ISSN:0007-1323    

DOI:10.1002/bjs.1800790702

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThis is the third of our series of sketches on the surgeons who edit the Journal and administer The British Journal of Surgery Society.

ISSN:0007-1323    

DOI:10.1002/bjs.1800790703

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800790704

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800790705

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe prognostic power of the extent of tumour invasion is indisputable; Dukes' classification has repeatedly been proven to be strongly correlated with patient survival. Modifications have led only to confusion, resulting in caution being required in the classification of patients with Dukes' A tumours. In the UK, the American tumour node metastasis and Australian clinicopathological systems are frequently considered too complex for routine clinical use. Meanwhile, Jass's classification may be complicated by observer variation between pathologists, and recent evidence suggests that it offers no advantage over that of Dukes. All the conventional staging systems also fail to take the skill of the surgeon into account when determining outcome. Attempts at quantifying tumour structure have not heralded the expected major advance. For instance, the expense and uncertain prognostic value of tumour DNA content assessed by flow cytometry are likely to restrict widespread use of this technique. It may soon be possible, however, to provide optimum treatment for patients based on individual tumour doubling times. Classifications using knowledge of how a small number of cells in the tumour have the ability to invade locally, enter blood vessels and metastasize would also provide important prognostic information on which treatment could be based. Until then, the ease of use and high prognostic power of Dukes' classification ensure that, after 60 years, it is still the ‘gold standard’ against which all other prognostic classifications in colorectal cancer should be asses

ISSN:0007-1323    

DOI:10.1002/bjs.1800790706

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractMalignant disease is often associated with weight loss and malnutrition. Nutritional support is frequently provided to patients with cancer in an attempt to improve nutritional status and reverse weight loss, with the aim of reducing morbidity and mortality rates. This review evaluates the effect of supplemental nutrition on morbidity and mortality in patients with malignancy undergoing treatment with surgery, chemotherapy or radiotherapy. It also assesses the effect nutritional supplementation has on host defence mechanisms and how nutrients affect tumour cell growth. The evidence suggests that perioperative nutritional support, if given for at least 10 days, reduces morbidity and mortality in patients with biochemical evidence of severe malnutrition, manifest as a low serum albumin concentration and excessive weight loss. In contrast, there is no evidence that parenteral nutritional support benefits patients undergoing chemotherapy or radiotherapy, in terms of either an increased tumour response rate or prolongation of survival. Current research on malignant disease is highlighting the role of specific nutrients (amino acids, essential fatty acids and polyribonucleotides) as key regulators of both anticancer host defence mechanisms and the control of nitrogen metabolism and tumour growth. Arginine, essential fatty acids and ribonucleotides have all been demonstrated to stimulate antitumour host defence mechanisms and some also modulate tumour cell metabolism. Dietary manipulation offers exciting possibilities for the innovative management of malignant disease.

ISSN:0007-1323    

DOI:10.1002/bjs.1800790707

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe March issue of the Journal carried the first digest, of articles published in late 1991 and January 1992 in The Americal Journal of Surgery and identified by that journal's Editor, Dr Hiram Polk, as of particular interest. This month we highlight papers from February and March. A digest from the same issues of The British Journal of Surgery written by our Editor, Professor John Farndon, is to be published in the July issue of our American sister journal. Correspondence on the content of papers should be addressed primarily to the source journal, although we would be interested to receive a copy.

ISSN:0007-1323    

DOI:10.1002/bjs.1800790708

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractFollowing our exchange of digests with Der Chirurg in April, Professor Christian Herfarth and Dr Thomas Lehnert have this month prepared an overview of key papers appearing in that journal in the first quarter of this year. The July issue of Der Chirurg carries a reciprocal digest. Specific comments should be addressed primarily to Professor Herfarth, although a copy to The British Journal of Surgery would also be welcome.

ISSN:0007-1323    

DOI:10.1002/bjs.1800790709

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractCovalent linkage of an antitumour antibody specific for a tumour cell surface antigen to an antilymphocyte antibody specific for the T lymphocyte receptor complex produces a heteroconjugated antibody that can activate and redirect cytotoxic T lymphocytes to lyse tumour cells. The ability of an antilymphocyte‐antitumour heteroconjugate (500A2 × 96.5) to direct the lysis of murine melanoma cells by cultured murine lymphocytes was tested in vitro using a 4‐h chromium release assay and in vivo with a tumour neutralization assay. In vitro, the addition of heteroconjugated antibody significantly increased tumour lysis by murine C3H/HeN lymphocytes (median specific lysis 82.7 per cent with lymphocytes plus heteroconjugate versus 9.5 per cent for lymphocytes alone,P<0.001). In vivo, treatment with heteroconjugated antibody plus lymphocytes significantly reduced the development of pulmonary metastases after intravenous tumour administration (median number of pulmonary metastases 28.5 for combined treatment versus 250 for heteroconjugate or lymphocytes alone,P<0.

ISSN:0007-1323    

DOI:10.1002/bjs.1800790710

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY

摘要:

AbstractThe treatment of lymphoedema is difficult; conservative and surgical management show variable results. Lymphovenous anastomoses (LVAs) in experimental animals and patients give poor results in the treatment of primary lymphoedema and variable results in that of secondary' lymphoedema. Conventional sutured LVAs were compared with anastomoses using polytetrafluoroethylene (Teflon) stents; 32 sutured and 21 stented LVAs were constructed in 16 rabbits with normal lymphatics. Anastomoses were assessed for quality and patency at 1‐16 weeks by direct exposure; 27 cases were further assessed using lymphangiography. Patency in stented and sutured LVAs was 71 and 38 per cent at 1 week, and 38 and 8 per cent at 3 weeks, respectively. After 4 weeks all anastomoses were occluded. The quality of stented LVAs seemed to be higher than that of sutured LVAs. Stented LVAs are feasible and probably superior to conventional sutured LVAs. However, the patency of LVAs is of short duration because of the disadvantageous pressure gradient from lymphatics to veins, and this limits their clinical applicatio

ISSN:0007-1323    

DOI:10.1002/bjs.1800790711

出版商:John Wiley&Sons, Ltd.    

年代:1992

数据来源: WILEY