bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of intermittently applied external pressure on the haemodynamics of the lower limb in man
Authors: Roberts V C , Sabri S , Beeley A H , Cotton L T 
Published: March 2007

Abstract
The effects of intermittently applied external pressure on blood-volume flow-rate in the femoral vein have been investigated in a series of 6 patients undergoing surgery for bilateral varicose veins. During the investigation, pressure was applied to the legs with the aid of an inflatable plastic splint, while blood-flow in the femoral veins was measured with an electromagnetic blood flow-meter.
The investigation has shown that intermittently applied pressure increases the pulsatility of the venous flow-wave while leaving its mean level largely unaltered. It has been shown that the increase in peak flow is directly proportional to the rate of pressure application, being maximal at about 10 mm. Hg per second. It has further been shown that the increase in both the pulsatility and the peak flow reaches a maximum when the interval between successive pressure applications is 1 minute.
The treatment of achalasia by cardiomyotomy
Authors: Wingfield H V , Karwowski A 
Published: March 2007

Abstract
The results of treatment in 27 cases of achalasia carried out in the Tehidy Thoracic Surgical Unit are reviewed. The value of air insufflation of the oesophagus to assist in the division of the muscle and to ensure that the mucosa is not damaged is stressed. The advantages of early operation using a modified Heller's procedure are shown, and the results demonstrate that a poor outcome is most common in cases with a long history and that usually these cases have been treated by conservative measures.
Tuberculosis of the gall-bladder
Authors: Bergdahl Leif , Boquist Lennart 
Published: March 2007

Abstract
Three female patients with tuberculous cholecystitis are reported. They had symptoms of cholecystopathy of varying duration. No jaundice was recorded. Cholecystograms disclosed non-functioning gallbladders in 2 cases and a functioning gall-bladder with two stones in the other case. At cholecystectomy, cholelithiasis was found in all the patients, and in addition 1 of them showed tuberculous peritonitis. Microscopic examination showed tuberculous changes in the gall-bladders. Postoperative tuberculostatic treatment was given. The presence of stones is believed to have been of importance for the development of the tuberculous infection in the present cases.
Spontaneous Aortoduodenal Fistula
Authors: Evans D M , Webster J H H 
Published: March 2007

Abstract
Two further cases, 1 fatal and 1 with long-term recovery, of patients treated surgically for spontaneous aortoduodenal fistula are reported, bringing the total number of published operations to 20. Thirty-six further examples of the lesion which were not treated by operation have been reported since 1957.
Of a wide variety of causes for this lesion, the commonést is arteriosclerotic aneurysm of the aorta.
The association of recurrent gastroduodenal haemorrhage with severe pain and collapse may indicate this lesion, and the treatment should be surgical.
Control of the aorta proximal to the fistula is the essential first step in prosthetic grafting of the aorta and closure of the duodenum. Otherwise, spontaneous aortoduodenal fistula is uniformly fatal.
Deep-Vein Thrombosis in Patients With Fractures of the Femoral Neck
Authors: Field E S , Nicolaides A N , Kakkar V V , Crellin R Q 
Published: March 2007

Abstract
Fifty patients with fractures of the femoral neck have been studied, using the 125I-labelled fibrinogen test for diagnosing deep-vein thrombosis (D.V.T.). There was an overall incidence of D.V.T. of 54 per cent in fractured limbs. In pertrochanteric fractures there was an incidence of 75 per cent and in subcapital fractures the incidence was 34 per cent.
The radioactive fibrinogen test is a most useful method of screening for D.V.T. under the conditions presented by these patients.
Leiomyosarcoma of the Spermatic Cord a Case Report
Authors: Jenkins D G , Subbuswamy S G 
Published: March 2007

Abstract
A case of leiomyosarcoma of the spermatic cord is presented, the twenty-sixth case in the world literature. The tumour metastasized to the skin and to the lungs, and had to be differentiated from a neurofibromatous lesion. There was histological evidence to suggest that the lesion had originated as a benign leiomyoma and then had undergone malignant change. The primary tumour was excised. The secondary deposits were radioresistant but showed some response to chemotherapy. It is suggested that the most suitable form of treatment is wide excision of the primary tumour with close follow-up and chemotherapy when recurrence or metastasis occurs.
A Method of Repair of Myelomeningoceles
Authors: Bannister Carys M 
Published: March 2007

Abstract
We believe that it is possible in the majority of myelomeningoceles to achieve a satisfactory repair of the lesion. To achieve dural closure the mobilization must be extensive and this can only be done if the anatomy of the myelomeningocele is thoroughly understood. Large skin defects can be closed with primary wound healing provided that the skin is mobilized extensively. To do this it is essential that the subcutaneous layer be retained intact to maintain the blood-supply to the skin. Only exceptionally large lesions require relieving incisions, skin-grafts, or swinging of skin-flaps.
An Assessment of the Value of Measuring Uncollected Gastric Secretion During Routine Secretion Studies in Man
Authors: Venables C W 
Published: March 2007

Abstract
A simple “wash-out” collection technique employing phenol red as a marker has been used during routine gastric secretion studies and its value has been assessed. Studies repeated on a single individual showed good reproducibility. When measured this way loss was not affected greatly by the volume secreted.
With this technique the repeatability of pentagastrin tests has been assessed at intervals of 6 weeks. This demonstrated that both acid and pepsin outputs could vary considerably, with a mean variation in acid of over 26 per cent.
The effects of histamine, pentagastrin, and insulin upon loss have been studied.
Loss has been found to vary considerably from one study to another and from one patient to another and may on occasions be considerable, particularly after previous surgery.
These findings suggest that a method of measuring loss should be adopted by any centre which wishes to use secretion studies to analyse the effects of treatment.
Hydatid Disease of the Spleen Report of an Unusual Case
Authors: Torbati M 
Published: March 2007

Abstract
A case of an unusually large hydatid cyst of the spleen measuring 53 cm. in diameter and containing 21 litres of fluid and scolices is reported in a 40-years-old farmer. He had a brief history of nausea, intermittent vomiting, and shortness of breath.
Surgical removal of the spleen with the cyst was followed by complete recovery.
Visceral Neurofibromatosis an Unusual Cause of Obstrutive Jaundice
Authors: Curry Bernadette , Gray Norman 
Published: March 2007

Abstract
A case of visceral neurofibromatosis presenting as obstructive jaundice is described. Laparotomy revealed an ampullary tumour which was presumed to be malignant. A palliative cholecystojejunostomy was performed but death occurred 10 days postoperatively as a result of obstructive jaundice. At necropsy the ampullary tumour was found to be a benign neurofibroma.
Malignant tumours of the bile-ducts
Authors: Warren Kenneth W , Mountain John C , Lloyd-Jones William 
Published: March 2007

Abstract
The 77 cases of malignant neoplasm of the extrahepatic bile-ducts treated at the Lahey Clinic between 1965 and 1969 are reviewed. Exploratory laparotomy was performed in 68 cases, although in 9 cases operation was not indicated because of the patients' poor condition. Of the 68 surgical patients, 24 (35 per cent) had a radical procedure, of which 17 survived for more than 1 year and 5 are still alive more than 3 years later, 3 having no evidence of recurrent disease. Forty-one patients had palliative treatment usually with some form of decompression procedure of the obstructed common bile-duct, and in 15 patients this was combined with hepatic artery infusion chemotherapy. Of these patients, 16 survived for more than 1 year, including 9 from the group treated by hepatic artery infusion chemotherapy. Only 1 patient is still alive after more than 3 years.
Of all the patients, 44 per cent survived for more than 1 year, 23 per cent for more than 2 years, and 8 per cent for more than 3 years. The mean survival time was 13 months. These results compare favourably with those of the previous survey from the Lahey Clinic, and it is concluded that the improvement is the result of the increase in the radical resection rate from 18 to 31 per cent and in the institution of hepatic artery infusion chemotherapy in palliative cases.
Repair of the laryngopharynx and cervical oesophagus after irradiation
Authors: Shaw H J 
Published: March 2007

Abstract
The present situation regarding the nature and treatment of cancer in this area is given. Types of defect and methods of repair, their complications, and the choice of methods are described. Emphasis is laid on the increased hazards of surgery for the patient after full dosage of irradiation. Treatment should be based on surgical resection, usually preceded by a modified plan of irradiation often completed after surgery.
In conclusion the most valuable recent advances in the techniques of surgical repair of the laryngopharynx and cervical oesophagus afer irradiation and resection for cancer are the use of large regional skin-flaps from outside irradiated areas, and total pharyngooesophageal replacement by means of vascular pedicled gut segments.
The effect of experimental bile-duct obstruction on critical biosynthetic functions of the liver
Authors: Lee Emanoel , Ross B D , Haines J R 
Published: March 2007

Abstract
Using biosynthetic activities which have a maximum energy requirement, the effect of obstruction of the bile-duct has been studied in isolated perfused rat livers, and compared with controls undergoing “sham” ligation and with normal animals. The maximum rate of gluconeogenesis from lactate was inhibited by 67 per cent after bile-duct ligation when compared with the normal value. The maximum rate of urea synthesis which occurred in the presence of ornithine was the same in the jaundiced and in the normal animals. ‘Sham’ operation, without ligation of the bile-duct, inhibited gluconeogenesis by less than 20 per cent but doubled the maximum rate of urea synthesis.
It is concluded that complete biliary obstruction seriously impairs gluconeogenesis and prevents the normal increase of urea synthesis which occurs in response to trauma and that these changes develop earlier than might be expected after the onset of obstruction.
Some possible mechanisms of these effects are discussed. If similar abnormalities of hepatocyte function are demonstrated in man it is suggested that surgical relief of obstructive jaundice is indicated at an early stage.
A case of gall-stone ileus in the absence of a biliary-enteric fistula
Authors: Newman J H 
Published: March 2007

Abstract
A case of gall-stone ileus is reported in which at operation no fistula between the biliary tree and the gut was found. The obstruction was removed and cholecystectomy and exploration of the common bile-duct were performed with a successful outcome. The pathogenesis of intestinal obstruction due to gall-stones in the absence of a fistula is briefly discussed.
Vesico-intestinal fistulae
Authors: Slade Norman , Gaches Christopher 
Published: March 2007

Abstract
Vesico-intestinal fistulae carry a serious prognosis by the nature of the underlying pathology. The inflammatory lesions offer the best hope for surgery and the necessity for early radical surgery in this group is stressed. The clinical details of 74 cases of vesico-intestinal fistulae are given together with their investigations, treatment, and results. The improved results over the past 10 years appear to bear out the necessity for early treatment.
Treatment of peritonitis with per- and postoperative irrigation of the peritoneal cavity with noxythiolin solution
Authors: Pickard R G 
Published: March 2007

Abstract
The present paper describes a technique for irrigating the peritoneal cavity in severe peritonitis, both at the time of laparotomy and in the immediate postoperative period, with a solution of noxythiolin. A consecutive series of 9 cases with fulminating peritonitis of various causes treated by this method is presented together with the operative findings, a discussion of the postoperative progress, and the bacteriological studies of the irrigating device. A full review of the literature of peritoneal lavage in the management of peritonitis is included in the discussion.
Central rupture of the liver with massive liver-cell necrosis. A case report and review of the literature
Authors: Soni S R , Persaud V 
Published: March 2007

Abstract
A case of massive central rupture of the liver in which the patient became jaundiced is described. Autopsy revealed, in addition to the intrahepatic haematoma, large areas of infarction in the liver, some of which had become infected and had given rise to septic embolization to various organs. There was deranged liver function which is ascribed to the structural changes found in the liver. The occurrence of hepatocellular jaundice with this type of liver injury has not, to our knowledge, been previously recorded. It is suggested that immediate investigation and treatment are essential if the patient is to survive.
Venous stasis and deep-vein thrombosis
Authors: Nicolaides A N , Kakkar V V , Field E S , Fish P 
Published: March 2007

Abstract
A venographic technique for studying stasis in the deep veins of the legs of conscious patients is described. A second technique involving the clearance of radioactive material from the veins has been developed for use during operation. The results of the two methods correlate closely.
There is considerable stasis of the blood, particularly in the soleal veins, in conscious patients with the legs horizontal, and it is prolonged considerably during surgery. Using these new techniques the effectiveness of various methods said to prevent stasis has been assessed.
A model which can be used to improve the treatment of acute hepatic failure
Authors: Winch John 
Published: March 2007

Abstract
A model using the pig from wich the liver has been removed for isolated perfusion, as a subject showing some of the features of acute hepatic failure for later treatment by cross-circulation with its own perfused liver, is desceribed. Effects of such a procedure on such a procedure on the glucose and halothane metabolism and intravascular coagulation and bleeding are detailed.
A technique for creating a skin-lined hemithorax
Authors: Wosornu Lade 
Published: March 2007

Abstract
Prosthetic lungs could permanently occupy the pleural space which must first be lined with silicone ‘skin’, i.e., Dacron-backed silicone membrane (Peirce, 1966). Initial experiments in dogs showed that the pleural membrane would not readily accept silicone ‘skin’; rather, the solution lay in the use of autogenous skin-grafts. A readily reproducible technique has been eveloped for transforming the left hemithorax of SPF rats into stable skin-lined cavities which can be opened to atmospheric pressure without embarrassing breathing in the contralateral lung.
Authogenous skin was formed into 35 × 20-mm. sacs and grafted into the left pleural spaces of 150 male SPF rats of mean weight 240±30 g. One hundred and thirty-two (88 per cent) survived 4 weeks or more. In these the skin-lined cavity grew to occupy the hemithorax, displacing the left lung. In 75 rats the cavity was opened to the exterior and sutured to the skin, thereby creating a permanent 5–8-mm. opening directly through the chest wall. Fifty-nine of the 75 rats so exposed survied.
The mean pressure in the cavity was +2.9±0.6 cm. H2O before it was opened to the exterior; after the creation of the stoma the mean pressure in the cavity became −2.5±0.6 cm. H2O (P &lt; 0.001), and the new pressure was in phase with and was similar in magnitude to the oesophageal pressure. The skin-lined hemithorax is presented as the model of a cavity which could be employed to house prosthetic organs designed for permanent implantation insie the chest cavity.
Twenty-four-hour preservation of canine kidneys exposed to 45 and 60 minutes of warm ischaemia
Authors: Snell M E , Hopkinson W I , Porter K A 
Published: March 2007

Abstract
This investigation was designed to test the ability of a new hyperbaric organ preservation system to preserve canine kidneys for 24 hours after they had been subjected to significant periods of warm ischaemia. In group I (45 minutes of warm ischaemia) all the kidneys functioned well, and the mean maximum serum creatinine was 4.4 ± 1.7 mg. per 100 ml. In group II (60 minutes of warm ischaemia) I dog died on account of acute tubular necrosis. The mean maximum serum creatinine was 5.4 ± 4.02 mg. per 100 ml. The results indicate that hyperbaric oxygen warrants serious consideration as an adjunct to organ preservation.
A review of 460 patients admitted to the intensive-therapy unit of a general hospital between 1965 and 1969
Authors: Skidmore F D 
Published: March 2007

Abstract
Four hundred and sixty patients with various severe disease processes were admitted to the intensive-therapy unit of a general hospital under the care of the anaesthetic and surgical staff in the 5-year period 1965-9 inclusive. The problems presented by these cases, their prognosis, and the lessons learnt in their management are reported, and the implications for similar units in the future are discussed.
The influence of electrical stimulation of the leg during surgical operations on the subsequent development of deep-vein thrombosis
Authors: Dejode L R , Khurshid M , Walther W W 
Published: March 2007

Abstract
The effect of galvanic stimulation of the calf muscles during surgical operations on the development of postoperative deep-vein thrombosis was assessed using 125I fibrinogen in 64 patients over 40 years of age undergoing major surgery. Alternate legs were stimulated in alternate patients using the opposite leg as a control. No significant difference in the incidence of deep-vein thrombosis was observed either in the immediate postoperative period or later.
Observations on acute pancreatitis. A retrospective clinical study
Authors: Gillespie W J 
Published: March 2007

Abstract
Aetiological features were sought in a retrospective review of 93 cases of acute pancreatitis diagnosed and treated in Edinburgh hospitals between 1961 and 1970. The incidence of alcoholism or precipitation by an excess of alcohol was 23 per cent, a figure which accords with reports from other parts of the world but which has no precedent in Great Britain. Possible reasons for this are discussed. There were no other unusual features. The need for a prospective study to reassess our current experience in Great Britain is stressed.
Bacterial flora in the duodenum of patients after biliary fenestration
Authors: Thomas E , Grant A Kerr , Holford M , Ringwood D , Derrington A W , Magarey J R 
Published: March 2007

Abstract
Fasting duodenal aspirates were studied in 15 patients with a biliary fenestration, 5 patients with a single duodenal diverticulum, 1 patient with a biliary fenestration and duodenal diverticulum, and 11 control subjects. A colonic type of bacterial flora, consisting of coliforms, Clostridium welchii, and Streptococcus faecalis, was found in 10 patients with biliary fenestration, 4 patients with a duodenal diverticulum, the patient with a fenestration and duodenal diverticulum, and in 1 of the control subjects. A high incidence of deconjugation of biles salts (10 out of 15 patients) and of steatorrhoea (8 out of 15 patients) was noted in the patients with biliary fenestration, as well as in those with a duodenal diverticulum (5 and 3 patients out of 5 respectively). Above-normal serum-folate levels were observed in 3 subjects with coliform colonization.
It is possible that vague abdominal symptoms which may be experienced by patients after biliary fenestration, may be due to the presence of an abnormal bacterial flora in the duodenum.
Kocher's perampullary approach for common bile-duct calculi
Authors: Carter A E 
Published: March 2007

Abstract
Supraduodenal choledochotomy for common bileduct stones carries the risk of biliary leakage, a predilection to stricture, and no certainty that all the stones are removed. Stones left behind after the first exploration and new stones formed later require secondary surgery, which is often difficult and has an even greater risk of serious complications.
Perampullary exploration, on the other hand, does not carry an increased initial risk of death or of the complications of biliary fistulae and retained stones of which none occurred in this series. Late complications of stricture and secondary unpassable stones similarly did not occur.
Neither method is free from the risk of postoperative pancreatitis (1 per cent in this series), but there is no evidence that perampullary exploration carries a greater risk than supraduodenal exploration. Even so, it is considered wise to give propantheline for 72 hours after perampullary exploration to reduce this risk.
It has been suggested that a wide, poorly competent, distal common-duct orifice might predispose to ascending cholangitis. No case in this series developed such cholangitis, nor has any case developed stenosis at the sphincteroplasty which might encourage cholangitis. In fact, in the 3 cases that came to post-mortem examination at intervals of 2 and 3 years the sphincteroplasties were still widely patent. Boulter (1961) suggested that sphincterotomy increased the flow of bile in the physiological pressure range and thus might be an additional benefit from the procedure.
Malnutrition and malabsorption in crohn's disease with reference to the effect of surgery
Authors: Dyer N H , Dawson A M 
Published: March 2007

Abstract
Sixty-three patients with Crohn's disease showed a high incidence of nutritional deficiencies as judged by laboratory tests. Malabsorption of fat (33 per cent) and vitamin B12 (60 per cent) was not sufficiently severe to account for the malnutrition. Malnutrition was especially severe in unoperated patients with active disease, whereas malabsorption was prominent in patients with recurrent disease after resection although they had less active disease and less severe nutritional deficits. Surgery should not be withheld from a malnourished patient for fear of inducing further malnutrition; excision of toxic inflammatory disease will not only improve the immediate outlook but will also reduce the severity of further recurrences. Xylose-excretion tests give a spurious impression of malabsorption in Crohn's disease, possibly as a result of occult renal impairment, and should be abandoned.
The influence of the vagus nerves on the biliary system
Authors: Hopton D S 
Published: March 2007

Abstract
Vagotomy has become accepted as a standard operation for the treatment of peptic ulcer during the past 15 years. Although used to treat a specific lesion in the stomach or duoddenum, vagus division can have a much wider effect on the digestive system, but little attentionhas been paid by most surgeons to the efffects of the vagus on other organs and it is timely to review the influence of the vagus nerves on the biliary system.
In 1887 Ruggero Oddi suggested that the sphincter which is named after him was partly controlled by a nervous reflex. Since then many anatomists, physiologists, and clinicians have investigated the effects of the vagus nerves on the biliary system. The anatomical distribution of the vagus nerve and its hepatic and coeliac branches has been more thoroughly worked out than have their physiological effects.