bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bush thoracotomy in the Highlands of Papua New Guinea
Authors: Fingleton L J 
Published: March 2007

Abstract
Bush thoracotomy is a procedure performed by traditional medicine men to let out blood and pus from the chest. It has a significant complication rate and 60 cases presenting to the major hospital in Papua New Guinea are analysed over a 2-year period. The complications were empyema (40), osteomyelitis of the rib (2), wound infection (2), pneumothorax (1), neuralgia (1) and chest pain (4). All cases were further complicated by underlying pulmonary infection and often by delay in presentation. Fifteen cases were seen in the first year (1983–84) and forty-five in the second (1984–85). A more aggressive surgical approach was adopted in the second year (21 thoracotomies with 17 decortications compared with 1 thoracoplasty in the first year). However, this course of events was accompanied by an increase in mortality from 0 to 5. Although there were a number of contributory factors, lesser surgical procedures, such as open pleural drainage, are recommended for the sicker patients.
The intragastric balloon: A novel idea proved ineffective
Authors: McFarland R J , Grundy A , Gazet J-C , Pilkington T R E 
Published: March 2007

Abstract
Twelve grossly obese patients who weighed 121 ± 22 kg (mean ± s.d.) had a free-floating 600 ml spherical intragastric balloon inserted per -oesophagus and have been followed for 12–24 months. Nine patients lost up to 21 kg (11 ± 6·4 kg) over 3 months after which they reached a plateau and then regained weight so that by 1 year only one patient had maintained her weight loss. Three patients could not tolerate the balloon owing to complete reflex inhibition of gastric emptying. Such marginal and temporary weight loss is of no value in the treatment of gross obesity.
The lower oesophageal sphincter after floppy Nissen fundoplication
Authors: Bancewicz J , Mughal M , Marples Margaret 
Published: March 2007

Abstract
The pressure and intra-abdominal length of the lower oesophageal sphincter (LOS) were measured by oesophageal manometry before and after floppy Nissen fundoplication (FNP) for intractable gastro-oesophageal reflux. Control of reflux was assessed by 24 h pH recording and endoscopy. It was complete in 67 cases (84·8 per cent) in this non-consecutive series. In the group as a whole LOS pressure increased significantly after FNP, but the intra-abdominal length did not. LOS pressure decreased in 21 cases of whom 16 (76·2 per cent) still had perfect reflux control. Likewise, intra-abdominal length decreased in 41 cases of whom 36 (87·8 per cent) had good reflux control. There was no evidence of a compensatory increase in length to account for reflux control when LOS pressure decreased. When a length—pressure diagram was plotted for the postoperative measurements no clear separation of those with persistent reflux could be seen. These results suggest that the measured changes in LOS pressure and length following FNP are an artefact of surgery rather than the means by which the operation controls gastro-oesophageal reflux.
Dietary habits of patients with regurgitation after colon interposition
Authors: Harju E , Isolauri J 
Published: March 2007

Abstract
The dietary habits after colon interposition following oesophagectomy in patients without symptoms (n = 8), with regurgitation (n = 22) and in sex-and age-matched healthy controls (n = 20) were studied by a 7-day diary method. The patients ate smaller meals (1080 ± 90 kJ versus 1810 ± 151 for the controls, P &lt;0·01), more frequently during the day (eight versus five in the controls). Solid and sour foods were preferred, especially by those with regurgitation, compared with controls. The asymptomatic patients consumed more milk and coffee and less cheese, sour milk, meat, fish, eggs, tea and orange juice than the patients with regurgitation. Vegetable fats and medium chain triglycerides were consumed in negligible amounts. The patients with regurgitation had more fluids separately from meals than the asymptomatic patients. The results suggest that intake of vitamin supplements and replacement of animal fats by vegetable fats may be useful in these patients. Much of the dietary difficulties after colon interposition might be the result of the intra-abdominal colon graft loop anastomosed to the antrum; a short graft with a more proximal anastomosis to the lesser curvature merits study in this context.
Accuracy of suture placement
Authors: Seki S 
Published: March 2007

Abstract
Three groups of seven surgeons were each randomly selected from three larger groups with surgical experience of &lt;1, 6–10 and 16–20 years. Each surgeon was asked to aim a needle at an exit point using two methods: ‘jiggling’ (readjustment of the needle in aiming at the target) allowed and jiggling not allowed. The results were not as precise as expected. An improvement from group 1 to group 2 was noticed in both methods (P &lt;0·01), but from group 2 to 3 there was improvement only in the method where jiggling was allowed (P &lt;0·01). All groups showed a tendency to overshoot the target (P &lt;0·01): a shift towards the surgeon in group 1(P &lt;0·05) and towards the opposite side in groups 2(P &lt;0·01) and 3 (P &lt;0·05). Jiggling significantly reduced the inaccuracy, and it was concluded that pinpoint accuracy improved with surgical experience. However, the experienced surgeons improve their accuracy by jiggling, with the potential danger of tissue damage by needle adjustment.
Favourable response to conservative surgery for extra-pancreatic gastrinoma with lymph node metastases
Authors: Bornman P C , Marks I N , Mee A S , Price S 
Published: March 2007

Abstract
Five patients with the Zollinger—Ellison syndrome who had extra-pancreatic (duodenal or paraduodenal) gastrinoma with lymph node metastases responded favourably to simple excision or mere shelling out of macroscopic tumour. Acid studies, serum gastrin and the secretin test became normal in all cases in the immediate postoperative period and remained so in three of the five patients when tested at 57, 33 and 8 months. The tests became abnormal in two patients when tested 8 and 53 months after surgery, but both patients are currently well-controlled on ranitidine 150 mg b.d. 22 and 65 months respectively after surgery. These results suggest that in patients with extra-pancreatic gastrinoma who have lymph node metastases simple excision of all macroscopic tumours may offer the prospect of long-term control. The place of total gastrectomy in such patients is questioned.
Cyclical mastalgia: Clinical and mammographic observations in a screened population
Authors: Leinster S J , Whitehouse G H , Walsh P V 
Published: March 2007

Abstract
The incidence of cyclical mastalgia in well women presenting for breast screening was 69 per cent. The incidence of cyclical mastalgia increases with age up to the menopause. There was a higher incidence of ‘high risk’ mammographic patterns and a lower incidence of ‘low risk’ patterns, according to the Wolfe classification, in women with cyclical mastalgia compared with the rest of the screened population. This finding correlated with the severity, duration and need for treatment. The differences in breast pattern did not persist after the menopause. The question of whether or not cyclical mastalgia can be regarded as a risk factor for breast cancer is uncertain and needs further evaluation.
Prospectively randomized clinical trial to compare in situ and reversed saphenous vein grafts for femoropopliteal bypass
Authors: Harris P L , How T V , Jones D R 
Published: March 2007

AbstractTwo hundred and fifteen femoropopliteal bypass procedures using autologous saphenous vein grafts were randomly allocated to either the reversed or in situ technique. Eleven veins (5 per cent) were rejected at operation on the basis of their small size, nine in the reversed group and two in the in situ group, and there were two (2 per cent) perioperative deaths in each group, leaving 102 reversed and 98 in situ grafts for further study. The cumulative patency at 3 years of the reversed grafts was 77 per cent and that of the in situ grafts was 68 per cent (n.s.). The patency of all grafts was affected adversely by small veins (P &lt;0·005), long grafts (P &lt;0·05), low volume of blood flow in the grafts (P &lt;0·001) and poor run-off (P &lt;0·05). These factors influenced the outcome of the in situ and reversed operations to a similar degree and there was no statistically significant difference between them within any subgroup. The mean compliance of the in situ grafts measured 3 months or more after operation with an ultrasonic echo-tracking system was 0·024 ± 0·01 per cent/mmHg (± s.d.) compared with 0·017 ± 0·01 per cent/mmHg for the reversed grafts (t = 2·43, P &lt;0·02). The incidence of fibrous stricture formation as shown by intravenous digital subtraction angiography was 29 per cent in both the reversed and the in situ grafts. The results of the study to date indicate that reversed and in situ vein grafts are equally effective for femoropopliteal bypass.
Transcranial Doppler assessment of cerebral collateral during carotid endarterectomy
Authors: Padayachee T S , Gosling R G , Lewis R R , Bishop C C , Browse N L 
Published: March 2007

Abstract
Sixteen patients (mean age 59 ± 9 years) who were to undergo carotid endarterectomy were examined pre- and peroperatively using pulsed Doppler-shifted ultrasound; blood velocities in the middle cerebral artery were measured before and during common carotid compression in the conscious patient, and before and during measurement of carotid stump pressures at surgery in the anaesthetized patient. Measurements at endarterectomy showed a significant difference in middle cerebral artery blood velocities from patients with stump pressures of greater and less than 50 mmHg (t = 4·0, P &lt;0·005). A threshold of 10 cm s−1 distinguished between stump pressures of greater and less than 50 mmHg in 15 of the 16 patients. Pre-operative blood velocity measurements during carotid compression did not correlate with those taken peroperatively at carotid clamping.
Acute superior mesenteric ischaemia
Authors: Wilson C , Gupta R , Gilmour D G , Imrie C W 
Published: March 2007

AbstractA review of case records and post-mortem reports from Glasgow Royal Infirmary over the past 12 years identified 102 patients with acute superior mesenteric ischaemia, 53 (52 per cent) of whom were first diagnosed at post mortem. Overall mortality was 92 per cent and mortality in the 49 patients diagnosed in life was 84 per cent. Fourteen patients (14 per cent) underwent exploratory laparotomy only with no survivors, 26 (25 per cent) had bowel resection alone with 7 surviving, and 9 (9 per cent) had a revascularization procedure, 5 requiring additional bowel resection, with only one surviving. Survivors were usually younger, had a shorter history and less extensive bowel infarction. Improvements in intensive care and nutritional support with the greater use of revascularization procedures in the past 6 years have barely influenced mortality. Delays in diagnosis and treatment contribute to the poor results. Earlier diagnosis might be aided by measuring serum inorganic phosphate and, coupled with the more widespread use of emergency angiography and revascularization procedures, holds out the best hope for future improvement.
Prevention of gastric mucosal lesions following aortic cross-clamping
Authors: Svensson L G , Von Ritter C , Oosthuizen M M J , Fimmel C J , Rickards Elizabeth , Hunter Shelagh J S , Robinson Marion F , Hinder R A 
Published: March 2007

Abstract
Stress ulceration is frequently encountered after cardiovascular surgery. In this study of 32 male baboons, severe gastric ischaemia was used to produce gastric stress lesions. The occurrence of these lesions was reduced by allopurinol (P = 0·03) and completely prevented by the combination of allopurinol with superoxide dismutase (P = 0·004). A shorter ischaemic period also reduced the number of lesions (P = 0·02). Concurrent with the stress lesion formation, there was a fall in mucosal glutathione and oxidized glutathione levels (P &lt;0·05).
Effect of duodenogastric reflux on gastric mucosal proliferation after gastric surgery
Authors: Houghton P W J , McC. Mortensen N J , Williamson R C N 
Published: March 2007

Abstract
The effect of duodenogastric reflux on cell proliferation and mucosal mass in the stomach was studied. Male Wistar rats (n=118) were submitted to Polya partial gastrectomy, partial gastrectomy with Rouxen-Y diversion of bile, total duodenogastric reflux or handling of the stomach alone (sham operation). Following oral administration of the carcinogen N-methyl-N′-nitro-N-nitrosoguanidine for 6 months, animals were killed 6, 9 or 12 months postoperatively and their stomachs were examined for crypt cell production rate and mucosal DNA content. Compared with shams, crypt cell production rate was more than twice as high in the gastric remnant 12 months after Polya partial gastrectomy (P &lt;0·001) and median DNA content was 31 per cent greater (P = 0·05). After total duodenogastric reflux, DNA content was 62 per cent greater than in shams (P = 0·02), while Roux-en-Y diversion reduced crypt cell production rate by 65 per cent (P &lt;0·001). Only Polya gastrectomy increased the number of rats developing gastric carcinomas (9 versus 2 shams; P &lt;0·05). Increased mucosal cell proliferation in rats with duodenogastric reflux may help to explain the development of gastric stump cancer.
Plunging ranula: A report of three cases and review of the literature
Authors: Parekh D , Stewart M , Joseph C , Lawson H H 
Published: March 2007

Abstract
Three cases of plunging ranula are reported and the literature reviewed. Extravasation of saliva from the sublingual gland due to trauma or obstruction of its ducts appears to he the most likely cause of plunging ranula. Available data suggest that the submandibular gland is usually not involved, although at the time of surgery it may be extremely difficult to exclude a submandibular origin of the cyst in the neck. Communication between the oral and cervical components of the plunging ranula probably occur via a hiatus in the mylohyoid muscle. Such communication passing directly into the submandibular compartment may simulate submandibular gland involvement. Since 1910, 139 procedures in 89 patients with plunging ranula have been reported in the English literature. The recurrence rate was 70 per cent after incision and drainage of the cyst, 53 per cent after marsupialization, 85 per cent after excision of the cyst in the neck and 2 per cent after excision of the sublingual gland via the cervical or intra-oral route. This review suggests that excision of the sublingual gland with intra-oral drainage of the cervical swelling appears to be the treatment of choice for the plunging ranula.
Effects of haemorrhage on wound strength and fibroblast function
Authors: Taylor D E M , Whamond J S , Penhallow J E 
Published: March 2007

Abstract
The impairment of healing in laparotomy wounds in rats with compensated oligaemia has been studied in two parallel investigations. Animals-bled 1 ml/100 g body weight (bled) were compared with unbled animals undergoing the same operation (control). Firstly, wounds were assessed after 22 days for strength of skin and muscle layers (11 control: 9 bled). Both layers were significantly weaker in bled animals; by 36 per cent for skin (P &lt;0·02) and by 22 per cent for muscle (P = 0·02). Secondly, wound fibroblast function was assessed after 10 days by quantitative histology and autoradiography (30 control: 31 bled). There were no significant differences between the two groups for fibroblast density, replication ([3H]thymidine), or general protein synthesis ([3H]leucine). Bled animals had less dense collagen packing by 21 per cent (P &lt;0·01), but 33 per cent more incorporation of ([3H]proline by fibroblasts (P &lt;0·01) compared with control animals. The effect of compensated oligaemia on wound healing is more marked in skin than in muscle; it appears to be a specific increase in collagen turnover with the increase in reabsorption exceeding that in synthesis.
Splenectomy in the management of haematological disease
Authors: Dawson Audrey A , Jones P F , King D J 
Published: March 2007

Abstract
Patients, both adults and children, with various haematological disorders who had splenectomy electively in the diagnosis, staging or treatment of their condition during a 15-year period in the Aberdeen hospitals were reviewed. The outcome regarding the disease and the immediate and long-term complications of splenectomy in this group of 185 patients are presented. Splenectomy has an acceptably low morbidity, even in patients with serious haematological disease, in the hands of an experienced surgical team, where there is close co-operation between surgeon and haematologist. Occasionally, late overwhelming infections may occur, despite prophylaxis with penicillin and pneumococcal vaccination. It seems likely that, in their zeal to report such hazards, authors may allow the pendulum against splenectomy to swing too far, in the direction of leaving patients, especially adults, with considerable symptoms and poor health, rather than risk the occasional consequences of the asplenic state.
Assessment of ornithine decarboxylase activity in rectal mucosa as a marker for colorectal adenomas and carcinomas
Authors: Moorehead R J , Hoper Margaret , McKelvey S T D 
Published: March 2007

Abstract
We have investigated the role of ornithine decarboxylase activity in rectal mucosa as a marker for colorectal neoplasia. Biopsies of normal rectal mucosa were taken from 18 patients with adenomas &gt; 1 cm diameter, 11 with carcinomas and 16 controls. The mean ornithine decarboxylase activity in normal rectal mucosa of adenoma patients, 6·52 nmol CO2 released h−1 (mg cell protein)−1, was significantly lower than that in controls, 16·8, P = 0·006. The difference in rectal ornithine decarboxylase activities between cancer patients, 3·58, and controls was also significant, P = 0·001. These preliminary results suggest that ornithine decarboxylase may be a useful marker in screening for colorectal neoplasia.
Influence of sialomucin at the resection margin on local tumour recurrence and survival of patients with colorectal cancer: A multivariate analysis
Authors: Dawson P M , Habib N A , Rees H C , Williamson R C N , Wood C B 
Published: March 2007

Abstract
In a multicentre prospective trial 358 patients undergoing curative surgery for colorectal cancer were followed for a median 18·0 months (± 7·2 months). The presence or absence of sialomucin in either resection margin was studied using the high iron diamine-alcian blue stain. There was evidence of excess sialomucin at one or other resection margin in 106 patients (29·6 per cent). Apart from sigmoid carcinomas occurring more often in the sialomucin positive group, there were no significant differences in any histological or clinical parameters between groups. Survival analysis for the events ‘death’, ‘local recurrence’, and ‘all recurrence’ was undertaken using the Cox regression model. The best prognostic variables selected in a stepwise fashion for death and all recurrence were ‘Dukes' classification’, ‘sialomucin present’ and ‘histological differentiation’. The best prognostic variables selected for local recurrence were ‘sialomucin present’, ‘Dukes' classification’ and ‘histological differentiation’. Sialomucin in a resection margin is an important independent prognostic variable for the development of local tumour recurrence and of subsequent survival for patients with colorectal carcinoma.
Outcome of colorectal cancer
Authors: Pescatori M , Mattana C , Maria G , Ferrara A , Lucibello L 
Published: March 2007

Abstract
The outcome of 454 patients who presented with colorectal carcinoma during a 16 year period is reviewed: 54 per cent were males, 58 per cent were aged more than 60 and 10 per cent had an emergency admission, 42 per cent of tumours occurred in the rectum. A curative resection was possible in 68 per cent. Postoperative mortality was 7 per cent. The overall crude 5-year survival was 41 per cent. The mortality from local recurrence was significantly higher in rectal (11·7 per cent) than in colonic cancer (8·8 per cent; P&lt;0·01). The rate of recurrence and metastases was higher in patients with low rectal cancer than in patients with cancer of the middle and the upper rectum (P&lt;0·01). Distant metastases were the cause of death in 94 per cent of the patients who had a Miles' operation for cancer of the middle rectum, whereas local recurrence was responsible for late mortality in 80 per cent of patients who underwent an anterior resection. No difference in 5-year survival was found in the restorative and in the excisional group.
Adenomatous polyposis: An association with carcinoma of the thyroid
Authors: Plail R O , Bussey H J R , Glazer G , Thomson J P S 
Published: March 2007

Abstract
A review of the St Mark's Hospital Polyposis Registry has revealed an association between adenomatous polyposis (familial polyposis coli) and thyroid carcinoma. Even though full clinical information was unavailable on all patients in the registry, it is evident that young women (below 35 years of age) are at particular risk of developing thyroid cancer, mainly of a papillary type, their chances of being affected being approximately 160 times that of normal individuals. All patients with adenomatous polyposis should thus have regular thyroid examination.
Sliding flap advancement for the treatment of high level fistulae
Authors: Wedell J , Meier Zu Eissen P , Banzhaf G , Kleine L 
Published: March 2007

Abstract
The technique of sliding flap advancement for the treatment of high anal fistulae is described. The technique is not suitable for cases with an acute abscess and is reserved for patients with a well-established chronic fistula track. Thirty patients with anal fistulae were treated by sliding flap advancement from 1980 to 1984. Twenty-nine patients had satisfactory results. With a follow-up ranging from 18 months to 4 years no recurrence of fistulae or abscess were observed. The advantages of the advancement flap technique over the staging division technique with application of a seton and over the rerouting technique are discussed.
New physiological method of evaluating oesophageal transit
Authors: Cranford C A , Sutton D , Sadek S A , Kennedy N , Cuschieri A 
Published: March 2007

Abstract
A method of measurement of oesophageal transit time in the upright posture of a chewed solid bolus has been developed and assessed in normal volunteers (n = 16) and in 32 patients with oesophageal disease: organic stricture (n = 5), oesophageal motility disorders (n = 19) and reflux oesophagitis without stricture formation (n = 8). The test involves swallowing a 10 ml poached egg white bolus labelled with 99mTc sodium pertechnetate and external scanning by a gamma camera. An on-line computer program allows detailed analysis by the condensed image technique (which demonstrates the pattern of oesophageal transit) and activity-time curves for the whole, the upper, middle and lower thirds of the oesophagus. The reproducibility of the test is good (coefficient of variation of the total transit of 14 per cent). The results on the normal volunteers have shown that oesophageal transit slows in an aboral direction with transit being faster in the upper, when compared with the middle and lower thirds. The test clearly differentiates patients with oesophageal disease from the normal. The condensed image analysis appears to be useful in outlining the pattern of transit in patients with motility disorders. Patients with reflux oesophagitis have delayed oesophageal transit.