bluuebunny/crossref_metadata_2025_split huggingface dataset:
An assessment of anorectal motility in the management of adult megacolon
Authors: Taylor I , Hammond P , Darby C 
Published: March 2007

Summary
Anorectal motility measurements have been performed on 19 patients with adult megacolon and the results compared with 12 normal subjects. Adult Hirschsprung's disease (4 patients) was recognized by the absence of anal canal inhibition on rectal distension (normal mean inhibition 21·9 ± 2·3 mmHg).
Seven patients with non-Hirschsprung's megacolon (idiopathic) had an elevated anal canal pressure (mean 90·4 ± 7·0 mmHg). These patients were treated with repeated anal dilatation. Eight further patients had normal anal canal pressures (mean 33·2 ± 11·7 mmHg) and were treated with enemas and regular suppositories. Little overall clinical improvement resulted in this group and 1 patient underwent subtotal colectomy.
Measurements of anorectal motility have been found to assist in the management of adult megacolon.
An improved method for primary repair after spontaneous oesophageal perforation
Authors: Westaby S 
Published: March 2007

Summary
Spontaneous perforation of the oesophagus is a rare but lethal condition requiring prompt surgical repair. Diagnosis is often delayed and this may lead to considerable morbidity or mortality. This report describes primary repair of the tear using a diaphragmatic pedicle graft and emphasizes the need for detailed pre- and postoperative care.
Cystic adventitial disease of the popliteal artery
Authors: Hunt Bernard P , Harrington Mary G , Goode John J , Galloway John M D 
Published: March 2007

Summary
A 62-year-old man with intermittent claudication but normal foot pulses at rest had no altheroma shown on femoral arteriography. There was evidence of external compression of the artery at the level of a popliteal cyst which was demonstrated by arthrography on films taken after sufficient exercise to be in communication with the knee joint.
At operation the cyst was continuous with changes of cystic adventitial disease of the popliteal artery. Both the main cyst and the cystic changes in the artery were removed. Postoperatively the patient's claudication disappeared.
Evidence is presented that synovial cysts play a part in the production of arterial cystic adventitial disease.
Loop ileostomy for protection of the newly constructed ileostomy reservoir
Authors: Hultén Leif , Fasth Stig 
Published: March 2007

Summary
Sixteen patients submitted to reservoir ileostomy were at the same time given a proximal loop ileostomy to defunction the reservoir for 2–3 months. All made smooth recoveries in the immediate postoperative period both before and after the closure of the loop ileostomy. During follow-up of at least 12 months the function of the reservoir ileostomy has been excellent except in one patient who developed dysfunction of the nipple valve requiring reoperation. On the basis of this experience, it is suggested that a temporary defunctioning loop ileostomy is a wise precaution in connection with reservoir ileostomy, which may lessen the incidence of complications and reduce the risks of later valve extrusion.
Arteriovenous fistula following lumbar disc surgery
Authors: May A R L , Brewster D C , Darling R C , Browse N L 
Published: March 2007

Summary
Injury to the aorta, vena cava and iliac vessels is a recognized hazard of lumbar disc surgery (1–4). Haemorrhage may be manifest at the time, or postoperatively false aneurysm or arteriovenous fistula occurs. Four cases of arteriovenous fistula, 2 with associated false aneurysm, are described. Presentation varied between immediately postoperatively and 8 years later. In none of these was injury suspected at the time of surgery.
Blood viscosity, Raynaud's phenomenon and the effect of fibrinolytic enhancement
Authors: Ayres M L , Jarrett P E M , Browse N L 
Published: March 2007

Summary
The whole blood and corrected blood viscosity of 17 patients with Raynaud's phenomenon (8 with idiopathic Raynaud's phenomenon and 9 with sclerodermaassociated Raynaud's phenomenon) have been compared with 12 normal controls. Viscosity has been measured with a Contraves LSV1 rotating viscometer and the Wells—Brookfield microviscometer at 37°C and 25°C and shear rates ranging from 0.775 s−1 to 230 s−1. Blood viscosity was higher at both the lower temperature and the lower shear rates but this change was the same in the patients as in the normal subjects.
There was a significantly higher level of plasma fibrinogen in the patients with scleroderma with a significant increase in the corrected blood viscosity, but not the whole blood viscosity, at both temperatures and all shear rates. The percentage increase of viscosity at low temperatures in the patients was the same as the controls.
No evidence was found to substantiate the hypothesis that Raynaud's phenomenon is caused by an excessive increase of blood viscosity at low temperatures.
Treatment of 10 patients with stanozolol, a stimulator of fibrinolysis, reduced the plasma fibrinogen and increased the haematocrit but did not change the whole blood viscosity. Hand blood flow increased. The improvement of hand blood flow was not therefore caused by change in blood viscosity secondary to the reduction of plasma fibrinogen.
Alanine metabolism in patients with chronic infection
Authors: Royle G T , Kettlewell M G W 
Published: March 2007

Summary
Alanine metabolism was studied in surgical patients with chronic infection and non-infected control subjects by means of an intravenous infusion of alanine. Septic patients had low basal blood concentrations of alanine compared with control subjects but alanine half-life was similar in both groups. This suggests that low basal alanine concentration in the septic patients was due to decreased release from muscle rather than increased hepatic uptake. Alanine infusion in septic patients caused a fall in the blood concentration of ketone bodies which was initially raised. Similar increases in blood concentrations of glucose, lactate, pyruvate and insulin occurred in both septic and control patients after alanine infusion. Hyperketonaemia may limit muscle breakdown and alanine release in patients with chronic infection.
Duplications of the alimentary tract
Authors: Hocking M , Young D G 
Published: March 2007

AbstractA review of 53 patients with 60 duplications of the alimentary tract treated at the Royal Hospital for Sick Children, Glasgow, from 1947 to 1978 has been made. This consisted of 19 foregut, 32 midgut and 9 hindgut duplications. The experience with these patients has been recorded and discussed with reference to the literature.
Emergency surgery for acute colonic haemorrhage—A retrospective study
Authors: Eaton A C 
Published: March 2007

Abstract
This paper reports a retrospective study of 28 patients undergoing emergency laparotomy and colonic resection for acute colonic haemorrhage out of a total of 292 patients admitted with the condition. The paper concludes that in those cases where the bleeding site cannot be accurately localized angiographically prior to laparotomy, the preferred surgical procedure should be total abdominal colectomy with ileoproctostomy as more limited colonic resection leads to an unacceptably high morbidity and mortality.
The management of acute sigmoid volvulus
Authors: Anderson J R , Lee D 
Published: March 2007

Abstract
One hundred and thirty-four patients with acute sigmoid volvulus are analysed. When the diagnosis is made preoperatively, decompression per rectum is effective in 85 per cent of cases, and should be the initial treatment of choice unless gangrene of the bowel is suspected. In this situation emergency laparotomy should be performed and where gangrenous bowel is confirmed a Hartmann resection appears to be associated with a low mortality and least complications. When the sigmoid loop is found to be viable, it should still be resected. The merits and pitfalls of various procedures in this situation are discussed.
Endometriosis of the appendix
Authors: Langman J , Rowland R , Vernon-Roberts B 
Published: March 2007

Abstract
The clinical and pathological features of 6 cases of appendiceal endometriosis are reported. The appendix alone was involved in 3. The findings have been compared with previously reported cases. One of the largest deposits caused intussusception but otherwise the microscopic size of deposits did not correlate with symptomatology. The diagnosis may be suspected when the abdominal pain does not shift from the peri-umbilical region to the right iliac fossa in the manner of classic appendicitis and when the symptoms begin during or are exacerbated by menstruation.
A modified circular stapler for gastrointestinal anastomosis
Authors: Papachristou Dimitri N , Fortner Joseph G 
Published: March 2007

Abstract
A circular stapler, which avoids the use of a purse-string suture, is described. The gut to be anastomosed is kept in position by a series of hooks. To avoid anastomotic bleeding two rows of B-shaped staples are inserted. The instrument is loaded manually with individual staples to reduce the cost. Experience with oesophageal anastomoses in 40 dogs showed that bleeding did not occur from the suture line and that there was only one leak from the anastomosis. Late stricture formation occurred in 1 dog.
Splenic abscess diagnosed with the aid of abdominal computerized tomography: Report of 2 cases
Authors: Baruch Y , Levy Y , Brook J G , Kleinhaus U , Hashmonai M 
Published: March 2007

Abstract
Two patients with splenic abscess successfully diagnosed and treated are described. The first case, a diabetic, developed a pyogenic abscess caused by klebsiella, while the other suffered a splenic infarct complicated by splenic abscess. Although relatively easy to treat, solitary abscess of the spleen is a potentially lethal condition due to diagnostic difficulties. In both present instances the final diagnosis was easily achieved before surgery by the aid of computerized tomography (CT). This investigation seems to be more accurate than 99Tcm-sulphur colloid scan and ultrasound scan, which failed in both cases to diagnose splenic abscess clearly. The use of this investigation is suggested in every suspected case and will, no doubt, confirm the diagnosis at an early stage of the disease. Splenectomy with antibiotic cover will usually result in cure.
Expanded polytetrafluoroethylene grafts for severe lower limb ischaemia
Authors: Kidson I G , Stoney D W , Tibbs D J , Morris P J 
Published: March 2007

Abstract
Three years' experience with the use of expanded polytetrafluoroethylene grafts for severe lower extremity ischaemia are reported; 44 femoropopliteal bypasses were performed, 35 for limb salvage. The prosthesis was used when no saphenous vein was available (23) or to shorten operation time in infirm patients (21). Of 41 patients with a mean age of 70 years,19 had significant ischaemic heart disease and 10 were diabetic.
The mean follow-up period for patent grafts is now 16 months (4–39 months), and the overall life-table cumulative patency is 59 per cent at 6 months, 52 per cent at 1 year and 40 per cent at 2 years. No correlation wasdemonstrated between patency and run-off, diabetes or smoking, but above-knee grafts may do better than those below the knee. Twenty grafts have occluded leading to 12 amputations, 3 further reconstructions and 1 death. Nine other deaths have occurred from causes not directly related to the lower limb ischaemia, 4 perioperatively and 5 later.
The grafts described were used in elderly unfit patients, most of whom would have had amputations before the introduction of polytetrafluoroethylene grafts. The results presented support the continued evaluation of this prosthesis in suchselected cases.
Retroperitoneal fibrosis—an association with hyperuricaemia
Authors: Cullen T H 
Published: March 2007

Abstract
A review of a small series of cases with idiopathic retroperitoneal fibrosis revealed that two of the patients had been under treatment for gout prior to developing retroperitoneal fibrosis. Investigation showed that other patients in theseries had hyperuricaemia. Examination of the retroperitoneal fibrotic tissue demonstrated the presence ofurate crystals in unusually high numbers. It is suggested that the pathological process of retroperitoneal fibrosis in these cases may have been initiated by the deposition of urate crystals in the retroperitoneal connective tissue and that the same process may be related to the causation of idiopathic hydrocoele.
Glutamate metabolism in malnutrition and sepsis in man
Authors: Kingsland Penelope A , Kingsnorth A , Royle G T , Kettlewell M G W , Ross B D 
Published: March 2007

Summary
The metabolism of intravenous glutamate has been studied for its usefulness as a nutrient in intravenous feeding regimens. Intravenously infused monosodium Lglutamate was rapidly removed from the blood with a halflife of 10·7 and 9·1 min in healthy control and malnourished septic patients, respectively. Under the same conditions, alanine was metabolized much more slowly, with a half-life of 35 min (1). After the infusion of glutamate, blood lactate fell and glucose was increased in the control patients but not in the sick patients. Blood pyruvate, ketone bodies, glutamine, aspartate and alanine levels did not change after the infusion of glutamate in either group of patients. Increased urinary excretion of aspartate was observed in the control patients following the infusion of glutamate, but in the sick patients there was an increased excretion of glutamine. Insulin concentration in the blood rose after the infusion of glutamatein the control patients but not in the sick patients. Although the glutamate half-life was similar in thetwo groups of patients, glutamate was metabolized differently in the sick. Deamination predominates over transamination. We conclude that glutamate, in the amounts provided in intravenous feeding, is safe, although its effectiveness may be less than previously thought.
Yersinia and viruses in acute non-specific abdominal pain and appendicitis
Authors: Morrison James Dougall 
Published: March 2007

Summary
Four out of 24 patients presenting as an emergency with acute non-specific abdominal pain showed serological evidence of infection with Yersinia pseudotuberculosis. Two out of 13 patients presenting with acute appendicitis during the same period also had evidence of Yersinia infection. Viral infection was present in only 1 patient in each group. Since it is rare to find antibodies to yersinia in healthy individuals, it seems likely that yersinia is a cause of some cases of non-specific abdominal pain. Viral infection does not appear to be an important aetiological factor in patients over 12 years of age.
The effect of topical povidone iodine on wound infection following abdominal surgery
Authors: Gray J G , Lee M J R 
Published: March 2007

Summary
The effect of povidone iodine on wound sepsis following gastrointestinal surgery was studied in a trial involving 153 patients of whom 72 had their wounds sprayed with povidone iodine dry powder (Disadine DP) and 81 acted as a control group. The infection rate of 9·9 per cent in the patients treated with povidone iodine was significantly lower than that of 24·4 per cent in the control group (P&lt;0·05). Bacterial contamination of the wound at the time of operation was shown to be of importance, being associated with a 52 per cent infection rate in the control group. However, spraying of contaminated wounds with povidone iodine reduced the infection rate to the significantly lower level of 11 per cent (P&lt;0·05). We conclude that povidone iodine is a safe and effective means of reducing wound sepsis following gastrointestinal surgery.
A new method for the assessment of gut viability
Authors: Piasecki Christopher 
Published: March 2007

Summary
A surface polarographic oxygen electrode was modified so that on the basis of physical considerations its reading became dependent on blood flow. The preliminary results show that when applied to the serosal surface of the bowel under operative conditions, readings correlated well with total blood flow to the segment measured by electromagnetic flowmetry. Graded local ischaemic areas could also be detected. Readings from the serosal surface appeared to be independent of those from the mucosa. The instrument may therefore provide a useful surgical tool for detecting partially ischaemic areas of bowel.
Presentation and outcome of strangulated external hernia in a district general hospital
Authors: Andrews N J 
Published: March 2007

SummaryTwo hundred consecutive emergency hernia operations are reviewed. Mortality from this condition has not significantly altered in the past 30 years. Half of the patients presented 48 h or more from the onset of symptoms. Mortality and bowel resection were clearly linked with the duration of symptoms prior to admission. There were no reliable clinical signs to predict the likelihood of bowel strangulation. Recurrent incisional and femoral hernias were associated with high resection rates and mortality. Right-sided hernias appeared to strangulate more frequently than left-sided hernias.
Abdominal emergencies in a tropical African population
Authors: Ajao Oluwole G 
Published: March 2007

Summary
A decade ago intestinal obstruction was the commonest cause of general surgical abdominal emergency admissions in many tropical African countries. Recently, there has been a change in this pattern and acute appendicitis has become the major cause of emergency admissions.
Most cases of intestinal obstruction are due to obstructed (strangulated or incarcerated) groin hernia. Intestinal ascariasis is a declining cause of intestinal obstruction while colorectal cancer is now an important differential diagnosis. Trauma due to road traffic accidents is increasing in frequency. Gallbladder disease is not a major problem; symptoms suggestive of acute gallbladder disease are more likely to be due to an amoebic abscess in the West African environment.
Suprapubic bladder drainage in colorectal surgery
Authors: Christensen P Borup , Kronborg O 
Published: March 2007

Summary
Seventy-six consecutive patients were studied prospectively in order to assess the value of suprapubic bladder drainage following surgery of the rectum and sigmoid colon. An Argyle—Ingram catheter (ICI) was inserted after the laparotomy incision had been made and the bladder was drained continuously for 24 h after which the catheter was closed and opened only every 6h for 10 min. The patients were invited to void at will after the first 24 h. The catheter was removed when the post-voided volume became less than 50 ml on each of two subsequent measurements. The longest period of drainage was necessary after rectal excision, while rectosigmoid resections demanded shorter periods. The catheter did not function in one patient and urethral catheterization became necessary after removal of the suprapubic catheter in 4 patients. The method of suprapubic bladder drainage is recommended because it permits spontaneous voiding, allows measurement of residual volume without urethral instrumentation, gives little discomfort to the patient and has few complications.
Conservative parotidectomy by the peripheral approach
Authors: Chan Steven , Gunn Alastair 
Published: March 2007

Summary
A series of 30 consecutive conservative parotidectomies is reported with a detailed assessment of the extent and duration of facial nerve damage. There was one case of severe temporary facial nerve paralysis but no cases of permanent palsy. All operations were performed using the peripheral approach to the facial nerve and the technique employed is described.
Tuberculosis in patients undergoing maintenance haemodialysis and renal transplantation
Authors: McWhinney N , Khan O , Williams G 
Published: March 2007

Summary
The difficulty in diagnosis of tuberculosis in patients with chronic renal failure or on immunosuppressive therapy is discussed. Anti-tuberculous therapy was required in 19 out of 315 patients who received a renal transplant in the Urology Unit, Hammersmith Hospital, between February 1961 and December 1979. Twelve patients were from overseas. Their management and the effect of antituberculous therapy on the immunosuppressed patient were also studied. The disease was treated successfully in 18 patients, even though there were problems with diagnosis. The patient who died had active tuberculosis on post-mortem examination. Prophylaxis should be considered in patients who have had tuberculosis in the past and may have received inadequate treatment.
Spleen scanning with 99Tcm-labelled red blood cells after splenectomy
Authors: Spencer G R , Bird C , Prothero D L , Brown T R , Mackenzie F A F , Phillips M J 
Published: March 2007

Summary
In order to correlate the haematological changes which occur after splenectomy, with the presence or absence of residual splenic tissue, spleen scans using 99Tcm-labelled red blood cells were performed in 36 patients who had had a splenectomy. Positive spleen scans were found in 44 per cent (8 out of 18) of patients who had undergone splenectomy for trauma and in 17 per cent (3 out of 18) of patients who had undergone elective splenectomy. No relationship was found between the presence of Howell-Jolly bodies, platelet counts, the levels of IgG, IgM and IgA and the scan result. It is concluded that these findings are due to the presence of splenunculi, whose incidence is more common than the 12 per cent usually quoted.
The management of colonoscopic and sigmoidoscopic perforation of the large bowel
Authors: Adair H M , Hishon S 
Published: March 2007

Summary
The treatment of 8 patients who sustained endoscopic perforation of the large bowel at this hospital in the past 5 years is described. Two had signs of general peritonitis and were operated on. One had a laparotomy under the same general anaesthetic as that during which perforation occurred. Of the remainder, 4 were treated conservatively, while no perforation was found at operation in the other case. All recovered. We conclude that when signs of general peritonism are absent and the patient's condition is good, expectant management with nasogastric suction, intravenous fluids and broad spectrum antibiotics should be adopted. Free gas on X-ray is not per se an indication for laparotomy. A defunctioning colostomy is often unnecessary in those patients treated operatively.
Deep venous thrombosis after total hip arthroplasty: A prospective controlled study to determine the prophylactic effect of graded pressure stockings
Authors: Ishak Magdy A , Morley Kenneth D 
Published: March 2007

Summary
Graded pressure stockings significantly reduced the incidence of venographically determined deep venous thrombosis (DVT) after total hip arthroplasty. Seventysix patients were studied; the incidence of DVT was 54 per cent in 41 control patients and 20 per cent in 35 patients who wore stockings. Administration of blood during the operation and in the first 24 h after operation, if given in excess of blood loss, was associated with a significantly increased risk of developing DVT. The application of graded pressure stockings and the avoidance of unnecessary perioperative blood transfusion are worth while in the management of total hip arthroplasty.
A comparative study of Dextran 70 and a sulphated polysaccharide in the prevention of postoperative thromboembolic complications
Authors: Bergqvist D , Ljungnér H 
Published: March 2007

Summary
A prospective randomized study has been performed, comparing a semisynthetic polysulphated xylan of vegetable origin (mol. wt ˜ 4000) with Dextran 70 as prophylactic agent against postoperative thromboembolic complications following elective abdominal surgery. A total of 109 patients entered the trial and the analysis after exclusions is based on 86 patients. The overall frequency of125 I -labelled fibrinogen test-detected thrombosis was 2·9 per cent in the polysaccharide group against 19·2 per cent in the Dextran 70 group (P &lt; 0·05). There was no difference in haemorrhage or different complications.