bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous drainage of pancreatic pseudocysts
Authors: Colhoun E , Murphy J J , MacErlean D P 
Published: March 2007

Abstract
Ultrasonography was used to diagnose, localize and direct the percutaneous transabdominal needle aspiration of 10 pancreatic pseudocysts in 9 patients. Thirty-four aspirations were performed without complication. In 9 pseudocysts no other treatment was necessary, and in all patients relief of pain or obstructive symptoms when present was obtained. None of the cysts have recurred with a mean follow-up of 26 months.
Haemorrhage from the pancreatic duct: A rare form of upper gastrointestinal bleeding
Authors: van Rooyen W , van Blankenstein M , Schattenkerk M Eeftinck , de Vries J E , Obertop H , Bruining H A , van Houten H 
Published: March 2007

Abstract
Recurrent upper gastrointestinal haemorrhage arising from the pancreatic duct presents diagnostic difficulties. Bleeding can be secondary to pancreatic disease (pancreatitis, pseudocysts) or vascular disorders (aneurysms of the splanchic arteries). Of the 5 cases reported here, 3 involved a ruptured aneurysm of the splenic artery and 2 chronic pancreatitis. Attacks of colicky pain in the left epigastric region associated with haematemesis and/or melaena were characteristic symptoms. Pancreatectomy controlled the bleeding in 4 and ligation of the splenic artery and the pancreatic duct in one. Fifty-five patients with similar pathology have been previously reported, suggesting that this syndrome should be borne in mind when gastrointestinal haemorrhage of obscure origin is encountered.
If routine endoscopy does not reveal the site of the haemorrhage and there are no signs of cholestasis, endoscopic retrograde pancreatography (ERP) and selective coeliac arteriography should be performed to evaluate the possibility of haemorrhage from the pancreatic duct. Surgical management depends on the site of the causative lesion.
Treatment of sputum retention by minitracheotomy
Authors: Matthews H R , Hopkinson R B 
Published: March 2007

Abstract
Retention of sputum is a major cause of morbidity and mortality following thoracic surgery and regular access to the trachea for suction can only be obtained either by tracheostomy or endotracheal intubation, both of which have significant disadvantages. A simple method of percutaneous tracheal cannulation for suction has therefore been developed in which a 4 mm Portex paediatric endotracheal tube is inserted through a 1 cm incision in the cricothyroid membrane, using a guarded knife and an introducer. The procedure can be performed in the ward or theatre, using local or general anaesthesia. Twenty-four patients have been treated between October 1981 and June 1982. Ages ranged from 19–80 years and the duration of cannulation from 1–45 days. No patient subsequently required any further treatment for sputum retention. Twenty-one patients made an uneventful recovery and 3 died from unrelated causes. Following decannulation healing occurred within 6 days and there were no late sequelae. The method is much simpler and less invasive than existing alternatives and can therefore be used at an early stage and before the consequences of sputum retention become irreversible.
Radical cure of pilonidal sinus by a transposition rhomboid flap
Authors: Azab A S G , Kamal M S , Saad R A , Abou Al Atta K A , Ali N A 
Published: March 2007

Abstract
A new operation for pilonidal sinus is described. This utilizes a rhomboid transposition flap to cover the defect left after radical excision. The results show healing by first intention in 29 out of 30 patients. No patient remained in hospital for more than ten days. Minor infection took place in five cases and major infection in one case. Patients have been followed for up to three years. No recurrence has yet been encountered. The reasons for the success of this operation are discussed.
The resistance of a lymph node to lymph flow
Authors: Browse N L , Doig R L , Sizeland D 
Published: March 2007

Abstract
The relationship between lymph flow, lymph node arterial and venous perfusion pressure and lymph node resistance have been studied in an in vivo isolated canine iliac lymph node perfused through an afferent lymphatic with heparinized canine plasma. The relationship between the rate of perfusion and perfusion pressure across the node was linear but the calculated resistance of the node decreased as the rate of perfusion increased. In nine dogs the mean resistance to lymph flows less than 0.1 ml/min was 180 mmHg/ml min, but 68 mmHg/ml min to rates of perfusion above 1.0 ml/min. An increase of venous pressure in the veins draining the node increased the node's resistance by 8.6 mmHg/ml min for each 10 mmHg increase of venous pressure. The effect on node resistance of an increase of venous pressure was greater at low rates of perfusion. A decrease of arterial pressure in the arteries supplying the node reduced the node's resistance by 2 mmHg/ml min for each 10 mmHg decrease of arterial pressure. Increases of arterial pressure had an opposite effect of a similar magnitude. The effect on node resistance of a change of arterial pressure in either direction was greater at low rates of perfusion.
Sites of recurrent tumour after ‘curative’ colorectal surgery: Implications for adjuvant therapy
Authors: Gilbert J M , Jeffrey I , Evans M , Kark A E 
Published: March 2007

Abstract
The pattern of recurrent tumour following ‘curative’ colorectal surgery was examined in a necropsy series and a prospective clinical series. In the necropsy series the commonest pattern of recurrence was disseminated disease (73 per cent) and recurrence in a single site was much less common (27 per cent). In the clinical series recurrence in a single site was commoner (55 per cent). The difference between the two series is statistically significant (P = 0.02, χ2), and is probably due to under-diagnosis of disseminated recurrence in the clinical series. In both series local recurrence and hepatic metastases occurred almost equally but usually as part of disseminated disease.
We conclude that after ‘curative’ surgery for colorectal cancer, recurrence is usually disseminated (73 per cent) and therefore therapy adjuvant to surgery should be active systemically. Adjuvant therapy directed at a single site (e.g. radiotherapy or intrahepatic chemotherapy) should be combined with a systemic therapy.
Pre-operative carcino-embryonic antigen and survival in patients with colorectal cancer
Authors: Lewi H , Blumgart L H , Carter D C , Gillis C R , Hole D , Ratcliffe J G , Wood C B , McArdle Mr C S 
Published: March 2007

Abstract
The relationship between pre-operative levels of carcino-embryonic antigen (CEA), resectability of the primary tumour, the extent of tumour spread and subsequent survival was studied in 333 patients with colorectal cancer. Twenty-five per cent of patients undergoing ‘curative’ resection had elevated CEA levels compared with fifty-six per cent of patients receiving palliative treatment. Twenty-five per cent of patients with Dukes B or C tumours had elevated pre-operative CEA levels compared with seventy per cent of patients with stage D disease. In patients undergoing ‘curative’ resection there was no correlation between pre-operative CEA levels and subsequent survival. In patients undergoing palliative resection, elevated pre-operative CEA levels were associated with poor survival. Although pre-operative levels of CEA reflect the extent of the underlying disease process, estimations of pre-operative CEA levels are of limited value in predicting patients with a poor prognosis following curative resection for colorectal carcinoma.
Surgical aspects of continuous ambulatory peritoneal dialysis — 3 years experience
Authors: Francis D M A , Donnelly P K , Veitch P S , Proud G , Taylor R M R , Ramos J M , Ward M K , Wilkinson R , Elliott R W , Kerr D N S 
Published: March 2007

Abstract
Since January 1979, 122 patients (mean age 38.5 years, range 5–72 years) with chronic renal failure have been treated with continuous ambulatory peritoneal dialysis (CAPD). Peritoneal access was achieved by inserting silicone rubber Tenckhoff peritoneal dialysis catheters (Quinton, Seattle, Washington) by an open (76 per cent) or closed technique. Actuarial analysis showed a patient survival of 98 and 94 per cent and a success rate of 88 and 64 per cent at 1 and 2 years, respectively. Currently, 74 patients are using CAPD and 8 have been treated for 30–36 months. Thirty-five patients (29 per cent) required two or more peritoneal catheters and 69 per cent of these patients are still on CAPD. Catheter-related peritonitis was the most frequent complication (233 separate episodes in 94 patients) and necessitated catheter removal in 16 per cent of episodes, although 37 per cent of patients from whom catheters were removed because of peritonitis later resumed CAPD. Extravasation of dialysate from the peritoneal cavity (31 episodes) and catheter obstruction (31 episodes) required surgical replacement of catheters in 8 and 23 cases, respectively. Twenty patients (16 per cent) developed 24 abdominal hernias, only one of which caused failure of CAPD. Infective and mechanical complications of CAPD frequently require surgical intervention but only occasionally result in failure of the technique, and even multiple catheter replacements are compatible with successful long term CAPD.
Sphincter of Oddi motility
Authors: Toouli J 
Published: March 2007

Abstract
Recent developments of manometric and endoscopic instrumentation have rekindled interest in sphincter of Oddi function. As a result of human and animal studies, our understanding of normal sphincter of Oddi physiology has increased and possible motility abnormalities are being identified. Manometric studies have shown that the sphincter of Oddi is characterized by prominent phasic contractions which are superimposed on a low tonic pressure. The phasic contractions are orientated mainly in an antegrade direction; however, both simultaneous and retrograde contractions are registered. Cineradiography has demonstrated that the phasic contractions have a propulsive function, expelling small volumes of fluid from the common bile duct into the duodenum. Intravenously administered cholecystokinin-octapeptide normally inhibits the phasic contractions and reduces the sphincter tone. Motility abnormalities may occur if the sphincter of Oddi exhibits abnormally high tone, alteration in the direction of the phasic contractions, abnormal changes in the contraction frequency, or abnormal responses to hormonal stimulation. Preliminary human studies demonstrate disorders in sphincter of Oddi motility patterns, suggesting that motility abnormalities may be associated with choledocholithiasis, dyskinesia and idiopathic relapsing pancreatitis.
Vascular injury with associated bone and joint trauma
Authors: Meek A C , Robbs J V 
Published: March 2007

Abstract
The clinical presentation and management of 102 vascular injuries associated with bone and joint trauma, in 100 patients over a 6-year period, is reviewed. Eighty-three injuries involved the lower limbs. Amputation became necessary in 16 patients. In 12 this was directly attributable to delay in revascularization or the extent of the soft tissue injury with consequent sepsis. Early graft occlusion in an otherwise salvageable limb occurred in four patients (3·9 per cent). Successful therapy involves close co-operation between vascular and orthopaedic surgeons with the vascular injury taking priority. The orthopaedic injury should be treated on its merits. In contaminated or comminuted fractures skeletal traction (or in suitable cases exoskeletal fixation) can be employed without adversely affecting the vascular repair. A plea is made for early diagnosis of concomitant vascular injury in patients with bone and joint injuries; this depends on clinical awareness and careful and repeated examination.
Polyamines in breast cancer
Authors: Kingsnorth A N , Wallace H M , Bundred N J , Dixon J M J 
Published: March 2007

Abstract
A meeting1 was held of the Surgical Research Society with Professor R. Shields in the Chair. The meeting was held at the Imperial College of Science and Technology, South Kensington, London on 5 and 6 January 1984. Seventy-eight papers were presented to the Society, and there were two surgical workshops on ‘Lasers in Surgery’ and ‘Computers for Surgical Audit’ prior to the meeting. The winner of the Patey Prize was awarded to T.W.J. Lennard, for his paper entitled ‘The Cholecystokinin provocation test: a prospective double-blind placebo controlled trial in patients with acalculous biliary pain’.
Polyamine levels (putrescine, spermidine and spermine) in breast cancers (n = 54) were measured as a potential guide to prognosis. Values (expressed as nmol per 100 mg tumour) ranged from: 0·9 to 4·5 for putrescine, 4·2 to 29·8 for spermidine and 5·6 to 39·7 for spermine concentration. Increased intracellular polyamine levels were positively correlated with factors known adversely to affect survival after mastectomy, namely histological grade III and oestrogen-receptor negative status. Advanced T4 tumours and medullary-type carcinomas also contained high polyamine levels. Tumour size and node status did not affect polyamine levels in primary tumours. Tumours that recurred within 2 years of mastectomy had significantly higher levels of spermidine and spermine than those that did not. Breast cancer polyamine levels are a biological marker of tumour aggressiveness and can be used as a prognostic indicator of early tumour recurrence that is independent of node status.
Adequate internal sphincterotomy for chronic anal fissure: Subcutaneous or open technique?
Authors: Boulos P B , Araujo J G C 
Published: March 2007

Abstract
The extent of sphincter division by the subcutaneous or the open technique is examined by comparing the change in anal canal pressure after either method of sphincterotomy in twenty-eight patients with chronic anal fissure randomly allocated. In all patients the fissures healed at one month with significant reduction (P &lt; 0·01) of anal canal pressures to 52 (17–75) cmH2O after subcutaneous and 47·5 (35–100) cmH2O after open sphincterotomy, a 51 (22–77) and 50 (11–68) per cent reduction of their respective pre-operative measurements. Adequate sphincterotomy can be achieved by both techniques.
Insulin- and histamine-stimulated secretion in relation to recurrence of duodenal ulceration after vagotomy
Authors: Boulos P B , Whitfield P F , Hobsley M 
Published: March 2007

Abstract
Gastric secretion after vagotomy for duodenal ulcer in response to a single injection of insulin and in response to a histamine infusion has been compared in 25 patients with and 56 patients without recurrent duodenal ulceration proven by endoscopy. The lower 95 per cent tolerance limits of the pre-operative ranges of secretion to either insulin or histamine stimulation measured in 81 unoperated patients provided thresholds that separated postvagotomy patients with recurrent ulceration and those without. Neither the ratios, nor the regression line, between secretion in response to each secretagogue provided similar discrimination. In a group of 43 patients who had gastric secretion studies before and after vagotomy the reductions in secretion to below the established 95 per cent tolerance limits of secretion were respectively 60 and 80 per cent of their pre-operative insulin- and histamine-stimulated secretion. The percentage reductions however failed to differentiate asymptomatic patients from patients with recurrent ulceration. It appears therefore that, irrespective of the pre-operative level or of the magnitude of the reduction of secretion, a vagotomy to be adequate must achieve a reduction of secretion to below a threshold level.
Gastric emptying after gastroplasty for morbid obesity
Authors: Horowitz M , Collins P J , Chatterton B E , Harding P E , Watts J McK , Shearman D J C 
Published: March 2007

Abstract
Gastric emptying was studied in 11 patients who had undergone gastroplasty for morbid obesity 6 to 8 months previously and in 22 normal controls without gastrointestinal disease. A dual isotope technique for measuring solid and liquid emptying was used. Liquid emptying was slower in patients than controls. The emptying of solid was initially faster, but was followed by a prolonged slow rate of emptying indicating retention of solid food in the proximal partitioned pouch. There was no correlation between the weight loss produced by the operation and rates of solid or liquid emptying. Unlike gastric bypass, the changes in gastric emptying produced by gastroplasty were relatively small and gastric emptying rates in patients overlapped considerably with the range of emptying rates found in control subjects. The success of the procedure may depend on the induction of satiety by the filling of the partitioned pouch.
Exclusion of the oesophagus: Is this a dangerous manoeuvre?
Authors: Mannell Aylwyn , Epstein B 
Published: March 2007

Abstract
If oesophagectomy is contra-indicated or dangerous, oesophageal bypass can restore the ability to swallow. It is not known if excluding the bypassed oesophagus by closing both ends will lead to serious complications. In this study we report on 89 patients who underwent bypass surgery for benign and malignant strictures of the oesophagus. The thoracic oesophagus was completely excluded in 51 patients and in 30 cases the bypass procedure was combined with distal oesophageal drainage. Gastro-oesophageal continuity was preserved in eight patients undergoing an extra-oesophageal colon bypass. The operative mortality was similar in the three groups. Neck abscesses, probably due to leakage from the upper end of the bypassed oesophagus, occurred in 17 per cent of patients with oesophageal exclusion and in 9 per cent of the remainder. Changes occurring in the bypassed oesophagus of 38 patients were monitored with computed axial tomography. Segmental, mucus-filled dilatations (mucocoeles) of the oesophagus were identified in 20 patients. In 19 patients these mucocoeles remained small and asymptomatic. One patient with achalasia developed an oesophago-airway fistula two years after operation. Provided both ends of the oesophagus are securely closed, oesophageal exclusion is not a dangerous manoeuvre in patients undergoing bypass surgery for locally invasive tumours or corrosive injuries of the oesophagus.
Pancreatic cystadenoma and cystadenocarcinoma
Authors: von Segesser L , Rohner A 
Published: March 2007

Abstract
Cystadenomas and cystadenocarcinomas are rare but not exceptional tumours of the pancreas. In this report six cases are added to the more than 300 cystadenomas and over 100 cystadenocarcinomas reported in the literature. We present here the case histories of four cystadenomas and two cystadenocarcinomas with complete follow-up. There is no evidence of recurrence after a maximum of 22 years in cystadenoma and 4 years in cystadenocarcinoma following resection. We have the impression that cystic lesions of the pancreas are nowadays more often detected than in former years. This might be due to abdominal investigation by computerized tomography and ultrasound on a large scale. Pathological features of proliferative cystic lesions of the pancreas permit distinction of three different tumours: serous cystadenoma, mucinous cystadenoma and cystadenocarcinoma. The serous cystadenoma is benign. The mucinous cystadenoma has to be considered as potentially malignant. The cystadenocarcinoma is malignant by definition. As benign and malignant elements can be found in the same cyst biopsy cannot exclude cystadenocarcinoma. Therefore all cystadenomas and cystadenocarcinomas should be totally excised, especially as prognosis after resection of cystadenocarcinoma is much better than after resection of adenocarcinoma of the pancreas.
Subcutaneous mastectomy for primary operable breast cancer
Authors: Hinton C P , Doyle P J , Blamey R W , Davies C J , Holliday H W , Elston C W 
Published: March 2007

Abstract
Subcutaneous mastectomy has been performed on 98 patients with primary breast cancer. Eighty-four have undergone breast reconstruction using a silicone prosthesis. The overall complication rate has been low. The rates of local recurrence and survival are similar to those in patients undergoing simple mastectomy.
Diagnosis and treatment of superior mesenteric artery syndrome
Authors: Gustafsson L , Falk A , Lukes P J , Gamklou R 
Published: March 2007

Abstract
Superior mesenteric artery syndrome (SMAS) is a rare clinical condition. Eleven cases of SMAS treated surgically are reported after follow-up periods of 6 months to 6 years. The value of hypotonic duodenography in the diagnosis of the syndrome is emphasized.
Haemodynamics of the adjunctive arteriovenous fistula in femorodistal bypass grafting: An experimental study
Authors: Parvin S D , Bentley S , Asher M J , Prytherch D R , Evans D H , Bell P R F 
Published: March 2007

Abstract
The results of femorotibial bypass for limb salvage vary a great deal. One of the reasons for this might be the discrepancy between potential inflow and run-off into the foot. An arteriovenous fistula at the distal graft anastomosis may improve results but the best anatomical arrangement for the fistula is unknown. Ileofemoral grafts were performed in dogs after the hind limb was rendered ischaemic. The distal end of the graft was anastomosed proximal to, superimposed upon, or distal to an arteriovenous fistula between the femoral artery and its accompanying femoral vein. The effect of the fistula on graft/run-off haemodynamics was then measured. The adjunctive arteriovenous fistula increased inflow by a mean of 900 per cent and reduced systemic pressure by 10 per cent. Peripheral resistance was reduced by 85 per cent. Distal arterial run-off was maximized with respect to total graft flow when the graft was placed distal to the fistula (P &lt; 0·05). The venous steal of flow and perfusion pressure produced by the fistula was minimized with the same configuration compared to the two other arrangements (P &lt; 0·01 and P &lt; 0·05). Placement of the graft distal to the adjunctive arteriovenous fistula maximized distal arterial flow and pressure, and significantly increased graft flow.
Does dihydroergotamine potentiate the thromboprophylactic effect of dextran 70? A controlled prospective study in general and hip surgery
Authors: Bergqvist D , Lindblad B , Ljungström K-G , Persson N H , Hallböök T 
Published: March 2007

Abstract
In a prospective randomized controlled study on postoperative thromboembolism, 259 patients undergoing elective general surgery, emergency general surgery, total hip replacement or hip fracture surgery were given thromboembolic prophylaxis with either a combination of dextran 70 and dihydroergotamine (DHE) or with dextran 70 alone. 500 ml dextran 70 was infused twice on the day of operation, once on postoperative days 1 and 3, and also on day 5 if the patient was still confined to bed. 0·5 mg DHE was given s.c. twice daily starting before operation and continued for 3 or 5 postoperative days. In hip fracture patients prophylaxis was started as soon as the diagnosis was made. 500 ml dextran 70 was given every other day before operation. DHE was given twice daily if so indicated from randomization. The patients were screened for deep-vein thrombosis (DVT) with the 125I-labelled fibrinogen test for 8 days and followed for one month postoperatively. In hip fracture surgery the incidence of DVT was significantly reduced by the combination of dextran 70 and DHE compared to dextran 70 alone (1/32 vs. 11/36, P = 0·003). However, this synergistic effect of DHE could not be detected in the other patient groups. Fatal pulmonary embolism did not occur. No severe side effects attributable to prophylaxis were noted in either group.