ISSN:0007-1323    

DOI:10.1002/bjs.1800721102

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800721103

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractMotor disorders of the sphincter of Oddi (SO) may play a role in the pathogenesis of idiopathic recurrent pancreatitis. We have compared manometric records from the SO in 28 patients with idiopathic recurrent pancreatitis with those from 10 control subjects. Patients with idiopathic recurrent pancreatitis had presented with episodes of upper abdominal pain associated with abnormal serum levels of amylase on at least two occasions, in the absence of alcohol abuse and biliary disease. Retrograde pancreatography was either normal or showed only minor changes in pancreatic ducts. A triple lumen low compliance manometric system was used to obtain a 5 min recording of spontaneous SO motor activity. From this recording were determined the SO basal pressure, SO phasic contraction amplitude, SO wave frequency and direction of wave propagation. The SO response to intravenous cholecystokinin‐octapeptide (CCK‐OP) 20 ng/kg was then recorded for at least 3 min. Twenty‐five of the twenty‐eight patients demonstrated one or more manometric abnormality when compared with data from the ten controls. The most frequent abnormality was an elevated SO basal pressure in 16 patients. In addition, excess of retrograde contractions in nine patients, high frequency of SO phasic contractions in nine patients, absence of phasic contractions in three patients, and paradoxical response to CCK‐OP administration in two patients were recorded. This study has demonstrated a spectrum of sphincter of Oddi manometric disorders in patients with idiopathic recurrent pancreatitis and suggests that motility disorders of the sphincter of Oddi may be associated with episodes of pan

ISSN:0007-1323    

DOI:10.1002/bjs.1800721104

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractThe effects of a somatostatin analogue, SMS 201‐995 on hepatic haemodynamics were studied in rats with dimethylnitrosamine‐induced cirrhosis. An intravenous infusion of 1, 2 or 4μg kg−1body wth−1SMS 201‐995 produced a rapid and sustained decrease in portal pressure, portal venous flow and liver blood flow without significantly altering arterial blood pressure or pulse. The reductions in portal pressure, portal venous flow and liver blood were accompanied by an increase in splanchnic vascular resistance. Portal venous resistance was not affected. Subcutaneous injection of 2μg kg−1body wt SMS 201‐995 produced a gradual decrease in portal pressure, the maximum reduction occurring 18 min after administration. This reduction in portal pressure was sustained for a further 20 min. The results suggest that SMS 201‐995 may be of value in the control of bleeding oesophageal varices. Furthermore, the prolonged duration of action of SMS 201‐995 following its subcutaneous administration suggests that the analogue may be useful in the long‐term management of portal hypertension in pa

ISSN:0007-1323    

DOI:10.1002/bjs.1800721105

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractA sophisticated staging technique (extended staging, ES) employing modern technology has been compared prospectively with conventional clinical assessment (initial staging, IS) in 45 patients with low rectal carcinoma (less than 12 cm from the anal verge) to determine its potential merit and its impact on clinical management. ES consisted of computerized tomography of liver and pelvis, ultrasound scan of liver, measurement of serum concentrations of carcinoembryonic antigen (CEA) and acute phase reactant proteins and multiple superficial and deep biopsies to determine not only the histological grade of the tumour but also its DNA cellular content as measured by flow cytometry. ES proved statistically superior to IS in the assessment of local spread and dissemination. Although histological grade proved to be more accurate on ES than IS this was only true when one specialist pathologist interpreted the slides. When several pathologists were involved interobserver variation made interpretation unreliable. Assessment of DNA content using flow cytometry, being quantitative, was more accurate and perhaps should be used in the future as a prognostic indicator. The improved accuracy of ES would have altered both pre‐ and intra‐operative clinical decisions. It would have prevented some patients receiving inappropriate adjuvant therapy as well as selecting patients more accurately for the correct treatm

ISSN:0007-1323    

DOI:10.1002/bjs.1800721106

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractContinuous fluid‐inflation proctometrograms were performed in men with the symptoms of chronic radiation proctitis and in age and sex‐matched control subjects (n = 10). Rectal volumes and compliance were measured. There was a significant reduction in the rectal volumes at sensory threshold, constant sensation and maximal tolerance and in rectal compliance (P<0.01). Comparable pressure measurements did not demonstrate significant differences. The maximum tolerable volume, symptomatic and sigmoidoscopic scoring correlated to rectal compliance (r = 0.77, −0.8, −0.73; P<0.01,<0.01,<0.02, respectively). Reduction in volume and compliance is often not obvious radiologically. Histological evidence suggests that smooth muscle hypertrophy and myenteric plexus damage are contr

ISSN:0007-1323    

DOI:10.1002/bjs.1800721107

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800721108

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800721109

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractThis retrospective study comprises 134 cases of penetrating colon injuries. In 92 cases the injury involved the left colon and in the remaining 42 the right colon. Death due to the colonic injury occurred in 1.5 per cent and the incidence of abdominal complications was 17.9 per cent. Patients treated by primary repair of the colon had less colon‐related complications and a shorter hospital stay than patients treated by colostomy. Left and right colon injuries treated by primary repair had similar complication rates and hospital stay (P>0.05). We believe that primary repair can safely be performed more frequently than is generally accepted. The site of colon injury, the presence of shock and the presence of multiple associated intraabdominal injuries do not exclude primary repair. It is suggested that colostomy should be reserved for both left and right colon injuries with gross peritoneal contamination, extensive colonic damage, and large amount of hard faeces in the colo

ISSN:0007-1323    

DOI:10.1002/bjs.1800721110

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800721111

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY