bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipids in breast carcinogenesis
Authors: Pritchard G A , Jones D L , Mansel R E 
Published: March 2007

Abstract
Excess dietary fat has been identified as a risk factor in the development of human breast carcinoma. However, the quality of fat may be more important than the overall quantity. We have studied the growth of human MCF7 breast carcinoma xenografts in athymic mice treated with dietary supplements of N-6 and N-3 series essential fatty acids given as natural preparations of evening primrose oil and fish oil. Olive oil and normal laboratory diet lacking the essential fatty acids served as controls. Animals treated with essential fatty acids developed tumours which were significantly smaller than both control groups (Mann-Whitney U test, P&lt;0.001). Median tumour weights according to diet were: evening primrose oil, 133 mg; fish oil, 70 mg; olive oil, 212 mg; and control, 270 mg. Nutritional intervention to increase the proportion of essential fatty acids in the diet may have a role in the management of breast carcinoma.
Postsplenectomy sepsis
Authors: Shaw J H F , Print C G 
Published: March 2007

Abstract
This review examines the infectious consequences of elective and emergency splenectomy, highlighting the importance of infection with Streptococcus pneumoniae. The influence of splenectomy on the immune system is discussed and the efficacy of vaccines in preventing postsplenectomy sepsis is reviewed. The value of alternative methods of preventing postsplenectomy sepsis is considered.
Acute pancreatitis and pancreatic fistula formation
Authors: Fielding G A , McLatchie G R , Wilson C , Imrie C W , Carter D C 
Published: March 2007

Abstract
The cause, management and outcome of 23 patients with a pancreatic fistula following acute pancreatitis are reviewed. Nineteen patients developed an external fistula following necrosectomy or drainage of a pancreatic abscess or pseudocyst; four of these patients died. In the 15 survivors spontaneous closure occurred in 11 cases with low output fistulae; operative intervention was needed in the four cases with high output fistulae. Four patients with internal fistulae had not undergone previous surgery; two of them had a pancreaticopleural fistula with associated pancreaticogastric fistulae, while two had pancreatic ascites. All four of these patients required surgical intervention and one died.
Surgical audit of patients undergoing common bile duct exploration for stone
Authors: McEntee G P , Mulvin D M , Peel A L G 
Published: March 2007

Abstract
One hundred and sixty-four patients operated on for calculus disease of the common bile duct during the period 1977–85 were followed in a special clinic; the attendance for follow-up at 1, 3, 5 and 7 years was 90, 74, 60 and 54 per cent respectively. Eleven patients died during the study period (6·7 per cent), none of the deaths being attributable to biliary tract disease. The overall incidence of retained calculus was 2·4 per cent (four patients), but no cases of retained calculi were recorded in the last 4 years of the study; in this period, with the advent of choledochoscopy and fluoroscopic cholangiography, the incidence of the supraduodenal compared with the transduodenal approach to the common bile duct increased significantly (P&lt;0·001). Twenty-two of 56 patients (39 per cent) followed up for 5 years remained or became symptomatic after surgery, the majority of whom had underlying conditions unrelated to disease of the biliary or pancreatic tree. This specific follow-up clinic has been of value in the long-term audit of patients undergoing bile duct surgery for choledocholithiasis and it has verified that a change of policy from transduodenal to supraduodenal choledochotomy with preservation of the sphincter, and use of the choledochoscope and fluorocholangiography, produce better results.
Effects of a somatostatin analogue (SMS 201-995) on the growth and development of hepatic tumour derived by intraportal injection of Walker cells in the rat
Authors: Nott D M , Baxter J N , Yates J , Grime J S , Day D W , Cooke T G , Jenkins S A 
Published: March 2007

Abstract
Administration of a long acting analogue of somatostatin, SMS 201-995 (2 μg subcutaneously twice a day) for 3 weeks after intraportal administration of Walker cells significantly inhibited their growth and development in the liver. This was not due to a direct cytotoxic effect of the analogue on Walker cells whose growth was stimulated in vitro. Furthermore, SMS 201-995 had no effect on the growth of Walker cells implanted into the thigh of rats suggesting that the inhibitory action of the analogue could be confined to tumour cells growing in the liver. Further studies suggested that the inhibitory effect of SMS 201-995 on the growth of Walker cells in the liver could be related to a marked stimulation of the hepatic reticuloendothelial system, by a reduction in portal venous flow in the early stages of treatment or by a combination of these effects. Further studies are required to delineate more precisely the mechanism whereby SMS 201-995 inhibits the growth of hepatic tumour derived from intraportal administration of Walker cells.
Prognostic value of nucleolar organizer regions and ploidy values in advanced colorectal cancer
Authors: Moran K , Cooke T , Forster G , Gillen P , Sheehan S , Dervan P , Fitzpatrick J M 
Published: March 2007

Abstract
The prognostic value of nucleolar organizer regions and ploidy status in patients with Dukes' C colorectal cancer was determined. In addition, nucleolar organizer regions and ploidy status were compared with the established prognostic indices age, sex, tumour location and degree of histological differentiation. Fifty-one patients (27 men, 24 women) aged 35–81 years (median 64·8 years) were studied. Five years after presentation, 16 patients were alive and well. Survivors had significantly lower nucleolar organizer region counts (median value and range) in primary tumours 12 (8–15) and lymph node metastases 11 (8–15) than non-survivors 17 (14–25) and 18 (13–25) respectively (P&lt;0·05). Fewer survivors had aneuploid tumours than non-survivors: four survivors compared with 17 non-survivors. In a regression analysis model, nucleolar organizer regions were the most important individual variable for predicting survival (χ2 = 15, P0·01) while ploidy values (χ2 = 6, P0·2) were equivalent to histological differentiation.
Long term results of anorectal myectomy for chronic constipation
Authors: Pinho M , Yoshioka K , Keighley M R B 
Published: March 2007

Abstract
Early evaluation of anorectal myectomy in this unit suggested that it might provide clinical benefit to patients with outlet obstruction. Long term results of anorectal myectomy are now available in 63 patients operated on between February 1984 and February 1988 with a median follow-up of 30 months. Spontaneous rectal evacuation without the need for laxatives was recorded in only 11 patients (17 per cent), while 44 (70 per cent) achieved no functional improvement. Mild incontinence developed in 6 patients (10 per cent). Results were independent of preoperative colonic transit or histological evidence of aganglionosis.
Prognosis after surgery for colonic Crohn's disease
Authors: Andrews H A , Lewis P , Allan R N 
Published: March 2007

Abstract
The long-term prognosis including operation rates, the incidences of recurrent disease, morbidity and mortality and current status has been analysed in a group of 360 patients with Crohn's colitis grouped according to the primary site of macroscopic disease at diagnosis. The group has been followed from diagnosis for a mean period of 14·9 years. The overall operation rate was 76 per cent. Prolonged spontaneous or drug induced remission occurred at all sites: right-sided disease (11 per cent), extensive colonic disease (21 per cent) and left-sided disease (38 per cent). The cumulative reoperation rates at 5 and 10 years after right hemicolectomy were 26 and 46 per cent, after colectomy and ileorectal anastomosis 46 and 60 per cent, and after panproctocolectomy 10 and 21 per cent, respectively. There was a twofold excess mortality rate from related Crohn's disease deaths during the period of review, but the mortality rate has fallen with time. There have only been 11 related deaths in the last decade, of which eight were probably unavoidable. The current status of most patients is good, although treatment has included a permanent stoma in less than half (41 per cent) the patients still under review. Currently all but 14 patients are well and symptom-free and only 16 are receiving specific medical treatment. Until the aetiology of Crohn's colitis is understood, if medical treatment has failed to resolve symptoms, appropriate surgical treatment in experienced hands is an effective way of restoring patients with chronic persistent symptoms to good health.
Functional closure of the femoral canal revealed by computed tomographic scanning
Authors: Hahn-Pedersen J , Bojsen-Møller F , Rosenklint A 
Published: March 2007

Abstract
The lacuna vasorum contains, as well as the external iliac vessels, a space called the femoral canal which allows pulsation and other changes in the diameter of the two vessels. The canal is closed by a connective tissue septum which is too weak to prevent a herniation alongside the vessels. The functional closure of the canal was investigated by artificial augmentation of the intraluminal pressure of the vein in five specimens and by computed tomographic (CT) scanning during a Valsalva manoeuvre in ten normal persons. In the abdomen the intraluminal and extraluminal pressures are raised in parallel, with no consequence for the diameter of the vessels. In the area of the lacuna vasorum the intravenous pressure is conveyed down to the first competent valve which is located 0·5 cm distal to the inguinal ligament, while the extraluminal pressure is reduced to normal. At each rise of the intra-abdominal pressure the vein will therefore bulge and exactly fill the empty space of the femoral canal thus preventing herniations by an on-demand mechanism. By CT scanning it was found that the vein in the femoral canal increased its diameter 2·5–3·0 times during the Valsalva manoeuvre.
The role of contrast radiography in presumed bowel obstruction
Authors: Riveron Fernando A , Obeid Farouck N , Horst H Mathilda , Sorensen Victor J , Bivins Brack A 
Published: March 2007

Abstract
A retrospective review of 229 patients with a final diagnosis of small-bowel obstruction was undertaken to evaluate the role of contrast radiography in the management of their conditions. In 84 patients (37%) the clinical findings and plain abdominal roentgenograms were sufficient for diagnosis and subsequent management. Of the remaining 145 patients with equivocal findings, 27% had an upper gastrointestinal series, 29% a barium enema, and 44% had both. Useful information (complete obstruction, unobstructed passage of contrast, or diagnosis other than adhesional obstruction) was obtained from 86% of the radiographic studies. Three patients had negative contrast studies yet eventually underwent adhesiolysis (enterolysis) and were classified as false-negative. Two patients had evidence of high-grade obstruction yet had nonoperative resolution and were classified as false-positive. The mortality in the contrast group (7%) was not statistically different than that in the no-contrast group (7%). Contrast radiography is a safe and effective means of increasing diagnostic accuracy in patients with presumed small-bowel obstruction. (SURGERY 1989; 106: 496-501.).
From The Division of Trauma and Critical Care Surgery, Henry Ford Hospital, Detroit, Mich.
Local low dose intra-arterial thrombolytic therapy: The risk of stroke or major haemorrhage
Authors: Berridge D C , Makin G S , Hopkinson B R 
Published: March 2007

Abstract
The use of local low dose thrombolysis is gradually increasing. Most experience is with streptokinase, although newer agents such as recombinant tissue plasminogen activator (rTPA) may offer more effective lysis with reduced complications. We have reviewed the experience documented in 19 prospective series published between 1974 and 1988 in an attempt to define the incidence of stroke, major haemorrhage and minor haemorrhage. The overall risk of stroke was 1·0 per cent. of patients (14 cases). Major haemorrhage occurred in 5·1 per cent of patients (71 cases) and minor haemorrhage occurred in 14·8 per cent (92 out of 620 cases). There was little difference between the two thrombolytic agents, although the experience with lower doses of rTPA suggests it may offer a reduced risk of haemorrhagic complications. It is essential that all studies concerning thrombolysis should give their exclusion and inclusion criteria in full to allow an accurate appraisal of haemorrhagic complications, with the hope of improved patient selection and reduced morbidity in the future.
Intravenous digital subtraction angiography for extracranial carotid artery disease
Authors: Turner W H , Murie J A 
Published: March 2007

Abstract
Intravenous digital subtraction angiography is relatively hazardous and inaccurate. It appears from the literature to have little place in either the screening of patients with putative carotid artery disease or in the assessment of those about to undergo carotid endarterectomy.
Long term outcome after resection of the first rib for thoracic outlet syndrome
Authors: Lepäntalo M , Lindgren K-A , Leino E , Lindfors O , von Smitten K , Nuutinen E , Tötterman S 
Published: March 2007

Abstract
A total of 112 first ribs in 103 patients were resected over 11 years for thoracic outlet syndrome. Seventy-seven patients (84 operations) were followed up for 2·5 years or more to assess the long term results of this procedure and the factors affecting them. One month after surgery 52 per cent of limbs were asymptomatic and 77 per cent were at least improved. A follow-up examination was performed, on average 6·1 years after the operation, by two independent examiners. This evaluation showed a permanent success rate of 37 per cent among 84 limbs examined. These long term results compare unfavourably with previously published data. The reason for the poor final outcome seemed to be difficulty in selecting patients for the operation. This was not aided by any of the preoperative tests. Patients in this study were evaluated by independent examiners, and only a total absence of preceding symptoms was accepted as the criterion for success. We emphasize the importance of unbiased evaluation and long term follow-up.
Attachment of indium-111 labelled endothelial cells to pretreated polytetrafluoroethylene vascular grafts
Authors: Budd J S , Bell P R L , James R F L 
Published: March 2007

Abstract
This study investigated the effect of different surface coatings on endothelial cell attachment to polytetrafluoroethylene (PTFE) vascular grafts. Small segments of PTFE vascular grafts were precoated with one of a number of substances: gelatin, poly-l-lysin, fibronectin, or collagen type I, III or IV. Indium-III labelled endothelial cells were then seeded on to the grafts and left for either 10, 30, 60 or 120 min. The unattached cells were removed and the degree of cell attachment was calculated. All coatings were significantly better at enhancing endothelial cell attachment at all times compared with controls, and fibronectin was significantly better as a coating material than any other material used. By pretreating with a substance such as fibronectin, the number of endothelial cells attaching to PTFE vascular grafts can be greatly increased, thereby enhancing the cell seeding process.
Comparison of intracavitary bleomycin and talc for control of pleural effusions secondary to carcinoma of the breast
Authors: Hamed H , Fentiman I S , Chaudary M A , Rubens R D 
Published: March 2007

Abstract
In a prospective randomized study, patients with pleural effusions secondary to breast carcinoma were randomly allocated to be treated by pleurodesis using either intracavitary talc or bleomycin. For 25 assessable treatments in 22 patients, recurrence of effusion was observed in 5 of 15 (33 per cent) of the bleomycin group compared with none in the talc group. It is concluded that talc is superior to bleomycin in controlling pleural effusions secondary to breast carcinoma, but bleomycin may have a role in patients unfit for general anaesthesia or with extensive disease elsewhere.
Management of high grade parotid carcinomas
Authors: Wyatt M G , Coleman N , Eveson J W , Webb A J 
Published: March 2007

Abstract
Thirty-four patients admitted to the Bristol Royal Infirmary during the 20-year period 1966–85 and diagnosed as suffering from high grade parotid carcinoma were studied. The male:female ratio was 2·4:1, with a mean age at presentation of 68 years. Facial swelling was present in all patients with a mean duration of 9·9 months before treatment. Pain, deep fixation, facial nerve involvement, ulceration and distal metastases were all associated with a poor prognosis. Diagnosis was made either at operation or by fine needle biopsy. All 34 patients received radiotherapy. Fourteen patients (41 per cent) underwent a definitive surgical procedure. The local recurrence rates for the non-surgical and surgically treated groups were 30 per cent (six patients) and 36 per cent (five patients) respectively; twelve patients (60 per cent) in the non-surgical group developed distant metastases as opposed to six patients (43 per cent) in the surgical group. Both local and distant recurrent, disease are indicators of poor prognosis, with only one patient alive at 104 months. Seven patients (21 per cent) remain recurrence free. Definitive surgery, combined with radiotherapy, improved survival in those with amenable localized disease.
Long acting somatostatin analogue in dumping syndrome
Authors: Tulassay Z , Tulassay T , Gupta R , Cierny G 
Published: March 2007

Abstract
The effect of long acting somatostatin analogue, SMS 201-995, on postprandial dumping syndrome was studied in eight patients with Billroth II gastric resection. Each patient was subjected to two oral glucose challenges with 75 g glucose. One challenge was premedicated with 50 μg SMS 201–995 subcutaneously 15 min before the oral intake of glucose, the other with placebo. With placebo all patients experienced the subjective symptoms of the early dumping syndrome with significant (P&lt;0·001) increases (mean (s.d.)) in pulse rate (from 66 (8) to 102 (10) beats/min), in packed cell volume (from 0·36 (0·05) to 0·43 (0·1) l/l) and in the plasma levels of vasoactive intestinal polypeptide (from 3·0 (0·5) to 10·2 (1·8) pmol/l). During the somatostatin study the subjective symptoms and the changes in the various parameters were not detected. In the control study seven patients showed postprandial hypoglycemia. In these patients significant elevations (P&lt;0·001) in the insulin level (from 10 (0·9) to 40 (9·1) μE/ml) and gastric inhibitory peptide (GIP) concentration (from 100 (13) to 220 (41) ng/l) were seen, compared with the initial values. During the application of SMS 201-995 hypoglycaemia did not develop and plasma insulin and GIP concentrations remained unchanged. These results indicate that the long acting somatostatin analogue alleviates the symptoms of early and late postprandial dumping syndromes.
Hepatic resection for colorectal secondaries
Authors: Karanjia N D , Rees M , Schache D , Heald R J 
Published: March 2007

Abstract
A postal survey of consultant surgeons in England and Wales was carried out to assess current attitudes towards screening for and treatment of hepatic metastases from primary colorectal carcinoma. The results showed that pre-, intra- and postoperative screening were inadequate. There was no consensus as to which patients would benefit from major hepatic resection for colorectal liver secondaries. Fewer than one-third of potentially operable patients underwent liver surgery.
Methyl-tert-butyl-ether for treating bile duct stones: The British experience
Authors: Neoptolemos J P , Hall C , O'Connor H J , Murray W R , Carr-Locke D L 
Published: March 2007

Abstract
Methyl-tert-butyl-ether (MTBE), infused via a nasobiliary catheter, was used to treat 33 patients with bile duct stones in nine units around Britain. MTBE contributed to success in 12 (36 per cent) cases: seven passed stones spontaneously during MTBE infusion and five had partial stone dissolution allowing subsequent endoscopic extraction. MTBE was non-contributory in 21 (64per cent) cases: four passed stones after MTBE was stopped, six were treated by subsequent endoscopic techniques without evidence of dissolution, seven underwent surgery, and four were treated conservatively (with one death). In at least ten of the 21 cases in which MTBE was non-contributory, pigment stones were present. Forty-two complications occurred in 26 (79per cent) patients. The efficacy of MTBE for treating bile duct stones might be improved by better methods of instillation and, since success may be related to technique, the use of MTBE should be restricted to units familiar with this chemical.
Roles of bile and bacteria in biliary peritonitis
Authors: Andersson R , Tranberg K-G , Bengmark S 
Published: March 2007

Abstract
Bile is known to have an adverse effect in peritonitis but the mechanism(s) and site of action of bile are unknown, as are the relative roles of bile and bacteria. The present study was designed to answer some of these questions. Experiments in which rats were injected intraperitoneally and intravenously with bile, Escherichia coli or saline showed that bile had no systemic toxicity and that it increased the mortality rate only when introduced into the peritoneal cavity together with bacteria. Measurements of peritoneal fluid volumes and blood pressure did not confirm the theory that the increased mortality rate was a consequence of loss of plasma volume into the peritoneal cavity. The number of intraperitoneal bacteria decreased continuously in animals receiving intraperitoneal E. coli alone. When bile was added by intraperitoneal injection, the number of intraperitoneal bacteria started to rise at 2 h and then increased steadily with a consequent bacteraemia at 10 h. The number of bacteria per peritoneal phagocyte was significantly lower after intraperitoneal injection of E. coli and bile, when compared with injection of E. coli alone. It is concluded that bile exerts its detrimental effect within the peritoneal cavity in the presence of bacteria. Bile impairs local host defence in a way that remains unknown and may be related to the detergent–lytic effects of bile salts.
T tube intubation in the management of seriously ill patients with oesophagopleural fistulae
Authors: Naylor A R , Walker W S , Dark J , Cameron E W J 
Published: March 2007

Abstract
Ten patients referred late with oesophagopleural fistulae were managed by T tube intubation of the oesophageal defect. Seven survived and six had radiographic evidence of closure of the defect. One patient who removed his T tube early was discharged to convalesce with a small oesophagocutaneous fistula. Three patients died as a consequence of pre-existing renal failure, upper gastrointestinal haemorrhage and adult respiratory distress syndrome. Patients presenting late with multisystem complications and ongoing sepsis secondary to oesophagopleural fistulae pose a major management problem. Our preliminary results suggest that T tube intubation offers a potential alternative to major surgical intervention, when more conservative measures have failed.