bluuebunny/crossref_metadata_2025_split huggingface dataset:
Penetrating injuries of the popliteal artery
Authors: O'Reilly M J G , Hood J M , Livingston R H , Irwin J W S 
Published: March 2007

Abstract
Military experience has consistently emphasized the unacceptably high amputation rate associated with popliteal arterial trauma. In this group of patients there were 23 arterial injuries and 26 injuries involving both an artery and a vein. The loss of only 5 limbs in this series was directly related to the policy of repair of the artery by both single segment vein grafts and by ‘panel’ grafts. Panel grafts are prepared by removing the long saphenous vein at ankle level, splitting it longitudinally and then dividing it transversely at the midpoint. The two segments of vein are placed side by side and sutured along each side, a no. 14 or 16 Ch. Foley catheter being used as a stent. Fasciotomy, carried out at an early stage in the postoperative course, and prompt re-exploration of repair sites when suspicion arose as to the effectiveness of limb circulation, were also major factors in establishing a successful outcome in so many patients.
The treatment of perforated duodenal ulcer
Authors: Kay P H , Moore K T H , Clark R G 
Published: March 2007

Abstract
The prognosis of 189 patients with a perforated duodenal ulcer was analysed. There were three treatment groups, non-operative, simple closure and definitive ulcer surgery. The prognosis of the patients was analysed in terms of the chronicity of the ulcer. Perforations occurring in acute duodenal ulcers have an excellent prognosis, with similar results in each group in this series. All perforations of chronic duodenal ulcers should be treated by emergency surgery.
Disinfection of the skin of the abdomen
Authors: Davies Jean , Babb J R , Ayliffe G A J , Wilkins M D 
Published: March 2007

Abstract
The skin of the abdomen of 106 staff and 358 patients was sampled 5 min and 2 h after disinfection using contact plates. Control areas of skin were treated with water only or left untreated.
A reduction of 99 per cent (log reduction factor = 2) or more in colony counts was obtained in 5 min with 70 per cent ethyl alcohol and alcoholic solutions of chlorhexidine, povidone-iodine and chloroxylenoll EDTA. Aqueous solutions of chlorhexidine (0·5 per cent), Savlon (5 per cent), povidone-iodine (10 per cent) and chloroxylenoll EDTA (× 10 recommended concentration) also showed similar reductions. Weaker aqueous solutions of chlorhexidine (0·05 per cent), Savlon (1 per cent) and chloroxylenoll EDTA (recommended concentration) were significantly less effective than the alcoholic and the most effective aqueous solutions, although all were more effective than water. Total bacterial counts were lower from the skin of female than from male staff and lower from staff than from patients. Pathogens (staphylococcus aureus or Gram-negative bacilli) were isolated from only one member of staff in small numbers and irregularly and rarely in large numbers from patients. Few pathogens were isolated after application of any of the disinfectants.
Congenital solitary cysts of the liver and spleen
Authors: Williamson R C N , Ramus N I , Shorey B A 
Published: March 2007

AbstractThree symptomatic cases of congenital solitary cyst are reported, one in the liver and two in the spleen. Recurrence of the hepatic cyst after partial excision and drainge was complicated by fistula formation between the cyst and the duodenum. The fistula was successfully closed at a second operation. Calcification of the cyst wall occurred in one of two epithelial cysts of the spleen in young women, which were treated by splenectomy. Besides their rarity, congenital solitary cysts of the liver and spleen have several other features in common. Isotopic and ultrasonic scanning assist diagnosis in both conditions.
Progress of acute appendicitis: A study in children
Authors: Doraiswamy N V 
Published: March 2007

Abstract
The results of six simple investigations are compared with the duration of the disease in 100 children with acute appendicitis. The results indicate that during the first day on which the appendix becomes inflamed the local defence mechanisms of the appendix are impaired sufficiently to allow invastion by the bacterial organisms in its lumen. This initially inflamed and subsequently infected appendix may develop in the manner indicated. Local and jor generalized complications may follow, i. e. acute appendicities in its successive stages of development, which may be regarded as (a) inflamed, (b) infected and (c) complicated, and thesed changes take place at intervals of 1 day. Bacteria and faecoliths are present in the lumen of the appendix, whether inflamed or not, and it is suggested that they complicate the disese rather than being responsible for causing it.
The value of corpus–antrum border determinations in highly selective vagotomy
Authors: Ahonen J , Hoepfner-Hallikainen D , Inberg M , Scheinin T M 
Published: March 2007

Abstract
In order to know whether the exact determination of the corpus–antrum border is of importance in highly selective vagotomy (HSV) the operation was performed on two matched groups of patients with duodenal ulcers. In group 1 (35 patients) HSV was performed using anatomical landmarks to define the distal extent of dissection. In group 2 (35 patients) HSV was performed using the same technique and then a gastrotomy was made and any remaining acid-secreting mucosa was identified using pH-metry under pentagastrin stimulation. In 22 cases secretion of acid was observed distal to the anatomically defined corpus-antrum border. In these patients afurther distal division of vagal branches was done until no acid secretion was observed. Two months and 1 year after the operation, basal acid output (BAO), pentagastrin-stimulated acid output (PAOpg), insulin-stimulated acid output (PAO1) and basal serum gastrin determinations were done and compared with the corresponding preoperative data. Our results show that despite the more extensive division of the antral vagal branches in group 2, BAO and PAOpg were similar in both groups postoperatively. Postoperative PAOI was also similar. Differences were observed, however, in postoperative serum gastrin levels–group 1 42.5 ± 6.0 pmol/l and group 281.7 ± 7.4 pmol/l 1 year after the operation. In no cases did the more extensive dissection of antral vagal branches lead to clinical or radiological gastric stasis. Thus, if the branches of the nerves of Latarjet are used as landmarks in performing HSV, in many cases vagally innervated, acid-secreting mucosa will be left in the stomach, but apparently this is quantitatively of minor importance. On the other hand, a more extensive distal vagal dissection leads to disturbingly high postoperative serum gastrin values.
Sequential patterns of haemodynamic and metabolic changes in experimental hypovolaemic shock. I. Responses to acute haemorrhage
Authors: Pardy B J , Dudley H A F 
Published: March 2007

Summary
Little is known about cardiorespiratory changes during the development of hypovolaemia. This study attempts to provide such information and compares the period of bleeding with that of established hypovolaemia.
Eleven anaesthetized and ventilated greyhounds were bled and analyses of cardiopulmonary function made at fixed intervals both during and after haemorrhage. Six sequential patterns of cardiopulmonary and metabolic change were recognized. It was apparent that bleeding caused the first three phases of change, recovery from the effects of bleeding the next two and steady hypovolaemia the last. The event of bleeding is the main factor that elevates total peripheral resistance and reduces tissue perfusion with consequent lowering of oxygen consumption and alkalosis secondary to impaired carbon dioxide production; when bleeding ceases these changes partially reverse in a manner characteristic of that induced by the reinfusion of shed blood; and hypovolaemia per se has a relatively weak influence.
These findings provide an explanation for disparities in previous published reports and have obvious clinical implications.
The value of different forms of treatment for varicose veins
Authors: Jakobsen Bjarne Hamilton 
Published: March 2007

Summary
In a controlled clinical investigation 516 patients with previously untreated saphenous varices were divided into three treatment groups according to a stratified group comparative design. The patients in treatment group 1 underwent a radical operation under full anaesthesia; the patients in group 2 were treated by means of minor operations followed by injection/compression therapy; the patients in group 3 were treated by means of injection/compression therapy alone. The results were evaluated both objectively and subjectively 3 months and 3 years after treatment, the follow-up being 100 per cent and 98.1 per cent complete at those times. With regard to the period of disability among those patients with jobs outside the home (63.8 per cent), there was a statistically significant difference between the three groups, the median period of disability being 14.2, 7.6 and 0 days respectively. In all three treatment groups the results were worse after 3 years than after 3 months, but the difference was significantly less following radical operation than after combined treatment, and significantly less following combined treatment than after injection/compression therapy alone. The patients were randomized and treated by the author and the results of treatment were evaluated by the author and partly controlled by another investigator.
It is concluded that the primary treatment for incompetence of the saphenous veins should be a radical operation.
The fibrinolytic activity of varicose veins
Authors: Wolfe J H N , Morland M , Browse N L 
Published: March 2007

Summary
The plasma fibrinogen concentration, plasma fibrinolytic activity and the vein wall fibrinolytic activity of hand, groin, knee, ankle and perforating veins have been studied in 10 patients with skin changes in the lower leg secondary to venous disease (lipodermatosclerosis), in 10 patients with uncomplicated varicose veins and in 17 normal volunteers undergoing surgery. There was significantly more vein wall fibrinolytic activity in normal volunteers than in the patients with lipodermatosclerosis, not only in the ankle (P &lt; 0.001) but also in the hand (P &lt; 0.05).
It is suggested that the reduced tissue fibrinolytic activity is a causative factor in the skin changes and ulceration of the post-phlebitic leg, and that since the reduced activity is not confined to the leg, it may be a primary systemic defect rather than a state secondary to venous congestion.
Prevention of intraperitoneal adhesions: A comparison of noxythiolin and a new povidone-iodine/PVP solution
Authors: Gilmore O J A , Reid Clare 
Published: March 2007

Summary
Peritoneal adhesions were induced in 250 female Wistar rats by the excision and closure of a right lower quadrant parietal peritoneal defect. After closure of the defect each rat was randomly allocated to one of five treatment groups: A, control with no instillate; B, control with Ringer solution; C, noxythiolin 0.5 per cent solution; D, noxythiolin 1 per cent solution; E povidone-iodine/PVP solution. Two millilitres of the appropriate solution were injected into the peritoneal cavity just before closure of a standard 4-cm midline incision. Assessment of adhesion formation was mad at 1 week in ignorance of the treatment group. Noxythiolin 1 per cent was more effective than Ringer solution and noxythiolin 0.5 per cent in reducing the mean number of adhesions (P &lt; 0.05) but was inferior to povidone-iodine/PVP (P &lt; 0.05). Povidone-iodine/PVP solution significantly reduced the number of adhesions compared with the four other groups. In addition, it significantly reduced the mean length of attachment of each adhesion compared with the two control groups (P &lt; 0.001).
Cytological study of fluid from breast cysts
Authors: Cowen P N , Benson E A 
Published: March 2007

Summary
A series of 215 patients with breast cysts has provided 348 specimens of cyst fluid for cytological diagnosis. Only one of these specimens was reported positive for malignant cells and this patient had a carcinoma. Nine specimens were reported as suspicious, but none of these patients had or subsequently developed carcinoma. In 338 specimens cytology was negative. A total of 178 patients (294 specimens) was available for follow-up. Of these 2 proved to have carcinomas on immediate follow-up, i.e. a lump persisted after aspiration, rind a further 2 patients developed cancers in the same breast, one 4 and the other 7 years after aspiration. We therefore conclude that the routine submission of' breast cyst fluid for cytology is wasteful of time and resources.
Haematogenous osteomyelitis of the metatarsal sesamoid
Authors: Cartlidge I J , Gillespie W J 
Published: March 2007

Summary
A case of haematogenous osteomyelitis of the medial first metatarsal sesamoid is presented and the differential diagnosis discussed. Review of the literature suggests that the condition is rarely seen and tends to present in childhood and adolescence. This contrasts with metatarsal sesamoid osteomyelitis due to direct spread of infection, which occurs in the elderly as an important complication of the diabetic foot.
Loop colostomy closure
Authors: Henry M M , Everett W G 
Published: March 2007

SummaryThe records of 74 patients who had loop colostomies closed at Addenbrooke's Hospital between 1970 and 1975 were studied retrospectively. One death from a pulmonary embolus occurred and the incidence of fistula from the site of closure was found to be 5.4 per cent.A number of differing factors were assessed. Closure 6 weeks after the colostomy's formation and preoperative antibiotic (antimicrobial) bowel preparation appeared to be factors associated with a favourable outcome. On the other hand, an initial operation for carcinoma and closure less than 6 weeks after the colostomy's formation were factors related to a less favourable outcome.
Extra–intracranial revascularization
Authors: Lumley J S P 
Published: March 2007

Summary
Twenty-four extra-intracranial revascularization procedures were undertaken in 23 patients with occlusion of the ipsilateral internal carotid artery. The superficial temporal artery was anastomosed to a cortical branch of the middle cerebral artery in 23 cases and a vein graft inserted between the external carotid artery and the cortical vessel in 1, a microsurgical technique being used.
Twenty-one patients were suffering from transient ischaemic attacks (TIAs) and 2 had developing strokes. Nineteen patients had radiologically demonstrated bilateral disease of the carotid vessels, 9 having undergone contralateral carotid artery surgery before the intracranial procedure.
No improvement was noted in the 2 patients with developing strokes; one patient developed a stroke contralateral to the intracranial procedure 24 h postoperatively, this being accompanied by occlusion of the anastomoses, and one patient had progression of the stroke syndrome following occlusion of the intracranial vein graft. All other patients have shown a reduction or abolition of TIAs over a follow-up period of 24 months.
These findings suggest that intracranial revascularization is of value in patients with total internal carotid artery occlusion and continuing TIAs.
Postoperative hypophosphataemia
Authors: England P C , Duari M , Tweedle D E F , Jones R A , Gowland E 
Published: March 2007

Summary
The possible mechanisms of postoperative hypophosphataemia were studied in women undergoing uncomplicated cholecystectomy. Six patients were allocated to each of three groups. Group I received no intravenous fluids, group II received dextrose/saline solution alone and group III received dextrose/saline solution with phosphorus supplementation. The serum concentration of inorganic phosphorus fell in all three groups, the greatest fall being in the group receiving dextrose/saline solution. However, the lowest level reached (0.82 mmol/l) was within the normal range for our laboratory. Concentrations of red blood cell adenosine triphosphate and 2,3-diphosphoglycerate showed similar changes. The operations were not associated with a large catabolic response nor with an increase in urinary phosphorus excretion. The postoperative reduction in serum concentration of inorganic phosphorus appeared to be due mainly to haemodilution. There is no indication for routine phosphorus supplementation following uncomplicated elective surgery.
Midline cancer of the floor of the mouth: role of suprahyoid dissection
Authors: El-Domeiri Ali A 
Published: March 2007

Summary
Of 37 patients with squamous cell carcinoma of the floor of the mouth seen during a 5-year period, 28 were treated primarily by surgery. Ten of the 28 patients presented with midline cancers measuring between 1·0 and 3 cm (T1 and T2). Three of these patients had local excision only. Metastases to the submandibular lymph nodes later occurred in 1 of these 3 patients. The remaining 7 patients with midline lesions had wide excision of the tumour, marginal resection of the mandible and bilateral suprahyoid node dissection. Of these 7 patients 4 remained free of disease for periods ranging between 2 and 5 years. Two of these had lymph node metastases. These results suggest that en bloc excision of relatively small midline cancers (i.e. not exceeding 2 cm (T1) in largest diameter) with bilateral suprahyoid node dissection gives effective control of these lesions.
Congenital chylothorax: report of unique case associated with ‘H’-type tracheo-oesophageal fistula
Authors: Harvey J G , Houlsby W , Sherman K , Gough M H 
Published: March 2007

Summary
A case of congenital chylothorax associated with a congenital ‘H’-type tracheo-oesophageal fistula is reported. The development of the thoracic duct is described and the possible embryological association with tracheo-oesophageal fistula is discussed. The management of the case is reaiewed.
Use of circular stapling gun with peranal insertion of anorectal purse-string suture for construction of very low colorectal or colo-anal anastomoses
Authors: Goligher J C 
Published: March 2007

Summary
A technique is described for construction of the colorectal or colo-anal anastomosis in low rectal resection by using an automatic circular stapling device and inserting the anorectal purse-string suture peranally from below. This method was employed in 4 patients resulting in complete healing in 3 cases and a moderate leak in 1, which, however, eventually healed satisfactorily.
The management of gross refractory obesity by jejuno-ileal bypass
Authors: Baddeley R M 
Published: March 2007

Abstract
Jejuno-ileal bypass has been performed in 226 massively obese patients, 190 of whom have been followed for a minimum of 1 year. End-to-side and end-to-end anasto-moses were compared and no difference in the weight reduction achieved by either technique was seen throughout the 5-year follow-up. There was no significant difference in weight reduction achieved between groups of patients in which the jejunal length varied from 10 to 35 cm and the ileal length from 35 to 10 cm.
The weight reduction achieved in the entire series averaged 36·7 ± 9·4 per cent at 2 years, after which no further loss occurred. Good psychological benefits were recorded. Remission of diabetes occurred in 12 of 13 patients and marked long term lowering of serum lipids was seen.
Side effects included fluid and electrolyte disturbances and fatty changes in the liver during the first year, improving thereafter. Early cirrhosis of the liver occurred in 8·6 per cent. Other side effects included abdominal bloating, arthralgia and renal colic.
The operative mortality was 0·9 per cent and the late mortality directly attributable to the jejuno-ileal bypass, 3·1 per cent. In 19 patients the bypass was discontinued because of severe side effects.
Influence of thyroid surgery on voice function and laryngeal symptoms
Authors: Watt-Boolsen Steen , Blichert-Toft Mogens , Boberg Arthur 
Published: March 2007

Abstract
A comprehensive examination of voice function and laryngeal symptoms was applied systematically to 20 patients undergoing thyroid surgery. Patients were excluded from the series if there had been previous neck surgery or if postoperative indirect laryngoscopy showed abnormal cord mobility. Examination before operation showed that patients with sporadic non-toxic goitre or medically pre-treated toxic goitre had impaired voice function based on stroboscopy, electroglottography, phono-oscillometry and determination of voice range, phonation time, pitch, and peak flow. Three months after thyroid surgery the voice function was significantly improved although not normal in nontoxic goitre patients, whereas the voice function in patients with thyrotoxicosis was unchanged. The number of laryngeal symptoms was significantly reduced in non-toxic goitres following surgery and unaltered in the group with thyrotoxicosis.
Carcinoma of the thyroid
Authors: Alagaratnam T T , Ong G B 
Published: March 2007

Abstract
Total thyroidectomy with excision of any enlarged cervical lymph nodes was the usual operation practised for carcinoma of the thyroid in this series. Extended thyroidectomy afforded cures in some patients with locally advanced disease. Preoperative drill biopsy of the goitre was a useful procedure. Other noteworthy features were the increasing occurrence of papillary carcinoma and the comparatively high incidence of malignancy in solitary nodules.
Bilio-pancreatic bypass for obesity: I. An experimental study in dogs
Authors: Scopinaro Nicola , Gianetta Ezio , Civalleri Dario , Bonalumi Umberto , Bachi Virgilio 
Published: March 2007

Summary
Bilio-pancreatic bypass is a new procedure that tries to obtain a maldigestion syndrome with selective malabsorption of the main high calorie foods. The operation consists of a gastric resection and division of the proximal jejunum just distal to the ligament of Treitz. A gastroentero-anastomosis is then constructed using the distal end of the transected jejunum, while the proximal jejunum is anastomosed to the side of the distal ileum.
An experimental study carried out on 12 dogs confirmed that the operation causes a selective malabsorption with loss of weight and no complications. On the basis of this study it is suggested that this procedure has the following advantages over jejuno-ileal bypass: (a) normal absorption of bile salts, water and electrolytes; (b) slow recovery of absorption; (c) absence of a blind loop.
The results of vaginoplasty in excision of the rectum
Authors: Johnston George W 
Published: March 2007

SummaryVaginoplasty was used in a consecutive series of 45 patients undergoing rectal excision for neoplastic and inflammatory bowel disease. Forty-three patients achieved primary perineal healing and none developed a persistent perineal fistula.One patient with Crohn's disease developed a perianal fistula a year after operation but healing occurred after minor surgery. Another developed a pre-sacral abscess 9 years after operation; spontaneous discharge into the vagina occurred.
A technique for the difficult peripheral arterial aneurysm
Authors: Birkenstock W E 
Published: March 2007

Summary
Complete external control of the vessels feeding some aneurysms may be very difficult and occasionally only achieved at the cost of damage to surrounding structures. A method is described in which Foley catheters are introduced into the feeding vessels from within the aneurysm and then cut distal to their clamped side branch to enable Dacron grafts to be passed over them and sutured in place. This technique has been used in 3 patients with very satisfactory results and is offered as an alternative when standard control is hazardous, or impossible.