bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of fistula-in-ano complicating anorectal sepsis: A prospective study
Authors: Henrichsen S , Christiansen J 
Published: March 2007

Abstract
The incidence of fistula-in-ano following anorectal abscesses was studied prospectively in 50 consecutive patients. A total of 13 patients (26 per cent; 95 per cent confidence limits: 14–40) had a fistula diagnosed either in the acute phase or during follow-up within 6 months. Half of the fistulas diagnosed at follow-up were unrecognized by the patients and no fistulas developed in patients where culture from the abscess only revealed skin-derived bacterias. X-ray examination was of no value in the diagnosis of anal fistula.
Colonic haemorrhage: A technique for rapid intra-operative bowel preparation and colonoscopy
Authors: Scott H J , Lane I F , Glynn M J , Theodorou N A , Lloyd-Davies E , Reynolds K W , Parkins R A 
Published: March 2007

Abstract
We describe a new technique of operative orthograde colonic washout followed by colonoscopy for use in patients with severe colonic haemorrhage. We report its use in four patients in whom the exact source of bleeding was localized and treated. In two of these cases a policy of ‘blind’ hemicolectomy would have been incorrect. The technique is simple and safe, and we advocate its use during laparotomy for major colonic haemorrhage.
Prostatic carcinoma cell DNA content measured by flow cytometry and its relation to clinical outcome
Authors: Fordham M V P , Burdge A H , Matthews Joyce , Williams G , Cooke T 
Published: March 2007

Abstract
DNA content of prostate tumour cells has been measured by flow cytometry of cell suspensions prepared from fixed tissue by an enzyme disaggregation technique. Two classes of tumours have been identified: diploid tumours, with a DNA content similar to benign cells and aneuploid tumours with grossly abnormal DNA values. The prognosis for the aneuploid tumours was significantly worse than diploid tumours (P &lt; 0.001). When ploidy is combined with histological grading, here using the Gleason numerical system, it is possible to predict which patients, whatever their age at diagnosis, will die from their tumour and which patients will probably die before their tumour kills them. With these facts it is possible to select patients for active or expectant treatment.
Pancreatic debridement in acute necrotizing pancreatitis: An obsolete procedure?
Authors: Smadja C , Bismuth H 
Published: March 2007

Abstract
Thirty-eight patients treated by pancreatic debridement for acute necrotizing pancreatitis were studied. Group 1 consisted of 12 critically ill patients who underwent early surgery. Group 2 was formed from 15 patients operated upon secondarily for supervening complications and group 3 contained 11 patients operated upon electively for gallstone pancreatitis. The operative mortality was 100, 27 and 0 per cent for groups 1, 2 and 3 respectively. Pancreatic debridement was associated with a high morbidity whether performed for complications (66 per cent) or elective biliary surgery (36 per cent). These data suggest that there is probably only limited indication for pancreatic debridement in patients with acute necrotizing pancreatitis.
New cervical approach for tracheopexy
Authors: Vaishnav A , Mackinnon A E 
Published: March 2007

Abstract
Deficiency of the tracheal cartilage is known to occur with oesophageal atresia resulting in abnormal compressibility. It does not require treatment unless symptomatic. Symptoms comprise apnoeic or cyanotic spells, often precipitated by feeds, and recurrent chest infections. When other causes such as stricture, recurrent fistula and gastro-oesophageal reflux have been excluded, the abnormality can be diagnosed radiologically and endoscopically. Previously tracheopexy through a lateral thoracic approach has been described. We describe three patients who had a successful tracheopexy through an anterior cervical approach, which is simpler, and a fourth in whom there was partial alleviation.
Gastric polyposis and malignancy
Authors: Harju E 
Published: March 2007

Abstract
Gastric malignancies developed in 15 patients with gastric polyps (seven men, eight women; mean age 66 ± 8.8 years) during a 14-year follow-up of 170 patients (8.8 per cent). The polyps were hyperplastic in 90 per cent of the patients, adenomas in 8.2 per cent and leiomyomas in 1.8 per cent. During follow-up 4.7 per cent of the patients had both adenomas and hyperplastic polyps. Ten patients developed adenocarcinoma, two lymphoma, one lymphoid sarcoma, one carcinoid tumour and one severe dysplasia. The incidence of malignancy was sevenfold higher than expected (P &lt; 0.01). There is an associated but lower risk of malignancy in stomachs with hyperplastic polyps than with adenomas; 2 of the 15 stomachs with adenomas and 3 of the 142 hyperplastic polyps showed later malignancy (P &lt; 0.001). Before the diagnosis of malignancy 1.1 ± 1.4 (0–4) gastroscopies were done and 12 ± 19 (0–48) months had elapsed since the first examination and detection of polyps, whereas the mean number of gastroscopies and length of follow-up period in all patients with polyps was 1.9 ± 0.9 (0–10) and 68 ± 35 (0–156) months, respectively. Eleven patients had a stage I malignancy and four had a stage IV tumour. The survival rate of the eight patients with malignancy found at the first examination was better (6/8) than for those diagnosed during the follow-up period (3/7) (P &lt; 0.01; x2 test). The results show the high risk of malignancy in stomach polyps, adenomas or hyperplasia, and stress the importance of careful and repeated examination of these patients.
Haemodynamic assessment of the femoropopliteal segment: Comparison of pressure and Doppler methods using ROC curve analysis
Authors: Baker A R , Evans D H , Prytherch D R , Bell P R F 
Published: March 2007

Abstract
Combined aorto-iliac and femoropopliteal vascular disease remains a problem in vascular surgery. Arteriography does not provide information on the relative contributions of the two lesions to the presenting symptoms. Aorto-iliac haemodynamics may reveal occult aorto-iliac disease but does not show whether combined proximal and distal reconstruction will be required to provide symptomatic relief. Haemodynamic assessment of both segments may help in this respect. A haemodynamic assessment of the femoropopliteal segment of 72 limbs in 38 patients is reported. The segmental pressure drop between a common femoral arterial cannula and a below-knee occlusion cuff is compared with a non-invasive Doppler method combining both transit time and damping factor. Comparison is made using receiver operating characteristic (ROC) curve analysis. The measurement of segmental pressure drop is more accurate than the Doppler method in detection of femoropopliteal stenoses of greater than 50 per cent of the luminal diameter (P &lt; 0.05).
Effect of the cyclo-oxygenase inhibitor indobufen on platelet accumulation in prosthetic vascular grafts
Authors: Lane I F , Irwin J T C , Jennings S A , Poskitt K R , Meek A C , McCollum C N 
Published: March 2007

Abstract
An in vivo method of measuring thrombus deposition and pseudo-intimal thickening in prosthetic arterial grafts in an animal model is described. The effect of indobufen, a new cyclo-oxygenase inhibitor, was evaluated and compared to aspirin plus dipyridamole and placebo in 24 greyhounds. Luminal platelet accumulation expressed as thrombogenicity index was 0.33 ± 0.07 in the placebo group. This was significantly reduced to 0.14 ± 0.01 by indobufen (P&lt;0.05). The reduction to 0.19 ± 0.04 by aspirin plus dipyridamole failed to achieve statistical significance. Pseudointimal thickness when measured 28 days after implacement was significantly reduced to 21.4 ± 10.6 per cent by indobufen (P&lt;0.01) and 29.4 ± 10.6 per cent by aspirin plus dipyridamole (P&lt; 0.02) compared to 75 ± 10 per cent found in the placebo group. This prosthetic graft model has considerable advantages in the evaluation of potential platelet inhibitory drugs for use in vascular surgery.
De-functioning stomas: A prospective controlled trial comparing loop ileostomy with loop transverse colostomy
Authors: Williams N S , Nasmyth D G , Jones D , Smith A H 
Published: March 2007

Abstract
Patients undergoing colorectal surgery who required a defunctioning stoma were randomly allocated to receive either a loop ileostomy (n = 23) or transverse loop colostomy (n = 24). Assessment was made during construction, immediately postoperatively, during the period of outpatient supervision and before and after stoma closure. The ileostomy was associated with significantly less odour than the colostomy (P&lt;0.01) and required significantly less appliance changes (P&lt;0.05). Furthermore eleven patients (58 per cent) with a colostomy experienced three or more problems with stoma management compared with only three patients (18 per cent) with an ileostomy (P&lt;0.05). Wound infection was also significantly more common after closure of the colostomy compared with the ileostomy. Both types of stoma were demonstrated objectively to defunction the distal bowel almost completely. These results indicate that a loop ileostomy is the procedure of first choice when a stoma is needed to defunction the distal colorectum.
Management of the septic complications of diverticular disease
Authors: Lambert M E , Knox R A , Schofield P F , Hancock B D 
Published: March 2007

Abstract
One hundred and five patients underwent surgical treatment of septic complications of diverticular disease. In nine cases, operation was carried out for acute large bowel obstruction and in the remainder for peritonitis. An inflammatory mass and/or localized abscess was found in 23 cases. Free pus without evidence of ‘communicating’ perforation was found in a further 33 and ‘communicating’ perforation in 40. Treatment by primary resection or by transverse colostomy and drainage were both associated with significantly lower mortality from sepsis than treatment by drainage alone. In cases without ‘communicating’ perforation, there was no difference in mortality between primary resection and transverse colostomy with drainage. Although the advantage of primary resection was most apparent in cases with ‘communicating’ perforation, it did not reach statistical significance. In three cases treated primarily without resection the pathology was subsequently found to be that of carcinoma. In ‘favourable’ circumstances, i.e. without ‘communicating’ perforation, defunctioning colostomy with drainage has an acceptably low mortality rate and may be undertaken by a less experienced surgeon to avoid a difficult resection. Ideally these problems should be dealt with by an experienced surgeon; we prefer to treat the septic complications of diverticular disease by primary resection.
Carcinoma of the breast associated with pregnancy
Authors: Ribeiro G , Jones D A , Jones M 
Published: March 2007

Abstract
A series of 178 patients in whom carcinoma of the breast was associated with pregnancy has been analysed. In 121 patients the carcinoma was diagnosed during pregnancy (CP group) and in 57 patients the pregnancy occurred subsequent to definitive treatment for primary breast carcinoma (SP group). Patients presented with more advanced disease in the CP group, 72 per cent being axillary node positive. Only 37 per cent of the 121 patients survived 5 years, although 79 per cent of the node negative patients survived 5 years. Survival was not affected by age, nor by the phase of pregnancy during which the carcinoma was diagnosed or treated. The majority of pregnancies (79 per cent) ended in the delivery of a normal child. The 5 year survival of the 57 patients in the SP group was 69 per cent. However only 26 per cent of the patients who had positive nodes at the time of primary surgery were disease free 10 years later. This fact should be borne in mind when considering the continuation of the pregnancy.
Supplement feeds and nitrogen and calorie balance following femoral neck fracture
Authors: Stableforth P G 
Published: March 2007

Abstract
A 10 day study of nitrogen and calorie balance has been undertaken in 61 women patients aged 65–96 years (mean age 81 years) with femoral neck fractures. All underwent fracture surgery with an inhalation anaesthetic lasting from 45 min to 2 h. Intake of ward food varied widely but was always low with a mean of 127 mg N kg−1 and 17 kcal kg−1 daily. Daily nitrogen production was 85–250 mg N kg−1 (mean 158 mg N kg−1) and calorie expenditure was 17–48 kcal kg−1 (mean 32 kcal kg−1). These were greatest in trochanteric fracture patients. Of the 61 patients, 90 per cent were in negative nitrogen balance with a mean 8 day deficit of 411 mg N kg−1 and all in negative calorie balance, mean 141 kcal kg−1. The deficits were greatest in trochanteric fracture patients. Sip feeding with supplementary enriched drinks raised protein and calorie intake substantially. Both nitrogen and calorie balance were significantly improved, but large calorie deficits remained; intolerance of the supplements proved to be a handicap in correcting the deficits in many patients.
Total parenteral nutrition: A four-year audit
Authors: Chang R W S , Hatton I , Henley Judith , Richardson Rosemary , Egail S 
Published: March 2007

Abstract
A four-year audit was carried out on 278 patients who received 289 courses of total parenteral nutrition (TPN) over 5213 patient days in a Saudi Arabian hospital. One hundred and forty-seven patients were discharged healthy, two of these after home TPN. The overall mortality was 36 per cent. ICU patients had the highest mortality (53 per cent). Among the survivors, 74·8 per cent showed an improvement in nutritional status. The incidences of metabolic complications and catheter sepsis were 2·9 per cent and 3·6 per cent, respectively. As a direct result of the audit, changes have been made in protocols and staffing patterns, and an attempt is being made to address the major problem of better selection of patients.
Effect of steel wire sutures on the incidence of chemically induced rodent colonic tumours
Authors: Phillips R K S , Cook H T 
Published: March 2007

Abstract
An experiment is presented which shows that colonic primary tumours cluster around a previously constructed anastomosis and that the choice of suture materials (but not the technique of their insertion) can influence this. In a rodent model where dimethylhydrazine was administered 2 months after surgery, anastomotic tumours were most often seen when wire sutures — as used in the staples of anastomotic stapling guns — had been employed (10 out of 16 large bowel tumours were anastomotic as compared with 2 of 12 in a silk sutured group, P = 0·019). An explanation may be that wire sutures persist much longer than silk (in the experiment, 10 months after insertion, 4 per cent of silk sutures were still present, 15 per cent of wire, P &lt; 0·01). This was translated into a greater degree of scarring at the anastomosis, being most severe in the presence of persisting sutures. Of the 12 anastomotic tumours found in both groups, 7 (58 per cent) were in the minority (17–26 per cent) who had persisting sutures and the remaining 5 in the 47 who had none. Techniques of suturing (needle always passed from the serosa in; needle from mucosa out — the latter in such a way that mucosal cells could be displaced into the bowel wall where it was supposed that they might be more susceptible to subsequent carcinogenesis) did not affect tumour yield. We suggest that non-absorbable sutures, and especially stainless steel wire, should not be used when constructing an anastomosis after large bowel cancer surgery.
Long term follow-up of 100 patients with portal hypertension treated by a modified splenorenal shunt
Authors: Rigau J , Terés J , Visa J , Bosch J , Conesa A , Grande L , Vilar J A , García-Valdecasas J C , Pera C 
Published: March 2007

Abstract
One hundred consecutive Child's A or B patients with portal hypertension who survived the index episode of variceal bleeding were electively treated by a distal splenorenal shunt modified by a retroperitoneal approach. The operative mortality of the whole series was 11 per cent, but fell from 16 per cent in the first 50 patients to 6 per cent in the second half of the series. The median survival probability (68 months) and the 5 year survival rate (52 per cent) of Child's A patients differed significantly from those of Child's B patients (8 months and 15 per cent respectively; P &lt; 0.001). The probabilities of freedom from rebleeding and hepatic encephalopathy at 5 years were also significantly greater in Child's A patients (70 per cent and 70 per cent respectively) than Child's B patients (25 per cent and 30 per cent respectively). These results suggest that the modified distal splenorenal shunt is an effective and relatively safe procedure for the elective treatment of variceal bleeding in Child-Campbell ‘A’ patients but that patients in group B should be considered for other forms of therapy.
Non-operative management of penetrating liver injuries: A prospective study
Authors: Demetriades D , Rabinowitz B , Sofianos C 
Published: March 2007

Abstract
This is a report of a study of 63 cases of penetrating liver injuries. Forty-two patients (67 per cent) who presented with signs of an acute abdomen were operated on. The liver was routinely sutured and drained. There was no incidence of postoperative intra-abdominal sepsis or haematobilia. In the remaining 21 patients (33 per cent) liver involvement was suggested by the fact that the wound was over the liver region, and penetrated the peritoneum, and abdominal paracentesis for blood was positive or the patient was shocked or pale. The patients in this group had a soft abdomen and they were treated conservatively with observation and blood transfusions if necessary. No complications were recorded in this group. It is concluded that many civilian penetrating injuries of the liver may be managed non-surgically. If an operative approach is selected suturing of the liver with drainage is the recommended procedure.
Controlled trial of transcutaneous electrical nerve stimulation (TENS) for postoperative pain relief following inguinal herniorrhaphy
Authors: Gilbert J M , Gledhill T , Law N , George C 
Published: March 2007

Abstract
We have evaluated the effect of transcutaneous electrical nerve stimulation (TENS) on postoperative pain following inguinal herniorrhaphy in a prospective randomized controlled trial. Forty male patients undergoing unilateral inguinal herniorrhaphy for the first time were randomized to receive either active or inactive TENS. Electrical stimulation was delivered by electrodes placed along either side of the wound following operation. An identical apparatus, which did not deliver an electrical current, was applied to control patients. Pain was assessed over the first 3 postoperative days by visual analogue pain scores, expiratory peak flow rates and analgesic requirements. There was no difference between the two groups for pain scores, peak flow rates or analgesic requirements and we conclude that TENS as used in this trial does not reduce postoperative pain. However TENS had considerable patient appeal and many patients believed that it was effective.
Specimen radiology of excised breast lesions
Authors: Farmer E , Kirkpatrick A E , Forrest A P M 
Published: March 2007

Abstract
The value of specimen radiology in the surgical management of palpable breast lesions was assessed in 100 consecutive patients undergoing excision of a palpable breast lump. Only 41 per cent of palpable breast lesions were demonstrable as a radiological abnormality on the excised specimen. The greatest sensitivity was found for lesions which proved to be malignant. Only 27 of 88 benign palpable breast lesions were radiologically visible in the specimen. Surprisingly, only 8 of 13 fibroadenomas were identified as discrete opacities. No residual breast lump was detected on clinical examination in patients reviewed postoperatively, including those patients who had a demonstrable pre-operative mammographic abnormality and a negative specimen radiograph. We conclude that specimen radiology does not contribute to the surgical management of palpable breast lesions.
Antiprotease capacity in acute pancreatitis
Authors: Goodman A J , Bird N C , Johnson A G 
Published: March 2007

Abstract
Serial measurements of circulating antiproteases were carried out on 42 consecutive patients admitted with acute pancreatitis. In the 7 days following admission the serum levels of α1 antitrypsin (α1 AT), α1 antichymotrypsin (α1 ACT) and the trypsin inhibitory capacity (TIC) increased by more than 300 per cent. The serum concentration of α2 macroglobulin (α2M) alone showed a decline which was most profound in those patients with severe acute pancreatitis. Initial experience of fresh frozen plasma as a source of extrinsic antiproteases in severe acute pancreatitis is that it fails to prevent the decline in α2M or increase the already elevated TIC of the patients' serum.
Duodenogastric reflux in rat gastric carcinoma
Authors: Mason R C 
Published: March 2007

Abstract
This study investigated the role of long-term reflux of bile and/or pancreaticoduodenal secretions in the genesis of gastric carcinoma in the rat. Adenocarcinoma, dysplasia and adenocystic proliferation were found only in those animals with reflux of pancreaticoduodenal secretions alone or in combination with bile. No such changes were found in control animals with no reflux or animals with bile reflux alone. The differences in incidence of adenocarcinoma were significant. The presence of adenocarcinoma was not related to the pH of the intragastric contents or to the bacterial flora. This suggests that duodenogastric reflux is implicated in gastric carcinogenesis in the rat and that pancreaticoduodenal secretions rather than bile are responsible.
Cosmetic results of immediate breast reconstruction post-mastectomy: A follow-up study
Authors: Mansel R E , Horgan K , Webster D J T , Shrotria Sunita , Hughes L E 
Published: March 2007

Abstract
We reviewed 95 patients who underwent immediate breast reconstruction at the time of mastectomy at least one year after operation for assessment of cosmetic results and complications. There were 45 rectus abdominis and 38 latissimus dorsi myocutaneous flaps used for reconstruction. Twelve patients had subpectoral implants without a flap. The results show a remarkable concordance of assessment by patient and surgeon: both found simple subpectoral prosthesis insertion to be inferior to flap reconstruction. Flap reconstruction gave satisfactory results in the majority of patients; latissimus dorsi and rectus abdominis flaps gave similar cosmetic results. However rectus abdominis flaps showed a higher complication rate of flap necrosis and incisional hernia of the abdominal wound. Psychological assessment showed no differences between the three types of reconstruction. We conclude that immediate breast reconstruction can give excellent cosmetic results, and provides an acceptable and safe means of ameliorating the effects of mastectomy. The number of grossly unsatisfactory results decreased notably as the series progressed. Experience and meticulous attention to detail are necessary, since many patients are unwilling to have revisionary procedures if the initial result is unsatisfactory.