bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temporary transcaecal ileal diversion in prevention of anastomotic leak in planned colonic surgery (an alternative to proximal colostomy)
Authors: Simpson Alan , Srivastava V K 
Published: March 2007

Abstract
An alternative to proximal colostomy in planned colonic resection is reported in 30 patients. The physiopathological background for this procedure of temporary transcaecal ileal diversion is explained together with details of the operation and the results obtained.
Carcinoma of the large bowel in the Sudan
Authors: Elmasri S H , Boulos P B 
Published: March 2007

Abstract
Large bowel cancer is not common but is showing increased frequency in the northern part of the Sudan. It is relatively uncommon among southerners, which may be due to the socio-economic factors prevailing in the Sudan.
The disease affected our population at a younger age than has been generally reported in the literature, and the lesions in nearly 30 per cent were of the mucoid and undifferentiated types.
The incidence in young adults is difficult to explain in the absence of precancerous lesions, and there is not enough evidence to incriminate parasitic infestation.
Intra-abdominal symptoms arising from spinal osteophytes
Authors: Rawat S S , Jain G K , Gupta H K D 
Published: March 2007

Abstract
A case of abdominal pain caused by irritation of a segment of jejunum and another due to irritation of the ureter are reported. In both cases the cause of the irritation was established to be osteophytic growth from the 4th lumbar vertebra. After its excision the symptoms disappeared in both cases. To the best of our knowledge, osteophytes have not been reported before to be the cause of intestinal and ureteric pain, and it is therefore urged that in cases of intractable pain these must be considered as a possible cause.
Extended deep femoral angioplasty: An alternative to femoropopliteal bypass
Authors: Cotton L T , Roberts V C 
Published: March 2007

Abstract
The results of extended deep femoral angioplasty (EDFA) have been analysed for 74 legs in 72 patients. In 69 per cent a femoropopliteal bypass would have been possible, so EDFA is considered here as an alternative operation. The success rate was 66.9 per cent, the failure rate 25.6 per cent and no effect was achieved in 7.5 per cent. Diabetes adversely affected the results. Of the failures, 45 per cent were diabetic, while the incidence of diabetes was only 14 per cent in the group where the operation was successful. The long term results of the operation were reasonable, 75 per cent being successful for 10–39 months. Age had no bearing on success or failure.
The effects of EDFA were most dramatic on intermittent claudication. In 52 per cent it was abolished and in 92 per cent claudication distance was increased to over 200 yards. Good results were achieved after failed lumbar sympathectomy and failed femoropopliteal bypass.
Successful results of EDFA could be predicted best by inspection of angiograms. Success or failure could have been predicted from the state of the run-off in 81 per cent of the cases. Claudication and rest pain were the most relieved by EDFA, followed by ischaemic ulceration of the leg. Gangrene of digits was helped but less than had been hoped.
We conclude that the indications for femoropopliteal bypass are limited to cases of digital gangrene where angiography shows that bypass is possible or where an EDFA operation has failed.
Recognition of infection associated with intravenous catheters
Authors: Freeman R , King B 
Published: March 2007

Abstract
Four cases are described in which the patients suffered from bacteriaemia due to infected intravenous infusions. Although all the patients were pyrexial, the white cell count was normal in all 4 cases at diagnosis and the infusion site appeared innocent.
Fllowing removal of the intravenous catheter and the institution of antibiotic therapy in each case, neutrophilia and localizing signs developed. It is stressed that a normal white cell count and an innocent appearance at the infusion site do not exclude this complication of intravenous therapy. Possible reasons for this presentation of sepsis are discussed.
Hepatic resection
Authors: Ong G B , Lee N W 
Published: March 2007

Abstract
One hundred and twenty-five hepatic resections were done in the University Surgical Unit at the Queen Mary Hospital, Hong Kong, from 1964 to 1974 for conditions varying from primary hepatoma and recurrent pyogenic cholangitis to spontaneous rupture of the liver due to a bleeding haemangioma.
The overall mortality was 17·6 per cent. A case was classed as an operative death unless the patient was discharged from hospital. There has been long term survival after resection for primary carcinoma of the liver and no mortality when resection was carried out for benign conditions.
Fatal Clostridium welchii septicaemia following acute cholecystis
Authors: Clancy M T , O'Briain S 
Published: March 2007

Abstract
A case of Clostridium welchii septicamia following acute cholecystitis is described. The onset was acute and a rapidly fatal outcome ensued. Radiological findings were negative. An approach to the antibiotic treatment and general management is discussed.
Localization of parathyroid adenomas by computer-assisted parathyroid scanning
Authors: Ell P J , Todd-Pokropek A , Britton K E 
Published: March 2007

Abstract
In an attempt to localize adenomas of the parathyroid glands 36 patients with suspected hyperparathyroidism were studied with a computer-assisted double isotope scanning technique. Six patients were excluded from the statistical analysis because of uninterpretable scans. A definite localization was made with the computer-assisted scan in 16 patients. In 14 of these patients the site of the tumours was correctly predicted. In 14 patients no localization was seen on the scan. Four of these patients were classified as false negatives.
In 14 out of the 16 correctly localized tumours two-thirds had weights equal to or less than 1·5 g.
True recurrence of hyperparathyroidism: Proposed criteria of recurrence
Authors: Muller H 
Published: March 2007

Abstract
Although recurrent hyperparathyroidism should not be rare on theoretical grounds, only a few cases of proved recurrence have been reported in the literature. In the present author's series only 4 patients (1 per cent) had true recurrence. Criteria for recurrence were: Histological identification by biopsy and frozen section of all the parathyroid glands at the first operation.Complete removal of the enlarged gland(s).A normocalcaemic period of at least 1 year.The finding of a tumour at the site of a previously normal-sized gland.
The low incidence of recurrent hyperparathyroidism might be explained by the long period of time needed for the recurrence to develop. However, since diagnosis of hyperparathyroidism is now more easily made and patients are treated surgically earlier in the course of the disease, the incidence of true recurrence might be expected to rise. A meticulous exploration during operation and careful follow-up of the patients are therefore required.
An incision for en bloc nephrectomy
Authors: Cassie G F 
Published: March 2007

Abstract
A surgical approach is described for en bloc removal of a large renal mass, enabling easy removal of such a mass with early palpation and ligation of the renal pedicle and with the minimum of assistance. The principle underlying the approach is that of detaching the costal margin and the free ribs from the abdominal musculature. In the experience of the author the wound always heals by first intention. No complications have been encountered and the patients have been discharged from hospital within 10 days of operation.
Nodular fasciitis: An unusual cause of extradural spinal cord compression
Authors: Sengupta R P , So S C , Perry R H 
Published: March 2007

Abstract
A case of nodular fasciitis causing extradural spinal cord compression with a successful outcome following removal is reported. Such a tumour within the spinal cord has never been reported. The pathogenesis of a nodular fasciitis in this situation and its differential diagnosis is discussed.
Antrectomy with Roux-en-Y anastomosis in the treatment of peptic oesophagitis with stricture
Authors: Royston C M S , Dowling B L , Spencer J 
Published: March 2007

Abstract
A series of 8 patients with severe oesophageal strictures secondary to reflux oesophagitis who have been treated by antrectomy with Roux-en- Y anastomosis is described. There was 1 postoperative death. The remaining patients have been completely relieved of heartburn and all have had a dramatic improvement in their dysphagia. This method of treatment is strongly recommended for patients who have had prior surgery to the hiatus which has failed, and for those who are too elderly or frail to withstand a direct attack on their oesophageal stricture.
The effect of noxytiolin in experimental peritonitis
Authors: King D W , Gurry J F , Brooke B N 
Published: March 2007

Abstract
The evidence for the value of noxytiolin (Noxyflex) in peritonitis is contradictory. In a controlled trial of the effect of noxytiolin in peritonitis in rabbits we have found a significant increase in mortality in the trial group compared with a control group, but no significant difference when a dose equivalent to the recommended human dose is used. The postoperative course is adversely affected in the animals receiving noxytiolin.
Results of modified Robert Jones operation for clawed hallux
Authors: M'Bamali E I 
Published: March 2007

Abstract
The results of modified Robert Jones operation for clawed hallux carried out on 36 feet were reviewed by clinical and radiological investigations. Twenty-nine feet (80 per cent) achieved good results while 3 feet (8.5 per cent) obtained fair results and in 4 feet (11 per cent) the results were poor. Better results were obtained in the poliomyelitis cases than in the other groups.
Correction of deformity appears to be achieved by the transferred extensor hallucis longus elevating the first metatarsal neck and by the flexor hallucis longus flexing the rigid toe obtained by interphalangeal arthrodesis.
Tendon regeneration which is associated with recurrent clawing remains a problem.
Internal fixation should be used for the interphalangeal arthrodesis.
Whither thyrotoxicosis?
Authors: Michie W 
Published: March 2007

Abstract
For 30 years the thyrotoxic patient has been subjected to a plurality of treatments by surgery, radio-iodine and long term anti-thyroid drugs. These therapies have been accepted as complementary to the needs of the individual patient, without regard for long term results or the economic situation as it affects both patient and hospital services. In the context of surgical treatment which is now available, it is suggested that the advantages of operation over other therapies presage a reversion to surgery as the treatment of choice.
Acute cholecystitis
Authors: Raine P A M , Gunn A A 
Published: March 2007

Abstract
One hundred and fifty-six successive patients have been admitted with the clinical diagnosis of acute cholecystitis and have been treated by operation on the next operating list. The diagnosis was correct in 154 and a diagnostic pathway has been determined. The clinical features, investigations, bacteriology and pathology are discussed.
There is an increased need for choledochotomy in acute cholecystitis and this bile is more commonly infected than in the elective patient. It is suggested that those with infection can be identified prior to operation and should be treated with antibiotics on admission.
The morbidity of operation on patients with uninfected bile is no greater than in those receiving elective surgery, and operative treatment is recommended for both groups of patients.
The effect of acute ethanol administration on the exocrine pancreatic secretion of the pig
Authors: Wheatley I C , Barbezat G O , Hickman Rosemary , Terblanche J 
Published: March 2007

Abstract
The acute effect of intravenous and intragastric alcohol on exocrine pancreatic secretion was studied in pigs with chronic pancreatic and gastric fistulas. A new H-type pancreatic cannula was designed for the study.
With intravenous alcohol and the gastric fistula open, increased gastric acid secretion occurred but pancreatic enzyme output was inhibited. When acid was allowed to enter the duodenum by closing the gastric fistula, intravenous alcohol produced a secretin-like effect of increased pancreatic volume and bicarbonate secretion.
Intragastric alcohol caused an increase in volume, bicarbonate and enzyme output. This was probably due initially to direct gastroduodenal stimulation as the same response occurred following intragastric mannitol of similar volume, pH and osmolality. The subsequently sustained increase in volume and bicarbonate was possibly a secondary secretin-like response following absorption of alcohol.
It is concluded that the pig pancreas responds to alcohol as has been described in other animals. The use of a single model has allowed clarification of various phases of response invoking the effects of secretin, gastric and glucagon.
Cause and management of high volume output salt-depleting ileostomy
Authors: Hill G L , Mair W S J , Goligher J C 
Published: March 2007

Abstract
Ileostomy function was studied in 12 patients with an established ileostomy following proctocolectomy, in 6 of whom minimal amounts (less than 9 cm) and in 6 significant amounts (30–120 cm, mean 60 cm) of terminal ileum had been removed.
Patients who had undergone significant ieal resection had daily faecal volumes considerably greater than those with minimal ieal resection (1202 ± 284 ml versus 401 ± 92 ml, P&lt; 0·001), and also greater daily outputs of sodium (146 ± 53 mEq versus 43 ± 12 mEq) and potassium (12·7 ± 9·0 mEq versus 4·0 ± 0·99 mEq). The percentage water content of the ileostomy fluid was greater in patients who had had the ileum resected (93·1 ± 1·8 per cent versus 89·8 ± 2·5 per cent). In addition, the sodiumfpotassium ratio in the urine in patients with a properly acting ileostomy after ileal resection was low.
It is Concluded that when recurrent inflammatory bowel disease, partial small bowel obstruction and intraperitoneal sepsis have been excluded there remains a number of patients whose high ileostomy output is due entirely to the amount of ileum resected.
The management of patients with a high output ileostomy with codeine phosphate, Lomotil and oral administration of sodium chloride tablets is discussed.
The transdiaphragmatic approach to the heart
Authors: Cameron E W J 
Published: March 2007

Abstract
A modification of the transdiaphragmatic approach to the heart is described. The technique has been used successfully in both adults and children, the youngest child being 8 years of age. The approach has advantages over others in gaining access to the heart for purposes of internal cardiac massage and drainage of suppurative pericarditis and is also a suitable manoeuvre in the surgical treatment of acute tamponade. Clinical experience in the use of this approach is summarized. The transdiaphragmatic approach is recommended as a standard technique for internal cardiac massage.
Use of logic-based flow patterns in the investigation and management of surgical disorders
Authors: Ellis B W 
Published: March 2007

Abstract
The principles used in the development of logic-based flow charts for use by computer have been applied to the decision-making processes encountered in surgical disorders. Such charts do not attempt to alter one's decisions, but rather present a more logical approach to a given problem, based on past experience. It has been shown that the use of flow charts may be of material benefit to the patient, as well as having other advantages.
The immune reaction to human breast cancer: A comparison of skin and leucocyte migration tests
Authors: Maureen Roberts M , Bathgate Eleanor M 
Published: March 2007

Abstract
In vivo and in vitro tests of cellular immunity using autologous tumour antigen have been performed in patients after mastectomy for cancer and in a control group with benign tumours of the breast. Overall, the incidence of positive immune reactions in both groups was 45 per cent. Poor correlation was found between the results of in vivo and in vitro tests, which could not be explained in terms of serum factors. The specificity of the reaction is questioned but the clinical relevance will be determined by long term follow-up.
The importance of an innervated and intact antrum and pylorus in preventing postoperative duodenogastric reflux and gastritis
Authors: Keighley M R B , Asquith P , Edwards J A C , Alexander-Williams J 
Published: March 2007

Abstract
This study has investigated the relationship between duodenogastric reflux, gastritis and certain symptoms 6–12 months after three operations for uncomplicated duodenal ulcer. The operations studied were proximal gastric vagotomy (PGV, 20 cases), truncal vagotomy and pyloroplasty (TV+P, 22 cases) and truncal vagotomy and antrectomy (TV+ A, 21 cases).
Duodenogastric reflux was assessed both by a radiological technique and by measuring the concentration of bilirubin in the gastric aspirate before and after operation. Incidence and severity of postoperative gastritis were determined by endoscopic biopsy. Symptoms were assessed by symptomatic score and Visick grading.
There was a significant correlation between duodenal reflux and histological evidence of both severe superficial gastritis and glandular atrophy (P&lt;0.01). There was also a close association between the degree of reflux and the presence of severe heartburn, epigastric pain and bile vomiting after operation. The amount of reflux did not differ before operation. There was significantly less reflux following PGV than after either TV+P (P&lt; 0.025) or TV+A (P&lt; 0.001). The results indicate that an operation which preserves an innervated and intact antrum and pylorus will protect against postoperative duodenogastric reflux, gastritis and symptoms.
Controlled clinical trial comparing early with interval cholecystectomy for acute cholecystitis
Authors: McArthur P , Cuschieri A , Sells R A , Shields R 
Published: March 2007

Abstract
The traditional management of acute cholecystitis is initial conservative treatment with antibiotics followed by elective cholecystectomy. Although early cholecystectomy has often been advocated, there has been only one randomized controlled clinical trial comparing the two methods of treatment. This paper reports the preliminary results of such a trial in which 32 patients have been studied so far.
Of the 17 patients managed conservatively, there was a misdiagnosis in 2 (11.8 per cent). In the remaining 15 patients with acute cholecystitis 3 (20 per cent) required urgent operation because of failure of medical treatment. Elective cholecystectomy was not technically difficult.
Of the 15 patients treated by early cholecystectomy, there was a misdiagnosis in 1 (6.8 per cent). Surgery was technically difficult in 2 patients but cholecystectomy was possible in all. The former 2 patients required blood transfusion, but in the remainder the estimated blood loss was only slightly more than in the elective group.
There was no mortality in either group nor any complication directly attributable to the biliary surgery. The incidence of minor postoperative complications was only slightly greater in those treated by early operation. The length of postoperative stay was similar in both groups but those treated conservatively spent an average of 11 more days in hospital.
The preliminary results indicate that those treated by early cholecystectomy spend less time in hospital and avoid the complications of failed conservative treatment without the added risk of increased postoperative mortality and major complications.
The effect of the size of the gastric outlet on gastric emptying after vagotomy for duodenal ulcer
Authors: George W D , Cowley D J , Royston C M , Glass H I , Spencer J 
Published: March 2007

Abstract
Gastric emptying of isotopically labelled solid meals was studied in normal human subjects and in 30 patients who had had an operation for chronic duodenal ulcer. Each patient had a vagotomy of the whole stomach combined with either a Finney pyloroplasty to produce a large gastric outlet or a Heineke-Mikulicz pyloroplasty to produce a relatively small outlet.
At 10–22 days after operation gastric emptying was equally and significantly slowed in both groups when compared with the normal controls. This delay occurred regardless of whether the vagotomy was complete or incomplete.
At 4–6 months after operation emptying had returned to normal in the patients who had had a Finney pyloroplasty but remained significantly slowed after Heineke-Mikulicz pyloroplasty.
Mild symptoms of gastric stasis frequently occurred in both groups in the early postoperative period, but were rare 4–6 months after operation. There was no correlation between the incidence of these early symptoms of stasis and the size of the gastric outlet constructed.
Experience with 26 reservoir ileostomies
Authors: Goligher J C , Lintott D 
Published: March 2007

Abstract
A personal experience of 26 reservoir ileostomies is reviewed. There were no operative deaths, but 3 patients developed non-fatal faecal fistula and 6 patients eventually had their reservoir removed for a variety of reasons. No patient given a reservoir without an intussusception valve was fully continent, but of 15 patients with a reservoir incorporating such a valve who were followed up, 9 enjoyed complete continence, though 2 experienced periodic difficulty with stomal intubation. The indications for this operation are discussed.
An assessment of the value of the white cell count in the management of suspected acute appendicitis
Authors: Bolton J P , Craven E R , Croft R J , Menzies-Gow N 
Published: March 2007

Abstract
A prospective study of 100 consecutive patients was carried out to determine if a knowledge of the white cell count was a useful factor in determining the correct management of patients presenting with suspected acute appendicitis.
A retrospective study of the differential white cell count and neutrophil morphology was performed to see if these investigations would provide more specific aids to diagnosis.
These studies show that such haematological information is only of limited supportive value in the total assessment of these patients. Where the clinical findings are at variance with the white cell count, the clinical findings should take precedence.
Comparison of impedance and strain gauge plethysmography in the measurement of blood flow in the lower limb
Authors: Schraibman I G , Mott D , Naylor G P , Charlesworth D 
Published: March 2007

Abstract
Simultaneous measurement of the flow of blood in the calf in 24 normal volunteers by impedance and mercury strain gauge plethysmography has revealed a systematic difference in the results from the two methods. Possible reasons for this discrepancy are discussed.
Loose bodies in the elbow
Authors: Bell M S 
Published: March 2007

Abstract
This is a retrospective study of 52 patients with loose bodies in the elbow joint. The major cause was osteoarthrosis, accounting for 37 per cent of the cases, and the commonest site was the anterior compartment of the joint. Restriction of elbow extension by 10° or more was the most constant clinical finding. Thirty-three patients were subjected to arthrotomy, with a low complication rate.
Identification of talc on surgeons' gloves and in tissue from starch granulomas
Authors: Henderson W J , Melville-Jones C , Barr W T , Griffiths K 
Published: March 2007

Abstract
Particles of talc have been identified on the route surface of surgeons' rubber gloves and in sections of tissue classified as “starch” or “foreign body” granulomas. This analytical study indicates that under certain circumstances these granulomas could have been caused by talc contamination.