bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of vertical banded gastroplasty on the natural history of gastritis in patients with morbid obesity: a follow-up study
Authors: Flejou J-F , Owen E R T C , Smith A C , Price A B 
Published: March 2007

Abstract
Vertical banded gastroplasty is an accepted surgical treatment for morbid obesity. The aim of this study was to evaluate its effect on the natural history of gastritis, as the occurrence of gastritis and dysplasia have been reported after gastric bypass, another type of bariatric surgery. Thirty-four patients who underwent vertical banded gastroplasty between 1983 and 1987 were studied, and the follow-up varied from 1 to 47 months (mean 22 months). We found no increase of gastritis and intestinal metaplasia after surgery, and we did not observe any case of gastric dysplasia. Only one patient with pre- and postoperative specimens showed a deterioration in gastric histology after surgery, and this was of a minor degree. These initial results are encouraging for surgeons interested in the treatment of morbid obesity.
Treatment of stomach cancer, a national experience
Authors:   Members of the Norwegian Stomach Cancer Trial, Valen B , Viste A , Haugstvedt T , Eide G E , Søreide O 
Published: March 2007

Abstract
A total of 1165 patients with stomach cancer were entered into a prospective, observational national study. They represented 54 per cent of all stomach cancer patients reported to the Cancer Registry in Norway during the study period, and data are analysed for three hospital levels (local, county and university hospitals). The median age was 71 years (range 18–96 years). The median pretreatment delay was 113 days, and 46 per cent of patients had a performance status (Karnofsky index) of 80. The diagnosis was confirmed by pre-operative histology in 88 per cent of cases. In all, 88 per cent of patients underwent surgery, the resectability rate was 67 per cent and 50 per cent had a potential curative operation. Total gastrectomy was most commonly performed. Lymph node dissection was performed in 14 per cent of those undergoing a curative resection. The postoperative complication rate was 27 per cent but varied with the type of operation, being highest in proximal resection (55 per cent) and lowest after distal resection (19 per cent). A total of 7 per cent of the patients died postoperatively. Most patients had advanced disease at the time of treatment and only 6 per cent had stage I tumours. There were significant differences in patient and treatment characteristics between the three hospital levels. In conclusion, patient selection bias which will influence results does occur. A fairly aggressive attitude towards local disease was found; but the low proportion of patients undergoing lymph node dissection not only leads to questions regarding the efficacy of this treatment policy, but also casts doubt on the validity of staging of stomach cancer. Morbidity and mortality rates are still high. The consequences of the differences revealed between hospital groups are difficult to interpret. Proponents of both regionalization of treatment and small hospital care may find arguments for their case in the data.
Trial of sclerosing agents in patients with oesophageal varices
Authors: Kitano S , Iso Y , Yamaga H , Hashizume M , Higashi H , Sugimachi K 
Published: March 2007

Abstract
Forty-five cirrhotic patients with oesophageal varices underwent endoscopic injection sclerotherapy in a prospective randomized trial carried out to compare two sclerosing agents (5 per cent ethanolamine oleate and 2 per cent sodium tetradecyl sulphate (STD)) with respect to safety, efficacy and complications. Twenty-three patients were allocated to the ethanolamine group and twenty-two to the STD group. The rate of control of acute bleeding was 100 per cent (6/6) in the ethanolamine group and 75 per cent (3/4) in the STD group. There was a significantly lower rate of postinjection bleeding after the over-tube was removed at the initial session of sclerotherapy when ethanolamine was injected 0/23 versus 7/22, 32 per cent; P &lt; 0.01) and at the second session there was a significantly (P &lt; 0.01) higher rate of jet-like bleeding from injection sites in the STD group (6/21, 29 per cent) than in the ethanolamine group (0/22). The disappearance rate of red colour signs 1 week after the initial session of sclerotherapy in the ethanolamine group was 100 per cent and 62 per cent in the STD group. Early oesophageal ulcers developed less frequently in the ethanolamine group (0 and 9 per cent) than in the STD group (24 per cent and 43 per cent both after the initial (P &lt; 0.05) and the second session of sclerotherapy (P &lt; 0.01)). Early bleeding from an oesophageal ulcer occurred only in the STD group (5/21, 24 per cent) before the third session of sclerotherapy (P &lt; 0.05). The rate of early mortality did not differ between the two groups. We conclude that ethanolamine seems to be safer and more efficacious than STD for sclerosing oesophageal varices.
Intramural haematoma of the alimentary tract in children
Authors: Chittmittrapap S , Chandrakamol B , Chomdej S 
Published: March 2007

Abstract
Thirteen children with intramural haematoma of the alimentary tract were treated in Chulalongkorn University Hospital during an 8-year period (1978–1986). A history of trauma was obtained in 11 cases, 1 case presented as a result of a coagulation defect secondary to a haematotoxic snake bite and no causative factor was apparent in 1 patient. Profound vomiting with abdominal pain is the typical presentation. Upper gastrointestinal contrast study is usually characteristic and diagnostic. Conservative treatment was successful in 12 of the cases with no morbidity and mortality.
Perforated gastric ulcer
Authors: Lanng C , Hansen C Palnæs , Christensen A , Thagaard C S , Lassen M , Klærke A , Tønnesen H , Ostgaard S E 
Published: March 2007

Abstract
A retrospective study is presented of 297 patients operated upon for perforated benign gastric ulcer in Denmark from 1975 to 1984. Male: female ratio was 0.9:1, mean age 64.2 years. The numbers of gastric and prepyloric perforations were almost equal (156:141), but gastric perforations were more frequent in elderly women and prepyloric perforations in younger men. Simple closure was performed in 83 per cent of the patients, gastric resection in 14 per cent and simple closure and vagotomy in 3 per cent. The postoperative mortality rate was 21 per cent and was related to the high proportion of elderly patients with concurrent diseases and delayed treatment.
Enucleated parotid tumours
Authors: Maynard J D 
Published: March 2007

Abstract
Five pleomorphic, one monomorphic adenoma and one acinic cell lower pole parotid tumours were thought to be lymph nodes and enucleated. Wide excision of the operative site within 2 months revealed microscopic recurrence in three cases. Three carcinomas were enucleated and two had recurred rapidly. It is suggested that such cases of inadvertent enucleation should undergo wide resection of the operative site with nerve dissection.
Use of older patients as cadaveric kidney donors
Authors: Foster M C , Wenham P W , Rowe P A , Blamey R W , Bishop M C , Burden R P , Morgan A G 
Published: March 2007

Abstract
We have no fixed upper age limit for cadaveric kidney donors and donors over the age of 50 provided kidneys for 22 per cent of our adult transplant recipients between 1983 and 1986. Immediate function following transplantation occurred in 17 per cent of these kidneys compared with 58 per cent for kidneys from donors under the age of 50. The 1-year actuarial graft survival rate for transplants from donors over 50 was 52 per cent, compared with 70 per cent for transplants from donors under 50 (P &lt; 0.05). Thus kidneys from older donors make an important contribution to the total pool of organs available for transplantation, but their use leads to inferior results in comparison with kidneys from younger donors.
Prophylactic antibiotics in elective colorectal surgery
Authors: Lau W Y , Chu K W , Poon G P , Ho K K 
Published: March 2007

Abstract
A randomized prospective study was conducted on 194 patients who underwent elective colorectal surgery for carcinoma. All patients received the same mechanical bowel preparation. In addition, patients in group A received oral neomycin and erythromycin base; patients in group B received systemic metronidazole and gentamicin, while patients in group C received both oral and systemic antibiotics. Postoperative septic complications related to colorectal surgery occurred in 27.4 per cent, 11.9 per cent and 12.3 per cent respectively in groups A, B and C (χ2 = 7; P &lt; 0.05). The incidence of sepsis in groups B and C was almost identical. Patients who received oral antibiotics alone (group A) had significantly higher risks of postoperative sepsis when compared with patients in either group B or group C (P &lt; 0.05). As there is no additional advantage of combining oral and systemic antibiotics, we recommend systemic metronidazole and gentamicin to be used with mechanical bowel preparation in elective colorectal surgery.
Choledochal cyst: A 33-year review
Authors: Robertson J F R , Raine P A M 
Published: March 2007

Abstract
We present 13 patients who were seen at Glasgow hospitals over a 33-year period. Only five (38 per cent) were children. Of the eight adults, two had complications of the cyst at presentation, namely biliary cirrhosis and cholangiocarcinoma respectively. Another adult patient developed a carcinoma in the cyst 9 years after internal drainage. The incidence of malignant change in the series was therefore 15 per cent. Only five patients have remained well after surgery: three had complete excision and two internal drainage. Of the eight other patients, one had complete excision, five had internal drainage, one had partial excision and one had cholecystectomy and (years later) sphincterotomy. We believe that excision of the cyst is the treatment of choice.
Cyclical mastopathy: A critical review of therapy
Authors: Goodwin P J , Neelam M , Boyd N F 
Published: March 2007

Abstract
Because of a recently completed trial which demonstrated that dietary fat reduction improved the symptoms of cyclical mastopathy, we have carried out a critical review of other studies of treatment for this disorder to determine what, if any, mechanisms of action were shared by effective treatments. Therapies were classified as ‘definitely effective’ if their effectiveness was demonstrated in at least one randomized placebo-controlled study of women with cyclical mastopathy, ‘probably effective’ if their effectiveness in relieving breast symptoms was demonstrated in at least one study in women with premenstrual syndrome, and ‘probably not effective’ if they had not been shown to improve breast symptoms in at least two studies in women with premenstrual syndrome. Bromocriptine, danazol, evening primrose oil, tamoxifen and reduction of dietary fat intake were classified as definitely effective and norethisterone and Bellergal as probably effective. Several therapeutic manoeuvres, including reduction of methylxanthine ingestion and the administration of vitamin E or diuretics, have not been adequately evaluated in women with cyclical breast symptoms. A review of the published reports of the physiological effects of therapies that were definitely or probably effective revealed that these agents acted either to alter serum prolactin levels or lipid metabolism, or both. As evidence exists that prolactin influences lipid metabolism it is postulated that cyclical mastopathy may be a disorder of lipid metabolism.
Dosage and duration of tamoxifen treatment for mastalgia: A controlled trial
Authors: Fentiman I S , Caleffi M , Hamed H , Chaudary M A 
Published: March 2007

Abstract
A controlled trial has been conducted in which 60 women with mastalgia were randomly allocated to receive tamoxifen at a dosage of either 10 mg or 20 mg daily for either 3 or 6 months. All eligible patients had self-rated moderate or severe mastalgia present for at least 6 months, for which no specific therapy had been given for the previous 3 months. End points of the study were pain control, measured by linear analogue scales, relapse rate and side-effects. Pain relief was achieved in 90 per cent of those receiving 10 mg daily and 86 per cent of those given 20 mg daily. The relapse rate was also similar for both dosages, being 48 per cent and 39 per cent respectively and usually occurred within 2–3 months of discontinuing treatment. However, side-effects were reported less frequently among those receiving 10 mg daily (21 per cent versus 64 per cent; x2 = 11·1, P &lt;0·001). Prolongation of treatment from 3 months to 6 months did not materially improve the response rate (85 per cent versus 90 per cent). Side-effects were similar, as was the relapse rate among the patients receiving the two durations of treatment. The agent proved to be significantly more effective in the relief of cyclical rather than non-cyclical pain (94 per cent versus 56 per cent). Use of tamoxifen for the treatment of mastalgia is still experimental. Nevertheless, for the majority of women with mastalgia, pain relief can be achieved using tamoxifen 10 mg daily, given for a 3-month course. As almost half these patients will develop relapse of breast pain it may be necessary to give longer courses of therapy, although the safety of this more protracted treatment has yet to be determined.
Effect of intraperitoneal saline irrigation at different temperatures on adhesion formation
Authors: Kappas A M , Fatouros M , Papadimitriou K , Katsouyannopoulos V , Cassioumis D 
Published: March 2007

Abstract
This study was designed to examine the influence of saline irrigation at different temperatures on adhesion/formation in the rat. Saline irrigation through a laparotomy incision was performed at the following temperatures: 30°C, 34°C, 37°C, 40°C, 45°C, 50°C, 55°C, and 60°C. The control group (Gc, n = 20) underwent laparotomy without irrigation. Adhesions were found in: 5/20 animals of the Gc (all slight); 6/20 of the 30°C group (all slight); 6/20 of the 34°C group (all slight); 6/20 of the 37°C group (all slight); 12/20 of the 40°C group (all slight); 12/20 of the 45°C group (11 slight, 1 moderate); 14/20 of the 50°C group (12 slight, 2 moderate); 18/19 of the 55°C group (2 slight, 6 moderate, 10 marked); and 18/18 of the 60°C group (1 moderate, 8 marked, 9 massive). These results indicate that saline irrigation below body temperature does not prevent adhesions whereas warmed saline encourages adhesion formation in the rat.
Neutrophil degranulation and increased pulmonary capillary permeability following oesophagectomy: A model of early lung injury in man
Authors: Rocker G M , Wiseman M S , Pearson D , Shale D J 
Published: March 2007

Abstract
In nine subjects undergoing oesophagectomy a transient but significant increase in pulmonary vascular permeability to transferrin was detected in both lungs 8 h after surgery. It coincided with a significant increase in plasma lactoferrin, evidence of intravascular and intra-alveolar neutrophil elastase release and with arterial hypoxaemia. The postoperative state in these patients had intravascular and pulmonary features often associated with the adult respiratory distress syndrome, and might be a useful model for the study of the early inflammatory events underlying lung injury in man.
Low molecular weight heparin given the evening before surgery compared with conventional low-dose heparin in prevention of thrombosis
Authors: Bergqvist D , Mätzsch T , Burmark U S , Frisell J , Guilbaud O , Hallböök T , Horn A , Lindhagen A , Ljungnér H , Ljungström K-G , Onarheim H , Risberg B , Törngren S , Örtenwall P 
Published: March 2007

Abstract
A prospective randomized double-blind trial was performed comparing conventional low-dose heparin with a low molecular weight heparin fragment for thromboprophylaxis in elective general abdominal surgical patients. The first dose of the heparin fragment was given the evening before surgery, and further doses were given thereafter every evening. There were 1002 analysable patients, 826 having received correct prophylaxis. Of these 1002 patients, 64 per cent were operated on for malignant disease. A total of 20 patients died, 10 in each group. The 5·0 per cent, P = 0·02). The frequency of bleeding was 6·7 per cent among patients with correct prophylaxis with the heparin fragment (9·2–5·0 per cent, P = 0·02). The frequency of bleeding was 6·7 per cent among the heparin fragment patients and 2·7 per cent among the patients given conventional heparin (P = 0·01), but all bleeds were of minor degree and there was no difference in the reoperation rate for bleeding, or in the transfusion requirements. Local pain at the injection site was reported significantly less often among patients given the heparin fragment.
Proliferation patterns and aneuploidy in adenomatous polyps of the colon
Authors: Matthews J , Sousha S , Parkins R A , Glynn M , Cooke T 
Published: March 2007

Abstract
The frequency of aneuploidy and the proliferative activity of 57 colorectal adenomatous polyps was investigated by static cytophotometry and compared with 43 adenocarcinomas and 60 samples of normal mucosa. Twenty per cent of the adenomas contained aneuploid cells compared with 63 per cent of the adenocarcinomas. Except in the case of villous adenomas, there was a general increase in the proliferative activity of the diploid adenomas with increasing degrees of dysplasia. All of the adenomas showed an increase in proliferation compared with normal mucosa. There was a positive correlation between the size of the diploid adenomas and proliferative activity (P &lt; 0·001).
Renal transplantation in patients over 55 years old
Authors: Lauffer G , Murie J A , Gray D , Ting A , Morris P J 
Published: March 2007

Abstract
From 1975 to 1987, 507 patients, of whom 63 (12.4 per cent) were over 55 years old at the time of operation, received first cadaver renal transplants. The annual percentage of recipients given transplants after the age of 55 has risen from 0 per cent in 1975 to 44 per cent in 1987. Of the 63 older patients, 41 had at least one serious non-renal disease at the time of transplantation. Perioperative mortality rate was 3 per cent. After successful transplantation these patients remained subject to a significant number of serious complications, even in the cyclosporin era. Despite these adverse factors, actuarial graft survival for the population over 55 years of age was no worse than for those patients receiving first cadaver grafts who were under 55 years old, although patient survival was poorer in the former group (P = 0.027). Analysis of the subgroup of 56 patients treated with an immunosuppression protocol containing cyclosporin failed to show any adverse effect of age on either graft or patient survival. It is concluded that renal transplantation can be as successful in patients over 55 years of age as it is in younger patients and, given an adequate supply of kidneys, should be considered the treatment of choice for the elderly patient with end-stage renal failure.
Pre-operative or postoperative colonic examination for synchronous lesions in colorectal cancer
Authors: Tate J J T , Rawlinson J , Royle G T , Brunton F J , Taylor I 
Published: March 2007

Abstract
A review of 130 consecutive large bowel examinations at which a cancer of the colon or rectum was diagnosed has been undertaken. Of 50 patients examined by colonoscopy, the whole colon was seen in only 21 (42 per cent) and almost half of these had a tumour in the caecum or ascending colon. In most cases, an incomplete examination was a result of narrowing of the lumen by the tumour preventing passage of the endoscope. Of 80 patients examined by double contrast barium enema, the entire length of the colon was visualized in 83 per cent but the quality of the examination was sufficient to confidently exclude synchronous neoplastic lesions in only 51 per cent. The incidence of synchronous cancer in this series was within the expected range, although two such cancers were not detected until laparotomy, but the incidence of synchronous adenomas was two-thirds of the expected number in colonoscopy patients and one-third in those examined by barium enema. It is concluded that, in patients with known colorectal cancer, preoperative investigation is unreliable for the detection of all synchronous neoplasia and that patients should have postoperative colonoscopy.
Comparison of a low molecular weight heparin and unfractionated heparin for the prevention of deep vein thrombosis in patients undergoing abdominal surgery
Authors:   The European Fraxiparin Study (EFS) Group, Encke A , Breddin K 
Published: March 2007

Abstract
In a prospective, randomized multicentre trial the efficacy and safety of the low molecular weight heparin (LMWH) fraction Fraxiparin® and unfractionated calcium heparin (Calciparin®) were compared for the prevention of postoperative deep vein thrombosis. Of 1909 patients included in the trial 1896 underwent abdominal surgery and received either one daily subcutaneous injection of 7500 anti-X a units Fraxiparin or 5000 units calcium heparin three times a day subcutaneously. Elastic compression stockings were worn by both groups of patients in the postoperative period. Before randomization the patients were stratified in two subgroups with or without malignant disease. To assess the rate of deep vein thrombosis (DVT), 125I-labelled fibrinogen leg scanning was performed daily for 7 postoperative days. Positive results were confirmed by phlebography whenever possible. Venous thrombosis occurred in 27 of 960 patients (2.8 per cent) given Fraxiparin and in 42 of 936 patients (4.5 per cent) given calcium heparin (P = 0.034). The rates of proximal vein thrombosis were 0.4 per cent (4 patients) and 1.4 per cent (13 patients) respectively (P&lt;0.05). Pulmonary embolism occurred in 2 of 960 patients (0.2 per cent) treated with Fraxiparin and in 5 of 936 patients (0.5 per cent) treated with calcium heparin. The two treatments were equally well tolerated. Intra- and postoperative blood loss, the number of wound haematomas as well as frequency and volume of transfusions were similar in both groups. The present trial demonstrates that a single daily subcutaneous injection of Fraxiparin is more effective than the established low dose subcutaneous heparin prophylaxis with 5000 units three times per day in preventing postoperative DVT after abdominal surgery in patients wearing compression stockings.
Obstructive pancreatitis: Unusual causes of chronic pancreatitis
Authors: Lowes J R , Rode J , Lees W R , Russell R C G , Cotton P B 
Published: March 2007

Abstract
Fifty-eight consecutive surgical pancreatic resections for chronic pancreatitis were examined. Eight cases were identified with obstructive pancreatopathy; all underwent pancreato-duodenectomy. Histological examination revealed that obstruction in three cases was due to duodenal wall cysts, and in two patients it was associated with pancreas divisum (the accessory papilla was obstructed by a neuroendocrine tumour in one case and by ectopic pancreatic tissue in the other). One case each was due to obstruction of an anomalous duct by vegetable matter, to segmental pancreatitis, and to an intraductal carcinoma. Obstructive pancreatitis has many causes and diligent pre-operative assessment is required as surgical resection may be beneficial. Special efforts should be made to identify ductal anomalies, duodenal cysts, ectopic pancreatic tissue, and small ampullary tumours of exocrine and endocrine origin in order to define the aetiology of pancreatitis.