bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anteroposition of the portal vein and spontaneous passage of gall-stones. Case report and embryological hypothesis
Authors: Brook Wilfrid , Gardner Michael 
Published: March 2007

Abstract
A case of a woman who passed seven gall-stones ‘per vias naturales’ is presented. At subsequent operation for painful jaundice the portal vein was found to lie in front of the common bile-duct, although in its lower part it was retroduodenal.
A new embryological hypothesis to explain the preductal portral vein is presented.
Alteration in Fibrinolysis Associated With Surgery and Venous Thrombosis
Authors: Mansfield Averil O 
Published: March 2007

Summary
A marked increase in fibrinolytic activity occurs during surgical operations, especially major surgery. This increase sometimes begins prior to the induction of anaesthesia. There is reduced fibrinolytic activity during the postoperative period and this occurs earlier and to a greater degree in those patients who develop a venous thrombosis as shown by the 125I-fibrinogen test.
Pyloroplasty alone in the management of patients with a negative exploration for duodenal ulcer
Authors: Douglas M , Duthie H L 
Published: March 2007

Abstract
If a preoperative diagnosis of duodenal ulcer in not confirmed at laparotomy an exploratory pyloroduodenotomy may be closed as a pyloroplasty without adding a vagal section. This study concerns 32 patients in whom this was done. As a group these patients tended to have somewhat atypical ulcer symptoms and indefinite radiological sings. Within a mean follow-up period of 3 1/2 years more than one-third of these patients developed recurrent ulcer symptoms, which in 4 patients ot date have been successfully treated by vagotomy. The functional result could not be predicted by the preoperative symptoms or radiological changes. The incidence of diarrhoea and post-cibal fullness, vomiting, dumping, colic, and hypoglycaemia was almos identical with that seen after vagotomy and pyloroplasty. The wisdom of using pyloroplasty without vagotomy in patients with ulcer symptoms is therefore questioned.
The value of upper gastro-intestinal fibrescopy
Authors: McColl Ian 
Published: March 2007

Abstract
In a series of 330 fibrescopies of the upper gastrointestinal tract the most usefull all-round instrument proved to be a long end-viewing panendoscope. The nature of the radilogical errors revaled by endoscopy indicated that the latter is essential before embarking on surgery for antral gastric ulcers, radiographically negative dyspepsia, and further gastric surgery.
The importance of bile in reflux oesophagitis and the success in its prevention by surgical means
Authors: Gillison E W , Kusakari K , Bombeck C T , Nyhus L M 
Published: March 2007

Abstract
A study was instituted using the Rhesus monkeyan animal which has been found to resemble man both in respect of the anatomy of the gastrooesophageal region and of the secretion of hydrochloric acid from the stomach—as a model.
Surgery for coronary artery disease
Authors: Bouch D C , Julian D J , Kitchin A H , Oliver M F , Wade J D 
Published: March 2007

Abstract
Direct distal aortocoronary vein-grafts have been used in 20 patients suffering form ischaemic heart disease. In 16 patients the indication for surgery was severe angina pectoris failing to respond to medical measures. Seven patients had angina decubitus and were Class IV according to the New York Heart Association classification and 9 patients were in Class III. Two patients had recurrent myocardial infarctions and 2 were in cardiac failure. There were 14 good results, 2 failures, and 4 deaths. Post-mortem studies of the hearts confirmed the accuracy of selective angiography in identifying the sites of major coronary obstruction. Findings at surgery showed that the absence r presence of extensive peripheral disease beyond a block could not be reliably assessed in all cases. Histological studies of the veno-arterial anastomoses suggested that rigid atherosclerotic arterial disease is a cause of graft thrombosis and that endarterectomy is a useful procedure though its longterm value is uncertain.
An assessment of above- and through-knee amputations
Authors: Green P W B , Hawkins B S , Irvine W T , Jamieson C W 
Published: March 2007

Abstract
Above- and through-knee amputations have been performed in 126 patients at St. Mary's Hospital between 1961 and 1970
Whilst there was a higher operative mortality amongst the above-knee amputees, the local complication rate was much higher in the through-knee group. The mortality rate in the two groups following discharge from hospital was high. The through-knee amputation provides a better functional result than the above-knee type but mobility in both groups might be improved by ‘refresher courses’ in walking training.
Heterologous liver perfusion a comparison of the use of livers from four different species
Authors: Hickman R , Parker J R , Saunders S J , Goodwin N E , Terblanche J 
Published: March 2007

Abstract
Isolated perfusion of livers from calves, pigs, and lambs with human blood resulted in thrombocytopenia within 30 minutes of the establishment of the circuit. No rebound of platelet levels was noted during a further 3 1/2 hours of perfusion. The levels of total complement and the heterophile antibody titres dropped during the same time in all the experiments. Levels of lymphocytotoxic and leuco-agglutinating antibodies decreased in blood perfusing lamb and pig livers but these were not measured in the calf-liver perfusions.
In contrast, isolated perfusion of livers from baboons with human blood did not provoke significant thrombocytopenia and the results of perfusion were similar to those noted in homologous perfusions of the pig liver with pig blood. There were no differences in platelt levels using livers from baboons with blood groups either compatible or incompatible with the human blood. Complement levels and heterophile antibody titres did not drop and no lymphocytotoxic or leuco-agglutinating antibodies were detectable in human blood against baboon cells.
Measurement of electrolytes, glucose, aspartate transaminase, plasma haemoglobin, and lactate and ammonia clearance showed no significant difference in perfusions of the baboon liver when compared with perfusion of the pig liver with pig blood.
Based on these results, clinical hepatic assist procedures in this hospital will in future only be performed with livers from baboons. These animals will be kept in isolation for a period of virological study in order to minimize the hazard of virus transmission to the patient of personnel.
Secondary haemorrhage from the arterial anastomosis of renal allografts
Authors: Robson A J , Evans D B , Calne R Y 
Published: March 2007

Abstract
Four cases of massive secondary haemorrhage from the arterial anastomosis of a renal allograft as a result of infection are described.
It is likely that the infections developed in the donors and that careful selection is necessary to prevent this. Immediate allograft nephrectomy is suggested as the treatment of choice. The external iliac artery may be ligated without necessarily embarrassing the circulation to the leg.
Surgical resection of recurrent Crohn's disease
Authors: Grogono J L , Parks A G 
Published: March 2007

Abstract
The outcome of a group of 24 patients having multiple resections for Crohn's disease is presented by means of ‘life charts’. These show that it is uncommon for a second resection to be the start of a downhill course and about half of the patients remain well over long periods of follow-up. Comparison with other series is difficult for various reasons, but where comparison is possible the results are similar, except that few patients in this series have so far come to a third resection.
‘Curative’ surgery in carcinoma of the colon involving duodenum. A report of 6 cases
Authors: Ellis Harold , Morgan M Naunton , Wastell Christopher 
Published: March 2007

Abstract
Six examples of duodenal involvement by colonic cancer are reported. Two had an associated duodenal fistula. Radical surgery was carried out in all 6 cases, 3 of whom remain alive and free from recurrence up to 6 years later.
Oesophageal perforation during abdominal truncal vagotomy for duodenal ulcer
Authors: Price J J , Powis S J A , Morrissey D M 
Published: March 2007

Abstract
A retrospective survey of patients having truncal vagotomy for duodenal ulceration has been carried out. In this series 41 cases of oesophageal perforation occurred; 29 were recognized at the time of operation, 6 were diagnosed postoperatively, and in the remaining 6 the time of diagnosis was not specified. Two of the 29 patients in whom the oesophageal perforation was recognized at the time of operation died, as did 2 of the 6 cases diagnosed postoperatively. An increase of mortality and morbidity occurred in those diagnosed postoperatively. The importance of confirming oesophageal integrity at the conclusion of vagotomy is stressed.
Circumferential oesophageal myotomy
Authors: Davidson James S 
Published: March 2007

Abstract
Circumferential division of the oesophageal muscle combined with hiatal hernia repair has been carried out in 26 patients, 19 of whom had a peptic stricture. The object of the procedure is to achieve slight elongation and relaxation of the oesophagus so as to make reduction of the hernia easier in the presence of slight degrees of oesophageal shortening and to reduce the likelihood of recurrence. The rationale and technique are described and details of illustrative cases are given. The postoperative radiological appearances, which are somewhat unusual, are illustrated. The indications and contra-indications are discussed. It is claimed that while circumferential myotomy is useless in the presence of gross shortening of the oesophagus it is of value in borderline cases where reduction of the hernia can be effected only by exerting slight tension on the oesophagus.
Arteriovenous fistulae for chronic intermittent haemodialysis: A modified surgical technique
Authors: Hashmonai M , Schramek A , Chaimovitz C , Erlik D 
Published: March 2007

Abstract
A side-to-end technique for arteriovenous fistulae of the wrist vessels for use in chronic intermittent haemodialysis with venepuncture is proposed. A series of 14 patients in whom this technique has been used is presented. A survey of the different shunting techniques described in the literature is given and their advantages and disadvantages are discussed. The problem of turbulence due to a sharp angulation of the flow through the anastomosis and the possibility of its causing aneurysmata and thrombosis of the fistulae are considered. This problem and its sequelae, together with the problem of the use of the sole remaining artery of the hand when the other has been either occluded or ligated in previous operations, and the possibility of creating an arteriovenous fistula with a vein distant from the artery, are all overcome by this technique.
Abdominal actinomycosis
Authors: Davies M , Keddie N C 
Published: March 2007

Abstract
A case of sigmoid actinomycosis is described and the cases of abdominal actinomycosis presenting at the Manchester Royal Infirmary over the past 20 years are reviewed. The whole problem of abdominal actinomycosis is discussed, with special reference to the sites of infection and mode of treatment. The relevant literature is reviewed.
Unabsorbable suture material—a rare cause of recurrent stones in the common bile-duct
Authors: Mackie D B , Haynes Stephen , May Roy E 
Published: March 2007

Abstract
Three cases are reported in which unabsorbable suture material used to ligate the cystic duct at chole-cystectomy was subsequently found within the lumen of the extrahepatic bile-ducts. In 2 cases well-formed gall-stones having a central nucleus of either silk or nylon were removed from the common bile-duct. In the third case two braided nylon sutures were found within the stump of the cystic duct. The use of absorbable suture material for ligating the cystic duct is therefore recommended.
Carcinoma of the ampulla of Vater and duodenum
Authors: Blumgart L H , Kennedy A 
Published: March 2007

Abstract
Thirty-one cases of carcinoma of the ampulla of Vater and duodenum have been classified on the basis of pathological criteria.
Two types of tumour were discernible. Nine were polypoid papillary adenocarcinomas occurring at the ampulla of Vater; 19 were adenocarcinomas without a papillary pattern, of which 4 were duodenal tumours and 15 were ampullary. There were 3 ampullary tumours of mixed type. The carcinomas without a papillary structure were more invasive, more often associated with abdominal pain, more frequently misdiagnosed, and were associated with a higher mortality-rate.
The data were insufficient to draw firm conclusions as to the prognosis but the clinical behaviour was related to the pathology of the tumours.
Lesions in the ampullary region were associated with jaundice which was often intermittent. Lesions outside the ampullary area presented early with vomiting of pyloric type but without jaundice.
The importance of a high index of suspicion in dealing with these lesions and the value of barium-meal examinations are emphasized.
It is noted that pancreaticoduodenectomy for ampullary carcinoma has a mortality of less than 25 per cent if performed by an experienced surgeon and can be considerably lower in clinics specializing in this condition.
We suggest that the pathological classification of these tumours used in this paper may form the basis for further investigations into the diagnostic and prognostic problems which these tumours present.
This classification of ampullary tumours is a factor to be considered in assessing the indications for pancreaticoduodenectomy.
Stercoral perforation of the sigmoid colon
Authors: Carter D C , Kirkpatrick J R 
Published: March 2007

Abstract
Stercoral perforation of the sigmoid colon is probably more common than is generally appreciated. The condition should be considered in patients who present with peritonitis, localizing signs in the left iliac fossa, and a history of chronic constipation. Operation after a period of resuscitation offers the only hope of survival and resection of the affected of sigmoid colon with exteriorization appears to be indicated.
Two additional examples of this condition are described and the salient features are reviewed.
Carcinoma involving the lower alveolus an appraisal of past results and an account of current management
Authors: Lee E Stanley , Wilson J S P 
Published: March 2007

AbstractThree hundred and fifty-six cases of carcinoma of the buccal mucosa, lower alveolus, and mouth floor treated under a policy of radiotherapy as the method of first choice are reviewed. Alveolar involvement, whether initial or by extension, greatly reduces the chance of radiotherapeutic success, and is more important in this respect than the exact site of origin of the tumour. A decision to switch to a trial of elective surgery in this group of cases with alveolar in involvement was strengthened by major advances in surgical management, especially the evolution of satisfactory techniques of repair. A cardinal point is that tumour excision and closure of the mouth defect can now be accomplished reliably in one stage. The uses of the ‘island’ forehead flap and of Bakamjian's deltopectoral flap are discussed, as well as the methods of providing mandibular support when necessary. The authors' current techniques are described in detail on the basis of 82 consecutive radical procedures. A preliminary survey of the results suggests that surgery in this group may yield better results than radiotherapy.
Starch and intraperitoneal adhesion formation
Authors: Jagelman D G , Ellis H 
Published: March 2007

Abstract
A series of experiments on surgical gloves, an animal model, and human biopsies is reported. These studies demonstrate that contamination of the peritoneal cavity is inevitable when starch-precoated gloves are used, and that small doses of starch contamination may be responsible for human intraperitoneal adhesion formation.
Previous publications are reviewed regarding the harmful effects of starch in humans.
Traumatic rupture of the ileum
Authors: Evans J P 
Published: March 2007

Abstract
Three cases of patients who sustained rupture of the ileum following blunt trauma to the abdomen are reported. The onset of symptoms was delayed for a period which varied between 5 and 12 hours after the injury.
As so many of these patients are either asymptomatic or have minimal symptoms for the first 6 hours after the injury it might be advisable to admit all cases of abdominal injury to hospital for observation.
Laboratory investigations of the haemoglobin, white-blood count, and serum amylase contributed nothing to the early diagnosis of the condition. Plain radiographs of the abdomen show gas under the diaphragm in only 34 per cent of cases of traumatic rupture of the ileum.
Needle aspiration of the abdomen for liberated intestinal contents was not carried out in this series. In other series this procedure was found to be accurate in 90 per cent of cases of traumatic rupture of the small bowel. This is the only investigation which can be regarded as making a useful contribution to the early diagnosis of the condition.
Laparotomy was carried out between 5 and 15 hours after the injury. There was gross contamination of the peritoneal cavity by intestinal contents. This was due in all 3 cases to a single laceration on the antimesenteric border of the bowel. The lacerations were situated at distances varying between 15 and 22.5 cm. from the ileocaecal valve and were between 1.3 and 2.5 cm. in diameter. These were closed using two layers of chromic catgut. The peritoneal cavity was washed out with saline and Noxyflex.
The death of 1 patient in the series occurred 13 hours after the injury and was due to a myocardial infarct. The mortality-rate of 33 per cent for the series is similar to that described in other reports.
The effect of increased oxygen in acute limb ischaemia
Authors: Stalker C G , McEwan A J , Ledingham I McA 
Published: March 2007

Abstract
Acute hind-limb ischaemia was produced in anaesthetized, ventilated dogs. During ischaemia the femoral venous oxygen tension fell markedly and both oxygen extraction and consumption appeared to increase. Oxygen at 2 ATA produced a relatively small increase in oxygen availability to the ischaemic tissues; femoral venous oxygen tension rose by 20 mm. Hg but oxygen extraction and consumption remained elevated.
The aetiology and prevention of pancreatitis following biliary-tract operations
Authors: Keighley M R B , Graham N G 
Published: March 2007

Abstract
The incidence of pancreatitis complicating biliarytract operations is reported from a prospective survey of 75 patients. This study confirms that pancreatitis is much more frequent after choledochotomy than after cholecystectomy alone. Biochemical pancreatitis was demonstrated in over a third of the patients in whom the duct was explored.
The validity of elevated serum amylase in the diagnosis of this complication is established provided that clinical evidence of pancreatitis is also present. The significance of amylasaemia in the immediate postoperative period in the absence of clinical signs is questioned.
Reflux of duodenal contents into the pancreatic duct may be provoked by operative damage to the sphincter of Oddi. In these patients clinical pancreatitis invariably occurred. The avoidance of sphincterotomy in the prevention of this potentially serious postoperative complication is advised. Since pancreatitis was more common after negative exploration of the common bile-duct the value of operative cholangiography in the avoidance of this complication is discussed.
Adenocarcinoma developing in an ileocystoplasty
Authors: Leedham P W , England H R 
Published: March 2007

Abstract
Multifocal adenocarcinoma and carcinoma-in-situ arising in the suture line of an ileocystoplasty are reported in a 52-year-old woman who presented with haematuria 15 years after bladder reconstruction for tuberculosis. An origin in the ileal mucosa was established by microscopy. There are similarities with a transitional-cell carcinoma in an ileocystoplasty which has recently been recorded. Both cases are related to tumours associated with ureterosigmoidostomy where the site, tumour types, and latent period are similar. Aetiological factors seem to include a long latent period (15 years or more) and possibly the direct action of urine, recurrent infection, and mucosal ulceration. It is concluded that all patients with gastro-intestinal urothelial anastomoses must be followed up indefinitely.
The effect of innervation, denervation, and muscle type on the reunion of skeletal muscle
Authors: Webb P 
Published: March 2007

Abstract
The left plantaris and soleus and the right and left sternohyoid muscles of rats were transected surgically and cross-repaired to form conjoined muscle bellies composed of two innervated muscles, two denervated muscles, and one denervated and one innervated muscle.
Subsequent maceration of the conjoined muscle belly showed that regeneration had taken place by inoculation of the growing tips of the regenerating fibres in the doubly denervated muscle belly and in the innervated-denervated muscle belly but not in the case of the doubly innervated muscle belly.
Muscle type was not found to influence this process.
The significance of these findings is discussed.
The arterial complications of polycythaemia vera
Authors: Barabas A P , Offen D N , Meinhard E A 
Published: March 2007

Abstract
Of 200 patients referred for management of polycythaemia vera, 98 (49 per cent) had presented with vascular complications and 68 (34 per cent) of these involved arteries. Transient but recurrent cerebrovascular accidents and digital artery occlusions were the typical arterial complications. If polycythaemia was not promptly treated there was a risk of perimanent hemiplegia, monocular blindness, and severe ischaemia of the leg.
Embolism may have accounted for some of the arterial complications. A possible source for emboli—a proximal mural thrombus—was demonstrated in all 5 patients who were examined with femoral arteriography and in 2 patients who underwent surgery. In selected cases thrombectomy may be indicated to prevent further embolism.
Mechanical sutures in surgery
Authors: Steichen Felicien M , Ravitch Mark M 
Published: March 2007

Abstract
Following the original introduction of an automatic stapling instrument producing B-form staples by de Petz (1924, 1927), there has been derived from the very important first generation of Soviet stapling instruments a second generation of American stapling instruments characterized by: (1) the use of preloaded, pre-sterilized, and disposable staple cartridges; (2) the adaptability of one instrument to a variety of cartridges for use in a variety of tissues and operative situations; (3) the transfer from the instrument itself to the disposable cartridge of delicate and fragile moving parts simplifying the maintenance and operation of instruments. The instruments have found wide and satisfactory application in numerous areas of thoracic, vascular, gastro-intestinal, and gynaecological surgery.
Coeliac and hepatic nerve function following selective vagotomy
Authors: McKelvey S T D , Toner D , Connell A M , Kennedy T L 
Published: March 2007

Abstract
In the intact patient insulin hypoglycaemia increases the output of amylase and bile-acids despite the exclusion of acid from the duodenum. This effect is abolished by truncal vagotomy. After selective vagotomy a partial response from the pancreas occurs consistent with preservation of a direct route in the coeliac nerve and the loss of vagally released pancreatic secretagogues. A similar effect in the biliary system could not be demonstrated.