bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fibronectin, complement and immunoglobulins in serum after surgery
Authors: Gauperaa T , Giercksky K-E , Revhaug A , Rekvig O P 
Published: March 2007

Abstract
In recent years it has been suggested that fibronectin is a non-specific opsonic protein of significance in host resistance against septic complications following trauma and surgery. The aim of the present study was to investigate the fluctuations in serum levels of fibronectin, immunoglobulins IgG and IgM, and complement factors C3 and C4 postoperatively. Serum samples were obtained pre-operatively and at different intervals postoperatively in 72 patients admitted for elective surgical procedures on the alimentary tract, the heart and the hip joint. The mean pre-operative fibronectin values were 257±79 μg/ml. The lowest values (166±65 μg/ml) were found immediately after the operation, followed by an increase which did not reach pre-operative levels within 120 h. Five patients who developed postoperative complications and 14 patients with malignant disease did not differ significantly either in their pre- or postoperative fibronectin levels, compared with the whole group. The lowest fibronectin levels seen were also significantly above the concentrations necessary to promote binding of gelatinized test particles to macrophages and monocytes in vitro. There was a significant decrease in C3, C4 and IgG levels postoperatively whereas IgM levels were unaltered. The observed reduction did not extend below the lower normal levels for these proteins. The probable mechanism behind the reduction in serum levels seems to be a sequestration at the site of tissue injury. The postoperative reduction in circulating fibronectin levels has probably no implications for host resistance against septic complications. When sequestered into the site of injury, it may, however, be of significance for normal wound healing, due to its cell-matrix interactions.
Treatment of acute abscesses by incision, curettage and primary suture without antibiotics: A controlled clinical trial
Authors: Stewart M P M , Laing M R , Krukowski Z H 
Published: March 2007

Abstract
One hundred and thirty-seven consecutive acute superficial abscesses were randomly allocated to incision, curettage and primary suture without parenteral antibiotics (64 cases) or to conventional treatment with incision, drainage and dressings (73 cases). Wound healing was faster; 7.0 days: 25.1 days (P&lt;0.01, Wilcoxon's rank sum test), the number of hospital visits was smaller; 3.8 visits: 11.1 visits (P &lt; 0.01) and the time off work was shorter; 4.0 days: 14.1 days (P&lt;0.01) in the group treated by primary closure compared with those managed conventionally. In this study no complications attributable to the withholding of antibiotics occurred. Incision and primary closure of abscesses is safe and more economic than conventional drainage. Routine antibiotic cover is not necessary.
A 13-year review of jejunoileal bypass
Authors: McFarland R J , Gazet J-C , Pilkington T R E 
Published: March 2007

Abstract
One hundred and eighty patients had a jejunoileal bypass performed during the years 1971-1982. By leaving only 14 in. (35 cm) of intestine in continuity a mean weight loss of 34.4 per cent (s.d. = 8.5) was achieved over 2 years and, unless the operation had to be reversed for complications, this weight loss was maintained. The improvement in quality of life for a majority of patients should not be undervalued. Two-thirds of patients required admission for complications and eight patients died (4 per cent). Many of these problems were provoked by an inability to control eating. There have been no hospital deaths since 1976 which we attribute to better management of complications and a policy of early reversal for patients with excessive weight loss and signs of metabolic failure. Despite performing jejunoileal bypass less often in recent years we are still frequently reversing patients with electrolyte disturbances, metabolic failure, urinary calculi or arthritis. Thirty patients (16-7 per cent) have been reversed, half more than 5 years after bypass. Metabolic failure may occur even after many years of stable weight reduction. Because this is not well known the insidious onset of new weight loss and malaise may not be recognized, or not associated with the bypass many years before. Indefinite outpatient surveillance is mandatory. Changes in the operation have not significantly affected results. There has been no serious liver dysfunction in the 7:7:CJ group but this may reflect better management of lesser metabolic disturbances. Jejunoileal bypass remains the most effective operation for gross obesity and, with experience, can be performed safely. However, the complication rate and difficulty maintaining satisfactory follow-up on large numbers of young patients makes it an unacceptable procedure on any major scale.
A randomized trial of oral 5-fluorouracil versus placebo as adjuvant therapy in colorectal cancer Dukes' B and C: Results after 5 years observation time
Authors:   The Swedish Gastro-Intestinal Tumour Adjuvant Therapy Group, Hafström L , Rudenstam C-M , Domellöf L 
Published: March 2007

Abstract
A double-blind randomized trial of daily oral 5-fluorouracil (5 mg kg−1 bodyweight) for 3 months versus placebo as adjuvant therapy to surgical treatment of colorectal cancer Dukes' B and C was conducted. In total 421 patients were randomized; 198 patients with Dukes' B, 159 with Dukes' C and 64 were referred to a limited resection group. The distribution of prognostic variables was similar in both groups indicating the absence of any bias and the efficacy of the randomization. Disease-free interval and survival time were analysed as end points. After 5 years of follow-up of all patients there was no significant difference between treatment or placebo group in the total material or the subgroups regarding either of the end points. There was no difference in localization of first recurrence between treated and control group. A high withdrawal of therapy was found in the 5-FU group (40 per cent) and in the placebo group (13 per cent).
Successes, failures, early complications and their management following endoscopic sphincterotomy: Results in 394 consecutive patients from a single centre
Authors: Leese T , Neoptolemos J P , Carr-Locke D L 
Published: March 2007

AbstractThe indications and results of 394 endoscopic sphincterotomies (ES) performed over a 6 year period from a single centre are described. The indications for ES were common bile duct (CBD) calculi (81 per cent), papillary stenosis (9 per cent), periampullary tumours, insertion of endoprostheses, sump syndrome and biliary dilatation for benign strictures. ES was achieved in 98 per cent of patients. In the calculus group the CBD was cleared of stones in 93·3 per cent following a successful ES (92 per cent overall success rate for CBD clearance). Early complications (⩽ 1 month) occurred in 41 patients (10-4 per cent) of which haemorrhage accounted for nearly half. Emergency surgery following ES was undertaken in 15 patients (3·8 per cent). There were 13 deaths within one month of ES (3·3 per cent) of which three were directly attributable to ES (0·8 per cent). The diagnosis and management of complications following ES is important with increasing numbers of patients being treated from outside the referral centre.
Intraperitoneal low-pressure suction drainage following splenectomy
Authors: Ugochukwu A I , Irving M 
Published: March 2007

Abstract
A consecutive series of 282 patients undergoing splenectomy on one surgical unit has been studied to ascertain the incidence of postoperative subphrenic abscess. Only two atypical subphrenic abscesses occurred (0·17 per cent), a rate of abscess formation much lower than that reported in other series. We believe that the use of low-pressure closed suction drainage to the splenic bed accounts for this low rate.
Resection of ‘inoperable’ rectal cancer following radiotherapy
Authors: James R D , Schofield P F 
Published: March 2007

Abstract
Forty-two patients with fixed inoperable adenocarcinoma of the rectum due to local extension in the pelvis have been treated using high dose radiotherapy followed by surgery when possible. Inoperability was determined initially by laparotomy in 15 patients and in the remainder by examination under anaesthetic. Twenty-nine patients underwent laparotomy following radiotherapy and resection was performed in 18. In three of these cases there was no residual tumour in the operation specimen. The median survival of the resected group was 28 months compared with 7 months for the unresected group. Treatment related mortality in the resected group was confined to five patients, two postoperative deaths and three small bowel fistulae which developed as late complications. Analysis of prognostic factors indicates that patients most likely to benefit from this approach are those with no evidence of distant metastases or of urinary obstruction at presentation. Patients who have a good clinical response to radiotherapy are more likely to achieve resection and subsequent long-term survival.
Malignant large bowel obstruction
Authors: Phillips R K S , Hittinger R , Fry J S , Fielding L P 
Published: March 2007

Abstract
Of 4583 patients in the Large Bowel Cancer Project, 713 (16 per cent) were obstructed. The site of greatest risk was the splenic flexure (49 per cent). Advanced stage was neither the full reason why some patients obstructed nor for their subsequent poor prospects (age-adjusted 5-year survival: not obstructed, 45 per cent; obstructed, 25 per cent). Also, there was no greater risk of vascular invasion, no heavier lymph node burden and no worse tumour differentiation in patients with obstruction. In-hospital mortality was high (23 per cent), was not reduced by either a policy of primary or staged resection and was not influenced by the site of obstruction. There was no survival advantage for either policy, but hospital stay after primary resection was half that of staged. Immediate anastomosis in the obstructed left colon had a high clinical leak rate (18 per cent versus 6 per cent elective; P &lt; 0·001). Both registrars and consultants had similar mortality rates for elective primary resection and for the management of obstruction itself (as evidenced by results after the first stage of a staged resection). Selection probably accounts for the very much better results achieved by consultants for primary resection in the presence of obstruction (in-hospital mortality: consultants, 13 per cent; registrars, 24 per cent).
Barrett's oesophagus
Authors: Hennessy T P J 
Published: March 2007

Abstract
The bulk of available evidence supports the view that Barrett's oesophagus is an acquired condition due to chronic gastro-oesophageal reflux. It is possible that a few cases are congenital. Barrett's oesophagus gives rise to severe stricture and ulceration and has a significant malignant potential. Treatment is designed to prevent reflux and, if possible, to reverse the metaplastic change. Dysplasia is of ominous significance and requires frequent careful surveillance.
Is tissue copper deficiency associated with aortic aneurysms?
Authors: Senapati Asha , Carlsson Linda K , Fletcher C D M , Browse N L , Thompson R P H 
Published: March 2007

Abstract
It has been suggested that patients with abdominal aortic aneurysms are deficient in tissue copper. Levels of copper and zinc in liver and aortic wall were therefore measured in 11 patients with aortic aneurysms and 11 fresh cadavers with normal aortas. The concentrations of copper were similar in both groups. Zinc concentration was higher in the normal aortic wall, probably because of the greater thickness of the media in the normal aorta. We found no evidence that aortic aneurysms are associated with reduced tissue copper concentrations.
Increased flow in the superior mesenteric artery in dumping syndrome
Authors: Aldoori M I , Qamar M I , Read A E , Williamson R C N 
Published: March 2007

Abstract
Transcutaneous Doppler ultrasound was used to measure resting and postprandial blood flow in the superior mesenteric artery (SMABF) in nine patients with dumping syndrome and in ten normal volunteers of matching age and sex. All nine patients experienced signs and symptoms of dumping during the investigation, but none of the controls did so. At rest, SMABF in the dumping patients (567.47 ml/min) (mean±s.e.m.) did not significantly differ from that of the normal volunteers (493.72 ml/min). Five minutes from the end of a balanced liquid meal, flow had approximately doubled in each group (1232 ± 140 and 941 ± 128 ml/min). Compared with controls, increased SMABF was observed in patients with dumping syndrome at 10 min (76 per cent), 15 min (66 per cent), 30 min (55 per cent) and 45 min (42 per cent) (P = 0.05−0.01). Splanchnic pooling and abnormal redistribution of blood probably contribute to the pathogenesis of the early dumping syndrome.
Inguinal herniotomy in children: A five year survey
Authors: Harvey M H , Johnstone M J S , Fossard D P 
Published: March 2007

Abstract
This retrospective review covers our experience over 5 years of 436 hernia repairs in 392 children upto the age of 15 years. The number of emergency presentations was 71 (18.1 per cent) and 66.2 per cent of these were under the age of 12 months. Most cases were initially treated conservatively and only 18 children required operation on the day of admission. There were 11 recurrences (7 elective and 4 emergency cases) giving a recurrence rate of 2.5 per cent. In all eleven cases the original operation was performed by a junior surgeon. The complication rate (excluding recurrences) was 2.8 per cent but may be an underestimate because of the limitations of a retrospective study. We suspect our results are typical of those to be found in any large British hospital and that with careful training and supervision of junior staff in the technique of inguinal herniotomy the results could be improved and approach those found in specialist paediatric units in America.
Treatment of rectal prolapse by sphincteric support using silastic rods
Authors: Hunt T M , Fraser I A , Maybury N K 
Published: March 2007

Abstract
The use of silastic perianal rings to control rectal prolapse in the elderly has been reviewed. Forty-one patients were treated over a 6 year period by a total of 52 operations. Their mean age was 80 years and there was no operative mortality. Prolapse was adequately controlled in 71 per cent of patients, and a further three patients had no recurrence despite failure and removal of the ring. The results of this procedure are inferior to those obtained by abdominal operations for rectal prolapse, but deserve serious consideration in those elderly patients who may be unfit for laparotomy.
Artefactual breast disease: A report of three cases
Authors: Rosenberg M W , Hughes L E 
Published: March 2007

Abstract
Three cases of suspected artefactual conditions of the breast are presented, one case each of recurrent bleeding, recurrent infection and atypical eczema. Involvement of the breast is rare, but may go undiagnosed in many cases. Patients are usually married and in the second half of their reproductive life. An unusual pattern of disease appearance and behaviour, lack of response to treatment, inappropriate affect and a request for mastectomy are helpful in suggesting the diagnosis. A disturbance in personal relationships can often be elucidated by psychiatric assessment. Treatment is difficult and may be limited to suspecting the diagnosis, excluding organic disease and avoiding unnecessary and repetitive surgery.
The outcome following sphincter-saving resection and abdomino-perineal resection for low rectal cancer
Authors: Williams N S , Durdey P , Johnston D 
Published: March 2007

Abstract
The introduction of new techniques has enabled more patients with low rectal carcinoma to undergo sphincter-saving resection (SSR). This policy, however, has provoked controversy concerning the adequacy of excision and fear of increased rates of recurrence compared with abdominoperineal resection (APER). We have therefore compared our results of SSR for low and mid-rectal cancers performed between 1978 and mid 1982 with those obtained with APER before this period. One hundred and fifty-nine patients presented with tumours between 3 and 12 cm from the anal verge; 153 (96 per cent) underwent resection, of whom 46 (30 per cent) had disseminated disease. One hundred (68 per cent) underwent SSR, 33 (22 per cent) had an APER and 16 (10 per cent) had a local procedure. Operative mortality was 4 per cent following APER and 7 per cent after SSR (n.s.). Patients were followed for a mean of 4·6 years (range 2–6 years), only four (2·5 per cent) being lost to follow-up. The incidence of recurrence after radical SSR (n = 74) was compared with the historical control group which underwent radical APER, the two groups being matched for Dukes' stage and height of the lesion. After 2 years, local recurrence cumulative rates were 13·6 per cent after SSR and 18·8 per cent after APER. Distant recurrence rates were 14·5 and 20 per cent respectively. Ten patients (13·5 per cent) died of their disease within 2 years of a radical SSR, 15 (15 per cent) after radical APER. Corrected 5-year survival and recurrence rates were similar. Thus, SSR does not appear to carry an increased risk of recurrent disease compared with APER after an equivalent follow-up period.
Staples or sutures for low colorectal anastomoses: A prospective randomized trial
Authors: McGinn F P , Gartell P C , Clifford P C , Brunton F J 
Published: March 2007

Abstract
One hundred and eighteen patients undergoing low colorectal anastomoses were randomly allocated to reconstitution by either single layer interrupted extramucosal sutures or circular staple gun. In the 60 patients undergoing sutured anastomosis there were 2 (3 per cent) clinical leaks and 4 (7 per cent) radiological leaks, and no failures of the 58 patients who underwent stapled anastomosis there were 4 failures, 7 (12 per cent) clinical leaks, 14 (24 per cent) radiological leaks and 1 death. Stapled anastomoses were more than ten times as expensive as sutured anastomoses and there were no savings in time or numbers of associated colostomies. An interrupted extramucosal suture technique remains the ultimate standard for low colorectal anastomosis.
The value of staging and serial follow-up investigations in patients with completely resected, primary, cutaneous malignant melanoma
Authors: Kersey Patricia A , Iscoe N A , Gapski J A P , Osoba D , From L , Deboer G , Quirt I C 
Published: March 2007

Abstract
The purpose of this study was to determine the value of staging and serial follow-up investigations in newly diagnosed patients with completely excised primary cutaneous malignant melanoma. We reviewed the records of the 393 patients with completely excised primary malignant melanoma who were referred to the Ontario Cancer Institute and the Toronto-Bayview Regional Cancer Centre between 1 January 1978 and 31 March 1982. Initial investigations included history and physical examination in all 393 patients, complete blood count (199 patients), liver function tests (198 patients), urinary melanins (159 patients), chest X-rays (345 patients), whole lung tomography (182 patients), radionuclide liver-spleen scans (207 patients), and bone scans (116 patients), bipedal lymphangiograms (78 patients), CT scans of the chest (59 patients), and CT brain scans (51 patients). The clinical stage of ten patients was changed as a result of history and physical examination or lymphangiogram. All other investigations failed to detect metastatic melanoma. Follow-up investigations included history and physical examinations, complete blood counts, liver function tests, radionuclide liver spleen and bone scans. History and physical examinations, chest X-rays and patients' awareness of abnormalities were responsible for detection of subsequent melanoma recurrences. All other tests failed to identify metastatic melanoma at the time of its occurrence. Therefore, we recommend that initial staging investigations be limited to history and physical examination with clinical photographs, and baseline chest X-ray. We recommend that subsequent follow-up include only history and physical examinations and chest X-rays.
Gastric surgery and the risk of subsequent colorectal cancer
Authors: Bundred N J , Whitfield B C S , Stanton E , Prescott R J , Davies G C , Kingsnorth A N 
Published: March 2007

Abstract
A matched case control study has been conducted in order to determine whether an association exists between gastric surgery and the subsequent development of colorectal carcinoma. Two hundred and eighty-nine patients (151 women and 138 men) presenting with large bowel cancer have been studied. Case controls were matched according to age, sex and date of admission. The case notes of each patient in the study were reviewed to determine the prevalence of peptic ulceration and gastric surgery. Significantly more patients with colorectal carcinoma had undergone gastric surgery P&lt;0·05, although the prevalence of peptic ulceration was similar in both groups. Colorectal carcinoma is more common in patients who have undergone gastric surgery for benign peptic ulcer disease than in the general population.
Gastric emptying after anterior lesser curve seromyotomy and posterior truncal vagotomy
Authors: Taylor T V , Holt S , Heading R C 
Published: March 2007

Abstract
Anterior lesser curve seromyotomy with posterior truncal vagotomy (ASPTV) provides a simple, safe and expeditiously performed method of denervating the parietal cell mass, whilst preserving the pylorus. Dumping and diarrhoea are uncommon after this procedure. Gastric emptying has been assessed after ASPTV and other elective operations for duodenal ulcer. Liquid and solid phase gastric emptying studies were performed in control subjects (17), patients before and at least six months after ASPTV (14), vagotomy and pyloroplasty both without (8) and with (6) diarrhoea, vagotomy and gastroenterostomy (11), and Polya gastrectomy (7). There was no delay in emptying time for liquids or solids between ASPTV patients and controls. With the exception of an increase in the early emptying of liquids (P = 0·02) after ASPTV, gastric emptying was not different from normal. After truncal vagotomy and pyloroplasty in patients without diarrhoea the gastric emptying of solids, but not of liquids, was markedly increased (P = 0·00001), whereas in those with diarrhoea both liquid and solid phase emptying were markedly increased (P &lt; 0·001). When gastroenterostomy was used as the drainage procedure both phases of emptying were increased. After Polya gastrectomy, both early and late emptying of liquids and solids were increased (early phase P &lt; 0·05, overall emptying P &lt; 0·001).
A survey of registrars undertaking general surgical research in the United Kingdom on 1 October 1983
Authors: Dehn T C B , Blacklay P F , Taylor G W 
Published: March 2007

Abstract
Data, concerning general surgical research, was obtained by means of a questionnaire from 103 junior surgeons undertaking full-time research. Most posts appeared to be adequately funded, though many respondents sustained a loss of salary on appointment. Less than half the posts were advertised in the national medical journals. All but one respondent were submitting their research for a higher degree. The majority felt that they were well supervised: a minority (24 per cent) were poorly supervised. The enjoyment of research and confidence of obtaining a higher degree were related to the standard of supervision.