bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bile composition and osmolarity in the interpretation of formation of bile stones and their classification
Authors: Chaimoff Ch , Menache R 
Published: March 2007

Summary
We studied the bile and gallstone composition of 38 surgical patients. According to their composition, the stones were classified as: 1, cholesterol stones, when they have more than 60 per cent cholesterol, or 2, pigment or pigment-mixed stones, when they have more than 40 per cent pigments (including stones with more than 30 per cent calcium). In the cholesterol-stone-forming group (24 cases) a ‘supersaturation’ in the cholesterol component of the bile and a concomitant reduction in bile salts was found. No such bile supersaturation was found in those with pigment or pigment-mixed stones (14 cases), or in the control group (8 cases).
The osmolarity of bile in patients with pigment or pigment-mixed stones is significantly higher than in those with cholesterol stones or in controls.
These results suggest a different mechanism for gallstone formation in the two groups: a ‘supersaturation’ of cholesterol with respect to bile salts and phospholipids in the formation of cholesterol stones and an ‘overconcentration’ of all bile components as a whole in the formation of pigment stones.
In an attempt to clarify the aetiology of gallstone formation, we measured in the bile of patients operated on for cholelithiasis the following parameters: cholesterol, bile salts, phospholipids and, for the first time, osmolarity. Chemical analysis of the gallstones was conducted to ascertain the content of cholesterol, pigments and calcium salts. We report the results of our study and the conclusions we have drawn.
Absorption from the jejunum is increased by forward and backward pacing
Authors: Collin Jack , Kelly Keith A , Phillips Sidney F 
Published: March 2007

Summary
In 4 dogs a 75-cm segment of jejunum was isolated from the intestinal stream. Stimulating electrodes were implanted at each end of the segment and recording electrodes at intervals between. The two ends of the segment were fashioned as stomas on the anterior abdominal wall. After recovery, the electrical activity of the segment was continuously recorded, whilst a solution of 100 mmol/l glucose and 90 mmol/l NaCl was infused into the proximal stoma at 2.9 ml/min. Effluent from the distal stoma was collected in 5-min aliquots for three consecutive 30-min periods. In the second period electrical stimuli were given via either the proximal or the distal bipolar electrodes to entrain pacesetter potentials. Both forward and backward electrical pacing decreased the output of water, glucose and sodium from the jejunal segment, but the decrease was significantly greater with backward pacing. We conclude that pacing a segment of jejunum backwards with electrical stimuli produces a greater increase in absorption from the segment than pacing it forwards, a finding which has therapeutic implications in patients with the short bowel syndrome.
An experimental evaluation of segmental reversal after massive small bowel resection
Authors: Barros D'Sa Aires A B 
Published: March 2007

Summary
The technique of reversal of a distal segment of residual small intestine was applied to the management of massive resection. A controlled evaluation was carried out in dogs into the effects of segmental reversal on the proximal remnant after the distal 75 per cent of the small bowel had been resected. The variables studied were survival, body weight, glyceryl tri(palmitate-1-14C) absorption and mouth-to-caecum transit time. Animals subjected to resection alone had accelerated intestinal transit, poor absorption, serious weight loss and a high early mortality. It was clearly demonstrated that segmental reversal after resection produced marked and progressive delay in transit time from mouth to caecum, sustained improvement in fat absorption and body weight and enhanced survival.
Reduction in road fatalities and injuries after legislation for compulsory wearing of seat belts: Experience in Victoria and the rest of Australia
Authors: McDermott F T , Hough D E 
Published: March 2007

Summary
In 1970 the Government of the State of Victoria became the first in the ‘western’ world to introduce legislation for compulsory wearing of seat belts. Within 14 months the other Australian states followed. Seat belt wearing rates increased to attain 90 per cent in 1977.
This paper presents an evaluation of changes during the period 1955–77 in the incidence of road crash fatalities and injuries for vehicle occupants in Victoria and the rest of Australia.
The introduction of the legislation in Victoria and subsequently in the other Australian states coincided with significant and marked decreases in driver and passenger fatality and injury rates (numbers per 10 000 registered vehicles). The decreases were enough to reduce the total numbers of vehicle occupant fatalities and injuries for all post-legislation years in Victoria. The improvements have been maintained throughout the entire post-legislation period.
The legislation did not apply to child passengers of less than 8 years of age and the frequency of seat belt or harness wearing among them remained low. These children did not share in the overall improvement for passengers.
The Australian experience supports the view that legislation for compulsory wearing of seat belts is the singt most effective method available for the protection of vehicle occupants in road crashes.
Prolonged post-vagotomy gastric atony treated by oxytocin
Authors: Hashmonai M , Torem S , Argov S , Barzilai A , Schramek A 
Published: March 2007

Abstract
Persistent and complete post-vagotomy gastric atony was treated in 3 patients by intravenous infusion of oxytocin. Despite failure of both convetional treatment with gastric aspiration and intravenous fluids or jejunal feeding, as well as the reported trials with bethanechol chloride and metoclopramide, these patients promptly responded to oxytocin. It appears that the latter may represent a solution to this uncommon but recalcitrant complication of peptic ulcer surgery.
Experience in the management of 50 consecutive penetrating wounds of the heart
Authors: Mandal Ashis K , Awariefe S Okpako , Oparah Sonny S 
Published: March 2007

Abstract
Fifty patients with penetrating wounds of the heart were grouped into three categories, based on the clinical severity of the injuries.
Gunshot wounds consistenly resulted in a higher mortality than knife wounds. Central venous pressure (CVP) was the single most important means of determining cardiac tamponade. The survival rates in the respective groups were 6, 79 and 100 per cent. The improved survival in our series was due to a rapid transportation system, increased awareness of the significance of cardiac injuries and an aggressive surgical approach.
Pyloric diaphragm, antral web, congenital antral membrane—a surgical rarity?
Authors: Mitchell K G , McGowan A , Smith D C , Gillespie G 
Published: March 2007

AbstractThree cases of pyloric diaphragm in elderly patients are reported. The finding of these patients within a 2-year period (1976–8) suggests that the condition is not as rare as previously thought. Diagnosis was achieved endoscopically and the condition managed surgically.While there has been controversy in the past over whether the disorder is acquired or congenital, the histological evidence of the cases presented here tends to suggest that it is a late presentation of a congenital abnormality.
Two gas-gangrene-like infections due to Bacillus cereus
Authors: Fitzpatrick D J , Turnbull P C B , Keane C T , English L F 
Published: March 2007

Abstract
Two cases of postoperative gas-gangrene-like infection due to Bacillus cereus are reported, drawing attention to the fact that Bacillus cereus, a common environmental bacterium, can occasionally give rise to severe postoperative infection. Characteristics of the organism related to the epidemiology and pathogenesis of such infections are discussed.
Leucocyte ascorbate levels and postoperative deep venous thrombosis
Authors: Taylor T V , Raftery A T , Elder J B , Loveday Christine , Dymock I W , Gibbs A C C , Jeacock Julie , Lucas S B , Pell M A 
Published: March 2007

Abstract
Forty-four general surgical patients were included in a prospective, randomized double-blind controlled trial of ascorbic acid (500 mg b.d.) or placebo for 7 days before operation. This was to test the hypothesis that vitamin C may reduce the instance of deep venous thrombosis postoperatively. Venous blood samples were taken before entering the trial, just immediately before surgery, on the day of operation and on three further occasions at 3-day intervals postoperatively for leucocyte ascorbic acid concentration (LAC). Venous thrombosis was diagnosed using the 125I-fibrinogen test and the leg scans interpreted by Roberts' criteria. There was no significant difference in the incidence of DVT between the treatment and placebo groups. In those with DVT (n = 23) the mean LAC on the day of operation was not significantly different from that in those without DTV. However, on the sixth and ninth postoperative days LAC levels were significantly lower in the DVT group. These results suggest that the administration of ascorbic acid preoperatively does not reduce the incidence of DVT, but a striking decrease in the LAC levels in the DVT patients in in keeping with the hypothesis that the initial event in the pathogenesis of DVT is adherence of leucocytes to the venous endothelium.
Solitary toxic adenoma of the thyroid gland
Authors: Bransom C J , Talbot C H , Henry L , Elemenoglou J 
Published: March 2007

Abstract
The incidence of solitary toxic adenoma of the thyroid in a general surgical unit with an interest in thyroid disease has been reviewed over a 15-year period. Six hundred and thirty thyrotoxic cases were treated surgically, 35 (5.6 per cent) having a solitary toxic adenoma. Thyroid enlargement or toxicity had been present for more than 5 years in 7 patients (20.0 per cent). Cardiovascular complications were present in 6 cases (17.1 per cent).
Thyroid lobectomy resulted in 30 (85.7 per cent) euthyroid and 5 (14.3 per cent) hypothyroid patients. One toxic adenoma contained a focus of carcinoma. The clinical features, diagnosis and management of solitary toxic adenoma, and the management of symptomatic nodules which are ‘hot’ but not biochemically toxic, are discussed.
Rupture of the abdominal oesophagus: A review
Authors: Walsh P V 
Published: March 2007

Summary
‘Spontaneous’ rupture of the oesophagus usually affects the lower third, less commonly the middle third and rarely the cervical oesophagus. Rupture limited to the intra-abdominal oesophagus is rare. Such a case is described here and previously reported cases are reviewed. Vomiting-induced gastro-oesophageal injuries and their aetiology are discussed and the management of spontaneous rupture is reviewed.
Dysphagia following selective vagotomy
Authors: Suleiman S I , Maglad S A , Hobsley M 
Published: March 2007

Summary
Progression of dysphagia after vagotomy to the stage of complete obstruction due to a peri-oesophageal fibrotic collar needing operaton is a rare event. Review of the 4 such cases previously described, all needing further operation and all after truncal vagotomy, indicates that the oesophageal mucosa was normal on oesophagoscopy and that bouginage appeared to make the condition worse. This paper describes the first patient in whom (a) the vagotomy was selective and (b) no bouginage was carried out before the condition was relieved by a further surgical operation.
Anastomotic recurrence in the oesophagus complicating gastrectomy for adenocarcinoma of the stomach
Authors: Papachristou D N , Karas M , Fortner J G 
Published: March 2007

Summary
Gastric adenocarcinomas often spread to the distal oesophagus. Failure to control the disease in this area during total and proximal subtotal gastrectomy results in recurrence at the oesophageal anastomosis. The incidence of recurrence in a series of 351 such patients was 10 per cent and was influenced by the location of the main lesion, the stage of the disease, the presence of tumour at the margin of resection and the length of clearance of the oesophageal margin. Recurrences were prevented only with in vivo margins greater than 12 cm. Dysphagia combined with radiological signs of oesophageal obstruction was diagnostic of anastomotic recurrence regardless of the results obtained by oesophagoscopy and biopsy.
Treatment was seldom effective in patients developing recurrence. Complete excision of the entire recurrent process offered the only hope for a long survival in these patients. Prevention by obtaining adequate oesophageal clearance at the time of gastrectomy is the only reasonable approach to this problem. The adequacy of resection cannot be judged accurately by intraoperative palpation of the oesophagus or by frozen section examination of the surgical margins.
Fulminating amoebic colitis: A clinical evaluation
Authors: Vajrabukka T , Dhitavat A , Kichananta B , Sukonthamand Y , Tanphiphat C , Vongviriyatham S 
Published: March 2007

Summary
Eleven cases of fulminating amoebic colits seen in 5 years are reported. Only people of low socioeconomic status were affected and most were in good health previously. The disease appeared to follow a fulminant course from the onset and was rarely a secondary phenomenon superimposing on the chronic amoebic dysentery. The diagnosis was difficult due to severe systemic manifestations and the periodic absence of Entamoeba histolytica in the stool. The development of colonic necrosis was often masked by the severe preexisting local signs and perforation could occur in spite of adequate anti-amoebic therapy. Mortality was related to late diagnosis, delayed recognition of irreversible colonic necrosis and inadequate surgical treatment.
To reduce the present 55 per cent mortality further it is proposed that, in an endemic area, early specific antiamoebic therapy is justified in severe and undiagnosed colitis. Even under specific anti-amoebic treatment the patient with severe amoebic colitis remains a potential surgical candidate. Surgery is indicated when the patient continues to deteriorate in spite of the therapy, when there is an acute episode which signifies perforation, or when severe diarrhoea, toxaemia and abdominal tenderness persist after a full course of specific anti-amoebic therapy. Primary total resection of the diseased colon is the treatment of choice.
Thyroid cancer: Prognosis in 469 patients
Authors: Staunton M D , Skeet R G 
Published: March 2007

Summary
A computer study of 469 patients with thyroid cancer is presented. There were 40 per cent anaplastic, 30 per cent papillary, 15 per cent follicular and 15 per cent rarer tumours. The 20-year survival was 7·5 per cent for anaplastic, 55 per cent for papillary and 35 per cent for follicular carcinoma. The dominant role of histology in prognosis is confirmed.
Other important factors are: all patients under 45 reap benefit; females survive longer than males with papillary and follicular tumours. Cervical node metastases confer no depression in papillary tumours. Local tumour advance depresses survival but cililates diagnosis. We find merit in the TNM classification, but warn against overelaboration.
We regret our failure to assess the differential effect of individual treatment, which poses a continuing challenge to oncologists.
Randomized prospective matched pair study comparing peritoneovenous shunt and conventional therapy in massive ascites
Authors: Wapnick Simon , Grosberg Saul J , Evans Mark I 
Published: March 2007

Summary
A prospective randomized matched pair study was designed to test the efficacy of the peritoneovenous (LeVeen) shunt as a treatment for massive cirrhotic ascites compared with traditional medical therapy. Patients who failed to lose weight while on a low salt diet and fluids restricted to 1000 ml daily were placed in the study group. Weight loss, decrease in abdominal girth and diuresis were significantly greater (P &lt; 0·01) for surgical patients than for their medically treated counterparts. The surgical technique is simple, quick and inexpensive. The surgical patients outlived their matched partners in 12 of 14 pairs where a definitive comparison was possible (P &lt; 0·02). The median stay in hospital after randomization was shortened from 32 days with medical therapy to 15 days for those undergoing the shunt operation. Those treated medically experienced a significant rise in mean blood urea nitrogen and K+ (P &lt; 0·02). Patients with alcoholic hepatitis, hyperbilirubinaemia (bilirubin &gt; 154 m̈mol/l), peritoneal sepsis, severe coagulopathy and those who had recently bled from oesophageal varices are poor risks for the surgical procedure.
The use of the Hickman catheter in the management of patients with leukaemia and other malignancies
Authors: Thomas Meirion 
Published: March 2007

Summary
The use of the Hickman right atrial catheter in 25 patients with leukaemia and other malignancies is reported, and it is concluded that with careful selection of patients, the benefits of this semi-permanent catheter outweigh the risks of infection. The catheter may be useful in the intensive care of children or adults with non-malignant conditions.
Breast cancer and prostaglandins: A new approach to treatment
Authors: Leaper D J , French B T , Bennett A 
Published: March 2007

Summary
The effect of the non-steroidal inhibitor of prostaglandin synthesis, flurbiprofen, has been studied on a transplanted mouse mammary tumour of spontaneous origin. Daily administration of 2·5 mg/kg flurbiprofen significantly reduced the growth of this NC adenocarcinoma transplanted subcutaneously into the right flank of WHT/Ht mice. Histological examination showed that primary tumours excised at 3 weeks from treated mice tended to have a more prominent lymphocytic infiltration. There was a non-significant tendency for mice treated with flurbiprofen alone to survive longer after tumour excision and to develop less local metastases, although scar recurrences seemed unaffected. The effect of adjuvant chemotherapy and local radiotherapy on local metastases and survival time tended to be greater when flurbiprofen was also given. This work supports and extends the basis for prospective clinical trials to evaluate the role of prostaglandins in Luman cancer and the value of prostaglandin synthesis inhibitors in cancer therapy.
The effect of uraemia upon wound healing: An experimental study
Authors: Colin J F , Elliot P , Ellis H 
Published: March 2007

Abstract
Acute uraemia was induced in rats by performing a 70 per cent nephrectomy. Uraemia was shown to delay the healing of intestinal anastomoses and abdominal wounds in rats as judged by bursting strength tests. Cellular proliferation was depressed at wound edges but there was no reduction in the total amount of hydroxyproline present in the wounds. Fibroblast growth in tissue culture was affected by the addition both of uraemic plasma and of urea solution to the culture medium. The possible causes of these effects are discussed.
Adjuvant cytotoxic liver perfusion for colorectal cancer
Authors: Taylor I , Rowling J , West C 
Published: March 2007

AbstractColorectal liver metastases develop by malignant cells entering the portal venous circulation. A randomized prospective clinical trial was commenced in 1975 to assess the value of adjuvant umbilical vein cytotoxic perfusion (with 5-fluorouracil) following colorectal resection.One hundred and fifty-four patients without macroscopic liver secondaries have so far entered the trial. The mean age, sex, site and stage of the disease were similar in the control and perfusion groups and there was no statistically significant difference in postoperative complications or hospital stay (17·1 ± 7·9 days control, 15·8 ± 7·4 days perfusion group).So far, 23 deaths have occurred in the control group (20 due to recurrent disease) and 7 in the perfusion. group (5 due to recurrent disease) Liver metastases were present in 13 control patients and 2 perfusion patients.These results show an encouraging trend and suggest that adjuvant cytotoxic liver perfusion may reduce the development of colorectal liver metastases and hence improve the subsequent prognosis.
Continent anal ileostomy with mucosal proctectomy: A bloodless technique using a surgical ultrasonic aspirator in dogs
Authors: Hodgson W J B , Finkelstein J L , Woodriffe Phillipa , Aufses A H 
Published: March 2007

Abstract
At present, mucosal proctectomy with ileo-anal anastomosis is a difficult, time-consuming operation involving much blood loss, often associated with impaired postoperative continence. A new operation has been devised in our department in which a surgical ultrasonic aspirator, the CUSATM System (Cavitron Corporation) was used to fragment directly and strip bloodlessly mucosa from the rectal wall in 20 dogs as part of a simple ileo-anal sleeve anastomosis. All dogs were closely followed for up to 10 months. The only operative mortality occurred in the first dog where the upper rectum sloughed because the superior haemorrhoidal artery was divided. Preoperative weight was regained within the first 2 months. Initially stools were loose and frequent. Within 2 weeks the daily stool count was 5–6 with gradual thickening to semisolid consistency by 6 weeks. Finally 3–4 normal stools were passed daily. Postoperatively, all dogs remained continent.
Modulation of the immune response and control of tumour spread by a new synthetic compound
Authors: Falk R E , Makowka L , Nossal N , Falk J A , Fields J E , Asculai S S 
Published: March 2007

Abstract
A small molecular weight biofunctional polymer, NED 137, has been investigated for its anti-neoplastic effect. Through its effect on the immune system, particularly the induction of B cell differentiation to antibody producing cells, this synthetic compound can retard tumour growth and prevent the development of distant metastases. Reactivity to tumour developed following administration of the NED 137. No toxicity has been observed. The polymer NED 137 is now being tested in phase I and phase II clinical trials.
The effect of epidural analgesia on postoperative sodium balance
Authors: Gow N Menzies , Cochrane J P S 
Published: March 2007

Abstract
The effect of a high epidural blockade on postoperative sodium (Na) retention has been studied in 8 patients undergoing cholecystectomy, with a further 8 patients, who received conventional anaesthesia and analgesia, acting as a control group. Preoperatively, all the patients received 90 mmol of Na per day and were in Na balance at the start of operation; this intake was continued for 48 h after the operation by intravenous infusion, and the epidural blockade was maintained with regular supplements of bupivacaine throughout. In addition to urine Na excretion and blood pressure changes, plasma levels of aldosterone, cortisol, renin activity and glucose were measured at appropriate intervals.
The Na retention in both the epidural and control groups was the same (139 mmol and 135 mmol respectively at 48 h), but there were significant differences in the measurements of all the other factors. It is concluded that the epidural was providing effective blockade, but that the factors which cause Na retention were not affected by the epidural blockade. These results are at variance with another study of the effect of epidural blockade on postoperative Na retention (Bevan, 1971), and the possible reasons for this are discussed.