bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent varicose veins: Correlation between preoperative clinical and hand-held Doppler ultrasonographic examination, and anatomical findings at surgery
Authors: Bradbury A W , Stonebridge P A , Ruckley C V , Beggs I 
Published: March 2007

Abstract
A consecutive series of 118 patients (148 legs) presenting with recurrent varicose veins underwent preoperative clinical and hand-held Doppler ultrasonographic examination by a single observer. The presence of saphenofemoral, mid-thigh perforator and saphenopopliteal reflux was noted. Ultrasonography markedly improved the accuracy of clinical assessment at all three potential sites of reflux compared with operative findings. Of 71 patients undergoing repeat groin dissection, only 20 (28 per cent) had a tied saphenofemoral junction, 31 (44 per cent) had intact major tributaries and 52 (73 per cent) had an intact long saphenous vein (LSV) in the thigh. There was a positive association between mid-thigh perforator reflux giving rise to recurrent varices and the presence of an intact LSV in the thigh. Of 45 legs with saphenopopliteal reflux, only four had previously undergone saphenopopliteal ligation, suggesting that most short saphenous varicosities had either appeared after or had not been recognized at the time of primary surgery. This study indicates that even an experienced vascular surgeon can have difficulty in assessing the presence or absence of recurrent deep to superficial reflux by means of clinical examination alone and that Doppler ultrasonographic examination is mandatory. Recurrence continues to be associated with persistent or recurrent incompetence at the site of previous inadequate surgery.
Cytodiagnosis of breast disease using a liquid suspension medium
Authors: Ross D A , Cunningham S C , Vincenti A C , Rainsbury R M 
Published: March 2007

Abstract
Fine-needle aspiration cytology specimens from 187 breast lesions were processed using conventional slide cytology. Results were compared with those from 201 lesions prepared using a liquid suspension medium (Cytospin) for specimen collection, to assess the clinical utility of each technique. The frequency of diagnostic groups was similar for each method. No significant difference was found in sensitivity (conventional slide cytology 86 per cent versus Cytospin 82 per cent), specificity (72 versus 82 per cent) or diagnostic accuracy (88 versus 91 per cent). The Cytospin technique compares favourably with conventional slide cytology and can be recommended for ease of use in breast cytodiagnosis.
Erythromycin improves emptying of the denervated stomach after oesophagectomy
Authors: Hill A D K , Walsh T N , Hamilton D , Freyne P , O'Hare N , Byrne P J , Hennessy T P J 
Published: March 2007

Abstract
Oesophagectomy, necessitating vagotomy, is associated with delayed gastric emptying. Cisapride and erythromycin have prokinetic effects and improve emptying of the innervated stomach. Their effect on the denervated stomach following oesophagectomy is unknown. The effect of pyloroplasty, cisapride and erythromycin on the rate of gastric emptying after oesophagectomy was studied using a radiolabelled meal. Oesophagectomy was associated with a marked delay in gastric emplying (56 per cent of the test meal remaining after 4 h) compared with age- and sex-matched normal controls (16 per cent; P &lt;0.001). Erythromycin improved the rate of gastric emptying to preoperative control values (18 per cent). Cisapride had no significant effect on gastric emptying. After pyloroplasty, 32 per cent of the label remained at 4 h (P = 0.065). The mean(s.e.m.) half-emptying time in patients receiving erythromycin was 94(29) min, which was similar to control values, 55(3) min (P = 0.26). Erythromycin may have a role in the treatment of gastric stasis following oesophagectomy or truncal vagotomy.
Pattern and surgical treatment of gastric cancer in Singapore
Authors: Ti T K 
Published: March 2007

Abstract
A personal series of 150 patients with gastric cancer operated on over an 11-year period in Singapore is reviewed. Cancer occurred in the antrum and/or body of the stomach in 117 patients and in the cardia in 33. Gastric tumours were well or moderately differentiated adenocarcinoma in 50 patients and poorly differentiated or signet ring cell carcinoma in 100. Surgical resection was performed on 115 patients, in whom it was palliative in 47. Attempted cure by R2 radical resection was performed in 68 patients: 14 with stage I, 12 with stage II and 42 with stage III disease. There was no operative death in these 68 patients. In 82 patients operated on more than 5 years ago, five patients with carcinoma of the cardia and 28 with cancer of the gastric antrum and/or body underwent curative resection. There were 12 known 5-year survivors among the latter 28 patients; 16 of the 28 had stage III disease, six of whom survived 5 years. These results compare favourably with those of an earlier report from Singapore in which there were no 5-year survivors. The improved results probably accrue from earlier diagnosis and the current policy of radical resection.
Orthotopic liver transplantation for hepatic complications of Wilson's disease
Authors: Rela M , Heaton N D , Vougas V , McEntee G , Ganet E , Farhat B , Chiyende J , Mieli-Vergani G , Mowat A P , Portmann S , Williams R , Tan K C 
Published: March 2007

Abstract
Thirteen orthotopic liver transplantations were performed in 12 patients for hepatic complications of Wilson's disease between May 1988 and July 1992. Ten patients had fulminant hepatic failure and two chronic liver disease. One patient underwent retransplantation for liver abscess secondary to hepatic artery thrombosis. Nine patients survive at a median follow-up of 18 (range 6–31) months. Three patients have died: two from multiple organ failure and sepsis, one from B cell lymphoma. Postoperative complications included bleeding requiring laparotomy in two patients, renal impairment in five, bacterial septicaemia in three, fungal sepsis in two and acute cellular rejection in six. The nine surviving patients are well with normal liver function test results.
Prophylactic use of cefuroxime in biliary tract surgery: Randomized controlled trial of single versus multiple dose in high-risk patients
Authors:   Galant Trial Study Group, Meijer W S , Schmitz P I M 
Published: March 2007

Abstract
To assess the efficacy of a single-dose short-acting antibiotic in the prevention of septic complications after biliary surgery, a randomized controlled double-blind multicentre trial was conducted. One dose of cefuroxime before operation (1.5 g intravenously) was compared with a three-dose regimen of the drug as control (1.5 g before and two doses of 0.75 g after operation). The study group comprised 1004 patients with risk factors for infection, who were followed for 4–6 weeks after surgery. The characteristics of both treatment groups were comparable. No significant difference was found between the one- and three-dose antibiotic regimens in preventing postoperative wound infection: 6.6 versus 6.2 per cent for minor wound infection (P = 0.78) and 4.6 versus 3.8 per cent for minor wound infection (P = 0.52). The estimated difference in major wound infection rate between the two groups was 0.8 per cent (95 per cent confidence interval −1.7 to 3.3 per cent).
Pouch–vaginal fistula
Authors: Groom J S , Nicholls R J , Hawley P R , Phillips R K S 
Published: March 2007

Abstract
Between January 1976 and June 1991, 161 women underwent restorative proctocolectomy. Seventeen (10.6 per cent) developed pouch-vaginal fistula. There was no difference in the incidence of inflammatory (15 of 141; 10.6 per cent) and non-inflammatory (two of 20; 10 per cent) disease, the severity of colitis or the number of stages in the operation. In 15 patients the fistula involved the ileoanal anastomosis; in two it had possibly occurred at the dentate line. There was no significant difference in the proportion of hand-sewn (ten of 120; 8.3 per cent) and stapled (seven of 41; 17 per cent) ileoanal anastomosis. Of the 17 women, six had pelvic sepsis in the immediate postoperative period and five had an anastomotic complication. There was no case of Crohn's disease. Three patients developed a pouch-vaginal fistula before closure of the ileostomy. The remaining 14 fistulas occurred a median of 7 (range 1–144) months after closure, Five further patients were referred from elsewhere to give a total of 22 for analysis of treatment and outcome. The fistula developed before ileostomy closure in five patients (group 1) and after closure in 17 (group 2). Following treatment, six fistulas had healed with five patients still undergoing treatment. In group 1, three of the five fistulas healed, whereas in group 2 only three of the 17 healed. Eight patients required excision of the pouch. The prognosis appears to be worse when pouch-vaginal fistula occurs after ileostomy closure. The optimal management is not yet established.
Surgical evaluation at the crossroads
Authors: Pollock A V 
Published: March 2007

Abstract
Surgeons have lagged behind physicians and oncologists in embracing randomized controlled clinical trials. This paper suggests that a complete, accurate and objective comparison of the outcome of a novel intervention with that of a traditional intervention in previous years, or in another surgical group, can yield valuable information and can lead surgeons to improve their practice. There has recently been a decline in the number of randomized controlled trials published in The British Journal of Surgery; this may reflect the unwillingness of many patients to allow their surgical treatment to be decided by chance.
Venous assessment using air plethysmography: A comparison with clinical examination, ambulatory venous pressure measurement and duplex scanning
Authors: Payne S P K , Thrush A J , London N J M , Bell P R F , Barrie W W 
Published: March 2007

Abstract
Air plethysmography was compared with clinical assessment, ambulatory venous pressure measurement and duplex ultrasonography in 103 unselected limbs with venous disease and ten normal control limbs without such disease. Measurements of venous function obtained by air plethysmography showed considerable overlap between groups of limbs classified on the basis of clinical condition or by the presence of popliteal incompetence detected by duplex scanning. The measurement of venous refilling time using air plethysmography correlated poorly with that obtained by venous cannulation (rs = 0·58). The residual volume fraction did not correlate with ambulatory venous pressure measurement (rs = 0·04). Air plethysmography was not found to be as useful as previously reported. The residual volume fraction should not be accepted as a substitute for ambulatory venous pressure measurement, which remains the ‘gold standard’ test of venous function.
Basic fibroblast growth factor accelerates wound healing in chronically ischaemic tissue
Authors: Uhl E , Barker J H , Bondàr I , Galla T J , Leiderer R , Lehr H-A , Messmer K 
Published: March 2007

Abstract
The influence of subcutaneously injected recombinant human basic fibroblast growth factor (bFGF) on wound healing in normal (n = 20) and ischaemic (n = 28) skin tissue was investigated. Standardized wounds (5 mm2) were created on the ears of hairless mice and treated for the first 3 days after wound creation with total doses of 720 ng (n = 24) and 4050 ng (n = 24) bFGF. The bFGF had no effect on wound healing in non-ischaemic tissue. In ischaemic skin, mean(s.d.) wound surface area after treatment with 720 ng bFGF was 1·6(0·9), 0·5(0·6) and 0·1(0·3) mm2 compared with 2·8(1·0), 1·4(1·0) and 0·8(0·7) mm2 for control wounds on days 7 (P &lt;0·04), 10 (P &lt;0·03) and 13 (P &lt;0·04) respectively. High-dose bFGF (4050 ng) reduced the mean(s.d.) wound surface area to 2·4(0·7) and 0·8(0·7) mm2 compared with 3·9(0·6) and 2·1(0·8) mm2 for control wounds on days 7 (P &lt;0·006) and 10 (P &lt;0·02) respectively. These results suggest that bFGF may be of use for the treatment of wounds in ischaemic tissue.
Plantar melanoma in black South Africans
Authors: Hudson D A , Krige J E J 
Published: March 2007

Abstract
The outcome of treatment in 40 black patients (27 women, 13 men; mean age 62·9 years) with plantar melanoma over a 13-year period was analysed to evaluate the efficacy of wide local excision with split skin grafting. Substantial delay in seeking medical attention occurred in 35 patients. At presentation, 20 patients had stage I disease, one stage II, 15 stage III and four stage IV. Acral lentiginous melanoma (27 patients) was the most common histological type. The mean Breslow depth was 6·9 mm and 35 patients had lesions of Clark level IV or V. The mean surface area of plantar lesions was 13·3 cm2. Wide local excision with split skin grafting was used in 29 patients; four patients with neglected advanced plantar lesions had below-knee amputation and seven with metastatic disease did not undergo surgery. Graft sepsis occurred in six patients and local recurrence in two. Nine patients were alive at follow-up; the 5-year survival rate was 25 per cent. Delay in presentation and locally advanced disease may explain the poor prognosis of plantar melanoma in black South Africans.
Prognostic relevance of systematic lymph node dissection in gastric carcinoma
Authors:   German Gastric Carcinoma Study Group, Siewert J R , Böttcher K , Roder J D , Busch R , Hermanek P , Meyer H J 
Published: March 2007

Abstract
In a prospective multicentre study of 2394 patients with gastric carcinoma the prognostic relevance of systematic lymph node dissection was evaluated. Of 1654 patients undergoing resection, 558 had a standard lymph node dissection, defined as fewer than 26 nodes in the specimen, and 1096 underwent radical lymphadenectomy, i.e. 26 or more nodes in the specimen. Radical dissection signficantly improved the survival rate in patients with Union Internacional Contra la Cancrum (UICC) stages II and IIIA tumours. Multivariate analysis identified radical dissection as an independent prognostic factor in the subgroups of patients with UICC tumour stages II and IIIA. Radical dissection conferred no survival advantage in patients with pN2 tumours. There was no significant difference in morbidity and mortality rates between radical and standard lymph node dissection. Radical lymphadenectomy improves survival in patients with UICC gastric cancer stages II and IIIA, and should be the recommended treatment for such patients.
Surgical polypectomy of duodenal adenomas in familial adenomatous polyposis: Experience of two European centres
Authors: Penna C , Phillips R K S , Tiret E , Spigelman A D 
Published: March 2007

Abstract
Between 1978 and 1988, 12 patients with familial adenomatous polyposis (FAP) and severe duodenal polyposis underwent duodenotomy and duodenal polypectomy. The patients were from two separate institutions; all were women, with a mean age of 45·6 (range 25–62) years at the time of duodenotomy. Recurrent duodenal polyposis was detected at endoscopy in all 12 patients, at a mean of 13·3 (range 5–36) months after duodenotomy. All patients had moderate to severe duodenal polyposis at the time of the last endoscopic examination. Local excision of duodenal adenomas is an unsatisfactory treatment option in those with FAP. The ideal management of patients with FAP who have severe duodenal polyposis remains uncertain.
Improved glucose metabolism after subtotal pancreatectomy for pancreatic cancer
Authors: Permert J , Ihse I , Jorfeldt L , von Schenck H , Arnquist H J , Larsson J 
Published: March 2007

Abstract
Diabetes occurs frequently in patients with pancreatic cancer. To investigate the impact of tumour removal, seven patients were studied before and after 85 per cent subtotal pancreatectomy for adenocarcinoma of the pancreas. The frequency of diabetes was determined by the oral glucose tolerance test. Fasting levels of C peptide and insulin were measured in plasma, and insulin secretion was investigated by hyperglycaemic glucose clamp and glucagon stimulation. Six of the seven patients were diabetic before surgery and four required insulin treatment. Improvements in diabetic status and glucose metabolism were found in all seven patients after operation, as demonstrated by increased glucose metabolic capacity during hyperglycaemia. This occurred despite a postoperative reduction in insulin secretion and is explained by the observed augmentation of whole-body insulin sensitivity after surgery. A diabetogenic factor may be produced by pancreatic adenocarcinoma that may be responsible, directly or indirectly, for the high frequency of diabetes in patients with pancreatic cancer.
Effect of antitumour necrosis factor treatment on circulating tumour necrosis factor levels and mortality after surgery in jaundiced mice
Authors: Bemelmans M H A , Gouma D J , Greve J W , Buurman W A 
Published: March 2007

Abstract
Tumour necrosis factor (TNF) may play an important role in the increased incidence of complications after surgery in patients with obstructive jaundice. This study evaluated the effect of three different anti-TNF treatments, a monoclonal anti-TNF antibody (TN3), pentoxifylline and lactulose, on outcome after severe surgical trauma in mice with experimental biliary obstruction. Circulating serum TNF levels and mortality rate were monitored. Severe surgical trauma, such as renal ischaemia, in jaundiced mice resulted in increased levels of circulating TNF (3·5 ng/ml) and a high mortality rate (54 per cent). The three different anti-TNF treatments caused a significant reduction in postoperative levels of circulating TNF (TN3, P &lt;0·001; pentoxifylline, P &lt;0·01; lactulose, P &lt;0·05). Treatment with TN3 and pentoxifylline did not lead to a significantly reduced mortality rate (36 and 44 per cent respectively). Only lactulose treatment produced a significantly reduced mortality rate (7 per cent, P &lt;0·01). TNF is therefore not the only mediator responsible for death after surgery in jaundiced mice. Other mechanisms affected by lactulose are also involved.
Silicone gel breast implants, breast cancer and connective tissue disorders
Authors: Park A J , Black R J , Watson A C H 
Published: March 2007

Abstract
Recent worldwide media speculation that silicone gel-filled breast implants may be linked to an increased incidence of breast and other cancers, and connective tissue disease(particularly systemic sclerosis) has caused concern to the medical profession and public alike. Until carefully controlled studies have been performed to prove the safety of these implants, the US Food and Drug Administration has restricted their use to research and breast reconstruction. Research has so far failed to prove a causative relationship between silicone implants and cancer or connective tissue disorders.
Role of surgery in patients with primary non-Hodgkin's lymphoma of the stomach: An old problem revisited
Authors: Bozzetti F , Audisio R A , Giardini R , Gennari L 
Published: March 2007

Abstract
The literature after 1980 dealing with the treatment of primary gastric non-Hodgkin's lymphoma (stages I and II) is reviewed. Gastrectomy is recommended for patients with acute symptoms at presentation or with complications of chemotherapy or radiotherapy. In elective cases, patients with stage I disease may be candidates for gastrectomy as a single therapy, provided that tumour-free resection margins are achieved. There is no evidence of substantial benefit from adding postoperative chemotherapy or radiotherapy after an apparently radical resection. In stage II disease, the best results are achieved with ablative surgery plus adjuvant therapy. The resection volume should be limited to macroscopically involved structures, in principle avoiding total gastrectomy and extensive lymph node dissection, since residual disease may be optimally controlled with radiotherapy or chemotherapy. Primary chemotherapy, with or without radiotherapy, represents an experimental approach; the advantages of sparing the stomach must be balanced against the toxicity of an aggressive chemotherapy regimen and the risk of emergency operation for iatrogenic complications.
Abdominal aortic aneurysm in the elderly
Authors: Chalmers R T A , Stonebridge P A , John T G , Murie J A 
Published: March 2007

Abstract
Thirty-five patients over the age of 80 years underwent surgery for abdominal aortic aneurysm between January 1985 and December 1990. Of these, 25 had surgery for ruptured aneurysm (mortality rate 56 per cent) and ten had surgery for symptomatic or asymptomatic aneurysm (mortality rate zero). The mortality rate for patients with rupture aged over 80 years was considerably greater than that for those under 80 years of age (56 versus 36 per cent). The mortality rate in the elderly population was zero for elective surgery but in those under 80 years it was 5 per cent. During the study period a prospective analysis of all referrals with aortic aneurysm was carried out, whether or not they underwent surgery and whether or not they were admitted to hospital. The ratio of patients accepted for operation to those not accepted for operation was 92:59 (1·56:1) in the under 80-year-old age group and 12:34 (0·35:1) in those aged over 80 years.
Posterolateral neck dissection: Technique and results
Authors: Plukker J Th , Vermey A , Roodenburg J L N , Oldhoff J 
Published: March 2007

AbstractPosterolateral neck dissection, alone or combined with a modified radical neck dissection, may be an appropriate method of treating occult and clinically manifest nodal metastases of malignant epithelial tumours of the skin of the posterior scalp. The technique and results are described in 21 patients treated between February 1981 and November 1989. Transformation of nodal status from cN0 to pN+ was seen in five of 13 patients treated electively, who may benefit from such a procedure. During a mean follow-up of 47 months the disease was controlled locally in all patients. Three patients suffered regional recurrence of whom only one had a nodal recurrence within the region previously operated on. The results of this limited retrospective study confirm the value of posterolateral neck dissection in posterior scalp lesions.
Staging of supratentorial hemispheric glioma using tumour extension, histopathological grade and extent of surgical resection
Authors: Iacoangeli M , Roselli R , Prezioso A , Scerrat M , Rossi G F 
Published: March 2007

Abstract
A ‘TGS’ classification for supratentorial brain glioma is proposed, based on three parameters: tumour extension (T), histopathological grade (G) and extent of surgical resection (S). Two groups of patients were analysed: the first (n = 137) had tumour submitted to stereotactic biopsy; the second (n = 60) had malignant glioma operated on by craniotomy and tumour resection. All three staging parameters signficantly influenced survival. Histopathological grade was the most significant factor, and the only independent variable on multivariate analysis, followed by extent of tumour and then extent of surgical resection. The data support the applicability of the proposed parameters for a staging classfication of hemispheric brain glioma.