bluuebunny/crossref_metadata_2025_split huggingface dataset:
No-Touch isolation technique in colon cancer: A controlled prospective trial
Authors: Wiggers T , Jeekel J , Arends J W , Brinkhorst A P , Kluck H M , Luyk C I , Munting J D K , Povel J A C M , Rutten A P M , Volovics A , Greep J M 
Published: March 2007

Abstract
In order to assess the effect of the no-touch isolation technique, in the treatment of large bowel cancers, on the site of first recurrence and disease-free and overall survival, 236 patients were prospectively and randomly assigned to either the no-touch isolation technique (117 patients) or to a conventional resection technique (119 patients). No patient with distant metastases or unresectable disease entered the study. The two treatment groups were comparable with regard to patient characteristics. Pre- and postoperative complications (including mortality within 30 days) were similar in both groups. After a complete follow-up of 5 years, a tendency for reduction in the number of, and time to, occurrences of liver metastases was seen in the no-touch isolation group (P = 0.14). This effect was most obvious in the sigmoid colon with angio-invasive growth. Overall (P = 0.42) and corrected (P = 0.25) survival did not differ significantly among the treatment groups although in every analysis the survival data of the no-touch isolation group were superior. The data do suggest a limited benefit of the no-touch isolation technique. This observation is important since the morbidity and mortality of surgery were equal in both groups.
Surgical treatment of colostomy complications
Authors: Allen-Mersh T G , Thomson J P S 
Published: March 2007

Abstract
One hundred and twenty-three patients (M:F, 0.9:1; mean age 62 years) underwent 156 operations between 1954 and 1984 for correction of late colostomy complications (stenosis 65 patients, prolapse 16 patients, paracolostomy hernia 42 patients). Sixty-three per cent of patients eventually had a good result but in some up to 5 operations were necessary. Local excision of scar tissue at the mucocutaneous junction was associated with a 61 per cent (43/71) success rate for relief of colostomy stenosis. Where local fixation failed to prevent recurrent colostomy prolapse (13/20, 65 per cent of local fixation operations), colectomy and ileostomy was the most effective second procedure (2/3,67 per cent success rate). Where local repair of a paracolostomy hernia failed (15/32,47 per cent of local operations), resiting of the stoma to the umbilicus or right side of the abdomen produced better results (3/7, 43 per cent success rate) than resiting to another trephine on the left side of the abdomen (2/14, 14 per cent success rate).
Inflow site: Its effect on femoropopliteal and distal graft patency
Authors: Najmaldin A , Clifford P C , Chant A D , Webster J H H 
Published: March 2007

Abstract
In a series of 245 vein grafts, results of 163 from the common femoral artery were compared with 82 from the proximal superficial femoral artery. Groups were comparable for risk factors, except that significantly more of the superficial femoral artery group were anastomosed to a single calf vessel (P&lt;0.02). Early technical failure was similar in both groups (14 per cent common femoral artery, 12 per cent superficial femoral artery, P = n.s.). Cumulative life table patency rates at 1 and 3 years were 77 per cent and 72 per cent in common femoral artery grafts, and 80 per cent and 70 per cent in superficial femoral artery grafts (P = n.s.). Analysis of 92 veins in situ (65 common femoral artery and 27 superficial femoral artery) showed l-year patency rates of 75 per cent in common femoral artery grafts and 79 per cent in superficial femoral artery grafts (P = n.s.). These results suggest that the proximal superficial femoral artery is a safe inflow site for distal bypasses.
Comparison of three Glasgow multifactor prognostic scoring systems in acute pancreatitis
Authors: Leese T , Shaw D 
Published: March 2007

Abstract
Modifications have been proposed in an attempt to improve the clinical value of the original nine-factor Glasgow prognostic scoring system for acute pancreatitis. These include the omission of age or serum transaminase, reducing the factors to eight. Debate exists as to which system should be employed. Assessment of the individual factors in 198 attacks of acute pancreatitis treated conventionally revealed that only serum transaminase did not differ significantly between mild and severe outcome groups. Multivariate analysis demonstrated four factors (Pa,O2, white cell count, lactic dehydrogenase, and urea) with independent significance in predicting severity, while serum glucose, albumin and transaminase were least useful. Findings were similar when considering only patients with gallstone aetiology. The reduction of the prognostic factors to eight by the omission of either age or transaminase improved the predictive value of the scoring system, both when considering all attacks and those of gallstone aetiology alone. We suggest that serum transminase should be omitted because: it shows no significant difference between mild and severe outcome groups, while age has prognostic significance; the system has greater sensitivity than if age is omitted; and the number of factors requiring emergency laboratory measurement for immediate prognostication is reduced by one.
Lack of necessity for corrections for pyloric losses and duodenogastric reflux in the performance of gastric secretory studies
Authors: Ogilvie A L , Atkinson M 
Published: March 2007

Abstract
Gastric secretory studies are subject to considerable error owing to incomplete collections and to contamination by reflux of alkaline duodenal contents. Corrections for these sources of error have been defined, and they have been extensively applied in a research setting. In order to assess their utility in the performance of routine gastric secretory studies? the value of such corrections was assessed in 56 studies in patients with duodenal ulceration (10), previous surgical vagotomy (8), reflux oesophagitis (30) and primary oesophageal motility disorders (8). The effect of such corrections was small, and there were close correlations between uncorrected and corrected acid outputs in all four groups. The status of the vagal efferent gastric fibres was assessed by comparing the acid output after insulin hypoglycaemia with the maximal acid output after pentagastrin (insulin: pentagastrin ratio). The application of the corrections did not alter the conclusion regarding the assessment of vagal status in 55 of the 56 studies performed. It is concluded that such corrections are not necessary in the routine performance of gastric secretory studies.
Mesenteric infarction: an analysis of 83 patients with prognostic studies in 44 cases undergoing a massive small-bowel resection
Authors: Sitges-Serra A , Mas X , Roqueta F , Figueras J , Sanz F 
Published: March 2007

Abstract
A series is presented of 83 patients surgically explored for massive bowel infarction. Old men with previous heart disease and symptoms of peripheral atherosclerosis were primarily affected. Clinical presenting features were abdominal pain (100 per cent), peritonitis (57 per cent), shock (34 per cent) and hypothermia (26 per cent). A third-space syndrome with metabolic acidosis and uraemia was the most common physiological derangement. Age was the only factor that appeared to have influenced the surgeon's decision to perform massive bowel resection (71 years in non-resected versus 64 years in resected patients, P &lt; 0.006). The overall mortality rate was 71 per cent. Forty-four patients underwent massive bowel resection (mean length of remaining small bowel 60 ± 40 cm) and twenty-four (54 per cent) survived the procedure. Axillary temperature was higher in survivors (36.7°C versus 36.1°C, P &lt; 0.03). Early postoperative total plasma protein and albumin concentrations were also higher in survivors (57 versus 46 g/l, P &lt; 0.005; 27 versus 22 g/l, P &lt; 0.02). Patients with previous symptoms of atherosclerotic disease and high pre-operative blood urea levels also had a bad prognosis. Survivors had a mean hospital stay of 57 days and parenteral nutrition had to be maintained for a mean of 34 days. The survival rate achieved with massive resection justifies this surgical approach in selected patients with massive bowel infarction.
Improvement of renal function in azotaemic hypertensive patients after surgical revascularization
Authors: Mestres C A , Campistol J M , Ninot S , Botey A , Abad C , Guerola M , Cases A , Revert L , Mulet J 
Published: March 2007

Abstract
Between 1974 and 1986, 17 patients (16 men and I woman) with renal insufficiency (serum creatinine &gt; 1.5 mg/dl, mean 3.75 mg/dl), with a mean age of 51.3 years, underwent surgical renal revascularization. Two of them were on maintenance haemodialysis. All were severely hypertensive in spite of antihypertensive drugs. Atherosclerosis was the cause of renal stenosis in 14 cases and fibromuscular dysplasia in 3. Operative procedures included splenorenal shunt (5), autotransplantation (3), aortorenal bypass (3), hepatorenal bypass (1), bilateral renal endarterectomy (1), renal ostial closure (1) and nephrectomy (3). Mean serum creatinine showed a decrease from 3.76 to 1.65 mg/dl (P &lt; 0.005). Mean arterial pressure dropped from 161 mmHg to 103 mmHg (P &lt; 0.001). Systolic and diastolic pressures also showed significant decreases. Two patients died. Four patients required a second operation and the renal function and blood pressure then improved. Renovascular disease must be ruled out in patients with renal insufficiency associated with hypertension, including those patients on haemodialysis. We conclude that renal revascularization surgery is a reliable and efficient form of treatment in selected cases of renal failure of renovascular origin.
Bile acid concentrations in the refluxate of patients with reflux oesophagitis
Authors: Gotley D C , Morgan A P , Cooper M J 
Published: March 2007

Abstract
Although reflux of bile acids has been implicated in the pathogenesis of reflux oesophagitis, attempts to document this in vivo have failed to detect more than trace amounts of bile acid in the oesophagus. To determine the bile acid composition of oesophageal reluxate, 45 patients with abnormal acid gastro-oesophageal reflux with oesophagitis and 10 controls had a size 14 Fr Salem sump tube positioned 5 cm above the lower oesophageal sphincter. Oesophageal contents were continuously aspirated and collected in aliquots every 2 h over 16 h. Fasting, postprandial, upright and supine (nocturnal) periods were assessed and total conjugated bile acids were measured by high pressure liquid chromatography with a sensitivity of 8 μmol/l. Conjugated bile acids were detected in 2 of 10 controls (maximum 40 µmol/l) and in 39 of 45 patients (87 per cent). Eleven patients had peak conjugated bile acid levels &gt; 200 µmol/l, and these levels occurred exclusively during the supine (nocturnal) period. Median conjugated bile acid levels during daytime reflux were &lt; 20 µmol/l which was significantly lower than during nocturnal reflux (median 51 µmol/l, P &lt; 0.001). Conjugated bile acids are detected in the oesophagus of most patients with oesophagitis and may play a role in the pathogenesis of oesophagitis in some patients with nocturnal gastro-oesophageal reflux.
Management of major colonic haemorrhage
Authors: Berry A R , Campbell W B , Kettlewell M G W 
Published: March 2007

AbstractMajor colonic haemorrhage remains a difficult diagnostic and therapeutic problem. We propose that those patients who continue to bleed after resuscitation are best served by immediate laparotomy. High flow antegrade irrigation and intra-operative colonoscopy can then be used to localize the site of bleeding and allow appropriate excisional surgery rather than blind colonic resection.
Intravenous digital subtraction angiography and Duplex scanning in the detection of late human umbilical vein degeneration
Authors: Nevelsteen A , Smet G , Wilmst G , Marchal G , Suy R 
Published: March 2007

Abstract
To define the exact incidence of late degeneration, 32 patients underwent intravenous digital subtraction angiography (IVDSA) and/or a Duplex scan more than 3 years after human umbilical vein (HUV) grafting. IVDSA (n = 26) showed a 23 per cent aneurysmal degeneration rate which increased to 40 per cent with Duplex scanning (n = 25). Although the differences obtained in those patients receiving both examinations (n = 19) were statistically not significant, Duplex scanning appeared to be more sensitive, demonstrating two additional cases of aneurysmal degeneration not detected by IVDSA. Since, moreover, Duplex scanning proved able to detect anastomotic stenosis, it appears to be the examination of choice in long-term follow-up of the HUV graft. Despite this relatively high degeneration rate, the authors consider continued use of the HUV graft in selected patients to be justified, especially when the long-term patency rates, the available alternatives, and the less favourable long-term survival after femoropopliteal reconstruction are taken into consideration.
Clinical observations on the wound healing properties of honey
Authors: Efem S E E 
Published: March 2007

Abstract
Fifty-nine patients with wounds and ulcers most of which (80 per cent) had failed to heal with conventional treatment were treated with unprocessed honey. Fifty-eight cases showed remarkable improvement following topical application of honey. One case, later diagnosed as Buruli ulcer, failed to respond. Wounds that were sterile at the outset, remained sterile until healed, while infected wounds and ulcer became sterile within 1 week of topical application of honey. Honey debrided wounds rapidly, replacing sloughs with granulation tissue. It also promoted rapid epithelialization, and absorption of oedema from around the ulcer margins.
Human gastric perfusion: Evidence for non-uniformity of blood flow
Authors: Allen P I M , Chesner I , Wheatley K , Goldman M 
Published: March 2007

Abstract
Post-mortem injection studies have demonstrated marked differences in the course and distribution of arterioles in the stomach, but evidence of differential perfusion in man is lacking. Using the non-invasive laser Doppler technique, we studied 38 patients referred for gastroscopy for dyspeptic symptoms. Flux measurements were made at nine sites: distal oesophagus, cardia, mid-body and antrum on lesser and greater curves, and pre- and post-pylorus. In all cases the stomach was macroscopically normal. Flux in the proximal stomach was significantly greater than that in the antrum, (P &lt; 0.001, Student's t test). This in vivo study demonstrates a flow gradient related to the previously demonstrated anatomical differences.
DNA ploidy pattern and tumour spread in gastric cancer
Authors: de Aretxabala X , Yonemura Y , Sugiyama K , Kamata T , Konishi K , Miwa K , Miyazaki I 
Published: March 2007

Abstract
The DNA ploidy pattern of gastric cancer was studied in 58 patients to investigate the heterogeneity between primary tumour and metastases. In both primary tumours and lymph node metastases, diploid patterns accounted for 33 per cent, whereas all liver metastases were aneuploid. The percentage of polyploid cells was higher in the liver metastases than in primary tumours and lymph node metastases. When the heterogeneity of DNA ploidy pattern between primary tumour and metastasis was evaluated, diploid tumours had a significantly lower rate of lymph node metastasis heterogeneity than aneuploid tumours. When the DNA ploidy pattern and survival were evaluated, the patients who had a diploid pattern in both primary tumour and metastasis had a significantly higher survival rate than the patients who had an aneuploid pattern in the primary tumour and metastasis (57 per cent versus 26 per cent at 5 years). These data suggest that cell heterogeneity is a common phenomenon in gastric cancer, and this may be important in the evolution of the disease. Furthermore, the role of the DNA ploidy pattern as a prognostic factor is emphasized.
Delayed external sphincter repair for obstetric tear
Authors: Laurberg S , Swash M , Henry M M 
Published: March 2007

Abstract
In some patients with faecal incontinence due to an obstetric tear of the external anal sphincter there is additional weakness of the anal sphincter muscles from damage to the innervation of these muscles during delivery. Of 19 patients who required surgical repair of an obstetric sphincter tear some months or years after injury, 9 (47 per cent) had evidence of pudendal nerve damage at pre-operative anorectal physiological investigation. The result of surgical repair was excellent or good in eight of the ten patients in whom there was no evidence of nerve damage, while this was the case in only one of the nine patients with nerve damage. These results are significantly different (P = 0.018). Thus the functional result of delayed anal sphincter repair after obstetric lesions is partly dependent upon whether the nerve supply is intact. Pre-operative physiological evaluation can give information on the probability of a successful surgical result.
Blood transfusion and infectious complications following colorectal cancer surgery
Authors: Tartter P I 
Published: March 2007

Abstract
Blood transfusion has been linked to clinical phenomena attributable to immune suppression. We prospectively studied the relationship between perioperative blood transfusion and postoperative infectious complications in 343 consecutive patients undergoing surgery for colorectal cancer. Of the 134 patients who received transfusions 33 (24.6 per cent) developed infectious complications compared with 9 (4.3 per cent) of the 209 patients who did not receive blood (P &lt; 0.0001). The mean number of units of blood received by patients who developed infectious complications significantly exceeded the number for patients without infectious complications (2.31 versus 0.74, P &lt; 0.0001). The association of transfusion with infections was highly significant (P &lt; 0.0001) after controlling for age, sex, blood loss, procedure, tumour differentiation, stage, admission haematocrit, duration of surgery, length of the specimen and tumour size. Blood transfusion appears to be an independent risk factor for postoperative infectious complications.
Ten-year computerized audit of infection after abdominal surgery
Authors: Krukowski Z H , Matheson N A 
Published: March 2007

Abstract
A prospective audit of the frequency of infective complications after all abdominal operations was carried out between January 1977 and December 1986. A total of 3100 abdominal procedures (2041 elective; 1059 emergency) were performed in 3056 patients. There were 50 (1·6 per cent) in-hospital and 66 (2·1 per cent) late wound infections (overall 3·7 per cent). Fifty-four (1·8 per cent) patients developed postoperative intraperitoneal sepsis. Ninety-eight patients died (overall mortality 3·2 per cent) and introperitoneal sepsis was a related factor in twelve (0·4 per cent). Wound infection, peritoneal sepsis and mortality were related to the degree of operative contamination and to reoperation. The results support the traditional, although sometimes inadequately stressed, teaching that technique is an important factor in preventing infection. Infection is also reduced by peroperative antibiotic lavage. The limited value and the potential difficulties of the unstructured introduction of computerized audit should be recognized.
Anterior lesser curve seromyotomy and posterior truncal vagotomy for chronic duodenal ulcer: The results at five years
Authors: Siriwardena A K , Gunn A A 
Published: March 2007

Abstract
In one surgical unit, 241 patients have undergone anterior gastric seromyotomy and posterior truncal vagotomy for chronic duodenal ulcer. The postoperative mortality rate was 0·4 per cent. Four patients (1·6 per cent) required a drainage procedure for gastric stasis. The first 66 patients (Group A) were followed prospectively and 58 were available for assessment at 5 years. Eight patients (14 per cent) had developed a recurrent ulcer. In seven of these patients this responded to conservative treatment with H2 receptor antagonists. One patient has required Polya partial gastrectomy for recurrent ulceration. At 5 years 47 patients (81 per cent) were placed in the Visick I or II categories. In the next 175 patients (Group B), the ulcer recurrence rate was 3 per cent, suggesting a learning curve in mastering the procedure. We conclude that the immediate and 5-year results of the first 66 patients are at least comparable with those of highly selective vagotomy. Anterior gastric seromyotomy with posterior truncal vagotomy is an easy and rapid procedure and may be more widely applicable than highly selective vagotomy.
Highly selective vagotomy: A 14-year experience
Authors: Byrne D J , Brock B M , Morgan A G , McAdam W A F 
Published: March 2007

Abstract
Since August 1971, 244 highly selective vagotomies were performed for pyloric and duodenal ulceration by one surgeon (W.A.F.M.). There was one postoperative death. Twenty (8 per cent) patients were lost to follow-up. The remaining 223 patients were followed up for 1 to 14 years (mean 4·2 years). On the modified Visick grading system 83·4 percent were Visick 1 or 11 and 16·6 per cent were Visick III or IV. The failures were mainly recurrences. The recurrence rate was 11·2 percent. Certain factors were examined to try to elucidate those influencing recurrence rate but no significant prognostic indicator was found. Acid studies were analysed and no significant relationship between these and the development of a recurrence could be found. The second 100 vagotomies were better than the first as judged by the results of studies of insulin-stimulated acid. Finally, we question whether all recurrences should automatically be regarded as treatment failures and the patients classified as Visick IV.
Hyperparathyroidism after neck irradiation
Authors: Christmas T J , Chapple C R , Noble J G , Milroy E J G , Cowie A G A 
Published: March 2007

Abstract
A retrospective review of 1550 cases of hyperparathyroidism (HPT) treated surgically over a 30-year period reveals a past history of exposure to neck irradiation in 10 cases (0·7 per cent). The indication for radiotherapy was benign disease in nine and papillary thyroid carcinoma in one case. The mean interval between radiation exposure and the detection of HPT was 32 years (range 3–63 years). Patients treated with radioactive iodine alone developed HPT after a mean of 5 years while the interval for those treated with external beam therapy alone was a mean of 44 years. The parathyroid histology was adenoma in six cases, carcinoma in three cases and nodular hyperplasia in one case. All patients had coincident benign thyroid disease apart from one that had previously had papillary carcinoma and another with follicular carcinoma. Neck irradiation has been shown to confer an increased risk of HPT due to parathyroid adenoma and carcinoma. Radiotherapy for benign disease has generally been abandoned and these cases demonstrate a further contra-indication for the use of neck irradiation.