bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep vein thrombosis after total hip replacement: A clinical and phlebographic study
Authors: Nillius Anders S , Nylander Göran 
Published: March 2007

Summary
Two hundred and forty-seven phlebograms (113 bilateral and 21 unilateral) were performed in 134 patients 10–14 days after total hip replacement. Fifty-eight per cent of the patients were found to have deep vein thrombosis. The patients with DVT were significantly older than patients without DVT, but there was no difference regarding sex, type of hip prosthesis, side of operation or day of mobilization. No difference was found in the duration of operation and anaesthesia, the operative haemorrhage and the amount of bank blood transfused in patients with and without DVT.
Fifty per cent of the thrombi were confined to the calf veins. Ninety-seven per cent of these thrombi were asymptomatic and were as frequent on the operated as on the non-operated side. The remaining 50 per cent of the thrombi engaged the thigh with or without simultaneous calf vein involvement. These thrombi produced symptoms in 23 per cent of the cases and were significantly more common on the operated than on the non-operated side.
It is concluded that DVT after hip replacement can be of two different types: thrombosis caused by stasis and the general effects of trauma and thrombosis caused by local factors involving the thigh veins of the operated leg.
A new look at the arterial supply of the bile duct in man and its surgical implications
Authors: Northover J M A , Terblanche John 
Published: March 2007

Summary
The blood supply of the human bile duct has been re-evaluated using high resolution resin casts prepared from 24 fresh human cadavers. The refined technique used yielded casts of all vessels, including capillaries, and produced a clear picture of the blood supply of the human bile duct for the first time. The arterial supply of the supraduodenal duct was shown to be axial, with the main vessels, which have been named the 3 o'clock and 9 o'clock arteries, running along the lateral borders. The retroportal artery, which has not been described by previous workers, was present in all complete casts and was a major source of the axial blood supply to the supraduodenal duct in 32 per cent of them.
The major importance of this new knowledge of bile duct blood supply may well lie in the understanding of the aetiology of postoperative bile duct strictures and in their prevention. An explanation is proposed for the long strictures sometimes seen after minimal surgical trauma to the bile duct, based on damage to the small vessels supplying the duct; guidelines to prevent such damage are presented. Ischaemia of the bile duct may also explain some of the biliary problems that have followed human liver transplantation and other procedures involving biliary anastomosis, such as Whipple's operation.
The effect of histamine and histamine antagonists on gastric acid secretion and mucosal blood flow in man
Authors: Knight S E , McIsaac R L , Rennie C D 
Published: March 2007

Summary
Histamine has been investigated for its effect on gastric acid secretion and mucosal blood flow in man. Dose–response curves were constructed and analysed in the presence of H1- and H2-antagonists. Mepyramine had no effect on acid secretion or mucosal blood flow. Cimetidine reduced acid secretion but had no effect on blood flow. This suggests that the vasculature is less sensitive to cimetidine than the parietal cell.
Low dose heparin and compression stockings in the prevention of postoperative deep venous thrombosis
Authors: Törngren Staffan 
Published: March 2007

Summary
The frequency of deep venous thrombosis (DVT) was studied in 98 patients undergoing major abdominal surgery. All the patients received low dose heparin prophylaxis 5000 i.u. every 12 h for 5–7 days. In each patient, a graduated compression stocking was also worn and randomly allocated to one of the legs and the other leg served as a control. DVT was diagnosed by the 125I-fibrinogen method. Four patients developed bilateral DVT and 8 patients unilateral DVT, all of whom developed it in the control leg. The difference in unilateral DVT between stockinged and control legs was significant (P &lt; 0·004). It is concluded that a combination of low dose heparin and graduated compression stockings is more effective than low dose heparin alone in reducing the frequency of postoperative DVT. It is suggested that this combination of prophylaxis might be of value in high risk patients.
Catecholamines and experimental stress ulcer: Morphological and biochemical changes in the gastric mucosa
Authors: Beraha N , Silveira M , Man W , Silcocks P B S , Spencer J 
Published: March 2007

Summary
A model for the production of gastric mucosal haemorrhages and ulcers, similar in morphology and distribution to those seen in stress states in man, has been produced by the intraperitoneal injection of adrenaline in single, double or treble doses of 0·6 mg/kg. Lesions were produced in 2 or 3 h, without ligation of the pylorus. Severe mucosal changes were associated with a fall in gastric mucosal histamine concentration. Mucosal serotonin did not change. Rises in mucosal adrenaline were accompanied by a fall in noradrenaline, total catecholamine levels being unchanged.
Changing survival prospects in carcinoma of the rectum
Authors: McDermott F T , Hughes E S R , Pihl E A , Milne B J 
Published: March 2007

Summary
The survival prospects for carcinoma of the rectum in a series of 1320 patients managed between 1950 and 1978 by one surgeon have been analysed by computer. Survival curve analysis showed a worsened survival after curative resection during 1970–8 in comparison with previous decades (P = 0·001). The 5-year cancer-specific survival after curative resection (832 patients) decreased from 73 per cent (1950–9) to 50 per cent (1970–3) (P = 0·001). An increase in the incidence of Dukes' stage C tumours from 22 per cent (1960–9) to 32 per cent (1970–8) (P = 0·003) explains, at least in part, the worsened survival prospects. Paradoxically the deterioration was paralleled by earlier presentation (P = 0·001).
The worsened survival prospects were not explained by alterations in sex or age distribution, tumour site, or increase in the percentage of sphincter-saving resections. The alternative hypotheses that earlier presentation has resulted in a larger proportion of aggressive tumours coming to curative resection or that worsened survival prospects represent a real change in the behaviour of carcinoma of the rectum in the Australian community are discussed.
A technique for the measurement of the amount and distribution of chronic gastritis
Authors: Lawson H H 
Published: March 2007

Summary
A technique has been described to measure the amount and distribution of gastritis in whole stomachs or resected partial gastrectomy specimens. At a magnification of × 360, mucosal normality or the predominant form of chronic gastritis was recorded at 0·4-mm intervals. Bar diagrams were prepared of the mucosa at 6-mm intervals. Examples are given of the appearance along the lesser curvature where a large ulcer was present, and after the healing of an ulcer. The technique can also be used for the display of information when only multiple biopsy specimens are available.
Segmental splenectomy in schistosomiasis
Authors: Kamel R , Dunn M A 
Published: March 2007

Abstract
Segmental splenectomy was performed in 5 patients with hepatosplenic schistosomiasis mansoni and symptomatic splenomegaly. The aim was to preserve a functional remnant comprising 20–30 per cent of the bulk of a greatly enlarged spleen. The operative technique involved devascularization of anatomic segments and suture of an omental patch to the residual spleen. This procedure was simple, well tolerated and effective in relieving abdominal discomfort and cytopenias. The residual spleens showed normal uptake of 99Tc-sulphur colloid. If long term observation confirms the value of segmental splenectomy in hepatosplenic schistosomiasis, it may become appropriate therapy for those patients with symptomatic splenomegaly who do not require portal decompression.
Gastric emptying and postprandial duodenogastric reflux in dogs with Heineke–Mikulicz pyloroplasty
Authors: Müller-Lissner Stefan A , Sonnenberg Amnon , Hollinger Albert , Schattenmann Gotthard , Siewert J Rüdiger , Blum André L 
Published: March 2007

Abstract
A two-marker technique avoiding transpyloric intubation was used to measure the volume of gastric secretion, the rate of gastric emptying and the degree of postprandial duodenogastric reflux in 8 dogs, 5 without and 3 with Heineke–Mikulicz pyloroplasties. The stomach emptied after a liquid fatty meal at an overall rate of 4·9 ml/min ± 0·2 s.e.m. in animals with a normal pylorus and 5·7 ± 0·2 ml/min in those with pyloroplasties (P &lt; 0·05). Though mean fractional emptying rates were similar, the fractional emptying rate was greater in animals with pyloroplasties than in those without in the first 10 and in the last 20 minutes. The rate of duodenogastric reflux was likewise greater in animals with pyloroplasties than in those without (1·8 ± 0·2 ml/min and 0·7 ± 0·2 ml/min respectively, P &lt; 0·05). The rates of gastric secretion did not differ materially (2·2 ± 0·3 ml/min and 2·1 ± 0·2 ml/min), but a greater proportion of the gastric contents was emptied more than once in animals with pyloroplasties than in those without (7·7 ± 1·5 per cent and 2·3 ± 1·0 per cent, P &lt; 0·05).
Fatal infection in mice after injection of immunosuppressive serum fractions from surgical patients
Authors: McIrvine A J , Wolfe J H N , Collins Katherine , Mannick J A 
Published: March 2007

Abstract
Following surgical or accidental trauma many patients show suppression of cellular immunity. In this investigation sera from severely burned patients and patients undergoing aortic aneurysm repair were studied. Sera shown to suppress phytohaemagglutinin-induced blastogenesis of normal human lymphocytes were fractionated using ion exchange and G25 Sephadex chromatography. Suppressive activity was largely confined to a low molecular weight (LMW) fraction and was dose dependent. LMW fractions of normal sera had no significant suppressive activity. The purpose of this study was to test the causal relationship between immunosuppressive serum and decreased resistance to bacterial infection. Listeria monocytogenes infected mice were used as an in vivo model to test suppression of cellular immunity. Injection of LMW fractions of suppressive sera significantly increased mortality in these mice, but had no effect on non-infected mice. There was good correlation between the in vitro and in vivo effects of the suppressive fractions. These results suggest that a circulating factor in the serum of injured patients suppresses cellular immunity and may be responsible for impaired resistance to infection.
Viability of exfoliated colorectal carcinoma cells
Authors: Umpleby H C , Fermor B , Symes M O , Williamson R C N 
Published: March 2007

Abstract
The viability of tumour cells shed into the intestinal lumen was determined in 49 patients with carcinoma of the large bowel. Preoperative colorectal lavage was performed in 19 patients and irrigation of the cut ends of the operative specimen in 30 patients. The resulting cell suspensions were centrifuged on a Nycodenz® linear density gradient column so that tumour cells, being larger, were concentrated in a band at the top. In 14 of 19 colorectal lavage cases viable tumour cells were recovered, as assessed by their characteristic morphology and ability to exclude trypan blue. A median of 0·78 × 106 viable tumour cells was recovered. The median percentage cell viability in the suspension was 92, i.e. 8 per cent of the tumour cells were dead (stained with trypan blue). In eight specimens viability was confirmed by the ability of tumour cells to hydrolyse fluorescein diacetate. In 17 of 30 proximal resection margin irrigations a median of 0·55 × 105 viable tumour cells was recovered, with a median percentage viability of 92·5. In 15 specimens the neoplastic cells showed fluorescence. In 21 of 25 distal resection margin irrigations a median of 1·92 × 105 viable tumour cells was recovered with a median percentage cell viability of 79·3, and fluorescence was observed in all specimens. The number of viable tumour cells did not correlate with the stage, differentiation, diameter or fixity of the tumour. However, the number of tumour cells recovered from the distal resection margin was inversely related to the distance of the tumour from that margin (Rank Difference Coefficient R = −0·6). Thus viable exfoliated tumour cells were demonstrated in 52 of 74 specimens (70 per cent). Their presence in large numbers at the site of intestinal anastomoses supports a potential role in the aetiology of suture-line recurrence.
Criteria from intra-arterial femoral artery pressure measurements combined with reactive hyperaemia to assess the aorto-iliac segment; A prospective study
Authors: Verhagen P F , van Vroonhoven Th J M V 
Published: March 2007

AbstractDirect femoral artery blood pressure measurements combined with reactive hyperaemia (FAP study) were performed on 50 extremities (45 patients) with multilevel arterial occlusive disease of the lower extremities. In a previous retrospective study we established criteria for detection of significant aorto-iliac occlusive disease. These criteria were used in a prospective way in this study. Twenty-seven extremities were subjected to a proximal and 23 extremities to a distal reconstruction. The half-year postoperative results were evaluated. The criteria used were 86 per cent sensitive, 100 per cent specific and 93 per cent accurate in relation to predicting the postoperative haemodynamic result. The positive predictive value was 100 per cent and the negative predictive value 89 per cent. The criteria are presented and compared with data from the literature. It is concluded that FAP studies are a simple and excellent way to assess the aorto-iliac segment and to predict the outcome of a reconstruction in multilevel arterial occlusive disease.
Long saphenous incompetence as a cause of venous ulceration
Authors: Sethia K K , Darke S G 
Published: March 2007

Abstract
Four hundred and seventeen consecutive patients referred with significant chronic venous disorders of the lower limb have been studied. Two hundred and ninety-nine were considered to have uncomplicated primary varicose veins, with saphenous incompetence. The remaining 118 presented with past or current skin ulceration, prominent pain and swelling, or both. Ascending and descending venography and further Doppler studies revealed only 18 patients (17 with ulceration) with an incompetent long saphenous system and ankle perforators as the only identifiable abnormalities. In 12 of these, patients' dorsal foot vein pressures were measured at rest and the maximum fall demonstrable after exercise expressed as a percentage of this (12.9 per cent ± 6.0). This test was repeated with a narrow tourniquet inflated to 160 mmHg, applied to the mid-thigh (35.6 per cent ± 7.4) (P &lt; 0.05), and again after accurate groin ligation and stripping of the long saphenous vein to the knee (31.9 per cent ± 10.7) (P &lt; 0.05). These results seem to validate the use of the foot pressure/tourniquet test in assessing the relevance of saphenofemoral incompetence, and suggest in a proportion of venous ulcers this is a princical factor.
Vascular spasm and gangrene during heparin–dihydro-ergotamine prophylaxis
Authors: Cunningham M , De Torrenté A , Ekoé J-M , Ackermann J-P , Humair L 
Published: March 2007

AbstractA case is reported of a multiple trauma victim who developed severe vascular spasm whilst receiving heparin-dihydro-ergotamine thrombo-embolic prophylaxis which ultimately led to amputation of the right foot. Identification of high risk groups for this complication is attempted from a review of the literature. Treatment should be with intra-arterial or intravenous nitroprusside or nitrates. Little information is as yet available on the use of prostacyclin in this condition.
Abnormalities of colonic function in patients with rectal prolapse and faecal incontinence
Authors: Keighley M R B , Shouler P J 
Published: March 2007

AbstractWe have investigated changes in colonic motility and anorectal function in 6 continent patients with a rectal prolapse; in 10 incontinent patients with rectal prolapse and in 16 patients with idiopathic faecal incontinence compared with 26 age and sex match controls. A history of incontinence, irrespective of a prolapse, was associated with significantly lower anal squeeze pressures (P &lt; 0·05), a deficient anorectal angle (P &lt; 0·05), failure to retain a balloon containing more than 250 cm3 of air in the rectum (P &lt; 0·01) and increased sigmoid motility (P &lt; 0·02) compared with controls. By contrast patients with rectal prolapse and no incontinence had normal anal pressures, a normal anorectal angle and normal sigmoid motility, but transit was delayed. These results indicate that abnormal sigmoid motility is commonly associated with faecal incontinence and that slow transit constipation is frequent in patients with rectal prolapse who are continent.
Changing patterns in colostomy closure: The Bristol experience 1975-1982
Authors: Foster M E , Leaper D J , Williamson R C N 
Published: March 2007

AbstractThe results of colostomy closure in 113 patients (1975–1982) were examined to determine whether the identification of risk factors or improvements in surgical management had made this procedure safer. Overall mortality was low (0.9 per cent), but faecal fistulas occurred in 16.5 per cent and the incidence of wound infection was high (34 per cent). Comparison of the first and second 4 year periods shows recent improvements in the rates of wound infection (24 versus 51 per cent: P &lt; 0.01) and anastomotic leakage (10 versus 30 per cent: P &lt; 0.05). A long delay (&gt; 6 months) between creation and closure of the colostomy was associated with an increased incidence of postoperative diarrhoea compared with shorter periods of defunction (38 versus 14 per cent: P&lt; 0.01). The morbidity of colostomy closure is decreasing but remains an important clinical problem.
Chronic pilonidal disease: A randomized trial with a complete 3-year follow-up
Authors: Kronborg O , Christensen K , Zimmermann-Nielsen C 
Published: March 2007

Abstract
Three treatments for chronic pilonidal disease were compared in a randomized trial. Healing without formation of new sinuses occurred equally frequent after excision (E), excision with suture (E + S) and excision with suture under cover with clindamycin (E + S + C). The times of healing were significantly shorter after E + S (median 14 days, n = 29) than after E (64 days, n = 29) and tended to be even shorter after E + S + C (11 days, n = 30). Recurrence rates within 3 years amounted to 13 per cent after E, 25 per cent after E + S and 19 per cent after E + S + C, but the total time of healing after initial surgery as well as excision of recurrences was significantly shorter after E + S than after E and tended to be even shorter after E + S + C.
Effects of propranolol on hepatic haemodynamics in the cirrhotic and non-cirrhotic rat
Authors: Jenkins S A , Baxter J N , Johnson J N , Devitt P , Shields R 
Published: March 2007

AbstractThe effects of systemic and intraportal administration of propranolol on hepatic haemodynamics were studied in cirrhotic and non-cirrhotic rats. In the non-cirrhotic rat systemic infusion of 4 μg (kg body wt)−1 min−1 propranolol significantly decreased portal pressure, wedged hepatic venous pressure, portal venous flow and liver blood flow without affecting heart rate. Similar changes were observed in the cirrhotic rat following an infusion of 2 μg (kg body wt)−1 min−1 propranolol. Higher rates of propranolol infusion produced greater reductions in portal pressure, wedged hepatic venous pressure, portal venous flow and liver blood flow in cirrhotic and non-cirrhotic rats but these changes were accompanied by a bradycardia. The reduction in portal pressure effected by propranolol was accompanied by an increased splanchnic vascular resistance. Intraportal injection of propranolol resulted in a rapid but transient fall in portal pressure. The decrease in portal pressure was sustained if propranolol was infused intraportally. The results indicate that propranolol effects a reduction in portal pressure via a combination of increased splanchnic vascular resistance, increased hepatic arterial resistance and reduced cardiac output. The observation that propranolol can significantly reduce portal pressure without affecting heart rate may be clinically important in the long-term management of portal hypertension. Furthermore, the rapid reduction in portal pressure following intravenous administration suggests that propranolol may be of value in the acute control of variceal haemorrhage.
Radial forearm flap for floor of mouth reconstruction
Authors: Matthews R N , Hodge R A , Eyre J , Davies D M , Walsh-Waring G P 
Published: March 2007

Abstract
Approaches to reconstructing floor of mouth defects are reviewed including methods of bony reconstruction following mandibular resection. The place of the free radial forearm flap, incorporating vascularized hemiradius if necessary, is described together with the anatomy, operative technique and a review of seven cases. It is concluded that this flap is an important addition to current methods of reconstructing substantial intraoral soft tissue defects alone or associated mandibular defects as well, owing to the high quality of results and to its low morbidity.
The surgical treatment of anorectal malignant melanoma
Authors: Ward M W N , Romano G , Nicholls R J 
Published: March 2007

Abstract
The clinical presentation and surgical treatment of 21 patients with anorectal melanoma over a 44 year period have been analysed. During the first 24 years of this period total rectal excision was regarded as the treatment of choice and since then wide local excision. Two groups of patients emerge for comparison of the results of surgical treatment. There were no long-term survivors in either group and little difference between survival rates after either procedure. It was concluded that the change from radical to conservative surgery for anorectal melanoma has made no difference in terms of survival and the possible advantages of this change have been discussed.
New method for assessment of anal sensation in various anorectal disorders
Authors: Roe A M , Bartolo D C C , McC. Mortensen N J 
Published: March 2007

AbstractA new technique for quantifying anal sensation utilizing mucosal electrosensitivity is described and has been tested in 97 patients. Normal subjects (n = 20) have a sensory threshold varying from 2 to 7·3 mA being most acute in the region of the anal valves. Sensory awareness also extends into the upper anal canal. Patients with neuropathic incontinence (n = 17) have a sensory deficit (P &lt;0·002) whilst patients with haemorrhoids (n = 28) have less sensitive mucosa displaced into the upper anal canal (P &lt; 0·0001). Patients with acute fissure-in-ano (n = 10) have lower thresholds of sensation at the site of the fissure and slow transit constipation patients (n = 22) have normal anal sensation. The technique is reproducible and should prove useful in the investigation of anorectal disorders.
Mammillary fistula
Authors: Lambert M E , Betts C D , Sellwood R A 
Published: March 2007

AbstractDuring a 6-year period 38 patients with 52 mammillary fistulae were seen. On average, 5 abscesses had preceded recognition of a fistula in the areolar region (range 1–18). In 11 cases the fistulae were immediately apparent as discharging openings but they more commonly presented as subareolar abscesses. Fistulae were treated either by laying open or by excision of the track and at mean follow-up of 25 months (range 1–75) there has been recurrent fistula formation in only one case. Mammillary fistulae should be suspected and sought in all patients presenting with abscesses adjacent to the nipple.