bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perforated peptic ulcer: A comparison of long term results following partial gastric resection or simple closure
Authors: Skarstein A , Høisæter P Å 
Published: March 2007

Abstract
The results of simple closure were compared with those of partial resection in the treatment of perforated peptic ulcer. The investigation was carried out 7–13 years after the primary operation on 126 patients who had been allotted to one of the two treatment methods on the basis of an almost randomized schedule.
Better late results were obtained with partial resection than with simple closure in patients in the age range 50–59 years at operation, with short duration of perforation and with a long history of symptoms before perforation.
None of the patients treated with partial resection later underwent surgical treatment for recurrence of symptoms. In the simple closure group 27·3 per cent needed further surgery at 3 months to 10 years after perforation.
Spontaneous rupture of liver tumours
Authors: Mokka R , Seppälä A , Huttunen R , Kairaluoma M , Sutinen S , Larmi T K I 
Published: March 2007

Abstract
Five geriatric patients with spontaneous rupture of the liver caused by hepatic malignancies were operated upon without mortality. Liver resection seems to be the treatment of choice, but in selected cases with unresectable tumours ligation of the hepatic artery alone is preferable to an attempt to control haemorrhage by packing and suture.
Effects of haemorrhage upon surgical operations
Authors: McGinn F P 
Published: March 2007

Abstract
The complications of emergency surgery for acute upper gastro-intestinal haemorrhage in 95 patients were compared with those of surgery for non-bleeding benign peptic ulceration in 380 patients. There was a significantly higher number of senior surgeons performing emergency surgery for haemorrhage. There was a significantly higher mortality (10·5 per cent), wound dehiscence rate (12·6 per cent) and wound complication rate with re-bleeding (33·7 per cent) in the post-haemorrhage patients compared with the non-bleeding group (1·3, 1·8 and 11·6 per cent respectively). There was no Significant difference in the incidence of chest infection in the two groups. Mortality and morbidity after haemorrhage were correlated directly with the amount of blood transfused before surgery.
Rats were used to study the effect of the removal of 13 per cent of the blood volume, and its restoration after varying time intervals, upon subsequent wound healing. Abdominal wounds were tested at 7 days for breaking and bursting strength. There was no difference between the wound strength of the control animals and animals which had been bled for 4 minutes before wounding. A significant reduction of wound strength occurred in animals which had been bled for 30–60 minutes before wounding.
Prolonged blood loss was associated with deficient wound healing even if blood loss was restored before the wounds were made. Stored blood may be deficient in a factor which is necessary for normal wound healing.
The value of preliminary bone scanning in staging and assessing the prognosis of breast cancer
Authors: Campbell D J , Banks A J , Oates G D 
Published: March 2007

Abstract
Preliminary bone scans have been performed on all patients with early breast cancer. The incidence of positive scans has been recorded and several factors determining scan status have been enumerated. Particular attention has been focused on the natural history of scan positive and scan negative patients. Eighteen per cent of stage I and 41 per cent of stage II cancers had positive bone scans. Scan results were correlated with age, menopausal status, tumour position, tumour size and histological node status. Postmenopausal patients were found to have a significantly increased risk of being scan positive (P &lt; 0·01). Follow-up studies have confirmed that the lesions demonstrated by scanning actually represent metastatic foci. At 18 months 85·7 per cent of scan positive patients had evidence of disseminated disease compared with only 11·4 per cent of scan negative patients (P &lt; 0·01). Clinically overt advanced disease evolves from positive scan lesions.
It is clear that a significant percentage of patients felt to have early breast cancer already have widely disseminated disease at the initial presentation. The biological significance of bone scan lesions makes a sensitive screening test for dissemination an essential part of the preliminary assessment of patients with breast cancer. Bone scans provide an excellent prognostic index at a patient's initial assessment.
Preclinical warning of recrudescent mammary cancers by pregnancy-associated alpha-macroglobulin
Authors: Anderson J Maxwell , Stimson W H , Kelly F 
Published: March 2007

Abstract
Nine of 30 mammary cancer patients developed metastases during 13–94 months after mastectomy. All 9 patients had elevated blood levels of pregnancy-associated α-macroglobulin (PAM) 1–21 months before conventional detection of metastases. Seven of the clinically well patients had PAM rises exceeding 90 per cent above the baseline and in 4 of these the PAM later fell to lower levels. PAM appears to have potential as an indicator of the growth of micrometastases.
Bilharzial granuloma of the gastro-intestinal tract
Authors: Elmasri S H , Boulos P B 
Published: March 2007

Abstract
Thirty-four patients with bilharzial granuloma of the gastro-intestinal tract were analysed. The commonest site was the rectosigmoid. Bilharzial ‘appendicitis’ was also common but the exact relation between bilharzial granuloma and acute inflammation remains unclear. Preoperative diagnosis of bilharzial granuloma is occasionally dificult and histological proof is necessary. Surgical treatment with polypectomy in the case of a solitary polyp and excision of the affected segment of bowel when there are multiple polyps are recommended, There is no evidence that the conditon is premalignant.
Bilharziasis and prolapse of the rectum
Authors: Abul-Khair Mahmoud Helmy 
Published: March 2007

Abstract
Twenty-six cases with complete prolapse of the rectum were investigated. In 8 of these, bilharziasis of the rectum and colon was found to be the cause of the prolapse. The role of bilharziasis in the pathogenesis of this condition is discussed. The age and sex incidence of bilharzial prolapse differs from that of cases without bilharziasis.
The effect of anti-thrombotic drugs on prosthetic grafts in the canine inferior vena cava
Authors: Calvert M H , Gough M H 
Published: March 2007

Abstract
The effect of phenylbutazone, an anti-thrombotic agent, on the occlusion rate of knitted Dacron grafts placed in the infrarenal inferior vena cava of dogs was studied. Grafts placed in dogs treated with phenylbutazone remained patent significantly longer than those in untreated animals. All the grafts in the untreated group occluded, but 2 remained patent in the treated animals.
Prophylactic lincomycin in the prevention of wound infection following appendicectomy: A double blind study
Authors: Leigh D A , Pease R , Henderson H , Simmons K , Russ R 
Published: March 2007

Abstract
The prophylactic use of a single dose of lincomycin in 100 patients undergoing appendicectomy reduced the incidence of postoperative wound injection from 17 to 6 per cent compared with a similar group of control patients. There was no correlation with the histological findings in the appendix, but patients with perforated appendicitis were excluded from the study. Bacteriological examination of the appendix area before surgery showed that Bacteroides fragilis and Escherichia coli were the organisms most frequently isolated. The majority of wound infections were due to B. fragilis, either alone or in association with aerobic organisms, but infection due to E. coli and Staphylococcus aureus also occurred.
Systemic antibiotic therapy can successfully reduce the complications following appendicectomy but it is necessary to use a compound with activity against anaerobic organisms.
Segmental dearterialization in penetrating renal trauma
Authors: Angorn I B 
Published: March 2007

Abstract
Refractory renal haemorrhage following low velocity penetrating trauma has conventionally been treated by nephrectomy or partial nephrectomy. Anatomical studies have demonstrated that the renal artery branches are end-arteries, each branch supplying a renal segment, with no collateral artery supply between segments. Lifethreatening haemorrhage is arterial, and usually issues from a single segmental artery easily demonstrable by renal angiography.
Fourteen patients had various segmental arteries ligated to control haemorrhage. Associated visceral injuries were present in 4 patients. Preoperative selective renal arteriography was possible in 13 patients and demonstrated the bleeding site in all cases. Segmental dearterialization produced haemostasis in 12 of the 14 patients. One patient required nephrectomy and one patient ligation of a second segmental artery to control bleeding. All the patients survived the operative procedure. Supine renin levels were normal on the fourteenth postoperative day and no patient developed hypertension during the follow-up period of 9–24 months.
Segmental renal dearterialization by open operation is a simple and effective technique of controlling refractory renal haemorrhage with maximum preservation of renal parenchyma.
The effects of prolonged hepatic ischaemia before 70 per cent partial hepatectomy in the dog
Authors: Mackenzie R J , Furnival C M , Wood C B , O'Keane Maureen A , Blumgart L H 
Published: March 2007

Abstract
The effect of prolonged normothermic ischaemia before partial hepatectomy was assessed in 10 dogs. During the period of ischaemia, portal decompression was maintained.
The survival rate for animals undergoing 75 minutes of total liver ischaemia was 60 per cent, and 2 of the dogs died as a result of hypoglycaemia. High levels of alkaline phosphatase and transaminases in the survivors indicated a severe degree of hepatocyte damage. However, complete restoration of liver mass was noted 6 weeks after partial hepatectomy and was not impaired by the prolonged ischaemia.
This study confirms the resistance of the dog liver to ischaemia before partial hepatectomy. The critical period beyond which ischaemia is followed by an increasing number of deaths and severe metabolic upset is in the region of 1 hour.
Parathyroidectomy: Extent of resection and late results
Authors: Cooke T J C , Boey J H , Sweeney E C , Gilbert J M , Taylor Selwyn 
Published: March 2007

Summary
Opinion is divided as to the necessary extent of parathyroid resection in primary hyperparathyroidism. Some surgeons urge that subtotal parathyroidectomy be performed routinely, while others reserve subtotal resections for patients with parathyroid hyperplasia.
In a review of 102 patients treated by parathyroidectomy for primary hyperparathyroidism and subsequently followed up for an average of 6 years, there were 73 patients with parathyroid adenoma, 26 with hyperplasia and 3 with carcinoma. The adenoma was not found at the first operation in only 3 cases; in the other 70 after removal of the adenoma no further hypercalcaemia was observed during the follow-up period. Persistent or recurrent hypercalcaemia was a problem in 9 out of the 26 patients with primary hyperplasia who had inadequate resection at the first operation, and also in the 3 patients with carcinoma.
Experience shows that peroperative biopsy with frozen section of all the parathyroids is useful in confirming their identity and can be a guide to the type of disease present and the appropriate extent of resection.
Aneurysms of the femoral artery
Authors: Adiseshiah Mohan , Bailey David A 
Published: March 2007

Summary
Eight aneurysms of the femoral artery out of a total of 27 in 16 patients developed symptoms requiring surgery. The operation of choice was Dacron prosthetic replacement of the aneurysm with preservation of profunda femoris perfusion. The incidence of complications of aneurysms was 30 per cent. The asymptomatic aneurysms were untreated and did not cause the patients any inconvenience as observed at their follow-up. Hence, surgery is advocated only for patients who develop symptoms provided that adequate follow-up and community medicine facilities exist.
Prosthetic replacement of a long segment of vein in the treatment of a lower limb injury
Authors: Tachakra S S , Smith J E M 
Published: March 2007

Summary
A patient who sustained exceptionally severe damage to the main blood vessels and to the collateral circulation of his left lower limb is reported. The femoropopliteal vein was replaced by a Dacron prosthesis which remained patent for 6 weeks until an adequate collateral circulation was established.
Sclerosing peritonitis due to practolol: A report on 9 cases and their surgical management
Authors: Eltringham W K , Espiner H J , Windsor C W O , Griffiths D A , Davies J D , Baddeley H , Read A E A , Blunt R J 
Published: March 2007

Abstract
Nine patients with an unusual and serious intraabdominal complication of the beta-adrenergic blocking agent practolol seen since 1973 are reported. The striking and bizarre peritoneal changes induced by the drug have distinctive features that are not shown by other forms of peritoneal disease.
The cases presented with small bowel obstruction, usually chronic in type and often associated with profound weight loss and an abdominal mass. Characteristic radiological features were present. The abnormalities at laparotomy were impressive, with a gross proliferation of the visceral peritoneum which formed a dense white cocoon which encased, constricted and markedly shortened the small bowel, usually from the duodenojejunal flexure to the ileocaecal valve. The obstruction was relieved by mobilizing the small bowel from the ensheathing tissue. Restoration of alimentary function after surgery was delayed but the long term result was satisfactory with full relief of symptoms and the absence of recurrent obstruction during the follow-up period.
This complication may arise after treatment with the drug has been stopped, and although long term oral therapy has been discontinued, further cases will almost certainly present for some time to come.
Aortocaval fistula as a complication of leaking aortic aneurysm
Authors: Magee H R , Mellick S A 
Published: March 2007

Abstract
The successful management of 2 patients is reported, each involving the closure of a fistula into the inferior vena cava as a sequel to the rupture of an atherosclerotic aortic aneurysm. It is an uncommon complication which should be suspected in the presence of an aortic aneurysm with a loud machinery bruit. Associated peripheral cyanosis and venous pulsation in the accessible proximal veins of the lower extremity and priapism afford strong supporting evidence.
Drug consumption before perforation of peptic ulcer
Authors: Jørgensen T Glarborg 
Published: March 2007

Abstract
In a retrospective study of 195 patients with a perforated peptic ulcer 18 per cent of the patients had taken aspirn, phenylbutzone or corticosteroids during the period before the perforation. In a controlled prospective trial, 18 of 22 patients (82 per cent) had taken drugs known to be potentially harmful to the stomach. Aspirin was the drug mainly used. Thirteen of 22 patients had taken the drugs within 12 hours of the perforation, usually because of symptoms not related to the gastro-intestinal tract. Drug consumption and perforation of pre-pyloric ulcers were most closely associated; the latter applies particularly to female patients, who either had only a short history of upper gastro-intenstinal dyspepsia or were asymptomatic.
Protection of the skin around intestinal fistulas
Authors: Gross Errol , Irving Miles 
Published: March 2007

Abstract
The use of two recently introduced skin protective preparations in the treatment of perifistular skin inflammation is described. Karaya gum in paste form (karaya paste) and a compressed wafer of gelatin, pectin and methyl cellulose (Stomahesive) were used, alone or in combination, with drainable collecting appliances. The method protects the inflamed skin from fistula discharge and allows healing to proceed beneath the dressing. A technique to improve the adhesion of the appliance, in spite of large fluid losses, is outlined.
Healing of skin excoriation was obtained in nearly all cases. Complete control of leakage was achieved in a group of patients with a high output fistula.
The early mobilization of the elderly amputee
Authors: Hutton I M , Rothnie N G 
Published: March 2007

Abstract
A policy of early mobilization of elderly leg amputees using a simple temporary prosthesis has been assessed in the context of a district general hospital.
Close cooperation between members of the hospital management team, adequate rehabilitation facilities and close liaison with the limb-fitting centre and domiciliary services were found to be essential to support this policy.
Of 42 elderly amputees, 34 were supplied as early as possible with temporary prostheses. Nearly 80 per cent of them were able to walk without assistance on discharge from hospital care. Delays in discharge were mainly for socio-domestic reasons.
Early prosthetic mobilization in this aged and often frail group of patients led to a reduced morbidity and mortality. There was improved morale in patients and staff, rapid clearance of acute surgical beds and the all-important early achievement of domestic mobility and independence for the amputee.
Idiopathic megacolon: A review of 42 cases
Authors: Lane R H S , Todd I P 
Published: March 2007

Abstract
Forty-two patients with idiopathic megacolon who were seen at St Mark's Hospital over an 18-year period are reviewed with regard to presentation, investigation and management. The differential diagnosis is discussed with particular reference to Hirschsprung's disease. The important aspects of medical treatment are outlined and the possible reasons for failure in more than one-half of the patients are discussed. The indications for surgical intervention in 14 patients are reviewed. The results following subtotal colectomy were better than following a localized sigmoid resection.
Preoperative diagnosis in carcinoma of the breast
Authors: Davies C J , Elston C W , Cotton R E , Blamey R W 
Published: March 2007

Abstract
Two methods of obtaining a preoperative diagnosis of breast lumps have been evaluated by simultaneous use on 131 patients. Tru-Cut needle biopsies gave a reliable diagnosis in 75 per cent of those suffering from primary carcinoma of the breast. No cases of benign disease were wrongly reported as carcinoma by this method. Fine-needle aspiration cytology gave no helpful information in one-half of the patients with malignant disease and in addition 5 cases of benign disease were falsely reported as carcinoma. Tru-Cut needle biopsy is a valuable preoperative investigation in patients with primary carcinoma of the breast.
The place of transthoracic vagotomy in the management of recurrent peptic ulceration
Authors: Hede J E , Temple J G , McFarland John 
Published: March 2007

Abstract
For the successful treatment of recurrent peptic ulceration confirmation of the presence of the ulcer by fibreoptic endoscopy is essential. Further investigation by barium meal and gastric acid secretion studies allows a rational surgical approach to be formulated. This process is illustrated by discussion of the investigative findings and the results of treatment in a series of 20 patients with recurrent peptic ulcer over a 5-year period. In onehalf of these patients a second abdominal operation was necessary, but in the other half a transthoracic vagotomy alone gave equally good results.
The long term results of profundaplasty in femoropopliteal arterial occlusion
Authors: Ward A S , Morris-Jones W 
Published: March 2007

Abstract
The long term results of profundaplasty in the treatment of femoropopliteal arterial occlusion have been reviewed. Fifty patients have been studied with a mean follow-up period of 4 years (range 6 months to 8 years).
Intermittent claudication was abolished or substantially improved in 5 of the 25 cases (20 per cent); rest pain was relieved in 10 of the 25 cases (40 per cent), the remainder requiring a major amputation. Lumbar sympathectomy produced little additional benefit in either group. The mortality rate in the rest pain group was high and only 5 patients survived for more than 3 years with both legs intact. The state of the distal ‘runoff’ and the degree of preoperative profunda stenosis appeared to have little influence on the clinical outcome. After operation pedal pulses were restored in 16 per cent of those presenting with claudication. Profundaplasty was without significant effect on the ankle systolic pressure index both in patients with claudication and those with rest pain.
Resection of the manubrium
Authors: Harrison D F N 
Published: March 2007

Abstract
Direct exposure of the superior mediastinum is essential when resecting subglottic tumours of the larynx, neoplasms of the cervical trachea or cervical oesophagus. This facilitates low resection of the trachea and clearance of the paratracheal nodes. This may best be carried out by removal of most of the manubrium sterni and both sternoclavicular joints and this operation has been performed in 22 patients with minimal morbidity or long term disability.
Crush syndrome: A report of 2 cases and a review of the literature
Authors: Brown A A , Nicholls R J 
Published: March 2007

Abstract
The crush syndrome was first defined as a clinical entity in 1941. This paper reports 2 patients suffering from the syndrome as a result of being trapped for several hours during the Moorgate tube train disaster. An account of the initial course, management and complications is presented and discussed with reference to the available literature on the subject.
Hiatus hernia repair combined with the construction of an anti-reflux valve in the stomach
Authors: Bingham J A W 
Published: March 2007

Abstract
An operation is described that combines hiatus hernia repair with the construction of an anti-reflux valve in the stomach immediately beyond the cardia.
One hundred and ten patients treated by this operation, including 28 with panmural oesophagitis, have been followed up by clinical and radiographic assessment at yearly intervals for periods from a little over 1 year to over 5 years. Three patients had return of reflux symptoms, 2 of these being the only patients in the series with X-ray reflux at follow-up. The return of reflux in these patients appeared to result from anatomical changes that were probably caused, at least in part, by over-tight application of the stapling instrument used in the operation.
Plasma gastrin concentration related to acid secretion during insulin hypoglycaemia
Authors: Russell R C G , Faber R G , Hobsley M 
Published: March 2007

Abstract
The release of gastrin by insulin hypoglycaemia was studied in man before and after vagotomy. Completeness of vagotomy was judged by the gastric acid response to the same hypoglycaemia, using several criteria including one that allows for pyloric losses and duodenogastric reflux. A total of 137 tests was performed on 10 subjects. The plasma gastrin concentration was found to rise in the preoperative studies and also in the postoperative studies no matter what type of vagotomy had been performed or what criteria of completeness of vagotomy were used. We concluded that gastrin can be released in response to hypoglycaemia in the absence of the vagus nerve.