摘要:

AbstractMacroscopic examination of the extrahepatic bile ducts in infants with biliary atresia reveals fibrous occlusion of variable extent from an inflammatory process of unknown aetiology. Histological studies have shown that bile duct remnants at the porta hepatis frequently contain small epithelium‐lined channels which communicate with intrahepatic ducts and through which effective bile drainage may be established by the operation of portoenterostomy. The 4‐year survival rate in untreated cases is 2 per cent, but surgical treatment can improve the outlook and recent reports suggest that a 5‐year survival rate of over 35 per cent can be achieved with portoenterostomies performed before 10 weeks of age. Complications after surgery include progressive liver disease, ascending bacterial cholangitis and portal hyperte

ISSN:0007-1323    

DOI:10.1002/bjs.1800700402

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800700403

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractOf 500 consecutive patients who underwent cervical exploration for presumed primary hyperparathyroidism, 461 (92·2 per cent) were cured, as judged by an immediate return of serum calcium levels to normal. Thirty‐nine patients (7·8 per cent) had persistent hypercalcaemia after the initial operation. The clinical profiles, operative and pathologic findings, surgical procedures performed and subsequent management of these 39 patients were reviewed. At re‐evaluation, 4 patients were noted to have been cured of their hyperparathyroidism: Twenty‐one patients had persistent hyperparathyroidism: in 6, all 4 parathyroid glands had not been identified at the initial operation and in 15, hypercalcaemia persisted after the identification of 4 glands. One patient had recurrent hyperparathyroidism after the removal of a 720 mg adenoma and the identification of 3 normal parathyroid glands. Nine patients had non‐parathyroid causes for the hypercalcaemia: 2 had occult malignant neoplasms, 6 had benign familial hypocalciuric hypercalcaemia and 1 had immobilization hypercalcaemia. In 4 patients the reason for the persistent hypercalcaemia remained unclear. We suggest a schema that may be used as a guideline in the investigation and management of patients with persistent hypercalcaemia after primary neck exploration for presumed hyperparat

ISSN:0007-1323    

DOI:10.1002/bjs.1800700404

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractIn 51 women with metastatic breast cancer calcium excretion per litre of glomerular filtrate (CaE) values were persistently higher in those with bone secondaries than in those with only soft tissue involvement despite a normal range of serum calcium in both groups. Measurement of CaEin 8 further patients who were severely hypercalcaemic as a result of their advanced breast cancer revealed the degree to which calcium resorption from bone secondaries and renal dysfunction contributed to the hypercalcaemia. Thus, in patients with breast cancer, CaEprovides a reliable indicator of early changes of calcium homeostasis. It may provide an objective indication of progression of bone secondaries and also has important therapeutic implications in established hypercalcaemia.

ISSN:0007-1323    

DOI:10.1002/bjs.1800700405

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractHistorical aspects of cicatrial cancer are presented and 18 cases of cicatrial cancer reviewed. The incidence of cicatrial cancer is increasing, paralleling other skin tumours. Survival is better than many series have suggested. Prevention and treatment is discussed in relation to the biological behaviour of scars and their tumours. A high index of suspicion for chronic non‐healing lesions in scarred areas will increase surviva

ISSN:0007-1323    

DOI:10.1002/bjs.1800700406

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractFour hundred and eight consecutive patients with upper gastrointestinal haemorrhage, admitted to a large hospital in India over the 5‐year period 1976–81, were studied prospectively. The mean age was 41 years, the male: female ratio was 3:1, causes of bleeding were oesophageal varices in 45·5 per cent, duodenal ulcer in 25 per cent, gastric ulcer in 5 per cent and gastritis in 8·5 per cent. One hundred and twelve patients had operations with an overall mortality of 20 (18 per cent). Thirty‐three (11 per cent) of the unoperated patients died. Eighty‐seven per cent of patients left hospital alive and 76 per cent returned to their former way of life. Patients with upper gastrointestinal bleeding in North India are mainly young males, nearly half bleeding from oesophageal varices, and have a moderately good

ISSN:0007-1323    

DOI:10.1002/bjs.1800700407

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800700408

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractIn a prospective study of 80 patients with acute testicular pain, static and dynamic scans of the scrotum were obtained by radionuclide imaging. Seven patients with acute testicular torsion were identified by gross reductions in isotope uptake. Enhanced uptake (indicating hyperaemia) was seen in 37 patients with acute epididymitis, testicular tumour or resolved torsion. Late torsion and some tumours demonstrated a ‘halo’ sign, with central necrosis and a peripheral increase in blood supply. A group of 22 patients with previous orchidopexy for torsion was reviewed 2–5 years postoperatively. In 15 the previously twisted testis was>10 per cent smaller than its opposite member and 12 patients showed severe abnormalities of seminal analysis. Hormonal profiles were generally normal. Retention of testes damaged by ischaemia may risk autoimmunization against spermatoge

ISSN:0007-1323    

DOI:10.1002/bjs.1800700409

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractFive cases of torsion of the testis are described in which scrotal surgery preceded the torsion. Suggestions as to the best surgical procedure are made.

ISSN:0007-1323    

DOI:10.1002/bjs.1800700410

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY

摘要:

AbstractThis retrospective study reviews the results of 200 consecutive transurethral resections of prostate (TURP) for benign disease performed in two small district general hospitals. There was 1 postoperative death (0·5 per cent). Ninety‐five per cent of the patients were discharged from follow‐up with satisfactory results. Nine patients (4·5 per cent) are still under review either for postoperative complications or persistent sym

ISSN:0007-1323    

DOI:10.1002/bjs.1800700411

出版商:John Wiley&Sons, Ltd.    

年代:1983

数据来源: WILEY