bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical treatment of the ‘slipping rib syndrome’
Authors: Copeland G P , MacHin D G , Shennan J M 
Published: March 2007

Abstract
This review seeks to draw attention to the existence of the ‘slipping rib syndrome’ as a not uncommon clinical entity. It is characterized by trunk pain in a radicular distribution, often related to certain movements or activity, but not associated with other visceral symptoms. The diagnosis is a clinical one, with surgical excision of the affected rib and costal cartilage a successful simple treatment for relieving those patients of a severe and persistent pain syndrome.
Wound sepsis after low risk elective cholecystectomy: The effect of cefuroxime
Authors: Morran C G , Thomson G , White A , McNaught W , Smith D C , McArdle C S 
Published: March 2007

Abstract
A prospective randomized double-blind study was performed to assess the value of a single intravenous injection of 1·5 g cefuroxime in the prevention of wound sepsis after low risk elective cholecystectomy. Wound infection developed in 10 of 81 control patients compared with 2 of 79 treated patients (P &lt; 0·05). Wound sepsis occurred more commonly in patients with infected bile or with a positive culture from a closing wound swab. Cefuroxime significantly reduced the isolation of staphylococci but not other organisms from the closing wound swab and also produced a significant reduction in wound infection in patients with sterile bile.
Results of colectomy for severe idiopathic constipation in women (Arbuthnot Lane's disease)
Authors: Preston D M , Hawley P R , Lennard-Jones J E , Todd I P 
Published: March 2007

Abstract
Twenty-one women with slow-transit constipation have been treated by bowel resection. All had a normal barium enema, but an increased colonic transit time. Pathological examination of the resected colons showed no evidence of aganglionosis. Some of the patients were treated by segmental colonic resection, anorectal myectomy, anal stretch or internal sphincterectomy but were not helped. Colectomy with ileorectal or caecorectal anastomosis gave the best results; on balance, ileorectal anastomosis seems preferable. Of sixteen patients who underwent colectomy, ten subsequently had normal bowel function and four were markedly improved. The spontaneous bowel frequency in this group rose from 0·3 ± 0·1 (s.e.m.) to 21·7 ± 8·3 weekly (P &lt; 0·001).
Parathyroid surgery in chronic renal failure: Subtotal parathyroidectomy or autotransplantation?
Authors: Welsh C L , Taylor G W , Cattel W R , Baker L R I 
Published: March 2007

Abstract
In the period 1970–1983, 27 patients with end stage renal failure underwent neck exploration for hyperparathyroidism. In 1977 the operative policy changed from subtotal parathyroidectomy to total parathyroidectomy and autotransplantation. Eight patients underwent subtotal parathyroidectomy while fifteen patients underwent total parathyroidectomy and autotransplantation. All were cured of their symptoms and hypercalcaemia was resolved. There was no significant difference in the requirement for postoperative calcium and vitamin D supplements between the two groups. Recurrent hypercalcaemia developed in one patient who had undergone total parathyroidectomy and autotransplantation. Resolution followed removal of approximately half the transplant. There were four deviations from the operative policy.
Advanced gastric cancer: Experience in Scotland using 5-fluorouracil, adriamycin and mitomycin-C
Authors: Cunningham D , Soukop M , McArdle C S , Carter D C , Smyth J F , Allan S G , Kaye S B , Sangster G , Calman K C , Hutcheon A W , Boyle P 
Published: March 2007

Abstract
Eighty-four patients with advanced gastric cancer treated in four centres in Scotland between June 1980 and December 1982 were reviewed following treatment with 5-fluorouracil, adriamycin and mitomycin-C (FAM). Eighty-one patients were evaluable. Twenty-eight patients (35 per cent) responded (four complete) with a median duration of response of 10·5 months and median survival of 17 months. Ten are still alive. Response was associated with an improvement in performance status. Eight patients (10 per cent) had stable disease with a median survival of 10 months. Forty-five (55 per cent) had progressive disease with a median survival of 4·5 months; one patient remains alive. Analysis of prognostic variables indicated that the presence of hepatic metastases had a negative influence on response to FAM (P &lt;0·001). Treatment was well tolerated on an outpatient basis. FAM offers good palliative therapy in a proportion of patients with this disease, especially those without overt liver metastases.
Surgical excision of first cleft branchial fistulae
Authors: Miller P D , Corcoran M , Hobsley M 
Published: March 2007

Abstract
Three patients were studied who had fistulae in the neck derived from the first branchial cleft. Evidence is presented to show that although these fistulae usually pass superficial to the facial nerve they may also pass deep to one or both main divisions of the nerve. We conclude that a formal superficial conservative parotidectomy with full exposure of the facial nerve is the safest operative course when excising these fistulae.
Lymphomas presenting as lumps in the parotid region
Authors: Watkin G T , MacLennan K A , Hobsley M 
Published: March 2007

Abstract
The clinical and pathological features of 17 patients who had lymphomas of the parotid region are discussed. Although it is in general impossible on clinical grounds to make a pathological diagnosis on clinical examination of a lump in the parotid region, features which are not typically seen in the majority of patients with parotid lumps, but which were present in 11 (65 per cent) of those patients, are emphasized. Multiple ipsilateral and bilateral lumps were seen in 30 per cent of our patients with lymphomas of the parotid region. However, these are statistically more likely to indicate the benign adenolymphoma. Palpable lymph nodes were seen in association with the parotid mass in 53 per cent of our patients. Whereas a clinical diagnosis cannot be established simply by the presence of an enlarged lymph node in association with the parotid lump, we suggest that the probability of the lump being a lymphoma is sufficient to justify biopsy of the lymph node as a first line of treatment. Biopsy of associated palpable lymph nodes enabled the diagnosis to be made in seven out of eight patients subjected to biopsy, and avoided the necessity for parotidectomy in these patients.
The aetiology and management of acute epididymitis
Authors: Redfern T R , English P J , Baumber C D , McGhie D 
Published: March 2007

Abstract
The aetiology of acute epididymitis presenting to a surgical unit in a District General Hospital is presented. Patients over 45 years old frequently have a coliform urinary tract infection which may be associated with bladder neck obstruction. These patients require treatment with a suitable antibiotic (Co-trimoxazole) and further investigation. This condition occurs more commonly in patients under 45 years old in whom it is not associated with urinary tract infection. We have not demonstrated significant chlamydial infection and in a double blind study the antibiotic Co-trimoxazole did not hasten recovery. In this group the aetiology remains obscure.
Plasma fibronectin and complement in surgical patients
Authors: Chadwick S J D , Mowbray J F , Dudley H A F 
Published: March 2007

Abstract
Plasma fibronectin and a fragment of the third component of complement (C3b) are both opsonins of the reticulo-endothelial system. Twenty patients undergoing uncomplicated gastro-intestinal surgery were studied. There was a significant reduction in plasma fibronectin and total haemolytic complement, but not C3, in the early postoperative period (days 1 to 3). In six surgical patients critically ill with severe sepsis both plasma fibronectin concentrations and C3 concentration were reduced significantly when compared with the early postoperative period of uncomplicated surgery. In addition, in the critically ill patients, direct evidence of complement activation was demonstrated. These studies show a transient reduction of humoral host defence mechanisms following surgery which may be permissive to bacteraemia and complement activation.
Incidence of pre-operative deep venous thrombosis in abdominal surgery
Authors: Rodzynek J J , Damien J , Huberty M , Abramowicz C , Garcez J L , Govaerts J P 
Published: March 2007

Abstract
In order to determine the incidence of pre-operative and postoperative deep venous thrombosis (DVT) in patients not receiving prophylactic anticoagulant therapy, bilateral phlebography was performed in a prospective study pre-operatively and on the 9th postoperative day, in 51 consecutive patients submitted for major abdominal surgery. The presence of a DVT before surgery was demonstrated in 15·7 per cent of the patients. This high frequency confirms objectively the rationale of starting prophylactic anticoagulant therapy before the surgical procedure. Thrombi were demonstrated postoperatively by phlebography in 54·9 per cent of the patients. Thus the true incidence of DVT induced by surgery was 39·2 per cent taking into account the 15·7 per cent pre-operative DVT rate.
Selective variceal decompression in portal vein thrombosis
Authors: Henderson J M , Millikan W J , Galambos J T , Warren W D 
Published: March 2007

Abstract
Thirty-two patients with congenital portal vein thrombosis have been managed for bleeding gastro-oesophageal varices. Fifteen had splenectomy and/or other therapy before referral: nine were managed by endoscopie sclerosis, four by devascularization and two by total shunt; six rebled. Seventeen had their spleen “in situ” at referral and were evaluated for selective shunt: thirteen had distal splenorenal shunts (DSRS)—one transiently rebled despite a patent shunt and one had shunt thrombosis; four had no veins suitable for shunt, and were managed by splenectomy and devascularization, with two rebleeds. Detailed study of seven patients before, and 1 year after DSRS, showed a rise in platelet count, maintenance of hepatocyte function, portal perfusion, liver blood flow and liver size. The spleen showed a significant (P &lt; 0.025) reduction in size with trans-splenic decompression. We conclude that DSRS provides an excellent method for long-term control of bleeding in such patients, without alteration of liver function or haemodynamics. Patients managed by splenectomy and direct ablative procedures have a significantly (P &lt; 0.05) greater risk of rebleeding than patients receiving DSRS.
The surgical factors influencing duodenogastric reflux
Authors: Brough W A , Taylor T V , Torrance H B 
Published: March 2007

Abstract
The surgical factors influencing duodenogastric reflux have been assessed in dog and man using the biliary radiopharmaceutical 99mTc-EHIDA. Cholecystectomy led to a significant increase in the amount of reflux (P &lt; 0.01), but the combination of truncal vagotomy and pyloroplasty in addition to cholecystectomy produced a greater amount of reflux (P &lt; 0.01). In man, cholecystectomy also resulted in a significant increase in the amount of reflux (P &lt; 0.01). In ten control subjects reflux occurred but the amount was small and was not significantly different from the modified highly selective vagotomy group (n = 20). Symptomatic patients after truncal vagotomy and pyloroplasty (n = 16) showed a significant increase in the amount of reflux (P &lt; 0.002) but the combination of vagotomy and pyloroplasty in addition to cholecystectomy (n = 15) demonstrated the greatest amount of reflux (P &lt; 0.002). Similarly the addition of cholecystectomy to highly selective vagotomy (n = 9) showed a significant increase in the amount of reflux (P &lt; 0.02). Reconstruction of the pylorus (n = 8) was not a satisfactory procedure for the prevention of reflux but antrectomy and Roux-en-Y biliary diversion (n = 8) resulted in a significant reduction in the amount of reflux (P &lt; 0.001) and this was associated with clinical improvement.
Faecal occult blood testing in the detection of colorectal cancer
Authors: Elliot M S , Levenstein J H , Wright J P 
Published: March 2007

Abstract
5012 asymptomatic patients over the age of 40 years were asked by their general practitioners to perform a Hemoccult faecal blood test over 3 days. 3422 patients on a normal diet completed the test (a compliance rate of 67 per cent). Ninety-nine patients (3 per cent) had a positive result. Those patients with a positive result then underwent a second Hemoccult test over 6 days on a restricted diet. Thirty-two patients had a positive result on repeat testing (1 per cent). Only those patients who were positive on the second testing were fully investigated (including double contrast barium enema and colonoscopy). Twenty-seven patients on investigation were found to have neoplastic disease (84 per cent). Twelve had invasive carcinomas (nine Dukes' A, two Dukes' B, one Dukes' C) and thirty-seven adenomas were identified and removed at colonoscopy (barium enema missed three carcinomas—all Dukes' A and only identified sixteen of the thirty-seven adenomas, 43 per cent). Those patients found to be negative after the second Hemoccult test are being followed up.
Postmastectomy breast reconstruction with an inflatable prosthesis
Authors: Kissin M W , Kark A E 
Published: March 2007

Abstract
Breast reconstruction was carried out in 38 patients after modified radical mastectomy, using a saline-filled inflatable prosthesis placed in a submuscular pocket. In 79 per cent the reconstructed breast had normal texture without complications. One patient was dissatisfied with the cosmetic result. Marked capsular contraction occurred in two cases (6 per cent) and late deflation in five (14 per cent).
The localization of human breast carcinomas by radiolabelled monoclonal antibodies
Authors: Rainsbury R M 
Published: March 2007

Abstract
Immune-deprived mice bearing HX99 human breast carcinoma xenografts were injected with a radiolabelled monoclonal antibody, LICR-LON-M8 (M8), to investigate the dependence of tumour localization on (i) tumour site and (ii) antibody radiolabel. No significant difference was found in the degree of localization of radio-iodinated M8 in subcutaneous, renal or intracranial xenografts, but a highly significant improvement in HX99 localization by M8 was recorded using an 111indium-DTPA conjugate of the antibody (111In-DTPA-M8), related to its rapid tumour uptake and blood pool clearance. Radioiodinated or 111In-labelled M8 was given to 29 patients with breast cancer, 7 with primary tumours and 22 with metastases. Tumour localization was assessed by (i) examination of surgical specimens and (ii) antibody scans, which were compared with conventional X-rays and 99mTc-methylene diphosphonate (MDP) bone scans. Radiolabelled M8 localized preferentially in all primary tumours (radioactivity tumour: normal breast = 6.2±1.4 [mean±s.e.]). All ten patients with skeletal metastases had positive 111In-DTPA-M8 scans, but the correlation with X-rays and MDP scans showed a regional variation. Radio-iodinated M8 failed to identify metastases in any site. The favourable biodistribution of 111In-DTPA-M8 has led to the clear localization of breast carcinomas in patients and mice. In future such reagents may rationalize the clinical management of breast cancer.
A randomized study of a semisynthetic heparin analogue and heparin in prophylaxis of deep vein thrombosis
Authors: Törngren S , Kettunen K , Lahtinen J , Koppenhagen K , Brücke P , Hartl P , Hutter O , Haller U , Lahnborg G , Forsskåhl B 
Published: March 2007

Abstract
The prophylactic effect of a semisynthetic heparin analogue (SSHA) on deep vein thrombosis was investigated in a prospective double-blind multicentre trial. 440 major general surgical and gynaecological patients were randomized to one of three treatment groups: 50 mg SSHA, 37·5 mg SSHA and 5000 units sodium heparin subcutaneously 12-hourly. Deep venous thrombosis (DVT) was diagnosed with the fibrinogen uptake test and verified with phlebography. Bleeding complications and other side-effects were carefully monitored. There were no significant differences between the three treatment groups of patients in age, sex, type of operation or risk factors. A DVT was diagnosed in 16 patients (12 per cent) in the SSHA 50 mg group, in 21 patients (15 per cent) in the SSHA 37·5 mg group and 21 patients (14 per cent) in the heparin-treated group. No significant differences were found in the number of patients who bled unexpectedly in the postoperative period, required transfusion or developed wound haematomas. Blood loss at operation was similar in all three groups. Three pulmonary emboli were diagnosed by pulmonary scintigraphy, one in each group.
Contrast tomography of the gallbladder wall and ultrasonography in the diagnosis of acute cholecystitis
Authors: Herlin P , Alinder G , Karp W , Holmin T 
Published: March 2007

Abstract
Rapid and reliable diagnostic methods are necessary for regular early surgical intervention in patients with acute cholecystitis. Eighty-three patients with clinical suspicion of acute cholecystitis were investigated with ultrasonography (US) and contrast tomography of the gallbladder wall (CTGW). The diagnosis in each case included in the study was verified either at operation or follow-up cholecystography. The sensitivity and specificity of US were 69 and 100 per cent, respectively. With CTGW the corresponding figures were 73 and 100 per cent. The combined use of these methods resulted in a sensitivity of 89 per cent and a specificity of 100 per cent.
Direct vision brush cytology with colonoscopy: An aid to the accurate diagnosis of colonic strictures
Authors: Mortensen N J McC , Eltringham W K , Mountford R A , Lever J V 
Published: March 2007

Abstract
The accuracy of direct vision brush cytology at colonoscopy was compared with colonoscopic biopsies, colonoscopy alone and radiology in the diagnosis of colonic strictures. There were 82 brushings in 79 patients; 55 had malignant and 24 had benign lesions. Cytology was correct in 66 (81 per cent), and biopsy was less accurate with 53 (68 per cent) correct reports. The combined accuracy of cytology and biopsy was 88 per cent. Whilst an endoscopic diagnosis was usually correct (96 per cent), direct vision brush cytology had an important place in the accurate tissue diagnosis of colonic strictures, particularly those in the rectosigmoid.
Is laparotomy for small bowel obstruction justified in patients with previously treated malignancy?
Authors: Walsh H P J , Schofield P F 
Published: March 2007

Abstract
We report 53 patients who developed small bowel obstruction some time after the treatment of a primary malignant tumour. Previous treatment of the primary tumour in these patients had been by abdominal surgery (22 patients) or pelvic radiotherapy (20 patients) but 11 of the patients had not received previous abdominal surgery or radiotherapy. All the patients had a laparotomy in an attempt to relieve the obstruction. Seventeen patients had a cause for the obstruction other than secondary malignancy. This was noted particularly when the patients had had pelvic radiotherapy, when radiation change of the ileum causing obstruction was common. Thirty-six patients had obstruction due to secondary tumour and it was found possible to overcome the obstruction in all but two of these. The operative mortality in the patients with secondary malignancy was 19 per cent, but 15 patients (42 per cent) survived for more than a year and the median survival was 11 months. It is concluded that a policy of aggressive surgical intervention is desirable in patients who develop small bowel obstruction after previous treatment for malignant disease.
Incidence of synchronous and metachronous colorectal carcinoma
Authors: Cunliffe W J , Hasleton P S , Tweedle D E F , Schofield P F 
Published: March 2007

Abstract
Two hundred and twenty-three patients with colorectal carcinoma were treated consecutively at the University Hospital of South Manchester from May 1976 to January 1981. Twenty-four patients (10·7 per cent) were found to have more than one colorectal carcinoma. In 18 patients this was recognized either immediately or within 6 months of the initial diagnosis—synchronous carcinoma. In the other six cases a second carcinoma was found at a later time—metachronous carcinoma. The incidence of synchronous, and consequently the combined incidence of synchronous and metachronous carcinoma, was higher than previously documented. The anatomical distribution of the multiple carcinomas and the sex incidence in these patients was similar to that seen in patients with a single carcinoma of the large bowel. A high association of adenomatous polypi with multiple large bowel carcinomas was observed. The possibility of more extensive colonic resection in the younger patient with a favourable carcinoma is discussed.
Improving prognosis for malignant melanoma in Britain
Authors: Taylor B A , Hughes L E , Williams G T 
Published: March 2007

Abstract
Analysis of a consecutive series of 225 patients with malignant melanoma in Cardiff has shown a 5 year cumulative survival rate of 73·3 per cent. This survival rate is considerably better than those reported in previous British series, equal to the high rates reported in the past from Australia, and far exceeds that of all common internal malignancies. It is suggested that the improving prognosis is associated with more accurate diagnosis and an increasing incidence of superficial spreading melanoma, a type for which earlier diagnosis might be expected to lead to improved prognosis. These facts provide a basis of optimism for future programmes of public and professional education.
Accessory sphincterotomy (endoscopic and surgical) in patients with pancreas divisum
Authors: Russell R C G , Wong N W , Cotton P B 
Published: March 2007

Abstract
Sixteen patients with the congenital anomaly of pancreas divisum have been treated by enlarging the orifice of the accessory papilla. Attempts to do this at duodenoscopy succeeded in only 5 of 12 patients, and only one had a good clinical result. Sphincteroplasty was performed surgically in seven patients; five had a good or fair result. Most patients with poor results have undergone pancreatic resection. One patient died post-operatively; the remaining 15 divide equally as good (5), fair (5) and poor (5) results at follow-up after periods ranging from 7 months to 5 years. Results appear to be better in patients presenting with recurrent attacks of acute pancreatitis than in those with chronic pain. The preferred management for these patients remains unclear.
A simple screening test for acute pancreatitis
Authors: Holdsworth P J , Mayerf A D , Wilson D H , Flowers M W , McMahon M J 
Published: March 2007

Abstract
A urinary test strip for amylase (Rapignost-Amylase) was compared with plasma amylase assay in samples of urine and plasma collected on the day of admission to hospital from 23 patients with acute pancreatitis and 38 patients with other causes of acute abdominal pain. Plasma amylase was greater than 1200 IU/l in 24 patients (23 with pancreatitis and 1 with a perforated duodenal ulcer) and all were Rapignost-Amylase positive. Twenty-nine of the remaining patients were Rapignost-Amylase negative, but there were eight ‘false positives’ with plasma amylase levels of 86–474 IU/l. The Rapignost-Amylase test is of potential value to screen for clinically occult acute pancreatitis.
Conservative management of post-traumatic parotid fistulae and sialoceles: A prospective study
Authors: Landau R , Stewart M 
Published: March 2007

Abstract
A prospective study of 14 consecutive patients with parotid injuries treated over a 4-month period, is presented. Three patients underwent emergency duct repair and 11 patients, presenting with delayed fistulae or subcutaneous collections of saliva (sialoceles), were treated conservatively with uniform success. Glandular injury closed within an average of 5 days of treatment and ductal leaks within approximately 14 days.