bluuebunny/crossref_metadata_2025_split huggingface dataset:
Oxygenation in the stomach and the effect of truncal vagotomy
Authors: Sheridan W G , Lowndes R H , Young H L , Lewis M H 
Published: March 2007

Abstract
A Clark polarographic oxygen electrode allowed detailed mapping of tissue oxygen (Pto2) levels on the anterior surface of the stomach in five patients undergoing cholecystectomy. No significant difference in mean Pto2 was detectable between greater and lesser curvatures. A significant difference in mean Pto2 was detected between the body of the stomach and the pylorus (Mann-Whitney, P&lt;0.01). The effect of truncal vagotomy on Pto2 was evaluated in six patients undergoing this procedure for duodenal ulceration. Mean postvagotomy stomach Pto2 levels (46 ± 12 mmHg) were significantly lower (Wilcoxon test, P&lt;0.001) than prevagotomy levels (59 ± 14 mmHg). Truncal vagotomy did not have any significant effect on small intestinal Pto2. This work provides the first objective evidence of the relatively diminished tissue oxygenation in the gastric antrum and pyloric region, and confirms blood flow studies of the effects of vagotomy.
Laparoscopic ligamentum teres (round ligament) cardiopexy
Authors: Nathanson L K , Shimi S , Cuschieri A 
Published: March 2007

Abstract
A technique of laparoscopic ligamentum teres cardiopexy for reflux oesophagitis unresponsive to medical treatment is described. The procedure has been performed on five patients and on postoperative testing has been shown to achieve competence of the lower oesophageal sphincter by lengthening of the intra-abdominal segment, accentuation of the angle of His and elevation of the pressure in the high pressure zone. All the patients have been relieved of their symptoms by the operation and have not sustained any adverse effects but the follow-up period is short.
Gastrointestinal mucormycosis
Authors: Thomson S R , Bade P G , Taams M , Chrystal V 
Published: March 2007

Abstract
Twenty patients with gastrointestinal mucormycosis are reviewed. This often fatal opportunistic fungal infection was diagnosed histologically, and was categorized as colonization (five patients), infiltration (seven patients), or vascular invasion (eight patients). There were no fatalities from colonization. In 10 patients, mucormycosis complicated peptic ulcer disease. Seven of these patients had infiltrative or invasive disease. The presentation and operative findings mimicked malignancy in five of these seven patients, and six had successful surgical intervention. The other patient was cured by medical therapy alone. Ten patients had infection associated with other gastrointestinal diseases: post-traumatic peritonitis (four patients), transmural amoebiasis (two patients), tuberculosis (one patient), gastroenteritis (one patient), gastric carcinoma (one patient) and diabetes (one patient). Eight patients had significant infection and only one survived. In this series, mucormycosis had a less aggressive course when complicating peptic ulcer than when it occurred in association with other gut diseases.
Percutaneous flexible choledochoscopy: A simple method for retained common bile duct stone removal
Authors: Menzies D , Motson R W 
Published: March 2007

Abstract
Conventional methods of treatment of retained common bile duct stones found on T tube cholangiography after common bile duct exploration include percutaneous extraction under fluoroscopic control and endoscopic sphincterotomy. Four cases of percutaneous stone extraction under direct vision using the flexible choledochoscope are described. Clearance of the bile ducts was achieved at one sitting in three cases and four sittings in one case. Follow-up tube cholangiography was performed in two cases and confirmed complete clearance. Percutaneous endoscopic stone extraction can be performed by any surgeon with experience of flexible choledochoscopy and offers the advantages of a minimally invasive procedure without the use of specialized equipment.
Accurate intraoperative transhepatic U tube placement
Authors: Krige J E J , Terblanche J , Beningfield S J 
Published: March 2007

Abstract
Cholangiocarcinoma of the main hepatic duct junction is best treated by curative resection, although this is not often possible as most lesions are associated with local infiltration, portal vein invasion or metastases. For unresectable lesions, we advocate the use of a wide bore U tube followed by radiotherapy. Placement of the U tube must be accurate and meticulous. This paper describes a simplified method allowing accurate intraoperative transhepatic U tube placement.
Randomized trial of intra-arterial recombinant tissue plasminogen activator, intravenous recombinant tissue plasminogen activator and intra-arterial streptokinase in peripheral arterial thrombolysis
Authors: Berridge D C , Hopkinson B R , Makin G S , Gregson R H S 
Published: March 2007

Abstract
Sixty patients were recruited into a randomized parallel group comparison of three thrombolytic regimens for acute or subacute peripheral arterial thrombosis. There were no significant differences in age, duration of history, length of occlusion or presence of neurosensory deficit between the groups. Initially successful lysis was significantly greater with intra-arterial (IA) recombinant tissue plasminogen activator (rt-PA) than with either streptokinase (Sk) (P &lt; 0·04) or intravenous (IV) rt-PA (P &lt; 0·01). The duration of therapy varied from a median of 35 h with IA rt-PA to 40 h with Sk (P &gt; 0·5). The median (confidence interval) increase in ankle:brachial pressure index following IA rt-PA of 0·57 (0·33–0·82) was significantly higher than for either Sk of 0·24 (0–0·57) or for IV rt-PA of 0·18 (0–0·41). Limb salvage at 30 days was achieved in 80, 60 and 45 per cent respectively for IA rt-PA, Sk and IV rt-PA. Haemorrhagic complications occurred in six patients following Sk and in 13 following IV rt-PA; only one minor haemorrhage occurred following a catheter perforation in a patient who received IA rt-PA (P &lt; 0·05). IA rt-PA provides a more effective, safer fibrinolytic regimen than conventional therapy with Sk. IV rt-PA has not been as successful and carries a significantly higher risk of haemorrhagic complications.
Infra-inguinal aneurysms: Outcome for patient and limb
Authors: Hands L J , Collin J 
Published: March 2007

Abstract
The outcome of conservative treatment of infra-inguinal (femoral and popliteal) aneurysms was compared with that following vascular reconstruction. Over a 12-year period up to December 1988, 43 femoral aneurysms and 35 popliteal aneurysms presented to the Oxford Regional Vascular Service; 88 per cent of the femoral and 60 per cent of the popliteal aneurysms were treated by vascular reconstruction. The outcome was assessed in terms of limb symptoms or preservation and patient survival at the most recent point of follow-up (median 4·5 years). At least 12 of the 13 initially asymptomatic femoral and popliteal aneurysms which were untreated remained asymptomatic. In contrast, six of the 26 limbs with asymptomatic femoral aneurysms and three of the 11 limbs with asymptomatic popliteal aneurysms developed significant distal ischaemia after vascular reconstruction; four limbs came to amputation after intervention. Aggressive surgical management of all asymptomatic infra-inguinal aneurysms is unjustified and dangerous.
Fibrinolytic activity and calf pump failure
Authors: Gajraj H , Browse N L 
Published: March 2007

Abstract
The interstitial fibrinolytic activity of the upper and lower limbs was investigated in subjects with abnormal calf pump function by measuring the lysis rate of experimentally produced subcutaneous 125I-fibrin clots. Thirty-three subjects with healed venous ulcers, five with varicose veins and 11 controls were studied. 125I-fibrin clots were produced in the subcutaneous tissue of the forearms and legs and clearance half-life was calculated. Calf pump function was assessed by foot volumetry and the ‘gaiter’ skin nutritive circulation by measuring the transcutaneous oxygen tension (PtcO2). Fibrin clearance was prolonged from the subcutaneous tissues of the legs of subjects with varicose veins and healed ulcers compared with controls. Negative correlations were found between fibrin clearance half-life and the half-volume refilling time (P &lt; 0·01) and the PteO2 (P &lt; 0·01).
Fibronectin and collagen gene expression in healing experimental colonic anastomoses
Authors: Braskén P , Renvall S , Sandberg M 
Published: March 2007

Abstract
The temporal and spatial expression of fibronectin and type I and III collagen genes were studied 1–14 days after surgery in the healing rat colonic anastomosis using recombinant deoxyribonucleic acid techniques. Messenger ribonucleic acids (mRNAs) coding for fibronectin and type III collagen synthesis increased from the first day after operation and type I collagen synthesis increased from the second day after operation, as demonstrated by Northern hybridizations. Maximal mRNA production for fibronectin and collagens was seen at 2 and 7 days, respectively, after anastomosis. Activation of type I and III collagen genes in the anastomotic area was confined to tissues developing in the anastomotic line, the serosal surface and the submucosal layer. Strong fibronectin expression was observed in the same areas. The results suggest that genetic events leading to collagen synthesis in the anastomotic area start immediately after surgery. Maximal gene expression is not reached until 1 week after surgery.
Evaluation of palliative surgical procedures in unresectable pancreatic cancer
Authors: de Rooij P D , Rogatko A , Brennan M F 
Published: March 2007

Abstract
To update our experience with palliative surgical procedures in unresectable adenocarcinoma of the pancreas, the records of 297 patients surgically treated at Memorial Sloan-Kettering Cancer Center were reviewed. Between October 1983 and November 1989, 117 patients underwent exploratory laparotomy as a single procedure: 24 patients had gastric bypass, 38 biliary bypass, and 118 both gastric and biliary bypass. The postoperative in-hospital mortality rate was 4.4 per cent. Overall morbidity was 20.9 per cent; the morbidity rate in patients with a double bypass was 29.7 per cent. Median(s.e.m.) survival was 231(20.3) days. Statistical analysis showed a significantly increased risk of morbidity in patients who underwent one therapeutic and one prophylactic bypass. Survival was decreased in patients who had a therapeutic gastric bypass (median(s.e.m.) survival 136(70.2) days) or a combination of two therapeutic bypasses (median(s.e.m.) survival 93(85.9) days). These data emphasize the poor prognosis of patients with pancreatic adenocarcinoma who cannot be resected. The need for therapeutic double bypass is a bad prognostic indicator, and a prophylactic bypass added to a therapeutic bypass increases morbidity without prolonging survival.
Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis
Authors: El Hamel A , Parc R , Adda G , Bouteloup P Y , Huguet C , Malafosse M 
Published: March 2007

Abstract
Spontaneous haemorrhage associated with chronic pancreatitis in 17 patients was related to a pseudocyst in 15 (88 per cent) patients and to pancreatic lithiasis (one patient) or to infarction-rupture of the spleen (one patient). Bleeding was massive in six patients and intermittent in 11. It resulted from erosion of the gastroduodenal or the splenic artery in four patients. Bleeding into the pancreatic duct occurred in four patients and erosion of the duodenum by a bleeding pseudocyst in five. Haemorrhage was confined to a pseudocyst in six patients and was intraperitoneal in two. Of the 15 patients with bleeding pseudocysts, ten underwent primary pancreatic resection (eight proximal and two distal pancreatectomies) with no mortality but four had early complications. Four of the five patients who underwent transcystic ligation of bleeding vessels and pseudocyst drainage had postoperative complications: one died from sepsis and liver failure and three underwent reoperation for severe postoperative bleeding. Of these, two had proximal pancreatic resection with one death. The third patient had further suture ligation and external drainage. The overall postoperative mortality rate was 12 per cent and following emergency surgery 33 per cent. Favourable results were achieved in two-thirds of patients when the primary operative strategy could be directed towards the control of bleeding and removal of the affected pancreatic segment. Primary pancreatic resection, although technically demanding in the presence of haemorrhage, is recommended whenever possible for the treatment of bleeding pancreatic pseudocysts and pseudoaneurysms associated with chronic pancreatitis.
Pulmonary microvasculature in experimental acute haemorrhagic and oedematous pancreatitis
Authors: Kelly D M , McEntee G P , McGeeney K F , Fitzpatrick J M 
Published: March 2007

Abstract
The pulmonary microvasculature was examined in two experimental models of acute pancreatitis by scanning electron microscopy of microvascular corrosion casts. Haemorrhagic pancreatitis was induced in eight male Sprague—Dawley rats using an intraductal injection of 5 per cent sodium taurocholate. Oedematous pancreatitis was induced in seven male Spague—Dawley rats using an intravenous infusion of supramaximal doses of caerulein (5 m̈g/kg per hour). The pulmonary vessels were cast using a polymer resin and the cast studied by scanning electron microscopy at 3 and 12 h in those with haemorrhagic and at 1 and 4 h in those with oedematous pancreatitis. Vascular abnormalities were present in both models at the initial study time with abruptly terminating vessels being more prominent in the caerulein model. At the later times, however, the abnormalities in the sodium taurocholate model were much more severe, with a substantial loss of vascular density, tortuosity and abrupt terminations of those vessels present. Micro-vascular abnormalities may be responsible for some of the pulmonary changes seen in oedematous and haemorrhagic pancreatitis.
Spontaneous perforation of the bile duct in infants
Authors: Davenport M , Heaton N D , Howard E R 
Published: March 2007

Abstract
Spontaneous perforation of the bile duct is a rare but well documented condition of infants. Six infants are described, five presenting within 2 months of birth without apparent antecedent factors and one associated with an ‘acquired’ type I biliary atresia at 8 months. All infants underwent definitive surgery, which included decompression of the biliary tree with cholecystenterostomy or T tube drainage. There was no morbidity or mortality associated with such surgical intervention.
c-myc protein product is a marker of DNA synthesis but not of malignancy in human gastrointestinal tissues and tumours
Authors: Rew D A , Taylor I , Cox H , Watson J V , Wilson G D 
Published: March 2007

Abstract
c-myc is a conserved cellular gene. The gene product is a nuclear-bound 62000 molecular weight phosphoprotein (p62c-myc). Although p62c-myc levels have been measured in colorectal cancers, little is known about the expression of the protein in upper gastrointestinal tumours and tissues. Studies were performed on tumour and mucosal specimens from 87 patients with colorectal cancer, from two with polyposis coli, from six with squamous oesophageal carcinomas and from 18 with gastric carcinomas. The mean p62c-myc content was measured in units of fluorescence in the G1 diploid and G2 diploid peaks of the cell cycle by multiparameter flow cytometry using the 6E10 antibody. The nuclear p62c-myc content increased with DNA synthesis in tumours and mucosa. G2 levels of p62c-myc were higher in glandular mucosa than in adenocarcinomas. No differences in peak nuclear c-myc expression were found in relation to histological grade or to anatomical site of colorectal tumours. There was a broadly inverse relationship between G2 p62c-myc levels in tumours and mucosa and their in vivo 5-bromo-2′-deoxyuridine labelling indices. Nuclear p62c-myc levels are cell cycle related but the protein has not been shown to be a marker of increased tissue proliferation or of gastrointestinal malignancy. The reduction of the nuclear p62c-myc content of many adenocarcinoma cells compared with glandular mucosa cells suggests that reduced synthesis or nuclear retention of the normal protein may be a factor in the development of gastrointestinal adenocarcinomas, although the mechanism by which this may occur is not clear.
Nutritional status after total and partial gastrectomy with Roux-en-Y reconstruction
Authors: Staël Von Holstein C , Walther B , Ibrahimbegovic E , Åkesson B 
Published: March 2007

Abstract
Dietary intake and nutritional status were studied in two groups of patients after total gastrectomy (n = 10) and after partial gastrectomy (n = 10). All patients were reconstructed with a Roux-en-Y loop. Investigations were carried out 4–17 years after the operation. Eight patients in the group undergoing total gastrectomy and four patients undergoing partial gastrectomy had gastric carcinoma and were without recurrent disease 5–15 years after the operation. A clinical dietician conducted an anthropometric evaluation. All patients underwent an upper gastrointestinal endoscopy, clinical examination, [14C]triolein breath test and a blood chemistry profile. The median weight loss from operation to investigation was 2.1 kg in the partial gastrectomy group and 6.7 kg in the total gastrectomy group (n.s.). After partial gastrectomy three patients had a subnormal body mass index (n.s.). This was not found in the total gastrectomy group. Energy intake was below that recommended in seven patients in the partial gastrectomy group (three of them had a subnormal body mass index) and in two in the total gastrectomy group (n.s.) [14C]triolein breath testing revealed fat malabsorption in three patients after partial gastrectomy and in five patients after total gastrectomy (n.s.).
Surgery improves defective oesophageal peristalsis in patients with gastro-oesophageal reflux
Authors: Escandell A Ortiz , De Martinez Haro L F , Paricio P Parrilla , Aguayo Albasini J L , Marcilla J A Garcia , Morales Cuenca G 
Published: March 2007

Abstract
Postoperative manometry was carried out in 12 patients with gastro-oesophageal reflux associated with hypomotility of the oesophageal body. A Nissen fundoplication was carried out in all patients. After a median follow-up of 3.5 years, patients underwent clinical, endoscopic, radiological, manometric and pH-metric evaluation. Manometric results revealed an overall improvement in oesophageal motor function with an increase in the amplitude of deglutition waves and a decrease in the percentage of deglutitions without response. Six of the patients (one with complete motor failure) recovered normal peristaltic function. Non-specific oesophageal motor disorders may be secondary to gastro-oesophageal reflux and are reversible in nature.
Effect of initial biopsy procedure on prognosis in Stage 1 invasive cutaneous malignant melanoma: Review of 1086 patients
Authors: Lees V C , Briggs J C 
Published: March 2007

Abstract
After treatment for primary clinical Stage 1 invasive cutaneous malignant melanoma, 1086 patients were followed for a minimum of 5 years from initial operation. Patient data were retrieved from the unit's melanoma registry; 96 (8.8 per cent) were treated initially by incisional biopsy, 292 (26.9 per cent) by narrow margin excision biopsy and 698 (64.3 per cent) by wide margin excision. Logistic regression analysis was performed to assess the statistical significance of the association between the various factors. The method of initial biopsy was related to maximal tumour thickness, age, and sex. Incisional biopsy rendered 38 out of 96 (40 per cent) lesions not fully assessable on current histopathological criteria, significantly higher than for the other biopsy techniques (P&lt;0.0001). Incisional biopsy did not adversely affect prognosis in terms of local recurrence and mortality. Prognosis was related to tumour thickness, age and sex of the patient, and not to biopsy technique. We recommend that all suspicious lesions should be submitted to excisional rather than incisional biopsy to avoid compromising the histological assessment, given the importance of maximal tumour thickness in determining treatment and prognosis.
Impalpable testis: Testicular vessel division in treatment
Authors: Lawson A , Gornall P , Buick R G , Corkery J J 
Published: March 2007

Abstract
Between 1984 and 1989, 110 boys with 130 impalpable testes were investigated and treated. One hundred and six boys underwent laparoscopy. Twenty had bilateral impalpable testes and 13 had a palpable, but maldescended, testis on the other side. Forty-nine testes were absent and one atrophic testis was found in the scrotum. Twelve orchidectomies were performed. One child had a microvascular transfer procedure. The remaining 67 testes were treated by orchidopexy: 28 single-stage and 39 two-stage procedures. One of the single-stage and 29 of the two-stage orchidopexies included division of the testicular vessels. Twenty-three testes examined 12 or more months after staged testicular vessel division revealed a good result in 15.
Retrograde femoral angioplasty: A new technique
Authors: Shanahan D , Grieve N W T , Bennett C E , Thomas M H 
Published: March 2007

Abstract
Percutaneous transluminal angioplasty cannot be used for lesions of the superficial femoral artery when the origin of the vessel is occluded. A new technique, retrograde femoral angioplasty, is described in which angioplasty is performed from below via the exposed popliteal artery. In four out of six patients retrograde femoral angioplasty was successfully completed, and three of the four vessels remain patent up to 1 year later. The method provides an alternative to the femoropopliteal bypass graft in some patients.
Objective assessment of high ligation without stripping the long saphenous vein
Authors: McMullin G M , Smith P D Coleridge , Scurr J H 
Published: March 2007

Abstract
Non-invasive methods of venous assessment were used to assess the procedure of high ligation plus multiple avulsion of varicosities for the treatment of varicose veins in 54 limbs. Duplex scanning before operation confirmed saphenofemoral incompetence and excluded short saphenous incompetence. After operation it revealed that in two limbs the saphenofemoral junction was still patent and incompetent. In the 52 limbs in which the junction had been ligated there was persistent reflux down the long saphenous vein in 24 cases. In only two limbs was this attributable to mid-thigh perforating veins. Photoplethysmography was also performed before and after operation and the venous refilling time measured. Improvement in refilling time produced by application of above knee tourniquets before operation was measured (predicted improvement) and the change in refilling time after operation was also recorded (observed improvement). There was a statistically significant correlation between observed improvement and predicted improvement in refilling times in the limbs with no reflux in the long saphenous vein after operation (Pearson's correlation coefficient, r = 0.6, P&lt;0.001). There was no correlation between predicted and observed refilling times in the limbs with persisting reflux in the long saphenous vein after operation. In conclusion, this operation fails to control functionally significant reflux within the long saphenous vein in a high proportion of cases.