摘要:

AbstractManometric radiological and neurophysiological measurements of the anal sphincter were carried out in 19 female patients who were incontinent to liquid faeces only, 15 female patients who exhibited incontinence to solid and liquid faeces and 18 normal female controls. Both groups of patients had abnormally obtuse anorectal angulation and perineal descent, a weak and easily inhibited sphincter tone and similar degrees of neuropathy during electromyography. However, patients who were incontinent to solids and liquids exhibited lower squeeze pressures during standard manometry and lower peak pressures during saline infusion than patients who were only incontinent to liquids. These findings suggest that it is the additional weakness of the external sphincter that renders patients incontinent to solids as well as liquids.

ISSN:0007-1323    

DOI:10.1002/bjs.1800710112

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractThe effects of altering the geometry of an end‐to‐side junction were investigated in a hydraulic model. The dimensions of the tubes, pressures and flow rate and the frequency of pulsation were calculated by dimensional analysis, to produce a model which simulated pulsatile flow in small arteries. The ratio between the impedance of the ‘bypass’ and the impedance downstream from the junction was greater than unity when the two tubes forming the junction were of unequal diameter. No increase in downstream impedance was measured when the angle of junction was increased from 45° to 135°. Cine photographs of streamlines at the junction showed that flow passed smoothly through the junction irrespective of angle and that perturbations occurred only during that part of the cycle when flow was reversed. The results indicate that the angle at which a junction is made affects flow. The effect is small and is only seen when the ratio of diameters of the tubes is unity. The ratio of the diameters of the two tubes which make up the junction has the greatest effect on flow through the

ISSN:0007-1323    

DOI:10.1002/bjs.1800710113

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractDoppler maximum frequency wave‐forms recorded from the femoral arteries of 50 patients with arterial disease have been submitted to three methods of objective analysis in an attempt to quantify the degree of proximal narrowing. The methods were compared with direct femoral artery pressure measurements at rest and during hyperaemia. There was marked overlap between the results of both pulsatility index and Laplace transform damping when compared with pressure assessment. Principal component analysis, however, produced significantly better agreement than Laplace transform damping (χ2= 5.8, P<0.02) and in addition was found to be sensitive to the presence or absence of disease in the superficial femoral artery. Principal component analysis appears to be the most powerful method of Doppler wave‐form analysis so far described and may have a place in the non‐invasive assessment of the aorto‐iliac

ISSN:0007-1323    

DOI:10.1002/bjs.1800710114

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractOne hundred and ninety‐five consecutive referrals to the vascular laboratory for carotid artery investigation have been studied. Carotid bruits were assessed by the referring clinician and documented. All patients underwent bilateral imaging and spectrum analysis of the extra‐cranial carotid vessels using a pulsed Doppler ultrasound technique. Eighty‐two were further assessed by X‐ray contrast angiography. Of 390 internal carotids examined by ultrasound, 65 exhibited intraluminal turbulence of which 49 (75 per cent) had a bruit. In 62 (56 per cent) of 111 internal carotids in the series which were said to have a bruit on clinical examination, no turbulence was found; in 15 instances the external carotid vessel was shown as the true source of turbulence and in the remainder the bruits may have been transmitted from the heart. One hundred and fifty‐six vessels were assessed by X‐ray and 55 shown to have significant stenosis; 38 (69 per cent) of these exhibited a bruit. Bruit was often absent at high degrees of stenosis and in occluded vessels.Although a carotid bruit is often a marker of internal carotid intraluminal turbulence and stenosis, this is by no means always so. Cervical bruit may also be due to a diseased external carotid or to sounds transmitted from a more proximal source. Conversely, absence of bruit is a feature not only of normal vessels but of many arteries which are stenosed (especially if this is of high degree)

ISSN:0007-1323    

DOI:10.1002/bjs.1800710115

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractThis paper describes a consecutive series of 215 carotid bifurcation endarterectomies performed by one surgeon for transient ischaemic attacks. One patient died from a pulmonary embolism (0.47 per cent). One patient developed a permanent stroke related to the contralateral hemisphere 3 days after operation (0.47 per cent). Five patients developed a weakness of one arm or hand which had clinically recovered 2 months after operation (2.35 per cent); four patients had a transient weakness of one arm or hand which had recovered in less than 24 h of the operation. There were no serious ocular complications. The incidence of serious permanent complications was therefore 0.94 per cent. The Javid shunt could not be used in only 4 of the 193 operations in which its insertion was attempted. It caused arterial damage in only one patient. The results suggest that the routine use of the shunt was of value and that carotid endarterectomy can be a safe, relatively complication‐free, procedur

ISSN:0007-1323    

DOI:10.1002/bjs.1800710116

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710117

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractA prospective study of thrombo‐embolism after total hip replacement in epidural analgesia was carried out in 116 patients, randomly allocated to dextran 70 or low‐dose heparin combined with dihydroergotamine (HDHE).Amounts of blood loss and transfused bank blood did not differ significantly between dextran 70 and HDHE prophylaxis.There was a lower incidence of femoral deep vein thromboses in patients given dextran prophylaxis as compared with those on HDHE (P<0.05). However, the total frequency of DVT and the frequency of pulmonary embolism did not differ between the two groups. There was no case of fatal pulmonary embolism. The side effects were major bleeding complications in 7 per cent of the HDHE group as compared to none in the dextran group. No anaphylactic reaction was noted from dextran 70 using hapten‐dextran prophy

ISSN:0007-1323    

DOI:10.1002/bjs.1800710118

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710119

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractNinety‐five patients, over the age of 40, having general surgical operations, were randomly allocated to a control and test group. The test group received 5000 units of subcutaneous heparin two hours before operation and then 12‐hourly for seven days. The patients in the control group received the same regimen of isotonic saline. There was a marked variation in the plasma heparin levels from patient to patient, and from day to day in the same patient. There was a significant increase in the incidence of wound haematoma in patients with a plasma heparin level greater than 0.2 units/ml. The results suggest that the increased incidence of wound haematoma previously reported is due to the increase of incidence in patients who have plasma heparin levels greater than 0.2 units

ISSN:0007-1323    

DOI:10.1002/bjs.1800710120

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractDuring a 2‐year period the diagnostic value of99mTc‐labelled‐plasmin test was evaluated in 63 patients admitted with clinical signs of deep vein thrombosis (DVT). In comparison with a conventional phlebography the diagnostic sensitivity and specificity of the plasmin test was 0.97 and 0.55, respectively. The predictive value in positive cases was 0.79 and in negative 0.92. The sensitivity was highest for thrombosis in the calf and popliteal regions, while the specificity was higher for thrombosis in the femoral veins. It is concluded that the99mTc‐labelled‐plasmin test is suitable for DVT‐screening in groups of high‐risk patients and is simple and rapid. In positive cases the DVT diagnosis must be verified by

ISSN:0007-1323    

DOI:10.1002/bjs.1800710121

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY