bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hidradenitis suppurativa: evidence for an endocrine abnormality
Authors: Harrison B J , Kumar S , Read G F , Edwards Catherine A , Scanlon M F , Hughes L E 
Published: March 2007

Abstract
Women patients with premenstrual exacerbation of hidradenitis suppurativa have been studied to determine if an endocrine abnormality can be detected. A functional disorder of the hypothalamopituitary axis was found in 13 patients with hidradenitis when compared with 9 controls. In response to a combined thyrotrophin releasing hormone and gonadotrophin releasing hormone test, the prolactin and TSH responses were significantly greater in the hidradenitis patients than the controls. No significant differences were found in the mean basal levels of oestrogen, progesterone, testosterone, dehydroepiandrosterone sulphate, T3 and T4. These results may reflect a disturbance of feedback signals from peripheral hormones, rather than a primary dysfunction of the control of specific anterior pituitary cells.
Effects of a somatostatin analogue (SMS 201-995) on hepatic and splenic reticulo-endothelial function in the rat
Authors: Baxter J N , Jenkins S A , Day D W , Shields R 
Published: March 2007

Abstract
The effects of a long acting somatostatin analogue, SMS 201-995, on reticulo-endothelial system (RES) activity were studied in rats. Administration of 2 μg SMS 201-995 subcutaneously twice a day for 7 days significantly increased the splenic and hepatic uptake of 99mTc-sulphur colloid and damaged 51mCr-red blood cells. Furthermore, SMS 201-995 administration significantly increased the plasma clearance of colloidal carbon as indicated by a lower area under the curve and an increased elimination constant. SMS 201-995 administration also significantly improved survival after intraperitoneal injection of Escherichia coli endotoxin. These results suggest that SMS 201-995 stimulates RES activity in rats. It is suggested that SMS 201-995 may be of value in stimulating RES activity in patients with cirrhosis and portal hypertension.
Effects of a somatostatin analogue SMS 201-995 on hepatic haemodynamics in the pig and on intravariceal pressure in man
Authors: Jenkins S A , Baxter J N , Corbett W A , Shields R 
Published: March 2007

Abstract
The effects of a somatostatin analogue, SMS 201-995, on hepatic haemodynamics in the pig and on intravariceal pressure in man were studied. An infusion of 250 μg/h SMS 201-995 significantly reduced portal pressure, portal venous flow and hepatic artery flow in the pig. These changes in hepatic haemodynamics were accompanied by a reduction in cardiac output, a reflex slowing of the heart and an increase in arterial blood pressure. Splanchnic vascular resistance was increased following SMS 201-995 administration but hepatic vascular resistance remained unchanged. Administration of 50 μg SMS 201-995 reduced the intravariceal pressure from 27.4 ± 2.5 to 15.8 ± 2.1 mmHg in 9 patients with cirrhosis and portal hypertension. Administration of 50 μg SMS 201-995 also reduced portal pressure from 29 to 22 mmHg in a patient undergoing an elective portacaval shunt. These results suggest that SMS 201-995 may be of value in the control of bleeding oesophageal varices. Furthermore, because of its prolonged duration of action SMS 201-995 may be useful in the long term management of portal hypertension in patients with cirrhosis.
Reflux versus dysphagia: an objective evaluation of the Angelchik prosthesis
Authors: Morris D L , Jones J , Evans D F , Foster G , Smart H , Gregson R , Amar S , Doran J , Hardcastle J D 
Published: March 2007

Abstract
Twenty-seven patients with proven longstanding gastro-oesophageal reflux underwent insertion of an Angelchik anti-reflux prosthesis. Pre-operative studies included oesophageal manometry, endoscopy, acid reflux provocation test (ARPT) and 24h oesophageal pH recording (24h pH). Following operation mean lower oesophageal sphincter pressure was increased from 11 to 20 cmH2O. ARPT revealed significant pre-prandial reflux before operation in 16/24 compared with only 1/20 postoperatively; 24 h pH also showed an improvement in that 21/22 patients refluxed before operation compared with no significant reflux after. Dysphagia for solids of some degree was seen postoperatively in 26 patients and this was also demonstrated by delay in transit of a marsh-mallow swallow test. Severe dysphagia was seen in 4 patients and in 3 of these was related to rotation and displacement of the prosthesis necessitating removal.
The impact of percutaneous transluminal angioplasty on the management of peripheral vascular disease
Authors: Anderson J B , Wolinski A P , Wells I P , Wilkins D C , Bliss B P 
Published: March 2007

Abstract
Percutaneous transluminal angioplasty is a well established technique with wide application, but its place in the overall management of peripheral vascular disease is not well defined. This study compares similar groups of patients with peripheral vascular disease in 1981 and 1984, before and after the introduction of the technique to a district general hospital. More patients are now being investigated and treated and this is almost entirely due to the availability of angioplasty. The rates for surgery have not changed. Percutaneous transluminal angioplasty should therefore be seen as a new and separate form of treatment for peripheral vascular disease, not necessarily influencing or replacing surgery, and requiring its own allocation of resources in accordance with the increase in the level of care afforded by the technique.
Haemodynamic effects of intra-arterial and intravenous administration of prostaglandin E1 in patients with peripheral arterial disease
Authors: Hirai M , Nakayama R 
Published: March 2007

Abstract
The purpose of this study was to compare the haemodynamic effects of intra-arterial and intravenous prostaglandin E1 (PGE1) both injected and infused into ischaemic legs. Continuous intra-arterial infusion of PGE1 induced a significantly greater increase in skin temperature and blood flow than did intravenous drip infusion. Furthermore, intra-arterial infusion caused no steal phenomenon in the toe as indicated by skin temperature. On the other hand, toe skin temperature decreased during intravenous drip in 33 per cent of the legs tested. Continuous intravenous infusion also produced a significantly greater increase in toe skin temperature than did brief intravenous drip. In three of ten ulcers healed by continuous intra-arterial infusion, no definitive effect was obtained from continuous intravenous infusion even when it was repeated up to three times before continuous intra-arterial infusion. Intra-arterial injection of PGE1 caused no significant increase in toe skin temperature.
A 5 year follow-up of Dacron femoropopliteal bypass grafts
Authors: Mosley J G , Marston A 
Published: March 2007

AbstractOver a 5½ year period, 66 Dacron femoropopliteal grafts were performed for patients with an absent or unsuitable long saphenous vein. The minimum follow-up has been 6 months and cumulative patency was 50 per cent at 5 years. Twenty-five patients had critical ischaemia (pre-operative Doppler ankle pressure &lt; 40 mmHg) and 41 patients had severe ischaemia (pre-operative ankle pressure &gt; 40 mmHg). The procedure significantly improved ankle pressures in both groups and this was maintained at follow-up. In the group of 25 patients with critical ischaemia there were three operative deaths and in 10 the graft subsequently occluded, precipitating an amputation. In the group of forty-one patients with severe ischaemia, there was one operative death and in two patients the graft occluded at 18 and 24 months. In this small series there was no significant difference in patency, whether the graft was placed to the popliteal artery above or below the knee joint, or whether the popliteal had less than three patent branches at its trifurcation.
Opsonic dysfunction secondary to plasma fibronectin depletion after aortic surgery
Authors: Powell Janet T , Poskitt K R , Irwin J T , Attanoos R L , McCollum C N 
Published: March 2007

Abstract
Fibronectin is a plasma opsonin which is depleted after major injury or surgery. The effect of major aortic surgery on plasma fibronectin has been studied in patients and in an equivalent experimental model in pigs. On the day after aortic surgery in eleven patients mean fibronectin (±s.e.m.) had fallen from 363 ± 11 mg/l pre-operatively to 179 ± 19 mg/l (P &lt; 0.01). No such fall was observed in patients undergoing herniorrhaphy. In fourteen pigs aortic surgery produced reproducible surgical shock and a fall in plasma fibronectin from 331 ± 10 mg/l to 43 ± 13 mg/l after resuscitation (P &lt; 0.01). Whenever plasma fibronectin fell below 190 mg/l the circulating free fibronectin was consumed in complexes of 1000 kDa containing collagenous debris. More severe depletion of plasma fibronectin was related to higher concentrations of circulating non-opsonized collagenous debris and to subsequent mortality in pigs. The depletion of free fibronectin that occurs following major surgery may produce clinically important opsonic dysfunction. The clinical relevance of this fibronectin consumption may be missed if measurement is limited to circulating fibronectin levels without determining that proportion bound in complexes and no longer available as an opsonin.
Indicators of surgical risk and clinical judgement
Authors: Pettigrew R A , Hill G L 
Published: March 2007

Abstract
A number of indicators of surgical risk were measured in 218 patients awaiting major gastrointestinal surgery. The indices chosen had been used by others to identify high risk patients and they were compared with each other and with two clinical assessments of risk, one by the operating surgeon and the other by an independent clinician who performed a complete physical examination. Anthropometric indices did not pick out patients who were significantly at high risk but the plasma proteins (albumin, pre-albumin, transferrin) identified subgroups of high risk patients, about a third of whom developed major postoperative complications. Although some nutritional indicators which use plasma proteins for the computation selected patients who were significantly more at risk, some (20–30 per cent) of the patients with low levels of plasma proteins (particularly those who were septic) did not have depleted fat or muscle protein stores. Although the surgeons were able correctly to identify only a small number of very high risk patients the results showed that a carefully performed clinical examination was able to do this as effectively as the plasma proteins. It is suggested that something more than a global assessment by the operating surgeon is required to identify high risk patients. A careful assessment of medical risk noting in particular cardiorespiratory disease and pre-existing sepsis, as well as nutritional state, is as effective as any other currently used indicator of risk.
Simulation in surgical training using freeze dried material
Authors: Stotter Ann T , Becket A J , Hansen J P R , Capperauld I , Dudley H A F 
Published: March 2007

Abstract
The acquisition of manual dexterity and surgical skills is usually achieved in the operating theatre under supervision. We describe an efficient way of learning intestinal anastomosis procedures with the use of gamma irradiated, lyophilized porcine or bovine tissues together with a purpose designed holding jig. Preliminary evaluation of this method with untrained subjects showed that they were able to improve their performance. Because the tissues are sterile, health hazards are avoided and no special laboratory facilities are required. This approach has promise as an aid to evaluation as well as training.
Clearance technique for the detection of lymph nodes in colorectal cancer
Authors: Cawthorn S J , Gibbs N M , Marks C G 
Published: March 2007

Abstract
Lymph node metastases are an important determinant of prognosis following surgery for colorectal cancer. A xylene alcohol clearance technique has been employed in Guildford to facilitate the identification of lymph nodes in the mesorectum of rectal cancer specimens. The numbers of lymph nodes and lymph node metastases were compared with seven other centres and St. Mark's Hospital, where clearance techniques were not employed in patients undergoing a randomized trial of preoperative radiotherapy for rectal cancer. The total number of lymph nodes identified per patient in the mesorectum of patients at Guildford (mean = 23.1 ± 1.18) was significantly higher when compared with patients at St. Mark's Hospital alone (mean = 13.1 ± 0.86) and the seven combined ‘non-cleared’ centres (mean = 10.5 ± 0.6) (P &lt; 0.001). The number of lymph node metastases per patient was significantly higher in the Guildford series (mean = 3.21 ± 0.58) when compared with the seven combined centres (mean = 1.9 ± 0.3) (P &lt; 0.05). The numbers of lymph node metastases found in the lowest part of the specimen close to the levator ani were significantly higher in the Guildford patients (mean = 1.2 ± 0.4) compared with St. Mark's Hospital (mean = 0.13 ± 0.1) and the seven combined ‘non-cleared’ centres (mean = 0.56 ± 0.1). This clearance technique identified not only a greater number of lymph nodes but also more metastases within those nodes, particularly in the supralevator area of the mesorectum.
On-table lavage to achieve safe restorative rectal and emergency left colonic resection without covering colostomy
Authors: Thomson W H F , Carter S St C 
Published: March 2007

Abstract
On table orthograde colonic lavage has been used in a nearly consecutive series of 122 cases of restorative rectal resection (16 for acutely obstructing rectosigmoid lesions), and in a further 4 cases of acutely obstructing left colonic carcinoma, with the aim of both achieving safer anastomoses in these adverse circumstances and avoiding a covering colostomy. The technique was found to be safe and to be effective, only five temporary colostomies being required for management of anastomotic leakage. The incidence of clinical anastomotic leakage was 4.8 per cent.
Carcinoma of the ampulla of Vater
Authors: Knox R A , Kingston R D 
Published: March 2007

Abstract
Experience in treating tumours of the ampulla of Vater in the North West region of the UK is reviewed. The results of local resection, radical resection and palliative bypass in 61 cases have been compared. Local resection in this series offers a better survival than radical procedures at one, two, three and five years. The operative mortality for radical procedures was 30 per cent. There were no operative deaths in those patients having a local resection. No patient having palliative bypass surgery survived more than 18 months.
Aspirate cellularity as a rapid indicator of renal allograft rejection
Authors: Wilson R G , Shenton B K , Taylor R M R , Proud G 
Published: March 2007

Abstract
No rapid and unequivocal test exists to diagnose renal allograft rejection. Despite advances in immunosuppression over the last 20 years, rejection is still the major problem in clinical organ transplantation. Most transplant centres report a renal graft survival rate of about 60 per cent at 5 years and the majority of graft losses are due to rejection. An influx into the graft of various cell types has been implicated in the diagnosis of rejection but it takes up to 24 h to obtain such information histologically. We have carried out fine needle aspiration biopsy of the allografts and estimated the number of white cells in the aspirate using a fluorescence activated cell sorter. Studies were performed in 34 cases of normal allograft function, 8 of rejection, 8 of acute tubular necrosis and 8 of cyclosporin nephrotoxicity. There was a statistically significantly higher cell number in the group undergoing rejection (P &lt; 0.01; Wilcoxon unpaired test) when compared to each of the other three groups. We believe that this technique, which takes only a few minutes to perform, could yield much valuable information. It deserves further study.
Meckel's diverticulum in the adult
Authors: Leijonmarck C-E , Bonman-Sandelin Kerstin , Frisell J , Räf L 
Published: March 2007

Abstract
The management of Meckel's diverticulum (MD) incidentally detected in adults remains controversial. To assess the risk involved in excision of such diverticula and the incidence of complications arising from MD in adult life, we analysed 260 cases of MD found at laparotomy in a baseline population during a 15-year period. There were 148 symptomless and 112 symptom-producing diverticula, with intestinal obstruction as the most common complication. Assuming a 2 per cent general incidence of MD, the complication rate in these adult patients was 0.03 per cent per year. The calculated lifetime risk of complication from MD was 3.7 per cent at age 16 years, falling to zero in old age. Excision of an incidentally detected MD entailed a 6 per cent rate of major complications. Twenty-eight symptomless diverticula were not excised, and follow-up revealed no complications in these cases. In adults an incidentally discovered, symptomless Meckel's diverticulum should be left in place.
Familial hypocalciuric hypercalcaemia as a differential diagnosis of hyperparathyroidism: Studies in a large kindred and a review of surgical experience in the condition
Authors: Lyons T J , Crookes P F , Postlethwaite W , Sheridan B , Brown R C , Atkinson A B 
Published: March 2007

Abstract
We have studied 46 members of a large kindred with familial hypocalciuric hypercalcaemia (FHH) after a neck exploration failed to cure hypercalcaemia in an asymptomatic patient. Serum calcium, serum phosphate, plasma parathormone and vitamin D metabolites do not distinguish affected members from patients with hyperparathyroidism. Because of the continuing debate as to whether or not FHH is a variant of, or distinct from, hyperparathyroidism, we have carried out a review of surgical experience with subtotal parathyroidectomy in hyperparathyroidism secondary to parathyroid hyperplasia and in FHH. Whereas the procedure is successful in 90 per cent of the former cases only one case of FHH has been cured by it. This provides evidence for the two conditions being aetiologically distinct. Before patients with asymptomatic hypercalcaemia are referred for parathyroid surgery the calcium:creatinine clearance ratio should be measured using a 2 h urine sample collected after an overnight fast and a fasting blood sample. If this ratio is less that 0·01 then screening of first degree relations should be undertaken before any parathyroid surgery is performed. Unnecessary surgery can therefore be avoided.
Injection sclerotherapy of oesophageal varices with the freehand technique: Experience in Hong Kong
Authors: Lai E C S , Choi T K , Fok M , Wong J 
Published: March 2007

Abstract
A prospective study of the efficacy of injection sclerotherapy with the freehand technique for acute bleeding oesophageal varices was conducted, to evaluate its use in the control of acute variceal bleeding and to assess long-term sclerotherapy as the definitive treatment. Between July 1981 and January 1985, a total of 108 patients (96 men, 12 women with mean age of 54·4 years) had intravariceal injection of 5 per cent ethanolamine oleate. The majority had non-alcoholic cirrhosis and alcoholism accounted for only 18·5 per cent. There were 22 Child's A, 42 Child's B and 44 Child's C patients. During the 411 sessions of injection, major complications occurred in 12 patients (11·1 per cent) with 3 deaths. Of the 145 episodes of acute variceal bleeding 91·7 per cent were successfully controlled. In episodes which required more than one injection to control the bleeding, there was a high mortality of 75 per cent. Over the three and a half year period, 33 out of the 93 patients on long-term sclerotherapy had re-bled (35·5 per cent). Varices were obliterated in 27 patients with a mean of 5·4 injections. From our experience, the procedure is safe and effective. However, its status as a definitive treatment when compared with conventional surgical treatment requires further controlled evaluation.
Twenty year experience with familial polyposis coli in Cape Town
Authors: Aitken R J , Elliot M S , Torrington M , Louw J H 
Published: March 2007

Abstract
Forty-nine patients undergoing surgery for familial polyposis coli (FPC) over a twenty year period are presented. Forty-three patients underwent total colectomy with ileorectal anastomosis (TC + IRA) and five patients subsequently developed a rectal carcinoma. The incidence of rectal carcinomafollowing TC + IRA appears to increase with time. There were significant postoperative complications secondary to adhesive obstruction and desmoid tumour recurrence. Upper gastrointestinal pathology has been detected by endoscopy in only one of nine patients, but the importance of upper gastrointestinal pathology is now appreciated. The problem of screening a widely distributed and closely knit community has been considerable. TC + IRA remains the operation of choice for the majority of patients with FPC, but a total colectomy with ieal reservoir and ileo-anal anastomosis is appropriate in some cases.
Amylase and gut infarction
Authors: Wilson C , Imrie C W 
Published: March 2007

AbstractSerum amylase has been determined on admission in 63 (52 per cent) of 122 patients with acute mesenteric infarction. Amylase levels were normal in 34 (54 per cent) and reached greater than twice normal in 15 patients (24 per cent). In 5 patients (3 on admission) amylase levels were in the diagnostic range of acute pancreatitis (&gt; 1200 units/I) leading to inappropriate non-operative treatment in 4. Hyperamylasaemia was found in association with all aetiologies of infarction. The magnitude of the hyperamylasaemia appeared to be related to the extent of the bowel infarction, the highest levels occurring when infarction involved the small bowel and colon. The mechanism of hyperamylasaemia in acute mesenteric infarction is discussed.
Surgery for peptic ulceration associated with hypergastrinaemia
Authors: Clark C G , Chowcat N L , Lewin M R , Gilbert J M , Gelister J S K , Boulos P B 
Published: March 2007

Abstract
Between 1971 and 1983, 31 males and 13 females were found to have peptic ulceration associated with hypergastrinaemia. An antral G-cell lesion was present in 11 (25 per cent) and a gastrinoma in 14 (32 per cent). There were 11 patients with multiple endocrine adenomatosis (MEA) (25 per cent) and 4 (9 per cent) with primary hyperparathyroidism. Four patients (9 per cent) were unclassified. Length of history and level of gastrin did not differentiate between the groups and an average of 2·5 operations was performed per patient, while the overall mortality was 27·3 per cent. The patients with G-cell lesions were significantly younger than all the other groups (P &lt;0·01). Partial gastrectomy adequately treated G-cell hyperplasia. Total gastrectomy was required to treat pancreatic gastrinomata but additional pancreatic resection did not improve the outcome. In MEA, parathyroidectomy did not influence the treatment of a gastrinoma. This is the first recorded experience of surgery for hypergastrinaemia in the United Kingdom and the outcome of such a retrospective study may be a guide to the future management of these conditions.
Daily salivary progesterone levels in cyclical mastalgia patients and their controls
Authors: Kumar S , Mansel R E , Wilson D W , Read G F , Truran P L , Hughes L E , Griffiths K 
Published: March 2007

Abstract
Progesterone levels were measured in samples of saliva collected daily throughout the menstrual cycle in patients with pronounced cyclical mastalgia and breast nodularity. A control group matched for age, length of menstrual cycle and parity was also studied. No significant differences in progesterone levels were detected between the two groups for the luteal phase of the cycle. These data indicate that cyclical mastalgia is not associated with significant luteal phase progesterone insufficiency, as demonstrated by salivary levels and, by implication, serum levels of progesterone.