摘要:

AbstractIn normal adult females, patients with benign breast disease and patients with breast cancer, hydroxyproline (OHPro) was found in the plasma attached to the protein fractions which were separated by Sephadex gel filtration. In addition, a distinct moiety, probably a protein sub‐unit, containing substantial amounts of this imino acid, occurred in between gel filtration fractions III and IV. Quantitative differences in the OHPro content of these various fractions were observed in the groups of patients studied. Significant elevations in the peptide‐bound OHPro (fraction IV) were found only in patients with breast cancer and the level appeared to correlate with the degree of advancement of the disease. Similar findings relate to the OHPro content of the sub‐protein moiety which is found between gel filtration fractions III and IV. A reduced level of high molecular weight hyproprotein (fraction I) was found in the breast cancer

ISSN:0007-1323    

DOI:10.1002/bjs.1800660702

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractOf 37 patients with squamous cell carcinoma of the floor of the mouth seen during a 5‐year period, 28 were treated primarily by surgery. Ten of the 28 patients presented with midline cancers measuring between 1.0 and 3 cm (T1and T2). Three of these patients had local excision only. Metastases to the submandibular lymph nodes later occurred in 1 of these 3 patients. The remaining 7 patients with midline lesions had wide excision of the tumour, marginal resection of the mandible and bilateral suprahyoid node dissection. Of these 7 patients 4 remained free of disease for periods ranging between 2 and 5 years. Two of these had lymph node metastases. These results suggest that en bloc excision of relatively small midline cancers (i.e. not exceeding 2 cm (T1) in largest diameter) with bilateral suprahyoid node dissection gives effective control of these lesion

ISSN:0007-1323    

DOI:10.1002/bjs.1800660703

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractPhaeochromocytomas were diagnosed in 72 patients in Hammersmith, Belfast and Newcastle between 1955 and 1976. Fourteen were found unexpectedly at autopsy while 58 were diagnosed in life. Associated lesions included neurofibromatosis (7 patients), medullary carcinoma of the thyroid (3), renal artery stenosis (2) and cerebellar haemangioblastoma (1). The clinical features were similar to those reported by others. Hypertension was found in all but one of the patients and was sustained only in 17 per cent, paroxysmal only in 48 per cent and sustained with superadded paroxysms in 33 per cent. Hypertension was significantly greater in the women than in the men.Diagnosis was confirmed chemically in all patients and urinary vanylmandelic acid (VMA) was elevated in all but one. Tumours were localized correctly by various radiographic techniques and by selective venous sampling in over 80 per cent of patients. The tumours were in adrenals in 59 patients (bilateral in 6) and at extra‐adrenal, intra‐abdominal sites in 13.The tumours were removed surgically from those in whom they were diagnosed in life. Before 1967 3 of 17 patients died after operation (18 per cent). Since then patients have been prepared with alpha blockade and have received infusions of plasma, blood or dextran after removal of the tumours. One of 41 patients so treated has died after operation (2 per cent). Phaeochromocytomas were diagnosed and treated in pregnancy in 4 patients, all of whom survived. Two of the fetuses died.Five tumours diagnosed in life were malignant and 2 recurred (40 per cent). Fifty‐three were benign and 2 of these recurred locally (4 per cent).All but 2 patients (who could not be traced) were followed completely from 1 to 20 years after operation and 3 died during this period. Two‐thirds of the patients were alive after 10 years.Paroxysmal hypertension was abolished by operation, but sustained hypertension often persisted and required drug therapy.It is concluded that at least one‐third of phaeochromocytomas are not diagnosed in life and that a high index of suspicion is required to bring them to light. If they are diagnosed and treated by present methods, the prognosi

ISSN:0007-1323    

DOI:10.1002/bjs.1800660704

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractA successful pancreatogram was obtained at endoscopic retrograde cholangiopancreatography (ERCP) in 53 patients with calculous biliary disease. Twenty‐eight patients presented with jaundice and 25 with pain. In both groups there was a high incidence of pancreatogram abnormalities (47 and 48 per cent respectively). These findings demonstrate that the pancreas is often abnormal in the presence of complicated calculous biliary disease even though there may be no recent clinical evidence of pancreatitis and suggest that asymptomatic chronic pancreatitis may be common. The clinical significance of the abnormalities is discusse

ISSN:0007-1323    

DOI:10.1002/bjs.1800660705

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractA collected series of 64 cases of chronic relapsing pancreatitis is reported. Analysis of this material reveals several points of interest. There is a difference in the aetiological spectrum in Britain when compared with reports from France and the United States. In particular, nearly half the British cases were idiopathic. The clinical presentation and the age and sex ratios also varied with aetiology. Endoscopic retrograde cannulation of the pancreatic duct was of little value in confirming a diagnosis of pancreatitis in the problem case. This investigation did, however, demonstrate that a widespread dilatation of the pancreatic duct was a minority finding. In those patients with alcoholic pancreatitis follow‐up studies have shown that, if the addiction can be broken, there is a 75 per cent chance that pain will diminish or disappear with the passage of time. The main indication for surgical intervention was severe pain and this study has shown that if strict criteria are observed, a worth‐while relief of symptoms can be achieved. In particular, subtotal pancreatectomy produced good results in up to 85 per cent of cases, although with an appreciable short term postoperative morbid

ISSN:0007-1323    

DOI:10.1002/bjs.1800660706

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractWe studied the bile and gallstone composition of 38 surgical patients. According to their composition, the stones were classified as: 1, cholesterol stones, when they have more than 60 per cent cholesterol, or 2, pigment or pigment‐mixed stones, when they have more than 40 per cent pigments (including stones with more than 30 per cent calcium). In the cholesterol‐stone‐forming group (24 cases) a ‘supersaturation’ in the cholesterol component of the bile and a concomitant reduction in bile salts was found. No such bile supersaturation was found in those with pigment or pigment‐mixed stones (14 cases), or in the control group (8 cases).The osmolarity of bile in patients with pigment or pigment‐mixed stones is significantly higher than in those with cholesterol stones or in controls.These results suggest a different mechanism for gallstone formation in the two groups: a ‘supersaturation’ of cholesterol with respect to bile salts and phospholipids in the formation of cholesterol stones and an ‘overconcentration’ of all bile components as a whole in the formation of pigment stones.In an attempt to clarify the aetiology of gallstone formation, we measured in the bile of patients operated on for cholelithiasis the following parameters: cholesterol, bile salts, phospholipids and, for the first time, osmolarity. Chemical analysis of the gallstones was conducted to ascertain the content of cholesterol, pigments and calcium salts. We report the results of our study and the conc

ISSN:0007-1323    

DOI:10.1002/bjs.1800660707

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractThe effect of obstructive jaundice on wound healing has been investigated in an experimental study of abdominal wounds in rats following ligation and division of the common bile duct. Animals were jaundiced for 2 weeks before a second operation at which the abdominal wounds were made. The wounds in jaundiced and control animals showed no significant differences in mechanical strength during a 21‐day period of study but there was a significant delay in the accumulation of collagen in the wounds of jaundiced animals. The findings suggest that the biochemical changes in the wounds of jaundiced animals did not interfere with wound repair and cast doubt on the thesis that jaundice has an adverse effect on wound healin

ISSN:0007-1323    

DOI:10.1002/bjs.1800660708

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractAxillary hyperhidrosis is a common condition and young people often suffer unnecessarily for many years in spite of the availability of good surgical methods for cure. We describe our own modification of Pettersson and Strömbäck's (1970) method of excision of the sweat glands. During the years 1972‐6 218 axillary operations have been performed on 109 patients at the surgical clinic in Västerås for axillary hyperhidrosis. We reviewed 104 of these and found that 71 patients were completely satisfied and only 7 unsatisfied. Twelve patients wanted to be reoperated either because they still sweated or because they were unhappy with their scars. Thus, we found that overall the surgical methods are safe, simple and give good re

ISSN:0007-1323    

DOI:10.1002/bjs.1800660709

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

摘要:

AbstractA case of congenital chylothorax associated with a congenital ‘H’‐type tracheo‐oesophageal fistula is reported. The development of the thoracic duct is described and the possible embryological association with tracheo‐oesophageal fistula is discussed. The management of the case is

ISSN:0007-1323    

DOI:10.1002/bjs.1800660710

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800660711

出版商:John Wiley&Sons, Ltd.    

年代:1979

数据来源: WILEY