bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new posterior exposure of the splenic vein for an H-graft splenorenal shunt
Authors: Barsoum M S , Rizk-Allah M A , Khedr M El-Said , Khattar N Y 
Published: March 2007

Abstract
A preliminary report is presented of a posterior exposure of the splenic vein allowing H-graft splenorenal shunt to be carried out without removing the spleen. The operation was successfully performed in 14 patients with portal hypertension due to schistosomal hepatic fibrosis, and this was associated with post-hepatitic cirrhosis in 5 of them. Dacron grafts were inserted in 8 patients and autologous internal jugular vein grafts in 6 patients. The long term follow-up of the patients (maximum 45 months) showed that recurrence of bleeding developed in 2 patients due to shunt thrombosis and one died. Complications occurred in 3 patients, including one patient who developed first grade encephalopathy. Shunt patency was demonstrated in 12 patients, including all the vein grafts.
Femoropopliteal bypass grafts—an isotope technique allowing in vivo comparison of thrombogenicity
Authors: Goldman M , Norcott H C , Hawker R J , Hail C , Drolc Z , McCollum C N 
Published: March 2007

Abstract
Prosthetic femoropopliteal grafts attract platelet thrombus and often occlude in the months following implantation. Hence a technique to measure the in vivo thrombogenicity of different vascular substitutes in patients has been developed. In 28 patients the rate of accumulation of 111-indium-labelled platelets in saphenous vein, polytetrafluoroethylene (PTFE) and double velour Dacron femoropopliteal grafts was studied. One week postoperatively autologous 111In-labelled platelets were injected and the isotope emissions over the graft and contralateral leg counted. Graft thrombogenicity was calculated as the daily rise over 7 days in the ratio of counts over the graft to those over the contralateral leg. Mean thrombogenicity index (± s.e.mean) was greatest in the Dacron grafts at 0·24 ± 0·03 which compared with 0·13 ± 0·02 in PTFE (P&lt;0·05). Saphenous vein was markedly less thrombogenic than either prosthetic graft with a mean index of only 0·025 ± 0·01 (P &lt; 0·01). Platelet survival failed to differentiate the three graft materials, demonstrating that the direct measurement of 111 In platelet deposition was a more sensitive technique.
Long term evaluation of a reservoir jejunal interposition with an isoperistaltic conduit in the management of patients with the small stomach syndrome
Authors: Cuschieri A 
Published: March 2007

Abstract
The results of reservoir jejunal interposition in 9 patients with severe symptoms of the small stomach syndrome have been reviewed after a median follow-up period of 4·2 years (range 6 months to 10 years). Objective assessment of improvement in terms of weight gain, haemoglobin and serum albumin levels was obtained in all the patients but only 3 have reached and maintained their ideal weight. No patient has been rendered symptom free, but significant improvement of the post-cibal symptoms was observed in 7 patients. The most common residual symptoms have been heartburn and postprandial epigastric fullness. These have improved with metoclopramide therapy.
Comparison of rigid and flexible fibreoptic sigmoidoscopy with double contrast barium enemas
Authors: Vellacott K D , Amar S S , Hardcastle J D 
Published: March 2007

Abstract
One hundred consecutive new patients attending a general surgical and gastrointestinal outpatient clinic had a flexible fibreoptic sigmoidoscopic examination before a double contrast barium enema. Colonic lesions were found in 45 patients and flexible sigmoidoscopy was superior to barium enemas in diagnosing lesions in the sigmoid colon. Two cancers, 1 histologically a Dukes' A lesion, and 6 adenomatous polyps greater than 0·5 cm in diameter, in the sigmoid colon, were not detected by barium enemas. In 6 of these patients extensive diverticular disease was present. In patients with rectal bleeding found to have diverticular disease demonstrated radiographically, an endoscopic examination must be performed to exclude polyps or cancer. Flexible fibreoptic sigmoidoscopy may reduce the numbers needing barium enemas.
Reduced catheter sepsis and prolonged catheter life using a tunnelled silicone rubber catheter for total parenteral nutrition
Authors: Mitchell A , Atkins Susan , Royle G T , Kettlewell M G W 
Published: March 2007

Abstract
One hundred and five patients were given total parenteral nutrition (TPN) for an average of 15 days via centrally placed venous catheters. Thirty-seven polyvinyl chloride (PVC) and 80 silicone rubber catheters were used. All the silicone rubber and 8 of the PVC catheters were buried in a subcutaneous tunnel. When silicone rubber catheters were used, there was significantly less catheter sepsis (P&lt;&lt;0·01), catheter life was prolonged by 50 per cent and fewer catheter insertions per patient were necessary.
Levamisole and postoperative complications: A controlled clinical trial
Authors: Ausobsky J R , Evans Mary , Pollock A V 
Published: March 2007

Abstract
We studied the relationship between cell-mediated immunity (assessed by preoperative skin reactions to four recall antigens) and postoperative infective complications in 166 patients undergoing major laparotomies. They were randomly allocated to receive ·150 mg of levamisole or placebo on the day of operation and for the following 2 days; their course was followed for at least 1 month. Neither the degree of preoperative anergy nor the administration of levamisole resulted in any significant differences in numbers of postoperative deaths or infective complications, but the levamisole group had significantly less postoperative pyrexia than the control group.
Adverse effects of exploratory laparotomy in patients with unsuspected liver disease
Authors: Powell-Jackson P , Greenway B , Williams R 
Published: March 2007

Abstract
Thirty-six patients were referred to the Liver Unit between 1971 and 1980 after unsuspected liver disease had been found at laparotomy. The preoperative diagnosis had been extrahepatic biliary obstruction in 16 patients and intra-abdominal malignancy in 15. Misdiagnosis resulted from insufficient attention to the history and physical signs in 31 patients and omission or misinterpretation of liver function tests and of other hepatobiliary investigations in the remaining 5 patients. The morbidity and mortality of the 36 patients within 1 month of operation was 61 per cent and 31 per cent respectively. All patients with viral or alcoholic hepatitis died, and severe complications, which included bacterial peritonitis, wound dehiscence and hepatic failure, developed in 13 of 15 in whom ascites due to cirrhosis or the Budd–Chiari syndrome was present before operation.
Pre-incisional intraparietal injection of cephamandole: A new approach to wound infection prophylaxis
Authors: Armstrong C P , Taylor T V , Reeves D S 
Published: March 2007

Abstract
Pre-incisional injection of cephamandole has been studied. Wound tissue levels of cephamandole have been found to be extremely high throughout the operation. Serum levels were comparable to those obtained with parenterally administered antibiotic. The use of a pre-incisional injection of antibiotic therefore offers major theoretical advantages over the use of either conventional parenteral or topical antibiotics in the prevention of postoperative sepsis.
Preoperative intraparietal (intra-incisional) cefoxitin in abdominal surgery
Authors: Taylor T V , Walker W S , Mason R C , Richmond J , Lee D 
Published: March 2007

Abstract
The effect of preoperative intraparietal (intra-incisional) injection of cefoxitin along the site of the intended incision on the incidence of wound infection has been investigated by a randomized prospective study of 181 consecutive patients undergoing abdominal surgery. A significant reduction in wound infection was evident in the cefoxitin-treated group (4·4 per cent) when compared with controls (16·7 per cent) (χ2 = 6; P = 0·02). Administration of antibiotic by this route did not delay wound healing or produce any undesirable sequelae.
Intraoperative microscopy of bile—is it useful?
Authors: Gallagher P , Ostick G , Jones D , Schofield P F , Tweedle D E F 
Published: March 2007

Abstract
Direct microscopy of the bile was performed during cholecystectomy in 111 patients in an attempt to identify those with a high risk of wound infection. Bacteria were identified in 23 patients, 11 of 83 undergoing cholecystectomy alone and 12 of 28 undergoing exploration of the common bile duct (P &lt; 0·01). These 23 patients were randomly allocated to an antibiotic group or a control group; there was one wound infection in the antibiotic group and two in the control group. A total of 14 patients developed wound sepsis. Infection was more likely if the common bile duct was explored (6 of 28) rather than cholecystectomy alone (8 of 83). There was a poor correlation between microscopy and culture of the bile for bacteria and there was no increase in sepsis when bacteria were observed on microscopy. We were not able to identify a high risk group of patients by intraoperative microscopy of bile.
Acute acalculous cholecystitis following trauma
Authors: Herlin P , Ericsson M , Holmin T , Jönsson P-E 
Published: March 2007

Abstract
A consecutive series of 11 patients with post-traumatic acute acalculous cholecystitis is reviewed. Three patients had sustained multiple trauma, whereas 6 patients had recently undergone alimentary tract surgery and 2 patients orthopaedic or gynaecological surgery. All patients were treated by cholecystectomy. Four cases required reoperation because of an abdominal abscess and 2 cases because of a subcutaneous abscess. One patient was re-explored due to haemorrhage from the gallbladder bed, and another patient due to occlusion of the coeliac axis. The mortality rate was 18 per cent. The importance of early diagnosis and surgical intervention with cholecystectomy are emphasized in this rare condition with high morbidity and mortality.
Partial excision and drainage of post-traumatic splenic cysts
Authors: Millar J S 
Published: March 2007

Abstract
In areas of the world where malaria is endemic it is now advisable to conserve the spleen whenever possible following trauma. Post-traumatic cysts of the spleen may therefore be more commonly encountered. The experience in the four cases presented here shows that such cysts can be successfully managed without splenectomy. Evacuation of the cyst contents at laparotomy, followed by excision of the capsular component of the cyst and external drainage, gives good results.
Safe removal of failed transplanted kidneys
Authors: Voesten H G J , Slooff M J H , Hooykaas J A P , Tegzess A M , Kootstra G 
Published: March 2007

Abstract
The surgical removal of a transplanted kidney following rejection or failure can be hazardous. A total of 110 grafts were removed consecutively in 84 patients (in 21 cases a second graft and in 5 cases a third graft was removed). Two surgical techniques were applied: extracapsular and intracapsular removal. The extracapsular technique was associated with complications in 11 out of 69 cases (16 per cent) and the intracapsular technique, in 3 out of 36 cases (8 per cent). In 5 cases the operative technique could not be determined from the records.
In the 14 cases developing complications, wound infection was observed in 7 cases, wound haematoma in 4 and mycotic aneurysm, pulmonary embolism and clotting in the bladder each in 1 case. One patient (1·2 per cent) died due to late complications after allograft nephrectomy following rupture of a mycotic aortic aneurysm. The technique of kidney transplant removal by either the intra- or extracapsular route and the exact timing of the operation are important features for safe treatment of patients with end-stage graft failure.
Nine years' experience with end-to-end arteriovenous fistula at the ‘anatomical snuffbox’ for maintenance haemodialysis
Authors: Bonalumi U , Civalleri D , Rovida S , Adami G F , Gianetta E , Griffanti-Bartoli F 
Published: March 2007

Abstract
One hundred and seventy-seven end-to-end arteriovenous fistulas were created at the ‘anatomical snuffbox’ between 1 January 1972 and 31 December 1980. The survival rate of the fistulas was 83·1 per cent at 1 year and 46·3 per cent at 6·5 years; 10·2 per cent failed immediately. Local and general complications were virtually absent. Forty fistulas stopped functioning after a period varying from 10 days to 6·5 years following the operation. The main cause of late failure (50 per cent) was aneurysm formation due to repeated needle venepuncture at the same site and subsequent obliteration of the upper venous segment.
The end-to-end anastomosis seems to be preferable to other techniques because of the absence of local vascular complications and a lower risk of cardiac embarassment. The ‘anatomical snuffbox’ site is convenient and spares the proximal vessels for reoperation if necessary.
Endoscopic retrograde cholangiopancreatography in the investigation and management of patients after acute pancreatitis
Authors: Hamilton I , Bradley P , Lintott D J , McMahon M J , Axon A T R 
Published: March 2007

Abstract
Thirty-one patients who had been admitted with acute pancreatitis underwent endoscopic retrograde cholangiopancreatography (ERCP) following initial investigation by cholecystogram or intravenous cholangiogram and by biochemical screening. Previously undiagnosed gallstones were demonstrated at ERCP in 4 patients, and in 2 others known gallstones were effectively treated by endoscopic sphincterotomy. Changes of chronic pancreatitis were found in 8 pancreatograms and no patient in whom a normal pancreatic duct was demonstrated has suffered a further recurrence of acute pancreatitis. ERCP was valuable in the management of patients with acute pancreatitis, both in the diagnosis and management of biliary disease and in the recognition of underlying chronic pancreatitis.
Sensitivity of endoscopic retrograde pancreatography in chronic pancreatitis
Authors: Caletti G , Brocchi E , Agostini D , Balduzzi A , Bolondi L , Labo G 
Published: March 2007

Abstract
This study examines the value of endoscopic pancreatography in chronic pancreatitis. With the cooperation of nine departments in Italy, the authors examined the pancreatograms of 1179 patients with chronic pancreatitis. The pancreatograms were abnormal in 80·6 per cent. There were difficulties in distinguishing between cancer and pancreatitis in 11·3 per cent, and difficulty in deciding whether the radiographs were normal or slightly abnormal in 6·8 per cent. The ability of pancreatography to diagnose chronic pancreatitis increased with the duration of the disease, reaching 92·3 per cent in those patients who had had chronic pancreatitis for 5 or more years. However, the failure to obtain a pancreatogram increased as calcification increased. A good correlation between abnormalities of the pancreatogram and of the pancreatic function tests was demonstrated.
Peptic ulceration in adolescence
Authors: Mohammed R , MacKay C 
Published: March 2007

Abstract
The fate of 22 adolescents (mean age 14 years) with proved peptic ulceration is reported. Five presened as an emergency with performation of haemorrhage, whilst the remining 17 had typical ulcer dyspepsia. Despite intensive medical measures 17 patients required difinitive surgery. Ten patients were under 18 years of age at the time of operation and all were opearted on at under 25 years of age. the results were excellent in 14 out of 17 patients at 5-year followup, suggesting that surgery should not be withheld on the grounds of age alone. The role of histamine H2 receptor antagonists needs to be assessed in this type of patient.
Implantation of autologous splenic tissue after splenectomy for trauma
Authors: Lanng Nielsen J , Sørensen F Hanberg , Saksø P , Hansen H Hvid 
Published: March 2007

Abstract
Implantation of autologous splenic tissue was performed in 2 patients after splenectomy for trauma. In order to demonstrate some function of the implanted splenic tissue, spleen scintigraphy, using 99Tcm-labelled heat-damaged autologous erythrocytes, and measurement of the percentage of circulating vacuolated erythrocytes were carried out 1 and 3 months after splenectomy. The spleen scans were positive after 1 month and the isotope uptake increased after 3 months, demonstrating splenic phagocytic function. The number of vacuolated erythrocytes also indicated some restoration of the pitting function of the implanted splenic tissue. No alterations in serum immunoglobulins were seen, but a moderate thrombocytosis and monocytosis persisted for 3 months. Future improvements in the implantation procedure are discussed.
Rubber band ligation versus haemorrhoidectomy for prolapsing haemorrhoids: A long term prospective clinical trial
Authors: Murie J A , Sim A J W , Mackenzie I 
Published: March 2007

Abstract
Eighty patients with prolapsing haemorrhoids, randomly treated by either rubber band ligation (n = 39) or haemorrhoidectomy (n = 41), were assessed 12 and 42 months after treatment. Thirty-eight patients in each group presented with rectal bleeding. Twelve months later, 36 in the rubber band ligation group and 37 in the haemorrhoidectomy group had benefited from treatment. After 42 months, all patients in the rubber band ligation group reported improvement in this symptom; one in the haemorrhoidectomy group did not. At 12 months all but one patient in the rubber band ligation group and all in the haemorrhoidectomy group had improved with respect to haemorrhoidal prolapse. At 42 months all except one in each group reported improvement in this symptom. Anal pain, pruritus ani and soiling are symptoms commonly associated with haemorrhoids. All were improved by both rubber band ligation and haemorrhoidectomy. Neither technique was superior in this respect and there was no change in results between 12 and 42 months.
Relief from symptoms of haemorrhoids at 12 months, obtained by rubber band ligation or by haemorrhoidectomy, is maintained 42 months after treatment. Thus, rubber band ligation has a good long term outcome and, as a convenient outpatient procedure, should continue to be advocated as the first-line management for prolapsing haemorrhoids.
Spectral analysis of Doppler ultrasound: Its clinical application in lower limb ischaemia
Authors: Aukland A , Hurlow R A 
Published: March 2007

Abstract
Twenty-nine patients with symptomatic lower limb ischaemia were studied using a continuous wave Doppler ultrasound spectrum analyser. Frequency spectra were recorded from the peripheral arteries to determine the pulsatility index, damping factor and pulse wave transit time, and the results were related to arteriography.
In the aortofemoral segment, the pulsatility index at the common femoral artery decreased significantly with increasing stenosis, but the transit time was only prolonged with total occlusion. In the femoropopliteal segment there were significant differences in all parameters between each grade of stenosis. Accurate Doppler and radiological assessments of the calf vessels were possible in only 31 limbs; ultrasound did not enable differentiation between patent and occluded vessels.
The pulsatility index at the common femoral artery may be helpful in detecting aortofemoral disease, and accurate assessment of the femoropopliteal segment is possible, but spectral analysis is of no value in assessing the calf vessels.
A trial of glucagon in the treatment of painful biliary tract disease
Authors: Stower M J , Foster G E , Hardcastle J D 
Published: March 2007

Abstract
Seventy-one patients with a clinical diagnosis of painful biliary tract disease have been entered into a double-blind trial of glucagon. Twenty-eight were excluded as gallstones were not proved: of the remainder, 21 patients received glucagon and 22 placebo. Glucagon-treated patients were pain free 14·26 h(± 2·77 s.e.m.) after commencing treatment compared to 29·14 h(± 6·01 s.e.m.) for the placebo group (P &lt; 0·05). Tenderness in the right hypochondrium showed a significant improvement when assessed at 12 h (P &lt; 0·02) and 24 h (P &lt; 0·1) for those given glucagon. A significant difference in blood glucose levels was seen between the two groups (P &lt; 0·05). No serious side effects were observed. Glucagon relieves the pain and tenderness associated with painful biliary tract disease more effectively than conventional therapy.
The ‘acute’ abdomen in heroin addiction
Authors: Leguit P , Slot H , Roos C 
Published: March 2007

Abstract
Twenty-two heroin addicts admitted with an acute abdomen to the surgical department in the years 1971–1981 were reviewed. Fifteen patients had symptoms suggesting intestinal obstruction, 7 proved to have pseudo-obstruction, 4 had withdrawal symptoms, 2 had faecal impaction and only 2 had adhesions which necessitated operation. A haematocrit level of more than 0·46 was found to be indicative of true obstruction. Frequently, elevation of the white blood cell count or erythrocyte sedimentation rate merely reflected a state of accompanying soft tissue infections which were very common in these patients. The remaining 7 patients were admitted with intra-abdominal inflammation, 2 patients had an appendix mass, I had gonococcal peritonitis, 3 had appendicitis and I had a normal appendix removed. In these 7 patients the history and physical findings were characteristic of the suspected pathology.
Rectal, bladder and sexual function after mucosal proctectomy with and without a pelvic reservoir for colitis and polyposis
Authors: Neal D E , Williams N S , Johnston D 
Published: March 2007

Abstract
Sexual, bladder and rectal function have been assessed prospectively in a group of patients undergoing mucosal proctectomy, primarily for ulcerative colitis. The function of the rectum and ‘neo-rectum’ was studied before and 3 months (on average) after operation in 18 patients. Intestinal continuity was restored by means of ileo-anal anastomosis; in addition to ileo-anal anastomosis, a pelvic reservoir (MP + RES) was constructed in 10 patients, while ileo-anal anastomosis alone (MP + IAA) was used in the remaining 8 patients. Thirteen of these patients have been studied for a minimum of 4 months after closure of the defunctioning ileostomy.
No evidence of impotence or of bladder dysfunction due to trauma to pelvic autonomic nerves was noted. Evidence of impairment of function of the internal anal sphincter was observed soon after operation in 16 of the 18 patients (P &lt; 0·05). However, reflex function of the external anal sphincter could still be elicited in over 70 per cent of patients who were tested 3 months after operation. The functional results of patients after MP + RES were significantly better than those of patients who had undergone MP + IAA. Thirteen months (on average) after closure of the ileostomy, the maximum capacity and compliance of the ‘neo-rectum’ in patients after MP + RES (423 ± 87 ml and 14 ± 7 ml/cm H2O respectively) were significantly greater than in patients after MP + IAA (181 ± 103 ml and 4 ± 3 ml/cm H2O respectively; P &lt; 0·05). A significant correlation between the capacity of the ‘neo-rectum’ and the frequency of defecation was noted. The results of the present study support the suggestion that a pelvic reservoir should be fashioned in adults undergoing mucosal proctectomy and ileo-anal anastomosis for inflammatory bowel disease.
The effect of split ileostomy on perianal Crohn's disease
Authors: Harper P H , Kettlewell M G W , Lee E C G 
Published: March 2007

Abstract
The effect of 32 split ileostomies on 29 patients with severe symptomatic perianal Crohn's disease is reported. The perianal disease improved or healed after 23 (72 per cent) split ileostomies, although it relapsed in 2 patients while diverted and in 6 after closure of the split ileostomy. Seven of 12 rectovaginal fistulas healed initially but only remained healed in those patients without rectal involvement with disease. At the time of review 6 patients have normal bowel continuity, 8 have had proctocolectomies and 15 are still defunctioned. Split ileostomy should be considered as an initial step in the management of intractable perianal disease.