摘要:

AbstractThis paper postulates that fat intolerance is a widespread metabolic disorder characterized by impairment of glucose tolerance caused by excess dietary fat intake, and cured in most cases by the fat‐free diet as defined in this paper.Fat intolerance may present as flatulent dyspepsia, surgical disease or disorder in the biliary tract, peptic ulcertion, diarrhoea associated with spasm or diverticular disease of the colon or colitis, or as maturity‐onset diabetes mellitus; one, two, or more of these syndromes may occur at the same or different times in the same patient. The dietary fat intake and the effect of the fat‐free diet in each of these syndromes have been investigated, and the findings and their implications are discussed.Treatment of disease and disorder in the biliary tract by sphincterotomy of the sphincter of Oddi in a series of 57 cases and of duodenal ulcer by pyloroplasty alone in 50 cases is reported. The results of treatment of duodenal ulcer by pyloroplasty alone in a series of 38 cases are compared with those after vagotomy and pyloroplasty in a similar series of 38 cases. Cure of peptic ulceration by pyloroplasty alone is reported, and vagotomy is considered to be unnecessary. The normal pylorus is defined, and the naked‐eye appearances of the pylorus observed during 87 cholecystectomies are reported. The significance of these observations and of radiological abnormalities seen in routine barium‐meal examinations of cases of disease or disorder in the biliary tract is discussed. Evidence is presented that the function of and pathological changes in the sphincter of Oddi and the pylorus are affected by the dietary fat intake and determine the absence or presence of abnormality in the biliary tract or of peptic ulceration respectively.The clinical syndromes of fat‐intolerant diarrhoea and its association with spasm of the colon, colitis, and diverticulitis, and of abdominal pain due to fat intolerance seen in a series of 17 children, are described as clinical entities.The effect of the fat‐free diet on glucose tolerance has been investigated in a series of 65 patients, and the significance of the increased tolerance observed has been assessed statistically. Four hundred and thirty‐three glucose‐tolerance tests have been performed to assess the change in glucose tolerance in 134 patients who had been on the fat‐free diet for periods of 3 months to 2 years as treatment for dyspepsia due to disease or disorder of the biliary tract, peptic ulceration, diarrhoea associated with spasm of the colon, diverticulitis or colitis, obesity, and migraine. Among these patients were 23 who also suffered from diabetes mellitus. Cure of maturityonset diabetes mellitus by the fat‐free diet is reported, and evidence is produced to show that it is an acquired abnormality of the metabolism caused by exce

ISSN:0007-1323    

DOI:10.1002/bjs.1800590902

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractPhleboliths originate as thrombi in the pelvic veins and are the result of injury to the vein wall.Although in children the pelvic veins and venous plexuses may be protected by valves, these have disappeared in adult life. In 20 dissections in adult cadavers remnants of osteal valves were sometimes seen, but a functioning bicuspid valve was noted only once.These unprotected veins are subjected to large and abrupt rises in pressure during normal acts of coughing and straining. Because of this the veins are distended and damage to the intima with the formation of a protective thrombus can occur.A locally high concentration of phosphatase in the perivesical tissues would explain why these thrombi become calcified in the pelvis and why phleboliths are so rarely found elsewhere.

ISSN:0007-1323    

DOI:10.1002/bjs.1800590903

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractSeven patients who had femoro‐femoral by‐pass grafts are reported and the results are noted.The value of the operation in poor‐risk patients with unilateral disease and ischaemic rest pain is confirmed. It is suggested that the indications for doing this procedure could be ext

ISSN:0007-1323    

DOI:10.1002/bjs.1800590904

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractSeventeen patients with aorto‐iliac occlusive disease have been treated by inserting a Dacron by‐pass prosthesis subcutaneously from the axillary artery to the common femoral artery, with acceptable immediate and poor late results. Only 4 grafts remained patent for more than a y

ISSN:0007-1323    

DOI:10.1002/bjs.1800590905

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractTwo cases of neurological complications of abdominal aortic aneurysm are described, with a brief review of the other neurological complications of this condition.

ISSN:0007-1323    

DOI:10.1002/bjs.1800590906

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractThe clinical and cellular changes which occur after cryosurgery are described. Its advantages as a form of therapy in the treatment of neoplasia are discussed, particularly with regard to pain relief in palliation. However, the limitations of the effectiveness of cryosurgery in cancer therapy are emphasized.The results of cryosurgery are presented in 30 cases of recurrent or persistent neoplasia, which followed more formal treatment. In 5 cases healing appeared to be complete; good palliation was achieved in 6 cases, and useful palliation in 13 cases. There was no response in 6 cases.

ISSN:0007-1323    

DOI:10.1002/bjs.1800590907

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractA venographic technique for studying stasis in the deep veins of the legs of conscious patients is described. A second technique involving the clearance of radioactive material from the veins has been developed for use during operation. The results of the two methods correlate closely.There is considerable stasis of the blood, particularly in the soleal veins, in conscious patients with the legs horizontal, and it is prolonged considerably during surgery. Using these new techniques the effectiveness of various methods said to prevent stasis has been assessed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800590908

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

Abstract1. The anatomy fo the external anal sphincter has been studied in 48 adult cadaveric and surgical specimens by anatomical dissection and histological sections in three‐dimensional planes.2. The bilaminar and trilaminar concepts of external anal sphincteric anatomy are reviewed.3. The significant anatomical differences in the anterior portion of the external sphincter compared with the lateral and posterior portion are emphasized.4. The different configuration of the anterior part of the external sphincter in men and women is described.5. A new terminology is proposed, ‘superficial compartment’ (subcutaneous and superficial) and ‘deep compartment’ (deep and puborectalis), on the basis of the close anatomical relationship between each of these two pairs o

ISSN:0007-1323    

DOI:10.1002/bjs.1800590909

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

Abstract1. Twenty patients previously reviewed from a functional standpoint following pull‐through resection of the rectum have been reassessed 2 years or more following the initial review.2. Fourteen of the 20 patients showed further improvement at the second examination, and half of these patients could be reclassified to indicate a significantly improved overall functional result.3. It is clear that functional improvement may occur to a varying extent either gradually or at times rapidly even years after pull‐through resection of the rec

ISSN:0007-1323    

DOI:10.1002/bjs.1800590910

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY

摘要:

AbstractClinical, radioactive iodine uptake, and scan studies on a series of measured thyroid remnants indicate that after thyroidectomy one lobe only actively functions in a significant number of cases and that the subthyroid state only appears in toxic cases, usually those with certain pathological, familial, or therapeutically induced changes.Remnant size did not appear to be critical, but under‐function did not occur over 8 c.c. Above this size of residuum hypothyroidism does not appear to be directly due to the operationper seand should not therefore be called postoperative.A fall in the assessment parameters after 6 months in a toxic case with a remnant measuring less than 8 c.c. and one or more of the associated features mentioned above would be an indication for commencing thyroxine.Minor degrees of lymphocytic infiltration did not correlate directly with under‐function.There was a suggestion of right‐sided dominance in the remnant as in normal and diseased g

ISSN:0007-1323    

DOI:10.1002/bjs.1800590911

出版商:John Wiley&Sons, Ltd.    

年代:1972

数据来源: WILEY