bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carotid flow disorders in patients with cerebrovascular disease: Their atraumatic assessment by carotigraphy
Authors: Britton K E , Duplock G , Hudson G Vaughan 
Published: March 2007

Abstract
Carotid arterial narrowing less than that considered to be ‘critical’ may cause turbulent blood flow. Eddying may aid the deposition of material from blood, and vortices may aid its embolization, leading to transient ischaemic attacks, the Cassandra of the stroke. Two scintillation detectors were collimated to monitor the distal portion of each internal carotid through the orbits, and a third, the root of the aorta. After the intravenous injection of 10–15 mCi of technetium-Wm, activity/time curves were obtained from 58 patients. Fourteen out of 24 patients considered to have cerebrovascular disorders had significantly different values of measured indices of carotid blood flow from a group of 24 ‘normal’ patients (P&lt;0.02). Improvement in these indices was associated with clinical improvement in 6 patients studied bejore and after carotid endarterectomy. In 38 patients a comparison of the results of this technique (carotigraphy)and angiography was made, In unilateral carotid disease, results of carotigraphy correlate significantly with results of angiography, but bilateral symmetricnl carotid artery disease gives normal results of carotigraphy. Analysis by deconvolution of the inflow and outflow activity/time curves obtained during carotigraphy allows study of the individual artery and indicates that normal carotid arterial flow is effectively non-turbulent. The prediction of turbulent flow by carotigraphy may allow assessment of the pathogenesis and a means of prevention of many strokes.
Torsion of the testis in childhood
Authors: Macnicol M F 
Published: March 2007

Abstract
Sixty cases of clinically diagnosed torsion of the testis have been admitted to a paediatric surgical unit over a period of 25 years. Of the 42 cases proved at operation to have torsion, 19 (46 per cent) underwent immediate orchidectomy, and a further 14 (33 per cent) showed partial or complete atrophy of the testis at follow-up at least 2 years postoperatively. The salvage rate was therefore only 21 per cent. Early diagnosis and immediate exploration may save a few cases from orchidectomy, but delay in referral remains the substantial factor determining viability. The importance of fixation of the surviving testis is stressed and contralateral orchidopexy at the time of the emergency procedure is recommended, Twelve cases of idiopathic scrotal oedema and 6 cases of proved torsion of the appendix testis were encountered over the same period and their clinical features are described. Symptomatology is milder in these two conditions and it is possible that a proportion of the 30 cases diagnosed as having epididymo-orchitis in fact suffered from torsion of the appendix testis.
Nodular lymphoid hyperplasia of the stomach and small intestine with hypogammaglobulinaemia
Authors: Munro A , Simpson J G 
Published: March 2007

Abstract
A 16-year old youth who presented with haematemesis and melaena from a duodenal ulcer was found to have multiple polyposis of the stomach and small intestine due to nodular lymphoid hyperplasia with hypogammaglobulinaemia.
Urinary excretion of corticosterone metabolites in demonstrating the adrenocortical remnant
Authors: Blichert-Toft Mogens , Nielsen Meta Damkjær , Lockwood Knud , Hasner Eivin 
Published: March 2007

Abstract
The spontaneous excretion and the secretory reserve of corticosterone and its metabolites (total B) after bilateral adrenalectomy were determined at an early postoperative date in 22 patients with ACTH-dependent Cushing's syndrome. On the basis of these early results two groups of patients could be distinguished. Group I comprised 19 patients with an immeasurable or negligible excretion, unresponsive to ACTH. The patients of this group exhibited lasting remission. Group 2 comprised the remaining 3 patients who had an abnormally high spontaneous excretion and/or an abnormally high secretory reserve. Primary remission was merely transitory or failed to appear. All the patients in this group exhibited residual adrenocortical tissue at reoperation or at autopsy.
At follow-up the biochemical investigation was repeated. The early results proved to be a reliable indication of the excretion pattern throughout the follow-up period (mean 5 years).
It is concluded that determination of urinary total B excretion early after bilateral adrenalectomy is valuable in assessing whether the adrenalectomy was total or whether residual adrenocortical tissue was left. In patients with Cushing's syndrome associated with adrenocortical hyperplasia the test was also reliable in predicting the probability of subsequent primary long term remission.
Racial incidence of postoperative deep vein thrombosis in South Africa
Authors: Joffe S N 
Published: March 2007

Abstract
Postoperatiue deep vein thrombosis is considered to be rare in non-Europeans (Burkitt, 1972). The 125I fibrinogen test, Doppler ultrasound and venography were used to determine the true incidence of postoperative deep vein thrombosis in a South African population. The results show that the European, Coloured, African and Indian patients were all at a similar high risk.
Long survival after operation for cancer of the lung
Authors: Brock Lord 
Published: March 2007

Abstract
A survey is presented of 293 cases of lung cancer operated on by one surgeon over a period of 35 years. Lobectomy was done in 86 cases with a mortality of 3.5 per cent. Simple pneumonectomy was done in 89 cases with a mortality of 20 per cent, and radical pneumonectomy in 118 cases with a mortality of 15.25 per cent.
The survival rate after 5 or more years for lobectomy was 41 per cent (34 patients). After simple pneumonectomy 21 patients (30 per cent) lived 5 years or more, and after radical pneumonectomy 39 patients (39 per cent) lived 5 years or more. The survival of the patients in whom the excised lymph nodes were involved by growth is presented. It is pointed out that at least 1 in 3 patients with cancer of the lung treated by operation was alive 5 years later.
The very good long term results are presented including the 10-year and 20-year survival rates. Two patients are still alive after 30 and 34 years respectively. One patient is alive 29 years after a lobectomy and 13 years after a contralateral lobectomy for a new primary cancer. A second new cancer occurred in 9 patients. Continuance of smoking is shown to be harmful.
The factors affecting the long term freedom from recurrence are discussed. The cell type of the cancer is shown to be important. Squamous-celled growths have the best results and oat-celled and small-celled the worst, although long term survival can follow operation for both these. The occurrence of a pleural infection after operation may be favourable to long term freedom from recurrence and this was probably so in 2 patients who lived 25 and 27 years respectively and 1 patient who is still alive after 34 years.
On the whole the evidence is unconvincing that much benefit may follow radiotherapy combined with operation.
Fatal cardiac tamponade and other mechanical complications of central venous catheters
Authors: Dane T E B , King E G 
Published: March 2007

Abstract
A fatal cardiac tamponade caused by an intact polyethylene central venous catheter perforating the wall of the right ventricle is reported. A retrospective review of 105 central venous catheters used in an intensive care unit revealed a high incidence of catheter malposition and a 20 per cent mechanical complication rate. The possible causes of these malpositions and complications are discussed. Guidelines for the safer use of central venous catheters are presented.
Atrophic gastritis in gastrectomy specimens
Authors: Skinner J M , Heenan P J , Whitehead R 
Published: March 2007

Abstract
Examination of gastrectomy specimens has shown that atrophic gastritis and intestinal metaplasia are widespread and have the same distribution in cancer of the stomach as in gastric ulcer affecting the body. Their distribution is restricted to the distal part of the stomach in pyloric ulcer. After gastrojejunostomy the distribution is also like that seen in cancer. There is a close association of widespread atrophic gastritis and intestinal metaplasia with the development of cancer and a high cancer rate after stomach operation for benign conditions. The similarity of distribution of atrophic gastritis and intestinal metaplasia in the stomach with body ulcer to that in cancer and after gastrojejunostomy points to a higher cancer risk in the stomach containing a body ulcer.
Surgical sterilization by vasectomy and its effect on the structure and function of the testis in man
Authors: Gupta A S , Kothari L K , Dhruva A , Bapna R 
Published: March 2007

Abstract
The early and late effects of vasectomy have been investigated in 40 men. Besides histopathological examination, the volume of the testis and its total content of testosterone-secreting Leydig cells have been measured.
The volume of the testis showed a wide normal variation (5·3–23·3 ml) but was not significantly changed by vasectomy. One month after vasectomy widespread degeneration of the germinal epithelium, thickening of the basement membrane and some intertubular fibrosis were observed. Spermatogenesis had ceased. However, cases examined 2–3½ years later showed an essentially normal structure with active spermatogenesis. This indicates that regeneration does occur spontaneously, even without recanalization. Whether the sperms formed are functionally normal remains uncertain.
The normal total Leydig cell volume was 2·2 ± 0·4 miltestis in young adults and showed a modest increase after vasectomy, rising to 2·5 ± 0·5 ml after 1 month and 2·6 ± 0·5 ml after 2–3½ years. The findings have been discussed in the light of Steinach's (1927) original hypothesis that vasectomy can rejuvenate ageing males by improving the endocrine function of the testis.
A clinical trial designed to discover if the primary treatment of varicose veins should be by Fegan's method or by an operation
Authors: Doran F S A , White Mary 
Published: March 2007

Abstract
1. The current practice of operating upon patients with varicose veins as the treatment of choice costs more than £15 millions a year.
2. The bulk of this expense is due to the length of time that patients are kept in the ward. If they were treated as outpatients, either by Fegan's method or by operation, the cost would be reduced to one-tenth of what is now spent. Even if the operation were done on a ‘short-stay’ basis the cost would be reduced to one-third or less.
3. Although the long term results of Fegan's method are uncertain there is no doubt that it gives better immediate results than an operation. Moreover, there is no particular type of varicosity or shape of limb which precludes its use.
Raised intracranial pressure due to spinal tumours: 3 rare cases with a probable common mechanism
Authors: Maurice-Williams R S , Lucey J J 
Published: March 2007

Abstract
Three cases are reported of raised intracranial pressure associated with spinal tumours. The theories which have been advanced to explain this complication are discussed and it is suggested that in many of the reported cases the underlying mechanism may have been intracranial spread of the tumour and not a blockage of the cerebrospinal fluid pathways with proteinaceous deposits, as has been widely maintained. Autopsy revealed the former process to have operated in 2 of the 3 cases and it may have done so in the third. Two cases had unusual features in common: they were malignant schwannomas (a very rare spinal tumour) and they had both developed within the field of irradiation given for benign conditions many years previously.
Arteriographic exposition of the parathyroids
Authors: Efsen F , Bruun E , Lockwood K , Hasner E 
Published: March 2007

Abstract
Arteriographic exposition of the parathyroids in 52 patients consecutively referred for primary hyper-parathyroidism is reported. Thirty-nine patients underwent neck exploration. In 29 patients pathologic parathyroids were found. The arteriographic evaluation was based on observation of the course of the inferior thyroid artery and the presence of parenchymal opacification. Comparison of arteriography and surgical findings revealed that selective angiography of the inferior thyroid artery had a high sensitivity and specificity in the detection of pathologic parathyroids far exceeding that of a non-selective technique.
Abdominal approach for the ligation of bleeding oesophageal varices
Authors: Miller Stanley S 
Published: March 2007

Abstract
The conventional surgical treatment of bleeding oesophageal varices in the emergency situation is based upon the Boerema-Crile operation of transthoracic oesophagotomy and ligation of the varices. This and the other methods of treatment of this condition in current practice are discussed.
Two cases are reported in which a transabdominal oesophagogastrotomy was used to approach the site of bleeding. This operation is described and the theoretical and practical advantages it appears to offer over the standard approach are considered.
The aetiology of hypocalcaemia in acute pancreatitis
Authors: Condon John R , Ives David , Knight Michael J , Day John 
Published: March 2007

Abstract
Plasma calcitonin, glucagon and parathyroid hormone were measured in patients with acute pancreatitis.
Plasma calcitonin was not detectable in 6 specimens obtained from the hypocalcaemic patients.
Plama glucagon values were similar in patients with acute pancreatitis and control subjects and were unrelated to hypocalcaemia, which was not even induced by glucagon infusion.
High or rising parathyroid hormone levels were noted in association with hypo- and normocalcaemia, suggesting that parathyroid hormone rises and maintains plasma calcium within normal limits. Plasma parathyroid hormone was, however, undetectable in 8 patients with prolonged hypocalcaemia. Deficiency of parathyroid hormone due to its destruction by proteolytic enzymes or because of parathyroid gland exhaustion is suggested as the major factor inducing persistent hypocalcaemia in acute pancreatitis. Administration of parathyroid hormone should, therefore, be considered in patients with acute pancreatitis when hypocalcaemia does not respond to intravenous calcium therapy.
Abdominal lavage in blunt trauma
Authors: Gill William , Champion Howard R , Long William B , Jamaris Joseph , Cowley R Adams 
Published: March 2007

Abstract
A technique for abdominal lavage is described and was used to evaluate the abdomen of 671 multiple trauma victims. In 44 per cent (299 cases) there was a bloodstained return and these were regarded as positive. Patients with a positive result underwent exploratory laparotomy which revealed that 89 per cent had significant intra-abdominal trauma requiring a surgical procedure, 8 per cent had trauma which did not require any active surgical correction and 3 per cent had no abnormal findings. Of all the lavages performed, there were 0.11 per cent false positive and 0.03 per cent false negative results. The value of the test in the context of multiple trauma is emphasized.
Carcinoma of the pancreas and periampullary region: A clinical study in a district general hospital
Authors: Webster D J T 
Published: March 2007

Abstract
One hundred patients with pancreatic and periampullary carcinoma have been reviewed. Diabetes mellitus may be an early presentation. Painless jaundice has a relatively good prognosis. Fifteen patients have had curative procedures with a 31 per cent operative mortality. Mortality is influenced by age and serum bilirubin levels. Where palliative procedures are undertaken, this should include biliary diversion and gastro-enterostomy.
A comparison of one layer and two layer techniques for colorectal anastomosis
Authors: Everett W G 
Published: March 2007

Abstract
In a randomized prospective clinical trial one layer and two layer techniques have been compared in 92 patients undergoing colorectal anastomosis. The results were assessed radiologically by barium studies on the tenth postoperative day. There was no significant difference in the incidence of anastomotic breakdown with either technique when the anastomosis was performed above the pelvic peritoneal reflection. When the anastomosis was situated below the pelvic peritoneum the incidence of dehiscence was significantly greater when a two layer technique was used.
Cervical spinal interbody fusion with Kiel bone
Authors: Ramani P S , Kalbag R M , Sengupta R P 
Published: March 2007

Abstract
Experience with the use of the Kiel bone graft in anterior cervical interbody fusion in cervical spondylosis is reported. The survey reviews the results of operations on 73 disc spaces in 65 consecutive patients, from 2 to 5 years after the operation. We have failed to confirm that any bony fusion in the true sense occurs with Kiel bone in anterior cervical interbody fusion. However, the aims of the operations are achieved, namely removal of the disc and osteophyte, fixation of the spine to prevent compression of the neural tissues, distraction of the adjacent vertebral bodies providing increased room in the intervertebral foramina and stability of the spine.
The early detection of postoperative deep vein thrombosis: An assessment of Doppler ultrasound, physical examination and the temperature chart
Authors: Rickford C R K , Negus David 
Published: March 2007

Abstract
The results of 12 months' experience in screening for deep vein thrombosis in one surgical unit are presented. A case is made for restricting screening to certain high risk patients. The inadequacies of available methods make reliable prophylaxis preferable.
Surgical management and problems of heart pacing
Authors: Borrje J , Lichter I 
Published: March 2007

Abstract
Experience with 40 patients and 150 pacemakers is reviewed. In 13 patients the initial pacing was by epicardial electrodes and in 27 by transvenous catheter electrodes. When epicardial systems were used, two electrodes were always fixed to the heart, the additional electrode being provided for temporary pacing and as a spare in case of future need. The battery unit was usually buried behind the rectus abdominis muscle. Vacuum drainage of the pacemaker pocket was used and was considered helpful in avoiding some complications.
The right cephalic vein was preferred for transvenous pacing but existing venous abnormalities sometimes required use of the external jugular vein. Five patients had epicardial systems changed to transvenous ones, and in 5 the reverse procedure was needed. Pacemaker battery problems included inadequate soft tissue protection for the unit, epoxy resin fracture, titanium case leak and problems relating to design change and the special needs for overseas travel. While the danger from diathermy and radiofrequency is now recognized, similar dangers exist for those paced by ‘demand’ units in large electromagnetic fields.
The application of the 99Tcm phosphate bone scan to the study of breast cancer
Authors: Citrin D L , Bessent R G , Greig W R , McKellar N J , Furnival C , Blumgart L H 
Published: March 2007

Abstract
Comparison of the gamma camera bone scan and radiological survey in 190 patients with breast cancer has confirmed the superiority of the bone scan in the positive diagnosis of skeletal metastases. In 47 patients with known (X-ray positive) bony metastases the scan was positive in all but 2, and in 24 (50 per cent) the scan showed more lesions than the X-ray had indicated. In 60 patients with a clinical suspicion of bone metastases but negative X-rays, the scan was positive in 29 (48 per cent). Eighty-three patients with primary breast cancer were studied at the time of initial presentation. All had a normal radiographic skeletal survey but 24 (27 per cent) had scan evidence of occult metastases. It is concluded that a bone scan is indicated in all patients with breast cancer where skeletal metastases are suspected.
Repeated bone scans may introduce new therapeutic possibilities, by providing an earlier objective index of progression of metastatic disease and also by providing a quantitative method of assessing the response to therapy.
Cystic thyroid nodules
Authors: Ma Michael K G , Ong G B 
Published: March 2007

Abstract
Among 300 patients with thyroid nodules subjected to a needle drill biopsy, 62 were found to contain cystic lesions. Analysis of these 62 cases showed that in 17 the swelling had completely disappeared after the biopsy. The remaining 45 had residual or recurrent swellings. Operative treatment was carried out in 35, which consisted of 28 (80 per cent) nodular goitres, 6 (17.1 per cent) adenomas and 1 (2.9 per cent) carcinoma.
Thyroid cancer: Twenty years' experience in a general hospital
Authors: Campbell D J , Sage R H 
Published: March 2007

Abstract
Twenty years' experience of thyroid cancer in a district general hospital has been reviewed. Its incidence, prognosis and natural history have been studied. Particular attention has been focused on the relationship of malignant to benign goitre. The relevance of this to the treatment of ‘apparently benign goitre’ is discussed.
Clinical evidence is presented supporting the hypothesis that differentiated thyroid carcinoma evolves from a solitary focus through a multinodular form before presenting the picture of a frankly malignant locally invasive cancer.
An increase in the incidence of papillary carcinoma is confirmed.
The management of bleeding acute gastric erosions: The role of gastric hypothermia
Authors: Himal H S , Watson W W , Jones C W , Maclean L D 
Published: March 2007

Abstract
Eighty-eight consecutive patients with bleeding acute gastric erosions were reviewed with the aid of a computer. Of the erosions, 31.8 per cent were related to the ingestion of ulcerogenic drugs and 40.9 per cent were associated with surgery and sepsis. The overall mortality was 20.5 per cent. Endoscopy was the most effective diagnostic examination. Conservative management was effective in the treatment of bleeding erosions due to the ingestion of ulcerogenic drugs. Gastric cooling successfully arrested haemorrhage from bleeding erosions due to surgery and sepsis.
Is ‘second look surgery’ justified in suspected recurrences of cancer of the stomach?
Authors: Ellis Harold , Jayasekar G 
Published: March 2007

Abstract
A series of 23 patients with suspected recurrent disease following ‘curative’ resection for gastric carcinoma was submitted to further laparotomy (24 operations). Three patients were found to have hopeless dissemination, 10 had palliative procedures performed which relieved their dysphagia, vomiting and jaundice, 4 had recurrences resected and 1 had a second primary of the gastric stump excised. No less than 6 were found to have benign lesions.
Although the reward as far as prolonged survival is small, we believe that the relief of symptoms and the occasional long term excellent result justifies judicious use of a ‘second look’ laparotomy for suspected recurrent disease.
Flatulent dyspepsia in patients with gallstones undergoing cholecystectomy
Authors: Kingston R D , Windsor W O 
Published: March 2007

Abstract
The incidence of flatulent dyspepsia and its relationship to gallbladder function has been studied in 100 consecutive patients with gallstones undergoing cholecystectomy. Thirty-three per cent of patients suffered significant flatulent dyspepsia of whom 80 per cent were cured or improved by operation.
In 15 patients gastric function was studied pre- and postoperatively and it was noted that there was no difference in gastric emptying times between patients with flatulent dyspepsia who were cured by operation and those who remained symptomatic.
Bacteriological studies on gallbladder bile from 39 patients suggested that infection within the gallbladder may be a factor in the causation of flatulent dyspepsia.