摘要:

AbstractThe effect of an environmental temperature of 28–30°C. and a relative humidity of 35–45 per cent on the protein metabolic response to injury of one or more major long bones of the lower limbs has been studied in 29 male patients and 28 similar controls housed at 20–22°C. The metabolic response was reduced at the higher temperature compared with the controls, the more severely injured showed a greater metabolic response than the less severely injured, and the ameliorating influence of environmental temperature was more noticeable in the former. The metabolic response seems to be principally one of catabolism of muscle, with increased urinary excretions of potassium, creatine, and zinc in the urine correlating well with those of nitrogen at 20°C. but not at 30°C. The response (i.e., catabolism of muscle) was not affected by post‐injury diet at 20°C. ambient temperature. There was a reduction in the disturbance of the plasma proteins.In general, the patients tolerated the warm drier conditions. Owing to the intrinsic difficult in assessing minor changes in bone healing it was not possible to assess what, if any, beneficial change occurred in the fracture site. From our experimental observations on the rat and the work of others on burned patients the reduction in heat production at the higher ambient temperature is accompanied by an enhanced rate of healing of su

ISSN:0007-1323    

DOI:10.1002/bjs.1800591202

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractSix examples of duodenal involvement by colonic cancer are reported. Two had an associated duodenal fistula. Radical surgery was carried out in all 6 cases, 3 of whom remain alive and free from recurrence up to 6 years later.

ISSN:0007-1323    

DOI:10.1002/bjs.1800591203

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractA retrospective survey of patients having truncal vagotomy for duodenal ulceration has been carried out. In this series 41 cases of oesophageal perforation occurred; 29 were recognized at the time of operation, 6 were diagnosed postoperatively, and in the remaining 6 the time of diagnosis was not specified. Two of the 29 patients in whom the oesophageal perforation was recognized at the time of operation died, as did 2 of the 6 cases diagnosed postoperatively. An increase of mortality and morbidity occurred in those diagnosed postoperatively. The importance of confirming oesophageal integrity at the conclusion of vagotomy is stressed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800591204

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractCircumferential division of the oesophageal muscle combined with hiatal hernia repair has been carried out in 26 patients, 19 of whom had a peptic stricture. The object of the procedure is to achieve slight elongation and relaxation of the oesophagus so as to make reduction of the hernia easier in the presence of slight degrees of oesophageal shortening and to reduce the likelihood of recurrence. The rationale and technique are described and details of illustrative cases are given. The postoperative radiological appearances, which are somewhat unusual, are illustrated. The indications and contra‐indications are discussed. It is claimed that while circumferential myotomy is useless in the presence of gross shortening of the oesophagus it is of value in borderline cases where reduction of the hernia can be effected only by exerting slight tension on the oesophagu

ISSN:0007-1323    

DOI:10.1002/bjs.1800591205

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractSeven patients with glomus tumours are described. Many authors still advocate surgery for these tumours, despite the excellent results obtained with radiotherapy. The results obtained by irradiation in the present series strongly support the view that it is the treatment of choice in large petrosal tumours and those with intracranial extension.

ISSN:0007-1323    

DOI:10.1002/bjs.1800591206

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractA side‐to‐end technique for arteriovenous fistulae of the wrist vessels for use in chronic intermittent haemodialysis with venepuncture is proposed. A series of 14 patients in whom this technique has been used is presented. A survey of the different shunting techniques described in the literature is given and their advantages and disadvantages are discussed. The problem of turbulence due to a sharp angulation of the flow through the anastomosis and the possibility of its causing aneurysmata and thrombosis of the fistulae are considered. This problem and its sequelae, together with the problem of the use of the sole remaining artery of the hand when the other has been either occluded or ligated in previous operations, and the possibility of creating an arteriovenous fistula with a vein distant from the artery, are all overcome by this techni

ISSN:0007-1323    

DOI:10.1002/bjs.1800591207

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractA method has been developed in which the simultaneous administration of51Cr‐labelled red bloodcells and125I‐labelled albumin in the dog has been used to compare the flow rates and transit times of erythrocytes and of plasma in three circulatory beds–the hindlimb, the kidney, and the small intestine. Blood‐flow rates calculated from either isotope agreed well and were significantly greater than simultaneous direct measurements and electromagnetic flowmeter readings. This difference was due to in complete recovery of the isotope from the venous cannula, recovery ranging from 23 to 96 per cent. When the isotope‐flow results were corrected for these losses they did not differ significantly from direct measurements though they were still greater than the electromagnetic flowmeter readings.The mean transit time for erythrocytes was, on average, 6–8 per cent shorter than that for plasma. There was no significant difference in this percentage for the three vascular beds studied or between a control period and haemorrhagic shock. Thus, in this shock preparation red‐cell ‘sludging’ cannot have been extensive. The rationale for the use of low‐molecular‐weight dextran as a specific ‘antisludging’ agent in shock is,

ISSN:0007-1323    

DOI:10.1002/bjs.1800591208

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractSix cases of thoracic enteric cysts and diverticulae are described to illustrate a manifestation of the split notochord syndrome. The varied clinical, radiological, and operative picture in these cases is emphasized, the common triad being respiratory symptoms, a posterior mediastinal mass, and a vertebral anomaly. The symptoms may, however, be entirely gastrointestinal in the form of abdominal enlargement or gastro‐intestinal haemorrhage. Because of the diversity of presentation these patients may come under the domain of the paediatric surgeon, the thoracic surgeon, or the neurosurgeon, and occasionally a combined team approach may be required to obtain satisfactory results in surgical treatment, which is mandator

ISSN:0007-1323    

DOI:10.1002/bjs.1800591209

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractTechnical descriptions of organ grafting in the pig are given for the liver, heart, and pancreas heterotopically, the kidney and pancreas orthotopically, and simultaneous orthotopic transplantation of the liver and pancreas and the liver, pancreas, and kidney. Recipient animals can withstand these procedures and they and their grafts can be studied from the point of view of immune reactions and organ function.

ISSN:0007-1323    

DOI:10.1002/bjs.1800591210

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractA prospective study of 50 patients with lung cancer who were treated by surgical resection of their tumour has shown that most of those who died within 1 year after resection had abnormalities in preoperative steroid excretion whereas most of those who are alive had normal steroid excretion. Of the 21 patients who died within 1 year, 5 died in hospital, mainly as a result of surgical complications, and were found to have an abnormally low androsterone to aetiocholanone ratio and a high total 17‐oxosteroid excretion. Those who were discharged alive and well from hospital but who died within 1 year as a result of metastasis to other organs had a low androsterone level in relation to aetiocholanolone and to total 17‐hydroxycorticosteroids. Thus, it has been possible to identify by their preoperative steroid excretion 12 out of 14 patients who died within 1 year although they had had a successful resect

ISSN:0007-1323    

DOI:10.1002/bjs.1800591211

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY