bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postoperative pulmonary complications — a prospective study in the tropics
Authors: Ti T K , Yong N K 
Published: March 2007

Abstract
A prospective study over a 4-month period in 663 patients operated on under general anaesthesia yielded 66 postoperative pulmonary complications (tracheobronchitis 29, atelectasis 10, pneumonia 21, pleurisy 6). An increased incidence occurred after abdominal surgery, especially emergency upper abdominal surgery, in males, tobacco smokers and patients over 40 years of age. Chronic respiratory disease is common and an important factor in the development of postoperative pulmonary complications in the tropics. The large proportion of underweight patients are also at greater risk of developing these complications.
Insensible water loss in surgical patients
Authors: Baumber C D , Clark R G 
Published: March 2007

Abstract
Insensible water loss has been studied before, during and after abdominal surgery of moderate severity. It has been shown that if normal hydration is maintained there is no significant change in insensible water loss. Patients who become relatively dehydrated have a significant fall in insensible water loss but there is no evidence that this is detrimental to their postoperative progress.
We would like to thank Professor H. L. Duthie for permission to study patients under his care, and the nursing, dietetic and technical staff who helped to carry out this study.
Postmastectomy lymphangiosarcoma-temporary response to cyclophosphamide chemotherapy in 2 cases
Authors: Tong David , Winter John 
Published: March 2007

Abstract
Two cases of lymphangiosarcoma developing in oedematous arms following radical mastectomy (Stewart-Treeves syndrome) are reported. Both patients showed marked symptomatic improvement and tumour regression on cyclophosphamide therapy although remission was only temporary.
Evaluation of a bulk-forming evacuant in the management of haemorrhoids
Authors: Broader J H , Gunn I F , Alexander-Williams J 
Published: March 2007

Abstract
Constipation is considered to play a part in causing haemorrhoids and the regular use of a bulk-forming aperient has been advocated in their management. The incidence of constipation in 140 patients with haemorrhoids was only 10 per cent. A double blind trial on 40 patients designed to compare a bulk-forming aperient (sterculia) with a non-bulk-forming placebo (starch) showed a slight but insignificant advantage for sterculia.
A controlled trial of Trasylol in the treatment of acute pancreatitis
Authors: Trapnell John E , Rigby C C , Talbot C H , Duncan E H L 
Published: March 2007

Abstract
Although Trasylol has been available for the treatment of acute pancreatitis for 15 years a review of the literature reveals that its effectiveness has never been either proved or disproved. A prospective double blind controlled trial was therefore started in 1967. The results are now reported.
One hundred and five patients were studied. They provided a uniform clinical material and all were managed on an identical strict protocol except that patients received either Trasylol A or B, allotted in sequence using random numbers. At the conclusion of the acute episode the illness was assessed according to criteria which were not open to observer variation and each attack was categorized as mild, moderate, severe or fatal. The trial showed that there was a mortality of 4 out of 53 cases (7.5 per cent) in group A and 13 out of 52 cases (25 per cent) in group B. Statistically this difference is significant (χ2 = 4.675, d.f. = 1, P = 0.05). The code was then broken and this revealed that group A had received the active Trasylol. Analysis of age patterns showed that in the Trasylol-treated group the usual tendency for mortality to rise with advancing age was abolished. Trasylol must therefore be regarded as a drug which is beneficial in the treatment of acute pancreatitis.
Haemangiomas of the gastro-intestinal tract
Authors: Taylor T V , Torrance H Bruce 
Published: March 2007

Abstract
Four cases of haemangiomatous malformations of the gastro-intestinal tract are described. In the first the lesion involced the whole stomach. The second case exhibited lymphangiomatosis together with haemangiomatosis which appears to be a unique situation. In the third the absence of the spleen, a rare condition in itself, emphasizes the association of apparently unrelated congenital anomalies which can occur. In the fourth a ‘cloacal’ haemangioma is described which was treated in an unusual manner, namely by ligation of the feeding vessels with the unexpected sequel of gross abdominal ascites.
Carcinoma of the stomach following partial gastrectomy for benign gastroduodenal lesions
Authors: Nicholls John C 
Published: March 2007

Abstract
Thirty-six patients presenting with a carcinoma in their gastric remnant following operation for benign lesions have been studied. The original pathology was found to be a gastric ulcer in 22 of 28 patients whose initial operation was undertaken at St James's Hospital. This represents an incidence of at least 1 carcinoma appearing for every 76 patients undergoing partial gastrectomy for gastric ulceration. Carcinoma is far more likely to develop in the stomach following partial gastrectomy when the original lesion is a gastric ulcer rather than a duodenal ulcer.
Traumatic pneumocephalus
Authors: Briggs Michael 
Published: March 2007

Abstract
The presentation and management of 33 patients with traumatic pneumocephalus have been analysed and two main groups recognized. The first consisted of 12 patients who developed an intracerebral aerocele, the onset of which was delayed for up to 52 days from the time of injury. These patients presented with signs of raised intracranial pressure which required urgent surgical treatment.
The intracranial air in the second group was situated in the subdural or subarachnoid spaces and was usually visible on the first X-ray taken after injury. Adequate early prophylactic antibiotic treatment against meningitis was of great importance to these patients, who did not all require surgical intervention.
A further comparison of the use of internal fixation and prosthetic replacement for fresh fractures of the neck of the femur
Authors: Hunter G A 
Published: March 2007

Abstract
Two hundred patients with femoral neck fractures have been reviewed. One hundred were treated by a primary prosthesis and the remainder by internal fixation. The complications and results of the two groups are compared and discussed. These results are compared with a similar survey carried out in Oxford 5 years ago. The mortality rate in the group treated by prosthetic replacement is higher than in the group treated by internal fixation. This survey again indicates that internal fixation offers the patient with a displaced fracture of the neck of the femur a lower morbidity and mortality rate and better results than the insertion of a prosthesis. The use of a primary prosthesis should be confined to patients in whom accurate reduction of the fracture is impossible or in pathological fractures where maintenance of the reduction is unlikely.
Chorda tympani neurectomy–a new approach to submandibular salivary obstruction
Authors: Zalin H , Cooney T C 
Published: March 2007

Abstract
Fifteen cases of chorda tympani neurectomy for the treatment of submandibular salivary gland obstruction have been under detailed observation for a minimum of 3 years. Complete relief of symptoms has been obtained in all the cases and there have been no significant complications.
The operation is indicated in all cases hitherto regarded as requiring surgical extirpation of the gland, with the very rare exception of neoplasia.
Spontaneous rupture of the ureter
Authors: Newman C E , Dawson-Edwards P , Howarth F H 
Published: March 2007

Abstract
A case of spontaneous perforation of the ureter in a 58-year-old woman is described. The difficulties in differential diagnosis from acute intraperitoneal catastrophes and the helpful role of the urgent intravenous pyelogram in atypical cases are stressed.
The literature has been reviewed to yield 41 previous cases, and some of the common factors in aetiology, diagnosis and management are discussed.
Topical ampicillin in the prevention of wound infection after appendicectomy
Authors: Bates T , Down R H L , Houghton Mary C V , Lloyd G J 
Published: March 2007

Abstract
The effect of topical ampicillin on the rate of wound infection after emergency appendicectomy was studied in a prospective controlled trial of 200 patients. Sixteen per cent of patients in the control group developed a wound injection compared with 3 per cent of those receiving ampicillin powder in the wound (P&lt;0·01). When patients with peritonitis were considered, 64 per cent of the 14 patients in the control group developed a wound infection compared with 13 per cent of the 15 patients in the ampicillin group.
Patients in the control group were discharged from hospital in a mean of 8·7 days postoperatively compared with 6·4 days in the ampicillin group (P&lt;0·05).
Obturator hernia
Authors: Martin Nimit C , Welch Theodore P 
Published: March 2007

Abstract
Twenty patients with obstructed obturator hernia were seen at the City of Chiang Mai Hospital between 1962 and 1973. The most helpful diagnostic points are described. The relative frequency with which this disease has been seen at this hospital has made preoperative diagnosis possible in most cases in recent years and this has helped to lower the mortality.
Haematoma of rectus abdominis from the use of an exercise wheel: A report of 3 cases
Authors: Fraser-Moodie Alistair , Cox Simon 
Published: March 2007

Abstract
Three cases are presented each with a haematoma of the rectus abdominis muscle. All 3 patients were using an exercise wheel at the time of onset of the abdominal pain. The fact that use of an exercise wheel can cause a haematoma of the rectus abdominis muscle is not well documented.
Elastofibroma: A rare cause of painful shoulder
Authors: McGregor J C , Rao S S 
Published: March 2007

Abstract
A case of elastofibroma presenting in a 72-year-old male with shoulder pain and limitation of movement is reported. Removal of this benign lesion resulted in relief of pain and gradual restoration of full shoulder mobility. No other cases of this condition appear to have been reported in the British literature. The histological characteristics of this rarity are described and the possible aetiology discussed although this is uncertain. It may be rare only because of its benign course and its obscure situation which render it liable to be overlooked. Elastofibroma may occur bilaterally and asynchronously.
Early postoperative small bowel obstruction
Authors: Sykes Peter A , Schofield Philip F 
Published: March 2007

Abstract
A prospective study is presented of the clinical features and laparotomy findings in 26 patients who were re-explored for complete mechanical small bowel obstruction which occurred when they were in hospital after abdominal surgery. This complication occurred particularly in patients after colorectal and pelvic surgery and operations for acute appendicitis. Attention is drawn to the fact that small bowel distension occurring after the fourth postoperative day is usually due to mechanical obstruction or intra-abdominal sepsis and rarely, if ever, due to ‘adynamic ileus’.
Evidence is presented that plain abdominal radiography is of high diagnostic accuracy in postoperative small bowel obstruction and that early re-exploration of the abdomen and surgical relief of the mechanical obstruction are indicated in these patients.
The features and course of bile vomiting following gastric surgery
Authors: Griffiths J M T 
Published: March 2007

Abstract
In a retrospective study 119 (9.1 per cent) of 1311 patients undergoing peptic ulcer surgery developed postoperative bile vomiting. Patients aged over 60 years at operation appeared particularly at risk. The sex distribution was equal. Operations that aim at reducing acid secretion had a similar incidence of vomiting, although the complication was not seen following 55 simple gastrojejunostomies. Vomiting developed within I month of operation in 39 per cent of patients, and 57 per cent suffered a significant degree of disability for 6–14 years after onset. Twenty-four per cent of patients underwent reoperation. Aetiological factors were gastric outlet obstruction and gastritis due to bile reflux; pre-existing constitutional and psychological abnormality seldom contributed significantly to the syndrome. It is concluded that bile vomiting as a persistent and disabling complication of gastric surgery demands objective physical and psychological assessment prior to a decision regarding management.
Oesophagogastrectomy in the treatment of malignancy of the thoracic oesophagus and cardia
Authors: Leverment J N , Milne D Mearns 
Published: March 2007

Abstract
Of 452 patients suffering from malignancy of the thoracic oesophagus and cardia of the stomach, 381 were treated by oesophagogastrectomy.
The need for early diagnosis is stressed in that palliation is all that can be achieved by this method of treatment in most cases, but palliative resection appears to offer the patient a better chance of survival and a more satisfactory relief of his distressing symptoms than palliative intubation.
The hospital mortality has been relatively high. However, surgical experience, improved anaesthetic technique and the recent establishment of postoperative intensive cure facilities have resulted in a marked decrease in this mortality, while still maintaining a high resection rate.
The causes of death and pathology encountered are also discussed.
The use of angiography in a case of recurrent epistaxis after multiple arterial ligation
Authors: Taylor P H , McCall I W 
Published: March 2007

Abstract
A patient with severe recurrent epistaxis which persisted despite multiple arterial ligation is described. The place of this procedure in the management of epistaxis is discussed. In the present case the bleeding was due to an underlying haemangioma which could only be demonstrated by angiography. It is suggested that this investigation should be carried out in patients who fail to respond to concentional treatment for recurrent epistaxis.
The Limulus test in experimental and clinical endotoxaemia
Authors: Fossard D P , Kakkar V V 
Published: March 2007

Abstract
Gram-negative septicaemia is being recognized (is an increasingly common cause of mortality in hospital practice. In this paper the value of a simple and rapid test which can be used to detect the presence of circulating endotoxins is assessed in experimental and clinical situations. The test is based on the ability of Gram-negative endotoxins to coagulate a protein moiety obtained from the horseshoe crab (Limulus polyphemus).
The sensitivity of a highly purified lysate when measured in vitro showed a positive Limulus test with as little as 510 μg/ml of endotoxin. In experimental animals we were able to detect endotoxin in the portal circulation only after the endotoxin was injected into the peritoneal cavity or when the bowel was made ischaemic or perforated, but never spontaneously.
The clinical studies were performed in 50 surgical patients to determine if the Limulus test was useful in detecting endotoxaemia. Seventeen patients were diagnosed clinically as having local infection, and Gram-negative organisms were cultured from various sources in 16. Fifty-one (77per cent) out of 66 Limulus tests performed during the episode of infection were positive, while only 1 (3 per cent) of the tests was positive once the infection had been adequately treated. Four patients in this group had persistent endotoxaemia, and all died. In the 8 patients with generalized peritonitis, 16 (73 per cent) out of 17 Limulus tests performed were positive at the time of peritonitis. In 25 patients with no clinical evidence of infection or peritonitis, 19 (18 per cent) out of 125 Limulus tests were positive.
The patients were also screened by the 125I-fibrinogen test for the presence of deep vein thrombosis, which was found in 13 (26 per cent). Thrombosis was detected in only 3 (19 per cent) of 16 patients in whom the Limulus test was negative throughout the investigation period. In contrast, 10 (29 per cent) of 34 patients who had positive Limulus tests developed thrombosis. In 6 the disease was bilateral, 5 had extensive thrombi which involved the major veins and 1 of these subsequently had a massive pulmonary embolism.
The implications of these findings and the use of the Limulus test in clinical practice are discussed.
Serum fibrin/fibrinogen degradation products after experimental pulmonary embolism
Authors: Jones D R B , Ruckley C V , Owens Rosemary , Cash J D 
Published: March 2007

Abstract
Serum fibrin/fibrinogen degradation products (FDP)have been measured for up to 12 hours after pulmonary embolism in 11 anaesthetized dogs. Embolism was produced by the reinjection of 3 ml/kg of clotted autologous blood. Five control animals received a similar volume of injected saline.
There was a significant increase in FDP levels in 8 out of 11 animals. The rise appeared within 10 minutes and reached a maximum at 30-60 minutes. High levels were sustained for up to 7 hours. There was considerable individual variation in response.
A second embolus 4 hours after the first in 5 animals tended to produce a greater increase in FDP.
The effect of truncal and selective vagotomy on the release of pancreatic glucagon, insulin and enteroglucagon
Authors: Russell R C G , Thomson James P S , Bloom S R 
Published: March 2007

Abstract
To study the effect of vagotomy on the endocrine function of the pancreas, plasma pancreatic glucagon levels were studied during insulin-induced hypoglycaemia, and the plasma insulin and enteroglucagon levels after an oral hypertonic glucose meal, These tests were performed on patients who had either a truncal or selective vagotomy, all of them also having a drainage procedure.
The rise of pancreatic glucagon levels during hypoglycaemia was significantly less in the truncal vagotomy group compared with the selective vagotomy group. The rise of enteroglucagon in the two groups was identical, but whereas in those with a selective vagotomy there was a significant correlation between the rate of rise of the plasma enteroglucagon and the 2-hour insulin output, no such correlation was present in those having a truncal vagotomy.
These results are interpreted as indicating that division of the coeliac branch of the vagus nerve impairs the pancreatic secretion of both glucagon and insulin.
Simplified repair of abdominal aortic aneurysms using non-bifurcated (straight) inlay prostheses
Authors: Orr W McN , Davies M 
Published: March 2007

Abstract
The treatment of abdominal aortic aneurysms by prosthetic replacement is still attended by considerable hospital mortality, particularly when rupture has already occurred. We consider that the results could be significantly improved by the more widespread use of a simplified repair which consists of the insertion of a non-bifurcated (straight) tubular inlay prosthesis within the aneurysm. No attempt is made to resect or to transect the aorta and its bifurcation is preserved.
In a series of 61 consecutive patients, from which 4 were excluded because they died before definitive surgery, there were 30 intact and 27 ruptured aneurysms. The hospital mortality for prosthetic replacement of intact aneurysms was 15 per cent using bifurcation grafts in 20 patients and nil for straight prostheses in 10 patients. The respective figures for leaking aneurysms were 64 per cent in 14 patients and 38 per cent in 13 patients.
In our experience this simplified technique has resulted in diminished hospital mortality as a consequence of reduced operating times, blood loss and postoperative morbidity. It can, moreover, be universally employed except where gross separation of the origin of the common iliac vessels has occurred, which is uncommon, or in the rare instance of coexistent acute limb ischaemia.
Vertebral osteomyelitis: A complication of urological surgery
Authors: Hale John E , Aichroth Paul 
Published: March 2007

Abstract
Three patients who developed vertebral osteomyelitis following genito-urinary surgery are presented. In each patient a persistent urinary tract infection was noted. Some months after operation these patients developed severe back pain, hut the correct diagnosis WIS not made initially because spinal X-rays were at first normal. In I patienr an abnormal gamma bone scan was thought, mistakenly, to be diagnostic of metastatic bone disease and it was only when the pain increased after radiotherapy that a diagnosis of. spinal osteomyelitis was considered.
The incidence of vertebral osteomyelitis in adults uppears to be increasing, and in order to make the correct diagnosis a high index of clinical suspicion is essential, particularly in patients who have had recent operations on the genito-urinary system.
Epicardial electrode implantation on both right and left ventricles using local anaesthesia
Authors: Guharay B N , Saha A K , Mittra D , Visvanathan Sushila , Gupta S M Sen , Basu A K 
Published: March 2007

Abstract
Experience with a simple method of epicardialintramural pacer lead implantation on either ventricle using local anaesthesia for long term cardiac pacing in cases of symptomatic heart block is presented. The report concerns 40 patients with 41 implants. The follow-up period was 6–19 months. There were 3 operative deaths. One of the deaths was coincidental and the other 2 were attributed to bad selection. Early electrode failure due to the development of an exit block occurred in 1 case; he has done well after his right ventricular electrode was transferred to the left ventricle through the same incision using local anaesthesia. There has been no late electrode failure. Nearly all the survivors have obtained excellent results.
The distinct advantages offered by this technique of epicardial pacing are discussed.
The modification which has been introduced in extending the scope of pacer lead implantation to the left ventricle has increased the usefulness of the technique. Left ventricular placement of the electrode assures better intramural pacing.
A comparison of gastric emptying at 3 and 12 months after proximal gastric or selective vagotomy without pyloroplasty
Authors: Donovan I A , Clarke R J , Gunn I F , Alexander-Williams J 
Published: March 2007

Abstract
A prospective study was performed to determine whether the early postoperative disturbance of gastric emptying after vagotomy altered with the passage of time. In 20 patients the rate of emptying of a 10 per cent dextrose meal was measured by a double sampling dye dilution technique before and 3 months after proximal gastric vagotomy or selective vagotomy without a drainage procedure. Ten of these patients agreed to a further emptying study at 12 months after operation.
Profound changes in the pattern of emptying occurred as a result of either operation. At 3 months after operation both selective and proximal gastric vagotomy were associated with an initial cascading of part of the meal (gastric incontinence). Selective vagotomy was then associated with an increase in the time taken for complete emptying, whereas after proximal gastric vagotomy the time taken for complete emptying was similar to that before surgery. In the next 9 months after operation no significant change occurred in the initial cascading, but the delay in complete emptying after selective vagotomy improved in some patients.
Rupture of the retroperitoneal duodenum after blunt abdominal trauma
Authors: Rasaretnam Rudra , Thavendran A 
Published: March 2007

Abstract
Four cases of rupture of the retroperitoneal part of the duodenum after blunt abdominal trauma are documented. Two of the patients continued with normal activity for some hours before presenting at hospital, and although the other 2 presented shortly after the injury, the diagnosis in both was made after a period of observation. Repeated abdominal examination is the best aid to diagnosis. Rupture of the second part of the duodenum is more common, Delay in diagnosis is associated with a high mortality.