bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of low-molecular-weight heparin (CY216) in preventing postoperative venous thrombo-embolism: A co-operative study
Authors: Kakkar V V , Murray W J G 
Published: March 2007

Abstract
The efficacy and safety of a low-molecular-weight (LMW) heparin fraction in preventing postoperative venous thrombo-embolism, was assessed in a double blind, randomly allocated trial, and in an ‘open’ study. of 395 patients included in the double blind trial, 199 received unfractionated (UF) calcium heparin, and 196 the LMW heparin fraction. The data were analysed on an ‘intention to treat’ basis. The two groups were well matched for risk factors which could predispose to the development of venous thrombosis. Fifteen (7·5 per cent) of one hundred and ninety-nine patients receiving UF heparin, and five (2·5 per cent) of one hundred and ninety-six patients in the LMW heparin group developed DVT (P&lt;0·05). There was no significant difference between the two groups in terms of excessive incisional or total blood loss during surgery, postoperative drainage or wound haematoma formation. Of 910 patients included in the ‘open’ study who received a single injection of LMW heparin every day, 30 (3·2 per cent) died during the postoperative period; in none of the autopsied patients were pulmonary emboli detected. Thirty-one (3·4 per cent) patients developed isotopic DVT; twentyseven (2·9 per cent) were receiving prophylaxis at the time the DVT was diagnosed. Thirty-six (3·9 per cent) patients developed wound haematoma; twenty-five (12·4 per cent) of those were in the two hundred and one undergoing surgery for gynaecological conditions, and eleven (1·5 per cent) in the seven hundred and nine patients having general abdominal surgery. This difference is statistically significant (P&lt;0·001). The results of a double blind trial indicate that a single daily injection of 1850 APTT units (7500 antifactor X a units) of a LMW heparin is more effective than 10000 APTT units of commercially available UF heparin in preventing postoperative DVT. The findings of the ‘open’ study suggest that this regimen also provides an effective prophylaxis against postoperative major pulmonary embolism.
Gastro-oesophageal reflux and oesophagitis before and after vagotomy for duodenal ulcer
Authors: Flook D , Stoddard C J 
Published: March 2007

Abstract
Fifty patients undergoing elective vagotomy for the treatment of chronic duodenal ulceration have been investigated pre-operatively and again 3 months postoperatively to determine the extent and severity of associated gastro-oesophageal reflux. Pre-operatively all patients had a normal lower oesophageal sphincter pressure but 50 per cent had symptoms of gastro-oesophagel reflux, 42 per cent had excessive reflux on 24 h pH monitoring and 30 per cent had oesophagitis on endoscopy and/or oesophageal biopsy. Postoperatively, reflux symptoms were present in only 12 per cent of patients but pH studies were still abnormal in 36 per cent and oesophagitis was observed in 32 per cent. Lower oesophageal sphincter pressure was unaffected by vagotomy. Gastro-oesopheageal reflux is common in pre-operative duodenal ulcer patients and is not significantly reduced by vagotomy. Careful pre-operative oesophageal assessment is necessary to determine which duodenal ulcer patients require an anti-reflux procedure in addition to vagotomy.
The detection of renal allograft rejection by fine-needle intrarenal manometry
Authors: Wilson R G , Taylor R M R , Proud G 
Published: March 2007

Abstract
The causes of early renal allograft malfunction include rejection, acute tubular necrosis, cyclosporin nephrotoxicity and vascular complications. Fine-needle intrarenal manometry is a potential method of distinguishing rejection from the other causes of malfunction and has been used by Salaman and Griffin1 in patients' treated with cyclosporin. The technique involves inserting a fine-needle, which is connected to a specially designed manometer, into the substance of the transplant kidney. One hundred and six measurements of intrarenal pressure have been made in 28 patients immunosuppressed with either azathioprine and prednisolone or cyclosporin. Thirteen rejection episodes were identified and confirmed by biopsy. These were treated by pulse steroid (methylprednisolone) therapy. Seven episodes of cyclosporin toxicity were identified and there were fifteen episodes of acute tubular necrosis. The mean intrarenal pressure in the rejecting group was 52-8 mmHg compared with 22·3, 24·1 and 24·3 mmHg for the normal function, acute tubular necrosis and cyclosporin nephrotoxicity groups, respectively (P&lt;0·01; Wilcoxon unpaired test). There were no differences within these groups related to the type of immunosuppression used. There were no clinical complications associated with the procedure. Thus in newly transplanted patients, fine-needle intrarenal manometry accurately identified rejection and distinguished it from normal function, acute tubular necrosis and cyclosporin nephrotoxicity in all the patients regardless of the immunosuppressants used.
Use of a ringed intraluminal graft in the operative management of abdominal aortic aneurysms
Authors: Cave-Bigley D J , Harris P L 
Published: March 2007

Abstract
The efficacy of a non-sutured technique of anastomosis has been assessed in 20 patients who had bifurcated grafts inserted for aneurysms of the infrarenal aorta. The grafts had rigid Dacron-covered metal rings incorporated at each end and the anastomoses were effected by securing these rings within the lumen of the vessel with a firmly tied Dacron tape. In order to allow access of the ring to the lumen of the aorta it was necessary to employ an intraluminal occlusion balloon catheter for proximal control. The patients included in the study formed a particularly high risk group. There were 12 emergency and 8 elective procedures. The mean duration of the operations was 134±34 min (± s.d.); the mean blood loss during surgery was 3498±2660ml (±s.d.) and the mean length of inpatient stay after operation was 16±13 days (±s.d.). There were eight postoperative deaths and post-mortem examination, which was allowed in six cases, showed satisfactory appearances of the grafts and anastomoses. The surviving patients have remained free from complications for up to 18 months after operation. A non-sutured technique is possible for most aortic anastomoses but is of limited applicability for iliac and more distal anastomoses. With further technical refinements an intraluminal graft with a non-sutured aortic anastomosis may become a valuable alternative to the conventionally sutured prosthesis in the management of ruptured abdominal aneurysms.
Accuracy of aspiration cytology in the diagnosis of breast disease
Authors: Smallwood J , Herbert A , Guyert P , Taylor I 
Published: March 2007

Abstract
The accuracy of fine needle aspiration cytology has been assessed in 480 consecutive breast lesions where definitive histology was later available. The results in terms of specificity and sensitivity have also been compared to mammography and clinical examination. With adequate smears aspiration cytology was 100 per cent specific with no false positive diagnosis. This compares with 15 false positive mammograms and 12 false positive diagnoses on clinical examination. Cytology was unsatisfactory in 36 per cent of benign lesions owing to poor cellularity of the sample but when considered with mammography and examination led to a reduction in biopsies for benign disease. A definitive cytological diagnosis of malignant tumours resulted in a reduction in frozen sections with a substantial saving of resources and improvement in patient counselling. No mastectomy was performed for benign disease.
Are the lesions of duct ectasia sterile?
Authors: Bundred N J , Dixon J M J , Lumsden A B , Radford D , Hood J , Miles R S , Chetty U , Forrest A P M 
Published: March 2007

Abstract
A prospective study was established to determine whether, using suitable transport media, bacteria could be isolated from the lesions of mammary duct ectasia. The results indicate that both aerobic and anaerobic organisms are present in a high proportion of patients with nipple discharge associated with this condition and in all patients who develop peri-areolar sepsis (abscess and mammillary fistulae) as part of the syndrome. The lesions of duct ectasia are therefore not sterile and the possibility exists that bacteria have a role in the aetiology and pathogenesis of this condition.
Pre-operative staging of rectal neoplasm and its impact on clinical management
Authors: Williams N S , Durdey P , Quirke P , Robinson P J , Dyson J E D , Dixon M F , Bird C C 
Published: March 2007

Abstract
A sophisticated staging technique (extended staging, ES) employing modern technology has been compared prospectively with conventional clinical assessment (initial staging, IS) in 45 patients with low rectal carcinoma (less than 12 cm from the anal verge) to determine its potential merit and its impact on clinical management. ES consisted of computerized tomography of liver and pelvis, ultrasound scan of liver, measurement of serum concentrations of carcinoembryonic antigen (CEA) and acute phase reactant proteins and multiple superficial and deep biopsies to determine not only the histological grade of the tumour but also its DNA cellular content as measured by flow cytometry. ES proved statistically superior to IS in the assessment of local spread and dissemination. Although histological grade proved to be more accurate on ES than IS this was only true when one specialist pathologist interpreted the slides. When several pathologists were involved interobserver variation made interpretation unreliable. Assessment of DNA content using flow cytometry, being quantitative, was more accurate and perhaps should be used in the future as a prognostic indicator. The improved accuracy of ES would have altered both pre- and intra-operative clinical decisions. It would have prevented some patients receiving inappropriate adjuvant therapy as well as selecting patients more accurately for the correct treatment.
The management of colon injuries by primary repair or colostomy
Authors: Demetriades D , Rabinowitz B , Sofianos C , Prümm E 
Published: March 2007

Abstract
This retrospective study comprises 134 cases of penetrating colon injuries. In 92 cases the injury involved the left colon and in the remaining 42 the right colon. Death due to the colonic injury occurred in 1.5 per cent and the incidence of abdominal complications was 17.9 per cent. Patients treated by primary repair of the colon had less colon-related complications and a shorter hospital stay than patients treated by colostomy. Left and right colon injuries treated by primary repair had similar complication rates and hospital stay (P &gt; 0.05). We believe that primary repair can safely be performed more frequently than is generally accepted. The site of colon injury, the presence of shock and the presence of multiple associated intraabdominal injuries do not exclude primary repair. It is suggested that colostomy should be reserved for both left and right colon injuries with gross peritoneal contamination, extensive colonic damage, and large amount of hard faeces in the colon.
Adult Hirschsprung's disease: results of the Duhamel procedure
Authors: Elliot M S , Todd I P 
Published: March 2007

Abstract
Hirschsprung's disease is a rare condition in the adult. The case reports of 39 patients managed by the Duhamel procedure were reviewed. One-third of the patients underwent at least one abdominal surgical procedure before the correct diagnosis was made. The operative mortality of the Duhamel procedure was zero. In 29 patients no defunctioning procedure was used to protect the anastomosis. The incidence of anastomotic dehiscence was 13 per cent. Thirty-six of the thirty-nine patients have excellent functional results.
Failure of Doppler ankle pressure to predict healing of conservative forefoot amputations
Authors: Welch G H , Leiberman D P , Pollock J G , Angerson W 
Published: March 2007

Abstract
Fifty minor foot and transmetatarsal amputations were studied to assess the reliability of Doppler ankle blood pressure (DABP) and skin blood flow (SBF) to predict healing. The level of amputation was determined solely on clinical criteria. Thirty-six (72 per cent) of the amputations healed. There was no statistical difference between mean DABP in healed 89±8 mmHg mean ± s.e.m.) and non-healed (91 ± 12 mmHg mean ± s.e.m.) amputations. SBF was assessed by 125I-iodoantipyrine clearance in 28 patients. There was no correlation between DABP and SBF (r = 0.038). SBF in patients with healed amputations was 14.8 ± 1.2 (mean ± s.e.m.) ml 100 g−1 min−1 in contrast to SBF of 5.9 ± 0.3 (mean ± s.e.m.) ml 100 g−1 min−1 in the patients with non-healing (P&lt;0.01). Where the flow was in excess of 8 ml 100 g−1 min−1 healing was always obtained while a flow of less than 7 ml 100 g−1 min−1 was associated with healing failure. These results suggest that DABP should be interpreted with caution as this technique fails as an accurate means of identifying those patients suitable for forefoot amputations. Skin blood flow assessment appears to provide an absolute value for the prediction of healing potential at this level.
Noninvasive technique using thallium-201 for predicting ischaemic ulcer healing of the foot
Authors: Ohta T 
Published: March 2007

Abstract
A post-stress imaging study utilizing single intravenous doses of thallium-201 was performed on feet with trophic skin lesions. Forty-two ischaemic ulcers were classified into four basic types according to the presence and degree of the inherent inflammatory response of the ulcer in both the initial and delayed distributions. Both the relationship between ulcer type and prognosis and the effects of therapy within ulcer type were assessed. The results suggest that ulcers of Type I or Type II heal in response to conservative treatment, while ulcers of Type III, although undergoing healing, require surgical treatment to prevent a protracted hospitalization. In Type IV ulcers, healing is not to be expected at all with conservative therapy; therefore an early decision of amputation may be necessary if surgical measures are not indicated. The technique reported may be helpful not only in the prediction of spontaneous ulcer healing but also in the selection of appropriate treatment.
The fate of polytetrafluoro-ethylene grafts in lower limb bypass surgery: a six year followup
Authors: Charlesworth P M , Brewster D C , Darling R C , Robison J G , Hallet J W 
Published: March 2007

Abstract
The success of lower limb bypass surgery depends, in the major part, on the availability of autologous saphenous vein as the most satisfactory arterial substitute known to date. Although various prosthetic conduits, used in the absence of saphenous vein, have shown promising success on short term follow-up, more long-term comparative data are required for adequate assessment. This study analyses, by life table method, the results of 134 infra-inguinal bypass grafts using polytetrafluoroethylene (PTFE) over a 6 year period. The results reconfirm the superior long-term patency of vein bypasses compared with such prosthetic grafts. Analysis suggests that, while PTFE may give acceptable results in the immediate and shortterm follow-up period, 6 year patencies approach 20–30 per cent.
Abdominal aortic aneurysm in Chinese patients
Authors: Wei W I , Siu K F , Wong J 
Published: March 2007

Abstract
From 1975 to 1983, 120 Chinese patients with infrarenal abdominal aortic aneurysm were seen, 72 of whom underwent aneurysmectomy; 45 were performed electively and 27 as emergencies. The operative mortality in the former was 4.4 per cent and the latter 33.3 per cent. All 27 patients who presented with rupture were operated on. However, only 45 of 93 patients (48.4 per cent) with intact aneurysm underwent surgery; the remainder were either unwilling (35) or unfit (13). Peptic ulcer disease was noted in 26.4 per cent of patients.
The effect of pre-operative total parenteral nutrition on energy-rich phosphates, electrolytes and free amino acids in skeletal muscle of malnourished patients with gastric carcinoma
Authors: Sandstedt S , Lennmarken C , Symreng T , Vinnars E , Larsson J 
Published: March 2007

Abstract
The effect of two weeks of total parenteral nutrition (TPN) on energy-rich phosphates, muscle water, electrolytes and free amino acids in skeletal muscle were determined in ten malnourished patients with gastric carcinoma. The total adenine nucleotide pool, phosphocreatine, creatine and glycogen were decreased before TPN, and only glycogen returned to normal after TPN compared with controls. Total muscle water and the intramuscular concentrations of sodium and chloride were initially increased and were not influenced by TPN. The total non-essential amino acids in muscle were decreased by 9 per cent, mainly due to a 15 per cent decrease in glutamine. The concentrations of free amino acids in muscle were not affected by two weeks of TPN. This study demonstrates disturbances in energy, water and amino acid metabolism in skeletal muscle of malnourished patients with gastric carcinoma, and that two weeks of TPN could not normalize these changes, except in the case of glycogen. The reason for this might be enzyme abnormalities due to adaptation to energy or protein deficit. A longer period of refeeding might therefore be necessary to improve peripheral metabolism in these patients.
Mortality and morbidity after anterior lesser curve seromyotomy with posterior truncal vagotomy for duodenal ulcer
Authors: Taylor T V , Gunnt A A , Macleod D A D , Van Vroonhoven Th J M V , Bornman P C , Terblanche J , Thomson J W W , Lythgoe J P , Macfarland J B , Salem R J , Gnarowski H 
Published: March 2007

Abstract
A survey has been performed of the mortality and morbidity of anterior lesser curve seromyotomy with posterior truncal vagotomy in the elective treatment of chronic duodenal ulcer. There was one death in a series of 605 patients due to a myocardial infarction, an operative mortality of 0.16 per cent. There was no case of ischaemic necrosis of the lesser curvature or fundus of the stomach. Eleven patients had symptoms of delayed gastric emptying (1.7 per cent) and seven of these underwent a drainage procedure (1.3 per cent). Postoperative dumping did not occur, significant diarrhoea was present in two patients (0.33 per cent). This operation is relatively simple, quick and extremely safe to perform. It is suggested that the more widespread use of this type of elective surgery for duodenal ulcer might reduce the mortality from the condition.
Maximal gastric secretion in smokers and non-smokers with duodenal ulcer
Authors: Whitfield P F , Hobsley M 
Published: March 2007

Abstract
Sex, stature, age and smoking habits were investigated as possible determinants of maximal gastric secretion in pre-operative patients with duodenal ulcer. Stimulation was by an intravenous infusion of histamine (130 nmol kg−1 h−1) in 201 patients. Men were found to secrete significantly more than women, and smokers secreted significantly more than non-smokers. By multiple regression analysis, height and the total number of cigarettes smoked were found to be significant positive, and age significant negative factors in the magnitude of maximal gastric secretion. Upon standardization for these factors, the differences between the sexes and the smoking groups disappeared. It is suggested that, at least in men, chronic smoking increases maximal gastric secretion, and therefore could have a role in the aetiology of duodenal ulcer.
To lay open or excise a fistula-inano: a randomized trial
Authors: Kronborg O 
Published: March 2007

Abstract
Two treatments for fistula-in-ano were compared in a randomized trial. Times of healing were significantly shorter when the fistula was laid open (median 34 days, n = 26) than after excision (41 days, n = 21) (P &lt; 0.02). Revisional surgery was necessary before healing could be obtained in 3 of 26 patients after lay open operations and 2 of 21 after excision. Recurrence rates within 1 year were similar (3/24 and 2/21).
Appendicectomy: assessment of stump invagination versus simple ligation: a prospective, randomized trial
Authors: Engström L , Fenyö G 
Published: March 2007

Abstract
The appendix stump was ligated and doubly invaginated in 374 patients and was simply ligated in 361 in a prospective, randomized trial of 735 consecutive appendicectomies. The two groups were similar with respect to sex, age, degree of appendiceal inflammation and antibiotic treatment. The incidence of wound infection and postoperative pyrexia and the postoperative hospital stay showed no significant intergroup difference. The median operating time was slightly shorter in the group without invagination. Simple ligation facilitates and shortens appendicectomy. It produces no deformation of the caecal wall that subsequently may be mistaken for a caecal neoplasm. Simple ligation is therefore recommended as standard procedure in appendicectomy.
Elevated rates of whole body protein metabolism in patients with disseminated malignancy in the immediate postoperative period
Authors: Ward H C , Johnson A W , Halliday D , Sim A J W 
Published: March 2007

Abstract
Protein metabolism after surgery in the presence of disseminated malignancy has been investigated and compared with results obtained from patients undergoing similar surgical procedures for benign disease and localized malignancy. Whole body nitrogen turnover, measured by primed continuous infusion of15 N glycine, was highest with disseminated malignancy. Similarly rates of whole body protein synthesis and breakdown, calculated from turnover and nitrogen excretion (nitrogen intake being zero), were elevated in the presence of disseminated malignant disease. The increased rates of protein metabolism may represent adaptation to the demands of inevitably growing malignant tissue.
Surgical reasearch society. Pre-operative determination of oestrogen receptor status in breast cancer by immunocytochemical staining of fine needle aspirates
Authors: Crawford D J , Lope-Pihie Azimahtol , Cowan Sheila , George W D , Leake R E 
Published: March 2007

Abstract
A meeting of the Surgical Research Society with Professor R. Shields in the Chair, was held at Trinity College, Dublin on 4 and 5 July 1985. Eighty-four papers were presented during the scientific part of the meeting which was preceded by a Workshop entitled ‘Oesophageal Investigation’, the participants being Mr J. Clark, Mr G. O'Sullivan, Mr J. Bancewicz and Dr M. O'Connor. The Patey Prize was awarded to Mr P. R. O'Connell for his paper entitled ‘Neorectal emptying after ileal ‘J’ pouch-anal anastomosis’.
The results of pre-operative staining of fine needle aspirate (FNA) samples from 48 breast cancers, with a polyclonal antibody raised against highly purified oestrogen receptor (ER) protein, have been compared with our standard biochemical method for measurement of cytosol and nuclear ER. FNA antibody staining correctly predicted the presence of ER in 20 of 21 ERC + /N+ tumours. There were 2 false positive results in 24 ER C-/N- tumours though both these tumours showed marked heterogeneity of staining. Three ER C + /N- tumours were negative by antibody staining, in keeping with the tendency for such tumours to be hormone independent in behaviour. This pre-operative method for ER determination appears to be a reliable alternative to other micro-assays for oestrogen receptors.