ISSN:0007-1323    

DOI:10.1002/bjs.1800721202

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800721203

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractReticulo‐endothelial function was evaluated by measuring the biokinetics of a standardized99mTc‐sulphur colloid using scintillation camera technique in rats with biliary obstruction. There was no difference in the uptake of the colloid in the liver (K1) between sham operation and biliary obstruction at 1 week and 3 weeks. However, when corrected for changes in liver volume, the corrected colloidal uptake rate (cK1) of the liver was significantly decreased in 1 week's biliary obstruction (P<0.005 compared with sham operation) and 3 weeks' biliary obstruction (P<0.025 compared with 1 week obstruction). Colloidal uptake rate of the extrahepatic reticulo‐endothelial system (K2) was significantly increased (P<0.005) in rats with 3 weeks' biliary obstruction. Activity distribution of99mTc‐sulphur colloid in 3 weeks' biliary obstruction was significantly decreased in both total organ basis and per gram basis (P<0.005). The results demonstrated a depression of RE activity of the liver in biliary obst

ISSN:0007-1323    

DOI:10.1002/bjs.1800721204

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractA survey has been performed of the mortality and morbidity of anterior lesser curve seromyotomy with posterior truncal vagotomy in the elective treatment of chronic duodenal ulcer. There was one death in a series of 605 patients due to a myocardial infarction, an operative mortality of 0.16 per cent. There was no case of ischaemic necrosis of the lesser curvature or fundus of the stomach. Eleven patients had symptoms of delayed gastric emptying (1.7 per cent) and seven of these underwent a drainage procedure (1.3 per cent). Postoperative dumping did not occur, significant diarrhoea was present in two patients (0.33 per cent). This operation is relatively simple, quick and extremely safe to perform. It is suggested that the more widespread use of this type of elective surgery for duodenal ulcer might reduce the mortality from the condition.

ISSN:0007-1323    

DOI:10.1002/bjs.1800721205

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractGastric partitioning is undertaken for morbid obesity but the mechanism by which weight loss is achieved is unclear. The effect of partitioning on gastric emptying has therefore been studied. In thirty patients with a mean weight of 124.6 ± 7.3 kg (± s.e.m.), a stapling technique was used to create a 50 cm3upper gastric reservoir which communicated via a 10 mm stoma with the distal stomach. Twenty‐four pre‐operative and nineteen postoperative gastric emptying studies were performed using separate 50cm3solid and liquid113mIn‐labelled meals. The time taken to achieve 50 per cent gastric emptying and the delay in isotope reaching the duodenum were measured from gamma camera images. There was no correlation between the pre‐operative weight of the patients and their gastric emptying rates. The median 50 per cent gastric emptying time for solids was increased from 21 min (range 8–34) to 37.5 min (range 8–60) (P<0.001), unpaired Wilcoxon), but was little changed from 17 min (1.5–30) to 16 (1.5–30) min using liquids. Delay in arrival at the duodenum was increased for solids from 0.5 min (.5–13) to 2.5 min (0.5–42.5) (P<0.05) but again there was no significant effect on liquid emptying. Postoperative 50 per cent emptying time for solids correlated with mean weight loss at 3, 6, 9 and 12 months (P<0.05). Following gastric partitioning there is delayed emptying of solids with related weight loss but liquid e

ISSN:0007-1323    

DOI:10.1002/bjs.1800721206

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractSex, stature, age and smoking habits were investigated as possible determinants of maximal gastric secretion in pre‐operative patients with duodenal ulcer. Stimulation was by an intravenous infusion of histamine (130 nmol kg−1h−1) in 201 patients. Men were found to secrete significantly more than women, and smokers secreted significantly more than non‐smokers. By multiple regression analysis, height and the total number of cigarettes smoked were found to be significant positive, and age significant negative factors in the magnitude of maximal gastric secretion. Upon standardization for these factors, the differences between the sexes and the smoking groups disappeared. It is suggested that, at least in men, chronic smoking increases maximal gastric secretion, and therefore could have a role in the aetiology of duodena

ISSN:0007-1323    

DOI:10.1002/bjs.1800721207

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractWe report on two cases of spontaneous intramural rupture and haematoma formation in the oesophagus. This is an unusual and often misdiagnosed condition. Its diagnosis relies on the history and a barium swallow. Instrumentation can result in further damage to the oesophagus and should be avoided. Treatment is conservative and results in resolution of the haematoma and a return to normal swallowing.

ISSN:0007-1323    

DOI:10.1002/bjs.1800721208

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractSince October 1980 a randomized multicentre trial has been in progress among patients with rectal carcinoma, in whom high‐dose fractionated pre‐operative irradiation (total dose 25.5 Gy in 5–7 days) is being tested against postoperative irradiation to a high dose level using a conventional fractionation scheme (totally 60 Gy in 8 weeks) delivered only to a high‐risk group of patients (Dukes' stages B and C). The primary aim of the trial is to investigate whether local recurrence rate differs between the two groups, and a secondary aim is to see whether 5‐year survival will differ between the two groups of patients. Up to October 1984, 360 patients have been randomly allocated to these two groups. Locally curative surgery has been performed in 161 patients in the pre‐operative irradiation group and in 152 patients in the postoperative irradiation group. Pre‐operative irradiation was extremely well tolerated and there were no irradiation‐related complications; 95 per cent of these patients received their treatment according to the intended schedule. However, 48 of the 161 patients had a tumour in Dukes' stage A. Pre‐operative radiotherapy had no impact on postoperative mortality or the occurrence of anastomosis dehiscence, but significantly more patients with perineal wound sepsis after an abdominoperineal resection were found in the group of patients receiving pre‐operative radiotherapy. This prolonged the stay in hospital after surgery. Postoperative radiotherapy was not so well tolerated as pre‐operative treatment, and in a substantial number of patients the treatment could not be commenced until a relatively long time after surgery. To date, the local recurrence rate is acceptably low (≈ 10 per cent) i

ISSN:0007-1323    

DOI:10.1002/bjs.1800721209

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractThe perianal mycotic flora was studied in proctological patients with and without pruritus ani, as well as in control subjects. Four groups of patients underwent perianal mycoculture. In Group 1, 53 patients with anal pruritus were treated for benign anorectal disease. In Group 2, 24 patients with no underlying disease presented with anal pruritus. Both of these groups underwent concomitant chemical and parasitical examination of the faeces and an oral glucose tolerance test. In Group 3, 50 patients without pruritus ani at present or in the past were treated for benign anorectal diseases. In Group 4, 47 surgical patients without pruritus ani were treated for benign (9) and malignant (38) non‐proctological diseases. In Group 1 the mycoculture was positive in 24/53 patients (Candida albicans 14, dermatophytes 10). In Group 2 fungal infections were seen in 16/24 patients (C. albicans 7, dermatophytes 9). No parasites or diabetes were found in either group. In Group 3 C. albicans was isolated in 14/50 patients. In Group 4 C. albicans was found in 11/47 cases (2 in benign, 9 in malignant diseases). Infection by C. albicans was observed in all groups studied, independent of the presence of disease or anal pruritus. The presence of dermatophytes was always associated with pruritus an

ISSN:0007-1323    

DOI:10.1002/bjs.1800721210

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractTwo treatments for fistula‐in‐ano were compared in a randomized trial. Times of healing were significantly shorter when the fistula was laid open (median 34 days, n = 26) than after excision (41 days, n = 21) (P<0.02). Revisional surgery was necessary before healing could be obtained in 3 of 26 patients after lay open operations and 2 of 21 after excision. Recurrence rates within 1 year were similar (3/24 and 2/

ISSN:0007-1323    

DOI:10.1002/bjs.1800721211

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY