bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biliary peritonitis without perforation of the gallbladder in acute cholecystitis
Authors: Kent S J S , Menzies-Gow N 
Published: March 2007

Abstract
Six patients with biliary peritonitis occurring as a complication of acute cholecystitis are reported. Five of the 6 patients had no detectable perforation of the gallbladder. The literature of this topic is reviewed and a theory is put forward to account for biliary peritonitis without perforation of the gallbladder in acute cholecystitis.
A survey of the results of the Boerema anterior gastropexy for hiatus hernia over a 4-year period
Authors: Davies C J 
Published: March 2007

Abstract
The results obtained by using the Boerema anterior gastropexy for symptomatic hiatus hernia over a 4-year period are reviewed. All 68 patients were operated upon by the same surgeon. The success rate as judged by relief of the patients' symptoms was 90 per cent.
It is felt that the operation has advantages such as to justify its wider use.
Secondary involvement of the penis by rectal cancer
Authors: Rees B I 
Published: March 2007

Abstract
Two cases of metastasis to the penis from a primary rectal carcinoma are described. The clinical features, treatment and prognosis together with the probable modes of metastasis are discussed. All previously reported cases of penile metastasis from the rectum are reviewed.
It is suggested that contrary to previous reports the prognosis is not uniformly poor and hence a more aggressive attitude to treatment should be adopted. Metastatic lesions in the penis should also be considered as a cause of urinary obstruction following abdominoperineal excision of the rectum.
Traumatic haemobilia
Authors: Vallidis E , Papalexandris N 
Published: March 2007

Abstract
A case of traumatic haemobilia which was diagnosed preoperatively, is reported. The site of bleeding was demonstrated by operative angiography through the right hepatic artery. The patient was treated by ligation of the common hepatic artery. Re-bleeding required a second operation and ligation of the right hepatic branch without adverse consequences on the hepatic function.
Rupture of subcapsular haematoma of the liver in a case of eclampsia
Authors: Browne C H , Hanson Gillian C , De Jode L R , Roberts P A 
Published: March 2007

Abstract
A case of rupture of subcapsular haematoma of the liver in a patient suffering from eclampsia is reported in which the patient survived. Peritoneal tap provided important diagnostic information. Surgical intervention with control of the liver haemorrhage provides the only chance of survival.
A controlled trial of parenteral prophylactic gentamicin therapy in biliary surgery
Authors: Keighley M R B , Baddeley R M , Burdon D W , Edwards J A C , Quoraishi A H , Oates G D , Watts G T , Alexander-Williams J 
Published: March 2007

Abstract
This trial has investigated the value of gentamicin therapy in patients requiring biliary surgery. One hundred consecutive patients were randomly allocated to receive either gentamicin or no antibiotic. Postoperative infection was assessed by an independent observer. Cultures and gentamicin assays were performed on bile and blood sampled during and after operation. The minimum inhibitory concentrations of gentamicin were measured with isolated bacteria.
In 80 per cent of patients biliary organisms were inhibited by 2μ g/ml of gentamicin. Twice this concentration was found in the serum at operation in 88 per cent, but in the bile in only 18 per cent. Nevertheless, gentamicin lowered the incidence of bacteria in the bile from 42 to 25 per cent. There was a reduction in wound sepsis from 21 to 6 per cent (P&lt;0·05). Bacteriaemia was demonstrated in only 1 patient receiving gentamicin compared with 5 controls and 1 death occurred from endotoxaemia in the control group.
These data suggest that gentamicin will reduce the morbidity of biliary surgery, particularly in patients in whom the bile is infected at operation.
Bacteria in flower vase water: Incidence and significance in general ward practice
Authors: Bartzokas C A , Holley Marguerite P , Sharp Christine A 
Published: March 2007

Abstract
Culture of flower vase water from wards in the David Lewis Northern Hospital, Liverpool, revealed large numbers of potentially pathogenic bacteria. The types of organisms isolated may reflect the particular ecology of this hospital as they differed in some ways from those reported from other centres. The incidence of wound infections during the period of study was low (5·2 per cent) despite the regular overgrowth of bacteria in flower vases, and there did not appear to be any definite correlation between the types of bacteria isolated from flower vase water and those responsible for wound infections.
The addition of hydrogen peroxide to flower vases proved a very effective antiseptic and is recommended for general use as a precautionary measure.
Analgesic abuse in urological practice
Authors: Parker R W , Shaw Richard E 
Published: March 2007

Abstract
Thirty-three patients seen in a urological department had taken large doses of analgesic for prolonged periods of time. In 9 cases a diagnosis of pyramidal necrosis was established, while 4 others had pyelographic evidence of pyelonephritis, and analgesic abuse was probably an important aetiological factor in their renal condition. Analgesic nephropathy is easily overlooked unless patients are questioned routinely regarding their intake of analgesic. It is important to identify the group of patients without evidence of serious renal disease who are taking excessive quantities of analgesic and to urge them to abandon the practice.
The Fowler—Weir approach to appendicectomy
Authors: Askew A R 
Published: March 2007

Abstract
The medial approach of Fowler-Weir enables rapid opening of the abdominal cavity and provides good access to the appendix. Although there is less muscle trauma the wound seems as painful postoperatively as with the classic muscle-splitting approach. However, morbidity is less as shown by a decrease in the wound and deep infection rate compared with that after appendicectomy by the McBurney approach.
The cause and treatment of postvagotomy diarrhoea
Authors: Condon John R , Robinson V , Suleman M I , Fan V S , McKeown M D 
Published: March 2007

Abstract
Six patients with watery postvagotomy diarrhoea and 4 patients with intractable diabetic diarrhoea were treated with cholestyramine. The diarrhoea responded completely to therapy, during which the stool content of water, sodium, potassium and magnesium fell. Two of the patients, while receiving cholestyramine, had a rise in faecal fat, but this was not accompanied by diarrhoea, the stools being well formed.
Evidence is presented which suggests that the mechanism of diarrhoea is similar in both disorders and is due to division or neuropathy of the hepatic fibres of the vagus nerve. This results in distension of the gallbladder, contraction of which expels increased quantities of bile salts, which swamp the reabsorptive capacity of the small intestine and induce diarrhoea by direct action on the colon. If this theory is valid, cholecystectomy, by preventing large quantities of concentrated bile salts from suddenly entering the gut, may result in improvement of postvagotomy and diabetic diarrhoea.
The cholecystokinin test: An assessment
Authors: Reid D R K , Rogers I M , Calder J F 
Published: March 2007

AbstractA cholecystokinin (CCK) test was performed on 13 female patients who were thought to be having attacks of gallbladder pain and in whom at least one cholecystogram had been normal. In 10 of these patients the CCK test was performed during the course of a repeat cholecystogram in order to assess the effect of CCK on gallbladder contraction.There was no constant relationship between a positive test and gallbladder contraction as measured radiographically.Cholecystectomy was undertaken in 9 patients and of these, 4 had been CCK positive, 4 had been CCK negative and 1 had reacted equivocally. None of the CCK positive patients had stones at operation, whereas 2 of the CCK negative patients had one or two small stones. In this small series cholecystectomy relieved both the CCK negative and CCK positive patients of pain with equal frequency.It is concluded that a negative CCK test by no means excludes the presence of symptomatic gallstones in patients with X-ray negative gallbladder pain.
Intra-arterial infusion of Solcoseryl: A clinical trial of a method of treatment for pre-gangrene of the lower limb
Authors: Charlesworth D , Harris P L , Palmer M K 
Published: March 2007

Abstract
A randomized double blind trial of the drug Solcoseryl given by intra-arterial infusion was carried out on 57 patients with pre-gangrene of the lower limb. A sequential analysis was carried out and the trial stopped when the results showed a statistically significant result in favour of the active drug.
Hydronephrosis complicating aortic reconstruction
Authors: Heard Gordon , Hinde Graham 
Published: March 2007

Abstract
Prompted by an encounter with a symptomatic case, a study has been made of hydronephrosis complicating operations for aortic reconstruction.
Twenty patients operated upon consecutively for occlusive vascular disease and undergoing reconstructions involving the use of synthetic material in the vicinity of the ureter have been investigated by intravenous pyelography.
The incidence of hydronephrosis in pyelograms after a year or more was 10 per cent of the patients and 5.7 per cent of the ureters at risk. Dilatation, when it arose, was always apparent in the immediate postoperative period, but half of the dilatations evident at that time resolved within a year.
Pancreatic pseudocysts in children: 4 Cases from Uganda
Authors: Carswell J Wilson , Cotter J , Master S P 
Published: March 2007

Abstract
Four cases of pancreatic pseudocyst in African children are described. There is some evidence that they followed pancreatitis of unknown aetiology. None had a history of trauma. Three were treated by cystogastrostomy, and the fourth by excision of the cyst.
Gas gangrene of the extremity: The presenting clinical picture in perforating carcinoma of the caecum
Authors: Mzabi R , Himal H S , MacLean L D 
Published: March 2007

Abstract
This paper reports 2 diabetic patients with perforating carcinoma of the caecum and gas gangrene of the pelvis and right lower extremity in whom the infective process was the main clinical feature.
Wound infections due to Bacteroides fragilis following intestinal surgery
Authors: Leigh D A 
Published: March 2007

Abstract
Ninety-six wound infections due to Bacteroides fragilis occurring after intestinal surgery are described. Most infections followed appendicectomy or colectomy for diverticulitis.
B. fragilis was isolated in pure growth from 47 per cent of infections, and in mixed culture the other common bacteria were Klebsiella spp., Escherichia coli and Enterobacter spp.
Fifty-three per cent of the infections responded rapidly to either non-specific measures or antibiotic therapy, but 47 per cent of patients developed complications, usually abscess formation.
The successful isolation of bacteroides from clinical material requires special precautions. The specimen for bacteriological examination must be sent to the laboratory in a transport medium which maintains an anaerobic environment and the culture techniques must include a selective agar for the isolation of anaerobic bacteria.
The role of antibiotic therapy in preventing postoperative wound infection after intestinal surgery is discussed. Bacteroides has an unusual pattern of antibiotic susceptibility and it is essential that an effective antibiotic such as lincomycin is included in the treatment of infection originating from the intestinal tract.
Early management of corrosive burns of the oesophagus
Authors: Balasegaram M 
Published: March 2007

Abstract
One hundred and sixteen patients with early corrosive burns of the oesophagus treated by the author are reviewed. It is emphasized that the all important aspect of management of these patients is prophylactic treatment to avoid stricture of the oesophagus. Early treatment consists of intravenous fluid therapy, broad spectrum antibiotics, sedation, parenteral hydrocortisone and more importantly maintaining the patency of the oesophagus followed by dilatation. The importance of early barium meal studies and oesophagoscopy is stressed.
Nitrogen mustard as adjunctive chemotherapy for breast carcinoma
Authors: Hines James R , Williams John S 
Published: March 2007

Abstract
A retrospective study is reported of 38 patients with breast carcinoma treated by radical mastectomy and a short course of nitrogen mustard. They were followed up for an average of 10 years. There were no serious untoward reactions to the drug. The 5- and 10-year corrected survival rates were 74 and 71 per cent respectively. There would appear to be a renewal of interest in adjuvant chemotherapy for patients with breast carcinoma.
The changing pattern of hospital admissions for diverticular disease of the colon
Authors: Kyle James , Davidson Alan I 
Published: March 2007

Abstract
Hospital admissions for symptomatic diverticular disease of the colon were studied during two periods, 1958–61 and 1968–71, in a relatively closed community in north-east Scotland. There was a significant increase in the numbers admitted, from 206 to 366. In the earlier 4-year period among patients aged 70 years and over there was a preponderance of females, but in the later study period the risk of developing symptomatic disease was almost as great among elderly males. Most of the elderly female patients were widowed city dwellers. The proportion of patients requiring operation for or dying from diverticular disease declined, but perforation remained as a frequent complication carrying a high mortality.
Gastric mucosal resection in the treatment of peptic ulcers: A 1–10 year clinical follow-up
Authors: Kirk R M 
Published: March 2007

Abstract
The clinical results of gastric mucosal resection are reported after a 1–10-year follow-up in which 76 per cent of patients were followed up for more than 5 years. There were 3 postoperative deaths in 152 patients. Mucosal antrectomy with vagotomy for duodenal ulcer in 96 patients, and for recurrent ulcer in 9 patients, has not been followed by a single recurrence. Gastric mucosal resection alone for the treatment of gastric ulcer in 21 patients resulted in 1 recurrence.
Although vagotomy combined with resection is currently out of fashion for the initial treatment of duodenal ulcer in Britain, mucosal gastric resection has technical advantages in combination with vagotomy for the cure of recurrent ulcers following duodenal ulcer surgery.
Abdominal tuberculosis: Demonstration of tubercle bacilli in tissues and experimental production of hyperplastic enteric lesions
Authors: Das Pritam , Shukla H S 
Published: March 2007

Abstract
Material obtained from 35 cases of abdominal tuberculosis was studied and an attempt was made to demonstrate tubercle bacilli by special staining of histological sections, culture and guinea-pig inoculation.
Acid fast bacilli could be demonstrated in 80 per cent of cases. The remaining cases were also possibly due to tuberculous infection because granulomas with Langhans's type of giant cells and caseation or calcification of lymph nodes were present. The bacilli were demonstrated in bowel tissue showing non-specific histology in 1 case. In 2 other cases with non-specific lesions in the bowel the bacilli were demonstrated in lymph nodes.
Guinea-pig inoculation studies showed that hypertrophic lesions of the bowel with a non-specific type of reaction could develop after intraperitoneal injection of tubercular material.
Although it cannot be said on the basis of this study that Crohn's disease is caused by tuberculous infection, it can be concluded that tuberculous infection can give rise to a Crohn's type of lesion.
A rabbit model of perforated appendicitis with peritonitis
Authors: King D W , Gurry J F , Ellis-Pegler R B , Brooke B N 
Published: March 2007

Abstract
No satisfactory animal model simulating acute perforating appendicitis followed by peritonitis in man has hitherto been achieved. A technique has been developed in New Zealand White rabbits to fulfil these desiderata. The bacterial flora associated with the ensuing peritonitis is similar to that found in man both as regards aerobes and anaerobes and their concentrations. The method effectively produces the required model in 70 per cent of rabbits subjected to the experiment. Satisfactory postoperative survival is achieved enabling therapeutic studies.
The role of surgery in the management of Hodgkin's disease
Authors: Irving Miles 
Published: March 2007

Abstract
The marked improvement in the prognosis of patients with Hodgkin's disease has resulted from advances in radiotherapy and chemotherapy. Success with these treatments depends upon accurate knowledge of the extent of the disease. Clinical assessment of the presence of abdominal disease is unreliable. Exploratory laparotomy with splenectomy, multiple lymph node biopsy and liver biopsy will reveal that preoperative assessment of the extent of the disease is inaccurate in 30 per cent of cases. The information obtained prevents relapses from undiagnosed abdominal disease and ensures that inappropriate radiotherapeutic treatment is not given to patients with disseminated disease.
Experimental studies on the pathophysiological responses of the newborn to injury
Authors: Little R A 
Published: March 2007

Abstract
Experimental studies are reviewed which show that there are significant differences with age in both the local and general responses to injury. The results seem to confirm the belief in the striking ability of the newborn to withstand injury and suggest that one important aspect of this resistance is an increased ability to compensate circulatory hypovolaemia.
Recurrence of gastric ulcer after selective vagotomy and pyloroplasty for chronic uncomplicated gastric ulcer: A 5–10 year follow-up
Authors: De Miguel Jacinto 
Published: March 2007

AbstractSelective vagotomy and pyloroplasty were used in the surgical treatment of 73 patients with benign gastric ulcer between July 1964 and February 1970. Over the long period of observation recurrence of the gastric ulcer was found in 13 patients (19.1 per cent). This complication occurred equally commonly after treatment of primary and secondary gastric ulcers and was twice as frequent in women as in men. Possible reasons for these recurrences are discussed.It is concluded that vagotomy and pyloroplasty cure benign gastric ulcer in about 80 per cent of patients, and this should be taken into account in the choice of surgical treatment, especially in patients in whom a gastrectomy might put the patient's life at risk. However, because of the high recurrence rate, it is doubtful whether this operation should be considered the treatment of choice for all cases of gastric ulcer.
The effect of metal clips on the tensile properties of healing skin wounds
Authors: Harrison I D , Williams D F , Cuschieri A 
Published: March 2007

Abstract
The effects of nylon sutures and metal skin clips on the tensile properties of healing skin wounds have been studied in the pig. Wounds closed with clips have significantly poorer mechanical properties at 5,7 and 14 days after wounding than similar wounds in the same animal closed with interrupted nylon sutures. This difference increased progressively with the period of retention of the clips. It is also shown that in equivalent groups of 14-day wounds, those in which clips were retained after the seventh day had a lower tensile strength, poorer ability to absorb energy and a lower elastic modulus than similar wounds where clips had been removed early. No such adverse effect was noted with nylon sutures.
Carcinoma of the duodenum: Its preoperative diagnosis
Authors: Satake K , Sowa M , Yamashita K , Kamino K , Kinoshita H , Kato M , Umeyama K 
Published: March 2007

Abstract
Carcinoma of the duodenum, although uncommon, can be diagnosed by direct visualization, photography of the tumour and biopsy by the fibre-duodenoscope. The duodenoscopic examination may not only distinguish carcinoma of the duodenum from pancreatic carcinoma, ampullary carcinoma and secondary tumour from an adjacent organ but will also enable a correct diagnosis to be made early in the course of the disease.
It is therefore suggested that duodenoscopy and biopsy will increase the resectability and 5-year survival rate.
Clinical features of the degenerate meniscus with the results of meniscectomy
Authors: Noble Jonathan 
Published: March 2007

Abstract
A series of 172 patients with an unambiguous diagnosis of horizontal cleavage lesion is reviewed, the average duration of which was 4 1/2 years. Although all the patients complained of pain, night pain and mechanical instability were not invariable. Joint line tenderness was the commonest physical sign. Whereas all but 7 per cent were either “cured” or “improved”, nearly half the patients had persistent complaints, usually pain. The objective physical findings at review frequently failed to correspond with patients' opinions of their knees. Recovery after meniscectomy may be slow.
Enzyme inhibition in colorectal surgery
Authors: Delaney Peter , Lalor Denis 
Published: March 2007

Abstract
Anastomotic dehiscence is particularly common after low anterior resection of the rectum. The enzyme collagenase is largely responsible for this high complication rate. Inhibition of this enzyme in an experimental model produced significantly stronger colonic anastomoses. There may be a place for such an inhibitor in clinical surgery.
Operative cholangiography: Criteria which make exploration of the common bile duct desirable
Authors: Marks C G , Kelvin F M 
Published: March 2007

Abstract
The purpose of this study was to evaluate the individual criteria and combination of criteria examined by operative cholangiography which make exploration of the common bile duct desirable. The overall accuracy of exploration of the common bile duct (89 per cent) was similar to that of previous series. In the normal group the accuracy of the criteria established by Le Quesne (1960) is confirmed.
The most reliable criteria in the abnormal cholangiograms were the presence of single or multiple filling defects in the common bile duct, the absence of free flow of contrast medium into the duodenum and an abnormality of the terminal narrow segment. Measurements to aid assessment of free flow into the duodenum are suggested. In 34 of 40 positive explorations the common bile duct diameter was 14 mm or less; 10 common bile ducts which contained stones were less than 10 mm in diameter. Excess filling of the intra-hepatic ducts was often impossible to judge in the abnormal group and was the least valuable criterion.
Attention is drawn to the advantage of an immediate radiological report.
Delayed arterial embolectomy: A plea for a more active surgical approach
Authors: Ammann J , Seiler H , Vogt B 
Published: March 2007

Abstract
In a series of 18 patients delayed embolectomy of the limb was performed 8-63 days after embolism had occurred. Three patients died (2 of them after amputation), and 7 limbs were amputated after surgery. In 10 instances blood flow was fully restored by the operation. Analysis of the 18 cases leads to the conclusion that the success of delayed embolectomy where neuromuscular function is intact depends primarily on surgical technique. Direct embolectomy by local or regional exposure of the obstructed arterial level is shown to produce better results than conventional (distant) balloon catheter embolectomy by proximal incision. This is thought to be due to increased mural adherence of the embolus, with secondary thrombus formation after a delay of 8 days or more. A plea is therefore made for a more aggressive surgical attitude to delayed arterial embolization. Provided that preoperative arteriography has localized the obstructive level and that the patient's general condition allows major vascular surgery, direct removal of the embolus and secondary thrombi by open exposure of the obstructed artery is recommended.