bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lugol's iodine: Its effect on thyroid blood flow in patients with thyrotoxicosis
Authors: Marigold J H , Morgan A K , Earle D J , Young A E , Croft D N 
Published: March 2007

Abstract
It has been established practice for 60 years to prepare thyrotoxic patients undergoing thyroidectomy with Lugol's iodine. However, evidence in support of its claimed benefits, namely a reduction in the vascularity and friability of the toxic thyroid gland, is scanty. We have therefore determined the effect of Lugol's iodine on thyroid blood flow, as measured by thyroid uptake of thallium-201, in nine patients with Graves’ disease and one euthyroid patient. Thallium-201 uptake, as well as serum thyroxine and triiodothyronine, fell significantly after treatment with iodine. Although not correlated with thyroid function tests, thallium-201 uptake was significantly correlated with thyroid weight. These results support the contention that thyroid blood flow is reduced in thyrotoxic patients treated with Lugol's iodine.
Prolonged ambulatory pH monitoring in patients following oesophageal transection and control subjects
Authors: Spence R A J , Johnston G W , Parks T G 
Published: March 2007

Abstract
Prolonged ambulatory oesophageal pH monitoring using a radiopill was carried out in 19 patients following oesophageal transection for varices. The results were compared with 14 asymptomatic control subjects. The duration of oesophageal pH less than five while erect was significantly greater in the post-transection group than in the control subjects. The duration of pH less than 4 while erect was also greater following transection but this did not quite reach statistical significance. The number of reflux episodes did not differ between the two groups. There was no significant difference in duration or number of reflux episodes while supine between the two groups.
A study of the mechanical properties of fresh and preserved human femoral vein wall and valve cusps
Authors: Ackroyd J S , Pattison M , Browse N L 
Published: March 2007

Abstract
In the hope that some varieties of the post-phlebitic syndrome might be treated by implanting a preserved vein valve, studies have been made of the mechanical properties of vein valves and vein wall before and after preservation with glutaraldehyde. The ultimate tensile strength (breaking stress) and strain (extensibility) of strips of vein wall and valve leaflet were measured with a Nene tensiometer. The ultimate tensile strength of valve leaflet was found to be twice that of vein wall. Preservation in glutaraldehyde (0.2 per cent, pH 7.4, for 7 days) with valve cusps closed by a minimum head of pressure caused no change in breaking stress or extensibility.
Deranged liver blood flow patterns in the detection of liver metastases
Authors: Leveson S H , Wiggins P A , Giles G R , Parkin A , Robinson P J 
Published: March 2007

Abstract
Hepatic flow scintigraphy has been used to evaluate 150 patients with gastrointestinal carcinoma. A normal range has been obtained on a group of 23 healthy volunteers. The flow scintigraphic findings have been correlated with the presence of metastases at the time of primary surgical therapy. The group of patients with livers ostensibly clear of metastases have been followed up over a one-year period. At one year the specificity of the investigation is 72 per cent with a sensitivity of 96 per cent. We conclude that flow scintigraphy is capable of not only detecting established hepatic metastases, but will also identify patients harbouring occult metastatic disease.
Re-routing of the track for the treatment of high anal and anorectal fistulae
Authors: Mann C V , Clifton M A 
Published: March 2007

Abstract
A transposition technique for the management of high anal and anorectal fistulae is described. The method involves re-routing the extrasphincteric portion of the track into an intersphincteric position with immediate repair of the external sphincter. The newly positioned intersphincteric fistula is then dealt with at a later date when the external sphincter is soundly healed. In this way the number of operations needed to deal with such a fistula may be reduced, a colostomy is not necessary, healing is more rapid and continence is preserved. Details of the first five cases dealt with in this way and their successful outcome are reported.
A randomized controlled trial of prophylactic cytotoxic chemotherapy in potentially curable breast cancer
Authors: Gough M H , Durrant K R , Giraud-Saunders A M , Paine C H , McPherson K , Vessey M P 
Published: March 2007

Abstract
A randomized controlled trial of the value of oral adjuvant cytotoxic chemotherapy in the treatment of potentially curable breast cancer has been in progress in the Oxford Region since 1977. Eighty-seven patients were allocated to treatment with melphalan 0.2 mg/kg for 5 consecutive days every 6 weeks for 2 years; 98 patients were allocated to treatment with oral combination therapy consisting of melphalan 10 mg daily for 5 consecutive days, plus methotrexate 15 mg and 5-fluorouracil 250 mg on the first day, courses being repeated every 6 weeks for 2 years; and 88 patients were allocated to a control group which received no adjuvant chemotherapy. So far, 125 patients have suffered a recurrence of breast cancer and 85 have died. No statistically significant differences in outcome are apparent between the three treatment groups, although there is some indication of a beneficial effect of chemotherapy on disease-free interval in pre-menopausal women. Toxic effects of treatment, notably nausea, vomiting and bone marrow depression, have been moderately severe. In our view, the beneficial effects of current adjuvant cytotoxic chemotherapy, if any, are too modest to justify the suffering which such treatment can cause at a time when a woman with breast cancer might otherwise expect to feel physically well.
Epidermal growth factor receptors on human breast cancers
Authors: Sainsbury J R C , Farndon J R , Harris A L , Sherbet G V 
Published: March 2007

Abstract
Epidermal growth factor (EGF) is a potent mitogen for many tissues including breast. The receptor for EGF (EGF-r) has the same peptide sequence as a known oncogene. Sixty-one human breast cancers and nine associated lymph node metastases have been examined for the presence of EGF receptors by competitive binding and immunocytochemical techniques. Oestrogen receptor analysis on the same specimens was performed by the dextran coated charcoal method and compared with EGF-r status. These were correlated with the clinical findings and histological data. An inverse relationship between EGF-r and ER was found (χ2 = 7·81, P&lt;0·01) with a higher incidence of EGF-r positive tumours in the metastatic group (χ2 = 14·51, P&lt;0·001). EGF-r positive tumours were of poor differentiation and had characteristics associated with poor prognosis.
Cholecystectomy in the elderly: A prospective study
Authors: Houghton P W J , Jenkinson L R , Donaldson L A 
Published: March 2007

Abstract
The mortality and morbidity of 151 elderly patients (&gt;64 years of age) undergoing biliary surgery for benign disease were prospectively studied. The overall mortality was 3·3 per cent. This comprised a 0·77 per cent mortality in the elective group and a 19 per cent mortality in the emergency group. In spite of 77 per cent of the emergency group having a gangrenous gallbladder, a complication difficult to predict pre-operatively, the majority of deaths were from cardiovascular disease. The overall incidence of common bile duct exploration was 36 per cent, which was similar in the elective and emergency groups. A comparison between the old (65–74 years) and the aged (over 74 years of age) revealed twice the number of emergency cases in the aged. Considering elective biliary surgery, there was no difference between the mortality, morbidity, or common bile duct exploration rate comparing the old with the aged. This suggests that elective biliary surgery is safe even in the aged.
Testicular torsion does not cause autoimmunization in man
Authors: Fraser I , Slater N , Tate Cathy , Smart J G 
Published: March 2007

Abstract
Forty-seven patients have been reviewed 2–10 years after torsion of the testicle. Thirty-six (77 per cent) were found to have abnormalities of exocrine or endocrine gonadal function. None showed evidence of testicular autoimmunization using standard assays of sperm agglutination and immobilization by serum or seminal plasma, and the serum mixed agglutination reaction (MAR) test. In addition, 11 cases of acute torsion were followed at intervals for 3–6 months after surgery, but no evidence was observed of the transient development of sperm antibodies. Our findings confirm poor gonadal function after torsion, but do not support the recent suggestion that it is caused by autoimmunization.
Experience using the carbon dioxide laser in the removal of cutaneous tattoos
Authors: James S E , Venn G E , Russell R C G 
Published: March 2007

Abstract
A preliminary study was undertaken to determine if the carbon dioxide laser was a suitable technique for the removal of tattoos. Twenty-eight patients with 47 tattoos had their tattoos removed by the carbon dioxide laser. The results were assessed by an independent observer 1 year after completion of treatment. The most satisfactory results were obtained in patients with discrete linear tattoos of amateur origin. In those with polychromatic blocked-in tattoos of professional origin, hypertrophic scars occurred and the overall result was unsatisfactory.
Long term results of the enteromesenteric bridge operation in the treatment of primary lymphoedema
Authors: Hurst P A E , Stewart G , Kinmonth J B , Browse N L 
Published: March 2007

Abstract
Eight patients with primary lymphoedema secondary to iliac lymph node and vessel obstruction were treated in 1977 and 1978 by the construction of an enteromesenteric bridge. All patients have been followed clinically for periods of 2·5–7 years. Six patients showed sustained clinical improvement. Two failed to improve and subsequently required leg reducing operations. Contrast lymphography was performed in the early postoperative period on all cases and showed function of the bridge in five. Isotope lymphography 6–7 years postoperatively showed normal clearance of isotope from three of the four limbs studied. In one patient contrast lymphography, performed 7 years postoperatively, confirmed continued conduction of lymph by the enteromesenteric bridge. These results have encouraged us to reintroduce this operation for suitable patients.
Effect of venous hypertension on canine hind limb lymph
Authors: Leach R D , Browse N L 
Published: March 2007

Abstract
The effect of acute and chronic venous hypertension on the lymph draining from the hind limb has been studied in 10 dogs. Acute venous hypertension was produced by venous occlusion, and chronic venous hypertension by fashioning an arteriovenous fistula in the groin. Acute venous hypertension trebled the lymph flow and doubled its fibrinogen concentration thus increasing the net transport of fibrinogen across the interstitial space by 600 per cent. Chronic venous hypertension had a similar effect and caused the appearance of α-2-antiplasmin in the lymph. The fibrinolytic activity of the lymph did not change significantly in either group of experiments. These results suggest that the deposition of interstitial fibrin seen in the skin of the postphlebitic limb is related to an increased concentration of interstitial fluid fibrin, and to the appearance of the fibrinolytic inhibitor, α-2-antiplasmin, without a concomitant increase of fibrinolytic activator.
Platelet count in radiation bowel disease: An aid to diagnosis
Authors: Carr N D , Holden D , Hasleton P S , Schofield P F 
Published: March 2007

Abstract
This study reports the results of serial observations of simple haematological indices (haemoglobin concentration, white cell count and platelet count) in 25 patients who developed radiation bowel disease as a late complication of pelvic radiotherapy for malignancy. It is compared with a control group of 25 women patients who received pelvic radiotherapy but did not develop radiation bowel disease. There is a highly significant elevation in the platelet count (P&lt;0·0001) at a time when the patients develop radiation bowel disease. The platelet count returns to normal after successful excision of the disease but the elevation recurs if further radiation disease develops in the urinary or gastrointestinal tracts. It is suggested that the platelet count may have a useful role in the diagnosis of radiation bowel disease.
Hepatic resection in the treatment of hepatocellular carcinoma: Report of 60 cases
Authors: Nagasue N , Yukaya H , Ogawa Y , Sasaki Y , Akamizu H , Hamada T 
Published: March 2007

Abstract
During the last 3 years and 9 months, hepatic resections were carried out on 60 patients with hepatocellular carcinoma (HCC). The resections were radical in 44 and palliative in 16 cases. Simultaneous operations were performed for oesophageal varices in 11 (9 prophylactic and 2 therapeutic) and for cholelithiasis in 9 patients. Fifty-nine patients had underlying hepatic disease; 52 had cirrhosis and 7 chronic hepatitis. Operative mortality rate within 1 month was 10 per cent and overall hospital mortality rate was 16·7 per cent. Excluding operative and hospital deaths, 76·8 per cent of patients who had radical excision and 18±8 per cent with palliative resections are alive. The result indicates that HCCs are frequently resectable even in the presence of liver cirrhosis provided that they are discovered at a relatively early stage.
The efficacy of lower axillary sampling in obtaining lymph node status in breast cancer: A controlled randomized trial
Authors: Steele R J C , Forrest A P M , Gibson T , Stewart H J , Chetty U 
Published: March 2007

Abstract
Four hundred and seventeen patients with operable breast cancer treated by simple mastectomy were randomly allocated to have node sampling or total axillary clearance. There was no significant difference in the incidence of node positivity. One hundred and thirty-five patients had node sampling and were randomized at the completion of this procedure to have axillary clearance or to have no further surgery. All node positive patients who went on to have a clearance had positive samples, confirming the accuracy of the sampling technique.
Proteinase-like peptidase activities in malignant and non-malignant gastric tissue
Authors: Vasishta A , Baker P R , Hopwood D , Marguerite Holley P , Cuschieri A 
Published: March 2007

Abstract
Activities of several proteinase-like peptidases have been determined in homogenates of malignant tissue, non-malignant tissue adjacent to the tumour (A-NM) and non-malignant tissue distant to the tumour (D-NM) from 17 patients undergoing surgery for histologically confirmed gastric malignancies. In homogenates of malignant tissues the activities of collagenase, cathepsin B, cathepsin (B+L), cathepsin H and cathepsin D were significantly higher than in D-NM tissues. By contrast, the levels of plasminogen activator were significantly lower in malignant tissues than in the D-NM tissues. Furthermore, the activities of collagenase-like and the cysteine-proteinase-like peptidases in the A-NM tissues were lower than in malignant tissues but higher than in the D-NM tissues. Separation of full-thickness non-malignant tissues into mucosal and seromuscular layers revealed significantly higher activities in the former. The elevated levels of these proteinase-like peptidases in homogenates of gastric cancer tissue suggests an important role for these enzymes in tumour invasion.
Dynamic liver scanning in cirrhosis
Authors: McLaren M I , Fleming J S , Walmsley B H , Ackery D M , Taylor I , Karran S J 
Published: March 2007

Abstract
Dynamic liver scanning using 99mTc sulphur colloid has been used in assessing 41 patients with cirrhosis and the data compared with 33 control subjects. The mesenteric fraction (MF) was significantly reduced in cirrhotics (0.30 ± 0.17) compared with controls (0.58 ± 0.09), P &lt; 0.001. The liver:spleen ratio (L:S) was also significantly different (1.6 ± 0.95 compared with 4.9 ± 1.4), P &lt; 0.001. Those patients who had undergone a recent variceal bleed had values less than patients who had not bled. Dynamic scintigraphy may be of value in monitoring the progress of disease and response to treatment.
Laparoscopy or scanning in oesophageal and gastric carcinoma?
Authors: Shandall A , Johnson C 
Published: March 2007

Abstract
A prospective study was undertaken of the accuracy in diagnosing intra-abdominal metastatic disease of the liver by scintigraphy, ultrasound scanning and laparoscopy. The effect of laparoscopy on management was also studied. Fifty patients were studied: 23 oesophageal carcinoma, 14 gastric carcinoma and 13 with suspected intra-abdominal metastatic spread. Accuracy was determined by laparoscopic biopsy, laparotomy and autopsy. The accuracy was 72 per cent for scintigraphy, 75 per cent for ultrasound and 96 per cent for laparoscopy (with 10 per cent failed ultrasound due to intra-abdominal gas). There was no morbidity or mortality associated with laparoscopy, with one failure due to adhesions. Thirteen patients without hepatic metastases had nodal and/or peritoneal spread diagnosed only by laparoscopy. Laparotomy was avoided in 58 per cent, and 74 per cent died in the 18 month follow-up period. Laparoscopy can obviate the need for laparotomy in inoperable cases of oesophageal carcinoma and allow better planning for potentially curable surgery. In gastric carcinoma the value of laparoscopy is doubtful as a high percentage require at least palliative surgery.
Vasopressin effects on the small intestine: A possible factor in paralytic ileus?
Authors: Mitchell A , Collin J 
Published: March 2007

Abstract
Experiments were performed on luminally perfused, isolated, canine, jejunal segments in vivo to determine the effects of vasopressin on intestinal motility, myoelectrical activity and absorption. Intravenous vasopressin abolished spike activity and sometimes disrupted slow wave activity. The jejunum became atonic with intraluminal pooling of perfusate. Transit time was prolonged and intestinal absorption of water was decreased. Radionuclide imaging of the intestinal contents showed a doubling of intraluminal volume with vasopressin and confirmed the loss of intestinal motility. It is suggested that the high plasma levels of vasopressin which are known to follow laparotomy may be a factor in the development of postoperative ileus.
Use of a single layer extramucosal suture for intestinal anastomosis in children
Authors: Brain A J L , Kiely E M 
Published: March 2007

Abstract
We report our experience using an interrupted single layer extramucosal suture technique to construct both large and small bowel anastomoses in children. There were 75 anastomoses constructed in 68 children without any clinical evidence of a leak or any complications attributable to the anastomosis. Function after completion of the anastomosis was rapid. The median time for the passage of the first stool after operation was 46 h. This technique allowed construction of an end to end anastomosis with minimal reduction of the lumen even when there was great disproportion between the ends of intestine. It was therefore particularly suitable for the anastomosis of bowel of very small calibre.
Small bowel tumours causing intussusception in childhood
Authors: Puri P , Guiney E J 
Published: March 2007

Abstract
In a series of 292 children with intussusception ten (3.5 per cent) were caused by small bowel tumours. The average age of these patients was greater than in idiopathic cases; seven of the ten being older than 2 years. Intussusception due to Peutz-Jeghers hamartomas was jejunojejunal whereas other small bowel tumours causing intussusception were in the terminal ileum. The majority of these intussusceptions were either irreducible or gangrenous and all required resection of bowel. There was only one death in the entire series of 292 patients, and this was a child with lymphosarcoma.
The Angelchik anti-reflux prosthesis — some reservations
Authors: Durrans D , Armstrong C P , Taylor T V 
Published: March 2007

Abstract
A prospective study has been made of the use of the Angelchik prosthesis in the treatment of hiatus hernia and gastro-oesophageal reflux. Forty-one patients under the care of one surgeon were studied over a 3-year period. The operation is simple and safe to perform. Twelve patients suffered transient dysphagia which spontaneously resolved within 3 months. Satisfactory results were obtained thereafter in 80·9 per cent. Seven of the prostheses have been removed (17·1 per cent), all within 18 months of performing the operation. Dysphagia and recurrent symptoms were the main reasons for removal and in two of these stricturing was present pre-operatively. We feel the presence of an established stricture is a contraindication to the use of the device. We have, however, been impressed by its use as a second procedure when previous surgery has failed and when revisional surgery for recurrent hiatus hernia is difficult due to dense adhesion formation. While it is still early to assess the legacy that the use of this prosthesis might incur, we would recommend conservatism if not abandonment of its use until longer-term evaluation is available.
Ultrasound examination in the diagnosis of popliteal artery aneurysms
Authors: MacGowan S W , Saif Mai F , O'Neill Geraldine , Fitzsimons Patricia , Bouchier-Hayes D 
Published: March 2007

Abstract
Popliteal artery aneurysm is a potentially limb-threating lesion which is frequently difficult to diagnose by clinical examination or angiography. The risk of limb loss can best be reduced by early diagnosis. Over the past 5 years we have prospectively evaluated ultrasound examination of the popliteal space in screening patients with clinically suspected popliteal artery aneurysms. One hundred patients who were suspected clinically of having a popliteal artery aneurysm underwent bilateral ultrasound examination of their popliteal fossae. There were 21 patients who had abnormal scans. The problems identified were popliteal artery aneurysm in thirteen patients, popliteal artery ectasia in four patients, Baker's cyst in two patients, thrombosis in one patient and popliteal stenosis in one patient. Eight patients with eleven popliteal artery aneurysms by ultrasound also underwent angiography. Seven of the aneurysms were confirmed, four were missed. All eleven aneurysms were confirmed at operation. In addition, angiography did not demonstrate an aneurysm in any patient with a normal ultrasound. This study confirms that ultrasound examination is a quick, accurate, and non-invasive method of screening for popliteal artery aneurysms.