ISSN:0007-1323    

DOI:10.1002/bjs.1800710202

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710203

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractThis is a prospective study comprising 156 cases of abdominal stab wounds. The cases were assessed exclusively on clinical grounds: 37.18 per cent of them were treated conservatively without any mortality and minimal complications. Shock, blood on abdominal paracentesis, omentum protruding through the wound, and radiologically free air under the diaphragm, were not absolute indications for surgery. Alcohol consumption did not interfere with the clinical assessment. Of all 130 cases with proved peritoneal penetration, 28.46 per cent had no significant visceral injury. The incidence of negative laparotomies was 7.0 per cent.

ISSN:0007-1323    

DOI:10.1002/bjs.1800710204

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractThis study represents the personal experience of the author, in 45 cases of penetrating cardiac wounds. Eleven patients with no signs of life had surgical intervention on the stretcher in the emergency room (ER). One patient survived (mortality 91 per cent). Thirty‐four patients were operated on in the operating theatre (OT) with a mortality rate of 12 per cent. The clinical triad of a low blood pressure, high central venous pressure (CVP) and distant cardiac sounds, proved diagnostic in 82 per cent of the patients with cardiac tamponade. Pulsus paradoxus was found in only 7 per cent of tamponade cases. Pericardiocentesis seems to have little value in diagnosing or treating tamponade. The most commonly injured cardiac chamber was the right ventricle (RV) (36 per cent). Coronary artery damage occurred in 4 cases with a mortality of 75 per cent. Aspiration of the ventricles for air embolism was performed in all 16 cases who arrested during operation. A significant volume of air was aspirated in 4 (25 per cent). Early intervention saved three of the

ISSN:0007-1323    

DOI:10.1002/bjs.1800710205

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractNine local recurrences have been diagnosed in 38 patients with carcinoma of the rectum operated on with anterior resection using the EEA‐stapling instrument. The characteristics of these recurrences have been compared with those of other authors, currently a total of 27 recurrences. The presence of a locally advanced growth with extramural spread, a distal location and a short margin of clearance seems to increase the risk of local recurrence, with often distressing symptoms. It is proposed that even if the EEA‐stapler offers technical possibilities for anterior resection in these growths, this operation should be restricted to less advanced tumo

ISSN:0007-1323    

DOI:10.1002/bjs.1800710206

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractNineteen patients who have had medullary carcinomas of the thyroid have been followed up at the Royal Marsden Hospital. All had nodal involvement. Postoperative unprovoked serum calcitonin assays have been performed.Four patients had incomplete excisions of their tumours and these had the highest postoperative levels. Two died within 3 years, one has stable disease 8 years later and one remains well 13 years later.Four patients had postoperative calcitonin assays of over 100 ng/ml but had no clinical evidence of remaining disease. Only one has died (7 years later), the others remaining well 10, 10 and 3 years later.Four patients died of their disease and all had assays of over 200 ng/ml, before death.Slightly raised postoperative assays were found in all the other patients, but these have not significantly altered. These patients had good prognoses.

ISSN:0007-1323    

DOI:10.1002/bjs.1800710207

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractThe excretion of urinary hydroxyproline has been measured before mastectomy in 342 patients presenting with breast cancer for the first time to Guy's Hospital. The first 106 women were maintained on a gelatine‐free diet whilst the remainder were on unrestricted diet.In both dietary groups hydroxyproline levels or the ratio of hydroxyproline to urinary creatinine were not related to pathological stage or histological grade.The time between initial presentation and subsequent bone metastases was negatively and significantly associated with hydroxyproline excretion (P<0.05) and the ratio of hydroxyproline to creatinine (P<0.01) in women on a gelatine‐free diet. A similar, but not significant, trend was observed in patients on unrestricted diet.Although hydroxyproline excretion was related to the time to onset of bone metastases the amount of hydroxyproline excreted by these patients was not significantly different from patients who had recurrences at sites other than bone or patients who were disease‐free up to 5 years after initial diagnosis.The conclusion is that hydroxyproline is of little value in the early detection of bone metas

ISSN:0007-1323    

DOI:10.1002/bjs.1800710208

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractThe pursuit of more effective systemic treatments in breast cancer has been limited by a failure to maintain or grow tumour cells in vitro. This study reports our experience in obtaining clonogenic growth in 54 primary breast cancers obtained at mastectomy. Of 47 assays free of infection, clonogenic growth was achieved in 22 (41 per cent). Only 5 of 23 oestrogen receptor positive tumours grew compared to 14 of 21 oestrogen receptor negative tumours (χ2= 9.03; P<0.01). None of the 5 cytosolic receptor positive tumours contained a nuclear receptor for oestrogen. Growth was not related to tumour stage, menopausal status, age or histological grade. Receptor negative tumours had higher thymidine labelling indices, but these were no different to the tumours grown in the assay

ISSN:0007-1323    

DOI:10.1002/bjs.1800710209

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800710210

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY

摘要:

AbstractPalliative treatment of upper gastrointestinal tract obstruction was undertaken by endoscopic laser therapy in 6 patients with carcinoma of the oesophagus or stomach. All had dysphagia for solids on admission and were considered unsuitable for surgery or radiotherapy. Three were in sites unsuitable for placement of an endoscopic prosthesis. The tumours occluded up to 90 per cent of the lumen (2 squamous and 4 adeno‐carcinomas). Treatment was carried out under direct vision, the laser wave guide being passed through the biopsy channel of a standard endoscope. Superficial tumour vaporized immediately using energies of 2–10 000 J per session, whereas deeper layers sloughed over the succeeding 2–3 days. Two to six treatments were required to relieve dysphagia and there were no major complications. Quantitative barium studies before and after treatment showed a significant increase in luminal diameter. These patients could eat solid food after treatment and all were able to go

ISSN:0007-1323    

DOI:10.1002/bjs.1800710211

出版商:John Wiley&Sons, Ltd.    

年代:1984

数据来源: WILEY