bluuebunny/crossref_metadata_2025_split huggingface dataset:
Follow-up study of left suprarenal to inferior mesenteric venous shunt for advanced breast cancer
Authors: Inokuchi Klyoshi , Nomura Yasuo , Ikejlri Taiji , Kaibara Nobuaki 
Published: March 2007

Abstract
Major endocrine ablation therapy was carried out in 133 patients with advanced breast cancer. of 40 patients undergoing left suprarenal to inferior mesenteric venous shunt with bilateral oophorectomy and right adrenalectomy, 16 cases (40 per cent) had an objective response. The mean postoperative survival of the patients with a positive response, those showing some response and those who failed to respond was 35·8, 26·5 and 8·8 months respectively. Thus, the results of the present procedure are comparable to those of adrenalectomy. No replacement therapy with corticoids was necessary. An increase in the response rate and extension of the survival time can be expected with the addition of postoperative long term maintenance therapy with chemotherapeutic agents and androgens.
The haematological hazards of autotransfusion
Authors: Stillman Richard M , Wrezlewicz Walenty W , Stanczewski Boguslaw , Chapa Liberato , Fox Michael J , Sawyer Philip N 
Published: March 2007

Abstract
Fourteen heparinized dogs were autotransfused from 1·5 to 6 times their calculated blood volume. Five animals retransfused 12 litres from an intraperitoneal bleed had marked decreases in all cellular elements, haematuria and a large (82 per cent) drop in fibrinogen. All these animals died within 12 hours and post-mortem examination revealed evidence of disseminated intravascular coagulopathy. The dogs in which a smaller volume (3–6 litres) was recycled showed similar, but less devastating, changes. Haematocrit and platelet count dropped by a half and fibrinogen by 20 per cent. A leucocytosis of about 30 000/mm3 occurred within 24 hours. Autotransfusion of salvaged blood which was not allowed extravascular tissue contact significantly lessened these adverse effects.
We conclude that the risk of cellular destruction and defibrination in large volume intra-operative autotransfusion is significant and must be weighed against its potential benefits in each case, and that red cell and platelet damage results primarily from extravascular tissue contact and is therefore unavoidable.
The effect of an infusion of low molecular weight dextran on peripheral resistance in patients with arteriosclerosis
Authors: Humphreys W V , Walker A , Cave F D , Charlesworth D 
Published: March 2007

Abstract
Low molecular weight dextran is frequently given to improve the flow of blood to the periphery, but its mode of action is uncertain. We measured the effect of an infusion of 500 ml of Dextran 40 on the peripheral resistance in 12 patients undergoing reconstructive surgery for atherosclerotic occlusion of the superficial femoral artery.
After the infusion, values of packed cell volume and blood viscosity indicated haemodilution. There was a consistent increase in mean flow and a fall in peripheral resistance, There was no correlation between change in viscosity and change in peripheral resistance, but there was a good correlation between the percentage change in resistance and the initial resistance. This suggests that the increase in flow of blood was due to reflex vasodilatation rather than to any reduction in viscosity.
Plasma fibrinolysis and postoperative deep vein thrombosis
Authors: Macintyre I M C , Webber R G , Crispin J R , Jones D R B , Wood J K , Allan N C , Prescott R J , Ruckley C V 
Published: March 2007

Abstract
In 23 high risk patients the change in plasminogen activator activity in response to surgical operation was studied by euglobulin lysis time (ELT) and fibrin plate lysis before, during and for up to 6 days following a major surgical procedure. Fibrin degradation products (FDP) were also measured. The aim was to relate any changes to postoperative deep vein thrombosis (DVT) as diagnosed by the 125I fibrinogen test. Peroperative increase and postoperative inhibition of fibrinolytic activity were seen in all the patients, Changes in fibrinolytic activity as measured by the ELT and during the first 24 hours by the fibrin plate technique were similar. This suggests that during this period the response was independent of plasma fibrinogen changes. There was no significant difference in these parameters between patients who developed DVT and those who did not. The relationship between venous thrombo-embolism and elevation of serum FDP was confirmed.
The microflora of the obstructed bowel
Authors: Sykes Peter A , Boulter Kenneth H , Schofield Philip F 
Published: March 2007

Abstract
A study of the alterations of intestinal microflora that occur in acute small and large bowel obstruction is presented. The results are discussed in relation to the duration of obstruction, the site of obstruction, the recovery following relief of obstruction and the septic complications which profoundly aflect the prognosis of these common surgical emergencies.
Blast injuries of the lungs
Authors: Coppel Dennis L 
Published: March 2007

Abstract
Up until 1968 Northern Ireland was a relatively peaceful community. The outbreak of civil disturbance has resulted in many patients being admitted to hospital with severe injuries from bullets and bomb explosions. Initial resuscitation must not be unduly delayed to be effective and should be carried out by experienced personnel. Respiratory failure from bomb explosions is rare and invariably fatal. The mechanism is discussed and is thought to be due to direct compression.
A new approach to the treatment of renal failure
Authors: Rosin R D 
Published: March 2007

Abstract
There is an apparent need for an alternative form of treatment for renal failure. This study, therefore, sought to determine the feasibility of dialysing across an isolated loop of colon and its possible application to augment failing renal function in chronic uraemic patients.
Haemodialysis and renal transplantation are undisputedly effective in treating renal failure but have many drawbacks. They are unavailable in the underdeveloped world, extremely expensive to institute and maintain, and their need and expense are compounded every year by the discovery of new cases.
Colonic loops were isolated in sheep and studies performed to find an effective solution in terms of urea clearance. The best solution was then used in animals in which acute or chronic uraemia was induced and, compared with controls, prolonged life significantly (P &lt; 0·05). Once it had been established that urea could be removed across the colonic mucosa, it was used in patients with established isolated loops of colon. Even though they had normal blood levels, urea was recovered in the dialysate.
Results indicate that colonic dialysis, which is simple and inexpensive, may have a place as an adjunctive therapy in the treatment of chronic renal failure.
Complications of supraduodenal choledochotomy: A comparison of three methods of management
Authors: Keighley M R B , Burdon D W , Baddeley R M , Dorricott N J , Oates G D , Watts G T , Alexander-Williams J 
Published: March 2007

Abstract
The complications of elective choledochotomy in a prospective study of 116 patients with suspected intraduct calculi are reported. Management included T tube drainage (n = 59), primary closure of the bile duct (n = 29) and choledochoduodenostomy (n = 28).
Septicaemia occurred in 12 patients (10 per cent), with 1 death, and was unrelated to the type of operation. Thirty patients (26 per cent) developed wound infection; this complication was more common after T tube drainage than the other procedures. Intra-abdominal abscess occurred in 3 patients only. Thrombo-embolism was recorded in 10 patients (9 per cent), 7 of whom had an intraduct drain. Postoperative pancreatitis occurred in 5 patients (4 per cent), with 2 deaths; a third of the patients in whom sphincteroplasty had been combined with supraduodenal choledochotomy developed this complication. Reoperation for stones was required in 3 patients with T tube; 3 patients developed a temporary biliary fistula after choledochoduodenostomy. The hospital stay was 9·5 days after primary closure, 14·0 days after choledochoduodenostomy and 16·8 days after T tube drainage.
Wound sepsis (32 per cent) and thrombo-embolism (12 per cent) were more common in patients with bacterbilia than in patients where the bile was sterile at operation (13 and 3 per cent respectively). Furthermore, wound sepsis, septicaemia and thrombo-embolism were reduced in patients who were given effective antibiotic cover.
A clinical index for selection of breast cancer patients for adrenalectomy
Authors: Leaper D J 
Published: March 2007

Abstract
Selection of patients with disseminated breast cancer for endocrine surgery has not been facilitated by sophisticated biochemical techniques. The present study was designed to produce a method of prognosis based exclusively on clinical data.
Eighteen features were studied in 95 patients who underwent adrenalectomy and oophorectomy, and correlated with their degree of response to produce predictive variables.
In a further group of 90 patients a prognostic score (the sum of the predictive variables) was calculated. There were 17 patients who scored less than 0 and in no case was a good response to endocrine surgery achieved. There were 40 who scored over 10, 29 of whom had a good response. The remaining 33 scored between 0 and 10 and there was no correlation between score and response.
This predictive system offers significant advantages over accepted methods of clinical assessment (χ2 = 6·61, P &lt; 0·02). When patients with a score between 0 and 10 are excluded, its advantages are even more obvious (χ2 = 11·26, P &lt; 0·001).
Patients who are likely to respond to endocrine surgery can be selected by clinical parameters alone, and total failure to respond can be forecast with complete accuracy. Between these two there is a third group whose response is unpredictable.
The plain X-ray in the acute abdomen: A surgeon's evaluation
Authors: Lee P W R 
Published: March 2007

Abstract
The plain abdominal X-rays of 277 patients suffering from five acute abdominal conditions were reviewed and specific radiological features found to occur in not less than 48 per cent of the cases. In a second series of 249 patients admitted to hospital with an acute abdomen due to all types of disease, the plain abdominal X-rays were helpful in 42 per cent of cases. A questionnaire of 50 plain abdominal X-rays was answered by surgeons and radiologists of varying clinical experience, the scores of the senior radiologists being higher. It is suggested that plain abdominal X-rays should become a routine investigation in the acute abdomen, and should be reported by senior radiologists at the time of the investigation.
Endotoxin, bile salts and renal function in obstructive jaundice
Authors: Bailey M E 
Published: March 2007

Abstract
It is generally agreed that there is an increased incidence of postoperative renal failure in patients with obstructive jaundice. The proposition that this may be due to endotoxin, and that the endotoxin may be absorbed from the patient's own bowel flora, has been investigated. The study was conducted in patients and in animals.
Twenty-four patients with obstructive jaundice were studied. Sixteen had endotoxin in the portal blood at operation and 13 of these had peripheral endotoxaemia at the time of operation or developed it during the 72 hours following operation. Only 3 of the patients had a proved possible site of infective origin for the endotoxaemia, the remainder absorbing the endotoxin from their own gastro-intestinal organisms.
Portal endotoxaemia occurred when the serum bilirubin was 8·5 mg/100 ml or greater.
There was a highly significant decrease in mean endogenous creatinine clearance postoperatively in patients with endotoxaemia, and expression of this as a percentage postoperative fall compared with preoperative levels enhanced the significance. Jaundiced patients without endotoxaemia had no significant fall in endogenous creatinine clearance.
Matched non-jaundiced control patients did not develop portal or peripheral endotoxaemia, and there was no significant fall in postoperative creatinine clearance.
Experiments using animals showed that the absence of bile salts in the intestinal tract in obstructive jaundice allows endotoxin to be absorbed, and that this absorption can be preuented by the oral administration of bile salts.
The therapeutic implications in patients are discussed.
The relationship of the serum gastrin and calcium concentrations in patients with multiple endocrine neoplasia type I
Authors: Thompson M H , Sanders D J , Grund E R 
Published: March 2007

Abstract
The relationship between the serum gastrin and calcium concentrations has been examined in patients with multiple endocrine neoplasia type I. Variations in gastrin concentrations were induced by metiamide and secret in: calcium concentrations were altered by parathyroidectomy and by culcium infusion. Changes in the serum gastrin concentration were not accompanied by changes in the serum calcium concentration. However, alteration of the serum calcium was accompanied by significant parallel changes in the serum gastrin. It is concluded that acute changes in the serum calcium may induce changes in the serum gastrin. Parathyroidectomy in these patients produced a fall in the seruni gastrin, but the ability to produce large quantities of gastrin remains. It is postulated that the thyro-parathyroid hormones may modulate the relationship between calcium and gastrin.
Acalculous gallbladder disease: A prospective study
Authors: Keddie Nigel C , Gough A L , Galland R B 
Published: March 2007

Abstract
A prospective study of 62 cases of acalculous gallbladder disease is reported. The clinical, radiological and pathological features are described as well as the results of cholecystectomy with a minimum follow-up of 3 years. The results compare favourably with those for calculous disease, and it is concluded that there is no clear-cut distinction between acalculous and calculous biliary disease.
Is colostomy closure a hazardous procedure? A comparison of elemental diet and routine bowel preparation
Authors: Tomlinson R J R , Newman B M , Schofield P F 
Published: March 2007

Abstract
Morbidity after closure of a colostomy is low if a simple antiseptic technique of intraperitoneal closure is used. In 26 patients there was no example of major wound sepsis and only 2 faecal fistulas both of which rapidly closed spontaneously. A randomized study of pre-operative bowel preparation incorporating an elemental diet showed no apparent advantage for this method using our criteria for assessment.
Results of jejuno-ileostomy for gross refractory obesity
Authors: Baddeley R Michael 
Published: March 2007

Abstract
The results of jejuno-ileostomy in 182 patients have been studied. The operative mortality was 1·1 per cent and the overall mortality 6·6 per cent, of which 3·3 per cent was attributable to the effects of the small bowel bypass. Weight reduction usually ceased at about 18–24 months postoperatively, by which time the average fall was 36·3 per cent of the mean original body weight. Males and younger patients achieved better than average results. The main side-effects were fatty infiltration of the liver, polyarthralgia, excessive diarrhoea and electrolyte upsets.
Experimental studies on the aetiology of acute scorpion pancreatitis
Authors: Bartholomew C , McGeeney K F , Murphy J J , Fitzgerald O , Sankaran H 
Published: March 2007

Abstract
This study examined the action of the venom of the scorpion Tityus trinitatis on the pancreas and gastrointestinal tract in anaesthetized dogs, on the isolated extracorporeal haemoperfised canine pancreas and on the isolated canine sphincter of Oddi. The venom induces exocrine secretion in both the isolated and intact pancreas and causes contraction of the isolated sphincter of Oddi. These results are discussed in relation to the pathogenesis of acute scorpion pancreatitis and possibly of some other form of acute pancreatitis.
Scanning electron microscopy of normal human scar tissue and keloids
Authors: Hunter J A A , Finlay J B 
Published: March 2007

Abstract
The fibrous architecture of 5 normal human scars between 1 week and 1 year old and 4 keloid scars has been studied by scanning electron microscopy. In normal wounds, significant changes in fibril and fibre orientations and mode of aggregation take place as the scars mature, indicating that remodelling carries on for many months. There are also major differences between the edge and centre of the wound. These changes can be related to the stresses placed on the fibroblasts which have responded by laying down collagen aligned in such a way as to resist these forces. It is suggested that keloid fibroblasts may lack this ability to respond appropriately to orientational stress.
Vascular reconstruction in Buerger's disease
Authors: Shionoya Shigehiko , Ban Ichiro , Nakata Yukifumi , Matsubara Chi , Hirai Umi , Miyazaki Shi , Kawai Chi 
Published: March 2007

Abstract
In 23 of 148 patients with Buerger's disease, it was possible to undertake 27 arterial reconstructive procedures: bypass in 22 and thrombo-endarterectomy in 5. In a follow-up of 10 months to 8 years, the overall patency rate was 26 per cent. The long term patency rate of bypass grafting was good in obstruction of main vessels, but unsatisfactory with multiple occlusions. Bypass grafting was preferred to thrombo-endarterectomy.
To obtain long term patency of revascularized segments, complete abstinence from tobacco is absolutely essential.
The preparatory manæuvres for autogenous venous graft should be as atraumatic as possible.
A functional diagnosis is indispensable when considering operative indications and for follow-up study of patients with peripheral arterial occlusive disease.
Structural deterioration in Celestin tubes
Authors: Mackenzie I , Whyte A S , Tankel H I 
Published: March 2007

Abstract
Two cases are described where, afrer 2 years, a nylon-latex Celestin tube which was left in situ to bypass a benign stricture underwent structural deterioration and produced complications requiring tube replacement. It is recommended that an alternative endo-oesophageal tube should be considered where a lifespan of this order is contemplated.
A practical reappraisal of the anatomy of the extrahepatic bile ducts and arteries
Authors: Benson E A , Page R E 
Published: March 2007

Abstract
Two hundred and five dissections of the extrahepatic biliary tree have revealed that although the anatomy of this area is remarkably variable there are only three important vascular and five important ductal anomalies (the former occurring much more frequently than the latter). Each anomaly is, however, easily recognized at operation. A higher incidence of anatomical anomalies was found in patients with gallstones compared with those without and in women than in men, and there was a remarkably low incidence of accessory hepatic ducts overall. The significance and practical implications of these findings are discussed.
Gallstone pancreatitis with normal biliary radiology
Authors: Smith Rodney , Williams Russell , Cotton P B 
Published: March 2007

Abstract
Three patients with relapsing gallstone pancreatitis and normal routine biliary radiology are reported and discussed.
It is emphasized that when dealing with recurrent pancreatitis for which no cause is evident, normal conventional biliary radiology (oral cholecystogram and intravenous cholangiogram) should not necessariry be accepted as conclusive. The use of endoscopic cholangio-graphy in such a situation is encouraging.
Allergic starch peritonitis in the guinea-pig
Authors: Grant J B F , Davies J D , Jones J V 
Published: March 2007

Abstract
An experimental starch peritonitis in guinea-pigs previously immunized with starch glove powder and Freund's complete adjuvant is described. After peritoneal challenge by 10 mg starch glove powder, 22 per cent of the animals developed florid omental granulomas resembling those found in some patients with postoperative glove powder peritonitis. It is suggested that delayed hyper sensitivity to a component of the glove powder may be responsible for the clinical features of starch peritonitis in man.
A comparison of polyglycolic acid and catgut sutures in rat colonic anastomoses
Authors: Munday Clair , McGinn F P 
Published: March 2007

Abstract
Standard colonic wounds were closed in 44 rats by either polyglycolic acid or catgut sutures. Seven days later portions of the colonic wounds were measured for tensile strength and examined histologically. There was no difference in the mortality, strength of the anastomosis or the amount of inflammation induced by either of the suture materials used.
The burst abdominal wound: A mechanical approach
Authors: Jenkins T P N 
Published: March 2007

Abstract
The burst abdominal wound has a mechanical cause. It is the result of suture breaking, knot slipping, the intact suture cutting out of the tissues or protrusion of gut or ornentum between stitches.
Measurements of abdominal girth and the xiphoidpubis distance before and during abdominal distension show that a wound may lengthen by 30 per cent if distension occurs. An adequate reserve of suture length in the wound is necessary to allow this lengthening to occur and to ensure a minimal resulting rise in tension between the sutures and the tissues.
Three variables present in every continuous wound closure—the suture length inserted, the wound fascial length and the number of stitches—determine the stitch interval and the size of the tissue bite, which are the two vital factors in wound strength under the surgeon's control. These variables may be expressed by the ratio of the length of suture (SL) inserted to the wound length (W), the ratio SL : WL.
Analytical and clinical evidence is presented to show that: Deep wound disruption (evisceration and ventral hernia) is associated with the use of an SL : WL ratio of 2 : 1 or less—the lower the ratio, the greater is the risk of a burst wound.Wound disruption because of cutting out of sutures can be prevented by the use of non-absorbable continuous sutures at 1-cm intervals and an SL : WL ratio of 4 : 1 or more.
The embryology and surgical management of gastroschisis
Authors: Thomas D F M , Atwell J D 
Published: March 2007

Abstract
Thirteen cases of gastroschisis are presented and a reduction in the operative mortality to 15 per cent is recorded. The aetiology of the condition is discussed and the opinion expressed that it represents the result of an intrauterine rupture of an incarcerated ‘hernia into the cord’ rather than any specific failure of development of the abdominal wall musculature. Early skin closure and the creation of a ventral hernia remain the surgical treatment of choice, but it is recognized that the use of a prosthetic sac may occasionally be necessary. Infection is now the most important single factor influencing mortality, and the prolonged administration of prophylactic antibiotics is justified on this basis. Skilled management of the protracted ileus is essential. In view of the low incidence of serious coexistent malformations the children who survive the initial operation can be offered the prospect of a life of normal duration and quality.