bluuebunny/crossref_metadata_2025_split huggingface dataset:
A controlled trial of colostomy management by natural evacuation, irrigation and foam enema
Authors: Doran J , Hardcastle J D 
Published: March 2007

Summary
Twenty patients entered a prospective controlled trial of colostomy management by three techniques—natural evacuation, colostomy irrigation and foam enema. Every patient spent 2 months using each technique.
The mean number of colostomy actions weekly was 17 during natural evacuation, 6 during irrigation and 10 with the enema. There was no significant difference in the time taken to manage the colostomy by each technique. Eighteen patients considered that both irrigation and the foam enema improved the quality of their life, and opted to continue with irrigation on completion of the study. There were no major complications during the trial but leakage of foam and an increase in flatus were problems with the foam enema. It is concluded that patients should be made aware of the alternative methods available for colostomy management and be encouraged to use the method of their choice.
Mechanical and humoral factors in wound healing
Authors: Li A K C , Koroly Mary Jo 
Published: March 2007

Summary
As wound contraction can be prevented by full-thickness skin graft and enhanced by licking and since saliva contains growth-promoting macromolecules, we have studied the mechanical and humoral aspects of wound healing.
Standardized burn and freeze-produced wounds were produced in rats. Contraction did not occur in wounds caused by freezing (n = 30), while burn wounds (n = 30) contracted to less than one-third of the original size in 3 weeks. If the centres of the freeze-produced wounds (n = 12) were excised, contraction would then occur and proceed at the same rate as open wounds (n = 12). The collagen contents of the burn wounds (n = 24) showed a greater initial loss followed by rapid replacement, while that of the freeze-produced wounds (n = 24) demonstrated a slower removal and more gradual replacement.
Submandibular sialadenectomized mice (n = 34) and sham controls (n = 34) had excision of a standard sized patch of sacral skin. Through a separate abdominal incision polyvinyl sponges of known weight were introduced subcutaneously into all the animals. Mice without the submandibular salivary glands showed a slower rate of wound contraction than the sham controls (P&lt;0.001). However, this delay in wound contraction was abolished if sialadenectomized mice were caged with mice having intact salivary glands. Collagen synthesis as determined by the hydroxyproline concentrations in the polyvinyl sponges were the same in both groups of animals irrespective of cage environment. Further standard sacral wounds in submandibular sialadenectomized mice (n = 120) were treated with different salivary components. Only high molecular weight nerve growth factor was able to accelerate wound contraction in these sialadenectomized animals to control values.
In conclusion, the degree of wound contraction following injury is dependent on the integrity of the matrix, while the initiation of contraction is likely to be chemically induced.
Solitary rectal ulcer syndrome in Northern Ireland, 1971–1980
Authors: Martin C J , Parks T G , Biggart J D 
Published: March 2007

Summary
Fifty-one cases of solitary rectal ulcer syndrome diagnosed over the past 10 years have been studied. The syndrome, of which solitary ulceration was a feature in only 35 per cent of cases, included patients with multiple ‘solitary’ ulcers (22 per cent), broad-based polypoid lesions (25 per cent) and patchy granular hyperaemic rectal mucosa (18 per cent). The syndrome was found to be strongly associated with abnormal rectal descent. Full-thickness prolapse to or beyond the anal verge was present in 59 per cent of patients while a further 32 per cent had lesser degrees of rectal descent. In only 9 per cent was no such abnormality demonstrated. Treatment with high roughage diet supplemented with bulking agents benefited two-thirds of 27 patients so treated. Ivalon sponge rectopexy has been performed in 6 patients with associated complete rectal prolapse, and in the first 3 of these (followed for a sufficient period) the results have been satisfactory.
Early versus delayed cholecystectomy: The effect of a change in management
Authors: Van Der Linden Willem , Edlund Gunnar 
Published: March 2007

Summary
After a controlled trial, conservative treatment followed by delayed operation was replaced by early operation as the treatment of choice for acute cholecystitis. Results before and after this change were compared. The comparison confirmed that early cholecystectomy leads to more rapid recovery and to less time spent in hospital. There was no significant difference between the two procedures in the duration of operation and the incidence of wound infection. Early operation caused fewer biliary fistulas and was accompanied by a lower mortality.
Choledochoduodenostomy in calculous biliary tract disease
Authors: Lygidakis N J 
Published: March 2007

SummaryDuring a 14-year period ending in June 1979, 342 patients with calculous biliary disease underwent choledochoduo-denostomy either as a primary procedure or during reoperation. Eighty per cent of the patients were aged 50 years or more. Follow-up was either by personal interview and physical examination or by means of a questionnaire, 90 per cent of the patients being assessed at periods ranging from 6 months to 14 years. A high incidence of common bile duct dilatation was found in older patients, in patients with a long history and in patients submitted to reoperation. There were no operative deaths. Postoperative complications occurred in 22 cases (6·4 per cent) and, in particular, no patient developed ascending cholangitis or symptoms related to the ‘blind segment’. Choledochoduodenostomy is a valuable and safe procedure and can be used on wide indications, especially where peroperative cholangiography is not available.
Thrombotic risks of staging laparotomy with splenectomy in Hodgkin's disease
Authors: Dawson A A , Bennett B , Jones P F , Munro A 
Published: March 2007

Summary
No significant excess of deep vein thrombosis (DVT) as measured by the 125I-labelled fibrinogen method was observed in patients having staging laparotomy and splenectomy for Hodgkin's disease (HD) compared with patients having elective cholecystectomy under highly standardized surgical conditions. Patients who did have DVT all had splenic involvement with HD. There was no correlation between the post-splenectomy thrombocytosis and the occurrence of DVT. Patients with non-Hodgkin's lymphoma (NHL) and splenomegaly had a high incidence of DVT after splenectomy.
Features of mammographically negative breast tumours
Authors: Cahill C J , Boulter P S , Gibbs N M , Price J L 
Published: March 2007

Summary
Mammography is a highly sensitive and specific technique in the diagnosis of breast cancer, but some tumours show no radiological features of malignancy. A total of 9·3 per cent of 323 consecutive patients with operable breast cancer had negative mammographic reports, and the clinical radiological and pathological findings in these cases are compared with those in the mammographically diagnosed group. Misinterpretation of carcinoma as a benign lesion and diagnostic difficulties in the dense dysplastic breast were found to be the main causes of error.
A double-blind trial of suloctidil v. Placebo in intermittent claudication
Authors: Jones N A G , De Haas H , Zahavi J , Kakkar V V 
Published: March 2007

Abstract
In a recent double-blind trial lasting over 6 months, 40 patients suffering from intermittent claudication were randomly allocated to receive 300 mg of suloctidil per day or exactly matching placebo capsules. In addition to treadmill walking distance, other objective criteria including ankle blood pressure response and muscle blood flow measured by 133Xe clearance were used to assess the effectiveness of therapy.
Nine patients (4 in the suloctidil group and 5 controls) did not complete the trial according to the protocol. Of the remaining 31 patients, 17 were in the control group and 14 received suloctidil. A significant improvement in the absolute walking distance, the level of β-thromboglobulin (βTG) compared to pre-therapy value and the time for the ankle pressure index to return to the pre-exercise value was observed in patients receiving suloctidil.
Stenosis of the common bile duct in chronic pancreatitis
Authors: Wisløff F , Jakobsen J , Osnes M 
Published: March 2007

Abstract
The incidence of common bile duct stenosis in patients with chronic pancreatitis was studied in a consecutive series of patients admitted for endoscopic retrograde cholangiopancreatography (ERCP). Thirty-six out of 79 patients (46 per cent) with moderate or advanced chronic pancreatitis as defined by radiological criteria were found to have a stenosis of the intrapancreatic portion of the common bile duct. There were no age or sex differences between the patients with and without biliary stenosis, but significantly more patients with stenosis had advanced chronic pancreatitis. In about two-thirds of the patients the stenosis was smooth, symmetrical and tapering. In the remaining cases, a shorter stricture of the hour-glass type was found. A complete obstruction was never seen. About one-half of the patients with bile duct stenosis were icteric at the time of the investigation. The jaundice resolved spontaneously in all but 1 patient in 3–42 (median 14) days. Stenosis of the common bile duct is a frequent complication of chronic pancreatitis, but biliary–enteric bypass operation seems to be unnecessary in the great majority of the patients.
The complications of injection sclerotherapy of bleeding oesophageal varices
Authors: Barsoum Maged Sami , Mooro Hisham Abdel-Wahab , Bolous Fathi Iskander , Ramzy Adel Fouad , Rizk-Allah Mounir Azmy , Mahmoud Fikry Ibrahim 
Published: March 2007

Abstract
The complications of injection sclerotherapy were retrospectively studied in 122 patients with acute variceal bleeding. Initial control of bleeding was achieved in 72·5 per cent of patients and the final success rate of sclerotherapy was 86·1 per cent. The overall morbidity rate was 30·3 per cent. Minor complications occurred in 13·9 per cent of patients and major complications were recorded in 16·4 per cent. Twenty patients developed complications directly attributable to sclerotherapy: 14 minor and 6 major. The overall mortality rate was 21·3 per cent, and 7·4 per cent of the patients died due to complications.
Pulmonary complications occurred in 15 patients and resulted in 3 deaths. Retrosternal pain developed in 8 patients, but dysphagia and oesophageal ulceration were rare. No stricture was recorded. The incidence of liver failure in 17 Child's grade C cases was almost certainly a complication of the underlying disease rather than the injection therapy. It is suggested that injection sclerotherapy is an effective and relatively safe treatment for variceal bleeding.
Management of retained cystic duct stones
Authors: Jennings Stephen A , Lusby Robert J , Drife James O , Davidson Colin M 
Published: March 2007

Abstract
A 20-year-old woman underwent cholecystectomy and common bile duct exploration. Seven days later, T-tube cholangiography showed two stones retained in a developmentally anomalous cystic duct stump. She was treated with thrice-daily flushings of large amounts of saline through the T tube, and after 7 days of treatment the biliary system was free of stones. The conditions necessary for successful non-operative management of retained cystic duct stones are discussed.
Resection of the liver with a water jet
Authors: Papachristou Dimitrios N , Barters Richard 
Published: March 2007

Abstract
Intrahepatic dissection in ablative liver surgery can be accomplished easily and safely with a jet of normal saline generated by a standard agricultural electric sprayer. The jet washes away the intrahepatic parenchyma leaving the ducts and vessels undamaged and easily controlled during dissection. The technique, applied in 45 lobectomies in the dog and in 4 liver resections in man, reduced blood loss.
The efficacy of peritoneal lavage at elective abdominal operations
Authors: Ambrose N S , Donovan I A , Derges Sheila , Minervini S , Harding L K 
Published: March 2007

Abstract
Human serum albumin microspheres of 1 μm diameter labelled with technetium-99 m were evaluated as a model for bacteria in two animal species. Peritoneal lavage recovered comparable amounts of an inoculum of microspheres and simultaneously instilled Escherichia coli. A prospective study was undertaken of 38 patients undergoing elective abdominal operations. Three lavages, each of 500 ml normal saline, were used. Over 80 per cent of the saline was recovered in 37 of the 38 patients with a median of 93 per cent. Recovery of microspheres was assessed from above the spleen, from Morison's pouch and from the pouch of Douglas. There was no difference in the recovery rates from the three sites of placement but significantly fewer microspheres were recovered via a right subcostal incision (median 59 per cent) compared with an upper midline incision (median 91 per cent).
Inpatient treatment of prolapsing piles: Cryosurgery versus Milligan–Morgan haemorrhoidectomy
Authors: O'Callaghan James Desmond , Matheson Thomas S , Hall Robert 
Published: March 2007

Abstract
A comparative retrospective study, based on clinical assessment and questionnaire analysis, of 97 patients treated by cryosurgical haemorrhoidectomy and 99 patients treated by Milligan – Morgan haemorrhoidectomy, at 4-year average follow-up, has shown that 70 per cent of patients in each group derived complete and lasting relief from their symptoms. Two patients in each group required further treatment. There was no significant difference between the numbers who remembered severe, moderate or mild pain, or in its duration, although fewer cryosurgical patients required opiates. Postoperative discharge ceased in 70 per cent of patients within 2 weeks. When skin tags remained, they were usually inconsequential. Anal stenosis following cryohaemorrhoidectomy did not occur, and has not been reported. Cryohaemorrhoidectomy gave results equal to Milligan – Morgan haemorrhoidectomy in patients with prolapsing piles, with fewer complications, and has the economic advantages of less time in hospital (P &lt; 0·01) and less time off work (P &lt; 0·01).
Does the type of suture material contribute to the strength of the lateral paramedian incision?
Authors: Donaldson D R , Hall T J , Zoltowski J A , Guillou P J , Brennan T G 
Published: March 2007

Abstract
A prospective randomized trial was carried out on 231 consecutive laparotomies in which the lateral paramedian incision was used in all cases. Closure of the wound was identical except for the anterior rectus sheath where closure was randomized to (a) chromic catgut, (b) polyglycolic acid or (c) polypropylene. Follow-up for 1 year has revealed no wound dehiscences and only one incisional hernia (in the catgut group). We conclude that the lateral paramedian incision is inherently strong, and that this strength is due to splintage of the wound by the rectus abdominis muscle itself and is unrelated to the type of suture material used.
Aorto-iliac reconstructions for intermittent claudication
Authors: King R Barry , Myers Kenneth A , Scott David F , Devine Terence J 
Published: March 2007

Abstract
Over a 12-year period, 290 aortofemoral reconstructions were performed for intermittent claudication involving 449 legs in 262 patients. The accumulative patency rate in surviving patients was 79 per cent at 5 years. The patency rate was significantly better in patients who stopped smoking after operation, and in men compared with women. Dacron grafts were significantly more successful than endarterectomy in men. If there was no associated superficial femoral artery occlusion, endarterectomy and Dacron bypass grafts were equally successful, but Dacron bypass grafts were significantly superior to endarterectomy if the superficial femoral artery was severely stenosed or occluded.
The success rates for improving the patients' intermittent claudication were 90 per cent at 3 months and 72 per cent at 3 years. The success rate at 3 years was 80 per cent if the superficial femoral artery was patent but only 62 per cent if the superficial femoral artery was severely stenosed or occluded. Mortality and morbidity rates fell markedly in the last 6 years of the study.
Diagnosis of granulomatous starch peritonitis by delayed hypersensitivity skin reactions
Authors: Grant J B F , Davies J D , Espiner H J , Eltringham W K 
Published: March 2007

Abstract
Intradermal skin tests were performed on 6 patients with histologically proved granulomatous starch peritonitis and on 15 control subjects. All patients with starch peritonitis developed an erythematous reaction at least 5 mm wide between 3 and 8 days after inoculation. Such a skin reaction was not seen at that time in any of the control subjects. The microscopic changes seen in the positive reactions were dense mononuclear perivascular exudates with organized giant cell or epithelioid cell granulomas in 4 patients and loose histiocytic aggregations in a fifth patient. This evidence of cutaneous delayed hypersensitivity suggests that an immunological response underlies granulomatous starch peritonitis and that intradermal skin tests are of value in its diagnosis.
Nerve growth factor potentiates stress-induced gastric ulceration
Authors: Li Arthur K C , Jo Koroly Mary , Jeppsson B W , Schattenkerk M E , Young Michael , Malt Ronald A 
Published: March 2007

Abstract
Increased salivary flow stimulated by intravenous isoproterenol (IPR) (6 mg/kg) doubled the incidence of gastric stress ulceration in normal male mice, but not after submandibular sialadenectomy. The submandibular salivary glands in these mice secrete large amounts of several growth factors, including epidermal growth factor (EGF) and nerve growth factor (NGF). Intragastric instillation of a quantity of high molecular weight NGF equimolar to that in IPR-stimulated saliva doubled the incidence of stress ulcers after submandibular sialadenectomy. This action of NGF in vivo is not mediated by its nerve growth promoting properties nor its plasminogen activating property.
Biliary-type pain as a manifestation of genital tract infection: The Curtis–Fitz-Hugh syndrome
Authors: Wood J J , Bolton J P , Cannon S R , Allan A , O'Connor B H , Darougar S 
Published: March 2007

Abstract
Ten patients with biliary-type pain, in whom investigations of the biliary tract were negative, are reported. All the patients were sexually active premenopausal women and all had evidence of infection with Chlamydia trachomatis. Five patients submitted to laparoscopy had fibrinous adhesions between the anterior surface of the liver and the parietal peritoneum (perihepatitis). All 10 patients were diagnosed as suffering from the Curtis—Fitz-Hugh syndrome caused by Chlamydia trachomatis. The clinical similarities between the Curtis—Fitz-Hugh syndrome (right upper quadrant abdominal pain, perihepatitis and genital tract infection) and acute biliary disease are emphasized and the diagnostic implications discussed.
Is an early ultrasound scan of value in acute pancreatitis?
Authors: McKay A J , Imrie C W , O'Neill J , Duncan J G 
Published: March 2007

Abstract
Grey scale ultrasound scanning has been performed within 1 week of admission in 114 patients with acute pancreatitis in order to establish its reliability in detecting gallstones and to document early pancreatic changes. When the gallbladder was identified (69·4 per cent of patients), grey scale ultrasound was 96·1 per cent accurate in predicting the presence of gallstones. Of 85 patients (74·5 per cent), in whom adequate pancreatic imaging was achieved on the initial scan, 35 were reported within normal limits, 28 had generalized pancreatic swelling and 22 a localized pancreatic mass of cystic collection. These ultrasound findings did not correlate significantly with the objective assessment of severity of disease. However, all 9 patients (8·1 per cent) who developed a pseudocyst were in the group shown to have early localized pancreatic swelling.
Grey scale ultrasound is a useful method of detecting gallstones in patients with acute pancreatitis, thus permitting early accurate biliary surgery. However, in almost one-third of our patients ultrasound failed to outline the gallbladder on the initial scan. While ultrasound scanning of the pancreas will detect the formation of pseudocysts and accurately chart their subsequent progress, we doubt whether an early scan is required to achieve this purpose. Although generalized pancreatic swelling is frequently reported, this finding was of no major clinical importance and did not relate to the severity of disease.
An assessment of dynamic gastric scanning with 99Tcm-pertechnetate
Authors: Keane F B , O'Connor M , Stephens R B , Freyne P J , Hennessy T P J 
Published: March 2007

Abstract
Following intravenous injection, technetium-99m (99Tcm) is selectively taken up by the stomach, and this uptake, which is stimulated by pentagastrin, may be quantified using a gamma camera. Using this property of 99Tcm as a means of assessing gastric function, we found that the mean rate of 99Tcm uptake was significantly greater in 24 duodenal ulcer patients than in 10 healthy controls (P&lt;0·01). Scanning values did not correlate with BAO or MAO which were measured on a separate day. Both vagotomy (n = 10) and cimetidine infusion (n = 5) significantly reduced the rate of uptake of 99Tcm (P&lt;0·01). Thus, although 99Tcm reflects a function of the stomach which is similar to acid secretion, scanning did not give a good estimate of acid secretion in this group of subjects.
A prospective study of the effect of haemorrhoidectomy on sphincter function and faecal continence
Authors: Read M G , Read N W , Haynes W G , Donnelly T C , Johnson A G 
Published: March 2007

Abstract
The effect of haemorrhoidectomy on anal sphincter manometry and continence to faeces and rectally infused saline was investigated in 24 unselected patients with third-degree haemorrhoids. Haemorrhoidectomy resulted in the abolition of ultra-slow waves and significant decreases in basal and squeeze pressures, though these were reduced to normal values from abnormally high levels. Pressures remained at normal levels up to a year after surgery. An association was found between mucous soiling following surgery and an abnormally low postoperative squeeze pressure. There was no alteration in the function of the recto-anal inhibitory reflex following surgery. Only two patients developed incontinence to rectally infused saline for the first time following surgery. The addition of four-finger dilatation of the anal canal to the operative procedure did not cause any significant differences in sphincter manometry.
Resection of lung metastases in large bowel cancer
Authors: Hughes E S R , McConchie I H , McDermott F T , Johnson W R , Price A B 
Published: March 2007

Abstract
A series of 14 patients had partial or, in one case, total excision of the lung for metastatic tumour originating in the large bowel. Two patients have survived long periods (9 years and 12 years) and are now apparently free of the disease. A third patient shows no recurrence after bilateral lobectomy 2 years ago. Six of the remaining 11 patients developed isolated pulmonary metastases 5 years and 4 months to 11 years and 4 months after the original bowel resection. All 6 survived for 9 months to 11 years after pulmonary resection before succumbing to the disease. In all 11 patients who died, death was caused by systemic metastases in the brain, spinal cord or bone.