bluuebunny/crossref_metadata_2025_split huggingface dataset:
Milk 99Tcm-EHIDA test for enterogastric bile reflux
Authors: Mackie Colin R , Wisbey Malcolm L , Cuschieri Alfred 
Published: March 2007

Abstract
The study and clinical assessment of enterogastric bile reflux has been restricted for want of a simple non-invasive test for its detection and quantification. This paper describes such a test in which biliary excretion scintigraphy has been combined with a milk meal provocation. Two of 10 healthy volunteers studied showed probable reflux of approximately 5 per cent of total initial abdominal field activity. Among 73 patients studied, 37 patients showed definite reflux of up to 47 per cent. Reflux occurred in 19 of 22 post-gastric surgery patients and in 7 of 22 patients with peptic ulcer disease, gastritis or gastro-oesophageal reflux. None of 7 patients with ‘nonspecific’ abdominal pain showed any reflux, but 11 of 22 patients with gallstone disease or previous cholecystectomy showed reflux of up to 35 per cent, including 9 of 11 patients with loss of gallbladder reservoir function.
Early discharge following hernia repair in unselected patients
Authors: Cannon S R , Ralphs D N L , Bolton J P , Wood J J , Allan A 
Published: March 2007

Abstract
The feasibility and safety of early discharge from hospital following inguinal hernia repair in selected patients is well established. The following is an account of 104 unselected patients who presented consecutively to an Inner London hospital with inguinal hernias. The intention was to discharge all patients 48 h after operation, but for a variety of reasons a later discharge day was planned preoperatively in 50. Of the 104 patients, 62 (60 per cent) were discharged on the planned day, but only 23 per cent left hospital 48 h after operation. The factors which accounted for this are discussed. It was possible, however, to discharge over 85 per cent within 5 days of operation.
Radiography of breast biopsy specimens
Authors: Philip John , Harris W G , Rustage J H 
Published: March 2007

Abstract
The radiological features of breast biopsy specimens can be visualized clearly if the specimens are X-rayed in water. This makes it possible to demonstrate on specimen radiographs lesions causing tissue distortions without calcification. By positioning the specimen correctly in water and by obtaining radiographs in two planes, the exact site of a small lesion within a large tissue mass can be demonstrated and the site marked to guide the pathologist to the suspect area.
Infantile hypertrophic pyloric stenosis: A review
Authors: Spicer R D 
Published: March 2007

Abstract
Infantile hypertrophic pyloric stenosis is a relatively common condition and there is some recent evidence that the incidence is increasing in this country. Gastric outlet obstruction is caused by hypertrophy of the pyloric smooth muscle and the clinical presentation is with non-bilious vomiting starting at the age of 3–4 weeks. The diagnosis can usually be made by palpation of the hypertrophied pylorus. Operation has now superseded medical treatment as the treatment of choice but meticulous assessment and correction of fluid and electrolyte imbalance is essential preoperatively. The operation of pyloromyotomy as described by Ramstedt in 1912 is simple and effective, but attention to detail is necessary if minimal morbidity and zero mortality are to be achieved. Untreated, the mortality is high but, after successful treatment, these babies are healthy and normal, so that treatment is both worth while and gratifying. The aetiology is obscure; a polygenic pattern of inheritance has been shown to be a predisposing factor, but the postnatal precipitating factors are less defined. Early hopes that the hormone gastrin might prove to be the key have not been sustained by more recent research, but the role of other gastrointestinal hormones awaits clarification.
A prospective trial comparing a silicone elastomer intravenous cannula (Visis) with a polytetrafluoroethylene cannula (Cathlon)
Authors: Dabir Reza , Moore Peter J , Price Kathrine J , Clark Ronald G 
Published: March 2007

Abstract
Post-infusion phlebitis remains one of the most frequent causes of hospital morbidity with an incidence varying between 13 and 39 percent (1–4). A recent study indicated that a silicone elastomer cannula (Visis) had desirable properties (5). We have carried out a prospective trial comparing the value of such a cannula with a Teflon cannula (Cathlon) already in routine use.
Colloid osmotic pressure and serum albumin following surgery
Authors: Moore P J , Clark R G 
Published: March 2007

Abstract
The fall in serum albumin which occurs after operation can be modified by an intraoperative infusion of 20 g salt-poor human albumin, and the associated fall in colloid osmotic pressure is also corrected. There is a decrease in postoperative oliguria following a colloid infusion but no significant effect has been demonstrated on urinary sodium excretion. The alteration of fluid and electrolyte metabolism after surgery does not appear to be a direct effect of lowered plasma colloid osmotic pressure. It is suggested that the effect of intraoperative albumin infusion is predominantly haemo-dynamic.
Rectal strictures associated with the intra-uterine contraceptive device
Authors: Rogers K , Hughes L E 
Published: March 2007

Abstract
Two cases of stricture of the mid-rectum following extensive pelvic cellulitis due to the use of an intra-uterine contraceptive device (IUCD) are presented. The resulting dense circumferential extrarectal strictures failed to respond to treatment by proximal colostomy and antibiotic therapy and required difficult corrective resection. These are contrasted with an example of the more common upper rectal strictures associated with intraperitoneal sepsis of gynaecological origin, in this case pyosalpynx. Circumferential and transmural spread of inflammation tends to be limited by peritoneal reaction and the resulting strictures (which may be radiologically as severe as those in the mid-rectum) are often readily managed by simple removal of the source of infection. Thus, it appears that simple anatomical factors may be responsible for the differing pathologies seen in the two sites, and different management problems encountered within the two types of strictures.
The pattern of metastatic disease in patients with pleural effusions secondary to breast cancer
Authors: Fentiman I S , Rubens R D , Hayward J L 
Published: March 2007

Abstract
The pattern of pleural metastases in women with effusions secondary to breast cancer was evaluated by thoracoscopy in a series of 46 patients with previously untreated effusions. Metastases involving the visceral pleura were seen in 59 per cent of patients wheras parietal deposits were found in only 15 per cent. No tumour deposits were seen in 26 per cent of cases. No patients had both visceral and parietal tumour secondaries. Patients within each of these groups showed differences in rates of positive effusion cytology, chest wall recurrence and previous evidence of recurrent breast cancer.
Acute complications of metastatic melanoma to the gastrointestinal tract
Authors: Klausner J M , Skornick Y , Lelcuk S , Baratz M , Merhav A 
Published: March 2007

Abstract
The gastrointestinal tract is a favoured site for metastatic melanoma. Complications such as obstruction, bleeding or perforation should be alleviated by surgery in order to improve the patient's condition for further systemic therapy. Six patients with melanoma involving the gastrointestinal tract are presented: 3 were operated upon for metastatic lesions in the small bowel causing intussusception, 2 patients were treated for perforation of the small bowel and 1 patient with massive bleeding from metastatic melanoma in the stomach underwent gastrectomy. Two of the patients are alive 6 months and 4 years respectively after these operations. The other 4 survived between 6 months and 2 years.
The effect of prophylactic heparinization on the venous blood flow using the Doppler ultrasonic flowmeter
Authors: Barsoum Maged Sami , Boulos Fathi Iskander , Ramzy Adel Fouad , Nassef Amir Imam , Aly Abdel Moatty Hussein , Farag Adel Naguib 
Published: March 2007

Abstract
The effect of prophylactic heparinization on the postoperative venous blood flow was prospectively studied in 100 lower limbs of 50 patients. Patients were randomized into two groups of 25 patients each: a control group and a heparin group. Changes in the venous blood flow were monitored using the Doppler ultrasonic flowmeter. The study illustrated the protective role of prophylactic heparinization in maintaining a near normal venous blood flow after surgery. The postoperative reduction in venous blood flow in heparinized patients was significantly less than the decrease in blood flow in non-heparinized patients during the same postoperative period. This significant difference between the two groups of patients applied to the steady and the augmented blood flow rates.
The beneficial role of prophylactic heparinization was shown to act significantly in patients undergoing minor surgery, in obese subjects and in those suffering malignant disease. Patients undergoing major surgery also benefited significantly from prophylactic heparinization apart from their steady venous blood flow during the first postoperative day.
Treatment of persistent perineal sinus with vaginal fistula following proctocolectomy for Crohn's disease
Authors: Ward M W N , Morgan B G , Clark C G 
Published: March 2007

Abstract
The utilization of a myocutaneous flap based on the gracilis muscle is described in two patients who had a persistent perineal sinus following proctocolectomy for Crohn's disease. In each case the posterior vaginal wall had eroded to form a fistula. This flap provided a cutaneous surface with good sensation to replace the posterior vaginal wall and tissue bulk to fill the excised cavity. A good functional result was obtained in each patient. This technique provides a useful contribution to the management of this unusual complication.
A simple parameter for accurate detection of severe carotid disease
Authors: Knox R A , Breslau P J , Strandness D E 
Published: March 2007

Abstract
The value of the ratio of the peak systolic velocity in the internal carotid artery to the end diastolic velocity in the common carotid artery in quantifying the severity of carotid arteriosclerosis has been investigated in 86 diseased vessels and 30 normal vessels. The ratio permitted gradation of disease into 60 per cent stenosis and greater with 95 per cent accuracy, 65 per cent stenosis and greater with 97 per cent accuracy and greater than 90 per cent stenosis with 100 per cent accuracy. The values for 30 normal sides studied fell below those of the 60 per cent stenosis group. The ratio has a value in predicting the severity of disease in the internal carotid artery in those with a 60 per cent stenosis and greater.
The causes and prevention of intestinal adhesions
Authors: Ellis Harold 
Published: March 2007

Abstract
Although intestinal obstruction from intra-abdominal adhesions is a relatively common surgical emergency, the vast majority of adhesions are harmless and may be protective or even life-saving. The causes of intestinal adhesions are presented, and various methods advocated to prevent adhesions are discussed. The surgeon is advised to reduce unnecessary adhesion formation by meticulous surgical technique, control those adhesions which inevitably form to obtain their beneficial effects, and to avoid the risk of subsequent obstruction.
Radical restorative surgery for poorly differentiated carcinoma of the mid-rectum
Authors: Elliot Michael S , Todd Ian P , Nicholls R J 
Published: March 2007

Abstract
A retrospective study was made to compare the results of restorative surgery with those of total rectal excision in the treatment of patients with a poorly differentiated adenocarcinoma of the middle third of the rectum (between 8 and 12 cm from the anal verge). Of 1163 patients presenting between 1963 and 1975, 42 with poorly differentiated tumours at this level were followed up after treatment by a radical (i.e. curative) operation. Twenty-eight underwent total rectal excision and 14 anterior resection. Examination of the preoperative biopsy correctly established the histological grade in 17 (40 per cent) of 42 cases. Pathological examination of the resected specimens showed a slightly higher proportion of Dukes' C2 tumours and those with venous invasion removed by total rectal excision, but the extent of local spread among tumours removed by either operation was similar.
There was no operative mortality. Ten out of 28 patients treated by total rectal excision (36 per cent) and 6 out of 14 treated by anterior resection (43 per cent) were alive at 5 years. One patient developed a histologically proved local recurrence after anterior resection; no other proved local recurrence was recorded. It would appear, therefore, that where radical surgery is possible, anterior resection offers as good a prospect of cure as total rectal excision for poorly differentiated tumours of the mid-rectum.
Local recurrence after low anterior resection using the staple gun
Authors: Hurst P A , Prout W G , Kelly J M , Bannister J J , Walker R T 
Published: March 2007

Abstract
Eleven early anastomotic recurrences have occurred after 34 low anterior resections for carcinoma of the rectum performed during the past 2 years using the EEA staple gun. These recurrences all occurred after resection of locally advanced tumours and caused distressing symptoms, and it is suggested that this technique might be best reserved for more favourable growths.
Gallium-67 scanning in patients with Crohn's disease: An aid to the diagnosis of abdominal abscess
Authors: Holdstock Greg , Ligorria J E , Krawitt E L 
Published: March 2007

Abstract
Gallium-67 scans correctly distinguished abdominal abscess from mural inflammation in 6 patients with Crohn's disease in whom abscess was suspected. Interpretation of the 48-h scan proved easiest and was aided by the use of bowel preparation to remove marker from lumen of the gut.
Gastric blood flow, mast cell degranulation and micromorphology of gastric mucosa following experimental haemorrhagic shock in dogs
Authors: Kokoschka R , Göber I , Gebhart W 
Published: March 2007

Abstract
Ischaemia of the gastric mucosa in haemorrhagic shock appears to be one of the principal factors underlying acute bleeding from the upper gastrointestinal tract. In the present experimental study on dogs the changes of blood flow in the upper gastrointestinal tract were recorded by direct flow measurement in the pertinent vessels. Fourteen mongrel dogs were subjected to haemorrhagic shock lasting for 3 and 4 h. A decline of 46 per cent cardiac output was observed while coeliac artery blood flow decreased by 40 per cent and gastric artery blood flow by 60 per cent. All stages of stress ulcers were documented by light and electron microscopy. In addition, pronounced degranulation of mast cells preceding major tissue damage was observed. In the light of these findings a cascade of events is thought to be present resulting in the development of stress ulcer.
Laparoscopy in the prevention of unnecessary appendicectomies: A prospective study
Authors: Deutsch Alexander A , Zelikovsky Avigdor , Reiss Raphael 
Published: March 2007

Abstract
More than one-third of all appendicectomies are unnecessary. A study was directed towards reducing the misdiagnosis of appendicitis, thus preventing needless operations. Thirty-six women in the fertile age group and with a diagnosis of appendicitis were subjected to laparoscopy before surgery. All women had undergone a gynaecological examination to rule out disease of the female genitalia. As a result of the laparoscopy, surgery was cancelled in one-third of the cases, which were found to have acute gynaecological disease not requiring surgery.
The consequences and effectiveness of intubation in the palliation of dysphagia due to benign and malignant strictures affecting the oesophagus
Authors: Pfleiderer A G , Goodall P , Holmes G K T 
Published: March 2007

Abstract
In a study of 66 patients intubated to relieve dysphagia, 52 (79 per cent) survived the procedure and were discharged home. Of these, 23 (44 per cent) developed further dysphagia due to tube dysfunction, and 19 patients (37 per cent) were readmitted for further procedures to restore swallowing. With early intervention, the periods of dysphagia were short and the palliation so achieved was effective. Overall, intubation proved to be an effective method of relieving dysphagia in patients unsuitable for curative treatment.
Ileal pelvic reservoir: A correlation between motor patterns and clinical behaviour
Authors: Rabau M Y , Percy J P , Parks A G 
Published: March 2007

Abstract
An attempt has been made to correlate motility patterns of the pelvic ileal reservoir with patients' clinical experience. In order to evaluate the motility characteristics of the ileal reservoir, we have related its behaviour to the motility pattern observed in ileum proximal to an ileostomy. Seven patients with an ileostomy and 11 patients with a pelvic ileal reservoir have been investigated. The ileum and ileal reservoir were found to behave similarly during the fasting state and in response to distension and eating; however, a quantitative functional difference was discovered. Distension with 30 ml was enough to produce forceful contractions in the normal ileum, while a mean of 322 ml was necessary to initiate similar activity in the ileal reservoir. The ileal reservoir thus behaves as a capacitance organ with the ability to distend without contraction before a considerable volume has accumulated within it. When it does contract, it initiates a sensation of impending evacuation, but escape of ileal content is opposed by active contraction of the intact external anal sphincter.
The clinical staging of rectal cancer
Authors: Nicholls R J , Mason A York , Morson B C , Dixon A K , Fry I Kelsey 
Published: March 2007

Abstract
The ability of rectal digital examination to recognize significant stages of local extent and lymph node involvement in adenocarcinoma of the lower two-thirds of the rectum was investigated. Seventy patients with a palpable rectal cancer were examined by 2 or 3 out of a panel of 10 clinicians including 2 consultants and 8 registrars. A defined protocol was used and the results were recorded on a proforma. Clinical findings were compared with the results of pathological examination of the resected specimen or the final surgical assessment when the growth was not removed. In 38 patients computed tomography of the primary growth was performed and the results were also compared to the pathological findings. Four groups of cases with different degrees of extent of spread were recognized by digital examination in 67–83 per cent by consultants and in 44–78 per cent by registrars. Computed tomography correctly identified growths with extensive local spread in 89 per cent of cases, but was no more reliable than digital examination in the assessment of other degrees of spread or of lymph node involvement.
Based on the results, a clinical staging system is proposed, comprising four stages of local extent as follows—stage 1: confined to rectum; stage 2: confined to rectum or slight extrarectal spread; stage 3: moderate or extensive extrarectal spread; stage 4: involvement of other organs or unresectability. Two stages of lymph node involvement are also proposed: namely, node negative and node positive. Each stage corresponds to different survival and local recurrence rates after surgery. Combined with other factors, such as level and size of tumour, histological grade and the general state of the patient, the clinical staging system may facilitate the choice of treatment. It might extend the use of major sphincter-saving procedures, indentify many patients suitable for local treatment and define those with a considerable risk of local recurrence where combined surgery and radiotherapy might be considered.
Fatigue and cardiorespiratory function following abdominal surgery
Authors: Christensen T , Bendix T , Kehlet H 
Published: March 2007

Abstract
Subjective feelings of fatigue were assessed before operation and 10, 20 and 30 days after uncomplicated elective abdominal surgery in 16 otherwise healthy patients, using a constructed fatigue scale model. In addition, all patients had an orthostatic stress test performed at the same times. Six of the patients also underwent a bicycle ergometer test measuring heart rate and oxygen consumption. Subjective feelings of fatigue were increased (P&lt;0·01) at all three postoperative observations, and only 5 of 16 patients returned to their preoperative level. The increased subjective feeling of fatigue correlated positively (Rs = 0·53, P&lt;0·001) with the increased pulse rate seen during orthostatic stress after operation. Heart rate was about 5 per cent higher (n.s.) after operation when bicycling at the same work loads, while oxygen consumption decreased by about 2 per cent (P&lt;0·01) at all three postoperative bicycle tests. It is concluded that even elective uncomplicated abdominal surgery is followed by a pronounced feeling of fatigue, which may persist 1 month after surgery in about one-third of patients. The fatigue scale model seems applicable for future studies on the pathogenesis and treatment of the postoperative fatigue syndrome.
Diagnostic features of early high post-laparotomy fever: A prospective study of 100 patients
Authors: Le Gall J R , Fagniez P L , Meakins J , Buisson C Brun , Trunet P , Carlet J 
Published: March 2007

Abstract
To define the most important diagnostic signs, symptoms and laboratory findings related to intra-abdominal sepsis in the early post-operative period, 15 binary variables were prospectively assessed in 100 febrile (&gt; 39 °C) post-laparotomy patients admitted to an intensive care unit. Intra-abdominal sepsis was found alone in 55 patients and in association with an extra-abdominal focus in 11 patients. Fever was related to an extra-abdominal septic focus in 23 patients and no infectious cause was found in 11. Analysis (χ2) indicated that 6 of the 15 variables were significantly associated with an intra-abdominal focus of infection. The predictive value of each variable, indicated by relative risk, ranked the six variables in order of diagnostic importances: no bacteraemia (1·67), leucocytosis (1·60), ileus (1·50), mental disturbances (1·41), contaminated first laparotomy (1·38), abdominal tenderness (1·22). The absence of bacteraemia was the most important finding separating intra- and extra-abdominal foci of infection. In a febrile post-laparotomy patient with any evidence of sepsis, the absence of bacteraemia should not lull the physician into a false sense of security but rather alert him to the likelihood of an intra-abdominal septic focus.
Does calcitonin cause hypocalcaemia after thyroidectomy?
Authors: Sawers J S A , Kellett H A , Brown N S , Beckett G J , Seth J , Sinclair I S R , Toft A D 
Published: March 2007

Abstract
Plasma calcitonin, parathyroid hormone, total thyroid hormones and calcium were measured in 6 patients before, during and after thyroidectomy for hyperthyroidism. In 4 patients, plasma calcium fell postoperatively by 0·23–0·46 mmol/l, but there was no change in calcitonin or parathyroid hormone levels. In one patient, in whom there was a postoperative fall in plasma calcium of 0·55 mmol/l, thyroid hormones rose to a peak at 1 h and calcitonin to a peak at 12 h after resection. However, the rise in calcitonin occurred 8 h after the initial decrease in plasma calcium. In this patient, parathyroid hormone levels showed a slight rise only. It is concluded that, while thyroid hormones and calcitonin may leak from the damaged thyroid remnant after surgery, it is unlikely that calcitonin is important in the production of postoperative hypocalcaemia. However, impaired parathyroid hormone secretion may be a contributing factor.