bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction and prophylaxis of postoperative thromboembolis—a comparison between peroperative calf muscle stimulation with groups of impulses and dextran 40
Authors: Lindström B , Holmdahl C , Jonsson O , Korsan-Bengtsen K , Lindberg S , Petrusson B , Pettersson S , Wikstrand J , Wojciechowski J 
Published: March 2007

Abstract
The effects of peroperative electrical calf muscle stimulation with groups of impulses giving a short lasting tetanus of the calf muscles on postoperative deep venous thrombosis (DVT) and pulmonary embolism (PE) were compared with that of dextran 40 given perand postoperatively. The incidence of DVT and PE during the first 4–6 postoperative days was recorded. The diagnosis of DVT was based on the 125I-fibrinogen uptake test and phlebography and of PE on pre- and postoperative perfusion pulmonary scintigram and chest X-ray examination. Both methods reduced the incidence of PE. Calf muscle stimulation reduced the DVT incidence in patients with malignant disease while the reduction in DVT incidence for the whole group only was significant in the stimulation as well as the dextran 40 group.
Mean values for preoperatively determined levels of antithrombin III, beta-thromboglobulin, fibrinopeptide A, plasminogen and ability to release fibrinolytic activity during venous stasis did not differ between those patients who developed or those who did not develop postoperative DVT or PE. However, antithrombin III levels below 80 per cent appeared to predispose to postoperative thromboembolism. The two prophylactic methods have similar effects on the incidence of postoperative thromboembolism. The stimulation method has certain advantages due to its safety and simplicity.
The clinical significance of gastric acid secretion in bilharzial hepatic fibrosis
Authors: El Masri S H , Okosdonossian E T , Boulos P B 
Published: March 2007

Abstract
Gastric acid secretion was studied in 19 patients with bilharzial hepatic fibrosis and in 19 healthy controls. The patients had significantly lower volumes and acid output than the control group. After splenectomy and vasoligation, the patients' gastric secretion did not increase significantly. Gastric secretion was similar in 19 patients with bilharzial hepatic fibrosis who had never experienced any episode of bleeding and in 19 who bled.
Non-specific stimulation of host defenses against a bacterial challenge in malnourished hosts
Authors: Galland R B , Polk H C 
Published: March 2007

Abstract
We have studied the effects of non-specific enhancement of host defenses in malnourished mice using muramyl dipeptide (MDP). The challenge, consisting of a bacteria laden suture, simulates a surgical wound infection. Adult mice were subjected either to a 48-h period of acute starvation or to a 2 week period of protein deprivation. In each type of malnutrition, mice treated with MDP 24 h before the bacterial challenge had statistically lower local and systemic bacterial recovery, with a corresponding improvement in short term survival, than did untreated controls. MDP enhances local bacterial containment, thereby substantially reversing the detrimental effects of malnutrition on host defenses.
Manchester regional breast study—5 and 10 year results
Authors: Lythgoe J P , Palmer M K 
Published: March 2007

Abstract
Patients with early breast cancer (n - 1022) were treated between March 1970 and October 1975 in a prospective clinical trial. The results are presented after follow-up of 5–10 years. Clinical stage I cancer cases (n = 714) were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy, or simple mastectomy alone. There was no statistically significant difference in overall survival between the two groups. There was a significant reduction in the frequency of local recurrence in those who received early postoperative radiotherapy compared with those who did not. Clinical stage II cancer cases (n = 308) were randomly allocated to treatment by simple mastectomy and postoperative radiotherapy or radical mastectomy alone. There was no statistically significant difference in survival or in the frequency of local recurrence between the two groups.
Urinary pseudouridine/creatinine ratio as an indicator of gastrointestinal cancer
Authors: Higley B , De Mello J , Oakes D Jane , Giles G R 
Published: March 2007

Abstract
Urinary pseudouridine/creatinine ratio was determined in 74 patients with gastrointestinal tumours and 34 patients with no known malignant disease. The reproducibility of a single random urine sample was demonstrated. The mean ratio for control patients was 26·9 ± 7·7 nmol/μmol and no control patient exceeded the mean by 2 standard deviations. There was no difference in the ratio between the sexes. Sixty-five per cent of colon cancer patients and 37·5 per cent of gastric and rectal cancer patients exceeded this upper limit of normality. There was no correlation between pseudouridine/creatinine ratio and histological differentiation, liver involvement or stage in either colorectal or gastric cancer patients. Urinary pseudouridine/creatinine ratio is one of the better non-specific cancer markers and may be particularly useful for detecting colonic cancer.
The fluid of choice for resuscitation of severe shock
Authors: Smith J A R , Norman J N 
Published: March 2007

Abstract
The choice of fluid for resuscitation in severe shock remains controversial. The various solutions commercially available have been compared in a standardized canine refractory shock model. The use of colloidal solutions proved preferable to the use of crystalloid solutions alone, as judged by oxygen debt, the volume required and the evidence of pulmonary overload. The three colloidal solutions studied, namely dextran 70, hydroxyethyl starch and Haemaccel (polygeline), produced very similar results. The clinical absence of reported serious side effects would suggest that Haemaccel is likely to be the colloidal fluid of choice. However, in the model studied, the use of a mixture of crystalloid and colloid produced results that were significantly better than either crystalloid or colloid alone. It is concluded that much of the controversy between crystalloid and colloid is artificial and that a mixture of these substances will be required in the resuscitation of the severely shocked patient.
Acute gallstone pancreatitis: Best timing for biliary surgery
Authors: Tondelli P , Stutz K , Harder F , Schuppisser J-P , Allgöwer M 
Published: March 2007

Abstract
The timing of biliary surgery in patients who have pancreatitis secondary to cholelithiasis is debatable. Of 523 patients admitted for acute pancreatitis between 1969 and 1978, 114 had gallstones for which an operation was performed. Immediate surgery was undertaken in 16 patients, early and late operation respectively in 98 patients. Complications occurred in 12 of the 114 patients and 7 patients died. Significantly more deaths occurred in the group who had an immediate operation (n = 5). In the group who had an operation more than 7 days after the amylase returned to normal, recurrent pancreatitis developed in 5 patients, 1 of whom died. It is concluded that immediate operation does increase mortality, and so may delay longer than 7 days after the amylase returns to normal.
The value of intensive follow-up after curative resection for colorectal carcinoma
Authors: Törnqvist A , Ekelund G , Leandoer L 
Published: March 2007

Abstract
A previous study undertaken by this department showed follow-up to be of little value in tracing curable recurrences in patients with colorectal cancer who had curative operations. The aim of the present investigation was to determine if more intensified follow-up would result in earlier diagnosis of recurrences and thus lead to earlier and more effective treatment. Altogether 599 patients with colorectal cancer were treated between 1973 and 1977. The 363 (61 per cent) patients who were operated upon for cure entered the study and were followed up until December 1979.
The same incidence of recurrence was seen in both series, but, with the more detailed protocol, they were more frequently detected before symptoms developed. However, the rate of curative reoperation for recurrence was not changed and only few patients survived after such reoperations. The conclusion is that the previous protocol is as efficient as the detailed one while no effective treatment of disseminated disease exists.
The aetiology of scrotal sepsis
Authors: Whitehead S M , Leach R D , Eykyn S J , Phillips I 
Published: March 2007

Abstract
The clinical findings and bacteriology of 30 abscesses of the scrotum are described. Anaerobic organisms were found in 27 abscesses (90 per cent), and in 3 cases in which they were not, the patients were receiving metronidazole at the time of drainage. Multiple anaerobic species were isolated, predominantly those found as commensals in the oropharynx and genital tract. ‘Gut specific’ Bacteroides spp. were very uncommon and were found only in patients with necrotizing fasciitis. It is suggested that the severity of some infections, particularly after scrotal surgery, is associated with thrombosis of the scrotal vessels.
The measured effect of stopping smoking on intermittent claudication
Authors: Quick C R G , Cotton L T 
Published: March 2007

Abstract
One hundred and twenty-four limbs in patients suffering from intermittent claudication were studied over 10 months. Changes in ankle pressure and treadmill exercise tolerance over the period were compared between two groups, one of patients who continued to smoke (group 1) and the other of those who gave up (group 2).
Resting ankle systolic pressure fell in smokers' limbs by a mean of 10·2 mmHg (t = 3·56, P &lt; 0·001), and rose in those patients who stopped smoking by a mean 8·7 mmHg (P - n.s.). Ankle pressures after exercise and maximum treadmill walking distance did not change in smokers but significantly improved in past smokers.
Stopping cigarette smoking increased the chance of improvement in ankle pressure and exercise tolerance in intermittent claudication.
Platelet accumulation on mature Dacron grafts in man
Authors: Goldman M , Norcott H C , Hawker R J , Drolc Z , McCollum C N 
Published: March 2007

Abstract
Prosthetic graft occlusion is most frequent in the early postoperative period when the luminal surface is highly thrombogenic. It is generally believed that graft maturation ultimately results in a non-thrombogenic surface. The accumulation of 111-indium-labelled autologous platelets in Dacron aortofemoral grafts has been measured 1 week following surgery and at intervals of 6 months to 1 year.
Platelets from 9 patients were labelled with 111-indium oxine and re-injected. Isotope emissions over the graft and a reference site (aortic arch) were measured daily for 8 days and gamma camera images taken on alternate days. Graft thrombogenicity was calculated as the daily rise in the graft: reference ratio of emissions.
All grafts, regardless of age, accumulated platelets and were imaged by gamma camera. Mean thrombogenicity (± s.e.mean) 1 week after surgery was 0·21 ± 0·04 compared with 0·08 ± 0·03 at follow-up (P &lt; 0·01). The platelet survival during the early study was reduced at 6·8 ± 0·6 days but recovered to a value of 8·6 ± 0·8 days (P &lt; 0·01) at follow-up. Further grafts, 2, 5 and 9 years old, were studied and all accumulated platelets, especially near the anastomoses.
Platelet accumulation on Dacron grafts does diminish with time but persists beyond the period of altered platelet survival and perhaps indefinitely.
Operative therapy of renovascular hypertension
Authors: Stanley J C , Whitehouse W M , Graham L M , Cronenwett J L , Zelenock G B , Lindenauer S M 
Published: March 2007

Abstract
Three hundred and thirteen patients exhibiting renal artery occlusive disease underwent operation for renovascular hypertension. These included 34 paediatric and 144 adult patients with fibrodysplastic disease. Atherosclerotic lesions affected an additional 64 patients without and 71 patients with clinically overt extrarenal arteriosclerotic cardiovascular disease. Ischaemic kidney renin hypersecretion (renal: systemic renin index &gt; 0·48), associated with suppressed contralateral kidney renin secretion (renal: systemic renin index approaching 0·0), predicted curability most reliably. Four hundred and fifteen operations were performed of which 356 were primary and 59 were secondary procedures. Aortorenal bypass using autogenous vein (227 cases) or prosthetic grafts (62 cases) was the most common primary operation. Nephrectomy was the initial therapy in 17 cases. Six operative deaths occurred in patients manifesting overt extrarenal arteriosclerotic disease. No operative mortality was encountered among the remaining 242 patients. Improvement was seen following operation in 97 per cent of paediatric patients and 94 per cent of adults with fibrodysplastic disease, in 91 per cent of patients with focal renal arteriosclerosis and in 72 per cent of those exhibiting overt extrarenal arteriosclerosis.
Experimental vein grafts in the rat: Re-endothelialization and permeability to albumin
Authors: Dilley R J , McGeachie J K , Prendergast F J 
Published: March 2007

Abstract
Intimal thickening in vein grafts is one of the major factors leading to graft failure. Studies have suggested that delayed re-endothelialization and an enhanced permeability to proliferative factors (macromolecules) in the blood are associated with the development of intimal thickening in these vessels. The aim of this study was to determine the pattern of re-endothelialization of vein grafts and the permeability of the new endothelium to a large molecule. Iliolumbar vein to iliac artery grafts 5 mm long were inserted microsurgically into 32 male albino Wistar rats. Graft re-endothelialization and permeability, at times ranging from 2 to 140 days after grafting, were studied by scanning electron microscopy and vital staining with Evans Blue dye, which binds to plasma albumin and was used as a model of a large molecule. Re-endothelialization of the graft had commenced by 2 days after grafting and in most animals was completed by 15 days. Some grafts exhibited local areas devoid of endothelium up to 4 weeks after grafting. The mechanism of re-endothelialization involved the migration of a sheet of endothelium across the anastomosis from the adjacent artery. This sheet subsequently linked up with islands of cells which developed in the centre of the graft by 5 days. Evans Blue dye was detected in all areas where endothelium had been removed by the grafting operation. Permeability of the graft to the dye was seen during the 2–4 week period after grafting, a time at which previous studies have shown that intimal thickening develops in this vein grafting model. Thus, delayed re-endothelialization and prolonged permeability to a large molecule (albumin) does occur in some experimental vein grafts. This may be the basis for intimal thickening which is known to occur in vein grafts.
Venous thrombosis after elective hip replacement—the influence of preventive intermittent calf compression and of surgical technique
Authors: Gallus A , Raman K , Darby T 
Published: March 2007

Abstract
The effect of preventive intermittent calf compression on the incidence, distribution and extent of venous thrombosis after elective hip replacement was examined by randomized trial in 90 patients who were screened for postoperative thrombosis with 125I-fibrinogen leg scanning and impedance plethysmography, followed by routine venography on the seventh postoperative day. Venography showed that leg compression reduced the incidence of calf vein thrombosis from 45 per cent (21/47) in untreated patients to 16 per cent (7/43) (P &lt; 0·005), but not that of proximal (i.e. popliteal or femoral) vein thrombosis, which occurred in 23 per cent of treated and 26 per cent of untreated patients. However, proximal vein thrombosis appeared to be less extensive in treated patients. Proximal vein thrombosis was found in 40 per cent of patients who had hip replacement by a modified Charnley technique (17/43 patients), and 9 per cent of patients in whom a posterior surgical approach was used (4/43 patients) (P &lt; 0·005), strongly suggesting that surgical technique may influence the proximal vein thrombosis rate after elective hip replacement.
Intestinal adaptation after jejunoileal bypass for morbid obesity: A possible explanation for inadequate weight loss
Authors: Miskowiak J , Andersen B 
Published: March 2007

Abstract
Thirty-two patients required further abdominal operations 6–77 months after jejunoileal bypass for morbid obesity. Twenty operations were needed because of inadequate weight loss, while the remaining 12 patients had lost sufficient weight but had developed complications. In all 32 patients the lengths of functioning jejunum and ileum were measured and compared with those recorded during the original operation; elongation had occurred in 29. There was a striking difference between the median increase in jejunoileal length of 44 per cent when weight loss was inadequate and 7 per cent when weight loss was adequate (P &lt; 0·01). Similarly, intestinal circumference and mural thickness were greater in the first group. There appears to be a relationship between intestinal adaptation and the extent of weight loss after jejunoileal bypass.
The effect of sepsis on the oxidation of carbohydrate and fat
Authors: Stoner H B , Little R A , Frayn K N , Elebute A E , Tresadern J , Gross E 
Published: March 2007

Abstract
Oxidative metabolism has been studied by indirect calorimetry in 27 patients with sepsis and in 7 non-septic patients while they were all receiving total parenteral nutrition. Glucose oxidation was reduced in the septic patients and fat oxidation continued despite the infusion of an excess of glucose. The extent of these changes depended on the severity of the septic state as measured by the scoring system described in the preceding paper. The mechanism of these changes is not known. They were not related to an elevation of the plasma non-esterified fatty acid concentration. Alterations must have occurred in the way fat was taken up and metabolized by the cells. Here insulin resistance and the highly significant positive relationship found between the plasma cortisol concentration and the sepsis score might be important.
Total parenteral nutrition as the sole therapy in Crohn's disease—a prospective study
Authors: Müller J M , Keller H W , Erasmi Heide , Pichlmaier H 
Published: March 2007

Abstract
The effect of total parenteral nutrition (TPN) as sole therapy was studied in 30 consecutive cases of complicated Crohn's disease. After insertion of a Broviac-type central venous catheter patients were nourished parenterally for 3 weeks in the hospital and then for an additional 9 weeks at home. During this time no medication or oral intake was allowed. Surgery was avoided in 25 patients by TPN. These patients returned to work, ate normal meals and needed no medical support. In 5 cases it was not possible to control the acute disease and the patients were treated by resection. During TPN, catheter-related sepsis occurred in 3 patients (0·9 cases/1000 days TPN) and catheter embolism in 2. Four other patients developed intrahepatic cholestasis. A relapse of Crohn's disease was observed in 17 cases 3–48 months after the course of TPN. The cumulative recurrence rate is 60 per cent after 2 years and 85 per cent after 4 years. Compared with the results of resection, obtained from a 10-year period before TPN was instituted at our hospital, the cumulative recurrence rate after TPN is four times higher. It is concluded that TPN is not an alternative to resection in the treatment of Crohn's disease and should be reserved for patients with multifocal lesions, when surgery is not advisable because of the risk of a short bowel syndrome.
Colonoscopic polypectomy in a regional teaching hospital
Authors: Minopoulos G J , McIntyre R L E , Lee E C G , Kettlewell M G W 
Published: March 2007

Abstract
Five hundred and thirty-five polyps were found in 200 patients over 6 years at a regional teaching hospital. Eighty-five per cent of the patients were from the hospital area yet the presentation of the patients, the complications of polypectomy, the size, distribution and histological features of the polyps were similar to large series reported from metropolitan specialist centres of referral both in this country and the USA. However, a smaller proportion of our polyps were over 1 cm diameter. Between 25 and 53 per cent of patients had recurrent or residual polyps on the second and third colonoscopy. Patients with two or more polyps at the first endoscopy were significantly more likely (P &lt; 0·01) to have further polyps at follow-up. We therefore recommend that patients with colonic polyps are colonoscoped annually until free from polyps for 2 years, before being placed on colonoscopic review at 5-year intervals.
Trial of maximal anal dilatation, cryotherapy and elastic band ligation as alternatives to haemorrhoidectomy in the treatment of large prolapsing haemorroids
Authors: Lewis A A M , Rogers H S , Leighton Monica 
Published: March 2007

Abstract
A selected group of 112 patients with prolapsing haemorrhoids which had failed to respond to injections of phenol in oil or which required manual replacement after defecation, were randomly allocated treatment by haemorrhoidectomy, maximal anal dilation, elastic band ligation or cryotherapy. When results were assessed 5 weeks after treatment, haemorrhoidectomy and maximal anal dilatation were equally effective in reducing symptoms, although more physical signs remained after maximal anal dilatation; cryotherapy and elastic band ligation were less effective in both respects. When patients were followed up between 6 months and 5 years haemorrhoidectomy was found to be the most effective method. Patients in the other three groups developed recurrent symptoms requiring haemorrhoidectomy.
Gastric emptying after intestinal resection in Crohn's disease
Authors: Dew M J , Harries A D , Rhodes M , Rhodes J , Leach K G 
Published: March 2007

Abstract
Gastric emptying, using a liquid meal labelled with 99Tcm DTPA was studied in 6 patients with Crohn's disease who had diarrhoea following resection of the small intestine. Results were compared with those obtained in 6 normal subjects and 6 patients who had classic dumping symptoms following gastric surgery. The rate of gastric emptying of patients with Crohn's disease was similar to that of normal subjects, and differed markedly from gastric emptying in patients with the dumping syndrome (P &lt; 0.001). Diarrhoea in patients with Crohn's disease who have undergone intestinal resection is not due to rapid gastric emptying and would therefore be unlikely to respond to therapeutic measures designed to improve similar symptoms in patients who have the dumping syndrome.
Tumoral calcinosis
Authors: Knowles S A S , Declerck G , Anthony P P 
Published: March 2007

Abstract
Tumoral calcinosis is an uncommon, usually solitary, tumour-like mass characterized by soft tissue calcification for no apparent reason. Nearly all cases have occurred in negroes, including 2 previously recorded in this country. We report 7 cases seen over a period of 3 years in English caucasian patients and suggest that the condition is not rare but goes unrecognized under a variety of guises. Three of these 7 patients, 2 of whom were on haemodialysis for renal failure, had isolated hyperphosphataemia, which is the only aetiological factor detected so far. Surgical excision appears to be the only effective treatment.