bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complete rectal prolapse: The anatomical and functional results of treatment by an extended abdominal rectopexy
Authors: Mann C V , Hoffman C 
Published: March 2007

Abstract
Between 1970 and 1985 (inclusive), 66 patients presented with complete rectal prolapse; 59 (89 per cent) were treated by extended abdominal rectopexy. Forty-four patients (75 per cent) have been followed for more than 2 years: all cases were cured of their complete prolapse, no patients died, and major complications were few. Constipation (47 per cent) and incontinence (19 per cent) caused serious problems for many patients postoperatively.
Tubercular fistula in ano
Authors: Shukla H S , Gupta S C , Singh G , Singh P A 
Published: March 2007

Abstract
Of 122 patients with fistulae in ano operated upon in a 5-year period, 19 (15.6 per cent) were found to have tubercular fistulae on histopathological examination. There was no characteristic clinical picture and concomitant pulmonary tuberculosis was present in only three patients. Histological examination of the excised fistula is mandatory for the diagnosis of anal tuberculosis. There were no cases of Crohn's disease of the anal region.
Anal fissure in Crohn's disease
Authors: Sweeney J L , Ritchie Jean K , Nicholls R J 
Published: March 2007

Abstract
There is little information on the natural history of anal fissure in Crohn's disease. The case notes of all new patients with Crohn's disease attending one hospital between 1977 and 1983 were reviewed: there were 61 patients with this diagnosis and an unhealed anal fissure as the only anal lesion. of these 61 patients the fissure healed in 42 (69 per cent) during medical treatment of the intestinal disease. Ten patients (16 per cent) developed other anal lesions and in the remaining nine patients the fissure remained unhealed at the time of rectal excision (six) or last out-patient attendance (three). Activity of the fissure did not reflect disease activity elsewhere in 11 cases in whom healing of the fissure occurred despite progressive intestinal disease subsequently requiring resection. This study validates the policy of conservative management of anal fissure in Crohn's disease with anal surgery (required in 9.8 per cent of patients in this series) being reserved for the development of other anal disease.
Appendicitis and schistosomiasis
Authors: Al-Kraida A , Giangreco A , Shaikh M U , Al-Shehri A 
Published: March 2007

Abstract
A retrospective clinical and pathological study of 15 cases associated with schistosomiasis drawn from 1920 patients undergoing appendicectomy is discussed. The average age of the patients was 31.6 years with a 12:3 male predominance. Hepatomegaly, past or present jaundice, or splenomegaly were not observed. One patient had a previous history of similar right lower quadrant pain for several days. Eighty per cent of the cases showed an inflammatory reaction on pathological examination. In the remaining 20 per cent no inflammation was seen, but there was severe congestion mainly involving the subserosal blood vessels. Schistosoma haematobiurn was present in 80 per cent of the cases.
Prognosis after simple incision and drainage for a first-episode acute pilonidal abscess
Authors: Jensen S L , Harling H 
Published: March 2007

Abstract
During a 3-year period 73 patients were treated consecutively for a first-episode acute pilonidal abscess with simple incision and drainage under local anaesthesia. In all cases the treatment relieved symptoms and all patients returned to work immediately after treatment. Healing per primam occurred in 42 patients (58 per cent; 95 per cent confidence limits: 45–69) within 10 weeks after treatment. These patients had significantly fewer pits and lateral tracts compared with patients who developed excessive granulation tissue after incision and who required definitive surgical treatment later. Nine patients (21 per cent; 95 per cent confidence limits: 10–37) with healing per primam developed recurrence of their pilonidal disease during the prospective follow-up period (median follow-up period was 60 months, range 36–84 months). Actuarial analysis of the data revealed a constant cure rate of 76 per cent (95 per cent confidence limits: 57–95) after 18 months.
Acral (volar-subungual) melanoma in Auckland, New Zealand
Authors: Shaw J H F , Koea J B 
Published: March 2007

Abstract
We have retrospectively reviewed the charts of 34 acral melanoma patients (melanoma arising from the volar skin of the hands, feet or a subungual site) seen in the Auckland area between 1970 and 1985. These 34 patients constituted 3.5 per cent of the total number of patients (972) reviewed over this period. Six of the thirty-four patients were either Polynesian or Maori. There were 19 men and 15 women, and the mean age of the group was 59 years. The primary lesion arose from the plantar or palmar skin in 25 patients and 9 patients had subungual lesions. All lesions but one were pigmented. Most patients with plantar or palmar lesions presented with clinical stage 1, Clark's level 4 disease, while those with subungual lesions presented most commonly with stage 2, Clark's level 5 disease. Treatment was wide local resection for plantar and palmar lesions and amputation for subungual lesions. Regional lymph node dissection was performed in 10 patients with positive nodes at presentation and in 6 patients who developed metachronous nodal disease. Patients were followed for between 1 and 16 years, and 18 patients died in this period, 15 of metastatic melanoma (mean time 34 months). Subungual melanoma carried a worse prognosis than melanoma arising in palmar or plantar skin.
Platelet aggregation on peritoneal tube grafts and double velour grafts in the inferior vena cava of the pig
Authors: Ribbe Else B , Jönsson B-A , Norgren L E H , Strand S-E , Thörne J L 
Published: March 2007

Abstract
In 14 pigs the infrarenal vena cava was replaced with a peritoneal tube graft or a collagen-coated double velour graft. With 111In-labelled platelets dynamic in vivo imaging of platelet aggregation over the graft was carried out using a scintillation camera. After removal, the grafts were examined by autoradiography for an evaluation of the platelet aggregation pattern. Measurements of activity in different regions of the grafts were also performed. The results indicated low activity uptakes both in vivo and in vitro. The dynamic study did not show any uniform increase of activity content 1–3 h postoperatively, in any of the groups. During the period 2–3 h postoperatively no increasing activity accumulation was found. Hemashield® Microvel® grafts had an uptake of 0.19 per cent of the total activity while the corresponding figure for peritoneal tube grafts was 0.17 per cent. The activity distribution on different parts of the grafts indicated lower accumulation on the Hemashield graft surfaces than in the anastomoses, while the accumulation was higher on the graft surface of peritoneal tube grafts. The autoradiographical findings supported this indication. In conclusion, low platelet aggregation was found with both dynamic in vivo imaging and in vitro activity measurements on both peritoneal tube grafts and collagen-coated double velour grafts.
Pancreatic abscess: Results of prolonged irrigation of the pancreatic bed after surgery
Authors: Nicholson M L , McC Mortensen N J , Espiner H J 
Published: March 2007

Abstract
The mortality from pancreatic abscess may approach 70 per cent and the survivors often require repeated operations to debride the pancreas and to drain recurrent abscesses. We report the results of prolonged irrigation of the pancreatic bed after surgical débridement in 11 patients. Surgery was performed at an average of 17 days (range 8–25 days) after the onset of symptoms. The pancreatic slough was thoroughly debrided and 2–6 large drains were placed in the pancreatic bed. Irrigation with saline or Diaflex® solution (2–6 l/day) was started after 2 days and continued for a mean of 25 days (range 5–54 days). There were three deaths (27·3 percent) after surgery: one of these patients required re-operation and packing for massive postoperative haemorrhage and all three had some evidence of persisting sepsis at autopsy. Prolonged irrigation of the pancreatic bed after surgical débridement may reduce mortality and the need for repeated drainage procedures in patients with pancreatic abscess, but the detection and treatment of persisting sepsis remains the major problem.
Anterior lesser curve seromyotomy with posterior truncal vagotomy versus proximal gastric vagotomy
Authors: Oostvogel H J M , Van Vroonhoven Th J M V 
Published: March 2007

Abstract
In a prospective randomized trial anterior lesser curve seromyotomy with posterior truncal vagotomy (ASPTV, n=48) has been compared with proximal gastric vagotomy (PGV, n=43). Eighty-eight and eighty-three patients were available for follow-up studies at 1 year and 2 years, respectively. Six months postoperatively the mean reduction in pentagastrin-stimulated peak acid output (PAO) was 48.5 per cent (s.d. 26.3) after PGV and 50.5 per cent (s.d. 23.3) after ASPTV. Two years after the operation satisfactory clinical results (Visick I + II) were found in 84.2 per cent of the patients after PGV and in 88.9 per cent after ASPTV. There was a significant difference in the duration of surgery. No serious postoperative gastric sequelae were encountered after either operation. Up till January 1987, eight endoscopically proven, symptomatic recurrent ulcers have been diagnosed: four in the PGV group (9.3 per cent) and four in the ASPTV group (8.7 per cent). The results of this randomized study suggest that ASPTV is as good as PGV in the surgical treatment of chronic duodenal ulcers.
Stimulation of the healing of experimental colon anastomoses by low-power lasers
Authors: Asencio-Arana F , Martinez-Soriano F 
Published: March 2007

Abstract
Anastomotic leakage following colorectal surgery remains a complication with high mortality and morbidity. Recent studies suggest that helium-neon (He-Ne) lasers at specific energy densities can be used to enhance wound healing in different tissues. In this experimental study we have tested the strength of end-to-end anastomosis of the rat colon irradiated by He-Ne laser by measuring bursting pressures and bursting wall tensions at 2, 4 and 7 days after operation. The study shows that He-Ne laser radiation induces a significant increase in colonic strength at the anastomosis. The laser does not cause the luminal narrowing observed in non-irradiated specimens.
Low molecular weight heparin compared with unfractionated heparin in prevention of postoperative thrombosis
Authors: Samama M , Bernard P , Bonnardot J P , Combe-Tamzali Sophie , Lanson Y , Tissot E 
Published: March 2007

Abstract
Three consecutive randomized open studies have been carried out to determine the optimal dosage of low molecular weight heparin (LMWH) in the prevention of postoperative thrombosis in general surgery (892 patients). All patients undergoing abdominal, gynaecological, thoracic or urological surgery were over 40 years old and presented at least one of the following risk factors for thrombosis: previous thromboembolism, obesity, varicose veins, malignancy (30 per cent), pre-operative hospitalization over 5 days, oestrogen therapy, chronic cardiac disease or bronchitis. Isotopic venous thrombosis and bleeding complications were assessed after subcutaneous administration of a LMWH fragment (LMWH, Enoxaparine) or unfractionated heparin (UH). The three studies compared 3 × 5000 units UH daily with 1 × 60 mg, 1 × 40 mg, 1 × 20 mg LMWH daily. Thromboembolic events rates were not significantly different from group to group (UH: 3.8 per cent, 2.7 per cent, 7.6 per cent respectively compared with LMWH: 2.9 per cent, 2.8 per cent, 3.8 per cent). Bleeding episodes including wound haematoma formation, perioperative blood losses and systemic haemorrhage were not significantly different in patients receiving LMWH or UH. Significant decreases in haematocrit and haemoglobin were only observed in patients receiving 60 mg Enoxaparine (as compared to UH). An analysis using the ‘intention to treat’ approach gave results consistent with those of an analysis of good compliers. An overview of isotopic thromboses in the three studies gave no evidence of differences amongst the effects of the three doses of LMWH (P = 0.20), and pooling the results of the three studies using the Mantel-Haenszel procedure gave no evidence of a global difference between Enoxaparine and UH (P = 0.54). These results suggest that an optimal dosage of 20 mg/day of Enoxaparine is safe and effective in the prevention of postoperative thrombosis in this population.
Cytotoxic-loaded albumin microspheres: A novel approach to regional chemotherapy
Authors: McArdle C S , Hansell D , Lewi H , Kerr D J , McKillop J , Willmott N 
Published: March 2007

Abstract
Adriamycin®-loaded albumin microspheres (15–40 μm diameter) incorporating 1 per cent by weight of Adriamycin were prepared by cross linking albumin with glutaraldehyde. After systemic administration in rats, the microspheres were trapped in the pulmonary capillary bed, biodegradation occurring over 48 h. After selective intrarenal arterial injection of 99mTc-labelled albumin microspheres in rabbits, 97 per cent of the injected microspheres were trapped within the kidney; less than 1 per cent were found in the contralateral kidney, lungs and liver. Similar results were obtained after selective intrahepatic arterial injection. The selective injection of cytotoxic-loaded microspheres may provide a reliable method of administering high concentrations of cytotoxic drug to a target organ without producing high serum levels; this technique may have a role in the management of solid tumours.
Prediction of choledocholithiasis using a pocket microcomputer
Authors: Taylor T V , Armstrong C P , Rimmer S , Lucas S B , Jeacock J , Gunn A A 
Published: March 2007

Abstract
A computerized method, using a small pocket computer, has been used to predict the presence of choledocholithiasis in a prospective series of 239 patients undergoing cholecystectomy. From an initial data base of 424 patients 36 factors were evaluated and the most important 2 of these were determined by multivariate analysis for use in the prospective analysis. Satisfactory operative cholangiograms were a prerequisite to evaluation of the statistical method and were obtained in 90.4 per cent of cases. Using the computerized method a common bile duct stone would have been overlooked in only 1 patient but 17 unnecessary explorations would have been carried out. The overall accuracy of the computerized method was 92.5 per cent. When the method was applied to a further study of 97 patients from a separate centre the overall accuracy was 85.6 per cent. If the method was used to aid selective use of operative cholangiography, cholangiograms would be performed in 20 per cent and stones would be overlooked in less than 1 per cent.
Anergy in jaundiced patients
Authors: Cainzos M , Potel J , Puente J L 
Published: March 2007

Abstract
A prospective study of delayed hypersensitivity was carried out in jaundiced patients. One hundred and nineteen subjects were studied. Fifty-nine were controls and sixty were patients with pancreatobiliary pathology and biliary tract obstruction. A Multitest technique was used to evaluate the delayed hypersensitivity response, classifying the subject into one of three groups: immunocompetent, relatively anergic and anergic. In the control group, 76 per cent of the subjects were immunocompetent as opposed to 17 per cent of the patients (P&lt;0.001). Ten per cent of the control subjects and fifty-five per cent of the patients presented anergy (P&lt;0.001). Amongst the patients no difference could be found in the index of anergy between malignant or benign pathology. A greater incidence of postoperative septic complications in anergic and relatively anergic patients was found. Our study indicates a relationship between jaundice and anergy.
Total pancreatectomy in the MEN-1 syndrome
Authors: Tisell L E , Ahlman H , Jansson S , Grimelius L 
Published: March 2007

Abstract
A family with the multiple endocrine neoplasia Type 1 (MEN-1) syndrome, followed over three generations, is presented. In the first generation, one family member died after a history indicating Zollinger-Ellison syndrome. In the second generation endocrine pancreatic tumours were diagnosed or suspected in three out of five members. In the third generation, five out of seven members were investigated and four of these had positive tests at hormonal screening. of particular diagnostic value in this family was the determination of peripheral serum levels of proinsulin and C-peptide, which were used as tumour markers both for diagnosis and in the postoperative follow-up. Two members in the third generation have been successfully managed by total pancreatectomy. A MEN-1 patien with malignant pancreatic tumours should be considered for total pancreatectomy if the pancreatic disease has caused high morbidity and mortality within the family. This is especially pertinent if the patient has multiple malignant tumours.
Surgery in tropical pancreatitis
Authors: Thomas P G , Augustine P 
Published: March 2007

Abstract
Nineteen consecutive patients with tropical pancreatitis and chronic pancreatic pain operated upon over a 3-year period in Kerala, India, are reported. The pancreatic ductal morphology was studied by ultrasound scan, endoscopic retrograde cholangiopancreatography and/or operative pancreatography. In 17 patients, duct drainage by lateral pancreatojejunostomy and/or transduodenal pancreatic sphincteroplasty constituted the main surgical procedure. Caudal pancreatic resection was required in six of these patients. Unresectable pancreatic masses were found in two patients. Three patients died. of the 16 survivors, 14 had good relief of pain within the limits of the available follow-up. In analysing the results, patients with ‘obstructive pancreatitis’ were found to have increased morbidity and mortality. The need to diagnose this subgroup of chronic pancreatitis pre-operatively is discussed.
Staphylococcus epidermidis as a cause of postoperative wound infection after cardiac surgery: Assessment of pathogenicity by a wound-scoring method
Authors: Wilson A P R , Grüneberg R N , Treasure T , Sturridge M F 
Published: March 2007

Abstract
Wound infection after clean surgery prolongs hospital stay but the organism most commonly isolated from wound discharge, Staphylococcus epidermidis, is often dismissed as a contaminant or commensal. The wounds of 517 patients were assessed, after cardiac surgery, by a wound-scoring method (‘ASEPSIS’) and a close comparison was made of the appearance and clinical outcome of 89 wounds, from which bacteria were isolated. There was no significant difference in the scores of 49 wounds, where S. epidermidis was the sole isolate (9.5 per cent of all wounds, 95 per cent CI 6.9-12.0 per cent), and 13 wounds infected with Staphylococcus aureus (2.5 per cent, 95 per cent CI 1.2-3.9 per cent). Repeat cultures were obtained from 21 of the 49 wounds and, in 16 of these, the second isolate showed the same biochemical reactions and antibiotic resistance pattern as the first. Infection of sternal wounds is commoner with coagulase-negative staphylococci than with S. aureus and, clinically, is just as severe.
Surgical gloves as a mechanical barrier against human immunodeficiency viruses
Authors: Dalgleish A G , Malkovsky M 
Published: March 2007

Abstract
A wide variety of surgical gloves are presently available. Seven different types of gloves were investigated for the ability to prevent transmission of the human immunodeficiency virus (HIV), the causative agent of AIDS. Six types of gloves withstood severe compression tests and also exhibited direct antiviral properties. No penetration of HIV through the intact glove was detected.
Biochemical prediction of gallstones in acute pancreatitis: A prospective study of three systems
Authors: Davidson B R , Neoptolemos J P , Leese T , Carr-Locke D L 
Published: March 2007

Abstract
Three clinicobiochemical systems have been proposed for predicting gallstones in acute pancreatitis based on one, three and five factors respectively, but have not been compared in a single prospective study. System I is based on the serum transaminase alone: system 2 uses alkaline phosphatase and bilirubin in addition to transaminase; and system 3 involves female gender, age, amylase and alkaline phosphatase in addition to transaminase. Over the 4-year period 1983-86, 368 patients with 391 episodes of acute pancreatitis had clinicobiochemical analysis within 48 h. Of these episodes, 220 were related to gallstones (56 per cent), 62 to alcohol (16 per cent) and 109 to other aetiologies or were idiopathic (28 per cent). Significant differences were found between the biliary and non-biliary groups with respect to sex (139 versus 59 women, P&lt;0·002), age (65±17 versus 52±19 years, P&lt;0·0001) and serum amylase (6041±6335 versus 4546±3990 units/l, P&lt;0·0001), alkaline phosphatase (257±225 versus 141±137 units/l, P&lt;0·0001), alanine transaminase (221±227 versus 72±119 units/l, P&lt;0·0001) and bilirubin (40±39 versus 24±30 μmol/l, P = 0·0001). The sensitivity and specificity was 75 per cent and 74 per cent for the one-factor system, 74 per cent and 78 per cent for the three-factor system and 62 per cent and 80 per cent for the five-factor system. The predictive value of a positive result was 78±8 per cent, 81±5 per cent and 80·1 per cent and of a negative result 69·4 per cent, 70·1 per cent and 62·3 per cent for the three systems respectively. The performances of the one- and three-factor systems were marginally better than that of the five-factor system; the one-factor system, however, had the advantage of simplicity.
Surgical morbidity and mortality in one hundred and twenty-nine patients with obstructive jaundice
Authors: Greig J D , Krukowski Z H , Matheson N A 
Published: March 2007

Abstract
One hundred and twenty-nine jaundiced patients were operated upon for the relief of benign and malignant bile duct obstruction during a 10-year period, 1977–86. The overall mortality was 4·7 per cent but increased to 9·1 per cent in patients with a serum bilirubin &gt; 300 μmol/l. In all, 46·5 per cent of patients had a rise in postoperative creatinine but renal dysfunction occurred in only 4·7 per cent. Wound infection developed in 3·1 per cent of patients and appeared unrelated to infected bile; 3·9 per cent of patients were treated for postoperative septicaemic episodes. The low morbidity and mortality observed suggests that pre-operative biliary drainage need not be considered in routine surgical practice if simple measures to maintain urine flow and prevent postoperative sepsis are used.
Management of penetrating abdominal stab wounds
Authors: de Lacy A M , Pera M , Garcia-Valdecasas J C , Grande L , Fuster J , Cugat E , Lopez-Boado M A , Visa J , Pera C 
Published: March 2007

Abstract
The authors present the results of a therapeutic trial of the conservative or surgical management of penetrating abdominal stab wounds (PASW) based on clinical criteria. In a prospective series of 100 patients, 70 were treated non-operatively. Thirty patients were operated upon, twenty-one immediately and nine during the 48 h observation period. In five laparotomies no significant injuries were found. Morbidity was similar in both immediate and delayed laparotomy groups (3/21 versus 1/9). Acute alcoholic intoxication identifies a subgroup of patients that are difficult to evaluate and hence are more likely to be managed by laparotomy (χ2 = 4·056, P&lt;0·05). The authors conclude that selective surgical management of PASW based on clinical criteria is an accurate and safe procedure.