bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative hypoxaemia and oxygen therapy
Authors: Parfrey P S , Harte P J , Quinlan J P , Brady M P 
Published: March 2007

Abstract
To observe the duration of hypoxaemia 8 patients were monitored every day for the first 7 days following upper abdominal surgery. Three of these patients who had failed to regain their preoperative Po2 value by the seventh postoperative day were further monitored on alternate days until the fourteenth postoperative day. A further 3 patients were similarly monitored on alternate days for 14 days. In another group of 10 patients blood gases were monitored every 4 h for the first 48 h following major abdominal surgery, during which time the patients were given 35 per cent oxygen for the first 24 h after operation. (All patients in this group had a diminished respiratory reserve preoperatively to a sufficient degree to warrant admission to the intensive therapy unit postoperatively, and these patients were treated with oxygen for 24 h, as is the practice in our unit and in other surgical units).
Oxygen was administered using a Ventimask at 8 l/min (British Medical Journal, 1972). Nine of the 10 patients did not show postoperative hypoxaemia while being treated with 35 per cent oxygen, although the Po2 values attained were lower than expected. On withdrawal of oxygen after 24 h, the Po2 decreased below preoperative levels in all patients. The Po2 of 7 patients in this group decreased below 8 kPa during the second 24 postoperative hours, in 4 of whom the level fell below 6·7 kPa. Some recommendations to improve the respiratory care of the surgical patient are presented.
The medical dissolution of phytobezoars using cellulase
Authors: Lee S P , Holloway W D , Nicholson G I 
Published: March 2007

Abstract
Phytobezoars are plant fibre concretions occurring in the stomach as a complication following some types of gastric surgery. Symptoms include distension, pain and vomiting. Ulceration, gastric bleeding and even perforation can occur. If untreated, they result in a significant mortality.
Dissolution of the phytobezoar can be achieved with-out operative intervention. Enzymes and especially cellulase help to break up the mass and it can then be aspirated or allowed to pass on. Five patients with phytobezoars were thus treated and the cellulase method was confirmed to be simple, safe and effective.
Recurrent massive haemorrhage from benign hepatic tumours secondary to oral contraceptives
Authors: Bein Norman N , Goldsmith Harry S 
Published: March 2007

Abstract
Liver cell adenoma as a cause of spontaneous haemoperitoneum has been noted with increasing frequency since Baum's initial report (Baum et al., 1973). The relationship between the use of oral contraceptives and bleeding from a hepatic tumour makes awareness of this condition mandatory for the physician involved in the differential diagnosis of the acute abdomen. The report presented here is that of a woman who, while taking oral contraceptives, subsequently bled from her liver 3 years after an initial hepatic haemorrhage.
Recurrence after proximal gastric vagotomy without drainage for duodenal ulcer: A 3–6-year follow-up
Authors: de Miguel Jacinto 
Published: March 2007

Abstract
During the period December 1970 to August 1973, 99 patients with duodenal ulcer underwent proximal gastric vagotomy without drainage, and 93 per cent of the patients were followed up for 3–6 years after the operation. A proved recurrent duodenal ulcer was noted in 4·3 per cent and a strongly suspected recurrent duodenal ulcer in 2 per cent. It is suggested that this rate of recurrence on medium term follow-up is compatible with the continued use of proximal gastric vagotomy in the surgical treatment of duodenal ulcer.
Bile composition in bilharzial hepatic fibrosis
Authors: El Masri S H , Lewin M R , Gumaa K 
Published: March 2007

Abstract
At operation for haematemesis in bilharzial hepatic fibrosis, the gallbladder was always found to be diseased but devoid of stones. This led to a study of gallbladder bile composition in a group of bilharzial patients and comparison with a group of cholelithiasis patients. When values for biliary lipid composition were plotted on triangular coordinates, both groups fell well outside the line of maximum cholesterol solubility. The bilharzia group had significantly more cholesterol and less phospholipid than the gallstone group. The absence of stones in patients with bilharzial hepatic fibrosis was possibly due to their early demise and the suggestion is that, in this condition, it is the disease of the gallbladder itself which renders the bile lithogenic.
Umbilical pilonidal sinus
Authors: Colapinto Nicholas D 
Published: March 2007

Abstract
A rare case of umbilical pilonidal sinus is reported—the only documented case of barber's pilonidal of the umbilicus. Possible mechanisms of formation are described. It is suggested that this possibility should be considered in cases of resistant or recurrent omphalitis. Definitive treatment consists of sinus excision with cosmetic umbilical reconstruction. Total omphalectomy is probably only justified for recurrence.
Intestinal obstruction after excision of the rectum
Authors: Hamer-Hodges D , Matheson N A 
Published: March 2007

Abstract
Over a 5-year period, 33 patients underwent excision of the rectum in the same unit of Aberdeen Royal Infirmary. Six patients in whom the abdominal contents were allowed to fall into the denuded pelvis showed a uniform pattern of delayed intestinal transit. Two of the patients required reoperation and one died. A similar pattern was not seen in patients managed by other methods. Even if leaving the pelvic peritoneum open were to improve the likelihood of primary perineal healing, for which there is no good evidence, the risks are such that the practice must be regarded as unacceptable unless omentum is mobilized to occupy the pelvic cavity.
Abdominal aneurysm in South African Negroes due to intimomedial mucoid degeneration
Authors: Decker G A G , Samson I D , Schmaman A 
Published: March 2007

Abstract
Nine South African Negroes with abdominal aortic aneurysms due to intimomedial mucoid degeneration are described. These occurred in a younger age group than atherosclerotic aneurysms and with a female predominance. The aneurysms are not syphilitic in origin and are unlike atherosclerotic aneurysms. This form of abdominal aneurysm constitutes a distinct entity which is relatively prevalent in South African Negroes and which has hitherto received little or no emphasis and attention.
Phenol lumbar sympathectomy for severe arterial occlusive disease in the elderly
Authors: Keane F B V 
Published: March 2007

Abstract
Phenol chemical lumbar sympathectomy is an additional aid in the management of ischaemic rest pain and incipient gangrene. This technique was used in 132 elderly patients in Bath between September 1972 and March 1975 and the results are presented here. The patients were unfit for reconstructive arterial surgery. In this series an image intensifier was used in order to make the procedure safer.
One hundred and twenty-six patients were available for review, their average age being 71·5 years. The average period of follow-up was 16·3 months. Of the 126 patients, 111 were not diabetic, and of these 45 (41 per cent) had satisfactory results while 17 (15·4 per cent) had persistent symptoms but had avoided amputation. Thirty (27 per cent) patients required amputation and 12 of these died as a direct result of this procedure. A further 19 patients in the non-diabetic group died during the period of follow-up.
However, of the 15 diabetic patients, only 3 (20 per cent) improved whilst one patient with persistent symptoms avoided amputation. The remainder either died (8) or had an amputation (5) during the period of fellow-up. Two died after amputation.
Submucosal arterial malformation of the stomach as the probable cause of recurrent severe haematemesis in a 16-year-old girl
Authors: Gough Malcolm H 
Published: March 2007

Abstract
A 16-year-old girl who had previously been in good health suffered recurrent life-threatening haematemesis. The cause of this bleeding appeared to be the spontaneous rupture of an abnormally large submucosal artery in the stomach. The site of bleeding was eventually localized by coeliac angiography via an indwelling percutaneous femoral catheter.
Congenital anal duplication: A cause of para-anal sinus
Authors: Tagart R E B 
Published: March 2007

Abstract
Four cases of recurring para-anal sinus originating, it is suggested, as congenital duplication of the anal canal, are described. The diagnosis depends upon the finding of columnar mucus-secreting epithelium in a sirus? ack which does not communicate with the bowel lumen. The sinus may or may not penetrate the levator ani muscle. Treatment should be by excision of the sinus, rather than by laying it open into the anal canal. If the sinus is superficial, the latter operation will result only in delayed healing and prolonged convalescence, but if it runs deep, there is a danger, of causing incontinence or an extra-sphincteric fistula. Untreated lesions may eventually be the site of malignant change. This complication was not encuntered in the present series.
Inhibition of plasma cyclic AMP, glucose and cortisol response to surgery by epidural analgesia
Authors: Madsen Stig Nistrup , Brandt Mogens R , Engquist Allan , Badawi Ibrahim , Kehlet Henrik 
Published: March 2007

Abstract
Cyclic AMP, glucose and cortisol in plasma were measured in three groups of patients undergoing hysterectomy. The operations were performed under general anaesthesia, under general anaesthesia combined with epidural analgesia and under epidural analgesia alone.
Surgery elicited a significant rise in plasma cyclic AMP, glucose and cortisol when performed under general anaesthesia alone. Epidural analgesia extending from T4–6 to S5 combined with general anaesthesia abolished the rise in cyclic AMP and reduced the increase in glucose and cortisol and epidural analgesia alone extending from T4 to S5 blocked the rise in glucose and cortisol as well as that in cyclic AMP.
The results support the theory that afferent nerve impulses from the area of trauma are of major importance for the catabolic state induced by surgical procedures and indicate that anaesthetic management which includes blockade of afferent nerve impulses from the area of trauma can reduce the catabolic response to surgery. These observations could be of value in the operative management of patients with diabetes mellitus and possibly in other groups of patients with a high surgical morbidity.
Knot properties of surgical silk: Model study
Authors: Holmlund D E W 
Published: March 2007

Abstract
The knot properties of surgical silk of different dimensions and from different manufacturers have been studied. Large variations were found. It is proposed that the differences are due mainly to the braiding technique. Only very few surgical silk sutures can be securely tied with a square (reef) knot today. A knot with three square throws is therefore recommended for modern surgical silk.
A non-invasive test of gastric function
Authors: Taylor T V , Bone D , Torrance Bruce 
Published: March 2007

Abstract
Using 99Tcm a non-invasive test of gastric function has been developed which completely obviates the need for a nasogastric tube and which adds to the accuracy of existing tests by overcoming losses due to incomplete aspiration or gastric emptying. 99Tcm is handled by the stomach like Cl−, the gastric secretion of which is equal to that of H+. The value of the pentagastrin stimulation test in the presence of varied gastric pathology is discussed in relation to 50 patients. Other possible diagnostic uses of the test are evaluated and a method of carrying out an insulin test by a modification of the technique is described.
Postoperative pulmonary perfusion defects: their natural history, origin and significance
Authors: Knight M T N , Metrewelli C 
Published: March 2007

Abstract
Unmatched perfusion defects occur during the early postoperative period. These defects can persist until the tenth postoperative day and their presence is not related to the transfusion of blood or to peripheral thrombosis detected by the 125I-labelled fibrinogen uptake test. It is suggested that prophylactic agents against deep venous thrombosis should be evaluated by using a combination of krypton ventilation-perfusion lung scans and 125I-labelled fibrinogen leg scans.
Varicocele: A review of radiological and anatomical features in relation to surgical treatment
Authors: Hill J T , Green N Alan 
Published: March 2007

Abstract
The patterns of venous drainage of the testis and scrotum have been evaluated in patients with varicocele by a variety of radiological procedures, including left renal venography, and at the time of operation by ascending venography and retrograde injection of contrast medium into prominent varicosities. These studies have allowed classification of the system of veins involved in the condition into several groups, including involvement of the internal spermatic vein alone, pure cremasteric varicocele, mixed internal spermatic and cremasteric varicosities in one or both systems with valvular incompetence or mere dilatation without apparent incompetence of valves. As a result, an anatomical approach to the surgical management of varicocele is suggested which attempts to place the operative treatment on a more rational basis appropriate to each case.
Alpha-adrenergic blockers in prostatism
Authors: Boreham P F , Braithwaite P , Milewski P , Pearson H 
Published: March 2007

Abstract
Thirty patients awaiting prostatectomy with no history of cardiovascular disease were selected for a trial of alpha-adrenergic blocking agents. Twenty-seven patients completed the trial, 19 of them with unpleasant side effects. Eighteen of them found their symptoms were improved and 10 showed urodynamic improvement.
Neoplasms at the site of ureterocolic anastomosis
Authors: Mogg Richard A 
Published: March 2007

Abstract
This paper discusses one of the more uncommon sequelae of ureterocolic anastomosis, namely the formation of tumours at the site of anastomosis. This is a very rare complication and until 1971 the literature recorded only 28 cases of this phenomenon. This present communication adds 2 more cases to the literature—a unilateral tumour and bilateral tumours at the site of anastomosis.
Closure of a loop colostomy by a modified Le Gac's operation
Authors: Qvist George 
Published: March 2007

Abstract
The results of closure of a loop colostomy presented by various authors are reviewed. It is suggested that postoperative faecal fistula is due most frequently to oedema and constriction at the site of bowel closure. Le Gac's method of closure is described. It comprises excision of the stoma and spur with side-to-side as well as end-to-end anastomosis, and it results in a wide lumen closure. A modified Le Gac's operation is described in which the mesocolic spur is not removed.
T cells and protein nutrition in hospitalized surgical patients
Authors: Warren Judith V , Hill G L 
Published: March 2007

Abstract
Percentage and number of T cells in peripheral blood and several indices of protein nutrition were assessed in a random sample of 51 hospitalized surgical patients.
Whole blood counts of the patients' lymphocytes and E rosette tests (after separation of lymphocytes from whole blood on Ficoll-Metrizoate) showed no difference from a control group of well-nourished people attending hospital for minor complaints. In general there was no consistent relationship between the level of protein nutrition and low T cell numbers, except for 5 malnourished patients tested less than 1 week after major surgery.
Although a group of 11 patients who fulfilled the criteria for ‘malnutrition’ had normal T cell numbers, the percentage of T cells was significantly higher and the number of total lymphocytes was significantly lower than in the controls.
Effect of selective gastric vagotomy on histamine concentration in gastric mucosa of patients with duodenal ulcer
Authors: Troidl H , Rohde H , Lorenz W , Häfner G , Hamelmann H 
Published: March 2007

Abstract
In a prospective controlled trial, histamine concentrations in human gastric mucosa were determined fluorometrically in 23 patients 6–11 months after selective gastric vagotomy with drainage and in patients who had undergone other types of operation for duodenal ulcer. The study was in two parts: part 1, a synchronous investigation of mucosal histamine concentrations in patients who had undergone vagotomy, in duodenal ulcer patients before operation and in control subjects; part 2, a consecutive study of the same patients before and after vagotomy.
In part 1, patients with Hollander-negative vagotomy were found to have significantly higher mucosal histamine concentrations than ‘healthy’ control subjects or duodenal ulcer, however, had as low mucosal histamine concentrations as duodenal ulcer patients who had not been operated on. In part 2, all duodenal ulcer patients showed an increase in gastric mucosal histamine concentration after vagotomy (P &lt; 0·01). The smallest increase was in a patient with an incomplete vagotomy. Control patients who were not operated on but who underwent endoscopy and biopsy twice in the period of investigation, did not show any increase in mucosal histamine concentration between the times of the first and the second biopsy. The overall results of selective vagotomy and drainage in this study, with respect both to clinical Visick gradings and to radiological and acid secretory findings, were comparable to those reported by other authors. No significant change in numbers of parietal cells was found after vagotomy. Thus, selective gastric vagotomy with a drainage procedure leads to increased concentrations of histamine in the mucosa of the body of the stomach in man. The mechanism is not clear, but might be through inhibition of histamine release from mast cell stores.
Effect of pyloroplasty on gastric emptying: Long term results as obtained with a labelled test meal 14–43 months after operation
Authors: Binswanger R O , Aeberhard P , Walther M , Vock P 
Published: March 2007

Abstract
The mean gastric transit time (t) and the half-time of gastric emptying (t/2) of a labelled test meal have been studied in 18 patients more than I year after gastrc surgery for peptic ulcer and compared with those in 18 healthy controls.
Of the patients, 6 had undergone proximal gastric vagtotomy alone (PGV), 6 had had proximal gastric vagotomy and pyloroplasty (PGVP) and in 6 truncal vagotomy and pyloroplasty (TVP) had been performed.
The t and t/2 of patients with PGV alone did not differ significantly from the values of the control group. The t and t/2 in patients after PGVP and TVP, however, were significantly lower than in both controls and patients after PGV alone. There was no statistically significant difference between the groups with PGVP and TVP.
The results of this study suggest that the lasting effects of vagotomy operatins on gastric emptying are due to the drainage procedure rather than the vagotomy.
The early diagnosis of non-union of fractures of the tibial shaft by osteomedullography
Authors: Boobbyer G N 
Published: March 2007

Abstract
Osteomedullography (osteomyelography) is a radiographic technique which demonstrates the intraosseous venous circulation. Its use in demonstrating the state of bone healing in fractures of the tibial shaft is described. Its importance lies in the fact that if, 3 months after the initial injury, there is doubt as to the state of union of the fracture, the information gained from osteomedullograhy allows an immediate decision as to the need for bone grafting. Twenty patients with fractures of the tibial shaft were studied. It was demonstrated that 14 patients had established non-union and 6 patients had delayed union.
Arterial anastomoses in renal transplantation
Authors: Mosley J G , Castro J E 
Published: March 2007

Abstract
A consecutive series of 260 renal transplants was analysed to find the outcome of different arterial anastomoses. In 177 cases the renal vessel was anastomosed to the end of the internal iliac artery; 125 per cent developed vascular complications. Thirty-eight of these patients subsequently underwent allograft nephrectomy; none died from haemorrahage.
In 83 patients the renal vessel was anastomosed end to side to the iliac artery, and vascular complications occurred in 14 per cent. Thirty-two patients subsequently underwent allograft nephrectomy; 8 wre associated with severe haemorrhage and 5 of these were fatal.
The emergency surgical management of massive and persistent intestinal haemorrhage due to typhoid fever: A report of 3 cases
Authors: Wong S H 
Published: March 2007

Abstract
The classic approach to the management of intestinal haemorrhage due to typhoid infection has been conservative, with sedation, rest to the intestine, blood transfusion and antibiotics. However, in the event of massive and persistent haemorrhage which does not respond to conservative measures, emergency resection should be considered. Surgical resection by removing the major ulcer-bearing areas will stop the bleeding and the intestine is not friable.
The value of an operative wound swab sent in transport medium in the prediction of later clinical wound infection: A controlled clinical and bacteriological evaluation
Authors: Kelly M J , Warren R E 
Published: March 2007

Abstract
Operative wound swabs taken at 214 transperitoneal operations were examined during the course of three controlled clinical trails to determine the value of transport medium in the carriage of specimens. The use of Stuart's transport medium more than doubled the number of swabs yielding pathogens in the laboratory compared with a control series of duplicate swabs not sent in transport medium. Anaerobes were even more severely affected than aerobes by ‘dry’ carriage. A polyester foam swab was shown to have no advantage over the standard cottonwool variety. Bacteriological swabs from superficial wound fat were shown to be superfluous if a peritoneal wound swab had already been taken. We suggest that operative abdominal wound swabs should not be accepted for processing by a microbiological laboratory unless sent in transport medium.
Wound infection, assessed on the fifth postoperative day, was shown to be related to the result of operative swab culture only when the swab was sent in transport medium. When the operative culture was negative at 48 h, only 1 per cent later became infected. When the operative swabs grew obligate anaerobes alone, 13 per cent became infected–aerobes alone, 23 per cent, and mixed aerobes plus anaerobes, 71 per cent. The growth of mixed aerobes plus anaerobes from the operative swab was a far superior predictive factor for later infection than the degree of operative contamination or the type of operation, and provided a simple, rapid means of identifying a subgroup of patients at high risk (71 per cent) of developing infection who might benefit from planned antibiotic therapy.
The insulin infusion test: a safe procedure?
Authors: de Vries B C , Holtkamp H C , Leeuwerik P J J , Muller H 
Published: March 2007

Abstract
One hundred and thirty insulin infusion tests (dose 0.05 u kg−1 h−1) were carried out in 87 patients with peptic ulcer or after a vagotomy. During the test ECG tracings were taken and blood was sampled for blood glucose and serum potassium determination.
In 31 per cent of the tests electrocardiographic changes were seen. The cardiovascular effects were supraventricular and ventricular ectopic beats, ST-T changes and U waves. In 2 tests there were potentially dangerous arrhythmias.
A significant relationship was seen between ECG abnormalities and the age of the patients. Such a relationship was not present between ECG changes and glucose and potassium values.
It is concluded that the insulin infusion test is probably safer than the conventional Hollander test, but constant monitoring is still required.