bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prophylactic use of metronidazole in preventing wound sepsis after elective cholecystectomy
Authors: Halsall Andrew K , Welsh Christopher L , Craven John L , Hopton David S , Peel R Nigel 
Published: March 2007

Summary
The effect of intravenous metronidazole as prophylaxis against postoperative wound infection was studied in a prospective, randomized, double-blind controlled trial of 116 patients undergoing elective cholecystectomy. No significant difference was found in the infection rate between the treated and the control groups.
The value of polymixin B in endotoxaemia due to experimental obstructive jaundice and mesenteric ischaemia
Authors: Ingoldby C J H 
Published: March 2007

Summary
The role of polymixin B in endotoxaemia due to obstructive jaundice and mesenteric ischaemia has been examined. Rats made jaundiced by common bile duct ligation were challenged with intragastric endotoxin. Rats given polymixin B infusions had improved survival (11/15) compared with controls (4/14).
Mesenteric ischaemia was induced in rats by clipping the mesenteric artery. Limulus assay revealed marked endotoxaemia in controls. Polymixin B infusions reduced the degree of endotoxaemia. Pre-treatment with nonabsorbable intestinal antibiotics markedly reduced endotoxaemia. Polymixin B infusions gave no advantage of survival (3/10) compared with controls (2/10), but all animals pre-treated with intestinal antibiotics survived (12/12).
The difference in results found between obstructive jaundice and mesenteric ischaemia may be due to different degrees of endotoxaemia. Polymixin B may have a place in the prophylaxis of endotoxaemia in clinical obstructive jaundice.
Subclavian and axillary vein compression of musculoskeletal origin
Authors: Daskalakis E , Bouhoutsos J 
Published: March 2007

SummaryTwenty instances of subclavian–axillary vein compression of musculoskeletal origin in 14 patients are reported. In 9 thrombosis had occurred and in the remainder the compression was intermittent. The cause appeared to be extraluminar factors such as the subclavius muscle, the scalenus anterior, the pectoralis minor and a malunited fracture of the clavicle. Ten cases were treated surgically with satisfactory results.
Coeliac artery compression
Authors: Lord Reginald S A , Tracy G Douglas 
Published: March 2007

Summary
Four women with abdominal pain and compression of the coeliac artery by the median arcuate ligament of the diaphragm are described. Pain was relieved in each case by decompression or reconstruction of the coeliac artery. A case in favour of the existence of the coeliac artery compression syndrome is presented.
Massive haemorrhage caused by left renal vein ligation
Authors: Devine T J , Scott D F , Myers K A , King R B 
Published: March 2007

Summary
It is common practice to ligate the left renal vein during aortic surgery. Although this does not usually lead to complications we report 2 patients in whom left renal vein ligation caused massive venous congestion of the kidney and major retroperitoneal haemorrhage. Nephrectomy was necessary to control the haemorrhage. In l patient immediate autotransplantation preserved renal function.
Transplantation of contaminated organs
Authors: van der Vliet J A , Tidow G , Kootstra G , van Saene H F K , Krom R A F , Slooff M J H , Weening J J , Tegzess A M , Meijer S , van Boven W P L 
Published: March 2007

Summary
In cadaveric organ transplantation there is a risk of transfer of infectious agents from donor to recipient.
The consequences can be fatal for immuosuppressed recipients. This is illustrated by a case history in which an infection with the fungus Monosporium apiospermum was transferred from a donor to two cadaveric kidney recipients, of whom one died and the other surviced with the loss of the graft.
These events led to a review of the literature to determine methods of demonstrating possible contamination of donor organs. Analysis of the case history of potential donors, a history taken from relatives or the family doctor, autopsy and laboratory examinations are considered useful. Victims of drowning, patients with severe burns and patients who have been ventilated for a long time are high risk donors.
Evidence for the flutter valve mechanism of the lower oesophageal high pressure zone
Authors: Clark J , Cuschieri A 
Published: March 2007

Summary
Simultaneous oesophageal manometry and pH monitoring was performed at rest and during abdominal compression in 189 subjects. The force exerted by the high pressure zone (HPZ) and by its intra-abdominal segment was reduced to the same extent in the 102 subjects who refluxed and the 87 who did not. Reflux during abdominal compression occurred in the subjects whose HPZ force fell into a critical range and in whom the contribution by the abdominal segment was reduced to less than 50 per cent of the total force exerted by the HPZ. These results are more in keeping with a mechanical flutter valve theory of lower oesophageal competence than sphincteric reflux control. Furthermore, the results indicate that measurements of oesophageal pressure, length or force in the resting state do not account for reflux or gastrooesophageal competence, but that it is the reserve of pressure, length or force during stress which is responsible.
An experimental study of the relationship between synergistic wound sepsis and suture materials
Authors: McGeehan D , Hunt D , Chaudhuri A , Rutter P 
Published: March 2007

Summary
In wounds on the back of guinea-pigs an inoculum of 6 × 105 of Escherichia coli and of Bacteroides fragilis produced afrank infection rate of 27 per cent. Addition of a catgut or a braided nylon tie statistically significantly increased the rate to 56 and 48 per cent respectively. Prolene and silk produced much smaller, non-significant rises. The rate with polyglycolic acid was 18 per cent which, though not statistically significant, suggests the possibility that this material produces conditions unfavourable to multiplication of bacteria that produce this type of infection.
Gastrointestinal bleeding, angiodysplasia of the colon and acquired von Willebrand's disease
Authors: Cass A J , Bliss B P , Bolton R P , Cooper B T 
Published: March 2007

Summary
A 66-year-old man is reported who was found to have acquired von Willebrand's disease, which presented when the patient was 63 with iron deficiency anaemia and gastrointestinal bleeding. He subsequently bled from various sites in the gastrointestinal tract including an angiodysplasia of the right colon, which was successfully treated by right hemicolectomy. This is the second reported association between acquired von Willebrand's disease and angiodysplasia of the intestinal tract.
Gastric pseudolymphoma
Authors: Anderson J R , Lee D , Naysmith A , Busuttil A 
Published: March 2007

Summary
Six histologically proved cases of gastric pseudolymphoma are described. This uncommon benign condition often simulates ulcerated gastric carcinoma radiologically, and pathologically it may cause considerable confusion with malignant lymphoma. Recognition of this condition is important to prevent unnecessary and often hazardous treatment whether by surgery or radiotherapy and to prevent inclusion in series of malignant gastric lymphoma, so that falsely high survival rates are not recorded.
Abdominal parasitic twin: An unusual cause of duodenal obstruction
Authors: Blumberg N A 
Published: March 2007

Summary
A 14-month-old child presented with complete duodenal obstruction due to pressure from a fetus-in-fetu. This was relieved by a subtotal excision of the tumour. The features support the diagnosis of FIF rather than abdominal teratoma. On this premise, future development of malignancy in the remnant is not anticipated. The follow-up period at the time of writing is 12 years.
Neural and humoral factors in postoperative ileus
Authors: Rennie J A , Christofides N D , Mitchenere P , Fletcher D , Stockley-Leathard Helen L , Bloom S R , Johnson A G , Rains A J Harding 
Published: March 2007

Summary
Two inhibitory mechanisms in the human colon which may contribute to postoperative ileus have been studied.
Dopamine, a possible peripheral neurotransmitter, inhibited isolated colonic smooth muscle strips by a direct effect in longitudinal muscle and by a nerve-mediated mechanism in circular muscle.
Plasma motilin levels were suppressed pre- and peroperatively and elevation of levels postoperatively correlated with the return of normal motility and the severity of the operation.
The serum sodium concentration after surgical operation: Precision permits predictions
Authors: Chan S , Radcliffe A , Johnson A 
Published: March 2007

Summary
In view of previous conflicting reports, the distribution of a water overload was investigated in 6 healthy volunteers. The fall in serum sodium was predictable from prior measurement of total body water (tritium) confirming that the induced hyponatraemia was dilutional.
Using a standard intravenous fluid regimen, a prospective study for 6 days on 50 patients undergoing major abdominal surgery established a confidence band for change in serum sodium concentration. This band not only enables precise prediction of whether observed sodium values in patients are ‘normal’ for that point in their postoperative course, but also demonstrates that changes are more prolonged than was at first thought. Their dilutional nature following uncomplicated surgery is supported by linear relationships between serum osmolality and serum sodium (s-Osm = 1·86 [s-Na+] + 18·74; P &lt; 0·001) and between observed and calculated osmolality (Obs-Osm = 0·97 [Cale-Osm] + 15·11; P &lt; 0·001). More detailed investigation of 14 patients by isotope dilution provided independent evidence of dilutional change. This conclusion is additionally supported by lesser changes in patients on a more restricted fluid regimen.
As a practical confirmation of the utility of this approach, departures from the simple dilutional relationships were observed in 7 critically ill patients whose postoperative course was complicated. In this group osmolal ‘gaps’ of 20–50 mosmol/kg were identified.
Current standard postoperative fluid regimens cause dilutional changes; these are predictable and provide a vardstick for use in management of both the healthy and the ill surgical patient.
The treatment and preoperative diagnosis of differentiated thyroid carcinoma presenting as a clinically solitary nodule
Authors: Wade Hilary 
Published: March 2007

Abstract
Some papillary and follicular carcinomas of the thyroid present as solitary nodules with no clinical or radiological evidence of metastases. The elective treatment of such early thyroid carcinomas is discussed, with particular reference to the surgical approach to the clinically solitary nodule. The investigations available for establishing a preoperative diagnosis of the pathology of a solitary nodule are also discussed. A high degree of accuracy is obtainable but absolute certainty, only occasionally. If doubt exists, the safe treatment is excision of the nodule and frozen section.
Wound healing after laser surgery: An experimental study
Authors: Cochrane J P S , Beacon J P , Creasey G H , Russell R C G 
Published: March 2007

Summary
Healing after carbon dioxide laser incisions has been assessed in three animal experiments. Nine incisions in pig skin were found to be significantly weaker after 7 days than similar incisions made with a scalpel, but stronger than those made with a cutting diathermy. Laser excision of skin discs in pigs provided a satisfactory base to take split-skin grafts, but graft take around the edges was less complete than after scalpel excisions. Division and anasto mosis of the colon of 75 rats showed that the laser produced anastomoses that were as strong after 7 days as those produced by scalpel or diathermy division, but the laser did not produce the narrowing of the lumen that occurred with diathermy. It is concluded that if epithelial surfaces are particularly thick and slow to cut with the laser then thermal damage wili impair healing, but that in general epithelial surfaces need not be avoided in laser surgery.
Functional results of rectal excision and endo-anal anastomosis
Authors: Keighley M R B , Matheson D 
Published: March 2007

Summary
Twelve consecutive patients have been treated by rectal excision and endo-anal anastomosis since March 1978. Eight operations were for invasive carcinoma; extension into perirectal fat was recorded in all except one patient and early recurrence was observed in 3 (6, 9 and 14 months after operation). Two operations were for carcinoma complicating extensive villous adenoma and 2 further patients underwent the procedure for excision of a Crohn's stricture. In the first 6 months after operation, stricture of the ‘neorectum’ was observed in 7 of 8 patients and was associated with urgency of defecation in 6. Manometric studies indicated that although normal sphincter pressures were maintained, the capacity of the ‘neorectum’ was significantly reduced at 6 months compared with preoperative values (P &lt; 0·01). At 12 months only 3 of 6 patients still had a stricture, with urgency in 2. Complete continence was reported in all except one patient.
Solitary rectal ulcer: Always a self-induced condition?
Authors: Thomson Hamish , Hill David 
Published: March 2007

Summary
Solitary rectal ulcer is a curious and uncommon condition of contentious aetiology. Six patients seen at Gloucestershire Royal Hospital during 5 years have been studied. In 4 self-interference was certain and likely in one other; no information was available concerning the sixth. Our evidence suggests that the disease is self-induced.
Comparison of rubber band ligation and haemorrhoidectomy for second- and third-degree haemorrhoids: A prospective clinical trial
Authors: Murie John A , MacKenzie Iain , Sim Andrew J W 
Published: March 2007

Summary
One hundred patients with second- or third-degree haemorrhoids were randomly allocated to haemorrhoidectomy (50) or rubber band ligation (50). Forty-two in each group presented with rectal bleeding; haemorrhoidectomy relieved 36 and rubber band ligation relieved 31 of this symptom. All patients had prolapsing haemorrhoids at presentation. One year after treatment 45 haemorrhoidectomy and 43 rubber band ligation patients were assessed. Haemorrhoidectomy relieved 44 of 45 patients and rubber band ligation relieved 34 of 43 (P &lt; 0·05). Haemorrhoidectomy caused pain in all cases, lasting for more than 48 h in 35. Rubber band ligation was painless in 5 and produced pain for more than 48 h in 15. Mean time off work was 32 days for haemorrhoidectomy and 3 days for rubber band ligation (P &lt; 0·001).
Rubber band ligation as an outpatient procedure is an effective treatment for second- and third-degree haemorrhoids and should be considered before recourse to surgery.
The effect of local infection upon wound healing: An experimental study
Authors: Bucknall T E 
Published: March 2007

Abstract
Local infection was introduced into rat abdominal wounds using a 108 bacterial/ml inoculum. Three groups of infection were used: Staphylococcus aureus, Pseudomonas aeruginosa and a combination group of Escherichia coli and Proteus mirabilis. Infection was shown to delay healing as judged by bursting tests. Fibroblast proliferation was depressed at the wound edges but there was an increase in the total amount of hydroxyproline present. Small vessel angiogenesis was increased in areas of abscess formation but larger vessels were commonly blocked by thrombus or distorted by surrounding inflamed tissue. The possible causes of these effects are discussed.
A controlled trial to evaluate and compare a sutureless skin closure technique (Op-Site Skin Closure) with conventional skin suturing and clipping in abdominal surgery
Authors: Eaton A C 
Published: March 2007

Abstract
Sutureless wound closure employing a new product, Op-Site Skin Closure, was evaluated in comparison with two standard techniques of skin closure, using interrupted nylon sutures and Michel clips. The trial involved 110 patients undergoing elective and emergency abdominal surgery. The results showed that Op-Site Skin Closure was good as the conventional techniques of skin closure with the advantages that it is easier and quicker to apply, produces a superior cosmetic result and, consequently, has gained excellent patient and nurse acceptance.
An evaluation of cholangiomanometry with synchronous cholangiography
Authors: Ribeiro B F , Williams J T , Lees W R , Roberts M , Le Quesne L P 
Published: March 2007

Abstract
A method of biliary manometry is described which enables simultaneous recording of both the pressure changes in the common duct during perfusion and the cholangiographic appearances. This examination has been performed on 86 patients undergoing cholecystectomy for gallstone disease, 17 of whom had demonstrable stones in the common duct. Ten patients received opiates or similar drugs as premedication and are considered separately. The remaining 76 patients were anaesthetized by a standard technique involving no opiates. On the basis of the pressure tracings they could be divided into two groups: group I (56 patients, 4 with stones in the common bile duct) showed a minimal rise in pressure during infusion of the common bile duct, with a rapid return to basal level: group II (20 patients, 13 with demonstrable stones in the common bile duct) showed a marked rise in pressure, with a delayed and often incomplete return to basal level. In 2 patients in group II a sudden fall in pressure during perfusion was associated with the passage of a stone, and the evidence suggests that 6 of the 7 patients with no demonstrable stones in the duct had in fact small stones in the duct, some of which may have passed during the examination. Clinical follow-up of the patients showed that only 3 of the patients had significant postoperative abdominal symptoms, for which there was an apparent extra-biliary cause in all 3.
This study provides no evidence in support of the hypothesis that there is a condition of sphincteric spasm which can cause symptoms after cholecystectomy, and which can be detected by pressure studies at the time of cholecystectomy.
A mechanism for prostaglandin cytoprotection
Authors: McGreevy James M , Moody Frank G 
Published: March 2007

Abstract
Topical 16,16-dimethyl (dm) prostaglandin E2 produces an alkaline secretion from the canine stomach. This study attempts to assess whether this prostaglandin-induced secretion might have a cytoprotective role. Chambered ex vivo perfused wedges of canine stomach were divided into equal halves: a control and test side. The mucosa of each half was sequentially exposed to isosmotic hydrochloric acid, 20μg, of 16,16 dm PGE2 in acid, 20 mmol aspirin + 20 μg of dm PGE2 in acid then isosmotic acid. The test side received 40 mmHg pneumatic counterpressure to reduce the prostaglandin-induced fluid movement before, during and after the aspirin exposure. The mucosal lesions produced on each side were graded 0 to 4. If prostaglandin exerts its cytoprotective effect by stimulating an alkaline secretion, elimination of that secretion with counterpressure should prevent a cytoprotective action. Nine dogs were studied.
Topical prostaglandin increased transmucosal fluid movement from 10 μl/min to 65 μl/min. Counterpressure decreased this volume flow by 50 per cent (P &lt; 0·01); it also decreased mucosal blood flow on the test side by 20 per cent (P &lt; 0·05). The lesions on the counterpressure side were worse 2·0·0·6 v. 0·8 ± 0·3 (P &lt; 0·01). Thus the greater damage in the counterpressure group could have been caused by diminished fluid movement or by reduced blood flow or a combination of both factors. Although this study cannot distinguish between these possibilities, it seems likely that the prostaglandin-induced alkaline secretion has a cytoprotective role.
Radiological appearances of parotid duct calculi
Authors: Suleiman Suleiman I , Hobsley Michael 
Published: March 2007

Abstract
A total of 42 patients presenting with recurrent unilateral parotid gland swelling was studied. Plain radiology of 38 patients with proved calculi showed that the lateral view is valueless. The anteroposterior view was positive in 58 per cent, and when coupled with an intrabuccal view 71 per cent of the calculi were radio-opaque. The overwhelming majority of calculi were visible as filling defects on sialography, while in 4 patients an area of narrowing with dilatation of the parotid duct proximal to it represented the site of the calculus. In the remaining 4 patients with the latter sign, repeat sialography showed normal appearances in 2, suggesting that the calculi had passed.
Pseudomembranous colitis after whole gut irrigation with neomycin and erythromycin base
Authors: Weidema W F , von Meyenfeldt M F , Soeters P B , Wesdorp R I C , Greep J M 
Published: March 2007

Abstract
An unprecedentedfatal case of pseudomembranous colitis (PMC) is described, associated with the use of topical antibiotics (neomycin and erythromycin base) during whole gut irrigation. This case was one of a cluster Offive, occurring within a period of 4 months in 1978. These observations tend to support the hypothesis that disturbances in bacterial flora give rise to PMC and furthermore that the short-term use of antibiotics does not prevent the occurrence of PMC.
Splenectomy for hypersplenism in malignant lymphomas
Authors: Gill P G , Souter R G , Morris P J 
Published: March 2007

Summary
Splenectomy has been performed in advanced malignant lymphomas in an effort to correct haematological cytopaenias in 41 patients since 1975. In both Hodgkin's disease and a variety of non-Hodgkin's lymphomas the operation has been associated with a high percentage of haematological correction (90 per cent overall). In many of these patients the haematological defect had prevented or led to the cessation of treatment and in those cases where chemotherapy was resumed after splenectomy worthwhile remission was achieved in 87.5 per cent of patients. There were no postoperative deaths and morbidity was considered acceptably low. We conclude that splenectomy is a valuable adjunct to treatment in advanced malignant lymphomas and should be considered at the first suggestion of splenic overactivity and reduced bone marrow reserves.
Repeated aspiration of breast cysts—a safe procedure
Authors: Hinton C P , Hughes R G 
Published: March 2007

Summary
We have made a retrospective study of 197 patients who underwent 367 breast cyst aspirations and in whom the fluid obtained was sent for cytological examination between January 1974 and August 1976.
Four specimens were reported as showing malignant cells in the aspirate. All of these were excised and 3 were confirmed to be malignant. A further 8 showed bizarre or atypical appearances, of which four were excised and I was malignant. The other 4 were subjected to repeat aspiration, at which time typical benign appearances were reported and no further action taken. No tumour developed in the follow-up period of at least 2 years.
Of the patients whose initial cytology was benign, 51 were subjected to repeated aspiration of clinically recurrent cysts, 28 on 3 or more occasions. Ten patients underwent excision biopsy of histologically benign lesions. None of these 51 patients developed a malignant tumour at the site of the cyst in the 2-year follow-up period.