bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late outcome of undersewing alone for gastric ulcer haemorrhage
Authors: Teenan R P , Murray W R 
Published: March 2007

Abstract
Between 1977 and 1988 22 patients requiring urgent surgery for bleeding gastric ulceration were managed by simple undersewing of the ulcer. Long-term follow-up of these patients was undertaken to determine the risk of recurrent gastric ulceration and further gastric ulcer haemorrhage. Two patients died in the immediate perioperative period leaving 20 patients available for long-term follow-up (mean 43·3 months). Three recurrent gastric ulcers were diagnosed, two of these presenting with haemorrhage. No patient presented with further gastric ulceration while on histamine (H2) receptor antagonist therapy. The long-term outcome of undersewing alone, when combined with maintenance H2-receptor antagonist therapy, is satisfactory in terms of low mortality and low risk of ulcer recurrence.
Late sequelae of penetrating cardiac injuries
Authors: Demetriades D , Charalambides C , Sareli P , Pantanowitz D 
Published: March 2007

Abstract
Fifty-four patients who survived a penetrating cardiac injury were assessed for late cardiac complications. The mean follow-up after injury was 23 months. Clinical history and physical examination suggested cardiac complications in nine patients (17 per cent). Electrocardiogram was abnormal, but usually not diagnostic, in 17 (31 per cent). Routine two dimensional Doppler echocardiography revealed abnormalities in 17 (31 per cent). Ten patients (19 per cent) had valvular or septal defects. Other abnormalities includedpericardial effusion, ventricular and septal dysfunction, and ventricular dilatation. Although it is impossible to determine how many of these abnormalities were post-traumatic, it seems that the incidence of late sequelae of cardiac injuries is high, and it is recommended that routine late follow-up of these patients should be done. Assessment should include routine echocardiograms.
Abdominocervical (transhiatal) oesophagectomy in the management of oesophageal carcinoma
Authors: Gotley D C , Beard J , Cooper M J , Britton D C , Williamson R C N 
Published: March 2007

Abstract
Fifty-four patients have undergone abdominocervical oesophagectomy for oesophageal carcinoma as an alternative to a conventional transthoracic approach. Their median age was 69 years, with a range of 38–90 years, and 39 per cent of patients had chronic cardiorespiratory disease. Lymph node metastases were found in 80 per cent of patients and transmural tumour spread in 91 per cent. Median duration of operation was 2·2 h (range 1·75–6·0 h), and median transfusion requirement was 2·5 units (range 0·8 units). Respiratory complications were common (41 per cent) and caused all six postoperative deaths (11 per cent). Other complications were atrial fibrillation (26 per cent), transient recurrent laryngeal nerve palsy (11 per cent), cardiac failure (2 per cent), stroke (2 per cent), subphrenic abscess (2 per cent) and empyema (2 per cent). There were two anastomotic leaks (4 per cent), clinically manifest as temporary salivary flstulae. There have been 32 deaths from recurrent carcinoma, with a median duration of survival of 14 months (range 4–53 months). Fifteen patients are still alive, with a median survival of 16·5 months (range 3–49 months); the current 3-year survival rate is 10 per cent. All patients resumed normal swallowing after operation, but 11 of them developed anastomotic strictures requiring a median of three dilatations. Avoidance of formal thoracotomy by the abdominocervical approach may allow more rapid oesophagectomy without increasing the risk of postoperative death and gives a quality of palliation at least equivalent to that of conventional transthoracic oesophageal excision.
Surgical therapy of oesophageal carcinoma
Authors: Müller J M , Erasmi H , Stelzner M , Zieren U , Pichlmaier H 
Published: March 2007

Abstract
During the past 10 years, postoperative mortality associated with surgical treatment of oesophageal carcinoma has been reduced by one-half. However, it appears that all efforts to improve long-term survival with extensive excisional procedures and adjuvant chemotherapy and radiotherapy have failed. Fifty-six of 100 patients presenting to the surgeon with an oesophageal carcinoma have resectable disease. Recent studies suggest that seven of them will die from postoperative complications and 49 patients will be discharged from the hospital after an average of 3 weeks. Of these patients, 27 will survive the first, 12 the second, and ten the fifth year. Although it may be possible to further reduce postoperative complications and mortality, the chances of improving the long-term prognosis of patients with oesophageal carcinoma seem small.
Endorectal ultrasonography for the assessment of invasion of rectal tumours and lymph node involvement
Authors: Glaser F , Schlag P , Herfarth Ch 
Published: March 2007

Abstract
Sophisticated therapies for rectal carcinoma, such as sphincter preserving operations, pouch-anal anastomosis, preoperative irradiation or adjuvant chemotherapy, require an exact pretherapy assessment of the tumour and its lymph node involvement. A 7·0 MHz transducer was used before operation in the staging of 117patients with rectal carcinoma or villous adenoma. In 90 per cent of cases it was possible correctly to stage the tumour before operation. Sensitivity for detection of perirectal fat infiltration was 97per cent. Lymph node involvement was accurately identified in about 80 per cent of cases. Six carcinomas, which had developed within 31 examined tubulovillous adenomas, were detected by endorectal ultrasonography. No carcinoma remained undetected. Endorectal ultrasonography is a highly accurate tool for the staging of rectal carcinoma before operation and for the detection of lymph node involvement. Malignant change in tubulovillous adenomas are also detectable.
Low anterior resection of the rectum using a double stapling technique
Authors: Varma J S , Chan A C W , Li M K W , Li A K C 
Published: March 2007

Abstract
Using a double stapling technique in 30 patients, anterior resection of the rectum was attempted for low rectal carcinoma (n = 28), giant rectal adenoma (n = 1) and radiation-induced rectal stricture (n = 1). There were three emergency operations. The rectum was stapled transversely more than 3 cm below the tumour using the adjustable-angle linear stapler (Roticulator®). Colorectal or coloanal anastomoses were constructed using the EEA® circular stapler introduced per anum through the anorectal stump staple line. Ten coloanal and 19 low rectal anastomoses were achieved. A protecting transverse loop colostomy was fashioned in one patient with coloanal anastomosis who developed a vaginal tear during the procedure. In one patient technical failure necessitated conversion to abdominoperineal excision of the rectum. All staple rings and resection margins were intact and free from tumour. There were two clinical anastomotic leaks, both treated successfully with a defunctioning transverse loop colostomy. One patient developed a small infective pelvic haematoma 2 weeks after surgery which required drainage. Hospital stay ranged from 6 to 15 days (mean 8 days). Continence was normal in all patients at 8 weeks. One soft coloanal anastomotic stricture required dilatation. No recurrences have been detected during a follow-up of between 10 and 22 months.
Surgery for Crohn's disease in childhood: Influence of site of disease and operative procedure on outcome
Authors: Davies G , Evans C M , Shand W S , Walker-Smith J A 
Published: March 2007

Abstract
Factors influencing outcome after surgery have been studied in 67 children requiring bowel resection or diversion of the faecal stream for Crohn's disease. Patients were divided into four groups on the basis of disease location at time of surgery, and mean follow-up was 4–5 years. All three children with panenteric disease (group 1) have relapsed. Best results were observed in cases with disease confined to the small bowel (group 2) and ileocaecal region (group 3), in whom surgery was followed by sustained remission in six out of seven and 24 out of 30 patients respectively. In the 27 children with colitis (group 4), results were mixed. Six of the seven patients who had staged colonic resections with a primary anastomosis relapsed, as did three out of four patients given a loop ileostomy to divert the faecal flow; in contrast, 15 out of 16 children who had a subtotal colectomy with ileostomy as the primary procedure have remained well, with only minor problems involving the rectal stump. An acceleration in growth velocity was observed during the first year after operation in 89 per cent of 40 children studied. Outcome after surgery for Crohn's disease in childhood depends mainly on disease location, but is influenced by the type of primary operation performed. In addition to symptomatic relief the principal early benefit of surgery is improved growth.
Ambulatory anorectal physiology in patients following restorative proctocolectomy for ulcerative colitis: Comparison with normal controls
Authors: Miller R , Orrom W J , Duthie G , Bartolo D C C , Mortensen N J McC 
Published: March 2007

Abstract
The purpose of this study was to determine the manometric activity of ileoanal W pouch reservoirs following restorative proctocolectomy for ulcerative colitis and to compare the results with normal controls. Thirty-one studies were carried out; there were 15 controls (median age 52 years (range 29–80 years), 10 men, 5 women) and 16 pouch patients (median age 40 years (range 28–52 years), 13 men, 3 women). Mid-anal sphincter pressure and ‘rectal’ pressure were measured with a microtransducer catheter. The signals were digitalized and recorded in a portable electronic memory for later computer display and analysis. The system allowed the study of patients with minimal constraints while fully ambulant. The frequency of sampling (rectal pressure ⩾ sphincter pressure), sensation of flatus present and flatus being passed were 7(1–41), 3(1–7) and 1(0–3·5)per hour in the normal controls and 0(0–3), 0(0–1) and 0(0-1) respectively per hour in the pouch patients (P&lt;0·001). Compared with the highly dynamic nature of the anorectum in normal subjects the patients with a pouch had very little activity. The sensation of pouch filling and the desire to defaecate were noted on 12 occasions and in six were associated with a rise in pouch pressure greater than 20 mmHg. One patient had nocturnal soiling and this was the only patient in whom frequent pouch contractions were noted. The results suggest that ileoanal pouch motility is usually quiescent and that incontinence in this group may be related to increased pouch activity.
Evaluation of herniography in the diagnosis of an occult abdominal wall hernia in symptomatic adults
Authors: Hall C , Hall P N , Wingate J P , Neoptolemos J P 
Published: March 2007

Abstract
Outpatient herniography as a means of confirming or refuting the presence of an occult abdominal wall hernia was performed in 50 symptomatic patients, including 13 who had previously undergone hernia repair. Altogether 30 occult hernias were detected in 27 patients, only one of which was considered to be unrelated to the presenting symptoms. On the basis of herniography, 17 patients were spared surgical exploration and, of these 17, 16 obtained a good result. One further patient with a clinically apparent hernia on one side but with contralateral symptoms was spared unnecessary surgery because the contralateral side was radiologically normal. There was one false negative and no false positive examinations. There were three minor complications: two cases of sigmoid colon puncture and one of abdominal wall haemorrhage (all managed conservatively). There were two technical failures. These results support the Scandinavian experience that herniography has a useful role in the management of patients who may have occult hernias as the underlying cause of abdominal wall symptoms.
Peripheral lymph node tuberculosis: A review of 80 cases
Authors: Dandapat M C , Mishra B M , Dash S P , Kar P K 
Published: March 2007

Abstract
One hundred and ninety-two patients with peripheral lymphadenopathy were screened and 80 patients with tubercular lymphadenitis were studied. Their ages ranged from 1 to 65 years; most were younger than 30 years and there was a slight female preponderance (1·2:1). Seventy per cent of patients were of low socioeconomic status. Of the 80 patients, 56 had affected cervical nodes, seven had inguinal nodes, five had axillary nodes and 12 had multiple sites of lymph node involvement. All had enlarged nodes which were matted in 44 cases and discrete in 18 cases, while the rest had either an abscess or a discharging sinus. Fifty-nine cases (74 per cent) showed a positive Mantoux test and four cases (5 per cent) had associated pulmonary tuberculosis. Fine needle aspiration cytology gave a positive diagnosis in 66 cases (83 per cent). Fifty-two cases showed a positive culture for Mycobacterium tuberculosis of human type in Lowenstein-Jensen medium. Short-term chemotherapy (9 months) consisting of rifampicin, isoniazid and ethambutol gave an excellent result. Surgery was not required in any of the cases.
Comparison of flow cytometry with static densitometry in papillary thyroid carcinoma
Authors: Cusick E L , Macintosh C A , Krukowski Z H , Ewen S W B , Matheson N A 
Published: March 2007

Abstract
The prognostic accuracy of flow cytometric and static densitometric DNA analysis was compared in 31 patients who had undergone surgery for papillary thyroid carcinoma between 1959 and 1978 (median follow-up 18 years'). There were five deaths from papillary thyroid carcinoma. Three of six patients with DNA aneuploid tumours onflow cytometry died (P&gt;0·05, Fisher's exact test) compared with four of eight patients whose tumours were found to be aneuploid by static densitometry (P&lt;0·02). When quantitative analysis was applied to the static densitometry data, all five patients who died from papillary carcinoma were distinguished, with no false positives (P&lt;0·002). The prognostic accuracy of flow cytometric DNA analysis is less than that of static densitometry in which morphological selection of malignant cells permits quantitative measurements. DNA analysis may add refinement to existing scoring systems in predicting the risk of death from papillary thyroid carcinoma. Such information could provide the basis for controlled prospective evaluation of bilateral resection as opposed to lobectomy in defined high risk patients. At present there is insufficient evidence upon which aneuploidy should be used as a determinant of the extent of operation for papillary thyroid carcinoma.
Plasma chloride and alkalaemia in pyloric stenosis
Authors: Goh D W , Hall S K , Gornall P , Buick R G , Green A , Corkery J J 
Published: March 2007

Abstract
Fifty infants with infantile hypertrophic pyloric stenosis were studied prospectively to evaluate the reliability of plasma chloride estimation in the assessment of the acid-base status on admission and during correction of alkalaemia. Four cases were subsequently excluded because of a breach of the study protocol, leaving 46 cases in the study. Seventeen (37 per cent) were normoacidaemic on admission; 13 had plasma chloride concentrations of ⩾106 mmol/l and four had chloride concentrations of 100–105 mmol/l on admission. Twenty-nine (63 per cent) were alkalaemic on admission; six cases had chloride concentrations of 100–105 mmol/l and 23 cases had concentrations of &lt; 100 mmol/l. Of those 29 cases requiring correction of alkalaemia, normoacidaemia was achieved at a plasma chloride concentration of ⩾ 106 mmol/l in 21 cases (72 per cent) and at a concentration of 100–105 mmol/l in eight cases (28per cent). Plasma chloride is a reliable parameter in the assessment and correction of alkalaemia in infantile hypertrophic pyloric stenosis provided that a concentration of at least 106 mmol/l is the goal.
Which balloon embolectomy catheter?
Authors: Niblett P G , Fleischl J M , Campbell W B 
Published: March 2007

Abstract
This study compared seven makes of balloon embolectomy catheter currently available, testing the most commonly used 4 Fr catheters. The volume of fluid and inflation pressure required to burst balloons of each type were measured. All balloons showed a similar shape of inflation curve, but compliance varied considerably, and the pressure required to burst different balloon types varied from 1060 to 1920 cmH2O. Two balloon types consistently fragmented when they burst in free space. On a specially designed mechanical rig balloon catheters were pulled through a 6 mm tube containing a fixed stenosis, with continuous measurement of traction force and intraballoon pressure. Traction force varied from 34 to 129 g (median 40 g) during passage along the tube, and from 254 to 463 g (median 350 g) during passage through the stenosis. The shear force imparted by the balloon to the tube wall was also calculated. This study provides comparative data which may help to guide surgeons in their choice of balloon embolectomy catheter.
Reappraisal of the oxygenation of blood in varicose veins
Authors: Scott H J , Cheatle T R , McMullin G M , Smith P D Coleridge , Scurr J H 
Published: March 2007

Abstract
Raised oxygen tension in the blood of varicose veins has led to arteriovenous communications being implicated in the pathogenesis of varicose veins. The aim of this study was to compare the oxygen tension of blood from varicose veins with that from normal legs, and to observe the effect of posture on these measurements. Twenty-six subjects (13 normal controls and 13 with uncomplicated varicose veins) had blood sampled from the long saphenous vein or a varicose vein near the ankle. Samples were taken after 30 min in the supine position and repeated after 30 min standing. Samples were also taken simultaneously from the arm. Transcutaneous oxygen measurements of the gaiter skin were performed continuously throughout the experiment. In the supine position, blood from varicose veins had a significantly higher oxygen tension (median = 6·09 kPa) than that from normal veins (median = 4·54 kPd) (P = 0·022). In all subjects, there was a higher oxygen tension in leg vein blood when lying (varicose vein median value = 6·09 kPa, control median value = 4·54 kPd) than while standing (varicose vein median value = 3·93 kPa, control median value = 3·74 kPa) (P&lt;0·002, varicose vein group; P = 0·005, normal group). Changes in transcutaneous oxygen tension correlate poorly with changes in venous blood. It is concluded that the theory of arteriovenous anastomoses is only one among a number of possible explanations for the pathogenesis of varicose veins.
Eradication of oesophageal varices recurring after portal non-decompressive surgery by injection sclerotherapy
Authors: Hashizume M , Kitano S , Yamaga H , Wada H , Sugimachi K 
Published: March 2007

Abstract
The results of injection sclerotherapy for oesophageal varices which recurred after portal non-decompressive surgery were analysed retrospectively to evaluate its efficacy. We treated 60 consecutive patients with portal hypertension; 19 were treated on an emergency basis, seven electively and 34 on a prophylactic basis. All acute bleeding was controlled with one session of sclerotherapy using a transparent overtube. After eradication by sclerotherapy, no bleeding episodes occurred and there was no recurrence of the varices, except in three uncompliant patients, during a mean follow-up period of 33·1 months. Bleeding from a gastric ulcer and gastritis occurred in one patient each. Oesophageal stenosis occurred in nine (15 per cent) patients and gastric varices developed in two (3 per cent) patients. Twelve patients died, Jive from liver failure and six with hepatoma, but there was no bleeding from the gastrointestinal tract. The overall 4-year survival rate was 80 per cent. We recommend the use of sclerotherapy as the primary treatment for recurrent oesophageal varices.
Intraoperative ultrasonography and the detection of liver metastases in patients with colorectal cancer
Authors: Olsen A K 
Published: March 2007

Abstract
A total of 213 patients with carcinoma of the colon and rectum were examined to detect liver metastases. The study compared preoperative ultrasonography and inspection and palpation of the liver during surgery with intraoperative ultrasonography. Preoperative ultrasonography, inspection and palpation identified 238 metastases in 42 patients. Intraoperative ultrasonography detected 116 previously unrecognized metastatic tumours during 40 surgical procedures (P &lt; 0·01). High resolution intraoperative ultrasonography is safe and more accurate than preoperative imaging and surgical exploratory methods. The examination is simple to perform and success appears to be related to careful attention to detail.
Anterior lesser curve seromyotomy and posterior truncal vagotomy versus truncal vagotomy and pyloroplasty in the treatment of chronic duodenal ulcer
Authors: Taylor T V , Lythgoe J P , McFarland J B , Gilmore I T , Thomas P E , Ferguson G H 
Published: March 2007

Abstract
In a prospective randomized controlled clinical trial, anterior lesser curve seromyotomy with posterior truncal vagotomy (AMPT, n = 77) has been compared with truncal vagotomy and pyloroplasty (TVP, n = 69) in 146 patients with chronic duodenal ulcer with a mean duration of symptoms of 7 years. The mean follow-up time was 4·5 years with a range of 2–7 years. One elderly patient died from a myocardial infarction in the TVP group. Acid secretory inhibition in response to insulin and pentagastrin stimuli was equal in both groups, indicating a similar degree ofvagaldenervation. Recurrent ulcers were more common after AMPT (five) than TVP (two) (P = 0·29, n.s.). Dumping and diarrhoea were significantly commoner (P &lt; 0·001) after TVP, with 31 instances as opposed to eight with AMPT. The mean operating time was increased by 6 min when AMPT was performed rather than TVP. The results of this study have shown that AMPT is associated with a lower incidence of dumping and diarrhoea and achieves better overall Visick grading. However, continued monitoring is required to assess the long-term incidence of recurrent ulceration after this procedure.
CA72–4: A new tumour marker for gastric cancer
Authors: Byrne D J , Browning M C K , Cuschieri A 
Published: March 2007

Abstract
To date, tumour markers for gastric cancer have proved unreliable. In this study the value of a new serum marker, CA 72–4, was compared with the serum activities of carcinoembryonic antigen (CEA) and CA19-9 in a consecutive series of patients with gastric cancer. The results show that the CAT2-4 assay is significantly better at separating stage I and II disease from normal controls (P &lt; 0·01) than CEA (n.s.) or CA19-9 (n.s.). CA72-4 also gave better differentiation between patients with positive and negative nodes (P &lt; 0·01) and between those who were serosa positive and negative (P &lt; 0·01). CEA differentiated between patients with positive and negative nodes (P &lt; 0·05) but CA19-9 could not. CA19-9 and CEA could not discriminate between patients who were serosa positive and negative. In this study, at a specificity of 95 per cent, the sensitivities of CEA, C A19-9 and CA72-4 were 0·25, 0·41 and 0·94 respectively. These preliminary findings indicate that CA 72-4 is a reliable tumour marker of disease stage and activity in gastric cancer. Further longitudinal studies are required for full evaluation of its clinical utility.