bluuebunny/crossref_metadata_2025_split huggingface dataset:
Colonic bacteria and bacterial translocation in experimental colitis
Authors: Gardiner K R , Erwin P J , Anderson N H , Barr J G , Halliday M I , Rowlands B J 
Published: March 2007

Abstract
The indigenous intestinal flora and an intact mucosa are vital components of body defences against luminal pathogenic bacteria. Disruption of these defences in inflammatory bowel disease may permit bacterial translocation and contribute to disease severity. Support for this hypothesis comes from this study of a hapten-induced rat model of colitis. Induction of colitis was associated with a significantly increased colonic Gram-negative aerobic bacilli count. The results, expressed as log10 [colony-forming units per gram tissue] were: colitic 6.97–8.86 versus control 4.90–6.69 (P &lt; 0.05). Colitis was also associated with a decreased Gram-positive cocci count at 4.00–8.04 versus control 6.45–8.30 (P &lt; 0.05). Bacteria translocated to the mesenteric lymph nodes in five of eight colitic rats (P = 0.01), to the spleen in four (P = 0.04) and to the liver in five (P = 0.01) but to these organs in none of the eight control animals. There was a positive correlation between the severity of colonic inflammation and extent of bacterial translocation in colitic animals (rS = 0.86, P = 0.007).
High prevalence of unsuspected abdominal aortic aneurysm in patients with confirmed symptomatic peripheral or cerebral arterial disease
Authors: MacSweeney S T R , O'Meara M , Alexander C , O'Malley M K , Powell J T , Greenhalgh R M 
Published: March 2007

Abstract
A group of 561 consecutive patients with proven symptomatic peripheral or cerebral arterial disease attending a vascular clinic was screened for abdominal aortic aneurysm (AAA) using B-mode ultrasonography. An aneurysm was present in 40 of 358 men (11.2 per cent) and 13 of 203 women (6.4 per cent), a total prevalence of 9.4 per cent. Thirty-three aneurysms were 3–4 cm in diameter. The prevalence of AAA was similar in patients referred with lower-limb and with cerebral ischaemia. Physical examination for AAA was performed in 200 patients before ultrasonography. The sensitivity of physical examination in the detection of aneurysm was 43 per cent (57 per cent for AAA &lt;4 cm in diameter, 29 per cent for AAA ⩽4 cm in diameter). Physical examination was an inadequate method of screening. Initial follow-up showed a mean aneurysm expansion rate of 0.20 cm/year. Patients with arterial disease have a high risk of AAA; routine ultrasonographic screening should be considered.
Comparison of long-term survival after successful repair of ruptured and non-ruptured abdominal aortic aneurysm
Authors: Stonebridge P A , Callam M J , Bradbury A W , Murie A , McL. Jenkins A , Ruckley C V 
Published: March 2007

Abstract
Long-term survival was assessed after the repair of non-ruptured (n = 311) and ruptured (n = 227) abdominal aortic aneurysm. Follow-up was 94.2 per cent complete, and the overall survival rate at 8 years was 43.6 per cent. There was no significant difference in 8-year survival rates between patients with non-ruptured (45.2 per cent) and ruptured (40.5 per cent) aneurysms. The survival curves were also compared with that for an age- and sex-matched population derived from Scottish Home and Health Department data.
Mesothelial seeding of knitted Dacron
Authors: Bearn P E , Seddon A M , McCollum C N , Marston A 
Published: March 2007

Abstract
Bilateral superficial femoral artery replacement using knitted Dacron was performed in 38 dogs. One side was seeded with omental mesothelium and the other acted as an unseeded contro. 111In-labelled platelet accumulation on grafts was measured at 5 days and 2 months and the thrombogenicity index of seeded and unseeded grafts calculated. Patency was monitored for 2 months, at which time grafts were removed and luminal thrombus, ultrastructural cell cover and prostacyclin release were measured. Cell seeding did not influence the mean(s.e.m.) thrombogenicity index of 0.95 (0.25) and 0.88(0.24) at 5 days in control and seeded grafts respectively; nor was there any difference between the groups at 2 months. Occlusion occurred in six control and four seeded grafts. Seeding did not significantly improve the percentage thrombus-free area or luminal cell cover. Neither did it enhance mean(s.e.m.) luminal 6-keto-prostaglandin F1α release of 2.58(0.80) pg cm−2 in controls and 2.63(0.78) pg cm−2 in seeded grafts. Further studies demonstrated that only a mean(s.e.m.) of 4.4(1.9) per cent of the seeded inoculum was present on grafts 48 h after implantation, providing too few cells to achieve confluent cover. Mesothelial cell seeding might be useful in promoting a healed graft surface but critical levels of seeding density must be achieved before the techinque can be properly evaluated.
Rectus repair for midline ventral abdominal wall hernia
Authors: Naraynsingh V , Ariyanayagam D 
Published: March 2007

Abstract
Recurrence-free repair of midline ventral abdominal wall hernia continues to elude surgeons, despite the abundance of described techniques. Based on the observation that spontaneous herniation through the rectus abdominis muscles is unknown, a new technique of repair was devised. The rectus muscles and their sheaths on either side of the hernial defect are directly brought together to obliterate the hernia, the intervening linea alba and intact hernia sac being “keeled” into the abdominal cavity. Using this technique, 85 consecutive midline abdominal hernias were repaired over an 11-year period. Follow-up was from 18 months to 12 years; there was one recurrence. The rectus repair is recommended as an effective method of dealing with ventral midline abdominal wall hernia.
Management of non-functioning neuroendocrine tumours of the pancreas
Authors: Cheslyn-Curtis S , Sitaram V , Williamson R C N 
Published: March 2007

Abstract
Between 1982 and 1991, 20 patients of median age 44 (range 22–76) years were treated for non-functioning neuroendocrine tumours of the pancreas. Presenting features were obstructive jaundice (seven patients), abdominal pain (seven), weight loss (six), abdominal mass (eight) and severe haemorrhage (four). Gut hormone profiles were normal except for one patient who had a raised pancreatic polypeptide level. Contrast-enhanced computed tomography localized the tumour in 17 patients and visceral angiography in 14 of 15; all but three tumours were highly vascular. Ten patients underwent curative resection, and the remainder were managed palliatively by resection (four). bypass procedures (three) or biopsy alone (three). There were two postoperative deaths and seven early complications. Seven of the remaining 18 patients have died from disease a median of 16 (range 4–30) months after presentation. The 11 survivors, eight of whom had curative resections, have been followed for a median of 42 (range 7–72) months. Ten patients are asymptomatic but only five are free from disease. These tumours are seldom curable by radical surgery, but patients may remain free from symptoms for many years.
Hepatitis B immunization and exposure to blood among surgical staff
Authors: Williams S , Gooch C , Cockcroft A 
Published: March 2007

Abstract
A questionnaire was sent to all 158 staff of the operating department of a London teaching hospital to confirm their hepatitis B immunization status and establish the number of incidents involving exposure to blood during the preceding 4 weeks. Of these personnel, 104 (66 per cent) were known to be immune to hepatitis B either through immunization (97) or previous infection (seven). A further 23 (15 per cent) had completed a course of immunization but their seroconversion had not been checked. There were 26 sharps injuries sustained by 14 (12 per cent) of 119 staff and 240 other exposures to blood. Four of the sharps injuries had been reported. Staff known to be immune were more likely than those with unknown or negative immunity to report incidents (20 versus 0 per cent (95 per cent confidence interval of difference 2-38 per cent)). Doctors sustained more non-sharps exposures to blood than others (47 versus 23 per cent (95 per cent confidence interval of difference 7-40 per cent)). An important minority of operating department staff remains unimmunized against hepatitis B, although exposure to blood is common. Incidents are rarely reported and staff with unknown or negative immunity seem less likely to report than those known to be immune.
Natural history of abdominal aortic aneurysm detected by screening
Authors: Bengtsson H , Nilsson P , Bergqvist D 
Published: March 2007

Abstract
A group of 88 patients with abdominal aortic dilatation found in four ulrasonographic screening studies was followed prospectively by repeated ultrasonography. The initial aortic diameter ranged between 18 and 70 mm. In 19 patients (22 per cent) the aortic diameter exceeded 39 mm. The mean(s.e.m.) annual expansion rate of dilatations &lt; 40 mm in diameter was 0.8(1.2) mm; among those ⩽ 40 mm it was 3.3(1.2) mm. The expansion rate increased with increasing initial diameter. Thirty-eight patients died; the overall mortality rate in the group was high in comparison with an age- and sex-matched population. One patient died after elective aneurysm surgery but none died from a ruptured aneurysm. In conclusion, in about 80 per cent of dilatations found in screening studies the aortic diameter was &lt; 40 mm, with a low risk of rupture. One annual rescanning of an aneurysm &lt; 35 mm in diameter is sufficient; a high overall mortality rate must be expected.
Use of desmopressin to prevent bleeding complications in patients treated with aspirin
Authors: Flordal P A , Sahlin S 
Published: March 2007

Abstract
Aspirin induces a haemorrhagic diathesis that persists for at least I week after discontinuation of the drug. The effect of the vasopressin analogue desmopressin was studied in 12 patitents treated with aspirin who were undergoing cholecystectomy. Desmorpressin was given to six of these patients. There were five postoperative bleeding complications; all occurred in patients who had not received desmopressin (P &lt; 0·05). The bleeding time was prolonged in aspirin-treated patients and normalized by desmopressin (P &lt; 0·05). Desmopressin can be used safely to prevent bleeding induced by aspirin.
Patterns of venous reflux in limbs with skin changes associated with chronic venous insufficiency
Authors: Lees T A , Lambert D 
Published: March 2007

Abstract
The distribution of venous reflux in patients with skin changes associated with chronic venous insufficiency presenting to a specialist clinic was assessed. A total of 300 limbs in 153 patients were examined by Doppler ultrasonography with colour-flow imaging for the presence of venous reflux in superficial veins, deep veins and medial perforating veins, both above and below the knee. Ninety-eight limbs had skin changes, which included hyperpigmentation, lipodermatosclerosis, atrophie blanche and ulceration. Of this group, 2 per cent had no evidence of venous reflux on duplex scanning, 39 per cent had deep vein incompetence, 57 per cent had superficial vein incompetence and 2 per cent had isolated medial perforating vein reflux. Of 25 limbs with ulceration, 13 had superficial and 12 deep vein reflux. A total of 202 legs, which included 20 normal control limbs, had no skin changes; 22·3 per cent of these had no venous reflux, 8·4 per cent had deep vein incompetence, 65·3 per cent had superficial incompetence and 4.0 per cent had isolated medial calf perforating vein incompetence.
Growth hormone therapy initiated before starvation ameliorates the catabolic state and enhances the protein-sparing effect of total parenteral nutrition
Authors: Koea J B , Douglas R G , Shaw J H F , Gluckman P D 
Published: March 2007

Abstract
The effect of 7 days of subcutaneously administered bovine growth hormone (bGH) (0.2 mg kg−1 day−1; n = 4) or an equivalent volume of 0.15 mol l−1 saline (n = 3) on protein metabolism was assessed in lambs. The catabolic response to 48 h of starvation and subsequent hypocaloric total parenteral nutrition (TPN) was measured using primed constant intravenous infusions of [15N]urea and[14C]leucine. Following 48h, of starvation and 7 h of TPN, bGH-treated animals had a significantly decreased rate of net protein catabolism compared with controls (mean(s.e.m.) 2·4(0·2) versus 3·2(0·3)g kg−1 day−1, P &lt; 0·01). The means(s.e.m.) rate of whole-body protein catabolism was also significantly decreased in bGH-treated animals at 10·9(0.3) g kg−1 day−1 compared with 12·9(0·7) g kg−1 day−1 in saline-treated controls (P &lt; 0·05). In addition, the rates of net and whole-body protein catabolism decreased significantly (P &lt; 0·05) during the period of hypocaloric parenteral feeding to mean(s.e.m.) values of 2·3(0·2) and 8·6(0·6) g kg−1 day−1 respectively in bGH-treated animals. By contrast, in saline-treated controls net and whole-body protein catabolism continued to increase during hypocaloric parenteral feeding. There was a significant decrease (P &lt; 0·05) in the rate of[14C]leucine uptake in tissues of the gastrointestinal tract, heart and diaphragm in bGH-treated animals compared with controls. These results demonstrate that daily administration of growth hormone decreases the catabolic response to a metabolic stress, resulting in the conservation of protein in the heart, diaphragm, gastrointestinal tract and musculoskeletal system by a primary anticatabolic action. In addition, growth hormone therapy initiated before induction of the catabolic state enhances the protein-sparing effects of TPN. Further study is justified to determine whether growth hormone therapy initiated before elective or urgent surgery in the nutritionally depleted patient may have a role in reducing the severity of the postoperative catabolic state, particularly in the patient in whom a complicated course is anticipated.
Prospective comparison of C-reactive protein level, Ranson score and contrast-enhanced computed tomography in the prediction of septic complications of acute pancreatitis
Authors: Vesentini S , Bassi C , Talamini G , Cavallini G , Campedelli A , Pederzoli P 
Published: March 2007

Abstract
Randomized clinical trials of antibiotic prophylaxis in acute pancreatitis are now warranted in the light of recent evidence of pancreatic penetration of certain antibiotics at therapeutic minimal inhibitory concentrations. The aim of the present prospective clinical study was to investigate whether there are detectable risk factors for pancreatic sepsis in acute pancreatitis that would allow better selection of patients for inclusion in clinical trials. Fifty-nine consecutive patients with acute pancreatitis were recruited and submitted to admission baseline and 48-h determinations of Ranson score, and assay of C-reactive protein at admission and weekly intervals thereafter. Contrast-enhanced computed tomography (CT) was also performed within 24 h of admission. Pancreatic sepsis, defined as infection of pancreatic and/or peripancreatic collections, was demonstrated in all cases by culture of samples obtained by needle aspiration and at laparotomy. Although all prognostic indices correlated significantly with sepsis, multivariate logistic regression analysis showed that the only variables predictive of the risk of subsequent sepsis were the presence and extent of necrosis. Early detection of pancreatic necrosis by CT should be the primary inclusion criterion in future clinical trials of antibiotic prophylaxis in acute pancreatitis.
Gunshot wounds of the colon: Role of retained bullets in sepsis
Authors: Demetriades D , Charalambides D 
Published: March 2007

Abstract
The role in the development of local sepsis of retained bullets that have passed through the colon was investigated. Of 84 patients with gunshot wounds of the colon, the bullet was retained in the body in 40 and had left or was removed from the body in 44. The groups were similar with regard to Revised Trauma Score, Injury Severity Score, Penetrating Abdominal Trauma Index and type of colonic trauma. The incidence of major local complications was 5 per cent in patients with a retained bullet and 7 per cent in those without. These results suggest that retained bullets that have penetrated the colon do not contribute to local septic complications.
Detection and enumeration of circulating tumour cells in colorectal cancer
Authors: Leather A J M , Gallegos N C , Kocjan G , Savage F , Smales C S , Hu W , Boulos P B , Northover J M A , Phillips R K S 
Published: March 2007

Abstract
Immunocytochemistry was used in parallel with conventional cytology to detect circulating malignant epithelial cells in 42 patients undergoing resection for colorectal cancer. Preoperative peripheral and peroperative mesenteric venous blood samples were taken. Tumour cells were isolated on a density gradient and cytospins prepared. Slides were stained by conventional cytology (May-Grünwald-Giemsa) and by an indirect immunoperoxidase technique with the anticytokeratin antibody KG 8.13. Using conventional cytology, definite morphological evidence of malignancy was observed in three patients and suspicious features in a further seven. Immunocytochemistry confirmed these findings in all three of the malignant but in only one of the suspicious cases. Counts of immunostained cytospins showed the concentration of tumour cells in blood samples from these four patients to be in the range 0-954 cells/ml. This study supports the use of immunological markers to detect and enumerate malignant cells. This method provides a powerful tool to investigate one aspect of the metastatic process.
Endoscopic transanal resection in the management of patients with sessile rectal adenomas, anastomotic stricture and rectal cancer
Authors: Wetherall A P , Williams N M A , Kelly M J 
Published: March 2007

Abstract
Forty patients underwent 61 endoscopic transanal resections using a urological resectoscope. Preoperative diagnoses were adenoma in 28 patients, carcinoma in seven and benign anastomotic stricture in five. Four patients with adenomas were found to have frank carcinoma. Ablation of 22 of 23 adenomas was achieved, 11 with a single transanal resection. Open operation was required for one patient. Locally advanced rectal malignancy was palliated in five of seven patients. All those with benign anastomotic stricture were cured by a single resection. The median operating time was 25 min, with 11 procedures exceeding 30 min. There were complications in seven cases (six bleeding, one septicaemia). The median hospital stay for the procedure alone was 3·5 days. There were no deaths within 30 days of operation. Endoscopic transanal resection is minimally invasive, quick, safe and effective. Histological surveillance is a major advantage and appears reliable. Low complication rates can be achieved by opting for several “easy” resections and by restricting use of the procedure to lesions within 15 cm of the anal verge.
Screening for breast cancer detects tumours at an earlier biological stage
Authors: Crisp W J , Higgs M J , Cowan W K , Cunliffe W J , Liston J , Lunt L G , Peakman D J , Young J R 
Published: March 2007

Abstract
Between August 1988 and July 1990, 17678 women in the Gateshead, Sunderland, South Tyneside and Durham districts attended the national breast screening programme. A total of 131 cancers were detected. The morphology of cancers detected by screening was compared with that of tumours in 71 patients presenting clinically in the same period. Screen-detected cancers included a higher proportion of tumours of more favourable histological grade and type, were smaller in size and had less axillary lymph node involvement than those detected clinically. Survival was predicted from the Nottingham Prognostic Index. Patients with screen-detected cancer had an expected survival advantage (95 per cent confidence interval) of 26.5 (12.3–40.6) per cent at 5 years, 26.5 (11.8–41.2) per cent at 10 years and 29.1 (14.5–43.7) per cent at 15 years. This survival advantage in screened patients expected at 5, 10 and 15 years is consistent with the 30 per cent reduction in mortality rate demonstrated in the Health Insurance Plan study and the Swedish two counties trial.
Oesophagomyotomy for achalasia: A 22-year experience
Authors: Ellis F H 
Published: March 2007

Abstract
To determine the clinical results in achalasia, particularly as regards postoperative gastro-oesophageal reflux, a 22-year personal experience with transthoracic short oesophagomyotomy without an antireflux procedure was analysed. A total of 185 such procedures were performed, of which 179 (97 per cent) were available for analysis. There was an overall improvement rate of 89 per cent over a mean postoperative interval of 9 years. Primary procedures were followed by a 93 per cent rate of improvement. Twenty patients, nine of whom had previously undergone one or more oesophageal operations, were considered as having a poor result. Marked gastro-oesophageal reflux accounted for a poor outcome in nine patients. Although the overall rate of postoperative improvement did not deteriorate significantly with time, the level of improvement did, the proportion of excellent results declining from 54 to 32 per cent (P = 0.02) at 10–20 years after operation. These findings substantiate the view that a short transthoracic oesophagomyotomy without an antireflux procedure provides excellent long-term relief of dysphagia for the patient with oesophageal achalasia and is accompanied by an extremely low risk of serious postoperative gastro-oesophageal reflux.
Kinetic changes and experimental carcinogenesis after Billroth I and II gastrectomy
Authors: Miwa K , Kamata T , Miyazaki I , Hattori T 
Published: March 2007

Abstract
To determine the risk of gastric remnant cancer according to the type of surgical reconstruction, the distal two-thirds of the glandular stomach was resected in male Wistar rats, followed by gastroduodenostomy (Billroth I anastomosis) or gastrojeunostomy (Billroth II anastomosis). No carcinogens were given and the animals were killed 50 weeks after operation. No cancers developed in 22 rats undergoing Billroth I gastrectomy, but five of 24 with Billroth II anastomosis had adenocarcinoma (P &lt; 0.05). All carcinomas were confined to the stoma. Animals with Billroth II anastomosis had a more advanced grade of mucosal atrophy at the stoma, with a higher incidence of cystic dilatation, submucosal adenocystic proliferation and pseudopyloric metaplasia (P &lt; 0.05). Cell kinetics in the stomal mucosa after Billroth II gastrectomy showed an increased cell count in the proliferative zone, longer duration of S phase and increased cell cycle time (P &lt; 0.05). These results suggest that Billroth II gastrectomy carries a greater risk of cancer than the Billfroth I procedure.
Superselective intra-arterial chemotherapy with mitomycin for gallbladder cancer
Authors: Mäkelä J T , Kairaluoma M I 
Published: March 2007

Abstract
A group of 27 patients with carcinoma of the gallbladder was treated by superselective intra-arterial chemotherapy with mitomycin between 1981 and 1990. Results were compared with those in 22 historical controls. The overall response rate to intra-arterial chemotherapy was 48 per cent. The median survival time for responders was 34 months and for non-responders 8 months. Survival was significantly related to tumour stage in patients treated by chemotherapy (P &lt; 0.001) and controls (P &lt; 0.01); all patients with tumour extending beyond the serosa died within 4 years. The median survival period after intra-arterial chemotherapy was 14 months, compared with 4 months in controls. The cumulative 5-year survival rates for patients treated by chemotherapy and controls were not significantly different. Cessation of chemotherapy was required in 16 of the 27 patients: in eight because of tumour progression, in seven after toxicity to chemotherapy and in one because of patient refusal. Superselective intra-arterial chemotherapy can be useful for patients with cancer restricted to the gallbladder wall but cannot prevent tumour growth once this has extended beyond the gallbladder serosa.