bluuebunny/crossref_metadata_2025_split huggingface dataset:
Naftidrofuryl for ischaemic rest pain: A controlled trial
Authors: Greenhalgh R M 
Published: March 2007

Summary
A preliminary study suggested that some patients with ischaemic rest pain improved during treatment with naftidrofuryl (Praxilene). Therefore, a controlled trial was performed in which 16 patients were treated for 7 days with placebo (given intravenously and in tablet form), and were then given Praxilene for a further 10 days and assessed subjectively and objectively. The drug regimen used was Praxilene 200 mg 8-hourly by mouth and 200 mg twice-daily intravenously. Although no objective improvement could be attributed to the drug, 7 of the 16 patients showed subjective improvementduring the placebo period, but reported no further improvement during the Praxilene period (placebo responders). Five patients did not respond to the placebo but reported an improvement whilst taking the drug. In 4 patients there was no improvement at all. Praxilene produced subjective improvement in the symptoms of rest pain in 5 patients out of 16 in this small study.
Recurrent inguinal hernia after local anaesthetic repair
Authors: Kingsnorth A N , Britton B J , Morris P J 
Published: March 2007

Summary
A consecutive series of 227 inguinal hernias were repaired under local anaesthetic between 1976 and 1978 in the Oxford hospitals. A total of 187 of these operations was performed on a day-case basis.
Data were available for analysis from 183 cases in whom there were 13 recurrences. The factor most strongly influencing the recurrence rate was the experience of a particular surgeon with the local anaesthetic technique. It was found thatonce 6 hernias had been repaired under local anaesthetic the chance of recurrence fell to a level of 2·5 per cent (which projects to 7·5 per cent at the end of 25 years).
The recurrence rate for beginners (those who have repaired less than 6 hernias under local anaesthetic) was unacceptably high at 9·4 per cent (which projects to 28 per cent at the end of 25 years).
Our recurrence rate was high in patients with a direct hernia in whom there were associated risk factors known to predispose to recurrence.
A controlled trial to compare systemic and intra-incisional cefuroxime prophylaxis in high risk gastric surgery
Authors: Hares M M , Hegarty M A , Warlow J , Malins D , Youngs Denise , Bentley Sandra , Burdon D W , Keighley M R B 
Published: March 2007

Summary
A prospective randomized controlled trial has compared single dose systemic cefuroxime (n = 27) or intra-incisional cefuroxime (n = 26) with a control group (n = 28) in 81 patients undergoing gastric resection, revision gastric surgery or operation for gastro-oesophageal malignancy. In the controls the incidence of sepsis was: 35 per cent wound infection, 29 per cent abscess, 21 per cent septicaemia. After intra-incisional cefuroxime the incidence was: 4 per cent wound sepsis, 19 per cent abscess and 4 per cent septicaemia. After systemic cefuroxime only 2 patients developed wound sepsis (7 per cent) with no cases of abscess or septicaemia. Excluded from this high risk group were 36 patients who had a vagotomy with or without drainage during the trial where antibiotics were not given, 4 of whom developed wound sepsis only (11 per cent). There was a poor correlation between the individual species isolated from the gastric aspirate and the organisms responsible for postoperative infection in the controls, but there was a good correlation between fasting gastric pH and the risk of sepsis in the controls.
Typhoid perforation: Choice of operation
Authors: Eggleston Forrest C , Santoshi Bannu 
Published: March 2007

Summary
Over a 17-year period 93 patients have been treated for typhoid perforation of the bowel. Forty-three of these have been treated by closure of the perforation, and 42 by end-to-side ileotransverse colostomy. These two groups are compared. Although there was no difference in mortality, postoperative morbidity in survivors was less in those having an end-to-side ileotransverse colostomy. End-to-side ileotransverse colostomy is a logical operation based upon the pathological changes in the bowel produced by typhoid fever and is the operation of choice.
Superior mesenteric venous thrombosis
Authors: Carr Nick , Jamison Michael H 
Published: March 2007

Summary
Superior mesenteric venous occlusion may be difficult to recognize, but is important as it carries a better prognosis than superior mesenteric arterial occlusion, and may be amenable to surgical treatment. Three cases of primary superior mesenteric venous occlusion are described. The diagnosis was unsuspected until discovered at laparotomy. Non-viable bowel was present in all cases and in two cases thrombosed veins were apparent in the mesentery. The lesion was localized in distribution, and generous bowel resection with primary anastomosis was performed. Recovery was uncomplicated in all cases. When the thrombosis appears well localized, generous resection with primary anastomosis seems a suitable alternative to resection and exteriorization or conservative treatment with a second-look procedure.
Circulating immune complexes in patients with benign and malignant colorectal tumours
Authors: Vellacott K D , Baldwin R W , Balfour T W , Hardcastle J D 
Published: March 2007

Summary
Circulating immune complexes were measured using a modified C1q binding assay in 100 preoperative patients with colorectal cancer and in 52 patients with benign polyps. Sixty-one per cent of the patients with cancer and 49 per cent of the patients with benign polyps had elevated levels, as did 92 per cent of those with malignant polyps. There was no relation to a, the stage of the disease, with 10 out of 13 Dukes' A tumours (77 per cent) having increased levels; b, the degree of differentiation of the cancers; c, the tumour mass. However, cancers on the right side of the colon had significantly higher levels than rectal cancers.
Anaerobic paronychia
Authors: Whitehead Stephen M , Eykyn Susannah J , Phillips Ian 
Published: March 2007

Summary
During 1 year 116 patients with paronychia had bacteriological cultures of the pus. Aerobic bacteria, predominantly Staphylococcus aureus were isolated from 81. Anaerobic bacteria were isolated from 35, and in 31 of these aerobes were also present. Anaerobic paronychias were less acute than those caused by aerobes but otherwise the clinical features and management were the same. The anaerobes isolated were those found as oro-pharyngeal commensals and did not include the colonic commensal Bacteroides fragilis. They were, with few exceptions, sensitive to penicillin.
High bile duct cancer: Incidence and pattern of investigation in the general hospital setting
Authors: Peel A L G , Dillon E , Dellipiani A W 
Published: March 2007

Summary
Between 1 April 1977 and 30 November 1979, 16 cases of high bile duct carcinoma presented at North Tees District Hospital, giving an incidence of one per 40 000 population per annum for Teesside. Results of this prospective study emphasize the potential accuracy of preoperative assessment using techniques which should be available in a district general hospital. Ultrasound revealed the site of obstruction in every patient in whom it was used (n = 13), and often indicated a neoplastic aetiology (n = 10). Percutaneous transhepatic cholangiography (PTC) and endoscopic retrograde cholangiography (ERC) correctly demonstrated the site of obstruction in each patient and suggested a primary bile duct carcinoma in 12 patients. Although intraoperative cholangiography gave additional information in some patients, it was not sufficiently reliable to dispense with either PTC or ERC.
Histological proof of a primary bile duct carcinoma was obtained in 15 patients. In the 10 patients without obvious metastatic disease frozen section analysis was positive in 7, but was negative in 3 patients with multiple strictures where malignant cells were relatively infrequent and were found in the perineural lymphatics on paraffin sections.
In this difficult group of patients the approach described eliminates the possibility of a false negative laparotomy, enables careful planning of the necessary surgical technique and also the consideration of nonoperative management.
The surgical treatment of enteritis necroticans
Authors: Millar John S 
Published: March 2007

Summary
The optimum timing of surgery in acute cases of enteritis necroticans with bowel obstruction has not been established. Two similar groups of patients with this condition were sequentially compared to determine if early surgical intervention reduces mortality. In the first group 42 per cent of the 79 patients received medical treatment only and 58 per cent had an operation at a median time of 4 days following the onset of obstruction. In the second group 96 per cent of the 50 patients received surgery at a median time of 2 days following the onset of obstruction and 4 per cent received medical treatment only. The mortality in the second group (21 per cent) was half that of the first group (43 per cent). Surgery after a short period of resuscitation is advocated for all cases of enteritis necroticans with bowel obstruction.
The surgical treatment of the radiation-damaged rectum
Authors: Cooke S A R , De Moor N G 
Published: March 2007

Summary
Details are given of 37 consecutive patients with radiation damage to the rectum. Twenty-eight presented with rectovaginal fistulas, 3 with haemorrhage from ulcerative proctitis, 3 with low rectal strictures, 2 with a painful rectal ulcer and 1 with a rectal carcinoma. Thirty-five of the 37 had been treated for carcinoma of the cervix, and of these, 30 were Black South African women in whom this disease forms approximately 70 per cent of all malignancies. Associated pathology in these patients included urinary fistulas, small bowel fistulas or stenoses and a variable degree of fibrosis of the pelvic cellular tissue.
Treatment involved subtotal rectal resection with restoration of continuity by means of a peranal sleeve anastomosis between healthy colon and the rectal stump denuded of its mucosa. Technical success was achieved in 35 of the 37 patients, with no mortality. The functional results were assessed both subjectively and objectively in 31 patients followed up for more than 6 months. Full continence was achieved in 54 per cent initially, improving to 75 per cent (21 of 28) at 1 year postoperatively. At 1 year, variable degrees of incontinence for a liquid stool persisted in 7 of 9 patients who had low fistulas with a low anastomosis at dentate line level. Where anastomosis was possible at a higher level, all 19 patients cured of fistula, ulcer, stenosis or haemorrhagic proctitis were fully continent at 1 year.
Kimura's disease with salivary gland involvement
Authors: Tham Kyi-Toe , Leung Ping-Chung , Saw Daisy , Gwi Elaine 
Published: March 2007

Summary
Fourteen cases of Kimura's disease involving parotid and submandibular glands in Chinese patients are described to draw attention to this unique lesion which has been reported mainly in the Chinese and Japanese literature. Blood eosinophilia is almost always present, there is a male preponderance and the aetiology is unknown. Surgical excision is recommended though irradiation and steroid therapy have also been used.
High colloidal uptake in axillary nodes with metastatic disease
Authors: Peyton J W R , Crosbie J , Bell T K , Roy A D , Odling-Smee William 
Published: March 2007

Summary
Axillary lymphoscintigraphy using 99Tcm antimony sulphide colloid has been carried out in 29 patients with suspected breast cancer and was correlated with histology. Of the 23 with proved tumour, axillary node metastases were found in 19 and, although 10 did have diminished uptake on the side of the lesion, 5 had an equal uptake in both sides and 4 had an increased uptake on the side of the lesion. Further, some of the nodes in which the high uptake had occurred were those heavily infiltrated by tumour. It is concluded that: a, lymphoscintigraphy with antimony sulphide colloid is not a reliable technique for the detection of metastatic disease in the regional nodes; b, any lymphoscintigraphy with this or any other agent requires more meticulous histological correlation than hitherto before it can be assumed to have any proved clinical value.
Anal fistulas in Crohn's disease
Authors: Marks C G , Ritchie Jean K , Lockhart-Mummery H E 
Published: March 2007

Summary
Anal fistulas were recorded in 112 patients out of a series of 329 patients with Crohn's disease admitted to St Mark's Hospital for the first time between 1965 and 1974. Only 13 of the 112 patients had small bowel disease alone. The remainder all had involvement of some part of the large bowel. There were 125 fistulas in the 112 patients. No treatment was attempted for 47 fistulas (38 per cent). Most patients had low fistulas which were treated by conventional techniques and healed successfully. Limited surgery was often successful in curing the symptoms of patients with more difficult fistulas. Anal lesions were the major reason for surgery in only a third of the patients who finally underwent excision of the rectum.
Physiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse
Authors: Neill Mischel E , Parks Alan G , Swash Michael 
Published: March 2007

Summary
The clinical, anorectal manometric and electrophysiological findings in 24 patients with faecal incontinence, 10 of whom also had rectal prolapse, and in 8 patients with rectal prolapse without incontinence, are reported. Single fibre electromyographic studies and anal reflex latencies were abnormal, indicating damage to the innervation of the pelvic floor musculature, in all the patients with faecal incontinence, with or without rectal prolapse. These studies were normal in 7 of the 8 patients in whom rectal prolapse occurred without incontinence. These investigations imply that denervation of the sphincter musculature can be recognized by electrophysiological tests in most patients with primary faecal incontinence and that the pathogenesis of rectal prolapse differed in the two groups of patients.
Integrity of low colorectal EEA-stapled anastomosis
Authors: Kirwan W O 
Published: March 2007

Summary
Anastomotic integrity after a low colorectal EEA-stapled anastomosis performed for cancer was assessed by a contrast enema in 30 patients. There was an overall 20 per cent radiological anastomotic leakage rate. The leakage rate in the last 10 cases, however, was zero. This indicates that increased familiarity with the technique results in fewer complications.
Colonic mucosal—submucosal blood flow and the incidence of faecal fistula formation following colostomy closure
Authors: Forrester Donald W , Spence Vance A , Walker William F 
Published: March 2007

Summary
Fistula formation following closure of a colostomy occurs most frequently when closure is carried out within the first few weeks of construction and may be related to an impaired local microcirculation. Using a recently described method for measuring colonic mucosal—submucosal blood flow, the variations in local flow which occur during the first month after colostomy construction were determined in 8 patients. Mean blood flow increased from 6·9±1·8ml min−1 100g−1 (s.d.) at 7 days to 31·1±12·5ml min−1 100g−1 (s.d.) at 28 days. In a further 40 consecutive patients undergoing colostomy closure, blood flow measurements were made before operation. Eight patients developed a faecal fistula, and in 5 of these patients mucosal—submucosal blood flow was found to be less than 15ml min−1 100g−1. In every successful colostomy closure blood flow was greater than 15ml mi−1 100g−1. This study provides evidence that a subnormal blood flow is one of the factors associated with fistula formation following the operation of colostomy closure.
The Kock ileostomy reservoir: An experimental study of methods of improving valve stability and competence
Authors: Cranley Brian , McKelvey S T D 
Published: March 2007

Summary
The performances of four valve designs which have been used in clinical practice in the Kock continent ileostomy reservoir were examined and compared to four further modifications in an experimental study on dogs. It was found that a stable valve could be consistently produced by subjecting the gut, which forms the valve, to deep seromuscular diathermy and by excluding the mesentery completely from the intussusception. Construction of the valve with the autosuture GIA Stapling device shortened the operating time considerably but did not improve on valvular stability.
A trial of total gastrectomy, combined with total thoracic oesophagectomy without formal thoracotomy, for carcinoma at or near the cardia of the stomach
Authors: Kirk R M 
Published: March 2007

Summary
There is a high incidence of residual tumour in the cut ends following orthodox resections for gastric adenocarcinoma and oesophageal squamous carcinoma at or near the cardia. In the hope of preventing the tragic recurrence of malignant dysphagia in patients who have survived a high-risk operation for its relief, the whole stomach and thoracic oesophagus were resected in 6 patients, establishing continuity using jejunum or colon, with anastomosis in the neck. Of 6 patients, 5 survived the operation. Of 2 followed up for more than 1 year, 1 has survived 5·5 years without recurrence, 1 died after 1 year with no post-mortem evidence of recurrence. This radical operation merits an extended trial in suitable patients.
Ventilatory capacity after three methods of anaesthesia for inguinal hernia repair: A randomized controlled trial
Authors: Godfrey P J , Greenan J , Ranasinghe D D , Shabestary S M , Pollock A V 
Published: March 2007

Summary
One hundred consecutive male patients undergoing elective inguinal herniorrhaphy were randomized to receive general, epidural or local anaesthesia, and the patterns of ventilation were studied before and after operation. General anaesthesia caused more depression of FEV1 and FVC than the other two methods, but no important arterial hypoxia or clinical chest complications ensued. One patient suffered minor staphylococcal wound infection, and one died of massive pulmonary embolism on the eleventh day.
A randomized trial to assess childhood circumcision with the Plastibell device compared to a conventional dissection technique
Authors: Fraser Ian A , Allen Michael J , Bagshaw Philip F , Johnstone Michael 
Published: March 2007

Summary
A randomized trial of routine circumcision in children using the Plastibell device is described and compared to a dissection suturing technique. One hundred children were studied with a mean age of 4·7 years. The device was applicable to all boys up to the age of 8, and a few older. General discomfort was carefully assessed and slightly less common after Plastibell circumcision, but dysuria more so. No serious complication was encountered with either method; infection was slightly more common after the conventional procedure. Cosmetic results were similar for both methods. It is concluded that the Plastibell device is a satisfactory method for circumcising children of this age.
Subclavian arteriopathy in the young patient
Authors: Drury J K , Pollock J G 
Published: March 2007

Summary
Non-atheromatous stenosis of the subclavian artery is rare. A 10-year experience, comprising 5 cases of non-infective arteritis and 1 of fibromuscular dysplasia, in patients of average age 29 years, is described. The literature is reviewed and the possible aetiology discussed. Acceptable functional results were obtained using extra-anatomical procedures such as carotid subclavian and carotid axillary bypass. There was no appreciable morbidity.
Delayed primary wound closure in gangrenous and perforated appendicitis
Authors: Pettigrew Ross A 
Published: March 2007

Summary
A prospective randomized trial was performed on 122 patients with perforated or gangrenous appendicitis to determine whether delayed primary wound closure lowered morbidity from wound infection. The 54 per cent wound infection rate with delayed primary closure was significantly inferior to the 18 per cent infection rate for primary closure with topical ampicillin powder (P = 0.0082), but not significantly different from the 37 per cent infection rate for primary closure alone. Furthermore, patients disliked delayed primary closure, their hospital stay was prolonged and 17 per cent of their wounds became contaminated with Staphylococci before being closed. Delayed primary wound closure should not be used in treating perforated and gangrenous appendicitis wounds.
Intussusception: Analysis of 98 cases
Authors: Raudkivi Peter J , Smith H Lawrence M 
Published: March 2007

Summary
A retrospective study of the clinical features and surgical management of 98 cases of paediatric intussusception treated in New Zealand during the past 16 years is presented. The classic triad of vomiting, rectal bleeding and abdominal pain occurred in only 20 per cent of patients. Barium enema examination was used in 67 patients but successful reduction was achieved in only 13. Laparotomy was performed in 85 patients with 1 operative death. Gangrenous bowel was found in 17 patients and 24 required bowel resection with no associated mortality. This high rate of bowel resection appears to be related to the long duration of symptoms before the diagnosis was established. It is concluded that earlier diagnosis is the single factor most likely to reduce morbidity.
Long term effects of arterialization of the portal vein stump in dogs with Eck's fistula
Authors: Aldrete Joaquin S , Soyer M Tanju , Han Sang Y 
Published: March 2007

Summary
This study investigates the possibility of avoiding the sequelae of Eck's fistula in dogs by preserving the hepatic blood flow with an autologous vein graft inserted between the infrarenal aorta and the transected stump of the portal vein at its entrance into the liver. Ten dogs with such experimental preparation were observed for signs of encephalopathy; the patency of the grafts was assessed by periodic arteriograms.
The signs of encephalopathy and general deterioration usually observed in dogs with Eck's fistula were prevented; however, marked dilatation of the intrahepatic branches of the portal vein leading sometimes to spontaneous rupture of the liver or to thrombosis of the venous graft was observed. Thus, this technique does not appear to be a satisfactory long term solution for preventing the deleterious effects of Eck's fistula in dogs.
A scanning electron microscopy study of ultrastructural changes in the colonic mucosa of patients with large bowel tumours
Authors: Traynor O J , Costa N L , Blumgart L H , Wood C B 
Published: March 2007

Summary
Scanning electron microscopy (SEM) has been used to compare the appearances of the colonic mucosal surface and overlying mucus layer of patients with normal colons, adenomatous polyps and colorectal carcinoma. The normal colonic mucosa had a characteristic orderly arrangement of crypts and was completely covered by an intact mucus layer. Epithelial and cryptal irregularities were seen on the surface of both polyps and carcinomas, and, in addition, the mucus layer was fragmented, leaving areas of the underlying epithelium exposed. These changes were more marked in colorectal cancers than in polyps and were present to a lesser degree in the apparently normal mucosa adjacent to tumours. The findings indicate that SEM can detect minor subtle irregularities on the surface of the colon and so may be useful in detecting pre-neoplastic and early neoplastic changes.