摘要:

AbstractThere is very little known about the subsequent behaviour of breast cancer following adjuvant endocrine therapy or the effect of this therapy on the oestrogen and progesterone receptor content of recurrent disease. Mammary tumours were induced in Sprague–Dawley rats usingN‐nitrosomethylurea. In two experiments animals were treated with tamoxifen at different doses prior to the appearance of tumours. Tamoxifen prolonged the induction time and reduced the total number of tumours. Subsequent treatment of established tumours exposed to tamoxifen in the induction period demonstrated a reduced response to further tamoxifen therapy. There was no difference in the oestrogen receptor content of the tumours previously exposed to tamoxifen, but there was a significant reduction in the progesterone receptor content. The results suggest that: (a) patients treated with adjuvant tamoxifen therapy will show a delay in the appearance of recurrent disease with a reduced response to further tamoxifen therapy; (b) the model may provide an in vivo method to examine the relationships between oestrogen and progesterone receptors and response to endocrine ther

ISSN:0007-1323    

DOI:10.1002/bjs.1800690302

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe radiological features of breast biopsy specimens can be visualized clearly if the specimens are X‐rayed in water. This makes it possible to demonstrate on specimen radiographs lesions causing tissue distortions without calcification. By positioning the specimen correctly in water and by obtaining radiographs in two planes, the exact site of a small lesion within a large tissue mass can be demonstrated and the site marked to guide the pathologist to the suspect are

ISSN:0007-1323    

DOI:10.1002/bjs.1800690303

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractInfantile hypertrophic pyloric stenosis is a relatively common condition and there is some recent evidence that the incidence is increasing in this country. Gastric outlet obstruction is caused by hypertrophy of the pyloric smooth muscle and the clinical presentation is with non‐bilious vomiting starting at the age of 3–4 weeks. The diagnosis can usually be made by palpation of the hypertrophied pylorus. Operation has now superseded medical treatment as the treatment of choice but meticulous assessment and correction of fluid and electrolyte imbalance is essential preoperatively. The operation of pyloromyotomy as described by Ramstedt in 1912 is simple and effective, but attention to detail is necessary if minimal morbidity and zero mortality are to be achieved. Untreated, the mortality is high but, after successful treatment, these babies are healthy and normal, so that treatment is both worth while and gratifying. The aetiology is obscure; a polygenic pattern of inheritance has been shown to be a predisposing factor, but the postnatal precipitating factors are less defined. Early hopes that the hormone gastrin might prove to be the key have not been sustained by more recent research, but the role of other gastrointestinal hormones awaits clarificat

ISSN:0007-1323    

DOI:10.1002/bjs.1800690304

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractPost‐infusion phlebitis remains one of the most frequent causes of hospital morbidity with an incidence varying between 13 and 39 percent (1–4). A recent study indicated that a silicone elastomer cannula (Visis) had desirable properties (5). We have carried out a prospective trial comparing the value of such a cannula with a Teflon cannula (Cathlon) already in routine

ISSN:0007-1323    

DOI:10.1002/bjs.1800690305

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThirty‐eight patients with severe antibiotic‐associated postoperative diarrhoea were entered into a randomized controlled trial to compare colestipol (an ion exchange resin) in 17 patients with placebo (sherbet) in 21 patients. Clostridium difficile or its toxin was present before treatment in 12 of the colestipol group, compared with only 5 in the placebo group. Because of the low incidence of Cl. difficile or its toxin, the placebo group data from 22 patients receiving placebo in a previous trial (9 of whom had Cl. difficile or toxin) were included for comparison. Neither colestipol nor placebo had any influence on the faecal excretion of Cl. difficile or its toxin. Colestipol was clinically no better than placebo. In view of the persistent faecal excretion of Cl. difficile toxin, ion exchange resins cannot be recommended for the treatment of antibiotic‐associated co

ISSN:0007-1323    

DOI:10.1002/bjs.1800690306

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractThe fall in serum albumin which occurs after operation can be modified by an intraoperative infusion of 20 g salt‐poor human albumin, and the associated fall in colloid osmotic pressure is also corrected. There is a decrease in postoperative oliguria following a colloid infusion but no significant effect has been demonstrated on urinary sodium excretion. The alteration of fluid and electrolyte metabolism after surgery does not appear to be a direct effect of lowered plasma colloid osmotic pressure. It is suggested that the effect of intraoperative albumin infusion is predominantly haemo‐dyna

ISSN:0007-1323    

DOI:10.1002/bjs.1800690307

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractHuman serum albumin microspheres of 1 μm diameter labelled with technetium‐99 m were evaluated as a model for bacteria in two animal species. Peritoneal lavage recovered comparable amounts of an inoculum of microspheres and simultaneously instilled Escherichia coli. A prospective study was undertaken of 38 patients undergoing elective abdominal operations. Three lavages, each of 500 ml normal saline, were used. Over 80 per cent of the saline was recovered in 37 of the 38 patients with a median of 93 per cent. Recovery of microspheres was assessed from above the spleen, from Morison's pouch and from the pouch of Douglas. There was no difference in the recovery rates from the three sites of placement but significantly fewer microspheres were recovered via a right subcostal incision (median 59 per cent) compared with an upper midline incision (median 91 per cen

ISSN:0007-1323    

DOI:10.1002/bjs.1800690308

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractIn vitro monocyte lysozyme production (IVMLP) was assessed in 10 male patients preoperatively and at intervals postoperatively. A similar procedure was carried out in 6 sex‐ and age‐matched controls. In contrast to the control group where the IVMLP was constant, the IVLMP levels in the surgical group showed a marked increase at 6–10 h postoperatively, falling to control levels after 10 days. In addition, peripheral monocyte counts were carried out using a Technicon Hemalog D counter which produces accurate reproducible counts for cells such as monocytes which occur at low frequency. The peripheral monocyte counts were stable in the control group, whilst in the surgical patients there were significantly higher readings at 36–48 h, which persisted for up to 10 days compared with preoperative counts. This study suggests that surgery has both a qualitative (IVMLP) and quantitative (monocyte counts) effect on the mononuclear phagocytes. These data may be relevant when considering factors that influence the early stages of wound

ISSN:0007-1323    

DOI:10.1002/bjs.1800690309

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

摘要:

AbstractA series of 75 patients with 87 postoperative enterocutaneous fistulas (PEF) is reported. All received parenteral nutrition after the diagnosis of PEF was made. There were 16 deaths (21·3 per cent) and 62 fistulas (71·2 per cent) closed spontaneously. A classification of PEF is proposed according to the results obtained. The therapeutic approach cannot be uniform in all types of PEF. We feel that parenteral nutrition has substantially improved the prognosis of fistulous patients by increasing the rate of spontaneous closure and improving the nutritional status of patients needing repeated operations. Comparison between series of patients to establish the usefulness of parenteral nutrition is bound to yield inconclusive data due to marked differences in patient populations. We suggest that proper information be obtained by studying series of homogeneous patients, namely those who develop oesophageal, gastric or intestinal fistulas after surger

ISSN:0007-1323    

DOI:10.1002/bjs.1800690310

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800690311

出版商:John Wiley&Sons, Ltd.    

年代:1982

数据来源: WILEY