bluuebunny/crossref_metadata_2025_split huggingface dataset:
Revagotomy for recurrent peptic ulceration
Authors: Taylor T V , Pearson K W , Torrance Bruce 
Published: March 2007

Abstract
A review has been made of 59 patients with recurrent peptic ulceration after incomplete vagotomy. Eighteen transthoracic procedures were performed, the remainder having abdominal revagotomy. An antrectomy was also carried out in 10 of these patients. An intact posterior nerve trunk was the most common operative finding and when either an anterior trunk or nerve strands only were present there was less likely to be an early positive insulin response (P = 0·033). Following incomplete vagotomy a longer period of symptomatic relief is obtained when gastro-enterostomy rather than pyloroplasty is used as the drainage (P &lt; 0·01). Completing the vagotomy by the abdominal route gave superior results to transthoracic revagotomy (P = 0·0015), the former procedure without antrectomy having no associated mortality in this series. Although the results of revagotomy and antrectomy are as good as those of transabdominal revagotomy alone, we recommend the latter more conservative treatment for recurrent ulceration after incomplete vagotomy.
Haemobilia: A report of 2 cases
Authors: Jansen W B J , Volder J G R 
Published: March 2007

Abstract
Although rare, haemobilia should be included in the differential diagnosis of obscure gastro-intestinal bleeding, particularly when accompanied by colic and jaundice. Case histories of 2 patients with haemobilia of different origin are presented. One had traumatic haemobilia after suture of a liver rupture; in the other patient an aneurysm of a branch of the right hepatic artery ruptured into the hepatic duct. The first patient recovered spontaneously; the second required ligation of the affected blood vessel. Diagnosis and treatment of the haemobilia syndrome are discussed, with reference to the liver blood supply.
Cryoprecipitated plasma perfusion preservation and cold storage preservation of duct-ligated pancreatic allografts
Authors: de Gruyl J , Westbroek D L , MacDicken I , Ridderhof E , Verschoor L , van Strik R 
Published: March 2007

Abstract
It has been shown previously that, at least in dogs, a vascularized pancreatic allograft with ligation of the pancreatic duct can maintain normal beta-cell function for at least 5 years. In this study common organ preservation techniques, as used in human cadaveric kidney transplantation, were applied to canine pancreatic allografts to determine the influence of 24-hour preservation on beta-cell function, graft survival and histological appearances.
Three groups of dogs were compared: group A consisted of 9 dogs with fresh grafts; group B consisted of 5 dogs who received grafts preserved for 24 hours by pulsatile hypothermic cryoprecipitated plasma perfusion; and group C was composed of 5 animals who received grafts that had been flushed with Collins' solution followed by hypothermic storage for 24 hours.
It appeared that both preservation methods were equally effective and that preservation did not alter either the graft's function or its histological appearance. No significant differences after transplantation were observed in the endocrine function tests of the three groups when compared with the preoperative values; neither was there a significant difference in the mean graft survival time between the groups.
The Erlangen magnetic colostomy control device: Technique of use and results in 22 patients
Authors: Goligher J C , Lee P W R , McMahon M J , Pollard Muriel 
Published: March 2007

Abstract
The evolution and general principle of the Erlangen magnetic ring colostomy device are described and its practical use illustrated by reference to a personal series of 22 patients treated with the device. Analysis of the functional results obtained in 13 of these cases, who were assessed after at least 3 months' trial, shows that only 3, or at most 4, could be considered to have achieved worth-while continence, but there are grounds for believing that these results might be improved a little by more stringent selection of patients for the procedure and by employing a more meticulous technique for implanting the rings.
Deep venous thrombosis in patients having aorto-iliac reconstruction
Authors: Angelides N S , Nicolaides A N , Fernandes J , Gordon-Smith I , Bowers Rosemary , Lewis J D 
Published: March 2007

Abstract
The 125I-labelled fibrinogen test has been used to assess the incidence of deep venous thrombosis in 88 patients who had undergone elective aorto-iliac reconstruction. Deep venous thrombosis was detected in 18 (20·5 per cent). The results suggest that these patients merit prophylaxis.
Computer-aided diagnosis of lower abdominal pain in women
Authors: Walmsley G L , Wilson D H , Gunn A A , Jenkins D , Horrocks Jane C , de Dombal F T 
Published: March 2007

Abstract
This paper describes the use of a system of computeraided diagnosis in an unselected, prospective survey of 393 women suffering from lower abdominal pain of less than 1 week's duration. An accurate diagnosis was made by clinicians at first patient contact in 68·5 per cent of the group of patients. The computer's diagnostic prediction (based on the same data) matched the final diagnosis in 81·6 per cent of the patients. During this survey a marked improvement in diagnostic accuracy was observed amongst the junior clinicians. It is suggested that this is because of the discipline of data collection imposed and the intermittent feedback received, and also that this educational aspect of computer usage may be of wider benefit.
Successful treatment of early cancer of the liver and portal hypertension in patients presenting with bleeding oesophageal varices
Authors: Kobayashi Michio , Inokuchi Kiyoshi , Nagasue Naofumi , Saku Motonori , Iwaki Atsushi 
Published: March 2007

Abstract
A small hepatoma was diagnosed by selective arteriography in 2 patients admitted for treatment of bleeding oesophageal varices. In both cases, hepatoma and variceal lesions were successfully treated. In the first case, left gastric vena caval shunt and local excision of the hepatoma were performed. In the second case, distal splenorenal shunt and local excision of the tumour were carried out. Although a combination of hepatoma and oesophageal varices may be an embarrassing problem, both lesions can be remedied provided that hepatoma is diagnosed at an early stage. It is stressed that arteriography is of value in assessment.
In vitro studies of gallstone dissolution using bile salt solutions and heparinized saline
Authors: Hardie I R , Green M K , Burnett W , Walland D R , Hall-Brown A 
Published: March 2007

Abstract
A controlled in vitro study of gallstone dissolution has been carried out using a model designed to simulate the in vivo situation in the bile ducts. Sodium taurocholate, sodium cholate, heparinized saline and physiological saline were infused for 10 days over 81 stones from 32 patients and changes in weight and structure were recorded. The bile salt solutions caused weight loss in 81·5 and 85·7 per cent respectively of the stones treated, but the two saline solutions caused weight gains in 74·5 and 88 per cent respectively. Fragmentation occurred in 18·5 per cent of stones treated with sodium taurocholate, in 25 per cent of those treated with sodium cholate and in 11·8 per cent of those treated with heparinized saline. Small stones lost a lower absolute amount of weight than large stones but this represented a greater proportion of their initial weight.
These investigations confirm the advantages of a dynamic in vitro model to study gallstone dissolution. Bile salt solutions infused into the bile ducts may clear retained stones by causing reduction in stone weight or fragmentation or both, but heparinized saline appears to be unsuitable for gallstone dissolution. Larger stones may require longer periods of infusion.
Nipple retraction in duct ectasia
Authors: Rees B I , Gravelle I H , Hughes L E 
Published: March 2007

Abstract
Thirty patients with nipple retraction associated with duct ectasia have been studied to determine the clinical features of this condition. This association is a common one and the similarity of these nipple changes to those produced by cancer is emphasized. While clinical evaluation of the nipple changes may give an indication of the diagnosis, it is by no means absolute and mammography is advocated in all cases. Combined clinical and mammographic assessment will allow confident differentiation of the two causes in many cases, and a policy for management of nipple retraction is presented.
Congenital oesophagobronchial fistula in the adult
Authors: Salepcioglu A , Cebeci H , Saner H , Akcal T 
Published: March 2007

Abstract
A case of congenital oesophagobronchial fistula presenting in adult life without the more usual accompanying pulmonary infection is presented. The clinical, radiographic, morbid anatomical and histological features of this lesion are discussed.
Where is your vagotomy incomplete? Observations on operative technique
Authors: Johnson A G , Baxter H K 
Published: March 2007

Abstract
There is a trend in gastric surgery towards more selective types of vagotomy but the techniques are more difficult and incomplete nerve section may be more likely. Using the Grassi intra-operative test of mucosal pH, we have studied 50 consecutive patients, 13 having truncal vagotomy, 9 having bilateral selective vagotomy and 28 having proximal gastric vagotomy. We have identified four distinct areas of the stomach where nerve fibres are likely to be left. Three of these can usually be eliminated by careful attention to technique, but the fourth—the distal extent of the parietal cell mass—can only be identified by a precise intra-operative test; this is relevant to proximal gastric vagotomy but not to truncal vagotomy. Unexpected anatomical variations of the vagus nerve branches were found in 8 patients. A precise intra-operative test of residual innervation is particularly helpful in establishing the technique of proximal gastric vagotomy.
The clinical significance of pneumatosis cystoides intestinalis: A report of 5 cases
Authors: Thomson W O , Gillespie G , Blumgart L H 
Published: March 2007

Abstract
Pneumatosis cystoides intestinalis is an uncommon condition characterized by the presence of gas within the wall of the bowel. In most cases the clinical course is benign and may well be self-limiting, while in others the appearance of pneumatosis may indicate the presence of bowel ischaemia and necessitate emergency laparotomy. This paper describes 5 cases which demonstrate some of the difficulties in diagnosis and management and the improvement which can result from clinical awareness of the condition.
The effect of the surgical approach on respiratory function after oesophageal resection
Authors: Black J , Kalloor G J , Collis J Leigh 
Published: March 2007

Abstract
Respiratory function has been studied in 32 consecutive patients having oesophageal resection to determine the overall pattern and to compare the effect on it of two standard surgical approaches. Eighteen patients had a left thoraco-laparotomy and 14 a laparotomy and separate right thoracotomy.
The two groups were similar in age, sex, chest symptoms and smoking habits. The average operative time and amount of blood transfused were almost identical.
Arterial PO2 and PCO2 were determined before surgery and on the first and third postoperative days. Spirometry was done preoperatively and on the thirteenth day after operation.
Before operation respiratory function was similar in the two groups. On the first postoperative day both groups showed a pronounced fall in arterial PO2, with partial recovery on the third day. This recovery was significantly greater in the double incision group (t = 2·64, P &lt; 0·02). Mean PCO2 levels altered less markedly, there being a small rise on the first day, with a fall to below normal on the third. There was no difference between the groups in PCO2. Vital capacity and I-second expiratory volume were reduced on the thirteenth day in both groups, but without a significant difference between the groups.
Two patients died of pulmonary embolism, but the others recovered satisfactorily. It is concluded that: There is pronounced hypoxaemia in the first few days after oesophageal resection in the majority of patients. This is consistent with a satisfactory clinical state.The double incision laparotomy and right thoracotomy approach affects respiratory function less than left thoraco-laparotomy. When technically feasible it may be preferable in patients with respiratory impairment.
The ultrasound diagnosis of rectus sheath haematoma
Authors: Lee P W R , Bark M , Macfie J , Pratt D 
Published: March 2007

Abstract
Three cases of rectus sheath haematoma are presented in which the diagnosis was confirmed by the use of ultrasound. The aetiology and diagnosis of the disease are discussed and the use of ultrasonography in a disease with a previously low preoperative diagnostic rate is emphasized.
The pacemaker-twiddler's syndrome: Another disadvantage of abdominal implantation of pulse generators
Authors: Guharay B N , Ghose J C , Majumdar H , Basu A K 
Published: March 2007

Abstract
Breakage of a pacer lead due to the pacemaker-twiddler's syndrome (PTS) occurred in 4 of 62 survivors following epicardial–intramural pacer lead implantation with the pulse generator placed in each case in a subcostal left upper quadrant subcutaneous pocket. The abdominal pulse generator pocket appears to invite spontaneously occurring PTS, more so in a pregnant woman. The important predisposing factor to the development of PTS is an excessively spacious pulse generator pocket containing a pool of fluid. Addition of a few simple modifications to the technique of cardiac pacing would prevent the complication; these include implantation of the pulse generator in a plane deeper to the pectoral muscles, suspending the pulse generator from the clavicle and application of vacuum-suction drainage to the generator pocket in the initial phase of wound healing. In the presence of an optimally fitting pulse generator pocket, PTS should be rare with subclavicular subpectoral pulse generator implantation without active patient participation. The syndrome may not be as rare a cause of pacer lead malfunction as may appear from the relative paucity of reports in the literature.
A new interpretation of the insulin test validated and then compared with the Burge test
Authors: Maybury N K , Russell R C G , Faber R G , Hobsley M 
Published: March 2007

Abstract
A prospective study of 40 patients undergoing proximal gastric vagotomy confirmed the validity of a new interpretation of the insulin test in the early post-operative period (Maybury et al., 1977). Of the 30 patients falling into the group expected to be free from recurrent ulceration (low risk group), none had developed symptoms suggestive of this condition, whilst of the 10 in the contrasting high risk group, 6 have already developed proved recurrences (mean follow-up period 26 months).
A further group of 24 patients was studied by performing a peroperative Burge test for completeness of vagotomy and comparing these results with a postoperative insulin test. This study showed that the Burge test, properly performed, is a reliable test of the adequacy of vagotomy. The use of this test has led to a better understanding of the operative technique required to achieve the objective of an adequate vagotomy.
The role of plastic wound drapes in the prevention of wound infection following abdominal surgery
Authors: Psaila J V , Wheeler M H , Crosby D L 
Published: March 2007

Abstract
A randomized controlled trial has been performed to assess the value of plastic wound drapes in the prevention of surgical wound infection. One hundred and forty-four patients undergoing abdominal surgery were allocated to one of three groups; a control group (A) in which standard cloth towels were applied to the abdominal wound, group B in which an adhesive plastic drape was added and group C in which a plastic ring protector was inserted into the wound.
There were 26 cases (18 per cent) of wound infection. The wound infection rate in the plastic drape groups did not differ significantly from that in the control group.
Bacteriological culture from a wound swab taken at operation was positive in 32 per cent of the cases. The presence of a plastic wound drape did not influence the positive culture rate.
In 68 per cent of wounds which became infected the operative swab was positive as compared with 24 per cent in those not developing a wound infection. Thirteen of the 33 patients (39 per cent) with a positive wound swab subsequently developed a wound infection. In 10 of these 13 cases of infection the operative swab permitted an accurate prediction of the organism responsible for the subsequent infection.
Distal lower limb arterial reconstruction with modified allograft saphenous veins
Authors: Sheil A G R , Stephen M S , Brooks A J , Johnson D S , Loewenthal J 
Published: March 2007

Abstract
Cadaveric donor saphenous veins subjected to proteolytic enzymatic digestion, crossbonding and heparin bonding were used for arterial reconstruction in the legs of 13 patients threatened with amputation and without suitable autogenous saphenous veins. Distal anastomoses were to the tibial and peroneal vessels. Twelve patients (92 per cent) were discharged from hospital with functioning grafts; 9 grafts (69 per cent) continue to function 2–16 (average 8) months after operation. Amputation was avoided in 11 patients (85 per cent). Although early results are encouraging, late results are yet to be determined.
Plasma catecholamine concentrations during operation
Authors: Butler M J , Britton B J , Wood W G , Mainwaring-Burton R , Irving M H 
Published: March 2007

Abstract
Plasma catecholamines have been measured before, during and after operation in 40 patients undergoing elective major abdominal surgery and in 12 patients during open heart surgery. Plasma concentrations did not increase during abdominal surgery and showed only small increase during cardiopulmonary bypass. It appears that it is not possible to assess individual intra-operative sympatho-adrenal responses to surgical trauma by measurement of plasma catecholamine concentrations because of the efficiency of catecholamine uptake mechanisms.
Partial hepatectomies with a hand-held laser knife: An experimental study
Authors: Orda R , Wiznitzer T , Goldwasser B , Bubis J J , Levene S , Kaye R M 
Published: March 2007

Abstract
Fifteen mongrel dogs underwent a left lateral non-anatomical partial hepatectomy using a carbon dioxide laser, diathermy or a surgical scalpel. An original prototype of a compact hand-held laser was used and its effects were compared with those of the other two instruments. An improved dry cut surface was achieved by placing a rubber snare proximal to the planned incision. While no significant differences in the blood loss or in the operating time were found among the experimental groups, the laser beam sealed vessels of up to about 6 mm in diameter without any complementary suture ligatures, which were needed in the other groups. Histological studies revealed less tissue trauma in the sections performed by the laser and only slight secondary inflammatory reaction.
Pilonidal sinus: A 5-year appraisal of the Millar–Lord treatment
Authors: Edwards M H 
Published: March 2007

Abstract
One hundred and two patients with a pilonidal sinus treated by minor excision had a life-table of 5-year freedom from recurrence of 89 per cent provided that they attended a dressing clinic until the wound healed. With failure to attend the clinic, the recurrence freedom fell to 57 per cent (P &lt; 0·004). Age, sex, acute abscess, previous excision, presence of hairs and the number of midline pits and lateral abscesses did not significantly influence the result. The method supersedes more extensive procedures, but should be tested against even less traumatic techniques.
A successful repair of a recto-urethral fistula: A case report
Authors: Miller William 
Published: March 2007

Abstract
A case report of a method of repair of a recto-urethral fistula is described. A combined synchronous abdominoperineal approach was used with the patient in the lithotomy–Trendelenburg position. The greater omentum was mobilized and interposed between the repaired rectum and the prostatic urethra. A review of the literature is presented.
A gravimetric plethysmograph and its evaluation in clinical use
Authors: Jackson J R , Matthews Jennifer A 
Published: March 2007

Abstract
A gravimetric plethysmograph, the technique of its use and its evaluation in vascular surgical practice are described. The instrument measures flow by the increase in leg weight (rather than volume) produced by an increase in blood content resulting from venous occlusion. The instrument was found to be convenient to use and satisfactory records were obtained in 88 per cent of patients. Values for flow at rest and during reactive hyperaemia were clearly related to the presence of indications for surgical treatment and were similar to those reported by other workers. It is suggested that a peak hyperaemic flow of greater than 15 g 100 ml−1 min−1 may indicate that there are no indications for surgical treatment. The changes in hyperaemic flow values after treatment were clearly related to the symptomatic improvement resulting from it. It is concluded that the gravimetric plethysmograph is suitable for use in the assessment of patients with obliterative arterial disease of the legs.
The effect of small bowel bypass on diabetes mellitus
Authors: Fielding J W L , Baddeley R M 
Published: March 2007

Abstract
The effect of jejunoileostomy on fasting blood sugar, glucose tolerance, hypoglycaemic therapy and weight reduction has been studied in 13 massively obese diabetic patients.
The average weight reduction was 36'7 per cent of the preoperative body weight. As a result, 12 patients resumed normal fasting blood sugars and 8 showed normal glucose tolerance tests. A significant improvement in the glucose tolerance tests of the remaining 5 patients was seen. None of the patients required long term hypoglycaemic therapy after the small bowel bypass.
Penetrating gunshot wounds of the chest in civilian practice: Experience with 250 consecutive cases
Authors: Oparah Sonny S , Mandal Ashis K 
Published: March 2007

Abstract
Our experience indicates a continued rising incidence of gunshot wounds of the chest in the United States. During the past 4½ years, 250 consecutive cases were treated at the King-Drew Medical Center in Los Angeles. Ninety per cent presented with a haemothorax or haemopneumothorax. Pneumothorax alone was present in only 3 per cent of cases. Twenty per cent had associated intra-abdominal injuries, involving mostly the diaphragm, liver, spleen and the gustrointestinal tract. Eighty per cent were treated with tube thoracostomy and among these there were 2 deaths, neither being related to the chest injury. About 16 per cent underwent thoracotomy with a mortality of 12·8 per cent, all the deaths being caused by severe cardiac wounds. The overall mortality was 2·8 per cent. The complication rate was 5·3 per cent, most complications occurring in patients with associated intra-abdominal and spinal cord injuries. The average period of hospitalization was 6·5 days. The management plan and the indications for the two courses of therapy are discussed.