bluuebunny/crossref_metadata_2025_split huggingface dataset:
Single layer anastomosis after rectosigmoid resection
Authors: Matheson N A , Irving A D 
Published: March 2007

Abstract
Anastomosis after resection of the rectosigmoid colon is often followed by leakage at the suture line. When occult leakage discovered on routine contrast study is included incidence rates of over 50 per cent have recently been reported.
A single layer interrupted seromuscular inverting technique was used for the anastomosis after elective rectosigmoid resection in 52 consecutive patients. The total incidence of suture line leakage was 6 per cent. Therefore a high incidence of anastomotic dehiscence in the rectum can be avoided and it is concluded that a single layer technique is sound.
Ureteric obstruction due to sigmoid diverticulitis
Authors: Rees B I , Bolton P M 
Published: March 2007

Abstract
Two cases in which the ureter was obstructed by an inflammatory diverticular mass are presented. The difficulties of distinguishing such a mass from a carcinoma both clinically and at operation are emphasized. In order to minimize the risk of ureteric injury and to facilitate planning of the operative procedure, it is recommended that intravenous pyelography should be performed before resection of a suspected diverticular mass.
The importance of environmental conditions, especially temperature, in the operating room and intensive care ward
Authors: Brock Lord 
Published: March 2007

Abstract
Although most patients are essentially well enough to be able to resist or to adapt to unfavourable ambient conditions, this may not be so with an ill patient or one who is having or has had a serious operation. The climatic conditions necessary in the operating room to give an optimal environment are discussed. These are second in importance only to control of infectivity. Airconditioning in operating suites should be obligatory; there is even official acceptance of this. Earlier recommendations that the operating room should be heated to up to 80 °F(27·9 °C) are obsolete. The temperature most favoured by surgeons is 18·5–21 °C; some prefer a range of 21–22 °C. The critical ambient temperature desirable is 21 °C. For infants and children this may be increased up to 24 °C. It is difficult or impossible to achieve climatic conditions in the operating room that are acceptable to all. The needs of the patient are of special importance and are largely neglected; he alone is unable to speak for himself. The disposition of air inlets in the operating room is fully discussed.
Climatic conditions in the intensive care unit are of great importance and are discussed. The need for full air-conditioning is absolute although this is often ignored. The delivery of conditioned air within the intensive care unit is also fully presented, especially the need to avoid direct chilling of the patient. The advantages of horizontal laminar air flow are presented.
Some observations on peripheral venous pressure using a non-invasive technique: A preliminary report
Authors: Gaylis H 
Published: March 2007

Abstract
Observations are presented which suggest that peripheral venous pressure can be measured indirectly by a noninvasive technique at the bedside, using a portable Doppler ultrasound flowmeter.
The pressure at which the audio signals are heard over veins on release of the occluding cuff seems to be a measure of peripheral venous pressure. This is supported by showing a correlation between the method and conditions in which raised venous pressure in the lower limb are known to exist. The results of a few direct venous pressure measurements are reported which appear to give added support.
It is suggested that this simple non-invasive technique may be of value in detecting certain cases of deep vein thrombosis of the lower extremities.
Neoplastic change in duplications of the alimentary tract
Authors: Orr M M , Edwards A J 
Published: March 2007

Abstract
Two cases of adenocarcinoma arising in sequestrated duplications of the bowel in adults are reported. The literature is reviewed and a tendency for duplications to present in early childhood is noted. Although relatively few of these anomalies persist into adult life 8 cases of neoplastic change have now been reported. The histological features of many of the duplications undergoing malignant degeneration suggest the presence of underlying epithelial instability in this condition. It is postulated that duplications of the large bowel have malignant potential.
A controlled clinical trial of three different methods of perineal wound management following excision of the rectum
Authors: Irvin T T , Goligher J C 
Published: March 2007

Abstract
Three methods of perineal wound closure were studied in a randomized prospective clinical trial in 106 patients undergoing excision of the rectum for inflammatory or malignant disease. In method 1 the perineal wound was managed by open drainage. In both methods 2 and 3 the perineal wound was closed by primary suture, suprapubic suction drains being left down to the presacral space, but in method 2 the pelvic peritoneal floor was reconstituted, whilst in method 3 it was left unsutured. Topical and systemic antibiotics were administered to all patients submitted to primary closure of the perineal wound but not routinely to those whose perineal wound was left open.
The overall operative mortality was 8·5 per cent but no deaths could be definitely attributed to perineal wound complications. The incidence of primary wound healing after methods 2 and 3 was 45·2 and 4·9 per cent respectively. Operative contamination of the perineal wound had an adverse effect on perineal wound healing. The incidence of persistent wound sinuses and unhealed wounds at 3 and 6 months after primary wound closure was rather less than that encountered after open drainage.
It was concluded that primary closure of the perineal wound is the treatment of choice following excision of the rectum, except in cases in which contamination of the perineal wound has occurred during operation or the final state of haemostasis in the pelvis with diathermy and suture at the conclusion of the dissection was deemed to be unsatisfactory.
Povidone-iodine for the control of surgical wound infection: A controlled clinical trial against topical cephaloridine
Authors: Pollock A V , Evans Mary 
Published: March 2007

Abstract
One hundred and ninety-two operation wounds in a general surgical practice were randomly allocated to receive either topical cephaloridine or a povidoneiodine spray, and the rate of wound sepsis was studied. In all types of operation cephaloridine proved superior to povidone-iodine as a prophylactic, the difference reaching a significant level in potentially contaminated wounds.
Subphrenic abscess in children
Authors: Mackenzie M , Fordyce J , Young D G 
Published: March 2007

Abstract
Nineteen consecutive cases of subphrenic abscess which were treated in the Royal Hospital for Sick Children, Glasgow, from 1962 to 1972 are analysed. This complication of intra-abdominal suppuration of surgery still carries a grave prognosis. Four of the patients died (21 per cent); 2 deaths were related to the subphrenic abscess while the remaining 2 were not directly related to the abscess. The mean hospital stay of the survivors was 59 days (range 30–122 days). The changing patterns of aetiology and presentation which have recently been emphasized in general surgical practice are not reflected in this paediatric series.
Possible parathyroid origin of gastrin in a patient with multiple endocrine adenopathy type I
Authors: Cassar J , Polak J M , Cooke W M 
Published: March 2007

Abstract
After removal of two large pancreatic insulinomas, although the presenting spontaneous hypoglycaemia was eliminated, severe and persisting haematemesis and melaena supervened with a rise in serum gastrin. The patient had multiple endocrine adenopathy (pituitary, parathyroids and islet cells), but no evidence of a pancreatic gastrin-producing tumour. After emergency gastric operation for the bleeding, the serum gastrin remained high until the hypercalcaemia and hyperparathyroidism had been corrected by subtotal parathyroidectomy. Immunofluorescence studies showed gastrin in the parathyroid tissue.
Cavernous haemangioma of the frontal bone: Case report
Authors: Gupta S D , Tiwari I N , Pasupathy N K 
Published: March 2007

Summary
A rare case of haemangioma of the frontal bone is presented together with a review of the literature. Carotid angiography was found to be a useful diagnostic aid to differentiate it from other lesions of the frontal bone. The best treatment is to excise both tables containing the haemangioma together with a rim of healthy bone in one block.
Postvagotomy dysphagia
Authors: Spencer J D 
Published: March 2007

Abstract
Following truncal vagotomy some patients develop dysphagia, which rarely can progress to complete obstruction. It has been postulated that haematoma formation in the tissues surrounding the lower oesophagus may lead to peri-oesophageal fibrosis and compression of the lumen of the oesophagus. This has been confirmed by open operation in only a few patients. A case is described in which oesophageal obstruction occurred 3 weeks after a vagotomy and pyloroplasty had been performed.
The relationship of anaemia to gastric secretion more than 15 years after vagotomy and gastro-enterostomy
Authors: Wheldon E J , Venables C W , Johnston Ivan D A 
Published: March 2007

Abstract
Iron deficiency anaemia is common following vagotomy and gastro-enterostomy, and this study has shown that all the anaemic patients had low gastric secretion.
After correction of their anaemia, gastric secretion was increased, but was still very low, and when these levels were compared with secretion in fit non-anaemic patients it was found that the latter group had a significantly higher secretion, and that a high proportion of them showed evidence of incomplete vagotomy.
These results suggest that there is a relationship between the levels of gastric secretion in patients after vagotomy and gastro-enterostomy and the development of anaemia. It may be that inadequate gastric secretion impairs the release of elemental iron from the diet and its subsequent absorption.
Diagnosis, clinical course and treatment of acute dermal gangrene
Authors: Ledingham I McA , Tehrani M A 
Published: March 2007

Abstract
Twenty patients with acute dermal gangrene following surgery, trauma or sepsis are described. In 12 the skin became gangrenous secondary to a necrotizing process affecting the subdermal fascia, and in 8 the condition arose primarily in the skin. In the first group mortality was high unless radical excision of the necrotic fascia was performed at an early stage; in 3 of the recent patients the overlying skin was removed, defatted and stored for later grafting. In the second group, incision and adequate drainage combined with antibiotics seemed to suffice. Hyperbaric oxygen was of dubious value in the first group but appeared to contribute to arrest of the lesion in the second group.
Epidermoid cysts, polyposis coli and Gardner's syndrome
Authors: Leppard Barbara , Bussey H J R 
Published: March 2007

Abstract
One hundred and ninety-six members of 15 families with Gardner's syndrome were investigated to determine the type of skin cyst that is part of this syndrome. These were shown to be epidermoid cysts and not pilar cysts or steatocystoma multiplex. They were solitary or multiple and seldom large and disfiguring. The skin cysts often occurred before the intestinal polyps were detectable. The presence of epidermoid cysts in children should be an indication for sigmoidoscopy when the child reaches the age of 14 years, and at 3-yearly intervals thereafter up to the age of 30 years, whether or not there is a family history of polyposis coli.
At present it is not possible to say if Gardner's syndrome is the same as, or different from, familial polyposis. Until all patients with colonic polyps have a full clinical examination, looking for skin cysts and osteomas, X-rays of the skull and long bones to detect osteomas and dental X-rays for abnormalities of the teeth this question will remain unanswered.
The effect of hepatic ischaemia on liver function and the restoration of liver mass after 70 per cent partial hepatectomy in the dog
Authors: MacKenzie R J , Furnival C M , O'Keane Maureen A , Blumgart L H 
Published: March 2007

Abstract
Partial hepatectomy was performed in dogs either as the only procedure or following a period of ischaemia to the liver remnant produced by inflow occlusion for periods of 30–60 minutes before partial hepatectomy. Temporary portal decompression was maintained through the portion of liver subsequently excised. Survival in dogs subjected to partial hepatectomy and ischaemia to the liver remnant was similar to that in animals after partial hepatectomy alone.Metabolic changes were similar in both groups but dogs submitted to partial hepatectomy and ischaemia to the remnant had higher serum alkaline phosphatase and alanine amino-transferase levels with increased bromsulphthalein retention in the fourth to sixth postoperative weeks.Replacement of liver mass proceeded rapidly in all groups of animals.
It is concluded that ischaemia of the liver remnant for up to 60 minutes preceding partial hepatectomy in the dog is consistent with survival and produces little change in postoperative liver function or in the rate of restoration of liver mass.
Orthotopic liver transplantation utilizing a vascular stapling instrument
Authors: Barron P T , Vogelfanger I J , Waddell W G 
Published: March 2007

Abstract
A technique of orthotopic liver transplantation in the pig is described in which the main feature is the accomplishment of four of the five anastomoses by the use of the Vogelfanger NRC vascular suturing instrument. The advantage of this instrument is the rapid accomplishment of safe leak-proof anastomoses.
Renal transplantation in the unimmunosuppressed pig: An abnormal response
Authors: Terblanche John , Hickman Rosemary , Uys C J 
Published: March 2007

Abstract
A series of 82 kidney allografts and autografts in unimmunosuppressed pigs surviving for longer than 5 days has been compared with a previously reported series of 24 unimmunosuppressed pig kidney allografts. In the previous series 40 per cent survived for longer than 20 days. In the present series only 2 per cent of 55 transplants performed in cross-bred pigs obtained from different farms survived for longer than 20 days. The major causes of death were unrelated to rejection, principally gastric ulcer bleeding. In the further 16 transplants between different pure-bred animals (thereby ensuring genetic disparity) the ulcer incidence was lowered by a gastro-enterostomy, and 12 per cent survived for longer than 20 days. Histological assessment of rejection in the latter group revealed 20 per cent with minimal rejection, and 60 per cent in which rejection was considered insufficient to account for the death of the animals. Based on the evaluation of 95 unimmunosuppressed pig kidney allografts in both series, it is concluded that a wide and unpredictable range of survival time occurs. Therefore the pig kidney allograft model is an unsatisfactory model in which to study immunosuppressive régimes. Also the unimmunosuppressed pig appears to show less evidence of kidney allograft rejection than the dog, irrespective of genetic disparity. It is tentatively suggested that this might be a lesser manifestation of the unexplained phenomenon of minimal rejection of liver allografts noted in unimmunosuppressed pigs.
Injuries caused by rubber bullets: A report on 90 patients
Authors: Millar R , Rutherford W H , Johnston S , Malhotra V J 
Published: March 2007

Abstract
The injuries in 90 patients caused by rubber bullets are described. There was 1 death and 17 people in the series had permanent disabilities or deformities. In 41 patients the injuries necessitated admission to hospital. One fatality outside this series is known. Injuries to the head and neck were frequent and severe.
A prospective study of acute pancreatitis
Authors: Imrie C W , Whyte A S 
Published: March 2007

Abstract
All 78 patients with acute pancreatitis admitted to one hospital in a 2-year period were included in a prospective survey of conservative management. The overall mortality rate was 11·5 per cent, being 46 per cent for 11 patients subjected to early laparotomy and only 6 per cent for patients managed without operation. Twenty-six patients were considered to have severe acute pancreatitis and all 9 deaths occurred in this group.
Biliary disease was present in 51 per cent of patients, and the majority of those with biliary disease were over 60 years old. Alcohol-related acute pancreatitis occurred in 26 per cent of the total patients, and none of this group was over 60 years old. Acute pancreatitis was considered idiopathic in origin in only 13 per cent of the patients.
Elective biliary surgery in 30 patients has resulted in freedom from recurrent attacks of acute pancreatitis for the follow-up period (12–30 months).
The results compare favourably with those in which glucagon and high dosage aprotinin (Trasylol) have been utilized in the management of acute pancreatitis.
The use of the vas deferens in inguinal herniorrhaphy
Authors: Sames Patrick 
Published: March 2007

Abstract
A new method of repair of inguinal herniae is described using the vas deferens as a suture material. It is especially suitable in very large and recurrent herniae. Nineteen cases have been operated on in this way with an average of 38 months' follow-up. In none has recurrence been noted. It is suggested that the vas deferens, so readily to hand, forms a more natural barrier than man-made fibres. It may also, in fact, remain viable, though this has not, as yet, been proved.
Bile salts and gallstone disease
Authors: MacKay Colin 
Published: March 2007

Abstract
Bile salts play an important role in maintaining cholesterol in aqueous solution in bile. There is evidence that in some patients at least gallstones arise as a result of bile salt deficiency. The evidence to date suggests that although oral bile salts may be of use in treating some gallstone patients they are unlikely to replace chole-cystectomy in the foreseeable future. The instillation of bile salts via an indwelling T-tube may well be of great use in the management of stones retained in the common duct after choledocholithotomy. There is no doubt that in this branch of medicine as in all others prevention is better than cure and our aim should be to perfect our technique so that we do not leave stones behind. However, should the situation occur we may soon have safe effective physiological solvents to dissolve our mistakes.
Long term changes in total body water, total exchangeable sodium and total body potassium before and after ileostomy
Authors: Hill G L , Goligher J C , Smith A H , Mair W S J 
Published: March 2007

Abstract
In 10 patients with inflammatory bowel disease, total body water, total body potassium and total exchangeable sodium were measured both before and 6 months after the establishment of a permanent ileostomy. All 10 patients underwent elective surgery for their inflammatory bowel disease but all were malnourished before surgery when their body composition was first measured.
Six months later, when the body composition was again determined, all the patients were in good health and had normally functioning ileostomies. As a group they had gained 6–8 kg in body weight and 372 mEq total body potassium over the 6-month period. When the “normal” total body water was calculated for each patient, a deficit of 12.4 per cent for the group was found before surgery and this was still present (11.1 per cent) 6 months later. The concentration of exchangeable sodium in the body water fell from an abnormally high level before surgery to within the normal range 6 months later.
These data show that deficits in total body water occurring preoperatively are not repaired in the months following the establishment of a well-functioning ileostomy, and that a reduction of total exchangeable sodium is present in patients with an ileostomy who are otherwise well. It is suggested that these findings should encourage the surgeon managing patients with intractable inflammatory bowel disease to strive for good nutrition and normal body composition before embarking on excisional surgery and the establishment of a permanent ileostomy.
Results of surgery for Crohn's disease in the Glasgow region, 1961–70
Authors: Young S , Smith I S , O'Connor J , Bell J R , Gillespie G 
Published: March 2007

Abstract
During the period 1961–70,283 patients in the Glasgow region have been studied with regard to the outcome of 418 surgical procedures performed for Crohn's disease.
Resection was followed by an overall recurrence rate of 33 per cent, but in disease confined to the large bowel the rate was 18 per cent.
Exploratory operations and bypass procedures were followed by a recurrence rate of 70 per cent. Evidence is provided that recurrence following bypass procedures for small bowel disease and ileocolitis occurs at a later stage than after exploratory operations alone.
By the end of the study period 77 per cent of patients in this series had required one or more resections.
Recurrent pleural effusion in chronic relapsing pancreatitis
Authors: Rasaretnam Rudra , Perera A B V , Kumarasinghe M 
Published: March 2007

Abstract
A case of recurrent pleural effusion occurring in a patient with chronic relapsing pancreatitis is presented. Although it is one of the less common manifestations of the pleuropulmonary complications of pancreatitis, the presence of such a lesion is of diagnostic importance when the enzyme content of the effusion is elevated above the levels in the serum. In most of the reported cases resolution has occurred with conservative therapy, but failure to do so necessitated subtotal pancreatectomy, following which the patient made an uneventful recovery.
Xanthogranulomatous pyelonephritis: A report of 2 cases
Authors: Morgan O S , Nicholson G D , Johnson P S , Atkinson D W 
Published: March 2007

Abstract
Two cases of xanthogranulomatous pyelonephritis are reported in Negroes. The clinical findings are similar to those in previously reported cases. In 1 case nephrolithotomy was followed by the development of a perinephric abscess 8 months later. Late diagnosis has limited experience with more conservative management, which should be reserved for demonstrably focal disease.
Peritoneal mesothelioma
Authors: Chan P S F , Balfour T W , Bourke J B , Smith P G 
Published: March 2007

Abstract
Two patients with primary peritoneal mesothelioma are reported. They had abdominal symptoms, no symptoms referable to the respiratory system and normal chest X-rays. There was no clinical evidence of impaired respiratory function. One of the patients had a history of brief asbestos exposure over 20 years before diagnosis. The procedure for obtaining compensation is outlined and the protean uses of, and hence possible exposure to, asbestos are noted. In screening programmes consideration should be given to both pulmonary and abdominal symptoms. Laparoscopy may have a part to play in earlier diagnosis of peritoneal mesothelioma.