bluuebunny/crossref_metadata_2025_split huggingface dataset:
Results of proximal gastric vagotomy over 1–5 years in a district general hospital
Authors: Makey D A , Tovey F I , Heald R J , Clark C G 
Published: March 2007

Abstract
One hundred and seventy-three patients underwent proximal gastric vagotomy for duodenal ulceration over a 6-year period. One hundred and fifteen of these have been followed up for 1–5 years. The operative mortality was nil and the result was satisfactory in 91 per cent. The incidence of side effects was small, notably that of dumping being 2.4 per cent and of diarrhoea, 3.6 per cent. Incidence of postoperative heartburn was reduced from 13 per cent to 4 per cent by the introduction of hepatic interposition.
The incidence of recurrent ulceration was 5.1 per cent after an average interval of 2 years and that of new gastric ulceration 2.6 per cent after an average of 4 years. There were no recurrent ulcers in those who had peroperative Burge tests, although secretory studies showed no difference between those tested and those not tested. Most recurrences occurred in the earliest cases operated on before Burge testing was introduced and when only 2 cm of the lower oesophagus were exposed.
Long term follow-up of patients with gastric ulcers treated by vagotomy, pyloroplasty and ulcerectomy
Authors: Cade David , Allan David 
Published: March 2007

Abstract
Vagotomy and pyloroplasty with excision of the ulcer has been performed in a series of 90 patients with benign gastric ulcers. Long term follow-up has shown only 2 patients with recurrent ulceration. Fifty-eight patients with more than 2 years' follow-up attended for personal interview, of whom 96 per cent had a satisfactory result.
Volume infusion in experimental refractory shock
Authors: Smith J A R , Norman J N 
Published: March 2007

Summary
The postulated contribution of primary myocardial failure to the pathogenesis of refractoriness of shock to conventional therapy is in direct contradiction to the widely advocated clinical practice of infusion of large volumes of fluid in shock resuscitation. A standard canine haemorrhagic shock model, in which refractory shock is induced by maintaining an arterial blood pressure of 40 mmHg for 2 h, has been used to assess the effects of volume infusion to maintain a central venous pressure of 0–2 mmHg for a further 2 h and the tolerance of such an infusion by the heart in refractory shock.
Fluid infusion ensured significantly better figures for oxygen balance than in those animals where additiotial fluid was not given, and the volumes required appeared to be well tolerated by the shocked myocardium.
Primary myocardial failure does not appear to be a major aetiological factor in refractory shock, and provided that the usual monitoring parameters are recorded, volume infusion remains a major part of shock resuscitation.
Sequential patterns of haemodynamic and metabolic changes in experimental hypovolaemic shock. II. Responses to reinfusion of shed blood
Authors: Pardy B J , Dudley H A F 
Published: March 2007

Summary
The haemodynamic and metabolic effects which follow the infusion of blood in experimental hypovolaemia have not been studied in detail. The 10 dogs that survived 90 min of hypovolaemia in a study of bleeding (Pardy and Dudley, 1979) were investigated during and shortly after the reinfusion of shed blood using the same techniques.
Data from 9 animals were suitable for analysis. As with bleeding, 6 sequential phases were identifed; reinfusion of blood was completed in the fifth phase. Initial reinfusion was associated with a rapid improvement in haemodynamic and metabolic status, although mean arterial pH fell because carbon dioxide production increased. Maximum metabolically effective tissue perfusion was probably attained in phase II, but haemodynamic improvement continued until phase IV. Arterial pH did not rise above the pre-infusion value until phase V, and this rise was the result of a fall in PaCO2 secondary to a reduction in physiological dead space and an increase in buffering capacity.
Pulmonary artery pressure was superior to systemic artery pressure as a predictor of cardiac output during blood volume restoration. A number of conclusions pertaining to clinical practice are drawn.
The reproducibility of the station pullthrough technique for measuring lower oesophageal sphincter pressure
Authors: Hay D J , Goodall R J R , Temple J G 
Published: March 2007

Summary
The results are presented of two studies of the station pullthrough technique for lower oesophageal manometry. The first part of the work is an assessment of the reproducibility of this technique using both an infused tube system and a system of subminiature, intraluminal strain gauge transducers. The second part of this report describes a study into the effect that the position of the recording hole on the probe may have in relation to the measured pressure for the lower oesophageal sphincter.
Chylothorax following resection of the oesophagus
Authors: Lam K H , Lim S T K , Wong John , Ong G B 
Published: March 2007

Summary
Chylothorax complicating operations on the oesophagus has been reported infrequently; it carries a mortality rate of about 50 per cent. A search of the literature has yielded only 10 cases. This paper reports 4 further cases which occurred among 685 resections of the oesophagus, giving an incidence of 0.6 per cent. The diagnosis should be confirmed with lymphangiography. Treatment should be early exploration and ligation in patients in whom the thoracic duct has been divided at operation. If the duct has been injured during blind dissection a period of conservative treatment is advisable. Parenteral nutrition is a useful adjunctive treatment.
Complications associated with the use of the Celestin tube for benign oesophageal obstruction
Authors: Ranson M B , John H T 
Published: March 2007

Summary
Two cases are described in which disruption of a Celestin tube took place after being lodged in a benign oesophageal stricture for 14 months. One patient presented with apparent acute pancreatitis and the other with a minor gastrointestinal bleed.
Translocating the aberrant right subclavian artery in dysphagia lusoria
Authors: Mok C K , Cheung K L , Kong S M , Ong G B 
Published: March 2007

Summary
A case of dysphagia lusoria with unusual associated symptoms in an adult is presented. The condition was treated by division of the aberrant right subclavian artery at its origin through a median sternotomy and translocating the distal subclavian artery to the aortic arch with an interposition Dacron graft. All the reported techniques of dividing and transposing the aberrant right subclavian artery in dysphagia lusoria are reviewed and discussed.
Gastric carcinoma and previous peptic ulceration
Authors: Ellis D J , Kingston R D , Brookes V S , Waterhouse J A H 
Published: March 2007

Summary
The incidence of patients with gastric carcinoma having had a previously diagnosed or suspected peptic ulcer was noted in two studies. These studies were the West Midlands Gastric Chemotherapy Trial (1974–6) and a retrospective study of patients presenting to the United Birmingham Hospitals with gastric carcinoma during the years 1958–62 and 1968–72.
The incidence of patients found to have had a previous operation for duodenal ulcer or to have post-mortem evidence of one was 6.5 per cent and 5.7 per cent respectively. A radiologically proved duodenal ulcer had been identified in 5.5 per cent and 2.1 per cent respectively and the incidence of previous symptoms suggestive of a duodenal ulcer was 4.0 per cent and 5.2 per cent. These figures indicate the total incidence could be 12.97 – 16.0 per cent, which is much higher than previously reported.
The mean time interval between operation for duodenal ulcer and the development of gastric carcinoma was much longer in patients having had a partial gastrectomy than in patients having had a vagotomy and drainage procedure.
The incidence of previous benign gastric ulcers was 2.5 per cent and 0.9 per cent. Fifty-three per cent of patients having had a previous operation for duodenal ulceration were found to have an unresectable carcinoma, compared with the overall unresectable rate of 35 per cent.
Late revascularization of the lower limb following acute arterial occlusion
Authors: Robbs J V , Baker L W 
Published: March 2007

Summary
Thirty-four patients presenting with signs of grave ischaemia of the lower limb following acute arterial occlusion had revascularization procedures performed. Fifteen of the incidents followed embolism or thrombosis and 19 were due to a traumatic cause.
Limb salvage was achieved in 67 per cent of the non-traumatic group und in 56 per cent of the traumatic group. Severe complications such as crush syndrome and disseminated intravascular coagulation occurred but there were no deaths.
No significant adverse factors with regard to limb prognosis could be defined.
We feel that late revascularization in the absence of major gangrene is worth while provided that facilities for critical postoperative care exist.
Ascaris lumbricoides and perforation of the ileum: A critical review
Authors: Ihekwaba Frank N 
Published: March 2007

Summary
Ileal perforation due to typhoid bacilli is the commonest cause of peritonitis in the Tropics. Perforation due to Ascaris lumbricoides is rare. Three cases of ileal perforation believed to be due to A. lumbricoides are presented and the evidence critically reviewed. It is suggested that signs of heavy infestation with A. lumbricoides make a diagnosis of intestinal perforation more likely in a patient with an acute abdomen.
Thyroid cancer in Kuwait: Review of 117 cases
Authors: El-Ghamrawi K A , Khalifa M S 
Published: March 2007

Summary
One hundred and seventeen patients with thyroid cancer were seen at the Radiotherapy and Isotope Centre, Al-Sabah Hospital, Kuwait, between 1963 and 1974. Thyroid cancer constituted 4.7 per cent of all cancer cases among females and 2.4 per cent among males. Of these carcinomas, 58 per cent were papillary, 25 per cent follicular, 11 per cent anaplastic and 1.7 per cent medullary. Four cases (3.4 per cent) were of malignant lymphoma. The 10-year survival was 74, 96 and 21 per cent for papillary, follicular and anaplastic tumours respectively. The present series confirms the prognostic value of age, sex and histology and shows that node metastasis does not prejudice survival. The study does not show any correlation between the type of operation and survival.
Non-occlusive acute intestinal vascular failure
Authors: Haglund Ulf , Lundgren Ove 
Published: March 2007

Summary
The records of 87 patients with vascular intestinal insufficiency leading to gangrene were analysed in retrospect. In 77 patients the cause of the vascular insufficiency could be determined. In 25 per cent no organic obstruction to blood flow was found in the macroscopic intestinal vessels. The patients with non-occlusive intestinal gangrene showed a tendency to be younger and to have associated cardiac infarction more frequently than those with vessel obstructions. Moreover, non-occlusive intestinal gangrene was found more frequently following a period of systemic arterial hypotension. A history of atrial fibrillation and digitalis therapy was present with equal frequency in both groups of patients.
Based on these cases and on current animal experimental data, it is suggested that the bowel gangrene seen in non-occlusive ischaemia is due to short-circuiting of oxygen at the base of the villi in the villous counter-current exchanger. This mechanism becomes much more effective in hypotension owing to reduced velocity of the villous blood flow. The possibility is emphasized that, with a coexisting atherosclerotic narrowing in the mesenteric vascular tree, cardiovascular disturbances which are themselves not enough to alter central arterial pressure, may none the less induce regional hypotension. Such regional hypotension could lead to villous destruction and initiate a vicious circle which ends in generalized gangrene of the bowel.
Grey-scale ultrasonography and endoscopic pancreatography after pancreatic trauma
Authors: Vallon A G , Lees W R , Cotton P B 
Published: March 2007

Summary
We have recently used grey-scale ultrasonography and endoscopic pancreatography to investigate II patients with symptoms attributed to pancreatic trauma weeks, months or even years earlier. The pancreas was normal in one patient, and another, who presented with pain and jaundice after a car accident, was shown to have cancer of the pancreatic head. The remaining patients all had local lesions due to trauma; ultrasound showed a mass or cyst close to the point of duct obstruction or stenosis shown on pancreatography. Ultrasonography and pancreatography can together provide a precise map with which to plan effective management in patients having suffered pancreatic trauma.
Modified surgical procedures in intestinal tuberculosis
Authors: Pujari B D 
Published: March 2007

Summary
The results of modified surgical procedures in intestinal tuberculosis in 79 patients are presented. Special emphasis is laid on the role of limited ileocaecal resection and ileoplasty. These procedures are safe, quick and easy with preservation of functional portions of the bowel. They are of immense value in emergencies in chronically ill and emaciated patients.
Randomized controlled trial of cefuroxime for established postoperative respiratory infection
Authors: Litchfield J C , Keighley M R B , Myatt I W , Edwards M C 
Published: March 2007

Summary
A randomized controlled trial has investigated the value of cefuroxime (a new antibiotic resistant to β-lactamase) in 80 patients with established postoperative respiratory infection. Although the majority of respiratory isolates were sensitive to cefuroxime, there was no significant advantage in the antibiotic group compared with the controls with respect to duration of fever, radiological abnormality or infected sputum. We conclude that antibiotics me rarely necessary for the majority of patients who develop postoperative respiratory injections.
The use of metronidazole in the preparation of the bowel for surgery
Authors: Taylor S A , Cawdery H M , Smith J 
Published: March 2007

Summary
A randomized trial was carried out in 120 patients undergoing colonic surgery mainly for carcinoma. Sixty-one patients received metronidazole and Thalazole and 59 received Thalazole alone. Sepsis occurred in 8 (13.1 per cent) of the 61 patients who received metronidazole, compared with 29 (49.2 per cent) of 59 patients who received only Thalazole. Of the 8 patients with sepsis who received metronidazole, none had infection due to anaerobic organisms.
Treatment of chronic oesophageal perforations with special reference to an endoscopic method
Authors: Gunning A J , Kingsnorth A 
Published: March 2007

Summary
The endoscopic treatment of chronic oesophageal perforations (more than 18–24 h old) by the application of sodium hydroxide 20 per cent to the edges of the perforation is described. The importance of pleural and mediastinal toilet and the accurate siting of drainage tubes and full expansion of the lung, together with measures for diminishing oral, gastric and bilary secretions from the perforation, are stressed.
Five patients who have been treated by this conservative method are presented and the method compared with the more radical surgery advocated by the majority of other surgeons.
The anatomical basis for gastric mobilization in total oesophagectomy
Authors: Thomas D M , Langford R M , Russell R C G , Le Quesne L P 
Published: March 2007

Summary
Following the injection of suitable media, the arterial tree of 22 post-mortem human stomachs was studied by angiography, or corrosion and micro-dissection. In stomachs infused exclusively by the right gastroepiploic artery, i.e. following ligation of all other gastric vessels on the stomach wall, both methods produced good fundal filling, while demonstrating consistently poor filling of a strip of stomach wall along the lesser curve.
These findings do not support the assertion that in operations involving mobilization and transposition of the stomach the viability of the fundus is critically dependent upon an anastomotic circulation involving the extragastric portion of the left gastric vessels, but rather indicate that these vessels can, if required, be excised with impunity in most patients, provided that there is no extensive atherosclerosis. However, these findings indicate that such a procedure may impair the blood supply of the lesser curve, and they provide an anatomical explanation of the occasional occurrence of necrosis of the lesser curve following proximal gastric vagotomy.
The temporary effect of proximal gastric vagotomy on experimental duodenal ulcers and gastric secretion
Authors: Joffe S N , Bapat R D 
Published: March 2007

Summary
A proximal gastric vagotomy (PGV) prevented experimental duodenal ulcers in rats for only 5 days and thereafter all rats developed duodenal ulceration. In sham-operated rats the mean stimulated gastric acid output was 186 μmol/60 min. Immediately following a PGV there was a significant decrease in gastric juice volume and aridity (P &lt; 0.001) with a fall in the mean stimulated acid output to 12 μmo1/60 min. On the seventh day after vagotomy the stimulated acid output (volume and concentration) significantly increased to 88 μmo1/60 min (P &lt; 0.001). When the dose of gastric secretagogues was reduced by 50 per cent, a PGV on day 0 prevented any changes occurring in the duodenal mucosa, but when repeated at 4 weeks after a PGV the severity of duodenal ulcers in vagotomized rats was greater than in those having had a sham operation (P &lt; 0.05). This transient effect of a PGV on duodenal ulcerogenesis and gastric secretion may be due to recovery of the parietal cell mass.
Vagotomy and pyloroplasty for gastric ulcers
Authors: Eastman M C , Gear M W L 
Published: March 2007

Summary
Eighty patients with benign gastric ulcer treated by vagotomy and pyloroplasty in a district general hospital are reviewed. There were no postoperative deaths in the patients undergoing elective surgery but 8 deaths in those undergoing emergency surgery for massive bleeding (38 per cent). Eighty-three per cent of patients had a result that was classed as good or satisfactory. Recurrent gastric ulceration was found in 8 per cent and a tendency to late asymptomatic ulcer recurrence is identified. Careful long term follow-up, including endoscopic re-examination, is advocated for patients undergoing conservative operations for benign gastric ulcer.
Comparison of brush cytology before or after biopsy for diagnosis of gastric carcinoma
Authors: Keighley M R B , Thompson H , Moore Janet , Hoare A M , Allan R N , Dykes P W 
Published: March 2007

Summary
A randomized trial has compared the results of brush cytology before or after biopsy in patients with solitary gastric lesions. One hundred and eleven carcinomas were identified in 324 patients. False positive histological reports were recorded in 2 patients but there were no false positive cytology results. The cumulative accuracy of biopsy and cytology in patients with carcinoma was 97 per cent, which was significantly better than biopsy alone (83 per cent, P &lt; 0.001) or cytology alone (87 per cent, P &lt; 0.001). The cumulative results of brushing before biopsy were significantly better than results obtained by brushing after biopsy (P &lt; 0.05) and indicate that brush cytology should normally be performed before biopsy.
Complete liver dearterialization and the carcinoid syndrome
Authors: Khoury George A , Divine Terry , Bolt David E 
Published: March 2007

Summary
A variety of surgical procedures are available in the treatment of the carcinoid syndrome, the aim being the destruction of liver secondaries and amelioration of symptoms. Dearterialization of the liver may be considered when liver secondaries are extensive and medical treatment inadequate in controlling symptoms.
The patient reported here had severe symptoms of epigastric pain, anorexia, flushing, diarrhoea and recurrent syncope and was generally deteriorating ropidly. Complete dearterialization of the liver, however, resulted in a dramatic improvement. Now, 2 years later, the patient's hepatic scan, liver function tests and 24-h urine 5-hydroxyindolacetic acid (5-HIAA) are all within normal limits. Destruction of liver secondaries by dearterialization is a relatively simple procedure. Careful attention should be paid to large quantities of pharmacologically active compounds released from the liver during the procedure. Ascites, jaundice and liver cell failure are definite contraindications to surgery.
Hepatic artery aneurysm: A pitfall in biliary surgery
Authors: Hubens A , De Schepper A 
Published: March 2007

Summary
This paper describes a patient operated upon for gallbladder and bile duct stones, who presented with an extrahepatic aneurysm of the main hepatic arterial trunk and with a central intrahepatic haematoma assumed to be caused by the rupture of an intrahepatic aneurysm or by secondary intrahepatic necrosis. Exploration of the bile ducts resulted in haemobilia. The presence of extrahepatic arterial collaterals precluded individualization of the left and right hepatic arteries and subsequent distal arterial ligation or partial hepatectomy. Ligation of the common hepatic artery, although initially successful, was insufficient to avoid a recurrent and fatal haemobilia.
Hypertrophic scarring: Dexon suture in a randomized trial
Authors: Simpson J E P , Ornstein M , Spicer C C , Cox A G 
Published: March 2007

Summary
In a randomized prospective trial of three methods of skin suture an increased incidence of hypertrophic scarring in paramedian and inguinal wounds has been found to be associated with the use of 2/0 Dexon suture subcuticularly. However, the variance associated with the type of suture was less than that associated with the sex of the patient. The patient's opinion of the appearance of the scar was the same for all three suture methods used in skin closure.
Necrotizing sialometaplasia of palate
Authors: Chakravorty Ranes C , Yoneyama Tatsuo , Makooi Cyrus 
Published: March 2007

Summary
A patient with necrotizing sialometaplasia of the hard palate was treated with wide resection on a biopsy diagnosis of carcinoma. The literature on this recently identified entity is reviewed and the characteristic clinical features, histopathology and ultrastructure are summarized. To the best of our knowledge, no ultrastructural study concerning this entity has been previously reported. Unless recognized early, an extensive resection might be done needlessly.
Wound drainage following radical mastectomy: the effect of restriction of shoulder movement
Authors: Flew T J 
Published: March 2007

Summary
A randomized prospective clinical trial has been performed to determine the effect of temporary immobilization of the shoulder on wound drainage followitig radical mastectomy. In 64 patients admitted to the trial the mean volume of drainage was reduced by 40 per cent in those who had shoulder movement restricted for the first 7 days afer operation when compared with the group in whom early arm exercises were encouraged. The mean drainage time was reduced by 29 per cent. Shoulder immobilization did not result in increased shoulder stiffness, although there was an increased incidence of mild lymphoedema of the arm.