bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vein compliance: A preoperative indicator of vein morphology and of veins at risk of vascular graft stenosis
Authors: Davies A H , Magee T R , Baird R N , Sheffield E , Horrocks M 
Published: March 2007

Abstract
Compliance measurements of 53 long saphenous veins before femorodistal bypass have been performed using a duplex scanner with venous occlusion for distension. These have been compared with the histological features of the veins. There was significantly more moderate or severe focal hyperplasia and circular muscle hypertrophy in distal long saphenous vein than in its proximal counterpart (P &lt; 0.01 and P &lt; 0.05 respectively). The mean (95 per cent confidence interval) compliance of distal vein with moderate or severe hyperplasia was 0.16 (0.13-0.19) compared with 0.29 (0.22–0.36) for that with no, minimal or mild hyperplasia (P = 0.001). The mean compliance of distal vein with moderate or severe muscle hypertrophy was 0.19 (0.17–0.21) and of vein with no, minimal or mild hypertrophy 0.25 (0.21–0.29) (P = 0.14). The mean lowest compliance in seven patients who developed stenosis was 0.10 (0.07–0.13) compared with 0.21 (0.16–0.26) in the rest (P &lt; 0.001). Preoperative measurement of vein compliance can be used to identify vein with marked pre-existing intimal hyperplasia and as a predictor of future graft stenosis.
Reperfusion injury in skeletal muscle: A prospective study in patients with acute limb ischaemia and claudicants treated by revascularization
Authors: Adiseshiah M , Round J M , Jones D A 
Published: March 2007

Abstract
A study was carried out to document the occurrence of rhabdomyolysis and renal complications in patients undergoing vascular reconstruction. Indices of muscle damage and renal function were monitored before, during and for up to 10 days after vascular reconstruction for a variety of conditions ranging from intermittent claudication to acute ischaemia. Seven patients with acute limb ischaemia (group 1) and nine with intermittent claudication (group 2) were studied prospectively. In group 1, median creatine kinase (CK) and myoglobin levels were markedly raised 24–48 h after surgery (CK, 29370 units/l myoglobin, 8.17 mg/l). Myoglobin reached its peak concentration and declined more quickly than CK, but both indices gave similar information about the extent of muscle damage. In contrast, patients undergoing elective surgery for claudication showed no significant departure from reference values for myoglobin or CK. All patients in group 1 underwent fasciotomy to relieve raised compartmental pressures and five were treated with alkali and mannitol to produce diuresis. Despite these measures, two patients suffered renal failure (peak creatinine levels 611 and 590 μmol/l) after successful revascularization and subsequently required haemodialysis; these patients did not have diuresis. One of these patients died following a stroke 8 days after surgery; the other survived and was discharged with a normal limb and restored renal function. There was no evidence of muscle damage or renal complications in group 2. It is concluded that: (1) the risk of muscle damage and renal complications is minimal in patients undergoing elective surgery for intermittent claudication; (2) in patients who present acutely, revascularization after several hours of ischaemia leads to rhabdomyolysis and high levels of circulating CK and myoglobin (despite fasciotomy there was evidence of subsequent muscle damage}; (3} it is not possible to predict which patients will go into renal failure; and (4) in all acutely ischaemic patients there is a risk of renal complications and it is suggested that prophylactic measures, such as an alkaline diuresis and mannitol infusion, be instituted during or before the operation as a matter of course.
Colour-coded duplex ultrasonography in the selection of patients for endovascular surgery
Authors: Vashisht R , Ellis M R , Skidmore C , Blair S D , Greenhalgh R M , O'Malley M K 
Published: March 2007

Abstract
Endovascular surgery using angioplasty or atherectomy may potentially relieve the symptoms of claudicants with minimal morbidity, but results are best when short stenoses are treated. In this study, colour-coded duplex ultrasonography has been compared with angiography. In aortoiliac segments duplex examination had a sensitivity of 88 per cent and a specificity of 100 per cent; infemoropopliteal disease the sensitivity was 100 per cent and duplex scanning identified more disease than angiography. Subsequently, 73 symptomatic limbs with femoropopliteal disease were scanned to assess their suitability for endovascular surgery. Of these limbs, 27 (37 per cent) had suitable lesions and the remaining 46 (63 per cent) were spared angiography. Colour-coded duplex ultrasonography can reliably be used to select patients for endovascular surgery.
Prevalence of lower limb ulceration in an urban health district
Authors: Lees T A , Lambert D 
Published: March 2007

Abstract
Before establishing a community leg ulcer programme, a survey was performed to assess the incidence and prevalence of lower limb ulceration in the Newcastle Health District. The prevalence was 1.9 per 1000 in patients over the age of 45 years, and the annual incidence 3.5 per 1000 in the same age group. Recurrent ulcers represented 47 per cent of the total and 50 per cent of all ulcers had been present for &gt;6 months. District nurses spent 190 h per week in the community dressing leg ulcers, making a total number of 25 922 visits each year. In the treatment of leg ulcers 35 different types of dressing were used and only 14 per cent of ulcerated limbs were treated by appropriate compression. Of all patients with leg ulcers, 35 per cent had been seen by a hospital specialist but only 7 per cent had been examined by a vascular surgeon at any time.
Needle core biopsy of the breast with a spring-loaded device
Authors: McMahon A J , Lutfy A M , Matthew A , Walls A D F , McOrmicky J Stc , Henderson M A , Auld C D 
Published: March 2007

Abstract
Over a 2-year period, 151 outpatients with a palpable breast lump requiring needle core biopsy were randomized to a Tru-Cut 14-G (T14), Bioptycut 14-G (B14) or Bioptycut 18-G (B18) needle. Use of a Biopty gun resulted in less pain than a Tru-Cut needle. An inadequate sample was obtained after two needle passes in 11 of 49 (T14), none of 51 (B14) and two of 51 (B18) patients (X2 = 14.6, 2 d.f., P = 0.0007). Tissue samples were assessed by a single pathologist for tissue volume and overall diagnostic value; the B14 group scored better than the B18 and T14 for both of these parameters (P &lt; 0.003). The sensitivities were 68(T14), 88(814) and 96 (B18) per cent (overall X2 = 7.3, 2 d.f., P = 0.026). The Biopty gun with a 14-G needle results in a higher sampling success rate, greater diagnostic sensitivity and a better specimen quality than the Tru-Cut, and is much easier to use.
Safety of fibreoptic endoscopy: Analysisa of cardiorespiratory events
Authors: Thompson A M , Park K G M , Kerr F , Munro A 
Published: March 2007

Abstract
Cardiorespiratory function during upper gastrointestinal endoscopy and colonoscopy was studied prospectively in 164 patients. Cardiorespiratory events, which were defined as oxygen saturation &lt;90 per cent, electrocardiographs changes, heart rate &lt; 50 or &gt; 100 beats/min and systolic blood pressure &lt;100 mmHg, occurred in 111 patients. In 24 of these, changes were attributed solely to intravenous sedation. In the remaining 140 patients, events were noted in 34 (52 per cent) of 66 upper gastrointestinal endoscopies and during 53 (72 per cent) of 74 colonoscopies. One patient suffered a myocardial infarction during colonoscopy. Although cardiorespiratory events were common (111 of 164; 68 per cent), the actual morbidity rate was low (one of 164; 0.6 per cent). Cardiorespiratory events were significantly more common in patients with a history of cardiac disease for both upper gastrointestinal endoscopy and colonoscopy (overall X2 = 7.41, 1 d.f., P &lt; 0.05) and more common for oesophageal dilatation than for diagnostic endoscopy (X2 = 5.56, 1 d.f., P &lt; 0.05). It is recommended that patients with a history of cardiac problems undergoing upper gastrointestinal endoscopy or colonoscopy and all those requiring therapeutic endoscopy should be monitored carefully to allow early detection of cardiorespiratory events, and that oxygen should be administered routinely.
Barrett's oesophagus: Effect of antireflux surgery on symptom control and development of complications
Authors: Attwood S E A , Barlow A P , Morris T L , Watson A 
Published: March 2007

Abstract
Forty-five patients with histologically proven Barrett's columnar-lined oesophagus (CLO) were treated in one unit over a 9-year period. Patients were studied prospectively as part of a surveillance programme; all initially received standard conservative treatment including high-dose H2-receptor antagonists. A satisfactory initial response was seen in 21 patients, but in 24 the symptoms were unchanged or progressed; 19 patients in the latter group were considered suitable for antireflux surgery and underwent fundoplication. Symptoms of heartburn or dysphagia persisted or recurred in 88 per cent of patients receiving medical treatment alone and complications developed in 38 per cent, including nine strictures and one adenocarcinoma. In patients undergoing antireflux surgery, symptoms persisted or recurred in 21 per cent and complications developed in 16 per cent (P &lt; 0-01). Complete regression of Barrett's CLO occurred in two patients (11 per cent) after antireflux surgery. The results of this study suggest the superiority of antireflux surgery over pharmacological acid suppression in the control of symptoms and prevention of complications in patients with Barrett' CLO.
Psychomotor testing and the ability to perform an anastomosis in junior surgical trainees
Authors: Steele R J C , Walder C , Herbert M 
Published: March 2007

Abstract
Ten junior surgical trainees underwent objective testing of manual dexterity and visuospatial ability and were required to carry out five consecutive anastomoses on fresh porcine jejunum. Anastomoses were scored by a single observer and a cumulative error score (CES) derived for each procedure. In the first anastomosis there was little correlation between the psychomotor test results and the anastomosis scores. In subsequent trials there were significant negative correlations between aspects of manual dexterity and the CES. Over the five anastomoses there were significant negative correlations between improvement and manual dexterity, but there was a positive correlation between improvement and visuospatial ability (rs = 0.76, P &lt; 0.005). Visuospatial skills are more important than pure motor ability in predicting the capacity to perform an anastomosis and tests of manual dexterity may be misleading in this context.
Prospective randomized trial comparing the shouldice technique and plication darn for inguinal hernia
Authors: Kingsnorth A N , Gray M R , Nott D M 
Published: March 2007

Abstract
The lowest recurrence rates after inguinal hernia repair have been achieved by specialized hernia clinics. The Shouldice repair achieves success through application of a meticulous standardized operation carried out by specialist hernia surgeons. In a trial designed to rule out surgeon-dependent variables, 322 inguinal hernias were randomized prospectively to Shouldice repair or plication darn. Fifteen general surgeons operated on 322 patients. Fourteen surgeons in training not familiar with Shouldice repair received constant supervision for six repairs before independent operation. The mean(s.d.) patient age was 58·3(1·5) (range 20·84) years for Shouldice repair and 57·s0(1·2) (range 18·85 years) for plication darn. The sex ratio (M:F) was 17:1 and right side to left side ratio 1.8:1. Six-week complication rates for wound infection (Shouldice repair, 5 per cent; plication darn, 4 per cent) and haematoma (Shouldice repair, 7 per cent; plication darn, 5 per cent) were similar in both groups. There were a similar number of sliding hernias in the Shouldice repair (14) and plication darn (20) groups. After a mean follow-up of 30 (range 24-48) months there were seven recurrences in the Shouldice group and four in the plication darn group (P &gt;0.05). The recurrences suggest that additional supervision of junior surgeons is required during the Shouldice repair learning period.
Role of the rectum in the physiological and clinical results of coloanal and colorectal anastomosis after anterior resection for rectal carcinoma
Authors: Lewis W G , Holdsworth P J , Stephenson B M , Finan P J , Johnston D 
Published: March 2007

Abstract
This study investigated the relationships between length of residual anorectum, anorectal physiological function and clinical outcome after anterior resection for rectal carcinoma. Thirty-four patients were studied a median of 13 (range 4–100) months after anterior resection. They were compared with a control group often patients who had undergone sigmoid colectomy for carcinoma without rectal excision. Resting anal pressure was found to be lower after coloanal than after colorectal anastomosis, and the capacity of the (neo)rectum was less after coloanal than after colorectal anastomosis. The (neo)rectoanal inhibitory reflex was found to be present in each patient, but maximum anal pressure during this “sampling” reflex was significantly lower (P &lt; 0.01) after coloanal than after colorectal anastomosis, and the volume required for maximal inhibition of the sphincter was also less (P &lt; 0.01). At 1 year after operation, median bowel frequency was greater after coloanal (4 per day) than after colorectal (2 per day) anastomosis and the degree of urgency of defaecation was also greater (P &lt; 0.01). Quality of life in terms of anorectal function after anterior resection is thus significantly influenced by the length of rectum that is left. This, in turn, influences the functional capacity of the neorectum and the degree of inhibition of the anal sphincter during the neorectoanal inhibitory reflex.
Survival after hepatic resection for malignant tumours
Authors: Savage A P , Malt R A 
Published: March 2007

Abstract
A retrospective analysis of 194 patients who underwent hepatic resection for primary or metastatic malignant disease from January 1962 to December 1988 was undertaken to determine variables that might aid the selection of patients for hepatic resection. Hepatic metastases were the indication for resection in 126 patients. The 5-year survival rate was 17 per cent. For patients with resected metastases from colorectal cancer (n = 104), the survival rate at 5 years was 18 per cent. The 5-year survival rate was 27 per cent when the resection margin was &gt;5 mm compared with 9 per cent when the margin was ≤5 mm (P &lt; 0.01). No patient with extrahepatic invasion, lymphatic spread, involvement of the resection margin or gross residual disease survived to 5 years, compared with a 23 per cent 5-year survival rate for patients undergoing curative resection (P &lt; 0.02). The survival rate of patients with poorly differentiated primary tumours was nil at 3 years compared with a 20 per cent 5-year survival rate for patients with well or moderately diflerentiated tumours (P not significant). The site and Dukes' classification of the primary tumour, the sex and preoperative carcinoembryonic antigen level of the patient, and the number and size of hepatic metastases did not afect the prognosis. The 5-year survival rate for patients with hepatocellular carcinoma (n = 42) was 25per cent. An improved survival rate was found for patients whose α-fetoprotein level was normal (37 per cent at 5 years) compared with those having a raised level (nil at 3 years) (P &lt; 0.01). Involvement of the resection margin, extrahepatic spread and spread to regional lymph nodes were associated with an 8 per cent 5-year survival rate versus 44 per cent for curative resection (P &lt; 0.005). The presence of cirrhosis, the presence of symptoms, and the multiplicity and size of the tumour did not affect the prognosis. The 5-year survival rate of 11 patients with hepatic sarcoma was 25 per cent. No patient with peripheral cholangiocarcinoma survived to 1 year in contrast to patients with hilar cholangiocarcinoma, all four of whom survived for more than 14 months.
Physiological variation in rectal compliance
Authors: SøRensen M , Rasmussen O ø , Tetzschner T , Christiansen J 
Published: March 2007

Abstract
The volume (V) of air inflated in a latex balloon placed in the rectum and the corresponding pressures (P) were measured in 48 subjects (24 men and 24 women) at three points: (1) earliest defaecation urge; (2) constant defaecation urge; and (3) maximum tolerable volume (MTV). The rectal pressures in all three cases were higher in men than in women. Woman aged over 60 years had higher rectal compliance (ΔV/ΔP) than men in the same age group, while no difference was found between men and women below the age of 60 years. Day-to-day variation of the measurements was tested in ten subjects. Reproducibility was good only for MTV (95 per cent confidence interval 57–183 per cent). Reproducibility of rectal compliance decreased with increasing values for this parameter. No such trend was found for the other parameters. In conclusion, MTV is a reproducible parameter and suitable for clinical use in evaluation of patients with faecal incontinence or constipation.
Mycetoma
Authors: Fahal A H , Hassan M A 
Published: March 2007

Abstract
Mycetoma is a chronic infective condition of tropical and subtropical regions. It is commoner in males, especially those in their third or fourth decade who work on the land. The clinical triad of subcutaneous nodule, sinuses and discharge usually leads to diagnosis; the disease is commonly painless. Treatment is by extensive surgical excision of afected areas and may include limb amputation. Recurrence is common, rates ranging from 20 to 90 per cent. Medical treatment may be used on its own or as an adjunct to surgery. Although such therapy may cure over half of those with actinomycetoma (caused by bacteria, mainly aerobic actinomycetes), those afected by eumycetoma (caused by fungi) have a poorer prognosis and may require many years of drug therapy.
Serotonin-induced contractility in human saphenous vein is inhibited by naftidrofuryl
Authors: Vashisht R , Sian M , Sharp E J , Leathard H L , O'Malley M K 
Published: March 2007

Abstract
Vascular endothelial denudation contributes to vasospasm by causing platelet aggregation und the subsequent releuse of vasoconstrictors such as serotonin. It has recently been suggested that naftidrofuryl fumarate (NFT) may oppose serotonin-induced vasoconstriction. Fourteen rings of human saphenous vein from 14 patients undergoing varicose vein surgery were tested in standard organ bath experiments. Cumulative dose—response curves and maximal Contraction in response to serotonin were recorded and this was repeated in the presence of NFT at 10−6 and 10−3 mol/l. The difference in maximal contractility between the three sets of curves was significant (P &lt; 0.0001). Sensitivity to serotonin in each of the three curues was meusured using the concentration for half-maximal response; differences were again significant (P &lt; 0.0001). It is concluded that NFT reduces serotonin-induced contractility in a dose-dependent fashion in rings of human saphenous vein in vitro. These results suggest a possible role for NFT in reducing vasospasm and support further investigation of this drug.
Laser recanalization versus endoscopic intubation in the palliation of malignant dysphagia: a randomized prospective study
Authors: Carter R , Smith J S , Anderson J R 
Published: March 2007

Abstract
Forty patients with histologically confirmed malignant dysphagia were randomized to either endoscopic intubation or laser recanalization. Age, sex, tumour histology and site were evenly distributed between the groups. Results were analysed on an ‘intention to treat’ basis. All patients treated by laser achieved patency; there was one failed intubation. The best swallowing grade achieved was significantly better with laser recanalization (median 4 (range 3–4)) than with intubation (median 3 (range 2–4)) (P &lt; 0.001). The median survival was 21.5 (range 4–62) weeks in the group receiving laser treatment, compared with 14.5 (range 7–102) weeks in the intubated group (P = 0.09). The median inpatient stay as a proportion of survival time was 14 per cent in the group receiving laser treatment compared with 15 per cent in the intubated group (P &gt; 0.05). The median weight loss was less in the laser-treated patients (2.0 (range 2–8) versus 3.0 (range 0–10) kg, P = 0.04). These results indicate that laser recanalization provides better palliation of dysphagia than does intubation, but this is not reflected in an improvement in survival time.
Closure of laparotomy wounds: skin staples versus sutures
Authors: Ranaboldo C J , Rowe-Jones D C 
Published: March 2007

Abstract
To investigate the routine use of a skin stapling device for the closure of midline abdominal wounds, 48 patients were randomized to receive skin staples or subcuticular polydioxanone sutures. The mean (range) time for closure with staples was 8.0 (3.4–14.8) s cm−1 while subcuticular closure took 12.7 (9.6–28.0) s cm−1. The mean time saved per patient with skin staples was 77s. Wound pain and requirements for analgesia were significantly lower in the sutured group. The mean cost per patient was £ 1.41 for subcuticular closure and £7.72 for stapling; the latter also incurred an additional cost of £6.27 for staple removal. No clear benefit derives from the use of staples in the closure of abdominal wounds.
Significance of intracystic pressure in abdominal hydatid disease
Authors: Yalin R , Aktan A Ö , Yeǧen C , Döşlüoǧlu H H 
Published: March 2007

Abstract
A prospective study was performed in 32 patients (24 female, eight male) with 50 abdominal hydatid cysts, to assess whether intracystic pressure (ICP) could predict viability. The median ICP, measured during operation, was 35 cmH20 for 31 viable cysts and zero for nine non-viable cysts located in the liver (P &lt; 0.05). The median ICP was significantly higher in cysts located in the left lobe of the liver than in those in the right (P &lt; 0.05). The ICP was not significantly different in unilocular or multilocular cysts. ICP increased as the diameter of the cysts increased. The sensitivity of the indirect haemagglutination test was 86 per cent and the specificity 75per cent. It is concluded that measurement of ICP is a simple and reliable method for assessment of the viability of abdominal hydatid cysts.
Liver transplantation for fulminant hepatic failure and late-onset hepatic failure in children
Authors: Tan K C , Mondragon R S , Vougas V , Mieli-Vergani G , Heaton N D , Mowat A P , Chiyende J , Baker A , Koukoulis G , Portmann B , Williams R 
Published: March 2007

Abstract
The mortality rate of fulminant hepatic failure (FHF) and late-onset hepatic failure (LOHF) in childhood has remained between 70 and 95 per cent despite recent improvements in medical therapy. Liver transplantation has become an important therapeutic option in adults with this condition but has been performed infrequently in children. Between March 1988 and August 1991, 12 children aged between 1 month and 14 years with FHF or LOHF received 13 liver transplants. The aetiology was viral hepatitis in eight children (non-A non-B in six, A in two), drug hepatotoxicity (carbamazepine) in two, autoimmune hepatitis in one and congenital haemochromatosis in one. Reduced-size livers were used for ten of the 13 transplants. Morbidity after operation included infective complications and abdominal bleeding. Two patients died from graft versus host disease, one from brain aspergillosis and another from graft infarction after portal vein thrombosis. Eight patients survive after a median follow-up of 18 months. Liver transplantation should be the therapeutic choice for children with FHF and LOHF for whom the chances of recovery are poor.