bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endoscopic sphincterotomy: Indications and results
Authors: Viceconte Giovanni , Viceconte Guido W , Pietropaolo Vincenzo , Montori Alberto 
Published: March 2007

Summary
Endoscopic sphincterotomy (ES) is a simple, effective and remarkably safe method of treatment of choledocholithiasis and papillary stenosis. In this series, ES was technically successful in 255 (86·1 per cent) of 296 patients in whom it was attempted. Forty-nine of the successful cases had papillary stenosis complicated by pain, cholangitis and/or jaundice in patients after cholecystectomy; 205 had choledocholithiasis, of whom 164 had a cholecystectomy and 41 were poor surgical risks and did not have cholecystectomy. One patient had a tumour of the ampulla of Vater. ES has been performed as an emergency in 16 subjects because of severe septic cholangitis in 11 and acute biliary pancreatitis in 5.
Of the 205 patients with choledocholithiasis, spontaneous passage of calculi after ES occurred in 151 cases (73·6 per cent), and instrumental extraction of stones was possible in 44 (21·5 per cent); 10 patients (4·9 per cent) had residual stones and required surgery. In this series the overall success rate of ES in removing common bile duct stones was 82 per cent in 238 cases; in the patients with benign papillary stenosis ES was successful in relieving symptoms and biochemical cholestasis in 72 per cent of 57 cases.
Complications occurred in 18 cases (7 per cent): cholangitis in 4 (1·6 per cent) and haemorrhage in 14 (5·4 per cent). Two patients (0·8 per cent) with acute bleeding following ES died; in one of these surgery had been performed to arrest the haemorrhage, but the patient died 3 days after operation of hepatorenal failure. The other complications were treated conservatively without mortality.
Acute pancreatitis associated with campylobacter infection
Authors: Gallagher P , Chadwick P , Jones D M , Turner L 
Published: March 2007

Summary
We report a case of acute pancreatitis associated with campylobacter infection. The patient presented with clinical symptoms and signs which suggested acute appendicitis. However, she was found to have acute pancreatitis with an acute campylobacter infection.
Recent reports have shown that campylobacter is pathogenic in the biliary tract, and we suggest that it may also be responsible for some cases of acute pancreatitis in the absence of biliary disease.
The clinical significance of heterotopic pancreas in the gastrointestinal tract
Authors: Armstrong C P , King P M , Dixon J M , Macleod I B 
Published: March 2007

Summary
A series of 34 histologically verified cases of pancreatic heterotopia in the records of the Department of Pathology at the University of Edinburgh between 1959 and 1979 has been analysed in order to determine the clinical significance of this unusual condition. In 13 patients (38 per cent) the heterotopic pancreatic tissue was symptomatic (i.e. the symptoms regressed completely on its removal). A correlation has been established between the presence of symptoms, the size of the lesion and the extent of mucosal involvement. Clinically significant lesions are greater than 1·5 cm in maximum diameter and are adjacent to or directly involve the mucosa.
The measurement of gastric emptying: A comparison of fixed scintillation detection and the double-sampling technique
Authors: Blake G , McKelvey S T D 
Published: March 2007

Summary
The gastric emptying of a fluid meal was measured simultaneously by fixed scintillation detection and the double-sampling technique in 14 normal subjects and 15 patients who had a vagotomy and drainage procedure. In the normal subjects good correlation was obtained between the two methods but in the operated group there was poor correlation owing to difficulty in measuring the initial rapid emptying phase by fixed scintillation detection.
Modification of the fixed scintillation method allows it to be used accurately in postoperative patients. The radioactivity of the meal is measured in vitro before ingestion and this reading is converted, using a constant derived from normal subjects, to a baseline value to which the subsequent in vivo readings are related. This modified technique permits the investigation of gastric emptying of fluid meals in patients with postvagotomy syndromes without the discomfort of a nasogastric tube. The equipment required is inexpensive.
Chemotherapy following palliative resection of gastric cancer
Authors: Lawton John O , Giles Geoffrey R , Hall Robert , Bird G G , Matheson Thomas 
Published: March 2007

Summary
Twenty-five patients with residual tumour after resection of a primary gastric cancer were randomized to receive either 5-Fluorouracil or BCNU postoperatively or kept under close observation. Some patients receiving chemotherapy may have benefited by a delay in progression of their disease but this was short lived and subsequently all but one patient has died within a 4-year period of follow-up. There does not seem to be any advantage in treating patients who have residual gastric cancer with 5-FU and BCNU therapy.
Treatment of anal fissure by lateral subcutaneous sphincterotomy should be under general anaesthesia
Authors: Keighley M R B , Greca F , Nevah E , Hares M , Alexander-Williams J 
Published: March 2007

Summary
Seventy-one consecutive patients with acute anal fissure were randomly allocated to treatment by lateral subcutaneous sphincterotomy under either local anaesthesia (n=34) or general anaesthesia (n=37). Four months after treatment there were 18 patients with a recurrent or persistent anal fissure, 17 had had local anaesthesia (50 per cent) and only one had a recurrent fissure after general anaesthesia (3 per cent). These results indicate that if lateral subcutaneous sphincterotomy is used for treatment of anal fissure the operation should be performed under a general anaesthetic.
Segmental mega-ileum presenting as anaemia
Authors: Leinster S J , Hughes L E 
Published: March 2007

Summary
Three cases are described of an unusual malformation of the ileum at the site of the vitelline duct, which presented with chronic anaemia. In each case localized mega-ileum was associated with a simple, non-specific ulcer leading to chronic blood loss. Two cases were at the site of and associated with a Meckel's diverticulum, while the third case was at the same level and associated with a vascular abnormality probably of vitelline artery origin. This syndrome of adult segmental ileal dilatation associated with non-specific ulcer and chronic anaemia does not appear to have been described previously.
Correlation of Doppler-derived high thigh pressure and intra-arterial pressure in the assessment of aorto-iliac occlusive disease
Authors: Flanigan D Preston , Gray Billie , Schuler James J , Schwartz John A , Post Kenneth W 
Published: March 2007

Summary
Ninety-five lower extremities in 53 patients underwent iliofemoral arteriography, high thigh wide cuff Doppler pressure measurements and direct intra-arterial pressure measurements at the common femoral level to determine the accuracy of the high thigh Doppler technique in the evaluation of aorto-iliac occlusive disease using intra-arterial pressure as the standard.
Results showed the high thigh cuff Doppler technique to be 79 per cent sensitive, 56 per cent specific and 63 per cent accurate in the evaluation of haemodynamically significant aorto-iliac disease. There was a false negative rate of 13 per cent, but a false positive rate of 59 per cent. All false positive tests were shown to be secondary to superficial femoral artery disease.
These results indicate that a normal high thigh wide cuff Doppler pressure is generally reliable in ruling out haemodynamically significant aorto-iliac occlusive disease at rest. An abnormal result, however, does not differentiate between aorto-iliac and superficial femoral artery disease.
Diagnosis, treatment and operative complications of carotid body tumours
Authors: Van Asperen De Boer F R S , Terpstra J L , Vink M 
Published: March 2007

Summary
A series of 42 patients who were treated in the Surgical Clinic of the University of Leyden on suspicion of a carotid body tumour between 1958 and 1979 is reported. Thirty-four patients in this series were operated upon in the University Hospital Leyden. Only 6 per cent of the tumours were malignant according to the criteria of nuclear polymorphia and metastases. Local infiltration, either histological or clinical, has no correlation with later outcome. In 11 per cent of the patients, vascular complications occurred. The necessity of operative damage to the surrounding cranial nerves increased with the size of the tumour. In one case the cranial nerve lesion was accidental. No per- or postoperative mortality was seen in this series.
Hyperparathyroidism in peptic ulcer patients
Authors: Mowat Elizabeth , Gunn A , Paterson C R 
Published: March 2007

Summary
The high incidence of peptic ulcers and abdominal pain from other causes in patients with primary hyperparathyroidism has been recognized for many years. This paper reports 20 patients with hyperparathyroidism: 12 with peptic ulcers and 8 with abdominal pain from other causes. Only in a minority of these was the diagnosis of hypercalcaemia made as a result of a deliberately sought assay; in most the plasma calcium had been measured as part of a ‘screening’ procedure with a multichannel analyser. In almost all of the patients who had parathyroid surgery the abdominal symptoms were completely relieved. We urge that plasma calcium assays should be made in all patients with dyspepsia particularly those with recurrent symptoms.
The solitary thyroid nodule
Authors: Sykes David 
Published: March 2007

Summary
In a 4-year period the solitary thyroid nodule was the most common form of thyroid pathology seen in the surgical section of a thyroid clinic. The cold thyroid nodule was the most frequent type of solitary nodule and half of these were unilocular cysts which were treated by aspiration and sclerotherapy. Cytological examination of the aspirated fluid revealed no evidence of malignant cells. Emphasis is placed on recommending operation if aspiration fails to cause the mass to disappear.
Cholecystectomy and cancer of the large bowel
Authors: Turnbull P R G , Smith A H , Isbister William H 
Published: March 2007

Summary
A matched case control study was conducted in order to determine the association between previous cholecystectomy and the development of large bowel cancer. One hundred and sixty men and 145 women presenting with large bowel cancer were studied. One control was selected for each case matched according to age, sex and date of admission. The medical records for each patient in the study were reviewed for evidence of previous cholecystectomy. No association was found among male patients, but for women an estimate of relative risk of 2·7 was obtained for patients who had had previous cholecystectomy. This association was largely a consequence of the fact that 10 female patients with rectal cancer had had a previous cholecystectomy compared with only one of their controls. It is possible that carcinogenic breakdown products of bile salts are most concentrated in the distal portion of the large bowel, but it is difficult to explain why the association should be confined to women only.
The microflora of the postoperative stomach
Authors: Muscroft T J , Deane S A , Youngs Denise , Burdon D W , Keighley M R B 
Published: March 2007

Summary
The microflora and pH have been assessed in gastric aspirates from 163 patients after gastric surgery and have been compared with 51 patients with gastro-oesophageal carcinoma, 152 unoperated patients with peptic ulceration, 72 of whom were receiving cimetidine, 3 patients with pernicious anaemia and 27 normal subjects. The total viable bacterial count was closely related to the pH of the aspirate and was independent of the cause of the hypochlorhydria; 90 per cent of aspirates of pH 1–2 were sterile, while 94 per cent of those of pH 4–8 contained bacteria.
Escherichia coli was found significantly more frequently in the postoperative and cancer groups, and Clostridium spp. were significantly more common in patients with carcinoma. Elevated gastric juice nitrite concentrations were significantly more common in aspirates of pH 4–8 and this correlated well with the presence of nitratereducing bacteria. The pH of an aspirate is a good indicator of the presence of bacteria and may be useful in selecting patients requiring postoperative prophylactic antibiotic cover. Hypochlorhydric patients are exposed to increased concentrations of nitrite and there may be an increased risk of gastric cancer induced by N-nitrosocompounds.
The laboratory assessment of a new fabric for reducing bacterial penetration of operating theatre apparel
Authors: Goldthorp Steven L 
Published: March 2007

Summary
A one-piece experimental suit was made up from Gore-Tex fabric and assessed in an environmental chamber using 20 male volunteers with respect to reducing airborne contamination. Comparison was made with a similar cotton suit, a two piece short-sleeved cotton suit (blues) and ‘Y-front’ underpants (briefs). The Gore-Tex suit produced a reduction in contamination (with 95 per cent confidence limits) of 85·9±5·9 per cent over the cotton suit and over the blues and briefs at similar levels. Scanning electron microscopy showed that bacterial penetration would not occur.
Perforation of the oesophagus: Experience in a general hospital
Authors: Banks James G , Bancewicz John 
Published: March 2007

Summary
The results of a retrospective study of 62 patients who sustained perforation of the oesophagus during the period 1956–78 are reviewed. Oesophageal instrumentation was implicated in 40 patients. A total of 69 per cent of perforations occurred in the lower third; 45 per cent of patients remained undiagnosed for at least 24 h and in 23 per cent the diagnosis was made only at post-mortem examination. Operative and non-operative management resulted in mortality rates of 48 per cent and 62 per cent respectively. Delay in operative treatment for more than 6 h was associated with increased mortality. However, 5 of 8 patients in whom diagnosis was delayed for more than 48 h recovered. The reason for this is discussed. The indications for conservative treatment are few and well defined; surgery is the treatment of choice. Early diagnosis and treatment are required if the mortality from oesophageal perforation is to be reduced.
The results of Ramstedt's operation in a district general hospital
Authors: Bristol J B , Bolton R A 
Published: March 2007

Summary
From 1970 to 1979 78 pyloromyotomies were performed for congenital hypertrophic pyloric stenosis in the Royal United Hospital in Bath. Fourteen surgeons were involved. Fifty-eight operations were performed using local anaesthesia, and in this group a significantly smaller number of infants vomited postoperatively compared with those given general anaesthesia. There were no deaths, but a relatively high proportion of complications were encountered. These complications were related to the infrequent performance of the operation by the surgeons concerned rather than to the choice of anaesthetic. Pyloromyotomy should be carried out by surgeons with a special interest in the condition. Local anaesthesia offers an advantage by limiting postoperative vomiting.
Dynamic radionuclide scanning of the testis in acute scrotal conditions
Authors: Thomas W E G , Cooke P H , Davies E R , Jackson P C , Williamson R C N 
Published: March 2007

Summary
The role of dynamic radionuclide scanning of the testis has been assessed in 45 patients presenting with acute testicular pain or swelling. The technique is a simple, safe and rapid method for assessing testicular blood flow; the results correlate closely with the clinical course or the findings at surgical exploration. Decreased uptake is diagnostic of testicular ischaemia resulting from acute torsion of the spermatic cord. A resolved torsion may not be detected because the testis is no longer ischaemic and may actually show increased uptake due to reactive hyperaemia.
The influence of high and low sodium intakes on postoperative antidiuresis
Authors: Tindall S F , Clark R G 
Published: March 2007

Summary
There remains some doubt over the influence of intravenous fluid and electrolyte therapy on the development of postoperative hyponatraemia. We believe the effect of varying sodium intakes on fluid balance during both the early antidiuresis phase and the later postoperative period has received insufficient emphasis. Therefore, the effects of intravenous regimens. containing either 450 mmol/24 h of sodium (saline group) or no sodium (dextrose group), on salt and water balance, plasma sodium and plasma water concentrations have been studied in two groups of 6 patients undergoing upper abdominal surgery.
Hyponatraemia was not seen in the saline group but marked salt (+1023 mmol) and water retention (+3509ml) were seen by day +4. The dextrose group became relatively hyponatraemic (131.8 mmol/1) by day +1 but, following a phase of fluid retention during the 24 h following surgery, they developed negative fluid balance with some recovery of plasma sodium levels.
This study confirms the importance of the sodium content of intravenous fluids both on the early development of hyponatraemia and on water and salt balance during the later postoperative period.
Total gastrectomy for gastric carcinoma: A retrospective study of different procedures and assessment of a new technique of gastric reconstruction
Authors: Lygidakis N J 
Published: March 2007

Summary
A retrospective study of the value of reconstructive surgery after total gastrectomy for gastric carcinoma in 118 patients who underwent different types of reconstructive procedures is presented.
Dissatisfaction with established methods of reconstruction led to the development of a new technique. The new method was associated with less regurgitation, less dumping and functioned as a reservoir without undue delay in emptying time. It was associated with an improved quality of life in the postoperative period, with minimal dumping symptoms, maintenance of weight and the ability to return to work. The mortality and morbidity of the new method are acceptable and it thus offers not only an improved reconstructive procedure for total gastrectomy after resection for gastric cancer, but offers potential for reconstructive surgery after total gastrectomy carried out for other reasons.
‘Currents and clots’—an approach to the problem of acute variceal bleeding
Authors: Taylor T V , Neilson J M M 
Published: March 2007

Summary
The Sengstaken—Blakemore tube will frequently control haemorrhage from oesophageal varices but a large proportion of patients rebleed soon after removing the tube and the hospital mortality in these patients is high. It has been demonstrated that the passage of an electric current across a blood vessel wall will precipitate a thrombus on the positively charged electrode, leading to complete occlusion of the vessel. A direct current of 3.2mA/cm2 of electrode passed for 1 h produced complete occlusion of the femoral vein in the dog, without arterial occlusion or adjacent tissue damage. A system of longitudinal flexible gold-plated strip electrodes was placed around the oesophageal component of a Sengstaken tube. The technique has been applied in 8 poor risk patients with active variceal bleeding; haemorrhage was arrested in 7 of these on removal of the tube.
Retrograde electrical pacing of the small intestine—a new treatment for the short bowel syndrome?
Authors: Layzell Trevor , Collin Jack 
Published: March 2007

Summary
Retrograde electrical pacing has been shown to increase absorption of sodium, glucose and water from a continuously perfused jejunal segment in dogs. Under similar circumstances, absorption of xylose, magnesium, calcium and chloride was also increased by pacing compared with before and after its use (P&lt;0.005). Following massive distal small intestinal resection, dogs undergoing post-cibal retrograde pacing showed an increase in body weight (P&lt;0.005) and a decrease in faecal fat (P&lt;0.005) and nitrogen (P&lt;0.01) losses during the test period, compared with similarly prepared dogs who did not undergo pacing. These results suggest that post-cibal retrograde electrical pacing of the small intestine may have a place in the management of patients with the short bowel syndrome.
Perineal rectopexy for rectal prolapse
Authors: Wyatt Arthur P 
Published: March 2007

Summary
Twenty-two female patients (mean age 75 years) with complete rectal prolapse have been treated by operative fixation of the rectum to the sacrum using a perineal approach. There has been no operative mortality, sepsis or serious morbidity. Recurrence of complete prolapse has been seen once only within a month of operation and was due to inadequate operative fixation. The other 21 patients have been followed for up to 4 years. This type of operation may be the treatment of choice in the elderly patient considered unfit for major abdominal surgery but further experience is required before it can be advocated in other groups of patients.
Surgical management of injuries of the large intestine
Authors: Parks T G 
Published: March 2007

Summary
During the period 1969–79, 106 patients were admitted to the Royal Victoria Hospital in Belfast suffering from injuries of the large intestine as a consequence of civil disturbances in Northern Ireland. Eighty-eight of these had penetrating wounds of the colon or rectum. Eighteen patients died as a result of multiple injuries. In these patients there was an average of 3.6 intra-abdominal organs injured compared with a mean of 2.2 in non-fatal cases. There were no deaths among patients who had isolated colonic or rectal injuries.
Lord's procedure for haemorrhoids: A prospective anal pressure study
Authors: Hancock Brian D 
Published: March 2007

Summary
Forty-eight patients treated by Lord's procedure were studied prospectively with preoperative and several postoperative anal pressure recordings over at least 5 years.
Excellent long term results were obtained in the patients with first and second-degree haemorrhoids but only just under half of those with third-degree haemorrhoids were symptom-free.
There was some evidence that patients with the most active internal sphincter had the best clinical results.
Pressure was significantly reduced by dilatation and pressure remained static over the next 5 years. Five patients developed recurrent symptoms between 1 and 5 years after dilatation. It was not possible to predict relapse from serial anal pressure measurements.
Assessment of exocrine pancreatic function by oral administration of N-benzoyl-l-tyrosyl-p-aminobenzoic acid (Bentiromide): 5 years' clinical experience
Authors: Lang C , Gyr K , Stalder G A , Gillessen D 
Published: March 2007

Summary
Exocrine pancreatic function was assessed in 588 sublets by oral administration of 1 g of the chymotrypsin-labile peptide N-benzoyl-l-tyrosyl-p-aminobenzoic acid Bentiromide) from 1974 to 1979. The pancreatic nmction test (PFT) was performed in 126 controls, 217 patients with pancreatic diseases, 196 patients with various non-pancreatic gastrointestinal disease, 18 patients with renal disease and 31 patients with various jiher diagnoses.
In 62 of 72 patients (86 per cent) with chronic pancreatitis and in 19 of 25 patients (76 per cent) with pancreatic carcinoma, the excretion of p-aminobenzoic acid (PABA) in the urine was significantly less than in the controls. In contrast, 328 of 353 controls and patients with non-pancreatic diseases (93 per cent) had PABA excretion within normal limits. The sensitivity and specificity of the Bentiromide-test observed in this study is sufficient to detect moderate to severe disturbances of pancreatic exocrine function.
The PFT has proved to be an easy and reliable screening test for pancreatic exocrine function in ambulatory as well as in hospitalized patients.