bluuebunny/crossref_metadata_2025_split huggingface dataset:
Familial phaeochromocytoma with von Hippel's disease in one sister and ectopic adrenal cortex in the kidney in another
Authors: Mendelow A David , Kay S , Levin E , Mieny C J 
Published: March 2007

Abstract
Two sisters with bilateral adrenal phaeochromocytomas are reported. Von Hippel's disease of the retina was found in the one and ectopic adrenal cortical tissue was found in the kidney of the other. The latter association has not previously been described with familial phaeochromocytoma.
The clinical significance of gallstones and their radiological investigation
Authors: Earlam R J , Thomas M 
Published: March 2007

Abstract
The symptoms of 122 patients with gallstones were correlated with the radiological findings. No specific indigestion was present which could be termed “flatulent dyspepsia”. Sensitivity to fatty foods occurred in 69 per cent, heartburn in 42 per cent, regurgitation of acidtasting or bitter fluid to the mouth in 31 per cent and increased passage of flatus from the stomach upwards in 38 per cent. If the gallbladder concentrated contrast medium on an oral cholecystogram but did not contract after a fatty meal, the patients suffered less heartburn than if the gallbladder functioned normally. However, since surgeons rarely perform a cholecystectomy for flatulent dyspepsia alone, knowledge of gallbladder function may be unnecessary.
An assessment of the accuracy of modern endoscopic diagnosis of oesophageal stricture
Authors: Eastman M C , Gear M W L , Nicol A 
Published: March 2007

Abstract
The results of 135 fibreoptic endoscopic examinations of oesophageal strictures carried out in a district general hospital are reported. The endoscopic diagnosis was correct in 90 per cent, uncertain in 3 per cent and incorrect in 7 per cent of these cases. This study indicates that endoscopic examination should include tissue sampling; this not only allows a precise tissue diagnosis to be made but also is shown to increase the accuracy of diagnosis. Tissue sampling should include cytological as well as histological material. Analysis of cases of stricture correctly diagnosed has shown that target biopsy and brush cytology each makes a significant contribution to diagnosis. The routine collection of cytological specimens in addition to the more commonly obtained histological specimens is strongly advocated.
The natural history of malignant oesophageal strictures in this study is reviewed. The mean survival in 58 cases was 6·9 months.
Tuberculous fistula between the 5th lumbar vertebra and the colon presenting as a left thigh abscess
Authors: Johnson A D , McIntosh W J 
Published: March 2007

Abstract
An abscess of the left thigh due to a fistula between a tuberculous 5th lumbar vertebra, the sigmoid colon and the muscles and subcutaneous tissues of the left thigh is described. This appears to be a unique occurrence and was only diagnosed at post-mortem. The treatment and diagnosis are discussed.
The bruit–occlusion test: A clinical method for localizing arterial stenosis
Authors: Dowell A J , Sladen J G 
Published: March 2007

Abstract
The bruit–occlusion test is accomplished by listening to a bruit whilst occluding and releasing an efferent artery, e. g. bruit in the groin, occluding the superficial femoral artery. If the bruit disappears, that efferent artery is stenosed. Changes in intensity of the bruit imply stenosis in the parent or alternate efferent vessels. The test is useful in the follow-up of aortofemoral and particularly femoropopliteal vein grafts. It can be applied in the abdomen and neck.
This simple manoeuvre can be added to a vascular examination whenever a bruit is discovered. It often allows specific anatomical diagnosis and can be more reliable than arteriography.
The nature of hypocalcaemia in acute pancreatitis
Authors: McMahon M J , Woodhead J S , Hayward R D 
Published: March 2007

Abstract
A retrospective and prospective study was made of 82 attacks of acute pancreatitis occurring in 80 patients. Attacks were defined as mild (55) or severe (27) according to clinical criteria. Severe attacks were associated with significantly low levels of uncorrected calcium and calculated ionized calcium, both at the time of admission and 48 h later.
Patients with severe attacks were found to have lower levels of parathyroid hormone than either those with mild attacks or other patients who had undergone an abdominal operation. These results indicate that severe pancreatitis is associated with true hypocalcaemia, and that deficiency of circulating parathyroid hormone may be a factor in its production.
Cushing's syndrome: 20 years after adrenalectomy
Authors: Montgomery D A D , Welbourn R B 
Published: March 2007

Abstract
The long term results (over 20 years) of our first 13 patients treated by adrenalectomy for Cushing'ssyndrome are described. Twelve survived operation and 5 of these died within 5 years, but thereafter the expectation of life of the treated patients was similar to that of the general population. At 20 years 7 patients were alive and 6 were well. If modern therapeutic measures to control adrenocortical function before operation had been available 20 years ago, some of the early deaths might have been prevented.
Inhibition of aldosterone response to surgery by saline administration
Authors: Engquist A , Blichert-Toft M , Ølgaard K , Brandt M R , Kehlet H 
Published: March 2007

Abstract
The renin-angiotensin system, ACTH and hyperkalaemia are known to induce increased plasma levels of aldosterone. In order to assess the relative significance of these mechanisms during surgical stress, aldosterone, cortisol and electrolytes in plasma were measured in 12 otherwise healthy women during and after cholecystectomy. The patients received either isotonic sodium chloride or 5 per cent glucose in water during the experimental period of 22 h.
The results showed that the pronounced increase of aldosterone and the concomitant decrease of sodium in plasma found in patients given glucose in water could almost be inhibited by the administration of saline. Cortisol and potassium concentrations were identical in the two groups of subjects.
It is concluded that the aldosterone response to surgery is mainly mediated via the renin-angiotensin system. This response is probably due to a reduced sodium content or volume of extracellular fluid, since it could almost be inhibited by administration of sodium chloride. The rationale of saline restriction during and after surgery is questioned.
Morbidity and mortality in renal transplant patients after incidental surgery
Authors: Bakkaloglu M , Hamilton D N H , Macpherson S G , Briggs J D 
Published: March 2007

Abstract
Sixty-five further surgical procedures were carried out in 39 renal transplant patients without mortality and with low morbidity. There was a 9 per cent incidence of clean wound infection, and minor chest infection occurred in another 9 per cent. Stay in hospital for these procedures was not prolonged. The function of the transplanted kidney showed no deterioration after these further surgical procedures. The successfully transplanted patient is thus a good candidate for further surgery despite the previous renal failure and the continuing immunosuppressive therapy.
Anorexia nervosa and Crohn'sdisease
Authors: Metcalfe-Gibson C 
Published: March 2007

Abstract
Two cases of anorexia nervosa who were subsequently found to have Crohn'sdisease are presented. The difficulties in determining whether they had anorexia nervosa and Crohn'sdisease concomitantly or whether the Crohn'sdisease alone was responsible for their condition are discussed without definite conclusion. The importance of excluding occult organie disease before assuming a diagnosis of anorexia nervosa is stressed.
Postoperative recurrence of hydatid disease
Authors: Mottaghian Hassan , Saidi Farrokh 
Published: March 2007

Abstract
Since larval scolices of the parasite Echinococcus granulosus are capable of developing in vivo into mature hydatid cysts in the human intermediate host, operative spillage of cyst contents can lead to local regrowth of hydatid cysts after a suitable interval. The overall rate of postoperative recurrence of hydatid cysts of soft tissue organs in 106 patients, followed-up form 6 months to 3 years, was 11.3 per cent. Both host and parasite factors determine recurrence. Serosal and surgical wound surfaces, unlike mucosal surfaces, provide fertile ground for the development of implanted scolices into hydatid cysts. No correlation was found between the size of removed cysts and postoperative recurrence. The risk of recurrence and associated morbidity was highest in patients with multiple intra-abdominal cysts. Certain technical problems increase the chance of inadvertent operative rupture and spillage of cyst contents, with subsequent regrowth of cysts. Routine measures against operative spillage of hydatid fluid are mandatory, but the actual method of surgical treatment must be individualized for every case.
The selective use of combined supraduodenal and transduodenal exploration of the common bile duct
Authors: Aubrey D A , Edwards J L 
Published: March 2007

Abstract
The results of combined supraduodenal and transduodenal exploration of the common bile duct in 42 selected cases are presented. The indications for this operation were: the presence of multiple calculi in the common bile duct: stones impacted in the ampullary region; residual stones in the common bile duct following previous surgery on the biliary tract; stricture at the papilla and pancreatitis associated with cholelithiasis. After the procedure no patient had residual stones in the common bile duct. Serious complications were infrequent; there were no postoperative deaths and postoperative pancreatitis occurred in only one patient.
The use of endoscopy in the surgical treatment of the Mallory-Weiss syndrome
Authors: Metcalfe-Gibson C , Chaudhury S C 
Published: March 2007

Abstract
Fibreoptic endoscopy has provided a new dimension in the diagnosis and management of oesophageal and upper gastrointestinal disorders. Its value as an aid to surgery of the lower oesophagus is demonstrated in a case of the Mallory-Weiss syndrome.
Evaluation of the thrombogenic potential of three types of arterial graft studied in an artificial circulation
Authors: Hamlin G W , Rajah S M , Crow M J , Kester R C 
Published: March 2007

Abstract
The thrombogenic potential of woven Dacron, expanded polytetrafluoroethylene (Gore-Tex) and gluteraldehydetreated human femoral artery (HFA) grafts was evaluated using an artificial circulation. The differences in the platelet parameters (platelet count, adhesion and aggregation) and scanning electron microscopy (SEM) appearances before and after perfusion were used as indices of thrombogenicity. Platelet counts fell significantly with woven Dacron, moderately with HFA and no fall was observed with Gore-Tex. Platelet aggregation was unaffected by any graft, but platelet retention was significantly marked in woven Dacron. SEM studies revealed minimal adherence of platelets to Gore-Tex and HFA endothelium, but marked adherence to woven Dacron, accompanied by morphological changes of the adhered platelets.
In an artificial circulation, of the three types of arterial graft, woven Dacron has the greatest influence on platelet function, indicating significant thrombogenicity, whereas HFA is intermediate in its effect and Gore-Tex appears to have the lowest thrombogenic potential.
Clinically silent gross hypergastrinaemia from a multiple hormone-secreting pancreatic apudoma
Authors: Joffe S N , Elias E , Rehfeld J F , Polak J M , Bloom S R , Welbourn R B 
Published: March 2007

Abstract
A patient is described who had a malignant pancreatic islet cell apudoma secreting corticotrophin (ACTH) and melanocyte-stimulating hormone (MSH), both of which were clinically active, and very large quantities of immunoreactive gastrins, which were biologically active but clinically silent (normal gastric acid secretion and no peptic ulceration). The presence of parietal cell antibodies, with no increase in the plasma concentrations of hormones which can inhibit gastric acid secretion (secretin, GIP and VIP), suggests that many of the parietal cells may have been blocked by the autoantibodies.
The role of the profunda femoris in aorto-iliac surgery
Authors: Ward A S , Morris-Jones W 
Published: March 2007

Abstract
The results of aorto-iliac surgery in 90 ischaemic limbs (68 patients) have been reviewed. The mean follow-up period was 18 months (rang 6 monts to 3.5 years). In 48 limbs the disease was confined to the aorto-iliac segment (group 1), while in 42 limbs severe occlusive changes were present in both the aorto-iliac and superficial femoral segments (group 2).
In group intermittent claudication was obolised or substanitally improved in 86 per cent. Rest pain was relieved in all cases. Lumbar sympathectomy was with out obvious additional benefit in either group. Pedal pules were restored in all except 3 limbs. A highly significant (P &lt;0.001) increase in the ankle systolic pressure (ASP) index occurred after surgery and normal values were restored both in claudicants and in those with rest pain. This response was maintained through out the follow-up period.
Claudication was effectively relived in 38 per cent of cases in group 2 following aortoprofunda reconstruction. Rest pain was abolished in 83 per cent of cases, the remainder requrining a major amputation. Lumbar sympathectomy failed to produce any additional benefit among either claudicants or those with rest pain. Pedal pulses were restored in only 2 limbs. Among claudicants the ASP index was uncharged, and although a significatn (P &lt;0.001) increase occurred in the rest pain group, the index remained within the ischaemic range. There was little variation in the value of the ASP index throughout the follow-up period in either group. The difference between the ASP response to surgery in patients with aorto-iliac disese alone and those with dual occlusion was highly significant (P &lt;0.001).
The present results suggest that among claudicants revascularization of the profunda alone may be followed by a limited clinical and hoemodynamic response. However, as a limb salvage procedure, aortoprofunda reconstruction can be recommended with confidence. When both the superficial and deep femoral vessels are patent, on excellent response is to be expected after aorto-iliac surgery in claudicants and patients with rest pain alike.
The treatment of early colorectal cancer by local excision
Authors: Lock M R , Cairns D W , Ritchie Jean K , Lockhart-Mummery H E 
Published: March 2007

Abstract
An analysis is presented of 143 patients with early colorectal carcinoma treated by local excision between 1948 and 1972 at St Mark's Hospital. The tumours are considered in three groups; colonic tumours, pedunculated rectal tumours and non-pedunculated rectal tumours. The importance of careful clinical assessment and accurate pathological examination is emphasized. Local excision of the tumours, using various operative techniques, gave good results and this method of management can be recommended in the carefully selected case.
A study of technetium-labelled sulphide colloid uptake by regional lymph nodes draining a tumour-bearing area
Authors: Boak J L , Agwunobi T C 
Published: March 2007

Abstract
With appropriate controls, experimental groups of inbred C3H mice bearing a syngeneic mammary carcinoma challenge in their right rear footpads were injected in both rear footpads with 99Tcm ASC. Mice were sacrificed 15 and 90 min after the labelled colloid injection. Popliteal and sacral lymph nodes were weighed and counted in a well scintillation counter. A marked inhibition of labelled colloid uptake was demonstrated in regional lymph nodes draining a tumour-bearing area.
Rabbits bearing VX2 carcinoma in a forelimb received 99Tcm ASC into each front footpad. Depression of labelled colloid uptake by regional lymph nodes draining tumour was evident on gamma-camera scanning.
Secondary acute pancreatitis: Aetiology, prevention, diagnosis and management
Authors: Imrie C W , McKay A J , Benjamin I S , Blumgart L H 
Published: March 2007

Abstract
Secondary acute pancreatitis occurs soon after surgery, upper abdominal trauma or the clinical investigations of endoscopic retrograde choledochopancreatography (ERCP) or translumbar aortography (TLA). In this study of secondary acute pancreatitis, 30 patients developed acute pancreatitis after surgery, 12 following trauma and 8 following ERCP or TLA. These 50 patients were drawn from a total of 501 patients with all forms of acute pancreatitis admitted to Glasgow Royal Infirmary from 1960 to 1976. Thirty-seven of the patients were part of a prospective study of 361 patients, while the remainder were examined retrospectively.
Important features in the prevention of secondary acute pancreatitis are avoidance of forceful surgical dilatation of the lower common bile duct and unnecessary operative procedures at the sphincter of Oddi. Careful technique is nessary when performing ERCP or TLA. In the prospective phase of this study, early diagnosis of secondary acute pancreatitis was achieved by careful clinical observation and biochemical screening of ‘at risk’ patients. The mortality rate in patients studied retrospectively was 46 per cent while in those studied prospectively it was 13.5 per cent.
Postoperative acute pancreatitis had the highest mortality rate (30 per cent) and most frequently followed biliary tract surgery. A disproportionately large number of patients developed pancreatitis after sphincterotomy or sphincteroplasty.
Early laporotomy is advocated in patients with pancreatitis occurring after blunt abdominal trauma. Where the initial management was conservative in this group, late pseudocyst formation requiring surgical drainage was common.
Arterial reconstruction extending below the popliteal bifurcation
Authors: Ferguson I A , Rosengarten D S , Stuchbery F E , Barnett A J 
Published: March 2007

Abstract
Results are reported for 172 anastomoses below the popliteal artery in patients almost exclusively suffering from severe distal ischaemia with an in-hospital mortality of 7.6 per cent. The patency rate in survivors was 83 per cent on discharge and 39 per cent at 3 years.
There were 37 major amputations following 172 operations and 15 following 47 operations on diabetics. As most of the patients would have lost their limbs if arterial repair was not undertaken this constitutes a considerable salvage rate.
Diabetes mellitus does not appear to influence the results unfavourably, so patients suffering from this disease should be considered for operation.
Management of recurrent peptic ulceration
Authors: Green W E R , Kennedy T , Hassard T , Spencer E F A 
Published: March 2007

Abstract
A series of 117 consecutive patients having operations for recurrent peptic ulcer is reported. There were no initial deaths but 9 patients developed further recurrent ulcer and 2 of 8 who had a third operation died, giving an overall patient mortality of 1.7 per cent. A further 6 patients underwent a third operation to correct bile vomiting or dumping, with no deaths.
The mean time of onset of symptoms of recurrent ulcer was 1.9 years after proximal gastric vagotomy, 3.2 years after vagotomy and drainage, 3.3 years after gastrectomy and 12.6 years after gastrojejunostomy.
One hundred and four patients were followed for more than 1 year (mean 5.2 years) and the result was good in 77 per cent. After a third operation the proportion of good results was improved to 88 per cent.
Second recurrence occurred in 1 of 43 patients after revagotomy and gastrectomy, in 2 of 28 after resection alone and in 6 of 33 after vagotomy or revagotomy alone (P &lt;0.05). When the patients whose primary operation included neither vagotomy nor gastric resection were excluded, there was a similar trend but the differences were not significant. It is suggested that gastric resection or re-resection should be combined with vagotomy or revagotomy whether the primary operation has been gastrectomy, vagotomy with or without drainage or gastrojejunostomy alone.
Endoscopic appearances and histological changes in ulcer-associated doudenitis
Authors: Stephen J G , Lesna M , Venables C W 
Published: March 2007

Abstract
A simple system of grading the endoscopic appearances of duodenitis is described. There was a good association between the degree of duodenitis recorded using this method and that obtained from a histological grading system in a group of duodenal ulcer patients and a group of dyspeptic patients with no endoscopic evidence of duodenitis. Endoscopic assessment is recommended as a reliable guide to the presence of duodenitis.
After 1 month of treatment with cimetidine there was a significant improvement in the endoscopic duodenitis scores of a group of 17 duodenal ulcer patients. In 16 of these patients there was complete ulcer healing.
Duodenitis can be a manifestation of chronic duodenal ulcer disease. In the absence of ulceration, the endoscopic diagnosis of duodenitis is of value in the recognition of patients with this condition.
Thermography in screening postoperative deep vein thrombosis: A comparison with the 125I-fibrinogen test
Authors: Bergqvist D , Hallböök T 
Published: March 2007

Abstract
The value of thermography as a screening method for postoperative deep vein thrombosis has been evaluated in 308 patients (616 legs). Comparison was made with the 125 I-fibrinogen test. The overall diagnostic agreement was 81.0 per cent; the sensitivity was 62.1 per cent and the specificity 90.3 per cent. The agreement increased with proximal extension of the thrombi. Thermography became positive 0.26 days after the 125 I-fibrinogen test but in 19.8 per cent thermography was positive before a positive fibrinogen test.
The origin of thrombi in the deep veins of the lower limb: A venographic study
Authors: Stamatakis J D , Kakkar V V , Lawrence D , Bentley P G 
Published: March 2007

Abstract
A series of 952 patients was examined by ascending venography; 812 with clinically diagnosed deep vein thrombosis (DVT) (group 1) and 140 with clinical features suggestive of pulmonary embolism (group 2). Thrombus was demonstrated in 401 (49.4 per cent) of group 1 and in 74 (53 per cent) of group 2 patients. A total of 535 limbs contained thrombus. In 493 (92 per cent) thrombus was present in the calf with either no further clot, or clot in continuity with that in more proximal veins. In the remaining 42 legs (8 per cent) thrombus either originated from multiple discontinuous sites in the legs and pelvis, or in proximal major veins without concomitant calf involvement. The clinical implications of these findings are discussed.
Saphenous neuralgia: A complication of arterial surgery
Authors: Jones N A G 
Published: March 2007

Abstract
The saphenous nerve may be damaged during arterial surgery in the thigh as it emerges through the aponeurotic covering of the adductor canal. A clean cut of the nerve gives rise to anaesthesia, but an incomplete cut or tearing of the nerve, followed by its involvement in scar tissue, leads to saphenous neuralgia–a painful sensation in the area supplied by the nerve.
Two hundred and fifty-seven arterial operations involving the course of the saphenous nerve in the thigh have been reviewed. Twenty-six of these operations were complicated by early failure of the arterial procedure necessitating amputation and have not been considered in assessing the incidence of damage to the nerve. One in five superficial femoral thromboendarterectomies and one in nine femoropopliteal bypass grafts were complicated by saphenous neuralgia. Profundaplasty was not followed by this complication.
Appreciation of this troublesome symptom should lead to greater care of the nerve during surgery.
Revascularization of an arm for incipient gangrene after Blalock-Taussig anastomosis
Authors: Mearns A J , Deverall P B , Kester R C 
Published: March 2007

Abstract
A case is reported of incipient gangrene of the right arm developing after a Blalock-Taussig (subclavian-pulmonary) shunt operation in an infant. The ischaemia was reversed by immediate common carotid-axillary artery-vein bypass, using a microvascular technique.