bluuebunny/crossref_metadata_2025_split huggingface dataset:
The use of Dexon and plain catgut in circumcision
Authors: Mouzas G L , Pompa Peter 
Published: March 2007

Abstract
Published clinical literature on the handling properties and qualities of Dexon (polyglycolic acid) suture material is reviewed. Of 68 patients (aged 3 months to 56 years) requiring circumcision, 37 were sutured with Dexon and 31 with plain catgut. There was no tissue reaction to Dexon in 36 patients (97.3 per cent) nor did any infection develop, but there was delay in absorption. Only 7 patients (22.5 per cent) sewn up with catgut were free from tissue reaction, and infection occurred in 8 of these patients. Catgut was absorbed more quickly. Dexon sutures had disappeared by the twenty-first day in 19 patients (51.3 per cent) and catgut had disappeared in the same time in 19 patients (63.3 per cent). In 5 of I2 patients photographed postoperatively there was a knobbly-looking, foreskin at 19–27 days. This was associated with Dexon in 4 patients and was probably due to unabsorbed suture material. The relative lack of tissue reaction to Dexon in comparison with catgut supports the findings of other clinicians. A way of tying Dexon and slipping the knot into place (like catgut) is also described.
A technique for highly selective (parietal cell or proximal gastric) vagotomy for duodenal ulcer
Authors: Goligher J C 
Published: March 2007

Abstract
The designation and comparative effects of the various types of vagotomy in current use for the treatment of duodenal ulcer are discussed and the surgical anatomy of the form known as ‘proximal gastric’ vagotomy, ‘parietal cell’ vagotomy or ‘highly selective’ vagotomy is examined. A detailed and fully illustrated description is given of a well-tried technique for the performance of this latter operationW.
It is emphasized that really long-term results of proximal gastric vagotomy without drainage for duodenal ulcer are still lacking, but the possible legitimate uses of this procedure at the present time are considered as well as its potential place in the future if its achievements live up to their early promise.
The effect of cholecystectomy on oesophageal symptoms
Authors: Barker John R , Alexander-Williams J 
Published: March 2007

Abstract
A prospective study was made of 225 patients with gallbladder disease treated by cholecystectomy. Of these, 77 (34 per cent) complained of oesophageal symptoms; after cholecystectomy 44 continued to hace these symptoms, 33 having been cured. Patients in the 40–59-year age group had a higher incidence of oesophageal symptoms and significantly fewer were cured by choiecystectomy than in the other age groups. In patients with refru× on barium studies andlor an enlarged hiatus at operation the incidence of oesophageal symptoms was higher (60 per cent), and less than 20 per cent of these were improved by cholecystectomy.
Sleep and delirium after open heart surgery
Authors: Johns M W , Large A A , Masterton J P , Dudley H A F 
Published: March 2007

Abstract
The quantity and quality of sleep have been measured objectively in 4 patients before and after open heart surgery; 2 of these became delirious on the third postoperative day. A fifth patient was studied in relation to major abdominal surgery. The degree of sleep disturbance in the early postoperative period was greater after cardiac than abdominal surgery but was not consistently related to the ensuing delirium. Although patients were woken frequently by the necessity for nursing and other care, they were unable to remain asleep when left undisturbed during the period of delirium, which lasted for several days. Rapid eye movement (REM) sleep was absent and delta wave sleep markedly reduced after cardiac surgery and with delirium although the patients described frequent ‘dream-like’ experiences in their drowsy state. Delirium after cardiac surgery difsers from that which sometimes occurs after withdrawal of addictive drugs, when a high proportion of REM sleep is observed.
The treatment of varicose veins by compression sclerotherapy
Authors: Stother I G , Bryson A , Alexander S 
Published: March 2007

Abstract
Two hundred and eighty-four patients (348 legs) with varicose veins were treated by compression sclerotherapy and reviewed 1–4 years later. Successful results were obtained at the end of a course of treatment in 89 per cent and after an interval of 3–4 years in 68 per cent. The majority of recurrences presented within 2 years. Factors affecting the results were examined. Women whose varicose veins first appeared in relation to a pregnancy and those whose symptoms were aggravated at the time of menstruation had significantly better results than the group as a whole. Patients with varicose veins who had previously been treated by surgery or sclerotherapy had a success rate not significantly different to that for new patients. Local thrombophlebitis following injection was not uncommon and the success rate in this group was not significantly different from that in the whole group.
An evaluation of kidney preservation techniques
Authors: McLoughlin Gerard A , Sells Robert A , Tyrrell Irene 
Published: March 2007

Abstract
Experimental evidence is presented showing that progressive renal ischaemic damage results in an increase in intracellular water with eventual production of the ‘no reflow’ phenomenon. Preservation techniques have been compared in their ability to resist intracellular water gain. A colloidal perfusate with low lipid content and a potassium concentration of greater than 15 mEqll was the most effective preservation medium tested.
Maintenance of human tumours and tissues in immunosuppressed mice
Authors: Castro J E , Cass Wendy 
Published: March 2007

Abstract
Fragments of human tumours and tissues have been maintained in mice made deficient in cell-mediated immunity by thymectomy, lethal irradiation and reconstitution with syngeneic† bone marrow. Tissue fragments from 84 patients were implanted and 68 per cent were viable 2 weeks after transplantation beneath the kidney capsule. Many specimens survived for 12 weeks or more and some were passaged to secondary hosts. When tissues were implanted subcutaneously survival was slightly less.
The histological appearances of maintained tumours were excellent and in some cases functional studies were undertaken. The implications of the method as a means for studying the sensitivity of human tumours to therapeutic agents are discussed.
Pathogenesis and prevention of disruption of colonic anastomoses in traumatized rats
Authors: Irvin Thomas T , Hunt Thomas K 
Published: March 2007

Abstract
Colonic operations complicated by excessive intra-abdominal trauma are followed by a high incidence of anastomotic disruption. Experimental studies have shown that the local effects of trauma result in impaired colonic healing and a significant incidence of disruption in colonic anastomoses.
The nature of the effect of local trauma on the healing of colonic anastomoses was studied in rats subjected to intra-abdominal trauma.
The incidence of anastomotic disruption in traumatized rats was 18·5 per cent, but disruption did not occur when the colon was defunctioned for 4 weeks prior to surgery, and the incidence of anastomotic disruption in animals given intraperitoneal cephalothin during surgery was only 3·6 per cent.
It was concluded that sepsis is the immediate cause of anastomotic disruption in traumatized rats, and it was suggested that the value of prophylactic intraperitoneal antimicrobial therapy in patients undergoing colonic surgery should be studied in a randomized prospective clinical trial.
Reduction in the incidence of stress incontinence complicating fistula repair
Authors: Hassim Abu M , Lucas Cynthia 
Published: March 2007

Abstract
The results of treatment of 11 gynaecological fistulae and 150 obstetrical fistulae over a period of 6¼ years is presented. Postoperative stress incontinence was the most serious complication. Its incidence following repair of obstetrical fistulae has been reduced to 7.3 per cent in this series. Meticulous technique, combining the appropriate operation for bladder neck reinforcement with the initial flap-splitting repair, contributed to the low incidence of postoperative stress incontinence. Suprapubic operations were utilized in 20 cases (13.3 per cent). Gross vesical contraction associated with incontinence in 7 cases responded to ileocystoplasty or sigmoidocystoplasty. The final functional cure rate in the series was 873 per cent. Closure was accomplished in about 95 per cent of fistulae. In 8 cases closure was unsuccessful; 4 of these were inoperable. There was I death due to endotoxic shock after ureterosigmoidostomy.
Initial experience with Helmstein's treatment by a hydrostatic pressure technique in carcinoma of the bladder
Authors: Glashan R W , Brown P R 
Published: March 2007

Abstract
Twenty cases of bladder tumour which have been treated by Helmstein's hydrostatic pressure technique are presented. Modifications to the technique are described and indications for its use suggested. Massive necrosis of tumour tissue has been shown to occur and it is suggested that this method of treatment requires further investigation in suitable cases.
The effect of vagotomy and drainage operations on the rate of gastric emptying in duodenal ulcer patients
Authors: Davies W T , Griffith G H , Owen G M , Shields R 
Published: March 2007

Abstract
The rate of gastric emptying was estimated in 29 patients with duodenal ulcers, before and after vagotomy and drainage operations, by measuring the disappearance from the stomach of a standard meal containing radioactive chromium. When Heineke-Mikulicz pyloroplasty accompanied vagotomy gastric emptying was observed to be slowed, whereas after vagotomy and Fitmey pyloroplasty the rate of gastric emptying was more rapid when compared with the preoperative rate. Gastric emptying after vagotomy and gastrojejunostomy showed no consistent alteration in rate. Temporary gastric stasis occurred in the early postoperative period after vagotomy and drainage procedures.
Reconstruction of the pylorus for postvagotomy diarrhoea and dumping
Authors: Christiansen P M , Hansen O Hart , Pedersen T 
Published: March 2007

Abstract
Five patients with incapacitating diarrhoea or severe dumping after vagotomy with pyloroplasty were treated by reconstruction of the pylorus. The operation was easily performed, and the postoperative course was unenventful in all the cases. All the patients had a significant improvement. The results suggest that pyloric reconstruction can be of benefit in patients who need revision operation for postvagotomy diarrhoea or dumping.
Oesophageal replacement by a gastric tube: An experimental study of the properties of the gastric tube
Authors: Henderson R D , Boszko A , Mugashe F , Szczepanski M M , Marryatt G 
Published: March 2007

Abstract
The effects of gastric tube replacement have been studied experimentally in dogs. A gastric tube can replace the lower oesophagus and, if maintained 2.5-6 cm below the diaphragm, will prevent reflux.
The gastric tube acts as a pressure barrier which is important in the prevention of reflux. Myotomy of the tube lowers the pressure barrier and allows free reflux. Atropine decreases the pressure within the gastric tube and gastrin increases the pressure within the tube.
Observations on acute pancreatitis
Authors: Imrie C W 
Published: March 2007

Abstract
One hundred and forty cases of acute pancreatitis are reviewed of whisch 127 cases wee primary and 13 secondary acute pancreatitis. An association with biliary disease was found in 50 per cent of cases; 12·2 per cent of case were associated with heavy alcohol intake. In just over one-third of cases no aetiological factor was identified.
The overall mortality rate was 21·4 per cent; the mortality for primary acute pancreatitis was 18·9 per cent but only 5·5 per cent in patients under 50 year old. The mortality for secondary acute pancreatitis was 46 per cent. In primary acute pancreatitis operative intervention was associated with a 36·6 per cent mortality as compared with conservative management which had a 10·5 per cent mortality.
The most important complication of acute pancreatitis was acute renal failure which accurred in 20 patients, 15 of whom died. Pseudocysts formed in 15 patients and were best treated by internal drainage, via cstogastrostomy where possible.
Aorto-oesophageal fistula: A late complication of a resected coarctation
Authors: Bigge T , Rothnie N G 
Published: March 2007

Abstract
A case of aorto-oesophageal fistula is reported as a rare and late complication of surgery for aortic coarction. The clinical and aetiological aspects are discussed. Awareness of the condition is the key to early diagnosis and treatment.
The delayed hypersensitivity reaction in breast cancer
Authors: Roberts M Maureen , Jones-Williams W 
Published: March 2007

Abstract
Women with breast cancer confined to the breast (stage I) have a reduced dermal delayed hypersensitivity reaction to Varidase; the degree of anergy to this antigen increases as the disease progresses. The in vitro reaction to phytohaemagglutinin, however, remains normal throughout the course of the disease.
Protein-losing enteropathy in primary lymphoedema: Mesenteric lymphography and gut resection
Authors: Kinmonth J B , Cox S J 
Published: March 2007

Abstract
Patients with primary disease of the lymph system may present with hypoproteinaemia and peripheral oedema. The latter may be partly lymphatic and partly ‘famine’ oedema due to low serum protein.
The hypoproteinaemia may be shown to be due to protein loss into the gut. At laparotomy characteristic changes caused by mesenteric lymph obstruction are visible. They may be further elucidated by mesenteric lymphography.
Three patients have been treated by excision of the worst affected length of bowel and anastomosis. Their clinical and nutritional states have improved. There have been no complications.
Antral acidification and the gastric secretory response to pentagastrin and acetylcholine in dogs
Authors: Wheeler M H , Prescott R J , Forrest A P M 
Published: March 2007

Abstract
In 6 dogs with innervated antral pouches (3 with vagally innervated fundic pouches and 3 with vagally denervated fundic pouches) gastric secretion was stimulated by a range of submaximal doses of pentagastrin, each infused intravenously for a period of 6 hours.
During the three consecutive 2-hour collection periods of each test the antral pouch was perfused with isotonic saline of pH 7 0, 1.0 and 7.0 respectively at a rate of I ml/min. Neither acid nor pepsin secretion was inhibited by antral acidification. When the antral perfusion rate was increased to 3 ml/min there was still no inhibition of acid secretion from either type of fundic pouch.
In each dog the acid response of the fundic pouch to perfusion of the innervated antral pouch with 0–5 per cent acetylcholine was significantly reduced when the pH of the perfusate was lowered from 7.0 to 1.0.
The results provide no support for the existence of either an antral inhibitory hormone or inhibitory neural reflex active against pentagastrin-stimulated gastric secretion in the dog. It would seem that antral inhibition of gastric secretion is the result of a diminished release or formation of endogenous gastrin.
The pattern of bile salt reflux and acid secretion in sliding hiatal hernia
Authors: Crumplin M K H , Stol D W , Murphy G M , Collis J L 
Published: March 2007

Abstract
The role played by gastric fluid refluxed from the stomach into the oesophagus of patients with symutomatic sliding hiatal hernia has been evaluated in terms of gastric bile salt concentration and acid secretion rates. Patients with a peptic stricture had a higher basal acid output than control subjects. Approximately half of both hiatal hernia groups studied had periods of increased total bile salt concentrations either while fasting or following a test meal, This would indicate abnormal pyloric function in these patients. The quantitative examination of total and individual bile salts in solution in gastric juice suggests that a combination of gastric acid pepsin and bile may be a major, factor in the pathogenesis of the clinical responses to gastrooesophageal reflux. Neither total nor individual bile salt concentrations found in gastric juice helped to differentiate between the specific types of response seen in symptomatic sliding hiatal hernia.
Thyroid function following partial thyroidectomy
Authors: Griffiths N J , Murley R S , Gulin R , Simpson R D , Woods T F , Burnett David 
Published: March 2007

Abstract
The main objective of this investigation was to establish the incidence of hypothyroidism and recurrent goitre following partial thyroidectomy. Accurate measurements of the thyroid remnants and resected specimens have been made in all cases. The postoperative thyroid status has been assessed clinically and also biochemically by serum thyroxine as iodine, T3 resin uptake, free thyroxine index and thyroid-stimulating hormone estimations. Serum calcium and phosphorus have also been measured and the necessary histological material reviewed.
Postoperative hypothyroidism occurred in approximately 11 per cent of previously toxic and 6.5 per cent of non-toxic patients, becoming evident in most cases within a year of operation. The T3 resin uptake measurement following operation in this and previous series suggests that in many patients there is a compensation process which is maintained by increased secretion of thyroid-stimulating hormone. No evidence has been adduced that patients who show this compensation mechanism are, as some have suggested, in a state of ‘subclinical hypothyroidism’ or that they become overtly hypothyroid later.
In this series hypothyroidism was more closely related to small remnant size than the presence of lymphadenoid change. A significantly higher proportion of patients with small thyroid remnants became hypothyroid in both toxic and non-toxic groups. Remnants of about 8–16 ml ‘cuboid’ volume (roughly 8–16 g by weight) have seemed reasonable for our patients.
Leiomyosarcoma of the foot presenting as an arteriovenous fistula
Authors: Thomas M H , Molland E A , Eadie D G A 
Published: March 2007

Abstract
A deeply situated leiomyosarcoma of the foot is a rare condition. The clinical presentation of such a case in a young man was confused with that of a postoperative arteriovenous fistula. The patient was treated initially by local excision of the tumour and later by amputation. The criteria for histological diagnosis and assessment of malignancy are discussed.
The ultrasonic detection of incompetent perforating veins
Authors: Miller Stanley Scott , Foote Andrew V 
Published: March 2007

Abstract
Of the methods of detecting incompetent perforators in current use, only two, clinical and ultrasouna, are easily performed and lend themselves to routine use in the ward or outpatients' department. The ultrasound method has a higher degree of accuracy than the clinical method, requires little in the way of additinal equipment or training and provides a very useful method of pre- and postoperative assessment of the varicose leg as well as a method for the study of the natural history of the disease.
In a pilot study of 100 limbs 28 incompetcnt perforators were discovered in 36 ‘normal’ limbs. A detection rate of 82 per cent in 165 marked sites was noted in limbs with varicose veins. Greater numbers of perforators were found in association with skin changes and previous operation than in uncomplicated varices. In 15 of 64 limbs with varicose veins no incompetent leg perforators were detected.
The value of gastrostomy in the surgery of aortic aneurysms
Authors: Morris Tom , Bouhoutsos John , Martin Peter 
Published: March 2007

Abstract
A retrospective study was made of the progress of 205 patients after operation for abdominal aortic aneurysm with special reference to the method of gastric decompression used. Forty-six patients had a gastrostomy, and their mean length of stay in hospital was 8 days less, a highly significant difference.
Recurrent head and neck cancer: The results of treatment
Authors: Williams R G 
Published: March 2007

Abstract
A study of 144 patients with cancer of the head and neck showed that 67 (46 per cent) developed recurrent cancer. Radical second treatment, almost exclusively by surgery, secured an 11 out of 67 or 16 per cent crude 5-year survival rate for recurrent head and neck cancer. Further analysis showed that the prospects of successful second treatment were negligible or nil with certain identifiable tumours or tumour sites. When these identifiable cases are excluded the survival rate for head and neck cancer became 11 out of 45 or 24 per cent. Age and general condition rendered some patients unfit for radical surgery. In this series 30 patients were treated by radical surgery with a patients cured: patients surgically treated ratio of 11 out of 30 or 36 per cent.
The effect of vagotomy on the inhibition of gastric secretion by intraduodenal acid
Authors: Ward A S 
Published: March 2007

Abstract
Acid in the duodenum is known to inhibit gastric secretion in man but whether this response is a humoral or a vagal phenomenon is unknown. If a vagal reflex is involved then selective and highly selective vagotomy, by preserving the duodenal nerve supply, could offer advantages over truncal division. This study was designed to investigate this claim.
The effect of intraduodenal hydrochloric acid on pentagnstrin-stimulated gastric secretion was stimulated in 17 control subjects, 32 preoperative duodenal ulcer patients and 28 vagotomized patients (16 truncal vagotomy and pyloroplasty; 6 selective vagotomy and pyloroplasty; 6 highly selective vagotomy). Inhibition of acid output occurred in 15 control subjects, and the mean inhibition for the group was 2.68 + 0.39 mEq/10 minutes (P &lt; 0.001). Inhibition occurred in 22 duodenal ulcer patients, and the mean reduction in acid output for the entire group was 2.26 ± 0.46 mEq/l0 minutes (P &lt; 0.001). Intraduodenal acid failed to produce a response in the vagotomized patients irrespective of the presence or absence of a duodenal nerve supply.
These results suggest that gastric secretory inhibition by intraduodenal acid is a vagal phenomenon in man; selective and highly selective vagotomy do not appear to carry any particular advantage over truncal section in terms of preserving this response.
Treatment of acute cholecystitis by routine urgent operation
Authors: Salleh Hussein Bin Mohamed , Balasegaram M 
Published: March 2007

Abstract
Two hundred and eighteen unselected cases of acute cholecystitis have been routinely treated by urgent cholcystectomy within 12 hours of admission to hospital. The mortality (0.5 per cent) and morbidity are within acceptable limits. The rate of diagnostic error has been low (1.4 per cent) so that negative laparotomy only occurred very occasionally.
Non-parasitic liver abscess
Authors: Schraibman I G 
Published: March 2007

Abstract
Fifteen proved cases of non-parasitic liver abscess from the Manchester region are presented with special reference to the diagnostic features, which with a high level of clinical suspicion will make the diagnosis possible. The value of the serum protein ratio and isotope scanning is particularly emphasized. A classification of the disease based on the pathology and the prognosis is advocated. Once the diagnosis is reached, surgical drainage is effective, but the consequences of delay or misdiagnosis may be fatal.
Pleural empyema due to ruptured amoebic liver abscess
Authors: Rasaretnam Rudra , Paul A T S , Yoganathan M 
Published: March 2007

Abstract
Thirty-one cases of empyema due to ruptured amoebic liver abscess treated by either intercostal tube drainage or decortication are presented. On account of the rapid development of a thick membrane, intercostal drainage was successful only in the cases which were seen early. The poor general condition of the patient was the cause of death in 4 of the 5 fatal cases.