bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of duplex scanning compared with angiography and pressure measurement in the assessment of aortoiliac arterial lesions
Authors: Legemate D A , Eikelboom B C , Teeuwen C , Hoeneveld H 
Published: March 2007

Abstract
To detect haemodynamically significant lesions in the aortoiliac arteries, invasive tests such as angiography and intra-arterial pressure measurement (IAPM) are considered valuable diagnostic tools. The value of duplex scanning as a direct non-invasive examination technique was prospectively compared with intra-arterial digital subtraction angiography (IADSA) and IAPM at rest, and after the administration of papaverine in 60 patients. Excellent agreement, as assessed by the K statistic, was shown between duplex scanning and IADSA (K = 0·81). A fair agreement was shown between duplex scanning and IAPM (K = 0·63), and between IADSA and IAPM (K = 0·63). Duplex scanning and IADSA both missed some less haemodynamically critical lesions if IAPM was considered the ‘gold standard’. It is concluded that duplex scanning detects haemodynamically significant lesions as effectively as angiography and so may be considered a new and valuable diagnostic tool. IAPM remains necessary to detect some lesions of borderline haemodynamic significance. However, with future developments, duplex scanning has the potential to replace the need even for IAPM.
Necrotizing enterocolitis following operation in the neonatal period
Authors: Shanbhogue L K R , Tam P K H , Lloyd D A 
Published: March 2007

Abstract
Over a 16-year period, 33 newborn infants developed necrotizing enterocolitis (NEC) following some form of operation (accounting for 19 per cent of all neonates with NEC), including repair of myelomeningocele, intestinal atresia, gastroschisis and congenital diaphragmatic hernia. The neonates with postoperative NEC had a median birth-weight of 3.05 (range 1.0–4.4) kg, and median gestational age of 40 (range 27–41) weeks. Twenty patients were treated non-operatively. The remaining 13 required operation for complications of NEC. Twenty-three patients are alive and have been followed for a median of 66 (range 3–168) months. If a neonate deteriorates following any operation NEC must be included in the differential diagnosis.
Penetrating missile injuries in the Gulf war 1991
Authors: Spalding T J W , Stewart M P M , Tulloch D N , Stephens K M 
Published: March 2007

Abstract
During the recent Gulf war 63 patients with penetrating missile injuries (including 29 Iraqi prisoners of war) underwent operation in a British Army Field Hospital. Their injuries and initial operative management are reported. Fifty-one casualties (81 per cent) suffered an average of nine wounds (range 1–45) due to fragmentation weapons, and 12 casualties sustained bullet wounds. All wounds were explored following the established principles of war surgery. The extremities were involved in 48 patients (76 per cent). Eight compound long bone fractures were managed with external skeletal fixators applied at the time of initial operation. Laparotomy was performed on seven patients, one of whom died. The average duration of operation was 77 min for shrapnel wounds and 85 min for bullet wounds.
Routine examination of the vocal cords before and after thyroid and parathyroid surgery
Authors: Järhult J , Lindestad P-Å , Nordenström J , Perbeck L 
Published: March 2007

Abstract
A prospective study of the value of routine examination of the vocal cords in 239 patients before and after thyroid or parathyroid surgery is presented. From the patient's history and voice the surgeon assessed before and after operation whether vocal cord examination was necessary or not. The surgeon's judgement was compared with the phoniatrician's* report. All except one of the documented recurrent laryngeal nerve palsies were suspected by the surgeon. No additional important clinical information was gained by the laryngologist's examinations. Routine vocal cord examination in connection with thyroid and parathyroid surgery is probably not necessary.
Prevalence of abdominal aortic aneurysm in Western Australia
Authors: Norman P E , Castleden W M , Hockey R L 
Published: March 2007

Abstract
The prevalence of abdominal aortic aneurysm (AAA) in Western Australia was studied using health department mortality data. Age-standardized and age-specific mortality rates related to the disease were calculated for the period 1980–88. The mortality rate has risen by 36 per cent for men and 24 per cent for women. Most of this rise was due to an increase in non-hospital and emergency admission hospital deaths. The number of elective and emergency operations has also risen. Despite two decades of elective surgery, the mortality rate for AAA continues to rise. This rise is highly suggestive of an increasing prevalence. This contrasts with the decline in deaths from other manifestations of arteriosclerosis and provides support for a policy of screening for aneurysm.
Abdominal aortic aneurysm in 4237 screened patients: Prevalence, development and management over 6 years
Authors: Scott R A P , Ashton H A , Kay D N 
Published: March 2007

Abstract
An ultrasonography screening programme for detecting abdominal aortic aneurysm (AAA) in the community is described in which 7200 men and women aged between 65 and 80 years were contacted by letter. Of these, 4237 were screened; the aorta was visualized in 4122 and 179 AAAs of 3 cm or more in diameter were detected (4.3 per cent). Criteria for surgery are suggested and the results of their application prospectively over 6 years are discussed. Using these criteria, under 10 per cent of patients with ultrasonographically-detected AAA should require surgery for this condition provided ultrasonography follow-up is used.
Detection and characterization of arterial thromboses using a platelet-specific monoclonal antibody (P256 Fab')
Authors: Berridge D C , Perkins A C , Frier M , Lonsdale R J , Ballantyne K C , Wastie M L , Makin G S , Hopkinson B R 
Published: March 2007

Abstract
Arteriography does not reliably distinguish between acute and chronic arterial occlusions. Seventeen patients with acute lower limb ischaemia were investigated by arteriography and by imaging with a platelet-specific monoclonal antibody (P256 Fab'); 20 MBq 111In-labelled P256 Fab' was administered intravenously and patients were imaged at intervals of between 20 min and 24 h. Thirteen patients were subsequently treated with intra-arterial thrombolysis. In six the images showed foci of increased uptake of 111In-labelled P256 Fab' and the corresponding arterial segment was recanalized. Patency to 30 days was maintained in four cases. Seven patients had negative scans, only four of whom achieved lysis, and two of these suffered early rethrombosis. The remaining four patients were excluded from thrombolysis by the arteriographic appearances. 111In-labelled P256 Fab' imaging can identify sites of acute arterial thrombosis and may have clinical applications in the management of peripheral vascular disease. Further studies are required to test whether the technique has a role to play in patient selection for thrombolysis.
Treatment perspectives in locally advanced unresectable pancreatic cancer
Authors: Jeekel J , Treurniet-Donker A D 
Published: March 2007

Abstract
Locally advanced unresectable pancreatic cancer is sometimes encountered without manifest distant metastases. Twenty patients with histologically proven unresectable pancreatic cancer without distant metastases were treated with radiotherapy and 5-fluorouracil (5-FU). Radiotherapy consisted of 50 Gy external upper abdomen radiation in two courses, concomitant with intravenous 5-FU 375 mg/m2 given as a bolus injection 4–6 h before radiation on the first 4 days of each treatment course. The treatment protocol was completed in 18 patients without complications. The median survival time was 10 months which compares favourably with a 3–5 months median survival time when treatment is withheld. Nine patients (45 per cent) were alive at 1 year, two patients at 2, 3 and 4 years. A second-look operation was performed in four patients 6, 11, 12 and 22 months after completion of radiotherapy. In two patients the tumour could be resected. It appears that treatment with radiotherapy and 5-FU may benefit patients with locally advanced unresectable pancreatic cancer.
Histopathological study of oesophageal mucosa in patients with varices: A comparison between bleeders and non-bleeders
Authors: Hirata M , Kawasaki S , Sanjo K , Idezuki Y 
Published: March 2007

Abstract
Thirty-six patients with oesophageal varices underwent a non-shunting operation including oesophageal transection. Of these, 16 had an emergency or elective operation (bleeders) and the remaining 20 had prophylactic surgery (non-bleeders). A comparative study was performed between the bleeders and non-bleeders in terms of preoperative endoscopic findings and histopathology of the oesophagus. The severity of red colour sign showed no significant difference between the two groups. The venous dilatation in each of the three layers of the oesophageal mucosa was demonstrated histologically to be of the same degree in bleeders and non-bleeders. In addition, the hepatic venous pressure gradient in cirrhotic patients did not differ between the two groups; for bleeders this was a mean(s.d.) of 15.2(6.1) mmHg and for non-bleeders 14.4(2.9) mmHg. We were unable to find any factors differentiating bleeders from non-bleeders, although these results do not justify prophylactic surgery for oesophageal varices.
Above-knee prosthetic grafts do not compromise the ipsilateral long saphenous vein
Authors: Budd J S , Langdon I , Brennan J , Bell P R F 
Published: March 2007

Abstract
Prosthetic graft materials are used preferentially by a number of surgeons for above-knee femoropopliteal bypasses. Using B-mode ultrasonography we have assessed the ipsilateral long saphenous vein in patients undergoing such bypasses to determine its suitability for future use in more distal bypasses. A total of 137 above-knee prosthetic grafts were performed over a 10-year period. Of the patients, 74 were available for further assessment. Overall, 97 per cent of veins were suitable for future bypass surgery if required. Above-knee prosthetic bypasses do not appear to jeopardize the ipsilateral long saphenous vein.
Management of the perineal wound following abdominoperineal resection: prospective study of three methods
Authors: Robles Campos R , Ayllon J Garcia , Paricio P Parrilla , Tebar J Cifuentes , Mompean J A Lujan , Ruiz R Liron , Martinez J A Torralba , Martinez J Molina 
Published: March 2007

Abstract
A prospective study was made of three procedures for treating the perineal wound and presacral cavity in 102 patients undergoing abdominoperineal excision for cancer of the rectum: (1) packing of the presacral space after suture of the pelvic peritoneum; (2) suture of the pelvic peritoneum and perineal wound, leaving two drains through the perineum; and (3) no suture of the pelvic peritoneum, and primary closure of the perineal wound, leaving drains through the abdomen for physiological saline irrigation. The parameters analysed were incidence of infection, primary healing of the perineum, extraperineal complications and mean hospital stay. Primary healing of the perineum was best with method 3, and overall incidence of infection highest with method 2. There were no differences between the methods with regard to extraperineal complications. Hospital stay was shortest with method 3.
Temporary loop ileostomy following restorative proctocolectomy
Authors: Hosie K B , Grobler S P , Keighley M R B 
Published: March 2007

Abstract
A retrospective study compared the outcome of restorative proctocolectomy in patients who had a covering ileostomy (n = 53) with those who had no proximal stoma (n = 32). Those who had a loop ileostomy had a higher incidence of anastomotic leakage (21 per cent), pelvic abscess (32 per cent) and postoperative fistula (28 per cent) than those with no covering ileostomy (6, 12 and 12 per cent respectively). Intestinal obstruction occurred in 23 per cent of those with an ileostomy, compared with 6 per cent in those who had no stoma. The functional outcome was identical.
‘Natural history’ of hepatectomy
Authors: Suc B , Panis Y , Belghiti J , Fékété F 
Published: March 2007

Abstract
The aim of this study was to describe biochemical and liver function test changes after hepatectomy in 33 patients with the following characteristics: absence of underlying liver disease, no blood or plasma transfusion during the perioperative period, uneventful postoperative course. Resection with a temporary pedicle inflow occlusion (10–45 min) consisted of unisegmentectomy or less in 15 patients and bisegmentectomy or more in 18. Blood tests showed: a correlation between aminotransferase rise and duration of ischaemia, and a fall in prothrombin time and factor V levels correlating with the weight of resected specimen at day 1; a moderate γ-glutamyl transpeptidase and alkaline phosphatase elevation and a rise in fibrinogen level correlating with the extent of resection at day 7. Changes in haemoglobin level, white cell count, platelet count, prothrombin time, factor V level and serum bilirubin level tended to return to preoperative levels by day 7. For γ-glutarnyl transpeptidase and alkaline phosphatase, increased levels persisted for 8–12 weeks after resection. These results, in this selected group of patients, allow a description of the ‘natural history’ of hepatectomy. The knowledge of these ‘natural’ changes may contribute to the early detection of postoperative complications.
Hepatic transplantation in children using reduced size allografts
Authors: Badger I L , Czerniak A , Beath S , Tisone G , Deakin M , Sherlock D J , Kelly D A , McMaster P , Buckels J A C 
Published: March 2007

Abstract
The shortage of paediatric liver donors has led to the use of reduced size hepatic allografts. Between July 1987 and July 1990, 30 reduced size orthotopic liver transplantations were performed in 24 children aged between 3 months and 7 years. All patients were in advanced chronic or acute liver failure and were considered unlikely to survive for long enough for a size-matched donor to become available. The most common indication was biliary atresia. The median intraoperative blood loss was 75 (range 13–1015) ml kg −1. Nine patients have died and seven have undergone retransplantation, four successfully. Seven patients had portal vein hypoplasia with a high graft failure rate due to ischaemic infarction. There was significant morbidity from biliary tract complications, leading to further operations in four cases. The 1-year actuarial survival rate was 62 per cent.
Outpatient treatment of non-lactational breast abscesses
Authors: Dixon J M 
Published: March 2007

Abstract
Eighteen consecutive patients with non-lactational breast abscesses have been treated by aspiration (ten patients), surgical drainage after application of local anaesthetic cream (seven patients) or a combination of aspiration and local anaesthetic cream drainage (one patient) combined with a 2-week course of either amoxycillin and clavulanic acid or cephradine and metronidazole. All abscesses resolved completely within 2 weeks of treatment and all 18 patients expressed satisfaction with the method of treatment used. The majority of patients with breast abscesses can now be managed as outpatients.
Breast abscesses and cigarette smoking
Authors: Bundred N J , Dover M S , Coley S , Morrison J M 
Published: March 2007

Abstract
An 11-year retrospective review of women with breast abscesses presenting to a district general hospital was performed. A total of 122 women were identified with a breast abscess: 85 (70 per cent) with non-lactational abscesses and 37 (30 per cent) with an abscess in the puerperium. Six of 37 lactational and 24 of 85 non-lactational abscesses recurred. Sixteen mammillary fistulae developed, all following incision and drainage of non-lactational breast abscesses. Women with non-lactational breast abscesses were more likely to smoke cigarettes (P &lt; 0·005). Breast abscesses containing anaerobic bacteria were signlficantly more likely to occur in current cigarette smokers (P &lt; 0·05). Women with non-lactational breast abscesses who were heavy cigarette smokers were more likely to sufer recurrent abscesses (P &lt; 0·01). There was histological evidence of duct ectasia on biopsy in 25 women with non-lactational abscesses and 21 of 25 were current smokers. Mammillary fistulae developed more frequently in current smokers (P &lt; 0·03). Cigarette smoking is important in the natural history of non-lactational breast abscesses and may predispose to anaerobic breast infections and the development of mammillary fistulae.
Factors influencing the healing of distal amputations performed for lower limb ischaemia
Authors: Byrne R L , Nicholson M L , Woolford T J , Callum K G 
Published: March 2007

Abstract
A total of 235 toes were amputated during 125 operations on 100 consecutive patients with lower limb ischaemia. The overall amputation wound healing rate for the series was 58·4 per cent and limb salvage was achieved in 66 patients. Toe amputation was performed under local anaesthesia in 57 cases and 32 (56 per cent) of these healed primarily, not significantly diflerent from the healing rate of 41 (60 per cent) of 68 under general anaesthesia. Reconstructive arterial surgery was performed in conjunction with toe amputation in 39 patients; the healing rate with reconstruction was 32 (82 per cent) of 39, significantly better than the 41 (48 per cent) of 86 patients not undergoing bypass surgery (P &lt; 0·001). There was no difference in healing rates when comparing diabetic and non-diabetic patients. Multiple regression analysis demonstrated that reconstructive arterial surgery was the only factor which had an independent and signficant influence on toe amputation healing. The use of local anaesthesia for distal amputation has no deleterious eflects on wound healing.
Low-dose intra-arterial thrombolysis in the treatment of occluded vascular grafts
Authors: Browse D J , Torrie E P H , Galland R B 
Published: March 2007

Abstract
As the use of intra-arterial thrombolysis increases, its application to specific areas requires definition. The results of treatment of occluded vascular grafts are presented. Thrombolysis using streptokinase or tissue plasminogen activator was planned in the treatment of 18 occluded vascular grafts (five aortofemoral bifurcation grafts and 13 infrainguinal grafts). Two patients, both with infrainguinal occlusions, did not receive thrombolytic therapy and were considered failures of treatment. Successful lysis occurred in three of five aortofemoral grafts, in both infrainguinal vein grafts and in five of nine infrainguinal synthetic grafts. The overall success rate was approximately 60 per cent. Two-thirds of the patients required no intervention following successful lysis. Percutaneous transluminal angioplasty was not found to be a useful additional procedure. A review of the literature revealed that intra-arterial thrombolysis is significantly more successful in the treatment of suprainguinal graft occlusion than in infrainguinal occlusions, there being no difference between infrainguinal vein and synthetic grafts. Provided that the limb is viable and there are no contraindications, intra-arterial thrombolysis is a useful means of clearing occluded grafts.
Anal endosonographic findings in the follow-up of primarily sutured sphincteric ruptures
Authors: Nielsen M B , Hauge C , Rasmussen O Ø , Pedersen J F , Christiansen J 
Published: March 2007

Abstract
Twenty-four women with primary suture of an obstetric tear of the anal sphincter were examined with anal endosonography a median of 12 (range 3–18) months after delivery. Endosonography was normal in ten patients, of whom one was incontinent. The examination showed a defect in the external anal sphincter in 13 patients; six of these were incontinent, two of whom had normal findings on palpation. An isolated internal sphincter defect was found in a continent patient. Since anal endosonography causes no more discomfort than digital examination, it may be useful to identify patients who would benefit from surgical reconstruction of the anal sphincter.
Function of the distal rectum after low anterior resection for carcinoma
Authors: Karanjia N D , Schache D J , Heald R J 
Published: March 2007

Abstract
From a personal series of 232 anterior resections performed over 10 years, functional results have been analysed in two specific groups of patients: those with anastomoses 3 cm (n = 26) and 6 cm (n = 42) from the anal verge. In both groups low anterior resection had been performed with total mesorectal excision. Function was assessed in four categories: bowel frequency, ability to distinguish flatus from faeces, ability to defer defaecation, and frequency of soiling. Independent analysis of the 3 cm group showed a significant deterioration in function in each category after operation. The ability to defer defaecation and the frequency of soiling were unchanged after operation in the 6 cm group, and these functions were significantly better than in the 3 cm group. On the basis of these results, patients undergoing low anterior resection with total mesorectal excision should benefit from the preservation of a short segment of distal rectum, provided that the distal resection margin is not compromised.
Preoperative assessment of lymph node metastases in patients with gastric cancer: evaluation of the Maruyama computer program
Authors: Bollschweiler E , Boettcher K , Hoelscher A H , Sasako M , Kinoshita T , Maruyama K , Siewert J R 
Published: March 2007

Abstract
The probability of survival of patients with gastric cancer depends upon depth of wall penetration by the primary tumour and metastatic lymph node burden. Radical lymphadenectomy may lead to prolonged survival but with increased morbidity. A computer program from Maruyama, National Cancer Centre, Tokyo enables evaluation of individual survival time and infiltration of lymph nodes, This analysis was applied to a German population. Computer-aided predictions were determined retrospectively using the prognostic factors of sex, age, Borrmann classification, histology, depth of wall penetration, location and diameter of the tumour. Data were collected from 222 patients at the Technical University of Munich (median age 66 years, sex ratio (M:F) 2:1), who had been operated on (72 per cent total gastrectomy, 28 per cent subtotal gastrectomy) for gastric cancer. The predicted results were compared with the postoperative pathological findings. The prediction of node metastases was highly accurate (lymph nodes 13–16, 96 per cent; 7–12, 89 per cent; 1–6, 82 per cent). These computer predictions may provide perioperative information of therapeutic value.
Muscle strength is improved after parathyroidectomy in patients with primary hyperparathyroidism
Authors: Kristoffersson A , Boström A , Söderberg T 
Published: March 2007

Abstract
Fatigue and muscular weakness are prevalent symptoms in patients with primary hyperparathyroidism. This study examined muscular strength before and after operation in a group of eight patients with hyperparathyroidism and in a control group of seven patients with benign thyroid lesions. The maximum power grip, pronation and supination, and endurance for the same muscular movements, were studied by means of a computer program. Patients with hyperparathyroidism had impaired muscular strength compared with the controls but 12 months after operation a significant improvement of all muscular performance was observed. No such improvement was detectable among the controls. There was no correlation between the levels of serum calcium and parathyroid hormone and the measurements recorded before and after operation. Muscular impairment in hyperparathyroidism is measurable by an objective technique. Improvement occurs after surgery.