bluuebunny/crossref_metadata_2025_split huggingface dataset:
Arterial hypoxia in acute pancreatitis
Authors: Imrie C W , Ferguson J C , Murphy D , Blumgart L H 
Published: March 2007

Summary
Severe arterial hypoxia while breathing ambient air (Pao2 &lt; 60 mm Hg) was recorded in 38 (45 per cent) of a group of 84 patients with acute pancreatitis when arterial blood gas monitoring was performed during the first week of illness. This contrasted with an incidence of 19 per cent severe hypoxia in a heterogeneous group of 68 patients with acute abdominal pain admitted as surgical emergencies. Clinical evidence of respiratory embarrassment was rarely present in either the patients with acute pancreatitis or the other patients. Arterial hypoxia was related to the prognosis in both groups.
It is recommended that all patients with acute pancreatitis have routine arterial blood gas monitoring performed during the first 5 days of illness. Furthermore, all older patients (over 60 years) and younger patients with moderate hypoxia (Pao2 &lt;70 mm Hg) should be given supplementary humidified oxygen. An awareness of occult respiratory insufficiency in surgical emergency admissions, and especially in acute pancreatitis, is of importance.
Superficial sepsis: The antibiotic of choice for blind treatment
Authors: Page R E , Freeman R 
Published: March 2007

Abstract
When all cases of superficial sepsis were considered together Staphylococcus aureus was the most frequently encountered organism. Various anatomical sites were considered separately and it was found that the axilla and breast were particularly prone to infection by Staph. aureus. The incidence of infection by coliform bacilli in Bartholin's and anorectal abscesses was significantly higher than in abscesses elsewhere. The importance of these observations in relation to antibiotic therapy is discussed.
Chylothorax: A complication of Dwyer's anterior instrumentation
Authors: Eisenstein Steve , O'Brien John Patrick 
Published: March 2007

Abstract
The authors report the development of an extensive right chylothorax several days after Dwyer's anterior instrumentation in a 6-year-old girl with a severe progressing infantile scoliosis. Instrumentation extended from T11 to L4 with removal of the tenth rib and with splitting of the diaphragm. The postoperative course was initially without any problems. However, respiratory distress on the tenth day after surgery was accompanied by mediastinal shift and the symptoms were relieved with aspiration of 600 ml of chyle from the right pleural cavity.
The literature on this complication of chylothorax is reviewed; it has been observed in cardiothoracic surgery. The management of the case is reported in detail and methods of detection and treatment are discussed.
The neutrophil count in childhood acute appendicitis
Authors: Doraiswamy N V 
Published: March 2007

Abstract
A study was made of the total leucocyte count, neutrophil percentage and absolute neutrophil count in 100 consecutive childre with acute appendicitis and in 25 children from whom, following a provisional diagnosis of acute appendicitis, a normal appendix had been removed, no other infective or inflammatory lesion having been found. In the first group there was a raised total leucocyte count in 42 per cent, a raised neutrophil percentage in 93 per cent and a raised absolute neutrophil count in 77 per cent. In the second group the corresponding figures were 4, 24 and 16 per cent. Acute appendicitis is associated with changes in the total leucocyte and neutrophil counts and a correct interpretation of the results of these investigations requires that account be taken of the age of each child. A probable maximum absolute neutrophil count has been calculated. An explanation has been suggested for the presence of normal total leucocyte counts in certain cases in spite of acute appendicitis.
The results of arterial reconstruction utilizing the profunda femoris artery in the treatment of rest pain and pre-gangrene
Authors: Hill D A , Jamieson C W 
Published: March 2007

Abstract
Arterial reconstruction utilizing the profunda femoris artery was performed for rest pain and pre-gangrene in 45 limbs. The preoperative mean ankle arterial pressure index of 0·21 (s.d. 0·12) was increased to 0·52 (s.d. 0·16) in the 22 limbs salvaged by the reconstruction.
In 38 limbs a proximal reconstruction was necessary in addition to profundaplasty. At a mean follow-up time of 15·4 months 41·6 per cent of the 36 patients were dead.
Carcinoma of the male breast: A review of 200 cases
Authors: Ribeiro G G 
Published: March 2007

Abstract
Two hundred cases of male breast carcinoma were treated at the Christie Hospital, Manchester, between 1942 and 1971. The survival rate of the group following curative treatment is presented; the response to palliative treatment is also discussed. The survival rate was particularly good for stage I cases, with 79 per cent surviving for 5 years and 56·3 per cent surviving for 10 years. However, the later stages did less well, particularly when compared with female patients of the same age and stage. With such a rare disease it would be of help to centralize the treatment of these patients as much as possible.
Pulmonary function in the early postoperative period
Authors: Parfrey P S , Harte P J , Quinlan J P , Brady M P 
Published: March 2007

Abstract
To the authors' knowledge, an intensive investigation of pulmonary function during the first 2 postoperative days has not previously been reported. Consequently, in this study the effect of regional surgery on respiratory function, monitored every 4 h during the first 2 postoperative days, was analysed. Hypoxaemia was a constant finding in all patients undergoing general anaesthesia. The degree and duration of hypoxaemia and spirometry changes were related to the site of surgical incision. Clinical signs of atelectasis were commonly observed during the first postoperative day and occurred after the change in Po2 and spirometry. Atelectasis was more common in patients having upper abdominal surgery. The current investigation reveals that the earliest postoperative change indicative of atelectasis is the fall in Po2; that auscultatory changes do not always occur in the presence of postoperative hypoxaemia; that auscultatory signs are not indicative of the extent of the Po2 fall; and that radiology represents a crude method of assessing postoperative atelectasis.
Saddlebag hernia
Authors: Qvist George 
Published: March 2007

Abstract
Saddlebag hernia occurs most commonly as a small indirect sac in association with an obvious direct inguinal hernia. It may be easily overlooked at operation. Hoguet's manœuvre is the most satisfactory method of operative treatment of saddlebag hernia. It is suggested that an overlooked indirect sac associated with a direct inguinal hernia is a common cause of recurrent inguinal hernia.
Carcinoma of the thyroid gland in Iran
Authors: Hashemian Hassan , Keyhani Amanelah 
Published: March 2007

Abstract
Of the 1698 cases of thyroid disease seen during the 17 years 1956–72 in the Taj Cancer Institute, Tehran, 398 were cases of carcinoma, an incidence of 23·4 per cent. The factors involved in this high incidence of malignancy are discussed and the treatment of these patients is described.
The effect of vagotomy on the lower oesophageal sphincter: A manometric study
Authors: Angorn I B , Dimopoulos G , Hegarty M M , Moshal M G 
Published: March 2007

Abstract
The pressure profile of the gastro-oesophageal junctional zone was studied at rest and during abdominal compression in 26 duodenal ulcer patients after subdiaphragmatic truncal vagotomy with a drainage procedure. An ‘early’ group of 9 patients was investigated 10–14 days after surgery and a ‘late’ group of 17 patients more than 1 year after operation. Comparisons were made with 25 control subjects.
The resting lower oesophageal sphincter pressures after vagotomy in both the early and late groups were similar to the levels of sphincter pressure in the controls. However, the increase in sphincter pressure always observed during abdominal compression in normal subjects was significantly decreased by complete vagotomy, and the normal increase in the gastrosphincteric pressure gradient was not produced.
All 26 patients were tested for completeness of vagotomy using the insulin/pentagastrin test. In 19 patients the vagotomy was complete and in 7 patients it was judged to be incomplete. A decrease in the gastro-sphincteric pressure gradient on manometric study of the lower oesophageal sphincter was interpreted as indicating complete vagotomy. Accurate correlation between secretory response and compression response was achieved in all patients with complete vagotomy and in 5 of the 7 patients with incomplete vagotomy.
Stricture-plasty for tubercular strictures of the gastro-intestinal tract
Authors: Katariya R N , Sood S , Rao P G , Rao P L N G 
Published: March 2007

Abstract
Twenty stricture-plasties have been performed for multiple tubercular strictures of the gastro-intestinal tract in 9 patients, who in total had 35 structures. The procedure has been found to be safe, simple and effective in relieving obstructive symptoms. It does not appear to carry the disadvantages of entero-anastomosis or multiple and/or massive resections in cases of multiple tubercular strictures of the small bowel.
Volvulus of the sigmoid colon
Authors: Khoury George A , Pickard Robert , Knight Michael 
Published: March 2007

Abstract
The clinical presentation and treatment of 31 consecutive patients with sigmoid volvulus are reviewed. Nearly half of these patients had a history of mental illness and one-third of all patients were chronically constipated. The main clinical features of abdominal pain and gross abdominal distension had been present for an average of 8 days before presentation of the patient to hospital. The clinical diagnosis of sigmoid volvulus was not difficult but the presence of non-viable bowel was more difficult to establish. A silent abdomen was the most valuable indication of the presence of gangrenous bowel.
Conservative measures, including sigmoidoscopy and therapeutic barium enema, successfully reduced the volvulus in half of the cases so treated.
In those patients undergoing surgery the procedure associated with the lowest mortality was sigmoid resection with end-to-end anastomosis. The overall mortality was 35 per cent.
Function of the anal sphincters following colo-anal anastomosis
Authors: Lane R H S , Parks A G 
Published: March 2007

Abstract
Developments in sphincter-saving operations for carcinoma of the rectum have led to renewed interest in the function of the pelvic floor muscles and the anal sphincters. Twelve patients with a colo-anal anastomosis have been investigated physiologically with reference to sphincter function. It has been shown that the rectum is not essential for the appreciation of impending evacuation, nor for the sphincter inhibitory reflexes, which in this study were elicited by balloon distension above the anastomosis.
The value of ultrasonic B-mode scanning in the diagnosis of persistent jaundice
Authors: Armitstead P R , Addison N V , Follows O J 
Published: March 2007

Abstract
The use of ultrasonic B-mode scanning of the liver and biliary tract in patients with persistent jaundice is described. Sixty-seven consecutive jaundiced patients have been scanned. A correct diagnosis was obtained in 66 per cent, useful information in 26 per cent and in only 8 per cent was the information misleading or of no diagnostic value. In our opinion this simple and non-invasive technique is of great value in the definitive diagnosis of persistent jaundice and should allow earlier surgery in the obstructive cases.
Breast screening and surgical problems
Authors: Owen A W M C , Forrest A P M , Anderson T J , Samuel E , Young G B , Scott A M 
Published: March 2007

Abstract
The Edinburgh Breast Screening Clinic in its first year completed the initial screening examination of 3005 invited women, who were apparently in good health, aged between 40 and 60 years; 141 were referred for a surgical opinion; 70 women ultimately underwent biopsy and 9 proved to have carcinoma. The indications for biopsy are described together with methods of management of the various lesions.
Haemodynamics of axillofemoral grafting in a case with normal inflow and outflow vessels
Authors: Delin A , Swedenborg J 
Published: March 2007

Abstract
Intra-operative haemodynamics were studied in a case of axillofemoral grafting. When the normal axillary artery acted as the donor artery no steal from the arm occurred, even after vasodilatation in the leg. When, conversely, the very poor arterial collaterals to the leg were required to serve as donor arteries because the axillary artery proximal to the anastomosis was occluded by a clamp, a steal from the leg to the arm was observed. The study supports the concept that only if the donor artery has a high resistance to flow can a steal develop.
Mesenteric venous thrombosis occurring late after splenectomy
Authors: Nagasue Naofumi , Inokuchi Kiyoshi , Kobayashi Michio , Saku Motonori 
Published: March 2007

Abstract
Two patients with mesenteric venous thrombosis which occurred late after splenectomy are reported. In the first case the thrombosis was seen, with preceding thrombocytosis, 3 years after splenectomy. In the second case the thrombosis occurred 2 years and 5 months postoperatively. Platelet counts had not been obtained before the mesenteric thrombosis in this case. In both instances persistent severe anaemia for several weeks preceded the symptoms and signs of mesenteric venous thrombosis. Both patients were treated by extended resection of the affected small bowel. Thus, dangerous thrombocytosis may occur in the presence of persistent severe anaemia even late after splenectomy. Thrombocytosis occurring immediately after splenectomy, which is almost inevitable, should be treated with heparin or other anticoagulants. In the late period the avoidance of persistent severe anaemia seems to be important in the prevention of thrombotic complications due to reactive thrombocytosis in splenectomized patients.
Ammonia absorption from the canine colon after portacaval shunt
Authors: Harrison I D , Smith A Hardy , Shields R 
Published: March 2007

Abstract
Ammonia absorption was studied from Thiry–Vella colon loops in 6 dogs. Four underwent an end-to-side portacaval shunt and it was shown that absorption of ammonia from the colon significantly increased postoperatively. Absorption of ammonia from various solutions was also measured before and after portacaval shunt and it was shown that absorption was increased from a high pH solution and from a solution with a high bicarbonate content and reduced from a low pH, low osmolality and high osmolality solution. Increased deposits of stainable iron were demonstrated in the livers of dogs following portacaval shunt.
Foreign body in the oesophagus: Review of 2394 cases
Authors: Nandi P , Ong G B 
Published: March 2007

Abstract
A total of 2394 patients with a foreign body in the oesophagus was treated in our unit between 1965 and 1976, including 343 children in whom fish bones (146) and coins (134) were most commonly responsible; in adults, bones (fish and chicken) were commonest. Most of the foreign bodies were impacted in the cervical oesophagus. Pharyngoscopy and oesophagoscopy were carried out under general anaesthesia in all cases except those in which the foreign body was ejected spontaneously or when the patient refused the examination. Oesophageal perforation due to a foreign body was encountered in only one child. Two patients in the series developed the fearsome complication of oesophagoaortic fistula.
The pattern of non-diabetic peripheral vascular disease in South India
Authors: Shead G V , Oomen Ranjit M , Savarirayan S S 
Published: March 2007

Abstract
One hundred and twelve South Indian males with nondiabetic peripheral vascular disease of the lower limb were classified clinically into three groups according to the level of obstruction (aorto-viliac, 26 patients; femoropopliteal, 46 patients; distal, 40 patients). Arteriography was done in 65 patients and serum lipid estimations in 69.
In the aorto-iliac group the mean age was 45 years (± 11·6 s. d.); 23 per cent had hypertension, 28 per cent polycythaemia and 55 per cent hyperlipidaemia. Aortography suggested atheroma in most. In the femoropopliteal group the mean age was 39 years (± 12·8); 22 per cent had hypertension, 11 per cent polycythaemia and 21 per cent hyperlipidaemia. Arteriography showed lesions typical of atheroma in many and was consistent with thrombo-angiitis obliterans in some. In the distal group the mean age was 37 years (± 9·8); 8 per cent had hypertension, 20 per cent polycythaemia, 25 per cent hyperlipidaemia and 20 per cent had distal arterial disease of the upper limb. Arteriography was consistent with thrombo-angiitis obliterans in most cases. Atheroma seemed to be implicated in 96 per cent of the aorto-iliac group and in 64 per cent of the femoropopliteal group.
Peritoneal lavage in faecal peritonitis in the rat
Authors: Stewart D J , Matheson N A 
Published: March 2007

Abstract
Intraoperative antibiotic peritoneal lavage was significantly better than systemic antibiotic in preventing death from induced faecal peritonitis in the rat. Its efficacy was due to the combined effects of lavage and intraperitoneal antibiotic, each factor alone being significantly inferior to the combined effect of both. Antiseptic lavage was less effective than antibiotic lavage.
Wound infection in emergency appendicectomy: A prospective trial with topical ampicillin and antiseptic solution irrigation
Authors: Tanphiphat Chanvit , Sangsubhan Chesada , Vongvaravipatr Viroj , La-Ongthong Banyat , Chodchoy Viroj , Treesaranuvatana Soontorn , Ittipong Poonpong 
Published: March 2007

Abstract
A randomized controlled trail in 374 patients requiring emergency appendicectomy to determine the value of topical ampicillin and antiseptic solution of chlorhexidine and cetyl trimethyl ammonium bromide (Savlon) in preventing wound infection is reported. The application of 1 g of ampicillin powder to the wound significantly reduced wound infection in perforated appendicitis, but not in unperforated appendicitis. Wound irrigation with 1 per cent cetyl trimethyl ammonium bromide was ineffective in preventing wound infection in all grades of appendicitis. When wound contamination is difficult to avoid, as in perforated appendicitis, topical ampicillin should be used to reduce the rate of wound infection.
The early use of fine-needle percutaneous transhepatic cholangiography in an approach to the diagnosis of jaundice in a surgical unit
Authors: Benjamin I S , Allison M E M , Moule B , Blumgart L H 
Published: March 2007

Abstract
Fine-needle percutaneous transhepatic cholangiography (PTC) was performed in a series of 46 patients with jaundice or suspected biliary tract disease. The ductal system was successfully outlined in each of 20 patients with dilated intrahepatic ducts and in 19 of 26 patients with intrahepatic ducts of normal calibre. There were two episodes of septicaemia after PTC, one of them fatal. Valuable accurate diagnostic information was obtained in all cases with biliary tract obstruction. A programmed approach to diagnosis of suspected obstructive jaundice is outlined. Fine-needle PTC is an acceptably safe procedure and need not be followed by immediate laparotomy.
Side-to-side choledochoduodenostomy in the management of choledocholithiasis
Authors: Engin A , Haberal M , Sanaç Y 
Published: March 2007

Abstract
Sixty patients with choledocholithiasis (either single or multiple stones of the biliary tree) were treated with lateral choledochoduodenostomy. Of these cases 83·3 per cent were followed up for from 1 to 7 years. Only 1 patient developed cholangitis, which responded well to conservative treatment. The other cases have been asymptomatic following surgery. The diameter of the common bile duct is not an important problem in constructing a functional anastomosis.
Gallstone disease presenting as septicaemic shock
Authors: Faber R G , Ibrahim S Z , Thomas D M , Beynon G P J , Le Quesne L P 
Published: March 2007

Abstract
Three patients are described who were admitted to hospital with septicaemic shock due to gallstones, but in none of whom had the presence of gallstones been diagnosed previously. All 3 had positive blood cultures, Clostridium welchii being isolated in one patient (in another patient this organism was isolated from the bile). Two patients had renal failure requiring dialysis. All 3 patients survived. The management of this serious presentation of gallstones, hitherto poorly described in British literature, is discussed.
In vivo release of gastrin into human gastric juice
Authors: Knight N F , Fiddian-Green R G , Vinik A I 
Published: March 2007

Abstract
The release of antral gastrin has been examined in human subjects by infusing saline and albumin into their stomachs. Immunoreactive gastrin (IRG) was present in fasting serum but not in fasting gastric juice. Intragastric infusions of saline and albumin induced small but significant (P &lt; 0.05) rises in the serum concentrations of IRG. There was no significant difference between the magnitude of the serum gastrin responses to these two stimuli. The stimuli induced a rise in the luminal concentration of IRG which was sixfold greater than that in the serum concentration of IRG. The response to albumin was significantly greater than the response to saline (P &lt; 0.05). The IRG in gastric juice was chromatographically similar to heptadecapeptide gastrin. The stimuli also released IRG in patients with duodenal ulcers. The magnitude of the release into serum and gastric juice in these patients was significantly reduced by antrectomy (P &lt; 0.05).
Prospective randomized multicentre trial of proximal gastric vagotomy or truncal vagotomy and antrectomy for chronic duodenal ulcer: Interim results
Authors: Dorricott N J , McNeish A R , Alexander-Williams J , Royston C M S , Cooke W M , Spencer J , de Vries B C , Muller H 
Published: March 2007

Abstract
In three centres, 222 patients (Birmingham 70, London 87 and Rotterdam 65 patients) with chronic duodenal ulcer were treated by proximal gastric vagotomy (PGV) (116 patients) or truncal vagotomy and antrectomy (TVA) (106 patients) in a prospective randomized trial. After 1 year 5 recurrent duodenal ulcers (4·3 per cent) have been recorded in the PGV group, compared with 1 (1 per cent) in the TVA group. The reoperation rate was high in both groups–6 after PGV, usually for recurrent ulcer, and 7 afer TVA, mostly for gastric retention.
PGV showed a marked superiority in the number of patients with a good clinical result (Visick I or II) at 1 year after operation, i. e. 82 per cent compared with 56 per cent for TVA.
Peroperative grading of pyuloric stenosis: A long term clinical and radiolgoical follow-up of patients with servere pyloric stenosis treated by highly selective vagotomy and dilatation of the stricture
Authors: Delaney Peter 
Published: March 2007

Abstract
Highly selective vagotomy (HSV) is now an accepted form of surgery for uncomplicated duodenal ulcer. Highly selective vagotomy and dilatation has been successfully used in some cases of pyloric stenosis, but many would regard severe pyloric stenosis as a contraindication to this procedure.
Eleven patients with severe pyloric stenosis, measured objectively at operation, have been treated by HSV and dilatation of the stenosis and reviewed for periods of up to 3 years. The clinical results, immediate and long term, were good in all cases. Barium studies and histopathological findings were slower to return to normal.
With intensive preoperative preparation to restore the tone of the dilated gastric muscle and gentle, controlled dilatation of the stricture, HSV in these patients should be as satisfactory as in those patients with uncomplicated duodenal ulcer.