bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute renal failure in surgical patients
Authors: Marshall V C 
Published: March 2007

Abstract
A group of 215 patients with acute renal failure is discussed.
Acute renal failure in surgical practice is due to obstruction, trauma, operation, or miscellaneous causes. The high mortality can be reduced by early diagnosis and treatment. Infective complications are common.
Treatment of renal failure is aided by peritoneal dialysis and by haemodialysis. Renal failure can usually be controlled by one or both of these methods of treatment.
Death is usually due to the severity of the original disease, and to infective complications.
Perfusion of the isolated pig liver functional assessment under control normothermic conditions
Authors: Hickman R , Saunders S J , Simson E , Terblanche J 
Published: March 2007

Abstract
A study of the isolated perfused pig liver has been made to assess function for hepatic assist and to provide baseline values for altering techniques in liver storage. In 23 analogous perfusions lasting 6 hours, pre- and post-perfusion tests of liver function were compared. These results suggest that during the perfusion period, cell-membrane integrity was maintained and that oxidative metabolism including gluconeogenesis was unimpaired. A rise in aspartate transaminase indicated some cellular damage and the fall in bile production was ascribed to altered solute load.
Preliminary results from the J. S. Marais Surgical Laboratory suggest that there is good correlation between the biochemical assessment of liver vialbility and the capacity of the perfused liver to support life after transplantation into another animal. At this time, the latter procedure remains the ultimate test of liver function after perfusion.
Epithelial cell division in acute renal failure: A radio-autographic study in the oesophagus of the mouse
Authors: McDermott F T , Nayman J , De Boer W G R M 
Published: March 2007

Abstract
The effect of acute renal failure, induced by intraperitoneal injection of the nephrotoxic agent uranyl nitrate or by urinary obstruction, upon cell division in the epithelium of the oesophagus was investigated in mice. Radio-autography with tritiated thymidine demonstrated that inhibition of cell division was pronounced when acute renal failure was severe and that less severe degrees of renal failure did not always inhibit cell division in this epithelial tissue. In conjunction with previous investigations it would appear that acute renal failure inhibits cell division in rapidly proliferating tissues. Inhibition of epithelial cell division may be a contributing factor in the development of uraemic lesions in the digestive tract.
Upper retroperitoneal injuries
Authors: Attard J 
Published: March 2007

Abstract
One hundred and ten cases of upper abdominal injuries have been reviewed. A significant proportion of them is retroperitoneal. It will be shown that an increased awareness of the importance of vague physical signs and the willingness to submit these patients to relevant investigations will result in an accurate diagnosis. A more logical and often vigorous approach to treatment has resulted in a dramatic reduction in the morbidity and mortality associated with such injuries.
Clinical applications and complications of umbilical vein cannulation
Authors: McK. Watts J , Douglas M C 
Published: March 2007

Abstract
Cannulation of the obliterated umbilical vein provides direct access to the portal venous circulation; by this means the portal venous pressure may be measured and venography performed to demonstrate the anatomy of the intra- and extrahepatic portal venous system and the presence of space-occupying lesions within the liver. Following dilatation the umbilical vein may also be used for temporary or permanent decompression of the portal system in patients with portal hypertension and bleeding oesophageal varices.
The technique of cannulation of the umbilical vein is described. The results of attempted umbilical vein cannulation in 26 patients are reported; in 16 for the investigation or treatment of portal hypertension and in 10 for the diagnosis of suspected space-occupying lesions in the liver. Cannulation was successful in 12 patients: the reasons for failure and the complications of the technique are described. One patient with bleeding oesophageal varices was treated by a shunt between the umbilical vein and the upturned saphenous vein; the shunt functioned initially but later thrombosed, possibly owing to insufficient dilatation of the umbilical vein.
The value of and indications for umbilical vein cannulation are discussed. The procedure may be technically difficult and is not free of complications, but can give valuable information in selected patients with portal hypertension and in patients with suspected, intrahepatic, space-occupying lesions. The high failure rate in this series may be related to initial lack of experience with the technique.
Detection of urethral carcinoma using a soluble SWAB
Authors: Trott P A 
Published: March 2007

Abstract
Swabs of acetone-soluble cellulose acetate were used to obtain fragments of tissue in cases of urethral carcinoma.
The histological appearances of tissue obtained in this way were comparable with those following biopsy and orthodox histology.
The method is relatively automatic and appears to be valuable in the diagnosis of carcinoma of the urethra.
“Spontaneous” perforation of the oesophagus treated by utilization of a pericardial flap
Authors: Millard A Henry 
Published: March 2007

Abstract
A case of “recurrent” spontaneous perforation of the oesophagus treated by the utilization of a pericardial flap is reported. It is suggested that this manœeuvre, which does not appear to have been described previously, may be life-saving when there has been delay in operating or major secondary leakage has occurred.
Multiple pathology in A unilateral supernumerary kidney
Authors: Browne M K , Glashan R W 
Published: March 2007

Abstract
Two separate unilateral renal masses, both replaced by tumour, are described. We suggest that one of these was, in fact, a supernumerary kidney which is a rare anomaly of the urinary tract. The lesions were associated with hypertension, apparently cuased by a renal artery stenosis and remedied by excision of both renal masses.
Late development of A false aneurysm of the common carotid artery
Authors: Beale Major P J 
Published: March 2007

Abstract
A case is presented of false aneurysm formationo f the common carotid artery occurring in a young soldier 8 months after his original injury, and immediately preceded by a severe hemiplegia. The relative frequency of such aneurysms is given, and also an account of the frequency of neurological complications from carotid arterial injuries. A possible explanation is given of the timing of events in this particular case, and the problem of follow-up is discussed.
The effect of vagotomy and a drainage procedure on alcohol tolerance
Authors: Fleming J A , Haynes S , Le Quesne L P 
Published: March 2007

Abstract
An oral alcohol-tolerance test using a bodyweight-related dose of alcohol was performed on two groups of patients undergoing truncal vagotomy and a drainage procedure for uncomplicated chronic duodenal ulcer. Eight patients received 0.65g. of absolute alcohol per kg. body-weight and 12 received 0.35 g. per kg. body-weight. The test was performed before operation and 4 months after operation on each patient. After operation the peak blood-alcohol concentration was significantly higher than before operation, and occurred significantly sooner after the ingestion of alcohol. The cause of these changes is discussed, and it is concluded that they are probably due to an increased rate of gastric emptying. The relevance of these results to the Road Safety Act, 1967, is discussed.
The treatment of anal fissure by lateral subcutaneous internal sphincterotomy—A technique and results
Authors: Notaras M J 
Published: March 2007

Abstract
A technique of internal anal sphincterotomy for anal fissure by the mid-lateral subcutaneous route is described. The operation avoids the “key-hole” deformity which occasionally follows the standard midposterior sphincterotomy. Lateral subcutaneous internal sphincterotomy resulted in rapid healing of the fissure with little discomfort and disturbance of anal function.
The prevention of infection in appendicectomy wounds
Authors: Longland C J , Gray J G , Lees W , Garrett J A M 
Published: March 2007

Abstract
Fifty cases of acute appendicitis were examined at operation for the presence of free organisms on or around the appendix in situ, and for bacterial contamination of the wounds after removal of the appendix. Fifty-four per cent had free organisms around the appendix, 40 per cent of the wounds probably became contaminated, and 18 per cent became clinically infected.
The operative technique was modified in 50 cases to minimize the chance of contaminating the wounds. There were 2 infections (4 per cent). In another series in which the usual operative technique was used the wounds were irrigated with tetracycline solution; there was 1 infection in 50 cases, an incidence of 2 per cent. In a similar trial the use of a mixture of powdered antibiotics in 50 cases did not influence the wound infection rate which remained at 18 per cent.
The use of tetracycline solution and care in avoiding contamination of the wound are recommended.
Carcinoma of the stomach, colon, and rectum: A survey of 772 surgical biopsies from Malaya
Authors: King M S , Kutty M Kannan 
Published: March 2007

Abstract
A survey of surgical biopsy material from carcinoma of the stomach, colon, and rectum in Malaya with its multiracial population was carried out.
The difficulty of interpretation of local frequency figures, owing to differences in rates of hospital utilization in the various races, is discussed.
The frequency of occurrence of carcinoma of the stomach would seem to be the same for all three races, Chinese, Indian, and Malay.
Carcinoma of the colon and rectum are not the uncommon diseases they had previously been thought to be in the region. The incidence of carcinoma of the colon and rectum is lower in Indians compared with the Chinese and Malays.
Leiomyosarcoma of the rectum
Authors: Somervell J L , Mayer P F 
Published: March 2007

Abstract
A patient with leiomyosarcoma of the rectum is presented with a brief review of 7 other patients seen in the Birmingham region from 1950 to 1967. A short discussion is given concerning the difficulties of diagnosis and treatment. We would concur with Diamante and Bacon's view (1967) that abdominoperineal excision is the treatment of choice, but that for small border-line tumours local excision may be adequate if intensive follow-up is used. Radical excision is practised at the first sing of possible local recurrence. The Birmingham cases seem unusual because of the predominance of distant metastases when compared with the local spread more commonly reported by other workers.
The Accurate assessment of maximal gastric secretion in control subjects and patients with duodenal ulcer
Authors: Hassan M A , Hobsley M 
Published: March 2007

Abstract
Maximal gastric secretion was studied in 34 control subjects and 29 patients with duodenal ulcer using the histamine-infusion test with the addition of an inert marker, phenol red, to correct for pyloric losses of gastric secretion.
In the control group, statistically significant correlations were found between maximal gastric secretion and almost all the indices of body stature. Correction for pyloric loss improved all the correlations and raised those correlation coefficients which were not significant to levels of confidence of 95 percent or more.
The validity of calculation of lean body mass from height and weight was checked by the estimation of total body potassium in 26 subjects.
When lean body mass was taken into account it was confirmed that maximal gastric secretion decreased with age, but the sex difference in maximal gastric secretion was no longer statistically significant.
In the duodenal ulcer group, maximal gastric secretion was also significantly correlated with stature, though not with age. It is, therefore, proposed that stature should be taken into account when defining hypersecretion.
As expected, patients with duodenal ulcer produced as a group significantly higher levels of maximal gastric secretion than did control subjects, but the effect appeared to be due to a minority of patients with hypersecretion.
Patients with a history of less than 4 years secreted proportionately less gastric juice than those with a longer history. This finding raises the possibility that gastric hypersecretion is a result of duodenal ulceration rather than a cause.
The cardiovascular complications of intravenous regional anaesthesia
Authors: Kew M C , Lowe J P 
Published: March 2007

Abstract
In view of the uncertainty over the safety of intravenous regional anaesthesia the heart-rate, blood-pressure, and electrocardiogram were recorded seriany in 100 Bantu gold-miners in whom this form of anaesthesia was used for minor surgical procedures on the extremities. Changes in blood-pressure were infrequent and mild. In 31 patients the heart slowed by more than 10 beats per minute after release of the tourniquet, falling to less than 60 beats per minute in 27. One patient with sinus bradycardia developed sino-atrial block with cardiac standstill of short duration, a second developed an intermittent idioatrial tachycardia and premature atrial beats, and in 3 others sinus bradycardia was complicated by atrial escape beats, nodal rhythm, and premature ventricular beats respectively. These toxic effects were thought to be due either to direct myocardial depression or to increased vagal or decreased sympathetic tone, or to both of these mechanis. It is suggested that the cardiovascular depression caused by large doses of lignocaine may be aggravated by coexisting ischaemic heart disease. The importance of monitoring the patients carefully after release of the tourniquet and having facilities available for resuscitation is stressed.
The effect of leg elevation on the incidence of deep-vein thrombosis after operation
Authors: Rosengarten David S , Laird James 
Published: March 2007

Abstract
Leg elevation during and after operation did not reduce the incidence of deep-vein thrombosis in patients undergoing elective surgery over the age of 40 years. The incidence was 31 per cent in the control group and 33 per cent in the patients in whom the legs were elevated.
A new test for complete nerve section during vagotomy
Authors: Grassi G 
Published: March 2007

Abstract
A new test of completeness of vagotomy based upon the evaluation of pH variations in the stomach is presented.
The test is performed during the operation through a minimal gastrotomy with a glass electrode after vagotomy and maximal histaminic stimulatin. In order to avoid errors a study of 28 ulcer patients had been performed previously. This study showed that under general anaesthesia with unsectioned vagi the pH can be used to evaluate the variations of gastric secretion, that there is no basal secretion, and that the maximal histminic test is able to stimulate the acidsecreting cells. The test performed later in 40 patients showed a completed denervation as demonstrated by pH values between 5·5 and 7 on the whole mucous gastric surface in 36 patients, while in 4 patients the presence of a limited zone of gastric mucosa with a pH of 1·2–2 surrounded by mucosa with a pH between 5·5 and 7 showed not only an incomplete vagotomy but also, on the basis of their localization on the wall of the stomach, whether the unsectioned branches were anterior or posterior.
Furthermore, the test performed in four series of patients, in which the vagotomy was left temporarily incomplete on purpose, showed that the presence of more than one acid zone in the gastric mucosa was due to one unsectioned fibre of the oesophageal plexus, while in the case of a single acid zone it was due to a terminal gastric branch.
Long-term follow-up (up to 1 year after the operation) showed that after amaximal histaminic tests the values found were similar to those found intraoperatively, and after Hollander tests, values for complete vagotomy without so-called “adequate vagotomies” were found.
Duodenal diverticulum treated by excision of mucosal pouch only
Authors: Slater R B 
Published: March 2007

Abstract
The incidence of duodenal diverticulum and complications is discussed. The incidence of symptoms is probably about 10 per cent. It is suggested that more cases merit operative treatment than receive it at present.
Operative procedures are discussed and a simplified method, involving removal of the mucosal pouch only after duodenotomy, is described and a case presented illustrating the method.
The results obtained with emergency surgery in the treatment of persistent haemorrhage from gastro-oesophageal varices in the cirrhotic patient
Authors: Rothwell-Jackson R L , Hunt Alan H 
Published: March 2007

Abstract
The management of the cirrhotic patient with bleeding gastro-oesophageal varices is discussed with particular reference to the role of emergency surgery. An analysis is made of the results obtained in 77 patients with emergency surgery to control recurrent haemorrhage.
The deleterious effect of failing to control haemorrhage immediately and effectively in these cases is emphasized. If haemorrhage recurs in spite of conservative measures, including tamponade, surgery is considered mandatory. Only 8 cases have had an emergency portacaval anastomosis, with 4 survivors, all good-risk cases. More patients might benefit from this operation but only if haemorrhage is rapidly and effectively brought under control in the first instance. The poor-risk case has a 30 per cent chance of survival with a Boerema-Crile operation. However, this is not a definitive operation and patients who survive this procedure should have a portacaval anastomosis as soon as their liver function has sufficiently recovered.
Congenital duodenal stenosis in an adult presenting with severe electrolyte imbalance
Authors: Ward E E , Walrond E R , Davison J S 
Published: March 2007

AbstractA man of 55 years presented with a 12-year history of intermittent vomiting and in a semi-comatose state. He had severe water and electrolyte disturbances, with a plasma chloride of 27 mEq./1., and a chloride deficit in excess of 2500 mEq.; he also had acid-base disturbances. Gastric acid studies suggested the possibility of the Zollinger-Ellison syndrome. At operation, the rare condition of congenital duodenal stenosis in an adult was found. He made an uneventful recovery.
Preparation of the intestine in patients undergoing major large-bowel surgery, mainly for neoplasms of the colon and rectum
Authors: Rosenberg I L , Graham N G , de Dombal F T , Goligher J C 
Published: March 2007

Abstract
This paper reports the results of a randomized prospective trial of three régimes of preparation of 150 patients for major large-bowel surgery, the criterion being the frequency of postoperative sepsis. One régime provided only mechanical preparation of the bowel, another gave the same mechanical preparation and also phthalylsulphathiazole, and the third included mechanical measures plus phthalylsulphathiazole plus neomycin.
As regards the use of bowel antiseptics, the combination of neomycin and phthalylsulphathiazole was not found to possess any advantage over sulphonamide alone. However, patients prepared by purely mechanical means fared substantially worse than those who had a combination of mechanical and antiseptic preparation. Gross faecal loading of the bowel and peritoneal contamination at operation were associated with a higher incidence of septic complications.
These findings suggest that in the prevention of postoperative infection at least three precautions are desirable–the correction of gross faecal loading before operation, the use of preoperative intestinal antiseptics, and the avoidance of peritoneal contamination during operation.
The effect of mechanical obstruction on tissue regeneration in the rabbit's ear
Authors: Joseph J , Dyson Mary 
Published: March 2007

Abstract
Tissue of area 1 cm.2 was excised through the full thickness of both ears of a group of rabbits. The excision site of one ear of each rabbit was blocked with Perspex for a time varying between 7 and 49 days. The other ear was allowed to heal and regenerate normally as a control. The growth of new tissue in the experimental ears was measured after block removal and compared with that of the opposite control ears. The regenerated tissue was also examined histologically for changes produced by blocking. Blocking for any period up to 49 days results in an increased growth rate on block removal. Only blocking for 14 days or less has a permanent stimulatory effect. All other blocking periods investigated (21, 28, 35, 42, and 49 days) were ultimately deleterious. The presence of the mechanical blocking device stops the development of a blastema in the normal position. The blastema cells gather in the uninjured tissue behind the wound edge and take up their normal position once the block is removed. The harmful effect of long-term blocking may be due to reduction of the vascularity of the marginal tissue and subsequently to damage to the blastema. Blocking for 14 days or longer results in deformation of the regenerating elastic cartilage.
Total thymectomy by the transcervical approach
Authors: Kark A E , Kirschner P A 
Published: March 2007

Abstract
The transcervical method of removal of the thymus gland is the preferred method especially in myasthenia gravis. This technique substantially reduces the postoperative complications permitting a rapid painfree convalescence with a minimum of postoperative psychiatric problems and cosmetic disfigurement.
Fifty-two patients with non-thymomatous myasthenia and 7 with high-lying thymoma have been operated on in the past 3 years by this method. In addition, in 1 case of hyperparathyroidism this technique proved invaluable immediately following a negative neck exploration.
The morbidity and complication rate is so much reduced that the trans-sternal technique is now reserved for selected cases of thymoma only.
One death has occurred in a near moribund patient with uncontrollable myasthenia and severe hyperthyroidism.
Ganglioneuromatosis of the sigmoid colon
Authors: Munro Kathleen M H 
Published: March 2007

Abstract
A man, aged 72 years, who came to hospital with a 9-month history of increasing constipation, had a narrowed segment of sigmoid colon removed. Increased numbers of nerve fibres and ganglion cells were found histologically in the plexuses of Auerbach and Meissner, and in the muscular layers of the affected bowel. This is apparently the first recorded case of this type of ganglioneuromatosis of the pelvic colon. The lesion was radiologically indistinguishable from a stenosing carcinoma of the colon.
An approach for operations on the iliac arteries
Authors: Rosengarten David S , Knight Barry , Martin Peter 
Published: March 2007

Abstract
An alternative approach to the iliac arteries, needing divisison of the inguinal ligament, is described by which operations on these vessels are simplified. The operation is a relatively minor one. There have been no serious complications from the divsion of the inguinal ligament nor has there been detectable weakness in the rectus abdominis muscle. Incisional hrenia above the inguinal ligament occurred in 3 of 150 patients so treated after wound haematoma and infection, and 1 patient suuffered a minor direct inguinal hernia.