bluuebunny/crossref_metadata_2025_split huggingface dataset:
The clinical significance of invasion of veins by rectal cancer
Authors: Talbot Ian C , Ritchie Sheila , Leighton Monica H , Hughes Anthony O , Bussey H J R , Morson Basil C 
Published: March 2007

Summary
A histopathological study of 703 surgical specimens from patients with adenocarcinoma of the rectum revealed invasion of veins by primary growth in almost 52 per cent. Follow-up studies on the patients showed that the corrected 5-year survival rate was significantly worse and liver metastases developed more frequently when venous invasion was present. Invasion of extramural veins was particularly significant whereas spread confined to intramural veins was less important. Invasion of large (thickwalled) veins was of greater consequence than invasion of small (thin-walled) veins and spread into thick-walled extramural veins had the greatest adverse influence of all. Venous spread of tumour takes place in parallel with local spread as measured by the Dukes' stage but exerts an influence on prognosis independent of the Dukes' stage. Similarly, vein invasion parallels the number of lymph node metastases but appears to exert an independent influence on prognosis. Observation of venous spread provides a precise assessment of the likely behaviour of rectal carcinoma and supplements, but does not replace indices such as the Dukes' stage or the number of lymph node metastases in routine use. The implications for surgical technique and management are discussed.
Results of surgical staging in Hodgkin's disease
Authors: Gill P G , Souter R G , Morris P G 
Published: March 2007

Summary
The results of surgical staging in Hodgkin's disease in 107 patients under the care of one surgeon over an 8-year period are presented. The inaccuracy of clinical staging is re-emphasized as 43 per cent of patients had their disease stage altered by surgical staging. Lymphangiography correctly predicted the presence of intra-abdominal disease in only 70 per cent of patients. Spleen size was not an indication of involvement, and furthermore the spleen was involved by disease in the absence of nodal involvement in 6 patients. In 2 cases mesenteric nodes were involved in the absence of pancreatic or coeliac nodal involvement. As a consequence of surgical staging many patients received a more extensive field of radiotherapy, and 18 per cent of patients were treated by combination chemotherapy instead of radiotherapy, There was no hospital mortality and a low operative morbidity following surgical staging. At present surgical staging is an essential part of the overall strategy of management of patients with Hodgkin's disease.
Predictive value of serum complement (C3) in renal allograft rejection
Authors: Kumar Prem , Kodlin Dankward , Marks Charles , Leech Stephen H 
Published: March 2007

Summary
The purpose of this study was to investigate whether or not changes in serum concentrations of complement component C3 are of value in predicting the long term survival of the transplanted kidney.
C3 was quantitated by radial immunodiffusion in fresh sera drawn immediately before transplantation and twice weekly thereafter from 10 recipients. Fourteen episodes of acute rejection occurred during the first 3 months post-operatively. These were diagnosed by the demonstration of graft tenderness, fever without evidence of infection and a rise in serum creatinine of 1 mg/dl in the absence of urinary or vascular obstruction.
Five rejection episodes in 3 patients were associated with a fall in C3. In one of these patients, C3 returned to normal levels after the episode was reversed, and the kidney is functioning well 2 years after transplantation. In the other 2 patients, C3 remained at low levels regardless of anti-rejection therapy. Transplant nephrectomy was soon required for irreversible rejection. In contrast, only 1 episode unaccompanied by a fall in C3 was irreversible.
Evidence is provided concerning the value of serial C3 complement determinations as a predictor of rejection in renal allografts. Using the variability measure si, the cumulated standard deviation up to week i, si &gt; 10 not only predicts rejection but does so rather early, providing more than 90 per cent of the ideal lead time. This suggests that loss of a graft may be predicted, but this needs confirmation in additional cases.
Palliation and survival in malignant oesophago-respiratory fistula
Authors: Weaver R M , Matthews H R 
Published: March 2007

Summary
Survival in the presence of malignant oesophagorespiratory fistula is usually limited to a few weeks.
In this paper we describe our experience with 3 cases treated by retrosternal oesophagogastric bypass with oesophageal exclusion, and review the experience of previous authors using this and other forms of bypass.
The results indicate that both survival and quality of life are considerably better with surgical bypass and exclusion than with any other form of treatment. Indeed, the survival times are frequently better than those achieved after palliative resection of oesophageal carcinoma without fistula.
Retrosternal oesophagogastric bypass with oesophageal exclusion is recommended as a simple method of bypass for this condition.
A trial of suction drainage in inguinal hernia repair
Authors: Beacon J , Hoile R W , Ellis Harold 
Published: March 2007

Summary
A prospective randomized trial was conducted on 301 adult males undergoing inguinal herniorrhaphy to assess the value of postoperative suction drainage. Hernias were classified into ‘complicated’ and ‘simple’. In the ‘complicated’ group suction drainage for 24 h significantly reduced the incidence of wound haematoma, seroma or infection from 48·7 per cent to 17·6 per cent (P &lt; 0·01); there was also a noticeable effect on the postoperative morbidity in the ‘simple’ hernias, although this just failed to achieve significance (4·5 per cent in the suction group compared with 9·8 per cent in the controls). It is concluded that suction drainage should be employed postoperatively following repair of hernias where dissection may be difficult or where other complicating factors are present.
Vascular complications of anterior dislocation of the shoulder
Authors: Drury J K , Scullion J E 
Published: March 2007

Summary
Vascular complications are rare in cases of simple anterior dislocation of the shoulder but the axillary and its branches may be damaged. Four cases of axillary artery injury, including 2 cases of complete transection of the artery, are presented. Full upper limb function may return if the vascular damage is recognized and prompt surgical treatment undertaken.
Does β-blockade affect surgical performance?. A double blind trial of oxprenolol
Authors: Foster G E , Makin Carol , Evans D F , Hardcastle J D 
Published: March 2007

Summary
Heart rates of surgeons rise when they carry out operations and this rise is abolished by β-blockade. In an assessment of the effect of oxprenolol on surgical performance a group of surgeons took double blind either oxprenolol 40 mg or a matching placebo. Oxprenolol abolished increases in heart rate (P &lt; 0·001) but had no effect on a profile of performance tests assessing tremor, suturing accuracy and co-ordination. Reaction time of the surgeons was significantly slowed by oxprenolol (P &lt; 0·01). Using a self-administered visual analogue scoring system the surgeons recorded no subjective changes in mood after β-blockade and were surprisingly unaware of whether they had taken oxprenolol or placebo.
The management of acute cholecystitis and its hospital cost
Authors: Fowkes F G R , Gunn A A 
Published: March 2007

Summary
This retrospective study compares the hospital costs of early and delayed cholecystectomy in the treatment of patients presenting with acute gallbladder disease. Of patients on the waiting list for delayed cholecystectomy, 27 per cent were readmitted as emergencies. The operating time was the same for early and delayed cholecystectomy. The overall average length of stay in the delayed group (16·1 days) was significantly greater (P &lt; 0·001) than in the early group (12·4 days). The main difference in length of stay was due to the initial medical admission in the delayed group. The hospital costs, calculated on the basis of length of stay and hospital attendances, were £156 cheaper (at 1977/78 prices) for early than for delayed cholecystectomy. Although the numbers were too small for valid statistical analysis, surgical outcome as measured by numbers of deaths, complications and readmissions was similar in the two groups. If more early cholecystectomies were performed, costs might be saved and surgical waiting lists reduced.
Cholelithiasis following peptic ulcer surgery: A prospective controlled study
Authors: Anderson J R , Ross A H McLean , Din N A , Small W P 
Published: March 2007

Summary
An association between gastric surgery and gallstones has been suggested but conflicting conclusions are found in the literature. A prospective study of 118 patients with proved duodenal ulcer disease has been undertaken to determine the true incidence of gallbladder disease. Sixty-one patients undergoing surgery and 57 patients treated medically were matched for age, sex and weight. All patients had oral cholecystography at entry into the study and at 18 months and 109 were reviewed radiologically at 3 years. Three patients in the surgical group developed asymptomatic gallstones whereas none were detected in the medical group. This gives an incidence of gallstones of 4.9 per cent 3 years after gastric surgery. These findings are discussed.
Plasma suppressive activity and kidney graft survival
Authors: Veitch P S , Shenton B K , Proud G , Taylor R M R 
Published: March 2007

Abstract
Over the past few years many centres have shown that blood transfusions given to potential renal transplant patients are beneficial to subsequent graft survival. Results from this centre have shown that an elevated ability of plasma to suppress lymphocyte reaction to antigen is associated with blood transfusions in chronic renal failure patients. In a prospective study, plasma suppressive activity was measured at the time of transplantation in 49 patients who were followed for between 3 and 15 months. Results showed that patients with a low level of plasma suppressive activity were at risk from early graft loss due to acute rejection. Furthermore, most of the suppressive activity was related to the naturally occurring plasma protein, α2-macroglobulin.
This prospective study reports a significant association between low plasma suppressive activity and early kidney graft loss through rejection, and suggests an explanation for the beneficial effects of blood transfusion on graft survival.
Whole body protein turnover, synthesis and breakdown in patients with colorectal carcinoma
Authors: Carmichael Michael J , Clague Malcolm B , Keir Mike J , Johnston Ivan D A 
Published: March 2007

Summary
As a basis for assessing protein metabolism in cancer patients, whole body protein turnover, synthesis and breakdown were measured preoperatively using a constant rate infusion of L-(1−14C) leucine in patients with differing stages of colorectal carcinoma. The levels of protein synthesis and breakdown were correlated with the extent of disease as measured by the percentage incorporation of the labelled amino acid into plasma protein (1) and the subsequent modified Dukes' classification (2). Eleven apyrexial patients were divided into two groups; 6 of whom had normal appetites while 5 were anorectic. Protein synthesis increased with advancement of disease in both groups, as did protein breakdown. Protein synthesis and breakdown were lower in the anorectic group, suggesting some degree of starvation adaptation. All patients were in positive balance, despite anthropometric data to support loss of host body protein. This suggests translocation of protein stores from muscle to areas of more rapid protein synthesis such as tumour. Remodelling of body protein is an important facet of metabolism in cancer patients.
Possible tests for selection of adjuvant systemic therapy in early cancer of the breast
Authors: Cooke Timothy , George W D , Griffiths K 
Published: March 2007

Summary
The oestrogen receptor content and the thymidine labelling index have been correlated in a series of primary cancers of the breast. Receptor was assayed in tumours of 409 patients with operable breast cancer. Recurrence rates were significantly higher in patients whose tumours did not contain receptors than in those whose tumours did. Women without axillary node involvement whose tumours lacked oestrogen receptors showed the same high rate of recurrence as all women with axillary involvement. The oestrogen receptor status of metastases was similar to that of the primary tumours. The thymidine labelling of 83 tumours was inversely related to their receptor content. Tumours without receptors had the highest indices and therefore the highest potential tumour growth. These results have been discussed in relation to selection of systemic adjuvant therapy.
Oesophageal resection with pharyngogastrostomy for corrosive stricture of pharynx and oesophagus
Authors: Ti T K 
Published: March 2007

Summary
A personal experience of 4 patients with combined pharyngeal and oesophageal stricture treated by total oesophagectomy with pharyngogastrostomy is reported. Postoperative recovery was smooth without any instance of anastomotic leakage and swallowing was restored. The major complication was recurrent dysphagia in the first 2 patients because of construction of too narrow an anastomosis, aggravated by postoperative scarring. Recurrent dysphagia did not occur during a 1-year follow-up in the subsequent 2 patients in whom a large pharyngogastrostomy anastomosis was established to the posterior pharyngeal wall. Minor tracheal aspiration occurred but even in the 2 patients with associated laryngeal injury, the symptoms subsided once swallowing was restored. Regurgitation was a problem only in one patient who developed gastric stasis; however, the symptoms subsided after pyloroplasty.
Reconstruction of pharyngo-oesophageal stricture by pharyngogastrostomy restores almost normal swallowing provided that laryngeal function is adequate and a large pharyngogastrostomy anastomosis is established.
The diagnosis of acute gallbladder disease by technetium-99m-labelled HIDA hepatobiliary scanning
Authors: O'Callaghan James D , Verow Peter W , Hopton David , Craven John L 
Published: March 2007

Summary
A series of 105 patients with upper abdominal pain suggestive of biliary colic who had hepatobiliary scans within 48 h of admission to hospital is presented. Fifty of the 65 patients with abnormal scans had operative treatment and gallbladder pathology was found in every case. Fourteen of these patients had hepatobiliary scans which also showed delayed excretion of tracer into the duodenum, and of these, 12 were found to have common bile duct stones and one a stricture of the distal end of the common bile duct. Of the 40 patients who had normal scans, 7 were found to have gallstones on further investigation.
In these patients abnormal hepatobiliary scans have shown a 100 per cent correlation with gallbladder disease. We suggest that this is the investigation of choice for the surgeon contemplating early cholecystectomy on patients with suspected acute gallbladder disease.
The effect of skin preparation and care on the incidence of superficial thrombophlebitis
Authors: Smallman Lesley , Burdon D W , Alexander-Williams J 
Published: March 2007

Abstract
Fifty patients having a variety of intra-abdominal operations necessitating postoperative infusion were randomly allocated to receive antiseptic skin preparation and daily care of the cannula site or no skin preparation either before or after cannula insertion. The study shows that without skin preparation superficial thrombophlebitis is inevitable after about 3 days. However, simple skin preparation and daily care of peripheral infusion sites significantly reduces the incidence of superficial thrombophlebitis.
A nutrient survey in elderly women with femoral neck fractures
Authors: Older M W J , Edwards Delyth , Dickerson J W T 
Published: March 2007

Abstract
This survey was undertaken to study the nutrition of elderly women following surgical treatment for a femoral neck fracture.
The voluntary food intake of 19 patients was measured 3, 7 and 14 days after operation. When the nutrient content was calculated and compared with DHSS recommended values for healthy women of the same age, only the intakes of vitamin A and calcium were adequate. The mean intakes of protein, energy, vitamin D, riboflavin, vitamin C, thiamin and niacin fell short of the recommendation.
The evidence suggests that whilst adequate food intake may be provided in hospital, the actual nutrient intake of elderly female patients recovering from a femoral neck fracture is often inadequate.
Abdominal tuberculosis
Authors: Lambrianides Andreas L , Ackroyd Nigel , Shorey Brian A 
Published: March 2007

Abstract
In Britain abdominal tuberculosis is an uncommon condition and most cases come to laparotomy for diagnosis. A high index of suspicion is required in areas with a large immigrant population and in areas which are overcrowded and nutritionally deprived. Nine of 28 patients presented acutely and a wide variety of preoperative diagnoses were entertained. Most of the remainder had a long history of vague constitutional symptoms and laparotomy was required for diagnosis in all but 5. Histology proved the surest way of establishing the diagnosis.
Possible antagonists to gastrin in parathyroid adenomas
Authors: Mollerup C , Cartensen H E , Bruun E , Christiansen L A , Stage G 
Published: March 2007

Abstract
The high incidence of gastroduodenal ulcers in patients with hyperparathyroidism has been ascribed to gastric hyperacidity induced by hypercalcaemia. In a clinical study comprising 40 patients with solitary parathyroid adenoma, a negative correlation between serum calcium and spontaneous gastric acid secretion was found. At the same time a positive correlation was found between serum calcium and gastrin. It is concluded that gastric hyperacidity is not part of the syndrome provoked by parathyroid adenomas, and that a mechanism inhibitory to gastrin is active in these patients. It is suggested that the inhibitor could be calcitonin.
Renal transplantation—15 years' experience
Authors: Marshall Vernon 
Published: March 2007

Summary
In Australia, it has been logistically possible, with integrated programmes of dialysis and transplantation, to use finite resources optimally for the treatment of patients presenting with terminal renal failure (30 per million population per year), Transplantation is offered as definitive treatment in most instances. Transplantation rates (20 per million per year) will need to increase to meet the continuing demand, if the results of transplantation remain unchanged.
Patient survival after transplantation is approximately 80 per cent at 1 year, 50 per cent at 5 years and 20 per cent at 15 years. Most grafts are from cadavers. Graft survival of 60 per cent at 1 year thereafter declines steadily with a 3 per cent graft loss per year. Patient and graft survival are adversely affected by increasing age, and the use of cadaver rather than living donors. Graft survival is superior with a 4 antigen match on HLA A and B matching, and is significantly lower in patients receiving no blood transfusions prior to transplantation.
Long term morbidity is significant in two-thirds of patients receiving grafts. Problems include chronic rejection and toxic effects of immunosuppression. The increased tumour risk after transplantation (which in Australia has been mostly skin tumours) is of major concern; 30 per cent of patients by 10 years have developed cancer.
Arterial graft maturation: The duration of thrombotic activity in Dacron aortobifemoral grafts measured by platelet and fibrinogen kinetics
Authors: McCollum C N , Kester R C , Rajah S M , Learoyd P , Pepper M 
Published: March 2007

Summary
Dacron is thrombogenic, hence small arterial grafts of this material frequently thrombose in the period prior to graft maturation. Anti-thrombotic therapy may therefore be indicated to preserve patency during this risk period. To evaluate the thrombogenicity of immature Dacron grafts, platelet and fibrinogen kinetics using 51Cr and 125I respectively were measured before operation and at 3, 6 and 9 months in 10 patients following aortobifemoral bypass and in 6 age-matched volunteers.
Platelet survival was reduced from 8.8±0.2 d before surgery to 7.4±0.24 d at 3 months. This was accompanied by an increase in platelet turnover from 39±2.4 × 109 l−1 d−1 to 46.9±2.9 × 109 l−1 d−1. Fibrinogen t1/2 fell from 3.72±0.13 d preoperatively to 3.36±0.11 d at 3 months, while fibrinogen fractional catabolic rate rose from 0.27±0.014 to 0.34±0.014. These changes were all significant (P &lt; 0.01). Fibrinogen consumption had returned to normal by 6 months following surgery but platelet kinetics only equated to pre-operative levels at 9 months. We suggest that Dacron grafts are thrombogenically active for about 9 months. When anti-thrombotic therapy is indicated it should be continued throughout this period.
Leucomethylene blue staining during vagotomy
Authors: Wille-Jørgensen Peer , Jensen Hans-Eric 
Published: March 2007

Abstract
Sixty patients were evaluated 10 years after vagotomy for duodenal ulcer. In 31 the stain leucomethylene blue had been used peroperatively to visualize remaining nerve twigs on the distal oesophagus when the surgeon had deemed the vagotomy to be complete and in 29 cases the staining technique was not used.
The frequency of recurrent ulcer was not influenced by the use of the staining technique.
A series of 48 patients who had a parietal cell vagotomy performed for duodenal ulcer was randomized into staining and control groups. There was no significant difference in the reduction of the preoperative peak acid output after pentagastrin stimulation between the two groups. Only 33 per cent of specimens stained contained nerve tissue.
It is concluded that the colouring of the distal oesophagus with leucomethylene blue is of no clinical value in achieving completeness of vagotomy.
A comparison of the Burge and Grassi intraoperative tests for completeness of nerve section in parietal cell vagotomy
Authors: Pendower J E H 
Published: March 2007

AbstractThe Burge and Grassi tests were compared in 22 patients after parietal cell vagotomy. Dissection was continued until the Burge test was negative or until no further nerve fibres could be found. Three Burge-negative patients were Grassi-positive, 2 due to inadequate division of the terminal branches of the nerve of Latarjet at the ‘crow foot’ and 1 due to epiploic fibres. One Burge-positive patient was also Grassi-positive but the latter test indicated the position of an undivided oesophageal nerve fibre. It is concluded that the Grassi intraoperative test for completeness of vagotomy is superior to the Burge procedure because it shows how much stomach needs to be vagotomized to denervate the parietal cells and abolish gastric acid secretion and also indicates the position of residual fibres if vagotomy is incomplete.