bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of fibrin sealant on the healing colonic anastomosis in the rat
Authors: van Der Ham A C , Kort W J , Weijma I M , Van Den Ingh H F G M , Jeekel J 
Published: March 2007

Abstract
Fibrin adhesives have been advocated as a protective seal in colonic anastomosis to prevent leakage. In order to assess the effect of fibrin glue sealing we compared the healing of sutured colonic anastomosis in the rat (group 1) with the addition of human-derived fibrin sealant (group 2). As a control for a possible reaction to foreign protein, in group 3 the sutured anastomosis was sealed with specially prepared rat fibrin adhesive. On days 2, 4 and 7, ten animals in each group were killed. Adhesion formation was scored and the in situ bursting pressure was measured. The collagen concentration and degradation were estimated by measuring hydroxyproline. Adhesion formation was significantly increased in groups 2 and 3 compared with the control group. On days 2 and 7 the bursting pressure was not different between the groups. On day 4 the bursting pressure in groups 2 and 3 was significantly lower than in group 1 (P &lt; 0·001). These findings correspond with the results of collagen measurements. On day 4 the concentration of hydroxyproline was significantly reduced in groups 2 and 3. Histological examination showed infiltration of neutrophilic granulocytes into the sealant on days 2 and 4; on day 7 the sealant had vanished. From these results it is concluded that fibrin sealing of the colonic anastomosis in the rat does not improve healing, as demonstrated by bursting pressure and hydroxyproline concentration. On the contrary, it seems to have a negative influence.
Influence of methylprednisolone on the healing of intestinal anastomoses in rats
Authors: Mastboom W J B , Hendriks T , de Man B M , de Boer H H M 
Published: March 2007

Abstract
Although steroids are generally thought to impair intestinal anastomotic healing, this effect has never been proven unequivocally in either clinical or experimental studies. We have investigated the influence of methylprednisolone (2·5 or 10·0 mg kg−1 day−1) given from 2 days before operation onwards, on 3-day-old and 7-day-old ileal and colonic anastomoses in rats. Anastomotic abscesses occurred more frequently in the ileum, but not in the colon, after steroid medication. However, methylprednisolone did not lower anastomotic bursting pressures in either of the bowel segments. Comparison of the hydroxyproline content of the anastomotic segment yielded no significant difference between control and methylprednisolone groups in either small or large bowel. Thus, healing of experimental colonic anastomoses remains unaffected by short-term administration of this corticosteroid.
Influence of local hyperthermia on the healing of small intestinal anastomoses in the rat
Authors: Shimizu T , Maeta M , Koga S 
Published: March 2007

Abstract
Peritoneal hyperthermia may have a role in limiting serosal metastatic disease. When applied to the peritoneal cavity immediately after surgery, it is important to know the optimum temperature, and to investigate the subsequent healing of intestinal anastomoses. To study the first problem, local hyperthermia was applied to the intestinal loop of rats for 30 min. Treatment at 46·0°C or 45·0°C resulted in 100 per cent and 90 per cent mortality respectively, but 100 per cent survival was obtained at 44·0°C. To study the second problem rats with intestinal anastomoses were studied in three groups: group A, local hyperthermia (44·0°C &lt; 30 min) applied to the intestinal loop containing the anastomosis; group B, local hyperthermia (44·0°C × 30 min) applied using saline supplemented with mytomycin C (10 mg/l); group C (controls) no thermal treatment was applied. Anastomotic healing was assessed by breaking strength and histological examination. On the third day after operation, the breaking strength of anastomoses decreased to the lowest values in each group, but no statistically significant differences were noted. On the seventh and 14th day, increased resistance to breaking developed in all three groups and was greatest in the thermally treated groups. Histological findings supported these results. Local hyperthermia up to 44·0°C × 30 min had no adverse effects on the healing of intestinal anastomoses.
Correlation between laboratory findings and clinical outcome after restorative proctocolectomy: Serial studies in 20 patients with end-to-end pouch-anal anastomosis
Authors: Sagar P M , Holdsworth P J , Johnston D 
Published: March 2007

Abstract
Clinical function and anorectal physiological function were assessed and correlated in 20 patients with ulcerative colitis before restorative proctocolectomy and 3, 7, and 12 months after operation. The entire anal sphincter was preserved by means of a stapled pouch-anal anastomosis. Before operation, the median resting anal pressure was 79 cmH2O (interquartile range 70–89 cmH2O), the rectoanal inhibitory reflex was present in all patients and anorectal ‘sampling’ was noted in 16 of 20 patients. Three months after operation, resting anal pressure was 68 cmH2O (range 50–87 cmH2O) (P &lt; 0·001), the reflex was present in only three patients (P &lt; 0·001) and sampling was observed in one patient. After 7 months, resting anal pressure was 76 cmH2O (range 64–89 cmH2O), the reflex was present in 11 patients and sampling was observed in nine patients. At 12 months, resting anal pressure was 84 cmH2O (range 66–94 cmH2O), the reflex was present in 19 patients and sampling was observed in 17 patients. The compliance and capacity of the reservoir increased significantly. Ability to discriminate flatus from faeces was associated with return of the rectoanal reflex and sampling.
Changes in anal canal sensation after childbirth
Authors: Cornes H , Bartolo D C C , Stirrat G M 
Published: March 2007

Abstract
Obstetic trauma predisposes to faecal incontinence. Anal canal sensation is impaired in incontinent patients. To assess the effect of childbirth on anal canal sensation anal mucosal electrosensitivity was measured in 122 primiparous patients in the immediate postnatal period and in 74 at 6 months postpartum. There were 35 normal vaginal deliveries, 36 forceps deliveries, 20 ventouse extractions, ten vaginal breech deliveries and 21 caesarean sections. Sensation was impaired in the lower, mid and upper anal canal immediately after delivery in those patients who had a normal vaginal delivery or a forceps delivery when compared with controls or with those delivered by caesarean section. Women who had ventouse deliveries had impaired sensation immediately after delivery in the mid anal canal compared with controls and those undergoing caesarean section. By 6 months there were no differences between any group. Patients who sustained a division of the external anal sphincter at delivery had impaired sensation which persisted in the upper anal canal at 6 months.
Role of the protease-antiprotease balance in peritoneal exudate during acute pancreatitis
Authors: Wilson C , Shenkin A , Imrie C 
Published: March 2007

Abstract
The peritoneal exudate formed during experimental pancreatitis is toxic when administered intraperitoneally or intravenously to other animals. Overwhelming of the peritoneal antiprotease defences by proteolytic enzymes released from the pancreas may be a key factor responsible for this toxicity and is examined in the current study. Human pancreatitis exudates possessed tryptic amidase activity indicating trypsinogen activation. The trypsin inhibitory capacities of exudates were reduced indicating a degree of consumption of the peritoneal antiproteases. Of 21 exudates examined, three showed marked reduction of their trypsin inhibitory capacity indicating almost complete consumption of their antiproteases. All three patients were shocked at the time of sampling, two dying of fulminant pancreatitis within 24 h. Overwhelming of the peritoneal antiproteases was not confirmed, but may occur in a few instances where proteolytic enzyme release or zymogen activation continues. Intraperitoneal administration of exogenous antiproteases prolongs survival in rats with pancreatitis and has been suggested as a therapy in man. The current data suggests that few patients are likely to benefit from such an approach.
Neonatal small bowel atresia, stenosis and segmental dilatation
Authors: Paterson-Brown S , Stalewski H , Brereton R J 
Published: March 2007

Abstract
In 8 years, 44 neonates were treated for small bowel atresia, stenosis or segmental dilatation by one surgical team. There was a single lesion in 30 infants and 14 had two or more sites of intestinal obstruction. Associated gastrointestinal abnormalities were found in 23 (52 per cent) patients. Resection of the atresia(s) and primary anastomosis were performed in 34 infants and staged procedures were carried out in ten patients with complicated lesions. Patients undergoing staged procedures had a higher complication rate than those having primary repair (six out of ten and 11 out of 34 respectively). The overall initial survival rate was 93 per cent, rising to 100 per cent in those without associated anomalies or prenatal complications, but more than a quarter (27 per cent) of survivors have long-term disabilities.
Solitary thyroid nodule: A prospective evaluation of nuclear scanning and ultrasonography
Authors: Cox M R , Marshall S G , Spence R A J 
Published: March 2007

Abstract
The aim of this study was to assess prospectively the value of thyroid nuclear scans and ultrasound examination in the preoperative investigation of patients with a solitary thyroid nodule. Total thyroid lobectomy for a solitary thyroid nodule was performed in 68 cases. Each patient had a thyroid isotope scan (except two women who were pregnant) and thyroid ultrasound examination. There were 10 (15 per cent) malignant nodules, 11 (16 per cent) benign neoplastic nodules and 47 (69 per cent) benign non-neoplastic nodules. All of the patients with malignant nodules who were scanned had a solitary cold nodule on thyroid scan, as did 40 (69 per cent) of those with benign solitary nodules. Ultrasound examination of the thyroid suggested correctly that one of 16 (6 per cent) cystic lesions, four of 16 (25 per cent) complex solid-cystic lesions and three of 18 (17 per cent) of solid lesions were malignant. One lesion reported as multinodular on ultrasonography and one reported as normal also turned out to be malignant. Thyroid isotope scans and ultrasound do not accurately differentiate between benign and malignant conditions and their routine use in the investigation of a solitary thyroid nodule should be abandoned.
DNA aneuploidy in follicular thyroid neoplasia
Authors: Cusick E L , Ewen S W B , Krukowski Z H , Matheson N A 
Published: March 2007

Abstract
The potential value of DNA aneuploidy, in distinguishing benign from malignant follicular thyroid neoplasms, was studied. The nuclear DNA content of 65 follicular thyroid neoplasms (52 adenomas and 13 carcinomas) was determined by flow cytometric analysis of paraffin embedded material; in 58 cases preparations were technically satisfactory. In 22 follicular neoplasms DNA analysis was also performed on fresh material obtained by fine needle aspiration of surgical specimens. Cell cycle analysis was performed on both fresh and fixed specimens. An aneuploid DNA profile was found on analysis of fixed tissue in eight of 45 (18 per cent) follicular adenomas and four of 13 (31 per cent) follicular carcinomas. DNA aneuploidy was also found in six of the 22 (27 per cent) fresh preparations from follicular adenomas. The frequency of DNA aneuploidy in apparently benign and malignant follicular neoplasms was similar. Follicular thyroid neoplasia are best regarded as a single entity with a low incidence of local and distant spread. All follicular neoplasia are therefore best excised.
Further evaluation of radical surgery following radiotherapy for advanced parotid carcinoma
Authors: Gallegos N C , Watkin G , Cook H P , Sanders R , Hobsley M 
Published: March 2007

Abstract
A series of 30 patients who have been treated for advanced carcinoma of the parotid gland using radiotherapy followed by radical surgery is presented. Three patients deteriorated during preoperative radiotherapy and remained unfit for surgery; the remaining 27 underwent radical parotidectomy with block dissection of the neck. Twelve patients received additional radiotherapy after operation. Of those patients undergoing surgery, three have been lost to follow-up, 17 have died and seven remain alive; the period of follow-up ranges from 3 to 133 months. Fourteen patients remained free of recurrent disease at death or when last seen, and six patients developed a local recurrence at a median period of 10·5 (range 3–36) months after surgery. For all 30 patients, the cumulative proportion surviving for 5 years was 30 per cent.
Role of phenytoin in healing of large abscess cavities
Authors: Lodha S C , Lohiya M L , Vyas M C R , Bhandari Sudha , Goyal R R , Harsh M K 
Published: March 2007

Abstract
The promotion of healing of large abscess cavities attained with topical phenytoin was evaluated in controlled studies of clinical and experimental wounds. In the clinical abscess cavities, phenytoin application in 20 patients compared with conventional treatment in 20 patients resulted in earlier separation of slough, decrease in oedema, control of pain and overall enhanced healing. The mean(s.d.) rate of reduction of wound area was 2·02(0·48) cm2/day in the phenytoin group versus 1·58(0·51) cm2/day in controls (P &lt; 0·05) on day 10, and 1·8(0·32) cm2/day versus 1·19(0·21) cm2/day (P &lt; 0·01) on day 20. The mean volume reduction rates at both the 10th and 20th day were 0·48(0·01) cm3/day for phenytoin versus 0·32(0·04) cm3/day for controls; (P &lt; 0·005). By day 20, 17 of the patients treated with phenytoin were rated as having healed completely, compared with only one of the controls. In a standardized guinea-pig model of the clinical abscess cavity, which included inoculation of the wound with Bacillus proteus and Klebsiella pneumoniae, an enhanced healing rate was also observed (at 7 days 0·40(0·05) cm2/day with phenytoin versus 0·21(0·08) cm2/day in controls; P &lt; 0·005). All eight of the animals treated with phenytoin healed by day 21, compared with one of the eight controls. Biopsies of wounds treated with phenytoin showed less inflammation, no necrosis, and enhanced neovascularization, collagen deposition and fibroblast proliferation compared to controls. Bacterial colonies also decreased more rapidly with the use of phenytoin.
Reduced postoperative hospitalization after laparoscopic cholecystectomy
Authors: Grace P A , Quereshi A , Coleman J , Keane R , McEntee G , Broe P , Osborne H , Bouchier-Hayes D 
Published: March 2007

Abstract
An initial experience of laparoscopic cholecystectomy in 50 consecutive patients was reviewed and the results compared with those of a group of 25 patients who underwent laparotomy cholecystectomy during the 3 months before the introduction of laparoscopic cholecystectomy. Laparoscopic cholecystectomy was successfully performed in 44 of 50 consecutive patients in whom it was attempted. When compared with laparotomy, laparoscopy cholecystectomy was associated with longer mean(s.d.) anaesthesia, 155(61) min versus 102(31) min (P&lt;0·001), shorter mean postoperative hospital stay, 3·5(1·5) versus 8·8(3·2) days (P&lt;0.001), and reduced mean cost, £895(376) versus £2210(822) (P&lt;0.001). Perioperative morbidity was also reduced following laparoscopy cholecystectomy (9 per cent versus 16 per cent) but not significantly so. Laparoscopic cholecystectomy is a safe, effective procedure which completely removes the gallbladder. It significantly reduces hospital stay, is cosmetically satisfactory and has financial benefits. We suggest that this technique be considered for all patients having cholecystectomy.
Non-steroidal anti-inflammatory drugs and complicated diverticular disease: A case—control study
Authors: Campbell K , Steele R J C 
Published: March 2007

Abstract
Fifty patients with severe complications of diverticular disease were compared with two groups of 50 controls, matched for age and sex. The first control group (A) was randomly selected from all emergency hospital admissions, and the second group (B) from patients with uncomplicated diverticular disease. Of the 50 study patients, 24 (48 per cent) were taking non-steroidal anti-inflammatory drugs (NSAIDs) at the time of admission compared with nine (18 per cent) of control group A and ten (20 per cent) of control group B. Both of these differences were statistically significant, indicating a strong association between the ingestion of NSAIDs and the development of severe complications of diverticular disease.
Role of intraoperative enteroscopy in obscure gastrointestinal bleeding of small bowel origin
Authors: Desa L A , Ohri S K , Hutton K A R , Lee H , Spencer J 
Published: March 2007

Abstract
Intraoperative enteroscopy was performed in 12 patients (median age 68 years) with obscure gastrointestinal bleeding probably of small bowel origin, six of whom were men. All the patients were evaluated by routine haematological, coagulation and biochemical profiles, upper and lower gastrointestinal endoscopies, visceral angiography and/or isotope scanning. All the patients were anaemic. Visceral angiography was useful on three of the 12 occasions on which it was used and isotope scanning was valuable on eight of the 11 occasions it was used. Nine patients had undergone previous laparotomy. Enteroscopy was performed successfully in all cases, with fresh blood and discrete vascular lesions being the chief findings (10 of 12 cases). Segmental resections (n = 8) and local resections (n = 2) were performed in ten patients, with two patients having more than one laparotomy for rebleeding. Five patients developed postoperative complications and there was an operative death and one late death. Three of the ten surviving patients experienced further rebleeding. Intraoperative enteroscopy is now an essential adjunct to laparotomy for gastrointestinal bleeding which has been localized to the small bowel before operation.
Risk of peritonitis and fatal septicaemia and the need to defunction the low anastomosis
Authors: Karanjia N D , Corder A P , Holdsworth P J , Heald R J 
Published: March 2007

Abstract
The aim of this study was to investigate the need to defunction the low anastomosis after anterior resection of the rectum with total mesorectal excision for rectal cancer. Two hundred consecutive patients (125 defunctioned, 75 non-defunctioned) undergoing low anterior resection for carcinoma were included in the study. Peritonitis requiring emergency laparotomy occurred in 8 per cent of the patients who did not have a defunctioning stoma compared with less than 1 per cent of those patients who had a defunctioning stoma (P &lt; 0·01). There was no mortality related to closure of the stoma but seven patients developed a faecal fistula and ten developed an incisional hernia. Despite current trends to avoid the defunctioning stoma, these results suggest that after total mesorectal excision the faecal stream should be temporarily diverted away from the anastomosis that is 6 cm or less from the anal verge to protect against potentially life-threatening anastomotic leakage.
Comparison of restorative proctocolectomy with and without covering ileostomy in ulcerative colitis
Authors: Järvinen H J , Luukkonen P 
Published: March 2007

Abstract
The experience of restorative proctocolectomy for ulcerative colitis is reported in 16 consective patients with no covering ileostomy (group 2) in comparison with 15 patients with a covering stoma (group 1); in each group a J pouch was constructed. All patients had pre- and postoperative clinical and manometric evaluations of the functional result up to 12 months. There were no deaths or permanent failures. The number of early complications was four in each group. Re-ileostomy was needed in one patient of group 1, and an ileostomy was constructed in three patients of group 2. At 1 year after operation the functional results did not differ between groups 1 and 2 in terms of daily frequency of defaecation (mean 5·6 and 5·4 in 24 h respectively), or in terms of anal basal or maximal squeeze pressures. There was a significant (P&lt;0·01) saving in total hospital stay (median 11 days) and in operating theatre time (mean 41 min) in patients with no covering ileostomy. It is concluded that a covering ileostomy may be unnecessary in restorative proctocolectomy, at least in suitable cases with no technical difficulty at the time of operation.
Principal causes of mechanical bowel obstruction in surgically treated adults in Western Turkey
Authors: Füzün M , Kaymak E , Harmancioǧlu Ö , Astarcioǧiu K 
Published: March 2007

Abstract
A retrospective study of the principal causes of mechanical bowel obstruction occurring in Western Turkey between 1979 and 1989 was undertaken. The records of 14 777 operations performed in the general surgery departments of two hospitals were reviewed. Mechanical bowel obstruction occurred in 582 patients. Among the causes of mechanical bowel obstruction, adhesions were most common (44·0 per cent), followed by strangulated hernia (23·9 per cent), volvuli (12·7 per cent) and colonic carcinomas (10·1 per cent). A previous appendicectomy appeared to be the most important cause of adhesions causing mechanical bowel obstruction.
Light reflection rheography: An effective non-invasive technique for screening patients with suspected deep venous thrombosis
Authors: Thomas P R S , Butler C M , Bowman J , Grieve N W T , Bennett C E , Taylor R S , Thomas M H 
Published: March 2007

Abstract
Light reflection rheography is a simple non-invasive technique for assessing venous function in the leg. One hundred and twenty-four patients referred for venography with a clinically suspected deep venous thrombosis were investigated by light reflection rheography to determine the accuracy of the technique in diagnosing acute thrombosis. In half of the patients venography confirmed a deep venous thrombosis. Light reflection rheography had a sensitivity of 92 per cent and a specificity of 84 per cent in detecting acute thrombosis. The technique had a negative predictive value of 92 per cent in selecting those patients with no thrombosis. Light reflection rheography can be performed at the bedside or in the radiography department which makes it a suitable technique for screening patients with suspected deep venous thrombosis.
Histological study of white blood cells and their association with lipodermatosclerosis and venous ulceration
Authors: Scott H J , Coleridge Smith P D , Scurr J H 
Published: March 2007

Abstract
The number of white blood cells per mm2 has been determined in serial histological slides taken from punch biopsies of skin from the gaiter region in patients with varicose veins. In eight patients the varicose veins were complicated by lipodermatosclerosis of the skin, and in a further six there was a history of ulceration. In uncomplicated varicose veins there was a median of 6 white blood cells per nm2, in patients with lipodermatosclerosis there were 45 white blood cells per mm2, and where there was a history of ulceration, 217 white blood cells per mm2. No change in white blood cell content was observed after the venous pressure was raised for 30 min by sitting the patient with the lower limb dependent. White blood cell infiltration of the skin is associated with lipodermatosclerotic changes caused by venous insufficiency.