bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polypoid lesions of the gallbladder: diagnosis and indications for surgery
Authors: Yang H L , Sun Y G , Wang Z 
Published: March 2007

Abstract
One hundred and eighty-two patients with an ultrasonographic and/or pathological diagnosis of polypoid lesions of the gallbladder(PLG) were reviewed to determine the reliability of ultrasonography in the diaynosis of PLG and the indications for operation in this disease. Of the 182 patients operated on, PLG were demonstrated by the gross appearance of the resected gallbladder in 172. Histologically benign lesions were present in 159 gallbladders and malignant lesions in 13. Cholesterol polyps accounted for most benign PLG. The sensitivity of ultrasonography in detecting PLG was 90·1 per cent, signijicantly higher than that of oral cholecystography, computed tomography or endoscopic retrograde cholangiopancreatography (P &lt; 0·01). The specificity of ultrasonography in the diagnosis of PLG was 93·9 per cent. Therefore, ultrasonography is a highly sensitive method for investigating PLG, and the preoperative diagnosis of PLG in this unit has now become entirely dependent on this technique. The size and number of PLG, the presence of gallstones and the patient's age all correlate with the nature of PLG, and these features are helpful in differentiating malignant from benign lesions before operation. Surgical treatment is indicated when PLG exceed 1.0 cm in diameter, when PLG are single in number, when PLG are associated with gallstones, when patients with PLG are over the age of 50 years, or when clinical symptoms of PLG are apparent.
Lymph node metastasis from early gastric cancer: endoscopic resection of tumour
Authors: Sano T , Kobori O , Muto T 
Published: March 2007

Abstract
The clinicopathological features of 748 solitary early gastric cancers were examined with regard to lymph node metastasis. Among several factors, only depth of invasion and tumour size correlated significantly with node involvement. Tumours which satisfy the following criteria may not metastasize to lymph nodes: (1) confined to the mucosa; (2) less than 1.5 cm in diameter; (3) macroscopically elevated; (4) macroscopically depressed, without intramural ulcers or ulcer scars (endoscopically, no fold convergence); and (5) histologically differentiated. With a recently developed endoscopic technique small gastric tumours can safely be resected. The cut margin and depth of tumour invasion can be verified histologically in the specimen. If an endoscopically removed tumour satisfies the above criteria, further surgical intervention may be optional as the outcome of endoscopic resection is comparable to that of radical surgery in the absence of node involvement.
Quality of life after gastrectomy in patients with carcinoma of the stomach
Authors: Korenaga D , Orita H , Okuyama T , Moriguchi S , Maehara Y , Sugimachi K 
Published: March 2007

Abstract
One hundred and fifty patients without recurrence of disease after R2 gastrectomy for carcinoma of the stomach were interviewed to determine their quality of life after surgery. Patients ate less and weighed less but most appeared to be well adjusted and had an optimistic attitude regarding their physical state. There was no evidence of a diminished quality of life in those who had undergone distal partial gastrectomy. These patients had a higher overall food tolerance, body-weight and performance status compared with those treated by total gastrectomy. Considering the satisfactory outcome and the sustained quality of life, radical R2 gastrectomy may be the treatment of choice for carcinoma of the stomach.
Colour Doppler ultrasonography studies of benign and malignant breast lesions
Authors: Dixon J M , Walsh J , Paterson D , Chetty U 
Published: March 2007

Abstract
Colour Doppler scanning was carried out on 53 patients with solid, discrete breast masses. Twenty-five of 32 breast cancers and none of 21 benign lesions gave a positive scan, giving a sensitivity of 78 per cent for association with malignancy, a specificity of 100 per cent and a positive predictive value of 100 per cent. Tumours less than 1 cm in diameter and invasive lobular cancers were least likely to give a positive scan. Axillary node scans were performed in 31 of 32 patients with breast cancer with 29 undergoing an axillary staging procedure. Nine patients had a positive axillary scan and all nine had involved axillry nodes. Three patients had involved axillary nodes, but a negative axillary scan. The sensitivity of colour Doppler scanning for axillary node involvement was 75 per cent, with a specificity of 100 per cent and a positive predictive value of 100 per cent.
Incidence of arm swelling following axillary clearance for breast cancer
Authors: Hoe A L , Iven D , Royle G T , Taylor I 
Published: March 2007

Abstract
Arm swelling was measured using volume determination in 118 patients following mastectomy (n = 60) or wide excision (n = 58), both with axillary clearance. The mean age was 60·5 years and the median follow-up was 22·5 months. Axillary clearance removed level III nodes. Axillary irradiation was given to only three patients with extensive (more than 75 per cent) nodal involvement. The incidence of early postoperative complications was 18·6 per cent. The incidence of lymphoedema was 7·6 per cent (nine patients). Three of these patients had early lymphoedema within 6 months of treatment. Arm circumference differences correlated poorly with volume diferences. The incidence of lymphoedema following axillary clearance is low and comparable to that for sampling or no axillary surgery.
Upper thoracic sympathectomy for primary palmar hyperhidrosis: long-term follow-up
Authors: Hashmonai M , Kopelman D , Kein O , Schein M 
Published: March 2007

Abstract
Primary palmar hyperhidrosis is a functionally and socially disabling condition. Upper thoracic sympathectomy is the best curative treatment. Several surgical approaches have been suggested and, recently, less invasive techniques have been communicated. To evaluate which method is the best, the short- and particularly the long-term results must be compared. A series is presented of 170 upper thoracic sympathectomies by the supraclavicular approach performed on 85 patients with palmar hyperhidrosis. Follow-up for a mean of 8·3 years was obtained on 124 operated limbs. The immediate failure rate for relief from hyperhidrosis was 2·4 per cent and hyperhidrosis recurred in another 4·1 per cent of limbs after a period of between 2 and 18 months. Thirteen per cent of patients were dissatisfied with the results of operation, one because of persisting vasomotor rhinitis, two because of Horner's syndrome and five because of persisting or recurrent hyperhidrosis. Satisfactory results in approximately 87 per cent of cases make the operation rewarding. This outcome should be compared with the long-term results of other methods, such as percutaneous phenol injection and the transthoracoscopic approach, when such data are compiled and published.
Influence of prazosin on experimental vein graft intimal thickening
Authors: Norman P E , House A K 
Published: March 2007

Abstract
The influence of prazosin on experimental vein graft intimal thickening was studied in a rat model. The iliolumbar vein was grafted into the common iliac artery in a prazosin-treated group (n = 17) and a control group (n = 23). Three weeks after grafting the animals were killed and the grafts harvested. Longitudinal sections were prepared and the intimal thickness measured in the proximal, mid and distal graft. Intimal thickness varied considerably in both groups. Median (range) intimal thicknesses for the control group were: proximal 50 (10–120) μm; mid 30 (10–70) μm; and distal graft 30 (10–100) μm. Results for the prazosin-treated group were: proximal 70 (10–160) μm; mid 25 (5–60) μm; and distal graft 25 (5–135) μm. There was no statistically significant difference in median intimal thicknesses between the control und treated groups.
Role of selective decontamination in surgery
Authors: Tetteroo G W M , Wagenvoort J H T , Bruining H A 
Published: March 2007

Abstract
Aspects of selective decontamination as an antibiotic prophylaxis in general surgery are discussed with respect to the respiratory tract and wound infection. The high rate of nosocomial infection encountered in surgical patients, who experience up to 71 per cent of all such infection, is considered. The infection rate increases to 70–80 per cent after 1 week in the surgical intensive care unit, while the infection-related mortality rate rises to up to 60 per cent. The endogenous origin of nosocomial infection suggests the importance of maintaining colonization resistance to prevent colonization with Gram-negative micro-organisms, especially using selective decontamination which eliminates potentially pathogenic micro-organisms while leaving colonization resistance intact. Selective decontamination has proved eflective in decreasing infection rates by 50–80 per cent, and is especially successful in respiratory tract infection. Possible adverse effects and future indications for selective decontamination are discussed.
Anterior resection without a defunctioning colostomy: questions of safety
Authors: Mealy K , Burke P , Hyland J 
Published: March 2007

Abstract
The need to defunction the anastomosis at anterior resection remains controversial. As the policy in this unit has been not to perform a defunctioning colostomy during anterior resection, the outcome of a consecutive series of 114 anterior resections, all carried out without a covering colostomy, was studied. During the period February 1985 to September 1991, 21 abdominoperineal resections, six Hartmann's procedures and two resections with coloanal anastomosis were also performed. Within the anterior resection group six clinical leaks (5.3 per cent) occurred, all in the low anastomosis group (8 per cent leak rate) and all of which required an end colostomy. The perioperative mortality rate within the anterior resection group was 3.5 per cent; of the four deaths one was attributable to anastomotic dehiscence and sepsis and the others were due to unassociated medical conditions. The results demonstrate similar leakage and mortality rates to published studies where anterior resection is frequently performed with a defunctioning colostomy. These results indicate that the routine use of a defunctioning colostomy at anterior resection should now be questioned.
Poor palliation of colorectal malignancy with the neodymium yttrium–aluminium–garnet laser
Authors: Bright N , Hale P , Mason R 
Published: March 2007

Abstract
The neodymium yttrium-aluminium-garnet (NdYAG) laser was used to palliate the symptoms of 38 patients with rectal carcinoma unsuitable for radical surgery. All patients with small tumours (n = 6) reported resolution of their symptoms. In contrast, those with large tumours frequently showed little improvement (n = 18) and alternative surgical management was necessary in 12 patients. The overall early mortality rate (&lt; 1 month after first treatment) was 21 per cent. The NdYAG laser offers good palliation and may even cure small colorectal tumours in patients who are unsuitable for surgery. For large circumferential tumours, those associated with obstruction and those close to or involving the anal sphincters, however, the results are poor and better symptom control may be achieved by other means.
Gastric involvement of oesophageal squamous cell carcinoma
Authors: Kuwano H , Baba K , Ikebe M , Kitamura K , Adachi Y , Mori M , Sugimachi K 
Published: March 2007

Abstract
Among 402 patients with squamous cell carcinoma of the oesophagus, gastric wall involvement was evident in 32 (8.0 per cent). These could be grouped into four types according to the pattern of involvement: group 1 included six patients with gastric involvement via metastases in perigastric lymph nodes: group 2 consisted of 11 patients with gastric intramural metastasis; group 3 contained 12 with direct invasion of the gastric wall by the oesophageal squamous cell carcinoma; and group 4 three patients with intraepithelial spread of oesophageal cancer to the gastric epithelium. Prognosis was poor, all patients dying except for one in each of groups 3 and 4. The mean survival time was 5.6, 8.6, 14.8 and 18.7 months in groups 1, 2, 3 and 4, respectively. Gastric involvement via metastases to lymph nodes and by intramural metastasis therefore indicates an extremely poor prognosis, while the prognosis in groups 3 and 4 was influenced by the depth of invasion and lymph node metastasis of the oesophageal cancer. Histological examination of tissues from group 4 patients demonstrated that malignant squamous cells proliferated and invaded the gastric epithelial layer, that is, there was intraepithelial spread of the oesophageal cancer.
Attitudes and experiences of human immunodeficiency Virus-positive patients to surgery and surgeons
Authors: Gill S K , Emberton M , Scott H J 
Published: March 2007

Abstract
The issues regarding screening and identification of patients at risk for human immunodeficiency virus (HIV) infection before surgery continue to be discussed, and there is a need for information regarding attitudes of both surgeons and patients to this issue. A population of HIV-positive patients attending a genitourinary medicine clinic were given an anonymous questionnaire to review their experiences of attending for operation. Of 174 patients who replied, 52 had undergone a total of 65 procedures. In all but three of the operations, the HIV status was made known to the surgeon.
Glomus tumour: An analysis of 43 patients and review of the literature
Authors: Heys S D , Brittenden J , Atkinson P , Eremin O 
Published: March 2007

Abstract
Glomus tumours are hamartomas derived from the normal glomus body. A total of 43 glomus tumours have been seen over the past 18 years, and are reviewed. Their clinical presentations and pathology are analysed and the continuing difficulty in diagnosis is examined.
Assessment of quality of life in surgery
Authors: O'Boyle C A 
Published: March 2007

Abstract
The concept patient's quality of life is assuming increasing importance in modern medicine and surgery. Interventions are increasingly being assessed in terms of their impact on such areas of functioning as mobility, mood, cognitive function, ability to fulfil occupational and social roles, and general life satisfaction. This paper discusses the theoretical underpinnings of the quality-of-life paradigm and its practical relevance for modern surgery.
Knotting technique and suture materials
Authors: Brown R P 
Published: March 2007

Abstract
Three groups of knots were examined using six no. 1 (metric 4) suture materials to identify the most effective and efficient knotting techniques. The three groups were the square or reef knot, the surgeon's knot and a double throw knot. Sequential single additional throws were added to these in order to determine when the strength of the knot reached the breaking force of the material, thus nullifying the need for additional throws. This strength was reached in all cases by a maximum of two additional throws. Suture materials examined were the non-absorbable monofilaments nylon and polypropylene, the absorbable monofilaments polyglyconate and polydioxanone and the braided materials polyglactin and polyglycolic acid, both coated. These were examined for their knot-holding capacity and breaking force to determine the best materials, which were polypropylene, polyglyconate and polyglycolic acid.
Prediction of wound tensile strength: An experimental study
Authors: Savunen T J A , Viljanto J A 
Published: March 2007

Abstract
Wound cell specimens were obtained using a Cellstic device after 24, 48 and 72 h healing time in guinea-pig skin wounds. Cell counts from these were compared with the tensile strength values of the same wounds 7, 14 or 21 days after operation. No single cell type was predictive of wound tensile strength, although absolute numbers of diferent cells and selected ratios of cell types on the second or third day after operation were more predictive. Absolute and proportional changes from day 1 to day 2 had the greatest predictive power with a mean error of 9.46 per cent (F = 13.6, P &lt; 0.0001). The same regression model was predictive in animals with lower wound tensile strengths given perioperative hydrocortisone (3 mg/100 g).
Adenomatous goitre: Therapeutic strategy, postoperative outcome, and study of epidermal growth factor receptor
Authors: Sugenoya A , Masuda H , Komatsu M , Yokoyama S , Shimizu T , Fujimori M , Kobayashi S , Iida F 
Published: March 2007

Abstract
A total of 377 patients with histologically proven adenomatous goitre was operated on, 34 as a second operation, and assessed for postoperative outcome (including the incidence of unsuspected malignancy) and immunohistochemical localization of epidermal growth factor receptor. In primary surgery, enucleation of all the nodules was carried out. Patients requiring reoperation showed multicystic degenerate nodules involving one or both lobes. A coexistent cancer was observed in 18 patients (4.8 per cent). The immunohistochemically detected expression of epidermal growth factor receptor in adenomatous goitre was more evident in patients with multinodular lesions. Near-total lobectomy of the involved side(s) is desirable for the prevention of recurrence and complications after operation.
Plasma fatty acid profiles in benign breast disorders
Authors: Gateley C A , Maddox P R , Pritchard G A , Sheridan W , Harrison B J , Pye J K , Webster D J T , Hughes L E , Mansel R E 
Published: March 2007

Abstract
Breast pain (mastalgia) and macroscopic breast cysts present commonly. Mastalgia may be improved by dietary manipulation to reduce saturated fat or supplement essential fatty acid intake. Fatty acid profiles were measured in women with mastalgia and breast cysts, before and during treatment with evening primrose oil, a rich source of essential fatty acids. The fatty acid profiles of both groups of patients were abnormal, with increased proportions of saturated fatty acids and reduced proportions of essential fatty acids. Treatment with evening primrose oil improved the fatty acid profiles towards normal, but this was not necessarily associated with a clinical response.
Effect of phosphatidylcholine on postoperative adhesions after small bowel anastomosis in the rat
Authors: Snoj M , Ar'Rajab A , Ahrén B , Bengmark S 
Published: March 2007

Abstract
The possibility of preventing postoperative adhesions using phosphatidylcholine (PC) was studied in rats. A small bowel anastomosis was created using continuous or interrupted 5/0 silk sutures. Adhesions were measured by recording the maximal length of adhesions around the anastomosis and the number of organs involved in the adhesions. PC was administered intraperitoneally either as a single dose or as three separate doses. Postoperative adhesions developed in all animals; the degree of adhesion was independent of the suture technique used. PC given once at a dose of 20 mg significantly decreased adhesion formation (P &lt; 0.01). The mechanism underlying this effect may be that the exogenous PC provides a lubricant layer replacing endogenous hydrolysed phospholipid. The result with repeated PC administration was not different from that after a single dose. Increasing the single dose of PC to 40 or 60mg resulted in anastomotic dehiscence and subsequent peritonitis. It is concluded that PC in a single dose of 20 mg reduces adhesion formation after small bowel anastomosis in the rat.
Audit of general practitioner referrals to an acute surgical unit
Authors: Dookeran K A , Thompson M M , Lloyd D M , Everson N W 
Published: March 2007

Abstract
One hundred and ninety referrals from general practitioners (GPs) to an acute surgical unit were audited prospectively over a 6-month period. A total of 78 admissions were considered inappropriate of whom 23 patients were thought to have needed neither surgical admission nor opinion. The estimated expenditure resulting from admissions deemed inappropriate was £25000. The daytime commitments of more senior staff on routine emergency duty days meant they were not easily available to deal with calls concerning acute GP referrals. These admissions reduce the efficiency of the service; this may be improved by a senior member of the team accepting and screening GP calls.
Management of colovesical fistulae associated with pelvic malignancy
Authors: Holmes S A V , Christmas T J , Kirby R S , Hendry W F 
Published: March 2007

Abstract
Thirteen patients with malignant colovesical fistulae are presented. The underlying pathology was cancer of the colon (seven cases), bladder (four cases) and cervix (two cases). The series demonstrates that wide surgical excision may be needed to achieve tumour clearance and that this may necessitate pelvic exenteration. Three patients who underwent inadequate tumour excision developed recurrence in the bladder, two with a fatal outcome. Wide excision of the bladder may be performed without urinary diversion by subtotal cystectomy and a reconstructive procedure. Substitution cystoplasty was performed on two patients at the time of tumour excision. Urinary tract involvement by such tumours is often extensive and optimal results may be achieved with a multidisciplinary approach.
Laparoscopic fixation of sigmoid volvulus
Authors: Miller R , Roe A M , Eltringham W K , Espiner H J 
Published: March 2007

Abstract
Colonic volvulus accounts for 1–2 per cent of cases of intestinal obstruction in western populations1. If conservative measures fail, colectomy is usually the treatment of choice. A case of laparoscopic fixation for a recurrent sigmoid volvulus is reported.
Outcome in patients with early colorectal carcinoma
Authors: Moreira L F , Iwagaki H , Hizuta A , Sakagami K , Orita K 
Published: March 2007

Abstract
Twenty-four patients seen between 1978 and 1990 with early colorectal carcinoma were reviewed to determine the outcome of surgical treatment. The mean age was 62 (range 35–79) years; there were 16 men and eight women. The site of the tumour was the ascending colon in two patients, sigmoid colon in ten and rectum in 12. The polypoid and flat-elevated ulcerated (IIa + IIc) subtypes were detected in 14 and nine lesions respectively. Restorative colectomy was carried out in 19 patients, andjive required Miles' operation. There were no postoperative complications or deaths at a mean follow-up of 71 (range 12–151) months. Neither recurrence nor distant metastasis was found during follow-up. There was a close relationship between the depth of submucosal invasion and presence of flat-elevated ulcerated subtype lesions with lymphatic infiltration. This association may play an important role in the mechanism of metastasis. Major surgical resection is probably required if longer disease-free intervals and better cure rates are desired.
Restoration of continence following rectopexy for rectal prolapse and recovery of the internal anal sphincter electromyogram
Authors: Farouk R , Duthie G S , Bartolo D C C , Macgregor A B 
Published: March 2007

Abstract
Twenty-two patients with full-thickness rectal prolapse underwent ambulatory fine wire electromyography of the internal anal sphincter (IAS), external anal sphincter and puborectalis, together with anorectal manometry, using a computerized system. Examinations were performed both before and 3 to 4 months after rectopexy. The median (interquartile range (i.q.r.)) preoperative IAS electromyogram (EMG) frequency was 0.18 (0.05–0.31) Hz and the median (i.q.r.) preoperative resting anal pressure was 28 (15–64) cmH2O. An improvement in the IAS EMG frequency, median (i.q.r.) 0.29 (0.19–0.38) Hz (P &lt; 0.03), and resting anal pressure, median (i.q.r.) 41 (20–72) cmH2O (P &lt; 0.05), was recorded after operation, but these variables remained significantly lower than those found in normal controls: median (i.q.r.) IAS EMG frequency 0.44 (0.36–0.48) Hz and median (i.q.r.) resting anal pressure 92 (74-98) cmH2O. We suggest that repair of the prolapse allows the IAS to recover by removing the cause of persistent rectoanal inhibition.