bluuebunny/crossref_metadata_2025_split huggingface dataset:
Observations on peripheral and central temperatures with particular reference to the occurrence of vasoconstriction
Authors: Brock Lord , Skinner J M , Manders J T 
Published: March 2007

Abstract
The importance is emphasized of the inadequacy of the term “body temperature”, but that both core temperature and the peripheral temperature must be considered. The assessment of vasoconstriction is informative, and advantage should be taken of the exact information that can be provided by an electro-thermometer as opposed, for example, to a touch of the hand. The core temperature is taken from the rectum, the nasopharynx or tympanic membrane, and the peripheral temperature from the great toe.
If the peripheral temperature falls the loss of body heat is prevented and the core temperature rises. If this is not understood or not recognized misguided attempts may be made to try to reduce the raised central temperature by cooling the skin. This can result in a further rise of central temperature. The recognition of peripheral vasoconstriction enables a proper assessment to be made of its basic cause and of the necessary treatment.
The most important cause is hypovolaemia from blood loss and a detailed account is given of how this should be recognized, especially by a study of the gradient between central and peripheral temperatures. Such studies should be a routine in any severe illness, whether medical or surgical, in which circulatory deterioration is likely, especially after major operations or injuries.
Study of the temperature of the heel (hindfoot) as well as of the toe (forefoot) can indicate a selective shutdown of peripheral circulation that reveals an especially critical circulatory state.
Oesophagogastrostomy without a drainage procedure in oesophageal carcinoma
Authors: Angorn I B 
Published: March 2007

Abstract
Ten patients with carcinoma of the lower third of the oesophagus who had oesophagogastrectomy followed by oesophagogastrostomy without a drainage procedure were investigated 6 months postoperatively. Postoperative symptomatic evaluation and modified Visick grading of the results were carried out by an independent observer. Objective assessment included fibre-optic endoscopy of the oesophagus, stomach and duodenum, gastric acid secretory studies and measurement of gastric emptying times following the ingestion of a barium food mixture.
Eight of the 10 patients had an excellent or very good result and the remaining 2 were graded as satisfactory. No evidence of macroscopic oesophagitis or gastritis was detected and pyloric obstruction was never observed. Gastric emptying time was not prolonged. The results obtained support the concept that a drainage procedure is unnecessary after oesophagogastrostomy.
Congenital hepatic fibrosis: Aspects of diagnosis and surgical management
Authors: Sokhi G S , Morrice J J , McGee J O' D , Blumgart L H 
Published: March 2007

Abstract
Five cases of congenital hepatic fibrosis are described. In all the patients the diagnosis was delayed as a result of either failure to perform liver biopsy or misinterpretation of the histological features. Four patients had multiple operations for the control of haematemesis or the relief of portal hypertension. It is stressed that a high index of suspicion, the use of endoscopy and a liver biopsy are essential to avoid delay in diagnosis. The patients have a good prognosis provided that the diagnosis is established at an early stage and portacaval anastomosis performed.
Immediate operative fitting of upper limb prosthesis at the time of amputation
Authors: Robinson K P , Andrews B G , Vitali M 
Published: March 2007

Abstract
Three patients are described–-2 with an above-elbow amputation and 1 with a through-wrist amputation–-in whom a temporary prosthesis was applied on the operating table and in all of whom function was rapidly established. The patients did not become one-handed, with the result that they have all continued to wear their prosthesis throughout their working hours and use their artificial hand for all everyday functions. The value of this technique in making the patient accept the prosthesis and therefore to make full use of it suggests that this procedure should be more widely applied in patients who require upper limb amputation.
The bacteraemia associated with burns surgery
Authors: Beard C H , Ribeiro C D , Jones D M 
Published: March 2007

Abstract
Fifty-four surgical procedures on 39 burnt patients were studied with serial blood cultures. In 25 (46 per cent) of these procedures the cultures were positive. In spite of the absence of prophylactic systemic antibiotics there were no clinical manifestations and not one of the bacteraemias developed into a septicaemia.
The role of natural immunity in controlling the bacteraemia is discussed and it is suggested that prophylactic systemic antibiotic therapy covering burns surgery is unnecessary in the presence of normal immunoglobulin levels.
The significance of occult skeletal metastases, detected by skeletal scintigraphy, in patients with otherwise apparently “early” mammary carcinoma
Authors: Galasko C S B 
Published: March 2007

Abstract
Fifty patients with apparently “early” mammary carcinoma on clinical, radiological and biochemical grounds had a skeletal scintigram carried out when they first presented. Twelve (24 per cent) of the patients had a positive scintigram. All these patients have developed metastatic disease in the first 5 years following mastectomy, and at least 9 (75 per cent), and probably 10 (83 per cent), have died from mammary carcinoma during this period. This compares with 10 (26 per cent) of the patients with a negative scintigram who have developed recurrent or metastatic disease, of whom 8 (21 per cent) have died from their disease. Five years following mastectomy none of the patients with a positive scintigram was alive and free from disease, compared with 25 (66 per cent) of the patients with a negative scintigram.
It would appear that skeletal scintigraphy is the most sensitive method of detecting skeletal metastases and of staging breast carcinoma at the moment. Where practicable, this investigation should be carried out before embarking upon treatment for any particular patient, and this certainly should become part of any clinical trial comparing different therapeutic regimens. However, before some of the newer bone-seeking isotopes are used in this way, further studies are required to determine their false positive rate.
The effect of heparin and of acid-citrate-dextrose solution on screen filtration pressure of blood in experimental hypotension
Authors: Pardy B J , Dudley H A F 
Published: March 2007

Abstract
Anticoagulation with heparin may not always adequately protect an ischaemic vascular bed. A screen filtration device has been employed to study the in vitro actions of acid-citrate-dextrose (ACD) and heparin on blood from the dog in haemorrhagic shock. With both anticoagulants, blood obtained during shock caused greater filter obstruction than blood taken before shock. However, the increased obstruction was nearly four times greater with heparinized blood than with acid-citrate-dextrose blood. These findings suggest that the anticoagulant action of heparin may be markedly diminished in low blood flow states.
Factors influencing local recurrence after abdominoperineal resection for cancer of the rectum and rectosigmoid
Authors: Moossa A R , Ree P C , Marks J E , Levin B , Platz C E , Skinner D B 
Published: March 2007

Abstract
One hundred and fifty-two patients who underwent abdominoperineal resection for cancer of the rectum and rectosigmoid are reviewed. Six physicians were selected to predict which of these patients would have a local recurrence. All the information available at the end of the operation was duplicated and submitted to the observers. None of the physicians was able to predict local recurrence significantly better than random. There were 31 local recurrences, i.e. an incidence of 20·4 per cent. Low level of tumour in the rectum, local spread into perirectal fat or serosa, lymph node involvement and age below 60 years at time of operation were the only factors that were statistically related to local recurrence. The strategy for careful follow-up of patients at risk is outlined and a plea is made for a controlled trial of postoperative radiotherapy.
Collagen biosynthesis in normal and hypertrophic scars and keloid as a function of the duration of the scar
Authors: Peter Craig R D , David Schofield J , Jackson David S 
Published: March 2007

Abstract
The rates of collagen biosynthesis and the tissue concentrations of collagen in normal scar, hypertrophic scar and keloid were determined as a function of the duration of the lesions. The rate of collagen synthesis in normal scar was approximately constant between 6 months and 20 years after the initial wounding, but in both hypertrophic scar and keloid the rate was initially approximately twice that in normal scar, and 2–3 years after wounding it fell to approximately the same level as in normal scar. The tissue concentration of collagen appeared to be relatively constant in normal scar with respect to the time elapsed after wounding, but in both types of abnormal scar it was initially somewhat lower than normal scar and then rose to values higher than in normal scar after about 2–3 years. Since similar results were obtained for both types of abnormal scar in terms of the rates of collagen biosynthesis with respect to the time elapsed after wounding and also in terms of the tissue concentrations of collagen, this may indicate that the events in the pathogenesis of both abnormal scar types are similar. The results also raise the possibility that the formation of both types of abnormal scar may occur in two phases: an initial phase characterized by abnormally high rates of collagen biosynthesis, and a later phase characterized by essentially normal rates of collagen biosynthesis.
Parathyroid identification by methylene blue infusion
Authors: Gordon Donald L , Airan Mohan C , Thomas William , Seidman Leon H 
Published: March 2007

Abstract
The intravenous infusion of methylene blue was investigated as a procedure that would identify parathyroid glands during operation in 17 patients with primary hyperparathyroidism. The dye was found to stain all adenomas, most hyperplastic glands and occasionally normal parathyroid glands. In addition, the frequency of glandular staining was directly related to the size of the gland, although size and histology may have been independent variables. Methylene blue infusion is a safe effective method of localizing abnormal parathyroid glands.
Selective surgery for abdominal stab wounds
Authors: Thavendran A , Vijayaragavan A , Rasaretnam Rudra 
Published: March 2007

Abstract
The value of selective surgery for abdominal stab wounds was assessed in a prospective study of 226 patients admitted over an 18-month period. Two died soon after admission and before operation, the indications for which were signs of peritoneal irritation or haemorrhage, evisceration of bowel and omental protrusion. Of the 226 patients, 113 were selected for immediate surgery, which was carried out within 3 hours of admission. There were 12 deaths (10·6 per cent). Of the III patients initially selected for observation, 47 (42·3 per cent) underwent delayed operation with 4 deaths (8·5 per cent), but in only 1 (2·1 per cent) of these patients could the delay have influenced the adverse result. There were no deaths in the 64 patients treated conservatively. The overall mortality rate for patients who were initially selected for observation was 3·9 per cent.
One hundred and fifty patients underwent laparotomy, positive findings justifying operation being present in 134 (89 per cent). Six patients required thoracotomy for concomitant thoracic injuries, including 2 patients who required cardiorraphy. Four other patients required combined thoracic and abdominal exploration. The selection of patients for either conservative or operative management was based entirely on clinical criteria; abdominal X-rays were not helpful in the early diagnosis of visceral lesions. The indications for operation were evident within 12 hours of admission in 156 of the 160 patients who were treated surgically.
A substantial reduction in the incidence of “negative laparotomy” can be made by this process of selection, and without an associated increase in the morbidity and mortality rates.
The aetiology and diagnosis of malignant tumours of the thyroid gland
Authors: Wade J S H 
Published: March 2007

Abstract
Known aetiological factors of thyroid tumours are: genetic, hormonal, irradiation and auto-immune thyroiditis. Some medullary carcinomas are familial. Thyroid-stimulating hormone plays a significant part in the initiation and maintenance of many well-differentiated thyroid carcinomas. Small doses of irradiation in childhood and probably also in adolescence may induce a papillary or follicular carcinoma. Some malignant lym-phomas develop in a previous auto-immune thyroiditis.
Diagnosis of a malignant thyroid tumour is usually obvious once there has been extrathyroidal spread. Intrathyroidal tumours are suspect if they are hard and irregular. The real diagnostic problem is the clinically solitary nodule which is smooth, firm and mobile in a euthyroid patient. Ultrasound and scanning may increase or decrease the suspicion of malignancy but excisional biopsy is the only certain diagnostic procedure.
The surgery of thyroid cancer
Authors: Johnston Ivan D A 
Published: March 2007

Abstract
Thyroid cancer accounts for just under 1 per cent of malignant disease. The prognosis varies from excellent with papillary carcinoma in young people to very poor in anaplastic carcinoma in the elderly. Modified rather than radical dissection of lymph nodes is indicated with well-differentiated tumours. The level of calcitonin in the blood is a sensitive marker for medullary carcinoma occurring either as sporadic or familial disease. The outcome of management in 7 patients with medullary carcinoma indicates that the prognosis is variable and that thyroidectomy is effective treatment.
Gram-negative septicaemia in surgical practice
Authors: Litton Adrian 
Published: March 2007

Abstract
Septicaemia in surgical patients usually occurs after operation or a manipulative event. The incidence of bacteraemia in one surgical unit was observed over a 7-year period. Gram-negative infections occurred three times more frequently than bacteraemia caused by Gram-positive bacteria. The clinical features of septicaemia, the portals of entry of the infection and the bacteria isolated from blood cultures are described.
Septic shock
Authors: Ledingham I McA 
Published: March 2007

Abstract
The problems associated with septic shock are highlighted, including those which arose during a 3-year prospective study. Mortality in the first year of the study was 71 per cent, falling to 38 per cent in the third year. The reasons, for this fall are detailed. The pattern of survival times changed over the 3 years, giving rise to the longer term complications such as stress bleeding, multiple organ failure and superadded infection.
The value of the radio-isotope hepatogram in the jaundiced patient
Authors: Watson A , Bone D E , Testa H J , Torrance Bruce 
Published: March 2007

Abstract
The distinction between ‘medical’ and ‘surgical’ jaundice is often difficult due to the lack of specificity of biochemical liver function tests, and the difficulty in assessing hepatocellular function and biliary tract patency in the jaundiced patient. We present a non-invasive isotopic technique which gives reliable information on these parameters, resulting in a high degree of accuracy in the classification of jaundice.
131I Rose Bengal, which is handled by the liver like bromsulphthalein, is administered intravenously and count rates during hepatic uptake and biliary excretion are recorded over the liver, biliary tract and duodenum using a gamma camera computer system, into which is built an electronic light pen, so that particular areas of interest can be studied. Blood clearance of the isotope is simultaneously measured, and from these data the T1/2 of uptake, the plasma retention and the excretion quotient are determined.
The results of the first 80 examinations show that by qualitative assessment of the uptake and excretory phases of the ‘hepatogram’ and by determination of the T1/2 and excretion quotient, jaundice has been classified with an 86per cent accuracy in cases where the diagnosis is not apparent from clinical and biochemical data. The T1/2 of uptake correlates well with bromsulphthalein retention in the non-jaundiced patient, and when applied to patients with obstructive jaundice enables the progress of hepatocellular impairment with time to be studied, and its recovery after relief of the obstruction. Preliminary results suggest that the technique may also have applications in the study of biliary tract dynamics in patients with post-cholecystectomy syndromes and relapsing acute pancreatitis.
Observations of gastric mucosal blood flow using 99Tcm in rat and man
Authors: Taylor T V , Pullan B R , Elder J B , Torrance Bruce 
Published: March 2007

Abstract
The 99Tcm clearance technique is shown to be a useful method of assessing gastric function. It is easily carried out and is relatively non-toxic–the dose of isotope could be reduced to 100 μCi or less without sacrificing the accuracy of the investigation. Although the results are preliminary and the number of cases investigated so far is small, they suggest that the measurement of pertechnetate clearance is directly related to gastric mucosal blood flow; it is a use ful parameter of gastric function and may well prove to be a more accurate discriminant in cases of peptic ulceration than the conventional measurement of gastric acid secretion.
Prophylactic interparietal povidone-iodine in abdominal surgery
Authors: Gilmore O J A , Sanderson P J 
Published: March 2007

Abstract
This study sought to determine in a district general hospital (a) the frequency and nature of bacterial contamination at operation, (b) the incidence of consequent infection and (c) the prophylactic effect, if any, of inter-parietal povidone-iodine against postoperative wound infection.
Bacterial contamination was shown in 49 per cent of all the abdominal surgical wounds at the end of operation. From 61 per cent of the subsequently infected wounds, organisms identified as contaminants at operation were again found. Interparietal instillation of povidone-iodine resulted in a statistically significant reduction in wound infection (P&lt;0.01) in treated patients compared with untreated, randomized, matched controls. It was of significant value in cases of intestinal resection and peritonitis, in obese patients and in those with paramedian incisions.
Laboratory studies indicate that povidone-iodine does not induce bacterial resistance. This chemical antibacterial agent may thus provide a preferable alternative to antibiotics in preventing such infections.
Sex hormones in breast disease
Authors: England P C , Skinner L G , Cottrell K M , Sellwood R A 
Published: March 2007

Abstract
Serum concentrations of oestradiol 17β and progesterone were measured daily throughout one menstrual cycle in 32 normal women, 32 women with benign disease of the breast and 10 women with cancer of the breast.
In normal women concentrations varied with age. Women with cysts had concentrations of oestradiol 17β which were significantly higher than normal. In women with cancer the concentrations of oestradiol 17β and progesterone were significantly higher than normal, but the difference was very small and much larger numbers of patients need to be studied. Concentrations of oestradiol 17β and progesterone in post-menopausal women were consistently very low.
Measurement of cell production rates in human gastro-intestinal cancer-a guide to treatment?
Authors: Britton D C , Bone G , Wright N A , Camplejohn R S 
Published: March 2007

Abstract
Cell production rates were measured in 19 cases of rectal carcinoma and in 11 cases of gastric carcinoma using a stathmokinetic technique. These measurements were compared with results from normal rectal and gastric mucosa. It was found that most of the cases of rectal cancer were proliferating more slowly than morphologically normal rectal mucosa. This was true for the majority of gastric cancers, but a small proportion appeared to be proliferating more rapidly. These results are discussed with their relevance to appropriate therapy.
A controlled clinical trial of three methods of closure of laparotomy wounds
Authors: Goligher J C , Irvin T T , Johnston D , De Dombal F T , Hill G L , Horrocks J C 
Published: March 2007

Abstract
A controlled clinical trial was conducted of three methods of closing elective paramedian laparotomy wounds-catgut layer suture alone, catgut layer suture with tension sutures and wire sutures alone. Three hundred and twenty-four patients were entered in the trial. The combined incidence of wound dehiscence and subsequent incisional herniation in patients who did not manifest overt dehiscence in the immediate postoperative period was significantly higher after catgut layer suture alone (14 per cent) than after catgut layer suture with tension stitches (4.8 per cent) or wire sutures alone (0.9 per cent). There seemed to be more wound sespis and sinus formation associated with catgut layer suture and tension sutures than with either of the other methods of closure. In 4 patients a wire suture had to be extracted, because of sinus formation in 2 and on account of pain in 2.
Is a “second look operation” justified in suspected recurrences after abdominal cancer surgery?
Authors: Ellis Harold 
Published: March 2007

Abstract
Seventy-three patients have been submitted to 74 further laparotomies for suspected recurrent malignant abdominal disease over a period of 13 months. The original tumour was situated in the large bowel in 42, oesophagus or stomach in 24, ovary in 3, small intestine in 2 and pancreas and retroperitoneum in 1 instance each.
There were 10 examples of benign lesions, 16 of further primary cancer and 24 of resectable local recurrences or metastases. Seventeen patients underwent some palliative procedure, and only 7 were beyond any surgical help.
The internal sphincter and Lord's procedure for haemorrhoids
Authors: Hancock B D , Smith K 
Published: March 2007

Abstract
Anal pressure and motility have been measured in 56 patients with haemorrhoids and 40 asymptomatic subjects. The anal pressure of patients with haemorrhoids (93.6 cm H2O) was very significantly higher than that of the controls (66.8 cm H2O; P&lt; 0.001). Ultra-slow pressure waves (amplitude 25–100 cm H2O, frequency 0.9–1.6lmin) were present in 39 per cent of patients with haemorrhoids, but in only 7.5 per cent of the controls (P&lt; 0.001). Ultra-slow waves are present under anaesthesia with the voluntary muscles paralysed and are associated with the highest anal pressure, and so represent abnormal activity of the internal anal sphincter. Measurements after anal dilatation showed complete abolition of ultra-slow wave activity and a very significant drop in pressure.
One year after dilatation 19 patients had a mean anal pressure of 62 cm H2O. Very good results were obtained unless the haemorrhoids were so large that they prolapsed at times other than defaecation. Lord's procedure is a rational treatment since it corrects an underlying overactivity of the internal sphincter.
Prolonged symptomatic and radiological remission of colonic gas cysts after oxygen therapy
Authors: Wyatt A P 
Published: March 2007

Abstract
Colonic gas cysts invariably shrink and disappear and symptoms associated with them resolve if an adequate concentration of oxygen is inhaled over a sufficient period of time. Careful monitoring of inhaled oxygen levels and arterial oxygen tension is necessary to ensure effective therapy. Plain X-ray of the abdomen is the best method of assessing the size and response of the cysts to treatment and for following the patients subsequently. Six consecutive patients managed in this way are discussed and their subsequent progress is documented.