bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fasting and postprandial serum gastrin levels before and after highly selective gastric vagotomy, truncal vagotomy with pyloroplasty and truncal vagotomy with antrectomy: Is there a cholinergic antral gastrin inhibitory and releasing mechanism?
Authors: Lam Shiu Kum , Chan Patrick K W , Wong John , Ong G B 
Published: March 2007

Abstract
Fasting serum gastrin levels and postprandial gastrin response were measured before and 1 month after highly selective vagotomy, truncal vagotomy with pyloroplasty and truncal vagotomy with antrectomy. The three groups of patients, 12 in each group, were closely matched for age, sex, maximum acid output and completeness of vagotomy. After highly selective and truncal vagotomy an identical and significant increase in fasting gastrin was observed, whereas after truncal vagotomy with antrectomy the pre- and postoperative fasting gastrin levels were not different. The net postprandial gastrin output over basal value was significantly increased after highly selective vagotomy, unchanged after truncal vagotomy and significantly lowered after truncal vagotomy with antrectomy. These results suggest the presence in the intact subject of a cholinergic inhibitory mechanism in the gastric body and fundus for the release of antral gastrin in the fasting and postprandial states and a possible cholinergic facilitatory mechanism for the release of antral gastrin after meals.
Management of abdominal aortic aneurysm
Authors: Gordon-Smith I C , Taylor E W , Nicolaides A N , Golcman L , Kenyon J R , Eastcott H H G 
Published: March 2007

Abstract
A series of 245 patients was operated upon for abdominal aortic aneurysm during the years 1969–77, of whom 162 were elective cases while in 83 the aneurysm was leaking or had ruptrued. The hospital mortality for the latter group fell from 77 per cent at the beginning of the study period to 30 per cent at the end. For elective operations, hospital mortality averaged 9·3 per cent, though during the last 2 years there were no deaths in the 51 consecutive cases. Operative methods and post operative treatment changed during the years of the study, with fewere excision-replacement grafts and greater use of the inlay technique, most of the latter being simple unbrached Dacron tubes. Early graft infection, the most important and serious surgical complication, caused 9 deaths, an overall incidence of 3·7 per cent, of which 8 were in patients who received no perioperative antibiotics and only I among the patients who did receive them. All deaths were in the inlay group. The reasons for this are discussed. Since July 1976 Perioperative antibiotic treatment has been routine for all arterial prosthetic graft patients in our hospital.
Ruptured abdominal aortic aneurysms
Authors: Butler M J , Chant A D B , Webster J H H 
Published: March 2007

Abstract
The results of operation in 76 patients with a ruptured abdominal aortic aneurysm are presented with an analysis of the cause of operative death. Overall mortality was 58 per cent and preoperative hypotension significantly increased mortality; deterioration while awaiting operation made a successful outcome particularly unlikely. No group could be identified, however, in which operation was without hope of saving life, and age alone should not contrairdicate surgery.
An androgen-associated hepatic adenoma in a trans-sexual
Authors: Coombes G B , Reiser J , Paradinas F J , Burn Ian 
Published: March 2007

Abstract
A case is reported of an hepatic adenoma developing in a patient who had been taking testosterone for 3 years. There appears to be an association between various steroid preparations and hepatic neoplasia. Reports of such cases with all relevant data will allow a balanced assessment of the problem to be made.
An abdominal extraperitoneal approach for the difficult orchidopexy
Authors: Jones Peter F , Bagley Frederick H 
Published: March 2007

Abstract
An abdominal extraperitoneal approach is described for use in patients who have a severe degree of incomplete descent of the testicle. In 86 such operations, the testicle was placed in the scrotum in 85. The approach allows certainty of diagnosis in cases of anorchia and it is helpful when orchidopexy has to be combined with a herniotomy in infancy.
Neurofibrosarcoma of the duodenum in von Recklinghausen's disease
Authors: Thomson W O , Carachi R , Wood C B , Short D W 
Published: March 2007

Abstract
The clinical features and surgical management of 2 patients with neurofibrosarcoma of the duodenum in association with von Recklinghausen's disease are described. The tumours were excised and the resulting duodenal defects closed satisfactorily using the jejunal serosal patch technique. Three such neurofibrosarcomas reported previously in English are reviewed.
Highly selective vagotomy with excision of the ulcer compared with gastrectomy for gastric ulcer in a randomized trial
Authors: Duthie H L , Bransom C J 
Published: March 2007

Abstract
Fifty-six patients with benign gastric ulcer of the body of the stomach have been entered into a randomized trial of highly selective vagotomy with excision of the ulcer (HSVE) (26 cases) against standard Billroth I partial gastrectomy (BI) (30 cases). The operations were carried out by all grades of surgical staff. No patient died within 1 month of operation. Postoperative morbidity was greater after gastrectomy than after HSVE. At an average follow-up of about 4 years, functional results according to a modified Visick classification were similar in both groups, with about 75 per cent good results. Two recurrent ulcers occurred after gastrectomy (7 per cent) and 4 after HSVE (15 per cent). Neither operation has a distinct advantage at this stage.
Pylorectomy and prepyloric antrectomy for gastric ulcer
Authors: De Miguel Jacinto 
Published: March 2007

Abstract
From July 1970 to May 1977 79 patients with chronic gastric ulcer were submitted to a pylorectomy and prepyloric antrectomy (only 4–5 cm of the distal stomach being removed). In most, the excision extended in the form of a narrow tongue along the lesser curvature to include the ulcer. Vagotomy was added when signs of a healed or active duodenal ulcer were seen (19 cases). Associated lesions in the distal stomach were detected in 38 more patients.
Up to the present no recurrence has been observed and functional results have been satisfactory in 90 per cent of patients.
Preliminary results show that this operation produces a satisfactory cure for gastric ulcer, thus making more extensive resections unnecessary.
The stripping of varicose veins: A clinical trial of intermittent compression dressings
Authors: Melrose D G , Knight M T N , Simandl E 
Published: March 2007

Abstract
This study compares a standard method of care for patients following excision and ligation of varicose veins with a new regimen which involves intermittent compression dressings. In a fully randomized between-patient prospective trial it has been found that the use of such dressings results in a significant reduction in postoperative pain and in the length of hospitalization and indicates that such dressings may improve the healing of surgical wounds.
Splenectomy for undiagnosed splenomegaly
Authors: Goonewardene A , Bourke J B , Ferguson R , Toghill P J 
Published: March 2007

Abstract
During the 9-year period 1968–76 116 splenectomies were performed at the General Hospital, Nottingham. Of these, 13 (11 per cent) were undertaken for unexplained splenomegaly. In 6 patients a diagnosis was established by the operative procedure (2 with sarcoidosis, 2 splenic cysts, 1 Gaucher's disease and 1 haemangiosarcoma). Histological examination of the excised spleens in the remaining 7 patients showed no specific features. Two of these patients benefited considerably from removal of very large spleens. Another patient died from lymphosarcoma which was diagnosed 21 months after splenectomy. In the remaining 4 patients with mild to moderate splenomegaly, there were no real diagnostic or therapeutic advantages. It is concluded that splenectomy should always be considered in patients with unexplained moderate or gross splenomegaly but it may not be helpful in the patient whose spleen is only mildly enlarged.
The surgical management of malignant tumours of the oesophagus and cardia: A review of the results in 292 patients treated over a 15-year period (1961–75)
Authors: Jackson J W , Cooper D K C , Guvendik L , Reece-Smith H 
Published: March 2007

Summary
Of 292 patients, excision of the tumour with replacement by stomach or jejunum was carried out in 216 in whom the lesion was considered operable on both technical and general grounds, intubation was performed in 45 and the remaining 31 were managed without operation.
Of the 216 in whom resection was performed, only 20 per cent were free from local spread, lymph node involvement or secondary deposits at the time of operation. Hospital mortality was 18 per cent and did not significantly differ between one 5-year period and another. Survival at 1 year was 54 per cent, at 2 years 25 per cent and at 5 years 14 per cent. The average length of survival following intubation was 2.6 months and following non-operative management 2.8 months. The poor average survival of between 3.5 and 5 months obtained in those patients with secondary deposits at the time of resection suggests that resection is of questionable value in this group.
There was a marked difference in survival following Roux loop procedures compared with upper partial gastrectomy for tumours of the lower third and cardia in patients without lymph node involvement or secondary deposits, strongly suggesting that upper partial gastrecsomy, although a rather simpler and quicker operation, is not the operation of choice in these patients.
On 31 December 1976, after a minimum follow-up of 1 year, there were only 22 patients still alive of the original 292 (7.5 per cent).
A reappraisal of the value of carcinoembryonic antigen in the management of patients with various neoplasms
Authors: Cooper M J , Mackie C R , Skinner D B , Moossa A R 
Published: March 2007

Summary
Eight hundred and eight patients with histologically proved malignant disease had carcinoembryonic antigen (CEA) estimations performed at the time of tissue diagnosis. An elevated level was found in 384 of 518 patients with gastrointestinal neoplasms (74 per cent) and in 162 of 290 patients with other neoplasms (56 per cent). No correlation was found between CEA elevations and tumour differentiation. There was a good correlation between tumour staging and CEA levels for patients with colorectal cancer; the more advanced the tumour, the higher the CEA.
Several illustrative cases are presented and the role of CEA assay in the diagnosis and management of neoplasia is discussed. CEA assay is a poor screening test for neoplastic disease, but serial CEA monitoring is valuable in the detection of residual or recurrent cancer.
Arterial obstruction of the upper limb in Buerger's disease: Its incidence and primary lesion
Authors: Hirai Masafumi , Shionoya Shigehiko 
Published: March 2007

Summary
In the present study, the incidence of upper extremity involvement and the primary lesion of the arm in Buerger's disease were investigated with special regard to arteriographic findings in the upper limb. Of 34 patients with Buerger's disease admitted to our hospital during the 12-month period from March 1977 to February 1978, in 31 cases (91 per cent) the existence of arterial obstruction of the upper limb was confirmed. From the results of arteriographic study in 78 arms, the primary lesion of Buerger's disease appears to develop most frequently in the digital arteries. However, it is possible for the disease to develop independently in the arteries of the hand, or in the radial or ulnar artery. Although the aetiology of Buerger's disease is not definitely known, it is suggested that repeated blunt injury to the hand or fingers is involved in the evolution of the disease as well as in the appearance of symptoms.
Surgical aspects of radiation injury to the intestine
Authors: Galland R B , Spencer J 
Published: March 2007

Summary
The clinical features are described of 37 patients requiring surgical management for radiation injury to the intestine sustained as a result of treatment of abdominal or pelvic malignancy. Twenty-nine of the patients underwent operation and only 4 remained symptom-free after the procedure. Thirteen patients died in the postoperative period, and of these, 5 were free of the original disease. Possible predisposing factors in the production of intestinal injury are discussed, as are various means of dealing with the established condition.
A prospective randomized trial of vagotomy in chronic duodenal ulceration
Authors: Koffman C G , Elder J B , Gillespie I E , Ganguli P C , Ostick D G , Cowley D J , Dymock I W , Tweedle D E F , Schofield P F , Pengelly C D R , Shafiq M , Shreeve D R , Palmer M 
Published: March 2007

Summary
In a prospective, randomized trial, 76 patients with duodenal ulceration treated by truncal vagotomy and pyloroplasty were compared with 77 patients who underwent highly selective vagotomy. A total of 149 patients was followed up for from 1 to 4 years, the average follow-up period being 2.6 years. There was no operative mortality and no significant difference in postoperative morbidity between the two groups. The incidence of recurrent ulceration was greater after highly selective vagotomy, but this difference was not statistically significant. The clinical results were comparable in each group, and although the incidence of diarrhoea and dumping was greater after vagotomy and pyloroplasty, this difference was not statistically significant.
Interrelations between serum gastrin levels, gastric emptying and acid output before and after proximal gastric vagotomy and truncal vagotomy and antrectomy
Authors: Donovan I A , Owens Caroline , Clendinnen B G , Griffin D W , Harding L K , Alexander-Williams J 
Published: March 2007

Summary
In a prospective study of proximal gastric vagotomy and truncal vagotomy and antrectomy measurements were made, before and after operation, of acid output, gastrin output and gastric emptying of a solid and a liquid meat extract meal. No relationships were demonstrable between acid output and gastrin output. Truncal vagotomy and antrectomy (TVA) produced rapid early emptying of both meals combined with gross prolongation of the overall emptying of the solid meal. Truncal vagotomy and antrectomy reduced the integrated gastrin output after either meal. Proximal gastric vagotomy (PGV) produced rapid early emptying of the liquid meal with no alteration in the early emptying of the solid meal; however, overall solid meal emptying was delayed. Proximal gastric vagotomy increased basal, peak and integrated gastrin output. In preoperative patients slow solid meal emptying was associated with higher gastrin output but after PGV the reverse was found, the slowest emptiers having the lowest gastrin output. These findings do not support the contention that a pyloroplasty should be added to PGV to reduce the hypergastrinaemia produced by the operation.
Scalp and cranial substitution with autotransplanted greater omentum using microvascular anastomosis
Authors: Browning F S C , Eastwood D S , Price D J E , Kester R C 
Published: March 2007

Summary
A case is described whereby a large defect of scalp and cranium was successfully covered using autotransplanted greater omentum, revascularized by microsurgical techniques.
One-dose antibiotic prophylaxis against wound infection after appendicectomy: A randomized trial of clindamycin, cefazolin sodium and a placebo
Authors: Donovan I A , Ellis D , Gatehouse D , Little G , Grimley R , Armistead S , Keighley M R B , Strachan C J L 
Published: March 2007

Summary
Two hundred and fifty patients were admitted to a prospective randomized trial of single dosage prophylaxis against wound infection after appendicectomy. There were 12 exclusions, 72 patients received placebo, 81 received 600 mg i.m. clindamycin phosphate and 85 received 1 g i.m. cefazolin sodium, the agent being given in the anaesthetic room. Clindamycin produced a significant reduction in the overall rate of wound infection from 33 per cent in the controls to 17 per cent. In cases with a gangrenous or perforated appendix the infection rate in controls was 78 per cent; this was reduced to 44 per cent by a single dose of clindamycin.
Cefazolin significantly reduced the number of aerobic organisms isolated from wound infections, but did not significantly reduce the incidence of wound infection. We conclude that anaerobic organisms are more important than faecal aerobic organisms in the pathogenesis of wound infection after appendicectomy.
Whole gut irrigation: A survey of patient opinion
Authors: Downing R , Dorricott N J , Keighley M R B , Oates G D , Alexander-Williams J 
Published: March 2007

Summary
Patients' assessment of whole gut irrigation via a nasogastric tube has been obtained by a questionnaire answered by 79 of 99 patients who received this method of bowel preparation before operation on the large bowel or colonoscopy. Abdominal pain during the irrigation was experienced by 13 patients (17 per cent) and nausea and vomiting occurred in 24 (30 per cent). Intubation with a nasogastric tube and the discomfort of prolonged sitting on a commode were considered the most disagreeable aspects of the procedure. Fifty-six patients (71 per cent) would have agreed to the irrigation being repeated if necessary and many patients preferred whole gut irrigation to previous ‘orthodox’ bowel preparations that they had experienced.
A new appliance for collecting ileostomy and jejunostomy fluid in the postoperative period
Authors: Hill G L , Pickford I R 
Published: March 2007

Summary
A new lightweight two-piece ileostomy appliance was tested in 11 patients with newly established ileostomies and jejunostomies. Seven of the patients presented difficult stoma care problems. The appliance was fitted in theatre on completion of the operation and the patient was followed until discharge from hospital.
The appliance remained in place for an average of 4.8 ± 1.2 days. In a total of 204 patient-days the pouch became dislodged from the flange on 10 occasions and there was leakage under the body flange on 7 occasions. All but one of the patients continued to use the appliance on discharge. No patient was allergic to the appliance nor complained of odour.
It is concluded that this new appliance represents an important advance in postoperative stoma care.
Hyperosmolar diabetes presenting as acute urinary retention: Report of three cases
Authors: Salem H H , Ramsay Ian 
Published: March 2007

Summary
Three elderly patients presented at one hospital in a 2-week period with acute urinary retention precipitated by the hyperosmolar non-ketotic diabetic state. In each case routine urine testing was reported as showing 1 per cent glycosuria. The first two patients were admitted at night and blood glucose estimations were not done. This led to a delay of 16 and 12 h respectively before the appropriate therapy was instituted. It is suggested that this clinical presentation, previously unreported, may not be a rarity and represents an avoidable cause of death in patients with acute urinary retention.
Spontaneous rupture of a liver cell adenoma after long term Methyltestosterone: Report of a case successfully treated by emergency right hepatic lobectomy
Authors: Bird David , Vowles Keith , Anthony P P 
Published: March 2007

Summary
A case of spontaneous rupture of a liver cell adenoma is reported in a female transexual treated with methyl-testosterone 150 mg daily for 7 years. Emergency right hepatic lobectomy was performed successfully. Histology showed peliosis hepatis also.
Emergency resection of a liver cell adenoma has been reported in a young woman taking oral contraceptives, and an elective resection in another female transexual treated with methyltestosterone. However, to the best of our knowledge this is the first case of emergency resection of a spontaneously ruptured liver cell adenoma in a transexual treated with long term methyltestosterone. Since there are numerous other patients similarly treated, it may be expected that this complication will he seen again.
Lipid metabolites and nitrogen balance after abdominal surgery in man
Authors: Foster K J , Alberti K G M M , Binder C , Hinks L , Karran S J , Ørskov H , Smythe P , Talbot S , Turnell D 
Published: March 2007

Summary
The relation of lipid metabolism to nitrogen balance was studied in patients having undergone abdominal surgery and was compared with control subjects who had fasted for a similar period. The patients had lower circulating concentrations of glycerol, non-esterified fatty acids and ketone bodies. There were inverse correlations between blood alanine and ketone body concentrations in both patients (r = −064, P &lt; 0.01) and controls (r = − 0.58, P &lt; 0.01). Nitrogen excretion by patients (12.7 mmol/kg body weight/day ± 1.4 s.e. mean) was greater than by controls (9.2 mmol kg−1 d−1 ± 0.8, P &lt; 0.05), but a more marked difference was noted for urinry methyl histidine excretion of 5.1 ± 0.5 μmol kg−1 d−1 by patients and only 2.5 ± 0.3 μmol kg−1 d−1 by controls (P &lt; 0.01), a disparity indicative of more active protein turnover after surgery.
Spontaneous and traumatic rupture of hepatoma
Authors: Nagasue Naofumi , Inokuchi Kiyoshi 
Published: March 2007

Summary
Hepatoma is a common cause of spontaneous rupture of the liver. During recent years, spontaneous rupture was found in 11 (7 per cent) of 157 patients with hepatoma. The rupture occurred spontaneously in 7 patients, traumatically in 1 while in 3 patients trivial trauma seemed to be the precipitating factor. A correct preoperative diagnosis was made in 7 patients, all of whom were known to have a hepatoma. Hepatic resection was performed in 4 patients, 2 of whom were long term survivors. Haemorrhage stopped in 2 of 3 patients who underwent hepatic artery ligation, but only 1 patient was discharged from hospital. The remaining patients, who were treated by packing, suture or laparotomy alone, died within a short time after admission. It is suggested that resection is the preferred management, but if this is not possible hepatic artery ligation should be performed.
Benign inflammatory tumour of the common bile duct
Authors: Stamatakis J D , Howard E R , Williams R 
Published: March 2007

Summary
A rare cause of obstructive jaundice in childhood is presented. Ultrasound and subsequent percutaneous cholangiography demonstrated the site of obstruction. Histological examination of the resected tumour showed features consistent with a diagnosis of benign inflammatory tumour of the common bile duct.