bluuebunny/crossref_metadata_2025_split huggingface dataset:
Growth rate of abdominal aortic aneurysms as measured by computed tomography
Authors: Delin A , Ohlsén H , Swedenborg J 
Published: March 2007

Abstract
The risk of rupture of an abdominal aortic aneurysm increases with size. It has thus been recommended that small aneurysms be continuously followed with some type of imaging technique to detect when aneurysm size constitutes an indication for surgery. The present study focuses on the growth rate of abdominal aortic aneurysms in 35 patients who were subjected to repeated computerized tomographic examinations of their abdominal aortic aneurysms. Several aneurysms were measured more than twice resulting in 57 different examinations. The mean growth rate of the transverse diameter was 0·52 cm/year. The individual growth rates were, however, variable. Aneurysms with an initial transverse diameter exceeding 6 cm showed a slightly but not significantly faster increase in size compared with smaller aneurysms. No correlation between initial size and growth rate could be established. Six patients died during the study period, two from myocardial infarction, three after elective aneurysm operations and one, refused for elective operation, died after rupture. It is concluded that the growth rate measured with computed tomography agrees well with previously reported estimates obtained with ultrasonography. It is recommended that small aneurysms particularly in patients with relative contraindications to surgery be followed with repeated examinations of size.
Chemical composition of biliary calculi in relation to the pattern of biliary disease in Singapore
Authors: Ti T K , Yuen R 
Published: March 2007

Abstract
The chemical composition of biliary calculi from 25 Singapore patients operated upon over a three month period was determined by a microanalytical technique and equilibrium swelling tests. Twelve patients had biliary calculi confined to the gallbladder and the main component of six calculi was cholesterol. In the other 6 patients, the dark brown to black pigment calculi contained bilirubin and calcium and a small quantity of cholesterol, but the chief component was an insoluble pigment with the swelling characteristics of a bilirubin polymer. These cholesterol and pigment calculi have similarities in composition to gallstones of Western patients. In 13 patients with cholangitis, the brown, soft pigment calculi found in the dilated bile ducts (and also concurrently in the gallbladder in 5 patients) had bilirubin as the main component. Fatty acid was frequently present. The insoluble pigment component was considerably less but the lower swelling ratio suggested more cross linkage compared with black gallbladder stones. Differences in chemical composition between pigment gallbladder and bile duct calculi support the concept that Western type cholelithiasis and Oriental cholangitis occur as separate disease entities in Singapore patients.
Segmental and subsegmental resections of the cirrhotic liver under hepatic inflow and outflow occlusion
Authors: Nagasue N , Yukaya H , Ogawa Y , Hirose S , Okita M 
Published: March 2007

Abstract
Segmental and subsegmental resections of the cirrhotic liver were carried out on 44 patients with hepatocellular carcinoma (HCC) and three cases with regenerating liver nodules. Seventeen patients underwent hepatectomies without hepatic vascular arrest (Group 1). In Group 2 (19 occasions), the Pringle manoeuvre was used for 8–46 min during parenchymal dissection. Hepatic resections were performed during simultaneous occlusion of hepatic inflow and outflow for 20–47 min in 11 patients (Group 3). The estimated blood loss during surgery was 2924 ml in Group 1,1239 in Group 2, and 765 in Group 3 (Group 1 versus Group 2; P &lt; 0·02, Group 1 versus Group 3; P &lt; 0·02). Haemorrhagic shock occurred in three patients of Group 1, one of Group 2, and none of Group 3. Life-threatening postoperative complications occurred in four patients in Group 1, two in Group 2, and none in Group 3. Hospital death rate was 23·5 per cent in Group 1, 10·5 per cent in Group 2, and nil in Group 3. The present results may indicate that in performing nonanatomical resection of cirrhotic livers temporary occlusion of both hepatic inflow and outflow can be achieved for at least 30 min and is useful in reducing postoperative morbidity and mortality.
Carbon-fibre versus Marlex mesh in the repair of experimental abdominal wall defects in rats
Authors: Cameron A E P , Taylor D E M 
Published: March 2007

Abstract
Large abdominal wall defects were created in Porton—Wistar rats and either left unrepaired (9 rats), or repaired with polypropylene (Marlex) mesh (11 rats), or with an open darn of filamentous carbon (11 rats). A further ten animals had a simple midline skin incision. At 5 months there were gross hernias in the unrepaired animals. Neither repair had resulted in gross recurrence although four of the carbon-repaired animals had bulges through the open weave. Tensiometry of the excised abdominal wall showed no difference in the strength of the two repairs. However, microscopy showed a striking difference—the Marlex had induced a chronic inflammatory response with disorganized collagen, whereas the carbon was not only well-tolerated but acted as a scaffold for well-organized and orientated collagen.
Vitamin K requirements in patients receiving total parenteral nutrition
Authors: Hands Linda J , Royle G T , Kettlewell M G W 
Published: March 2007

Abstract
The vitamin K requirements of 47 adult patients on total parenteral nutrition (TPN) were investigated by randomly allocating them to receive either 0·15 mg vitamin K1 (1 ampoule of ‘Vitlipid’) per week or 20·15 mg vitamin K1 (1 ampoule of ‘Vitlipid’ plus 10 mg vitamin K × 2) per week. Vitamin K1 in a dose of 0·15 mg was as effective as a dose of 20·15 mg per week in maintaining a normal BCR (British Corrected Ratio) in most TPN patients. Seven patients in each group developed a BCR greater than 1·3; this was significantly associated with the use of cephalosporin antibiotics and responded to 10 mg vitamin K1 per day. Most patients receiving parenteral feeding require no more vitamin K than that provided by 1 ampoule of ‘Vitlipid’ per week. Regular monitoring of the BCR, especially in patients on antibiotics, will reveal those who need more. Such patients need 10 mg vitamin K1 per day.
Long-term results after pancreas resection for acute necrotizing pancreatitis
Authors: Nordback I H , Auvinen O A 
Published: March 2007

Abstract
This study was designed to investigate the long-term effects of early pancreatic resection for acute necrotizing pancreatitis. During 1973–1978 40 resections were performed in our clinic. Eleven patients died initially (28 per cent). None of the four further deaths was due to pancreatitis or associated disorders. Twenty-four patients were reexamined 5–11 years after resection — one patient refused to participate. Five had not been able to return to work because of severe polyneuropathy; one more had retired because of chronic pancreatitis in the pancreatic remnant. Polyneuropathy was found in five further patients. The reason for this high incidence of polyneuropathy (42 per cent) remains unknown. Eight patients still drank excessive alcohol; three of them had had recurrent pancreatitis and dyspepsia, and insulin requiring diabetes. All but 2(92 per cent) had diabetes, 14 needing insulin - half of them at 6 months to 6 years after the resection. Moreover, 11 patients (46 per cent) suffered from dyspeptic symptoms. The results suggest that because of the high frequency of late complications, in addition to the early complications, early resection of pancreas should be critically re-evaluated as the treatment for acute necrotizing pancreatitis. If resection is used in patients with extreme pancreatic necrosis, careful and continuous postoperative follow-up will be needed.
Immediate resection in emergency large bowel surgery: a 7 year audit
Authors: Koruth N M , Hunter D C , Krukowski Z H , Matheson N A 
Published: March 2007

Abstract
In a consecutive series of 153 emergency admissions with large bowel disease during a 7 year period, 49 per cent were for colonic obstruction, 46 per cent for peritonitis and 5 per cent for miscellaneous conditions. Urgent operation was performed on 104 (68 per cent) patients. Of those operated upon, 82 (79 per cent) had a primary resection with a mortality rate of 12·2 per cent, intraperitoneal sepsis rate of 2·4 per cent and wound sepsis rate of 7·3 per cent. The median postoperative hospital stay was 21 days. An immediate anastomosis was performed in 46 (56 per cent) patients with a mortality rate of 8·7 per cent, anastomotic leak rate of 2·2 per cent, and wound sepsis rate of 8·7 per cent. The median postoperative hospital stay was 19 days.
The mortality in patients presenting with large bowel emergencies is related to age and advanced malignant disease. Immediate resection is applicable in over 80 per cent of patients requiring urgent operation and morbidity can be low and treatment economical. Immediate anastomosis after proximal colonic resection is safe and the use of intra-operative colonic irrigation permits a primary anastomosis in selected patients after emergency resection of the distal colon.
Congenital diaphragmatic hernia: a 20 year experience
Authors: Simson J N L , Eckstein H B 
Published: March 2007

Abstract
The records of 253 children with congenital diaphragmatic hernia admitted to The Hospital for Sick Children, Great Ormond Street, between 1961 and 1980 were analysed. The overall mortality of 37 per cent is greater than that reported in the preceding 13 years from the same institution, and showed no improvement over the 20 years. While there was no significant increase in the number of admissions over the study period, the proportion of children who underwent surgery within the first 6 h of life steadily increased from 13 per cent in the first five years to 39 per cent in the last five years. The mortality of this group (65 per cent) did not improve over the study period and this would account for the lack of improvement in the overall survival figures. However, analysis of birth weights, onset and severity of signs and lung weights indicates that the increasing number of early admissions was due to speedier transfer rather than to referral of more severely affected children in the later years.
A randomized trial to compare single with multiple phenol injection treatment for haemorrhoids
Authors: Khoury G A , Lake S P , Lewis Margaret C A , Lewis A A M 
Published: March 2007

Abstract
One hundred and twenty consecutive patients were entered into a randomized trial of single versus multiple phenol injection for the treatment of haemorrhoids. Follow-up at 3 and 12 months was available in 105 patients (56 in the single group and 49 in the multiple group). The results have shown that injection therapy, whether this be single or multiple, is an extremely effective form of therapy for patients with first or second degree haemorrhoids.
Intramuscular haemangioma of the extremities: is computerized tomography useful?
Authors: Christenson J T , Gunterberg B 
Published: March 2007

Abstract
Fourteen patients with intramuscular haemangiomas of the extremities were included in the study. All had computerized tomography (CT) and thirteen had angiography. Twelve of the thirteen were operated upon. CT scan proved to be an extremely valuable tool in the pre-operative planning as the extent of the lesion could be assessed accurately by this method; in most cases this was not possible with angiography.
Cystic adventitial disease of the common femoral and popliteal arteries
Authors: Hall R I , Proud G , Chamberlain J , McNeil I F 
Published: March 2007

Abstract
Cystic adventitial arterial disease (CAAD) is usually situated in the popliteal artery and is a well recognized cause of intermittent claudication in otherwise healthy, young, non-smokers. Three cases of CAAD have recently been encountered, involving the popliteal artery in two patients and the common femoral in one. Two of these patients were hypertensive smokers in their sixth decades and only one was an otherwise healthy nonsmoker, but all three had a characteristically rapid onset of symptoms. All had angiographic appearances suggestive of CAAD, confirmed by ultrasound and CAT scanning in one patient. Two were treated by resection of the affected artery and a replacement graft, both with excellent results. One popliteal lesion was bypassed with a vein graft which occluded after 3 months. CAAD may occur more commonly than generally realized. It can present in patients whose condition suggests an atheromatous cause for their symptoms. Since good results can be expected from appropriate surgical treatment in most cases, CAAD should be considered in the diagnosis of all patients with claudication, particularly when the onset has been rapid.
Secondary carcinomatous infiltration of the penis: palliation with radiotherapy
Authors: Gillatt D A 
Published: March 2007

Abstract
Secondary carcinomatous involvement of the penis is surprisingly uncommon considering its proximity to the site of many common primary malignancies. Management of this unpleasant condition is difficult and should be primarily aimed at palliative relief of symptoms. Four cases are presented, two with primary prostatic adenocarcinoma, one rectal carcinoma and one carcinoma of the caecum. Three of these patients, on developing penile involvement, were subjected to a single course of radiotherapy. This resulted in marked relief of pain and reduction in tumour bulk allowing an improvement in micturition, where obstructive symptoms were present. Due to the small number of cases available treatment cannot be prospectively evaluated. A logical palliative treatment for metastatic penile disease is suggested.
Pancreatic resection for severe acute pancreatitis
Authors: Aldridge M C , Ornstein M , Glazer G , Dudley H A F 
Published: March 2007

Abstract
Non-operative management of acute necrotizing pancreatitis carries a mortality of up to 80 per cent. Over the last 6 years we have pursued an aggressive policy of intensive supportive therapy followed by pancreatic resection in those patients with this severe form of the disease. We have managed 15 patients in this way, 14 by subtotal pancreatic resection (usually body and tail of the gland) and one by total pancreatectomy; 7 had early overwhelming multi-system failure with a median of 4 positive prognostic factors whilst 8 were operated on later between 3 and 8 weeks (plus one at 32 weeks) and had varying clinical pictures. Eight patients had ischaemia of the transverse colon which was noted at operation in four, and presented postoperatively in the remainder. Re-operation was necessary in 13 patients to remove further slough or resect ischaemic bowel. Five patients (33 per cent) died between 10 days and 4 weeks postoperatively, death being due to sepsis and multi-system failure in four and a massive retroperitoneal haemorrhage in one. of the ten survivors, four require insulin. Timely excision of necrotic pancreatic tissue combined with intensive supportive therapy may help reduce the high mortality in this condition.
Endoscopic management of upper urinary tract stones
Authors: Payne S R , Ford T F , Wickham J E A 
Published: March 2007

Abstract
Since 1981, 525 renal and ureteric calculi have been removed with percutaneous nephrolithotomy (PCN) or transurethral ureteroscopy as the primary modalities of therapy. Successful extraction of the stone at the first attempt was achieved in 92 per cent of cases by PCN and 70 per cent of cases by ureteroscopy, whilst further endoscopic surgery improved the overall success rates to 98 per cent and to 80 per cent respectively. Complication rates from these procedures have both been low as has the morbidity, with most patients leaving hospital within 4 days and returning to work within 2 weeks. The successful development of endoscopic lithotomy and the use of in situ destruction techniques has meant that we now reserve open surgery for difficult multibranched staghorn calculi and ureteric stones embedded in the urothelium. With the advent of extracorporeally generated shockwave lithotripsy it is likely that even these types of stone will be amenable to minimally invasive procedures.
The effects of a somatostatin analogue SMS 201-995 on hepatic haemodynamics in the cirrhotic rat
Authors: Jenkins S A , Baxter J N , Corbett W A , Shields R 
Published: March 2007

Abstract
The effects of a somatostatin analogue, SMS 201-995 on hepatic haemodynamics were studied in rats with dimethylnitrosamine-induced cirrhosis. An intravenous infusion of 1, 2 or 4μg kg−1 body wth−1 SMS 201-995 produced a rapid and sustained decrease in portal pressure, portal venous flow and liver blood flow without significantly altering arterial blood pressure or pulse. The reductions in portal pressure, portal venous flow and liver blood were accompanied by an increase in splanchnic vascular resistance. Portal venous resistance was not affected. Subcutaneous injection of 2μg kg−1 body wt SMS 201-995 produced a gradual decrease in portal pressure, the maximum reduction occurring 18 min after administration. This reduction in portal pressure was sustained for a further 20 min. The results suggest that SMS 201-995 may be of value in the control of bleeding oesophageal varices. Furthermore, the prolonged duration of action of SMS 201-995 following its subcutaneous administration suggests that the analogue may be useful in the long-term management of portal hypertension in patients with cirrhosis.
Chemodectomas of the neck: the response to radiotherapy
Authors: Mitchell D C , Clyne C A C 
Published: March 2007

Abstract
In the 16 year period 1965–81, 12 patients with head and neck chemodectomas received radiotherapy. In only 1 patient did the tumour fail to respond, due to metastases, and 9 showed complete resolution of the tumour. As this form of treatment is associated with few complications, we conclude that it is the treatment of choice in those patients who are unfit for surgery and those whose tumours are technically unresectable.
Operation for recurrent saphenofemoral incompetence using a medial approach to the saphenofemoral junction
Authors: Greaney M G , Makin G S 
Published: March 2007

Abstract
Forty-seven patients (53 limbs) with recurrent saphenofemoral incompetence and varicose veins underwent re-ligation of the saphenofemoral junction using a medial approach to the femoral vein. Twenty-seven patients (31 re-ligation procedures) were available for assessment at long-term follow-up (mean 30.4 months). Saphenofemoral incompetence was demonstrated in five limbs (16.1 per cent) The operative procedure is described and the alternatives discussed. This is a valuable procedure in the repertoire of the surgeon who has to treat recurrent varicose veins.
Pulmonary embolism in acute iliofemoral venous thrombosis
Authors: Plate G , Ohlin P , Eklöf B 
Published: March 2007

Abstract
Serial perfusion lung scanning and chest radiography were used to study the incidence of pulmonary embolism in patients with acute iliofemoral venous thrombosis. The efficacy of conventional anticoagulation and surgical thrombectomy in controlling embolism and the risk of creating emboli during thrombectomy were also evaluated. Lung scans obtained on admission in 49 patients were normal in 37 per cent, inconclusive in 18 per cent and positive for embolism in 45 per cent of the patients. Symptoms suggestive of embolism were present in only 24 per cent of the patients and correlated poorly with lung scans. Massive embolism was present in only two patients. Additional, usually asymptomatic, emboli developed within one month in 21 per cent of 29 patients treated conservatively with anticoagulation alone and in 20 per cent of 20 patients having acute thrombectomy combined with a temporary arteriovenous fistula and systemic anticoagulation. Only one conservatively treated patient required caval interruption. Pulmonary embolism, usually of minor degree, is thus present in nearly every other patient with acute iliofemoral venous thrombosis. Anticoagulation alone or in conjunction with thrombectomy and arteriovenous fistula in most cases effectively prevents further embolization and the risk of creating additional emboli by the surgical procedure is insignificant.
Out-patient diagnosis of breast cancer
Authors: Bradbeer J W 
Published: March 2007

Abstract
A method of diagnosis of the solid discrete breast lump using frozen section examination of a Tru-cut needle biopsy is described. In 194 patients, the Tru-cut biopsy report is compared to the histological report of the excised lesion. Overall accuracy is 90 per cent, sensitivity 89 per cent, specificity 96 per cent, predictive value of a positive report 99 per cent, and predictive value of a negative report 56 per cent. The advantage of the technique is that many patients with breast cancer can be informed of the diagnosis at their first attendance.
The mycotic flora in proctological patients with and without pruritus ani
Authors: Dodi G , Pirone E , Bettin A , Veller C , Infantino A , Pianon P , Mortellaro L M , Lise M 
Published: March 2007

Abstract
The perianal mycotic flora was studied in proctological patients with and without pruritus ani, as well as in control subjects. Four groups of patients underwent perianal mycoculture. In Group 1, 53 patients with anal pruritus were treated for benign anorectal disease. In Group 2, 24 patients with no underlying disease presented with anal pruritus. Both of these groups underwent concomitant chemical and parasitical examination of the faeces and an oral glucose tolerance test. In Group 3, 50 patients without pruritus ani at present or in the past were treated for benign anorectal diseases. In Group 4, 47 surgical patients without pruritus ani were treated for benign (9) and malignant (38) non-proctological diseases. In Group 1 the mycoculture was positive in 24/53 patients (Candida albicans 14, dermatophytes 10). In Group 2 fungal infections were seen in 16/24 patients (C. albicans 7, dermatophytes 9). No parasites or diabetes were found in either group. In Group 3 C. albicans was isolated in 14/50 patients. In Group 4 C. albicans was found in 11/47 cases (2 in benign, 9 in malignant diseases). Infection by C. albicans was observed in all groups studied, independent of the presence of disease or anal pruritus. The presence of dermatophytes was always associated with pruritus ani.