ISSN:0007-1323    

DOI:10.1002/bjs.1800601002

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractRadioactive iodine has been used to treat over 300,000 thyrotoxic patients since 1946. This paper reviews the knowledge gained in the past 23 years about the efficacy and safety of131I therapy for thyrotoxicosis. Modifications with reference to case selection, dosage, and follow‐up are discusse

ISSN:0007-1323    

DOI:10.1002/bjs.1800601003

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractPreparation of selected thyrotoxic patients for partial thyroidectomy can be safely and quickly achieved using propranolol, the duration of preoperative therapy and the number of out‐patient attendances being reduced by over 50 per cent. No problems have been encountered during preparation or intra‐operatively in patients pretreated with propranolol when compared with patients pretreated with conventional preparations. The commonest form of morbidity following destructive therapy for thyrotoxicosis is hypothyroidism. In surgically treated patients hypothyroidism can be defined within 1 year of operation. The factors influencing postoperative hypothyroidism are discus

ISSN:0007-1323    

DOI:10.1002/bjs.1800601004

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractThe amount of lymphoid tissue in the thyroid gland and thymus at the time of partial thyroidectomy was measured quantitatively with the point‐counting technique.The normal pattern of age involution of the thymus was established in patients with non‐toxic nodular goitre. In all the patients with thyrotoxicosis the thymus is hyperplastic; after pretreatment with antithyroid drugs, such as carbimazole, the pattern of age involution is similar to that in the control subjects, whereas after propranolol therapy very little age involution is seen. Patients treated with antithyroid drugs show much less lymphoid infiltration of the thyroid gland than those prepared with proprano

ISSN:0007-1323    

DOI:10.1002/bjs.1800601005

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800601006

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractA review of 250 traumatic urethral strictures in our series has provided the basis for a consideration of their management. Techniques that we have adopted or adapted for their resolution are outlined and the principles involved in reducing the effects of the initial injury are discussed. The value of the fenestrated shaft catheter in providing free drainage of periurethral exudates after urethral injury and repair is stressed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800601007

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractA review of 105 patients operated on over a 25‐year period for primary hyperparathyroidism indicates that the diagnosis is now being made at an earlier stage of the disease. The incidence of bone disease is falling but renal symptoms remain the principal reason for presentation.Hypertension in the presence of established disease persists after successful surgery and renal function frequently continues to deteriorate. Renal function is little affected in patients with minimal symptoms.An accurate diagnosis can be made on the basis of persistent hypercalcaemia and elevated serum parathormone levels in peripheral or neck venous blood measured by sensitive immuno‐assay.Surgery is indicated as soon as the diagnosis is established with certainty even in the absence of any sympt

ISSN:0007-1323    

DOI:10.1002/bjs.1800601008

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractIn 1969 Professor Nils Kock of Göteborg published a description of a new kind of continent ileostomy. A pouch is formed of the terminal ileum. The pouch although small at first enlarges with time until its capacity is adequate to contain about one‐third of the day's ileal output. The pouch is emptied several times a day by passing a catheter along a short efferent loop of ileum which is brought to the surface as an ileostomy stoma. The pouch is made in such a way that it does not develop expulsive contractions when it fills. It is therefore continent. By constructing a valve mechanism on the efferent loop continence is maintained under the stress of increased abdominal pressure as in coughing, laughing, etc. Since the pouch is continent the patient need wear no apparatus and the ileal stoma may be made flush with the skin.This paper describes the author's experience with 6 patients in whom this type of ileostomy has been constructed. The results confirm the claim by Professor Kock that the technique is of value in selected patien

ISSN:0007-1323    

DOI:10.1002/bjs.1800601009

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractThe good results of highly selective vagotomy (H.S.V.) in the elective surgical treatment of uncomplicated duodenal ulcer led to its use in the treatment of 30 patients who were suffering from complications of peptic ulcer, over a period of 21 months. In the emergency situation it is vital to select for H.S.V. patients who are fit enough to withstand a 1–2‐hour operation.Five out of a total of 9 patients with perforated duodenal ulcer were deemed to be suitable for H.S.V. In contrast, H.S.V. was used in the treatment of all 10 patients with haemorrhage (5 patients with duodenal ulcer and 5 with gastric ulcer), because definitive treatment for the ulcer is essential after haemorrhage has been arrested by direct suture.Pyloric stenosis was diagnosed in 15 of 75 patients who came to elective surgery for duodenal ulcer. The diagnosis was made on clinical and radiological grounds and was confirmed at operation. Seven of the 15 patients had concomitant gastric ulceration. All 15 patients were treated by H.S.V. without a drainage procedure. The stenosis was simply dilated digitally. Seven patients who were followed up for at least a year underwent barium‐meal examination, which showed that gastric emptying was normal in each case and that there was no sign of recurrent ulceration.There was no operative mortality. None of the patients with haemorrhage bled again after operation. Only 1 of the 30 patients developed gastric retention, which was transient. Of the 14 patients who were reviewed more than 1 year after H.S.V., 11 had a perfect clinical result, 2 were very good, and 1 was ‘fair’ (Visick grade 3). The long‐term prognosis should be the same as that of patients who have undergone elective H.S.V.Granted a modicum of case selection, H.S.V. is a safe operation in the treatment of emergencies such as haemorrhage or perforation. In pyloric stenosis H.S.V. preserves and makes use of the stomach's compensatory mechanisms of hypertrophy and hyperperistalsis, whereas both gastrectomy and vagotomy with drainage destroy them. Vagotomy of the entire stomach makes necessary the addition of a drainage procedure. Vagotomy with drainage impairs the ability of the antrum to ‘mill’ food and to propel chyme onwards, and destroys or by‐passes the pyloric sphincter. These surgical insults to normal gastric physiology harm the patient by producing dumping, diarrhoea, bilious vomiting, steatorrhoea, and gross elevation of serum gastrin. The main conclusion of this paper is that such harm can be avoided, because it is shown that even patients with pyloric stenosis can be treated by H.S.V. without a drainage procedure. The routine use of complete gastric vagotomy with a drainage procedure in the elective surgical treatment of duodenal ulcer is no

ISSN:0007-1323    

DOI:10.1002/bjs.1800601010

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY

摘要:

AbstractThe results of 15 years of sclerotherapy for acute variceal haemorrhage are reviewed retrospectively. One hundred and seventeen patients with portal hypertension received a total of 217 injections. Haemorrhage was controlled in 93 per cent of admissions. The mortality per injection was under 12 per cent, and the total admission mortality was 18 per cent. Even where a subsequent shunt was impracticable, sclerotherapy provided useful palliation with few serious complications.

ISSN:0007-1323    

DOI:10.1002/bjs.1800601011

出版商:John Wiley&Sons, Ltd.    

年代:1973

数据来源: WILEY