bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duct ectasia in the male
Authors: Mansel R E , Morgan W P , Hughes L E 
Published: March 2007

SummaryThree cases of inflammatory duct ectasia occurring in the male breast are described. The clinical presentation of the disease in the male closely resembles that in the female. Nipple retraction, nipple discharge, periareolar inflammation and bilateral involvement are all seen. Conservative measures produced unsatisfactory results similar to those in women. A similar operative approach to that used in women is advocated.
Preservation of the injured spleen
Authors: Slim Michel S , Najjar Najwa E , Mishalany Henry G 
Published: March 2007

Summary
Experience with suture repair of splenic lacerations in 14 children and 8 adults is reported. The youngest patient was 3 days old and the oldest 60 years. Adequate healing was confirmed by postoperative splenic scans with or without arteriography. The 2 deaths in this series were not related to the splenic repair and were due to associated major injuries. The course of illness in the remaining 20 survivors did not reveal a failure of this technique or a complication related to the use of this conservative approach. It is expected that salvage of the traumatized spleen will eliminate the risk of fulminant postoperative infections that may be fatal.
Long term results of autogenous vein bypass grafts in femoropopliteal arterial occlusion
Authors: Grimley R P , Obeid M L , Ashton F , Slaney G 
Published: March 2007

Summary
The results of 329 consecutive autogenous vein grafts carried out between January 1962 and June 1973 have been reviewed. The 5- and 10-year mortality rates were 14·6 per cent and 18·7 per cent respectively.
The corresponding patency rates were 70 per cent at 5 years and 34 per cent at 10 years, the lowest patency (27·8 per cent) occurring in below-knee anastomoses with grafts of 5 mm or less in diameter. As others have noted, the state of the popliteal—tibial run-off vessels had a considerable influence on long term patency rates. In severely ischaemic limbs, the limb salvage rate following this operation was 77 per cent.
No valid conclusions could be made regarding the effect of lumbar sympathectomy and postoperative anticoagulants on long term patency.
This review has confirmed the findings of earlier studies that a satisfactory 5-year patency rate and a gratifying limb salvage rate can be achieved with an extremely low operative mortality rate of 0·37 per cent. Despite the presence of widespread atherosclerotic arterial disease, the 5-year mortality rate is 14·6 per cent, indicating that an attempt at reconstructive surgery is usually well worth while.
Antibiotic-associated colitis—A review of 66 cases
Authors: Mogg G A G , Keighley M R B , Burdon D W , Alexander-Williams J , Youngs Denise , Johnson Margaret , Bentley Sandra , George R H 
Published: March 2007

SummaryWe have reviewed 66 cases of antibiotic-associated colitis since March 1975, which have been associated with a 27 per cent mortality. We believe antibiotics may predispose patients to this condition which is caused by a toxin produced by Clostridium difficile. Although the disease is rare, it is more common than previously reported. The presentation, methods of diagnosis and treatment are discussed.
Hepatic resection for trauma, tumour and biliary obstruction
Authors: Blumgart L H , Drury J K , Wood C B 
Published: March 2007

Abstract
Hepatic resection was performed in 37 patients. Fifteen emergency procedures were undertaken for blunt trauma and 16 patients had elective resection for hepatic tumour. A further 6 resections were performed for benign biliary tract obstruction. The importance of preoperative assessment and the indications for resection are discussed particularly in relation to resection for biliary obstruction. Operative procedures are outlined and the technique of extended left lobectomy is described in detail.
A new vascularized bone graft transferred by microvascular anastomosis as a free flap
Authors: Sanders Roy , Mayou Bryan J 
Published: March 2007

Abstract
We describe a new, versatile bone and soft tissue compound free flap which may be transferred quickly and simply and describe its use in the treatment of compound fracture of the tibia and fibula with non-union due to loss of bone. The iliac crest and overlying soft tissue is transferred to the leg in one stage by microvascular anastomosis of the deep circumflex iliac vessels to vessels in the leg.
Salmonellosis associated with late rupture of an aortofemoral bypass graft
Authors: Scott A R , Hope D M 
Published: March 2007

Abstract
Salmonella infection is a rare cause of rupture of the atherosclerotic abdominal aneurysm. A case never previously reported is presented in which salmonella infection occurred involving an aortofemoral bypass graft which had been inserted 10 years previously. The infection caused a leak in the region of the graft which presented as a haematoma in the thigh.
Haematemesis in infantile hypertrophic pyloric stenosis: The source of the bleeding
Authors: Spitz Lewis , Batcup Gillian 
Published: March 2007

Abstract
Thirteen infants with haematemesis associated with hypertrophic pyloric stenosis were investigated in order to elucidate the source of bleeding. All 13 patients showed endoscopic evidence of oesophagitis, moderate in 4 and severe in 9. No significant gastric mucosal lesion was found. It was concluded that the site of the haemorrhage was the oesophageal mucosa in all 13 infants. Eleven of the patients experienced troublesome postoperative vomiting.
High bile duct strictures
Authors: Aubrey D A , Chare M J B 
Published: March 2007

Abstract
The diagnosis and surgical treatment of carcinoma of the common hepatic duct present difficult problems. Accurate preoperative localization of the obstructive lesion is essential and slim needle transhepatic percutaneous cholangiography is the investigation of choice. Worth while palliation may be achieved if biliary-enteric flow can be re-established by introducing a plastic stenton through the obstructive lesion in the bile duct. Three patients are reviewed who survive 36, 31 and 26 months after this operation. A further patient died of metastases after 5 months.
A comparative study of methods for the prediction of severity of attacks of acute pancreatitis
Authors: McMahon Michael J , Playforth Michael J , Pickford Ian R 
Published: March 2007

Abstract
Diagnostic peritoneal lavage was carried out in 79 patients with acute pancreatitis, at a mean time of 7 h after admission to hospital. The presence of more than 10 ml of free peritoneal fluid, brown-coloured free fluid or mid-straw-coloured lavage fluid was the criterion used for the prediction of a severe attack by lavage.
Prior to lavage the attack was assessed as mild or severe by the clinician and reassessed by him at 24 and 48 h. All attacks were finally classified as mild or severe by means of a simple clinical grading scheme. There were 61 mild and 18 severe attacks (including 4 deaths).
Initial clinical assessment correctly predicted only 39 per cent of the severe attacks compared with a 72 per cent success rate for diagnostic lavage. All the mild attacks were correctly predicted by clinical assessment but lavage was wrong in 3 out of 61 cases (95 per cent success rate).
By 48 h after admission clinical assessment was comparable to systems using multiple criteria in its predictive value, success rates being 83 per cent and 82 per cent respectively for prediction of severe attacks. We did not find either the presence of methaemalbumin in the serum or the presence of hypocalcaemia to be of additional value.
Diagnostic peritoneal lavage was the most accurate early guide to severity, and correctly predicted all patients who developed shock or died.
Acute caecal volvulus
Authors: Anderson J R , Lee D 
Published: March 2007

Abstract
Forty-one cases of acute caecal volvulus have been analysed. The diagnosis is rarely made on clinical grounds alone but plain radiography of the abdomen should suggest the diagnosis in nearly 90 per cent of cases. Prompt surgery is imperative. When the bowel is viable, simple caecopexy combined with tube caecostomy is effective in fixing and decompressing the bowel in the short term and prevents recurrence.
Severe leg ischaemia caused by anterior resection of the rectum
Authors: Devine T J , Myers K A , Slattery P G 
Published: March 2007

Abstract
A 45-year-old man developed severe leg ischaemia following anterior resection for rectal carcinoma. A previously unrecognized infrarenal aortic occlusion was also present. Division of important collateral arterial pathways during the anterior resection was the cause of ischaemia which contributed to the patient's death. Patients having rectal or colonic resection should be carefully assessed for aortoiliac occlusive disease. Extra-anatomical arterial reconstruction before the bowel resection would avoid this complication.
The management of the open perineal wound using a foam elastomer dressing: A prospective clinical trial
Authors: Macfie John , McMahon Michael J 
Published: March 2007

Summary
In an attempt to improve the management of the perineal wound after abdominoperineal excision of the rectum we have assessed the value of foam elastomer, a catalysed silicone polymer dressing. This substance has already been used successfully in the treatment of open, granulating wounds at other sites (1).
On the fourteenth postoperative day 50 patients with open perineal wounds were randomized to receive either conventional gauze packing or treatment with a foam elastomer dressing. Patients were received weekly until healing occurred. When no cavity remained, a dry dressing alone was used. Initial wound volume was calculated in all patients by forming a foam dressing the volume of which was measured by displacement of water.
Healing times were shorter in patients who received foam elastomer, but not signficantly so. However, less analgesia (P &lt; 0·01) and fewer district nurse visits (P &lt; 0·001) were required by patients in the foam elastomer group.
This study suggests that foam elastomer dressing is a more comfortable alternative to a gauze pack in the management of the perineal wound and substantially reduces the amount of nursing supervision which is required. We recommend its routine use in the management of the open perineal wound particularly in the young and cooperative patient.
Single and multiple dose cotrimoxazole and metronidazole in colorectal surgery
Authors: Higgins A F , Lewis Adam , Noone Paul , Hole Margaret L 
Published: March 2007

Summary
Cotrimoxazole and metronidazole were given prophylactically to patients undergoing colorectal surgery as a single peroperative dose or in multiple doses for 5 days. A total of 60 operations randomly divided into two groups showed that the rate of wound infection was low in both groups and there was no statistical difference between them. There were no cases of anastomotic dehiscence in those patients where the anastomosis was carried out from within the abdomen, but 7 out of 9 patients with transsphincteric colo-anal anastomoses developed a suture line dehiscence. A greater degree of post-catheterization urinary tract infection was seen in the single dose group (which lacks statistical significance). There were no toxic effects.
Clindamycin in the treatment of soft tissue infections: A review of 15 019 patients
Authors: Wilson David H 
Published: March 2007

Summary
A retrospective survey of 15 019 patients treated with clindamycin for a soft tissue infection was carried out to determine whether the incidence of serious side effects was sufficient to preclude the continuing use of this antibiotic. Thirteen patients were found to have had severe diarrhoea and 2 of these required inpatient treatment for pseudomembranous colitis. Certain limitations of the use of clindamycin are suggested but, in view of the recently improved understanding of the nature of pseudomembranous colitis and more effective methods of treatment of this complication, it is concluded that this antibiotic still has a useful role to play in the treatment of acute soft tissue infection.
Alleviation of autotransfusion-induced haematological damage by corticosteroids
Authors: Stillman Richard M , Gottlieb Bruce S , Sawyer Philip N 
Published: March 2007

Summary
Thrombocytopenia and haemolysis in intraoperative autotransfusion result mainly from extravascular tissue contact and therefore are not correctable by mechanical improvements in the autotransfusion apparatus. Instead, attention must be directed towards prevention of blood ‘recognition’ of extravascular tissue or stabilization of blood components against this damage. Methylprednisolone is shown to be effective in alleviating red cell and platelet damage induced by intraoperative autotransfusion in the canine model.
The use of flexible carbon fibre in the repair of experimental large abdominal incisional hernias
Authors: Johnson-Nurse C , Jenkins D H R 
Published: March 2007

Summary
Ventral hernia was induced surgically in sheep and either left unrepaired(5 animals), repaired with plastic mesh (20 animals) or with carbon fibre (20 animals). In unrepaired animals the hernia persisted. Three hernias recurred in the group repaired with plastic mesh, 2 as a consequence of sepsis. All the hernias repaired with carbon fibre remained sound over periods varying from 8 months to 2 years. There was a gradual invasion of the carbon fibres by collagenous tissue and thus a transition from one to the other of the stress of maintaining the abdominal wall intact.
Intussusception in infancy and childhood
Authors: Hutchison I F , Olayiwola B , Young D G 
Published: March 2007

Summary
A total of 209 cases of intussusception treated at the Royal Hospital for Sick Children, Glasgow, in the past decade has been reviewed. The results are compared with similar reports for the two preceding decades from the same hospital. The mortality rate has fallen; there were 5 deaths in this series, 2 of these deaths occurring some months after the presentation with intussusception and death being caused by dissemination of lymphosarcoma. The continuing delay in diagnosis is apparent.
Reversible arteriopathy following an ergotamine overdose in a heavy smoker
Authors: Fielding J W L , Donovan R M , Burrows F G O , Hurlow R A 
Published: March 2007

Summary
A case of reversible arteriopathy developing in a heavy cigarette smoker taking an overdose of ergotamine is reported. Characteristic radiological changes are illustrated and the aetiology and management of this condition àre discussed.
Influence of orchidopexy for cryptorchidism on subsequent fertility
Authors: Eldrup Jesper , Steven Kenneth 
Published: March 2007

Summary
The concentration of spermatozoa in ejaculate from testes that had been subjected to orchidopexy during childhood was studied in semen samples taken after unilateral wasectomy of the contralateral normal testis in 4 patients. The counts were extremely low, which suggests that this operation does not improve fertility later in life. Sperm concentration is not influenced by unilateral vasectomy or by inguinal herniotomy during childhood.
Popliteal aneurysm: Sinister harbinger of sudden catastrophe
Authors: Guvendik L , Bloor K , Charlesworth D 
Published: March 2007

Summary
A series of twenty-eigth aneurysms of the popliteal artery is reviewed. The cases were collected from the records of two large hospitals each with a unit with a special interest in vascular surgery.
They are uncommon–-only 1 popliteal aneurysm to every 17 aneurysms of the abdominal aorta–-but onethird of our patients had both types of aneurysm present. The majority of patients had symptoms and 7 lost a leg as a direct result of thrombosis or rupture. The results of treatment were best when saphenous vein was used to replace an uncomplicated aneurysm and, since the behaviour of aneurysms is unpredictable, we conclude that this is the treatment of choice.
The influence of heparin on intravenous infusions: A prospective study
Authors: Tanner William A , Delaney Peter V , Hennessy Thomas P 
Published: March 2007

Abstract
In a prospective study of 108 intravenous infusions a significant decrease was noted in the incidence of both cannula-related sepsis and cannula-related phlebitis in those patients on low dose (1000 units/1000 ml infusate) heparin given intravenously. A signficant decrease in the incidence of cannula-related phlebitis was also noted in patients receiving subcutaneous low dose heparin (5000 units 8-hourly). This significant decrease may be due to inhibition of fibrin clot formation around the tip of the indwelling intravenous cannula.
Impairment of skin graft take after CO2 laser surgery in melanoma patients
Authors: Lejeune F J , Van Hoof G , Gerard A 
Published: March 2007

Abstract
Twenty-four patients presenting with primary malignant melanoma of the skin (stage 1) were submitted to wide excision of the tumour, followed by immediate split-skin grafting. In 12 patients a CO2 laser was used to excise the melanoma and only 1 of these patients had a 100 per cent skin graft take, while 9 out of 12 patients whose melanoma was excised with a conventional scalpel had a 100 per cent take. It is concluded that skin excision with the CO2 laser impairs subsequent skin graft take.
Irradiation injury to large arteries
Authors: Butler M J , Lane R H S , Webster J H H 
Published: March 2007

Abstract
Four cases of irradiation injury to large arteries are presented and the literature is reviewed. Three patterns of injury have emerged. Intimal damage resulting in mural thrombosis presenting within 5 years of irradiation.Fibrotic occlusion presenting within 10 years of injury.A predisposition to the development of atheroma together with periarterial fibrosis associated with a latent interval of 20 or more years.
The treatment of choice is a bypass procedure of the arterial lesion.
The effect of naftidrofuryl (Praxilene) on intermittent claudication
Authors: Waters Kenneth J , Craxford Alan D , Chamberlain John 
Published: March 2007

Abstract
In a randomized double-blind controlled trial the effect of naftidrofuryl (Praxilene) 200 mg t.d.s., taken for 6 months, was compared with placebo in intermittent claudication. Whilst there was a significant subjective improvement regardless of age or treatment, patients over 60 on naftidrofuryl experienced a more rapid symptomatic relief than other patients. At six months this age group showed a significant improvement over the placebo group. There was no significant objective evidence of improvement.
Thyroid morphology and function after subtotal resection for hyperthyroidism
Authors: Lundström B , Norrby K 
Published: March 2007

Abstract
Two main patterns of hyperplasia of the thyroid epithelium are seen in hyperthyroidism–toxic diffuse hyperplasia and toxic nodular hyperplasia. Toxic diffuse hyperplasia may affect the entire gland or it may arise in the extranodular tissue in a gland with nodular lesions. A series of patients treated by subtotal thyroidectomy for hyperthyroidism were classified into three morphological groups of goitre: 98 had a toxic diffuse goitre (TDG), 58 toxic nodular goitre with diffuse hyperplasia (TNGDH), and 105 toxic nodular goitre with nodular hyperplasia (TNGNH). The type of goitre was correlated to the development of disturbed thyroid function 1–6 years after surgery. Twenty-two patients with TDG and 18 (31 per cent) with TNGDH developed hypothyroidism; only 3 (3 per cent) with TNGNH showed hypofunction. Six patients with recurrent hyperthyroidism were found; all showed diffuse hyperplasia of the gland.
It is concluded that the development of disturbed thyroid function after surgery is closely related to the histopathological type of goitre.
Oesophageal squamous cell carcinoma: I. A critical review of surgery
Authors: Earlam Richard , Cunha-Melo J R 
Published: March 2007

Summary
Authors writing on oesophageal cancer include adenocarcinoma to a variable extent–between 1 and 75 per cent–but the true incidence of this histological type is about 1 per cent. Most adenocarcinomas are gastric in origin, involving the lower oesophagus, have a lower operative mortality than in the middle or upper one-third of the oesophagus and poorer prognosis than squamous cell carcinoma, but there is no alternative treatment to surgery. Squamous cell carcinoma of the oesophagus, separated incompletely but as far as possible, has been analysed by reviewing data on 83 783 patients in 122 papers. After trying to standardize the data, it appears that of 100 patients with the condition, 58 will be explored and 39 have the tumour resected, of whom 13 will die in hospital. Of the 26 patients leaving hospital with the tumour excised, 18 will survive for 1 year, 9 for 2 years and 4 for 5 years. Oesophageal resection for squamous cell carcinoma has the highest operative mortality of any routinely performed surgical procedure today.
Presentation of cancer to hospital as ‘acute abdominal pain’
Authors: De Dombal Francis T , Matharu Santokh S , Staniland John R , Wilson David H , Macadam William A F , Gunn Alexander A , Allan Walter R , Bjerregaard Beth 
Published: March 2007

SummaryIn a survey of 5675 patients presenting to five hospitals in England, Scotland and Denmark with acute undiagnosed abdominal pain, 106 patients later proved to have intraabdominal cancer. The risk of cancer was age-dependent: amongst patients over 50 years with ‘non-specific’ pain the risk of cancer was 10 per cent. The commonest primary cancer site (in 57 cases, 53·8 per cent) was the large bowel. Most cancers neither perforated nor obstructed: 73 patients merely presented with a short history of unexplained abdominal pain.Of those patients with cancer presenting with ‘unexplained’ pain, haaf (37/73, 50·7 per cent) left hospital without a diagnosis of cancer having been made. Subsequently, a computer-aided system was constructed to discriminate (in patients over the age of 50) between those with unexplained acute abdominal pain who did and did not have cancer. Overall accuracy was 84.7 per cent in 138 cases. The most helpful clinical features in making this discrimination are listed.It is suggested (a) that cancer is now a relatively common cause of acute abdominal pain, (b) that the diagnosis is frequently difficult and (c) that urgent screening of all patients over 50 with non-specific acute abdominal pain may be warranted.
Is pancreatic duct obstruction or stricture a major cause of pain in calcific pancreatitis?
Authors: Bornman P C , Marks I N , Girdwood A H , Clain J E , Narunsky L , Clain D J , Wright J P 
Published: March 2007

Summary
Forty-seven patients with calcific pancreatitis were submitted to ERCP, 24 of whom were designated ‘painless’ and 23 ‘painful’, according to whether or not pain had occurred during the previous year. The pancreatic duct was cannulated in 39 of these patients. The incidence of pancreatic duct obstruction or stricture was of the same order in the painless (13/20, 65 per cent) and painful (15/19. 79 per cent) groups.
Alcohol was the aetiological factor in 46 patients. Twenty-four (52 per cent) continued to drink, and were equally divided between the painless (12) and painful (12) groups. Four out of 13 in the painless and 7 out of 14 in the painful groups, with a stricture or obstruction, continued. to drink. The difference was statistically not signifcant.
These results suggest that ERCP findings of pancreatic duct obstruction or stricture need not necessarily be pertinent to the pain in patients with chronic pancreatitis.