bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute necrotizing colitis and obstruction
Authors: Teasdale C , Mortensen N J McC 
Published: March 2007

Abstract
Acute necrotizing colitis is a rare complication of colonic obstruction. Six cases occurring during a 20-month period are described. The presenting features were those of colonic obstruction with shock but without perforation. At laparotomy changes ranged from mucosal necrosis to frank gangrene in the colon proximal to the obstructing lesion. Gram stains of resected colon showed Gram-positive bacilli, resembling clostridia, invading the mucosa and submucosa. Two patients treated by defunctioning colostomy alone died but the remaining 4 survived after total colectomy. The cause is not known but raised intraluminal pressure may result in terminal mucosal ischaemia allowing anaerobic organisms to invade the bowel wall.
The effect of faecal loading on colonic anastomotic healing
Authors: Smith S R G , Connolly J C , Gilmore O J A 
Published: March 2007

Abstract
The effect of faecal loading of the colon on the healing of rat colonic anastomoses has been investigated in a prospective randomized and controlled study. Anastomotic dehiscence occurred significantly more often when the bowel was loaded with faeces at the time of operation than when it was empty. Suture line cultures bore no relationship to the outcome of the anastomosis. This result emphasizes the importance of an empty colon as a contributory factor in successful colonic healing in the rat.
Rectus abdominis myocutaneous flap—clinical experience with ipsilateral and contralateral flaps
Authors: Parkash S , Palepu J 
Published: March 2007

Abstract
This study summarizes our experience with the use of 15 superior and inferior rectus abdominis myocutaneous flaps for filling defects in the chest wall, pectoral region, abdominal wall and groin. An extension of this flap above the costal margin, recommended in the study, provides valuable additional tissue. The flap is reliable and easily constructed.
A randomized clinical trial of PTFE versus human umbilical vein for femoropopliteal bypass surgery. Preliminary results
Authors: Eickhoff J H , Hansen H J Buchardt , Brommé A , Ericsson B F , Kordt K F , Mouritzen C , Myhre H O , Norgren L , Rostad H , Trippestad A 
Published: March 2007

AbstractPTFE (Goretex) and modified human umbilical vein (Biograft) vascular grafts were compared in femorodistal popliteal artery bypass surgery in a randomized clinical multicentre trial. During 18 months 104 patients (104 limbs) entered the trial. Twenty-five patients suffered from claudication, 54 suffered rest pain and 25 patients had ulceration or gangrene. The median preoperative ankle–arm blood pressure index was 0·34. Twenty-three limbs had 3 patent tibial arteries, 45 limbs had 2 tibial arteries, 31 limbs had 1 tibial artery while 5 limbs had an isolated popliteal segment. Thirty-six of the operations were redo-operations. Fifty-four patients were allocated to PTFE and 50 to umbilical vein. During follow-up (maximum 650 days) 24 PTFE grafts occluded against 12 umbilical veins. The 1-year patency rate was 40 per cent in the PTFE group against 75 per cent in the umbilical vein group (P = 0·014, Gehans test). During the first year the PTFE failure rate was on average 3·1 times higher than that of the umbilical vein.
The Kock reservoir ileostomy: A review of its development, problems and role in modern surgical practice
Authors: Cranley B 
Published: March 2007

Abstract
The Kock continent ileostomy reservoir was designed in an attempt to overcome many of the problems associated with the conventional ileostomy. An account is given of the technical developments of this procedure since its inception. An intussusception valve within the reservoir is necessary for continence. However, valve failure is a common problem and the developments in construction which have helped to overcome this are described. The major complications associated with the continent ileostomy are discussed in detail, and an attempt is made to define its present role in the treatment of inflammatory disease of the colon.
The value of parotid sialography
Authors: Adam E J , Willson S A , Corcoran M O , Hobsley M 
Published: March 2007

Abstract
One hundred consecutive parotid sialograms were reviewed to assess the clinical usefulness of the technique. In 54 per cent of patients significant information was provided by the sialogram, and in 22 per cent the diagnosis was made on sialographic appearances alone or the findings altered subsequent management. The highest proportion of useful investigations was found in those presenting with bilateral parotid swelling. No significant information was obtained in patients with an isolated lump in the parotid region.
Final inline filtration for intravenous infusions: A prospective hospital study
Authors: Allcutt D A , Lort D , McCollum C N 
Published: March 2007

Abstract
Phlebitis is the most common complication of intravenous therapy affecting more than 50 per cent of infusions. Particles in or added to infusions have been implicated, hence a filter with pore size of 0.2/ μm containing both hydrophobic and hydrophilic elements (Pall Biomedical) has been evaluated. All infusions of likely duration greater than 48 h, set up in a 2-month period at this hospital, were randomized to filter or identical dummy. The endpoints and statistical power of the study were determined at the outset. Of the 226 infusions randomized, 32 failed within 24 h and were excluded leaving 194 of whom 93 had dummy and 101 filter. Only 38 infusions with dummy survived until no longer required compared to 63 infusions with filter (χ2 = 7.68, P &lt; 0.01). Analysed by life table, the trend for filtered infusions to survive longer failed to achieve statistical significance, but inline filtration prolonged the phlebitis-free survival of infusions (P &lt; 0.01). These benefits were most marked in the 49 infusions where antibiotics were administered via the drip site. Inline filtration delays the onset of phlebitis, thus more infusions survive until they are no longer required. This effect is not sufficiently strong to institute an overall hospital policy but filters may be indicated in patients requiring intravenous antibiotics.
The preoperative detection of axillary lymph node metastases in breast cancer by isotope imaging
Authors: Osborne M P , Payne Julie H , Richardson V J , McCready V R , Ryman Brenda E 
Published: March 2007

Abstract
Axillary lymphoscintigraphy using 99Tcm-labelled liposomes was carried out in 40 patients with breast cancer as a part of pretreatment staging in an attempt to improve the accuracy of axillary evaluation. Patients were injected interstitially in the periareolar region of each breast with 250–300 μCi of 99Tcm-labelled liposomes. Subsequently the patients were imaged with a gamma-camera using computerized data processing. Interpretation of images was based on prior experimental data; a diminished uptake of isotope by the primary regional lymph node (PRLN) and the group of axillary regional lymph nodes (RLN) draining the tumour, when compared to the control side, was considered to be abnormal and to suggest node metastases. An equal or enhanced uptake by the PRLN or RLN draining the tumour, when compared to the control side, was considered normal, indicating an absence of lymph node metastases. Eighteen patients (45 per cent) had abnormal scans and 14 patients (35 per cent) had normal scans. Eight patients (20 per cent) had technically unsatisfactory images where axillary nodes could not be identified. Twenty-two patients of the 32 with evaluable scans had correlation of preoperative images with postsurgical axillary lymph node histopathology. One patient out of 12 with an abnormal scan had normal lymph nodes on serial sectioning, and 2 patients out of 10 with normal scans had lymph node metastases. Eight of the 32 patients (25 per cent) with evaluable images had enhanced uptake of isotope by the PRLN and RLN draining the tumour. In 3 of these cases a marked reactive hyperplasia only was shown on histopathological examination, in 2 cases the reactive hyperplasia was associated with lymph node metastases, accounting for the 2 false negative interpretations. This preliminary study suggests that axillary lymphoscintigraphy may be of value in preoperative staging in breast cancer. Long term studies are needed to evaluate the prognostic potential of such a test as a measure of macrophage function. Further studies, by blind replication, are required to evaluate the accuracy of axillary lymph node imaging.
Early or delayed cholecystectomy in acute cholecystitis? A clinical trial
Authors: Norrby S , Herlin P , Holmin T , Sjödahl R , Tagesson C 
Published: March 2007

Abstract
Patients with a preoperative diagnosis of acute cholecystitis were prospectively allocated to treatment with early cholecystectomy (ES) within 7 days of the onset of symptoms, or initial conservative treatment followed by delayed elective surgery (DS). Patients whose symptoms required emergency operation, patients older than 75 years and patients with pancreatitis were excluded from the trial but were followed up. During the study period 402 patients with acute cholecystitis were admitted, 101 fell into the ES group and 91 into the DS group. The conservative regimen had to be interrupted in 15 patients (13·8 per cent) because their clinical status deteriorated and 13 patients (11·9 per cent) in the DS group did not return for planned elective surgery. One patient in the DS group died. There was no difference in the frequency of intra- and postoperative complications between the 2 study groups, the incidence of bacterial complications being markedly low, especially in the ES group. The ES group had a moderate but significantly greater intraoperative blood loss. Hospital stay was almost 1 week shorter in the ES group and insurance payment for loss of working capacity was also shorter in the ES group. These results indicate that early cholecystectomy is the treatment of choice in acute cholecystitis in patients aged 75 years and under.
Proliferative cholangitis (cholangitis glandularis proliferans)
Authors: Krukowski Z H , McPhie J L , Farquharson A G H , Matheson N A 
Published: March 2007

Abstract
A case of extrahepatic biliary obstruction is presented in a patient with a previously unrecognized condition of the bile ducts. Five other cases with similar histological features in the bile ducts are also presented. The possible relationship between this condition and other causes of biliary obstruction is discussed and its characteristic features are described. The problems of diagnosis and management are discussed. Because of clinical, radiological and pathological similarities to cholecystitis glandularis proliferans it is proposed that the condition be called proliferative cholangitis (cholangitis glandularis proliferans).
Effects of gastrocystoplasty on serum gastrin levels and gastric acid secretion
Authors: Lim S T K , Lam S K , Lee N W , Wong J , Ong G B 
Published: March 2007

Abstract
Hypersecretion of gastric acid and hypergastrinaemia occur when the antrum of the stomach is transposed as a diverticulum to the colon. Thus, when an antral pouch is transposed to increase bladder capacity or to replace the bladder as a gastrocystoplasty, similar pathophysiological disturbances can be anticipated. However, previous studies in our laboratories in dogs have shown that acid overproduction and stomal ulcerations do not occur. This paper reports the results of gastrocystoplasty in 13 patients followed up from 1 to 6 years. Gastric acid hypersecretion and hypergastrinaemia did not occur.
Adult intussusception in the tropics
Authors: Hadley G P , Simpson R L 
Published: March 2007

Abstract
Thirty-two cases are reported of intussusception occurring in patients over the age of 12 years, diagnosed in Papua New Guinea in the 8 years from March 1973. Malignant disease was found in only 2 patients (6·3 per cent), and in 21 cases (65·5 per cent) no associated pathology was detectable. Benign inflammatory polypi were encountered in 7 patients (22 per cent). A high proportion of primary intussusceptions is characteristic of series reported from tropical countries. Many may be due to the abnormal motility associated with acute diarrhoeal illnesses. Due to the rarity of associated malignancy a policy of conservative operative management is justifiable in a tropical environment.
Standardized diagnosis and treatment of fluid, acid–base and electrolyte disorders in the surgical patient with the aid of a programmable pocket calculator
Authors: Kievit J 
Published: March 2007

Abstract
The approach to fluid, acid–base and electrolyte disorders in the surgical patient has been standardized in a pocket calculator program that categorizes these disorders into formal diagnoses and subsequently uses these diagnoses to determine the appropriate therapy. The program was tested in 80 infusion regimens of patients in the intensive care and surgical wards. The advantages of a standardized approach to these disorders, using diagnostic and therapeutic algorithms, are briefly discussed.
Incisional hernias: When do they occur?
Authors: Ellis H , Gajraj H , George C D 
Published: March 2007

Abstract
Incisional herniation remains a major problem for the general surgeon. Most published studies have followed up patients for 6–12 months after operation. In this study, 363 patients, known not to have an incisional hernia at 1 year, were renewed between 2·5 and 5·5 years after operation. Twenty-one patients (5·8 per cent) were found to have developed incisional hernias. None of the causal factors previously implicated in the aetiology of incisional herniation (wound infection, male sex, obesity, age, postoperative chest infection or abdominal distension), was found to be associated with the development of these ‘late hernias’.
The effect of breast biopsy on reactive changes in the axillary lymph nodes
Authors: Steele R J C , Blackie R A S , McGregor J D , Forrest A P M 
Published: March 2007

Abstract
The reactive changes in the axillary lymph nodes of 50 breast cancer patients treated by mastectomy immediately following frozen section diagnosis have been compared with the changes in the nodes of 50 patients whose biopsy preceded mastectomy by between 2 and 5 days. The frequency of sinus histiocytosis was significantly greater in those patients who had been subjected to previous biopsy. This finding suggests that prior breast biopsy may negate the prognostic significance of sinus histiocytosis in breast cancer.
Causes and clinical significance of gastritis following Billroth II resection for duodenal ulcer
Authors: Fischer A B , Græm N , Christiansen L A 
Published: March 2007

Abstract
Billroth II resection was carried out in 1000 duodenal ulcer patients in the period 1948–1956. Twenty-two to thirty years later, gastroscopy and biopsy was performed in 196 of 423 survivors. Chronic atrophic gastritis appeared in 93 per cent of the cases, 47 per cent showed slight and 46 per cent severe changes. Seven per cent had normal mucosa. The microscopic grade of gastritis proved to be independent of age, alcohol and tobacco consumption and serum gastrin. No correlation between clinical status, such as dumping, diarrhoea, vomiting and pain, haematological parameters and the microscopic grade of gastritis, could be found. It is suggested that gastritis might be caused by reflux of bile, pancreatic and intestinal juices, and that postgastrectomy symptoms and anaemia do not depend on the microscopic grade of gastritis.
Surgical implications of malnutrition and immunodeficiency in patients with carcinoma of the oesophagus
Authors: Belghiti J , Langonnet F , Bourstyn E , Fekete F 
Published: March 2007

Abstract
A nutritional and immunological assessment was prospectively performed in 75 patients with squamous cell carcinoma of the oesophagus. Abnormal nutritional and/or immunological values were present in 37 patients (50 per cent) and absent in 38. The tumour was resectable in 27 patients (71 per cent) with normal values and only in 11 among the 37 (29 per cent) with abnormal values (P &lt; 0·001). Complications after resection including death, pneumonia and anastomotic failure were not significantly different in the two groups of patients except for anastomotic failure. This observation suggests that reduction of surgical complications by preoperative nutritional therapy might be expected only in few patients with oesophageal carcinoma.
Long term follow-up of hyperthyroid patients treated by subtotal thyroidectomy
Authors: Sugrue D D , Drury M I , McEvoy M , Heffernan S J , O'Malley E 
Published: March 2007

AbstractThe early and long term complications of subtotal thyroidectomy in 306 hyperthyroid patients (multinodular goitre and diffuse hyperplasia) followed for up to 30 yr are reviewed. There were no perioperative deaths. Sixteen patients (5·2 per cent) had transient symptomatic hypocalcaemia, while 9 (2·9 per cent) had permanent hypocalcaemia. Permanent unilateral vocal cord paralysis occurred in 11 (3·6 per cent) patients (1·8 per cent of nerves at risk). Cumulative per cent (± s.e.m.) relapse and hypothyroid rates at 30yr (life-table analysis) were 15·6 ± 2·4 per cent and 20·5 ± 2·1 per cent, respectively. Lifelong follow-up of post-thyroidectomy patients is mandatory because of the risk of relapse or hypothyroidism.
Does fixity affect prognosis in colorectal tumours?
Authors: Habib N A , Peck M A , Sawyer C N , Blaxland J W , Luck R J 
Published: March 2007

Abstract
In-a retrospective series of 301 colorectal tumours, tumour fixity was assessed, and was found to be of prognostic significance in relation to 5-year survival. Fixity of the tumour was associated with low curative resection rate and advanced tumour stage. Fixation did not correlate significantly with the site or differentiation of the tumour nor with operative mortality.
Function of liver, gallbladder and sphincter of Oddi after major surgery studied by computer-assisted cholescintigraphy and real-time ultrasonography
Authors: Van Der Linden W , Kempi V , Edlund G 
Published: March 2007

Abstract
Patients with normal gallbladders were subjected to computer-assisted Tc-HIDA cholescintigraphy at fixed intervals after major surgery. Hepatic time–activity curves showed that hepatic excretion of the material was first reduced and later a reduction of hepatic uptake followed. The gallbladder responded first by dilatation and reduction of motility and later by delay in or even absence of visualization. Postoperative dilatation was confirmed with real-time ultrasonography. No tracer passed into the duodenum in the early postoperative stage indicating spasm of the sphincter of Oddi. Healthy volunteers were studied with and without morphine and with and without a 24 h fast. The sphincter of Oddi closed after morphine but not after fasting. Transient non-visualization of the gallbladder after surgery makes the diagnosis of postoperative cholecystitis more difficult.
Reoperative parathyroid surgery
Authors: Billings P J , Milroy E J G 
Published: March 2007

Abstract
The increasing recognition of hypercalcaemia caused by primary hyperparathyroidism has led to a rise in the number of failed parathyroid explorations. We report a series of 37 parathyroid re-explorations on 33 patients with persistent hypercalcaemia following the failure of their previous parathyroid surgery. Of these patients, 27 have been cured of their hypercalcaemia but 7 are permanently hypocalcaemic. The results of the parathyroid localization tests used in this series are described, and the difficulties of reoperative parathyroid surgery are discussed. The reasons for failure of the original operations are analysed. Many are avoidable. Based on our experience strategies are described for parathyroid localization and reoperative surgery.
Changes in small bowel myoelectrical activity following laparotomy
Authors: Morris I R , Darby C F , Hammond P , Taylor I 
Published: March 2007

Abstract
Recordings of the myoelectrical activity have been obtained from the small intestine of 4 dogs by means of serosally implanted electrodes. The occurrence of the activity front (phase III) of the migrating myoelectrical cycle (MMC) in the recordings obtained each day after abdominal surgery have been compared. No activity fronts were seen on postoperative days 1 and 2. From days 3 to 6 there was a slightly reduced incidence, but from day 7 onwards an activity front was observed in each recording. It is concluded that the normal pattern of cyclic myoelectrical activity in the small intestine is disrupted for at least 2 days following a laparotomy, and the view that small bowel motility returns to normal soon after routine abdominal surgery may be inaccurate.
Should surgeons operate on the evidence of ultrasound alone in jaundiced patients?
Authors: Eyre-Brook I A , Ross B , Johnson A G 
Published: March 2007

Abstract
The biliary ultrasound scans of 132 patients having a laparotomy for jaundice have been reviewed to assess the role of ultrasound in the selection of patients for surgery. When scans were technically satisfactory the finding of a dilated extrahepatic duct (EHD) indicated obstructive jaundice in all cases, but the obstructing lesion in 5 per cent of such cases was too proximal for jaundice to be relieved by direct surgical decompression. Scans were further classified on the basis of abnormalities detected in the gallbladder. When EHD dilation was associated with gall bladder findings ‘typical’ of distal common bile duct (CBD) obstruction due to gall stones (small gallbladder with multiple gallstones) or tumour (dilated gallbladder without gallstones), surgically remediable obstruction was always present. Although ultrasound identified the obstructing lesion itself in a minority of cases, the cause of obstruction could be correctly inferred in 95 per cent of ‘typical’ scans. These results suggest that it is safe to proceed directly to surgery only when an experienced ultrasonographer demonstrates findings ‘typical’ of distal CBD obstruction due to gallstones or tumour.
The morphological basis of human breast cyst populations
Authors: Dixon J M , Miller W R , Scott W N , Forrest A P M 
Published: March 2007

Abstract
Forty human cysts have been examined to determine the relationship between the epithelial lining and the content of sodium (Na+) and potassium (K+) in the cyst fluid. The ratios of Na+ to K+ for cysts lined by flattened epithelium were higher in all cases than the values obtained for cysts lined by apocrine epithelium. These findings suggest a morphological basis for the two populations of human breast cyst fluids which can be defined on cationic content.
Differences in anorectal manometry between patients with haemorrhoids and patients with descending perineum syndrome: Implications for management
Authors: Read N W , Bartolo D C C , Read M G , Hall J , Haynes W G , Johnson A G 
Published: March 2007

Abstract
Anorectal manometry was carried out at rest, during balloon distension of the rectum and during rectal infusion of saline in 19 patients with haemorrhoids, 30 patients with descending perineum syndrome and 21 controls. Basal and squeeze pressures were significantly higher in patients with haemorrhoids than patients with the descending perineum syndrome. A lower rectal volume was required to inhibit internal sphincter tone in patients with descending perineum syndrome compared with control subjects or patients with haemorrhoids. During rectal infusion of saline basal and peak anal pressures in patients with the descending perineum syndrome were lower than in haemorrhoid patients. Peak rectal pressure was abnormally high in both groups. These differences in anorectal function suggest that despite a similar presentation, the two conditions have a different pathogenesis. Moreover, inappropriate anal sphincter stretch or mucosal excision in patients with descending perineum syndrome may lead to severe incontinence.