bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computed tomography (CT) of abdominal aortic aneurysms: determination of longitudinal extent
Authors: Dixon A K , Springall R G , Fry I Kelsey , Taylor G W 
Published: March 2007

Summary
The aim of this study was to evaluate computed tomography (CT) in the assessment of abdominal aortic aneurysms with particular reference to their longitudinal extent. Twenty-nine patients were examined by CT, 21 of whom came to surgery. Sixteen of these 21 patients were also examined by ultrasound. At CT the relation of the aneurysm to the renal arteries proximally and the bifurcation distally was noted, along with the definition of the aortic outline. At subsequent surgery the longitudinal relations of the aneurysm and evidence of localized stretching of or leakage from the sac were assessed by an observer without knowledge of the CT scan report. Correct extent of the aneurysm in relation to the renal arteries was predicted by CT in 20 out of the 21 patients who underwent surgery. CT assessment with respect to the bifurcation was correct in 16. The CT findings proved correct in one patient with localized stretching of one part of the aneurysm and in one patient where leakage was occurring. CT scanning was found to be superior to ultrasound in our preoperative assessment of the superior extent of abdominal aortic aneurysms. CT is considered to be the investigation of first choice when evaluating an abdominal aortic aneurysm.
The effect of intravenous aprotinin (Trasylol) on intraperitoneal adhesion formation in the rat
Authors: Young Howard L , Wheeler Malcolm H , Morse David 
Published: March 2007

Summary
A randomized controlled trial to assess the effect of intravenous Trasylol on postoperative intraperitoneal adhesion formation has been performed in rats. Before undergoing a standard left colonic resection, animals received i.v. Trasylol 10 000 KIU. This dose was repeated 8-hourly for 3 days postoperatively. Control animals received saline placebo. The mean percentage circumference of the anastomosis covered with adhesions in the Trasylol group animals was 20.86±6.08 compared with 45.24±5.97 in the control group (P &lt; 0.01).
Significantly more animals treated with Trasylol were completely free of adhesions than those receiving saline. Bursting pressures did not differ between the two groups. Intravenous Trasylol clearly inhibits intraperitoneal adhesion formation in this model.
Total parenteral nutrition versus gastrostomy in the preoperative preparation of patients with carcinoma of the oesophagus
Authors: Lim S T K , Choa R G , Lam K H , Wong J , Ong G B 
Published: March 2007

Abstract
Castrostomy feeding has been a well established form of nutritional support for patients presenting with total dysphgia for carcinoma of the oesophagus. More recently, total parenteral nutrition has proved to be efficient and safe, offering an alternative to gastrostomy feeding. Twenty-four patients were randomly selected into two groups to compare the efficacy of total parenteral nutrition and gastrostomy feeding with respect to nitrogen balance and weight gain.
Total parenteral nutrition was found to be superior to gastrostomy feeding in achieving an earlier positive nitrogen balance and greater weight gain during a 4-week period. However, gastrostomy feeding is still preferred as it is cheap, simple and safe, and allows patients to be active, mobile and self dependent. Total parenteral nutrition is reserved for those patients in whom an earlier operation is advisable.
Peroperative frozen section and cytology to assess proximal invasion in gastro-oesophageal carcinoma
Authors: Keighley M R B , Moore Janet , Lee J R , Malins D , Thompson H 
Published: March 2007

Abstract
Peroperative frozen sections and cytological material have been obtained in 39 consecutive gastro-oesophageal resections between October 1978 and February 1980. Material from the proximal edge of the resected specimen was unreliable because of 3 false positive cytology results and 1 false positive frozen section report. Frozen section (no errors) was shown to be significantly more accurate than cytology (6 errors) when material was obtained from the distal oesophagus. Fatal anastomotic dehiscence occurred in only 1 of 30 resections when the excision was adequate. Where the results of frozen section were acted upon, in 5 of 9 patients with an inadequate excision, only 1 fatal dehiscence occurred compared with fatal dehiscence in all 4 patients where a second excision was not performed. These results indicate that frozen section of the distal oesophagus should be used to determine the extent of oesophageal resection in operations for gastrooesophageal cancer.
Does osmotic control of gastric emptying persist after truncal vagotomy?
Authors: Gough Michael J , Humphrey Christopher S , Giles Geoffrey R 
Published: March 2007

Abstract
Gastric emptying of 5 per cent and 10 per cent glucose test meals has been measured in 43 patients with a duodenal ulcer prior to surgery and in 52 patients with an unsatisfactory result following truncal vagotomy and a drainage procedure. Seventeen patients had a recurrent ulcer and incomplete vagotomy while 35 patients were symptomatic with complete vagotomy. In both the preoperative and postoperative patients the 10 per cent glucose test meal emptied significantly more slowly than the 5 per cent glucose test meal regardless of the completeness of vagotomy. Thus, osmotic control of gastric emptying persists after vagotomy.
Bowel motility after primary resection for colonic obstruction
Authors: Fraser Ian D , Condon Robert E , Schulte William J , Decosse Jerome J , Cowles Verne E 
Published: March 2007

Abstract
The duration of postoperative ileus and changes in contractile frequency of circular muscle were recorded in the colon of monkeys before and after primary resection for distal large bowel obstruction. Obstruction was induced gradually by an implanted device. Resection and primary anastomosis resulted in reduced contractile frequency (postoperative ileus) lasting less than 48 h, significantly shorter than the period of ileus after a control laparotomy.
The wound fibroblast and macrophage. II: Their origin studied in a human after bone marrow transplantation
Authors: Stewart Richard J , Duley John A , Dewdney Janet , Allardyce Randall A , Beard Michael E J , Fitzgerald Peter H 
Published: March 2007

Abstract
The origin of the wound fibroblast and macrophage was studied in a patient following bone marrow transplantation, using sex chromosome markers. Fibroblast-like cells emigrating from explants of a 5-day-old skin wound had the host karyotype, whereas macrophages had donor markers. These results suggest that the wound fibroblast in man is of local tissue origin, whereas wound macrophages are derived from haemopoietic tissue.
111Indium-abelled leucocyte scintigraphy in the diagnosis of inflammatory disease—first results
Authors: Rövekamp Mechelien H , Hardeman M R , Van Der Schoot J B , Belfer A J 
Published: March 2007

Abstract
In 61 patients, 66 scans were performed with 111In-abelled autologous leucocytes to evaluate this method in the diagnosis of inflammatory disease. All scintigraphic results were compared with clinical, operative or postmortem findings.
In the first 20 examinations in 19 patients, 2 scintigrams were true positive, 9 true negative and none false positive, whereas 9 scintigrams had to be considered as false negative. These false negative results were probably due to loss of viability of the labelled cells.
A modified labelling technique, in which a much lower concentration of oxine was used, was employed for a further 46 examinations in 42 patients. Twenty-our scintigrams were true positive and 22 true negative, while no false positive or false negative results were observed. These results suggest that this modified technique is useful in the diagnosisof inflammatory disease.
The PO2 in venous valve pockets: Its possible bearing on thrombogenesis
Authors: Hamer J D , Malone P C , Silver I A 
Published: March 2007

Abstract
The Po2 in the lumen and valve pockets of veins in 2 patients and 8 dogs was measured during streamline blood flow and in conditions of intermittent pulsatile flow. The blood within the valve pockets became rapidly hypoxicwhen undisturbed during streamline flow (i.e. when ‘static’), but the Po2 in the pockets rose to that of the lumenal blood when the column of venous blood was made to pulsate and so empty the valve pockets at short intervals. The observations suggest that the endothelium covering the valve cusps is entirely dependent on pocket or lumenal blood for its oxygen supply. The endothelium facing the pocket can therefore become hypoxic during non-pulsatile blood flow when that facing the lumen is adequately oxygenated. Early thrombus formation was seen to develop on a valve cusp after only 2 h non-pulsatile flow. The demonstration that localized hypoxaemia occurs readily and can produce endothelial damage, in circumstances and situations where thrombi are commonly found to originate, is additional circumstantial evidence that hypoxia may trigger thrombogenesis.
A tube system for the management of ruptured oesophagus
Authors: Hinder R A , Baskind A F , Le Grange F 
Published: March 2007

Abstract
In a patient who has ruptured his oesophagus a major objective should be to prevent access of swallowed material or refluxed gastric contents to the area of the rupture. We describe a tube system, introduced into the oesophagus via a cervical oesophagostomy, which prevents swallowed material from getting to the lower oesophagus and allows a tube to be passed into the stomach for continuous aspiration of gastric contents. To discontinue the diversion, a surgical procedure is not required. The successful use of this tube system in 3 patients is described.
The effect of topical povidone-iodine on the incidence of infection in surgical wounds
Authors: Walsh J A , Watts J McK , McDonald P J , Finlay-Jones J J 
Published: March 2007

Abstract
A randomized stratified clinical trial of topical povidone-iodine in 627 patients undergoing abdominal procedures demonstrated a reduction in postoperative wound sepsis in female patients, in patients receiving subcutaneous low dose heparin and during the first quarter of the trial when the infection rate in control subjects was high. Overall, there was no significant reduction in wound sepsis after administration of povidone-iodine due mainly to a high infection rate in povidone-iodine treated male appendix operations where, by chance, there was an increased incidence of contamination with Bacteroides fragilis.
Postoperative stay in those developing wound infection was significantly reduced in the povidone-iodine group. This is considered as indirect evidence for a decrease in severity of wound infection.
Highly selective vagotomy and pyloric dilatation for duodenal ulcer with stenosis
Authors: Dunn D C , Thomas W E G , Hunter J O 
Published: March 2007

Abstract
This paper presents the results obtained in 15 patients with duodenal ulcer and stenosis who were treated more than 3years ago by highly selective vagotomy (HSV) and dilatation of the stenosis without a gastric drainage procedure. Patients were taking solid food 3–6 days postoperatively and were discharged after 7–14 days. There have been no recurrent stenoses. Fourteen of the 15 patients were Visick grade 1 or 2 at their last visit. One patient has a recurrent ulcer, but no restenosis. Barium meals performed on 6 patients with severe stenosis preoperatively showed satisfactory gastric emptying 1–3 years postoperatively. HSV and pyloric dilatation seems to be a safe and effective procedure for the treatment of pyloric stenosis due to chronic duodenal ulceration.
Excision of bullae without pleurectomy in patients with spontaneous pneumothorax
Authors: Ferguson L J , Imrie C W , Hutchison J 
Published: March 2007

Abstract
In a retrospective review of 294 patients with spontaneous pneumothorax (398 episodes), 45 patients came to surgical treatment. The period of the study was 7½ years, with a mean follow-up of 3 years in which there was no recurrence of pneumothorax after surgery. Operation consisted of simple excision of bullous lesions, usually located at the apexof the upper lobe, without pleurectomy. This simplified surgical approach has met with excellent results, indicating thatpleurectomy is unnecessary in the treatment of this disease.
A randomized trial to compare rubber band ligation with phenol injection for treatment of haemorrhoids
Authors: Greca F , Hares M M , Nevah E , Alexander-Williams J , Keighley M R B 
Published: March 2007

Summary
A prospective randomized trial has compared rubber band ligation with phenol injection in 82 patients with symptomatic haemorrhoids. The symptomatic results in all patients 12 months after treatment were indistinguishable, 64 per cent being improved after rubber band ligation, compared with 70 per cent after injection. Complications of treatment were recorded in 5 patients after rubber band ligation, 3 of whom required hospital admission compared with one minor complication after injection. However, repeated treatment was necessary in 13 patients after phenol injection compared with only 4 following rubber band ligation (P&lt;0·05). Additional treatment was necessary in 6 patients from each group. Two-thirds of patients with third-degree piles required additional therapy. It is concluded that rubber band ligation and injection provide similar results, but rubber band ligation is more liable to complications with inexperienced operators.
A comparison of the traumatic effects of vascular clamps
Authors: Harvey J G , Gough M H 
Published: March 2007

Summary
The nature and extent of damage to the walls of the femoral artery of the dog caused by five different vascular clamps is reported. This is related to the ability of the clamp to both occlude the vessel and to hold the wall without slipping. Intimal damage was assessed by supravital staining, scanning electron microscopy of the surface and the histological appearance of sagittal sections of the arterial wall. The Atraugrip, Satinski and Potts clamps caused more apparent damage to the vessel wall and achieved occlusion by holding of the vessel at higher pressures than did the Blalock and Fogartyclamps. There is a difference between the damage produced when closure is sufficient to just occlude the vessel and that produced when the clamp is fully closed.
The salvage of occluded Dacron grafts
Authors: Macpherson D S , Bell P R F 
Published: March 2007

Summary
The technical details of unblocking occluded Dacron grafts in 8 patients are described. The early results in 4 unilaterally occluded bifurcation aortic grafts and 1 unilateral iliofemoral graft are encouraging with all 5 grafts patent 8–16 months postoperatively (mean 9 months). We recommend this operation as the procedure of choice in symptomatic patients presenting with a graft occlusion of this type before resorting to the insertion of a new prosthesis, and emphasizethe importance of improving the outflow, usually by a profundaplasty. Only 1 out of 5 axillofemoral grafts remains patentat 8 months in spite of vigorous attention to operative detail. In this situation, an alternative procedure is suggested in the long term.
The management of anal carcinoma
Authors: Madden M V , Elliot M S , Botha J B C , Louw J H 
Published: March 2007

Summary
In a 20-year survey of anal carcinoma at Groote Schuur Hospital 55 cases were studied retrospectively. Patientsof mixed race with anal margin carcinoma had a median age 29 years below that of Whites with anal margin carcinoma. Patients in these two groups with anal canal carcinoma had the same median age. Anal margin tumours were smaller than anal canal tumours at presentation and had a substantially better 5-year survival rate. The approach to treatment of theseconditions is outlined.
The excretion of cefuroxime in human bile
Authors: Thomas M H , Dash C H , Burnand K G , Woodyer A B 
Published: March 2007

Summary
Cefuroxime is a broad spectrum cephalosporin antibiotic. An intravenous injection of cefuroxime 1·5g was administered to 25 patients after induction of anaesthesia for cholecystectomy. Concentrations of antibiotic were measured andthe mean levels in μg/ml found to be: serum 120·5, common bile duct bile 42·8, gallbladder bile 5·4, gallbladder wall 39·2. The drug levels exceeded the minimum inhibitory concentrations for most organisms commonly encountered in the biliary tract. There was no difference in cefuroxime levels in bile from functioning or non-functioning gallbladders. It is suggested that the diffusion of antibiotic into and out of the inflamed gallbladder is similar to that in abscesses and in experimental tissue cages. No side effects, toxicity or wound infections occurred.
The relationship between the number of capillaries in the skin of the venous ulcer-bearing area of the lower leg and the fall in foot vein pressure during exercise
Authors: Burnand K G , Whimster I , Clemenson G , Thomas M Lea , Browse N L 
Published: March 2007

Summary
The changes in foot vein pressure during exercise have been measured in 30 normal legs and 109 legs with varicose veins or postphlebitic changes and correlated with the number of capillaries visible in a histological section of skin from the ulcer-bearing area. There was a significant correlation between the inability of the calf pump to reduce foot vein pressure during exercise and the number of capillaries in the skin. It is suggested that the increased number of capillaries secondary to venous hypertension during exercise may be the prime cause of the nutritional abnormalities that eventually cause a venous ulcer.
Penetration of a prophylactic antibiotic into peritoneal fluid
Authors: Corbett C R R , Hollands M J , Young A E 
Published: March 2007

Summary
The ability of an antibiotic, given for prophylaxis, to enter the peritoneal fluid was measured in 40 patients having abdominal operations. Cefuroxime, the antibiotic studied, attained a satisfactory level (4 mg/1) in the peritoneal fluid of 34 of the 40 patients (85 per cent). There was no difference between emergency and elective operations, suggesting that peritoneal inflammation does not enhance the penetration of cefuroxime into peritoneal fluid.
Does ‘intestinal angina’ exist? A critical study of obstructed visceral arteries
Authors: Croft Rodney J , Menon G P , Marston Adrian 
Published: March 2007

Summary
A study of the mesenteric arteries was carried out in 203 unselected autopsies. Although mild degrees of stenosis were common, the incidence of a ‘critical stenosis’ was rare and no correlation between degrees of stenosis and previous gastrointestinal symptoms could be found. Radiological demonstration of stenosed or blocked visceral arteries remains therefore of doubtful clinical significance.
Bile reflux and gastric emptying in patients with combined gastric and duodenal ulceration
Authors: Gough Michael J , Humphrey Christopher S , Feather David B , Giles Geoffrey R 
Published: March 2007

Summary
Measurements of duodenogastric reflux of bile and gastric emptying of a 5 per cent glucose liquid test meal have been made in 8 patients with combined gastric and duodenal ulcers and the results compared with those found in 21 patients with a diagnosis of uncomplicated duodenal ulceration. It was not possible to demonstrate any differences between the two groups of patients in respect of these studies and it is suggested that gastric stasis and duodenogastric reflux may not be important factors in the aetiology of combined ulcer disease.
Local tumour invasion as a prognostic factor in colorectal cancer
Authors: Wood C B , Gillis C R , Hole D , Malcolm A J H , Blumgart L H 
Published: March 2007

Summary
A prospective study was carried out of 404 patients with colorectal cancer who were followed up for a mean period of 42 months. Macroscopic extramural tumour invasion was found at laparotomy in 46 patients undergoing apparently curative surgery and the survival rate was significantly reduced in these patients. The site of primary tumour in the colon or rectum did not influence the incidence of local tumour spread, but local invasion was related to the incidence of lymph node metastases and histological grading of the tumour. A staging classification has been proposed based not on lymphatic metastases, but on the extent of local tumour penetration. This modified staging system combines the operative findings with pathological grading of the tumour and emphasizes the prognostic significance of local tumour invasion.
The low stapled anastomosis
Authors: Heald R J , Leicester R J 
Published: March 2007

Summary
The complications of 100 stapled anastomoses onto the rectum or anus are reviewed. Anastomotic leakage in very low cases is the major problem; no leak occurred if the anastomosis was performed above 7 cm, but 3 leaks in 17 patients occurred if the anastomosis was performed between 5·5 and 7 cm, and 10 leaks occurred in 52 patients if the anastomoses was less than 5 cm from the anal margin. A covering colostomy is essential for these lower anastomoses, and for those not covered by a colostomy, an immediate colostomy with a distal loop washout is performed, if a leak develops. Attention to technique is mandatory, with a good blood supply, absence of tension and the elimination of the pelvic cavity being of great importance.
Complications of anterior resection of the rectum using the EEA stapling device
Authors: Cade David , Gallagher Patrick , Schofield Philip F , Turner Leslie 
Published: March 2007

Summary
Fifty patients had anterior resection of the rectum performed with end-to-end anastomosis using the EEA stapling device. The instrument certainly facilitated low anastomoses, but anastomotic dehiscence occurred in 3 cases, stenosis in 2, wound sepsis in 10, some degree of incontinence (usually only temporary) in 7 and anal fissure in 4 cases.
British experience with duodenoscopic sphincterotomy for removal of bile duct stones
Authors: Cotton Peter B , Vallon A G 
Published: March 2007

Summary
Duodenoscopic sphincterotomy is rapidly becoming popular in Britain. Representatives of 14 British centres met in January 1980 to discuss progress and problems with the technique. This report summarizes current experience, with particular reference to hazards.
Duodenoscopic sphincterotomy is mainly being used in patients who have previously undergone cholecystectomy and who no longer have a T tube drain in place. Sphincterotomy was achieved in 87 per cent of 679 patients attempted, and the common duct was cleared of stones in 87 per cent of these. Immediate complications followed in 8·5 per cent; 1·6 per cent required urgent surgery and 7 patients (1 per cent) died. Centres with the greatest experience had better results and fewer complications.
Those performing duodenoscopic sphincterotomy believe it to be a major advance in the management of high risk patients with common duct stones, after cholecystectomy. Its use remains controversial in high risk patients who still have gallbladders and in low risk patients after cholecystectomy; long term follow-up studies are essential.