bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolation and preservation of islets from the mouse, rat, guinea-pig and human pancreas
Authors: Ferguson J , Allsopp R H , Taylor R M R , Johnston I D A 
Published: March 2007

Abstract
Viable islets of Langerhans have been isolated from the mouse, rat, guinea-pig and human pancreas using a free hand microdissection procedure. Viability has been assessed by light microscopy of sections stained with Gomori's aldehyde fuchsin and by measuring the insulin release from islets in vitro in response to a glucose stimulus. Ten pieces of human cadaver pancreas have been studied. Islets were isolated from 6 and in 5 cases were shown to respond to a glucose stimulus in vitro. Five pieces of human pancreas removed at operation have been studied. Islets were isolated in all cases but only 2 showed a response to a glucose stimulus.
Isolated animal islets have been subjected to three preservation systems and their viability following storage noted. Simple cold storage in Hank's balanced salt solution at 4°C. At 15 hours 100 per cent survival was noted. This dropped to 10 per cent at 48 hours. There were no survivors at 72 hours.Subzero storage. In group I (freezing rate 1°C/min) histological survival was 35 per cent and frtnctional survival 20 per cent. In group II (freezing rate 5°C/min with a 24-hour culture period after rewarming) histological survival was approximately 87 per cent and functional survival 75 per cent.Organ culture. Islets from the guinea-pig, rat and mouse showed minimal morphological damage when cultured for 21 days in a simple organ culture system. At 28 days histological survival was approximately 30 per cent. We were unable to correlate histological and functional survival in this group.
Inhibitors of gastric secretion: Current progress
Authors: Carter D C 
Published: March 2007

Abstract
Several new compounds have become available recently which are potent inhibitors of gastric secretion. The therapeutic potential of these inhibitors in the peptic ulcer diathesis is reviewed and it is concluded that the histamine H2-receptor antagonists show most promise at present. The prostaglandins and gastro-intestinal polypeptides are of considerable physiological interest but are unlikely to have clinical importance in the immediate future.
Layer closure of laparotomy wounds with absorbable and non-absorbable suture materials
Authors: Irvin T T , Koffman C G , Duthie H L 
Published: March 2007

Abstract
Opinions vary regarding the best suture material for abdominal wound closure. Some surgeons favour non-absorbable sutures while others use absorbable materials, but there is little objective clinical information regarding the relative merits of the different suture materials.
In a randomized prospective clinical trial the synthetic absorbable polyglactin and polyglycolic acid sutures were compared with the non-absorbable polypropylene suture in the closure of 161 laparotomy wounds. A layered closure technique was used in all cases.
The total incidence of wound dehiscence and herniation was 8·1 per cent, and there was no significant difference between polyglycolic acid (9·6 per cent), polyglactin (5·8 per cent) and polypropylene (8·8 per cent). Dehiscence and herniation were significantly more common in wounds closed by surgeons in training.
It was concluded that none of the suture materials provided satisfactory freedom from wound complications. It is possible that these sutures may prove satisfactory with an alternative technique of abdominal wound closure, but this should be the subject of further clinical studies.
Reconstruction of the breast as a primary and secondary procedure following mastectomy for carcinoma
Authors: Watts G T 
Published: March 2007

Abstract
During a period of 8 years over 200 cases of carcinoma of the breast have had replacement procedures carried out as either a primary or a delayed procedure. The end results do not appear to be in any way inferior to those of conventional treatment of this condition.
Selection of cases is important, but equally vital is meticulous dissection technique, haemostasis and planning of incisions together with preservation of the blood supply.
Recurrence locally appears to be somewhat less than anticipated when compared with other methods of treatment. It can be treated by irradiation or excision without removal of the prosthesis.
Chagas' disease of the colon
Authors: da Silveira Geraldo Milton 
Published: March 2007

Abstract
One hundred cases of chagasic megacolon operated upon in Bahia, Brazil, have been analysed. The principal theories of the pathological physiology of the disease are discussed. The pre- and postoperative radio-graphic features of the colon are presented, and the surgical treatment as well as the incidence of complications and late results are reported.
Surgical treatment of kinked internal carotid arteries
Authors: Vollmar J , Nadjafi A S , Stalker C G 
Published: March 2007

Abstract
Carotid artery insufficiency is caused by an abnormal kinked or coiled internal carotid artery in 15–20 per cent of symptomatic patients. Surgical correction should be considered if other causes for the neurological signs are excluded, a pronounced kinked or coiled area is demonstrated and if there is not a severe neurological deficit. As well as eliminating the elongation, surgical correction should include intralunzinal inspection of the artery as, in 38·5 per cent of cases, a concomitant arteriosclerotic stenosis requires simultaneous correction.
The immunogenicity of starch glove powder and talc
Authors: Grant J B F , Davies J D , Jones J V , Espiner H J , Eltringham W K 
Published: March 2007

Abstract
An antigen responsible for cutaneous delayed hypersensitivity to starch glove powder in guinea-pigs was found to be associated with starch grains. Talc was not immunogenic in this system, and did not cross-react in skin tests with starch glove powder. Additives and protein components in the glove powder did not appear to be antigenic.
Tension pneumoperitoneum: A report of 4 cases
Authors: Addison N V , Broughton A C 
Published: March 2007

Abstract
Four cases of tension pneumoperitoneum are described. In 3 patients this condition followed a perforation of a grossly distended caecum. In 2 of these patients there was an associated malignant neoplasm of the pelvic colon with obstruction. The third patient had a pseudo-obstruction of the transverse colon. The fourth patient had a tension pneumoperitoneum with associated surgical emphysema in the neck and subcutaneous tissues of the abdomen and chest walls, following perforation of a duodenal ulcer. The aetiology, presentation and management, together with the mechanism of tension pneumoperitoneum, are discussed.
Malignant lymphoma of the thyroid
Authors: Taylor I 
Published: March 2007

Abstract
Two cases of malignant lymphoma are reported and the clinical features of a further 6 cases collected over a 10-year period are presented. The literature is reviewed and the treatment, prognosis and relationship to Hashimoto's disease are discussed. It is suggested that lymph node biopsy at the time of operation is important in confirming the diagnosis and that the prognosis may be more hopeful than has previously been suggested.
Emergency abdominal surgery in the aged
Authors: Blake Richard , Lynn John 
Published: March 2007

Abstract
The results of 375 emergency abdominal operations in elderly patients over the age of 75 years are presented and discussed in detail. There has been a fourfold increase in the population over the age of 75 years in England and Wales during the 60-year period from 1911 to 1971. The overall mortality of these patients of 31·7 per cent is unrelated to the age of the patient, but appears to be directly related to the severity of the surgical condition and to cardiorespiratory complications. Our approach to these problems is presented and discussed.
An elemental diet as preoperative preparation of the colon
Authors: Gurry J F , Ellis-Pegler R B 
Published: March 2007

Abstract
In a study comparing patients prepared for colonic surgery with an elemental diet (Vivonex) with a control group there was no significant difference in incidence of wound infection or other complications between groups. Furthermore, there was no change in the population levels of the colonic microflora nor were the numbers of species decreased after 2–4 days on the diet. Although in most cases aiding in the mechanical preparation of the colon, the elemental diet has not been shown to confer any other advantage.
Inflammable antiseptics and theatre fires
Authors: Briscoe C E , Hill D W , Payne J P 
Published: March 2007

Abstract
This paper describes an investigation designed to find out if theatre fires could be started by the antiseptic painted on the patient's skin being ignited by cautery or diathermy.
It was found that hot wire cautery or diathermy generated enough heat to ignite all alcohol-based antiseptics even if these contained as little as 20 per cent alcohol. They could also cause iodine to explode in the presence of nitrous oxide, and nobecutane to explode in the presence of nitrous oxide or increased oxygen.
The likelihood of these combinations causing fires is discussed, and it is recommended that when diathermy or cautery is to be used near the surface of the body, either an aqueous-based antiseptic is used or if spirit solutions are required they are carefully dried of before proceeding.
Comparison of pulmonary artery pressures and mixed venous oxygen tension with other indices in acute haemorrhage: An experimental study
Authors: Pardy B J , Dudley H A F 
Published: March 2007

Abstract
A pulmonary artery cannula allows the determination of free and wedge pulmonary artery pressures and mixed venous oxygen tension. These indices have been reported to provide useful information in the assessment of the haemodynamic status of the ill patient. The purpose of this study was to compare them with systemic arterial and central venous pressures as predictors of cardiac output during acute continuous haemorrhage in the dog. Pulmonary artery pressure changed almost linearly with cardiac output, and the percentage changes in each were similar; by contrast, systemic arterial pressure was an inferior predictor of cardiac output. Pulmonary artery wedge pressure fell rapidly in the initial phase of bleeding, but right atrial pressure more gradually. The oxygen tension of blood in the pulmonary artery fell steadily during haemorrhage. These findings suggest that data derived from the use of a pulmonary artery cannula may be more useful than systemic arterial and central venous pressures in the detection of hypovolaemia and reduced cardiac output; more frequent use of a pulmonary artery cannula should be made in patients in whom blood volume may fluctuate rapidly.
The pathophysiological changes of experimental fat embolism: Early pre-hypoxaemic changes
Authors: Sikorski J , Pardy B J , Bradfield J W B , Dudley H A F 
Published: March 2007

Abstract
Glyceryl trioleate has been injected into greyhounds as a model of the fat embolism syndrome. Pulmonary vascular pressures, systemic arterial pressure and cardiac output were determined at regular intervals over an 8-hour period. It has been shown that glyceryl trioleate causes an increased pulmonary vascular resistance and a fall in cardiac output. These effects are mediated partly by a direct mechanical block of pulmonary vessels and partly through a thrombogenic property of the injected fat. The relevance of these findings to the clinical situation is discussed and a sequence of events for the fat embolism syndrome is proposed.
Experimental fat embolism: A dynamic assessment of pulmonary fat-handling characteristics
Authors: Sikorski J M , Pardy B J , Dudley H A F 
Published: March 2007

Abstract
Injection 125I-glyceryl trioleate (0.5 mg/kg) into the right atrium of anaesthetized greyhounds caused the following changes: sequestration of fat in the right side of the heart; 95 per cent removal by the lungs in a single passage through the pulmonary circulation; subsequent release of fat into the systemic circulation; rapid overall turnover of fat trapped in the lungs and slow removal of recirculating fat by other tissues.
We believe that if there is release of unemulsified fat into the circulation in traumatic fat embolism these findings are of significance in interpreting the subsequent pulmonary events.
Effect of truncal vagotomy on gastroduodenal content of gastrin
Authors: Malmstrøm J , Stadil F , Christensen K C 
Published: March 2007

Abstract
The vagal influence on gastroduodenal content of gastrin was studied in duodenal ulcer patients. Endoscopic biopsies were assayed for total concentrations of gastrin, and fractionated for measurements of gastrin components before and after total vagotomy. Antral concentration was 17.0±2.0 μg gastrin/g mucosa (mean±s.e.m.) in 52 unoperated patients compared with 25.2 ± 3.2 μg in 32 vagotomized patients. In 14 patients studied before and 3 months after vagotomy antral content was almost doubled (10.9 ± 2.3 and 20.4 ± 2.9 μg respectively). In the duodenal bulb the concentration was 2.4 ± 0.3 μg in 37 unoperated patients and 2.2 ± 0.4 μg in 19 vagotomized patients. In 6 patients in whom measurements were made throughout the duodenum, gastrin concentrations were slightly but significantly lower 3 months after vagotomy. Fractionations of pooled homogenates on Sephadex G-50 showed that gastrin component III (gastrin-17) made up 95 per cent of the antral gastrins before and after operation. In the duodenum component III constituted more than half of the gastrins preoperatively but only one-third postoperatively. The total amount of gastroduodenal gastrin was considerably increased by vagotomy, and it is well established that in serum the gastrin concentration is also higher postoperatively. The most likely implication of these findings is that in man the vagus, directly or indirectly, suppresses gastrin production.
Recurrent ulcer after proximal gastric vagotomy for duodenal and pre-pyloric ulcer
Authors: Holst-Christensen J , Hansen O Hart , Pedersen T , Kronborg O 
Published: March 2007

Abstract
Factors thought to be important in the development of recurrent ulcer after proximal gastric vagotomy were investigated 1–4 years after operation in 211 patients with duodenal ulcer and in 49 with pre-pyloric ulcer. Recurrent ulcer was found in 25 patients with duodenal ulcer (12 per cent) and in 6 with pre-pyloric ulcer (12 per cent). Recurrence was not related to age, sex, duration of dyspepsia, radiological findings or peak acid output before and 10 days after vagotomy. Fiftysix patients were operated upon by the method of Amdrup and Jensen (1970), including skeletonization of about 2 cm of the oesophagus. The remaining 204 patients were operated on by a technique in which the dissection of the lesser curve was begun at the ‘crow's foot’ and the oesophageal dissection was extended, in most cases, to more than 4 cm above the cardia. Recurrence was more frequent among the 56 patients in the first group than among the remaining patients with duodenal ulcer. Recurrence was positively related to basal acid output after vagotomy. An increase of peak acid output of 50 per cent was seen in a smaller group with recurrence and patients with dyspepsia within 18 months of vagotomy.
It was concluded that the risk of recurrence is not related to the number of parietal cells, as expressed by peak acid output to histamine. The risk may probably be reduced by extension of the oesophageal skeletonization. A marked increase in peak acid output may be seen during the first year after proximal gastric vagotomy in patients with recurrence or dyspepsia.
Anal fistulas at St Mark's Hospital
Authors: Marks C G , Ritchie Jean K 
Published: March 2007

Abstract
This paper presents the application of a classification of anal fistulas to an unselected consecutive series of 793 patients treated for this condition at St Mark's Hospital front 1968 to 1973 inclusive. The fistulas were divided into five categories on jheir anatomical relationships: superficial (16 per cent), intersphincteric (54 per cent), trans-sphincteric (21 per cent), suprasphincteric (3 per cent) and extrasphincteric (3 per cent), with the remaining cases multiple or unclassified (3 per cent).
There was good correlation between the categories and presentation, physical signs and treatment of the fistulas.
Two hundred and forty-nine patients had potentially difficult fistulas. Follow-up of these patients revealed healing of almost all the fistulas, but the functional results were less satisfactory (incontinence of loose stool in 17 per cent and of flatus in 25 per cent, soiling in 31 per cent).
Intestinal changes after jejuno-ileal shunt in obesity: A report of 2 cases
Authors: Grenierj J F , Dauchel J , Marescaux J , Eloy M R , Schang J C 
Published: March 2007

Abstract
Two cases of end-to-end and end-to-side jejuno-ileal bypass for the treatment of obesity are reported in which both patients underwent reoperation 17 and 23 months later respectively. Macroscopic examination and measurements of length of the various segments of the small intestine have been performed twice in each patient: at the time of the bypass and at the second surgical procedure. In one patient a histological study of both the excluded and functioning small intestine was carried out at the time of each surgical procedure. The functioning intestine had increased in size while the excluded segment had become narrowed. The height of the villi had increased slightly in the functioning ileum and more so in the functioning jejunum compared with the preoperative measurements. In contrast, the height of the villi was moderately reduced in both the bypassed jejunal and Heal segments. These findings confirm the results of experimental studies in animals.
Gas gangrene and related infection: Classification, clinical features and aetiology, management and mortality. A report of 88 cases
Authors: Darke S G , King Ann M , Slack W K 
Published: March 2007

Abstract
The clinical features of gas gangrene and related infection seen in 88 patients over a 10-year period are described. It is suggested that clostridial infection could be simply classified as either ‘gas-forming’ or ‘non-gas-forming’. The gas-forming group represents the more severe form of infection. Non-clostridial gas gangrene may present in a variety of forms. The anaerobic streptococcus was the organism most frequently responsible, but these cases were indistinguishable from clostridial infection on clinical grounds.
The treatment of gas gangrene in this series of patients is reported. Emphasis is laid on the importance of adequate prophylaxis with penicillin in patients at risk. The value of antibiotics in established infection remains equivocal. The evidence supporting the value of hyperbaric oxygen therapy is assessed and an attempt made to quantify the response to this treatment. Benefit was apparent in only a proportion of patients. A favourable response indicated clostridial infection and guaranteed immediate survival. Extensive debridement or amputation is unnecessary in this group. No response following hyperbaric oxygen therapy indicated widespread mixed clostridial and non-clostridial infection, or infection due to organisms other than clostridia. Urgent and extensive debridement and amputation remain the predominant measures in this group.
Pulsion intubation for palliation of carcinoma of the oesophagus
Authors: Hegarty M M , Angorn I B , Bryer J V , Henderson B J , Le Roux B T , Logan A 
Published: March 2007

Summary
One hundred and eighty-one patients with carcinoma of the upper thoracic oesophagus were intubated perorally using a Procter Livingstone tube. The mortality was 16·6 per cent but, in the patients who survived, the palliation achieved, as judged by improved swallowing, was considered satisfactory. Factors influencing the success of intubation are also considered.
Agenesis of the vermiform appendix in a thalidomide child
Authors: Shand J E G , Bremner D N 
Published: March 2007

Summary
A case of congenital absence of the appendix occurring in a child with severe thalidomide deformities is described. The literature on agenesis of the appendix is reviewed. The frequency and significance of internal abnormalities in thalidomide children are discussed.
Herniation through the foramen of Morgagni in children
Authors: Thomas G G , Clitherow N R 
Published: March 2007

Summary
Eight cases of herniation through the foramen of Morgagni are described. They fell into two distinct groups presenting either as neonatal respiratory distress or as an incidental finding in older children. Diagnosis is essentially radiological, stressing the importance of a lateral film. Surgical repair is advocated, the abdominal approach being preferred. Pneumopericardium is a rare but severe complication.
Wound infection following appendicectomy: The effect of extraperitoneal wound drainage and systemic antibiotic prophylaxis
Authors: Everson N W , Fossard D P , Nash J R , Macdonald R C 
Published: March 2007

Abstract
The value of extraperitoneal wound drainage and a 3-day course of prophylactic systemic cephaloridine used both separately and together have been assessed in a prospective controlled randomized trial involving 246 patients undergoing appendicectomy at the Leicester Royal Infirmary. Extraperitoneal wound drainage was shown to reduce significantly the incidence of post-operative wound infection in patients with a gangrenous or perforated appendix (P&lt;0·025). Prophylactic cephaloridine significantly reduced the overall incidence of wound infection (P&lt;0·02) and was also effective when the appendix was gangrenous or perforated (P&lt;0·01). A highly significant reduction in wound infection was achieved when the appendix was gangrenous or perforated by the addition of wound drainage to the antibiotic regimen (P&lt;0·001).
Adult Hirschprung's disease
Authors: Todd Ian P 
Published: March 2007

Abstract
Hirschprung's disease (aganglionosis) in the adult is a rare condition but needs to be considered as a diagnosis in any case of intractable constipation. A series of 35 cases of probable aganglionosis seen at St Mark's Hospital since 1954 is reviewed. Diagnosis is discussed and operative management evaluated.
The implications of scrotal interference for the preservation of spermatogenesis in the management of testicular tumours
Authors: Thomas P R M , Mansfield M D , Hendry W F , Peckham M J 
Published: March 2007

Abstract
Seminal analyses have been performed in 14 patienrs who have received radiation therapy following unilateral orchidectomy for testicular tumours. In patients receiving scrotal in addifion to para-aortic and pelvic lymph node irradiation azoospermia occurred in 17 out 18 specimens examined, whereas in those patients not requiring scrotal irradiation, restoration of spermatogenesis occurred. The difference is a result of the increased dose of radiation received by the remaining testicle when the contralateral side of the scrotum is irradiated.
Following scrotal aspiration, trans-scrotal biopsy or scrotal orchidectomy for testicular tumour, the scrotum becomes a possible site of recurrence and it should be electively irradiated. In order to give the patient the best chance of preserving fertility it is essential that scrotal interference in the management of testicular tumours must be avoided.