bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fine needle catheter jejunostomy—An assessment of a new method of nutritional support after major gastrointestinal surgery
Authors: Yeung C K , Young G A , Hackett A F , Hill G L 
Published: March 2007

Summary
The results of our experience with the technique of fine needle catheter jejunostomy and early postoperative feeding through the catheter over a 12-month period are presented. Of the 43 patients who had the catheter inserted, 27 (63 per cent) completed a course of feeding with an elemental diet without complications, 3 (7 per cent) were not fed for different reasons and 13 (30 per cent) developed complications that led to temporary or permanent cessation of the feeding. One patient in this group died of inhalation pneumonia.
The voluntary food intake of 12 of the patients who were fed by jejunostomy after major colorectal surgery was assessed daily for 2 weeks after operation and compared with that of 12 control patients who did not have nutritional support. No significant difference in voluntary food intake was found between the two groups.
The changes in body composition and plasma proteins and the clinical outcome of 20 of the patients fed by jejunostomy after major colorectal surgery were also compared with those of 20 matched controls. Body weight and lean body mass (as assessed by total body potassium and arm muscle circumference) and plasma prealbumin fell significantly in the control patients but not in those fed by jejunostomy. However, plasma transferrin decreased in both groups and there was no significant difference in clinical outcome in terms of complication rate or duration of postoperative hospital stay.
The study would suggest that this technique of jejunostomy feeding should be reserved for selected cases where it may prove to be of real value, rather than being used routinely.
Lesser curve superficial seromyotomy—An operation for chronic duodenal ulcer
Authors: Taylor Thomas V 
Published: March 2007

Summary
Lesser curve superficial seromyotomy has been investigated in the dog and in man. The anatomical basis for the operation, which produces an easily performed denervation of the parietal cell mass, is discussed. Acid studies in the dog confirmed that the operation was capable of producing secretory inhibition in keeping with vagotomy of the parietal cell area.
A consecutive series of 25 patients with chronic duodenal ulcer has been treated by lesser curve myotomy without a drainage procedure. The operation has the advantages of being easily performed and the risk of damage to the nerve of Latarjet or of ischaemic necrosis of the lesser curvature is obviated. In 20 insulin tests performed within the first month postoperatively all patients have been negative within the first 75 min and there were 4 late positive responses. Early clinical results have been encouraging, there has been no dumping or diarrhoea and all patients are well. It is suggested that further investigation of lesser curve myotomy is warranted.
Bone scanning: Its lack of value in the follow-up of patients with breast cancer
Authors: Bishop H M , Blamey R W , Morris A H , Rose D H , Preston B , Lane Joyce , Doyle P J 
Published: March 2007

Summary
Three hundred and fifty-four women with primary operable breast cancer had a bone scan performed within 6 weeks of a simple mastectomy. Eight (2·3 per cent) were positive, but 7 of these patients had radiological evidence of bony metastases. Follow-up bone scans 1 year postoperatively on 278 patients showed only 12 (4·3 per cent) positive, and of these, 9 had other radiological evidence of metastatic disease. At 2 years postoperatively there were 13 (9·2 per cent) positive bone scans amongst 141 patients. Only 2 of these 13 had no other evidence of metastases. Although a bone scan is a useful investigation in patients with bone pain, there is no place for routine bone scanning in either the staging or follow-up of women with operable breast cancer.
Gastric reduction for morbid obesity: Technique and indications
Authors: Kark A E , Burke M 
Published: March 2007

Abstract
The results of gastric reduction for obesity in 12 patients are described. Emphasis is laid on preoperative weight loss, using jaw wiring in 9 patients. The successful outcome of the operation was found to depend on the formation of a small gastric pouch and a narrow gastrojejunal anastomosis. A constant-sized pouch was achieved by forming the pouch around a 100-ml silicone balloon devised for the purpose. Postoperative results were good in 7 patients, partial success was achieved in 3 patients and there were 2 failures.
The effect of bile acids on colonic myoelectrical activity
Authors: Flynn M , Darby C , Hyland J , Hammond P , Taylor I 
Published: March 2007

Abstract
The effect of different concentrations of sodium cholate, sodium chenodeoxycholate and sodium deoxycholate on colonic myoelectrical activity was studied in 4 dogs. There was no statistically significant difference in percentage motility, motility index, basal pressure or mean slow wave frequency with either cholic or chenodeoxycholic acid (5–15 mm). Deoxycholic acid (15 mm), however, caused a marked increase in percentage motility (median control value 4·1, range 0–23; after installation, median value 27·0, range 20·6–45·0, P &lt; 0·001). This was accompanied by an increase in spike activity, but no alteration in mean slow wave frequency or basal pressure was seen. Cholestyramine inhibited the motor response. It appears that only deoxycholic acid affects both motility and absorption, presumably by different pathways, and may thus assume importance in disorders of colonic motility.
The early diagnosis of ectopic pregnancy
Authors: Hughes Graeme J 
Published: March 2007

Abstract
In a survey of 235 consecutive cases of ectopic pregnancy it was found that over 50 per cent were incorrectly diagnosed by the general practitioner and 36 per cent by a hospital doctor. Ten per cent of patients were sent home before the diagnosis was made.
Over 30 per cent of patients were sent to general surgical wards and these patients had different characteristics from those sent to gynaecological wards.
High risk patients can be identified from their past history. The increasing use of the laparoscope has been associated with earlier detection of ectopic pregnancy before the stage of rupture.
Granular cell myoblastoma of the breast: A report of 2 cases
Authors: McCracken M , Hamal P B , Benson E A 
Published: March 2007

Abstract
Two cases of granular cell myoblastoma of the breast are presented occurring in women aged 20 and 22 years. The clinical findings, mammographic and naked eye appearances suggested carcinoma. The difficulties of diagnosis and the pathogenesis of this rare tumour are discussed. A definitive histological diagnosis of an apparently malignant breast lump, particularly in a young woman, is mandatory before proceeding to major surgery.
Emergency treatment of variceal haemorrhage
Authors: Sagar S , Harrison I D , Brearley R , Shields R 
Published: March 2007

Abstract
For the initial control of haemorrhage from oesophageal varices, two methods of vasopressin administration have been compared—the conventional bolus of 20 units and a low dose infusion of 0·4 units per minute.
Twenty patients bleeding from oesophageal varices, confirmed by endoscopy, were allocated into either treatment group (10 in each). Vasopressin infusion stopped bleeding in 86 per cent of the episodes in contrast to 12·5 per cent (P &lt; 0·01) with bolus doses. Balloon tamponade with a Sengstaken-Blakemore tube was used to control bleeding in only 2 episodes in patients on infusion and in 10 episodes in patients on bolus doses of vasopressin (P &lt; 0·05). Our study confirms that low dose vasopressin infusion is more effective in controlling bleeding from oesophageal varices than conventional bolus doses.
A comparative randomized trial of heparin versus streptokinase in the treatment of acute proximal venous thrombosis: An interim report of a prospective trial
Authors: Elliot M S , Immelman E J , Jeffery P , Benatar S R , Funston M R , Smith J A , Shepstone B J , Ferguson A D , Jacobs P , Walker W , Louw J H 
Published: March 2007

Abstract
A controlled, prospective study comparing streptokinase and heparin treatment has been completed in 51 patients presenting with acute proximal venous thrombosis of less than 8 days' clinical duration. Patients were studied by means of pre-treatment, post-treatment, 3- and 12-monthly phlebography and pulmonary perfusion scanning and were followed up at 3-monthly intervals.
Of the 26 patients randomized to receive streptokinase, therapy was stopped in 3 because of complications. Phlebography 5 days after starting treatment showed 80–100 per cent lysis in 17 of the 23 patients who completed the course of streptokinase. Two patients later developed partial rethrombosis. One patient developed an asymptomatic pulmonary embolus during treatment. During follow-up (mean 19 months) only 1 of the 17 patients with 80–100 per cent lysis developed postphlebitic symptoms, 3 patients died of unrelated causes and 1 patient was lost to follow-up.
In patients randomized to heparin therapy no significant lysis was achieved in any of the 25 patients and only 2 of these patients were found to have asymptomatic legs on follow-up. Two patients in this group died and autopsy confirmed massive pulmonary embolus during treatment.
These data suggest that streptokinase is superior to heparin in the treatment of acute proximal venous thrombosis of less than 1 week's clinical duration especially if the thrombus is largely non-occlusive. It must be stressed that in order to avoid the bleeding complications of thrombolytic therapy, streptokinase must not be used within 10 days of major surgery, or even longer after vascular, neurosurgical or eye operations.
Circulating breast tumour antigen-sensitive T lymphocytes in early breast cancer and high risk benign breast disease
Authors: Ramey William G , Hashim George A , Fitzpatrick Hugh F 
Published: March 2007

Abstract
Levels of circulating T lymphocytes sensitized to breast tumour associated antigens (BTA) were correlated with pathological tumour stage or benign histopathology in preoperative studies of 180 patients by the antigen-stimulated active rosette-forming T cell (AgARFC) assay. Incubation of lymphocytes with allogeneic BTA extracts produced increased AgARFC compared with incubation without BTA. Significant levels of BTA-sensitive T cells were found in 78 per cent of breast cancer patients compared with 23 per cent of patients with benign disease (P &lt; 0·0005, by Ch2). Over 93 per cent of stage I cancer patients responded to BTA, compared with 69 per cent of stage II patients (P &lt; 0·0025) and 59 per cent of stages III–IV patients (P &lt; 0·005). Twenty-nine per cent of 42 patients with fibrocystic disease were positive to BTA in contrast to 8 per cent of 25 patients with fibroadenomas. This was a 3·6-fold higher incidence of BTA-sensitive T cells associated with fibrocystic disease than with fibroadenomas, which was in agreement with the increased breast cancer risk rate associated with fibrocystic disease. These findings suggest that the AgARFC assay may detect early malignant change in fibrocystic disease. The AgARFC assay was found to reliably detect early invasive carcinoma.
Multi-element analysis of the living body by neutron activation analysis—application to critically ill patients receiving intravenous nutrition
Authors: Hill Graham L , King Roderick F G J , Smith Ross C , Smith Alan H , Oxby Clement B , Sharafi Ali , Burkinshaw Lewis 
Published: March 2007

Abstract
Neutron activation analysis has been used to determine the total content in the body of N, K, Na, Cl, P and Ca in 25 critically ill surgical patients before and after a 14-day course of intravenous nutrition. Muscle elemental compostion was also determined in these patients at the same time as the total body analysis.
Over the 14-day period of intravenous feeding the total body contents of all the measured elements increased (2–9·7 per cent) but only the increase in K was statistically significant. Muscle chemistry suggested an intracellular K depletion which was corrected over the study period. The results of the total body multi-element analysis were interpreted to show a mean gain of 1·25 l of extracellular fluid and 0·51 l of intracellular fluid and direct measurement of total body water suggested that this interpretation was probably valid.
The first application of the technique to patients with nutritional and metabolic problems has quantified the weight gained by two body compartments during a 2-week period of intravenous nutrition. Its further application should help to solve a number of nutritional and metabolic problems in clinical surgery.
Absorbable haemostatic materials and intraperitoneal adhesion formation
Authors: Raftery Andrew T 
Published: March 2007

Abstract
The effect of two absorbable haemostatic materials, oxidized cellulose gauze (Surgicel) and absorbable gelatin sponge (Sterispon) has been investigated in relation to intraperitoneal adhesion formation using the rat as experimental animal. Neither oxidized cellulose gauze nor absorbable gelatin sponge was associated with an increased incidence of adhesions. On the contrary, oxidized cellulose gauze was associated with a decreased incidence of adhesions. If haemostatic material is required in the peritoneal cavity, oxidized cellulose gauze may be preferable to absorbable gelatin sponge since it is associated with a lower incidence of adhesions.
Fibrinolysis and the prediction of postoperative deep vein thrombosis
Authors: Reilly D T , Burden A C , Fossard D P 
Published: March 2007

Abstract
Fibrinolytic activity was measured in 28 patients undergoing elective abdominal surgery in order to assess the value of fibrinolytic activity as a predictive indicator of deep vein thrombosis. Eighty-nine non-smoking adults acted as controls. Fibrinolytic activity was estimated before and during operation, immediately postoperatively and 24 h and 48 h after operation. The onset of deep vein thrombosis was assessed daily for 5 days using 125 I-fibrinogen uptake scans. Fibrinolytic activity in 9 patients changed significantly and 7 of these developed deep vein thrombosis. Preoperative assessment of fibrinolytic activity cannot alone predict deep vein thrombosis but changes in the pattern of activity may be of help in defining those at risk.
Does a high fibre diet prevent the complications of diverticular disease?
Authors: Hyland J M P , Taylor I 
Published: March 2007

Summary
The management of diverticular disease has altered radically with the widespread use of high fibre diet (HFD) over the past decade. However, whether this regimen has improved the prognosis in patients admitted with acute complications is still debatable.
In this study the outcome of 100 such patients admitted to hospital with acute episodes of diverticular disease has been reviewed. Seventy-five per cent were treated conservatively with HFD and review after 5–7 years showed that over 90 per cent remained symptom-free, suggesting that HFD may afford protection by preventing further complications.
Peroperative antibiotics in the prevention of chest infection following cardiac operations
Authors: Galland R B , Shama D M , Prenger K B , Darrell J H 
Published: March 2007

Summary
Seventy-nine patients about to undergo cardiac operations were randomly allocated to two treatment groups in an attempt to reduce postoperative chest infections. The group receiving a short peroperative course of cefamandole, an antibiotic effective against both the pneumococcus and Haemophilus influenzae, had a significantly lower postoperative chest infection rate than the group receiving a 3-day course of cephradine, an antibiotic previously chosen to prevent intracardiac infection during the operation. By selecting an appropriate antibiotic it is possible, using a short peroperative course, to reduce the post-operative chest infection rate in patients undergoing cardiac operations.
Carcinoma of the tongue: Factors affecting the results of surgical treatment
Authors: Lam K H , Wong John , Lim S T K , Ong G B 
Published: March 2007

Summary
Sixity-five cases of carcinoma of the tongue treated by surgery were reviewed. The types of operation included hemiglossectomy, subtotal and total glossectomy with or without hemimandibulectomy and laryngectomy. Simultaneous neck dissection was usually performed except for patients who had radiotherapy and did not have clinical lymph node involvement. The hospital mortality and five-year survival rates were analysed for individual subgroups of patients classified according to clinical and pathological features.
The overall hospital mortality rate was 21·5 per cent. The size of the tumour and the presence of extension posteriorly, to the opposite side and to the floor of the mouth increased the mortality. Lesions situated on the dorsum fared worse than those at the edge or undersurface. Clinically and pathologically involved lymph nodes adversely affected the mortality. The more extensive the resection, the higher the mortality. Old age and previous failed radiotherapy also increased mortality. The overall five-year survival rate was 46 per cent. Long term survival was not so much affected by the size of the primary tumour and degree of local extension as was the hospital mortality. Clinical as well as pathological staging of regional lymph nodes were more important in influencing long term survival. Recurrence after radiotherapy had a worse prognosis than previously untreated tumours.
Solitary abscess of the spleen
Authors: Simson Jay N L 
Published: March 2007

Summary
Solitary abscess of the spleen is a potentially lethal condition. It is difficult to diagnose but relatively easy to treat, resulting in cure of the majority of the patients. A case is described to illustrate the important factors in aetiology, presentation, diagnosis and treatment. All cases reported since 1960 are reviewed: the mortality of untreated patients is shown to be 100 per cent. If this condition is sucessfully diagnosed and treated, without rupture, no patient should die from it.
Transrectal biopsy of the prostate and bacteraemia
Authors: Thompson P M , Talbot R W , Packham D A , Dulake C 
Published: March 2007

Summary
Bacteraemia and urinary tract infection are wellrecognized complications of urological procedures. This paper compares, for the first time, the incidence of bacteraemia after cystoscopy and transrectal biopsy of the prostate with that following cystoscopy alone. The incidence of bacteraemia in those undergoing biopsy was 73 per cent; following cystoscopy alone the incidence was 13 per cent. In view of this high incidence we recommend prophylactic antibiotic cover of transrectal prostatic biopsy.
Modification of the physiological disturbances produced by whole gut irrigation by preliminary mannitol administration
Authors: Donovan Ian A , Arabi Y , Keighley M R B , Alexander-Williams J 
Published: March 2007

Summary
In a prospective non-randomized study of 42 patients it was found that the oral administration of 50 g of mannitol 2 h before whole bowel irrigation (WBI) improved the success rate of the bowel preparation and reduced the time required for the WBI. Mannitol is an osmotic cathartic, and it reduced fluid absorption from a mean value of 2·7 1 in patients who had WBI alone to a mean of 1·2 I in those who received mannitol beforehand. Sodium absorption was also significantly reduced.
The angiographic anatomy of the coronary arteries
Authors: Raphael M J , Hawtin D R , Allwork S P 
Published: March 2007

Summary
The angiographic anatomy of the coronary arteries is described and illustrated by three corrosion casts of normal human hearts, photographed in projections comparable to those used in coronary arteriograms. They are accompanied by matched normal coronary arteriograms. The study of casts of the heart and of the coronary arteries in particular facilitates understanding of the radiographic projections commonly employed in coronary arteriography.
Towards fewer colostomies—the impact of circular stapling devices on the surgery of rectal cancer in a district hospital
Authors: Heald R J 
Published: March 2007

Summary
Circular stapling devices can be used to extend the range of anterior resection of the rectum to encompass most rectal carcinomas. In one district general hospital the number of abdominoperineal resections performed in a 12-month period has been reduced from 27 to 4. A personal series is presented of 40 patients in whom the new technique allowed restorative resection to replace permanent colostomy. Special care is essential in the preparation of the colon for the low anastomosis.
Intussusception due to inflammatory fibroid polyps of the ileum: A report of 12 cases from Africa
Authors: Nkanza N K , King M , Hutt M S R 
Published: March 2007

Summary
Eleven cases of inflammatory fibroid polyp of the ileum from Malawi and 1 from Sierra Leone are described. All 12 patients presented with acute intestinal obstruction as a result of an intussusception caused by the polyp.
The lesions are characterized by a variable proliferation of fibroblasts and small vessels which may involve the whole thickness of the bowel wall. Tissue mast cells and eosinophils were noted in all the polyps.
The aetiology of these lesions remains obscure but they appear to be reactive rather than neoplastic. The condition appears to occur more commonly in Malawi than in the United Kingdom or North America and is an important cause of small bowel obstruction in that part of Africa.
Perineal wound healing after proctectomy for carcinoma and inflammatory disease
Authors: Baudot Phillipe , Keighley Michael R B , Alexander-Williams John 
Published: March 2007

Summary
The rate of wound healing after proctectomy was assessed in a series of 105 patients. Early healing was dependent principally on the primary diagnosis, to a lesser extent on faecal contamination and was not related to steroid administration. Early healing (within 3 months) occurred in 72 per cent of patients undergoing operation for cancer and 45 per cent of these operated on for ulcerative or Crohn's colitis.
The use of Silastic foam dressing in the treatment of advanced hidradenitis suppurativa
Authors: Morgan Wyn P , Harding Keith G , Richardson Gill , Hughes Leslie E 
Published: March 2007

Summary
We describe our experience in the use of a Silastic foam dressing in 17 patients undergoing radical excision of hidradenitis suppurativa whose wounds were allowed to heal by granulation. Axillary excisions were carried out in 9 patients and perineal excisions in 8 patients. The technique permits adequate excision of the disease and results in a cosmetically acceptable scar, superior to that obtained by skin grafting and with little limitation of movement. It avoids the pain of conventional management of granulating wounds by gauze packing.
It is considered that this method of management is superior in most respects to other techniques used to manage the defect resulting from adequate excision of hidradenitis.
Missile injuries of the abdomen in Zimbabwe–Rhodesia
Authors: Dent Roger I , Jena George P 
Published: March 2007

Abstract
One hundred and thirteen patients with missile injuries of the abdomen were seen over a 3-year period at one hospital in Zimbabwe–Rhodesia. The details of these injuries and the results of their treatment are presented.
Twenty-four patients died (21 per cent). Twenty of these patients had sustained high velocity missile injuries, 18 had damaged colons and 3 died from major vascular injuries before surgery. Excluding these last 3 patients, the mortality rate for high velocity wounds of the colon was 52 per cent and that for all other patients was 6 per cent (P &lt; 0·01). More than half the postoperative deaths were due to septicaemia.
The importance is stressed of early and effective resuscitation, including appropriate antibiotic therapy and rapid evacuation to facilities for major surgery.