bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic haemodynamic changes after portacaval anastomosis in normal, cirrhotic and chronic prehepatic portally hypertensive rats
Authors: Romeo J M , Lopez-Farre A , Martin-Paredero V , Lopez-Novoa J M 
Published: March 2007

Abstract
Radioactive microspheres were used to determine the hepatic haemodynamic response to portacaval anastomosis in normal, cirrhotic and chronic prehepatic portally hypertensive rats 20 days after operation, and in normal rats 2 months after operation. After 20 days portacaval anastomosis caused a decrease in liver mass only in normal and cirrhotic animals, whereas hepatic arterial blood flow per unit of mass increased in normal (+ 488 per cent), cirrhotic (+ 191 per cent) and prehepatic portally hypertensive rats (+ 133 percent). Despite these facts, animals with portacaval anastomosis showed a reduced hepatic total perfusion (arterial plus portal inflow) per unit of mass with respect to controls in normal (−53 per cent) and cirrhotic rats (−68 per cent), but not in those with prehepatic portal hypertension. Comparing studies carried out at 2 months with those performed 20 days after portacaval anastomosis in normal rats, some recovery of liver mass and total liver blood flow was observed. In conclusion, portacaval anastomosis produced a limited increase in hepatic arterial blood flow which was unable to preserve liver mass and its total perfusion in normal and cirrhotic animals. In contrast, portacaval anastomosis did not significantly alter liver mass or its perfusion in animals with chronic prehepatic portal hypertension, as both values were previously diminished in controls. Thus, the risk of liver failure after portacaval anastomosis is higher in normal and cirrhotic rats than in those with chronic prehepatic portal hypertension.
Graduated compression stockings in the prevention of postoperative deep vein thrombosis
Authors: Jeffery P C , Nicolaides A N 
Published: March 2007

Abstract
This review examines the role of graduated elastic compression stockings in the prevention of postoperative deep vein thrombosis. Used alone compression stockings reduce the incidence of postoperative deep vein thrombosis by approximately 60 per cent and when used in combination with other preventive methods, such as low dose heparin or intermittent calf compression, they further reduce the incidence by up to 85 per cent.
Femoropopliteal arterial fibrodysplasia
Authors: van den Dungen J J A M , Boontje A H , Oosterhuis J W 
Published: March 2007

Abstract
Fibrodysplasia is a rare and unusual cause of obstruction of the superficial femoral or popliteal artery. Three young patients with intermittent claudication due to occlusion of the femoropopliteal artery are described. Histological examination showed destruction of the elastic and muscle fibres of the media. In one patient secondary fibrosis of the intima was seen. The adventitia showed an increase in elastin fibres in all cases. The lesions described can be respectively classified as perimedial fibroplasia, as medial dissection and as intimal fibroplasia. This is the first description of a patient with histopathologically proven perimedial fibroplasia and medial dissection of the femoropoliteal artery and the second case of intimal fibroplasia.
Intermittent hepatic dearterialization induces glucose intolerance: An experimental study in the rat
Authors: Sjövall S , Ahrén B , Bengmark S 
Published: March 2007

Abstract
Intermittent hepatic dearterialization is used in the palliative treatment of liver malignancy. However, its metabolic consequences are not established. Therefore the influences of the procedure on the plasma insulin, glucagon and glucose responses were studied in healthy rats and in rats with a tumour inoculated subcapsularly into the liver. To study the influence on stimulated islet hormone secretion we infused arginine intravenously (7 mg/min) for 30mm, because arginine is known to stimulate the secretion of both insulin and glucagon. During hepatic dearterialization, hyperglycaemia developed; mean(s.e.m.) blood glucose levels after 60min of dearterialization were 20·2(1·3)mM versus 14·7(1·5) mM in controls (P &lt; 0·001). Concomitantly, compensatory hyperinsulinaemia and hypoglucagonaemia occurred. Furthermore, during both dearterialization and in the immediate reperfusion phase, the arginine-induced increase in plasma insulin levels was impaired (P &lt; 0·001), whereas the arginine-induced increase in plasma glucagon levels was not significantly affected. These changes were qualitatively the same in tumour-free and tumour-bearing rats. We conclude that glucose intolerance develops during selective hepatic dearterialization, which is evident both from basal hyperglycaemia and impaired insulin secretion.
Nitrogen requirements in severely injured patients
Authors: Larsson J , Lennmarken C , Mårtensson J , Sandstedt S , Vinnars E 
Published: March 2007

Abstract
The study was designed to evaluate nitrogen needs in severely injured patients during the first week after trauma. Thirty-nine patients aged from 18 to 65 years with a burn or fractures of more than two long bones were studied. Energy requirements were given par enter ally as fat and glucose in isocaloric amounts. The patients were randomized into five groups receiving different amounts of nitrogen from zero to 0·3 g kg body-weight−1 24 h−1. Daily and cumulative nitrogen balance, urinary 3-methylhistidine excretion and nitrogen retention were calculated on days 2–8 after trauma. With no nitrogen, the mean(s.e.m.) daily nitrogen balance after the trauma was −13·8(0·5) gN. The balance improved markedly in groups with a nitrogen intake of up to 0·2 g kg body-weight−1 (P &lt; 0·001) compared with the no-nitrogen group. The 3-methylhistidine excretion increased because of the trauma in all groups with no statistically significant difference between the groups. Nitrogen retention decreased with increase in nitrogen supply and with time after injury. It is suggested that a nitrogen supply of 0·20 kg body-weight−1 24 h−1 is optimal for severely injured patients during the first week after trauma.
Splenectomy for hypersplenism in chronic lymphocytic leukaemia and malignant non-Hodgkin's lymphoma
Authors: Delpero J R , Houvenaeghel G , Gastaut J A , Orsoni P , Blache J L , Guerinel G , Carcassonne Y 
Published: March 2007

Abstract
Between 1 January 1980 and 31 July 1988, 62 patients with chronic lymphocytic leukaemia (CLL) or malignant non-Hodgkin's lymphoma (NHL) were splenectomized for splenomegaly and presumed hypersplenism. All patients except one had splenomegaly (mean(s.d.) weight 1585 (872) g, range 150–4300 g) and 34 had massive splenomegaly (&gt; 1500 g). Forty-nine patients had platelet counts &lt; 100 × 109/l and 16 patients had anaemia with haemoglobin levels &lt; 10 g/dl. White cell counts were &lt; 3×109/l in six NHL patients. Fifteen patients had bicytopenia, and three NHL patients had tricytopenia. The selected group of 62 patients underwent splenectomy largely because of failure to respond to medical therapy (39 patients) or inability to tolerate or start adequate chemotherapy because of very low blood counts (11 patients). There was one postoperative death, and a 29 per cent morbidity rate. The response rate was 89 per cent in the first month after splenectomy and 39 patients (63 per cent) had a continuing complete response with a median follow-up of 26 months (range 3–96 months). Twelve patients (10 with CLL) received no further therapy after splenectomy. Seven patients failed to respond and 15 relapsed after splenectomy. These 22 patients could be distinguished on the basis of: (1) lower average preoperative platelet counts (P &lt; 0·007), postoperative platelet counts (P &lt; 0·001), and postoperative rise in platelets (P &lt; 0·004); (2) lower average spleen weight (P &lt; 0·052); (3) preoperative chemotherapy (P &lt; 0·044). However preoperative and postoperative platelet counts were the only two variables selected by stepwise regression analysis (P &lt; 0·05 and P &lt; 0·01, respectively). Bone marrow failure did not preclude complete response after splenectomy. Long-term survivors emerged from the group of patients with continuing complete response. Of the seven patients who failed to respond, five died with a median survival of 4 months, and of the 15 patients who relapsed after splenectomy, 13 died, with a median survival of 6 months after relapse and 18 months after splenectomy. Thus, splenectomy may be an effective palliation for both CLL and NHL patients with splenomegaly and hypersplenism.
Hypertensive anal cushions as a cause of the high anal canal pressures in patients with haemorrhoids
Authors: Sun Wei Ming , Read N W , Shorthouse A J 
Published: March 2007

Abstract
Anorectal manometry and electrophysiology studies were conducted in 25 men with non-prolapsing haemorrhoids, ten men with prolapsing haemorrhoids, and 20 age-matched normal men. Mean(s.e.m.) minimum basal pressures were significantly higher in patients with non-prolapsing haemorrhoids than in normals (61(5) versus 43(7) cmH2O; P &lt; 0·05) or patients with prolapsing haemorrhoids (55(4) cmH2O; P &lt; 0·05). There were no significant differences in maximum basal pressures and maximum squeeze pressures. During rectal distension, all normal subjects showed relaxation in all anal channels. However, 92 per cent of patients with non-prolapsing haemorrhoids and 40 per cent of patients with prolapsing haemorrhoids showed no relaxation in the outer anal channels, even when relaxation occurred in the inner anal channels; internal sphincter electrical slow waves were suppressed and the integrated electrical activity of the external sphincter had returned to predistension values. Maximum residual anal pressures during balloon distension were significantly higher in patients with non-prolapsing haemorrhoids than normals (75(7) versus 45(7) cmH2O; P &lt; 0·01), or patients with prolapsing haemorrhoids (53(3) cmH2O; P &lt; 0·05). When subjects increased intra-abdominal pressure rectal pressure was significantly higher in patients with non-prolapsing haemorrhoids than in normal subjects (157(10) versus 105(15) cmH2O; P &lt; 0·05), but not in patients with prolapsing haemorrhoids (126(14) cmH2O). Resting anal cushion pressures in patients with non-prolapsing or prolapsing haemorrhoids were much higher than normal capillary or venous pressure and significantly higher than those recorded in normals (median 35, 35 versus 10 cmH2O; P &lt; 0·0001). Pressures recorded during coughing (60, 60 versus 30 cmH2O) and straining (78, 80 versus 55 cmH2O) were also significantly higher (P &lt; 0·0001) in patients than in normals. Pressures after straining were higher than those recorded before (38 versus 29 cmH2O; P &lt; 0·05) in 60 per cent of patients but no normal subjects and took 18–36 s to return to baseline. This study suggests that the abnormally high pressures in the anal canal in patients with haemorrhoids may be related to an increased vascular pressure in the anal cushions.
Satisfying patients' needs for surgical information
Authors: Edwards M H 
Published: March 2007

Abstract
Patients facing operation need good information. This is implicit in informed consent but it is often lacking. A solution is a comprehensive set of leaflets covering 65 different general surgical operations. The leaflets describe the illness, operation, exact management regimen, some complications and outlook, in a deliberately simple style. Master copies are stored on a wordprocessor to allow unlimited expansion and updating. A retrospective survey of 200 patients showed that those receiving leaflets were significantly more satisfied with information (72 per cent overall) than those not receiving leaflets (42 per cent overall) (P &lt; 0·01). This was especially apparent for information about postoperative progress, both in hospital (92 per cent versus 52 per cent) and after discharge from hospital (88 per cent versus 39 per cent). The system is effective, cheap and popular with patients and medical and nursing staff. The wordprocessor allows extensive modifications of the information to suit other surgeons' requirements.
Bullet emboli to the systemic and venous circulation
Authors: Michelassi F , Pietrabissa A , Ferrari M , Mosca F , Vargish T , Moosa H H 
Published: March 2007

Abstract
The rarity of bullet emboli leads to frequent delays in diagnosis and inadequate early management. Our recent experience with this entity is described, and 153 cases reported in the English-language literature are reviewed and summarized. The majority of cases occurs as a consequence of civilian violence among men in their 20s and 30s. Most bullet emboli follow the direction of blood flow, although 15% of venous bullets cause embolization in a retrograde manner. One in 10 arterial emboli follow a right-heart or venous injury. Arterial bullets are symptomatic in 80% of cases, venous bullets in only one third. The choice of surgical management must be individualized according to the symptoms caused by the bullet and its location in the vascular system. In general, arterial bullet emboli are removed because of symptoms or findings of acute peripheral ischemia. Arterial and venous emboli not causing symptoms should be removed according to the risk of possible displacement and further embolization. Selective intraoperative angiograms and phlebograms can precisely localize the migrating bullet and permit appropriate placement of incisions before removal. (SURGERY 1990;107:239–45.)
Effect of postanal repair on progress of neurogenic damage to the pelvic floor
Authors: Laurberg S , Swash M , Henry M M 
Published: March 2007

Abstract
Physiological evaluation of the anorectum and pelvic floor muscles was carried out in 18 patients before and 9–35 months after postanal repair for anorectal incontinence. Thirteen patients (72 per cent) were improved, but in these patients the fibre density in the external anal sphincter muscle and the pudendal nerve terminal motor latency were both increased after surgery. In the five patients not improved after surgery only a few unstable motor unit potentials could be recorded in the external anal sphincter muscle. In two of these patients the pudendal nerve terminal motor latency could not be recorded after surgery. We suggest that this progression in the neurogenic damage to the pelvic floor muscles after postanal repair may be caused by the operation, and that it may be responsible for the poor functional outcome noted in some patients.
Bile duct size after cholecystectomy: An endoscopic retrograde cholangiopancreatographic study
Authors: Chung S C S , Leung J W C , Li A K C 
Published: March 2007

Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) was performed in 43 patients before and 4–14 months after cholecystectomy. All patients had a normal common bile duct and were asymptomatic after the operation. Preoperative and postoperative films of adequate quality were available for scrutiny in 35 patients. The largest mean(s.d.) diameter of the common duct, after correcting for magnification, was 0·96(0·27) cm before cholecystectomy and 1·16(0·29) cm after surgery (P &lt; 0·0001). Thirty-one of the 35 patients showed increased duct size after cholecystectomy, and the difference was 1 mm or more in 26 patients. There was a positive correlation between the increase in bile duct size and the time interval after cholecystectomy. After cholecystectomy a small but significant increase in bile duct diameter is demonstrable on ERCP.
Pathogenesis of acute cholecystitis after gastrectomy
Authors: Takahashi T , Yamamura T , Utsunomiya J 
Published: March 2007

Abstract
The increased incidence of gallbladder diseases after gastrectomy is discussed with regard to contractile motility of the gallbladder. Ultrasonographic findings and contraction of the gallbladder in response to egg yolk or caerulein were studied before and after gastrectomy at intervals ranging from 2 weeks to 6 months. Enlargement of the gallbladder with accumulation of biliary sludge and hypomotility were frequently observed within a month of operation for gastric cancer, suggesting that biliary stasis is an important contributing factor in postoperative acute cholecystitis. Within 3 months of operation, contraction had recovered to close to preoperative levels and the incidence of biliary sludge formation gradually decreased. Daily administration of an opiate antagonist, naloxone (0·8 mg), significantly improved gallbladder dyskinesia and decreased the incidence of biliary sludge formation within 1 month of gastrectomy.
Recurrent reflux and wrap disruption after Nissen fundoplication: Detection, incidence and timing
Authors: O'Hanrahan T , Marples M , Bancewicz J 
Published: March 2007

Abstract
One hundred and twenty-five patients with refractory gastro-oesophageal reflux disease underwent floppy Nissen fundoplication. Median follow-up was 52 months, and included endoscopy, manometry and prolonged pH recordings in all cases in addition to clinical assessment. Using objective criteria, 12patients (9·6per cent) developed recurrent reflux. In nine of these patients, endoscopy had suggested that the Nissen fundoplication had disrupted; wrap disruption was confirmed in seven patients who underwent reoperation. The median time to endoscopic recognition of wrap disruption was 7 months (range 3–10 months). In contrast, of 115 patients with endoscopic evidence of an intact fundoplication, only 3 (2·6 per cent) had recurrent reflux. Endoscopy allowed reliable differentiation between those with and without reflux control after operation (P&lt; 0·007). These results suggest that recurrent reflux after Nissen fundoplication is due to wrap disruption. This phenomenon occurs within the first postoperative year and can be recognized by informed endoscopic assessment.
Vomiting after Roux-en-Y biliary diversion: Relationship to surgical technique
Authors: Ferguson G H , Rose M , Maclennan I , Taylor T V , Torrance H B 
Published: March 2007

Abstract
Vomiting is a frequent complaint after revisional gastric surgery using a Roux-en- Y biliary diversion. This is believed to be due to gastric stasis or stasis in the jejunal component of the Roux-en-Y. Thirty-three patients, ten with a satisfactory outcome following Roux-en- Y diversion and 23 with an unsatisfactory outcome, were studied using a semisolid, radiolabelled meal and compared with 12 normal subjects. Outcome was assessed by modified Visick grading. Seven patients with an unsatisfactory outcome because of frequent vomiting had gastric stasis and two had delay in emptying of the jejunal component of the Roux-en-Y. Vomiting was more likely in patients with a dependent sump (P&lt;0·0006) and emptying was significantly prolonged where a sump was present (P = 0·0009). Surgical technique contributed to the dependent sump.
Clinical trial of calcium alginate haemostatic swabs
Authors: Blair S D , Jarvis P , Salmon M , McCollum C 
Published: March 2007

Abstract
The influence of a new haemostatic material on surgical bleeding was evaluated in 100 patients who were prospectively randomized to either normal surgical gauze or calcium alginate swabs used throughout cholecystectomy (n = 40), simple mastectomy (n = 18) or inguinal hernia repair (n = 42). Overall, median (range) blood loss was 91(3–329) ml for gauze and was significantly reduced by calcium alginate swabs to 72(2–181)ml (P&lt;0·05). Unexpectedly, operation times were also shortened from 45(17–95) min for gauze to 35(13–70) min with calcium alginate swabs (P &lt; 0.02). This reduction in blood loss and operating time was greatest for mastectomy, was still statistically significant for cholecystectomy, but was unimportant in inguinal hernia repair. Calcium alginate haemostatic swabs may become routine in major surgery, particularly where blood loss leads to the need for transfusion.
Changes in cardiorespiratory and muscle function associated with the development of postoperative fatigue
Authors: Zeiderman M R , Welchew E A , Clark R G 
Published: March 2007

Abstract
An understanding of the factors which contribute to postoperative fatigue may benefit the rehabilitation of patients after surgery. Subjective feelings of fatigue and fatigue measured objectively in the adductor pollicis muscle after ulnar nerve stimulation have been studied in relation to changes in cardiorespiratory function and muscular efficiency both at rest and when walking on a treadmill at a work rate of 20 and 56 kpm min−1. Twelve patients admitted for elective abdominal surgery were studied before operation and again on the third postoperative day. The postoperative period was characterized by an increased feeling of fatigue. Surgery had no effect upon fatigue in the adductor pollicis muscle suggesting that the genesis of postoperative fatigue is partly central in origin. Muscular efficiency (s.d.) fell from 34(6) per cent before operation to 22(3) percent (P&lt;0·05) on the third postoperative day and was accompanied by a 19 per cent rise in the net energy(s.d.) expenditure (7·3(0·8) to 8·6(0·3) kJ min−1; P&lt;0·03) required to perform a given workload. The increased cardiorespiratory effort and reduced muscular efficiency associated with the performance of low-intensity exercise may limit mobilization after surgery and contribute to a greater feeling of fatigue.
Association between transfusion with plasma and the recurrence of colorectal carcinoma
Authors: Marsh J , Donnan P T , Hamer-Hodges D W 
Published: March 2007

Abstract
Data was collected from patients with colonic or rectal tumours undergoing potentially curative surgery. Univariate analysis showed an association between perioperative transfusion with plasma and the earlier recurrence of tumour. Allowing for possible confounding factors the relative risk of recurrence for patients receiving plasma was 2·44 (95 per cent confidence interval= 1·10–5·46, P = 0·041) and for patients receiving whole blood or plasma, it was 2·39 (95 per cent confidence interval =1·19–4·83, P = 0·021). The risk of recurrence for those receiving a transfusion of plasma was, therefore, more than twice that of those not given it. We were unable to demonstrate an independent harmful effect of transfusion with packed cells. These data suggest that the plasma protein, rather than the cellular component of whole blood, mediates the accelerated tumour recurrence.
Clinical assessment and anorectal manometry before postanal repair: Failure to predict outcome
Authors: Scott A D N , Henry M M , Phillips R K S 
Published: March 2007

Abstract
It has been suggested that preoperative measurement of resting anal canal pressure and internal sphincter function can be used to identify those patients with neurogenic faecal incontinence who are unlikely to benefit from the operation of postanal repair. We have therefore analysed the results of the operation in 62 patients (six men and 56 women, mean age 59 years, range 30–83 years) and related clinical outcome to preoperative assessment of: resting anal canal pressure, the presence of gape and a combination of gape and low resting pressure. None of these factors was found to predict a poor result after postanal repair.
The long-term sequelae of ileocolic anastomosis in childhood: A retrospective survey
Authors: Parashar K , Booth I W , Corkery J J , Gornall P , Buick R G 
Published: March 2007

Abstract
The long-term effects of ileocolic anastomosis in children are not known. We therefore carried out a survey of all such patients treated at our hospital between 1971 and 1985. Thirty-seven patients were identified and invited to attend for follow-up. Twenty-seven (73 per cent) were examined and included in the survey. Mean age at survey was 7·8 years (range 1·6–17·6 years) and mean duration since operation was 6·3 years. Necrotizing enterocolitis and intussusception were the commonest indications for operation. As judged by height, weight and skin fold thickness, all patients were well nourished. Seven (26 per cent) had loose stools, five had chronic folic acid deficiency and one was vitamin B12 deficient. We conclude that resection of the ileocaecal region is well tolerated in childhood and does not affect growth. Loose stools are directly related to the length of ileal resection.