bluuebunny/crossref_metadata_2025_split huggingface dataset:
Focal nodular hyperplasia of the liver
Authors: Evans John E , Dick Robert , Sherlock Sheila 
Published: March 2007

Summary
Focal nodular hyperplasia of the liver (FNH) in a fit young Iranian girl of 19 months presented with asymptomatic hepatomegaly. Liver scan and ultrasound examinations demonstrated a space-occupying lesion involving both hepatic lobes. Arteriography revealed a vascular pattern suggestive of liver cell carcinoma with dilated arterial branches and tumour blush on the capillary phase. At laparotomy the large mass involved both right and left hepatic lobes and was not resected. Tissue diagnosis was established by surgical wedge biopsy.
FNH should be considered in the differential diagnosis of an hepatic mass in a clinically well child, particularly female, in which the liver biopsy suggests cirrhosis but arteriography favours liver cell carcinoma. If FNH is diagnosed and the lesion is not resected it is recommended that patients be advised against sex hormone therapy as there may be an increased risk of rupture with intraperitoneal haemorrhage.
The measurement of arterial perfusion of the liver in man using the radioisotope xenon-133
Authors: Holroyd A M , Peters A M 
Published: March 2007

Summary
The washout from the liver of xenon-133 injected into the thoracic aorta of human subjects undergoing cardiac investigation was monitored externally with a sodium iodide scintillation detector. The washout curve displayed an initial peak of activity, followed by a brief decline, and then a second, slower rise. The initial peak was thought to be due to isotope arriving in the liver via the hepatic artery, and the second rise due to isotope arriving via the portal vein. A method of analysis is presented which uses the height of this arterial peak to calculate arterial perfusion of the liver.
Midline or transverse laparotomy? A random controlled clinical trial. Part I: Influence on healing
Authors: Greenall M J , Evans Mary , Pollock A V 
Published: March 2007

Summary
Five hundred and seventy-nine patients undergoing major laparotomy were randomly allocated to have midline or transverse incisions. Transverse incisions took longer to make and caused more bleeding but (in the absence of wound sepsis) no transverse wound burst and there were only 2 incisional hernias. In the midline group, without wound sepsis, there were 2 burst abdomens and 9 incisional hernias.
When, however, those patients who suffered wound sepsis were also considered, there were no significant differences between the two groups.
Midline or transverse laparotomy? A random controlled clinical trial. Part II: Influence on postoperative pulmonary complications
Authors: Greenall M J , Evans Mary , Pollock A V 
Published: March 2007

Summary
In a series of 579 patients undergoing major laparotomy, the direction of incision (midline or transverse/oblique muscle-cutting) was decided randomly. The severity of postoperative pulmonary complications was expressed by a scoring system which allowed categorization into mild (score 0–3), moderate (score 4–6) and serious (score 7 or more) complications.
The important determinants of high scores were found to be male sex, preoperative pulmonary dysfunction, postoperative ventilatory depression, hypovolaemic and septic shock, inhalation of gastric contents and embolism. In no stratum did the direction of incision have any significant effect.
The long term effect of sphincter preserving operations for rectal carcinoma on function of the anal sphincter in man
Authors: Williams Norman S , Price Robert , Johnston David 
Published: March 2007

Summary
Anal function was studied in 20 normal subjects and in 20 patients who had undergone sphincter-saving resection of the rectum for carcinoma. In each the anastomosis had been constructed 3–7 cm from the anal verge. Inhibition of the internal sphincter was judged to have taken place when distension of a balloon 10 cm from the anal verge produced an immediate fall of at least 20 per cent in resting anal pressure as measured by a balloon probe: inhibition of the external sphincter in response to the same stimulus was defined as complete cessation of EMG activity. Threshold for sensation was the minimal volume of balloon distension required to elicit a response. Maximum tolerable volume was the largest volume of distension tolerated.
Inhibition of the activity of the internal sphincter was found in all controls and in 17 of 20 patients. External sphincter activity was inhibited in 16 of 20 controls and 11 of 19 patients. Threshold for sensation and its quality were similar in both groups. Patients had more frequent bowel actions than the controls which is probably explained by significant reductions in resting anal pressure and maximum tolerable volume found in patients.
These results suggest that some, at least, of the physiological mechanisms subserving continence remain intact after complete or nearly complete excision of the rectum.
Intussusception: A study of its surgical management
Authors: Pollet J E 
Published: March 2007

Summary
Seventy-seven consecutive records of patients with intussusception presenting to the Royal Aberdeen Children's Hospital have been reviewed. The clinical features of the disease, the methods and the results of treatment are described. An attempt has been made to correlate clinical findings with the use, success and safety of operative intervention. Retrospectively, over 40 per cent of the cases possibly justified surgical intervention, but 10 per cent of those operated on had complications. There were no deaths in this series.
Meckel's diverticulum: Its association with congenital malformation and the significance of atypical morphology
Authors: Simms M H , Corkery J J 
Published: March 2007

Summary
Retrospective analysis of the records of a children's hospital shows an increased incidence of Meckel's diverticulum in children born with major malformation of the umbilicus, alimentary tract, nervous system or cardiovascular system in descending order. A consideration of the risks associated with Meckel's diverticulum suggests that elective resection is indicated only for diverticula that are atypical on inspection or palpation.
Three-year experience with glutaraldehyde-stabilized umbilical vein for limb salvage
Authors: Dardik Herbert , Ibrahim Ibrahim M , Jarrah Mamoon , Sussman Barry C , Dardik Irving I 
Published: March 2007

Summary
During the past 3 years, 361 vascular reconstructions were performed employing glutaraldehyde-stabilized umbilical veins. The distal anastomosis terminated at the popliteal segment (n = 183), at either of the tibial arteries (n = 108) or at the peroneal artery (n = 70). One hundred and forty-one (77 per cent) of the popliteal reconstructions were below the knee. Many of the patients undergoing these bypasses had a previous failed reconstruction and were operated upon for limb salvage. Operative mortality rates for the popliteal, tibial and peroneal reconstructions were 2·7, 2·8 and 4·3 per cent respectively. Cumulative graft patency rates at 36 months for each of the three types of reconstruction were 76·4 per cent (popliteal), 63·4 per cent (tibial) and 39·8 per cent (peroneal). Failures were usually due to inappropriate case selection or progressive disease, particularly in the distal circulation. Two grafts were removed because of wound and secondary graft infection. There were no instances of biodegradation, either by aneurysm formation or by myointimal proliferation. These data confirm that attempts at revascularization are definitely preferable to amputation. The use of the glutaraldehyde-stabilized umbilical vein has facilitated the performance of these operations. In appropriately selected cases and with expert surgical technique, long term graft function with limb salvage can be obtained.
The evaluation of blood flow measurement using a gravimetric plethysmograph
Authors: Humphrey C S , Leveson S H , Wiggins P A , Wilde D T , Kester R C 
Published: March 2007

Summary
The gravimetric plethysmograph is a simple, robust and inexpensive device which measures blood flow in the limb in terms of the increase in weight which follows temporary venous occlusion. Validation of the instrument using an artificial circuit shows that it is accurate and gives reproducible results.
The mean resting blood flow in the legs of 18 healthy volunteers was 3·95 ml 100 ml−1 tissue min−1 and this measurement was not reproducible. A 3-min period of arterial occlusion resulted in an immediate hyperaemic response of a mean 43·5 ml 100 ml−1 min−1, and this result was much more reproducible (r = 0·18).
The mean resting blood flow of 45 patients with occlusive arterial disease of the legs was 2·1 ml 100 ml−1 min−1, and this flow rate was variable (r = 0·71). Their immediate hyperaemic response of 5·18 ml 100 ml−1 min−1 was much less than that in normal volunteers, but was quite reproducible (r = 0·93). Following arterial reconstruction, their mean immediate hyperaemic response rose to 10·35 ml 100 ml−1 min−1, which was a significant increase compared to their preoperative values (P &lt; 0·0005, Student's t test) and was associated with concomitant improvement in symptoms, treadmill performance and ankle/brachial systolic pressure indices. Measurement of the immediate hyperaemic response to temporary arterial occlusion with the gravimetric plethysmograph may assist in the evaluation of patients with occlusive arterial disease of the legs, and in their medical and surgical management.
Incidence of postoperative deep vein thrombosis in Hong Kong Chinese
Authors: Nandi P , Wong K P , Wei W I , Ngan H , Ong G B 
Published: March 2007

Summary
Postoperative deep vein thrombosis is considered to be rare in Chinese. The125 I-labelled fibrinogen test was used to determine the true incidence of postoperative deep vein thrombosis in Chinese. Deep vein thrombosis was found in 2·6 per cent, a very low incidence compared with Caucasian series.
Necrotizing enteritis
Authors: Pujari B D , Deodhare S G 
Published: March 2007

Summary
Clinicopathological feazures and follow-up of 150 cases of necrotizing enteritis observed over the period of 8 years at Miraj, India, are presented. This is a distinct pathological entity with seasonal occurrence, frequently affecting male patients of the low socioeconomic groups between the third and fifth decades of life. The symptoms are disproportionately greater than the physical. signs. The ischaemic lesions, which mainly affect the jejunum, show a variable degree of severity ranging from segmental congestion and ulceration to extensive gangrene and perforation. In the early stage of the disease recovery is complete. Conservative treatment is preferred in early cases, surgery being indicated only for advanced lesions. No definite aetiology has been detected.
Intrahepatic biliary intestinal diversion for biliary obstruction: Experience in 34 patients
Authors: Moreno-González E , Sanmartin J Hebrero , Herruzo J A Solis , Azcoita M Moreno 
Published: March 2007

Summary
Intrahepatic biliary intestinal diversion for biliary obstruction was performed in 34 patients. Benign strictures were found in 15 patients and malignant disease in 19. Central cholangiojejunostomy was performed on 15 patients with iatrogenic strictures of the hepatic junction and on 2 patients after removal of a common hepatic duct carcinoma. In 14 patients an isolated jejunal loop interposed between the hepatic ducts and duodenum was used. In patients with malignant obstruction of the common hepatic duct peripheral cholangiojejunostomy was performed using the left hepatic duct radicals in 14 patients, a bilateral cholangiojejunostomy in 3 patients and a left cholangiogastrostomy in 2 patients.
One patient died on the twenty-first postoperative day. The follow-up of patients with benign disease varied between 5 months and 6 years; all patients were free of symptoms at the time of their last follow-up examination. In patients with malignant disease, the follow-up varied from 6 months to 29 months, 7 patients being still alive 8–29 months after operation.
We believe cholangiojejunostomy is the best biliary diversion procedure in obstructions of the common hepatic duct.
Studies of the immediately vascularized skin allograft
Authors: Perlof Leonard J , Barker Clyde F 
Published: March 2007

Summary
In order to evaluate the effect of the nature of revascularization on survival rates of skin allografts, a rat model was devised which provided simultaneous and immediate establishment of arterial and venous blood supply to a composite skin–renal allograft. For 5 days after transplantation the skin portion of the composite grafts appeared normal, with minimal inflammation in 11 recipients. From 6 to 11 days, in 6 rats, active rejection developed with a marked inflammatory reaction of the skin–kidney interface. In 10 rats in which the composite grafts remained in the secondary hosts for 12–21 days rejection of the skin was complete. The renal portion of all composite grafts appeared normal in all three panels and all recipients of composite grafts rejected subsequent orthotopic skin grafts in an accelerated manner, with median survival times of 8·2 ± 0·3 days compared with median 11·5 ± 0·7 days in untreated Fischer → Lewis controls.
These results demonstrate that the skin on the composite graft retained its immunogenicity, that immediately vascularized skin allografts between AgB compatible rats will be rejected in a normal time and that anatomical factors are not sufficient to account for the difference in survival times between skin and solid organs.
An evaluation of 99Tcm-labelled HIDA in hepatobiliary scanning
Authors: Taylor T V , Sumerling M D , Carter D C , McLoughlin G P , Miller A M 
Published: March 2007

Abstract
99Tcm-labelled HIDA administered intravenously is promptly taken up by the liver and excreted into the bile duct and gallbladder. In this study the use of this agent in hepatoscintigraphy was evaluated. Thirty patients with a variety of hepatobiliary pathology were studied. After an overnight fast 2 mCi of 99 Tcm HIDA were given intravenously and the patient was scanned continuously for 1 h. A rapid outline of the liver and biliary tract was usually obtained and the T½ of the tracer in the blood stream was 20 min. In total obstructive jaundice, isotope was excreted through the renal tract without visualization of the liver. Hepatoscintigraphy was compared with conventional radiographs and ultrasonography in 19 patients presenting as emergencies with suspected hepatobiliary disease and was found to be comparable to the latter modes of investigation. In the jaundiced patients hepatoscinsigraphy was inferior to percutaneous transhepatic cholangiography and to ultrasonography. No adverse side effects have followed the use of the radiopharmaceutical.
Penetrating injuries of the popliteal vein: A report on 34 cases
Authors: O'Reilly M J G , Hood J M , Livingston R H , Irwin J W S 
Published: March 2007

Abstract
The results of treatment in 34 cases of penetrating injury to the popliteal vein are presented. In 26 cases there was associated damage to the popliteal artery. Satisfactory venous repair by lateral suture was achieved in 11 of 12 limbs. Autogenous vein grafts were used to repair the damaged popliteal vein in 10 limbs. In 4 the saphenous vein was anastomosed directly to the popliteal vein; in 6 cases it was used as a wide-bored panel or compilation graft. Three popliteal veins were ligated. Major postoperative limb oedema and chronic venous insufficiency were not a problem in those cases where the veins were repaired. Fasciotomy was performed in 19 of the 34 cases of venous injury. In 12 of these cases fasciotomy, performed as part of the original operation to repair the vascular injury, led to an excellent clinical result.
Computer-assisted diagnosis of acute Crohn's disease
Authors: Nixon S J , Rundle J S H 
Published: March 2007

Abstract
A study comparing the symptoms and signs of patients with acute Crohn's disease and those with acute appendicitis and intestinal obstruction is reported and a preliminary evaluation of computer-assisted diagnosis in this problem is given. There are significant differences between the three conditions. However, the accuracy of computer-assisted diagnosis in Crohn's disease is reduced by the high false positive rate of diagnosis in both appendicitis and intestinal obstruction. Computer accuracy in Crohn's disease may increase when further information is available to extend the data base.
Benign liver nodules presenting as apparent hepatic metastases: A report of 5 cases
Authors: Fletcher M S , Everett W G , Hunter J O , Smellie W A B , Wight D G D 
Published: March 2007

Summary
Five cases are described in which hepatic nodules discovered as an incidental finding at laparotomy performed for other reasons were thought to be metastatic tumour. In each case histology and clinical course proved this assumption to be incorrect. It is emphasized that biopsy is mandatory in such circumstances to establish the diagnosis. Where the nature of the hepatic lesion might affect the choice of operative procedure frozen section examination should be performed at the time of surgery. Bacteriological culture may also be helpful.
The acute abdomen following cardiopulmonary bypass surgery
Authors: Wallwork J , Davidson K G 
Published: March 2007

Summary
Over a 5-year period, 9 patients (0.85 per cent) developed a major acute abdominal complication after cardiopulmonary bypass surgery. Difficulties in the initial recognition and diagnosis of these complications in sedated, ill patients are highlighted. A high index of suspicion is important in the early diagnosis of these complications. The numbers are too small for statistical analysis, but experience suggests that each case should be dealt with on its merits in accordance with common surgical practice and that operative management should not be rejected because the patient has recently undergone a major cardiac operation.
Volvulus of the sigmoid colon in the Gezira
Authors: Taha Salah E , Suleiman Suleiman I 
Published: March 2007

Summary
Out of 34 consecutive patients presenting with volvulus of the signoid colon in the Gezira area of The Sudan, 30 were western Sudanese farmers (age range 25–52 years) who habitually ate a single daily meal of high residue food: their colons were long and hypertrophied. In contrast, the 4 northern Sudanese (age range 60–92 years) ate a Western European type of diet and had a thin colon. This factor may have been responsible for the finding that the 5 patients presenting with gangrene of the sigmoid colon included all 4 northern Sudanese patients. Shock was a reliable indicator of gangrene but rebound tenderness was valueless. Deflation of the sigmoid volvulus via the sigmoidoscope succeeded in curing 19 of 25 patients in whom there was no suspicion of gangrene (4 later recurrences). Laparotomy was performed in the other 15 patients with operative untwisting in the absence of gangrene in 10 (2 later recurrences), and resections in the presence of gangrene (3 died).
Oesophageal squamous cell carcinoma: II. A critical review of radiotherapy
Authors: Earlam Richard , Cunha-Melo J R 
Published: March 2007

Summary
There has been no controlled trial of radiotherapy versus surgery for squamous cell carcinoma of the oesophagus. Radiotherapy is generally used for those patients with extensive disease or those who are unfit for surgery. In spite of this, the 1-year survival of 18 per cent is similar to that for surgically treated patients and there is no equivalent operative mortality. The 5-year survival is 6 per cent compared with that for surgery of 4 per cent. There are no results available to suggest what would happen if a patient with a localized tumour, technically suitable for surgical resection, were treated instead by radiotherapy.
The reduction of postoperative chest infection by prophylactic co-trimoxazole
Authors: Morran C , McArdle C S 
Published: March 2007

Summary
A prospective randomized double-blind study was conducted to evaluate the effect of a single prophylactic dose of co-trimoxazole on the incidence of pulmonary complications following upper abdominal surgery. Of 68 patients studied, 36 were judged clinically to have no postoperative pulmonary complications, 18 to have pulmonary atelectasis and 14 to have chest infection. Serial analysis of arterial oxygen tensions supported the clinical assessment.
Of 34 controls, 6 developed pulmonary atelectasis and 11 (32 per cent) chest infection. Of the 34 treated patients, 12 developed atelectasis and 3 (9 per cent) chest infection. The reduction in chest infection was significant (P &lt; 0·05). These results support the use of prophylactic cotrimoxazole to prevent chest infection following abdominal surgery.
Gastro-oesophageal reflux: An aetiological factor for bleeding in oesophageal varices?
Authors: Heil T , Mattes P , Loeprecht H 
Published: March 2007

Summary
The precipitating factor in bleeding oesophageal varices is unkown. To Investigate this problem 10 patients who had bled from oesophageal varices were examined by manometry. pH monitoring and gastroscopy to determine whether gastro-oesophageal reflux occurred. No evidence for reflux was found.
These results, together with previously published reports cast doubt on peptic oesophagitis or reflux as an aetiological factor in the initiation of oesophageal variceal bleeding.
Anal cancer treated by fast neutron radiation
Authors: Franklin Alfred 
Published: March 2007

Summary
Ten patients with anal cancer were treated with fast neutrons from the Medical Research Council Cyclotron at the Hammersmith Hospital. In all cases a temporary colostomy was established before treatment commenced. Three of the patients had advanced tumours that were exending into the pelvis; treatment for these patients was palliative and all died within 1 year. Four of the remaining 7 have normal and function with no evidence of local recurrence of the tumour. Two others developed necrosis in the irradiated area and in another, the tumour recurred locally. The colostomy was re-established in 1 and the 2 others had abdominoperineal resections, after which wound healing was prolonged. A majority of the surviving patients have thus been able to avoid a permanent colostomy.
Famoropopliteal vein grafts for intermittent claudication
Authors: King R Barry , Myers Kenneth A , Scott David F , Devine Terence J , Johnson Neil , Morris Peter J 
Published: March 2007

Summary
Femoropopliteal vein grafts were performed for intermittent claudication in 160 patients (182 legs) over a 12-year period. The accumulative patency rate was 67 per cent at 5 years. However, patency rates improved significantly in the latter 6 years of the study, to 75 per cent at 5 years. Early postoperative occlusion and morbidity rates also markedly declined in this latter period. Patency rates were significantly better in males than in females, in patients who were able to stop smoking after operation and in legs with a three-vessel run-off compared with those with a two- or one-vessel run-off. The patients' age did not influence graft patency rates.
Inhibition of metabolic responses to surgery with β-adrenergic blockade
Authors: Tsuji Hideo , Asoh Tsukasa , Shirasaka Chiaki , Takeuchi Yoshihiko 
Published: March 2007

Summary
Glucose, lactate, non-esterfied fatty acid and insulin levels in plasma were measured in two groups of 12 patients undergoing gastrectomy under general anaesthesia. Propranolol in a dose of 0·3 mg/kg body weight was intraoperatively infused in one of the two groups.
Surgery under general anaesthesia elicited a significant rise in blood glucose, lactate and NEFA concentrations. These metabolic responses were significantly inhibited by intraoperative infusion of propranolol without producing any undesirable side effect. Plasma insulin levels showed a slight decrease during the operation and no significant difference was noted between the two groups.
The results suggest that β-adrenergic activity is playing a major role in these metabolic responses, promoting the mobilization of substrates. Possible benefits of inhibiting β-adrenergic activation in surgical stress are discussed.