ISSN:0007-1323    

DOI:10.1002/bjs.1800820902

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820903

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820904

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe transjugular intrahepatic portasystemic stent‐shunt (TIPSS) is a side‐to‐side portocaval shunt, performed by interventional radiological methods, linking the hepatic and portal veins through the liver parenchyma with an expandable metal stent. The technique can be performed successfully in over 90 per cent of patients. The procedure‐related mortality rate is about 1 per cent, mainly from intraperitoneal bleeding. The main indications for TIPSS insertion are control of acute variceal bleeding in patients with cirrhosis that is refractory to sclerotherapy and recurrent variceal haemorrhage despite sclerotherapy or band ligation. TIPSS insertion is followed by variceal rebleeding in about 10–20 per cent of cases, encephalopathy in 10–20 per cent, transient deterioration of liver function in 25–35 per cent and subsequent shunt dysfunction over a 6–12‐month period in 15–60 per cent. The final place of TIPSS insertion in the management of portal hypertension is being evaluated in controlled studies, but its use in the treatment of uncontrolled variceal haemor

ISSN:0007-1323    

DOI:10.1002/bjs.1800820905

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820906

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractLocal excision of colorectal tumour may be palliative or curative. Recent advances in minimal access techniques have allowed curative excision to be offered to a wider range of patients. Absolute indications for potentially curative local excision include mobile tumours, T1tumours (assessed by ultrasonography), well or moderately differentiated histology (determined by biopsy) and tumour size less than 3 cm. Relative indications include T2and T3tumours (by ultrasonography), poorly differentiated histology (by biopsy) and tumour size greater than 3 cm depending on patient fitness. The rationale for these recommendations is described in detail.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820907

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractProfessor Keizo Sugimachi, Editor‐in‐Chief ofSurgery Today(The Japanese Journal of Surgery), has selected from the April, May and June 1995 issues of his journal for this quarter's digest. A digest ofBJSfor the same perio written by Mr Colin Johnson, European Editor, appears i the Japanese jour

ISSN:0007-1323    

DOI:10.1002/bjs.1800820908

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractFor this quarter's digest, Dr Denis Castaing ofAnnales de Chirurgie, chooses the best from issues three, four and five of 1995. A reciprocal digest written by our European Editor, Mr Colin Johnson, appears in the French journal.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820909

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractA proportion of patients with faecal incontinence experience debilitating urgency of defaecation and urge incontinence. This study prospectively assessed 56 faecally incontinent patients by means of standard interview, physical examination and anorectal physiology. Patients with urge incontinence, when compared with those without urge incontinence, were symptomatically worse, had had more vaginal deliveries and had more bowel actions each day. Physiological tests included anal manometry, anal electrosensitivity, pudendal nerve terminal motor latency and a standard proctometrogram. The only physiological differences between the groups were a reduction in voluntary squeeze pressure (median (interquartile range (i.q.r.)) 43 (26–67)versus67 (45–122) mmHg,P= 0.01) and a smaller percentage change in pressure‐volume, an integral of sphincter length and squeeze (median (i.q.r.) 43.5 (0–289)versus247 (71–455),P= 0.02), in those with urgency. The authors conclude that urge incontinence is associated with impairment of the striated musculature of the anal sphincte

ISSN:0007-1323    

DOI:10.1002/bjs.1800820910

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThis study was performed to determine whether nitric oxide contributes to inhibitory non‐adrenergic non‐cholinergic (NANC) neurotransmission in the circular smooth muscle layer of pig rectum. Smooth muscle strips were mounted for isometric tension recording in superfusion organ baths. In the presence of atropine sulphate and guanethidine, transmural electrical field stimulation (EFS) produced frequency‐dependent relaxation of precontracted muscle strips. Nω‐nitro‐L‐arginine (L‐NOArg), a powerful competitive antagonist of nitric oxide synthase, reduced the relaxant response in dose‐dependent fashion; this response was maximally reduced by mean(s.e.m.) 86.5(2.6) per cent (P= 0.0003) at a concentration of 3 × 10−5mol/lL‐NOArg. The response was restored by the addition ofL‐arginine. Sodium nitroprusside, an exogenous donor of nitric oxide, mimicked the relaxant response. Responses to EFS were abolished by tetrodotoxin. These results suggest that inhibitory NANC neurotransmission in this tissue is mediated, at least in part, by nitric oxide. The failure ofL‐NOArg to completely abolish the relaxant response suggests that additional neurotra

ISSN:0007-1323    

DOI:10.1002/bjs.1800820911

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY