摘要:

AbstractThe pathology and prognosis of 205 patients treated by total or partial gastrectomy for carcinoma of the stomach during the years 1951‐5 have been evaluated. One hundred and sixteen patients (61 per cent) had a partial gastrectomy and 74 (39 per cent) had a total gastrectomy. The overall postoperative mortality was 25 per cent and this was greater for total than for partial gastrectomy. The crude survival rate was 19.4 per cent at 5 years and 11.4 per cent at 10 years. Carcinoma of the cardia had a worse prognosis than tumours at other sites. There were no 5‐year survivors among patients with the linitis plastica type of carcinoma of the stomach. Tumours classified as poorly differentiated or anaplastic carcinoma had a poorer prognosis than well‐differentiated adenocarcinomas. The amount of lymphocytic and plasma‐cell infiltration of the tumour has a very significant effect on prognosis. Five out of the 7 patients with a heavy infiltrate of such cells survived over 5 years. Lymph‐node involvement is the feature having the greatest influence on prognosis. There was a 40 per cent 5‐year survival rate in the absence of node involvement and an 11 per cent 5‐year survival rate with involved nodes. Patients with involved nodes surviving over 5 years had, on the average, fewer positive glands than those with involved nodes who survived for less than 5 years. No benefit follows from total rather than partial gastrectomy provided the cancer and regional lymph‐nodes can be removed with the simpler procedure. Four case reports are presented to illustrate the difficulties in assessing the prognosis of

ISSN:0007-1323    

DOI:10.1002/bjs.1800571202

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractA case of malakoplakia is reported in a patient who gave a history of repeated passage of portions of pseudo‐tumour per urethram over 8 years. A review of the disease process supports the view that it is a benign granuloma associated withE. coliinfectio

ISSN:0007-1323    

DOI:10.1002/bjs.1800571203

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractThree popular surgical techniques for the treatment of postanal (pilonidal) sinus disease have been evaluated. The lay‐open technique appears to have several advantages over the open excision and the primary closure methods.As the aetiology of this condition is still disputed, and as a result of clinical facts obtained from this study, it is suggested that it be known as a postanal sinus rather than as a pilonidal sinu

ISSN:0007-1323    

DOI:10.1002/bjs.1800571204

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractIn a study of kidneys obtained from adult human subjects at necropsy, the specificity and sensitivity of the alizarin red S method for detecting calcification is confirmed.A survey of the relevant literature indicates that, while calcification is frequently found in the human renal papilla at necropsy, conflicting opinions have been expressed regarding its anatomical site. In the present study of 62 adult human kidneys, in which specific renal disease had been excluded, papillary calcification was present in 43 (69 per cent). A detailed histological study of the papilla, using thin and thick sections, demonstrates the predominant site of calcification to be in the walls of the long loops of Henle, where it is closely related to the basement membrane.The nature of papillary calcification and its possible relationship to the physiology of the renal medulla are briefly discussed. The question is raised as to the possible part played by the loops of Henle in the genesis of renal calculi.

ISSN:0007-1323    

DOI:10.1002/bjs.1800571205

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractAn experimental study in rabbits demonstrates that a significant postoperative decrease in bursting wall pressure is associated with a similar reduction in the colonic collagen from around the anastomosis.Mature collagen is broken down by the action of specific enzyme collagenase. This has been estimated by a tissue‐culture method and is produced by viable explants of mucosa. There is a significant increase in the amount of this enzyme produced post‐operatively and it is suggested that this is responsible for the decrease in collagen and weakness of the colon.An increased amount of enzyme is produced by explants from the colon than from those of other parts of the gastro‐intestinal tract. This is regarded as an important reason for the high incidence of colonic and rectal anastomotic breakdown compared with breakdown of anastomoses in other parts of the gastro‐intestinal tract.Following colonic anastomosis there is increased collagenase production not only locally but throughout the gastro‐intestinal tract, suggesting that wound healing is not only under loca

ISSN:0007-1323    

DOI:10.1002/bjs.1800571206

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractThere is an increased production of collagenase from explants of rabbit colon postoperatively. The enhanced reaction is not confined to the site of injury but occurs throughout the gastro‐intestinal tract, suggesting that the healing process is not purely under local control. This is not the result of increased endogenous steroid production, for injection of 10 mg. cortisone acetate into rabbits for 2 or 3 days produces no alteration in bursting pressure of the colon, no decreased collagen content of the colon or skin, or increased production of collagenase.Addition of serum significantly inhibits the collagen‐collagenase reaction of tissue explants. This inhibitory effect has been demonstrated by protein fractionation methods to be due to an alpha‐globulin of high molecular weight. Adult and foetal serum from several mammals all contain an alpha‐globulin inhibitor to collagenase. Following injury, collagen lysis occurs as a result of increased collagenase activity. This is associated with a decrease in circulating in

ISSN:0007-1323    

DOI:10.1002/bjs.1800571207

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractThree cases of spontaneous abdominal aortocaval fistula are described and the rarity of this condition is commented upon.The distinct syndrome which may be associated with an aortocaval fistula is described. The authors emphasize that this syndrome is not an inevitable accompaniment of such a fistula. The management and the surgical technique of repair are restated.

ISSN:0007-1323    

DOI:10.1002/bjs.1800571208

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractThree cases of chronic relapsing pancreatitis arising in childhood are reported. The consideration of this condition in children with unexplained, recurrent abdominal pain is urged. The results of surgery in these 3 cases and in others elsewhere appear to be excellent.

ISSN:0007-1323    

DOI:10.1002/bjs.1800571209

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800571210

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY

摘要:

AbstractThe electrical activity of the gastric antrum, up to 6 cm. from the pylorus, has been studied at operation by means of electrodes implanted through the serosa in 68 patients; electrodes were also attached to the mucosa in 13. Records made from the mucosal electrodes show the same frequency as the serosal electrodes. Control records made in 12 patients with gall‐stones showed a frequency of electrical waves in the region of 3 per minute (median 2.85 cycles per minute), which is significantly less than the frequency in 11 patients with gastric cancer, in 8 patients with gastric ulcer, and in 24 patients with duodenal ulce

ISSN:0007-1323    

DOI:10.1002/bjs.1800571211

出版商:John Wiley&Sons, Ltd.    

年代:1970

数据来源: WILEY