DHE alone produced a reduction in the incidence of thromboembolism but this reduction was not statistically significant. Blood loss was calculated using pre- and postoperative haemoglobin levels, taking into account the amount of blood transfused. It was found that the blood loss in the DHE/heparin-treated patients was identical to that in the untreated controls. The patients who received DHE alone had a significantly lower mean blood loss than the other two groups. It is concluded that this reduction in blood loss by DHE may be due to its venoconstrictor properties.
The effect of acute haemorrhage and of delayed blood replacement on wound healing: An experimental study
Authors: Nasution Ahmed F , Taylor David E 
Published: March 2007

Summary
Haemorrhage whether untreated or with volume replacement delayed for 1 h has been shown by other workers to result in weaker scars 7–10 days after wounding. Studies have been carried out 6 weeks and 3 months after median laparotomy in three groups of Wistar rat: control, bled 10 ml/kg without replacement and bled 10 ml/kg with replacement of heparinized shed blood after 1 h. At 6 weeks the burst pressure of the laparotomy scar was significantly less (Mann—Witney U) in both the haemorrhage group (n = 6; 181·7±30·5 mmHg s.e.m.; P = 0·026) and the replacement group (n = 6; 207·8±27·4 mmHg s.e.m.; P = 0·037) than in the control animals (n = 7; 301·9±42·0mmHg s.e.m.). At 3 months there were no significant differences between the groups. On histology there was no difference in cellularity between the groups, but in both the haemorrhage and replacement animals collagen was less abundant and less well organized. These differences also had disappeared by 3 months. Neither collagen nor the fibroblast ultrastructure showed significant differences between groups, all animals showing patchy vacuolation of endoplasmic reticulum of fibroblasts at 6 weeks. It is concluded that oligaemia slows wound healing but does not affect the ultimate strength of the scar.
A comparison of two methods of whole gut lavage for colonoscopy
Authors: Gilmore I T , Ellis W R , Barrett G S , Pendower J E H , Parkins R A 
Published: March 2007

Summary
Two forms of bowel preparation for colonoscopy were compared—19 patients were given 5 per cent mannitol solution orally while a further 19 were infused with isotonic saline via a nasogastric tube. Both methods proved equally acceptable to the patients and endoscopists. Saline led to a rise in body weight (+0·75±0·35kg) and blood pressure (+7·5±2·8 mmHg) while mannitol caused a significant fall in both body weight (−0·74±0·28 kg) and blood pressure (−3·8±2·9 mmHg).
Plasma volume measurements were carried out on 17 patients; 8 receiving saline showed a rise (+0·22±0·08l) while 9 taking mannitol experienced a fall (−0·17±0·08l). Twelve further subjects prepared with a combination 10 per cent mannitol and isotonic saline showed a small fall in plasma volume (−0·08±0·05l).
Mannitol proved an acceptable preparation for colonoscopies but a fall in body weight, blood pressure and plasma volume posed a small risk to the elderly subject and in view of the known risks of mannitol during diathermy this form of preparation was not considered a suitable alternative to isotonic saline.
To strip or not to strip the long saphenous vein? A varicose veins trial
Authors: Munn S R , Morton J B , Macbeth W A A G , McLeish A R 
Published: March 2007

Summary
A double blind controlled trial of surgery for varicose veins was conducted on the legs of patients with bilateral symmetrical varicose veins. The two treatments, saphenofemoral ligation and avulsion of varices, with and without stripping of the long saphenous vein from ankle to groin, were randomly allocated among the legs of individual patients. At follow-up, between 2·5 and 3·5 years, an objective (observer) assessment was that stripping conferred a significant advantage, but the incidence of paraesthesia and pain biased patient's opinion against stripping.
Proximal gastric vagotomy in stenosed or perforated duodenal ulcer
Authors: Ferraz Edmundo Machado , Filho Horacio Alipio Ferreira , Bacelar Tercio Souto , Lacerda Claudio Moura , de Souza Ayrton Ponce , Kelner Salomao 
Published: March 2007

Summary
Thirty-five patients suffering from stenosed or perforated duodenal ulcer, who were submitted to surgical treatment in the form of proximal gastric vagotomy, are presented. There were no deaths in the series and the results were considered to be very good in the cases of perforation, whereas a high incidence of poor results (27 per cent) occurred in the cases of stenosis submitted to a proximal gastric vagotomy combined with digital dilatation of the pylorus.
Dacron graft erosion of the duodenum: A complication of interposition mesocaval shunt operations
Authors: Osborne D R , Hobbs K E F 
Published: March 2007

Summary
Two cases are reported of patients presenting with septicaemia as a late complication of a Dacron interposition mesocaval shunt operation. In both cases the prosthesis had eroded through the duodenal wall and the Dacron was in direct contact with intestinal contents. One patient died and the diagnosis was only made at postmortem examination. The other patient recovered after the problem had been recognized and treated surgically.
Delorme's operation for complete rectal prolapse
Authors: Christiansen John , Kirkegaard Preben 
Published: March 2007

Summary
Twelve patients with a median age of 73 years were treated for complete rectal prolapse by Delorme's operation. The patients were mildly sedated, and local anaesthesia with lidocaine—adrenaline was administered submucously. No postoperative mortality or cardiopulmonary complications occurred. After a median follow-up of 3 years, two recurrences were found. The Delorme procedure seems to be superior to the Thiersch operation, and the postoperative mortality and morbidity is equally low. Delorme's operation should be considered as an alternative treatment for complete rectal prolapse in patients who are not suitable for a transabdominal procedure.
Postoperative gastric emptying
Authors: Ingram D M , Sheiner H J 
Published: March 2007

Summary
Postoperative intolerance of oral fluids is common after abdominal surgery, and their premature administration may result in abdominal distension, nausea and vomiting. The ability of the stomach to empty 100 ml of water was investigated in patients undergoing elective cholecystectomy. Patients were studied preoperatively and on the first postoperative day using a radio-isotopic method of measurement of gastric emptying. Factors such as age, electrolyte disturbance, duration of operation and the many drugs used during the perioperative period were analysed in relation to postoperative gastric emptying rates.
Postoperative gastric emptying showed wide variation, being normal in some patients but absent in others. No correlation was found between postoperative gastric emptying and age, plasma potassium and the duration of operation and anaesthetic. A significant correlation was found, however, between gastric emptying and drugs administered in the perioperative period. In particular, gastric emptying was grossly retarded following an injection of opiate, but this returned to normal if more than 5 h had elapsed since the last injection of opiate. It is suggested that opiate therapy is a major factor in a patient's inability to tolerate fluids following cholecystectomy.
Vertical forces acting on the feet of diabetic patients with neuropathic ulceration
Authors: Ctercteko G C , Dhanendran M , Hutton W C , Quesne L P Le 
Published: March 2007

Summary
The vertical forces acting on the sole of the foot in walking have been measured in 24 diabetic patients with neuropathic ulceration of the foot using a load-sensitive surface divided into 128 load cells, and compared with those in two groups of controls: (a), 21 diabetic patients with peripheral neuropathy but no ulceration and (b) 47 normal individuals.
The results showed that the patients with neuropathic ulceration were significantly heavier, that diabetic patients with neuropathy, with or without ulceration, transmitted proportionally less force through the toes than normal individuals, and showed a medial shift of the force transmitted through the metatarsal heads. All plantar ulcers occurred at the site of maximum loading. The absolute force at the site of maximum loading was significantly greater in the patients with ulcers than in both control groups, though there was a considerable overlap. A significant difference remained even when the absolute force had been corrected for differences in toe loading and body weight, indicating that a further factor (or factors) must contribute to the development of these localized areas of high loading.
Recurrent ulceration after highly selective vagotomy for duodenal ulcer
Authors: Blackett Richard L , Johnston David 
Published: March 2007

Summary
Recurrent peptic ulceration was diagnosed in 9 per cent of 433 patients who were treated by elective highly selective vagotomy (HSV) for duodenal ulcer (DU) between 1969 and 1980. In 233 patients followed up for 5–12 years (12 per cent being lost to follow-up), the incidence of recurrence was 10.7 per cent. The site of recurrence was duodenal in 23 patients, pyloric in 4, gastric in 6 and combined duodenal and gastric in 2 (total of 35 patients). One patient presented with a perforation, 4 with haemorrhage and 30 with epigastric pain. Asymptomatic patients were not endoscoped and so asymptomatic recurrence would have been missed. Nine patients were treated by reoperation (5 Polya partial gastrectomy, 4 vagotomy + antrectomy), the remainder with cimetidine. There was no mortality.
When the 35 patients with recurrence were compared with the patients, without recurrence, no preoperative factors could be identified that might be used to predict recurrence. Thus, for the two groups, the sex distribution, age, length of ulcer history, previous ulcer complications and preoperative acid outputs (basal and maximal) were very similar. This was true also when the data for patients with true recurrence in the duodenum were examined separately. Hence, contrary to some previous reports, no evidence was found that patients who are hypersecretors of acid, either basal or maximal, before operation should be treated by vagotomy combined with antrectomy.
After HSV, however, patients with recurrent DU secreted more acid (basal, insulin and pentagastrinstimulated) than patients without recurrence, the difference between the two groups being statistically significant for basal acid output (BAO) and the response to insulin. The only factor which was found to influence the incidence of recurrent ulceration after HSV strongly was the surgeon who performed the operation.
Do prostacyclin and thromboxane play a role in endotoxic shock?
Authors: Webb P J , Westwick J , Scully M F , Zahavi J , Kakkar V V 
Published: March 2007

Summary
The role of prostacyclin and thromboxane during endotoxic shock is unknown. Using new radioimmunoassay techniques, we have studied the plasma levels of stable metabolites of prostacyclin (6-keto-PGF1α) and thromboxane (TxB2) in a porcine model of endotoxic shock. TxB2 levels were markedly elevated but the production of prostacyclin appears to be impaired. Correction of this prostanoid imbalance by the infusion of prostacyclin or pre-treatment with a specific thromboxane synthetase inhibitor produces significant and beneficial effects on blood pressure and pre-kallikrein activation.